PMID- 1763544 TI - Triazolam--the never-ending story. PMID- 1763545 TI - Seventy years in retrospect. PMID- 1763546 TI - Possible dissociation of the Digibind-digoxin complex in renal failure. PMID- 1763547 TI - Methyldopa-induced granulomatous hepatitis. PMID- 1763548 TI - Switching haloperidol from oral to im depot formulation. PMID- 1763549 TI - Streptokinase versus recombinant tissue-type plasminogen activator. PMID- 1763550 TI - Nitrate tolerance: does tid isosorbide dinitrate mean dosing every eight hours? PMID- 1763551 TI - Comment: fluoxetine adverse effects and drug interactions. PMID- 1763552 TI - Comment: legal duty to counsel. PMID- 1763553 TI - [Food allergies and intolerance reactions]. AB - Adverse reactions to food and food additives are defined by its different pathomechanisms. Clinically most important are allergic (immunologic) reactions (types I and III), which occur in 7-10% of the general population, and nonimmunologic (pseudoallergic) reactions (PAR), which occur in 1-2%, besides nonallergic reactions by vasoactive amines. Clinical features are equal. Sources of antigens for allergic reactions are proteins of cow's milk, fish, hen's egg, meat, and all kinds of cereals, fruits, vegetables, and spices, while pseudoallergic reactions are induced by chemicals (preservatives, colorants, antioxidants). The diagnostic procedures of allergic reactions include the proof of sensitization by case history, skin test, specific IgE (and IgG) in-vitro, elimination diet and provocation test; pseudoallergic reactions with no underlying sensitization are diagnosed only by elimination and provocation procedures. PMID- 1763554 TI - On the problematic nature of vitamin E requirements: net vitamin E. AB - The requirement for vitamin E is closely related to the dietary intake of polyunsaturated fatty acids (PUFA). By the protective mechanism to prevent PUFA from being peroxidized, vitamin E is metabolically consumed. In addition, PUFA impair the intestinal absorption of vitamin E. Therefore PUFA generate an additional vitamin E requirement on the order of 0.6, 0.9, 1.2, 1.5, and 1.8 mg vitamin E (RRR-alpha-tocopherol-equivalents), respectively, for 1 g of dienoic, trienoic, tetraenoic, pentaenoic, and hexaenoic acid. For this reason, the gross vitamin E content of food containing PUFA does not allow an evaluation of this food as a source of vitamin E. A suitable measure is the net vitamin E content, i.e., gross vitamin E minus the amount needed for PUFA protection. Therefore, some food-stuffs generally considered as vitamin-E sources, as concluded from their gross vitamin E content, cause in reality a vitamin E deficiency if not sufficiently compensated by other vitamin E supplying food constituents. Examples of the net vitamin E content of some fats and oils, fish and nuts are shown. Consequences for food composition data and food labeling and the problem of meeting the vitamin-E requirements are discussed. PMID- 1763555 TI - [The question of nickel release from stainless steel cooking pots]. AB - For three items of foods (rhubarb, spinach, sauerkraut) the possible release of nickel (by means of AAS) was analysed, a release which may be caused by a possible corrosive effect of the concerned (oxalic-, milk-, vinegar-) acids (as well as common salt) within a normal domestic food-preparation. For this analysis stainless steel cooking pots of different manufacturers, various types and in a representative selection and quantity were taken into consideration; the detailed analyses were extended so far that clear statistical evaluations were possible. This method complies regulations for accuracy to determine traces of heavy metal. For all three analysed food-stuffs an identical result was reached that no nickel release from the stainless steel cooking pots into the food was found. Differences of the various stainless steel cooking pots with regard to their surfaces' quality or their origin (manufacturers) were not yielded, either. All detected concentrations of nickel are within the reach of the natural nickel content of the analysed food-stuffs and their amount is even much lower than other food's content of nickel. This leads up to the conclusion that the former view of a possible nickel release of stainless steel cooking pots has to be revised because these assumptions were not confirmed in the presented results of this analysis and therefore have to be regarded as not correct. PMID- 1763556 TI - [In vitro studies of the effect of different mixture proportions of omega-3 and omega-6 fatty acids on thrombocyte aggregation and thromboxane synthesis in human thrombocytes]. AB - In order to estimate the influence of the tested fatty acids on platelet aggregation, synthesis of prostaglandin E and thromboxane B in vitro, platelet rich plasma (PRP) was incubated with the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), with linoleic acid as representative of the omega-6 fatty acids, as well as with mixtures of EPA and DHA and all fatty acids, resp., with and without addition of alpha-tocopherol. For the determinations, platelets were prepared from blood of young adult male volunteers (age 26.6 +/- 8 years). Platelet aggregation and synthesis of thromboxane were measured after 30 and 60 min of incubation. Smoking habits were not regarded. The incubation of platelets with DHA and EPA itself, as well as the mixture of fatty acids dominated by omega-3 fatty acids (omega-3/omega-6 = 15/1) caused a significant decrease (p less than 0.05) of collagen-induced platelet aggregation. Tocopherol, linoleic acid, and the linoleic-acid-rich mixtures (omega-3/omega-6 = 1/4) caused only a slight inhibition of platelet aggregation. No uniform influence of omega-3 fatty acids could be observed that showed their influence on synthesis of thromboxane to be of importance for the promotion of platelet aggregation. EPA and the mixture of EPA and DHA did decrease thromboxane synthesis significantly (p less than 0.05). On the other hand, single incubation with DHA as well as with linoleic acid rich mixtures caused a statistically not significant increase of rate of the synthesis, which did not increase the aggregation. This observation indicates the formation of less effective TXA3. An influence of tocopherol could also not be observed. PMID- 1763557 TI - [Salmonella in commercial chickens cooled by air-water sprays]. AB - Chicken cooled by air/water-spray systems were investigated for salmonella by two methods (OSRT-test versus section 35 Food Regulation-Method). The total contamination rate was 95%. Obviously, the air/water-spray system does not allow a significant improvement of hygienic status. PMID- 1763558 TI - [Nutritional status of workers in Jordan]. AB - The nutritional status of 306 Jordanian workers was studied according to their eating habits, nutrient intake, and anthropometric measurements. Their use of cafeteria service at the factory was not regular. This led to a shifting in their nutrient intake time from work-hours to the evening-hours. The anthropometric indicators showed no prevalence of severe malnutrition or overnutrition. Only 5% of the persons examined were overweight, and 4% were underweight. PMID- 1763559 TI - Heat-induced changes in casein-derived phosphopeptides. AB - Phosphopeptides derived from casein may function as carriers for calcium and trace elements. In regard to such specific nutritive effects, the heat-induced changes in tryptic phosphopeptides liberated from bovine sodium caseinate as a model system were investigated. Both microwave and oven heating resulted in a marked loss of peptide-bound phosphorous (dephosphorylation) and a decrease of casein-phosphopeptides in the soluble part of the tryptic hydrolysate. It is concluded that hydrolysis of phosphoseryl to seryl residues was the prevailing degradation step to soluble proteolytic products, whereas lysinoalanyl-casein is claimed to be present almost exclusively in the pH 4.6-insoluble part of the tryptic digest. PMID- 1763560 TI - [Transport of the hydroxy analogs of leucine in the brush border membrane vesicles of the rabbit small intestine]. AB - Hydroxy analogues of essential amino acids can be used in clinical nutrition to minimize nitrogen intake. In this study intestinal uptake of L-leucine hydroxy analogue into rabbit jejunal brush-border membrane vesicles was investigated. An inward directed H(+)-gradient was a driving force of uptake (pHoutside = 6.0; pHinside = 7.5) and led to a transient accumulation. The saturable system has a apparent transport constant Kt = 15.4 mM. By trans stimulation experiments it could be shown that both D- and L-stereoisomers of hydroxy analogues of branched chain amino acids as well as L-lactate share with the same H(+)-driven uptake system. PMID- 1763561 TI - Low-dose antacid therapy in the treatment of duodenal ulcer--a multicentre double blind trial vs. misoprostol. AB - We conducted a 4-week double-blind randomized controlled multicentre trial to compare low-dose-antacid (AA) therapy (225 meq total neutralizing capacity per day) with therapy using the prostaglandin E1-analogue, misoprostol (MS) (400 micrograms bid), on ulcer healing and relief of symptoms in 100 outpatients with endoscopically proven duodenal ulcer (DU, 49 patients on AA, 51 patients on MS). Of the 100 patients enrolled in the study 96 could be evaluated; 49 received AA, 47 MS. Endoscopies were performed before treatment, 2 and 4 weeks after initiation of treatment. Healing rates of AA- and MS-treatment were 36.7% vs. 25.5% (2 weeks) and 79.6% vs. 74.4% (4 weeks) and did not differ as much as relief of pain during the daytime. Rates of relief of nighttime pain were significantly higher on AA-treatment after 2 weeks of treatment (81.1% vs. 48.6%; p less than 0.05), but not during the later course of treatment. Thus, it can be concluded that low-dose AA-treatment using an aluminum/magnesium hydroxide preparation in tablet form represents an effective and safe therapy for duodenal ulcer. PMID- 1763562 TI - [Effect of pellet size of a pancreas enzyme preparation on duodenal lipolytic activity]. AB - Release of lipolytic activity from enteric coated microspheres occurs after emptying from the stomach. Gastric emptying of the spheres is strongly influenced by their size, as several studies indicate. In the present study 10 patients with exocrine pancreatic insufficiency received two types of enzyme substitution (Kreon) and were investigated using the cholesterol-14C-octanoate breath test. Preparation A with microspheres of the size 1.0-1.2 mm and B with the size 1.8 2.0 mm. All patients showed an obvious delay in intraduodenal lipolytic activity using the 1.8-2.0 mm preparation. In 3 out of 10 patients lipolytic activity increased much more early using the 1.0-1.2 mm preparation, in the other patients differences were not as clear. The effectiveness of enzyme substitution was 25% greater for the 1.0-1.2 mm preparation for the time of testing (mean values, p less than 0.10). PMID- 1763563 TI - Failure of ranitidine and omeprazole treatment in eosinophilic gastritis with ulceration. AB - In a 32-year-old woman with an ulcer that had persisted for more than 13 months despite treatment with the H2 blocker ranitidine, the latter was replaced by the H+K(+)-ATPase inhibitor omeprazole. Treatment with omeprazole also failed to bring about healing of the ulceration which, at times, measured up to 10 cm in diameter. On account of a hemorrhage from the ulcer, a Billroth II resection of the stomach had to be performed. The histological work-up of the surgical specimen confirmed the tentative diagnosis of a secondary ulceration in underlying eosinophilic gastritis established on the basis of the work-up of biopsy material obtained from the ulcer. The reason for the failure of the lesion to respond to the H2 blocker or omeprazole in this case was a diffuse infiltration of the antral wall with eosinophilic granulocytes, and the resulting secondary persistent ischaemic ulceration. PMID- 1763564 TI - [Extracorporeal shockwave therapy in giant stones in the common bile duct--a case report]. AB - A huge common bile duct stone of 6 to 3 cm in diameter in a 64 year old lady was approached by ESWL, after endoscopic therapy such as mechanical lithotripsy and removal with the Dormia basket had failed because of the extraordinary size of this stone. A surgical therapy was not possible because of pronounced vascular and cardiopulmonary risk, so ESWL was applied to this patient. The stone was fragmented in two sessions of ESWL under sonographic targeting and the fragments were removed endoscopically. After one month one fragment still remained in the common bile duct, which then was removed also endoscopically. Two months later the ERC showed a stone-free common bile duct. This case demonstrates, that even common bile duct stones of extraordinary size can be removed by combining ESWL with endoscopic techniques. Following the trend to minimally invasive therapy, sonography should be preferred over XRay in diagnosis before ESWL as well as during ESWL. PMID- 1763565 TI - [No-touch functional diagnosis in lactose malabsorption]. PMID- 1763566 TI - [Percutaneous rotational lithotripsy of gallstones]. PMID- 1763567 TI - Leisure time physical activity behavior in three British cities. AB - This article provides baseline information on leisure time physical activity. The data were collected in 1989 by telephone in the cities of London, Glasgow and Edinburgh. Twenty-eight percent of the respondents living in London reported that they engage in physical activity for exercise three or more times per week. For Glasgow and Edinburgh these figures are 24% and 28% respectively. Female respondents, respondents in the lower occupational categories and older respondents exercised on average less than male respondents, respondents from the higher occupational categories and younger respondents. Walking was the most popular form of physical activity for exercise in the three cities, for all age groups, all occupational groups and both sexes. Female respondents, respondents from the lower occupational categories and older respondents engaged in less strenuous physical activities. The differences between groups were independent of the stringency of the definition of exercise. The data showed that levels of leisure time physical activity for exercise do not meet standards which are advocated internationally. However, the levels and patterns found are similar to those found in North American studies. It would appear that the differences between the two Scottish cities and London are small. PMID- 1763568 TI - [Cigarette smoking and psychosocial work stress in middle-management employees]. AB - The association between psychosocial work stress and cigarette smoking is analyzed in a socioeconomically and professionally homogeneous group of 163 middle managers (40-55 years; 48.4 +/- 4.5) in a large industrial company. Psychosocial stress is defined in terms of an imbalance between effort spent and reward obtained at work. The relative risk of regular smoking is 4.34 (odds ratio after controlling for age; 95% CI 1.50-12.54) in those middle managers who suffer from a marked imbalance between effort and reward, compared to those who are free from this type of psychosocial stress at work. This effect persists in the older age group although the proportion of smokers decreases with age. Within the group of regular smokers, every second middle manager suffering from a marked imbalance between effort and reward is a heavy smoker (greater than or equal to 20 cigarettes/day) whereas in the group experiencing less stress at work, only 28% heavy smokers are found. However, due to small numbers this difference is not statistically significant. In conclusion, the data reported in this study demonstrate an association between psychosocial stress at work in terms of high effort and low reward and the risk of regular smoking. This association is not confounded by age, socio-economic status or type of occupation. PMID- 1763569 TI - Overweight and coronary risk factors results from a western Austrian survey. AB - Objectives of the study are to estimate prevalence of weight categories in a western Austrian population and to determine differences in primary coronary risk factors between weight categories in adults. The study population consists of 635 males and 693 females aged 25 to 64 years from the state Vorarlberg in western Austria. Age-standardized prevalence of body-mass-index 25.0 to 29.9 kg/m2 is 42.8% in men and 23.0% in women. The prevalence of a body-mass-index of 30.0 kg/m2 or more is 8.6% in men and 13.3% in women. Categories of relative weight correlated in both sexes significantly with all investigated risk factors, i.e. total cholesterol, HDL cholesterol, triglycerides, fasting blood glucose and systolic blood pressure. Significance remained in multivariate regression analysis in all parameters for both sexes, when controlling for age. Thus, the survey clearly shows the importance of relative weight as an indicator of elevated coronary risk and the importance of overweight for public health. PMID- 1763570 TI - [Health and disease in single homeless men: a secondary analysis of findings in a deaconess facility in the Federal German Republic]. AB - Only few empirical investigations on living conditions and health status of single homeless men have been conducted in Germany. The secondary analysis of a sample of 342 homeless men in a welfare hotel was conducted to describe the health status of this group and to gather informations for a possibly higher illness-risk in this group. For this purpose the medical documents and other socio-demographic data were evaluated at one point (one day in February 1985) along the ICD. A relatively high multi-morbidity for the homeless men, especially for the elder ones, could be stated. The results emphasize in etiological perspective the need to take a deeper insight into factors of workload before getting homeless and to strengthen socioepidemiological, socio-therapeutical and political efforts. PMID- 1763571 TI - [Prevalence, circumstances and consequences of falls in institutionalized elderly; a pilot study]. AB - Falls are frequent among elderly people, and are a still-underestimated medical problem with respect to causes and consequences. The present epidemiological study describes the experience from a 79-bed nursing home in the city of Zurich, regarding frequency, circumstances and consequences of falls. Over half of residents of the studied nursing home fell at least once during the study period of one year, and one third even suffered 3 or more falls. Dizziness, tripping and slipping were among the reasons given for falling. However, in one third of the cases the person involved was not able to specify the cause of the fall. Every fifth fall to injury or fracture, and every tenth fall to fall-related pain. The fall-related overall morbidity therefore amounted to 35.3%. PMID- 1763572 TI - [Suicide prevention]. PMID- 1763573 TI - Prevention of head injuries: a priority for World Health Organization. PMID- 1763574 TI - [Comparative study between conservative and surgical therapy of fibular ligament ruptures of the upper ankle joint]. AB - From January 1985 to February 1987 361 patients with ruptured lateral ankle ligaments were treated at the Department of Trauma and reconstructive Surgery at the University Hospital of Hamburg. 225 patients were included in a retrospective study. They were divided into conservative and operative groups of treatment with subdivision of immobilized treatment (Plaster Paris short-leg-cast for 6 weeks) and functional therapy (special shoe). Clinical-radiological follow-up examinations of 49 operatively and 44 conservative treated patients were carried out 2 to 4 years after cessation of therapy. The clinical results were evaluated according to a questionnaire, X-ray and clinical controls. These results lead to the conclusion that operative treatment combined with conservative plaster cast immobilization yielded better mechanical stability than conservative-functional therapy. Best results were seen after surgical treatment, but conservative immobilization with prevailing good clinical-radiological results seems to be an alternative to operative therapy in carefully elected patients. PMID- 1763575 TI - [Osteosynthesis of fractures of the coxal femoral end with the dynamic compression hip screw]. AB - Results of 179 surgical osteosynthetic procedures applying the dynamic hip screw (DHS) are reported. 103 (65.2) patients were able to walk with or without cane after hospital discharge. 48 (30.4%) patients dependent on an assisting person while 7 (4.4%) patients are not able to walk at all. 46 patients had been controlled clinically in a time-period of 4 months up to 6 years post-surgically. Results indicate an ideal application of the DHS for intertrochanteric femoral fractures, whereas it's application is limited to all other types of femoral fractures occurring near the capital region. The DHS proves to be suited to either avoid or postpone prosthesis in very young patients; it also can be favoured for high aged patients with short life-expectancies in femoral neck fractures of the medial and lateral type. PMID- 1763576 TI - [Postoperative dislocation as an early complication of total hip endoprosthesis]. AB - Basing on 13 dislocations of 215 total hip arthroplasties are presented the characteristics of this complication. All things considered the dislocation following total hip arthroplasty seems to be no serious complication, if there is no severe operation failure and if the necessary treatment consisting in plastic cast immobilisation is performed. PMID- 1763577 TI - [Aspects of rehabilitation after early stabilization of complex injury of the cervical spine]. AB - Within the scope of catamnestic investigation and a follow-up examination 170 fractures of the cervical spinal cord, operated in a period of 8 years, were explored. Dependent on the neurological starting point the length of stay in hospital, the time of temporary disablement and the results of social rehabilitation were evaluated. The examination results are appraised. PMID- 1763578 TI - [Spinal epidural hematoma and its etiology]. PMID- 1763579 TI - [Prevention of thrombosis with reference to legal liability and malpractice]. PMID- 1763580 TI - [Physician competence in medical care]. PMID- 1763581 TI - [Treatment of acute manifestation of hemichorea with aspirin. A case report]. AB - A patient is described with a history of coronary artery disease and diabetes showing unilateral continuous jerking limb movements immediately after general anaesthesia. Carotid territory hypoperfusion is assumed to be the pathogenetic factor of these involuntary limb movements. 2 days after administration of 1000 mg Aspirin these movements ceased, supporting this trial prior to invasive surgical procedures especially in high risk patients. PMID- 1763582 TI - [Positive inotropic substances in therapy of heart failure: digitalis, catecholamines, phosphodiesterase inhibitors]. AB - The discussion about the importance of inotropic agents in the treatment of congestive heart failure is still open. A review of studies concerning the effects of digitalis, adrenoceptor stimulating or blocking agents, as well as phosphodiesterase inhibitors on hemodynamics and the physical state of heart failure patients is presented. Most authors agree that digitalis is indicated in patients with impaired left ventricular function and supraventricular arrhythmias, as well as in patients with heart failure who remain symptomatic during treatment with diuretics and vasodilators. While adrenoceptor stimulation with catecholamines is widely accepted in patients with acute and severe heart failure, beta-receptor blockers seem to have beneficial effects on some patients with mild to moderate congestive heart failure. PMID- 1763583 TI - [Silent myocardial ischemia. Current concepts of pathophysiology and diagnosis]. AB - Silent myocardial ischemia (SMI) is divided into 3 groups: type I: completely asymptomatic patients, type II: patients after acute myocardial infarction with SMI, type III: patients with angina pectoris (AP) and SMI. Pathophysiology on the lack of pain-perception and the cause for high tolerance against pain in SMI patients has not yet been cleared up. It is most likely that more than one mechanism is involved in every patient, e.g. generally lower pain-perception in SMI-patients, physically counter-regulation in pain, duration and strength of myocardial ischemia. Diagnosis of SMI can be made by exercise- and long-term-ECG, thalliumszintigraphy and coronary angiography, in doing so the pros and cons of the 4 established methods have to be noted. The summary of the findings together with the lack of pain leads to the diagnosis of SMI. PMID- 1763584 TI - [Silent myocardial ischemia. Current concepts of prognosis and therapy]. AB - Type-I-patients with silent myocardial ischemia (SMI) have a 2-4fold higher longterm-risk for coronary-events than healthy people. With increasing gravity and duration of ischemia type-II-patients have an increased event-risk. Reliable statements about prognosis of type-III-patients are very difficult. Therapy of SMI is equivalent to therapy of "loud" ischemia and comprises: 1) treatment of cardiovascular risk-factors (nicotine, arterial hypertension, hyperlipidemia, adiposis), 2) nitrates as effective straight at the coronary stenosis, 3) beta blockers, which influence the circadian ischemic rhythm, 4) calcium-channel blockers with especially for nifedipine little effect, 5) thrombocyte-aggregation inhibitors and 6) invasive therapeutical methods (percutaneous transluminal coronary angioplasty [PTCA] and aorto-coronary bypass grafting [ACBG]). PMID- 1763585 TI - [Rehabilitation following myocardial infarct]. AB - Today rehabilitation after myocardial-infarction is a routine measure in most countries, yet its effectiveness is still under discussion. Rehabilitation aims at ameliorating the quality of life and at preventing a cardiovascular reevent, in other words at prolonging life. The latter "hard" endpoints is best amenable to quantification. Only recent meta-analyses of pooled data were able to show that rehabilitation in fact does prolong life. The relative importance of physical exercise in mostly complex rehabilitation programs is even less clear. This analyses implies a benefit, yet the exact proof is still missing. If rehabilitation could be shown to improve quality of life, its application would, of course, be justified even if it did fail to prolong life. Important open questions relate to the optimizing of rehabilitation: duration, frequency, intensity as well as age and sex of responders. Answering these will be a challenge for tomorrow's rehabilitation medicine. PMID- 1763586 TI - [Recommendations for carrying out nuclear medicine kidney function tests with a gamma camera and computer]. AB - Standardization of nuclear medicine renal studies is required in order to permit the comparison of study results of a patient obtained at different laboratories. Furthermore, standardization is a prerequisite for quality control of the analysis part of the procedure. The guidelines presented here are based on a survey carried out amongst nuclear medicine laboratories in Austria and have been edited and harmonized in a workshop organized by the Austrian Nuclear Medicine Society. The guidelines include detailed descriptions of the requirements of instrumentation, of the methods of acquisition, dosage and radiation dose of the commonly used radiopharmaceuticals and all aspects of the analysis of digital renograms. A comprehensive section deals with the determination of renal clearance from the renogram, further sections cover the usage and recommended methods of captopril renography for the diagnosis of unilateral renal artery stenosis and of the frusemide renogram for the diagnosis of nephropathy and uropathy. PMID- 1763587 TI - Intraoperative transesophageal echocardiography: an anesthesiologist's perspective. PMID- 1763588 TI - A comparison of median frequency, spectral edge frequency, a frequency band power ratio, total power, and dominance shift in the determination of depth of anesthesia. AB - Five numerical descriptors were derived from the electroencephalogram (EEG), recorded, and processed (Tracor Nomad) during emergence from isoflurane-nitrous oxide anesthesia. The five descriptors (median frequency, spectral edge frequency 90%, total power, a frequency band power ratio, and the ratio of frontal to occipital power) were compared for their ability to predict imminent arousal. Arousal was defined as spontaneous movement, coughing or eye opening. All of the descriptors except the frontal-occipital power ratio underwent significant (P less than 0.05) changes between the initial recordings made intraoperatively during surgical stimulus under anesthesia and later recordings in the 40 s preceding arousal. A post hoc analysis was performed to identify the threshold value for each parameter that best served to predict imminent arousal. For median frequency, spectral edge frequency-90%, total power, and the frequency band power ratio, thresholds that predicted imminent arousal with sensitivities of 90% and specificities of 82-90% could be identified. The data indicate that, even in the favorable circumstances of the present study (uniform anesthetic technique, post hoC identification of thresholds), none of several previously popularized EEG descriptors (median frequency, spectral edge frequency-90%, total power, a frequency band power ratio) can serve as a completely reliable sole predictor of imminent arousal. As presently derived, these EEG descriptors at best provide trend information to be used in concert with other clinical signs of depth of anesthesia. PMID- 1763589 TI - Failure of transcutaneous electrical nerve stimulation and indomethacin to reduce opiate requirement following cholecystectomy. AB - This randomized study examined the effect of transcutaneous electrical nerve stimulation (TENS) and indomethacin on postoperative opiate requirement in 60 patients after cholecystectomy. An open intravenous bolus of 25 mg of indomethacin followed by an infusion of 5 mg in 1 h, alone or combined with either low or high frequency TENS, was administered during the study period of 16 h. An intravenous bolus of either 5 mg of oxycodone or 0.15 mg of buprenorphine was administered double blindly for postoperative pain relief. The number of doses of buprenorphine given (3, 9) differed (P = 0.01) from the number of doses of oxycodone given (5, 4). Neither indomethacin nor TENS reduced the postoperative opiate requirement. PMID- 1763590 TI - Evaluation of 119 anaesthetics received after investigation for susceptibility to malignant hyperthermia. AB - A questionnaire was sent to the first 371 patients investigated for MH susceptibility at the Danish MH Register, in order to assess sequelae from the muscle biopsy and possible subsequent anaesthetic complications. The purpose was to evaluate both the safety of anaesthetizing MH-susceptible (MHS) patients without the use of trigger agents, and the safety of giving trigger agents to non susceptible (MHN) patients. Eighty-eight per cent of patients alive replied to the questionnaire. Of these, 22% complained about discomfort at the site of the biopsy, 2% had experienced problems when needing a subsequent anaesthetic, and 0.9% had had trouble when applying for life or accident insurance. The median observation period for all patients following the muscle biopsy was 5.5 years (range 27 months-11 years). During this period, 36 MHS patients had been anaesthetized 52 times (28 general and 23 regional anaesthetics, data missing in one case) without any MH-related complications. None of the patients had received prophylactic dantrolene. Three MHE patients had received non-trigger anaesthetic agents on three occasions without development of MH. Thirty-five MHN patients had been anaesthetized 64 times, and 13 of these MHN patients had received trigger agents 26 times without any signs of MH. An estimate of the probability of clinical MH developing in MHN patients subsequently anaesthetized with trigger agents was found to be 0-24.7% (95% confidence limits), whereas the probability of clinical MH developing in MHS patients anaesthetized with non-trigger agents was 0-9.7% (95% confidence limits). PMID- 1763591 TI - Gas flow distribution in distal high frequency jet ventilation and lung thorax compliance. AB - To investigate the influence of changes in thorax and lung compliance on ventilation during distal High Frequency Jet Ventilation (HFJV), similar ventilator settings were compared before and after changing the compliance in two groups of anaesthetized mongrel dogs. Each period of distal HFJV was preceded by adequate Intermittent Positive Pressure Ventilation (IPPV) to assure a start with baseline values. In Group 1 (n = 7), thorax compliance was changed by chest strapping, while in Group 2 (n = 7) lung compliance was changed by inducing acute lung injury by injection of oleic acid into the right atrium. Gas flow distribution in the ventilatory circuit during distal HFJV was determined before and after the changes in compliance were induced. Comparing similar ventilator settings during distal HFJV in the same dog, a decrease in lung or thorax compliance led to changes in gas flow distribution in the ventilatory circuit. Entrainment was decreased and bypass increased with a negative effect on the gas volume entering the lungs and on gas exchange. The results indicate that distal HFJV should be regarded as pressure-limited ventilation. PMID- 1763592 TI - Central circulation during halothane-diethyl-ether azeotrope and isoflurane anaesthesia in the pig. AB - The fatal anaesthetic ratio (FAR) has been determined for halothane-diethyl-ether (HE) in pigs, and the central circulation during hypovolaemia has been investigated using a well-documented agent such as isoflurane as a standard. The fatal anaesthetic ratio for HE in pigs was (3.21/1.03) = 3.12. This is high compared to the FAR for halothane of 1.7. The central circulation was investigated in 12 pigs which were randomly allocated to either HE or isoflurance anaesthesia, respectively. Baseline values were recorded when they were stable at 1.3 MAC of the volatile anaesthetic used. The pigs were bled 30% of their blood volume, and measurements were made at 5 and 30 min. There was one significant difference between these groups in central circulation: the blood pressure was higher at baseline measurement in the HE group. At 5 min and 30 min, there were no significant differences between these groups. There was a general depression of central circulation without any sign of decreased contractility. HE anaesthesia is well tolerated during hypovolaemia in pigs. PMID- 1763593 TI - Hemodynamic effect of the prone position during anesthesia. AB - We studied 21 patients undergoing lumbar spinal surgery under halothane anesthesia on a convex saddle frame, in order to determine the hemodynamic effect of the prone position. A thermodilution pulmonary arterial catheter was placed in 14 patients (Group PA-1: n = 8; and Group PA-2: n = 6), and an inferior vena caval catheter in the remaining seven patients (Group IVC). Group PA-1 and Group IVC patients were placed in the prone position on a convex saddle frame. In the prone position, the cardiac index (CI) decreased significantly from 3.1 +/- 0.5 to 2.5 +/- 0.3 (l.min-1.m-2, mean +/- s.d., P less than 0.01) without accompanying significant changes in the other hemodynamic variables in Group PA 1. The postural change in Group IVC did not exert a significant effect on the inferior vena caval pressure. Group PA-2 were initially placed in the flat prone position on a flat saddle frame, which produced no significant changes in the hemodynamic variables. Then the convex curvature of the frame was adjusted to the grade appropriate for surgery, which produced a significant reduction in CI (from 2.9 +/- 0.3 to 2.4 +/- 0.4, P less than 0.05). We conclude that the prone position itself may not interfere with the circulatory function. The prone position using a convex saddle frame causes significant reductions in CI, but little change in the other hemodynamic variables. PMID- 1763594 TI - Prevention of endotoxin-induced increase of cerebral oxygen consumption in dogs by propranolol pretreatment. AB - Cerebral blood flow (CBF) and cerebral metabolic rate of oxygen (CMRO2) were studied in experimental endotoxic shock in dogs. Eight animals were pretreated with a beta-adrenoceptor blocking agent, propranolol (PPL), per os 12 mg/kg once a day for 7 days. Ten animals served as controls. After an intravenous injection of endotoxin, 1 mg/kg, CBF decreased in both groups, with no significant differences between the groups. CMRO2 increased in the control animals by about 18% from the baseline value both 1 and 2 h after the injection of endotoxin. CMRO2 in the PPL-pretreated animals was unchanged after endotoxin. The CMRO2 reactions to endotoxin in control and PPL animals were significantly different after both 1 and 2 h (P less than 0.05). The present results indicate that the increase in CMRO2 following intravenous endotoxin is mediated via beta adrenoceptors. PMID- 1763595 TI - Recovery after total intravenous anaesthesia using combined midazolam/alfentanil infusion and reversal with flumazenil. AB - One of the major problems with total intravenous anaesthesia (TIVA) is postoperative sedation, possibly with respiratory depression. The aim of the present study was to evaluate the recovery characteristics after TIVA using a continuous infusion of a mixture of midazolam and alfentanil with flumazenil reversal before extubation. This method was compared to balanced anaesthesia using midazolam, alfentanil and nitrous oxide without flumazenil reversal. The degree of sedation was measured by reaction time test, Glasgow Coma Scale, cipher copying test and subtraction test. We found significantly faster reaction times postoperatively in the TIVA group (n = 15) compared to the balanced group (n = 13), despite larger doses of both midazolam (median 21 mg versus 9 mg) and alfentanil (median 5.9 mg versus 4.5 mg). The other tests revealed no difference between the groups. One patient became resedated after flumazenil. We conclude that the TIVA technique described here resulted in slightly better recovery characteristics, offering a usable alternative to balanced anaesthesia. PMID- 1763596 TI - Intravenous ketamine for prevention of severe hypotension during spinal anaesthesia. AB - Spinal block causes paralysis of preganglionic sympathetic fibres, while ketamine induces activation of the sympathetic nervous system. Hypotension is a frequent complication during spinal anaesthesia and is associated with an increased risk of postoperative mortality. The aim of our study was to compare circulatory changes in patients who received either fentanyl or ketamine during spinal anaesthesia. Thirty patients (ASA I-III) scheduled to undergo spinal anaesthesia for osteosynthesis of hip fractures were allocated to receive either ketamine or fentanyl intravenously during the procedure. Immediately before anaesthesia, 7 ml/kg BW of an isotonic NaCl solution was administered i.v. Patients received either fentanyl 1.5 mg/kg BW i.v. before anaesthesia, or ketamine 0.7 mg/kg BW i.v. before anaesthesia, and 0.35 mg/kg BW 15 and 30 min after the first dose. No prophylactic vasopressor was used. During the first 40 min of anaesthesia a fluid load of 14 ml/kg BW was given i.v. If the mean arterial pressure (MAP) fell more than 20%, the infusion rate was increased. If the reduction in MAP exceeded 33% or if the systolic pressure decreased to less than 80 mmHg, patients were registered as haemodynamically unstable. In both groups the spinal anaesthesia caused a reduction in MAP. The MAP was lower in the fentanyl group than in the ketamine group at all times. In the fentanyl group six subjects developed a haemodynamically unstable condition, while only one subject in the ketamine group was registered as such (P less than 0.05). There was no significant change in heart rate in either group. We conclude that during spinal anaesthesia patients can in part be kept haemodynamically stable by intravenous administration of ketamine. PMID- 1763597 TI - Haemodynamic effects of heparin during coronary bypass surgery. AB - Heparin has been suggested as an activator of the plasma kallikrein-kinin system, with possible formation of bradykinin, a potent vasodilator. Haemodynamic effects and changes in the kallikrein-kinin system were studied after heparin- and saline injections in ten patients undergoing coronary bypass surgery. A moderate decrease in mean arterial pressure was found in all patients in the observation period, but significantly more at 2 and 3 min after heparin-injection compared with saline-injection. None of the other haemodynamic variables measured were significantly different when comparing heparin- to saline-injection. Heparin injection resulted in significant changes in the kallikrein-kinin system, with a marked increase in spontaneous kallikrein-like activity as the most prominent feature, while no changes were found after saline-injection. Liberation of bradykinin would be expected to give a decrease in systemic vascular resistance with an increase in cardiac output. The results indicate that the plasma kallikrein-kinin system, though apparently activated after heparin-injection, does not contribute significantly to the decrease in arterial pressure in the patients studied. PMID- 1763598 TI - CVP catheter electrocardiography: an alternative to radiographic control after cannulation of central veins? AB - We evaluated 160 electrocardiograms taken after placement of central venous catheters (CVC) to determine their locations. Usable recordings were obtained in 154 patients. Subsequent radiographs revealed 30 misplaced catheters. Twenty-five of those were detected by CVC electrocardiograms. There were five false positive and five false negative traces. The sensitivity of CVC electrocardiography was 96%, the specificity 83.3%, and the total predictive power 93.5%. Electrocardiograms obtained from guide-wires were of significantly better quality than those from 0.9% NaCl filled catheters. The technique is accurate, safe and easy to learn. It may reduce the need for routine radiographic control to less than 10% of patients. PMID- 1763599 TI - Opioid supplementation to propofol anaesthesia for outpatient abortion: a comparison between alfentanil, fentanyl and placebo. AB - One hundred and sixty-four patients scheduled for elective termination of pregnancy under general anaesthesia were randomly assigned to receive one of three different supplements to propofol and oxygen in nitrous oxide anaesthesia: 0.1 mg fentanyl, 0.5 mg alfentanil or placebo. Postoperative pain and nausea, as well as complications during anaesthesia were studied. There were no differences in complications or complaints by surgeons during anaesthesia, and no patient in any group reacted unsatisfactorily to surgery. The patients in the placebo group consumed significantly more propofol during the procedure (P less than 0.001). No differences were seen in time until hospital discharge between the three groups. Complaints about postoperative pain were significantly less frequent among patients receiving fentanyl (P less than 0.01). The number of patients requesting postoperative analgetics, however, did not differ. There was no difference in the frequency of nausea or vomiting, but postoperative pain was found significantly to increase complaints of nausea (P less than 0.01) and also time until hospital discharge (P less than 0.01). In conclusion, opioid supplementation lowered the amount of propofol needed for anaesthesia. Alfentanil 0.5 mg did not improve the postoperative course. Fentanyl 0.1 mg decreased the frequency of postoperative pain without increasing the time to hospital discharge. PMID- 1763600 TI - Influence of nitrous oxide administration and discontinuation thereof on blood flow in cerebral cortex, cerebellum and brain stem in the rat. AB - The effect of nitrous oxide on blood flow in the cerebral cortex, the cerebellum and the brain stem was evaluated in a rat model. Catheters were surgically implanted in advance to avoid influence from other anaesthetics. The animals were housed in a plastic tube where they were allowed to breathe spontaneously. Blood flow was determined with a microsphere technique. Animals were exposed to nitrous oxide, 75-80%, for 45 min and blood flow was measured after 15 and 45 min exposure and was compared to values obtained during room air breathing. In one animal group, nitrous oxide was administered for 45 min and blood flows were measured after 5 and 30 min withdrawal of the gas. Results showed that all animals had significant hyperventilation. In three groups CO2 had to be added to inspiratory gases to normalize arterial blood gases. This was interpreted as caused by stressful experimental conditions, not blunted by the nitrous oxide. Cortical blood flow values in the control situation were also higher than obtained in other animal studies. Despite this, nitrous oxide showed a significant vasodilation in the cerebral cortex and the brain stem at 15 min exposure. At discontinuation of nitrous oxide administration, blood flow values had decreased at 5 min. PMID- 1763601 TI - Furosemide, when used in combination with positive end-expiratory pressure, facilitates the resorption of extravascular lung water in experimental hydrostatic pulmonary oedema. AB - The study aimed to establish whether furosemide given intravenously improved resorption of hydrostatic pulmonary oedema in 14 dogs mechanically ventilated with positive end-expiratory pressure (PEEP). Hydrostatic pulmonary oedema was created by simultaneous inflation of a left atrial balloon and rapid intravenous infusion of isotonic saline. The hydrostatic process was terminated by deflating the balloon and reducing the infusion rate. A PEEP of 10 cmH2O (1.0 kPa) was applied in all animals; in seven, furosemide was administered (diuretic group), 1 mg/kg intravenously as a bolus followed by an infusion of 0.5 mg/kg per hour, while the remaining seven dogs served as a control group. All dogs were studied for a period of 4 h. The extravascular lung water measured with the double indicator dilution technique was 28.3 +/- 3.8 (diuretic group) and 28.2 +/- 6.8 ml/kg (control group) during maximum oedema. It was reduced to 16.4 +/- 2.2 (diuretic group) vs 19.8 +/- 3.7 ml/kg (control group) after 4 h of resorption, P less than 0.05. Postmortem gravimetric values of extravascular lung water were 9.1 +/- 3.4 (diuretic group) vs 12.6 +/- 5.0 g/kg (control group). In the diuretic group the urinary output increased threefold, and haemoglobin and serum protein concentrations were higher than in the control group. There was a significantly greater decrease in cardiac output and central blood volume in the diuretic group. In conclusion, furosemide given intravenously improved lung fluid resorption in hydrostatic pulmonary oedema, probably by increasing the plasma colloid osmotic pressure. PMID- 1763602 TI - Termination of paroxysmal supraventricular tachycardia with a nasogastric tube--a case report. AB - The case is described of a 29-year-old man with a history of recurrent attacks of paroxysmal supraventricular tachycardia. The patient presented to the emergency ward with complaints of palpitations which had not been relieved by vagal stimulation maneuvers and propranolol. When intravenous metoprolol failed to convert the rhythm, a nasogastric tube was passed which immediately converted the tachycardia to normal sinus rhythm. The literature is reviewed and problems and complications of various techniques are discussed. PMID- 1763603 TI - Acta fifty years ago. Fistulas, pelvic hyperalgesia, uterine rupture and giant babies. PMID- 1763604 TI - Metabolism of prostaglandin E2 on the fetal and maternal sides of intact fetal membranes. AB - The metabolism of prostaglandin E2 (PGE2) added to the chorio-decidual side or the amnion side of the intact fetal membrane was compared. Similar rates of metabolism were found when the PGE2 was added to the fetal side or the maternal side of the membrane, even though the amnion (on the fetal side of the membrane) contains no metabolizing enzymes. The appearance of PGE2 metabolites on the opposing side of the membrane was also independent of whether the PGE2 was added to the fetal or maternal side, which suggests that the chorion, which lies between the amnion and the decidua, is the major determinant of the rate of metabolism of PGE2. Furthermore, it might be expected that less PGE2 metabolism subsequent to diffusion across the membrane may occur on the amnion side, since this tissue contains no metabolizing enzymes, but no evidence for this was found. PGE2 synthesized by the amnion would therefore have little effect on PGE2 levels on the maternal side of the fetal membrane, and may not be directly involved in labour. PMID- 1763605 TI - Differences in vasomotor responses between main stem and smaller branches of the human uterine artery. AB - Specimens of the human uterine artery and its branches were taken at hysterectomy. By microscopical dissection, three groups of arteries were obtained with respect to size-main stem, medium and small branches (inner diameters of greater than 1, 0.6-0.8 and less than 0.4 mm, respectively). The contractile effects of different vasoactive substances were studied and the responses expressed as percentages of that of K(+)-depolarization calculated. The most potent vasoconstrictor (the lowest EC50 concentration) was arginine vasopressin (AVP) followed in order by endothelin, oxytocin, prostaglandin (PG)F2 alpha, noradrenalin and dopamine. Angiotensin had inconsistent effects. Atrial natriuretic peptide (ANP) counteracted the contractile effects of endothelin. AVP, endothelin, oxytocin and noradrenalin were significantly more potent on the smallest branches than on the main stem of the artery. Since the former type of vessel represents resistance arteries, the present results suggest that AVP, endothelin, oxytocin and noradrenalin could be of specific importance in the regulation of uterine blood flow. PGF2 alpha, dopamine and angiotensin appear to be of minor importance from this aspect but ANP could play a role by regulating the effects of endothelin. PMID- 1763606 TI - The effect of various drugs with neuroendocrine activity and transdermal estradiol on plasma gonadotropin concentrations after ovariectomy in reproductive aged women. AB - In the present study we compared the effect of different neuroactive drugs with that of estrogen treatment on the ovariectomy-induced plasma luteinizing hormone (LH) and follicle-stimulating hormone (FSH) changes. A total of 35 menstruating women undergoing ovariectomy were randomly divided into five groups of 7 patients each, receiving a 4-week treatment with oral clonidine, lisuride and sodium valproate, transdermal 17 beta-estradiol, or placebo. The treatment started the day after ovariectomy. Surgery was done during the early follicular phase of the cycle. Blood samples were collected before and after 3, 5, 7, 14, 21 and 28 days of treatment. During the treatment, hot flushes were subjectively recorded. The placebo-treated group showed a progressive increase in plasma LH and FSH concentration during the month following ovariectomy. The same changes occurred in the lisuride and sodium valproate treated groups. Plasma LH levels in ovariectomized women treated with clonidine showed an increase which was higher than in placebo-treated women (p less than 0.01), while FSH levels were similar to those in the placebo group. In the estradiol-treated group the increase in both gonadotropins was significantly less (p less than 0.01) than in the placebo group. The frequency and intensity of hot flushes were high in placebo and sodium valproate treated subjects, being significantly reduced by clonidine, lisuride and estrogen treatment. Our results seem to indicate that clonidine treatment modulates the LH postcastration rise and that both neuroendocrine and gonadal mechanisms influence the changes in the activity of the GnRH-pituitary axis following ovariectomy. PMID- 1763607 TI - Incidence of adenomyosis uteri in a Greek population. AB - The reported incidence of adenomyosis based on unselected hysterectomies varies so widely that conclusions regarding the influence of any factor on that incidence are difficult to reach, although the relation of adenomyosis uteri to endometrial carcinoma has been the subject of only a few studies. In a 5-year period at the General Hospital of Athens, 646 hysterectomies were performed. All data were retrieved from the surgical pathology laboratory files concerning adenomyosis uteri with either simultaneous endometrial carcinoma or endometrial hyperplasia. A control population was selected from patients operated upon for a variety of benign pelvic diseases. Adenomyosis was found in association with endometrial carcinoma in 17.5% of 40 cases, and in association with endometrial hyperplasia in 21.6% of 60 cases. The control series of 546 patients had a 26% incidence of adenomyosis. The results of our study do not indicate any correlation between adenomyosis uteri and endometrial carcinoma. PMID- 1763608 TI - The effect of magnesium on maternal blood pressure in pregnancy-induced hypertension. A randomized double-blind placebo-controlled trial. AB - The effects of magnesium were compared with those of placebo in a randomized double-blind controlled study of 58 patients with pregnancy-induced hypertension, of whom 27 received magnesium and 31 placebo. Twenty patients in each group were nulliparas. The treatment comprised 48 h of either intravenous magnesium or placebo infusion followed by daily oral magnesium or placebo tablets until one day after delivery. Magnesium supplementation significantly reduced maternal mean arterial blood pressure (MAP). The gestational age at delivery was the same in both groups, whereas the relative fetal birth weight among nulliparas was reduced in the placebo group. Unbalanced analyses of variance suggested an influence of magnesium supplement on birth weight. The infants in the magnesium supplemented group spent fewer days in the neonatal intensive care unit. There were no perinatal deaths. Magnesium appeared to be beneficial in the management of pregnancy-induced hypertension. The better outcome associated with magnesium supplementation may not have been due to reduction of MAP and further studies are needed to clarify whether magnesium influences birth weight. PMID- 1763609 TI - International collaborative effort (ICE) on birth weight, plurality, perinatal, and infant mortality. IV. Differences in obstetrical delivery practice: Norway, Scotland and the United States. AB - We have carried out a comparative study on differences in operative obstetrical practice during the 1970s and 1980s, in Norway, Scotland and the United States of America. It was based on information from official sources in each country. We compared rates of cesarean section (CS) and operative vaginal delivery according to maternal age, parity and gestational age at delivery, birthweight, fetal presentation, and other characteristics of the child, indications for operative delivery, and hospital size and teaching status. While all three countries had rising CS rates, the Scottish rates, which lay between those of the U.S.A. and Norway, rose more slowly than in the latter. In 1985, the rates were 22.8% in the U.S.A., 13.5% in Scotland and 12.0% in Norway. Use of forceps and vacuum extractor declined in the U.S.A. and Scotland, but increased in Norway. CS rates in mothers aged 35 and over were uniformly high in 1970 and rose relatively little. Specific CS rates for very low birthweight children, breech presentation and twins rose to 30-50% in all three countries with some national trend differences. Rate ratios of operative delivery between large and small hospitals fell from about 2-3 in the 1970s to approximately 1.5 in 1985, least markedly in Scotland. The impact of previous CS as an indication for CS cannot be resolved because of notification and recording differences. PMID- 1763610 TI - Treatment of hyperthyroidism in pregnancy. AB - One hundred and five consecutive pregnancies in 79 women affected by hyperthyroidism were observed during an 8-year period. All had received treatment either with carbimazole alone (Group I) or with the combination of carbimazole and propranolol (Group II). There were 72 pregnancies in Group I, 33 in Group II. Seventy-five pregnancies occurred whilst the mother was receiving antithyroid therapy and in the other 30 the diagnosis of hyperthyroidism was made following conception. The total fetal loss was 17.1%, with a spontaneous abortion rate of 5.5% in Group I and 24.2% in Group II. No congenital malformation or maternal deaths occurred. Carbimazole is safe and effective during pregnancy. Adding propranolol offers no further advantage and may indeed be detrimental. PMID- 1763611 TI - A circadian variation in the observed duration of labor. Possible causes and implications. AB - The distribution of the duration of labor during the day was analyzed. MATERIAL: A one-year material consisting of 1,881 deliveries at the Department of Obstetrics, Regional Hospital of Trondheim, Norway. Only singleton pregnancies with spontaneous onset of contractions and intended vaginal delivery were included. Duration of labor was routinely recorded by the midwife. METHODS: Stepwise multiple regression. Logarithmic transformation of the dependent variable (duration measured in hours) was applied. Parity (0/1+) and hour of birth were the independent variables. RESULTS: The variable indicating delivery during the night (0 to 08) contributed significantly to explain the variation in the duration of labor, in terms of a decrease in the median duration. The effect is substantial, median duration of labor 1.2 h shorter than for deliveries during the day. The variable indicating delivery during the evening (16-24) did not reach the required level of significance (0.05). This reflects a clustering of cases with longer duration of labor, unfavourable progress and less good prognosis during the latter half of the day, which has practical implications for the obstetrical staff. This may explain the similar circadian pattern in perinatal mortality which has been repeatedly documented, the etiology of which has remained enigmatic. PMID- 1763612 TI - An enzyme (beta-D-N-acetylglucosaminidase) released from the decidua to maternal plasma prior to the onset of labor. AB - Changes in the activity of beta-N-acetylglucosaminidase (E.C. 3.2.1.30; NAG), a lysosomal marker enzyme, in the maternal plasma and utero-placental tissues during late pregnancy and parturition were examined in order to determine if lysosomal enzymes participate in the cervical ripening. NAG activity in the plasma gradually increased as gestation advanced, to reach a maximum 3-4 days before the spontaneous onset of labor, and remaining at this level until the second stage. The activity measured in decidua and amnion obtained from the women who had undergone routine repeat cesarean section after labor onset was lower than in those before the onset. Since the decidua was much heavier than the amnion, it was concluded that NAG was released to the maternal circulation mainly from the decidua and only partly from the amnion. Our data revealed that lysosomal enzyme release occurs prior to the onset of labor, and that NAG may play a role primarily in the ripening of the cervix rather than in the onset of labor, by hydrolysing GAGs in the uterine cervix. PMID- 1763613 TI - Reference intervals for serum sex steroids and gonadotropins in regularly menstruating women. AB - Reference intervals for novel fluoro-immunoassays for serum luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol (E2) and progesterone (P) were established in 40 healthy regularly menstruating women. Serum samples for sex steroids, including testosterone (T), androstenedione (A) and dehydroepiandrosterone sulphate (DHEAS), as well as sex hormone binding globulin (SHBG) and gonadotropins, were collected in the early follicular and mid-luteal phases of the menstrual cycle. The need for the timing of androgen and gonadotropin samples was also determinated. Serum E2 and P were measured by radio immuno- and time-resolved fluoro-immunoassays. Various assay methods correlated closely, but the reference intervals varied considerably from one method to another. In the early follicular phase the LH/FSH ratio only ranged between 0.2 and 1.7 (mean +/- S.D.; 0.8 +/- 0.3); the variation was greater (from 0.3 to 3.5) in the luteal phase, when the mean was also significantly higher (1.5 +/- 0.9, p = 0.0001). Similarly the mean values of T and SHBG were higher in the luteal phase, while the other androgen concentrations and calculated androgen indexes were equal, compared with the follicular phase values. Thus the timing of hormone determinations is warranted in the investigation of the gonadotropin and androgen status in normally menstruating women. Moreover, the upper limit of the LH/FSH ratio examined with new, sensitive methods is lower than that previously stated. The use of an intra-uterine contraceptive device (IUD) had no effect on hormone levels. PMID- 1763614 TI - Reproductive failure and antisperm-antibody production among prostitutes. AB - Reproductive failure and anti-sperm antibody (ASA) production among prostitutes were investigated. A questionnaire including the subject's age, years of prostitution, date of most recent birth, number of children and contraceptive method used at the beginning of prostitution were asked of 109 prostitutes, but only 53 agreed to complete the questionnaire. ASA was detected by ELISA in the prostitutes (n = 109) and in the control group (n = 40) sera. The tests revealed a high ASA rate (43.1%) among the prostitutes. The difference in the incidence of ASA between controls (5%) and the prostitutes (43.1%) was highly significant (p less than 0.01). It was found that ASA positivity incidence in 27 prostitutes who had never use any contraception method and who became infertile within 9.3 years (average) was 61.3%. These results may be explained by repeatedly inoculations with multiple sperm antigens and/or microorganisms. PMID- 1763615 TI - Acetyl-l-carnitine as possible drug in the treatment of hypothalamic amenorrhea. AB - Several neuroendocrine disregulations have been demonstrated in patients with hypothalamic amenorrhea, but a definite therapeutic strategy has not yet been found. Since acetyl-l-carnitine (ALC) has been reported to have a specific effect on central cholinergic, serotoninergic, dopaminergic and opioidergic systems, 20 patients with hypothalamic amenorrhea were treated with ALC (2 g/day, per os). Both the clinical efficacy and the endocrine parameters were evaluated after 6 months. The patients were subdivided in two groups according to their LH plasma levels: A) hypogonadotropic: 10 subjects with plasma LH less than 3 mIU/ml, and B) normogonadotropic: 10 subjects with plasma LH greater than 3 mIU/ml. All subjects underwent: 1) a pulsatility study (4 h sampling every 10 min), 2) GnRH test (two bolus injections of 10 micrograms at time 0 and +120), 3) TRH test (200 micrograms). These parameters were evaluated before and after 6 months of ALC administration. The occurrence of a spontaneous menstruation was observed in 6 out of 10 hypogonadotropinemic and in 4 out of 10 normogonadotropinemic patients. Menstrual bleeding occurred between the 3rd and the 6th month of therapy. Major hormonal changes after ALC administration were observed in the hypogonadotropic subjects. They showed a significant increase in baseline plasma LH levels (from 0.9 +/- 0.1 to 3.5 +/- 0.7 mIU/ml, p less than 0.05) (mean +/- SEM), a significant increase in LH pulse amplitude (p less than 0.01) with no changes in LH pulse frequency, and a significantly increased response of LH to the latter GnRH bolus during the GnRH test. Hypogonadotropic patients also showed a significant increase in both estradiol (from 18.8 +/- 2.5 to 48 +/- 3.3 pg/ml, p less than 0.05) and PRL (from 6 +/- 1 to 11.4 +/- 1.7 ng/ml, p less than 0.05). No significant differences were observed in the hormonal parameters of normogonadotropic patients after 6 months of ALC therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1763616 TI - Vaginal bromocriptine in hyperprolactinemic patients and puerperal women. AB - Fifteen hyperprolactinemic and 7 puerperal women were treated with bromocriptine per vaginam (2.5-5 mg) because of absolute intolerance to the oral administration of this drug. In both groups the prolactinemia was normalized without the typical side effects of bromocriptine. Three patients reported vaginal burning, but only one discontinued the therapy because of the intensity of the symptom. This study suggests that vaginal bromocriptine should be considered as a useful alternative for the treatment of hyperprolactinemia. PMID- 1763617 TI - Duplex Doppler ultrasound in the evaluation of pregnancies complicated by pregnancy-induced hypertension. AB - Umbilical artery velocimetry using pulsed Doppler technique was carried out in 49 pregnancies complicated by pregnancy-induced hypertension (PIH). Outcome of the pregnancies was evaluated after delivery. We found the systolic to diastolic ratio of the umbilical artery to be highly sensitive and specific in predicting abnormal outcome in pregnancies complicated by PIH. In our opinion, the pulsed Doppler technique can be a useful adjunct to other methods for evaluation of fetal well-being in patients with PIH. PMID- 1763618 TI - Umbilical metastasis (Sister Joseph's nodule) from carcinoma of the vagina. AB - A case is reported of a squamous cell carcinoma of the vagina with metastasis to the umbilicus (Sister Mary Joseph's nodule). Systemic cisplatinum chemotherapy resulted in partial response, however, the "nodule" was a sign of poor prognosis and indicative of short-term survival. To the best of our knowledge, this is the first report of umbilical metastasis from a primary carcinoma of the vagina. PMID- 1763619 TI - Air embolism due to pulmonary barotrauma in a patient undergoing cesarean section. AB - Air embolism may occur following criminal abortion, vaginal douching, powder insufflation as treatment for vaginal infections, and orogenital sex. The patient reported in this work deteriorated following pulmonary barotrauma. Diagnosis was made 16 h after the appearance of neurological signs. She was transferred immediately to the hyperbaric unit. The speed and completeness of recovery are directly related to the prompt diagnosis and commencement of therapy. Failure is more likely related to delay. PMID- 1763620 TI - Circadian rhythm dependent kanamycin-induced hearing loss in rodents assessed by auditory brainstem responses. AB - An antimicrobial agent, kanamycin, has been shown to produce as an untoward effect, ototoxicity. The purpose of this study was to investigate differential effects of kanamycin ototoxicity as a function of Rx timing with regard to circadian rhythms. Four groups of comparable weight Sprague-Dawley rats received a daily subcutaneous dosage of 225 mg/kg kanamycin sulfate with each receiving the antibiotic at a different time: 8 AM (8A), 2 PM (2P), 8 PM (8P), and 2 AM (2A). The rats were housed in separate cages, in a room on a light-dark (12:12) illumination cycle with light between 6 AM and 6 PM. Hearing loss was assessed with the auditory brainstem response (ABR) using pure tone stimuli at 8, 16, 24, and 32 kHz. ABR measures were obtained before dosing began and 2, 4, and 6 weeks after the initial dosing. Kanamycin produced a hearing loss which reflected the total dosage given to each group. Significant differences in physiologic thresholds were observed for both timing of the daily dosage (p less than 0.05), and the 2, 4 and 6 week testings (p less than 0.001). After 2 weeks, the 8A group showed an average hearing loss of 11.5 dB at 32 kHz, with the other timed treatment groups exhibiting minimal effects (3.0-6.5 dB). For the 8A group at this frequency, the loss progressed at 4 (19.5 dB) and 6 (22.5 dB) weeks. The 2P group after 4 weeks exhibited similar losses as the 8A group for this frequency, with the loss at 6 weeks being even greater (34.0 dB). The 8P and 2A groups exhibited only slight losses over all frequencies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1763621 TI - An ultrastructural study on vestibular sensory cells in a new-mutant mouse. AB - The ultrastructural characteristics of the vestibular epithelium and light microscopical study of the central nervous system of a strain of new-mutant mice were analyzed. For the vestibular study, we used 72 homozygotes with ages ranging from 10 days to 18 months. The most striking findings observed in these mice were the disarray of the stereocilia of the utricular and saccular maculae and disintegration of the saccular otoconia. Many hair cells displayed abnormality of the stereocilia such as reduced number, disorganized distribution, and giant cilia, although the hair cell cytoplasm, including the nerve terminals, became fully developed. Demineralization of the saccular otoconia was age dependent, and a complete loss of the saccular hair cells was demonstrated. In conjunction with the disarray of the outer hair cells of the cochlea, morphological manifestation of the gene abnormality of these mice was related to immaturation of the stereociliary tufts. Because no morphological abnormality was observed in the central nervous system, the abnormal behavior in these mice was primarily correlated with morphological abnormalities of the vestibule. PMID- 1763622 TI - Effects of systemic and lateral semicircular canal administration of aminoglycosides on normal and hydropic inner ears. AB - Streptomycin was injected subcutaneously into guinea pigs (n = 12) with unilateral endolymphatic hydrops. In the unoperated ears, sensory cells were degenerated at the basal ends of all cochleas and to varying extents in the vestibular sense organs. Hydropic ears, in contrast, showed greater ototoxicity in the cochlear and saccular sensory cells, while the drug's effect on the utricular and cristae sensory cells was increased, but less remarkable. In another series of normal animals (n = 16), streptomycin was applied to a fenestra of the lateral semicircular canal. Sensory cells of all three canal cristae and utricular macula were degenerated frequently, but the sensory cells of the cochleas were rarely affected. The vestibular lesions resulting from the canal approach were greater than those produced by systemic injection. Comparison with a former gentamicin-lateral canal series revealed very little difference in action of the two drugs. However, in hydropic ears, gentamicin application to the lateral canal produced increased lesions in all sensory cells, particularly in the organ of Corti. Hydropic ears are vulnerable and a greater caution is needed in administering aminoglycosides by both the systemic and the canal route to patients with Meniere's disease. PMID- 1763623 TI - Sexual dimorphism and development of the human cochlea. Computer 3-D measurement. AB - The length of the cochlear turns was measured in 9 pairs of temporal bones from age-matched male and female individuals (1 day to 76 years old), using a computer aided three-dimensional reconstruction and measurement method. The mean cochlear length was significantly longer (Two-way analysis of variance, F = 31.87, d.f. = 1, p less than 0.01) in males (37.1 +/- 1.6 mm) than in females (32.3 +/- 1.8 mm), whereas it did not vary with postnatal age in either sex. Sexually dimorphic cochlear length may pose a new issue in auditory physiology in man. The lack of postnatal elongation also indicates that length of the cochlea becomes close to its maximum during fetal life. PMID- 1763624 TI - Carbohydrates in the guinea pig stria vascularis demonstrated with lectin-gold techniques. AB - Soybean agglutinin (SBA), Helix pomatia agglutinin (HPA), Ricinus communis agglutinin-II (RCA-II), Limax flavus agglutinin (LFA) and wheat germ agglutinin (WGA) were employed to determine the localization of specific carbohydrates on thin sections of lowicryl K4M embedded guinea pig striae vasculares using the lectin-gold and glycoprotein-gold techniques. SBA, HPA and RCA-II gold labeling was observed in many of the cytoplasmic vesicles, endosomes and apical tubules located in the supranuclear region as well as on the microvilli and micropinocytotic invaginations of the luminal plasma membrane of the marginal cells. LFA labeling was found on the basal plasma membrane of the marginal cells as well as in the basement membrane of the perivascular spaces. WGA binding sites were detected along the plasma membrane of all types of cells constituting the stria vascularis. Our present results revealed that the membranes of internalization and many of the cytoplasmic vesicles, endosomes and apical tubules in the supranuclear region of the marginal cells are associated together and it is suggested that these structures may be related to the regulation of endolymph. PMID- 1763625 TI - Homing of lymphocytes to the inner ear. AB - The migration of lymphocytes to the inner ear was studied during an immune response in the cochlea. Sensitized lymphocytes from peripheral blood, neck lymph nodes and spleen from strain 13 inbred guinea pigs were labelled with 51Cr and injected intravenously into strain 13 recipients undergoing an inner ear immune response. Eighteen hours later the temporal bones and immune organs of the recipients were assayed for radioactivity to detect the infiltration of labelled cells. In addition autoradiography was performed to localize labelled cells in the inner ear. More lymphocytes from the peripheral blood entered the inner ear during the immune response than spleen or lymph node cells. This indicates that the inner ear comes under the immuno-surveillance of the peripheral circulation in response to antigenic stimulation. Most labelled lymphocytes were observed in the basal turn of the scala tympani and in and around the spiral modiolar vein of the challenged cochlea. A few cells were seen also in the control cochleas but almost all where inside the blood vessels. This pattern suggests that the blood vessels of the spiral modiolar vein are the initial site through which lymphocytes entered the inner ear. PMID- 1763626 TI - Involvement of the VIIIth cranial nerve and the brainstem in patients with hemifacial spasm. AB - Twenty-seven patients with hemifacial spasm underwent neurotological (auditory and equilibrium) examinations to evaluate the VIIIth cranial nerve and/or brainstem involvement. Radiological examinations were performed to evaluate the underlying abnormalities. Twenty patients had abnormal neurotological findings, with the VIIIth cranial nerve involvement being suggested in 10 and brainstem involvement in the other 10. Radiological examinations indicated that vascular abnormalities could be detected more often in the patients with brainstem involvement than in those with VIIIth cranial nerve involvement. PMID- 1763627 TI - Lip-length and snout indices in Bell's palsy. A comparison with the House grading system. AB - The lip-length (LL) and snout (S) indices provide information on peri-oral muscular function. They were determined in 18 patients suffering from Bell's palsy and compared with the results obtained by scoring according to the House grading system. A high correlation was found. LL and S indices are continuous variables, which facilitates their statistical evaluation. Results of the House scoring system are given in an ordinal scale and reflect overall facial muscular function. It is concluded that the indices and the House scoring system produce a different kind of information, but they are complementary to each other in the assessment of facial muscular function. PMID- 1763628 TI - The HLA system and T-cell subsets in Bell's palsy. AB - The etiology of Bell's palsy (BP) is still unknown, but infectious, immunological and genetic factors have been suggested to play a role in the pathogenesis of the disease. We analyzed blood samples of 92 Mexican Mestizo patients diagnosed as having BP according to established international criteria, and the results were compared to a group of apparently healthy controls of the same ethnic origin. HLA class I (A, B, C) and Class II (DR, DQ) products of the major histocompatibility complex (MHC), and the percentages of CD3, CD4 and CD8 T-cell subsets were investigated. The number of family antecedents was surprisingly high (46%), supporting a genetic basis. There was a slight increase of DRw13, suggesting a possible susceptibility class II-linked gene. A significant decrease of DR4 (pc = 0.001) was detected, which may indicate the existence of a resistance DR-linked gene. Thus, a non DR4 carrier may be in high risk of expressing BP. In the acute phase of the disease, the T-cell subsets showed a decrease in CD3 and CD4 cells when compared to controls. CD8 cells were increased in the same stage. A transient T-cell imbalance was thus observed which recovered in the convalescent phase. None of the patients with CD4 lower than 40% were DR4, suggesting that the DR-linked resistance gene may predispose to the T-cell defect. PMID- 1763629 TI - The effect of postural change and upper respiratory tract infection on middle ear pressure. AB - The effect of a change in posture from sitting erect to lying supine and horizontal on middle ear pressure was investigated in 5 healthy adults and 5 adults with symptoms of an acute upper respiratory tract infection (URTI). The change in posture had no significant effect on middle ear pressure in the healthy subjects (p greater than 0.05). In those with URTI mean middle ear pressure increased from -39.5 daPa (erect) to -16.9 daPa (supine) (p = 0.026, n = 10). In the supine posture the middle ear pressure in subjects with URTI was raised. The cause of the increase in middle ear pressure is discussed in terms that the postural change may alter middle ear physiology such that in the supine posture there is a net production of middle ear gas as opposed to a net reabsorption in the erect posture. This may indicate that an increase in jugular venous pressure causes a net positive production of middle ear gas. PMID- 1763630 TI - Experimental recurrent pneumococcal otitis media. Protection and serum antibodies. AB - To elucidate immune mechanisms in otitis media, middle ear infection was induced in 12 rats by intratympanic inoculation of Streptococcus pneumoniae type 3, either the ipsilateral or the contralateral middle ear being re-challenged 4 weeks later. Otomicroscopy inspection confirmed the presence of acute otitis media (AOM) in all rats after the first challenge. After re-challenge, protection against AOM was noted both in the ipsilateral and contralateral ears. Serum antibody concentrations increased after the initial challenge, reaching a maximum at 4-7 days, but had decreased to pre-immune levels at re-challenge, after which no new increase was noted. Serum IgG-antibodies to pneumococcal type 3 polysaccharide were triggered following the initial induction of unilateral pneumococcal AOM, but mucosal immune mechanisms are argued to be a more probable explanation of the ipsilateral protection seen after re-challenge. PMID- 1763631 TI - Treatment failure in otitis-prone children with prophylactic tympanostomy tubes is correlated with nasopharyngeal Haemophilus influenzae colonization. AB - Tympanostomy tubes are used to prevent recurrent otitis media among otitis-prone children. However, not all children benefit from this treatment. In the present study 28 children (19 boys, 9 girls) were given bilateral tympanostomy tubes at age 9-22 months (mean 14 months). They were observed 6 months before and after tube insertion. The treatment was considered successful for 20 children. Among these, 16 completely lacked or had one episode of middle ear discharge and 4 had otorrhea on two occasions. A total of 8 children suffered from three or more episodes of otorrhea and were considered as treatment failures. In the failure group, the nasopharyngeal average carrier rate of H. influenzae 6 months before and after tube insertion was 64% vs. 29% in the group responding well to the treatment (p less than 0.001). Nonencapsulated forms of H. influenzae were in a great majority. In the failure group 7 out of 8 presented middle ear discharge as soon as within 2 weeks after tube insertion whereas this occurred in only 3 out of 20 in the responding group. IgG, IgG1 and IgG2 antibody response to pneumococcal polysaccharide (6A, 19F) were equally distributed in the two groups. The present data suggest that one reason for an unsatisfactory response to treatment with prophylactic tympanostomy tubes is nasopharyngeal colonization and subsequent middle ear infections caused by H. influenzae. PMID- 1763632 TI - Surface active substances in the chinchilla tubotympanum. A biochemical study. AB - It has been demonstrated that the eustachian tube and middle ear epithelium produce Tubal Surface Active Substances (TSAS), which facilitate the opening of the eustachian tube. In order to characterize the biochemical contents of chinchilla TSAS, the tubal washings were analyzed using 2-D thin layer chromatography. The results indicate that phosphatidylcholine was the predominant phospholipid, followed by sphingomyelin, phosphatidylinositol phosphatidylethanolamine, and phosphatidylserine. In comparison, pulmonary lavage showed phosphatidylcholine to be highest allowed by phosphatidylethanolamine and sphingomyelin. Phosphatidylcholine/phosphatidylethanolanim ratios were 5:1 in the tubal lavage, and 8:1 in the pulmonary lavage. Phosphatidylcholine/sphingomyelin ratios were 2:1 in the tubal lavage, and 67:1 in the pulmonary lavage. It is concluded that the biochemical content of TSAS is similar but not identical to that of pulmonary surfactants. PMID- 1763633 TI - GC serum groups and otosclerosis. AB - Five genetic serum protein marker systems (HP, TF, GC, BF and PI) were studied in patients with otosclerosis and in controls. The distributions of GC phenotypes and alleles showed significant differences between patients and controls with an excess of the IF-allele and the IF-variant among the patients. PMID- 1763634 TI - Pneumatization of the temporal bones in a Greenlandic Inuit anthropological material. AB - The degree of pneumatization of the temporal bones correlates with exposure during childhood and adolescence to infectious middle ear diseases (IMED), both acute and chronic. The pneumatized area as seen on cranial X-rays can be measured. This was applied to an anthropological material in order to develop methods for assessing ancient populations' exposure to IMED. Fifty-six Greenlandic Inuit (Eskimo) crania were examined. The crania were sexed and measured. X-rays were taken bilaterally, using the projection of Runstrom II, and the pneumatized area was measured planimetrically by computer. In blind trials it was found that the inter- and intraobserver variation was non-significant; that the degree of pneumatization of the temporal ossa did not reflect cranial size or sexual dimorphism; and that the pneumatized areas correlated bilaterally. Asymmetry in the size of the pneumatized areas, an indicator of exposure to IMED, was found in 5 crania (9%). PMID- 1763635 TI - 125I-albumin may not be used as a tracer of absorption across the human nasal airway barriers. AB - This study set out to examine the effects of histamine on airway absorption of macromolecules. By employment of a novel "nasal pool" technique instillates containing 125I-albumin, with or without histamine, were kept for 15 min on human nasal mucosa. Unaffected by the presence of histamine, the instillations produced significant levels of plasma radioactivity, increasing for 60 min. However, gel filtration data showed that only 30% of the plasma radioactivity was still bound to albumin. Incubation experiments indicated that radioiodine did not dissociate from albumin in nasal liquids nor in the blood. Further experiments involved oral ingestion of the entire nasal instillate. Prompt gastrointestinal absorption of radioactivity occurred, giving rise to plasma levels about two orders of magnitude higher than those recorded after the nasal applications. Moreover, only 25% of the plasma radioactivity was now bound to albumin. It must be considered unavoidable that a small portion (less than 1%) of the nasal instillate is swallowed. Hence, the plasma radioactivity detected in this study may largely reflect gastrointestinal break-down of 125I-albumin and subsequent absorption of radioiodine. We conclude that 125I-albumin may not be employed in studies addressing macromolecular absorption across the human nasal mucosa and that previous work and conclusions based on nasal absorption of 125I-albumin are invalid. PMID- 1763636 TI - The effect of ice packs upon nasal mucosal blood flow. AB - The effect on nasal mucosal blood flow of ice packs on the forehead and ice packs within the mouth was investigated in 16 healthy subjects. The laser Doppler flowmeter was used to record changes in blood flow to the inferior turbinate, as measured by change in the flux. Ice packs within the mouth produced a significant decrease in nasal mucosal blood flow (p less than 0.05). The average fall was 23% (SEM 5.9) compared with the control measurements. No significant change was recorded following the application of ice packs to the forehead. The results of this study question the scientific rationale behind the use of forehead ice packs in clinical practice. PMID- 1763637 TI - Secretory IgA- and IgG-coated bacteria in the nasopharynx of children. An immunofluorescence study. AB - Bacterial samples were obtained from the posterior wall of the nasopharynx (NPH) of 18 healthy children (age range 1 to 14 years, 10 males, 8 females) and subjected for immunofluorescence studies using fluorescein-labelled goat anti human IgG and goat anti-human SIgA antibodies. Quantitative and qualitative bacteriological analyses were performed simultaneously. IgG-coated bacteria in the NPH were observed in 1-year-old subjects and opsonized bacteria seemed to increase in numbers and fluorescence intensity with increasing age. SIgA-coated bacteria appeared later, and intensely fluorescing bacteria were not seen until the age of 3 to 6 years. Thirteen out of the 18 children harboured middle ear pathogens in the NPH, but generally speaking non-pathogens dominated the bacterial flora. Immunoglobulins are of the utmost importance for the mucosal defence system, including protection against bacterial attachment to the epithelial cells (SIgA), and bacteriolysis and opsonization of the bacteria (IgG). PMID- 1763638 TI - Quantitative analysis of laryngeal EMG in normal subjects. AB - A method for quantitative analysis of the electromyographic interference pattern called "turns/amplitude analysis" was carried out with recordings from the cricothyroid and thyroarytenoid muscles of 12 normal subjects, 6 males and 6 females. The purpose was to investigate how the two muscles vary contraction force in relation to variations in pitch and voice intensity. Sustained phonations with systematic variation of pitch and intensity were analysed. The contraction force, in terms of turns and amplitude, increased with increasing pitch in both the cricothyroid and thyroarytenoid. More variability in contraction activity as a function of intensity was noted in the cricothyroid than in the thyroarytenoid. The increase in turns and amplitude in the thyroarytenoid with increasing pitch was highly significant, while little effect was seen of intensity variation. No great differences between males and females were noted. PMID- 1763639 TI - Swallowing problems in rheumatoid arthritis. AB - Twenty-nine female patients with definite or classical rheumatoid arthritis (RA) and 30 controls were investigated in order to evaluate oral symptoms, particularly xerostomia, and swallowing difficulties in RA by means of a questionnaire, physical examination, stimulated saliva secretion, labial salivary gland biopsy, esophageal manometry and laboratory blood tests. Xerostomia was reported by 6 patients (21%), compared with no-one in the control group. Four of these 6 patients had decreased stimulated saliva secretion, compared with 2 of the remaining 23 patients. Dysphagia was experienced by 8 patients (28%), compared with one control subject. Dysphagia was associated with disease severity. Esophageal manometry revealed a decrease of the amplitude of the peristaltic pressure complex in the proximal part of esophagus in the RA group, indicating dysfunction of the striated muscles. No correlation was found between dysphagia and esophageal manometry results. PMID- 1763640 TI - Occurrence of tracheal carcinoma in Finland. AB - During the period 1967-1985, 95 primary tracheal carcinomas occurred in Finland. The mean annual incidence rate was one per one million inhabitants, the male:female ratio being 7:3. There was a significant increase of the disease by increasing age with the exception of 70-79 years. The most common location was the lower third of the trachea. Over two-thirds of the tumours were squamous carcinomas. Smoking seems to be an important risk factor at least in males. PMID- 1763641 TI - Growth of xenografted head and neck cancer in nude mice pre-treated with whole body irradiation. AB - In an attempt to enhance the primary acceptance rate of human squamous cell carcinoma of the head and neck (HNSCC), nude mice (BALB/c) were given whole body irradiation (WBI) prior to heterotransplantation of tumour specimens. A total of 27 fresh HNSCC biopsies were transplanted, with a take rate of 15%. No difference in primary tumour acceptance rate was found between irradiated and non-irradiated mice. Only one of the accepted tumours established growth both in irradiated and non-irradiated mice. In a second experiment, three previously established tumour lines of HNSCC were re-transplanted to irradiated and non-irradiated mice. As compared with non-irradiated mice, the growth rate was lower in all tumours transplanted to irradiated mice, the difference being statistically significant in two out of the three tumour lines. The results of the study show that attempted immunosuppression by WBI of nude mice prior to tumour implantation does not improve the growth conditions of HNSCC. These findings further emphasise the complexity of the transplantation barrier against human tumour xenografts in nude mice. PMID- 1763642 TI - Is UPPP the treatment of choice for obstructive sleep apnea? PMID- 1763643 TI - Effects of total cochlear haircell loss on integrity of cochlear nucleus. A quantitative study. AB - In cochleas of chincillas treated with amikacin, cochlear sensory cells were totally destroyed in all new-born animals. In animals treated as adults some occasional haircells remained in apical turns. In the neonatally treated animals, the resulting auditory deprivation significantly affected the volume of the ventral cochlear nucleus and large-dark spherical cell area. The density of large dark spherical cells increased significantly from normal in both neonatally and adult treated groups. Our results suggest that the VCN is more dependent on auditory stimulation for proper development than the DCN. In adult chinchillas treated with amikacin there was a significant change in large-dark spherical cell density without a change in total cell numbers or large-dark spherical cell area volume. Our study indicates that the mature cochlear nucleus is much more resistant to the effects of auditory deprivation than the developing cochlear nucleus and that the maintenance of the mature auditory system is not as dependent on auditory stimulation. Studies such as this examining the morphological effects of profound cochlear deafness on higher levels of the auditory system are essential in cochlear implant research. PMID- 1763644 TI - The effects of long and short term profound deafness on the responses of inferior colliculus to electrical stimulation of the cochlea. AB - It is widely assumed that adequate sensory stimulation is important for the proper post-natal development of the central nervous system, particularly during certain critical or sensitive periods in development. To examine the functional effects of long-term profound deafness on the development of the auditory system, the response properties of neurons in the inferior colliculus (IC) to electrical stimulation of the cochlea were investigated in chinchillas (i) deaf from birth and (ii) deafened as adults. In animals deafened as adults there was a 50% reduction in the number of neurons activated by electrical stimulation of the cochlea, compared with studies in normal controls. In contrast, very few or no responses could be elicited from IC of animals made deaf from birth. The results imply that lack of neural activity in the ascending auditory pathways from an early stage of development results in an inactivation of IC neurons. It is not clear if such inactivity is temporary or permanent. PMID- 1763645 TI - Morphological changes to the cochlea in an animal model of profound deafness. AB - We have used systemic application of the ototoxic drug amikacin, to induce total cochlear haircell loss in the chinchilla, in order to create an animal model of profound deafness. We have produced models of both neonatal deafness (by treatment of new-born pups), as well as of acquired total hearing loss (by treatment of mature animals). We present a description of our techniques for producing cochlear lesions and for evoked potential monitoring of the resulting threshold elevations. We also give a qualitative description of cochlear haircell damage as viewed by scanning electron microscopy, and a quantitative assessment of the spiral ganglion cell survival after total haircell loss. PMID- 1763646 TI - Betahistine dihydrochloride versus flunarizine. A double-blind study on recurrent vertigo with or without cochlear syndrome typical of Meniere's disease. AB - This study was designed to compare the efficacy and safety of betahistine dihydrochloride and flunarizine. All patients included in this multicenter, double-blind, randomized trial showed a specific pattern of vertigo, i.e. recurrent paroxysmal vertigo with or without the cochlear symptoms typical of Meniere's disease. Fifty-five patients were treated for 2 months (28 in the betahistine group and 27 in the flunarizine group). Analysis of intra-group symptom changes demonstrated a greater efficacy for betahistine. Statistically significant decreases in duration and severity of attacks, and in the presence of vegetative symptoms were seen in the betahistine group after the first and second months of treatment, whereas in the flunarizine group this was the case only at the end of the first month of treatment. Furthermore in the betahistine group, statistically significant decreases occurred for the other major criteria, including number of attacks, evidence of vestibular dysfunction, and presence of cochlear symptoms. Adverse effects were similar to those reported in previous studies of both products: stomach pains only with betahistine, and drowsiness, asthenia, and depression with flunarizine. PMID- 1763647 TI - Development of acute morphine tolerance in peripheral clinico-chemical parameters. AB - Changes in peripheral clinico-chemical parameters packed cell volume (PCV), hemoglobin (HGB), serum glucose, carbamide-nitrogen (CN), and creatinine were investigated in mice during the development of acute morphine tolerance. Acute morphine treatment (in drug-naive organism) altered the PCV, HGB, serum glucose and CN levels in a naloxone-reversible manner. Acute tolerance developed in PCV, HGB and CN values. The data raise the possibility of a relationship between clinico-chemical and pharmacological tolerance. PMID- 1763648 TI - Influence of extracellular magnesium on the contractile and endothelium-dependent dilatory responses of feline mesenteric arteries. AB - To clarify the effect of extracellular magnesium on the vascular reactivity of feline isolated mesenteric arteries, the effects of slight alterations in the extracellular magnesium concentration on the contractile and endothelium dependent dilatory responses were investigated in vitro. The contractions, induced by noradrenaline 10(-8)-10(-5) M, were not affected in the mesenteric artery at low extracellular magnesium (0.8 mM versus to the normal, 1.2 mM). High (1.6 and 2.0 mM) magnesium exerted a modest inhibitory effect on the contractile responses. This depression of the contraction was accompanied with a significant shift to the right in the EC50 value for noradrenaline. The endothelium-dependent relaxations induced by acetylcholine 10(-8)-10(-5) M, were inhibited by high (1.6 and 2.0 mM) magnesium. Lowering of the extracellular magnesium concentration to 0.8 mM, however, failed to alter the dilatory potency of acetylcholine. The depression of the dilatory responses was also accompanied with a shift to the right in the EC50 values for acetylcholine. The present results show, that contractions and endothelium-dependent relaxations of the mesenteric artery are modulated by the extracellular magnesium asymmetrically: slight magnesium deficiency does not affect these responses, whereas elevation of the concentration of this ion inhibits both processes. Extracellular magnesium probably affects rather the binding of these contractile and endothelium dependent dilatory agonists to their receptors than the calcium influx into the endothelial- and smooth muscle cells in this vessel. PMID- 1763649 TI - Noninvasive estimation of pulmonary arterial blood pressure in burned patients with acute respiratory failure. AB - Pulmonary arterial hypertension develops in acute respiratory failure and mostly an enhanced PADd-PCWP gradient has an important effect on the outcome of that complication. Considering that this critical state of septic burned patients may last for weeks, the long-term direct monitoring of pulmonary arterial blood pressure with indwelling Swan-Ganz catheter is impossible because of the high risk of endocarditis. Therefore, the aim of this study was to elaborate a noninvasive method to estimate the pulmonary arterial hypertension. Determination of cardiac index and pulmonary arterial blood pressure was carried out with Swan Ganz catheter, P32 Statham transducer, cardiac output computers (Gould IM 1000, Marquette 7010). Extended systolic time interval measurements (with Medicor 661 polygraph completed by PC program package) were performed simultaneously in 7 burned patients (av. age 38.7 ys, means of TBS 38%) with acute respiratory failure at 38 occasions. The values of cardiac indices with the two methods were practically the same CI t = 3.4 +/- 1.21 1/min/m2 CI s = 3.1 +/- 1.10 1/min/m2; regression equation: CI s = 0.874 CIt + 0.135, r = 0.98, n = 38. Close correlations have been found between PAPm and PO2/FiO2 (r = 0.75), as well as between PAP values and some noninvasively measured hemodynamic data. Using these interrelations: 1) regression equations for PAPs., PAPm, PAPd, PCWP, PVRI were elaborated (r values: 0.855, 0.869, 0.681, 0.644, 0.817 respectively); 2) discriminant analysis with noninvasive parameters correctly classified the cases at critical PAPd-PCWP gradient (greater than 4 mm/Hg) in 84%. These results suggest that a continuous noninvasive hemodynamic and blood gas monitoring completed with a periodic bedside computer analysis of the PC-processed data for calculation of the pulmonary arterial pressure may be enough for the therapy during the long-term critical periods. PMID- 1763650 TI - Effect of the bioflavonoid silymarin on the in vitro activity and expression of superoxide dismutase (SOD) enzyme. AB - Superoxide dismutase activity and expression of the erythrocytes and lymphocytes of patients suffering from chronic alcoholic liver disease and those of healthy controls were investigated after in vitro incubation with silymarin. It was concluded that silymarin treatment in a concentration achievable by in vivo treatment (10 micrograms/ml) significantly increased the SOD activity of both the erythrocytes and lymphocytes of patients with liver disease, whereas the SOD expression of the lymphocytes enhanced to a considerable extent. These results indirectly indicate that the scavenger silymarin is able to increase the antioxidant protection of the cells by ameliorating the deleterious effects of free radical reactions. PMID- 1763651 TI - Local cerebral tissue glucose utilization in graded arterial hemorrhagic hypotension, studied by the 14C-2-deoxyglucose method in rats. AB - The effect of hemorrhagic arterial hypotension on local cerebral glucose metabolism was studied on 33 rats. The mean arterial pressure was set with the aid of a reservoir at 80, 60, 50 and 40 mmHg pressures. Local cerebral glucose utilization was measured with the 14C-2-D-deoxyglucose accumulation autoradiographic technique. Local glucose consumption decreased somewhat in cortical structures when mean arterial pressure was reduced to 60-50 mmHg. Further decrease in mean arterial pressure to 50-40 mmHg caused inhomogeneity of tissue metabolism. Columns and patches of high glucose consumption interchanged with areas of very low glucose consumption in most telencephalic and cerebellar gray matter structures. Brain stem and white matter structures seem to be less sensitive to decreased mean arterial pressure in the range studied. We found a decrease in glucose utilization rather than an increase with decreasing mean arterial pressure down to 60-50 mmHg (in the range of the autoregulation of cerebral circulation). This finding makes it improbable that autoregulation would be connected with elevated anaerobic metabolism of the tissue. Patchy areas and columns of high glucose consumption found at 50-40 mmHg in all probability reflect areas of increased anaerobic metabolism of glucose. Here, circulation was not enough to transport adequate quantity of oxygen to the tissue, but still it transported relative large amount of glucose. Columns and patches of very low glucose consumption should reflect areas, where circulation was inadequate to transport both enough glucose and oxygen. PMID- 1763652 TI - Role of endothelium, oxygen and ionic milieu in the prostacyclin and thromboxane production of rat aortic tissue slices. AB - The present study was executed in order to get further data on the role of vessel wall constituents in prostanoid synthesis and on the effect of anorganic constituents on it. Prostacyclin and tromboxane production of rat aortic tissue slices with intact endothelium and after mechanical as well as chemical endothelium removal were studied. The effects of hypoxia and changes in the ionic milieu on the release of these prostanoids were also examined. The tissue slices were incubated in normal or in modified Krebs-Ringer solution, bubbled with 95% O2 and 5% CO2 (with the exception of the studies in hypoxic conditions). Prostacyclin and thromboxane release was determined by specific radioimmunoassay of the stable metabolites, 6-keto-PGF1 alpha and TxB2, from the incubation medium. 174 tissue samples obtained from 164 rats were studied. Mechanical removal of the endothelium increased prostacyclin production of the aortic segments about fivefolds from a basal rate of 52.9 +/- 19.4 ng/gr/min, while it had no significant effect on thromboxane release (basal rate 0.83 +/- 0.13 ng/gr/min). Treating the endothelium with 1.0 M HCl almost totally suppressed prostacyclin release. Lowering the partial oxygen tension of the incubation medium significantly decreased the production of prostacyclin, while release of TxB2 somewhat increased. Increasing the Ca2+ concentration of the medium between 0-5 mM the release of prostacyclin was augmented and the release of thromboxane was diminished. Potassium free medium caused a very large increase in prostacyclin release of the tissue slices. The results show that release of vasoactive prostanoids from isolated rat aortic wall is dependent not exclusively on the endothelium and that various methods of endothelium removal may have distinct influences on prostacyclin and thromboxane productions. The changes in anorganic constituents of the surrounding medium could massively affect prostacyclin and thromboxane production of rat aortic tissue. The alternative effects of the above listed treatments on the release of prostacyclin and thromboxane from the rat aortic wall suggest the existence of different mechanisms in the control of the production of the two major prostanoids possessing opposite physiological effects. PMID- 1763653 TI - Cardiac output distribution and intrarenal haemodynamics: role of thromboxanes. AB - The effects of imidazole, an inhibitor of thromboxane synthesis, were studied on the distribution of cardiac output and on the intrarenal haemodynamics in anaesthetized, furthermore on the salt and water excretion in conscious rats. Imidazole treatment (10 mg/100 g b.m., intraperitoneally, twice a day for two days) failed to influence the arterial blood pressure, the cardiac output and its distribution in organs investigated (heart, muscle, lung [bronchial fraction], skin, liver, spleen, small intestine, adrenal gland and kidneys). The medullary blood flow increased, while cortical blood flow remained unchanged, but the intrarenal percentile blood flow shifted towards the medulla. Imidazole elevated the water turnover in the animals, but no change in sodium and potassium excretion occurred. It is supposed that thromboxanes may affect the renal medullary vascular tone without altering the vascular smooth muscle activity in other organs. PMID- 1763654 TI - Adrenergic and dopaminergic regulation of circulating beta-endorphin-like immunoreactivity in hypertension. AB - The central alpha-2-adrenergic receptor agonist, clonidine (300 micrograms daily) significantly increased the plasma beta-endorphin-like immunoreactivity (beta ELI) in 12 patients with mild to moderate essential hypertension in a randomized, crossover study. A significant linear correlation between the increase in plasma beta ELI and the decrease in blood pressure (both systolic and diastolic) was found after clonidine administration. The role of the reduced central sympathetic tone, induced by alpha-2-adrenoceptor stimulation, in the elevation of circulating beta ELI can be suggested. The plasma beta ELI increased also significantly after the dopaminergic D-2 receptor agonist, bromocryptine treatment, (5 mg, daily) in 13 patients with borderline and mild essential hypertension in a randomized, crossover study. A significant drop in circulating noradrenaline and in arterial blood pressure and a significant linear correlation between the changes of plasma noradrenaline level and blood pressure was found after bromocryptine administration. There was no correlation between the rise in plasma beta ELI and the decrease in blood pressure after bromocryptine. The importance of the central sympathetic activity and not only a direct pituitary dopaminergic agonist effect on the beta-endorphin secretion can be stressed in the effect of bromocryptine on the immunoreactive beta-endorphin level. PMID- 1763655 TI - Characterization of the nuclear factors involved in 202 gene induction by IFN alpha in NIH-3T3 cells. AB - When treated with IFN-alpha, NIH-3T3 cells express after a few hours high levels of the mouse 202 gene mRNA. This activation takes place at the transcriptional level as shown by nuclear "run on" assay. For this purpose a fragment of 806 base pairs (the b fragment), spanning the 5'-flanking region of the 202 gene, was linked to the reporter CAT gene and transiently transfected into mouse NIH 3T3. The data suggest that the b fragment is sufficient to confer transcriptional inducibility upon IFN stimulation and can account in large part for the response of the 202 gene. Binding assays, using a 40-bp probe derived from the IFN stimulated response element (ISRE) comprised in the b fragment, demonstrated the presence of two DNA-binding proteins. One of these, defined as complex A, was inducible upon IFN treatment, whereas the other, defined as complex B, was constitutively present regardless of IFN treatment. The IFN-alpha-induced complex A appears to have the necessary characteristics to be the transcriptional activator of the 202 gene: it requires the same nucleotides for binding as are required for IFN-dependent gene activation and is dependent on IFN-alpha treatment. PMID- 1763656 TI - Cell type-specific expression of the human renin gene. AB - We have previously produced transgenic mice carrying the human renin gene, whose expression is regulated in a tissue-specific manner. In the present study, we further characterized expression of the transgene. Northern blot analysis showed that the human renin gene is expressed in the kidney but not in the liver of two lines of transgenic mice with 10 and 50 copies of the transgene, suggesting that the integrated copy number of the human renin gene does not influence the dominant-renal expression pattern. Immunohistochemical study using a monoclonal antibody specific for human renin demonstrated that expression of human renin in the transgenic mouse kidney is confined to the epithelioid juxtaglomerular cells. Transfection experiments indicated that the chloramphenicol acetyltransferase fusion gene containing the 3-kb upstream sequences of the renin gene is activated only in human epithelioid embryonic 293 cells derived from kidney but not in human HepG2 cells from liver. These findings suggest that transfer of the cloned renin gene into mice and in vitro cultured cell lines can give rise to cell type specific expression. PMID- 1763657 TI - Lack of specificity in the mechanisms involved in the enhancement of the concanavalin A driven human T lymphocyte stimulation by beta-endorphin: studies on activation marker expression, cell cycle and interleukin release. AB - We report on the effects of a physiological concentration of Beta-Endorphin (BE) (10(-12)M) on Concanavalin A (ConA) stimulated human peripheral blood T lymphocytes and monocytes. We evaluated the effect of timing of BE addition to the culture medium on thymidine uptake, the kinetics of expression of activation markers (CD69, CD25 and CD71) on CD4+ and CD8+ lymphocytes, and of class II MHC antigens on CD14+ cells (monocytes), the kinetics of interleukin-1 (IL-1), interleukin-2 (IL-2) and interferon gamma (IFN-gamma) release, and the cell cycle. Data show that BE is able to influence T lymphocyte only when added together with ConA at the beginning of culture, suggesting its major activity is on the early phases of the T cell response. BE did not increase the amount of class II MHC antigens on monocytes and did not preferentially stimulate CD69, CD25 and CD71 antigen expression on either CD4+ or CD8+ lymphocytes. After 24 hours, the relative proportions of CD4+ and CD8+ lymphocyte in S and G2-M phases were not affected by BE, although the opioid did augment the number of cells in the proliferative compartments of the cell cycle, S and G2-M, indicating an actual increase in the number of cells committed to proliferation. BE did not consistently influence the amount of IL-1, IL-2 and IFN-gamma found in the supernatant of ConA stimulated cultures. The mechanism of the enhancing effect on the proliferative response of normal human lymphocytes to ConA by BE, does not seem to be selective for or unique to specific lymphocyte subsets. PMID- 1763659 TI - Proceedings of the NIH Consensus Development Conference on diagnosis and management of asymptomatic primary hyperparathyroidism. Bethesda, Maryland, October 29-31, 1990. PMID- 1763658 TI - Modulation of proliferation, estradiol receptors and estrogen regulated protein PS2/BCEI in human breast cancer cell lines by gamma interferon. AB - The effects of recombinant gamma interferon (IFN gamma) on proliferation, estrogen-receptor (ER) content, mRNA level and protein secretion of a breast cancer estrogen-induced protein pS2/BCEI were investigated in two human breast cancer cell lines, ZR75-1 and T47D. Both cell lines have estrogen and progesterone receptors and previously showed HLA class I and class II responses to IFN gamma (Int J Cancer 1990; 45: 1169). An antiproliferative effect of IFN gamma (1000-5000 U/ml) was observed in serum containing medium on ZR75-1 but not on T47D cells. Noninhibitory concentration of IFN gamma (100 U/ml) had sensitising antiproliferative effect with antiestrogens on ZR75-1 cells whereas IFN gamma did not modify the growth inhibition observed in T47D cells with antiestrogens. In serum-free, estradiol-free, phenol-red-free chemically defined medium (Cancer Res 1984; 44: 4553), IFN gamma abolished in ZR75-1 but not in T47D the 30% growth stimulation induced by estradiol. In ZR75-1 cells, IFN gamma induced a transitory 30-50% increase of ER content, as measured by ER enzymoimmunoassay, at day 2 of culture, and reduced mRNA level and secretion of pS2/BCEI. In T47D cells, a 30-50% decrease of ER content was observed but only when cells were long term cultured (30 weeks) with IFN gamma. In this cell line, no transcription of pS2/BCEI was observed. Antiproliferative action of IFN gamma on ZR75-1 cells is associated with an inhibition of estradiol effects and a reduction of pS2/BCEI mRNA level and protein secretion. PMID- 1763661 TI - Longitudinal studies of mild primary hyperparathyroidism. AB - In 1969, a health survey was offered to all inhabitants of a town district in Sweden. A clinical examination was carried out, and among other variables, a measurement was made of serum calcium. The same procedure was repeated in 1971. From these two investigations a cohort of 176 individuals (1.1%) with sustained hypercalcemia was identified who could be followed during the subsequent 15 years. Comparisons were made with an age- and sex-matched control group from the same health survey. Survival was significantly lower in the hypercalcemic cohort than in the control group. This reduction was related to the degree of hypercalcemia and apparently mainly due to diseases of the circulatory organs. There was no marked deterioration of renal function, and although there was in some patients a moderate progression of the hypercalcemia, none developed a hypercalcemic crisis during 15 years of follow-up. In consecutively referred patients with primary hyperparathyroidism, psychiatric disturbances of mainly a depressive character were found upon detailed analysis within a majority of the patients, and parathyroid surgery resulted in a clear improvement in mental health. PMID- 1763660 TI - Asymptomatic primary hyperparathyroidism. AB - Of 118 consecutive white patients referred for asymptomatic primary hyperparathyroidism, the diagnosis was clinically confirmed in 100, of whom 85 adults had a serum calcium less than 3.0 mM (12 mg/dl) and no skeletal, rheumatic, or significant neuropsychiatric symptoms, azotemia, or other significant illnesses. Among these 85, 68 had both asymptomatic and medically uncomplicated hyperparathyroidism, whereas 17 had historical, radiographic, or ultrasonic evidence of renal stone disease. The 20% with past or present renal calculi concentrated their urine significantly better than the 68 others (p = 0.05), but these two groups were otherwise not distinguished by the tests we performed, so all 85 patients were analyzed together. Systolic and diastolic blood pressures were normal, but premature osteopenia and/or impaired renal function were present in 29-36% of the patients. Micrometer measurements of metacarpal radiographs and 125I photon absorptiometry at the shaft of the radius revealed cortical osteopenia. Osteopenia was equally significant in the distal radius (cortical plus trabecular bone). These quantitative measurements were superior to routine bone radiography, and ROC analysis showed that 125I absorptiometry at either site was superior (p less than 0.01) to metacarpal cortex measurements for detecting premature osteopenia, which was present in more than a third of these patients. Creatinine clearances (24 h) and maximum urine concentrating capacity (overnight dehydration plus the synthetic vasopressin analog DDAVP) were each significantly reduced, despite all patients' normal BUN and serum creatinine levels. Sequential performance of a 24 h creatinine clearance and a urine concentration test revealed abnormalities in the renal function of 27 of 74 patients (36%), with a specificity of 95% and a higher sensitivity than either test alone (27-29%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1763662 TI - Conservative management of primary hyperparathyroidism. AB - The personal management of patients seen with primary hyperparathyroidism over the past 10 years has been reviewed; 248 cases were identified of which 122 have been managed conservatively. These patients were mainly asymptomatic. Apart from 4 who developed renal stones, which were spontaneously passed, there was no clinical or biochemical evidence that patients sustained adverse consequences by conservative management. These studies support the need for further studies of the conservative management of asymptomatic hyperparathyroidism. PMID- 1763663 TI - Estrogens and progestins in the management of primary hyperparathyroidism. AB - One of the common dilemmas in clinical endocrine practice is the management of patients with hyperparathyroidism (HPT) who either cannot or will not undertake definitive surgical treatment. Therapeutic decisions would be simplified by the availability of a nonsurgical approach to control biochemical abnormalities and forestall the consequences of this condition. In the short term, oral phosphorus salts can be safe and effective. For chronic therapy, only estrogens and progestins have been examined in sufficient detail to merit discussion. Estrogens normalize serum and urinary calcium in the majority of older women with HPT. Biochemical control is generally maintained for as long as patients continue treatment. The data support the view that estrogen inhibits the actions of PTH, particularly on bone, but does not reduce the abnormal PTH secretion. Androgenic progestins may also lower serum and urinary calcium in HPT, but current data suggest that normalization of serum calcium levels is more likely to occur with estrogen. Although reduction in urinary calcium excretion should prove effective in preventing nephrolithiasis, it is unclear whether hormone therapy provides protection against fracture. Whether or not hormone replacement is prescribed, nonsurgical management requires a highly committed patient who is willing to undergo extensive and prolonged follow-up. PMID- 1763664 TI - Medical management of asymptomatic primary hyperparathyroidism. AB - Patients with mild asymptomatic primary hyperparathyroidism who do not meet currently accepted guidelines for surgery may be followed medically. General medical management of these individuals should be directed toward maintaining adequate hydration, therapy of hypertension, and avoiding immobilization. Diuretics should be used only with caution. Moderate dietary calcium intake (500 800 mg/day) should be encouraged. Propranolol and cimetidine are not useful in the therapy of primary hyperparathyroidism. Oral phosphate is efficacious in lowering serum and urinary calcium. However, because of concerns related to ectopic calcification, phosphate is usually reserved for those patients who meet surgical guidelines but who are not to undergo surgery. Bisphosphonates, potent inhibitors of osteoclast-mediated bone resorption, have been shown to lower serum and urinary calcium in patients with primary hyperparathyroidism. However, long term data on their efficacy in this disorder are not yet available. The use of bisphosphonates at the present time is generally restricted to the research setting. More potent bisphosphonates as well as the design of newer agents that interfere with parathyroid hormone secretion may become very useful in future approaches to the medical management of primary hyperparathyroidism. PMID- 1763665 TI - Diagnosis and management of asymptomatic hyperparathyroidism: safety, efficacy, and deficiencies in our knowledge. AB - Several recent articles question whether patients with asymptomatic hyperparathyroidism and minimal hypercalcemia should be treated by parathyroidectomy. We therefore reviewed our experience in 103 consecutive patients with primary hyperparathyroidism who were treated by parathyroidectomy to determine, first, how many of these patients had asymptomatic or symptomatic hyperparathyroidism, and second, did these patients benefit from parathyroidectomy? We also analyzed the safety of parathyroidectomy in 426 consecutive patients, including 79 who required reoperation for hyperparathyroidism, specifically looking for complications and the outcome of these procedures. Our study documents the following: (1) only 2 of 103 (2%) patients referred for parathyroidectomy had "true" asymptomatic hyperparathyroidism; (2) only symptoms of fatigue, bone pain, and weight loss correlated with the degree of hypercalcemia, whereas muscular weakness, psychiatric symptoms, nocturia, polyuria, recent memory loss, constipation, and nephrolithiasis did not; (3) only 1 of 15 patients who were referred as asymptomatic were truly asymptomatic after more thorough questioning, and all 14 improved following parathyroidectomy; (4) 81% of the patients who were referred with symptoms improved following parathyroidectomy; and (5) permanent complications occurred in only 4 patients. All but 1 had reoperations for persistent or recurrent hyperparathyroidism (3 vocal cord paralyses and 1 hypoparathyroidism requiring autotransplantation of cryopreserved parathyroid tissue). There was 1 death of an 84-year-old woman with hypercalcemic crisis. Thus, most patients with hyperparathyroidism are symptomatic and benefit symptomatically and metabolically from parathyroidectomy, which is a safe operation. PMID- 1763666 TI - Surgical therapy of patients with primary hyperparathyroidism: long-term benefits. AB - Primary hyperparathyroidism was thought 30 years ago to be a rare disease, and the diagnosis was most often made in patients presenting with either bone disease or kidney stones. Today the minority of patients with hyperparathyroidism present with such symptoms, a fact accounted for by the introduction into general medical practice three decades ago of laboratory technology for efficiently determining the serum concentrations of various blood minerals, including calcium. Hypercalcemia was detected more frequently, and it was realized that most patients with hyperparathyroidism either had minor symptoms, such as constipation, polyuria, tiredness, and muscle weakness, or they were "asymptomatic" and indistinguishable from normal subjects. It was thought that primary hyperparathyroidism was a progressive disease and that sooner or later all patients would become symptomatic and require parathyroidectomy. Since this operation was curative in a high percentage of cases, it was recommended for virtually all patients once the diagnosis was established. In this contribution the long-term benefits of parathyroidectomy in patients with and without symptoms from primary hyperparathyroidism are reviewed. It is concluded that a multicenter prospective randomized trial is needed to resolve the indications for operative and nonoperative management of patients with this disease. PMID- 1763667 TI - Pathophysiology of primary hyperparathyroidism. AB - Primary hyperparathyroidism (PHPT) is characterized by hypersecretion of parathyroid hormone (PTH) leading to hypercalcemia and relative hypophosphatemia. PTH acts by binding to cell surface receptors coupled to G proteins. Cyclic AMP is the classic second messenger of PTH action, but substantial evidence indicates that PTH also acts to stimulate formation of the dual second messengers, inositol trisphosphate and diacylglycerol, thereby mobilizing intracellular calcium. The physiologic actions of PTH include (1) an increase in extracellular fluid ionized calcium through direct actions on kidney and bone, the classic target organs for PTH, and (2) a decrease in extracellular fluid phosphate primarily through renal action. The pathophysiologic effects of PTH arise from (1) direct actions of PTH on bone and kidney, and possibly on nonclassic target organs, and (2) indirect effects of altered mineral homeostasis. PTH hypersecretion in PHPT can lead to bony demineralization, nephrolithiasis, and hypercalcemic crisis. PHPT may also be associated with mental disturbances, neuromuscular disease, hypertension, and glucose intolerance. PMID- 1763668 TI - Localization of parathyroid tumors in patients with asymptomatic hyperparathyroidism and no previous surgery. AB - A number of recently published series were reviewed evaluating noninvasive localizing studies (ultrasound, thallium-technetium subtraction scintigraphy, computed tomography, and magnetic resonance imaging) in patients with primary hyperparathyroidism and no previous surgery. The average true positive (%) and false positive (%) rates were (1) ultrasound, 66 and 12; (2) Th/Tc scanning 55 and 13; (3) computed tomography, 63 and inadequately documented; (4) magnetic resonance imaging, 75 and 18. The success rate of initial operation in this group of patients is over 90%. There is no evidence that preoperative localizing studies shorten operating time or prevent surgical failures. For these reasons, noninvasive localization studies are not indicated in patients with primary hyperparathyroidism before initial surgery. PMID- 1763669 TI - Epidemiology of primary hyperparathyroidism. AB - The impact of primary hyperparathyroidism (HPT) on the population has not been well documented, and even less information is available for asymptomatic HPT. Only 57 deaths were attributed to the condition in the United States in 1986, for a reported HPT death rate of 0.24 per million per year. Many more patients were affected, however, and the incidence of hospitalization for HPT was 6.6 per 100,000 in 1986, counting all listed diagnoses, and 2.9 per 100,000 counting only first-listed diagnoses. Surgery was performed on approximately 10,000 hospitalized patients in the United States in 1986, for a parathyroidectomy rate of about 4.2 per 100,000 per year. When nonhospitalized cases are included, the rates are even higher. The estimated annual incidence of HPT was 42.1 per 100,000 in Rochester, Minnesota in 1974-1976; the prevalence of HPT was 4.3 per 1000 in a population survey in Sweden. By any of these measures, HPT is more common in women than men and increases with aging in both sexes. The potential cost of HPT could be as high as $420 million/year in the United States, but no formal estimates have been made. Disability related to HPT or its treatment has not been quantified; randomized clinical trials to determine the utility of parathyroidectomy have not been performed; and no assessment of cost benefit or cost effectiveness of any therapeutic modality has been carried out. Until patient management and cost issues are resolved, it is premature to consider an aggressive program to screen the general population for HPT. PMID- 1763670 TI - Differential diagnosis of hypercalcemia. AB - The differential diagnosis of hypercalcemia has expanded to over 25 separate disease states, with primary hyperparathyroidism and malignancy accounting for 80 90% of all hypercalcemic patients. Primary hyperparathyroidism comprises the majority of hypercalcemic patients among the ambulatory population, but malignancy accounts for up to 65% of such patients in the hospital. Factors favoring primary hyperparathyroidism include a family history of hyperparathyroidism or multiple endocrine neoplasia, a history of childhood radiation to the head and neck, the postmenopausal state, a history of renal calculi or peptic ulcer, hypertension, the induction of hypercalcemia by thiazides, or an asymptomatic patient with a prolonged, stable mild hypercalcemia. The usefulness of the serum calcium, parathyroid hormone, chloride, phosphorus, serum 25-OHD, and 1,25-(OH)2D, and urinary calcium in the differential diagnosis of hypercalcemia is discussed. The pitfalls of an excessive reliance on the serum PTH in diagnosing hyperparathyroidism are stressed. The discriminant values of the serum calcium, chloride, phosphorus, and parathyroid hormone are explored, with the serum parathyroid hormone, chloride, and calcium proving most useful in separating primary hyperparathyroidism from other forms of hypercalcemia. Multivariate discriminant analysis using the serum calcium, phosphorus, and chloride and the hematocrit achieves an accuracy of 95 98% and is the most economical method of identifying hyperparathyroidism. The addition of the amino-terminal or intact PTH assay increases the accuracy to 99% and is essential in the presence of renal insufficiency. PMID- 1763671 TI - Clinical spectrum of primary hyperparathyroidism: evolution with changes in medical practice and technology. AB - Over the last 25 years, the perceived clinical spectrum of primary hyperparathyroidism (HPT) has changed dramatically from a disorder characterized by severe bone and renal disease to one typically manifested by few or mild symptoms and little evidence of organ damage. Reasons for this change in spectrum include changing demographics (primary HPT is primarily a disease of the middle aged and elderly), diffusion of medical knowledge leading to a higher index of suspicion, and improved clinical laboratory technology (especially inexpensive and accurate determination of serum calcium and parathyroid hormone). In the first 343 cases of primary HPT seen at the Massachusetts General Hospital, 57% had renal stones, 23% had hyperparathyroid bone disease, and less than 1% had no symptoms. By contrast, studies dating from the availability of automated serum calcium measurement found renal stones and hyperparathyroid bone disease in less than 5% of cases, and about half of cases had few or no symptoms. Most patients with primary HPT today have mild, nonspecific symptoms, such as weakness, fatigue, and mental depression, and such signs as arterial hypertension and osteopenia, and detection of their hypercalcemia is generally serendipitous. The mildness and slow progression seen in many cases of primary HPT has resulted in much controversy about appropriate management. PMID- 1763672 TI - Methods of determining bone mass. AB - Bone disease is one of the most important clinical manifestations of primary hyperparathyroidism. Recent studies have shown that the loss of bone in "modern" hyperparathyroidism is not homogeneous throughout the skeleton. Whereas measurements of the spine and the trabecular portion of iliac crest are normal or even slightly increased, the wrist and the cortical bone of the iliac crest are significantly lower than expected. Thus, knowledge of the percentage of trabecular bone at each measurement site is important. These include distal radius, 80%; midradius, 5%; vertebrae, 19-25%; vertebral body, 33-42%; and femoral neck, 43%. Knowledge of the precision and its relationship to ranges and rates of change of bone mass are essential. For an individual, the bone mass should change by 2.8 times the precision before one can determine with 90% confidence that the change was real, not due to measurement error. Noninvasive methods of measuring bone mass that are commercially available include single- and dual-photon absorptiometry, quantitative computed tomography, and dual-energy x-ray absorptiometry. The precision of these techniques varies, with the best values reported using dual-energy x-ray absorptiometry. Research should be done to describe more completely the patterns of bone loss in this disease, including longitudinal studies on rates of loss at different skeletal sites. Studies that relate the bone mass at a particular site to fractures must be done in populations with hyperparathyroidism to see if the risk of fracture is similar to the risk in normal or osteoporotic individuals. PMID- 1763673 TI - Interpretation of bone mass determinations as they relate to fracture: implications for asymptomatic primary hyperparathyroidism. AB - Determination of bone mass is currently the most clinically useful measurement of bone strength and of fracture risk. Interpretation of bone mass determination as it relates to fracture has been developed largely from studies of age-related bone loss. A decrease in bone mass and an increase in fracture incidence with aging are universal phenomena that are causally related by virtue of the major contribution bone mass makes to skeletal strength. Over 70% of the skeleton's strength to resist fracture resides in its mineral content in vitro. Clinically, the relationship between trauma and fracture is complex, and in the general population, fracture appears as a random event occurring more frequently as bone mass decreases. In the individual, measurement of bone mass in relation to the range of bone mass and the fracture incidence of the reference population provides an estimate of the risk of sustaining a fracture in the future. In primary hyperparathyroidism, interpretation of a bone mass determination must take into account the effect of the disease activity on the skeleton against the background of universal age-related changes in bone mass and fracture incidence. This general relationship is likely to be altered by at least three unique effects that parathyroid hormone may have on the skeleton: (1) parathyroid hormone has a differential effect on cortical and cancellous bone; (2) it has a biphasic effect on bone that is concentration dependent; and (3) it alters bone quality and architecture.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1763674 TI - Consensus development conference statement. PMID- 1763675 TI - Longitudinal changes in forearm bone mineral content in primary hyperparathyroidism. AB - Forearm bone mineral content was measured in 28 patients with primary hyperparathyroidism before and 1 year after successful parathyroidectomy. The forearm bone mineral content rose from a mean value of 1.068 to 1.092 g/cm (P less than 0.05, paired t-test). Those patients with the lower initial values had the largest rise. In an additional study, the forearm bone mineral content was measured in 10 women over the age of 40 years (mean age 58.6 +/- 7.9SD years) with hyperparathyroidism before and for 2 years after successful parathyroidectomy and compared with the forearm bone mineral content measured over 2 years in 12 women (mean age 56.3 +/- 5.5SD years) with continuing hyperparathyroidism and with the forearm bone mineral content of 12 eucalcemic control women (mean age 58.8 +/- 8.2SD years), also measured over 2 years. The parathyroidectomized group gained bone, whereas the ongoing hyperparathyroid group and the eucalcemic control group lost bone. The difference between the parathyroidectomized group and the ongoing hyperparathyroid group was significant after 2 years (P less than 0.05). The percentage loss of forearm bone mineral in the eucalcemic control subjects was not significantly different from the percentage loss of forearm bone mineral in the ongoing hyperparathyroid group, although the initial mean bone mineral content in the eucalcemic group was significantly higher than in the ongoing hyperparathyroid group, suggesting that a possible determinant of bone mineral loss in women in this age group is the initial bone mineral content. PMID- 1763676 TI - Asymptomatic primary hyperparathyroidism discovered by multichannel biochemical screening: clinical course and considerations bearing on the need for surgical intervention. AB - The sustained effects of biochemical screening to increase both apparent incidence and age at diagnosis indicate that, without screening, most patients with primary hyperparathyroidism would would never be diagnosed. This suggests that asymptomatic patients discovered as a result of screening have a nonprogressive form of the disease, with adverse health effects that are few or nontraditional, for which treatment policies validated only in symptomatic patients may be inappropriate. Accordingly, in 1975 we formulated criteria for withholding surgical treatment from such patients. Of 174 who were eligible for study over a 10 year period, clinical, biochemical, and densitometric assessment was repeated after at least 1 year (mean 52 months) in 106 patients who did not differ in any initial characteristic from 68 patients in whom follow-up was inadequate. There was no change in symptoms, no disease complications, and no change in any index of hormone secretion or disease severity. In 30 patients, individual regression slopes against time were not significant for any serum measurement. In these patients the disease appeared to have stopped progressing by the time the diagnosis was made, most likely because of cessation of tumor growth. There was a significant deficit in appendicular cortical bone at the time of diagnosis but no further acceleration of bone loss thereafter. In an earlier study, surgical cure was followed by a modest increase in forearm bone density for the first 6 months, but even after 3 years only about 20% of the deficit was corrected. The deficit in bone density is smaller in the spine than in the forearm and is not accompanied by any increase in vertebral fracture risk.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1763677 TI - The carotid endarterectomy: experience with 260 cases and discussion of the indications. AB - During 1978 to 1989, 235 patients were operated upon with 260 procedures for cervical carotid endarterectomy. The patients were classified according to the presence or absence of ischaemic symptomatology, and for symptomatic patients, according to the reversibility or persistence of ischaemic symptoms. So the selection of patients was: reversible ischaemia 46%, stroke 29%, asymptomatic patients 25%. In the stroke group, no patient was operated on as an emergency, the endarterectomy was only performed after stabilization of the clinical state. Three subgroups were included in patients operated on for asymptomatic carotid stenosis: casual discovery 40%, treatment of the second carotid artery (previous endarterectomy for symptomatic contralateral stenosis) 34%, and treatment of the second carotid artery (previous ECIC by-pass for contralateral carotid occlusion) 26%. All patients were operated upon after angiographic exploration (femoral catheterisation in most cases), and after cerebral CT scan. The surgical technique included general anaesthesia, systematic shunting, endarterectomy after longitudinal arteriotomy, closure without patch. The operating microscope has been used since 1985. The surgical results were studied in terms of uneventful postoperative course (87%), reversible complications (8%) and long lasting complications (5%). The long lasting complications were of local origin (1%), of neurological origin (2%), of general origin (1%). Overall the operative outcome at 6 months was: return to previous clinical state 95%, neurological sequelae 2%, death 3%. In the patients operated on for asymptomatic carotid stenosis the overall outcome was: previous clinical state 97%, death 3%. The legitimacy of carotid endarterectomy procedure is discussed in relation to some recent pertinent literature. PMID- 1763678 TI - Treatment of proximal vertebral artery stenosis. Vertebral to subclavian transposition. AB - For vascular reconstruction in cases of atherosclerotic stenosis at the origin of the vertebral artery, we use vertebral to subclavian artery transposition. We discuss the advantages and effectiveness of such treatment based on a study of 32 cases. We have experienced neither surgical mortality nor morbidity and the outcome at the time of discharge has been favourable. Follow-up revealed no deaths, however, three cases exhibited symptoms of cerebral ischaemia. One had a supratentorial completed stroke, and the other two hat TIA or RIND, but without any notable lesion in the angiograms. There were no cases of cerebral infarction of the posterior fossa. We believe that this method should be the first choice for treatment of cases without lesions of the subclavian artery for the following reasons: serious operative complications have not been encountered, surgical invasion is minimal, temporary occlusion of the common carotid artery is unnecessary, the operation can be done by occluding only the vertebral artery, and unlike various bypass operations, anastomosis is required at only one location and is consequently technically uncomplicated. Following anastomosis the cerebral blood pathway is physiological. PMID- 1763679 TI - Reversal of oculomotor disorders after intracranial aneurysm surgery. AB - Forty-nine patients with oculomotor nerve palsy due to intracranial aneurysm were examined. The reversal of third nerve palsy is related to modality of onset and surgical timing: "early" surgery (within 14 days from the onset of oculomotor palsy) promises a better prognosis for ocular function; recovery starting within the first month will probably be complete. A full recovery is probably seen only with conduction block (neuroapraxia) or minor axonal changes (axonolysis). Clinical features of third nerve palsy due to intracranial aneurysms versus other causes of oculomotor palsy are discussed. PMID- 1763680 TI - Cyclosporine A prevents neurological deterioration of patients with SAH--a preliminary report. AB - In the present study we found that the neurological outcome in patients anaesthetized for early clipping (up to 72 h after SAH) of a ruptured aneurysm and treated with cyclosporine A was significantly better than the neurological state of control patients without immuno-suppressive treatment. The results justify the presumption that auto-immune reactions are involved in the deterioration of the postoperative neurological state of patients with SAH after rupture of an intracranial aneurysm. Supplementing a standard surgical and pharmacological treatment with cyclosporine A seems to reduce the undesirable neurological consequences of the immunologically, induced vascular disturbance after SAH. PMID- 1763681 TI - Effect of continuous cisternal drainage on cerebral vasospasm. AB - The effect of continuous cisternal drainage on cerebral vasospasm was studied under strict criteria in 140 patients with ruptured intracranial aneurysms. The degree of subarachnoid haemorrhage (SAH) on the computed tomography scan was graded from I to IV. The patients were classified according to the total amount of cisternal drainage into three groups, regardless of the duration of the drainage and whether or not it was accompanied by irrigation; i.e., those with less than 500 mL (group 1: 57 cases), those with 500-3000 mL (group 2: 44 cases), and those with 3000-9500 mL (group 3: 39 cases). While correlations could be found between both clinical and SAH grades with the severity of vasospasm, closer correlation could be found in the SAH grades. In analyzing the cases with subarachnoid haemorrhage grades III-IV (severe clots), the angiographic vasospasm was less severe in groups 2 and 3 than in group 1, and the incidences of permanent symptomatic vasospasm and low-density area on computed tomography were lower in groups 2 and 3 than in group 1. Regarding the surgical outcome in cases with SAH grades III-IV, the mortality rate was lower in groups 2 and 3 (22% and 19%) than in group 1 (33%). Further, the rate of good recovery was higher in groups 2 and 3 (61% and 57%) than in group 1 (28%). However, there were no differences between groups 2 and 3 in cerebral vasospasm or in surgical outcome. As a shortcoming of continuous cisternal drainage, the need for shunt operation was higher in groups 2 and 3 than in group 1. PMID- 1763682 TI - Lateral ventricular arteriovenous malformations: natural history and surgical indications. AB - The authors report 21 cases of lateral ventricular arteriovenous malformation (AVM) focusing on their natural history and surgical indications. Eighteen of 21 patients (86%) had bleedings prior to admission. We performed definitive surgery in 9 patients and conservative treatment in 12 patients. In 7 of 9 patients (78%) in the operative group and in 5 of 12 patients (42%) in the non-operative group, the nidus of the AVM was less than 4 cm in diameter. The other 2 AVMs in the operative group, more than 4 cm in diameter, were located in the temporal lobe and widely extended to the temporal horn of the lateral ventricle. The nidi of the AVMs were totally removed in all 9 cases in the operative group. All patients have been doing well except one who had a mental breakdown 6 years after surgery. In 10 patients in the non-operative group, AVMs were located in the left cerebral hemispheres. Three patients in the non-operative group had rebleeding of the AVM. Two of the 12 patients in the non-operative group (17%) died of the recurrent haemorrhages. The rate of bleeding of the lateral ventricular AVM seems to be higher than that of the cerebral cortical AVM, but the mortality due to recurrent bleeding might be similar between the two. The operative indications we made depended on the sizes and locations of the AVMs. For AVMs in the temporal horn, even though they were large, we performed total removals of the nidi and had good results. We did not perform any definitive surgery for AVMs more than 4 cm in diameter except for those in the temporal horn. The mortality and morbidity of the 21 cases were 10% and 14%, respectively. Patients with AVMs in the temporal horn and patients with small AVMs in the frontal horn were good candidates for definitive surgery. We undertook conservative treatment for patients with large AVMs, and the results were acceptable. PMID- 1763683 TI - Visual evoked potentials in optic nerve injury. Does it merit a mention? AB - The value of Visual Evoked Potentials (VEP) in the management of indirect optic nerve injury was prospectively studied in 128 patients. In fifty patients who were either unconscious, uncooperative or had massive black eye, preventing the assessment of vision, a light Emitting Diode (LED) was used to record visual evoked potentials. The initial VEPs were normal in 17, abnormal in 49 and absent in 62. All 17 patients with normal VEP showed visual recovery. Amongst the 49 patients with abnormal VEP, 43 (88%) showed improvement. In 62 patients, initial VEPs showed no response but, in 12 subsequent VEP recordings wave formation was demonstrated. Thus in 50 patients repeated VEP recordings failed to demonstrate wave formation, and none of them improved. This study, thus brings out the high predictive value of both positive and negative VEPs, and specially the role of LED. PMID- 1763684 TI - Reappraisal of the intracranial pressure and cerebrospinal fluid dynamics in patients with the so-called "normal pressure hydrocephalus" syndrome. AB - Fifty-four shunt-responsive patients were selected from a prospective protocol directed to study patients with suspected normal pressure hydrocephalus (NPH). Patients with gait disturbances, dementia, non-responsive L-Dopa Parkinsonism, urinary or faecal incontinence and an Evans ratio greater or equal to 0.30 on the CT scan were included in the study. As a part of their work-up all patients underwent intracranial pressure monitoring and hydrodynamic studies using Marmarou's bolus test. According to mean intracranial pressure (ICP) and the percentage of high amplitude B-waves, patients were subdivided in the following categories: 1) Active hydrocephalus (mean ICP above 15 mmHg), which is in fact no tone normal pressure hydrocephalus; 2) Compensated unstable hydrocephalus, when mean ICP was below 15 mmHg and B-waves were present in more than 25% of the total recording time and 3) Compensated stable hydrocephalus when ICP was lower or equal to 15 mmHg and beta waves were present in less than 25% of the total recording time. The majority of the patients in this study (70%) presented continuous high or intermittently raised ICP (active or unstable compensated hydrocephalus group). Mean resistance to outflow of CSF (Rout) was 38.8 mm Hg/ml/min in active hydrocephalus and 23.5 mm Hg/ml/min in the compensated group (Students t-test, p less than 0.05). Higher resistance to outflow was found in patients with obliterated cortical sulci and obliterated Sylvian cisterns in the CT scan. No statistically significant correlation was found when plotting the percentage of beta waves against pressure volume index (PVI), compliance or Rout. An exponential correlation was found when plotting beta waves against the sum of conductance to outflow and compliance calculated by PVI method (r = 0.79). Patients with the so-called normal pressure hydrocephalus syndrome have different ICP and CSF dynamic profiles. Additional studies taking into consideration these differences are necessary before defining the sensitivity, specificity and predictive value of ICP monitoring and CSF studies in selecting appropriate candidates for shunting. PMID- 1763685 TI - "Standard" microsurgical lumbar discectomy vs. "conservative" microsurgical discectomy. A preliminary study. AB - The "conservative" microsurgical lumbar discectomy described by Williams for the treatment of herniated lumbar disc is compared in a retrospective study with the standard microsurgical technique of Caspar and Loew. In order to enable such a retrospective comparison, a special randomization had to be chosen. The data concerning outcome are based on a questionnaire, in which the patient can describe his actual health situation. The result in the group of 56 patients operated on by the Williams technique with a mean follow-up of 27 months is excellent or good in 89% vs. 74% in the standard technique group. Reoperations due to a recurrence were identical in both groups (3.6% and 3.9%). PMID- 1763686 TI - The results of "lumbar disc surgery" following unsuccessful chemonucleolysis. AB - A group of 100 patients submitted to microsurgical treatment for herniated lumbar disc following unsuccessful chemonucleolysis with chymopapain were retrospectively compared to a statistically comparable group of patients primarily submitted to microsurgery. This comparison demonstrated that previous unsuccessful chemonucleolysis has no influence on either the short-term or the long-term results of subsequent microsurgery. PMID- 1763687 TI - The value of different methods of treatment of brain abscess in the CT era. PMID- 1763688 TI - Factors associated with postoperative hypertension complicating carotid endarterectomy. AB - Blood pressure lability following carotid endarterectomy is a commonly observed phenomenon. Distinct hypertensive and hypotensive responses exist. Unlike postoperative hypotension, the etiology of postoperative hypertension remains unclear. In order to examine factors associated with hypertension following carotid endarterectomy, 100 carotid endarterectomies were examined retrospectively. The variables evaluated included pre- and postoperative blood pressure, age, sex, race, the use of an indwelling shunt, and complications. Postoperative hypertension (defined as systolic blood pressure greater than or equal to 200 mm Hg, diastolic blood pressure greater than 100 mm Hg, or any BP requiring intravenous infusion of antihypertensive agents for control), was observed in 35% of all patients. Postoperative hypertension was significantly associated with both preoperative systolic and diastolic blood pressure elevation, as well as the use of indwelling shunts. Increased age and race (black) were also associated with an increased incidence of postoperative hypertension. No correlation existed with respect to postoperative complications. In view of an observed lack of correlation with postoperative complications, a cautious and conservative therapeutic approach must be undertaken for postoperative hypertension. It is suggested that, perhaps, the utilization of transcutaneous doppler evaluations may be useful for assessing the clinical significance of postoperative hypertension. PMID- 1763689 TI - Halothane inhibits binding of calcium channel blockers to cardiac sarcolemma. PMID- 1763690 TI - Contribution of the known subcellular effects of anesthetics to their negative inotropic effect in intact myocardium. AB - The results of these studies suggest that halothane, in addition to its effect of reducing the trans-sarcolemmal Ca2+ influx, has a direct effect on the function of the sarcoplasmic reticulum by making the organelle leaky to Ca2+ and reducing the amount of Ca2+ stored. Isoflurane, on the other hand, does not appear to make the sarcoplasmic reticulum leaky to Ca2+. In fact, our observations suggest that isoflurane makes the sarcoplasmic reticulum less leaky to Ca2+. Halothane may enhance the reduction in the myofibrillar response to activator Ca2+ when the muscle fiber length is shortened. Thiopental appears to reduce the trans sarcolemmal Ca2+ influx without reducing the amount of Ca2+ stored in the sarcoplasmic reticulum. PMID- 1763691 TI - Effects of volatile anesthetics on the intracellular Ca2+ concentration in cardiac muscle cells. PMID- 1763692 TI - Effects of volatile anesthetics on cardiac sarcoplasmic reticulum as determined in intact cells. PMID- 1763694 TI - The effects of volatile anesthetics on the calcium sensitivity of cardiac myofilaments. PMID- 1763693 TI - Alcohol and anesthetic actions on myocardial contractility. Evidence for a lipophilic/electrophilic sarcoplasmic reticulum site. PMID- 1763695 TI - Evidence for a halothane-induced reduction in maximal calcium-activated force in mammalian myocardium. PMID- 1763696 TI - Mechanisms of negative inotropy of halothane, enflurane and isoflurane in isolated mammalian ventricular muscle. PMID- 1763697 TI - Anesthetic effects on vascular smooth muscle. PMID- 1763698 TI - Effect of volatile anesthetic agents on endothelium-dependent relaxation. PMID- 1763699 TI - Isoflurane-, halothane- and agonist-evoked responses in pig coronary arteries and vascular smooth muscle cells. PMID- 1763700 TI - Mechanisms of action of anesthetics on inositol phospholipid hydrolysis in vascular endothelial cells and rat basophilic leukemia cells in tissue culture. PMID- 1763701 TI - Direct actions of volatile anesthetics on the coronary vasculature. PMID- 1763702 TI - Effects of volatile anesthetics on the coronary circulation in chronically instrumented dogs. PMID- 1763703 TI - Skeletal muscle targets for the action of anesthetic agents. PMID- 1763704 TI - Halothane-cooling contractures and regulation of the myoplasmic Ca2+ concentration in skeletal muscle. PMID- 1763705 TI - Why does halothane relax cardiac muscle but contract malignant hyperthermic skeletal muscle? AB - We have studied the question of the possible role of sarcoplasmic reticulum (SR) in the interaction of volatile anesthetics (such as halothane, enflurane and isoflurane) with muscle. We used two cardiac muscle models, i.e., isolated rat myocytes and Langendorff perfused rat hearts. We compared the results with those for skeletal muscle SR from rabbits, rats and pigs susceptible to malignant hyperthermia (MH). In both skeletal and cardiac muscle SR, volatile anesthetics enhanced the calcium release from the SR. In cardiac muscle, these agents are known to decrease contractility (negative inotropism). We found that caffeine, a well-known agent which releases calcium from the SR, also had a negative inotropic effect in cardiac muscle, raising the possibility of an unexpected link between the potentiation of calcium release and mechanism underlying the observed negative inotropism. Current understanding of anesthetic mechanisms does not include this possibility. We further found that both volatile anesthetics and caffeine decrease the content of calcium in the SR, suggesting that the increase of calcium permeability results in the decrease of calcium ions in the SR which are available for excitation-contraction (E-C) coupling. In MH-susceptible skeletal muscle, a similar increase in calcium permeability does not cause a decrease of contractility, but rather may contribute to a fatal syndrome of temperature increase provoked by abnormal contracture. This difference may be because in skeletal myoplasm calcium ions recycle internally, while in the cardiac muscle cell they are in dynamic equilibrium with extracellular calcium ions. PMID- 1763706 TI - Cardiac effects of anesthetics. PMID- 1763707 TI - Evolutionary genetics of fish. PMID- 1763708 TI - The genetics and molecular biology of zeste in Drosophila melanogaster. PMID- 1763709 TI - The structure and biogenesis of yeast ribosomes. PMID- 1763710 TI - Structural and lipid biochemical correlates of the epidermal permeability barrier. AB - As reviewed in this article, the stratum corneum must now be accorded the respect due to a structurally heterogeneous tissue possessing a selected array of enzymatic activity. The sequestration of lipids to intercellular domains and their organization into a unique multilamellar system have broad implications for permeability barrier function, water retention, desquamation, and percutaneous drug delivery. Yet, the functions and organization of specific lipid species in this membrane system are still unknown. Certain novel insights have resulted from comparative studies in avians and marine mammals. Further elucidation of the molecular architecture and interactions of lipid and nonlipid components of the stratum corneum intercellular domains will be a prerequisite for a comprehensive understanding of stratum corneum function. PMID- 1763711 TI - Lipid modulators of epidermal proliferation and differentiation. AB - The importance of lipids within the skin as components of the permeability barrier has been appreciated for quite some time. However, the more recent work reviewed here suggests numerous alternative bioactive functions for lipid molecules within the skin and other tissues. The precise roles of lipids in epidermal proliferation and differentiation have only begun to be studied and are far from being defined. PMID- 1763712 TI - Strategies to enhance permeability via stratum corneum lipid pathways. PMID- 1763713 TI - Lipids in normal and pathological desquamation. PMID- 1763714 TI - Chemistry and function of mammalian sebaceous lipids. PMID- 1763715 TI - The biochemistry and function of stratum corneum lipids. PMID- 1763716 TI - Integumental lipids of plants and animals: comparative function and biochemistry. PMID- 1763717 TI - Epidermal vitamin D metabolism, function, and regulation. PMID- 1763718 TI - The regulation and role of epidermal lipid synthesis. AB - One of the key functions of the epidermis is to form a barrier between the organism and the outside world. As shown in Fig. 3, disruptions of the barrier result in a cascade of events that ultimately leads to barrier repair. The initial signal that initiates this repair response is unknown. The exocytosis of preformed lipid-enriched lamellar bodies is the first step in this response, which is followed by an increase in lipid synthesis in the epidermis. Our studies demonstrate that this increase in epidermal lipid synthesis is required for the synthesis of new lamellar bodies and repair of the barrier. Inhibition of epidermal lipid synthesis by artificial membranes or drugs impairs barrier recovery by preventing the reformation of lamellar bodies and the continued secretion of lipid. Whether the stimulation of lipid synthesis is primarily regulated by disturbances in barrier function or secondarily by decreases in the lipid content of the cells due to the utilization of lipid for the formation of lamellar bodies is unknown. Additionally, the precise mechanisms by which lipid synthesis is increased (enzyme activation, transcriptional regulation, etc.) remain to be elucidated. The secretion of lipid-containing lamellar bodies results in the reaccumulation of lipid in the intercellular spaces of the stratum corneum and the recovery of normal barrier function. Epidermal lipid synthesis also is probably required to provide lipid for new cell membrane formation to allow for the increase in epidermal cell proliferation, which is stimulated following barrier disruption. Additionally, epidermal lipid synthesis may provide regulatory molecules or crucial substrates that are required for DNA synthesis. Thus, epidermal lipid synthesis plays a key role in the major biological functions of the epidermis, the cutaneous permeability barrier, and cell proliferation. PMID- 1763719 TI - Lipid metabolism in cultured keratinocytes. PMID- 1763720 TI - Experimental models in interventional neuroradiology. AB - Various experimental models have been developed to test interventional neuroradiologic techniques. Most have been used to test various devices and embolic materials, and a small number of models have been designed for teaching or training purposes. Experimental models in endovascular techniques have seldom been used to stimulate disease processes in order to facilitate their understanding. PMID- 1763721 TI - Improved detection of cerebral hypoperfusion with internal carotid balloon test occlusion and 99mTc-HMPAO cerebral perfusion SPECT imaging. AB - A new method that employs a cerebral perfusion imaging agent, 99mTc-HMPAO, is described for identifying those patients who clinically pass an internal carotid artery balloon test occlusion but who then may develop a cerebral infarction after permanent occlusion. Test balloon occlusion of the internal carotid artery was performed in 17 patients, and 99mTc-HMPAO was injected intravenously while the balloon was inflated. The balloon was deflated and removed approximately 15 20 min later, and single-photon emission CT (SPECT) imaging of the brain was performed. In patients with an area of focal hypoperfusion, the 99mTc-HMPAO study was repeated the next day to determine if the hypoperfusion was due to the temporary balloon occlusion or to a preexisting abnormality. All 17 patients had normal neurologic examinations at the time of the balloon test occlusion. Fifteen had symmetric perfusion on the 99mTc-HMPAO SPECT scans. Five of these had permanent internal carotid artery occlusion, and four did not develop a neurologic deficit. One patient developed an ipsilateral watershed infarction after internal carotid artery occlusion during significant intraoperative hypotension. Two patients had ipsilateral regions of hypoperfusion with the test occlusion. Both these patients had repeat nonocclusion 99mTc-HMPAO SPECT studies that were normal. One patient is being followed. The second patient had ipsilateral EEG changes associated with temporary intraoperative occlusion of the internal carotid artery during aneurysm surgery. Although the numbers are relatively small, this study suggests that this protocol may be able to predict a good outcome after permanent carotid artery occlusion as well as to identify patients who are at greater risk for developing cerebral infarction after permanent occlusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1763722 TI - 99mTc-HMPAO SPECT imaging in interventional neuroradiology: validation of balloon test occlusion. PMID- 1763723 TI - Assessing adequacy of collateral circulation during balloon test occlusion of the internal carotid artery with 99mTc-HMPAO SPECT. AB - A balloon test occlusion of the internal carotid artery was performed in 11 patients with internal carotid artery aneurysms. Tolerance by patients was assessed by a combination of clinical examination; angiography; electroencephalography; 99mTc-hexamethylpropyleneamine oxime (99mTc-HMPAO) single photon emission computed tomography (SPECT) with relative quantification; and, in four patients, 99mTc-HMPAO SPECT with absolute quantification of cerebral blood flow. During test occlusion, angiography showed a patent circle of Willis in all patients. No patient developed new clinical findings or electroencephalographic changes. The SPECT studies of five patients in whom 99mTc-HMPAO was injected during test occlusion demonstrated changes from their baseline SPECT studies. The internal carotid artery was permanently occluded in two of these patients, neither of whom became symptomatic because of the occlusion. Three patients who demonstrated no changes between baseline and test occlusion SPECT studies underwent permanent occlusion of the internal carotid artery without incident, and postoperative SPECT images were unchanged from baseline. Our preliminary results suggest that patients who have no changes between baseline and test occlusion 99mTc-HMPAO SPECT studies should have adequate collateral circulation to sustain cerebral blood flow after occlusion of the internal carotid artery if no thromboembolic episodes occur. In contrast, a patient's tolerance of permanent occlusion cannot be consistently and reliably predicted if there are changes between baseline and test occlusion SPECT studies. In these patients, absolute quantitation of cerebral blood flow is important. Greater numbers of patients are required to confirm these initial results. PMID- 1763724 TI - The challenge of carotid occlusion. PMID- 1763725 TI - Particulate embolization of the anterior choroidal artery in the treatment of cerebral arteriovenous malformations. AB - The anterior choroidal artery is commonly recruited to supply arteriovenous malformations in the temporal lobe, basal ganglia, lateral ventricle, and internal capsule. Embolization of this artery is theoretically hazardous owing to its supply to important motor territory, relative lack of collaterals, and small caliber. However, this procedure can be a beneficial adjunct to surgery or radiation in the treatment of arteriovenous malformations. We describe our experience in performing particulate embolization of the anterior choroidal artery in 15 patients (16 procedures). Significant flow reduction was achieved in 14 patients. Two symptomatic and two asymptomatic complications arose, including permanent hemiparesis in one patient. PMID- 1763726 TI - Balloon occlusion of a giant lower basilar aneurysm: death due to thrombosis of the aneurysm. PMID- 1763727 TI - Coil embolization of an acutely ruptured saccular aneurysm. PMID- 1763728 TI - Sharp vascular calcifications and acute balloon rupture during embolization. PMID- 1763729 TI - Angle-closure glaucoma consequent to embolization of dural cavernous sinus fistula. PMID- 1763730 TI - Subacute necrotizing myelopathy: MR imaging in four pathologically proved cases. AB - This report describes the MR and correlative imaging findings of four histologically proved cases of subacute necrotizing myelopathy in which there was no evidence of a spinal dural arteriovenous fistula. Subacute necrotizing myelopathy is characterized clinically by progressive motor and sensory deterioration, and pathologically by necrosis in the spinal cord. Initial MR imaging showed focal enlargement of the spinal cord and nonspecific T1 and T2 lengthening. Rimlike enhancement was demonstrated in one case. Clinically, steroid therapy failed in all four patients. Follow-up MR scans showed two slightly enlarged lesions, one stable thoracolumbar lesion, and atrophy of a cervical lesion. Open spinal cord biopsies revealed foci of necrosis and abnormal parenchymal vessels with thickened hyalinized walls. A prolonged course distinguishes subacute necrotizing myelopathy from acute transverse myelitis, but the clinical course and imaging appearance are similar to those of intramedullary tumor. Rimlike rather than solid contrast enhancement may be a distinguishing feature. In the absence of a demonstrable spinal dural arteriovenous fistula, the radiologic differentiation of subacute necrotizing myelopathy from tumor is probably impossible, and biopsy establishes the correct diagnosis. PMID- 1763731 TI - Necrotizing myelopathy. PMID- 1763732 TI - Spinal epidural abscess: evaluation with contrast-enhanced MR imaging. AB - Seven patients with spinal epidural abscess were evaluated with MR imaging. T1 weighted images were obtained before and after administration of gadopentetate dimeglumine, and contrast-enhanced images were compared with available T2 weighted images and unenhanced T1-weighted images. In all seven cases, the epidural infection was iso- to hypointense compared with the spinal cord on unenhanced T1-weighted images, and increased in intensity on proton-density- and T2-weighted images. Three patterns of enhancement were observed after contrast administration. In three patients the infection enhanced homogeneously, likely representing thickened, inflammed tissue with microabscesses and granulomatous material. In one patient, peripheral enhancement surrounded a central focus of low signal intensity, representing necrotic abscess. In two patients, a combination of both patterns was observed. One abscess infiltrated the posterior thoracic epidural fat, producing decreased signal within the high-signal fat on T1-weighted images. Enhanced T1-weighted images were equivalent to unenhanced T2 weighted images in detecting the extent of epidural involvement in three cases. In two cases, enhanced T1-weighted images were superior to T2-weighted images in differentiating the infectious component from surrounding CSF. In one case, contrast administration produced no discernible enhancement. Enhanced images also provided important information regarding the composition of the abscess (liquid versus solid). Contrast-enhanced MR images are valuable in the characterization of spinal epidural abscesses. PMID- 1763733 TI - MR imaging of the spinal cord in 23 subjects with ALD-AMN complex. AB - Twenty-three subjects from two family groups with the adrenoleukodystrophy (ALD) adrenomyeloneuropathy (AMN) complex were examined with MR imaging at 1.5 T to determine the presence and extent of brain and spinal cord abnormalities. Nineteen individuals were identified as having ALD or AMN, or as having carrier status on the basis of pedigree analysis and/or evaluation of serum very-long chain fatty acids. In addition to the expected intracranial white matter changes for this disorder, decreased spinal cord diameter was found in seven (30%) of the 23 subjects. In three of these cases, atrophy was limited to the thoracic spinal cord, while atrophy of both the cervical and thoracic cord was identified in four patients. Two patients who did not have MR imaging of the spine were found to have spinal cord atrophy at autopsy. The finding of decreased spinal cord diameter on MR examinations in individuals who are heterozygous for ALD-AMN, in patients with ALD or AMN, and in asymptomatic ALD-AMN patients may represent a new anatomic marker for the variable clinical presentations of this condition. In addition to cranial MR examination, MR imaging of the spine may be indicated in patients with suspected ALD or AMN, or in women with carrier status. PMID- 1763734 TI - Unstable Jefferson variant atlas fractures: an unrecognized cervical injury. AB - We retrospectively reviewed the plain films and CT scans of 11 unstable atlas fractures from a series of 72 atlas fractures to better characterize these injuries and to determine if the correct diagnosis could have been made. These 11 atlas fractures were unstable because either the anterior bony ring was disrupted (six cases), the posterior longitudinal ligament was torn (one case), or both the anterior bony ring and the posterior longitudinal ligament were disrupted (four cases), allowing C1-C2 subluxation to occur. Although all the fractures were potentially unstable, only eight demonstrated subluxation on the lateral radiography. Despite the abnormal open mouth view in all cases, the plain films showed minimal abnormalities, requiring CT for definitive diagnosis. Less than half (five of 11) of the patients had other levels of spine injury or associated transverse ligament tear. Three of the 11 patients were quadriplegic, and two died as a result of their spinal cord injury. These unstable atlas fractures were similar to the classical Jefferson fracture in appearance and mechanism, except that they had fewer than four breaks in the atlas ring and were associated with severe neurologic injury and lower level spine injuries. The pattern of bilateral anterior arch fractures was associated more often with neurologic injury. Because of these differences, we chose to refer to them as Jefferson variant fractures to distinguish them from the classical Jefferson fracture and to emphasize the seriousness of this injury. PMID- 1763735 TI - MR imaging in cryptococcal spondylitis. PMID- 1763736 TI - Pseudoarthrosis in ankylosing spondylitis mimicking infectious diskitis: MR appearance. PMID- 1763737 TI - Early angiographic and CT findings in patients with hemorrhagic infarction in the distribution of the middle cerebral artery. AB - Hemorrhagic infarction subsequent to ischemic brain damage, even if small, slight, or marbled, can be detected by CT. The mechanisms that give rise to this transformation in humans are not well elucidated. Previous reports indicate that hemorrhagic infarction is most common in embolic stroke and large infarcts, and can worsen the clinical state of ischemic patients. We examined 36 patients with supratentorial ischemic signs and symptoms within the first hours after onset. CT was used to judge if hypodensity on early CT studies might predict the development of hemorrhagic infarction. Angiography was used to observe the site of arterial occlusion, the state of collateral circulation, and the mechanisms of late reperfusion. Hemorrhagic infarction was present in 18 of our 36 patients. Angiography revealed occlusion of the middle cerebral artery or internal carotid artery (three cases) in all patients. Hypodensity was present on early CT studies in all of the 18 patients who developed hemorrhagic infarction. The finding of hypodensity on CT studies performed soon after embolic ischemic stroke is strongly predictive of hemorrhagic transformation. PMID- 1763738 TI - Hemorrhagic infarction: guilt by association? PMID- 1763739 TI - MR contrast enhancement in brainstem and deep cerebral infarction. AB - MR imaging with IV administration of gadopentetate dimeglumine was performed in 89 patients with 100 clinically and radiologically documented brainstem or deep cerebral (basal ganglia/internal capsule) infarctions to determine the patterns and time course of contrast enhancement. By location, there were 61 deep cerebral, eight midbrain, 23 pontine, and eight medullary infarctions. The age of the infarctions ranged from 1 day to 3 1/2 years, with 22% of the patients scanned within 4 days and 43% scanned within 2 weeks of clinical ictus. Abnormalities on T2-weighted images were encountered in every case. Mass effect was seen in 10 infarctions, most commonly noted between days 2 and 6, but persisting to day 20 in a single case. Parenchymal contrast enhancement was seen in 43 cases, occurring predominately between days 2 and 80. By postinfarction day 3 only half the strokes enhanced, although all did after day 6. Intravascular enhancement within the vertebral or basilar arteries was noted in five cases; all were brainstem infarctions imaged during the first week following ictus. Meningeal enhancement adjacent to the infarction was not seen in any case. Our results indicate that MR contrast enhancement of brainstem and deep cerebral infarctions typically occurs over a period from about 3 days to 3 months following ictus. Lack of both parenchymal and intravascular enhancement is thus to be expected for several days after a brainstem or deep cerebral infarction. PMID- 1763740 TI - Intracranial MR angiography: a direct comparison of three time-of-flight techniques. AB - During the past few years, several time-of-flight MR angiographic techniques have been described for rapid, reliable, noninvasive vascular evaluation. This investigation was performed to directly compare three time-of-flight methods in imaging the intracranial vasculature: a single-volume method, a sequential two dimensional slice technique, and a technique using the sequential acquisition of multiple thin volumes. Thirty-two normal volunteers were imaged, and direct comparisons of the three techniques were performed in 20 subjects. Analysis of the resulting images revealed optimal depiction of large vessels with the single volume and multiple thin-volume methods, small vessels with the multiple thin volume technique, and venous structures with the sequential two-dimensional slice acquisition. The effects of progressive spin saturation in time-of-flight MR angiography are discussed along with the individual benefits and disadvantages of each method. We conclude that the diagnostic value of intracranial time-of-flight MR angiography can be maximized through tailoring the angiographic method to the suspected abnormality based on the requirements for spatial resolution and slow flow sensitivity, as suggested by the clinical history or prior imaging studies. PMID- 1763741 TI - MR angiography: reaching adolescence. PMID- 1763742 TI - Diffusion imaging of the human brain: a new pulse sequence application for a 1.5 T standard MR system. AB - We developed a new pulse sequence and investigated whether the anisotropic diffusion in the human brain can be detailed with a standard whole-body MR imager. Apparent diffusion coefficient maps were produced by the proposed sequence using a 1.5-T MR unit. The sequence employed simultaneous application of three orthogonal gradients to achieve an optimal signal attenuation for imaging the brain without any increase in echo time. The orientation of the effective diffusion-encoding gradient was off-axis. On the in vivo apparent diffusion coefficient maps of four healthy volunteers, white matter tracts (the internal capsule and the corpus callosum) and the cortical and deep white matter showed anisotropic diffusion. In the gray matter, such as basal ganglia and thalami, anisotropic diffusion was not observed. A typical whole-body imager can provide in vivo human brain diffusion images of clinical quality. This technique has promising implications for the evaluation of brain development and the diagnosis of degenerative diseases. PMID- 1763743 TI - Resective surgery for intractable epilepsy in children: radiologic evaluation. AB - Epilepsy surgery is gaining popularity for the treatment of children with intractable seizures in whom either a focal or extensive unilateral structural brain lesion is demonstrated. We evaluated the pre- and postoperative imaging findings in 29 patients (aged 22 days to 19 years) who underwent hemispherectomies, 12 total and 17 subtotal. Pathologic correlation was obtained in all cases. Preoperatively, positron emission tomography and electroencephalography demonstrated abnormalities in all of the 28 children studied, but frequently could not characterize the lesion. CT or MR or both demonstrated focal or unilateral lesions in only 19 of these but gave additional information regarding the nature of the lesion. Preoperative angiographic findings were abnormal in five of 17 patients studied and were particularly useful in the evaluation of the extent of abnormality in patients with Sturge Weber syndrome. Postoperatively, CT and MR demonstrated early complications such as the development of epidural blood and fluid collections, parenchymal hemorrhage, infection, and early hydrocephalus. Postoperatively, MR demonstrated the early development of septations, the presence of subarachnoid hemorrhage, and/or the deposition of hemosiderin in four patients, findings that historically have been associated with the development of devastating clinical complications. From these data, a recommended protocol of radiologic evaluation for patients undergoing hemispherectomy has been established. PMID- 1763744 TI - Neuroimaging of acoustic nerve sheath tumors after stereotaxic radiosurgery. AB - Using a strict method for measuring tumor size, we evaluated tumor response to radiosurgery in 88 patients with 89 acoustic tumors treated over 3 years with a 201-source cobalt-60 gamma unit. Overall, tumor size was unchanged in 73% of patients and increased in 4%. In 22% of patients, tumor diameter decreased an average of 4.9 mm 3-33 months after treatment. Tumor shrinkage occurred in 36% of 50 patients who were followed for at least 1 year after treatment. Loss of tumor contrast enhancement was seen in 79% of patients 1-18 months after treatment. Delayed communicating hydrocephalus developed in four patients. In eight patients, increased signal on T2-weighted MR images developed in the adjacent cerebellar peduncle (n = 5) or the peduncle and dorsolateral pons (n = 3) 5-15 months after treatment. T1-weighted MR imaging and CT were insensitive to these adjacent brain changes. Stereotaxic radiosurgery is an important alternative treatment for selected patients with acoustic tumors. There is no mortality or major perioperative morbidity, hospitalization time and costs are smaller than for microsurgery, patient employment or functional level is maintained, and hearing preservation and facial neuropathy rates are comparable to those in published microsurgical series. Although the rate of occurrence of trigeminal neuropathy is greater than those reported in published microsurgical series, the majority of cases are mild, transient, and nondebilitating. MR imaging before and after radiosurgery is the most sensitive imaging tool to evaluate tumor response, the presence of adjacent parenchymal signal changes, and ventricular size. With a mean follow-up time of 14.6 months, the rate of complications detected by neuroimaging is low and the tumor control rate is 96%. PMID- 1763745 TI - Neurofibroma of the aryepiglottic fold. PMID- 1763746 TI - Brown tumor of the facial bones. PMID- 1763747 TI - Squamous carcinoma arising in a cerebellopontine angle epidermoid: CT and MR findings. PMID- 1763748 TI - MR-guided aspiration and drainage of a nasopharyngeal mucus retention cyst. PMID- 1763749 TI - Radiation necrosis vs high-grade recurrent glioma: differentiation by using dual isotope SPECT with 201TI and 99mTc-HMPAO. AB - Conventional imaging techniques are often unreliable in distinguishing between radiation necrosis and recurrent glioma in patients who are symptomatic after high-dose radiotherapy. We performed dual-isotope single-photon emission computed tomography (SPECT) with the use of thallium-201 (201TI) and the perfusion agent 99mTc-hexamethyl-propyleneamine oxime (HMPAO) to aid in this differentiation in 15 patients with glioma prior to biopsy. We found that dual-isotope SPECT scanning correlated with the pathologic findings in 14 of the 15 cases. All patients with high 201TI uptake in their treated tumor beds had local tumor recurrence, and all patients with low 201TI uptake showed only radiation changes without evidence of solid tumor. In patients with an intermediate level of 201TI concentration in their tumor bed, 99mTc-HMPAO uptake differentiated those patients with active tumor from those without; three of four patients with preserved or increased perfusion had pathologic evidence of solid tumor, whereas none of the four patients with decreased perfusion to the tumor bed had evidence of local recurrence. We believe that dual-isotope SPECT with 201TI and 99mTc HMPAO may be useful in differentiating sites of likely tumor growth from nonspecific radiation changes in patients treated for malignant glioma. PMID- 1763751 TI - Desmoplastic infantile ganglioglioma: CT and MR features. PMID- 1763750 TI - Cavernous hemangioma of the clivus: case report and review of the literature. PMID- 1763752 TI - MR of intracranial neuroblastoma with dural sinus invasion and distant metastases. PMID- 1763753 TI - Choroid plexus papillomas of the foramen of Luschka: MR appearance. PMID- 1763754 TI - Bilateral choroid plexus cysts in the lateral ventricles. PMID- 1763755 TI - Dural "tail" associated with an acoustic schwannoma in MR imaging with gadopentetate dimeglumine. PMID- 1763756 TI - CT and MR evaluation of the brain in patients with anorexia nervosa. AB - Thirteen adolescent girls with anorexia nervosa had MR imaging of the brain; 11 were also examined by CT. Fifteen children, ages 10-12 years, served as a control group. The CT and MR studies were evaluated qualitatively for cortical and central atrophic changes. CT detected sulcal and ventricular enlargement in 5/11 patients. On the MR images, enlarged sulci were seen in 10/13 and dilated ventricles in 5/13. In the anorectic patients, the range of the width of the third ventricle was 1-5 mm (mean, 3.2 mm) and the maximal distance between the anterior horns was 22.5-39.0 mm (mean, 30.0 mm). Anterior horns at their minimal width measured 11-30 mm (mean, 16.5 mm). The corresponding measurements in the control group were 1.5-3.5 mm (mean, 2.3 mm) for the third ventricle, 21-35 mm (mean, 28.5 mm) for the distance between the anterior horns, and 10-16 mm (mean, 12.8 mm) for their minimal width. Overall, the patient group had larger ventricles than the control group; however, the difference between the two groups was not significant. Measurement of the number of visible cortical sulci at one cut below the vertex yielded 2-11 sulci in the anorectic girls (mean, 6.6) versus 0-6 sulci (mean, 3.3) in the controls. These results are statistically significant (p = .0009), indicating peripheral volume loss in the anorectic patients. The MR examination did not reveal any additional structural or parenchymal changes when compared with the results of the CT studies. However, the pituitary glands of these patients did not have the expected normal pubertal hypertrophy on the MR examinations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1763758 TI - Accessory middle cerebral artery as a source of collateral blood flow. PMID- 1763757 TI - Bicaudate ratio as a measure of caudate volume on MR images. AB - Many studies have used ratios based on intercaudate distance as a measure of caudate atrophy and ratios based on bifrontal distance as a measure of ventricular enlargement independent of caudate atrophy. The purpose of the current study was to determine to what extent these ratios correlate with caudate area and volume and frontal horn area in various groups of patients. The three linear ratio measures, obtained from MR scans, were bicaudate ratio, bifrontal ratio, and bifrontal distance divided by bicaudate distance. Area and volume measures were corrected for brain size. Subjects included patients with autism, obsessive-compulsive disorder, and Huntington disease, as well as normal controls. As expected, the patients with Huntington disease had the largest bicaudate ratio, bifrontal ratio, and frontal horn area. Both bicaudate ratio and bifrontal ratio were fairly good measures of frontal horn size for most groups. Consistent with theoretical expectations, the bifrontal ratio was not highly correlated with caudate area or volume ratios. Bicaudate ratio and bifrontal distance/bicaudate distance were correlated with caudate volume for the patients with Huntington disease, but not for any of the other groups. Bifrontal distance/bicaudate distance was the best single predictor of caudate volume for all groups combined. It is concluded that bicaudate ratio and bifrontal distance/bicaudate distance are fairly good measures of caudate atrophy, but are poor measures of caudate size when no atrophy is present. PMID- 1763759 TI - MR angiography of an aberrant internal carotid artery. PMID- 1763760 TI - CNS sarcoidosis: evaluation with contrast-enhanced MR imaging. AB - Reports of findings on unenhanced MR images and contrast-enhanced CT scans in patients with intracranial sarcoidosis have suggested that MR imaging without contrast enhancement may miss meningeal involvement, which is a frequent and prominent finding in neurosarcoidosis. We studied 14 patients with CNS sarcoidosis with T1- and T2-weighted pre- and postcontrast sequences and T1 weighted postcontrast sequences. Eight of 12 patients with intracranial sarcoidosis and one of two with spinal sarcoidosis had meningeal involvement that was not apparent on the unenhanced scans. Eight of 12 patients had intraaxial areas of high signal intensity on T2-weighted images, although only two of these lesions enhanced. Three patients had enhancing extraaxial masses mimicking meningiomas on postcontrast T1-weighted images. In two patients, the lesions decreased markedly in size after steroid treatment. In one patient with sarcoidosis of the optic nerve, the lesion decreased in size and the patient's vision returned to normal after Cytoxan therapy. In five of 14 patients, CNS findings were the initial clinical manifestation of the disease. In nine of 14 patients, the diagnosis of neurosarcoidosis was suggested only after administration of contrast agent. Use of gadopentetate dimeglumine greatly enhances the sensitivity of MR imaging in the detection of CNS sarcoidosis. PMID- 1763761 TI - MR features in patients with residual paralysis following aseptic meningitis. PMID- 1763762 TI - Ipsilateral motor deficit resulting from a subdural hematoma and a Kernohan notch. PMID- 1763763 TI - Highlights of the 29th annual meeting of the American Society of Neuroradiology, Washington, DC, June 9-14, 1991. PMID- 1763764 TI - Highlights of the scientific exhibits of the 29th annual meeting of the American Society of Neuroradiology, Washington, DC, June 9-14, 1991. PMID- 1763765 TI - The STIR sequence in MR imaging. PMID- 1763766 TI - Diagnosis of lumbar synovial cysts. PMID- 1763767 TI - MR imaging of migraine. PMID- 1763768 TI - MR-guided needle biopsy with a high-field-strength MR system. PMID- 1763769 TI - DdI for AIDS patients intolerant to AZT. PMID- 1763771 TI - Evaluating pharmacy software. PMID- 1763770 TI - Antibiotic more effective for AIDS-related pneumonia. PMID- 1763772 TI - Patients need advice as array of cold products grows. PMID- 1763773 TI - Exploring the benefits of a third drug class. PMID- 1763775 TI - Why pharmacists should document their actions. PMID- 1763774 TI - FDA's Kessler: a prescription for change. Interview by Marlene Z. Bloom. PMID- 1763776 TI - The crisis in rural pharmacy practice. PMID- 1763777 TI - Prothrombin times: when are they not the same? PMID- 1763778 TI - Impact of gene therapy on the future of pharmacy practice. PMID- 1763779 TI - DdI approval offers second chance. PMID- 1763780 TI - Stop drug price increases. PMID- 1763781 TI - New directions in the treatment of asthma. PMID- 1763782 TI - Tacrine for Alzheimer's. PMID- 1763783 TI - Self-help groups. Introduction to the special issue. PMID- 1763784 TI - An exploration of leadership in a medical mutual help organization. AB - Studied 45 current leaders of local chapters of a medical mutual help organization. Cluster analysis of variables depicting routes to leadership produced six clusters: Health Professionals with a Mission, Connected Health Professionals, Career Leaders, Grass-roots Founders, Connected Grass-roots Leaders, and Obligated Veterans. These clusters differed on criterion measures of burnout, hardiness, and perceived obligation to continue as a leader, e.g., Connected Health Professionals and Career Leaders were less burned out, more hardy, and perceived less of an obligation to continue in the leadership role than Health Professionals with a Mission. In terms of leadership activities, Help Provision and Advocacy constituted less than one fifth of all activities but were rated as most rewarding. In contrast, the activities that made up the bulk of leaders' work--building membership, system maintenance, and organizational growth -were not rated as particularly rewarding. Results are discussed in the context of research directions and practice. PMID- 1763785 TI - Understanding the attitudes and intentions of future professionals toward self help. AB - Examined the attitudes, beliefs, and intentions toward self-help groups of 168 graduate students in clinical psychology and social work from five universities using the theory of reasoned action as a model (Fishbein, 1979). Participants held positive attitudes and beliefs regarding self-help and intended to collaborate. Participants who were members of self-help groups had significantly greater intentions to collaborate and had more positive beliefs vs. nonmembers. There were no differences between social work and psychology students. Path analysis showed that students who held positive attitudes and beliefs and perceived that their faculty were positive regarding self-help had intentions to collaborate with self-help groups. Involving self-help groups as partners in professional training was considered empowering and a wise use of the expert resources that groups can provide. PMID- 1763786 TI - Charting uncharted terrain: a behavioral observation system for mutual help groups. AB - Describes the development of a behavioral observation system for mutual help meetings and presents evidence supporting its reliability, validity, and utility. The MHOS-BIC (Mutual Help Observation System-Behavioral Interaction Codes) was used by 10 observers to record the sequential flow of group interaction in 527 meetings. Psychometric analyses indicate that the system performed consistently with measurement objectives. Mean kappas for each of the 12 coding categories ranged from .62 to .87; the system demonstrated sensitivity to setting and time differences; and a predictable pattern of correlations was found among BIC categories and conceptually related participant and observer ratings. Studies using the BIC to address substantive questions about mutual help are reviewed, providing further evidence for its validity and utility. An empirical description of mutual help is presented using BIC data, and the promises and limitations of the system are discussed. PMID- 1763787 TI - Participatory action research with self-help groups: an alternative paradigm for inquiry and action. AB - Presents participatory action research (PAR) as a scientific paradigm most relevant for inquiry and action with self-help groups. "Subjects" individual and collective involvement in the design, conduct, and utilization of research, and scientists' involvement in action to improve group functioning, are among the hallmarks of PAR. Such an approach is most consistent with self-help characteristics and ideology: highly participative membership, aprofessional leadership, localist and grass-roots orientation, and respect for experience based knowledge. Conducting research and action for change that simultaneously generates useful knowledge and advances group goals requires new scientific roles and techniques. The orthodoxy of the conventional scientific paradigm is problematic for productive inquiry about self-help and for aiding self-help groups. PMID- 1763788 TI - An organizational typology for self-help groups. AB - Those investigating the nature and functioning of self-help groups have been handicapped by the lack of a conceptual framework to bridge the diversity among such groups as well as to clarify the boundaries between consumer-owned and professionally owned groups. This paper describes a typology that classifies local units of these groups in terms of differences and similarities in their organizational structures. Rooted in organizational theory, it has two dimensions: external dependence upon resources and internal extent of experiential authority. Using it, the authors identified five types of groups, referred to as Unaffiliated, Federated, Affiliated, Hybrid, and Managed. The typology was validated with actual groups. PMID- 1763789 TI - Research workshop on Methodological Issues in Evaluating Preventive Interventions Using Mutual Support. AB - The Prevention Research Branch, Division of Clinical Research, of the National Institute of Mental Health held a research workshop on the methodological issues in evaluating preventive interventions using mutual support. This workshop, held in June 1989, was part of an effort to stimulate high-quality research on preventive interventions using mutual support. These interventions include but are not limited to naturally occurring self-help groups. Participants reviewed methodological problems, generated strategies for dealing with these problems, and made recommendations for future research in this area. PMID- 1763790 TI - Self-help research and the public mental health system. AB - Discusses views of self-help leaders, researchers, and policy makers from the public mental health system about collaborative research with self-help groups. Topics include assumptions underlying collaborative research, barriers to collaborative research, and the potential benefits of collaborative research. Special attention is given to the rationale and methods for including minorities in self-help research. Initial discussions were held at a meeting convened by the NIMH-funded Center for Self-Help Research and Knowledge Dissemination at the University of Michigan. PMID- 1763791 TI - Low prevalence of human immunodeficiency virus-1 (HIV-1), HIV-2, and human T cell lymphotropic virus-1 infection in Somalia. AB - A seroepidemiologic survey was conducted to determine the prevalence of human immunodeficiency virus type 1 (HIV-1), HIV-2, human T cell lymphotropic virus type I (HTLV-I), and Treponema pallidum infection among southern Somalis. Sera were collected from 1,269 study subjects in the urban area of the capital city, Mogadishu, and in the rural towns of Merka, Qoryoley, and Kismayo. The subjects included 57 prostitutes, 79 sexually transmitted disease (STD) patients, and 1,133 others, including outpatient and hospitalized patients with leprosy, tuberculosis, other infectious diseases, individuals from rehabilitation camps and secondary schools, and Ethiopian immigrants. Results indicated that none of the sera were positive for HIV-1 and HIV-2 by Western blot, but one was positive for HTLV-I. The prostitutes had a significantly higher prevalence of treponemal antibody (50.8%; P less than 0.0001) than either the STD patients (12.6%) or the other subjects (5.2%). Epidemiologic data indicated that 94% of the males and females were circumcised and only 2.6% of the males used condoms. Overall, the results of this study suggested a very low prevalence of HIV-1, HIV-2, and HTLV-I infections, especially among prostitutes and STD patients, who were considered at greatest risk of contracting these retroviral infections. PMID- 1763792 TI - Gold immunoblot analysis of IgM-specific antibody in the diagnosis of human leptospirosis. AB - An immunoblot for the detection of leptospirosis was developed in our laboratory. Antigen prepared from Leptospira interrogans serovar bataviae was dotted onto nitrocellulose paper and blocked with skim milk. Test and control sera diluted 1:20 were applied to the dot, incubated, and washed. Anti-human IgM colloidal gold conjugate was added and the dots were washed. A positive reaction was shown by the development of a pink dot against a white background. The test was performed on 62 sera that tested positive for leptospirosis by a microagglutination (MA) test, on 40 sera that were positive by an indirect hemagglutination (IHA) test, and on sera from forty healthy blood donors. Four sera from the blood donors showed a faint pink dot, but the remainder showed a colorless reaction. All 62 sera that tested positive by MA were positive by this new test, while 95% of the 20 sera that tested positive by IHA were positive. Tests for IgG antibody were performed on 20 sera positive by MA using protein A colloidal gold conjugate, and all showed weak reactivity. The results confirmed previous findings that most antibodies present in leptospirosis patients are of the IgM type. The ELISA takes three hours to perform, but the gold immunoblot can be completed in 30 min. In addition, the test blot can be kept as a permanent record, and is a significant improvement over existing tests. PMID- 1763793 TI - Detection of IgM antibodies to Neisseria meningitidis group A polysaccharide in meningitis patients by direct and antibody capture enzyme-linked immunosorbent assays. AB - Serum specimens obtained from culture-positive group A meningococcal meningitis patients in Cairo, Egypt were tested for immunoglobulin M (IgM) antibodies to Neisseria meningitidis group A polysaccharide by direct and IgM capture enzyme linked immunosorbent assays (ELISAs). Sera from patients with meningitis caused by other bacteria were used as negative control specimens. The IgM antibodies to this antigen were detected by direct ELISA in 93% of 58 specimens obtained from patients with group A meningococcal disease three or more days after hospital admission, and by IgM capture ELISA in 83% of 60 such specimens. Sixteen percent of 25 specimens obtained three or more days after admission from negative control patients were positive by direct ELISA, and 4% were positive by IgM capture ELISA. The correlation coefficient of the results with the two assays was 0.85. PMID- 1763794 TI - Randomized clinical trial of norfloxacin for shigellosis. AB - In a randomized clinical trial, norfloxacin was compared with nalidixic acid in the treatment of acute invasive diarrhea, with particular reference to shigellosis in adults. Of 104 patients studied, 40 were positive for Shigella in stool cultures, of which 22 received norfloxacin and 18 received nalidixic acid. The patients in these two groups were comparable on admission. In the treatment of culture-positive shigellosis cases, the responses to therapy with both drugs were similar, except that the duration of fever, anorexia, and abdominal pain were less in those who received norfloxacin. Norfloxacin appeared to be superior to nalidixic acid in the treatment of shigellosis cases caused by Shigella strains resistant to nalidixic acid. PMID- 1763795 TI - DNA sequences for the specific detection of Cryptosporidium parvum by the polymerase chain reaction. AB - The objective of this project was to construct specific and sensitive molecular probes and amplification primers for Cryptosporidium parvum that could be used in diagnosis, retrospective tissue studies, and in epidemiologic surveys. Whole genomic DNA was extracted from oocysts of C. parvum purified from human and bovine feces. A genomic library was constructed in plasmid pUC18 and propagated in Escherichia coli DH5 alpha. Transformants were screened by colony hybridization and autoradiography. The 2.3-kilobase segment in plasmid pHC1, a clone specific for C. parvum, was sequenced by the Sanger method. Computer analysis gave a G+C content of 35%. A 400-base region (bases 470-870) was selected as an amplification target because it contained a unique restriction endonuclease site that could serve as a useful marker. Primers of 26 nucleotides each were synthesized. Sensitive and specific amplification of the target sequence was demonstrated both by ethidium bromide staining of agarose and acrylamide gels, and by hybridization with chemiluminescence-labeled synthetic oligonucleotide probes. PMID- 1763796 TI - Safety and immunogenicity of a recombinant sporozoite malaria vaccine against Plasmodium vivax. AB - A recombinant Plasmodium vivax circumsporozoite (CS) antigen representing approximately 70% of the CS protein was expressed in yeast and adsorbed onto aluminum hydroxide for use as a malaria vaccine. In a study of safety and immunogenicity, 30 volunteers were divided into four groups of 5, 5, 10, and 10 individuals, and inoculated intramuscularly with 50, 100, 200, or 400 micrograms of vaccine, respectively. Primary vaccinations were followed by two booster immunizations at six weeks and six months. Overall, the vaccine was well tolerated. Following the third vaccination, one volunteer developed acute hepatitis of uncertain etiology that resolved without sequelae. All volunteers in the 400-micrograms group, and six of 10 in the 200-micrograms group generated IgG against P. vivax CS protein, as determined by Western blot using recombinant CS protein. However, the magnitude of the antibody response measured by indirect immunofluorescence of intact sporozoites or enzyme-linked immunosorbent assay against the recombinant protein was low, and responses could not be boosted. Antigen-driven replication studies using peripheral blood lymphocytes failed to detect proliferative responses specific to peptide sequences represented in the recombinant vaccine, except in one volunteer. Minimal humoral and cell-mediated immune responses developed in most recipients who received this recombinant CS vaccine. PMID- 1763797 TI - Quinine treatment of severe falciparum malaria in African children: a randomized comparison of three regimens. AB - The pharmacokinetics and effectiveness of three dosage regimens of quinine were studied in a group of 59 children with severe malaria. The children were randomized to receive high-dose intravenous or intramuscular quinine (20 mg salt/kg loading, then 10 mg salt/kg every 12 hr), or low-dose intravenous quinine (10 mg salt/kg loading, then 5 mg salt/kg every 12 hr). In the group receiving the high-dose intravenous regimen, mean high and low quinine concentrations were consistently greater than 10 and 6.5 mg/l, respectively. Peak concentrations as well as the time required to achieve them were similar in the intramuscular and high-dose intravenous groups. The low-dose intravenous quinine regimen resulted in mean peak concentrations greater than 6 mg/l and mean low concentrations greater than 3.5 mg/l. All blood concentrations exceeded the 99% in vitro inhibitory concentration (EC99) of 0.89 mg/l or less of quinine for 60 isolates of Plasmodium falciparum, which were taken from children with malaria during the same period. Judged by a number of clinical criteria, the response was better in patients receiving the high-dose than the low-dose intravenous regimen. The time taken to clear parasites with both the high-dose intravenous and intramuscular regimens were significantly shorter than those obtained in the low-dose group. We have also shown for the first time that the rate of parasite clearance can be directly related to the area under the quinine concentration versus time curve. This applied to all three quinine regimens (r = 0.4252, P less than 0.02; n less than or equal to 35). Five patients, two on the low-dose regimen, two on the intramuscular regimen, and one on the high-dose regimen, developed hypoglycemia after admission, but in these cases, insulin concentrations were correspondingly low. No significant quinine toxicity was observed in any of the cases. The high dose intravenous quinine regimen described here may be optimal for treatment of severe falciparum malaria in areas of chloroquine resistance in Africa. Our data provide no justification for reducing the dose of quinine in the treatment of severe malaria in Africa. The intramuscular regimen could provide a satisfactory alternative in areas where intravenous administration might be delayed or is impossible. PMID- 1763798 TI - Characterization of a Leishmania isolate from the rodent host Neotoma micropus collected in Texas and comparison with human isolates. AB - We report the biological and biochemical parameters of Leishmania parasites (MNEO/US/90/WR972) isolated from a rodent host, Neotoma micropus, collected in Texas. Footpad inoculations of WR972 promastigotes into BALB/c mice and Syrian hamsters resulted in ulcerating lesions six and eight weeks post-inoculation, respectively. Using monoclonal antibody-stained touch preparations, amastigotes were found in the liver of both laboratory hosts. Infection of J774 macrophages with WR972 promastigotes supported the growth of amastigotes for 12 days at 35 degrees C. The WR972 parasite was identified by enzyme electrophoresis as L. mexicana. Isozyme comparison of WR972 with 42 L. mexicana isolates (from humans and rodents) from four different endemic areas, including Texas, suggest that these parasite populations are identical for approximately 97% of their genetic loci. Pulse field gel electrophoresis (PFGE) of WR972 resolved 18 chromosomes with a size range of 300- greater than 2,000 kb. The karyotype strongly resembles that of two other Texas L. mexicana isolates from humans. Taken together, the PFGE, hybridization, and isoenzyme data suggest that the wood rat isolate (WR972) is identical to parasites from human cutaneous lesions isolated in Texas and Central America. In addition, the biological characteristics of WR972, its infectivity of BALB/c mice and the Syrian hamster, and the potential of the isolate to infect, transform, and divide in J774 macrophages indicate that WR972 will be pathogenic in humans if transmission occurs. Health care providers should consider this possibility when studying the epidemiology and control of cutaneous leishmaniasis in Texas. PMID- 1763799 TI - Acute fatal Trypanosoma cruzi meningoencephalitis in a human immunodeficiency virus-positive hemophiliac patient. AB - A 37-year-old hemophiliac patient with known, asymptomatic human immunodeficiency virus infection and chronic Chagas' disease was admitted to the hospital complaining of fever and headache. A computed tomographic scan revealed multiple ring-enhancing lesions in both cerebral hemispheres. No antibodies to Trypanosoma cruzi were found in the cerebrospinal fluid. Treatment for toxoplasmosis of the central nervous system, which was considered the most likely diagnosis, was instituted, but the patient died after progressive neurologic deterioration. An autopsy revealed severe meningoencephalitis caused by T. cruzi. PMID- 1763800 TI - Bancroftian filariasis: long-term effects of treatment with diethylcarbamazine in a Haitian population. AB - Two groups of Wuchereria bancrofti-infected Haitians who had undergone treatment with diethylcarbamazine (DEC) were followed for up to five years after treatment to document the long-term effects of treatment on adult worms and microfilariae and on the recurrence of infection. One group of 69 persons who had received 12 daily treatments had a significant decrease in microfilaria levels until year 4, when a small number of individuals experienced a resurgence of this parasite stage in the peripheral blood. In a second group of 57 persons who had been treated weekly for 12 consecutive weeks, there was a greater reduction in the microfilaria levels following treatment, and for the full four years of followup, these levels remained more depressed than those of the group that received daily treatment. Our results indicate that DEC kills or permanently sterilizes adult W. bancrofti. Furthermore, these results demonstrate conclusively that in Haiti, the use of DEC provides long-term benefits to treated persons, even though they continue to reside in an area with endemic filariasis. PMID- 1763801 TI - Specific cellular and humoral immune responses in patients with different long term courses of alveolar echinococcosis (infection with Echinococcus multilocularis). AB - Alveolar echinococcosis is a serious and often fatal disease of humans that in most cases can be efficiently cured only by complete surgical resection of the Echinococcus multilocularis lesion. In a few patients, however, a spontaneous cure of the disease has been observed by demonstrating the presence of lesions with dead metacestodes. The present study shows a comparative analysis of the cellular (lymphoproliferative assay) and humoral (antibody activity in an Em2 enzyme-linked immunosorbent assay [ELISA] and immunoblotting) immune response in 1) patients who were cured by a radical surgical resection of the E. multilocularis parasite lesion, 2) patients who had a partial surgical resection of the parasite lesion, 3) patients who had a non-resectable alveolar echinococcosis, and 4) patients who were shown to be spontaneously cured and had lesions with dead parasites. The in vitro lymphoproliferative response to E. multilocularis antigen stimulation was very high in cured patients who had radical surgery or in patients with lesions containing dead parasites, but it was significantly lower in patients who had partial surgical or no resection. Antibody concentrations in the Em2-ELISA were high in patients who had incomplete or no surgery, and low or negative in cured patients who had radical surgery or in patients with lesions containing dead parasites. Immunoblot analysis of patient sera revealed a consistent antibody banding pattern among cured patients with radical surgery and patients with incomplete or no surgery, whereas cured patients with lesions containing dead parasites showed a very faint antibody pattern.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1763802 TI - The impact of endemic schistosomiasis on acute viral hepatitis. AB - One hundred forty-four of 166 adults with acute viral hepatitis (AVH) admitted to an Egyptian fever hospital were followed for 12 months. The hepatitis B surface antigen (HBsAg) carrier rate in 95 with hepatitis B virus (HBV) hepatitis decreased from 53% at three months to 13% at 12 months. At 12 months, 22% of the male patients had persistent HBsAg compared with only 7% of the female patients. The HBsAg carrier rate was 25% at 12 months in those with schistosomiasis compared with 9% in those with only acute HBV infection. Splenomegaly persisted in those with palpable spleens at the initial examination and others developed splenomegaly. The prevalence of splenomegaly increased from 11% on admission to 20% at 12 months in those with only AVH, and from 40% to 69% in those with concomitant schistosomiasis. Patients with concomitant schistosomiasis had higher mean values for liver function test results and a greater proportion had abnormal liver function test results during hospitalization and follow-up than those with AVH only. Concomitant schistosomiasis increased the prevalence and prolonged splenomegaly and morbidity due to AVH. Both male sex and concomitant schistosomiasis prolonged the HBsAg carrier state. We propose that AVH frequently converts uncomplicated intestinal schistosomiasis to hepatosplenic schistosomiasis. PMID- 1763803 TI - Serum levels of bothropic venom in patients without antivenom intervention. AB - Serum kinetics of bothropic venom were evaluated in eight snakebite patients, who due to a national shortage, received no specific antivenom therapy. The cases were clinically classified as mild, moderate, and severe. Patients were bled sequentially and serum levels of venom were assayed by ELISA. Venom level ranges differed among the groups, with peak levels of less than 13 ng/ml, 32 ng/ml, and 120 ng/ml for the mild, moderate, and severe groups, respectively. There was no clear pattern of kinetics in the groups. Regression analysis involving the variables severity and peak venom levels yielded a statistically significant correlation (rs = 0.80, P less than 0.05). These data indicate that different amounts of circulating venom correlate with clinical severity, even in highly complex venoms, and stress the importance of careful clinical classification in the proper management of bothropic incidents. PMID- 1763804 TI - Fundamentals of sinusoidal flow sequential injection spectrophotometry. AB - A rational design of the sequential injection analyzer is based on description of the mutual penetration of sample and reagent zones, which are sequentially stacked into a tubular conduit and then injected into a reactor and transported toward the detector by means of a carrier stream, flowing at a preprogrammed rate. Variables governing zone penetration have been identified by a series of dispersion experiments, for sequential injection of two and three zones, thus outlining the conditions for performing single- and double-reagent-based assays. A parallel is drawn between conventional flow injection and corresponding sequential injection colorimetric determinations of chloride and phosphate, with the aim of suggesting guidelines for the development of spectrophotometric- and fluorescence-based sequential injection methods. PMID- 1763805 TI - Matrix-assisted UV-laser desorption/ionization mass spectrometric analysis of monoclonal antibodies for the determination of carbohydrate, conjugated chelator, and conjugated drug content. AB - The chemically averaged molecular weights of a variety of native and conjugated monoclonal antibodies, approximately 150,000, were measured by matrix-assisted UV laser desorption/ionization mass spectrometry. The average mass of the carbohydrate present in a monoclonal antibody was estimated from the difference between the measured mass of the monoclonal antibody and the mass of the protein present in the monoclonal antibody computed from the amino acid translation of the DNA sequence. The loading of chelators and anticancer drugs conjugated to a monoclonal antibody was quantitated from the difference in the measured masses for the conjugated and untreated monoclonal antibody relative to the expected mass change upon conjugation of 1 mol of chelator or drug. The loading results obtained by mass spectrometry were consistent in most cases with measurements obtained by radioactivity trace assay or UV spectrometry. Similar matrix-assisted UV-laser desorption/ionization mass spectrometric studies were also made after reducing untreated and conjugated monoclonal antibodies with dithiothreitol to determine the distribution of carbohydrate and chelator between the light and heavy chains of the molecules. Matrix-assisted UV-laser desorption/ionization mass spectra were used to compute loading values for covalently bound drugs and proteins, while the loading values obtained by use of gel-filtration HPLC and UV spectrometry cannot distinguish between covalently and noncovalently bound drugs and proteins. PMID- 1763806 TI - Direct introduction of large-volume urine samples into an on-line immunoaffinity sample pretreatment-capillary gas chromatography system. AB - An immunoaffinity precolumn containing immobilized antibodies raised against the synthetic steroid hormone beta-19-nortestosterone, has been used for the automated sample pretreatment of urine samples containing beta-19-nortestosterone or the related steroids norethindrone and norgestrel. The sample pretreatment system was coupled on-line to a capillary GC. The on-line connection between the immunoaffinity precolumn and the capillary GC was realized with an interface that consisted of a 10 mm X 2 mm i.d. reversed-phase pre-column and a diphenyltetramethyldisilazane-deactivated GC retention gap. After preconcentration on the immunoaffinity precolumn the analytes were eluted and reconcentrated on the reversed-phase precolumn. Subsequently, this precolumn was desorbed with 75 microL of ethyl acetate, which was directly introduced into the retention gap by using partially concurrent solvent evaporation. The system allows the automated pretreatment and GC analysis of 5-25-mL urine samples for the ppt-level determination of 19-norsteroids. The general applicability and potential of on-line immunoaffinity-capillary GC systems are discussed. PMID- 1763807 TI - Tandem mass spectrometry of very large molecules: serum albumin sequence information from multiply charged ions formed by electrospray ionization. AB - Serum albumin proteins, Mr approximately 66 kDa, from 10 different species (bovine, human, rat, horse, sheep, goat, rabbit, dog, porcine, and guinea pig) have been studied by electrospray ionization mass spectrometry (ESI-MS) and tandem MS using a triple-quadrupole instrument. The effectiveness of collisional activation for the multiply charged albumin ions greatly exceeds that for singly charged ions, allowing an extension by a factor of at least 20 to the molecular mass range for obtaining sequence-specific product ions by tandem MS. Efficient dissociation is largely attributed to "preheating" in the interface Coulombic instability and the large number of collisions. Increasing the electric field in the intermediate pressure region, between the nozzle-skimmer elements of the atmospheric pressure/vacuum interface, allows fragmentation of the multiply protonated (to 96+) molecules produced by ESI. The most abundant dissociation product ions assigned have a low charge state (2+ to 5+) and are attributed to "bn" mode species from cleavage of the -CO-N- peptide backbone bonds. Particularly abundant dissociation products originate from regions near residues n = 20-25 from the NH2 terminus for parent ions of moderate charge (approximately 50+). Collisionally activated dissociation (CAD) mass spectra from porcine serum albumin, in contrast to the other albumins, also gave prominent singly charged "yn" fragments formed from cleavages near the COOH terminus. Tandem mass spectrometry (MS/MS) of the multiply charged molecular ions, and of fragment species produced by dissociation in the interface (i.e., effective MS/MS/MS), produced similar "bn" species and served to confirm spectral assignments. We also show that ESI mass spectra allow a qualitative assessment of protein microheterogeneity and, in some cases, resolution of major contributions. The physical and analytical implications of the results are discussed, including the identification of possible errors in previously published sequences. PMID- 1763808 TI - Migration behavior of cationic solutes in micellar electrokinetic capillary chromatography. AB - A phenomenological approach is presented to describe the migration of cationic solutes in micellar electrokinetic capillary chromatography (MECC). The migration behavior of an organic base is complicated by the presence of an acid-base equilibrium, the ion-pairing formation between the conjugated acid of the base and the monomer surfactants, and the interactions of both the base and its conjugated acid with the micellar pseudophase. An equation was derived that allows the calculation of the migration factor of a cationic solute in MECC with anionic micelles. Two limiting cases were considered: first the cationic solute completely associates with the anionic surfactant (ion-pair formation constant, KIP, approaches infinity), and therefore there is no free charged species in the solution; second, the KIP = 0 and the free conjugated acid, BH+ migrates in the aqueous bulk solvent at its own electrophoretic velocity. An estimate for the ion pair formation constant between cationic solutes and free surfactant can be obtained by using the model. PMID- 1763809 TI - Concentration of hydrophobic organic compounds and extraction of protein using alkylammoniosulfate zwitterionic surfactant mediated phase separations (cloud point extractions). AB - The zwitterionic surfactants 3-[nonyl- (or decyl-) dimethyl-ammonio]propyl sulfate, (C9-APSO4 or C10-APSO4) were synthesized using Nilsson's procedure, and their phase separation behavior under different experimental conditions was evaluated. The results indicate that such zwitterionic surfactants can be utilized for the extraction/preconcentration of hydro-phobic species in a manner akin to that previously reported for nonionic surfactants. This was demonstrated for several practical applications including the extraction/preconcentration of some steroidal hormones and vitamin E prior to high-performance liquid chromatography analysis. The zwitterionic surfactant mediated phase separation was also applied to the extraction of the hydrophobic membrane protein, bacterio rhodopsin, from the hydrophilic cytochrome c protein, both originally present in an aqueous phase. The concentration factors for this aqueous two-phase extraction technique using C10-APSO4 ranged from 26 to 35 with recoveries in the range 88 to greater than 96%. Some comparative studies indicate that the use of zwitterionic surfactants in lieu of nonionic surfactants (e.g. polyoxyethylene(7.5) nonyl phenyl ether PONPE-7.5) in such an extraction method offers some significant advantages such as purer, homogeneous surfactant preparation, minimum background absorbance at UV detection wavelengths, the two-phase region occurring at lower temperatures, and greater extraction efficiencies/concentration factors among others. PMID- 1763810 TI - Determination of total and free sulfur dioxide in wine by flow injection analysis and gas-diffusion using p-aminoazobenzene as the colorimetric reagent. PMID- 1763811 TI - On-line preconcentration and volatilization of iodine for inductively coupled plasma atomic emission spectrometry. PMID- 1763812 TI - In vivo morphometry and functional morphology of brown adipose tissue by magnetic resonance imaging. AB - Brown adipose tissue (BAT) is the main effector of nonshivering thermogenesis and diet-induced thermogenesis in mammals. Assessment of the magnitude and perturbations of BAT deposits in the intact, living body would be of much relevance for quantitative studies of BAT functions, but such studies have been impossible to date. In this paper it is shown that magnetic resonance imaging (MRI) morphometry can provide the means for accurate, repeated determinations of the volume of BAT deposits in a living animal; moreover, tissue modifications due to acclimation at different ambient temperatures are revealed in vivo by MRI, which correlates with histology and ultrastructure. Furthermore, MRI differentiates areas of BAT responsive to acute adrenergic stimulation, thereby giving information on the thermogenetically active tissue in the intact animal. Therefore, MRI represents a reliable tool for correlative morphological and functional studies of BAT in the living animal. PMID- 1763813 TI - Sperm actin and calmodulin during fertilization in the hamster: an immune electron microscopic study. AB - The distribution of actin and CaM in hamster spermatozoa was examined during the early events of fertilization using postembedding immunogold procedures. Actin was immunolocalized with a polyclonal antibody and two monoclonal antibodies. CaM was immunodetected with a polyclonal antibody. In epididymal sperm, actin labeling was found solely in the principal piece of the flagellum. CaM labeling was observed in the postacrosomal lamina, subacrosomal ring, and tip of the perforatorium. These distributions were not modified after capacitation and acrosome reaction. During the successive steps of sperm-egg fusion actin remained undetected in the sperm head whereas its location did not change in the flagellum. CaM distribution remained unmodified until the sperm head begins to decondense. At later stages of sperm head decondensation the postacrosomal lamina and its CaM labeling disappeared, whereas gold particles were still detected in the subacrosomal layer. The predominant location of actin into the egg cortex, particularly the microvillus-free area was confirmed. Except for the CaM labeling of the meiotic spindle, no special CaM location could be found throughout the egg. Thus, in hamster, a role for sperm actin in sperm-egg fusion appears unlikely. In contrast the CaM present in the Ca(2+)-rich postacrosomal lamina could be involved in the regulation of egg activation. PMID- 1763814 TI - Thecal and interstitial cells in polycystic ovaries (PCO) in the rat. AB - Two different types of experimentally-induced polycystic ovaries (PCO) have been examined. A macrocystic ovarian condition is induced by estradiol valerate (EV) injection, whereas a microcystic ovarian condition is engendered with subcutaneous estradiol implants. In both of these models thecal and secondary interstitial cells were characterized using three functionally significant indices. Expression of alkaline phosphatase was evaluated immunohistochemically, hCG/LH-binding capacity was assessed by means of EM radioautography, and the size and percent cytoplasmic area of intracytoplasmic lipid were determined, in the same cells, by morphometry. In both types of ovary, thecal cells of healthy and atretic follicles stained heavily for alkaline phosphatase whereas cystic theca exhibited little or no staining. Intermittent faintly stained patches of secondary interstitial cells, as well as intensely stained spheroidal cell clusters, were most numerous in the microcystic ovary and occurred less frequently in the macrocystic ovary. Cystic thecal cells in both conditions exhibited large lipid droplets and minimal hCG binding. Lipid droplet area was minimal and hCG binding maximal in secondary interstitial cells of both types of ovary. It is concluded that specific clusters of secondary interstitial cells are important steroidogenic elements in PCO, whereas cystic theca is relatively inert. PMID- 1763815 TI - Alteration of the mammotroph Golgi complex by the dopamine agonist 2 Br-alpha ergocryptine (CB-154) in ovariectomized estrogen primed rats. AB - The present study examined the acute effects of 2 Br-alpha-ergocryptine (CB-154, a dopamine agonist) on mammotroph organelles during prolactin (PRL) suppression. Ovariectomized estrogen-primed rats received a single injection (sc) of 0.5 mg CB 154 and the animals were killed at intervals following injection. The anterior pituitary glands were fixed for electron microscopy and immunocytochemistry was used to confirm mammotroph identification. Serum PRL levels were determined by RIA. Following CB-154 administration, serum PRL was significantly (P less than 0.05) reduced within 15 minutes and was suppressed (P less than 0.01) to ovariectomized levels at 2 and 6 hours. A stereological analysis of mammotrophs in the central regions of the anterior pituitary showed that the Golgi complex volume was significantly (P less than 0.05) reduced at 2 hours after CB-154 treatment. However, the Golgi complex volume had recovered by 6 hours post CB-154 injection. In addition, the volumes of the mammotroph cells, the mature secretory granules, and the secondary lysosomes had significantly increased by 6 hours. There were no significant changes in any of the organelles following CB-154 in the mammotrophs from the peripheral regions of the gland. These studies show that the Golgi complex is especially susceptible to acute morphological changes induced by bromocryptine and that the mammotrophs in the central regions are more responsive to CB-154 than those in the peripheral regions. PMID- 1763816 TI - Pars distalis vasculature: Discovery Shuttle STS-29 rats compared to ground-based antiorthostatic rats. AB - The anterior pituitary glands of male, adult Long Evans rats carried 5 days in the Space Shuttle Discovery (STS-29) have been compared with two groups of ground based controls. All of the animals were part of a study (SE82-08) into the effects of gravity versus a microgravity environment on fracture healing. All had sustained a right, mid-shaft fibular osteotomy. The duration of the study was 10 days, and animals in all groups were weight bearing for the 5 days prior to shuttle lift off. The three experimental groups consisted of four rats each: flight (F) and two ground-based control groups, weight bearing (WB) and suspended (S). The suspension group was in a Holton/Sweeney head-down suspension apparatus (antiorthostatic) for the final 5 days of the study. The anterior pituitary glands of F and WB rats were essentially identical. The vasculature and parenchymal cells appeared unaffected in both instances. However, the anterior pituitary glands of S rats were dramatically altered. The vasculature was widely expanded with proteinaceous deposition covering the lumenal endothelial surfaces, and entrapping numerous platelets and aggregates of red blood cells. Parenchymal cells were highly vacuolated, occasionally with membranous vacuoles, but most often revealing large, clear cytoplasmic zones unlined by any membranes. Whereas profiles of exocytosis were numerous in F rats, and present in WB rats, they were essentially absent in S rats. These results indicate that weightlessness over a 5 day flight period does not influence the structural integrity of the anterior pituitary gland and may in fact promote secretory granule release. However, the head-down tilt model, frequently used to study fracture repair under conditions that mimic weightlessness, has a profound impact on the vasculature of the anterior pituitary gland which then affects the structural and functional characteristics of the parenchymal cells. PMID- 1763817 TI - Intercellular communication within the rat anterior pituitary gland. III. Postnatal development and periodic changes of cell-to-cell communications in female rats. AB - Cell-to-cell communication by gap junctions was investigated in the female rat anterior pituitary gland from 10 through 45 days of postnatal development and in 60-day-old animals. Gap junctions initially appeared between adjacent folliculo stellate cells on day 25. Their appearance in female rats was 5 days later than that observed in males (Soji et al., 1990). Gap junction number increased until the animals became 40 days of age, when they reached a level that resembled that found in adults. In addition, a correlation was evident between the frequency of gap junctions and stages of the estrous cycle, where they were most numerous during either proestrus or estrus. These results along with those previously published suggest that gap junction formation within the female rat hypophysis is in part modulated by both gonadal steroid hormones as well as prolactin. PMID- 1763818 TI - Immunohistochemical localization of components of the immune barrier in the olfactory mucosae of salamanders and rats. AB - Immunohistochemical techniques were used to investigate the cellular distribution of components of the secretory immune system, including secretory immunoglobulin, secretory piece, and J chain, as well as other immunoglobulins and nonspecific defense factors in the olfactory mucosae of salamanders and rats. In the salamander, secretory immunoglobulin M, and J chain were localized in duct and acinar cells of Bowman's glands, in B lymphocytes, and in sustentacular cells in immature regions of the olfactory mucosa. Lactoferrin and lysozyme were also present in Bowman's glands, in sustentacular cells in immature regions of the olfactory mucosa, and in blood cells in the lamina propria. Olfactory nerve section resulted in the presence of increased numbers of secretory immunoglobulin immunoreactive B lymphocytes and in an altered distribution of IgM, secretory piece, and lactoferrin. In the rat, secretory immunoglobulin A and J chain were localized in duct and acinar cells of Bowman's glands and in B lymphocytes in the lamina propria. Secretory piece could be demonstrated in Bowman's glands only in rats that had a prior viral infection. Other defense factors, localized in the lamina propria, included IgG in the connective tissue stroma and in B lymphocytes, IgD-immunoreactive B lymphocytes, and IgE-immunoreactive cells that were identified as mucosal mast cells. Lactoferrin and lysozyme were present in serous acinar cells of Bowman's glands and in blood cells. These results demonstrate that the olfactory mucosa is protected from pathogenic invasion by the secretory immune system as well as other immunoglobulins, lactoferrin, and lysozyme. PMID- 1763819 TI - Reconstruction of basement membrane in recombinants of epidermis and dermis of chick embryonic skin in vitro: an electron microscopic study. AB - The tarsometatarsal skin from 13-day-old chick embryos was treated with EDTA and/or Dispase to separate it into epidermis and dermis, and the basal lamina was removed. The isolated epidermis and dermis were then recombined and cultured on Millipore filters in a chemically defined medium (BGJb). Beginning at 3-4 days after recombination, short fragments of new basal lamina and subbasal dense plaque were formed along the epidermal basal cell outer surface immediately subjacent to hemidesmosomes. After 6-8 days of culture, fragments of the basal lamina started to fuse together and the lamina became progressively continuous. At the same time, anchoring fibrils were formed to attach to the basal lamina. The hemidesmosome formation preceded the basement membrane formation. When normal embryonic epidermis was recombined with retinol-pretreated dermis and cultured for 7 days in BGJb, short fragments of the basal lamina, the subbasal dense plaque, and anchoring fibrils were formed, but the basement membrane remained discontinuous with many interruptions in the interspace between hemidesmosomes. These results demonstrate that pretreatment of dermis with retinol causes the changes noted in the basement membrane. PMID- 1763820 TI - Endothelial cell origin and migration in embryonic heart and cranial blood vessel development. AB - Using the QH-1 monoclonal antibody as a marker for quail endothelium, blockage and transplant experiments were carried out to construct fate maps for the embryonic endocardium, to determine whether preendocardial angioblasts are migratory, and, if these cells are migratory, to outline the pathways that they use for directed migration in embryonic blood vessel development. Recent descriptive studies using QH-1 to make immunofluorescent whole mounts have described a sequence of events leading to the establishment of the embryonic heart tube. These reports suggest that the pattern for the endocardium and cranial vasculature is established by migrating angioblasts that form vascular cords which mature into blood vessels. Blockage experiments showed that the ventrolateral edge of the anterior intestinal portal serves as a substrate for the directed migration of pre-endocardial angioblasts and that the pattern of the cranioventral vasculature forms independent of the source of angioblasts. Transplant experiments showed that the origin for endocardial angioblasts lies in mesodermal tissue just anterior to Henson's node, that these cells undergo directed migration to the pericardial area, and that angioblasts are pluripotent with the ability to form different blood vessels. The transplant studies also showed that the embryonic mesoderm may contribute to extraembryonic blood vessels on the embryonic yolksac. These results support the hypothesis that embryonic blood vessels may develop by either the vasculogenesis or by the angiogenesis mechanism, and show that the endocardium of the primitive heart tube forms by vasculogenesis. PMID- 1763821 TI - Mechanoreceptors of the hard palate of the Mongolian gerbil include special junctions between epithelia and Meissner lamellar cells: a comparison with other rodents. AB - As a part of our comparative morphological study of mechanoreceptors in rodent oral mucosae, the hard palate of the mongolian gerbil (a kind of sand rat) was investigated by light and electron microscopy. Subepithelial connective tissue papillae of palatine rugae contained a dense distribution of lamellated corpuscles that showed an ultrastructure similar to that of Meissner corpuscles of primates. The corpuscles in the palate of the mongolian gerbil, however, frequently formed compound large corpuscles with a palisade-like extension. Antemolar rugae predominated in containing such compound "Meissner" corpuscles. Superficial cytoplasmic lamellae of the corpuscles closely adhered to overlying epithelial cells without an intervening basal lamina. Although a small number of simple corpuscles was seen in the first antemolar rugae, no similar corpuscles were encountered in other parts of the palate. On the other hand, numerous Merkel cell-nerve endings were seen in epithelial pegs and sometimes in epithelial ridges of palatine rugae. Quinacrine labelling showed that intermolar rugae contained a rather dense distribution of Merkel cells in comparison with antemolar rugae. The present and previous data indicate that the pattern of palatine mechanoreceptors of the mongolian gerbil is analogous to that of the mouse, but not of the rat. PMID- 1763822 TI - A survey of nurses' knowledge, opinions, and reported uses of the Body Substance Isolation system. AB - The Body Substance Isolation (BSI) system was implemented at the University of California San Diego Medical Center in May 1987. About 2 years later, an evaluation was done of the long-term effects of BSI education and training on the knowledge, attitudes, and reported behaviors of nursing personnel. In June 1989, a questionnaire was sent to 600 nursing personnel, including all 100 nurses in the 20-bed surgical intensive care unit, all 66 charge nurses, and a random sample (434) of the remaining nursing staff (about 1000). Results from the 190 respondents (a response rate of 32%) indicated an understanding of the two purposes of BSI: (1) to reduce nosocomial infection risks to patients and (2) to reduce health care workers' risks of acquiring infections from patients. Over half of the respondents reported handling more than 11 needles per day and nearly half reported recapping contaminated needles two-handed "sometimes or often." Only 54% of the respondents reported they had received hepatitis B vaccine. Although more than two-thirds of the respondents had worked at the University of California San Diego Medical Center during the entire BSI system training, implementation, and follow-up period, there is still room for improvement in knowledge and use of the system, including issues related to the safe handling of sharps. PMID- 1763823 TI - Epidemiologic observations of operating room infections resulting from variations in ventilation and temperature. AB - Over a period of years the ventilation system of a community hospital progressively deteriorated until it no longer met regulatory guidelines. The hospital, a publicly funded military facility, requested funding to repair the ventilation system, but funds were not forthcoming because of budget austerity. When an increase in infections was documented, high-risk operations were curtailed and funding was expedited. With the new improved ventilation system the operating rooms once again met regulatory guidelines and infections returned to baseline rates. Throughout the period infections remained below recognized national levels. PMID- 1763824 TI - A cluster of sternal wound infections requiring muscle flap repair: problems in epidemiologic investigation. AB - A cluster of sternal wound infections (SWI) requiring muscle flap closure occurred in a California hospital in 1988. Review of SWI rates by surgical team revealed that a single team (Team A) was associated with a cluster of SWI requiring muscle flap repair (MFR). Team A's rate of SWI requiring MFR was 2.27% in 441 heart operations. A case/control study was conducted to determine if the higher rate of SWI requiring MFR could be attributed to disproportionately large numbers of patients at high risk treated by Team A. Data on major risk factors for SWI collected for case and control groups included the following: age at operation, weight, body surface area, history of obesity, diabetes mellitus, or cigarette smoking, duration of cardiopulmonary bypass, use of internal mammary artery graft, number of coronary arteries bypassed, use of prostheses, operating room staffing, and emergent nature of operation. No statistically significant differences between Team A cases requiring MFR and control cases were observed for predisposing risk factors. Surgical technique remains a principal suspected risk factor for SWI requiring MFR in this cluster. PMID- 1763825 TI - Measles. AB - Measles has become epidemic over most of the world, with an important increase in the number of cases and associated morbidity and mortality in the United States since 1986. The two major factors responsible for this rise in the number of cases are, first, the increase in unvaccinated preschool-age children and, second, vaccine nonresponders (approximately 5%). The highest attack rate occurred in teenagers (15 to 19 years old) and in nine states (82% of cases). This situation has prompted revised immunization recommendations for those counties reporting more than five cases of measles among preschool-age children during each of the previous 5 years. In these counties, a first dose with monovalent measles vaccine is recommended at 9 months of age, followed by a second dose with measles, mumps, and rubella vaccine at 15 months of age, and revaccination of all children at the time of school entry. Recent publications regarding the use of vitamin A and certain antiviral agents are encouraging and are discussed in the manuscript. All cases of measles should be reported and investigated promptly. A good outbreak-control program will depend on the rapid recognition of the disease, a team approach, and prompt vaccination or IgG administration to susceptible persons. PMID- 1763826 TI - The APIC statement on purposes for and elements of patient notification programs related to the health care worker infected with human immunodeficiency virus or the hepatitis B "e" antigen. The Association for Practitioners in Infection Control, Inc. Committee on Bloodborne Pathogens. PMID- 1763827 TI - Ventricular tachycardia as a first manifestation of right ventricular myxoma--a case presentation. AB - The authors present a case of a thirty-nine-year-old white man in good health who developed episodes of ventricular tachycardia as a first manifestation of a right ventricular myxoma, which was diagnosed by two-dimensional echocardiogram and then resected with no complications and total disappearance of the cardiac arrhythmia. After reviewing the literature they consider the present case as a rare manifestation of an infrequent location of an uncommon disease. PMID- 1763828 TI - Effect of exercise training on multiple respiratory variables in patients with coronary artery disease: correlation with change in exercise capacity. AB - Multiple measurements of pulmonary function were performed during exercise testing in 29 patients with coronary artery disease (CAD) before and after exercise training. Following training, significant increases in oxygen consumption (VO2), carbon dioxide production (VCO2), and peak flow at maximal exercise were seen as compared with pretraining values (p less than .01), but not in any other respiratory variables. Only the peak respiratory exchange ratio (RER) achieved during pretraining exercise testing and peak values of minute ventilation (VT), respiratory rate, and VCO2 during a posttraining exercise test showed significant correlations with the change in maximum VO2 following exercise training (p less than .05). Significant correlations were also found among VT, VCO2, and peak flow at peak exercise following exercise training and the change in exercise duration between pretraining and posttraining stress tests. Of 22 patients evaluated with thallium 201 scintigraphy during their pretraining exercise test, 11 developed ischemic ST depression or a reversible perfusion defect. No significant differences in pulmonary function measurements during exercise testing were seen between patients who developed ischemia and those who did not. However, the change in peak metabolic equivalents (METS) achieved between pretraining and posttraining exercise was significantly greater in patients who developed ischemia (.836 +/- 1.003 versus .091 +/- .481, p less than .05). These results indicate that exercise training in patients with CAD is not associated with significant changes in most measurements of pulmonary function and, with the exception of RER at peak exercise, pretraining measurements do no show a significant correlation with changes in exercise capacity. PMID- 1763829 TI - Internal carotid artery occlusion: diagnostic inaccuracy of the ocular pneumoplethysmography. AB - The diagnosis of internal carotid artery (ICA) occlusion has serious management and prognostic consequences. The accuracy of noninvasive techniques in this setting remains questionable, with the result that contrast arteriography remains the diagnostic method of choice in patients in whom ICA occlusion is suspected. Ocular pneumoplethysmography-Gee (OPG-Gee) is one of the noninvasive methods that is still utilized extensively in the evaluation of carotid artery disease. In order to determine the real utility of OPG-Gee, the authors conducted a retrospective comparison of the results of OPG-Gee and arteriography in 26 patients (52 internal carotid arteries) who had undergone both examinations. [table: see text] With the angiography results as the standard of comparison, 4 incorrect diagnoses were obtained by OPG-Gee, thus yielding an overall accuracy of 92 for this method. However, duplex ultrasonography, also performed in the same 26 patients, correctly identified the 2 ICA occlusions defined by angiography and further demonstrated patency in the 48 arteries so shown by angiography. The authors conclude from this experience that OPG-Gee is less reliable than duplex ultrasonography in the diagnosis of ICA occlusion. Furthermore, despite the 92% overall accuracy of their results with OPG-Gee, the occurrence of both false-positive and false-negative results renders this examination modality suspect in the diagnosis of ICA occlusion. PMID- 1763830 TI - Can rheologic variables be of prognostic relevance in arteriosclerotic diseases? AB - The hypothesis that blood rheology is of prognostic value in patients with arteriosclerotic diseases was tested in a prospective study of 843 patients at a rehabilitation clinic. They were tested for blood serum and plasma viscosity, hematocrit, fibrinogen, red cell aggregation and deformability, erythrocyte sedimentation rate, white cell count, cholesterol, and triglycerides. End points were defined as a second stroke or myocardial infarction or cardiovascular death within two years of the initial examination. Patients suffering such end points as compared with matched pairs (n = 74; matching criteria: identical manifestation of arteriosclerosis, identical sex and similar age and risk factors) had significantly higher native blood viscosity (p = 0.002), red cell aggregation (p = 0.01), serum viscosity (p = 0.01), fibrinogen (p = 0.02), and cholesterol (p = 0.01). It is concluded that rheologic factors are associated with the prognosis in patients with arteriosclerotic diseases. PMID- 1763831 TI - Peripheral and renal vein renin activity in patients with renovascular hypertension due to nonspecific aortoarteritis. AB - The diagnostic utility of peripheral and renal vein renin estimations in relation to angiographic findings was evaluated in 13 patients with renovascular hypertension and non-specific aortoarteritis (NSAA, Gr I), in comparison with 10 patients with renal artery stenosis due to other causes (Gr II). Plasma renin activity (PRA) was measured by radioimmunoassay. Blood samples were collected after angiography from the femoral vein and renal vein on the affected side followed by sampling from the less affected or unaffected side. Renal vein renin ratio (RVRR) was calculated from renal vein renin values. The effect of captopril (25 mg oral) on blood pressure, PRA, and RVRR was examined in 8 patients from each group. Normotensive volunteers (8) with moderately low salt intake were also included in the study for comparison of twenty-four-hour urinary sodium output, peripheral PRA, and response to captopril. The mean peripheral PRA was high in both groups as compared with normotensive controls; however, the values were lower in patients with NSAA. The rise in PRA in response to captopril was insignificant in Gr I (p greater than 0.05) and RVRR greater than 1.5 was observed in 5 of 13 patients in contrast to 9 of 10 in Gr II (p less than 0.05). A paradoxical ratio, ie, (high renal vein renin levels on the less stenotic side) was noticed in 3 patients of Gr I, whereas none of the patients of GR II showed such a ratio. An improvement in RVRR after captopril was observed in 50% of patients of Gr I as compared with a marked response in all patients of Gr II.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1763832 TI - Prediction of postoperative pulmonary function following thoracic surgery for bronchial carcinoma. AB - At present surgery is accepted as the most effective mode of therapy for carcinoma of the lung. Because the lack of respiratory reserve is the major determinant of postoperative function, it is useful to identify the patient, who is at significant risk. Eighteen patients with lung cancer (mean age = 56 +/- 6.5 years) were studied preoperatively (preop) and postoperative (postop) (three to four months after lung resection) by spirometry, measurement of arterial blood gases, and quantitative lung scanning (99mTc). A predicted postoperative value of some variables was calculated by the formula: postop value = preop value x % function of regions of lung not resected. The correlation coefficient between the predicted (pred) and postoperatively observed (observ) values VC = vital capacity, FEV1 = forced expiratory volume in 1 second) is: VC pred/VC observ r = 0.83 p less than 0.001 FEV1 pred/FEV1 observ r = 0.82 p less than 0.001. The authors' results agree with earlier reports and show that the method used can accurately predict the postoperative respiratory function in patients undergoing lung resection (pneumonectomy or lobectomy). A predicted FEV1 of 0.8 L does not permit a surgical program, because, below this level, carbon dioxide retention becomes more frequent and exercise intolerance is increasingly severe (poor quality of life). The method proposed to predict the postoperative respiratory function is simple and routinely useful. The authors choose a perfusion instead of ventilation scan, because the former provides similar predicted postoperative data, and can be done routinely. PMID- 1763833 TI - Metabolic, hemodynamic, and electrocardiographic responses to increased circulating adrenaline: effects of pretreatment with class 1 antiarrhythmics. AB - In order to study the effects of treatment with class 1 antiarrhythmics on the metabolic, hemodynamic, and electrocardiographic responses to adrenaline, 12 healthy volunteers were infused on four occasions, after pretreatment with placebo, disopyramide, mexiletine, and flecainide, respectively, with adrenaline at a rate producing serum adrenaline concentrations comparable with those seen in acute myocardial infarction. After pretreatment with placebo adrenaline caused significant falls in serum potassium, serum magnesium, serum calcium, and serum phosphate and a significant increase in blood glucose. Adrenaline also caused a significant increase in heart rate and systolic blood pressure and a significant fall in diastolic blood pressure. On the electrocardiogram a significant prolongation of QTc duration and a flattening of the T-wave amplitude were seen. Pretreatment with disopyramide had no effect on the hemodynamic response to adrenaline but caused a significant prolongation of Qtc duration before the adrenaline infusion. Pretreatment with mexiletine was associated with a significantly greater fall in serum potassium during adrenaline infusion, and pretreatment with flecainide with a greater fall in serum magnesium, as compared with placebo pretreatment Flecainide also caused a significant prolongation of the QRS duration before adrenalin infusion, and after all the active pretreatments a prolongation of QRS duration was seen during adrenaline infusion. The metabolic and hemodynamic changes during adrenaline infusion may not only reduce the antiarrhythmic efficacy of antiarrhythmics but may also increase the risk of proarrhythmic effects in a clinical setting. These results may help to explain why treatment with antiarrhythmics seems to be without beneficial effect on mortality in post-myocardial infarction patients. PMID- 1763834 TI - The Angle collection. PMID- 1763835 TI - Vertical malocclusions: etiology, development, diagnosis and some aspects of treatment. AB - Vertical malocclusions develop as a result of the interaction of many different etiological factors; one of the most important of these factors is mandibular growth. Variations in growth intensity, function of the soft tissues and the jaw musculature as well as the individual dentoalveolar development further influence the evolution of these malocclusions. This article reviews the most common etiological factors and their possible contribution to the development of vertical malocclusions with special emphasis on the role of mandibular growth in the development of open bite and deep bite. The role of the cephalometric morphological analysis in the differential diagnosis of vertical malocclusion is emphasized. Aspects of orthodontic treatment of vertical malocclusions are illustrated with individual cases. PMID- 1763836 TI - Evaluation of orthodontic results--a discussion of some methodological aspects. AB - The informative value of clinical material presented at meetings and in the literature poses a dilemma for the typical orthodontist. To aid in the resolution of this problem, methodological aspects of the following topics are discussed: criteria for the evaluation of orthodontic treatment results, the selection of cases to be evaluated, the presentation of orthodontic treatment results and the interpretation of case presentations. Orthodontic relapse should be considered to be a number of continuous variables affecting treatment results; different follow up criteria should be employed when comparing pretreatment, posttreatment and postretention results. PMID- 1763837 TI - Long-term soft tissue response to LeFort I maxillary superior repositioning. AB - The purpose of this study was to compare short-term (approximately 12 months postoperatively) and long-term (24 to 81 months postoperatively) records of 36 patients who underwent superior repositioning of the maxilla via LeFort 1 osteotomies. The parameters of measurement were set up to analyze the net response of the soft tissues of the face to superior repositioning of the maxilla. The results of this study show that soft-tissue changes associated with maxillary impaction are minimal and that no significant differences exist between twelve-month records and five-year records. PMID- 1763838 TI - Patterns of electromyographic activity in subjects with different skeletal facial types. AB - Integrated electromyographic activity of masseter and anterior temporal muscles was recorded using bipolar surface electrodes in 33 young adults. Subjects were skeletally classified according to ANB angle reading corrected both for maxillary position and rotation of the jaw. Postural activity for both muscles was higher in Class III subjects than in Class I and Class II, whereas in Class I and II subjects activity was similar. During swallowing, masseter muscle activity in Class III subjects was higher than Classes I and II, whereas anterior temporal muscle activity was not different between Classes III and I. During maximal voluntary clenching, activity was not different among classes. High correlations between electromyographic activity and corrected ANB angle as well as with overjet were observed. Skeletal classification used in the present study may have clinical relevance regarding treatment and prognosis, as well as in the assessment of the relationship between muscular activity and craniofacial characteristics. PMID- 1763839 TI - Wire friction from ceramic brackets during simulated canine retraction. AB - The present study was designed to investigate the nature of friction between orthodontic wire and various ceramic brackets. The amount of tooth movement with metal and ceramic brackets was measured, and the wire surfaces were examined microscopically immediately after artificial tooth movement. The amount of tooth movement produced by the ceramic brackets was significantly less than that produced by metal bracket. The wire surfaces were scratched more obviously by ceramic brackets than by metal bracket. Slot surfaces and edges of the ceramic brackets were substantially more porous and rougher than those surfaces of the metal bracket. These material differences between metal and ceramic brackets significantly affect the efficiency of orthodontic tooth movement. PMID- 1763840 TI - Comparison of the frictional coefficients for selected archwire-bracket slot combinations in the dry and wet states. AB - Coefficients of friction were evaluated in the dry and wet (saliva) states for stainless steel, cobalt-chromium, nickel titanium, and beta-titanium wires against either stainless steel or polycrystalline alumina brackets. For both operators' experiments, an 0.010" stainless steel ligature wire pressed each archwire into the 0.018" or 0.022" bracket slot at 34 degrees C. In the dry state and regardless of slot size, the mean kinetic coefficients of friction were smallest for the all-stainless steel combinations (0.14) and largest for the beta titanium wire combinations (0.46). The coefficients of the polycrystalline alumina combinations were generally greater than the corresponding combinations that included stainless steel brackets. In the wet state, the kinetic coefficients of the all-stainless steel combinations increased up to 0.05 over the dry state. In contrast, all beta-titanium wire combinations in the wet state decreased to 50% of the values in the dry state. The mixed reports that saliva may promote adhesive and lubricious behaviors may have some substance. PMID- 1763841 TI - Orthodontic treatment and demand of a cleft lip and palate patient. AB - Most orthodontists would agree the treatment plan followed in this case was a severe compromise; many oral surgeons will find it completely unacceptable. However, during the relatively short treatment time--a total of 12 months--the anterior crossbite was corrected and the patient got the front teeth she wanted. Demand or perceived need of the patient should always be the prime objective of any kind of treatment in order to have patient's cooperation. The patient and her parents are now very grateful and ready for the prosthodontic procedures. Although this case was not treated according to the need perceived by the specialists, the result is by all means acceptable and satisfactory to both parties. PMID- 1763842 TI - [Critical study of ELISA technique and high sensitivity direct agglutination test for the screening of antitoxoplasma IgG]. AB - The authors have evaluated an ELISA (Toxo-IgG EIA; bioMerieux) and a direct agglutination test using a sensitized antigen (Toxo-Screen DA; bioMerieux), with a fluorescent test antibody (Toxo-Spot IF; bioMerieux) as a reference for the screening of toxoplasmosis IgG antibodies. A good correlation was obtained for these two methods with fluorescent test antibody (p less than 0.00001) on 841 sera. However, results obtained with direct agglutination test were better than those obtained with ELISA (direct agglutination versus fluorescent test antibody: 97.4% of agreement; ELISA versus fluorescent test antibody: 96.1% of agreement). In addition, the use of the Receiver Operating Characteristic (ROC) curve, showing the changes of sensitivity and specificity as a function of the possible values of each threshold, indicated that sera with titers between 15-20 IU/ml should be interpreted very cautiously. PMID- 1763843 TI - [Effect of starvation and phenobarbital on the activity of liver uroporphyrinogen synthetase]. AB - Liver uroporphyrinogen synthetase activity was measured in 45 mice, divided in three groups. The mice of the 1st group served as controls, those of the 2nd starved for 24 hours, while those of the 3rd were injected intraperitoneally with phenobarbital. The enzymic activity was found significantly (p less than 0.001) lower in the animals of the 2nd group (17.49 +/- 2.25 nmol/g/h) and higher in those of the 3rd (25.82 +/- 3.73 nmol/g/h) as compared to the controls (20.89 +/- 2.11 nmol/g/h). If these effects also exist in the human it could be suggested that starvation may be doubly harmful for the patients with acute intermittent porphyria by aggravating both their enzymic disorders. On the contrary, in the case of phenobarbital its undesired effect on porphyria may be moderated by a simultaneous induction of the uroporphyrinogen synthetase. PMID- 1763844 TI - [A case of urinary elimination of methionine sulfoxide without hypermethioninemia]. PMID- 1763845 TI - [IgG subclass deficiency]. PMID- 1763846 TI - [Technical indications and results of totally implantable catheter systems]. AB - The development of the total implantable catheters has produced a lot of benefits, specially in oncological patients, who save venose punctions for blood controls and for administration of cytostatics. Important conditions for the success of the catheters are to avoid unnecessary manuvres during the surgical act and the postoperative care. In the University Hospital of Munster 68 children have been treated between 1984 and 1988 with this system. The implantation was mostly performed in oncological patients but also in patients who needed a total parenteral nutrition. With optical and electronic microscope studies has been observed that in the inside part of the Port and the catheter, deposits with different characteristics have been found. These deposits could be divided in four groups depending on the structure. PMID- 1763847 TI - [Four years of pediatric emergencies. Relationship between the increase in their number and personal initiatives in complementary examinations as well as hospital admissions]. AB - In 16,848 paediatric emergencies taken care of from 1986 to 1989 in a regional hospital which had started work in 1985, we have confirmed an initial increase of over 20& per year in the number of paediatric emergencies that have become stable as we have reached full coverage of the total paediatric population in area. We have also stated that the volume of personal initiative emergencies has been increasing rather meaningluffly every year, going up from an initial 55% to a 75% in four years. On opposite the number of complementary checkups has decreased significantly from 38% to 35% and children hospital entries including those that required urgency observation have also gone down from a 21,69 in 1986 to a 15,8 in 1989. The growing tendency to overuse paediatric emergencies indiscriminately on the part of the population, leads us to make a serious proposal towards the adaptation and suitabilisation of emergency service in hospitals in order to be prepared to deal with non-urgent pathology. PMID- 1763848 TI - [Prediction of complications in children of hypertensive mothers]. AB - The hypertensive disorders of pregnancy are a frequent cause of neonatal morbidity and mortality. 259 newborns of hypertensive women were study to establish the relationship between some maternal findings and the subsequent neonatal complications. The severity, early onset of hypertension, proteinuria and the gestation of 32 week or less, are related with special risk of small-for date, anoxia, seizures and neutropenia. Preeclampsia was related with foetus more compromised. Also hyperuricemia, thrombocytopenia and cesarean section were light predictors of neonatal trouble. These findings can orientate the neonatologist to select the newborns prone to complications, watching them closely to start the treatment, if necessary, as soon as possible. PMID- 1763849 TI - [Rheumatic fever and post-streptococcal arthritis. Clinical review]. AB - We report 11 patients diagnosed of Acute Rheumatic Fever (ARF), and 7 of Poststreptococcal Reactive Arthritis (PSRA): patients with group A beta hemolytic streptococcal infection and articular disease who do not fulfill the modified Jones criteria. All patients with ARF were treated with monthly prophylaxis (with penicillin G benzathine). Carditis was seen in five patients, but only one of them has developed a mitral valve insufficiency. The prophylaxis in patients with PSRA was individualized. None of these patients had clinical evidence of carditis during the acute disease, but one of them developed a mitral and aortic stenosis two years after the initial episode. The possible indication of penicillin prophylaxis in these patients with PSRA in suggested. PMID- 1763850 TI - [Pulmonary function in preterm and full term infants during the neonatal period: 1. respiratory pattern]. AB - The pattern of breathing of 18 preterm newborn infants weighing less than 1500 g. at birth, and old 35 full-term newborns weighing more than 2500 g. at birth were studied during the neonatal period. The newborns were grouped according to postnatal age. (less than 24 hrs; 24 hrs.-7 days and less than 7 days). The inspiratory and expiratory flow was measured by means of pneumotachography. The respiratory rate values (f) decrease with postnatal age: The highest values in all three postnatal age groups correspond to the preterm newborns. The decrease in is a accompanied by an increase in the duration of inspiratory (TI) and expiratory (TE) time to such and degree that the relationship TI/total respiratory cycle (TI/TTOT) shows no significant differences between the groups studied. Both in preterm and full-term newborns, the peak expiratory flow occurs at a later point in expiration during the first 24 hours of life. The tidal volume (VT) and the minute ventilation increase with age. The VT in proportionate to the weight in all groups. The mean inspiratory flow (VT/TI) is lower in the preterm newborns, and within each group, the values are higher in those whose postnatal age is greater. PMID- 1763851 TI - [Value of the Coombs test in ABO incompatibility]. AB - We studied the ABO haemolytic disease of the newborn in our neonatal unit to consider their serological aspects and clinical importance. 21% of all pregnancies were ABO incompatibles. The direct antiglobulin test was positive in 46 (11.3%) of them. The Elution was positive in all the newborns with direct antiglobulin test positive (Cd+). The anti-A o anti-B antibodies concentration in mothers was higher than 1/128 in 38 (84%). The C3d complement fraction was activated in two newborns. The infants Cd+ were born to group O mothers in all cases, and nobody was premature. Twelve (26%) of Cd+ presented jaundice which need phototherapy, and one moreover exchange transfusion. The direct antiglobulin test is very useful for detect the liable newborns of serious jaundice; therefore, we thing that is suitable to make this test in infants born to group O mothers. The newborns Cd+ did not have significant anemia at first three months of life. PMID- 1763852 TI - [Incidence of celiac disease in Vizcaya]. AB - Celiac disease (CD) is a permanent gluten-sensitive enteropathy appearing in individuals genetcally predisposed. Its incidence varies according to the authors, but is situated about 1/1.500 alive newborn infants (ANI). Recently, a decreased in the incidence of the disease as well as a delay in the onset of symptoms have been reported in several countries. The incidence of the disease in Spain is unknown so we have studied it in our population. In the period 1976 1987, 117 patients were suspected to have CD in the different centers performing intestinal biopsies in Vizcaya. Diagnosis was confirmed in 87 cases, thus implying an incidence of 1/2.151 ANI. Age onset has been stable along the years, and most cases continue to be diagnosed during the first 2 years of life. PMID- 1763853 TI - [Prognosis in tetralogy of Fallot]. AB - We review here our results in the management of 314 patients with tetralogy of Fallot. These cases represent 13.5% of the congenital heart defects diagnosed by angiohemodynamic methods in the period 1971-1988. Of the 314 children, 234 were subjected to intracardiac repair. The overall mortality was 25.8%. The surgical mortality rate for the intracardiac repair was above 30% in the period 1972-1979, and decreased to nearly 10% afterwards. The 7-year survival was 70% for the entire cohort, 76.3% for the children subjected to complete correction, and 90% for children operated after 1983. Residual hemodynamic abnormalities and dysrhythmias were uncommon in this series. Our results favour primary repair of the defect in practically all patients. PMID- 1763854 TI - [Diet therapy of phenylketonuria. Current aspects]. PMID- 1763855 TI - [Combined use of amrinone and dobutamine in the postoperative period following cardiovascular surgery]. PMID- 1763856 TI - [Congenital fiber type disproportion. Report of an atypical case and review of the literature]. PMID- 1763857 TI - [Unusual parasitic infestation by leeches in a child]. PMID- 1763858 TI - [Current state of the knowledge about hemophilia B in the female. Apropos of a new case]. PMID- 1763859 TI - [Histiocytic hemophagocytic syndrome associated with leishmaniasis]. PMID- 1763860 TI - [Acute interstitial nephritis associated with streptococcal infection]. PMID- 1763861 TI - [Technical report no. 2. Working Group of the Session of CIP (Pediatric Intensive Care Units)]. PMID- 1763862 TI - [Diagnosis of hyperlipidemias]. PMID- 1763863 TI - [Dietary intervention in children with hypercholesterolemia: a plan to follow]. PMID- 1763864 TI - [From ambulatory pediatrics to global pediatrics]. PMID- 1763865 TI - [Drug therapy of hyperlipoproteinemias]. PMID- 1763866 TI - [Future of extra-hospital pediatrics. Supportive aspect]. PMID- 1763867 TI - [Educational role of extra-hospital pediatrics]. PMID- 1763868 TI - [Future of extra-hospital pediatrics. Research aspects]. PMID- 1763870 TI - [Tympanometry]. PMID- 1763869 TI - [Current process of immunizations: vaccination schedule]. PMID- 1763871 TI - [Technics for the examination of the locomotor apparatus]. PMID- 1763872 TI - [Future of extra-hospital pediatrics. New prescription formularies]. PMID- 1763873 TI - [Dermatologic problems most frequently encountered in pediatrics]. PMID- 1763874 TI - [Towards an early diagnosis of gender identity disorders]. AB - This paper deals with children's gender identity disorders on a bibliographical basis. Their etiopathogeny, their scarce but dramatical evolution towards transsexualism and their treatment are described. The record of a personal case illustrates these topics. A consistent basis, made of the various clinical patterns found by different authors is built and enriched, contributing to an earlier assessment of gender identity disorders. PMID- 1763875 TI - [Psychiatric hospital. The years 1935-1945. A computerized study]. AB - Studying the files collected during a 11-years stay in a psychiatric hospital, the authors wonder about the patients' characteristics in those days, and especially about the recorded diagnoses. They show the patients' evolution and notably the fact that most of them became institutionalized. They also underline the huge percentage of psychotics as opposed to the small number of deteriorations resulting from age, times and rural environment allowing older people to continue their life at home. PMID- 1763876 TI - [Chronic respiratory insufficiency and "coping with the illness"]. AB - Chronic pulmonary disease is an impairment of the respiratory function which leads to some somatic, social and psychological consequences. After a clinical analysis of 150 patients with chronic pulmonary disease, the authors define the psychological characteristics of the patients' reactions and their psychological working-through of the illness. Date analysis shows some transformations in the perception of time (more references to the past, lack of references to the future), and psychological elaborations of the illness which appear in the characteristics of the patients' language and in their personal etiological theories. The most common psychopathologies are anxious and depressive disorders, and confusion. The patients' elaborations about their suffering, their symptoms and their illness make it possible to reopen the discussion about the psychological and metapsychological analysis of respiration. The authors emphasize the characteristics of a "respiratory organization of the libido" and its discontinuity. PMID- 1763877 TI - [Unipolar and bipolar disorders: 2 mood disorders]. PMID- 1763878 TI - [Psychiatric commitment under the law of 27 June 1990 regarding the rights and protection of patients hospitalized for mental disorders and the conditions of their hospitalization. Limits and consensus concerning the wish to be treated]. PMID- 1763879 TI - [Psychology and cancer: role of rationalization in cancerous disease of unfavorable prognosis (apropos of a clinical case)]. AB - This text intends to tackle one of the aspects of psychosomatic interactions in cancer: the patient's irrational cognitions related to his trouble. The authors design as cognitive process (CP) the mental work implying the production and the evolution of personal cognitions bound to a personal event. In cancer, CP often drives the subject to adopt irrational points of view concerning his disease, which onset is readily described as a consequence of significant life events; in such explanations, the part of hazard is excluded. The authors suggest that spontaneous CP may be useful helping the patient to avoid strong depressive affects, to alleviate feelings of anger or despair and to improve self-esteem threatened by the illness. The authors consider that using CP concept may be an accurate tool in psychotherapy of patients suffering from cancer. Therapeutic strategies may tend to favour the CP development so that the subject's conceptions stabilize on an ego-syntonic level. PMID- 1763880 TI - [From social distress to psychic pain]. AB - Regarding 75 subjects of both sex sent to psychiatric and alcological consultations by social departments to which they required some help, the authors ask the question about limits between social alienation and mental alienation for people in precarity and poverty position. They inquire into role part and position of the psychiatrist beside them. PMID- 1763881 TI - [Results of an epidemiological survey conducted with psychiatrists, general practitioners, liberal nurses and social workers in a mental health sector]. AB - An epidemiological survey was carried out, amongst psychiatrists, general practitioners, social workers and liberal nurses, with a double aim. To determine the number of psychiatric cases followed or identified; these were classified according to DSMIII criteria (simplified for use by those interviewers little used to psychiatric jargon), essentially: dementia, depression, schizophrenia, other psychosis, other cases (neurosis, substance abuse, alcoholism). Another aim was to determine how the psychiatric care facilities were perceived and used by the person's interviewed. The results reveal a lack of information on their part, despite pst information given by us (systematic misappreciation?); as well as the lack of a desire to collaborate: the practitioners address their patients to the public health service (and preferentially for full-time hospitalisation) when they feel the case is beyond them. PMID- 1763882 TI - [Extended leave, extended sick leave and retirement caused by disability of civil servants, medico-psychiatric considerations]. PMID- 1763883 TI - [Guiraud at the Societe Clinique de Medecine Mentale (1908-1930)]. PMID- 1763884 TI - Polymerase chain reactions with alphoid-repeat primers in combination with Alu or LINEs primers, generate chromosome-specific DNA fragments. AB - Y alphoid primers in combination with Alu and LINEs primers generated new DNA fragments in polymerase chain reactions (PCR) on DNA from a Y-only somatic cell hybrid but not from X-only, 3-only, or 21-only hybrids. X alphoid primers used in a similar manner generated new DNA fragments from the X-only hybrid, and 1 of the primers (X2) also generated new DNA fragments on 3-only and 21-only hybrids when used in conjunction with Alu or LINEs primers. In all but one case, consensus alphoid primers generated new chromosome-specific fragments in PCR reactions with the Alu or LINEs primers. A search for cryptic Alu- or alphoid-alone PCR products as the source for one Alu-alphoid band (chosen at random) was negative. Partial sequencing of products demonstrated that alphoid and Alu sequences were indeed contiguous in some newly synthesized DNA fragments. While Alu or LINEs primers generate smears of DNA fragments on total human DNA, the alphoid-non-alphoid repeat combinations generated electrophoretically distinguishable bands of DNA when the template was total DNA. While these were distinguishable with different chromosome-specific alphoid primers, the DNA fragments were not of the same sizes as those generated with the chromosome-only hybrids. PMID- 1763885 TI - The human chromosome 19 linkage group FUT1 (H), FUT2 (SE), LE, LU, PEPD, C3, APOC2, D19S7 and D19S9. AB - Families segregating for deficiency of the H alpha-2-L-fucosyltransferase, FUT1, have been investigated for linkage between FUT1 and other markers on chromosome 19. The results provide evidence for close linkage between FUT1 and FUT2 and for looser linkage between FUT1 and APOC2 and between FUT1 and D19S7. Pairwise linkage data are also reported between other markers investigated. PMID- 1763886 TI - Gene maps and location databases. AB - A location database is defined in linear space by a vector of genetic and physical locations for each locus, which may be ordered by virtual sorting on composite location. This contrasts with an interval database defined in metric space, for which location must be inferred by list-processing from numbered intervals which are assigned different ordinals in different tables and overlap other intervals in many ways. A location database has been used for all well studied experimental organisms. Principles for a human genome database may be derived from this experience. PMID- 1763887 TI - Testing for haplotype sharing by siblings with incomplete information of parental haplotypes. AB - Testing for the inheritance of a disease susceptibility gene by analysis of haplotype sharing among affected siblings has been well established for the case where all four parental haplotypes have been ascertained. This paper presents a modification of a published method to cover the situation where there is incomplete information concerning parental haplotypes and this new test is applied in a worked example. PMID- 1763888 TI - Kinship structures and migration in the Po Delta. AB - The kinship analysis of seven genetic systems in the province of Ferrara permits some considerations on the possible chronology of emergence of their polymorphisms in the area. It is proposed that, assuming neutrality of these systems, and under several restrictions, the emergence by migration of the polymorphisms in the seven systems ACP, ESD, GLO, GPT, PGD, PGM1, PGP might have had the following sequence: PGP and GLO and possibly PGD; PGM1 and GPT; ACP and ESD. All polymorphisms must be older than the beta-thalassemia polymorphism in the area. PMID- 1763889 TI - Recombinant human nerve growth factor infusions prevent cholinergic neuronal degeneration in the adult primate brain. AB - Atrophy of cholinergic neurons is a prominent component of Alzheimer's disease, and may explain in part the profound memory loss that is characteristic of patients with this disorder. Previous studies in animal models have shown that infusions of nerve growth factor into the adult brain can prevent both age related and lesion-induced cholinergic neuronal atrophy. Recently, recombinant human nerve growth factor was found biologically active in nonprimate animal models. In the present experiment, recombinant human nerve growth factor infusions into the brains of adult primates prevented lesion-induced cholinergic neuronal degeneration and promoted cholinergic neurite sprouting. These findings provide additional support for potential therapeutic trials of human nerve growth factor in patients with Alzheimer's disease. PMID- 1763890 TI - Cerebral amyloid angiopathy without and with cerebral hemorrhages: a comparative histological study. AB - To identify those factors associated with cerebral hemorrhage among brains with cerebral amyloid angiopathy (CAA), we undertook a comparative postmortem histopathological study of amyloid-containing vessels in the brains of patients with and without hemorrhage. Those without hemorrhage were represented by the following two groups: (1) elderly patients from a large general hospital (n = 66; age range, 75-107 years) and (2) patients with various neuropsychiatric disorders (n = 70; age range, 27-96 years). CAA was found in 45% of the first group and in 54% of the second group. The findings in these patients were compared with those in 17 brains in which both CAA and cerebral hemorrhage were present. We found that CAA was more severe in the brains with cerebral hemorrhage than in those without, and that fibrinoid necrosis was seen only in the brains with cerebral hemorrhage (12 of the 17 brains). Microaneurysms occurred only in the presence of severe, rather than moderate or mild, CAA. Serial sections in 2 brains of patients with cerebral hemorrhage showed fibrinoid necrosis, microaneurysms, and vascular rupture in close association with the hemorrhage. In 2 patients, hemorrhage was precipitated by trauma, and in 1, it was secondary to metastatic carcinoma. The features of brains from patients with CAA that are most consistently related to cerebral hemorrhage are (1) a severe degree of CAA and (2) the presence of fibrinoid necrosis, with or without microaneurysms. PMID- 1763891 TI - Hereditary branching enzyme dysfunction in adult polyglucosan body disease: a possible metabolic cause in two patients. AB - We describe 2 unrelated patients with adult polyglucosan body disease (APBD) diagnosed by sural nerve biopsy. Both patients were offspring of consanguineous marriages. They presented clinically with late onset pyramidal tetraparesis, micturition difficulties, peripheral neuropathy, and mild cognitive impairment. Magnetic resonance imaging of the brain revealed extensive white matter abnormalities in both. In search of a possible metabolic defect, we evaluated glycogen metabolism in these patients and their clinically unaffected children. Branching enzyme activity in the patients' polymorphonuclear leukocytes was about 15% of control values, whereas their children displayed values of 50 to 60%, suggesting a possible autosomal recessive mode of transmission. This is the first report of an inherited metabolic defect in patients with adult polyglucosan body disease. We suggest that branching enzyme dysfunction may be implicated in the pathogenesis of some patients with adult polyglucosan body disease. PMID- 1763892 TI - Visual attentional disturbance with unilateral lesions in the basal ganglia and deep white matter. AB - To elucidate the role of the basal ganglia and deep white matter in the visual attention mechanism, a new visual attention task was carried out by 15 patients, 9 with left-side and 6 with right-side basal ganglia and/or deep white matter damage without visual field defects, and by 12 normal subjects. Their reaction times were recorded in response to a random visual stimulation by pushing a button with the hand ipsilateral to the side of the lesion. All the patients with damage to the right side of the brain had a longer reaction time in the left space than in the right or middle space. With conventional test, only one of them showed left unilateral spatial neglect. Seven of the 9 patients with a left lesion had a significantly longer reaction time in the right space than in the left. None had unilateral spatial neglect. Both the right and left brain-damaged groups showed longer reaction times in both spaces, compared to the normal groups. There was no significant difference in reaction time among the control subjects. These findings suggest that the basal ganglia and deep white matter in each hemisphere play some role in directing visual attentional factors into both spaces. Visual attentional disturbance was highly evident even with left-side brain damage, and this kind of disturbance is not usually revealed with the current tasks used for testing unilateral spatial neglect. PMID- 1763893 TI - Expression patterns of beta-amyloid precursor protein (beta-APP) in neural and nonneural human tissues from Alzheimer's disease and control subjects. AB - Both neural and nonneural human tissues from patients with or without Alzheimer's disease (AD) were surveyed to detect the presence of the beta-amyloid protein and its precursors. This was accomplished using polyclonal and monoclonal antibodies to epitopes in the 695 amino acid long beta-APP (i.e., beta-APP695), as well as in related beta-APPs. Immunoreactivity in beta-APP in brain was prominent in senile plaques, extraneuronal tangles, and neurons. Outside the brain, beta-APP staining was seen in neurons and satellite glial cells of the dorsal root, enteric and trigeminal ganglia, the adeno- and neurohypophysis, megakaryocytes, and adrenal gland in samples from patients with AD and those without AD. Western blots of neocortex revealed three major proteins with apparent molecular masses of 105, 115, and 125 kDa in the insoluble membrane-associated fractions, while two broad bands with a molecular weight centered at about 100 and 120 kDa were detected in soluble fractions. In addition, the pituitary and adrenal glands as well as cardiac muscle revealed prominent immunobands in membrane-associated fractions. Notably, other nonneural tissues were devoid of beta-APP immunoreactivity. Thus, the beta-APPs are detectable only in a limited number of nonneural tissues. Taken together, these data suggest that beta-APPs produced in the brain are sources of beta-APP peptides that accumulate as senile plaques in AD. PMID- 1763894 TI - Leber's hereditary optic neuropathy and complex I deficiency in muscle. AB - We investigated a family with Leber's hereditary optic neuropathy in which affected individuals were homoplasmic for the point mutation of the NADH dehydrogenase 4 gene of mitochondrial DNA, described by Wallace and colleagues in 1988. The proband had bilateral optic atrophy, tremor, dystonia, and sharply defined lesions in the putamen on magnetic resonance images. Optic atrophy was found in another 3 of 13 investigated relatives on the maternal side. Additional neurological signs were found but only in patients with optic neuropathy. The morphological appearance and the respiratory chain function of muscle tissue were investigated in the proband, his mother, and 3 siblings. Polarographic measurements revealed complex I deficiency in the 5 investigated subjects. Morphological changes of mitochondria were found in 4 of these subjects. There was no decrease in complex I activity measured as NADH ferricyanide reductase or rotenone-sensitive NADH cytochrome c reductase activities. In other cases with complex I deficiency, good agreement between polarographic and spectrophotometric measurements was found. This study showed that there is decreased activity of complex I of the respiratory chain in muscle and that cerebral striatal lesions occur in Leber's hereditary optic neuropathy with the NADH-dehydrogenase 4 gene point mutation. PMID- 1763895 TI - Chronic cardiomyopathy and weakness or acute coma in children with a defect in carnitine uptake. AB - A defect in intracellular uptake of carnitine has been identified in patients with severe carnitine deficiency. To define the clinical manifestations of this disorder, the presenting features of 15 affected infants and children were examined. Progressive cardiomyopathy, with or without chronic muscle weakness, was the most common presentation (median age of onset, 3 years). Other patients presented with episodes of fasting hypoglycemia during the first 2 years of life before cardiomyopathy had become apparent. A defect in carnitine uptake was demonstrable in fibroblasts and leukocytes from patients. The defect also appears to be expressed in muscle and kidney. Concentrations of plasma carnitine and rates of carnitine uptake in parents were intermediate between affected patients and normal control subjects, consistent with recessive inheritance. Early recognition and treatment with high doses of oral carnitine may be life-saving in this disorder of fatty acid oxidation. PMID- 1763896 TI - Mitochondrial DNA sequence analysis in congenital myotonic dystrophy. AB - Mitochondrial genetic modifying factors have been suspected in several autosomally inherited diseases. The congenital variant of myotonic dystrophy, in which there is striking maternal inheritance pattern, is a likely candidate disease. To investigate this possibility, we sequenced completely the mitochondrial genome in 2 patients with congenital myotonic dystrophy. Comparison of the two sequences with control data failed to reveal a specific nucleotide variant or length variant in this disease. We conclude that a mitochondrial genetic modifying factor is not present in congenital myotonic dystrophy. PMID- 1763897 TI - Medullary lesion inducing pulmonary edema: a magnetic resonance imaging study. AB - A 27-year-old woman with a recent diagnosis of multiple sclerosis developed several episodes of noncardiogenic pulmonary edema over a 3-month period, each requiring intubation and ventilatory support. The development and subsequent resolution of an isolated lesion at the obex was correlated with the episodes. The literature regarding the anatomical basis of neurogenic pulmonary edema is reviewed. PMID- 1763898 TI - Codon 618 variant of Alzheimer amyloid gene associated with inherited cerebral hemorrhage. AB - Hereditary cerebral hemorrhage with amyloidosis, Dutch type (HCHWA-D) is an autosomal dominant form of severe cerebrovascular amyloid angiopathy causing recurrent strokes during the fifth and sixth decades of life. The major constituent of the amyloid deposits in HCHWA-D is the amyloid beta-protein (A beta), also found in Alzheimer's disease. A point mutation in the DNA sequence encoding A beta has been found in 2 unrelated patients with HCHWA-D, and an assay detecting the single base change was developed for diagnostic purposes. We describe the detection of the point mutation in a patient living in the United States, suffering from recurring cerebral hemorrhages, who only recently was diagnosed with HCHWA-D. In addition, we tested a number of family members, and found the mutation in 2 additional individuals, one of them too young to exhibit clinical manifestations. This study combined with the study of two other families in Holland indicates that the codon 618 variant in the amyloid precursor protein gene segregates with HCHWA-D. PMID- 1763899 TI - Muscle mitochondrial changes in cerebrotendinous xanthomatosis. PMID- 1763900 TI - Cerebrospinal fluid taurine in Alzheimer's disease. PMID- 1763901 TI - Continuous muscle fiber activity associated with thymoma. PMID- 1763902 TI - Brain and retinal microemboli during cardiac surgery. PMID- 1763903 TI - Isolation of a complementary DNA clone encoding an autoantigen recognized by an anti-neuronal cell antibody from a patient with paraneoplastic cerebellar degeneration. PMID- 1763904 TI - Self-control and impulsiveness in adult humans when food is the reinforcer. AB - Moderately food- and water-deprived women repeatedly chose between longer access to juice after a long delay (the self-control alternative), and shorter access to juice after a short delay (the impulsive alternative). In contrast to previous experiments using points exchangeable for money as the reinforcer, which have found consistent self-control across subjects, behavior of the present subjects varied between complete self-control and complete impulsiveness. Individual subjects' degree of self-control was not related to their majors, to their past or present degree of reported actual food deprivation, to their ratings of desire for the juice, or to their latency to respond. However, subjects who reported that they were currently dieting were significantly more impulsive; they obtained juice earlier within individual trials but had smaller total juice access time. The operant conditioning laboratory paradigm developed for the present research can be useful in investigating general determinants of self-control and impulsiveness for food reinforcers, as well as in investigating the origins of individual differences in food choice. PMID- 1763905 TI - Is the effect of a social model on eating attenuated by hunger? AB - Two experiments were conducted to assess the effect of social influence pressures on eating in individuals differing in initial hunger; we assumed that conformity to a model would decline as hunger increased. In the first experiment, subjects' eating conformed closely to the model's eating, with subjects eating very little when the model ate very little, even after 24 h of food deprivation. In a second experiment, the conformity effect again dominated the results, even after lengthy deprivation. We discuss the implications and limitations of this powerful modelling effect on eating. PMID- 1763906 TI - Variation in chemosensitivity and the control of dietary selection behaviour in the locust. AB - Investigations into the behavioural and underlying physiological mechanisms of dietary selection are presented for the locust, Locusta migratoria. Locusts were fed for 4, 8 or 12 h on one of four chemically defined artificial diets: diet PC, which was nutritionally complete; diet P, containing no digestible carbohydrate; diet C, containing no protein; and diet O, which lacked both protein and digestible carbohydrate. Following this pretreatment, the locusts were provided with both the P and the C diet in a choice test. Detailed analyses of selection behaviour indicated that diets lacking a nutrient for which the insect was deficient were either rejected before a meal was initiated, or, if feeding commenced, eaten in meals of only short duration, while those containing the appropriate nutrients were accepted more readily and eaten in longer meals. Electrophysiological studies showed that this behaviour was paralleled by nutrient-specific changes in gustatory responsiveness. Locusts pretreated for 4h on C diet had increased gustatory responsiveness to stimulation with an amino acid mix, but not to sucrose, while insects fed on P diet showed increased responsiveness to stimulation with sucrose, but not to the amino acid mix. This result is consistent with earlier experiments in which levels of blood nutrients were shown to modulate taste responsiveness in the locust. PMID- 1763907 TI - Tolerated sensory changes. PMID- 1763908 TI - Likings for complex foods and meals. PMID- 1763910 TI - Are low-calorie substitutes compensated? PMID- 1763909 TI - Take chips off or make them healthier? PMID- 1763911 TI - The effects of prefeeding lipid on energy intake from a meal. PMID- 1763912 TI - When are calories most fattening? PMID- 1763913 TI - Approaches to permanent weight control. PMID- 1763914 TI - Situational dieting self-efficacy and short-term regulation of eating. AB - The Situation-Based Dieting Self-Efficacy Scale (SDS) measures dieters' beliefs in their abilities to adhere to a diet in eating situations. The scale has high internal consistency and test-retest reliability. Female dieters were recruited who were either high or low on SDS, and assigned either to consume a high calorie preload or to a no preload condition. Subjects with high SDS ate less in a subsequent "taste rating" task than subjects with low SDS. Amount eaten was not predicted by hunger, weight, palatability, mood, or restrained eating style. This finding challenges the tendency to view all dieters as equally likely to lapse in response to dietary challenges. PMID- 1763915 TI - Behavioral economic analysis of food choice in obese children. AB - Behavioral economic analysis has shown food choice in normal weight adults is influenced by both liking and constraints on access to food. The present study assessed the contributions of food liking and environmental constraints to choice of moderately liked, low-calorie foods or highly liked high-calorie foods in obese children. Access to the moderately liked food remained on a VR2 schedule, while response requirements for the highly liked food ranged from VR2 to VR32. Subjects chose to work for the higher-rated food at comparisons up to VR2/VR4, showed no preference at VR2/VR8 and their choice shifted to the lower rated food when response requirements for the highly liked food were increased to VR16. These results show that both subjective and environmental factors contribute to children's choice of foods. PMID- 1763916 TI - Sham-feeding sucrose or corn oil stimulates food intake in rats. AB - In separate experiments, rats with open gastric cannulas were sham-fed either 32% sucrose solution or 15% corn oil emulsion. The rats' cannulas were then closed, and food intake was measured for 2 h. Food intake was greater after sham-feeding either fluid than after tests when no fluid was available. These results suggest that the oral stimulation produced by ingestion of sweet or oily fluids can stimulate appetite in the rat. PMID- 1763917 TI - [Implantable automatic defibrillator. Evaluation after 8 years of use]. AB - The thirty nine patients (30 men and 9 women, mean age 49 +/- 14 years) who were implanted with an automatic cardioverter defibrillator (AICD) between October 1982 and April 1990 were reviewed retrospectively. This group included 22 patients with ischaemic cardiomyopathy (55%), 9 primary cardiomyopathies (23%) 5 ventricular tachycardias in patients with normal hearts (13%), 1 case of arrhythmogenic right ventricular dysplasia and two of mitral valve prolapse. The mean ejection fraction for the whole group was 38 +/- 14%. The indication for implantation of the AICD was life-threatening ventricular arrhythmias for which other forms of treatment were either ineffective (29 patients), impossible to assess (9 patients) or poorly tolerated (1 patient). Two patients died during the perioperative period and the follow-up is too short in two other cases. Therefore, 35 patients were studied over an average of 23.7 +/- 16 months. During follow-up, 5 patients died, 3 of progressive cardiac failure and 2 suddenly, one of whom was waiting for a replacement of an exhausted generator. The AICD never functioned in 40% of patients. In addition, it was impossible to determine for the majority of shocks delivered if they had been triggered by a sustained ventricular arrhythmia. Long term tolerance was generally good but two patients developed cardiac constriction induced by the epicardial patch electrodes. The results of this review confirm the efficacy of AICD in preventing sudden death at the expense of a low operative mortality and with good long term tolerance. Quite a large proportion of AICDs never functioned and the interpretation of the delivered shocks remains questionable.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1763918 TI - [Dysfunction of aortocoronary bypass. Prognosis]. AB - From 1978 to 1988, 108 patients with at least one occluded or stenosed aorto coronary bypass graft (over 75% stenosis) underwent coronary angiography on average 31 months after the initial coronary bypass surgery. The occluded or stenosed coronary graft was either a saphenous vein (n = 126 including 9 sequentials) or internal mammary artery (n = 5). The bypassed artery was the left anterior descending (n = 66), right coronary (n = 40), left marginal (n = 25) or diagonal (n = 9). The number of occluded or stenosed grafts by patient was 1.2. The left ventricular ejection fraction was 55% (range 25 to 77%). During a mean follow-up period of 60 months after coronary angiography, there were 14 cardiac deaths and 15 non-lethal myocardial infarctions. Treatment comprised 12 angioplasties, 26 new bypass grafts and 3 cardiac transplantations. The 8 year actuarial survival was 84%. The survival without infarction at 8 years was 69%. Survival was significantly decreased to 72% when the occluded or stenosed graft was located on the left anterior descending artery. The survival without infarction at 8 years was 52% in the patients with dysfunction of left anterior descending artery grafts and 89% when the diseased graft was located on another artery (right coronary, left marginal, diagonal). Therefore, the data of this retrospective study show that coronary graft dysfunction on the right coronary, left marginal or diagonal arteries do not greatly influence life expectancy in the medium term after coronary bypass surgery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1763920 TI - [Thrombosis of atrioventricular prosthesis. Contribution of transesophageal echocardiography]. AB - The aim of this study was to assess the diagnostic value of transesophageal echocardiography for the detection of thrombosis of a mechanical mitral or tricuspid valve prosthesis. Twelve patients (mean age 54 +/- 12 years) out of a series of 39 patients operated between April 1988 and June 1989 for prosthetic valve dysfunction had valve thrombosis at operation (11 mitral and 1 tricuspid valve prosthesis). Transesophageal echocardiography was routinely performed preoperatively in addition to transthoracic Doppler echocardiography to search for an abdominal mass on the prosthetic valves. The largest diameter of the diastolic jet at the level of the prosthetic valve annulus was measured using transesophageal color flow Doppler in the 8 Starr-Edwards mitral valve prostheses and compared with 5 control valves. The results of transthoracic Doppler echocardiography and transesophageal echocardiography were compared with the operative findings. The specificity of transthoracic echocardiography for the positive diagnosis of prosthetic valve thrombosis was 18%. A thrombosis could be suspected in 10 of the 12 cases by transthoracic echocardiography giving a sensitivity of 83%. Eleven of the 12 abnormal masses on the prostheses were visualised by transesophageal echocardiography, a sensitivity of 91%. Detection of the masses on the arterial side was possible in all cases (10/10) but 5 of the 6 extensions of the thrombus into the ventricle could not be visualised. The diameter of the transprosthetic jet was less than 12 mm in 7 of the 8 thrombosed valves compared with greater than 15 mm in the 5 normal control prostheses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1763919 TI - [Comparison of long-term results of the Starr and Saint-Jude mitral valve prostheses]. AB - Two groups of patients having undergone mitral valve replacement with a Starr Edwards (Group A = 149 patients) or Saint Jude (Group B = 87 patients) prosthesis between 1981 and 1987 were included in this study. The aim of the study was to evaluate and compare the mortality, the morbidity--especially with respect to thromboembolic events--and echo Doppler haemodynamic profiles of the two types of prosthesis. The two patient groups were comparable with respect to age, aetiology and preoperative haemodynamic status. Late mortality was greater in Group A (13% versus 4.5%) and the 5 year survival was significantly better in Group B (95% versus 89%). Thromboembolic events were significantly more common in Group A (2.6% per patient year versus 0.5% per patient year in Group B, p = 0.01). Five years survival without thromboembolic event was 94% in Group B versus 86% in Group A. The haemodynamic Doppler echocardiography profiles were compared on random samples of 30 cases from each group, the only exclusion criterion being suspected or confirmed prosthetic valve dysfunction. PMID- 1763921 TI - [Electrophysiological characteristics of asymptomatic Wolff-Parkinson-White syndromes]. AB - The management of the Wolff-Parkinson-White syndrome (WPW) is controversial especially when the patient is asymptomatic. The aim of this study was to evaluate the electrophysiological characteristics of such patients. Thirty two asymptomatic subjects with overt WPW on the surface ECG aged 14 to 68 years (average 36 +/- 15 years) underwent endocavitary or oesophageal electrophysiological study with the following protocol: programmed atrial stimulation using 1 or 2 extrastimuli over 3 cycles to evaluate the induction of paroxysmal junctional tachycardia and atrial fibrillation; atrial pacing at increasing frequencies to assess the shortest cycle conducted by the bundle of Kent. This protocol was repeated during intravenous infusion of 20 to 30 mg of Isoproterenol. Four electrophysiological characteristics were identified: the incidence of induction of junctional tachycardia was very low (2 cases, 6%); the incidence of induction of atrial fibrillation or tachycardia was similar to that of symptomatic WPW (9 cases 30%); the incidence of rapid conduction via the bundle of Kent (cycle conducted by the Kent less than 250 ms under basal conditions less than 200 ms with Isoproterenol) was 19% (6 cases); the incidence of potentially serious forms of WPW with rapid conduction in the bundle of Kent and atrial vulnerability (induction of atrial fibrillation at a frequency less than the Wenckebach point by programmed atrial stimulation) was similar to that in symptomatic WPW, 3 cases (10%). In conclusion, the asymptomatic character of the WPW is very probably due to the absence of junctional tachycardias. Nevertheless, these patients are at risk of atrial fibrillation with an incidence of potentially serious forms of 10%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1763922 TI - [Contribution of the continuity equation for the assessment of mitral valve area in mitral stenosis]. AB - The aim of this study was to evaluate the continuity equation in the quantification of mitral valve area in mitral stenosis, the area being considered as the product of the area of the left ventricular outflow tract multiplied by the ratio of the velocity time integrals of the aortic or pulmonary flow to that mitral flow. The continuity equation was compared to two other echocardiographic methods, planimetry and Hatle's method, and to the results obtained at catheterization using the Gorlin formula in a population of 44 patients with mitral stenosis. All were in sinus rhythm; twelve had Grade I mitral regurgitation and 9 patients had Grade I aortic regurgitation. Excellent correlation were observed between the values obtained by the continuity equation and planimetry (r = 0.91; SEE = 0.19 cm2; p less than 0.001) and Hatle's method (r = 0.87; SEE = 0.20 cm2, p less than 0.001). The correlation with the catheter values were also excellent (r = 0.83; SD = 0.22 cm2, p less than 0.001), better than those observed with Hatle's method (r = 0.73; SEE = 0.27 cm2, p less than 0.001) and very similar to those obtained with planimetry (r = 0.87; SEE = 0.23 cm2, p less than 0.001). The sensibility and specificity of the continuity equation for the diagnosis of severe mitral stenosis (surface less than 1.5 cm2) were 90% and 100% respectively, when those of Hatle's method were 88% and 91% respectively. The continuity equation in the evaluation of mitral valve area in mitral stenosis seems to be reliable and accurate compared with catheter data, and superior to Hatle's method. PMID- 1763923 TI - [Efficacy and tolerance of LA 50 mg nicardipine in hypertensive athletes]. AB - The beneficial effects of physical exercise on the blood pressure are widely recognised. Nevertheless, some athletes remain hypertensive and the treatment of this population makes special demands with respect to treatment efficacy and tolerability, the respect of athletic performance and problems of proscribed substances. For example, the Athletic Boards have prohibited betablockers and diuretics in competitive athletes. The aim of this study was to assess nicardipine LA 50 mg administered twice daily in the special context of hypertensive athletes. Thirty-eight athletes with mild or moderate hypertension undergoing endurance training were included in this double blind trial versus placebo. After two months treatment, the systolic and diastolic blood pressures were significantly lower at rest in the nicardipine than in the placebo group (delta SBP = -18.9 vs -4.1 mmHg, p less than 0.001; delta DBP = -15.7 vs -4.1 mmHg, p less than 0.01). In addition the maximum SBP on effort was significantly lower in the nicardipine group (200 vs 215 mmHg, p less than 0.05). On the other hand, no difference was observed between the two groups as regards the maximum oxygen consumption (delta VO2 max = 6.2 vs -0.4 ml/min/kg, NS) and duration of effort (13.75 vs 12.32 min, NS), showing that athletic performance was unchanged in the group treated by nicardipine LA. These results suggest that treatment with nicardipine LA fulfills the special criteria of hypertensive athletes. PMID- 1763924 TI - [Hemodynamic effects of milrinone in the treatment of cardiac insufficiency after heart surgery with extracorporeal circulation]. AB - Milrinone is an inotropic agent of the phosphodiesterase inhibitor family. In common with all molecules of this class it has both positive inotropic and vasodilator effects. The haemodynamic effects of 3 dosages of milrinone were studied in 25 patients with low output states after open heart surgery. The low cardiac output was defined as a cardiac index of less than 2.5/min/m2 and pulmonary capillary pressures greater than 8 mmHg. Milrinone was administered as a bolus of 50 micrograms/kg/min over 10 minutes followed by a continuous infusion for at least 12 hours. Six patients were given 0.375 micrograms/kg/min, six patients 0.5 micrograms/kg/min, and 13 patients 0.75 g/kg/min. A significant increase in cardiac index was observed but without any difference between the 3 groups. The heart rate and stroke volumes were increased. There was a mild reduction in systemic blood pressure with a decrease in systemic arterial resistances which returned to almost normal values. Left and right filling pressures did not decrease significantly from the initial values until the end of the bolus injection. Indirect measurements of myocardial oxygen consumption showed an increase in this parameter. There were no changes in blood gas concentrations. The treatment was stopped in only one patient because of peripheral vasodilation. Two patients developed supraventricular tachycardia of no consequence. Milrinone may therefore be proposed as treatment of first intention of low cardiac output states after open heart surgery. It is associated with a mild vasodilatory effect. Improved myocardial function is observed providing attention is paid to vascular filling. None of the maintenance doses used after the bolus injection was shown to be more effective than the others. PMID- 1763925 TI - [Induction of ventricular tachycardia by esophageal stimulation. Apropos of 2 cases]. AB - The utility of transesophageal atrial pacing in sustained left ventricular tachycardia is reported in two cases. A 46 year old man without any apparent cardiac disease presented with invalidating but undocumented palpitations. Transesophageal atrial pacing with isoproterenol infusion induced wide complex tachycardia with a right bundle branch block morphology and left axis deviation. Atrio-ventricular dissociation was observed and it was possible to reduce the ventricular complex width by rapid transesophageal atrial pacing: the tachycardia was terminated by an injection of verapamil. It was not possible to reinduce the tachycardia after treatment with atenolol 100 mg/day, introduced because of the catecholinergic nature of the arrhythmia. The patient is symptom free after 2 years of treatment with this drug. Regular wide complex tachycardia with right bundle branch block and left axis deviation without any detectable atrial activity was recorded in a 50 year old man without known cardiac disease. Transesophageal atrial pacing with isoproterenol infusion induced an identical tachycardia. The tachycardia started after a normally conducted atrial extrastimulus followed by ventriculo-atrial dissociation and it was possible to overdrive with atrial pacing. The tachycardia could not be reinduced after treatment with atenolol and the patient is asymptomatic 12 months later. These reports show that it is possible to study certain ventricular tachycardias by transesophageal atrial pacing. The efficacy of antiarrhythmic therapy can be controlled simply by this non-invasive technique. PMID- 1763926 TI - [Experimental models of atherosclerosis. Contribution, limits and trends]. AB - Experimental approaches to the problem of atherosclerosis involve animal or cellular models and procedures of lesional induction. Relevant animal models are rare. The rat, the mouse and the dog are free of "natural" atherosclerosis and only develop diffuse lipidosis after high cholesterol diet and thyroid block. They are more appropriate models of experimental arteriosclerosis and intimal proliferation induced by different procedures. The rabbit, also free of spontaneous atherosclerosis, is extremely sensitive to lipid-rich diets, but the lesions induced resemble more a xanthomatosis than an atherosclerosis. Immunological procedures in this model result in a generalised immune arteriosclerotic arteriopathy. The monkey and pig, which are phylogenetically close to man, develop spontaneous atherosclerosis exacerbated by lipid-rich diets or other procedures: hormones, psychosocial stress. The cost and problems of upkeep make these two models inaccessible to most laboratories. Although the hen, turkey and pigeon are grain-eating, they develop natural atherosclerosis, are sensitive to atherogenic diets, and provide satisfactory replacement models, especially for research into the viral and tumoral theories of atherogenesis. The pigeon is particularly suitable for studying cellular, biochemical and genetic aspects of atherosclerosis: these spontaneous plaques, similar to those in man, are ontogenetically and topographically predictable. The species include genetic types both sensitive and resistant to the disease. Moderately lipid-rich diets induce lesions even in very young pigeons. They also lend themselves well to the study of the antiatherosclerotic effects of pharmacological agents. Endothelial, smooth muscle and macrophage cell cultures are widely used to study the factors influencing cellular modulation and proliferation, lipid metabolism and movement of cholesterol, cellular biosynthesis and cell-cell and cell-matrix interactions. PMID- 1763927 TI - [Persistent pulmonary hypertension in the newborn infant. Progresses and perspectives]. PMID- 1763928 TI - [New challenges in medicine]. PMID- 1763929 TI - [Familial characteristics of children born to HIV-seropositive women]. AB - The family situation of 122 children followed at the Necker hospital is analysed in this study: 40% of these children live with both parents, while 22% live with one parent, 10% with their maternal grand mother and 28% are under the care of the Aide Sociale a l'Enfance (Social Services for Children). At this time, less stable family situations and the separation of a child from his mother are not due to the child's HIV status but rather to the social and family context. A better knowledge of these factors is essential to prevent future family separation. Increased awareness and training in this context is urgently needed by the personnel in care of these children as the situation will undoubtedly become even more serious in the next few years. PMID- 1763930 TI - [Effects of respiratory physical therapy and nasopharyngeal suction on gastroesophageal reflux in infants less than a year of age, with or without abnormal reflux]. AB - The purpose of this study was to analyse the effects on gastro-oesophageal reflux (GOR) of the different manipulations used during pulmonary physical therapy (nasal suctions, oropharyngeal suctions, acceleration of expiratory flow). 115 children less than 1 year old, were divided into two groups according to the results of oesophageal pH monitoring: 44 with and 61 without pathological GOR. Nasal suctions did not significantly increase GOR in children without pathological GOR. Oropharyngeal suctions increased GOR significantly more than nasal suctions (*p = 0.031). The technique of acceleration of expiratory flow, used in 35 degrees verticalized position and supine position, increased the index of reflux and the time with oesophageal pH below 4 in children with pathological GOR. However it did not increase reflux in normal children. The index of induced reflux in the whole population was increased in the horizontal position (4.81 +/- 0.88 reflux/hour) as compared with 35 degrees verticalized (2.92 +/- 0.79 reflux/hour). These oesophageal pH measurements confirm the clinical observations often made during physical therapy (vomiting, regurgitations, reflex cough). This statistical study suggests that one should take into account the adverse factor of GOR secondary to pulmonary physical therapy. It seems better to use nasal rather than oropharyngeal suctions and also to use the acceleration of expiratory flow technique in the 35 degrees verticalized rather than in the supine position, even more so if a pathological reflux does exist. PMID- 1763931 TI - [Use of flecainide in the preventive treatment of tachycardia crisis of Wolff Parkinson-White syndrome in 4 newborn infants]. AB - Four neonates with Wolff-Parkinson-White syndrome developed supraventricular tachycardia and received flecainide orally after reduction of the arrhythmia. The initial doses were 5 mg/kg/day. They are increased according to clinical response and flecainide concentrations, with 5 and 10 mg/kg/24 h respectively, were in the therapeutic range of 200 to 1000 micrograms/l. Flecainide was effective and well tolerated in the 4 cases. Therefore, this drug may be an alternative to digoxine to prevent supraventricular tachycardias in the neonatal period. PMID- 1763932 TI - [Currarino syndrome: an association not to be overlooked]. AB - The Currarino triad consists of an anorectal malformation, a presacral tumor and a sacrum defect. A new case is reported in a female neonate. The diagnosis was suspected because of delayed emission of meconium associated with an occlusion syndrome. It was confirmed by bone imaging, ultrasonography and magnetic resonance imaging. A colostomy was performed on day 7 then closed on day 43 after several rectal dilation were carried out. A presacral lipoma was operated on at 10 months. The 56 cases reported in the literature are reviewed. PMID- 1763933 TI - [Mediterranean boutonneuse fever disclosed by severe neurological involvement]. AB - The authors report a case of mediterranean boutonneuse fever disclosed in a 6 year-old child presenting with severe neurological disorder, coma, hypotonia, sphincteral disorders, rash and eschar at the site of bite. Rise of antibodies detected by indirect immunofluorescence test (1/80----1/320) confirmed the diagnosis. Visualization of ischemic internal capsules at cerebral CT scan brought evidence of vascular lesions in rickettsial disease. PMID- 1763934 TI - [Hepatic and renal transplantation in the treatment of type I hyperoxaluria]. AB - Hyperoxaluria type I (HPI) is a metabolic disorder secondary to liver alanine glyoxylate aminotransferase deficiency. Renal failure occurs due to the excessive production and precipitation of oxalate in the kidney. Combined liver-renal transplantation is the correct treatment for this condition when end-stage renal failure occurs as with renal transplantation alone the risk of recurrence of the same pathology in the transplanted kidney would be high. We report the case of a 4 year-old child with HPI suffering from terminal renal failure in whom a hepato renal transplantation was performed: six months later, creatinine clearance was 62 ml/min/1.73 m2 and liver function tests were normal. PMID- 1763935 TI - [Iconographic rubric: a case of cerebral and renal venous thrombosis after heart catheterization]. PMID- 1763936 TI - [Iconographic rubric: a case of dumbbell neurofibroma in a 13 year-old child]. PMID- 1763937 TI - [Tumor necrosis factor (TNF-alpha)--cachectin. Physiological and pathological aspects]. PMID- 1763938 TI - [Recent advances in oncology. Acute lymphoblastic leukemia in children]. PMID- 1763939 TI - [Loperamide and acute diarrhea in infants]. PMID- 1763940 TI - [Achalasia of the esophagus: a rare cause of severe malaise in an infant]. PMID- 1763941 TI - [Pseudo-allergic eosinophilic monoarthritis]. PMID- 1763942 TI - [Role of malaria in convulsions in children at Pointe-Noire]. PMID- 1763943 TI - [Early hospital discharge in neonatology. Changes for 10 years]. PMID- 1763944 TI - [Pulmonary transplantation and cystic fibrosis. French organization]. PMID- 1763945 TI - Reaction of isatin with thiocarbohydrazide: a correction. AB - Heterocycles containing the indole ring system include some novel pharmacologically active compounds. Isatin and its N-acetylisatin are extremely versatile intermediates in the construction of a variety of heterocyclic systems when reacted with thiosemicarbazide derivatives. Literature survey revealed various interesting reactions of thiocarbohydrazide with cyclic ketones, cyclic 1,2-diketones and isatin. PMID- 1763946 TI - [Synthesis of CNS-activity of pyran derivatives: 6,8-dioxabicyclo(3,2,1)octane]. AB - The amino nitriles 4a,b and 5a,b, prepared from (1S,5R)-6,8 dioxabicyclo[3,2,1]octan-4-one (2), react with phenylmagnesium bromide to afford the diastereomeric 4-amino-4-phenyl derivatives 7a,b and 8a,b, respectively. The diastereomeric piperidine derivatives 7b and 8b show different CNS-activity. PMID- 1763947 TI - Synthesis of new benzimidazole derivatives as potential antimicrobial agents. AB - Barbiturates 3 as possible antimicrobial agents were obtained by reacting the N,N'-disubstituted urea 1a or the thiourea analogues 1b,c with the magic malonates 2a,b. On the other hand, reaction of 1a with ethoxycarbonyl isocyanate (4) yielded the substituted s-triazine-2,4,6(1H,3H,5H)-trione 5. The reaction of 4 with 2-aminomethyl-benzimidazole (6) gave the allophanate 7 which upon treatment with Na2CO3 yielded N-(1H-benzimidazol-2-yl)urea 8. PMID- 1763948 TI - Physiological activity of new heparinoids derived from plant polysaccharides. AB - Derivatisation and anticoagulant effects of three heparinoid model substances are described which are derived from three different types of plantpolysaccharides. Degree of sulphatation and structural prerequisites for inhibiting coagulation are discussed. PMID- 1763949 TI - Antimicrobial activity of some isoquinoline alkaloids. AB - The isoquinoline alkaloids are of great importance to humanity because of their medicinal value and different structure. During the last ten years, many isoquinoline alkaloids were isolated from Fumaria and Corydalis species growing in Turkey. There have been many researches on the antimicrobial activity of extracts of higher plants, but relatively few pure compounds have been investigated. PMID- 1763950 TI - Synthesis and anticonvulsant properties of some novel quinazolone thiosemicarbazone and 4-thiazolidone derivatives. AB - Diverse biological activities have been found in compounds having a quinazolinone ring system. A large number of 4(3H)-quinazolinones, in particular those possessing 2-alkyl-3-aryl, 2,3-dialkyl, and 2-alkyl-3-amino substitution, have been evaluated for pharmacological activity. On the other hand, thiazolidone derivatives are reported to have anesthetic, anticonvulsant, and hypnotic activity. PMID- 1763951 TI - Tumor inhibiting [1,2-bis(fluorophenyl)ethylenediamine]platinum(II) complexes. Part IV: Biological evaluation--in vivo studies on the P 388 leukemia. PMID- 1763952 TI - Synthesis and hypolipidemic activity of amine-carboxyboranes, and their amides and esters in rodents. AB - A series of amine carboxyboranes including their amides and esters were synthesized and shown to have potent hypolipidemic activity in rodents at 20 mg/kg/day. Ethylamine carboxyborane, di-n-propylamine-carboxyborane, trimethylamine-carbomethoxyborane, n-butylamine carbomethoxyborane, methylamine-N ethyl carbamoylborane and trimethylamine-N-n-octyl carbamoylborane were the most potent derivatives demonstrating hypocholesterolemic and hypotriglycemic activities in rats orally at 20 mg/kg/day. These derivatives lowered tissue lipids, e.g. cholesterol, in the rat liver, small intestine and aorta. The fecal lipids were elevated. Furthermore, the agents lowered cholesterol and triglycerides in the serum VLDL and LDL fractions but caused elevations in the HDL fraction after 14 days. The agents inhibited hepatic enzymatic activities of rate limiting steps involved in lipid metabolism, e.g. ATP dependent citrate lyase, sn-glycerol-3-phosphate acyltransferase and phosphatidylate phosphohydrolase. PMID- 1763953 TI - Rapid assay for the quantification of piretanide in biological fluids. AB - Piretanide was determined from plasma and urine using reversed-phase high performance liquid chromatography. Plasma was extracted with diethylether at pH 4 using bumetanide as internal standard. The chromatographic separation was performed on an octadecylsilane column (ODS) with acetonitrile/pH 7 phosphate buffer (3:7, v/v). In order to determine piretanide in urine, bumetanide was added to a urine aliquot. Then the sample was centrifuged and the supernatant directly injected without extraction followed by chromatography on an ODS column with a mixture of methanol and pH 7 phosphate buffer (12:13, v/v). The compounds were detected by their intrinsic fluorescence, monitoring the eluate at 287/450 nm. Total chromatography times were 8 min for plasma and 13 min for urine samples. The method was applied for the assay of piretanide in plasma of healthy volunteers after i.v. or p.o. dosage of 6 mg piretanide. PMID- 1763954 TI - Synthesis and antimicrobial activities of some new tetrahydro-2H-1,3,5 thiadiazine-2-thione derivatives of cefadroxil. AB - Eleven new 7-[2-(dihydro-5-substituted-6-thioxo-2H-1,3,5-thiadiazine-3( 4H)-yl)-2 (4-hydroxyphenyl)acetamido]-3-methyl-3-cephem-4-carboxylic acid derivatives were synthesized by the reaction of cefadroxil monohydrate, formaldehyde and substituted potassium dithiocarbamate. Their structures have been elucidated by spectral data and elementary analysis. The title compounds were tested for antimicrobial activity in vitro against gram-positive bacteria (Staphylococcus aureus, Streptococcus faecalis), gram-negative bacteria (Escherichia coli, Pseudomonas aeruginosa) and yeast-like fungi (Candida albicans, C. parapsilosis, C. stellatoidea, C. pseudotropicalis) in comparison with cefadroxil monohydrate. The activity of compounds 1 and 10 against S. aureus (MBC: 37.5 micrograms/ml) and compound 1 against E. coli (MBC: 75 micrograms/ml) were found to be the same as cefadroxil monohydrate. Compounds 1 and 10 were more effective than cefadroxil monohydrate against S. faecalis with 25 and 37.5 micrograms/ml MBC values, respectively. None of the compounds and cefadroxil monohydrate proved to be effective against P. aeruginosa (MBC: greater than 100 micrograms/ml). While cefadroxil monohydrate had no activity against yeast-like fungi, compounds 9 and 10 were significantly effective against yeast-like fungi (MFC: 37.5 micrograms/ml). PMID- 1763955 TI - Pyridazine derivatives, VIII: Synthesis and antihypertensive activity of 6-(2 thienyl)-5-aminomethyl-3-hydrazino-pyridazines. PMID- 1763956 TI - [Polycyclic azines with heteroatoms in the 1- and 3-position. 30. Synthesis of 6,7-dimethoxy-substituted 3,1-benzothiazin-4-ones]. PMID- 1763957 TI - [Airway epithelial cells]. PMID- 1763958 TI - [Endothelin-1 induced relaxation of guinea pig trachea after an anaphylactic reaction]. AB - Endothelin-1 (ET-1), one of the most potent constrictors of airway smooth muscles, is reported to act on such inflammatory cells as mast cells and release several chemical mediators. We observed a transient relaxation response to ET-1 after an anaphylactic constriction of guinea pig tracheal smooth muscle. The guinea pig was actively sensitized with ovalbumin, and the tracheal strip was challenged with ovalbumin in vitro. ET-1 induced a transient relaxation followed by a constriction of the tracheal strip. The potency of the relaxation induced by 10(-9) M of ET-1 was 16.0 +/- 1.3%, compared to the response to isoproterenol (2 x 10(-5) M), and the duration of the relaxation was 7.2 +/- 0.7 minutes. Indomethacin (10(-6) M) had no effect on the response, indicated that prostaglandins have no relation. Mechanical denudation of the tracheal epithelium did not reduce the relaxation, but rather augmented it. These results indicate that ET-1 induces a relaxation, associated with a relaxation factor from non epithelial tissue. PMID- 1763959 TI - [Psychosomatic study of inhalation therapy in patients with bronchial asthma. II. Relationship between subjective self assessment of dyspnea and peak expiratory flow rates]. AB - The degree of dyspnea when using metered-dose inhalers (MDIs), and the relationship between subjective self assessments and objective peak expiratory flow rates were examined by means of visual analogue scales and mini wright peak flow meters in 16 subjects with asthma. Three subjects who were neurotic in character were found to have a poor perception of the degree of airway obstruction after inhalation compared with objective changes in their condition. Two subjects, one neurotic and one alexithymic, assessed the degree of dyspnea to be worse after inhalation, when objectively there were few changes. However, one neurotic subject perceived an improvement in his condition when, in fact, there was little change. Furthermore, some severe cases used MDIs in the rogressive state of airway obstruction. In conclusion, we must pay attention to patients' characters when determining treatment in order to prevent overuse of MDIs or delays in treatments including the use of MDIs. PMID- 1763960 TI - [Measurement of serum eosinophil cationic protein levels in patients with bronchial asthma--analysis according to various clinical backgrounds]. AB - To evaluate the clinical relevance of serum eosinophil cationic protein (ECP) levels, we measured serum ECP levels in 126 asthmatic children, and investigated its relationship with some of the clinical backgrounds. Serum was separated at 1 hour after blood was drawn, and ECP was measured by radioimmunoassay. Serum ECP levels were significantly higher in the patients who had asthma attack within 24 hours than those who did not, and were higher in the patients who had asthma attack almost everyday for the past two weeks than those who had not. In addition, serum ECP levels were correlated with severity of asthma in the previous year, and the patients who had longer history of asthma showed higher levels of ECP. Among the patients who had asthma attacks at the time of blood sampling, serum ECP levels were higher in the patients in whom the attack lasted less than 12 hours than those more than 12 hours. However, no significant correlations were observed between serum ECP levels and the severities of attacks, between serum ECP levels and eosinophil counts. These results suggest that serum ECP level increases during the asthma attack, especially in its chronic active status. Serum ECP may reflect eosinophil activation in vivo and may be a better parameter than eosinophil counts. It is suggested that the measurement of serum ECP level may be useful to evaluate the clinical status of bronchial asthma. PMID- 1763961 TI - [Study of IgE.IgG4 antibodies on eczema in infants. II. Clinical characteristics of infants with egg white.RAST 4+]. AB - The author made an assessment in his first report, regarding relationship to the degree of skin involvement. As a result, it was suggested that the extent of eczema is a good index for determining the severity of the allergy and also that the severity of the allergy early in the infancy has a good correlation with egg white.specific IgE antibody. Therefore, an assessment had been made this time regarding the clinical characteristics of 32 infants who have strong reactions (egg white.RAST 4+) to egg white. The results were as follows; 1. All the infants with egg white.RAST 4+ had a systemic eczema, and their IgE antibodies showed high values of 445.6 +/- 626.9 IU/ml. 2. There were many cases with positive multiple allergens. Particularly, all the infants with egg white.RAST 1+ - 2+ were negative to rice and wheat, while 7 cases positive RAST score to rice and 9 cases to wheat were seen out of the 32 who showed the RAST 4+ to egg.white early in the infancy (rice; p less than 0.02 and wheat; p less than 0.01). 3. If the growth curves of the group from which egg and milk were completely eliminated are compared with the curves of the healthy infants, the height and head circumference were entirely in the normal range while the weight and Kaup index had a trend of being a little low, though they were within the normal range. 4. Regarding family history of allergies, past histories of atopic dermatitis on the mother's side were observed at a high rate. PMID- 1763962 TI - [Human fetal mast cells under development of the skin and airways]. AB - We made histochemical and ultrastructural studies of mast cells of the skin and airways in human fetuses (7 to 40 weeks' gestation) and newborn infants. Epithelial differentiation of the skin and bronchial airways was assessed of immunohistochemical characteristics, especially on their basal cells. Histological phenotype and the characteristics to anti-total keratin antibody became identical with the phenotype in the adult by the 11th and 36th week of gestation, respectively. Interstitial fibroblastoid cells appeared oval in shape and remained relatively immature to the termination. Mast cells were first recognized by electron microscopy in the fetal skin of 18-week-old fetuses and histochemically detected in both skin and airways of 24-week-old fetuses. Mast cell counts under high power magnification (40X optical lens) light microscopy gradually increased and made a relatively dramatic rise in the early postnatal periods. The cytoplasm of mast cells showed irregular pseudopod-like elongations which gradually developed microvillous protrusions. It contained immature granules composed of varieties of morphology such as amorphous dense bodies, vesicles with dense cores, particulates and their compound forms. They were located in a corner of the cytoplasm surrounded by lamellated rough-surfaced endoplasmic reticulum. These granules became scattered widely in the cytoplasm showing distinct particulate type. Granules typical of the scroll type became dominant in the process of maturation, and the transformation of crystal substructures occasionally took place. Prior to birth, mast cell granules fully developed as mature as those in the adult. This process of granule maturation is indicative of a reversed proceeding of slow degranulation, which is commonly seen in the so-called mucosal mast cells. PMID- 1763963 TI - [11 cases of anaphylaxis caused by grand keyhole limpet (abalone like shellfish)]. AB - We reported 11 cases of patients who developed moderate to severe anaphylactic reactions induced by the ingestion of grand keyhole limpet (GKL) and abalone. Specific IgE-mediated hypersensitivity to these shellfish was demonstrated by history, skin prick test, RAST and immunoblotting. The RAST inhibition technique revealed cross antigenicity between GKL, abalone and keyhole limpet hemocyanin. By immunoblotting analysis, the major antigens of GKL are shown in the MW range of about 38 Kd and 80 Kd. PMID- 1763964 TI - Volumetric control of continuous haemodialysis in multiorgan failure. AB - The authors have developed a system for volumetric control of continuous haemodialysis. The article describes this system and reports its successful use in providing renal support in the intensive care unit to 10 patients with multiorgan failure. In addition to providing effective treatment of uraemia, it permits the precise control of fluid balance in a prospective manner ("dial-up" fluid balance) while reducing nursing workload. PMID- 1763965 TI - Acid-base regulation in hemodialyzed renal failure patients: effect of serum proteins and bicarbonate buffering. AB - Interpretation of acid-base balance in human physiology relies on the accuracy of the Henderson-Hasselbalch equation governing pH, HCO3- concentration, and dissolved CO2 in blood. The influence of strong ions and plasma proteins is not generally assigned any quantitative importance. We have taken advantage of the electrolyte and acid-base abnormalities of patients with end stage renal failure to explore the interrelationship among these factors as they pertain to pH maintenance. We find a complex association between pH and plasma protein fractions. pH failed to correlate with the strong ion difference, net cationic equivalency of plasma proteins, pCO2, or serum phosphate considered singly or together. The pK1' for the dialysis population differed significantly from 6.10. The largest calculated value was 6.285. This difference was independent of the dialysate buffer anion composition. The loss of CO2 from blood during sample preparation in the clinical laboratory may fully account for the increase in calculated pK1' and may explain why measured venous rather than arterial total CO2 more closely matches the arterial blood gas calculated HCO3-. PMID- 1763966 TI - Clinical application of modified polyurethane graft to blood access. AB - Based on a study of 34 clinical implantations, a porous poly(ether-urethane) graft developed for blood access was evaluated. Although it became clear that the graft has several advantages over expanded polytetrafluoroethylene (E-PTFE), it was also revealed that the occlusion at the anastomotic site was more frequently observed than that with E-PTFE. To improve the patency rate, a small modification of the luminal surface was attempted to give a better anchoring of the neointima. The results so far are better than those with the unmodified graft. However, the number of cases is small and the period of observation is short. More work will be necessary to confirm these preliminary results. PMID- 1763967 TI - Computer analysis of hypoxemia during hemodialysis. AB - Arterial oxygen partial pressure decreases during hemodialysis if acetate as buffer is used or if certain types of bioincompatible dialyzer membranes are used. Several hypotheses considering the main cause of this hypoxemia have been proposed. To gain more insight into the mechanisms leading to this hypoxemia, a mathematical model for the computerized simulation of exchange processes during hemodialysis has been used. To simulate the ventilation-perfusion ratio (VA/Q), a simplified two-compartment model of the lung has been applied. The simulation results reveal that hypoxemia during hemodialysis has two reasons. In acetate hemodialysis, the main cause is a shift of the CO2-bicarbonate equilibrium caused by "consumption" of hydrogen ions during acetate metabolization resulting in hypoventilation due to a decrease in CO2 partial pressure. During hemodialysis with bioincompatible dialyzer membranes, the hypoxemia may be explained by an increase in inhomogeneity of the VA/Q ratio in the lung. The loss of CO2 and bicarbonate into the dialysate during acetate hemodialysis has only a minor effect on arterial PO2 and cannot explain the observed hypoxemia. The decrease of O2 diffusing capacity during hemodialysis with bioincompatible membranes has only a negligible effect on the arterial PO2. The simulation results show also that the venous PO2 in the brain may fall below a critical level of less than 25 mm Hg, thereby possibly causing oxygen deficiency in the cortex. PMID- 1763968 TI - Effects of single-dose infusion of pyridoxalated-hemoglobin-polyoxyethylene conjugate solution on canine renal function. AB - Pyridoxalated-hemoglobin-polyoxyethylene conjugate (PHP) is an acellular oxygen carrying red blood cell substitute made from outdated human red blood cells. This study assessed the effect of PHP on renal function when PHP was infused with a clinically relevant dosage. A single dose of PHP that contains 8% wt/vol each of hemoglobin and maltose or an 8% maltose control solution was infused into the intact circulation of eight dogs (five dogs for PHP and three for the control; 20 ml/kg each, at the rate of 2.5 ml/h/kg for 8 h) in the awake state. Serial measurements of glomerular filtration rate (GFR) and renal plasma flow (RPF) were carried out before and after infusion for up to 2 weeks, along with determinations of urine volume flow rate, fractional excretion of sodium (FES), and free water clearance (CH2O). The results showed an elevation of plasma colloid osmotic pressure by an average of 4.4 mm Hg immediately postinfusion with PHP solution. An average 23% decrease in GFR, without notable changes in RPF immediately postinfusion, was observed in the PHP group; the value returned to the preinfusion level by 1 week postinfusion. Increases in parameters such as urine output, FES, and CH2O, which were more pronounced in the PHP group, were observed for 24 h after the infusion in both groups. Light microscopic examination of kidney specimens taken at 2 weeks postinfusion revealed a slight degree of vacuole formation in approximately 80% of the proximal tubules in the PHP group. The tubules were devoid of typical pathologic features of acute renal failure, and the vacuoles did not cause any observable changes in the assessed tubular functions. PMID- 1763969 TI - Encapsulated multicellular spheroids of rat hepatocytes produce albumin and urea in a spouted bed circulating culture system. AB - Multicellular spheroids are spherical cell-aggregates that retain tridimensional architecture and tissue-specific functions. For use of multicellular spheroids of hepatocytes in a bioreactor for hybrid artificial liver support, we studied the effect of encapsulation and circulating culture on their integrity and tissue specific functions. Multicellular spheroids of rat hepatocytes were encapsulated into microdroplets of calcium alginate gel and were used as a bioreactor in medium circulating in a spouted bed chamber. Approximately 10% of the hepatocytes of an adult rat were entrapped in a bioreactor chamber, connected to a gas exchanger and a medium reservoir. The total bed volume of the system was 250 ml. The pH and DO2 of the hormonally defined circulating medium was maintained constantly. Albumin and urea were produced in a linear fashion for 64 h at the rates of 0.02 micrograms/microgram cell protein/day and 0.15-0.2 ng/micrograms cell protein/day, respectively. Viability and structural stability of the spheroids were well preserved after the culture period. These results indicate that these encapsulated multicellular hepatocyte spheroids will provide a useful bioreactor for the continuous production of albumin, in vitro and also a prototype hybrid artificial liver support. PMID- 1763970 TI - Binding of antithrombin to immobilized heparin under varying flow conditions. AB - Rheologic factors are likely to influence the balance between thrombotic and antithrombotic forces at the level of the vascular wall. In this study, the effects of flow-velocity/wall shear stress on the interaction of antithrombin (AT) with surface-immobilized heparin were investigated. The binding of AT to low affinity and high-affinity heparin could be discriminated by measurements at physiological of elevated ionic strength. Under low shear stress conditions, substantial binding of AT to both high- and low-affinity heparin was observed, in relative quantities largely reflecting the proportion of these polysaccharide populations on the surface. With increasing shear stress, the binding to high affinity sites was relatively constant, while total low-affinity binding decreased. Furthermore, under the highest shear stress (greater than 1,000 N/m2), the binding of AT to low-affinity heparin completely disappeared while binding to the high-affinity fraction persisted. These results were related to values obtained in a mathematical model, describing the theoretical maximum transport of AT from the liquid phase to the surface under the conditions used in the experimental system. PMID- 1763971 TI - Platelet adhesion to a biomimetic prosthesis prepared from canine arterial wall. AB - A biomimetic prosthesis was prepared from canine arterial wall by extraction with 70% formic acid. Under these conditions, the arterial architecture consisting of elastic lamella was conserved and the tensile strength was retained. Attachment of 51Cr-endothelial cells to the surface of the prosthesis was enhanced in the presence of collagen (50 micrograms/ml), fibronectin (20 micrograms/ml), and fibrinogen (500 micrograms/ml). These agents also enhanced the adhesion of 51Cr platelets. However, preattachment of endothelial cells to prostheses prevented platelet adhesion. PMID- 1763972 TI - The effect of anesthetics and analgesics on protein adsorption, platelet adhesion, and plasma recalcification time at blood-polymer interface. AB - Protein adsorption and subsequent cellular reactions are important biological events at the blood-polymer interface. Mediators like drugs, vitamins, and steroid hormones play a significant role in protein adsorption. An attempt is made to understand the effect of several i.v. agents on protein-platelet interaction with an artificial surface, polycarbonate. Pentothal, an anesthetic; lignocaine, a local anesthetic; pethidine, a narcotic anesthetic; Calmpose, a tranquilizer; and Novalgin, an analgesic, were drugs used for this study. Competitive adsorption of proteins is evaluated using a trace-labeled technique from a mixture of proteins (25 mg/dl of albumin, 15 mg/dl of tau-globulin, and 7.5 mg/dl of fibrinogen). Platelet and lymphocyte adhesion and plasma recalcification time are studied from calf blood. It is observed that these agents modulate the protein and cellular interaction and also the blood coagulation time. Therefore, proper selection of such including agents should not be overlooked for an implant surgery or while ministering to a patient with an implant. PMID- 1763973 TI - Novel method of valve replacement with interrupted sutures using protractor rings for the partitioning of a prosthetic sewing ring. AB - Newly devised protractor rings that can equally partition a prosthetic valve sewing ring into 10-20 acrs have been used on 46 patients who underwent 59 aortic, mitral, and/or tricuspid valve replacement. After an appropriate number of interrupted mattress sutures were placed along the host annulus, one of the 11 protractor rings was chosen and used to copy the partition onto the sewing ring with a tissue pen. The interrupted mattress sutures kept on a suture holder were then passed through the prosthetic sewing ring directly from one end to the other. Based on ex vivo experiments in simulating valve replacement, it was evident that time required for placing sutures around the sewing ring was significantly shortened by the use of such protractor rings. The use of these protractor rings may thus be useful in decreasing valve replacement time as well as in potentially simplifying operative procedures. PMID- 1763974 TI - Clinical relevance of biological incompatibility and role of a central register. AB - Different aspects relevant for the assessment and characterization of biomaterials are presented. Quite a number of basic concepts that play an important role when detecting unwanted adverse effects of drugs have to be taken into consideration when registering and evaluating unwanted effects of biomaterials. The institutionalization of the Central Bioregister at the University of Saarland is described. This Bioregister is a so-called "spontaneous" ad hoc recording system whose efficiency depends largely on the collaboration of physicians. Thus, the efficiency and rationality of the use of biomaterials can certainly be improved. The possibility of registering even rarely occurring unwanted effects as well as new indications will result in and allow a more general and/or a more specific therapy, depending on the biomaterial. PMID- 1763975 TI - Role of sulphation in post-translational processing of rat salivary mucins. AB - Segments of rat submandibular salivary gland were incubated in MEM supplemented with 10-800 microM sulphate in the presence of [3H]-glucosamine, [3H]-proline and [35S]-Na2SO4, with 0-8 mM chlorate, an inhibitor of 3'-phosphoadenosine-5' phosphosulphate formation. Incorporation of glucosamine and sulphate depended upon the sulphate content of the medium and reached a maximum at 400 microM sulphate. The introduction of chlorate into the medium, while having no effect on the protein synthesis as shown by [3H]-proline incorporation, caused, at its optimal concentration of 4 mM, a 90% decrease in mucin sulphation and a 29% drop in mucin glycosylation. At low sulphate content in the medium and in the presence of chlorate the incorporation of sulphate and glucosamine was mainly into the low molecular-weight form of mucin. An increase in sulphate in the medium caused an increase in the high molecular-weight form of mucin and in the extent of sulphation in its carbohydrate chain. This effect of sulphate was, however, inhibited by chlorate. The results suggest that sulphation takes place at an early stage of mucin assembly and that sulphate availability is essential for the formation of the high molecular-weight mucin. PMID- 1763976 TI - Lipopolysaccharide stimulation of hyaluronate synthesis by human gingival fibroblasts in vitro. AB - Exposure of gingival fibroblasts to LPS caused a dose-dependent increase in hyaluronate synthesis. Stimulation of hyaluronate synthesis by LPS was significantly greater 24 h after exposure and by 48 h an approx. 50% increase was evident. In parallel, there was an increase in the activity of the hyaluronate synthetase enzyme. Inhibition of PGE2 synthesis by indomethacin abolished the stimulatory effect of LPS on hyaluronate synthesis. Thus, this stimulatory effect of LPS on hyaluronic acid synthesis may be a secondary response to the induction of PGE2. The molecular size of newly synthesized hyaluronate was not affected by LPS. The metabolic changes observed may be a primary response of the cells to bacterial toxins and may aid extracellular matrix repair. PMID- 1763977 TI - Changes in mandibular condyle morphology related to tooth wear in a prehistoric human population. AB - The exact relationship between tooth wear and changes in the shape of the articulating surface of the mandibular condyles is unknown. It is assumed that to some degree these changes are in response to the loads on the joint generated during chewing. Excavated skeletal remains from sites of primitive human habitation provide an opportunity to study the masticatory system of human beings in their natural context, with the features of form and function expressed to their full potential. Accurate measurements of the condylar head can also be made on such remains. A collection of skulls from an excavation site known as Oakhurst on the South African coast provided material for this study. Occlusal wear was measured using the scale devised by Molnar; approximal wear was assessed by measuring the size of the wear facet between the first and second molars. The width of the condyles were measured directly, and a method was devised to measure changes in the proportion of medial and lateral articulating facets. An increase in the size of the lateral facet of the condyle was found to be associated with increased tooth wear. It is suggested that the direction of condylar remodelling may give an indication of the reaction at the joint to optimal mastication. PMID- 1763978 TI - Regeneration of calcitonin gene-related peptide immunoreactive nerves in replanted rat molars and their supporting tissues. AB - First maxillary right molars in 66 rats were elevated and replanted and the pulps allowed to regenerate for 1-90 days. The contralateral tooth served as control. Regeneration of nerves in the pulp and periodontium was studied by CGRP immunohistochemistry and the avidin-biotin-peroxidase method. The pulp and periodontium of the controls were richly supplied with CGRP-labelled nerves. One day after replantation the pulp was completely devoid of CGRP-immunoreactive nerves. After 2 days, axon sprouts were present in the apical, regenerated pulp and in the periodontium. From 3-7 days CGRP-immunoreactive axons were regularly seen to have regenerated in front of the cellular inflammation in the pulp. After 10 days, the pulps were reinnervated up to the horns, although more sparsely than in the controls. From day 20-90 there was a marked divergence in pulpal healing: 17 pulps formed irregular postoperative dentine with a gradual increase in nerve density; 16 pulps remained sparsely innervated and were gradually replaced by bone. Root resorption was most extensive in the teeth with bone replacement of pulp. The soft tissue adjacent to extensive resorbing areas had many more CGRP labelled axons than in the controls. The reinnervation of the regenerating pulp occurred at the same time as pulpal wound healing, but did not achieve the innervation density of the controls. PMID- 1763979 TI - Ultrastructural changes in the masseter muscle of Macaca fascicularis resulting from intramuscular injections of botulinum toxin type A. AB - Intramuscular injections of botulinum toxin type A (Oculinum) is used to treat strabismus and focal dystonias affecting orofacial muscles. However, the toxin induced morphological changes that underlie the therapeutic alterations of tone in the muscles of mastication have not been described. In this study, paired intramuscular injections of botulinum toxin (10 units) were made in three adult monkeys (Macaca fascicularis) allowed to survive 14, 28 and 63 days. Another monkey received multiple injection-pairs over 84 days. Animals were killed by deep pentobarbital anaesthesia before transcardiac perfusion-fixation. Tissue sampled from comparable regions of the injected masseter, the uninjected masseter and an uninjected animal was processed for ultrastructural analysis. Few changes were found 14 days post-injection. However, muscle fibres showed myofibrillar dissolution, aberrations in the Z-line, and enlarged mitochondria in the region of the I-band by 28 days. In the 63-day and 84-day animals, the injected muscle was considerably smaller than the uninjected, contralateral muscle. Regions of the injected muscle contained fibres with markedly reduced cross-sectional area. Internalization of myonuclei, loss of myofibrillar organization, and helical complexes were common. Toxin-induced changes, though similar to those that follow denervation by axotomy, were not accompanied by degeneration of neuromuscular junctions. Instead, morphological evidence for axonal sprouting in the region of the neuromuscular junction, possibly contributing to functional recovery, was seen as early as 14 days in toxin-treated muscles. PMID- 1763980 TI - A histological study of tissue response to simulated cleft palate surgery at different ages in beagle dogs. AB - The response of maxillary tissues to mucoperiosteal manipulation at different ages was studied microscopically early after operation and at maturity. Thirty two Beagles were divided into three experimental groups, a sham-operated group and a control group. At the age of 6, 16 or 25 weeks in the experimental groups an elliptical mucoperiosteal flap was excised in the midsagittal region of the palate, relaxation incisions were made and the mucoperiosteum was elevated and closed in the midline leaving two areas of denuded bone adjacent to the teeth. The animals were killed 1, 2 or 3 weeks after the operation or at the age of 37 weeks and serial sections of the jaw tissues were examined. Two weeks after the operation, scar had formed, its lack of elastic fibres indicating a more rigid type of tissue. The palatal bone showed rapid trabecular deposition. Cervico palatal and apico-buccal bone resorption in the alveolar socket indicated medial tipping of the teeth. The different soft tissue composition persisted until maturity. In the areas where scar tissue had developed, attachment by means of Sharpey's fibres from the mucoperiosteum to the palatal bone was found at the age of 37 weeks. Thus the different mechanical properties of scar tissue adjacent to the teeth and its attachment to the palatal bone may influence the growth and development of dento-alveolar structures. PMID- 1763981 TI - Estimation of tendon-plane orientation within human masseter muscle from reconstructed magnetic resonance images. AB - The human masseter is a powerful multipennate jaw elevator with complex internal architecture. The three-dimensional disposition of tendon planes within the muscle is thought to be an important determinant of function. We selected five adult subjects and used cephalometric radiography, magnetic resonance imaging and graphical, three-dimensional reconstruction to describe the organization of these planes within the muscle. Putative tendon planes were fitted to the surfaces of the three-dimensional reconstructions, and these were related to the mid-sagittal plane in the coronal and transverse views. To confirm whether putative planes disclosed by magnetic resonance represented true anatomical entities, a fresh human cadaver head was imaged and the magnetic resonance slices were compared with cryosections obtained in the same planes. Tendon-plane angulation appeared to be related to ramal length and lower face height measured cephalometrically. In the transverse view, the tendon planes appeared roughly to follow the angulations of the zygomatic arch and the lateral face of the mandibular ramus. These findings suggest that the angulation of tendon planes, and possibly pennation angles, are different depending on the viewing angle. Rather than reporting pennation angle as a single angle, alpha, which has been the convention, it may be more appropriate to express it as a three-dimensional angle relative to the normal of a particular tendon plane. The inference is that muscle fibres inserting on either side of a central tendon may need to develop different tensile forces if translation is to occur directly along the tendon axis. PMID- 1763982 TI - A comparative quantitative histological investigation of atrophic changes in the major salivary glands of liquid-fed rats. AB - Adult male rats were maintained on a wholly liquid diet for 9 days. The three pairs of major glands were removed, weighed, histologically sectioned and examined by stereological and morphometric techniques. The results were compared with the same glands from control rats maintained on normal hard diet and water, and the extent of the differences was compared between the three different types of gland. Up to 50% of the serous acinar volume in the parotid glands, but only 15% in the submandibular glands, was lost after liquid feeding. There was no loss of the mucous acinar tissue in the sublingual gland. Mean acinar diameters were reduced by 33% in parotids and 15% in submandibular glands after liquid feeding, whereas the mucous acini of the sublingual gland remained unaltered. The results point to varying levels of susceptibility to the loss of masticatory reflexes between the parotid serous acini and the submandibular serous acini, and show that the morphology of the sublingual mucous acini is independent of masticatory reflex stimulation. The reductions in acinar diameters suggest that most of the glandular atrophy after liquid feeding is due to acinar cell shrinkage rather than to losses of acinar cell numbers in both parotid and submandibular glands. PMID- 1763983 TI - M.R.I. spectrum of intrinsic spinal cord lesions. AB - We report our experience of 42 patients undergoing magnetic resonance imaging (MRI) studies demonstrating intrinsic lesions of the spinal cord, excluding those secondary to spondylosis, trauma or congenital malformations. Histological confirmation of the radiological diagnosis was obtained in 15 (36%). MRI is more sensitive than either myelography or CT. MRI identified a previously non visualised lesion in 17 of 30 cases. In a further 13 cases, MRI contributed by identifying associated features such as cysts and haemorrhage which have aided in the diagnosis and management of the patients. The last 12 cases, which were patients with multiple sclerosis, had MRI as the only neuroradiological examination. These illustrate a range of appearances. The overlap of imaging appearances of the various pathologies implies that a useful diagnosis and differential can only be offered by considering the MRI appearances of a lesion, with its associated features, with the clinical presentation, and with other imaging modalities where appropriate. PMID- 1763984 TI - Duplication of the vertebro-basilar system. AB - During the examination of 75 fixed brains and 2086 vertebral angiograms we encountered two cases of fenestration of the vertebral artery and two cases of partial duplication of the basilar artery. In the first case, an 81 year old male, there was fenestration, of the basilar artery at the union of the two vertebral arteries. The fenestration was 9mm long with no associated vascular disease. The other partial duplication of the basilar artery was observed in the upper portion of the artery in a 54 year old male patient investigated angiographically for subarachnoid haemorrhage. The fenestration of the third case was demonstrated in the intracranial part of the right vertebral artery of a 50 year old female patient during digital subtraction angiography for subarachnoid haemorrhage. In the fourth case, the fenestration was found angiographically at the atlanto-axial level in the extracranial portion of the left vertebral artery in a 37 year old female patient with subarachnoid haemorrhage from an arteriovenous malformation in the left cerebral hemisphere. The embryonic, histological and radiological implications of the duplication are discussed. PMID- 1763985 TI - Sonographic evaluation of chest masses in children. AB - The sonographic appearances of 12 intrathoracic masses in children are presented. Seven out of 12 masses were malignant and presented with opaque hemithorax on chest X-ray. Different types of masses encountered were: Lymphoma, Neuroblastoma, Ewing's sarcoma, metastatic Ewing's sarcoma, Teratocarcinoma, Pseudotumor of the lung, Neuroenteric duplication cyst, Bronchogenic cyst and tubercular mediastinal lymph nodes. PMID- 1763986 TI - Carbon localisation of impalpable mammographic abnormalities. AB - A prospective study was undertaken to assess the usefulness, safety and cost effectiveness of stereotactically guided carbon localisation of impalpable breast lesions. Fifty six lesions in 53 patients were localised by this method, some in combination with fine-needle aspiration and hookwire localisation. Some modification of the study was required due to ready acceptance of the technique by surgeons, who preferred carbon to hookwire localisation. The technique was proven to be safe and accurate, and highly acceptable to patients, referring clinicians and radiology staff. It is now the preferred procedure for localising impalpable breast lesions prior to excision biopsy. PMID- 1763987 TI - Radical radiotherapy for carcinoma of the larynx--Westmead Hospital experience. AB - Between January 1980 and December 1988, 141 patients were treated with radical radiotherapy for carcinoma of the larynx. One hundred and ten (78%) tumours arose on the vocal cords, twenty nine (21%) from the supraglottis and two (1%) from the subglottis. All 63 stage T1 cases, and all except three of 62 T2 cases seen in the time period, were treated by radiotherapy. In addition 14 selected T3 and 5 T4 cases were irradiated. Only 7% had clinical evidence of regional lymph node metastases at presentation. Median follow up is 47.5 months and 2+ year actuarial local control rates are T1-87%, T2-63%, T3-79% and T4-53%. The rates for vocal cord primaries are T1-86%, T2-58%, and T3-75%. Median time to local failure was 8 months with none occurring beyond 21 months. Two of 130 N0 cases (1.5%) relapsed in cervical lymph nodes with a policy of selective prophylactic irradiation of the regional lymphatic areas. Thirty three/thirty seven patients with locoregional failure underwent salvage surgery with 27/32 (84%) evaluable patients achieving ultimate locoregional control with median follow up of 18.5 months from salvage. Four patients (3%) developed distant metastases and 21 (15%) developed a second primary malignancy (including 13 lung cancers) with an actuarial rate of second primary tumours of 23% at five years. Three year actuarial survival for the whole group is 77% but 66% of deaths were due to causes other than larynx cancer. Tumour specific mortality by stage is T1-1.6%, T2-12%, T3,4-21%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1763988 TI - Testicular lymphoma--the need for a new approach. AB - Thirteen cases of malignant lymphoma of the testis were referred to the Queensland Radium Institute between 1975 and 1989. The age varied from 43 years to 84 years and the histology was intermediate to high grade in all cases. Seven patients had Stage I/II and 6 had Stage III/IV. The 4 year survival was only 16%. Half of the relapses were systemic, 1 was in the para-aortic nodes (unirradiated) and 2 were in the opposite testicle. Adjuvant radiotherapy to para-aortic nodes and mild chemotherapy have produced disappointing results. A new approach using aggressive combination chemotherapy and adjuvant scrotal irradiation is proposed for early stage disease. PMID- 1763989 TI - Duodenal diverticulum simulating a pancreatic mass on computed tomography. PMID- 1763990 TI - Bilateral traumatic posterior hip dislocation: CT findings. PMID- 1763991 TI - Rhizomelic bone dysplasia with club-like femora (case report and confirmation of a syndrome). AB - A newborn with rhizomelic bone dysplasia with club-like femora is reported. This is the fourth case of this easily recognizable, recently reported, congenital bone disease. Maroteaux et al recently reported two patients with rhizomelic bone dysplasia and club-like femora as a distinctive new bone dysplasia. Their observation was confirmed by Gugliantini et al (2) who reported another case. This paper reports a fourth patient with this easily recognisable disorder. PMID- 1763992 TI - Intraosseous lipomata in Paget's disease: an unusual CT appearance. AB - A case of multiple intraosseous lumbar vertebral lipomata is reported occurring in the presence of Paget's disease. The pathology and radiology are correlated. PMID- 1763993 TI - Multiple intracranial aneurysms and neurofibromatosis: a case report. PMID- 1763994 TI - Unilateral breast edema in congestive heart failure--a mimic of diffuse carcinoma. AB - Mammography in a patient with congestive heart failure showed unilateral skin thickening and a reticular pattern mimicking diffuse carcinoma. Resolution after treatment of the heart failure established the abnormality as secondary to dependent edema. PMID- 1763995 TI - The accessory soleus muscle: a case report and review of the literature. AB - A case of histologically proven accessory soleus muscle simulating a soft tissue tumour in a young male is reported. The radiological features are demonstrated and reviewed. PMID- 1763996 TI - Primary renal carcinoid--case report. AB - Carcinoid tumour is a rare cause of a renal mass. Only fourteen cases have been reported since it was first described in 1966. This case illustrates most of the commoner features. PMID- 1763997 TI - The recalcitrant subclavian pseudoaneurysm: a case report. AB - A case of pseudoaneurysm of the left subclavian artery is presented. It demonstrates not only the difficulties facing the surgeon and radiologist in the management of this rare condition, but also how interventional radiology and surgery can be used in tandem to approach such a complex vascular problem. PMID- 1763998 TI - Magnetic resonance imaging of peripheral T-cell lymphoma. AB - We report magnetic resonance (MR) findings of two unusual cases of peripheral T cell lymphoma, one initially presenting as a soft-tissue mass in the neck and the other in the foot. MR imaging provides better tissue contrast and lesion delineation than CT. However, MR signal characteristics cannot differentiate this lymphoma from other soft-tissue tumours. Although it is rare, peripheral T-cell lymphoma should be included in the differential diagnosis of a soft-tissue mass. PMID- 1763999 TI - Re: Obstetric ultrasound reporting--a plea for consistency. PMID- 1764000 TI - Cases from the aerospace medicine residents' teaching file. Case #46. A boom operator with evidence of keratoconus. AB - A boom operator with evidence of keratoconus. The clinical presentation, evaluation, and diagnosis of a boom operator being evaluated for keratoconus. The aeromedical disposition of this patient is also discussed. PMID- 1764001 TI - Chronic fatigue syndrome. PMID- 1764002 TI - Carotid baroreceptor influence on forearm vascular resistance during low level lower body negative pressure. AB - The degree of forearm vasoconstriction induced by low levels of lower body negative pressure (LBNP) provides a measure of the responsiveness of the cardiopulmonary baroreflex. The validity of this measurement is based on the assumption that this vasoconstriction response is not influenced by unloading of carotid baroreceptors. To test the hypothesis that arterial baroreceptor unloading does not alter the degree of forearm vascular resistance during low levels of LBNP, we exposed 12 subjects to -15 and -20 mm Hg LBNP with and without additional artificial (+10 mm Hg neck pressure) unloading of the carotid baroreceptors. There was no measurable influence of carotid unloading on forearm vascular resistance at either level of LBNP. We conclude that forearm vascular resistance measured during cardiopulmonary baroreceptor unloading is unaffected by carotid baroreceptor unloading within the magnitude encountered during low levels of LBNP. PMID- 1764003 TI - Lower body negative pressure to provide load bearing in space. AB - Presently, exercise protocols and equipment for spaceflight are unresolved, although recent calculations suggest that all exercise in space to date has lacked sufficient loads to maintain preflight musculoskeletal mass. We hypothesized that lower body negative pressure (LBNP) produces a footward force equal to the product of the pressure differential and body cross-sectional area at the waist seal. Twelve male volunteers weighing 67.6-86.9 kg were sealed at the superior iliac crest in upright and supine LBNP chambers. Neither configuration included a saddle, so that the force due to LBNP was transmitted to the feet of our subjects. Each subject was exposed to 10 mm Hg increments of LBNP up to 70 mm Hg (standing) or to 50-100 mm Hg (supine), depending upon individual tolerance. Static reaction force was measured at each LBNP level for approximately 1-2 min. An additional static force approximately equivalent to 1% Earth body weight was generated against the feet by each mm Hg of LBNP either during upright standing or supine posture. Furthermore, the forces measured during LBNP agreed well with forces calculated from the cross-sectional areas of our subjects' waists. These results indicate that exercise in microgravity against 100 mm Hg LBNP could produce static and inertial forces similar in magnitude to those occurring on Earth. This gravity-independent technique may help maintain the musculoskeletal and cardiovascular systems of crewmembers during prolonged exposure to microgravity. PMID- 1764004 TI - Cardiopulmonary baroreflex control of forearm vascular resistance after acute blood volume expansion. AB - We report the stimulus-response characteristics of cardiopulmonary (CP) baroreflex control of forearm vascular resistance (FVR) in young adult male volunteers before and after: 1) blood volume expansion (8 ml/kg infusion of 5% human serum albumin solution, n = 5) and 2) a redistribution of blood volume toward the heart (6 degrees head-down tilt (HDT), n = 6). We assessed the relationship between reflex stimulus (i.e., changes in central venous pressure (CVP] and response (i.e., FVR) during unloading of CP mechanoreceptors with lower body negative pressure (0 to -20 mm Hg). Changes in CVP were estimated from changes in venous pressure of a large peripheral vein of the dependent arm with the subject in the right lateral decubitus position. In all conditions, reflex forearm vasoconstriction occurred in response to a reduction in estimated CVP. The absolute change in FVR per unit of CVP was reduced from -4.24 +/- 1.68 to 2.15 +/- 1.16 units/mm Hg (p less than 0.05) following blood volume expansion but was similar before (-3.34 +/- 0.89 units/mm Hg) and during 6 degrees HDT (-3.30 +/- 0.92 units/mm Hg). The reduced sensitivity of the CP baroreflex following volume expansion was manifested primarily as a smaller FVR response to LBNP (p less than 0.05). Blood volume expansion and 6 degrees HDT increased resting estimated CVP by 1.5 and 0.9 mm Hg, respectively (p less than 0.05) and resting levels of FVR decreased slightly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764005 TI - Cerebrospinal fluid pressure in conscious head-down tilted rats. AB - Cerebrospinal fluid pressure (PCSF) was continuously measured in conscious male Sprague-Dawley rats gently restrained by a cotton towel. PCSF, evaluated in 15 min time blocks over a 3-h experiment, increased slightly (p less than 0.05) during the first 30 min of a control hour at 0 degree. There was a transient increase for about 5 min immediately after tilt (-45 degrees) that may have been due to head movement after the position change. However, PCSF was statistically unchanged (p greater than 0.05) during the 2nd (-45 degrees) hour and the 3rd (0 degree) recovery hour. The data show that the dynamics of intracranial pressure regulation can accommodate the acute cephalad fluid shift after tilting. PMID- 1764006 TI - Pineal physiology in microgravity: relation to rat gonadal function aboard Cosmos 1887. AB - For the first time pineal glands obtained from 5 male rats flown aboard an orbiting satellite (Soviet Biosatellite #1887) were analyzed for their melatonin, serotonin (5-HT), 5-hydroxyindole acetic acid (5-HIAA), and calcium content. In addition, plasma 5-HT and 5-HIAA were measured. These parameters were compared to indicators of gonadal function: plasma testosterone concentration and spermatogonia development. Plasma melatonin was low at the time of euthanasia (lights on) and was not different among the experimental groups (flight animals, synchronous controls, and vivarium controls). Pineal calcium of flight animals was not different from ground controls. However, pineal 5-HT and 5-HIAA in the flight group were significantly higher than those in ground controls (p less than 0.05). These findings suggest a possible increase in pineal 5-HT turnover in flight animals which may result in increased melatonin secretion. Since melatonin is known to possess antigonadal properties, the alteration of pineal 5-HT turnover and its expected effects on melatonin secretion may, in part, explain the lower plasma testosterone levels (p less than 0.001) and 4-11% fewer spermatogonia cells (p less than 0.02) observed in flight animals. PMID- 1764007 TI - The use of cardiac and eye blink measures to determine flight segment in F4 crews. AB - Discriminant analysis techniques were used to classify 8 flight segments for 19 F4 crewmembers and to classify pilots from Weapons Systems Officers (WSOs). Heart rate and eye blink data were used as variables. Pilots and WSOs were correctly classified 84% of the time, while 92% of the flight segments were correctly classified for pilots and 89% for WSOs. The percent correct classifications of flight segments using the jackknife procedure were 69% and 68%, respectively. The advantage of collecting multiple physiological signals was demonstrated. Combined cardiac and eye blink data produced better classifications than when each was used alone. Application of this technique to the flight environment is discussed. PMID- 1764008 TI - Markers for development of hypertension in commercial flight aviators. AB - In order to discover markers for the development of cardiovascular disease and hypertension, we studied systolic and diastolic blood pressure, ECG, and heart rate before, during and after exercise; body mass index (BMI); serum cholesterol; and smoking habits in 183 male aviators (mean age 41 years at commencement, and 55 at follow-up). Those developing cardiovascular disease had an overrepresentation of smokers but the disease could not be related to any other variable. By contrast we found the following independent markers for prediction of future hypertension in normotensive aviators: increased BMI, increased diastolic blood pressure at 50 W, low heart rate at maximal exercise and smoking. Of these markers high diastolic blood pressure and low heart rate during exercise are new. Subjects with initially elevated blood pressure who did not develop hypertension decreased their diastolic blood pressure after exercise in contrast to those developing hypertension. PMID- 1764009 TI - Psychiatric diagnoses in a group of astronaut applicants. AB - Between 1959 and 1987, the psychiatric evaluation of astronaut candidates evolved from a 30-h intensive examination evaluating applicants for psychopathology, and studying their performance under stress, to a 2-h clinical interview whose structure and contents were determined by the individual examiner. Evaluations done during these years applied both psychiatric (or, "select-out") criteria and psychological (or, "select-in") criteria. In an attempt to more rigorously define the psychiatric, "select-out" component, a standardized, semi-structured clinical interview was developed to identify the presence or history of psychiatric disorders listed in the Diagnostic and Statistical Manual of Mental Disorders, 3rd Ed. ("DSM-III"). A total of 117 astronaut applicants underwent this clinical interview as part of a comprehensive medical evaluation during a recent astronaut selection. Of the 117 applicants, 9 (7.7%) met DSM-III criteria for a variety of Axis I and Axis II diagnoses, including V-code diagnoses. PMID- 1764010 TI - Extent and etiology of aeromedical duty restrictions at a U.S. Coast Guard air station. AB - Aircrew are subject to flight and duty restrictions for various health-related problems. The major classifications of aeromedical limitations in the US Coast Guard are: Fit For Limited Duty (FFLD), fit for Duty Not Involving Flying (DNIF), and Sick In Quarters (SIQ). I studied the etiology and distribution of these restrictions among aircrew at a busy Coast Guard Air Station. Data were collected over a 6-month period from personnel Health Records and various medical reporting systems. A total of 391 health care episodes among 179 (56.6%) flight crew resulted in 1,961 days of flight/duty restriction. There were 1,349 (68.8%) days of DNIF, 439 (22.4%) days of FFLD, and 173 (8.8%) days of SIQ. The annual crude rate of restrictions per flight crew is 12.4 d. The most common causes for flight or duty restriction were infectious diseases of the respiratory and gastrointestinal tract and musculoskeletal problems. In conclusion, aeromedical flight/duty restrictions are substantial and have impact on flight crew availability. PMID- 1764011 TI - Heat stress on helicopter pilots during ground standby. AB - We attempted to use measurements of ambient thermal conditions to characterize and then predict thermal conditions in the cockpit before takeoff and during an hour standby period in Bell 206 and Bell 212 helicopters with a crew of two and with the cockpit doors opened. Dry bulb, wet bulb, and globe temperatures were measured on 28 separate summer days. The wet bulb globe temperature index (WBGT) was used to estimate heat stress. Ambient WBGT at time 0 ranged from 13 degrees C to 31 degrees C. There was a 2.9 +/- 3.7 degree difference in WBGT between ambient and cockpit conditions at time 0 which increased to 7.2 +/- 3.5 degrees after 1 h. Because of the cooling effect of opening the helicopter cockpit doors, the cockpit WBGT actually decreased over the standby period when cockpit WBGT values were 30 degrees C or more at time 0. Thus, there was an inverse correlation between cockpit WBGT at time 0 and the change in cockpit WBGT over the 1-h period (r = -0.767, p less than 0.001). The mean WBGT in the cockpit over the 1-h standby period was positively correlated with the ambient WBGT at time 0 (r = 0.783, p less than 0.001). We conclude that the greenhouse effect results in a cockpit WBGT which is significantly higher than ambient conditions. Subsequent changes in cockpit WBGT depend on the balance between heat transfer from the pilot's bodies to the cockpit and the loss of heat after the doors of the helicopters are opened. Ambient thermal conditions can be used to predict heat stress during the ground standby period. PMID- 1764012 TI - Visual evoked and brain stem auditory evoked potentials in divers. AB - Visual evoked potentials (VEP) were examined in 14 divers during dives to 360 metres of seawater (msw). All latencies increased significantly with depth. VEP and brain stem auditory evoked potentials (BAEP) were similarly examined in 18 divers before and after these dives. N75 was significantly increased after compared to before the dive, while there was no significant difference in the P100 and N145 latencies. BAEP I-V latency was significantly decreased after the dives. VEP and BAEP were examined in 156 divers and 99 controls. There was no significant difference in VEP. BAEP I-III interpeak latency was significantly increased for the divers, but with no significant changes in I-V and III-V latencies. VEP and BAEP were examined in 26 divers after treatment for neurological decompression sickness. There was no significant difference compared to the control group. The conclusions are that VEP and BAEP change transitorily with influence of hyperbaric pressure, but do not measure major permanent disturbances in the divers' visual and auditory pathways. PMID- 1764013 TI - Unequal narrowing of the visual field in a +Gz environment. AB - Anecdotally, the existence of individuals who experience an unequal loss of peripheral vision (left versus right) under sustained +Gz acceleration is well known. However, there is little mention or explanation of the etiology in the literature. Only recently has there been a surge of interest in this phenomenon. The operational significance is more important. The most common interpretations for this phenomenon are unequal arterial pressure between the left and right blood supplies to the retina (ophthalmic artery, its branch to the retina, the central retinal arteries, the circle of Willis, and the internal carotid artery), and a difference in the intraocular pressure. Two case histories of unequal peripheral light loss (PLL) are discussed. It is possible for a pilot not to be aware of his or her full sequence of PLL and, in an operational environment, lose half the visual field and not realize it. We need more controlled studies to define unequal PLL and to ensure valid centrifuge subject data. PMID- 1764014 TI - Techniques to enhance safety in acceleration research and fighter aircrew training. AB - Acceleration (+Gz) research and aircrew training using human centrifuges involves considerable stress that can alter normal cardiovascular and neurologic function even in completely healthy individuals. It is clear that electrocardiographic rate, rhythm, and conduction disturbances are frequently associated with +Gz exposures. These cardiac changes can result in altered perfusion of the central nervous system (CNS) to an extent which exceeds that induced by the +Gz stress alone. Although centrifuge-based research and training have a proven record of overall safety, there is finite risk associated with such stressful exposures, and adverse events have been observed. It is, therefore, extremely important to continually develop improved avenues to enhance human safety during centrifuge exposure. We have implemented techniques that can be immediately employed by centrifuge medical personnel to reduce the potential for significant CNS embarrassment and possible injury. These include techniques to 1) reduce excessive parasympathetic tone that may result in marked bradycardia and transient asystole post +Gz stress, and 2) manually controlled inflation and pulsation of the anti-G suit to enhance CNS perfusion post +Gz stress. PMID- 1764015 TI - Decompression sickness: USN operational experience 1969-1989. AB - This report presents data on the U.S. Navy's experience in decompression sickness occurring in operational flight from 1 January 1969 to 30 December 1989. During these 21 years, decompression sickness was reported in 12 USN aircraft and involved 15 aircrew. The primary cause of decompression, as might be expected, was a loss of cabin or cockpit pressurization. The most common manifestation of decompression sickness was limb or joint pain although some crewmembers experienced various manifestations of neurological dysfunction. One crewmember experienced chokes. Of the 15 afflicted aircrew, 13 (87%) had complete remission of symptoms by the time they landed. Two crewmembers required compression therapy for resolution of symptoms. None of the reported symptoms were incapacitating and none of the aircraft involved crashed or received even minor damage. PMID- 1764016 TI - Doppler detection of decompression bubbles with computer assisted digitization of ultrasonic signals. AB - Precordial Doppler ultrasonic monitoring is routinely used for detection of venous gas bubbles resulting from decompression in hypobaric or hyperbaric applications. Bubble scoring codes have been devised in an attempt to quantify the number of audible bubble signals heard over the background sounds of the cardiac cycle. The audio interpretation of these ultrasonic backscatter signals remains the most common method for decompression evaluation. We report on the use of an inexpensive, commercially available audio digitizer in conjunction with a personal computer to digitize Doppler bubble signals for visual and electronic evaluation. This device can be operated simultaneously with Doppler audio monitoring. Precordial and arterial Doppler recordings of gas bubbles were obtained from anesthetized dogs after intravascular infusion or following decompression. Additional evaluations were conducted on Doppler bubble recordings obtained from human decompression studies. The device can be used in real-time or for later signal analysis. Accompanying menu-driven software provides for numerous signal modification options and visual displays. This device can provide a simultaneous visual display of Doppler signals normally only available for audio evaluation. PMID- 1764017 TI - A living systems analysis of organizational pathology. AB - Organizations have essentially the same subsystem processes as living systems at other levels. All of them adjust subsystem variables to changing environmental and internal circumstances. Pathology exists in any system when a subsystem variable remains out of its steady-state range for an extended period. The same classes of pathology can be found at all levels. This article analyzes the various forms of pathology that exist in living systems at the level of organizations and describes living systems process analysis. Studies of several types of organizations including U.S. Army battalions, a corporation, a hospital, and a possible space station or lunar base, are discussed. PMID- 1764018 TI - Graduate and post-graduate medical education with the synchronous systems model. AB - Behavioral sciences have an important new role, particularly in medicine and prevention (Revans, 1990; Starr, 1982). A decade ago when the ideology of medical care shifted from a biomedical to a biopsychosocial model, behavioral and social factors ascended in importance in modern health concerns (see Engel, 1977). Now, a living systems model called Synchronous Systems (Jasnoski & Schwartz, 1985) incorporates environmental (including the social and physical) along with physiological and psychological factors into its structure. The environment has been gaining recognition as an important determinant in health, disease, and wellness (Daniel, 1990; Demick & Wapner, 1990; Lawton, 1990; Stokols, 1990). The phrase "Synchronous Systems" departs from the traditional linear thought patterns to depict contemporaneous occurrences. Synchrony refers to simultaneous experiences or events, with an emphasis on healthy, congruent process and function. Positive, beneficial process in human functioning emphasizes prevention as found in public health efforts but refers also to dysfunctional and recuperative foundation of medicine as a departure from the healthy norm. These process and functional dynamics in the Synchronous Systems Model derive conceptually from systems theory, specifically from control and cybernetic theories (Cannon, 1932; Weiner, 1948). The dynamic complexity of health in the whole human system, which also incorporates the environment, requires synthesis of knowledge from the biological, social, behavioral, and ecological sciences. This article provides the fundamentals of the structural and functional synthesis possible in the Synchronous Systems Model. Its direct application to multidisciplinary research is also presented along with its specific application to medical education, policy, research, and service delivery. PMID- 1764019 TI - Experimental testing of constructivism and related theories. AB - The purpose of this article is to show that experimental scientific methods can be applied to explain how the analytic mechanism of the left cerebral hemisphere and the synthetic mechanism of the right one create complex cognitive constructions like ontology and mathematics. Nominalism and ordinal mathematical concepts are related to the analytic left hemisphere while Platonism and cardinal mathematical concepts are related to the synthetic right one. Thus persons with a dominant left hemisphere tend to prefer nominalist ontology and have more aptitude for ordinal mathematics than for cardinal mathematics, while persons with a dominant right hemisphere tend to prefer platonist ontology and have more aptitude for cardinal mathematics than for ordinal mathematics. It is further explained how the Kantism temporal mode of perceiving experience can be related to the left hemisphere while the Kantian spatial mode of perceiving experience can be related to the right hemisphere. This relation can be tested experimentally, thus the Kantian source of constructivism, and through it constructivism itself, can be tested experimentally. PMID- 1764020 TI - H.p.l.c. of oligo(sialic acids). Application to the determination of the minimal chain length serving as exogenous acceptor in the enzymic synthesis of colominic acid. AB - A rapid, sensitive and easy h.p.l.c. method was developed for the quantitative analysis of oligosialic acids. This procedure which permits the complete separation (in 23 min) of several sialyloligomers with a degree of polymerization of between 1 and 16, has been employed to establish the minimal chain length of oligomer accepted, as an exogenous acceptor, by Escherichia coli K-235 sialytransferase complex (ST) leading to the synthesis in vitro of colominic acid. We showed that this membrane-bound enzyme catalyses the direct transfer of Neu5Ac residues (one by one) from CMP-Neu5Ac to an exogenous acceptor molecule which contains at least three Neu5Ac residues. Free Neu5Ac or (Neu5Ac)2 were not recognized as substrates, whereas the maximal rate of polymer elongation was achieved when (Neu5Ac)5 was used as substrate. PMID- 1764021 TI - Human myocardial cytosolic Ca(2+)-independent phospholipase A2 is modulated by ATP. Concordant ATP-induced alterations in enzyme kinetics and mechanism-based inhibition. AB - Although phospholipases A2 (PLsA2) have been implicated as enzymic mediators of electrophysiological dysfunction during myocardial ischaemia and reperfusion in man, no information on the regulation of human myocardial PLsA2 is available. We now report that human myocardial cytosolic Ca(2+)-independent PLA2 is modulated by ATP through mechanisms which are independent of protein phosphorylation, since: (1) ATP and its non-hydrolysable analogues reversibly augment the initial rate of crude (but not purified) human myocardial cytosolic PLA2 activity 3-4 fold; (2) ATP and its non-hydrolysable analogues dramatically attenuate the rate of thermal denaturation of human myocardial cytosolic PLA2 activity; (3) ATP and its non-hydrolysable analogues alter the sensitivity of human myocardial cytosolic PLA2 to mechanism-based inhibition by (E)-6-(bromomethylene)tetrahydro 3-(1-naphthalenyl)-2H-pyran-2-one; (4) adenine nucleotide triphosphates are more potent than guanine nucleotide triphosphates in activating and stabilizing human myocardial cytosolic PLA2; (5) adenosine 5'-[beta gamma-methylene]triphosphate is more potent than its guanosine counterpart in protecting an essential thiol residue(s) in human myocardial cytosolic PLA2 from covalent modification by 5,5' dithiobis-(2-nitrobenzoic acid); and (6) ATP-dependent activation and stabilization of human myocardial cytosolic PLA2 are mediated by a cytosolic protein(s) which can be functionally reconstituted with purified human myocardial cytosolic PLA2 catalytic polypeptide. Collectively these results demonstrate that multiple physical and kinetic properties of human myocardial cytosolic Ca(2+) independent PLA2 are dramatically influenced by dynamic interactions with ATP. PMID- 1764022 TI - Ursodeoxycholic acid increases low-density lipoprotein binding, uptake and degradation in isolated hamster hepatocytes. AB - Ursodeoxycholic acid (UDCA), in contrast to both chenodeoxycholic acid (CDCA), its 7 alpha-epimer, and lithocholic acid, enhanced receptor-dependent low-density lipoprotein (LDL) uptake and degradation in isolated hamster hepatocytes. The increase in cell-associated LDL was time- and concentration-dependent, with a maximum effect observed at approx. 60 min with 1 mM-UDCA. This increase was not associated with a detergent effect of UDCA, as no significant modifications were observed either in the cellular release of lactate dehydrogenase or in Trypan Blue exclusion. The effect of UDCA was not due to a modification of the LDL particle, but rather was receptor-related. UDCA (1 mM) maximally increased the number of 125I-LDL-binding sites (Bmax.) by 35%, from 176 to 240 ng/mg of protein, without a significant modification of the binding affinity. Furthermore, following proteolytic degradation of the LDL receptor with Pronase, specific LDL binding decreased to the level of non-specific binding, and the effect of UDCA was abolished. Conversely, the trihydroxy 7 beta-hydroxy bile acid ursocholic acid and its 7 alpha-epimer, cholic acid, induced a significant decrease in LDL binding by approx. 15%. The C23 analogue of UDCA (nor-UDCA) and CDCA did not affect LDL binding. On the other hand, UDCA conjugated with either glycine (GUDCA) or taurine (TUDCA), increased LDL binding to the same extent as did the free bile acid. The half maximum time (t1/2) to reach the full effect was 1-2 min for UDCA and TUDCA, while GUDCA had a much slower t1/2 of 8.3 min. Ketoconazole (50 microM), an antifungal agent, increased LDL binding, but this effect was not additive when tested in the presence of 0.7 mM-UDCA. The results of the studies indicate that, in isolated hamster hepatocytes, the UDCA-induced increase in receptor-dependent LDL binding and uptake represents a direct effect of this bile acid. The action of the bile acid is closely related to its specific structural conformation, since UDCA and its conjugates are the only bile acids shown to express this ability thus far. However, certain agents other than bile acids, such as ketoconazole, have a similar effect. Finally, the studies suggest that the recruitment of LDL receptors from a latent pool in the hepatocellular membrane may be the mechanism by which UDCA exerts its direct effect. PMID- 1764023 TI - Clonal analysis of sucrase-isomaltase expression in the human colon adenocarcinoma Caco-2 cells. AB - To investigate the biosynthetic basis for the mosaic expression of brush border enzymes in confluent Caco-2 cells, a human colon carcinoma cell line exhibiting characteristics of adult small intestinal enterocytes, we have obtained a series of clones differing markedly in their growth rates, amounts of transforming growth factor-alpha/epidermal growth factor-like activity released into the culture medium, and sucrase-isomaltase (SI) activity. Other intestinal markers (aminopeptidase N, dipeptidylpeptidase IV, lactase, alkaline phosphatase and 'crypt cell antigen') displayed a much more limited variability in expression, suggesting that the Caco-2 cell clones we have obtained did not differ in their overall ability to differentiate. Immunofluorescence staining, metabolic labelling with radioactive methionine and hybridization analysis of SI mRNA abundance were used to investigate SI synthesis and its regulation in clones endowed with low, intermediate or high sucrase activity. The results obtained have demonstrated heterogeneous SI expression, even in clonal cell lines, and a negative correlation between SI expression and growth factor concentrations in the culture medium, suggesting an autocrine regulation of cell proliferation and differentiation in confluent Caco-2 cells. Pulse-chase experiments using the two clones endowed with the lowest and highest levels of SI activity, followed by immunoprecipitation of labelled SI with epitope-specific antibodies and SDS/PAGE analysis, suggested that both transcriptional and post-translational mechanisms play a role in the regulation of SI expression in intestinal cells. PMID- 1764024 TI - Differences in the regulation of endothelin-1- and lysophosphatidic-acid stimulated Ins(1,4,5)P3 formation in rat-1 fibroblasts. AB - Endothelin-1 (ET-1)- and lysophosphatidic acid (LPA)-stimulated PtdIns(4,5)P2 hydrolysis has been studied in Rat-1 fibroblasts. Although both agonists caused the dose-dependent accumulation of inositol phosphates, a number of differences were observed. LPA induced a transient increase in Ins(1,4,5)P3 mass which returned to basal levels within 90 s, whereas the response to ET-1 did not desensitize, with levels remaining at 3-4 times basal values for up to 15 min. Stimulated decreases in mass levels of PtdIns(4,5)P2 mirrored Ins(1,4,5)P3 formation for both agonists. Experiments with electropermeabilized cells demonstrated that the effects of both agonists are stimulated by a phospholipase C controlled by a guanine-nucleotide-binding regulatory protein; however, there are differences in the nature of these interactions. The inositol phosphate response to ET-1 is poorly potentiated by guanosine 5'-[gamma-thio]triphosphate (GTP[S]) and markedly inhibited by guanosine 5'-[beta-thio]diphosphate (GDP[S]), whereas that to LPA is potentiated by GTP[S] but is relatively insensitive to GDP[S]. In addition, LPA decreased the lag time for the onset of GTP[S] stimulated [3H]InsP3 accumulation, whereas ET-1 was without effect. Phorbol 12 myristate 13-acetate treatment of the cells inhibited LPA-stimulated, but not ET 1-stimulated, inositol phosphate formation in both intact and permeabilized cells, suggesting that the site of protein kinase C-mediated phosphorylation may be blocked in ET-1-stimulated Rat-1 cells. The results indicate that the receptor G-protein-phospholipase C interaction for the two agonists may not conform to the same model. PMID- 1764025 TI - The human collagen X gene. Complete primary translated sequence and chromosomal localization. AB - We report on the complete primary translated sequence of human alpha 1(X) collagen, deduced from a genomic clone, and the chromosomal localization of the human collagen X gene. The primary translated product of human collagen X is encoded by two exons of 169 bp and approx. 2940 bp. The 169 bp exon encodes 15 bp of 5'-end untranslated sequence, 18 amino acid residues (54 bp) of signal peptide and 33 1/3 amino acid residues (100 bp) of the N-terminal non-collagenous domain. The 2940 bp exon encodes 4 2/3 amino acid residues (14 bp) of the N-terminal non collagenous domain, the complete triple-helical domain of 463 amino acid residues (1389 bp), the complete C-terminal non-collagenous domain of 161 amino acid residues (483 bp) and 1054 bp of 3'-end untranslated sequence up to and including a potential cleavage/polyadenylation signal. The size of the intron separating the two exons, as estimated by partial sequencing and Southern-blot analyses, is approx. 3200 bp. By a combination of somatic cell hybrid screening and hybridization in situ the human collagen X gene (COL10A1) has been assigned to the distal end of the long arm of chromosome 6 at the locus 6q21-6q22.3. PMID- 1764026 TI - Masses of inositol phosphates in resting and tetanically stimulated vertebrate skeletal muscles. AB - The masses of inositol phosphates have been determined in isolated skeletal muscles from Xenopus laevis (sartorius, tibialis anterior and iliofibularis) and rat (gastrocnemius and soleus) which were quick-frozen in the resting state and at different stages of an isometric (Xenopus) or isotonic (rat) tetanus. The isomeric spectrum of inositol phosphates detected was similar to that in other tissues and cell types. The total sarcoplasmic concentrations of the isomers Ins (1,4,5,6)P4/Ins(3,4,5,6)P4 (0.2-0.9 microM), Ins(1,3,4,6)P4 (not detectable), Ins(1,3,4,5,6)P5 (about 1 microM) and InsP6 (3.2-4.6 microM) were lower than in other cell types. Variations in these concentrations were due to the muscle type rather than to the donor species. The putative second messenger Ins(1,4,5)P3, as well as its dephosphorylation product Ins(1,4)P2, were present at surprisingly high total myoplasmic resting concentrations, ranging from 1.2 to 2.5 microM and 3.5 to 6.9 microM respectively. Upon tetanic stimulation these two inositol phosphates in particular exhibited significantly increased total sarcoplasmic concentrations, up to 4.2 microM and 11.3 microM respectively, with a time scale of seconds. From the initial rate of increase in the total sarcoplasmic concentrations of Ins(1,4,5)P3 and its rapidly formed metabolic products, a minimal phosphoinositidase C (PIC) activity in tetanically activated Xenopus skeletal muscle of about 1.7-2.6 microM/s can be estimated. This PIC activity observed in vivo seems to be far too low to account for a functional role for Ins(1,4,5)P3 as a chemical transmitter in the fast excitation-contraction coupling (ECC) process in skeletal muscle. The presence of Ins(1,3,4,5)P4 in all muscle types is indicative of a Ca(2+)-activated Ins(1,4,5)P3 3-kinase activity. The rapid transient increases in Ins(1,3,4)P3 and Ins(1,3)P2 in isometrically contracting Xenopus muscles suggest that corresponding Ins(1,3,4,5)P4 phosphatases are operating in skeletal muscle as well. In all muscles investigated except rat soleus, the fructose 1,6-bisphosphate [Fru(1,6)P2] concentration increased substantially during a tetanus, up to about 2 mM. This increase is correlated with a simultaneous decrease in phosphocreatine, whereas the energy charge of the muscles was essentially unaffected by the applied tetani. The time course of the rise in Fru(1,6)P2 was used to model changes in the free concentrations of high-affinity aldolase-binding inositol phosphates during the course of a tetanus. These calculations demonstrate that the free concentration of Ins(1,4,5)P3 and other aldolase-bound inositol phosphates can increase much faster and to a larger extent than the corresponding total concentrations as a result of their competitive displacement from aldolase binding sites by the rapidly rising concentration of Fru(1,6)P2. PMID- 1764027 TI - Chitin synthase in encysting Entamoeba invadens. AB - Although the cyst wall of Entamoeba invadens contains chitin, synthesis of this structural polymer during encystation has not been described before. Here we report that conditions which stimulate encystation of the parasite lead to increased chitin synthase (ChS) activity, measured by incorporation of [3H]GlcNAc ([3H]N-acetylglucosamine) from UDP-GlcNAc. The radiolabelled product was precipitable by trichloroacetic acid or ethanol and identified as chitin because it was digested by purified chitinase to radioactive chitobiose and GlcNAc. Cell fractionation indicated that approx. 60% of the enzyme is in the high-speed supernatant. pH-activity profiles showed that soluble ChS has an optimum at 6.0, whereas particulate ChS has a peak at pH 7.0-7.5. Both the activities were dependent on bivalent metal ions, especially Mn2+ and Mn2+ plus Co2+. In contrast with the ChS of other organisms, neither the particulate nor the soluble ChS of E. invadens was activated by trypsin treatment. Soluble and particulate ChS were also stimulated by digitonin and phosphatidylserine, whereas phosphatidylethanolamine stimulated only the soluble ChS. The enzyme activities were inhibited by UDP, UDP-glucose and UDP-GalNAc, but not by the analogues Polyoxin-D or Nikkomycin. This is the first report of an enzyme which is developmentally regulated during encystation of the primitive eukaryotic genus Entamoeba. PMID- 1764028 TI - A study of the relaxation parameters of a 13C-enriched methylene carbon and a 13C enriched perdeuteromethylene carbon attached to chymotrypsin. AB - L-1-Chloro-4-phenyl-3-tosylamido[1-13C]butan-2-one (Tos-[1-13C]Phe-CH2Cl) and Tos [1-13C,2H2]Phe-CH2Cl were prepared and used to alkylate delta-chymotrypsin. The relaxation parameters of the 13C-n.m.r. signal resulting from the alkylation of histidine-57 in both enzyme-inhibitor complexes were determined at 1.88 T and 6.34 T as well as the spin-lattice relaxation times of the backbone alpha-carbon atoms of the unenriched Tos-Phe-CH2-delta-chymotrypsin complex. It is concluded that the species examined do not have significant internal librational motions and that the rotational correlation time of the monomeric enzyme-inhibitor complex is 16.0 +/- 3.2 ns. The signal from the 13C-enriched atom of Tos-[1 13C,2H2]Phe-CH2Cl is split into a quintet (JCD = 23 Hz) whereas in the Tos-[1 13C,2H2]Phe-CH2-delta-chymotrypsin complex the signal from the 13C-enriched inhibitor carbon atom is decoupled. This decoupled signal had linewidths of 16 +/ 3 Hz and 52 +/- 2 Hz at 1.88 T and 6.34 T respectively, whereas linewidths at 40 +/- 2 Hz and 53 +/- 4 Hz were obtained for the same signal in the Tos-[1-13C]Phe CH2-delta-chymotrypsin complex at 1.88 T and 6.34 T respectively. Therefore whereas deuteration produces a 2.5-fold reduction in linewidth at 1.88 T there is no significant decrease in the linewidth at 6.34 T. This result is explained by using the rigid rotor model, which predicts that the quadrupolar spin-lattice relaxation rate will be faster at low field strengths, resulting in more efficient deuterium decoupling by scalar relaxation of the second kind at lower field strengths. It is also predicted that deuterium decoupling by scalar relaxation will become less efficient as rotational correlation times increase. The consequences of these predictions for the detection of 13C-enriched atomic probes of proteins are discussed. It is also shown that a spin-echo pulse sequence can be used to remove signals due to protonated carbon atoms without attenuating the signal due to deuterated carbon atoms. PMID- 1764029 TI - Chemical modification of serine at the active site of penicillin acylase from Kluyvera citrophila. AB - The site of reaction of penicillin acylase from Kluyvera citrophila with the potent inhibitor phenylmethanesulphonyl fluoride was investigated by incubating the inactivated enzyme with thioacetic acid to convert the side chain of the putative active-site serine residue to that of cysteine. The protein product contained one thiol group, which was reactive towards 2,2'-dipyridyl disulphide and iodoacetic acid. Carboxymethylcysteine was identified as the N-terminal residue of the beta-subunit of the carboxy[3H]methylthiol-protein. No significant changes in tertiary structure were detected in the modified penicillin acylase using near-u.v. c.d. spectroscopy. However, the catalytic activity (kcat) with either an anilide or an ester substrate was decreased in the thiol-protein by a factor of more than 10(4). A comparison of sequences of apparently related acylases shows no other extensive regions of conserved sequence containing an invariant serine residue. The side chain of this residue is proposed as a candidate nucleophile in the formation of an acyl-enzyme during catalysis. PMID- 1764030 TI - Inhibition of gluconeogenesis in isolated rat hepatocytes after chronic treatment with phenobarbital. AB - Gluconeogenesis was studied in hepatocytes isolated from phenobarbital-pretreated rats fasted for 24 h. In closed vial incubations, glucose production from lactate (20 mmol/l) and pyruvate (2 mmol/l), alanine (20 mmol/l) or glutamine (20 mmol/l) was suppressed by about 30-45%, although glycerol metabolism was not affected. In hepatocytes perifused with lactate and pyruvate (ratio 10:1), glucose production was inhibited by 50%, even at low gluconeogenic flux. From the determination of gluconeogenic intermediates at several steady states of gluconeogenic flux, we have found a single relationship between phosphoenolpyruvate and the rate of glucose production (Jglucose), and two different curves between cytosolic oxaloacetate and Jglucose in controls and in phenobarbital-pretreated hepatocytes. By using 3-mercaptopicolinate to determine the flux control coefficient of phosphoenolpyruvate carboxykinase we found that phenobarbital pretreatment led to an increase in this coefficient from 0.3 (controls) to 0.8 (phenobarbital group). These observations were confirmed by the finding that the activity of phosphoenolpyruvate carboxykinase was decreased by 50% after phenobarbital treatment. Hence we conclude that the inhibitory effect of phenobarbital on gluconeogenesis is due, at least partly, to a decrease in the flux through phosphoenolpyruvate carboxykinase. PMID- 1764031 TI - Tissue-specific ceruloplasmin gene expression in the mammary gland. AB - Using a ceruloplasmin cDNA clone in RNA blot analysis, a single 3.7 kb ceruloplasmin-specific transcript was detected in rat mammary gland tissue from pregnant and lactating animals. Ceruloplasmin gene expression in the mammary gland was tissue-specific, with no evidence of expression in brain, heart or other extrahepatic tissues. Ceruloplasmin mRNA was also detected in mammary gland tissue from male, virgin female and non-pregnant/multiparous animals, and the abundance of ceruloplasmin-specific transcripts in virgin female rats was independent of their stage of oestrus. In virgin female mammary gland the content of ceruloplasmin mRNA was 20% of that in hepatic tissue from these animals and approx. 2-3-fold greater than that found in mammary gland tissue of pregnant or lactating animals. Development studies revealed ceruloplasmin gene expression in male and female mammary gland by only 2 weeks of age, prior to the onset of puberty. Biosynthetic studies indicated that the ceruloplasmin mRNA in mammary gland tissue was translated into a 132 kDa protein qualitatively similar to that synthesized in liver. By in situ hybridization, ceruloplasmin gene expression was localized to the epithelium lining the mammary gland alveolar ducts, without evidence of expression in the surrounding mesenchyme. Ceruloplasmin gene expression was also detected in a human breast adenocarcinoma cell line and in biopsy tissue from women with invasive ductal carcinoma. Taken together, these data indicate that the mammary gland is a prominent site of extrahepatic ceruloplasmin gene expression and add to the evidence that ceruloplasmin biosynthesis is associated with growth and differentiation in non-hepatic tissues. PMID- 1764032 TI - A proteolytic fragment from human link protein is taken up and processed by monocytes and B cells. AB - Mild digestion of 125I-labelled human proteoglycan aggregates with trypsin or stromelysin produced specific peptides that were taken up rapidly by THP-1 monocytes. SDS/PAGE of undigested aggregate showed that the three components of molecular mass 48, 44 and 41 kDa, corresponding to isoforms of link protein originally present, had been converted into a single component of 41 kDa by trypsin treatment, and that fragments of 6-12 kDa were present in fractions containing the high-uptake peptide. Separate proteolysis of isolated proteoglycan monomer and link protein confirmed that the specific high-uptake fragment was derived from link protein. Uptake of the link fragment was rapid, reaching a maximum after 5 min, and specific, since it was blocked by metabolic or serine proteinase inhibitors and at 4 degrees C. After uptake the cleaved fragment was processed further, with 50% of the radiolabel being released as degraded peptides within 5 min. In contrast, accumulation of whole aggregate reached a maximum after 45 min and only 50% had been released after 2 h. Uptake of aggregate was less affected by inhibitors or at low temperature, suggesting that a separate mechanism existed for its turnover. The aggregate was transported to lysosomes after uptake, although the link fragment did not sediment with either lysosomes or plasma membranes, suggesting that it was present in the cytoplasm or in very labile vesicles. However, the mode of handling of the peptide by the cells remains unclear. The link fragment was taken up by several different monocytic and B cell lines, but not by mouse fibroblasts or peritoneal macrophages. These data suggest that a surface serine proteinase on monocytes and B cells enables them to process and take up a fragment of link protein derived by extracellular proteolysis. PMID- 1764033 TI - Heparin-binding serum protein(s) is required for the protection of sialyltransferase released during the incubation of rat jejunal slices. AB - Incubation of rat jejunal slices in Krebs-Ringer bicarbonate buffer (KRB) required the presence of heat-inactivated horse serum (HHS) in order to show time dependent release of sialyltransferase into the medium. Sialyltransferase activity could not be detected in the medium when KRB alone or KRB supplemented with either albumin or glycerol was used in the incubations. The viability of the jejunal slices for up to 4 h of incubation was determined by studying the incorporation of glucosamine and leucine into acid-insoluble proteins. Supplementation of KRB with HHS had no beneficial effect on the rate of incorporation of leucine and glucosamine into proteins. KRB medium obtained after different periods of incubation contained higher trypsin-like activity than KRB medium containing HHS. Various antiproteases present as supplements to KRB resulted in the release of sialyltransferase activity from the jejunal slices. Among these antiproteases, alpha 1-proteinase inhibitor (alpha 1-PI) was the most effective. Also, HHS added to KRB immediately following incubation resulted in partial restoration of sialyltransferase activity in the medium, suggesting the presence of anti-proteolytic factors in HHS. The addition of increasing concentrations of heparin to incubations containing HHS caused a decrease in the medium sialyltransferase activity. The heparin-binding fraction (HBF) from HHS, when added to incubations, was able to protect the sialyltransferase released into medium. However, HHS depleted of its heparin-binding fraction by heparin agarose affinity chromatography was unable to protect the sialyltransferase. HBF was separated into high- and low-molecular-mass fractions (fractions A and B respectively) by gel-filtration chromatography. The capacity to protect the released sialyltransferase was contained in fraction B. Fraction A contained multiple bands on SDS/PAGE and did not protect the enzyme. Fraction B contained a major protein band on the gel which corresponded to the migration of a similar band in human alpha 1-PI. HBF as well as fraction B isolated from HHS showed anti trypsin-like activity. The results presented indicate that HHS contains a heparin binding protein(s) similar to human alpha 1-PI which plays a role in the protection of sialyltransferase released from jejunal slices. PMID- 1764034 TI - Processing and secretion of human carboxypeptidase E by C6 glioma cells. AB - Carboxypeptidase E (CPE) catalyses the removal of C-terminal basic amino acids and is implicated in the processing of peptides and hormones in secretory vesicles. The enzyme has been isolated in multiple forms from both soluble and membrane-bound compartments, and has been demonstrated to be co-secreted with peptides from pancreatic and adrenal cells. To address the question regarding the origin of the multiple forms of the enzyme, we have transfected a construct containing the cDNA for human CPE under the control of the murine-sarcoma-virus enhancer and metallothionein promoter into the C6 rat glioma cell line, which itself has extremely low levels of CPE expression. Within transfectants, multiple forms of the enzyme have been detected by Western blotting, and their sizes are comparable with that in pituitary. Fractionation of the intracellular forms of CPE with Triton X-114 at various pH values indicates that the membrane-bound, but not the soluble, form is amphipathic; this difference probably arises from post translational modification of the enzyme. Interestingly, the secreted enzyme is found to have the amphipathic characteristics of the membrane-bound form. By modification of the cDNA sequence, enzyme lacking N-terminal and C-terminal domains have been expressed: deletion of the 'pro' region of CPE, leading to loss of the signal cleavage site, gives a more hydrophobic but active enzyme which is not efficiently secreted from the cell; deletion of a C-terminal region gives a secreted form of the enzyme which no longer exhibits amphipathic behaviour. Our data indicate that a single mRNA species can give rise to the multiple forms of CPE enzyme that have been identified and that the C6 cells are able to carry out the intracellular processing events to generate these forms. PMID- 1764035 TI - Impact of tumour necrosis factor-alpha and interferon-gamma on tetrahydrobiopterin synthesis in murine fibroblasts and macrophages. AB - Tumour necrosis factor-alpha causes an up to 30-fold induction of GTP cyclohydrolase I (EC 3.5.4.16) activity in murine dermal fibroblasts in a dose dependent manner. Owing to the high constitutive activities of 6 pyruvoyltetrahydropterin synthase and sepiapterin reductase (EC 1.1.1.153), this potentiates biosynthesis of tetrahydrobiopterin. Murine macrophages already contain high activities of GTP cyclohydrolase I when unstimulated, and this is further augmented up to 4-fold by tumour necrosis factor-alpha/interferon-gamma. In Western blots an antiserum to murine liver GTP cyclohydrolase I does not stain cell extracts with high enzyme activities, suggesting that the cytokine induced peripheral form of GTP cyclohydrolase I might differ from the liver form. PMID- 1764036 TI - Tyrosine transport in a human melanoma cell line as a basis for selective transport of cytotoxic analogues. AB - Tyrosine is an essential amino acid for the initial step of melanin synthesis, yet little is known concerning its transport in melanocytes. As an important first step in the development of new anti-melanoma agents based upon chemical and pharmacological modifications of melanin synthesis, the present study characterized the transport mechanism of tyrosine in vitro using the human melanoma cell line SK-MEL 23. Several tyrosine transport systems may be involved in melanocytes: systems L and T, which transport neutral amino acids with branched or aromatic side chains, and systems A and ASC, which transport neutral amino acids with smaller side chains. In order to determine which system or combination of systems is involved in tyrosine transport in melanoma cells, studies of kinetics, Na(+)-dependence and competitive inhibition were undertaken. The Km and Vmax. for the Na(+)-independent transport system were found to be 0.164 +/- 0.016 mM and 21.6 +/- 1.1 nmol/min per mg of protein respectively. This transport was preferentially inhibited by the system L specific analogue, 2 aminobicyclo[2.2.1]heptane-2-carboxylic acid, the system T substrate tryptophan, and the sulphur homologue of tyrosine, 4-S-cysteinylphenol. Sequential addition of these inhibitors at increasing concentrations indicated that they inhibit the same transporter. Our results suggest that tyrosine transport in SK-MEL 23 melanoma cells is similar to system L transport previously characterized in other cell types. This one transport system appears to supply all the tyrosine required for both cell growth and melanin synthesis. The transport system may be subject to manipulation by melanogenic stimulating factors, making the transport of cytotoxic tyrosine analogues an important area for further study. PMID- 1764037 TI - Melatonin biosynthesis and metabolism in peripheral blood mononuclear leucocytes. AB - Cultured human peripheral blood mononuclear leucocytes (PBML) were able to synthesize indoleamines, including melatonin, and were also able to convert melatonin taken up from the incubation medium into N-acetyl-5-hydroxytryptamine (NAHT) and 5-hydroxytryptamine (5-HT). These compounds were analysed by h.p.l.c., and melatonin was additionally characterized by two-dimensional t.l.c., mass spectrometry and radioimmunoassay. Only hydroxyindoles were detected by h.p.l.c. in unstimulated PBML culture. Sustained stimulation by melatonin or interferon gamma (IFN-gamma) increased markedly the basal production of 5-HT. IFN-gamma- or 5-HT-stimulated (but not resting) cells produced NAHT and melatonin. Furthermore, the addition of melatonin to the culture medium strongly enhanced NAHT and 5-HT production without affecting tryptophan hydroxylation, suggesting the possibility of direct or indirect transformation of melatonin into NAHT and 5-HT. PMID- 1764038 TI - Dissociation of lethal toxicity and enzymic activity of notexin from Notechis scutatus scutatus (Australian-tiger-snake) venom by modification of tyrosine residues. AB - Notexin from Notechis scutatus scutatus snake venom was subjected to tyrosine modification with p-nitrobenzenesulphonyl fluoride (NBSF), and four modified derivatives were separated by h.p.l.c. The results of amino acid analysis and sequence determination revealed that only Tyr-7, Tyr-70 and Tyr-77 were modified in notexin. Modification of Tyr-7 resulted in decreases in lethal toxicity and enzymic activity by 70.2% and 22.7% respectively. Conversely, modification of Tyr 77 caused a 1.8-fold increase in enzymic activity, in contrast with the loss of 52.5% of lethality. A drastic decrease in lethal toxicity was observed when both Tyr-7 and Tyr-70 were modified, whereas the enzymic activity decreased by only 35.8%. Likewise, the derivative in which Tyr-7 and Tyr-77 were modified retained 44.4% of enzymic activity, but showed a marked decrease in lethal toxicity. It is obvious that modification of tyrosine residues causes a decrease in lethal toxicity of notexin, which does not directly correlate with the change in enzymic activity. On the other hand, the antigenicity of NBS derivatives remained unchanged. The modified derivatives retained their affinity for Ca2+, indicating that the modified tyrosine residues did not participate in Ca2+ binding. These results indicate that modification of tyrosine residues can differentially influence the enzymic activity and lethal toxicity of notexin, and suggest that notexin might possess two functional sites, one being responsible for the catalytic activity and the other associated with its lethal effect. PMID- 1764039 TI - Identification of functional cis-acting elements within the rat liver S14 promoter. AB - The structure of DNAase I hypersensitive site 1 (Hss-1), located adjacent to the 5' end of the rat liver S14 gene, is regulated by tissue-specific factors, and its formation correlates with the transcriptional activation of the S14 gene. We propose that tissue-specific trans-acting factors interacting with key cis-linked elements within this site function in the initiation of S14 gene transcription. To examine this hypothesis we used DNAase I footprint, gel shift and in vitro transcriptional analyses to identify cis-linked elements that function in the control of S14 gene transcription. Binding of rat liver nuclear proteins to the S14 promoter (from -8 to -464 bp) produced four DNAase I footprints (designated A D). Gel shift studies showed that DNA-protein binding was tissue- and sequence specific, differentially heat-sensitive, and abolished by proteinase K. The function of the four cis-acting elements was assessed by using an in vitro transcription initiation assay in which the S14 promoter was fused to a reporter gene (G-free cassette). Deletion studies showed that nuclear factors binding to regions A (-48 to -63 bp), B (-88 to -113 bp) and D (-286 to -310 bp) enhanced the rate of initiation of transcription, while proteins binding to region C (-227 to -244 bp) suppressed the rate of initiation of transcription. Based on oligonucleotide competition studies, we suggest that hepatic NF-1 (or a related protein) binding to the A region enhances the rate of initiation of S14 gene transcription. Since trans-acting factors interacting with regions B and D are found in liver but not in spleen or kidney, we suggest that the proteins interacting with these regions may be involved in the tissue-specific augmentation of S14 gene transcription. PMID- 1764040 TI - Possible role of histone acetylation and histone H1(0) replacement for the initiation of replication in regenerating rat liver. AB - The role of histone acetylation and DNA synthesis has been investigated extensively in the regenerating rat liver system in the presence and absence of the cyclophosphamide derivative mafosfamide. We demonstrate a mafosfamide-induced inhibition of maximum histone acetyltransferase activity followed by a second elevation of enzyme activity and an accompanying total suppression of DNA synthesis for 7-8 h. The maximum of histone acetyltransferase activity, in parallel with an elevated acetylation in vivo, the consecutive replacement of histone H1(0) amd initiation of replication occur sequentially in the presence and absence of mafosfamide, but with a temporary delay of 7-8 h. Our data indicate that modifications of histone acetyltransferase (EC 2.3.1.48) activity do not significantly influence the acetylation patterns of histones H3 and H4. The mafosfamide-induced change of histone acetyltransferase activity and acetylation in vivo, the shift of histone H1(0) exchange and the consecutive transition of initiation of replication suggest that these three events might be functionally related. PMID- 1764041 TI - Agonist-induced Ca2+ influx into human platelets is secondary to the emptying of intracellular Ca2+ stores. AB - We have studied the relation between the filling state of the intracellular Ca2+ stores and the plasma-membrane permeability to Mn2+, used here as a Ca2+ surrogate for Ca2+ channels. Emptying of the intracellular Ca2+ stores either by incubation in Ca(2+)-free medium or by treatment with low concentrations of the Ca2+ ionophore ionomycin accelerated the influx of Mn2+. Refilling of the Ca2+ stores by incubation in Ca(2+)-containing medium restores low Mn2+ permeability. This Ca(2+)-store-regulated permeability was inhibited by Ni2+ and by cytochrome P-450 inhibitors. Stimulation of platelets with thrombin produced Ca2+ release from the intracellular stores, which was followed, after a temperature-dependent lag (2 s at 37 degrees C; 5 s at 18 degrees C), by an acceleration of Mn2+ influx. Cytochrome P-450 inhibitors prevented the thrombin-induced Mn2+ influx, with little effect on the Ca2+ mobilization from the intracellular stores. Ki values were similar to those estimated for inhibition of the store-regulated permeability in non-stimulated platelets. Similar results were found in platelets stimulated by platelet-activating factor or by ADP. We propose that agonist induced Ca2+ (Mn2+) influx in platelets is secondary to the emptying of the intracellular Ca2+ stores. The activation of the plasma-membrane Ca2+ (Mn2+) pathway may take place by a mechanism involving microsomal cytochrome P-450, similar to that described previously in thymocytes [Alvarez, Montero & Garcia Sancho (1991) Biochem. J. 274, 193-197] and neutrophils [Montero, Alvarez & Garcia-Sancho (1991) Biochem. J. 277, 73-79]. PMID- 1764042 TI - A novel one-step purification of human alpha-thrombin after direct activation of crude prothrombin enriched from plasma. AB - Crude prothrombin enriched from human plasma was directly activated to generate alpha-thrombin without prior exhaustive purification of the proenzyme using a combination of several different types of chromatographic techniques, as in all previously described methodologies. Activated thrombin was separated from other components in a single step by taking advantage of its highly specific affinity to heparin immobilized on a matrix support of Sepharose CL-6B. On the basis of the data presented herein, we have demonstrated the ease with which at least 25 mg of a highly purified enzyme (greater than 97% homogeneous by laser densitometry) can be obtained per litre of plasma. Our product exhibits a specific activity of at least 4000 National Institutes of Health units/mg and is stable after being freeze-dried for the purpose of long-term storage. PMID- 1764043 TI - Labelling in vivo and chirality of griseofulvin-derived N-alkylated protoporphyrins. AB - 1. We have compared the response to griseofulvin of rats and mice and, in mice, the effect of griseofulvin itself with that of two of its analogues. The severity of protoporphyria shows a correlation with the accumulation of both types of N alkylated porphyrins previously described after treatment with this drug, namely N-methylproptoporphyrin and the N-griseofulvin protoporphyrin adduct. 2. Both N alkylporphyrins are chiral, are labelled from 5-amino[4-14C]laevulinate, and their liver accumulation can be inhibited by pretreatment with a suicide substrate of cytochrome P-450, which also prevents porphyria. 3. These findings suggest that cytochrome P-450 is involved in the mechanism of griseofulvin induced protoporphyria by generating N-methylprotoporphyrin. The N-griseofulvin protoporphyrin adduct may also originate from cytochrome P-450, but more work is necessary to elucidate whether it acts as the precursor for N methylprotoporphyrin. PMID- 1764044 TI - Identification of bile acid-CoA: amino acid N-acyltransferase in rat kidney. AB - A novel location of the bile-acid-conjugating enzyme bile acid-CoA:amino acid N acyltransferase (BAT) has been discovered in the cytosolic fraction of rat kidney. Both taurine and glycine were utilized as substrates. Formation of bile acid N-acyl amidates was verified by h.p.l.c. by comparison with authentic standards and by specific hydrolysis using cholylglycine hydrolase. Immunoblot analysis using a human liver anti-BAT polyclonal antibody indicated that rat kidney BAT has the same molecular mass as rat liver BAT. These findings suggest that the kidney has a role in bile acid metabolism and physiology. PMID- 1764045 TI - Diamines interfere with the transport of L-ornithine in Ehrlich-cell plasma membrane vesicles. AB - 1. L-Ornithine transport by plasma-membrane vesicles isolated from Ehrlich cells is Na(+)-independent and shows a saturable and a diffusional component. 2. Putrescine, histamine, 5-hydroxytryptamine and 2,3-diaminopropane at 55 microM concentration significantly inhibit 0.5 mM-L-ornithine transport at least for the first 10 min of incubation. 3. There is a trans-stimulatory effect of putrescine on L-ornithine transport. PMID- 1764046 TI - Accurate measurement of sn-1,2-diradylglycerol mass in cell lipid extracts. PMID- 1764047 TI - Part of the phospho group of pyridoxal phosphate may titrate over the pH range 5 8 in aspartate aminotransferase. PMID- 1764048 TI - A common pattern between the TGF-beta family and glutaredoxin. PMID- 1764049 TI - Does fatty acid-binding protein facilitate the diffusion of oleic acid? PMID- 1764050 TI - Implanting mouse embryo stain with a LNF-I bearing fluorescent probe at their mural trophectodermal side. AB - Mouse embryos at implantation stage were stained successfully with lacto-N fucopentaose I (LNF-I) bearing neoglycoprotein labeled with rhodamine synthesized by us for the first time. The fluorescent neoglycoproteins carrying LNF-II, -III, LND-I, or LNT failed to stain the embryos. The embryo was stained only at the cell surface of trophectoderm at the mural side. Since the attachment of the mouse embryo to the uteric epithelium occurs at its mural side trophectoderm and LNF-I is the key substance in mouse implantation (Lindenberg, S. et al, (1988) J. Reprod. Fert. 83, 149-158), the material stained with the probe carrying LNF-I appears to be the molecule responsive to attachment to the endometrium surface and leading to implantation. PMID- 1764051 TI - Adenosine (A2) antagonist inhibits induction of long-term potentiation of evoked synaptic potentials but not of the population spike in hippocampal CA1 neurons. AB - The effects of adenosine A2 receptor antagonist (CP-66713) on long-term potentiation were studied using guinea pig hippocampal slices in a perfusion system. Tetanic stimulation of Schaffer collateral input which was applied during perfusion of CP-66713 (10 microM), did not induce long-term potentiation but rather long-term depression of evoked synaptic potentials (field EPSP), but induced long-term potentiation of the population spike in CA1 neurons. Thus, adenosine derivatives which accumulate in the synaptic cleft during the tetanic stimulation may be involved in induction of the long-term potentiation via A2 receptors at the synapse. The clear discrimination between long-term depression of the field EPSP and long-term potentiation of the population spike suggests EPSP-spike potentiation at the postsynaptic sites. PMID- 1764052 TI - Replacement of three troponin components with cardiac troponin components within single glycerinated skeletal muscle fibers. AB - The tension of single glycerinated rabbit skeletal muscle fiber was desensitized to a Ca(2+)-concentration after treatment with an excessive amount of bovine cardiac troponin T and reached a level of about 70% of the maximum tension of the untreated fiber. A SDS-gel electrophoretic examination indicated that troponin C.I.T complex in the fiber was replaced with the added cardiac troponin T. The Ca(2+)-sensitivity of the tension of the troponin T-treated fiber was then recovered by the addition of bovine cardiac troponins I and C. The rabbit skeletal muscle fiber thus hybridized with bovine cardiac troponin C.I.T showed the same cooperativity of Ca(2+)-activation as the cardiac muscle. PMID- 1764053 TI - Fecal excretion, uptake and metabolism by colon mucosa of diacylglycerol in rats. AB - In a previous paper we demonstrated that human fecal bacteria can convert phosphatidylcholine to diacylglycerol (DAG), an activator of protein kinase C. The present study demonstrates that several foods contain appreciable levels of DAG, especially certain vegetable oils. On the other hand, when rats were administered [14C]-labeled DAG by intragastric intubation less than 0.1% of the administered radioactivity was recovered as DAG in the feces. Thus only negligible amounts of dietary DAG actually reach the colon. When [14C]DAG was injected directly into ligated segments of rat colon we found appreciable uptake of the intact DAG by the mucosal cells. The major metabolite was arachidonic acid, suggesting that the DAG lipase pathway is more active than the DAG kinase pathway in these cells. Taken together, these results are consistent with our hypothesis that much of the DAG present in the colonic lumen is produced by the intestinal bacteria and that this DAG can actually enter the colonic mucosal cells, where it might influence their function. PMID- 1764054 TI - Rabbit antibodies toward extracellular loops of the membrane spanning region of human thyrotropin receptor possess thyroid stimulating activities. AB - We have synthesized three different peptides, E1 (amino acid residues 478-497), E2 (amino acid residues 561-580) and E3 (amino acid residues 649-652), corresponding to the first, the second and the third extracellular loops of the membrane spanning region of human thyrotropin receptor (TSH-R), respectively. We have produced rabbit antibodies toward these peptides and evaluated their thyroid stimulating antibody (TSAb) and TSH-binding inhibitor immunoglobulin (TBII) activities. Although only slight TSAb activity was observed in E1 antibodies, E2 and E3 antibodies possessed strong TSAb activities, the values of which were 1118% and 910%, respectively. None of these antibody had TBII activities. These results suggest that antibodies against the extracellular loops of the TSH-R can stimulate cAMP formation in thyroid cells and that these regions may be one of the candidates for the epitope against autoantibodies from patients with Graves' disease. PMID- 1764055 TI - Effect of erythroid differentiation factor on megakaryocytic differentiation of L8057, a murine megakaryoblastic leukemia cell line. AB - To assess the potent effect of erythroid differentiation factor (EDF) on megakaryocytopoiesis, effect of EDF on megakaryocytic differentiation of L8057, a murine megakaryoblastic cell line, was examined. EDF potentiated AchE induction of L8057 in a dose dependent manner. The potency of EDF on megakaryocytic differentiation is comparable to that on erythroid differentiation reported previously. The present results suggest that EDF may play a regulatory role in megakaryocytopoiesis as well as in erythropoiesis. PMID- 1764056 TI - Production of benzodiazepine-like compounds in bovine rumen. AB - The presence of benzodiazepine-like molecules was detected radioimmunologically in bovine rumen contents and in incubates of ruminal contents with homogenates of several common grasses. A similar production was found "in vivo" in samples obtained from a grazing cow with a rumen cannula. PMID- 1764057 TI - Gene expression from multicopy T7 promoter vectors proceeds at single copy rates in the absence of T7 RNA polymerase. AB - Three different genes (trpR+, tyrR+ and phi (trpR-lacZ)) were inserted into pET3a, a multicopy transcription-translation vector designed by Rosenberg et al. (1) for the T7 RNA polymerase-driven overexpression of proteins in Escherichia coli. Gene orientation was in the anticlockwise ("silent") direction. Gene expression in the absence of T7 RNA polymerase was evaluated either directly using lacZ reporter systems or indirectly by observing the susceptibility of plasmid-bearing tester strains to inhibition by an aromatic amino acid analog. The production of repressor proteins and of a Trp repressor-LacZ chimera was readily detected, at levels comparable to those of haploid trpR+ or tyrR+ E. coli strains. Such T7 vector constructs thus have two especially useful properties: first, they provide a means for the high-level production of various proteins in E. coli; second, they offer a technically advantageous point of departure for structure-function studies of genes whose overexpression from multicopy plasmids would normally be cytotoxic. PMID- 1764058 TI - Lactogenic hormones increase epidermal growth factor messenger RNA content of mouse mammary glands. AB - Epidermal growth factor (EGF) is known to stimulate mammary epithelial proliferation, has been identified in milk and is expressed in lactating mammary epithelia. This study examined hormonal control of EGF mRNA in mammary glands of mice. Prepro-EGF mRNA (4.7 kb) was detected during lactation (and increased significantly during this period), whereas a smaller EGF-like RNA (.5 kb) was at highest levels in mammary glands of virgin and pregnant mice. The 4.7 kb RNA was polyadenylated, whereas .5 kb RNA was not. In mammary gland organ cultures from steroid-primed mice, the combinations of insulin + hydrocortisone and insulin + prolactin + hydrocortisone increased both prepro-EGF and beta-casein mRNA expression. When hydrocortisone was present there was a decrease in mammary gland content of EGF-like RNA (.5 kb band). We conclude that prepro-EGF mRNA expression in mouse mammary tissue is under the control of the lactogenic hormones prolactin and hydrocortisone. PMID- 1764059 TI - Differential regulation by trophic conditions of phosphorylating and non phosphorylating NADP(+)-dependent glyceraldehyde-3-phosphate dehydrogenases in Chlorella fusca. AB - The two NADP(+)-dependent glyceraldehyde-3-phosphate dehydrogenases present in the green alga Chlorella fusca, namely, the phosphorylating (chloroplastic) enzyme and the non-phosphorylating (cytosolic) enzyme, are differently affected by the trophic conditions prevailing in the cell cultures. The addition of metabolizable sugars to cell cultures growing in the light promotes a marked decrease of the phosphorylating enzyme activity down to a barely detectable cellular level. In contrast, the cellular level of the non-phosphorylating enzyme is even enhanced in the presence of such sugars. These effects are not observed, however, with a number of non-assimilable sugar analogs. After sugar removal, a recovery of the phosphorylating activity--in a process which is inhibited by cycloheximide but not by lincomycin--is observed in illuminated cells but not in darkness, thus indicating a light-dependent nuclear synthesis of the chloroplastic enzyme. It seems therefore that the two dehydrogenases are adaptative enzymes subject to differential regulation by nutritional conditions. PMID- 1764060 TI - Differences in substrate specificities of monoamine oxidase A from human liver and placenta. AB - The substrate specificities of monoamine oxidase (MAO) A isolated from human placenta and of human liver expressed in yeast have been compared in homogeneous preparations with respect to Vmax and Km values for natural and synthetic substrates and Ki values for competitive inhibitors. MAO A from these two sources is known to differ in at least 5 amino acid residues. While the Km and Ki values were found to be nearly identical in the enzymes from these two sources, the Vmax differed significantly on bulky synthetic substrates. PMID- 1764061 TI - Characterization of an isoelectric focusing variant of SAA1 (ASP-72) in a family of Turkish origin. AB - An acidic variant of serum amyloid A (SAA) identified previously by isoelectrofocusing in a family of Turkish origin has been characterized at the genomic level. DNA sequence analysis revealed that individuals expressing the variant pI6.1/pI5.7 isoforms (the mother and three of four children) were heterozygous at the SAA1 gene locus. Their SAA1 gene sequences contained an adenine, as well as the usual guanine, at the position corresponding to the second base of codon 72. The presence of both bases predicts two SAA1 protein sequences, one having aspartic acid and the other glycine at position 72. While the Gly-72 SAA1 (+/- Arg-1) sequence represents the normal pI6.5/pI6.0 isoforms, the Asp-72 SAA1 (+/- Arg-1) sequence corresponds to the variant pI6.1/pI5.7 isoforms. PMID- 1764062 TI - Cadmium (Cd2+) disrupts Ca(2+)-dependent cell-cell junctions and alters the pattern of E-cadherin immunofluorescence in LLC-PK1 cells. AB - Recent findings from our laboratories have shown that Cd2+ has relatively specific damaging effects on the adhering and occluding junctions in the established porcine renal epithelial cell line, LLC-PK1. Results of the present studies show that the junction-perturbing effects of Cd2+ in LLC-PK1 cells are more pronounced when Cd2+ is applied to the basolateral cell surface than when it is applied to the apical surface, and that the severity of the effects is inversely related to the concentration of Ca2+ in the medium. Additional results show that exposure to sublethal concentrations of Cd2+ decreases the amount of E cadherin that is associated with cell-cell contacts. These results suggest that Cd2+ damages Ca(2+)-dependent cell-cell junctions in LLC-PK1 cells by interacting with E-cadherin or a similar Ca(2+)-sensitive site that is oriented toward the basolateral cell surface. PMID- 1764063 TI - The conformation of a-factor is not influenced by the S-prenylation of Cys12. AB - Two-Dimensional NMR was used to examine the solution conformation of the lipopeptide a-factor, YIIKGVFWDPAC (S-farnesyl) OCH3, from the yeast Saccharomyces cerevisiae and five analogues containing various S-alkylated cysteines in DMSO-d6. NOESY data, NH temperature coefficients, and 3J alpha NH coupling constants indicate that the a-factor is a predominantly unstructured peptide in DMSO. Similar results were obtained for the other peptides indicating that S-prenylation of Cys12 does not affect the conformation of these peptides. PMID- 1764064 TI - Identification of rat cDNA encoding hck tyrosine kinase from megakaryocytes. AB - A rat homologue of hck tyrosine kinase cDNA from a rat megakaryocyte library contains 1911 nucleotides with an open reading frame encoding 503 amino acids. The rat hck had distinct amino acid residues from the mouse homologue exhibiting 97.6% identity. The sequence contains the SH2 and SH3 regions that interact with cytoplasmic signaling proteins, the kinase domain including the nucleotide binding site and the autophosphorylation site, and the C-terminal Tyr-499 known as a negative regulator. PMID- 1764065 TI - cDNA and amino acid sequences of bovine tissue factor. AB - A cDNA encoding bovine tissue factor has been isolated from a lambda gt11 bovine adrenal cDNA library. The cDNA insert was 1877 base pairs with an open reading frame of 876 base pairs that encoded a presequence of 35 amino acids and a mature tissue factor of 257 amino acids. Bovine tissue factor had three potential N glycosylation sites, four extracellular cysteine residues, a cytoplasmic cysteine residue, and one tripeptide tryptophan-lysine-serine motif. Identities of the amino acid sequences of the mature forms between the bovine tissue factor and each of human, mouse, and rabbit tissue factors were 70.4%, 57.2%, and 74.1%, respectively. PMID- 1764066 TI - Functional expression of transcobalamin II cDNA in Xenopus laevis oocytes. AB - The products of in vitro transcription of human transcobalamin II (TC II) cDNA when microinjected into Xenopus laevis oocytes yielded a single secretory protein of 43 kDa. The mobility of the 43 kDa band did not change following digestion with peptide N-glycosidase F. [57Co]Cbl bound to the medium was immunoprecipitated with anti-serum to human TC II, but not to other Cbl binders. In addition, the [57Co]Cbl complex also bound to placental microsomes. These results suggest that TC II mRNA transcribed encodes TC II which contains both the Cbl and receptor binding domains. Furthermore, Xenopus oocytes can be used as a screening system to define structural elements important in TC II's secretion and binding reactions. PMID- 1764067 TI - Dystrophin: a sensitive and reliable immunochemical assay in tissue and cell culture homogenates. AB - A modified polyacrylamide gel electrophoresis system is described which provides excellent resolution of very high molecular weight proteins. This system has been successfully applied to the immunochemical detection of dystrophin in mouse and rat skeletal muscle, mouse myotubes in cell culture, and in human muscle-biopsy specimens. The mass of total homogenate protein (3-12 micrograms) and the relative quantity of dystrophin detected immunologically were found to be strongly correlated (r = 0.970 - 0.995). The method described here requires minute quantities of tissue or cells to accurately evaluate the relative amount of dystrophin present. The entire procedure for the detection of dystrophin is simple, rapid and cost efficient compared to other available techniques. PMID- 1764068 TI - Purification of S-adenosylmethionine decarboxylase from soybean. AB - S-Adenosylmethionine decarboxylase (EC 4.1.1.19) was purified to homogeneity from the cytosol of soybean (Glycine max) axes by ammonium sulfate fractionation, DEAE Sepharose and methylglyoxalbis(guanylhydrazone)-Sepharose 6B chromatographies. The enzyme was free from diamine oxidase activity. The molecular weight of the enzyme estimated by gel filtration and sodium dodecyl sulfate polyacrylamide gel electrophoresis was 66,000. The Km value for S-adenosylmethionine was 0.26 mM. The optimum pH and temperature were 7.5 and 40 degrees C. Neither putrescine nor Mg2+ affected the enzyme activity, but the enzyme was inhibited by spermidine, spermine, methylglyoxalbis(guanylhydrazone), sodium borohydride and phenylhydrazine. Agmatine was a novel inhibitor which inhibited S adenosylmethionine decarboxylase and arginine decarboxylase, preventing the accumulation of decarboxylated S-adenosylmethionine and putrescine, respectively. PMID- 1764069 TI - Effects of melatonin on [3H]-thymidine incorporation into DNA of rat thyroid lobes in vitro. AB - The effects of 4-h incubation in the presence of melatonin and N-acetylserotonin on the incorporation of [3H]-thymidine into DNA of the rat thyroid lobes were investigated. Additionally, thyroid lobes were incubated in the exposure to melatonin with thyrotropin jointly. Melatonin, when applied in the lowest concentration examined (10(-9)M), inhibited [3H]-thymidine incorporation, the effect of other concentrations (10(-6)M-10(-8)M) being not significant. N acetylserotonin (10(-6)M) did not affect the rate of incorporation of that labelled nucleoside. As expected, thyrotropin enhanced the [3H]-thymidine incorporation into DNA of thyroid lobes. Melatonin (10(-7)M) suppressed that stimulatory effect of thyrotropin. The participation of melatonin in the regulation of thyroid growth processes is considered. PMID- 1764070 TI - Different proliferative responses of periportal and perivenous hepatocytes to EGF. AB - Stimulation of DNA synthesis by EGF was compared in cultured periportal and perivenous hepatocyte populations. Periportal hepatocytes responded to EGF more sensitive (IC50-values 20 vs 75 ng/ml) and with a higher maximal stimulation (420 vs 290%) than perivenous hepatocytes with respect to both [3H]thymidine incorporation and labeling index. The glutamine synthetase-positive hepatocytes responded much less to EGF than did the perivenous cells in general. The simultaneous presence of insulin increased the sensitivity for EGF predominantly in the periportal hepatocytes. These inherent differences in the growth potential of hepatocytes from different acinar localizations may contribute to different growth patterns across the lobules in normal and regenerating liver. PMID- 1764071 TI - Distribution of the SGLT1 Na+/glucose cotransporter and mRNA along the crypt villus axis of rabbit small intestine. AB - The expression of the Na+/glucose cotransporter (SGLT1) mRNA and protein along the crypt-villus axis of the rabbit small intestine was examined using in situ hybridization and immunocytochemical techniques. We detected mRNA in the cells on the villus, but not in the crypts, and the mRNA abundance increased 6-fold from the base to the tip of the villus. SGLT1 protein was restricted to the brush borders of mature enterocytes. We suggest that the high rate of sugar transport across the tips of the villus is due to the transcription of the SGLT1 gene in mature enterocytes, the subsequent translation of SGLT mRNA, and the insertion direct of the functional SGLT1 transporter into the brush border membrane of these cells lining the villus tip. PMID- 1764072 TI - Molecular cloning of human XPAC gene homologs from chicken, Xenopus laevis and Drosophila melanogaster. AB - We cloned homologs of the human Xeroderma Pigmentosum Group A complementing (XPAC) gene from chicken, Xenopus laevis and Drosophila melanogaster. A comparison of the amino acid sequences of these homologs with that of the human XPAC protein revealed that in the NH2-terminal domain there are only two conserved regions, one of which is presumed to function as the nuclear localization signal, whereas the COOH-terminal domain is highly conserved, the frequency of identical amino acids in all four XPAC proteins being 50%, and the four cysteine residues predicted to form a zinc-finger motif, and three other cysteine residues are all conserved. These results strongly suggest that the COOH terminal domain containing a zinc-finger motif plays an important role in the function of these proteins. PMID- 1764073 TI - Proline enhances primary photochemical activities in isolated thylakoid membranes of Brassica juncea by arresting photoinhibitory damage. AB - The presence of L-proline in the reaction mixture enhances the photosystem II (H2O----DCPIP) and whole chain (H2O----MV) catalysed electron transport activities of thylakoids isolated from the cotyledonary leaves of Brassica juncea seedlings raised in the absence and the presence of NaCl. The extent of stimulation in activities was higher in the thylakoids of NaCl raised plants than the controls. The extent of proline mediated stimulation was seen even in the presence of uncoupler NH4Cl suggesting that this stimulation is not due to uncoupling. However, photosystem I (DCPIPH2----MV) catalysed photoreaction remained almost insensitive to proline. The presence of proline in the incubation medium brought about a significant reduction in the time dependent loss in photochemical activity of thylakoids exposed to strong light suggesting that proline prevents photoinhibitory loss in chloroplast activity. Also, proline brought about a considerable reduction in the production of lipid peroxidation linked maiondialdehyde during strong illumination. We suggest that proline protects the components involved in water oxidation capacity by reducing the production of free radicals and/or scavenging the free radicals and thereby reducing thylakoid lipid peroxidation. PMID- 1764074 TI - 1H-NMR spectroscopy of manno-oligosaccharides of the beta-1,2-linked series released from the phosphopeptidomannan of Candida albicans VW-32 (serotype A). AB - Manno-oligosaccharides (DP 2 to greater than 15) were released by mild acid hydrolysis from the phosphopeptidomannan of a Candida albicans strain of A serotype (VW-32). Manno-oligosaccharides ranging from biose to heptaose were obtained in appreciable amount. Structural investigation of these oligosaccharides showed them to be of the beta-1,2-linked series. The occurrence of such compounds has already been reported in other strains of Candida albicans. We here report the assignment of the structural reporter groups of each of them, and general rules applicable for the 1H-NMR spectrum analysis of linear manno oligosaccharide of general structure: Man(beta 1-2) [Man(beta 1-2)]nMan PMID- 1764075 TI - Inactivation of NADPH oxidase from human neutrophils by affinity labeling with pyridoxal 5'-diphospho-5'-adenosine. AB - When a particulate NADPH oxidase prepared from phorbol ester-activated human neutrophils was treated with pyridoxal 5'-diphospho-5'-adenosine (PLP-AMP), the superoxide anion-producing activity was inhibited according to affinity labeling kinetics. NADPH afforded a protection against inactivation which was competitive with respect to PLP-AMP; 2',5'-ADP and 2'-phospho-5' diphosphoadenosine (ATP ribose) appeared to be as potent as NADPH as protecting agents. NADP+ and ATP were less effective, while ADP and GTP-gamma-S did not protect significantly. These results suggest that PLP-AMP can be used, in conjunction with tritiated cyanoborohydride, to identify the elusive NADPH-dependent flavoprotein which is part of the electron transfer chain of NADPH oxidase. PMID- 1764076 TI - Photocleavage of DNA by the p-nitrobenzoyl group covalently linked to proflavine. AB - We have synthesized two novel DNA photocleaving agents,3,6-diamino-10-[6-(4 nitrobenzoyloxy)hexyl]acridinium chloride and 3,6-diamino-10-[6-(4 nitrobenzamido)-hexyl]acridinium chloride, and studied their DNA binding mode and cleavage properties. These compounds contain the photoactive p-nitrobenzoyl group attached to proflavine via an amide or ester linker group and a polymethylene chain. Spectroscopic and viscometric studies have shown that the compounds bind DNA by an intercalative mode. The presence of covalently-bonded intercalator is essential for the UV (310 nm) induced DNA scission. Above a critical ratio, an increase in the relative concentration of compound to DNA did not induce further cleavage. The cleavage efficiency was dependent on the type of linker group. These results are discussed in regard to possible mechanisms for photoinduced DNA breakage. PMID- 1764078 TI - Expression of human T-cell leukemia virus type I protease in Escherichia coli. AB - Human T-cell leukemia virus type I (HTLV-I) genome is believed to encode its own protease, although the protease has not yet been detected. To identify the HTLV-I protease, an in-frame gag (3' portion)-prt region was expressed in Escherichia coli. The 14-kDa product was detected using antisera against a synthetic peptide mimicking the fragment of HTLV-I protease, although the molecular weight of the primary translational product was 27,000. A cell extract had a proteolytic activity to cleave a synthetic peptide substrate containing the cleavage site of gag p19/p24 at the correct site in vitro. Replacement of the putative active site Asp-64 with Gly abolished both in vivo processing activity and in vitro proteolytic activity. These results suggest that the 14-kDa product is the mature enzymatically active HTLV-I protease generated through posttranslational autoprocessing in E. coli. PMID- 1764077 TI - Altered response to growth factors or retinoic acid in phenotypic transformation of normal rat kidney cells expressing human c-fos gene. AB - Anchorage-independent growth of normal rat kidney (NRK) fibroblast in soft agar depends on both transforming growth factor beta (TGF beta) and epidermal growth factor (EGF). To examine whether c-fos protein is involved in phenotypic transformation of NRK cells, we have transfected and isolated several NRK cell lines that carry the human c-fos gene fused to the metallothionein IIA promoter. A transfectant, Nf-1, had constitutive levels of the human c-fos expression. Anchorage-independent growth of Nf-1 was already stimulated by EGF alone, and the colony sizes of Nf-1 were comparable to those of the parental NRK in the presence of both EGF and TGF beta. Anchorage-independent growth of NRK could be observed in the presence of TGF beta or retinoic acid or platelet derived growth factor (PDGF) and EGF. No growth of NRK in soft agar appeared when basic fibroblast growth factor (bFGF) and EGF were present. By contrast, anchorage-independent growth of Nf-1 was surprisingly enhanced by EGF and TGF beta or retinoic acid or PDGF or bFGF. Expression of the human c-fos gene may compensate the signal to phenotypic transformation induced by TGF beta as well as retinoic acid or PDGF or bFGF. PMID- 1764079 TI - Amylin is more potent and more effective than glucagon in raising plasma glucose concentration in fasted, anesthetized rats. AB - Amylin is a 37 amino-acid peptide secreted from the pancreatic beta-cells. It has actions on carbohydrate metabolism in vivo, including elevation of blood glucose. In this study, the hyperglycemic effect of intravenous bolus injections of amylin was compared with similar injections of glucagon in 20-hour fasted rats lightly anesthetized with halothane. Administered doses ranged from 0.01 micrograms to 1000 micrograms (about 7 pmol/kg--750 nmol/kg for amylin and 8 pmol/kg--800 pmol/kg for glucagon). Control animals received an equal volume of saline. A single intravenous injection of amylin or glucagon led to an increase of plasma glucose levels, which peaked approximately at 1 hour after treatment. The calculated ED50 for amylin was 1.48 nmol whereas that for glucagon was 7.46 nmol; the maximum glucose increment was 4.3 mM for amylin, and 2.9 mM for glucagon. These results show that amylin is a more potent and more effective hyperglycemic agent than glucagon under these experimental conditions. PMID- 1764080 TI - Molecular cloning and amino acid sequencing of rat liver class theta glutathione S-transferase Yrs-Yrs inactivating reactive sulfate esters of carcinogenic arylmethanols. AB - A cDNA containing the entire coding sequence for the subunit protein of rat liver class theta glutathione S-transferase (GST) Yrs-Yrs was isolated from a rat liver lambda gt11 cDNA library. The cDNA, designated GST theta-1, consisted of 1,258 bp which had an open reading frame of 732 bp encoding a polypeptide of 244 amino acid (AA) residues, including the leading AA Met to be removed on expression. The authenticity of the cDNA structure was supported by matching its deduced AA sequence with N-termini of Yrs and peptides obtained thereof by tryptic digestion as well as by CNBr cleavage. The deduced AA sequence of the subunit Yrs (M.W. 27,311) had only a weak homology (19-23%) with those of rat liver classes alpha, mu, and pi GST isozymes. Thus, the first evidence for the molecular cloning of the class theta GST was provided. PMID- 1764081 TI - Bacteriorhodopsin "detergent-monomers," blue shift and velocity of light-dark adaptation. AB - Bacteriorhodopsin was incubated in various detergent solutions. Absorbance, circular dichroism and size of fragments obtained were investigated. Among all the detergents used, only Triton-X-100 and Nonidet P 40 led to monomers of bacteriorhodopsin. The blue shift of the absorbance maximum of the dark-adapted form and the slow down of dark adaptation are the sole parameters affected by the disruption of the trimeric organization of bacteriorhodopsin. Other spectral characteristics, such as reduction of amplitude of light adaptation, are affected by the presence of detergents independently of the associated or dispersed state of the pigment. PMID- 1764082 TI - Early changes of alpha B-crystallin mRNA in rat skeletal muscle to mechanical tension and denervation. AB - alpha B-Crystallin specifically decreases in atrophied rat soleus muscle with hindlimb suspension (HS). alpha B-Crystallin cDNA was cloned from rat heart cDNA library using oligonucleotide probe, and its complete coding and partial non coding regions were sequenced. Northern blot analysis revealed that alpha B crystallin mRNA in slow muscle decreases at 36 hour after HS but recovered at 24 hour after HS stopped. Denervation decreased the expression of alpha B-crystallin mRNA in slow muscle but increased it in fast muscles, which hardly expressed in normal condition. Passive tension increased the expression of alpha B-crystallin mRNA in both muscle types. Based upon these Northern blot analysis of alpha B crystallin, nerve innervation and external load on muscle are essential regulatory factors on the expression of the mRNA of alpha B-crystallin in rat skeletal muscle. PMID- 1764083 TI - Inhibition of platelet function by high-density lipoprotein from a patient with apolipoprotein E deficiency. AB - Apolipoprotein E-(apoE-) rich high-density lipoprotein (HDL) of normal subjects showed marked inhibitory effects on platelet aggregation and ATP release as compared with apoE-poor HDL, suggesting that apoE has inhibitory effects on platelet function (Desai et al. J. Lipid Res. 30:831, 1989; Higashihara et al. FEBS Lett. 282:82, 1991). A patient with apoE deficiency showed evidence of decreased platelet aggregability in platelet-rich plasma, but normal aggregability in washed platelets. Both patient's plasma and HDL fraction inhibited platelet aggregation of normal subjects. Patient's HDL reconstituted with recombinant apoE showed further inhibitory effects on platelet function. These results suggest that apoE is a potent, but not unique, inhibitory factor for HDL. PMID- 1764084 TI - Skeletal muscle relaxation with diazo-2: the effect of altered pH. AB - In a fatigued muscle fibre, the concentrations of ADP, Pi and H+ are all increased and relaxation is slowed. We have used the technique of laser flash photolysis of the caged calcium-chelator, diazo-2, to investigate the direct effect of changes in pH (pH 6.5, 7.0, 7.5) upon tension during relaxation of single chemically skinned fibres, when the effects of the sarcoplasmic reticulum are absent. The relaxation transients were closely fitted with 2 exponentials, a fast (42.3 +/- 1.4; pH 7.0) and a slow process (12.0 +/- 0.7; pH 7.0). The fast phase of relaxation was pH sensitive; lowering pH leading to a slowing of the rate of force decline and raising pH leading to an increase of the rate. The rate of the slow phase was unaltered by changing pH over the range investigated. Thus the slowing of relaxation in fatigued muscle may be due, in part, to the direct action of protons on the myofilaments independent of any effects upon the sarcoplasmic reticulum. PMID- 1764085 TI - Binding of oligonucleotides to cell membranes at acidic pH. AB - Antisense oligodeoxynucleotides [oligo(dN)] have the ability to enter living cells and block the expression of specific genes. However, little is known about the mechanism of cellular uptake of oligo(dN). We have found that oligo(dN) can bind to the cell membranes of eukaryotic cells with much greater efficiency under acidic conditions (pH 4.0-4.5) than at neutral pH. The binding appears to be specific to poly nucleic acids since various sizes of oligo(dN), DNA and RNA, but not mononucleotides, compete for the binding. We have identified a 34 kDa membrane protein from T-cells, which binds to oligo(dT) cellulose at pH 4.5 and can be eluted at pH 7.5. This protein fraction blocked the binding of oligo(dN) to living T-cells in a competitive fashion. Our results suggest that eukaryotic cells have a receptor for oligo(dN) at acidic pH and that the 34 kDa dalton protein on the cell membrane may mediate such binding. PMID- 1764086 TI - Endothelin induces the Ca(2+)-transient in endothelial cells in situ. AB - Using front-surface fluorometry of fura-2 and valvular strips of the pig aorta, we recorded changes in the cytosolic Ca2+ concentration, [Ca2+]i, of endothelial cells in situ, quantitatively, and investigated the effects of endothelin-1 and 3 on these endothelial cells. Both endothelin-1 and -3 elevated [Ca2+]i of a peak (the first phase) and sustained type. This first phase is considered to be due to a release of Ca2+ from intracellular storage sites. The sustained phase depended on extracellular Ca2+ and is considered to be due to an influx of Ca2+ through the plasma membrane. At equimolar concentrations, the peak elevations of [Ca2+]i induced by endothelin-1 were much higher than those induced by endothelin-3. We suggest that, in endothelial cells in situ, endothelin-1 mobilizes stored Ca2+ and may activate Ca(2+)-sensitive pathways, including the release of prostacyclin and endothelium-derived relaxing factors, more potently than does endothelin-3. PMID- 1764087 TI - Cytochrome b mutations in Leber hereditary optic neuropathy. AB - New mutations were discovered in the apocytochrome b gene in Leber hereditary optic neuropathy probands who did not harbor either of the two known Complex I mutations (positions 3,460 and 11,778). A mutation at position 15,257 was found in eight independent probands which changed a highly conserved aspartate to asparagine, was not found in controls, and appears to be pathogenetically significant. The 15,257 mutation occurred in association with a known synergistic mutation at position 13,708 in 7/8 probands and in association with a new apocytochrome b mutation at position 15,812 in 4/8 probands. Mutations in Complex III genes may be involved in Leber hereditary optic neuropathy and multiple, simultaneous mutations occur frequently. PMID- 1764088 TI - Radioiodinated CGP 42112A: a novel high affinity and highly selective ligand for the characterization of angiotensin AT2 receptors. AB - CGP 42112A, a potent angiotensin AT2 receptor selective ligand, was radio iodinated and its binding characteristics compared with those of [125I]angiotensin II. In human myometrium (only AT2 expressed), binding was saturable (Kd 1.03 x 10(-10) M; Bmax 807 fmol/mg) and reversible (K+1 1.89 x 10(8) M-1.min-1; K-1 3.77 x 10(-3) min-1). The order of potency of a number of peptides and non-peptides was the same as when [125I] angiotensin II was used as tracer. No specific binding could be detected on membranes from vascular smooth muscle cells (only AT1 expressed). In rat adrenal glomerulosa membranes (mixed AT1/AT2), [125I]CGP 42112A bound only to AT2. [125I]CGP 42112A can therefore be used as a specific probe for AT2 receptors and will be especially useful in tissues where other subtypes are also present. PMID- 1764089 TI - A peptide from the GAP-binding domain of the ras-p21 protein as well as azatyrosine block ras-induced maturation of Xenopus oocytes. AB - The ras-oncogene-encoded p21 protein is known to produce malignant transformation of NIH 3T3 cells as well as maturation of Xenopus oocytes when microinjected into these cells. p21 protein is known to bind a GTPase activating protein (GAP) intracellularly; residues 32-45 have been implicated in interacting with GAP. We demonstrate here that a peptide corresponding to residues 35-47 of p21 as well as the antibiotic azatyrosine inhibit the ras-induced maturation of Xenopus oocytes in a dose-related manner upon microinjection. We have previously shown that this p21 peptide and azatyrosine could inhibit the effects of p21 protein on cell transformation and pinocytosis in NIH 3T3 cells. In the present study, in which we have extended these results to the oocyte system, we also demonstrate that both partially inhibit insulin-induced oocyte maturation, a process which is thought to involve activation of endogenous p21 protein; on the other hand, both agents fail to inhibit oocyte maturation induced by progesterone, which is known not to act through p21 protein activation. Control studies with other peptides and tyrosine analogues support the selective nature of these events. These results suggest that both the p21-related peptide and azatyrosine have potent anti-ras effects intracellularly. PMID- 1764090 TI - Identification of the metal associated with the insulin degrading enzyme. AB - Insulin degrading enzyme (IDE) is a thiol-dependent metalloendoprotease that is responsible for initiation of cellular insulin degradation. However, its exact mode of action and the factors controlling it are poorly understood. Since IDE is a metal requiring enzyme, we have examined which metal(s) is(are) endogenously associated with it. Using neutron activation analysis, we studied the metal content of a partially purified enzyme from three different tissues: rat skeletal muscle, rat liver, and human placenta. Our results indicate that zinc and manganese are associated with the enzyme with approximately 10 times more zinc as manganese being present. These results suggest that one or both of these two metals are endogenously associated with this enzyme and are a means of controlling the enzyme's activity. PMID- 1764091 TI - In vivo regulation of apolipoprotein A-I gene expression by estradiol and testosterone occurs at the translational level in inbred strains of mice. AB - Testosterone and estrogen alter the hepatic synthesis of apoA-I in castrated inbred strains of mice, but apoA-I mRNA levels remain unaltered, suggesting post transcriptional regulation of apoA-I production in liver. To test this hypothesis, females of the C3H/HeJ and C57BL/6J strains of mice were castrated and after 2 weeks were given testosterone propionate (Testo 1 microgram/g body weight/day,), 17 beta-estradiol (0.16 or 5 microgram/g/day, E2L, E2H, respectively) or vehicle (placebo) for 14 days (n = 5/group). Liver polysomes were isolated from pooled livers of each group and "run-off" assays were performed. Testo increased apoA-I gene translation to 124% and 171% of controls in C3H and C57BL strains, increased polysomal mRNA levels to 276% and 438% and increased apoA-I synthesis to 181% and 269% of respective controls. Decreases in polysomal "run-off", mRNA levels and apoA-I synthesis were produced by E2H. E2L produced non-parallel changes, i.e., it raised apoA-I synthesis and polysomal apoA-I mRNA, but did not affect rates of translation. The data suggest that sex hormones exert their effects on apoA-I gene expression at the translational level. PMID- 1764092 TI - Mono(ADP-ribosyl)ation of poly(ADP-ribose)polymerase by cholera toxin. AB - Poly(ADP-ribose)polymerase (PADPRP) was found to be an efficient protein acceptor for the arginine-specific ADP-ribosylation reaction catalyzed by cholera toxin (CT). The covalent modification of PADPRP was carried out with [32P]2'-dNAD as a selective mono(ADP-ribosyl)ation substrate. Mono(2'-dADP-ribosyl)ated-PADPRP was identified by autoradiographic analysis of the CT reaction products following sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Addition of recombinant ADP-ribosylation factor (rARF), a small GTP-binding protein that stimulates the enzymatic activity of CT, enhanced the mono(2'-dADP-ribosyl)ation of PADPRP in a time- and substrate-dependent manner. In contrast, rARF did not change the ADP-ribose polymerizing activity of PADPRP. Peptide mapping mapping of [32P] labeled (2'-dADP-ribose)-PADPRP, following partial proteolysis with papain, revealed that the DNA-binding domain of PADPRP contained the mono(2'-dADP ribosyl)ated arginine residue(s). Our results are consistent with the conclusion that PADPRP is susceptible to arginine-specific mono(ADP-ribosyl)ation catalyzed by CT. PMID- 1764093 TI - Altered expression of the two naturally occurring human insulin receptor variants in isolated adipocytes of non-insulin-dependent diabetes mellitus patients. AB - The human insulin receptor gene is expressed in two variant isoforms which differ by the absence (HIR-A) or presence (HIR-B) of 12 amino acids in the COOH-terminus of the extracellular alpha-subunit as a consequence of alternative splicing of exon 11. Expression of the two variant isoforms is regulated in a tissue-specific manner. In this study, we have measured the levels of the two receptor variants in isolated adipocytes from 10 non-insulin-dependent diabetes mellitus (NIDDM) and 11 normal subjects using an immunological assay, based on the ability of a human anti-receptor autoantibody to discriminate between HIR-A and HIR-B. Results indicate that levels of HIR-B variant are increased in NIDDM patients. PMID- 1764094 TI - Effect of elevated extracellular calcium on the proliferation of osteoblastic MC3T3-E1 cells:its direct and indirect effects via monocytes. AB - There has been evidence that elevated calcium concentration at the resorptive site of the bone directly regulates osteoclast function. In the present study, in order to clarify the role of elevated calcium concentration at the resorptive site in the regulation of osteoblast function, not only direct but also indirect effect via human monocytes of the increase in extracellular calcium (Cae) on the proliferation of osteoblastic MC3T3-E1 cells have been investigated in serum-free condition. The increase in Cae enormously stimulated osteoblast proliferation at the concentration of 3 to 20 mM. When human monocytes were cultured at the elevated Cae concentration, monocyte-conditioned medium-induced stimulation of osteoblast proliferation was significantly amplified. Present data demonstrate that elevated Cae has pronounced stimulatory effect on osteoblast proliferation not only directly but also indirectly via monocytes. Calcium released from bone matrix at the resorptive sites might be linked to the coupling of osteoclast and osteoblast functions. PMID- 1764095 TI - Active transcription of the selenium-dependent glutathione peroxidase gene in selenium-deficient rats. AB - Selenium-dependent glutathione peroxidase (Se-GSH-Px, Ec.1.11.1.9) is the best characterized selenoenzyme in higher animals. However, neither the mechanism whereby selenium (Se) becomes incorporated into the enzyme nor the level at which the expression of Se-GSH-Px gene is regulated by Se is fully understood. In the current investigation, we have determined the relative rates of the transcription of the Se-GSH-Px gene in purified liver nuclei isolated from rats fed on Se supplemented or Se-deficient diets. No significant difference in the transcription rates appeared in these two groups. These results are consistent with the previous observations that active message for Se-GSH-Px- that is, translatable mRNA for Se-GSH-Px- is present in Se-deficient tissues (Li et al., J. Biol. Chem., 265, 108-113, 1990). The data also suggest that the alteration of Se-GSH-Px activity and the corresponding protein and mRNA levels in rats subjected to dietary Se manipulation can be attributed only to post transcriptional regulation. PMID- 1764096 TI - Apoptosis and DNA degradation induced by 1-methyl-4-phenylpyridinium in neurons. AB - Apoptosis is a prominent mechanism of programmed cell death in lymphocytes and in cancer cells not previously found in neurons. We have identified apoptosis and internucleosomal DNA degradation in cultures of cerebellar granule neurons. 1 methyl-4-phenylpyridinium, a selective neurotoxin that destroys the dopaminergic nigrostriatal pathway and results in a parkinsonian syndrome, increases the rate of apoptosis and kills cerebellar granule cells in culture via induction of programmed cell death. Inhibition of gene expression in granule cells with cycloheximide prevents the MPP(+)-induced apoptosis and the DNA fragmentation. Our findings demonstrate a new pathway of neuron death and suggest the possibility that neurodegenerative diseases may result from the inappropriate activation of programmed cell death by apoptosis. PMID- 1764097 TI - Modification of the radiochemical assay of rat liver mevalonate-5-diphosphate decarboxylase and induction and stabilization of the activity. AB - Problems encountered in attempts to purify mevalonate-5-diphosphate decarboxylase from rat liver are addressed. These are the quantitative, facile separation of [14C]isopentenol in the radiochemical assay (2) the instability of the enzyme activity and (3) the very low activity in rat liver. The assay was modified by using Sep Pac C18 filters to bind and release [14C]isopentenol. Authentic isopentenol was quantitated by absorbance at 210 nm wavelength and the extinction coefficient estimated to be epsilon m = 3.26 X 10(3). Recovery of authentic isopentenol from aqueous solution after binding and elution into methanol was quantitative from 10-100 nmols. Recovery of [14C]ispentenol from assay mixtures using 2-[14C]mevalonate-5-diphosphate and alkaline phosphatase to hydrolyze phosphate was quantitative using Sep Pac filter but not using petroleum ether extraction. Enzyme activity was stabilized by phenylmethylsulfonyl fluoride, aprotinin and leupeptin and was stable at -73 degrees C for 3 months. Activity of the decarboxylase was increased by 5-fold after feeding young rats 2.5% cholestyramine for ten days to four weeks. PMID- 1764098 TI - HIV-1 protease inhibitory activity of L-694,746, a novel metabolite of L-689,502. AB - L-689,502 is a potent inhibitor of HIV-1 protease activity in vitro. Microbial biotransformations of L-689,502 by cultures belonging to the genus Streptomyces sp. were performed. Extracts of culture broths were examined for the production of metabolites of L-689,502 that could inhibit HIV-1 protease activity. One culture, MA 6804 (Streptomyces lavendulae, ATCC 55095), produced L-694,746 that, while being structurally related to L-689,502, is a novel metabolite and a potent inhibitor of HIV-1 protease. PMID- 1764099 TI - Nanosecond fluorescence of tryptophans in cytochrome P-450scc (CYP11A1): effect of substrate binding. AB - Fluorescence of eight tryptophan residues in cytochrome P-450scc with bound endogenous cholesterol could be fitted with a two component model: a single exponential and a "top-hat" distribution of lifetimes as the second component. The short-lived component (tau 1 about 700 ps) does not change significantly upon binding of substrate (22R-hydroxycholesterol). The parameters of the long-lived component (central lifetime tau m about 3.4 ns) change upon binding of carbon monoxide and substrate. 22R-hydroxycholesterol binding broadens the distribution of the long-lived component; that is the heterogeneity of the Trp environment is increased when this substrate displaces the endogenous cholesterol. PMID- 1764100 TI - The conversion of eIF-2.GDP to eIF-2.GTP by eIF-2B requires Met-tRNA(fMet). AB - We have investigated why the recycling of eIF-2.GDP to eIF-2.GTP, mediated by the guanine nucleotide exchange factor eIF-2B, is rapid in rabbit reticulocyte lysate, reconstituted for optimal protein synthesis, but slow in an isolated reaction with purified eIF-2B. We have found that purified eIF-2B dissociates eIF 2.[3H]GDP as efficiently in the presence of GTP as it does in the presence of GDP provided Met-tRNA(fMet) is added. tRNA(fMet) is ineffective, and there is no Met tRNA(fMet) requirement for exchange with GDP. Exchange of eIF-2 bound GDP for GTP is completely dependent upon Met-tRNA(fMet) in the presence of ATP, suggesting that under physiological conditions efficient recycling of eIF-2.GDP to eIF-2.GTP requires conversion of the latter, a relatively unstable complex, to a more stable Met-tRNA(fMet).eIF-2.GTP complex. PMID- 1764101 TI - Studies on the metabolic inversion of the 6'chiral center of simvastatin. AB - In two simvastatin (SV) metabolites the 6' alpha-methyl of SV is oxidized to either 6' beta-CH2OH (I) or 6' beta-COOH (II). A possible intermediate is 6' exomethylene SV (III). When Sprague Dawley rats received an i.v. dose of [14C] III (1 mg/kg) metabolite II was excreted in bile. When dogs received an i.v. dose of [14C] III together with either [3H] SV (1 mg/kg) or its hydroxy acid form, [( 3H] SVA) (10 mg/kg), both 3H and 14C I and II were excreted in bile. These results strongly indicate that I and II are secondary metabolites of SV formed from III perhaps via a common aldehyde intermediate. PMID- 1764102 TI - Oxidative conversion of 6-fluorobenzo(c)phenanthrene to its K-region oxide by liver microsomes from 3-methylcholanthrene treated rats: reversal of stereoselectivity of cytochrome P-450c due to the influence of fluoro group. AB - We have shown earlier that metabolism of carcinogenic 6-fluorobenzo(c) phenanthrene by liver microsomes of 3-methylcholanthrene treated rats generate K region oxide as the major metabolite, while no K-region oxide survives in benzo(c)-phenanthrene metabolism under identical conditions. To understand the influence of fluoro group on the generation of K-region oxide from this hydrocarbon, we have determined the enantiomeric composition and absolute configuration of the metabolic 6-fluorobenzo(c)phen-anthrene-7,8-oxide. Interestingly, the microsomal cytochrome P-450c forms predominantly the 5R,6S enantiomer from B(c)Ph, while it exhibits a reversal of stereoselectivity with 6 fluorobenzo(c)phenanthrene forming predominantly the 7S,8R enantiomer. We have attributed this observation to an unfavourable interaction of the fluoro group with the hydrophobic binding pocket of the isozyme. PMID- 1764103 TI - Association of calmodulin with isolated nuclei from rat hepatocytes. AB - Calmodulin plays an important role in regulating cell proliferation and intranuclear processes (J. Biol. Chem. 265: 18595, 1990). Therefore we studied the association of 125I-calmodulin with highly purified rat hepatocyte nuclear preparations which were characterized by marker enzymes and electron microscopy. Steady-state association of 125I-calmodulin was reached within 5 minutes. Half maximal binding was achieved at approximately 7.1 microM. This association was partially Ca(2+)-dependent, but was not influenced by ATP, GTP or wheat germ agglutinin. Ultrastructural autoradiography showed specific association of 125I calmodulin with peripheral and non-peripheral heterochromatin, nuclear membranes, and nucleoli. Specific binding (ratio of the grain density of 125I-calmodulin to Na125I) was greatest in the regions of the nucleoli and non-peripheral heterochromatin. The data indicate that exogenous calmodulin can associate with specific nuclear components in an energy-independent and Ca(2+)-dependent manner. PMID- 1764104 TI - The TRH-like peptide pGlu-Glu-ProNH2 is present in the porcine pituitary but not in reproductive tissues. AB - The peptide pGlu-Glu-ProNH2, which differs from thyrotrophin-releasing hormone (TRH) by only one amino acid, was initially detected and characterised in the rabbit prostate complex and more recently in human semen and rat pituitary. A previous study reported that TRH and a homologous peptide were present in a range of porcine tissues and it was of interest to further characterise these peptides. In this study, high levels of TRH-immunoreactivity have been demonstrated in the porcine pituitary, the majority of which was authentic TRH; although 9% was found to be chromatographically identical to pGlu-Glu-ProNH2. In contrast, TRH immunoreactivity was not detected in follicular fluid, ovary or prostate. The unexpected finding that pGlu-Glu-ProNH2 is present in the porcine pituitary but absent from regions of the reproductive tract may be of biological significance. PMID- 1764105 TI - Tandem translation of E. coli initiation factor IF2 beta: purification and characterization in vitro of two active forms. AB - Two forms of E. coli initiation factor IF2, IF2 alpha and IF2 beta, have been known for several years. Both forms are products of the gene infB with translational initiation at codon 1 (AUG) and codon 158 (GUG) in the same reading frame. In this work we demonstrate that IF2 beta exists in two forms, IF2 beta and IF2 beta' with initiation codons 158 (GUG) and 165 (AUG) and molecular masses of 79.7 kDa and 78.8 kDa respectively. We have recently described a fast purification method for IF2 alpha, using an FPLC procedure consisting of ion exchange liquid chromatography on Q Sepharose HP, Mono Q and Mono S. After the Mono Q step, an apparently homogeneous IF2 beta was observed when analyzed by SDS PAGE. However the chromatography on Mono S results in the elution of two peaks containing IF2 beta. The N-terminal amino acid sequence of the two proteins identified the first peak to be IF2 beta and the second as a protein which we term IF2 beta' starting seven residues downstream at the AUG codon 165. The activity in vitro of the two purified forms of IF2 beta was tested by measuring the stimulation of binding of the initiator fMet-tRNA(fMet) to 70S ribosomes in the presence of GTP and poly(A,U,G) as messenger-RNA. In this assay no difference in activity is detected. PMID- 1764106 TI - Isolation and identification of a new diuretic peptide from the tobacco hornworm, Manduca sexta. AB - A 30-amino acid diuretic peptide was isolated from the corpora cardiaca-corpora allata complexes and, separately, from medial neurosecretory cells of the Sphingid moth, Manduca sexta. The peptide was found to have the following sequence, determined by automated Edman degradation and mass spectrometry: SFSVNPAVDILQHRYMEKV AQNNRNFLNRV-NH2. We have named the peptide Mas-DP II. The peptide was synthesized and shown to possess diuretic activity in decapitated moths. Mas-DP II is related by sequence homology to a 41-amino acid diuretic peptide identified previously from M. sexta, and it belongs to the family of corticotropin releasing factor-like peptides. PMID- 1764107 TI - Amino-terminal presequence of the precursor of peroxisomal 3-ketoacyl-CoA thiolase is a cleavable signal peptide for peroxisomal targeting. AB - To examine the function of the amino-terminal presequence of rat peroxisomal 3 ketoacyl-CoA thiolase precursor, fusion proteins of various amino-terminal regions of the precursor with non-peroxisomal enzymes were expressed in cultured mammalian cells. On immunofluorescence microscopy, all constructs carrying the presequence part exhibited punctate patterns of distribution, identical with that of catalase, a peroxisomal marker. Proteins lacking all or a part of the prepiece were found in the cytosol. These results indicate that the presequence of the thiolase has sufficient information for peroxisomal targeting. PMID- 1764108 TI - Cholecystokinin activation: evidence for an ordered reaction mechanism for the tyrosyl protein sulfotransferase responsible for the peptide sulfation. AB - The kinetics of the forward tyrosyl protein sulfotransferase (TPS) reaction were examined using an assay based on the 35SO4 transfer from 3'-phosphoadenosine 5' phospho(35S)sulfate [( 35S]PAPS) to tyrosyl residues of the non-sulfated cholecystokinin derivative, BocCCK-8(ns). TPS present in the microsomal membranes from rat cerebral cortex was used for these studies. Initial velocity measurements performed over a wide range of PAPS, BocCCK-8(ns), 3'-PAP and BocCCK 8(s) concentrations, indicated that the reaction follows an ordered mechanistic pathway. The KM value determined for BocCCK-8(ns) was 160 +/- 18 microM, and that for [35S]PAPS was 0.15 +/- 0.03 microM. 3'-Phosphoadenosine 5'-phosphate (3'-PAP) was found to be a product inhibitor with a Ki = 0.30 +/- 0.02 microM. BocCCK-8(s) produced an uncompetitive inhibition pattern on the TPS reaction. Adenosine 5' phosphosulfate (APS) behaved as a competitive inhibitor versus PAPS with a Ki = 3.0 +/- 0.3 microM. ATP inhibited competitively the reaction when PAPS was the varied substrate with a Ki = 3.6 +/- 0.5 microM. The results of product and substrate inhibition studies and the patterns of dead end inhibition obtained with APS are best fit by an ordered Bi-Bi reaction mechanism where PAPS is the first substrate to bind and 3'-PAP is the last product to be released. PMID- 1764109 TI - Mass measurements of inositol 1,4,5-trisphosphate and inositol 1,3,4,5 tetrakisphosphate in a neuronal cell line stimulated with bradykinin: inositolphosphate response shows desensitization. AB - In a neuronal cell line (108CC15, NG108-15) the levels of inositol 1,4,5 trisphosphate (InsP3) and inositol 1,3,4,5-tetrakisphosphate (InsP4), as measured by receptor binding assays, rise transiently after stimulation with bradykinin (EC50 approx. 150 nM). Maximal InsP3 level of 354 pmol/mg protein (15-fold basal level) is obtained at 10-15 s after addition of bradykinin, the InsP4 level rises maximally to 78 pmol/mg protein (14-fold basal level) at 20-30 s. In a rat glioma cell line, bradykinin (2 microM) causes a fast 6-fold increase in InsP3 and InsP4 levels. In the neuronal cells the bradykinin-dependent rise of the inositolphosphate levels is diminished with reduced extracellular Ca2+ concentration. However, depletion of internal Ca2+ stores does not affect the bradykinin-induced rise in InsP3 and InsP4 levels. Homologous desensitization to bradykinin occurs in the signal transduction pathway already at the production of inositolphosphates, since after a 2 min stimulation with bradykinin the rise in cellular masses of InsP3 and InsP4, inducible by a following second bradykinin stimulus, is substantially reduced. PMID- 1764110 TI - Elevated levels of all-trans-retinoic acid in cultured rat embryos 1.5 hr after intraamniotic microinjections with 13-cis-retinoic acid or retinol and correlations with dysmorphogenesis. PMID- 1764111 TI - Inhibition of vitamin B12-dependent methionine biosynthesis by chloroform and carbon tetrachloride. PMID- 1764112 TI - In vitro studies of intestinal drug absorption. Determination of partition and distribution coefficients with brush border membrane vesicles. AB - Brush border membrane vesicles (BBMV) were isolated from rat small intestine and characterized in terms of relative enrichment of specific organelle marker enzymes (20-fold enrichment; 20% yield), contamination by other subcellular organelles (less than 1%) and functional integrity (Na(+)-dependent glucose uptake). Using these vesicles, techniques were developed for the determination of partition and distribution coefficients for the model solutes, nitrobenzene, toluene and benzoic acid. No gender, age or regional variation along the small intestine in partition coefficient (log P) values was detected. There was no temperature (10-40 degrees) or pH (4.5-8.0) dependence in partition coefficients of nitrobenzene and toluene. Fair agreement was obtained for log P and log D values for these two solutes determined with BBMV and those reported with octanol and propylene glycol dipelargonate. Selective removal of proteins, both ecto brush border and micro-villus core proteins, did not alter the partition coefficients of the three model solutes. In contrast, depletion of the BBMV of non-esterified fatty acids significantly decreased the partition coefficients. Liposomes prepared from BBMV lipid extracts were also used for partition coefficient determinations and gave similar values to intact BBMV; addition of increasing amounts of cholesterol to the lipid extract caused small increases in the partition coefficients of the model solutes in the liposomes. It was concluded that the partition coefficients of the BBMV were related to the lipid and not to the protein composition of the vesicles. The method offers a rapid and reliable means of measuring the partition coefficient of non-protein bound drugs and nutrients in isolated intestinal BBMV and should assist in the subsequent modelling and prediction of intestinal absorption in vivo. PMID- 1764113 TI - Comparative cardiotoxicity of doxorubicin and a morpholino anthracycline derivative (KRN8602). AB - The toxicities of doxorubicin (DXR) and 3'-deamino-3'-morpholino-13-deoxy-10 hydroxycarcminomycin (KRN8602) were compared in perfused rat heart preparations. In addition, their toxicities in isolated myocytes as well as their abilities to cause oxidation of intracellular reduced glutathione (GSH) were evaluated. Finally, their capacities to initiate oxygen consumption and lipid peroxidation in isolated microsomes were determined. DXR caused a dramatic decrease in left ventricular pressure in the perfused hearts and a leak of lactic acid dehydrogenase (LDH) from isolated myocytes. These effects were not observed with KRN8602 at comparable concentrations although KRN8602 caused oxidation of GSH to oxidized glutathione (GSSG) in the myocytes. Both anthracyclines caused an increase in oxygen consumption and lipid peroxidation in isolated microsomes although these effects were more pronounced with KRN8602. The results of these experiments demonstrate that, despite the high capacity to redox cycle and to generate oxygen-derived oxidants, KRN8602 exhibited no measurable cardiotoxicity. The findings are consistent with a view that, if the formation of such oxidants is central to the cardiotoxicity of DXR, these substances must be formed in cellular compartments, e.g. plasma membranes, where the morpholino derivative (KRN8602) does not accumulate. PMID- 1764114 TI - Studies on the reactivity of acyl glucuronides--I. Phenolic glucuronidation of isomers of diflunisal acyl glucuronide in the rat. AB - Diflunisal (DF) is metabolized primarily to its acyl glucuronide (DAG), phenolic glucuronide (DPG) and sulphate (DS) conjugates. Whereas DPG and DS are stable at physiological pH, DAG is unstable, undergoing hydrolysis (regeneration of DF) and rearrangement (intramolecular acyl migration to the 2-, 3- and 4-O-acyl positional isomers). We have compared the in vivo disposition of DAG with that of an equimolar mixture of its three isomers after i.v. administration at 10 mg DF equivalents/kg to conscious, bile-exteriorized rats. After dosing with DAG, excretion in urine and bile (46% as DAG), hydrolysis (as assessed by recovery of 9% DPG and 8% DS resulting from reconjugation of liberated DF) and rearrangement (17% recovery as isomers of DAG) were important pathways. Highly polar metabolites excreted almost exclusively in bile and accounting for 13% of the dose were identified as an approximate 4:1 mixture of the 2- and 3-O-isomers of DAG which had been glucuronidated at the phenolic function of the salicylate ring i.e. "diglucuronides" of DF. Evidence for trace quantities only of the phenolic glucuronides of the 4-O-isomer of DAG, and of DAG itself, was found. After dosing rats with an equimolar mixture of the isomers, 52% was recovered (as the isomers) in urine and bile in 6 hr. Hydrolysis was less important--less than 3% (total) of the dose was recovered as DPG and DS. The phenolic glucuronides of the 2- and 3-O isomers (ratio ca. 3:7) accounted for 37%. Evidence for appreciable formation of the phenolic glucuronide of the 4-O-isomer was not found. In one rat dosed with DPG, there was no evidence for further glucuronidation of the salicylate ring at its carboxy function. The data suggest that the 2- and 3-O-isomers of DAG, but not the 4-O-isomer, DAG itself or DPG, are good substrates for further glucuronidation. PMID- 1764115 TI - Studies on the reactivity of acyl glucuronides--II. Interaction of diflunisal acyl glucuronide and its isomers with human serum albumin in vitro. AB - A major metabolite of diflunisal (DF) is its reactive acyl glucuronide conjugate (DAG) which can undergo hydrolysis (regeneration of DF), intramolecular rearrangement (isomerization via acyl migration) and intermolecular reactions with nucleophiles. We have compared the fate of DAG and its individual 2-, 3- and 4-O-acyl positional isomers (at ca. 55 micrograms DF equivalents/mL) after incubation with human serum albumin (HSA, 40 mg/mL) at pH 7.4 and 37 degrees. Initial half-lives (T1/2) for DAG and its 2-, 3- and 4-isomers were 53, 75, 61 and 26 min, respectively. DAG was more labile to hydrolysis than any of its isomers but the latter, in particular the 4-isomer, were much better substrates for formation of covalent DF-HSA adducts. After a 2-hr incubation, 2.4, 8.2, 13.7 and 36.6% of substrate DAG and its 2-, 3- and 4-isomers (respectively) were present as DF-HSA adducts. With long term incubation, the concentrations of adducts so generated in situ declined in a biphasic manner, with apparent terminal T1/2 values of ca. 28 days. DAG was much more labile to transacylation with methanol (i.e. formation of DF methyl ester) than an equimolar mixture of its isomers after incubation in a 1:1 methanol:pH 7.4 buffer solution at 37 degrees (T1/2 values of 5 and 70 min, respectively). The data do not support direct transacylation with nucleophilic groups on protein as the predominant mechanism of formation of covalent DF-HSA adducts in vitro. PMID- 1764116 TI - Kinetics of the inhibition of human serum cholinesterase phenotypes with the dimethylcarbamate of (2-hydroxy-5-phenylbenzyl)-trimethylammonium bromide (Ro 02 0683). AB - The inhibition of the human serum cholinesterase phenotypes, usual (U), atypical (A) and heterozygous (UA), by the dimethylcarbamate of (2-hydroxy-5-phenylbenzyl) trimethylammonium bromide (Ro 02-0683), was followed with benzoylcholine, acetyl , butyryl- and propionyl-thiocholine as substrates. The first-order rate constants were calculated from the linear part of the inhibition curves and were independent of the substrate used for measuring the enzyme activity. The second order rate constants for the U, UA and A phenotypes were 8.3 x 10(6), 6.1 x 10(6) and 0.05 x 10(6) M-1 min-1, respectively. The constant of the enzyme-inhibitor complex for the atypical serum was 7.7 microM, and the rate of carbamylation of the enzyme was 0.386 min-1. The rate of reactivation of carbamylated usual and atypical enzyme was found to be same; the half-time of reactivation was about 3.5 hr. The deviation from the linearity of the inhibition course was explained by spontaneous reactivation of the inhibited enzyme; the theoretical inhibition curves were in good agreement with the experimentally obtained values. The three phenotypes could be distinguished by the rate of inhibition by the dimethylcarbamate, Ro 02-0683, in the progressive phase of inhibition or by the degree of inhibition in the apparent steady-state. PMID- 1764117 TI - Effect of colchicine on hepatobiliary function in CCl4 treated rats. AB - A number of toxic chemicals affect the biliary excretory function of liver. Organochlorines and halomethanes are known to enhance bile flow. Despite the demonstration that a diversity of agents modify biliary function, the mechanism by which these chemicals manifest this effect is not fully understood. This study was designed to assess the effect of colchicine (0.1, 1.0, or 2.5 mg/kg, i.p., in saline) administration on biliary excretory function 6 and 24 hr later. Additionally, the effect of colchicine (1 mg/kg, i.p. in saline) pretreatment in rats 2 hr prior to the administration of a single low dose of CCl4 (100 microL/kg, i.p., in corn oil) or corn oil alone (1 mL/kg, i.p.) on hepatic biliary excretory function was also assessed at 6 and 24 hr after the last treatment. The hepatotoxicity was evaluated by serum enzymes, alanine and aspartate aminotransferases, and histopathological alterations of the liver. Biliary excretion of intravenously administered phenolphthalein glucuronide (PG) was assessed in bile duct cannulated anesthetized rats. Only the highest dose of colchicine (2.5 mg/kg) resulted in detectable liver injury as revealed by elevations of serum transaminases. While the lowest dose of colchicine (0.1 mg/kg) did not influence bile secretion, the two higher doses caused a slight choleretic effect at 24 hr. The highest dose caused a transient inhibition of bile flow, but this effect was no longer evident at 6 hr. Biliary excretion of PG was inhibited significantly by colchicine within 6 hr after administration, an effect that was also persistent at 24 hr. Colchicine at a 1 mg/kg dose did not cause any adverse effect on hepatobiliary function. Therefore, for the interactive toxicity study with CCl4, 1 mg colchicine/kg was chosen as a moderate dose which did not cause any significant adverse effect on hepatobiliary function. Biliary excretion of PG was significantly lower in rats at 6 and 24 hr after the combination treatment with colchicine + CCl4 than in rats receiving either CCl4 or colchicine alone. In contrast, rats receiving CCl4 alone or colchicine + CCl4 showed a significant increase in cumulative bile flow at 6 hr, whereas, at 24 hr, the bile flow was increased significantly in rats receiving colchicine regardless of CCl4 treatment. The data suggest that colchicine pretreatment leads to significant inhibition of hepatobiliary excretion in CCl4 treated rats. Serum alanine transaminase and aspartate transaminase levels were elevated significantly after the colchicine + CCl4 combination, indicating hepatic injury.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1764118 TI - Neurocatin-induced inhibition of monoamine oxidase A in rat brain synaptosomes. AB - Neurocatin is a small (about 2000 Da) neuroregulator isolated from mammalian brain. Earlier it was shown that addition of nanomolar concentrations of neurocatin to synaptosomes isolated from rat brain increased levels of serotonin and decreased catabolism of serotonin to 5-hydroxyindoleacetic acid (Fernandez Novoa L and Pastuszko A. Neurosci Lett 122: 83-86, 1991). In the present study, we report that neurocatin addition resulted in a striking inhibition of monoamine oxidase A activity. This inhibition became statistically significant at a neurocatin concentration of approximately 5 nM and was significant at all higher neurocatin concentrations. Neurocatin at approximately 50 nM inhibited monoamine oxidase A activity by about 90%. The inhibitory effect of neurocatin on monoamine oxidase required its incubation with intact synaptosomes since addition after breaking the synaptosomes by hypotonic buffer or lysis by Triton X-100 almost completely blocked the inhibitory effect. Measurements of the kinetic parameters of the enzyme in lysates prepared from synaptosomes incubated with neurocatin showed a decrease in Vmax with no change in Km for the substrate (serotonin) compared to controls. Incubation of the synaptosomes with approximately 25 nM neurocatin resulted in an 80% decrease in the Vmax of monoamine oxidase A. Evidence that neurocatin is a powerful endogenous modulator of monoamine oxidase activity is particularly intriguing. This enzyme plays a major role in catabolism of the biogenic amines and is believed to contribute to several important neurological disorders. PMID- 1764119 TI - Contribution of different amine oxidases to the metabolism of dopamine in bovine retina. AB - The contribution of monoamine oxidase (MAO) A, MAO B and semicarbazide-sensitive amine oxidase (SSAO) to the metabolism of dopamine in the bovine retina was studied. These activities were present in the optic nerve, iris, choroid and bovine retina, but they were absent in the lens. SSAO activity towards dopamine was present in the choroid and the retina, but not in the iris or the optic nerve. The corresponding kinetic values for this substrate in the retina and the choroid showed higher affinity for MAO A (Km 271 and 197 microM, respectively) than for MAO B (Km 861 and 404 microM, respectively). This effect was counteracted by the higher Vmax value for MAO B resulting in the Vmax/Km ratio being similar for both cases. The absence of detectable SSAO activity towards dopamine in these last two tissues contrasts with the presence of that enzyme when benzylamine was studied as substrate. These results indicate that two different SSAO activities could be present in the bovine eye. PMID- 1764120 TI - Inhibition of prostaglandin production in the inflammatory tissue by loxoprofen Na, an anti-inflammatory prodrug. AB - The effect of loxoprofen-Na, a novel non-steroidal anti-inflammatory drug with a prodrug property, on prostaglandin (PG) levels in the inflammatory tissue was investigated with a carrageenin-induced pleurisy model in rats. The intrapleural injection of carrageenin caused a marked increase in the levels of PGE2 and 6 keto-PGF1 alpha in the pleural exudate up to 3 hr after the injection. When [14C]PGE2 was injected into the cavity 2 hr after the carrageenin injection, the PG rapidly disappeared from the cavity (T 1/2 = 5 min). Thus, the PG level determined in the inflammatory exudate represents PG produced in the inflammatory tissue. Loxoprofen-Na, administered orally 2 hr after the carrageenin injection, dose-dependently inhibited the increase in the levels of PGs in the exudate 1 hr after administration (ID50 = 0.07 mg/kg for PGE2 and 0.10 mg/kg for 6-keto-PGF1 alpha). Indomethacin also inhibited PG production, but was less effective (ID50 = 0.24 mg/kg for PGE2 and 0.47 mg/kg for 6-keto-PGF1 alpha). Similar results were obtained 3 hr after the administration of these drugs (ID50 of PGE2 production = 0.14 mg/kg for loxoprofen-Na and 0.28 mg/kg for indomethacin). The time-course analysis of the effect of loxoprofen-Na showed that this drug had more immediate and stronger inhibitory activity than indomethacin. The relative potencies of suppression of protein leakage and leukocyte infiltration correlated well with the inhibition of PG production, but higher doses were needed for an obvious anti inflammatory effect. The active metabolite (SRS trans-OH) of loxoprofen-Na determined in the inflammatory exudate 1 hr after oral administration of 0.2 and 2 mg/kg of loxoprofen-Na was 0.05 and 0.25 micrograms/mL, respectively. The concentration was sufficient to suppress PG production in the exudate, because the IC50 of the SRS trans-OH for PG production in vitro with leukocytes was 0.02 microgram/mL (0.01 microM). The potency of the SRS trans-OH metabolite to inhibit PGE2 production in leukocytes was about 20 times stronger than that of the parent compound and 3 times stronger than that of indomethacin. PMID- 1764122 TI - Reduction of fluoromisonidazole, a new imaging agent for hypoxia. AB - [18F]Fluoromisonidazole (1-(3-[18F]fluoro-2-hydroxypropyl)-2-nitroimidazole, [18F]FMISO) is a nitroimidazole compound that is being used as a new imaging agent for hypoxia. Because its uptake in hypoxic tissue is dependent on reduction of the nitro group on the imidazole ring, it is necessary to verify the availability of nitroreductase enzymes in a variety of tissues. FMISO reduction was studied using chemical and enzymatic reducing systems and mammalian cells. FMISO reduction by iron/HCl eliminated the absorbance peak at 325 nm caused by the nitro group. FMISO reduction by xanthine oxidase, as measured by a decrease in absorbance at 325 nm, occurred at a rate of 2.4 +/- 0.3 nmol/min/unit enzyme (mean +/- SEM, N = 15). This reaction was inhibited by allopurinol. Separation of the parent drug from its reduction product following chemical and enzymatic reductions indicated that iron/HCl reduced the majority of the FMISO molecules present, while xanthine oxidase did not. Reduction of FMISO by NADH dehydrogenase could not be demonstrated spectrophotometrically. Measurement of the reduction of FMISO in V79 cells based on the binding of [3H]FMISO to cellular macromolecules was performed using a cell suspension in a three-neck flask. Hypoxic V79 cells bound [3H]FMISO at the rate of 0.26 +/- 0.07 pmol/10(6) cells/min (N = 8). When specific inhibitors of two nitroreductase enzymes and a general inhibitor of electron transport were added to the cell suspension, no consistent, statistically significant inhibition of FMISO binding could be shown. We conclude that while inhibition of FMISO reduction by a purified nitroreductase can be shown, nitroreductase activity in cells is not inhibited so easily. This supports the hypothesis that nitroreductases are plentiful and will not limit the rate of FMISO reduction and uptake in hypoxic tumors or nonmalignant tissues. PMID- 1764121 TI - Human embryonic cytochrome P450S: phenoxazone ethers as probes for expression of functional isoforms during organogenesis. AB - Human embryonic tissues were investigated during the period of organogenesis with a combination of substrate probes, selective inhibitors and immunoprobes in terms of their capacity to express functional P450 isoforms. A series of phenoxazone ethers utilized as substrate probes revealed that human embryonic hepatic, pulmonary, renal, adrenal and cardiac tissues each contained a complement of functional P450 isoforms when analyzed between days 50 and 60 of gestation. Preparations of each of these tissues contained isoforms capable of catalyzing O demethylation, O-deethylation, O-depentylation and O-debenzylation of the respective phenoxazone ethers. Investigations with chemical inhibitors and inhibitory antibodies as well as comparisons with vector-expressed, human P450 isoforms suggested that isoforms of P450 subfamilies 1A, 2B, 2C or 3A were not major contributors to any of the observed reactions. The P450-dependent reactions studied exhibited several unexpected and unusual characteristics including a preference for NADH over NADPH as the initial electron donor. Results were consistent with the concept that conceptal-specific P450 isoforms participate in the human embryonic O-dealkylation/debenzylation probe reactions investigated. PMID- 1764123 TI - Role of n-butyl group of buformin in modifying the conformations of poly-L lysine. PMID- 1764124 TI - Isolated collapse of left-sided heart chambers in cardiac tamponade: demonstration by two-dimensional echocardiography. PMID- 1764125 TI - Total anomalous pulmonary venous return: diagnosis by transesophageal echocardiography. PMID- 1764126 TI - Signal-averaged electrocardiography: a new technique for determining which patients may be at risk for sudden cardiac death. AB - Signal-averaged electrocardiography is a useful diagnostic tool and screening test for those patients at risk for the development of VT. It is also useful in the evaluation of the patient after MI and the patient with unexplained syncope. The prognostic value of the signal-averaged ECG process is gaining popularity. More investigation is needed, especially in the areas of technique and significance of abnormalities, before the signal-averaged ECG becomes a routine test in diagnosing dysrhythmias. The signal-averaged ECG provides the health care team with a new, non-invasive test. Knowledge of its use and application can provide the clinician with additional information that can aid in the screening process for patients at risk for sudden cardiac death. PMID- 1764127 TI - Management of hypertensive emergencies: changing therapeutic options. AB - Rapid lowering of severe hypertension is essential to prevent irreversible damage to vital organs. The patient's clinical status should be evaluated, noting particularly cardiac, neurologic, and renal functions. Choice of treatment should be based on speed and efficacy of action and on hemodynamic, vascular, and renal consequences. It is also important to preserve circulatory homeostasis and vital organ function. Sodium nitroprusside, labetalol, diazoxide, and hydralazine have been used parenterally for rapid control of severe hypertension, but they do not always produce optimal, balanced hemodynamic effects. Calcium antagonists have been advocated because of their beneficial circulatory effects. Nicardipine, a new dihydropyridine calcium antagonist, produces significant antihypertensive effects, and when given intravenously, results in a rapid fall in blood pressure. Studies have confirmed that nicardipine is effective and safe in the management of severe hypertension and hypertensive crises. Because the aim of rapidly controlling severe hypertension is to prevent target organ dysfunction, nicardipine therapy offers a useful additional option in the clinical management of severe hypertension and hypertensive crises. PMID- 1764128 TI - A Golgi study on the red nucleus in the mouse. AB - The intrinsic organization of the red nucleus (RN) was studied in the mouse using the rapid Golgi method. Cytoarchitecturally, the RN was divided into the magnocellular (RNmc) and parvocellular parts (RNpc). The former occupied the caudal one-third and the latter formed the rostral two-thirds of the RN. Based primarily on the size of somata, the RN neurons were classified into four types: giant, large, medium-sized and small neurons. Of these, the former two types of neurons were distributed mainly in the RNmc, while the latter two types of neurons were seen mainly in the RNpc. Axons of the RN neurons, at least those of the former three types of neurons, ran medially or caudomedially. Some axons ran across the mesencephalic raphe region to be lost in the medial region of the contralateral tegmentum. Two groups of afferent fibers to the RN were distinguished. Group I afferents were fibers composing the superior cerebellar peduncle. After crossing in the decussation of the superior cerebellar peduncle, these fibers entered the RN from the caudomedial aspect, ran rostrally in the nucleus emitting numerous collaterals. Group II afferents reached the RN from the ventrolateral aspect and traveled mediodorsally to be distributed totally within this nucleus. PMID- 1764129 TI - Severity of coronary artery disease in young patients with insulin-dependent diabetes mellitus. AB - Cardiovascular events remain a leading cause of morbidity and mortality in patients with juvenile-onset, insulin-dependent diabetes mellitus. To examine the extent and severity of the atherosclerotic lesions underlying this excess morbidity and mortality, clinical and angiographic findings were examined in 32 patients with insulin-dependent diabetes and in 31 nondiabetic patients, matched for age and symptoms, undergoing elective cardiac catheterization for evaluation of coronary artery disease. With respect to the individuals without diabetes, patients with insulin-dependent diabetes were significantly more likely to have severe narrowings, to have them in all three major coronary arteries, and to have them in distal segments. Severe narrowing of multiple vessels was significantly more common in men than in women and in individuals with hypercholesterolemia. We conclude that the high risk of cardiovascular events observed in young patients with insulin-dependent diabetes is secondary to advanced atherosclerotic lesions in coronary arteries. Involvement of distal segments of coronary arteries make these patients frequently unsuitable for bypass grafts. PMID- 1764130 TI - Enhancement of pulsed-dye laser ablation of arterial tissues with blood medium: effects of laser-induced shock waves. AB - The influence of blood medium on tissue ablation by a pulsed dye laser and its selectivity for atheroma were investigated. The role of shock waves on tissue ablation was also evaluated. Normal and atherosclerotic human aortas were irradiated by a 480 nm pulsed dye laser activated at 5 Hz. The laser was coupled with a single 0.2 mm fiber (Uni-guide) (40 mjoules/pulse) or a multifiber catheter (14 x 150 microns) (100 mjoules/pulse). Shock waves were measured using a fluid-filled catheter connected to a strain gauge manometer. With the Uni guide, pulse-dye lasing resulted in greater ablation of atheroma in blood (11.6 x 10(-3) mm3/joule, p less than 0.001 versus atheroma measured in saline and normal tissue in blood) followed by normal tissue in blood (2.5 x 10(-3)mm3/joule), atheroma in saline (1.71 x 10(-3)mm3/joule, p less than 0.05 versus normal tissue in saline), and normal tissue in saline (0.54 x 10(-3) mm3/joule). With the multifiber catheter, laser ablation was the greatest in atheroma in blood (0.55 +/- 0.26 mm3/joule p less than 0.001 versus atheroma in saline and normal tissue in blood), followed by normal tissue in blood (0.27 +/- 0.12 mm3/joule), atheroma in saline (0.14 +/- 0.15 mm3/joule, p less than 0.001 versus normal tissue in saline), and normal tissue in saline (0 mm3/joule). The ablation efficiency of the multifiber catheter was greater than that of the Uni-guide (p less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764131 TI - Confirmation of anomalous origin of the right coronary artery from the left sinus of Valsalva by means of transesophageal echocardiography. PMID- 1764132 TI - Current concepts of hypoxic-ischemic cerebral injury in the term newborn. AB - Acute perinatal hypoxic-ischemic cerebral injury in the term newborn is a major cause of long-term neurologic abnormalities in childhood. Earlier diagnosis and more precise localization of hypoxic-ischemic cerebral injury has been made possible by optimal timing and the use of new imaging modalities (e.g., magnetic resonance imaging, spectroscopy, computed tomography, cerebral perfusion techniques). Recent concepts on pathogenesis of such injury involves metabolic factors, regional distribution of excitatory (glutamate) synapses, and factors related to active myelination in specific areas at the time of insult. Consideration of these aspects of pathogenesis permit a rational approach to the management of this major neurologic problem in the newborn. PMID- 1764133 TI - Somatosensory evoked potentials after posterior tibial nerve stimulation in focal spinal cord diseases. AB - We investigated the somatosensory evoked potentials (SEPs) produced by posterior tibial nerve (PTN) stimulation in 8 infants and children with focal spinal cord disorders. The spinal responses of the PTN-SEPs were considered to assist in the localization of spinal lesions because their abnormalities were consistent with the neurologic and/or radiologic findings in all 6 examinations that revealed abnormal spinal SEPs. The cortical responses correlated significantly with proprioception in the lower limbs because proprioception was only disturbed when the cortical SEPs were absent (3 examinations). When both the spinal and cortical responses were abnormal, the spinal lesion probably involved the dorsal column so extensively that it completely interrupted the afferent impulses. In contrast, when SEP studies demonstrated abnormal spinal and normal cortical SEPs (3 examinations), the dorsal column involvement was probably less severe; therefore, both the spinal and cortical responses provided useful information regarding afferent conduction in the dorsal column. PTN-SEPs appear to have the potential to be of value in the diagnosis of focal spinal disease, especially in infants and young children who cannot cooperate with detailed neurologic examinations. PMID- 1764134 TI - Presentation, clinical course, and outcome of childhood stroke. AB - We reviewed the presentations, clinical courses, and outcomes of 42 children with unilateral hemispheric stroke. Infants with strokes identified within the first few days of life usually presented with seizures. These infants had few abnormal neurologic findings as neonates, but hemiparesis became evident as gross motor development proceeded. Infants with strokes identified later in the first year of life usually presented with pathologic early hand preference without a history of an ictus. During subsequent development, the motor deficits in these children became more evident, producing an apparent progression of the neurologic abnormalities. Strokes identified in older children typically presented as sudden hemiparesis, often associated with seizures. The hemiparesis in these children was most severe at the onset, followed by some improvement in strength in all patients. Functional outcome was variable. At last follow-up, all children were ambulatory, some with clinically apparent hemiparesis. Eight of the 42 children (19%) developed recurrent seizures with an onset ranging from 4 months to more than 10 years (median: 26 months) after the stroke. PMID- 1764135 TI - Sources of information used in diagnosing childhood learning disabilities. AB - One hundred nineteen questionnaires in which board certified/eligible child neurologists were asked to rank the diagnostic importance of 8 sources of information commonly used in the assessment of children with learning disabilities were analyzed by the Wilcoxon matched-pairs signed ranks test. All pairwise comparisons of the 8 sources revealed significant differences (P less than or equal to .033) except for psychologic reports (mean rank +/- 1 S.D. = 2.09 +/- 1.14) and medical histories (2.26 +/- 1.45) which were rated equal (P = .397) and, compared to the other sources, diagnostically most useful (P less than .0001). Analysis of the 6 remaining sources demonstrated the following: teachers' reports (3.39 +/- 1.35) were deemed more helpful than the mental status examination (3.92 +/- 1.61; P = .033) and questionnaires distributed to parents and teachers (5.05 +/- 2.11) were more useful than findings on the remainder of the neurologic examination (5.81 +/- 1.46; P = .012). Social service reports (6.45 +/- 1.32) took precedence over soft signs (7.12 +/- 1.05; P = .001) which were considered the least diagnostically helpful. Analysis of variance revealed that this rank order was relatively independent of the responders' age, type of practice, years elapsed since completion of training and percentage of professional time spent examining pediatric patients. Information derived from outside sources (collective mean rank +/- 1 S.D. = 4.25 +/- 0.9) contributed significantly more to the diagnosis of learning disabilities than to information elicited directly by the examining neurologists (4.77 +/- .88; P = .002).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764136 TI - Volumetric analyses of central nervous system neoplasm based on MRI. AB - Morphometric analyses were performed using an objective semiautomated algorithm on 5 sequential three-dimensional T1-weighted magnetic resonance imaging scans of a metastatic choroid plexus carcinoma, concurrent with a course of chemotherapy. The 5 scans were positionally normalized in a three-dimensional coordinate system for uniform definition of the borders of the mass. Volumes were calculated for the gadolinium-DTPA enhancing and nonenhancing cystic-appearing regions. Volumetric changes of up to 145% were measured using this method which were associated with changes in the calculated (spherical) radii of only up to 2.7 mm. Volumetric changes of up to 59% were not appreciated by visual inspection, most probably due to irregular borders and positional variability across the scans. Volumetric analyses were also performed on the right cerebellar hemisphere, producing a 1.83% coefficient of variability across the 5 scans. The growth rates of this mass were estimated from the sequential computations, permitting in vivo observations on tumor behavior otherwise not obtainable. These analyses demonstrate the potential of this morphometric method to detect significant volumetric changes, and illustrate its use to define in vivo the growth properties of central nervous system tumors in response to therapeutic interventions. PMID- 1764137 TI - Alteration of DNA synthesis in human brain tumor cells by gallium nitrate in vitro. AB - We measured 3H-thymidine incorporation by human brain tumor cell lines treated with varying doses of gallium nitrate. These DNA synthesis data indicate that the effects of gallium documented for brain tumor cell viability parallel those for alterations in DNA synthesis. The primitive, poorly-differentiated, small, round cell tumors (medulloblastoma and rhabdomyosarcoma) appear to be more sensitive than glially differentiated neoplasms (glioblastoma) to DNA synthesis inhibition by gallium nitrate. PMID- 1764138 TI - Pediatric AIDS: comparative cranial MRI and CT scans. AB - Fourteen consecutive children (age range: 4 months to 11 years; median: 4 years) with acquired immunodeficiency syndrome (AIDS) were studied prospectively with cranial magnetic resonance imaging (MRI) and unenhanced computed tomography (CT). In 4 children, human immunodeficiency virus infection was transfusion-related, while in 10, transplacental transmission occurred. Twelve children had abnormal neurologic examinations; of these, 10 had developmental delay and 2 were normal by developmental history and neurologic examination. Standardized neuropsychologic tests were given to all children; 5 were in the normal range and 9 demonstrated significant delays in verbal or motor/perceptual development. All children with abnormal neuropsychologic results were developmentally delayed; however, in 2 infants with normal neuropsychologic assessments, developmental delay and abnormal neurologic examinations were documented. Brain parenchymal volume loss (8 patients) and cervical lymphatic hypertrophy (4 patients) were demonstrated equally well by MRI and CT. CT alone demonstrated striatal-thalamic calcification (1 patient), whereas MRI alone demonstrated delayed myelination (1 patient). The extent of focal white matter lesions in 1 patient was demonstrated better by MRI than by CT. No intracranial mass lesions were demonstrated; however, significant correlations were found between peripheral volume loss imaged by either MRI or CT and both verbal and performance scores. In our small series, MRI offered no apparent advantage over CT in evaluating children with AIDS. We suggest that CT alone is sufficiently sensitive in evaluating pediatric AIDS-related brain abnormalities. PMID- 1764139 TI - Neonatal seizures: electroclinical dissociation. AB - Electroclinical dissociation is a phenomenon in which the clinical component of a seizure occurs at times with or without an electrical correlate. The epidemiology of this observation was studied in a neonatal intensive care unit from July, 1983 to December, 1988. Infants demonstrating electroclinical dissociation were compared to those having exclusively electroclinical seizures. Sixteen percent of infants with electrographically-confirmed seizures and 19% of 243 analyzed seizures demonstrated electroclinical dissociation. The two groups revealed very few differences with respect to perinatal factors, etiology, and outcome. The subsequent electroencephalographic background was more disturbed in the electroclinical dissociation group, but did not correlate with clinical outcome. Extremity movements occurred at a statistically significant higher rate during electroclinical seizures. Electroclinical dissociation seizures arise from foci not consistently reflected in surface electrodes. PMID- 1764140 TI - CBF and CBF/PCO2 reactivity in childhood strangulation. AB - Four children with self-inflicted strangulation injuries had cerebral blood flow determined by stable xenon computed tomography (XeCTCBF) within 24 hours of admission. All had suffered a severe hypoxic-ischemic cerebral injury; 3 initially had fixed pupils, all were apneic with varying bradyarrhythmias, and the initial mean arterial pH was 7.26 (+/- 0.18). The initial blood glucose values were greater than 300 mg/dl (334 and 351 mg/dl) in the 2 patients who died compared to the 2 who survived (104 and 295 mg/dl). The cardiac index was depressed during the first several days of hospitalization in the 2 patients who died (less than 2.0 L/min/m2) compared to the 2 who survived. Total CBF was normal (63 +/- 8 ml/min/100 gm) and local variations in CBF were present. PCO2 reactivity was determined by hyperventilating the 4 patients for 20 min from an end tidal PCO2 of 39 +/- 3 torr to 29 +/- 1 torr and then repeating the XeCTCBF study. Marked regional variability in the CBF/PCO2 response was observed, ranging from 0.5-5.5 ml/min/100 gm/torr PCO2. In the 2 patients who died, the CBF/PCO2 was decreased (1.2 ml/min/100 gm/torr PCO2) compared to the 2 patients who survived (2.1 ml/min/100 gm/torr PCO2). Although CBF was normal in these 4 children, the hyperventilation response was depressed, variable, and even paradoxical which may be important in the evolution of further brain injury and is a critical factor in deciding whether hyperventilation may be of clinical benefit.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764141 TI - Auditory brainstem response in hyperbilirubinemic rats: Part II. AB - The effect of an albumin-bilirubin solution on the auditory brainstem response (ABR) of rats was examined and compared with that of rats in which only bilirubin was administered. In albumin-bilirubin-loaded rats, the latencies of waves II and IV were prolonged and the amplitudes decreased, whereas the ABR wave I did not change significantly. The I-IV interpeak latency also was prolonged. These changes were more severe in rats loaded only with bilirubin. Mannitol injection hastened the appearance of ABR changes when only bilirubin was used, but peak levels of ABR changes were almost the same in the mannitol-injected groups. When the blood-brain barrier is intact, albumin administration is useful in hyperbilirubinemia for the prevention of damage to the central auditory pathways. The reversibility of the ABR changes were demonstrated in all bilirubin administered groups. PMID- 1764142 TI - Focal cerebral deficits in severe hypomagnesemia. AB - Hypomagnesemia has been associated with multiple neurologic abnormalities, including irritability, seizures, paralysis, and choreiform movements. A patient with short gut syndrome who developed severe hypomagnesemia during an intercurrent diarrheal illness is reported. This patient had a transient neurologic syndrome consisting of hemiparesis, mental status changes, and aphasia which resolved as the magnesium levels returned to normal. Neurologic abnormalities of this child were largely secondary to severe hypomagnesemia and should be included in the list of neurologic abnormalities that can result from this metabolic derangement. PMID- 1764143 TI - Childhood onset oculopharyngeal muscular dystrophy. AB - Oculopharyngeal muscular dystrophy is an inherited disorder, usually autosomal dominant, which typically becomes symptomatic during the fifth decade of life with slowly progressive ptosis and dysphagia; childhood onset has not been reported. A 13-year-old female of French-Canadian descent developed nasal speech and strabismus at 5 years of age; there was no family history of neuromuscular disease. Ptosis and mild facial and proximal muscle weakness were present by 9 years of age. Over the next 4 years, the patient developed dysphagia, palatal paralysis, weight loss, decreased ocular motility, scoliosis, shortness of breath, and obstructive apnea. Tracheostomy and gastrostomy were required. Creatine kinase and repetitive facial nerve stimulation were normal. Edrophonium testing was negative and electromyography revealed myopathic motor units in the iliopsoas muscle. A preponderance of type I fibers and scattered atrophic and angulated muscle fibers were present in 3 muscle biopsies. The clinical presentation and findings are consistent with childhood onset oculopharyngeal muscular dystrophy. PMID- 1764144 TI - Unusual case of Kluver-Bucy syndrome in a Chinese boy. AB - Following an encephalopathic illness, a 13-year-old Chinese boy had a partial form of Kluver-Bucy syndrome with emotional disturbance, recent memory loss, hypersexuality, and polyphagia. Other unusual features included narcolepsy, polydipsia, and polyuria. Virologic studies failed to incriminate the etiologic agent, including herpes simplex virus. Brain biopsy of the frontal lobe demonstrated Alzheimer type II astrocytosis. PMID- 1764145 TI - Recurrent coma and Lesch-Nyhan syndrome. AB - A patient with Lesch-Nyhan syndrome has had 3 recurrent episodes of coma, each associated with an acute illness. Extensive investigation for known causes of coma has failed to yield a diagnosis. Although coma is not generally recognized as a feature of Lesch-Nyhan syndrome, similar patients have been reported previously. This and other episodic phenomena observed in Lesch-Nyhan syndrome may be explained by the disruption of cellular energy metabolism due to purine depletion, consequent to lack of the purine salvage pathway normally provided by the hypoxanthine-guanine-phosphoribosyl-transferase enzyme. PMID- 1764146 TI - Brain perfusion in acute encephalitis. PMID- 1764147 TI - A randomized, controlled trial to measure the frequency of use of a hospital telephone line for new parents. AB - New parents have fewer supports today than in previous decades due to factors such as short postpartum hospital stay, fragmentation of services, and long distance families. This controlled trial evaluated the frequency of use of a 24 hour, in-hospital telephone line by 130 parents randomly invited to use the service and 130 who were not aware of this service. A special line with a separate extension was installed on the postpartum unit. Randomly arranged, sealed envelopes were given to 260 women at the time of discharge, containing a congratulations message or description of a new 24-hour telephone line for advice given by postpartum nurses. Of 53 calls requesting help, 36 were received on the special line and 17 on regular ward telephones; 28 percent of those invited to call back did so, and 13 percent of those without an invitation called on the regular extension, (P = 0.015). Recommendations for future program planning are based on the results of this study. PMID- 1764148 TI - The influence of birth setting on the father's behavior toward his partner and infant. AB - As part of a controlled, clinical trial conducted to compare medical and psychological outcomes of a birth room and a conventional hospital setting, we examined the behavior of fathers toward their partners and infants. One hundred fourteen couples were systematically assigned to either locale by strict alternation. They learned about this allocation on arrival at the hospital in labor. Observations of fathers' behavior were made at midlabor and during home visits at three months and one year. During labor, fathers assigned to the conventional setting were more involved in helping and encouraging their partners. Parenting behavior was not influenced by the birth setting. Unexpectedly, fathers were more involved with their infants when the mothers had expressed less satisfaction with childbirth. Compensation behavior may explain these results, which can be seen as appropriately adaptive in the face of perceived environmental deficiencies affecting the laboring woman and the infant. PMID- 1764149 TI - Just another day in a woman's life? Women's long-term perceptions of their first birth experience. Part I. AB - This study explored and analyzed the long-term impact of the birth experience on a group of 20 women from the natural childbirth culture of the late 1960s and early 1970s. The data consisted of 1) a structured labor and birth questionnaire and an unstructured account of their experiences written shortly after their babies were born; 2) a similar questionnaire and account written 15 to 20 years later; and 3) a transcribed one- to one-and-a-half-hour interview during which each woman's memories and perceptions were discussed. Women reported that their memories were vivid and deeply felt. Those with highest long-term satisfaction ratings thought that they accomplished something important, that they were in control, and that the birth experience contributed to their self-confidence and self-esteem. They had positive memories of their doctors' and nurses' words and actions. These positive associations were not reported among women with lower satisfaction ratings. PMID- 1764150 TI - Postnatal depression: its nature, effects, and identification using the Edinburgh Postnatal Depression scale. AB - Postnatal depression, or clinical depression in mothers during the months after childbirth, occurs at a time when heavy demands are placed on these women's resources, and when infant learning and development are taking place. Identification and treatment are facilitated when health professionals and services are in close contact with the family and can provide beneficial intervention. Two studies examined whether women with nonpsychotic postnatal depression could be recognized and treated within existing services, using the Edinburgh Postnatal Depression Scale and a randomized, controlled trial of counseling intervention with health visitors. PMID- 1764151 TI - Why women decide not to breastfeed. AB - The reasons for the low frequency of breastfeeding at an urban medical center were evaluated in a study in which 81 women were interviewed concerning the factors affecting their choice of infant feeding method and attitudes toward breastfeeding. One-half of the women made their decision during pregnancy, and 41 percent did so before conception. They received information on infant feeding methods from health care providers, family, and friends. In addition to their own thoughts and feelings, family members had the most influence on the feeding method. The influence of health care providers was minimal, yet most women received early and comprehensive prenatal care. Although they thought that breastfeeding was better for the baby, the majority chose to bottle feed due to negative attitudes toward breastfeeding, conflicting responsibilities or schedules, convenience, negative breastfeeding experiences, and health or medical reasons. PMID- 1764152 TI - Roundtable: the breastfeeding decision. Will it become American to breastfeed? PMID- 1764154 TI - Roundtable: the breastfeeding decision. Keep breastfeeding simple, keep it simple, keep it fun. PMID- 1764153 TI - Roundtable: the breastfeeding decision. How do we influence the breastfeeding decision? PMID- 1764155 TI - Multi-faceted use of calcium alginates. A painless, cost-effective alternative for wound care management. AB - At the Memorial Medical Center, calcium alginate dressings have consistently produced dramatic wound healing with a wide variety of wounds. No adverse reactions have been noted to date. The flexibility and comfort in the dressing application/removal have promoted patient and staff participation in wound care management. Cost-containment is directly related to a decrease in nursing time, fewer dressing changes, a decrease in wasted dressing material, and earlier discharges with outpatient management. PMID- 1764156 TI - In search of efficacy and efficiency. An alternative to conventional wound cleansing modalities. AB - Based upon the above results, Dey-Wash was found to be an effective wound cleansing agent. In over 80% of the patients, it cleansed the wound of exudate and debris in less than half the time and without the effort or abundance of materials required by the bulb syringe method. While splashback was reported by some nurses, this risk exists for all methods. Inservicing and protocols based on universal precautions will decrease the occurrence of this problem. As nurses became familiar with the proper angle and distance for applying the Dey-Wash, the problem of splashback became more manageable. Effective wound cleansing is a very necessary step in the wound healing process. The literature clearly describes the importance and variances of this practice in terms of different methodologies. Knowledge of the current literature concerning wound irrigation can guide nursing actions. Emphasis continues to be placed on appropriate utilization of nursing time and materials. Therefore, it is in the best interest of healthcare providers to evaluate new materials and methods in order to maximize care and facilitate optimum wound healing. PMID- 1764157 TI - Cost-effective technology for pressure relief. PMID- 1764158 TI - A new hydrogel wound dressing for the treatment of open wounds. Gel-Syte wound care dressing evaluation. PMID- 1764159 TI - Pouching procedure to collect drainage from around a biliary drainage catheter. PMID- 1764160 TI - Assessment and follow-up of problem wounds in the hyperbaric oxygen setting. AB - Ongoing wound assessment is essential to track the progress or lack of progress of non-healing wounds treated with HBO. By incorporating the entire HBO team, the assessment tool encourages clinicians to take a comprehensive view of the patient's physiological status and progress toward desired outcomes. Clinical assessment tools are a useful method to monitor and document the effectiveness of HBO as an adjunctive therapy to wound healing. As a result, other treatment measures that are also beneficial for wound healing can be included in the patient's plan of care. PMID- 1764161 TI - Major Medicare policy changes related to reimbursement for wound care products demand immediate response. PMID- 1764162 TI - Influence of lipophilicity on cytotoxicity of anthracyclines in LoVo and LoVo/Dx human cell lines. AB - Quantitative structure-activity relationship studies aimed at improving drug activity profiles require the determination of the physicochemical properties possibly involved in biological action. The lipophilic character of selected anthracyclines has been measured by means of reverse-phase high performance liquid chromatography, selecting appropriate experimental conditions. The capacity coefficients at zero percentage of the organic phase (log K0), which are retention indexes, have been used as lipophilicity descriptors in a QSAR study, involving as biological data the cytotoxicity of anthracyclines in a doxorubicin sensitive (LoVo) and in a doxorubicin-resistant (LoVo/Dx) human cell lines. The results obtained in these in vitro models indicate that lipophilicity plays a role in anthracycline activity, influencing drug availability at the site of action. PMID- 1764163 TI - Molecular determinants of singlet oxygen binding by anthraquinones in relation to their redox cycling activity. AB - A series of model anthraquinones with varying symmetry of pi-electron density distribution have been examined to verify our previous hypothesis concerning the essential role of quinone-singlet oxygen complex formation by asymmetric anthraquinones in their peroxidating properties. Comparison of the results of enzymatic studies using NADH dehydrogenase with those of cyclovoltammetric measurements fully confirmed the assumption that one-electron transfer mediation is facilitated by the preceding quinone-oxygen complex formation. To extend the scope of the molecular determinants of oxygen binding found in our previous studies, CNDO/2 and molecular electrostatic field (MEF) calculations have been performed. It has been concluded that the analysis of molecular electrostatic field as well as the dipole moment components has to be taken into account to judge whether a mutual orientation of the quinone and oxygen molecule can be reached which enables binding to occur. The second important factor is the appropriate symmetry of the quinone outer filled orbitals which assures that binding is not forbidden by the Woodward-Hoffman rules. These characteristics also explain the lack of oxygen binding by some asymmetric anthraquinones. The efficient electron transfer mediation be anthraquinones requires, beside the formation of the intermediate quinone-oxygen complex, effective catalysis of this process by oxidoreductase enzyme. The results obtained with model anthraquinones indicated that compounds with more than one phenolic group and an unsubstituted quinone carbonyl are good NADH dehydrogenase substrates. Imino derivatives and compounds with a reduced number or without free phenolic groups exhibit low affinity towards the enzyme. PMID- 1764164 TI - 2-Phenylbenzo[b]furans: relationship between structure, estrogen receptor affinity and cytostatic activity against mammary tumor cells. AB - A number of 2-(4-hydroxyphenyl)benzo[b]furans with a hydroxy group in position 5 or 6 and a short alkyl group at C-3 were synthesized from appropriate 1,2 diarylethanones and studied for their estrogen receptor affinity. The relative binding affinities in the 5-hydroxy series were higher than those of 6-hydroxy derivatives by a factor of 10. The trifluoroethyl and the propyl derivatives displayed the best relative binding affinity values (33 (15a) and 20 (12a); 17 beta-estradiol = 100). All benzofurans with high receptor affinity were tested for specific cytostatic activity using hormone-sensitive human MCF-7 mammary tumor cells and hormone-independent MDA-MB 231 cells. 5-Hydroxy derivatives with an ethyl (11a) or a propyl (12a) group completely inhibited the growth of MCF-7 cells at a concentration of 5 microM (tamoxifen: 70% inhibition). Since the cytostatic activity in MDA-MB 231 cells was much lower, an anti-tumor effect mainly mediated by the estrogen receptor has to be assumed. In the mouse uterine weight test these compounds gave rise to a partial estrogen antagonism which may account for the inhibitory effect in estrogen-sensitive tumor cells. PMID- 1764165 TI - Comparison of half-lives and cytotoxicity of N-chloroethyl-4-amino and N mesyloxyethyl-benzoyl compounds, products of prodrugs in antibody-directed enzyme prodrug therapy (ADEPT). AB - The synthesis of two novel drugs, 4-[bis[2-(mesyloxy)ethyl]amino]benzoic acid (7) and 4-[(2-chloroethyl)[2-(mesyloxy)ethyl]amino]benzoic acid (8) is described here. They are the active drugs of two prodrugs (9 and 10) designed for use as anti-cancer agents. The prodrugs (9, 10 and 11) were made as a series of compounds which are bifunctional alkylating agents in which the activating effect of the ionized carboxyl function is masked through an amide bond to a glutamic acid residue. These relatively inactive prodrugs were designed to be activated to their corresponding alkylating agent active drugs (7, 8 and 12 respectively) at a tumour site by prior administration of a monoclonal antibody conjugated to a bacterial enzyme. This system is called antibody-directed enzyme prodrug therapy (ADEPT). The chemical half-lives of the prodrugs and their active drugs were measured in order to determine their relative reactivities. The half-lives ranged from 21 to 324 min for the active drugs and from 42 to 1158 min for the prodrugs. The viability of two different tumour cell lines was monitored with each active drug and prodrug. The IC50 values varied from 65 to 625 microM for the active drugs: no IC50 values could be obtained for the prodrugs, using a rapid incubation procedure. Each in vitro technique demonstrated the ability of the glutamic acid moiety to deactivate the drugs, forming effective prodrugs. PMID- 1764166 TI - Synthesis and biological activity of galactopyranoside derivatives of 4' demethylepipodophyllotoxin showing VP-16 (etoposide)-like activity. AB - To investigate the role of the glucoside moiety in the biological activity of VP 16 (etoposide; 4'-demethylepipodophyllotoxin-ethylidene-beta-D-glucoside) and VM 26 (teniposide; 4'-demethyl-epipodophyllotoxin-thenylidene-beta-D-glucoside), a number of acetal and ketal derivatives of 4'-demethylepipodophyllotoxin (DMEP) beta-D-galactoside were synthesized. The compounds synthesized included acetaldehyde, propionaldehyde, 2-thiophenecarboxaldehyde, phenylacetaldehyde and acetone derivatives. In contrast to the glucose derivatives, where the acetal ring is trans to the pyranose ring, in galactose derivatives it is located in the cis position. The activities of the above compounds have been measured in two different biological assays, based on cross resistance towards mutants exhibiting specific resistance to VP-16/VM-26-like drugs and DNA-strand breaks as measured by the alkaline elution technique. All of the above compounds showed specific cross resistance to VpmR mutants (mutants resistant to VP-16 and VM-26) and caused a dose-dependent enhancement in DNA-strand breakage, providing evidence that they possessed the same kind of biological activity as VP-16 and VM-26. The relative activities of the DMEP-galactose derivatives have been compared with the corresponding DMEP-glucoside compounds. These studies reveal that, for the acetal and ketal derivatives with small R groups (acetaldehyde and acetone derivatives), the activities in the two series are comparable. However, for derivatives with larger, more hydrophobic R groups (2-thiophene or phenylacetaldehyde), the glucoside derivatives showed about 8-10-fold higher activity in comparison with the corresponding galactoside compounds. PMID- 1764167 TI - Structural studies on bio-active compounds. Part 18. Crystal structure and molecular modelling of methyl 4-(3-ethyl-3-hydroxymethyltriazen-1-yl) benzoate. AB - The title compound is an isomer, differing only by the shift of a methyl group, of the anti-cancer agent ethyl 4-(3-hydroxymethyl-3-methyltriazen-1-yl) benzoate; yet its half-life at physiological pH is only one-third as long. It forms crystals with triclinic symmetry, space group P1, and unit cell dimensions a = 6.184 (2), b = 7.214 (2), c = 14.575 (2) A, alpha = 89.61 (2), beta = 79.96 (2), gamma = 68.76 (2)0. Its labile N-CH2OH bond is slightly shorter than that of the more stable isomer but becomes almost equal after optimization of geometry by semi-empirical molecular orbital techniques. Calculated heats of formation are virtually identical for these compounds, as they are for the daughter species after loss of CH2O. The hydroxyl group forms an intermolecular hydrogen bond to a carboxyl oxygen atom in preference to the less negative triazene N(1). PMID- 1764168 TI - The use of CT-based 3-D anatomical modeling in the design of customized perineal templates for interstitial gynecologic implants. AB - A system for preplanning interstitial treatment of gynecologic malignancies with a CT-based 3-dimensional planning system is presented. The preplan produces a custom template design that optimizes catheter placement. The procedure begins with a CT scan with a vaginal cylinder and blank template in place. Contours of the anatomic structures of interest, cylinder, and template are entered into the system, and 3-D surfaces are generated. The first view evaluated is oriented in a "cylinder's-eye view," which shows the path of the catheters placed parallel to the cylinder. In most cases this path to the tumor is obstructed by the pubic bones and bladder. By rotating the view posteriorly, the catheters can travel under the symphysis and bladder to the tumor. Once the optimum angle for visualization of the tumor has been determined, an array of catheters is designed to optimize the dose to the tumor. This array includes the special distribution in the oblique plane as well as the depth of insertion for each catheter. The design is then used in drilling the appropriate guide holes in the template. Orthogonal film dosimetry as well as CT verification of source placement will be compared to the preplan distribution. PMID- 1764169 TI - The provision of a uniform vaginal surface dose rate by a novel afterloading cylinder. AB - The administration of a uniform dose rate to the vaginal surface is important in the management of endometrial, cervical, and vaginal malignancies. Unfortunately, conventional vaginal cylinders fail to provide this uniformity, and although dome cylinders do so, they require specialized 137Cs sources. Thus, a new acrylic vaginal cylinder has been developed to use with standard 137Cs sources and provides a uniform dose rate independent of vaginal size. Each contoured cylinder follows a particular isodose line. A metal ring is used to secure the device to minimize vulvar trauma associated with other vaginal cylinders. The construction and use of a set of these cylinders has allowed determination of their utility and limitations, which will be discussed in detail. Although these applicators do not completely replace conventional cylinders, they do offer a useful addition to the brachy-therapeutic armamentarium. PMID- 1764170 TI - Graduated block technique for the treatment of paranasal sinus tumors. AB - Cancers of the head and neck often present difficult dosimetric challenges; tumors of the paranasal sinuses, often advanced at diagnosis, pose several problems in treatment planning. Adequate coverage of involved areas often necessitates inclusion of the ipsilateral orbit due to direct extension of disease; sparing the uninvolved contralateral orbit may be difficult, especially if the superior nasal cavity and ethmiod sinus must be treated. We will report on a technique that allows delivery of a relatively homogeneous dose to a treatment volume that includes the paranasal sinus and ipsilateral orbit, with significant sparing of the anterior chamber of the contralateral eye. This technique uses a heavily weighted anterior field designed to deliver 100% to a plane posterior to the lens of each eye. From this plane posteriorly, lateral wedged fields are employed to increase the dose as the anterior contribution decreases. To achieve maximum homogeneity would require a wedge angle of greater than 60 degrees, the maximum wedge commonly available. To overcome this restraint, this technique uses multiple lateral wedged fields whose anterior field edges graduate in a posterior direction allowing for further compensation of the anterior field's fall-off. Film densitometry using a Rando phantom* is used to verify the technique. PMID- 1764171 TI - Design of MRI scan protocols for use in 3-D, CT-based treatment planning. AB - MRI has the potential of providing the radiation therapy treatment planner with new insights into the definition of target and normal tissue volumes to augment CT in 3-D treatment planning. The current speed of MR scan sequences is not sufficient to enable the acquisition of both T1 and T2 weighted images in all three orthogonal planes in a reasonable period of time. Therefore, compromises must be made in the design of protocols specifically for use in radiotherapy planning which: (1) provide enough information to readily enable image registration; (2) preserve the three-dimensionality provided by image acquisition directly in coronal and sagittal planes; (3) yield tissue contrast as well as tumor specificity (where available); but (4) can be completed in a short enough span of time (or with enough checks) that the patient position is not compromised. Protocols designed for use in planning treatment of the brain, head and neck, lung, prostate, cervix, and sarcomas are presented. PMID- 1764172 TI - Dosimetric considerations in the choice of photon energy for external beam radiation therapy: clinical examples. AB - Laughlin, Mohan, and Kutcher have evaluated photon beams for Co-60 through 24 MV for eight clinical disease sites plus pediatrics and concluded that two energy ranges are required for the best patient care: a 4 to 6 MV beam and a 10 to 18 MV beam. The present study investigates the question which two energies in a dual energy machine are optimum for the average patient mix. The method used is to calculate two dimensional sample cases including breast, head and neck, and pelvic tumors on the same treatment planning system using machine data including Co-60, 4 MV, 6 MV, 10 MV, and 18 MV x-ray beams. The resulting plans were evaluated considering tumor doses, spinal cord doses, doses to subcutaneous tissues and doses to other radiosensitive structures. The conclusion is that the optimum two beams are 6 and 10 MV. PMID- 1764173 TI - A policy for radiotherapy in patients with implanted pacemakers. AB - As the prevalence of implanted pacemakers increases, the likelihood that cancer requiring radiotherapy will develop in pacemaker-bearing patients increases proportionately. A management policy for pacemaker-dependent patients who require radiotherapy helps assure that they will be safely and efficiently treated with external beam radiation. Guidelines for external beam treatment have been set forth in the ASTRO Newsletter. These guidelines are the basis of the specific policy that was developed and implemented. This policy (1) requires a cardiology consultation and discussion with the manufacturer before treatment, (2) prohibits the use of a betatron, (3) suggests that attempts be made to limit the dose received by the pacemaker to 2-Gy, (4) requires that pacemaker dose be calculated, measured, and recorded in the patient chart, (5) requires cardiac monitoring in accordance with the degree of patient pacemaker dependence, and (6) requires a follow-up cardiology consultation after the patient's final treatment. Adherence to this policy is assured by use of a worksheet that is included in each pacemaker patient's chart. PMID- 1764174 TI - 3-D treatment planning and dose delivery verification integrating a variety of state-of-the-art techniques: a case report. AB - A patient previously treated with radiation for base-of-tongue cancer presented with recurrent disease seven years later. The spinal cord had received tolerance dose. Using state-of-the-art treatment planning techniques, including beam's-eye view and volumetrics, dose-volume histograms, split field technique, mixed energies, and beam intensity modulation (with a compensator), we achieved uniform dose coverage of the target in 3-D. This was verified in vivo with thermoluminescence dosimeters positioned in the esophagus by means of a nasogastric tube that ran centrally through the target volume. The various techniques applied will be presented with a discussion of the rationale used in each step of plan optimization and verification. PMID- 1764175 TI - The use of a negative beam to simulate a midline block. AB - The physics behind the use of a negatively weighted beam to calculate the dose distribution under a midline block in computerized treatment planning systems is reviewed. To correctly reproduce the dose under the block, it is necessary and sufficient to know the relative dose at one reference depth on the central axis under the block. If the relative weight of the negative beam is then adjusted to produce agreement at that depth, good agreement can be obtained throughout. Comparisons between calculated and measured dose distributions under a midline block are presented for two therapy beams with 4MV and 6MV nominal energies. PMID- 1764176 TI - Estimation of doses to heart, coronary arteries, and spinal cord in mediastinal irradiation for Hodgkin's disease. AB - Early-stage Hodgkin's disease is highly curable with radiotherapy. However, radiotherapy for Hodgkin's disease is not without complications, particularly those related to irradiation of the mediastinum. In attempts to decrease complications, it is important not to compromise the results. To plan such a strategy, one needs to know the doses delivered to various volumes of normal tissues with present techniques. However, such dose-volume data do not exist. Here we demonstrate, with computerized tomography-based dosimetric techniques, such a dose-volume relationship for the heart, coronary arteries, and spinal cord. The doses were determined retrospectively in eight patients. With a prescribed dose of 44 Gy, the volumes of the heart receiving at least 22, 26, 31, 35, 40, or 44 Gy were: 77%, 75%, 70%, 57%, 33%, and 2%, respectively. The average modal doses to the coronary arteries were: anterior interventricular artery, 18.48 Gy; circumflex arterial branch, 37.84 Gy; left coronary artery, 34.76 Gy; and right coronary artery, 36.96 Gy. The average maximum spinal cord dose was 37.25 Gy. A similar prospective documentation of dose-volume relationships and correlation with (functional) long-term complications may be helpful in the development of new strategies for decreasing complications. PMID- 1764177 TI - Practical 3-D radiotherapy planning of brain tumors. AB - In postoperative radiotherapy of brain tumors it is usually the case that preoperative imaging studies, either CT or MRI, were performed outside of the purview of the radiation therapy department. Thus the target volume is defined in an imaging study that does not lend itself readily for entry to a 3-D treatment planning system. A method is described that adjusts the patient structure defined by scan data to an appropriate position for radiotherapy. Software tools that are simple to use have been incorporated in a 3-D treatment planning program that allows oblique treatment planes to be defined. The program provides beam's-eye view plots of the fields that are used to overlay simulation films and will automatically describe a field blocking outline that provides a prescribed margin on the target volume or other structures that have been defined. Finally, dose calculations in arbitrary planes through the head are made and isodose plots produced. PMID- 1764178 TI - Efficient fabrication of precise electron cut-outs. AB - A time-saving method for creating accurate patient-personalized cerrobend cut outs, utilized in electron beam therapy, is described--implemented by radiographic films taken during simulation. This technique is used frequently (but not exclusively) for the treatment of head and neck cancer, where isocentric lateral films taken for photon treatment also provide the information needed to define the posterior off-cord electron boost. The boost field is traced from the film and demagnified by xerox to the distance of the cone cut-out holder. A second simulation of the electron field is not necessary. Matching of the electron fields to the photon fields is accurate, consistent, and easy to define on the patient. PMID- 1764179 TI - Documentation of ovoid cap size. AB - The need for precise documentation in radiation oncology is paramount; assurance of the quality of therapy delivered is the responsibility of everyone engaged in the treatment of cancer patients. Although all aspects of quality assurance require meticulous attention to detail, the documentation of brachytherapy procedures, both written dose prescription and film verification, is particularly important as no single method of dose reporting is universally accepted and used. The size of ovoid caps used in brachytherapy applications for gynecologic malignancies cannot be verified on treatment planning films, as the caps are not radio-opaque. If the cap size is improperly reported by the physician, resulting surface dose calculations used to determine source loading and implant duration could cause over- or underdosing. In an effort to improve and refine gynecologic brachytherapy record-keeping, we have devised a method to verify and document cap size. Narrow stainless steel bands have been embedded into grooves cut circumferentially on the surface of the ovoid caps. These bands are readily visible on localization films, producing documentation of the cap diameter, reducing the risk of error in dose reporting, and providing a permanent record of ovoid size. We will review the nature of possible dose errors affecting clinical decisions. PMID- 1764180 TI - Simple manufacture of pencil eye shields. PMID- 1764181 TI - The task analysis survey: report to the membership. AB - A task analysis was begun during the summer of 1988 under the auspices of the Education Committee. Data was collected by means of a survey of the Medical Dosimetry community. The analyzed information confirms the medical dosimetrist's job description and validates the certification exam content. Minor changes in the exam specification have been recommended to the certification board. PMID- 1764182 TI - Breastmilk versus breastfeeding: product versus process. PMID- 1764183 TI - LCs--remember your roots! PMID- 1764184 TI - "Suckling" or "sucking?" Which is it? PMID- 1764185 TI - Epidermal growth factor: an important constituent of human milk. AB - Epidermal growth factor is a human milk mitogen that has been shown to promote growth and maturation of infant intestinal mucosa. Since epidermal growth factor is not destroyed by proteolytic enzymes, it may be absorbed in the infant's gut and thus affect other tissues of the suckling infant. PMID- 1764186 TI - The lactation consultant as expert witness. AB - Several factors contributed to the impact of Ms. Scott's testimony on the judge and thereby on the case. Most obvious was the degree of her expertise; just as important was the way in which she presented her testimony. She maintained a moderate tone throughout and never gave the impression that what she was saying was anything but mainstream or that she was speaking from zealotry. Her greatest strength, as for any LC's testimony, is that she spoke in terms of what was best for the child. In any initial custody case the judge must decide what is in the child's best interests or some small variation on that theme. By its very nature, breastfeeding and all the information provided about it speaks to the same issue. In that sense, the testimony is not offered on behalf of one of the parents, but on behalf of the welfare of the child. It is this nonpartisan aspect of an LC's testimony that can make it so powerful. PMID- 1764187 TI - Expert witness: what to emphasize. PMID- 1764188 TI - Quinolone antibiotics and breastfeeding. PMID- 1764189 TI - Can a woman breastfeed while taking Prozac? PMID- 1764190 TI - Human milk banking in Sweden and Denmark. PMID- 1764191 TI - Time was ... 1924. The baby's first two years. PMID- 1764192 TI - [The treatment and prevention of acute diarrheal disease]. AB - Diarrheal diseases are the main cause of infant mortality in children under five year of age in the Third World. In order to diminish the mortality and morbidity rate, the World Health Organization developed the Diarrhoeal Diseases Control Programme (DDCP). The DDCP recommends two actions: to prevent diarrheal diseases and treatment of dehydration, the main cause of death in diarrheal diseases. Plan A is devoted to prevent dehydration; Plan B to treat orally dehydration; and Plan C to treat severe dehydration by means of rapid intravenous therapy. These plans were devised by health workers skill in the management of adults presenting Asiatic Cholerae. Thereafter the same method was used in non cholerae diarrhea, and finally in infants and children of all ages. The method has proven to be useful for treating all dehydration complications. The pediatric textbooks recommend the use of oral rehydration therapy (ORT) but do not support it very strongly. Plan C is not known by these authors, who recommend the old fashioned method used in the 70's. Here in I present the most advanced rehydration methods. PMID- 1764193 TI - [The initial clinical probability in the diagnosis of the hospitalized pediatric patient]. AB - OBJECTIVES: 1. To determine the degree of correlation among different physicians concerning their initial diagnosis and 2. identify the degree of correlation between the probability that physicians assing an initial diagnosis and the number of days the patient is hospitalized, laboratory test and X-rays taken of the patient. DESIGN: A comparative questionnaire. STUDY SITE: Pediatric hospitalization Unit of a third level medical care ward of the Mexican Social Security Institute. STUDY UNITS: All new admissions or non-programmed readmitted patients to the hospital during the months of November and December 1990. MAIN MEASUREMENTS: The treating physicians (Staff pediatricians (MB) and third (R3) and second (R2) year residents) were each asked to independently assign a probability (0 to 100) to each of the diagnosis emitted on the day the patient was admitted. When the patient was discharged, the number of days hospitalized as well as the number of laboratory tests and X-rays taken of the patient were added. RESULTS: 106 patients were evaluated, a correlation was gathered between MBs and R3s of 0.79 (P less than 0.001) and among MBs and R2s of 0.83 (P less than 0.001). The correlation between resident physicians was discretely less 0.60 (P less than 0.01). When relating the probability assigned by the physicians and the number of days the patients were hospitalized, associations were observed of 0.31 (P less than 0.05), 0.15 (P less than 0.05) and 0.19 (P = 0.04) for the MB, R3 and R2s respectively. In the case of laboratory test a correlation of 0.38, 0.06 and 0.04 (MB, R3, R2 respectively) was found. None of these correlations were statistically significant. The X-rays showed a significant correlation in cases of the MBs (0.50, P less than 0.05). CONCLUSIONS: The probabilities assigned by the staff physician as well as the resident doctors are closely related and a lesser grade of association is seen when comparing the residents among each other. No tendencies were identified in the correlation of the probability assigned by the residents and the variables analyzed. A consistent relation was seen between the staff physician and high probabilities, longer stays, and greater number of laboratory tests and X-rays. PMID- 1764194 TI - [The incidence of external congenital malformations at the Hospital de Ginecopediatria No. 48 in Leon, Guanajuato]. AB - From June 1st, 1989 to May 31st, 1990, 16,987 consecutive newborns were examined at the No. 48 Gynecological Pediatric Hospital of the IMSS National Medical Center, looking for external congenital malformations including esophageal atresias, anorectal malformations and congenital hip luxations, all easily detected during a routine exploration. Each deformed newborn assigned two control patients the following two newborn babies showing no birth defects. 308 deformed newborns were detected, an incidence of 1.81%. Among the most frequent defects were midline flat hemangiomas, polyotia, Down syndrome, congenital hip luxation and myelomeningocele. The only significant statistical difference found with respect to the control group was a greater family history of defects in the case group (P less than 0.0001). When comparing our results with those from other studies, including a study done locally 15 years ago, we found differences among specific malformations: congenital hip malformation, polydactylia, foot deformities, flat hemangiomas, nevus and polyotias. Yet, the overall frequency of defects found was similar. PMID- 1764195 TI - [An analysis in traumatic lesions of the demand for emergency services at 12 pediatric hospitals of the city of Mexico]. AB - A study on damages to a child's good health caused by injuries (accidents and violence), has been mainly directed towards the analysis of mortality. In reference to morbidity, very few studies have been carried out in our country. One of the primordial objectives of these studies was to explore morbidity through the demand of hospital emergency services. The study was designed using a questionnaire applied to patients during the months of September-October of 1988 while admitted in 12 pediatric hospital emergency wards. The analysis was done using a representative sample per hospital, applying the finite population formula, with a Zc = 90% and a interval of 0.05. The total number of cases studied was 3,294. The most important variables studied were: type of demand, traumatic lesion, place of occurrence, external cause, age groups, sex, day and shift of the demand, hospitalization and number of days in the ward. The results give an overall view of this health problem concerning morbidity, besides offering a basis for future investigations dealing with the identification of risk factors or the application of concrete interventions for their prevention. PMID- 1764196 TI - [Nephropathy in Schonlein-Henoch purpura]. AB - Over one hundred patients diagnosed with vascular purpura at the National Institute of Pediatrics between 1979 and 1988 were retrospectively studied. Frequency was similar for both sexes. 82% were between the ages of six months and 11 years old. The extrarenal clinical manifestations were: petechias in 98%; abdominal pain 78% arthralgias 45%; melena 39%; and arthritis in 19% of the cases, 49 patients had nephropathy of different degrees and they did differently, 32 had hematuria with or without proteinuria within a nephrotic range, seven suffered from a nephrotic syndrome, one with a nephritic syndrome and nine others had a combination of two or three syndromes (nephritic/nephrotic/renal failure) with an unfavorable evolution towards terminal renal failure in eight of them; on the other hand, this was not seen in the remaining patients. Thirteen renal biopsies were taken from patients with more severe clinical manifestations, finding in them mesangial proliferation or endo- and extracapillary proliferation. These findings suggest that the initial clinical presentation of the illness allows for the prediction of the future. PMID- 1764197 TI - [The null effect of Somatrem during typhoid fever]. AB - The simultaneous occurrence of typhoid fever in a child with an idiopathic growth hormone insufficiency treated with Somatrem, produced a lack of response to the recombinant hormone, evidenced by a lack of growth during the acute disease. It is concluded that the administration of Somatrem should be suspended during the simultaneous occurrence of any severe illness. PMID- 1764198 TI - [Necrotic and systemic arachnidism. A case report and review of the literature]. AB - Arachnidism can be manifested either through the skin or systemically. The genus Loxosceles is typically associated with wide necrotic skin lesions, in some cases accompanied by a generalized affection. This is a clinical case of a 16-month-old male, with an ulcer-necrotic lesion in the inferior abdomen associated to a spider bite. In addition, the patient had fever, was vomiting, and was in a general state of malaise, with plateletpenia, leukopenia and anemia. Summarized are the pathogenic processes, clinical findings and recommended treatment methods. Something worth noting is the importance of the clinical history since the spider is rarely found and therefore difficult to identify. PMID- 1764199 TI - [Helicobacter pylori: can it be a contributing factor in peptic ulcer in childhood?]. AB - Helicobacter pylori is a recently identified microorganisms which is thought to be the causing agent of the peptic acid disease in children as well as in adults. It is currently accepted that frequent relapses of this illness in spite of an adequate treatment can be associated to the faulty eradication of this bacteria. This article outlines the characteristics of H. pylori, its incidence, pathogenesis, as well as the current diagnostic methods used and the treatment applied. PMID- 1764200 TI - [Summaries of the papers presented at the XI investigative sessions, Pediatric Hospital, National Medical Center, Mexican Institute of Social Security, February 1991, Mexico, D.F. Part II]. PMID- 1764201 TI - The role of different nuclei of the thalamus in processing episodic information. AB - Male rats received either electrolytic or sham lesions bilaterally into the dorsomedial nucleus or the anterior nuclei of the thalamus or were assigned to an unoperated control group. After the postoperative recovery period all lesioned and control animals were tested for the ability to master a delayed alternation task. It was characterized by the alternation of Go and No Go trials, which were separated by intervals ranging between 0 and 80 s. Its successful performance required, firstly, the learning of the general principle that Go and No Go trials alternate with each other and secondly, in every trial, recalling the specific consequences of the responses in the previous trial after a short or long delay. Bilateral damage of the thalamus including the dorsomedial nucleus or anterior nuclei severely disrupted the performance of a delayed alternation task. A detailed analysis of the performance throughout the training suggests that the impairment associated with both thalamic lesions could be interpreted as a deficit in recalling specific information. This analysis also reveals a failure in the early stages of learning. Further research concerning the role of the dorsomedial nucleus and the anterior nuclei of the thalamus in learning and memory is proposed as necessary. PMID- 1764202 TI - Relationship between mental imagery and sporting performance. AB - Simultaneous measurement of six autonomic nervous system (ANS) variable responses during mental rehearsal of an action, makes it possible to draw a parallel between mental imagery of a task and its actual execution. The experiment was carried out in the field during precision shooting competitions and in the laboratory for imagery activity, on 22 subjects. Results show that there is similarity of ANS response in the three situations: the period of concentration prior to shooting, actual shooting and mental representation of shooting. The ratio formed by ANS response during concentration and imagery of actual firing tends towards the value one, therefore towards some identity. All subjects may be classified around this value; it is worth noting that subject distribution around this value corresponds to performance value. It seems that the better the subject, the closer his concentration/shooting or imagery/actual shooting ratio is to the theoretical value one. These results show the utmost importance of the quality of mental representation for performance improvement. It can be supposed that subject classification above the theoretical value one corresponds to overflowing emotional reactivity in one of the two phases and that this interferes with accuracy; a placing below the theoretical value one shows a lack of similarity between mental representation and the action. PMID- 1764203 TI - Role of the mesopontine area in the circling behavior induced by apomorphine in rats bearing unilateral lesion of the entopeduncular nucleus. AB - The role of the mesopontine area and superior colliculus in turning behavior induced by systemic administration of apomorphine was studied in rats bearing a unilateral entopeduncular lesion. Bilateral electrolytic damage of the superior colliculus resulted in an enhancement of the ipsilateral circling response to apomorphine, perhaps as a consequence of an increased locomotor drive in such animals. Bilateral electrolytic lesions of the mesopontine area decreased apomorphine-induced turning in entopeduncular rats, while a bilateral kainic acid lesion of the same region was ineffective. It was concluded that the pedunculopontine nucleus and adjacent reticular formation are not an essential link for the striopallidal complex output mediating circling in this model. Fibers running through this region could be implicated in the expression of the behavior under study. Since a unilateral electrolytic lesion of the mesopontine area contralateral to the damaged entopeduncular nucleus reduced drug-induced turning, we propose that an uncrossed pathway from the intact striopallidal complex mediates circling in our rats. PMID- 1764204 TI - Relationship between performance in the Morris water task, visual acuity, and thermoregulatory function in aged F-344 rats. AB - The present experiments were designed to determine whether the loss of visual acuity and thermoregulatory control in aged rats contributes significantly to age related deficits in the Morris water task. Relative to 2.5 mo rats, 16-18 mo F 344 rats were found to perform poorly in this spatial learning task. Their performance was also impaired in a test of visual acuity, and they became hypothermic during testing in the Morris water task. Nevertheless, 23 mo F-344 rats still retained a fairly high degree of visual acuity, and reducing the degree of visual acuity required to perform spatial mapping by adding large visual cues in close proximity to the target platform did not improve their performance. However, preventing hypothermia by warming 23 mo rats between trials in the Morris water task did significantly improve performance. These results suggest that age-related deficits in the Morris water task are not due to the loss of visual acuity; but, as a specific measure of cognitive function, performance in the Morris water task may be confounded by the loss of thermoregulatory control. PMID- 1764205 TI - Visual habit formation in 3-month-old monkeys (Macaca mulatta): reversal of sex difference following neonatal manipulations of androgens. AB - The ability to perform on a concurrent visual discrimination task with 24-h intertrial intervals (24-h ITI task) develops a few weeks earlier in female than in male infant monkeys. To test whether this sex difference was related to the presence of perinatal androgens, plasma testosterone levels were reduced in male infant monkeys by neonatal orchiectomy and increased in neonatally ovariectomized female infant monkeys by treatment with either testosterone propionate (TP) or its reduced metabolite, dihydrotestosterone (DHT). At 3 months of age, the animals were tested on the 24-h ITI task and their performance compared with that of age-matched intact male and female monkeys. Orchiectomy which was followed by a slight but visible atrophy of the external genitalia, hastened performance of male infant monkeys to the level of intact infant females. Conversely, androgenization of ovariectomized female infant monkeys given DHT, which had only a slight virilizing effect on the external genitalia, showed the learning of these female infants to the rate of intact male infant monkeys. Curiously, although TP treatment in ovariectomized female infant monkeys was more effective than DHT in virilizing the external genitalia, it failed to slow the rate of learning. This dissociation between the effects of TP and DHT on external genital organs and learning abilities is discussed in terms of possible differences in dose-dependent, time-dependent, and receptor-binding mechanisms of the two androgens. The present study provides further evidence that early androgen secretions affect the organization not only of brain structures related to primary sexual characteristics but also of those related to learning abilities. PMID- 1764206 TI - Visual field organization and peck localization in the pigeon (Columba livia). AB - Some aspects of the stimulus control of peck localization in the pigeon were examined using conditioning paradigms, visual occlusion procedures, and 'touch screen' technology. Birds were reinforced for pecks made to a small circular (target) stimulus projected upon a computer monitor and located within an electronically defined contingency area. The terminal location of each peck was monitored under binocular and monocular viewing conditions and when using either the frontal or lateral visual fields. Peck localization was highly accurate under either binocular or monocular viewing conditions or with the frontal field alone; there were no systematic differences between the right and left eyes and differences between monocular and binocular localization performance, though significant, were minimal. When viewing with the lateral field alone, subjects were initially unable to locate the food hopper and, even after retraining, conditioned peck localization was profoundly disrupted. The results confirm previous reports of functional differences between the frontal and lateral visual fields, but suggest that monocular cues are sufficient for highly accurate peck localization. PMID- 1764207 TI - Cerebellar interpositus nucleus lesions disrupt classical nictitating membrane conditioning but not discriminative avoidance learning in rabbits. AB - Cerebellar interpositus nucleus lesions were given to 14 rabbits trained in two behavioral paradigms; discriminative avoidance conditioning of locomotor behavior and classical nictitating membrane conditioning. Bilateral lesions that prevented acquisition of the classically conditioned response on both the left and right side failed to affect the acquisition or performance of the conditioned discriminative avoidance response. The results are discussed in terms of differences in neural substrates that apparently subserve the two forms of learning. PMID- 1764208 TI - Correlation between amount of retinal afferents to the pretectal nucleus of the optic tract and dorsal terminal accessory optic nucleus and performance of horizontal optokinetic reflex in rat. AB - Intraocular kainic acid injection in Long-Evans rats induces loss of retinal afferents to subcortical visual centers as assessed by the axoplasmic transport of [14C]valine. The optical terminal fields of the pretectal nucleus of the optic tract (NOT), superior colliculus and accessory optic system (AOS) nuclei appear particularly affected. Since NOT and the AOS dorsal terminal nucleus (DTN) represent the first relay station of the visuomotor pathway mediating horizontal optokinetic nystagmus (HOKR), we have studied the characteristics of HOKR after various degrees of retinal deafferentation of these nuclei induced by intraocular KA injection. Taking advantage of the arrangement of the primary optic projections to NOT-DTN, that in rats are almost entirely crossed, in each animal, monocular HOKR induced by stimulation of the injected eye was compared to monocular HOKR elicited by stimulation of the intact, ipsilateral eye. Following NOT-DTN optic denervation, HOKR gain always worsened, and in a way, that the greater the deficits of retinal afferents, the greater the HOKR inability to compensate for visual motion. Furthermore, for any given retinal denervation the higher the stimulus velocity, the greater the HOKR deficit. While the correlation between HOKR gain and the amount of retinal afferents to NOT-DTN would seem to indicate a functional homogeneity of the retinal ganglion cells sending axons to these nuclei, the finding that the extent of HOKR impairment also varied with velocity might not support the above view. PMID- 1764209 TI - Spatial learning in two inbred strains of mice: genotype-dependent effect of amygdaloid and hippocampal lesions. AB - Spatial learning performance and maze-running strategies were estimated in two inbred strains of mice, C57BL/6 and DBA/2, submitted to an 8-arm radial maze task. Subsequently the genotype-dependent effect of hippocampus and amygdala on the mastering of this task was examined as a function of the different acquisition model provided by each strain. The results firstly show that unoperated C57BL/6 mice reach a higher level of performance and develop a stronger preference for adjacent arms - 45 degrees angle - turns than unoperated DBA/2 mice. In the high learner C57BL/6 strain, both hippocampal and amygdaloid lesions impair performance and modify maze-running strategies. With practice, however, the difference between amygdala-lesioned mice and controls disappears while that between hippocampus-lesioned mice and controls persists. Conversely, in the low learner DBA/2 strain, hippocampal lesions have a negative effect on a single parameter of performance, while amygdaloid lesions only affect maze running strategies. Taken together, these results confirm the specific control exerted by the hippocampus on spatial learning. Moreover, they suggest that the amygdala can parallel the role of the hippocampus as far as the baseline level of performance of the strain considered is high. PMID- 1764210 TI - Strain and sex differences in the degree of paw preference in mice. AB - The direction and degree of paw preference was studied in male and female mice from the C3H/He, C3H/OuJIco and New Zealand Black (NZB) strains, using the method previously described by Collins. All the populations of mice tested exhibited a low degree of lateralization, which varied among strains: NZB mice were more strongly lateralized than both C3H substrains; C3H/He had a higher degree of lateralization than C3H/OuJIco mice. Females tended to be more strongly lateralized than males, particularly in the C3H/He mice. No direction bias was observed in the strains tested, as lateralized mice were equally distributed into left-and right-handers. The distributions of paw preference found in the strains tested in this study are different from those obtained by Collins in C57BL/6J mice, in that most of his animals were strongly lateralized and only a few were ambidextrous. These strain differences in the degree of paw preference may be explained by genetic factors or differential rearing histories, which are known to influence the development of brain asymmetries. PMID- 1764212 TI - Iron-mediated oxidative DNA damage detected by fluorometric analysis of DNA unwinding in isolated rat liver nuclei. AB - Studies were performed to determine the extent of nuclear DNA degradation induced by iron, iron-ascorbate, or iron-bleomycin under aerobic conditions in a model system using isolated rat liver nuclei. The effects of five antioxidants (catalase, superoxide dismutase, dimethyl sulfoxide, glutathione and diallyl sulfide) on this oxidative nuclear damage were also investigated. At the 0.05 level for statistical significance, iron induced concentration-dependent DNA degradation, and this effect was enhanced by ascorbate and bleomycin. The antioxidants catalase, dimethyl sulfoxide, and diallyl sulfide significantly reduced the iron-ascorbate-induced DNA damage, whereas superoxide dismutase and dimethyl sulfoxide significantly reduced iron-bleomycin-induced damage. Glutathione significantly increased the iron-bleomycin-induced DNA damage. These results suggest that the reactive oxygen species generated by iron, iron ascorbate, and iron-bleomycin are responsible for the DNA strand breaks in isolated rat liver nuclei. PMID- 1764211 TI - The effects of Chinese tea on the methylation of DNA by the esophageal carcinogen N-nitrosomethylbenzylamine. AB - In order to investigate the mechanisms of the anticarcinogenic effect of Chinese tea on the development of esophageal tumors in rats induced by N nitrosomethylbenzylamine, the alkylation of DNA in various organs was studied in rats treated with 2 varieties of Chinese tea, i.e. Fujian Oolong tea and Jasmine tea. Male Wistar rats were given a single i.v. injection of N-nitroso-[methyl 14C]-benzylamine (2.5 mg/kg body wt) after having been provided tea in drinking water and by gavage for 2-3 weeks. Control rats were provided with tap water. Three to four hours after administration of the N-nitroso compound, the methylation of purine bases in the DNA isolated from various organs was measured by high performance liquid chromatography and liquid scintillation counting. In the tea-drinking rats, there was an appreciable reduction of O6-methylguanine formation in the esophageal DNA as well as the ratio of O6-methylguanine to N7 methylguanine, as compared to the control rats. No O6-methylguanine was detected in lung or liver DNA. PMID- 1764213 TI - Pitfalls in assessing risks from carcinogens. AB - The decision to classify a chemical as a human carcinogen must depend upon agreed conclusions from epidemiology, bioassays, and some short-term corroborating tests; information from only one of these disciplines is inadequate. Most pitfalls appear in interpreting the results from animal bioassays; this report will concentrate on them. Often the conclusion is accepted that a chemical is an animal carcinogen without a critical appraisal of the experimental design. By manipulating the experiment, 90 + % of all chemicals can induce some tumor in a rodent. Pitfalls encountered in bioassays result from not specifying the exact agent under test and how it relates to human exposure, using inappropriate routes of administration unrelated to humans, administering illogically high doses, or concluding that a cancer was induced without adequate histopathological description of the lesion. Importance of animal husbandry is often overlooked. Pitfalls are also related to short-term tests. Finally, a major pitfall in assessing carcinogenic risk from chemicals is drawing global conclusions about the carcinogenicity of an agent after the detection of only one or two tumors in the treated group. PMID- 1764214 TI - Microalgae as bioabsorbents for treating mixture of electroplating and sewage effluent. AB - The effectiveness of copper and nickel uptake by microalgae grown in the mixture of electroplating effluent and sewage was studied. The results showed that a high percentage of copper removal (68.1%-88.2%) was achieved by Chlorella pyrenoidosa (strain No. 26) reared in the mixture of 90% electroplating effluent and 10% raw sewage during the first 3 days despite the fact that cell growth was inhibited. Similar results were also obtained by using Chlorella HKBC-C3, another species collected from one of the heavy metal polluted sites in Hong Kong, isolated and cultured in the Biology Department. There was no significant difference (P greater than 0.05) in the removal of copper and nickel from the effluent between these 2 algal species. However, it was noted that removal of nickel from the mixture by the two species were comparatively lower (less than 20%) than the removal of copper (greater than 68%). PMID- 1764215 TI - Effects of high erucic acid rapeseed oil on fatty acid oxidation in rat liver. AB - The effects of high erucic acid rapeseed oil (HER) on fatty acid oxidation in rat liver compared with low erucic acid rapeseed oil (LER) were studied. Weanling male SD rats were fed diets containing 20% HER or LER for 1 week or 4 weeks, or 5% HER diet for 4 weeks. The hepatic oxidation capacity of butyric acid or palmitic acid was determined by titrating the propanone produced by their oxidation. The results showed that feeding HER to rats led to an increase in the weight of liver and a decrease in the hepatic oxidation capacity of palmitic acid. Hepatic oxidation of butyric acid was not influenced by the intake of HER. The inhibitory action of HER on the oxidation of long-chain fatty acids probably resulted from the incorporation of erucic acid into mitochondrial membranes, interfering the fatty acyl-CoA transferring system on the membranes, but not from the beta-oxidation enzyme system in mitochondria being directly inhibited. PMID- 1764216 TI - Radiotracer study on residues and residue distribution of zineb in plant-soil system. AB - In view of the widespread use of zineb on food plants and the toxicity of one of its metabolites, ETU, a study on the residues and residue distribution of zineb and ETU in plant-soil systems was carried out. The half-life values for total zineb residues on egg-plant leaves and in soil were observed to be over three and two weeks, respectively. Egg-plant skin contained higher amount of zineb residues than the fruit pulp. Washing with water greatly reduced zineb residue levels, especially those in the fruit skin. Compared with zineb, ETU is much easier to be uptaken by plants and to leach into deeper layer of soil due to its high water solubility. Therefore, attention should be paid to the contents of ETU in zineb formulations as impurity and formation of ETU in the environment. PMID- 1764217 TI - Suppression of radioactive strontium absorption by sodium alginate in animals and human subjects. AB - The effect of 23 sodium alginate preparations from different species of algae (Sargassum sp.) and kelp (Laminaria sp.) on reducing the absorption of strontium was studied in detail. A pilot production procedure has been established. Na alginate from S. siliquastrum was proven to be a potent agent for reducing Sr absorption, with high efficiency and virtually no toxicity. It reduced the body burden of strontium 3.3-4.2 fold in rats. Strontium absorption in human subjects was reduced by 78% (+/- 8.9) or completely suppressed the increase of serum Sr at 2 h after ingestion of stable Sr in volunteers and decrease 24 h urine Sr to similar extent. No undesirable effects on gastrointestinal function was observed nor were Ca, Fe, Cu and Zn metabolism changed, both in the animal experiments and in human. It was concluded that alginate preparations derived from Sargassum species are a suitable antidote against radiostrontium absorption on a long-term basis, when added to bread at a 6% level. In cases of emergency, an alginate syrup preparation appears to be more suitable because of its rapid action. PMID- 1764218 TI - Subchronic oral toxicity of pyridostigmine bromide in rats. AB - This study evaluated the oral toxicity of pyridostigmine bromide in Sprague Dawley rats when administered for 13 weeks by daily gavage. Groups of 10 rats/sex received doses of 0, 5, 15, 30, or 60 mg/kg/day. Toxicity was limited to exaggerated cholinergic stimulation at doses of 15 mg/kg/day or greater. Significant findings included tremors and inhibition of RBC acetylcholinesterase. Thus, 5 mg/kg/day of pyridostigmine bromide appears to be the no observed toxic effect level under the conditions of the present investigation. PMID- 1764219 TI - Effect of moniliformin on myocardial contractility in rats. AB - The present study was carried out on rat heart to in situ determine the myocardial toxicity of moniliformin, a synthesized compound, originally isolated from mouldy corn and soil samples in the Keshan disease prevalent area in China. Perfusion of moniliformin 10(-7) mol/liter in isolated heart decreased myocardial contractile force by 52 +/- 17%. Intravenous injection of moniliformin at 1/6 and 1/4 LD50 markedly inhibited cardiac hemodynamic variables relative to myocardial contractile function. Particularly, it decreased +/- LV dP/dt max by 52 +/- 6%, and induced ventricular arrhythmia. These data indicate that moniliformin is toxic to mammalian heart and might be an important factor relative to Keshan disease. PMID- 1764220 TI - The energy expenditure and nutritional status of college students. I. The energy cost and the total energy expenditure per day. AB - The energy cost of major activities was determined in healthy students. Among the 606 medical students, 319 were males and 287 were females. Their ages ranged from 18 to 24 years. Douglas' method was used to measure energy cost of each of a total of 42 activities, as well as that of the basal metabolic rates (BMR), resting metabolic rates (RMR) and the total energy expenditure per day under normal situations. The average RMR of male and female subjects were 0.669 +/- 0.033 and 0.656 +/- 0.030 kcal/sq.m/min respectively. The total energy expenditure per day of male students were 2706 kcal, and 2373 kcal for female students. The energy cost of single activities can be used as the basal data in studies of energy metabolism. PMID- 1764221 TI - Time related influence of alpha-mercapto-beta-(2-furyl)acrylic acid (MFA) in cadmium toxicity. AB - The effect of alpha-mercapto-beta-(2-furyl) acrylic acid (MFA, 200 mg/kg, oral) administered 30 min or 24 h post cadmium (1 mg/kg, i.p.) exposure on cadmium toxicity, was investigated in rats. The Cd induced hepatic metallothionein was reduced by MFA treatment parallel to the depletion of hepatic Cd. However, in renal tissue, MFA caused only redistribution of metal from the particulate to the soluble fraction. Hepatic and renal Zn and renal Cu were significantly increased on Cd exposure. MFA therapy, however, lowered the hepatic Zn and increased the renal Cu levels. The action of MFA appears to be via metal chelation rather than by MT induction. PMID- 1764222 TI - Studies on the mutagenicity of hair dyes made in China. AB - A total of 13 commercial hair dye products made in China were tested for mutagenicity in 2 short-term bioassays, the histidine-requiring mutants of Salmonella typhimurium (strains TA98 and TA100) and the micronucleus test with mouse bone-marrow polychromatic erythrocyte cells in vivo. The results showed that the 13 hair dyes were not mutagenic in strains TA98 and TA100 with and without S-9. In the micronucleus test, no mutagenic effect was observed. PMID- 1764223 TI - Signs and mechanisms of chlordane intoxication. AB - Chlordane is a cyclopentadiene-derived insecticide that exerts its toxic action on the nervous system. In experimental animals the characteristic signs of acute toxicity are hypothermia, hyperexcitability, tremors and convulsions. In human, signs of acute chlordane toxicity are tremors and convulsions. There have been many different signs of acute toxicity attributed to chlordane, however, there is no substantiation within the primary literature for them. The literature indicates a convulsive chlordane serum level of 3 ppm and fatal serum level exceeding 5 ppm in human. Chlordane toxic action is rapid, appearing within two hours of an acute dose with improvement and recovery after 24 hours. Chlordane intoxication does not result in delayed neurotoxic effects. There is discussion of the mechanism of action of chlordane's toxicity in the central nervous system. PMID- 1764224 TI - Teratogenicity studies of a new potent tetanus vaccine in rabbit (Oryctolagus cuniculus). AB - Glaxo Laboratories, Bombay, have prepared a potent tetanus vaccine of 250 Lf as a substitute of the previous 5 Lf tetanus vaccine. The safety evaluation of the vaccine has been reported, but the teratogenic potential was not studied. In the experiment reported herein we have studied the teratogenic action of the vaccine in the progeny of rabbits. No congenital anomalies were observed. PMID- 1764225 TI - Pharmacological studies of meisoindigo: absorption and mechanism of action. AB - Meisoindigo, an indirubin derivative, is a new type of cancer chemotherapeutic agent. It exhibited higher activity against rodent tumors than indirubin itself. Experiments have shown the improved absorption of meisoindigo, compared to indirubin to be one of the major reasons for the enhancement of antitumor activity. Studies on the mechanism of meisoindigo action indicate that it strongly inhibits DNA biosynthesis in tumor cells. Strong inhibition of the drug on assembly of microtubule protein was also obtained. By means of FCM technique the effects of meisoindigo on mouse leukemia L1210 cell cycle were examined. Experimental results showed that under the action of meisoindigo the S phase cells accumulated and the traverse of the cells in G2 + M phase to G1 phase may also be blocked to some extent. PMID- 1764226 TI - Chronic subdural haematoma. PMID- 1764227 TI - Chronic subdural haematoma treated by burr holes and closed system drainage: personal experience in 131 patients. AB - One-hundred and thirty-one patients with chronic subdural haematoma were treated by burr holes and closed system drainage. Four patients died, and in 19 patients postoperative complications were noted: intracranial hypotension in eight, cerebral oedema in four, haematoma recurrence in three, bronchopneumonia in three, and intracerebral haematoma in one. The high risk groups were those in grade III and IV on admission, and the elderly. Follow-up revealed that more than 80% of patients recovered completely, 10% still had neurological or mental deficits and 7% suffered epileptic seizures. PMID- 1764228 TI - Chronic subdural hematoma: pathophysiological basis for treatment. AB - Fifty-three consecutive adult patients treated surgically for chronic subdural hematoma are reviewed. The current understanding of the pathogenesis of chronic subdural hematoma is discussed. In the current neurosurgical literature, wide discrepancies exist, in patients treated by burr-hole evacuation, regarding the rate of subdural recollection. Possible factors responsible for these discrepancies include (1) failure to recognize and properly treat multiloculated chronic subdural hematomas, (2) too aggressive a surgical approach toward persistent CT-demonstrated but asymptomatic subdural residual or recurrent collections, and (3) failure to use corticosteroids in the post-operative management of patients with persistent or recurrent symptoms as a step prior to re-operation. A prospective controlled clinical trial of glucocorticoids in chronic subdural hematoma is needed to establish their place in the management of this condition. PMID- 1764229 TI - The Dandy-Walker syndrome: diagnostic and surgical considerations. AB - Thirteen cases of the Dandy-Walker syndrome were seen over a period of 12 years. In this study their preoperative evaluation, surgical treatment and outcome is reviewed. The incidence of hydrocephalus in the series was 77%. Eight of the patients had associated central nervous system anomalies, and the need to identify these abnormalities is stressed. Because the two conditions require different surgical management, during the diagnostic work-up it is crucial to differentiate between the Dandy-Walker syndrome and extra axial cerebrospinal fluid (CSF) filled cysts, and to establish the patency of the aqueduct. The reliability of different diagnostic methods is discussed and the value of metrizamide computed tomographic ventriculography is emphasized. Unsatisfactory results following membrane excision in early cases, and observations of CSF dynamic disturbances confirm the futility of the direct approach for the management of the Dandy-Walker syndrome. The aqueduct was invariably patent and allowed either primary cyst or ventricular shunting, although simultaneous double shunting using a 'Y' connector may need to be carried out later. The mortality rate for the series was 18%. At follow-up 54.5% of the children were judged to have normal IQs. PMID- 1764230 TI - Does nimodipine eliminate arterial hypertension as a prognostic risk factor in subarachnoid haemorrhage? AB - Several studies have demonstrated an association between arterial hypertension (AH) and an increased morbidity and mortality from both cardiovascular diseases and stroke (including subarachnoid haemorrhage, SAH). Among the functional disturbances implicated in hypertension much interest has been focused on the calcium handling in the vascular smooth muscle cells, and it has been proposed that a defect in the calcium gating mechanisms in the cell membrane is of major importance. Clinical trials have confirmed that calcium antagonists of the dihydropyridine type (nimodipine) are useful in preventing secondary ischaemia after SAH. The purpose of this retrospective study was to determine if the protective effect of nimodipine differs between normotensive and hypertensive patients focused on delayed ischaemia, total morbidity and mortality. In the group (137 patients) without nimodipine treatment 17 out of 31 individuals (55%) with AH had an unfavourable outcome. In the nimodipine group (also 137 patients) four out of 25 individuals (16%) with AH had an unfavourable outcome. In terms of vasospasm and delayed ischaemia only, the difference was even more evident. These results indicate that nimodipine seems to significantly reduce the prognostic difference between normo- and hypertensive individuals with an aneurysmal SAH. PMID- 1764231 TI - Delayed traumatic intracerebral hematoma. AB - Although delayed traumatic intracerebral hematomas (DTICHs) have been frequently reported since 1970, the time interval from trauma to hemorrhage and diagnosis has not been well defined. Eight patients with DITCH were found among 1,320 head injured patients admitted to the neurosurgical service through the emergency department from March 1989 to March 1990. The mean time interval between initial and follow-up CT scan was 22 h. The mean time interval between initial trauma and diagnosis of DITCH was 24 h. One patient was diagnosed incidentally by magnetic resonance imaging. Three patients underwent operation and five patients were managed conservatively. Three patients died, resulting in a case mortality rate of 37.5%. The time interval for DTICHs' development and pitfalls in its diagnosis were discussed. PMID- 1764232 TI - A medieval example of meningiomatous hyperostosis. AB - An archaeologically retrieved skeleton, a female aged 35-50 years, from medieval Rochester, displays osseous changes which are considered to be diagnostic of meningiomatous hyperostosis. The dry bone findings are supported by X-ray and CT scan evidence. A search of the palaeopathological literature reveals only seven other convincing examples. PMID- 1764233 TI - Long-term abolition of parkinsonian tremor following attempted ventriculography. AB - Three patients are described who were selected for stereotactic thalamotomy to alleviate the tremor and rigidity of Parkinson's disease but in whom these symptoms were abolished whilst attempting ventriculography. Discrete deep brain lesions were seen on post-operative CT scan and the basis for their relieving the patients' symptoms is discussed. Although the tremor and rigidity was abolished in these cases and a favourable result ensued, ventriculography is an invasive and potentially dangerous procedure and it is therefore recommended that CT derived thalamic targets should be employed for functional stereotaxy. PMID- 1764234 TI - Cysto-peritoneal shunt infection with Trichosporon beigelii. AB - Infection is a frequent problem affecting cysto-peritoneal shunts, the usual causative organisms being Staphylococcus epidermidis and Staphylococcus aureus. Fungi are rarely isolated from such infections. We present the first report, as far as the authors are aware, of a case of Trichosporon beigelii shunt infection that responded to shunt removal and antifungal therapy. PMID- 1764235 TI - Unusual sciatica: traumatic rupture of the ligamentum flavum. AB - We describe a case of acute traumatic rupture of the ligamentum flavum. A condition occurring where there had been histological evidence of previous ligamentous damage. The symptoms were extreme and the surgical treatment highly effective. PMID- 1764236 TI - Cranial tangential gunshot wounds. PMID- 1764237 TI - Management of chronic subdural haematoma. PMID- 1764238 TI - 3-Aminorhodanine and 2-hydrazino-2-imidazo-line hydrazones. Synthesis and antiparasitic pharmacology. AB - Two series of hydrazones were prepared by condensation of various aldehydes with 2-aminorhodanine (series 1) and 2-hydrazino-2-imidazoline (series 2). These compounds showed interesting antiparasitic activities against amoeba, trichomonas, leishmania and plasmodium. PMID- 1764239 TI - Absorption of some cephalosporins by rectal route in rabbits. AB - In order to obtain an effective alternative to parenteral administration of several cephalosporins, experiments were carried out in rabbits by rectal route. The suppositories of cefotaxime (CTX), ceftazidime (CAZ) and cefoxitin (CFX) in association with surface active sodium lauryl sulfate (SLS), release the antibiotic for absorption. Based on the positive results of the comparative plasmatic levels, this dosage appears to be applicable to humans too. PMID- 1764240 TI - [Non-steroidal anti-inflammatory agents. XXII. Chiral aryl-hydroxy fluorenylpropionic acids]. AB - As fluorenyl rigid analogues of previous biphenylyl alcanoic acids with very interesting antiinflammatory activity, the 3-(m-tolyl and m-anisyl)-3-hydroxy-3 (2-fluorenyl)-propionic acids have been prepared by means of the Reformatsky reaction and following hydrolysis of the obtained ethyl esters. The preliminary antiinflammatory assay showed that the structural modification inactivates the compounds. PMID- 1764241 TI - Identification of a developmentally regulated keratan sulfate proteoglycan that inhibits cell adhesion and neurite outgrowth. AB - Monoclonal antibodies have been used to identify a 320 kd keratan sulfate proteoglycan that is primarily expressed in the embryonic chick nervous system. Immunohistochemical localization of the proteoglycan shows that it is expressed by putative midline barrier structures in the developing chick central nervous system. When added to laminin or neural cell adhesion molecule that has been adsorbed onto nitrocellulose-coated dishes, the proteoglycan abolishes cell attachment and neurite outgrowth on these adhesive substrata. This effect can be reversed by keratanase treatment and incubation with a monoclonal antibody that recognizes the keratan sulfate chains of the proteoglycan. These data suggest that this neural keratan sulfate proteoglycan plays an important role in the modulation of neuronal cell adhesion during embryonic brain development. PMID- 1764242 TI - The stress protein response in cultured neurons: characterization and evidence for a protective role in excitotoxicity. AB - We used purified cultures of cerebellar granule cells to investigate the possible protective role of stress proteins in an in vitro model of excitotoxicity. Initial experiments used one- and two-dimensional polyacrylamide gel electrophoresis to confirm the induction of typical stress protein size classes by heat shock, sodium arsenite, and the calcium ionophore A23187. Immunoblot analysis and immunocytochemistry verified the expression of the highly inducible 72 kd heat shock protein (HSP72). Granule cell cultures exposed to glutamate showed evidence of cellular injury that was prevented by the noncompetitive NMDA antagonist MK-801, yet glutamate did not induce a detectable stress protein response. Nonetheless, preinduction of heat shock proteins was associated with protection from toxic concentrations of glutamate. These results imply that the HSP72 expression observed in in vivo models of excitotoxicity may not be directly related to the effects of excitatory amino acids. However, the ability of stress protein induction to protect against injury from glutamate may offer a novel approach toward ameliorating damage from excitotoxins. PMID- 1764243 TI - The homeodomain LIM protein Isl-1 is expressed in subsets of neurons and endocrine cells in the adult rat. AB - We have used immunocytochemical methods to localize the homeodomain LIM protein Isl-1 in the adult rat. Isl-1 immunoreactivity is expressed in polypeptide hormone-producing cells of the endocrine system, in neurons of the peripheral nervous system, and in a subset of brain nuclei. Isl-1 is also expressed in a subset of motoneurons in the spinal cord and brain stem, but not in regions of the central nervous system involved in sensory function or in neocortical areas. The pattern of expression of Isl-1 suggests that this gene may be involved in the specification and maintenance of differentiated phenotypical properties of these cells. PMID- 1764244 TI - Target-dependent morphological segregation of Aplysia sensory outgrowth in vitro. AB - The adult nervous system is characterized by partial or complete morphological segregation of terminals from different afferent neurons innervating the same postsynaptic target. This segregation is thought to result, in part, from competition between the afferent terminals. To explore the role of the target cell in the spatial distribution of presynaptic inputs, the sensory neurons of Aplysia were cultured either with or without a common target motor neuron. In the presence of a common target, the outgrowth from two different sensory neurons tends to occupy separate postsynaptic regions. When cultured without a target motor neuron, processes from different sensory neurons do not segregate, but rather grow freely along one another. Thus, morphological segregation of sensory outgrowth requires interaction with a target neuron and may reflect competition between presynaptic terminals for a limited number of synaptic sites on the motor neuron, or for a postsynaptic trophic factor. PMID- 1764245 TI - NGF and EGF rapidly activate p21ras in PC12 cells by distinct, convergent pathways involving tyrosine phosphorylation. AB - Activation of p21ras, demonstrated directly as an increase in p21ras-associated GTP, was induced rapidly but transiently by both nerve growth factor (NGF) and epidermal growth factor (EGF) in PC12 cells. The factors activate p21ras to equal extents and with virtually identical time courses. Growth factor-induced p21ras activation and tyrosine phosphorylation have similar time courses and sensitivities to genistein inhibition, indicating that p21ras activation is a result of tyrosine kinase activity. Furthermore, PC12 mutants lacking the Trk NGF receptor tyrosine kinase also lack NGF-inducible p21ras activation. The protein kinase inhibitor K252a and the methyltransferase inhibitor MTA abolish NGF induced, but not EGF-induced, p21ras activation--effects correlated with inhibition only of NGF-induced tyrosine phosphorylation. In spite of differences in sensitivity to genistein, MTA, and K252a, EGF- and NGF-stimulated p21ras activation are not additive, implying that they do share at least one step in common. PMID- 1764246 TI - Birth and differentiation of reticular neurons in the chick hindbrain: ontogeny of the first neuronal population. PMID- 1764248 TI - Fibroblast-dependent differentiation/proliferation of mast cells. AB - Fibroblast-dependent differentiation and proliferation of mast cells were reviewed from the viewpoint of mast cell-deficient mutant animals. Mice of W/Wv, Sl/Sld or mi/mi genotype are deficient in mast cells. However, since T cell dependent differentiation and proliferation of mast cells are intact in these mutant mice, mast cells do develop when bone marrow cells of these mutant mice were cultured in the presence of T cell-derived growth factors. Cultured mast cells (CMC) of W/Wv mice cannot receive the proliferative stimulus from fibroblasts whereas fibroblasts derived from Sl/Sld embryos cannot provide normal (+/+) CMC with the proliferative stimulus. The W locus encodes a tyrosine kinase receptor and the Sl locus the ligand for the receptor. Although +/+ CMC acquire the phenotype resembling connective tissue-type mast cells when cocultured with fibroblasts in medium containing T cell-derived growth factors, mi/mi CMC do not. We recently found a mast cell-deficient mutant of rats. Biological features of the mast cell-deficient rats were very similar to those of W/Wv mice. The mast cell-deficient mutant animals are invaluable tools for investigations of differentiation/proliferation and functions of mast cells. PMID- 1764247 TI - Tip-link integrity and mechanical transduction in vertebrate hair cells. AB - An attractive hypothesis for hair-cell transduction is that fine, filamentous "tip links" pull directly on mechanically sensitive ion channels located at the tips of the stereocilia. We tested the involvement of tip links in the transduction process by treating bundles with a BAPTA-buffered, low-Ca2+ saline (10(-9) M). BAPTA abolished the transduction current in a few hundred milliseconds. BAPTA treatment for a few seconds eliminated the tip links observed by either scanning or transmission electron microscopy. BAPTA also eliminated the voltage-dependent movement and caused a positive bundle displacement of 133 nm, in quantitative agreement with a model for regulation of tension. We conclude that tip links convey tension to the transduction channels of hair cells. PMID- 1764249 TI - Mast cells and their mediators in immediate and delayed immune reactions. AB - Tissue mast cells and the closely related blood basophils are distinguished by their special mediators and their high-affinity IgE membrane receptors. These properties have made the cells be viewed traditionally as effector cells of immediate-type hypersensitivity reactions. More recently, mast cells have been shown to develop from the myeloid series of the bone marrow under the influence of interleukins 3, 4, 6, 9, 10 and 11. Mast cell and basophil lines of murine and human origin have also been shown to express and release interleukins 1, 3, 4, 5, 6, 8, tumor necrosis factor-alpha, granulocyte-macrophage colony-stimulizing factor and interferon-gamma. Certain cytokines are also able to induce mediator release from mast cells. Furthermore, mast cells have in the past been shown to be modestly phagocytic and to express major histocompatibility complex class II membrane markers after appropriate stimulation. These findings show that mast cells are intricately associated with immune reactions and suggest that they may not only sustain and modulate but possibly also initiate immune responses. PMID- 1764250 TI - Immunohistology of human allergic late-phase skin reactions. AB - Human late-phase allergic skin reactions (LPSR) are characterised histologically by a mixed infiltrate of granulocytes and mononuclear cells. Quantitative immunohistology reveals a correlation between the numbers of CD4+ T-cells and the number of activated eosinophils at LPSR sites. These CD4+ T-cells are predominantly CD45RO+ and belong to the 'memory' T-cell subset. Immunofluorescence studies indicate that type III (immune complex) mechanisms make no significant contribution to the LPSR. On the other hand, the LPSR and classical delayed-type hypersensitivity (DHT) both have a marked CD4+ T-cell component. T-cell infiltration is a more diffuse process in DTH than in the LPSR; between 24 and 48 h, DTH sites show a further increase in T-cell numbers with the appearance of CD8+ T-cells and an influx of monocytes. Activated eosinophils are present in the early stages of both LPSR and DTH, but are more prominent in the LPSR. These different patterns of cellular infiltration and activation are probably due to differences in the cytokine secretion pattern of the infiltrating T-cells. Detailed analysis of this hypothesis will require the use of in situ hybridization techniques. PMID- 1764251 TI - Coculture of neoplastic and normal keratinocytes as a model to study tumor promotion. AB - In order to study skin tumor promotion, a cell culture model system analogous to initiated mouse epidermis was developed. Keratinocytes of the neoplastic cell line 308 display the initiated phenotype since papillomas are produced when the cells are grafted to the backs of athymic mice. Coculture of a small number of these initiated cells with confluent normal keratinocytes results in the suppression of growth of colonies of 308 cells. This inhibition, which is calcium dependent, epidermal cell specific, and requires cell contact, can be overcome by exposure to various tumor promoters. Promoters and antipromoters of diverse structure and mechanism of action are recognized in this keratinocyte coculture model. PMID- 1764252 TI - Ultraviolet radiation and the development of non-melanoma and melanoma skin cancer: clinical and experimental evidence. AB - Clinical and experimental evidence explaining and supporting the role of UV radiation as a causal factor for the induction and promotion of nonmelanoma and malignant melanoma skin cancer are presented. While there is excellent animal experimental data and human epidemiologic evidence supporting the causal relationship of UVR (UVB, as well as UVA radiation) for basal and squamous cell carcinomas, the data establishing a direct causal relationship between melanoma and exposure to sunlight appear to be complex. They do, however, suggest a definite promotional role of sunlight in the causation of melanoma. Using a hairless pigmented mouse strain (Skh-hr2), experiments were initiated to examine the role of UVR in the induction of melanoma. A single application of DMBA as an initiator and subsequent thrice-weekly exposures to either UVB (290-320 nm) or UVA (320-400 nm) or the combined exposures of UVA and UVB resulted in the formation of blue nevus-like lesions. Repeated UVR exposures for over 30 weeks resulted in the development of melanoma (38%), as well as lymphoma and squamous cell carcinoma only in those mice that were pretreated with DMBA and had developed nevi. Mice receiving UVB, UVA, or the combination treatments of UVB plus UVA without DMBA pretreatment developed papillomas and squamous cell carcinoma but no melanoma. These studies indicate that some initiation event is essential to transform melanocytes to blue nevus-like lesions before UVR (UVB + UVA) can act as a promoter and accelerate the development of malignant melanoma, as as well as lymphoma. PMID- 1764253 TI - Cutaneous NAD(P)H: quinone reductase: a xenobiotica-metabolizing enzyme with potential cancer and oxidation stress-protecting properties. AB - The toxicity of quinones--including certain chemotherapeutic agents such as doxorubicin--have been related to the enzymatic or nonenzymatic formation of the corresponding semiquinones and their subsequent reaction with molecular oxygen yielding superoxide anion radicals by spontaneous regenerating of the quinones. This semiquinone redox cycling is prevented by the NAD(P)H:quinone reductase (NQR; EC 1.6.99.2) because it mediates a 2-electron reduction which results in the formation of hydroquinones instead of semiquinones. Interestingly, inducers of this enzyme such as butylated hydroxytoluene protect against the severe ulceration of accidental infiltration of doxorubicin into the area around the intravenous infusion. Recently, it has been shown that this highly protective enzyme has a very high basal activity in the epidermis which is in the same range as in the liver. The human gene of the NQR is localized on chromosome 16 and has been cloned recently as well as the gene of the murine liver NQR. We determined NQR in the cytoplasma of murine skin, liver, and human keratinocytes using 2,6 dichlorophenol-indophenol as substrate. In order to characterize this enzyme, induction by polycyclic hydrocarbones and inhibition with several known inhibitors of dihydrodiol dehydrogenase, aldo-keto and carbonyl reductase activities were determined. There was a similar pattern of inhibition of the basal and induced activity in all tissues so far investigated. Pyrazole, progesterone and phenobarbital did not inhibit; however, rutin and indomethacin inhibited dose-dependently. The most potent inhibitor was dicoumarol. These findings suggest that the same enzymatic form is present in liver and skin, and in murine skin and human keratinocytes. PMID- 1764254 TI - Congenital disorders of the extremities. PMID- 1764255 TI - Developmental disorders of the extremities. PMID- 1764256 TI - Avascular necrosis and related conditions. PMID- 1764257 TI - Fibrous lesions of the extremities. PMID- 1764258 TI - Chondroid lesions of the extremities. PMID- 1764259 TI - Osteoid lesions of the extremities. PMID- 1764260 TI - Miscellaneous disorders of the extremities. PMID- 1764261 TI - Molecular cloning and structure of the human transforming growth factor-beta 2 gene promoter. AB - Genomic DNA extending over 10 kb 5' of the transforming growth factor-beta 2 (TGF beta 2) coding region was isolated from a human lung fibroblast lambda phage library. A 5.6 kb Hind III fragment containing the 5'-untranslated region and flanking sequences was subcloned and sequenced. S1 nuclease protection analysis identified a transcriptional initiation site 1357 nucleotides 5' of the methionine initiation codon (ATG). A "TATA box" consensus sequence was identified 30 bp from this transcriptional start site; however, consensus "CAT box" sequences were not observed. Approximately 50 nucleotides of homopurine pyrimidine [d(GA.CT)50] sequence were identified in the 5'-untranslated region, as well as two short open reading frames of 5 and 45 amino acids. Several AP-1, AP-2, CRE and SP1-like DNA consensus sequence elements were also identified surrounding the transcription initiation site. 5'-deletion mutants of the promoter region were fused to the chloramphenicol acetyl transferase (CAT) gene and promoter activity of the isolated genomic DNA was demonstrated in several cell lines. DNA constructs containing nucleotides between -508 to +63 demonstrated high levels of promoter activity. However, sequences between -778 and -508 nucleotides modulated this promoter activity in a manner which was dependent upon the cell line utilized, suggesting that regulation of TGF-beta 2 gene transcription may be dependent upon the cellular background. The TGF-beta 2 promoter is markedly different from the promoters that have been recently characterized for TGF-beta 1 and TGF-beta 3. PMID- 1764262 TI - Growth factor-induced proliferation of osteoblasts measured by bromodeoxyuridine immunocytochemistry. AB - Immuno-localization of BUdr was used to identify DNA synthesis in vitro in chicken embryonic bone cells stained positively or negatively for alkaline phosphatase activity. The results were similar to, but more sensitive than, our standard bioassay which assesses 3H-thymidine incorporation into DNA by liquid scintillation counting, and more rapid than autoradiographic localization of 3H thymidine. SGF/IGF-II and bFGF stimulated cellular proliferation equally in ALP(+) and ALP(-) cells. In contrast, IGF-I and TGF-beta stimulate proliferation more in the ALP(-) than ALP(+) cells. The greatest increase in DNA replication of ALP(-) cells occurred following incubation with SGF/IGF-II or TGF-beta, and in the ALP(+) cells with SGF/IGF-II or bFGF. TGF-beta stimulated cellular proliferation at the lowest dose (1 ng/ml). The differential effect of the growth factors on each population of cells indicates that all these bone-matrix derived growth factors may play different roles in the local regulation of skeletal metabolism. PMID- 1764263 TI - Multiple forms of bFGF: differential nuclear and cell surface localization. AB - The single copy gene for human basic fibroblast growth factor (bFGF) has been shown to encode not one but multiple proteins of 24, 23, 22 and 18 kD. Although bioactivities of the 18 kD protein are currently used to define bFGF gene function, it is not yet known if the three larger proteins have these same bioactivities or whether they will serve to define new bFGF gene functions. In this report we present a comparative study describing the de novo synthesis, transport, processing and intracellular location of individual bFGF isoforms. Data from cDNA mutagenesis and COS cell expression experiments show that individual isoforms are differentially localized to either the cell surface or to the nucleus. The 24, 23 and 22 kD proteins (CUG-mediated initiation) exclusively localize in the nucleus while the 18 kD protein (AUG-mediated initiation) is preferentially exported onto the cell surface, but is not released into the surrounding culture medium. Specific CUG or AUG translation initiation codons are necessary and sufficient for the synthesis of each isoform examined and thereby, indirectly, mediate differential localization. Since bFGF does not contain the characteristic signals predicted for cell surface or nuclear targeting, our continuing studies will either unmask its functionally equivalent domain(s) or will identify the requisite participation of yet unknown cellular components. PMID- 1764264 TI - Functional characterization of the human basic fibroblast growth factor gene promoter. AB - In order to understand the regulation of basic fibroblast growth factor (bFGF) gene expression, we have cloned and characterized the human bFGF gene and its regulatory elements. Using restriction endonuclease digestion, we have mapped the entire gene and sequenced all intron/exon boundaries to confirm authenticity and to determine organization. The data show that intron 1 is at least 16 kb long while intron 2 is 16 kb long. The human bFGF gene, including its three exons, is therefore at least 36 kb long. There are five GC boxes which may represent SP-1 binding sites and one potential AP-1 binding site within the core promoter region. Primer extension analysis indicates the presence of one bFGF-RNA transcription start site. We used a standard bacterial CAT gene expression system to identify the DNA sequence containing the functional bFGF gene promoter. Deletion analysis suggests the presence of two negative regulatory elements; one in the non-transcribed 5'-promoter region and the other within transcribed (but non-translated) sequences 3' of the promoter core. PMID- 1764265 TI - Regulatory mechanisms for the expression of a functional beta chain of interleukin 2 receptor on T4 chronic lymphocytic leukemia cells. AB - Monoclonal antibodies, each recognizing interleukin 2 receptor (IL-2R) alpha, or beta, were used to see the regulatory mechanisms of the expressions on leukemic cells from a patient with T4 chronic lymphocytic leukemia (T4-CLL). Cells from this patient expressed only IL-2R beta, and the expression was enhanced by medium cultivation. IL-1 enhanced the expression of not only IL-2R beta but also IL-2R alpha on the cells. Binding studies using 125I-IL-2 showed the presence of an intermediate receptor (734 sites/cell, Kd = 1.2 nM) and a few high-affinity receptor (172 sites/cell, Kd = 132 pM) on cells cultured with IL-1. IL-2 and IL-1 synergistically promoted the proliferation of the cells, suggesting that the induced IL-2R was functional. In addition, anti-IL-1 antibodies inhibited IL-2R beta expression by cultured cells, suggesting that it was dependent on IL-1 produced by the leukemic cells. These findings suggested that IL-1 might enhance the expression of IL-2R beta in a subset of human T cells, and implied a role of IL-1 in the proliferation of the leukemic T cells. PMID- 1764266 TI - Superoxide dismutase specifically inhibits erythroid cell DNA synthesis and proliferation. AB - The antioxidant enzyme superoxide dismutase (SOD) was previously shown to inhibit both the proliferation of murine erythroid DA-1 cells growing in the presence of Interleukin-3 (IL-3) and the DNA synthesis of marrow erythroid progenitor cells (BFU-E) in vitro. We show here that the inhibition of marrow cell DNA synthesis by SOD is specific for BFU-E and erythroid precursors (CFU-E), with other myeloid progenitors (CFU-GM) and stem cells (CFU-S) being unaffected, and IL-3 blocks the inhibitory effects of SOD on BFU-E in a dose-dependent manner. Extending earlier observations on the effects of SOD on cell proliferation, it was found that SOD was capable of inhibiting DA-1 cell proliferation supported by either IL-3 or erythropoietin (epo), but had no effect on IL-3 dependent FDCP-1 cells, nor on epo-dependent HCD-57 cells. Of several murine erythroleukemia cell lines tested, only those transformed with Friend SFFVa virus were inhibited by SOD, while those transformed with Friend SFFVp or MuLV virus were not affected. These results show that the effects of SOD are not antagonistic to particular growth factors but rather the inhibition is specific for erythroid cells, and cells of the proper stage can be inhibited even if they have been transformed to factor independence. PMID- 1764268 TI - Prognosis of breast cancer with small primary tumor (pT1). AB - Prognosis of 141 women with pT1 breast cancer from a defined urban area was investigated. Only one of the 47 women with a primary tumor diameter less than or equal to 10 mm in diameter (pT1a or pT1b) died from breast cancer within 5 years after the diagnosis. The 5-year survival rate corrected for intercurrent deaths of the women with pT1c cancer (from 11 to 20 mm in diameter, n = 94) was 83%; 96% in pT1cN0 and 62% in pT1cN+ cancer respectively (p less than 0.0001). In a multivariate analysis axillary nodal status and S-phase fraction determined by flow cytometry were independent prognostic factors. The excellent survival of women with pT1a or pT1b breast cancer, and women with pT1cN0 breast cancer with no axillary nodal metastases, does not support the policy of giving adjuvant treatment to all women with breast cancer. PMID- 1764267 TI - Growth factors acting via tyrosine kinase receptors induce HSP90 alpha gene expression. AB - Hsp90 is a heat-shock protein constitutively expressed in most cells. Besides regulation by thermal stress, the expression of hsp90 is also positively regulated by developmental and mitogenic stimuli. The effect of serum and insulin on protein and hsp90 alpha-mRNA levels has been studied in the chicken hepatoma cell line DU249. The culture of cells in serum-free medium resulted in a decrease of hsp90 alpha-mRNA level. A transient increase was observed at 6-9 h after serum restimulation. The expression of hsp90 gene was also increased by insulin alone in a dose-dependent manner and was maximum between 6 and 9 h treatment. The insulin induced increase of hsp90 alpha-mRNA was suppressed by cycloheximide (10 micrograms/ml) but not by an inhibitor of DNA synthesis, demonstrating that this induction requires protein neosynthesis. In serum starved cells, other growth factors (IGF1, EGF and bFGF) showed a positive effect on hsp90 alpha-mRNA level which took place before DNA synthesis with the same time-course as that of insulin. With PDGF, the induction of hsp90 alpha-mRNA occurred earlier. The time interval between the maximum of hsp90 alpha-mRNA induction and that of DNA synthesis was the same for all growth factors studied. From these results, we conclude that growth factors acting via tyrosine kinase receptors up-regulate hsp90 alpha-mRNA level in a DNA synthesis independent manner, possibly in late G1. PMID- 1764269 TI - Cytosol albumin content in operable breast cancer. Correlations to steroid hormone receptors, other prognostic factors and prognosis. AB - Albumin content has been reported to be significantly different in cytosols from benign and malignant breast tumors, with a higher level in benign lesions. Low albumin content is suggested to be associated with a higher tendency to axillary nodal involvement in breast cancer patients. Albumin contributes greatly to the total amount of protein in tumor cytosol, and is easily measured. Albumin was measured in cytosols from 382 patients with breast cancer stage I and II, to evaluate correlations to other tumor variables and to investigate whether it may add information as a prognostic factor. The albumin content was expressed in percentages of total cytosol protein, with a median value of 18.5% for the study population. It was found to be significantly inversely correlated to estrogen receptor (ER) content. Cytosol protein content was inversely correlated to albumin. In addition to tumor size and axillary nodal involvement, albumin content was found to be an independent prognostic factor for relapse-free survival in an analysis of different prognostic variables in patients not given adjuvant endocrine treatment. Low albumin content (less than median) seems to predict effect of adjuvant tamoxifen treatment. PMID- 1764270 TI - Electrical potential difference across the stomach wall and gastric morphology in anaesthetized pigs after intravenous administration of cytotoxic drugs. AB - Nausea and vomiting are frequent side-effects of cancer chemotherapy. To investigate whether such therapy has an acute toxic effect on the gastric mucosa, cyclophosphamide, epirubicin and fluorouracil were administered intravenously to anaesthetized pigs. Gastric mucosal function was evaluated by continuous measurements of the gastric transmucosal electrical potential difference (PD) and the intragastric pH by using a newly developed microelectrode principle. After sacrifice, gastric histology was examined. During chemotherapy a significant decline in gastric PD was observed two hours after drug infusion, indicating a hampered gastric mucosal function. Apart from a slight hyperemia, gastric histology was normal. In this animal model a change in gastric mucosal function developed at the same time after chemotherapy as the gastric side-effects in humans. PMID- 1764271 TI - Changes in the gastric potential difference during chemotherapy in patients with metastatic breast cancer. AB - Nausea and vomiting are frequent side-effects of intravenous cancer chemotherapy. How these complications were related to the gastric mucosal function was investigated by measuring the gastric mucosal potential difference (PD). Eight patients with metastatic breast cancer receiving chemotherapy were investigated. The liquid junction-corrected gastric PD and pH were measured with a newly developed microelectrode. The measurements started half an hour before chemotherapy and continued for 4-5 hours. Nausea, vomiting, psychological stress and sleeping episodes were registered. The initial PD values were -34 mV +/- 8 mV (mean +/- SD). During the observation period 6 of 8 patients had one or more episodes of nausea and vomiting. All episodes were preceded by a significant decline in PD. The magnitude of the decline in PD was unrelated to the time-lag between administration of chemotherapy and the occurrence of nausea and vomiting, and there was no correlation between the time for these episodes and the time for the administration of the chemotherapy. One patient had three episodes of severe psychological stress causing a marked decline in PD. The last patient experienced no nausea, vomiting or stress and had no changes in PD. During sleeping periods PD increased significantly. PMID- 1764272 TI - Relationship between plasminogen activators and stomach carcinoma stage. AB - The antigen levels of plasminogen activators (PAs), tissue-type PA (t-PA) and urokinase-type PA (u-PA), were measured in extracts from 30 gastric carcinomas and corresponding normal gastric mucosa. The t-PA level was significantly higher in normal mucosa than in cancer tissue, while the u-PA level was significantly higher in cancer tissue. The u-PA level increased with increasing tumor stage, and there was a significant difference between early and advanced cancer. The u PA level also increased with the degree of nodal involvement, and it was higher in undifferentiated tumors than in well-differentiated ones. It was higher in cases with venous invasion, liver metastasis or peritoneal dissemination than in cases without these features. PMID- 1764273 TI - Trofosfamide in non-Hodgkin's lymphoma. A phase II study. AB - Twenty-three patients (12 females, 11 males) with malignant non-Hodgkin's lymphoma were treated with oral trofosfamide 50 mg t.i.d. Median age was 72 years. Fifteen patients had low-grade and 8 had high-grade lymphomas. Twenty-one patients had stage III and IV disease. Seven patients had WHO performance status of 3-4. The overall response rate was 61% (CR 22%, PR 39%) and the median duration of response 4 months (range 1.5-15+). The main side-effect was bone marrow depression and 7 patients experienced grade II or III hematological toxicity. No gastrointestinal or renal toxicity, no hair loss and no neurotoxicity were observed. The subjective tolerance was good. PMID- 1764275 TI - Proliferation of normal and malignant human epithelial cells post irradiation. AB - Fragments of human oesophageal mucosa, urothelium, squamous and adenocarcinoma of the oesophagus and carcinoma of the bladder have been plated in culture and irradiated. The cells growing from the explanted tissues have then been studied for four weeks post irradiation to assess the overall rate of growth from the irradiated explants and the fraction of proliferating cells. The results show that when using cell number as an endpoint it is possible to derive growth curves from this type of data which permit a doubling time to be obtained for the cell population surviving different doses. In an attempt to determine the proliferating fraction of the cell population, cultures were labelled at appropriate intervals with tritiated thymidine and were also stained with Ki-67 antiproliferating antigen. The results show an interesting relationship between the dose response obtained for cell labelling with tritiated thymidine and area of cellular outgrowth. Ki-67 staining when used carefully and analysed as described was a useful indicator of proliferating cells. The results provide a means of determining the post irradiation growth potential of fragments of tissue from human organs and may be important for determined overall response of the tumour bulk to proposed treatment. PMID- 1764274 TI - ProMACE-C-MOPP in aggressive non-Hodgkin's lymphoma. Long-term results in 45 patients treated in a single institution. AB - Forty-five previously untreated patients with intermediate or high-grade non Hodgkin's lymphoma were treated with the Pro-MACE-C-MOPP regimen (flexitherapy). The median age of the patients was 51 years, 51% had constitutional symptoms, 78% were in Ann Arbor stage III-IV, 40% had two or more involved extranodal sites and 87% had serum lactate dehydrogenase (LDH) above 225 U/l. Twenty-two (49%) patients had immunoblastic lymphoma (Working Formulation). Overall, 40% of the patients attained complete response (CR) and there were no relapses. The dose limiting toxicity was myelosuppression (69% of the patients with WBC less than 1.9 x 10(9)/l). Three deaths were attributed primarily to chemotherapy, but another two patients died of long-term complications of therapy. After a median follow-up of 50 months (18-80), 15 patients (33%) were alive without lymphoma. Only histologic subtype (intermediate vs. high) and abdominal involvement were prognostic factors for CR rate. Our results indicate that ProMACE-C-MOPP is an effective regimen for intermediate-grade lymphomas. However, in high-risk patients the regimen seems to be less effective than originally reported. PMID- 1764276 TI - Dissolution time for three formulations of cyclophosphamide powder for injection. PMID- 1764277 TI - Cerebral metastases from multiple myeloma. PMID- 1764278 TI - Estrogen receptors in gastric cancer. PMID- 1764279 TI - 'Professional integrity'. PMID- 1764280 TI - Inappropriate use of the term 'Asian': an obstacle to ethnicity and health research. PMID- 1764281 TI - Travel-associated hepatitis A: effect of place of residence and country visited. AB - The association between hepatitis A and domestic or international travel from Italy was investigated. Data from a nationwide surveillance system (SEIEVA) for type-specific acute viral hepatitis were used to compare 1102 hepatitis A cases with 3671 hepatitis B cases. An association between hepatitis A and travel was found in northern Italy, where most young and adult people are susceptible. Estimates of odds ratios vary dramatically according to geographical area of travel. Travellers to Mediterranean countries, Eastern Europe, Africa, Asia, and South and Central America had the highest education and age-adjusted odds ratios for hepatitis A, ranging from 6 to 25. Prophylaxis against hepatitis A for such travellers is recommended. PMID- 1764282 TI - A treatment service for minor injuries: maintaining equity of access. AB - Many studies have indicated that inner-city Accident and Emergency departments treat a large number of patients with minor injuries who do not require their specialized skills. However, if these patients are to be persuaded to go elsewhere then an acceptable alternative service must first be made available to them. This paper describes the events that surrounded the closure of Ancoats hospital Accident and Emergency department in North Manchester and the subsequent opening of a nurse-run minor injuries treatment service in a new community clinic. It provides a detailed review of the workload over the first six months and concludes that the treatment service is popular with the community and is used appropriately by the vast majority of attenders. Estimates of the average cost of attendance are given. A nurse-run treatment room is recommended as an acceptable alternative service for the treatment of minor injuries. PMID- 1764283 TI - Study to examine the timeliness of care received by patients with open fractures of the lower limb. AB - The aim of this study was to identify deficiencies in the timeliness of emergency care received by patients with open fracture of the lower limb treated in the Accident and Emergency department at the City Hospital Truro, to help decide whether further investments in emergency ambulance services are warranted and, if so, where specific investments should be made. The ambulance service 'response time', 'on-scene times' and 'mission times', and the 'time to operation after attendance in casualty' were considered. The major deficiency in care identified was the long in-hospital delay before operation, probably resulting from unavailability of operating theatre staff. A lesser deficiency was that ambulance crew seemed to be spending too long on-scene. Suggestions are made on how to identify weaknesses in emergency service, and thus prevent costly and inappropriate investments. PMID- 1764284 TI - The effects of demographic shift on coronary heart disease mortality in a large migrant population at high risk. AB - Asian immigrants to the United Kingdom and elsewhere are at greater risk of mortality and morbidity from coronary heart disease (CHD) than UK whites. This predisposition has yet to be explained. More than 63,000 Asian people, a high proportion of whom are under 40, live in Leicester. Projections of the local Asian and non-Asian populations indicate that numbers of Asian people in higher risk age groups will more than double between 1988 and 2008. In the absence of effective intervention, numbers of CHD deaths among Asian people, and the prevalence of other manifestations of CHD in this group, will rise by an equivalent amount. This predicted shift in the ethnic distribution of CHD has important implications for the planning of acute services in Leicester. Our predictions also demonstrate both a valuable opportunity and a pressing need for local research into the aetiology of CHD among Asian people, upon which preventative strategies may be based. PMID- 1764285 TI - A framework for investigating geographical variation in diseases, based on a study of Legionnaires' disease. AB - Demonstration of geographical variations in disease can yield powerful insight into the disease pathway, particularly for environmentally acquired conditions, but only if the many problems of data interpretation can be solved. This paper presents the framework, methods and principles guiding a study of the geographical epidemiology of Legionnaires' Disease in Scotland. A case-list was constructed and disease incidence rates were calculated by geographical area; these showed variation. Five categories of explanation for the variation were identified: short-term fluctuations of incidence in time masquerading as differences by place; artefact; and differences in host-susceptibility, agent virulence, or environment. The methods used to study these explanations, excepting agent virulence, are described, with an emphasis on the use of previously existing data to test hypotheses. Examples include the use of mortality, census and hospital morbidity data to assess the artefact and host susceptibility explanations; and the use of ratios of serology tests to disease to examine the differential testing hypothesis. The reasoning and process by which the environmental focus of the study was narrowed and the technique for relating the geographical pattern of disease to the putative source are outlined. This framework allows the researcher to plan for the parallel collection of the data necessary both to demonstrate geographical variation and to point to the likely explanation. PMID- 1764286 TI - The health care reform in Czechoslovakia after 17 November 1989. AB - This paper describes the present state and discusses the future prospects of the Czechoslovak health services. The crisis in the state of health of the Czechoslovak population is briefly outlined and the main conditions of the social transformation are considered. The key features of the proposed new system of health care in the Czech republic are critically evaluated. Collaboration with individuals and institutions in the United Kingdom in the preparation, evaluation and implementation of the consecutive stages of this reform will be much appreciated. PMID- 1764287 TI - Evaluation of the effect of the removal of the family income supplement (FIS) free school meal on the food intake of secondary schoolchildren. AB - Four secondary schools in Southampton were chosen to study the effect of the changes in Social Security regulations in April 1988 on the food intake of schoolchildren. A self-completed questionnaire asking about food intake throughout the previous school day was given to each child by the form teacher on two occasions; one in March 1988 and again after the benefit changes in May 1988. All children who were entitled to a Family Income Supplement (FIS) free school meal in March were included in the study. This group (n = 50) was compared with an age- and sex-matched group of children entitled to a Supplementary Benefit (SB) free school meal (n = 49) and a control group (n = 100) of children. Before the benefit changes there were a few differences between the groups, mainly in the control group, who had different foods at lunchtime. After the benefit changes only 10 per cent of the FIS group had a school lunch compared with 66 per cent before. The major changes were at the lunchtime meal, with fewer in the FIS group eating burgers, pies, chips and ice-cream, and more eating crisps, sandwiches and fruit than had done so before the benefit changes. PMID- 1764288 TI - The South West Thames Regional Health Authority approach to the method of audit in public health medicine. AB - Following the Faculty Training Conference on Audit in March 1990, South West Thames Region set up a Working Group to develop a framework for audit in Public Health Medicine that could be adopted across the Region. This paper outlines the methodology used by the Working Group, introducing the concept of an 'Audit Tree', and describes how audit in Public Health Medicine can be approached using such a model. PMID- 1764289 TI - Low immunization uptake rates in an inner-city health district: fact or fiction? AB - Immunization uptake rates are assuming considerable importance as performance indicators for district health authorities (DHAs) and general practitioners (GPs). Data from the Cover of Vaccination Evaluated Rapidly (COVER) programme suggest that immunization uptake rates in innercity districts are well below the 90 per cent target. Using Parkside DHA, a district with consistently poor uptake, as an example, this paper has examined the accuracy of the Child Health Computer (CHC) records on which the COVER figures are based. In October 1989 a cohort of 1485 children born between April and June 1988 were identified. The 462 children identified by the CHC as immunization defaulters (using diphtheria and tetanus immunizations) were followed up by contacting child health clinics, GP surgeries and parents. This exercise revealed that 195 children were in fact immunized and 176 children were erroneously listed, largely because they were no longer resident at the address given. Only a small proportion of this information had reached the CHC by the end of the follow-up period. In addition to high population mobility, information inaccuracies appeared to be caused partly by a failure in data transfer between GPs and the DHA and by failures in data transfer between districts. Overall, the results of the study suggest that there is a considerable discrepancy between actual and recorded immunization uptake levels in Parkside and probably other inner-city areas. This will have a considerable impact on GPs and other health professionals who are striving to achieve 90 per cent targets. PMID- 1764290 TI - Which deprivation? A comparison of selected deprivation indexes. AB - A number of indexes of deprivation which have been devised or adopted for use by the health services are examined in relation to their performance in explaining the variation observed in a range of health measures, using data for postcode sectors in Scotland. The Scottish deprivation score and the Townsend index are found to explain most variation, and to adhere most closely to the concept of material disadvantage. The Jarman score is less effective as a result of the inclusion of individual variables which are seen to correlate very weakly, even negatively, with the health indicators. The use of these measures in relation to resource allocation and the new GP contract is discussed. PMID- 1764291 TI - Audit in primary care--new structures, new processes. PMID- 1764292 TI - Quarterly communicable disease review April to June 1991. From the PHLS Communicable Disease Surveillance Centre. PMID- 1764293 TI - Plus ca change, plus c'est la meme chose. PMID- 1764295 TI - Displaying risk and odds ratios. PMID- 1764294 TI - Breast cancer screening. PMID- 1764296 TI - When does consensus exist in expert panels? PMID- 1764297 TI - Valediction--a personal view from Professor Francis O'Grady, Chief Scientist of the Department of Health 1986-1990. PMID- 1764298 TI - Black on class and health: a reply to Strong. PMID- 1764299 TI - PIS and DRGs: coding inaccuracies and their consequences for resource management. PMID- 1764300 TI - Communication and public health: a question of scope or readership? PMID- 1764301 TI - [A new method for the plastic repair of the aorta in coarctation]. AB - Thirty-six patients underwent operation in the Samara Cardiosurgical Centre in the period from 1987 to 1991. Their ages ranged from 18 months to 28 years, 32 of them were under 16 years of age. The operation was carried out through a lateral approach in third or fourth intercostal space. After mobilization of the aorta the constricted part was resected together with the orifice of the ductus arteriosus at a distance of 2-3 mm from the constricting membrane without removal of areas of conic constrictions of the remaining ends of the vessels. Longitudinal incisions were made in the aortic walls perpendicular to one another and the edges of the flaps were shaped to form triangles. An anastomosis was then formed with continuous sutures. The average time of compression of the aorta was 27 +/- 2.5 min. There were no fatal outcomes. Among the complications were bleeding which called for rethoracotomy in 2 patients, and suppuration of the wound in 3 patients. Thirty-two persons were discharged from the clinic with normal arterial pressure, in 4 patients the pressure reduced as compared to the preoperative level. The long-term results were studied in 29 patients in follow up periods of 6 months to 4 years. Twenty-five of them had no complaints, residual hypertension was encountered in 4 patients but without signs of recoarctation. Thus, with the use of the described method the possibility for forming a direct anastomosis in cases in which a prosthesis had to be formed applied is greater, and in operations on children it became possible to increase the lumen of the anastomosis with growth of a child. PMID- 1764302 TI - [Repeated operations in recurrent stenocardia after aortocoronary bypass]. AB - With growth of the number of primary operations and duration of the postoperative period, there was an obvious tendency towards an increase of the absolute number of patients with recurrent angina pectoris. Among 990 patients who were operated on successively during a period of 9 years, 9% had severe Functional Class III-IV angina pectoris, in whom coronary bypass graphy was indicated to determine the possibility of undertaking a reoperation. The examination was conducted in 61 patients with recurrent marked angina pectoris. Impaired patency of the aortocoronary shunts was found to be the main cause of recurrence. At present, reoperations were carried out in 18 patients, 2 years after the first operation, on the average. The authors claim the immediate results of the reoperations to be satisfactory. The hospital mortality was 5.6%. PMID- 1764303 TI - [Reconstructive operations in mitral insufficiency under whole-body hypothermia (27-25 degrees C) without perfusion]. AB - The article discusses the results of reconstructive valve-preserving operations in mitral insufficiency performed under conditions of hypothermic (27-25 degrees C) protection without perfusion in 114 patients. Depending on the valve morphological changes multicomponent intervention was under taken contemplating the performance of commissurotomy, chorda fenestration, resection and sewing of the cusps, removal of fibrous deposits from the cusps, resection of peripheral and intermediate chordae. The discrepancy between the cusp area and the perimeter of the fibrous ring was corrected in 99 patients by annuloplasty with sutures. The hospital mortality was 6.1%. Six-year postoperative survival was recorded in 91% of cases; no thromboembolic complications encountered in 97.4% of patients. The condition improved in most patients and they moved to NYHA Functional Class I II. Unfavourable results were due to a severe initial clinical and functional condition and to the operations conducted in the active stage of septic endocarditis. PMID- 1764304 TI - [The current diagnostic procedure in chronic pathology of the veins of the lower extremities]. AB - Stepwise (out- and inpatient) examination forms the basis of diagnostic examination tactics in chronic abnormalities of the veins. Noninvasive ultrasonic methods of studying the venous system are preferred. With the gradual formation of groups of patients with an affection of the veins, invasive isotope and angiographic methods are supplemented. The authors emphasize that such examination of patients in stages raises the efficacy and the quality of diagnosis in individuals with chronic venous abnormalities. PMID- 1764305 TI - [Combined ultrasonic methods in the diagnosis and treatment of patients with chronic venous insufficiency]. AB - The use of combined ultrasonic methods in chronic venous insufficiency of the lower extremities is of high diagnostic value. A colored doppler image demonstrates most vividly the vascular blood flow. Quantitative values of arterial and venous hemodynamics obtained by means of the image in real time and dopplerography allow correct choice of the tactics of treatment. With the use of ultrasonic methods in reconstructive operations all necessary corrections can be introduced into the treatment in time. PMID- 1764306 TI - [The effect of the methods of anesthesiological assistance and blood oxygenation on the oxygen-transport properties of the blood in reconstructive interventions on the abdominal aorta and vessels of the lower extremities]. AB - Methemoglobin (MtHb) formation was studied during reconstructive operations on the abdominal aorta and its branches. It was established that the appearance of pain at rest and trophic tissue disorders in the lower extremities causes intensification of MtHb formation. The intensity of MtHb formation increases sharply during the operation and is determined by the injurious character of the intervention, level of arterial blood oxygenation, and the efficacy of nociceptive pulsation block. Arterial blood hyperoxia proved to be among the most important factors of increased MtHb formation and decreased blood oxygen capacity. Nociceptive pulsation block is less effective in general anesthesia than in epidural anesthesia and also increases the content of MtHb in the blood and the severity of the stress and reperfusion damages of the tissues and organs. On the basis of the results of the study it is concluded that normoxia of arterial blood and denervation of the operative zone reduce the risk of ischemic and hypoxic complications in patients with generalized atherosclerosis. PMID- 1764307 TI - [A comparative evaluation of a prosthetic operation and balloon valvuloplasty in aortic valve stenosis in elderly people]. AB - The results of surgical treatment of aortic stenosis (AS) in elderly patients were studied in a group of 602 patients aged from 70 to 90 years (average age 74.6 years) chosen from a total number of 1,643 persons who underwent operation for AS in 1975-1988. Total operative mortality with consideration for mortality connected with combined interventions was 11.4%, in the group of isolated prosthetics it was 10.4%. The late-term results were appraised in 96.6% of patients (in 3.6 years, on the average). According to actuarial charts, survival after 3 years was 75.9%, after 5 years--66.7%, and after 7 years--55.6%. There was no difference in the survival values of recipients of biological and mechanical prostheses. Significant improvement of the functional condition was noted (96.5% of patients belonged to NYHA classes I and II). Demographic and epidemiological studies showed this pathology in the elderly to be a new problem of surgery. Surgical treatment is justified by the quality of the results, prolonged survival, and an admissible risk level even at the age of 80-90 years. Comparison with the results of aortic balloon valvuloplasty studied on basis of a rich literature review shows these to be much poorer. On the whole, only surgery may be the real method of treatment allowing effective removal of AS. The operation can be carried out even on very old patients if there are no substantiated contraindications on the part of the brain and the patient's general condition. PMID- 1764308 TI - [Repeated operations on the lungs and pleura in tuberculosis]. AB - Reoperations were performed on 71 patients for tuberculosis of the lungs and pleura at the Phthisiosurgical Department of the Kostroma Regional Antituberculotic Clinic from 1971 to 1990. A total of 159 operative interventions were carried out. Among the indications for repeated operations were complications in the early postoperative period, recurrence, reactivation, and progress of the tuberculous process in the lung which had been operated on, tuberculous empyema of the pleura with a bronchopleural fistula, empyema of the residual pleural cavity and a bronchial fistula forming in the late-term periods after the first operation. Operative interventions were undertaken for the second time for tuberculosis of the lung on which the first operation was conducted in chronic abscess. Finally, operations were repeated for other reasons (excision of a ligature fistula, resection of the ribs for osteomyelitis, etc.). Reoperations on 23 patients who had undergone surgery for recurrence or exacerbation of a tuberculous process in the lung consisted in removal of areas of pulmonary tissue remaining after the first operation, they were of the type of pulmonectomy. This is a technically difficult intervention due to the presence of marked cicatricial adhesions in the pleural cavity and changed topography of the thoracic organs and tissues of the thoracic wall. The results of the reoperations were good. PMID- 1764309 TI - [Bilateral lung resections]. AB - Bilateral operations on the lungs were carried out in 90 patients with hydatid disease, intrapulmonary metastases, carcinoma, and bronchiectasis. Various types of stepwise resections of the lung are the operation of choice. One-stage interventions are allowable in rare cases of circumscribed affection with a hydatid cyst or metastases. Sternotomy is the standard approach in such cases. The total postoperative mortality was 4.4%. Economical operations less than lobectomy in volume are safest and most effective. Neither complications nor fatal outcomes were encountered subsequently. More extensive operations are marked by increased risk of complications, particularly if the volume of the resection exceeds lobectomy on both sides. Such an approach is justified in carcinoma because other methods of treatment leave no hope. Bilateral resections are indicated in purulent diseases mainly in children and young persons with circumscribed atelectatic forms of bronchiectasis. PMID- 1764310 TI - [The diagnosis and treatment of bronchial carcinoids]. AB - The results of diagnosis and treatment of bronchial carcinoids in 37 patients are discussed. Establishment of the diagnosis is difficult because the clinico radiological pictures of these tumours are similar to those of unspecific diseases of the lungs as well as tuberculosis. Twenty-six patients received antituberculotic treatment for a long period of time (2 to 5.5 years). Bronchoscopy with biopsy revealed the true cause of the disease in all of the 37 patients, in 9 of them coexistence of bronchial carcinoid and tuberculosis of the lung was found. Eight operations for pulmonectomy, 4 for bilobectomy, and 25 for lobectomy were performed. The volume of the surgical intervention was determined by the location of the bronchial carcinoids and extent of the secondary changes in the pulmonary tissue. Retrospective analysis showed that in timely diagnosis of bronchial carcinoids treatment of some of the patients could be limited to reconstructive-plastic operations with preservation of the whole lung or part of it. PMID- 1764311 TI - [Pancreatobronchial fistulae]. AB - The authors followed up 2 patients with pancreatobronchial fistulas in the period between 1963 and 1990. On the basis of the data in the literature and the results of their own observations the authors analyse the etiology, pathogenesis, and methods for the diagnosis and treatment of the rare pathological condition. Patients with a recognised pancreatobronchial fistula were subjected to complex therapy including drainage of the pleural or abdominal cavity and, whenever necessary, an operation, which made it possible to achieve good results. PMID- 1764312 TI - [Bronchial patency and the treatment characteristics of patients with giant cavities in the lungs]. PMID- 1764313 TI - [The thoracoscopic use of the CO2 laser in the combined treatment of pleural empyema]. AB - A new method for treating acute pneumothorax with a bronchopleural fistula was experimentally developed and clinically tested. It is based on thoracoscopic use of CO2 laser radiation. The laser beam energy is employed for evaporation of necrotic tissues in the area of pulmonary destruction, "welding" of the bronchopulmonary fistulae, and general irradiation of the empyema cavity with a defocused beam. Nineteen patients with various disease duration were treated. In 16 patients the bronchial fistulae and the empyema cavity were eliminated and the lung re-expanded. The purulent inflammation in the pleural cavity was acute in these cases. PMID- 1764314 TI - [One-stage total and intrapleural esophagoplasty in cancer and benign esophageal strictures]. AB - The authors compared the results of one-stage intrapleural (114 patients) and total esophagoplasty (214 patients). The immediate postoperative results are better in total esophagoplasty both in carcinoma and in benign strictures of the esophagus. Incompetence of the esophageal anastomosis is much less dangerous on the neck than in the pleural cavity. The authors recommend wider performance of total plastics of the esophagus with its replacement by an isoperistaltic gastric tube. PMID- 1764315 TI - [A wound of the brachiocephalic arterial trunk]. PMID- 1764316 TI - [Myxoma of the heart complicated by multiple embolisms of the arteries of the lower extremities]. PMID- 1764317 TI - [Plastic repair of the ostium and trunk of the left coronary artery in a female patient with unstable stenocardia]. PMID- 1764318 TI - [Laser angioplasty in occlusion of the brachiocephalic trunk]. PMID- 1764319 TI - [A case of the migration of the damaged obturator element of an aortic valve prosthesis]. PMID- 1764320 TI - Validating impaired physical mobility. AB - The clinical presence of impaired physical mobility documented for acute-care patients was studied. The frequency, individual, and group sensitivity levels of the defining characteristics documented as empirical referents for the diagnosis were examined. The frequency of the related factors associated with the diagnosis, patient demographics, length of stay (LOS), discharge destination, and diagnostic-related groups (DRGs) were also examined. Data were obtained from electronic tapes of patient information. Support was found for impaired mobility, as a high-frequency diagnosis, in heterogeneous acute-care patients. No support was found for any major defining characteristics across the heterogeneous sample. A cluster of three defining characteristics: (a) inability to purposefully move within the environment; (b) decreased muscle strength, control, or mass; and (c) imposed restrictions of movement was supported by group sensitivity measures. Major defining characteristics were supported in two DRG subsets. Clusters of defining characteristics varied among four DRGs. The NANDA-preidentified related factors were associated with the diagnosis. Electronic storage and retrieval of computerized nursing data, including the elements of the Nursing Minimum Data Set (NMDS), was an effective, efficient method for data collection and analysis. PMID- 1764321 TI - Nursing effort and the exchanging human response pattern. AB - This descriptive, comparative study was done to determine the nursing effort required to treat actual and potential nursing diagnoses from the Exchanging Human Response Pattern in two patient care specialties: acute medical-surgical and postpartum. Patterns of diagnosis identification are described for the two groups, and differences in allocation of nursing resources (nursing effort) are examined. The sample included 200 observations (hospital days) for 50 patients: 33 postpartum patients, and 17 medical-surgical patients. Data were collected daily during the study period by nurses who provided direct care to the selected patients using an investigator-developed version of the Nurse-Patient Summary (NPS) nursing information and patient classification tool (Halloran, 1985). Potential nursing diagnoses received most of the nursing effort in the postpartum area (mean effort = 5.28), whereas actual nursing diagnoses in the Exchanging Human Response Pattern received a higher priority in the medical-surgical area (mean effort = 12.03). Statistically significant differences existed between groups in total nursing effort (t = -4.73, p less than .0001) and in nursing effort required to treat actual (t = -7.42, p less than .0001) and potential diagnoses (t = 3.99, p less than .0001) in the Exchanging Human Response Pattern. This study provides unique information about how nurses allocate their time to patients for the treatment of actual and potential nursing diagnoses, and outlines areas for further development in diagnosis-based patient classification. PMID- 1764322 TI - Patients' perceptions of health, chronic illness, and nursing diagnoses. AB - This descriptive, exploratory study sought to determine how persons with chronic health problems define their experiences of health and illness and to collect information from these subjects regarding their ability to identify their health problems on the list of NANDA-approved nursing diagnoses. A convenience sample of 19 subjects was interviewed using qualitative triangulation methods. Subjects defined experiences of health in terms of their abilities to perform functions independently. Illness was defined primarily in terms of physical symptoms. Thirteen subjects identified self-initiated activities oriented toward alleviation of physical symptoms as strategies for helping themselves get better or feel better when "sick." Subjects were able to use nursing diagnoses to identify their health problems, selecting 61 of the 106 NANDA-approved diagnoses. Data related to subject-selected diagnoses are compared with available NANDA diagnoses by taxonomy category and nurse-interviewer diagnoses. Moving, Perceiving, and Valuing were the taxonomy categories that were most frequently identified by this sample. A new nursing diagnosis of altered nutrition: regimentation (in timing, amounts, and types of food), as well as the need for additional diagnostic development in the areas of urinary frequency, disrupted relationships, and medications were identified by the subjects. Finally, the researchers propose the development of nursing diagnoses that foster health promotion and illness prevention based on the health orientation of this sample, despite their chronic health problems. PMID- 1764323 TI - Nursing diagnoses and functional health patterns in patients receiving external radiation therapy: cancer of the head and neck. AB - A descriptive study using clinical methods was conducted to identify and describe core and site-specific symptoms reported by 15 patients with cancer of the head or neck who received external radiation therapy. A 45-item Radiation Symptom Scale (RSS) was designed by the investigators for this study. Symptoms identified by patients with a mean occurrence of at least "sometimes" were considered potential defining characteristics and were submitted to a panel of experts for identification of nursing diagnoses. Eighteen nursing diagnoses with their associated defining characteristics were identified and classified within eight Functional Health Patterns. Half of the nursing diagnoses were formulated within the Nutritional-Metabolic and Activity-Exercise health patterns. Four of the health patterns were primarily physiologic; four were primarily psychologic behavioral. Results of the study describe the nursing needs of patients who receive radiotherapy to the head and neck and are formulated within a nursing diagnosis/Functional Health Pattern framework. These findings have implications for nursing assessment, nursing interventions, and evaluation of patient outcomes, and findings provide a beginning empiric basis for identifying nursing diagnoses and their associated defining characteristics for cancer patients who receive external radiation therapy. PMID- 1764324 TI - The need for operational definitions for defining characteristics. AB - Although much attention has focused on the validation of defining characteristics for nursing diagnoses, equal attention has not been devoted to the development of operational definitions for defining characteristics. Operational definitions, however, provide a reference for determining whether defining characteristics are present in patients who participate in clinical validation studies. Validation of nursing diagnoses emerges from occurrence of the diagnostic label in clinical practice. Operational definitions provide the bridge between incidental observation and scientific validation of nursing diagnoses. PMID- 1764325 TI - Alice in NANDAland. AB - This entertainment was created for the 1991 student-faculty banquet at the University of Rochester School of Nursing, which honored the graduating seniors. Traditionally, groups of juniors, seniors, and faculty present a skit at this event that recalls some aspect of the year's activities. Because nursing diagnosis received more emphasis in junior coursework this year than in previous years, the faculty agreed to use this theme for their presentation. The author volunteered because she enjoys writing parody and has a fondness for the works of Lewis Carroll. The cast, which included one member of the NANDA Board of Directors, consisted of undergraduate faculty from all clinical areas. PMID- 1764326 TI - Rural advanced practice nurses: a decade of growth. PMID- 1764327 TI - Sexual harassment of nurses. PMID- 1764328 TI - Managing the politics of change in a conservative hospital environment. PMID- 1764329 TI - Total quality management and the marker management system 1988. Part I: An overview. PMID- 1764330 TI - Intramolecular hemiacetals. The acid-base-catalyzed ring-chain interconversion of 2-substituted 2-hydroxy-4,4-dimethylmorpholinium cations in aqueous solution. AB - The ring-chain tautomerism in aqueous solution of some aryl-substituted morpholinium salts (bromides), has been studied and equilibrium constants are reported. In the crystals the substrates exist entirely in their cyclic forms as hemiacetals, but in aqueous solution NMR measurements reveal that an equilibrium is established between the cyclic (hemiacetal) and the noncyclic (ketone) form, the degree of ring-opening being more pronounced with electron-donating aryl substituents at the carbonyl carbon. The kinetics of the ring-chain interconversion in water has been investigated spectrophotometrically by a 'pH jump' stopped-flow technique. General base catalysis is observed with a Bronsted beta value apparently independent of substituent and equal to 0.60. The Hammett rho values for various base catalysts are close to those for very similar intermolecular reactions involving hemiacetal breakdown, leading to the suggestion of a 'normal' class n mechanism for base catalysis. For acid catalysis, however, a quite different situation is encountered, since no general acid but only (weak) catalysis by the hydronium ion can be detected. We believe this deviation from 'normal' general acid catalysis is caused by an electrostatic interaction, and we suggest that it might result from a change in the usual class e mechanism for general acid catalysis by a situation in which rate-limiting concerted proton transfer is replaced by rate-limiting preprotonation. This is supported by the observed drastic change in Hammett rho value for catalysis by the hydronium ion, compared with the 'normal' case. An interesting case is encountered for the 4-aminophenyl-substituted substrate, in which the amino group becomes protonated in acid solution, thus representing a new substituent. Despite this complication, the various equilibrium and rate constants may also be evaluated experimentally for this substrate. PMID- 1764331 TI - Coordination geometry of cadmium at the zinc and copper sites of superoxide dismutases: a study using perturbed angular correlation of gamma-rays from excited 111Cd. AB - 111Cd time-differential perturbed gamma-gamma angular correlation (PAC) has been used to investigate the Zn site in yeast and bovine copper and zinc-containing superoxide dismutases by substitution of the zinc ions with excited 111Cd(2+) ions. The PAC spectra obtained from the enzymes in aqueous solution reveal a single coordination geometry of 111Cd(2+) showing that the coordination of 111Cd(2+) to the Zn site in the two subunits is identical. Furthermore, the PAC spectra of the yeast and bovine enzymes show that the Zn sites are very similar in the two enzymes. The PAC experiments show a clear difference depending on whether the copper ion is in the oxidized or the reduced state. In the latter case the results resemble those obtained for derivatives with no metal ion at the Cu site. Hence the coordination geometry of the Zn site in these two situations must be similar, and it is very unlikely that the imidazole ring of His61 bridges the two metal ions in the reduced enzyme. The PAC spectrum of 111Cd(2+) ions at the Zn site with copper(II) ions at the Cu site is in agreement with that predicted by applying the angular overlap model (AOM) to the known crystal structure of the bovine enzyme, with known nuclear quadrupole interactions for the ligands involved. Furthermore results from experiments with copper in the reduced state show that reduction of the copper ion causes a significant change at the Zn site. An explanation for this conformational change has been proposed by computer modelling. The PAC experiments also show that it is possible to incorporate cadmium ions into the Cu site in the absence of copper ions, and the result has also been interpreted in terms of the AOM. PMID- 1764332 TI - Synthesis, NMR and function of an O-phosphorylated peptide, comprising the RGD adhesion sequence of osteopontin. AB - The bone phosphoprotein osteopontin owes its cell adhesion property to the RGD sequence. In order to determine whether a phosphate substituent on the serine following the RGD-sequence interferes with cell binding, we have synthesized GRGDSL along with the corresponding peptide phosphorylated on serine. The latter peptide showed significantly lower cell binding as measured by inhibition of adhesion of R1 cells to surfaces coated with BSP. GRGDSL and phosphorylated GRGDSL show NMR spectra which resemble each other more than that of GRGDSP derived from the fibronectin sequence. PMID- 1764333 TI - Peroxide chemistry of triaryl-substituted imidazoles. Fenflumizole, a non steroidal, anti-inflammatory agent. AB - Fenflumizole, [2-(2,4-difluorophenyl)4,5-bis(4-methoxyphenyl)imidazole] is a nonsteroidal, anti-inflammatory analgesic. It reacts quantitatively with 1O2 forming 2-(2,4-difluorophenyl)-4-hydroperoxy-4,5-bis(4-methoxyphenyl)imidazole in a reversible reaction. In ethanol solution at ambient temperatures, the peroxide regenerates parent fenflumizole and 1O2 together with minor quantities of other products. The structures of those products point to the intermediacy of a 1,3 endoperoxide and a dioxetane. These observations may be relevant to the biological activity of fenflumizole. PMID- 1764334 TI - From conception to birth: the development of skin and nursing care implications. AB - The skin undergoes important and dramatic changes from embryogenesis through infancy. Understanding the development, structure, and function of the skin is vital for the nurse providing comprehensive health care to the child and family. PMID- 1764335 TI - An overview of moist wound dressings: the under cover story. AB - The variety of wound dressings available is growing as more is learned about wound healing. The major types of moist dressings are discussed with descriptions of their uses, advantages, and disadvantages. PMID- 1764336 TI - Phototherapy: a nursing overview. AB - Phototherapy can be administered in several settings, but should only be administered by a knowledgeable, trained individual. This article presents an understanding of what this form of treatment is, to whom it is given, and guidelines for safe, effective administration. PMID- 1764337 TI - Current dermatologic laser applications in patient care. AB - Laser is an acronym for Light Amplification by Stimulated Emission of Radiation. Current clinical applications of lasers are changing the practice of dermatology. Research and the changing practice significantly impact dermatologic nursing practice. PMID- 1764338 TI - Proteins of AIDS virus may link AIDS and Kaposi's sarcoma. PMID- 1764339 TI - Detection of complications after liver transplantation by technetium-99m mebrofenin hepatobiliary scintigraphy. AB - Fifty-five hepatobiliary scintigraphic studies using 99mTc-Mebrofenin were performed in 52 orthotopic liver transplant patients to evaluate suspected biliary complications, namely biliary extravasation and extrahepatic obstruction. Final diagnosis was made by analysis of the clinical course and other procedures. Three out of three studies of biliary leak and four out of five studies of biliary obstruction were detected. There were no false positives in either complication. The sensitivity, specificity and accuracy were 100, 100, 100% for ectravasation and 80, 100, 98% for obstruction, respectively. Hepatobiliary scintigraphy appears to be an accurate means of detecting biliary leak and obstruction associated with the transplanted liver. PMID- 1764340 TI - Evaluation of the protective effect of verapamil on reperfusion injury by 111In anticardiac myosin antibody in canine myocardial infarction. AB - We quantitated the protective effect of verapamil on reperfusion injury in canine myocardial infarct using 111In-anticardiac myosin antibody and correlated to the electronmicroscopic findings. Experimental myocardial infarction was performed by one hour occlusion of the anterior descending coronary artery and followed by reperfusion. Saline or verapamil (0.6 mg/kg/hr) was started at 40 minutes after coronary artery occlusion and continued throughout the experiment. There was an inverse exponential relationship between anticardiac myosin uptake and regional coronary blood flow in both the control (r = -0.86) and the verapamil treated (r = -0.71) groups. Less uptake of 111In-anticardiac myosin antibody was observed in the verapamil treated group than in the control group of the regions where blood flow was lower than 30% of normal. In the control group, the myocardium showed signs of the typical contraction band necrosis. In the verapamil treated group, however, the myocardium contained fewer electron dense granules and mild degree of contraction bands. PMID- 1764341 TI - Performance of a multislice fan beam collimator for SPECT imaging of the head. AB - A multislice fan beam collimator was designed for a SPECT system with a rotating scintillation camera, and it was constructed by the lead casting method which was devised in recent years. The focal length from the surface of the detector side of the collimator is 75 cm. In order to reconstruct the SPECT images we modified the interpolation method which was developed for reconstruction of the X-ray CT and applied it. Primary photopeak data were obtained with a 20% energy window centered at 140 keV for 99mTc and 159 keV for 123I. The fan beam collimator reduces the field of view, and it would therefore be limited to use only for the head and neck region at present; however, both resolution and sensitivity were approximately 20% better than those of the parallel hole collimator. A fan beam collimator is a useful implement for the SPECT study. PMID- 1764342 TI - Application of single-photon emission computed tomography (SPECT) with 99mTc-MAA in evaluation of perfusion patterns during hepatic infusion chemotherapy. AB - In 6 patients receiving hepatic artery infusion chemotherapy for liver metastases, planar and single-photon emission computed tomography (SPECT) images of the abdomen were obtained after intravenous injection of 99mTc-phytate, and intra-catheter injection of 99mTc-MAA in the same geometrical settings. With this method, the three-dimensional intra- and extra-hepatic distribution of the agents during hepatic artery infusion chemotherapy can be evaluated. PMID- 1764343 TI - Preparation of radioiodinated secretin for radioimmunoassay. AB - Radioiodination of synthetic human secretin on its N-terminal histidyl residue was not difficult when a greater amount of Chloramine T and a longer reaction time were employed to achieve better incorporation of 125I. The radioiodinated tracer for an optimal radioimmunoassay required purification. The combination of Sep-pak C18 Cartridge and high performance liquid chromatography for the purification of 125I-secretin in our study revealed that the Sep-pak cartridge was a preliminary step in removing unlabeled radioactive iodide, the reactant, and labeled materials unadsorbed to the cartridge. The eluate eluted from the Sep pak containing high radioactivity and high immunoreactivity to the antibody were selected for further purification by HPLC which eliminated undesirable radiolabeled substances with lower immunoreactivity. The purified radiolabeled secretin was used in developing a sensitive radioimmunoassay. PMID- 1764344 TI - Incidence of pulmonary embolism in a chest hospital in Japan and importance of preoperative perfusion lung imaging in the diagnosis of postoperative pulmonary embolism. AB - The incidence of pulmonary embolism was retrospectively studied in a University Chest Institute and its affiliated hospital in Sendai, Japan, whose annual numbers of discharged patients from chest medical wards and lung operations as a whole are about 600 and 400, respectively. Before 1975 there was no documented patient with pulmonary embolism. Since then 70 patients had been clinically suspected of having pulmonary embolism and 31 of the 70 were diagnosed as having pulmonary embolism; 15 without and 16 with surgical operations in the immediate past. Fourteen of the 31 patients required combined perfusion and aerosol inhalation lung imaging for diagnosis. Twelve postoperative patients could be diagnosed as pulmonary embolism by comparing postoperative perfusion lung images taken at the time of suspicion with preoperative perfusion counterparts. Although it is said to be rising, the incidence of pulmonary embolism in a chest hospital still seems to remain low compared with that in western countries. For postoperative patients, comparison with preoperative studies was found very useful in diagnosing postoperative pulmonary embolism. The importance of preoperative perfusion lung imaging cannot be overstressed not only as a preoperative lung function test but as a baseline study to be compared with postoperative perfusion images when pulmonary embolism is clinically suspected in postoperative patients. PMID- 1764345 TI - Ventilation-perfusion scintigram in diabetics. AB - We carried out ventilation and perfusion scintigraphies and pulmonary function tests in 20 diabetics under 50 years of age. 99mTc-MAA perfusion scintigrams showed evidence of minimal nonuniformity (MNU) in four cases (20%) and nonsegmental defect (NSD) in eight cases (40%). There was a ventilation defect in the single-breath image in one case (5%) and a delayed washout in three cases (15%) upon 133Xe ventilation scintigram. In the NSD group, the mean diffusing capacity value was abnormally low and the mean duration of the diabetes was long compared with other groups. The frequency of perfusion defects was higher than that of ventilation abnormalities; moreover, abnormal findings on ventilation scintigrams were very mild compared with those of perfusion defects. Perfusion defects correlated significantly with a decrease in diffusing capacity. These findings suggest that the disturbance in pulmonary arterial perfusion caused a decrease in diffusing capacity in diabetics. PMID- 1764346 TI - Developmental characteristics of topographic EEG in the newborn using an autoregressive model. AB - Autoregressive topographic EEG analysis was used to determine topographic EEGs of the total power in quiet and active sleep stages in 33 healthy premature infants of 34 to 40 weeks conceptional age. The developmental characteristics were also examined by simultaneously referring to the autoregressive pattern discrimination of topographic EEGs between different conceptional age groups in both sleep stages. Treating 10.24 seconds of EEG as one segment, the topographic EEG of 10 segments in each of the quit and active sleep stages as well as their mean were obtained. In both sleep stages the results showed a small peak in total power in the frontal region and a large peak in the occipital region, but total power was greater in the quiet sleep. Total power decreased with increasing conceptional age. Topographic pattern discrimination between different conceptional age groups showed significant differences mainly in the frontal, temporal and occipital regions. It was concluded that regional differences in the development of EEG in premature infants could be clarified by means of topographic EEG analysis and the pattern discrimination method using the autoregressive model. PMID- 1764347 TI - Artificial neural networks for source localization in the human brain. AB - Source localization in the brain remains an ill-posed problem unless further constraints about the type of sources and the head model are imposed. Human head is modeled in various ways depending critically on the computing power available and/or the required level of accuracy. Sophisticated and truly representative models may yield more accurate results in general, but at the cost of prohibitively long computer times and huge memory requirements. In conventional source localization techniques, solution source parameters are taken as those which minimize an index of performance, defined relative to the model-generated and clinically measured voltages. We propose the use of a neural network in the place of commonly employed minimization algorithms such as the Simplex Method and the Marquardt algorithm, which are iterative and time consuming. With the aid of the error-backpropagation technique, a neural network is trained to compute source parameters, starting from a voltage set measured on the scalp. Here we describe the methods of training the neural network and investigate its localization accuracy. Based on the results of extensive studies, we conclude that neural networks are highly feasible as source localizers. A trained neural network's independence of localization speed from the head model, and the rapid localization ability, makes it possible to employ the most complex head model with the ease of the simplest model. No initial parameters need to be guessed in order to start the calculation, implying a possible automation of the entire localization process. One may train the network on experimental data, if available, thereby possibly doing away with head models. PMID- 1764348 TI - Effects of stimulus intensity increase on short-latency somatosensory evoked potentials: application of polynomial curvature coefficients. AB - We assessed the influence of increasing stimulus intensity from motor threshold to pain threshold on short latency somatosensory evoked potentials recorded over the parietal and frontal scalp in 14 subjects during median nerve stimulation at the wrist. We used the curvature polynomial coefficient to evaluate alterations of the main components. The N20 and P27 curvature coefficients are not modified. The change of the N30 curvature coefficient is the result of shortened P45 latency. The increase of N60 curvature coefficient shows a great interindividual variability, probably due to a central amplification and synchronization or to involvement of nerve fibres with different excitability. PMID- 1764349 TI - Attenuation of somatosensory evoked potentials by acupuncture and tactile skin stimulation in man. AB - The effects of acupuncture and tactile skin stimulation on somatosensory evoked potentials (SEPs), elicited by the median nerve stimulation, were investigated in healthy subjects. Acupuncture needles were inserted into either Hegu plus Shousanli, Hegu plus Waiguan, or Shousanli positions ipsilateral to the median nerve stimulation. Tactile skin stimulation was applied to either the ulnar side of the palm, or the dorsal surface of the hand or forearm ipsilaterally to the nerve stimulation. It was found that acupuncture significantly suppressed the amplitude of P22 and P40, and that the tactile skin stimulation of the ulnar side of the palm significantly suppressed the amplitude of P22 and P40, but that the peak latencies were not affected. Dipole tracing analysis showed that the location and vector direction of P22 were not changed but the vector moment of P22 was changed by both acupuncture and tactile stimulation. Based on these findings the suppressive effect of acupuncture and skin stimulation on P22 was proposed to be due to the afferent inhibition in the somatosensory cortex. Although the suppressive mechanism of P40 by tactile skin stimulation seemed to be similar to that of P22, the suppression of P40 by acupuncture appeared to include different mechanisms. PMID- 1764350 TI - Topographic mapping and source localization of the pattern reversal visual evoked magnetic response. AB - The topography of the visual evoked magnetic response (VEMR) to pattern reversal stimulation was studied in four normal subjects using a single channel BTI magnetometer. VEMRs were recorded from 20 locations over the occipital scalp and the topographic distribution of the most consistent component (P100M) studied. A single dipole in a sphere model was fitted to the data. Topographic maps were similar when recorded two months apart on the same subject to the same stimulus. Half field (HF) stimulation elicited responses from sources on the medial surface of the calcarine fissure mainly in the contralateral hemisphere as predicted by the cruciform model. The full field (FF) responses to large checks were approximately the sum of the HF responses. However, with small checks, FF stimulation appeared to activate a different combination of sources than the two HFs. In addition, HF topography was more consistent between subjects than FF for small check sizes. Topographic studies of the VEMR may help to explain the analogous visual evoked electrical response and will be essential to define optimal recording positions for clinical applications. PMID- 1764351 TI - Regional cerebral blood flow asymmetries in a group of 189 normal subjects at rest. AB - Regional cerebral blood flow (rCBF) asymmetries were studied in 189 subjects (96 males and 93 females) at rest with the 133Xenon inhalation method using a fixed detector system. rCBF asymmetries in the resting condition were very small, nevertheless a significant (p less than 0.001) effect for their topographical distribution was present, reflecting higher rCBF in the right fronto-temporal and left parieto-occipital regions. rCBF asymmetries were not correlated with age, and there were no significant differences between males and females. Asymmetries are therefore useful from a statistical point of view in detecting rCBF abnormalities in the resting condition: they are more stable than absolute values in normal subjects and no matching according to age or sex is required when statistical comparisons are performed. PMID- 1764352 TI - An approach to a synopsis of EEG parameters, morphology of brain convolutions and mental activities. AB - A method for the projection of EEG data on the brain surface is proposed. The EEG data are obtained during the performance of mental tasks and represented as probability maps of power and coherence changes with respect to the averaged EEG at rest. The morphological data are obtained from 3D reconstructions of the brain by means of serial slices provided by an MRI scanner. Before scanning the positions of the EEG electrodes were marked by dummy electrodes of plexiglass filled with a contrast medium. Changes of power are color-coded and entered at the respective electrode positions, changes of coherence between the respective positions. The applicability of this procedure in the fields of psychology, psychiatry and neurology is discussed. PMID- 1764353 TI - The dermatosis of kwashiorkor in young children. AB - A characteristic dermatosis is often seen in young children suffering from kwashiorkor, one of the severe forms of protein-energy malnutrition (PEM). The skin lesions usually first occur in areas subject to friction or pressure, for example the groin, behind the knees, on the buttocks, and at the elbows; in advanced cases, the dermatosis may be almost anywhere on the body--trunk, limbs, or head. Darkly pigmented patches form, and these may peel or desquamate, rather like old, sun-baked blistered paint. This has led to the terms "peeling paint" or "flaky paint" dermatosis. Underneath these flakes are atrophic depigmented areas that may resemble a healing burn. This dermatosis does not occur in children with nutritional marasmus, the other life-threatening form of PEM. Kwashiorkor may be diagnosed and the condition be serious without any dermatosis being present. However, when "flaky paint" dermatosis is seen in a malnourished child with edema, it is pathognomonic of the disease kwashiorkor. PMID- 1764354 TI - Malnutrition in the elderly. AB - Malnutrition is known to be very common in hospitalized and institutionalized elderly. Various studies report an incidence ranging from 33% to 67% of all patients. Recent evidence also suggests that the presence of nutritional deficiencies is associated with increased morbidity, mortality, and greater use of health care resources. The problem is compounded by the lack of resources in most acute care hospitals and nursing homes to obtain an adequate nutritional assessment or to monitor nutritional status over time. This report will present an overview of nutritional problems in the elderly, and provide an approach aimed at identifying patients at high risk of being malnourished in order to develop rational strategies for management. The role of nutritional factors in the development of pressure sores will also be discussed. PMID- 1764356 TI - Riboflavin deficiency: mucocutaneous signs of acute and chronic deficiency. AB - Mucocutaneous lesions are present in both acute and chronic riboflavin deficiency. The distribution of the lesions varies with the age and gender of the patient. Lesions of acute riboflavin deficiency are similar to those observed in protein-energy malnutrition of the kwashiorkor type. In chronic riboflavin deficiency the cutaneous lesions resemble monilial intertrigo and the mucous membrane lesions include a characteristic glossitis. Prompt resolution of lesions after therapeutic doses of the vitamin are given confirms the diagnosis. Biochemical changes caused by riboflavin deficiency, which explain the dermatoses and mucous membrane lesions, have not as yet been determined. Lack of information in this area is explained by the difficulty of separating cutaneous changes caused by the deficiency from those caused by trauma or other proximate etiologic agents. PMID- 1764355 TI - Pellagra and pellagralike dermatoses: etiology, differential diagnosis, dermatopathology, and treatment. AB - Clinical pellagra is a multiple vitamin-deficiency disease. The clinical manifestations include dermatitis, diarrhea, and dementia; the result is often death. Photosensitivity has also been associated with pellagra. Other clinical findings may depend on the nutritional status of the patient. Pellagrins may not have specific cutaneous pathological findings, although necrolytic migratory erythema has been reported in clinical pellagra. Most pellagrins respond to niacin combined with a high-protein diet, although other concomitant vitamin deficiencies may prevent the use of niacin. Clinical pellagra should be considered in the differential diagnosis of patients with chronic alcoholism, malnutrition, and amino acid imbalance. PMID- 1764357 TI - Skin manifestations of biotin deficiency. AB - This article reviews current knowledge concerning the dermatologic manifestations of biotin deficiency. Biotin is a water-soluble vitamin that acts as an essential cofactor for four carboxylases, each of which catalyzes an essential step in intermediary metabolism. For example, acetyl-CoA carboxylase catalyzes the rate limiting step in fatty acid elongation. In infants, children, and adults, deficiency of biotin causes alopecia and a characteristic scaly, erythematous dermatitis distributed around body orifices. The rash closely resembles that of zinc deficiency. Candida albicans often can be cultured from the skin lesions. Biotinidase deficiency, an inborn error, causes biotin deficiency, probably as a consequence of unpaired intestinal absorption, cellular salvage, and renal reclamation of biotin; biotinidase deficiency causes dermatologic manifestations similar to biotin deficiency. There is evidence that impaired fatty acid metabolism secondary to reduced activities of the biotin-dependent carboxylases (especially acetyl-CoA carboxylase) plays an etiologic role in the dermatologic manifestations of biotin deficiency. Candida infections secondary to impaired immune function might also contribute to the dermatitis of biotin deficiency. PMID- 1764359 TI - Acquired zinc deficiency in breast-fed infants. AB - Zinc deficiency in breast-fed infants is a rare disease caused by a low level of zinc in their mother's milk. Premature infants are more vulnerable to develop zinc deficiency than full-term infants because, despite their high zinc requirements, they have insufficient body stores of zinc and a poor capability to absorb zinc from the gut. The clinical aspect of zinc deficiency is acrodermatitis enteropathica, in which the severity is proportional to the zinc level. The patients respond well to oral zinc supplements. PMID- 1764358 TI - Assessment of risk factors for carotenodermia and cutaneous signs of hypervitaminosis A in college-aged populations. AB - Carotenodermia occurs in individuals in a college-aged population who exhibit signs of anorexia and/or bulimia nervosa. It is caused by consuming large amounts of raw carrots. In the same population, athletes are at risk for hypervitaminosis A because of injudicious self-administration of high-potency vitamin preparations. PMID- 1764360 TI - Iron deficiency: structural and microchemical changes in hair, nails, and skin. AB - Deficiency of nutritional iron represents a public health problem recognized throughout much of the world. The overall prevalence rate of patients with iron deficiency (ID) who need supplementary iron therapy ranges markedly from less than 10% to as high as 70% among various ethnic and socioeconomic groups. Dermatologically, the iron-deficit state can be a secondary condition or trigger a wide range of mucocutaneous alterations. Early appreciation of adverse cutaneous manifestations of ID seems to have commensurate significance not only in predicting the presence of undiagnosed ID, but also for providing specified avenues for rational therapeutic approaches to patients with ID. Dermatopathic anemia has attracted the attention of clinicians because ID was found to be a metabolic consequence of skin diseases such as erythroderma, exfoliative dermatitis, psoriasis, eczema, and many others. Previous studies had suggested that iron may be lost in accelerated turnover of the keratinocyte from scaling; currently, malabsorption of iron is accepted implication accounting for dermatopathic anemia. However, mucocutaneous affections adversely manifested by ID have not been extensively reviewed and published in the current dermatologic literature because of the potentially benign course of the adverse conditions and the limited degree of clinical expression. Therefore, changes in hair, nails, mucosa and tongue, pruritus, chronically sustained inflammation, dermatitis herpetiformis, and photodermatitis are among the adverse cutaneous sequelae whose relation to ID are highlighted and discussed in the present review. Because of their clinical and diagnostic importance, other extracutaneous physical signs of ID, such as blue sclerae and pica, are also included in this review.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764361 TI - Reversible control of oestradiol-stimulated growth of MCF-7 tumours by tamoxifen in the athymic mouse. AB - We investigated the ability of high concentrations of oestradiol to reverse the growth inhibitory action of tamoxifen on MCF-7 breast cancer cells in vivo. Tamoxifen inhibits the oestradiol stimulated growth of MCF-7 cells in athymic mice. Using a sustained release preparation of tamoxifen we consistently achieved serum concentrations of the drug in the 40 to 50 ng ml-1 range and much higher levels in tissues. These serum levels are sufficient to inhibit the oestrogen stimulated growth of MCF-7 tumours exposed to physiologic (i.e. 300-600 pg ml-1 serum oestradiol concentrations). However, by administering dosages that increase serum oestradiol concentrations to 900-2000 pg ml-1, mimicking the increase often observed clinically in premenopausal women taking tamoxifen, we show that the growth inhibitory action of tamoxifen can be partially reversed. Serum tamoxifen levels were elevated to nearly 400 ng ml-1 by injecting 1 mg day-1 tamoxifen (IP 3 x weekly); this dosage was more effective at inhibiting oestradiol stimulated tumour growth than subcutaneous tamoxifen capsules alone. Our data suggest that at low serum levels tamoxifen may not act optimally. There may be a need to monitor tamoxifen levels in premenopausal patients to ensure that they are high enough not to be overcome by a tamoxifen induced increase in ovarian steroidogenesis. PMID- 1764362 TI - Evidence for heterogeneous groups of neuronal differentiation of Ewing's sarcoma. AB - We have investigated the capability of differentiation of Ewing's sarcoma (ES) towards a neuronal direction through the establishment of four extraosseous ES cell lines and by in vitro stimulation with dibutyryladenosine cyclic monophosphate (db-cAMP) of eight ES lines. All except one of the lines expressed the molecule defined by 5C11, the antibody specifically reactive with ES. Two ES lines expressed a 200 kilodalton (kD) neurofilament protein (NFP) although their original tumours were negative for NFP. Elongation of cytoplasmic processes and increased NFP expression were observed after db-cAMP treatment of these lines and microtubules in the cytoplasmic processes were ultrastructurally demonstrated. Six lines were NFP negative, but three lines changed their morphology after induction of 200 kD NFP expression by db-cAMP treatment. The other three showed no definitive differentiation after db-cAMP treatment. Chromosomal analysis of the new ES lines showed the typical t(11;22) in one line and a +der(22) in two lines. No correlation was observed between the chromosomal abnormality and the differentiation capability. We conclude that ES is a heterogeneous group of tumours with respect to capability of differentiation into the neuronal lineage, but it is clearly distinguished from peripheral primitive neuroectodermal tumours by its 5C11 reactivity. PMID- 1764363 TI - Regional delivery of microspheres to liver metastases: the effects of particle size and concentration on intrahepatic distribution. AB - There is increasing interest in the use of microspheres, loaded with chemotherapeutic agents, for regional therapy to hepatic metastases. It is necessary to deliver these particles predominately to tumour rather than to normal liver. This study investigates factors influencing the distribution of regionally injected microspheres. Discreet tumour was induced in rats by subcapsular hepatic inoculations of HSN cells. At 20 days, 12.5 microns, 25 microns or 40 microns diameter, radiolabelled albumin microspheres were administered, in various concentrations, via the gastroduodenal artery. Tumour to normal liver microsphere distribution ratios were determined and median values ranged from 0.1 (0.2 mg ml-1 12.5 microns microspheres) to 1.8 (20 mg ml 40 microns microspheres). Concentrated suspensions (20 mg ml-1) of large microspheres (40 microns) produced the most favourable tumour to normal liver distribution ratios. These results not only have implications for the therapeutic administration of microspheres but also for their use in blood-flow studies. PMID- 1764364 TI - Effect of the lipid-lowering agent bezafibrate on tumour growth rate in vivo. AB - The growth rate of the MAC16 tumour in cachectic animals was significantly enhanced by the hypolipidemic agent bezafibrate, while the growth rate of a histologically similar tumour, the MAC13, which grows without an effect on host body compartments was unaffected. Growth of the MAC16 in vitro was unaffected by bezafibrate, suggesting that it was an in vivo phenomenon only. The stimulatory effect of bezafibrate correlated with the maximum plasma levels of free fatty acids (FFA) arising from the catabolism of adipose tissue. Accumulation of 14C lipid from 1-14C-triolein administered by intragastric intubation was enhanced in heart, gastrocnemius muscle and tumour of bezafibrate treated animals, while the total lipid absorption did not differ from solvent treated controls. The increased lipid accumulation in the heart, but not the tumour correlated with an increased tissue lipoprotein lipase level. The increased tumour level may arise from an increased uptake of FFA arising from a weakening of the bonds between FFA and albumin. These results suggest that growth of certain tumours is dependent on maintaining sufficient lipid levels and that the lipid mobilising effect of the tumour may be necessary to sustain tumour growth. PMID- 1764366 TI - Insulin-tumour interrelationships in thymoma bearing mice. Effects of dietary glucose and fructose. AB - Control (C) or Thymoma (T) implanted male C57BL/6J mice received a basal diet containing 16.5% glucose (G) or fructose (F). Compared to the C-G group, the C-F mice consumed more food and less water, and gained more weight. The blood glucose, insulin and triglyceride levels were higher in the C-F than in the C-G mice. Thymoma implantation into the right flank caused a transient decrease in body weight followed by a steady increase due to tumour growth. Tumours were detected earlier and tumour size was greater in the T-F group than in the T-G mice. Tumour chemical composition was similar in both groups. Blood analysis showed that the T mice had lower glucose and higher insulin and triglyceride levels than the C group. Carcasses from the T groups contained more water and ash and less fat than their C counterparts, but the type of sugar did not affect the body composition of the C or T groups. The results suggest that dietary fructose may enhance the growth of tumour via its hyperinsulinaemic action. PMID- 1764365 TI - Expression of members of the myf gene family in human rhabdomyosarcomas. AB - Northern analysis of tumour RNA has been used to examine the expression of members of the myf family of muscle determining genes (myf3, myf4, myf5 and myf6) in a series of 20 rhabdomyosarcomas. A 2.0 kb myf3 transcript was observed in 85% of tumours, a 1.8 kb myf4 transcript was detected in 70% of tumours and a 1.7 kb myf5 transcript was observed in 55% of tumours. Transcription of myf6 occurred in 28% of tumours, but there were several transcript sizes (1.2, 1.5, 2.0 and 3.5 kb) and in some individual tumours two or more transcripts were observed. Only two rhabdomyosarcomas, one classified as embryonal and one as pleomorphic, failed to exhibit transcription of members of the myf gene family. We were unable to detect transcription of myf genes in neuroblastomas, Wilms' tumours, hepatoblastomas, paediatric non-Hodgkin's lymphoma and leiomyosarcomas. When considered together these observations suggest that expression of myf genes could provide an extremely useful marker in the diagnosis of rhabdomyosarcoma. PMID- 1764367 TI - Biological profile of FCE 24517, a novel benzoyl mustard analogue of distamycin A. AB - FCE 24157 (chemically (beta-[1-methyl-4-(1-methyl-4--[1-methyl-4-(4-N,N- bis(2 chloroethyl) amino-benzene-1-carboxy-amido) pyrrole-2-carboxiamido]pyrrole-2 carboxyamido)pyrrole-2-c arboxyamido]) propionamidine, hydrochloride) is a distamycin A (Dista A) derivative bearing a benzoyl mustard moiety instead of the formyl group at the N-terminal. Contrary to Dista A, FCE 24517 has been found to display potent cytotoxic activity on human and murine tumour cell lines. The compound maintains activity on melphalan (L-PAM)-resistant cells, whereas cross resistance is observed on doxorubicin-(DX)-resistant cells. In vivo, FCE 24517 was found to possess evident antineoplastic activity on a series of murine transplanted solid tumours and human tumour xenografts. The following neoplasms were in fact found to be sensitive to FCE 24517 treatment: M14 human melanoma xenograft, N592 human small cell lung carcinoma, MTV murine mammary carcinoma, Colon 38 murine carcinoma, PO2 murine pancreatic carcinoma and M5076 murine reticulosarcoma. Lower effectiveness was observed against the murine P388 and Gross leukaemia, Lewis lung murine carcinoma, LoVo human colon carcinoma xenografts and A459 human lung adenocarcinoma. Against the murine L1210 leukaemia, FCE 24517 displayed a clear activity only when the tumour was transplanted i.p. and treatment was given i.p., whereas only marginal activity was seen against this leukaemia if transplanted i.v. and the drug was given i.v. As true also in vitro, FCE 24517 was effective against i.p. implanted L1210 leukaemia resistant to L-PAM. The mode(s) of action of this new compound is under active investigation. PMID- 1764368 TI - Radiolocalisation and imaging of stably HPLAP-transfected MO4 tumours with monoclonal antibodies and fragments. AB - Immunotargeting of PLAP-expressing tumours was studied for two radioiodinated, highly specific anti-PLAP monoclonal antibodies, 7E8 and 17E3, differing 10-fold in affinity, as well as for 7E8 F(ab')2 fragments. An anti-CEA monoclonal antibody or anti-CD3 F(ab')2 fragments were used as controls. Specific and non specific targeting was examined in nude mice simultaneously grafted with PLAP positive tumours derived from MO4 1-4 cells, and CEA-positive tumours, derived from 5583-S cells. Results indicated that (1) MO4 1-4 tumours, with a stable expression of PLAP on the plasma membrane, represent a useful new in vivo model for immunodirected tumour targeting; (2) differences in antibody affinity for PLAP in vitro are not reflected in antibody avidity for tumour cells in vivo; and (3) excellent selective and specific localisation of the PLAP-positive tumours is achieved when 7E8 F(ab')2 fragments are used. The high tumour/blood ratios (10.7 +/- 3.9 at 46 h after injection) were due to a much faster blood clearance of 7E8 F(ab')2 fragments. At this time point, the mean tumour/non-tumour tissue ratio was as high as 34.5, and the mean specific localisation index was 29.0. As expected, the F(ab')2 fragments provided high tumour imaging efficiency on gamma camera recording. These data imply important potentials of the PLAP/anti-PLAP system for immunolocalisation and therapy in patients, but also emphasise that in vitro criteria alone are not reflected in in vivo tumour localisation capacities of antibodies. PMID- 1764369 TI - Increasing the effective concentration of melphalan in experimental rat liver tumours: comparison of isolated liver perfusion and hepatic artery infusion. AB - Regional chemotherapy allows further exploitation of the steep dose response curve of most chemotherapeutic agents, while systemic toxicity remains tolerable. We investigated the difference in maximally tolerated dose, pharmacokinetics and antitumour effect comparing administration of melphalan as a bolus in isolated liver perfusion (ILP) or via hepatic artery infusion (HAI). For these in vivo studies an experimental model for liver metastases in male WAG/Ola rats is obtained by subcapsular inoculation of CC531 rat colon carcinoma cells. In this system, ILP allowed administration of a two times higher dose than HAI (12 mg kg 1 vs 6 mg kg-1). In both treatment modalities systemic toxicity (leukopenia) was dose limiting. No hepatic toxicity was observed. Bolus administration of the maximally tolerated doses of melphalan in HAI (6 mg kg-1) and ILP (12 mg kg-1) resulted in four times higher concentrations in both liver and tumour tissue of the ILP treated rats. However, the ratio of mean drug concentration in liver vs tumour tissue appeared to be 1.5 times that found for HAI. In the range of the in tumour tissue measured melphalan concentrations the CC531 cells showed a steep dose response relationship in vitro. Whereas HAI resulted in significant tumour growth delay, complete remissions were observed in 90% of the rats treated with ILP. This study shows that with 12 mg kg-1 melphalan in ILP highly effective drug concentrations are achieved in CC531 tumour tissue; although the melphalan concentration in liver tissue shows an even higher increase than in tumour tissue, hepatic toxicity is negligible in this dose range.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764370 TI - Abnormalities of the p53 tumour suppressor gene in human pancreatic cancer. AB - The tumour suppressor gene p53 has been found to be mutated or inactivated at high frequency in several common human tumours. We have examined a series of exocrine pancreatic carcinomas for over-expression of mutant forms of p53 by immunohistochemistry with a panel of specific antibodies. We found immunodetectable p53 in 13 of 22 (60%) frozen pancreatic cancers and seven of 13 pancreatic cell lines. One of the antibodies, CM1, recognises p53 in formalin fixed, paraffin-embedded archival material and using this reagent we found immunodetectable p53 in 28 of 124 (23%) pancreatic cancers. We have successfully demonstrated the presence of point mutations by direct sequencing of genomic DNA extracted from archival tissue showing CM1 immunoreactivity. We conclude that p53 activation is an important event in human pancreatic tumorigenesis and that the CM1 antibody can detect a proportion of cases of overexpression of mutant p53 in archival pathological material. PMID- 1764371 TI - Changes in hepatic haemodynamics in rats with overt liver tumour. AB - Overt liver tumour was induced in Fisher rats by intraportal administration of 1.6 x 10(7) Walker carcinosarcoma cells. Control groups of rats received similar volumes of dead cells or saline intraportally. All animals were studied at 3 weeks when overt tumour was present. The Hepatic Perfusion Index (HPI) was significantly raised in rats with overt tumour compared to both groups of control animals. Portal flow and portal venous inflow were significantly reduced in the presence of overt tumour but hepatic arterial flow did not alter. These observations suggest that the alteration in the HPI in the presence of overt tumour results from an alteration in portal venous flow and inflow even though the blood supply to the tumour is principally derived from the hepatic artery. The changes in hepatic haemodynamics in the presence of tumour were accompanied by a reduction in portal pressure, an increase in splanchnic vascular resistance and an increase in the degree of arteriovenous shunting through the liver. Portal vascular resistance was unchanged. These findings indicate that the presence of overt hepatic tumour results in gross derangements of hepatic blood flow. These changes must be taken into consideration when attempting to potentiate the delivery of cytotoxic drugs to hepatic tumour by manipulation of hepatic haemodynamics. PMID- 1764372 TI - A study of the effects of photodynamic therapy on the normal tissues of the rabbit jaw. AB - Photodynamic therapy (PDT) is an anti-cancer treatment which involves the systemic administration of a photosensitising drug which is preferentially absorbed by tumour tissue. Relatively little drug should be absorbed by the surrounding normal tissues. Tumour destruction is achieved when the tumour is illuminated with light of a wavelength which activates the photosensitising drug thereby inducing a cytotoxic reaction. However studies in many tissues have shown that the hoped for tumour selectivity is rarely achieved. Using the rabbit mandible and gingiva as our models we have studied the effects of various doses of PDT on the tissues of the oral cavity, namely mucosa, bone, muscle and salivary gland. The photosensitiser used was di-sulphonated aluminium phthalocyanine. Results show that whereas bone is extremely resistant to PDT the other tissues are vulnerable to it. In the case of muscle and salivary gland this susceptibility is very much dose related. In salivary tissue necrotising sialometaplasia was observed in areas of the gland adjacent to those that had undergone necrosis. All tissues were noted to heal or regenerate well following PDT injury. PMID- 1764373 TI - Development of cyclosporin A mediated immunity in L1210 leukaemia. AB - Cyclosporin A (CsA) is an effective modulator of multidrug resistance (MDR) in vitro and in murine tumour systems in vivo. We now report the production of immunity to L1210 leukaemia by the addition of CsA to VP-16 therapy of leukaemic BDF/1 mice. VP-16/cyclosporin A tumour immunity induction arises as a consequence of active therapy independently of immunisation with modified tumour cells. The addition of CsA to VP-16 prolongs survival of BDF/1 host mice bearing L1210 leukaemia beyond that produced by equivalent dose VP-16 alone. A subpopulation of 60-day surviving mice after combined VP-16/CsA are immune to rechallenge with the same leukaemia inoculum to which they were originally exposed. Spleen cells from immune mice adoptively transfer anti-L1210 leukaemia immunity to untreated BDF/1 mice in a dose dependent, statistically significant manner. Adoptive transfer experiments additionally suggest active recruitment of immunologic response in recipient animals: (1) We have been able to perpetuate leukaemia immunity in four sequential cohorts of naive recipient mice. This propogation of adoptive immunity is accomplished by use of spleen cells harvested from each preceeding passively protected animal cohort; (2) Cyclophosphamide pretreatment of adoptive transfer recipient mice abrogates the ability of their splenocytes to perpetuate passive protection in sequential adoptive transfer experiments. PMID- 1764374 TI - Distribution and photodynamic effect of disulphonated aluminium phthalocyanine in the pancreas and adjacent tissues in the Syrian golden hamster. AB - Necrosis of small volumes of tumour tissue with photodynamic therapy (PDT) can be achieved relatively easily. For this to be clinically relevant, it is essential to know what the same treatment parameters do to adjacent normal tissues into which the tumour has spread. For pancreatic cancers, local spread to vital structures is common. We have studied chemical extraction, microscopic fluorescence kinetics and photodynamic effects of disulphonated aluminum phthalocyanine (AlS2Pc) in normal pancreas and adjacent tissues in hamsters. Chemical extraction exhibited a peak duodenal concentration of AlS2Pc 48 h after sensitisation, with levels much higher than in stomach and pancreas. With microscopic fluorescence photometry highest levels were seen in duodenal submucosa and bile duct walls 48 h after photosensitisation. Pancreatic ducts, duodenal mucosa and gastric mucosa and submucosa exhibited intermediate fluorescence with relatively weak fluorescence in pancreatic acinar tissue and the muscle layer of the stomach. As expected, on the basis of fluorescence intensity and chemical extraction studies, the duodenal and bile duct wall were the most vulnerable tissues to photodynamic therapy. When the dose of 5 mumol kg 1 of sensitiser was used, duodenal perforations, gastric ulcers and transudation of bile from the bile duct occurred. However, the lesions in the stomach and bile duct healed without perforation or obstruction, so only the duodenum was at risk of serious, irreversible damage. Using a lower dose of photosensitiser markedly reduced damage. PMID- 1764375 TI - Photodynamic therapy with chlorins for diffuse malignant mesothelioma: initial clinical results. AB - Four patients underwent intraoperative photodynamic therapy after surgery with meso-tetra-(hydroxyphenyl)-chlorin (mTHPC-PDT) for diffuse malignant mesothelioma. Preliminary procedures were performed in two patients in order to establish the efficacy of mTHPC-PDT and to optimise its tumoricidal effect. The tumoricidal effect was related to the mTHPC dose, light dose and the time interval between sensitation and activation. 0.3 mg kg-1 mTHPC activated after 48 h with 10 Joules cm-2 of non-thermal laser light at 650 nm resulted in a 10 mm deep tumour infarction, due to tumour vessel necrosis and thrombosis. The mTHPC tissue concentration was up to 14 times higher in the tumour than in normal tissues. Skin photosensitivity was mild, dose dependent and occurred 3 to 10 days after administration of mTHPC. According to the results obtained, intraoperative mTHPC-PDT was performed following pleuropneumonectomy in two, pleurectomy and lobectomy in one and pleurectomy in one patient. Ten Joules cm-2 were delivered to the diaphragm and the costophrenic sulcus and 5 Joules cm-2 to the remaining thoracic cavity. The postoperative course was marked by loss of appetite, fluid retention, hypoproteinemia and severe chest pain. One patient succumbed from aspiration pneumonia. The remaining patients developed no neural or vascular alterations and no bronchial stump insufficiency during follow-up. mTHPC-PDT following surgical tumour resection deserves further evaluation in good risk patients with diffuse malignant mesothelioma. PMID- 1764376 TI - Pharmacokinetic and imaging studies in patients receiving a formulation of liposome-associated adriamycin. AB - Pharmacokinetic and imaging studies in 19 patients receiving liposome-entrapped adriamycin (L-ADM) were carried out within the framework of a Phase I clinical trial (Gabizon et al., 1989a). The formulation of L-ADM tested consisted of 0.2 microM-extruded multilamellar vesicles composed of egg phosphatidylcholine, egg derived phosphatidyl-glycerol (PG), cholesterol, and ADM intercalated in the fluid lipid bilayer. Plasma clearance of total drug extracted from the plasma after L-ADM infusion followed a biexponential curve with a pattern similar to that reported for free ADM. The plasma concentration of drug circulating in liposome-associated from was also measured in a subgroup of seven patients. Liposome-associated drug was found to be rapidly cleared from plasma. Its ratio to non-liposome-associated drug appeared to correlate with liver reserve, with highest ratios in patients with normal liver function. Liposome clearance, as measured by the plasma concentration of PG in three patients was slower than the clearance of liposome-associated ADM, suggesting that liposomes lose part of their drug payload during circulation. To learn about the liposome organ distribution, imaging studies were carried out with 111Indium-deferoxamine labelled liposomes of the same composition. Liposomes were cleared predominantly by liver and spleen and to a lesser extent by bone marrow in seven out of nine patients. In two patients with active hepatitis and severe liver dysfunction, there was minimal liver uptake and increased spleen and bone marrow uptake. Except for one hepatoma patient, intrahepatic and extrahepatic tumours were not imaged by liposomes, suggesting that liposome uptake is restricted to cells of the reticulo-endothelial system (RES).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764377 TI - Breast screening, prognostic factors and survival--results from the Swedish two county study. AB - The results of the Swedish two-county study are analysed with respect to tumour size, nodal status and malignancy grade, and the relationship of these prognostic factors to screening and to survival. It is shown that these factors can account for much of the differences in survival between incidence screen detected, interval and control group cancers but to a lesser extent for cancers detected at the prevalence screen where length bias is greatest. Furthermore, examination of the relationships among the prognostic factors and mode of detection indicates that malignancy grade, as a measure of inherent malignant capacity, evolves as a tumour grows. The proportion of cancers with poor malignancy grade is several fold lower for cancers of diameter less than 15 cm than for cancers greater than 30 cm, independent of the length bias of screening. The implications of these findings for screening frequency are briefly discussed. PMID- 1764378 TI - Nucleolar organiser regions (AgNORs) as predictors in transitional cell bladder cancer. AB - The predictive value of silver stained nucleolar organiser regions (AgNORs) was assessed in 229 patients with transitional cell bladder cancer followed up for over 10 years. The AgNORs were enumerated in pretreatment biopsy specimens. The AgNORs were related to clinical stage (T) (P = 0.0111), papillarity (P less than 0.0001), WHO grade (P less than 0.0001), DNA ploidy (P = 0.0010) and S-phase fraction (P less than 0.0001). Tumours presenting with pelvic lymph node involvement (P = 0.0085) or metastasis (P = 0.0780) at the time of diagnosis had more AgNORs than tumours confined to the bladder wall. Progression in T-, N- and M-categories (P = 0.0010-0.0030) was related to AgNORs and consequently they predicted bladder cancer related survival (P = 0.0005). The diploid tumours could be regrouped according to survival by AgNORs (P = 0.0001). In papillary tumours AgNORs predicted progression (P = 0.0110) and survival (P = 0.0038). In Ta-T1 tumours AgNORs predicted progression (P = 0.11) and survival (P = 0.0751) and also in T2-T3 tumours AgNORs contributed to survival significantly (P = 0.0039). The AgNORs subdivided WHO grade III tumours according to their ability to progress during the follow-up time (P = 0.0711). In a multivariate analysis AgNORs predicted progression independently in Ta-T1 category (P = 0.0165). AgNORs predicted recurrence free period like SPF (P = 0.0010). In conclusion, AgNORs are inferior to classic prognostic factors or DNA flow cytometric variables in muscle invasive bladder cancers whereas they have independent predictive value in superficial cancers. PMID- 1764379 TI - Verification of the cause of death in the trial of early detection of breast cancer. UK Trial of Early Detection of Breast Cancer Group. Trial Co-ordinating Centre. AB - The limitations of case review as a means of identifying errors in death certificates among breast cancer patients in a non-randomised trial of screening are illustrated by the findings of this large study. Records of 928 out of 990 deaths were available for review but were very variable in quality. Definite errors were found in 1%, errors were suspected in a further 5% and uncertainty about the cause of death, despite review, was recorded for 27%. The overall bias in reporting breast cancer deaths was less than 1%. It was concluded that the certified underlying cause of death without review provides an adequate endpoint for evaluating breast cancer screening programmes in the UK. PMID- 1764380 TI - Essential fatty acid distribution in the plasma and tissue phospholipids of patients with benign and malignant prostatic disease. AB - There is increasing evidence that essential fatty acids (EFA) may have a role to play in the aetiology of some types of cancer although their precise mode of action is unknown. Differences in the metabolism of EFA between patients with benign or malignant prostatic disease may help to elucidate their role in the latter. We have, therefore, measured the concentration of the essential fatty acids, and their metabolites, in the phospholipid fractions of both plasma and tissue, in patients with either benign or malignant prostatic disease. Comparison of the median concentration of fatty acids in each group (n = 10) revealed significant differences between them. The phospholipid component of total lipid was greater in malignant (P less than 0.04, unpaired t-test) than in benign tissue. The concentrations of linoleic acid (LA) and di-homo gamma linolenic acid (DGLA) in plasma and tissue were not different between the two groups of patients, but a significant reduction in arachidonic acid (ARA) (P less than 0.002, Mann-Whitney U-test) and docosapentaenoic acid (DPA) (P = 0.009) concentrations was observed in malignant tissue as compared to benign. Patients with malignant prostatic disease also had a significantly higher concentration of oleic acid in phospholipids from both plasma and prostatic tissue. The stearic to oleic acid ratio was similar in plasma but was significantly reduced in malignant tissue (P = 0.006). We suggest that the decreased arachidonic acid concentration in malignant tissue may be due to its increased metabolism, via the lipoxygenase and cyclooxygenase pathways to produce higher concentrations of eicosanoids, rather than an impairment in desaturase activity in situ. PMID- 1764381 TI - Molecular monitoring of low grade non-Hodgkin's lymphoma by gene amplification. AB - Molecular monitoring by the polymerase chain reaction was used to detect and follow minimal disease in working formulation category B and C on non-Hodgkin's lymphoma. Rearrangement of the bcl-2 gene served as the target for gene amplification. Thirty patients were studied. Bone marrow histology was compared to PCR analysis of bone marrow aspirate and blood. PCR upstaged disease status in approximately 50% of patients. Results are shown from a patient whose disease was followed with PCR during chemotherapy from initial remission to relapse. We conclude that PCR of bone marrow and blood can be used to upstage disease status in low grade lymphoma and PCR of blood may be used to monitor response to treatment with obvious patient benefit. The general approach of molecular monitoring provides a means for appraising therapies in the setting of subclinical disease. PMID- 1764382 TI - Genetic susceptibility to naevi--a twin study. AB - The risk of malignant melanoma to an individual is strongly related to their total number of benign melanocytic naevi. To investigate the possibility that numbers of naevi may have an inherited basis, naevi were examined in 23 monozygotic and 22 dizygotic twin pairs. A strong correlation in total numbers of naevi 3 mm or more in diameter was observed between MZ twins (intraclass correlation 0.83), but there was no significant correlation between DZ twins (correlation -0.24). There was no increased concordance in presence of naevi 5 mm or more over that expected by chance, for MZ or DZ twins. The results suggest a strong inherited basis for total naevus count and hence melanoma risk, perhaps involving a number of interacting genes. PMID- 1764383 TI - Protocol allocation and exclusion in two Danish randomised trials in ovarian cancer. AB - Between September 1981 and November 1984 the Danish Ovarian Cancer Group (DACOVA) performed two randomised trials. One for adjuvant therapy in stages Ib, Ic and II and one for chemotherapy treatment in stages III and IV. One hundred and twenty patients fulfilled criteria for the early stage protocol but only 60% was randomised. Three hundred and sixty-one fulfilled criteria for the advanced stages protocol, 73% was randomised. In early stages 11% were excluded because of unavoidable reasons and 29% because of avoidable reasons. In contrast, in advanced stages 21% were excluded because of unavoidable reasons and only 6% because of avoidable reasons. Allocation to the early stage protocol varied with stage, histologic type, residual tumour, and the presence of ascites. These factors had no influence upon allocation to the advanced stages protocol. The experience from this study is: only essential and simple questions should be examined in multicentre trials. Patient accrual and the difference between randomisation groups are usually overestimated, large scale trials are often required to get statistically significant differences, and the participation of departments only randomising a small and selected part of their patients is questionable. PMID- 1764384 TI - Growth factors in ovarian cancer. AB - Epidermal growth factor and transforming growth factor alpha are two peptides which bind to the epidermal growth factor receptor. One hundred and seventy-four samples from 133 patients with ovarian cancer were examined for EGF and TGF alpha. EGF was detected in only 27.6% of samples while TGF alpha was present in 88.5%. The median values for TGF alpha presence were at least 10-fold greater than those of EGF. There was no statistical difference between either TGF alpha or EGF levels and degree of differentiation of the tumours. There was no statistical difference between stage three and four in relation to concentration of either peptide. Median concentration did not differ significantly among the histological sub-groups. PMID- 1764385 TI - Intestinal and diffuse types of gastric cancer: secular trends in Sweden since 1951. AB - In order to test the hypothesis that the general decline in gastric cancer observed in many countries is due to a selective decline in Lauren's intestinal type, we re-examined all 427 histologic sections obtained from gastric carcinomas diagnosed at the Department of Pathology, University Hospital, Uppsala, Sweden, in 1951, 1961, 1971-72 and 1981. The relative proportions of intestinal and diffuse type cancers were compared. The intestinal type was significantly (P less than 0.001) more common among elderly people than in the younger age groups. The relative proportions of intestinal type carcinoma in the four periods under study were 65%, 55%, 42% and 60%, respectively. The absence of any clearly discernible trend over time contradicts the hypothesis of diverse secular trends for intestinal and diffuse types of gastric carcinoma. PMID- 1764386 TI - Phase II trial of didox in advanced breast cancer. Cancer Research Campaign Phase I/II Clinical Trials Committee. AB - Fourteen patients with advanced breast cancer were treated with the ribonucleotide reductase inhibitor didox 6 g m-2 given by intravenous infusion over 36 h every 3 weeks. None responded and toxicity was minimal. Possibilities for the more effective use of this agent are discussed. PMID- 1764387 TI - Serum gastrin levels in patients with intestinal and diffuse type of gastric cancer. PMID- 1764388 TI - LHRH analogues and breast cancer. PMID- 1764389 TI - Studying stress in care givers: art or science? PMID- 1764391 TI - Molecular aspects of a negative regulator of haemopoiesis. PMID- 1764390 TI - The EUROSCAN Study. EUROSCAN Steering Committee. PMID- 1764392 TI - Treatment of cancer in the elderly. PMID- 1764393 TI - Correlation between class I antigen expression and the ability to generate tumour infiltrating lymphocytes from bladder tumour biopsies. AB - Analysis of tissue sections from transurethrally resected bladder tumours using anti-CD3 antibody showed the presence of T lymphocytes in intra-epithelial layers in eight of 12 cases investigated. In a larger group of patients, Tumour Infiltrating Lymphocyte (TIL) growth was established from six of 19 cases using Interleukin-2 (IL-2) and conditioned medium (CM) and resulted in the expansion of TILs up to 100-fold. TILs from these individuals were phenotyped with W6/32 (anti HLA-A,B,C), HB55 (anti-DR) and anti-CD3 antibodies using FAC sorter. The mean +/- s.d. frequency of positive staining with these antibodies were 96.7 +/- 4.0%, 87.5 +/- 10.0% and 82.5 +/- 7.8% respectively, indicating the activated nature of these T cells. The cytotoxic activity of these TILs against Daudi (ie, LAK activity) cell line at 25/1 E/T ratios varied from 26.3 +/- 3.2 to 62.8 +/- 5.2%. In one case where TILs and autologous tumour cell line were established, cytotoxicity studies showed low level of cytotoxicity against the autologous tumour cells (15.8 +/- 1.6%) compared with 62.8 +/- 5.2% against Daudi. Staining of tumour sections from these 19 individuals with W6/32 and BBM.1 revealed positive staining in six of six that developed TILs but only six of 13 (46%) cases, whose tumour failed to grow TILs (P less than 0.02, Fisher exact test). These results are indicative of the presence of IL-2 passageable T cells in bladder cancer biopsy and demonstrate that the successful expansion of these cells correlates with the normal expression of class I antigens on the tumour cells. PMID- 1764394 TI - Pay: reviewing the situation. PMID- 1764395 TI - Pay: a question of due credit. PMID- 1764396 TI - World AIDS Day: beyond myth and hysteria. PMID- 1764398 TI - Advocacy within the multidisciplinary team. PMID- 1764399 TI - Continuing education: assessment of prior experiential learning. PMID- 1764397 TI - Endoscopy nursing: setting up a local endoscopy service. PMID- 1764400 TI - Education: a conversion course in mental handicap. PMID- 1764401 TI - Paediatric nursing: computer detection of child abuse. AB - A computerised system which enables the detection of children who regularly attend an accident and emergency department with seemingly trivial injuries is described. The system is linked to the Nottinghamshire Children at Risk register and alerts staff to the possibility of non-accidental injury. Concern about safeguarding the confidentiality of data stored on the computer has been allayed by strict observation of the rules governing accessibility to medical information. Despite experiencing some problems with the system, operators believe it gives them the opportunity to intervene in suspected child abuse cases at an early stage. PMID- 1764402 TI - Working parents: single parents' double bind. PMID- 1764403 TI - Breast care. A commitment to quality care. PMID- 1764404 TI - Breast care. Psychological issues in breast care. PMID- 1764405 TI - Breast care. Skin reactions to radiotherapy. PMID- 1764406 TI - Breast care. Advocating the right choice for women. PMID- 1764407 TI - ALS--decision making under uncertainty: a positive approach. AB - Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease. It is characterized by feelings of uncertainty and predictable crises points where difficult decisions have to be made by both the client and the family. These crises points involve progressive and sometimes sudden impairment in mobility, communication, nutrition and ultimately, respiratory function. This paper will use case analysis to illustrate the decisions that have to be made at each crisis point. A model will be presented that will focus on the nursing assessment of decision making behaviours of families experiencing the crisis of a debilitating illness. Emphasis will be on educating the client and family to anticipate what to expect and what decision making strategies they can use. In addition, recent literature will be presented that reviews nursing interventions designed to improve the quality of life of the client and family during these difficult time periods. PMID- 1764408 TI - Assessing the prevalence of cognitive impairment in multiple sclerosis: implications for patient management. AB - Many patients with multiple sclerosis exhibit behavioural changes, including alterations cognitive functions and psychiatric abnormalities. Increasingly sophisticated neuropsychologic assessment techniques plus magnetic resonance imaging have added to our knowledge in this area, showing that these alterations may be more common than previously recognized. Research studies have attempted to address the question of whether these changes are primarily function of the demyelinating process itself or a reaction to the disability produced by the disorder. This is an important issue in terms of possible intervention. This paper will include a review of the literature. PMID- 1764409 TI - Amyloidosis. Part I. Implications for neuroscience nurses: introduction and amyloidosis secondary to spinal cord injury. AB - Amyloidosis describes a group of diseases characterized by deposition of abnormal fibrous proteins in body organs and soft tissues. This disease complex is classified under the broad headings primary and secondary based on whether or not chronic infections or inflammatory conditions co-exist. In addition, localized versus systemic involvement and heredofamilial considerations are used to subclassify amyloidosis. Many primary and secondary amyloid diseases involved the central, peripheral and autonomic nervous systems. This paper will focus on the latest information concerning systemic and localized forms of amyloidosis involving the nervous system with special emphasis on Alzheimer's disease and amyloidosis secondary to spinal cord injury. The roles of the nurse related to diagnosis, patient care, patient and family education and identification of support systems in the community will be covered. Patient care will be discussed from the standpoint of process and outcome criteria for specific nursing diagnoses. PMID- 1764410 TI - The relationship between critical care nurses' knowledge about sleep, and the initiation of sleep promoting nursing interventions. AB - This descriptive correlation study examined the relationship between critical care nurses' sleep-promoting nursing interventions and their knowledge about sleep; the priority they gave to sleep; their perceptions about the ICU environment; the quantity and quality of sleep they perceived the patients to have obtained; and their sleep promoting nursing interventions. The data were described and then analysed using multiple regression/correlational analysis. Critical care nurses were not very knowledgeable about sleep. They perceived the ICU environment to be moderately conducive to sleep and perceived that they had only some ability to change the ICU environment in order to promote sleep. There was no statistically significant relationship between critical care nurses', sleep promoting nursing interventions and their knowledge about sleep. Several explanations for this are given. There was a statistically significant relationship between sleep promoting nursing interventions and the priority critical care nurses gave to sleep. Several implications for nursing research were drawn from the data and presented. PMID- 1764411 TI - Metastable motion anisotropy. AB - The phenomenon of apparent motion can arise when two spatially separated visual tokens are presented in temporal sequence. If tokens at opposite corners of a hypothetical square are presented simultaneously followed by simultaneous presentation of tokens at the remaining two corners, an apparent motion percept may occur along either the vertical or horizontal axis. The display is perceptually metastable since most observers will perceive motion along only one axis at a time. The metastable display, however, produces anisotropic results, in that with central fixation, vertical motion is seen more frequently than horizontal motion. The ratio of the vertical to horizontal length of the sides of a rectangle needed to achieve equal frequencies of motion judgments along the respective axes falls in the range of 1.18-1.92 for different observers in our experiments. It appears that signal transmission across the vertical midline is a major determinant of the vertical bias, since the anisotropic effects disappear when the fixation point is sufficiently offset along the horizontal meridian so as to cause a fully homonymous representation of all of the metastable tokens. One of the factors may be signal degradation or delay in callosal transmission which could reduce the strength of the motion signal along the horizontal axis. In addition, there appears to be a strip along the vertical midline with a width of 30-50 min arc within which reduced levels of anisotropy are found. The possibility that this strip is a consequence of a zone of naso-temporal overlap in the projection of the retina to the brain along the vertical meridian will be discussed. PMID- 1764412 TI - Synaptic inputs to physiologically defined turtle retinal ganglion cells. AB - Two physiologically distinct, HRP-marked turtle retinal ganglion cells were examined for their morphology, GABAergic, glycinergic, and bipolar cell synaptic inputs, using electron-microscopic autoradiography and postembedding immunocytochemistry. One cell was a color-opponent, transient ON/OFF ganglion cell. Its center response to red was a sustained hyperpolarization, and its center response to green was a depolarization with increased spiking at onset. The HRP-injected cell most resembled G6, from previous Golgi-impregnation studies (Kolb, 1982; Kolb et al., 1988). It was a narrow-field bistratified cell, whose two broad dendritic strata peaked at approximately levels L20-25 (sublamina a) and L60 (sublamina b) of the inner plexiform layer. Bipolar cell synapses onto G6 were found evenly distributed between its distal and proximal dendritic strata, spanning L20-75. These inputs probably originated from several different bipolar cells, reflecting the complexity of the center response. GABAergic inputs were found onto both the distal and proximal strata, from near L20-L85. Only a few glycinergic inputs, confined to dendrites at L50-70, were observed. A second ganglion cell type that we physiologically characterized and HRP-injected had sustained ON-center, sustained OFF-surround responses. Two examples were studied; both were bistratified in sublamina b, near L60-70 and L85-100, with branches up to near L40. They resembled G10, from previous Golgi-impregnation studies (Kolb, 1982; Kolb et al., 1988). One cell was partially reconstructed to look at the distributions of GABAergic and glycinergic amacrine cell, and bipolar cell inputs. Although synapses from bipolar cells were equally divided between the two major dendritic strata of G10, the inputs to the distal stratum were close to the soma, and the inputs to the more proximal stratum were on the peripheral dendrites. This arrangement may reflect input from two distinct types of ON bipolar cell. GABAergic and glycinergic inputs to G10 costratified to both strata and to the distal branches; but where glycinergic inputs were found distributed throughout the arbor, GABAergic inputs appeared to be confined to peripheral dendrites. We hypothesize on the neural elements involved and the circuitry that may underlie the physiologically recorded receptive fields of these two very different ganglion cell types in the turtle retina. PMID- 1764413 TI - Effects of synaptic drugs on turtle optokinetic nystagmus and the spike responses of the basal optic nucleus. AB - Behavioral and electrophysiological measures were used to elucidate the retinal modulation of oculomotor control in the turtle. Eye movements were recorded following intravitreal applications of 2-amino-4-phosphonobutyrate (APB) and the GABA antagonists picrotoxin and bicuculline. Visual responses of single basal optic nucleus (BON) neurons of the accessory optic system were studied in parallel experiments. The effectiveness of APB, a glutamate analog thought to act selectively on the retinal ON pathway, was assessed independently by recording electroretinograms or ganglion cell activity. Injections of APB into the turtle's eye reduced or blocked the injected eye's ability to drive horizontal optokinetic nystagmus, as also observed in rabbit and cat (Knapp et al., 1988; Yucel et al., 1989). Single-unit recordings from the BON during APB superfusion (50-200 microM APB) of the contralateral retina demonstrated that these cells, which are direction-sensitive and respond to the offset of light flashes, have their responses to moving stimuli blocked by APB. During the APB effect, GABA antagonists were applied to the same eye. Although moderate doses of APB were sufficient to block optokinetic or BON light responses, the addition of GABA blockers still elicited a spontaneous temporal-to-nasal nystagmus (Ariel, 1989) or visually responsive yet direction-insensitive responses from BON cells (Schuerger et al., 1990). These results are discussed in terms of the retinal output to pathways involved in oculomotor control of optokinetic nystagmus. PMID- 1764414 TI - Background illumination reduces horizontal cell receptive-field size in both normal and 6-hydroxydopamine-lesioned goldfish retinas. AB - The effect of background illumination on horizontal cell receptive-field size and dye coupling was investigated in isolated superfused goldfish retinas. Background illumination reduced both horizontal cell receptive-field size and dye coupling. The effect of light on horizontal cell receptive-field size was mimicked by treating the retina with 20 microM dopamine. To test the hypothesis that the effects of light were due to endogenous dopamine release, the effect of light was studied in goldfish retinas in which dopaminergic interplexiform cells were lesioned using 6-hydroxydopamine treatment. In lesioned retinas, background illumination reduced both horizontal cell receptive-field size and dye coupling. Furthermore, the effect of background illumination on unlesioned animals could not be blocked by prior treatment with the D1 dopamine receptor antagonist SCH 23390. These results suggest that, in goldfish retina, dopamine release is not the only mechanism by which horizontal cell receptive-field size could be reduced by light. PMID- 1764416 TI - Organization of ascending projections from the optic tectum and mesencephalic pretectal gray in Rana pipiens. AB - The ascending projections from the dorsal mesencephalon to the thalamus and pretectum in Rana pipiens were investigated by using the anterograde and retrograde transport of HRP with regard to two major issues: (1) the degree of tectotopic organization in the projections, and (2) their cells of origin. The results indicate that the spatial organization of the tecto-thalamic tract is specifically related to the laminar organization of the contributing tectal efferent neurons. Axons of neurons in the superficial portion of tectal layer 8 exit the tectum through layer 9 and travel in the superficial portion of the dorsal and ventral tecto-thalamic tracts and innervate the nucleus lentiformis mesencephali, the posterior lateral dorsal nucleus, and corpus geniculatum. The distribution of terminals within these structures varied with the tectal HRP injection site. HRP injections in the ventral tecto-thalamic tract retrogradely labeled neurons in the superficial portion of tectal layer 8 across the lateral and caudal portion of the tectal lobe. HRP injections into the dorsal tecto thalamic tract, at the level of the pretectum, retrogradely labeled pyriform neurons in the superficial portion of tectal layer 8 in the rostral and medial portions of the tectal lobe. With regard to the deep tectal layers, axons from pyramidal neurons in layer 6 and ganglionic neurons in layer 8 leave the tectum through layer 7, travel in both the dorsal and ventral tecto-thalamic tracts, and are located internal to the axons of the pyriform neurons of superficial tectal layer 8. The majority of the ganglionic neurons project to the posterior lateral ventral nucleus and the anterior lateral nucleus. The distribution of terminals within these nuclei did not display a tectotopic organization. A second major projection to the thalamus originates from the mesencephalic pretectal gray and innervates the nucleus lentiformis mesencephali, the posterior lateral dorsal nucleus, the anterior lateral nucleus, dorsal and ventral divisions of the ventral lateral thalamus, and the nucleus of Bellonci. Other axons from the mesencephalic pretectal gray terminate in the contralateral, medial portions of the posterior lateral dorsal thalamus, the ventral lateral thalamus, and the anterior lateral nucleus. The isthmo-tectal projection was also retrogradely labeled following tectal injections of HRP. This pathway travels in the most ventral portion of the ventral tecto-thalamic tract; its axons passed over the lateral margin of the endopeduncular nucleus bilaterally, and crossed the midline in the caudal portion of the optic chiasm. Extensive, bead-like varicosities were observed on these axons both in the endopeduncular nucleus and in the posterior optic chiasm.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1764415 TI - Effects of light stimuli on the release of dopamine from interplexiform cells in the white perch retina. AB - Interplexiform cells are centrifugal neurons in the retina carrying information from the inner to the outer plexiform layers. In teleost fish, interplexiform cells appear to release dopamine in the outer plexiform layer after prolonged darkness that modulates the receptive-field size and light responsiveness of horizontal cells (Mangel & Dowling, 1985; Yang et al., 1988a, b). It has been proposed that interplexiform cells may also release dopamine upon steady illumination because horizontal cells' receptive fields shrink in the light (Shigematsu & Yamada, 1988). Here, we report the shrinkage of the receptive fields of horizontal cells seen in the presence of background illumination is not blocked by dopamine antagonists, indicating that dopamine does not underlie the receptive-field size changes observed during steady illumination. Flickering light, however, does appear to stimulate the release of dopamine from the interplexiform cells, resulting in a marked reduction of horizontal cell receptive-field size. Taken together, experiments on horizontal cells indicate that dopamine is released from interplexiform cells in the teleost retina after prolonged darkness and during flickering light, but that dopamine release from interplexiform cells during steady retinal illumination is minimal. PMID- 1764417 TI - Melatonin inhibits ACh release from rabbit retina. AB - Previous studies have suggested that melatonin, released from photoreceptors, may modulate retinal dark-adaptive responses by inhibition of dopamine release from retinal interneurons. We have broadened these studies to examine the effect of melatonin on release of another retinal neurotransmitter, acetylcholine (ACh). The ACh system in rabbit retina has been localized to starburst amacrine cells, which release ACh in response to a variety of experimental stimuli, including direct potassium depolarization, flashing light, and glutamatergic as well as GABAergic inputs. The effect of melatonin on release of endogenously synthesized [3H]-ACh was measured in perfusates from retinas or retinal synaptosomes preloaded with [3H]-choline chloride. Melatonin significantly inhibited ACh release stimulated by potassium in intact retina but not in synaptosomes. Stimulation of intact retina by flashing light or by the glutamate receptor agonist, kainic acid, was also inhibited by melatonin. In contrast, there was no significant effect of melatonin on picrotoxin-induced release. These findings suggest that melatonin does have an inhibitory effect on ACh release, either by direct interaction with the cholinergic amacrine cell, or indirectly via GABAergic but not glutamatergic neurons. PMID- 1764419 TI - Occurrence of express saccades under isoluminance and low contrast luminance conditions. AB - Saccadic reaction times (SRTs) of three human subjects were analyzed. The gap paradigm was used (i.e. fixation point offset precedes target onset) to obtain high proportions of express saccades (i.e. saccades of extremely short reaction times) in the SRT distributions. In one set of experiments, the luminance of the (red) saccade target was varied from brighter to darker than the (green) background including an isoluminance condition. Express saccades were obtained in response to pure color contrast stimuli with about the same frequency and reaction time as to stimuli with both color and luminance contrast. In a second experiment, the luminance contrast of a white target on a white background was lowered below 10%. Again the number of express saccades was not reduced. Thus, in contrast to other perceptual phenomena the visual neural mechanisms underlying the generation of express saccades are not affected by isoluminance nor low contrast luminance. PMID- 1764418 TI - Dim background light and Cerenkov radiation from 32P block reversal of rhodopsin phosphorylation in intact frog retinal rods. AB - The phosphorylation of photoexcited rhodopsin (Rho*) is thought to inactivate this receptor by inhibiting its interaction with the GTP-binding protein transducin (Gt). Here we report that the time course of phosphorylation dephosphorylation after bright illumination of intact rod outer and inner segments (ROS-RIS) incubated in 33Pi can be altered if the ROS-RIS are first exposed to levels of dim illumination that cause light adaptation in these ROS RIS. The dephosphorylation of greater than 10(7) phosphorylated rhodopsin molecules/ROS following a bright flash can be blocked by prior dim continuous illumination (generating 10(3) Rho*/ROS/s) that cumulatively bleaches approximately 10(5) rhodopsin molecules/ROS. The phenomenon has not been previously noted because these low levels of light are emitted as a result of Cerenkov radiation from the 32P isotope that is usually employed to monitor rhodopsin phosphorylation. The inhibition of rhodopsin dephosphorylation by dim conditioning illumination is observed in intact ROS-RIS but is lost when ROS-RIS are electropermeabilized or fragmented. PMID- 1764420 TI - Anaplastic carcinoma of the lacrimal gland presenting with recurrent subconjunctival hemorrhages and displaying incipient sebaceous differentiation. AB - Primary adenocarcinomas of the lacrimal gland rarely display sebaceous differentiation. An anaplastic lacrimal gland neoplasm manifesting this feature was excised from a 64-year-old man who initially appeared with recurrent painless subconjunctival hemorrhages. Globe displacement and tumor-induced hyperopia were later findings. Electron microscopic studies performed on the widely excised tumor documented prominent lipid vacuoles, desmosomes, scattered cytoplasmic filaments, and linear segments of basement membrane material. The patient refused radical surgery and instead opted for 6,000 rads of adjuvant radiotherapy. Eleven months postoperatively liver and bone metastases developed, but he was free of local orbital recurrence. Twenty-two months postoperatively he died from complications of his metastatic disease. This most unusual lacrimal neoplasm is discussed in terms of its initial signs and symptoms and its histopathology. When the current case is analyzed in combination with three earlier reports, there is evidence that primary lacrimal gland sebaceous carcinoma is probably among the most malignant orbital tumors due to its uniform early fatality. PMID- 1764421 TI - Massive orbital extension of posterior uveal melanomas. AB - Among 2,135 consecutive patients with posterior uveal melanoma who were evaluated clinically in the Ocular Oncology Service of Wills Eye Hospital between February 1974 and December 1986, 123 (5.8%) were found to have some degree of extrascleral extension of the tumor. Ten of the 2,135 patients (0.5%) had massive orbital extension we defined as extrascleral tumor having an estimated volume exceeding 1,000 mm3. Three of these patients were characterized by orbital recurrence sometime after enucleation, whereas seven had massive orbital extension as the initial manifestation of the neoplasm with no prior history of enucleation. These cases of advanced orbital extension are presented in detail with emphasis on clinical features, diagnostic problems, pathologic findings, and follow-up observation. Based on our observations, suggestions are made regarding the diagnosis and management of advanced orbital extension of posterior uveal melanoma. PMID- 1764422 TI - Mechanisms of visual loss in severe proptosis. AB - Vision loss in orbital hypertension secondary to sudden space-occupying lesions is usually attributed to one of three causes: central retinal artery occlusion, direct compressive optic neuropathy, or compression of optic nerve vasculature. Accepted modes of decompressive therapy include lateral canthotomy and cantholysis; drainage of localized orbital air, hematoma, or abscess; and bony wall decompression. Five cases are presented in which orbital hypertension caused severe proptosis with traction on the optic nerve and tenting of the posterior globe. Another mechanism contributing to visual loss is proposed in these cases: ischemic optic neuropathy due to stretching of nutrient vessels. In these cases, rapid posterior decompression should theoretically be favored to reduce orbital pressure and relieve traction on the optic nerve vasculature. PMID- 1764423 TI - Avoiding blood loss in outpatient dacryocystorhinostomy. AB - The control of perioperative hemorrhage is a concern in dacryocystorhinostomy, which has traditionally been done as an inpatient procedure, often with general anesthesia. The trend now is toward outpatient surgery under local anesthesia. With proper patient selection and education, adequate anesthesia, and a meticulous surgical technique aimed at preventing blood loss, complications related to outpatient dacryocystorhinostomy can be minimal and associated with a high degree of patient acceptance. This article reviews my technique and experience in preventing blood loss in 434 procedures over 3 years. PMID- 1764424 TI - Delayed chocolate cyst after blow-out fracture. PMID- 1764425 TI - Surgical correction of trachoma-related upper eyelid cicatricial entropion utilizing the Barbera-Carre technique. AB - Upper eyelid cicatricial entropion is commonly encountered as a sequela of inflammatory conditions. The surgical correction of this defect is often difficult and frequently unsuccessful. We have used the Barbera-Carre technique with good results in 20 patients with cicatricial entropion due to trachoma. We take this opportunity to present the surgical technique and our results. PMID- 1764426 TI - Involutional entropion: a retrospective analysis of the Wies procedure alone or combined with a horizontal shortening procedure. AB - The surgical management of 95 cases of involutional entropion were reviewed to form this retrospective study. The 66 cases treated with the Wies procedure alone had a recurrence rate of 11%. The 29 cases treated with a combined procedure consisting of a Wies procedure with a lateral canthal horizontal shortening had no recurrences. All patients had a minimum of 6 months postoperative follow-up. The etiologic factors as they relate to the appropriate surgical procedures are discussed. PMID- 1764427 TI - Interpositional polytetrafluoroethylene grafts. Conjunctival biocompatibility. AB - Polytetrafluoroethylene (PTFE) is a synthetic, woven, nonabsorbable, nonantigenic, Teflon-related material that has been shown to be useful in correcting eyelid retraction and as an implant enveloping material in primary and secondary surgery to correct anophthalmos. Implanted PTFE will extrude if not entirely covered with a layer of conjunctival epithelium. In vitro studies demonstrated that coating PTFE with collagen, fibronectin, gelatin, or laminin promotes epithelial cell and fibroblast migration over and adherence to PTFE. In vivo studies showed that a coating of type 1 collagen is most successful in preventing graft extrusion by promoting conjunctival epithelial attachment and growth over exposed PTFE. Further studies are needed to determine the optimum PTFE coating and pore size needed to ensure the consistent retention of uncovered implanted PTFE grafts. PMID- 1764428 TI - HIV and banked fascia lata. AB - Concern over the transmission of communicable diseases through donor tissue has recently increased. Nine hundred and fifty-nine pieces of banked homologous irradiated fascia lata have been distributed to ophthalmic plastic surgeons nationwide over the past 3 years since the establishment of the Wills Eye Hospital Fascia Lata Bank. Safeguards taken against the transmission of disease include strict donor selection; negative antibody testing for human immunodeficiency virus (HIV), rapid plasma reagin (RPR), and hepatitis B surface antigen (HbsAg); heat treatment; and radiation sterilization with 4 million rads of cobalt-60 gamma radiation. To date, no cases have been reported of the transmission of HIV through surgical implantation of banked irradiated homologous fascia lata. PMID- 1764429 TI - Transconjunctival frontalis suspension (TCFS). AB - We have devised a frontalis suspension technique originally described in an article entitled, "Transconjunctival frontalis suspension for blepharoptosis" (Trans Am Acad Ophthal Otolaryngol 83:684-92), by Swan and Tongue in 1977. This modified transconjunctival frontalis suspension (TCFS) procedure is described. It has been used at the Oregon Health Sciences University in its original or modified form since 1970. To better understand how this procedure successfully corrects blepharoptosis in patients with poor levator function, a study was undertaken to discern the anatomic relationship of the suspension material to important ocular adnexal structures. The findings are based on gross anatomic dissection and histologic examination of a cadaver eyelid after postmortem transconjunctival fascia lata frontalis suspension. The distal, horizontal limb of the fascia suspends the central portion of the levator aponeurosis in a hammock-type fashion. The two vertical limbs pierce the aponeurosis at the level of Whitnall's ligament and incorporate this ligament. The fascia then exits the orbit through the orbital septum near the arcus marginalis and is incorporated into the frontalis muscle near the junction of the medial one-third and lateral two-thirds of the brow, temporal to the supraorbital neurovascular bundle. This anatomic location is not only relatively easily and safely attained, but also maximizes the principles of more traditional frontalis suspensions while minimizing the effort and surgical manipulation. PMID- 1764430 TI - Kahn's wire passer used in medial canthal tendon fixation. AB - The history of fixation of the medial canthal structures is one of gradual improvement in instrumentation and technique. Today, open reduction and internal fixation remain the mainstay of treatment for the medial canthal structures. With regard to the internal fixation method, we have developed a wire passer that can facilitate wire fixation of the delicate medial canthal tendon. We present two cases that manifest abnormalities of the medial canthal tendon. Both were corrected successfully with this wire passer. PMID- 1764431 TI - Phagocytosis of fluorescent latex microbeads by peritoneal macrophages in different strains of mice: a flow cytometric study. AB - The phagocytosis of uniform fluorescent latex particles by resident and thioglycollate-elicited macrophages was analysed by flow cytometry. The percentage of phagocytosing macrophages and the number of internalized microspheres per cell was determined from cell size and fluorescence histograms. Results were corrected for the adherence of microbeads to the cells in the presence of sodium azide in the medium. Human C3b- or murine monoclonal IgG coated microspheres were applied to assess receptor-mediated phagocytosis in different inbred strains of mice. Phagocytic activity of thioglycollate-elicited macrophages was consequently higher than that of resident macrophages. A decreasing gradient of C3b and Fc receptor-mediated phagocytosis was established in the following order: B10.BR, B10, C3H/Di and C3H.SW strains. Our results indicate that the phagocytic function of murine macrophages is under control of both the somatic (non-H-2) and H-2 genes. PMID- 1764432 TI - HLA class I nucleotide sequences, 1991. AB - The HLA class I sequences included in this compilation are taken from publications listed in the accompanying paper, Nomenclature for factors of the HLA system, 1990 (Bodmer et al., 1991), and also in Nomenclature for factors of the HLA system, 1989 (Bodmer et al., 1990). Where discrepancies have arisen between reported sequences the original authors have been contacted where possible, and necessary amendments to published sequences have been incorporated into this alignment. Future sequencing may identify errors in this list and we would welcome any evidence that helps to maintain the accuracy of this compilation. In the sequence alignments identity between residues is indicated by a hyphen (-). An unavailable sequence is indicated by a full point (.). Gaps in the sequence are inserted to maintain the alignment between different alleles showing variation in amino acid number. PMID- 1764433 TI - HLA class II nucleotide sequences, 1991. AB - The HLA class II sequences included in this compilation are taken from publications listed in the accompanying paper, Nomenclature for factors of the HLA system, 1990 (Bodmer et al., 1991), and Nomenclature for factors of the HLA system, 1989 (Bodmer et al., 1990). Where discrepancies have arisen between reported sequences the original authors have been contacted where possible, and necessary amendments to published sequences have been incorporated into this alignment. Future sequencing may identify errors in this list and we would welcome any evidence that helps to maintain the accuracy of this compilation. In the sequence alignments identity between residues is indicated by a hyphen (-). An unavailable sequence is indicated by an asterisk (*). Gaps in the sequence are inserted to maintain the alignment between different alleles showing variation in amino acid number. PMID- 1764434 TI - Tired of AIDS. PMID- 1764435 TI - Nashville CARES: providing hope & support. PMID- 1764437 TI - When do you 'say no' to work assignments? PMID- 1764436 TI - New emphasis should be on 'prevention': health care system must be restructured. PMID- 1764438 TI - Tormented. Addictions: are Americans caught in a backdraft? PMID- 1764439 TI - Compulsive sex. PMID- 1764440 TI - Sexual addiction screening test. PMID- 1764441 TI - TNF Peer Assistance Program: when Judy fell, she didn't know it was into a trap. PMID- 1764442 TI - Spotting the chemically dependent nurse. PMID- 1764443 TI - Imagine Murphy Brown on your floor: from new graduate fears to veteran fatigue, nurses have to deal with stress. PMID- 1764444 TI - FDA agrees to allow breast implants to remain on market: silicone gel not conclusively linked to cancer. PMID- 1764445 TI - America's secret. PMID- 1764446 TI - Overcoming the 'brain,' 'bucks,' and 'I didn't know nurses did research' barriers: develop knowledge to make a difference in peoples' lives. PMID- 1764447 TI - Glucose transport of Haloferax volcanii requires the Na(+)-electrochemical potential gradient and inhibitors for the mammalian glucose transporter inhibit the transport. AB - The uptake of glucose and its non-metabolizing analogues by Haloferax volcanii, one of the glucose-utilizing Halobacteria, was examined using intact cells and envelope vesicles. Results obtained were: (1) The transport system is inducible. (2) The uptake requires the gradient of Na(+)-electrochemical potential. (3) Inhibitors for mammalian glucose transport also have an effect on this system, implying that the transporters resemble each other. (4) It is suggested that the mobility of the transporter is regulated by the membrane energization. PMID- 1764448 TI - Renal heme metabolism in hereditary tyrosinemia: use of succinylacetone in rat renal tubules. AB - Succinylacetone (SA), a metabolic end-product found in urine from individuals with hereditary tyrosinemia and associated renal Fanconi syndrome and a known inhibitor of hepatic 5-aminolevulinic acid dehydratase (ALAD), has been used to study heme metabolism in isolated rat renal tubules. Heme biosynthetic porphyrin precursors are increased selectively in the presence of 4 mmol/1 SA. Total porphyrin content of the tubules are increased approximately 2-fold, while both ferrochelatase and heme oxygenase activities remain unaffected by SA. Nonetheless, total heme content is reduced, as was incorporation of radioactive label from amino[14C]levulinic acid. Cytochrome P-450 content remained unaffected. Impairment of iron uptake and/or transport within the cell or enhancement of heme catabolism via a non-heme oxygenase-dependent pathway could explain the observations. PMID- 1764449 TI - Protein-chromophore interactions in bacteriorhodopsin: the effects of a change in surface potential. AB - The chromophore retinal is bound to bacteriorhodopsin via a protonated Schiff base linkage. The retinal binding site is reported to be buried in the transmembrane portion of the protein, distant from the membrane surfaces. When bound to bacteriorhodopsin, the absorption maximum of retinal is red-shifted from 366 nm to 568 nm producing a purple color. This color persists across a wide pH range. However, when the pH is raised above 12.0, the membranes become pink in color, while at pH values of 3.0 or below, a blue color is produced. The blue color can also be obtained by removing the divalent cations bound to the surface of the protein. In this study, bacteriorhodopsin was examined by circular dichroism and absorption spectroscopy to determine if protein conformational changes were associated with the color shifts. It was found that although the retinal chromophore can be completely removed by bleaching with hydroxylamine with no significant influence on the secondary structure of the protein, a change in the surface charge of bacteriorhodopsin results in measurable conformational change in the protein, which apparently affects the nature of the retinal binding site. PMID- 1764450 TI - The use of the potential-sensitive fluorescent probe bisoxonol in mast cells. AB - The regulation of the plasma membrane potential of rat peritoneal mast cells at the resting state and during activation was investigated using bisoxonol as a potential-sensitive fluorescent dye. Fluorescence microphotography showed that this negatively charged probe was not only present in the plasma membrane, but was also distributed in the cytoplasm. The intracellular localization of bisoxonol was confirmed by conducting experiments which showed that bisoxonol fluorescence was not enhanced in ATP-permeabilized mast cells. Rotenone (10(-7) M) and oligomycin (10(-6) M) did not change the fluorescence of bisoxonol showing, therefore, mitochondrial depolarization was not recorded with bisoxonol and suggesting that bisoxonol may represent a useful probe to study plasma membrane potential changes in the absence of exocytosis. We showed that, in non stimulated mast cells, the blockade of the sodium pump enhanced the fluorescence of bisoxonol as did gramicidin a non selective ionophore used to fully depolarize the cells. High concentration of potassium (30 mM) as well as different ionic channel blockers did not significantly change the fluorescence intensity of bisoxonol, suggesting that ionic channel permeabilities were not involved in maintaining the resting plasma membrane potential of mast cells. Mast cells stimulated by compound 48/80 completely lost the fluorescence, shown by fluorescence microphotography, suggesting that exocytotic phenomena might induce a dye redistribution which is not only due to changes in the plasma membrane potential. In mast cells pretreated with pertussis toxin, which blocks mast cell exocytosis, compound 48/80 induced a delayed (2 min) decrease of bisoxonol fluorescence which was shown to be dependent on the activity of the sodium pump. Considering that bisoxonol is a useful potential-sensitive probe in exocytosis deprived mast cells, our results suggest that the sodium pump is mainly involved in the changes of plasma membrane potential of mast cells. PMID- 1764451 TI - Chronic ethanol ingestion modifies liver microsomal phosphatidylserine inducing resistance to hydrolysis by exogenous phospholipase A2. AB - Chronic ethanol ingestion leads to the acquisition of a tolerance to membrane lipid disordering, a lowered partition coefficient to hydrophobic compounds and a resistance to the hydrolysis of the phospholipids by exogenous phospholipase A2. Anionic phospholipids have been implicated as being responsible for the resistance to lipid disordering and a number of modifications to these phospholipids are known to occur as a result of chronic ethanol-ingestion. In this study the basis of the resistance to phospholipase A2 in hepatic microsomes was investigated. It was found that chronic ethanol-induced modifications to each of the major phospholipid classes was responsible to some extent for the resistance to phospholipase A2, however, PS was particularly potent considering it is a compositionally minor constituent. The effect was interpreted as a reduced ability to activate the phospholipase A2 since PS acts as an essential activator of phospholipase A2 (along with PI). Fatty acid analysis revealed that the chronic ethanol-treatment resulted in a elevated level of docosahexaenoate with a parallel reduction in arachidonate in phosphatidylserine. Lipid packing and organization is important in the regulating the level of exogenous phospholipase A2 activity but the activity was not found to correlate with lipid order of different phosphatidylserine species. It is concluded that subtle differences in the molecular species arrangement or disposition around the enzyme may be responsible for the altered phospholipase A2 interaction with the membrane induced by chronic ethanol-treatment. One implication of this study is that other anionic phospholipid dependent membrane proteins, of which there are many known examples, may also be modified as a result of chronic ethanol-ingestion. PMID- 1764452 TI - Carboxyacyl derivatives of cardiolipin as four-tailed hydrophobic anchors for the covalent coupling of hydrophilic proteins to liposomes. AB - Two carboxyacyl derivatives of cardiolipin, O-succinyl- and O glutarylcardiolipin, were synthesized with the aim of using them as artificial membrane anchors for the immobilization of hydrophilic proteins to liposomes. Four adjacent fatty acid residues can be introduced into a protein with only one single amino group being blocked, by reacting the cardiolipin derivatives with the protein amino groups after carbodiimide activation. alpha-Chymotrypsin, used as a model protein, and modified with on average two molecules of O succinylcardiolipin was incorporated into liposomes, which had been prepared by different methods, with very high yield. If incorporated in preformed liposomes, the carboxyacyl cardiolipin anchors were also efficient in binding proteins to liposomal surfaces. Up to 350 micrograms chymotrypsin/mumol lipid were coupled to small unilamellar vesicles, preserving reactivity of the enzyme towards specific macromolecular inhibitors. Human IgG could also be bound to anchor-containing liposomes with high protein to lipid coupling ratio as well as high coupling yield. PMID- 1764453 TI - The uptake of pristane (2,6,10,14-tetramethylpentadecane) into phospholipid bilayers as assessed by NMR, DSC, and tritium labeling methods. AB - Unilamellar dioleoylphosphatidylcholine (DOPC) liposomes (250 microM) incorporated 2 mol% of [3H]pristane at 37 degrees C after addition of 50 microM pristane solubilized with beta-cyclodextrin. Conventional solubilization in dimethyl sulphoxide resulted in much lower uptake. Premixing of perdeuterated pristane with DOPC and dipalmitoylphosphatidylcholine (DPPC) prior to the formation of multilamellar liposomes resulted in homogeneous incorporation of up to 5 mol% pristane at 22 degrees C and 50 degrees C, respectively, as observed by 2H-NMR. Lipid order parameters measured by 31P and 2H-NMR remained unchanged after pristane uptake. Pristane induced the transformation of part of the dioleoylphosphatidylethanolamine (DOPE)/DOPC (3:1, mol/mol) liquid crystalline lamellar phase into an inverse hexagonal phase. 5 mol% pristane in DPPC bilayers decreased the midpoint of the main phase transition temperature of DPPC from 41.5 degrees C to 40.9 degrees C. Upon cooling in the temperature range from 41 degrees C to 36 degrees C, pristane was either displaced from the DPPC bilayer or the mode of incorporation changed. These results may aid in defining the mechanisms whereby pristane, an isoprenoid C19-isoalkane, induces plasmacytomagenesis in mice. PMID- 1764454 TI - A comparative study on interactions of alpha-aminoisobutyric acid containing antibiotic peptides, trichopolyn I and hypelcin A with phosphatidylcholine bilayers. AB - Interactions of alpha-aminoisobutyric acid containing antibiotic peptides, trichopolyn I and hypelcin A with phosphatidylcholine bilayers were investigated to obtain some basic information on their bioactive mechanisms. Trichopolyn I as well as hypelcin A induced the leakage of a fluorescent dye, calcein, entrapped in sonicated egg yolk L-alpha-phosphatidylcholine vesicles. A quantitative analysis revealed that both the binding affinity and the 'membrane-perturbing activity' of trichopolyn I to the vesicles are about one-third of those of hypelcin A. The conformations and the orientations of the peptide and lipid molecules in the membranes were studied using polarized Fourier transform infrared-attenuated total reflection spectroscopy, circular dichroism, and differential scanning calorimetry. In phosphatidylcholine bilayers, both peptides mainly conformed to helical structures irrespective of the membrane physical state (gel or liquid-crystalline). The helix axes, penetrating the hydrophobic region of the bilayers, were oriented neither parallel nor perpendicular to the membrane normal. The disruption in the lipid packing induced by the peptide insertion seems to be responsible for the leakage by these peptides. PMID- 1764455 TI - Sequence of critical events involved in fusion of phospholipid vesicles induced by clathrin. AB - Membrane fusion induced by clathrin is accompanied by several events such as conformational change, membrane binding and association of clathrin, and membrane aggregation (Maezawa et al. (1989) Biochemistry 28, 1422-1428; Maezawa and Yoshimura (1990) Biochem. Biophys. Res. Commun. 173, 134-140). To clarify the sequence of these events, we examined their time-courses by reducing the pH of the medium from 7.4 to a given pH in the range of 3.5-5.0 at 25 degrees C or 10 degrees C. Large unilamellar vesicles composed of phosphatidylserine and phosphatidylcholine were used in most experiments. The half-time for conformational change of clathrin was less than those for membrane binding and association of clathrin. The half-times and the initial rates of membrane binding and association of clathrin were similar order of magnitude, although the pH profiles of the initial rates of the two events were somewhat different. Membrane aggregation started after membrane binding of clathrin. A lag phase was observed in the time-course of membrane fusion, whereas there was no lag phase in membrane binding and association of clathrin and membrane aggregation. Moreover, the lag time before fusion was independent of the clathrin concentration, although the initial rates of these three events were dependent on it, suggesting that the three reactions are not responsible for the lag phase before fusion, and that there is some other event(s) in the lag time. On the other hand, there was a threshould-pH in the pH profile of the lag-time and the threshold-pH coincided with the critical pH at which the final associated state of clathrin was apparently reversed in the presence and absence of liposomes, suggesting that the event(s) in the lag phase may be related to this final associated state of clathrin molecules on the liposome membranes. These results indicate that clathrin-induced fusion of liposomes is initiated through the following sequential events: conformational change of clathrin, membrane binding and association of clathrin, which occur simultaneously but independently, membrane aggregation, an event(s) in the lag phase, and actual fusion. PMID- 1764456 TI - Chloroplast biogenesis. Cell-free transfer of envelope monogalactosylglycerides to thylakoids. AB - An ATP- and temperature-dependent transfer of monogalactosylglycerides from the chloroplast envelope to the chloroplast thylakoids was reconstituted in a cell free system prepared from isolated chloroplasts of garden pea (Pisum sativum) or spinach (Spinacia oleracea). Isolated envelope membranes, in which the label was present exclusively in monogalactosylglycerides, were prepared radiolabeled in vitro with [14C]galactose from UDP-[14C]galactose to label galactolipids as the donor. ATP-dependent transfer of radioactivity from donor to unlabeled acceptor thylakoids, immobilized on nitrocellulose strips, was observed. In some experiments linear transfer for longer than 30 min of incubation was facilitated by the addition of stroma proteins but in other experiments stroma was without effect or inhibitory suggesting no absolute requirements for a soluble protein carrier. Transfer was donor specific. No membrane fraction tested (plasma membrane, tonoplast, endoplasmic reticulum, nuclei, Golgi apparatus, mitochondria or thylakoids) (isolated from tissue radiolabeled in vivo with [14C]acetate) other than chloroplast envelopes demonstrated any significant ability to transfer labeled membrane lipids to immobilized thylakoids. Acceptor specificity, while not absolute, showed a 3-10-fold greater ATP-dependent transfer of labeled galactolipids from chloroplast envelopes to immobilized thylakoids than to other leaf membranes. The results provide independent confirmation of the potential for transfer of galactolipids between chloroplast envelopes and thylakoids suggested previously from ultrastructural studies and of the known location of thylakoid galactolipid biosynthetic activities in the chloroplast envelope. PMID- 1764457 TI - The effect of myotoxins isolated from Bothrops snake venoms on multilamellar liposomes: relationship to phospholipase A2, anticoagulant and myotoxic activities. AB - The effect of four myotoxins isolated from Bothrops snake venoms on the release of peroxidase trapped in large multilamellar liposomes was studied and correlated to their phospholipase A2, myotoxic and anticoagulant activities. The four myotoxins affected negatively-charged liposomes in a dose-dependent way, having no effect on positively-charged liposomes. Conditions that inhibited phospholipase A2 activity, i.e., substitution of calcium by EDTA, reduced liposome-disrupting activity of Bothrops asper myotoxin I and Bothrops atrox myotoxin, both of which have high phospholipase A2 activity, but did not affect the action of B. asper myotoxin II and Bothrops moojeni myotoxin II, which have extremely low phospholipase A2 activity. However, all myotoxins disrupted to some extent negatively-charged liposomes under conditions where phospholipase A2 activity was abolished. Since these toxins behave as amphiphilic proteins in charge-shift electrophoresis, it is suggested that membrane-disorganization is at least partially due to a non-enzymatic penetration and alteration of bilayers. There was no strict correlation between liposome-disrupting activity and myotoxicity in vivo. Thus, although both effects probably depend on the toxins' ability to disturb membranes, it is likely that variation in complexity between skeletal muscle plasma membrane and liposome bilayers are the basis for this difference. The anticoagulant effect seems to depend on the ability of the toxins to enzymatically degrade phospholipids, since only B. asper myotoxin I and B. atrox myotoxin prolonged the plasma recalcification time. PMID- 1764458 TI - Intramitochondrial K+ as activator of carboxyatractyloside-induced Ca2+ release. AB - The role of intramitochondrial K+ content on the increase in membrane permeability to Ca2+, as induced by carboxyatractyloside was studied. In mitochondria containing a high K+ concentration (83 nmol/mg), carboxyatractyloside induced a fast and extensive mitochondrial Ca2+ release, membrane de-energization, and swelling. Conversely, in K(+)-depleted mitochondria (11 nmol/mg), carboxyatractyloside was ineffective. The addition of 40 mM K+ to K(+)-depleted mitochondria restored the capability of atractyloside to induce an increase in membrane permeability to Ca2+ release. The determination of matrix free Ca2+ concentration showed that, at an external free-Ca2+ concentration of 0.8 microM, control mitochondria contained 3.9 microM of free Ca2+ whereas K(+) depleted mitochondria contained 0.9 microM free Ca2+. It is proposed that intramitochondrial K+ affects the matrix free Ca2+ concentration required to induce a state of high membrane permeability. PMID- 1764459 TI - Effect of phloretin on the carrier-mediated electrically silent ion fluxes through the bilayer lipid membrane: measurements of pH shifts near the membrane by pH microelectrode. AB - The effect of phloretin on the carrier-mediated electrically silent ion fluxes through the bilayer lipid membrane (BLM) was studied. The measurements were carried out according to our conventional technique, i.e. electrical potential recording in the presence of a protonophore, and by a new method--direct measurements of pH shifts in the unstirred layers of the BLM by pH microelectrode. Both techniques gave similar results. It was shown that the addition of phloretin increased the rate of cation/H+ exchange induced by nigericin and decreased the rate of anion/OH(-)-exchange induced by tributyltin. The effect of phloretin was higher in the presence of cholesterol in the BLM. Cholesterol decreased the nigericin- and tributyltin-induced fluxes under our experimental conditions. The application of an external voltage to the membrane had no effect on the ion fluxes thereby showing that these fluxes were electroneutral. The most probable explanation of these results bases on the effect of the membrane dipole potential on the electroneutral fluxes of ions. The possible mechanism of the dipole potential effect on the carrier-mediated electrically silent ion fluxes was discussed in terms of two competing hypotheses -the translocation through the membrane or the reactions at the membrane surface being the rate-limiting steps of the whole transport process. PMID- 1764461 TI - Do helices in membranes prefer to form bundles or stay dispersed in the lipid phase? PMID- 1764460 TI - Nigericin-mediated H+, K+ and Na+ transports across vesicular membrane: T-jump studies. AB - The decay of delta pH across vesicular membranes by nigericin-mediated H+ and metal ion (M+) transports has been studied at 25 degrees C after creating delta pH by temperature jump (T-jump). In these experiments K+ or Na+ were chosen as M+ for the compensating flux. Theoretical expressions derived to analyse these data suggest a method for estimating the intrinsic rate constants for the translocation of nig-H (k1) and for the translocation of nig-M (k2) across membrane, from the pH dependence of the delta pH decay. The following could be inferred from the analysis of data. (a) At pH approximately 7.5 and 250 mM ion concentrations, nigericin-mediated H+ and M+ transport rates are lower in a medium of K+ than in a medium of Na+, although ionophore selectivity of nigericin towards K+ is 25-45-times higher than that towards Na+. However, at lower [M+] (approximately 50 mM) the transport rates are higher in a medium of K+ than in a medium of Na+. Such behaviours can be understood with the help of parameters determined in this work. (b) The intrinsic rate constants k1 and k2 associated with the translocations of nig-H and nig-K or nig-Na across membrane are similar in magnitude. (c) At pH approximately 7.5 translocation of nig-H is the dominant rate-limiting step in a medium containing K+. In contrast with this, at this pH, translocation of nig-M is the dominant rate-limiting step when metal ion is Na+. (d)k1 approximately k2 approximately 6.10(3) s-1 could be estimated at 25 degrees C in vesicles prepared from soyabean phospholipid, and lipid mixtures of 80% phosphatidylcholine (PC) + 20% phosphatidylethanolamine and 92% PC + 8% phosphatidic acid. (e) The apparent dissociation constants of nig-M in vesicles were estimated to be approximately 1.5.10(-3) M for K+ and 6.4.10(-2) M for Na+ (at 50 mM ion concentrations) using approximately 10(-8.45) M for the apparent dissociation constant of nig-H. PMID- 1764462 TI - Structural and electronic characterization of heme moiety in oxygenated hemoproteins by using XANES spectroscopy. AB - Iron K-edge X-ray absorption near edge structure (XANES) spectra were measured for oxy-forms of cytochrome P-450cam (P-450cam), horseradish peroxidase (HRP) and myoglobin (Mb) by using Synchrotoron Radiation of Photon Factory (Tsukuba). A pronounced 1s-4p transition and some fine structures were well-resolved in the spectra obtained. Comparing the spectra, the features at the fine structures termed P, C and D, were similar among the three hemoproteins, suggesting a similar site-symmetry around the heme iron and the same Fe-O-O bond angle (about 115 degrees). On the other hand, absorption features at the edge region (7115 7135 eV) were slightly but significantly different from one another; the absorption intensity at 7115-7125 eV region increased in the order of Mb, HRP and P-450cam, while that at 7125-7135 eV decreased in the same order. A similar absorption feature was also obtained with their deoxy (ferrous high spin) forms. We assumed that the absorption at the lower energy region (7115-7125 eV) reflects the pi-character in the Fe-ligand bond, whereas that at the higher energy region (7125-7135 eV) does the sigma-character, on the basis of the previous and comprehensive studies of the XANES spectroscopy of the adsorbed molecules on the metal surface (McGovern et al. (1989) Handbook on Synchrotoron Radiation, Vol. 2, pp. 467-539). According to our assumption, our XANES results indicated that the pi-character of the Fe-ligand bond increases in the order of Mb, HRP and P 450cam, and that the pi-electron of the thiolate S- in P-450cam is donated to the Fe-O-O moiety, most probably to the antibonding pi* orbital of O2. Such an interpretation is consistent with the experimental findings or data accumulated so far by other methods, such as the resonance Raman spectroscopy. PMID- 1764463 TI - Functional studies of a glutamate dehydrogenase with known three-dimensional structure: steady-state kinetics of the forward and reverse reactions catalysed by the NAD(+)-dependent glutamate dehydrogenase of Clostridium symbiosum. AB - Steady-state kinetic properties of glutamate dehydrogenase from Clostridium symbiosum are reported. Rates with NADP(H) are over three hundred times lower than with NAD(H) under identical conditions. The 3-acetyl pyridine and 6-deamino adenine analogues of NAD+, on the other hand, are used almost as well as NAD+ itself. Amino acid specificity is very tight at both pH 7 and pH 9. The best alternative substrate of those tested, L-alpha-amino-gamma-nitraminobutyrate, gave only 0.5% of the rate seen with glutamate. With 400 microM NAD+ a 160-fold variation of the glutamate concentration gave a linear Eadie plot apart from slight inhibition at the highest concentrations. With 40 mM L-glutamate and varied [NAD+], the Eadie plot appeared linear between 1.6 microM and 60 microM and again between 60 microM and 2000 microM, but the slopes of the two lines differed by a factor of 8.4. This striking pattern is not attributable to impurities in the coenzyme or to changes in the state of aggregation of the enzyme. For the high concentration range (greater than 60 microM NAD+), the presence of all four linear terms in the reciprocal form of the initial rate equation indicates a sequential mechanism. Similar measurements made for APAD+ and dnNAD+ show no sign of non-linearity in the Eadie plot over the wide concentration ranges explored. In the reductive amination direction, with NADH as coenzyme, linear reciprocal plots were obtained for all three substrates. Systematic variation of concentrations led via primary, secondary and tertiary plots to all eight possible initial-rate parameters in a linear reciprocal initial-rate equation. Compulsory-order and enzyme-substitution mechanisms appear to be excluded, and a random route to the central complex seems the only possibility compatible with the results. PMID- 1764464 TI - Regulation of PGI2 activity by serum proteins: serum albumin but not high density lipoprotein is the PGI2 binding and stabilizing protein in human blood. AB - Although previous studies have shown that serum albumin binds PGI2 and protects it from rapid degradation, it remains debatable whether it is physiologically important due to its low binding affinity for PGI2. We were intrigued by the observations of Yui et al. (J. Clin. Invest. 82 (1988) 803-807) which suggested that apo A-I of the high density lipoprotein (HDL) is the "serum PGI2 stabilizing factor". To clarify this, we carried out experiments to determine the binding kinetics and parameters of HDL and albumin purified from normal pooled human serum. Despite the use of multiple binding assays, we could not detect any binding activity in HDL2, HDL3 or nascent HDL preparations, nor could we demonstrate any PGI2 protecting activity by these molecules. By contrast, purified albumin exhibited essentially identical binding parameters as the native serum from which the albumin was purified. The binding activity of various albumin preparations was not due to the contamination of apo A-I. Computer simulation analysis also failed to provide evidence to support the notion that HDL bound and prolonged PGI2 activity. To determine whether physiological concentrations of albumin influence PGI2 binding to platelet receptors, we measured PGI2 binding to platelet membrane in the absence and presence of albumin. Albumin at 40 mg/ml increased the KD of PGI2 binding to the receptors by 2-3 fold. These findings indicate that albumin plays a major role in protecting PGI2 activity and regulating its availability for platelet PGI2 receptors. PMID- 1764465 TI - Evaluation of antigen-antibody affinity constants by partition equilibrium studies with a two-phase aqueous polymer system: a more rigorous analysis. AB - A quantitative procedure is devised for the determination of affinity constants from the composition-dependence of the antigen partition coefficient in liquid liquid partition studies of antigen-antibody mixtures. Its use is illustrated by application to published results (Elling, L.R., Kula, M.-R., Hadas, E. and Katchalski-Katzir, E. (1991) Anal. Biochem. 192, 74-77) obtained for the interaction of horseradish peroxidase with an elicited monoclonal antibody by antigen distribution studies with a two-phase aqueous polymer system (poly(ethylene glycol)/dextran) for the partition analysis. Shortcomings in the original interpretation of these results are eliminated. PMID- 1764466 TI - Iron K-edge absorption spectroscopic investigations of the cores of ferritin and haemosiderins. AB - The extended X-ray absorption fine structure (EXAFS) associated with the iron K edge has been measured and interpreted for ferritin and haemosiderin extracted from horse spleen, and haemosiderin extracted from the livers of humans with treated primary haemochromatosis, and from the spleens of humans with treated secondary haemochromatosis. For ferritin, the data are consistent with, on average, each iron atom being in an environment comprised of approx. six oxygen atoms at 1.93 +/- 0.02 A, approx. 1.5 iron atoms at 2.95 +/- 0.02 A and approx. 1.1 iron atoms at 3.39 +/- 0.02 A, with a further shell of oxygens at approx. 3.6 A. Iron in horse spleen haemosiderin is in an essentially identical local environment to that in horse spleen ferritin. In contrast, the EXAFS data for primary haemochromatosis haemosiderin indicate that the iron-oxide core is amorphous; only a single shell of approx. six oxygen atoms at approx. 1.94 +/- 0.02 A being apparent. Secondary haemochromatosis haemosiderin shows an ordered structure with approx. 1.4 iron atoms at both 2.97 +/- 0.02 and 3.34 +/- 0.02 A. This arrangement of iron atoms is similar to that in horse spleen haemosiderin, but the first oxygen shell is split with approx. 2.9 atoms at 1.90 +/- 0.02 A and approx. 2.7 at 2.03 +/- 0.02 A, indicative of substantial structural differences between secondary haemochromatosis haemosiderin and horse spleen haemosiderin. PMID- 1764467 TI - Cholyl-lysylfluorescein: synthesis, biliary excretion in vivo and during single pass perfusion of isolated perfused rat liver. AB - A fluorescent bile salt, cholyl-lysylfluorescein (cholyl-lys-F), was synthesised so that it retained both an intact steroid ring and a side chain structure with an unblocked carboxyl group. Its biliary kinetics and hepatic extraction were studied in Wistar rats and in the isolated perfused rat liver, respectively. The synthetic method used excess N-epsilon-CBZ-l-lysine methyl ester hydrochloride (7 mmol) and cholic acid (5 mmol) via EEDQ with a yield of 94% for cholyl-lys. Cholyl-lys-F was synthesized employing equimolar amounts of cholyl-lys (sodium salt) and fluorescein isothiocyanate (FITC) in bicarbonate buffer (pH 9.5) over 16 h at room temperature (21 degrees C) with a yield of 70%. The fluorescent property of cholyl-lys-F was similar to fluorescein with a strong apple-green fluorescence. In bile-fistula rats under pentobarbital anaesthesia, the cumulative 20 min biliary excretion as a percentage of injected dose were as follows: cholyl-lys-F, 94.4 +/- 0.3%, [14C]cholylglycine (CG), 93.1 +/- 1.2% and fluorescein (F), 34.8 +/- 0.5. Furthermore the single-pass hepatic extraction of cholyl-lys-F was 64.1 +/- 3.9%, [14C]CG was 66.1 +/- 1.2% and F was 16.5 +/- 2%. The similarity in biliary output and hepatic extraction of cholyl-lys-F to that of the natural bile acid cholylglycine suggest that both compounds are handled in a similar fashion. The greater biliary excretion and hepatic extraction of cholyl lys-F relative to free fluorescein further suggest that conjugation with a bile salt may be an efficient way of targeting compounds to the liver. PMID- 1764468 TI - A liposomal enzyme electrode for measuring glucose. AB - Enzyme electrodes have been described for measuring glucose but have been limited by the saturation kinetics of the glucose oxidase not allowing clinically relevant glucose concentrations to be measured (0-25 mM). One way of alleviating this problem is to use diffusion-controlled membranes which result in the enzyme experiencing a smaller substrate concentration than that of the bulk solution. As an extension of this concept we have encapsulated glucose oxidase in liposomes whereby the lipid bilayer wall provides the diffusion-limiting membrane as well as providing a biocompatible layer which is of particular relevance when blood glucose is to be measured. Linear ranges were found to embrace the required glucose concentrations and moreover by using liposomes prepared from different lipids, e.g., dimyristoyl (14:0) phosphatidylcholine (DMPC), dipalmitoyl (16:0) phosphatidylcholine (DPPC) and distearoyl (18:0) phosphatidylcholine (DSPC), the electrode response was shown to depend on the bilayer permeabilities in relation to the lipid phase transition temperatures and as a consequence the linear ranges were duly altered. PMID- 1764469 TI - Glucose and glutamine metabolism in rat macrophages: enhanced glycolysis and unaltered glutaminolysis in spontaneously diabetic BB rats. AB - Metabolism of glutamine (Gln, 2 mM) and glucose (5 mM) was studied in vitro in isolated resident peritoneal macrophages from both normal (BBn) and spontaneously diabetic BB (BBd) rats. The major products from Gln were ammonia, glutamate, CO2 and to a lesser extent aspartate. Glucose decreased (P less than 0.01) the production of ammonia, CO2 and aspartate from Gln by 34-60%, but had no effect on the amount of glutamate accumulated. The major products from glucose were lactate and to a much lesser extent pyruvate and CO2. Gln decreased (P less than 0.01) 14CO2 production from [U-14C]glucose by 19-28%, increased (P less than 0.01) pyruvate production by 35-49%, but had no effect on lactate production. The fraction of glucose metabolized via the pentose phosphate pathway (PC) was less than 5%. There were no significant differences in Gln metabolism between BBn and BBd macrophages. The production of lactate and pyruvate and the flux from glucose into the PC were increased (P less than 0.01) by 2.4, 1.8 and 1.5-fold, respectively, in BBd cells. Increased macrophage glucose metabolism was also observed in diabetes-prone BB (BBdp) rats at 75-80 days but not at 50 days of age. In the presence of both Gln and glucose, potential ATP production from glucose was 2- and 4-times that from Gln, respectively, in BBn and BBd cells. Lactate production was the major pathway for glucose-derived ATP generation. These results demonstrate (a) glycolysis and flux from glucose through the pentose phosphate pathway are enhanced with no alteration in glutaminolysis in BBd macrophages; and (b) glucose may be a more important fuel than Gln for macrophages, particularly in BBd rats. The increased glucose metabolism may be associated with functional activation of the macrophages that have been proposed to be involved in beta-cell destruction and the development of diabetes. PMID- 1764470 TI - The rheology of pig small intestinal and colonic mucus: weakening of gel structure by non-mucin components. AB - Mechanical spectroscopy has been used to study the structure and properties of pig small intestinal and colonic adherent mucus gel. Both mucus secretions had properties of viscoelastic gels, but that from the small intestine was substantially weaker in quality. Small intestinal mucus gel was disrupted by acid (pH 1), detergents (bile) and protein denaturants while that from the colon remained stable following these treatments. Concentration of purified colonic mucin produced a gel with the same rheological properties as the native secretion. Purified small intestinal mucin when concentrated produced a stronger gel than the native secretion and, in contrast to the latter, one which was not disrupted by acid or denaturants. The instability of native small intestinal mucus was shown not to be a function of the mucin components (which alone could account for the gel-forming properties), but to arise from the presence of insoluble material largely from sloughed mucosal cells. These studies show (1) that mucus gels from the colon and small intestine have similar mechanical behaviour and properties to those from the stomach and duodenum, and (2) emphasise the caution that should be exercised when interpreting the rheological properties of mucus preparations, particularly with respect to their content of mucosal cellular material. PMID- 1764471 TI - Density determination by analytical ultracentrifugation in a rapid dynamical gradient: application to lipid and detergent aggregates containing proteins. AB - A rapidly developing dynamical gradient can be formed in the analytical centrifuge when a buffer solution prepared in D2O is underlayered under the same buffer solution prepared in H2O in a specially designed double sector cell. In a short time the boundary layer spreads to form the gradient. Heavy particles (S greater than or equal to 10S) will band in the gradient corresponding to their density, which can be determined accurately. To this end, the buffer may contain density adjusting additives such as sucrose. We present results with this technique for lipid vesicles, for a Ca-antagonist bound to vesicles, as well as for a lipoprotein and reconstituted regular membrane protein-lipid arrays. PMID- 1764472 TI - Anomalous properties of water in macromolecular gels. AB - Low molecular weight solutes often exhibit elution characteristics on gel filtration columns which deviate from ideal behaviour. In many previous studies this anomalous behaviour was attributed to the existence of extremely narrow pores in the gel, inaccessible even to very small solute molecules, to explain Kd values lower than unity. Kd values of small solutes higher than unity were usually ascribed to adsorption of the solute to the gel matrix. In the present paper several observations are presented that contradict these suggestions. Experimental evidence indicates that with small solute molecules Kd values differing from unity can be fully explained by the anomalous properties of vicinal water layers at the gel matrix-water interface. PMID- 1764473 TI - Synthesis and kinetic study of transition state analogs for ribonuclease T1. AB - Based on the proposal that ribonucleases cleave the RNA phosphodiester bond with a mechanism involving pentacovalent phosphorous as transition state, complexes of guanosine and inosine with vanadate-(IV, V), molybdate-(VI), tungstate-(VI), chromate-(VI) and hexacyanochromate-(III) were synthesized and probed as inhibitors of recombinant ribonuclease T1, obtained from an E. coli. overproducing strain. The apparent dissociation constants of these inhibitors and RNase T1, as determined by Michaelis-Menten kinetics, vary between 0.5-0.9 microM and indicate very strong binding, 100- to 1000-fold stronger than the binding of guanosine (Kd = 545 microM) and inosine (Kd = 780 microM), and 50-100-fold stronger than the binding of the product 3' GMP (Kd = 55 microM). Therefore the synthesized inhibitors may be considered as genuine transition state analogs for the enzyme. PMID- 1764474 TI - The behavior of remaining enzyme activity in a suicidal enzyme system. AB - We derived an equation which describes the plot of the remaining enzyme activity versus ratio of initial concentration of suicide substrate to that of enzyme to obtain a partition ratio from the time-course of remaining enzyme activity. The simulation data calculated from the representative kinetic model for a suicide substrate were used to verify this equation, which approximated steady state kinetics. Although the time-dependent loss of enzyme activity is usually characterized by pseudo-first-order kinetics, the present results show that pseudo-first-order kinetics are followed only when the ratio of initial concentration of suicide substrate to that of enzyme is greater than the partition ratio. Our results also show that the present method can be used to obtain the partition ratio of a suicide substrate from the time-course of the remaining enzyme activity when the suicide substrate is given an arbitrary concentration of one, where the ratio of initial concentration of suicide substrate to that of enzyme is less than the partition ratio. The theoretically verified equation was also checked against reported experimental data for a microsomal enzyme system. PMID- 1764475 TI - 1H-NMR characterization of cucumber peroxidases. AB - Two peroxidase isoenzymes from Cucumber seedlings, one acidic (pI = 4) and one basic (pI = 9), were characterized by 1H-NMR spectroscopy. The NMR spectra were obtained in the native (ferric high-spin) and cyanide ligated (ferric low-spin) forms of both isoenzymes. The NMR spectral comparison of paramagnetically shifted resonances with those of the well characterized horseradish peroxidase C, HRP(C), isoenzyme indicates that both cucumber peroxidases have a protohemin IX prosthetic group with proximal histidine coordinated to the heme iron. The downfield heme 1H-NMR shift pattern is distinct for each isoenzyme, and this reflects presumably dissimilar heme active site environments. The basic isoenzyme shows less asymmetry in heme 1H-NMR signals as compared to the acidic isoenzyme or HRP(C) isoenzyme. It was also found that the acidic cucumber peroxidase exists predominantly as a monomeric species in solution with 30 kDa molecular mass as opposed to its earlier characterization as a 60 kDa dimeric protein. PMID- 1764476 TI - Purification and characterization of a novel glucooligosaccharide oxidase from Acremonium strictum T1. AB - A novel glucooligosaccharide oxidase was purified 495-fold from wheat bran culture of a soil-isolated Acremonium strictum strain T1 with an overall yield of 21%. This enzyme was composed of a single polypeptide chain with a molecular mass of 61 kDa as determined by sodium dodecyl sulfate polyacrylamide gel electrophoresis and size-exclusion high-performance liquid chromatography. Its isoelectric point was pH 4.3-4.5. This enzyme contained 1 mol of FAD per mol of enzyme and showed absorption maxima at 274, 379 and 444 nm. This enzyme was stable in the pH range of 5.0 to 11.0 with an optimal reaction pH of 10.0. The optimal reaction temperature was 50 degrees C. It was stable up to 50 degrees C for 1 h at pH 7.8. This enzyme oxidized those oligosaccharides with glucose residue on the reducing end and each sugar residue jointed by alpha or beta-1,4 glucosidic bond. The relative activity of this enzyme toward maltose, maltotriose, maltotetraose, maltopentaose, maltohexaose, maltoheptaose, lactose, cellobiose and glucose was 100:94:74:46:66:56:64:47:59. To our knowledge, this is the first report on the discovery of an glucooligosaccharide oxidase as judged from enzyme substrate specificity. PMID- 1764477 TI - Mossbauer spectroscopic investigation of structure-function relations in ferritins. AB - Ferritin plays an important role in iron metabolism and our aim is to understand the mechanisms by which iron is sequestered within its protein shell as the mineral ferrihydrite. We present Mossbauer spectroscopic data on recombinant human and horse spleen ferritin from which we draw the following conclusions: (1) that apoferritin catalyses Fe(II) oxidation as a first step in ferrihydrite deposition, (2) that the catalysis of Fe(II) oxidation is associated with residues situated within H chains, at the postulated 'ferroxidase centre' and not in the 3-fold inter-subunit channels previously suggested as the initial Fe(II) binding and oxidation site; (3) that both isolated Fe(III) and Fe(III) mu-oxo bridged dimers found previously by Mossbauer spectroscopy to be intermediates in iron-core formation in horse spleen ferritin, are located on H chains; and (4) that these dimers form at ferroxidase centres. The importance of the ferroxidase centre is suggested by the conservation of its ligands in many ferritins from vertebrates, invertebrates and plants. Nevertheless iron-core formation does occur in those ferritins that lack ferroxidase centres even though the initial Fe(II) oxidation is relatively slow. We compare the early stages of core formation in such variants and in horse spleen ferritin in which only 10-15% of its chains are of the H type. We discuss our findings in relation to the physiological role of isoferritins in iron storage processes. PMID- 1764478 TI - Novel non-productively bound ribonuclease inhibitor complexes--high resolution X ray refinement studies on the binding of RNase-A to cytidylyl-2',5'-guanosine (2',5'CpG) and deoxycytidylyl-3',5'-guanosine (3',5'dCpdG). AB - The X-ray structures of two complexes of bovine ribonuclease-A produced by soaking pre-grown crystals in solutions of the inhibitors cytidylyl-2',5' guanosine (2',5' CpG) and deoxycytidylyl-3',5'-guanosine (3',5'dCpdG) have been determined at 1.5 A resolution and refined by restrained least squares to R = 21.0% for 17,855 reflections, and R = 19.1% for 16,347 reflections, respectively. Binding of the substrate analogs to the protein has taken place in a completely unexpected and previously unreported manner. In each case the guanine base occupies the well characterized B1 pyrimidine binding site adjacent to Thr-45 (described by Richards, F.M., Wyckoff, H.W., Carlson, W.D., Allewell, N.M., Lee, B. and Mitsui, Y. (1971) Cold Spring Harbor Symp. Quant. Biol. 36, 35-54, and others including Palmer, R.A., Moss, D.S., Haneef, I. and Borkakoti, N. (1984) Biochim. Biophys. Acta 785, 81-88) having entered through a secondary channel external to the active site itself. We designate this reversed non-productive mode as retro-binding. In this mode of binding the SO4(2-) anion bound in the active site of the native protein crystals (Borkakoti, N., Moss, D.S. and Palmer, R.A. (1982) Acta Crystallogr. B38 2210-2217) has not been displaced by the phosphate of the inhibitor molecule as originally anticipated and observed in other studies. Instead the CMP or dCMP moiety of the inhibitor molecule is held loosely in a channel running towards the surface of the protein molecule and is thus completely external to the active site. Consequently, although it has been possible to model them, no attempt has been made to refine either the disordered cytosine in the CpG complex or the deoxycytosine in the dCpdG complex. The traditional B2 purine binding site of RNase (Richards et al., 1971) is unoccupied by the soaked inhibitors. Important changes that have taken place in the protein structure include: stabilization of both Lys-41 and Gln-11 via H-bonding to SO4(2 ); stabilization of His-119 in the A conformation (Borkakoti, N., Moss, D.S. and Palmer, R.A. (1982) Acta Crystallogr. B38 2210-2217); and stabilization of SO4(2 ) by H-bonds formed with the retro-bound guanine base. Binding of the inhibitors and stabilization of the active site is accompanied by displacement and redistribution of solvent molecules. PMID- 1764479 TI - Substrate specificity of alpha-chymotrypsin-catalyzed esterification in organic media. AB - 11 amino acid derivatives were tested as alpha-chymotrypsin substrates in the esterification reaction with methanol in organic media. The reactions were carried out in water-saturated ethyl acetate and in acetonitrile containing 4% water. alpha-Chymotrypsin adsorbed on Celite was used as a catalyst. From initial reaction rate measurements, the Michaelis-Menten parameters Vmax and KM were determined. All the amino acid derivatives tested were esterified, and the highest values of kcat/KM were obtained with the N-acylated aromatic amino acids. Correlations between Michaelis-Menten parameters and physical properties of the substrates such as molar refractivity (MR) and log P were deduced. The results show that the specificity of the alpha-chymotrypsin towards the side chain of the amino acids in organic media is the same as that in aqueous media. However, the specificity towards the N-protecting group is opposite to that in water, so the reaction medium affects the interaction of this part of the molecule with the enzyme to a large extent. PMID- 1764481 TI - Deplores cost/benefit ratio of precertification program. PMID- 1764480 TI - Characterization of the cooperative cross-linking of doxorubicin N hydroxysuccinimide ester derivatives to water soluble proteins. AB - Protein-anthracycline interactions have been examined by using reactive N hydroxysuccinimide ester derivatives of doxorubicin. These compounds cross-link to lysine epsilon-amino groups with high efficiency and offer the possibility for structural studies of protein-anthracycline complex formation by using gel filtration, ultracentrifugation and spectrophotometric methods. The results are in accordance with association of anthracycline to the hydrophobic ligand binding cavities of serum albumin. The results for proteins not having hydrophobic domains (IgG, serum transferrin, lactotransferrin, ovotransferrin) suggest that complex formation is cooperative and involves two steps: initial self-association of anthracycline into aggregated structures and subsequent binding of protein at the aggregate surface. With serum transferrin, anthracycline self-association makes possible the assembly of stable nanometer-sized protein-anthracycline particles held together by non-covalent bonds. This reaction, which is highly reproducible and efficient, may have applications in the field of development of anthracycline carrier systems. PMID- 1764482 TI - Final safe harbor regs bear down on MD-investment referrals. PMID- 1764483 TI - Confederate medicine: the view from Virginia. PMID- 1764484 TI - Pneumoperitoneum and portal venous air after barium enema. PMID- 1764485 TI - Celiac artery aneurysms: case reports. AB - Two recent patients with celiac artery aneurysms focus attention on the relevant diagnosis and therapeutic alternatives that lead to a successful outcome in these patients. Awareness of the nonspecific symptoms associated with splanchnic arterial aneurysms combined with ultrasonography, computerized axial tomography, and arteriography lead to the appropriate diagnosis of a celiac artery aneurysm prior to rupture and exsanguinating hemorrhage. Aneurysm resection offers a definitive means of treatment. Selective use of revascularization techniques bolsters the surgical approach by preventing hepatic ischemia and serving as an additional source of visceral arterial blood flow. Our use of an autogenous or prosthetic graft from the intrarenal abdominal aorta proved to be a helpful adjunctive technique. Long-term vigilance is important because of the association of celiac artery aneurysms with other arterial occlusive and aneurysmal disease. PMID- 1764486 TI - Routine HIV serology. PMID- 1764487 TI - "Homeward bound". PMID- 1764488 TI - Role of reproductive and menstrual history in the etiology of pre- and postmenopausal breast cancer. PMID- 1764489 TI - Influence of age-related nephropathy on plasma lipoproteins of the aging rat. PMID- 1764490 TI - Prevalence, characteristics and factors associated with falls among the elderly living at home. AB - Attempts to determine the underlying causes of falls have come to conflicting conclusions, partly because subject groups studied have not been representative of all elderly people. Two hundred and three randomly selected people of 75 years and over, living at home, were visited and questioned about falls experienced in the previous 12 months, and about factors that might be related to falling. Eighty-six subjects (42.4%) had suffered one or more falls during this time, and of fallers, 49 (59.3%) were injured, 9 of them seriously. Women were slightly more likely to have had falls and were more likely to have suffered injury, but no increase in frequency of falls with age was demonstrated. Only a minority of fallers (43.0%) sought medical attention following their fall. Falls outside the home accounted for 39.5% of falls and these were more likely to be due to simple trips or slips. Analysis of the factors related to falls showed a considerable overlap between fallers and non-fallers. Fallers had significantly greater dependency and cognitive impairment, more physical symptoms, and higher scores for anxiety and depression, but there was no association with postural hypotension, neurological abnormalities, or measurements relating to nutritional state. The factors found to be significant on discriminant analysis were combined to determine a "fall risk score". This type of easily calculated score might be of use to medical and paramedical personnel for assessing the risk of falling among the elderly living at home. PMID- 1764491 TI - Nursing home care: factors influencing the quality of life in a restricted life situation. AB - The quality of life and care situation of 191 patients living in 4 nursing homes (NHs) were evaluated with regard to patient functional impairment and staff competence. Patient disability levels in the different NHs were similar. A high incidence of dementia in combination with somatic diseases were limitations to achieve quality of life. The patients had limited access to privacy. Their possibilities to communicate with the world outside, interpersonally, and via mass-media were small. Only about half of them went out of the NHs during their mean stay of 1.8 years, but they were often visited by relatives and friends. The staff seemed to be indifferent to the patients' needs, which was reflected in insufficient physical and mental training, bad mealtime routines and only a minute of time allowed for personal acquaintance at admittance. The competence of the nursing staff and their working in a nursing team seemed to be of major importance in the care situation for the quality of life available. It was evident that there was a great need to improve the care situation. PMID- 1764492 TI - Wish to transfer to other jobs among long-term care workers. AB - This study is based on questionnaires that were sent to the homes of health care personnel working in geriatric care (N = 583) and acute care (N = 328). The purpose was to investigate differences between these groups of personnel regarding job assignment, intention to transfer to another job, attitudes towards demented patients, and the experience of burnout. The results showed that more persons working in acute care were self-assigned to their jobs than those working in geriatric care. More persons in geriatric care stated a wish to transfer to another job in the health care field than those in acute care. The personnel who constantly work with demented patients showed the most positive attitudes towards this group of patients. A larger proportion of personnel with high burnout scores wanted to transfer to another job, compared to those with low burnout scores. PMID- 1764493 TI - Cross-sectional echocardiography: a window on congestive heart failure in the elderly. AB - The value and limits of ultrasonic cardiac imaging in elderly patients with congestive heart failure (CHF) are not yet fully known. We report the results of an echocardiographic survey on 154 consecutive elderly persons with chronic CHF. The aim of this study was to establish the feasibility and the diagnostic yield of echocardiography in this population, and the relationship, if any, between left ventricular systolic function and main clinical parameters. Satisfactory cardiac imaging was achieved in 118 patients (77%). All patients had abnormal echocardiograms, although no single abnormal finding was present in all the cases. Echocardiography (ECHO) confirmed 147 previously diagnosed CHFs, and further detected a silent coronary artery disease in 26 cases, a valvular disease in 22, and an atrial septal defect in one patient. The most frequent findings were left ventricular (LV) mass increase and dilation (70% and 68%, respectively), and mostly degenerative valvular disease (40%). The LV ejection fraction was within normal limits in 44% of the cases. Although a depressed LV systolic function was more common among patients in III or IV NYHA class, no clinical parameters could identify the 52 patients with normal ejection fraction. Thus, ECHO could play a key role in evaluating CHF in elderly patients. In these patients, due to misleading signs and symptoms, and to multiple CHF etiologies, basic structural and functional features are frequently missed by clinical investigation, chest x-ray and electrocardiography. PMID- 1764494 TI - Catecholamine excretion in old age. AB - Catecholamine excretion was studied in two groups of nonhospitalized subjects, 60 and 80 years of age, N = 35 and 29, respectively. Urinary 24h dopamine excretion exhibited an age-related decline (p = 0.001). There was a sex difference for dopamine excretion; men had higher excretion levels (p = 0.04). Twenty-four-hour excretion of epinephrine and norepinephrine was slightly higher in 60- than in 80 year-old individuals (NS). Smoking was associated with a considerable increase in epinephrine (p = 0.001) and norepinephrine (p = 0.04) excretion. Body mass index was negatively correlated to epinephrine excretion (r = -0.27; p less than 0.05). When analyzed with a multi-way analysis of variance with analysis of covariance, significant influences of age on dopamine excretion, of creatinine clearance on dopamine and norepinephrine excretion, and of smoking on epinephrine excretion were seen. Thus, factors such as age, gender, body mass, kidney function and smoking habits considerably influence catecholamine excretion in elderly people. PMID- 1764495 TI - Body composition and dietary habits in 80-year-old smoking men without cardiovascular disease. AB - Eighty-year-old male residents in the community of Malmo were questioned about smoking habits and the occurrence of cardiovascular disease (CVD). Of 1,280 subjects, 122 were selected for further studies and allocated into 4 groups: 1) no CVD, non-smokers; 2) no CVD, smokers; 3) CVD, smokers; and 4) CVD, non smokers. The smokers had consumed on the average 13 g of tobacco daily for 59 years. Lean body mass (LBM), body fat (BF), % body fat (%BF), and total body water (TBW) were estimated by means of bioelectrical impedance analysis. The mean body weight (BW), LBM, and %BF for all subjects were 74.1 +/- 10.2 kg, 58.0 +/- 6.8 kg, and 21.3 +/- 5.9 kg, respectively. There were no significant differences between all subjects with and without CVD. A lower BW among smokers than in non smokers was explained by lower BF and %BF in the former. Smokers who had lived predominantly in rural areas had lower BW (6.9 kg) and LBM (5.2 kg) than those from an urban area. A positive correlation was noted between the degree of physical activity and LBM and TBW. Seventeen percent of the smokers exercised regularly. The CVD group had higher plasma cholesterol concentrations than the non-CVD group. Plasma triglycerides showed a positive correlation with BF, %BF and BW, whereas HDL cholesterol was negatively correlated with BF, %BF and BW. It is concluded that smoking is one of several important factors related to body composition, and the penetrance of this factor is still apparent in elderly men. PMID- 1764496 TI - Long-term follow-up of patients aged 75 years and older admitted to an acute care hospital in Israel. AB - Certain biomedical and psychosocial factors may be important in predicting short term and long-term outcomes in elderly inpatients in an acute care hospital. We prospectively studied all patients aged 75 years and older who were admitted to an acute inpatient geriatrics unit between June, 1984 and May, 1985, and we followed them for 5 years. Patients were followed by phone and/or the outpatient ambulatory service; follow-up visits occurred at 4 to 6 weeks following discharge and annually thereafter. After 5 years, 21% of the patients were alive. Apparently, age and gender were the major parameters associated with prognosis. Functional status and nutritional state (body weight, serum albumin) were also important prognostic factors. Of the geriatric syndromes, urinary incontinence seemed to be most strongly associated with a poor outcome, followed by falls and confusion. Iatrogenic conditions apparently had no such association. These findings suggest that certain demographic and clinical factors may be useful prognosticators for elderly hospitalized patients. PMID- 1764497 TI - Syst-Eur. A multicentre trial on the treatment of isolated systolic hypertension in the elderly: objectives, protocol, and organization. AB - The Syst-Eur Trial is a concerted action of the European Community's Medical and Health Research Programme. The trial is carried out in consultation with the World Health Organization, the International Society of Hypertension, the European Society of Hypertension and the World Hypertension League. This article describes the objectives and the protocol of Syst-Eur, a multicentre trial designed by the European Working Party on High Blood Pressure in the Elderly (EWPHE), to test the hypothesis that antihypertensive treatment of elderly patients with isolated systolic hypertension results in a significant change in stroke morbidity and mortality. Secondary endpoints include cardiovascular events, such as myocardial infarction and congestive heart failure. To be eligible patients must be at least 60 years old and have a systolic blood pressure averaging 160-219 mmHg with a diastolic pressure less than 95 mmHg. Patients must give their informed consent and be free of major cardiovascular and non-cardiovascular diseases at entry. The patients are randomized to active treatment or placebo. Active treatment consists of nitrendipine (10-40 mg/day), combined with enalapril (5-20 mg/day) and hydrochlorothiazide (12.5-25 mg/day), as necessary. The patients of the control group receive matching placebos. The drugs (or matching placebos) are stepwise titrated and combined in order to reduce systolic blood pressure by 20 mmHg at least to a level below 150 mmHg. Morbidity and mortality are monitored to enable an intention-to-treat and per protocol comparison of the outcome in the 2 treatment groups. A one-year pilot trial (1989) showed that the protocol is practicable. The Ethics Committee therefore decided to start the definite study (1990), in which randomized patients will be followed for 5 years. Recruitment of new centres and of the required 3,000 patients will last 3 years (until 1993). PMID- 1764498 TI - Different specificities of ribonuclease II and polynucleotide phosphorylase in 3'mRNA decay. AB - We review recent evidence on the in vivo and in vitro mRNA degradation properties of 2 3'-exonucleases, ribonuclease II and polynucleotide phosphorylase. Although secondary structures in the RNA can act as protective barriers against 3' exonucleolytic degradation, it appears that this effect depends on the stability of these structures. The fact that RNase II is more sensitive to RNA secondary structure than PNPase, could account for some differences observed in messenger degradation by the 2 enzymes in vivo. Terminator stem-loop structures are often very stable and 3' exonucleolytic degradation proceeds only after they have been eliminated by an endonucleolytic cleavage. Other secondary structures preceding terminator stem-loop seem to contribute to mRNA stability against exonucleolytic decay. PMID- 1764499 TI - Chlorpheniramine binding to human serum albumin by fluorescence quenching measurements. AB - The binding of chlorpheniramine to human serum albumin has been studied by fluorescence quenching, as a function of temperature; the experimental data could only be fitted to the Stern-Volmer modified equation. A statistical analysis of the results was performed in order to determine the significance of the constants calculated by this equation, as well as their thermodynamic parameters. The chlorpheniramine binding to human serum albumin accounts for almost half of the binding of this antihistaminic agent to human plasma proteins. PMID- 1764500 TI - Metabolism of glucose, glutamine, long-chain fatty acids and ketone bodies by lungs of the rat. AB - The maximum activities of some key enzymes of metabolism were studied in lungs of fed and 48-h-starved rats. The maximum activity of hexokinase in the lung is similar to that of other tissues of the body, but lower than that of phosphorylase and 6-phosphofructokinase. High activities of glucose-6-phosphate dehydrogenase and 6-phosphogluconate dehydrogenase were found in lung tissue, suggesting the importance of the pentose phosphate pathway in the lung. The activities of hexokinase and 6-phosphofructokinase were decreased whereas that of phosphorylase increased in response to starvation. Of the enzymes of the tricarboxylic acid cycle whose activities were measured, that of oxoglutarate dehydrogenase was the lowest, yet its activity (approximately 4.2 nmol/min per mg protein at 37 degrees C) was considerably greater than the flux through the cycle (0.46 nmol/min per mg protein at 37 degrees C; calculated from oxygen consumption by incubated lung slices). The activities of both oxoglutarate dehydrogenase and citrate synthase were decreased by starvation. The activities of 3-oxoacid CoA transferase and acetoacetyl-CoA thiolase were low in lung tissue compared to those of other tissues (eg kidney, brain) and that of 3-hydroxybutyrate dehydrogenase was very low. The activity of carnitine palmitoyl transferase is higher in the lung, suggesting that fatty acids (and possibly acetoacetate) could provide acetyl-CoA as substrate for the tricarboxylic acid cycle. Very low rates of utilization of 3-hydroxybutyrate were observed during incubation of lung slices, but that of oleate was 1.2 nmol/h per mg of protein.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764501 TI - Chemical modification studies of Artocarpus lakoocha lectin artocarpin. AB - The effect of chemical modification on an anti T-like lectin, artocarpin isolated from Artocarpus lakoocha seeds was investigated in order to identify the type of amino acids involved in its agglutinating activity. Modification of carboxyl groups, arginine and lysine residues, did not affect the lectin activity. However, modification of tryptophan, tyrosine and histidine residues led to a complete loss of its activity, indicating the involvement of these amino acids in the saccharide-binding ability. A protection was observed in the presence of inhibitory sugar. A marked decrease in the fluorescence emission was found when the tryptophan residues of lectin were modified. The circular dichroism spectra showed the presence of an identical pattern of conformation in the native and modified lectin, indicating that the loss in activity was due to modification only. The effect of pronase on artocarpin showed loss of activity whereas papain and trypsin had no effect. The specific activity of artocarpin remained unaltered on treatment with glycosidases but remarkable increase in the activity (of the same) was observed with xylanase treatment. Immunodiffusion studies with chemically modified lectin showed no gross structural changes, indicating that the group specific modifying agents did not alter the antigenic sites of the modified lectin. PMID- 1764502 TI - The presence of two forms of the phosphocarrier protein HPr of the phosphoenolpyruvate:sugar phosphotransferase system in streptococci. AB - The protein, HPr, a necessary component of the phosphoenolpyruvate phosphotransferase system (PTS) in bacteria, was purified from Streptococcus salivarius by column chromatography. The purified preparation gave only one band when analyzed by sodium dodecylsulfate gel electrophoresis or by isoelectric focusing in polyacrylamide gel (pI = 4.85). However, electrophoresis in Tris containing buffers under non-denaturing conditions revealed 2 bands that could be phosphorylated by PEP in the presence of enzyme I of the PTS or by ATP with the HPr kinase. Homogeneous preparations of these 2 forms could be obtained by preparative electrophoresis. Each preparation exhibited only 1 band when analyzed by electrophoresis under non-denaturing conditions, indicating that the doublet observed before preparative electrophoresis was not an electrophoretic artefact. The electrophoretic mobility of each protein was not modified following heat treatment at 100 degrees C for 20 min or storage at -40 degrees C for several months. Both HPr proteins catalyzed in vitro the PEP-dependent phosphorylation of glucose, but at a rate slightly lower than that observed with a preparation of HPr containing both forms of the protein. Both forms were also able to transfer the phosphate group from PEP to the other specific PTS proteins known in S salivarius. Rabbit polyclonal antibodies directed against each form reacted with both proteins. The presence of the 2 forms of HPr was detected in fresh cellular extracts of S salivarius; however, their intracellular ratio varied according to growth conditions. A doublet was also found in many other streptococcal species tested (S mutans, S sobrinus, S sanguis, S thermophilus, S bovis, S rattus) and also in L lactis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764503 TI - Hexose metabolism in pancreatic islets: pyruvate carboxylase activity. AB - The anaplerotic hypothesis for insulin release postulates that an increased generation of malonyl-CoA, acyl residues and diacylglycerol in nutrient stimulated pancreatic islets may couple the catabolism of nutrient secretagogues to more distal events in the secretory sequence. In the light of this hypothesis, pyruvate carboxylase activity was measured in rat pancreatic islets using two distinct radioisotopic procedures. The first procedure is based on the conversion of oxalacetate generated from pyruvate to 14C-labelled citrate in the presence of [1-14C]acetyl-CoA and citrate synthase. The second technique involves the conversion of 14C-labelled oxalacetate generated from [1-14C]pyruvate to radioactive aspartate in the presence of L-glutamate and glutamate-oxalacetate transaminase. Pyruvate carboxylase activity amounted to 10 pmol/min per islet, was restricted to mitochondria, displayed a Km for pyruvate close to 0.4 mM, and demonstrated dependency towards ATP (apparent Ka close to 0.1 mM), Mg2+ and acetyl-CoA. It is proposed that pyruvate carboxylase activity accounts for the generation of 14C-labelled amino acids other than alanine in islets exposed to D [3,4-14C]glucose and participates to the pyruvate/citrate shuttle for the transport of acetyl-CoA out of the mitochondria in nutrient-stimulated islets. PMID- 1764504 TI - Translational efficiency and competitive ability of mRNAs with 5'-untranslated alpha beta-leader of potato virus X RNA. AB - The 5'-untranslated leader sequence of potato virus X (PVX) RNA (63 nucleotides apart from cap-structure) consists of two sub-sequences referred to as alpha sequence (41 nucleotides with no G) and beta-sequence (42 nucleotides upstream from the first AUG). Computer-based folding predictions suggest that the 5' proximal region of alpha beta-leader is unstructured. The second structural feature of alpha beta-leader is the presence of the sequences apparently complementary to the 3'-terminal region of 18S rRNA. The alpha beta-leader has been shown to strongly enhance the translation of the contiguous foreign gene (NPT1) transcripts in cell-free translation systems from rabbit reticulocytes (RRL), wheat germ (WG) and Krebs-2 ascite cell extract (KA). In competitive translation PVX, RNA strongly inhibited tobacco mosaic virus (TMV) RNA, in RRL and WG systems. No competition occurred between PVX and TMV RNAs in KA system. There was no correlation between the translational efficiency and competitive ability of PVX RNA in different cell-free translation systems. The competitive ability did not solely depend on the presence of alpha beta-leader in mRNA. We present evidence to suggest that alpha beta-leader together with about 150 bases of the coding sequence is responsible for the translation competitive ability of PVX RNA. PMID- 1764505 TI - Fast preparative separation of 'native' core E coli 30S ribosomal proteins. AB - We have developed an ion-exchange high performance liquid chromatographic method for preparative separation of 'core' proteins from E coli 30S ribosomal subunits, extracted with salt under non-denaturing conditions. This method yields individual proteins in pure and native form at high concentrations, (5 to 25 mg/ml) suitable for direct use in 1D-, 2D- or 3D-NMR studies. PMID- 1764506 TI - Preliminary studies on quinoprotein glucose dehydrogenase under extreme conditions of temperature and pressure. AB - The kinetics of the reduction of the quinoprotein glucose dehydrogenase by substrate were studied as a function of 3 parameters: pressure (1-1000 bar), temperature (down to -25 degrees C) and solvent (water and 40% dimethyl sulfoxide, DMSO) using a high-pressure low-temperature stopped-flow apparatus. A 2-step formation of the reduced enzyme by its substrate (xylose), was observed. A rapid equilibrium described by the constant K1 was followed by a slower process described by the constants k2 and k-2. By using the transition state theory, the thermodynamic quantities delta V (activation volumes) were determined for these various kinetics constants under different experimental conditions. The results are discussed in terms of conformational change and solvation effect on the protein shell, and compared with results obtained for other systems as the 2-step formation of horseradish peroxidase compound I. PMID- 1764507 TI - Amino terminal sequence of the mitochondrial protein mtDBP-C: similarity with nonhistone chromosomal proteins HMG 1 and 2. AB - We have previously reported the characterization of a DNA-binding protein isolated from Xenopus laevis mitochondria (mtDBP-C). The amino terminal sequence of this protein (26 residues) has been determined by automated Edman degradation and used to search for sequence similarity with the NBRF library. A segment of 17 amino acids displays 47.1% of identity with proteins HMG-1 and 2 of various vertebrate species. PMID- 1764508 TI - Albumin Paris 2: a new genetic variant distinguished by isoelectric focusing. AB - Until recently, the characterization of genetic variants of human serum albumin was performed by electrophoretic typing prior to the determination of their amino acid substitutions. We describe a procedure using isoelectric focusing in the presence of urea for the analysis of the genetic variation of albumin. This procedure allowed a clear distinction of a new variant, previously found to be identical with albumin Sondrio according to its relative electrophoretic mobilities at 3 pHs. This new variant, the third rare albumin allotype identified in the Ile-de-France region, was called albumin Paris 2. PMID- 1764509 TI - Dimethyl sulfoxide enhances lipid synthesis and secretion by long-term cultures of adult rat hepatocytes. AB - Dimethyl sulfoxide (DMSO) was tested for its effects on lipid metabolism of long term cultures of adult rat hepatocytes. The addition of 1% DMSO to 3T3-hepatocyte cultures was not toxic to cells and in fact treated cultures maintained better their characteristic morphology for up to 14 days of exposure. DMSO treatment increased 2-3 fold the de novo synthesis of total lipids from[14C]acetate. The analysis by thin layer chromatography of cellular and secreted lipids revealed that DMSO increased the levels of cellular triglycerides, phospholipides and free and sterified cholesterol at 7 days of exposure while at 14 days there was also a 2-3-fold increase in medium secreted lipids. Additionally, DMSO increased the activity of glycerol-phosphate dehydrogenase, a marker enzyme of glycerolipid synthesis, by greater than 50% at either 7 or 14 days of exposure. These results show that 1% DMSO not only is not detrimental to cultured hepatocytes but also enhances lipid synthesis and secretion, both hepatic-differentiated functions. PMID- 1764510 TI - Structure and organization of ribosomal DNA. AB - Three trends are seen in the organization of ribosomal DNA genes during evolution: 1) gradual separation and separability of the regulation of transcription of 5S and larger subunit rRNAs; 2) retention of a transcription unit containing both large and small rRNAs; and 3) clustering of genes for both 5S and 18S-28S rDNAs, with the possible association of other 'non-rDNA' in the clusters of 18S-28S rDNA genes by the time mammals evolve. PMID- 1764511 TI - Structures of ribosomes and mechanisms of protein synthesis. PMID- 1764512 TI - Genetic engineering and overexpression of ribosomal L12 protein genes from three different archaebacteria in E coli. AB - Genes coding for ribosomal protein L12 from Methanococcus vannielii (Mva), Halobacterium halobium (Hha) and Sulfolobus solfataricus (Sso) have been subcloned in the polylinker region of pUC19. An efficient Shine-Dalgarno sequence has been attached to the 5' end of the genes, and two ochre stop codons have been created at their 3' ends, where necessary. In addition, mutants of the MvaL12 and HhaL12 genes were constructed, which coded for a cysteine residue at the C terminus of the protein. The constructs were transferred together with the pUC19 polylinker as gene cartridges into different expression vectors. These constructed plasmids were transformed in the appropriate E coli hosts and tested for expression. Two systems were found to work efficiently for overexpression, namely the pKK223-3 vector featuring a tac promoter, and the pT7-5 vector featuring a T7-promoter. The over-expressed proteins were purified to homogeneity; their purity was investigated by one and two-dimensional gel systems, amino acid analysis and N-terminal protein sequencing for 10 steps or more. The amount of protein purified from E coli test cultures bearing the expression plasmids was always more than 2.5 mg/l of medium used. PMID- 1764513 TI - Primary structures of ribosomal proteins from the archaebacterium Halobacterium marismortui and the eubacterium Bacillus stearothermophilus. AB - Approximately 40 ribosomal proteins from each Halobacterium marismortui and Bacillus stearothermophilus have been sequenced either by direct protein sequence analysis or by DNA sequence analysis of the appropriate genes. The comparison of the amino acid sequences from the archaebacterium H marismortui with the available ribosomal proteins from the eubacterial and eukaryotic kingdoms revealed four different groups of proteins: 24 proteins are related to both eubacterial as well as eukaryotic proteins. Eleven proteins are exclusively related to eukaryotic counterparts. For three proteins only eubacterial relatives and for another three proteins no counterpart-could be found. The similarities of the halobacterial ribosomal proteins are in general somewhat higher to their eukaryotic than to their eubacterial counterparts. The comparison of B stearothermophilus proteins with their E coli homologues showed that the proteins evolved at different rates. Some proteins are highly conserved with 64-76% identity, others are poorly conserved with only 25-34% identical amino acid residues. PMID- 1764514 TI - Comparative analysis of ribosomal protein L5 sequences from bacteria of the genus Thermus. AB - The genes for the ribosomal 5S rRNA binding protein L5 have been cloned from three extremely thermophilic eubacteria, Thermus flavus, Thermus thermophilus HB8 and Thermus aquaticus (Jahn et al, submitted). Genes for protein L5 from the three Thermus strains display 95% G/C in third positions of codons. Amino acid sequences deduced from the DNA sequence were shown to be identical for T flavus and T thermophilus, although the corresponding DNA sequences differed by two T to C transitions in the T thermophilus gene. Protein L5 sequences from T flavus and T thermophilus are 95% homologous to L5 from T aquaticus and 56.5% homologous to the corresponding E coli sequence. The lowest degrees of homology were found between the T flavus/T thermophilus L5 proteins and those of yeast L16 (27.5%), Halobacterium marismortui (34.0%) and Methanococcus vannielii (36.6%). From sequence comparison it becomes clear that thermostability of Thermus L5 proteins is achieved by an increase in hydrophobic interactions and/or by restriction of steric flexibility due to the introduction of amino acids with branched aliphatic side chains such as leucine. Alignment of the nine protein sequences equivalent to Thermus L5 proteins led to identification of a conserved internal segment, rich in acidic amino acids, which shows homology to subsequences of E coli L18 and L25. The occurrence of conserved sequence elements in 5S rRNA binding proteins and ribosomal proteins in general is discussed in terms of evolution and function. PMID- 1764515 TI - Presence of a gene in the archaebacterium Methanococcus vannielii homologous to secY of eubacteria. AB - The nucleotide sequence of a gene located at the promoter-distal side of the 'spectinomycin-operon' homologue of the archaebacterium Methanococcus vannielii was determined. Its derived amino acid sequence displayed 20% (identical positions) or 52% (including conservative exchanges) similarity, respectively, to SECY from E coli. An alignment of the Methanococcus SECY with eubacterial SECY sequences showed the existence of 10 membrane-associated primary structure domains in equivalent positions. The 5' and 3' ends of the secY transcript were mapped and the gene was expressed in the T7 promoter/polymerase system in E col. The temperature-sensitive growth of the E coli mutant IQ292 which harbours a secYts mutation could be complemented by the secY gene from Methanococcus. This indicates that a protein integral to an archaebacterial ether-lipid membrane can be inserted into a eubacterial phospholipid membrane without apparent loss of function. PMID- 1764516 TI - Analysis of sequence elements important for the synthesis and control of ribosomal RNA in E coli. AB - The regulation of the synthesis of ribosomal RNA is a key problem for the understanding of bacterial growth. Many different regulatory mechanisms involving cis and trans acting components participate in a concerted way to achieve the very efficient, flexible and coordinated production of this class of molecules. We have studied three different sequence regions within a ribosomal RNA transcription unit which are believed to control different stages of ribosomal RNA expression. In the first part of the study the function of AT-rich sequences upstream of the -35 hexamer of rRNA promoter P1 in the activation of rRNA transcription was analyzed. We confirm that a sequence dependent bend upstream of P1 is responsible for the high promoter activity. Experiments employing linker scanning mutations demonstrated that the distance as well as the angular orientation of the bent DNA is crucial for the degree of activation. In addition, the effect of the trans activating protein Fis on the transcription initiation of promoter P1 was investigated. We can show, using the abortive initiation assay, that the predominant effect of Fis is due to an increase in the affinity of RNA polymerase for the promoter (binding constant KB) while the isomerisation rate (kf) from a closed to an open RNA polymerase promoter complex is not altered significantly. We also describe the characterization of sequence determinants important for stringent regulation and growth rate control. Evidence is provided that the discriminator motif GCGC is a necessary but not sufficient element for both types of control. Furthermore we show that not simply a particular DNA primary structure but the higher order conformation of the complete promoter region is recognized and triggers the two regulatory mechanisms, both of which are apparently mediated by the effector molecule guanosine tetraphosphate (ppGpp). Finally, we have carried out a systematic mutational analysis of the rrnB leader region preceding the structural gene for 16S RNA. We could demonstrate that highly conserved sequence elements within the rrnB leader, which were believed to be involved in transcription antitermination have post transcriptional functions. We present evidence that these sequence elements direct the biogenesis of active ribosomal particles. PMID- 1764517 TI - FIS-induced bending of a region upstream of the promoter activates transcription of the E coli thrU(tufB) operon. AB - The upstream activator sequence (UAS) of the thrU(tufB) operon, which is the target of the trans-activating protein FIS, has a bent structure. Here we show that the center of bending lies around position -95, between the two FIS-binding regions. Studies with fis+ and fis- cells show that FIS-induced bending of the UAS plays a major role in the trans-activation of the thrU(tufB) operon. This has been concluded from the finding that insertions of small DNA segments, comprising less than one or two complete helix turns, in the junction of the UAS and the RNA polymerase-binding site reduce transcription significantly. Partial restoration of transcriptional activity occurs when one or more full helix turns are inserted. These data are in line with but do not prove that a direct interaction between FIS and RNA polymerase is involved in trans-activation. A role of bending per se resulting from FIS/DNA interaction cannot be excluded. PMID- 1764518 TI - Ribosomal protein L4 of Escherichia coli: in vitro analysis of L4-mediated attenuation control. AB - Ribosomal protein L4 of Escherichia coli functions not only as a component of the ribosome but also as a regulatory factor inhibiting both transcription and translation of its own operon, the 11 gene S10 operon. L4-mediated transcription control results in premature termination of transcription within the 172 base S10 operon leader. This attenuation control can be reproduced in a purified transcription system containing RNA polymerase, but depends on the addition of transcription factor NusA. The NusA stimulation saturates at about 2-4 copies per RNA polymerase. The L4 effect plateaus at about 4 copies per RNA polymerase. The specific recognition sites on 23S rRNA and in the S10 leader for L4 binding are not yet known. However, we can demonstrate that a fragment of 23S rRNA containing the proximal 840 bases can eliminate in vitro L4-stimulated attenuation, and hence, contains the information sufficient for L4 binding to 23S rRNA. PMID- 1764519 TI - Turnover rate of yeast PGK mRNA can be changed by specific alterations in its trailer structure. AB - The effect of insertions in the 5'- and 3'-untranslated regions (UTR) of the Saccharomyces cerevisiae mRNA encoding phosphoglycerate kinase (PGK) on the stability of the transcript in vivo was determined. None of the structural alterations in the 5'-UTR affected mRNA turnover significantly, despite the strong negative effect on translational efficiency of some of these alterations previously observed. We conclude that the structure of the 5'-UTR is not important for the relatively high affinity of PGK mRNA in yeast cells. Moreover, translation cannot be a major factor in determining the rate of turnover of this mRNA. Insertion of either a polyG or polyU, but not a polyA or polyC, tract into the 3'-UTR of PGK mRNA increased its half-life by a factor of about two. Introduction of a hairpin structure containing 18 G.C base pairs had only a slight stabilizing effect. We argue that the stabilization by the structural changes in the 3'-UTR is due to altered folding of the mutant mRNA which retards a rate-limiting endonucleolytic cleavage step in the normal turnover pathway of PGK mRNA. The stabilizing effect of local structural alterations in the 3'-UTR opens the possibility for further increasing the product yield of a (heterologous) gene cloned in yeast cells. PMID- 1764520 TI - The assembly of prokaryotic ribosomes. AB - The targets of in vivo studies of the ribosomal assembly process are mainly the events of rRNA processing, whereas in vitro studies (total reconstitution) focus on principles of the assembly process such as assembly-initiation proteins, rate limiting steps and a detailed sequence of assembly reactions (assembly map). The success of in vitro analyses is particularly remarkable in view of ionic and temperature requirements of the total reconstitution which differ significantly from the in vivo conditions. Features of the in vivo assembly are surveyed, however, the focal point is a description of experimental strategies and results concerning the in vitro assembly of ribosomes. PMID- 1764521 TI - Lack of complete cooperativity of ribosome assembly in vitro and its possible relevance to in vivo ribosome assembly and the regulation of ribosomal gene expression. AB - Earlier studies have shown that the reconstitution of Escherichia coli 50S as well as 30S ribosomal subunits from component rRNA and ribosomal protein (r protein) molecules in vitro is not completely cooperative and binding of more than one r-protein to a single 16S rRNA (or 23S rRNA) molecule is required to initiate a successful 30S (or 50S) ribosome assembly reaction. We first confirmed this conclusion by carrying out 30S subunit reconstitution in the presence of a constant amount of 16S rRNA together with various amounts of total 30S r-proteins (TP30) and by analyzing the physical state of reconstituted particles rather than by assaying protein synthesizing activity of the particles as was done in the earlier studies. As expected, under conditions of excess rRNA, the efficiency of 30S subunit reconstitution per unit amount of TP30 decreased greatly with the decrease in the ratio of TP30 to rRNA, indicating the lack of complete cooperativity in the assembly reaction. We then asked the question whether the cooperativity of ribosome assembly is complete in vivo. We treated exponentially growing E coli cells with low concentrations of chloramphenicol which is known to inhibit protein synthesis without inhibiting rRNA synthesis, creating conditions of excess synthesis of rRNA relative to r-proteins. Several concentrations of chloramphenicol (ranging from 0.4 to 4.0 micrograms/ml) were used so that inhibition of protein synthesis ranged from 40 to 95%. Under these conditions, we examined the synthesis of RNA, ribosomal proteins and 50S ribosomal subunits as well as the synthesis of total protein. We found that the synthesis of 50S subunits was not inhibited as much as the synthesis of total protein at lower concentrations of chloramphenicol, but the degree of inhibition of 50S subunit synthesis increased sharply with increasing concentrations of chloramphenicol and was in fact greater than the degree of inhibition of total protein synthesis at chloramphenicol concentrations of 2 micrograms/ml or higher. The inhibition of 50S subunit synthesis was significantly greater than the inhibition of r-protein synthesis at all chloramphenicol concentrations examined. These data are consistent with the hypothesis that the cooperativity of ribosome assembly in vivo is also not complete as is the case for in vitro ribosome reconstitution, but are difficult, if not impossible, to explain on the basis of the complete cooperativity model.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1764522 TI - The protein composition of reconstituted 30S ribosomal subunits: the effects of single protein omission. AB - Using reverse phase HPLC, we have been able to quantify the protein compositions of reconstituted 30S ribosomal subunits, formed either with the full complement of 30S proteins in the reconstitution mix or with a single protein omitted. We denote particles formed in the latter case as SPORE (single protein omission reconstitution) particles. An important goal in 30S reconstitution studies is the formation of reconstituted subunits having uniform protein composition, preferably corresponding to one copy of each protein per reconstituted particle. Here we describe procedures involving variation of the protein:rRNA ratio that approach this goal. In SPORE particles the omission of one protein often results in the partial loss in uptake of other proteins. We also describe procedures to increase the uptake of such proteins into SPORE particles, thus enhancing the utility of the SPORE approach in defining the role of specific proteins in 30S structure and function. The losses of proteins other than the omitted protein provide a measure of protein:protein interaction within the 30S subunit. Most of these losses are predictable on the basis of other such measures. However, we do find evidence for several long-range protein:protein interactions (S6:S3, S6:S12, S10:S16, and S6:S4) that have not been described previously. PMID- 1764523 TI - The absence of modified nucleotides affects both in vitro assembly and in vitro function of the 30S ribosomal subunit of Escherichia coli. AB - 16S RNA of Escherichia coli lacking all post-transcriptional modifications and with 5'-termini of pppGGGAGA-, pppGAA-, pppAAA-, and pAAA- were prepared by in vitro transcription of appropriately engineered plasmids with T7 or SP6 RNA polymerases. These synthetic versions of 16S RNA were compared with natural 16S RNA for their ability to reconstitute 30S ribosomal subunits in vitro using varied conditions for both the isolation of the RNA and for reconstitution. Under all conditions studied, natural 16S RNA assembled correctly, as judged by velocity centrifugation comparison with an internal standard of native 30S particles, and the recovered ribosomes were 80-100% as active as native 30S ribosomes in initiation complex formation, P site binding of AcVal-tRNA, A site binding of Phe-tRNA, and formation of the first peptide bond. In contrast, all of the synthetic constructs including pAAA-, which has the same sequence as native 16S RNA, were only partially active in reconstitution and in the functional assays. We conclude that the lack of the 10 methylated nucleotides and/or the 2 pseudouridylate residues present in natural 16S RNA must be responsible for the reduced activity of the synthetic RNAs in ribosome assembly and function. PMID- 1764524 TI - The binding site of ribosomal protein L10 in eubacteria and archaebacteria is conserved: reconstitution of chimeric 50S subunits. AB - It has been shown by electron microscopy that the selective removal of the stalk from 50S ribosomal subunits of two representative archaebacteria, namely Methanococcus vaniellii and Sulfolobus solfataricus, is accompanied by loss of the archaebacterial L10 and L12 proteins. The stalk was reformed if archaebacterial core particles were reconstituted with their corresponding split proteins. Next, structurally intact chimeric 50S subunits have been reconstituted in vitro by addition of Escherichia coli ribosomal proteins L10 and L7/L12 to 50S core particles from M vaniellii or S solfataricus, respectively. In the reverse experiment, using core particles from E coli and split proteins from M vaniellii, stalk-bearing 50S particles were also obtained. Analysis of the reconstituted 50S subunits by immunoblotting revealed that E coli L10 was incorporated into archaebacterial core particles in both presence or absence of E coli L7/L12. In contrast, incorporation of E coli L7/L12 into archaebacterial cores was only possible in the presence of E coli L10. Our results suggest that in archaebacteria - as in E coli - the stalk is formed by archaebacterial L12 proteins that bind to the ribosome via L10. The structural equivalence of eubacterial and archaebacterial L10 and L12 proteins has thus for the first time been established. The chimeric reconstitution experiments provide evidence that the domain of protein L10 that interacts with the ribosomal particle is highly conserved between eubacteria and archaebacteria. PMID- 1764526 TI - The mitochondrial ribosomes. PMID- 1764525 TI - Preribosomal RNA processing in Xenopus oocytes does not include cleavage within the external transcribed spacer as an early step. AB - Recently it has been reported that U3 snRNA is necessary for: (a) internal cleavage at +651/+657 within the external transcribed spacer (ETS) of mouse precursor ribosomal RNA (pre-rRNA); and (b) cleavage at the 5' end of 5.8S rRNA in Xenopus oocytes. To study if U3 snRNA plays a role at more than one processing site in the same system, we have investigated whether internal cleavage sites exist within the ETS of Xenopus oocyte pre-rRNA. The ETS of Xenopus pre-rRNA contains the consensus sequence for the mammalian early processing site (+651/+657 in mouse pre-rRNA), but freshly prepared RNA from Xenopus oocytes has no cuts in this region. The only putative cleavage sites we found in the ETS of Xenopus oocyte pre-rRNA are a cluster further downstream of the mouse early processing site consensus sequence. This cluster is not homologous to the mouse +651/+657 sites because unlike the latter it is (a) not abolished by disruption of U3 snRNA, (b) not cleaved during early steps of pre-rRNA processing, and (c) lacks sequence similarity to the +651/+657 consensus. Therefore, pre-rRNA of Xenopus oocytes does not cleave within the ETS as an early step in rRNA processing. We conclude that cleavage within the ETS is not an obligatory early step needed for the rest of rRNA maturation. PMID- 1764527 TI - Proteins of mammalian mitochondrial ribosomes. AB - The bovine mitochondrial system is being developed as a model system for studies on mammalian mitochondrial ribosomes. Information is emerging on the structural organization and RNA binding properties of proteins in these mitochondrial ribosomes. Unexpectedly, these ribosomes appear to interact directly with GTP, via a high affinity binding site on the small subunit. Despite major differences in their RNA content and physical properties, mammalian mitochondrial and cytoplasmic ribosomes contain about the same number of proteins. The proteins in each kind of ribosome have a similar size distribution, and both sets are entirely coded by nuclear genes, raising the possibility that these different ribosomes may contain the same set of proteins. Comparison of bovine mitochondrial and cytoplasmic r-proteins by co-electrophoresis in two-dimensional gels reveals that most of the cytoplasmic ribosomal proteins are more basic than the mitochondrial ribosomal proteins, and that none are co-migratory with mitochondrial ribosomal proteins, suggesting that the proteins in the two ribosomes are different. To exclude the possibility that the electrophoretic differences result only from post-translational modification of otherwise identical proteins, antibodies against several proteins from the large subunit of bovine mitochondrial ribosomes were tested against cytoplasmic ribosomes by solid phase radioimmunoassay and against cytoplasmic ribosomal proteins on Western blots. The lack of cross-reaction of these antibodies with cytoplasmic r-proteins suggests that mitochondrial ribosomal proteins have different primary structures and thus are most likely encoded by a separate set of nuclear genes. PMID- 1764528 TI - The nuclear coded mitoribosomal proteins YmL27 and YmL31 are both essential for mitochondrial function in yeast. AB - Using synthetic oligonucleotides deduced from the N-terminal amino acid sequence of purified mitoribosomal protein (mt r-protein) YmL27, the corresponding nuclear gene MRP-L27 of the yeast Saccharomyces cerevisiae has been cloned and sequenced. The MRP-L27 gene codes for 146 amino acids and is located on chromosome X. The mature YmL27 protein consists of 130 amino acids - after cleaving the putative mitochondrial signal peptide - with a net charge of +17 and a calculated relative molecular mass of 14,798 Da. The YmL27 protein as well as the yeast mitoribosomal protein YmL31, which had been characterized and its gene (MRP-L31) cloned previously, is essential for mitochondrial function as shown by the inability of gene disrupted mutants for the MRP-L27 or MRP-L31 genes to grow on non fermentable carbon sources. PMID- 1764529 TI - The nuclear:organelle distribution of chloroplast ribosomal proteins genes. Features of a cDNA clone encoding the cytoplasmic precursor of L11. AB - The majority of chloroplast ribosomal proteins are encoded in the nuclear genome. In order to characterize these proteins through their mRNA, we have previously constructed a spinach cDNA expression library and raised antisera to several spinach chloroplast ribosomal proteins. Here we describe the immuno isolation of cDNA clones encoding protein L11 and its chloroplast-targeting presequence. The cytoplasmic precursor form of L11 is 224 amino acid residues long (Mr 23,662); the mature L11 and the transit sequence are predicted to be of approximately 159 and approximately 65 residues, respectively. The predicted chloroplast L11 is significantly longer than the E coli L11, but similar (in size) to archaebacterial and yeast cytoplasmic L11. In sequence it is closer to E coli L11 (54% identity) than to the archaebacterial (32%) or yeast (23%) proteins. These results and the conservation of the contexts of the 3 methyl modified residues found in E coli L11 are discussed in the light of the endosymbiont theory and nuclear relocation of the rp/KAJL gene cluster. PMID- 1764530 TI - [Folates in human nutrition, Different clinical situations in which folate deficiencies exist]. AB - The alimentary surveys carried out on various sectors of the population in industrialized countries have shown the existence of chronic clinically silent deficiency in micronutrients. In some cases, as in folates, their lability against conservation techniques, the change in alimentary habits, the abuse of alcohol and the great quantity of frequently used drugs which interfere in their absorption, diminish their content in the diet and their bio-availability. The appearance of macrocytic anemia is a late deficiency sign, and therefore in situations of an increase need and in patients included in the risk groups, a supplemental intake must be given in order to avoid irreversible lesions if it is not possible to monitor the folate levels. There are risk groups in which various etiological factors come into play, acting at a different metabolic level on the folates and making more difficult their dietetic or pharmacological compensation even if supply is considerably increased. We studied these factors independently and in each specific situation (old people, patients with liver disease, alcoholics, pregnant women and nursing mothers, neonates, children, malabsorption syndromes, gastrectomy, AIDS, anaesthesia and patients being treated with antifolic medication), evaluating their mechanisms of action and their potentiation in determined specific situations. PMID- 1764531 TI - [Behavior of thyroid function following massive intestinal resection. Experimental study]. AB - With the purpose of research the behaviour of the thyroid function after massive intestinal bowel resection, we have designed an experimental model of short bowel syndrome. For this aim two groups of study were employed, each one with seven animals (minipigs). RIA for T4, T3 y TSH were made in four different times: basal (R1), immediately after intestinal resection (R2), two weeks after it, and six months later (R4). The results show that, once short bowel syndrome is established, the animals remain in euthyroid state. But the transitory oscillations of T4 in R3 and T3 in R2 suggested that these could be caused for alterations in the enterohepatic circulation of thyroid hormones in the acute diarrheal state. PMID- 1764532 TI - [Nutritional support in liver transplantation]. AB - Given the malnutrition present in patients suffering from advanced hepatic illness, as well as the implications of this in the post-hepatic transplant period, a study was made of various biochemical parameters (prealbumin, retinol bound protein, zinc, magnesium, cholesterol and amino acid pattern) as indicators of the nutritional condition of a series of 15 patients who underwent hepatic transplants and required total parenteral nutrition (TPN) during the first 10 post-transplant days. Before the transplants were carried out, all the patients studied showed a decrease in all evaluated parameters. Ten days after the transplant, and having been fed parenterally during this time, the different parameters corrected themselves, with the exception of cholesterol. TPN, administered with enrichment of branched amino acids by 35%, practically normalized the plasma amino acid pattern. PMID- 1764533 TI - [Menu design for total parenteral nutrition: simplified model derived from a computerized system]. AB - After the design and use of a computerized system for the prescription of parenteral nutrition, the authors drew up clinical choice tables, as well as others of a pharmaceutical elaboration, based on the same algorithm of the computer program. The conclusion reached was that the nutrition selection process based on these tables is simpler, saves more time, is based on a logical plan of decision making and does not need a computer support. PMID- 1764534 TI - [Stability of folic acid and vitamin B12 in TPN]. AB - The stability of folic acid (FA) in mixtures of Total Parenteral Nutrition has been and is a controversial subject, with discussion concerning the influence of factors such as temperature, light and storage time. As regards the stability of the vitamin B12, there are few studies in scientific literature. For all those reasons, we consider it necessary to make a proper study to evaluate the influence of different factors in the stability of both vitamins. The study was made on 3 liter TPN bags of the EVA type, the composition of which was as follows: AA (85g), glucosa (225g), fat (50g), Na (86mEq), K (60 mEq), Ca (15 mEq), Cl (90 mEq), P (17 mmol) acetate (149 mEq) and 10 ml of MVI-12 which contain 400 micrograms of PA and 5 micrograms of Vitamin B 12. Consideration was also given to the stability of these two vitamins in the same diet, to which were added 10 ml of a commercial preparation of oligo-elements. Six TPN bags were prepared (without oligo-elements); two of them were kept in a fridge and protected from the light, two were kept at room temperature and protected from the light and the other two at room temperature without protection from the light. Samples were taken from all the bags immediately after their preparation and after 24, 48, 72 and 96 hours. The same process was carried with other TPN bags which did contain oligo-elements. The method for determining FA and Vitamin B12 was by radioassay.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764535 TI - Studies of the geographic patterns of c-myc expression in bone marrow. AB - C-myc expression was studied semi-quantitatively in bone marrow biopsies obtained from normal individuals, patients with non-malignant haematological disorders and patients with various haematological malignancies. In normal bone marrow and in the bone marrow of patients with non-malignant haematological disorders, cells containing c-myc protein are present in small clones (average 7 +/- 2.5 cells/clone) located in the centre of the histotopographic region of the biopsy. In contrast, c-myc-containing cells are diffusely distributed in the bone marrow of patients with acute myelogenous leukaemia (AML). In the marrow of patients with myelodysplastic syndromes evolving to AML and in patients with AML in early relapse, the clones of cells containing c-myc are larger than those present in normal marrows (average clone size = 17.5 +/- 3.5 cells). Additionally, the proportion of the cells in normal bone marrow which express c-myc protein is less than that present in AML marrows (23.3 +/- 10.17 v. 60.2 +/- 6.17) and the intensity of staining is also less. Non-Hodgkin's lymphoma patients with bone marrow involvement had distribution of c-myc positive cells similar to those with leukaemic infiltration. PMID- 1764536 TI - The type, origin and function of the odontogenic cells of continuously growing guinea-pig molars. AB - Little is known about which cell types act as the origin of odontogenic stem cells and how these stem cells differentiate to become functional. In the present study 3-day-old guinea-pigs were injected with tritiated thymidine, killed at intervals and their molars studied. The odontogenic cells were found to originate from the stem cells which by autoradiography were shown to be slow cycling and lightly labelled. As they differentiated they became heavily labelled and were designated transit 'dividing cells'. With further differentiation the cells were unlabelled and were designated 'simple transit cells'. It was concluded from the present study that outer enamel epithelium functioned as the source of all odontogenic epithelium; that primitive mesenchyme around the cervical loop functioned as the source of all odontogenic mesenchyme and that all of the transit cells which differentiated to become functional migrated coronally. PMID- 1764537 TI - Age-related changes in the cell proliferation of ATPC+ mouse ascites tumour. AB - The growth of ATPC+, an ascites tumour derived from a spontaneous mammary carcinoma in BALB/c+ mice, was studied at different ages. It was observed that the number of cells increases rapidly during the first 5 days after implantation. Thereafter, the cell number increases more slowly, reaching a plateau after 8 days. This slowing-down is not due to a reduction in the growth fraction but to a lengthening of the cell cycle. Between 5 and 8 days the duration of all phases increases, including the S phase, which increases from 5.2 h in 5-day tumours to 8.2 h in 8-day tumours. In 12-day tumours both the cell cycle and S phase are only slightly longer than in 8-day tumours whereas the growth fraction is reduced. The slowing-down of cell growth can be attributed to growth fraction reduction rather than cell loss, which is maximal in the 5-day tumour. At this age the time course of the percent labelled cells and of the number of grains/nucleus suggests reutilization of [3H]-thymidine. Incorporation of [3H] thymidine/cell decreases sharply in 12-day tumours due to a reduced availability of thymidine, which is degraded to thymine in the in vivo ascitic fluid faster than in 8-day tumours. This indicates an age-related change in the ascitic fluid composition. PMID- 1764538 TI - Optimal conditions for immunohistochemical determination of the in vitro DNA synthesis labelling index with bromodeoxyuridine in head and neck cancer. AB - The in vitro DNA synthesis labelling index was assessed immunohistochemically in 24 freshly obtained specimens of head and neck cancer using bromodeoxyuridine (BrdUrd) as the DNA precursor to determine the influence of BrdUrd concentration on labelling index (LI). Initially, tumour fragments were incubated in varying concentrations of BrdUrd from 2 to 100 microM for 2 h, and BrdUrd was detected with an anti-BrdUrd monoclonal antibody using immunoperoxidase labelling. There was a dose-response gradient with mean LI varying from 1.6% at 2 microM BrdUrd to 8.8% at 100 microM. The concentration-response gradient best fit a quadratic model when LI was plotted against log BrdUrd concentration (r = 0.65, P less than 0.0001). Eleven additional tumours were then studied to determine whether LI increased for BrdUrd concentrations above 100 microM. The mean LI at 125 microM and at 150 microM in these 11 tumours did not differ from the value at 100 microM, suggesting a plateau at this level. The gradient effect accounted for 17% of the variance in LI, while 60% of the variance was explained by between tumour differences. Within individual tumours, three response patterns were observed: (i) LI rose at a constant rate to the highest concentration tested (n = 8), (ii) the LI plateaued or declined at high BrdUrd concentrations (n = 6); and (iii) there was a biphasic slope slope in which the rate of rise in the LI increased at the higher BrdUrd concentrations (n = 2). The data show that BrdUrd concentration is an important variable in the immunohistochemical assessment of the in vitro LI in head and neck cancer. PMID- 1764539 TI - Verhulstian analysis of the growth of transplantable mammary tumours in sialoadenectomized mice. AB - In this report we have analysed data published in 1989 by Inui et al. (Incidence of precancerous foci of mammary glands and growth rate of transplantable mammary cancers in sialoadenectomized mice. J. Natl Cancer Inst. 81, 1660) involving the effects of perturbation of the epidermal growth factor (EGF) status of mammary tumour-bearing mice on subsequent volumetric responses. Removal of an endogenous EGF stimulus by surgical ablation of the submaxillary glands, the major EGF producing organ in mice, produced significantly slower growth of rodent mammary neoplasms, decreased success rate of transplantation, and an increase in the latent period before growth occurred. Administration of i.p. EGF (5 micrograms/mouse/day) to sialadectomized tumour-bearing mice would however, increase tumour growth rate. Data were analysed using the Verhulst equation which indicated that the observed effects on tumour volumetrics by either sialoadenectomy or EGF administration could be interpreted as being produced through paracrine pathways. The use of the Verhulstian analysis indicates that it is possible to analyse neoplastic responses and infer whether paracrine or autocrine pathways are involved. PMID- 1764540 TI - Dual effect of lovastatin and simvastatin on LDL-macrophage interaction. AB - Lovastatin and simvastatin which are very potent cellular cholesterol biosynthesis inhibitors, significantly affect the plasma lipoprotein concentration. After incubation of plasma with 14C-labelled compounds, radioactivity was found in all lipoprotein fractions but mainly (40%) in high density lipoprotein (HDL), and in the lipoprotein-deficient plasma fraction (20 30%). Drug-treated lipoproteins showed reduced electrophoretic mobility on cellulose acetate in comparison with control lipoproteins. The lovastatin-treated low density lipoprotein (LDL) displayed 28% increased fluidity in comparison with control LDL. The immunoreactivity of drug-treated LDL with monoclonal antibody directed towards the LDL receptor binding domains (B1B6) was significantly less than that of control LDL, suggesting reduced binding to the LDL receptor. When drug-treated LDL was incubated with J-774 A.1 macrophage-like cell line, its binding (at 4 degrees C) was 28% less than that of control LDL, whereas a substantial increase in the cellular cholesterol esterification rate (by 83% with lovastatin and by 67% with simvastatin) was noted. Similarly, the degradation of lovastatin and simvastatin-treated LDL by macrophages was 87-89% greater than that of control LDL. The "apparent Vmax" for the macrophage degradation of lovastatin-treated LDL was 70% greater than that for control LDL. Thus, both drugs may have a dual effect on the macrophage uptake of LDL; they may increase the number of LDL receptors on the cell surface, but they may also reduce the affinity of LDL for its receptor, the former being the major effect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764542 TI - Practical implications of coexistent different technologies in clinical chemical laboratories. Solid phase chemistry and conventional analysis. AB - If different analytical methods are alternatively used for the determination of the same analyte, basic differences in test methodology can give rise to an increased number of deviating results. Such coexistence of methods might be necessary, for example, during a transition phase while upgrading to new technologies. We have exemplarily investigated this topic for the comparison of solid phase chemistry ("dry chemistry") versus conventional methods ("wet chemistry"). The Kodak Ektachem 700XR clinical chemistry analyser was compared with the Hitachi 737 analyser from Boehringer Mannheim using 18 clinical chemical analytes and specimens submitted for routine analysis. Before the start of the evaluation, the Ektachem 700XR was adjusted ("calibrated") by the manufacturer for optimal agreement with the Hitachi 737. Satisfactory agreement was obtained for most investigated analytes as judged by correlation coefficients and three commonly applied regression methods (linear regression, principal components, and Passing/Bablok method). For some analytes, however, strongly deviating results were often obtained. Quality control-derived limits (maximum acceptable inaccuracy) and data from biological variation (critical differences) were used for the assessment of the inter-instrument bias for diagnosis and patient monitoring, respectively. For enzymes, 0% (amylase) to 22% (creatine kinase) of all pathologic results differed by more than the maximum acceptable analytical inaccuracy (21%-27%) of these analytes. If more stringent limits derived from biological variation were used, 24% (creatine kinase)--62% (aspartate aminotransferase) of all differences between paired measurements exceeded the critical difference for enzymes. Deviations greater than the critical differences were also marked for serum concentrations of sodium, calcium, and creatinine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764541 TI - Preparation of nucleoside-LDL-conjugates for the study of cell-selective internalization: stability characteristics and receptor affinity. AB - Antiviral therapy of human immunodeficiency virus (HIV) infection is currently based on inhibition of reverse transcriptase by dideoxynucleosides, such as azidothymidine. Because of widespread toxicity it is reasonable to selectively target these drugs to infected cells. This may be accomplished utilizing drug-LDL conjugates, which are internalized via cell specific receptor pathways. With respect to HIV infection, scavenger receptors of the macrophage system seems to offer a hopeful perspective. This pathway requires chemical modification of surface polarity of the LDL. Cell experiments were conducted in HepG2 hepatocytes, which express apolipoprotein B receptors, and in P388 macrophages, which express scavenger receptors. LDL particles to be conjugated were isolated from blood donor plasma and from LDL-apheresis waste material. Non-covalent LDL conjugation with amphiphilic nucleoside derivatives produced only an unspecific nucleoside transfer to cell membranes, due to instability of the LDL conjugates. An experimental method (coincubation test) was developed to identify those conjugates that are stable in the presence of other lipophilic compartments. Covalent coupling of nucleosides to the apolipoprotein B moiety of LDL particles resulted in stable conjugates. As a consequence, the surface charge became negative, and the LDL displayed scavenger receptor affinity rather than apolipoprotein B receptor affinity. Selective targeting of nucleosides to macrophages can be accomplished by covalent coupling to LDL. PMID- 1764543 TI - Incorporation of biotinylated nucleotides for the quantification of PCR-amplified HIV-1 DNA by chemiluminescence. AB - Chemiluminescent detection of polymerase chain reaction (PCR-)amplified DNA was used as a quantitative method for detecting HIV-1. For this purpose, biotinylated dUMP was directly incorporated into the amplified DNA during the PCR reaction. Biotinylation was visualized in an enzymatic reaction using avidine-conjugated alkaline phosphatase and its chemiluminescent 1,2-dioxetane substrate AMPPD, which decomposes upon dephosphorylation and emits light. Light emission was either detected with X-ray films or quantified with a single-photon counting camera connected to a computer imaging system. The specificity of the method was shown by hybridization with a biotinylated or radiolabelled HIV-1-specific oligonucleotide probe. Besides being quantitative, this method represented a non hazardous, rapid and sensitive technique for the detection of HIV-1 DNA. PMID- 1764544 TI - Antibodies against calcitonins as a source of analytical errors. PMID- 1764545 TI - Creatine kinase determination: a European evaluation of the creatine kinase determination in serum, plasma and whole blood with the Reflotron system. AB - We evaluated a new dry-reagent carrier system for the determination of creatine kinase (EC 2.7.3.2) activity, Reflotron CK, with special attention to analytical performance with whole blood. We found a good within series imprecision. The median coefficient of variation was 3.1% for Reflotron CK (blood, serum and plasma) and 0.9% for the automatic analysers (serum and plasma only). The between days imprecision with Reflotron CK (median CV: less than or equal to 3%) was similar to that for the comparison method on different analysers. Fresh samples of human blood, plasma and serum were examined by Reflotron CK and by a N acetylcysteine activated creatine kinase method in six different clinical laboratories and in the Evaluation Department of Boehringer Mannheim GmbH. The correlation between these methods was excellent (r greater than or equal to 0.99), the median systematic deviation (bias) for all samples being smaller than 5%. Haematocrits between 0.25 and 0.50, haemolysis up to 6 g/l haemoglobin, and icteric samples with bilirubin concentrations up to 0.2 g/l showed no interference. No drug in therapeutic concentration was found to affect the Reflotron CK results; ascorbic acid, calcium dobesilate and sulphamethoxazole lowered the values only when present in high concentrations. Reflotron CK may be considered as a suitable alternative for decentralized testing sites, especially in situations where creatine kinase results are needed quickly. PMID- 1764546 TI - The determination of thyroxine and thyroxine uptake with new homogeneous enzyme immunoassays using Boehringer Mannheim/Hitachi analysis systems. AB - New homogeneous enzyme immunoassays for the determination of thyroxine and thyroxine uptake have been developed. The CEDIA assays are based on the cloned enzyme donor immunoassay technology, which involves fragments of beta galactosidase prepared by genetic engineering. The assays have been adapted for Boehringer Mannheim/Hitachi analysers. The CEDIA T4/T Uptake assays were evaluated in eleven clinical chemistry laboratories on various Boehringer Mannheim/Hitachi analysis systems, using a 2-point calibration. The analytical range of the T4 test was 10 to 258 nmol/l thyroxine. The T uptake test had a measuring range between 20-50%. Depending on the concentration of the analyte (samples from hypo-, eu- or hyperthyroid patients), mean coefficients of variation ranged from 1.8 to 4.8% within-run and from 4.1 to 6.5% between-run for the T4 assay. Even better coefficients of variation were obtained for the T uptake assay (1.4 to 2.3% within-run, 2.8 to 3.3% between run). The relative inaccuracy of the CEDIA assays with respect to values assigned by other tests was satisfactory in various control sera. The T4 assay was compared with one radioimmunoassay, one enzyme immunoassay and one fluorescence polarisation immunoassay. Slopes ranging from 0.9 to 1.1 and intercepts ranging from -10 to +10 nmol/l thyroxine were obtained with two exceptions. The results of the T uptake test correlated reasonably with those of other thyroxine-binding methods. No interference was observed with icteric and lipaemic sera. Haemoglobin up to 4 g/l had no significant influence. Results of the CEDIA T Uptake test are mainly used for calculation of the free thyroxine index, in which the thyroxine value is corrected for variations of thyroxine-binding protein concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764547 TI - Classical and modern methods of cerebrospinal fluid analysis. Report on the First All-German Symposium of the Society for Laboratory Medicine (FRG) and the Study Group for CSF Analysis and Clinical Neurochemistry of the Society for Psychiatry and Neurology (formerly GDR) in Marburg a. d. Lahn, October 5-6, 1990. AB - The aim of the symposium was to prepare an inventory of cerebrospinal fluid (CSF) analysis used in Germany, and to evaluate them in comparison with modern methods. From the large field of CSF analysis, four main topics were selected, all related to the practical application of the methods. The following conclusions were drawn: Classical techniques of cytodiagnosis are clinically important. Therefore, manual and mechanized techniques must be further improved with respect to counting, collection, and differentiating of CSF cells. As cytokines and complement factors are early mediators of diverse processes in CNS, highly sensitive techniques must be developed for their routine analysis e.g. in CNS inflammation. Recent efforts to detect specifically viral and bacterial agents (e.g. by polymerase chain reaction, Particle Counting Immuno-Assay, Enzyme Immuno Assay) or antibodies (e.g. affinity-mediated immunoblot, specific antibody index) in CSF must be continued in order to develop definite and practicable assays for daily routine. For the detection of intrathecally produced antibodies, qualitative procedures appear to be more reliable then quantitative ones, provided that the former are highly sensitive and specific. PMID- 1764548 TI - Erosion process of calcium hydroxide cements in water. AB - Erosion process of calcium hydroxide cements was examined for 7 days by chemical analysis of eluates and observation of structural change of the eroded cements when the cements were immersed in water at 37 degrees C. The elution of salicylate from the set cements as well as that of Ca continued during the immersion time. In the early stage of the erosion, unreacted Ca(OH)2 was preferentially extracted from the cements in comparison with Ca-alkyl salicylate chelate of the cement matrix. The elution rate of N-ethyl o- and p-toluene sulphonamides, which were contained as plasticizer, was higher than those of Ca and salicylate. Insoluble inorganic filler remained at the surface of the cements after extraction of unreacted Ca(OH)2 and disintegration of the cement matrix. Types of salicylate ester seemed to affect the cement durability. PMID- 1764549 TI - Comparative evaluation of treated bovine pericardium as a xenograft for hernia repair. AB - Two forms of bovine pericardium (BPC) were assessed as hernia repair materials: non-cross-linked (lyophilized) and cross-linked through treatment with glutaraldehyde (GA). These were compared with polypropylene mesh (Marlex) in a rabbit model. Over 52 wk implantation, the GA BPC grafts developed a strong, stable, fibrous tissue replacement with good incorporation into the abdominal muscle wall. The lyophilized BPC grafts were substantially resorbed within 12 wk of implantation, however the thin, fibrous replacement tissue was inadequate for abdominal wall support. Marlex grafts provided sufficient abdominal support, however these grafts were associated with extensive adhesion formation and, in this model, fat deposition around the perimeter of the graft. Control (ungrafted) rabbit abdominal muscle in the transverse orientation had an ultimate tensile load (UTL) of 11.4 +/- 5.1 N (x +/- s.d.) and a strain at UTL of 35 +/- 12% (n = 169). At 52 weeks the UTL of the repair sites was 7.3 +/- 4.5 N (n = 6), 5.1 +/- 3.5 N (n = 6) and 5.6 +/- 2.7 N (n = 6) for GA BPC, lypophilized BPC and Marlex grafts, respectively. PMID- 1764550 TI - Porous polymer implant for repair of meniscal lesions: a preliminary study in dogs. AB - Artificial meniscal lesions extending into the avascular part of the meniscus, which do not heal by any other means, were repaired by suturing either a porous polymer implant or a synovial flap into the defect. The implant guided the ingrowth of vascular repair tissue into the defect. This fibrous tissue later on transformed into fibrocartilage. Reconstruction with a synovial flap was not successful. It appeared that healing can be achieved by implantation of a porous polymer implant in a large number of cases. Future research will be aiming at improvement of the results of meniscal repair and application of this type of polymer for repair of cartilage defects. PMID- 1764551 TI - Biochemical and physico-chemical aspects of biomaterials calcification. AB - Intrinsic tissue calcification mainly results from increased penetration of plasma proteins into the leaflets of bioprosthetic cardiac valves. The loss of activity of natural calcification inhibitors changes tissue properties and promotes pathological processes. N-vinylpyrrolidone, 3-amino-1,1 hydroxypropylendiphosphonic acid, O,O-diethylvinylphosphonates and antiaggregant (acryloilsalicylic acid) were used to decrease porosity and prevent calcification. gamma-radiation and glutaraldehyde were used to immobilize these agents. Tissue calcification was studied using subcutaneous implantation of the samples in young rats. The study indicates that the copolymerization of N vinylpyrrolidone, O,O-diethylvinylphosphonates and acryloilsalicylic acid decreases calcium and phosphorous accumulation during in vivo experiments. PMID- 1764552 TI - Bioactive polymers 66. Theophylline retardation in xanthan-based hydrogels. AB - Xanthan has been reticulated with epichlorohydrin to obtain a hydrogel for use in drug retardation. The obtained gel shows swelling degrees up to 1000. Theophylline has been inserted by diffusion into this gel; concentrations around 150 mg theophylline/g dry hydrogel being obtained. Controlled release of theophylline has been established by elution in a close recirculation system. Zero-order kinetics has been obtained in the diffusion process of theophylline into the eluent, within a 14 h time interval. PMID- 1764553 TI - Crystallographic behaviour of fluoridated hydroxyapatites containing Mg2+ and CO3(2-) ions. AB - Fluoridated hydroxyapatites containing small amounts of magnesium and carbonate ions were synthesized at 80 and 60 degrees C to examine their inhibiting properties regarding apatite crystal growth, in contrast to the promoting action of fluoride. The shortening of a-axis and c-axis dimensions of the apatite crystals, as revealed by X-ray diffraction analysis, suggested that both magnesium and carbonate ions were substituted into the apatite crystals. The a axis dimensions also decreased with the degree of fluoridation. The infrared spectra due to CO3(2-) ions at 875 cm-1 were shifted with increasing fluoride content. The overall crystallinity was inhibited in comparison with that of Mg and CO3-free fluoridated hydroxyapatites, but recovered considerably with increased fluoride content. The apparent solubility of the apatites at pH 4.0 and 37 degrees C was higher than that of Mg and CO3-free fluoridated hydroxyapatites at lower fluoride contents, but gradually approached the latter at higher fluoride content. After 1 month's incubation, dicalcium phosphate dihydrate was formed from fluoride-free Mg-CO3 apatite synthesized at 60 degrees C. PMID- 1764554 TI - Long-term structural changes in pH-sensitive hydrogels. AB - The long-term swelling properties of lightly cross-linked copolymer hydrogels consisting of methyl methacrylate (MMA) and N,N-dimethylaminoethyl methacrylamide (DMAA) were studied as a function of pH at 25 degrees C and 37 degrees C. In acidic pH regions, the swelling equilibria were found to be stable over 200 d. In alkaline pH environments, however, the 'equilibrium' swelling increases slowly with time. Gas chromatography of the supernatant shows that substantial methanol is produced, along with trace amounts of N,N-dimethylethylene diamine. Thus, the primary mechanism underlying the structural changes appears to be hydrolysis of ester groups in the MMA side-chains, with a much smaller contribution due to amidolysis of the DMAA side-chains. The implications of these structural changes for the application of this hydrogel, as well as other related hydrogels as long term implantable biomaterials, are discussed. PMID- 1764555 TI - In vitro and in vivo evaluation of polyhydroxybutyrate and of polyhydroxybutyrate reinforced with hydroxyapatite. AB - Polyhydroxybutyrate (PHB) is a polyester made by many microorganisms under conditions of nitrogen deficiency, and is produced commercially in bulk by biotechnology. It has been suggested that PHB-based materials (copolymers and composites) could be suitable for medical applications and may be biodegradable. This paper presents some findings regarding the degradation and biological properties of polyhydroxybutyrate and composites reinforced with particulate hydroxyapatite. It has been established that the strength and stiffness of these materials reduce on in-vitro environment exposure in phosphate-buffered saline at 37 degrees C for periods up to 4 months, and that the degradation rate is a function of composition and processing conditions. It has also been demonstrated that materials based on PHB produce a consistent favourable bone tissue adaptation response with no evidence of an undesirable chronic inflammatory response after implantation periods up to 12 months. Bone is rapidly formed close to the material and subsequently becomes highly organized, with up to 80% of the implant surface lying in direct apposition to new bone. The materials showed no conclusive evidence of extensive structural breakdown in vivo during the implantation period of the study. PMID- 1764556 TI - Silicone rubber-hydrogel composites as polymeric biomaterials. III. An investigation of phase distribution by scanning electron microscopy. AB - The structure of silicone rubber-hydrogel composite materials was investigated by scanning electron microscopy (SEM) and light microscopy. The polymer phases in these materials composed of the polysiloxane matrix and very small particles of lightly cross-linked poly(2-hydroxyethylmethacrylate) or poly(2 hydroxyethylmethacrylate-co-methacrylic acid) were visualized using both methods. The distribution of polymer phases was studied by SEM of fracture surfaces of the materials. The results are discussed in relation to the transport properties of the materials. PMID- 1764557 TI - Adhesion of Escherichia coli on to a series of poly(methacrylates) differing in charge and hydrophobicity. AB - The adhesion of three Escherichia coli strains on to six poly(methacrylates) differing in hydrophobicity and surface charge was measured as a function of time under laminar flow conditions. Polymers used were poly(methyl methacrylate) (PMMA), poly(hydroxyethyl methacrylate) (PHEMA) and copolymers of MMA or HEMA with either 15% methacrylic acid (MAA) or 15% trimethylaminoethyl methacrylate HCl salt (TMAEMA-Cl). Bacterial and polymer surfaces were characterized by means of water contact angles and zeta potentials. Both the sessile drop contact angles and the zeta potentials of the bacterial surfaces were significantly different. No significant differences in the sessile drop contact angles of the polymer surfaces were observed. Using the Wilhelmy plate technique large contact angle hysteresis was observed for the different polymer surfaces. Surfaces of copolymers with MAA had more negative zeta potentials than those of the corresponding homopolymers. Surfaces of copolymers with TMAEMA-Cl had positive zeta potentials. The highest numbers of adherent bacteria were found on materials with positive zeta potentials, irrespective of the bacterial strain used. Bacterial adhesion on to copolymers with MAA was less than on to the corresponding homopolymers. Bacterial equilibrium adhesion values correlate with the zeta potentials of the polymer surfaces (r greater than 0.85). On substrates with less negative zeta potentials high numbers of adhered bacteria were observed. Additionally, the equilibrium bacterial adhesion values could be related with receding contact angles of polymer surfaces with negative zeta potentials (r greater than 0.86). High equilibrium adhesion values were obtained for polymers with high contact angles. No correlation between the zeta potentials and contact angles of the bacteria with the adhesion values was found. PMID- 1764558 TI - Surface modification of haemoglobin-containing liposomes with polyethylene glycol prevents liposome aggregation in blood plasma. AB - With a view to prevention of liposome aggregation in plasma which is a lethal problem when using artificial erythrocytes, modification of the liposome surface with polyethylene glycol (PEG)-bound cholesterol or phospholipid was studied. The cholesterol or phospholipid moiety works as a scaffold for immobilization of the modifiers to the liposome. The modified liposome aggregability is significantly reduced with increased PEG content and particularly with increased PEG chain length. In addition, the zeta potential of modified liposomes decreases with increased PEG chain length. It is concluded that the long PEG chain exposed on the liposome surface prevents the adsorption of plasma proteins on to the surface by its excluded volume effect and, as a result, effectively reduces the liposome aggregability in plasma. PMID- 1764559 TI - The early host and material response of bone-bonding and non-bonding glass ceramic implants as revealed by scanning electron microscopy and histochemistry. AB - The interface of bone-bonding and non-bonding glass-ceramics in the femur of of rats with the concomitant material and host response has been investigated by scanning electron microscopy (SEM) and histochemistry after transverse fractures in the interface level. During wound healing around these implants, four overlapping phases could be distinguished: (1) blood clot formation, (2) formation of organization tissue, (3) formation of primary bone and calcification, and (4) remodelling which lasts from months to years. This sequence of healing was disturbed around metal ions containing non-bonding implants, as shown by a longer settlement of acid phosphatase positive macrophages and a disturbed calcification at the surface of the material. Only bone-bonding implants developed considerable changes in surface morphology due to leaching and corrosion phenomena. A preferential leaching of the glass moiety, starting at the phase transition between glass and ceramic, contributes to the production of surface elevations which provide adhesion points for fibres and fibrils. Subsequent mineralization of inserting fibres contributes to a tensile strength at the interface. These findings are essential for further understanding of bone-bonding mechanisms and for further development of surface-reactive materials. PMID- 1764560 TI - Cancer of the lung and urinary bladder in Denmark, 1943-87: a cohort analysis. AB - National data from 1943 to 1987 on the two most frequent tobacco-related cancers in Denmark, lung and bladder cancer, were analyzed with multiplicative Poisson models. The temporal trends in the cohort-specific risks for both sites and sexes were similar: the risks increased in the beginning of the period covered by the analysis, but then levelled off; and there was no increase among cohorts born after circa 1930. Women experienced a smaller increase during the period covered by the analysis in the cohort-specific risk for bladder cancer than men (3.7 cf 6.1 times), whereas the overall increase in lung-cancer cohort-specific risk was the same for both sexes. The difference could not be explained by trends in tobacco consumption, types of tobacco consumed, or occupational exposures. On the basis of these findings, it is suggested that women may be less susceptible than men to developing bladder cancer from tobacco smoking. PMID- 1764561 TI - Risk of urinary bladder cancer among blacks and whites: the role of cigarette use and occupation. AB - A case-control study was conducted in the United States to examine the relationship between urinary bladder cancer, usual occupation and industry, and cigarette smoking. A total of 2,160 bladder cancer cases and 3,979 colon and rectum comparison cases, with complete histories of occupation and tobacco use, were included in the analysis. Ever having smoked cigarettes significantly elevated bladder cancer risk (odds ratio = 2.4). A dose-response relationship was demonstrated between bladder cancer and pack-years of smoking, usual number of cigarettes smoked per day, and number of years having smoked. This study observes greater risk of urinary bladder cancer due to cigarette smoking among Black males and females than among White males and females. A significant excess of bladder cancer was found among armed services personnel; this excess was restricted to White males when the analysis was performed separately by race. Black males with 'mechanic' as their usual occupation had a significant sevenfold excess of bladder cancer. The population attributable risks for occupation and smoking were 25 percent and 51 percent, respectively. The results demonstrate the strength of the association between cigarette smoking and bladder cancer and the need to control for smoking in occupational analyses. PMID- 1764562 TI - Smoking cessation and nonsmoking intervals: effect of different smoking patterns on lung cancer risk. AB - A case-control study of lung cancer was conducted in northwestern Germany in 1985 86. The study included 194 lung cancer cases and the same number of hospital controls and population controls who were matched to the cases by sex and age. Personal interviews were conducted by trained interviewers. We report here the effect of different smoking patterns--such as nonsmoking intervals, and time since quitting smoking--on lung cancer risk. Both quitting smoking and having a nonsmoking interval are seen to reduce lung cancer risk significantly. For a nonsmoking interval of three years or more, relative risk (RR) = 0.21, 95 percent confidence interval (CI) = 0.08-0.52; for quitting smoking for 10 years or more, RR = 0.23, CI = 0.11-0.48). A dose-response relationship was estimated for cigarette dose, length of nonsmoking interval, and time since stopped smoking. PMID- 1764563 TI - Risk of breast cancer in relation to use of combined oral contraceptives near the age of menopause. WHO Collaborative Study of Neoplasia and Steroid Contraceptives. AB - Data from a multinational, hospital-based, case-control study were analyzed to determine whether use of combined oral contraceptives (OC) around the time of menopause preferentially increases risk of breast cancer. Results show that the relative risk (RR) of breast cancer was increased in women of all ages who had used oral contraceptives within the past year, but not to a greater extent in women near the age of menopause than in younger women. RRs did not increase with duration of OC use after age 45 in either pre- or postmenopausal women. RRs also were not found to be higher in women who were using OCs near the time of either a natural or artificial menopause than in women who used them at other times. This study thus provides no support for the hypothesis that OCs enhance risk of breast cancer by a greater amount when taken around the time of menopause than when taken at other times. PMID- 1764564 TI - Risk factors of nonmelanoma skin cancer in Ragusa, Sicily: a case-control study. AB - A case-control study on 133 consecutive incident cases of nonmelanoma skin cancer registered by Cancer Registry of Ragusa (Sicily) was carried out in order to evaluate the correspondence between risk factors observed in other geographic areas with those of a Latin country with a strong solar exposure. A multivariate analysis showed that family history of skin cancer, cancer-related cutaneous diseases, fair skin color, residence more than 400 meters above sea level, and prolonged solar exposure without protection, significantly and independently increase the risk of skin cancer. Ease of suntanning was an important protective factor. Solar exposure was a stronger risk factor for squamous cell than for basal cell cancer. The results of the study enable us to identify a high risk group of people to whom simple methods of protection against solar exposure may be suggested to reduce the risk of skin cancer. PMID- 1764565 TI - Malignant melanoma risk by nativity, place of residence at diagnosis, and age at migration. AB - Although geographic latitude is clearly linked to the risk of cutaneous malignant melanoma, the chronology of this link is unclear. Based on the 4,611 cases of melanoma with known place of nativity diagnosed in 1972-82 among the non-Latino White residents of Los Angeles County (California, United States) of known place of origin, migrants to Los Angeles from higher US latitudes enjoy relative safety from skin melanoma. This relative safety is largely unaffected by the interval since migration, even after decades of residence in Los Angeles. The same relative protection is enjoyed by native residents of more northerly US communities in comparison with co-resident migrants from the southwestern US. While the observed effect of latitude is consistent with the accepted importance of solar radiation as a determinant of melanoma risk, it suggests that early, rather than late or cumulative, exposure is of most importance. This finding does not affirm the belief that protection of adult skin from exposure to the sun will reduce the risk from melanoma. It does suggest that decades must pass before it will be possible to assess the impact on melanoma risk of any increase in ultraviolet radiation delivered to the earth as a result of the destruction of atmospheric ozone. PMID- 1764566 TI - Cigarette smoking and leukemia: results from the Lutheran Brotherhood Cohort Study. AB - In a 20-year follow-up (1966-86) of 17,633 White males who described tobacco use in a mailed questionnaire sent in 1966, there were 74 deaths from leukemia (including 30 myeloid, 30 lymphatic, and 14 other and unspecified leukemia). Among men who ever smoked cigarettes, increased risks were observed for lymphatic (relative risk [RR] = 2.7), and other and unspecified leukemia (RR = 1.5); risks rose with increasing number of cigarettes smoked, although the dose-response relationship was statistically significant only for total leukemia. Mortality from myeloid leukemia was not elevated, except among those smoking over a pack of cigarettes per day. Results from this cohort support a relationship between cigarette smoking and leukemia. Further studies are needed to elucidate subtype associations with cigarette smoking. PMID- 1764567 TI - Colon cancer incidence: recent trends in the United States. AB - Between 1976-78 and 1985-87, the age-adjusted incidence rates of invasive colon cancer in the United States rose by 15 percent, 3 percent, 21 percent, and 16 percent among White males, White females, Black males, and Black females, respectively. The increases in incidence occurred in all age groups over age 54 and affected each of the major subsites of the colon nearly equally. The larger rates of increase have resulted in higher incidence among Blacks than Whites by the mid-1980s and an increasingly greater excess of this cancer in males. Trends toward earlier diagnosis of invasive colon cancer were found, with increasing rates for localized and regional diseases coupled with stable or decreasing distant-stage disease-rates. The incidence of in situ colon cancer also rose substantially. The findings suggest that changes in diagnostic trends and risk factor prevalence may be contributing to these patterns, and that the era when colon cancer predominated among White females is clearly over. PMID- 1764570 TI - Future trends in the management of coagulation disorders. Introduction: solving the coagulation problem. PMID- 1764571 TI - The contribution of fibrinolysis to postbypass bleeding. PMID- 1764569 TI - Dietary retinol: prevention or promotion of carcinogenesis in humans? AB - A number of epidemiologic studies have found that 'vitamin A' is associated with a reduced risk for human cancers. Dietary vitamin A indices reflect intake of several compounds in the diet including retinol and pro-vitamin A carotenoids such as beta-carotene, and recent cancer epidemiology studies have attempted to distinguish effects of retinol from those of beta-carotene. While beta-carotene has been associated consistently with a reduced risk for a number of human cancers, particularly epithelial cancers, retinol is generally found to be unassociated with, or positively associated with, risk for many cancers. An apparent enhancement of carcinogenesis has been observed in numerous studies, particularly for cancer of the esophagus, oral cavity, pharynx, larynx, stomach, colon, and rectum. While this finding could be artifactual, experimental studies in animals as well as mechanistic considerations suggest that this effect deserves serious consideration. As discussed in this article, an apparent enhancement of carcinogenesis could be related to an ethanol/retinol interaction, and/or a mechanism involving pro-oxidant activity of retinol but anti-oxidant activity of beta-carotene. This article concludes with suggestions for further research to help clarify the association between retinol and human carcinogenesis. PMID- 1764568 TI - Vegetables, fruit, and cancer. II. Mechanisms. AB - The epidemiologic literature on the relationship between vegetable and fruit consumption and human cancer at a variety of sites was reviewed systematically in Part I. It was concluded that consumption of higher levels of vegetables and fruit is associated consistently, although not universally, with a reduced risk of cancer at most sites, and particularly with epithelial cancers of the alimentary and respiratory tracts. Possible mechanisms by which vegetable and fruit intake might alter risk of cancer are addressed here. A large number of potentially anticarcinogenic agents are found in these food sources, including carotenoids, vitamins C and E, selenium, dietary fiber, dithiolthiones, glucosinolates and indoles, isothiocyanates, flavonoids, phenols, protease inhibitors, plant sterols, allium compounds, and limonene. These agents have both complementary and overlapping mechanisms of action, including the induction of detoxification enzymes, inhibition of nitrosamine formation, provision of substrate for formation of antineoplastic agents, dilution and binding of carcinogens in the digestive tract, alteration of hormone metabolism, antioxidant effects, and others. It appears extremely unlikely that any one substance is responsible for all the associations seen. Possible adverse effects of vegetable and fruit consumption are also examined. One way to consider the relationships reviewed here is to hypothesize that humans are adapted to a high intake of plant foods that supply substances crucial to the maintenance of the organism, but only some of which are currently called 'essential nutrients.' Cancer may be the result of reducing the level of intake of foods that are metabolically necessary- it may be a disease of maladaptation. PMID- 1764572 TI - Bleeding hearts. PMID- 1764573 TI - Monitoring hemostasis in the perioperative period: anticoagulation control. PMID- 1764574 TI - The contribution of platelet dysfunction to postbypass bleeding. PMID- 1764575 TI - Subcellular localization of enzymes related to PAF metabolism in Krebs-II ascites cells: evidence for the lack of intracellular PAF transfer activity. AB - We have investigated various steps in the metabolism of Platelet-Activating Factor (PAF-acether or PAF) at the subcellular level in Krebs-II ascites cells. Microsomes contained an active acetyltransferase located on a heavy-rough domain of the endoplasmic reticulum quite rich in ribosomes, as monitored by [3H]uridine labelling, and which displayed a very high density across the Percoll gradient. This membrane domain, which was separated from all other cellular organelles including peroxisomes, also contained a membrane-bound acetylhydrolase with similar activity as the acetyltransferase. However most part of the cellular acetylhydrolase was located in the cytosol, which was actually devoid of PAF transfer activity, normally involved in transport of the mediator within the cell. PMID- 1764576 TI - The lyso-precursor of platelet-activating factor (lyso-PAF) in ischaemic myocardium. AB - While it has been postulated that lyso-PAF and PAF might contribute to structural and functional damage in myocardial ischaemia, there has been no clear evidence for the accumulation of these bioactive compounds in ischaemic myocardium. In open chest, anaesthetised dogs, the proximal left anterior descending coronary artery was ligated and myocardial samples from the central ischaemic and normal areas assayed for lyso-PAF, free arachidonic acid and PLA2 activity. Ischaemic myocardium contained 50 +/- 29% (SD) more lyso-PAF than non-ischaemic myocardium after 20 min ischemia (P less than 0.002; N = 8) and 53 +/- 39% more after 60 min (P less than 0.01; N = 8) but there was no difference after 10 min (N = 8). Free arachidonic acid significantly increased in ischaemic myocardium after 60 min (122 +/- 136%; P less than 0.05) while no increase in PLA2 activity was found in vitro. Since lyso-phospholipids themselves damage cell membranes and, additionally, lyso-PAF is the precursor of PAF which has potent effects on platelets, leukocytes and small vessels, the increase in lyso-PAF in ischaemic myocardium could contribute to myocardial damage. PMID- 1764577 TI - Platelet activating factor is one of the mediators involved in endotoxic shock in pigs. AB - The role of platelet activating factor (PAF) in endotoxic shock was investigated in anaesthetized pigs receiving 5 micrograms/kg E. coli endotoxin (LPS) into the superior mesenteric artery over a 60 min period. Concentrations of PAF and tumor necrosis factor (TNF) were measured in blood obtained from the superior mesenteric vein and aorta before, during and 60 min after the LPS infusion. The effect of 4 mg/kg of BN 52021, a PAF receptor antagonist, given as a bolus injection 5 min prior to LPS infusion and/or PAF administration into the superior mesenteric vein was studied on systemic and regional hemodynamic variables. Eight of the 17 animals infused with LPS died within 30 min after start of LPS, while the other 9 survived the experimental period of 3 h, though in a shock state. In survivors, PAF concentration in both superior mesenteric vein and aorta increased twenty-fold at 30 min of endotoxaemia, but rapidly returned back towards normal values. No changes in PAF release, but a marked rise in TNF production were measured in non-survivors. Exogenous administration of PAF (0.01 micrograms/kg) produced similar hemodynamic effects as observed in survivors. BN 52021 markedly reduced the effects of PAF on arterial blood pressure for over 1 h. Treatment with BN 52021 (4 mg/kg), injected 5 min prior to LPS infusion, failed to exert any effect on the surviving rate. However, in survivors all circulatory and laboratory parameters studied were improved after treatment with BN 52021. PAF release observed during LPS infusion in survivors may play a role in the development of shock; however, its role in the rapid death seems to be negligible. Present results clearly demonstrate that endotoxin shock is not crucially dependent on one class of mediators. PMID- 1764578 TI - Antibodies to platelet-activating factor (PAF) inhibit PAF-induced platelet aggregation. AB - Platelet-activating factor (PAF) is the most potent platelet agonist known. PAF induced platelet aggregation was blocked by pre-incubation of PAF with the immunoglobulin fraction from sheep or rabbit anti-PAF anti-serum. Inhibition was specific for PAF and was dependent upon immunoglobulin and PAF concentrations. Antibody-mediated inhibition of PAF-activity may be a valuable method for studying the biological effects of PAF in some systems. PMID- 1764579 TI - Unnecessary arterial Doppler examination of the legs. Clinical decision rules may help? AB - Health resources consumption depends mainly on physicians prescription habits. We identified reduction of unnecessary prescribed lower limbs arterial Doppler examinations as an area of potential cost control and quality improvement. We designed therefore a screening method based on clinical decision rules derived from epidemiological considerations: study of our records showed that patients with normal clinical examination and low risk factors score could be considered free from arterial disease by clinical grounds only, and that patients with normal clinical examination and very high risk score needed an extensive noninvasive evaluation. By offering a screening clinical examination (needing a working time shorter than a Doppler examination) with short waiting lists, we were able to safely exclude many normal patients from extensive Doppler examination, improving effectiveness by reducing total examination time by 22% and service quality by a Doppler examinations scheduling based on clinical severity judgement. PMID- 1764580 TI - Learning from experience--a revised approach to quality assurance. AB - This article introduces a model for directing quality assurance activity in hospitals outside of the US. We believe that this model will be more expedient than the systems presently in use. The rationale for this new approach is based on the American experience but proposes an improved organizational and scientific method that has evolved to replace the previously existing ad hoc committees and punitive, post-factum approach. The suggested model includes the establishment of an inter-related network of institutional and departmental committees coupled with the active participation of the hospital director and a specialized unit for quality assurance activities. This approach has the potential for affording major improvements in the implementation of quality assurance in hospitals, outside of the US, which have not been part of the evolutionary process which has taken place in America. PMID- 1764581 TI - Doctor's compliance with compulsory reporting of occurrences. PMID- 1764582 TI - Characteristics of the external quality assessment (EQA) scheme for haematology in Spain. AB - Ensuring reliable results of the tests which are performed in large haematology laboratories is essential because of the problems resulting from the use of complex automated instruments and the ever increasing workload. The Spanish Haematology EQA Scheme started in 1984 with 56 laboratories, a number which rose to 332 in 1989. The general scheme follows the guidelines established by the International Committee for Standardization in Haematology (ICSH) with participants from Public Health (57.9%) and Private (42.1%) laboratories. Surveys are performed monthly and on each occasion the following samples are prepared and sent by the Organizing Center (Haematology Laboratory Department, Hospital Clinic i Provincial of the University of Barcelona): whole blood for full blood counts (FBC), platelet suspensions (or equine total blood) and lyophilized plasma for prothrombin time (PT), partial thromboplastin time (PTT) and fibrinogen (F). After preparation, control materials are sent to participant laboratories where the requested tests are performed and the results reported back to the Organizing Center for statistical analysis. For result evaluation, laboratories are divided into four to eight groups depending on the methodologies used. Individuals results are assessed against a consensus value (mean) deviation index (DI) from the mean, coefficient of variation (CV) and Youden diagram for all results and groups of each parameter. Between 58.3 and 74.5% of laboratories responded. For WBC, the CV improved from 17 to 7%, for platelets from 34.4 to 24.3%. For coagulation tests CV was 18.1% for PT, 16% for PTT, and 26% for fibrinogen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764583 TI - Patient satisfaction among day surgery patients in a central hospital. AB - Satisfaction among patients treated one year before day surgery in a central hospital was studied by questionnaires, sent to 100 and returned by 70 patients. The satisfaction before surgery was positive in 74% and negative in 6% of the patients. Based on their experiences from surgery, patients satisfaction improved in 59%, and did not decline. The preferred waiting times to the out-patients examination and also between this and the operation day was 8-10 weeks. Except for patients unable to work (mostly orthopedic patients) very short waiting times were difficult. Hospital arrangements during the treatment day (before, during and after the operation) were considered very good by 56 to 62%, good by 31-40%, satisfactory by 1-6%, and weak by 0-1% of the patients. In all, 96% of the patients would be ready to return to day surgery. The two patients who would refuse had difficulties at discharge. Thus day surgery has had a positive effect on surgical patient satisfaction. The most important improvement was increased surgical availability. In order to improve satisfaction further, patients unable to work as a result of their surgical problem should be treated almost immediately. PMID- 1764584 TI - How representative are members of expert panels? AB - A study was undertaken to test the hypothesis that consultants who are willing to participate in expert panels are similar, in terms of routinely available characteristics, to those who are not participating. All consultants in acute specialties in North-east Thames Region were asked to participate in a series of expert panels. Routinely available data was used to compare those who agreed to participate with those who declined or did not reply. Consultants who are willing to participate in expert panels are similar to those who are not in terms of years since qualification, specialty, sex, country of graduation, and possession of higher degrees. Consultants working in district general hospitals seem to be more likely to be willing to participate than those employed in teaching hospitals (37% versus 26%, p less than 0.02), although this difference may be accounted for by errors in the list of teaching hospital consultants. PMID- 1764586 TI - [The imaging diagnosis of the pancreas]. PMID- 1764585 TI - Health science information management. An approach to improving QA and clinical practice. AB - To help quality assurance (QA) professionals and clinical practitioners keep up with advances in health care knowledge and technology, we describe a prototype Health Science Information Management (HSIM) publication. We conceptualize HSIM to include: (a) identification of unique science information needs; (b) rapid retrieval of valid needed information; and (c) use the information to improve health care benefits. To more adequately accomplish these functions, we suggest that five specific categories of information will be essential: (1) reports of recent advances in Science Information Management methods; (2) original reports of Science Information Syntheses (SISs) providing information immediately applicable for QA; (3) previously published reports of "classic" SISs relevant to QA; (4) reviews of new technologies and products immediately applicable to quality management; (5) cumulative indexing of the above methods and products. Making the above information available to QA professionals might substantially improve the impact of quality management. PMID- 1764587 TI - [Computed tomographic and anatomical studies on the morphology of the minor pulmonary fissure]. AB - The morphology of the minor fissure, i.e., the shape of the upper surface of the middle lobe, was studied in 10 specimens and in 60 thoracic CT's. In 8 specimens and 54 CT's there was the arrangement typical for the right lung consisting of 3 distinct lobes. The upper surface of the middle lobe had a convex upward shape against the base of the upper lobe in all anatomical preparations and in 52 of the CT's. The position and shape of the convexity was, however, quite variable. In 2 cases the upper surface of the middle lobe was flat. In 78% the minor fissure was incomplete and in 2 cases it was absent. PMID- 1764588 TI - [The intrapulmonary pseudo-malposition of chest tubes in the computed tomogram (CT)]. AB - The diagnosis of an intrapulmonary malposition of chest tubes on CT may be problematic. We report about 13 chest tubes which were suspected on CT to be in an intrapulmonary malposition. In all cases as well as clinical and radiological follow up ruled out such a malposition. The use of a stiff tube and the presence of a soft lung parenchyma obviously led to a sinking of the tube into a "channel". Whereas after removal of the tube in case of such a pseudo-malposition solely a transitory local fluid collection and later a tender scar is seen, real intrapulmonary malposition leads to parenchymal injury and concomitant complications. The diagnosis of intrapulmonary malposition should be doubted, if the drain is positioned within the pleural space after having crossed the lung parenchyma in a supposed intrapulmonary rout. The CT criteria of this pseudo malposition are presented and discussed. PMID- 1764589 TI - [Magnetic resonance tomography in patients with a heart valve prosthesis]. AB - Artificial valve prostheses are often regarded as a contraindication for magnetic resonance imaging (MRI), although preliminary in vitro studies suggested, that patients with these metallic implants might safely undergo MR examination. This study reports on the experience with a group of 89 patients with 100 heart valve prostheses who were examined by spin-echo MR and gradient-echo MR. MR examination was performed in all patients without complications. The spin-echo sequence showed advantages in the depiction of anatomical structures like paravalvular abscesses. Anatomical structures adjacent to the artificial valve were clearly visible and the metal components of the valves showed no or only small artifacts. Artifacts were accentuated when using gradient-echo sequences. Gradient-echo sequences provided valuable information regarding the presence of valvular insufficiency. Physiological valvular regurgitation was easy to differentiate from pathological paravalvular or transvalvular regurgitation. These results demonstrate that patients with artificial valve prostheses can be imaged by MR without risk and that prosthesis-induced artifacts do no interfere with image interpretation. PMID- 1764590 TI - [In vivo 31P-cardiac magnetic resonance spectroscopy: methods and the first clinical results]. AB - 31P-magnetic resonance (MR) spectra of the heart can be obtained from well defined myocardial regions by combined MR imaging and variable selected volumes for spectroscopy. 31P-spectra of 33 volunteers and of 43 patients with dilated and hypertrophic cardiomyopathy and with coronary artery disease were quantified using a curve-fitting routine. To optimize our technique, we recorded unsaturated and partially saturated spectra in several volunteers. Relative peak areas and signal-to-noise ratios showed significant changes with varying pulse repetition times. Saturation factors were applied to correct spectra from volunteers and patients for the effects of partial saturation. Under resting conditions, peak areas of volunteers and patients from the various groups were statistically indistinct. PMID- 1764591 TI - [The magnetic resonance procedure in the diagnosis of osteomyelitis. Its value and comparison with skeletal scintigraphy]. AB - 61 patients with clinical findings suspicious for an osteomyelitis were examined by MRI between January 1985 and November 1989. All results were verified either by surgery or by the clinical course. MRI criteria of a musculoskeletal infection were: decreased signal intensity of the lesions on short TR, short TE images and increased signal to intensity on long TR, long TE images when compared to the intensity of normal bone marrow, adipose tissue and muscles. 35 of 61 patients had been examined by 99mTc-MDP three phase bone scans prior to the MRI examination. Sensitivity and specificity of the MRI examinations were superior to those of bone scans. We therefore recommend MRI examinations as the method of choice in the diagnosis of the early musculoskeletal infections and in all chronic complicated cases. PMID- 1764592 TI - [Postoperative nuclear magnetic resonance tomography of the talocrural joint after external syndesmorrhaphy]. AB - 20 patients with acute traumatic rupture of the anterior talofibular ligament and ligamental suture were studied postoperatively by MRI. MR results were correlated with stress x-ray studies. We found a normal anterior talofibular ligament in eight cases. However, stress x-ray images showed normal stability of the ankle joint in eighteen cases. In six patients the anterior talofibular ligament was thickened, in another six cases it could not be separated from scar tissue. Therefore MR imaging of ankle ligaments did not allow a diagnosis of their function. Nevertheless, sequelae of the ankle trauma such as osteochondrosis, exudation into the ankle joint and tendovaginitis of the flexor muscles were sensitively visualised by MR. PMID- 1764593 TI - [CT diagnosis in instability of the shoulder joint]. AB - CT is able to demonstrate the predisposing factors for recurrent and posttraumatic subluxation of the shoulder. In addition to demonstrating bony changes in the glenoid (Bankart lesion) and in the humeral head (Hill-Sachs lesion), CT can measure the degree of retroversion of the glenoid and torsion of the humerus. Measurements on 17 shoulders with habitual and 24 shoulders with recurrent posttraumatic subluxation showed low values for glenoid retroversion as compared with a control group. Particularly patients with habitual anterior subluxation frequently showed anteversion of the glenoid. Measurements of humeral torsion showed wide scatter amongst all groups, indicating wide biological variability. The results were compared with those published in the literature and the indications and limitations of CT for the investigation of shoulder instability are discussed. PMID- 1764594 TI - Femoral head anteposition after surgery of congenital dislocation of the hip. A computerised tomography study of 22 hips suspected of anterior dislocation. AB - A new term called "femoral head anteposition" to describe the clinical appearance of a hip operated on because of CDH and suspected of anterior dislocation, has been introduced. CT scans of both the horizontal and sagittal planes of 22 hips suspected of iatrogenic anterior dislocation were made from 22 children. These had been operated on because of CDH by the open reduction method with derotation varus osteotomy of the femur and transiliac osteotomy by Dega. An evaluation of the CT scans combined with clinical examination allowed the differentiation of the homogeneous clinical appearance from the "anteposition". It was then possible to establish one or several coexisting reasons to the situation. These were: anterior dislocation of the hip, coxa magna after avascular necrosis, gluteal muscle fibrosis or periarticular ossifications. PMID- 1764595 TI - [The percutaneous removal of osteoid osteomas via CT-guided drilling]. AB - Osteoid osteomas were removed by CT-guided core drill excision of the nidus in 4 patients. All osteoid osteomas were located in the lower extremity and included cortical lesions in the femur (n = 2), and the tibia (n = 1) and one spongious lesion in the navicular bone of the foot. Nidus diameter ranged from 2 to 3 mm. The patients were discharged after the procedure same day or next day depending on the kind of anaesthesia performed. Follow-up periods ranged from 6 to 56 months and revealed no signs of recidivation. CT-guided core-drill excision of the nidus seems to be a very promising alternative to surgical procedures because of its high cost-effectiveness and minimal invasiveness. PMID- 1764596 TI - [The potentials and limits of percutaneous needle biopsy in the histological classification of malignant tumors]. AB - 180 sonographically guided percutaneous biopsies in a variety of anatomic regions (abdomen, 110; thorax, 33; neck, 28; breast, 4; extremity, 5) were retrospectively reviewed to evaluate the percentage of correct histologic diagnoses of malignant tumours. A positive diagnosis of malignancy was established in 101 (96%) of 107 malignant tumours. A correct histologic classification was achieved in 79 (73%) of 108 malignant tumours by means of cytologic and histologic examination of the tissue acquired. Correct histologic classification of malignant tumours depends on several factors including a) needle diameter, b) location of the tumour, c) clinical constellation and, most important d) the complexion of the tumour histology. The percentage of correct histological diagnoses varied between carcinomas (79%), Hodgkin lymphomas (100%), non-Hodgkin lymphomas (45%), sarcomas (50%) and carcinoid tumours (0%). Histological classification of malignant tumours by means of percutaneous biopsy can be improved by multiple biopsies of different portions of the tumour and by using larger cutting needles. PMID- 1764597 TI - [The etiological differentiation of neuromuscular produced dysphagia by x-ray cinematography]. AB - 850 patients with dysphagia were examined by x-ray cinematography. On the basis of these examinations the normal events of swallowing are compared with the abnormalities observed. The technique is described. An algorithm has been developed depending on the presence of symmetry or asymmetry of the abnormalities and on muscle tone, which permits classification of the various aetiological groups. In addition, specific features of individual diseases often make it possible to arrive at a definite diagnosis. PMID- 1764598 TI - [The marking of the gastrointestinal tract in computed tomography: experiences with a barium sulfate contrast medium (Micropaque CT)]. AB - Micropaque CT, a new suspension of barium sulphate, has recently become available for clinical use in abdominal CT. The attenuation of the 1.5 per cent solution, measured in vitro, was 222 HU (without artifacts). In about 45 per cent of the clinical examinations artifacts occurred which, however, were not disturbing. Sufficient opacification of stomach and bowel was achieved in 65 per cent. 55 per cent of patients found the suspension pleasant to take, ten per cent complained of mild diarrhoea. Micropaque CT is particularly suitable for upper abdominal CT in outpatients. PMID- 1764599 TI - [The clinical value of Mn-DPDP: a new paramagnetic hepatobiliary contrast medium for magnetic resonance tomography of the liver]. AB - In an open prospective study the tolerance and diagnostic value of the new hepatobiliary contrast agent Mn-DPDP in MR imaging was evaluated in 20 patients suspected of having focal liver lesions. T1- and T2-weighted spin-echo sequences and T1-weighted gradient-echo sequences were obtained before and after intravenous application of Mn-DPDP. In all patients the signal to noise (S/N) values of normal liver tissue increased significantly after application of Mn DPDP. All focal lesions could be better localized and differentiated due to increased contrast to noise ratios of lesion to liver. Pathological examination revealed in 14 patients malignant and in 5 patients benign liver lesions; one patient had no pathological findings. In metastatic disease of the liver 25-120% more lesions could be detected in MRI after Mn-DPDP-application, compared with the unenhanced images. In 5 patients the lesions showed significant enhancement of Mn-DPDP (2 cirrhotic nodules, 2 hepatocellular carcinomas, 1 focal nodular hyperplasia). Our preliminary results indicate that Mn-DPDP is a well-tolerated contrast agent useful for the detection and differentiation of liver lesions in MR imaging. PMID- 1764600 TI - [Unusual causes of a perforation of the small intestine]. PMID- 1764601 TI - [Subtotal restenosis after the insertion of a vascular endoprosthesis into the arteria iliaca communis]. PMID- 1764602 TI - [The malignant degeneration of Gorham-Stout disease?]. PMID- 1764603 TI - Lymphangioleiomyomatosis. Diagnostic imaging approach to a rare disease in women. PMID- 1764604 TI - Opioids in the milk. AB - In various studies, the milk has been screened for the presence of free or precursor-bound opioids. In fact, various opioid receptor ligands with agonistic or even antagonistic activity were found. Besides the alkaloid morphine, peptides derived from alpha-casein (alpha-casein exorphins), beta-casein (beta casomorphins; beta-casorphin), alpha-lactalbumin (alpha-lactorphins) and beta lactoglobulin (beta-lactorphin) were among the agonists. In addition, certain peptides derived from k-casein (casoxins) or from lactoferrin (lactoferroxins) were found to behave like opioid antagonists. Although a functional role in the mammalian organism for all of these compounds appears to be well possible, evidence has only been presented for the functional significance of beta casomorphins, so far. These peptides might play a role in reproduction or nutrition in the female, in the newborn's or in a milk consumer's organism, respectively. Thus, opioids related to milk might represent essential exogenous extensions of the endogenous opiodergic systems. PMID- 1764605 TI - Do the circulating neurohypophysial hormones affect basal or stress induced prolactin (PRL) release in male rats? AB - The action of acute administration of oxytocin (OXY), vasopressin (AVP) or its analog 1-deamino-8-D-arginine-vasopressin (dDAVP) on basal and stress induced PRL release in normal male rats and the effect of chronic injection of AVP on PRL stress response in AVP deficient rats were studied. The hormones (OXY, 600 ng min 1 per rat; AVP 6, 12 or 24 ng min-1 per rat and dDAVP 24 ng min-1 per rat) were infused to conscious rats via the jugular vein for 10 min and then the rats were immobilized under continuing the infusion for further 20 min. In parallel experiments arterial blood pressure (BP) was measured. OXY and 24 ng min-1 AVP caused high BP elevation of the same magnitude, yet the effect of 12 ng min-1 AVP was significantly lower. Neither OXY, dDAVP, nor 6 and 12 ng min-1 of AVP affected basal or stress stimulated PRL values when compared with saline treated animals. 24 ng min-1 of AVP highly stimulated nonstressed PRL levels and no additional stress effect was observed. Intramuscular injection of 2 micrograms (1 U) of AVP daily for 7 days did not influence the basal values or stress induced PRL response in Brattleboro homogygous rats as compared with vehicle treated controls or heterozygous rats treated with AVP or vehicle. These results show that the infusion of 24 ng min-1 per rat of AVP stimulated PRL release which cannot be explained by the nonspecific effect of high BP. Repeated AVP administration did not modulate either the basal or IMO stress stimulated PRL secretion in rats with or without genetic vasopressin deficiency. PMID- 1764606 TI - Circadian variations of serum triiodothyronine, thyroxine, corticosterone and lipids in starved rats. AB - Circadian variation of serum triiodothyronine (T3), thyroxine (T4), corticosterone (B) and lipids was studied in male Wistar rats after one week of the starvation. The animals were adopted to 12:12 h light-dark cycle (lights on from 7.00 to 19.00 h) and tap water was available ad libitum. Blood samples were drawn at 3 h intervals along a 24 h span. The hormone levels were measured by RIA kits, plasma lipids by photometric method. The results were evaluated by cosinor method. The presence of a circadian rhythm of T3 and B was found in control rats. The starvation resulted in changed circadian rhythm of T3 with lower values of mesor and amplitude, and while acrophase shifted from 14.48 to 2.12. In addition, the starvation induced circadian rhythm of T4 with acrophase at 1.00. The circadian rhythm of B showed significantly higher values of mesor and amplitude, while acrophase shifted from 17.42 to 4.06. The concentration of lipids was changed in the animals deprived of food as compared with controls. PMID- 1764607 TI - Effects of phenotype, feeding condition and cold exposure on thyrotropin and thyroid hormones of obese and lean mice. AB - The effects of acute cold exposure on rectal temperature (Tr) and circulating thyrotropin (TSH), thyroxine (T4) and triiodothyronine (T3) levels were examined in fed and food-deprived obese (ob/ob) and lean (?/+) C57BL/6 mice. At 23 degrees C, obese mice had lower body temperatures but higher TSH, T4 and T3 values than lean mice while male mice of both phenotypes had similar body temperatures and higher levels of all three hormones than females. Obese mice became severely hypothermic during 4 h cold exposure (8 degrees C) although TSH and T4 concentrations declined equally in obese and lean mice and T3 values were unaffected by cold. Male and female mice exhibited similar Tr responses to cold, while males continued to have higher values of TSH and thyroid hormones than females. When allowed food during cold exposure, both obese and lean mice displayed higher Tr although obese mice remained hypothermic. Thyroid hormones in all groups were increased by feeding but only male mice exhibited increased TSH values. These data show that the acute feeding, metabolic and thermogenic responses of mice to low ambient temperatures are not closely associated with altered systemic levels of TSH, T4 or T3. Furthermore, since ob/ob mice did not display lower hormone levels or defective hormone responses to cold or feeding, the data suggest that their apparent hypothyroidism is largely independent of hormone availability to target tissues. PMID- 1764608 TI - Effect of vasopressin, oxytocin and LHRH on the proliferation and metabolism of rat bone marrow stromal cells in culture. AB - Effect of vasopressin, oxytocin and LHRH (10 and 20 pg/ml medium) on the proliferation and metabolism of cultured rat bone marrow stromal cells was investigated by methyl-3H-thymidine incorporation, cytochemistry and estimation of enzyme activities. Vasopressin did not change of the activity of tetrahydrofolate dehydrogenase (4HFDH), lactate dehydrogenase (LDH), glucose-6 phosphate dehydrogenase (G6PD) and the level of reduced glutathione (GSH). However, the higher concentration of vasopressin significantly lowered the activity of acetylcholinesterase (AchE). As compared with the control cultures, stromal cells grown in the presence of oxytocin showed higher (at lower hormone concentration) and lower (at higher concentration) LDH activity as well as lower G6PD activity (only at higher concentration), while the activity of AchE and the level of GSH was not changed. LHRH significantly increased G6PD and AchE activity and decreased LDH activity in the cultured cells. As revealed by cytochemistry, LHRH specifically enhanced 4HFDH activity in reticular cells. PMID- 1764609 TI - Effect of vasopressin antagonist d(CH2)5Tyr(Et)VAVP on plasma arginine vasopressin level after osmotic stimulus. AB - The effect of the vasopressin antagonist d(CH2)5Tyr(Et)VAVP on the immunoreactive arginine vasopressin (AVP) level in plasma was studied in rats after osmotic stimulus. The blood samples were obtained from the eye plexus. An increased AVP level (193.2 +/- 70.0; control: 30.5 +/- 4.3 pmol/l) was detected after the administration of hypertonic NaCl solution. A much higher elevation of AVP level (1180.9 +/- 181.0 pmol/l) was observed when treatment with the antagonist was applied before the osmotic stimulus. The results indicate that this compound exerts a biological effect as a vasopressin receptor blocking agent through a mechanism of competitive antagonism. PMID- 1764610 TI - Cardiovascular risks: among Black and White rural-urban low income women. AB - The purpose of this descriptive comparative pilot study was to determine if there are rural-urban and racial differences in the prevalence of four modifiable risk factors (blood pressure, serum cholesterol, diabetes and smoking) for cardiovascular disease among low income Black and White women. Of the 163 low income women who participated in the study, it was found that Black women had a significantly higher prevalence of elevated blood pressure and serum cholesterol levels than White women. The observed rates for smoking and diabetes were highest among rural White women. Implications for health education and continued research are presented. PMID- 1764611 TI - Preceptorship programs: a public relations tool. AB - This article discusses the components and benefits of the public relations model, as developed by Black and Sharp (1983), and the use of this model in the development and implementation of a successful preceptorship program at Columbus College in Columbus, Georgia. PMID- 1764612 TI - Battered women: an African American perspective. AB - This paper presents an overview of battered women. The initial statistics describe the magnitude of the problem--that a woman who is battered is at high risk for being murdered at the hands of her spouse or partner. The cycle of violence, the reasons for staying in such a dangerous environment and the profile of the battered woman are also discussed. The unique experience of the battered African American woman will be incorporated throughout this paper as will be an overview of assistance for battered women. Finally, conclusions and implications for future research are presented. PMID- 1764613 TI - Chronically dead persons. PMID- 1764614 TI - Extended critical care orientation program a recruitment/retention incentive. AB - The Prince of Wales, Prince Henry, and Prince of Wales Children's Hospital offered an Extended Critical Care Orientation Program for the first time in 1990. This program included pre-course worksheets, a five day lecture series and an Individual Clinical Learning Contract. This paper will consider the impact that the program has had on the critical care units involved. Ongoing evaluation questionnaires indicated that the program was successful. The program met with continued support and enthusiasm from nurse administrators, nursing unit managers, clinical educators, ward staff and course participants. Early figures have indicated that at twelve months post program, the overall retention rate was 71%, compared to 41.1% in the twelve months prior to program commencement. PMID- 1764615 TI - Oxygen transport in the critically ill. PMID- 1764616 TI - Nurse initiated advanced life support (ALS) requirements for role extension--a NSW perspective. PMID- 1764617 TI - Endothelial transport of macromolecules: transcytosis and endocytosis. A look from cell biology. PMID- 1764618 TI - A review of DNA metabolism in Escherichia coli. PMID- 1764619 TI - Corneal endothelial structure and function under normal and toxic conditions. AB - Our understanding of the function of the corneal endothelium in corneal thickness regulation, and the role of ion transport mechanisms in endothelial physiology, has expanded greatly over the past 25 years. The basic events occurring across the apical and basolateral membranes of the cells are far better understood today, although gaps still exist in the area of the relationship of the cellular and paracellular pathways and their relative contribution to the overall behavior of the endothelium. Little is known about the movement of ions or fluid between the cells or in what proportion this may occur compared to the cellular events. Furthermore, although our knowledge of the ionic movement processes has been enhanced, the link between fluid transfer across the endothelium and ion movements remains an enigma. Important questions also remain concerning the link between electrical characteristics and either ion movement or fluid transport. Improved storage solutions are needed that will preserve endothelial function after transplantation through the provision of a significant improvement in long term cell survival. The limit to preservation time at present is about 14 days, and the use of other variables in the storage solution may extend this time. In reality, however, extension of preservation time is now of secondary importance relative to the need to enhance cell survival and reduce cell loss following surgery. Whether such improvement can be made with manipulation of the solution alone, or whether refinements are needed in the surgical technique awaits further study. Our comprehension of the biochemical linkage between energy supply and ion movement also remains uncertain in view of the particular intracellular localization of the anionic ATPases to mitochondrial loci. Despite numerous attempts there have been only a few chemicals identified that stimulate the fluid pump, but the level of stimulation has been relatively small and short-lived. No sustained effects have been found that would be of clinical benefit in reducing corneal thickness. A considerable variety of chemicals has been tested on the endothelium and it is unlikely that any new compounds will be identified that will cause enhancement of the fluid pump that would be of clinical benefit in dystrophic, or otherwise swollen, corneas. Of all the toxic responses of the endothelium the majority have been identified because of a malfunction of corneal thickness regulation, with the resultant corneal swelling, or by morphological examination. Only in a few instances has the permeability to non-electrolytes (carboxyfluorescein, inulin/dextran) been measured, and even more rarely have ion fluxes, or pump activity (3H-ouabain binding), been measured.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1764621 TI - Gastrointestinal emergencies: Part II. PMID- 1764620 TI - Hepatobiliary disease: medical emergencies. AB - Medical emergencies involving the liver and biliary tract are common clinical problems. If it is already known that the patient has cirrhosis it may be an easy matter to identify the cause of complications such as gastro-intestinal bleeding or coma, but it must be borne in mind that oesophageal varices are not the only cause of such bleeding in cirrhotics and that hepatic encephalopathy is not the only cause of coma. Bacterial infection should always be considered as a possible cause of deterioration in the clinical picture; it may be a complication of pre existing acute or chronic liver or biliary tract disease or a cause of hepatobiliary disease; prompt administration of appropriate antibiotics may save the patient's life. If there is any suspicion of biliary obstruction in a patient with signs of bacteraemia the biliary tree should be drained without delay. The key to the management of hepatobiliary emergencies lies in prompt and appropriate supportive therapy, and then in a correct diagnosis which may allow specific treatment to be administered. However, it is often difficult to establish the cause, and the resources of a specialist centre may be needed. Prompt referral is indicated when a patient is clearly very ill and shows no signs of rapid improvement. PMID- 1764622 TI - Acute pancreatitis: the role of endoscopic papillotomy. PMID- 1764623 TI - Acute pancreatitis: the role of early surgery. AB - Conservative treatment for an attack of acute pancreatitis still takes priority. The treatment of choice in biliary pancreatitis is endoscopic papillotomy with extraction of any bile duct stones. After this procedure the patient usually recovers quickly and cholecystectomy should be done as an interval operation. An early operation has to be done when conservative treatment fails and organ failure occurs. The 'gold standard' of surgical therapy today is the opening of the lesser sac with continuous postoperative lavage and drainage, digital elimination of necrotic tissue and drainage of the paracolic areas. Other described surgical procedures do not produce significantly better results. Necrotizing pancreatitis still has a high mortality in contrast to mild oedematous pancreatitis, which is rarely a problem. PMID- 1764624 TI - Acute cholecystitis: radiological management. AB - Acute cholecystitis is a common condition which may be difficult to diagnose with confidence on clinical grounds alone. A large number of techniques are now available for imaging the gall bladder but, in practice, ultrasonography and cholescintigraphy are of greatest value. The former is cheap, readily available and features such as the presence of gall stones, gall bladder wall inflammation and a positive sonographic Murphy sign strongly suggest the diagnosis of acute cholecystitis. In addition to its diagnostic uses, ultrasonographically guided percutaneous cholecystostomy provides an alternative and sometimes life-saving form of treatment in those patients who are unfit for surgery. Cholescintigraphy is a highly accurate, non-invasive method for assessing patency of the cystic duct but is not always available in the emergency situation and takes longer to perform than an ultrasound examination. Acute cholecystitis, however, has many manifestations and may be calculous or acalculous, be associated with a patent or obstructed cystic duct, and may be complicated or uncomplicated. Imagining modalities other than those mentioned above may be useful in certain circumstances and this chapter aims to present the advantages and disadvantages of each technique in order to provide guidance for the clinician caring for a patient with suspected acute cholecystitis. PMID- 1764625 TI - Nutritional support in acute intestinal failure. PMID- 1764626 TI - Gastroenterological emergencies in the tropics. AB - Significant differences exist in the prevalence of most gastroenterological emergencies in tropical compared with temperate countries. Both ethnic and environmental (often clearly defined geographically) factors are relevant. The major oesophageal lesions which can present acutely in tropical countries are varices and carcinoma; bleeding and obstruction are important sequelae. Peptic ulcer disease (and its complications), often associated (not necessarily causally) with Helicobacter pylori infection, has marked geographical variations in incidence. Emergencies involving the small intestine are dominated by severe dehydration, and its sequelae, resulting from secretory diarrhoea, most notably cholera. However, enteritis necroticans ('pig bel' disease), paralytic ileus (sometimes caused by antiperistaltic agents) and obstruction (secondary to luminal helminths, volvulus and intussusception) are other important problems, especially in infants and children. Enteric fever is occasionally complicated by perforation and haemorrhage; the former (which is notoriously difficult to manage) is accompanied by significant mortality. Ileocaecal tuberculosis is a major cause of right iliac fossa pathology--sometimes associated with malabsorption; amoeboma is an important clinical differential diagnosis. The colon can be involved in invasive Entamoeba histolytica infection (which, like complicated enteric fever, is difficult to manage if the fulminant form, with perforation, ensues), shigellosis, volvulus and intussusception. Acute colonic dilatation occasionally follows Salmonella sp., Shigella sp., Campylobacter jejuni, Yersinia enterocolitica and rarely E. histolytica infections. Acute hepatocellular failure is a major cause of morbidity and mortality in the tropics and subtropics. It usually results from viral hepatitis (HBV, sometimes complicated by HDV, and HCV), but there is a long list of differential diagnoses. Hepatotoxicity resulting from herbs, chemotherapeutic agents or alcohol also occurs not infrequently. Chronic liver disease and its sequelae (often long-term results of viral hepatitis) are commonplace. Haematemesis and hepatocellular failure are usually very difficult to manage due to a lack of sophisticated support techniques in developing countries. Invasive hepatic amoebiasis usually responds well to medical management; however, spontaneous perforation can occur and the consequences of this are serious. Pyogenic liver abscess, although far less common than amoebic 'abscess', carries a bad prognosis whatever the method(s) of management. Hydatidosis and schistosomiasis also involve the liver, and helminthiases are important in the context of biliary tract disease. Gall stones are unusual in most tropical settings. Acute pancreatitis is overall unusual, but chronic calcific pancreatitis can present as an acute abdominal emergency. PMID- 1764627 TI - Gastrointestinal emergencies in HIV infection. PMID- 1764628 TI - Paediatric emergencies. AB - During the last decade neonatal surgical results have improved considerably. Except for infants born with serious congenital heart disease, diaphragmatic hernia or exomphalos, postoperative mortality rates for infants with single anomalies have fallen to the region of 10%. This dramatic success story has been marred by a corresponding increase in the number of individuals with several anomalies entering late childhood with severe chronic handicaps. During the remainder of this century much effort will be expended in devising programmes of investigation which will attempt to predict which individuals will have a poor long-term prognosis. Such programmes will necessitate very close liaison between obstetricians, radiologists, neonatologists, local paediatricians, paediatric surgeons, general practitioners and parents. Very urgent surgery is necessary for the best results in infants with gastroschisis, intestinal volvulus and irreducible inguinal hernia, but for most other conditions there have been recent trends away from very urgent surgery to operation during daylight hours within the ensuing 24 h. Surgery within a few hours of presentation is necessary for intussusception and for early acute appendicitis, but perforated appendicitis should be treated by aggressive fluid replacement and intravenous antibiotics and surgery should be contemplated only in the rare cases of continued deterioration. PMID- 1764629 TI - A comparative study of the actions of tamoxifen, estrogen and progesterone in the ovariectomized rat. AB - This study was undertaken to examine the separate and combined effects of tamoxifen (T), estrogen (E2) and progesterone (P) treatment on ovariectomized (Ooph) rats. The animals were treated for 40 days. Ovariectomy reduced cancellous bone volume at the proximal tibia by 50%. Estradiol treatment completely prevented the bone loss and further increased bone volume 77% over the level for the control group. Tamoxifen also prevented the ovariectomy induced bone loss, but significantly reduced the increase in cancellous bone induced by estradiol. In the ovariectomized rats, cancellous bone apposition rate increased 23%. This increase was suppressed 63% by estradiol, and only 18% by tamoxifen. Tamoxifen significantly suppressed the inhibitory effect of estradiol on cancellous bone apposition rate. In contrast, the effect of progesterone treatment was only marginal. Our findings indicate that the action of tamoxifen on bone is influenced by the ambient level of circulating estradiol, such that in estrogen deficiency, tamoxifen has a weak estrogen agonist action on bone, and in the presence of estrogen it has anti-estrogen actions, with the dose level and mode of administration employed. These conclusions have implications for the use of tamoxifen in the treatment of pre- and postmenopausal women. PMID- 1764630 TI - The index of radiographic area (IRA): a new approach to estimating the severity of vertebral deformity. AB - To assess the overall severity of vertebral deformity for an individual, we developed the index of radiographic area (IRA), a computerized method for analyzing vertebral dimensions from lateral radiographs of the spine. Six coordinates for each vertebral body are recorded in a computer by means of a digitizer. A computer program identifies all abnormal vertebrae, computes the radiographic area of the remaining normal vertebrae, and then estimates the expected normal radiographic area for the abnormal vertebrae in that individual. Differences between the expected and observed radiographic area of all abnormal vertebrae are summed to produce the IRA score. The score correlated well with the quantitative score of vertebral deformity of an experienced radiologist (r = 0.85), and with the vertebral bone density by quantitative computed tomography (QCT) (r = 0.66). The IRA is a practical, standardized method for quantitating the overall severity of vertebral deformity in individuals who have vertebral fractures. Its reproducibility for longitudinal studies and clinical trials needs further study. PMID- 1764631 TI - Distribution of type X collagen mRNA in normal and osteoarthritic human cartilage. AB - The function of collagen X, a unique homotrimer synthesised by hypertrophic chondrocytes, is not known but its localisation and transient expression at sites of calcification suggest that it is likely to be associated with events in the early stages of endochondral bone formation. Osteoarthritis (OA) is a disorder characterised by new bone formation but the role of type X collagen in its pathogenesis is unclear. A 700-bp restriction fragment encoding most of the C terminal non-collagenous domain and part of the 3'-untranslated region of the human collagen X gene has been used for in situ hybridisation studies on human OA joints removed from hip and knee replacement operations and the results compared with immunohistochemical localisation of type X collagen gene product. Collagen X gene expression was detected in chrondrocytes present in OA tissue in areas where there appeared to be a re-initiation of the endochondral bone formation process including osteophytes and areas of subchondral bone sclerosis. PMID- 1764632 TI - Further studies on acute effect of prolactin on intestinal calcium absorption in rat. AB - The present investigation aimed to (1) reconfirm the acute effect of prolactin on intestinal calcium absorption in the rat, (2) evaluate the influence of age on prolactin action, and (3) further investigate the mechanisms of prolactin action on calcium absorption. The intestinal calcium absorption in mature rats was evaluated by measuring the plasma 45Ca content at intervals during a 1-h period following intragastric administration of a 45Ca-containing test solution and by measuring tibial 45Ca content in weaned rats. By using weaned (50-70 g), sexually mature (180-200g) or aged (greater than 250 g) female Wistar rats, we demonstrated that calcium absorption was inversely related to age. Prolactin at a dose of 0.02 mg/100 g body weight, administered intraperitoneally 1 h before Ca administration, significantly enhanced calcium absorption in sexually mature and weaned rats but not in aged rats. At a luminal calcium concentration of 5 mM, prolactin had no effect when the luminal solution was either CaCl2 alone or an Na free electrolyte solution. On the other hand, prolactin significantly increased the plasma 45Ca content by 57, 42 and 28% at 5, 15 and 30 min respectively, when the electrolyte solution contained sodium. In contrast, in the presence of 0.5 mM calcium, the enhancing effect of prolactin on calcium absorption was not dependent on the presence of sodium. Compared with the saline control, the plasma 45Ca content in prolactin treated animals was significantly elevated by 63% at 5 min when the test solution was a sodium-free electrolyte solution. PMID- 1764633 TI - Histochemical, connectional and cytoarchitectonic evidence for a secondary reduction of the pretectum in the European eel, Anguilla anguilla: a case of parallel evolution. AB - There are at least three different patterns of pretectal organization in teleost fishes: a simple pattern observed in cyprinids, an elaborate pattern present in percomorphs, and an intermediately complex pattern seen in many other teleost groups. The taxonomic distribution of the pretectal patterns indicates that the simple and the elaborate patterns are both evolutionarily derived (apomorphic) from the primitive (plesiomorphic) intermediately complex one. In anguillids, the pretectal pattern observed cytoarchitectonically has an anatomical configuration similar to that of the simple pattern in cyprinids. The distribution of acetylcholinesterase positivity in the pretectum (namely acetylcholinesterase positivity in the parvo- and magnocellular superficial and posterior pretectal nuclei, and acetylcholinesterase negativity in the pretectal cell plate and the ovoid preglomerular cell aggregate), as well as the retinal projections (namely retinal terminals in the parvocellular superficial and central pretectal nuclei, and absence of such terminals in the magnocellular superficial and posterior pretectal nuclei and the pretectal cell plate), strongly supports the interpretation suggested by the cytoarchitectonic analysis. As anguillids (elopomorpha) and cyprinids (ostariophysi) are related only distantly, this secondary simplification in the pretectum likely occurred independently, i.e. this simplification represents a case of parallel reduction. PMID- 1764634 TI - Neuronal correlates of sex/role change in labrid fishes: LHRH-like immunoreactivity. AB - Gonadotropins have been implicated in the proximate control of socially induced sex and role change in labrid fishes. Since the release of gonadotropins is controlled by Gonadotropin Releasing Hormones, immunocytochemical techniques were used here to determine the qualitative and quantitative distribution of Luteinizing Hormone Releasing Hormone (LHRH, the primary Gonadotropin Releasing Hormone in mammals) in the brain of a sex-reversing labrid fish, Thalassoma bifasciatum. Fibers showing LHRH-like immunoreactivity were distributed throughout the brain, with densest concentrations in the olfactory bulb, the telencephalic area dorsalis and preoptic area of the forebrain, the medial posterior tuber and nucleus of the saccus vasculosus of the hypothalamus, and the tectum and tegmentum of the midbrain. Somata positive for LHRH were found in the anterior and posterior divisions of the ganglion of the nervus terminalis, the preoptic area, and the periventricular rostral midbrain. There were no qualitative differences in the distribution of LHRH-like immunoreactive cells and fibers among the different sexual phases. However, there were quantitative differences in the number of LHRH-like immunoreactive cells in the preoptic area, a brain region known to be involved both in sexual development and in the control of sexual physiology and behavior in adults. Based on this, and results in other teleosts, it seems likely that central control of sex reversal and expression of alternative reproductive behaviors in labrid fishes is more directly related to quantitative changes in the number and/or biosynthetic activity of LHRH-positive somata and their fiber projections. PMID- 1764635 TI - Thalamic and midbrain auditory projections to the preoptic area and ventral hypothalamus in the green treefrog (Hyla cinerea). AB - Iontophoretic injections of horseradish peroxidase (HRP) into either the preoptic area or ventral hypothalamus of the green treefrog, (Hyla cinerea), demonstrated inputs from thalamic and midbrain auditory nuclei. In a pattern similar to that seen in Rana catesbeiana and Rana pipiens, the central thalamic and secondary isthmal nuclei were found to provide heavy input to the ventral hypothalamus. Additionally, a lighter input from the anterior thalamic nucleus was seen. In contrast, the preoptic area receives a major input from the anterior thalamic and secondary isthmal nuclei, and possibly a sparse input from the central thalamic nucleus. These results suggest that in treefrogs multimodal and auditory information may reach the preoptic area and ventral hypothalamus, two regions involved in endocrine regulation and the control of reproductive behavior, via largely separate major pathways from the thalamus combined with a common midbrain input. Furthermore, the ventral hypothalamus receives heavy input from the preoptic area, lateral amygdala, suprachiasmatic nucleus, anterior entopeduncular nucleus, and a lighter input from the striatum. Nonauditory afferents to the preoptic area originate in the medial and lateral septal nuclei, medial pallium, and the dorsal-, lateral-, and ventral hypothalamus. The preoptic area and ventral hypothalamus are reciprocally connected. PMID- 1764636 TI - Suprachiasmatic nucleus and retinohypothalamic projections in moles. AB - The suprachiasmatic nucleus of the hypothalamus (SCN) and the retinohypothalamic projections were identified in one species of old-world moles, all of whom are blind as a result of natural loss of vision. A cyto-architectonic study revealed that the SCN is well developed, even though other visual nuclei in the dorsal thalamus and the midbrain are not. An immunohistochemical study showed that vasoactive intestinal polypeptide (VIP)-like immunoreactive cell bodies and fibers were distributed in the SCN, as has been reported in other mammals. Following intraocular injections of wheatgerm agglutinin conjugated to horseradish peroxidase (WGA-HRP), the central retinal projections were examined. The results indicated that the SCN receives a direct projection from the retina, as seen in many other mammals. In addition to the projection to the SCN, retinal fibers were seen to terminate in the anterior hypothalamic region and the retrochiasmatic area, as observed in some other mammals. In moles, retinohypothalamic projections are bilateral, with an ipsilateral predominance. Considering that the retinogeniculate and retinotectal projections are vestigial, it is highly probable that the optic pathway in moles primarily consists of retinohypothalamic projections, which are devoted to the entrainment of circadian and circannual rhythms. PMID- 1764637 TI - Public education defuses cry for forced HIV testing. PMID- 1764638 TI - New law requires patient information on advance directives. PMID- 1764639 TI - Maintenance of competence. PMID- 1764640 TI - Cryotherapy for treatment of active retinopathy of prematurity: experience in London, Ontario. AB - Between January 1985 and May 1990, 49 infants (97 eyes) with stage 3 "plus" retinopathy of prematurity (ROP) were treated with cryopexy. The mean gestational age at birth was 29.6 weeks and the mean birth weight 753 g. At the time of treatment the mean chronologic age was 8.7 weeks and the mean weight 1629 g. Noncutting cryopexy was applied to the entire avascular peripheral retina, anterior to the mesenchymal ridge. Confluent treatment was done anteriorly to the posterior border of the pars plana. Favourable results, defined as a normal appearing fundus (apart from the cryopexy scars) with no retinal folds or traction, were observed in 70% of the eyes an average of 13.8 (range 2 to 60) months after treatment. Our results emphasize the importance of early detection of ROP and diligent monitoring and treatment of affected infants. PMID- 1764641 TI - Birdshot retinochoroidopathy and HLA-A29+ and HLA-A29- idiopathic retinal vasculitis: comparative study of 56 cases. AB - We reviewed the records of 20 patients with birdshot retinochoroidopathy and 36 patients with idiopathic retinal vasculitis. The numbers of patients with the HLA A29 phenotype were 19 (95%) and 22 (61%) respectively. Overall, similar findings were noted in the birdshot retinochoroidopathy group and the HLA-A29+ idiopathic vasculitis group: more posterior pole involvement, more severe course and poor visual prognosis despite intense corticosteroid therapy. In contrast, the patients with HLA-A29- idiopathic vasculitis showed more peripheral involvement, the course was less severe and the prognosis was better; smaller amounts of steroids were used. Only one patient with HLA-A29+ idiopathic vasculitis eventually presented with signs of birdshot retinochoroidopathy; complete cure was obtained in other cases. Our results suggest the existence of an HLA-A29 syndrome encompassing birdshot retinochoroidopathy as well as other conditions whose expression would be determined genetically. PMID- 1764642 TI - Corneal endothelial decompensation after argon laser iridotomy. AB - Focal corneal edema overlying the site of argon laser iridotomy followed by generalized corneal decompensation developed in six eyes of five patients. The average interval between the iridotomy and the development of focal edema was 3 years, with generalized edema appearing an average of 3.5 months later. Light, scanning and transmission electron microscopy of tissue removed at the time of corneal transplantation showed abnormalities characteristic of Fuchs' dystrophy in two patients. Possible contributing factors include episodes of intraocular pressure elevation, cornea guttata and the use of high total amounts of energy during laser iridotomy. PMID- 1764643 TI - Pars plana vitrectomy for macular degenerative disorders. AB - We describe nine patients (10 eyes) treated with pars plana vitrectomy for vitreous hemorrhage secondary to disciform macular degeneration. Nine of the eyes showed improved acuity at about 3 months and at the last follow-up visit (6 to 30 months). Two of the patients had ambulatory acuity (counting fingers or better) before surgery, compared with all the patients at the last follow-up visit. Vitrectomy may be beneficial in this subgroup of patients with macular degeneration. PMID- 1764644 TI - Glaucomatous optic neuropathy and field loss in primary empty sella syndrome. AB - Primary empty sella syndrome is associated with certain visual field defects. Typical glaucomatous field defects, however, have rarely been reported. We reviewed eight cases of primary empty sella syndrome. Seven patients had typical glaucomatous optic disc and visual field changes. Three patients had low-tension glaucoma and four had typical primary open-angle glaucoma. We recommend that in addition to neurologic and endocrinologic assessment, patients with primary empty sella syndrome and visual field loss should have a detailed ophthalmologic examination, particular attention being paid to intraocular pressure and optic disc appearance to rule out glaucoma as a cause of the field loss. PMID- 1764645 TI - Temporary tarsorrhaphy induced with type A botulinum toxin. AB - We describe two children with corneal epithelial defects resistant to healing in whom protective temporary ptosis was induced with type A botulinum toxin injected to the levator palpebrae superioris. Epithelial healing was rapid, and no complications were noted. With further study this procedure may become useful in the treatment of corneal epithelial defects resistant to healing. PMID- 1764647 TI - The art of medicine can also be a multimillion-dollar business. PMID- 1764646 TI - Streptococcal lid necrosis in previously healthy children. AB - Fulminant preseptal eyelid cellulitis developed in two previously healthy children, aged 17 months and 8 years, following minor trauma. Despite appropriate intravenous antibiotic therapy, lid necrosis with ulceration developed in both patients. In both cases group A beta-hemolytic Streptococcus was the causative agent. Spontaneous granulation of the ulcerated areas resulted in cicatricial defects, which in one case may require surgical correction. Neither child had a past history of susceptibility to infection. Group A beta-hemolytic Streptococcus has been known to cause lid gangrene, but almost all previously documented cases occurred in debilitated or elderly patients. PMID- 1764648 TI - Measuring clinical nurse specialist effectiveness. PMID- 1764649 TI - Long-term lifestyle management. AB - The Clinical Nurse Specialist impacts the client with chronicity by strategic management of cost and quality outcomes. Three enabling strategies: counseling, social support, and teaching-learning are the tools the nurse and client use to implement long-term lifestyle adjustment to chronicity. Reduced health care system utilization and increased self-esteem and self-care abilities are the result of the strategies. Lifestyle management warrants further nursing research. PMID- 1764650 TI - Case management: clinical nurse specialist and nurse practitioner, converging roles. AB - In nursing there is discussion about the commonalities and differences among nurses in advanced practice. This article compares the roles of the clinical nurse specialist and the nurse practitioner. A case management model integrating the two roles is described. PMID- 1764651 TI - Developing the research role and functions of the CNS with a low birthweight center investigative team. PMID- 1764652 TI - Functions of the CNS in early discharge and home followup of very low birthweight infants. AB - Various studies have been conducted which explore the different functions of the clinical nurse specialist (CNS). This study details the functions of CNSs providing direct patient care before and following hospital discharge of very low birthweight infants and effect on patient outcome. The study reports on CNS interactions with 36 families whose infants were discharged early from the hospital, and who received discharge planning, teaching, and home followup for 18 months. PMID- 1764653 TI - Accountability and outcome measurement: where do we go from here? PMID- 1764654 TI - Measuring success: CNS performance appraisal. AB - With the current focus on quality outcomes and economic issues related to health care, clinical nurse specialists (CNSs) must effectively document their unique contributions that enhance the realization of organizational missions. This paper examines an outcome-oriented performance appraisal tool designed to quantify CNS services. Eleven performance criteria with performance behaviors were negotiated by CNSs and their respective supervisors based on job descriptions and organizational goals. A quantitative scoring system was then developed based on specific performance behaviors. This method of objective outcome based evaluation has not only substantiated the CNS's value but also has enhanced collaboration between CNSs and administrators. PMID- 1764655 TI - Measuring the effectiveness of nursing practice. AB - This article examines the importance of outcomes as indicators of quality of care. The appropriateness of selected traditional and emerging outcomes in measuring the effectiveness of nursing interventions is addressed. PMID- 1764657 TI - Collaboration: impacting professionalism and quality of care. PMID- 1764656 TI - The compassionate hands of the nurse. PMID- 1764658 TI - Achieving maximal utilization of an advanced practice council. AB - In the James A. Haley Veterans' Hospital, it became increasingly apparent to those in advanced practice roles that a forum was needed to provide a supportive milieu in which nursing staff in expanded and advanced practice roles could come together and discuss the clinical needs of patients and nursing practice issues. Using a dynamic theoretical framework based upon the identification of need for such a forum, an Advanced Practice Council was established to: (1) enhance an understanding of the advanced practice role; (2) promote consultation, support, and networking among Council members; (3) facilitate and refine communication systems; (4) share new ideas; (5) collaborate for research; (6) contrast methods of practice; and (7) increase consultation services. The current activities of this group focus around role clarification and utilization. Peer review of advanced practice roles, for example, has been explored by the council and is in the stages of implementation. Future activities include examining the effects of expanded roles on staff practice and patient care, expanding standards of clinical nursing practice, and facilitating the autonomy of nursing practice through a privileging process. PMID- 1764659 TI - Northern nurses and burn out. PMID- 1764660 TI - Women as informal caregivers. PMID- 1764661 TI - Independent nurse practitioners. Is society ready for us? Should they be? PMID- 1764663 TI - The essence of nursing. PMID- 1764662 TI - The sleep apnea/hypopnea syndrome. PMID- 1764664 TI - Practice-based research on a unit level. PMID- 1764665 TI - The living will issue. PMID- 1764666 TI - [An exercise in mutual complementation between nurses and educators]. AB - This article describes the strategy adopted by the Philippe Pinel Institute of Montreal in implementing the Callista Roy conceptual model. The institute, which specializes in forensic psychiatry, has some 300 patients. It is interesting to note that there are approximately twice as many therapists as nurses at the institute. This seemed at the outset to be a major stumbling block. The authors give an overview of the institute's mission, which is fourfold: health care, teaching, research and guardianship of the patients. The reasons for adopting the Roy model and the process followed are described. The primary challenge was to change the organization's corporate culture and health care philosophy. This was enormously time-consuming and required a great deal of mental energy and conscious effort on the part of the staff. To ensure successful implementation, the institute addressed not only the philosophical and policy dimensions of the model (the why), its technical aspect (the how), but also its logical and systematic dimension (the what). The article describes the elements of the model and its assumptions, with an emphasis on the various modes of adaptation to stimuli. It also looks at the training approach that was taken, the methods used to overcome resistance to change and the problems encountered. The clinical example will help readers better understand the implementation process. The subject is a 27-year-old woman, mother of a 10-year-old son and a four-month-old baby girl. She was confined to the institute by a court order after having drowned the infant while giving her a bath. The assessment process consisted of: data collection, analysis and determination of relevant stimuli, for example, the stimuli that could be manipulated, either to promote more adaptive behavior patterns, or to diminish negative responses. Normal daily and weekly activities are the means through which behavioral change can be achieved. The nursing care plan describes this in detail. PMID- 1764667 TI - If we're professionals, why are we on strike? PMID- 1764668 TI - Schooling the family. Going through nursing school is a family affair. PMID- 1764669 TI - Nursing in an international context. PMID- 1764670 TI - Same day admission surgery. Teamwork is the key to this dual approach to surgery in the 90s. PMID- 1764671 TI - Too old for care. PMID- 1764672 TI - Restraints. Protection or abuse? PMID- 1764673 TI - Doctorate in nursing: idea to reality. PMID- 1764674 TI - [Chronic crying in the elderly]. AB - The author is an undergraduate nursing student who has researched the effect of human contact on elderly clients who cry repetitively and without apparent reason. The study attempts to incorporate what we already know about the constant interaction between the individual and the family or social group. The theory developed by Martha A. Rogers was used as the conceptual framework. Rogers' theory compares individuals and their environments to waves in continual motion. Two clients were the focus of this study--a 78-year-old man and an 81-year-old woman. A detailed observation and analysis of their behavior were followed by the identification and charting of the clients' daily rhythms and those of the health care unit, in order to pinpoint regular patterns. For example, in noting the exact time medication is given, it is possible to see how it affects the client's behavior. The author is convinced that human contact is far more beneficial than physical constraints or medication. She proposes an individualized care plan directed by a primary nurse and a select group of other caregivers in order to ensure a consistent approach. The key to resolving the problem of chronic crying is a combination of patience, respect and kindness. The results of her research seem to bear this out. For the male client, the frequency and volume of crying were markedly reduced. The female client learned to express her needs in more acceptable ways. For the staff, this new approach resulted in a significant boost in morale. PMID- 1764675 TI - [Cultural awareness in nursing]. AB - Cultural differences play a significant role in how people react to health problems. Culture also affects the relationship between patient and caregiver. This article describes four basic characteristics of culture: it is learned, not hereditary; it is shared by all members of the same cultural group; it develops in adaptation to the environment; and it is dynamic, in constant evolution. The author shows how a patient's culture can affect his or her health. Three specific aspects are discussed--eating habits, communication and health beliefs. The need for nurses to be aware of the cultural dimension and its significance in the caregiving process is emphasized. This is particularly important in a multicultural society such as Canada. The effectiveness of the care provided depends on the nurse's awareness and sensitivity. In the same vein, the prevention of misunderstandings requires an appreciation of the other person's culture. Nurses who reach out to understand other cultures will come to respect individual differences. PMID- 1764676 TI - [Caregivers and HIV]. AB - An exploratory study conducted among 18 natural caregivers of persons with HIV revealed that extreme emotion was the results of the high cost of personal devotion. PMID- 1764677 TI - The visualization of apoferritin in the secretory pathway of vertebrate liver cells. AB - Electron microscopy has shown that normal mouse liver cells contain abundant cytosolic and lysosomal holoferritin but none in cisternae of the rough endoplasmic reticulum (RER). This does not mean that ferritin is absent from the secretory pathway, since the low contrast of apoferritin and ferritin containing little iron makes it difficult to resolve using standard transmission electron microscopy. We hypothesized that treatment of permeabilized cells and cell fractions with iron should make apoferritin visible by converting it to holoferritin. The iron treatment caused particles resembling the cores of holoferritin to appear in RER and in RER microsomes from mouse liver. We conclude that ferritin occurs in the endoplasmic reticulum and could be secreted, allowing the liver to be a source of serum ferritin. PMID- 1764678 TI - Three-dimensional structure of the sarcoplasmic reticulum of skeletal myofibers in chicken and frog. AB - The three-dimensional structure of the sarcoplasmic reticulum (SR) of the twitch and slow tonic fibers in the skeletal muscles of the chicken and frog was examined using a modified Golgi method combined with stereoscopy employing high voltage electron microscopy. In both types of fibers the SR network was classified into two categories, intermyofibrillar SR and subsarcolemmal SR. The intermyofibrillar SR in twitch fibers was basically similar and consisting of three or four typical structural regions. The configuration of the intermyofibrillar SR in twitch fibers was divided into two main groups which represented the SR in the fast twitch and the slow twitch fibers. The form of intermyofibrillar SR in slow tonic fibers is entirely different from that in twitch fibers in chicken, whereas it was rather similar in frogs. Regarding their function, the most striking feature of the SR structure was the paucity of the junctional SR in slow tonic fibers. The structure of subsarcolemmal SR in slow tonic fibers of the chicken and frogs was almost the same as in twitch fibers, forming polygonal mesh at the center of A-band and a loose tubular network including distended cisternae. PMID- 1764679 TI - The three-dimensional architecture of the myosalpinx in the rabbit as revealed by scanning electron microscopy. AB - The three-dimensional (3-D) architecture of the myosalpinx in the rabbit has been investigated by means of scanning electron microscopy after microdissection and the removal of interstitial connective tissue with KOH digestion. In the extramural portion of the tubo-uterine junction, the myosalpinx presents outer longitudinal bundles which form a well-defined continuous muscular layer extending towards the ampulla. Underlying this layer there are single muscular bundles which follow an uneven circular arrangement. At a deeper level the same bundles present a plexiform arrangement. Several bundles reach the base of the mucous folds and follow a discontinuous, approximately longitudinal arrangement. In the isthmus, the myosalpinx shows superficial longitudinal strips that abruptly bend sideways as they approach the ampulla, thereby enveloping the underlying muscular structure. The latter is arranged in the same way as at the extramural portion of the tubo-uterine junction, except for the lack of the outer longitudinal layer originating from the uterus. Our 3-D results revealed that the architecture of the rabbit myosalpinx consists of muscular bundles independent of one another that follow multiple spatial arrangements and form a complex network. Such a type of structure seems to be capable of stirring rather than pushing the embryo and gametes. PMID- 1764680 TI - Distribution of sodium, magnesium, phosphorus, sulphur, chlorine, potassium, calcium and iodine in mammalian thyroid gland. AB - Anhydrous specimen preparation techniques and X-ray microanalysis were used to study the elemental composition of the rat thyroid follicular cells and colloid in the follicular lumen. Analysis were performed in morphologically defined follicular cells and adjacent colloid. Use of semithin cryosections allowed us to selectively analyze cell nucleus and dense vesicles in the cytoplasm of follicular cells. The analytical results indicate that the basolateral and apical cell membrane of follicular cells act differently in the transport of iodine and other ions, thus creating ionic gradient in the follicular lumen as compared to that found in the follicular cells. High potassium levels were found in the colloid. This finding indicates an active secretion of potassium from the apical plasma membrane into the follicular lumen. High sulphur and calcium levels were also found in the colloid. Dense vesicles found in the cytoplasm of follicular cells varied in size and had different elemental composition. PMID- 1764681 TI - Histochemical localization of glycoconjugates in the palmar aponeurosis of Dupuytren's patients. AB - Acridine orange added to the primary fixative or reduced osmium tetroxide as postfixative have been used in order to localize by thin section electron microscopy glycoconjugates in the extracellular matrix of the normal palmar aponeurosis as well as in tissues at different stages of Dupuytren's contracture. After use of acridine orange or reduced osmium tetroxide, in the nodule of the active stage an extensive network of fine filaments separated single or small bundles of collagen fibrils from each other. In the cord of the residual stage fixed in presence of acridine orange, the tightly packed collagen fibrils in the central region of the specimens were swollen and had stained material interposed between the single microfibrils. In specimens of the same cord first fixed with glutaraldehyde alone, followed by reduced osmium tetroxide, the disaggregation of collagen fibrils could be seen only occasionally and the intrafibrillar stained glycoconjugates were less evident. Comparable alterations were absent from the normal tissue. The possible reasons of these differences are discussed. PMID- 1764682 TI - Confronting cisternae in cultured mammalian cells: development and prevalence in arrested metaphases. AB - HeLa S-3 cells held in metaphase with colcemid or vinblastine sulphate (VLB) for up to 6 h developed confronting cisternae (CCs) in their protoplasm. They were first detected about 1 h after exposure to alkaloid began and became progressively more prominent until by 6 h they could be found in almost every metaphase cell. As time elapsed, there was also an increasing incidence of multiple stacking of CCs. The progressive development of CCs with length of alkaloid exposure was mirrored by a corresponding reduction of rough endoplasmic reticulum (rER) in the protoplasm of the arrested metaphases. In contrast, an equally extensive survey of HeLa S-3 metaphases arrested with nocodazole revealed only one poor example of a CC-like structure. CCs were not found in a) normal mitotic cells, b) interphase cells whether or not they had been exposed to alkaloids, c) cells arrested in metaphase for some period of time by incubation of cells at 27 degrees C for 3 days, and d) large polyploid metaphases which had spent long times progressing through division. In a brief survey of three other cell lines before and after colcemid treatment (3T3, L-132, and B16F10 cells), CCs were encountered relatively infrequently in the colcemid exposed cells, even after 6 h exposure. The relationship of CCs to other cell membrane systems, and their appearance relative to those previously reported in neoplastic and virus infected cells are discussed. PMID- 1764683 TI - Radioprotectant effects of atropine on small intestinal villous shape. AB - Previous work has shown that irradiation produces changes in small intestinal villous shape, which can be quantified using a villous scoring system applied to scanning electron micrographs. It has already been shown that reserpine, which, like irradiation, increases gastrointestinal motility, produces a similar type of villous collapse, thereby supporting the theory that this form of injury may not be due entirely to changes in the cryptal epithelial compartment, as has been assumed previously. Atropine, chosen for its ability to decrease gut motility, produces a different form of villous shape change. The aim of the current work was to investigate the ability of atropine to decrease the villous damage caused by irradiation and thereby improve the likely absorptive capacity of the small intestine. The current experiments used crypt counting, qualitative light microscopy and villous scoring techniques. Groups of unirradiated mice examined included baseline controls and those treated with atropine, sham irradiation and a combination of these two schedules. Two irradiated groups were studied, one with and one without atropine treatment. The results show that atropine given with irradiation reduces the extent of the damage to villous shape, implying that the total effect on the neuromuscular tissues is less destructive after the combined treatment. It is also of interest that atropine appears to have an additional radioprotectant effect on the radiation induced crypt depletion, implying that neuromuscular behaviour may influence this compartment, hitherto considered as dependent on epithelial proliferative capacity. PMID- 1764684 TI - On the different patterns of erythroblast denucleation. PMID- 1764685 TI - Lipid-rich residual bodies in human myometrium: qualitative observations. AB - Uterine leiomyomata and histologically normal myometrium were examined by light and electron microscopy. All myometrial samples contained smooth muscle cells with distinctive cytoplasmic inclusions located at the nuclear poles. These were seen in only one case in routine paraffin wax sections, where they appeared as clear vacuoles, but they were more obvious in epoxy resin sections stained with toluidine blue. Staining with Oil Red O and for acid phosphatase was positive at the site of the vacuoles. In ultrathin sections, these structures possessed a single membrane and contained abundant lipid droplets, with a sparse, coarsely granular matrix. They were designated as lipid-rich residual bodies. Such organelles were all but absent from leiomyomata. Lipid-rich residual bodies with the features described here have not been studied in detail before in smooth muscle cells of the human myometrium. The possibility that they arise from the cyclical stimulation of lipid synthesis by ovarian hormones is discussed. PMID- 1764686 TI - Interactions between megakaryocytes and sinus wall. An ultrastructural study on bone marrow tissue in primary (essential) thrombocythemia. AB - An ultrastructural study was performed on bone marrow tissue in primary (essential) thrombocythemia to evaluate possible interactions between megakaryocytes and sinusoids. In addition to a preferential localization of megakaryocytes in the subendothelial space, two different kinds of cytoplasmic processes could be discriminated penetrating the sinus wall. Serial sections disclosed that megakaryocytes developed multiple pseudopod-like plump projections derived from their peripheral zone and devoid of organelles. It is tempting to speculate that these ameboid features could serve as anchors to keep the cell in a subendothelial position and to monitor changes occurring in circulation. The second type of cytoplasmic processes reaching into the vascular lumen consisted of tentacle-like elongated protrusions rich in organelles, apparently originating from the intermediate zone. These projections were thought to present either the beginning of megakaryocytes egress into circulation or putative platelets. Frequently, there was an intrasinusoidal localization of megakaryocytes which revealed numerous so-called platelet territories and apparently an enforced platelet shedding. Generally, these features are comparable with aspects obtained from animal studies, following excessively stimulated megakaryo- and thrombocytopoiesis by application of anti-platelet serum. PMID- 1764687 TI - Demonstration of the orientation of the Cestodes spermatozoon illustrated by the ultrastructural study of spermiogenesis and the spermatozoon of a Cyclophyllidea: Thysaniezia ovilla, Rivolta, 1874. AB - Spermiogenesis in Thysaniezia ovilla begins with the appearance of a differentiation zone equipped with peripheral microtubules, surrounded by arched membranes and containing two parallel centrioles surrounded by electron dense granular material. One of the centrioles aborts, the other gives rise to a flagellum which quickly grows in the cytoplasmic extension in which the nucleus migrates and protein granules form. During the nuclear migration crested-like bodies appear among the peripheral microtubules in the differentiation zone. The Th. ovilla spermatozoon is filiform. One of its extremities, which we show to be anterior, exhibits two helicoidal crested-like bodies, surrounded by electron dense material resembling an acrosome. Cortical microtubules run along almost the whole length of the spermatozoon. The cytoplasm has no mitochondria and contains protein granules. The axoneme is of the 9 + '1' pattern. It stops before reaching the posterior extremity of the gamete. The nucleus is wrapped round the axoneme, in the middle region of the spermatozoon. It generally stops before reaching the posterior extremity of the flagellum. This study has enabled us to describe precisely the orientation of the spermatozoon of cestodes in general. PMID- 1764688 TI - Development of the cloacal bursa in the domestic fowl. II. A quantitative and fine structural analysis of the follicular cortex and medulla. AB - The estimated volumes of the follicular medulla (x) and cortex (y) from 14-day old embryos till 28-day-old White Leghorn chicks were associated through the allometric formula y = bxk or log y = log b + k log x. Two successive allometric growth stages (I and II) are discernable, being hatching the transition region between them. The volumetric growth of the cortex is 2.49 times greater than that of the medulla in stage I, whereas cortex and medulla grow isometrically in stage II. The curve fitting procedure analysis of the absolute cortical and medullary growth confirmed these results. The fine structure of the cell types in the follicular medulla revealed that: a) in the allometric stage I pre-existing, bud precursor (Pr) cells appear to give rise to basal (Ba) and medullary epithelial (ME) cells, in both cases showing lucent and dark varieties. A medullary cytoreticulum is established at the onset of this stage. b) The marked lymphocyte proliferation during stage II occurs among the thin and short cytoplasmic processes of BA cells. These processes extend towards the centre of the medulla and also show many lateral interdigitating processes. During this same stage, the cytoplasmic processes of ME cells elongate and become thinner promoting a widening of the cytoreticulum interstices. The fine structural analysis of the cortical cytoarchitectural arrangement showed that: a) before the onset of stage I (14-day-old embryos) the cortex consists mainly of typical fibroblasts (F) and a few blastic (Pr?) cells. Later in this stage I, a poorly defined cortical framework is made up of typical fibroblasts, few cortical branching (CB) cells of the epithelial variety (which seem to be derived from Pr cells) and CB cells of the fibroblast-like variety. These cells are interspersed with mature and immature lymphocytes. b) Allometric stage II of the cortex is characterized by the presence of very thin and long cytoplasmic processes from CB cells of both epithelial and fibroblast-like varieties. The arrangement of CB cell profiles, visualized in electron micrographic montages, is remarkably similar to that of the ME cells profiles which are known to form a cytoreticulum. We thus propose that the mature follicular cortex is endowed with a cellular framework forming wide interstices in which packed mature lymphoid cells are lodged. PMID- 1764689 TI - Application of cryo-sapphire knife in rapid frozen ultrathin sectioning for electron microscopy. AB - Conventional sectioning of frozen and fixed tissues is usually performed using the glass knife. Although the glass knife is economical, it has several disadvantages. In this study, the Authors have examined the sectioning quality of the sapphire knife in frozen tissues as an alternative to the glass knife. It was concluded that the sapphire knife has better quality and durability than the conventional glass knife in cutting frozen tissues. PMID- 1764690 TI - Morphometric studies of normal muscle mitochondria. AB - The study describes mitochondrial morphometry in normal adult limb muscles of various mammalian species. The size, area, shape, and volume of mitochondria were compared in two regions (subsarcolemmal and intermyofibrillary) and fiber types (type 1 and type 2) of the 1) human and monkey quadriceps, 2) cat soleus and caudofemoralis-CF, and 3) rat soleus and extensor digitorum longus-EDL. The Z band width showed distinct differences between the two types of fibers in all muscles. The mitochondrial size and volume varied in different muscles but the shape remained oval throughout. The human quadriceps mitochondria were the smallest in size and volume. The monkey and rat muscles showed higher mitochondrial volume which was not significantly different between the two fiber types. The cat soleus and EDL muscles showed significant difference in the mitochondrial volume of two fiber types and also significant correlation between the Z band width and the mitochondrial volume, the soleus being pure type 1 fibers and the EDL being pure type 2B fibers. We conclude that only the shape of mitochondria, but not the size and volume, is independent of the species, the type of muscle and the region of a fiber. PMID- 1764691 TI - Primary hepatic leiomyosarcoma. A case report with immunohistochemical studies and review of the literature. AB - A case of primary hepatic leiomyosarcoma is documented with the use of intermediate filament and actin isoform antibodies. The majority of the tumour cells were positive with alpha smooth muscle actin antibody and about 20% with anti-desmin antibody indicating their smooth muscle nature. A review of the literature revealed 16 previously documented cases. PMID- 1764692 TI - Studies on varicocele. 1. Submicroscopical and endocrinological features. AB - In this study we have selected a group of patients affected by a more or less severe condition of varicocele. After the evaluation of spermatogenesis and sperm function by electron microscopy we have demonstrated that the sperm malformations are mostly due to immaturity. Subsequently we have observed low FSH levels in the blood, concomitant with inhibin high contents, and we have studied Sertoli cells at submicroscopical level. In conclusion we suggest the following mode of action of varicocele in endocrinologically and spermatologically altered patients: varicocele----Sertoli cells----increased inhibin----hypophysis----decreased FSH-- -decreased testosterone----aberrant spermatogenesis----immature spermatozoa. The research will continue. PMID- 1764693 TI - Differences in skin carcinogenesis by methylnitrosourea between mice of several strains. AB - To compare the susceptibilities of the skin of different strains of mice to the carcinogenic effect of a directly acting alkylating agent, groups of 20 mice were treated twice a week with 25 microliters of a solution of methylnitrosourea in methanol. The solution was 0.04M and was applied to the shaved back of female BALB/c, Sencar, CD-1 and Swiss mice for 25 weeks. Four groups of 20 mice of each strain were 8 weeks old at the beginning of treatment. Another four groups were 58 weeks old when treatment began. More of the BALB/c mice developed skin tumors than the other three strains, the Sencar mice somewhat less. Few CD-1 mice developed skin tumors and about one third of the Swiss mice. In all four strains, there were fewer animals with skin tumors among those begun at 58 weeks than in the young mice, but the difference was small. Survival was poor among CD-1 mice, but there was not a large difference between the strains in time of appearance of first tumor, or in average latent period of skin tumors, almost all of which were carcinomas. The Sencar mice were not outstandingly more sensitive to skin carcinogenesis by MNU, as they were to UV radiation-induced skin carcinogenesis. In a comparable study in Swiss mice neither dimethylnitrosourea nor diethylnitrosourea induced skin tumors by painting and both showed only a weak systemic carcinogenic effect in the lungs, although they are directly acting mutagens. PMID- 1764694 TI - Lung adenoma structure among inbred strains of mice: the pulmonary adenoma histologic type (Pah) genes. AB - Urethane-induced, lung adenoma multiplicity and histologic type vary among mouse strains. We asked whether the Pas genes which control multiplicity also determine adenoma structure. Lung adenomas from inbred mice, F1 hybrids, and recombinant inbred mice were classified by growth pattern as either solid or papillary. Since no correlation was observed between adenoma multiplicity and histologic type, no linkage apparently exists between the Pas genes and adenoma morphology. We propose the name Pah (Pulmonary Adenoma Histologic type) for the genes controlling lung adenoma growth patterns. Genetic analysis indicated dominance of the papillary phenotype, and that two or more Pah genes determine adenoma structure. PMID- 1764695 TI - Inhibition of mouse skin tumor promotion by tenuazonic acid. AB - Tenuazonic acid (TA) was topically applied to the interscapular region of Swiss albino mice at different doses before the application of 12-O-tetradecanoyl phorbol-13-acetate (TPA). Skin from the painted area was examined for ornithine decarboxylase (ODC) enzyme estimation. It was observed that TA inhibited TPA induced ODC activity. The inhibitory effect of TA was also found in mouse skin tumor promotion in the two stage initiation promotion protocol. There was a remarkable delay in the latency period and decrease in the number of tumors developed and the percentage of tumor bearing animals after TA treatment. PMID- 1764696 TI - Tumor localization of monoclonal antibodies against human renal carcinoma in a xenograft model. AB - We investigated the localization of intravenously injected DAL K45 and DAL K29, two monoclonal antibodies (MABs) against human renal cell carcinoma (RCC), and their F(ab)2 fragments in nude mice bearing intrarenal transplants of the RCC line Caki-1. More of the MABs or their F(ab)2s specifically localized in the tumor than in any normal tissue with the exception of blood. Compared to parent MABs, F(ab)2s were cleared faster from all tissues. In serum, the MABs and F(ab)2s showed a single radioactive peak retaining partial immunoreactivity. DAL K45-F(ab)2 showed the highest tumor:normal tissue localization ratios and the most distinct gamma-camera image at 24 h. PMID- 1764697 TI - Augmentation of cytotoxicity using combinations of interferons (types I and II), tumor necrosis factor-alpha, and tamoxifen in MCF-7 cells. AB - The cytotoxic effect of a combination of interferons (type I and II) and tumor necrosis factor (TNF), with an antiestrogenic drug, tamoxifen (TAM), was investigated in the estrogen receptor positive human breast carcinoma cell line, MCF-7. Cytotoxicity was measured by the MTT assay. In an attempt to define the molecular basis for the interaction between the interferons (IFNs) and TNF or any one of the cytokines with TAM, the induction characteristics of a number of IFN induced mRNAs in response to IFNs, TNF, and TAM were studied. We observed an augmentation of the cytotoxic effect of TNF when it was combined with TAM. There appears to be an overlap in signalling mechanisms of IFNs and TNF as two of the IFN-inducible genes, 1-8 and 6-16 are also induced by TNF. mRNA 1-8 was induced by both IFN-alpha (type I) and IFN-gamma (type II). We conclude that TNF potentiates the cytotoxic effects of TAM in MCF-7 cells and that the three cytokines IFN-alpha, IFN-gamma, and TNF share some pathways that lead to specific induction of some cytokine responsive genes. PMID- 1764698 TI - Effects of 3-aminobenzamide on the post-initiation phase of N-nitrosobis(2 oxopropyl)amine induced pancreatic carcinogenesis in Syrian hamsters. AB - Effects of 3-aminobenzamide (ABA) on pancreatic carcinogenesis after initiation by N-nitrosobis(2-oxopropyl)amine (BOP) were investigated in Syrian hamsters. Animals were given BOP at a dose of 70 mg/kg body weight by subcutaneous injection and following a 2-week recovery period, were administered basal diet or basal diet containing 0.5, 0.75 and 1.5% ABA for 30 weeks. While the incidences of resultant pancreatic lesions, including hyperplasia, atypical hyperplasia and carcinoma, induced by BOP were not significantly influenced by ABA treatment, the mean numbers of those pancreatic lesions were significantly decreased in a dose dependent way. The results therefore suggested the possible involvement of poly(ADP-ribosyl)ation in the post-initiation phase of pancreatic carcinogenesis in hamsters. PMID- 1764699 TI - Combination of the minor groove-binder U73-975 or the intercalator mitoxantrone with antitumor alkylating agents in MCF-7 or MCF-7/CP cells. AB - In an effort to improve the cytotoxicity of clinically used anticancer alkylating agents, the topoisomerase II inhibitory drugs U73-975 or mitoxantrone were added to cell cultures exposed to CDDP, carboplatin, BCNU, melphalan or thiotepa. In the MCF-7 human breast cancer cell line and in the MCF-7/CP (CDDP resistant) subline, U73-975 and mitoxantrone were both potent cytotoxic agents (IC50 0.002 microM and 0.006 microM for U73-975, respectively and 0.8 microM and 0.1 microM for mitoxantrone, respectively). As evaluated by isobologram analysis, the addition of either U73-975 or mitoxantrone to 1 h exposure to CDDP resulted in greater-than-additive killing in the MCF-7 parent cells. While U73-975 was also greater-than-additive in cytotoxicity with CDDP in the MCF-7/CP line, mitoxantrone and CDDP were only additive in cytotoxicity in these cells. In the case of carboplatin, the addition of U73-975 or mitoxantrone to treatment with the drug resulted in greater-than-additive cell killing in the MCF-7 parental cell line but in the MCF-7/CP cell line these combinations were only additive in cell killing. Addition of U73-975 to treatment with BCNU resulted in only additive cytotoxicity in both cell lines; however, the combination of mitoxantrone with BCNU resulted in greater-than-additive cell killing in both the parental and CDDP resistant cell lines. When either U73-975 or mitoxantrone was added to treatment with melphalan greater-than-additive cytotoxicity resulted in both cell lines except at low melphalan concentrations in the MCF-7/CP cell line. Finally, the addition of either modulator to treatment with thiotepa in the MCF-7 cell line produced variable interactions depending on thiotepa concentration, but in the MCF-7/CP cell line either modulator in combination with thiotepa caused greater-than-additive cell killing. These results indicate that the addition of topoisomerase II inhibitory drugs may substantially increase the cytotoxicity of some alkylating agents. In vivo experiments are necessary, however, to ascertain whether a therapeutic gain is achievable. PMID- 1764700 TI - Low-frequency electromagnetic radiation enhances the induction of rat mammary tumors by nitrosomethyl urea. AB - Low-frequency electromagnetic fields enhance the induction of mammary gland tumors in rats using nitrosomethyl urea. The incidence of tumors depended on the duration of exposure to static (dc) and variable (ac) magnetic fields. Variable magnetic fields induced mammary gland cancer much more frequently than static ones. Apart from increasing the incidence of mammary gland tumors, household low frequency electromagnetic fields reduced the mean latent period of tumor development and led to predominance of malignant tumors in the exposed animals as compared to controls. Mammary gland tumors developed rarely under the effect of static or variable magnetic fields per se, without preliminary administration of a carcinogen. Household low-frequency electromagnetic fields may potentially present an oncogenic hazard for animals and humans. PMID- 1764701 TI - Relationship between dietary, serum, and tissue levels of carotenoids. AB - A study was undertaken to assess the utility of the buccal scrape technique for measuring tissue levels of carotenoids in short-term intervention trials and epidemiologic studies. In 14 healthy volunteers a good correlation was found between serum beta-carotene levels and recent dietary intake of beta-carotene as estimated from measured food records. Supplementation with 30 mg/day of beta carotene for 1 week resulted in a sixfold increase in average serum levels, while serum lycopene concentrations remained constant. Presupplementation levels of beta-carotene and lycopene in the buccal mucosa cells were not correlated with dietary intakes or with serum levels. After supplementation, levels of both carotenoids were found to increase in buccal cells, however, most of this increase was found to be an artifact due to repeated sampling. After correcting for this artifact, beta-carotene was found to increase less than twofold in tissue after supplementation. PMID- 1764702 TI - B16 melanoma response in vivo to photochemotherapy with mitoxantrone and red light. AB - The cytocidal activity of light-activated mitoxantrone in mice bearing B16 melanoma was investigated. Mice inoculated with 10(6) tumor cells on day 0 were i.p. injected with 1 mg/kg body weight of mitoxantrone on days 1, 5 and 9 and exposed to 108 J/cm2 of suitably filtered red light from a halogen lamp on days 2, 6 and 10. The treatment significantly prolonged the median survival time compared to both therapy with mitoxantrone and with red light alone. PMID- 1764703 TI - Do children with severe head injury benefit from intensive care? AB - Intensive management of severe closed head injury is pursued in most neurosurgical units, as it no doubt reduces mortality. However, the fate of those salvaged from death is less clearly defined. The impact of aggressive management on the psychological recovery is even less clear. This retrospective study of children admitted to a regional paediatric neurosurgical service attempts to address these issues. Eighty-four children between the ages of 3 to 16 years with severe head injuries were studied and categorized according to conservative or intensive treatment groups. The availability of intensive management led to a greater number of such children referred. The mortality in those children sustaining more severe injury, i.e. Glasgow Coma Score (GCS) 3 or 4, was halved (44%) with intensive management from 80% in the conservative group. For those with less severe injury (GCS 5-8), it was unchanged at about 23%. The reduced mortality is at the expense of increased morbidity. Psychological testing showed that the cognitive recovery was comparable. PMID- 1764704 TI - Idiopathic ischemic infarction of the brain stem in children. AB - Three cases of idiopathic brain-stem infarction are added to the literature on 12 children. There is no age predilection, and the youngest case is 3 years old. However, there is a striking male preponderance of 13:2. The residual neurological deficit covers the range of normal to quadriparesis. Laboratory studies investigating hypercoagulopathy, platelet dysfunction and atrial septal defect may provide an etiology for some cases in the future. PMID- 1764705 TI - Occult spinal dysraphism in children: need for early neurosurgical referral. AB - The natural history of occult spinal dysraphism in children is one of progressive and unpredictable neurological deficit. The modern role of neurosurgery is in the prevention of deterioration rather than correction of established disability. A prospective study was carried out on 40 consecutive patients to analyse the referral pattern of children with this condition. The age, reason for referral, clinical history and source of referral was recorded in each case. The reason for referral varied with age. Of the 40 patients studied, only 12 were found to be without neurological deficit at the time of referral. The incidence of progressive neurological deterioration increased with increasing age. The referral source in different age groups varied, but in all age groups relatively few were referred by the general paediatricians or paediatric neurologists. For optimum surgical results, early referral and treatment is desirable and should become our objective. PMID- 1764706 TI - The effects of labor and delivery on spinal cord function and ambulation in patients with meningomyelocele. AB - Two hundred and eight patients with meningomyeloceles were reviewed to assess the role of birth trauma in the pathogenesis of their neurological deficit. Vaginal breech-delivered patients appeared to have poorer neurological function in the newborn period. The factors responsible include: (1) a mid or upper lumbar level, that by sparing hip flexors and knee extensors, predisposes to breech presentation; (2) limb posturing due to residual neurological function and intrauterine positioning that limits the accurate neurological assessment of the newborn; (3) nervous system or soft tissue injury due to labor and delivery. Regardless of the mechanism, vaginal breech-delivered patients showed improvement in function, and eventually exhibited ambulatory function comparable to those infants born by cesarian section or vaginally after vertex presentation and labor. In our patient population, elective cesarian section did not offer a spinal cord or ambulatory advantage over vaginal delivery for those pregnancies presenting in a vertex fashion. Thus, it should be reserved for fetuses who are presenting breech or who have other obstetrical indications for operative delivery. PMID- 1764707 TI - Brain stem auditory-evoked potentials in meningomyelocele. Natural history of Chiari II malformations. AB - Brain stem auditory-evoked potentials (BAEPs) were recorded in 30 patients with meningomyelocele and shunted hydrocephalus ranging in age from birth to 33 years. Twenty-two of them had Chiari II malformation, one of which was symptomatic. In 22 cases, including 15 with Chiari II malformation, BAEPs were recorded repeatedly after periods ranging from 18 months to 7 years. The results were as follows: (1) III-V interpeak latency (IPL) decreased progressively from prolonged to the normal range with growth until 25 years of age; (2) I-III IPL tended to prolong gradually from the normal range; (3) these findings may indicate that the natural history of Chiari II malformation is delayed maturation of the brain stem and intensification in the elongation and stretching of the hindbrain and lower cranial nerves. PMID- 1764708 TI - CO2 reactivity and autoregulation in fetal brain. AB - Intraventricular hemorrhage (IVH) in preterm infants is well known to be associated with the high morbidity and mortality of this group. Previous studies have suggested altered cerebral blood flow (CBF) as an important pathologic factor. We measured the CBF in near-term rabbit fetuses using the hydrogen clearance technique. The local CBF of the rabbit fetuses was significantly low compared with that of the maternal rabbits. The response of CBF to changes in PaCO2 was observed in rabbit fetuses. The CO2 reactivity index of the fetal rabbit was lower than that of the maternal rabbit. This low CO2 reactivity might reflect the immaturity of the fetal brain and its low CBF. We were unable to monitor the fetal blood pressure, but the fetal CBF remained stable when the maternal blood pressure was altered. It is well known that IVH in preterm infants originates from the subependymal germinal matrix and that this has many fragile vessels. Our observation suggests that even a small increase of CBF during hypercapnia might have a large effect towards producing hemorrhage. PMID- 1764709 TI - Hypodense extracerebral images on computed tomography in children. "External hydrocephalus": a misnomer? AB - External hydrocephalus (EH) was identified in 58 infants under 3 years of age during the period 1 June 1986 to 28 February 1990. Radiological images and clinical features were compared with 11 cases of cerebral atrophy (CA). Significant differences were found in delivery, head circumference, and the incidence of motor and developmental abnormalities. The population with EH was found to be quite heterogeneous, with a male preponderance. Intracranial pressure was normal in 15 cases in which lumbar puncture was done. The flow of cerebral spinal fluid was considered to be within the normal range in 6 cases. The results of a few cases examined with metrizamide cisternography are presented. The prognosis in our cases was not as benign as previously published, and use of the name EH is questioned. The less committal term "hypodense extracerebral images" is proposed when computed tomography (CT) is the only study done. The hypothesis that encephalocranial disproportion is the basic underlying entity for the CT images is proposed. PMID- 1764710 TI - Bilateral ballismus in children. AB - Bilateral ballismus is extremely rare. We found 23 reported cases, and only 2 of these were in children. In older patients the movement disorder is usually due to cerebrovascular disease, but in younger patients a variety of aetiopathological causes may be found. There are few data regarding medical treatment. There have been no previous reports on stereotactic operations. We report on two severely disabled children who underwent stereotactic surgery. A 9-year-old boy suffering from bilateral ballismus after meningoencephalitis was operated on bilaterally (two operations 1 year apart). Another 9-year-old boy, who was suffering from progressive, presumably degenerative, basal ganglia disease, was operated on unilaterally. The nosological and conceptual controversies differentiating bilateral ballismus as a phenomenological entity are reviewed. The therapeutic options, indications, and special problems of stereotactic surgery in these rare cases are discussed. PMID- 1764711 TI - Benign cyst of the paramedian pontine tegmentum. AB - A benign ovoid cyst, without an epithelial lining, localized in the paramedian pontine tegmentum, was examined by computed tomography (CT) and magnetic resonance imaging (MRI) (25 x 15 x 15 mm) and successfully operated upon. The one and-a-half syndrome (horizontal gaze palsy to the right and paralysis of adduction of the right eye) and ipsilateral "peripheral" VII nerve palsy dominated the clinical picture. Fenestration, 5 mm in diameter, of the cyst wall through the floor of the IV ventricle was performed and 2.6 ml of clear, colorless fluid was evacuated. Inspection of the cyst, using the operating microscope, revealed a smooth, white, glistening cavity with no evidence of other pathological tissue. Duraplasty was performed with allogenic pericardium. Neurological symptoms improved immediately after surgery. Light and electron microscopy of the cyst wall revealed a fibrillar astroglial network and fragments of ependyma at the ventricular side of the biopsy. PMID- 1764712 TI - Giant aneurysm of the calloso-marginal artery. AB - A giant aneurysm of the right callosomarginal artery is reported in a 3-month-old child. This location is rare: including our case reported here, only three cases have been described. Clinicoradiological findings are presented and the surgical procedure is illustrated. PMID- 1764713 TI - Arachnoid cyst as a complication of ventricular shunting. AB - Overdrainage of cerebrospinal fluid (CSF) is a well-known complication of shunting procedures. Several clinical manifestations of excessive drainage of CSF have been documented, such as subdural hematoma, subdural effusions, slit ventricles, isolated IV ventricle, etc. To the authors' knowledge, this is the first report of an arachnoid cyst due to the excessive function of a VP shunt. PMID- 1764714 TI - [Insulitis--new findings on the role of genetic and external factors]. AB - The autoimmune process focused on B-cells of the islets of Langerhans and leading gradually to their destruction and the development of type I diabetes takes place under the morphological picture of insulitis. The disease affects genetically predisposed individuals. At the end of the eighties knowledge was greatly expanded due to methods of molecular genetics. The majority of authors assumes that in the pathogenesis of insulitis also environmental factors participate. More detailed information is provided on chemical compounds, nutritive substances and viruses. PMID- 1764715 TI - [Evaluation of the status of diabetes mellitus during a 2-year period using traditional methods and determination of glycosylated hemoglobin A1c and fructosamine in the blood]. AB - In the course of two years the authors checked 23 diabetic patients (13 type 2, 10 type 1), using the traditional approach, by assessment of haemoglobin A1c and serum fructosamine. The patients were classified according to compensation into four and three groups resp. Assessment of haemoglobin A1c evaluated the patients, in the same group as the traditional evaluation in 57.7% into the best compensated group and in 62.5% into the worst compensated group. In fructosamine agreement with traditional evaluation in the best compensated group was in 84.2% and in the worst compensated group in 50.0%. In 40.2% the evaluation was in agreement for all three methods of evaluation, differences between evaluation according to haemoglobin A1c and serum fructosamine were recorded in 51.5%. Assessment of haemoglobin A1c and serum fructosamine improves information on the state of diabetes, concurrent estimation of both is, however, often associated with difficulties as regards interpretation. These problems are discussed in the presented paper. PMID- 1764716 TI - [Favorable effects of oral steroidal contraceptives]. AB - In addition to preventing pregnancy which in the wider sense of the word implies prevention of all complications of gestation, incl. extrauterine pregnancy, the use of steroid contraceptives has a favourable effect on some other diseases which are not directly associated with gestation. The authors give an account of all diseases where the use of steroid contraceptives may act as a preventive factor as regards the incidence of these disease and/or their intensity. This action is frequently omitted in the professional and lay press. The authors also draw attention to the advantages of modern steroid contraceptives with a minimal dose of oestrogens and on gestagens of the third generation. PMID- 1764717 TI - [Pharmacotoxicologic characteristics of pentacaine]. AB - Long-term administration of pentacaine to experimental animals in investigations of chronic toxicities confirmed that this substance is relatively safe in amounts of 10 mg/kg/day. Larger doses caused ECG changes, as well as changes of some clinical and biochemical indicators and histopathological findings which were independent on the dose and sex. The embryotoxic and teratogenic action of pentacaine was manifested only after large doses in mice (more than 20 mg/kg). Doses under 10 mg/kg per day did not produce toxic effects in mother and foetus, whereby the substance penetrates through the placenta and is distributed in the maternal and foetal organs of rabbits in a proportionate way. From the in vitro action of pentacaine ensues that it has a strong stimulating action on isolated cells which gradually changes into cytotoxic action. The results support the decision not to use pentacaine for intravenous, infiltration and conduction anaesthesia and to recommend only its oral administration. PMID- 1764718 TI - [Relation between hepatic lipid metabolism and the formation of lipid plaques in the rabbit aorta in an experimental model of atherosclerosis]. AB - The objective of the work was to follow up on a model of experimental atherosclerosis induced in rabbits by a 1% cholesterol diet the mutual relationship of the deposition of total cholesterol as well as esterified and free fatty acids in the liver and the formation of lipid plaques in the rabbit aorta. The authors investigated also the influence exerted on this process by the s.c. administration of calcium antagonists--Verapamil 0.25 mg.kg-1.day-1 (Lek Ljubl., Jugoslavia), Dilthiazem 2 mg.kg-1.day-1 (Lachema CSFR) and Isradipine 2.5 mg.kg-1.day-1 (Isradipine--N Sandoz, Ltd, Switzerland). The interference of calcium antagonists with the lipid metabolism in the liver as well as the transport mechanism of lipids in the blood stream is differentiated. Verapamil administered in therapeutic doses promotes HDL-cholesterol formation and thus hastens the cholesterol transport from the blood stream into the liver where the latter cumulates. This may be one of the mechanisms of the antiatherogenic action of verapamil. On the other hand, isradipine and in particular dilthiazem administered in treble doses, as compared with therapeutic doses, slightly potentiated the formation of lipid plaques in the rabbit aorta and reduced the HDL-cholesterol level and thus also the cholesterol shift to the liver. PMID- 1764719 TI - [The effect of diltiazem on hemodynamic parameters in patients with liver cirrhosis]. AB - Previous investigations of authors abroad provided evidence of a reduction of portal pressure by blockers of slow calcium channels group II by verapamil. We decided to investigate the effect of a quite new preparation dilthiazem on the portal haemodynamics in patients with compensated cirrhosis of the liver and oesophageal varices. Doppler examinations of the width, rate of blood flow and flow through the trunk of the portal vein did not prove a statistically significant effect of dilthiazem on the investigated parameters. After the preparation a significant decline of the median pressure in the pulmonary artery was recorded at the 5% level of significance. The significantly elevated pressure values in the wedged position in the hepatic vein (WHVP) as well as of the portohepatic gradient (P-H) rose further after administration of the preparation (WHVP by 12.3%, p P-H by 15%). Even maximum doses of dilthiazem did not influence the portal flow in patients and did not lead to a reduction of the portohepatic gradient. From the results it is apparent that dilthiazem is not suitable for the treatment of portal hypertension. PMID- 1764720 TI - [Current therapeutic use of gamma globulin preparations]. AB - Non-specific intramuscular and especially intravenous immunoglobulins became an important part of the treatment of two different immunopathological states. They are used as substitution therapy in absolute or relative shortage of specific antibodies in primary humoral immunodeficiencies--especially various types of hypogammaglobulinemia, and secondary humoral immunodeficiencies--lymphatic system malignancies, serious septic states etc. The second indication area of intravenous immunoglobulins is based on the proved abilities of intravenous immunoglobulins to suppress the production of antibodies (and autoantibodies), and to block phagocytic cells. Intravenous gammaglobulin treatment is generally used in idiopathic thrombocytopenic purpura and Kawasaki disease. The results of the treatment of autoimmune diseases of connective tissue, hematological and nervous system diseases are also promising. Side-effects of treatment are not frequent, but anaphylactic reactions may be fatal. PMID- 1764721 TI - [Mucosal candidiasis]. AB - The authors demonstrate the case of a female patient with a prolonged mucosal form of candidosis caused by different biotypes of Candida albicans. Despite the fact the long-term and repeated treatment with Nizoral and transfer factor was applied, relapses of the disease developed. Marked improvement of clinical manifestations occurred only after a change of the dietary habits and long-term administration of immunomodulating agents. The authors discuss therapeutic and diagnostic aspects of the disease. PMID- 1764722 TI - [Anezka and Zdislava--2 Czech healers of the 13th century in the arts]. PMID- 1764723 TI - [Competition-based administration of the American grant system for research funds]. PMID- 1764724 TI - [Bohuslav Niederle, Czech surgeon]. PMID- 1764725 TI - Antigenic heterogeneity of the reticular meshwork in the white pulp of mouse spleen. AB - Monoclonal antibodies against cellular components of reticular meshworks were produced by immunizing rats with heterogeneous stromal-cell population of mouse spleen. Immunohistochemical screening selected two antibodies, WP-1 and RPSC-2. WP-1 proved to immunostain the meshwork of the B area densely, leaving the marginal zone unstained; it also reacted sparsely with the meshwork of the T-cell region. In contrast, RPSC-2 selectively immunostained the meshwork of the T region. Immuno-electron microscopy clearly visualized, for both antibodies, reaction products being deposited along the cytomembrane of the fibroblastic reticulum cells, along their abundant cytoplasmic processes that were densely intertwined with lymphocytes. Double immunostaining with RPSC-2 followed by WP-1 clearly divided the white pulp into the T and the B domains. The meshwork in the T-cell region proved to be immunostainable with both WP-1 and RPSC-2. Thus, the fibroblastic reticulum cells of the T- and the B-cell areas, while indistinguishable by routine microscopy, are at least partially heterogeneous. PMID- 1764726 TI - Immunocytochemical and immuno-electron-microscopical study of growth hormone cells in male and female rats of various ages. AB - Growth hormone (GH) secretory cells were identified by immunogold cytochemistry, and were classified on the basis of the size of secretory granules. Type I cells contained large secretory granules (250-350 nm in diameter). Type II cells contained the large secretory granules and small secretory granules (100-150 nm in diameter). Type III cells contained the small secretory granules. The percentages of each GH cell type changed with aging in male and female rats of the Wistar/Tw strain. Type I cells predominated throughout development; the proportion of type I cells was highest at 6 months of age, and decreased thereafter. The proportion of type II and type III cells decreased from 1 month to 6 months of age, but then increased at 12 and 18 months of age. The pituitary content of GH was highest at 6 months of age, and decreased thereafter. Estrogen and androgen, which are known to affect GH secretion, caused changes in the proportion of each GH cell type. The results suggest that when GH secretion is more active the proportion of type I GH cell increased, and when GH secretion is less active the proportion of type II and type III cells increased. The type III GH cell may therefore be an immature type of GH cell, and the type I cell the mature type of GH cell. Type II cells may be intermediate between type I and III cells. PMID- 1764727 TI - Distribution of actin-filament bundles in myoid cells, Sertoli cells, and tunica albuginea of rat and mouse testes. AB - Frozen sections of the rat and mouse testes were stained with either FITC phalloidin or NBD-phallacidin and viewed with conventional fluorescence and confocal laser microscopes in order to demonstrate the arrangement of actin filament bundles in myoid cells, Sertoli cells and tunica albuginea. Myoid cells are rich in actin-filament bundles crossing at right angles. These bundles running in different directions can also be visualized by means of electron microscopy. Nerve fibers occur in the vicinity of myoid cells, suggesting a neural control of the cell. At Sertoli cell junctions actin filaments occur at the circumference of the cell, where they show a honeycomb pattern. The ratio of the number of Sertoli cells per myoid cell can be calculated by means of confocal microscopy; this technique may provide a new parameter for determining spermatogenic activity. In the tunica albuginea of the juvenile mouse testis, actin filaments are arranged in an alternate fashion. PMID- 1764728 TI - Occluding junctions in the epithelia of the gut-associated lymphoid tissue (GALT) of the rabbit ileum and caecum. AB - The zonulae occludentes of the dome epithelia and adjacent non-dome epithelia in four locations of the gut-associated lymphoid tissue (GALT) in the rabbit ileum and caecum (Peyer's patches, sacculus rotundus, caecal lymphoid patches, appendix) were studied in freeze-fracture replicas. In all locations the zonulae occludentes of the dome epithelium are composed of more junctional strands than in the corresponding non-dome epithelium. In the dome epithelia of Peyer's and caecal lymphoid patches the zonulae occludentes show considerable structural variation; the number of superimposed strands is approximately 10 (range 5-18). In the dome epithelia of sacculus rotundus and appendix, in addition to zonulae occludentes, extended networks of junctional strands (fasciae occludentes) are present particularly between M-cells and enterocytes. The zonulae occludentes consist of approximately 8 to 9 (range 5-15) superimposed strands; the fasciae occludentes extend up to a depth of 20 microns on the lateral membranes. The presence of the fasciae occludentes correlates with the appearance of regularly shaped clusters of lymphocytes, which are most developed in the dome epithelia of sacculus rotundus and appendix. These results suggest (1) that in contrast to the dome epithelia of Peyer's and caecal lymphoid patches those of sacculus rotundus and appendix are compartmentalized, and (2) that the mobility of lymphocytes and diffusion of antigens in the dome epithelia of sacculus rotundus and appendix is restricted. PMID- 1764729 TI - Transient expression of a calcium-binding protein (spot 35-calbindin) and its mRNA in the immature pituicytes of embryonic rats. AB - Spot 35 protein is a Ca-binding protein originating from the rat cerebellum; it is now referred to spot 35-calbindin. This protein is expressed in immature pituicytes of the neurohypophyseal anlage in the E11-E18 rat embryo. The gene expression of spot 35-calbindin was detected by in-situ hybridization analysis only at stage E11-E12. Profiles of spot 35-positive nerve fibers of a neurosecretory nature were found in anlage at stage E16. At this stage, some immature pituicytes are partially immunopositive for spot 35-calbindin only in their peripheral cytoplasm; others are immunonegative. At birth and thereafter through adulthood, abundant nerve fibers are the sole structures immunoreactive for spot 35-calbindin; all the pituicytes are immunonegative, resulting in a light-microscopic appearance of numerous immunonegative round profiles, corresponding to pituicytes, and capillaries embedded in the granularly immunostained neurohypophysis. The present findings suggest that, during specific embryonic stages, immature pituicytes exert some as yet unidentified roles related to Ca-mediated functions involving the expression of spot 35-calbindin. PMID- 1764730 TI - Immunocytochemical analysis of the cytoskeleton of the human amniotic epithelium. AB - The amniotic epithelium constitutes a diffusion barrier controlling the passage of solutes and water between the amniotic cavity and maternal circulation. With the present immunocytochemical approach, we have shown that several major components of the cyto-skeleton, i.e., actin, alpha-actinin, spectrin and ezrin, are preferentially associated with the apical and lateral cell surfaces of the human amniotic epithelium. Keratins are distributed throughout the entire cytoplasm, whereas vimentin mainly forms a perinuclear scaffold. These findings indicate a role of the various components of the cytoskeleton in the structural integrity and modulation of cell shape and junctional permeability. PMID- 1764731 TI - Mating alters topography and content of oxytocin immunoreactivity in male mouse brain. AB - Sexual stimulation of males has been reported to affect hypothalamic oxytocinergic systems. In the present study we used radioimmunoassays of microdissected forebrain regions and immunocytochemical analysis of Vibratome sections to study the oxytocin systems of naive males, males killed after one mating, and males mated daily with different receptive females for 3 weeks. In males that had mated once, less oxytocin-immunoreactive neurons were observed in the paraventricular (PVN), supraoptic (SON) and periventricular (NPE) nuclei than in naive males. However, after repeated matings, the number of immunoreactive neurons and their staining intensity was increased in these regions. Furthermore, additional oxytocinergic neurons could be found in the lateral subcommissural nucleus, the zona incerta and the ansa lenticularis of repeatedly mated males. Oxytocin-immunoreactive neurons were only occasionally seen in these areas in unmated males or in animals that had been killed after initial mating. Radioimmunoassays of microdissected PVN, SON, NPE and the lateral hypothalamus confirmed the reduction in oxytocin-immunoreactive levels after a first mating by a male and the increase after repeated matings. It is likely that oxytocin secretion into peripheral and portal circulation is stimulated by the endocrine conditions associated with initial mating. These immediate effects may be followed by the activation of synthesis in oxytocin neurons in several sites of the basal forebrain. PMID- 1764732 TI - Angioplasty from the horizontal position. PMID- 1764733 TI - Morphological changes of coronary stenosis after repeated balloon angioplasties: a quantitative angiographic study. AB - To study the sequential changes of an atherosclerotic narrowing after repeated balloon dilatation, we reviewed the coronary angiograms of 11 patients who underwent at least 3 percutaneous transluminal coronary angioplasties of the same coronary segment for two restenoses. No significant changes in reference and stenosis diameters were found when comparing the three successive stenosis, but lesion length and stenosis area progressively increased. The identification of these morphological changes after repeated angioplasties may be of interest in the management of recurrent restenosis. PMID- 1764734 TI - Prognosis of culprit lesion PTCA in acute myocardial infarction for multi versus single vessel disease. AB - We studied 417 patients undergoing single vessel culprit lesion percutaneous transluminal coronary angioplasty (PTCA) for acute myocardial infarction to determine the impact of disease in other vessels. Group A (189 patients, 45%) had coronary artery disease (greater than or equal to 70% stenosis) in at least 1 additional vessel while Group B (228 patients, 55%) did not. The groups were similar in sex distribution (A = 75% male, B = 76%), number of lesions in the single culprit vessel dilated (1 lesion in 83% A, 80% B), and PTCA success (A = 92%, B-94%) (all p = NS). Group A patients were older (63 +/- 10 vs. 56 +/- 11 years) and had more prior myocardial infarctions (27% vs. 7%), and more prior coronary artery bypass grafting (15% vs. 0.4%) (all p less than .01). Group A patients were more likely to have repeat catheterization (48% vs. 32%, p less than .005) although restenosis of the infarct-related vessel was similar (A = 24%, B = 16%) (p = NS). Group A was more likely to need angioplasty in a 2nd vessel (23% vs. 8%) and to need coronary artery bypass grafting (20% vs. 8%) (both p less than .001). Cumulative mortality was higher in Group A at 1 month (10% vs. 5%), 1 year (11% vs. 6%), and long-term (13% vs. 7%). This difference appeared to be due to the impact of lower mean ejection fraction in Group A. CONCLUSION: Treatment of acute myocardial infarction by direct PTCA of the culprit lesion can be performed with a high likelihood of success in patients with or without multivessel coronary artery disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764735 TI - Elevated left atrial pressure does not cause left-to-right shunting after mitral balloon valvuloplasty. AB - To assess the hemodynamic factors affecting left-to-right shunting following balloon mitral valvuloplasty we studied 10 patients at 3 points during the procedure: pre-septal dilation, post-septal dilation pre-valvuloplasty, and post valvuloplasty. Hemodynamic parameters were recorded and an oximetry run was obtained at each stage. Mitral valvuloplasty was successful in 8 and unsuccessful in 2 patients. No patient had a significant oxygen step-up at any stage, including the 2 patients with unsuccessful valvuloplasty. Significant left-to right shunting through the atrial septal puncture in mitral valvuloplasty is infrequent, even before successful balloon valvuloplasty when left atrial pressure is maximally elevated. PMID- 1764736 TI - Contralateral femoral neuropathy: an unusual complication of anticoagulation following PTCA. AB - This case report describes the occurrence of femoral neuropathy secondary to a hematoma of the iliacus muscle. This unusual complication was a result of heparin therapy following Percutaneous Transluminal Coronary Angioplasty (PTCA). We have reviewed the anatomic correlates, mechanism, and treatment options of this condition. PMID- 1764737 TI - Angiographically documented thrombotic coronary artery occlusion secondary to mild nonpenetrating thoracic trauma. AB - A 22-yr-old man was found to have a subtotally occluding thrombus in the proximal left anterior descending (LAD) coronary artery shortly after suffering mild blunt chest trauma. After 6 days of anticoagulant therapy, the LAD appeared angiographically normal. PMID- 1764738 TI - Acute myocardial infarction after blunt chest trauma in young people: need for prompt intervention. AB - We describe four cases of acute myocardial infarction in young patients, secondary to blunt chest trauma. One case was treated with intracoronary thrombolysis and angioplasty, two cases received systemic thrombolysis, and the last one did not have any reperfusion therapy. The coronary angiograms of the left anterior descending artery showed thrombosis in two cases, coronary dissection in one case, and no morphological lesions in the other. We encourage the early performance of angiographic studies in these patients, adjusting the therapy to their pathophysiologic mechanism. PMID- 1764739 TI - Spontaneous coronary artery dissection in a young man with anterior myocardial infarction. AB - A case of spontaneous coronary artery dissection in a young male with subsequent myocardial infarction is reported. In addition, distal vessel occlusion is noted, presumably from embolization of thrombotic material originating from the site of dissection. Postulated mechanisms of this uncommon cause of myocardial infarction and subsequent therapeutic options are reviewed. PMID- 1764740 TI - Complete block below the His bundle induced by left-sided cardiac catheterization. AB - A patient with right bundle branch block and left anterior fascicular block developed complete heart block during passage of a catheter into the left ventricle. Intracardiac electrograms showed the block to be in the distal His Purkinje system. The block resolved without complications. PMID- 1764741 TI - Brachial approach directional coronary atherectomy of right coronary artery saphenous vein bypass grafts. AB - We describe here a technique for performing directional coronary atherectomy to right coronary artery saphenous vein bypass grafts from the brachial approach using a long introducer sheath system. This technique has the advantages of 1) avoiding femoral artery trauma and 2) ease of access into the bypass graft, avoiding occasional problems with guide catheter kinking or non-coaxial alignment. PMID- 1764742 TI - Urokinase infusion of chronically occluded femoropopliteal Gortex bypass grafts via the popliteal approach. AB - Thrombolysis of two occluded above-knee femoropopliteal Gortex bypass grafts utilizing the popliteal approach for catheter placement was successfully performed without complication. In both cases, the proximal anastomoses of the graft could not be identified. A percutaneous popliteal approach was used for catheter placement and delivery of urokinase. Angioplasty was performed on the unveiled stenoses that, presumptively, led to graft closure. Selective thrombolysis via catheter placed from popliteal approach is a new technique for recanalization of occluded femoropopliteal bypass grafts and warrants further investigation. PMID- 1764743 TI - An easy way to remove the Linx guidewire extension. PMID- 1764744 TI - Comparison of the hydrophilic guidewire in double- and single-wall entry needles: potential hazards. AB - Using an in vitro model, the potential hazard of using a new plastic-coated guidewire directly through both beveled, single-wall and nonbeveled, double-wall arterial puncture needles was assessed. Guidewire withdrawal directly through both types of needles resulted in either scraping and/or shearing of the plastic coating of the guidewire, leading to potential embolic debris. This problem was more significant when the guidewire was withdrawn through the beveled needle, in comparison to the nonbeveled type. Extreme caution should be used when using plastic-coated guidewires directly through metallic arterial entry needles. PMID- 1764745 TI - Interpretation of cardiac pathophysiology from pressure waveform analysis: the pulmonary valve. AB - Although an uncommon lesion, when pulmonary stenosis is considered, pulmonary artery and right ventricular pressures should be assessed simultaneously on two catheter pullback to appreciate the precise location of pulmonary-right ventricular pressure gradients. The case examples demonstrate that the peripheral pulmonic stenosis can mimic pulmonary valve stenosis and that pulmonary artery insufficiency may be difficult to delineate on pressure alone (as is often the case with the hemodynamics of aortic insufficiency). These hemodynamic tracings are complemented by the echocardiographic and angiographic characterization of pulmonic valve lesions. Conduction defects or ventricular hypertrophy can affect the right ventricular pressure tracing and either delay or increase the timing of pressure rise and decline depending on the conduction disturbance and abnormality of myocardial contraction. PMID- 1764746 TI - Thrombolysis by rotational thrombectomy followed by tissue plasminogen activator: evaluation by angioscopy. AB - Thrombus removal using percutaneous rotational thrombectomy (PRT), followed by tissue plasminogen activator (t-PA), was studied by contrast angiography and fiberoptic angioscopy in a canine femoral artery model of thrombosis. After thrombus induction and following each treatment, comparisons were made between angioscopy and angiography for the detection of thrombus and subintimal dissection. Angioscopic images were scored in a blinded fashion for lining, protruding, or occlusive thrombus (class 1,2, or 3) as well as estimated wall coverage by thrombus. Angiograms were studied for percent diameter stenosis and the presence of flaps. Following external forceps crush injury of 18 arteries, two hour occlusion, and injection of thrombin, mean angiographic stenosis was 66%, thrombus coverage by angioscopy was 81%, and mean angioscopy class was 2.5. Following PRT, stenosis decreased to 27% (p less than 0.008), thrombus coverage was reduced to 49% (p less than 0.02), and angioscopy class dropped to 2.0 (p less than 0.07). After t-PA treatment, these values were further reduced to 25% (p = NS), 26% (p less than 0.02), and 1.3 (p less than 0.008), respectively. In comparison to angiography, subintimal dissection (seen as flaps) and thrombus (lining, protruding, or occlusive) were present significantly more often by angioscopy (p less than 0.001). It is concluded that PRT results in significant thrombolysis, apparent by angiography and angioscopy. Follow-up t-PA can produce additional, incremental thrombolysis, apparent only by angioscopy. A beneficial role for t-PA following mechanical thrombolysis is suggested by this model. The superior sensitivity of angioscopy for detection of flaps and thrombus is underscored by this study. PMID- 1764747 TI - Transseptal left heart catheterization: usefulness of the intracavitary electrocardiogram in the localization of the fossa ovalis. AB - One of the major difficulties in left heart catheterization through the interatrial septum is to ensure that the Brockenbrough needle tip is correctly laid on the fossa ovalis floor (FOF), which is the only area where the puncture must be done. The difficulties may be enhanced in patients with atrial enlargement and subsequent distortion of the anatomical structures. In order to reduce the hazards of the septal puncture, an electrocardiographic mapping of the right atrial endocardium was performed using the Brockenbrough needle as an exploratory electrode in a group of 20 patients. When the tip of the needle was laid against the FOF, the endoatrial electrocardiogram (EAE) registered a slight or no injury curve, even when the pressure was tight enough to perforate the septum. On the contrary, the pressure on any other area of the muscular septum or atrial walls elicited a bizarre monophasic injury curve. The peculiar electrocardiographic response of the FOF to the pressure exerted by the Brockenbrough needle tip was a valuable aid to identify the area where the transseptal puncture must be done. In addition, the sudden changes in the P wave morphology immediately after the septal perforation, provided the first clue that the left atrium has been reached. PMID- 1764748 TI - New option for balloon recanalization of total coronary occlusions. AB - In 9 out of 12 patients with a total coronary occlusion but definite signs of viable myocardium a new approach for the recanalization procedure was successfully employed: Following recanalization using an on-the-wire 2.0 or 2.5 mm angioplasty catheter, a standard coronary guidewire was placed along the angioplasty catheter. After withdrawal of the catheter, over-the-wire angioplasty with an appropriately sized balloon was performed for final dilatation. Pending further studies in a larger patient population, this new method may offer an alternative approach for revascularization of total coronary occlusions. PMID- 1764749 TI - [Epidemiology of Rift Valley fever in west Africa. 1. Serological investigation of small ruminants in Niger]. AB - A serosurvey of Rift Valley Fever virus infection conducted among 557 sheep and 643 goats from Niger in 1986 points out that 2.8% of the 1,200 animals tested had RVF virus reacting antibodies. The circulation of the virus is demonstrated, as well for another phlebovirus related to RVF virus, the strain Arumowot. PMID- 1764750 TI - [Prevalence of antibodies to West Nile virus in youngsters from 5 to 20 years old in Madagascar]. AB - In 1990 a serological investigation among 3,177 children (5 to 20 years old) sera has been conducted by the Pasteur Institute of Madagascar in several areas of Madagascar, in order to evaluate the prevalence of West Nile virus antibodies. 29.9% out of human sera tested by ELISA for West Nile IgG antibodies are positive, that shows a rather high level of West Nile virus circulation in Madagascar. Prevalence is increasing with age but no significant difference has been registered among prevalence according to sex. The diffusion of the virus appears lighter in Central Highlands. PMID- 1764751 TI - [Evolution of the seroprevalence of HIV-1 and HIV-2 infections in the national hospital of Niamey, Niger]. AB - For 25,368 serologies examined in the biological laboratory of National Hospital of Niamey, Niger, from March 1987 to May 1990, the authors studied seroprevalence HIV1, HIV2 and HIV1 + HIV2 during this periode in the different groups studied: Blood donors, in women patients of child bearing age, pregnant women, prostitutes, prisoners and during systematic visits. It appears there is a tendancy of an increase in HIV1, a decrease in HIV2 and relative stability for the two profiles together. PMID- 1764753 TI - [Deep mycoses observed in New Caledonia. Evaluation of observations from the laboratory of pathologic anatomy of the Pasteur Institute of New Caledonia 1975 1990]. AB - All cases of deep mycotic diseases observed between 1975 and 1989 in the Laboratory of Anatomical Pathology at Noumea's Pasteur Institute have been studied retrospectively together with all available data concerning this pathology both in New Caledonia and the Pacific area. During the period under review, two cases of histoplasmosis, 4 of actinomycosis, 3 sporotrichosis, 5 mycetoma and 5 chromoblastomycosis were recorded in New Caledonia. Clinical and histological data appear to be identical to those observed in other Pacific Islands. Diagnosis is most usually supported only by histological examination and, thus, for future studies it is vital that specific mycologic culture of all cases be carried out. PMID- 1764752 TI - [Seroprevalence of HIV-1 infections in patients consulting the clinic for sexually transmitted diseases in Bangui, Central African Republic]. AB - 140 consecutive African, exclusively heterosexual, adult outpatients to the Clinique des Maladies Sexuellement Transmissibles, with genital ulcers or urethritis, were studied in order to determine the status for HIV1-infection and syphilis. Comparison with 194 age and sex matched subjects, without STD, were chosen as controls. In the "STD"'s population, the HIV1 seroprevalence was 17.8%, and anti-treponema antibodies were found in 30% of the cases. Patients with genital ulcer were associated with a higher HIV1 seroprevalence than patients with urethritis. The "STD"'s population in Bangui is at risk for HIV1-infection (risk ratio: 2.12), and constitutes probably a very sensitive group in Central Africa for the epidemiological survey to HIV infection, and for the estimation of the prevention against AIDS. PMID- 1764754 TI - [Clinical presentation of non-pernicious malaria attacks in patients hospitalized in Brazzaville (Congo) in 1989]. AB - The clinical manifestations observed in 102 malaria patients (parasitaemia of over 8,000 Plasmodium falciparum/mm3) hospitalized in 1989 in Brazzaville (Congo) were analyzed after ruling out the cases of pernicious malaria. The clinical picture was fever, stomach upset with headache and musculo-articular pain as in classical cases. In children these manifestations were frequently associated with convulsions. Diarrhoea was not uncommon in young children. Vomiting was frequent in both children and adults. Splenomegaly and hepatomegaly were closely related to age. In these subjects, chemoprophylaxis was rare in children, practically non existent in those aged over 5 years. However, presumptive treatment and self medication was usual regardless of age. PMID- 1764756 TI - [Urinary bilharziasis in Djidiouia: still nothing to report]. AB - The authors carried out 1043 urine examinations to look eggs of Schistosoma haematobium in Djidiouia, a known focus of urinary schistosomiasis. All these examinations were negative. However, the authors recommend vigilance because of the existence of Bulinus, the snail intermediate host in the area. PMID- 1764755 TI - [Malaria in the republic of Sao Tome and Principe. Epidemiologic evaluation and chemoresistance of P. falciparum]. AB - The authors report the results of a valuation of paludometric indices during mai 1990 in Democratic Sao Tome e Principe Republic (RDSTP). These investigations (parasitic index and spleen index) suggest that malaria is mesoendemic in these area. Plasmodium susceptibility to chloroquine at posology of 25 mg/kg per os was evaluated (WHO standard 7 days field test). Among 58 children, ranging from 5 to 11 years old, resistance at level R I was observed in 9% of cases, at level R II in 14%. Among 10 strains of P. falciparum, 9 were chloroquine resistant in vitro. 2 strains were also less sensible to quinine. PMID- 1764757 TI - [Myiasis of wounds of long-haired skin in two children in Tlemcen]. AB - Two children with a neglected scalp and sitting near a rubbish tip have seen ulcerations of the scalp appear in which are found fly larva of the Lucilia type. PMID- 1764758 TI - [Antivenom serotherapy: its applications, its limitations, its future]. AB - A hundred years after its discovery, authors review the antivenom therapy. Antivenom manufacture is described and antivenom therapy methods are presented. Indication of antivenom should be reserved to those who are really envenomed. Delay from the bite should not discredit antivenom therapy. Quantity of antivenom should depend on snake species, clinical features and evolution after treatment. Intravenous injections of antivenom should be strongly recommended as the most efficient. The future of antivenom therapy is emphasized. PMID- 1764759 TI - [Trial of halofantrine in the treatment of malaria attacks by Plasmodium falciparum in Dakar (Senegal)]. AB - Halofantrine has been given to 14 children and 15 adults suffering from an acute attack of P. falciparum malaria and living in Dakar (Senegal) to a total dose of 24 mg/kg/body weight for the first group and 1,500 mg for the second in 3 times at 6-hourly intervals. This treatment has allowed the fever to clear in all cases within 36.3 +/- 19.9 hours and headache to disappear at D3 in 93.1% of cases. A reduction by 93.6% of the average parasite density which amounted before treatment to 27,710 trophozoites/mm3 of blood has been recorded from the day following the beginning of treatment and the parasite clearance obtained in all the patients of whom had chloroquine-resistant P. falciparum strains in mean time of 58.0 +/- 14.7 hours. In 3 cases (10.7%) a recrudescence of parasitemia has been noticed in D14. Only 1 of them was treated again with halofantrine which proved efficient from D2. The only adverse reactions have been nausea, vomiting, a slight diarrhoea and dizziness which affected only 13.8% of the patients. No abnormality has been noticed at a biological level. These results confirm the efficacy and good tolerance of halofantrine and allow to list it among the resource drugs used for the treatment of chloroquine-resistant P. falciparum malaria in our area. PMID- 1764760 TI - New restoration and direct pulp capping systems using adhesive composite resin. AB - There have been many arguments on the irritating mechanisms of the composite resin on the dental pulp. While the direct irritative effect of the resin has been preferred, some authors considered that the marginal microleakage and the resulting bacterial infection play a more important role in inducing the complicating pulp irritation. We developed a new filling technique, called the direct inlay restoration method, which could prevent the marginal leakage associated with the polymerization shrinkage of the adhesive composite resin. In this study, we tried to apply our method clinically. None of the 440 cases which were filled with the adhesive composite resin and 60 cases out of 64 cases in which the pulps were directly capped with the adhesive composite resin developed any signs and symptoms of pulp irritation. The other 4 cases developed signs of pulp irritation. Two of those 4 cases were pulpectomized due to spontaneous pain and the other 2 cases turned out to be well after re-restoration. With the informed consent of the patients, the direct pulp capping using the adhesive composite resin was experimentally performed on 6 caries-free 3rd molars and the histopathological examination of these capped molars revealed that neither significant degenerative nor inflammatory changes were brought about in the dental pulp. These clinical and histopathological observation suggest that the dental pulp irritation after resin filling is not induced by the composite resin itself. PMID- 1764761 TI - Ultrastructural observation on matrix fibers in the condylar cartilage of the adult rat mandible. AB - In this study, ultrastructural and immunohistochemical studies were performed on the adult rat (15 weeks old) mandibular condyle, with particular attention to the matrix fibers in the condylar cartilage. The fibrous zone had thick collagen fibrils which formed fibril bundles. These collagen fibrils consisted mainly of Type I collagen. From the proliferative zone to the mature zone, the density of the collagen fibrils became higher. In the hypertrophic zone, thick collagen fibrils were formed around the chondrocytes. Immunohistochemical study indicated that these collagen fibrils consisted mainly of Type I collagen. Therefore, it was confirmed that the hypertrophic chondrocytes in this tissue had one of the osteoblastic phenotypes. PMID- 1764762 TI - Abnormal particle size of lipoprotein in non-insulin-dependent diabetics and nondiabetics with and without hyperlipidemia. AB - To clarify the mechanism of the high incidence of ischemic heart disease in the diabetics, we studied the particle size of the lipoprotein with particular attention to the structural abnormality. Using high performance liquid chromatography, the particle size of the lipoprotein was determined with elution volume, which was precisely correlated with the particle size. The particle size of low density lipoprotein (LDL) from the diabetics with normolipidemia is larger than that from the nondiabetics (p less than 0.001) in the elution pattern of triglyceride. The examination of the elution pattern of the triglyceride and cholesterol revealed that this large LDL was composed of a large amount of triglyceride. These characteristics of the large LDL resembled that of the atherogenic intermediate density lipoprotein. The particle size of high density lipoprotein (HDL) from the diabetics with normolipidemia was larger than that from the nondiabetic controls (p less than 0.001), detected by the elution pattern of triglyceride. The comparison of the triglyceride and cholesterol elution pattern indicated that also the large HDL in the diabetics with normolipidemia was rich with triglyceride, which was reported to inhibit the activity of the lipid transfer protein. These facts revealed that the disorder of the lipid metabolism not accompanied with hyperlipidemia produced the large LDL and HDL, which might lead to the excess mortality rate of the ischemic heart disease in the diabetics even with normolipidemia. PMID- 1764763 TI - New developments in in vivo models of neoplasia. PMID- 1764764 TI - Potential of the scid mouse as a host for human tumors. AB - Animal models of human tumors and their metastases that effectively mimic clinical disease are in considerable demand. While it is certainly true that athymic nude mice provide us with useful models to study a large number of human tumors in vivo, it is also well known that nude mice usually do not develop spontaneous metastases and are not suitable for all types of tumors. Therefore, the scid mouse that allows disseminated growths for a number of human tumors, particularly hematologic disorders and malignant melanoma, can be used preferentially for the investigation of such malignancies. The potential to study the interaction of human immune cells and human tumor in an in vivo model is another unique feature of scid mice that will add to their usefulness in experimental cancer research. PMID- 1764765 TI - Importance of orthotopic transplantation procedures in assessing the effects of transfected genes on human tumor growth and metastasis. AB - Assessment of the function of putative dominantly-acting oncogenes or recessive tumor-suppressor genes in human tumor development and progression must ultimately involve xenografting experiments using immune deficient animals such as nude mice. Most human tumor xenograft experiments have employed conventional subcutaneous injection procedures. However, despite the simplicity of this procedure, it poses some serious potential drawbacks as most types of human tumor will not readily grow or metastasize from a subcutaneous ('ectopic') site of injection. In contrast, 'orthotopic' injection procedures will often enhance the tumorigenic and/or metastatic ability of tumor cell populations. An example of this is summarized in the context of human malignant melanoma where the effects of subcutaneous versus subdermal injection are compared. Despite the seeming subtle and minor change in injection site, superior growth of human melanomas can be obtained by the latter, orthotopic-like, route of injection. It therefore follows that induction of tumorigenic or metastatic properties in a given human cell population by gene transfection may not be detected if the transfected cells are assayed in vivo only by subcutaneous injection procedures. An example of this is provided by experiments involving transfection of normal or mutated ras genes into a low-grade, well-differentiated human bladder carcinoma cell line, called RT-4. Thus overexpression of normal or mutated (valine 12) c-H-ras resulted in acquisition of a clinical-like invasive phenotype. However, this was clearly seen only if the cells were injected into the bladders (i.e. 'intravesically') of nude mice. In contrast, conventional subcutaneous injection of the high ras expressing transfected RT-4 cell lines did not reveal acquisition of invasive properties: all cell lines grew locally as well-encapsulated tumor masses. It is argued that similar orthotopic injection procedures should be employed when assessing the suppressive effects of various wild-type tumor-suppressor genes on human tumor growth in vivo. Utilization of subcutaneous injection procedures may grossly exaggerate the growth suppressive effects of such genes. This could explain the paradox of why, on the one hand, alterations involving many different genes (including different suppressor genes) appear to be involved in human carcinoma tumorigenesis while on the other hand, complete suppression of tumorigenicity can be caused by transfer of a single wild-type suppressor gene. Such complete suppressions might be observed only after ectopic (usually subcutaneous) injection procedures. PMID- 1764766 TI - Orthotopic implantation of human colon carcinomas into nude mice provides a valuable model for the biology and therapy of metastasis. AB - Human colon carcinomas (HCC) are heterogeneous for a variety of biological properties that include invasion and metastasis. The presence of a small subpopulation of cells with a highly metastatic phenotype has important clinical implications for diagnosis and therapy of cancer. For this reason, it is important to develop animal models for the selection and isolation of metastatic variants from human colon cancers and for testing the metastatic potential of these cells. We have implanted cells from more than 100 HCC (obtained from surgical specimens) into different organs of nude mice. Regardless of their malignant potential in the patient, the HCC did not metastasize unless they were implanted orthotopically. Only when they were injected into the cecum or spleen of nude mice did they yield hepatic metastases. These metastases consisted of highly metastatic cells. The invasive phenotype was influenced by the organ environment. HCC cells in the subcutis did not produce degradative enzymes and the cells did not metastasize. In contrast, HCC cells in the cecum did both. Collectively, the results demonstrate that the orthotopic implantation of HCC cells can yield metastatic subpopulations of cells suitable for the study of metastasis. PMID- 1764767 TI - Basement membrane and the SIKVAV laminin-derived peptide promote tumor growth and metastases. AB - Laminin, the major glycoprotein component of basement membrane, promotes the malignant phenotype. Cells which are adherent to laminin are more malignant than the non-adherent cells and in certain tumor cells, the number of laminin receptors is positively correlated with malignancy. Laminin also increases collagenase IV activity, an enzyme demonstrated to be critical for tumor spread. A site on laminin, containing the amino acid sequence SIKVAV, has been identified which when injected intravenously with B16F10 melanoma cells, causes an increase in the number of colonies on the surface of the lungs. This peptide does not affect tumor cell arrest in the vasculature or the immune system. It does promote angiogenesis in various in vitro and in vivo models, thereby facilitating tumor cell survival. When a complex mixture of laminin-enriched basement membrane components (Matrigel) is coinjected with tumor cells subcutaneously, tumor incidence and growth increases. Various tumor cell lines and primary isolates, which previously could not form tumors in mice, can be induced to grow rapidly in the presence of Matrigel. Slowly growing tumors or arrested tumors can also be induced to grow more quickly with additional injections of Matrigel. When an SIKVAV-containing synthetic peptide is coinjected with B16F10 tumor cells and Matrigel subcutaneously in mice, larger tumors are formed than that observed with either Matrigel or cells alone. Such studies define the role of laminin in tumor growth and spread and generate new models for studying therapeutic agents. Of particular interest is the ability to grow primary isolates which generally do not grow in mice. PMID- 1764768 TI - Tumor models in drug development. AB - In this short essay, we have taken the opportunity to review briefly the history of anticancer drug screening, consider the changes that have been made throughout that history, and reflect on the suitability of current screening practices and the models employed. A major change in emphasis in drug discovery has influenced the development and selection of new model tumor systems as well as screening practices. This new direction, a search for drugs that are selective for particular tumor histotypes, especially solid tumors, was stimulated by the paucity of drugs that have clinical solid tumor activity. The new approach to drug discovery and screening is in itself an experiment. Only time will tell if this approach is successful. PMID- 1764769 TI - Applications of hydrophilic disposable contact lenses as therapeutic bandages. AB - We employed Acuvue (Johnson & Johnson) and SeeQuence (Bausch & Lomb) disposable hydrophilic contact lenses for therapeutic purposes on 39 patients with varying pathology. Concomitant medial therapy was implemented where appropriate. The disposable bandage lens was associated with improved patient symptomatology and objective findings in the majority of cases; complications were infrequent. The disposable hydrophilic lens appears to be a reasonable alternative to traditional hydrophilic bandage lenses. PMID- 1764770 TI - Early deposition trends on group I (Polymacon and Tetrafilcon A) and group III (Bufilcon A) materials. AB - One of the problems with hydrophilic contact lenses is that they are susceptible to spoilage. This study investigated the degree of spoilage associate with lenses of various surface changes during the early stages of wear and the effect of surfactant cleaning of lenses at this stage. Ten patients wore a control HEMA lens on one eye and either an ionic (Bufilcon A) or non-ionic (Tetrafilcon A) lens on the other for one week and used a peroxide system for disinfection. The lenses were then replaced with identical lenses, which were also worn for 1 week, with surfactant cleaning added to the care regimen. The lenses then were examined by fluorescence spectroscopy in order that the extent of lipid and protein deposition could be assessed. The results indicate that protein accumulation is highly material dependent, whereas lipid deposition is primarily patient dependent. Also the term "ionic" does not necessarily indicate equally enhanced deposition in all lenses so termed. Surfactant cleaning appears to be of little benefit in reducing deposits during the early stages of wear, its benefit in the long-term being of much greater significance. PMID- 1764771 TI - The concentric distribution of protein on patient-worn hydrogel lenses. AB - We investigated the concentric distribution of protein on patient-worn hydrogel lenses. We measured patient-worn lenses for diameter, sagittal depth, and thickness so that the surface area of each lens could be calculated. The lenses were then cut with a circular blade to give an inner circular core and an outer concentric ring having approximately equal lens surface area. Total protein was then determined for each lens half using a modified ninhydrin procedure. The protein deposition on the inner core was compared to the amount on the outer ring for each of the four FDA lens groups. Lenses of group III and group IV were found to deposit significantly more protein on the outer portion while the other groups showed essentially the same amount on both halves. This finding indicates that the type of lens has an effect on the distribution pattern of protein. PMID- 1764772 TI - Microbial keratitis associated with plano tinted contact lenses. AB - The use of plano contact lenses for cosmetic purposes is a recent phenomenon. We report five cases of severe microbial keratitis associated with the use of these lenses. This subpopulation of patients who possess no refractive error are at risk of developing severe complications from contact lens wear. We have identified several issues which should be addressed by eye care professionals and regulatory agencies. PMID- 1764773 TI - Conrad Berens Lecture. Renewal of the corneal epithelium. PMID- 1764774 TI - Observations of tear film break up on model eyes. AB - Models of the human eye's anterior surface were constructed from polymethylmethacrylate. Some models had a rigid gas permeable contact lens cemented to the corneal apex; others had strips of plastic or metal cemented at the location of the lids in the open human eye. When the level of water was lowered in the bath surrounding the upward-gazing eye model, tear film break up could be observed. Covering the model with mucin (from saliva) changed the pattern of tear film break up. On the mucin-covered model eye, the tear film break up resembled break up observed in the human eye. These studies on model eyes suggest that tear film break up occurs when tension in the tear film becomes greater than the tensile strength of the film. The mucin layer reduces the thickness of the tear film at break up and the thickness of the retreating film. PMID- 1764775 TI - The bioavailability and therapeutic effectiveness of prednisolone acetate vs. prednisolone sodium phosphate: a 20-year review. AB - The superior bioavailability and therapeutic effect of prednisolone acetate over prednisolone sodium phosphate was described about 15 years ago. Review of the original articles and subsequent studies show that in clinical situations the two medications are probably equally effective. Further, patient compliance studies show that prednisolone sodium phosphate may actually be superior. PMID- 1764776 TI - Albuminuria and diabetic nephropathy: an evolving story. PMID- 1764777 TI - Carbohydrate-deficient transferrin in serum: a new marker of potentially harmful alcohol consumption reviewed. AB - During the last 16 years an increasing number of studies have indicated a new diagnostic marker of alcohol abuse, unrelated to any of the conventional markers of alcoholism. This marker, now called carbohydrate-deficient transferrin, consists mainly of one or two isoforms of transferrin that are deficient in their terminal trisaccharides. Such isoforms have so far been detected by methods based on charge, i.e., isoelectric focusing, chromatofocusing, and anion-exchange chromatography of various designs combined with immunological detection techniques. This transferrin abnormality measures an accumulated effect of alcohol consumption, appearing after regular intake of 50-80 g of ethanol/day for at least one week and normalizing slowly during abstinence (half-life = about 15 days). To summarize all studies to date, approximately 2500 individuals have been examined, with a total clinical sensitivity of 82% and a specificity of 97%. False-positive results have only occasionally been reported: in a few patients with severe liver disease, usually primary biliary cirrhosis and chronic active hepatitis; in patients with genetic D variants of transferrin; and in patients with (and some carriers of) a recently identified inborn error of glycoprotein metabolism. The mechanism behind the transferrin abnormality is unknown but an acetaldehyde-mediated inhibition of glycosyl transfer has been suggested. Carbohydrate-deficient transferrin may thus offer a new possibility of diagnosing alcohol-related disorders. Its measurement is little affected by other conditions and, contrary to conventional markers of alcohol abuse, is apparently largely independent of concomitant liver disease. PMID- 1764778 TI - Plasma neopterin as an adjunct to C-reactive protein in assessment of infection. AB - C-reactive protein (CRP) concentrations are increased in plasma in people with inflammatory conditions and bacterial infections. Plasma neopterin concentrations are increased in people with bacterial septicemias, viral infections, and graft vs host disease. Plasma concentrations of CRP and neopterin were measured daily in 21 bone-marrow transplant (BMT) patients, 64 patients in intensive-care units (ICU), and 12 patients with squamous cell carcinoma of the head and neck (HN). In the BMT patients, plasma neopterin measurements in addition to CRP measurements allowed infectious episodes to be distinguished from graft vs host disease. In the ICU patients, increased concentrations of CRP were not specific for infection and the additional plasma neopterin measurements did not improve this specificity. In all three patient groups, the derivation of a neopterin/CRP ratio was of no clinical use. These three groups of patients showed patterns of CRP and neopterin concentrations characteristic of their underlying diseases, the BMT patients with the immunological activation of graft vs host disease showed predominantly increased concentrations of plasma neopterin, ICU patients with infectious and inflammatory conditions had increased concentrations of both CRP and neopterin in plasma, and the HN group with localized inflammation showed increased plasma concentrations of CRP without increases in neopterin. PMID- 1764779 TI - Serum catalase: reversibly formed charge isoform of erythrocyte catalase. AB - The different electrophoretic mobilities of erythrocyte and serum catalase (EC 1.11.1.6) were confirmed and the causes responsible for their differences were examined. The presence of a catalase-binding protein in serum that could form a complex with erythrocyte catalase was excluded by incubating serum proteins with erythrocyte catalase. No new unequivocal catalase bands representing a catalase binding protein were detected. The erythrocyte and serum catalase proved to be charge isoforms: their molecular masses, estimated by gel permeation chromatography or polyacrylamide gel electrophoresis in a nondenaturing system, were very similar, whereas their electrophoretic mobilities were different. Assay of serum catalase by gel permeation and hydrophobic chromatography yielded a product with the same electrophoretic mobility as that of erythrocyte catalase. Different dilution of erythrocyte catalase with human sera led to a gradual decrease of its mobility, 20-fold or greater dilution yielding the same results as for serum catalase. Similarly, when serum catalase was diluted 20-fold or more with 60 mmol/L phosphate buffer, it migrated similarly to erythrocyte catalase. I detected no effect of dialyzable serum ligands, NADPH, or protection of SH groups on the electrophoretic mobility of either catalase isoform. I conclude that formation of charge isoforms of catalase is caused by a reversible, conformational modification due to matrix effect of serum. PMID- 1764780 TI - Borderline increases in albumin excretion rate and the relation to glycemic control in subjects with type I diabetes. AB - We evaluated "borderline" increases in overnight albumin excretion rates (AERs)-- -i.e., those between the upper 95th percentile of normal (7.6 micrograms/min) and the lowest value currently considered predictive of nephropathy (30 micrograms/min)----to determine their importance and to see whether glucose control influenced subsequent changes in the "borderline" AER values. Between 1985 and 1990, we studied 190 subjects with insulin-dependent diabetes mellitus (Type I), analyzing a mean of 6.5 timed overnight urine samples collected per subject. Above-normal AERs were associated with a significantly (by ANOVA) higher mean age (P = 0.03), longer duration of diabetes (P = 0.0002), and greater mean glycohemoglobin values (P = 0.002). The transition rate between borderline and abnormal AERs was significantly higher (P less than 0.0001, chi-square test) than the direct transition rate between normal and abnormal AERs, thus showing the borderline AER to be a definite intermediate stage. Good and poor glucose control were clearly associated with improvement and worsening, respectively, of the borderline AER values (P = 0.032, chi-square test of trend). More attention to borderline AER values is clearly indicated. PMID- 1764781 TI - Factors influencing the accuracy of the national reference system total cholesterol reference method. AB - Previous comparisons between the Reference and Definitive Methods for measuring serum cholesterol have demonstrated a small but persistent positive bias in the Reference Method, averaging about +1.6%. Here we describe the results of further investigations designed to better characterize the nature of this bias. Analysis of a well-characterized model serum sample (SRM 909) suggests that more than half of the difference in cholesterol values determined by the two methods is the result of small contributions from cholesterol precursor sterols and phytosterols, which are also measured for the Reference Method. An additional significant contribution may be from cholesterol oxidation products, particularly 7-hydroxycholesterol isomers, which are active in the Liebermann-Burchard reaction. The 7-hydroxycholesterol in SRM 909, most of which appeared to be already present in the serum rather than formed during saponification, may account for as much as 20% of the observed difference between the methods. Contributions from other possible sources, including impurities in the cholesterol standard and incomplete saponification of cholesteryl esters, are very small. Because the observed bias is both quite small and consistent among samples, the cholesterol Reference Method continues to meet all of the requirements generally expected for a dependable and effective Reference Method. PMID- 1764782 TI - 31P nuclear magnetic resonance and zero-point titration compared for measuring free magnesium concentration in erythrocytes. AB - Intracellular ionized magnesium concentrations ([Mg2+]i) were measured in erythrocytes by 31P nuclear magnetic resonance (NMR) and zero-point titration in 14 controls and seven patients with renal magnesium loss. The mean intracellular ionized magnesium concentration in controls measured by 31P NMR was 0.20 (SD 0.03) mmol/L cell water, compared with 0.55 (SD 0.12) mmol/L cell water by zero point titration. Total erythrocyte magnesium content measured with the lysate method was 0.63 mmol/L cell water higher than estimated by 31P NMR, probably because not all magnesium complexes are fully visible to the NMR technique. We found a positive correlation between plasma ultrafiltrable magnesium and [Mg2+]i irrespective of the [Mg2+]i assay used. [Mg2+]i measured with 31P NMR correlated modestly but significantly with [Mg2+]i determined by zero-point titration (r = 0.58, P less than 0.02). Washing erythrocytes before the zero-point titration decreased the ATP content and the cell water fraction, which led to overestimation of [Mg2+]i by zero-point titration. Although absolute values for [Mg2+]i differ with the assay used, both methods determined significantly lower values for [Mg2+]i in patients with isolated renal magnesium loss. PMID- 1764783 TI - Novel method for quantifying alpha(1----3)-L-fucosyltransferase activity in serum. AB - A novel method has been developed to quantify alpha(1----3)-L-fucosyltransferase activity in human sera by applying a sandwich-type immunoradiometric assay. H type 2 trisaccharide (6Fuc alpha 1----2Gal beta 1----4GlcNAc) covalently attached to bovine serum albumin (BSA) was used as an acceptor and incubated with serum samples in the presence of guanosine diphosphate-fucose. The resulting product, Y tetrasaccharide (Fuc alpha 1----2Gal beta 1----4[Fuc alpha 1----3] GlcNAc beta BSA), was detected by a sequential use of anti-BSA antibody-coated bead and 125I labeled anti-Y antibody. Inter- and intra-assay CVs for alpha(1----3)-L fucosyltransferase were both less than 4%, and the results of the dilution linearity and analytical recovery studies were satisfactory. Using the present assay method, we measured alpha(1----3)-L-fucosyltransferase in serum from patients with benign and malignant gastric disorders and in healthy subjects. The detection rate of alpha(1----3)-L-fucosyltransferase for cancer was apparently higher than that of carcinoembryonic antigen measured in the same samples, particularly in the early clinical stage; indeed, no correlation was observed between the concentrations of the two potential markers. The results indicate that the present assay method seems to be excellent for the determination of serum alpha(1----3)-L-fucosyltransferase activity and useful for the detection of cancer-associated increases of the enzyme activity at the early stage of gastric cancer. PMID- 1764784 TI - Dual-label time-resolved fluoroimmunoassay for simultaneous detection of myoglobin and carbonic anhydrase III in serum. AB - We developed a dual-labeled time-resolved fluoroimmunoassay for simultaneous quantification of myoglobin (Mb) and carbonic anhydrase III (CA III) in serum involving polyclonal antibodies and the fluorescent lanthanides europium (Eu3+) and samarium (Sm3+). This solid-phase immunoassay is based on competition between Eu(3+)- or Sm(3+)-labeled antigen and the sample antigen for polyclonal rabbit antibodies. Standards and patients' samples containing antigen inhibit binding of the lanthanide-labeled antigen to the antibody. A second antibody directed against rabbit IgG is coated on a solid phase and binds the IgG-antigen lanthanide complex, giving rapid and complete separation of antibody-bound and free antigen. The assay requires only one incubation step. An enhancement solution dissociates Eu3+ and Sm3+ ions from the labeled CA III and Mb, respectively, into a solution where they form highly fluorescent chelates. Spectra of the fluorescent chelates in the microtitration-strip wells were run on a time-resolved fluorometer equipped with filters for Eu3+ (613 nm) and Sm3+ (643 nm), the fluorescence from each sample being inversely proportional to the concentration of antigens. The measurement range for both analytes is from 5 to 1500 micrograms/L. The mean within- and between-assay precisions (CV) were 4.6% and 6.2% for CA III and 5.9% and 7.3% for Mb, respectively. Good correlations were obtained with the results of CA III RIA and a commercial myoglobin RIA kit. PMID- 1764785 TI - Alterations of serum lipids in breast cancer: effects of disease activity, treatment, and hormonal factors. AB - Fasting venous blood collected from 83 patients with breast cancer was analyzed for triglycerides; total, high-density lipoprotein (HDL), and low-density lipoprotein (LDL) cholesterol; tumor necrosis factor (TNF alpha); glucose; creatinine; insulin; glucagon; growth hormone; cortisol; and thyrotropin. Patients with stage IV disease had significantly higher (P less than 0.05) triglyceride concentrations and significantly lower (P less than 0.05) concentrations of total and HDL cholesterol than did patients with less advanced disease or age-matched controls. Furthermore, LDL cholesterol concentrations in patients with boney metastases were significantly lower (P less than 0.05) than concentrations in patients with liver or liver plus boney metastases or in controls. These results could not be attributed to smoking habits, alcohol consumption, or treatment. We observed no correlations between serum concentrations of lipid and concentrations of TNF alpha, insulin, glucose, creatinine, cortisol, growth hormone, or thyrotropin. However, there was a significant (P less than 0.05) negative correlation between total cholesterol and glucagon and between LDL cholesterol and glucagon for patients with stage II, III, and IV disease, suggesting that glucagon may reduce LDL cholesterol concentrations by an as-yet-unidentified mechanism. PMID- 1764786 TI - Free thyroxin measured in dried blood spots from normal, low-birth-weight, and hypothyroid neonates. AB - We have adapted a new radioimmunoassay for free thyroxin (FT4) measurement in dried blood spots for use in neonatal screening for hypothyroidism. The method is easy, fast, and cheap. Within-assay and between-assay CVs are respectively 9.6% and 13.2%. In 997 neonates three days postpartum with normal thyrotropin concentrations, the mean FT4 concentration was 27.2 pmol/L (SD 7.3 pmol/L). There was no significant difference in mean FT4 concentration between boys and girls. FT4 concentrations increased linearly with birth weight or with gestational age, as expressed by multiple linear regression: FT4 (pmol/L) = 0.0016 birth weight (g) + 0.6931 gestational age (weeks) - 4.8772. Only gestational age significantly affected the FT4 value. For five hypothyroid infants tested on day three postpartum, FT4 values were all below the 1st percentile of values from healthy neonates. Thus, when the neonatal concentration of thyrotropin is above normal, FT4 measured in the same sample can provide a reliable earlier diagnosis of hypothyroidism. PMID- 1764787 TI - Determination of erythrocytic polyamines by reversed-phase liquid chromatography. AB - A simple and rapid semiautomated procedure for determining polyamines in erythrocytes by high-performance liquid chromatography is described. Putrescine, spermidine, and spermine are converted to fluorescent dansyl derivatives, extracted with cyclohexane, and separated in less than 10 min on a reversed-phase C18 ODS column, with an acetonitrile-water gradient as the mobile phase. The method showed a coefficient of variation of 2.73% for spermidine and 3.27% for spermine. The respective reference values, evaluated in 10 healthy patients, were 7.88 (SD 2.09) and 5.42 (SD 1.55) mumol/L of packed erythrocytes. Only negligible amounts of putrescine were found. PMID- 1764788 TI - Considerations when measuring urinary albumin: precision, substances that may interfere, and conditions for sample storage. AB - The measurement of small but abnormal amounts of albumin in urine is important in evaluating kidney disease in people with diabetes mellitus, hypertension, or possible adverse health effects from exposure to nephrotoxins. Routine laboratory methods for measuring albumin are not sensitive enough to measure the amounts that are significant in urine (less than 30 mg/L). In our laboratory we used three immunoassays for measuring urinary albumin: enzyme-linked immunosorbent assay (EIA), radioimmunoassay (RIA), and immunoturbidimetric assay (IT). We calculated the CVs of the three methods, investigated potential interfering substances at three times their normal concentrations, and stored urine under different conditions to find the best way to protect the sample until assay. The potential interferents we checked were transferrin, urea, beta 2-microglobulin, retinol-binding protein, creatinine, kappa and lambda light chains, IgG, hemoglobin, ketone, and glucose. The stability study involved two study temperatures (-20 and -70 degrees C) and four treatments (centrifuging or filtering, before or after storage). We found the following: the RIA had the lowest CV; the results from the interference study showed no interference from normal physiological concentrations of the substances investigated; storage at 70 degrees C regardless of the treatment should be adequate to prevent loss of albumin immunoreactivity. PMID- 1764789 TI - Emergency toxicology testing (detection, confirmation, and quantification) of basic drugs in serum by liquid chromatography with photodiode array detection. AB - We investigated the applicability of liquid chromatography with photodiode array detection as a serum drug screening technique in an emergency toxicology setting. Basic compounds are extracted from alkalinized serum with hexane and chromatographed on a cyanopropyl reversed-phase column. The photodiode array detector records the ultraviolet spectrum of each eluting peak for identification and quantification. More than 30 drugs/metabolites including antidepressants, antihistamines, phenothiazines, and analgesics are detected at their therapeutic concentrations or less. Quantitative run-to-run precision (CV) for antidepressant drugs at low therapeutic concentrations is less than 6%. We evaluated the potential for interference of greater than 140 compounds of clinical interest. In a split-sample study, 151 of 154 positive drug findings by the method were confirmed by alternative techniques (gas chromatography/mass spectrometry and liquid chromatography with either normal-phase or reversed-phase columns). In the three unconfirmed findings, this method detected drugs at concentrations below the limit of identification of the comparison method. Also, 275 samples judged negative by this procedure were negative by a different liquid-chromatographic method. PMID- 1764790 TI - Analytical performance of EMIT cyclosporine assay evaluated. AB - We evaluated the EMIT Cyclosporine Assay (Syva Co., Palo Alto, CA), using the Cobas-Mira analyzer to assess the precision, accuracy, and analytical recovery from whole-blood samples supplemented with cyclosporine. We also performed comparative analysis of whole-blood samples containing cyclosporine from liver and kidney transplant patients by using EMIT, HPLC, and RIA (IncStar Cyclo-Trac, SP assay). Before assay by EMIT or RIA, cyclosporine was extracted from whole blood with methanol. For the HPLC method, whole blood containing cyclosporine was hemolyzed with 300 mL/L acetonitrile in water; cyclosporine was extracted from the hemolysate with acetonitrile. The within-run and between-run CVs for the EMIT assay of cyclospoprine were 9.9% (means = 72.6, SD = 7.2 micrograms/L; n = 20) and 13.5% (means = 75.0, SD = 10.1 micrograms/L; n = 26) for the low control; 3.5% (means = 194.7, SD = 6.8 micrograms/L; n = 20) and 8.1% (means = 189.0, SD = 15.3 micrograms/L; n = 26) for the medium control; and 7.0% (means = 332.5, SD = 23.3 micrograms/L; n = 20) and 7.1% (means = 340.0, SD = 24.2 micrograms/L; n = 24) for the high control (Bio-Rad, whole-blood controls). Analytical recovery of cyclosporine from drug-supplemented samples averaged 99% for EMIT, 104% for HPLC, and 90% for RIA over a concentration range of 50-500 micrograms/L. Analysis of 196 specimens by HPLC (x) vs EMIT (y) gave the following regression statistics: y = 1.27x + 16.44; IncStar's RIA (x') vs EMIT: y = 1.12x' - 2.50; HPLC vs RIA: x' = 1.10x + 23.87. PMID- 1764791 TI - Measurement of porphobilinogen in urine by a simple resin method with use of a surrogate standard. AB - In this method for urinary porphobilinogen (PBG), urine is added to Bio-Rad AG1 X2 (200-400 mesh) acetate resin under alkaline conditions and mixed. After two water washes, the adsorbed PBG is eluted with acid and reacted with Ehrlich's reagent (p-dimethylaminobenzaldehyde). Quantification is by comparison of the color developed with that of a PBG standard similarly treated or of a calibrated methyl red solution. The precision of assay of PBG at 20 and 50 mumol/L is 1.4% and 0.9% within-batch and 4% and 3.9% between-batch, respectively. The analytical recovery is about 90%, a proportion that appears to be inherent in the resin method. The proposed method (y) agreed well with the method of Mauzerall and Granick (x; J Biol Chem 1956;19:435-46), yielding the regression equation y = 0.957x + 2.9 (r = 0.993, n = 26). Good agreement was achieved with results determined from the PBG and the methyl red standards. The proposed method is inexpensive, simple to perform, and suitable for routine and emergency use. PMID- 1764792 TI - PCR-based method to create a specific mutation as a reference for oligomelting. PMID- 1764793 TI - Frequencies of immunoglobulin classes involved in monoclonal gammopathies in Guadeloupe. PMID- 1764794 TI - Effect of protein concentration on the formation of glycated albumin and fructosamine. PMID- 1764795 TI - Accuracy, precision, and interferences of three modified EMIT procedures for determining serum phenobarbital, urine morphine, and urine cocaine metabolite with a Cobas-Fara. PMID- 1764796 TI - Stability of phencyclidine and amphetamines in urine specimens. PMID- 1764797 TI - Simple, rapid detection of PCR heteroduplexes in DNA mutations and polymorphisms. PMID- 1764798 TI - Clinical chemistry in New York at the founding of the AACC: recollection and remembrance. PMID- 1764799 TI - Interference in assay of free triiodothyronine by triiodothyronine-binding antibodies. PMID- 1764800 TI - Specific measurement of cyclosporine concentrations in whole blood: radioimmunoassay and fluorescence polarization immunoassay compared. PMID- 1764801 TI - Sensitive, selective, and rapid procedure for quantifying cocaine in urine. PMID- 1764802 TI - Increased estradiol concentration of unknown origin. PMID- 1764803 TI - False-positive titers of thyroid autoantibodies in patients undergoing hemodialysis? PMID- 1764804 TI - Interferences with determination of 17-hydroxyprogesterone in amniotic fluid. PMID- 1764805 TI - Prognostic value of rate of decline of creatinine kinase and MB-isoenzyme activity after acute myocardial infarction. PMID- 1764806 TI - Usefulness of thromboxane B2 in diagnosis of renal transplant rejection. PMID- 1764807 TI - Simplified assay of galactose-1-phosphate uridyltransferase. PMID- 1764808 TI - Derived quantities in clinical chemistry: further need for improved performance. PMID- 1764809 TI - Passive inhalation of cocaine. PMID- 1764810 TI - Storage of methane breath-test samples in plastic syringes. PMID- 1764811 TI - Non-adrenergic, non-cholinergic neural control of the airways. AB - 1. In addition to the classical cholinergic bronchoconstrictor and adrenergic bronchodilator neural mechanisms, there is a large volume of evidence to suggest the existence of neural pathways within the airways of a variety of species which are neither adrenergic nor cholinergic, the non-adrenergic, non-cholinergic (NANC) mechanisms. With respect to airway smooth muscle tone, NANC neural responses may induce either contraction (excitatory, e-NANC) or relaxation (inhibitory, i-NANC). Early investigations of NANC mechanisms in both human and other animal airways suggested a role for neuropeptides as the putative neurotransmitters. 2. Excitatory NANC (e-NANC) bronchoconstrictor responses are believed to be mediated by the release of sensory neuropeptides from a subpopulation of non-myelinated C-fibre primary afferent neurones in the airways. e-NANC nerves, which release tachykinins such as substance P (SP), neurokinin A (NKA) and the peptide calcitonin gene-related peptide (CGRP, produced as a result of alternative splicing of the calcitonin gene) are selectively degenerated by the nerve toxin capsaicin (an extract from hot peppers), with the subsequent abolition of the e-NANC responses. Tachykinin receptors have been detected by radio-ligand receptor binding studies and visualized by autoradiographic mapping, and exogenous addition of these peptides elicits a bronchoconstrictor response in both human and other animal airways. In addition to these effects on airway smooth muscle tone, tachykinins produce an increase in microvascular permeability (and associated oedema formation), mucus hypersecretion and cause an exaggerated cholinergic bronchoconstrictor response. Thus, tachykinins may play a role in the inflammatory process and contribute to the neurogenic inflammation as seen in asthma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764812 TI - Effect of long-term treatment with an angiotensin-converting enzyme inhibitor on the renin-angiotensin system in spontaneously hypertensive rats. AB - 1. To obtain information on regulation of the brain renin-angiotensin system, the effect of long-term administration of angiotensin-converting enzyme (ACE) inhibitor on brain renin and angiotensinogen mRNA was studied. 2. Spirapril (3 mg/kg) was orally administered daily for 8 weeks to spontaneously hypertensive rats (SHR) from 12 weeks after birth. Renin and angiotensinogen mRNA in the brain and kidney were then quantitated by Northern blot analyses with [32P]-labelled rat renin and angiotensinogen cDNA as hybridization probes. Plasma renin activity (PRA), angiotensin II (AII) concentration, plasma ACE activity and brain tissue ACE activity were also measured. 3. Compared with the control group, the Spirapril-treated group had significantly lower blood pressure (P less than 0.01), significantly higher PRA (P less than 0.01), a not significantly different plasma AII concentration, and lower plasma and brain ACE activities (P less than 0.01). Interestingly, the brain renin and angiotensinogen mRNA levels of the two groups were similar, but the renal renin mRNA level was significantly higher in the Spirapril-treated group (P less than 0.01). 4. These results indicate that the mRNA levels of brain renin and angiotensinogen were not affected by chronic ACE inhibition in the circulation and suggest that AII in the brain might not be affected by systemic ACE inhibition. PMID- 1764813 TI - A comparison of the anticonvulsant effects of propofol and thiopentone against pentylenetetrazol-induced convulsions in the rat. AB - 1. The anticonvulsant effects of subanaesthetic doses of propofol and thiopentone against PTZ-induced seizures and mortality were examined in the rat. 2. Administration of propofol (50 mg/kg, i.p.) 5 min prior to PTZ treatment increased the 2 h CD50 and the 24 h LD50 of PTZ by 3.4-fold, whereas thiopentone pretreatment (20 mg/kg, i.p.) increased these values by more than five-fold. 3. Both propofol and thiopentone prolonged the latency to the onset of clonic seizure but the effects of the former were more marked. 4. The data demonstrate that propofol was more effective than thiopentone in providing complete protection against PTZ-induced seizures for the first 30-40 min of observation and that thiopentone, because of its sustained effects, was more effective in reducing the cumulative incidence of seizures and mortality over 2 and 24 h, respectively. 5. We conclude that propofol is a very effective anticonvulsant and provides complete protection of short duration against PTZ-induced seizures in the rat. PMID- 1764814 TI - Acute effects of exercise on plasma lipids, noradrenaline levels and plasma volume. AB - 1. Total plasma cholesterol, high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), noradrenaline, haematocrit, haemoglobin and heart rate were measured in blood sampled from an antecubital vein in nine volunteers after 1 min standing and at intervals up to 1 h following 5 min of vigorous bicycle exercise. 2. Heart rates and plasma noradrenaline levels rose substantially immediately following exercise and gradually returned toward baseline levels 60 min post-exercise. 3. Total plasma cholesterol levels rose by 24% immediately post-exercise and slowly returned to baseline levels 60 min post exercise. Similar changes were observed for LDL-C (20.2%) and HDL-C (27.7%). As a result, LDL:HDL ratios did not alter. 4. These changes in total plasma cholesterol, HDL-C and LDL-C were explained by changes in plasma volume that occurred as a consequence of vigorous exercise. 5. Changes in plasma volume may be a mechanism by which some environmental factors such as stress are associated with elevated plasma cholesterol levels. PMID- 1764816 TI - Effects of clonidine on blood pressure and heart rate responses to an emotional stress in the rat: a spectral study. AB - 1. The fluctuations that underlie the spontaneous variability of blood pressure (BP) and heart rate (HR) were investigated in conscious normotensive rats using power spectral analysis. 2. Air jet stimulation determined a significant BP rise associated with a tachycardia. This environmental mild stressor amplified the 195 605 mHz oscillations of HR which are under autonomic control. No habituation to this stressor was observed since a second stimulation determined similar responses. 3. Clonidine (10 micrograms/kg, i.v.) prevented the BP rise normally associated with air jet stimulation. In addition, clonidine dramatically reduced the amplitude of BP and HR oscillations in the frequency region of 195-605 mHz. 4. It is concluded that a mild emotional stressor elicits in normotensive rats a rise in BP and HR associated with modified spectral profiles reflecting sympathetic hyperactivity. Clonidine minored the effects of stress on BP and HR variability and also prevented BP elevation. PMID- 1764815 TI - Stress in mice increases intrinsic pentobarbitone sensitivity by a predominantly pharmacodynamic mechanism. AB - 1. Mice were swum for 3 min at room temperature. 2. After this stress 'sleeping time' in response to pentobarbitone was increased by over 70%. 3. Loss of 'righting reflex' occurred in these stressed animals at brain concentrations of pentobarbitone which were 40% lower than those needed for 'sleep' in the unstressed mice, indicating a true increase in sensitivity to the drug. 'Waking' (the return of the righting reflex) occurred at identical levels in both groups. 4. Kinetic analysis showed that the rates of absorption, elimination and transfer between plasma and brain were slower in the swum than in the unswum mice, probably because of the reduced body temperatures produced by the swimming. PMID- 1764817 TI - Vasopressin response to haemorrhage in rats: effect of hypoxia and water restriction. AB - 1. The aim of the present study was to determine the effect of water restriction and/or hypoxia on the vasopressin response to haemorrhage in conscious rats. 2. Male, Long-Evans rats (n = 39) were prepared with chronically indwelling femoral artery and vein catheters and exposed to 24 h of one of the following: normoxia with ad lib drinking water (N + W); normoxia with water restriction (N - W); hypoxia with ad lib drinking water (H + W); and hypoxia with water restriction (H - W). At the end of 24 h, a 15 mL/kg arterial haemorrhage was performed. 3. Water restricted rats had elevated pre-haemorrhage vasopressin levels. Haemorrhage induced an increase in vasopressin in all groups. Water restriction (N - W) or hypoxia (H + W) each augmented the vasopressin response to haemorrhage. However, the combination of hypoxia and water restriction (H - W) failed to augment the vasopressin response to haemorrhage as compared to normoxic, water replete (N + W) rats. 4. Hypoxia or water restriction per se augment the vasopressin response to haemorrhage. This augmented vasopressin response to haemorrhage is not maintained when hypoxia and water restriction are combined. PMID- 1764819 TI - Thrombolytic therapy of myocardial infarction--it's time for science, not marketing: the perspective of a practicing cardiologist. PMID- 1764818 TI - Decreased conversion of big endothelin-1 to endothelin-1 in patients with diabetes mellitus. PMID- 1764820 TI - Coronary stenosis after successful angioplasty: clinical observations. PMID- 1764821 TI - Role of lipoprotein peroxidation in the pathogenesis of atherosclerosis. AB - Oxidative modification of low-density lipoprotein (LDL) has been shown to alter its properties in a way that tends to increase its atherogenicity. Cultured arterial endothelial cells and smooth muscle cells can promote LDL oxidation in vitro. Several recent studies have provided evidence for the presence of oxidized LDL in atherosclerotic lesions. Furthermore, treatment of atherosclerosis-prone rabbits with an antioxidant was found to slow the progression of aortic lesions. Additional experimental work is required to determine if LDL oxidation is indeed an important causal step in atherogenesis in humans, but the preliminary data are encouraging and offer the potential for a new approach to the prevention and therapy of atherosclerosis. PMID- 1764822 TI - The underlying coronary lesion in myocardial infarction: implications for coronary angiography. AB - Myocardial infarction is usually caused by sudden thrombotic occlusion of a coronary artery at the site of a fissured atherosclerotic plaque. Recent evidence suggests that coronary angiography may be insensitive in detecting and quantitating atherosclerosis. Serial angiographic studies demonstrate that the majority of myocardial infarctions occur due to occlusion of arteries that previously did not contain angiographically significant (greater than 50%) stenoses. Similarly, quantitative angiography performed after thrombolytic therapy indicates that the coronary lesion underlying the clot is frequently not severely stenotic. Thus, an angiographically apparent stenosis is not necessary for the development of a thrombotic occlusion resulting in an MI. These observations suggest that coronary angiography does not accurately predict the site of a subsequent occlusion that will produce a myocardial infarction. PMID- 1764823 TI - Prognosis in acute myocardial infarction in relation to development of Q waves. AB - In a totally nonselected group of patients with acute myocardial infarction (AMI) (n = 921) admitted from the emergency department to the coronary care unit or other hospital ward, the occurrence of non-Q-wave AMI and the prognosis in these patients was determined and compared with those in whom Q waves were developed. Fifty-two percent had AMI without new Q waves. Patients with a non-Q-wave AMI differed from patients with Q-wave AMI, more frequently having a previous history of AMI (p less than 0.001), angina pectoris (p less than 0.01), diabetes mellitus (p less than 0.05), congestive heart failure (p less than 0.001), and a higher mean age (p less than 0.001), whereas smoking was more common in Q-wave AMI. Patients with non-Q-wave AMI had a 1-year mortality of 31% compared with 26% in Q wave AMI (p greater than 0.2) and a reinfarction rate of 20% compared with 12% for Q-wave AMI (p less than 0.01). Among patients aged less than 75 years without a previous history of AMI, congestive heart failure, and diabetes mellitus, the 1 year mortality rate was 16% for patients with Q waves versus 15% for those without Q waves (NS). Appearance of Q waves was not independently associated with death. We conclude that in a nonselected group of patients with AMI the occurrence of a non-Q-wave AMI is much higher than previously reported. The prognosis in AMI during one year of follow-up is not associated with development of Q waves. PMID- 1764824 TI - Painless myocardial ischemia in elderly patients compared with middle-aged patients and its relation to treadmill testing and coronary hemodynamics. AB - We compared painless ST-segment depression (1 mm greater than or equal to 80 ms and lasting greater than or equal to 60 s) in elderly patients with coronary artery disease (greater than or equal to 65 years, mean 67 years; n = 22) and that of middle-aged patients (less than 60 years, mean 54 years; n = 20) by Holter monitoring for 24 hours to determine the relationship between episodes of painless myocardial ischemia, findings of treadmill testing, and coronary hemodynamics. Coronary arteriographic findings (Gensini score) and ejection fraction (EF) did not differ between the two groups. Painless ST-segment depression was found to be 77% in the older age group versus 45% in the middle aged group (p less than 0.05). However, treadmill exercise score, ST-segment depression, and ST-segment integral achieved did not differ significantly between the two groups. Within 2 weeks after the above testing, coronary hemodynamic study was performed. The increment of coronary sinus flow in the older age group was 1.4 +/- 0.3 versus 1.8 +/- 0.3 in the middle-aged group (p less than 0.05), and the change of lactate extraction ratio from the basal condition in the older age group was -50 +/- 40% versus -2 +/- 15% in the middle-aged group (p less than 0.05). We conclude that episodes of painless myocardial ischemia in elderly patients with aging may be associated with the impairment of the coronary vascular reserve and easier anaerobic myocardial metabolism by pacing stress despite similar findings of coronary artery disease and EF in both groups. PMID- 1764825 TI - Evolution of the electrocardiographic changes in patients with hypertrophic cardiomyopathy. AB - In 75 patients with hypertrophic cardiomopathy (HCM) followed for a mean period of 5.5 years (range 2-20 years), evolution of the electrocardiographic (EKG) changes was assessed. Progression of EKG abnormalities occurred in 35 patients (47%). It was manifested by an increase in precordial QRS voltage in 33 patients, development of new P-wave mitral in 11 patients, and development or disappearance of pathologic Q waves in 14 patients. With follow-up times greater than 5 years, 5-8 years, and greater than 8 years, EKG progression was present in 27, 41, and 80% of patients, respectively. Age less than 30 years at the beginning of study and left ventricular outflow obstruction predisposed to EKG progression within 5 8 years. Patients with progressive EKG changes were more prone to experience clinical deterioration than those without EKG progression (63 vs. 15%, p less than 0.001). With chronic verapamil administration, progression of EKG abnormalities occurred insignificantly less often than with propranolol treatment (35 vs. 64%, p = 0.20). It is concluded that with long-term follow-up, HCM tends to progress in a significant proportion of adult patients. PMID- 1764826 TI - Subjective visual echocardiographic estimate of left ventricular ejection fraction as an alternative to conventional echocardiographic methods: comparison with contrast angiography. AB - Left ventricular ejection fraction (LVEF) is a measure of ventricular function with clinical and prognostic significance and can be reliably calculated with various M-mode and two-dimensional echocardiographic formulas in selected, good quality echocardiograms. Subjective visual echocardiographic estimate of LVEF is a potentially less time consuming and more widely applicable method. In order to test its reliability, we performed a prospective blind trial in 40 consecutive patients undergoing biplane contrast ventriculography (BCV), to compare the visual estimate of LVEF during a complete echocardiogram of three independent observers with (1) cubed M-mode formula, (2) Teichholz M-mode formula, (3) length area method from the four-chamber view, and (4) Simpson's single plane formula. BCV was the reference method. The best correlation with BCV was obtained by visual estimate [r of the three observers, respectively = 0.75; 0.84; 0.81] and M mode measurements [r (1) = 0.8; r (2) = 0.8], but the most sophisticated methods provided the poorest estimate [r (3) = 0.54; r (4) = 0.49]. All correlation coefficients improved when good studies, defined as a definition of the endocardial surface of more than 75%, were selected (n = 23), but the differences persisted. One observer systematically estimated higher values than the other two (Friedman's test, p less than 0.01) and this interobserver variability suggests that each echocardiographer should test himself against BCV in his lab in order to apply the visual estimate method reliably. PMID- 1764827 TI - Endomyocardial biopsy in infants and children with cardiomyopathy. AB - We reviewed our experience of endomyocardial biopsy performed on 21 symptomatic infants and children with cardiomyopathy. Clinical congestive cardiomyopathy was noted in 18 patients, 2 had hypertrophic cardiomyopathy, and 1 a restrictive cardiomyopathy. The biopsy findings led to a diagnosis of hemochromatosis in one patient, Adriamycin cardiomyopathy in another, and lymphocytic myocarditis in a third. Five patients had features of endocardial fibroelastosis, one endomyocardial fibrosis, and a further one, a mitochrondrial abnormality. In 11 patients normal or nonspecific features were seen. There were 2 myocardial perforations, both patients being successfully resuscitated. Endomyocardial biopsy, although occasionally hazardous, may sometimes provide valuable information which may lead to a diagnosis, facilitate treatment, and be of prognostic value. Despite the low positive yield, it may still be indicated in selected patients, in view of the seriousness and often poor prognosis of this disorder: 5 of our study group subsequently died. PMID- 1764828 TI - Comparison of respiratory response of jogging in place and Bruce treadmill exercise test. AB - A comparison of the respiratory responses of jogging in place, an alternative exercise test we recently proposed, was made with those of the Bruce exercise test. We obtained on-line measurements of heart rate, ventilation, oxygen uptake, and carbon dioxide production from 9 healthy subjects of mean age 25 years. There was a higher heart rate and ventilatory response with jogging than with the Bruce test, but by 10 minutes the responses of the two tests were similar. Oxygen consumption, while higher with jogging, rose in parallel with that of the Bruce test from the second to the seventh min, and the change of the ratio of minute ventilation to oxygen consumption indicated that the anaerobic threshold occurred earlier during jogging. These results show that jogging in place is more vigorous than the graded exercise test and may produce ischemia earlier. PMID- 1764829 TI - Single-lead VDD pacing: excellence or expedience? AB - The interest in VDD pacemakers has been renewed by the introduction of single pass leads, and continuing modifications and technical developments promise significant improvement. However, convincing long-term data confirming the reliability and the use of newer leads are not yet available. Compared with VVIR pacemakers VDD pacing has theoretical advantages over the VVIR mode, offering better hemodynamic and endocrine responses. However, its range of indications is narrow and rate adaptation is essential when sinus node chronotropic inadequacy is present or likely to occur. In addition, on certain occasions a VDD pacemaker may not maintain persistent atrial-synchronous pacing, thus necessitating the use of a DDD unit. PMID- 1764830 TI - Catheter balloon valvuloplasty of stenotic aortic valves--Part II: Balloon valvuloplasty during life subsequent tissue examination. AB - This review describes 23 patients with aortic valve stenosis who underwent balloon valvuloplasty during life and had subsequent valve tissue examined at the time of aortic valve replacement or at necropsy. Of 23 stenotic aortic valves, 17 were examined within 30 days (early) after balloon dilation. Of these 94% had nonrheumatic (nonfused commissures) etiologies for the aortic stenosis. Of the 6 valves examined after 30 days (late) (restenosis), mechanisms of restenosis involve refusion of split commissures and probable elastic recoil. Clinical prediction of the aortic stenosis etiology prior to balloon valvuloplasty may help predict short- and long-term success of the dilation procedure. PMID- 1764831 TI - Refractory cardiogenic shock and complete heart block after unsuspected verapamil SR and atenolol overdose. AB - A 57-year-old female presented with complete heart block and then developed refractory hypotension despite temporary pacing. Moderate left ventricular dysfunction with focal wall motion abnormalities, as well as severe hypoxemia, were demonstrated. However, neither significant coronary disease nor evidence for pulmonary embolus or other lung disease could be determined. Hemodynamic stabilization was achieved with the use of an intra-aortic balloon pump and multiple high-dose pressor agents. A retrospective diagnosis of toxic verapamil SR and atenolol ingestion was confirmed, and the patient gradually recovered. The relevant literature is reviewed and various treatment approaches are discussed. PMID- 1764832 TI - Left ventricular aneurysm associated with apical hypertrophic cardiomyopathy. AB - A 47-year-old man with apical hypertrophic cardiomyopathy and an apical left ventricular aneurysm with palpitation as the initial manifestation is described. There was no intraventricular pressure gradient. The aneurysm is suggested to be a part of the myocardial disease or to be caused by myocardial bridging of the left anterior descending coronary artery demonstrated by angiography. The 24-hour ambulatory ECG recording showed only isolated ventricular ectopic beats and the clinical course has been favorable during 20 months without therapy. PMID- 1764833 TI - Robert Hebard Bayley: 1906-1969. PMID- 1764834 TI - Contrast echocardiography enhances tricuspid but not mitral regurgitation. AB - Tricuspid regurgitation refers to a systolic leak of blood between the right ventricle and right atrium, across the tricuspid valve. Doppler echocardiographic examination of large numbers of normal individuals has shown that trivial tricuspid regurgitation is extremely common. Measurement of the peak velocity of the regurgitant frequency spectrum on Doppler echocardiography is of considerable clinical importance since it may be used to calculate peak right ventricular and, consequently, peak pulmonary systolic pressure. Doppler recording of the frequency spectrum of a tricuspid regurgitation jet optimally shows a smooth, parabolic, sharply demarcated envelope. In many individuals with trivial tricuspid regurgitation, however, this frequency spectrum is incomplete and its envelope is poorly demarcated. Such inadequate signals do not allow measurement of the spectrum's peak velocity. Like other contrast agents, air-filled microspheres composed of sonicated human serum albumin enhance reflection of Doppler ultrasound and thus have the potential to enhance incomplete tricuspid regurgitation spectra. Furthermore, since sonicated albumin microspheres can cross the pulmonary circulation intact, they have the potential to enhance mitral regurgitation spectra. The purpose of our study was to investigate whether injection of sonicated albumin microspheres enhances incomplete tricuspid and mitral regurgitation frequency spectra to a diagnostic quality. Sonicated albumin microsphere injection enhanced tricuspid regurgitation spectra to optimal quality in 11 of 15 patients (73%). Microsphere injection caused a minor degree of enhancement of the mitral regurgitant spectrum in 1 patient, but did not optimize the spectra in any of 10 patients tested. Saline contrast injection optimally enhanced tricuspid regurgitation spectra in all 8 patients in whom it was used.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764835 TI - Contrast echocardiography and myocardial perfusion. AB - New clinical applications for myocardial contrast echocardiography (MCE) are being developed in both the operating room and the catheterization laboratory. Studies have shown that red blood cell transit time through the myocardium is a measure of myocardial blood flow. Sonicated albumin microbubbles can mimic intramyocardial behavior of red blood cells. Other studies have used MCE to assess collateral flow to determine myocardial viability after acute myocardial infarction. The authors have developed a computer system that allows on-line quantitation of contrast echocardiographic data in the operating room, and this system is able to confirm that bypass grafts are properly placed. The ability to quantitate myocardial flow with MCE may be useful in guiding the sequence of graft placement and for assessing the success of the operation. These measures will help lower the incidence of perioperative infarction. Experiments in our laboratory using the canine model have shown that MCE may be useful in assessing the intramyocardial distribution of retrogradely delivered cardioplegia. This technique may, therefore, assist the surgeon in determining the adequacy of retrograde cardioplegia delivery and may improve myocardial preservation during bypass surgery. PMID- 1764836 TI - Opacification and border delineation improvement in patients with suboptimal endocardial border definition on routine echocardiography: results of a phase III trial of sonicated albumin microspheres. AB - To determine whether contrast medium in the left ventricle improves endocardial border delineation, enabling better assessment of left ventricular (LV) wall motion, a 5% solution of sonicated albumin microspheres was administered in 30 adult patients who exhibited endocardial border drop-out of 20% or more on routine echocardiography. The investigator and two blinded reviewers evaluated efficacy using an opacification grading system of 0 to 3+, with 0 indicating no contrast effect and 3+ indicating full opacification of the left ventricle. A score of 2+ or greater indicated effective opacification. Border delineation improvement was defined as a change from grade A (not well delineated) to grade B, C, or D (well delineated) of at least 1 of 6 LV wall segments. All patients received an initial injection of 0.08 cc/kg. If this volume produced LV opacification of at least 2+, the patient received two additional injections of 0.14 cc/kg and 0.08 cc/kg, each given 5 minutes apart. Otherwise, the patient received a final injection of 0.22 cc/kg. In all cases, the patient's arm was raised after injection to enhance venous passage. The total number of patients exhibiting 2+ or greater opacification was 29 (97%) when graded by the investigator and 27 (90%) when graded by the blinded observers. The investigator noted improved border delineation in 90% of patients, and the blinded observers noted improvement in 97% (excluding 1 patient who would have received a higher dose of contrast agents if scored by a blinded observer). Investigator confidence in assessing LV wall motion improved in 24 (80%) of the 30 studies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764837 TI - Relation of mean pixel intensity to concentration of sonicated albumin microspheres: effects of ultrasound system settings. AB - Myocardial contrast echocardiography (MCE) is a recently developed technique to assess myocardial perfusion. Previous studies have shown that MCE frequently underestimates coronary reserve as compared with other methods. Previous reports have suggested that some of the limitations of MCE are due to the nonlinear processing algorithms of the ultrasound systems. Therefore we designed an in vitro model to study the effects of various processing algorithms and levels of acoustic power (AP) on the relation between concentration of echocontrast and mean pixel intensities. A beaker containing a commercially produced, diluted solution of sonicated albumin microspheres was imaged with a commercial Hewlett Packard ultrasound system, and mean pixel intensities were determined with an off line computer system. The solution was imaged at a wide range of APs (40-10 dB) and time gain compensation (40-60 dB). Concentration versus intensity curves were generated using all possible combinations of compression and processing algorithms available on the ultrasound system used. Contrast effect diminished rapidly when exposed to high AP. Lower powers had less effect on contrast intensity duration, with no effect seen below 20 dB. Changes in time gain compensation did not affect contrast intensities. Regardless of the processing algorithm examined, the relation between concentration of echocontrast and mean pixel intensities was near linear in the first two to three concentrations; thereafter, the curves flattened during increasing concentrations of contrast. At higher concentrations, acoustic shadowing produced a decrease in pixel intensities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764838 TI - Safety and efficacy of sonicated albumin microspheres in perfusion and vein graft patency assessments. AB - This study was designed to identify a concentration of sonicated albumin microspheres that is safe, useful in determining graft patency, and provides an estimate of regional myocardial perfusion. The study included 8 patients between 50 and 72 years of age who were undergoing coronary artery bypass grafting. All patients were hemodynamically stable with left ventricular ejection fractions greater than or equal to 0.35. None had congestive heart failure or myocardial infarction within 4 months prior to the study. All had normal baseline neurologic and renal functions, and none had experienced allergic reactions to blood products or contrast dyes. A standard median sternotomy was performed for exposure of the heart at surgery, and saphenous veins were harvested and used for grafting. Intraoperative epicardial echocardiography (EE), always in the left ventricle short-axis at midpapillary level, was performed before and after grafting to determine regional myocardial wall motion. Sonicated albumin microspheres were prepared and injected into a single vein graft using an 18 gauge needle; 20 x 10(6), 100 x 10(6), and 200 x 10(6) microspheres were injected into the first graft sequentially. All other vein grafts were injected once with the dose that gave optimal contrast enhancement in the initial graft studied. In each patient, a minimum of 3 and maximum of 5 injections were performed, and graft perfusion was studied using EE. Graft flow, blood pressure, and electrocardiographic (ECG) measurements were continuously monitored, with a final EE performed after weaning the patient off cardiopulmonary bypass to assess wall motion. Preliminary results showed that no patient had adverse effects during or after the study and all remained hemodynamically stable.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764839 TI - Ultrasonic backscatter tissue characterization in cardiac diagnosis. AB - Ultrasonic tissue characterization has shown the potential to yield information about structural and functional properties of cardiovascular tissue. The development of real-time two-dimensional integrated backscatter imaging has made feasible clinical investigations of ultrasonic tissue characterization, including detection of stunned myocardium in patients with acute ischemia, recognition of remote infarction, detection of cardiac allograft rejection, and study of diffuse myocardial involvement with systemic diseases such as diabetes mellitus. Technical improvements and scientific advances in the understanding of the interaction between ultrasound and tissue may open an even wider range of clinical applications. Even in its present, relatively preliminary form, tissue characterization appears to have the potential for clinical application. Additional clinical experience will stimulate refinements and increases in the diagnostic power of this promising approach. PMID- 1764840 TI - Methotrexate for systemic lupus erythematosus: a retrospective analysis of 17 unselected cases. AB - We report a retrospective study of 17 patients with systemic lupus erythematosus who were treated with oral methotrexate given as a mean weekly dose of 8.47 +/- 1.72 mg. Methotrexate treatment resulted in symptomatic improvement in 57% of patients and allowed the reduction of the mean daily dose of prednisone from 16.66 mg initially to 8.99 mg at one year follow-up. Twelve of 17 patients (70.6%) experienced at least one episode of toxicity. Factors which might be associated with toxicity are analyzed. Because of its potential as a corticosteroid-sparing agent, controlled studies of methotrexate for the treatment of systemic lupus erythematosus are indicated. PMID- 1764841 TI - Characterization of anti-endothelial antibodies in patients with rheumatoid arthritis complicated by vasculitis. AB - Anti-endothelial antibodies (AEA) have been described in patients with rheumatoid arthritis (RA) complicated by vasculitis. In this study we made use of an ELISA and immunoblot technique (IBT) to further characterize AEA of the IgG class in serum of patients with rheumatoid vasculitis (RV) and to investigate the relationship between the presence of IgG-AEA and vasculitis. IgG-AEA as measured by ELISA or IBT could be detected in the serum from 20 of the 23 (87%) RV patients, in 2 out of 13 (15%) patients with RA and in one of 15 healthy donors. The IBT revealed reactivity of IgG-AEA against a total of 12 bands of endothelial antigens ranging in size from 16 to 68 kD. IgG-AEA as measured by ELISA and IBT in serum samples of patients followed longitudinally were present more frequently and in higher titres in patients with active RV as compared to patients with vasculitis in remission. A significant correlation was found between the presence of clinical signs of vasculitis and serum IgG-AEA reactivity against an endothelial membrane antigen of 44 kD. These data show that the pattern of IgG AEA reactivity in the serum of RV patients is heterogeneous and suggest that IgG AEA against one particular antigen is involved in the pathogenesis of RV. PMID- 1764842 TI - Correlation of antiperinuclear factor with antibodies to streptococcal cell-wall peptidoglycan-polysaccharide polymers and rheumatoid factor. AB - Antiperinuclear factor (APF) has been noted in most seropositive rheumatoid arthritis (RA) and juvenile rheumatoid arthritis (JRA) patients. The nature of the antigen is unknown; however, there are some suggestions that it might be a glycoprotein or proteoglycan. We studied the correlation of APF with antiproteoglycan antibodies and the reactivity of IgM-rheumatoid factor (RF) with the perinuclear antigen. Ten serum samples were separated to IgG, IgM, and IgM-RF enriched fractions. In seven samples, APF was found in the IgG fraction. Only 4 had APF in their IgM rheumatoid factor (RF)-containing fraction. In two of these, APF activity was present solely in the IgM RF fraction and was inhibited by pre incubation with IgG. Fifty-five JRA patients' sera were also tested for the presence of antibodies to Streptococcal cell wall peptidoglycan-polysaccharide polymers (PG-PSP). 76% of the APF-positive sera were anti-PG-PSP positive and 59% of the APF-negative sera were also anti-PG-PSP negative. Furthermore, 75% of the APF-positive sera lost their APF activity following adsorption to Streptococcal cell wall PG-PSP. Our results show that in JRA sera APF are polyclonal antibodies of both the IgG and IgM classes. Although the presence of APF correlates with RF positivity, and they sometimes may cross-react, many IgM RF-containing fractions do not show APF activity. However, the presence of APF does correlate with anti PG-PSP positivity and the data suggest cross-reactivity between these two antibodies. This implies antigenic similarity between Streptococcal cell wall PG PSP and the perinuclear antigen. PMID- 1764843 TI - Osteomalacia secondary to renal tubular acidosis in a patient with primary Sjogren's syndrome. AB - We report a case of a 41-year-old woman whose disease manifested as osteomalacia and whose etiological investigation revealed renal tubular acidosis secondary to primary Sjogren's syndrome. Proximal tubular dysfunction was also present and was documented by increased urinary excretion of beta-2-microglobulin and retinol binding protein. The patient showed clinical and laboratory improvement after treatment with oral potassium citrate, calcium supplements and steroids. PMID- 1764844 TI - Pubic post-fracture osteolysis simulating a malignancy. AB - The authors report one case of pubic post-fracture osteolysis, an uncommon and as yet not well understood pathology. It corresponds to an unusual healing of an insufficiency fracture in osteoporotic patients. Its pathogenesis is unclear, but the biomechanical theory seems to be the most convincing. PMID- 1764845 TI - Sex hormones, HLA and rheumatoid arthritis. AB - Recent evidence indicates that the HLA system might, in some way, regulate androgen concentrations. Male patients affected by rheumatoid arthritis have been shown to possess low serum testosterone levels associated with a particular HLA haplotype. Furthermore, androgen receptors have been recently described in macrophage-like synoviocytes that are HLA-DR positive. Since androgens generally are immunosuppressive, the possible mechanisms of their action in rheumatoid arthritis are here reviewed and discussed. It has now become evident that the well known relationship between sex hormones and the immune system is more complex than was previously suspected. PMID- 1764846 TI - Autoantibodies in Greek juvenile chronic arthritis patients. AB - The aim of this study was to investigate sera of Greek patients with juvenile chronic arthritis (JCA) for the presence of autoantibodies and correlate these antibodies with the clinical picture and disease activity. Sera from 69 JCA patients and sera from 66 healthy children matched for sex and age, were tested for antinuclear antibodies (ANAs), antibodies to extractable cellular antigens (ENAs), rheumatoid factor (RF), immunoglobulins (IgG, IgM), antibodies to double stranded (ds) DNA and anticardiolipin (CL). Our results indicate that: (a) autoantibodies to dsDNA are a not uncommon finding in JCA sera; (b) these autoantibodies have a low affinity for the antigen since they are found in low titers only by ELISA, while the Farr assay and Crithidia lucilliae immunofluorescence assay (IF) are negative; and (c) active JCA patients express many autoantibodies. PMID- 1764847 TI - Elevated IgA anti-gliadin antibodies in juvenile chronic arthritis. AB - Increased intestinal permeability secondary to treatment with non-steroidal anti inflammatory drugs (NSAIDs) and raised levels of anti-gliadin antibodies (AGA) have been reported in adults with rheumatoid arthritis. We have therefore retrospectively investigated the presence of serum AGA of the IgA and IgG classes in 70 patients with juvenile chronic arthritis (JCA). Serum IgA (but not IgG) AGA were found to be higher in JCA patients than in controls (6.2 +/- 8.7 vs 2.1 +/- 1.5 AU/ml; p less than 0.0001). This finding was observed independently of the JCA onset subtype or disease activity; however, lower levels of IgA AGA were found in patients with pauciarticular JCA and in those in remission. No significant differences in IgA AGA serum levels were observed between untreated patients and patients treated with NSAIDs. Five patients who presented the highest levels of IgA AGA were further studied a second time; serum IgA AGA were found to be markedly reduced or normalized and no clinical or laboratory evidence of coexistent coeliac disease was observed. In conclusion, our results suggest that the elevation of IgA AGA seen in our patients is secondary to non-specific immune stimulation rather than to an NSAID-induced increase in intestinal permeability. PMID- 1764848 TI - Chronic lupus ascites. PMID- 1764849 TI - Combined steroid, methotrexate and chlorambucil therapy for steroid-resistant dermatomyositis. PMID- 1764850 TI - Three-dimensional reconstruction of some vessel types in meningeal hemangiopericytoma. AB - Hemangiopericytomas (HP) have a characteristic vascular structure in histologic sections but this has not yet been visualized in three-dimensional form. Parts of typical vascular patterns were separated from paraffin blocks, re-embedded and cut in series. Three-dimensional images were created using the graphic reconstruction procedure of Staubesandt and Andres. The densely vascularized tumor tissue includes only very few arteries. Among these are some recurrent vessels and they abruptly divide into a large number of capillaries. Arterio venous shunts could not be detected. Characteristic sinusoids, some of them like antlers in cross-section, change remarkably in calibre and have bizarre indentations and dilatations along their length. Their polymorphism includes an often collagenous wall, sometimes as spherical indentations. It seems that they are exclusively connected to the capillary network. The structure of the vessels can explain some angiographic characteristics such as diffuse accumulations of contrast media or their prolonged circulation time. PMID- 1764851 TI - Cervical neurenteric cyst associated with Klippel-Feil syndrome: a case report and review of the literature. AB - A neurenteric cyst of the spine is a rare congenital disorder secondary to alimentary duplication and vertebral malformation. It should, however, be included in the differential diagnosis of an intradural, extramedullary spinal lesion. We present a case of a cervical neurenteric cyst associated with Klippel Feil syndrome and discuss the clinical, radiologic, histopathologic, immunohistochemical and embryologic characteristics of this disorder. PMID- 1764852 TI - Degeneration of the substantia nigra in familial amyotrophic lateral sclerosis. AB - We have studied a large family with familial amyotrophic lateral sclerosis (FALS) and examined the brain and spinal cord of a 40-year-old male family member at autopsy three years after clinical onset of the disease. The most unusual finding was a severe degree of neuronal loss of the substantia nigra accompanied by gliosis and numerous pigment-laden macrophages. There was marked degeneration of the upper and lower motor neurons and the corticospinal tracts. In addition, there was an unusually severe degree of diffuse degeneration throughout the anterolateral columns of the spinal cord. The posterior columns and Clarke's nucleus were not involved. Nigral degeneration has rarely been reported in FALS. The findings in this case emphasize the great variability of morphologic changes encountered in FALS and raise the question of a relationship between FALS and extrapyramidal disorders such as Parkinson's disease. We conclude that careful postmortem examinations of further cases of FALS are needed to fully define the extent of degenerative changes in this disease. PMID- 1764853 TI - Extensive replacement of spinal cord and brainstem by hemangioblastoma in a case of von Hippel-Lindau disease. AB - We report an extremely unusual case of von Hippel-Lindau disease, characterized by almost total replacement of the spinal cord and most of the medulla by capillary hemangioblastoma (CHB). A 34-year-old female presented 20 years earlier with signs of lower limb weakness. She developed progressive quadriplegia despite multiple surgical attempts to remove separate CHBs from the midthoracic and cervical spinal cord. Spinal cord lesions continued to develop as did multiple cerebellar CHBs. She eventually became respirator-dependent and died following severe upper gastrointestinal hemorrhage. At autopsy there was extensive replacement of spinal cord and medulla by CHB as well as multiple solid and cystic cerebellar tumors. Both kidneys were enlarged and largely replaced by renal cell carcinomas and simple cysts. Additionally she had small pancreatic cysts and microscopic pulmonary hamartomas were observed. There was no evidence of retinal lesions clinically or at autopsy. Light microscopic and immunohistochemical studies of the lesions are presented. The early onset of this disease in a female, with such extensive spinal cord involvement, in addition to other CNS and visceral manifestations of von Hippel-Lindau disease, is unusual and has not been previously reported. PMID- 1764854 TI - Gliomatosis cerebri: a case report. AB - We report a case of gliomatosis cerebri in a 46-year-old woman with five-year history of seizures and psychiatric disturbance. There were also two episodes of lethargy, disorientation, and headache which cleared promptly with Mannitol. A 3rd episode terminated in her death. Remarkably, between the episodes of presumed increased intracranial pressure, the neurologic examination was normal except for the patient's denial of her illness. Postmortem examination revealed the entire right cerebral hemisphere to be enlarged and infiltrated by cells resembling astrocytes. The clinical signs, symptoms, and controversial histopathologic features of this rare entity are discussed. PMID- 1764855 TI - [Effects of A23187 and cytochalasin B on proliferation and differentiation of the cultured myoblasts]. AB - The effects of A23187 (a substance acting on cell membrane) and cytochalasin B (a substance acting on cell structure) on the growth and differentiation of myoblasts (L6 cell) were examined using a cultured system. The L6 cells (1 x 10(5)) were incubated for 10 days in DMEM medium containing 10% fetal calf serum (a growth medium) by exchanging the medium every 3rd day. They showed no morphological differentiation and no increase in creatine kinase activity, myoglobin content and Ca2+ concentration. However, when L6 cells were incubated in DMEM medium containing 2% horse serum and 6 micrograms/ml insulin (an incubation medium for differentiation), they were morphologically differentiated into the myotube after 6-day culture with increase in creatine kinase activity, myoglobin content and Ca2+ concentration. In the presence of 40 nM A23187, no marked morphological change was observed in the L6 cells as compared with the control, but the myoglobin level rapidly increased to 18.2 x 10(-2) ng/micrograms (4.2-fold value of the control) at 10-day culture. In the presence of 200 nM cytochalasin B, there was no morphological change in the L6 cells, and no increase in the levels of creatine kinase and myoglobin. These data suggest that the function of the cell membrane and intracellular Ca2+ concentration play important roles in differentiating the muscle cells, because A23187 promotes biochemical differentiation of L6 cells as shown by increased myoglobin content. PMID- 1764856 TI - [Abnormality of hypothalamic dopaminergic system in neuro-degenerative diseases- evaluation of alpha-melanocyte-stimulating hormone-like immunoreactivity in cerebrospinal fluid]. AB - Dopaminergic neuron controls CNS functions such as meso-limbic, striato-nigral and tubero-infundibular systems. The purpose of the present study is the evaluation of the hypothalamic dopaminergic neuron activity in neuro-degenerative disorders. alpha-melanocyte-stimulating hormone (alpha-MSH) is synthesized in the arcuate nucleus and lateral part of the hypothalamus, and its secretion is under the inhibitory control of the dopaminergic neuron both in the hypothalamus and pituitary. alpha-MSH-like-immunoreactivity (alpha-MSH-LI) in CSF is thought to be representative to the dopaminergic neuron activity in the hypothalamus. We therefore evaluated CSF levels of alpha-MSH-LI in spinocerebellar degenerations and extrapyramidal diseases. The subjects are 11 patients with Parkinson's disease, 16 with Shy-Drager syndrome (SDS), 16 with cerebellar cortical atrophy, 3 with Machado-Joseph disease, 3 with dentato-rubro-pallido-luysian atrophy and 2 with Huntington's disease as well as 24 controls. All patients with Parkinson's disease were administered levodopa and carbidopa. CSF was sampled through lumbar puncture in the morning. After the centrifugation, supernatant of CSF was stored at -40 degrees C until used. alpha-MSH in CSF was extracted by Rainero's method and measured by RIA. alpha-MSH-LI levels in control was 23.9 +/- 2.6 pg/ml (mean +/- SD). The significant elevation was observed in Parkinson's disease (40.3 +/- 7.5, p less than 0.001) and SDS (42.3 +/- 9.4, p less than 0.001). The levels showed not significant correlation with age, duration of illness or severity of autonomic disorder. Most of other diseases demonstrated the levels within normal range.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764857 TI - [Apolipoprotein B immunoreactivity in cerebral amyloid deposits and neurofibrillary tangles in senile dementia of Alzheimer type]. AB - Since apolipoprotein E immunoreactivity has been shown in senile plaque and neurofibrillary tangle in Alzheimer's disease brains, we performed immunohistochemistry to examine whether or not apolipoprotein B (apoB) was associated with these abnormal structures. Sections of hippocampus from formalin fixed, paraffin-embedded tissues were immunostained with a standard ABC method. We found that apoB immunoreactivity was associated with amyloid both in senile plaques and cerebral vessels and with neurofibrillary tangles. Positive staining was abolished with pretreatment of the antibody with the human apoB. It is suggested that the potential blood-brain barrier impairment may allow an increasing amount of serum proteins, such as apoB, to penetrate the brain and bind to these AD-associated abnormal structures. PMID- 1764858 TI - [Sympathetic nerve activity in amyotrophic lateral sclerosis--analysis by microneurography]. AB - Muscle sympathetic nerve activity (MSA) was quantitatively analyzed in amyotrophic lateral sclerosis (ALS) by using microneurography. Studies were conducted in 10 ALS patients (2 males, 8 females; mean age 56.4 SD 17.3 years; range 31-77 years). The duration of the disease after onset of symptoms was from 0.8 to 2.5 years. They were classified as a type of classical ALS having mild degree of bulbar signs, an ability to walk by themselves and no subjective breathing impairment. Control groups were selected from 16 healthy age-matched volunteers (8 males, 8 females; mean age 52.9, SD 15.5 years; range 29-76 years). MSA was recorded directly from peroneal nerve fascicles at the popliteal fossa by means of tungsten microelectrodes. The changes in MSA, blood pressure and heart rate were analyzed in the ALS groups and controls laid at recumbent and 30 degrees head-up tilted positions. The parasympathetic functions were evaluated by CVR-R and baroreflex latency. MSA bursts/minute, bursts/100 heart rate and total MSA at recumbent position were significantly higher (p less than 0.01), but their changes at 30 head-up tilted position were slightly lower in the ALS groups compared with the controls. Furthermore, a linear correlation between age of the subjects and MSA in the controls was not found in ALS groups. There were no differences between both groups in blood pressure and heart rate at the two positions. The parasympathetic function was normal in ALS groups. In ALS, sympathetic hyperfunction independent of cardiovascular systems was found especially at the recumbent position. These findings were considered specific to ALS, but the etiology was unclear. PMID- 1764859 TI - [A case of Garcin's syndrome caused by pachymeningitis secondary to otitis media, responsive to antibiotic therapy]. AB - A 55-year-old woman noticed progressive hearing loss, earache and tinnitus in the left side in December 1988, followed by dysesthesia of the left face and hypogeusia. Those symptoms did not respond to the otological treatment of otitis media. In addition, the left eyelid ptosis, double vision and dysphagia appeared in May 1989. On admission, cranial nerves from III to XII were affected exclusively in the left side. The cell counts and the protein levels in the CSF were elevated. The MRI of the head showed hypertrophic dura mater at the left base of the skull covering the temporal lobe. No bone destruction was found in CT. The biopsy revealed the thickened dura mater with microabscess containing Langhans giant cells and lymphocytes. A diagnosis of pachymeningitis was made. After the therapy with antibiotics and then with prednisolone for several months, cranial nerve disturbances disappeared except hearing loss with decrease in cell counts and protein levels of the CSF. The follow-up MRI after one year showed decrease in thickness of dura mater. The MRI, particularly using enhancement with Gd-DTPA, was useful to make a diagnosis of hypertrophic pachymeningitis. It is suggested that the administration of antibiotics should be considered in the treatment of the pachymeningitis even if the causative agents were not identified. PMID- 1764860 TI - [A case of posttraumatic parkinsonism]. AB - We report a case of a 52-year-old man with posttraumatic parkinsonism. He was admitted to our department because of right-sided hand tremor and gait disturbance. He had suffered from a severe head injury incurred in a traffic accident with brief unconsciousness 6 months before admission. Three weeks after his injury, tremor and rigidity in the right upper limb developed, and he walked dragging his right leg. Five months after his injury, he received 1-dopa therapy, exhibiting a moderate improvement in parkinsonian symptoms. On admission, he was demented to a mild degree with masked face and monotonous speech. He presented with resting-postural-kinetic tremor and muscle rigidity on the right side. Cranial CT and MRI showed no abnormality. Inter-peak latencies of waves III to V of BAEP were significantly longer in this patient than in normal subjects. This BAEP findings suggested an upper brainstem lesion. 123I-IMP SPECT disclosed decreased cerebral blood flow in the left thalamus, bilateral frontal and parietal cortices. We diagnosed this case as having posttraumatic parkinsonism. Parkinsonism in the present case may be due to the involvement of multiple neuronal circuits of the extrapyramidal system at the level of the midbrain to the thalamus. PMID- 1764861 TI - [A case of Behcet's disease associated with myopathy during cyclosporin treatment]. AB - A 46-year-old male was admitted to the Department of Neurology complaining of gait disturbance. He was given a diagnosis of Behcet's disease and placed on colchicine (0.5-1.0 mg/day) for 7 months without improvement. Subsequently cyclosporin (290 mg/day) was added this regimen. However, 7 months after initiation of combined colchicine/cyclosporin therapy serum creatine kinase (CK) rose to 1,255 U/l. On admission, neurological examination revealed generalized muscle atrophy with predominant proximal muscle weakness and decreased deep tendon reflexes. No myalgia was noted. Laboratory tests demonstrated anemia, liver dysfunction, chronic renal failure and an elevated serum CK level. The plasma cyclosporin concentration was 220 ng/dl, which is within therapeutic limits. Motor unit potentials in electromyography of bilateral quadriceps muscles were generally of short duration and reduced amplitude. A biopsy of quadriceps muscle showed variability in the size of type 2 fibers and scattered small vacuoles. Some of the vacuoles resembled rimmed vacuoles. These vacuoles were stained positively for acid phosphatase. Electronmicroscopy revealed that these vacuoles contained dense bodies, myeloid bodies, and glycogen particles. Collectively suggesting that these structures are autophagic vacuoles. Cyclosporin was reduced to 200 mg/day with unchanged colchicine dose and bromocriptine, which potentiates cyclosporin effects, was started. Gradual recovery from muscle weakness ensued. These findings suggest that cyclosporin contributed to the pathogenesis of this myopathy. On increase in use of cyclosporin, one should consider the possibility of myopathy as one of its side effects especially in combination therapy with myotoxic drugs such as colchicine. PMID- 1764862 TI - [A case of familial essential myoclonus--electrophysiological study]. AB - A case of familial essential myoclonus was reported with electrophysiological studies. A 58-year-old female presented with involuntary movement (myoclonic jerk) since age 6 years. At the age over 50, she developed difficulty in writing and fine finger movements. Two years ago, the diagnosis of hyperthyroidism was made, but she did not take any anti-thyroid medication. She was admitted to our hospital for further evaluation of myoclonus. On family history, her grandson (4 years-old) had myoclonus. On general physical examination, she showed a diffuse goiter. On neurological examination, she showed spontaneous myoclonus in the face, neck, trunk and the proximal limb muscles, especially in the left upper and right lower extremities. The myoclonus was exacerbated with auditory stimulation and emotional tension, but there was no temporal relationship between each stimulus and myoclonus. There was no myoclonus during sleep. Finger-to-nose test showed coarse intention myoclonus. Laboratory examinations including lysosomal enzyme assay revealed no abnormalities except for the decrease in total cholesterol (118 mg/dl) and the increase in serum lactate (19.7 mg/dl). The serum concentration of thyroxin was 18.4 micrograms/dl, that of triiodothyronine 3.0 ng/ml, and that of thyroid stimulating hormone (TSH) 0.027 microIU/ml. Anti thyroglobulin antibody and anti-microsomal antibody were positive (X100, X6400). Neurological laboratory tests were normal including cerebrospinal fluid, peripheral nerve conduction study, electromyogram (EMG), muscle biopsy, cranial computed tomography and magnetic resonance imaging, and positron emission tomography. Electron transport system of the biopsied muscle was normal. So, we made a diagnosis of familial essential myoclonus and hyperthyroidism. In the electrophysiological studies, the electroencephalogram (EEG) was within normal limits.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764863 TI - [Symptomatic adrenoleukodystrophy heterozygote with fluctuated neurological symptoms--a case report]. AB - We report a patient with symptomatic adrenoleukodystrophy (ALD) heterozygote, a 57-year-old female, who manifested fluctuated neurological symptoms. She is a mother of the patient with adrenoleukomyeloneuropathy associated with hypoparathyroidism and cerebral calcification. The heterozygote of ALD was diagnosed by elevated levels of very long chain fatty acids in her plasma and erythrocyte membranes. At age 51, she had a disturbance of consciousness, which subsided two months later. Neurologically, bilateral pyramidal tract signs were noted. CT revealed low-density areas in the white matter neighboring the bilateral anterior horns of lateral ventricles and small calcification in the basal ganglia. Four years later, her neurological manifestations including gait disturbance and mental deterioration subacutely progressed. MRI (T2-weighted image) showed diffuse high intensity areas in the cerebral white matter. Adrenal insufficiency, hypoparathyroidism and peripheral neuropathy were not detected. It has been reported that some ALD heterozygotes developed neurological symptoms, which resembled those of the patients with adrenomyeloneuropathy. The presented patient manifested neurological symptoms with fluctuation, which was not common clinical course in the heterozygotes of ALD. On the differential diagnosis of neurological diseases such as multiple sclerosis, cerebrovascular disease or other cerebral white matter diseases, it is important to consider the possibility of ALD heterozygotes. PMID- 1764864 TI - [A case of HTLV-1 associated myelopathy with diffuse white matter lesion of the frontal lobe and continuous lesion of the pyramidal tract on cranial MRI]. AB - In this report, the characteristic findings of cranial MRI of a case with HTLV-1 associated myelopathy (HAM) is described. The patient was a 62-year-old woman with 6 years history of paraplegia. Her main clinical signs were bilateral spastic paraplegia in the lower limb girdle muscles and extremities, paresthesia below the tenth thoracic cord level and urinary disorder. There was bilateral blepharoptosis. Hyperreflexia was observed in the examination of the cranial nerves and upper extremities. She showed no dementia or any other higher cortical dysfunctions. Positive anti-HTLV-1 antibody in the serum and cerebrospinal fluid established a diagnosis of HAM. T2 weighted MRI study revealed the symmetrical diffuse hyperintensity in the subcortical white matter of the frontal lobe and temporal lobe. The hyper-intensity was also observed in the bilateral internal capsule-peduncular base junction and pontine base, which indicated the continuous lesions in the intracranial pyramidal tracts. These MRI findings were different from those of reported cases of scattered lesion in central nervous system. There are some speculations for the nature of the diffuse lesion in the white matter, i.e., fusion of solitary gliosis and/or perivascular cuffing, or diffusely advanced spongy state. The continuous lesion of the pyramidal tract is suspected a systemic demyelination. Although the pathomechanism still remains uncertain, HTLV-1 infection generally affects the spinal pyramidal tract. It seems that this case is selectively affected in the pyramidal tracts in CNS. PMID- 1764865 TI - [A case of respiratory dyskinesia due to clebopride malate]. AB - Clebopride malate is therapeutically used for the treatment of peptic ulcer. This drug has potent antidopaminergic activity that causes acute dystonic reaction, parkinsonism and tardive dyskinesia as adverse effects. Here, we have reported an 86-year-old man who developed abnormal involuntary movement of respiratory muscles and lower limb muscles after this drug had been given for four months. This involuntary movement appeared spontaneously at resting state and disappeared during sleep. Surface EMG demonstrated a synchronous grouping discharge in m. orbicularis oris, m. sternocleidomastoideus and m. interstales which synchronized with diaphragmatic movement on cinefluorography. Involuntary movement of the lower limbs was synchronous bilaterally and had little relationship with diaphragmatic movement. This involuntary movement was irregular not only in rhythm but also in duration. According to this irregular nature, we diagnosed this involuntary movement as respiratory dyskinesia with limb dyskinesia that belongs to tardive dyskinesia. After cessation of clebopride malate limb dyskinesia disappeared rapidly and respiratory dyskinesia markedly decreased. We emphasize that respiratory dyskinesia should be differentiated from psychogenic hyperventilation as easily misdiagnosed on initial examination. PMID- 1764866 TI - [Guillain-Barre syndrome preceded by diarrhea with the infection of Campylobacter jejuni]. AB - We report a 77-year-old woman with Guillain-Barre syndrome following Campylobacter jejuni infection. She was admitted complaining of mild weakness in the left leg. Seven days before, she had severe diarrhea, which continued several days. After admission, the weakness soon worsened resulting in tetraparesis, and the respiration became so impaired that she was supported by the artificial ventilator. Deep tendon reflexes were absent in four limbs, and no sensory disturbance was noted. CSF contained the protein as low as 20.4 mg/dl in concentration; no pleocytosis was seen. Muscle action potentials evoked by the stimulation of nerves were markedly reduced in amplitude, but conduction velocity along the nerve was decreased mildly. Campylobacter jejuni was detected by bacterial culture of the stool; the antibody was positively raised against this bacteria in serum. By 90 hospitals days, she was restored to spontaneous respiration. PMID- 1764867 TI - [A clinical evaluation of the inorganic mercurialism--its pathogenic relation to amyotrophic lateral sclerosis]. AB - The pathogenic relation of chronic mercurialism and amyotrophic lateral sclerosis (ALS) was evaluated clinically on 83 ex-mercury workers who were poisoned or exposed to mercury vapor about 18 years ago at one of the biggest mercury mines in Hokkaido, as well as on the causes of 65 expired workers in the cohort. The 83 ex-mercury workers were subdivided into two groups according to severity of mercury poisoning: 31 ex-workers who had been hospitalized for treatment of mercury poisoning and the remaining 52 ex-workers severely exposed to mercury vapor but not hospitalized. Neurologic examinations and measurements of mercury contents in the blood, urine, and hair samples in the 83 cases, failed to disclose any pathogenicity of mercury to ALS. Among these 148 including the 65 deceased cases, no ALS cases were found. Further clinical and epidemiological studies should be required on mercury poisoning as one of the risk factors in the development of ALS, especially in relation to selenium. PMID- 1764868 TI - Liposomal drug delivery. Advantages and limitations from a clinical pharmacokinetic and therapeutic perspective. PMID- 1764869 TI - Clinical pharmacokinetics of famotidine. AB - Famotidine is a potent histamine H2-receptor antagonist widely used in the treatment and prevention of peptic ulcer disease. After intravenous administration the plasma famotidine concentration-time profile exhibits a biexponential decay, with a distribution half-life of about 0.18 to 0.5h and an elimination half-life of about 2 to 4h. The volume of distribution of the drug at steady-state ranges from 1.0 to 1.3 L/kg; plasma protein binding is low (15 to 22%). Famotidine is 70% eliminated unchanged into urine after intravenous administration. The total body and renal clearances of famotidine correlate significantly with creatinine clearance. Because its renal clearance (15 L/h) far exceeds the glomerular filtration rate, famotidine is considered to be eliminated not only via glomerular filtration but also via renal tubular secretion. Since its clearance is reduced in patients with renal insufficiency and in elderly patients, the maintenance dosage should be reduced in these patient groups. Removal of famotidine by any of the currently employed blood purification procedures (haemodialysis, peritoneal dialysis and haemofiltration) does not occur to a clinically significant degree. Liver cirrhosis does not appear to affect the disposition of famotidine unless severe renal insufficiency coexists. After oral administration, peak plasma concentrations are attained within 2 to 4h; the oral bioavailability ranges from 40 to 50%, due mainly to incomplete absorption. The oral absorption of the drug is dose-independent within a range of 5 to 40 mg. There are 3 formulations available (tablet, capsule and suspension), which appear to be bioequivalent. Coadministration of potent antacids reduces the oral absorption of famotidine by 20 to 30%. On a weight-to-weight basis, the antisecretory effect of famotidine is about 20 and 7.5 times more potent than those of cimetidine and ranitidine, respectively. Plasma famotidine concentrations correlate with its antisecretory effect: values of about 13 and 20 micrograms/L produce a 50% reduction in the gastrin-stimulated gastric acid secretion and a fasting intragastric pH of greater than 4, respectively. Available data suggest that famotidine interacts neither with the hepatic oxidative drug metabolism nor with the tubular secretion of other commonly used therapeutic agents. However, further studies are required to evaluate a full spectrum of its drug interaction potential. PMID- 1764870 TI - Omeprazole drug interaction studies. AB - This review examines the literature on drug interactions with omeprazole. Different mechanisms have been proposed as potential causes for such interactions. First, the absorption of some drugs might be altered due to the decreased intragastric acidity resulting from omeprazole treatment. There was no effect of omeprazole on the absorption of amoxycillin, bacampicillin and alcohol, while the amount of digoxin and nifedipine absorbed was increased by 10 and 21%, respectively, both increases probably being of no clinical significance. Secondly, the metabolism of high clearance drugs might be altered by changes in liver blood flow, although that is not affected by omeprazole, as indicated by the unchanged elimination of indocyanine green. In addition, the clearance of intravenously administered lidocaine (lignocaine) [a high clearance drug] was unaffected by omeprazole, further indicating that the latter does not alter liver blood flow. Thirdly, since omeprazole is a substituted benzimidazole, it might have the potential to interfere with the metabolism of other drugs by altering the activity of drug metabolising enzymes in the cytochrome P450 system, through either induction or inhibition. There is no indication of induction of this enzyme system in any interaction study with omeprazole. As regards inhibition, on the other hand, there is now considerable information available which indicates that omeprazole has the potential to partly inhibit the metabolism of drugs metabolised to a great extent by the cytochrome P450 enzyme subfamily IIC (diazepam, phenytoin), but not of those metabolised by subfamilies IA (caffeine, theophylline), IID (metoprolol, propranolol) and IIIA (cyclosporin, lidocaine, quinidine). Since relatively few drugs are metabolised mainly by IIC compared with IID and IIIA, the potential for omeprazole to interfere with the metabolism of other drugs appears to be limited. PMID- 1764872 TI - Methylphenidate protocol: feasibility in a pediatric practice. AB - This report examines the feasibility of double blind individual trials of methylphenidate versus placebo in a general pediatric practice to assess benefit of this medication in the treatment of attention deficit disorder. Children presenting with the diagnosis of attention deficit disorder were enrolled in a three-week protocol. The first week was a baseline week during which teachers and parents completed the Connors rating scales. During the second and third weeks of each trial, placebo or methylphenidate was given for a week each in an unknown order to parents, teachers or the investigator. Respective Connors rating scales were also completed for each of these weeks. At the end of the third week, the three parent questionnaires and the three teacher questionnaires were returned to the investigator for scoring and disclosure about findings. During a pilot period, 53% of the trials were improperly completed. Reasons for this were addressed and with simple measures the rate of successful completion was raised to 83%. During the study phase, 43% of the children were found to be hyperactive but they did not benefit from medication. In six trials there was disagreement between teachers and parents. The completed trials and many of the incompleted trials were helpful in the assessment of the children with attention deficit disorder and their response to medication. It is felt that this approach is suitable for a private general pediatric practice. PMID- 1764873 TI - Delay in obstetrical care in newly diagnosed teenage pregnancy. AB - A retrospective study of 42 adolescent patients diagnosed as being pregnant between June 1987 and February 1990 at the Downtown Health Center (DHC), an inner city pediatric primary care clinic, was conducted to determine whether patients referred to a hospital-based Teen Pregnancy Clinic (TPC) were seen within a reasonable period of time. The frequency of sexually transmitted diseases (STDs) was also determined when these women were initially seen at TPC. Only 5 of the 42 patients seen at DHC had a pelvic exam prior to referral. Of the 40 patients seen at TPC, 20% were not seen until four weeks or more after initial diagnosis. Fifty percent had a STD. Pediatricians should recognize that pregnant teenagers may have a significant delay between diagnosis of pregnancy and entry into obstetrical care. Pelvic exam including cultures for STDs is recommended prior to referral. PMID- 1764874 TI - No-enema therapy for idiopathic constipation and encopresis. AB - Idiopathic constipation and encopresis of childhood are thought to occur when children volitionally withhold stool. Withholding may be prompted by social pressures or by episodes of painful defecation. Repetitive withholding may result in colonic dilatation and colorectal dysfunction. Therapy involves removal of impacted stool, stool softening, and behavioral therapy. The use of enemas in this therapy is widespread but may be counterproductive. A retrospective review of patients treated without enemas revealed 45 patients whose course could be followed for six months. Ninety-eight percent of these had successful initial cleanouts without enemas; 94% had continued success at six months. These results, comparable with other treatment programs, demonstrate that therapy without enemas is a reasonable alternative in the treatment of childhood constipation and encopresis. PMID- 1764871 TI - Pharmacokinetic optimisation of anticancer therapy. AB - It is obvious that there are great problems with pharmacokinetic individualization of anticancer therapy. The strong relationship between dose intensity (total dose/unit time) and response revealed in clinical trials with some tumours provides a strong support for studies seeking relationships between the individual plasma pharmacokinetic profile and response to treatment. Unfortunately, studies that define a therapeutic window are sparse, and trials that prospectively test such models are even rarer. Thus, for most cancer drugs, it is not possible to give any definite advice on how to use pharmacokinetic determinations to establish individualised therapy, and there is therefore a definite need for such studies. It is important, however, that attempts to establish relationships between drug concentrations and therapeutic effects be founded on a sound theoretical base. When drugs, mainly antimetabolites, are extensively metabolised intracellularly and interact with intracellular processes about which there are data showing a strong interindividual heterogeneity, such data must be considered when designing pharmacokinetic investigations. Cytarabine and fluorouracil are good examples of this. The monitoring of intracellular drug/metabolite concentrations or of the direct biochemical events in the tumour cells seems to be a promising approach with such drugs. It also needs to be emphasised that pharmacokinetically guided individualization cannot be achieved before a therapeutic window is established, i.e. a knowledge of the relationship between drug concentration and clinical effects. The investigators in this field accept a great responsibility when clinical studies are undertaken: a poorly designed study showing no benefit from pharmacokinetically guided individualization can impair the possibilities of performing more adequate studies in the future. PMID- 1764875 TI - Bacterial meningitis--an update. AB - This report emphasizes new clinical information about bacterial meningitis in infants and children. Important elements of diagnosis include examination for the presence of shock and increased intracranial pressure. In such cases, initial treatment should focus on appropriate fluid therapy, administration of oxygen, reduction of intracranial pressure and use of corticosteroids. Currently, antibiotics of choice include ampicillin plus either cefotaxime or ceftriaxone in young infants, and one of these cephalosporins in older patients (beyond 3 months of age). Shorter durations of therapy (5 to 7 days for meningococcus, 7 days for haemophilus and 7-10 days for pneumococcus) are now commonly employed. In many centers, dexamethasone is started before the first dose of antibiotic and continued for 4 days to reduce neurologic and audiologic sequelae. Future trends will include studies of endotoxin neutralizers and non-steroidal anti inflammatory drugs to reduce further tissue injury in meningitis. Prevention of meningitis is the ultimate goal. Since Haemophilus influenzae vaccination can now begin at 2 months, this approach may bring important results soon. PMID- 1764876 TI - Sun protection in childhood. AB - There is compelling evidence that childhood is a particularly vulnerable time for the photocarcinogenic effects of sun exposure on the skin. Studies indicate that excessive sun exposure during the first 10-20 years of life greatly increases the risk of skin cancer. Nonmelanoma skin cancer (basal cell and squamous cell carcinoma) has been associated with cumulative sun exposure, whereas melanoma has been associated with short, intense sun exposure or blistering sunburn. Under normal circumstances, children receive three times the annual sun exposure of adults; most of one's lifetime sun exposure occurs in childhood. Depletion of the earth's protective ozone layer adds to the photodamage problem. It is clear that sun protection is most vital in the early years. Those with fair skin are at highest risk. Photoprotective measures including sunscreen, clothing, and sun avoidance in childhood may significantly reduce the occurrence of melanoma and other skin cancer in later life. Regular use of sunscreen with a sun protection factor of 15 during the first 18 years of life could reduce the lifetime incidence of nonmelanoma skin cancer by 78%. Pediatricians can play a major role in educating parents and children. PMID- 1764877 TI - New concepts in the understanding of hypertensive diseases during pregnancy. An overview. AB - Preeclampsia is a syndrome of unknown etiology characterized by the sequential development of facial and hand edema, hypertension, and proteinuria after the 20th week of gestation. Patients with preeclampsia may progress to a seizure-like state: The patient is then said to have eclampsia. The major goal of prenatal care is detecting the early onset of preeclampsia and to activate aggressive therapy to prevent severe complications either for the mother or the fetus. There currently are no specific forms of therapy to prevent the disease. PMID- 1764878 TI - Hypertension and pregnancy. PMID- 1764879 TI - Pathophysiology of preeclampsia. AB - Preeclampsia is a complex clinical syndrome, with hypertension representing but one manifestation. Pathogenetically important events in the development of preeclampsia include incomplete trophoblastic invasion of the maternal spiral arteries, poor trophoblastic perfusion, elaboration of a putative endothelial cell toxin, and endothelial cell injury with resulting activation of coagulation, impairment of vasodepressor function, and altered endothelial permeability. These changes lead to the clinical signs and symptoms, which occur relatively late in the course of preeclampsia. The primary immunologic, genetic, and biochemical basis of preeclampsia remains speculative. PMID- 1764880 TI - Hemodynamics of preeclampsia. AB - A review of the English literature reveals considerable disagreement regarding the cardiovascular hemodynamics of preeclampsia as measured by both noninvasive and invasive techniques. In the untreated patient, most of the data suggest the presence of low CO, low PCWP, and elevated SVR as compared to normotensive pregnancy. In contrast, in patients receiving treatment prior to the measurements, the majority of the data indicate the presence of normal to elevated CO, PCWP, and SVR. There is general agreement that plasma colloid oncotic pressure is markedly reduced in patients with severe disease, and this reduction is more dramatic in the postpartum period especially in those receiving excessive crystalloid therapy. As a result, these patients are at increased risk for pulmonary edema. Several studies recommended using plasma and plasma substitutes to correct the reduced plasma volume and PCWP prior to the use of vasodilator therapy in such pregnancies. This management requires the use of invasive hemodynamic monitoring, and its benefit is transient and not well established. Finally, the true cardiovascular hemodynamics of preeclampsia remain unknown. PMID- 1764881 TI - Doppler flow velocimetry in hypertension in pregnancy. AB - Early studies suggested that Doppler ultrasound held great promise as a noninvasive, repeatable, and simple method of predicting hypertension in pregnancy and identifying those hypertensive pregnancies at high risk of maternal and fetal complications. Further studies have tempered this early enthusiasm by revealing the multiplicity of factors that may influence the Doppler waveform pattern. This makes interpretation of changes in the FVW pattern difficult. Despite these difficulties, there is evidence to suggest that Doppler velocimetry may contribute to two aspects of the management of hypertensive pregnancies. First, as a noninvasive method of investigating the effect of pharmacologic agents on maternal, fetal, and placental circulations. Second, a number of studies support a useful role for Doppler ultrasound measurements in the assessment of fetal well being in hypertensive complications. Present knowledge suggests that the technique will not replace existing fetal monitoring tests or be capable of indicating the optimum time for delivery. It does however, appear to be a useful adjuvant in assessing the risk of perinatal complications, especially in hypertensive pregnancies presenting before 30 weeks' gestation. PMID- 1764882 TI - Prevention of preeclampsia. AB - Preeclampsia is a disease unique to pregnancy. Treatment for the disease has remained suboptimal because of the unknown etiology of the disease. Preventive strategies have been suggested and have provided new ways to approach the patient at risk for developing preeclampsia. PMID- 1764883 TI - Management of preeclampsia. AB - Prompt hospitalization is the optimum management of all patients with preeclampsia. Expectant management is possible in most patients remote from term. The success rate of expectant management will depend on both fetal gestational age and the state to which the disease has progressed at the time of hospitalization. Maternal and perinatal complications are increased significantly in patients with severe preeclampsia and in those with the HELLP syndrome. Thus, these patients should be managed only at tertiary care centers. PMID- 1764884 TI - Antepartum fetal assessment in hypertensive pregnancies. AB - Antepartum fetal assessment in hypertensive pregnancies helps to prevent perinatal morbidity and mortality. The pathophysiology of chronic maternal hypertension often leads to placental insufficiency and fetal growth retardation. Current testing schemes include serial ultrasonographic assessment of fetal growth, placental morphology, and amniotic fluid volume; fetal heart rate testing using either non-stress or contraction stress methods; multiple parameter biophysical profile; and Doppler flow velocimetry of fetal umbilical and maternal uterine arteries. The values of individual and combined testing approaches are evaluated and an integrated scheme for fetal management, illustrated by case examples, is presented. PMID- 1764885 TI - Chronic hypertension in pregnancy. AB - Women with chronic hypertension who are considering pregnancy should undergo extensive evaluation and work-up prior to conception. This evaluation is important to establish the cause and severity of the hypertension. The patient should be seen early in pregnancy and counseled regarding the possible adverse effects of hypertension and the importance of adherence to prenatal visits and prescribed medications. Patients classified to have high-risk hypertension are at increased risk for significant maternal and perinatal complications. These patients should have intensive antenatal follow-up and will require antihypertensive therapy irrespective of the severity of the hypertension. In contrast, in women with mild uncomplicated hypertension, good perinatal outcome is expected with proper obstetric care, without the use of antihypertensive drugs. Finally, most of the poor perinatal outcome in such pregnancies is related to the development of superimposed preeclampsia. PMID- 1764886 TI - Hypertensive drugs in pregnancy. Antihypertension therapy in pregnancy, preeclampsia, and eclampsia. AB - The value of antihypertensive drugs in pregnancy is unproved. This article summarizes the available literature on the subject and gives guidance to the obstetrician who is considering the use of these agents in pregnancy. The possible benefits and side-effects are discussed. PMID- 1764887 TI - Anesthetic considerations in preeclampsia. AB - The successful anesthetic management of women with preeclampsia requires familiarity with the pathophysiology and hemodynamic changes characteristic of the disease process. Currently, overwhelming laboratory and clinical evidence attests to the safety and benefits of continuous lumbar epidural anesthesia in women with preeclampsia. For women with the milder form of the disease process, routine anesthetic care is sufficient. In those with severe preeclampsia, blood pressure should be controlled and intravascular volume status optimized with the aid of invasive monitoring. It is important to remember that decreased plasma proteins and presence of hepatic and renal dysfunction can influence maternal responses to drug therapy. The use of short-acting beta-adrenergic blocking agents, such as esmolol, and calcium entry-blocking agents, such as nifedipine, for blood pressure control before anesthetic induction and the role of epidural morphine and clonidine for postcesarean section pain relief are currently under investigation. PMID- 1764888 TI - Cerebral pathology in eclampsia. AB - Eclampsia is a syndrome that may be characterized by functional derangement of multiple organ systems including the central nervous system. Cerebral manifestations are rare in eclampsia but may include cerebral hemorrhage, blindness, and coma. Management of eclampsia involves the control of convulsions and hypertension as well as delivery. Cerebral manifestations such as increased intracranial pressure or coma require aggressive well-formulated intervention. PMID- 1764890 TI - Update: pediatric trauma. PMID- 1764889 TI - Of needles and haystacks: finding human disease genes by positional cloning. PMID- 1764891 TI - Peptic ulcer diseases in children. PMID- 1764892 TI - Local anesthetics in the management of acute pain in children: a primer for the non-anesthesiologist. PMID- 1764893 TI - Specific reading disability in children: etiology, diagnosis and intervention. PMID- 1764894 TI - Food allergy in childhood. PMID- 1764895 TI - Dietary studies in children: cardiovascular disease prevention: the Bogalusa Heart Study. PMID- 1764897 TI - Evaluation of a radiographic partial recording system assessing the extent and severity of periodontal destruction. AB - The purpose of the present study was to evaluate the validity and reliability of a partial radiographic bivariate index system (PESI-2). The principles of the index were applied to data from a random sample of 192 industrial employees aged 30-65 yr. Estimates of Extent and Severity of radiographic bone loss provided by the PESI-2, as well as adjusted estimates by means of simple regression models, were compared to values obtained by a full mouth radiographic examination. It was shown that the values provided by the PESI-2 were of rather high validity and reliability. The use of the adjusting models resulted in increased validity of the severity estimates and enhanced reliability of both components of the bivariate. The results verified the applicability of the PESI-2 in epidemiologic research of destructive periodontal disease. PMID- 1764896 TI - Extent and Severity Index based on assessments of radiographic bone loss. AB - The purpose of the present study was to develop a partial recording system based on the principles of the Extent and Severity Index, aiming at describing the degree of radiographic alveolar bone loss on a population level. The data analyzed were derived from a subject sample comprising 531 individuals aged 25-75 yr. In these subjects alveolar bone level (ABL) was radiographically assessed at all approximal tooth surfaces. An ABL value of greater than 2 mm was required for a tooth site to be included in the computation of a full mouth bivariate Extent and Severity Index (FESI). A partial recording index (PESI-2) based on 18 ad hoc selected tooth sites depicted in one periapical and one vertical bitewing radiograph was evaluated in comparison with the FESI as well as with partial recording indices based on the 9 and 18 tooth sites which displayed the highest correlation with full mouth scores (PESI-9 and PESI-18, respectively). It was shown that all three partial recording systems generated values reasonably close to the full-mouth scores. However, the fitness of all partial indices varied with age. The potential of the partial indices to predict full-mouth scores could be further enhanced via simple regression models. Such an evaluation should, ideally, be carried out in an independent subject sample. PMID- 1764898 TI - Dental health behavior and attitudes--an application of correspondence analysis. AB - Differences in dental behavior and dental attitudes between people with (almost) all natural teeth, people with a full denture in both jaws and people with a full denture in only the maxilla are visualized by means of correspondence analysis in one overall picture. In this picture the three distinguished subgroups of dental patients and their characteristics are indicated as points in a two-dimensional space. The distances between the points in this picture show to what extent these points are connected. The findings obtained in this study can lead to the conclusion that: a. differences in dental status are related to differences in dental behavior and dental attitudes; b. people with all natural teeth and people with a full denture in both jaws obviously are opposite of each other in many respects, whereas people with a full denture in only one jaw can be characterized as a dental in-between group. PMID- 1764899 TI - A random effects model for some epidemiological features of dental caries. AB - We describe a random effects model for caries lesion development and progression based on considering the effects of the pH fluctuations over time in microbial dental plaque as a Wiener process with a single absorptive barrier. The model predicts that the period of greatest risk to developing caries occurs shortly after eruption, but thereafter the longer a surface survives without developing a lesion, the less likely will it be that a lesion will subsequently develop. The model is able to anticipate why the effect of water fluoridation on caries prevalence is most pronounced when caries is diagnosed at cavity level. This model offers one way in which the variability which characterizes the complex ecosystem associated with dental caries may be considered a subject of interest for enhancing our understanding of its pathogenesis and epidemiology. PMID- 1764900 TI - Primary reasons for extraction of permanent teeth in Norway: changes from 1968 to 1988. AB - The purpose of the present study was to investigate time trends in primary reasons for extraction of permanent teeth in Norway from 1968 to 1988. Johansen studied reasons for extraction of 8757 teeth in 4216 patients during a 3-week period in 1968. Twenty years later a random sample of 500 Norwegian dentists provided particulars about all extractions carried out during a 2-week period. 350 dentists (70%) replied in 1988 but 96 of them had not extracted any teeth during the observation period. Reasons for extraction of 985 teeth from 692 patients were available for analysis. Caries and its sequelae accounted for 35%, periodontitis for 19%, and orthodontic reasons for 20% of extractions in 1988. A comparison of the distribution of extraction according to reasons for patients over 20 yr of age revealed a highly significant difference between 1968 and 1988 (P less than 0.001) mainly due to a decrease in the role of caries and an increase in extractions for other reasons. Caries and its sequelae accounted for a higher proportion of extractions than periodontitis at all ages over 20 yr in 1968, only up to 45 yr of age in 1988. Thus it is concluded that the observed time trend in primary reasons for extraction corroborates expectations based on declining caries prevalence, increasing retention of teeth and a rise in dental attendance in Norway during the last 20 yr. PMID- 1764901 TI - Optimism-pessimism dimension and dental anxiety in children aged 10-12 years. AB - This study explored the relationships between Previous Dental Experience (PDE), Corah's Dental Anxiety Scale (DAS), the Dental Anxiety Question (DAQ), dispositional optimism as measured by the Life Orientation Test (LOT), and Clinical Behavioral Rating (CBR). The main purpose of the study reported here was to investigate the possible usefulness of the optimism-pessimism dimension in predicting clinical dental anxiety. 163 children aged 10-12 yr participated in the investigation. The results indicate that both self-reported dental anxiety and optimism-pessimism were unique contributers to prediction of behavioral ratings of dental anxiety. PMID- 1764902 TI - Salivary levels of mutans streptococci and lactobacilli in dentate 80- and 85 year-old Swedish men and women. AB - The number of Streptococcus mutans, Streptococcus sobrinus, and lactobacilli in whole stimulated saliva was examined in 130 dentate 80- and 85-yr-old persons. 88.5% were positive for mutans streptococci and 29% carried greater than 10(6) cfu per ml saliva. S. mutans was most frequently isolated and was found in 114 persons (88%) alone or in combination with S. sobrinus. S. sobrinus was detected in 33 persons (25%), who also showed significantly higher salivary numbers of both mutans streptococci and lactobacilli than persons from whom S. sobrinus was not isolated. The S. sobrinus carriers also had significantly lower stimulated saliva secretion rates than the non-carriers. 95% of the subjects had detectable levels of lactobacilli in saliva with 35% having greater than 10(5) cfu per ml saliva. When the subjects were divided into classes according to the number of intermaxillary contacts, i.e. the Eichner classification, the distribution of subjects with high and low salivary counts of cariogenic bacteria varied. Thus fewer subjects belonging to Eichner class A showed higher salivary numbers of mutans streptococci (14% had greater than 10(6) cfu/ml) as well as lactobacilli (21% had greater than 10(5) cfu/ml) than, for example, subjects belonging to Eichner class B (26% had greater than 10(6) cfu/ml of mutans streptococci, 35% had greater than 10(5) cfu/ml of lactobacilli). Subjects who carried a removable denture(s) had significantly higher salivary numbers of both mutans streptococci and lactobacilli than subjects without removable dentures. PMID- 1764903 TI - Oral health of a group of non-institutionalised mentally handicapped adults in the UK. PMID- 1764904 TI - Prevalence of juvenile periodontitis in Israeli military recruits as determined by panoramic radiographs. PMID- 1764905 TI - Fish plasma lipoproteins--comparative observations in serranides and sparides. AB - 1. Diet, time from last feeding, temperature, season and sexual stage are some of the factors influencing the lipoprotein pattern. 2. Keeping these factors constant species-specific differences observed among lipoprotein patterns of Sparus aurata, Puntazzo puntazzo, Diplodus sargus, Diplodus vulgaris and Dicentrarchus labrax are discussed. 3. Feeding habits and therefore lipid absorption and the rate of lipoprotein maturation process are the factors determining the observed differences. PMID- 1764906 TI - The hepatic glutathione content and glutathione S-transferase activity in the pike (Esox lucius L.) and rat. AB - 1. The content of glutathione and glutathione disulfide and the activity of the glutathione S-transferase were determined in the liver of pike and rat. 2. It was found that the liver of pike contains far less glutathione than the liver of rats, while the glutathione disulfide content was similar in both species. 3. The activity of the hepatic glutathione S-transferase was more effective in pike than in rats. PMID- 1764907 TI - Role of microsomal cytochrome P-450 in the formation of ecdysterone in larval house fly. AB - 1. Six cytochrome P-450 species have been purified to varying extents from microsomes obtained from ecdysone-induced house fly larvae by the use of octylamino Sepharose-4B, Synchropak AX-300, Synchropak CM-300 and TSK-DEAE-5 PW column chromatography. 2. One of the fractions apparently corresponded to a mixture of low- and high-spin cytochrome P-450 as judged by spectral characteristics. 3. Molecular weights of the cytochrome P-450 species ranged from 50,000 to 57,000. 4. In a reconstituted system, all the microsomal species hydroxylated ecdysone at rates within the range of microsomal suspensions, as it occurs with mitochondrial fractions 1, 2, 3, 5, and 6 (Srivatsan et al., 1990, Biochem, biophys. Res. Commun. 166, 1372-1377); whereas, mitochondrial fraction 4 hydroxylates ecdysone at significantly higher rates. 5. It is postulated that the 20-monooxygenation of ecdysone is a mitochondrial event which requires the induction of a low-Km cytochrome P-450 species by ecdysone. 6. Microsomal hydroxylation of ecdysone may not be of physiological significance, as Km values for the reaction are above the normal concentrations of the hormone and the activity is not inducible by ecdysone (Agosin et al., 1988, Arch. Insect Biochem. Physiol. 9, 107-117). PMID- 1764908 TI - Liver 3-hydroxyanthranilic acid oxygenase activity in rainbow trout (Oncorhynchus mykiss). AB - 1. In rainbow trout, 3HAA activity was comparable with those of terrestrial animals; 3HAA:PC activity ratio suggests ineffective conversion of tryptophan to niacin. 2. Inactivation as well as reactivation under different conditions was investigated. 3. Some characteristics of the enzyme extract were studied with the aim of optimizing assay in fish. PMID- 1764909 TI - The relationship between red cell aging and enzyme activities in experimental animals. AB - 1. The relationship between red cell aging and enzyme activities was studied in rabbit, guinea-pig, hamster, rats (F344/N and SD), and mice (BALB/c and DBA/2). 2. The activities of six enzymes: glucose-6-phosphate dehydrogenase (G-6-PD), 6 phosphogluconate dehydrogenase (6-PGD), hexokinase (Hx), glutamate oxaloacetate transminase (GOT), lactate dehydrogenase (LDH) and acetylcholinesterase (AChE), were measured in the red cells of different ages which were obtained either by centrifugation or experimental anaemia. 3. Hx, AChE and GOT activities were much higher in younger red cells than in older cells, hence the activities of these enzymes may be used as an indicator of age of the cells. PMID- 1764910 TI - Immunological identification of uncoupling protein in interscapular "brown" adipose tissue of suckling and adult pipistrelle bats (Pipistrellus pipistrellus). AB - 1. Interscapular adipose tissue of suckling and adult pipistrelle bats was examined for the presence of the 32,000 Mr "uncoupling protein" diagnostic of brown adipose tissue. 2. Following separation by SDS-polyacrylamide gel electrophoresis, mitochondrial proteins were blotted onto nitrocellulose and probed for uncoupling protein with an anti-(ground squirrel uncoupling protein) serum. 3. Immunoreactivity consistent with the presence of uncoupling protein was found in all samples of adipose tissue mitochondria from both suckling and adult bats. 4. It is concluded that interscapular adipose tissue in pipistrelle bats exhibits the critical biochemical criterion for being designated functionally "brown". PMID- 1764911 TI - Aminopeptidase activities present in tissues of Helix aspersa. AB - 1. Tissues of Helix aspersa have been examined for the presence of aminopeptidase activities. 2. Enzyme activities were detected using synthetic peptide substrates containing the fluorescent leaving group 7-amino-4-methyl coumarin. The methods used included continuous fluorimetric assay and activity staining of enzymes in non-denaturing polyacrylamide gels. 3. Several types of peptidase activity were detected, including three distinct aminopeptidases which differ in molecular size and substrate preference. PMID- 1764912 TI - Structural and kinetic properties of chymotrypsin from Atlantic cod (Gadus morhua). Comparison with bovine chymotrypsin. AB - 1. Two chymotrypsins with isoelectric points pI 6.2 and 5.8 were purified from the pyloric caeca of Atlantic cod using a phenyl-Sepharose column and chromatofocusing chromatography. The apparent molecular weight was 26,000 as judged by SDS-polyacrylamide gel electrophoresis and gel filtration. 2. The cod enzymes differed from bovine chymotrypsin in having a slightly higher molecular weight and more acidic pI points. N-terminal amino acid sequence analysis of cod chymotrypsin B showed considerable similarity with bovine chymotrypsin. 3. Heat stability and stability towards acidic pH were reduced in the cod enzymes. Generally, the cod and bovine chymotrypsins responded similarly to various protease inhibitors. However, the cod chymotrypsins were less sensitive to aprotinin inhibition but more sensitive towards soybean trypsin inhibitor and cysteine. 4. Kinetic properties were examined and the cod enzymes found to be more active towards both ester (N-benzoyl-tyrosine ethyl ester) and amide (N benzoyl-tyrosine-p-nitroanilide) substrates. The observed differences in kinetic properties are indicative of an adaptive response towards the low temperature environment in which the cod lives. PMID- 1764913 TI - Distribution of carotenoids in the eggs from four species of salmonids. AB - 1. The distribution of carotenoids in unfertilized ovulated eggs from chum salmon, kokanee (natural and cultured), masu salmon and cultured rainbow trout was examined from the comparative biochemical point of view. 2. The carotenoid contents in the eggs from cultured salmons such as kokanee and rainbow trout were low, whereas those from natural salmons were high. 3. The carotenoids were distributed in both chylomicra particles with high levels of triglyceride and lipovitellin. The carotenoids in the eggs of cultured kokanee and masu salmon were mostly distributed in lipovitellin, whereas those of the other salmons were equally contained in both chylomicra particles and lipovitellin. 4. Comparison of carotenoid distribution in the eggs from immature and mature chum salmon indicated that the carotenoids were bound to lipovitellin, as well as to chylomicra particles, during vitellogenesis. PMID- 1764914 TI - A comparative study of the biological properties of some sea snake venoms. AB - 1. The protease, phosphodiesterase, alkaline phosphomonoesterase, L-amino acid oxidase, acetylcholinesterase, phospholipase A, 5'-nucleotidase, hyaluronidase, arginine ester hydrolase, procoagulant, anticoagulant and hemorrhagic activities of ten samples of venoms from seven taxa of sea snakes were examined. 2. The results show that venoms of sea snakes of both subfamilies of Hydrophiinae and Laticaudinae are characterized by a very low level of enzymatic activities, except phospholipase A activity and, for some species, hyaluronidase activity. 3. Because of the low levels of enzymatic activities and the total lack of procoagulant and hemorrhagic activities, venom biological properties are not useful for the differentiation of species of sea snakes. Nevertheless, the unusually low levels of enzymatic activities of sea snake venoms may be used to distinguish sea snake venoms from other elapid or viperid venoms. PMID- 1764915 TI - Effect of temperature on the adenylate cyclase activity of Mytilus galloprovincialis mantle tissue. AB - 1. The basal and NaF-stimulated adenylate cyclase activities of Mytilus galloprovincialis mantle tissue were studied at different temperatures. 2. There are no significant differences in the Km for ATP at 13 degrees C and 20 degrees C in both basal and NaF-stimulated conditions. 3. NaF increases the Vmax of the enzyme (5-fold) and decreases about 50% the Km for ATP at both temperatures assayed. 4. Activation energy of the enzyme reaction is 33.4 kJ/mol. K in basal conditions and 29.4 kJ/mol. K when NaF is present. The Q10, at saturating substrate concentrations, is approximately 1.5 and this value is constant in the temperature range studied, 10-30 degrees C. 5. The adenylate cyclase starts being inactivated from 30 degrees C. The enzyme shows greater sensitivity to denaturalization by temperature in NaF-stimulated than in basal conditions. PMID- 1764916 TI - Purification and characterization of different "acid" beta-galactosidases from sheep kidney. AB - 1. Two "acid" forms, Am and Al, of beta-galactosidase from sheep kidney have been isolated and purified 349- and 154-fold, respectively, with a recovery of about 8%. 2. Their mol. wts were about 450,000 and 230,000, respectively. Am seems to be a dimer of Al. The aggregation is stimulated by NaCl. 3. The "acid" beta galactosidase has a pH optimum between 4.0 and 5.0 for both forms. They are located in the lysosomes. The optimal temperature is 37 degrees C and 40 degrees C for Al and Am forms, respectively. 4. Three peaks were detected by isoelectric focusing. After sialidase treatment, these peaks were obtained at higher pH values. 5. The activation energy values were 10.75 and 11.72 kcal/mol for Am and Al, respectively. 6. A variety of chemicals were tested as possible activators or inhibitors. The enzyme is strongly inhibited by gamma-D-galactonolactone, and the kinetic evidence suggests a competitive inhibition in all cases. PMID- 1764917 TI - Purification and properties of two molecular forms of arginine kinase from the adductor muscle of the scallop, Pecten maximus. AB - 1. Two molecular forms of arginine kinase, AK1 and AK2 have been purified from the adductor muscle of the scallop, Pecten maximus. AK2 was retained on a DEAE cellulose column at pH 7.5, but AK1 was not. 2. Both forms were monomeric (mol. wt. approximately 42,000) and showed the same pH optimum (7.5-8.0) in the direction of phosphoarginine synthesis. 3. AK1 had slower electrophoretic mobility at pH 8.3 towards the anode, higher lysine content, lower glutamate content, lower Km for L-arginine and higher Km for Mg(2+)-ATP than AK2. Unlike AK1, AK2 was strongly inhibited at high concentrations of Mg(2+)-ATP. 4. Both molecular forms cross-reacted with antisera raised against native as well as performic acid-oxidized lobster muscle arginine kinase. However, AK1 showed a greater affinity than AK2 to anti-lobster arginine kinase antibodies, particularly to those raised against the native enzyme. PMID- 1764918 TI - The basic isoelectric form of alpha-L-fucosidase from the hepatopancreas of the shrimp Penaeus monodon (Crustacea: Decapoda). AB - 1. alpha-L-Fucosidase was purified ca 10,889-fold to homogeneity from Penaeus monodon, with a final spec. act. of 31,250 U/mg of protein. 2. By using SDS polyacrylamide gel electrophoresis, the monomers of shrimp alpha-L-fucosidase were discovered to have mol. wts of 63,000 and those of human placental enzyme, 46,000 and 20,000. Since the active shrimp alpha-L-fucosidase was found to have a mol. wt of 233,000 by Superose 12 FPLC, it was concluded that the purified shrimp enzyme was tetrameric. 3. In contrast to the discovery of thermolability with human placental alpha-L-fucosidase, the shrimp enzyme was found to be stable to heating at 65 degrees C for 10 min. 4. The shrimp alpha-L-fucosidase has an isoelectric point (pI) of 8.5, but the human placental enzyme has a pI of 4.0. The shrimp enzyme was sialyated. 5. The shrimp alpha-L-fucosidase has a pH optimum at 5.5 and its Km was 22.2 microM with 4-methyl-umbelliferyl-alpha-L fucopyranoside as substrate. The human enzyme has a broad pH optimum between 5.0 and 6.5. PMID- 1764919 TI - Comparison of rat and human major platelet glycoproteins. AB - 1. Using electrophoretic techniques combined with various detection methods we ascribed rat platelet glycoproteins (GPs) related to human GPIb, GPIIb and GPIIIa. 2. Rat GPIIb and GPIIIa crossreacted with rabbit polyclonal antibodies against human GPIIb and GPIIIa. 3. Species differences in glycosylation of GPs were shown using various lectins. 4. Molecular mass of rat major GPs was determined by SDS-PAGE (unreduced, reduced, kDa): GPIb (200, 166/26), GPIIb (140, 120/32) and GPIIIa (96, 106). 5. Isoelectric points of rat GPIIb and GPIIIa are shifted to the alkaline region as compared to human related GPs. PMID- 1764920 TI - cDNA cloning, sequencing and temporal expression of the protease responsible for vitellin degradation in the silkworm, Bombyx mori. AB - 1. We have cloned the cDNA encoding the vitellin (Vtn)-degrading protease (30 k Vtn protease and 24 k Vtn protease) of the silkworm, Bombyx mori, and determined the primary structure by sequencing the cDNA along with mRNA. 2. The deduced amino acid sequence comprised 264 amino acid residues and had high homology to the trypsin-like proteases of vertebrates and invertebrates. 3. Northern blot analysis using the cDNA as a probe revealed that the transcription of the Vtn protease gene occurred at the restricted stage of embryogenesis when the protease activity appeared. 4. The in vitro translation experiment demonstrated that a 32 kDa polypeptide was the primary translation product and the translation activity changed according to transcriptional activity. 5. By Western blotting using the antiserum against each Vtn protease, two enzymes were shown to share the common antigenicity, and the titer of both enzyme proteins changed closely related with activity of proteases. 6. These results led us to conclude that the biosynthesis of Vtn protease is regulated at the level of transcription. PMID- 1764921 TI - Differential effects of oleic acid, sodium dodecyl sulfate, and protease inhibitors on the endopeptidase activities of the lobster multicatalytic proteinase. AB - 1. Lobster muscles contain a latent multicatalytic proteinase; heating at 60 degrees C for 1-2 min converts the latent form to a heat-activated form with enhanced proteolytic activity. Both forms have three endopeptidase activities, which are classified as the trypsin-like, chymotrypsin-like, and peptidylglutamylpeptide bond hydrolyzing activities. 2. Sulfhydryl reagents (mersalyl acid, N-ethylmaleimide, hemin, iodoacetamide, and p chloromercurisulfonic acid), benzamidine, and chloromethyl ketones inhibited all three activities of the heat-activated form. Leupeptin and antipain inhibited only the trypsin-like activity, while the chymotrypsin-like activity was the most sensitive to diisopropyl fluorophosphate, phenylmethanesulfonyl fluoride, aprotinin, and soybean trypsin inhibitor. Pepstatin and L-trans epoxysuccinylpeptides had little effect on the peptidase activities. 3. Sodium dodecyl sulfate and oleic acid preferentially activated the peptidylglutamyl peptide hydrolyzing activity of the latent form, whereas N-ethylmaleimide stimulated both the trypsin-like and peptidylglutamyl-peptide hydrolases. These results suggest that the lobster enzyme is an atypical serine proteinase. PMID- 1764922 TI - Effect of maturation on activities of various proteases and protease inhibitors in the muscle of Ayu (Plecoglossus altivelis). AB - 1. Increases in activities of muscle muticatalytic proteinase, modori-inducing proteinase (latent trypsin-like proteinase), cathepsin B and L-like proteases and cathepsin D were observed more markedly for male fish than female fish, in the spawning stage. 2. Decreases in inhibitory activities of muscle serine and cysteine protease inhibitors were observed more markedly for male fish than female fish in the spawning stage. PMID- 1764923 TI - Structure of the polypeptide chain of extracellular hemoglobin from the nematode Ascaris suum. AB - 1. Ascaris suum extracellular hemoglobin is composed of eight identical single polypeptide chain subunits carrying two heme binding sites each. 2. Limited trypsinolysis followed by sodium dodecyl sulphate-polyacrylamide gel electrophoresis gave a major band corresponding to half the molecular mass of an intact subunit. 3. Peptide mapping of tryptic hydrolysates yielded 27 to 30 fluorescamine positive spots, about half the number of lysyl and arginyl residues in a polypeptide chain. 4. The findings indicate that a subunit of Ascaris hemoglobin consists of two structural units of roughly equal size, corresponding to two recurring sequences, connected together by the continuity of the polypeptide chain. PMID- 1764924 TI - Production of an antibody to arterial fatty acid-binding protein (FABP) using a synthetic peptide as the antigen. AB - 1. A procedure is described for the preparation of an antibody to arterial FABP using a synthetic peptide as an antigen. In order to locate a highly conserved region located on the outer surface of FABP, computer analysis of primary and secondary structures of several proteins from the FABP family was undertaken and a 24 amino acid sequence beginning at the fifth position from the N-terminus of rat heart FABP was chosen. 2. The synthetic peptide consisted of eight replications of the 24 amino acid sequence individually attached to the alpha and epsilon amino groups of each terminal lysine on an octalysine branched peptide. 3. Antibody to the synthetic antigen was raised in New Zealand rabbits. Western analysis was conducted and detection was accomplished by using goat-anti-rabbit second antibody conjugated to alkaline phosphatase. 4. The antibody produced from the previously described peptide, recognized purified rat heart FABP and demonstrated a high positive correlation (r = 0.96) when known concentrations of purified hFABP were plotted against densitometric measurement of the bands. 5. Additionally, the antibody recognized FABP from the 104,000 g supernates of rat atrial and arterial tissue fractionated by a Sephadex G-75 column. 6. Therefore, the antibody produced from this particular protocol employing a synthetic peptide can be utilized qualitatively and quantitatively in the analysis of the heart and arterial FABP content. PMID- 1764925 TI - Purification and characterization of two odorant-binding proteins from nasal tissue of rabbit and pig. AB - 1. Soluble proteins showing binding activity to 2-isobutyl-3-methoxypyrazine have been purified to homogeneity from rabbit and pig nasal tissue; their characteristics are similar to the bovine odorant-binding protein and are to be considered members of the same family. 2. The rabbit protein is a homodimer with subunits of Mr 19k and an isoelectric point of 4.7, whereas the pig protein appears to consist of a single polypeptide chain of Mr 22k and an isoelectric point of 4.2. 3. Both proteins bind 2-isobutyl-3-methoxypyrazine with dissociation constants in the micromolar range. 4. Antibodies against the bovine OBP react well with the rabbit protein, and slightly with the porcine one. PMID- 1764926 TI - Cuticular proteins from the shrimp, Pandalus borealis. AB - 1. The percentages of mineral salts, chitin, and urea-extractable and non extractable proteins were determined in pieces of cuticle from selected body regions of the shrimp, Pandalus borealis. 2. Two-dimensional gel-electrophoresis of the urea-extractable proteins shows that a large number of different proteins are present. Identical protein patterns are obtained from the various cuticular regions. 3. A fractionation scheme is presented, which is suitable for obtaining the major proteins in quantities sufficient for further characterization. The amino acid compositions are reported for several of the proteins. PMID- 1764927 TI - Scale and bone type I collagens of carp (Cyprinus carpio). AB - 1. Soluble Type I collagens were isolated from the scale and bone (skull) of lathyritic carp. Each tissue collagen was assumed to consist of two different molecular forms, (alpha 1)2 alpha 2 as a main component and alpha 1 alpha 2 alpha 3 as a minor one. 2. The possible coexistence of these two forms in soluble Type I collagen of carp was previously observed for skin and muscle, but not for the swim bladder in which only the form of (alpha 1)2 alpha 2 was found. 3. These composite results suggest the wide distribution of alpha 1 alpha 2 alpha 3 heterotrimers in collagenous tissues of carp. PMID- 1764928 TI - The value of an expert system in performing clinical drug trials. AB - An expert system has been designed to assist the cardiologist in determining whether patients can be included in clinical trials. This system contains knowledge on inclusion and exclusion criteria for six drug trials, and has been validated in 100 randomly selected patients. In 97 cases, the expert system and the cardiologist made an identical classification; in the remaining three cases, the patient was incorrectly classified by the physician. The system will also optimize the order in which questions are asked in order to minimize the time required to decide on inclusion or exclusion. PMID- 1764929 TI - Autospec: computerized processing of the data output from a spectrophotometer in a biochemical laboratory. AB - Autospec was designed to acquire data output from a Beckman DU series 60 spectrophotometer and to process these data with an IBM or IBM-compatible computer. It functions in conjunction with the Beckman DU Data Capture and Lotus 1-2-3 softwares. Autospec automatically stores data produced by the spectrophotometer, determines standard curves and calculates unknown concentrations of the substance being assayed. The principal features of Autospec are simplicity of use, adaptability and flexibility, minimal intervention from the operator, standardized print-outs of all data in tabular and graphic forms, accuracy of computations, speed of operation, and ease of storage and back-up of data files. PMID- 1764930 TI - A microcomputer-based device to simulate biomechanical environments for cultured cells. AB - We describe software and hardware for a microcomputer-based cyclic strain device which applies programmed cycles of elongation and relaxation to cultured cells. This system has the potential to simulate many of the complex mechanically active environments found in living systems. As a sample application, we use it to simulate the cyclic stresses to which vascular smooth muscle cells in the arterial system are exposed. PMID- 1764932 TI - Color modulation of Doppler spectra with the use of a personal computer. AB - This paper describes a method for the use of a personal computer in developing color modulated spectral maps of blood flow echoes from a Doppler flowmeter. The acoustical signal from a Doppler flowmeter is digitized and transformed into the frequency domain with a fast Fourier technique with the use of an Apple IIe microcomputer in conjunction with a Motorola 68000 co-processor. The resultant transform is displayed as a pseudo three-dimensional, color modulated spectral map by way of a color monitor, or a television projector onto the meeting room screen. We have found this technique to be useful in appreciating differences in blood flow from different hydraulic conditions, as well as in helping the medical students appreciate these differences in pulsatile flow in various arteries. PMID- 1764931 TI - Development and evaluation of two automated methods for quantifying human muscle sympathetic nerve activity. AB - The microneurographic technique of directly recording muscle sympathetic nerve activity (SNA) in conscious humans was developed over 20 yr ago, but analysis and quantification of the resultant mean voltage neurogram has been largely by visual inspection by a trained observer. Two computer-assisted methods were developed to quantitate these bursts of efferent activity: peak detection, and ECG R-wave triggered burst averaging. Peak detection was optimized using statistical techniques; burst averaging was compared to both the manual technique and to the peak detection method. Burst averaging was found to be the superior method because of its speed, consistency, and objectivity. PMID- 1764933 TI - Can the analytic techniques of nonlinear dynamics distinguish periodic, random and chaotic signals? AB - Recent advances in the mathematical discipline of nonlinear dynamics have led to its use in the analysis of many biologic processes. But the ability of the tools of nonlinear dynamic analysis to identify chaotic behavior has not been determined. We analyzed a series of signals--periodic, chaotic and random--with five tools of nonlinear dynamics. Periodic signals were sine, square, triangular, sawtooth, modulated sine waves and quasiperiodic, generated at multiple amplitudes and frequencies. Chaotic signals were generated by solving sets of nonlinear equations including the logistic map, Duffing's equation, Lorenz equations and the Silnikov attractor. Random signals were both discontinuous and continuous. Gaussian noise was added to some signals at magnitudes of 1, 2, 5, 10 and 20% of the signal's amplitude. Each signal was then subjected to tools of nonlinear dynamics (phase plane plot, return map, Poincare section, correlation dimension and spectral analysis) to determine the relative ability of each to characterize the underlying system as periodic, chaotic or random. In the absence of noise, phase plane plots and return maps were the most sensitive detectors of chaotic and periodic processes. Spectral analysis could determine if a process was periodic or quasiperiodic, but could not distinguish between chaotic and random signals. Correlation dimension was useful to determine the overall complexity of a signal, but could not be used in isolation to identify a chaotic process. Noise at any level effaced the structure of the phase plane plot. Return maps were relatively immune to noise at levels of up to 5%. Spectral analysis and correlation dimension were insensitive to noise. Accordingly, we recommend that unknown signals be subjected to all of the techniques to increase the accuracy of identification of the underlying process. Based on these data, we conclude that no single test is sufficiently sensitive or specific to categorize an unknown signal as chaotic. PMID- 1764934 TI - [What is psychiatry?]. PMID- 1764937 TI - [Effort toward theorization: a leading force in practice, education and research]. PMID- 1764936 TI - [Asking about 'nursing and medicine']. PMID- 1764938 TI - [The world of Hildegard von Bingen]. PMID- 1764935 TI - [Case study reports, No. 181 (Society for Scientific Nursing)]. PMID- 1764939 TI - [Searching for logic of children's recognition]. PMID- 1764940 TI - Comparison of local signs and symptoms after the insertion of Norplant implants with and without a scalpel. AB - The study compares NORPLANT subdermal implants acceptors enrolled randomly for two different insertion procedures. One group (420 women) received the implants with the use of a scalpel according to the manufacturer's instructions. The other group (423 women) received the implant without an incision, directly through a sharpened trocar. The local signs and symptoms were observed at 7 and 30 days after insertion. Pain, tenderness, edema/swelling, ecchymosis and defective scar were considered. Complication rates were low and no significant differences were found between the two procedures. Based on the data of this study, we recommend inserting NORPLANT implants without the use of a scalpel. PMID- 1764941 TI - Progestagen-only oral contraceptives: comparison of the metabolic effects of levonorgestrel and norethisterone. AB - A 6-month single-blind study compared the use of a progestagen-only oral contraceptive containing norethisterone 350 micrograms/day (NE 350) with one containing levonorgestrel 30 micrograms (LN 30), to assess the metabolic effects. At the end of 6 months, there were no significant differences between the two groups with respect to plasma cholesterol, lipoproteins including HDL subfractions, triglycerides or glucose concentration. Levels of fibrinogen, plasminogen, Factor VII, Factor X and antithrombin III were also similar. Women changing from a combined oral contraceptive to LN 30 showed a significant fall in Factor X. Mean blood pressure fell on LN 30 by 7/9 mmHg, but the 6-month reading did not differ significantly from that in women on NE 350. Acceptability, and the metabolic effects of the two preparations were similar in this study. Further larger studies are warranted. PMID- 1764942 TI - Effects of intranasal administration of norethisterone on folliculogenesis, cervical mucus, vaginal cytology, endometrial morphology and reproductive endocrine profile in women. AB - The effects of intranasal administration of norethisterone (NET) on menstrual cycle length, folliculogenesis, serum levels of estradiol, FSH, LH and progesterone, vaginal cytology, cervical mucus and endometrial morphology were studied in 8 volunteers (age 28 to 39 years, weighing between 46 and 54 kg). The study period comprised 4 consecutive menstrual cycles. In the first cycle (pretreatment cycle), only the vehicle (alcohol, propylene glycol, water; 3:3:4) was sprayed intranasally (100 microliters in each nostril), using a metered nebulizer, once daily from day 3 to the last day of menstrual cycle. In the next two cycles (treatment cycles), NET (300 micrograms/day) was administered once daily, starting from day one of menstrual cycle, between 9 and 10 a.m. The fourth cycle was a post-treatment cycle in which the volunteers were monitored for recovery. Blood samples (about 5 ml each) were collected once daily from day 8 to 24 and thereafter on alternate days until the last day of cycle during all the 4 cycles. Levels of estradiol, FSH, LH and progesterone were measured in the serum samples by radioimmunoassay methods. Cervical mucus samples and vaginal smears were collected once daily starting from day 7 or 8 of each cycle until the mucus was very scanty. Serial pelvic ultrasonography was performed starting from day 7 or 8 until the growing follicle disappeared or throughout the cycle in case a growing follicular cyst was observed. Endometrial aspirates were collected once around day 22 in each cycle and processed for routine histological examination. PMID- 1764943 TI - Transdermal absorption of the progestin ST-1435: therapeutic serum steroid concentrations and high excretion of the steroid in saliva. AB - The synthetic progestin ST-1435 was administered transdermally to six healthy women during the late luteal phase. The steroid was applied to the periumbilical area in a commercial gel ("Progestogel"), also containing progesterone. Single doses of 2.3, 4.5 and 9.0 mg of ST-1435 were given in three experiments and repeated doses of 2.3 mg of ST-1435 for five days were given in another three experiments. Samples of serum and saliva were collected and the concentrations of ST-1435 and progesterone were determined by radioimmunoassays. Transdermal absorption of the synthetic progestin ST-1435 was shown to result in serum steroid concentrations high enough for therapeutic purposes. The concentration of ST-1435 in serum was still high 24 hours after application, reflecting sustained release of the steroid from the skin. In the five-day experiments, relatively constant serum levels were achieved in different individuals, and a single dose per day seems sufficient. High excretion of ST-1435 in saliva was found two hours after gel application. However, the concentrations of serum and salivary ST-1435 were not directly correlated in different individuals. Transdermal application of ST-1435 might offer a good alternative for systemic progestin treatment. PMID- 1764944 TI - Multivitamin supplementation in oral contraceptive users. AB - The effects of oral contraceptives (OC) containing 30 micrograms of ethinyl oestradiol and of subsequent multivitamin and folic acid supplementation on vitamin A, total B2 [including its three individual constituents, i.e. riboflavine, RB; flavine-mono-nucleotide, FMN; and flavine-adenine-dinucleotide, FAD], B12, C and folate concentration in serum and red blood cells have been studied in a group of 59 non-pregnant female volunteers. The group taking OC comprised 28 women while 31 women were included in the group of non-OC users serving as the controls. The women were studied for four cycles. Blood samples were taken on days 3 and 23 of the first cycle to obtain baseline values of each analyte. Multivitamin and folic acid supplementation started on day 1 of the second cycle and this was continued daily throughout three consecutive cycles until the end of the study. Vitamin A levels were significantly higher and vitamin B12 levels were significantly lower in the group using OC. Comparison of the baseline values of vitamin total B2, FAD, C, serum and red blood cell folate as determined on days 3 and 23 of the first cycle of the two groups compared revealed no significant differences. Multivitamin and folic acid supplementation did not affect the concentrations of vitamin A and vitamin B12 with either group, whereas all other vitamins increased significantly in both groups. The consistency of each effect of multivitamin supplementation between the two groups was also tested. The degree of these effects was not statistically different between both groups. The results suggest that the vitamin status is indeed affected by OC treatment, but the effects of multivitamin supplementation are not different in OC and non-OC users. Supplementation during OC use or just after discontinuing treatment cannot be justified for healthy young women. However, in the case of women with a critical vitamin balance or higher folate needs, multivitamin supplementation may be considered. PMID- 1764946 TI - Antifertility activity of volatile fraction of neem oil. AB - NIM-76, the odorous and volatile fraction of neem oil, was investigated for its antifertility activity in vivo in rats, rabbits and rhesus monkeys. The drug is effective when applied before coitus but not so when applied during post-coital stages. It, therefore, appears to act mainly by its spermicidal effect. No alteration in the estradiol (E2) and progesterone (P) values was observed after the application of the drug in monkeys. PMID- 1764945 TI - Changes in the concentrations of testosterone, luteinising hormone and progesterone associated with administration of embelin. AB - The mode of action of embelin, a naturally occurring plant benzoquinone with male fertility regulating potential, was investigated. Sexually mature white New Zealand male rabbits were injected intra-muscularly with embelin (30 mg/kg body wt) on alternate days for 14 days (7 injections). Blood was collected on alternate days over 27-day period from the beginning of embelin administration. Testosterone and progesterone levels were measured by radioimmunoassay and luteinising hormone (LH) by mouse interstitial cell testosterone bioassay. There was a marked reduction of testosterone concentrations within two days of embelin administration and up to 90% reduction by the 6th day. LH showed a corresponding rise with the falling testosterone levels. Similarly, there was rapid increase in progesterone levels with the administration of embelin. Both the concentrations of progesterone and LH declined when embelin dosage was stopped. Evidence from the observed changes in the levels of the three hormones suggest that embelin disrupts production of testosterone at the testicular level. PMID- 1764947 TI - Bioavailability of norethindrone and menstrual pattern after insertion of norethindrone acetate implants in rhesus monkeys. AB - Subdermal silastic implants releasing norethindrone acetate were inserted in five rhesus monkeys for a period of seven months. The serum norethindrone (NET) levels were estimated from blood samples collected fortnightly. There was an initial high level of NET followed by fluctuating levels of NET in 4 out of five monkeys. The serum NET values showed individual variation between time periods as well as between monkeys. The analysis of menstrual cycles showed initial amenorrhoea up to day 120-140 in four out of five monkeys. Only one monkey showed vaginal bleeding pattern comparable to normal menstrual cycles; this monkey had serum NET levels less than 10 ng/ml. The pharmacokinetic and pharmacodynamic parameters were similar to those reported in the human female. PMID- 1764948 TI - Interchangeability of low-dose oral contraceptives. Are current bioequivalence testing measures adequate to ensure therapeutic equivalency? PMID- 1764949 TI - Poetic transformations of Yolmo 'sadness'. AB - One way in which Yolmo Sherpa of Helambu, Nepal, come to terms with loss is to sing of it. The paper seeks to show how one Yolmo 'song of sadness' works to express, evoke and assuage sentiments of funerary grief. Yet to best explore the transformative poetics of the song, we must trace its semantic links to other songs and situations, and so develop a contextual understanding of the experiential contours of Yolmo 'sadness,' the local ethos of emotional avoidance and restraint, and the sociopolitical nature of emotional distress in the Helambu valley. The findings of this analysis lead the author to argue, in contrast with recent ethnographies which treat discourses on emotions as rhetorical strategies rather than as reflections of personal or communal experience, that we need an integrative approach which focuses on the relationship between language and experience, politics and felt emotion. PMID- 1764950 TI - Between folk concepts of illness and psychiatric diagnosis: kitsune-tsuki (fox possession) in a mountain village of western Japan. AB - Two cases of kitsune-tsuki (fox possession) in a mountain village are examined from psychiatric and ethnographic viewpoints. Kitsune-tsuki, one of the most familiar expressions of "madness" in Japan, represents, as an interactive performance, religious and mythopoetic contexts metaphorically in time of crises. The atypical symptoms and the complicated clinical process of these cases reflect a multistratified cultural background and its transformation; communal religion, folk tales, kyogen play, shared concepts of illness, and the post-war rise of one religious cult. The psychiatric diagnosis, trying to arrive at a single correct understanding, partially translates the entangled indigenous illness. Focusing on these issues; the dichotomy between form and content of mental illness, the atypicality of the symptoms and the restructive process of illness experiences, the author reconsiders the possibility of interpretation, diagnosis and treatment which respect the multiple realities. PMID- 1764951 TI - Adult psychiatric epidemiology in China in the 80s. AB - This paper presents the prevalence rates of the main adult psychiatric disorders as determined by seven community surveys conducted in China in the 1980s. The prevalence rates are compared with previous findings in China and those from Taiwan and the West. PMID- 1764952 TI - Bioavailability and pharmacokinetics of oral ofloxacin formulations in normal subjects. AB - The relative bioavailability and pharmacokinetics of ofloxacin tablets and a reference oral solution of ofloxacin were compared in 32 normal male subjects using a randomized two-way crossover design. After an overnight fast, subjects were randomized to receive a single 200 mg or 300 mg dose of ofloxacin (tablet or solution) and blood samples were obtained prior to and 0.5, 1, 1.5, 2, 3, 4, 6, 8, 12, 16, 24, 36, 48, 72, 96, and 120 hours after the dose. After a 5-day wash out period, subjects were administered the same dose but of the other formulation, and blood samples were collected in an identical manner. Plasma concentrations of ofloxacin were determined by high-pressure liquid chromatography. The results showed that ofloxacin tablets were more slowly absorbed when compared to the solution and mean peak plasma concentrations were obtained in about 1.5 hours for the tablet preparation. Maximum plasma concentrations were higher after administration of the solution (Cmax = 2.24 micrograms/ml, 200 mg; Cmax = 3.25 micrograms/ml, 300 mg) compared to the tablet (Cmax = 1.74 micrograms/ml, 200 mg; 2.61 micrograms/ml, 300 mg). The bioavailability of ofloxacin tablets was greater than 98% compared to the solution. The other pharmacokinetic parameters were similar between the two dosage formulations. Ofloxacin tablets revealed an apparent volume of distribution of 1.5 l/kg, an elimination half-life of 5.6 hours, and a total clearance of 251 ml/min. In addition, a linear increase in plasma concentrations was observed when the dose of ofloxacin was increased. In summary, ofloxacin tablets was found to be reliably bioavailable and bioequivalent to the reference solution. PMID- 1764953 TI - Atenolol and ischaemic heart disease: an overview. AB - Data generated to date on the use of beta-blockers, especially atenolol, in ischaemic heart disease are reviewed and compared with the results available with the calcium antagonists. Atenolol appears to be effective as an anti-ischaemic agent in patients with obstructive coronary artery disease when reduction in myocardial oxygen supply (ischaemia not preceded by an increase in heart rate and due presumably to functional coronary stenosis) or increase in demand are the likely causes. Based on current concepts and available data, there is convincing evidence to support the use of atenolol across the spectrum of ischaemic heart disease. In contrast, results with the calcium antagonists have been disappointing and variable. Atenolol, to date, is the only beta-blocker which has been demonstrated to have a life-saving benefit in acute intervention (within 12 hours of onset) in myocardial infarction. This cardioprotective aspect of the drug is likely to be applicable to other areas of ischaemic heart disease, including silent ischaemia. PMID- 1764954 TI - Budesonide once-daily in seasonal allergic rhinitis. AB - A randomized, parallel group, double-blind multi-centre study was carried out in 342 patients with symptomatic seasonal allergic rhinitis to assess the efficacy and tolerability of intranasal budesonide administered either as a single morning dose of 400 micrograms or as a 200 micrograms twice-daily dose, morning and evening, for 4 weeks. Both treatments improved the symptoms of seasonal allergic rhinitis; specific nasal symptom scores recorded daily by the patient being reduced. The proportions of patients symptom free after 4-weeks' treatment were 46% in the 400 micrograms once-daily group and 54% in the 200 micrograms twice daily group, with total daily symptom scores recorded by diary cards reduced by 79% and 80%, respectively. The differences between the groups were not statistically significant. Sub-group analysis of patients allergic to grass pollen (n = 166) showed similar total symptom scores at each level of grass pollen exposure (no significant difference between treatment groups). Patients assessed both treatments to be effective (no significant difference between groups), with 65% of patients questioned stating a preference for a once-daily treatment given equal symptom control. Both treatments were equally well tolerated and few side-effects were reported. PMID- 1764955 TI - Treatment with atenolol prevents progression of microalbuminuria in type I diabetic patients. AB - Nine patients with Type I diabetes mellitus, diastolic blood pressure of 90 to 100 mmHg and persistent microalbuminuria of greater than or equal to 30 micrograms/min were treated with 50 to 100 mg atenolol daily for 3 years in an uncontrolled pilot study to assess the effect of long-term reduction of blood pressure on microalbuminuria. Treatment with atenolol prevented progression of microalbuminuria with a median (range) urinary albumin excretion rate before treatment of 74 (33 to 196) micrograms/min and 50 (5 to 123) micrograms/min after 3 years of therapy (p less than 0.05). Blood pressure was significantly reduced from 156 (121 to 187) mmHg systolic and 95 (90 to 100) mmHg diastolic before treatment to 143 (112 to 168) mmHg systolic (p less than 0.04) and 82 (66 to 84) mmHg diastolic (p less than 0.0003) at 3 years. Measurements of renal function and diabetic control remained unchanged throughout the study period. These results suggest that early and prolonged use of antihypertensive therapy is beneficial in slowing down progression of microalbuminuria. PMID- 1764956 TI - Double-blind, randomized study of the anti-anginal and anti-ischaemic efficacy of fendiline and diltiazem in patients with coronary heart disease. AB - In a 6-week, randomized, double-blind trial, the drug effects of the calcium antagonists, fendiline (75 mg twice daily) and diltiazem (90 mg twice daily), as measured by subjective and objective parameters of coronary heart disease, were studied in 79 patients with stable angina pectoris. The statistical analysis included the data of 71 patients. The results of exercise-ECG tests showed that both medications were effective anti-ischaemic agents. Fendiline was found to be effective in reducing ST-segment depression at maximum comparable load (71 watts) as well as at the time of reaching the individual maximum tolerated load (discontinuation of exertion). Diltiazem, on the other hand, proved effective only at maximum comparable load (72 watts). There was no significant difference between the groups with regard to the reduction after 6 weeks. As regards work tolerance, the duration of exercise and time until appearance of a ST-segment depression of 0.1 mV, before and after treatment comparisons revealed significant changes only in the group receiving diltiazem and the differences between fendiline and diltiazem were statistically significant with regard to these three parameters. Reduction in the frequency of anginal attacks and the diminution of nitroglycerin consumption were comparable in both medication groups, and the changes from baseline were statistically significant. Assessment of the efficacy and tolerability of the medications by patients as well as by investigators revealed no statistically significant differences between the two groups. Blood pressure and heart rate were clearly lowered by diltiazem, whereas fendiline induced only a slight decrease in blood pressure. The results indicate that both medications are equally suited for the treatment of stable angina pectoris. PMID- 1764958 TI - Patient noncompliance. PMID- 1764957 TI - The efficacy and tolerability of enteric and non-enteric coated naproxen tablets: a double-blind study in patients with osteoarthritis. AB - A double-blind, crossover study was undertaken to compare the efficacy and tolerability of a novel enteric coated 500 mg naproxen tablet with normal release 500 mg naproxen in patients with osteoarthritis. Eighty-eight patients were randomly allocated to receive enteric coated naproxen as a single daily dose of 2 tablets at night or 1 normal release naproxen tablet twice daily for a period of 3 weeks, followed by the alternative treatment for a further period of 3 weeks. The results of patient and doctor assessments showed that both treatments were increasingly efficacious, with a significant period effect found in the measures for pain on passive movement and duration of morning stiffness. No significant treatment differences were seen in any of the measures of efficacy and tolerability, although there were more withdrawals on normal release than on enteric coated naproxen (p = 0.07). It was concluded that enteric coated naproxen given as a single 1 g dose at night and normal release 500 mg naproxen given twice daily are equally efficacious and well tolerated. PMID- 1764959 TI - A dermatologic diary. Portrait of a practice. PMID- 1764960 TI - Inflammatory tinea capitis caused by Microsporum gypseum in a five-year-old girl. AB - An otherwise healthy five-year-old girl presented for evaluation of a large patch of erythematous scaling alopecia on the vertex of her scalp. Previous attempts to treat this with various topical agents resulted in no improvement. Our evaluation included examination of fungal cultures, which grew out a colony with characteristic morphology of Microsporum gypseum, supported by lactolphenol blue tease mounts, demonstrating the characteristic conidia for this fungus. Treatment was begun with oral griseofulvin, and evidence of inflammation resolved along with conversion to negative cultures for M. gypseum, although an area of scarring alopecia from the kerion remains. The epidemiologic basis, clinical presentation, differential diagnosis, evaluation, and treatment principles for this important geophilic organism are reviewed. Physicians need to be aware of this agent of tinea capitis, since it is destructive and only responsive to oral therapy. PMID- 1764961 TI - Aquagenic pruritus: effective treatment with intramuscular triamcinolone acetonide. PMID- 1764962 TI - Complications of ear piercing: treatment and prevention. AB - Ear piercing and wearing earrings have been associated with many medical problems including local infection, sepsis, superficial cervical lymphadenopathy, localized argyria, contact dermatitis, lymphoplasia, edema and hematoma formation, exuberant granulation tissue, keloids, lipomas, embedded earrings, epidermal cyst formation, sarcoidal granulomas, earlobe deformities, cutaneous injury resembling frostbite, pressure sores or bruising of the postauricular area, syncope, aspiration, and ingestion. Proper precautions should help to prevent many of these common complications. PMID- 1764963 TI - The dermatology of chronic lung disease. AB - Patients with chronic obstructive lung disease have an interesting array of dermatologic lesions that have never been reviewed. Some of these unusual findings are directly related to the underlying lung disease, but most are the iatrogenic result of various treatments. This paper presents a pictorial and descriptive review of these lesions. PMID- 1764964 TI - Oral acyclovir for chickenpox. PMID- 1764965 TI - Second-generation tetracyclines, a dermatologic overview: clinical uses and pharmacology. AB - Tetracycline and its derivatives are frequently used in the treatment of acne, soft tissue bacterial infections, Lyme disease (borreliosis), chlamydial infections, and respiratory tract infections. Several pharmacologic and microbiological properties of these antibiotics make them particularly suitable for such uses. First-generation tetracyclines have long been in use; however, the second-generation tetracyclines minocycline, doxycycline hyclate, and doxycycline monohydrate have also become widely prescribed, and can offer advantages to the dermatologist over tetracycline. This paper reviews the important pharmacologic and microbiological characteristics of these three commonly used second generation tetracyclines, and their clinical applications in dermatology. PMID- 1764967 TI - Characterization of bacteriophage P1 library containing inserts of Drosophila DNA of 75-100 kilobase pairs. AB - A multiple-hit bacteriophage P1 library containing DNA fragments from Drosophila melanogaster in the size range 75-100 kb was created and subjected to a preliminary evaluation for completeness, randomness, fidelity, and clone stability. This P1 library presently contains 3840 individual clones, or approximately two genome equivalents. The library was screened with a small set of unique-sequence test probes, and clones containing the sequences have been recovered. In situ hybridization with salivary gland chromosomes indicates that the clones originate from the site of the probe sequences in the genome, and filter hybridization of restriction digests suggests that the clones are not rearranged in comparison with the genomic sequences. Approximately 1.7% of the clones contain sequences that hybridize with ribosomal DNA. A small subset of these clones was tested for stability by examination of restriction fragments produced after repeated subculturing, and no evidence for instability was found. The P1 cloning system has general utility in molecular genetics and may provide an important intermediate level of resolution in physical mapping of the Drosophila genome. PMID- 1764966 TI - Molecular analysis of the Philadelphia chromosome. PMID- 1764968 TI - Drosophila genome project: one-hit coverage in yeast artificial chromosomes. AB - We present a strategy for assembling a physical map of the genome of Drosophila melanogaster based on yeast artificial chromosomes (YACs). In this paper we report 500 YACs containing inserts of Drosophila DNA averaging 200 kb that have been assigned positions on the physical map by means of in situ hybridization with salivary gland chromosomes. The cloned DNA fragments have randomly sheared ends (DY clones) or ends generated by partial digestion with either NotI (N clones) or EcoRI (E clones). Relative to the euchromatic portion of the genome, the size distribution and genomic positions of the clones reveal no significant bias in the completeness or randomness of genome coverage. The 500 mapped euchromatic clones contain an aggregate of approximately 100 million base pairs of DNA, which is approximately one genome equivalent of Drosophila euchromatin. PMID- 1764970 TI - Ultrastructural localization of nucleic acid sequences in Saccharomyces cerevisiae nucleoli. AB - The putative nucleolus in Saccharomyces cerevisiae is visible in electron micrographs as a darkly stained, crescent-shaped structure associated with the nuclear envelope. The haploid yeast genome contains 100-200 tandem copies of a 9.1 kb ribosomal DNA (rDNA) repeat predicted to reside in this structure. We combined in situ hybridization of non-isotopically labeled probes to isolated S. cerevisiae nuclei with immunogold detection to localize rDNA and rDNA precursor sequences in nuclei at the electron microscope (EM) level. Gold particles are restricted to defined regions of nuclei which appear more electron dense than the bulk of the nucleus and which generally exhibit the crescent shape typical of the structure thought to be the nucleolus. In addition, snR17, the yeast homolog of mammalian U3, a nucleolar-restricted small nuclear RNA (snRNA), was localized to the same electron dense region of the nucleus. These data, in conjunction with published immunofluorescent localizations of nucleolar-associated antigens, provide definitive proof that the dense crescent is the nucleolus. Finally, the technique described is applicable to probing nuclear organization in a genetically manipulable system. PMID- 1764969 TI - Molecular cloning and immunolocalization of two variants of the major basic nuclear protein (HCc) from the histone-less eukaryote Crypthecodinium cohnii (Pyrrhophyta). AB - Two clones that encode variants (HCc1 and HCc2) of the major basic nuclear protein of the dinoflagellate Crypthecodinium cohnii, were identified by immunoscreening of a cDNA expression library. The first clone carries a full length cDNA with an open reading frame (HCc1) encoding 113 amino acids. The cDNA from the second clone lacks some of the 5' end, and the coding sequence is only 102 residues. The two proteins display 77% sequence similarity and their NH2-ends are homologous to the NH2-peptide of the HCc protein determined by P. Rizzo. The amino acid composition, which confirms the basic nature of lysine-rich HCc proteins, differs markedly from other known DNA-binding proteins such as histones, HMGs or prokaryotic histone-like proteins. No convincing homology was found with other proteins. HCc antigens were localized on C. cohnii by immunofluorescence, and by electron microscopy (EM) with immunogold labelling. HCc proteins are mainly detected at the periphery of the permanently condensed chromosomes, where active chromatin is located, as well as in the nucleolar organizing region (NOR). This suggests that these basic, non-histone proteins, with a moderate affinity for DNA, are involved at some level in the regulation of gene expression. PMID- 1764971 TI - Induction of multipolar mitoses in cultured cells: decay and restructuring of the mitotic apparatus and distribution of centrioles. AB - During recovery after a long (up to 12 h) treatment of pig embryo culture cells (PK) with nocodazole at concentrations of 0.02 microgram/ml and 0.2 microgram/ml all c-metaphase cells divide normally into two daughter cells. During recovery after a short (1-4 h) treatment with 0.6 microgram/ml nocodazole only multipolar mitoses (as a rule tripolar) arise. At the ultrastructural level, the increasing nocodazole concentration leads to progressive disruption of the mitotic spindle. At a nocodazole concentration of 0.2 microgram/ml kinetochores are not associated with microtubules. At a nocodazole concentration of 0.6 microgram/ml there are no microtubules around the centrosomes, and in every cell one of the two diplosomes disintegrates. In tripolar telophase centrioles are distributed among the spindle poles generally in a 2:2:0 pattern. Mother and daughter centrioles are always disoriented but not separated. The centriole-free pole contains a cloud of electron-dense material. During tripolar division two of the three daughter cells mainly fuse shortly after telophase forming one binucleate cell. Thus a multipolar mitosis arises as a result of the uncoupling of mother centrioles and spindle microtubules, but not of the duration of the c-mitotic arrest. Centriole free poles account for the divergence of chromosomes, but mainly they are unable to ensure the normal cytokinesis of daughter cells. PMID- 1764972 TI - Experimental and theoretical investigations on the validity of the geometrical optics model for calculating the stability of optical traps. AB - We have developed a computer program based on the geometrical optics approach proposed by Roosen to calculate the forces on dielectric spheres in focused laser beams. We have explicitly taken into account the polarization of the laser light and thd divergence of the laser beam. The model can be used to evaluate the stability of optical traps in a variety of different optical configurations. Our calculations explain the experimental observation by Ashkin that a stable single beam optical trap, without the help of the gravitation force, can be obtained with a strongly divergent laser beam. Our calculations also predict a different trap stability in the directions orthogonal and parallel to the polarization direction of the incident light. Different experimental methods were used to test the predictions of the model for the gravity trap. A new method for measuring the radiation force along the beam axis in both the stable and instable regions is presented. Measurements of the radiation force on polystyrene spheres with diameters of 7.5 and 32 microns in a TEM00-mode laser beam showed a good qualitative correlation with the predictions and a slight quantitative difference. The validity of the geometrical approximations involved in the model will be discussed for spheres of different sizes and refractive indices. PMID- 1764973 TI - Single beam optical trapping integrated in a confocal microscope for biological applications. AB - Confocal microscopy is very useful in biology because of its three dimensional imaging capacities and has proven to be an excellent tool to study the 3D organization of, for instance, cell structures. This property of confocal microscopy makes it also very suitable for observation during guidance of the three dimensional manipulation of single cells or cell elements. Therefore we decided to integrate a confocal microscope and a single beam optical manipulator into a single instrument. The advantage of optical manipulation over mechanical techniques is that it is non-invasive and therefore may be applied on living (micro-) organisms and cells. The creation of an effective single beam optical trap requires the use of a high numerical aperture (N.A.) objective to focus the laser beam. In this paper we briefly discuss the vertical or axial force exerted on a sphere in a single beam trap. The axial force on a sphere placed on the optical axis, caused by reflection and refraction, is calculated applying a electromagnetic vector diffraction theory to determine the field distribution in the focal region. One of the results is that the particle also experiences a vertical trapping force towards the focusing lens when it is in the strongly convergent part of the field in addition to the known negative signed trapping force in the divergent part of the field. Further we describe an instrumental approach to realize optical trapping in which the optical trap position is controlled by moving the focusing objective only.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764974 TI - Compliance of bacterial polyhooks measured with optical tweezers. AB - In earlier work, a single-beam gradient force optical trap ("optical tweezers") was used to measure the torsional compliance of flagella in wild-type cells of Escherichia coli that had been tethered to glass by a single flagellum. This compliance was nonlinear, exhibiting a torsionally soft phase up to 180 degrees, followed by a torsionally rigid phase for larger angles. Values for the torsional spring constant in the soft phase were substantially less than estimates based on the rigidity determined for isolated flagellar filaments. It was suggested that the soft phase might correspond to wind-up of the flagellar hook, and the rigid phase to wind-up of the stiffer filament. Here, we have measured the torsional compliance of flagella on cells of an E. coli strain that produces abnormally long hooks but no filaments. The small-angle compliance of these cells, as determined from the elastic rebound of the cell body after wind-up and release, was found to be the same as for wild-type cells. This confirms that the small angle compliance of wild-type cells is dominated by the response of the hook. Hook flexibility is likely to play a useful role in stabilizing the flagellar bundle. PMID- 1764975 TI - Laser induced cell fusion in combination with optical tweezers: the laser cell fusion trap. AB - A single-beam gradient force optical trap was combined with a pulsed UV laser microbeam in order to perform laser induced cell fusion. This combination offers the possibility to selectively fuse two single cells without critical chemical or electrical treatment. The optical trap was created by directing a Nd:YAG laser, at a wavelength of 1.06 microns, into a microscope and focusing the laser beam with a high numerical aperture objective. The UV laser microbeam, produced by a nitrogen-pumped dye laser (366 nm), was collinear with the trapping beam. Once inside the trap, two cells could be fused with several pulses of the UV laser microbeam, attenuated to an energy of approximately 1 microJ/pulse in the object plane. This method of laser induced cell fusion should provide increased selectivity and efficiency in generating viable hybrid cells. PMID- 1764976 TI - Three-dimensional DNA image cytometry by confocal scanning laser microscopy in thick tissue blocks. AB - A method for the quantification of nuclear DNA in thick tissue blocks by confocal scanning laser microscopy is presented. Tissues were stained en bloc for DNA by chromomycin A3. Three-dimensional images, 60 microns deep, were obtained by stacking up confocal fluorescent images obtained with an MRC-500 (Bio-Rad, Richmond, CA). The effects due to bleaching and attenuation by depth of fluorescence emission were corrected mathematically. The DNA contents were estimated by summing up the detected emission intensities (discretized into pixel gray levels) from each segmented nucleus. Applications to an adult rat liver and to a human in situ carcinoma of theesophagus are shown to demonstrate, respectively, the precision of the method and its potential usefulness in histopathology. Comparisons are made with DNA histograms obtained on the same materials by image cytometry on smears and by flow cytometry. Ploidy peaks obtained with the confocal method, although wider than with other methods, are well separated. Confocal image cytometry offers the invaluable advantage of preserving the tissue architecture and therefore allowing, for instance, the selection of histological regions and the evaluation of the degree of heterogeneity of a tumor. PMID- 1764977 TI - Two- and three-color immunofluorescence using aminocoumarin, fluorescein, and phycoerythrin-labelled antibodies and single laser flow cytometry. AB - Antibodies coupled to 7-aminocoumarin (AMCA) emit a bright blue fluorescence under ultraviolet (UV) excitation and are therefore ideal for three-color immunofluorescence (IF) with fluorescein (FITC) and phycoerythrin (PE) labeled reagents; however, due to the different absorption spectra, the use of these fluorophores for multicolor flow-cytometric analysis requires a double light excitation source (e.g., two-laser system). We report a strategy which uses a single argon-ion laser to simultaneously excite AMCA, FITC, and PE, thus allowing the flow cytometric analysis of three immunological parameters. When the UV visible argon-ion laser is fitted with an appropriate set of mirrors, the 35.1 363.8 nm (UV) and 488 nm wavelengths (accounting for 80 mW and 520 mW, respectively) are simultaneously generated; these lines can then be exactly focused on the same observation point by an achromatic cylindrical lens. A number of comparative analysis were performed with this instrumental set up to verify the sensitivity of AMCA IF and its possible application for multicolor immunophenotypic evaluation of blood cell subsets. When AMCA- and FITC-labeled antimouse Ig antibodies were assessed for their ability to detect limiting amounts of mouse monoclonal antibody bound to cells, the former was less sensitive than the latter. A number of factors, including differences in excitation energy (80 mW for AMCA and 520 mw for FITC) and extinction coefficients (1.9 x 10(4) for AMCA and 6 x 10(4) for FITC) could explain this result.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764978 TI - Quantitative flow cytometric analysis of ABO red cell antigens. AB - A flow cytometry method has been employed to quantitatively compare the expression of A, B and H antigens on various red blood cells (RBC). The H substance was directly labelled by fluorescein-conjugated anti-H lectin and the A and B antigens by indirect staining first with monoclonal anti-A or anti-B antibodies followed by fluorescently, fluorescein (FITC) or phycoerythrin (PE), labelled anti-mouse immunoglobulin (Ig) antibodies. More than a ten-fold difference in cellular fluorescence intensity was found within each sample. Both the percentage and the mean fluorescence of the positive subpopulation for each antigen were determined. Each RBC population was characterized with respect to the expression of A, B or H antigen by a compound mean value that was the calculated product of these two parameters. The results demonstrated a reciprocal relationship between the compound means of A or B and H. The ratio of A/H or B/H was found to be most informative. Homozygotes for A or B had ratios of greater than 200 and greater than 30, respectively, while heterozygotes (AO or BO) had ratios of less than 5. This method could also distinguish between A1 and A2; RBC carrying the A1 phenotype (as determined by agglutination with anti-A1 lectin) showed a higher A/H ratio than those carrying A2. In contrast to the reciprocity in the expression of A (or B) and H found in RBC obtained from different individuals, a direct correlation was found in the expression of these antigens by individual cells within a given population.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764981 TI - [A quick and effective method for the maceration of vertebrates]. AB - This study describes a method which uses enzymatic additions of detergents (household washing products) to macerate small vertebrates or their heads, respectively, in a rapid, most effective, careful, rather odorless way and without any pollution of the environment. The maceration solution produced excellent results when applied to fresh or deep-frozen specimens as well as to ethanol-fixed material, while the results with formalin-fixed specimens were unsatisfying. PMID- 1764980 TI - CUBIC: a three-dimensional colored projection of Consort 30 generated trivariate flow cytometric data. AB - The CUBIC program displays three-dimensional colored dot plots of flow cytometric trivariate data collected by unmodified commercial instruments (FACScan flow cytometer, FACS 440 cell sorter). Assuming a bimodal distribution of the fluorescence intensity of the cells, the eight theoretical subpopulations involved in a three-color fluorescence histogram are clearly localized in the 3-D space by colored dots that are clustered near each corner of a cubic frame. Rotation, tilting, and zoom functions are available. Table look-up is not needed. CUBIC was illustrated by two experiments: 1) three-color immunofluorescence of antigens on human lymphocytes using monoclonal antibodies conjugated either to fluorescein (FITC), to R-phycoerythrin (PE), or to biotin revealed by a streptavidin coupled to a PE-Texas red tandem conjugate (TC); 2) two-color immunofluorescence of CD4 and CD8 antigens on thymocytes of healthy or preleukemic mice correlated to the DNA content quantified by 7-amino-actinomycin D (7-AAD). The three fluorescences were excited by a single argon-ion laser emitting at 488 nm. PMID- 1764979 TI - Membrane cell permeabilization with saponin and multiparametric analysis by flow cytometry. AB - Saponin, a detergent like molecule, can permeabilize cell membranes without destroying them, and thus can be used for the detection of intracellular antigens on intact cells with a flow cytometer. First experiments were reported that demonstrated the detection of intracytoplasmic antigens such as intermediate filaments and CD3 in T acute lymphoblastic leukemia (ALL). Further experiments were also performed to prove that intranuclear structures were equally accessible: dyes such as propidium iodide (PI) and monoclonal antibodies (mAb) such as Ki67 could penetrate the nucleus and lead to the analysis of DNA content and to the discrimination between the different cell cycle phases (G0, G1, S, G2 M). This rapid and sensitive method retained sufficient integrity of cells being treated to enable differentiation of cell types on the basis of morphology. Furthermore, it did not alter membrane expression of most antigens. Therefore, it was of particular interest for multiparametric analysis, especially for simultaneous study of membrane and intracellular structures. PMID- 1764982 TI - [Examination of the udder quarters of the first calving for Streptococcus group B of breeding cow market management of the Rhinish Association for the Schwartzbund cattle breed (RVS)]. AB - Quarter milk samples from 344 heifers were examined on group-B-streptococci. In none of the 1376 milk-samples Streptococcus agalactiae could be detected. The problem of examination of B-streptococci is discussed and proposals from the examination on udders of heifers are given. PMID- 1764983 TI - [Dependence of transfer factors for cesium on the contamination level of feed]. AB - The transfer factor-values feedstuff/meat so as the value of biological half life time for caesium are not constant but are depending on external and internal conditions. The most important external condition is the level of feedstuff contamination which reduces proportional the transfer factor's value of 0.5 +/- 0.1 asymptotically to 0.3 +/- 0.1. These values are then decreasing till to two thirds by the increasing part of uncontaminated feedstuff in the daily diet. The internal conditions, namely type of gastrointestinal tract, metabolic individuality and actual animal health, may cause a variability of transfer factor's values up to +/- 35% of the mean resulting from external conditions. The value of biological half life time of caesium may be considered as a constant for each respective tissue or organ in balanced conditions, but the changes of external conditions, especially the beginning of uncontaminated feeding, results in immediate gradually shortening of this half life time till to 50-30% of its original value. PMID- 1764984 TI - [Ethologic selection studies with early weaned piglets kept in pens with different use of straw. 3. Results of studies of the position sequence of area size and stall air temperature]. AB - In continuation of our earlier investigations on the range of environmental factors in housing systems with perforated floors and the experiments with or without free choice on litter or deep litter the effects of the size of the area and the environmental temperatures on the behaviour of early weaned piglets (8 kg to 30 kg) kept on litter and deep litter have been investigated. Both factors had a crucial but diametrical influence. While for the total activity of the pigs the size of the compartment proved more important than room temperature, for the total inactivity it was the other way around. Therefore some essential requirements have to be obeyed even for housing systems with litter or deep litter, which can be considered more suitable for the housing of pigs from the start on. Because of their different importance for the activity (20% of the total behaviour) and the inactivity (80%) the factors can't replace each other. For housing systems with litter size allocation shouldn't amount less than 0.45 m2/animal and with deep litter not less than 0.70 m2/animal with room temperatures starting at about 25 degrees C and 20 degrees C, respectively. PMID- 1764985 TI - Influence of dimethoate on testicular and epididymal organs, testosterone plasma level and their tissue residues in rats. AB - The effect of dimethoate at two dosage levels (6.25 and 12.50 mg/kg b. wt.) on male reproduction tissues and their tissue residues in rats were studied. The tested doses were given orally to male rats for 65 consecutive days. Sex organs weight analysis, semen picture, testosterone levels and histopathology of the male genital organs were the criteria used to evaluate the reproductive efficiency of the treated rats. There was a dose-related decrease in the weights of most genital organs and sperm motility associated with an increase in the percentages of dead and morphologically abnormal spermatozoa of treated rats. A decrease in plasma testosterone levels was observed in the treated groups. Histological examination revealed that dimethoate caused testicular lesions characterized by moderate to severe degenerative changes of spermatogonial cells and by partial arrest of spermatogenesis. Sections from liver revealed that the central veins and hepatic sinusoids appeared dilated, with some areas of haemorrhage. The highest concentrations from dimethoate were found in liver and tests and the lowest in skeletal muscle. Dimethoate and its metabolite analog were still present in a detectable concentration 21 days after stopping its oral administration. PMID- 1764986 TI - [Ascorbic acid concentration in plasma, in amniotic and allantoic fluids, in the placenta and in 13 tissues of sheep fetuses and newborn lambs]. AB - At each 8 on an average 92 (body weight 615 +/- 49 g) and 120 days (b.w. 1.8 +/- 0.40 kg) old fetuses as well as at 6 newborn lambs (b.w. 2.8 +/- 0.65 kg) the concentration of ascorbic acid in the plasma, in the amniotic- and allantois fluid, in the fetal and maternal part of the placenta and in 13 tissues was analyzed. The highest concentration in the plasma (73 +/- 11 micrograms/ml) was determined in the newborns. The concentration in the amniotic-fluid decreased and that in the allantoic-fluid, the adrenals and the fetal part of the placenta increased in the course of growth. In the cerebrum, the cerebellum, the brain stem, the lungs, the heart, the kidneys, the M. longissimus and the M. semimembranosus the concentration diminished during the fetal growth. In the liver, the spleen and the pancreas the concentration was similar. The function of the ascorbic acid during the fetal development is discussed. The results are compared with those at human, pig and calf fetuses. In analyzing the ascorbic concentration in fetal body fluids of ungulates the high concentration of fructose as an influence-factor in the usual applied methods has to be considered. PMID- 1764987 TI - [Tibial aplasia and agenesis in a rabbit (case report)]. AB - The occurrence of a tibial aplasia (left side) and agenesia (right side) in a rabbit (aged 4 weeks) is reported. Apart from extreme distorsions of the fibular bones, there were no other skeletal malformations. PMID- 1764988 TI - The development of adult muscles in Drosophila: ablation of identified muscle precursor cells. AB - A small subset of mesodermal cells continues to express twist in the late embryo of Drosophila. These cells are the precursors of adult muscles. Each late twist expressing cell begins to divide early in the second larval instar and division continues throughout the second and third instars, resulting in a small clone of twist-expressing cells at puparium formation. Treatment with a DNA-synthesis inhibitor, hydroxyurea (HU), ablates these cells if applied during S-phase of their replication cycle. We ablated twist-expressing lineages in the larva and demonstrated that this results in the absence of subsets of muscles in the adult abdomen and leg. HU treatment during this larval period has no discernible effect on the adult epidermis or innervation. We conclude that the twist-expressing cells identified in the late embryo are the unique primordia of adult muscles. Each primordium is fated to establish 6-10 adult muscle fibres, defined here as a 'muscle fibre group'. Each primordium has a unique fate and, after ablation, is not replaced by neighbouring cells. This unique fate does not rest with a particular founder cell within the primordium but is specified at the primordium level: ablation of a subset of cells within a muscle primordium does not result in an ablation of the resulting muscle group or in a decrease in the number of fibres within that muscle group, but rather results in a uniform decrease in the number of nuclei/fibres throughout the entire muscle. Thus, the twist-expressing primordia in the abdomen appear to be fated to give rise to a particular muscle group but act as an equivalent precursor pool in the formation of that muscle group. Our results permit the conclusion that specific muscle groups in the adult leg arise from restricted pools of twist-expressing adepithelial cells in the larval imaginal disc in a similar fashion. We conclude that the fate restriction of myoblast pools in early development defines elements of the final adult muscle pattern. The fate restriction of myoblast cells may be a result of genetic determination to form a specified muscle group or, alternatively, reflect the spatial isolation of otherwise equivalent cells to form muscle-specific precursor pools. PMID- 1764989 TI - Methylation levels of maternal and paternal genomes during preimplantation development. AB - The methylation status of three highly repeated sequences was studied in sperm, eggs and preimplantation embryos with different combinations of parental chromosomes. High levels of methylation of the IAP and MUP sequence families were found in sperm and in eggs, whereas the L1 repeat was found to be highly methylated in sperm but only about 42% methylated in eggs. To assess how the two parental genomes behaved during preimplantation development, normal, fertilised embryos were compared with parthenogenetic embryos where the chromosomes are exclusively of maternal origin. It was observed that the high levels of methylation at the IAP and MUP sequences were retained through early development, with the first signs of demethylation at the IAP sequences apparent on both parental chromosomes in the blastocyst. Methylation at the sperm-derived L1 sequences dropped to about the same level as that of the egg-derived sequences by the late 2-cell stage, both then remain at this intermediate level until around the time of cavitation when levels fell to about 10% in the blastocyst. High levels of DNA methylase were detected in germinal vesicle and metaphase II oocytes; these high levels were maintained in fertilised and parthenogenetic embryos through into the morula and then declined to be undetectable in the blastocyst. Our comparison of maternal and paternal genomes suggests that methylation levels at repeat sequences are remarkably similar at the time of fertilisation or, as in the case of the L1 sequences, they become so during the first few cell cycles. Hence, there do not appear to be global methylation differences between the genomes that are retained through preimplantation development.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764990 TI - Neurothelin: molecular characteristics and developmental regulation in the chick CNS. AB - Neurothelin has recently been identified as a cell surface protein specific for chick endothelial cells forming the blood-brain barrier. Neurons of the adult brain are essentially devoid of neurothelin. In contrast, neurons of the chick retina, which lack blood vessels and accessory astrocytes, express neurothelin. Here we demonstrate that during chick brain development initially neurothelin is expressed probably in all neuroblasts. With proceeding cytodifferentiation, such as vascularization and gliogenesis, brain neurons become neurothelin negative. Coincidentally the endothelial cells forming the blood-brain barrier start to synthesize neurothelin. In contrast to brain neurons, in retina neurons, neurothelin expression increases by one order of magnitude during the course of histogenesis. Coculturing of chick retinal cells with purified rat astrocytes in vitro results in reduction of neural neurothelin expression as quantified by ELISA. Conversely, disruption of the glia-neuron interactions by culturing brain neurons as individualized cells in vitro leads to a reexpression of neurothelin. This is consistent with the hypothesis that astrocytes inhibit neurothelin expression in neurons. Biochemical characterization classifies neurothelin as an integral membrane protein. Temperature-induced-detergent phase separation, phospholipase C digestion and sodium carbonate treatment were employed to distinguish between integral membrane proteins, lipid-anchored proteins and peripheral membrane proteins. Two-dimensional gel electrophoresis reveals an isoelectric point of about 6.4 for neurothelin. Polysaccharide analysis by glycosidase digestion and lectin binding indicates that neurothelin is highly glycosylated. The relative molecular mass of glycosylated neurothelin is 41 x 10(3), whereas the peptide backbone is only 25 x 10(3). The very strict spatiotemporal regulation of neurothelin expression in the central nervous system suggests that neurothelin fulfils possibly a crucial function such as transport of low relative molecular mass components that are essential for neuronal metabolism. The proposed biological activity of neurothelin might be specifically affected by some of its distinct biochemical features. PMID- 1764991 TI - Differential binding of gold-labeled zona pellucida glycoproteins mZP2 and mZP3 to mouse sperm membrane compartments. AB - Egg zona pellucida glycoproteins mZP3 and mZP2 serve as primary and secondary sperm receptors, respectively, during initial stages of fertilization in mice [Wassarman (1988) A. Rev. Biochem. 57, 415-442]. These receptors interact with complementary egg-binding proteins (EBPs) located on the sperm surface to support species-specific gamete adhesion. Results of whole-mount autoradiographic experiments suggest that purified egg mZP3 and mZP2 bind preferentially to acrosome-intact (AI) and acrosome-reacted (AR) sperm heads, respectively [Bleil and Wassarman (1986) J. Cell Biol. 102, 1363-1371]. Here, we used purified egg mZP2, egg mZP3 and fetuin, which were coupled directly to colloidal gold ('gold probes'), to examine binding of these glycoproteins to membrane compartments of AI and AR sperm by transmission electron microscopy. mZP3 gold-probes were found associated primarily with plasma membrane overlying the acrosomal and post acrosomal regions of AI sperm heads. They were also found associated with plasma membrane overlying the post-acrosomal region of AR sperm heads. mZP2 gold-probes were found associated primarily with inner acrosomal membrane of AR sperm heads, although some gold was associated with outer acrosomal membrane of AI sperm that had holes in plasma membrane overlying the acrosome. Fetuin gold-probes, used to assess background levels of binding, were bound at relatively low levels to plasma membrane and inner acrosomal membrane of AI and AR sperm, respectively. None of the gold-probes exhibited significant binding to sperm tails, or to red blood cells and residual bodies present in sperm preparations. These results provide further evidence that mZP2 and mZP3 bind preferentially to heads of AR and AI sperm, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764992 TI - Restrictin: a chick neural extracellular matrix protein involved in cell attachment co-purifies with the cell recognition molecule F11. AB - We report here the characterization of restrictin, a novel chick neural extracellular matrix glycoprotein associated with the cell recognition molecule F11. Immunoaffinity chromatography using monoclonal antibody 23-13 directed to restrictin yield a major relative molecular mass band at 170 x 10(3) and minor bands at 160, 180, 250 and 320 x 10(3) which are immunologically related to each other. Neural cells attach on immobilized restrictin in a short-term adhesion assay. This adhesion can be blocked specifically by monoclonal or polyclonal antibodies to restrictin but not by antibodies to F11 or by the peptide GRGDSP. Antibodies to restrictin do not interfere with the fasciculation of retinal axons and the isolated restrictin does not stimulate the outgrowth of axons. In the developing nervous system, restrictin is localized in very restricted regions and is found within areas of F11 expression. The timing and pattern of expression of restrictin and its cell attachment activity suggest that it participates in developmental events of the nervous system. PMID- 1764993 TI - Localization and actions of transforming growth factor-beta s in the embryonic nervous system. AB - We present evidence for unique localization and specific biological activities for transforming growth factor-beta s (TGF-beta s) 2 and 3, as compared to TGF beta 1, in the nervous system of the 12-18 day mouse embryo. Each TGF-beta isoform was localized immunohistochemically by specific antibodies raised to peptides corresponding to unique sequences in the respective TGF-beta proteins. Staining for TGF-beta 1 was principally in the meninges, while TGF-beta s 2 and 3 co-localized in neuronal perikarya and axons, as well as in radial glial cells. In the central nervous system, staining was most prominent in zones where neuronal differentiation occurs and less intense in zones of active proliferation, while in the peripheral nervous system, many nerve fibers as well as their cell bodies were strongly immunoreactive for TGF-beta s 2 and 3. Functionally, we have also found that in the presence of an extract of chick eye tissue, TGF-beta s 2 and 3 inhibit survival of cultured embryonic chick ciliary ganglionic neurons in a dose-dependent fashion; TGF-beta 1 shows no inhibitory effects. Our data suggest that TGF-beta s 2 and 3 may play a role in regulation of neuronal migration and differentiation, as well as in glial cell proliferation and differentiation. PMID- 1764994 TI - LIF, the ES-cell inhibition factor, reversibly blocks nephrogenesis in cultured mouse kidney rudiments. AB - Mouse kidney induction proceeds in vitro much as it does in vivo: the ureteric bud bifurcates to give collecting ducts while the mesenchyme condenses into aggregates which epithelialise and then elongate into tubules with glomerular and other nephron structures. We report here that the factor known as LIF (leukaemia inhibitory factor), which regulates the differentiation and growth of embryonic stem (ES) and other cells in culture, has little effect in vitro on growth or on ureteric-bud morphogenesis other than to stimulate the bifurcation process. It does however exert a striking effect on the mesenchyme. At about four times the concentration required to inhibit ES-cell differentiation, LIF strongly but reversibly blocks the effects of metanephric mesenchyme induction: although mesenchyme condenses around growing duct tips, the number of mature nephrons that form over 6 days is reduced by 75% or more. The few nephrons that do develop in the presence of LIF probably come from mesenchyme already induced at the time of culture and are indistinguishable from those that form in controls as assayed by morphology, by X-gal staining of endogenous galactosidase and by antibodies to brush-border and CD15 antigens. There is a further unexpected feature of rudiments cultured in LIF which is absent in controls: they contain an unexpectedly high number of stable epithelialised aggregates that express laminin around their periphery and which do not develop further. These results argue that the process of nephrogenesis involves at least two distinct stages which can be blocked by LIF: the effect of the initial induction and the future development of epithelialised aggregates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1764995 TI - A homolog of Drosophila Notch expressed during mammalian development. AB - Drosophila Notch and the related Caenorhabditis elegans proteins lin-12 and glp-1 function as mediators of local cell-cell interactions required for cell-fate decisions during invertebrate development. To investigate the possibility that similar proteins play determinative roles during mammalian development, we isolated cDNA clones encoding rat Notch. The deduced amino acid sequence of this protein contains 36 epidermal growth factor (EGF)-like repeats, and is remarkably similar in both its extracellular and cytoplasmic domains to the sequence of Xenopus Xotch and Drosophila Notch. In the developing central nervous system, in situ hybridisation analyses revealed that Notch transcripts were dramatically restricted to the ventricular proliferative zones of embryonic neuroepithelia. Notch was also strongly expressed during development of non-neural tissues, such as hair follicles and tooth buds, whose correct differentiation requires epithelial-mesenchymal interactions. These data support the hypothesis that Notch plays an essential role in mammalian development and pattern formation that closely parallels its role in the development of invertebrates. PMID- 1764996 TI - Tissue interactions affecting the migration and differentiation of neural crest cells in the chick embryo. AB - A series of microsurgical operations was performed in chick embryos to study the factors that control the polarity, position and differentiation of the sympathetic and dorsal root ganglion cells developing from the neural crest. The neural tube, with or without the notochord, was rotated by 180 degrees dorsoventrally to cause the neural crest cells to emerge ventrally. In some embryos, the notochord was ablated, and in others a second notochord was implanted. Sympathetic differentiation was assessed by catecholamine fluorescence after aldehyde fixation. Neural crest cells emerging from an inverted neural tube migrate in a ventral-to-dorsal direction through the sclerotome, where they become segmented by being restricted to the rostral half of each sclerotome. Both motor axons and neural crest cells avoid the notochord and the extracellular matrix that surrounds it, but motor axons appear also to be attracted to the notochord until they reach its immediate vicinity. The dorsal root ganglia always form adjacent to the neural tube and their dorsoventral orientation follows the direction of migration of the neural crest cells. Differentiation of catecholaminergic cells only occurs near the aorta/mesonephros and in addition requires the proximity of either the ventral neural tube (floor plate/ventral root region) or the notochord. Prior migration of presumptive catecholaminergic cells through the sclerotome, however, is neither required nor sufficient for their adrenergic differentiation. PMID- 1764997 TI - Hepatocyte differentiation initiates during endodermal-mesenchymal interactions prior to liver formation. AB - Previous studies with embryonic tissue explants showed that cellular interactions with mesenchyme are required for endodermal cells to differentiate into hepatocytes. However, these studies assayed hepatocyte characteristics that were evident after days of culture, leaving open the question of whether the primary inductive interactions initiated hepatocyte differentiation, or whether subsequent steps, such as may occur during cell aggregation to form the liver, were necessary. Using the technique of in situ hybridization, we find that serum albumin mRNA, a liver-specific gene product, is first detected in hepatic precursor cells of the endoderm as early as 9.5 days of mouse embryo development, a full day prior to cell aggregation and liver formation. The endodermal cells express albumin mRNA upon migration into strands of connective tissue matrix within mesenchyme. Thus, the onset of differentiation of the endoderm is coincident with its interaction with mesenchyme. Early albumin transcripts are initiated at the same site of the albumin promoter as in adult hepatocytes, suggesting that at least a subset of the transcription factors that control albumin transcription in the adult may be involved in executing the early steps of hepatic determination. We also observe a sharp increase in albumin mRNA levels shortly after the definitive formation of the liver, apparently reflecting cell interactions that enhance hepatocyte differentiation. Hepatocyte differentiation is therefore similar in several respects to pancreatic exocrine cell development, and may represent a general pattern for gut-derived tissues. For both cell types, early interactions with mesenchyme are coincident with the initial expression of differentiated gene products at a low level in proliferating endoderm, and the initial pattern of expression is amplified upon organ formation. PMID- 1764998 TI - Segmental lineage restrictions in the chick embryo spinal cord depend on the adjacent somites. AB - We have investigated whether the developing spinal cord is intrinsically segmented in its rostrocaudal (anteroposterior) axis by mapping the spread of clones derived from single labelled cells within the neural tube of the chick embryo. A single cell in the ventrolateral neural tube of the trunk was marked in situ with the fluorescent tracer lysinated rhodamine dextran (LRD) and its descendants located after two days of further incubation. We find that clones derived from cells labelled before overt segmentation of the adjacent mesoderm do not respect any boundaries within the neural tube. Those derived from cells marked after mesodermal segmentation, however, never cross an invisible boundary aligned with the middle of each somite, and tend to be elongated along the mediolateral axis of the neural tube. When the somite pattern is surgically disturbed, neighbouring clones derived from neuroectodermal cells labelled after somite formation behave like clones derived from younger cells: they no longer respect any boundaries, and are not elongated mediolaterally. These results indicate that periodic lineage restrictions do exist in the developing spinal cord of the chick embryo, but their maintenance requires the presence of the adjacent somite mesoderm. PMID- 1764999 TI - The Drosophila extramacrochaetae protein antagonizes sequence-specific DNA binding by daughterless/achaete-scute protein complexes. AB - In Drosophila, a group of regulatory proteins of the helix-loop-helix (HLH) class play an essential role in conferring upon cells in the developing adult epidermis the competence to give rise to sensory organs. Proteins encoded by the daughterless (da) gene and three genes of the achaete-scute complex (AS-C) act positively in the determination of the sensory organ precursor cell fate, while the extramacrochaetae (emc) and hairy (h) gene products act as negative regulators. In the region upstream of the achaete gene of the AS-C, we have identified three 'E box' consensus sequences that are bound specifically in vitro by hetero-oligomeric complexes consisting of the da protein and an AS-C protein. We have used this DNA-binding activity to investigate the biochemical basis of the negative regulatory function of emc. Under the conditions of our experiments, the emc protein, but not the h protein, is able to antagonize specifically the in vitro DNA-binding activity of da/AS-C and putative da/da protein complexes. We interpret these results as follows: the heterodimerization capacity of the emc protein (conferred by its HLH domain) allows it to act in vivo as a competitive inhibitor of the formation of functional DNA-binding protein complexes by the da and AS-C proteins, thereby reducing the effective level of their transcriptional regulatory activity within the cell. PMID- 1765001 TI - Tissue-specific control of expression of the tight junction polypeptide ZO-1 in the mouse early embryo. AB - The processes governing differential protein expression in preimplantation lineages were investigated using a monoclonal antibody recognising the tight junction polypeptide, ZO-1. ZO-1 localises to the maturing tight junction membrane domain in the polarised trophectoderm lineage from compaction (8-cell stage) onwards, ultimately forming a zonular belt around each trophectoderm cell of the blastocyst (32- to 64-cell stage). The protein is usually undetectable within the inner cell mass (ICM) although, in a minority of embryos, punctate ZO 1 sites are present on the surface of one or more ICM cells. Since ICM cells derive from the differentiative division of polarised 8- and 16-cell blastomeres, the distribution of ZO-1 following differentiative division in isolated, synchronised cell clusters of varying size, was examined. In contrast to the apical cytocortical pole, ZO-1 was found to be inherited by nonpolar (prospective ICM) as well as polar (prospective trophectoderm) daughter cells. Following division, polar cells adhere to and gradually envelop nonpolar cells. Prior to envelopment, ZO-1 localises to the boundary between the contact area and free membrane of daughter cells, irrespective of their phenotype. After envelopment, polar cells retain these ZO-1 contact sites whilst nonpolar cells lose them, in which case ZO-1 transiently appears as randomly-distributed punctate sites on the membrane before disappearing. Thus, symmetrical cell contact appears to initiate ZO-1 down-regulation in the ICM lineage. The biosynthetic level at which ZO-1 down-regulation occurs was investigated in immunosurgically isolated ICMs undergoing trophectoderm regeneration. By 6 h in culture, isolated ICMs generated a zonular network of ZO-1 at the contact area between outer cells, thereby demonstrating the reversibility of down-regulation. This assembly process was unaffected by alpha-amanitin treatment but was inhibited by cycloheximide. These results indicate that the ICM inherits and stabilises ZO-1 transcripts which can be utilised for rapid synthesis and assembly of the protein, a capacity that may have significance both in maintaining lineage integrity within the blastocyst and in the subsequent development of the ICM. PMID- 1765000 TI - The relationship of decapentaplegic and engrailed expression in Drosophila imaginal disks: do these genes mark the anterior-posterior compartment boundary? AB - Imaginal disks, the primordia of the adult appendages in Drosophila, are divided into anterior and posterior compartments. However, the developmental role of such compartments remains unclear. The expression of decapentaplegic (dpp), a pattern formation gene required for imaginal disk development, has the intriguing property of being expressed in a line at or near the boundary between these compartments. Here, we compare the distribution of dpp-driven reporter gene expression to the pattern of expression of the engrailed (en) gene, known to be required for the maintenance of the compartment boundary. Using confocal microscopy to obtain single cell resolution, we have determined that the majority of the en+ imaginal disk cells expressing the dpp-driven reporter genes about those cells expressing en, while a small percentage of dpp reporter gene expressing cells also express en. In posterior regions of en mutant disks, where compartmentalization is abnormal, we observe ectopic expression of the dpp-driven reporter genes. We conclude that the pattern of dpp expression in imaginal disks is delimited in part through the direct or indirect repression by engrailed. Our results lead us to question the widely held assumption that the anterior edge of en expression demarcates the A/P compartment boundary. PMID- 1765002 TI - Expression of the cystic fibrosis gene in human development. AB - The specialised epithelia lining the respiratory tract, pancreatic ducts, male genital ducts and sweat gland ducts are defective in the severe inherited disease, cystic fibrosis (CF). We have looked at the expression of the CF gene in human fetal tissues to throw light on the development of function in specialised ductal epithelia and to determine the age of onset of the CF disease process. The CF gene is already seen to be transcribed in mid-trimester fetal lung, pancreas and male genital ducts. Hence, by this developmental stage, and before they are fully differentiated, these epithelia have the capability to perform important transport functions. Epithelial cell cultures derived from fetal pancreas and male genital ducts maintain expression of the CF gene in vitro and so form good models for analysing CF gene function and differentiation of these specialised epithelia. PMID- 1765003 TI - Sex chimaerism, fertility and sex determination in the mouse. AB - Adult intraspecific mouse chimaeras, derived by introducing male embryonal stem cells into unsexed host blastocysts, were examined to determine whether gonadal sex was correlated with the sex chromosome composition of particular cell lineages. The fertility of XX in equilibrium XY and XY in equilibrium XY male chimaeras was also compared. The distribution of XX and XY cells in 34 XX in equilibrium XY ovaries, testes and ovotestes was determined by in situ hybridisation using a Y-chromosome-specific probe. Both XX and XY cells were found in all gonadal somatic tissues but Sertoli cells were predominantly XY and granulosa cells predominantly XX. The sex chromosome composition of the tunica albuginea and testicular surface epithelium could not, in general, be fully resolved, owing to diminished hybridisation efficiency in these tissues, but the ovarian surface epithelium (which like the testicular surface epithelium derives from the coelomic epithelium) was predominantly XX. These findings show that the claim that Sertoli cells were exclusively XY, on which some previous models of gonadal sex determination were based, was incorrect, and indicate instead that in the mechanism of Sertoli cell determination there is a step in which XX cells can be recruited. However, it remains to be established whether the sex chromosome constitution of the coelomic epithelium lineage plays a causal role in gonadal sex determination. Male chimaeras with XX in equilibrium XY testes were either sterile or less fertile than chimaeras with testes composed entirely of XY cells. This impaired fertility was associated with the loss of XY germ cells in atrophic seminiferous tubules. Since this progressive lesion was correlated with a high proportion of XX Leydig cells, we suggest that XX Leydig cells are functionally defective, and unable to support spermatogenesis. PMID- 1765004 TI - Expression of syndecan, a putative low affinity fibroblast growth factor receptor, in the early mouse embryo. AB - Syndecan is an integral membrane proteoglycan that binds cells to several interstitial extracellular matrix components and binds to basic fibroblast-growth factor (bFGF) thus promoting bFGF association with its high-affinity receptor. We find that syndecan expression undergoes striking spatial and temporal changes during the period from the early cleavage through the late gastrula stages in the mouse embryo. Syndecan is detected initially at the 4-cell stage. Between the 4 cell and late morula stages, syndecan is present intracellularly and on the external surfaces of the blastomeres but is absent from regions of cell-cell contact. At the blastocyst stage, syndecan is first detected at cell-cell boundaries throughout the embryo and then, at the time of endoderm segregation, becomes restricted to the first site of matrix accumulation within the embryo, the interface between the primitive ectoderm and primitive endoderm. During gastrulation, syndecan is distributed uniformly on the basolateral cell surfaces of the embryonic ectoderm and definitive embryonic endoderm, but is expressed with an anteroposterior asymmetry on the surface of embryonic mesoderm cells, suggesting that it contributes to the process of mesoderm specification. In the extraembryonic region, syndecan is not detectable on most cells of the central core of the ectoplacental cone, but is strongly expressed by cells undergoing trophoblast giant cell differentiation and remains prominent on differentiated giant cells, suggesting a role in placental development. Immunoprecipitation studies indicate that the size of the syndecan core protein, although larger than that found in adult tissues (75 versus 69 x 10(3) Mr), does not change during peri-implantation development. The size distribution of the intact proteoglycan does change, however, indicating developmental alterations in its glycosaminoglycan composition. These results indicate potential roles for syndecan in epithelial organization of the embryonic ectoderm, in differential axial patterning of the embryonic mesoderm and in trophoblast giant cell function. PMID- 1765005 TI - The control of cell fate along the dorsal-ventral axis of the Drosophila embryo. AB - We have analyzed the contributions made by maternal and zygotic genes to the establishment of the expression patterns of four zygotic patterning genes: decapentaplegic (dpp), zerknullt (zen), twist (twi), and snail (sna). All of these genes are initially expressed either dorsally or ventrally in the segmented region of the embryo, and at the poles. In the segmented region of the embryo, correct expression of these genes depends on cues from the maternal morphogen dorsal (dl). The dl gradient appears to be interpreted on three levels: dorsal cells express dpp and zen, but not twi and sna; lateral cells lack expression of all four genes; ventral cells express twi and sna, but not dpp and zen. dl appears to activate the expression of twi and sna and repress the expression of dpp and zen. Polar expression of dpp and zen requires the terminal system to override the repression by dl, while that of twi and sna requires the terminal system to augment activation by dl. The zygotic expression patterns established by the maternal genes appear to specify autonomous domains that carry out independent developmental programs, insofar as mutations in the genes that are expressed ventrally do not affect the initiation or ontogeny of the expression patterns of the genes that are expressed dorsally, and vice versa. However, interactions between the zygotic genes specific to a particular morphological domain appear to be important for further elaboration of the three levels specified by dl. Two of the genes, dpp and twi, are unaffected by mutations in any of the tested zygotic dorsal-ventral genes, suggesting that dpp and twi are the primary patterning genes for dorsal ectoderm and mesoderm, respectively. PMID- 1765006 TI - Clonal analysis of astrocyte diversity in neonatal rat spinal cord cultures. AB - Within the mammalian CNS, astrocytes appear to be a heterogeneous class of cells. To assay the number of distinct types of astrocytes in the rat spinal cord, cell lineage and phenotypic analyses were carried out on cultures from newborn rat spinal cord and five distinct types of astrocytes were observed. Proliferating precursors for each class of astrocyte were isolated by low density culture and shown to give rise to 5 distinct and morphologically homogeneous clusters of GFAP + astrocytes. Immunocytochemical analysis with antibodies A2B5 and Ran-2, which identify different glial lineages in optic nerve cultures, demonstrated that many clusters included both A2B5+ and A2B5- cells. Similarly, many clusters also possessed a mixture of Ran-2+ and Ran-2-cells, suggesting that in spinal cord cultures, in contrast to optic nerve cultures, expression of these antigens is regulated by individual cells rather than by cell lineage. Single-cell cloning studies, revealed that the abundance and proliferative capacity of individual astrocyte precursors differed depending on the type of astrocyte. To assay the effects of a complex cellular environment on the composition of astrocyte clones, lineage analysis was performed in complete spinal cord cultures using a replication deficient retrovirus. Although similar morphologically homogeneous clones of cells to those seen with single-cell clones were observed, the proliferative capacity and relative abundance of the distinct astrocyte precursors differed from that seen in single-cell cloning studies. Together these observations suggest that in spinal cord, gliogenesis is considerably more complex than in the optic nerve and that cultures of newborn rat spinal cord contain multiple, distinct populations of astrocytes. PMID- 1765008 TI - Mutations in a newly identified Drosophila melanogaster gene, mago nashi, disrupt germ cell formation and result in the formation of mirror-image symmetrical double abdomen embryos. AB - The mago nashi (mago) locus is a newly identified strict maternal effect, grandchildless-like, gene in Drosophila melanogaster. In homozygous mutant mago females reared at 17 degrees C, mago+ function is reduced, the inviable embryos lack abdominal segments and 84-98% of the embryos die. In contrast, at 25 degrees C, some mago alleles produce a novel gene product capable of inducing the formation of symmetrical double abdomen embryos. Reciprocal temperature-shift experiments indicate that the temperature-sensitive period is during oogenetic stages 7-14. Furthermore, embryos collected from mago1 homozygous females contain no apparent functional posterior determinants in the posterior pole. In viable F1 progeny from mago mutant females, regardless of genotype and temperature, polar granules are reduced or absent and germ cells fail to form (the grandchildless like phenotype). Thus, we propose that the mago+ product is a component of the posterior determinative system, required during oogenesis, both for germ cell determination and delineation of the longitudinal axis of the embryo. PMID- 1765007 TI - Glucose transporter gene expression in early mouse embryos. AB - The glucose transporter (GLUT) isoforms responsible for glucose uptake in early mouse embryos have been identified. GLUT 1, the isoform present in nearly every tissue examined including adult brain and erythrocytes, is expressed throughout preimplantation development. GLUT 2, which is normally present in adult liver, kidney, intestine and pancreatic beta cells is expressed from the 8-cell stage onward. GLUT 4, an insulin-recruitable isoform, which is expressed in adult fat and muscle, is not expressed at any stage of preimplantation development or in early postimplantation stage embryos. Genetic mapping studies of glucose transporters in the mouse show that Glut-1 is located on chromosome 4, Glut-2 on chromosome 3, Glut-3 on chromosome 6, and Glut-4 on chromosome 11. PMID- 1765009 TI - Development of the indirect flight muscles of Drosophila. AB - We have followed the pupal development of the indirect flight muscles (IFMs) of Drosophila melanogaster. At the onset of metamorphosis larval muscles start to histolyze, with the exception of a specific set of thoracic muscles. Myoblasts surround these persisting larval muscles and begin the formation of one group of adult indirect flight muscles, the dorsal longitudinal muscles. We show that the other group of indirect flight muscles, the dorsoventral muscles, develops simultaneously but without the use of larval templates. By morphological criteria and by patterns of specific gene expression, our experiments define events in IFM development. PMID- 1765010 TI - Cells with persistent twist expression are the embryonic precursors of adult muscles in Drosophila. AB - twist expression in the embryonic mesoderm of Drosophila declines during germ band retraction to leave a residual population of twist-expressing cells in the late embryo. In the abdomen, the pattern of twist expression is a simple one: a single cell ventrally, pairs of cells laterally and three cells dorsally in each hemisegment. In the thorax, there are patches of cells associated with the imaginal discs and there are additional clusters in A8 and A9. During larval life, the twist-expressing cells proliferate and, in the abdomen, they form ventral, lateral and dorsal clusters, which are the precursors of the adult abdominal muscles, while in the thorax, they form populations of cells in the imaginal discs that correspond to the adepithelial cells described by previous authors. While most thoracic twist-expressing cells are associated with the discs, the abdominal cells are separate from the precursors of the adult abdominal epidermis, the abdominal histoblasts, and lie on branches of peripheral nerves. The distribution of these cells is tightly linked to the pattern of peripheral nerves, but they segregate normally in da/da embryos despite the absence of the peripheral nervous system. PMID- 1765011 TI - The development of adult abdominal muscles in Drosophila: myoblasts express twist and are associated with nerves. AB - During metamorphosis, the adult muscles of the Drosophila abdomen develop from pools of myoblasts that are present in the larva. The adult myoblasts express twist in the third larval instar and the early pupa and are closely associated with nerves. Growing adult nerves and the twist-expressing cells migrate out across the developing abdominal epidermis, and as twist expression declines, the myoblasts begin to synthesize beta 3 tubulin. There follows a process involving cell fusion and segregation into cell groups to form multinucleate muscle precursors. These bipolar precursors migrate at both ends to find their correct attachment points. beta 3 tubulin expression continues at least until 51 h APF by which time the adult muscle pattern has been established. PMID- 1765013 TI - Chromosomal abnormalities: experience at Harare Hospital. AB - A study of 107 cases with chromosomal abnormalities seen over a four-year period is presented. The commonest abnormality was Trisomy 21 which accounted for 37% of all cases. There were also many cases with intersex. The results of this study were similar to a previous one done in the same department a few years ago. All the patients seen in this study presented with similar features to those seen elsewhere in patients with these syndromes. PMID- 1765012 TI - Sensitivity of falciparum malaria to chloroquine and amodiaquine in four districts of western Kenya (1985-1987). AB - In-vivo and in-vitro studies to determine the sensitivity of Plasmodium falciparum malaria to chloroquine and amodiaquine were conducted in 4 districts of Western Kenya over a 2-year-period. Patients aged 5-60 years, were treated with chloroquine or amodiaquine base 25 mg/kg over 3 days. Recurrence of parasitaemia within 7 days (R1 resistance) or failure to clear parasites (R11 resistance) was observed in 27% of infections in West Pokot district, 51% in Busia, 45% in Bungoma and 19% in Rusinga Island. R111 resistance (failure to decrease parasitaemia by at least 75%) was documented in Rusinga Island. The proportions of parasites with minimum inhibitory concentrations (MICs) for chloroquine greater than 114 nM in in-vitro tests ranged from 37% in Busia to 68% in Bungoma. For amodiaquine, 20% of 30 isolates tested had MICs greater than 80 nM. We conclude that resistance to chloroquine is now established in the area and amodiaquine may be useful in uncomplicated chloroquine resistant falciparum infections in the region. PMID- 1765014 TI - Retention of urine in females: causes and management. AB - Retention of urine in the female results from various medical, surgical and gynaecological causes, but is often thought to be due to psychological disturbances. In order to find out the causes of urinary retention in females in our own population and the results of its management, we conducted a retrospective study on 30 female patients with retention of urine, seen at King Abdulaziz University Hospital, Jeddah, over a five year period. Only six (20%) patients were found to have psychological disturbances. Out of the 30 patients, 27 were available for follow-up. In those patients followed up, a success rate of over 85% was achieved through using clean intermittent catheterization with or without pharmacological treatment, either in regaining complete bladder function or in overcoming this clinical problem. PMID- 1765015 TI - Incidence and causes of maternal mortality in five Kampala hospitals, 1980-1986. AB - This report presents results of a descriptive study to estimate the mortality rate, identify the type and the causes of maternal deaths. The study was conducted in 1987 in Kampala hospitals for a period covering seven years from 1st January 1980 to 31st December, 1986. The non abortion maternal mortality rate (NAMMR) was 2.65 per 1000 deliveries while the abortion related maternal mortality rate (ARMMR) was 3.58 per 1000 abortions. There was a statistically significant increase in NAMMR while the increase in ARMMR was almost significant over the seven year period. Of all maternal deaths, 80 per cent were non abortion while 20 per cent were abortion related. The commonest immediate causes of death, in order of importance, were sepsis, haemorrhage, ruptured uterus, anaesthesia and anaemia. The commonest patient management factors which contributed to death, in order of importance, were lack of blood for transfusion, lack of drugs and intravenous fluids, theatre problems and doctor related factors. We feel that a lot happens to the pregnant mother before she finally reaches a health unit for delivery and that there is a great need to improve on the community's gynaecological and obstetrical services as well as ambulance and emergency services. We also feel that maternal mortality in developing countries could be reduced if the health workers were imaginative in respect to each patient, tried not to operate as though they were working in a developed country, and created relevant solutions for the local problems.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765016 TI - Experience with MacDonald's cervical cerclage in a rural setting. AB - Eighty-two patients with cervical incompetence were managed with MacDonald's cervical cerclage, bed rest, tocolytics and sedatives. 78 of the patients were followed upto termination of pregnancy and their pregnancy data recorded. 69.5% delivered at term. 78.1% were discharged from hospital with live babies. The incidence of operative delivery was encountered. MacDonald's cervical cerclage has a high success rate in a rural setting, well comparable to that in urban settings and prolonged in-patient treatment is not always necessary. PMID- 1765017 TI - Patent ductus arteriosus in African preterm infants. AB - During a 7 month period, April to October, 1984, 537 consecutive babies weighing upto 2000 gm were studied at the Kenyatta National Hospital's newborn unit. Of these 48 (8.9%) had murmurs suggestive of patent ductus arteriosus (PDA). Their mean birth weight was 1364 +/- 482 gm while the mean gestation was 30.5 weeks. The peak incidence occurred in the weight group 1001 to 1500 gm. 15 (31%) of all infants with PDA died. The PDA closed spontaneously in 21 (43.7%) infants before discharge from hospital and 4 closed after discharge bringing the total closure of 25 (52%). This represented 76% of the survivors. 4 were lost to follow up. In another 4 infants there was inadequate information as to when the ductus closed. It is suggested that the relatively low incidence of PDA may be due to underdiagnosis and the high mortality infants less than 1000 gm in the first few days of life before diagnosis of PDA can be made. Wider use of objective diagnostic modalities may help to make definitive diagnosis. PMID- 1765018 TI - Monitoring impact of oral poliovirus vaccine on poliomyelitis trends from physiotherapy records, Ilorin, Nigeria, 1981-1988. AB - During the eight years of a poliomyelitis control programme in Ilorin Local Government Area, Nigeria, 85% of children aged 12-23 months were estimated to have received three doses of trivalent oral polio vaccine. The estimated incidence of paralytic poliomyelitis decreased by 59%, indicating a low vaccine efficacy for the currently used TOPV. This has a serious implication for the World Health Organization's global poliomyelitis eradication strategy of immunizing at least 80% of children aged one year by the year 2000, that eradication may not be achieved by this strategy alone in tropical Africa. Supplementary strategies of mass OPV campaigns, combined IPV/OPV vaccine regimens, or the introduction of new generation of poliomyelitis vaccines may be needed. Similar low-cost efforts at documenting the impact of TOPV on the incidence of poliomyelitis using physiotherapy clinics as independent sentinels, are needed from other states of Nigeria. To increase the efficacy of the primary series of TOPV in Nigeria, the number of doses constituting the primary series should be increased to four (including one at birth). There is now reason to consider a properly timed combination of both IPV and OPV in Nigeria. PMID- 1765019 TI - Review of the management of duodenal ulcer in Tikur Anbessa Hospital Department of Surgery, 1973-1980. AB - During the period which comprised this study, September 1973 to August 1980, 346 patients were operated on for duodenal ulcer. 230 patients whose charts could be retrieved were retrospectively analysed. The diagnosis was confirmed by barium meal in 168 patients and endoscopy in 57 cases, and all were operated by the staff of the department. The peak age incidence was 30 to 40 years with male to female ratio of 5:1, a sex proportion more consistent with that usually reported for duodenal ulcer in the west. Although pyloric stenosis was relatively more observed among peasant farmers, no preferential predilection to any other professional group was noticed. The commonest surgical indication was gastroduodenal obstruction. Truncal vagotomy and drainage was performed in 178 (77.4%) patients. Follow up of patients was extremely difficult and therefore only two thirds could be followed for about 24 months. In these, dumping was present in 4 (2.60%) patients; diarrhoea in 2 (1.30%) patients, and a recurrence of ulcer in 5 (3.40%) patients. It is to be concluded that truncal vagotomy and gastric drainage is a satisfactory modality of therapy for chronic duodenal ulcer in general and pyloric stenosis in particular since this can be accomplished with an acceptable morbidity and mortality. PMID- 1765021 TI - Ossifying fibroma of the jaws: a case report. AB - This communication presents the first case report of ossifying fibroma of the jaw from Kenya and reviews the literature including the available published case reports from Africa. The relationship between ossifying fibroma and other related benign fibro-osseous lesion of the jaws is briefly discussed. Intensified research work on this condition in Africans is called for so that more cases should be published since it is reportedly more common in black race. The majority of the African cases are generally reported in advanced stages indicating neglect or delay in seeking for medical help. Since ossifying fibroma is a well encapsulated and expansile benign bone neoplasm, surgical enucleation appears to be the treatment of choice; recurrence is rare. PMID- 1765020 TI - The lumbar spinal canal and its anatomical walls in Nigerian children. AB - A prospective study of the lumbar spinal canal and its anatomical walls was carried out by measuring the radiological characteristics of 68 healthy Nigerian children aged 6 to 11 years (mean 8.5 years). The study showed no features of congenital stenotic lumbar canal in all the children. The interpedicular diameter (IPD) and the vertebral diameter (VD) increased progressively in a cranio-caudal fashion. The pedicular height (PH) increased from L1 to L2 and thereafter decreased from L3 to L5. The pedicular diameter (PD) increased progressively from L1 to L5. The canal-to-body ratio (CBR) was found to approximate to a constant of 0.65. Age does not have significant positive correlation with the IPD, VD, PH, and PD(P greater than 0.05). PMID- 1765022 TI - Relapse of tetanus in a child: a case report. AB - This report concerns the relapse of a case of tetanus which occurred one week after complete cessation of initial symptoms which had taken 4 weeks to nurse. Eventual and lasting resolution of the symptoms followed the removal of a foreign body from the left foot on the 58th day of admission. PMID- 1765023 TI - [Potential reversal/amplitude analysis: problems of normal value determination]. AB - Turn/amplitude-analysis was applied to the right m. biceps brachii and the right m. rectus femoris of 30 healthy women aged 19 to 39 years. Interference patterns were recorded at 20, 40 and 60% of the individual maximum force of both muscles. We evaluated the turns/s, the amplitude/turn and the ratios amplitude/turns:turns/s and turns/s:amplitude/turn. Normal values of the turn/amplitude-parameter were calculated as means +/- 2 SD at defined levels of force (table 1 and fig. 2) and in form of clouds (fig. 3). Our clouds were clearly different from those of Stalberg. Since normal values of our and other studies were inconsistent we believe that every laboratory has to elaborate its own normal values. Turns/s, amplitude/turn and the ratio turns/s:amplitude/turn increased and the ratio amplitude/turns/s decreased with increasing force (fig. 6 and 7). Turn/amplitude-parameters were partly significantly higher or lower in the m. biceps brachii than in the m. rectus femoris (fig. 8.). PMID- 1765024 TI - [The median nerve evoked potential in normal children and youths: normal values]. AB - The derivation of cortical somatosensory evoked potentials permits a good local and functional diagnosis of supratentorial structures and the localisation of damage in this area. The special diagnostical relevance of early cortical somatosensory evoked potentials as a sage, non-invasive examination method in pediatric neurology is given both by these characteristics and by the fact that they cannot, in principle, be influenced by sleep or by drugs affecting the central nervous system. Somatosensory evoked cortical potentials of N. medianus were investigated for 35 children (17 boys, 18 girls) between the ages of 6 and 17, for whom there were no anamnestic or clinical indications of neurological or otological diseases. Investigations demonstrate that the SEPs of the N. medianus from the P15 up to and including the N55, is in every case clearly measurable in children from preschool age up to the end of adolescence. In the evaluation of the cortical SEPs, the P15, N20 and P25 were considered to be the components most stable and those most valuable for clinical practice. These could also be presented with the smallest standard deviations and side differences. The latencies of the P15 and N20 of the N. medianus show significant dependencies on the height of the children. The later potential components, side differences, interpeak intervals and amplitudes show no correlations with height. The SEPs of N. medianus show no dependencies on gender or on physical parameters such as weight or head circumference of the experiments. In summary it can be established that, using the procedure mentioned above, the cortical somatosensory evoked potentials in children can be described well and reproducibly and within practical narrow standard limits. PMID- 1765025 TI - [The effect of the lead electrodes on the conduction velocity of the sural nerve]. AB - The result of nerve conduction velocity measuring depends upon all components of the measurement system. Earlier investigations showed that the nerve conduction velocity of the sural nerve depends also on technical attributes of recording electrodes. It was the objective of our study to investigate correlations between different recording electrodes and neurophysiological norm values as nerve conduction velocity and latency prolongation after paired stimulation of the sural nerve. Our investigations were carried out in twenty healthy volunteers aged 39 +/- 14 years. Stimulation of the sural nerve was performed at the lateral malleolus using always surface electrodes of the same type. Recording of nerve action potentials was done in each proband by four different types of electrodes. Surface electrodes consisted of tin, stainless steal and sintered silver/silver chloride, needle electrodes of stainless steel. The nerve conduction velocity using silver/silver chloride was 53.6 +/- 4.3 m/sec, using tin electrodes 53.1 +/ 3.9 m/s, using stainless steel 51.4 +/- 3.0 m/s and using needle electrodes 48,7 +/- 2.7 m/s. The Wilcoxon-test confirmed the differences of nerve conduction velocity between needle and silver/silver chloride and tin electrodes yielding p less than 0.05. Latency prolongation after paired stimulation of the sural nerve was independent from electrodes. In conclusion, our results indicate that electrodes take part in the system of standardization. Changing of recording or stimulation electrodes provoke the necessity of new standardization of norm values in clinical neurophysiology. PMID- 1765026 TI - [Somatosensory evoked potentials in moderate hyperthermia]. AB - The effects of moderate whole-body hyperthermia on the cervical and cortical somatosensory evoked potentials (SEP) were studied in healthy male subjects, aged 22-32 years. They were immersed in hot water and heated to a median rectal temperature of 39.0 degrees C. Serial SEPs to median nerve stimulation were recorded during cooling at intervals of 0.1 degrees C. The general wave form and the amplitudes did not systematically change. For a 1 degrees C drop there was a median latency increase of 2.6-3.7% in cervical and 1.5-7.4% in cortical SEP components. In individual cases significant latency delays of cervical N13 and cortical N20 could already be observed at differences of 0.2 degrees and 0.5 degrees respectively. All other components showed significant latency changes at temperature intervals of 0.6 to 0.8 degrees C. PMID- 1765027 TI - [Primary extinct evoked cerebral potentials in the diagnosis of brain death]. AB - In a collective of 82 patients with the clinical signs of brain death and examination of evoked cerebral potentials the incidence of primary abolished evoked potentials was studied. The initial examination occurred at the same time after onset of disease in both groups. We found a marked correlation with the clinical course of the patients. Whereas the group with primary loss of evoked potentials mainly contained patients with intracerebral and subarachnoid hemorrhages and short survival times, the other group with primary preserved evoked potentials showed a high rate of ischemic infarctions and longer survival periods. The rate of primary abolished evoked potentials can be lowered only by routine examination at the earliest time possible. Outside of neurological intensive care units the early examination of evoked potentials is hardly possible. In these units, the EEG remains the technical examination of choice in the confirmation of brain death. PMID- 1765028 TI - [SEP monitoring during clonidine therapy of alcohol delirium]. AB - In 12 patients with developing alcohol withdrawal syndrome after abdomino thoracic surgical procedures who were treated with Clonidine, short latency somatosensory evoked potentials were recorded. Clonidine leads to a good sedation, anxiolysis and moderated the psychotic symptoms. However, there was no significant correlation between the Clonidine medication and the SEP results over the time of drug administration concerning the primary cortical response N20 and the following N20/P25 wave. Therefore, the short-latency SEP-recording cannot provide a reliable monitoring of the good sedative effect of Clonidine in alcoholic withdrawal. The SEP responses after Clonidine are like those of morphine and are thought to have a similar central mode of action. PMID- 1765030 TI - [Pattern recognition techniques in sleep polygraphy]. AB - The evaluation of EEG-patterns is usually accomplished by visual analysis. Nowadays however, even personal computers are fast enough for an efficient pattern recognition of EEG signals. Using sleep spindles and K-complexes as examples, our aim was to demonstrate how patterns can be detected in an EEG signal with a high degree of accuracy. Furthermore, recognition of K-complexes has been improved by applying an additional "adaptive algorithm" allowing individual adjustments to the signal's form and amplitude. PMID- 1765029 TI - [Saccadic eye movements: methodologic aspects and possibilities of clinical use]. AB - Saccades are fast eye movements that occur when the eye makes a refixation movement. Initially clinically relevant physiological and anatomical data are given. The two most frequently used oculographic methods are presented briefly. For clinical use it is particularly important that ocular motor disorders and effects of various drugs are compensated partially by plastic adaptation of central mechanisms. The main diagnostic fields are disorders of brain stem, cerebellum or peripheral oculomotor apparatus. Examination of horizontal and vertical saccades is a useful help in diagnosis of subclinical ocular motor disorders in encephalomyelitis disseminata. PMID- 1765031 TI - Ambulatory and laboratory blood pressure in individuals with negative and positive family history of hypertension. AB - Undertook 24-hr ambulatory blood pressure (BP) monitoring in men and women with and without family history of essential hypertension. Cardiovascular functions were also recorded in the laboratory during mental arithmetic, image star tracing, isometric exercise, and the cold pressor test. Ambulatory daytime, but not nighttime, systolic and diastolic BP as well as heart rate (HR) level and variability was higher in those with than without family history. During sleep, HR level and variability were higher among those with family history; at rest in the laboratory, however, all cardiovascular functions were similar in both groups. The strongest laboratory-based predictor of daytime BP was stress-induced BP levels. BP reactivity also significantly predicted daytime BP but with less accuracy. The best predictor of BP and HR at sleep was resting cardiovascular functions. Thus, ambulatory BP recordings add information to resting and stress induced levels in identifying cardiovascular risk reactions. PMID- 1765032 TI - Diminished weight loss and behavioral compliance during repeated diets in obese patients with type II diabetes. AB - Compared weight losses during first and second bouts of a very low calorie diet (VLCD) and examined whether decreased compliance might in part explain the decrease in weight loss during the second bout. Forty-five Type II diabetic patients participated in a year-long behavioral weight-reduction program that incorporated a VLCD (400 to 500 kcal/day) during Weeks 1 to 12 and 28 to 40. Weight losses decreased dramatically from the first to the second VLCD (15.54 vs. 1.42 kg, p less than .0001). There was also markedly diminished adherence as assessed by weeks ketonuric, attendance, and completeness of self-monitoring records. The percentage of weeks subjects were in ketosis dropped from 61% during VLCD 1 to 13% during VLCD 2 (p less than .0001). Similarly, subjects attended significantly fewer treatment meetings during VLCD 2 and self-monitored less during VLCD 2 than during VLCD 1. Weeks ketonuric and initial weight accounted for 63% of the variance in weight loss during VLCD 1 (p less than .0001); weeks ketonuric and attendance predicted weight loss during VLCD 2 (p less than .0001), accounting for 54% of the variance. These results suggest the importance of behavioral factors in explaining poorer performance on a repeated diet. PMID- 1765033 TI - Stress reactivity and exercise training in premenopausal and postmenopausal women. AB - Examined the influence of ovarian function on psychophysiological stress responses and determined if aerobic exercise reduced stress reactivity. Fifty premenopausal and postmenopausal women initially were subjected to a public speaking task and an ice-on-the-forehead procedure, during which time their blood pressure and heart rate were monitored and continuous blood samples were obtained. Subjects also underwent aerobic fitness evaluations with a maximum exercise treadmill test. Subjects were then randomly assigned to a 12-week exercise program of either aerobic exercise (e.g., walking and jogging at a prescribed exercise intensity) or non-aerobic strength and flexibility training and were then reevaluated. Results indicated that postmenopausal women exhibited lower resting epinephrine levels but greater epinephrine reactivity to the speaking task compared to the premenopausal women. There were no differences between premenopausal and postmenopausal women with respect to cardiovascular or catecholamine responses during the cold challenge. Premenopausal and postmenopausal women also achieved comparable improvements in aerobic fitness. However, results of the mental stress testing were complex and provided only partial support for the role of aerobic exercise in reducing stress responses. PMID- 1765034 TI - Sex differences in cardiovascular reactivity: effects of the gender relevance of the stressor. AB - Suggests that sex differences in cardiovascular reactivity (CVR) in past research are a function of differences in cognitive appraisal of stressors as masculine or feminine tasks. In the present study, we examined the role of the gender relevance of the stressor as a mediator of sex differences in CVR. The CVR of male and female college students (n = 95) to the cold pressor test (CPT) was compared under masculine and gender-neutral instructions during an anticipation phase, a stressor phase, and a recovery phase. Men were expected to show greater CVR than women to the masculine CPT but not to the gender-neutral CPT. Results supported this prediction for systolic blood pressure reactivity and heart rate reactivity but not for diastolic blood pressure reactivity. The potential influence of sex differences in appraisal of situations on CVR and coronary heart disease is discussed. PMID- 1765035 TI - Health care involvement preferences and social-emotional recovery of male coronary-artery-bypass patients. AB - Examined how the preferences of male coronary-bypass patients either for information or behavioral involvement, respectively, predicted social and emotional recovery during the year following hospital release. Preferences for health care involvement were assessed prior to surgery. Outcome measures were collected at 1-, 4-, and 13-month follow-ups. Results indicated that patients who preoperatively had a high relative to a low desire for behavioral involvement experienced less ambulation dysfunction, fewer social interaction problems, and less emotional upset during the initial 4 months following hospital release. Also, patients who had a high relative to a low desire for information involvement experienced more social interaction and emotional problems during this period. At the final follow-up, these involvement-group differences for social interaction and emotional status had disappeared, and no differences in cardiac health were found. However, there were systematic differences in use of medical services. Results are discussed with reference to recent considerations about the potential benefits of more active patient involvement in the health care process. Possible mechanisms and clinical implications are also discussed. PMID- 1765036 TI - Four pathways to young-adult smoking status: adolescent social-psychological antecedents in a midwestern community sample. AB - Evaluated the ability of social-psychological factors, measured in adolescence, to predict young-adult smoking outcomes. Results showed substantial continuity in the antecedents of adolescent and young-adult smoking but important discontinuities as well. Beliefs in the negative social consequences of smoking and beliefs about academic success and independence were important to adolescent but not to adult smoking. Conversely, beliefs in the negative health consequences of smoking were more important to adult smoking than to adolescent smoking. Results also showed an appreciable amount of smoking onset after the high school years, as well as an appreciable amount of adolescent smoking that did not persist into young adulthood. Antecedents of late-onset smoking and of nonpersistent smoking are described. PMID- 1765037 TI - Individual differences in the day-to-day experience of chronic pain: a prospective daily study of rheumatoid arthritis patients. AB - Explored the distribution and temporal patterning of daily pain reported by 47 patients with rheumatoid arthritis (RA) for 75 consecutive days. Approximately half the pain series were significantly positively skewed, trended significantly across the recording period, or both. One fourth of the sample had relatively painful "outlier" days that clustered together. Most series displayed a significant autocorrelation in pain intensity across successive days even when the series were detrended. Patients with more active disease had pain that was more intense but more predictable from day to day and reported fewer painful outlying days and briefer episodes of atypically severe pain. Patients describing themselves as more depressed on the Center for Epidemiological Stress Depression Scale also reported more intense pain across the recording period, independent of their level of disease activity and disability. Implications for daily process studies of RA pain are discussed. PMID- 1765038 TI - Psychosomatic symptoms in medical outpatients: an investigation of self handicapping theory. AB - Investigated self-handicapping theory as it relates to somatization in medical patients. We predicted that medical outpatients (N = 113) would report psychosomatic symptoms in response to events that threaten their self-esteem. As predicted, results of hierarchical multiple regression indicated that high perfectionism patients reported somatic symptoms positively related to the number of events that jeopardize their sense of accomplishment, whereas low perfectionism patients' somatic symptoms were not related to these events (p = .005). Contrary to prediction, high-dependency patients did not differ significantly from low-dependency patients in the relationship of somatic symptoms and events that threatened their interpersonal relationships (p = .115). Implications of these findings and the utility of self-handicapping theory for predicting somatization in medical patients are discussed. PMID- 1765039 TI - Psychosocial predictors of gay men's AIDS risk-reduction behavior. AB - Used psychosocial variables derived from the health belief model (Rosenstock, 1974), Bandura's (1986) self-efficacy framework, and protection motivation theory (Rogers, 1984) to predict self-reported AIDS risk-reduction behaviors in a sample of 389 homosexual men who participated in the Multicenter AIDS Cohort Study in Los Angeles and who knew their HIV antibody status. Hierarchical multiple regression analyses showed that self-efficacy, perceived risk, response efficacy, and prior sexual behavior accounted for approximately 70% of the variance in the total number of sexual partners and the number of anonymous partners over a 6 month interval, controlling for demographic variables, HIV antibody status, and presence of a primary partner. A logistic regression analysis showed that barriers to change predicted increased unprotected anal receptive intercourse over a 6-month interval, controlling for prior behavior. The relation of health beliefs to risk-reduction behavior was substantially different for HIV seropositive men without primary partners than for other groups of gay men. Implications for interventions are discussed. PMID- 1765040 TI - Thoracolumbar epidural anaesthesia and isoflurane to prevent hypertension and tachycardia in patients undergoing abdominal aortic surgery. AB - Cardiovascular and hormonal responses to reconstructive abdominal aortic surgery were studied in 20 patients anaesthetized either with moderate-dose fentanyl (20 micrograms kg-1) combined with isoflurane, nitrous oxide and oxygen (n = 10), or with thoracolumbar epidural bupivacaine combined with isoflurane, nitrous oxide and oxygen (n = 10). After the start of operation, hypotension occurred in four patients in the epidural group. In both groups, the aortic cross-clamping caused slight increases both in mean arterial pressure and in calculated systemic vascular resistance, and a significant decrease in cardiac index. At the same time, a marked increase in plasma vasopressin was seen in the fentanyl group. Plasma catecholamines were low in both groups. After aortic declamping, the cardiac index improved in both groups, although two patients in the fentanyl group and four patients in the epidural group were hypotensive. Post-operatively, eight patients in the fentanyl group were hypertensive, versus none in the epidural group, in which bupivacaine-fentanyl was administered epidurally. At the same time, plasma vasopressin and adrenaline increased significantly in both groups, whereas plasma noradrenaline did so only in the fentanyl group. The results suggest that thoracolumbar epidural bupivacaine combined with low-dose isoflurane in nitrous-oxide-oxygen prevents intra-operative hypertension and tachycardia, but it may cause hypotension. Post-operative hypertension and tachycardia as well as the increase in plasma noradrenaline are prevented by epidural administration of bupivacaine-fentanyl. PMID- 1765041 TI - Left-ventricular performance, volumes, and catecholamine responses during anaesthesia induction--monitoring by combined radionuclide cardiography and right heart catheterization. AB - Sequential radionuclide imaging and continuous recording of arterial and right heart pressures were carried out during anaesthesia with midazolam 0.2 mg kg-1, pancuronium 0.15 mg kg-1 and fentanyl 10 micrograms kg-1 in eight patients with normal cardiopulmonary status scheduled for craniotomy. The aim was to examine how a stress-free anaesthetic induction tailored to protect against the hypertension and tachycardia provoked by laryngoscopy and intubation influenced left-ventricular performance, left-ventricular loading conditions and plasma catecholamine concentrations. During the 20-min study period no significant changes were observed in heart rate, left-ventricular ejection fraction, ratio of peak systolic pressure to left-ventricular end-systolic volume, pulmonary capillary wedge pressure, left-ventricular end-systolic volume, cardiac output, dopamine and noradrenaline concentrations. Except for a minor increase in mean arterial pressure after laryngoscopy and intubation, mean arterial pressure decreased 24%, left-ventricular end-diastolic volume decreased 15%, and left ventricular stroke volume decreased 21%. Central venous pressure increased by 75% but there was no parallel increase in pulmonary wedge pressure, which in turn did not reflect the alterations in ventricular end-diastolic volume. Plasma adrenaline concentrations decreased significantly (66%). The chosen induction regimen preserved global left-ventricular pump function during laryngoscopy and intubation without any activation of the sympathetic nervous system. Central venous and pulmonary wedge pressures were unreliable in the assessment of ventricular preload during induction of general anaesthesia. PMID- 1765042 TI - Paracetamol metabolism after general anaesthesia. AB - Paracetamol metabolism was compared between nine patients after general anaesthesia and nine healthy volunteers. Each subject received 1.5 g of paracetamol orally, and paracetamol concentrations in venous blood were measured by HPLC at intervals over 12 h. Urine samples collected over 24 h were analysed by HPLC for cysteine, mercapturic acid, sulphate and glucuronide metabolites. There were no significant differences in the area under the concentration-time curve for paracetamol, or plasma half-life. Statistically significant differences were observed in the median percentages of unchanged paracetamol (volunteers 2.9%, patients 2.0%) and mercapturic acid (volunteers 4.5%, patients 6.5%) excreted in 24 h. The percentage of sulphate excreted was significantly lower in the 8-24-h period, although there was no difference over the total 24 h. PMID- 1765043 TI - Immunological assays following exposure to halothane in clinical usage. AB - Venous blood samples were obtained from 30 patients undergoing surgical intervention, as well as 25 anaesthetists and operating-room personnel. Twenty non-exposed physicians served as a control group. Blood samples were subjected to total and differential leucocyte counts, T- and B-lymphocyte counts, serum immunoglobulin estimation, and in-vitro T-lymphocyte proliferative response to Con A-mitogen. In comparison with values from control subjects, halothane anaesthesia resulted in an increased number of T- and B-lymphocytes, whilst the serum immunoglobulins level and lymphoproliferative response were decreased. Three days after surgery, all the estimated parameters had returned to the pre operative value. Chronic exposure to trace halothane concentrations resulted in decreased proliferative responses, lymphocytosis, and decreased immunoglobulins levels. It is concluded that halothane has different effects on the human immune system, depending on the particular conditions of the groups studied. PMID- 1765044 TI - Intramuscular injections through indwelling cannulae. AB - A study was performed to establish the feasibility of an indwelling intramuscular cannula for the administration of post-operative analgesic and anti-emetic medication. One-hundred cannulae were inserted for periods up to 7 days (mean = 2.4). A mean of five and maximum of 15 injections were made through each cannula with a maximum volume in any patient of 29 ml. On 18 occasions cannulae were removed for minor complications; no serious complications were seen. This technique may be useful for administration of intramuscular analgesic and anti emetic medications in the post-operative period. PMID- 1765045 TI - Upward transtentorial herniation of posterior fossa structures. PMID- 1765046 TI - Pulmonary oedema following temporomandibular arthroscopy of a healthy patient. PMID- 1765047 TI - The assessment of European departments of anaesthesiology involved in teaching and training. PMID- 1765048 TI - Changes in oxygen saturation following propofol induction of anaesthesia at different rates in the elderly. PMID- 1765049 TI - Inspiratory force in the intubated patient during spontaneous respiratory effort following general anaesthesia. PMID- 1765050 TI - European Anaesthesia Research Group. Abstracts of the 4th meeting, Strasbourg, 29 August 1991. PMID- 1765051 TI - Etomidate vs. propofol for suspension laryngoscopies. PMID- 1765052 TI - Physiological effects of micropauses in isometric handgrip exercise. AB - The physiological response to continuous and intermittent handgrip exercise was evaluated. Three experiments were performed until exhaustion at 25% of maximal voluntary contraction (MVC): experiment 1, continuous handgrip (CH) (n = 8); experiment 2, intermittent handgrip with 10-s rest pause every 3 min (IH) (n = 8); and experiment 3, as IH but with electrical stimulation (ES) of the forearm extensors in the pauses (IHES) (n = 4). Before, during, and after exercise, recordings were made of heart rate (HR), arterial blood pressure (BP), exercising forearm blood flow, and concentrations of potassium [K+] and lactate [La-] in venous blood from both arms. The electromyogram (EMG) of the exercising forearm extensors and perceived exertion were monitored during exercise. Before and up to 24 h after exercise, observations were made of MVC, of force response to electrical stimulation and of the EMG response to a 10-s test contraction (handgrip) at 25% of the initial MVC. Maximal endurance time (tlim) was significantly longer in IH (23.1 min) than in CH (16.2 min). The ES had no significant effect on tlim. During exercise, no significant differences were seen between CH and IH in blood flow, venous [K+] and [La-], or EMG response. The HR and BP increased at the same rate in CH and IH but, because of the longer duration of IH, the levels at exhaustion were higher in this protocol. The subjects reported less subjective fatigue in IH. During recovery, return to normal MVC was slower after CH (24 h) than after IH (4 h).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765053 TI - Acoustic myography reflects force changes during dynamic concentric and eccentric contractions of the human biceps brachii muscle. AB - The relationship between acoustic myography (AMG), electromyography (EMG) and force during submaximal dynamic contractions was examined in the biceps brachii muscles of eight healthy males (aged 17-26 years). Different weights were lifted and lowered at a constant speed, using a wall pulley system, to perform concentric and eccentric contractions, respectively. Integrated AMG (iAMG) and integrated EMG (iEMG) activity both increased linearly with force during concentric (iAMG r = 0.94; iEMG r = 0.99) and eccentric (iAMG r = 0.90; iEMG r = 0.94) contractions. The slopes of the concentric regression lines were significantly different from the eccentric slopes (P less than 0.01) for both iAMG and iEMG with concentric contractions showing greater levels of activity. The results indicated that AMG can be used to detect changes in force during dynamic contractions which has important implications for the use of AMG in rehabilitation. The differences in iAMG activity between concentric and eccentric contractions are discussed in relationship to the origin of the AMG signal. PMID- 1765054 TI - Thermogenic effect of adrenaline: interaction with insulin. AB - The contribution of insulin (3.6 pmol.kg body mass-1.min-1) to adrenaline-induced (0.164 nmol.kg fat free mass-1.min-1) thermogenesis was studied in ten postabsorptive healthy volunteers using two sequential protocols. Variables considered were oxygen consumption as well as carbon dioxide production, heart rate, blood pressure, plasma concentrations of glucose, insulin, glycerol, free fatty acids, beta-HO-butyrate and lactate. Adrenaline increased plasma concentrations of glucose, glycerol, free fatty acids, and beta-HO-butyrate, and heart rate and metabolic rate during normo-insulinaemia [61.3 (SEM 6.6) pmol.l 1]. Similar effects were observed during hyperinsulinaemia [167.9 (SEM 18.7) pmol.l-1], but the effect of adrenaline on oxygen consumption was reduced. On average, metabolic rate increased by 12.9% during normo-insulinaemia and by 8.9% during hyperinsulinaemia. We concluded that relative hyperinsulinaemia resulted in decreased adrenaline-induced thermogenesis and therefore increased whole body anabolism. PMID- 1765055 TI - Muscle cross-section measurement by magnetic resonance imaging. AB - Muscle cross-section areas were measured by magnetic resonance imaging (MRI) in the thigh of a human cadaver, the results being compared with those obtained by photography of corresponding anatomic macroslices. A close correlation was found between MRI and photographic evaluation, differences between the methods ranging from nil to 9.5%, depending on the scan position and the muscle groups. In vivo MRI measurements were performed on 12 female and 16 male students, the objectivity, the test-retest reliability and the variability of the MRI measurements being studied by fixing the scan position either manually or by coronary scan. The latter method appeared to be more objective and reliable. The coefficients of variation for muscle cross-section areas measured by MRI were in the range of those for the planimetry of given cross-section areas. Allowing for differentiation between several small muscle bundles in a given area, MRI proved to be a suitable method to quantify muscle cross-sections for intra- and interindividual analysis of muscle size. PMID- 1765056 TI - Effects of prolonged exercise at a similar percentage of maximal oxygen consumption in trained and untrained subjects. AB - Six trained male cyclists and six untrained but physically active men participated in this study to test the hypothesis that the use of percentage maximal oxygen consumption (%VO2max) as a normalising independent variable is valid despite significant differences in the absolute VO2max of trained and untrained subjects. The subjects underwent an exercise test to exhaustion on a cycle ergometer to determine VO2max and lactate threshold. The subjects were grouped as trained (T) if their VO2max exceeded 60 ml.kg-1.min-1, and untrained (UT) if their VO2max was less than 50 ml.kg-1.min-1. The subjects were required to exercise on the ergometer for up to 40 min at power outputs that corresponded to approximately 50% and 70% VO2max. The allocation of each exercise session (50% or 70% VO2max) was random and each session was separated by at least 5 days. During these tests venous blood was taken 10 min before exercise (- 10 min), just prior to the commencement of exercise (0 min), after 20 min of exercise (20 min), at the end of exercise and 10 min postexercise (+ 10 min) and analysed for concentrations of cortisol, [Na+], [K+], [Cl-], glucose, free fatty acid, lactate [la-], [NH3], haemoglobin [Hb] and for packed cell volume. The oxygen consumption (VO2) and related variables were measured at two time intervals (14-15 and 34-35 min) during the prolonged exercise tests. Rectal temperature was measured throughout both exercise sessions. There was a significant interaction effect between the level of training and exercise time at 50% VO2max for heart rate (fc) and venous [la-].(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765058 TI - Recovery of the human biceps electromyogram after heavy eccentric, concentric or isometric exercise. AB - Five men performed submaximal isometric, concentric or eccentric contractions until exhaustion with the left arm elbow flexors at respectively 50%, 40% and 40% of the prefatigued maximal voluntary contraction force (MVC). Subsequently, and at regular intervals, the surface electromyogram (EMG) during 30-s isometric test contractions at 40% of the prefatigued MVC and the muscle performance parameters (MVC and the endurance time of an isometric endurance test at 40% prefatigued MVC) were recorded. Large differences in the surface EMG response were found after isometric or concentric exercise on the one hand and eccentric exercise on the other. Eccentric exercise evoked in two of the three EMG parameters [the EMG amplitude (root mean square) and the rate of shift of the EMG mean power frequency (MPF)] the greatest (P less than 0.001) and longest lasting (up to 7 days) response. The EMG response after isometric or concentric exercise was smaller and of shorter duration (1-2 days). The third EMG parameter, the initial MPF, had already returned to its prefatigued value at the time of the first measurement, 0.75 h after exercise. The responses of EMG amplitude and of rate of MPF shift were similar to the responses observed in the muscle performance parameters (MVC and the endurance time). Complaints of muscle soreness were most frequent and severe after the eccentric contractions. Thus, eccentric exercise evoked the greatest and longest lasting response both in the surface EMG signal and in the muscle performance parameters. PMID- 1765057 TI - Some aspects of metabolism following a 35 km road run. AB - The metabolism of eight men (mean: age, 26.0 years; maximal oxygen consumption, 65.0 ml.kg-1.min-1; body fat, 10.3%) was measured on counterbalanced control (baseline values for 8 h) and experimental (post 35 km run values for 8 h) days. The excess postexercise volume of oxygen consumed of 32.37 l and increase in energy used of 594 kJ during the 8 h after completion of the run were equivalent to average increases of 23.7 and 21.1%, respectively, when compared with time matched controls. Furthermore, the oxygen uptake and energy expenditure were still elevated by 12.7 (P less than 0.0005) and 9.7% (P = 0.001), respectively, at the end of this period but the fact that they had returned to baseline 24 h after the 35 km road run contrasts with some reports in the literature that metabolism is still elevated at this time following less demanding exercise intensities. Rectal temperature was elevated by 2.3 degrees C at the end of the run but the difference had decreased to 0.2 degrees C by 7 h postexercise. The respiratory exchange ratio and changes in blood metabolites (nonesterified fatty acids, glycerol and ketone bodies) indicated a greater postexercise utilisation of fat notwithstanding a 6300 kJ meal ingested on both control and experimental days. The highest measured serum creatine kinase enzyme activity of 1151 U.l-1 (P less than 0.05) occurred 24 h postexercise, as compared with the control value of 145 U.l-1, and indicates the possibility of skeletal muscle damage. PMID- 1765060 TI - Influence of prolonged physical exercise on the erythropoietin concentration in blood. AB - Erythropoietin (EPO) and red blood cells were studied in 15 well-trained men before and several times after a marathon run. Changes in red blood cells reflected changes of plasma volume. Immediately after the run, red blood cells were increased due to haemoconcentration, whereas 31 h later the values were decreased due to haemodilution. The EPO concentration was increased 3 h, and more impressive 31 h, after the run. This long-lasting increase in EPO concentration after the marathon run would seem to be responsible for the increased red blood cell mass in long distance runners. PMID- 1765059 TI - Effects of immobilization on electromyogram power spectrum changes during fatigue. AB - The maximal force and median frequency (MF) of the electromyogram (EMG) power density spectrum (PDS) have been compared in disused (6 weeks' immobilization) and control (contralateral) human adductor pollicis muscles during fatigue induced by voluntary or electrically-triggered (30 Hz) contractions. The results indicated that after 6 weeks' immobilization, MF was not significantly different in disused and control muscles although the force and integrated EMG were drastically reduced during a maximal voluntary contraction (MVC; by 55% and 45%, respectively, n = 8). During sustained 60 s MVC, the force decreased at the same rate in immobilized and control muscles, but the shift of MF towards lower frequency values was smaller (P less than 0.05) in disused muscle as compared to control by (14% vs 28%, respectively). In electrically-induced fatigue, the force decrease and the MF shift were larger after inactivity (41% and 43% in one subject, and 50% and 54% in the other subject, respectively) as compared to control (29% and 34% in one subject, and 37% and 38% in the other subject, respectively). These results emphasize the caution that should be exercised when EMG signals are quantified by computing the power density spectrum. The different effects of fatigue during voluntary and electrically-imposed contractions in disused and control muscles indicated that immobilization induced changes in the neural command for the contraction which compensated, at least in part, for its decreased contractile efficiency and resistance to fatigue. PMID- 1765061 TI - Comparison of changes in testosterone concentrations after strength and endurance exercise in well trained men. AB - Changes in the testosterone concentrations after single sessions of endurance and strength training were measured in seven well trained men, experienced in both forms of training. Both training sessions were rated as hard to very hard on the Borg scale. Blood samples for testosterone measurements were taken before, immediately after, and 2, 4 and 6 h after the training sessions as well as the next morning. The mean testosterone concentration increased 27% (P less than 0.02) and 37% (P less than 0.02) during the strength and endurance training session, respectively. Two hours after the training sessions the mean testosterone concentration had returned to the pre-training level and remained at that level for the length of the observation period. There were no significant differences in the changes in testosterone concentration after strength and endurance training but there were large differences in the testosterone response at the level of the individual. A high correlation (r = 0.98; P less than 0.001) for individuals was found between increases in testosterone concentration after strength and after endurance training. It was concluded that the changes in mean testosterone values followed the same timecourse after single sessions of strength and endurance training of the same duration and perceived exertion. The interindividual differences in testosterone response may be of importance for individual adaptation to training. PMID- 1765062 TI - Cloning, sequencing and expression studies of the genes encoding amicyanin and the beta-subunit of methylamine dehydrogenase from Thiobacillus versutus. AB - The genes encoding amicyanin and the beta-subunit of methylamine dehydrogenase (MADH) from Thiobacillus versutus have been cloned and sequenced. The organization of these genes makes it likely that they are coordinately expressed and it supports earlier findings that the blue copper protein amicyanin is involved in electron transport from methylamine to oxygen. The amino acid sequence deduced from the nucleotide sequence of the amicyanin-encoding gene is in agreement with the published protein sequence. The gene codes for a pre protein with a 25-amino-acid-long signal peptide. The amicyanin gene could be expressed efficiently in Escherichia coli. The protein was extracted with the periplasmic fraction, indicating that pre-amicyanin is translocated across the inner membrane of E. coli. Sequence studies on the purified beta-subunit of MADH confirm the amino acid sequence deduced from the nucleotide sequence of the corresponding gene. The latter codes for a pre-protein with an unusually long (56 amino acids) leader peptide. The sequencing results strongly suggest that pyrroloquinoline quinone (PQQ) or pro-PQQ is not the co-factor of MADH. PMID- 1765063 TI - Cell-free synthesis of rat and human catechol O-methyltransferase. Insertion of the membrane-bound form into microsomal membranes in vitro. AB - The protein-coding capacities of rat and human catechol O-methyltransferase (COMT) DNA clones were analysed by in vitro transcription and translation using bacteriophage RNA polymerase and rabbit reticulocyte lysate. Two types of clones corresponding to the structures of human placental cDNA clones were used. The shorter clones, containing the 663-residue open reading frame for the soluble COMT (S-COMT), produced 24-kDa (rat) and 26-kDa (human) polypeptides. Translation of the longer clones, containing 43 (rat) or 50 (human) amino acid amino-terminal extensions to the S-COMT polypeptides, yielded 28-kDa (rat) and 30-kDa (human) putative membrane-bound COMT (MB-COMT) polypeptides as the main products. These clones also yielded low amounts of the S-COMT polypeptides. Labelling time or ionic conditions during translation did not eliminate the shorter products, suggesting translation initiation from the second S-COMT AUG codon. In accordance with this postulation, the relative amount of S-COMT could be affected by changing the translation initiation contexts preceding the first AUG codon. The 28-kDa and 30-kDa products, but not the 24-kDa and 26-kDa products, associated with microsomal membranes cotranslationally, indicating that the amino-terminal extensions were functional signal sequences. However, the presence of membranes did not affect the mobilities of the proteins in SDS/polyacrylamide gels. The MB COMT polypeptides could not be released from the microsomes by treatments with phospholipase C or alkali and were not protected by the microsomes against proteinase K digestion. These results indicate that MB-COMT synthesized in vitro is an integral membrane protein having an amino-terminal signal-anchor sequence. PMID- 1765064 TI - Arabidopsis thaliana H1 histones. Analysis of two members of a small gene family. AB - We have isolated two Arabidopsis thaliana cDNA clones that encodes different H1 histone proteins. The H1-1 and H1-2 proteins are 274 and 273 amino acids in length, respectively. Unlike the H1 histones within a single animal species, the two plant H1 proteins share little sequence similarity outside the protein's central globular domain. Within the globular domain, a pentapeptide that is extremely well conserved in animal H1 histones, is not found in either of the plant proteins. Southern blot analysis suggests that A. thaliana has only three H1 histone genes. A genomic clone encoding the H1-1 protein was isolated and the protein-coding region was found to consist of two exons separated by a 104-bp intron. The site of transcriptional initiation of the H1-1 gene was mapped by primer-extension analysis and a conserved octamer motif, identical to that observed in most plant core histone genes that have been characterized to date, was found 101 nucleotides upstream of the presumed transcription-initiation site. The 3' portion of the gene encoding H1-2 was also isolated and sequenced. When the 3'-flanking regions of the two H1 genes were compared, several highly conserved sequences were observed that might be convergently transcribed relative to the histone genes. PMID- 1765065 TI - The conformational stability of the redox states of lipoamide dehydrogenase from Azotobacter vinelandii. AB - The conformational stability of holo-lipoamide and apo-lipoamide dehydrogenase from Azotobacter vinelandii was studied by thermoinactivation, unfolding and limited proteolysis. The oxidized holoenzyme is thermostable, showing a melting temperature, tm = 80 degrees C. The thermal stability of the holoenzyme drastically decreases upon reduction. Unlike the oxidized and lipoamide two electron reduced enzyme species, the NADH four-electron reduced enzyme is highly sensitive to unfolding by urea. Loss of energy transfer from Trp199 to flavin reflects the unfolding of the oxidized holoenzyme by guanidine hydrochloride. Unfolding of the monomeric apoenzyme is a rapid fully reversible process, following a simple two-state mechanism. The oxidized and two-electron reduced holoenzyme are resistant to limited proteolysis by trypsin and endoproteinase Glu C. Upon cleavage of the apoenzyme or four-electron reduced holoenzyme by both proteases, large peptide fragments (molecular mass greater than 40 kDa) are transiently produced. Sequence studies show that limited trypsinolysis of the NADH-reduced enzyme starts mainly at the C-terminus of Arg391. In the apoenzyme, limited proteolysis by endoproteinase Glu-C starts from the C-terminus at the carboxyl ends of Glu459 and/or Glu435. From crystallographic data it is deduced that the susceptible amino acid peptide bonds are situated near the subunit interface. Thus, these bonds are inaccessible to the proteases in the dimeric enzyme and become accessible after monomerization. It is concluded that reduction of lipoamide dehydrogenase to the four-electron reduced state(s) is accompanied by conformational changes promoting subunit dissociation. PMID- 1765066 TI - The effect of enhanced alpha-helicity on the activity of a winter flounder antifreeze polypeptide. AB - The antifreeze polypeptide (AFP) from the winter flounder displays partial alpha helix formation at lower temperatures. To investigate the relationship between antifreeze activity and alpha-helical structure, we designed and then chemically synthesized an AFP analog with enhanced alpha-helicity, and compared its conformation and antifreeze properties with those of the native AFP. The synthetic analog was more helical than the native AFP; however, the antifreeze activity of both peptides were identical. The antifreeze activity of the peptides displayed a strong pH dependence, which paralleled pH-induced changes in helix content. At pH 8.5, the antifreeze activity of both peptides displayed identical concentration dependences. In addition to antifreeze activity measurements, the effects of the peptides on the rate of ice crystal growth were also measured. While both peptides affected the a- and c-axis growth rates of ice crystals, the highly helical analog was able to exert its effect on ice crystal growth rates at 7-8-fold lower concentrations than the native AFP. These data indicate that there is a direct but complex relationship between alpha-helicity and antifreeze activity. PMID- 1765067 TI - Oxidation-reduction potentials of ferredoxin-NADP+ reductase and flavodoxin from Anabaena PCC 7119 and their electrostatic and covalent complexes. AB - The oxidation-reduction potentials of ferredoxin-NADP+ reductase and flavodoxin from the cyanobacterium Anabaena PCC 7119 were determined by potentiometry. The potentials at pH 7 for the oxidized flavodoxin/flavodoxin semiquinone couple (E2) and the flavodoxin semiquinone/hydroquinone couple (E1) were -212 mV and -436 mV, respectively. E1 was independent of pH above about pH 7, but changed by approximately -60 mV/pH below about pH 6, suggesting that the fully reduced protein has a redox-linked pKa at about 6.1, similar to those of certain other flavodoxins. E2 varied by -50 mV/pH in the range pH 5-8. The redox potential for the two-electron reduction of ferredoxin-NADP+ reductase was -344 mV at pH 7 (delta Em = -30 mV/pH). In the 1:1 electrostatic complex of the two proteins titrated at pH 7, E2 was shifted by +8 mV and E1 was shifted by -25 mV; the shift in potential for the reductase was +4 mV. The potentials again shifted following treatment of the electrostatic complex with a carbodiimide, to covalently link the two proteins. By comparison with the separate proteins at pH 7, E2 for flavodoxin shifted by -21 mV and E1 shifted by +20 mV; the reductase potential shifted by +2 mV. The potentials of the proteins in the electrostatic and covalent complexes showed similar pH dependencies to those of the individual proteins. Qualitatively similar changes occurred when ferredoxin-NADP+ reductase from Anabaena variabilis was complexed with flavodoxin from Azotobacter vinelandii. The shifts in redox potential for the complexes were used with previously determined values for the dissociation constant (Kd) of the electrostatic complex of the two oxidised proteins, in order to estimate Kd values for the interaction of the different redox forms of the proteins. The calculations showed that the electrostatic complexes, formed when the proteins differ in their redox states, are stronger than those formed when both proteins are fully oxidized or fully reduced. PMID- 1765068 TI - Ornatins: potent glycoprotein IIb-IIIa antagonists and platelet aggregation inhibitors from the leech Placobdella ornata. AB - The purification and characterization of six isoforms of ornatin, potent glycoprotein IIb-IIIa (GP IIb-IIIa) antagonists and platelet aggregation inhibitors are described. These isoforms were purified from whole leech homogenates of the leech Placobdella ornata, a North American leech commonly known as the turtle leech, by trichloroacetic acid precipitation, Sephadex G-50 size exclusion chromatography, GP IIb-IIIa affinity chromatography, and C18 reverse-phase HPLC. Each of the five completely sequenced isoforms, which range from 41 to 52 residues in length, contains the Arg-Gly-Asp (RGD) sequence, a common recognition sequence in adhesion proteins, as well as 6 cysteine residues; the positions of both of these features are conserved in the primary sequences. The amino acid sequences of ornatin isoforms B, C, D, and E are highly conserved, whereas ornatin A2 and A3 are less similar and lack 9 residues at the N-terminus. The ornatins are approximately 40% identical with decorsin, a GP IIb-IIIa antagonist isolated from the leech Macrobdella decora [Seymour, J. L., Henzel, W. J., Nevins, B., Stults, J. T. & Lazarus, R. A. (1990) J. Biol. Chem. 265, 10143 10147]; furthermore, the RGD sequence and 5 out of 6 cysteine residues are maintained in the same relative positions in both decorsin and ornatin. The ornatin isoforms do not exhibit significant similarity to any members of the snake-venom-derived family of GP IIb-IIIa antagonists [Dennis, M. S., Henzel, W. J., Pitti, R. M., Lipari, M. T., Napier, M. A., Deisher, T. A., Bunting, S. & Lazarus, R. A. (1990) Proc. Natl Acad. Sci. USA 87, 2471-2475] except in the RGD region of these proteins. The ornatin isoforms inhibit the binding of GP IIb-IIIa to immobilized fibrinogen with IC50 values ranging over 2.9-5.3 nM; ornatin isoforms A2, C, and E inhibit ADP-induced human platelet aggregation with IC50 values of about 130, 280, and 440 nM, respectively. PMID- 1765071 TI - Surface topography of histidine residues in lysozymes. AB - Several avian and mammalian c-type lysozymes were chromatographed on chelated (to iminodiacetate) and immobilized transition metal ions (Co2+, Ni2+, Cu2+ and Zn2+) under a variety of experimental conditions. The varied affinity of evolutionary variants of the lysozyme family for chelated metal ions, IDA-M(II), can be rationalized primarily in terms of the presence, multiplicity and microenvironments of histidine residues. The chromatographic resolution of some of these closely related proteins attests to the analytical power of immobilized metal-ion affinity chromatography. PMID- 1765069 TI - Refolding kinetics of pig muscle and yeast 3-phosphoglycerate kinases and of their proteolytic fragments. AB - The time course of refolding of both pig muscle and yeast 3-phosphoglycerate kinase (molecular masses about 47 kDa), as well as their proteolytic C-terminal fragments (30 and 33 kDa, respectively) has been investigated. Very similar refolding kinetics (with half-time between 80-120 s, at 20 degrees C) were observed by fluorescence and ultraviolet absorbance spectroscopy, as well as by activity measurements, for the intact enzyme from both sources. This time course appears not to depend on the time the protein spends in the unfolded state, i.e. it is certainly not controlled by proline isomerization. Furthermore, after removal of a large N-terminal part (molecular mass of about 18 kDa for pig muscle enzyme or 13 kDa for yeast enzyme) of the molecule by proteolysis, refolding of the remaining C-terminal fragment of both proteins follows kinetics virtually indistinguishable from those of the intact protein molecule. PMID- 1765070 TI - Redox and flavin-binding properties of recombinant flavodoxin from Desulfovibrio vulgaris (Hildenborough). AB - Flavodoxin from Desulfovibrio vulgaris (Hildenborough) has been expressed at a high level (3-4% soluble protein) in Escherichia coli by subcloning a minimal insert carrying the gene behind the tac promoter of plasmid pDK6. The recombinant protein was readily isolated and its properties were shown to be identical to those of the wild-type protein obtained directly from D. vulgaris, with the exception that the recombinant protein lacks the N-terminal methionine residue. Detailed measurements of the redox potentials of this flavodoxin are reported for the first time. The redox potential, E2, for the couple oxidized flavodoxin/flavodoxin semiquinone at pH 7.0 is -143 mV (25 degrees C), while the value for the flavodoxin semiquinone/flavodoxin hydroquinone couple (E1) at the same pH is -440 mV. The effects of pH on the observed potentials were examined; E2 varies linearly with pH (slope = -59 mV), while E1 is independent of pH at high pH values, but below pH 7.5 the potential becomes less negative with decreasing pH, indicating a redox-linked protonation of the flavodoxin hydroquinone. D. vulgaris apoflavodoxin binds FMN very tightly, with a value of 0.24 nM for the dissociation constant (Kd) at pH 7.0 and 25 degrees C, similar to that observed with other flavodoxins. In addition, the apoflavodoxin readily binds riboflavin (Kd = 0.72 microM; 50 mM sodium phosphate, pH 7.0, 5 mM EDTA at 25 degrees C) and the complex is spectroscopically very similar to that formed with FMN. The redox potentials for the riboflavin complex were determined at pH 6.5 (E1 = -262 mV, E2 = -193 mV; 25 degrees C) and are discussed in the light of earlier proposals that charge/charge interactions between different parts of the flavin hydroquinone play a crucial role in determining E1 in flavodoxin. PMID- 1765072 TI - Physical characterization and sequence identification of the ovary maturating parsin. A new neurohormone purified from the nervous corpora cardiaca of the African locust (Locusta migratoria migratorioides. AB - A novel neurohormone, which anticipates ovarian maturation, was recently purified using liquid chromatography from the African locust nervous corpora cardiaca. Both its function and production by the pars intercerebralis of Locusta migratoria lead to its name, the ovary maturating parsin (Lom OMP). In this study, the Lom OMP was physically and chemically characterized. Its multiply charged ion spectrum was interpreted as two peaks of quite equal size having molecular masses of 6923.4 Da (major peak) and 6907.3 Da. The Lom OMP presented no periodic secondary structure according to the far ultraviolet circular dichroism spectrum obtained. It is composed of 65 amino acids and included a high concentration of alanine but is devoid of cysteine, isoleucine, methionine, lysine and threonine. The amino acid sequence indicated only one microheterogeneity, observed at position 26, consisted in the replacement of serine by alanine. The calculated Mr of the two acidic isoforms (calculated pHi = 4.87) were found to be in agreement with mass spectrometry measurements. When compared to the sequence libraries, the Lom OMP, the first insect gonadotropic neurohormone, was revealed as an unique protein. PMID- 1765073 TI - Inhibitory activity and conformational transition of alpha 1-proteinase inhibitor variants. AB - Several variants of alpha 1-proteinase inhibitor (alpha 1-PI) were investigated by spectroscopic methods and characterized according to their inhibitory activity. Replacement of Thr345 (P14) with Arg in alpha 1-PI containing an Arg residue in position 358 (yielding [Thr345----Arg, Met358----Arg]alpha 1-PI) results in complete loss of its inhibitory activity against human alpha-thrombin; whereas an exchange of residue Met351 (P8) by Glu [( Met351----Glu, Met358--- Arg]alpha 1-PI) does not alter activity. [Thr345----Arg, Met358----Arg]alpha 1-PI is rapidly cleaved by thrombin, while [Met358----Arg]alpha 1-PI and [Met351--- Glu, Met358----Arg]alpha 1-PI form stable proteinase-inhibitor complexes. The stability of [Thr345----Arg, Met358----Arg]alpha 1-PI against guanidinium chloride denaturation is significantly enhanced compared to wild-type alpha 1-PI, and does not change after cleavage, resembling ovalbumin, a serpin with no inhibitory activity, from which the Thr345----Arg amino acid exchange had been derived. [Met351----Glu, Met358----Arg]alpha 1-PI and [Met358----Arg]alpha 1-PI resemble the wild-type protein in this respect. The CD spectra of intact and cleaved alpha 1-PI variants do not compare well with the wild-type protein, probably reflecting local structural differences. Insertion of a synthetic peptide, which corresponds to residues Thr345----Met358 of human alpha 1-PI, leads to the formation of binary complexes with all variants having the characteristic features of the binary complex between peptide and wild-type protein. PMID- 1765074 TI - A comparison of the reactivity and stability of wild type and His388----Gln mutant phosphoglycerate kinase from yeast. AB - A variety of physico-chemical techniques have been used to probe the possible interactions between the characteristic structural domains of yeast phosphoglycerate kinase by comparison of the wild-type enzyme with the specific H388Q mutant in which a potential interaction between His388 and Glu190 in the crucial interdomain region is disrupted. Enzyme kinetic studies indicate that, despite being structurally remote from the active site, this mutation has significant effects on both the Vmax and Km values for various substrates. The single cysteine residue in the N domain of the protein is markedly more reactive in the mutant, and this enhanced accessibility is moderated by binding of substrates and various anions. Differences are also observed in the near ultraviolet CD spectra of these proteins. The chemical and thermal stability of the mutant enzyme is reduced, as indicated from guanidinium chloride and differential-scanning calorimetry denaturation studies. Moreover, interdomain interactions seem to be altered in the mutant, resulting in the appearance of independent thermal transition for the two domains, in contrast to the single cooperative transition observed for the wild-type enzyme. The conformational and/or dynamic effects of the mutation on the H388Q enzyme are therefore various and not solely localised in the hinge region. PMID- 1765076 TI - Over-production, purification and properties of the uridine diphosphate N acetylmuramoyl-L-alanine:D-glutamate ligase from Escherichia coli. AB - The UDP-N-acetylmuramoyl-L-alanine:D-glutamate ligase of Escherichia coli was over-produced in strains that harbour recombinant plasmids bearing the murD gene under the control of the lac or PR promoter. Purification to homogeneity was achieved by a two-step procedure from a 181-fold over-producing strain. The N terminal sequence of the purified protein was determined and correlated with the nucleotide sequence of the murD gene. The purified activity was highly dependent on the concentration of potassium phosphate and Mg2+. The enzyme also catalysed the reverse reaction. The Km values for UDP-N-acetylmuramoyl-L-alanine; D glutamate and ATP/Mg2+ were estimated at 7.5, 55 and 138 microM, respectively. Under the most optimal in vitro conditions determined, a turnover number of 931 min-1 was estimated. When considering the plasmid-free parental strain, the copy number of the murD gene product was not more than 1000.cell-1. PMID- 1765077 TI - Mechanism of action of the calpain activator protein in rat skeletal muscle. AB - Rat skeletal muscle contains a calpain activator protein characterized by a high specificity for calpain II, the high Ca(2+)-requiring isoform of this class of proteinases. The activator protein increases the rate of intramolecular conversion of the native 80-kDa catalytic subunit of calpain into the autolysed 75-kDa forms with maximal rate at concentrations of calcium approximately 25 times lower than those required by the native proteinase. The activator protein interacts with native calpain II forming a 1:1 complex; interaction does not occur with the fully activated form, produced by autoproteolysis. Even after immobilization to membranes, the activator binds to calpain, which then undergoes sequential activation and release from its bound form. The activator is itself resistant to digestion by calpain II, whereas it increases the rate at which homologous calpastatin is degraded by the proteinase. Taken together, these results are indicative of the existence in rat skeletal muscle of an activating system specific for calpain II which is potentially involved in the regulation of the inhibitory efficiency of calpastatin, through modulation of its intracellular level. PMID- 1765078 TI - NMR studies of lantibiotics. The structure of nisin in aqueous solution. AB - Nisin is a posttranslationally modified protein of 34 amino acids, and is a member of the class of bacteriocidal polypeptides known as lantibiotics, that contain the unusual amino acid lanthionine. Its structure in aqueous solution has been determined on the basis of NMR data, i.e. interproton distance constraints derived from nuclear Overhauser enhancement spectroscopy and torsion angle constraints derived from double-quantum-filtered correlated spectroscopy. Translation of the NMR constraints into a three-dimensional structure was carried out with the distance-geometry program DISMAN, followed by restrained energy minimization using CHARMm. The internal mobility of the peptide chain prohibited the determination of a precise overall folding of the molecule, but parts of the structure could be obtained, albeit sometimes with low resolution. The structure of nisin can best be defined as follows. The outermost N-terminal and C-terminal regions of nisin appear quite flexible, the remainder of the molecule consists of an amphiphilic N-terminal fragment (residues 3-19), joined by a flexible 'hinge' region to a rigid double-ring fragment formed by residues 23-28. The latter fragment has the appearance of a somewhat overwound alpha-helix. It is suggested, by assuming the presence of a (transient) alpha-helical structure in this part of prenisin, that the coupling between residues 23 and 26, as well as between 25 and 28, by thioether bridges, and the inversion of the C alpha chiralities at positions 23 and 25, can be rationalized. PMID- 1765075 TI - The primary structure of ammodytin L, a myotoxic phospholipase A2 homologue from Vipera ammodytes venom. AB - A new myotoxic phospholipase A2 homologue, having a serine residue in position 49 instead of highly conserved aspartic acid, was found in the venom of Vipera ammodytes. The primary structure revealed additional mutations in the positions important for enzymatic activity. Tyr28 is exchanged for a histidine and Gly33 for asparagine. These changes render earlier-reported weak enzymatic activity unlikely. The role of this rather abundant venom fraction is apparently in myotoxicity, which was confirmed in the muscle-cell culture from neonatal rats. The muscle-cell culture proved to be a good tool to investigate the effects of various myotoxins on muscle cells. PMID- 1765079 TI - Extremely thermostable glutamate dehydrogenase from the hyperthermophilic archaebacterium Pyrococcus furiosus. AB - The hyperthermophilic archaebacterium Pyrococcus furiosus contains high levels of NAD(P)-dependent glutamate dehydrogenase activity. The enzyme could be involved in the first step of nitrogen metabolism, catalyzing the conversion of 2 oxoglutarate and ammonia to glutamate. The enzyme, purified to homogeneity, is a hexamer of 290 kDa (subunit mass 48 kDa). Isoelectric-focusing analysis of the purified enzyme showed a pI of 4.5. The enzyme shows strict specificity for 2 oxoglutarate and L-glutamate but utilizes both NADH and NADPH as cofactors. The purified enzyme reveals an outstanding thermal stability (the half-life for thermal inactivation at 100 degrees C was 12 h), totally independent of enzyme concentration. P. furiosus glutamate dehydrogenase represents 20% of the total protein; this elevated concentration raises questions about the roles of this enzyme in the metabolism of P. furiosus. PMID- 1765080 TI - Sequence and properties of beta-xylosidase from Bacillus pumilus IPO. Contradiction of the previous nucleotide sequence. AB - The nucleotide sequence of the beta-xylosidase (xynB) gene from Bacillus pumilus has been reported previously [Moriyama, H., Fukusaki, E., Crespo, J.C., Shinmyo, A. & Okada, H. (1987) Eur. J. Biochem. 166, 539-545]. However, the sequence identified in the present study is quite different from the previously reported one. The total length of the PstI--EcoRI fragment of a plasmid pOXN295 containing the xynB gene is 2201 bp from our sequencing, while the length of the fragment in the previous data was 2466 bp. The sequences are similar in the N-terminal (500 bp) and C-terminal (260 bp) regions, but those in the central region are completely different. From the following observations, the previous sequence seems to have no reliable experimental basis. First, the restriction sites observed for pOXN295 are quite different from the sites deduced from the sequence. Second, the amino acid composition deduced from the sequence and the composition identified by amino acid analysis of the purified beta-xylosidase are very different. It is confirmed, on the other hand, that our new sequence agrees well with these experimental data. The enzyme was purified to homogeneity from Bacillus pumilus and Escherichia coli harboring a hybrid plasmid which highly expresses the xynB gene. The molecular mass of the enzyme was estimated to be 190 kDa by high performance gel filtration chromatography using TSK-G3000SW and 56 kDa by SDS/polyacrylamide gel electrophoresis. The pH optimum was 7.0, and the optimum temperature was 40 degrees C. The Vm value was estimated to be 1.23 +/- 0.14 mukat/mg (or p-nitrophenyl beta-D-xyloside) and 0.14 +/- 0.011 mukat/mg (for xylobiose), while Km was estimated to be 3.9 +/- 0.59 mM (for p-nitrophenyl beta D-xyloside) and 8.9 +/- 1.19 mM (for xylobiose). PMID- 1765081 TI - Hydrogen-forming and coenzyme-F420-reducing methylene tetrahydromethanopterin dehydrogenase are genetically distinct enzymes in Methanobacterium thermoautotrophicum (Marburg). AB - A coenzyme-F420-reducing and an H2-forming methylenetetrahydromethanopterin dehydrogenase have been isolated from Methanobacterium thermoautotrophicum (Marburg). Indirect evidence suggested that the former enzyme (32 kDa) might be derived from the latter enzyme (42 kDa) by proteolysis. To test this hypothesis the gene sequence of the H2-forming dehydrogenase was determined and compared with the N-terminal amino acid sequence of the F420-reducing dehydrogenase. No corresponding sequences were found indicating that the two dehydrogenases are genetically distinct enzymes. With purified enzyme preparations it is shown that the activity of the F420-reducing dehydrogenase is inhibited in the presence of the H2-forming enzyme. This finding is discussed in terms of substrate competition. PMID- 1765082 TI - Small and medium-angle X-ray analysis of bacterial lipoteichoic acid phase structure. AB - X-ray scattering analysis was performed on various types of bacterial lipoteichoic acid in solution. The X-ray data show that all samples investigated were characterized by a similar micellar ultrastructure (hydrophilic moiety on the outside) with a fatty acid chain conformation of the disordered, alpha-type at all temperatures between 5 degrees-53 degrees C. The size distribution of Staphylococcus aureus lipoteichoic acid micelles was sufficiently homogeneous to determine their size and some related molecular parameters by detailed small angle X-ray scattering analysis. Nearly independent of the degree of D-alanine substitution and the ionic strength of the aqueous dispersion, an average micelle contained about 150 lipoteichoic acid molecules arranged in a spherical assembly with a diameter of about 22 nm, whereby the hydrophilic region occupied an outer shell of about 8.5 nm thickness. Based on the average chain length of lipoteichoic acid, it could be estimated that each glycerophosphate residue contributed by about 0.34 nm to the thickness of the hydrophilic shell as compared to a theoretical value of approximately 0.8 nm for a fully extended chain conformation, indicating a highly coiled conformation of the hydrophilic chain. The bearing of these findings on the properties of membrane-associated and secreted lipoteichoic acids is discussed. PMID- 1765083 TI - Mutation of the pseudo-EF-hand of calbindin D9k into a normal EF-hand. Biophysical studies. AB - The two Ca(2+)-binding sites in calbindin D9k, a protein belonging to the calmodulin superfamily of intracellular proteins, have slightly different structure. The C-terminal site (amino acids 54-65) is a normal EF-hand as in the other proteins of the calmodulin superfamily, while the N-terminal site (amino acids 14-27) contains two additional amino acids, one of which is a proline. We have constructed and studied five mutants of calbindin D9k modified in the N terminal site. In normal EF-hand structures the first amino acid to coordinate calcium is invariantly an Asp. For this reason Ala15, is exchanged by an Asp in all mutants and the mutants also contain various other changes in this site. The mutants have been characterized by 43Ca, 113Cd and 1H NMR and by the determination of the calcium binding constants using absorption chelators. In two of the mutants (one where Ala14 is deleted, Ala15 is replaced by Asp and Pro20 is replaced by Gly, the other where, in addition, Asn21 is deleted), we find that the structure has changed considerably compared to the wild-type calbindin. The NMR results indicate that the calcium coordination has changed to mainly side chain carboxyls, from being octahedrally coordinated by mainly back-bone carbonyls, and/or that the coordination number has decreased. The N-terminal site has thus been turned into a normal EF-hand, in which the calcium ion is coordinated by side-chain carboxyls. Furthermore, the calcium binding constants of these two mutant proteins are almost as high as in the wild-type calbindin D9k. That is, the extensive alterations in the N-terminal site have not disrupted the calcium binding ability of the proteins. PMID- 1765084 TI - Secondary structure of the membrane-bound form of the pore-forming domain of colicin A. An attenuated total-reflection polarized Fourier-transform infrared spectroscopy study. AB - The structure of the pore-forming domain of the bacterial toxin colicin A was studied by attenuated total-reflection polarized Fourier-transform infrared spectroscopy. This channel-forming fragment interacts with dimyristoylglycerophosphoglycerol (Myr2GroPGro) vesicles and forms disk-like complexes. Analysis of the shape of the amide I' band indicates that its secondary structure is not affected by the pH 5.0-7.2. However, 5-10% of the peptide amino acids adopt an alpha-helical structure upon complex formation with Myr2GroPGro, while the random-coil and beta-sheet structure contents decrease. Interestingly, the increase in alpha-helical content is essentially due to an increase in the high-frequency component of the alpha-helical domain of amide I'. The fact that only this component was 90 degrees polarized (i.e. the helix is parallel to the acyl chain) suggests that only this particular type of helix is associated with the Myr2GroPGro bilayer. PMID- 1765085 TI - Mechanisms of dramatic fluctuations of ornithine decarboxylase activity upon tonicity changes in primary cultured rat hepatocytes. AB - We investigated the mechanisms underlying the marked induction of ornithine decarboxylase (ODC) activity by hypotonic treatment and its rapid decay upon reversal to isotonicity in primary cultures of adult rat hepatocytes. Upon hypotonic treatment, ODC synthesis rate increased progressively whereas the amount of ODC mRNA increased only about twofold. In addition, ODC was stabilized severalfold. ODC activity rapidly decreased upon restoration of isotonicity, owing to immediate and nearly complete suppression of ODC synthesis and 3-6-fold stimulation of ODC decay. The stimulation of ODC decay caused by restoration of isotonicity was mostly independent of time and protein synthesis. ODC decay was also stimulated by putrescine, even under hypotonic conditions, depending on time and new protein synthesis. Restoration of isotonicity and putrescine treatment together caused a synergistic stimulation of ODC decay, confirming that these act by different mechanisms. PMID- 1765086 TI - Analysis of calcium binding to alpha-lactalbumin using a fluorescent calcium indicator. AB - A sensitive and rapid assay of Ca2+ binding to proteins was developed, based on the competition of Ca2+ binding to the protein of interest and fluo-3, a fluorescent Ca2+ indicator. Ca2+ binding to fluo-3 and bovine alpha-lactalbumin was analyzed at ten different pH values and a range of Na+ and K+ concentrations. We demonstrate that the binding constants of alpha-lactalbumin, determined by means of the competition assay and using intrinsic protein fluorescence, are the same within experimental error. The dissociation constant of the alpha lactalbumin--Ca2+ complex in 50 mM Hepes containing 150 mM Na+ at pH 7.4 and 25 degrees C, was found to be 123 +/- 2 nM and 103 +/- 43 nM when determined by the competition assay and intrinsic protein fluorescence, respectively. Binding of Ca2+ to alpha-lactalbumin did not depend on pH in the range 6.6-8.4 and was differently affected by Na+ and K+. EDTA-agarose, a chelating chromatography material, was synthesized and used to remove Ca2+ from buffer and protein solutions. The total concentration of Ca2+ in 50 mM Hepes, containing 150 mM Na+ at pH 7.4, was lowered to 119 +/- 13 nM and the number of Ca2+ bound/molecule alpha-lactalbumin was lowered to 0.069 +/- 0.006. No interaction between fluo-3 and alpha-lactalbumin could be discerned from spectral analysis and fluorescence anisotropy measurements. PMID- 1765087 TI - Molecular aspects of neuronal voltage-dependent K+ channels. PMID- 1765088 TI - Protein stability and molecular adaptation to extreme conditions. AB - Proteins, due to the delicate balance of stabilizing and destabilizing interactions, are only marginally stable. Adaptation to extreme environments tends to shift the 'mesophilic' characteristics of proteins to the respective extremes of temperature, hydrostatic pressure, pH and salinity, such that, under the mutual physiological conditions, the molecular properties are similar regarding overall topology, flexibility and solvation. Enhanced intrinsic stability requires only minute local structural changes so that general strategies of stabilization cannot be established. Apart from mutative changes of amino-acid sequences, extrinsic factors (or cellular components) may be involved in 'extremophilic adaptation'. The molecular basis of acidophilic, alkalophilic and barophilic adaptation is still obscure. Mechanisms of enhanced thermal stability involve improved packing density, as well as specific local interactions. In halophiles, water and salt binding of the intrinsically stable protein inventory is accomplished by favoring acidic over basic amino acid residues and decreased hydrophobicity. General limits of viability are: (a) the susceptibility of the covalent structure of the polypeptide chain toward hydrolysis or hydrothermal degradation; (b) the competition of extreme solvent parameters with the weak electrostatic and hydrophobic interactions involved in protein stabilization; (c) perturbations of the folding and assembly of proteins; and (d) 'dislocation' of biochemical pathways due to effects of extreme conditions on the intricate network of metabolic reactions. PMID- 1765089 TI - Molecular and cellular aspects of immunologic tolerance. AB - This review seeks to explain the most exciting recent data concerning the nature of self/non-self discrimination by the immune system in a manner accessible to a biochemical readership. The nature of recognition in the two great lymphocyte families, B cells and T cells, is described with special emphasis on the nature of the ligands recognized by each. The history of the field of immunologic tolerance is surveyed, as are the key experiments on conventional mice which provided a conceptual framework. This suggested that tolerance was essentially due to 'holes' in the recognition repertoires of both the T and B cell populations so that lymphocytes competent to react to self antigens were not part of the immunologic dictionary. There were essentially two ways to achieve this situation. On the one hand, self antigens might 'catch' developing lymphocytes early in their ontogeny and delete the cell, a process of clonal abortion. On the other hand, self antigens might signal lymphocytes (particularly immature cells) in a negative manner, reducing or abolishing their capacity for later responses, without causing death. This process is referred to as clonal anergy. Evidence for both processes exists. Special emphasis is placed on a wave of experimentation beginning in 1988 which imaginatively uses transgenic mouse technology to study tolerance. Transgenic manipulations can produce mice which synthesize foreign antigens in a constitutive and/or inducible manner, sometimes only in specific locations; mice which possess T or B lymphocytes almost all expressing a given receptor of known specificity; and mice which are an immunologic time bomb in that the antigen is present and so too are lymphocytes all endowed with receptors for that antigen. These experiments have vindicated the possibility of both clonal abortion and clonal anergy in both T and B cell populations, the choice of which phenomenon occurs depending on a number of operational circumstances. For T cell tolerance, clonal abortion occurs if the self antigenic determinant concerned is present within the thymus; if not, clonal anergy is more likely. For B cell tolerance, the strength of the negative signal and therefore the choice between abortion and anergy depends on the molar concentration of the self antigen, the capacity for multivalent presentation to a B cell, and the affinity of the B cell's receptor for the antigen in question. Some B cells with low affinity for self antigens certainly escape censorship and remain capable of secreting low affinity anti-self antibodies, which however do no harm.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1765090 TI - Characterization of glutamate-1-semialdehyde aminotransferase of Synechococcus. Steady-state kinetic analysis. AB - Synechococcus glutamate-1-semialdehyde aminotransferase was expressed in large amounts in transformed cells of Escherichia coli. The resulting purified enzyme has an absorption spectrum characteristic of B6-containing enzymes and could be converted to the pyridoxal-phosphate form with excess dioxovalerate (O2Val), and back to the pyridoxamine-phosphate form with diaminovalerate (A2Val). Both enzyme forms are similarly active in the conversion of glutamate 1-semialdehyde (GSA) to 5-aminolevulinate (ALev), suggesting that A2Val and O2Val are intermediates. Initial rates of ALev synthesis at various fixed concentrations of GSA followed typical Michaelis-Menten kinetics (Km of GSA for the pyridoxamine-phosphate form of GSA aminotransferase = 12 microM, kcat = 0.23 s-1). In submicromolar amounts A2Val stimulates ALev synthesis, and in a series of concentrations with various fixed concentrations of GSA, gives a family of parallel lines in Lineweaver-Burk plots (Km for A2Val = 1.0 microM). On the other hand, O2Val gives competitive inhibition of the pyridoxamine-phosphate form of GSA-aminotransferase and mixed type inhibition of the pyridoxal-phosphate form (Ki for O2Val = 1.4 mM). In general the kinetics were typical of ping-pong bi-bi mechanisms in which A2Val is the second substrate (intermediate) and O2Val is an alternative first substrate. There is no compelling evidence that O2Val accepts an amino group at its C5 position resulting in the direct formation of ALev, or the reverse involving the apparent formation of O2Val from ALev. These results are consistent with the hypothesis that the mechanism of GSA aminotransferase mimics that of other aminotransferases and that A2Val is the intermediate. PMID- 1765091 TI - Alpha B-crystallin exists as an independent protein in the heart and in the lens. AB - Alpha B-crystallin, a polypeptide of molecular mass 22 kDa, is considered to be one of two subunits (alpha A and alpha B) of the multimeric lens-specific protein, alpha-crystallin. Recent demonstrations of the extra-lenticular presence of alpha B-crystallin have suggested that outside of the lens, this polypeptide may have functions independent of alpha A. Within the lens however, as part of the protein alpha-crystallin, its function is assumed to be structural. In an effort to investigate the functional status of alpha B-crystallin in the lens, we have characterized this polypeptide in the rat heart and the human lens. Unequivocal identity of alpha B-crystallin in the rat heart and the rat lens was established by the sequence analyses of the respective cDNA clones. Size exclusion chromatography (FPLC) and immunoblotting showed that in the rat heart, alpha B-crystallin exists as an aggregate of 300-400 kDa average molecular mass, similar to that of purified alpha B-crystallin isolated from bovine lens. Interestingly, analysis of the human lens proteins by immunoblotting showed that, with age, unlike alpha A-crystallin, the alpha B subunit remains detectable in the soluble fractions derived from normal lenses as old as 82 years. Importantly, the average molecular mass of the alpha B subunit in the soluble fractions prepared from 60-80-year-old human lens nuclei was also found to be 300-400 kDa. These data lead to the conclusion that alpha B-crystallin may exist as an independent protein not only in non-lens tissues (e.g. heart) but in the lens as well. PMID- 1765092 TI - Characterization and distribution of cis-prenyl transferase participating in liver microsomal polyisoprenoid biosynthesis. AB - The properties of rat liver cis-prenyl transferase, mediating the synthesis of polyisoprenoid pyrophosphate from trans,trans-farnesyl pyrophosphate and [3H]isopentenyl pyrophosphate were studied. The Km values for farnesyl pyrophosphate and isopentenyl pyrophosphate were found to be 25 microM and 4.4 microM, respectively. Appropriate conditions were established to measure the condensation reaction, which was linear during the first hour using 1 mg microsomal protein. Various detergents could solubilize the enzyme, but the presence of Triton X-100 was required during the incubation to obtain full activity. There was also an absolute requirement for Mg2+ and the pH maximum was 7.0. Inorganic phosphate, especially pyrophosphate, proved to be inhibitory. cis Prenyl transferase is associated mainly with the cytoplasmic surface of rough microsomes and, to some extent, also with smooth I microsomes, but was almost absent from smooth II microsomes. At all localizations, the product is polyprenyl pyrophosphate and to some extent, also polyprenyl monophosphate. The isoprenoids formed contain 15-18 units in the presence of detergents and 16-20 units in the absence of detergents. PMID- 1765093 TI - Site-directed mutagenesis of the conserved histidine residue of phosphoenolpyruvate carboxylase. His138 is essential for the second partial reaction. AB - Histidine residues have previously been suggested to be essential for the activity of phosphoenolpyruvate carboxylase as demonstrated by chemical modification of these residues. Although the location of these residues on the primary structure is not known, a comparison of nine phosphoenolpyruvate (P pyruvate) carboxylases sequenced recently revealed that there are only two conserved histidine residues (His138 and His579, coordinates from the E. coli enzyme). Site-directed mutagenesis of these residues were undertaken with the E. coli P-pyruvate carboxylase and the properties of purified mutant enzymes were investigated. Mutation of His138 to asparagine (H138N) produced a protein which did not show carboxylase activity. However, this mutant enzyme catalyzed the bicarbonate-dependent dephosphorylation (Vmax = 1.4 mumol.min-1.mg-1) of the P pyruvate. Since this reaction is due to one of the two partial reactions proposed for this enzyme, the results indicate that His138 is obligatory for the second step reaction, i.e. the carboxylation of the enolate form of pyruvate by carboxyphosphate. Mutation of His579 to asparagine (H579N) produced an enzyme which had 69% of the wild-type carboxylase activity, but its affinity for P pyruvate was decreased by 24-fold. PMID- 1765094 TI - Structural studies on sulfated oligosaccharides derived from the carbohydrate protein linkage region of chondroitin sulfate proteoglycans of whale cartilage. AB - From the carbohydrate-protein linkage region of whale cartilage proteoglycans, which bear predominantly chondroitin 4-sulfate, one nonsulfated, two monosulfated and one disulfated hexasaccharide alditols were isolated after exhaustive digestions with Actinase E and chondroitinase ABC, and subsequent beta elimination. Their structures were analyzed by chondroitinase ACII digestion in conjunction with HPLC and by 500-MHz 1H-NMR spectroscopy. The nonsulfated compound (A) had the following conventional structure: delta GlcA(beta 1-3) GalNAc(beta 1-4)GlcA(beta 1-3)Gal(beta 1-4)Xylol, where GlcA, delta GlcA and GalNAc are glucuronic acid; 4,5-unsaturated glucuronic acid and 2-deoxy-2-N acetylamino-D-galactose, respectively. The other compounds were sulfated derivatives of compound A. Two monosulfated compounds (B and C) had an ester sulfate on C4 or C6 of the GalNAc residue, respectively and the disulfated compound (D) had two ester sulfate groups, namely, one on C4 of the GalNAc and the other on C4 of the Gal residue substituted by GlcA. The molar ratio of A/B/C/D was 0.21:0.16:0.36:0.27. The compound containing Gal-4-O-sulfate was previously isolated by us in the form of a sulfated glycoserine [delta GlcA(beta 1-3)GalNAc(4-O- sulfate)(beta 1-4)GlcA(beta 1-3)Gal(4-O-sulfate)(beta 1-3) Gal(beta 1- 4)Xyl beta 1-O-Ser] from the carbohydrate-protein linkage region of rat chondrosarcoma chondroitin-4-sulfate proteoglycans [Sugahara K., Yamashina, I., DeWaard, P., Van Halbeek, H. & Vliegenthart, J.F.G. (1988) J. Biol. Chem. 263, 10,168-10,174]. The discovery of this structure in the carbohydrate-protein linkage region of chondroitin 4-sulfate proteoglycans from nontumorous cartilage indicates that it is not a tumor-associated product but rather a physiological biosynthetic product since it represents a significant proportion. The biological significance of this structure is discussed in relation to glycosaminoglycan biosynthesis. PMID- 1765095 TI - Phorbol esters inhibit the activity of the chicken acetylcholine receptor alpha subunit gene promoter. Role of myogenic regulators. AB - Protein kinase C has previously been implicated in the regulation of chicken acetylcholine receptor (AChR) gene expression. To investigate the molecular basis of this regulation, the promoter of the AChR alpha-subunit (alpha AChR) gene was linked to a reporter gene and introduced into cultured chick myotubes by transient transfection. Treatment of myotubes with protein-kinase-C-activating phorbol esters was found to inhibit promoter activity. These inhibitory actions were mediated by promoter sequences between nucleotides -110 and -45, relative to the start point of transcription of the alpha AChR gene. In particular, phorbol ester responsiveness could be conferred by a short DNA sequence that contains one of the two MyoD binding sites of the alpha AChR gene muscle-specific enhancer. 12 O-Tetradecanoylphorbol 13-acetate was found to inhibit rapidly and potently the expression of mRNAs coding for the myogenic regulators CMD1 and myogenin. Moreover, its inhibitory effect on the alpha AChR gene promoter could be attenuated by cotransfection of a MyoD1 expression vector. These results provide a molecular basis for the previously demonstrated involvement of protein kinase C in the regulation of alpha AChR biosynthesis. In addition, they lend further support to the notion that myogenic proteins play an important role in the control of alpha AChR gene expression. PMID- 1765096 TI - The longest 18S ribosomal RNA ever known. Nucleotide sequence and presumed secondary structure of the 18S rRNA of the pea aphid, Acyrthosiphon pisum. AB - An EMBL4 recombinant phage which encodes one of the full length of the aphid ribosomal DNA has been isolated from the aphid genomic library. Determination of the complete nucleotide sequence of the aphid 18S rRNA gene revealed that it is 2469 bp with a G + C content of 59%. The aphid 18S rRNA gene studied here is the longest and has the highest G + C content among the 18S rRNA genes examined so far. Evidence provided by the S1 nuclease assay suggests that the aphid 18S rRNA gene examined in this study is not a pseudogene containing an insertion sequence. Based on the nucleotide sequence of the 18S rRNA gene, we constructed a presumed secondary-structure model of the aphid 18S rRNA. In the aphid 18S rRNA, the eucaryote-specific E21 and 41 region are supposed to be longer and more complex than the counterparts of other 18S rRNA. PMID- 1765097 TI - Site-directed mutagenesis of the dihydrolipoyl transacetylase component (E2p) of the pyruvate dehydrogenase complex from Azotobacter vinelandii. Binding of the peripheral components E1p and E3. AB - Site-directed mutagenesis was performed in the protease-sensitive region, between the lipoyl and catalytic domains and in the catalytic domain, of the dihydrolipoyl transacetylase component (E2p) of the pyruvate dehydrogenase complex from Azotobacter vinelandii. The interaction of the mutated enzymes with the peripheral components pyruvate dehydrogenase (E1p) and lipoamide dehydrogenase (E3) was studied by gel filtration experiments, analytical ultracentrifugation and reconstitution of the pyruvate dehydrogenase complex. Upon binding of peripheral components, the 24-subunit core of A. vinelandii wild type E2p dissociates into tetramers. Four E1p or E3 dimers can bind to a tetramer. Binding is mutually exclusive, resulting in an active complex containing one E3 and three E1p dimers. Large deletions of the protease-sensitive region of E2p resulted in a total loss of the E1p and E3 binding. A small deletion (delta P361-R362) or the point mutation K367Q in the protease-sensitive region did not influence E3 binding, but affected E1p binding strongly, although with excess E1p almost complete reconstitution was reached. For E2p with the point mutation R416D in the N-terminal region of the catalytic domain only 16% overall activity could be measured in reconstituted complexes. This is due to a very weak E1p/E2p interaction, whereas the E3 binding was not affected. The point mutation R416D did not influence the catalytic activity of E2p, although a function for this residue in the formation of the active site was predicted from amino acid similarities with chloramphenicol acetyltransferase type III from Escherichia coli. Deletion of the complete Ala + Pro-rich sequence between the protease-sensitive region and the catalytic domain did not affect the enzymological properties of E2p, nor the affinity for E1p or E3. A further deletion of 20 N-terminal residues from the catalytic domain destroyed the E2p activity. From gel filtration experiments it was concluded that the quaternary structure was unaffected, as was E3 binding. E1p binding was lost and, in contrast to the wild-type enzyme, no dissociation of the core upon addition of E3 was observed. This mutant enzyme possesses, like E. coli E2p, six E3 binding sites and clearly shows that interaction of E3 or E1p with the E1p sites and dissociation are linked processes. It is concluded that the binding site for E3 is located on the N-terminal part of the protease-sensitive region. In contrast, the binding site for E1p consists of two regions, one located on the protease sensitive region and one of the catalytic domain. These regions are separated by a flexible sequence of about 20 amino acids. PMID- 1765098 TI - Amino acid sequence of PR-39. Isolation from pig intestine of a new member of the family of proline-arginine-rich antibacterial peptides. AB - We recently isolated from pig intestine and characterized a 31-residue antibacterial peptide named cecropin-P1 with activity against Escherichia coli and several other Gram-negative bacteria. The isolation involved a number of batch-wise steps followed by several chromatography steps. The continued investigation of these antibacterial peptides has now yielded another antibacterial peptide with high activity against both E. coli and Bacillus megaterium. Amino acid analysis showed a very high content of proline (49 mol%) and arginine (26 mol%), an intermediate level of phenylalanine and low levels of leucine, tyrosine, isoleucine, and glycine. The primary structure was determined by a combination of Edman degradation, plasma desorption mass spectrometry and C terminal sequence analysis by carboxypeptidase Y degradation using capillary zone electrophoresis for detection of liberated residues. The calculated molecular mass was 4719.7 Da, which is in excellent agreement with 4719 Da obtained by plasma desorption mass spectrometry. The peptide was named PR-39 (proline arginine-rich with a size of 39 residues). The lethal concentration of the peptide was determined against six Gram-negative and four Gram-positive strains of bacteria. PMID- 1765099 TI - 5'-nucleotidase from the electric ray electric lobe. Primary structure and relation to mammalian and procaryotic enzymes. AB - A cDNA encoding a 5'-nucleotidase was identified by screening a lambda gt10 cDNA library from the electric lobe of Discopyge ommata using a cDNA probe containing the complete open reading frame coding for the rat liver enzyme. Nucleotide sequence analysis defines an open reading frame of 577 amino acids, corresponding to a calculated molecular mass of 63,833 Da. The N-terminus of the mature protein, as determined by direct protein sequencing, is preceded by 29 amino acid residues comprising a signal peptide. The C-terminus contains a stretch of hydrophobic amino acids, considered to be cleaved on post-translational modification and exchanged for glycosylphosphatidylinositol as a membrane anchor. The predicted protein contains four potential N-linked glycosylation sites. Electric ray 5'-nucleotidase shares 61% amino acid identity with the enzymes from rat liver and human placenta, and about 23% with bacterial proteins possessing 5' nucleotidase activity and also additional enzyme activities like UDP-glucose hydrolase. Polyclonal antibodies raised against 5'-nucleotidase from mammalian sources or the electric ray electric organ reveal mutual cross-reactivity. Interestingly, there are 5-7 domains highly conserved in procaryotes and vertebrates in enzymes exhibiting 5'-nucleotidase, 3'-nucleotidase or phosphodiesterase activity. 5'-nucleotidase isolated from Torpedo electric organ hydrolyzes UDP-glucose at 8% of the rate of AMP hydrolysis. The possible phylogenetic origin of vertebrate 5'-nucleotidase from multifunctional nucleotide hydrolases is discussed. PMID- 1765100 TI - Synthesis and evaluation of (+) and (-)-2,2-difluorocitrate as inhibitors of rat liver ATP-citrate lyase and porcine-heart aconitase. AB - The enantiomers (+) and (-)-2,2-difluorocitrate have been synthesized. Both are good inhibitors of ATP-citrate lyase, showing competitive inhibition against citrate, with Kis = 0.7 microM for (+)-2,2-difluorocitrate and 3.2 microM for (-) 2,2-difluorocitrate. The inhibition patterns with either ATP or CoA as the varied substrate were uncompetitive and mixed, respectively, but with much weaker inhibition constants. Neither isomer undergoes carbon-carbon bond cleavage as a substrate and there is no evidence of irreversible time-dependent inactivation. When ATP-citrate lyase is incubated with CoA and difluorocitrate, the maximal intrinsic ATPase rate is 10% of the citrate-induced rate for the (+)-enantiomer and 2% for the (-)-enantiomer. 19F-NMR studies confirm that only the (+) enantiomer is chemically processed. The effects of the difluorocitrate enantiomers on the reaction catalysed by aconitase were examined. (-)-2,2 Difluorocitrate is a competitive inhibitor against citrate (Kis = 1.5 microM), whereas the (+)-enantiomer is a relatively poor mixed inhibitor (Ki greater than 300 microM). The (-)-enantiomer irreversibly inactivates aconitase at 1.1 min 1.mM-1 at 25 degrees C and pH 7.4, whereas no irreversible inhibition is seen with the (+)-enantiomer. Therefore, it would be expected that the (+)-enantiomer would slow the rate of acetyl-CoA synthesis in vivo, without inhibiting the citric acid cycle. PMID- 1765101 TI - Functional expression of the cDNAs encoding rat 11 beta-hydroxylase [cytochrome P450(11 beta)] and aldosterone synthase [cytochrome P450(11 beta, aldo)]. AB - Expression plasmids containing two cDNAs of a rat cytochrome P450(11 beta) family, pcP450(11 beta)-62 [Nonaka, Y., Matsukawa, N., Morohashi, K., Omura, T., Ogihara, T., Teraoka, H. & Okamoto, M. (1989) FEBS Lett. 255, 21-26] and pcP450(11 beta, aldo)-46 [Matsukawa, N., Nonaka, Y., Ying, Z., Higaki, J., Ogihara, T. & Okamoto, M. (1990) Biochem. Biophys. Res. Commun. 169, 245-252], were constructed and introduced into COS-7 cells by electroporation. Enzymatic activities of the expressed cytochromes P450(11 beta) and P450(11 beta, aldo) were determined by using 11-deoxycorticosterone, corticosterone, 18-hydroxy-11 deoxycorticosterone, 18-hydroxycorticosterone, or 19-hydroxy-11 deoxycorticosterone as a substrate. Cytochrome P450(11 beta) catalyzed 11 beta-, 18- and 19-hydroxylations of 11-deoxycorticosterone and 19-oxidation or 19 hydroxy-11-deoxycorticosterone at substantial rates, 18-hydroxylation of corticosterone at a very low rate, but no aldosterone production. Cytochrome P450(11 beta, aldo) catalyzed 11 beta- and 18-hydroxylations of 11 deoxycorticosterone, 18-hydroxylation of corticosterone and aldosterone production from 11-deoxycorticosterone or corticosterone. But neither 19 hydroxylation of 11-deoxycorticosterone nor 19-oxidation of 19-hydroxy-11 deoxycorticosterone was catalyzed by cytochrome P450(11 beta, aldo). PMID- 1765102 TI - Combined glyceraldehyde-3-phosphate dehydrogenase/phosphoglycerate kinase in catecholamine-stimulated guinea-pig cardiac muscle. Comparison with mass-action ratio of creatine kinase. AB - The steady-state reactant levels of triose-phosphate isomerase and the glyceraldehyde-3-phosphate dehydrogenase/phosphoglycerate kinase system were examined in guinea-pig cardiac muscle. Key glycolytic intermediates, including glyceraldehyde 3-phosphate were directly measured and compared with those of creatine kinase. Non-working Langendorff hearts as well as isolated working hearts were perfused with 5 mM glucose (plus insulin) under normoxia conditions to maintain lactate dehydrogenase near-equilibrium. The cytosolic phosphorylation potential ([ATP]/([ADP].[Pi])) was derived from creatine kinase and the free [NAD+]/([NADH].[H+]) ratio from lactate dehydrogenase. In Langendorff hearts glycolysis was varied from near-zero flux (hyperkalemic cardiac arrest) to higher than normal flux (normal and maximum catecholamine stimulation). The triose phosphate isomerase was near-equilibrium only in control or potassium-arrested Langendorff hearts as well as in postischemic 'stunned' hearts. However, when glycolytic flux increased due to norepinephrine or due to physiological pressure volume work the enzyme was displaced from equilibrium. The alternative phosphorylation ratio [ATP]'/([ADP]).[Pi]) was derived from the magnesium dependent glyceraldehyde-3-phosphate dehydrogenase/phosphoglycerate kinase system assigning free magnesium different values in the physiological range (0.1-2.0 mM). As predicted, [ATP]/([ADP].[Pi]) and [ATP]'/([ADP]'.[Pi]') were in excellent agreement when glycolysis was virtually halted by hyperkalemic arrest (flux approximately 0.2 mumol C3.min-1.g dry mass-1). However, the equality between the two phosphorylation ratios was not abolished upon resumption of spontaneous beating and also not during adrenergic stimulation (flux approximately 5-14 mumol C3.min-1.g dry mass-1). In contrast, when flux increased due to transition from no-work to physiological pressure-volume work (rate increase from approximately 3 to 11 mumol C3.min-1.g dry mass-1), the two ratios were markedly different indicating disequilibrium of the glyceraldehyde-3-phosphate dehydrogenase/phosphoglycerate kinase. Only during adrenergic stimulation or postischemic myocardial 'stunning', not due to hydraulic work load per se, glyceraldehyde-3-phosphate levels increased from about 4 microM to greater than or equal to 16 microM. Thus the guinea-pig cardiac glyceraldehyde-3-phosphate dehydrogenase/phosphoglycerate kinase system can realize the potential for near equilibrium catalysis at significant flux provided glyceraldehyde-3-phosphate levels rise, e.g., due to 'stunning' or adrenergic hormones. PMID- 1765104 TI - Gene sequence of mouse B-type proline-rich protein MP4. Transcriptional start point and an upstream phylogenetic footprint with ets-like and rel/NFkB-like elements. AB - A mouse genomic B-type proline-rich protein (PRP) cosmid clone was isolated by cDNA hybridisation and mapped, the gene region was subcloned and 3770 bp were sequenced. This gene (MP4) contained three introns and encoded a 1020-nt (nt, nucleotide) mRNA for a PRP precursor 300 amino acids long arranged with 11 imperfect 18-residue proline-rich repeats. The transcriptional start point was determined by S1 nuclease mapping and primer extension to be 26 bp downstream of a TATAA sequence. Sequence comparisons revealed that only two regions from positions -650 bp - -30 bp were highly conserved in all other PRP genes, PRP boxes 1 and 2. Box 1 at positions -112 to -135 contained ets-like and rel/NFkB like elements and was 74% conserved over 23 bp. Box 2 at positions -33 - -51 was 53% conserved over 19 bp. A search of the EMBL and GenBank sequence libraries indicated that PRP box 1 was only present upstream of the known mammalian PRP gene sequences and was absent from other genes. These conserved sequences may thus be relevant to the tissue-specific and beta-adrenergic regulation of PRP gene transcription. PMID- 1765103 TI - Structure and properties of a ubiquitously expressed protein kinase C, nPKC delta. AB - cDNA clones coding for novel protein kinase C delta (nPKC delta) were isolated from a mouse brain cDNA library. Mouse nPKC delta consists of 674 amino acid residues and has sequence identity of 95% with rat nPKC delta. Antiserum raised against a C-terminal peptide of rat nPKC delta identified a 79-kDa protein in COS cells transfected with a mouse nPKC delta cDNA expression plasmid. nPKC delta expressed in COS1 cells had phorbol-ester-binding activity and protein kinase activity in a phorbol-ester- or diacylglycerol-dependent manner, like conventional protein kinase C (cPKC) isozymes and nPKC epsilon. However, nPKC delta, like nPKC epsilon, is not activated by Ca2+, a known activator of cPKCs, and requires lower concentrations of Mg2+ for full activation than cPKCs. Moreover, apparent kinetic constants for synthetic oligopeptides (MBP4-14, EGFR peptide and epsilon-peptide) were quite different between nPKC delta and cPKC in two different conditions. Among various phospholipids tested, phosphatidylinositol is the most potent activator of nPKC delta, in clear contrast to cPKCs and nPKC epsilon. Limited proteolysis of nPKC delta generated a C-terminal active fragment with a cofactor-independent kinase activity. Northern blot analysis indicated that nPKC delta, like cPKC alpha, is widely distributed in almost all the tissues and cells examined and, in some cases such as fibroblast cells, exists as a major PKC type. These results suggest that nPKC delta is involved in fundamental cellular functions regulated by diacylglycerols and mimicked by phorbol esters. PMID- 1765105 TI - Effect of the amine non-leaving group on the structure and stability of DNA complexes with cis-[Pt(R-NH2)2(NO3)2]. AB - The antitumor compound cis-[Pt(NH3)2Cl2] (cisplatin), conserves two ammine ligands during the reaction with its cellular target DNA. Modifications of these non-leaving groups change the antineoplastic properties of this compound and its genotoxic effects. It is therefore of interest to determine the influence of non leaving groups on the structure and stability of DNA in vitro. We have investigated platinum-DNA adducts formed by cis-[Pt(R-NH2)2(NO3)2] (where R-NH2 = NH3, methylamine, cyclobutylamine, cyclopentylamine and cyclohexylamine) as a function of DNA binding. All compounds quantitatively reacted with DNA in less than 1 h at 37 degrees C. They formed bifunctional adducts with adjacent nucleotides judging from the displacement of the intercalating molecule ethidium bromide, ultraviolet absorption spectroscopy and circular dichroism. Substitution of a H on the NH3 ligand by alkyl groups dramatically destabilized the platinum DNA complex. Thermal stability decreased progressively with an increasing number of carbon atoms, delta tm = -4.4 degrees C for 3 cyclohexylamine-platinum-DNA adducts/1000 nucleotides, conditions where cisplatin had no effect. DNA adducts with cyclobutylamine and cyclohexylamine ligands inhibited the hydrolysis of platinum-DNA complexes by S1 nuclease. Km for the digestion of DNA containing these lesions was 2.3 times greater than for cisplatin, indicating steric inhibition of enzyme-substrate complex formation. These results show that the non leaving groups of substituted cis-Pt(II) compounds may destabilize DNA and interfere with protein-DNA interactions. These perturbations may have consequences for the genotoxic and antitumor activities of platinum compounds. PMID- 1765106 TI - Base 2661 in Escherichia coli 23S rRNA influences the binding of elongation factor Tu during protein synthesis in vivo. AB - The binding of the EF-Tu.GTP.aminoacyl-tRNA ternary complex (EF, elongation factor) to the ribosome is known to be strengthened by a 2661G-to-C mutation in 23S ribosomal RNA, whereas the binding to normal ribosomes is weakened if the factor is in an appropriate mutant form (Aa). In this report we describe the mutual effects by the 2661C alteration in 23S rRNA and EF-Tu(Aa) on bacterial viability and translation efficiency in strains with normal or mutationally altered ribosomes. The rrnB(2661C) allele on a multicopy plasmid was introduced by transformation into Escherichia coli K-12 strains, harbouring either the wild type or the mutant gene (tufA) for EF-Tu as well as normal or mutant ribosomal protein S12 (rpsL). Together with wild-type EF-Tu, the 2661C mutant ribosomes decreased the translation elongation rate in a rpsL+ strain or a non-restrictive rpsL224 strain. This reduction was not seen in strains which harbored EF-Tu(Aa) instead of EF-Tu(As) (As, wild-type form). Nonsense codon suppression by tyrT(Su3) suppressor tRNA was reduced by 2661C in a rpsL224 strain in the presence of EF-Tu(As) but not in the presence of EF-Tu(Aa). The lethal effect obtained by the combination of 2661C and a restrictive ribosomal protein S12 mutation (rpsL282) disappeared if EF-Tu(As) was replaced by EF-Tu(Aa) in the strain. In such a viable strain, 2661C had no effect on either the translation elongation rate or nonsense codon suppression. Our data suggest that the G base at position 2661 in 23S rRNA is important for binding of EF-Tu during protein synthesis in vivo. The interaction between this base and EF-Tu is strongly influenced by the structure of ribosomal protein S12. PMID- 1765107 TI - Molecular cloning of soluble aminopeptidases from Saccharomyces cerevisiae. Sequence analysis of aminopeptidase yscII, a putative zinc-metallopeptidase. AB - Plasmids capable of complementing lap1, lap2 and lap3 mutations [R.J. Trumbly and G. Bradley (1983) J. Bacteriol. 156, 36-48] were isolated from a yeast YEp13 library by screening for activity against the chromogenic aminopeptidase substrate L-leucine beta-naphthylamide in intact yeast colonies. The genomic inserts were shown to contain the structural genes for aminopeptidases yscII, yscIII and yscIV. Plasmids containing the gene encoding aminopeptidase yscII of Saccharomyces cerevisiae, APE2 (LAP1) were analyzed in detail. APE2 was determined by DNA blot analysis to be a single-copy gene located on chromosome XI. The cloned fragment was used to identify a 2.7-kb mRNA. The cloned APE2 gene was sequenced and found to consist of an open reading frame of 2583 bp encoding a protein of 861 amino acids. The protein sequence contains two putative N glycosylation sites. A significant amino acid similarity was detected between the APE2 gene product and members of the zinc-dependent metallopeptidase gene family. Chromosomal disruption of the APE2 gene completely abolishes the distinct activity band previously identified as aminopeptidase yscII [H.H. Hirsch, P. Suarez-Rendueles, T. Achstetter and D.H. Wolf (1988) Eur. J. Biochem. 173, 589 598] in crude extracts subjected to non-denaturing polyacrylamide gel electrophoresis and subsequent aminopeptidase activity staining. No vital consequence of aminopeptidase yscII absence on cell growth could be detected. PMID- 1765108 TI - Epidemiologic considerations in studies of cognitive function in the elderly: methodology and nondementing acquired dysfunction. PMID- 1765109 TI - The epidemiology and prevention of disease caused by Haemophilus influenzae type b. AB - Disease caused by H. influenzae type b is a world-wide problem of major proportions that affects both developed and developing countries. Young children are at particularly high risk of developing serious invasive infections. There has been tremendous recent progress in the development of vaccines that are immunogenic even in young infants. Clinical trials have demonstrated the efficacy of these polysaccharide-protein conjugate vaccines in infants. Two of these vaccines have been licensed in the United States for use in infants, and licensure of a third conjugate vaccine is expected soon. Many questions still remain to be answered. Are there significant differences in the efficacy for infants of the different licensed conjugate vaccines? Are the differences in the recommended schedules of immunization for the different vaccines justified? Would a combination of an initial dose of PRP-OMP (which is the most immunogenic vaccine in 2-month-old children) followed by subsequent doses of HbOC or PRP-T provide better overall protection than a schedule that uses only a single vaccine? Although much more research remains to be done, these vaccines, which have been recommended for routine universal immunization of infants in the United States, give us the capability of effectively preventing this potentially devastating infection of children. PMID- 1765110 TI - The epidemiology of HIV infection in children and their mothers--vertical transmission. PMID- 1765111 TI - The epidemiology of classic, African, and immunosuppressed Kaposi's sarcoma. AB - The etiology of Kaposi's sarcoma remains somewhat obscure. While lesions of classic Kaposi's sarcoma, African Kaposi's sarcoma, and immunosuppressed Kaposi's sarcoma have been found to be indistinguishable from one another, the reasons for the variations in type and severity have not been established. The origin of the spindle cell is yet to be agreed on. Geographic variation does not seem as important as ethnic variation. The very young and the very old, perhaps two ages of weakened immunity, tend to have a higher incidence of Kaposi's sarcoma. Children and AIDS patients tend to develop more virulent disease. Males tend to get Kaposi's sarcoma at higher rates than do females. Jewish and Mediterranean males have the highest incidence of classic Kaposi's sarcoma, and African Bantu have the highest incidence of African Kaposi's sarcoma, classifications which do not apply to the Kaposi's sarcoma population in the United States. Male homosexuals have much higher incidence of Kaposi's sarcoma than do male heterosexuals, but since the early 1980s, its incidence as the presenting manifestation of AIDS has decreased dramatically. There is no unequivocal association with HLA haplotype (though DR5 carriers may be at especially high risk) or evidence of family clustering. There is an impressive but not always consistent association between Kaposi's sarcoma development and immunodeficiency. Environmental factors, such as nitrite use, immunosuppression, and repeated cytomegalovirus infection, are associated with Kaposi's sarcoma, but the exact mechanism is unclear and the associations remain inconsistent. Finally, it is still unclear if there is a causative infectious agent for Kaposi's sarcoma. While cytomegalovirus has been linked to Kaposi's sarcoma, there are weaknesses in its hypothetical role as an etiologic agent as is the case for HIV itself.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1765112 TI - Prostate cancer: a current perspective. PMID- 1765114 TI - Inbreeding and diseases: demographic, genetic, and epidemiologic perspectives. PMID- 1765113 TI - Unintentional injuries in developing countries: the epidemiology of a neglected problem. PMID- 1765115 TI - High blood pressure in the elderly. PMID- 1765116 TI - Update on the epidemiology of schizophrenia. PMID- 1765117 TI - Advances in the epidemiology and control of Legionella infections. PMID- 1765118 TI - Update: rubella and congenital rubella syndrome, 1980-1990. PMID- 1765119 TI - The epidemiology of Helicobacter pylori infection. AB - The evidence that H. pylori causes gastritis in humans comes from both primary and secondary observations. The most important primary observations are the human volunteer studies, the animal models, and the treatment studies with antimicrobial agents. Supporting information comes from studies showing the specific association of H. pylori infection with type B gastritis and with gastric (but not intestinal) epithelial cells; the specific ultrastructural lesions, including adherence pedestals; the ubiquity and stability of the immune response; the response to bismuth treatment; and the association with epidemic gastritis and hypochlorhydria. It is important to note that all of Koch's postulates have been fulfilled, and despite nearly universal initial skepticism, no evidence exists against the hypothesis that H. pylori plays an etiologic role in type B gastritis. Therefore, it is reasonable to conclude that H. pylori is a pathogen in humans. The known features of H. pylori infection are listed in. Infection is chronic and common throughout the world, with a higher prevalence in developing countries than in developed countries. The prevalence of H. pylori infection increases with age in parallel with that of gastritis. Acquisition of H. pylori infection does not appear to have any seasonality, and infection is equally common among men and women. Without a significant animal or environmental reservoir for human strains of H. pylori, person-to-person contact appears to be the most likely mode of transmission. Exactly how the organism is transmitted from the stomach of one person to that of another remains unclear. Also unknown are the factors which determine who becomes ill after infection; why one person has gastritis alone while another person develops a duodenal ulcer; and how the traditional risk factors for ulcer disease, such as smoking, aspirin, and alcohol, interact with H. pylori infection. Finally, the long term neoplastic consequences of infection must be understood. Further elucidation of the natural history of H. pylori and the consequences of H. pylori infection is the most important goal for future study. PMID- 1765120 TI - The epidemiology of infections caused by Escherichia coli O157:H7, other enterohemorrhagic E. coli, and the associated hemolytic uremic syndrome. PMID- 1765121 TI - Molecular recognition and the development of self-replicating systems. AB - Weak intermolecular forces lie at the heart of biochemical recognition phenomenon and the last decade has seen much activity in the evaluation of these forces. A number of model systems have been developed including macrocyclic structures and molecular clefts. With these structures it has been possible to measure forces at the sub-kilocalorie level involving hydrogen bonding, aromatic stacking and van der Waals interactions. This manuscript deals with molecular clefts as synthetic receptors for nucleic acid components and their ultimate use in developing chemical reactions between components within a complex. This has led to an entirely synthetic, self-replicating system that shows the features of self complementarity and autocatalysis. A general discussion of self-replicating systems and their implications for prebiotic chemistry is developed. PMID- 1765123 TI - Stereochemistry of enzymic processes in the biosynthesis of pyrrolizidine alkaloids. AB - The harmonization of biosynthetic pathways with organic reaction mechanisms has relied heavily on stereochemical studies. The field of biosynthesis of pyrrolizidine alkaloids exemplifies these connections through a wide range of common organic reactions including oxidation condensation, and decarboxylation. Further, the applications of biogenetic concepts and enzyme-catalysed reactions to synthesis are illustrated. The results are exciting, not only for their intrinsic scientific interest, but because they point the way to using plant enzymes to recognise structurally modified biosynthetic intermediates and hence open routes to the synthesis of new compounds that would otherwise be difficult to obtain. PMID- 1765122 TI - A comparison of pyridoxal 5'-phosphate dependent decarboxylase and transaminase enzymes at a molecular level. AB - Pyridoxal 5'-phosphate is a coenzyme for a number of enzymes which catalyse reactions at C alpha of amino acid substrates including transaminases, decarboxylases and serine hydroxymethyltransferase. Using the X-ray coordinates for a transaminase, aspartate aminotransferase, and the results of stereochemical and mechanistic studies for decarboxylases and serine hydroxymethyltransferase, an active-site structure for the decarboxylase group is constructed. The structure of the active-site is further refined through active-site pyridoxyllysine peptide sequence comparison and a 3-D catalytic mechanism for the L-alpha-amino acid decarboxylases is proposed. The chemistry of serine hydroxymethyltransferase is re-examined in the light of the proposed decarboxylase mechanism. PMID- 1765124 TI - New developments in enzymatic peptide synthesis. AB - This review article describes new enzymatic methods developed for the efficient and irreversible synthesis of peptides based on native and modified proteases, and for the synthesis of polypeptides containing D- and/or unnatural amino acids. Potential opportunities for future developments in the field based on new enzymes, tailor-made catalytic antibodies, and on the technique of in vitro mutagenesis are also described. PMID- 1765125 TI - Molecular recognition in antibodies and its application. AB - The structure and function of immunoglobulins, and the nature of the antibody antigen interaction are described. Applications of the molecular recognition properties of antibodies are discussed in the areas of immunotherapy, immunoassay, immunotargeting and catalytic antibodies. PMID- 1765126 TI - Molecular recognition in applied enzyme chemistry. AB - Molecular recognition impinges upon many fields of biological chemistry, especially those involving catalytic processes. This review gives examples from studies at Strathclyde of both small and macromolecular systems. Mechanism-based enzyme inhibitors are described with reference to dihydrofolate reductase, dihydroorotate dehydrogenase, and cholesterol metabolism. Applications of molecular recognition related to synthetic transformations are discussed in terms of aromatic substitution, chemically modified papain, and catalytic antibodies for Diels-Alder reactions. PMID- 1765127 TI - Molecular recognition: models for drug design. AB - The review takes examples, mostly from the recent literature, to illustrate how an understanding of physico-chemical properties and an appreciation of the molecular shape and electronic properties can lead to a better insight into molecular recognition processes. The techniques used to generate 3-dimensional structures of molecules and the influence this information has had on the drug design cycle, are briefly discussed. PMID- 1765130 TI - Inhibitory effects of flavonoids on several venom hyaluronidases. AB - In vitro studies showed that the flavonoid aglycones apigenin, luteolin and kaempferol inhibited the hyaluronidase activity of five different venoms dose dependently. They were also able to delay the venom action when injected into mice. Naringenin, catechin and flavonoid glycosides had no effect. The flavonoids with unsubstituted hydroxyl groups at C-positions 5, 7 and 4', a double bond between carbons 2 and 3, as well as a ketone group at position 4, exhibited potent inhibitory actions on the venom hyaluronidases. PMID- 1765129 TI - Fifty years of amanitin. AB - Pharmacokinetic studies have provided new insights into human Amanita poisoning, but it appears to be impossible to treat this intoxication by immunotherapy. New synthetic analogs have revealed structure-activity relationships that were unknown so far. The main toxin, alpha-amanitin, is in constant use as a tool in molecular biology and in biological research. First experiments have been reported in which amanitin bound to polymers could be internalized into tumor cells via a receptor-mediated endocytosis. PMID- 1765131 TI - Role of protein kinase C and Ca2+ in glucose-induced sensitization/desensitization of insulin secretion. AB - The role of protein kinase C and Ca2+ in glucose-induced sensitization/desensitization of insulin secretion was studied. A 22-24 h exposure of mouse pancreatic islets to glucose (16.7 mmol/l) in TCM 199 culture medium, with 0.26 mmol/l or 1.26 mmol/l Ca2+, reduced total islet protein kinase C activity to approx. 85% and 60% of control values, respectively. At 0.26 mmol/l Ca2+ in TCM 199 medium, exposure to glucose (16.7 mmol/l) led to a potentiation of both phase 1 and phase 2 of glucose-induced insulin secretion, and caused a shift in the dose-response curve with 10 mmol/l and 16.7 mmol/l glucose exhibiting equipotent effects in stimulation of insulin secretion. In glucose sensitized islets, the phorbol ester 12-O-tetradecanoylphorbol 13-acetate (0.16 mumol/l) did not further potentiate induction of secretion by 10 mmol/l or 16.7 mmol/l glucose. At 3.3 mmol/l glucose, however, phorbol ester-induced secretion was augmented, and was characterized by a faster onset of secretion in glucose sensitized islets relative to control islets. In contrast, a partial reduction in arachidonic acid (100 mumol/l)-induced insulin release was observed in glucose sensitized islets in the absence of extracellular Ca2+. Increasing the Ca2+ concentration to 1.26 mmol/l in TCM 199 during the 22-24 h exposure to glucose (16.7 mmol/l) led to inhibition of phase 1 and abolition of phase 2 of glucose (10 mmol/l, 16.7 mmol/l)-induced insulin secretion. In addition, this treatment abolished phorbol ester-induced and arachidonic acid-induced insulin secretion at 3.3 mmol/l glucose. Altogether, these data suggest that sensitization of insulin secretion is caused by a preferential down-regulation of the inhibitory effects of protein kinase C, leading to an increased first phase, and an increased coupling of glucose to the stimulatory effects of protein kinase C during the second phase of glucose-induced insulin secretion. Desensitization of insulin secretion appears to be a consequence of sustained Ca2+ influx, inducing extensive down-regulation of protein kinase C and also causing deleterious effects on islet cell function in protein kinase C-deprived islets. PMID- 1765128 TI - Biological aspects of cytosine methylation in eukaryotic cells. AB - The existence in eukaryotes of a fifth base, 5-methylcytosine, and of tissue specific methylation patterns have been known for many years, but except for a general association with inactive genes and chromatin the exact function of this DNA modification has remained elusive. The different hypotheses regarding the role of DNA methylation in regulation of gene expression, chromatin structure, development, and diseases, including cancer are summarized, and the experimental evidence for them is discussed. Structural and functional properties of the eukaryotic DNA cytosine methyltransferase are also reviewed. PMID- 1765132 TI - Distribution of polyamine oxidase activity in rat tissues and subcellular fractions. AB - The activity of polyamine oxidase (PAO) in rat tissues, and its subcellular distribution, were assayed using a simple polarographic method. The highest PAO activity was measured in the liver and the lowest in the skeletal muscle. In liver, kidney and uterus the highest specific PAO activity was found in the light mitochondrial fraction. PAO was not found in the microsomal fraction except in the kidney. PMID- 1765133 TI - Neuronal degeneration in the striatum of the groggy rat: a new mutant with a movement disorder. AB - A new mutation displaying abnormal movement was obtained in the progeny of a female Wistar rat which had been given 10 mg/kg methylnitrosourea at an early stage of the gestational period. Genetic studies revealed that the character is inherited by an autosomal single recessive gene, and we designated this mutation groggy (gene symbol gr). The abnormal movement of the groggy rat was first apparent around postnatal day 15, while the histological studies revealed the appearance of numerous necrotic neurons in the striatum of the groggy rat on postnatal days 60 and 120. PMID- 1765134 TI - Role of genetic variability in neonatal jaundice. A prospective study on full term, blood group-compatible infants. AB - A series of genetic, developmental and environmental variables have been analyzed in a prospective sample of full-term newborn babies, compatible with their mothers in the major blood group systems, in order to attempt an evaluation of the effect of these variables on serum bilirubin level during the first few days of life. Three genetic factors (PGM1, ACP1 and ADA) and three non-genetic variables (rise of bilirubin level during the first day of life, a mother with a history of previous abortion, and use of alcoholic beverages by the mother) have a significant predictive value for the separation of newborns with clinically relevant jaundice from other infants. PMID- 1765135 TI - Antimicrobial and antiviral activity of xylosyl-methylthio-adenosine, a naturally occurring analogue of methylthio-adenosine from Doris verrucosa. AB - Xylosyl-methylthio-adenosine, a naturally occurring analogue of 5'-deoxy-5' methylthio-adenosine, has been postulated to play a protective role during egg development in the mollusc Doris verrucosa. However, in vitro tests showed that this analogue is devoid of activity against fungi, bacteria and viruses. PMID- 1765136 TI - Oriental orchid (Cymbidium pumilum) attracts drones of the Japanese honeybee (Apis cerana japonica) as pollinators. AB - The discovery that drones of the Japanese honeybee (Apis cerana japonica) pollinate the oriental orchid (Cymbidium pumilum) is reported. Drones are attracted to the orchid flower aroma mainly during their mating flights in April through May. Some drones cluster on the flower racemes and others insert their heads deep into the flowers. Drones with pollinia on their scutellum visit other orchids, which facilitates pollination. Individual workers and swarming colonies are also strongly attracted by the flower aroma, but the allopatric western honeybee (Apis mellifera) is not attracted. PMID- 1765137 TI - (HX)n repeats: a pH-controlled protein-protein interaction motif of eukaryotic transcription factors? AB - A characteristic sequence repeat of type His-X, repeated several times in a row, is present in several eukaryotic transcription factors, e.g. HPHAHPHP in paired protein. Detailed molecular modelling and database searches lead to the suggestion that (HX)n repeats can mediate interaction between transcription factors in a pH-controlled fashion. PMID- 1765138 TI - A novel strategy for production of a highly expressed recombinant protein in an active form. AB - Under standard growth conditions, E. coli transformed with the high-level expression vector pMON5525 produces recombinant DMAPP/AMP transferase in inactive, insoluble complexes. We have produced large amounts of active, soluble protein by growing and inducing the cells under osmotic stress in the presence of sorbitol and glycyl betaine. This caused an increase of up to 427-fold in the active yield, and the disappearance of the protein from the pelletable fraction of cell extracts. This treatment may have wide applicability. PMID- 1765139 TI - Type-1 inhibitor of plasminogen activators. Distinction between latent, activated and reactive centre-cleaved forms with thermal stability and monoclonal antibodies. AB - Type-1 inhibitor of plasminogen activators (PAI-1) occurs in purified preparations in a latent form that can be activated with denaturants; in vivo, latency is prevented by binding to vitronectin. We have compared latent, denaturant-activated and reactive centre-cleaved human PAI-1 with respect to thermal stability and affinity to monoclonal antibodies. By both criteria, latent and cleaved PAI-1 are very similar or indistinguishable, and clearly different from active PAI-1. Our findings suggest that the conformations of latent and reactive centre-cleaved PAI-1 are similar and resemble the so-called relaxed (R) serpin conformation, while that of active PAI-1 is different and resembles the stressed (S) serpin conformation. PMID- 1765140 TI - Delayed activation of phospholipase D by gonadotropin-releasing hormone in a clonal pituitary gonadotrope cell line (alpha T3-1). AB - Stimulation of cultured pituitary cells from a gonadotrope lineage (alpha T3-1) by the gonadotropin-releasing hormone agonist analog [D-Trp6]GnRH (GnRH-A) resulted in a manifold increase in accumulation of phosphatidylethanol, a specific product of phospholipase D phosphatidyl transferase activity when ethanol is the phosphatidyl group acceptor. Levels of the natural lipid product of phospholipase D, phosphatidic acid, were increased 2-3-fold. Activation of phospholipase D by GnRH-A was dose- and time-dependent and was blocked by a GnRH receptor antagonist [D-pClPhe2,D-Trp3.6]GnRH. GnRH-A stimulated phospholipase D activity after a lag of 1-2 min. We conclude that in alpha T3-1 gonadotropes GnRH receptor occupancy results in delayed activation of phospholipase D which could participate in late phases of gonadotrope regulation by the neurohormone. PMID- 1765141 TI - Two isoforms of the muscle acetylcholine receptor alpha-subunit are translated in the human cell line TE671. AB - We have previously reported the existence of 2 forms of mRNA for the human muscle acetylcholine receptor (AChR) alpha-subunit, thought to be generated by alternate splicing of a primary transcript and to encode 2 alpha-subunit protein isoforms. The 2 predicted alpha-subunit isoforms, differing by the insertion of 25 amino acids at position 58/59, have been synthesized from cRNA transcripts using rabbit reticulocyte lysates; these protein isoforms could be differentiated by immunoprecipitation using antibodies raised against synthetic peptides. The antibodies were used to demonstrate translation of both AChR alpha-subunit isoforms in the rhabdomyosarcoma (muscle) cell line TE671, in an approximate 1:1 ratio. PMID- 1765143 TI - Evidence for two protein-lipoylation activities in Escherichia coli. AB - The lipoate acyltransferase subunits of the 2-oxo acid dehydrogenase complexes are post-translationally modified with one or more covalently-bound lipoyl cofactors. Two distinct lipoate-protein ligase activities, LPL-A and LPL-B, have been detected in E. coli by their ability to modify purified lipoyl apo-domains of the bacterial pyruvate dehydrogenase complex. Both enzymes require ATP and Mg2+, use L-lipoate, 8-methyllipoate, lipoyl adenylate and octanoyl adenylate as substrates, and both activate lipoyl-deficient pyruvate dehydrogenase complexes. In contrast, only LPL-B uses D-lipoate and octanoate and there are differences in the metal-ion and phosphate requirements. It is suggested that LPL-B may be responsible for the octanoylation of lipoyl domains observed previously under lipoate-deficient conditions. PMID- 1765142 TI - A novel alternatively spliced viral mRNA transcribed in cells infected with human T cell leukemia virus type 1 is mainly responsible for expressing p21X protein. AB - The pX sequence of human T cell leukemia virus type 1 (HTLV-1) has been thought to be expressed as a doubly spliced mRNA that codes for p40tax, p27rex and p21X. However, we identified a novel alternatively spliced mRNA in the HTLV-1 infected cells by using reverse transcription followed by the polymerase chain reaction. This mRNA contains only the first and third exons of the doubly spliced mRNA and encodes only p21X. Our data that this mRNA is responsible for expressing p21X exists in most of HTLV-1 infected cells strongly suggests that p21X may play a crucial role for HTLV-1 replication. PMID- 1765144 TI - Augmentation of macrophage recognition of oxidatively damaged erythrocytes by substratum-bound fibronectin and macrophage surface fibronectin. AB - Thioglycollate-induced mouse peritoneal macrophages plated on a coverglass bind oxidized mouse erythrocytes in the absence of serum. Macrophages plated on a coverglass pre-coated with fibronectin (FN) were more active in binding of the oxidized erythrocytes. This effect of FN-coated coverglass was due to specific binding of an RGD-containing sequence of FN to FN-receptors on the macrophage, since GRGDSP hexapeptide in solution inhibited this effect, and GRGDSP-coated coverglass exhibited the same effect as FN-coated coverglass. Removal of FN originally present on the macrophage surface by trypsinization, prior to attachment to the coverglass, resulted in diminution of their ability of recognition of the oxidized erythrocytes, but the diminished ability was restored when the trypsinized macrophages were plated on a FN-coated coverglass, indicating that the cell surface FN is required for the macrophage recognition. Attachment to the coverglass was necessary for the cell surface FN to be effective. These results suggest that solid-phase FN, produced either by deposition of soluble FN to substratum or attachment of macrophage surface FN to substratum, activates the macrophages and augments their ability to recognize the oxidized erythrocytes. PMID- 1765145 TI - Alternatively spliced mRNA of the pX region of human T lymphotropic virus type I proviral genome. AB - The pX region of human T lymphotropic virus type I (HTLV-I) is believed to be expressed as a consequence of a 2 step splicing. It is conceivable, however, that a donor site of the 1st splicing and an acceptor site of the 2nd splicing results in the production of an alternatively spliced mRNA which is capable of coding p21X-III. This possibility was examined by amplifying cDNA derived from HTLV-I+ cells between the 5' LTR and pX region. Bands of 2 different sizes were consistently observed. Sequencing of the longer band corresponded to a cDNA derived from a double-spliced pX mRNA as previously reported. The shorter band was derived from a single-spliced mRNA. HTLV-I+ cell lines had both mRNAs to a varying degree. Expression of p40tax and p21X-III seem to be well correlated with a double-spliced and a single-spliced mRNA, respectively. PMID- 1765146 TI - Inhibition of protein tyrosine phosphatase activity by diamide is reversed by epidermal growth factor in fibroblasts. AB - Diamide (azodicarboxylic acid bis(dimethylamide] inhibits protein tyrosine phosphatase activity in fibroblasts without altering protein tyrosine kinase activity associated with the epidermal growth factor receptor. The loss of protein tyrosine phosphatase activity caused by diamide is reversed by 2 mercaptoethanol or epidermal growth factor. PMID- 1765147 TI - Cloning and functional characterization of a cocaine-sensitive dopamine transporter. AB - We report the cloning of a rat cDNA encoding a functional dopamine transporter. This cDNA, derived from an intron-containing gene, encodes a protein of 620 amino acids. Hydropathicity analysis of the protein sequence suggests the presence of 12 putative transmembrane domains. The protein displays considerable identity with transporters for noradrenaline and GABA (64 and 30%, respectively). Transient expression of the cDNA in COS7 cells directs the expression of dopamine uptake activity with appropriate pharmacology and in a sodium-dependent fashion. In situ hybridization reveals that the mRNA for this transporter is expressed in the substantia nigra and ventral tegmental area, regions that contain dopaminergic cell bodies. PMID- 1765148 TI - Chloramphenicol is an inhibitor of photosynthesis. AB - Chloramphenicol inhibited significantly but incompletely photosynthesis in leaf segments of rice. Fluorescence and polarographic experiments indicated that chloramphenicol competes with the CO2 reducing cycle for electrons from photosystem I because it serves as an electron acceptor of photosystem I and its reduction intermediate transfers its electron to molecular oxygen. PMID- 1765149 TI - Fluorine-19 NMR studies of the thermal unfolding of 5-fluorouracil-substituted Escherichia coli valine transfer RNA. AB - 19F NMR spectroscopy was used to monitor the thermal unfolding of E. coli tRNAVal labeled by incorporation of 5-fluorouracil (FUra). With rising temperatures, resonances in the 19F NMR spectrum of (FUra)tRNAVal gradually shift towards the central region of the spectrum and merge into a single broad peak above 85 degrees C. FU55 and FU12 are the first to shift, beginning at temperatures below 40 degrees C, which suggests that the initial steps of thermal denaturation of tRNAVal involve disruption of the tertiary interactions between the D- and T arms. The acceptor stem and the FU64-G50 wobble base pair in the T-stem are particularly stable to thermal denaturation. A temperature-dependent splitting of the 19F resonance assigned to FU64, at temperatures above 40 degrees C, suggests that the T-arm of (FUra)tRNAVal exists in two conformations in slow exchange on the NMR time scale. PMID- 1765150 TI - A plant metallothionein produced in E. coli. AB - A metallothionein cDNA was generated from pea (Pisum sativum L.) roots, amplified by PCR and inserted into a plasmid for expression in E. coli. Purification of the resultant product generated 3 pools of cadmium-containing material after DEAE cellulose chromatography. The amino acid composition of each was in excellent agreement with that predicted for pea metallothionein. A cadmium content of approximately 6 g.atoms per mole of protein was estimated. N-terminal sequence analysis revealed that the recombinant molecule had been proteolysed within the extended region linking the 2 cysteine-rich (putative) metal-binding regions. The significance of these findings in terms of the protein folding/targeting of the molecule are considered. PMID- 1765151 TI - Xylose-specific antibodies as markers of subcompartmentation of terminal glycosylation in the Golgi apparatus of sycamore cells. AB - Antibodies specific for xylose-containing plant complex N-linked glycans are used for indirect immunolocalization of xylosyltransferase in sycamore cells. The use of high pressure freezing and freeze substitution for sample preparation resulted in very good morphological preservation of the different Golgi cisternae. Xylosyltransferase shows a diffuse distribution all over the Golgi stacks and xylosylation appears to be an early processing event that is initiated in the cis Golgi compartment. PMID- 1765152 TI - A single activity carboxyl methylates both farnesyl and geranylgeranyl cysteine residues. AB - Members of the Ras superfamily of small GTP-binding proteins, gamma-subunits of heterotrimeric G proteins and nuclear lamin B are subject to a series of post translational modifications that produce prenylcysteine methylester groups at their carboxyl termini. The thioether-linked polyisoprenoid substituent can be either farnesyl (C15) or geranylgeranyl (C20). Small molecule prenylcysteine derivatives with either the C15 or C20 modification, such as N-acetyl-S trans,trans-farnesyl-L-cysteine (AFC), S-trans,trans-farnesylthiopropionate (FTP), as well as the corresponding geranylgeranyl derivatives (AGGC and GGTP) are substrates for the carboxyl methyltransferase. Saccharomyces cerevisiae ste14 mutants that lack RAS and a-factor carboxyl methyltransferase activity are also unable to methylate farnesyl and geranylgeranylcysteine derivatives. Moreover, C20-substituted cysteine analogs directly compete for carboxyl methylation with the C15-substituted cysteine analogs and vice versa. Finally, AGGC is even more effective than AFC as an inhibitor of Ras carboxyl methylation, despite the fact that Ras is methylated at a farnesylcysteine rather than a geranylgeranylcysteine residue. PMID- 1765153 TI - Binding of inositol phosphates to arrestin. AB - Arrestin binds to phosphorylated rhodopsin in its light-activated form (metarhodopsin II), blocking thereby its interaction with the G-protein, transducin. In this study, we show that highly phosphorylated forms of inositol compete against the arrestin-rhodopsin interaction. Competition curves and direct binding assays with free arrestin consistently yield affinities in the micromolar range; for example, inositol 1,3,4,5-tetrakisphosphate (InP4) and inositol hexakisphosphate (InP6 bind to arrestin with dissociation constants of 12 microM and 5 microM, respectively. Only a small control amount of inositol phosphates is bound, when arrestin interacts with phosphorylated rhodopsin. This argues for a release of bound inositol phosphates by interaction with rhodopsin. Transducin, rhodopsin kinase, or cyclic GMP phosphodiesterase are not affected by inositol phosphates. These observations open a new way to purify arrestin and to inhibit its interaction with rhodopsin. Their physiological significance deserves further investigation. PMID- 1765154 TI - Conformational changes in melittin upon complexation with an anionic melittin analog. AB - Melittin and its Glu-(7,21,22,23,24) analog upon mixing in equimolar concentrations form a hybrid oligomer with significant helical structure, in conditions in which each peptide separately adopts a largely disordered structure. The hybrid exhibits both cold- and heat-induced denaturations similar to the phenomena exhibited by proteins. The hybrid also retains significant residual structure at higher temperature, similar to the 'molten globular state' that has been suggested for protein. Melittin, at concentrations in which it forms helical tetramers, also exhibits these phenomena and may be used as a model for protein-denaturation studies. PMID- 1765155 TI - Isolation of cDNAs encoding a novel member of the neurotransmitter transporter gene family. AB - Degenerate oligonucleotides deduced from two regions of the rat gamma aminobutyric acid (GABA) transporter were used to amplify related sequences from rat spinal cord by polymerase chain reaction (PCR). The resulting product then allowed isolation of two overlapping cDNA clones with an open reading frame encoding a hydrophobic polypeptide of 630 amino acids. This protein, termed NTT, exhibits 38% sequence homology to the GABA and 48% to the noradrenaline transporters and contains 12 putative transmembrane regions. PCR amplification revealed low-level expression of NTT transcripts in spinal cord, but not in brain and cerebellum. PMID- 1765156 TI - A new distinct group of 2 S albumins from rapeseed. Amino acid sequence of two low molecular weight napins. AB - Two napins (nIa and nIb), isolated from Brassica napus (rapeseed) seeds, have been sequenced. The two proteins show the common structural pattern of the 2 S albumins, since they are composed of two disulfide-linked chains of different size, yet they exhibit an atypical low molecular weight (12.5 kDa vs. 14.5 kDa of the major napins). High sequence similarity has been found between these 2 proteins, but only 54% similarity can be estimated from their comparison with the 14.5 kDa major napins. Thus, nIa and nIb are considered representatives of a new distinct group of rapeseed napins since all the previously known napins exhibit 95% sequence similarity. Unexpectedly, the similarity increases when compared with the 2 S proteins from other species. PMID- 1765157 TI - Compositional properties of telomeric regions from human chromosomes. AB - We have investigated the GC levels of third codon position of genes localized in G- (Giemsa), R-(reverse) and T-(telomeric) bands of human metaphase chromosomes, as well as the hybridization of telomeric probes on fractionated human DNA. The first set of results shows much higher GC levels for genes localized in T-bands than in G- or R-bands (the latter being higher than the former). The second set of data shows that telomeric probes corresponding to T-bands hybridize on the GC richest family (H3) of isochores, whereas telomeric probes corresponding to R bands hybridize on GC-rich families H1 and H2; in agreement with these findings, the telomeric repeat common to all chromosomes hybridized on isochore families H1, H2 and H3. PMID- 1765158 TI - The proton pump bacteriorhodopsin is a photoreceptor for signal transduction in Halobacterium halobium. AB - Halobacterium halobium swims by rotating its polarly inserted flagellar bundle. The cells are attracted by green-to-orange light which they can use for photophosphorylation but flee damaging blue or ultraviolet light. It is generally believed that this kind of 'colour vision' is achieved by the combined action of two photoreceptor proteins, sensory rhodopsins-I and -II, that switch in the light the rotational sense of the bundle and in consequence the swimming direction of a cell. By expressing the bacteriorhodopsin gene in a photoreceptor negative background we have now demonstrated the existence of a proton-motive force sensor (protometer) and the function of bacteriorhodopsin as an additional photoreceptor covering the high intensity range. When the bacteriorhodopsin generated proton-motive force drops caused by a sudden decrease in light intensity, the cells respond by reversing their swimming direction. This response does not occur when the proton-motive force is saturated by respiration or fermentation. PMID- 1765159 TI - A bovine brain cDNA purported to encode calmodulin-insensitive adenylyl cyclase has extensive identity with neural cell adhesion molecules (N-CAMs) PMID- 1765160 TI - Molecular mechanisms for mammalian melanogenesis. Comparison with insect cuticular sclerotization. AB - Melanogenesis is an important biochemical process for the production of skin pigments which protect many animals from the damage of solar radiation. The abnormalities in melanogenesis are associated with albinism, vitiligo, as well as malignant melanoma in humans. In the lower forms of animals viz., insects, the exoskeleton is hardened to protect their soft bodies by a process called sclerotization, which is often accompanied by melanization. Recent advances in the biochemistry of sclerotization and melanization reveal remarkable similarity between these two processes. The seven stages of sclerotization are: (a) enzymatic oxidation of N-acyldopamine, (b) Michael-1,4-addition reactions of N acyldopamine quinone, (c) tautomerization of quinone to quinone methide, (d) Michael-1,6-addition of quinone methides, (e) tautomerization of N-acyldopamine quinone methide to 1,2-dehydro-N-acyldopamine, (f) enzymatic oxidation of 1,2 dehydro-N-acyldopamine, and (g) the reactions of resultant quinonoid compounds. Amazingly, striking similarities in the reaction sequences are found in the melanization process starting from dopa. These comparisons predict a central role for quinone methides as reactive intermediates during melanization. Accordingly, recent studies provide increasing evidence in favor of this proposition. PMID- 1765161 TI - Nature of papain products resulting from inactivation by a peptidyl O-acyl hydroxamate. AB - Mass spectrometry has been used to provide insights into the mechanism of inhibition of cysteine proteases by a hydroxylamine derivative, CBZ-Phe-Gly-NH-O CO-(2,4,6-Me3)Ph. An oxidized form of papain resulting from the incubation of the enzyme with the peptidyl hydroxamate in the absence of a reducing agent has been identified as a sulfinic acid. The presence of a covalent enzyme-inhibitor complex of molecular mass consistent with a sulfenamide adduct of papain could also be detected by this method. Implications on the mechanism of inactivation of cysteine proteases by peptidyl hydroxamates are discussed. PMID- 1765162 TI - The evolution of placental mammals. AB - Based on morphological, virological, biochemical and molecular biological data, it is proposed that the presence of endogenous retrovirus particles in the placental cytotrophoblasts of many mammals is indicative of some beneficial action provided by the virus in relation to cell fusion, syncytiotrophoblast formation and the creation of the placenta. Further, it is hypothesised that the germ line retroviral infection of some primitive mammal-like species resulted in the evolution of the placental mammals. PMID- 1765163 TI - Structural properties of connectin studied by ultraviolet resonance Raman spectroscopy and infrared dichroism. AB - Ultraviolet resonance Raman spectra of solubilized connectin indicated the presence of beta-sheets and hydrogen-bonded irregular structures. Some Trp and Tyr sidechains are located in hydrophobic environments and some NHs of mainchain amides and Trp indoles are not easily reached by solvent water, suggesting the presence of folded structures constructed of the beta- and irregular parts. Infrared spectra showed an abundance of beta-sheets in a connectin fiber, some of which were aligned with their mainchain axes parallel to the fiber axis. Thus, the beta-spiral structure proposed for elastin is improbable in connectin. This conclusion is also supported by their different amide III frequencies in the visible Raman spectra. A possible filamentous structure of repeated domains, consisting of beta-sheets and irregular parts, is discussed. PMID- 1765164 TI - Tomato alcohol dehydrogenase. Expression during fruit ripening and under hypoxic conditions. AB - We have isolated and sequenced a partial tomato alcohol dehydrogenase (Adh) cDNA clone. Expression of tomato Adh was studied at the messenger RNA level in seedlings, roots, and fruit. High induction was observed under hypoxic conditions, both in tomato seedlings and in roots. In addition, the Adh mRNA was present at the mature green and pink stage of the tomato fruit, and was highly induced in late ripening. Moreover, an artificial ripening treatment resulted in at least 50-fold induction compared to the mature green mRNA level. Genomic DNA gel blotting suggested the presence of a multigene family for Adh in tomato. PMID- 1765165 TI - Muramyl peptide-binding sites are located inside target cells. AB - Using flow cytometry and fluorescence polarization analysis, specific muramyl peptide-binding sites were shown to be located inside T-lymphocytes, macrophages and neuroblastoma cells, but not inside B-cells. No binding sites were found on the cell surface. The number of binding sites for each cell type was determined. Two types of binding sites were observed for myelomonocytic WEHI-3 cells with Kd values of 21 and 540 nM. Inhibition analysis demonstrated that for effective binding, an intact glycopeptide molecule and D-configuration of isoglutamine residue are important. PMID- 1765166 TI - MAP2: a sensitive cross-linker and adjustable spacer in dendritic architecture. AB - Microtubule-associated protein 2 (MAP2), a long, filamentous molecule thought to cross-link dendritic cytoskeleton, is rich in PEST sequences, putative signals for rapid proteolytic degradation. It is suggested that MAP2 is indeed highly susceptible to protease, e.g. calpain, attack, which is needed for a plastic change, but actual breakdown depends on the regulation of protease(s). Phosphorylation is expected to make the molecule longer and rigid, similarly to what was observed with the related tau protein. Such a structural transition may provide a mechanism for the putative role of MAP2 in dendritic branching. PMID- 1765168 TI - Regulatory light chain influences alterations of myosin head induced by actin. AB - The effect of magnesium-for-calcium exchange and phosphorylation of regulatory light chain (LC2) on structural organization of rabbit skeletal myosin head was studied by limited tryptic digestion. In the presence of actin, exchange of magnesium bound to LC2 by calcium in dephosphorylated myosin accelerates the digestion of myosin and heavy meromyosin heavy chain and increases the accumulation of a 50 kDa fragment. This effect is significantly diminished in the case of phosphorylated myosin. Thus, both phosphorylation and cation exchange influences the effect of actin binding on the structural organization of myosin head. PMID- 1765167 TI - Uncoupling effect of fatty acids on heart muscle mitochondria and submitochondrial particles. AB - The effect of ATP/ADP-antiporter inhibitors on palmitate-induced uncoupling was studied in heart muscle mitochondria and inside-out submitochondrial particles. In both systems palmitate is found to decrease the respiration-generated membrane potential. In mitochondria, this effect is specifically abolished by carboxyatractylate (CAtr) a non-penetrating inhibitor of antiporter. In submitochondrial particles, CAtr does not abolish the palmitate-induced potential decrease. At the same time, bongkrekic acid, a penetrating inhibitor of the antiporter, suppresses the palmitate effect on the potential both in mitochondria and particles. Palmitoyl-CoA which is known to inhibit the antiporter in mitochondria as well as in particles decreases the palmitate uncoupling efficiency in both these systems. These data are in agreement with the hypothesis that the ATP/ADP-antiporter is involved in the action of free fatty acids as natural uncouplers of oxidative phosphorylation. PMID- 1765169 TI - Possible requirement of serum progression factors for transformation of BALB/c 3T3 fibroblasts by v-ras p21. AB - To form colonies in soft agar, ras-transformed 3T3 fibroblasts require serum. We examined what growth factors in serum were essential for ras-induced transformation. Temperature-sensitive (ts) v-Ki-ras-transfected BALB/c 3T3 cells were used to strictly control both the activity of the ras protein and the cell cycle. When G0-arrested ts cells were cultured with 10% serum at a permissive temperature, greater than 50% of cells formed colonies. A similar colony-forming activity was observed in the presence of 10% platelet-poor plasma, but not in the presence of 10% plasma isolated from hypophysectomized rats. Inhibitors of IGF signals attenuated colony formation in the presence of serum. These data suggest that progression factors, probably IGFs, are essential components in serum for ras-induced transformation of 3T3 fibroblasts. PMID- 1765170 TI - A C-terminal proline is required for bioluminescence of the Ca(2+)-binding photoprotein, aequorin. AB - The requirement for a proline residue at the C-terminus of the Ca(2+)-binding photoprotein, aequorin, was investigated by measuring luminescence activities of a series of C-terminal deletion mutants, substitution mutants and an addition mutant. CD spectral measurements of apoaequorin with the C-terminal proline deleted showed a small change in secondary structure. In all cases studied, the C terminal proline was required for bioluminescence activity. PMID- 1765171 TI - Direct observation of the biphasic conformational change of DNA induced by cationic polymers. AB - The interaction between T4 DNA and basic polypeptides was observed using fluorescence microscopy. Free DNA molecules exhibited random Brownian motion accompanying the conformational change. With the addition of polycation, such as histone and polyarginine, DNA molecules tended to shrink to become spherical shapes. The persistent lengths and the distributions of long axis lengths of DNA polyarginine complexes were determined from the video images at various polyarginine concentrations. It is demonstrated that the conformation of DNA changes in a biphasic manner in the presence of polyarginine. PMID- 1765172 TI - Interaction of a synthetic peptide of the interferon alpha-2 C-terminal part with human blood leukocytes. Binding to peripheral blood mononuclear cells. AB - A biologically active synthetic peptide, 2438, representing the 124-138 amino acid sequence of the human interferon alpha-2 (IFN alpha-2) molecule, which is known to possess IFN-like antiproliferative activity, specifically binds to human blood leukocytes. Scatchard plots reveal two different Kd values, for the 'low' and 'high' affinity binding. The interaction of the 125I-labelled peptide 2438 with the cells is not impaired by human IFN alpha-2 or cholera toxin. PMID- 1765173 TI - Dynamic light scattering studies of the aggregation of lysozyme under crystallization conditions. AB - The intensity autocorrelation functions of light scattered by lysozyme solutions under pre-crystallization conditions in NaCl-containing media were recorded at scattering angles from 20 degrees to 90 degrees. The measurements, conducted on freshly prepared protein solutions supersaturated more than 3-fold, indicate the simultaneous presence of two scatterer populations which can be assigned to individual protein molecules and to large particles. When solutions are undersaturated, or slightly supersaturated, light scattering only reveals the presence of the small scatterers. In the supersaturated medium, where aggregates were detected, lysozyme crystals grew in a time-span of 1-3 days after the scattering experiments. These results are medium, where aggregates were detected, lysozyme crystals grew in a time-span of 1-3 days after the scattering experiments. These results are correlated with the nucleation step during protein crystallization. PMID- 1765174 TI - [The organization of the work of a women's consultation]. PMID- 1765175 TI - [Cholera]. PMID- 1765176 TI - [Idiopathic thrombocytopenic purpura (Werlhof's disease) in children]. PMID- 1765177 TI - [The direct study of the organs of the gastrointestinal tract and of the hematopoietic system]. PMID- 1765178 TI - [Scoliosis (1)]. PMID- 1765179 TI - [Fractures of the proximal femur in middle-aged and elderly patients]. PMID- 1765180 TI - [Anesthesia procedures and methods in acute myocardial infarct]. PMID- 1765181 TI - [Smoking as a sociomedical problem]. PMID- 1765182 TI - [Experience with the use of the vacuum aspiration method in the early periods of pregnancy]. PMID- 1765183 TI - [10th anniversary of the 1st Congress of the international movement Physicians of the World for the Prevention of Nuclear War]. PMID- 1765184 TI - [The pathological preliminary period]. PMID- 1765185 TI - [Typhus]. PMID- 1765186 TI - [Acute porphyria]. PMID- 1765187 TI - [Chronic cervicitis and pseudoerosion of the cervix uteri]. PMID- 1765188 TI - [The economic loss caused by temporary loss of work capacity related to infectious diseases]. PMID- 1765189 TI - [The organizational problems of medical care in children's institutions]. PMID- 1765190 TI - [The role of paramedical personnel in organizing the examination of children in rural districts for tuberculosis]. PMID- 1765191 TI - [The direct study of the organs of the respiratory and cardiovascular systems]. PMID- 1765192 TI - [Changes in the tongue and oral, nasal and pharyngeal mucosa in acute and chronic pathology]. PMID- 1765193 TI - [Errors and complications in the treatment of injuries to the locomotor apparatus]. PMID- 1765194 TI - [The compensation of surgical blood loss in patients with trauma to the locomotor system]. PMID- 1765195 TI - [Sergei Sergeevich Iudin (on the centenary of his birth)]. PMID- 1765196 TI - [Nephropathy in a 30-year-old primipara]. PMID- 1765197 TI - [The most important problems of preventive vaccination in the USSR]. PMID- 1765198 TI - [Epidemic cerebrospinal meningitis simulating influenza]. PMID- 1765199 TI - [Acute aplastic anemia after viral hepatitis]. PMID- 1765200 TI - [Bacterial vaginosis]. PMID- 1765201 TI - [Histological evaluation of the effect of intra-arterial cytostatic treatment]. AB - In cases of untreated mouth cavity carcinomas cisplatin, farmorubicin as well as a combination of the two have been administered intra-arterially to three groups of patients. Result of the treatment was similar tumor regression in all three groups. Thrombotic complications were more frequent in cases treated with farmorubicin. Possibilities of preventing vein damages are reported on. PMID- 1765202 TI - [Stomatologic implications of bulimia nervosa. Review of the literature]. PMID- 1765203 TI - [Significance of the CO2-laser angle, oral cavity endoscopes]. AB - The CO2-laser ray guided at 90 degrees to the surface creates a crater of typical "v" shape. If the guide angle of the ray deviates therefrom and the smaller the angle of incidence than 90 degrees, destruction becomes the more astymmetric, the crater takes an ever more flattened eliptical shape. The lack of tissue becomes even more superficial, thus removal of a circumscribed pathological area requires the sacrifice of more ambient healthy tissue. Consterning the possible angle of incidence of the laser ray instrumental measurements were carried out. It has been ascertained that in the pharinx third of the mouth cavity behind the plain corresponding to the premolars, as a rule, only guide angles below 50 degrees, in the middle third of the mouth cavity corresponding to the area between the front teeth and the molars guide angles between 50-70 degrees, and in the front third mostly a ray guiding below 90 degrees are possible. In the middle and rear third of the mouth cavity the ideal rey-guiding at 90 degrees can be obtained but with reflection, certain areas even cannot be treated directly, are visible but in mirrors. By transforming the hand piece of the laser apparatus endoscopes with fixed mirror and rotating mirror have been constructed. By means of the endoscope with fixed mirror already all parts of the mouth cavity have been rendered accessible while the rotating mirror model became suitable even to admit the laser ray to the surfaces at the ideal angle of incidence of 90(2). PMID- 1765204 TI - [Measuring the excretion of aminoglycosides into the saliva]. PMID- 1765205 TI - Induction of labor by prostaglandin E2: intracervical gel or vaginal pessaries? AB - To investigate the best route of prostaglandin medication for induction of labor, 125 pregnant women with unfavorable cervices (Bishop scores less than or equal to 6) were randomized to induction of labor with either PGE2 (0.5 mg) in a viscous intracervical gel once daily or PGE2 pessaries (2.5 mg) 1-2 a day. As estimated by life table analysis, the pessaries were significantly more effective inducing vaginal delivery compared to intracervical gel (24 h: P less than 0.025, 48 h: P less than 0.01, logrank test) and vaginal delivery was obtained within 24 h/48 h in 50%/72% of the women in the pessary group and in 29%/55% of the women in the intracervical group. Cervical ripening was found within 3 h (P less than 0.001) and in the subsequent 3 to 24 h period (P less than 0.005) after both treatments, no difference being found between the groups. The pessaries were much more effective inducing regular contractions compared to the intracervical gel (P less than 0.005, logrank test), so the latter seems preferable if cervical ripening rather than induction is intended. No difference was found analyzing the active labor period. No difference was found in methods of delivery, neonatal parameters (Apgar scores, umbilical artery blood pH and standard base excess), and the patients' attitude towards both methods of induction were equally favorable. PMID- 1765206 TI - Do biphasic uterine contractions imply poor uterine function? AB - In a retrospective study of 362 cardiotocographic recordings of primigravidae in labour we found 8% biphasic or coupled uterine contractions. In augmented labour, biphasic contractions occurred almost twice as often as in spontaneous and induced labour. The duration of labour complicated with biphasic contractions was increased significantly in all types of labour. Therefore biphasic contractions may reflect uneffective uterine function. Contrary to other studies, the appearance of biphasic contractions showed no correlation with epidural analgesia and the incidence of instrumental deliveries or caesarean sections was not increased. PMID- 1765207 TI - Fresh versus frozen thawed semen for initial and late insemination in IVF cycles. AB - Frozen thawed semen has been associated with reduced semen quality and as a result diminished pregnancy rates. In vitro fertilization (IVF) can supply the true measure of the functional fertilizing capacity of fresh versus frozen-thawed semen. One hundred and six patients in an IVF program who underwent donor insemination were divided into two groups. Group I included 51 women in whom initial insemination with donor fresh or frozen semen was performed. They were compared to 65 group II women in whom late insemination with donor fresh or frozen semen was performed after initial insemination with husband semen had failed to fertilize the eggs. There was no statistically significant difference between groups I and II on initial insemination; however, statistically significant difference in fertilization (P less than 0.006) and pregnancy rates (P less than 0.001) between the two groups were achieved when late insemination was carried out. Consequently, we prefer initial insemination with frozen-thawed donor semen in cases indicated. PMID- 1765208 TI - Structure of premenstrual endometrium in HMG + HCG induced anovulatory women. AB - In this study structural alterations were tested on anovulatory infertile women who had undergone treatment of HMG + HCG to induce ovulation and subsequently to achieve pregnancy. For this purpose, a single premenstrual endometrial fundal biopsy was performed and evaluated using light and electron microscopy. The aim of the study was to evaluate the biopsies with respect to 'in-phase' or 'out-of phase' at light microscopic level, in which a series of strict criteria were chosen, and then to detect the additional structural abnormalities at electron microscopic level, if present. Only one of the women in our study who had an in phase endometrium became pregnant after proper treatment protocol individually adjusted and consequently terminated by an early abortion. Histologic features of the biopsies revealed that about half were normal while the rest had various types of structural abnormalities in the transformation of the secretory endometrium detected by light and/or electron microscopy. At the electron microscopic level, multiple alterations were seen in cellular and intercellular components even in those diagnosed as normal by light microscopy. As a result of the above data it was concluded that the cause of inconceivability might arise from some fine structural alterations which may affect the endometrial receptivity of an implanting embryo. PMID- 1765209 TI - Outcome, complications and follow-up in surgically treated squamous cell carcinoma of the vulva 1956-1982. AB - Between 1956 and 1982, 139 patients were surgically treated in the Netherlands Cancer Institute because of a squamous cell carcinoma of the vulva. Eighty-nine of these patients underwent radical vulvectomy and inguinal lymph-node dissection. Five-year survival rates were 91% for stage I, 85% for stage II, 64% for stage III and 33% in stage IV cases. The fact that 5 year survival rates between the group of patients with a more extensive surgical treatment (i.e., inguinal lymph node dissection) and the group of patients only being treated by a vulvar operation were equal, is a remarkable result. Postoperative complication rates were, in conformity with results found elsewhere, high. Only 25% of the patients did not have any early complication at all. The most important early complication was found to be wound infection (52%). Late complications were mostly miction problems (24%) and pelvic relaxation, resulting in cystocele, rectocele and/or descensus uteri (26%). Patients who were treated only by a vulvar operation had significantly less late complications (P = 0.027). The majority of recurrences were observed in the first 2 postoperative years. Patients with a pelvic relapse or with distant metastases could in no case be treated successfully. Inguinal relapses, however, could only be treated with success when primary treatment of the groin had not been given before. Complete remissions were very often accomplished in case of vulvar relapse and second, third, or fourth relapses on the vulva. Ten percent of all the patients still alive 5 years after primary treatment had a relapse as yet, or more likely, a second vulvar carcinoma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765210 TI - Fetal heart rate variability and cerebral oxygen consumption in fetal sheep during asphyxia. AB - This study was designed to examine the relationship between fetal heart rate variability and fetal cerebral oxygen uptake. Fetal sheep were chronically prepared with catheters and electrodes to determine cerebral blood flow (microsphere method), cerebral arteriovenous oxygen difference, and the electrocardiogram. An adjustable occluder was placed on the maternal common internal iliac artery to induce fetal asphyxia by reducing uterine blood flow. Fetal heart rate variability tended to decrease in the first 11 min of asphyxia, when cerebral oxygen consumption was approximately 53% of control. Despite stable cerebral oxygen consumption and worsening metabolic acidosis, however, fetal heart rate variability progressively returned towards normal by 36 min. There was no relationship between the depression of FHR variability and the degree of reduction of cerebral oxygen consumption. Nor was there any relationship between an alteration in regional cerebral blood flow or myocardial blood flow and the return of FHR variability with increasing duration of asphyxia. We conclude that there is an association between loss of fetal heart rate variability and reduced cerebral oxygen consumption, but the reduced variability does not persist with time at this degree of reduced cerebral metabolism in fetal sheep. This appears to be at variance with human clinical experience. Among the explanations for this may be insufficiently severe asphyxia, a species difference, removal of an inhibitor to FHR variability, or progressive use of other substrates for metabolism. PMID- 1765211 TI - Congenital heart block with hydrops fetalis treated with high-dose dexamethasone; a case report. AB - A 32-year-old woman with systemic lupus erythematosus was found to have a fetus with heart block and fetal ascites at 23 weeks gestation. Treatment with high dose corticosteroids ameliorated the early signs of heart failure, although the fetal heart rate gradually fell from 48 beats/min to 42 beats/min by 34 weeks. Sudden deterioration of the fetal state occurred at 35 weeks, and this only partially responded to digitalisation. Neonatal death occurred on Day 18 from the consequences of severe birth asphyxia. The relationship and pathogenesis of anti Ro antibodies, congenital heart block and hydrops fetals are discussed, together with the in utero management of this condition. PMID- 1765212 TI - Ginger in preventing nausea and vomiting of pregnancy; a caveat due to its thromboxane synthetase activity and effect on testosterone binding. PMID- 1765213 TI - Serum concentrations of intact parathyroid hormone during late human pregnancy: a longitudinal study. AB - In the present study an assay reactive with the intact PTH molecule supposed to be the biological active has been used for measurements in 10 normal pregnant women during the late pregnancy and post-partum. Simultaneously serum concentrations of ionized calcium, phosphate, magnesium and albumin were determined. Serum concentrations of intact PTH were low compared to non-pregnant levels, while concentrations of ionized calcium, phosphate, magnesium (corrected) were unaffected. PMID- 1765214 TI - Maternal and umbilical cord concentrations of fentanyl after epidural analgesia for cesarean section. AB - The maternal and umbilical concentrations of fentanyl were measured after epidural analgesia for cesarean section, using a highly sensitive radioimmunoassay method. Sixteen parturients were anesthetized with a single epidural injection of a mixture of 85 mg bupivacaine 0.5%, 60 mg etidocaine 1%, and 100 micrograms fentanyl with epinephrine 1:200,000. Apparent maternal individual maximum peak concentration (Cmax) of fentanyl was 0.38 +/- 0.16 ng/ml (mean +/- SD) (range 0.12-0.59 ng/ml) and the time to reach Cmax (Tmax) was 24 +/ 14 min (range 5-60 min). Infants were born 19 to 42 min after epidural administration of fentanyl (mean 27 min). Fentanyl concentrations in neonates was 0.13 +/- 0.04 ng/ml for the umbilical vein and 0.06 +/- 0.03 ng/ml for the artery. The fetus extraction ratio was 53 +/- 19% (range 20-83%). The large difference between arterial and venous concentrations of fentanyl may be due to a metabolization by the fetus and/or an uptake of the drug in the fetal tissues. Thus, even if fentanyl levels reaching the fetus after cesarean section under epidural anesthesia, using local anesthetics with 100 micrograms of fentanyl, are within safe range values, the likelihood of fentanyl uptake by fetal tissues calls for a cautious use of repeated fentanyl administration. PMID- 1765215 TI - Lipid peroxidation products, selenium-dependent glutathione peroxidase and vitamin E in normal pregnancy. AB - Twenty healthy women with normal pregnancy were simultaneously analysed with regard to lipid peroxidation products, selenium-dependent glutathione peroxidase and vitamin E. Conjugated diene double bonds, fluorescent chromolipids and thiobarbituric acid-reactive material were analysed as breakdown products of lipid peroxidation. The level of conjugated dienes in serum rose more than 45% when pregnancy advanced from the first to second trimester, but after that it declined almost to the same level as in the first trimester. The fluorescent chromolipids tended to behave in the same way. While the lipid peroxidation products reached their highest level in the second trimester, the activity of glutathione peroxidase rose progressively till the third trimester both in erythrocytes and platelets, in spite of the stable concentration of selenium in blood and plasma. The concentration of vitamin E in serum rose progressively till the end of pregnancy, but in the relation of vitamin E to cholesterol only a slight rising tendency was noted. We suggest that in normal pregnancy lipid peroxidation is controlled by adequate antioxidative response. PMID- 1765216 TI - Metabolism of the flame retardant plasticizer tris(2-chloroethyl)phosphate by human and rat liver preparations. AB - Previous studies indicate that tris(2-chloroethyl)phosphate (TCP) preferentially produces hippocampal brain lesions in female versus male rats, and the expression of these lesions is inversely related to the in vivo rate of TCP metabolism. In the present studies, TCP (0.17 mM in all incubations) was metabolized in vitro by liver slices and microsomes from human and Fischer 344N rat liver to bis(2 chloroethyl) hydrogen phosphate (BCP), 2-chloroethanol (CE), and three unidentified metabolites. The rate of TCP metabolism by male rat liver microsomes and liver slices was 0.049 nmol/min/mg protein and 2.53 nmol/min/g liver, respectively. TCP metabolism by male rat liver microsomes was inhibited by 10 microM diisopropyl fluorophosphate, 10 microM paraoxon and carbon monoxide. TCP did not appear to be metabolized by female rat liver microsomes, but female rat liver slices metabolized TCP at a rate of 1.51 nmol/min/g liver. TCP was metabolized by male and female rat plasma at a rate of 0.156 and 0.169 nmol/ml plasma, respectively. TCP was metabolized by male and female human liver microsomes at a rate of 0.027 and 0.031 nmol/min/mg protein, respectively. TCP was metabolized by male and female human liver slices at a rate of 1.37 and 1.82 nmol/min/g liver, respectively. BCP and CE were the major metabolites formed in all studies, except for liver slices and microsomes from two human male subjects in which an unidentified metabolite constituted 29 to 38% of the total TCP metabolism. TCP was not metabolized by plasma or whole blood from male or female human subjects. These results support the previously reported sex-specific difference in TCP metabolism by male and female Fischer 344N rats. However, no sex-specific difference in rates of TCP metabolism by male and female human liver microsomes or slices was observed. PMID- 1765217 TI - Reproductive toxicity of boric acid in Swiss (CD-1) mice: assessment using the continuous breeding protocol. AB - The potential reproductive toxicity of boric acid (BORA) in CD-1 mice (Swiss) was evaluated using the Reproductive Assessment by Continuous Breeding (RACB) Protocol. BORA was administered in the feed for 27 weeks to male and female Swiss (CD-1) mice at concentrations of 0, 1000, 4500, or 9000 ppm. Estimated doses, based on feed consumption and body weight, averaged 152, 636, and 1262 mg/kg body wt during Week 1 for males for 1000, 4500, and 9000 ppm, respectively. During 14 weeks of cohabitation, fertility of F0 mice was partially reduced at 4500 ppm and totally eliminated at 9000 ppm. No litters, dead or alive, were produced by 9000 ppm cohabited pairs. Among the litters born at 4500 ppm, live litter size and body weight were significantly reduced. A crossover mating trial of control and 4500 ppm groups confirmed the male as the affected sex, with fertility rates and the mating index significantly lower in the 4500 male x 0 ppm female group. At necropsy, after 27 weeks of BORA exposure, dose-related changes were present in F0 males for reduced body and reproductive organ weights, increased incidence of abnormal sperm, decreased sperm concentration and motility, and seminiferous tubule degeneration. In the 4500 ppm females, dietary BORA for 27 weeks caused significantly decreased weights of kidney/adrenals and livers; kidney/adrenal weight was also reduced in 4500 ppm males. The last litters of the control and 1000 ppm females, born in the 14-week breeding phase, were reared to 74 days of age and then mated in nonsibling pairs within treatment groups. These F1 mice had normal fertility, but the adjusted mean body weight of F2 pups was decreased. These data establish the reproductive toxicity of BORA in CD-1 mice and demonstrate that the male is the most sensitive sex. PMID- 1765218 TI - Ninety day toxicity study of chloroacetic acids in rats. AB - Chloroacetic acids are produced in drinking water as a result of disinfection processes. Chloroacetic acids are also metabolites of widely used and toxic halogenated hydrocarbons. Thus, chronic human exposure to these chemicals is likely to occur. The objective of the present study was to examine the toxic effects of monochloroacetic acid (MCA), dichloroacetic acid (DCA), and trichloroacetic acid (TCA) in a 90-day subchronic study in rats via oral exposure by drinking water. Chloroacetic acid solutions were prepared at concentrations which provided an approximate intake of 1/4 the LD50 dose per day: MCA, 1.9 mM; DCA, 80.5 mM; TCA, 45.8 mM. Control rats received distilled water only. After 90 days, major organs were removed, fixed, paraffin embedded, and stained. Light microscopic examination of the major organs revealed variable degrees of alterations in the lung and liver of all three treated groups. In the liver, morphological changes were predominantly localized to the portal triads, which were mildly to moderately enlarged with random bile duct proliferation, extension of portal veins, fibrosis, edema, and occasional foci of inflammation. In the lungs, minimal alterations were observed as foci of perivascular inflammation on small pulmonary veins. Morphological changes in the testes and brain were seen only in the DCA treated group. Testes were atrophic with few spermatocytes and no mature spermatozoa. Focal vacuolation and gliosis were present in the forebrain and brainstem. The results of these studies indicate that, relative to their respective LD50 values, DCA given at 80.5 mM is more toxic than TCA given at 45.8 mM and MCA at 1.9 mM is least toxic. PMID- 1765219 TI - Pulmonary response to perfluoropolymer fume and particles generated under various exposure conditions. AB - Combustion-product toxicity of perfluorinated polymers in small-scale tests varied markedly under various exposure conditions. The toxicity of perfluoropolymer fumes is associated with submicron pyrolysis particles (0.03 0.15 microns) in the fumes. The toxicity of pyrolysis products was not observed in rats exposed to the fumes filtered to remove the particles. The particles in the fume were agglomerated by aging or a water-treatment process, and the toxicity of particles was markedly reduced when rats were exposed to aged or water-treated fumes. Some agglomerated particles showed chain-aggregation and ultimately attained nonrespirable size. The reduced toxicity of pyrolysis fume is believed to be due to a decreased number of toxic particles resulting from particle agglomeration. Aged particle agglomerate was not toxic when instilled intratracheally into the rats. However, the particle agglomerate became toxic when rats were exposed by the inhalation to fumes evolved from the reheated agglomerate. The fumes contained numerous toxic submicron particles evolved from thermal decomposition of agglomerates by reheating. Rats exposed to the pyrolysis fumes died with pulmonary edema and hemorrhage due to Type I pneymocyte damage. The edematous lungs revealed some agglomerated particles, but it was difficult to distinguish small pyrolysis particles from contaminating dust or cellular debris. PMID- 1765220 TI - Reproductive toxicity assessment by continuous breeding in Sprague-Dawley rats: a comparison of two study designs. AB - The protocol for Reproductive Assessment by Continuous Breeding (RACB) studies was originally designed to use mice as the test species. However, rats are commonly used for reproductive toxicity research and could be used in the basic RACB design. One of the studies reported below evaluated a standard murine RACB design using rats, which rears the fifth litter to test second generation fertility. The second design tested the logistics and feasibility of rearing the second litter for second generation fertility testing. The standard fifth litter design (L5) was modified slightly for rats by increasing the time allowed for gestation and delivery. Compared to rats rearing their second litter (L2), rats in this L5 design had more litters per pair during continuous breeding and maintained this fertility better over time, as evidenced by producing more pups per litter during the crossover mating segment. Both L2 and L5 rats gave sufficient pups to conduct the second generation fertility evaluation. In addition, the L5 design was easier to conduct and produced pups from gametes exposed to chemical throughout spermatogenesis, making it the preferred design for using rats in Continuous Breeding studies. PMID- 1765221 TI - Comparative toxicity and carcinogenicity studies of tetracycline and oxytetracycline in rats and mice. AB - Two-year toxicity and carcinogenicity studies of oxytetracycline hydrochloride and tetracycline hydrochloride, two structurally similar and widely used antibiotics, were performed in F344/N rats and B6C3F1 mice. Rats and mice were continuously exposed via their diet to the following levels of antibiotic: oxytetracycline HCl--rats 0, 25,000, or 50,000 ppm; mice 0,6,300, or 12,500 ppm; tetracycline HCl--rats and mice 0, 12,500, or 25,000 ppm. On a milligram per kilogram of body weight basis these exposures represent doses that are 20 to 140 times daily human therapeutic doses. Dose-related increased survival was noted among oxytetracycline-treated male rats and tetracycline-treated female rats and male mice, while treatment-related reduced body weight gain occurred in oxytetracycline- and tetracycline-treated mice. Microscopic changes included fatty metamorphosis and focal cellular change in livers of oxytetracycline treated male rats and basophilic cytoplasmic and clear cell change in livers of tetracycline-treated male rats. The only neoplastic changes were a marginally increased trend in pheochromocytoma of the adrenal medulla (equivocal evidence only) among oxytetracycline-exposed male rats (12/50 controls, 19/50 low dose, 24/50 high dose) and an increased incidence of pituitary adenoma or adenocarcinoma among high-dose oxytetracycline-treated female rats (20/50 controls, 32/50 high dose). Although oxytetracycline and tetracycline appeared to increase the incidence of pituitary hyperplasia in high-dose male and female rats, respectively, the total incidence of proliferative changes (hyperplasia, adenoma, and adenocarcinoma) was not affected by antibiotic exposure. The results from these studies therefore support the notion that neither antibiotic is carcinogenic in rodents. There were several negative trends suggesting possible protective effects by both these tetracycline analogs against certain spontaneous neoplastic and non-neoplastic changes. PMID- 1765222 TI - Toxicity studies of acetone administered in the drinking water of rodents. AB - Two- and thirteen-week toxicity studies were conducted using male and female F344/N rats and B6C3F1 mice. Animals were exposed to the following concentrations of acetone in their drinking water: two-week studies 0; 5000; 10,000; 20,000; 50,000; or 100,000 ppm acetone. Thirteen-week rat and female mouse studies 0; 2500; 5000; 10,000; 20,000; or 50,000 ppm acetone. Thirteen week male mice were exposed to 0; 1250; 2500; 5000; 10,000; or 20,000 ppm acetone. Depressed body weight gain was restricted to the 50,000 and 100,000 ppm exposure groups. Male and female mice exposed respectively to 20,000 or 50,000 ppm acetone for 2 weeks developed hepatocellular hypertrophy. This change was not apparent after 13 weeks of exposure although relative and absolute liver weight was increased in high dose female mice. Bone marrow hypoplasia was observed in 5/5 high dose (100,000 ppm) male rats during the 2-week studies. Treatment of male rats for 13 weeks resulted in a variety of mild and subtle hematological changes that often occurred at relatively low levels of exposure (5000 ppm) and resembled those seen during the clinical condition of megaloblastic anemia. Changes characteristic of hypogonadism (depressed sperm motility and cauda epididymal and epididymal weight and elevated incidence of abnormal sperm) were observed in male rats receiving 50,000 ppm acetone for 13 weeks. The incidence and severity of a kidney lesion that is morphologically similar to the spontaneously occurring nephropathy among aging F-344 rats were increased at 20,000 and 50,000 ppm acetone, respectively, in 13-week male rats. In summary, the effects of acetone were either subtle in nature or occurred during very high levels of exposure confirming acetone's low level of toxicity. The daily levels of acetone exposure were often several-fold greater than possibly encountered by humans during the accidental consumption of contaminated groundwater (250 ppm; 5 mg/day) and frequently exceeded maximum levels reported following acute toxic exposures (2,500 mg/kg). PMID- 1765223 TI - Metabolic induction of the hepatic cytochrome P450 system by chlorfenvinphos in rats. AB - Previous studies have shown that a single oral pretreatment of rats with the organophosphorus insecticide 2-chloro-1-(2,4-dichlorophenyl)vinyl diethyl phosphate (chlorfenvinphos, CVP) afforded protection against the toxicity of a subsequent challenge with the same compound within 24 hr. This protection may be due to the reduction in brain cholinesterase inhibition caused by the decrease in plasma CVP concentration. The purpose of this study was to investigate the mechanism of the decrease in plasma CVP concentration in relation to metabolic induction. CVP was preferentially metabolized by a liver microsomal fraction with an NADPH-generating system, compared with serum or kidney subcellular fractions. A single oral 24-hr pretreatment with CVP (15 mg/kg) increased the oral LD50 of its next dosage to threefold. The same treatment also increased CVP metabolism (to 178%), cytochrome P450 content (to 130%), cytochrome P450 reductase activity (to 130%), cytochrome b5 content (to 121%), and cytochrome P450-linked activities such as aminopyrine demethylase (to 140%) and aniline hydroxylase (to 127%) in the hepatic microsomal fraction. A single oral 24-hr pretreatment of phenobarbital (50 mg/kg), which is known as an inducer of cytochrome P450, increased the oral LD50 of CVP and all the related metabolic parameters listed above in an order of magnitude similar to that of CVP, although the increments induced by the phenobarbital treatment were greater than those induced by the CVP treatment. These results indicate that the increase in hepatic CVP metabolism may be due to the induction of the hepatic cytochrome P450 system caused by the single oral short-term treatment with CVP. This induction may be one of the reasons for the decrease in plasma CVP concentration which may be responsible for the reduction in toxicity of its next dosage. PMID- 1765224 TI - Sensitive periods for behavioral toxicity of polychlorinated biphenyls: determination by cross-fostering in rats. AB - Polychlorinated biphenyls (PCBs) are transferred to developing organisms via the milk rather than through placental barriers. Recent epidemiological data, however, suggest a greater importance of the prenatal exposure period for the development of neuropsychological disorders. The relative effectiveness of pre- and postnatal PCB exposure was compared in a cross-fostering experiment in rats. Female Wistar rats were fed diets containing 0 or 30 mg PCB/kg. After birth half of the litters in each exposure group were nursed by dams of the other condition. Six different congeners were determined in the brains of the offspring at various ages. Internal exposure to higher chlorinated congeners peaked at weaning in groups with postnatal or permanent exposure, whereas the concentration of a low chlorinated compound was lower at weaning than at birth or at later age stages. Brain tissue levels in prenatally treated rats declined with aging. In two behavioral paradigms, active avoidance learning and retention of a visual discrimination task, prenatally exposed rats exhibited alterations similar to those of permanently treated subjects, while postnatal exposure caused no detectable behavioral changes. These results support the above-mentioned epidemiological studies which related neurodevelopmental deficits in children to prenatal PCB exposure. PMID- 1765225 TI - 90-Day toxicity study of dichloroacetate in dogs. AB - Male and female juvenile beagle dogs were dosed daily for 90 days with dichloroacetate (DCA). The compound was administered orally via gelatin capsules at doses of 0, 12.5, 39.5, and 72 mg/kg/day. Each dose group consisted of five males and five females. The dogs were observed clinically and blood samples were taken at 15-day intervals for hematologic and serum chemistry values. Decreased total erythrocyte count and hemoglobin levels were observed in mid- and high-dose dogs beginning at Day 30. Serum concentrations of LDH were elevated at Days 30 and 45 in females and at Day 75 in males treated with DCA at 72 mg/kg/day. One female of the high-dose group died at Day 50 and two high-dose males died at Days 51 and 74. Hindlimb partial paralysis was observed in many high-dose dogs. Vacuolization of myelinated white tracts of cerebrum, cerebellum, and/or spinal cord was observed in many high-dose dogs as well as some mid- and low-dose subjects. Degeneration of testicular germinal epithelium and syncytial giant cell formation was noted in males of all dose groups. Hepatic vacuolar change and chronic hepatitis appeared only in DCA-treated dogs. In addition, suppurative bronchopneumonia and chronic pancreatitis were noted in many high-dose and some middose subjects. A "no-adverse-effect level" was not determined in this study. PMID- 1765226 TI - 13-Week oral toxicity study of captafol in F344/DuCrj rats. AB - Captafol fed at concentrations of 0, 0.075, 0.15, 0.3, and 0.6% to both sexes of F344 rats for 13 weeks produced dose-related decreases in body weight in males and females given 0.15% or higher concentrations. A dose-dependent decrease in urinary pH was observed in males receiving 0.3 or 0.6% and in females given 0.15% or higher concentrations of captafol. The 0.3 and 0.6% doses produced slight increases in leukocyte count and glutamic-pyruvic transaminase activity in females, along with a mild increase in alkaline phosphatase activity in the 0.6% case. The liver- and kidney-to-body weight ratios were increased in both male and female rats. Histopathological changes were observed in the forestomach, liver, and kidney. Squamous cell hyperplasia and edema accompanied by polynuclear leukocyte infiltration and dilation of vessels in the lamina propria were observed in the forestomach of both sexes given 0.15% or higher concentrations. Oval cell proliferation was apparent around Glisson's sheath in the livers of females given 0.3 and 0.6% captafol. Multifocal appearance of karyocytomegaly and tubular cell atypia in the proximal tubules of the kidney was found in the 0.3 and 0.6% groups of both sexes. PMID- 1765227 TI - Difference in the developmental toxicity of ethylenethiourea and three N,N' substituted thiourea derivatives in rats. AB - Sprague-Dawley rats were administered ethylenethiourea (ETU), 1,3-dimethyl-2 thiourea (DMT), 1,3-dibutyl-2-thiourea (DBT), or 1,3-diphenyl-2-thiourea (DPT) by gavage from Days 6 to 20 of gestation. Daily dosage levels (mg/kg/day) were ETU at 0, 15, 25 and 35; DMT at 0, 15, 25, 50, 100, and 200; DBT at 0, 15, 25, 50, 100, and 200; and DPT at 0, 25, 50, 100, and 200. There was evidence of maternal toxicity at all doses of DMT and at doses greater than or equal to 50 mg DBT/kg/day. DPT was embryolethal at 200 mg/kg/day. Fetotoxicity was observed at doses greater than or equal to 15 mg DMT/kg/day, greater than or equal to 15 mg DBT/kg/day, and greater than or equal to 100 mg DPT/kg/day. ETU was the only chemical tested that proved to be teratogenic. PMID- 1765229 TI - Suppression of local gut-associated and splenic mitogen responsiveness of lymphoid cells following oral exposure of B6C3F1 mice to 7,12 dimethylbenz[a]anthracene. AB - In these studies, the mitogen responsiveness of lymphocytes obtained from local gut-associated lymphoid tissues (GALT) and the spleen were evaluated following a 5-day exposure to 7,12-dimethylbenz(a)anthracene (DMBA) at doses of 50 or 150 mg/kg. Phytohemagglutinin and lipopolysaccharide (LPS) responses were suppressed in all lymphoid tissues studied. However, the LPS response in mesenteric lymph nodes and Peyer's Patches seemed to be the most sensitive indicator of immunotoxicity, indicating that B cells appear to be particularly sensitive to DMBA toxicity in the GALT. These studies demonstrate that both splenic tissues and GALT are important targets of immunotoxicity following oral administration of DMBA. Based upon these and past studies we conclude that the total administered dose of DMBA is a more important determinant of immunotoxicity than the length of exposure. PMID- 1765228 TI - Covalent binding of inhaled formaldehyde to DNA in the respiratory tract of rhesus monkeys: pharmacokinetics, rat-to-monkey interspecies scaling, and extrapolation to man. AB - DNA-protein cross-links were formed in the respiratory tract of rhesus monkeys exposed to [14C]formaldehyde (0.7, 2, or 6 ppm; 6 hr). Concentrations of cross links (pmol/mg DNA) were highest in the mucosa of the middle turbinates; lower concentrations were produced in the anterior lateral wall/septum and nasopharynx. Very low concentrations were found in the larynx/trachea/carina and in the proximal portions of the major bronchi of some monkeys exposed to 6 ppm but not to 0.7 ppm. No cross-links were detected in the maxillary sinuses or lung parenchyma. The pharmacokinetics of cross-link formation in the nose were interpreted using a model in which the rate of formation is proportional to the tissue concentration of formaldehyde. The model includes both saturable and nonsaturable elimination pathways and describes regional differences in DNA binding as having an anatomical rather than a biochemical basis. Using this model, the concentration of cross-links formed in corresponding tissues of different species can be predicted by scaling the pharmacokinetic parameter that depends on minute volume (V) and quantity of nasal mucosal DNA (MDNA). The concentration-response curve for the average rate of cross-link formation in the turbinates, lateral wall, and septum of rhesus monkeys was predicted from that of F-344 rats exposed under similar conditions. There was significant overlap between predicted and fitted curves, implying that V and MDNA are major determinants of the rate of cross-link formation in the nasal mucosa of different species. Concentrations of cross-links that may be produced in the nasal mucosa of adult men were predicted based on experimental data in rats and monkeys. The results suggest that formaldehyde would generate lower concentrations of cross links in the nasal mucosa of humans than of monkeys, and much lower concentrations in humans than in rats. The rate of formation of DNA-protein cross links can be regarded as a surrogate for the delivered concentration of formaldehyde. Use of this surrogate should decrease the uncertainty of human cancer risk estimates derived by interspecies extrapolation by providing a more realistic measure of the delivered concentration at critical target sites. PMID- 1765230 TI - [Psychological and social aspects in women with syndrome X]. AB - A sizeable proportion (20-30%) of patients undergoing coronary arteriography for a chest pain syndrome are found to have angiographically normal coronary arteries. Some of these subjects (10-15%) have ischemic-like electrocardiographic changes during stress and no evidence of spasm of the epicardial coronary arteries (syndrome X). The vast majority of these patients are middle aged females. In the present investigation we evaluated the psychological and social characteristics of a group of patients with syndrome X (PX, n = 30). The results obtained in the PX group were compared with those in a sex and age matched group of patients with angiographically proven coronary artery disease (PI, n = 32) and with those in a group of control subjects (C, n = 29). Two original questionnaires were employed to collect the demographic and family data. The psychological data were obtained through the following 4 questionnaires: Symptom Rating Test (SRT); Symptom Questionnaire (SQ); Illness Behaviour Questionnaire (IBQ); Maudsley Personality Inventory (MPI). The results of our study indicated that in most of the patients with syndrome X the psychological and social conditions are similar and they are not compatible with a satisfactory lifestyle. In most cases both family and social difficulties are present, which impose excessive workload and distress on the patients. Very often the beginning of the chest pain history tends to coincide with the periods of greatest stress and with the occurrence of dramatic events in the family. On the other hand, the onset of symptoms often has the effect of releasing some of the environmental pressure on the patient.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765231 TI - Peripheral vascular circulation in trained athletes. AB - Modifications in the neurogenic control are important in cardiovascular adaptation to physical training. To examine the influence of such variations on arterial blood pressure, heart rate and limb blood flow the Authors have studied the reaction to cardiovascular stress tests of soccer players and sedentary controls. No difference was found in the blood flow response between athletes and sedentary subjects. However, the tests inducing sympathetic activation determined blood pressure response of different intensity, possibly related to the differences in the autonomic nervous system control. PMID- 1765232 TI - [Use of 5 French catheters in percutaneous femoral coronaro-ventriculography (500 consecutive procedures with 5 French catheters)]. AB - To verify the advantages and the systematic use of 5 French catheters in femoral percutaneous coronaroventriculography, 500 consecutive unselected patients with confirmed or suspected coronary artery disease underwent this procedure. In one case only (0.2%) we had recourse to 7 French catheters on account of the inability to enter the left coronary ostium. There were no major local complications. General complications were represented by vagal reactions in 20 cases (4%) and by transient minor motor aphasia in one case (0.2%). The cardiac complications were represented by: -1 (0.2%) atrio-ventricular isorhythmic dissociation; -1 (0.2%) complete right bundle branch block; -3 (0.6%) atrial fibrillation; (all had a rapid and spontaneous regression) -1 (0.2%) ventricular fibrillation treated successfully with D.C. shock; -1 (0.2%) non fatal acute myocardial infarction (at the end of the procedure); -2 (0.4%) attacks of cardiac asthma treated successfully with medical therapy. 5 French catheters have proved to be extremely efficacious, with some technical experience, in percutaneous coronaroventriculography via femoral approach. The possible advantages could consist of a reduction in local complications, a patient's precocious mobilization and a minor traumatism on the arterial wall. The major complications are comparable with those observed using 7-8 French catheters. In the future it might be possible, in selected patients, to use 5 French catheters to perform ambulatory cardiac catheterization with reduction of both costs and hospitalization period. PMID- 1765233 TI - [Use of integrated echocardiography in the evaluation of neonatal asphyxia]. AB - Perinatal asphyxia provides a dramatic example of vulnerability of the cardiovascular system during adaptation to the extrauterine life. The clinical picture is variable, depending upon the severity of perinatal stress and the individual response of pulmonary vascular bed and myocardium. Doppler Echocardiography is a reliable and noninvasive method which allows both the ruling out of congenital heart disease and the making of an early diagnosis in these neonates. PMID- 1765234 TI - Prognostic value of total ischemic burden in patients with stable ischemic heart disease. AB - Patients with stable coronary artery disease commonly have transient myocardial ischemia with or without experiencing angina, but the prognostic implications of this "total ischemic burden" is still a matter of debate. We studied 112 consecutive patients with coronary artery disease, normal left ventricular function at rest and exercise-induced myocardial ischemia, a 24-hour ambulatory EKG was performed after drug withdrawal. The mean exercise duration was 572 +/- 192 seconds, with an ischemic threshold (ST depression = 1 mm) of 390 +/- 190 seconds). By Holter monitoring 30 patients had no ischemia and 82 (73%) had a total of 332 episodes of ST segment changes, the majority of which were asymptomatic (242/332, 73%). Among 82 patients with transient myocardial ischemia, 44 (54%) had only asymptomatic episodes. Nine patients (11%) complained of angina coincident to ST changes. Twenty-nine patients (35%) had both painful and painless ST segment alterations. All patients were prospectively followed-up while on conventional medical therapy. During a mean follow up of 25 +/- 10 months cardiac events occurred in 31 patients; there were 5 cardiac deaths, 3 non fatal myocardial infarctions, 2 hospitalization for unstable angina and 21 revascularization procedures (PTCA or CABG). By multivariate analysis the number of stenotic vessels on coronary angiography was predictive of the events during the follow-up (p = 0.03), while other demographic, clinical, ergometric and angiographic variables were not influential. Event-free survival was similar for all subsets of transient myocardial ischemia (silent, symptomatic, or none).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765235 TI - [Informatics for cardiology: on its way]. PMID- 1765236 TI - [Tetralogy of Fallot with absence of the pulmonary valve and the left branch of the pulmonary artery: echocardiographic diagnosis]. AB - The absence of the pulmonary valve and the left pulmonary artery were recognized by cross-sectional and Doppler echocardiography in one patient with tetralogy of Fallot. The right oblique subxiphoid view was the best approach for visualization of these anatomical abnormalities. The diagnosis was confirmed at catheterization and at operation. It is suggested that premature closure of the ductus arteriosus may be responsible for the failure in the development of both the pulmonary valve and the left pulmonary artery. PMID- 1765237 TI - [Transesophageal echocardiography in the diagnosis of cor triatriatum in the adult]. AB - Cor triatriatum (CT) is a rare congenital defect, surgically correctable, and sometimes difficult to diagnose by cardiac catheterization. This report describes three young patients with this particular defect, one of whom was sent to us because of signs of right ventricular failure. The diagnosis of CT was made by transesophageal echocardiography and confirmed by cardiac catheterization and surgical data. The other two cases underwent cardiac catheterization and cardiac surgery during infancy for other congenital defects. The diagnosis of CT was made only during post-operative controls by transthoracic echocardiography. In these two cases transesophageal echocardiography provided the most valuable information about the morphological features of the membrane and the mitral valve, and about the flow between the two left atrial chambers. PMID- 1765238 TI - [Some considerations on the organization of cardiologic assistance. The problem of the chronic cardiopathy patient. An invitation to discussion]. PMID- 1765239 TI - [Research in hospitals in light of the new European Economic Community. The hospital's point of view]. PMID- 1765240 TI - [GISSI-3 research protocol (Italian Group for the Study of Survival in Myocardial Infarct)]. PMID- 1765241 TI - [Animal rights and experimentation in cardiology]. PMID- 1765242 TI - Lipids and coronary disease--resolved and unresolved problems. PMID- 1765243 TI - [Regional myocardial perfusion and ischemia in hypertrophic cardiomyopathy]. PMID- 1765244 TI - Prediction of the recurrence of esophageal varices based on portal vein pressure and oxygen tension in portal and peripheral blood. AB - In 27 variceal patients completely treated by ethanolamine oleate and polidocanol and followed for more than one year, the recurrence of varices was studied by measuring portal vein pressure and oxygen tension in the portal vein and peripheral arteries and veins before and after EIS. Frequent recurrence was observed in patients with increased PVP after EIS and lower or inverse PVO2-VO2 tension after EIS. The recurrence of varices after EIS may thus possibly be predicted based on portal vein pressure and PVO2-VO2 tension differences. PMID- 1765245 TI - Effect of secretin on lower esophageal sphincter pressure in patients with esophageal achalasia. AB - The effect of a bolus intravenous administration of secretin (2.0 U/kg) on resting lower esophageal sphincter pressure (LESP) was investigated in seven patients with esophageal achalasia. Basal LESP before secretin injection in the patients was 60.1 +/- 3.4 mmHg (Mean +/- SEM), which was significantly higher than 26.9 +/- 2.5 mmHg in normal controls consisting of eight healthy volunteers. LESP significantly decreased within 1 min after the injection both in the patients and the controls. The maximum pressure change from each basal LESP was 31.2 +/- 5.2 mmHg in the patients, which was significantly greater than 12.1 +/- 1.8 mmHg in the controls. The effect of secretin disappeared within 5 min in the controls. The effect in the patients, however, lasted throughout the investigation time of 30 min. It is concluded that secretin has a long-acting effect on muscular relaxation of the lower esophageal sphincter in esophageal achalsia patients. PMID- 1765246 TI - Toxin involvement in methicillin-resistant Staphylococcus aureus enteritis in gastroenterological surgery. AB - The authors investigated the production of toxic shock syndrome toxin-1 (TSST-1) and staphylococcal enterotoxins (SE) by Methicillin-resistant Staphylococcus aureus (MRSA) isolates to clarify the pathogenesis of postoperative MRSA enteritis in patients undergoing gastroenterological surgery. Regarding the percentage of TSST-1 producing strains, there was a significant difference between type II MRSA strains (68.8%) and type IV MRSA strains (4.2%). Among type II strains, all those producing staphylococcal entorotoxin (SE) type C (SEC) also produced TSST-1, although other strains that produced SEB without TSST-1 were commonly isolated. Strains producing SEA were potent producers of SE which was considered to be responsible for enteritis. Therefore, we hypothesized that the strains which produced both SEA and SEC tended to cause enteritis associated with TSS-like symptoms owing to the high titer of these toxins. PMID- 1765247 TI - Glycyrrhizin withdrawal followed by human lymphoblastoid interferon in the treatment of chronic hepatitis B. AB - Seventeen patients with chronic hepatitis B were treated with a 4-week administration of glycyrrhizin followed by a 4-week treatment with human lymphoblastoid interferon, then followed for 6 months after the end of treatment. All were positive for hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), and hepatitis B virus-associated DNA polymerase (DNA-p) for at least 6 months before entry. All patients were Japanese and none of them were homosexuals. Eleven patients lost DNA-p activity and 10 of them lost HBeAg. Three of these 10 patients had antibody to HBeAg. In 10 patients who became HBeAg negative, alanine aminotransferase levels after glycyrrhizin administration were higher and initial DNA-p activities relatively lower than the levels found in seven patients who remained HBeAg-positive. The immunomodulator provided by a short course of glycyrrhizin before administration of human lymphoblastoid interferon may be an effective treatment for patients with chronic hepatitis B. PMID- 1765248 TI - Simultaneous extensive resection of the liver and the pancreas in dogs. AB - Mortality, morbidity, liver function and regeneration were evaluated in dogs that had undergone simultaneous major resection of the liver and the pancreas. The 10 week survival rate was only 25% in the dogs that underwent 70% hepatectomy with more than 92% pancreatectomy, and many of them died of liver failure. Long-term survival was observed in more than 60% of the dogs after 70% hepatectomy with less than 92% pancreatectomy or after 40% hepatectomy with more than 92% pancreatectomy. The liver regeneration rate was reduced with the extent of the pancreatectomy, and the reduction was remarkable especially when more than 92% of the pancreas was resected. The frequency of diabetes was reduced when the pancreatectomy was combined with hepatectomy. Hyperlipemia and fatty liver were noted in all the dogs of the group that underwent more than 92% pancreatectomy alone. They were observed also in the postoperative diabetic groups but not in non-diabetic groups. The postoperative recovery of hepatic function and liver regeneration were delayed after simultaneous hepatectomy-pancreatectomy. Also, postoperative carbohydrate and lipid metabolism was better maintained in the hepatectomy-pancreatectomy groups than in the pancreatectomy-alone groups. PMID- 1765250 TI - Endoscopic microwave coagulation therapy for villous adenoma of the duodenum--a case report. AB - The effects of endoscopic microwave coagulation therapy on duodenal adenoma in a 58-year-old man are reported. The patient had a 35-mm sessile tubulo-villous adenoma in the duodenal bulb. Endoscopic polypectomy followed by microwave coagulation therapy for duodenal adenoma was performed to avoid a major surgical procedure which would disturb the physiological functions of the gastrointestinal tract. After partial polypectomy which included the core of the adenoma, the entire remaining adenoma was destroyed after three microwave therapy sessions. During a follow-up period of 14 months, neither endoscopic nor histologic evidence of recurrence has been noted. Endoscopic microwave coagulation therapy is considered to be useful in the treatment of large sessile duodenal villous adenoma, provided that repeated endoscopic follow-up surveillance is also performed. PMID- 1765249 TI - Two cases of gastric antral vascular ectasia--response to medical treatment. AB - Two patients with severe iron deficiency anemia and gastric antral vascular ectasia (GAVE) are reported. The anemia caused by the chronic blood loss from the abnormally dilated mucosal and submucosal capillary veins in the gastric antrum was unresponsive to oral iron supplementation. However, one of the patients was successfully treated with intramuscular injection of (Asu1,7) eel calcitonin. The other one was treated by oral prednisolone with resulting improvement iron deficiency anemia. The possible mechanisms of successful calcitonin and prednisolone treatments on chronic blood loss from GAVE is discussed. PMID- 1765251 TI - A case of primary malignant lymphoma of the liver. AB - Primary lymphoma of the liver is extremely rare, and its preoperative or premortem diagnosis is still difficult. The author report here a case of primary malignant lymphoma of the liver diagnosed on a basis of ultrasonically guided biopsy of the tumor. A 51-year-old man was found to have a relatively large tumor in the right lobe of the liver as well as elevated serum LDH with abnormal isoenzyme pattern. Immunohistological studies of both biopsy and postmortem specimens of the tumor indicated T cell malignant lymphoma of the liver. The present case appears to be the second case of T cell origin of the disease. PMID- 1765252 TI - A case of splenic inflammatory pseudotumor. AB - Inflammatory pseudotumor of the spleen in a 50-year-old man was encountered in our surgical clinic. This splenic tumor is very rare and in the ninth of the cases in the literature. The removed spleen, weighting 255g, revealed the presence of a firm, circumscribed mass, measuring 4.5 x 4.0 x 4.5 cm, and histologically presenting marked lamination of collagen fibers around the small vessels associated with granulomatous lesions. The implications of its pathogenesis was analyzed with a review of the literature. PMID- 1765254 TI - Abstracts from the First Consultation-Liaison Research Forum. New York City, May 12, 1990. PMID- 1765253 TI - Informed consent and truth telling to cancer patients. PMID- 1765255 TI - Intravenous haloperidol treatment of severely regressed, nonviolent psychiatric inpatients. AB - The use of intravenous haloperidol in five severely regressed, nonviolent, psychiatric inpatients with psychotic disorders is described. Unlike previous reports in the consultation psychiatry literature, this treatment was not instituted to control combative behavior in the medically ill. All patients had intravenous access in place for hydration. Four of five patients were discharged in complete remission of psychotic symptoms after brief hospitalizations. The indications for use, dosages, and general absence of side effects are described. Intravenous haloperidol is a viable option for treating severely ill psychiatric inpatients with psychotic disorders. PMID- 1765256 TI - Organization and development of pediatric medical-psychiatric units. Part II: Clinical management issues. AB - Scant literature exists regarding combined medical-psychiatric units for pediatric populations. The present article is the second in a two-part series describing issues relevant to the organization and development of such a unit within a tertiary-care children's hospital. Case examples of medical-psychiatry patients are presented, together with summary patient statistics for the first 3 years of operation. Additionally, issues regarding the physical layout, treatment program, and staffing are discussed. PMID- 1765257 TI - Cocaine abuse during pregnancy: psychiatric considerations. AB - Cocaine abuse is an increasing problem in the obstetric population. It not only poses a health risk to the pregnant woman, but can precipitate premature labor and abruptio placentae, and has been associated with a number of physical and behavioral problems in the newborn. Evaluation and management of the pregnant cocaine abuser is similar in most respects to that of nonpregnant adults, but diagnosis, psychotherapy, and pharmacotherapy is strongly influenced by the pregnancy. This article describes the risks of cocaine use during pregnancy and outlines the evaluation and management of the pregnant cocaine abuser. PMID- 1765258 TI - Reluctance to care for patients with AIDS. PMID- 1765259 TI - Genetic analysis of a switch in cell specificity of P lysozyme expression in molossinus mice. AB - An electrophoretic survey of concentrations of lysozymes M and P was carried out with seven species in the house mouse group (spretus, hortulanus, abbotti, musculus, castaneus, domesticus and molossinus). In most species M is the predominant lysozyme in all tissues tested, except the small intestine, where P predominates if present. In inbred strains of molossinus mice P is more abundant than M in all tissues tested. The phenotypes of high expression of P lysozyme and low expression of M lysozyme in peritoneal and alveolar macrophages were examined genetically. Results of interspecific crosses and backcrosses to domesticus mice support the model that the phenotypes are caused by mutation(s) tightly linked to the lysozyme locus. Alleles at the regulatory loci show additive inheritance. PMID- 1765260 TI - Two new X-autosome Robertsonian translocations in the mouse. I. Meiotic chromosome segregation in male hemizygotes and female heterozygotes. AB - Two new X-autosome Robertsonian (Rb) translocations, Rb(X.9)6H and Rb(X.12)7H, were found during the course of breeding the Rb(X.2)2Ad rearrangement at Harwell. The influence of these new Rbs on meiotic chromosome segregation was investigated in hemizygous males and heterozygous females and compared to that of Rb(X.2)2Ad. Screening of metaphase II spermatocytes gave incidences of sex chromosome aneuploidy of 9.2% in Rb(X.2)6H/Y and 9.6% in Rb(X.9)2Ad/Y males; no metaphase II cells were present in the testes of the Rb(X.12)7H/Y males examined and no males with this karyotype have so far proved fertile. In breeding tests, 5% of the progeny of Rb(X.2)2Ad/Y males were sex chromosome aneuploids compared to 10% of the Rb(X.9)6H/Y offspring. The difference was not significant, however. Cytogenetic analyses of metaphase II stage oocytes showed elevated rates of hyperhaploidy (n + 1) in Rb heterozygous females over chromosomally normal mice: 4.2% for Rb(X.2)2Ad/+; 2.1% for Rb(X.9)6H/+; 2.2% for Rb(X.12)7H/+ and 1.1% for normal females. There was, however, no statistically significant difference in the rates of hyperhaploidy between the three different Rb types, nor overall between Rb/+ and normal females. Karyotypic analyses of liveborn offspring of Rb heterozygous females revealed low incidences of X0 animals but no other type of sex chromosome aneuploidy. Intercrosses of heterozygous females and hemizygous males yielded 5.5% aneuploidy for Rb(X.2)2Ad and 5.4% for Rb(X.9)6H. In heterozygous females, there was evidence from the metaphase II and breeding test data for all three rearrangements, of preferential segregation of the Rb metacentric to the polar body resulting in a deficiency of cells and progeny carrying a translocation chromosome. PMID- 1765261 TI - Analysis of lines of mice selected for fat content. 3. Flux through the de novo lipid synthesis pathway. AB - The flux through the de novo fatty acid synthesis pathway was estimated in lines of mice which differed substantially in fat content following 26 generations of selection at 10 weeks of age. Previous estimates of lipogenic enzyme activities had indicated an increase in the capacity for lipogenesis in the Fat compared to the Lean line. Therefore the in vivo flux in lipogenesis was measured in both liver and gonadal fat pad (GFP) tissues of males at 5 and 10 weeks of age, using the rate of incorporation of 3H from 3H2O and 14C from acetate and citrate into total lipids. At both ages and in both tissues the Fat line had a higher flux, about 20% increase in the liver and up to three-fold increase (range 1.2- to 3.4 fold) in the GFP. We conclude that direct selection for fatness in mice has resulted in metabolic changes in the rate of de novo fatty acid synthesis, and that the changes are largely detectable before 10 weeks, the age of selection. PMID- 1765262 TI - A method for detecting effect of beneficial mutations in natural populations of Drosophila melanogaster. AB - An experimental method is proposed for detecting the effects of positive natural selection on DNA polymorphisms. Since beneficial mutations are expected to increase in frequency faster than neutral mutations, variants which have reached high frequencies in a relatively short period could be linked to some beneficial mutation. D. melanogaster has a cosmopolitan polymorphic inversion -In(2L)t- whose age in some local populations has been estimated. Setting the age of In(2L)t as the upper limit for the age of variants, we searched for variants whose frequencies were possibly influenced by positive natural selection. We detected a single candidate whose frequency and distribution met the requirements imposed by our method. PMID- 1765263 TI - A theoretical test of the DNA repair hypothesis for the maintenance of sex in eukaryotes. AB - The DNA repair hypothesis for the maintenance of sex states that recombination is necessary for the repair of double-strand DNA damage. In a closed (mitotic) genetic system crossing-over generates homozygosity. This reduces fitness if deleterious recessive alleles become expressed. Thus, outcrossing is required to restore heterozygosity destroyed by recombination. The repair hypothesis is tested by comparing outcrossing sexuality with a hypothetical parthenogenic strategy (the Prudent Reparator) which destroys as little heterozygosity during repair as possible. In the Prudent Reparator, repair of double-strand DNA damage results in a small amount of homozygosity due to gene conversion only, since this process does not render outside markers homozygous. Diploidy, deleterious recessives, multiplicative fitness and linkage equilibrium in mutation-selection balance are assumed. The average fitness of this population increases, and complementation (i.e. masking of recessives in heterozygous form) decreases with the rate of damage per locus. The equilibrium fitness of the Prudent Reparator can be well above that of the sexual population. A lower complementation ability of parthenogens may not be an impenetrable barrier to their successful establishment if the invader's genome is relatively uncontaminated by mutant alleles: there are always such genotypes in the sexual population. Thus, the Prudent Reparator could solve the problem of repairing damage as well as that of invading an existing outcrossing population. As we do not see this strategy widely adopted instead of sexuality, the repair hypothesis is likely to miss some essential feature of the evolution of sex. PMID- 1765264 TI - Inbreeding coefficients and coalescence times. AB - This paper describes the relationship between probabilities of identity by descent and the distribution of coalescence times. By using the relationship between coalescence times and identity probabilities, it is possible to extend existing results for inbreeding coefficients in regular systems of mating to find the distribution of coalescence times and the mean coalescence times. It is also possible to express Sewall Wright's FST as the ratio of average coalescence times of different pairs of genes. That simplifies the analysis of models of subdivided populations because the average coalescence time can be found by computing separately the time it takes for two genes to enter a single subpopulation and time it takes for two genes in the same subpopulation to coalesce. The first time depends only on the migration matrix and the second time depends only on the total number of individuals in the population. This approach is used to find FST in the finite island model and in one- and two-dimensional stepping-stone models. It is also used to find the rate of approach of FST to its equilibrium value. These results are discussed in terms of different measures of genetic distance. It is proposed that, for the purposes of describing the amount of gene flow among local populations, the effective migration rate between pairs of local populations, M, which is the migration rate that would be estimated for those two populations if they were actually in an island model, provides a simple and useful measure of genetic similarity that can be defined for either allozyme or DNA sequence data. PMID- 1765265 TI - Structure and expression of the Drosophila melanogaster gene encoding 6 phosphogluconate dehydrogenase. AB - We have determined the nucleotide sequence and structure of Pgd+, the Drosophila melanogaster gene that encodes the enzyme, 6-phosphogluconate dehydrogenase (6PGD). The derived 481-amino acid sequence for D. melanogaster 6PGD is presented and compared with 6PGD sequences from other species. To characterize the cis acting sequences necessary for expression of Pgd+, fragments containing this gene as well as Pgd+ promoter-lacZ fusions were introduced into the D. melanogaster germ line by P-element-mediated transformation. Our results indicate that the large second intron is critical for Pgd+ expression in adults. Only 421 bp of Pgd+ 5'-flanking DNA are necessary to direct expression in imaginal discs, gonads and gut of third-instar larvae. Sequences downstream from the transcription start point are necessary for expression in the larval fat body. PMID- 1765266 TI - Isolation and characterization of the gene encoding EF-1 alpha O, an elongation factor 1-alpha expressed during early development of Xenopus laevis. AB - In Xenopus laevis, the gene encoding the elongation factor 1-alpha variant EF-1 alpha O, where O stands for oocyte, is expressed in oocytes and early embryos. A genomic library from X. laevis was screened with a cDNA probe coding for EF-1 alpha O. Two recombinant phages were isolated, one of which carries an entire EF 1 alpha O gene. This clone was characterized by restriction enzyme mapping and sequencing. Comparison of cDNA and genomic sequences revealed that EF-1 alpha O consists of seven exons spanning about 6.5 kb. The structure of the gene is very homologous to the human EF-1 alpha gene, as all locations of the splice junctions are conserved between the two genes. The sequence immediately upstream from the transcription start point (tsp) contains a CCAAT box, but does not contain either a TATA box or a Sp1-binding site. Interestingly, this sequence has a sequence homologous to the negative regulatory element from the TFIIIA promoter. A region located about 400 bp upstream from the tsp contains an additional number of possible regulatory sequence elements. The first intron contains G + C-rich elements which exist both isolated and as part of longer inverted repeats. Furthermore, one octamer and four Sp1-binding sites are found in this intron. PMID- 1765267 TI - Sequence of the cDNA encoding ovine tumor necrosis factor-alpha: problems with cloning by inverse PCR. AB - We have cloned and sequenced the ovine tumor necrosis factor-alpha (TNF-alpha) encoding cDNA, using gene amplification by polymerase chain reaction (PCR) technology, to aid studies of assorted diseases in this species. We used primers selected from published TnfA sequences of other species on a cDNA template prepared from lipopolysaccharide-stimulated ovine alveolar macrophages, to generate a product representing the central region of the molecule. We then used a novel method based on 'inverse PCR' to generate a product containing the 5' and 3' ends of the molecule. Here, we present the complete sequence of the ovine TNF alpha cDNA and compare it with other published TNF sequences. The cloned cDNA has a leader sequence of 156 bp followed by a protein-coding sequence of 702 bp and a 3'-untranslated region of 800 bp. The protein product of the gene is a protein of Mr = 25,586, 79% homologous to human TNF-alpha. An mRNA produced by alveolar macrophages, which hybridises to the cloned gene, is induced greatly, with a peak induction time of approx. 135 min, in response to stimulation by lipopolysaccharide and to plating on plastic. We also discuss the resolution of some artefacts of the inverse PCR technique. PMID- 1765268 TI - Human dopamine D5 receptor pseudogenes. AB - Molecular cloning studies have now identified five structurally homologous genes encoding the biosynthesis of the human dopamine receptors, DRD1, DRD2, DRD3, DRD4, and DRD5. Two of these dopamine receptors (DRD1 and DRD5) are encoded by intronless genes. To ascertain whether there are other intronless genes that share identity with the gene (DRD5) encoding the DRD5 receptor, we used a cloning method based on the polymerase chain reaction (PCR). Human genomic DNA was amplified by PCR with oligodeoxyribonucleotides (oligos) based on the DRD5 nucleotide (nt) sequence. Amplification of nt sequences between these oligos allowed the isolation of two independent intronless genes that share identity with DRD5. The full-length clones have also been isolated by screening human genomic libraries. The deduced amino acid sequences for these genes, PG-1 and PG 2, share 91% and 92% identity to DRD5, respectively. However, each of the genes contains differences in the coding regions that would render these genes incapable of encoding functional receptors. Thus, the human genome contains at least two DRD5 pseudogenes, consistent with in situ human chromosomal hybridization analysis which reveals the presence of two pseudogenes. PMID- 1765270 TI - Identification of cis-regulatory sequences in ascidian ribosomal DNA using a rapid filter-binding assay. AB - Using 32P-labelled random primed ribosomal DNA (rDNA) from the ascidian, Herdmania momus, multiple and large-scale filter-binding assays were performed to identify cis-regulatory sequences interacting with H. momus oocyte germinal vesicle protein. A vacublot apparatus was used to isolate DNA-protein complexes, providing a means of filtering multiple binding reactions simultaneously and for isolating sufficient amounts of bound DNA for further investigations. DNA bound to the filter was used to identify unknown cis-elements in the rDNA by Southern blot analysis. The trapped rDNA hybridized specifically to the intergenic spacer, a region which contains cis-regulatory sequences that interact with rDNA transcription factors in several other species. Gel shift analysis of intergenic spacer fragments and native Southwestern blots confirmed that cis-elements were localized in the rDNA intergenic spacer. In principle, this method allows for the rapid identification of cis-regulatory sequences within any large, cloned DNA fragment which interact with nuclear extract. PMID- 1765269 TI - Two introns in the pheromone 3-encoding gene of Euplotes octocarinatus. AB - The portion of the pheromone 3 (Phr3)-encoding gene (phr3) of Euplotes octocarinatus, corresponding to secreted Phr3 was isolated using the polymerase chain reaction and oligodeoxyribonucleotide primers flanking the Phr3-encoding cDNA. Unexpectedly, the sequence analysis revealed that this gene is interrupted by two introns with lengths of 63 bp and 72 bp. These introns belong to the class of nuclear pre-mRNA introns and contain typical 5'- and 3'-consensus sequences, as well as unique features. Our findings constitute the first example of introns in any Euplotes species and the first case of multiple introns in hypotrichous ciliates. In ciliates such as Euplotes, the macronucleus is the transcriptionally active nucleus. It develops from a micronucleus in a process which involves chromosome breakage and the elimination of up to 95% of the micronuclear genome. The existence of the introns in the macronuclear version of phr3 shows that, in spite of this extensive elimination, some noncoding sequences are nevertheless retained in the macronucleus of hypotrichous ciliates. It was recently discovered by Meyer et al. [Proc. Natl. Acad. Sci. USA 88 (1991) 3758-3761] that the Phr3 encoding cDNA contains three in frame TGA triplets coding for cysteine. The genomic sequence of phr3 confirms this finding. PMID- 1765271 TI - Nucleotide sequence of a cDNA encoding rat brain carbonic anhydrase II and its deduced amino acid sequence. AB - A carbonic anhydrase II (CAII)-encoding cDNA clone was isolated from a rat brain lambda gt11 library. The 1459-bp cDNA codes for 260 amino acids with sequence similarity to mouse and human CAII and hybridizes to a single 1.7-kb mRNA. PMID- 1765272 TI - The gene encoding rat liver glycogen phosphorylase contains multiple polyadenylation signal sequences. AB - RNA blot analysis of rat liver and adipose tissues detected two glycogen phosphorylase (GP)-encoding transcripts. The polymerase chain reaction was used to characterize the 3'-noncoding region of the gene (L-GP) encoding liver-GP (L GP) from the lean Zucker rat (Fa/Fa). Three distinct classes of colinear cDNA clones were identified by nucleotide (nt) sequence analysis, demonstrating that the L-GP gene contains at least three functional polyadenylation sites. The predominant L-GP transcript was generated by polyadenylation 130 nt 3' from the end of the coding region. A previously uncharacterized L-GP transcript is generated by polyadenylation at 346 nt 3' of the first polyadenylation site. Polyadenylation site selection does not appear to be regulated in a tissue specific fashion. The relative steady-state L-GP mRNA levels in the different types of adipose tissues were comparable to, or exceeded transcript levels in liver. PMID- 1765274 TI - Cloning and nucleotide sequence of the structural gene encoding for human tryptophanyl-tRNA synthetase. AB - A structural gene encoding bovine (b) tryptophanyl-tRNA synthetase (WRS) has recently been cloned and sequenced [Garret et al., Biochemistry 30 (1991) 7809 7817]. Using part of this sequence as a hybridisation probe we have cloned and sequenced a structural gene encoding human polypeptide highly homologous with two mammalian proteins, bWRS [Garret et al., Biochemistry 30 (1991) 7809-7817; EMBL accession No. X52113] and rabbit peptide chain release factor [Lee et al., Proc. Natl. Acad. Sci. USA 87 (1990) 3508-3512]. Identification of the sequence encoding a human WRS is based on (i) the presence of 'HIGH' and 'KMSKS' structural motifs typical for class-I aminoacyl-tRNA synthetases [Eriani et al., Nature 347 (1990) 203-206]; (ii) coincidence of the number of SH groups per subunit estimated experimentally [Muench et al., Science 187 (1975) 1089-1091] and deduced from the cDNA sequence (six in both cases); (iii) close resemblance of two WRS polypeptides sequenced earlier [Muench et al., Science 187 (1975) 1089 1091] and the predicted structure in two different regions. PMID- 1765273 TI - Molecular evolution of the urate oxidase-encoding gene in hominoid primates: nonsense mutations. AB - Nucleotide sequences of portions of second and fifth exons of urate oxidase encoding gene (UOX) of chimpanzee, gorilla, orangutan, rhesus monkey and squirrel monkey obtained following amplification by polymerase chain reaction have been compared with corresponding sequences of human, baboon and rat UOX. Two or more nonsense mutations are found in the coding regions of this UOX gene thus far analyzed in human, chimpanzee, gorilla and orangutan, but not in the baboon, rhesus monkey and squirrel monkey. Of these nonsense mutations, the stop codon at amino acid position 33 is constant in the human and the three great apes suggesting that this may be the original mutation responsible for the inactivation of the UOX gene during hominoid evolution. PMID- 1765275 TI - Transcription factor requirements for U2 snRNA-encoding gene activation in B lymphoid cells. AB - Transcription of a human U2 small nuclear RNA(snRNA)-encoding gene in HeLa cells requires a distal enhancer element, which is composed of one octamer motif (Oct) and three Sp 1-binding sites. To study the transcription factor requirement in B cells, different U2 enhancer constructions were transfected into the lymphoid cell line, BJA-B. The results showed that the activation of U2 snRNA transcription in B-cells also requires an enhancer comprising both the Oct and at least one Sp 1-binding site. Deletion of all the Sp 1-binding sites from the enhancer reduces transcription by 80-90% in HeLa, as well as in BJA-B cells, whereas the removal of the octamer-binding site reduces transcription to levels below detection in both cell types. Enhancers containing a single Oct have, nevertheless, the capacity to partially activate U2 snRNA transcription in both HeLa cells, in which only OTF-1 is expressed, and in BJA-B cells in which OTF-2 is the predominantly expressed octamer-binding factor. The most likely interpretation of our results is that both the ubiquitous transcription factor, OTF-1, and the B-cell-specific transcription factor, OTF-2, can activate U2 snRNA transcription. The results also revealed a similar functional cooperation between the transcription factors which bind to the Oct and the adjacent Sp 1-binding site in BJA-B cells, as has been observed in HeLa cells, since a template which contains a weak binding site for OTFs expresses wild-type levels of U2 snRNA in both cell types when the weak octamer-binding site is combined with a Sp 1 binding site. PMID- 1765276 TI - The long leader sequence of the mouse ornithine decarboxylase mRNA, previously suspected to be a cloning artifact, is probably a product of recombination with MuLV-like retrovirus. AB - Sequence analysis of the first 549 nucleotides (nt) of the non-translated 5' end of the cloned mouse ornithine decarboxylase (ODC; L-ornithine carboxy-lyase, EC 4.1.1.17)-encoding sequence shows that this sequence is closely related to nt 1946-1395 of Moloney murine leukemia virus (MuLV). The viral sequence, however, is oriented anti-sense relative to the ODC sequence. This orientation makes it unlikely to be a cloning artifact mediated by reverse transcriptase, but rather a recombination between genomic DNA and a MuLV-like provirus. In the cell line, from which the cDNA clone originated, Katz and Kahana [EMBO J. 8 (1989) 1163 1167] have shown that an intragenic deletion and amplification of the ODC gene had taken place. We believe that an additional recombination also has occurred in this cell line. The cDNA clone studied was obtained after selecting for high ODC expression. It is conceivable that the retroviral sequence contains an intragenic enhancer which is also functional in the anti-sense orientation. The inserted sequence contains two repeats which share homology with known enhancer elements. The reported recombination event shows that caution is needed when selective pressure is applied for the isolation and characterization of genes. PMID- 1765277 TI - A new vaccinia recombinant plasmid pSC-O. AB - A new plasmid pSC-O for generation of recombinant vaccinia virus was constructed. It offers additional advantages when compared with other widely used insertion vectors. This plasmid allows the expression of coding sequences lacking codons for the initiation as well as for termination of translation. Additional sequences modulating translation, but also transcription or affecting intracellular processing can be introduced. Sequences flanking the transcription unit of the gene of interest are complementary to SP6/T7 sequencing primers and thus may allow rapid sequencing (amplification) of the inserted DNA. PMID- 1765278 TI - Lymphocyte proliferation and sister chromatid exchange in Alzheimer's disease. AB - Sister chromatid exchange (SCE) and lymphocyte proliferation were studied in peripheral lymphocyte cultures derived from 5 patients with Alzheimer disease (AD), 5 control elderly subjects and 5 young donors. These parameters did not differ significantly between the AD group and the elderly control group, but higher SCE frequency and less intensive proliferation were observed in the AD group and in the elderly control group when compared to the young donors. PMID- 1765279 TI - Effect of age on thermal inactivation of glucose-6-phosphate dehydrogenase in liver and kidney of the male garden lizard. AB - A comparison between middle-aged and old lizards revealed no significant age change in glucose-6-phosphate dehydrogenase activity of liver and kidney. Thermal inactivation at 51 +/- 1 degree C induced a significantly higher degree of decline in enzyme activity of tissues of old than that of middle-aged lizards. The increase in thermolability of enzyme in liver and kidney of ageing lizards suggests an accumulation of altered enzyme molecules. PMID- 1765280 TI - Age-related elevation of lipid peroxidation products: diminution of superoxide dismutase activity in the central nervous system of rats. AB - Alteration in lipid peroxidation products such as lipid peroxides, lipid hydroperoxides were studied in different regions of CNS of ageing rats (13, 26, 52, 78 and 104 weeks). The levels of lipid peroxide and lipid hydroperoxide were increased in various regions of brain and spinal cord. However, the activity of superoxide dismutase was decreased in cerebrum, hypothalamus, hippocampus, cerebellum, brain stem and spinal cord. The present communication demonstrates that the different parts of CNS at 13 and 26 weeks of age have lipid peroxidation products different from that of 104-week-old rats. PMID- 1765281 TI - Effect of exercise training on antioxidant and metabolic functions in senescent rat skeletal muscle. AB - Aging is known to be associated with alterations of both oxidative capacity and antioxidant status in skeletal muscle. In the present investigation we compared the activity of enzymes involved in both metabolic functions and antioxidant defense capacity in young adult (5 months old) and senescent (27.5 months old) Fischer 344 rats. In addition, we studied the effects of chronic exercise training on these enzymes in the senescent skeletal muscle. Old sedentary rats had significantly lower glutathione peroxidase (GPX) activity (-22%, p less than 0.05) in the deep portion of vastus lateralis muscle (DVL) than young sedentary rats, but after a progressive 10-week treadmill training program GPX activity in DVL was significantly increased in old rats to a level higher than that seen in young sedentary rats. Superoxide dismutase and catalase activities in the DVL were not altered significantly with aging or by training. Glutathione S transferase activity in the same muscle was elevated (p less than 0.05) with aging but unaffected by training. Citrate synthase and malate dehydrogenase activities in the DVL muscle were significantly decreased in senescence, whereas training increased these two enzyme activities by 71 and 48%, respectively (both p less than 0.05). Lactate dehydrogenase activity in the same muscle decreased with age but increased 23% (p less than 0.05) in old rats. These data indicate that while aging may significantly affect antioxidant and metabolic capacities in skeletal muscle, regular exercise can preserve functions of these enzyme systems at old age. PMID- 1765282 TI - Factors associated with Colles' fracture in the elderly. AB - We have measured sway, hearing and eyesight in a group of elderly patients with Colles' fracture (3 males, 21 females, mean age 75.9 years) and in a control group of elderly fallers (5 males, 19 females, mean age 76.9 years) who had no fractures. The Colles' fracture group had better eyesight than the control group (p = 0.022), but worse hearing, particularly at lower frequencies (p less than 0.0001 at 500 Hz), suggesting a conductive hearing loss. We conclude that those individuals with better eyesight would try to stretch their arm to break a fall, so breaking their wrist. Osteoporotic changes in the auditory ossicles is proposed as a possible cause for the hearing loss in the Colles' fracture group. We conclude that those individuals presenting with Colles' fracture may also have hearing loss and conversely, patients presenting with a conductive hearing loss may be at risk of developing the further symptoms of osteoporosis. PMID- 1765283 TI - A novel approach to the assessment of drug compliance in the elderly. AB - A reliable drug history is not always available, and the constant accurate updating of patients' current medication at a Day Hospital may be difficult. This pilot study examined the use of a qualitative thin-layer chromatographic technique (Toxi-Lab system) applied to urine specimens in assessing drug compliance in the elderly. The system proved capable of detecting 36% of prescribed drugs in a group of elderly patients, and offers a novel and inexpensive approach to monitoring compliance with certain medications. PMID- 1765284 TI - Serum erythropoietin levels in the elderly. AB - We evaluated the relationship between erythropoietin (EPO) and hemoglobin (Hb) concentrations in 156 normal subjects ranging from 60 to 98 years old. EPO was determined by a radioimmunoassay. The serum EPO concentration in subjects with Hb concentrations greater than 12.0 g/dl (26.9 +/- 15.2 mU/ml), was significantly higher than that in younger controls (15.8 +/- 5.0 mU/ml, p less than 0.001). No sex difference in serum EPO level was detected. In addition, there was an inverse semilogarithmic relationship between EPO and Hb concentrations in subjects with Hb concentrations less than 12.0 g/dl (r = -0.559, p less than 0.001). EPO concentrations in the elderly were lower than those in young subjects with iron deficiency anemia with the same Hb level. Thus, in the elderly, a high EPO concentration may be preventing a decrease in the Hb concentration. However, a decreased EPO response to low Hb concentrations may be a contributing factor in anemia in the elderly. PMID- 1765285 TI - Labyrinth learning impairment in presenile dementia: 1 year later. PMID- 1765286 TI - The learning and fatigue effect in automated perimetry. AB - A visual field test was performed on 100 volunteers to study learning or fatigue effects during one session. The test was carried out with the help of the Octopus program J1, which measures the threshold 12 times at 3 test locations. In the majority of cases the sensitivity was quite stable during the session. We noted no difference between trained and untrained subjects or between normal and pathological eyes. However, patients with refractive errors, especially myopes, revealed a larger learning effect than did emmetropes. PMID- 1765287 TI - Argon-laser gonioplasty following goniosynechialysis. AB - We performed laser gonioplasty following goniosynechialysis on 12 eyes that exhibited a very narrow angle. In these cases, angle closure had recurred postoperatively, although gonioscopy carried out at the time of goniosynechialysis revealed opening of the trabecular meshwork. The use of laser gonioplasty following goniosynechialysis was most effective in flattening the configuration of the iris and opening the iridocorneal angle. The induced alteration of the structure of the iris remained unchanged in all cases throughout the follow-up period, and intraocular pressure remained below 20 mmHg in 9 of the 12 eyes. It thus appears that a combination of goniosynechialysis and laser gonioplasty may be effective in the management of refractory angle-closure glaucoma in the presence of an extremely narrow angle. PMID- 1765288 TI - Electroretinographic responses in patients with pulseless disease vary with head and body positions. AB - We examined bright-flash electroretinograms obtained in two Japanese women with pulseless disease. One 48-year-old woman (case 1) who has had the disease for 17 years showed no oscillatory potentials. When she sat and tilted her head to the right, a- and b-wave amplitudes diminished in the left eye. A second 48-year-old woman (case 2) who has had the disease for 10 years also demonstrated absent oscillatory potentials. When she sat and raised her chin, a- and b-wave amplitudes diminished in both eyes. These amplitudes were normal when the patients were in a supine position. PMID- 1765289 TI - Experience with transscleral fixation of posterior chamber lenses. AB - A total of 83 eyes with transsclerally sutured PCLs were followed for an average of 10.5 months (range 2-23 months). The vast majority of patients benefitted considerably from the procedure; 8% of cases experienced a reduction in visual acuity and 2% suffered monocular visual loss. General vascular risk factors seemed to be important in bringing about long-term complications. Patients presenting such a risk must be better identified in the future. The solution of some remaining surgical problems and questions will also add to the safety of the procedure in the future. PMID- 1765290 TI - Comparison of retinal nerve-fiber layer in high- and normal-tension glaucoma. AB - In all, 20 eyes of 20 normal-tension glaucoma (NTG) patients and 20 eyes of high tension glaucoma (HTG) patients matched for similar visual field defects underwent retinal nerve-fiber-layer (RNFL) analysis using a computerized digital image analysis system. Subjects with NTG showed more localized RNFL loss than diffuse loss as compared with HTG patients. The results support the hypothesis that there may be different mechanisms of damage in glaucoma. PMID- 1765291 TI - Pseudophakic retinal detachment. AB - A total of 93 cases of pseudophakic retinal detachment are reported. The present study showed that vitreous loss had occurred during cataract surgery in 28% of eyes, indicating that anterior segment complications are an important contributory factor to aphakic retinal detachment in these cases. There was impairment of the retinal view in 46% of eyes, and in 22.5% no retinal breaks could be identified. The main factor responsible for poor visibility was inadequate pupillary dilatation, which was found particularly in association with the use of iris-supported lenses. Detachment of the macula was unexpectedly found to occur in as many as 88% of cases. Reattachment of the retina either by conventional detachment procedures or by pars plana vitrectomy was achieved in 76.3% of eyes. Complications directly attributable to the presence of an intraocular lens (such as dislocation or haemorrhage) are described. Failure of surgery was more likely to occur in eyes exhibiting a poor fundal view, in which the detection of retinal breaks was difficult. The best results were achieved in eyes in which posterior-chamber lenses had been implanted. PMID- 1765292 TI - Serous macular detachment associated with optic nerve pits. AB - Between September 1972 and March 1989, we examined 25 eyes of 24 patients exhibiting optic nerve-head pits associated with serous macular detachment. We followed 21 patients for a period of 1-15 years (mean, 62 months). Various treatment modalities were applied, depending on the time of initial examination. Five eyes underwent no treatment and three eyes underwent two distinct treatment modalities. Photocoagulation treatment was performed in ten eyes. Argon laser photocoagulation was combined with intravitreal injection of pure SF6 in eight eyes and of C3F8 in three. Intravitreal injection of pure C3F8 without photocoagulation was carried out in two eyes. The results of biomicroscopy of the vitreous gel and of fluorescein angiography and the responses to the various treatment modalities support the hypothesis that the mechanism underlying serous macular detachment complicating optic nerve-head pits is traction retinal detachment combined with a rhegmatogenous component in the roof of the optic pit. PMID- 1765293 TI - Epithelial permeability in corneal grafts by fluorophotometry. AB - The epithelial permeability to fluorescein of 27 clear corneal grafts in 23 patients was determined by fluorophotometry at greater than 1 year after penetrating keratoplasty (PKP) so as to study the recovery of corneal epithelial function. The mean epithelial permeability of the corneal grafts did not differ significantly from that of normal corneas (0.042 +/- 0.016 and 0.038 +/- 0.017 nm/s, respectively; P greater than 0.3). Multiple linear regression analysis showed that permeability correlated with recipient age but not with donor age (permeability increase, 0.00054 nm/s per year; r = 0.6, P less than 0.005 and r = 0.1, P greater than 0.5, respectively). These results indicate that corneal grafts can regain a normal epithelial barrier function and that recovery of epithelial function is better in young than in old recipients. PMID- 1765294 TI - Idiopathic posterior subretinal neovascularization (IPSN) is related to myopia. AB - In 153 eyes with idiopathic posterior subretinal neovascularization (IPSN) and myopia of no greater than -6 dpt, the relative risk of this disorder was determined with regard to refraction. It was shown that the probability of developing this condition is directly proportional to the degree of myopia. By using data obtained from the literature for calculating the relative risk regarding refraction, it was demonstrated that the same is true for subretinal neovascularization in degenerative myopia greater than -7.5 dpt (Fuchs' spot). The relative risk for developing one of both disorders increases exponentially with increasing myopia. PMID- 1765295 TI - Management of retinal detachment after penetrating eye injury. AB - Between December 1981 and April 1989 the authors operated on 61 eyes presenting with retinal detachment after penetrating eye injury. Air or expanding gases were used for retinal tamponade. The follow-up between complete gas absorption and last examination ranged from 8 months to 8 years (mean, 29 months). Retinal reattachment was achieved in 50 eyes (81.9%). Anatomic success was achieved by a single operation in 43 eyes (70.5%). A postoperative visual acuity of 20/40 or better was achieved in 46% of the eyes. The factors found to influence the postoperative outcome adversely include (1) association of severe blunt trauma (P less than 0.05), (2) anterior proliferative vitreoretinopathy (PVR) involving two or more quadrants (P less than 0.01), and (2) retinotomies (P less than 0.007). PMID- 1765296 TI - Relationship between peripheral vascular closure and proliferative retinopathy in sickle cell disease. AB - In a study involving 97 patients with hemoglobin SC sickle cell disease (Hb SC) and 87 subjects with hemoglobin SS sickle cell disease (Hb SS) on the island of Curacao, we found a higher incidence of peripheral retinal vascular closure and proliferative retinopathy in the former as compared with the latter. Examination of composite fluorescein angiograms obtained from 15 Hb SS and 36 Hb SC patients, whose mean and median age were the same and in whom more advanced stages of sickle retinopathy were equally represented, revealed statistically significantly smaller measurements of perfused retina (indicative of larger areas of non perfusion) in Hb SC patients as compared with Hb SS patients (P = 0.002, P = 0.014) as well as in subjects exhibiting neovascularization as compared with those who did not (P = 0.022, P = 0.004). This suggests that a vaso-occlusive tendency in the retina is greater in individuals with Hb SC than in those with Hb SS; the more extensive ischemic areas provide a stimulus for neovascularization, explaining the higher prevalence of proliferative retinopathy in the former patients as compared with the latter. PMID- 1765297 TI - Effect of eledoisin on tear volume and tear flow in humans as assessed by fluorophotometry. AB - Topical application of the endekapeptide eledoisin has been reported to increase tear secretion in patients with dry eye. However, to date the efficacy of eledoisin has been proved only by methods that are not easily reproduced and have an enormous intraindividual scatter range (Schirmer test, basic secretion test). In the present study the effect of topically applied eledoisin on tear volume and tear flow was determined quantitatively by means of objective fluorophotometry in 40 subjects, 20 of whom suffered from severe dry eyes. Both tear volume and tear flow were found to be significantly increased up to 2 h after instillation, reaching a maximum 1 h after application (tear volume: +87% and +35% for dry eyes and healthy controls, respectively; tear flow: +250% and +27% for dry eyes and healthy controls, respectively). PMID- 1765298 TI - Factors influencing the ocular pulse--the heart rate. AB - Using pneumotonometry combined with a Langham ocular blood-flow system, measurements of pulsatile ocular blood flow (POBF) were performed in eight ocular normotensive patients with implanted cardiac pacemakers, with the subjects assuming both the erect and the supine postures. Sequential measurements of POBF were made at pre-set values of heart rate over the physiological range between 60 and 120 beats/min at intervals of 10 beats/min. With patients in the supine position, measurements of cardiac output and stroke volume indices were also recorded by impedance cardiography. The mean pulse amplitude of the intraocular pressure (the ocular pulse) decreased as heart rate increased, and this change was statistically significant in both postures according to repeated-measures analysis of variance (erect: f = 18.7, P less than 0.0001; supine: f = 18.8, P less than 0.0001). As measured in supine patients following an increase in heart rate, the pulse amplitude decreased in parallel with a decline in stroke volume index (f = 18.8, P less than 0.0001). Up to a level of 90 beats/min, the mean POBF increased with heart rate, but it declined above this rate in both erect and supine postures. At all heart rates, intraocular pressure was higher when subjects were supine than when they stood erect (f = 4.3, P less than 0.001). At lower heart rates of 70 and 80 beats/min, ocular pulse volume and POBF were significantly lower in supine patients than in erect subjects (70 beats/min: t = 3.89, P less than 0.01 vs; t = 3.87, P less than 0.01; 80 beats/min: t = 2.85, P less than 0.05 vs; t = 2.87, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765299 TI - The principle of retinal rheometry. AB - A novel technique termed retinal rheometry, which is used to quantify the microcirculation of the human retina, is detailed. The applicability of different types of technological equipment (cameras and laser scanning ophthalmoscopes, among others) to the proposed technique are compared. The individual steps of the data reduction process are presented, and initial results obtained in a small population of healthy volunteers are given. PMID- 1765300 TI - Experimental traction retinal detachment in the cat. AB - We developed a reproducible model of traction retinal detachment (TRD) in the cat eye by creating a serous retinal detachment and then injecting 2.5 x 10(5) kitten dermal fibroblasts into the vitreous cavity at the site of a retinal wound. Serous detachments were produced by exposing an area of retina to focused light after intravenous injection of rose bengal (a photosensitizing dye). TRD developed rapidly within the first 2 weeks after fibroblast injection, accompanied by the formation of vitreoretinal strands and, to a lesser degree, epiretinal and/or subretinal proliferation. Histopathology demonstrated fibroblasts within the vitreous or along the posterior hyaloid face. Focal deposits of fibroblasts were occasionally found on the inner surface of the retina and/or in the subretinal space. Fibroblast proliferation was confirmed by uptake of radiolabeled thymidine. Deposition of collagen was noted at as early as 3 days after fibroblast injection. Neovascularization was not observed. Control eyes that did not receive fibroblasts showed resolution of serous detachment without retinal traction. In all eyes, retinal degeneration and thinning were seen in the area of previous photodynamic treatment. In this model of TRD, anteroposterior traction (due to vitreous strands) predominates, as is observed in experimental posterior penetrating ocular injury induced by intravitreal blood injection, which also results in vitreous strand formation. Our model, however, enables clinical assessment of TRD in the cat without the media opacification produced by vitreous blood. PMID- 1765301 TI - Intraretinal oxygen tension in the rat eye. AB - Oxygen-sensitive microelectrodes were used to measure the intraretinal oxygen distribution in the rat during both air and oxygen breathing. During air breathing the average PO2 profile obtained showed a value of 19 +/- 2.5 mmHg (n = 36) at the internal limiting membrane (ILM). As the penetration depth increased, a minimal PO2 of 8.2 +/- 2.4 mmHg was attained at 50% of the retinal depth, from which point the PO2 increased to a peak of 33 +/- 3.3 mmHg at 100% of the retinal depth at Bruch's membrane. During oxygen ventilation, all intraretinal oxygen tensions were increased and the profile became almost monotonic, increasing from 36.1 +/- 3.3 mmHg (n = 9) at the ILM to 134.3 +/- 6.7 mmHg at 100% of the retinal depth. These results are qualitatively similar to those found in the cat, and they demonstrate the importance of oxygen delivery by both the retinal and the choroidal circulation during normoxia, as well as the inability of vascular autoregulation to maintain a constant retinal PO2 during hyperoxic ventilation. PMID- 1765302 TI - "Black prosthesis" revisited: a study of epinephrine-induced pigment deposits on poly(methyl methacrylate). AB - To investigate in detail the "black prosthesis" syndrome, experimental production of melanin from epinephrine was performed both in bulk and onto the surface of a common prosthetic material, poly(methyl methacrylate) (PMMA). The study by ultraviolet/visible spectrometry showed that the radiation-absorptive properties of PMMA were significantly enhanced; a sample treated for 20 days in epinephrine absorbed all ultraviolet radiation up to a 344-nm wavelength and transmitted only 4.9% from the ultraviolet spectrum at 400 nm and 16.2% from the visible spectrum at 500 nm. Transmission electron microscopy studies suggest that melanogenesis occurs on the surface of PMMA, and the pigment does not penetrate the polymer. Using infrared spectrometry, it was confirmed that the pigmentation is caused by a melanin formed through the oxidative polymerization of epinephrine. PMID- 1765303 TI - Central retinal artery occlusion after local anesthesia for blepharoplasty. PMID- 1765304 TI - [Systematic examination of the uterine cavity after parturition]. AB - The revision of uterine cavity afterbirth should be a process preventing complications immediate or late during puerperium, due to the retention of ovular remains that are not diagnosed in opportunely, avoiding so the risk that implies for the patients who show bleeding that leads them to complications of hemorrhaging in the interest of puerperal infection, with consequences so serious such as mutilation or death, otherwise undergoing surgery under poor conditions, in addition to the extra administrative costs, that imply surgery and those costs, derived from hospitalization; 1,205 patients were studied. On 1,155 the revision of the uterine cavity was performed; only one of them developed complications irrelevant to the process, consisting in fever, uterine subinvolution, more than normal hemorrhaging. On fifty patients the uterine cavity afterbirth was not found, fourteen patients experienced greater than normal hemorrhaging and hypothermia two to five days after being released, caused by the presence of ovarian remains, requiring posterior hospitalization. One patient experienced inflammation of the peritoneo due to the presence of placental remains. PMID- 1765305 TI - [Cervical isthmus myomatosis]. AB - Ten patients with isthmico-cervical leiomyoma as the only one localization, were surgically treated, from Jan, 1989 to May, 1990. It was 2.8% of all treated myomatosis. Average age was 42.4 years, with gestation of 1.1 per patients. Nine cases were treated by the abdominal via. One case presented with a recurrence. These cases represent a technico-surgical difficulty, due to tumor localization and size, as well as an ample knowledge about pelvic structures, in order to avoid digestive tract lesions, urinary and vascular. The present series confirms that this type of surgery is justified considering morbi-mortality, so it would be possible a definite histopathological evaluation. PMID- 1765306 TI - [Pregnancy in a non-communicating rudimentary uterine cavity. Presentation of a case in a multipara]. AB - A case of pregnancy in a rudimentary uterine horn is presented. The pregnancy developed asymptomatically until the 14th week when spontaneous rupture of the uterine horn occurred. The diagnosis was made at laparotomy indicated for hypovolemic shock due to intraperitoneal hemorrhage. The pathologic study of uterine horn showed a normally developed fetus and the placental tissues protruding at the rupture site of horn. The purpose of this paper is analysis of fecundation, implantation and the type of endometrium of the rudimentary uterine horn. PMID- 1765307 TI - [Identification of Mycoplasma hominis and Ureaplasma urealyticum in patients with sterility of tubal origin]. AB - The peritoneal fluid of two groups of patients was cultivated; the first one was of 67 patients with tuboperitoneal problem; the second of 14 patients was the control; we founded Mollicutes in 39% of the patients of the problem group and 28% of the control group. The correlation between laparoscopic aspects with the positive Mollicutes cultures suggested the infection by Mollicutes in the tubal cause of sterility. PMID- 1765308 TI - [Myth and realities about the follicle which does not release the ovum and minimal endometriosis]. AB - The intact luteinized follicle is closely related to minimal endometriosis. This one alters the biology of pelvic peritoneum in ways about which there is not accord or agreement, but that surely influence clinical manifestations of disease. In fact, fertility is altered, but the intimal mechanism for it, is unknown. PMID- 1765309 TI - Effects of nifedipine on normotensive rat placental blood flow, placental weight and fetal weight. AB - Recently, nifedipine (Ca antagonist) has been used for the treatment of preeclampsia. In this study, we investigated the effects of nifedipine on the normotensive Wistar Kyoto rat's placental blood flow, fetal weight and placental weight. We measured the rat's placental blood flow using clearance of hydrogen gas generated by electrolysis. The placental blood flow, placental and fetal weights of nifedipine-treated rats (5, 10 and 25 mg/kg) were significantly (p less than 0.05) reduced compared with normal pregnant rats. These data suggest that nifedipine might have some reducing effects on placental blood flow, fetal weight and placental weight. PMID- 1765310 TI - Transplacental transfer of ritodrine and its effect on placental glucose and oxygen consumption in an in vitro human placental cotyledon perfusion. AB - Maternofetal transfer of ritodrine and its effect on placental glucose and oxygen consumption were studied using a recycling perfusion of maternal and fetal circulations of an isolated cotyledon of a term human placenta. 3H-labeled ritodrine was introduced into the maternal side of the perfusion system. Transfer was calculated from the linear rise of ritodrine concentrations on the fetal side and was found to be 7.31 +/- 1.02 ng/g placental wet weight/min (SEM) when 1.4 micrograms/ml of ritodrine was used (n = 3) and 14.7 +/- 1.06 ng/g placental wet weight/min when the concentration was 2.8 micrograms/ml (n = 5). The antipyrine transfer rate, 4.1 +/- 0.51 mg/kg/min (n = 8), was used to demonstrate perfusion adequacy and served as an internal standard. Upon computing the mass balance of ritodrine and antipyrine at the end of the experiment, it was found that 17% of ritodrine disappeared from the perfusion system compared to 0.7% of antipyrine (p less than 0.01). The introduction of ritodrine into the perfusion system did not affect placental glucose and oxygen consumption rates of 0.35 +/- 0.01 mumol/g/min (n = 7) and 0.19 +/- 0.013 mumol/g/min (n = 5), respectively. PMID- 1765311 TI - Ovine fetal breathing and swallowing activity in response to plasma glucose changes. AB - Fetal swallowing activity generally occurs simultaneously with fetal breathing movements (FBM) in sheep. The present study investigated the FBM and swallowing responses to altered fetal plasma glucose. Fetal lambs were chronically prepared with laryngeal, esophageal and diaphragm electromyogram (EMG) wires, an esophageal flow probe and vascular catheters. Beginning at 138 +/- 1 day, FBM and swallowing were monitored during control periods and in response to intravenous glucose infusions (14 mg/kg/min for 120 min) to fetuses of fed and fasted ewes. Glucose infusions to fetuses of fed ewes resulted in significant increases in fetal plasma glucose (21.2 +/- 0.7 to 40.5 +/- 1.9 mg/dl) and time breathing (46.2 +/- 6.3 to 60.0 +/- 9.5 min/2 h). In response to maternal fasting, fetal glucose levels (13.4 +/- 1.0 mg/dl) and time breathing (23.0 +/- 7.2 min/2 h) decreased significantly. Glucose infusion to fetuses of fasted ewes resulted in significant increases in time breathing (50.3 +/- 13.4 min/2 h) and diaphragmatic EMG activity (1,295 +/- 654 to 3,012 +/- 1,182 spikes/2 h). There was no change from basal levels of fetal EMG swallows (83.2 +/- 4.3 swallows/2 h) or esophageal flow (40.8 +/- 7.9 ml/2 h) in response to maternal fasting or fetal glucose infusions. PMID- 1765312 TI - Relationship between fetal growth and echogenicity of the fetal liver. AB - This study investigates the relationships between the incidence and degree of echogenicity of fetal livers and some prognostic variables of pregnancy. This was done by measuring and evaluating the echogenicity of the fetal liver on sonograms and then comparing the degree of echogenicity to tabulations of the incidence of each of the prognostic variables. The echogenicity of each of the fetal livers was established by comparing them to the texture of the fetal bowels. They were then graded and divided into three categories: hypodense (diaphanous), isodense (medium density) and hyperdense (very dense). The results were then compared to the incidences of the complications of pregnancies as they occurred in the same patients. This study reveals that fetuses with hypodense livers have a higher than normal incidence of intrauterine growth retardation (p less than 0.01) and significantly lower than normal birth weight (p less than 0.01), especially when compared to those with isodense livers. Further, fetal distress plus Apgar scores of less than or equal to 7 were more common in fetuses with hyodense livers than in those with hyperdense livers (p less than 0.03). This study demonstrates (1) that measurements and analysis of echogenicity of fetal livers on sonograms are a safe, noninvasive method of evaluating fetal development and (2) that the sonograms can be useful indicators of fetal development and that they can aid physicians in managing the pregnancy. PMID- 1765313 TI - Midtrimester bleeding--variables which affect the outcome of pregnancy. AB - A prospective study of 65 women with midtrimester bleeding was undertaken in order to assess the outcome of pregnancy and to determine variables which significantly affect it. Of the entire group, 48 (73.8%) delivered after 26 weeks of gestation (39 of them at term). The total fetal loss (abortions plus perinatal deaths) was 31.8%. Three patients who needed blood transfusions subsequently required immediate termination of pregnancy due to severe bleeding. Discriminant analysis revealed that three independent variables had a significantly unfavorable effect on the outcome of the pregnancies: a decrease in hemoglobin of more than 1 g%, duration of hospitalization (reflecting duration of bleeding) of more than 1 week and the presence of a previous uterine scar. PMID- 1765314 TI - Prognostic value of cervical distensibility index measurement in the outcome of pregnancies with threatened premature labor. AB - Threatened premature labor remains a difficult diagnostic and therapeutic problem, and various clinical scores have been designed to evaluate its prognosis. This study presents the use of a cervicotonometer to measure cervical distensibility in 58 women hospitalized for threatened premature labor. This value will be used to determine whether preterm labor is preceded by preterm cervical maturation and thus to assess prognosis. The cervical distensibility index (CDI) obtained with the cervicotonometer was significantly elevated at the time of hospitalization in women who had a preterm delivery when compared to those who delivered at or after 37 weeks of amenorrhea, whereas clinical scores showed no difference between these two groups. No preterm deliveries occurred when the CDI was normal or low at the time of hospitalization. Therefore, CDI measurement, reflecting cervical maturation, seems to be a good prognostic indicator in premature labor. PMID- 1765315 TI - Cardiac output in anencephalic fetuses. AB - The cardiac output was measured by means of Doppler echocardiography in four anencephalic fetuses during the late second or third trimester of pregnancy. Anencephalic fetuses showed a higher dominance of right ventricular output when compared to healthy fetuses, suggesting that the relationship between brain mass and body weight affects the distribution of cardiac output. PMID- 1765316 TI - Relationship between mechanical properties of the uterine cervix and occurrence of postdate pregnancy. AB - Postmaturity is associated with an increased risk of fetal distress and of intrauterine fetal death. In order to assess the probability of the occurrence of postdate delivery, we have determined the Bishop score and measured the cervical distensibility index (CDI) using a cervicotonometer in 52 normal pregnant primiparous women between 37 and 40 weeks of pregnancy. 16 out of the 52 patients delivered after 41 weeks. Bishop scores and CDI were significantly lower in women who delivered after term than in those who delivered at or before 41 weeks (p less than 0.05; Student's test). The patients who had both a low Bishop score (less than or equal to 4) and a CDI less than 4 cm.kg-1 delivered after 41 weeks in 73% of the cases. Those who had a Bishop score less than or equal to 4 associated with a CDI greater than 4 cm.kg-1 delivered at or before 41 weeks in 80% of the cases. These results confirm the etiologic role of incomplete cervical maturation in postdate pregnancies. CDI measurement associated with the Bishop score could permit selection of the patients who would benefit from pharmacological cervical ripening. PMID- 1765317 TI - Intravenous pethidine and nalbuphine during labor: a prospective double-blind comparative study. AB - The perfect analgesic regimen is constantly sought, no matter how labor is conducted. The quest for an effective drug that will afford maximum relaxation and pain relief with minimum interruption of any natural homeostatic mechanism is a foremost subject in present obstetric analgesics research. Synthetic alternatives are being offered, promising perfect compatibility with the clinician's demands. Nalbuphine, a semisynthetic narcotic agonist-antagonist analgesic of the penanthren series, is supposed not to be liable to cause respiratory depression and is expected to have fewer side effects. A double blind, randomised prospective study of 137 patients who received 10 mg nalbuphine or 50 mg pethidine i.v. during the active phase of labor in term was carried out. Maternal cardiovascular variables, pain intensity, progress of labor and fetal heart rate during labor were related to side effect and neonatal outcome (1- and 5-min Apgar scores and umbilical venous pH). Neither regimen showed an advantage over the other. Data analysis points to a possible transient depressive effect induced by nalbuphine on the fetal or neonatal central nervous system. PMID- 1765318 TI - Aryl hydrocarbon hydroxylase activity in the first-trimester human placenta: induction by carcinogens and chemoprotectors. AB - The activity of aryl hydrocarbon hydroxylase (AHH) was measured in the placenta using radioenzymatic techniques and benzo(a)pyrene (BP) as substrate. The optimal assay conditions were defined, including cofactor dependence. The Km of BP to the enzyme was 2 microM and Vmax 0.02 nmol/min. When compared to the AHH activity at term (0.35 +/- 0.03; mean +/- SEM), 1st-trimester activity was significantly lower (0.18 +/- 0.05; p less than 0.05). However, in the rat liver the enzyme activity was even higher than that found at term. In order to determine whether the 1st-trimester placental AHH activity is sensitive to environmental exposures, explants were incubated with two classes of xenobiotics: carcinogens and chemoprotectors. The carcinogen BP at 50 microM caused a significant (2.7-fold; p less than 0.05) increase in the enzyme activity after an incubation period of 6 h. After an incubation period of 24 h, however, no effect was noted. In contrast, 50 microM 20-methylcholanthrene had no effect. The effect of chemoprotectors was also examined: at 25 microM, coumarin, 2-(3)-tert-butyl-4-hydroxy-anisole, and 1 phenylazo-2-naphthol significantly increased 1.7, 1.7-, and 1.8-fold, respectively, the enzyme activity after an incubation period of 24 h (p less than 0.05). In conclusion, AHH in the 1st-trimester placenta is sensitive to environmental exposures and is induced in vitro by both carcinogen and chemoprotectors. PMID- 1765319 TI - The role of beta-lactamase-producing bacteria in obstetrical and gynecological infections. AB - Pelvic inflammatory disease (PID) is a polymicrobial infection that evolves multiple aerobic and anaerobic bacteria. Several of the bacterial pathogens that participate in PID can produce the enzyme beta lactamase. These include Bacteroides species (including Bacteroides bivius, Bacteroides disiens, and Bacteroides fragilis group), Neisseria gonorrheae, Enterobacteriaceae and Staphylococcus aureus. A recent increase in numbers of beta-lactamase-producing strains of these organisms in PID has been associated with increased failure rates of penicillins in eradication of this infection. These organisms cannot only survive penicillin therapy but also protect penicillin-susceptible pathogens from the drug. These direct and indirect virulence characteristics of beta lactamase-producing bacteria require the administration of appropriate antimicrobial therapy directed against all of these pathogens in the therapy of PID. PMID- 1765320 TI - Clinical significance of squamous cell carcinoma antigen in cancer of the human uterine cervix. Comparison with CEA and CA-125. AB - Serum squamous cell carcinoma antigen (SCCa) concentrations were determined by a radioimmunoassay kit before and during the treatment of 50 patients with cervical carcinoma: 44 with squamous cell carcinoma (SCC) and 6 with adenocarcinoma. The positivity rate of SCCa was 50% (52% for SCC and 33% for adenocarcinoma). The sensitivity of SCCa for SCC was twice as high as that of CEA and CA-125. Low serum concentrations were observed in early-stage carcinoma, indicating that SCCa is not useful for diagnosis. In advanced cases, serum levels were directly and significantly correlated with the stage of the disease. PMID- 1765321 TI - Pregnancy and relapse of peripheral T cell lymphoma. A case report. AB - A patient was admitted to our hospital, in the 34th week of her pregnancy, who presented a non-Hodgkin lymphoma. The delivery was induced in the 38th week and the newborn baby had no other anomalies than a single umbilical artery and a slight dilation of the cerebral ventricles which receded spontaneously. Peculiar characteristics, not previously described, were a peripheral T cell lymphoma with relapse after 5 years since its remission with chemotherapy. PMID- 1765322 TI - Acardiac acephalic monster extremely larger than its co-twin. A case report. AB - The acardiac monster represents a rare but one of the severest congenital anomalies which occur only in multiple pregnancy. The affected fetus is sustained by a parasitic anastomosis to the umbilical blood vessels of the normal fetus. We report an interesting case of a macrosomic acardiac acephalic fetus weighing 4.5 fold of another variable donor fetus (approximately 6 kg) in a twin pregnancy. PMID- 1765323 TI - Manufacturing processes at two French rapeseed oil companies: possible relationships to toxic oil syndrome in Spain. AB - The toxic oil syndrome (TOS) epidemic that occurred in Spain in spring 1981 has been associated with the consumption of rapeseed oil that was denatured with aniline for industrial use but diverted for human consumption. The precise aetiologic agent in the oil responsible for the outbreak has not been identified. To learn more about possible contaminants and how the contamination might have occurred, we visited two French companies that process rapeseed oil and that were identified in Spanish administrative and judicial records as the ones exporting aniline-denatured rapeseed oil to Spain in 1981. With the apparently full and voluntary co-operation of personnel at both companies, we reviewed the processes involved in manufacturing, treating and transporting rapeseed oil, and we have summarized the information provided to us. Of particular importance is the finding that oil exported to Spain was taken from stock, the rest of which was sold for human consumption in the French domestic market, apparently without any adverse health effects. The differences between the oil exported to Spain and the oil sold as food in France were that aniline equivalent to 2% of the weight of the oil was added to most of the Spanish oil but not to that sold in France, and that contamination of the Spanish oil may have occurred in the tank trucks used for transportation to Spain, which had previously carried industrial chemicals. There is no assurance that the trucks were cleaned appropriately for transporting a food product before the oil was loaded for the journey to Spain. Since the clinical manifestations of TOS are not those of aniline toxicity, we conclude that the aetiological agent of TOS is likely to be one of the following: (1) a contaminant in the aniline, (2) a contaminant introduced during transportation, (3) a reaction product of normal oil components or materials used in refining with either aniline or the potential contaminants mentioned under (1) or (2) above. PMID- 1765324 TI - Tissue disposition and excretion of 14C-labelled aflatoxin B1 after oral administration in channel catfish. AB - The pharmacokinetics, tissue distribution and excretion of 14C-labelled aflatoxin B1 (AFB1) were examined after oral administration (250 micrograms/kg body weight) in channel catfish (Ictalurus punctatus). Plasma concentrations of parent AFB1 were best described by a one-compartment pharmacokinetic model, in which peak plasma concentration (503 ppb) occurred at 4.1 hr after dosing. The absorption and elimination half-lives were 1.5 and 3.7 hr, respectively. AFB1 was highly bound (95%) to plasma proteins. Concentrations of 14C (in AFB1 equivalents) measured in the tissues were highest at 4 hr, ranging from 596 ppb in the plasma to 40 ppb in the muscle. AFB1 residues were rapidly depleted; at 24 hr the concentrations in the plasma and muscle were 32 and less than 5 ppb, respectively. Concentrations in the bile exceeded 2000 ppb (at 24 hr), whereas the highest concentration in the urine was 51 ppb (4-6-hr collection interval). Renal and biliary excretion accounted for less than 5% of the administered dose, indicating incomplete absorption. Pharmacokinetic modelling and tissue data demonstrate a very low potential for the accumulation of AFB1 and its metabolites in the edible flesh of channel catfish through the consumption of AFB1 contaminated feed. PMID- 1765325 TI - Influence of subchronic exposure to low dietary deoxynivalenol, a trichothecene mycotoxin, on intestinal absorption of nutrients in mice. AB - During a 6-wk feeding trial, effects of low dietary deoxynivalenol (DON; 0, 0.1, 1 and 10 ppm) on food consumption and weight gain were investigated in male mice. Food intake was similar in all four dietary groups. Weight gain in the group receiving 10 ppm DON was significantly (P less than 0.01) reduced. At the end of the feeding period, test animals were sacrificed and absorption of water, D glucose, L-leucine, L-tryptophan, 5-methyltetrahydrofolic acid and iron was measured in isolated perfused jejunal segments in vitro. No effects were observed on absorption of water, leucine, tryptophan and iron. However, at a dietary DON concentration of 10 ppm, a slightly but significantly (P less than 0.05) reduced transfer of glucose was measured. Furthermore, transfer as well as tissue accumulation of 5-methyltetrahydrofolic acid in the jejunal segment were both significantly decreased up to 50%. Heavy metal and trace element content was determined in liver, kidney and small intestine. Manganese and molybdenum content in liver tissue was reduced with a DON concentration of 10 ppm in the diet. The findings indicate that subchronic ingestion of DON, in concentrations occurring in contaminated food and feed, results in an impairment of intestinal transfer and uptake of nutrients such as glucose and 5-methyltetrahydrofolic acid. PMID- 1765326 TI - Effectiveness of ammonia treatment in detoxification of fumonisin-contaminated corn. AB - Corn throughout the world is frequently contaminated by the fungus Fusarium moniliforme, which produces toxic fumonisins. Ammonia has been shown to detoxify effectively aflatoxins in corn and cottonseed. Since corn can be contaminated by both fumonisins and aflatoxins, we investigated the effects of ammoniation of corn either cultured with or naturally contaminated by F. moniliforme. Fumonisin B1 levels in the culture material and in naturally contaminated corn were reduced by 30 and about 45%, respectively, by the ammonia treatment. Despite the apparent reduction in fumonisin content, the toxicity of the culture material in rats was not altered by ammoniation. Reduced weight gains, elevated serum enzyme levels and histopathological lesions, typical of F. moniliforme toxicity, occurred in rats fed either the ammoniated or non-ammoniated culture material. Atmospheric ammoniation of corn does not appear to be an effective method for the detoxification of F. moniliforme-contaminated corn. PMID- 1765327 TI - Dietary nicotine: a source of urinary cotinine. AB - Foods, principally from plants in the family Solanaceae, and a number of teas were examined for the presence of nicotine. Dietary nicotine would give rise to cotinine in urine and compromise estimates of exposure to tobacco smoke that depend on urinary cotinine. All foods were homogenized, extracted and analysed for nicotine and cotinine by gas chromatography with nitrogen-sensitive detection (GC) and/or GC/MS (mass spectrometry). Weak acid and aqueous extracts of the teas were analysed in a similar manner. Nicotine was not detected (less than 1 ng/ml of extract) in egg plant or green pepper. The average values for nicotine in tomato and potato were 7.3 ng/g wet weight and 15 ng/g wet weight, respectively. Black teas, including regular and decaffeinated brands, had nicotine contents ranging from non-detectable to greater than 100 ng/g wet weight. Instant teas yielded the highest nicotine contents observed (up to 285 ng/g wet weight). The possible sources of nicotine in these foods are discussed. A range of potential values for urinary cotinine concentrations (0.6 to 6.2 ng/ml) was calculated based upon estimated average and maximal consumptions of these foods and beverages. Because of the potential for exposure to nicotine by way of these routes, the use of urinary cotinine as a biomarker of exposure to environmental tobacco smoke may be compromised. PMID- 1765328 TI - Effects of high levels of brussels sprouts in the diet of rats. AB - To examine the possible harmful effects of feeding Brussels sprouts to rats, groups of 10 male, weanling rats received the non-dehydrated vegetable in moist diets at levels providing 2.5-30% of the dry matter for 4 wk. A first study comprised test diets with 15 and 30% of the dry matter as uncooked or cooked Brussels sprouts and control diets without and with 0.2% potassium thiocyanate (KSCN) for comparison. The second study comprised diets with 0, 2.5, 5, 10 and 20% of the cooked vegetable and diets with 0 and 20% of the cooked vegetable with extra iodine. Diets with the uncooked vegetable contained considerably less intact glucosinolates than did diets with the cooked product, probably as a result of more extensive enzymatic degradation in the uncooked product. Growth depression and decreased food intake, not accompanied by decreased food efficiency, occurred in rats fed 10% or more dry matter as Brussels sprouts. These findings were less marked with the cooked than with the uncooked vegetable, probably because of unpalatability. Decreased levels of blood haemoglobin and plasma thyroxin were found with 15% or more Brussels sprouts. Prothrombin times were increased if 2.5% or more was fed. Thyroid stimulating hormone was increased by feeding potassium thiocyanate, but not by feeding the vegetable. Increased kidney weights and impaired kidney function not accompanied by microscopic renal changes were observed in rats fed 10% or more Brussels sprouts. Increased liver weights, which occurred from the 5% level, were accompanied by microscopic hepatic changes only at feeding levels from 10% of the cooked vegetable. 'Morphological activation' of the thyroid was increased with 10% or more of the cooked vegetable and with 0.2% KSCN. Iodine supplementation of the diets did not influence the results obtained with the vegetable. These studies indicated that 2.5% Brussels sprouts dry matter in the diet was not without effect, and that the thyroid characteristics were less sensitive to Brussels sprouts than were other criteria examined. PMID- 1765329 TI - Mutagenic activities of tryptophan metabolites before and after nitrite treatment. AB - The mutagenic activities of 16 kinds of tryptophan metabolites, before and after nitrite treatment, were examined in the Ames test. None of the compounds showed mutagenic activity before nitrite treatment. After nitrite treatment under acidic conditions, 11 compounds showed mutagenic activity towards Salmonella typhimurium TA100 strain in the absence of a metabolic activation system. Tryptophan induced 1000 revertant colonies/mumol, while 5-hydroxyindole, 5-hydroxytryptamine and 3 hydroxykynurenine, all containing a hydroxy group in the molecule, induced 11,000, 5200 and 2700 revertant colonies/mumol, respectively. These results indicate that the introduction by nitrite treatment of a hydroxy group into the indole or benzene ring of tryptophan-related compounds increases their mutagenic activity. PMID- 1765330 TI - Assessment of in vivo mutagenic potency of ethylenediaminetetraacetic acid in albino mice. AB - Ethylenediaminetetraacetic acid (EDTA) disodium salt, a widely used metal chelator, was studied for its potency to induce bone marrow micronuclei, dominant lethal mutations and sperm-head abnormalities in albino mice. The acute oral LD50 dose computed by probit regression was 30 mg/kg body weight in the strain used. Preliminary studies showed that oral administration of EDTA disodium salt at doses of 5, 10 and 15 mg/kg body weight/day on 5 consecutive days did not induce any obvious signs of toxicity. In the bone marrow micronucleus assay acute doses of EDTA disodium salt (5-20 mg/kg body weight) induced a dose-dependent increase in the incidence of micronucleated polychromatic erythrocytes at a 24-hr sampling. However, administration at doses of 5, 10 and 15 mg/kg for 5 consecutive days did not produce any observable effect on either the testicular or epididymal weights and histology. No appreciable alterations were observed in the caudal sperm counts at any of the sampling intervals and there was no treatment-related increase in the incidence of sperm-head abnormalities. Furthermore, treatment of male mice with EDTA disodium salt (10 mg/kg body weight/day for 5 consecutive days) induced no increase in the incidence of post implantation embryonic deaths, except for a marginal but statistically insignificant increase during wk 2 and 3 of mating. PMID- 1765331 TI - Acute inhalation toxicity of cetylpyridinium chloride. AB - Cetylpyridinium chloride (CPC) is a quaternary ammonium salt and cationic surfactant. It has been used as a biocide in personal hygiene products and a charge control additive in some reprographic toners. CPC is orally toxic to rats, mice and rabbits and can cause severe eye irritation. Acute inhalation toxicity studies of CPC and other quaternary ammonium salts have not, however, been reported. Groups of five rats per sex were exposed to aerosols containing 0 (control), 0.05, 0.07, 0.13 and 0.29 mg CPC/litre for 4 hr and observed for toxicity and ocular effects for 14 days thereafter. All animals were subjected to autopsy and the eyes were examined microscopically. The LC50 (sexes combined) of CPC was 0.09 mg/litre with upper and lower 95% confidence limits of 0.13 and 0.07 mg/litre, respectively. Clinical signs of toxicity included weight loss, nasal discharge, chromodacryorrhoea, respiratory difficulty and eye irritation, and all these non-lethal effects were reversible. Acute inflammation of the cornea, iris and/or aqueous humour were found in one, seven and four of 10 rats exposed to 0.07, 0.13 and 0.29 mg CPC/litre, respectively. Corneal epithelial hyalinization, without evidence of ongoing inflammation, was found in three additional rats among the 10 exposed to 0.29 mg CPC/litre. PMID- 1765332 TI - Effect of tyrosine on the potentiation by aspartame and phenylalanine of metrazol induced convulsions in rats. AB - Male rats were treated by oral intubation with tyrosine (Tyr), at doses of 0.5 and 1.0 g/kg body weight, alone or together with 1 g aspartame (APM)/kg body weight, or an equivalent dose of phenylalanine (Phe; 0.5 g/kg body weight); the effects on seizures induced by an effective dose of metrazol (ED50) were observed. Tyr (0.5 g/kg body weight) had a protective effect against the Phe potentiation of metrazol-induced clonic-tonic convulsions. At the same dose Tyr had no effect on the seizure-promoting activity of APM, but at 1 g/kg it reduced the proconvulsant potential of the sweetener. Analysis of the brain and plasma amino acid concentrations indicated that the Tyr to Phe ratio tended to be enhanced in Tyr-Phe treated rats compared with those treated with Phe alone. This ratio remained essentially constant in the brain of APM-treated rats, compared with those treated with APM plus 1 g Tyr/kg body weight, whereas an increase in this ratio in the plasma was observed. These results confirm that Tyr antagonizes the proconvulsant effect of Phe and APM and they further suggest that no simple relationship exists between the relative brain concentrations of the two amino acids and the response to metrazol convulsions. PMID- 1765333 TI - Localization and quantification of histamine in injured skin as parameters for the timing of wounds. AB - Localization and estimation of the histamine (HA) content in skin wound edges in 86 Sprague-Dawley rats and three cases of human injuries were carried out by a microfluorimetric method specific for this amine which forms a complex with o phthalaldehyde (OPT). Distribution and density of the mast cells in the same areas were observed at the same time by toluidine blue stain. In all skin specimens with antemortem wounds, both the epidermis and upper dermis exhibit extracellular yellowish fluorescence of the HA-OPT complex. The fluorescent zone spreads in the wound edges with the lapse of time in vital injuries. The HA content increases gradually up to 30 min and then the yellow histamine fluorescence in areas 0-200 microns from the wound edge decreases. None of these features can be observed in normal skin and postmortem-injured skin. Mast cell degranulation can be demonstrated in all antemortem-injured skin. No statistical relationship exists between the number of mast cells and the HA-OPT fluorescence in either ante- or postmortem-injured groups. This study indicates that skin HA microfluorimetry by the OPT method is of practical value for distinguishing ante- from the postmortem wounds and for timing antemortem wounds. PMID- 1765334 TI - Analysis of benzophenones by gas chromatography/Fourier transform-infrared spectrometry. AB - A gas chromatograph/Fourier transform-infrared spectrometric analysis of benzophenones, as hydrolyzed products of benzodiazepine, was evaluated and the vapor phase spectra obtained were compared with those measured in the condensed phase. Each infrared spectrum obtained in the vapor phase showed a much greater difference in comparison to differences found in those in the condensed phase, especially in the fingerprint region. The identification of 14 benzophenones by their infrared spectra in the vapor phase was possible. The detection limits for these benzophenones were between 50-100 ng with high signal-to-noise ratios. The vapor phase spectra of the benzophenones were unique and the analytical method allowed the differentiation of closely related classes of drugs, such as benzophenones. PMID- 1765335 TI - Postmortem absorption of drugs and ethanol from aspirated vomitus--an experimental model. AB - Using human cadavers an experimental model was developed to simulate the agonal aspiration of drug- and alcohol-laden vomitus. By needle puncture, an acidified (N/20 HCl) 60-ml slurry of drugs (paracetamol 3.25 g, dextropropoxyphene 325 mg) and ethanol 3% w/v was introduced into the trachea. After 48 h undisturbed at room temperature, blood samples were obtained from ten sites. Ethanol and drug concentrations were highest in the pulmonary vessels in all five cases studied. Pulmonary vein mean ethanol was 58 mg% (range 13-130), paracetamol 969 mg/l (range 284-1934), propoxyphene 70 mg/l (range 11-168). Pulmonary artery mean ethanol was 53 mg% (range 10-98), paracetamol 476 mg/l (range 141-882), propoxyphene 29 mg/l (range 7.6-80). Ethanol and drug concentrations in aortic blood were higher than in the left heart and concentrations in the superior vena cava were higher than in the right heart, suggesting direct diffusion into these vessels rather than diffusion via the pulmonary and cardiac blood. Potential interpretive problems arising from this phenomenon can be avoided by using femoral vein blood for quantitative toxicological analysis. PMID- 1765336 TI - Preliminary report on a new method of human age estimation from single adult teeth. AB - A total of 317 upper and lower third molars were randomly divided into working and control samples and used to estimate chronological age employing a method which combined multiple regression analysis of data from Gustafson's and Maples's scoring system, direct morphological measurements obtained with a Kontron image analysis system and logarithmic data transformation. The standard errors of estimate were 2.4-6.8 years in the working sample and 1.9-7.5 years when the derived formulae were tested on the control sample, respectively. Compared to previous studies, this method provides a smaller standard error of estimate from a single molar tooth. The method is presently being tested on other tooth categories, like premolars, canines and other types of molars. PMID- 1765337 TI - [Current possibilities in reproduction medicine. 1. Diagnosis]. AB - The methods employed by assisted conception, presuppose a rational diagnostic evaluation. The endocrine work-up concentrates on demonstrating adequate ovulation. Today, apart from vaginal ultrasonography, this largely means LH determination in the urine in the middle of the cycle, together with progesterone measurements in the luteal phase. Recording the basal body temperature can offer no more than an orientation. The clarification of tubal patency is ideally served by laparoscopy with pertubation. With the aid of new sonographically visible contrast media, tubal flow can also be investigated using sonography. For the male work-up, classical evaluation of the ejaculate has declined in importance. As a means of establishing a fertility prognosis, forward progression, lateral movements of the head of the sperm, and functional sperm analysis (hamster oocyte penetration test) would appear most suitable. PMID- 1765338 TI - [Current possibilities in reproduction medicine. 2. Spectrum of therapeutic procedures]. AB - As measures of assisted conception, GIFT, ZIFT, TV test and insemination require patent Fallopian tubes. In the majority of cases, intra-uterine insemination is attempted before the invasive methods. Intratubal gamete transfer is employed in particular in the case of infertility that has resisted treatment for years, some forms of male subfertility, and in patients with endometriosis or other forms of genital pathology. In addition, ZIFT and the TV test permit an assessment of in vitro fertilization. In the case of IVF, the classical indication of microscopically non-treatable tubal occlusion has been expanded considerably. Although GIFT is associated with a pregnancy rate of between 30 and 40%, IVF is increasingly being used in women in whom GIFT is indicated, thus avoiding the need for laparoscopy. The alternative techniques of transvaginal GIFT or transvaginal embryo transfer cannot yet be definitively evaluated for clinical routine use. In view of the wide range of therapeutic possibilities, individual counselling of the patient is an essential requirement. PMID- 1765339 TI - [Immunology and reproduction]. PMID- 1765340 TI - [Male fertility disorders. 1: Diagnostic procedures]. AB - The current situation in the diagnosis of male fertility disorders is discussed. The importance of an accurate diagnosis to provide a basis for rational therapy is emphasized. In addition, an accurate prognosis can obviate the need for reproductive-medical measures in the female partner in some cases. PMID- 1765341 TI - [Current chemotherapy of urogenital infections. 2. Cephalosporins]. PMID- 1765342 TI - [Therapy of bronchitis. Successful single-dosage treatment with N-acetylcysteine, results of an administration surveillance study in 3,076 patients]. AB - The efficacy and safety of N-acetylcysteine prescribed in general practice were investigated. METHOD: open, non-controlled surveillance study conducted at 744 centers. PATIENTS: 3,076 patients suffering from bronchitis. MEDICATION: 600 mg N acetylcysteine (Fluimucil-Long, Inpharzam Germany), administered as a single daily dose. END POINTS: evaluation of coughing, amount and quality of sputum, expectoration, dyspnea, compliance and tolerance. RESULTS: impressive improvement of the symptom complex, good compliance. Adverse reactions were reported in 45 patients (rate: 1.5%). CONCLUSIONS: treatment of chronic and acute bronchitis with the mucolytic agent N-acetylcysteine administered once daily, proved to be both effective and well tolerated. PMID- 1765343 TI - Etiology and pathogenesis of thromboembolism. AB - Thrombus formation in the left atrium and left ventricle is primarily due to stasis of blood which causes activation of the coagulation system. Migration of thrombotic material into the circulation depends on the dynamic forces of the circulation. Atrial fibrillation is the commonest underlying cardiac disorder predisposing to thromboembolism. Rheumatic mitral stenosis, left atrial enlargement, prior myocardial infarction, hypertension, and echocardiographic left ventricular hypertrophy are risk factors for thromboembolic stroke in elderly patients with chronic atrial fibrillation. Non-valvular atrial fibrillation accounts for 45% of cardiac sources of thromboembolic stroke and includes patients with ischemic heart disease, hypertension, thyrotoxic heart disease, hypertrophic cardiomyopathy, chronic sinoatrial disorder, and idiopathic atrial fibrillation. 15% of cardiac sources of thromboembolic stroke are associated with acute myocardial infarction, 10% with left ventricular aneurysm and mural thrombi remote from an acute myocardial infarction, 10% with rheumatic valvular heart disease, and 10% with prosthetic cardiac valves. Mitral valve prolapse, mitral annular calcium, nonischemic cardiomyopathies, infective endocarditis, nonbacterial thrombotic endocarditis, left atrial myxoma, paradoxical embolism associated with congenital heart disease, calcific aortic stenosis, and complex atherosclerotic plaque within the proximal aorta also contribute to thromboembolism. PMID- 1765344 TI - [Cardiological diagnosis in arterial embolism]. AB - Potential cardiac sources of arterial embolism are in particular thrombi within the left atrium or ventricle, or attached to a prosthetic valve, intracardiac tumors, and vegetations due to endocarditis. Patent foramen ovale and atrial septal defect may lead to paradoxical embolism, and spontaneous echo contrast within the heart has to be considered as a parameter of increased thromboembolic risk. In rare cases, atrial septal aneurysm, mitral valve prolapse or annulus calcification and calcified aortic stenosis has to be taken into consideration. Current method of choice for diagnosis of these abnormalities is echocardiography. When the transthoracic approach fails, transesophageal echocardiography (TEE) leads to a definite diagnosis in most cases. Precordial echocardiography allows the detection of left ventricular thrombi with a sensitivity ranging between 72 and 95%, and monoplane TEE does usually not increase these numbers. In contrast, thrombi within the left atrium and particularly in the left atrial appendage can be detected with a significantly higher detection rate when TEE is used. The same is true for spontaneous echo contrast in the left atrium, a phenomenon which is almost exclusively diagnosed by TEE, as well as for endocarditis associated vegetations that can be identified by TEE with a sensitivity higher than 90%. Patient foramen ovale is usually diagnosed by precordial contrast echocardiography combined with a Valsalva maneuver; color Doppler or contrast TEE allows to increase the detection rate. In the diagnosis of prosthetic valve attached thrombi and vegetations, TEE is clearly superior compared to the precordial examination, at least concerning prosthetic devices in mitral position. If echocardiography fails to identify a potential cardiac source of embolism, other techniques don't add significant information in most cases. Detection of a potential source of embolism, however, does not necessarily prove that the particular finding represents the true etiology of an embolic event; results of all clinical and technical examinations have to be evaluated in a critical synopsis. In addition, proper therapeutic consequences in quite a number of abnormalities considered as potential cardiac sources of embolism are not yet defined. PMID- 1765345 TI - [The diagnosis of peripheral arterial embolism]. AB - Acute embolic occlusion of a peripheral artery requires rapid and precise diagnosis in order to provide the appropriate treatment without delay. The symptoms and findings of acute arterial occlusion are characterized by "the six Ps": pain of sudden onset in the hypoperfused extremity, paleness, pulselessness, paresthesias, paralysis and, in the extreme case, prostration with the symptoms of shock. With embolization in arterial segments with only minimal residual perfusion via collaterals (for example, the femoral bifurcation), a complete ischemic syndrome is usually incurred manifesting the six Ps as delineated. If preformed collateral systems provide some perfusion distal to an arterial occlusion (for example, in the common iliac artery), there is frequently an incomplete ischemic syndrome observed which is characterized by pain, paleness and pulselessness. Peripheral arterial embolism has a predilection for the femoral bifurcation, the superficial femoral artery and the popliteal artery. In principle, however, embolization can occur in every arterial segment. The diagnosis of the acute ischemic syndrome can generally be established on the basis of the history and physical examination. Diagnostic aid can be provided by electronic segmental oscillography to demonstrate diminished or absent oscillations and with the Doppler sonographically-determined systolic arterial pressure at the ankle which, in the case of severe ischemia, is less than 50 mmHg. Arteriography provides the most accurate morphological information. Abrupt occlusion of the vessel and no collateral perfusion especially in the absence of arteriosclerotic changes are strongly indicative of embolism but not conclusive. If the clinical diagnosis is unequivocal, arteriography need not be performed prior to embolectomy with a Fogarty catheter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765346 TI - [Diagnosis and treatment of visceral and renal embolisms]. AB - In surgical practice, about 15% of all emboli are visceral emboli. Diagnosis is frequently delayed or established at autopsy. ETIOLOGY: The most common cause are atrial arrhythmias with intraatrial thrombus formation, less frequently, ventricular thrombus after myocardial infarction or in an aneurysm, emboli from vegetations due to infective endocarditis, from atrial myxomas and, occasionally, from arteriosclerotic plaques, aortic tumors or mural aortic thrombi. Cholesterol embolism: Cholesterol embolism or the multiple cholesterol emboli syndrome (MCES) is of particular importance. There are three large groups of symptoms: a peripheral manifestation with livedo reticularis, renal manifestation with progressive renal failure and visceral manifestation with intestinal bleeding and segmental infarction. The only possibility for treatment is surgical removal of the source of embolization through infrarenal aortic replacement or suprarenal aortic arteriectomy. Renal embolism: Acute traumatic interruption of the renal perfusion in otherwise healthy subjects usually leads to loss of the organ due to the limited ischemia tolerance. On the other hand, the results of renal artery embolectomy can be favorable even after 24 hours of ischemia since, as a rule, embolism does not completely occlude the vascular lumen and, in patients with arteriosclerosis, collateral vessels are usually present. The clinical presentation usually encompasses acute onset of flank or back pain, tenderness to percussion of the kidneys, nausea, vomiting and hematuria. In 25% of the cases, the course of renal embolism is bland. The low specificity of the complaints requires delineation of high-risk patients. At the first level of diagnostics, other causes of the complaints should be ruled out with catheterization of the bladder, ultrasound, intravenous pyelography and computer tomography with intravenous contrast medium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765347 TI - [Neurological diagnosis and therapeutic measures in cerebral embolism]. AB - Stroke is caused by intracerebral or subarachnoid hemorrhage in about 15% of clinical presentations and the remaining 85% result from ischemia. About 15% of ischemic strokes are caused by emboli arising from the heart. In younger patients (18 to 50 years) with ischemic strokes or transient ischemic attacks (TIA), the incidence of cardiac embolism is increased to 23 to 36%. DIAGNOSIS: a) SYMPTOMS: Individual neurologic symptoms of stroke do not provide sensitive or specific indications of the underlying mechanism. In 25 to 82% of patients with possible embolic stroke, there is an acute onset with initially maximal manifestation of neurologic deficits as well an initial loss of consciousness in 20%. Antecedent TIAs occur in 11 to 30% but are more frequently associated with arteriosclerotic vascular disease. Stroke due to cardiac embolism mostly involves the cortex of both hemispheres and causes its symptoms through occlusion of isolated arterial branches. Cerebral infarctions with isolated Wernicke aphasia, global aphasia without hemiparesis and isolated syndromes of the posterior cerebral artery are frequently due to cardiac embolism. The strokes in 16 to 22% of those caused by cardiac embolism are found in subcortical regions. Amaurosis fugax is most frequently due to high-grade stenosis of the internal carotid artery. In association with cardiac embolism, secondary hemorrhage into the infarcted zone can frequently be seen on CT scans. b) DIAGNOSTIC PROCEDURES: In the case of cardiac embolism, the computer tomography (CT) usually shows infarction in or near the cortex in the region of the middle or posterior cerebral artery. About 10 to 20% of strokes due to cardiac embolism show secondary hemorrhage after the event, more frequently in association with large infarcts and in patients on anticoagulant treatment. Angiography can provide indirect evidence of embolic origin by showing occlusion of an intracerebral artery in the absence of arteriosclerotic changes. Traditional echocardiography may detect a possible source of embolism in 10% of all patients with ischemic stroke, only in 1.5%, however, in patients with no clinical signs of heart disease. Transesophageal echocardiography has a higher sensitivity for detection of sources of cardiac embolism. The use of magnetic resonance tomography and ultrafast CT will assume greater importance in the future. Holter monitoring of the ECG in patients with acute ischemic stroke or TIAs detects arrhythmias possibly responsible for emboli in about 2%. High-risk patients: The most common cause of cardiac embolism is atrial fibrillation (45%), followed by ischemic heart disease (15%) and in 10% each, aneurysm, rheumatic heart disease, prosthetic valve replacement and other cardiac diseases.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1765348 TI - Prophylaxis and acute therapy of arterial embolism with special reference to cerebral embolism. AB - Prophylaxis and treatment of arterial embolism in high-risk patients includes therapy with antiplatelet drugs, anticoagulation, and vascular surgery. The prominent causes of cerebral ischemia are intraarterial emboli from atheromatous plaques and cardiac emboli. In patients with recent hemispheric transient ischemic attacks or minor stroke and ipsilateral high-grade internal carotid artery stenosis of 70 to 99% carotid endarterectomy has shown to be effective in prevention of major stroke or death. In the majority of patients with moderate atherosclerotic disease of the extracranial arteries as well as in patients with a cardiac source of emboli, no generally excepted therapy for primary and secondary prevention of cerebral ischemia or systemic embolism exists. The efficacy of antiplatelet drugs and anticoagulants in these patients is still investigated in a number of clinical multicenter studies. From the presently available data one can conclude that the antiplatelet agent acetylsalicylic acid in a dosage of 300 mg per day is effective in the secondary prevention of stroke and death in patients with preceding transient ischemic attacks, minor or major stroke and suspected artery-to-artery embolism from mild to moderate atherothrombotic carotid and vertebral artery disease. If there are no contraindications, we recommend anticoagulation in recurrent transient ischemic attacks not responding to antiplatelet drugs, in progressing stroke especially in the vertebrobasilar territory, in transient ischemic attacks in patients with rheumatic atrial fibrillation and left atrium thrombi, in minor stroke and proven cardiac embolism, in cerebral ischemia due to traumatic large vessel disease, and before and following elective cardioversion in patients with long-standing atrial fibrillation. A therapeutic dilemma still exists in patients with nonrheumatic atrial fibrillation; the presently available data are not sufficient to give recommendations whether aspirin or anticoagulants should be given for primary and secondary prevention of stroke and systemic embolism in these patients. PMID- 1765349 TI - Portal hypertension in chronic liver disease. PMID- 1765350 TI - Surgery for portal hypertension. AB - Now that endoscopic sclerotherapy is available, the role of surgery in portal hypertension needs to be reconsidered. Emergency treatment of bleeding esophageal varices is based on sclerotherapy, which has widely replaced such surgical procedures as emergency portocaval shunts. Sclerotherapy can be extended to repeated endoscopic sclerosis as definitive management to prevent recurrence of variceal bleeding. Only if varices cannot be treated adequately by sclerotherapy, or in the case of local complications are surgical measures of decompression indicated. For "Child C" patients gastric devascularization or transsection should be considered. For "Child A" or "Child B" patients, distal splenorenal shunts or portocaval shunts should be given preference. PMID- 1765351 TI - Pathophysiology of ascites formation in cirrhosis of the liver. AB - Current concepts of the pathophysiology of ascites formation in cirrhosis of the liver have become more complex. Traditionally, the initiating event of renal sodium and water retention in cirrhosis was considered to be ascites formation ("underfilling" hypothesis) or primary renal dysfunction ("overflow" hypothesis). Changes in systemic, splanchnic and renal hemodynamics, as well as of volume regulating hormones observed in cirrhosis are compatible with a decrease in effective blood volume as suggested by the "underfilling" hypothesis. These changes, however, have been shown to precede ascites formation. This observation, together with the demonstration of an increase in total blood volume in cirrhosis prompted the "overflow" hypothesis. However, many studies are incompatible with this concept and, in addition, the agent causing primary renal sodium retention in cirrhosis still remains to be defined. The recently proposed "vasodilation" hypothesis reconciles the most salient features of both theories, proposing peripheral arterial vasodilation as the initiating event of decreased effective blood volume and renal sodium retention. Further studies are needed to elucidate the temporal relationship and more precisely define the character of hemodynamic, humoral and renal changes in cirrhosis of the liver. PMID- 1765352 TI - Strategies in the treatment of ascites. AB - Abnormalities of sodium excretion in chronic liver disease show wide variation. Depending on the degree of decompensation, sodium restriction and diuretic treatment using spironolactone as a basis, paracentesis with substitution of albumin or plasma expanders, or the peritoneovenous shunt is appropriate treatment. Prognostic factors for treatment success are needed. Up to now fractional sodium excretion has been used. Since treatment is palliative, side effects and complications should be minimized. Stepwise treatment and prevention of complications based on an understanding of the pathophysiology are mandatory. PMID- 1765353 TI - Effect of bile on liver function tests in experimental E. coli peritonitis in the rat. AB - Hepatic dysfunction is a frequent finding in sepsis and peritonitis. In the present study, hepatic function in experimental peritonitis in the rat was determined by measuring serum levels of bilirubin, alkaline phosphatase (ALP), glutamic-oxaloacetic transaminase (GOT) and glutamic-pyruvic transaminase (GPT), together with antipyrine (AP) clearance as a determinant of microsomal function. Peritonitis was induced by intraperitoneal injection of 3 x 10(8) colony-forming units of E. coli together with either 1.0 ml bile or saline. E. coli + bile peritonitis rats had significantly elevated levels of bilirubin, ALP, GOT and GPT as compared with both controls and rats with peritonitis induced by E. coli alone. The derangements gradually increased with time over the 10-hour period studied. In contrast, no reduction of AP clearance was observed in the peritonitis models. On the contrary, AP clearance was enhanced at 10 hours after induction of peritonitis by E. coli alone. In conclusion, hepatic dysfunction as revealed by routine laboratory tests is seen early in experimental peritonitis in the rat, but this is not accompanied by a reduced AP clearance rate. PMID- 1765354 TI - Metabolism of vitamin A in inflammatory bowel disease. AB - The aim of this study was to determine serum retinol levels in patients with inflammatory bowel disease and to attempt to elucidate the mechanism of changes in vitamin A metabolism in these disorders. It was found that in 15 patients with active ulcerative colitis, 14 patients with active Crohn's disease and in 3 operated patients with recurrent Crohn's disease serum retinol levels and retinol binding protein were significantly lower than in controls. Concentrations of vitamin A did not depend on the localization of inflammatory bowel disease, previous ileal resections, duration of the disease or age and sex of the patients. During successful treatment of active ulcerative colitis normalization of serum retinol levels without substitution of vitamin A was observed. Repeated determinations in patients with Crohn's disease who had low serum retinol levels in an active phase of disease revealed normal vitamin A levels in an inactive phase. The absorption of vitamins A and E in patients with inflammatory bowel disease was normal. The normal serum retinol concentrations in patients with diarrhea due to irritable bowel syndrome, and in those with anorexia nervosa exclude the influence of diarrhea and body weight itself on vitamin A levels. The results of this study indicate that serum retinol levels in patients with active inflammatory bowel disease are secondary to the decreased serum retinol-binding protein concentrations, and probably depend on the increased protein catabolism in these disorders. PMID- 1765355 TI - An autopsy case of pancreatic duct cell carcinoma associated with ossification. AB - A case of pancreatic duct cell carcinoma with ossification was reported. A 71 year-old female died of pancreas carcinoma with liver and diffuse lymph node metastasis. Computed tomography (CT) revealed a punctate calcification of the body of the pancreas. At autopsy, the carcinoma occupied almost all of the pancreas, and histological examination revealed a moderately to well differentiated adenocarcinoma with mucin production in the glands. The whole of the pancreas was examined microscopically by multiple-step sections, and mature ossification was found in the body, corresponding to its CT localization. Around the ossification were found cancer cells with massive mucin in the cytoplasm, capillary proliferation, scattered necrosis and mesenchymal cells, which were thought to be fibroblasts. But neither cartilage nor calcification was found. The pathogenesis of ossification was believed to be associated with metaplastic changes of mesenchymal cells. This is the fourth case of pancreatic carcinoma with ossification, and the second case of pancreatic duct cell carcinoma with mature bone formation to have been reported. PMID- 1765356 TI - Omeprazole 20 mg uid and ranitidine 150 mg bid in the treatment of benign gastric ulcer. Italian Cooperative Group on Omeprazole. AB - The primary aim of this double-blind, randomized Italian multicenter trial was to compare the healing rates in patients with benign gastric ulcers after 4-8 weeks treatment with either omeprazole 20 mg uid or ranitidine 150 mg bid. Secondary aims were to compare the healing rates in a subgroup of patients after two weeks and to study symptom relief and frequency of adverse events. One hundred and sixty-seven (167) patients were randomized to treatment with either omeprazole (84) or ranitidine (83). Four and three patients in the omeprazole and ranitidine groups, respectively, were found to have malignant gastric ulcers, and were therefore excluded from the analysis. Protocol healing rates were significantly higher in the omeprazole group (35%, 74% and 96%) than in the ranitidine group (9%, 53% and 85%) after two (p = 0.004), four (p = 0.015) and eight weeks (p = 0.04) of treatment (chi 2 test). Relief of both daytime and nocturnal epigastric pain, as reported on clinic visits, was more rapid in the omeprazole group than in the ranitidine group. Diary card reports of nocturnal and day pain during the first two weeks showed a similar pattern, with somewhat faster relief of pain in the omeprazole group. Both omeprazole and ranitidine were well tolerated, and only few adverse events were reported. No changes in the laboratory tests were considered to be clinically important. PMID- 1765357 TI - Chronic pancreatitis: evolution of the disease. AB - The aim of this study was to review the pathology of acute pancreatitis, resolving acute pancreatitis and chronic pancreatitis in order to find an answer to the unresolved question as to whether chronic pancreatitis is a primary disease or may be due to recurrent acute pancreatitis. Our series consisted of 71 pancreatic resection specimens and 15 autopsy pancreases from 8 patients with acute pancreatitis, 5 patients with pancreatitis 5-7 weeks prior to examination (resolving acute pancreatitis), and 66 patients with chronic pancreatitis. Peripancreatic and intrapancreatic fat necrosis was the key finding in acute pancreatitis. Organization of fat necrosis with early perilobular fibrosis and/or peripancreatic pseudocysts characterized the pancreas with resolving acute pancreatitis. Pseudocysts were present in 52% of pancreases with an early stage of chronic pancreatitis that was characterized by a focally accentuated fibrosis of the perilobular and, to a lesser degree, intralobular type. Marked fibrosis, ductal distortions and presence of intraductal calculi were the main features of advanced chronic pancreatitis. Pseudocysts were less frequent (36%) than in the early stage of the disease. On the basis of these findings it is suggested that acute pancreatitis, if it is severe and also affects the intrapancreatic fat deposits, may evolve into chronic pancreatitis. PMID- 1765358 TI - Papillomatosis of the intra- and extrahepatic bile ducts with involvement of the pancreatic duct. AB - An 80-year-old patient presented with multiple biliary papillomatosis of both intra- and extrahepatic bile ducts, with focal epithelial dysplasia. After repeated attempts at drainage the patient died of a massive hemorrhage. The histology of this very unusual tumor is discussed, and a complete review of the literature is presented. PMID- 1765359 TI - Extracorporeal lithotripsy and oral bile acid dissolution of gallstones: the Lyon experience. PMID- 1765360 TI - Intracavitary irradiation treatment via the inferior vena cava for caudate lobe invasion in hepatic hilar bile duct cancer. AB - Cancer invasion to the caudate lobe of the liver is considered an important prognostic factor in hepatic hilar bile duct cancer, and caudate lobectomy is required in cases with massive invasion. In many cases, however, the invasion is difficult to confirm even at intraoperative examination. As the caudate lobe is close to the inferior vena cava, it can be irradiated by a source in the inferior vena cava. In this paper, intracavitary irradiation of the caudate lobe via the inferior vena cava is proposed instead of resection for possible, but not confirmed, invasion. In experiments on dogs, intracavitary irradiation was performed by remote after-loading using 60Co at a dose of 20 and 300 Gy via the inferior vena cava. The radiation is so highly concentrated on the designated target that an anticancer effect can be expected. No noteworthy side effects were observed by functional and morphological studies after 20 Gy irradiation. This treatment has been applied clinically, with favorable results. This treatment modality is a non-surgical caudate lobectomy aimed at avoiding useless, and potentially hazardous, resection. PMID- 1765361 TI - Early gastric cancer: total gastrectomy vs. distal resection. Results of a study of 271 cases. The Italian Stomach Cancer Group (A.C.O.I.-I.S.C.G.). AB - Two hundred and seventy-one (271) patients with early gastric cancer from 26 different hospitals were examined in a retrospective study conducted by the I.S.C.G. (Italian Stomach Cancer Group). The patients were divided into two series: the first, comprising 234 patients with negative lymph nodes (Stage ITNM UICC), had 5-year survival rates of 85%. The second group comprised 37 patients with positive lymph nodes (Stage III TNM-UICC) with a 72% five-year survival rate. Both results appear to be of great significance when compared with the five year survival rate for advanced gastric cancer, namely 29.3%. As far as the difference between the late results of total gastrectomy and subtotal distal resection are concerned, the latter was associated with a higher five-year survival rate in the case of tumors located in the lower third and in the middle third of the stomach. PMID- 1765362 TI - Gastric hyperplastic changes and thymidine uptake after partial gastrectomy in rats. AB - Foveolar hyperplastic changes have been recently considered to be the most distinctive histological finding after partial gastrectomy, and their relationship with bile reflux has been proven. The present study was undertaken to establish whether an increase in 3H-thymidine uptake--which is an expression of increased gastric mucosal proliferative activity--might correspond to these hyperplastic changes. Histology and thymidine uptake values were assessed and compared in nineteen rats operated upon either by means of a Polya gastrectomy (11), or with a Roux-en-Y biliary diversion (8). Thymidine uptake values and the extent of gastric hyperplastic changes were greater in the Polya than in the Roux en-Y group. Moreover, a significant correlation was found between thymidine uptake values and the extent of hyperplastic changes. The relationship between hyperplastic changes and post-gastrectomy increased mucosal proliferative activity would thus seem to have been demonstrated. Since bile acids have been shown to stimulate cell proliferation in ileal and colonic mucosa, a role for bile reflux can be hypothesized for the increased cell proliferation activity in the gastric stump. PMID- 1765363 TI - Hiccups and related esophageal motor disorders. AB - The clinical course of a patient with pyrosis and intractable hiccups is presented. Hiccups persisted six years after an effective fundoplication had cured pyrosis, and the patient was eventually treated with baclofen. Esophageal function during and after hiccups was studied in detail by means of esophageal manometry and 24-hour-pH monitoring. The relationship between hiccups and gastro esophageal reflux is discussed. PMID- 1765364 TI - Factors of prognostic value in long-term survival of colorectal cancer patients. AB - We have studied 191 protocolized colorectal cancer patients, analyzing the prognostic factors described in the literature as being important to long-term survival. Of the data studied, sex, age, duration of symptoms, tumor location, tumor extension within the circumference of the bowel lumen, and the surgical technique employed, all showed differences in terms of five-year survival, but without reaching statistical significance. The factors with statistically significant prognostic value were first symptoms, occlusion, perforation, primary tumor size and configuration, lymph node involvement, degree of wall infiltration, presence of emboli, degree of differentiation and Scarff index. In view of these results, we consider that the evaluation of bowel wall infiltration, lymph node involvement, venous and/or lymphatic embolization, and tumor differentiation is necessary to establish long-term prognosis in these patients. The remaining factors lack prognostic value. PMID- 1765365 TI - Normal values in anal manometry and rectal sensation: a problem of range. AB - Anal manometry was performed in 80 individuals, mainly healthy volunteers, 40 men and 40 women aged 20-87, mean 45 years. An open-tip perfusion system employing a catheter with 4 sideports and a terminal balloon (to be inflated with air) was used. The maximum basal pressure (MBP) showed no significant difference between men and women (68 +/- 21 and 63 +/- 19 mmHg). With respect to the maximum squeeze pressure (MSP) a significant difference was found between men and women (183 +/- 73 and 102 +/- 36 mmHg, p less than 0.001). Both MBP and MSP decreased significantly with age (both p less than 0.001). The sphincter length was larger in men than in women (4.1 +/- 0.7 and 3.5 +/- 0.5 cm, p less than 0.001) and was related to BMP (p less than 0.002). The distension reflex seemed to change with age: the threshold volume increased (p less than 0.02), the pressure drop decreased (p less than 0.03), and the recovery time increased (p less than 0.001). The pressure drop was also related to MBP (p less than 0.005). The volume of rectal perception increased with age (p less than 0.005). Ultra-slow waves were related to MBP, and were only seen when MBP greater than 70 mmHg. No relationship was to be found between parity and MBP or MSP in women. In conclusion, anal pressures and sphincter length in normal individuals have a large range and vary with age and sex. The sensitivity of the rectum to balloon inflation decreases with age. When making therapeutic decisions in patients with anorectal disorders all these factors should be taken into account. PMID- 1765366 TI - Iatrogenic hemobilia: how to approach it. AB - Hemobilia after surgical or non-surgical interventions on the liver, biliary tree and pancreas is a serious postoperative complication. Two different therapeutic approaches i.e. superselective hepatic artery embolization and surgical management were retrospectively evaluated in a group of 19 patients. Superselective embolization showed a lower mortality and morbidity than did surgery. Superselective embolization resulted in a higher success rate in terms of control of bleeding and identification of the origin of the bleed. PMID- 1765367 TI - Evaluation of surgical and anesthetic strategy as a key factor in the postoperative results of liver transplant. AB - Since the inauguration of our liver transplant program two years ago, retrospectively we can distinguish two different periods as regards postoperative results. The patients studied were distributed in two groups by chronological order and date of introduction of an improved surgical and anesthetic strategy: retrohepatic dissection during the veno-venous bypass phase and meticulous hemostasis in the anhepatic phase: Group A: 11 transplants in 10 patients and Group B: 22 transplants in 21 patients. Preoperatively, both groups were homogeneous with respect to the clinical situation. During the operation, significantly larger transfusion volumes were given in group A (25.4 +/- 10.5 ml/kg/hr) than in group B (10.0 +/- 5.7 ml/kg/hr) (p less than 0.01). The anhepatic phase lasted 1'50" +/- 20" in group B (p less than 0.05). The postoperative outcome of group B was better than that of A as regards hemodynamic and respiratory parameters, functional impairment of the graft and mortality (p less than 0.05). We conclude that the realization of retrohepatic dissection and careful hemostasis during the anhepatic phase, which prolongs the duration of venovenous by-pass but does not increase intraoperative morbidity, reduces the need for blood transfusion, and yields better postoperative results. PMID- 1765368 TI - Chromosomal assignments of the genes for neuroendocrine convertase PC1 (NEC1) to human 5q15-21, neuroendocrine convertase PC2 (NEC2) to human 20p11.1-11.2, and furin (mouse 7[D1-E2] region). AB - The chromosomal localization of the genes coding for the pro-protein and pro hormone convertases PC1, PC2, and Furin has been achieved by in situ hybridization. The genes for PC1 and PC2 were located on human chromosomes 5q15 21 and 20p11.1-11.2, respectively. The gene for Furin was assigned to the mouse chromosome 7D1-7E2 region. These data complete the chromosomal localization of these three convertases in both human and mouse. The results confirm the regional correspondence of the human chromosomes 15 and mouse chromosomes 7, as well as between human chromosome 20 and mouse chromosome 2. Furthermore, the identification of the NEC1 locus on human chromosome 5 and mouse chromosome 13 suggests a conservation of synthenic regions between these regions of the human and mouse genomes. PMID- 1765369 TI - Cloning and sequence analysis of a human Y-chromosome-derived, testicular cDNA, TSPY. AB - The human Y-specific gene TSPY (testis-specific protein Y-encoded) was originally defined by the genomic probe pJA36B2 (DYS14), which detects a poly(A)+ RNA transcript in human testis tissue. Using this probe we have now isolated the cDNA sequence pJA923 from a human testis cDNA library. Southern blot hybridization experiments with both probes yielded identical male-specific banding patterns, but sequence analysis revealed an overall homology of only 92.3%. It appears that pJA36B2 (DYS14) is a pseudogene to pJA923 (TSPY), as only pJA923-specific transcripts were discovered in testis mRNA. PCR analysis of genomic DNA from patients with specific primers confirmed the simultaneous presence of at least two independent loci on the proximal short arm of the Y chromosome. PMID- 1765370 TI - Construction and characterization of a NotI-BsuE linking library from the human X chromosome. AB - We describe the construction and characterization of methylation-resistant sequence-tagged NotI linking clones specific for the X chromosome, referred to as NotI-BsuE linking clones. The approach consists of methylating the X-chromosome specific cloned DNA with BsuE methylase (M. BsuE), an enzyme that methylates the first C residue in the CGCG sequence, followed by selection of the methylation resistant NotI sites by insertion of a kanamycin-resistance gene in the clones cleavable by NotI. The frequent occurrence of NotI sites in CpG islands is expected to cause methylation of a large number of NotI sites with BsuE methylase, thereby rendering them resistant to NotI cleavage. Thus, the combination of M. BsuE and NotI yields less frequent cutting than the NotI alone. We have isolated, partially sequenced, and characterized 113 NotI-BsuE linking clones, and mapped 50 clones to various regions along the chromosome. PMID- 1765371 TI - The use of synthetic tandem repeats to isolate new VNTR loci: cloning of a human hypermutable sequence. AB - Synthetic tandem repeats (STRs) of oligonucleotides have previously been shown to detect polymorphic loci in the human genome. Here, we report results from the use of three such probes to screen a human cosmid library. Nine of the 45 positive clones that were analyzed appear to contain highly polymorphic minisatellite or VNTR loci. The degree of enrichment for minisatellite sequences varied with the choice of STR: one provided a 15- to 20-fold enrichment (4 polymorphic loci among 10 clones), whereas 2 others gave a 3- to 5-fold enrichment (5 polymorphic probes in a total of 35 clones) compared to random screening. The 9 VNTR markers have been localized by linkage analysis in the CEPH panel and/or by in situ hybridization. Eight probes identify new loci, one of which maps to an interstitial region. One of the VNTR loci (identified by probe CEB1) was found to be hypermutable, with 52 mutation events identified among 310 children characterized in 40 CEPH families. The parental origin of the mutation could be identified in all instances, and only one mutation was found to be of maternal origin. The mutation rate in males was estimated to be approximately 15%. Segregation analysis of flanking markers suggests that mutations are not associated with crossing over. As the only previously described hypermutable minisatellite loci in humans have equal rates of male and female mutations, these observations establish that a second type of hypermutable minisatellite exists in the human genome. In neither case does the generation of new alleles appear to be associated with unequal crossing over. PMID- 1765372 TI - The exon organization of the triple-helical coding regions of the human alpha 1(VI) and alpha 2(VI) collagen genes is highly similar. AB - The alpha 1(VI) and alpha 2(VI) chains, two of the three constituent chains of type VI collagen, are highly similar in size and domain structure. They are encoded by single-copy genes residing in close proximity on human chromosome 21. To study the evolution of the type VI collagen genes, we have isolated and characterized genomic clones coding for the triple-helical domains of the human alpha 1(VI) and alpha 2(VI) chains, which consist of 336 and 335 amino acid residues, respectively. Nucleotide sequencing indicates that, in both genes, the exons are multiples of 9 bp in length (including 27, 36, 45, 54, 63, and 90 bp) except for those encoding for regions with triple-helical interruptions. In addition, the introns are positioned between complete codons. The most predominant exon size is 63 bp, instead of 54 bp as seen in the fibrillar collagen genes. Of particular interest is the finding that the exon structures of the alpha 1(VI) and alpha 2(VI) genes are almost identical. A significant deviation is that a segment of 30 amino acid residues is encoded by two exons of 54 and 36 bp in the alpha 1(VI) gene, but by a single exon of 90 bp in the alpha 2(VI) gene. The exon arrangement therefore provides further evidence that the two genes have evolved from tandem gene duplication. Furthermore, comparison with the previously reported gene structure of the chick alpha 2(VI) chain indicates that the exon structure for the triple-helical domain of the alpha 2(VI) collagen is strictly conserved between human and chicken. PMID- 1765373 TI - Chromosome-specific alpha satellites: two distinct families on human chromosome 18. AB - Two types of human chromosome 18-specific alpha satellite fragments have been cloned and sequenced. They represent closely related but distinct alphoid families formed by two different types of the higher-order repeated units (1360 bp EcoRI and 1700-bp HindIII fragments) that do not alternate in the genome. The individual repeats within each family are 99% identical and interfamily homology is about 78%. Sequence analysis shows that both repeats belong to alphoid suprachromosomal family 2, but their homology is not higher than that of family members located on different chromosomes. Therefore, the two repeats shared a common origin in the recent past, although they are not the direct offspring of one ancestral sequence. Our data indicate that these two 18-specific domains have appeared as a result of two separate amplification events. Despite the high degree of homology, they are not undergoing intrachromosomal homogenization, although some variation of this process might take place within each domain. PMID- 1765374 TI - Assignment of the YT blood group locus to chromosome 7q. AB - The antithetical antigens YT1 and YT2 constitute the YT blood group system (International Society of Blood Transfusion system number 11). Despite being serologically well defined, the YT blood group locus (YT) has not secured a chromosomal location. In our report, peak lods of 3.61 at theta = 0.00 for YT:COL1A2 and of 3.31 at theta = 0.00 for YT:D7S13 allow us to assign YT to the long arm of chromosome 7. PMID- 1765375 TI - Human clathrin heavy chain (CLTC): partial molecular cloning, expression, and mapping of the gene to human chromosome 17q11-qter. AB - The nucleotide sequence of a 916-bp human cDNA clone isolated from a human colon lambda gt11 cDNA library was determined. Sequence analysis showed this cDNA to have 88% homology to the nucleotide sequence of the heavy chain of rat clathrin. The deduced amino acid sequence was 98.7% identical to the rat sequence, a change of only four amino acids. The mRNA identified in both human and rat cells with the human clathrin clone revealed transcripts of approximately 6.5 kb, which is consistent with the predicted 180 kDa molecular weight of the clathrin heavy chain. Southern analysis of human/rodent somatic cell hybrids localized the human clathrin heavy chain gene (CLTC) to chromosome 17. Additional analyses using panels of human/rodent somatic cell hybrids with specific chromosomal translocations and deletions mapped the human clathrin heavy chain gene locus to 17q11-qter. PMID- 1765376 TI - Mapping the Treacher Collins syndrome locus to 5q31.3----q33.3. AB - Treacher Collins syndrome is an autosomal dominant disorder of abnormal craniofacial development. Linkage analysis was performed in Treacher Collins families with restriction fragment length or microsatellite polymorphisms associated with eight loci previously mapped to 5q31----qter. Positive lod scores were obtained for four loci, D5S119, D5S207, D5S209, and D5S210, which map to 5q31.3----q33.3. The Treacher Collins syndrome locus was linked closest to locus D5S210, which is associated with microsatellite polymorphisms, with a maximum lod score of 8.65 at theta = 0.02. The Treacher Collins syndrome locus was excluded from locus ADRB2R, which maps to 5q31----q32, and loci D5S22, D5S61, and D5S43, which map to 5q34----qter. There was no evidence for genetic heterogeneity among eight families with variable expression of the condition. PMID- 1765377 TI - Autosomal dominant retinitis pigmentosa: four new mutations in rhodopsin, one of them in the retinal attachment site. AB - Several mutations in the rhodopsin gene in patients affected by autosomal dominant retinitis pigmentosa (ADRP) have recently been described. We report four new rhodopsin mutations in ADRP families, initially identified as hetero-duplexed PCR fragments on hydrolink gels. One is an in-frame 12-bp deletion of codons 68 to 71. The other three are point mutations involving codons 190, 211, and 296. Each alters the amino acid encoded. The codon 190 mutation has been detected in 2 from a panel of 34 ADRP families, while the remaining mutations were seen in single families. This suggests that, consistent with a dominant condition, no single mutation will account for a large fraction of ADRP cases. The base substitution in codon 296 alters the lysine residue that functions as the attachment site for 11-cis-retinal, mutating it to glutamic acid. This mutation occurs in a family with an unusually severe phenotype, resulting in early onset of disease and cataracts in the third or fourth decade of life. This result demonstrates a correlation between the location of the mutation and the severity of phenotype in rhodopsin RP. PMID- 1765378 TI - In vitro mutagenesis helps to unravel the biological consequences of aspartylglucosaminuria mutation. AB - Aspartylglucosaminuria (AGU) is a lysosomal storage disease resulting in severe mental retardation. We have recently reported that mutations in the aspartylglucosaminidase (AGA) locus are responsible for this disease. About 90% of reported AGU cases are found in Finland, and we have shown that the vast majority (98%) of AGU alleles in this isolated population contain two point mutations located 5 bp apart. We expressed these Arg161----Gln and Cys163----Ser mutations separately in vitro and demonstrated that deficient enzyme activity is caused by the Cys163----Ser mutation, whereas the Arg161----Gln substitution represents a rare polymorphism. Further analyses of in vitro expressed AGA proteins and the enzyme purified from an AGU patient revealed that Cys163 participates in and S-S bridge. The absence of this covalent cross-link in the mutated protein most probably results in disturbed folding of the polypeptide chain and a consequent decrease in its intracellular stability. PMID- 1765379 TI - Nucleotide sequence of the 3' nuclease-sensitive region of the human phosphoglycerate kinase 1 (PGK1) gene. AB - Many genes are known to have nuclease-sensitive sites and/or control sequences in their 3' flanking regions, but for very few genes has this region been sequenced. Previously, we mapped specific, gene activity-dependent DNAase I- and MspI sensitive sites at the 3' end of the human X-linked housekeeping gene phosphoglycerate kinase (PGK1). Sequence information presented here shows that the 3' nuclease-sensitive site maps precisely to an Alu sequence and near a "BKM" repeat. This is the first report of an Alu sequence that has alternative chromatin configurations depending on gene activity. PMID- 1765380 TI - Isolation of a human chromosome 14-only somatic cell hybrid: analysis using Alu and LINE-based PCR. AB - Interspecific somatic cell hybrids containing single human chromosomes are valuable reagents for localization of cloned genes and DNA fragments to specific chromosomes, for the development of chromosome-specific libraries, and for generation of hybrid cell lines containing subchromosomal regions. A CHO somatic cell hybrid containing a single, intact human chromosome 14 (MHR14) was developed and confirmed by LINE PCR amplification gel pattern, by Alu-517 PCR product dot blot hybridization, and by cytogenetic analysis. MHR14 will serve as the chromosome source for the development of a radiation map of human chromosome 14. PMID- 1765381 TI - A graphical representation of genetic and physical maps: the Marey map. AB - A novel, simultaneous, visual representation of sex-specific genetic maps and physical maps is introduced. Such maps, called Marey maps, provide direct comparisons of multiple genetic maps and elucidate the relationship of recombination frequency to physical distance. PMID- 1765382 TI - The human homolog of the mouse common viral integration region, FLI1, maps to 11q23-q24. AB - FLI1 is a common mouse viral integration region in virus-induced leukemias and lymphomas. Using an evolutionarily conserved mouse probe and Southern hybridization to (rodent x human) somatic cell hybrid DNAs, the human homolog of FLI1 has been shown to lie on a fragment of chromosome 11 flanked on the centromeric side by the acute lymphoblastic leukemia-associated t(4;11)(q21;q23) translocation breakpoint and on the telomeric side by the Ewing- and neuroepithelioma-associated t(11;22) (q24;q12) breakpoint. PMID- 1765383 TI - The 5-HT2 serotonin receptor gene Htr-2 is tightly linked to Es-10 on mouse chromosome 14. AB - Clones coding for the 5-HT2 serotonin receptor were isolated from rat brain cDNA libraries. Using one of the cDNA clones as the probe, mouse genomic DNAs from intersubspecific backcrosses were analyzed by Southern blot hybridization for a restriction fragment length polymorphism. The 5-HT2 serotonin receptor gene, Htr 2, was mapped to mouse Chromosome 14 and is closely linked with the marker Es-10. PMID- 1765384 TI - Characterization of a set of variable number of tandem repeat markers conserved in bovidae. AB - Screening purpose-built libraries with minisatellite probes, we have isolated 36 bovine variable number of tandem repeat markers (VNTRs) characterized by a mean heterozygosity of 59.3 within the American Holstein breed. Matching probabilities and exclusion powers were estimated by Monte-Carlo simulation, showing that the top 5 to 10 markers could be used as a very efficient DNA-based system for individual identification and paternity diagnosis. The isolated VNTR systems should contribute significantly to the establishment of a bovine primary DNA marker map. Linkage analysis, use of somatic cell hybrids, and in situ hybridization demonstrate that these bovine VNTRs are scattered throughout the bovine genome, without evidence for proterminal confinement as in the human, and that at least some of them are organized as clusters. Moreover, Southern blot analysis and in situ hybridization demonstrate conservation of sequence and map location of minisatellites within Bovidae. PMID- 1765385 TI - Simultaneous screening for beta-thalassemia mutations by chemical cleavage of mismatch. AB - We used the chemical cleavage of mismatch (CCM) method to screen the beta-globin gene simultaneously for Mediterranean beta-thalassemia mutations. The beta-globin gene was amplified in two segments encompassing the whole gene and hybridized to a corresponding labeled PCR product from a normal subject. All the known mutations tested were identified and discriminated. Three beta-thalassemic subjects with previously undiagnosed mutations were identified as carriers of two rare DNA changes. The inheritance of the mutations could be traced in family studies, showing the reliability of the method even for prenatal diagnosis. The beta-globin gene polymorphisms were also detected and the framework was determined for most alleles. Our results suggest further applicability of the CCM method as a means to screen a gene simultaneously for multiple mutations. PMID- 1765387 TI - A population genetic study of six VNTR loci in three ethnically defined populations. AB - To investigate the population genetic characteristics of VNTR polymorphisms in human populations, we have studied the allele frequency distribution of six VNTR loci (D1S57, RB1, D1S77, D1S61, alpha-globin 5'HVR, D1S76) in three well-defined populations (Kachari of Northeast India; Dogrib Indian of Canada; and New Guinea Highlander of Papua New Guinea). Even though the number of alleles sampled is limited, 48 to 92 alleles per locus per population, significant variation is noticed in the number of alleles per locus for all the populations. Using alternate summary measures, we have observed that genotype distributions at the six VNTR loci apparently conform to their respective Hardy-Weinberg predictions. Multilocus genotype profiles of the individuals in each of the three populations suggest that the VNTR alleles are independently segregating with the exception of the two linked loci D1S76 and D1S77. Lack of fit of all VNTR loci to one particular model of mutational change, either the Infinite Allele Model or the Stepwise Mutation Model, suggests more than one mechanism for production of new VNTR alleles. This study also indicates that increased heterozygosity at VNTR loci in comparison to protein and blood group loci may lead to more accurate estimates of genetic distance. PMID- 1765386 TI - The structure of the mouse lipoprotein lipase gene: a B1 repetitive element is inserted into the 3' untranslated region of the mRNA. AB - The catabolism of triglycerides-rich lipoproteins and the subsequent uptake of free fatty acids by muscle and adipose tissue is dependent on the enzyme lipoprotein lipase (LPL). To better understand the regulation of this enzyme, we have isolated and characterized the mouse LPL gene. The gene is 28 kb in length and comprises 10 exons which encode a 4.0-kb mRNA. In this report, almost 6 kb of DNA sequence is presented, including 1251 bp 5' to the gene, over 4 kb of exon and exon-intron junctions, and 583 bp 3' to the gene. RNA from differentiated 3T3 L1 adipocytes was used in primer extension and RNase protection assays to show that the 5' untranslated region is not interrupted by an intron and the start site of transcription is 199 bp 5' to the ATG codon that begins translation. The first exon codes for the 5' untranslated region and the signal peptide of 27 amino acids and 2 amino acids of the mature protein, exons 2-9 code for 445 amino acids of the mature protein. These exons are short and vary in length from 102 to 287 bp. The 10th exon codes for the 3' untranslated region and is 2346 bp long. This exon contains a single copy of a B1 repetitive element of 152 bp followed by a 169-bp homopurine stretch. These elements are flanked by a pair of 16-bp direct repeats. The mouse gene is similar in size to the human, which also contains 10 exons in similar locations. There is a high degree of sequence homology between the two genes, 5' region (700 bp), 75%; 5' untranslated region, 74%; coding region, 88%; 3' untranslated region, 75%. The most striking difference is the absence of the B1 repetitive element and homopurine region in the human 3' untranslated region. This information about the mouse LPL gene may lead to a better understanding of its regulation and role in plasma lipoprotein metabolism. PMID- 1765388 TI - The effect of guidance on the knowledge level of expectant mothers seen at maternity health care clinics. The Finnish Family Competence Study. AB - The importance of quality prenatal care is generally acknowledged. Quality care must include counseling and health education materials as well as clinical monitoring. The present study is part of a long term programme designed to evaluate the health education aspects of prenatal care in Finland. PMID- 1765389 TI - The "Besancon smoke-free" programme. Concepts, measures and evaluation. AB - Three years ago the city of Besancon, France, launched a city-wide, multi-level and multi-disciplinary smoking prevention programme with the ambitious goal of reducing the number of smokers by 50%. This paper describes the philosophy and methodology behind the programme while reporting on its mid-term progress. PMID- 1765390 TI - [Smoking prevention through health promotion. A novel experience in schools of the northern region of Portugal]. AB - Tobacco consumption in Portugal remains a serious problem, particularly among young people. According to a 1987 CEE Expert Commission report, 45% of youth between the ages of 15 and 24 are regular smokers, and the rate seemed to be on the rise for young women. In an attempt to combat this tendency, the Portuguese Ligue Against Cancer, together with the Institute of Oncology implemented a comprehensive multi-level, multidisciplinary smoking prevention programme in the north of the country. Although the principle target group was youth (ages 5-17), the programme was designed to create an informed, supporting climate throughout the different participating communities. Various aspects targetting adults were also integrated into the project. The global programme was thus composed of school-based activities supported by community outreach activities and mass-media campaigns. Training programmes and materials were designed to enable teachers to integrate tobacco information and smoking prevention activities into their usual courses. Teachers were also given training in group dynamics and positive self image preparation practices so that they were able to conduct workshops such as "global and positive approaches to health"; "saying no" exercises; and "responsibility to self and others", which made up part of the global programme. Youth workers outside of schools were also offered similar training programmes in order to be able to implement various smoking prevention activities within the community. The various community-level projects were carried out to complement the school-based programmes and targetted participation from throughout the community, parents and other adults, as well as the young people. Tee-shirt, poster competitions, and athletic competitions were among some of the more popular community-level activities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765391 TI - Zigzaids--an educational game about AIDS for children. AB - In spite of the progress made in treating the different opportunistic illness in HIV syndrome, prevention remains the only real answer we have in stopping the spread of this disease. Programmes using new, innovative and interactive materials are necessary to reach a maximum number of people. PMID- 1765392 TI - Medication education for an elderly black and Hispanic population in the United States. PMID- 1765393 TI - The birth of the WHO/GPA Regional AIDS Information Exchange Resource Centre; African Regional Health Education Centre, University of Ibadan, Nigeria. PMID- 1765394 TI - Breastfeeding: an old practice or a new technique? AB - "Health care and other professionals must work together through local and international channels to successfully promote breastfeeding". This position paper presents an excellent reminder of the importance of breastfeeding techniques which favour successful breastfeeding, and a call for international collaboration for its promotion. PMID- 1765395 TI - Legal information. Administration of medication p.r.n. by nursing assistants. PMID- 1765396 TI - The role of the clinical nurse consultant and the use of research and development days. PMID- 1765397 TI - Primary health care. PMID- 1765398 TI - A profile of undergraduate/graduate entrants from non-nursing discipline to the pre-registration nursing programme at Royal Adelaide Hospital from 1987-1990. PMID- 1765399 TI - Reflections upon caring for dying people. PMID- 1765400 TI - Facilitating clinical problem solving--the use of an information system based on nursing standards or putting standards into practice. PMID- 1765401 TI - Hospital care financing and DRG's: how Belgium takes nursing care into account. PMID- 1765402 TI - Competency statements evaluating nurses performance. PMID- 1765403 TI - Consensus management as a pattern of care within a general surgical ward. AB - This paper describes changes in the pattern of care delivery in a general surgical ward. The results reported are from the pilot study which was designed to establish that a model other than the team leader model was possible within this setting. Data was collected from staff regarding their perceptions of the changes and also from patients regarding their perceptions of the quality of their care. The research showed that a patient centred, consensus management pattern of care was the preferred choice by staff. Patient opinion surveys and staff evaluations supported the greater continuity in care of the patients in the trial group as compared to the control group. Initial nursing assessment and planning of nursing care were significantly better (p greater than 0.05) within the trial group as compared to the control group when measured utilising a standardised quality assurance tool. PMID- 1765404 TI - Royal Adelaide Hospital graduation November 22, 1990. PMID- 1765405 TI - Polyoptimum--a review. PMID- 1765406 TI - Is choice of catheter size an important factor in patient discomfort? AB - This paper describes a study which was undertaken in order to assess nurses' knowledge regarding catheter size and determine whether the size of the catheter chosen related to patient discomfort. The results presented are those of the pilot study. The knowledge level of nurses regarding criteria for selection of catheter size was variable and demonstrated deficits reported by other studies. The patients included in the sample (n = 23) did not experience significant discomfort, leaking or pain as a result of catheter size which varied from 14 2Ch. PMID- 1765407 TI - Experimental study on the metabolism of dimethylethylamine in man. AB - Dimethylethylamine (DMEA) is an aliphatic tertiary amine, which is used as a catalyst in the mould core manufacturing. During 8 h, four healthy volunteers were exposed to four different DMEA air concentrations (10, 20, 40 and 50 mg/m3; 20 mg/m3, two subjects only). DMEA was biotransformed into dimethylethylamine N oxide (DMEAO). On average, DMEAO, accounted for 90% of the combined amount of DMEA and DMEAO excreted into the urine. The half-lives of DMEA and DMEAO in plasma were 1.3 and 3.0 h, respectively. The urinary excretion of DMEA and DMEAO followed a two-phase pattern. The half-lives in the first phase were 1.5 h for DMEA and 2.5 h for DMEAO. In the second phase, which started about 9 h after the end of exposure, half-lives of 7 h for DMEA and 8 h for DMEAO were recorded. The combined concentration of DMEA and DMEAO, in both plasma and urine, showed an excellent correlation with the air concentration of DMEA. Thus, both urinary excretion and plasma concentration can be used for biological monitoring of exposure to DMEA. An 8-h exposure to 10 mg DMEA/m3 corresponds to a postexposure plasma concentration and 2-h postexposure urinary excretion of 4.9 mumol/l and 75 mmol/mol creatinine, respectively. PMID- 1765408 TI - Methanol in urine as a biological indicator of occupational exposure to methanol vapor. AB - The exposure-excretion relationship and possible health effects of exposure to methanol vapor were studied in 33 exposed workers during the second half of 2 working weeks. Urinary methanol concentrations were also determined in 91 nonexposed subjects. The geometric mean value for methanol in urine samples from the latter was less than 2 mg/l (95% upper limit of normal, less than 5 mg/l) when log-normal distribution was assumed. Among the exposed workers, the methanol level in urine samples collected prior to the work shift exceeded the 95% upper limit of normal. The time-weighted average intensity of exposure to methanol vapor was measured using personal sampling devices (in which water severed as an absorbent) in 48 cases of methanol exposure (i.e., 2 of the 33 exposed workers failed to provide urine samples, whereas 17 subjects were examined twice). Methanol concentrations in urine were determined in samples collected at the end of the shift from the 48 exposed cases as well as from 30 nonexposed controls. There was a significant correlation between the exposure to methanol vapor at concentrations of up to 5,500 ppm and the levels of methanol measured in the shift-end urine samples. The calculation indicated that a mean level of 42 mg methanol/l urine (95% confidence range, 26-60 mg/kg) was excreted in the shift end urine sample following 8 h exposure to methanol at 200 ppm (the current occupational exposure limit). Dimmed vision and nasal irritation were among the most frequent symptoms complained during work. Three cases showing clinical signs of borderline significance were identified. PMID- 1765409 TI - Biological monitoring of occupational exposure to methyl ethyl ketone. AB - This study was conducted to evaluate the usefulness of three commonly used methods of biological monitoring for worker exposed to methyl ethyl ketone (MEK) under field conditions using blood, breath and urine. Environmental MEK exposures were measured by personal sampling with carbon-felt dosimeters. The correlation coefficient (r) between the time-weighted average (TWA) MEK concentration in air and the MEK concentration in blood collected at the end of the work shift was 0.85. The correlation coefficient between the TWA MEK level in air and the concentration exhaled in the breath of workers at the end of the work shift was 0.71. The end-of-shift urinary MEK excretion correlated best with the environmental concentration (r = 0.89). Correlations became lower after urine samples had been corrected for urinary creatinine (r = 0.83) or specific gravity (r = 0.73). After 8 h exposure to 200 ppm MEK, the corresponding end-of-shift urinary excretion was 5.1 mumol/l or 4.11 mg/g creatinine. This value is higher than that previously found in some studies, the difference probably being due to the physical activities of the present workers and their extensive skin contact with the solvent. The kinetics of inhaled MEK was also studied in eight subjects. Breath and urine samples were collected during the 8-h work shift on 2 consecutive Mondays. The results showed that urinary MEK excretion rose steadily until the end of exposure, whereas the MEK concentration in exhaled air varied markedly throughout the day.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765410 TI - Biological monitoring of 2,4-dichlorophenoxyacetic acid-exposed workers in agriculture and forestry. AB - This is a report on the application of a radioimmunoassay (RIA) for the herbicide 2,4-dichlorophenoxyacetic acid (2,4-D) in biological monitoring of occupationally exposed sprayers. Urinalysis was conducted on two workers involved in spraying 2,4-D sodium salt solution with car mounted ground rigs in agriculture and on the pilot and the mixer-loader of a helicopter crew applying 2,4-D dimethylamine salt for brush control in forestry. All sprayers showed detectable quantities of 2,4-D in morning urine samples voided over 4 or 6 days in the post-spraying period. The highest 2,4-D urinary concentrations of about 2.5 ppm could be measured in a car driver on the 3 day after exposure. The 2,4-D level in urine was much lower in forestry workers, with 0.365 ppm for the mixer-loader and 0.052 ppm for the pilot on the 1 day after spraying. Urinary 2,4-D concentrations in the agricultural study were adjusted for endogenous creatinine and, when normalized for body weight, resulted in a total 2,4-D uptake of about 5.7 or 84.9 micrograms/kg body wt. for a single spraying operation. Thus, the calculated absorbed dose was less than the NOAEL (no observed adverse effect level) of 10 mg/kg body weight per day by a large margin of safety. Further, the calculated amounts excreted seemed to be sufficiently reliable to be used for assessing the risk of human exposure to 2,4-D. However, more studies are desirable for confirmation of the association of urinary 2,4-D and creatinine excretion. Clearance occurs with a 12-h to 22-h half life. PMID- 1765411 TI - The applicability of the measurement of urinary thioethers. A study of humans exposed to styrene during diet standardization. AB - The excretion of thioethers was measured in the urine of 6 volunteers, who were experimentally exposed to styrene, and 18 styrene workers. In addition, 12 clerks (non-smokers) and 12 sheet-metal workers (smokers) served as control groups. Diet was standardized during the experiments. Thioethers were measured by a spectrophotometric method. The volunteers were exposed to styrene, 210 mg/m3, for 2h at a 50-W workload. An increase in thioether excretion was observed; the largest was in the urine samples collected between 0.5 and 5 h after the end of the exposure. After 43 h the excretion of thioethers was close to the pre exposure level (3.5 mmol/mol creatinine). About 1% of the styrene absorbed was detected as thioethers in urine, which is only about 1/10 of the conversion reported for rats. From excretion rate curves a half-life of about 11 h was calculated for styrene thioethers. The styrene workers were employed at two plants. The average exposure to styrene (time-weighted average 8 h) was estimated to be about 115 mg/m3 (smokers in plant A), 55 mg/m3 (non-smokers in plant A) and less than or equal to 10 mg/m3 (non-smokers in plant B). The excretion of thioethers in exposed workers at plant A was higher by 2-4 mmol/mol creatinine than that in non-exposed controls. In plant B, where exposure was lower, an increase in that amount of thioethers excreted in the urine by exposed workers was less pronounced, and was statistically significant only when post-shift samples were compared with pre-shift samples.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765412 TI - Biological monitoring and medical screening at the workplace in the EC countries. AB - Health surveillance in the work environment involves continuous biological monitoring and medical screening, with the purpose of primary and secondary prophylaxis of work-related diseases. Is this screening activity governed by a rationale based on knowledge of dangerous exposure and the availability of valid tests? In the USA, where health surveillance programmes are used extensively, a study has found screening activity to be associated more with plant size than which relevant exposure. This study was done to elucidate the character and extent of use of health surveillance in the work environment in the EC countries with the aid of a questionnaire survey. The chief medical officers of the National Labour Inspectorates supplied information on substances covered by health surveillance programme in the EC member states, together with the legislative status and numbers of exposed workers. Belgium, France, Italy and the former Federal Republic of Germany made extensive use of health surveillance programmes in cases of known exposure to metals, organic solvents, carcinogenic and genotoxic substances, mineral dust, ionizing radiation, and biological agents. Denmark and Holland ran national programmes only for substances covered by EC directives, while England, Ireland, Spain, and Portugal comprised an intermediate user group. The result suggest that the use of health surveillance is related more to the national choice of standard regulatory instruments than to relevant exposure. PMID- 1765413 TI - Relative cardiac cost and physical, mental and psychological work load among a group of post-operative care personnel. AB - Continuous registration of heart rate and careful minute-by-minute observation of all physical, mental and psychological job-related events was carried out in a group of nine post-operative care personnel. The relative cardiac cost (RCC) correlated significantly with the observed work events. The magnitude of participation of physical, mental and psychological work elements in the changes in RCC varied in the investigated subjects according to the type and magnitude of the different work events. However, collective data on the group indicated that changes in RCC were related mainly to physical effort and to a lesser, albeit significant, extent to psychological reaction. The results indicate the possibility of using the heart rate in monitoring working conditions and, probably, in guiding their improvement. PMID- 1765414 TI - Urinary excretion of proteins and enzymes in workers exposed to hydrocarbons in a shoe factory. AB - A cross-sectional study was conducted to determine whether exposure to hydrocarbons in a shoe factory may produce renal effects that can be detected by determination of the urinary excretion of proteins and enzymes. The study population included 59 women who had been exposed to petroleum naphtha and toluene and 24 age-matched control women. The time-weighted average exposure to petroleum naphtha, toluene and ethylacetate was 1,619,81 and 160 mg/m3, respectively. The integrity of the renal structures or functions was assessed by measuring the urinary excretion of total protein, beta 2-microglobulin, retinol binding protein, albumin, transferrin, lysozyme, lactate dehydrogenase and beta-N acetylglucosaminidase (NAG). The only parameter that was significantly influenced by hydrocarbon exposure was the urinary activity of beta-N-acetylglucosaminidase. Although the health significance of this renal change, which was not accompanied by changes in the urinary excretion of low- or high-molecular-weight proteins, is unclear, the results of the present study are in agreement with our previous observations suggesting that long-term moderate exposure to solvents does not entail a significant risk for the development of nephrotoxicity. PMID- 1765415 TI - Atopic allergy to chloramine-T and the demonstration of specific IgE antibodies by the radioallergosorbent test. AB - Chloramine-T is a small molecular oxidizing agent that has been widely used as a disinfectant since the beginning of this century. It is generally used in a 5% solution but it is also supplied in powder form. Sporadic case reports of immediate-type sensitization to this agent associated with symptoms of asthma, rhinitis and urticaria have appeared during recent decades. In one of the reports, specific IgE antibodies in sera of four patients who developed asthmatic symptoms after exposure to chloramine-T were demonstrated using a radioimmuno assay. Three cases of bronchial asthma in workers who had handled chloramine-T powder are described in the present report. Positive skin-prick test reactions to chloramine-T were observed and specific IgE antibodies to human serum albumin treated with chloramine-T were detected using the classic radioallergosorbent (RAST) technique in all three patients. PMID- 1765416 TI - Effects of age and drugs on food and fluid intake. AB - In young adults rats (5-month-old) d-amphetamine (2 mg/kg/d), administered on a long-term basis via drinking water, caused a moderate reduction in the intake of nutriments, which in part normalized within three weeks. Self-administration of a daily dose of 20 mg per kg diazepam over a period of 26 days led neither to hypodipsia nor to anorexia. Pentylenetetrazol (70 mg/kg/d) primarily produced a hypodipsia. The three drugs did not influence body weight. In 27-month-old rats d amphetamine and pentylenetetrazol had the same qualitative effects. Intake of nutriments and the development of body weight were influenced more strongly than in young rats. Diazepam also had a marked effect in old animals. Nootropics (piracetam, pyrithinol, hydergin, centrophenoxin, aniracetam) had no effects on the parameters observed. When the agents were given in combination in both age groups the nootropic piracetam (230 mg/kg/d) weakened the effects induced by d amphetamine, pentylenetetrazol or diazepam alone. The benzodiazepine, however, enhanced the loss of body weight and fluid intake in old rats caused by the stimulant or analeptic, whereas food intake remained unaffected. The results support the hypothesis that an organism's adaptivity to external and internal stimuli is reduced in later life. The behavior of young and old rats in the open field was not affected by any drug medication. PMID- 1765417 TI - Reduction in rate of occurrence of age related lesions in dietary restricted laboratory mice. AB - This report describes the results of a study to find differences in the distribution of pathologic lesions between 40% dietary restricted (DR) and ad libitum (AL) fed mice of four genotypes, C57BL/6NNia, DBA/2NNia, B6D2F1NNia and B6C3F1NNia. Representative samples of all organs were studied from 1134 mice killed at 12, 18, 24 and 30 months of age. Approximately half were female, half male. All mice were fed a natural ingredient diet, NIH-31 and were maintained under pathogen free conditions. A total of 135 lesions was observed. The rate of occurrence of each of 35 common lesions is described for each age/genotype/sex in the study. Fifteen lesions are described in detail. Highly significant differences were found between mice of the same age, sex and genotype in the two diet groups in the percent rate of occurrence of total lesions, total tumors, and total lymphoid nodules of various organs. These parameters generally increased with age in both diet groups. For example, of female mice of all genotypes at 24 months, 51% AL and 13% DR mice had tumors. These percentages were 123% and 17% respectively at 30 months. The evidence presented here suggests that total tumors, total lymphoid nodules, total lesions, and absence of lesions are all useful measures of aging, independent of the life span, that reflect the long known effect of dietary restriction on reducing the rate of aging. These parameters, however, only partially reflected the longer life span of hybrid as compared with inbred mice. PMID- 1765418 TI - Separation of two subpopulations of old human fibroblasts by mitochondria (rhodamine 123) fluorescence. AB - The mitochondria-binding fluorescent dye rhodamine 123 (R123) was used to sort two subpopulations of cells from mass cultures of old human fibroblasts (HF). Both subpopulations showed unusual dye retention kinetics when compared to young HF. Additionally, electron microscopy revealed differences in numerical density of mitochondria between young and old HF. Moreover, the two subpopulations exhibited differences in radiolabeled thymidine incorporation and proliferative capacity. The results obtained suggest a possible relationship between mitochondria, proliferative potential and cellular aging. PMID- 1765419 TI - Multiphasic analysis of growth curves for progeny of a somatotropin transgenic male mouse. AB - Diphasic functions were applied to growth curves for body weight and for tail length of mice that were progeny of a transgenic male mated to random-bred NMRI females. A group of 20 female and male mice with high (H) body weight at week 12, assumed to be transgenic, and a group of 20 with normal (N) body weight, assumed to be non-transgenic, were selected for comparison. Body weight and tail length were measured about weekly from 3 to 26 weeks of age. Body weight for H mice at week 26 averaged 1.6 (females) times and 1.9 (males) times that of N littermates. The H mice averaged 1.3 times the gain in weight in first phase for N mice; H mice averaged 2.0 times the gain in second phase for N mice. Tail length for H mice at week 26 averaged 1.1 times that of N littermates. The H mice averaged .9 times the gain in length in first phase for N mice; H mice averaged 1.5 times the gain in second phase for N mice. For H mice, larger tail-length gain in second phase more than compensated for smaller gain in first phase. The transgenic effect may be different for body weight than for tail length. For body weight, the effect was continuous over the entire 26 weeks. For tail length, however, the effect was to delay growth of the tail. PMID- 1765421 TI - Pooling resources for HIV/AIDS orphans. PMID- 1765420 TI - Multiphasic growth and allometry. AB - Multiphasic growth assumes increase in body weight, or in other body measures, to be a result of more than one growth phase. Therefore, the concept of allometry can be extended from relation between body measures to relation between phases of growth. For two phases of growth, body weight (W) and tail length (L) can be partitioned into W1 + W2 and L1 + L2. Here, W1 and W2 correspond to phases 1 and 2 of weight and L1 and L2 to phases 1 and 2 of length, where each phase is described by a logistic function. Diphasic functions were applied to growth curves for body weight and for tail length of mice that were progeny of a transgenic male mated to random-bred NMRI females. A group of 20 female and male mice with high body weight at week 12, assumed to be transgenic, and a group of 20 with normal body weight, assumed to be non-transgenic, were selected for comparison. Body weight and tail length were measured about weekly from 3 to 26 weeks of age. Allometric relations between phases for weight (W1 and W2) and tail length (L1 and L2) are presented using predicted values based on estimated parameters of the diphasic growth functions. Differences between ages at maximum gain and ratios of duration of phases were analyzed. Growth in second phase of body weight appeared to be unrelated to growth in first phase of body weight and unrelated to growth in tail length. Growth in each phase of tail length appeared to be close to a simple allometric relation with growth in first phase of body weight. It is now feasible to study multiphasic allometric relations of growth between phases of one body measure and between phases of different body measures by comparing estimates of parameters of the multiphasic growth function. PMID- 1765422 TI - Rampant HIV spread in developing countries. PMID- 1765423 TI - Switzerland: an innovative AIDS prevention campaign. PMID- 1765424 TI - Support workers in the UK. PMID- 1765425 TI - Support workers in Japan. PMID- 1765426 TI - Support workers in Zimbabwe. AB - The Ministry of Health in Zimbabwe inherited a health delivery system that was characterized by inequalities in terms of both health status and provision of health care. Inherent in this system is social injustice in that 80% of the budget catered for the privileged 20% of the population that was based in urban areas in the former system. There was maldistribution of resources to the extent that the majority of Zimbabwean people (mostly peasant blacks) had no access to any of the health care. Human resources for nursing were tailored only to meet the needs of the privileged few. PMID- 1765427 TI - Support workers in Panama. PMID- 1765428 TI - Global issues for nurses and nursing. PMID- 1765429 TI - Use of physical assessment skills by Australian nurses. AB - The use of physical assessment skills, though limited, has been an integral part of nursing since the time of Florence Nightingale, when aids such as sight and touch were relied upon to assess patients. Now with more nurses involved in primary health the use of a wider range of physical assessment has become necessary. Below is a report of how Australian nurses are putting more of these skills into practice. PMID- 1765430 TI - Primary nursing in Finland. PMID- 1765431 TI - Correlation between urokinase-type plasminogen activator production and the metastatic ability of human rectal cancer cells. AB - The correlation between the production of plasminogen activators (PA), especially urokinase-type PA (u-PA), by cancer cells and their metastatic potential was studied. For this purpose, cells from the human rectal adenocarcinoma tumor line (RCM-l/nu) originally maintained by serial passage in nude mice as the solid subcutaneous tumor, were injected into the spleen. Cancer cells from liver metastatic foci were suspended and then injected into the spleen. After 10 cycles of this selection, a highly metastatic liver tumor line termed L-10 was obtained. The amount of u-PA in the supernatant of the tumor homogenate of L-10 was larger than that of RCM-l/nu. Using an in vitro culture system, the media conditioned by L-10 cells had a higher PA activity and a higher u-PA antigen level than by RCM l/nu cells. The apparent difference in u-PA activity and antigen levels of these two lines was not due to the difference in the production of plasminogen activator inhibitor (PAI), because PAI antigen level and PAI activity in the culture media were almost equal between them. No tissue-type PA production was detectable in these tumor lines. From these results we deduce that u-PA may play an important role in tumor metastasis. PMID- 1765432 TI - Growth properties, differentiation capacity and oncogene expression in metastatic and nonmetastatic Friend leukemia cell variants. AB - The aims of this study were: (1) to characterize the biologic properties of the WGA-resistant (WR) Friend leukemia cells (FLC) as compared to the original nonmetastatic or highly metastatic FLC; (2) to investigate the possible correlations between the expression of some oncogenes (i.e., c-myc, H-ras and K ras) and the in vitro and in vivo behavior of FLC. The tumorigenic behavior of the different FLC types strongly depended on the site of tumor injection. Both WR FLC and in vitro passaged FLC did not grow as ascites (when injected intraperitoneally) and developed large solid tumors (when injected subcutaneously), without forming any spleen or liver metastasis. In contrast, in vivo passaged FLC rapidly formed hemorrhagic ascites when injected intraperitoneally; the subcutaneous injection of these cells resulted in the development of solid tumors, which were smaller than the other FLC tumors, but capable of metastasizing to the liver and to the spleen. No significant differences were observed in the in vitro growth characteristics and cell cycle parameters among the different FLC types under various experimental conditions (i.e., FCS concentration or cell seeding densities). Similarly to the metastatic in vivo passaged parental cells, WR FLC exhibited a much lower erythroid differentiation after in vitro addition of either dimethyl sulfoxide or hexamethylene bisacetamide than the in vitro passaged FLC. High levels of c-myc oncogene mRNA were expressed in all FLC variants; no major variations in the c myc expression were observed in FLC cultivated in medium supplemented with different FCS concentrations and/or seeded at various cell densities. In addition, no changes in the expression of H-ras or K-ras were observed between the different FLC types. PMID- 1765433 TI - Relative malignant potential of human breast carcinoma cell lines established from pleural effusions and a brain metastasis. AB - Three human breast cancer cell lines from pleural effusions (MDA-MB-435, MDA-MB 231, MDA-MB-468) and one from a brain metastasis (MDA-MB-361) were tested for growth potential in vitro (minimum serum requirements, growth in semisolid agarose), for tumorigenicity and metastasis in nude mice following injection into the mammary fatpad (m.f.p.) and intravenously (i.v.), and for formation of experimental brain metastasis following injection into the carotid artery (i.a.). Colony-forming efficiency of the breast cancer cells in dense agarose corresponded with metastatic potential of the m.f.p. tumors. The results consistently ranked the 4 cell lines as follows: MDA-MB-435 greater than MDA-MB 231 greater than MDA-MB-468 greater than MDA-MB-361, from the most to the least aggressive. The exception was for tumor growth in the brain after i.a. injection of cells, where MDA-MB-361 cells were ranked as second highest for tumor take, but with the slowest growth rate. These results indicate that in this series of breast carcinomas, the cells from a brain metastasis (MDA-MB-361) have a lower malignant potential than cells from visceral metastases. PMID- 1765434 TI - Parathymic lymph nodes during growth and rejection of intraperitoneally inoculated tumor cells. AB - The omental lymphoid organ (OLO) is a part of the greater omentum composed of vascularized milky spots situated between fat cells and containing lymphocytes, plasma cells and macrophages. We analysed the disappearance of intraperitoneally injected tumor cells from the peritoneal cavity and their infiltration into and disappearance from the OLO and the parathymic lymph nodes (PTLN) that drain the peritoneal cavity. After intraperitoneal inoculation of irradiated syngeneic tumor cells, they were visible in the OLO within 24 h. After 3 days, no tumor cells were seen anymore, but there were many macrophages that had phagocytosed tumor cells. After intraperitoneal inoculation of nonirradiated syngeneic tumor cells, a solid growing tumor mass developed in the OLO. The PTLN were also invaded by these nonirradiated tumor cells within 24 h as transfer of cell suspensions of these lymph nodes into naive mice leads to the death of the recipient mice due to tumor growth. However, from day 6 onwards, after tumor inoculation, these lymph nodes contained no tumor cells, despite progressive tumor growth intraperitoneally and in the liver and lungs. In allogeneic mice, tumor cells were rejected in the OLO after 7-10 days. Simultaneously, the number of lymphocytes and macrophages increased and a plasma cell reaction developed. The PTLN did not have tumor-inducing potency at any stage after intraperitoneal tumor injection. This study suggests, that the PTLN are more effective in the (local) eradication of tumor cells than the OLO. Still, considering its immunological potential, the OLO might be important as 'inducer' of immunological reactions in the peritoneal cavity. PMID- 1765435 TI - Modulation of host resistance to metastasis in the lungs of aged retired breeder mice. AB - Pretreatment with a single injection of poly I.C inhibited lung colonization by tumor line 4T07 cells in mice regardless of age. However, preimmunization inhibited lung colonization by intravenously injected 4T07 cells in young mice (10-16 weeks of age) but not in retired breeders (median age greater than 72 weeks). Analysis of kinetics of clearance and expansion of the clonogenic tumor stem cell population revealed that the initial rates of clearance were similar for control young mice and retired breeders, but the subsequent rate of expansion in control retired breeders was half that in young mice. As in young mice, pretreatment of retired breeders with poly I.C increased the initial rate of clearance of intravenously injected 4T07 cells but did not inhibit growth measured between days 1 and 8. Preimmunization, which inhibits growth of neoplastic cells in young mice, did not inhibit expansion of the clonogenic population in the lungs of retired breeders. PMID- 1765436 TI - Fatty liver. Chemical shift phase-difference and suppression magnetic resonance imaging techniques in animals, phantoms, and humans. AB - In vitro animal and human models were used to evaluate the potential of chemical shift magnetic resonance imaging (MRI) for assessing fatty liver. Phantoms of varying fat content were created from mayonnaise-agar preparations. Fatty liver was induced in eight rats by feeding them ethanol for three to six weeks (36% of total calories), whereas eight control rats were fed a normal diet. T1-weighted in-phase and opposed-phase MR images were obtained of the phantoms animals, and 28 human subjects. Additional images obtained in animals included long TR images with in-phase and opposed-phase technique, and hybrid chemical shift water and fat suppression. The rats were killed and histologic status was graded blindly by a hepatopathologist as normal, mild, moderate, or severe fatty change, for correlation with MR grading. Quantitative analysis of MR images included fat signal fraction for animals, and relative signal decrease between in-phase and opposed-phase images for phantom and human data. Phantom in-phase signal increased linearly with respect to fat content, whereas opposed-phase signal decreased linearly. MRI and histologic grading of rat livers were highly correlated, especially when based on water suppression images (r = 0.91, P = .0001). Opposed-phase images were also highly correlated, while fat suppression images were less effective. There was no overlap between MR-derived fat fractions for control (2.6%-5.7%) versus ethanol-fed rats (7.7%-17.9%, P = .0002). Human liver considered to be fatty by visual inspection (n = 8) had higher relative signal decrease than nonfatty liver (n = 22) (P less than .001). Phantom, animal, and human data demonstrate that comparison of T1-weighted in-phase and opposed phase images is both practical and sensitive in the detection and grading of fatty liver. PMID- 1765437 TI - Clinical magnetic resonance spectroscopy of human breast disease. AB - Using image-guided volume-selection techniques, in vivo phosphorus-31 magnetic resonance (MR) spectroscopic profiles were obtained from 12 patients with malignant breast tumors, six patients with benign breast tumors, and nine volunteers with no underlying pathologic condition. Phosphatic metabolites identified in the spectral profiles included the phosphomonoesters (PME), inorganic phosphate (Pi), phosphodiesters (PDE), phosphorylated glycans (PG), phosphocreatine (PCr) and adenosine triphosphate (ATP). Based on the results of previous high-resolution ex vivo 31P MR spectroscopic analyses of breast tissues, the resonance of PG was identified in malignant and benign breast tumors. Malignant tumors were found to have a significantly (P less than .05) lower concentration of (PME + Pi) than normal breast parenchyma, and were distinguishable from both benign tumors and normal breast parenchymal tissue by significantly (P less than .01) elevated levels of (PDE + PG). 31P MR spectroscopy is the first technique potentially capable of differentiating among malignant breast tumors, benign breast tumors, and normal breast parenchymal tissues based on their in vivo phosphatic metabolic profiles. PMID- 1765438 TI - Gadolinium-DTPA-enhanced magnetic resonance imaging of the isolated rat heart after ischemia and reperfusion. AB - The objective of this study was to assess the potential of gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) to identify myocardial ischemia and reperfusion in the isolated rat heart model. Ischemia was induced by reducing the perfusion pressure from 80 to 30 mm Hg for 2 hours. Hearts were not reperfused, or were reperfused for 20 minutes or for 2 hours. Perfusion was performed with Evans blue dye and/or Gd-DTPA for 3 minutes. Twenty isolated rat hearts were perfused according to the Langendorff method, and divided into five groups according to the perfusion status and the use of Gd-DTPA and/or Evans blue as perfusion markers. The Evans blue distribution in the hearts was assessed by point-counting volumetry. The Gd-DTPA distribution was assessed by magnetic resonance microimaging at 6.3 T field strength. Evans blue staining clearly identified areas with "no flow" or "no reflow." Perfusion with Gd-DTPA enhanced signal intensity significantly, both in ischemic and reperfused myocardium. Signal intensity in hearts reperfused for 2 hours was increased significantly compared to nonreperfused ischemic hearts, but not to ischemic hearts reperfused for 20 minutes. Magnetic resonance imaging with the aid of Gd-DTPA can identify ischemia and reperfusion in the isolated rat heart, dependent on residual perfusion. PMID- 1765439 TI - Quantitation of reperfused myocardial infarction by Gd-DOTA-enhanced magnetic resonance imaging. An experimental study. AB - Because there is evidence that myocardial infarct size is modified by coronary artery reperfusion, an ex vivo experimental model of myocardial infarction was developed to determine the influence of the timing of gadolinium tetraazacyclododecane tetraacetic acid (Gd-DOTA)-enhanced magnetic resonance imaging (MRI) on the accuracy of infarct size quantitation. Eighteen dogs underwent a 2-hour coronary occlusion followed by 1 (n = 6), 6 (n = 6), or 48 (n = 6) hours of reperfusion. Gd-DOTA was injected 10 minutes before the dogs were killed. T1 (SE 250/26) and T2 (SE 1500/78) weighted images were performed on excised hearts. Gd-DOTA concentration was measured in myocardium by atomic emission spectrometry, and correlated with myocardial blood flow evaluated by radioactive microspheres. All dogs presented with myocardial infarction (mean size 20.4% +/- 3.1% of the left ventricle), and a corresponding area of increased signal intensity on T1-weighted MR images. In none of the three groups did the area of high signal intensity correlate with the ischemic area. By contrast, after 6 and 48 hours of reperfusion, the high signal intensity area (17.9% +/- 2.4%) closely matched the area of nonreversible jeopardized tissue (16.4% +/- 2.5%), as determined on tetrazolium-stained heart slices. Although a noreflow phenomenon was observed in the jeopardized tissue, Gd-DOTA concentration was higher in the subendocardial central ischemic zone than in normally perfused myocardium. Gd-DOTA imaging enhancement seems to be the consequence of a delayed clearance of the agent from the injured tissue. Gd-DOTA-enhanced MRI accurately quantitates the size of reperfused myocardial infarction on the ex vivo heart for more than 6 hours after the beginning of reperfusion. It remains to be determined whether the in vitro results obtained here can be applied to assess the myocardial infarct size in vivo. PMID- 1765440 TI - Cine phase-contrast magnetic resonance imaging for analysis of flow phenomena in experimental aortic dissection. AB - Using a 1.5 T magnetic resonance imaging (MRI) system, cine phase-contrast and magnitude images were obtained in three phantoms that simulated different anatomic configurations of aortic dissection. The dissection phantoms were made of compliant materials, and pulsatile flow was used in all experiments. Phantoms differed only in the location of the fenestration between the true and false lumens (I: an upstream "entry" only, II: both upstream "entry" and downstream "re entry," and III: a downstream "entry" only). Flow jets, flap motion, and wave propagation were clearly visualized in cine MR images of each phantom, and quantitatively analyzed with reference to the stimulated cardiac cycle of the pump. Flow in the false lumen was always bidirectional. Upstream and downstream flow waves collided and dispersed within the false lumen. Flow through the false lumen was the same in phantoms I and II, and least in phantom III. The average area of the true lumen was largest in phantom III and smallest in I. Phantom I had the highest overall flow rate in the false lumen and greatest change in false lumen size during the cardiac cycle, while the downstream "entry" phantom had the lowest of both parameters. Flow phenomena in aortic dissections can be studied by cine phase-contrast MRI. PMID- 1765441 TI - Influence of cardiac pacing on intracellular sodium in the isolated perfused rat heart. AB - Increased myocardial contractile tension has been described as being associated with increased heart rate. This phenomenon is believed due to greater sodium influx than efflux, resulting in accumulation of intracellular sodium. Sodium-23 nuclear magnetic resonance spectroscopy in combination with extracellular shift reagents offers near-continuous measurements of intracellular sodium that may be correlated with mechanical performance. In this study, the influence of cardiac pacing on intracellular sodium (Na+i), was examined in the isolated perfused rat heart using the paramagnetic shift reagent, Tm(DOTP)5-. The effect of changing heart rate on mechanical performance was measured using a pressure transducer tipped catheter or a fluid-filled catheter during spectroscopic observation. There was no significant change in Na+i with increasing heart rate over a wide range of heart rates, and a fall in developed pressure with increasing heart rate (negative force-frequency relationship) was observed. It is concluded that the concentration of intracellular sodium monitored by this method is not sensitive to changes in heart rate. PMID- 1765442 TI - Pretreatment with steroids before intravenous injection of diatrizoate or iohexol. Effects on urine and serum profiles. AB - The effects on urine and serum profiles of intravenous injection of diatrizoate, iohexol, or saline were studied in male rats pretreated with steroids or saline. Using urinary albumin, glucose, sodium, and the enzymes lactate dehydrogenase (LDH), gamma-glutamyltransferase (GGT), and N-acetyl-beta-D-glucosaminidase (NAG) as markers of glomerular and tubular function, it was found that diatrizoate caused temporary glomerular and tubular dysfunction; the effect was independent of the kind of pretreatment. Iohexol did not cause increased glomerular permeability in steroid- and saline-pretreated rats. When used following saline, iohexol induced increased excretion of three tubular components, whereas iohexol plus steroids caused increased excretion of all five tubular components. The dysfunctional effect of iohexol plus steroids was less than that of diatrizoate plus steroids. The serum components revealed no abnormalities induced by either contrast media or methylprednisolone. Pretreatment with steroids has no effect on the glomerular or tubular dysfunctional effect of diatrizoate, whereas it worsens the temporary tubular dysfunctional effect of iohexol in rats. PMID- 1765443 TI - The effects of gadolinium-DTPA and -DOTA on neural tissue metabolism. AB - Gadolinium DTPA and DOTA are being used extensively for imaging blood-brain barrier lesions. This study was performed to determine clinically relevant blood, cerebrospinal fluid (CSF), and neural tissue concentrations of these agents, and to determine if they alter neural tissue glucose metabolism. Bolus injections of 0.2 mmol Gd-DTPA/kg were made in rabbits, and blood, CSF, and neural tissue Gd concentrations were measured using atomic emission. Rat hippocampus slices were incubated for 6 hours in solutions of Gd-DTPA and Gd-DOTA, and effects on the production of carbon-14-labeled CO2 from glucose determined. Plasma concentrations reached a peak of 2.46 mmol at 1 minute postinjection, and dropped to 50% of peak in 6 minutes. The highest CSF concentration observed was approximately 0.1 mmol, and the mean lumbar cord concentration was approximately 8.5 mumol/g. Gd-DTPA and Gd-DOTA concentrations greater than 1.0 mmol caused significant increases in CO2 production. In areas of blood-brain barrier lesions, Gd-DTPA and Gd-DOTA may cause changes in tissue metabolism; however, in other areas it is much less likely. PMID- 1765444 TI - Effects of nonionic contrast media on the blood-brain barrier. Osmolality versus chemotoxicity. AB - This study was performed to assess the relative contributions of contrast medium osmolality and chemotoxicity to contrast-induced blood-brain barrier (BBB) damage. Experimental carotid angiography was carried out in rabbits with mannitol at an osmolality of 714 mOsm/kg, with the nonionic, monomeric contrast media iohexol and ioversol at similar osmolalities, and with the nonionic, dimeric contrast media iodixanol and iotrolan at osmolalities less than half that of the mannitol. The amount of damage caused by the procedure was assessed by determining the amount of intracerebral extravasation of intravascularly injected technetium-99m-pertechnetate. Mannitol caused no detectable BBB damage, but all four contrast media caused BBB damage that was significantly more severe than that caused by mannitol. The BBB damage caused by carotid angiography with iohexol, ioversol, iodixanol, and iotrolan was not attributable to their osmolalities, but due to some other physical and/or chemical effects of these media on the BBB. PMID- 1765445 TI - Glucose homeostasis in rats exposed to magnetic fields. AB - The development of diagnostic and therapeutic applications of magnetic fields, especially with regard to magnetic resonance imaging (MRI), draws attention to accompanying possible adverse effects. Recent investigations revealing an increase in insulin release in diabetic rats, increase in glycogen, and decrease in glucose level in rats exposed to magnetic fields, have provided the stimulus for the current studies. Rats were exposed to uniform constant magnetic fields of 10(-3) T and 10(-2) T, 1 hour each day, for a period of ten days. Blood glucose slightly increased, the release of insulin decreased, and the glucagon content increased when compared with controls. The efficiency of the hypophysis hypothalamic system changed, as indicated by an increase in the level of growth hormone and thyroid-stimulating hormone. The content of the thyroid hormones, triiodothyronine and thyroxine, was higher between the third and seventh day of exposure. An increase in the cortisol level was also observed. The results might implicate a temporarily diabetic-like response in rats exposed to the magnetic field. PMID- 1765446 TI - Mediastinal bulk in Hodgkin disease. Method of measurement versus prognosis. AB - The presence of a large mediastinal mass (bulk disease) in patients with newly diagnosed Hodgkin disease is believed by many to predict a poorer prognosis and to warrant more aggressive treatment. These masses are formed by an aggregate of mediastinal lymph nodes. The determination of bulk disease is confusing, with at least 27 definitions having been proposed. This study seeks to determine the best definition, and determine the role of thoracic computed tomography (CT) versus chest radiographs in the evaluation of mediastinal bulk disease. One hundred seven consecutive newly diagnosed adult patients with Hodgkin disease were evaluated using 13 commonly used definitions of mediastinal bulk. Of the 76 patients with mediastinal disease, 73 had bulk disease as defined by at least one definition. Of the 16 patients who had recurrence of mediastinal disease, only the presence of bulk disease according to one definition (hilar adenopathy, greater than or equal to 2 cm) was statistically significant in its prediction (P = .05). No definition based on the size of the mediastinal nodal mass reliably predicted those patients with recurrence. No differences in our data were found for differing stages or disease cell types, the presence of extension, or with differing treatment regimens. This study highlights the confusion and controversy surrounding the use of bulk disease of the mediastinum as an adverse prognostic indicator. The numerous methods of measuring mediastinal bulk in patients with newly diagnosed Hodgkin disease are confusing, overlap, and are not statistically reliable in predicting recurrence. Efforts to create a standard or ideal definition were unsuccessful. Thoracic CT was useful in those patients whose bulk disease distorted only one side of the mediastinal silhouette on chest radiographs. PMID- 1765447 TI - The Gold Medal Awards. PMID- 1765448 TI - Latex--a new cause of anaphylaxis. AB - Increased use of latex gloves and condoms as protection against HIV could increase incidence of anaphylactic reaction, say these authors. Contact with latex during an examination, catheterization, delivery or surgery can also cause an anaphylaxis in some patients. PMID- 1765449 TI - The cold war against RSV. AB - Respiratory Syncytial Virus (RSV) can cause substantial morbidity and mortality in high risk patients. The authors discuss prevention and treatment of this virus. PMID- 1765450 TI - Lead intoxication in children. PMID- 1765451 TI - The best interests standard: a comparison of the state's parens patriae authority and judicial oversight in best interests determinations for children and incompetent patients. PMID- 1765452 TI - The Report of the Dutch Governmental Committee on Euthanasia. PMID- 1765453 TI - In re Browning. AB - HELD: Prior judicial approval is not required for a surrogate to exercise the state constitutional right of self-determination of a patient who has become incompetent and who, while competent, specifically expressed her wishes regarding medical treatment decisions orally or in writing. The surrogate, in so exercising that right, must satisfy herself that certain requirements are met. PMID- 1765454 TI - In re Christine Busalacchi. PMID- 1765455 TI - In re Smerdon. PMID- 1765456 TI - State of Minnesota District Court--probate Court Division, County of Hennepin, Fourth Judicial District. PMID- 1765457 TI - Organs for transplantation. The Singapore experience. AB - Singapore's Human Organ Transplant Act presumes that competent adults consent to donate their kidneys in the event of a fatal accident, unless they have refused in writing. No family consent is required. What can other countries wishing to implement a presumed-consent model of organ donation learn from Singapore's experience? PMID- 1765459 TI - The Dutch & the dying. PMID- 1765458 TI - Directed donation. The relevance of race. AB - The difficulty in finding well-matched kidneys for transplantation into black Americans is compounded by the disproportionately low rate of black donation. A program of directed donation that privileged black-to-black transplant could ease the chronic shortage of organs. PMID- 1765460 TI - AIDS & entrepreneurs. PMID- 1765461 TI - Is consent useful when resuscitation isn't? AB - A Do Not Resuscitate order reflects a considered judgment that a physician can no longer stave off death. Why, then, have a patient consent to such an order? The primary point is that physicians should share with patients their judgment about what medicine can and cannot do. Because we cannot make death go away, we must make decisions about when to withhold or limit resuscitation openly, in honest and trusting conversation between doctor and patient. PMID- 1765462 TI - Whose child is this? PMID- 1765463 TI - Please don't tell! PMID- 1765464 TI - Back in the USSR. PMID- 1765465 TI - The patient's choice. PMID- 1765466 TI - Not out of court. PMID- 1765467 TI - Vested interests. PMID- 1765468 TI - About face. PMID- 1765469 TI - Second thoughts on living wills. AB - Advance directives such as living wills are attractive in that they give us a sense of control over our futures. But they also tend to obscure conflicts between a patient's competent wishes and later, incompetent interests. They allow caregivers to avoid evaluating quality of life in assessing the best interests of incompetent patients. PMID- 1765470 TI - Sports medicine in Hawaii: care of the high school athlete in Oahu's public schools. AB - A recent study by the National Athletic Trainers Association indicated that injuries occur more often during practice than during games in high school athletics. Results of the 3-year study indicated that 60% of basketball injuries occurred in boys and young men during practice and 59% occurred in women. About 2/3 of the estimated 120,000 injuries suffered by prep wrestlers each year happen during practice. The study found that an average of 331,865 high school football players (1/3 of the million who play football each year) were sidelined by an injury at least once. With these statistics in mind, our study looks at the approach to the management of injury in the public schools that make up the Oahu Inter-scholastic Association (OIA) in the state of Hawaii. The estimated number of student athletes that participate in organized athletics in the OIA is 7,960 and the number of coaches is 1,189. PMID- 1765471 TI - Principles of traumatic surgery.1942. AB - Traumatic surgery is emergency surgery and the fundamental thing is "to do it now." The 6-hour period is the Golden Period. If we can take care of our wounds during that time we are very much less likely to get infections. After the 6-hour period there is a different type of treatment because the situation is different. Let us debride our wounds; let us use the sulfa drug on the outside as well as internally; but do not regard them as substitutes for the ordinary surgery asepsis of years back. In the infected cases, sulfa drugs are invaluable, but don't rely on sulfa drugs to carry you through; the sulfa drugs won't do it without giving the wound ordinary cleansing; and don't forget that the sulfa drugs are specific for infections of the erysipelas type and other cellulitis. Do not sew up a debrided case, and above all, do not sew it up in a compound fracture. In infections there are 3 indications for incision: local fluctuation, localized tenderness and local induration. Never for brawny induration; never for adenitis. PMID- 1765472 TI - War came to Hawaii.1942. PMID- 1765473 TI - The surgical treatment of patent ductus arteriosus.1955. AB - Fourteen cases of patent ductus arteriosus operated upon without a fatality have been presented. All were treated by ligation and division of the ductus. The importance of the safety factor provided by the Potts-Smith-Gibson clamp has been discussed. A detailed case report of one patient whose operation was complicated by excessive hemorrhage is given in detail. No cerebral or renal damage followed a prolonged period of cardiac massage and only slight permanent cord damage resulted from complete occlusion of the aorta for over 1 hour. PMID- 1765474 TI - The relative value studies: fixed conversion vs. customary fees.1966. AB - Health care legislation, technological advances, increases in biological knowledge, better health and increasing longevity of people, changing patterns of professional activity, and changes in the structure and function of medical institutions are among the factors involved in the changes occurring in the character of the practice of medicine. PMID- 1765475 TI - A review of some tumors of interest for demographic study in Hawaii.1974. AB - Because of its multiracial character, Hawaii presents a unique opportunity to carry out demographic investigations of the etiology of certain common cancers. Tumors with substantially different incidence rates among the major ethnic groups in the Islands, or between a given immigrant group and its country of origin, are of particular interest for such studies. Among the cancer sites meeting these criteria, nasopharynx, stomach, prostate, large bowel, liver, female breast, uterine corpus, ovary, bladder, and thyroid are particularly prominent. PMID- 1765476 TI - Hereditary anemias in Hawaii. 1987. AB - The differential diagnosis of microcytic anemias in Hawaii presents special problems because of the hereditary anemias prevalent in its large Asian subpopulations. Both the alpha- and beta-thalassemias are important because of morbidity and mortality. Heterozygous carriers for either type mimic iron deficiency, which may lead to inappropriate work-up or treatment. The thalassemias and hemoglobin (Hb) variants are all benign in heterozygotes, but if a couple are both heterozygous for the same or for incompatible variants, their children have 25% risk of inheriting a serious anemia. These can be prevented by detecting the heterozygotes, and by offering genetic counseling and fetal testing to couples at risk of having severely affected children. Early detection is also possible by the screening of newborns. Fetal diagnosis, or early detection and treatment, can greatly reduce the consequences of these anemias. Screening and prevention will cost far less than the cost of care for affected patients. PMID- 1765477 TI - Glasgow patients' attitude to doctors' dress and appearance. AB - Three hundred out patients were surveyed by questionnaire to determine their views of doctors' dress and appearance. The majority felt that this was important. Most patients did not mind a male doctor with an earring, a women in trousers or a man without a tie. A majority preferred their doctors to wear a white coat, be free of political badges and for men to have conventional length hair. Older patients are stricter than young patients. Most strict patients would accept more relaxed standards at night and during the weekend. PMID- 1765478 TI - Visitors' perceptions of continuing care. AB - One hundred and sixty-one replies (72% response rate) to a questionnaire sent to regular visitors of elderly continuing care patients showed that 73% of the visitors were first degree relatives. Sixty three per cent visited more than once per week, and were more likely to do so when the distance travelled was less than five miles (p less than 0.01) and the cost under pounds 2.00 (p less than 0.01). The physical surroundings and nursing care were rated as adequate or better by 80% and 92% respectively. Numbers of nurses were rated as inadequate by 44% and numbers of physiotherapists as inadequate by 46%. Increasing the numbers of nurses was suggested as the measure that would most improve the patients' quality of life. To facilitate visiting, continuing care units should be sited close to the community they serve. PMID- 1765479 TI - Audit of a breast cancer screening programme using clinical examination and lightscanning. AB - To ascertain the accuracy of a breast cancer screening programme which relied on clinical examination and lightscanning, women attending between 1984 and 1989 were retrospectively followed-up. Three thousand, seven hundred and twenty women, median age 40 years, made 5,150 visits for screening. Two hundred and sixteen women (4.2%) were positive on screening but only six were found to have breast cancer. The sensitivity of clinical examination was 46%. The likelihood that a lesion found on clinical examination was a breast cancer rose with age, from 1.1% in women under 45 years to 33% in women over 54 years of age. Lightscanning had a sensitivity of 8%, but did not make an independent contribution to diagnosis. Sixty-five asymptomatic women without clinical abnormalities had false positive lightscans requiring subsequent investigation. This screening programme has demonstrated a demand for breast cancer screening from women of all ages. However the yield of clinical examination was low, and lightscanning proved to be an unsatisfactory screening test. Routine audit must be an integral part of all screening programmes. PMID- 1765480 TI - The emergency medical services of Scotland from 1939: a retrospect. PMID- 1765481 TI - Haemorrhoids--fifty years on. PMID- 1765482 TI - A survey of psychiatric patients' views of outpatient clinic facilities. AB - Psychiatric services have been slow to solicit the views of their patients about quality. This study asked attenders at an outpatient clinic at a large psychiatric teaching hospital about their opinions on the referral process, waiting time, access, waiting within the clinic, consultations, and overall satisfaction. Response rates were 86% and 70% for the two parts of an interviewer administered, structured questionnaire. A range of criticisms and concerns were identified, some of which have since been addressed by practical measures. Overall satisfaction was related to the quality of communication within the consultation and to the length of waiting time from referral to appointment. The study confirms the practicality of consumer studies in a psychiatric setting. PMID- 1765483 TI - Costs of investigative protocols for cerebellopontine angle lesions in Scotland. AB - Efficient use of resources demands evaluation of current practices. This paper presents a prospective evaluation of investigative protocols for cerebellopontine angle lesions. Commonly used protocols vary greatly in their clinical effectiveness and in their costs. The use of appropriate protocols would increase the number of tumours correctly diagnosed each year while also limiting the costs of investigation. PMID- 1765484 TI - Scotland's changing diet, gastrointestinal disease and dietary therapy. AB - The changes in the Scottish diet over a long period are outlined. The relevance of diet to the origin and therapy of certain gastrointestinal diseases is discussed. PMID- 1765485 TI - The chief scientist reports ... Health Services Research Networks. PMID- 1765486 TI - Action research and standards of care. The prevention and treatment of pressure sores in elderly patients. PMID- 1765487 TI - [Segmental neurofibromatosis and germ-line mosaicism]. AB - Segmental neurofibromatosis, also designated "NF-V" according to Riccardi's classification, should be considered a mosaic manifestation of one of the other types of neurofibromatosis, mostly of NF-I. Irrespective of the site and size of the body area affected, the patients are always at risk of germ-line mosaicism and they may therefore transmit the phenotype, but not the mosaic, to the next generation. Hence it follows that segmental neurofibromatosis does not constitute a distinct entity, and it is not reasonable to discriminate unilateral from bilateral or "hereditary" from "nonhereditary" forms. PMID- 1765488 TI - [Dermatological manifestations of Sjogren's syndrome]. AB - In primary Sjogren's syndrome, various cutaneous manifestations may become apparent: annular erythema or eruptions reminiscent of erythema multiforme, lichen planus or erythema nodosum (dermo-panniculitis), chilblain-like erythema, purpura, cheilitis, and xerosis, are some of them. In the clinical diagnosis, the following laboratory tests are of value: Schirmer test, rose bengal test, fluorescence staining techniques, gum test, sialography, sialoscintigraphy, lip biopsy. In some cases, dryness can be absent though the above-mentioned skin manifestations are observed. Mothers with Sjogren's syndrome can deliver babies with neonatal lupus erythematosus. Serological testing almost always reveals anti Ro/SSA-autoantibody and the more specific anti-La/SSB in the sera of patients. The sensitivity of detection can be enhanced by using the immunoblotting technique and the two-dimensional immunoblotting method. In some cases, a new antibody against carbonic anhydrase has been detected. PMID- 1765489 TI - [Detection of causal agents of AIDS using polymerase chain reaction and chemiluminescence measurement]. AB - The polymerase chain reaction (PCR) allows the detection of minimal amounts of DNA segments, and thus is used for the laboratory diagnosis of HIV (human immunodeficiency virus). In the present study a solution hybridization assay using acridinium ester-labelled probes was applied for detection of amplified HIV 1 DNA segments. Amplification was achieved by 30 cycles of the polymerase chain reaction using SK38/SK39 primers specific for a constant region of the HIV-1 gag region. Amplified products were hybridized with acridinium phenyl ester-labelled probes and measured by chemiluminescence. All of 163 blood samples obtained from HIV-infected patients (CDC II-CDC IV) were reactive, while autoradiography with a 32P-labelled SK19 probe only detected 146 patients (89.5%). The combination of PCR with chemiluminescence avoids the use of radioactive material and is sensitive and quick, allowing the "PCR results" to be reported on the same day. PMID- 1765490 TI - [Porphyria cutanea uraemica: an obligate systemic disease in chronic kidney insufficiency?]. AB - Patients with chronic renal failure, especially those receiving maintenance haemodialysis, have a number of dermatological alterations. Some of them are similar to those seen in porphyria cutanea tarda (PCT). Whereas early studies showed normal plasma porphyrin levels, a striking elevation of plasma porphyrins, and particularly of uroporphyrin, has recently been found. We measured the concentrations of porphyrins in the plasma and erythrocytes of 55 patients with chronic renal failure and receiving maintenance haemodialysis and also in 7 patients with PCT and 100 healthy volunteers. The mean concentration of porphyrins in plasma was 2.7-fold, and the maximum concentration, 6-fold the highest value measured in plasma of controls. The mean plasma concentration of uroporphyrin was 6-fold higher up to a maximum value of 37-fold the upper limit of the controls. The plasma porphyrin values of 3 of 7 patients with PCT were on the same high level as those measured in patients undergoing haemodialysis. The mean porphyrin concentration in the erythrocytes of haemodialysis patients were 1.5-fold the control values. Because of the known pathophysiological effect of uroporphyrin, especially its stimulation of the collagen synthesis and the activation of the complement system, we suppose that the porphyria cutanea tarda like skin lesions in patients with chronic renal failure are due to the highly increased uroporphyrin concentration. PMID- 1765491 TI - [Bilateral segmental neurofibromatosis]. AB - Segmental neurofibromatosis is a rare type of neurofibromatosis. We report a case of bilateral manifestation, review the literature on this extremely uncommon variant, and discuss the possible causative mechanisms and the genetic risk of segmental neurofibromatosis. PMID- 1765492 TI - [75 years of Cignolin]. AB - Eugen Galewsky (1864-1935), dermatologist in Dresden, introduced 1,8 dihydroxyanthrone (Cignolin, Dithranol) for therapy of psoriasis. He intended to substitute Chrysarobin, a synthetic product, which causes strong discolouring and irritation of skin. In 1916 the firm Farbenfabrik Bayer, Leverkusen, obtained a patent for synthesis of 1.8-dihydroxyanthrone by an inexpensive method. There is a reason to believe that the brother of Eugen Galewsky, the chemist Paul Galewsky, was a co-worker to the Farbenfabrik Bayer and that he recommended his brother Eugen testing Cignolin. Even now Cignolin is still used in the treatment of psoriasis. PMID- 1765493 TI - [Hyperpigmentation of the face]. PMID- 1765494 TI - Swan song or dawn chorus? PMID- 1765495 TI - Perinatal mortality. The bitter fruits of fragmentation. PMID- 1765497 TI - UKCC tackles community nursing. PMID- 1765496 TI - A view of what life is about. Interview by Nick Robin. PMID- 1765498 TI - Project 2000. A challenge to health visiting? PMID- 1765499 TI - What people want to know about health. AB - Brighton health authority and Brighton borough council are jointly planning a 'Healthy living centre' to provide a focal point for local health promotion activities. Sandra Winn and Martin Bradford report on a survey of community groups which not only provided information for the development of the centre but also gave useful insight into the community's concerns about health and people's needs for health information. PMID- 1765500 TI - Chronic and severe eating problems in young children. AB - Children's eating problems are a common worry mentioned by parents. The severity of these can vary widely and the medical services seem to become concerned mostly when the child either starts to lose weight or fails to gain weight adequately. But low weight may not always be the only indicator of severe or chronic eating problems. Jo Douglas describes the children referred to the Day Centre in the Great Ormond Street department of psychological medicine where a based treatment programme is being carried out by a team of therapists to evaluate the most effective form of intervention. PMID- 1765501 TI - How children cope with death. AB - Zoe and Daniel's parents were killed in a car accident. Jessica Markwell describes their reactions to the trauma and how these two young children came to terms with their sudden and tragic bereavement. PMID- 1765502 TI - Power to the parent. AB - Local mothers called them the 'health police'; they set up a group to find out what clients wanted but no-one came; they were spending more time on paperwork than on seeing clients; they were demoralised and stressed. Cath Jackson describes how handing over child health records to parents transformed the working lives of one team of health visitors. PMID- 1765503 TI - Ask the right questions. PMID- 1765504 TI - Private fostering. Racial and health implications. AB - Why should health visitors be concerned with private fostering? First, writes Carol Woollard, because it affects a small but significant number of children, both in London and in county areas throughout England, whose particular health needs should not be ignored. Second, because the Children Act 1989 is bringing in legislative changes which have clear implications for health policies and practices relating to private fostering. It is essential that health visitors be aware of these changes and be able to act on them appropriately. PMID- 1765505 TI - A brief guide to the benefits system. 1. PMID- 1765506 TI - Displaced persons. PMID- 1765508 TI - Flexible tactics. PMID- 1765507 TI - A catalyst for needed changes. PMID- 1765509 TI - Hands across the health divide. PMID- 1765510 TI - 'The health of the nation'. The HVA responds. PMID- 1765511 TI - Family poverty: what can health visitors do? AB - Poverty levels have risen substantially since 1979, particularly among families with dependent children. Between 1979 and 1987 the number of families with children in poverty (with incomes below 50 per cent of average income) increased from 2.8 million to 5.5 million. Families with dependent children are now the largest single group in poverty. Many health visitors see poor families and witness the health effects of poverty on a daily basis. Clare Blackburn attempts to identify what action health visitors can take to make a positive impact on family poverty and draws out some of the key elements of responsive service provision. PMID- 1765512 TI - Campaigning for change. AB - Some health visitors are wary of getting involved in campaigning. But, writes Annette Furley, campaigning and other political action need not conflict with professional codes or personal beliefs. On the contrary, such activities should be part of the health visitor's role although it is important to work through the HVA and not to 'go it alone'. PMID- 1765513 TI - Using the law to improve housing conditions. PMID- 1765514 TI - Breaking the links between social deprivation and poor child health. AB - Shirley Goodwin outlines the evidence demonstrating the links between social deprivation and poor child health outcomes and the sorts of policies and interventions which might break them, with special reference to the provision of social support. She points out the challenges for health visitors and school nurses developing their work in this area in the context of the NHS reforms and the new systems for contracting services. PMID- 1765515 TI - Debt counselling. PMID- 1765516 TI - Setting up a fireguard bank. PMID- 1765517 TI - Maternity rights. The worst in western Europe. PMID- 1765518 TI - A brief guide to the benefits system. 2. PMID- 1765520 TI - Labour relations. Getting streetwise. PMID- 1765519 TI - Skill mix fraud. PMID- 1765521 TI - More on child development. PMID- 1765522 TI - Trusts. Opt out insecurity. AB - Ninety nine more hospitals and health units are to become trusts on 1 April 1992. The government also agreed a further 153 could apply for trust status by April 1993. Four London teaching hospitals, given the go ahead to become trusts, have been delayed until April 1993 to allow an inquiry into the capital's health services. PMID- 1765523 TI - Call for better services and universal screening. PMID- 1765524 TI - Filling the primary health care vacuum. PMID- 1765525 TI - The Children Act 1989: the professional dilemma of advocacy. AB - Stevie Holland looks at the background to the Children Act 1989 and argues that there is a contradiction between the Act's commitment to the welfare of the child and its policy of non-intervention in family life. Although written as a speech for this year's HVA annual professional conference, owing to illness it was not delivered at the conference. PMID- 1765526 TI - Working together to support women with postnatal depression. AB - One in seven mothers is likely to experience postnatal depression. Yet health professionals may still ignore or trivialise this distressing and common disorder, either because they do not understand it or they do not know how to help, writes Christine Jebali. Health visitors and community psychiatric nurses can usefully collaborate to support women experiencing depression after the birth of their child, she believes. Here she describes a special initiative set up in the West Midlands to meet this often unacknowledged need. PMID- 1765527 TI - Health visitor intervention in postnatal depression. AB - Using the Edinburgh postnatal depression scale (EPDS) Ruth Cullinan undertook a study to identify postnatal depression among new mothers in North West Hertfordshire. Following health visitor intervention--which involved six to eight weekly counselling visits--87 per cent of those mothers who had been identified as postnatally depressed had improved. PMID- 1765528 TI - Parent education in preventing behaviour problems. AB - The 'parent education package' (PEP) uses a combination of leaflets and health visitor intervention to help parents prevent the development of behaviour problems in their children. In evaluating PEP Kevin Hewitt et al found that, though popular with parents, the programme produced no actual behaviour change in their children. The results suggest that a successful prevention programme should perhaps focus on encouraging parents to think more positively about their children. PMID- 1765529 TI - Indian summer. AB - Health visitor, Val Rose, won a Florence Nightingale memorial fund scholarship to travel to the Navajo Indian reservation in north America. The health problems of the Navajo are similar to those affecting the traveller population on her own caseload, forced by changing circumstances and legislation to settle on local authority sites in England. Here she describes some of the health problems arising from the settlement of nomadic people. PMID- 1765530 TI - Hands-off health visiting. AB - Health visitors in the east Sussex town of Hailsham have revolutionised their practice with the introduction of team visiting--a controversial move which they believe opens the way to greater flexibility, creativity and, importantly, power to the parent. PMID- 1765531 TI - Maternity leave. Better for baby. AB - Women working in the NHS have won radically improved maternity pay and leave provision under a new general Whitley council (GWC) agreement. The agreement gives women up to a year's paid and unpaid leave and better options for flexible working arrangements on their return. PMID- 1765532 TI - Children's rights. PMID- 1765533 TI - Quantity or quality? PMID- 1765534 TI - Time for action on black health. AB - Black health visitors and school nurses in Wandsworth have formed a special interest group 'Action on black health' to press for improved community health services for African, Afro-Caribbean and Asian communities, as well as the other significant ethnic minority groups inside the south London health authority. PMID- 1765535 TI - Environment. Nappy wars. AB - Disposable nappy manufacturers are coming under increasing pressure from the environmental lobby. Now the Women's Environmental Network (WEN) has hauled Proctor & Gamble before the Advertising Standards Authority. WEN says the company is making false claims about the environmental impact of its Pampers disposable nappies. P&G's claims are endorsed by both the National Childbirth Trust and the Worldwide Fund for Nature. Have the faeces hit the fan? And how much dirt will stick to charities and professional organisations--including the HVA--who accept sponsorship from the company? PMID- 1765536 TI - Open learning. Back to the front line. PMID- 1765537 TI - Physical punishment. Positively no smacking. AB - Like many health visitors Robyn Pound felt uncomfortable when clients threatened or smacked their children, yet seldom felt able to broach the subject as a topic for health promotion. The mother who raises her hand in threat to her toddler is demonstrating a method of management which may well be stacking up problems for the future. Every child needs to learn in a warm and encouraging environment which fosters self esteem. Having clarified in her own mind why parents should not hit their children she describes how she has gone public. PMID- 1765538 TI - Is 'evaluation' a dirty word? AB - How do we measure the important aspects of preventive health care? - what the users of the service value and what we know from experience is working. Pippa Mackeith and Ann Rowe's work at 45 Cope Street, a centre for young mothers, suggests that evaluation can be both acceptable and useful to clients, workers, managers and taxpayers. PMID- 1765539 TI - Is the community health profile necessary? PMID- 1765540 TI - What about adopters? AB - Alison Stewart and Wendy Ring consider the adjustments people who adopt have to make when becoming parents. They outline a scheme to offer parentcraft to adopters and consider the implications for health visiting of this minority group. PMID- 1765541 TI - Records. Rights of access. AB - From 1 November 1991 clients will have right of access to their health records. Health visitor journal outlines the provisions of the Access to Health Records Act 1990; HVA professional officer Jane Naish examines the implications for health visitor and school nurse practice, and solicitor Melanie Barr describes the legal context. PMID- 1765542 TI - School meals. Disappearing dinners. PMID- 1765543 TI - Child care. Bidding for best practice. PMID- 1765544 TI - Smothered by safety. PMID- 1765545 TI - HIV/AIDS prevention. PMID- 1765546 TI - Comparison of longitudinally and cross-sectionally determined age-related decline in spirometric measurements. AB - In order to compare the longitudinally and cross-sectionally determined annual decline of spirometric measurements, we measured spirograms from 326 male adults four times over five years. Acceptable results were obtained three times or more in 269 subjects aged 30 to 55 at the initial survey. Longitudinal annual changes in the height-squared proportional values of forced vital capacity (CFVC), forced expiratory volume in one second (CFEV1), and maximal expiratory flow at 50% and 25% of FVC (CVmax 50 and CVmax 25), was estimated by the model in which the effect of each individual's level was included as an explanatory variable. The cross-sectional annual change in those indices was determined by including the effect of each survey's level in the model. The longitudinal estimate of annual decline was significantly smaller than the cross-sectional estimate for all indices except CVmax 25. No evidence suggested that systemic error of measurement or a learning effect caused significant bias in the data. The discrepancy in the estimated annual changes seemed to be caused by the cohort effect in our subjects, since the cross-sectional analysis is primarily sensitive to harmful factors operating in the past. We concluded that the longitudinal data for individuals or groups should not be compared with any reference value based on a cross-sectional analysis. PMID- 1765547 TI - Subjective symptom increase among dry-cleaning workers exposed to tetrachloroethylene vapor. AB - Subjective symptoms, hematology, serum biochemistry and other clinical signs were investigated in 56 dry-cleaning workers exposed to tetrachloroethylene at 20 ppm (as a geometric mean of 8-hr time-weighted average), and the results were compared with the findings in 69 non-exposed controls from the same factories. There were exposure-related increases in the prevalence of subjective symptoms during the work as well as in the past 3 month period, whereas there was no significant changes in hematology. Effects of the exposure on liver and kidney functions were also negative as judged by emission enzyme activities, BUN and creatinine in the serum. PMID- 1765548 TI - Self-judged work activity level and lipid metabolism in young male adults. PMID- 1765549 TI - Isolation of mouse cells with heavy metal-dependent resistance to G418. AB - Metallothioneins (MTs) are heavy metal-binding proteins which play key roles in protection against heavy metal toxicity, and therefore it is toxicologically important to understand the regulatory mechanism of MT production. In the present work, I isolated mouse cell clones which express the bacterial neo gene (G418 resistance gene) under the control of an MT gene regulatory sequence; such cells will serve as parents for the isolation of mutants defective in MT gene regulation. C-127 and L-929 cells were transformed with a plasmid construct containing the regulatory region of the human MTIIA gene linked to the neo structural gene, and stable G418-resistant transformants were selected. When Zn was given during the selection, the number of the resulting colonies increased significantly, suggesting a Zn-induced expression of the introduced neo gene. The C-127 transformants selected in the presence of Zn have several copies of the neo sequence in the chromosome, and express a neo message in a Zn-inducible manner. When Zn was removed from the medium, G418 damaged the cells. These cell clones are expected to be useful for isolating mutants that will help further understanding of the control mechanism of MT gene expression. PMID- 1765550 TI - [Midwife's role in Chile--impressions from a study trip. Scholarship report]. PMID- 1765551 TI - [Gunny Rockner; the 7th midwife PhD. Interview by Birgit Negussie]. PMID- 1765552 TI - [Innovation activities in a maternity ward, Varnamo hospital]. PMID- 1765553 TI - [Cenaplanf; a center for natural family planning in Montevideo, Uruguay. Report from a study trip]. PMID- 1765554 TI - [Working environment and pregnancy]. PMID- 1765555 TI - [A day full of deliveries--delivery midwife 1991]. PMID- 1765556 TI - [Quality in midwifery activities. Individual care planning--Care record- childbirth plan]. PMID- 1765557 TI - [Pain--a quality of life in women giving birth?]. PMID- 1765558 TI - [More secure parents--study with a joint team of midwives within the maternal health center, delivery room and maternity ward]. PMID- 1765559 TI - [Family planning in New York]. PMID- 1765560 TI - [Observations on a study trip to England. Rotation--future melody]. PMID- 1765562 TI - [Scholarship report from Israel, Summer '90]. PMID- 1765561 TI - [Obstetric Doppler ultrasound--course in Malmo 22-24 April 1991. Report]. PMID- 1765563 TI - Altered testicular hormone production in infertile patients with idiopathic oligoasthenospermia. AB - We studied the kinetics of testicular response to human chorionic gonadotropin (hCG) in oligoasthenospermic and asthenospermic patients (OAZ-AZ). The responses of testosterone (T), androstenedione (A), 17 OH-progesterone (17OHP), and estradiol (E2) were evaluated in 60 OAZ-AZ patients and compared to those of 10 normal men. The responses of T, A, and 17OHP to hCG in the control group displayed a biphasic pattern with an initial peak at 4 hours and a second peak after 24 hours. The E2 response showed a single peak between 24 and 48 hours after hCG administration. OAZ-AZ patients had two types of T responses: group 1 (n = 40) had no first peak and group 2 (n = 20) had a normal response pattern. The response of A was similar to that of T, and the E2 response was normal in both groups. There were three types of 17OHP responses in group 1 (low, high, or normal); however, the 17OHP response was normal in group 2. Treatment of group 1 with aromatase inhibitors (aminoglutethimide or testolactone) induced an improvement of the acute T response only in patients with high or normal 17OHP response to hCG, whereas no effects were observed in patients with low 17OHP response. In group 2, the aromatase inhibitors induced no changes in the T response. These results demonstrate that in some OAZ-AZ patients (group 1, blunted T response) testicular hormone production is altered. They also suggest the presence of two enzyme blocks: one at the 17,20 desmolase level, mediated by E2, and another at early biosynthetic steps, not mediated by E2. PMID- 1765564 TI - Assignment of the gene for human intra-acrosomal protein SP-10 to the p12----q13 region of chromosome 11. AB - The human sperm antigen SP-10 is a testis-specific, intra-acrosomal protein associated with the membranes of the acrosomal vesicle. The molecule has been designated a "primary vaccine candidate" by a World Health Organization (WHO) Taskforce on Contraceptive Vaccines. cDNA cloning and sequencing have indicated that SP-10 is encoded by a 795-base-pair (bp) reading frame that predicts a 265 amino acid protein of 28.3 kd. In this study, we used a 634-bp fragment (bp 68 through 700, amino acids 3 through 222) of the SP-10 sequence to probe, by Southern blotting, EcoRI-digested DNA from 33 mouse/human somatic cell hybrids involving 16 unrelated human cell lines and 4 mouse cell lines. The hybrids were characterized by karyotypic analysis and by mapped enzyme markers. The presence or absence of positive human bands was scored on the blots and the percent of concordance and discordance with a specific human chromosome was determined. The DNA probe for SP-10 showed a concordance of 31 and a discordancy of 0 for human chromosome 11, mapping SP-10 unequivocally to this chromosome. The hybrid XER-7 with the 11/X translocation: 11p12 or 11p11----11qter:: Xq11----Xqter and the hybrid EXR-5CSAZ with the X/11 translocation: Xpter----Xq22::11q13----11qter localized the SP-10 gene to the p12----q13 region. The SP-10 locus has been assigned the gene symbol ACRV1 (acrosomal vesicle protein-1). PMID- 1765565 TI - Endocytosis of androgen-binding protein, clusterin, and transferrin in the efferent ducts and epididymis of the ram. AB - The amount of androgen-binding protein (ABP) in luminal fluid from the central caput epididymidis of the ram, on a per sperm basis, remains the same as that in rete testis fluid (RTF) entering the ductuli efferentes, although greater than 85% of the testicular protein is absorbed in proximal sites. To determine if ABP is spared from endocytosis in proximal sites and if proteins are differentially and selectively absorbed at specific sites in the excurrent ducts, we studied the endocytosis of ABP, clusterin, transferrin, and a 26/35-kd dimer isolated from ovine RTF. Each protein was labeled with colloidal gold and microinjected into the lumen of a ductulus efferens and five specific sites in the ductus epididymidis; uptake was quantified by electron microscopy. Endocytosis of each protein, including ABP, was substantially greater in the ductuli efferentes than in any site in the ductus epididymidis. More ABP was endocytosed in proximal regions of the epididymis than any other protein studied. Endocytosis of the 26/35-kd dimer, like ABP, was greater in proximal sites of the epididymis, whereas endocytosis of clusterin and transferrin was greater in distal sites. Thus, there was a differential absorption, since proteins were endocytosed in one or another specific region of the epididymis, depending on the protein. ABP was endocytosed in the ductuli efferentes and caput epididymidis in amounts similar to or greater than other major testicular proteins, and was not spared from endocytosis in the proximal excurrent ducts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765566 TI - Use of neonatal tolerization and chemical immunosuppression for the production of monoclonal antibodies to maturation-specific sperm surface molecules. AB - Mammalian sperm acquire functional maturity as they move from the caput to the cauda epididymidis. Changes occur in the protein/glycoprotein composition of the sperm plasma membrane during this time, and may be essential to the maturation process. The production of monoclonal antibody (Mab) probes to the maturation specific molecules has been difficult since new proteins comprise a minor portion of total membrane proteins. This report describes a protocol for enhancing the production of Mabs to maturation specific molecules. By injecting neonatal mice with caput epididymal sperm plasma membranes, in combination with chemical immunosuppression at adulthood, the mice were made tolerant to the antigens expressed on the caput sperm membranes. Subsequent immunization with cauda epididymal sperm plasma membranes allowed the production of Mabs to the maturation-specific moieties without the necessity for extensive antigen purification procedures. The majority of the resulting Mabs recognize cauda, not caput, epididymal sperm plasma membranes as determined by enzyme-linked immunosorbent assay (ELISA), immunocytochemistry on unfixed cells, and Western blot analyses, even though the protein profile from caput epididymal sperm plasma membranes is very similar to that from cauda membranes. The five Mabs described also recognize cauda fluid antigens, suggesting that the maturational changes on the sperm plasma membranes arise from interactions with the epididymal fluid. Use of the tolerization/immunosuppression protocol has provided Mab tools to assist in the study of sperm maturation during epididymal transit. PMID- 1765567 TI - 4-MAPC, a 5 alpha-reductase inhibitor, reduces rat ventral prostate weight, DNA, and prostatein concentrations. AB - Several compounds, such as 4-MAPC (4-methyl-3-oxo-4-aza-5 alpha-pregnane-20- carboxylate), that inhibit conversion of testosterone (T) to dihydrotestosterone (DHT) by 5 alpha-reductase have been demonstrated to reduce prostate size in rats and dogs. The current studies were undertaken to determine if this effect is due to a reduction in cell number, in epithelial cell synthetic activity, or both. Eight-week-old intact rats were treated daily for 14 days with sesame seed oil, 4 MAPC (10 mg/kg), 4-MAPC + testosterone propionate (TP, 1 mg/kg), or 4-MAPC + TP (3 mg/kg). Rats were killed 24 hours after the last injection. In the animals treated only with 4-MAPC, ventral prostate weight was reduced 37%, but the 14% reduction in total DNA was not significant. The mean intraprostatic concentration of prostatein, a major secretory protein, was reduced 45% (P less than 0.05). The 3 mg/kg dose of TP increased ventral prostate weight, prostatein concentrations, and acid phosphatase activity, even though DNA/ventral prostate was similar to that in control animals. These observations indicate that the reduction in ventral prostate weight in adult rats is due in part to a reduction in cell number, but the primary effect was due to a reduction in synthetic activity, and possibly atrophy of the epithelial cells. Furthermore, TP in pharmacologic doses increased ventral prostate weight and synthetic activity without increasing DNA. PMID- 1765568 TI - Intracellular calcium accumulation and responsiveness to progesterone in capacitating human spermatozoa. AB - Progesterone induced a rapid, long-lasting, dose-dependent increase of intracellular free calcium concentration ([Ca2+]i) in human sperm capacitated overnight. This effect was not counteracted by the cytosolic progesterone receptor antagonist RU486 (1 mumol/L) nor by the GABA-A receptor antagonists bicuculline (10 mumol/L) and picrotoxin (50 mumol/L). Also, the rank order of potency of several progestative steroids on [Ca2+]i differed from that previously reported for uterine intracellular progesterone receptor or for P-GABA interaction in the central nervous system, indicating a different pathway for progesterone stimulation of human sperm. Modifications of basal and progesterone stimulated [Ca2+]i during sperm capacitation were also studied. A progressive, parallel increase of basal and progesterone-stimulated [Ca2+]i in capacitating spermatozoa was found. In particular, progesterone-stimulated [Ca2+]i increased from a basal concentration of 147% +/- 17% at 10 minutes to 327% +/- 65% after 120 minutes of incubation in capacitating medium. This increase was well correlated with basal [Ca2+]i (r = 0.93). In contrast, basal and progesterone stimulated [Ca2+]i concentrations were constantly low in spermatozoa incubated in noncapacitating medium. In capacitated spermatozoa, initial responsiveness to progesterone and basal [Ca2+]i was higher than in capacitating and noncapacitated samples, and remained constant throughout the duration of the experiment. The progressive, parallel increase of [Ca2+]i and response to progesterone observed during in vitro capacitation of human spermatozoa might be physiologically relevant in vivo during capacitation of sperm in the female genital tract. PMID- 1765569 TI - Impact of clinically silent inflammation on male genital tract organs as reflected by biochemical markers in semen. AB - Three hundred eight-nine healthy, infertile patients were studied to determine the effects of inflammation on genital tract organs. Clinically silent inflammation was diagnosed by measuring polymorphonuclear granulocyte (PMN) elastase in semen. Seminal vesicle, prostate, and epididymis functions were assessed by measuring fructose, citric acid, and neutral alpha-glucosidase in semen. There was a significant relationship between high PMN elastase levels and low citric acid levels in semen; fructose and neutral alpha-glucosidase were not related to PMN elastase. Semen samples with increased PMN elastase levels (greater than 250 and greater than 1,000 ng/ml) showed a high incidence of pathologic citric acid levels (67% and 73%, respectively). These biochemical data indicate that the prostate is the main target in clinically silent male genital tract inflammation. PMID- 1765570 TI - Outliers--noise, nuisance, or opportunity? PMID- 1765571 TI - Triazolam diminishes daytime sleepiness and sleep fragmentation in patients with periodic leg movements in sleep. AB - Fifteen subjects (9 men and 6 women) exhibiting objective evidence of excessive daytime somnolence and periodic leg movements in sleep underwent 4-7 days of treatment with triazolam (0.25 or 0.50 mg) and placebo in a double-blind crossover design. One night of polysomnography followed by daytime multiple sleep latency testing were conducted on the first and last days of each treatment block. By the last day of treatment, the mean multiple sleep latency test score after triazolam (9.0 minutes) was significantly greater than that after placebo (5.7 minutes). Thus, triazolam treatment led to a decrease in daytime somnolence. Triazolam also improved sleep architecture and continuity; it increased total sleep time, decreased the number of awakenings and arousals, and decreased stage 1 and increased stage 2 percentages. Although the frequency of periodic electromyographic bursts remained unchanged, the frequency of associated arousals decreased after treatment. Short-term treatment with triazolam is thus effective in diminishing daytime sleepiness and in improving sleep architecture, continuity and duration in patients with periodic leg movements in sleep. These effects do not seem to be mediated through a decrease in periodic leg movement activity. PMID- 1765572 TI - Thiothixene pharmacokinetic interactions: a study of hepatic enzyme inducers, clearance inhibitors, and demographic variables. AB - Fifty-nine plasma thiothixene concentrations were measured in 42 patients as part of routine therapeutic drug monitoring. Data collection included concomitant medications, smoking history, and demographic variables. A retrospective analysis was performed to assess the effect of these parameters on oral thiothixene clearance. When groups of patients were categorized by concomitant medications (i.e., no interacting drugs, enzyme/clearance inducers, and enzyme/clearance inhibitors), thiothixene clearance was found to be significantly increased by enzyme inducing drugs (e.g., anticonvulsants) and decreased by clearance inhibiting agents (e.g., cimetidine). Tobacco smoking significantly increased the hepatic clearance of thiothixene within the no interactions and inhibitor groups, but not in the inducer group. Significantly more patients in the inducer group had nondetectable plasma concentrations of thiothixene than the other groups. When the entire patient population was dichotomized by age, patients less than 50 years old had a significantly greater mean clearance (48.2 +/- 37.8 liters/min) versus those greater than or equal to 50 (20.0 +/- 12.6 liters/min). Men in this cohort exhibited a significantly higher clearance (49.2 +/- 38.7 liters/min) than did the women (22.0 +/- 13.5 liters/min). By taking into account these potential sources of pharmacokinetic variability when monitoring plasma thiothixene concentrations, more appropriate dosing of thiothixene may be achieved. Controlled, prospective studies are needed to validate these findings. PMID- 1765573 TI - Principles of clinically important drug interactions with carbamazepine. Part II. PMID- 1765574 TI - Effects of carbamazepine on serum antidepressant concentrations in psychiatric patients. AB - The combination of carbamazepine and an antidepressant (doxepin, amitriptyline, mianserin) was given to 22 psychiatric inpatients with 29 measurements of their serum antidepressant concentrations. For comparison, sex-, age-, and dose-matched inpatients, treated with the antidepressant but not with carbamazepine, were selected as controls (N = 29). All the patients were treated with their routine daily dose for at least 7 days before the gas-chromatographic measurement of serum predose concentrations of the antidepressants. In patients with carbamazepine, serum doxepin and doxepin + nordoxepin concentrations (N = 17) were decreased significantly (p less than 0.05), on average to 46% and 45%, respectively, as compared to that in subjects without carbamazepine. Also in carbamazepine + amitriptyline patients, serum nortriptyline and amitriptyline + nortriptyline concentrations (N = 8) were significantly lower than in those not receiving carbamazepine (p less than 0.05). The mean serum antidepressant levels were decreased to 42% and 40%, respectively. The serum mianserin concentration of carbamazepine patients (N = 4) was reduced to 30% of that in patients not treated with carbamazepine (p less than 0.01). The percentage fractions of demethylated metabolites (nordoxepin, nortriptyline) from the total antidepressant levels were not influenced by carbamazepine. In patients treated with carbamazepine, serum total antidepressant concentrations remained more often below the suggested therapeutic ranges than in those patients without carbamazepine. The results suggest that serum antidepressant concentrations are reduced by concurrent carbamazepine therapy, and that the concentrations should be carefully monitored when carbamazepine is added to the antidepressant regimen. PMID- 1765575 TI - An open trial of fluoxetine in the treatment of posttraumatic stress disorder. PMID- 1765576 TI - Possible bupropion precipitation of mania and a mixed affective state. PMID- 1765577 TI - Effect of clozapine on psychotic depression and parkinsonism. PMID- 1765578 TI - Potential interactions between monoamine oxidase inhibitors and prescribed dietary supplements. PMID- 1765579 TI - The Science Research Protection Act. PMID- 1765580 TI - Reorganization of organotypic cultures of mouse cerebellum exposed to cytosine arabinoside: a timed ultrastructural study. AB - This study was designed to examine the sequential changes in the developing granuloprival cerebellar culture. In this model of anomalous cerebellar development, organotypic cultures derived from newborn Swiss-Webster mice were exposed to the DNA synthesis inhibitor, cytosine arabinoside, at explantation and were fixed for electron microscopic examination on successive days in vitro. Similar developmental stages were compared in control explants. Granule cell destruction began early, and was widespread by 2 days in vitro, when oligodendrocyte destruction also began in treated cultures. A few granule cells survived, but no recognizable oligodendrocytes remained by 7 days in vitro, at a time when myelin was initially evident in control explants. Purkinje cell recurrent axon collateral sprouting began at 3 days in vitro in cultures exposed to cytosine arabinoside, and the sprouted terminals initially synapsed with Purkinje cell somata, somatic spines and dendritic shafts. Synapses with Purkinje cell dendritic spines developed later, at approximately the same time as parallel fiber-Purkinje cell dendritic spine synapses formed in control cultures. Astrocytic ensheathment of control Purkinje cells was well underway by 6 days in vitro and Purkinje cell somata were relatively rounded and almost completely ensheathed by 9 days in vitro. Glial ensheathment did not occur in cytosine arabinoside treated cultures, and Purkinje cell somata were scalloped at 7 days in vitro by excess impinging recurrent axon collateral terminals, and never developed the smooth contours characteristic of control Purkinje cells. Purkinje cell somatic spines persisted in treated explants, and reduction of excess extracellular space was delayed until 12 days in vitro, when most of the developmental changes had been completed. The earlier development of synapses by excess recurrent axon collateral terminals with Purkinje cell somata, somatic spines and dendritic shafts, followed by the later development of heterotypical synapses with dendritic spines, in parallel with synapse formation by normal presynaptic elements, suggests that the sequence of development of synapses is a function of the maturational state of the postsynaptic components. PMID- 1765581 TI - Access to gastric tissue promotes the survival of axotomized neurons in the dorsal motor nucleus of the vagus in neonatal rats. AB - Lesioning the vagus nerve in the neck (cervical vagotomy) results in a rapid and virtually complete loss of motoneurons in the dorsal motor nucleus of the vagus in neonatal rats. The present study sought to determine whether access to gastric target tissue will promote the survival of these motoneurons after axotomy. Quantitative analysis demonstrates that subdiaphragmatic vagotomy, which leaves the cut vagal axons in close proximity to their normal gastric targets, results in significantly less motoneuron loss than cervical vagotomy. Furthermore, the loss of motoneurons after cervical vagotomy can be significantly reduced by transplanting embryonic gastric tissue to the neck of vagotomized neonatal host rats, in the vicinity of the cut axons. The survival effect of transplanted gastric tissue appears specific because control transplants of embryonic bladder tissue fail to reduce motoneuron death after cervical vagotomy. Injections of the neural tracers Fluoro-Gold and cholera toxin-horseradish peroxidase into gastric transplants labeled surviving motoneurons in cervically vagotomized rats, whereas tracer injections into bladder transplants or into host cervical tissues did not. These results indicate that neonatal vagal motoneurons are capable of making the adjustments necessary to survive axotomy if they have access to gastric target cells. The apparent dependence of injured neonatal vagal motoneurons on gastric tissue offers a new system in which to examine in vivo the trophic interactions between neurons and their targets. PMID- 1765582 TI - Calcitonin-gene related peptide is an evolutionarily conserved marker within the amniote thalamo-telencephalic auditory pathway. AB - The distribution of neurons and fibers containing calcitonin-gene-related peptide (CGRP) was mapped in the thalamo-telencephalic auditory pathways of four amniote species, rats, pigeons (Columba livia), caiman (Caiman crocodilus), and turtles (Pseudemys scripta). In colchicine-treated turtles and pigeons, numerous CGRP+ perikarya were observed in the auditory relay nucleus of the thalamus (n. reuniens of reptiles, and n. ovoidalis of birds). In pigeons, these neurons were most abundant in the outer circumference of the nucleus and were not observed without colchicine pretreatment. In the telencephalon of turtles, caiman, and pigeons, CGRP+ fibers were observed within portions of the dorsal ventricular ridge previously shown to receive projections from the auditory thalamus, thus implying that the thalamic CGRP+ neurons observed here in fact project to these telencephalic areas. In colchicine treated rats, numerous CGRP+ perikarya were observed along the ventral margin of the medial geniculate nucleus extending into the posterior intralaminar and peripeduncular nuclei, as well as occasionally within the ventral subdivision of the medial geniculate nucleus. Injections of fluorogold into the auditory cortex combined with immunofluorescence labeling for CGRP revealed that CGRP+ cells in these areas do, in fact, project to the auditory cortices. The present results are interpreted as providing strong support for the theory, advanced previously, that the medial geniculate nucleus of mammals, nucleus ovoidalis of birds, and nucleus reuniens of reptiles contain at least some homologous cell populations. Although the data are consistent with the theory that the telencephalic projection fields are homologous, other interpretations are also consistent with the data presented here. These include the possibility that auditory thalamic projections to the telencephalon arose independently in the lines of evolution leading to mammals and sauropsids. PMID- 1765583 TI - Dendritic morphology and development in the ferret lateral superior olivary nucleus. AB - The dendritic morphology of cells in the lateral superior olivary nucleus was studied with the Golgi method in adult and postnatal ferrets. The lateral superior olivary nucleus in the adult ferret is a convoluted structure with an M shape in frontal sections. The major cell type appears to have disk-shaped dendritic trees. Most dendritic trees appear to be approximately orthogonal to the curved medial-lateral axis of the nucleus. Depending on their position in the limb and on the plane of section with respect to the dendritic tree, the disk shaped cells are either bipolar or radiate in orientation. One subclass of disk shaped cells has secondary dendritic branches that end as tufts of tendril-like processes. In a second subclass of cells, the dendrites exhibit several orders of dichotomous branching and lack obvious tufts of terminal processes. Marginal cells are observed at the border of the nucleus and have dendrites restricted to the margins of the cell plate. The bipolar orientation of disk-shaped cells orthogonal to the axis of the limbs is already apparent by the time of birth. Transient spines and other appendages are abundant on somata and dendrites during the first postnatal week. By the end of the first postnatal month only distal appendages are found. Tufts of fine tendril-like processes appear at the ends of dendrites between postnatal days 28 and 56. PMID- 1765584 TI - Thalamoamygdaloid projections in the rat: a test of the amygdala's role in sensory processing. AB - We used the autoradiographic tract-tracing method to define the amygdaloid projection fields after injecting 3H-amino acids into individual thalamic nuclei in the rat. The parvicellular division of the ventroposterior nucleus, the thalamic taste relay, projected lightly to the central and lateral amygdaloid nuclei. The central medial, interanteromedial, and paraventricular thalamic nuclei, viscerosensory relays of the thorax and abdomen, projected heavily to the amygdala. All projected to the basolateral amygdaloid nucleus, the paraventricular nucleus in addition having terminations in the central nucleus, the amygdaloid portion of the nucleus of the stria terminalis, and the amygdalohippocampal transition area. The magnocellular division of the medial geniculate, a thalamic auditory (and, to a moderate degree, a spinothalamic) relay, sent heavy projections to the central, accessory basal, lateral, and anterior cortical nuclei, and to the anterior amygdaloid area and the nucleus of the accessory olfactory tract. Other thalamic nuclei projecting to the amygdala, for which functions could not be associated, were the paratenial and subparafascicular nuclei. The former projected to the lateral, basal, and posterolateral cortical nuclei; the latter projected very lightly to the central, medial, and basal accessory nuclei. These results show that, like the cortical amygdaloid nuclei, which are sensory (olfactory) in nature, the subcortical amygdaloid nuclei must have major sensory functions. These thalamic afferents, when correlated with cortical and brainstem data from the literature, suggested that the amygdala is in receipt of sensory information from many modalities. To uncover the manner by which such information is processed by the amygdala and relayed to effector areas of the brain, six hypothetical mechanisms relating to modality specificity and convergence were posited. By charting sensory-related afferents to all subdivisions of the amygdala, each nucleus was characterized as to its mechanism of information processing. Four proposed amygdaloid systems emerged from this analysis. A unimodal corticomedial amygdaloid system relays pheromonal information from the accessory olfactory bulb to medial basal forebrain and hypothalamic areas. A second system--the lateral-basomedial- collects and combines input from a number of sensory modalities and distributes it to the same basal forebrain and hypothalamic areas as the corticomedial. The central system appears to concentrate the effect of viscerosensory information arriving from multiple brainstem, thalamic, cortical, and amygdaloid sources; this information is combined with significant auditory and spinothalamic inputs from the thalamus and cortex. The central system projects to lateral nuclei in the basal forebrain, hypothalamus, and brainstem.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1765585 TI - A possible mechanism of mechanoreception in Ruffini endings in the periodontal ligament of hamster incisors. AB - The topographical relationship between Ruffini endings and the surrounding collagen fibers in the periodontal ligament of hamster incisors was investigated by means of both immunohistochemistry for neurofilament protein (NFP) and electron microscopy. Periodontal Ruffini endings, a type of stretch receptor, were present exclusively in the alveolar half of the periodontal ligament. Their axon terminals were densely and regularly associated with transverse collagen fibers, possibly forming a mechanoreceptive complex. Since blood sinuses with frequent anastomoses extended throughout the alveolus-related part, the densely innervated collagen bundles were separated from each other by the vascular spaces. Electron microscopic observation of specimens stained with tannic acid revealed a linkage between the axon terminals of the Ruffini endings and the surrounding collagen filaments. The axon terminals were enveloped by multiple layers of the basal lamina, which were penetrated by collagen filaments. The irregularly arranged collagen filaments were sandwiched between electron-dense laminae of the multilayered basal lamina. The possible mechanism of mechanoreception by the periodontal Ruffini endings is discussed on the basis of the immunohistochemical and ultrastructural findings. PMID- 1765586 TI - GABA-like immunoreactive cells containing nicotinic acetylcholine receptors in the chick retina. AB - The possibility that GABA-like immunoreactive cells of the chick retina also contain neuronal nicotinic acetylcholine receptors was investigated by means of immunohistochemical techniques. Double-labeled cell bodies containing GABA-like immunoreactivity and nicotinic receptor-like immunoreactivity were seen in the inner third of the inner nuclear layer and were presumably amacrine cells. Approximately 29-36% of the GABA-positive cells in the inner nuclear layer contained nicotinic receptor immunoreactivity. Their soma sizes ranged from 5-12 microns. Some double-labeled cells ranging from 7-21 microns were observed in the ganglion cell layer as well. Between 9-37% of the GABA-positive cells in this layer contained nicotinic receptor-like immunoreactivity. Following injection of a retrograde tracer into the optic tectum, some of the retrogradely labeled cells were also double labeled with antibodies against GABA and nicotinic receptors. This indicates that at least some of the GABA-positive cells containing nicotinic acetylcholine receptors in the ganglion cell layer are indeed ganglion cells. The present data appear to represent the first demonstration of the presence of acetylcholine receptors in GABA-containing cells in the retina, thus providing a basis for a possible influence of acetylcholine upon those presumptive GABAergic cells. PMID- 1765587 TI - Prediction of responses in milk constituents to changes in the nutrition of dairy cows. AB - Milk quotas, based on an average fat content, severely limit milk production on UK farms. Predictions of the time-course of lactation are incorporated into most computerized herd management programs but these models take no account of food inputs, body weight change or milk composition. Dynamic models are generally used to simulate metabolic pathways and, as such, have little direct relevance to commercial milk production. Dynamic models can be converted to an adaptive predictive model that partitions food energy into milk and non-milk constituents. This paper reports the development of an adaptive-predictive model to partition food into milk and non-milk components. Additional functions further partition milk energy into the principal constituents, fat, protein and lactose. PMID- 1765588 TI - Influence of milk flow rate and streak canal length on new intramammary infection in dairy cows. AB - Eighteen cows with a wide range of quarter peak flow rates (0.35-2.22 kg/min) were inoculated with Streptococcus agalactiae and Str. dysgalactiae 4 mm into each streak canal every 3 d for 12 d. Thirty of the 72 quarters developed intramammary infection. Mean peak flow rate and length of streak canal of those quarters that became infected were 1.26 +/- 0.08 kg/min (mean +/- SEM) and 11.47 +/- 0.41 mm respectively, compared with 1.01 +/- 0.05 kg/min and 12.05 +/- 0.35 mm for those that remained uninfected. Logistic regression analysis showed that the probability of infection increased significantly with the increase in peak flow rate (P = 0.01). The influence of streak canal length on new infection, after allowing for the effect of peak flow rate, was not significant at the 5% level (P = 0.07), suggesting that there may be an inverse relationship between teat duct length and infection, but that it is of secondary importance to peak flow rate. If increased mass of milk distends the teat duct by raising intramammary pressure, then quarter susceptibility to infection is further compromised. These results strongly suggest that the benefits of reduced infection from mastitis control, achieved despite dramatic increases in milk flow rate and milk yield, are significantly underestimated. PMID- 1765589 TI - Interquarter comparison of markers of subclinical mastitis: somatic cell count, electrical conductivity, N-acetyl-beta-glucosaminidase and antitrypsin. AB - We have evaluated the usefulness in mastitis diagnostics of new diagnostic measures using the continuous nature of the variation in quarter milk samples of four inflammatory markers: somatic cell count, N-acetyl-beta-glucosaminidase (EC 3.2.1.30), electrical conductivity and antitrypsin. A two-way analysis of variance was performed for each of the inflammatory markers on results from 273 cows sampled six times at 14 d intervals. Adjustment for the individual cow's mean removed approximately half the total variation for all four markers, indicating that comparisons in marker levels between quarters without taking the cows' overall level into account, as is done in diagnostic keys based on fixed threshold, is a rash procedure. After adjusting for the individual cow means, the total variation of the marker observations was partitioned in three sources of variation: between the four quarter levels, between different sampling days, and the experimental error, i.e. the variation within each quarter over the study period. As expected, the variation between quarters accounted for the largest percentage of the variation (44-65%). In contrast the variation between days was only 16-34% and of the same magnitude as the experimental error. These figures can profitably be taken into account when designing experiments in future mastitis research studies. They imply that mastitis diagnostics based on quarter milk samples collected over time will be influenced only slightly by random biological variation and that the same relative differences that exist in marker levels between the four quarters of a cow as a rule will be disclosed irrespective of sampling day. Thus, the udder health state is relatively stable when determined by these inflammatory markers. In addition to simple correlations between markers measured on the same day, correlations of the logarithm of the interquarter ratios and of the experimental errors were computed. Stronger associations between the markers emerged and these correlations reflect more precisely than simple correlations the real diagnostic relations of the markers. PMID- 1765590 TI - Xanthine oxidase/dehydrogenase in mammary gland of mouse: relationship to mammogenesis and lactogenesis in vivo and in vitro. AB - Xanthine oxidase/dehydrogenase (XO/XDH) increases at mid gestation in mammary gland but not in liver of the mouse and remains elevated until the pups are weaned at 20 d post partum. The increase in enzyme activity is due neither to alteration in activators or inhibitors nor to a production of a variant enzyme with altered catalytic properties. The increase is preceded in vivo by a surge of prolactin-like activity (placental lactogen) in plasma, and prolactin is required for induction of XO/XDH in explant culture in vitro. Induction of XO/XDH in vivo and in vitro precedes the full histological differentiation of the gland. In addition, induction of XO/XDH in vitro occurs more rapidly and at lower concentrations of prolactin than does histological differentiation. Thus although XO/XDH is present in milk, increased XO/XDH activity is an early event in mammogenesis in vivo and in vitro rather than a terminal component of differentiation. PMID- 1765591 TI - Enzymic modification of alpha s1-casein with peptidylarginine deiminase: preparation of less acid-coagulable and less calcium-sensitive casein. AB - Enzymic modification with peptidylarginine deiminase (EC 3.5.3.15) enabled five out of six arginyl residues in alpha s1-casein to be converted to citrullyl residues, only the N-terminal arginyl residue remaining unaffected. An increase in the net negative charge was confirmed by PAGE. The isoelectric point was decreased from 4.46 for the intact alpha s1-casein to 4.30 for the deiminated type, while simultaneously lowering the acid-precipitation starting point from pH 5.17 to pH 4.62. The deiminated alpha s1-casein self-associated less in the absence of Ca and was less Ca-sensitive than the native type, although its Ca binding ability was slightly enhanced. In the presence of 25 mM-CaCl2 and kappa casein, Ca-induced precipitation of alpha s1-casein did not occur, the solution of the mixture remaining transparent. Deimination of alpha s1-casein resulted in altering its characteristics, possibly by interfering with interactions through hydrophobicity and/or hydrogen bonding. The positive charge of the arginyl residues might play an important role in casein micelle formation. PMID- 1765592 TI - Extent of damage to amino acid availability of whey protein heated with sugar. AB - The effect of heat treatments, at various water activities (aW), on digestibility and on the availabilities of amino acids of whey protein samples in the presence of lactose was estimated by an in vitro digestion method with continuous dialysis. Four aW (0.3, 0.5, 0.7 and 0.97), three temperatures (75, 100 and 121 degrees C) and three heating periods (50, 500 and 5000 s) were selected. The initial lysine:lactose molar ratio was 1:1. Amino acid profiles showed that excessive heating of whey (121 degrees C, 5000 s) destroyed a significant proportion of cystine at all aW, lysine at aW 0.3, 0.5 and 0.7, and arginine at aW 0.5 and 0.7. At aW 0.3, 0.5 and 0.7, protein digestibility decreased (P less than 0.05) as the temperature increased from 75 to 121 degrees C for a heating period of 5000 s, and as the heating time was prolonged, from 500 to 5000 s at 121 degrees C. Excessive heating also decreased (P less than 0.05) the availabilities of all amino acids at aW 0.3, 0.5 and 0.7. The availabilities of lysine, proline, aspartic acid, glutamic acid, threonine, alanine, glycine and serine were particularly affected. Severe heating at aW 0.97 did not seem to favour the Maillard reaction, but the availabilities of cystine, tyrosine and arginine were decreased, probably as a result of structural modifications of the protein upon heating. Heating whey protein concentrates in the presence of lactose not only affected lysine, but also impaired enzymic liberation of other amino acids, according to the severity of heat treatments and aW. PMID- 1765593 TI - Potential value of photoacoustic spectroscopy for determining iron content of milk protein concentrates. AB - Photoacoustic and proton-induced X-ray emission measurements were performed on iron-enriched milk protein concentrates. The possibility of measuring Fe content by photoacoustic measurements in the visible region of the spectrum is discussed. PMID- 1765594 TI - Proteolytic activity of two commercial proteinases from Aspergillus oryzae and Bacillus subtilis on ovine and bovine caseins. AB - Electrophoretic analysis of the action of two commercial enzymes, Neutrase 0.5 and MKC Fungal Protease, on whole casein and alpha s-, beta- and kappa-caseins from cows' and ewes' milk showed that Neutrase 0.5 chiefly degraded beta-casein, giving rise to peptides soluble at pH 4.6 detectable by PAGE. In contrast, although MKC Fungal Protease caused intense hydrolysis of bovine beta-casein, in ovine casein it resulted in more active degradation of alpha s- than beta-casein. The latter enzyme did not produce peptides soluble at pH 4.6 detectable by PAGE. Both enzymes degraded kappa-casein, yielding a breakdown product that exhibited an electrophoretic mobility similar to that of the breakdown product produced by the action of commercial rennet. PMID- 1765595 TI - Evaluation of a rapid fluorogenic method for the detection of Escherichia coli in dairy products. AB - A rapid fluorogenic medium was evaluated for the detection of Escherichia coli in dairy products. The medium was capable of detecting Esch. coli after 7.5 h incubation at 41.5 degrees C. Samples of pasteurized milk (136), raw milk (63), soft cheese (60) and pasteurized cream (39) were examined with media based on 4 methylumbelliferyl-beta-D-glucuronide (MUG-7) and Violet red bile agar and there were no significant differences between the numbers of Esch. coli detected on the two media. MUG-7 medium had a specificity of 98.6% and the small number of organisms giving a false positive reaction were identified as Klebsiella pneumoniae. The incidence of false negative results was approximately 2%. MUG-7 medium was suitable for pour plate, spread plate and membrane filtration methods. Possible applications of the method are discussed. PMID- 1765596 TI - Should dental education be at the table for national health care reform? The answer is absolutely yes! PMID- 1765597 TI - Future paradigm: challenge for dental education. PMID- 1765598 TI - Public response to announcement of an HIV positive dental student. PMID- 1765599 TI - Student preference for a case-based vs. lecture instructional format. PMID- 1765601 TI - Licensure and credentialing--position paper. PMID- 1765600 TI - Elbow angle during a simulated task requiring fine psychomotor control. PMID- 1765602 TI - Faculty mobility in the 1990s. PMID- 1765603 TI - Problems related to the use of human subjects in clinical evaluation/responsibility for follow-up care. PMID- 1765604 TI - A global profile of the dental applicant pool. PMID- 1765605 TI - What's in a name? A sense of self. PMID- 1765606 TI - Calculating the stakes. PMID- 1765607 TI - Philosophy in a nurse's world. PMID- 1765608 TI - Research who? PMID- 1765609 TI - Functional assessment in the determination of the need for a substitute decision maker. PMID- 1765610 TI - Nurse-physician conflict. PMID- 1765611 TI - Is the insurance mechanism broken? PMID- 1765612 TI - The cornerstones of collaboration. PMID- 1765613 TI - The human genome initiative--implications for nurse researchers. PMID- 1765614 TI - An analysis of the historical context of liberal education in nursing education from 1924 to 1939. AB - This study examines in historical context the liberal education theme in nursing education as expressed in nursing literature from 1924 to 1939. The specific questions addressed are: What is the nature of liberal education as presented in the literature of the time? What did nurse educators believe would be the effect of the liberal education of the nurse on the profession of nursing? To what extent did the articulation of beliefs regarding liberal education parallel the development of nursing education at the collegiate level? The data include literature published in the major nursing journals, the proceedings of the national professional nursing organizations, and the major studies of nursing by various committees. The literature was examined for central themes. The study concludes that during this period, nurse educators believed the purposes of a liberal education for nurses to be the development of the individual and the citizen, the acquisition of cultural knowledge, the development of critical thinking, and the possession of a strong science background. A nurse with these abilities would be able to meet the changing demands of practice at a professional level. The college and university continued to be viewed as the optimum site for this education. PMID- 1765615 TI - Moral outrage and moral discourse in nurse-physician collaboration. AB - True collaboration between clinical nurses and physicians in acute care settings can be difficult to achieve. The author describes a patient care unit dedicated to the study and development of such collaborative relationships. She reports an unexpected favorable outcome of such collaboration: the decline in incidents of moral outrage among nurses faced with moral dilemmas. This decline is attributed to such factors as mutual trust and respect between nurses and physicians, an appreciation that the two practice areas are interdependent, and the development of a synergistic alliance between the two that enhances patient care. PMID- 1765616 TI - The effect of pentobarbital anesthesia on the autonomic nervous system control of heart rate during baroreceptor activation. AB - This study determined the influence of pentobarbital anesthesia on the autonomic nervous system control of baroreceptor mediated reflex bradycardia in the rat. Reflex bradycardia was elicited by phenylephrine-induced hypertension in conscious and pentobarbital anesthetized (PA) rats before and after sympathetic blockade with the beta-1 receptor antagonist atenolol or parasympathetic blockade with the peripherally acting muscarinic receptor antagonist methyl-atropine. Reflex bradycardia was significantly decreased by pentobarbital anesthesia. Cardiosympathetic blockade produced equivalent relative decreases in baroreflex gain in conscious and PA rats. In contrast, parasympathetic nervous system blockade with methyl-atropine produced relatively less inhibition of baroreflex gain in the PA rat compared with the conscious rat. These results suggest that pentobarbital anesthesia decreases baroreflex gain by inhibiting vagally mediated reflex bradycardia. PMID- 1765617 TI - Periodic abnormal fluctuations of blood pressure, heart rate and skin blood flow appearing in a resuscitated comatose patient. AB - Fluctuations with a period of several tens of seconds, so called third-order waves, were recognized in the blood pressure, heart rate and Laser Doppler skin blood flow of a comatose patient following cardiac arrest and resuscitation. The waves fluctuated with an abnormally high amplitude and were apparently synchronous with each other. These abnormal fluctuations appeared continuously over 6 h on the day of resuscitation, while their periodicity gradually lengthened. The patient remained in a comatose state for the next 4 days. During that period, functional signs of the sympathetic nervous system, such as peripheral vasomotion and perspiration, were also absent. However, on the 6th post-resuscitation day, when the patient exhibited signs of restoring consciousness, he also regained some sympathetic function. This patient subsequently recovered full consciousness, although abnormalities of intelligence and motor function remained to some extent. PMID- 1765618 TI - Reduced preabsorptive insulin response in aged rats: differential effects of amphetamine and arginine-vasopressin. AB - The experiments presented here have been designed to investigated whether the age related attenuation of the vagal reactivity to emotional stressors and its modulation by amphetamine (Amph) or arginine-vasopressin (AVP) can be generalized for other physiological response patterns. We therefore studied the vagal control of the endocrine pancreas during food intake. Young (3 months old) and aged (27 months old) male Wistar rats were provided with permanent cardiac catheters allowing free movement and repeated, stress-free blood sampling. The vagally mediated preabsorptive insulin response (PIR) in relation to food intake as seen in young rats was reduced in aged ones. Blood glucose increments were the same at both ages. Administration of Amph (0.5 mg/kg; s.c.) 30 min before, or AVP (10 micrograms/kg; s.c.) 60 min before presentation of a test meal led to an elevation of the magnitude of insulin secretion in young rats but reduced the response in aged rats. Moreover, the PIR was not reinstated in aged rats. Blood glucose increments were not influenced by the treatments. The results are interpreted in terms of age-related general reduction of parasympathetic reactivity. The differential effect of amphetamine and AVP treatment on the insulin response suggests that the central aminergic or peptidergic drive of vagal output to the endocrine pancreas is also age-related. PMID- 1765619 TI - Locally and reflexly mediated effects of cholecystokinin-octapeptide on the ferret stomach. AB - This study was undertaken to investigate the site of origin of vagal reflexes which cholecystokinin (CCK) activates to cause reflex inhibition of gastric motility. In the anaesthetized ferret, close intraarterial injections of CCK-8 (100 pmol) caused a short latency increase in duodenal contractile activity; antral motor responses to CCK were variable, often comprising excitation followed by inhibition. The corpus, in contrast, consistently showed a decrease in pressure which lasted 2-3 min before returning to prestimulus levels. Similar responses to CCK-8 were seen in guanethidine (5 mg/kg) treated preparations, indicating that release of noradrenaline was not responsible for the relaxatory responses observed. After bilateral cervical vagotomy the duodenal response was unchanged, but the antrum showed consistent monophasic increases in tone. The response of the corpus was reversed to one of excitation, which was significantly different from prevagotomy responses (P less than 0.0001). In 10 experiments, corpus responses to CCK were tested after removal of the intestine and again after removal of the antrum. Upon removal of these segments the inhibitory motor response to CCK was reversed to one of excitation (P less than 0.01). Corpus relaxation in response to duodenal distension was significantly smaller (P less than 0.05) than that to CCK despite higher duodenal pressures during distension. Minimizing intraantral pressure changes by means of an isotonic reservoir system did not affect the response of the corpus to CCK administration. The data indicate that the inhibition of gastric motility by CCK is mediated by a direct vagal reflex and is not secondary to motility changes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765620 TI - Reflex control of renal nerve activity originating from the osmoreceptors in the hepato-portal region. AB - The reflex effects of hepatic osmoreceptors on the renal sympathetic nerve activity (RNA) were studied in 30 pentobarbital anesthetized, vagotomized and sino-aortic baroreceptor denervated (SAD + VD) rabbits. The changes in mean arterial pressure (MAP), heart rate (HR), and RNA were examined when 9% NaCl, 6.5% LiCl or 50% glucose solution was infused into the hepatic portal vein at a rate of 0.15 ml/kg/min for 10 min. Infusion of 9% NaCl solution into the hepatic portal vein increased the plasma osmolality by 10.8 +/- 1.0 mOsmol/kg from the control level in the blood of the hepatic portal vein and by 2.8 +/- 2.0 mOsmol/kg from the control level in the systemic blood. MAP was significantly elevated by 10.2 +/- 5.0 mmHg but HR did not change with hepatic portal infusion of 9% NaCl solution. Intraportal infusion of 9% NaCl solution significantly decreased the RNA by 28.6-34.2% from the control level, 6.5% LiCl solution by 28.6 +/- 4.7%, and 50% glucose solution by 26.2 +/- 3.0%. Femoral arterial infusion of hypertonic NaCl solution, however, did not evoke any significant change in RNA in SAD + VD rabbits. These findings suggest that increases in osmolality and NaCl concentration in the systemic circulation do not result in a decrease of RNA. Furthermore, after section of the anterior and posterior plexus of the hepatic nerve, hepatic portal infusion of hypertonic NaCl solution elicited no change in RNA. The present data indicate that an increase in osmolality in the hepatic portal venous blood results in a reflex decrease of RNA. This reflex may be important for restoration of a postprandial increase in osmolality. PMID- 1765621 TI - Endothelin-sensitive areas in the ventral surface of the rat medulla. AB - In urethane-anesthetized rats, subregions of the ventral surface of the medulla (VSM) in which endothelin (ET) caused cardiorespiratory effects were mapped by topically applying 1 pmol of ET-1. Two distinct subregions, termed the rostral and caudal ET-sensitive areas, were identified. The rostral area was also sensitive to L-glutamate and glycine. It extended between the caudal end of the trapezoid body and the rootlet of the XIIth nerve partly overlying the pyramidal tract. In this position ET-1 caused the type I response consisting of an initial increase (excitatory component) in arterial pressure (AP), renal sympathetic nerve activity (RSNA), heart rate (HR), phrenic nerve activity (PNA) and the number of bursts of PNA (burst rate) followed by a sustained decrease (inhibitory component) in them. The caudal ET-sensitive area was located near the rootlet of the XIIth nerve. In this position ET-1 caused the type II response consisting of a decrease in PNA and an increase in burst rate. Part of this area responded to nicotine but not to glutamate or glycine. ET-3 (10 pmol) applied to the two ET sensitive areas produced responses similar to those elicited by ET-1. The dose response relationship was investigated by delivering ETs to the rostral area. The excitatory component of most of the variables was elicited at a dose of 1 fmol of ET-1 or 1 pmol of ET-3, whereas the inhibitory component was produced at 10 fmol of ET-1 or 10 pmol of ET-3. These results suggest that subregions of the rat's VSM may participate in the central cardiorespiratory control by ET. PMID- 1765622 TI - Neurons labelled after the application of tracer to the distal stump of the transected hypogastric nerve in the rat. AB - Axons within the hypogastric nerve (HGN) provide sympathetic innervation to various tissues of the pelvic viscera (e.g. bladder, urethra, ureter, colon and sexual organs). Traditionally the HGN was considered to carry efferent impulses from the lumbar spinal cord to the periphery and afferent information from the periphery to the lumbar cord. In recent years however, there have been a number of reports of axons in the hypogastric nerve carrying impulses in directions opposite to these traditional ones. To further study this phenomenon fast blue dye was applied to the distal (or for comparison the proximal) stump of one transected hypogastric nerve and the locations of retrogradely labelled neurons determined in the spinal cord, the dorsal root ganglia (DRG), the sympathetic chain ganglia and the major pelvic ganglia (MPG). Labelled neurons were found in the spinal cord only for proximal stump dips. Labelled DRG neurons were mainly located in the L6-S1 ganglia when dye was applied to the distal stump, and mainly in the L1-L2 ganglia for proximal stump dips. The distribution profile of labelled sympathetic chain neurons was shifted caudally about one segment when the distal stump was dipped compared to the distribution obtained following a proximal stump dip. Labelled neurons were found contralateral to the dipped distal stump in all categories although in reduced numbers. More labelled neurons were found in male animals than in female animals. Fast blue in neurons in the DRGs and sympathetic chain labelled from the distal HGN reached these structures via the pelvic nerves. Labelled MPG neurons were found when the distal stump was dipped. Labelled MPG neurons were larger in the male than in the female. These fast blue labelled MPG neurons were also tested immunohistochemically for the presence of tyrosine hydroxylase (TH), neuropeptide Y (NPY) and vasoactive intestinal polypeptide (VIP). Labelled neurons which were TH+ were only found in the male; labelled neurons which were NPY+ or VIP+ were found in males and in females. PMID- 1765623 TI - The effects of electrical stimulation of lobule IXb of the posterior cerebellar vermis on neurones within the rostral ventrolateral medulla in the anaesthetised cat. AB - This study was designed to investigate the effects of electrical stimulation of sublobule IXb of the posterial cerebellar vermis (the uvula) on the activity of neurones in the rostroventral medulla (RVLM) of anaesthetised cats. The ongoing activity of 38 RVLM neurones was studied in detail. One group consisted of 22 neurones that had axons projecting to the spinal cord (Group A, 22 neurones), the second had only an excitatory synaptic input from the spinal cord (Group B, 14 neurones) and the last were inhibited by equivalent spinal cord stimulation (Group C, 2 neurones). In Group A 16 neurones were excited, 2 inhibited and the other 5 showed a biphasic response involving excitation followed by inhibition, to lobule IXb stimulation. In Group B, lobule IXb stimulation excited 9 cells, inhibited 2 and evoked a biphasic response in 3 neurones. In Group C both cells were inhibited on cerebellar stimulation. Some cells in Group A and B were affected by electrical stimulation of the carotid sinus nerve--the predominant effect being an excitation. Specific baroreceptor stimulation invariably caused inhibition and several neurones had pulse modulated discharge. These data indicate that stimulation of sublobule IXb has marked influences on RVLM neuronal activity including a proportion of those neurones that have axons descending to the spinal cord that has been described as presympathetic 'vasomotor' neurones. A striking finding is the more widespread action of sublobule IXb, baroreceptor and sinus nerve inputs on other neurones of the RVLM, and the implications of this for the integration of cardiovascular control are discussed. PMID- 1765624 TI - The life stress paradigm and psychological distress. AB - The paper focuses on two forces (stressors and resources) in the life stress process as they affect psychological distress. Utilizing three waves of panel data from a representative community sample in upstate New York, six causal models of the life stress process are tested with indicators of two types of stressors (social and physiological) and two types of resources (social and psychological). Both deterring and coping models are tested. Analysis shows that: (1) stressors and resources in the social environment have a direct impact on depressive symptoms, (2) social resources mediate the effects of social stressors on psychological distress, and (3) psychological resources indirectly affect distress by enhancing social resources. The critical role played by the social environment in the life stress process involving psychological distress is substantiated. The implications of these and other findings are discussed. PMID- 1765625 TI - Racial differences in health and health care service utilization in later life: the effect of socioeconomic status. AB - In this paper we examine the hypothesis that health differences between Blacks and Whites in later life are related to socioeconomic status. Using the 1984 panel of the Survey of Income and Program Participation, we construct four measures of health and two measures of health care service utilization. Multivariate analyses show that the racial differences are eliminated in some measures of health and health care service utilization after holding constant individual-level socioeconomic characteristics and resources. However, even after accounting for differences in socioeconomic status, Black self-rated health is poorer than that of Whites. Further, Blacks report more visits to medical personnel but do not report higher rates of hospitalization when levels of health and economic resources are controlled. Additional analyses suggest that the impact of socioeconomic status on health is different for Blacks than for Whites. PMID- 1765626 TI - Social hassles and psychological health in the context of chronic crowding. AB - Data are presented on the interactive effects of an enduring environmental stressor with acute, daily social stressors on psychological distress. A cross sectional study of males in urban India and a longitudinal study of male and female American college students examined the interplay of these two types of stressors. In India, social hassles in the home predicted psychological symptoms only among residents of crowded homes, after statistically adjusting for income. In America, the interaction between social hassles and crowding was replicated in analyses adjusting for prior psychological symptoms, prior social acquaintanceship with housemates, and income. A six-month follow-up study with the American sample replicated the interaction. In all three analyses of the social hassle-crowding interaction, there was a main effect of crowding but no main effect of social hassles on psychological symptoms. These findings suggest that some chronic environmental stressors may increase the impact of acute social stressors, and highlight the importance of examining contextual factors in the stress and health process. PMID- 1765627 TI - The factor structure of the pregnancy anxiety scale. AB - This paper presents a measurement model of a ten-item scale of maternal anxiety during pregnancy. Using confirmatory factor analysis, its reliability and validity are examined in a hospital sample of mothers (N = 266) surveyed postpartum in Galveston, Texas. According to several indices of overall fit as well as individual parameter estimates, a latent internal structure of three interrelated dimensions is confirmed for the scale items. These first-order constructs are anxiety about being pregnant, childbirth, and hospitalization. This model exhibits a considerably better fit than both a no-factors model and a model in which the dimensions are uncorrelated. Finally, several exogenous constructs expected to be associated with pregnancy anxiety--age, marital status, and worry over health--exert significant effects on dimensions of the model or on a second-order factor. PMID- 1765628 TI - Do close parent-child relations reduce the mortality risk of older parents? AB - This analysis examines the association between affectional solidarity in older parent-child relationships, and the parents' length of survival over a 14-year interval. It is hypothesized that close intergenerational relations have the capacity to reduce pathogenic stress among elderly parents, thereby enhancing their ability to survive. Direct and buffering effects of affectional solidarity, as expressed by 439 elderly parents, are tested using data from the U.S.C. Longitudinal Study of Generations collected between 1971 and 1985. Buffering effects are examined in the context of social decline and social loss experienced by the older parent. Hazard regression models indicate that greater intergenerational affect increases survival time among parents who experienced a loss in their social network, particularly among those who were widowed less than five years. Neither a direct effect of affection nor a buffering effect in the presence of social decline were found. It is concluded that the mortal health risks associated with the stress of being widowed can be partially offset by affectionate relations with adult children. PMID- 1765629 TI - Divorce and psychological stress. AB - While research on adjustment to divorce has been extensive, the paucity of studies assessing stress before and after divorce has kept the relation between psychological stress and martial dissolution unclear. Conflicting findings cast some doubt on the utility of using a crisis model to study divorce. Analysis of three-wave panel data from a national sample of persons married in 1980 indicates that the crisis model is appropriate for understanding adjustment to divorce. Comparisons of divorced persons with married persons show a predivorce rise in stress which then returns to levels comparable to those reported by married individuals. No evidence was found supporting the idea that a high level of psychological stress is a general cause of divorce or that dissolution resulted in more or less permanent elevation of psychological stress. Findings support the hypothesis that predivorce resources and outlooks influence the amount of stress experienced in the two years immediately following divorce. Below median family incomes, no post-high school experience, and wife not in the labor force put divorcing individuals at a disadvantage. Individuals reporting few premarital troubles and beliefs in the immorality of divorce also appear to experience heightened stress in the two years following divorce. PMID- 1765630 TI - Mental health, social relations, and social selection: a longitudinal analysis. AB - A wide body of literature documents the effect of social networks and social supports on mental health. Fewer studies, however, have examined the reciprocal effect of mental health on social relationships. This problem is examined using data from a national panel survey of adults aged 20-64. For the sample as a whole, support was found for a social selection process, since psychological distress predicted decreases in primary, but not secondary, social relationships. The extent of primary relationships also were found to be associated with subsequent distress, providing evidence that the relationship between mental health and social environment may be transactional. When examined separately by gender, males but not females were found to be vulnerable to the process of social selection, supporting the hypothesis that the expression of distress is less role-appropriate for men and therefore more likely to invite social sanctions. Social causation effects also were observed only among males. PMID- 1765631 TI - Managing classification for individualised care. PMID- 1765632 TI - Oxygen delivery and consumption in septic shock. PMID- 1765633 TI - Giving up and withdrawal by ventilator treated patients: nurses' experience. AB - If a patient on admission to the Intensive Care Unit (ICU) already seems to have given up and behaves in a withdrawn manner the nurses usually interpret it as an expression of the patient's personality. However the nursing care activities are more or less characterized by uncertainty and fear of misjudgements due to difficulties in interpreting the patient's wishes and needs. If this syndrome of giving up and withdrawal develops during ventilator treatment in the ICU nurses interpret the patient's behaviour as a sign of depression caused by exhaustion, awareness of severe illness, injuries or disabilities or loss of hope, meaning and will to live. The nurses' reactions are either to wait for spontaneous changes in the patient's behaviour or to make more active interventions, trying to support the patient and alleviate his/her condition. Most nurses feel helpless and powerless not knowing how to lessen and relieve the patient's suffering. Caring for these patients is often frustrating, stress-evoking and tiring for the nurses, especially if this syndrome is present for a long period. It is therefore important to do further studies to increase knowledge about the syndrome and its effects. PMID- 1765634 TI - Matching demands and resources in an intensive care environment. PMID- 1765635 TI - Working towards dependency scoring in critical care. AB - One of the main disadvantages of dependency scoring in the intensive care unit, is that popular scoring systems such as the Intensive Care Register (ICR) fail to take into account many of the most important factors that contribute to patient dependency. Factors such as counselling of patients and their families, setting up for certain procedures and dealing with an agitated patient, for example, all contribute to the overall dependency of the patients; and ultimately influence the level of nursing support required. It is with these thoughts in mind that a system of dependency scoring has been developed for the intensive care unit (ICU). The system outlined here is designed to be used in conjunction with the ICR, thus providing a more accurate and realistic measure of dependency; while still maintaining a vital link to a well established system. PMID- 1765636 TI - Dealing with stress of caring for the dying in intensive care units: an overview. PMID- 1765637 TI - Critical care nurses' roles--traditional or expanded/extended. AB - The concept of role is an important one and an issue which should be more often addressed within the so called high technology areas. The unique environment within specialist critical care units means that nurses are frequently in danger of becoming pseudo medics. The intention in this paper is to explore the issue of nurses' role--traditional, extended/expanded and futuristic from an intensive care perspective. PMID- 1765638 TI - The psychological impact of intensive therapy: the role of nurses. AB - The concept of intensive therapy has developed since the early 1950s following the poliomyelitis epidemic when patients required respiratory assistance. Intermittent positive pressure ventilation and the development of large integrated general intensive therapy units where all critically ill patients could be managed has resulted. The environment in the intensive therapy units (ITUs) has thus become increasingly sophisticated with the use of highly specialised equipment. This has led to changes in the role of nurses in critical care areas. As intensive therapy nurses require considerable technical knowledge comparisons have been made with their role and that of a technician. The aim in this paper is to emphasise the importance of the nurses' role in caring for patients in intensive therapy units, by highlighting the psychological impact an intensive therapy unit may have on patients and how a nurse may promote psychological well-being. PMID- 1765639 TI - Application of Jean Piaget's theory of human development for nursing children in an adult intensive therapy unit. AB - Piaget (1964) believed that interaction with the environment has a large part to play in human development. Matthew (1986) states that in an ideal world critically ill children should be cared for by staff trained in paediatrics, within designated paediatric intensive therapy units. Unfortunately, there are only 28 paediatric intensive therapy units in Great Britain (CMA Medical Data, 1987), consequently each year a third of children requiring intensive care are admitted to adult intensive therapy units (ITU). A knowledge and understanding of developmental psychology can therefore be beneficial to nurses in assessing which stage of development a child has reached, in order to plan the correct level of stimulation, and hence facilitate progress rather than regression in the accomplishment of developmental tasks. The psychological and social processes involved in Jean Piaget's (1896-1980) theory of human development are discussed with regard to nursing children requiring intubation and ventilation in an adult ITU. PMID- 1765640 TI - British Association of Critical Care Nurses. National Annual Meeting--president's report. PMID- 1765641 TI - An isotype-specific spot-ELISA for the enumeration of antibody-secreting hybridomas and the determination of isotype switch variants. AB - A solid-phase spot enzyme-linked immunosorbent assay (spot-ELISA) using rat monoclonal antibodies (MAbs) and an image-processing system is described. This isotype-specific spot-ELISA permits the enumeration of antibody-secreting cells irrespective of the specificity of the secreted antibodies. When used in combination with an ELISA, the antibody production per cell can also be evaluated. In addition, isotype switch variants, which arise spontaneously in antibody-producing cell lines, can be determined. This study compared four assays: three antigen-specific spot-ELISAs, using enzyme-conjugated polyclonal antibodies as well as rat MAbs; and an isotype-specific spot-ELISA using rat MAbs. There were no significant differences between these four spot-ELISA systems. For one tested cell line (alpha huIgA1/gamma 1), the number of antibody secreting cells fluctuated between 60% and 95% during several passages. For the other tested cell line (alpha huIgA1/gamma 2b), the number of antibody-secreting cells decreased from 90% to 70% after several passages. The results of the spot ELISA were in agreement with flow cytometric (FC) analysis of cytoplasmic IgG. This indicates that for these two cell lines, the synthesized IgG was also secreted into the culture fluid. Using the isotype-specific spot-ELISA, the switch frequency of five murine hybridomas (alpha huIgA1/gamma 1, alpha huIgA1/gamma 2b, alpha HRP, RIV6, MN12) was determined. The switch frequencies varied from 1/82,000 for the alpha HRP cell line to 1/660,000 for the alpha huIgA1/gamma 2b cell line. PMID- 1765642 TI - Comparison of two techniques for targeting the production of monoclonal antibodies against particular antigens. AB - We have compared the efficacy of two methods for enhancing the probability of producing monoclonal antibodies against particular target antigens in a complex mixture. These methods use two tissue extracts, one extract that contains (A) and one extract that does not contain (B) the target antigen(s) of interest. In the chemical immunosuppression approach, cyclophosphamide is used to suppress the mouse's response to common antigens in extract B before injection of extract A containing the target antigens. In the tolerization approach, neonatal mice are tolerized against the common antigens in extract B before injection of extract A containing the target antigens. Although small numbers of animals were used in this initial comparison, immunodot assays clearly indicate that the cyclophosphamide immunosuppression method yields significantly more monoclonal antibodies specific for the target antigen-containing extract A than does the tolerization method. PMID- 1765643 TI - A simple and improved method to generate human hybridomas. AB - By improving our previous method for production of human hybridomas, we developed a simple and remarkably efficient method for production of human hybridomas. We reformed our previous method in the following three points: (1) we added irradiated (30 Gy) myeloma cells as feeder cells to culture of fusion cells; (2) ouabain concentration in the selective medium was reduced from 2 x 10(-6) M to 1 x 10(-6) M; (3) selective medium (GIT-HAT-OL) was added to the culture after overnight cultivation of fusion cells. Consequently, we obtained higher fusion frequency (1/700 vs. 1/5500) compared with our previous method. By our present method, only so small number of human B cells (EBV-LCL) is required, so that the time necessary to establish human hybridomas is reduced. PMID- 1765644 TI - A novel method for synchronizing a B cell lymphoma. AB - Certain sub-lines of the murine B cell lymphoma BCL1 can be maintained in vitro and respond to cytokines including IL-2 and IL-5. BCL1 cells, as well as other B lymphomas, are difficult to synchronize using conventional techniques such as thymidine block or DNA synthesis inhibition. We have found that BCL1 cells maintained in Dulbecco's minimum essential medium (DMEM) with non-essential amino acids (NEAA) can be readily synchronized by culture in DMEM lacking NEAA. Within 10-18 h of medium replacement, 98% of BCL1 cells are 2 N in DNA content, suggesting that these cells are arrested in G0/G1. This population of BCL1 cells is viable and can be stimulated to enter S phase by culture in media containing NEAA; however, arrested cells did not appear to return synchronously into the cell cycle on addition of NEAA. A transient increase in levels of c-fos and c-myc mRNA was not detected after arrested BCL1 cells were stimulated to enter S phase, suggesting that arrested cells are in the G1 phase of the cell cycle, rather than G0. This technique for obtaining G1 arrested B lymphoma cells may prove useful in the analysis of molecular events that occur in B cells as a function of cell cycle position. PMID- 1765645 TI - An improved method of loading pH-sensitive liposomes with soluble proteins for class I restricted antigen presentation. AB - We have recently shown that ovalbumin (OVA) entrapped in pH-sensitive liposomes could sensitize mouse thymoma cells for lysis by MHC class I-restricted cytotoxic T lymphocytes (CTL) (Reddy et al. (1991) J. Immunol. Methods, 141, 157-163). The present studies were designed to optimize the antigen delivery system. A simple freeze-thaw method was developed to load OVA into pH-sensitive liposomes, and the protocol was optimized in terms of the choice of buffer, pH and ionic strength of the medium, lipid composition, lipid and OVA concentrations and the number of freeze-thaw cycles. Under optimized conditions, approximately 25% of OVA could be entrapped in pH-sensitive liposomes at 172 micrograms protein/mg lipid. This compares to only about 5% entrapment (70 micrograms protein/mg lipid) using the previous method. OVA loaded to pH-sensitive liposomes using the improved method led to a sensitive measure of CTL activity. The approach promises to be suitable to measure CTL against less available soluble antigens such as viral proteins. PMID- 1765646 TI - Improvements and important considerations of an ex vivo assay to study Candida albicans-splenic tissue interactions. AB - Improvements were made on an ex vivo assay to study adherence properties of Candida albicans to host internal organs. The assay is applicable to understanding mechanisms of C. albicans dissemination following a fungemia. Binding patterns of yeast forms to splenic tissue are intriguing and we found the following modifications to be especially relevant. Mice serving as spleen donors for the assay should be injected with 0.1 ml i.v. of a 10% concentration of luconyl blue, 5 min before killing. After collecting splenic sections on a glass slide, 100 microliters of a 1-2 x 10(8)/ml suspension of stationary yeast cells should be applied to the sections. The assay does not require a carbonate buffering system or serum supplements. Attachment of yeasts to host tissue occurs best if the interaction is allowed to proceed without agitation by rotation. Assessment of binding is facilitated by staining the slides with crystal violet and computer image analysis can be used for quantification of binding. PMID- 1765647 TI - A sensitive ELISA for measuring recombinant human interleukin-3 in human plasma or serum. AB - We describe a sensitive ELISA for the measurement, of the recombinant human cytokine, interleukin-3 (IL-3), in human plasma or serum samples. The assay design uses two different anti-IL-3 monoclonal antibodies, giving a two-site assay configuration. The assay incorporates the use of alkaline phosphatase conjugated to streptavidin and a biotinylated anti-IL-3 monoclonal antibody to amplify the resultant signal. This ELISA can measure both glycosylated and non glycosylated IL-3. The limits of quantification, as determined by precision profiles and quality control samples prepared in 100% human plasma, are 20 pg/ml and 30 pg/ml for non-glycosylated and glycosylated IL-3, respectively. PMID- 1765648 TI - Immunoassay in the presence of water-soluble polymers. AB - To overcome the adverse consequences of antibody immobilization (impairment of the antigen-binding parameters) the interaction of a number of antigens with both soluble and covalently immobilized antibodies in the presence of water-soluble polymers has been investigated. Incorporation of some water-soluble polymers (Ficoll, Dextran) into the assay mixture was shown to substantially increase the antigen-binding capacity of both soluble and immobilized antibodies. The use of dextran T70 enhanced the sensitivity of competitive radioimmunoassays for CEA and beta 2-microglobulin 3-4-fold. This procedure may be also applied to shorten the incubation period when performing an assay. PMID- 1765649 TI - Commercial serum-free media: hybridoma growth and monoclonal antibody production. AB - Various growth factors, hormones and proteins present in serum are presumed to be responsible for its growth-stimulating activity in culture media. However, synthetic or serum substitute media supporting cell growth are advantageous when it is necessary to standardize culture conditions, particularly when cell products are used. In this study we have evaluated and compared the effects of some commercially available serum substitute media (10% NU Serum, 10% BMS, 2% Ultroser HY, 1% ITS + Premix, 1% Nutridoma, Ultradoma, FEB100, DCCM1 and DCCM2) on growth and immunoglobulin production in different hybridoma cell lines. Six different hybrids were studied: OKT3, OKT4 and OKT8 (producing monoclonal antibodies against CD3, CD4 and CD8 molecules), HB43 and HB57 (producing monoclonal antibodies against human IgG and IgM), and CRL 8019 (producing monoclonal antibodies against high-molecular weight CEA). Several parameters were evaluated, such as viability, doubling time, DNA synthesis, monoclonal antibody production and cell cycle under different culture conditions. Since not all of the hybridomas grew equally well in the same serum substitute media, one synthetic medium cannot be used for all the lines. We found that the serum-free media that best supported hybridoma growth were Nutridoma, DCCM1, DCCM2, NU Serum and FEB100. PMID- 1765650 TI - The JAM test. A simple assay for DNA fragmentation and cell death. AB - Most current methods for measuring cell death are based on plasma membrane disintegration and the consequent release of cytoplasm. The relevant cells are usually loaded with a label (usually 51Cr or 125I), the release of which is measured. I describe here a method, based on the recent evidence that dying cells often degrade their DNA into small fragments, which measures the DNA retained by living cells rather than the cellular components lost by dying cells. The assay is set up essentially like the current cell lysis assays and harvested like a cell proliferation assay. It is faster, more sensitive, easier to set up, less expensive and safer than the current standard 51Cr release assay. PMID- 1765651 TI - Detection of antibody to the PreS2 sequence of the hepatitis B virus envelope protein using an immuno-ligand assay with a silicon sensor detection system. AB - Sensitive immunoassays are essential for establishing the efficacy of recombinant vaccines to hepatitis B virus (HBV). These experimental vaccines include the PreS2 and S domains of the HBV envelope protein. To facilitate measurement of antibody against HBV PreS2, we employed the immuno-ligand assay with silicon sensor-based detection. Labeling of immune reagents with the haptens biotin and fluorescein allows adaptation to the immunofiltration light addressable potentiometric sensor (LAPS) system. A biotinylated monoclonal anti-PreS2 antibody and anti-PreS2 in clinical serum samples competitively bind in liquid phase to a fluorescein labeled PreS2 + S antigen. Streptavidin mediates the immobilization on biotinylated nitrocellulose membranes. Fluorescein mediates binding of an anti-fluorescein urease conjugate to the immune complex. Urease serves as the signal-generating component which subsequently is measured in the LAPS reader. In comparison to a competitive RIA, the immuno-ligand assay demonstrated a four-fold improved sensitivity using a smaller sample volume. The higher sensitivity resulted in earlier detection of seroconversion during a clinical vaccine study. PMID- 1765652 TI - Rapid colorimetric assay for the quantification of leukemia inhibitory factor (LIF) and interleukin-6 (IL-6). AB - The methods in general use for quantifying leukemia inhibitory factor (LIF) activity involve measurements of suppression of proliferation or stimulation of phagocytic activity of mouse myelocytic leukemia (M1) cells. We have developed a novel assay for LIF activity which consists of measuring MTT reduction by M1 cells. The ability of M1 cells to reduce MTT correlates with the level of LIF used for stimulation. The MTT assay of LIF is much quicker than previously used quantitation methods and it is just as sensitive. The MTT assay can also be used to quantify IL-6. PMID- 1765653 TI - A sensitive reverse passive haemagglutination immunoassay for hepatic caeruloplasmin. AB - A reverse passive haemagglutination assay for the measurement of caeruloplasmin in homogenates and organelle fractions prepared from needle biopsies of human liver tissue is described. Use of serial dilutions over a narrow range of concentrations permits accurate quantitation of caeruloplasmin down to 10 ng/ml, sufficient to detect the protein in needle biopsies with as little as 5 mg wet weight of tissue. Applied to the measurement of caeruloplasmin in human sera, the assay gives values which correlate well with those obtained by the standard radial immunodiffusion technique. PMID- 1765654 TI - Hybridoma antibody production in vitro in type II serum-free medium using Nutridoma-SP supplements. Comparisons with in vivo methods. AB - Six hybridoma clones (three producing anti-bovine viral diarrhoea antibodies and three producing anti-hog cholera virus antibodies) were studied with respect to their growth in type II serum-free medium. This was found to be successful in all cases when the serum-free medium was supplemented with 1% v/v Nutridoma, but only after adaptation over a small number of subcultures. Adapted hybridoma cultures could be grown in 250 ml spinner flasks, and the antibody-containing supernatants concentrated by tangential flow filtration. These were compared both with conventional cultures of the clones grown in serum-containing media and with ascites fluids generated using the latter type of culture. Adaptation to growth in the Nutridoma-based serum-free medium did not impair the capacity of the cells to produce and secrete antibodies, although their growth rate was slightly reduced when 250 ml spinner cultures were employed. The titre obtained from the ascites fluids were, as expected, higher than those from the tissue cultures, but contamination by other proteins, a significant problem in ascites fluids, did not present itself with the serum-free cultures. Consequently, 'serum-free' hybridoma antibodies could easily be concentrated in a relatively pure form, with respect to immunoglobulins present, having no need for affinity purification procedures. In addition, the acute in vivo problems of solid tumours and haemorrhage production could be avoided through the use of in vitro methods. PMID- 1765655 TI - An isoelectric focusing method for the study of the humoral response against the antigen 85 complex of Mycobacterium bovis BCG in the different forms of leprosy. AB - Isoelectric focusing was used to separate the three components of the antigen 85 complex of Mycobacterium bovis BCG. Antibody responses of leprosy patients against each Mycobacterium bovis BCG. Antibody responses of leprosy patients against each component were quantitated by densitometric analysis of immunoblot assays. The 85A component was recognized by 40% (8/20) of the lepromin positive and negative healthy subjects, by 76% (19/25) of the tuberculoid and by 96% (24/25) of the lepromatous leprosy sera. In contrast, the 85B component was not stained by the control sera, nor by the tuberculoid leprosy sera but by 64% (16/25) of the lepromatous leprosy sera. The results suggest that antigen 85B contains one or several epitopes that are specifically recognized by sera of lepromatous leprosy patients only. PMID- 1765656 TI - Kinetic analysis of monoclonal antibody-antigen interactions with a new biosensor based analytical system. AB - An automated biosensor system for measuring molecular interactions has been used to study the kinetics of monoclonal antibody-antigen reactions. The system combines a microfluidic unit in contact with a sensor surface for surface plasmon resonance detection. The specificity of the surface is determined by the operator. Antibody or antigen is immobilised in a dextran matrix attached to the sensor surface. The interaction of matrix bound antibody or antigen with the corresponding partner in solution is monitored in real time. None of the interacting molecules needs to be labelled and it is not necessary to determine the concentration of the the matrix bound component in advance. Two systems were studied: matrix bound monoclonal antibodies (MAbs) interacting with HIV-1 core protein p24 and immobilised aminotheophylline reacting with MAbs. Control of the amount of immobilised ligand and reusable sensor surfaces permits the comparison of different MAbs reacting with antigen under almost identical conditions. Differences in affinity and reaction rates are immediately apparent. The calculated association rate constants for p24 MAbs ranged from 3 x 10(4) - 7.4 x 10(5) M-1 s-1 and for theophylline MAbs association rate constants as high as 1 x 10(6) M-1 s-1 were encountered. The calculated dissociation rate constants were in the region 2 x 10(-4) s-1 to 2 x 10(-2) s-1. PMID- 1765657 TI - Determination of non-immune binding of immunoglobulin G to Staphylococcus aureus by enzyme-linked immunosorbent assays. AB - Non-immune binding of human IgG to Staphylococcus aureus was studied by enzyme linked immunosorbent assays using whole bacteria or bacterial cell walls as the solid phase. Two types of anti-human IgG peroxidase conjugates each with a low affinity for protein A, were used: F(ab')2-fragments of goat IgG and chicken IgY. PMID- 1765658 TI - One-step method for establishing 8-azaguanine-resistant hybridomas suitable for the preparation of triomas. AB - A simple and rapid one-step method for establishing azaguanine resistant (Agr) hybridomas, which can be used as a fusion partner for the construction of triomas (hybridoma x splenocyte), has been developed. The method relies on cloning the hybridoma cells in soft agar supplemented with 20 micrograms/ml 8-azaguanine. The drug-resistant subclones were isolated after 3-5 days, in comparison with 4-5 weeks reported for the conventional adaptation method. The high frequency (about 10(-3) of Agr-mutants achieved by the cloning method was demonstrated with five different hybridoma clones. One of the derived Agr-hybridomas was fused with mouse immune spleen cells in order to demonstrate its suitability for the generation of triomas secreting bispecific monoclonal antibodies. PMID- 1765659 TI - Reduction of rubella ELISA background using heat denatured sample buffer. AB - During the analysis of rubella-specific antibodies in sera from adult vaccinees, it was observed that the inclusion of heat-denatured blocking proteins in the sample dilution buffer substantially reduced non-specific binding of serum IgG to microtitre plates. Results suggest that this modification to standard ELISA technique may reduce the incidence of false positive results in these assays. PMID- 1765660 TI - Differential binding properties of protein A and protein G for dog immunoglobulins. AB - We studied the binding of dog immunoglobulins G, A, M and E to protein A and protein G. Passive cutaneous anaphylaxis (PCA) testing was used for the measurement of dog IgE and enzyme-linked immunosorbent assays (ELISA) were used for the measurements of dog IgG, IgA and IgM. Protein A from lyophilized cells of Staphylococcus aureus bound 97% of IgE, 98% of IgG, 81% of IgA, and 97% of IgM. Protein A-Sepharose CL-4B bound 87% of IgE, 100% of IgG and IgA, and 98% of IgM. In a stepwise elution with varying pH, a small amount of IgE was eluted at pH 5 and pH 6 and all the remaining Igs were eluted at pH 3 from the protein A column. In contrast to protein A, dog IgE was not bound to Protein G-Sepharose, while 100% of IgG, 95% of IgA, and 44% of IgM were bound to Protein G-Sepharose. PMID- 1765661 TI - An improved colorimetric assay for tumor necrosis factor using WEHI 164 cells cultured on novel microtiter plates. PMID- 1765662 TI - One-step purification of murine monoclonal antibodies of the IgM class. PMID- 1765663 TI - PROBIT: a computer program analysis. PMID- 1765664 TI - A simple and rapid slide blot method to quantify cytokine-mRNA in small numbers of lymphocytes. AB - In this study we describe an in situ hybridization protocol suitable for the measurement of interleukin mRNAs in small numbers of cells in suspension. In this procedure defined numbers of such cells are coated onto defined areas of microscopic slides using LAB-TEK tissue culture chamber slides. 32P-labelled oligonucleotides are then hybridized to them in situ. Binding of the probes is measured by autoradiography using X ray film followed by densitometry (slide blot) or, as in standard in situ protocols, by exposure to photoemulsion. In experiments designed to demonstrate the specificity and feasability of this protocol, peripheral blood T cells were activated with mitogenic stimuli and oligonucleotide probes specific for IL-2, IFN-gamma, or a control probe (IL-2 random) were hybridized to them. Both lymphokine genes were found to be transcribed in two discrete phases with the first peak at 12 h and another peak 48 h after stimulation, as measured semi-quantitatively on a per cell basis using X ray film exposure. The proposed experimental protocol supports the advantages of X ray film autoradiography such as rapidity, simplicity and the objectivity of densitometric evaluation, but also permits microscopic evaluation of individual cells as performed in classical in situ hybridization protocols using photoemulsion. PMID- 1765665 TI - Measurement of IgE specific to a major allergen of house dust mite: Der p I. AB - A monoclonal antibody assay has been developed to measure Der p I specific IgE in sera of D. pteronyssinus sensitive patients. In this assay a specific monoclonal antibody was bound to the solid-phase and this complex was used for insolubilization of the allergen. Two procedures using two different solid phases, CNBr activated paper discs and microtitre plate wells, were compared. In the paper disc assay about 90% of specific IgE was bound to the solid-phase. A study of 80 sera from mite sensitive children confirmed the importance of Der p I; indeed all the sera contained Der p I specific IgE and IgE anti Der p I contributed from 5% to 100% (mean = 39%) of the mite specific IgE response. In the microtitre plate assay only 45% of specific IgE was immobilized and it was necessary to express the results in arbitrary units. The correlation with the paper disc assay was significantly positive (r = 0.89) but five samples were found to be negative. However, this assay appears to be of interest for studying the affinity of specific IgE in different samples. The use of specific monoclonal antibodies as allergosorbents is a useful approach to a better standardization of the in vitro diagnostic reagents. PMID- 1765666 TI - Simultaneous use of poly- and monoclonal antibodies as enzyme tracers in a one step enzyme immunoassay for the detection of hepatitis B surface antigen. AB - A one-step third generation enzyme immunoassay (EIA) was developed for the detection of hepatitis B surface antigen (HBsAg) in human serum or plasma using a polyclonal (Pab-HBsAg) and two monoclonal antibodies to HBsAg (Mab1-HBsAg and Mab2-HBsAg). In this assay, the solid phase is coated with Mab1-HBsAg and the specimen is incubated simultaneously with peroxidase labelled Pab-HBsAg and Mab2 HBsAg. If HBsAg is present in a specimen it will form sandwich complexes with capture and tracer antibodies. The hook effect, observed in some HBsAg detection tests when a high concentration of HBsAg is present, was minimized in this assay by increasing the concentration of the peroxidase-labelled Mab2-HBsAg. The sensitivity of this assay for HBsAg/ay and HBsAg/ad subtypes in a standard (2 h incubation) procedure was 0.6 and 0.3 ng/ml and in an overnight (16-22 h incubation) procedure 0.2 and 0.15 ng/ml, respectively. Strong elimination of the hook effect was observed with specimens containing high levels of HBsAg compared with test results using peroxidase-labelled Pab-HBsAg alone as enzyme tracer. This EIA offers a procedure, with a high specificity and wide range of sensitivity for the detection of HBsAg in human sera or plasma. PMID- 1765667 TI - Ultrasensitive two-site assays for inhibin-A and activin-A using monoclonal antibodies raised to synthetic peptides. AB - Monoclonal antibodies produced to synthetic peptides of the alpha and beta A subunits of inhibin were used to develop the first highly sensitive two-site assays for recombinant human inhibin-A and activin-A. The assay for inhibin-A could detect as little as 5 pg/ml. Activin-A gave a 5.2% cross-reactivity in the inhibin assay. The assay for activin-A could detect 0.1 ng/ml and inhibin-A showed a 5.3% cross-reaction in the activin assay. Determination of inhibins and activins in biological fluids is complicated by the presence of multiple molecular forms and an excess of free alpha subunits. The present study demonstrates the potential of antibodies raised to synthetic peptides to configure more specific two-site assays for inhibins and activins which could facilitate research on these molecules. The monoclonal antibody used as the labelled antibody in these studies was made by immunizing mice with a peptide corresponding to an internal sequence of the beta A subunit. It appears likely that similar high affinity anti-peptide monoclonals suitable for use in ultrasensitive two-site assays could be made to other molecules if a rigorous screening of the fusion supernatants on the native molecule was carried out. The use of anti-peptide monoclonal antibodies in the development of ultrasensitive immunoassays may be more widely applicable than commonly realised. PMID- 1765668 TI - Production of monoclonal antibodies specific for African swine fever virus following in vitro primary immunization of mouse splenocytes in the presence of stimulated T lymphocyte supernatants. AB - Splenocytes from non-immune mice were stimulated in vitro using a kit of cytokine preparations (obtained from murine MLR and EL-4 cell cultures), and concomitantly immunized with African swine fever (ASF) virus antigen. In addition, fusions were performed at 5 days after primary or secondary stimulation/immunization. The detection of specific antibodies in the culture supernatants was not successful. In contrast, specific antibody-producing hybridomas could be generated, and this was at least comparable to a standard in vivo immunization regime, even though the optimum fusion ratio employed with these in vitro immunized splenocytes was one which is not optimum when in vivo immunized lymphocytes are used. Consequently, it would appear that hybridoma generation is a more sensitive method than the direct measurement of antibody at detecting in vitro primary immune responses. After primary in vitro immunization, the majority of immunoglobulins produced were apparently of the IgG isotype, with only 8-17% clearly IgM. These antibodies were mainly against VP73 (the major viral envelope protein) as expressed on viral antigen extracted from infected cells, although other specificities were also found. This demonstrated, by in vitro means, that the VP73 carried dominant immunogenic epitopes on ASF virus. Such observations show that the in vitro responses were closely related to those which have been detected in vivo. PMID- 1765669 TI - Human serum induced opsonization of immunoglobulin G-coated polystyrene microspheres with complement components C3 and C4 as measured by flow cytometry. AB - Human IgG-coated polystyrene microspheres (IgG-ms) were incubated with human serum followed by biotinylated monoclonal anti-C3d or anti-C4d antibody, and phycoerythrin-streptavidin. The intensity of fluorescence was measured by flow cytometry and corresponds to the amount of deposited C3 and C4. Binding of C3 and C4 was dependent on the activation of the classical pathway of complement and on the amount of IgG adsorbed to the particles. No deposition was observed on control particles coated with bovine serum albumin or ovalbumin. Incubation of constant amounts of IgG-ms with increasing amounts of normal human serum (NHS) resulted in a dose-dependent increase in C3 deposition. The same result was found for C4 deposition at moderate NHS dilutions, but less C4 was detectable using a higher input of NHS. Half-maximum C3 and C4 deposition was observed at a mean serum dilution of 1/114 and 1/520, respectively (n = 26). No correlation was found between C4 or C3 deposition and either total C4 and C3 serum concentrations as measured by nephelometry or complement-mediated lysis of antibody-coated sheep red blood cells. Reduced or absent C4 or C3 deposition was found in the sera of patients with low amounts or deficiencies of components involved early in classical complement pathway activation whereas essentially normal C4 or C3 deposition was obtained with the sera of patients with deficiencies in components of the membrane attack complex. With this simple and specific functional assay using stable reagents an altered function of early components of the classical pathway of complement may be quickly and reliably detected in routine diagnostic laboratories. Moreover, such opsonized and well characterized particles may be useful in assays of phagocytic cell function. PMID- 1765670 TI - The immune response in the rat to Streptococcus pneumoniae type 3 and type 4 capsular polysaccharide. Detection by double immunocytochemical staining of antibody-containing cells in situ and ELISA. AB - Two different methods have been used to study immune responses in the rat to Streptococcus pneumoniae type 3 and type 4 capsular polysaccharides (PPS). First, for simultaneous detection of the specificity and isotype of anti-PPS antibody containing cells (ACC) in cryostat sections of lymphoid tissue, a double immunocytochemical method was developed. This method is a combination of a three step immunoperoxidase method to demonstrate specific anti-PPS ACC as bright red cells and a two-step immunophosphatase method to detect the isotype of ACC as blue cells. Double positive cells appear violet. Using this staining procedure, the detection of antigen was also possible. Second, to study the anti-PPS response in serum, an ELISA procedure was modified. In this ELISA, polyvinylchloride microtiter plates are coated directly with type-specific pneumococcal polysaccharide. After intraperitoneal (i.p.) immunization of rats with PPS-3 or PPS-4, both antigen (PPS) and specific ACC could be detected. Specific ACC were found in the spleen and mesenteric lymph nodes. In the spleen, the specific ACC were found in the red pulp, marginal zone, outer PALS, and follicles. Most of these ACC were IgM-positive and to a lesser extent IgG positive and IgA-positive. However, specific ACC in mesenteric lymph nodes were predominantly of the IgA isotype, with only few IgM or IgG positive cells. The anti-PPS response in serum, as measured by the ELISA, consisted mainly of IgM antibodies with small amounts of IgG and IgA. Both methods were found to be valuable in studies of immune responses against bacterial polysaccharides. PMID- 1765671 TI - The epidemiology of Taenia pisiformis infections in domestic dogs in Cairo. AB - The epidemiology of Taenia pisiformis infections in domestic dogs in Cairo, Egypt. Over 5000 street dogs humanely killed in a culling programme organized by the Egyptian Ministry of the Interior in the winter of 1986 and the spring of 1987 have been utilized to examine the final host epidemiology of the cestode Taenia pisiformis in Cairo. In the winter months the prevalence of infection was 63.4% and the mean intensity 2.82 per dog: by the spring of 1987 these values had risen to 70.8% and 3.78 respectively. These parasite burdens probably represent the highest infection levels with T. pisiformis yet described from urban dog populations anywhere in the world. The dispersion of T. pisiformis within the street dog population was assessed and found to be significantly aggregated and well described by a negative binomial model of overdispersion (variance/mean ratio: 5.16, coefficient k = 0.795). A separate analysis was carried out of infection in each of 18 circumscribed regional areas of Cairo which revealed considerable area-to-area differences with mean intensities varying between 1.62 and 6.54 and prevalences between 43.3% and 91.2%. The size structure of the winter and spring worm samples were very similar with about 45% of worms less than 35 cm in length, about 35% between 35 and 59 cm, about 20% between 60 and 100 cm and less than 5% greater than 100 cm in length. The epidemiological factors which lead to high T. pisiformis infection levels in Cairo dogs have been considered and the consumption of discarded rabbit offal containing Cysticercus pisiformis by street dogs is regarded as a crucial mode of transmission. PMID- 1765672 TI - Prevalence of Giardia lamblia antibodies in serum and milk in lactating women from different social classes in Egypt. AB - Prevalence and levels of systemic and milk antibodies to G. lamblia in the different social classes of the population were studied using the IFAT and nor partigen immunoglobulin plates. Blood and milk samples were collected simultaneously from lactating women in urban (Cairo) and rural (Benha) areas. Serum IgG was present in 90% of rural low standard mothers, 58% of urban moderate standard mothers, and 25% or urban high standard mothers (P less than 0.01, P less than 0.001 and P less than 0.01). Antilog of mean of antibody titers was significantly higher in the low standard rural mothers than in the urban moderate and high standard ones. Specific secretory IgA antibody in milk was found in 71% of rural low standard mothers, 31% of urban moderate standard mothers, and 16.6% of urban high standard mothers (P less than 0.001, P less than 0.01 and P greater than 0.05). The antilog of mean S-IgA titers was also higher in the low standard rural mothers. The titer levels of S-IgA in the three classes did not show any correlation with the quantitative levels of total IgA in milk, while specific IgG showed a positive correlation with the total serum IgG in the low standard rural mothers only (P less than 0.05). This study documented the widely different antibody response to G. lamblia in individuals living in different social classes. PMID- 1765673 TI - Cyclosporin A in experimental trichinosis; parasitological study. AB - During the last few years, antiparasitic effects has been related to the immunosuppressant cyclosporin A (CsA). This work was planned to study the effect of this drug against different aspects of experimental trichinosis. The work included three experiments. The first experiment was to study the effect of (CsA) on infection when administered to mice at different durations i.e. post infection as well as before and on the same day of infection. It proved to be most effective when given on the same day of infection as evidenced by the significant reduction in adult count, length of female, larval count and index of reproductive capacity (RCI). However, the effect though still significant, diminished when the drug was given pre- and post-infection. The second experiment was to study the effect of (CsA) on infectivity of the T. spiralis larvae treated either in vivo or in vitro. The results showed that the drug has marked effect in that part of the study as shown by the reduction in all parameters of assessment. The third experiment demonstrated the challenge that followed (CsA) treated primary compared to that of non treated one. Results showed significant reduction in all values. These results evoke ideas for further designs of other treatment and control strategies for the disease. PMID- 1765674 TI - Steinernema parasitism of larvae of the house fly Musca domestica Linneous. AB - The histopathological effect of different dosages 50, 100, 200, 500 and 1000 of Steinernema feltiae Filipjev larvae on the larval tissues of Musca domestica Linneous has been studied. It was found that S. feltiae nematodes invade the fat tissue, gut, cuticle and muscle tissue of the host. All of these tissues, along with the gut epithelium, show signs of disintegration before death of the host. The tissue of the gut and the fat body are the most severely damaged by the presence of S. feltae. The destructive damages described in this investigation depend mainly upon the time and the intensity of infection. PMID- 1765675 TI - Fleas as an allergen in Egyptian asthmatic patients. AB - Fleas are widely distributed and partially host specific ectoparasites of man and animal. The aim of this work was to study the role of fleas as one of the causative allergens of bronchial asthma in Egyptian patients. Two flea extract antigens were locally prepared. The first from the head and the salivary glands and the second from the abdomen. The sensitivity of the first antigen (head and salivary glands) was evaluated among a known group of flea bite allergic individuals and normal control group using two dilutions 1/50 and 1/100, and proved to be sensitive. Regarding bronchial asthma and fleas, two groups of individuals were examined, asthmatic patients and control ones, using flea extract antigen and common inhalant antigens as skin test as well as precipitin test using flea extract antigen. This test was done by prick method using the routine allergens (house dust, cotton dust, mixed mould, mixed pollens, cat hair, dog hair, wool, feather) and also with locally prepared two flea extracts: one was prepared from the head and salivary glands, the second was prepared from the abdomen. Out of these sixty asthmatic patients, only six (10%) gave positive skin reactions to the antigens of fleas extract. All the control gave negative skin reaction. The precipitin test using the double immuno diffusion method gave positive results with one case who showed reaction to flea extract skin antigen. PMID- 1765676 TI - Opportunistic parasitic infections in immunocompromised hosts. AB - Parasitological and serological examination was done for 111 cases with various types of malignancies under immunosuppressive therapy and another 20 apparently healthy individuals as a control group to determine the prevalence of opportunistic parasitic infections among immunocompromised patients. Single examination showed that 74 (66.7%) harboured infection with different parasites: Strongyloides stercoralis infection was found in 4 (3.64%) cases; 3 cases (2.7%) had Pneumocystis carinii infection. No Cryptosporidium oocysts were detected; IFAT for toxoplasmosis was positive in 40 cases (36%) with titres ranging from 1/16 - 1/256 but IFAT-IgM was negative. The control group did not show any parasitic infection except that IFAT was positive in 4 out of 20 (20%) with titres ranging from 1/16 to 1/128 but IFAT-IgM was also negative. Although Toxoplasma infection was higher among patients the difference was insignificant. Generally the percentages recorded for the different parasites were found to be within the expected prevalence. One case report of concomitant opportunistic Pneumonocytis and Toxoplasma infection is reviewed. PMID- 1765677 TI - Studies on the enteric helminths infecting Clarias lazera in El-Minia Governorate, Egypt. AB - Clarias lazera fishes have been examined for helminth parasites. The following parasites were identified Orientocreadium batrachoides (Tunbangui, 1931), Glossidium pedatum (Looss, 1899), Polyonchoborthrium clarias (Woodland, 1925), Procmaollanus leveiconchus (Railliet and Henery, 1915) and Paracamallans cyathopharynx (Baylis, 1932). PMID- 1765678 TI - Two abnormal cases of anthroponotic cutaneous leishmaniasis in Al Baha, Saudi Arabia. AB - Two cases of ACL which showed extreme variation of cutaneous disease encountered in infection with Leishmania tropica were reported. Biochemically, the two isolates proved to be L. tropica (Zymodeme LON 72, one isolate and 71 second isolate. PMID- 1765679 TI - Relation of parasitic infection to blood group in El Minia Governorate, Egypt. AB - 148 patients attending the outpatient Tropical Medicine clinic, El Minia University Hospital were studied for parasitic infections in relation to ABO blood groups. There was a statistically significant relationship between G. lamblia infection (69.23%) and blood group (A), as well as a tendency of blood group B to be excess among cases of E. coli (46.15%). On the other hand S. haematobium, S. mansoni, H. nana, E. vermicularis, A. lumbricoides and E. histolytica showed no significant relationship to ABO blood groups. PMID- 1765680 TI - Comparative studies on the development of the entomogenous nematodes Steinernema feltiae Filipjev on Spodoptera littoralis (Boisduval) and Musca domestica Linneous. AB - Comparative studies were made at 26 degrees C under laboratory conditions on the development of Steinernema feltiae Filipjev (= Neoaplectana carpocapsae) on the different stages of Spodoptera littoralis (Biosduval) and Musca domestica (Linneous). In the present investigation the host species influence manifested itself, in a quicker development rate along with the cotton leafworm S. littoralis. Particular development stages took place earlier in the S. littoralis than in M. domestica. As far as the occurrence dates of particular stages of S. feltiae were concerned, the differences in relation to the two host species were significant. The changes in numbers of giant forms in the development course of populations in the caterpillars, pupae and imagos body of both species were studied. The numbers of giant forms correspond with the numbers of invasive larvae, it seems that at first they are growing and then decreasing. PMID- 1765681 TI - Detrusor morphology and pathology in relation to bladder outflow obstruction in bilharzial patients. AB - The light and electron microscopic structure of detrusor muscle of trabeculated urinary bladder from patients with urodynamically proved bilharzial outflow obstruction had been compared with normal detrusor muscle. In bilharzial outflow obstruction, the detrusor muscle bundles were formed of relatively smaller smooth muscle cells widely separated by dense connective tissue, fatty infiltration, bilharzial ova, inflammatory cells and hyalinosis. No evidence of smooth muscle hyperplasia, mitosis, or fibroblastic proliferation. At the level of electron microscopy. The connective tissue infiltration was proved to be microfibriles apparently in continuity of the basal lamina of the smooth muscle. These pathological changes can explain both the morphological and urodynamic changes in bilharzial urinary bladder outflow obstruction. PMID- 1765682 TI - Age-related rate of seropositivity of antibody to Giardia lamblia in different age groups in Cairo. AB - Two hundred and twenty normal individuals were subjected to Giardia lamblia antibody IgG analysis. All subjects were of low socioeconomic standard using Indirect Immunofluorescent Antibody Test (IFAT). According to age the study persons were divided into 4 groups : group I with age in between 6 to 35 months, group II with age in between 3 years and less than 6 years, group III with age group ranged between 6 years and 16 years old and group IV with age above 16 years. The Seropositivity to Giardia infection was (37%) in all age groups, while it was 23%, 52%, 32% and 40% in each of the four age groups respectively. It is a noteworthy that infants after 12 months of age showed seropositivity to Giardia infection which meant that they caught actual infection in this early period of life while infants younger than 12 months were all seronegative to Giardia antibody. Different patterns of age associated acquisition of antibody levels were noted in the study groups. Infants and children showed a progressive acquisition of antibody titre which arrived to the highest level at the adult age group greater than 16 years that was significantly higher than other age groups. PMID- 1765683 TI - Scanning electron microscopy of normal and praziquantel treated S. haematobium worms (Egyptian strain). AB - The ultrastructure of the tegument of S. haematobium was examined before and after treatment with Praziquantel using scanning electron microscopy. The surface of the adult male worms prior to treatment showed numerous tubercles with apically directed spines and the lateral border showed highly pitted folds. The oral and ventral suckers showed well developed spines. Praziquantel administration caused various structural changes in the various groups studied. Blebs and spine deformities appeared as early as half an hr. after administration. Changes were also observed when the drug was administered prior to worm maturation resulting in generalized deformities in the worms which survived treatment, loss of spines and tegumental swellings. PMID- 1765684 TI - Effectiveness of the non-steroidal ecdysone mimic, RH-5849 for the control of Musca domestica vicina. AB - The new non-steroidal ecdysone mimic, RH-5849 (1, 2-benzoyl-1-tert butylbenzohydrazine) was investigated, its biological actions were evaluated in the laboratory against a susceptible strain of Musca d. vicina. The larvae of 1 day old and of 4-day-old were fed on diets treated with different concentrations of the compound. RH-5849 shortened the larval and pupal durations and induced the initiation of premature lethal moult. The pupation rate was highly affected, where it was reduced to 46.7% at a concentration rate of 250 ppm. Also, the adult emergence was drastically blocked by the action of RH-5849 where its percentage was decreased to 42.9 at 250 ppm. In regard to the fecundity and egg viability, RH-5849 induced a cessation of oviposition in females produced from 1-day-old and from 4-day-old larvae fed on diets treated with 160 and 200 ppm, respectively. In addition, RH-5849 halted the larval and pupal growth, where the untreated pupae were generally heavier than those produced from treated larvae. PMID- 1765685 TI - The relation between Cimex lectularius antigen and bronchial asthma in Egypt. AB - In bronchial asthma, house dust is one of the important precipitating factor. Cimex lectularius or bedbug is a well known house insect and share in the constitution of house dust. 54 asthmatic patients and 11 control individuals were skin tested using the common environmental inhalant antigens as well as Cimex extracts (Head and thorax, 1st antigen and abdomen, 2nd antigen). Also precipitin test using both Cimex extracts were used. The percentage of positive skin reactions to 1st Cimex antigen was 37.1 as compared to 9.1 in controls The percentage of positivity to Cimex 2nd antigen was 50.1 as compared to 18.2 in controls. On the other hand, the asthmatic patients showed different percentages of positivity to the common environmental inhalant antigens. The whole results were discussed. Of interest was the significant relation between the positivity in asthmatic patients to the antigens of Cimex abdominal extract and cotton dust extract. On the other hand, the precipitin tests gave negative results in both the asthmatic and control group. PMID- 1765686 TI - Seasonal variation of sandflies in Beni-Suef, Egypt. AB - The sandflies were collected from Beni-Suef district over one year, and identified as P. papatasii, P. sergenti and Sergentomia m. minuta. The first species was predominant and increased during hot months. PMID- 1765687 TI - Study of C-reactive protein in bilharziasis and malignancy as causes of ascites. AB - C-reactive protein titre was estimated in serum and ascitic fluid in 23 patients, 12 with cancer stomach accompanied by liver metastatases and 11 with bilharzial liver fibrosis. The results showed no statistically significant differences between the titre in serum and ascitic fluid in the group of cancer with mean of serum/ascitic level ratio 1.3, while in bilharzial group there was significant difference with ratio mean 6.3. PMID- 1765688 TI - Preliminary assessment of prevalence of toxoplasmosis in patients with chest diseases. AB - Frequency of Toxoplasma antibodies in chest disease patients was assessed by IFAT. An overall positivity of 20.5% was recorded which is the range of prevalences reported in Egypt. The majority (90.3%) were positive at titre 1/16 and one case of atypical pneumonia showed titre of 1/256. The implications are discussed. PMID- 1765689 TI - Humoral and cell mediated immune responses in scabietic patients. AB - Humoral and cell-mediated immune responses were studied in forty scabietic patients and twenty healthy control individuals. The parameter findings for quantitative assessment of humoral immune response by the single radial immune diffusion technique indicated that IgA was significantly decreased, IgG & IgM were significantly increased while there was no statistical difference in the level of IgE, C3 & C4 compared to the normal control group. The cell mediated immune response was estimated in vivo by the intradermal test. It showed insignificant decrease in the number of positive reactors versus the control group. The macrophage migration inhibition test as an in vitro index for determining the cell mediated immune response was significantly diminished. This study indicates that humoral and cell-mediated immune responses play an important role in the pathogenesis of scabies. PMID- 1765690 TI - Correlation between the level of IgA and Pneumocystis carinii infection. AB - Sputum examination for detection of P. carinii pneumonia (PCP) can be substituted for more invasive techniques. There was a significant correlation between PCP and the increased level of IgA in serum (P less than 0.01) and sputum. The increase in IgA level in sputum was much more higher than that in the serum. This supports the concept that local antibody formation by the lung may have a more important role in the immune and inflammatory response to P. carinii. PMID- 1765691 TI - The effect of the initial inoculum dose and post-infection period on larval dispersal in experimental murine toxocariasis. AB - The distribution of Toxocara canis larvae throughout the tissues of mice was studied in three groups of fourty mice each using three inocula sizes, (200/500 and 1000 eggs/mice). The results obtained revealed a significant interaction between the duration of infection, the inoculum size and the dispersal rate of larvae through the examined organs of experimented with mice. PMID- 1765692 TI - Malabsorption syndrome in patients with cryptosporidiosis. AB - Out of 130 patients presenting with gastroenteritis, oocysts of Cryptosporidium species were detected in the faecal samples of 10 persons (7.69%). The prevalence of the parasite was higher among rural inhabitants (11.47%) than city dwellers (4.35%), particularly in the young age. The parasite lead to impairment of the intestinal absorptive function as indicated by the significant change in the fat in stools and the decreased excretion of D-xylose. PMID- 1765693 TI - Scanning electron microscopy of the tegumental surface of in vivo treated Schistosoma mansoni (Saudi Arabian geographical strain) with oxamniquine and praziquantel. AB - Praziquantel (40 mg/Kg.) and Oxaminquine (30 mg/Kg.) were administered orally to mice at seven weeks after infection with S. mansoni. The tegumental surfaces of non-treated as well as treated adult worms were examined by scanning electron microscope seven days after treatment. The surfaces of the worms were shown to be different from other studied strains. Such differences include; the devoideness of the female tegument of several sensory appandages; the number of sensory bulbs per papillae was high and the interpapillar setae were absent on the dorsal and dorsolateral surfaces of the male. Both drugs affected the surfaces of the male more pronouncedly than the female. Praziquantel was more effective in the destruction of spined papillae, wrinkling and disturbing the interpapillar spaces. Oxamniquine destructed the suckers, but had little effect on the spined papillae. No post-treatment recovery of worm's teguments was noticed. PMID- 1765694 TI - Toxoplasmosis among pregnant women in Abha, Saudi Arabia. AB - The prevalence of toxoplasmosis in Abha, Saudi Arabia, was measured in pregnant women, by the indirect hemagglutination test. It was found to be still as high (31.6%) as reported previously, and the problem of toxoplasmosis in Saudi Arabia needs an organised health education and control program. PMID- 1765695 TI - Topical niclosamide as a protective agent against schistosome infection. AB - Niclosamide, as a semisolid pharmaceutical form suitable for external use, was used in 4 different concentrations (0.5%, 1%, 2% & 4%) to paint albino mice tails at different periods before exposure to infection with S. mansoni cercariae. Complete protection (100%) was achieved in all mice painted on the same day, the previous day and 3 days before exposure to cercariae irrespective to the niclosamide concentrations. Neither eggs nor worms were detected. Also, no pathological changes were found in livers, spleens or intestines of those mice. On the other hand, no protection against infection was achieved in mice painted with, 0.5% or 1%, 7 days before exposure to cercariae. Partial protection (25% and 40%) was gained in mice painted with 2% or 4% concentration of the drug respectively. It can be concluded that locally application of niclosamide as an ointment can completely prevent the infection with S. mansoni for three days. So, testing the promising drug for human trials to evaluate its efficacy specially for those at high risk is recommended. PMID- 1765696 TI - Diagnostic value of DNA content in keratosis and adult papilloma of the larynx. AB - Nuclear DNA content of laryngeal epithelial cells in smears was carried out by DNA cytometry with automatic microscope and T.V. image analysis system in 6 adult papilloma and 10 keratosis of the larynx patients. The method had high degree of precision confirmed by whole tissue biopsy and serial sections. The method is non invasive and allows fair diagnosis of suspicious and early malignant cases. PMID- 1765697 TI - Haematological values and parasitic infections in school children in Riyadh, Saudi Arabia. AB - A total of 1426 apparently healthy Saudi children, were subjected to clinical and laboratory investigations of blood, urine and stools. Lower means were observed for Hb concentration, Hot ratio, RBC and WBC counts. The MCV was in the range of Western levels. Of 1343 stool specimens 156 (11.6%) were positive for intestinal parasites (5.4% pathogenic and 6.3% commensals). The higher infection rate of commensals strongly suggests the presence of potentially infectious environmental sources and a public health problem. Giardia lamblia was the most common pathogenic parasite 3.6% and its high infection rate seemed to be associated with lower Hb level. So screening for parasitic infections especially among anaemic children is necessary as a part of the general health care programme. PMID- 1765698 TI - House-fly distribution in certain general hospital in Cairo. AB - Fly sampling was evaluated under laboratory conditions before starting the field surveys. Three different fly traps were tested, of which the Spiralettes (a commercial one) proved to be the most efficient. Sampling conditions were also considered in this laboratory evaluation, light, air current, swinging, height and temperature were tested, all of them have affected fly trapping except height. Fly density and distribution in two general hospitals and two specialized ones, were estimated in order to evaluate them epidemiologically in relation to hospital bacterial contamination. Results of these surveys revealed the followings: (1) The location of the hospital has no impact on the fly density. (2) Flies are attracted more to swinging hanged ribbon traps than to fixed ones. (3) Fly densities were relatively high in the main kitchens and the main garbages followed by toilets (common ones), patient wards, outpatients investigating rooms, surgical theaters and plasterrooms of the hospitals. (4) Fly density is higher during warm seasons than in cold ones. PMID- 1765699 TI - A case of cervical lymphadenopathy due to pediculosis. AB - This paper reports a case of cervical lymphadenopathy due to infestation with Pediculus h. capitis. Clinically and histopathologically the case was diagnosed to a non malignant and a non specific one. PMID- 1765700 TI - Two cases of human ophthalmomyiasis. AB - Myiasis is a subject of medical and veterinary importance. This paper reports two human cases of ophthalmomyiasis due to Oestrus ovis and Wohlfahrtia magnifica. PMID- 1765701 TI - The role of parasitic infection in the aetiology of phlyctenular eye disease. AB - Stool and urine analysis of 150 cases of phlyctenular eye disease, revealed that 115 (76.67%) were positive for intestinal parasites. The most prevalent parasites were Hymenolepis nana (49.56%) followed by Ascaris lumbricoides (27.82%). Eosinophilia (5-10%) was detected in 90 phlycten cases (60%), 80 of them (88.8%) had parasitic infection. Since H. nana can produce a type of tissue hypersensitivity, phlyctenular eye disease may be partly referred to such an infection. PMID- 1765702 TI - Responses of larval Chrysomyia albiceps (Wiedemann) to light. AB - Investigations into the phototactic behaviour of Chyrsomyia albiceps led to the following results: (a) The phototactic behaviour of the third instar fresh larvae had moved away from the light within 50 sec. (96%). (b) Fatigued larvae moved across the division line several times and took more time to travel away from light. PMID- 1765703 TI - Otitis media and aural myiasis. AB - Myiasis is a diseased condition caused by larvae of myiasis producing flies. Still little is known about such an important subject in Egypt. In this paper, the author described three human cases of otitis media associated with aural myiasis. The causative larvae were those of W. magnifica and S. falculata. PMID- 1765704 TI - [Molecular architecture and evolution of annelid giant hemoglobin]. PMID- 1765705 TI - [Regulation of signal transduction and response by (ADP-ribosyl)n ation in eukaryotes]. PMID- 1765706 TI - [Coordination between nuclear and mitochondrial genetic systems in mitochondrial biogenesis]. PMID- 1765707 TI - [Sweet proteins and sweet-inducing proteins]. PMID- 1765708 TI - [Chemical synthesis of multiple antigen peptide]. PMID- 1765709 TI - [Simple method of "mini-prep": small scale preparation of plasmids from E. coli]. PMID- 1765710 TI - Brief historical note of the development of angiology and vascular surgery in Brazil. PMID- 1765711 TI - Experimental study of a biograft as aorto-aortic "bypass". AB - The authors present experimental results with a bovine "mammary" artery graft with a 6 months follow-up and histological study up to 3 months (Transmission and Scanning Electron Microscopy). They report a 100% patency in the 16 dogs operated on (there were 2 controls). Grafts used were 6 cm long, had a 4 mm diameter and were implanted as aorto-aortic bypass. Dinamic evolution of the pseudo-intima is described as thickening up to the 14th day, when it is "cleaned". These facts would be related with variation in the peripheral resistance and their objectives would be narrowing or widening the graft in order to accelerate or slow the flow speed, respectively. Factors related to Poiseuille's law (diameter, length, viscosity) are mentioned as important elements for the patency rate of long lengthened, thin-diametered grafts. Also, the electrical charge of the intima and the endothelial seeding are discussed. PMID- 1765712 TI - Abdominal aortic aneurysm in association with horseshoe kidney. AB - The authors report 3 cases of infra-renal abdominal aortic aneurysms resected in the presence of horseshoe kidney. In all these cases the diagnosis of the renal anomaly was done before the aneurysmectomy. In the first case, the diagnosis of horseshoe kidney was done by an aortography. In the second case by a previous operation to remove an urinary calculi. Three years after this surgery the diagnosis of abdominal aortic aneurysm was done when a computed tomography, an intravenous pyelography and an aortography, confirmed the diagnosis of horseshoe kidney. The third case come to our hospital in the fourth day after an exploratory laparotomy done in another hospital, when was observed the aneurysm and the horseshoe kidney. The second case had two anomalous arteries. One of them arose from the aneurysm to the renal isthmus and the other one from the common iliac to the isthmus. The three patients had an uncomplicated postoperative course. Only in the second case we had the necessity to reattache an anomalous artery directly to the graft. PMID- 1765713 TI - In situ saphenous vein arterial bypass for infrainguinal revascularization: initial experience using an open technique. AB - The authors describe their initial experience with the use of the in situ saphenous vein arterial by-pass technique for infrainguinal revascularization. From December 1986 to August 1989, we performed 101 in situ saphenous vein arterial by-passes. From these 101 by-pass, 18 composite or partial in situ vein by-passes (in situ + reversed vein) and 2 extra-anatomical sequencial by-passes (one axillofemoral and one cross-over femorofemoral proximal by-passes extended by in situ saphenous vein femoropopliteal arterial by-passes) were withdrawn from the statistics, with the purpose of analysing the natural evolution of the in situ vein arterial by-pass without the insertion of reversed vein segments and/or the influence of artificial grafts to improve arterial inflow. Therefore only 81 in situ by-pass cases will be analysed in the present paper. From these 81 cases, 44 (54.3%) were performed in diabetic patients and limb salvage was the indication for by-pass in 63 (81%). The saphenous vein valves were rendered incompetent utilising the retrograde Mills-Leather valvulotome and exposing the greater saphenous vein with a continuous incision. In the 81 cases, wound complications occurred in 18 limbs (22%) and operative mortality (30 days) was 6.1%. Primary cumulative patency rate of the 81 cases was 77% and secondary cumulative patency rate was 80%, at the end of the analysed period. The open technique, using a retrograde valvulotome and exposing the entire conduit of the greater saphenous vein, became our preferred technique for infrainguinal revascularization. PMID- 1765714 TI - Ruptured abdominal aortic aneurysm. Analysis of 50 procedures. AB - The authors report their experience in the management of 50 patients operated on for ruptured abdominal aortic aneurysms. The importance of an early surgical indication will be discussed. A didactically written chart will be presented to simplify and allow early diagnosis. The results will be analysed as to onset of rupture, quantity of transfused blood and shock condition of the patient. PMID- 1765715 TI - Peripheral aneurysms. AB - Between January 1970 and December 1990, 17 cases of peripheral aneurysms were observed in 15 patients. Fourteen patients were male and one patient was female. Age ranged between 4 years and 82 years. From the 17 peripheral aneurysms, 4 were false aneurysms, 9 were true atherosclerotic aneurysms, 2 were mycotic and 2 were true blunt traumatic aneurysms. The false aneurysms were caused by gun shot (one case, common carotid artery); complication of carotid endarterectomy (2 cases); iatrogenic (one case, common femoral artery). The atherosclerotic aneurysms (9 cases) were located in the subclavian artery (one case); superficial femoral artery (2 cases in a single patient); and popliteal artery (5 cases). The mycotic aneurysms (two in one patient) were located in the profunda femoris artery and in the anterior tibial artery. The two traumatic true aneurysms were located in the distal radial artery and in one interdigital artery, respectively. From the 17 peripheral aneurysms, 15 were submitted to surgical treatment, with fairly good results, except for one case of infection and another case of fatal renal insufficiency. Follow-up time ranged from 1 to 18 years. PMID- 1765716 TI - The management of venous trauma: early and late results. AB - The result of a fifteen year study related to the management of the venous injuries in the iliac-femoro-popliteal segment have been assessed. The patients were divided in Group I--comprised 20 patients with venous revascularization and Group II--12 cases without revascularization. The early results at 30 days evaluated by the clinical examination revealed edema in all limbs without revascularization. The phlebographic patency of the revascularization was 70%. The difference between the two groups was significant (X2 = 14.93; X2 critical = 3.84). The late results were evaluated clinically in 14 patients (ranged from 6 months to 12 years) and phlebographically in 8 (ranged from 2 years to 9 years). The comparison between the two groups revealed residual edema in 5 patients of Group II as well as in 2 patients of Group I (p = 0.0105 or 1.05%). Supported in this experience we recommend the revascularization of major injured veins. PMID- 1765718 TI - Graduate and postgraduate teaching program on angiology in France. PMID- 1765717 TI - Chronic venous insufficiency of the lower limbs and its socio-economic significance. AB - The author, based on data furnished by the Brazilian Ministry of Social Welfare in the year 1983, draws attention to the socio-economic repercussion of chronic venous insufficiency (CVI) of the lower limbs on the contributors to social security in the country. The available statistical data have been restricted to small population groups. A comprehensive study is made for the first time, which includes twenty-five million workers. Despite the high incidence of the disease, the numbers do not reflect entirely Brazilian reality, since social security in Brazil, in the specific case of diseases, grants benefit only to the contributor, and not to his dependents. Nevertheless, CVI ranks in the 14th place among the 50 principal diseases that cause absence from work which consequently give the right to receive the benefit from Brazilian Social Security. PMID- 1765719 TI - The time has come for vascular medicine? Angiology: a subspecialty of internal medicine and dermatology in Switzerland. PMID- 1765720 TI - Combined carotid endarterectomy and coronary artery bypass grafting. A literature review. AB - This is a review article on the management of patients with both carotid and coronary artery lesions. Most authors agree that patients with symptomatic coronary and symptomatic carotid disease should be offered a combined operation (same anaesthetic) in the presence of unstable angina or left main stem coronary disease and staged operations in the presence of stable angina. Patients with symptomatic coronary disease and asymptomatic severe (greater than 80% stenosis) carotid disease should be offered the staged procedure not for preventing perioperative but late stroke. This statement is tentative and not supported by hard data. It should be revised when the results of the multicentre randomised studies of asymptomatic carotid stenosis become available. A prospective randomised study is required in patients with symptomatic coronary and asymptomatic severe unilateral and bilateral carotid stenosis (greater than 80%) in order to determine whether surgery in the carotid decreases the incidence of late stroke. It cannot be overemphasised that the team that does the carotid endarterectomy should have a good track record of combined mortality and morbidity of less than 5% for patients with TIA's and less than 3% for patients with asymptomatic carotid disease. PMID- 1765721 TI - Mean flow velocity in the right common carotid artery before and after maximal exercise. AB - The effect of exercise on mean flow velocity (MFV) in the right common carotid artery (RCC) was studied using pulsed Doppler ultrasound. MFV was measured at rest and at 2 minutes intervals after a 6 minute rowing ergometer test. Age related maximum heart rate of 190 +/- 10 beats.min-1, maximum respiratory rate of 60 +/- 5 breaths.min-1, and postexercise lactate level of greater than 8 mmol.l-1 were the criteria used to define maximal exercise. The control group comprised 13 healthy, active males, mean age 19.8 years, with 19 healthy oarsmen, mean age 19.9 years, in the exercise group. At rest, MFV in the RCC was found to be 18.6 +/- 5.6 and 16.4 +/- 6.3 cm.min-1 in the control and exercise groups respectively. After exercise, MFV decreased to 21% of its resting value and remained significantly reduced (posthoc tests, Newman Keuls at alpha = 0.01) until 14-16 minutes of recovery. Mean systemic arterial pressure (MSAP) remained within normal limits. Mean age-related maximum heart rate was 182 +/- 3 beats.min 1, respiratory rate 58 +/- 3 breaths.min-1, and postexercise serum lactate 20.2 +/- 3.5 mmol.l-1 which satisfied the criteria for maximal exercise. In this group of young males, MFV in the RCC decreased markedly after maximal exercise and remained significantly reduced for a long period. This sustained reduction in MFV has not previously been described and is most likely due to vasoconstriction in distal cerebral resistance arterioles mediated by hypocapnia and autonomic activity. PMID- 1765723 TI - Long-term peripheral stent evaluation using angioscopy. AB - To evaluate incorporation of peripheral artery stents into the arterial wall, we performed angioscopy on 13 patients fitted with Palmaz endoluminal stents. Of the 15 stents inspected, 5 were in the iliac artery, 9 in the femoral artery and 1 in the popliteal artery. The indications for placement were occlusion in 4 cases and high-grade stenosis in 11 cases including 3 restenosis after balloon dilatation and 1 restenosis after surgery. In 9 cases prosthesis insertion was preceded by laser treatment (Trimedyne Nd:YAG Cardiolase 4000). The decision to use a stent was based on radiologic findings in 3 cases (residual stenoses, dissections) and on angioscopic visualization in 7 cases (2 dissections, 5 flaps). In the remaining cases stent placement was performed electively. The only postoperative treatment was antiplatelet therapy (Ticlopidin). At the time of examination, the mean duration of placement was 6 months (extremes: 2 and 12 months). Inspection was made using Sopro-Meadox angioscope with a 0.75 mm probe mounted on an occlusive balloon for stents in the iliac artery and with a 2.2 mm probe with a working channel and sometimes a deflecting device for stents in the femoral or popliteal artery. Angioscopy was successful in all cases. Angiography was always performed at the same time as endoscopy. Endothelialization was observed in all cases. It appeared as a uniform and smooth whitish layer with a thickness proportional to the duration of placement. Endothelialization was most rapid in femoropopliteal arteries, total coverage being achieved within 4 months. Endothelialization took the longest on medial side of the iliac artery which may remain partially exposed after 12 months.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765722 TI - Intraarterial perfusion of prostaglandin E1 after lumbar sympathectomy or reconstruction on femoropopliteal segment. AB - Out of 100 patients treated by intraarterial perfusion of prostaglandin E1 we selected 36 cases who have been treated after a lumbar sympathectomy or reconstruction on the femoro-popliteal segment. The patients were in the III and IV stage of occlusive diseases by Fontain. All patients were divided into four groups: (a) prostaglandin E1 after a lumbar sympathectomy (20); (b) prostaglandin E1 after failed femoro-popliteal bypass (8); (c) prostaglandin E1 with patent femoro-popliteal bypass and distal progression of the occlusive disease (3); (d) prostaglandin E1 with previously femoro-popliteal reconstruction and poor run off (5). After intraoperative introduction of a catheter into the superficial femoral artery, profunda femoral artery (a, b), a patent graft (c) or just implanted graft (d), a continuous intraarterial perfusion of prostaglandin E1 was applied, in doses 10 nanograms/kg body weight/minute, in total doses 3000 nanograms. The perfusion time was 48-72 h. The patients were controlled immediately after treatment as well as 1, 3, 6 and 12 months after. Our early and late results of the intraarterial perfusion of prostaglandin E1 proved as a very successful limb salvage procedure. PMID- 1765724 TI - Pulmonary embolectomy (answered and unanswered questions). AB - Pulmonary embolectomy under total cardiopulmonary bypass was carried out in 16 patients with cardiogenic collapsus and hypotension not responding to vasopressors or cardiac arrest. Eleven patients (68.75%) survived and were followed up for years. Our observations are presented with special emphasis on the early and accurate diagnosis, the exact timing of the therapeutic methods, the use of the portable cardiopulmonary bypass-even in the ward, and the possibilities of decreasing the operative mortality rate in less than 30% (from 40% to 22% in our series). Despite the fact that in many countries, especially European, pulmonary artery embolectomy is no more carried out as a primary therapy for massive or submassive embolism since thrombolysis is today considered as the best therapy with a low mortality rate of 8-11%, we still believe that there is a number of patients who could benefit only from surgical intervention. Based on our own experience and that presented in the international literature, an attempt was made to discuss the existing problems, mainly diagnosis and treatment of this formidable condition, reevaluating pulmonary embolectomy. PMID- 1765725 TI - Irlen lenses. PMID- 1765726 TI - Attention deficit disorder. PMID- 1765727 TI - Matching three classifications of secondary students to differential levels of study guides. AB - This study examined the effectiveness of matching three classifications of secondary students (17 with learning disabilities, 18 remedial, and 47 nondisabled) to differential levels of study guides. The students, 45 males and 37 females, were enrolled in science and social studies classes in middle school and high school. In one treatment, students were assigned multilevel study guides containing different levels of referential cues, with the guides implemented through three instructional groups: teacher-directed, dyadic, and independent. In another treatment, the same students were assigned single-level study guides that did not contain referential cues, with the guides implemented as an independent activity. An equivalent time samples design was arranged, with six multilevel and six single-level treatments randomly assigned in two-session blocks. The dependent measures consisted of two types of test items, factual and interpretive. The results of group analyses indicated that multilevel study guides were more effective than single-level study guides in all classes and overall on factual questions, with individual analyses verifying that the greatest benefit occurred for the teacher-directed students. On interpretive test items, the results of group analyses favored the multilevel study guides in high school social studies and overall, with individual analyses revealing few remarkable differences for students in any instructional group. A trend analysis revealed little practice effect over time in either treatment. Several methodological and clinical issues involved in matching heterogeneous students to differential levels of textbook instruction in secondary programs are discussed. PMID- 1765728 TI - Identifying native language difficulties among foreign language learners in college: a "foreign" language learning disability? AB - The present study compared successful and unsuccessful college foreign language learners on measures of intelligence, foreign language aptitude, native oral and written language, and math. Unsuccessful students had received petitions to waive the foreign language requirement. No significant differences between groups were found on intelligence and reading comprehension. Significant differences were found on the Modern Language Aptitude Test, on tests of written and oral language in the syntactic and phonological domains, and on math calculation. Authors suggest that students with foreign language learning difficulties may have underlying native language problems manifested especially in the areas of syntax and phonology. Suggestions for diagnosing a foreign language disability are made. PMID- 1765729 TI - A trial of piracetam in two subgroups of students with dyslexia enrolled in summer tutoring. AB - Sixty children with dyslexia (41 boys, 19 girls; ages 9 to 13) were enrolled in a 10-week summer tutoring program that emphasized word-building skills. They were randomly and blindly assigned to receive either placebo or piracetam, a purportedly memory-enhancing drug that has been reported to facilitate reading skill acquisition. The children were subtyped as "dysphonetic" or "phonetic" on the basis of scores from tests of phonological sensitivity and phoneme-grapheme correspondence skills. Of the 53 children who completed the program, 37 were classified as dysphonetic and 16 as phonetic. The phonetic group improved significantly more in word-recognition ability than the dysphonetic group. Overall, the children on medication did not improve more than the nonmedicated ones in any aspect of reading. The phonetic subgroup on piracetam gained more in word recognition than any subgroup but did not improve significantly more than the phonetic subgroup on placebo. Results are discussed in relation to findings from previous studies of piracetam in children with dyslexia. PMID- 1765730 TI - Mild head injury as a source of developmental disabilities. AB - The hospital-reported incidence of mild head injury among children indicates a prevalence of 2% to 3% in high-school-aged adolescents (14 to 18 years). Yet, our survey of 616 high school adolescents suggests that light and mild head injury (not necessarily leading to hospital admission) is almost 10 times this level. Despite the common notion that such injury is generally benign, we found significant relationships in our sample between reported head injury and hyperactivity, stuttering, mixed handedness, and dislike of mathematics. PMID- 1765731 TI - Effects of reading and writing on cerebral laterality in good readers and children with dyslexia. AB - The present study evaluated the idea that the hemisphere-specific cognitive demands of reading and writing may induce task-specific maladaptive patterns of language lateralization in children with dyslexia. Situation-specific lateralization was examined in a repeated measures design under three dichotic listening conditions: baseline, concurrent reading, and concurrent writing. Twelve males with phonological dyslexia, 8 to 12 years old, were compared to 12 age-matched and 12 younger reading-matched good readers. Lateralization patterns were examined for condition-specific relationships to pseudoword decoding, word recognition, reading comprehension, spelling, and arithmetic. The results show that dyslexia is not related to incomplete lateralization or to a failure to inhibit verbal processing in the right hemisphere during reading and writing. Reading increased the lateralization of the children with dyslexia, which had a negative relation to arithmetic; writing caused a decrease in lateralization, which was linked specifically to deficits in phonological decoding and visual word recognition. The results suggest that children with dyslexia suffer from a selective linguistic vulnerability to left-hemisphere interference from the idiosyncratic attentional and processing demands of particular school tasks. Dyslexia is a much more dynamic and environmentally sensitive disorder than previously thought. PMID- 1765732 TI - Qualitative descriptions of error recovery patterns across reading level and sentence type: an eye movement analysis. AB - Purposes of the present study included describing a variety of error recovery patterns based on eye movement (EM) measures of sentence parsing across reading level and error type. A qualitative pattern analysis of EM mappings was completed for students with reading disabilities (n = 10) and nondisabled students (n = 10) who were parsing control and erred sentences. Independent variables included error type (syntactically ambiguous, semantically anomalous, and control sentences) and reading proficiency level. Dependent variables consisted of seven eye movement measures. Chi-square analyses were performed to examine group differences across frequencies per pattern. Results suggest that the error recovery strategies deployed by both groups were similar in pattern and frequency; patterns were largely organized, strategic, and efficient, as predicted. Evidence for seven newly defined strategies was found, with indications of multiple strategies within sentences by both groups. Strategies tended to be error "reanalysis" (vs. "recovery") heuristics, in that readers from both groups used regressions to reanalyze regions of inconsistency rather than regions of disambiguation. Earlier conclusions regarding disorganized processing and individual differences among adolescents with reading disabilities are discussed. PMID- 1765733 TI - Selection-mutation at a diallelic autosomal locus in a dioecious population. AB - The population is assumed to be infinite dioecious with nonoverlapping discrete generations and random mating. It is assumed that the fitnesses and mutation rates are constant, heterozygotes are viable and the mutation rates are less than one-half. It is proved that the allelic frequencies converge to equilibria as the number of generations tends to infinity. The a priori types of phase portraits are determined. The method employed is elementary. The results extend those of [1, 2, 5, 8] to the case of selection-mutation rather than pure selection and those of [7] to the case of an autosomal rather than a sex-linked locus. PMID- 1765734 TI - Models for the effect of toxicant in single-species and predator-prey systems. AB - Models of single-species and predator-prey systems in a polluted closed environment are developed and partially analyzed. Three cases are considered: a single influx of toxicant, a constant influx of toxicant, and a periodic pollution of the environment. In the case of single-species growth we are able to determine some local and global dynamics. In the case of predator-prey systems, we investigate the existence of steady states for a small constant influx of toxicant. PMID- 1765735 TI - The threshold of survival for system of two species in a polluted environment. AB - The effects of toxicants on naturally stable two-species communities are studied. Persistence-extinction thresholds are given for populations in the toxicant stressed Lotka-Volterra model of two interacting species. The threshold results are expressed in terms of relationships involving the population intrinsic growth rates, dose-response parameters, and interaction rates. PMID- 1765736 TI - Non-linear phenomena in oxygen transport to tissue. AB - A non-linear partial differential equation is analyzed using multiple scale techniques and similarity transformations in order to examine the role of hemoglobin and myoglobin in facilitating oxygen transport to tissue. PMID- 1765737 TI - Traveling waves in a chemotactic model. AB - A model for chemotaxis in a bacteria-substrate mixture introduced by Keller and Segel, which is described by nonlinear partial differential equations, is studied analytically. The existence of traveling waves is shown for the system in which the substrate diffusion is taken into account and the chemotactic coefficient is greater than the motility one, and the instability of traveling waves is discussed. PMID- 1765738 TI - Establishment of allelic two-locus polymorphisms. AB - An exact analysis of necessary and sufficient conditions for the establishment and protectedness of biallelic two-locus polymorphisms is developed for the classical model with constant, sexually symmetric fitnesses and random association of the successful gametes. To demonstrate application of the results to common model types, the model of symmetric viabilities depending on the degree of heterozygosity only is chosen as a paradigm. It is pointed out that a unique locally stable internal equilibrium may exist even though all marginal equilibria (including the fixation states) are locally attractive. This example is quoted as an indication of the priority that analyses of protectedness deserve over analyses of local stability or instability of internal equilibria. Further applications of broader appeal concern the role that recombination plays in protecting polymorphisms. Probably the most interesting finding is that with increasing recombination frequency the chances for protectedness of a polymorphism generally decline. Yet, if a certain hierarchic ordering of the fitnesses with respect to the degree of heterozygosity is realized, the polymorphism is protected for arbitrary amounts of recombination. If recombination is rare, heterozygote advantage is not a universal precondition for persistence of polymorphisms. This phenomenon is utilized to derive conditions under which deleterious recessive mutants can be maintained in a population. PMID- 1765739 TI - Moments, cumulants, and polygenic dynamics. AB - A new approach for describing the evolution of polygenic traits subject to selection and mutation is presented. Differential equations for the change of cumulants of the allelic frequency distribution at a particular locus and for the cumulants of the distributions of genotypic and phenotypic values are derived. The derivation is based on the assumptions of random mating, no sex differences, absence of random drift, additive gene action, linkage equilibrium, and Hardy Weinberg proportions. Cumulants are a set of parameters that, like moments, describe the shape of a probability density. Compared with moments, however, they have properties that make them a much more convenient tool for investigating polygenic traits. Applications to directional and stabilizing selection are given. PMID- 1765740 TI - Cryptosporidium oocysts in stool specimens submitted to routine ova & parasite examination: 38 months survey. AB - The fecal samples submitted for routine ova and parasite examination in Children's Hospital, Bangkok, Thailand, between October 1984 and November 1987, were investigated for Cryptosporidial oocysts, indicated that the prevalence was 1.61 per cent. The infection played an important role in aetiology of gastroenteritis and/or diarrhea. Because the children, particularly those less than 2 years of age who had watery and non-bloody stools and accompanied with gastrointestinal symptoms were found to have Cryptosporidium oocysts, almost (84.31%) of the infected children were hospitalized. Suggestively, Cryptosporidiosis should be included in the diagnosis of diarrheal disease in children and diarrheal illness in immunocompetent patients. In this report, the source of infection and the route of transmission was not identified but 80.39 per cent of children with cryptosporidiosis children were admitted with primary diagnosis of diarrhea together with pneumonia. The medication was Furazolidone or the combination of Trimethoprime and Sulphamethoxazone. PMID- 1765741 TI - Treatment of adult acute myelogenous leukemia: a pilot study at Chulalongkorn Hospital. AB - Twenty-seven patients with acute myelogenous leukemia (AML), aged 15 to 65 years, were treated with standard induction remission chemotherapy and two different strategies for postremission treatment. Seventeen patients (63%) achieved complete remission (CR). Nine patients (37%) died during marrow hypoplasia. The median survival of complete remitters allocated to the intensive postremission therapy is projected to be in excess of 24 months with 53 per cent probability of remaining in CR at two years. The median remission duration for patients who entered the nonintensive postremission therapy was 11 months. Age was the major factor significantly correlated with the outcome of treatment. It is concluded that intensive curative treatment should be indicated in AML patients who are less than 30 years. PMID- 1765742 TI - Effect of a selective restriction policy on antibiotic expenditure and use: an institutional model. AB - Strictly enforced antibiotic formulary restriction in combination with formulation of agreed guidelines for antibiotic use in common infection problems such as septicemia, febrile neutropenia, urinary tract infection, biliary sepsis, liver abscess, peritonitis, nosocomial pneumonia, soft tissue infection and purulent meningitis, generated a combined savings of 307,748.5 bahts or 13.5 per cent cost reduction over a 6 month period, and improved quality of use, appropriate 54.8 vs 67.5 per cent, statistically significance (P less than 0.002). Although this saving was offset in part by increased spending of unrestricted antibiotics, such as Penicillin and Gentamicin, an overall cost saving remained. In the months during the restrictions, no significant changes occurred regarding patients response and mortality. However, after the onset of the controls, it was revealed that antibiotics were more appropriately used afterwards. This study has shown, most importantly, that savings were achieved with no negative effect on good patient care. Moreover, the antibiotic use control was operationally successful, most house-staff and attending physicians, not only antibiotic evaluating team, have accepted the program in a very positive way. Overall, this program successfully achieved its initial goal, cost saving without compromising good medical practice. We are now continuing our program and also trying to modify so that it will be useful to all departments in the hospital. PMID- 1765743 TI - Analysis of serum urinary proteins in normal and renal diseases by cellulose acetate electrophoresis. AB - A method using dried polyacrylamide gel to concentrate urine samples has been described, tested and used for the purpose of urine protein analysis. Concentrated urine samples from 10 normals and 100 patients with IgM nephropathy and systemic lupus erythematosus (SLE) were analysed by cellulose acetate electrophoresis (CAE). The results demonstrated that the patterns of proteins in the electrophoresis could be used to discriminate the two diseases. The best discriminating power was found in the logarithm of gamma globulin to albumin ratio. In IgM nephropathy the ratio of gamma globulin to albumin is much smaller than the ratio in SLE, indicating that relatively larger gamma globulins were excreted in SLE. In addition, the ratio can be used to discriminate subgroups of patients with IgM nephropathy. Urine from patients with IgM nephropathy with focal and segmental changes showed a significantly higher ratio. The study indicated the usefulness of the technique in discriminating the two common glomerular diseases. PMID- 1765744 TI - Efficacy of dosage schedule for rational dosage prescribing of gentamicin. AB - In our pilot study of 30 patients who were on gentamicin, the adequate peak level (5-10 mg/dl) was found in 27 per cent, trough level (less than 2 mg/dl) in 67 per cent and both peak and trough level in only 10 per cent. We have several reasons to believe that it is due to inappropriate dosage prescribing. The objective of the study is to test the efficacy of using a recommended dosage schedule for rational dosage prescribing of gentamicin. All medical residents were invited to attend a 2-hour session on gentamicin pharmacokinetics. The problems and the use of recommended dosage schedule were extensively discussed. Then serum gentamicin levels were re-monitored by Fluorescence Polarization Immunoassay (TDx). Of 73 gentamicin recipients, 39 (53%, C gr.) were given at the correct dosage according to the schedule and 34 (47%, IC gr) were given incorrectly. The characteristics of the patients in both groups were not different. The appropriate peak, trough, peak and trough levels in C gr were 87, 80, 67 per cent respectively compared with 24, 80 and 9 per cent in the IC group, p less than 10(-4) for peak, peak and trough. The incidence of nephrotoxicity was not different between the two groups. The patients' outcomes were difficult to assess because most of the patients received antibiotic combinations. However, case fatality of documented gram negative infection tended to be less in the C group. It is concluded that dosage schedule can improve rational dosage prescribing of gentamicin. Most of the patients given gentamicin may not need monitoring.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765745 TI - Cholesterol and triglycerides levels in Thai diabetics. AB - One thousand, one hundred and twenty-five diabetics, aged 17-90 years (456 males, 669 females), underwent cholesterol and triglyceride determination showing the cholesterol value of 64 per cent or 717 diabetics was over 200 mg/dl and the cholesterol value of 7 per cent or 74 diabetics was lower than 200 mg/dl, but triglycerides were over 200 mg/dl, of which HDL and LDL cholesterol had been determined; and in 30 per cent of diabetics or 334 patients, the cholesterol and triglycerides values were lower than 200 mg/dl, which suggested no hyperlipidemia. From these results, the authors suggest hyperlipidemia be screened in all diabetics to prevent atherosclerosis. The clinical laboratory should have cholesterol, triglycerides and HDL cholesterol available for routine check up of diabetics of prevention of atherosclerosis complications and to decrease the mortality rate of the diabetics. Primary screening of cholesterol and triglyceride tests, also HDL and LDL cholesterol, should be determined if cholesterol is over 200 mg/dl or triglycerides are over 200 mg/dl. PMID- 1765746 TI - Multifocal brain damage due to lacquer sniffing: the first case report of Thailand. AB - The first patient of multifocal brain damage due to lacquer sniffing was reported in Thailand. He was a 24-year-old man who had a 5 year history of lacquer sniffing (toluene abuse). He had difficulty in walking and had tremor for 1 year which became progressively worse and he was finally confined to bed. Examination revealed marked cerebellar signs of both upper and lower extremities with scanning speech. Five of his friends who were lacquer abusers also had similar symptoms and were confined to bed. Investigations showed marked atrophy of both cerebellar hemispheres, vermis, brainstem and less atrophy of both cerebral hemispheres in both computerized brain scanning and magnetic resonance imaging. Diffuse toxic demyelination of white matter and excess iron deposition over both thalami, basal ganglia and cerebral cortex were demonstrated on magnetic resonance imaging. Brainstem evoked response showed abnormal response of both sides. Nerve conduction velocity, electromyographic study and electroencephalogram were normal. Psychometric tests revealed dull normal or below average IQ-test of 82. He was admitted for 2 months with gradual recovery of neurological deficits. After six months of abstinence from lacquer and daily physical rehabilitation. This report of toluene abuse is not only public health problem but also reflects the socioeconomic status as well as political unawareness of this condition in the Thai community. PMID- 1765747 TI - Familial hypertrophic cardiomyopathy associated with spontaneous complete heart block. AB - Spontaneous complete A-V block is very rare in hypertrophic cardiomyopathy. We report here two siblings with hypertrophic cardiomyopathy who developed spontaneous complete A-V block with deterioration of cardiac symptoms, necessitating implantation of permanent pacemaker. PMID- 1765748 TI - Wells' syndrome with lock jaw: report of a case in Thai patient. AB - A case of Wells' syndrome with lock jaw in a 26-year-old Thai female is presented. The clinical features, the course of disease, the histological findings of tissue eosinophilia and flame figures and also significant peripheral blood eosinophilia support the diagnosis of Wells' syndrome in this patient. To the best of our knowledge this is the first case reported in Thailand. The association of lock jaw and Wells' syndrome has never been published in the literature. PMID- 1765749 TI - Lung cavities from Pneumocystis carinii in a patient with systemic lupus erythematosus. AB - A patient with SLE developed pneumonia due to Pneumocystis carinii. The unusual presentation was the multiple lung cavities. There appeared to be a temporal relationship between the lung infection and reducing steroid intake in this patient. PMID- 1765750 TI - National health insurance? Is this really the way to go? PMID- 1765751 TI - To Washington! Like Mr. Smith I Wish. PMID- 1765752 TI - Insulin dependent diabetes 1991. AB - Insulin dependent diabetes (IDD) most often results from the autoimmune destruction of pancreatic beta cells. During this process, autoantibodies to islet cell constituents (islet cell cytoplasm, 64KDa protein [GAD]) and to insulin arise and can be used for disease prediction if found before onset or for classification at onset in cases in which type of diabetes is not clear. Approximately 4-5% of immediate family members have at least one of these antibodies. The younger the age and the higher the antibody titer, the greater the chance of IDD developing. Because studies using immunosuppression in newly diagnosed IDD have shown transient prolongation of beta cell function, efforts to use such therapies prior to diabetes onset may prevent beta cell destruction and clinical disease. A multicenter trial is underway in Florida to screen relatives for diabetes-related antibodies and then to enter those found positive and at increased risk in a study to prevent diabetes. Details of the study and its rationale are presented. PMID- 1765753 TI - Diabetes mellitus. A perspective on management. AB - Diabetes mellitus results in multiple complications including over 10,000 new cases of blindness each year in the United States. The evidence that consistent good control significantly reduces these complications is overwhelming, i.e., a return to normal or close to normal glycemic state. This evidence is reviewed. Particularly noteworthy are data showing that when hemoglobin A1c values are consistently less than 8.4% (with 8.0% being the upper limit of normal), only 2.9% of subjects with existing retinopathy progress to a more severe retinopathy, whereas with higher hemoglobin A1cs, there is a progressive increase of severe retinopathy. Multiple biochemical hemodynamic and endocrine processes which appear abnormal in diabetes, return to normal when euglycemia is reestablished. Despite such evidence, physicians often resist conclusions regarding proper management of the diabetic state. The reasons are briefly reviewed. PMID- 1765754 TI - Hypertriglyceridemia in diabetes. An approach to management. AB - Hypertriglyceridemia is not a common finding in well controlled patients with insulin dependent diabetes; however, in noninsulin dependent, or Type II diabetes, hypertriglyceridemia and coronary heart disease are a well recognized clinical triad. In the latter setting, hypertriglyceridemia is usually the result of an associated inherited hyperlipidemia, most commonly familial hypertriglyceridemia but also familial combined hyperlipidemia. In the former, one sees elevated triglycerides and a low HDL-cholesterol, in the latter the same phenotype may be present but often there is a high LDL-cholesterol. Irrespective of the pathogenesis of the primary hypertriglyceridemic disorder, the occurrence of poorly controlled diabetes will enhance the hypertriglyceridemia and even in the Type II diabetic, with triglycerides in the thousands, dietary and glycemic control, alone, will strikingly ameliorate the hypertriglyceridemia. In contrast to patients with hypercholesterolemia, no national guidelines have been proposed for the treatment of patients with hypertriglyceridemia. Yet both experimental and clinical data support an algorithm in which dietary and glycemic control are optimized with a resultant major improvement in triglycerides, followed by the introduction of drug therapy. Three agents are particularly useful in correcting the hypertriglyceridemia: gemfibrozil, niacin, and fish oils, with the first two having the added benefit of increasing HDL levels. Lovastatin is also useful in treating these patients, but primarily for lowering LDL-cholesterol while triglycerides are independently being brought under control. Correction of hyperlipidemia in diabetic patients can generally be achieved with judicious use of dietary, glycemic and drug therapy; however, maintenance of a favorable response requires a high level of patient compliance, which is usually difficult to sustain. PMID- 1765755 TI - Hypertension and kidney disease of diabetes mellitus. AB - Kidney disease is a primary cause of morbidity and mortality in diabetic patients. Factors that predetermine development of nephropathy remain unknown. Poor glycemic control, insulin requirement, duration of diabetes and family history of hypertension appear to be associated with an increased risk. Arterial hypertension, which is twice as common in diabetic patients as in the normal population, accelerates the progression of diabetic nephropathy. The pathophysiologic mechanisms responsible for hypertension appear to be different in IDDM and NIDDM. In IDDM, hypertension occurs usually as a consequence of diabetic renal disease. Conversely, the pathogenesis in NIDDM appears to be multifactorial. In either condition, aggressive blood pressure control is the single most important intervention proven to retard the progression of nephropathy. A stepped-care approach similar to that for essential hypertension with slight modifications is indicated in the treatment of the hypertensive diabetic patient with nephropathy. Nonpharmacological therapy, including dietary protein restriction, should be used as first step. Selection of the ideal antihypertensive must be based not only on efficacy but also on its side effect profile. Angiotensin converting enzyme inhibitors and calcium antagonists have a low incidence of side effects and do not induce metabolic disturbances. Therefore, they are the agents of choice for patients who do not respond to nonpharmacological therapy alone. Thiazide diuretics and beta-blockers should be used as first line therapy only for specific indications. Antihypertensive therapy combined with good glycemic control and dietary protein restriction constitute the standard of care for diabetic patients with hypertension and renal disease. PMID- 1765756 TI - Eye care guidelines for patients with diabetes mellitus. AB - Diabetic retinopathy is the leading cause of blindness in adults under age 65 in the United States. Risk is related to the stage of retinopathy. With new treatments available, it is imperative that diabetics be properly screened. Those with retinopathy of more than five years duration should be referred to an ophthalmologist. Since photocoagulation has been shown effective for treatment of macular edema and proliferative retinopathy, it is imperative that these patients be referred for timely evaluation. PMID- 1765757 TI - Evaluation and treatment of sexual dysfunction in men with diabetes mellitus. AB - Sexual dysfunction is common among men with Type I and Type II diabetes. Tests of nocturnal penile tumescence (NPT) combined with waking tumescence and questionnaires can more accurately differentiate between primary organic and primary psychogenic impotence. This ability to differentiate the etiology of erectile dysfunction avoids the inappropriate use of penile injections and costly surgical procedures which are unnecessary in treatment of diabetic patients with primary psychogenic impotence. In patients with primary organic impotence, several new treatments are available which result in high patient satisfaction. PMID- 1765758 TI - Natural killer cells. Role in resistance to cancer and infection. AB - Specific immunity via antigen-recognizing T cells and B cells is crucial for complete host defense against infectious agents and cancer. However, the nonspecific arm of the host defense system plays an important role. NK cells, first described as an ever-present immunosurveillance mechanism against tumor development, are also important in early defense against microbes. With each type of microbe, NK cells use a different tactic to arm the host against the offending agent. To tackle intracellular viruses inaccessible to antibodies, they appear to lyse virus-infected fibroblasts and epithelial cells prior to maturation of the virions for dissemination in the host. Intracellular bacteria are dealt with in much the same manner, except that the targets are infected monocytes. Lastly, with organisms that cannot be directly killed, NK cells produce cytokines that can recruit and activate neutrophils. All accumulating evidence thus points to NK cells as a unique type of nonspecific lymphocytes that may be critical in either defense against microbes, particularly of the opportunistic nature, and in surveillance against certain types of tumors. PMID- 1765759 TI - The demented elderly patient. Evaluation and management. PMID- 1765760 TI - Acquired memory insufficiency syndrome. PMID- 1765762 TI - Sensitivity and transduction mechanisms of responses to general odorants in turtle vomeronasal system. AB - (a) The responses of the vomeronasal organ to general odorants in the turtle, Geoclemys reevesii, were measured by recording the accessory olfactory bulbar responses. The threshold concentrations of the vomeronasal responses to various odorants were similar to those in main olfactory bulbar responses, indicating that vomeronasal cells lacking cilia and olfactory cells having many cilia have similar sensitivities to general odorants. (b) The vomeronasal epithelium was perfused with 100 mM NaCl solution and the salt-free solution and the effects of NaCl on the vomeronasal responses to various odorants were examined. There was no essential difference between the concentration-response curves for n-amyl acetate and menthone dissolved in 100 mM NaCl solution and those dissolved in the salt free solution in the whole concentration range examined. The ratios of the magnitudes of vomeronasal responses in the salt-free solution to those in 100 mM NaCl solution were between 1.01 and 1.10 for seven odorants tested. (c) The magnitudes of responses to the odorants were unchanged by changes in NaCl concentrations. The replacement of Na+ with organic cations such as choline+, Bis Tris propane2+, and N-acetyl-D-glucosamine+ did not affect the magnitudes of the responses to the odorants. The Na channel blocker amiloride also did not affect the responses. (d) The vomeronasal responses were practically unchanged by changes in CaCl2 concentration. The Ca channel blockers diltiazem and verapamil did not affect the responses. (e) The replacement of Cl- with SO4(2-) did not affect the magnitudes of the vomeronasal responses. (f) The present results suggest that ion transport across the apical membranes of vomeronasal receptor cells does not contribute to the responses to odorants in the turtle. PMID- 1765761 TI - In vivo magnetic and electric recordings from nerve bundles and single motor units in mammalian skeletal muscle. Correlations with muscle force. AB - Recent advances in the technology of recording magnetic fields associated with electric current flow in biological tissues have provided a means of examining action currents that is more direct and possibly more accurate than conventional electrical recording. Magnetic recordings are relatively insensitive to muscle movement, and, because the recording probes are not directly connected to the tissue, distortions of the data due to changes in the electrochemical interface between the probes and the tissue are eliminated. In vivo magnetic recordings of action currents of rat common peroneal nerve and extensor digitorum longus (EDL) muscle were obtained by a new magnetic probe and amplifier system that operates within the physiological temperature range. The magnetically recorded waveforms were compared with those obtained simultaneously by conventional, extracellular recording techniques. We used the amplitude of EDL twitch force (an index of stimulus strength) generated in response to graded stimulation of the common peroneal nerve to enable us to compare the amplitudes of magnetically recorded nerve and muscle compound action currents (NCACs and MCACs, respectively) with the amplitudes of electrically recorded nerve compound action potentials (NCAPs). High, positive correlations to stimulus strength were found for NCACs (r = 0.998), MCACs (r = 0.974), and NCAPs (r = 0.998). We also computed the correlations of EDL single motor unit twitch force with magnetically recorded single motor unit compound action currents (SMUCACs) and electrically recorded single motor unit compound action potentials (SMUCAPs) obtained with both a ring electrode and a straight wire serving as a point electrode. Only the SMUCACs had a relatively strong positive correlation (r = 0.768) with EDL twitch force. Correlations for ring and wire electrode-recorded SMUCAPs were 0.565 and -0.366, respectively. This study adds a relatively direct examination of action currents to the characterization of the normal biophysical properties of peripheral nerve, muscle, and muscle single motor units. PMID- 1765763 TI - Two novel cardiac atrial K+ channels, IK.AA and IK.PC. AB - Two K(+)-selective channels in neonatal rat atrial cells activated by lipophilic compounds have been characterized in detail. The arachidonic acid-stimulated channel (IK.AA) had a slope conductance of 124 +/- 17 pS at +30 mV in symmetrical 140 mM potassium and a mean open time of approximately 1 ms, and was relatively voltage independent. IK.AA activity was reversibly increased by lowering pH to 6.0. Arachidonic acid was most effective in activating this channel, although a number of lipophilic compounds resulted in activation. Surprisingly, choline, a polar molecule, also activated the channel. A second K+ channel was activated by 10 microM phosphatidylcholine applied to the intracellular surface of inside-out atrial patches. This channel (IK.PC) had a slope conductance of 60 +/- 6 pS at +40 mV and a mean open time of approximately 0.6 ms, and was also relatively voltage independent. Fatty acids are probably monomeric in the membrane under the conditions of our recording; thus detergent effects are unlikely. Since a number of compounds including fatty acids and prostaglandins activated these two channels, an indirect, channel-specific mechanism may account for activation of these two cardiac K+ channels. PMID- 1765764 TI - Viruses in the phytoreovirus genus of the Reoviridae family have the same conserved terminal sequences. AB - The 5'- and 3'-terminal nucleotide sequences of the dsRNA genome segments of rice dwarf virus (RDV) and rice gall dwarf virus (RGDV), members of the Phytoreovirus genus of the Reoviridae family, were determined and compared with those of wound tumour virus (WTV). The 3' tetranucleotides of the plus strand of all genome segments of RDV and RGDV were found to be the same (---UGAU 3'), except for segment 9 of RDV which had the 3'-terminal sequence---CGAU 3'. The conserved 3' terminal sequence (---UGAU 3') was the same as that found in the genome segments of WTV, another member of the Phytoreovirus genus. On the other hand, the 5' termini of the plus strands of RDV and RGDV were found to have two or three types of common sequence. RDV had either 5' GGCAAA--- or 5' GGUAAA---, whereas RGDV had 5' GGCAUUUU---, 5' GGUAUUUU--- or 5' GGUAAUUU---. These conserved sequences were similar to the conserved 5'-terminal sequence of WTV (5' GGUAUU---). Although the three viruses differ in plant host range, tissue specificity, vector specificity and disease symptom expression, these results suggest that they have a common ancestral origin. PMID- 1765765 TI - Nucleotide sequence of the genomic RNA of pepper mild mottle virus, a resistance breaking tobamovirus in pepper. AB - The entire genomic RNA of a Spanish isolate of pepper mild mottle virus (PMMV-S), a resistance-breaking virus in pepper, was cloned and sequenced and shown to be similar to other tobamoviruses in its genomic organization. It consisted of 6357 nucleotides (nt) and contained four open reading frames (ORFs) which encode a 126K protein and a readthrough 183K protein (nt 70 to 4908), a 28K protein (nt 4909 to 5682) and a 17.5K coat protein (nt 5685 to 6158). This is the first tobamovirus in which none of the ORFs overlap. Both its nucleic acid and predicted protein sequences were compared with the previously determined sequences of other tobamoviruses. The variations and similarities found and their relationship with the pathogenicity of this virus are discussed. PMID- 1765766 TI - Change in phenotype and encapsidated RNA segments of an isolate of alfalfa mosaic virus: an influence of host passage. AB - A local lesion isolate of alfalfa mosaic virus (AMV-N20) from lucerne was found to encapsidate two extra RNAs in addition to the four major RNAs (RNA1, -2, -3 and -4). These were resolved by gel electrophoresis both under native conditions and after glyoxal denaturation. The RNA with an electrophoretic mobility between that of RNAs 2 and 3 was designated RNA31, that between RNAs 3 and 4 was designated RNA3s. Sucrose density gradient centrifugation analysis of AMV-N20 showed six instead of the normal four nucleoprotein components, the additional two presumably representing encapsidated RNAs 31 and 3s. RNAs 31 and 3s were both shown by Northern blot hybridization to be unrelated to host plant RNA and to contain the AMV coat protein gene sequence, which resides in RNA3. Primer extension of the RNAs 31 and 3s using a primer complementary to the 3' common terminus of all genomic AMV RNAs provided further evidence that they contained AMV sequences. RNA31 represents an addition of about 255 nucleotides, compared with RNA3, and RNA3s represents a loss of about 308 nucleotides. The coat proteins of variants encapsidating either RNA31, -3 or -3s had the same Mr indicating that the addition or deletion of the nucleotides was outside the coat protein gene. Serial mechanical passage of AMV-N20 over 5 years in four host species led both to changes in the composition of the RNA3 mixture, and to changes in symptom severity. For example, following passage in Nicotiana clevelandii, RNA3 was lost whereas passage in either N. glutinosa, Chenopodium quinoa or C. amaranticolor resulted in the loss of RNA31. No association was found between the changes in RNA3 and phenotypic changes that resulted from continuous passage for 5 years. Phenotypic changes with passage are thus presumably determined by mutations elsewhere in the virus genome. PMID- 1765767 TI - Infection of a polarized epithelial cell line with wild-type reovirus leads to virus persistence and altered cellular function. AB - The mechanisms and consequences of persistence of non-transforming viruses are poorly understood. Reovirus infections are usually regarded as cytocidal and infection is associated with inhibition of cellular protein and DNA synthesis. Reovirus infection of the polarized epithelial MDCK cell line is not associated with inhibition of protein synthesis, and cells become persistently infected and continue to grow without c.p.e. after infection. After several passages, virus persistence is associated with profound morphological and functional changes. The cells lose their usual cobblestone appearance and acquire a fibroblastic, undifferentiated morphology. This is associated with an inability to form tight junctions. In addition, expression of epidermal growth factor receptors and one adhesion protein is altered in the persistently infected cells. These results demonstrate that reovirus persistence will occur readily, and that infection of differentiated cells with a non-transforming virus can lead to loss of differentiation and abnormal protein expression. PMID- 1765768 TI - The nucleotide sequence and deduced amino acid composition of the haemagglutinin and fusion proteins of the morbillivirus phocid distemper virus. AB - The amino acid composition of the two surface proteins of the recently isolated morbillivirus phocid distemper virus (PDV) were deduced from the nucleotide sequence. The fusion (F) protein of PDV exhibited characteristics similar to those of other morbillivirus F proteins. The overall amino acid similarity with its closest homologue, canine distemper virus (CDV), was 72%. From the context of the starting codons and the requirement for a hydrophobic signal peptide, it is likely that translation of the PDV F mRNA starts at the third AUG, corresponding to codon 95 in the long open reading frame of the PDV F gene. After removal of the signal peptide, F0 starts at amino acid 105. From this position the F protein of PDV and CDV exhibit 84% amino acid similarity. The PDV haemagglutinin (H) protein showed 74% amino acid similarity with CDV H protein and highly conserved features responsible for the tertiary structure. Despite these similarities, the two H proteins show marked antigenic differences when probed with monoclonal antibodies. Earlier studies have indicated that rinderpest virus (RPV) is the prototype virus of the morbillivirus genus, from which first CDV/PDV and later measles virus (MV) evolved. From the close relationship shown in this study, it is likely that the divergence of CDV and PDV occurred after MV evolved from RPV. PMID- 1765769 TI - A baculovirus dual expression vector derived from the Autographa californica nuclear polyhedrosis virus polyhedrin and p10 promoters: co-expression of two influenza virus genes in insect cells. AB - A baculovirus transfer vector, pAcUW3, was developed to facilitate the insertion of two influenza virus genes, those encoding the haemagglutinin (HA) and neuraminidase (NA) membrane glycoproteins, into the Autographa californica nuclear polyhedrosis virus genome in a single cotransfection experiment. The NA gene was inserted in place of the polyhedrin coding sequences under the control of the polyhedrin promoter, whereas the HA gene was placed under the control of a copy of the p10 promoter at a site upstream of and in opposite orientation to the polyhedrin promoter. After infection of Spodoptera frugiperda cells with the recombinant virus, AcUW3HANA, both HA and NA were expressed in the very late phase of infection and were shown to be functional in appropriate assays. Immunofluorescence assays demonstrated their localization at the surface of infected insect cells. The expression of both foreign genes in the recombinant virus was found to be stable for at least 12 passages in cell culture. PMID- 1765770 TI - The DNA-binding domain of nuclear factor I is sufficient to cooperate with the adenovirus type 2 DNA-binding protein in viral DNA replication. AB - Recombinant baculoviruses have been constructed which express the full-length nuclear factor I (NFI) protein or a derivative of NFI that contains only the DNA binding domain of the protein in infected insect cells. Both proteins were purified from insect cells infected with the respective baculoviruses and tested for their ability to cooperate with the adenovirus type 2 (Ad2) DNA-binding protein during virus replication. DNase I protection experiments demonstrated that the viral DNA-binding protein increased the affinity of both the full-length NFI and the DNA-binding domain of NFI for their recognition site in the Ad2 origin of DNA replication. As a consequence, the NFI-dependent increase in the efficiency of DNA replication observed upon addition of viral DNA-binding protein was the same when the full-length or DNA-binding domain derivative of NFI was added. Thus it appears that all of the activities associated with the ability of NFI to stimulate Ad2 DNA replication are located within the DNA-binding domain of the protein. PMID- 1765771 TI - Post-translational processing and oligomerization of the fusion glycoprotein of human respiratory syncytial virus. AB - The post-translational maturation of the fusion protein (F) of human respiratory syncytial virus was investigated. Chemical cross-linking experiments indicated that F forms homotetramers and provided evidence that the intermonomer contacts involve primarily the F1 subunit. Homooligomerization as measured by sedimentation in sucrose gradients was insensitive to carbonyl cyanide m chlorophenylhydrazone, indicating that it occurs in the endoplasmic reticulum. Cleavage of the F0 precursor to yield the F1 and F2 subunits was blocked by monensin or brefeldin A, indicating that it takes place in distal cisternae of the trans Golgi compartment or in the more distal trans Golgi network. The F0 precursor was not detected at the cell surface in surface immunoprecipitation experiments, indicating that cleavage is intracellular. The appearance of the cleaved F1 protein at the cell surface was concurrent with that of the attachment glycoprotein (G); this and other information indicated that the type 2 membrane orientation of G is not obligatorily associated with a reduced transit rate. Examination of F maturation in the presence of tunicamycin provided evidence that its expression at the cell surface depends upon cleavage and not directly upon glycosylation. PMID- 1765772 TI - Sequence comparison between the haemagglutinin-neuraminidase genes of simian, canine and human isolates of simian virus 5. AB - The nucleotide sequence of the haemagglutinin-neuraminidase (HN) gene was determined for a simian (W3), human (LN) and two canine (CPI+/CPI-) isolates of simian virus 5 (SV5). A comparison of the predicted amino acid sequences revealed that the human and canine isolates varied from the simian isolate by 1.7% and 2.4% respectively. This lack of significant variation between the HN proteins of the four SV5 isolates suggests that insufficient differences have occurred between isolates to confine them to a specific host. PMID- 1765773 TI - The mechanism of translation of cowpea mosaic virus middle component RNA: no evidence for internal initiation from experiments in an animal cell transient expression system. AB - The possibility that internal initiation of translation is responsible for the synthesis of the middle component (M) RNA-encoded 95K protein of cowpea mosaic virus (CPMV) has been investigated by constructing plasmids in which the entire sequence of CPMV M RNA was cloned downstream of a chloramphenicol acetyltransferase gene. Expression of these plasmids in an animal cell expression system revealed that no synthesis of the proteins encoded by the downstream CPMV open reading frame takes place from RNA derived from these constructs under conditions where the internal ribosome entry site of foot-and-mouth disease virus is functional. The results indicate that internal initiation is not responsible for the synthesis of the 95K protein in this system. PMID- 1765774 TI - Transmission of cucumber leaf spot virus by Olpidium radicale. AB - The ability of zoospores of four cultures of Olpidium radicale and one of O. brassicae to transmit viruses acquired in vitro from dilute virus solutions was compared. Transmission was demonstrated by infectivity and serological assays of the roots of cucumber seedlings 6 days after inoculation. A bulk culture of O. radicale, from cucumber plant roots collected near Nantes, France, a single sporangial culture derived from it, and a single-sporangial culture from melon plant roots collected near Woodland, California, U.S.A., transmitted cucumber leaf spot virus (CLSV) and the cucumber fruit streak strain of CLSV (CLSV-FS). A bulk culture of O. radicale from melon plant roots collected at Montfavet, France, did not transmit CLSV or CLSV-FS. All four cultures transmitted cucumber necrosis and melon necrotic spot viruses, used as positive controls, but they did not transmit cucumber soil-borne, squash necrosis, petunia asteroid mosaic or tobacco necrosis viruses. In each of the trials a single-sporangial culture of O. brassicae from lettuce plant grown in California transmitted only tobacco necrosis virus. PMID- 1765775 TI - Human parvovirus B19 specific IgG, IgA, and IgM antibodies and DNA in serum specimens from persons with erythema infectiosum. AB - To determine the diagnostic use of different markers of acute parvovirus B19 infection, serum specimens obtained from 128 persons with erythema infectiosum were tested for specific immunoglobulin G (IgG), IgA, and IgM antibodies by capture enzyme immunoassay (EIA) using Chinese hamster ovary (CHO) cell-expressed B19 antigen, and tested for circulating B19 DNA by polymerase chain reaction (PCR). A significant rise in specific IgG and IgA antibodies was detected in 87% and 77%, respectively, of persons from whom acute- and convalescent-phase serum specimens were available. Specific IgA antibodies were detected in single serum specimens from 90% of cases and were present in 22 (18%) of 120 persons from a control group without a history of recent exposure to B19. Specific IgM antibodies were detected in 97% of cases and one person (1%) from the control group. B19 DNA was detected in 94% of cases and was absent in 20 persons from the control group positive for both IgG and IgA antibodies. Serum specimens obtained between 4 and 6 months after onset of illness from six additional persons were also tested. All had specific IgG antibodies, four (67%) had IgA, five (83%) had IgM, and none had detectable B19 DNA. Our data indicate that 1) specific IgA antibodies are too persistent to be a useful indicator of recent B19 infection; 2) specific IgM antibodies are the most sensitive indicator of acute B19 infection in immunologically normal persons but can persist up to 6 months; and 3) B19 DNA can often be detected up to 2 months after onset of illness even in immunologically normal hosts and might be a useful adjunct test for diagnosis of acute B19 infection. PMID- 1765776 TI - Acute hepatitis B viral infection in a patient with anti-HBs. AB - We report a patient with antibody to hepatitis B surface antigen (anti-HBs) but no antibodies to other hepatitis B virus components, who developed acute symptomatic type B hepatitis. The possible explanations for this unusual serological pattern are 1) the antibody-positive status, which developed against only a subdeterminant of hepatitis B surface antigen (HBsAg), arose naturally or as the result of cross-reaction with a variety of antigens; and 2) seroconversion to anti-HBs occurred in response to surface antigen of a mutant strain of hepatitis B virus (HBV). This anti-HBs positivity, in the absence of antibody to hepatitis B core antigen, does not provide natural immunization against HBV infection, and so is not protective. Individuals who are positive to anti-HBs antibody alone which is not elicited by HBV vaccine, should be vaccinated against possible HBV infection. PMID- 1765777 TI - Significance of isolated hepatitis B core antibodies detected by enzyme immunoassay in a high risk population. AB - Serum samples, which were found positive for anti-HBc and negative for HBsAg and anti-HBs during routine testing with Abbott enzyme immunoassays (EIA), were collected prospectively. The samples were obtained from patients with a high risk of hepatitis B. Further analysis was carried out using radioimmunoassays and tests for additional markers of hepatitis B. 84 of the 203 initially collected samples (41.4%) were found positive for anti-HBs by RIA. Of the 119 samples negative for anti-HBs by RIA, 103 were available for further investigation, and 35 (34.0%) of these were negative for anti-HBc by RIA. This indicates that low sensitivity of the anti-HBs EIA and non-specificity of the anti-HBc EIA may account for about 60% of the cases presenting with isolated anti-HBc at initial testing. Fifty-two samples positive for anti-HBc by RIA, with isolated anti-HBc confirmed after RIA testing for HBsAg and anti-HBs, were examined further: anti HBe was detected in 16 sera, anti-HDV in one serum and HBV-DNA in 5 sera by PCR. Additional testing of serum samples with isolated anti-HBc is warranted. PMID- 1765778 TI - Isolation and partial characterization of neuropeptides that mimic prolonged inhibition produced by bag cell neurons in Aplysia. AB - The bag cell neurons of the marine mollusk Aplysia are part of a neural system that utilizes four neuropeptides as neurotransmitters. The peptides, derived from the egg-laying hormone/bag cell peptide (ELH/BCP) precursor protein, are released during a 20-min burst discharge of the bag cells and produce several types of responses in various abdominal ganglion neurons. In the identified neurons L3 and L6, bag cell activity produces prolonged inhibition that lasts for more than 2 h. One of the bag cell peptides, alpha-BCP, mediates an early component of the inhibition in these neurons. To identify the co-transmitter mediating the prolonged component of inhibition, we purified material from an acid extract of abdominal ganglia using molecular sizing high-pressure liquid chromatography (HPLC) on TSK 250-125 followed by two steps of reverse-phase HPLC on C4 or C18. We isolated three inhibitory factors that mimic the prolonged component of inhibition. Mass spectroscopy and partial amino acid sequence analysis indicate one factor is ELH [2-36], that is, ELH that lacks the first, N-terminal amino acid. This inhibitory activity was similar in potency to that of ELH and is the first to be described for an ELH-related peptide. The two other factors were approximately 3,300 and 4,700 Da and were effective at 10- and 50-fold lower concentration, respectively, than ELH or its fragment. Amino acid composition analysis suggests that they are not derived from the ELH/BCP precursor protein. The 4,700 Da factor is effective at the lowest concentration and produces an effect that lasts as long as 100 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765779 TI - Interactions of Schwann cells with neurites and with other Schwann cells involve the calcium-dependent adhesion molecule, N-cadherin. AB - During embryogenesis, Schwann cells interact with axons and other Schwann cells, as they migrate, ensheath axons, and participate in organizing peripheral nervous tissues. The experiments reported here indicate that the calcium-dependent molecule, N-cadherin, mediates adhesion of Schwann cells to neurites and to other Schwann cells. Cell cultures from chick dorsal root ganglia and sciatic nerves were maintained in media containing either 2 mM Ca++ or 0.2 mM Ca++, a concentration that inactivates calcium-dependent cadherins. When the leading lamellae of Schwann cells encountered migrating growth cones in medium with 2 mM Ca++, they usually remained extended, and the growth cones often advanced onto the Schwann cell upper surface. In the low Ca++ medium, the frequency of withdrawal of the Schwann cell lamella after contact with a growth cone was much greater, and withdrawal was the most common reaction to growth cone contact in medium with 2 mM Ca++ and anti-N-cadherin. Similarly, when motile leading margins of two Schwann cells touched in normal Ca++ medium, they often formed stable areas of contact. N-cadherin and vinculin were co-concentrated at these contact sites between Schwann cells. However, in low Ca++ medium or in the presence of anti-N-cadherin, interacting Schwann cells usually pulled away from each other in a behavior reminiscent of contact inhibition between fibroblasts. In cultures of dissociated cells in normal media, Schwann cells frequently were aligned along neurites, and ultrastructural examination showed extensive close apposition between plasma membranes of neurites and Schwann cells. When dorsal root ganglia explants were cultured with normal Ca++, Schwann cells migrated away from the explants in close association with extending neurites. All these interactions were disrupted in media with 0.2 mM Ca++. Alignment of Schwann cells along neurites was infrequent, as were extended close apposition between axonal and Schwann cell plasma membranes. Finally, migration of Schwann cells from ganglionic explants was reduced by disruption of adhesive contact with neurites. The addition of antibodies against N-cadherin to medium with normal Ca++ levels had similar effects as lowering the Ca++ concentration, but antibodies against the neuronal adhesive molecule, L1, had no effects on interactions between Schwann cells and neurites. PMID- 1765780 TI - Lack of evidence for cell death among avian spinal cord interneurons during normal development and following removal of targets and afferents. AB - Chick embryos and posthatched chicks were examined at several ages for the presence of pyknotic interneurons in the lumbar spinal cord. Because no pyknotic interneurons were found, direct cell counts of healthy interneurons were carried out and a comparison made between early- and late-stage embryos and hatchlings. There was no decrease in the number of interneurons in the ventral intermediate gray matter of the spinal cord between embryonic day (E) 8 and 2 weeks posthatching (PH) or in the dorsal horn between E10 and 2 weeks PH. To study whether interneuron survival is regulated by targets or afferents, a situation known to exist in other developing neural populations, early embryos were subjected to (1) removal of one limb, resulting in the loss of lateral motor column motoneurons and dorsal root ganglion sensory afferents; (2) transection of the thoracic spinal cord, thereby removing both descending afferents and rostral targets of spinal interneurons, or (3) a combination of the two operations. No reductions in interneuron numbers were found as a result of these operations. Furthermore, morphometric analysis also revealed no change in neuronal size following these experimental manipulations. By contrast, there was a slight decrease in the total area of spinal gray matter that was most prominent in the dorsal region following limb bud removal. Our results indicate (1) that spinal interneurons fail to exhibit the massive naturally occurring death of postmitotic neurons that has been observed for several other populations of spinal neurons, and (2) spinal interneurons appear to be relatively resistant to induced cell death following the removal of substantial numbers of afferent inputs and targets. PMID- 1765781 TI - Gonadal steroids affect LHRH preoptic cell number in a sex/role changing fish. AB - In diandric sex-reversing fishes, sexually active males and females (primary phase) regularly transform into an alternative reproductive morph, terminal-phase males, that are morphologically and behaviorally distinct. The transformation from primary to terminal phase is associated with a twofold increase in the number of luteinizing hormone-releasing hormone (LHRH) immunopositive cells in the forebrain preoptic area, a region involved in both the initial development and daily control of reproductive physiology and behavior. We now show that implants of 11-ketotestosterone induce increases in LHRH cell number in both primary phase sexes to the level observed in field-collected terminal phase males. Conversely, gonadal steroids had no effect on the number of LHRH preoptic cells in terminal phase males, suggesting that this is indeed a terminal stage in the development of this species. These results demonstrate that transition to the terminal phase by both sexes involves a parallel and convergent change in LHRH cell number, which utilizes an evolutionarily conserved mechanism of sexual differentiation: the inductive effects of gonadal steroid hormones. PMID- 1765782 TI - Early estrogen treatment alone causes female zebra finches to produce learned, male-like vocalizations. AB - The male zebra finch produces learned song and long calls while the female does not. This difference in behavior is believed to result from the action of sex steroids on brain areas responsible for vocal production and learning. In this study, the female zebra finch was used to explore further the specific role sex steroids play in vocal masculinization. We show that estradiol (E2) treatment at birth was sufficient to masculinize the vocal behavior of female zebra finches. Thirteen of 18 females treated with E2 as nestlings produced song-like vocalizations. Fifteen of 18 produced long calls with male-typical features. The degree of masculinization varied between individuals. Of the 15 early E2 females that produced at least one type of male-like vocalization, 7 showed evidence of vocal learning from their tutors. The ability of E2 to cause masculinization of vocal behavior was age dependent: treatment from birth was most effective, treatment at 20 days of age was partially effective, and treatment in adulthood was ineffective. The effect of subsequent testosterone exposure in adulthood differed depending on the quality of the vocalization produced after E2 treatment alone. These results suggest that E2 may play a more important role than previously thought in the development of sex differences in vocal behavior. Furthermore, this study demonstrates that exogenous E2 treatment alone can induce vocal learning. PMID- 1765783 TI - Early estrogen treatment of female zebra finches masculinizes the brain pathway for learned vocalizations. AB - Telencephalic nucleus HVC and its two efferent targets, RA and X, play essential roles in the production of complex, learned vocalizations in the male zebra finch. Normal females do not produce these learned vocalizations; HVC, RA, and X are small in volume, and HVC and RA are not synaptically connected. We have shown that estrogen treatment during development causes females to learn and produce male-like vocalizations. This article describes the neural masculinization of these E2 females, replicating and extending the work of others. Female zebra finches were treated with 17 beta-estradiol (E2) at hatching, at 14-22 days of age, or as adults. In adulthood, the volumes of nucleus RA and area X were measured and the efferent projections of nucleus HVC examined using the anterograde tracer PHA-L. Early, sustained E2 treatment caused the greatest increase in the volume of RA and X, the innervation of RA and X by HVC axons, and the masculinization of auditory responses of cells in RA. Treatments that lasted for a shorter period or started later in development resulted in different patterns of partial brain masculinization. E2 treatment in adulthood had no effect on the volume of RA or X or their innervation by HVC. Bilateral lesions of the tracheosyringeal nerves or of HVC had the same effects on the male-typical vocalizations produced by E2 females as they do on the vocalizations produced by males. These results demonstrate that the neural masculinization of telencephalic nuclei induced by E2 treatment sets up a functional circuit in females similar to one in males that enables the learning and production of complex vocalizations. PMID- 1765784 TI - Synthesis, characterization, and cytotoxic studies of alpha-diimine/1,2-diamine platinum(II) and palladium(II) complexes of selenite and tellurite and binding of some of these complexes to DNA. AB - Eleven new complexes of formula [M(NN)(XO3)] (where M is Pd(II) or Pt(II); NN is 2,2'-bipyridine, 1,10-phenanthroline, 2,2'-dipyridylamine, ethylenediamine or (+ )trans-1,2-diaminocyclohexane, and XO3(2-) is SeO3(2-) or TeO3(2-)) have been synthesized. These water soluble complexes have been characterized by chemical analysis and conductivity measurements as well as ultraviolet-visible and infrared spectroscopy. In these complexes the selenite or tellurite ligand coordinates to platinum(II) or palladium(II) as bidentate with two oxygen atoms. These complexes inhibit the growth of P 388 lymphocytic leukemia cells, their targets are DNA. The selenite complexes invariably show I.D.50 values less than cisplatin. However, the I.D.50 values of the tellurite complexes are usually higher than cisplatin, except that of [Pd(dach)(TeO3)] which has comparable I.D.50 values, as compared to cisplatin. [Pt(bipy)(SeO3)] and [Pd(bipy)(SeO3)] have been interacted with calf thymus DNA and bind to DNA through a coordinate covalent bond. PMID- 1765785 TI - Guanine-06 methylation reduces the reactivity of d(GpG) towards platinum complexes. AB - 6-methylated guanine dinucleotides were used to study the influence of hydrogen bonding on the specific binding of the antitumor drug cDDP, cis-PtCl2(NH3)2, to DNA. In this interaction, the guanine-06 site appears to be important in explaining the preference for a pGpG-N7(1),N7(2) chelate, which results from H bridge formation with the ammine ligand of cDDP. Guanine-06 methylated dinucleotides and the nonmodified dinucleotides were reacted with [Pt(dien)Cl]+, cis-PtCl2(NH3)2, and cis-[Pt(NH3)2(H2O)2]2+ and the reaction products were characterized by 1H NMR using pH titrations. Methylation at guanine-06 clearly reduces the preference for the guanine. In competition experiments monitored by NMR and experiments using UV spectrophotometry a decreasing reactivity towards [Pt(dien)(H2O)]2+ and cis-[Pt(NH3)2(H2O)2]2+ was found, in the order of d(GpG) greater than d(GomepG) greater than d(GpGome) greater than d(GomepGome). The difference in reactivity between 5' guanine methylation and 3' guanine methylation is ascribed to differences in the H-bond formation with the backbone phosphate. The resulting reduced stacking of the bases in both modified dinucleotides, compared to the bases in d(GpG), results in a preference for the 3' guanine over 5'. PMID- 1765786 TI - Changes in ornithine decarboxylase activity and polyamine levels in response to eight different forms of selenium. AB - The biological activity of selenium is known to depend on its chemical form. In this study, eight forms of selenium that differed in oxidation state or degree of methylation were studied for their acute effects on the activities of ornithine decarboxylase (ODC) and S-adenosylmethionine decarboxylase (AdoMet DC) and on the concentrations of the polyamines putrescine, spermidine, and spermine in the liver. The polyamine pathway was studied because it is involved in the control of cell growth and in the cell's response to trophic, carcinogenic, and toxic stimuli, activities that selenium has been reported to affect. Female Sprague Dawley rats were administered 12 mumol Se/kg body weight via intraperitoneal injection and were sacrificed six hours later. Injection of sodium selenate, sodium selenite, selenomethionine, Se-methylselenocysteine, selenobetaine, and selenobetaine methyl ester resulted in significant increases in liver selenium, whereas injection of dimethylselenoxide and trimethylselenonium chloride did not. ODC activity and AdoMet DC activity were induced by those selenium compounds that also increased liver selenium content, but the magnitude of enzyme induction by those compounds was not correlated with the hepatic concentration of total selenium determined fluorometrically. Furthermore, the induction of ODC activity by the various forms of selenium did not result in concomitant increases in putrescine, spermidine, and spermine except in the case of selenite. Given that alterations in the metabolism of selenium are induced when the level of tissue selenium is elevated and that the relative abundance of various selenometabolites can be affected by the point of entry of selenium into intermediary metabolism, these data suggest that the changes that were observed in enzyme activities and polyamine levels are likely to be associated with the accumulation of a specific metabolite of selenium. The relevance of these findings to elucidation of the biological activities attributable to various forms of selenium is under investigation. PMID- 1765787 TI - Potassium current kinetics in bursting secretory neurons: effects of intracellular calcium. AB - 1. The kinetics of delayed rectifier (IK) and transient potassium (IA) currents and their modification by intracellular calcium ions in bursting X-organ neurons of the crayfish were studied with whole-cell patch-clamp technique. Activation and inactivation kinetics were analyzed according to Hodgkin and Huxley-type equations. 2. IK activates with sigmoidal time course at membrane potentials more positive than -38.4 +/- 3.5 (SD) mV (n = 5), and does not inactivate. The conductance through delayed rectifier channels (gK) is described by the equation gK = GKn2. 3. IA activates at membrane potentials close to the resting potential (-52.2 +/- 4.3 mV, n = 5) and, after a peak, inactivates completely. The conductance through A-channels (gA) can be described by the product of independent activation and inactivation parameters: gA = GAa4b. Both activation and inactivation processes are voltage and time dependent. 4. Steady-state activation of IK and IA as well as inactivation of IA can be described by Boltzmann distributions for single particles with valencies of 2.55 +/- 0.01 (n = 5), 1.60 +/- 0.25 (n = 5), and 3.87 +/- 0.39 (n = 3), respectively. 5. Increasing [Ca2+]i, we observed the following: 1) a considerable inactivation of IK during test pulses, 2) an increase of maximal conductance for IA, 3) a reduction of the valency of IA inactivation gating particle (from 3.87 to 2.27), 4) a reduction of the inactivation time constants of IA, and 5) a shift of the inactivation steady state curve to more positive membrane potentials.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765788 TI - Rescue of motoneurons from the axotomized state by regeneration into a sensory nerve in cats. AB - 1. We studied the electrical properties of spinal motoneurons, the axons of which had regenerated into a cutaneous nerve. 2. In cats, all or part of the medial gastrocnemius (MG) muscle nerve was cut and directed distally into the caudal cutaneous sural (CCS) nerve, a sensory (primarily cutaneous) nerve. One or 2 yr later, electrical properties [conduction velocity (CV), rheobase (Irh), input resistance (RN), afterhyperpolarization (AHP), and excitatory postsynaptic potentials (EPSPs)] of MG motoneurons that had cross-regenerated into the CCS nerve were determined. These were compared with properties of normal and of axotomized MG motoneurons and with data from previous studies in which MG motoneurons had reinnervated their own or a foreign muscle. 3. Electrical stimulation of the MG-innervated CCS nerve produced no detected mechanical activity, indicating an absence of muscle innervation. Tactile stimulation of skin did not activate these motoneurons; i.e., they did not acquire properties of cutaneous afferents. 4. The CV and Irh of MG motoneurons axotomized 11 mo declined by 48 and 60%, respectively. 5. The CV of MG motoneurons that had regenerated through CCS was only slightly slower than normal, similar to that of MG motoneurons that reinnervated the "slow" muscle soleus (Foehring and Munson 1990). 6. The Irh and RN were also similar to those of MG motoneurons that had regenerated into the soleus muscle. 7. Electrical stimulation of the lateral gastrocnemius-soleus nerve generated EPSPs of normal or almost normal amplitude in MG motoneurons axotomized for 11 mo or cross-regenerated into CCS up to 2 yr.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765789 TI - Nonuniform fatigue characteristics of slow-twitch motor units activated at a fixed percentage of their maximum tetanic tension. AB - 1. The endurance of slow-twitch motor units from the soleus (SOL) and medial gastrocnemius (MG) muscles of the cat were tested by determining the length of time (endurance time, Et) that a unit could maintain its tension output at 85% of maximum. Motor-unit tension was clamped at the target level by altering the stimulation rate of a unit's motor axon through computer feedback control. Tested in this way, units of both muscles displayed a wide range of Ets, approximately 40- to 50-fold. 2. Electromyographic (EMG) waveforms of motor units subjected to force-clamp contractions were analyzed to access whether any activity-dependent changes in their waveform shape might predict Et. Three measurements of waveform shape were determined: baseline-to-baseline duration, peak-to-peak amplitude, and area. Typically, amplitude decreased and duration increased as a contraction proceeded, whereas area remained fairly constant. Because changes in each measure were very similar for units of widely different Ets, it was concluded that neuromuscular junction failure and changes in the excitability of the sarcolemma (excluding the t-tubule system) play a minor role in determining Et. 3. Et was highly correlated with the mean stimulation rate (Et/number of stimuli) used during the force-clamp contractions. Mean rate was seen to progressively decrease with increasing Et. This correlation could not be explained by measures of isometric contractile speed or relaxation (e.g., twitch contraction time or half relaxation time) measured before the force-clamp contractions. Both contraction time and half-relaxation time were found to be unrelated to both Et and the rate used to stimulate the unit during the force-clamp contraction. 4. Among type S units of SOL and MG, maximum tetanic tension and Et were not related. A significant relation (r = -0.49) was found between axonal conduction velocity and Et for SOL units (n = 38). In addition, a significant correlation (r = 0.47) was found between conduction velocity and tetanic tension for SOL units. Perhaps because of the small sample of type S units from MG (n = 10), conduction velocity was found not be related to either Et or tetanic tension. 5. Others have shown that a motor unit's maximum tetanic tension and axonal conduction velocity are correlated with its order of recruitment among motoneurons innervating a muscle. Recent work has further shown that among type F units the order in which a motoneuron is recruited is highly correlated with the fatigue resistance of its muscle unit.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1765790 TI - Visual activity in areas V3a and V3 during reversible inactivation of area V1 in the macaque monkey. AB - 1. Behavioral studies in the monkey and clinical studies in humans show that some visuomotor functions are spared in case of a V1 lesion. This residual vision appears to be subserved at least partially by visual activity in extrastriate cortex. Earlier studies have demonstrated that neurons in area V2 lose their visual responses when V1 is reversibly inactivated. On the other hand, Rodman and collaborators have recently shown that neurons in the middle temporal area (area MT) remain visually responsive when V1 is lesioned or inactivated. The purpose of the present study was to determine whether area MT is unique among extrastriate cortical areas in containing visually responsive neurons in the absence of input from area 17. 2. A circular part of the opercular region of area V1 was reversibly inactivated by cooling with a Peltier device. In that condition, 149 sites were recorded in the retinotopically corresponding regions of areas V3 and V3a. 3. About 30% of sites in area V3a still responded to visual stimulation when V1 was inactivated. On the contrary, nearly all sites in area V3 ceased to fire to visual stimulation. Receptive-field properties were assessed with qualitative measures; for most single cells or multiunit sites that responded during V1 inactivation, these properties did not change during cooling. 4. These results suggest that area V3a could take part in spared visuomotor abilities in case of a lesion of V1. Areas V3a and MT are both part of the occipitoparietal pathway, which suggests that the residual vision observed after a lesion of area 17 may depend mostly on this pathway. PMID- 1765791 TI - Morphological correlates of response dynamics and efferent stimulation in horizontal semicircular canal afferents of the toadfish, Opsanus tau. AB - 1. We used the intraaxonal labeling technique to study correlations between the terminal dendritic morphology of horizontal semicircular canal primary afferents and their response dynamics to sinusoidal head rotation and combined electrical stimulation of central efferent vestibular neurons. Thirty-eight canal afferents were identified by their sensitivity and phase of response to rotation between 0.1 and 1.0 Hz (+/- 10 degrees/s) and were subsequently labeled with horseradish peroxidase or biocytin. The afferent's dendritic field and synaptic specializations in the neuroepithelium of the crista were examined under light microscopy. 2. Rate and regularity of background discharge of the afferent were not correlated with its axon diameter or relative location of its dendritic field in the crista. 3. Response sensitivity of the afferent to rotation was correlated both with the relative location of its dendritic field in the crista and with the number of terminal endings it possesses. Afferents having low sensitivities, slow dynamics, and few terminal endings supply the peripheral portions of the crista; afferents with higher sensitivities, faster dynamics, and greater number of terminal endings supply the more central portions. It is suggested that the differences in sensitivity among the afferents reflect principally the variations in both the cupular dynamics along the crista and the number of possible hair cell contact sites in the neuroepithelium. 4. Response phase of the afferent was correlated only with the extent of its dendritic processes along the transverse axis of the crista. Afferents having transversely oriented dendritic fields had less phase lags relative to acceleration than did those having a more longitudinally oriented dendritic field. 5. Efferent stimulation produced a change in both the afferent's discharge rate and its response sensitivity to rotation. Afferents discharge rate and its response sensitivity to rotation. Afferents having a centrally located dendritic field and acceleration afferents, defined by their response to rotation, were the most affected by efferent stimulation. These results suggest that efferent innervation is either directed toward, or most efficacious in, the central regions of the crista and that it may select specific hair cell-afferent complexes. PMID- 1765792 TI - Octopaminergic modulation of interneurons in the flight system of the locust. AB - 1. Modulatory effects of octopamine perfusion on identified central neurons in the flight system of the locust Locusta migratoria were examined by means of intracellular recordings from the isolated metathoracic ganglion. 2. Octopamine increased the excitatory response of elevator motoneurons to electrical stimulation of the hindwing tegula and increased the probability of triggering rhythmic activity in the flight system by current injection into single interneurons. 3. These effects of octopamine on the flight system are due in part to octopamine inducing intrinsic bursting properties in flight interneurons. Plateau potentials were evoked in these interneurons by synaptic input from tegula or by the injection of depolarizing current pulses. These potentials were prematurely terminated by hyperpolarizing currents, and their generation was voltage sensitive in that they were suppressed with hyperpolarizing offset currents. 4. Longer depolarizing current pulses evoked endogenous bursting in a number of flight interneurons. This rhythmic bursting was reset by the injection of pulses of hyperpolarizing currents. The frequency of bursting was dependent on the injected current strength. 5. The injection of hyperpolarizing current into flight interneurons during octopamine-induced rhythmic activity lead to sudden decreases in the amplitude of the depolarizations thus indicating that plateau potentials contribute to the generation of the rhythmic depolarizations. 6. The shape of the depolarizations, the duration of the bursts (50-75 ms), and the frequency range of endogenous bursting (4-16 Hz) as seen in individual interneurons during octopamine perfusion were similar to the corresponding characteristics in the same neurons during wind-induced flight activity in deafferented locusts. This correspondence suggests that intrinsic bursting properties may play an important role in generating the normal motor pattern for flight. PMID- 1765793 TI - Neuronal pair and triplet interactions in the auditory midbrain of the leopard frog. AB - 1. With the use of two independent microelectrodes and multiunit spike separation, 26 neural pairs, 17 triplets, and 8 quadruplets were recorded in the auditory midbrain of the leopard frog, resulting in a total of 125 neural pairs. 2. Functional interrelationships between neurons were studied by analyzing 638 cross-coincidence histograms as functions of stimulus type, stimulus level, and estimated neuron distance. Significance criteria for correlograms were established on the basis of the distribution of extreme values in a large number of correlograms for nonsimultaneously recorded pairs. 3. Simultaneous recordings from three neurons, that all showed significant neural pair correlations were analyzed with the use of the joint occurrence diagram, which displays the joint coincidences for the firings of two units (a and b) with the firings of the trigger unit (c). 4. It was found that 97.5% of the pairs showed a significant stimulus-induced correlation; neighboring neurons exhibited a stronger stimulus correlation (synchrony) than more distant neurons. 5. Positive neural interaction strength (75% to shared excitatory input) was independent of neuron distance (taking into account that the estimated electrode distance in the present investigation was never greater than 300 microns) and occurred in 25% of the pairs investigated. About 25% of the positive neural correlations could be attributed to unidirectional excitation, the majority of which was found for single-electrode pairs. Negative neural correlation occurred in 8% of the pairs and, with one exception, was found only for neurons recorded on the same electrode. 6. Evidence for the presence of feed-forward and/or feedback inhibition was found. 7. There was a strong stimulus-type influence on stimulus correlation and on positive neural correlation, whereas stimulus intensity affected the stimulus correlation but not the neural correlation. 8. From the incidence of triplet correlations, it was concluded that the divergence of afferents onto midbrain neurons was limited; it was unlikely that more than three neurons were contacted by one afferent. In contrast, convergence of afferents on torus semicircularis cells was widespread; 40-50% of the midbrain neurons were bimodally tuned and received input originating from the two auditory papillae. Convergence of fibers from the same papilla was also extensive. 9. Fast modulation of functional neural connectivity through the activity of other neurons was found, although this was probably not the result of actual changes in synaptic strength but of synchronized changes in firing rate. PMID- 1765794 TI - Discharge patterns of trigeminal commissural last-order interneurons during fictive mastication in the rabbit. AB - 1. The aim of these experiments was to examine the physiological properties and patterns of firing of trigeminal interneurons during fictive mastication in anesthetized and paralyzed rabbits. Antidromic stimulation was used to show that the 82 interneurons projected to the area of the contralateral fifth nerve motor nucleus (NVmot). 2. Straight-line conduction velocities calculated from stereotaxic coordinates of the stimulating and recording electrodes for 63 interneurons were found to range between 3.7 and 16.3 m/s (mean, 9.5 m/s). 3. Histological reconstructions of recording electrode tracks showed that the interneurons observed in this study were located in the lateral brain stem in or just medial to the rostral trigeminal sensory nuclei, including the intertrigeminal (NVint) and supratrigeminal (NVs) areas, the main sensory nucleus of the fifth nerve (NVsnpr), the rostral subdivision of the oral nucleus of the spinal trigeminal tract (NVor tau), and the rostral part of the parvocellular reticular nucleus (NRpc alpha). 4. Forty-six interneurons were shown to have low threshold (LT) peripheral receptive fields, and 41 of these (88%) were in the oral cavity. Most of the responses were rapidly adapting. 5. Twenty-eight interneurons changed their pattern of firing during cortically induced fictive mastication. The discharge frequency of 20 neurons varied in phase with the fictive masticatory motor output, which was recorded from central ends of cut hypoglossal nerves (XII) and/or from the NVmot. Others were briefly excited and then inhibited (n = 2), only inhibited (n = 4), or tonically excited during fictive mastication (n = 2). Fifteen others were unaffected by this test. 6. It was found that the rhythmically active neurons could be further subdivided into two categories: those receiving short-latency excitatory input from the masticatory area of the cortex (n = 11) and those that did not (n = 9). No obvious differences in peripheral receptive fields for neurons in these categories were found. 7. We suggest that these phasically active premotor neurons are part of the circuitry generating the rhythmic masticatory pattern, specifically those that directly control the bursts of firing of the trigeminal motoneurons (burst generators, BGs). Their properties allow them to integrate sensory information and descending commands with the masticatory rhythm that is probably generated in midline brainstem reticular nuclei. PMID- 1765795 TI - Initiation rules for planar, two-joint arm movements: agonist selection for movements throughout the work space. AB - 1. The question we addressed was the following: what rules does the CNS employ, given the initial and final positions of the arm for a pointing movement, to decide which shoulder and elbow muscles ("agonists") to activate for initiating movement? 2. Widely varying initial and final positions were used, so that the movements studied encompassed much of the reachable work space within the horizontal plane. For each movement, the initial electromyographic (EMG) activity at each joint was classified qualitatively in terms of the "sign," i.e., flexor or extensor muscle activity, and quantitatively in terms of the integral of the rectified EMG. 3. The sign of initial muscle activity at each joint was found to be related to the angular excursions at both joints during movement to the final position. 4. Two different hypothesized rules, derived from previously proposed strategies for control of multijoint limb movements, were tested for their ability to predict correctly the sign of initial muscle activity at each joint. Although four variables are needed to describe the initial and final positions of a two-segment arm, only two combinations of these four were relevant for testing the rules. The two positional variables were the spatial direction of the final tip position with respect to the initial forearm orientation (psi) and the initial elbow angle (theta Einit). 5. According to one of the rules tested, which was based on statics, the initial muscle activity at each joint should be such that the distal tip of the limb exerts an initial force in the direction of the final tip position. Our data concerning the sign of initial shoulder muscle activity clearly contradicted this rule in two distinct regions of the (psi, theta Einit) plane. 6. According to the other rule tested, which was based on dynamics, the initial muscle activity at each joint should be such that the initial acceleration of the distal tip is in the direction of the final tip position. The data contradicted the predicted sign of initial shoulder muscle activity for a certain range of psi. This shows that the activation of muscles is not always appropriate even qualitatively for a straight-line path. Furthermore, the effects of added inertial loads predicted by this rule were not observed for trials in which a 1.8-kg mass was attached to the distal portion of the limb.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1765796 TI - Timing and magnitude of electromyographic activity for two-joint arm movements in different directions. AB - 1. We studied electromyographic (EMG) and kinematic features of self-paced human arm movements involving rotations about the shoulder and elbow joints. Movements were initiated from various positions and covered much of the reachable work space in the horizontal plane. The attempt was to characterize robust features of the relative timing and magnitude of the EMG activity at the two joints, and to correlate them with variables related to the initial and final positions. 2. The pattern of muscle activity at each joint was typically characterized by bursts of alternating agonist and antagonist activity, comparable with the three-burst pattern associated with single-joint movements. As the spatial direction of the target was altered, the magnitude of each burst was modulated over a continuous range. Modulation down to zero activity was observed, not only for later bursts, as has been shown in some cases of single-joint movements, but for the first agonist burst as well. 3. In the preceding paper we showed that the choice of agonists (i.e., flexors or extensors) at each joint is predictable on the basis of the target direction relative to the distal segment (psi). Here, we present quantitative analyses of initial agonist EMG activity at the shoulder and elbow, which reveal that the onset-time difference between agonists at the two joints also varied systematically with psi, and so did their relative magnitude. 4. For most target directions, initial EMG activity at the shoulder preceded that at the elbow by 5-40 ms. Exceptions were observed mainly for target directions near the transitions between initial flexor and initial extensor activity at the shoulder. In these cases the initial agonist activity at the shoulder was greatly reduced or, in some cases, appeared entirely suppressed, although the later bursts were present in their usual temporal alignment with the corresponding bursts at the elbow. 5. Antagonist onset at the elbow tended to precede antagonist onset at the shoulder, but the difference in timing did not vary consistently with psi. 6. Despite the consistency of initial agonist timing between the two joints, the agonist onset-time difference was poorly correlated with the apparent difference in the onset times of shoulder and elbow joint rotations. The latter difference, which is affected by mechanics, cannot therefore be imputed directly to the CNS.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1765797 TI - Control of orienting gaze shifts by the tectoreticulospinal system in the head free cat. I. Identification, localization, and effects of behavior on sensory responses. AB - 1. The input-output connectivity, in cat, of tectoreticular (TRNs) and tectoreticulospinal (TRSNs) neurons [together called TR(S)Ns] suggests a role for these cells in the sensorimotor transformations necessary for controlling orienting behavior. Multimodal sensory information converges directly onto these tectal neurons, and they project to several brain stem and spinal cord centers involved in the control of eye- and head-orienting movements. In this and the following two papers, we describe the sensorimotor discharges of antidromically identified TR(S)Ns. Here we describe the process of localizing and identifying them, characteristics of both their antidromic and sensory responses, and effects of behavioral context on these responses. 2. In 13 alert, chronically prepared cats, a total of 293 neurons were antidromically identified from either the predorsal bundle (PDB) immediately rostral to abducens nucleus or the ventromedial funiculus of the spinal cord at the level of the first cervical vertebra (C1). The cell bodies of all identified TR(S)Ns were confined to the intermediate and deep laminae of the superior colliculus (SC). The antidromic nature of the action potential evoked by stimulating either the PDB or C1 was verified by the use of a number of established criteria, including collision testing. 3. The mean antidromic latency from the PDB (TRNs + TRSNs) was 0.84 +/- 0.59 (SD) ms (n = 217). The conduction velocities of all cells activated by PDB stimulation ranged from 4 to 40 m/s. The mean latency from C1 (TRSNs) was 1.03 +/ 0.52 ms (SD) (n = 64), whereas conduction velocities ranged from 14 to 80 m/s. 4. One hundred thirty-eight TR(S)Ns were studied long enough to yield significant data regarding their involvement in visuomotor-orienting behavior. Ninety-eight percent (130/133) of the TR(S)Ns tested for visual responses could be induced to discharge action potentials in response to some form of visual stimulation. The other three neurons remained silent, even in response to the most provocative stimuli. These silent neurons nevertheless were shown to be depolarized by visual stimuli. TR(S)Ns were occasionally tested for auditory and somatosensory responses and some were multimodal. 5. TR(S)Ns had visual receptive fields that conformed to the retinotopic map of the visual field that is represented within the SC. Cells found in the lateral SC had receptive fields located in the lower visual field, whereas neurons that were situated medially had receptive fields in the upper visual field. Cells found in the rostral SC had small fields that included a representation of the area centralis.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1765798 TI - Control of orienting gaze shifts by the tectoreticulospinal system in the head free cat. II. Sustained discharges during motor preparation and fixation. AB - 1. We recorded from electrophysiologically identified output neurons of the superior colliculus (SC)--tectoreticular and tectoreticulospinal neurons [together called TR(S)Ns]--in the alert cat with head either unrestrained or immobilized. A cat actively exploring its visual surrounds typically makes a series of coordinated eye-head orienting movements that rapidly shift the visual axis from one point to another. These single-step shifts in gaze position (gaze = eye-in-space = eye-in-head + head-in-space) are separated by periods in which the visual axis remains stationary with respect to surrounding space. 2. Eighty-seven percent (86/99) of the TR(S)Ns studied during periods when the visual axis was stationary presented a sustained discharge, the intensity of which depended on the magnitude and direction of the vector drawn between current gaze position and the gaze position required to fixate a target of interest (gaze position error or GPE). The maximum sustained discharge recorded from each TR(S)N corresponded to a specific GPE vector and was correlated with the cell's position on the SC's retinotopically coded motor map. 3. The 86 TR(S)Ns could be divided into two classes. "Fixation TR(S)Ns" [fTR(S)Ns, n = 12] discharged maximally when the animal attentively fixated a target of interest, (i.e. GPE = 0 degrees). These neurons were located in the rostral SC and had visual receptive fields that included a representation of the area centralis. "Orientation TR(S)Ns" [oTR(S)Ns, n = 62] had visual receptive fields that excluded the area centralis and discharged for nonzero GPEs. The oTR(S)Ns were recorded more caudally on the SC's map. 4. For a given value of GPE, an ensemble of TR(S)Ns was active. When the cat changed its gaze position relative to a fixed target of interest, the zone of sustained activity shifted to a new collicular site. Thus, to maintain the maximum sustained discharge of a TR(S)N when target position was changed relative to the fixed body, it was necessary that gaze move to a new position that reestablished the preferred GPE. 5. The areal extent of GPEs for which a TR(S)N discharged defined a gaze position error field (GPEF) that was approximately coaligned with the cell's visual receptive field. The maximum sustained discharge occurred when GPE corresponded approximately to the center of the cell's GPEF. 6. The diameter of a TR(S)N's GPEF was related to the magnitude of that cell's optimal GPE. fTR(S)Ns had the smallest GPEFs, approximately 15-20 degrees; GPEF diameter was larger for oTR(S)Ns.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1765799 TI - Control of orienting gaze shifts by the tectoreticulospinal system in the head free cat. III. Spatiotemporal characteristics of phasic motor discharges. AB - 1. In this paper we describe the movement-related discharges of tectoreticular and tectoreticulospinal neurons [together called TR (S) Ns] that were recorded in the superior colliculus (SC) of alert cats trained to generate orienting movements in various behavioral situations; the cats' heads were either completely unrestrained (head free) or immobilized (head fixed). TR (S) Ns are organized into a retinotopically coded motor map. These cells can be divided into two groups, fixation TR (S) Ns [f TR (S) Ns] and orientation TR (S) Ns [oTR(S)Ns], depending on whether they are located, respectively, within or outside the zero (or area centralis) representation of the motor map in the rostral SC. 2. oTR(S)Ns discharged phasic motor bursts immediately before the onset of gaze shifts in both the head-free and head-fixed conditions. Ninety-five percent of the oTR(S)Ns tested (62/65) increased their rate of discharge before a visually triggered gaze shift, the amplitude and direction of which matched the cell's preferred movement vector. For movements along the optimal direction, each cell produced a burst discharge for gaze shifts of all amplitudes equal to or greater than the optimum. Hence, oTR(S)Ns had no distal limit to their movement fields. The timing of the burst relative to the onset of the gaze shift, however, depended on gaze shift amplitude: each TR(S)N reached its peak discharge when the instantaneous position of the visual axis relative to the target (i.e., instantaneous gaze motor error) matched the cell's optimal vector, regardless of the overall amplitude of the movement. 3. The intensity of the movement-related burst discharge depended on the behavioral context. For the same vector, the movement-related increase in firing was greatest for visually triggered movements and less pronounced when the cat oriented to a predicted target, a condition in which only 76% of the cells tested (35/46) increased their discharge rate. The weakest movement-related discharges were associated with spontaneous gaze shifts. 4. For some oTR(S)Ns, the average firing frequency in the movement-related burst was correlated to the peak velocity of the movement trajectory in both head-fixed and head-free conditions. Typically, when the head was unrestrained, the correlation to peak gaze velocity was better than that to either peak eye or head velocity alone. 5. Gaze shifts triggered by a high-frequency train of collicular microstimulation had greater peak velocities than comparable amplitude movements elicited by a low-frequency train of stimulation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1765800 TI - Nonlinearity of spatial summation in simple cells of areas 17 and 18 of cat visual cortex. AB - 1. Nonlinearity of spatial summation in areas 17 and 18 of cat visual cortex was compared with the type of spatial nonlinearity that differentiates X and Y cells in the lateral geniculate nucleus (LGN) and retina. The comparisons were made to examine to what extent the information from X and Y cells may remain separated in higher visual centers. 2. Responses of simple cells in areas 17 and 18 were recorded while stationary, optimally oriented sinewave gratings were sinusoidally modulated within the receptive field of the cell. Both the spatial frequency and spatial phase of the stimulus were varied. 3. Y cells in the retina and LGN are defined by the presence of a specific form of spatial nonlinearity. When tested with contrast-modulated sinewave gratings of spatial frequencies about three-fold greater than the optimal, their responses are dominated by a frequency-doubled component. The amplitude of the frequency-doubled component is not dependent on the spatial phase of the stimulus. 4. Many simple cells in the cortex showed a form of spatial nonlinearity similar to the defining nonlinearity found in retinal and geniculate Y cells. A frequency-doubled response dominated at spatial frequencies more than threefold greater than the optimal spatial frequency. When this response was present, it was phase independent. 5. More than 50% of the simple cells in area 18 showed the Y-like spatial nonlinearity. Fewer than 10% of the simple cells in area 17 showed the Y-like spatial nonlinearity. 6. The virtual absence of Y-like nonlinearity in area 17 and its relative abundance in area 18 suggest that the functional separation between the parallel X and Y pathways remains distinct within areas 17 and 18 of cat visual cortex. PMID- 1765801 TI - Representation of sensory information in the cricket cercal sensory system. I. Response properties of the primary interneurons. AB - 1. Six different types of primary wind-sensitive interneurons in the cricket cercal sensory system were tested for their sensitivity to the orientation and peak velocity of unidirectional airflow stimuli. 2. The cells could be grouped into two distinct classes on the basis of their thresholds and static sensitivities to airflow velocity. 3. Four interneurons (the right and left 10-2 cells and the right and left 10-3 cells) made up one of the two distinct velocity sensitivity classes. The mean firing frequencies of these interneurons were proportional to the logarithm of peak stimulus velocity over the range from 0.02 to 2.0 cm/s. 4. The other two interneurons studied (left and right 9-3) had a higher air-current velocity threshold, near the saturation level of the 10-2 and 10-3 interneurons. The slope of the velocity sensitivity curve for the 9-3 interneurons was slightly greater than that for the 10-2 and 10-3 interneurons, extending the sensitivity range of the system as a whole to at least 100 cm/s. 5. All of the interneurons had broad, symmetrical, single-lobed directional sensitivity tuning curves that could be accurately represented as truncated sine waves with 360 degree period. 6. The four low-threshold interneurons (i.e., left and right 10-2 and 10-3) had peak directional sensitivities that were evenly spaced around the horizontal plane, and their overlapping tuning curves covered all possible air-current stimulus orientations. The variance in the cells' responses to identical repeated stimuli varied between approximately 10% at the optimal stimulus orientations and approximately 30% at the zero-crossing orientations. 7. The two higher threshold interneurons (left and right 9-3) had broader directional sensitivity curves and wider spacing, resulting in reduced overlap with respect to the low-threshold class. PMID- 1765802 TI - Representation of sensory information in the cricket cercal sensory system. II. Information theoretic calculation of system accuracy and optimal tuning-curve widths of four primary interneurons. AB - 1. Principles of information theory were used to calculate the limit of accuracy achievable by a subset of the wind-sensitive primary interneurons in the cricket cercal sensory system. For these calculations, an ensemble of four neurons was treated as an information channel, which encoded the direction of air-current stimuli for a defined range of air-current velocities. The specific information theoretic parameter that was calculated was the "transin-formation" or "mutual information" between the air-current directions and the neuronal spike trains, which were characterized in the preceding report. Under the assumptions used for these calculations, the ensemble of four interneurons was demonstrated to be capable of encoding between 4.2 and 3.5 bits of information about wind direction. This corresponds to an average directional accuracy of 4.7 and 7.7 degrees, respectively. 2. The same principles were applied to estimate the extent to which any variation in the width of the tuning curves would affect the transfer of information. As the widths of simulated tuning curves were varied, the mean ensemble accuracy showed a clear global maximum. This maximum corresponds to tuning curves widths of 110 degrees wide (at half maximum), which was remarkably close to the actual mean widths of the tuning curves observed in the cricket of 130 degrees. 3. The effect of varying the parametric "spacing" of the tuning curves within the stimulus range was also examined through a series of simulations. The configuration allowing the maximum information transfer corresponded to equal spacing of the tuning curves around the stimulus range (i.e., 90 degrees separation of peak sensitivity points). This theoretically optimum spacing corresponded exactly to the values observed in the experiments presented in the preceding report. 4. These simulations also showed that the degradation in the accuracy resulting from a shift in the tuning-curve spacing would depend on the plasticity of the higher order decoder of directional information. If there were no plasticity in the interneurons making up the higher order decoder, then the accuracy would be degraded by 50% for a mean tuning-curve shift of only 3.5 degrees. However, if the higher order decoding network were capable of being reoptimized to any arbitrary shift in tuning curves, the degradation in attainable accuracy would be much less severe as shifts of up to 10 degrees would result in virtually no degradation in the accuracy. 5. From these results, two general conclusions can be drawn about the coding of specific stimulus parameters by arrays of sensory cells.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1765803 TI - Superior colliculus neurons mediate the dynamic characteristics of saccades. AB - 1. The locus of activity within the superior colliculus (SC) is related to the desired displacement of the eye. Current hypotheses suggest that the location of this locus of activity determines the amplitude of the saccade and that the level of activity at this locus determines eye velocity. We present evidence that suggests that, although the locus determines the amplitude of the saccade, the level of activity in the colliculus encodes dynamic motor error (the difference between desired and current eye displacement). 2. We categorized 86 neurons in the intermediate and deep layers of the superior colliculus of two rhesus monkeys by their activity in relation to the end of saccadic eye movements. In 36% of the cells (n = 31), activity was completely cut off by the end of the saccade (clipped cells). For 53% of cells (n = 46), the major burst of activity ceased by the end of the saccade, but activity continued for 30-100 ms after the end of the movement (partially clipped cells). The remaining 10% of the cells (n = 9) had no clear burst of activity (unclipped cells) but rather had activity that increased gradually before the saccade and then slowly decreased for up to 100 ms after the saccade. These categories were part of a continuum of cell types rather than discrete classes of cells. 3. We first determined whether this new categorization of cells revealed a special relation between the discharge of clipped and partially clipped cells and saccadic amplitude and peak velocity. As expected, we found a steady increase in spike count as saccadic amplitude increased up to the center of the movement field, and an increase in peak spike discharge as peak velocity increased up to a maximum radial eye velocity. Variability in the cell discharge was substantially greater than the variability of saccadic amplitude or peak velocity. We concluded that these single point or averaged measures did not reveal any new functional relationship of these cells. 4. We then examined the relationship of the temporal pattern of discharge of clipped and partially clipped cells to instantaneous changes in radial error and radial velocity. There was a monotonic decay in spike discharge with declining radial error. In contrast, there was a complex, multivalued relationship between spike discharge and radial velocity; collicular cells produced two different values of spike discharge for the same velocity, one during acceleration and the other during deceleration of the eye during a saccade.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1765804 TI - The terminations of single, physiologically identified, somatosensory, corticospinal tract axons in the lumbar spinal cord of the cat. AB - 1. Two hundred and twelve corticospinal axons were identified by stimulation in the hindlimb representation in area 3b of the somatosensory cortex and were recorded in the left dorsolateral funiculus of the spinal cord of the cat. The mean conduction velocity was 38 m/s, range 9-113 m/s. 2. Electrical stimulation of the receptive field evoked discharge in corticospinal axons with a mean latency of 36 ms (range 9-100 ms). 3. One hundred nine of the 212 recorded axons were successfully intra-axonally labeled by iontophoretic injection of horseradish peroxidase, with the mean length of labeled axon being 4.8 mm. Seventy-three of the labeled axons issued no collaterals, and 36 issued at least one labeled collateral into the spinal gray matter along the labeled portion of the parent axon. 4. Most labeled axons issued only one labeled collateral per spinal cord segment. Fourteen collaterals from 10 units were labeled well enough to permit reconstruction of their terminal arborizations. 5. Most terminal collaterals were oriented rostrocaudally and terminated in laminae V, VI, and VII. Most collaterals terminated within large mediolateral extents of the gray matter with no apparent topographic organization. 6. No collaterals terminated in laminae I or II or within the motoneuron pools, and no apparent correlation was found between their anatomic and physiological characteristics. PMID- 1765805 TI - Organization of dorsal cochlear nucleus type IV unit response maps and their relationship to activation by bandlimited noise. AB - 1. Response maps of 49 type IV neurons in cat dorsal cochlear nucleus (DCN) were studied by moving a tone in small steps along the frequency dimension and along the intensity dimension. Type IV responses are recorded from DCN principal cells. Data were collected from 38 units with best frequencies (BFs) from 2.16 to 50.3 kHz with the use of electrode penetrations along the long (strial) axis of the DCN; an additional 11 units from a previous study were analyzed. A stereotypical type IV response map is defined as consisting of two excitatory and two inhibitory regions. Type IV units from both the pyramidal cell layer (probably pyramidal cells) and the deep layer (probably giant cells) show the same types of response maps. 2. Two of the regions, one excitatory and one inhibitory, are seen in all type IV units. These regions are a low-threshold excitatory region at best frequency (BFER) and an inhibitory area at higher levels, usually centered below BF but extending upward in frequency to include BF (central inhibitory area, or CIA). The high resolution of the response maps in this paper allows us to show that type IV units fall into two groups on the basis of whether their CIAs are narrow with well-defined borders (35 units) or broad with poorly defined borders (14 units). 3. Two additional features of type IV response maps can be defined, most consistently in units with well-defined CIAs. These features are an excitatory region along the high-frequency edge of the CIA (upper excitatory region, UER) and an upper inhibitory sideband (UIS). The BFER and UER are continuous in many units, but in some cases their continuity is broken by the CIA. It seems likely that the BFER and UER represent a single excitatory input to type IV units and are revealed because the tuning curve of the stronger inhibitory inputs that produce the CIA has thresholds greater than and BFs lower than the excitatory inputs. 4. The CIA is probably produced by inhibitory inputs from DCN type II neurons. The bandwidths of type IV CIAs are about 1-3 times larger (at 40 dB above threshold) than the excitatory bandwidths of DCN type II units, suggesting a convergence of the equivalent in tuning of about two type II units onto each type IV unit. The BF of the CIA is below the excitatory BF of the type IV unit in most cases.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1765806 TI - Position-specific adaptation in simple cell receptive fields of the cat striate cortex. AB - 1. Responses of simple cells in cat striate cortex were studied with flashed light-slit stimuli. The responses to bars flashed in different positions in the receptive field were assessed quantitatively before and after periods of prolonged stimulation of one small region. This type of prolonged stimulation resulted in reduced responsivity over a limited zone within the simple cell receptive field. 2. The adaptation-induced responsivity decrement was generally confined to the receptive-field subregion that was adapted (either ON or OFF). Prolonged stimulation within an ON region did not usually result in adaptation effects that spread into neighboring OFF regions. Furthermore, the adaptation induced response decrement did not necessarily spread throughout the subregion in which the adapting stimulus was presented. The adaptation effects from prolonged stimulation at a single receptive-field position spread throughout the subregion in nearly one-half of the 25 cells examined for position-specific adaptation. Another subpopulation of neurons (n = 12) displayed adaptation effects that spread through only one-half of the subregion, whereas in two neurons the spread of the adaptation effect was even more restricted and encompassed only one-fourth of the subregion. 3. The spread of adaptation was not systematically related to the size of the stimulus presented, the size of the receptive field, or the magnitude of the adaptation-induced response decrements but was significantly correlated with the spatial wavelength of the cell (the reciprocal of the cell's preferred spatial frequency) and with the size of the subregion in which the adapting stimulus was presented. Cells with large receptive-field subregions and long wave-lengths showed adaptation effects that spread further than those of cells with small subregions. 4. The adaptation effects from repeated stimulation at a single receptive-field position did not spread symmetrically across the receptive field, and the preferred direction of motion for a given cell indicated the direction of the asymmetric spread of the adaptation. Receptive-field positions that would be stimulated by a light slit originating at the point of adaptation and moving in the preferred direction (preferred side) showed greater adaptation-induced response decrements than did receptive-field positions that would be stimulated by a light slit moving in the opposite direction from the point of adaptation (nonpreferred side). There was significant enhancement of responses at some receptive-field positions on the nonpreferred side of the point of adaptation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1765807 TI - Synaptic plasticity in visual cortex: comparison of theory with experiment. AB - 1. The aim of this work was to assess whether a form of synaptic modification based on the theory of Bienenstock, Cooper, and Munro (BCM) can, with a fixed set of parameters, reproduce both the kinetics and equilibrium states of experience dependent modifications cortex. 2. According to the BCM theory, the connection strength of excitatory geniculocortical synapses varies as the product of a measure of input activity (d) and a function (phi) of the summed postsynaptic response. For all postsynaptic responses greater than spontaneous but less than a critical value called the "modification threshold" (theta), phi has a negative value. For all postsynaptic responses greater than theta, phi has a positive value. A novel feature of the BCM theory is that the value of theta is not fixed, but rather "slides" as a nonlinear function of the average postsynaptic response. 3. This theory permits precise specification of theoretical equivalents of experimental situations, allowing detailed, quantitative comparisons of theory with experiment. Such comparisons were carried out here in a series of computer simulations. 4. Simulations are performed by presenting input to a model cortical neuron, calculating the summed postsynaptic response, and then changing the synaptic weights according to the BCM theory. This process is repeated until the synaptic weights reach an equilibrium state. 5. Two types of geniculocortical input are simulated: "pattern" and "noise." Pattern input is assumed to correspond to the type of input that arises when a visual contour of a particular orientation is presented to the retina. This type of input is said to be "correlated" when the two sets of geniculocortical fibers relaying information from the two eyes convey the same patterns at the same time. Noise input is assumed to correspond to the type of input that arises in the absence of visual contours and, by definition, is uncorrelated. 6. By varying the types of input available to the two sets of geniculocortical synapses, we simulate the following types of visual experience: 1) normal binocular contour vision, 2) monocular deprivation, 3) reverse suture, 4) strabismus, 5) binocular deprivation, and 6) normal contour vision after a period of monocular deprivation. 7. The constraints placed on the set of parameters by each type of simulated visual environment, and the effects that such constraints have on the evolution of the synaptic weights, are investigated in detail.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1765808 TI - RSNA 90: highlights of neuroradiology. PMID- 1765809 TI - Value of 3D imaging for the study of craniofacial malformations in children. AB - Three-dimensional (3D) imaging was performed on 150 children with craniofacial malformations divided into three groups: craniostenosis, craniofacial dysraphism and labio-maxillo-palatine clefts arbitrarily included in a corpus of constitutional and acquired abnormalities. The authors believe that this technique is of interest not only for the management of these children, but also to understand the pathogenesis of their malformations. PMID- 1765810 TI - Radioanatomy of the laterosellar veins. Value of dynamic computerized tomography. AB - Dynamic computerized tomography is a simple and rapid technique which can provide an accurate mapping of the vascular elements of the cavernous sinus. It is not very different from the technique used to visualize the capillary bed of the pituitary gland and its progressive contrast enhancement. From a series of 780 dynamic CT explorations, we were able to individualize 5 groups of veins: (1) the veins of the lateral wall of the cavernous sinus; (2) the veins of the infero lateral group, located beneath the intracavernous segment of the internal carotid artery (ICA); (3) the vein of the carotid sulcus, located between the intracavernous ICA and the carotid sulcus; (4) the medial vein, situated between the intracavernous ICA and the pituitary gland, and (5) the pericarotid plexus. In some cases the anterior and inferior coronary sinuses and the basilar sinus can be visualized. PMID- 1765811 TI - Three-dimensional reconstruction in routine computerized tomography of the skull and spine. Experience based on 161 cases. AB - Three-dimensional (3D) reconstruction in routine computerized tomography (CT) presupposes that the referring clinicians are motivated, software programs are of good quality, a second working console is available and manipulations are made by experienced persons. Maxillofacial surgery is the main, conventional indication, but the method is also used to plan the surgical treatment of craniofacial malformations and that of injuries and tumours. 3D reconstruction cannot replace a thorough analysis of the acquisition sections since its spatial definition is not as good as theirs. Without competing with pure research-work, a number of applications remain in the realm of speculative imaging, but it cannot be denied that 3D reconstruction has an interesting potential for teaching. PMID- 1765812 TI - Imaging of chordomas of the mobile spine. AB - In this retrospective study twelve histologically confirmed cases of spinal chordoma have been reviewed. Plain radiographs were performed in all cases, and CT scans in 11 patients. Four patients had post-myelography CT. Five patients were explored by MRI, and two had a post-DOTA-gadolinium MR study. Ten patients underwent spinal arteriography. Cervical spine chordomas (3 cases) were osteolytic, developed laterally to the vertebral body and involved one of more adjacent vertebrae. Thoracic and lumbar chordomas (9 cases) were usually centrally located in the vertebral body with no adjacent involvement and presented as osteo-sclerotic or mixed osteolytic-osteosclerotic lesions. CT scans provide a good view of the extravertebral component of the tumour, but MRI is the best imaging method to evaluate tumoral extension. Intravenous gadolinium injection seems to produce a better delineation of the epidural extent of the tumour at cervical level. Angiography remains useful for presurgical evaluation. PMID- 1765813 TI - Aneurysm of the azygos pericallosal artery. One case. AB - The Authors describe a case of aneurysmal rupture of the azygos pericallosal artery, a variant of the anterior cerebral artery. The association between aneurysm and this anatomical anomaly is of interest because of its rarity and clinical-therapeutic implications. PMID- 1765814 TI - Edward Smith (1819-1874). PMID- 1765815 TI - Dietary taurine content changes liver lipids in cats. AB - Adult female cats were fed a completely defined purified diet (taurine-free) alone or containing 0.05% taurine (the normal dietary requirement) or 1% taurine (20-fold the normal dietary requirement) for greater than 2 y. The relative composition of conjugated biliary bile acids was not different among the three groups and virtually all bile acids were conjugated with taurine. The taurine concentration in liver varied dramatically with the amount of taurine in the diet. Total liver lipid content decreased with increasing dietary taurine. Individual lipid components also varied, especially free fatty acids (which decreased with increasing dietary taurine) and triglycerides (which increased with increasing dietary taurine), indicating that taurine has a metabolic effect on lipid metabolism. Taurine deficiency also caused significant changes in the fatty acid distribution of sphingomyelin. In particular, a decrease of lignoceric acid and an increase of nervonic acid were observed. The present data suggest that hepatocellular levels of taurine can modulate the mobilization of liver lipid stores and the utilization by the liver of circulating free fatty acids. These effects are probably mediated by factors affecting membrane fluidity, such as the ratio of cholesterol to phospholipids, the degree of unsaturation of phospholipids and the changes in sphingomyelin fatty acid composition. PMID- 1765816 TI - Hepatic cholesterol and fatty acid synthesis in pregnant and fetal rats: effect of maternal dietary fat and cholestyramine. AB - Previous studies from this laboratory have demonstrated that 20% rather than 5% (wt/wt) safflower oil or addition of 5% (wt/wt) cholestyramine to the diet of pregnant rats leads to an increase in the activity of 3-hydroxy-3-methylglutaryl CoA reductase, the rate-limiting enzyme of cholesterol synthesis, in the fetal liver. Total cholesterol, however, was not altered in fetal plasma or liver. The effect of these diets on cholesterol and fatty acid synthesis in vivo was therefore studied in fetal and maternal liver. In fetuses of rats fed a reference nonpurified diet, rates of hepatic cholesterol and fatty acid synthesis decreased from gestation d 20 to 21. In contrast, total and active 3-hydroxy-3-methyl glutaryl CoA reductase activity increased. Adding cholestyramine to the diet or modifying the quantity of safflower oil fed had no effect on fetal hepatic lipogenesis. Maternal hepatic cholesterol synthesis was greater in rats fed cholestyramine, whereas fatty acid synthesis was lower in the dams fed the diet containing 20% compared with 5% safflower oil. The results suggest near-term fetal liver 3-hydroxy-3-methylglutaryl CoA reductase activities do not reflect fetal cholesterol synthesis in vivo. PMID- 1765817 TI - Response of (n-3) and (n-6) fatty acids in piglet brain, liver and plasma to increasing, but low, fish oil supplementation of formula. AB - Addition of fish oils to infant formula provides (n-3) long-chain polyenoic fatty acids (LCP), specifically 22:6(n-3), to infants fed formula rather than human milk. Most fish oils, however, contain high levels of 20:5(n-3) and low (n-6) LCP. These studies determined the brain total, synaptic plasma membrane phosphatidylethanolamine and phosphatidylcholine, and plasma and liver phospholipid fatty acids of piglets fed from birth to 15 d with formula containing (percent fatty acids) 34% 18:2(n-6), 0.8% 18:3(n-3) and 0, 2 or 6 g/L menhaden oil, or sow milk. The brain 22:6(n-3) was higher and 22:4(n-6) lower in piglets fed 6 g/L menhaden oil compared with sow milk. Brain levels of 20:5(n-3) did not increase, or levels of 20:4(n-6) decrease, with increasing dietary (n-3) LCP. A diet concentration-dependent increase in 20:5(n-3) and decrease in 20:4(n 6) (P less than 0.0001) in liver phospholipid showed no evidence of maximum saturation or depletion, respectively, over the range of (n-3) LCP intake studied. The fish oil supplementation was effective in supplying 22:6(n-3) to the developing brain. The accompanying increase in 20:5(n-3) and decrease in 20:4(n 6), important eicosanoid precursors, in plasma and liver phospholipid show the need for caution in the use of fish oils low in (n-6) LCP as a source of (n-3) LCP for infant formula. PMID- 1765818 TI - Dietary essential fatty acids change the fatty acid profile of rat neural mitochondria over time. AB - This experiment examined the time course over which the amount of dietary essential fatty acids (EFA) affects brain mitochondrial fatty acids. Weanling rats were fed 20% (wt/wt) fat diets that contained either 4 or 15% (wt/wt of diet) EFA for 1, 2, 3 or 6 wk or a 10% EFA diet for 3 or 6 wk. The EFA ratio [18:2(n-6)/18:3(n-3)] of all diets was approximately 30. Fatty acid analysis of brain mitochondrial phosphatidylethanolamine, phosphatidylcholine and cardiolipin revealed that the largest dietary effect was on 18:2(n-6), which was 30% higher in rats fed the 15 vs. 4% EFA diets after 1 wk. This difference increased to twofold by 3 wk and was still twofold after 6 wk. These results demonstrate several facts: 1) the response of 18:2(n-6) in cardiolipin to dietary EFA is very fast and large, relative to changes in other quantitatively major fatty acids observed in weanling rats; 2) the 18:2(n-6) level in neural cardiolipin stabilizes after 3 wk of feeding at a level dependent upon the amount of dietary EFA; and 3) at least one neural fatty acid, 18:2(n-6), is very sensitive to amounts of dietary EFA that are well above the animal's EFA requirement. PMID- 1765819 TI - Differential effects of fish oil, safflower oil and palm oil on fatty acid oxidation and glycerolipid synthesis in rat liver. AB - Studies were conducted to explore the mechanisms by which dietary fish oil decreases hepatic triglyceride secretion. Forty-five rats (15/group) were fed purified diets containing 10% fat as either fish oil, safflower oil or palm oil for 10 d. Plasma triglyceride concentration was lowest in the fish oil-fed group followed by the groups fed safflower oil and palm oil. The liver's capacity to oxidize fatty acids was assessed by assays of mitochondrial and peroxisomal beta oxidation pathways in whole homogenates. Additionally, key enzymatic activities in the biosynthesis of triglyceride (diacylglycerol acyltransferase, phosphatidate hydrolysis) and phosphatidylcholine (CTP:phosphocholine cytidylyltransferase) were assayed. Compared with those fed palm oil the fish oil fed animals showed 25% greater mitochondrial beta-oxidation but this difference was not statistically significant (P = 0.1). Fish oil feeding led to 45% greater (P less than 0.05) peroxisomal beta-oxidation. Diacylglycerol acyltransferase activity was unaffected by the type of dietary fat and slightly (13%) but significantly (P less than 0.02) lower cytidylyltransferase activity due to fish oil feeding was observed. More strikingly, both fish oil and safflower oil diets significantly lowered phosphatidate hydrolysis by 37 and 22%, respectively, compared with the palm oil diet. This activity directly correlated (r = 0.68; P less than 0.001) with plasma triglyceride concentration. Thus, dietary fish oil might suppress triglyceride secretion by decreasing glycerolipid synthesis, an effect mediated by changes in one or more enzymes involved in phosphatidate catabolism. PMID- 1765820 TI - Changes in colonic antioxidant status in rats during long-term feeding of different high fat diets. AB - The effects of dietary fat on antioxidant mechanisms in colon mucosa were examined using male Sprague-Dawley rats. Animals were fed one of four AIN-76A based test diets differing in amount and type of fat. The basal diet (BD) contained 5% corn oil; the menhaden oil diet (MO) contained 1% corn oil and 19% menhaden oil; the corn oil diet (CO) contained 20% corn oil; and the beef tallow diet (BT) contained 1% corn oil and 19% beef tallow; all were adjusted to provide equal amounts of other nutrients per kilojoule. Homogenates of colon mucosa were assayed after 2 wk and 1, 3, 6 and 9 mo for activities of catalase (CAT), glutathione peroxidase (GSHPx), superoxide dismutase (SOD), glutathione-S transferase, glutathione reductase (GSSGRx), and total glutathione (GSH) content. Activity of GSHPx was depressed in rats fed high fat diets compared with rats fed the low fat BD. Animals fed the BD and MO diets had higher levels of CAT and GSSGRx as compared with rats fed the CO and BT diets. Activities of SOD, GSSGRx and GSHPx, as well as GSH concentration, decreased over time. Ornithine decarboxylase activity was not induced by the high fat diets. Thiobarbituric acid reacting substances were virtually undetectable. Thus, both type and amount of fat affected antioxidant mechanisms in colon mucosa without producing overt oxidative damage in the tissue. PMID- 1765821 TI - Composition of nitrogen-containing fractions in digesta from the distal ileum of pigs fed a protein-free diet. AB - The levels of free, peptide-bound and protein-bound amino acid nitrogen in endogenous N at the distal ileum of the pig were determined when the digestion of protein after sample collection was minimized. Six 14-kg pigs were fed a protein free diet and samples of digesta from the distal ileum were collected. The digesta were centrifuged and the supernatant ultrafiltered. On average, 86% of the total N in the digesta was found in the precipitate + retentate (greater than 10,000 mol. wt.) fraction, and in this fraction 78% of the total N was protein N. Of the total N in the ultrafiltrate (less than 10,000 mol. wt) the majority (69%) was peptide N. Amino N (free amino acid plus peptide) in the ultrafiltrate was 11% of the total N in the whole ileal digesta. Non-amino N (urea N + ammonium N + creatinine N) was only 0.73% of the total N in the whole ileal digesta. The mean amounts of nitrogen from individual amino acids (free + peptide) in the ultrafiltrate (expressed as percentages of the total nitrogen for the respective amino acid in whole ileal digesta) were low, ranging from 3.0% for isoleucine to 16.6% for proline. The finding that free amino acid N + peptide N is a small fraction of total N in endogenous ileal digesta supports the use of a new method for determining endogenous loss, whereby the animal is fed hydrolyzed casein and the ileal digesta are ultrafiltered. The high-molecular-weight fraction provides a measure of endogenous nitrogen loss. PMID- 1765822 TI - Relationship between protein intake and hepatic protein synthesis in rats. AB - Protein synthesis has been measured in vitro in postmitochondrial extracts from livers of rats fed levels of casein ranging from 0 to 40% by weight. The maximal capacity for protein synthesis per milligram of RNA, measured with each amino acid added at 250 mumol/L, was 40-60% higher in rats fed a protein-free diet than in those fed 6 or 15% casein. Our results suggest that the livers of rats fed a protein-free diet are primed for the synthesis of tissue proteins and, given an adequate supply of amino acids, the rate of protein synthesis would be as high as or higher than the rate in protein-replete animals. When amino acids were added to the in vitro system at concentrations found in plasma of rats fed 0, 6, 15 or 40% casein the rate of protein synthesis increased by three- to fourfold over this range, with the highest rate observed for the 15% dietary casein level. We conclude that when protein intake is below the requirement level, the rate of liver protein synthesis may be limited by amino acid supply, by the capacity of the system for protein synthesis or by both. PMID- 1765823 TI - Arginine-deficient diets alter plasma and tissue amino acids in young and aged rats. AB - Blood and urine metabolites were measured in two experiments for young (2-mo-old) and aged (20-mo-old) male Sprague-Dawley rats fed arginine-devoid diets made isonitrogenous to a control 1.12% arginine diet by adding alanine or glycine. Diet, fed for 7 or 13 d, had little effect on urinary or plasma ammonia and urea. Urinary orotate excretion was more than 40-fold higher in rats fed the arginine deficient diets (P less than 0.01) in both experiments. Source of nonessential N (alanine or glycine) in the arginine-deficient diets did not alter orotic acid excretion or plasma or urine ammonia or urea. Changes in plasma arginine, alanine and glycine concentrations reflected the levels of these amino acids in the diet. Tissue ornithine levels reflected dietary arginine level, but tissue citrulline was unaffected by dietary arginine. Glutamate and glutamine were greater in the plasma and liver of rats fed arginine-deficient diets. Plasma concentrations of glutamate and glutamine were positively correlated with urinary orotic acid excretion (P less than 0.05) and ornithine and arginine were negatively correlated with orotic acid excretion (P less than 0.01). Increased tissue glutamine may be related to the greater orotate excretion in rats fed arginine devoid diets. The metabolic responses to dietary arginine deficiency were similar in young and aged rats. In general, concentrations of amino acids in plasma, liver and spleen were higher in aged rats. PMID- 1765824 TI - Carbohydrate utilization by white sturgeon as assessed by oral administration tests. AB - Oral carbohydrate administration tests were used to gain more insight into the ability of white sturgeon (Acipenser transmontanus) to utilize different carbohydrates. Nine carbohydrates in gelatin capsules were administered orally after the sturgeon were fasted for 48 h. Blood was sampled at selected time intervals from 2 to 72 h thereafter. Maximum plasma glucose concentration in the glucose-fed sturgeon was significantly higher (P less than 0.05) than in the maltose-fed sturgeon, which in turn was higher than in sturgeon fed the other carbohydrates. Maximum plasma glucose concentrations in the sturgeon fed fructose, galactose, sucrose, lactose, dextrin, raw cornstarch or cellulose were not significantly different. New findings in this study include the following: 1) plasma glucose concentrations in the glucose- or maltose-fed sturgeon were higher than the other animals under similar conditions; 2) the pattern of plasma galactose and glucose concentrations was similar in sturgeon after they were fed galactose and glucose, respectively, except that the maximum plasma galactose concentration was observed 8 h later than the maximum plasma glucose concentration; and 3) a small amount of the same disaccharide was detected in the plasma of sturgeon 4 to 20 h after they were fed the disaccharides. PMID- 1765825 TI - 4'-galactooligosaccharide affects sodium and potassium metabolism in rats. AB - The effect of different levels (0, 10 and 20%) of O-beta-D-galactopyranosyl-(1-4) O-beta-D-galactopyranosyl-(1-4)-D- glucose (4'-GL) on the bioavailability of sodium and potassium was studied in 18 male rats. Three 3-d metabolic balance studies were conducted during the 62-d feeding trial. These were between d 30 and 32 (first period), 45 and 47 (second period) and 60 and 62 (third period). Growth and food intake were not significantly different (P less than 0.05) between the control group and the 4'-GL-fed groups. In rats fed 10 and 20% 4'-GL diet, the fecal sodium excretion was significantly greater (P less than 0.05) in all three balance periods. Fecal potassium excretion was significantly greater (P less than 0.05) in the 10% 4'-GL-fed group in the second balance period and the 20% 4'-GL fed group in all balance periods relative to the control group. Although not statistically significant, rats in the 4'-GL-fed groups exhibited a tendency for lower sodium retention and higher potassium retention compared with the control group. The cecal weight of rats in both 4'-GL-fed groups was significantly heavier (P less than 0.05) than that of the control group at the end of study. Sodium concentration in the cecum was significantly lower (P less than 0.05) in the 20% 4'-GL-fed group relative to the other groups. PMID- 1765826 TI - Concentrations of selected carotenoids and vitamin A in human liver, kidney and lung tissue. AB - Concentrations of preformed vitamin A and five individual carotenoids (alpha carotene, beta-carotene, cryptoxanthin, lutein and lycopene) were determined in liver, kidney and lung tissue from 20 autopsies of subjects ranging in age from 4 mo to 86 y. Total carotenoid concentrations in liver tissue were always greater than in kidney or lung tissue within the same patient. Total carotenoid concentration in adult subjects was 2.5-77.1 nmol/g tissue (mean 21.0 nmol/g tissue) in liver tissue (n = 14), 0.2-12.7 nmol/g tissue (mean 3.1 nmol/g tissue) in kidney tissue (n = 13) and 0.1-8.4 nmol/g tissue (mean 1.9 nmol/g tissue) in lung tissue (n = 13). Carotenoid content in tissue samples from two infants was low, ranging from 0 to 1.0 nmol/g tissue. beta-Carotene and lycopene were almost always the predominant carotenoids found in liver, kidney and lung tissue. beta Carotene was positively correlated (P less than 0.05) with alpha-carotene, lycopene and total carotenoids in all of the tissues examined. In addition, beta carotene and total carotenoids from liver tissue were positively correlated with the same carotenoids in both kidney and lung tissue within each patient. Total vitamin A (free plus esterified) concentration was 8.7-1102.2 nmol/g tissue in liver (n = 17), 3.5-343.9 nmol/g tissue in kidney (n = 14) and 0.7-404.6 nmol/g tissue in lung (n = 14). Vitamin A concentrations were significantly correlated with both beta-carotene and total provitamin A carotenoid concentrations in liver tissue, but not in kidney or lung tissue. PMID- 1765827 TI - L-ascorbyl-2-monophosphate has equal antiscorbutic activity as L-ascorbic acid but L-ascorbyl-2-sulfate is inferior to L-ascorbic acid for channel catfish. AB - Channel catfish (Ictalurus punctatus) fingerlings (13 g average initial weight) were fed semipurified diets supplemented with 0, 0.06, 0.12, 0.24 and 0.72 mmol/kg (0, 11, 22, 44 or 132 mg/kg) of ascorbic acid molar equivalent supplied by either L-ascorbic acid, L-ascorbyl-2-monophosphate (Mg salt) (AAP), or L ascorbyl-2-sulfate (K salt) (AAS). After 14 wk, weight gains were equal for all fish fed diets containing L-ascorbic acid or AAP; however, growth rates were less for fish fed AAS at all dietary levels and for fish fed the ascorbic acid-free diet (control). There were no gross signs of vitamin C deficiency in any of the fish fed L-ascorbic acid or AAP, whereas spinal deformities were found in the controls and in fish fed all but the highest concentration of AAS. The percentage of spinal deformities decreased as dietary levels of AAS increased. Reduced bone collagen content and histopathology in liver and gill tissues also indicated ascorbic acid deficiency in the controls and in fish fed all but the highest concentration of AAS. Limited histopathology was found in fish fed the lowest level of L-ascorbic acid but not in those fed the lowest level of AAP. Regression analysis of weight gain data showed that the vitamin activity of ascorbic acid from AAS was only 5.2% of that from L-ascorbic acid for growth. This study indicates that AAP has equimolar activity to L-ascorbic acid as a vitamin C source for channel catfish and that AAS has vitamin activity for this species but at a much lower level than the other compounds. PMID- 1765828 TI - Insensitivity of the tryptophan-load test to marginal vitamin B-6 intake in rats. AB - The tryptophan-load test for vitamin B-6 nutritional status was administered to adult female Long-Evans rats fed graded levels of pyridoxine hydrochloride (PN.HCl) in two experiments, and its sensitivity to marginal vitamin B-6 intake was evaluated. In Experiment 1, rats were 4-h meal-fed an AIN-76A (20% casein) diet devoid of PN.HCl for 3 wk, then repleted (n = 12) for 6 wk with 4-h pair-fed meals of either 0.25, 0.5, 1.0 or 7.0 (control) mg PN.HCl/kg diet. In Experiment 2, rats (n = 16) were pair-fed for 10 wk either 0.0, 0.5, 1.0 or 7.0 (control) mg PN.HCl/kg diet, with 24-h access to food. Vitamin B-6 nutritional status was assessed at the end of each experiment. Except in rats fed 0 mg PN.HCl/kg diet, mean body weights were not significantly different among diet groups of either experiment. Plasma pyridoxal phosphate (PLP), pyridoxal and total vitamin B-6 concentrations, determined by HPLC, were very sensitive to gradations in dietary PN.HCl concentrations (P less than 0.05). Red blood cell endogenous and PLP stimulated alanine and aspartate aminotransferase activity did not statistically differentiate all levels of dietary vitamin B-6, although the calculated activity coefficient for each enzyme (stimulated/endogenous activity) did. Urinary xanthurenic acid excretion following a tryptophan load [24.5 mumol (5 mg) L tryptophan/100 g body weight, injected intraperitoneally] was significantly (P less than 0.05) elevated compared with controls only in the group fed 0 mg PN/HCl/kg diet. At the tryptophan dose used here, the tryptophan-load test was not useful in detecting marginal vitamin B-6 intake in rats. PMID- 1765829 TI - Dietary phosphate deprivation increases renal synthesis and decreases renal catabolism of 1,25-dihydroxycholecalciferol in guinea pigs. AB - In guinea pigs, dietary phosphate deprivation decreases plasma phosphate concentration, increases plasma 1.25-dihydroxycholecalciferol [1,25-(OH)2D3] concentration and causes hypercalcemia concurrent with the maximal increase in plasma 1,25-(OH)2D3 levels. Our objective was to determine whether increased synthesis or decreased catabolism contributed to the elevation in plasma 1,25 (OH)2D3. Preliminary experiments using renal mitochondria from guinea pigs fed a control diet revealed that 23,25-dihydroxycholecalciferol [23,25-(OH)2D3], not 24,25-dihydroxycholecalciferol [24,25-(OH)2D3], was the reciprocal side-chain metabolite to 1,25-(OH)2D3 in this species. An assay employing guinea pig renal mitochondria was used to measure the renal synthesis of 1,25-(OH)2D3 and 23,25 (OH)2D3 from [3H]25-OH-D3. These metabolites were unequivocally identified by combinations of HPLC, ultraviolet spectrophotometry and mass spectrometry. This renal mitochondrial assay was subsequently used to investigate the effect of dietary phosphate deprivation on guinea pig vitamin D metabolism. Within 1 wk the rate of synthesis of 1,25-(OH)2D3 was maximal in phosphate-deprived guinea pigs. This rate was significantly (P less than 0.005) higher than that achieved in same day control guinea pigs. Conversely, within 1 d the synthesis of 23,25-(OH)2D3 was significantly (P less than 0.005) decreased in phosphate-deprived guinea pigs. Similarly, the rate of 1,25-(OH)2D3 metabolism was decreased within 1 d of dietary phosphate deprivation and was at a minimum within 1 wk. This rate was significantly (P less than 0.005) less than that attained in same-day control guinea pigs. These results suggest that both increased synthesis and decreased metabolism of 1,25-(OH)2D3 contribute to the plasma 1,25-(OH)2D3 elevation that occurs in response to dietary phosphate deprivation. PMID- 1765830 TI - Biological activity of racemic folate mixtures fed to folate-depleted rats. AB - Most commercially available tretrahydro and substituted folates are racemic mixtures of R and S isomers about pteridine-carbon 6. Some reports show the unnatural stereoisomers modify specific aspects of folate metabolism, whereas others show no significantly different biologic effects between isomers. The extent to which unnatural folate stereoisomers are inert in vivo is unclear. Possible interactions between isomers at normal dietary folate intakes were tested by comparing growth, liver and serum folate concentrations, and congener patterns of folate-depleted rats fed amino acid-based diets with 283, 566 or 1132 nmol folic acid (standards), or 566 nmol racemic 5-methyltetrahydrofolate, 5 formyltetrahydrofolate or 5,10-diformyltetrahydrofolate/kg diet for 3 wk. Growth and tissue folate levels increased with each increment in dietary folic acid. Growth and liver and serum folate concentrations of rats fed 566 nmol 5 formyltetrahydrofolate or 5-methyltetrahydrofolate/kg diet were similar to those of rats fed 283 nmol folic acid/kg diet. Rats fed 5,10-diformyltetrahydrofolate lost weight and had depressed serum folate levels, and most died. Results show that biologic activity of racemic 5-formyltetrahydrofolate and 5 methyltetrahydrofolate was half that of folic acid, and the R isomer did not affect growth at the levels fed. Addition of a second formyl group destroyed folate bioactivity. The folate-depleted rat model is useful for testing biologic effects of individual folate stereoisomers in vivo as they become commercially available. PMID- 1765831 TI - Canthaxanthin and excess vitamin A alter alpha-tocopherol, carotenoid and iron status in adult rats. AB - beta-Carotene and excess vitamin A have been shown to reduce plasma alpha tocopherol when fed to young rats. The present study assessed the effects of beta carotene, excess vitamin A and canthaxanthin (4,4'-diketo-beta-carotene) on carotenoid, alpha-tocopherol and iron status in adult retired breeder rats. Male 8- to 10-mo-old rats (10/group) were fed varying levels of vitamin A as retinyl palmitate, beta-carotene and canthaxanthin ad libitum for 8 wk. The AIN-76A diet was modified to contain 16% (wt/wt) fat and 50% carbohydrate (control) plus beta carotene or canthaxanthin at 0, 0.048 (BC1 or CX1) and 0.2% (BC2 or CX2) of the diet. These compounds were fed with and without excess retinyl palmitate (RP, 220 mg/kg). Higher relative liver weights were observed in CX- and RP-fed groups. Plasma retinyl esters were detected in all RP-fed groups. Plasma retinyl palmitate was 1.6- and 1.5-fold higher in RP-BC and RP-CX groups, respectively, than in the RP groups. Plasma and liver beta-carotene and canthaxanthin were 11 54% and 26-74% lower, respectively, with excess retinyl palmitate feeding. Feeding canthaxanthin and retinyl palmitate but not beta-carotene, resulted in lower levels of plasma alpha-tocopherol. Liver non-heme iron levels were also lower in CX-fed rats irrespective of retinyl palmitate feeding. These results extend to adult rats previous findings that excess retinyl palmitate alters vitamin E and carotenoid status prior to the manifestation of clinical signs of hypervitaminosis A. Additionally, canthaxanthin feeding lowers alpha-tocopherol and iron status in adult rats. PMID- 1765832 TI - Nutrient balance and stage of lactation affect responses of insulin, insulin-like growth factors I and II, and insulin-like growth factor-binding protein 2 to somatotropin administration in dairy cows. AB - Six Holstein cows were used in a complete block design to examine effects of period of lactation and somatotropin (bST) administration on concentrations of insulin, insulin-like growth factors (IGF-I, IGF-II), and IGF-binding protein 2 (IGFBP-2). During late lactation, the dry period and the subsequent early lactation, cows received injections of NaHCO3 buffer for 5 d and bST for 7 d. Cows were in positive energy and protein balances during late lactation and the dry period and in slight negative balances during early lactation. Basal insulin concentrations were highest in late lactation (170 pmol/L), whereas bST concentrations were higher in early lactation (0.6 micrograms/L). Insulin was increased by bST in the dry period (255 pmol/L) and late lactation (149 pmol/L) but not in early lactation (14 pmol/L), probably because of greater availability of glucose during positive nutrient balance. Basal IGF-I was lowest in early lactation (63.6 micrograms/L) but was increased by bST during all periods. The IGF-I response to bST administration was lower during early lactation (74.1 micrograms/L) compared with late lactation (123.6 micrograms/L) and dry period (146.0 micrograms/L). The IGF-II concentrations were not affected by period of lactation of bST administration but IGF-II tended to be higher during bST administration when cows were dry. Concentration of IGFBP-2 was higher during early lactation when cows were in negative nutrient balance (479.5 micrograms/L) than during the dry period (289.2 micrograms/L) and was decreased with bST. These data support a role of insulin and IGF in regulation of milk production. Availability of nutrients may be involved in regulating these hormones, particularly during bST treatment. PMID- 1765833 TI - Leucine and its catabolites alter mitogen-stimulated DNA synthesis by bovine lymphocytes. AB - This study determined effects of leucine and its catabolites on in vitro, mitogen stimulated DNA synthesis by bovine lymphocytes. Cultures grown in leucine-free or leucine-replete (0.4 mmol/L leucine) medium were supplemented with 0-10.0 mmol/L leucine or individual catabolites. Leucine at greater than or equal to 0.08 mmol/L was necessary for normal DNA synthesis by mitogen-stimulated bovine lymphocytes. beta-Hydroxy-beta-methylbutyrate (HMB) and beta-hydroxy-beta methylglutarate (HMG) had minimal effect on unresponsiveness of mitogen stimulated bovine lymphocytes in leucine-free medium; however, alpha ketoisocaproate (KIC) at 0.4 and 2.0 mmol/L partially or completely restored DNA synthesis. In leucine-replete medium, 0.016-0.4 mmol/L KIC and 0.016-2.0 mmol/L HMB and HMG did not affect DNA synthesis. At 2.0 and 10.0 mmol/L, KIC inhibited (P less than 0.01) DNA synthesis, whereas HMB and HMG at 10.0 mmol/L enhanced (P less than 0.01) DNA synthesis. Overall, these results suggest that leucine is necessary for mitogen-induced DNA synthesis by bovine lymphocytes, and that this requirement for leucine can be partially met by KIC. When leucine was not limiting, KIC, HMB and HMG at concentrations that might occur in vivo did not alter lymphocyte DNA synthesis in vitro. PMID- 1765834 TI - Effect of soy products on methotrexate toxicity in rats. AB - Several experiments were conducted to determine the effect of various soy products on methotrexate (MTX) toxicity. Products tested included soybean meal, soybean concentrate, soybean isolate and soybean fiber, which were provided as replacements for casein or cornstarch in a semipurified diet. Soybean meal and soybean concentrate offered the greatest protection, completely alleviating MTX induced anorexia and diarrhea when included as the sole protein source and fed 14 d prior to and 7 d following intraperitoneal MTX injection at 20 mg/kg body weight. Positive responses also were observed with soybean isolate and soybean fiber. Histological examination of the small intestine of MTX-injected animals revealed that soybean concentrate and soybean isolate prevented the necrosis observed in animals fed the casein-based semipurified diet. Methotrexate levels in plasma were similar for animals fed semipurified diets in which protein was supplied by casein, soybean concentrate or soybean isolate. Thus, altered plasma MTX levels did not explain the differences among protein sources in ameliorating MTX-induced anorexia and gut toxicity. White blood cell counts were depressed by MTX in animals fed all diets. PMID- 1765835 TI - Dietary soybean isolate and methionine supplementation affect mammary tumor progression in rats. AB - The effect of feeding soybean protein isolate (SBP) diet or soybean protein isolate diet supplemented with 0.7% DL-methionine (SBP + Met) on mammary tumor progression was investigated. Sprague-Dawley female rats were fed from weaning a 20% casein (CAS) diet supplemented with 0.3% DL-methionine (AIN-76) and injected via jugular vein with N-nitrosomethylurea (NMU, 40 mg/kg body weight) at 7 wk of age. Five weeks after NMU treatment, animals were divided into the three isoenergetic, isoprotein diet groups: CAS (25 rats); SBP (26 rats) and SBP + Met (25 rats). First palpable mammary tumors were evident 8, 9 and 13 wk and the mean latency period was 13.30 +/- 1.23, 16.70 +/- 1.32 and 17.82 +/- 1.28 wk after NMU treatment in the CAS, SBP + Met and SBP diet groups, respectively. Tumor incidence was 80% in the CAS group compared with 42.3% in the SBP group (P = 0.01). Methionine supplementation increased tumor incidence to 64%. Total number and total weight of tumors was greater in the CAS group compared with either SBP + Met or SBP groups: 41 vs. 28 or 21 tumors and 97.28 g vs. 27.87 or 32.46 g, respectively. These data indicate that SBP diet, low in methionine content, fed 5 wk after carcinogen exposure significantly repressed mammary tumor progression. Methionine supplementation increased the number of animals with tumors but not the mean tumor weight. PMID- 1765836 TI - Calcium bioavailability from calcium fortified food products. AB - The calcium balance of 12 presumed healthy human young adult subjects was assessed. Subjects consumed a constant laboratory-controlled diet supplemented with one of four calcium-fortified food products: orange juice (OJ), milk (M), experimental pasteurized processed cheese (T), soda (S), or a calcium carbonate plus vitamin D tablet (CC). Study length was 6 weeks with seven-day experimental periods (2-days allowed for adjustment with 5-days combined for purposes of analysis). All urine and fecal samples were collected by the subjects for the duration of the study. Blood samples were drawn at the end of each experimental period. Urine and fecal calcium contents were determined. Blood samples were analyzed for alkaline phosphatase. Results of this study indicate a higher fecal calcium content (mg/day) when subjects consumed CC and T, and when subjects consumed self-selected diets, than when given S, M, or OJ. Urinary calcium excretion was significantly lower when subjects consumed OJ than when they consumed M, T, or their self-selected diets. A significantly larger positive calcium balance was demonstrated when subjects consumed OJ as compared to T. Fecal transmit time did not vary significantly. Serum alkaline phosphatase was significantly lower when subjects consumed T than when they consumed self selected diets. PMID- 1765837 TI - Minimization of cytogenetic toxicity of malathion by vitamin C. AB - Genotoxic effect of agriculture-used concentration of organophosphorous pesticide, Malathion, is decreased by the dietary concentration of sodium salt of L-ascorbic acid for parameters like mitotic-index and clastogeny in onion root tip cells, clastogeny and meiotic-index in mice, and lethal mutation rate in Drosophila melanogaster. The vitamin itself is not genotoxic, and its concurrent administration is more effective than pretreatment with it. Possible mechanism of such vitamin C-mediated minimization of pesticide-genotoxicity is discussed. PMID- 1765838 TI - Absorption and metabolism of pyridoxamine in mice. I. Pyridoxal as the only form of transport in blood. AB - [3H]Pyridoxamine was orally administered to mice in physiological amounts, and the distribution of isotope between the six recognized forms of vitamin B6 and pyridoxic acid was determined at different times in the intestine, liver, blood, and brain. After 7 min about 50% of the radioactivity in pyridoxamine had been absorbed by the intestine and transported to the blood and other organs. Labeled pyridoxal phosphate was found in the intestine and liver. Labeled pyridoxamine could not be detected in the peripheral blood, but substantial amounts of labeled pyridoxal and pyridoxal phosphate were found in the blood. However, when a large amount (40-140 nmol) was given, a significant amount of labeled pyridoxamine was found in the blood, together with labeled pyridoxal and pyridoxal phosphate. These results suggest that the intestine and/or liver play a major role in completely converting physiological amounts of pyridoxamine to circulating pyridoxal, which is then taken up and phosphorylated by other organs. PMID- 1765839 TI - Effect of vitamin B6 deficiency on glycogen metabolism in the skeletal muscle, heart, and liver of rats. AB - The effect of vitamin B6 deficiency was studied on glycogen metabolism in the gastrocnemius muscle, heart, and liver of rats. The glycogen phosphorylase activities in the gastrocnemius muscle and heart but not in the liver of vitamin B6-deficient rats were significantly decreased. The decrease in the enzyme activity in the gastrocnemius muscle was due to decrease in the amount of enzyme. The glycogen content of the muscle of vitamin B6-deficient rats was higher than that of the controls, but the glycogen content of the liver was similar in the two groups. These data suggest that glycogen degradation was impaired in the muscle but not the liver of vitamin B6-deficient rats. PMID- 1765840 TI - Synergistic action of vitamin E and vitamin C in vivo using a new mutant of Wistar-strain rats, ODS, unable to synthesize vitamin C. AB - It is well known that vitamins E and C exhibit synergistic action in in vitro systems, but with regard to in vivo systems, much of the available data are confusing. To elucidate this problem we used a new mutant of Wistar-strain rats that cannot synthesize vitamin C, namely, ODS rats. Two experiments were planned: (1) during development of vitamin E deficiency, whether vitamin C could spare the consumption of vitamin E; and (2) under conditions of a regular level of vitamin E intake, whether different dose levels of vitamin C can affect vitamin E concentration in tissues. The results obtained show that with vitamin C intake, higher levels of vitamin E were deposited in tissues in both experiments. With the development of vitamin E deficiency, rats in the group with a higher dose of vitamin C deposited higher concentrations of alpha-tocopherol. With simultaneous administration of vitamin E and vitamin C to the same mutant rats, the rats in the group with a higher dose of vitamin C deposited higher levels of vitamin E in all tissues tested. Thus, we concluded that vitamin C can spare the consumption of vitamin E in vivo as well as in vitro. PMID- 1765841 TI - The regulatory effect of ascorbate on the carnitine synthesis in primary cultured guinea pig hepatocytes. AB - The effect of ascorbate (AsA) on the synthesis of carnitine from gamma butyrobetaine (BB) in primary cultured guinea pig hepatocytes was investigated. The hepatocyte monolayers preloaded with AsA were incubated for 4 h in medium with various concentrations of BB as the precursor of carnitine. The accumulation of carnitine reached a maximum when the cells were incubated with 0.05-1.0 mM BB and significantly decreased with excess BB (5 mM). In contrast, increasing concentrations of AsA supplemented to medium led to an increase in carnitine content, but AsA and total AsA contents in cells decreased by BB supplementation. Regarding the enhancement of hydroxylation of BB in the hepatocytes, AsA was the most effective among such other reducing agents as glutathione and dithiothreitol. Although erythorbate (ErA) also stimulated the hydroxylation of BB, carnitine content in cells preloaded with ErA was only 60% of that with AsA. These results suggest that AsA is specifically required for the hydroxylation of BB. Furthermore, AsA can regulate carnitine synthesis in the primary cultured guinea pig hepatocytes. PMID- 1765842 TI - Effects of dietary proteins on absorption and gastrointestinal movement of p aminobenzoic acid in conscious rats. AB - We monitored the absorption and movement of dietary soluble components along the gastrointestinal tract of rats by using p-aminobenzoic acid (PABA) as a marker after feeding 8 and 16% casein or soybean protein isolate (SPI) diets containing 1% PABA. The portal concentration of PABA, as an index of absorption, increased rapidly and reached the same high level 10 min after the feeding of all four diets, and the increased level of portal PABA was maintained for 30-80 min in each group. The increased levels of the SPI-fed groups continued longer than those of the casein-fed groups. In contrast, the gastric emptying rate slowed after 20 min in all the groups, and the gastric emptying of PABA for the initial 60 min in the 8% casein group was significantly faster than that in the 8% SPI group. The PABA content of the first small intestinal segment, which may be influenced by small intestinal transit, was higher in the casein group. These results indicate that the absorptive rate of PABA is determined not only by gastric emptying but also by small intestinal transit. The gastric emptying and the content of PABA in the first segment of the small intestine was not correlated in 8% protein groups. This suggests that the effect of SPI on gastrointestinal movement is different from that of casein. PMID- 1765843 TI - Dietary cholesterol influences on various lipid indices and eicosanoid production in rats fed dietary fat desirable for the protection of ischemic heart disease. AB - Young male Sprague-Dawley rats were fed diets containing 10% fat with P/S and n 6/n-3 ratios of 1.2 and 5.0, respectively, and differing levels of dietary cholesterol (0.05 to 1.0% by weight) for 3 weeks, following which the tissue lipid concentration, fatty acid composition, desaturation of linoleic acid, and eicosanoid production were examined. The composition of dietary fat was that recommended for the prevention of atherosclerosis. Dietary cholesterol did not largely influence the concentration of serum cholesterol, but it markedly increased liver cholesterol in a dose-dependent manner. The delta 6-desaturase activity in liver microsomes, linoleate desaturation index in liver phosphatidylcholine, and the production of prostaglandin by the aorta and thromboxane A2 by platelets all decreased to a similar extent in relation to dietary cholesterol above 0.2%. Thus, dietary cholesterol influenced various lipid parameters characteristically even when dietary fat with a fatty acid composition desirable for the prevention of atherosclerosis was consumed simultaneously. The dietary cholesterol level of 0.2% was the point of maximum influence in rats upon the indices examined. PMID- 1765844 TI - Fatty acid composition of serum phospholipids in an elderly institutionalized Japanese population. AB - The fatty acid composition of serum phospholipids of 277 persons, aged 63-97 y (average 78 y), was measured. Subjects had been living independently in a facility with full food service for 1 y or more. Eleven saturated and unsaturated fatty acids were detected in all the subjects. Stearic acid (18:0) was positively (p = 0.028) and dihomo-gamma-linolenic acid (20:3 n-6) was negatively (p = 0.012) related to age. Arachidonic acid (20:4 n-6) tended to decline with age (p = 0.063). In addition, the oleic acid (18:1 n-9)/18:0 ratio decreased significantly with age (p = 0.024). 18:0 and total saturated fatty acids were lower, and linoleic acid (18:2 n-6) and 20:4 n-6 and n-6 fatty acids were higher in males than in females. These results suggest deficits in n-6 essential fatty acids as age advances, particularly in females. PMID- 1765845 TI - Effect of beta agonist clenbuterol on the body composition of rats with hypothyroidism induced by oral administration of propylthiouracil. AB - The object of this experiment was to examine whether the administration of clenbuterol exerts clenbuterol's repartitioning effects in rats with hypothyroidism induced by the oral administration of propylthiouracil (PTU). Male Wistar rats aged 5 weeks were divided into 4 groups: control, PTU administrated (PTU), clenbuterol administrated (CL), and PTU plus clenbuterol administrated (PTU/CL) groups. Rats were raised for 7 weeks at 26 degrees C and given 13 g of diet every day. The PTU and PTU/CL groups were fed a basal diet containing PTU at the level of 30 mg/kg diet throughout the experimental period. Clenbuterol was added to the diet of the CL and PTU/CL groups at the dose of 0.1 ppm from the 3rd week. Serum thyroxine concentrations of rats were significantly lower in rats in the PTU and PTU/CL groups than those in the control and CL groups. Thus, the administration of PTU succeeded to induce hypothyroidism. The clenbuterol administration seemed to exert its repartitioning effects in euthyroid rats, while the administration neither increased body protein nor decreased body fat in hypothyroid rats. This result therefore suggests that the effects of clenbuterol on the alteration of body composition may vary with the level of thyroid activity in rats. PMID- 1765846 TI - Effect of pyridoxine-deficiency on degradation of cytosolic aspartate aminotransferase in rat liver lysosomes. AB - Highly purified lysosomes were isolated from the livers of control and pyridoxine deficient rats. The calculation of the lysosomal protein contents indicated that the livers of both groups of rats contain virtually the same amounts of the lysosomal proteins (12.0 and 13.0 mg lysosomal proteins/g liver proteins for the control and pyridoxine-deficient rats, respectively). The immunoblotting of the lysosomal proteins with anti-cytosolic aspartate aminotransferase (cAspAT) showed 46 kDa band, corresponding to the subunit molecular weight of cAspAT, as well as the bands representing degradative intermediates of cAspAT. The relative amounts of the immuno-reactive substances were estimated by scanning the immuno-stained bands and measuring the densitometric tracings. It was found that the lysosomes in the pyridoxine-deficient rat liver contain almost twice as much cAspAT and its degradative intermediates as those in the control rat liver. On the basis of these observations, it was concluded that the increased rate of degradation of cAspAT in the liver of the pyridoxine-deficient rats is brought about by the increased rate of sequestration of cAspAT into lysosomes. PMID- 1765847 TI - Increase of urinary ketone body excretion in selenium-deficient rats is a ketone specific change. AB - The effects of selenium (Se) deficiency on urinary ketone body excretion in starved rats were examined. Rats were fed a basal diet which was Se-deficient (Se content: 0.011 micrograms/g) or a Se-adequate diet (the basal diet supplemented with 0.1 micrograms Se/g as sodium selenite). On the 11th and 22nd week of the feeding period, Se-deficient status in rats fed the basal diet was verified by the observation that the Se content and glutathione peroxidase activity in their plasma, erythrocytes, and livers were markedly lowered. On the 4th, 6th, 11th, 15th, and 22nd week, the rats were starved for 48 h and the urinary excretion of ketone bodies (acetoacetate (AcAc) and 3-hydroxybutyrate (3-OHBA)), urea, and creatinine were examined. The urinary excretion of AcAc and 3-OHBA during the second 24 h of the 48-h starvation period were markedly higher in the Se deficient rats than in the Se-adequate rats for all weeks examined, while the urine volume and the excretion of urea and creatinine were similar in the Se deficient and Se-adequate rats, irrespective of the feeding period and the number of hours of starvation. On the 22nd week, the plasma ketone body levels were also determined and significantly higher plasma 3-OHBA levels were observed in the Se deficient rats than in the Se-adequate rats 72 h after starvation began. These results indicate that Se deficiency causes an increase of urinary ketone body excretion in starved rats and that the increase is ketone-specific with no changes in major urinary profiles. PMID- 1765848 TI - Fatty acid composition of breast milk from Nigerian and Japanese women. AB - The fatty acid composition of samples of breast milk obtained from well-nourished Nigerian and Japanese women was determined by gas chromatography. The cultural differences in dietary intake was reflected in the fatty acid composition of breast milk samples. The milk of Nigerian women contained a significantly higher percentage of saturated fatty acids (48.75%) than that of Japanese women (46.65%). Nigerian milks were also richer in arachidonic (20:4 n-6), eicosatrienoic (20:3 n-6), and docosatetraenoic (22:4 n-6) acids. Conversely, the milk of Japanese woman contained significantly higher percentages of monoun saturates as palmitoleic, heptadecenoic, oleic, and polyunsaturates of n-3 series as alpha-linolenic, eicosapentaenoic, and docosahexaenoic acid. PMID- 1765849 TI - Ruster examinations. PMID- 1765850 TI - Carpal tunnel syndrome diagnosis. PMID- 1765851 TI - The effects of behavioral risks on absenteeism and health-care costs in the workplace. AB - The impact of behavioral risk factors on absenteeism and health-care costs was analyzed among 45,976 employees in a large, diversified industrial work force. A cross-sectional design was used to evaluate health risk appraisal and physical examination data collected from 1984 through 1988. Employees with any of six behavioral risks had significantly higher absenteeism (range = 10% to 32%) compared with those without risks. These differences led to significantly higher illness costs (defined as compensation, health care, and non-health care benefits) for those with risks compared with those without risks. Annual excess illness costs per person at risk were smoking, $960; overweight, $401; excess alcohol, $389; elevated cholesterol, $370; high blood pressure, $343; inadequate seatbelt use, $272; and lack of exercise, $130. Only one factor, lack of exercise, was not significant after adjusting for age, education, pay category, and the six other behavioral risks. The total cost to the company of excess illness was conservatively estimated at $70.8 million annually. These findings suggest that the cost of key behavioral risks provides an opportunity to manage health-care cost increases through health promotion, financial incentives for healthy lifestyle, and environmental changes that affect health behaviors. PMID- 1765852 TI - Employee knowledge and attitudes about a work-site nonsmoking policy: rationale for further smoking restrictions. AB - This study examines employee knowledge of and satisfaction with a nonsmoking policy instituted at approximately 600 work sites of the New England Telephone company in 1986. A stratified random sample of employees was surveyed 20 months after the policy was implemented; 1120 (74.5%) returned surveys. Awareness of the rules about smoking in most areas was high, especially where smoking was totally banned. Respondents were highly satisfied with the policy, but half preferred additional restrictions on smoking. The policy was effective in reducing perceived environmental tobacco smoke exposure in work areas where smoking was banned but not in nonwork areas where smoking was allowed in designated areas. This study suggests that a highly restrictive nonsmoking policy--including a total ban on smoking--may be more easily and successfully implemented than are less restrictive policies. PMID- 1765853 TI - Medication reporting in the workplace. AB - Impairment from medication use in hazardous work environments has not been well studied. We analyzed incident events in an explosive manufacturing facility using a retrospective case control study to determine whether medication use was related to safety incidents. Medication use between the incident group and the controls was not significantly different. However, 23% of the incident group had been employed by the facility for less than 1 year compared with 2% of controls. Only 19% of restricted medication use was self-reported. In this study, being employed less than 1 year was a greater predictor of safety incidents than was medication use, and self-reporting did not reflect actual medication use. We conclude that medication use is not directly related to safety events and that a self-reporting program is difficult to justify in the corporate setting. PMID- 1765854 TI - Physical fitness capacity and absenteeism of police officers. AB - Police officers (n = 514) were studied to determine the relationship between physical fitness capacity and annual absenteeism rate. Hierarchical regression analyses revealed that for officers aged 34 years and younger, only 5% of the variability in absenteeism could be accounted for by age, sex, and physical fitness variables. For officers 35 years old and older, 7% of the variability was explained by these variables, and a bicycle ergometer score was a significant predictor of absenteeism. Each individual test and an overall physical fitness score were classified into five levels. ANOVAs revealed no significant differences between overall fitness levels and absenteeism. However, men 35 and over who were most fit on the bicycle ergometer test had fewer absences, and women 34 and under who were thinnest had more absences. In conclusion, at least among police officers, the extent to which physical fitness capacity can predict absenteeism is low. PMID- 1765855 TI - Hand-arm vibration syndrome: clinical evaluation and prevention. AB - Increasing recognition by workers that blanching of their fingers may be due to hand-arm vibration exposure from the tools they use at work and their consequent claims for compensation emphasize a need for better clinical evaluation and prevention. We describe the symptoms and signs, and enumerate the diagnostic procedures (both screening and laboratory) necessary to establish the diagnosis and severity grading of subjects with hand-arm vibration syndrome. Although effective treatment of the condition other than avoidance of further vibration exposure is still being researched, prevention is all important. The necessary steps are identified. PMID- 1765856 TI - Mortality and cancer incidence in aluminum reduction plant workers. AB - An historical cohort study was conducted among 4,213 men who worked for 5 or more years at a Soderberg aluminum reduction plant in British Columbia (BC), Canada. Standardized mortality and incidence ratios were used to compare the mortality and cancer incidence of the cohort with that of the BC population and to examine risk by cumulative exposure to coal-tar pitch volatiles (CTPV) and electromagnetic fields. Significantly elevated rates were observed for bladder cancer incidence (standardized incidence ratio [SIR] = 1.69) and brain cancer mortality (standardized mortality ratio = 2.17). The risk of bladder cancer was strongly related to cumulative exposure to CTPV (P less than .01). The risk for non-Hodgkin's lymphoma also increased with increasing exposure (P less than .05), although the overall rate was similar to that of the general population (SIR = 1.06). The lung cancer rate was as expected (SIR = 0.97), but showed a weak association with CTPV exposure that was not statistically significant. No individual cause of death or incident cancer site was related to exposure to electromagnetic fields. Analysis of the joint effect of smoking and CTPV exposure on lung and bladder cancer showed the exposure response relationships to be independent of smoking. PMID- 1765857 TI - Comparison of computerized and examiner-administered neurobehavioral testing techniques. AB - To better understand the relationship of newly developed computerized neurobehavioral tests to their examiner-administered counterparts, performance on four pairs of tests was compared among 185 solvent-exposed workers in the paint manufacturing industry. Two approaches to the comparison of the test methods (computer or examiner) were employed: (1) the multitrait-multimethod correlation matrix and (2) linear regression modeling of the difference scores between pairs of tests (same functional domain, different test formats). The data revealed that the validity criteria of the multitrait-multimethod technique were met for the tests of simple visual reaction time and attention-concentration (digit symbol substitution). Linear regression analyses demonstrated that the digit symbol substitution and visual memory test pairs were differentially affected by age, vocabulary, solvent exposure, or manual dexterity. Overall, this latter approach holds promise as a means of understanding test format similarities and differences. PMID- 1765858 TI - Pulmonary function and respiratory symptoms in wildland firefighters. AB - We studied cross-seasonal changes in pulmonary function and respiratory symptoms in 52 wildland firefighters in Northern California. The mean cross-seasonal change in forced expiratory volume in 1 second (FEV1) was -1.2% (95% confidence interval [CI] -0.5%, -2.0%) with a corresponding mean change in forced expiratory volume (FVC) of -0.3% (95% CI 0.4%, -1.0%). Decreases in FEV1 and FVC were most strongly associated with hours of recent fire-fighting activity (P = .002 and .01, respectively). When the study group was divided into three categories based on recent fire-fighting activity, firefighters in the high activity category (mean +/- SE, 73 +/- 7 hours of fire-fighting in previous week) had a -2.9% (130 mL) change in FEV1 and a -1.9% (102 mL) change in forced vital capacity (FVC). There was a significant cross-seasonal increase in most respiratory symptoms evaluated. Several symptoms (eye irritation, nose irritation, and wheezing) were associated with recent fire-fighting. These findings suggest that wildland firefighters experience a small cross-seasonal decline in pulmonary function and an increase in several respiratory symptoms. Research is under way to identify the fire conditions and specific components of exposure that produce pulmonary irritants, and to examine the potential reversibility of acute pulmonary change. PMID- 1765859 TI - Contamination of urine with diazepam and mefenamic acid from an Oriental remedy. PMID- 1765860 TI - Quality assurance audits of medical surveillance programs for hazardous waste workers. AB - The Occupational Safety and Health Administration (OSHA) Hazardous Waste Operations and Emergency Response Regulation (29 CFR 1910.120) requires medical surveillance examinations for hazardous waste workers. We investigated the consistency and appropriateness of the services provided under OSHA 29 CFR 1910.120 as part of a quality control audit. Our study revealed that in most cases the required paperwork including fitness for duty and restrictions or limitations was completed. However, it is also apparent that many of the components of a complete occupational history were not performed. Spirometric examinations often were performed incorrectly. Documentation of baseline tests was not uniformly done, nor were patients always informed of the findings of their examinations. Our study indicated there may be a lack of education, training, and experience of occupational health providers. This suggests that further efforts should be made to educate physicians and nurses providing medical surveillance and other services to hazardous waste workers. PMID- 1765861 TI - Potential contribution of dietary sources to urinary cadmium and beta 2 microglobulin excretion of occupationally exposed workers. AB - To determine the potential contribution dietary cadmium may have toward total urinary excretion of cadmium and beta 2-microglobulin of occupationally exposed workers, 260 residents of the town of Walsall, United Kingdom, who grew a proportion of their vegetable diet in urban garden soils, were studied. Urinary excretions of cadmium were significantly elevated above those reported for the general population (P less than .001). For nonsmoking, nonoccupationally exposed residents, urinary excretion of cadmium was found to be up to 34% of the American Conference of Governmental Industrial Hygienists Biological Exposure Index. In evaluating biological monitoring data of cadmium-exposed workers, the potential significance of dietary intake from urban grown produce should not be overlooked. PMID- 1765862 TI - Validity of a mortality study based on a corporate health surveillance system. AB - We evaluated the Shell Health Surveillance System (HSS) by conducting two mortality studies at an oil refinery. Study A used the HSS to measure the mortality of active and retired workers during 1973 to 1982. Study B used additional information sources and followed up terminated employees. For subjects included in both studies, results were very similar. However, the mortality experience of terminees before 1973 (included only in study B) was different from that of study A subjects, reflecting differences in length of employment and time since hire. HSS-based studies provide valid measures of long-term effects of past exposures among retirees and of short-term effects of recent exposures among active employees. However, they cannot detect short-term effects of past exposures, and they have limited power for evaluating dose-response relationships. PMID- 1765863 TI - Blood testing for chronic beryllium disease. PMID- 1765864 TI - Hyperosmolarity and acidosis in diabetes mellitus: a three-year experience in Rhode Island. AB - OBJECTIVES: Diabetic acidosis (DA) and the diabetic hyperosmolar state (DHS) are generally considered to be two distinct clinical entities. However, clinical experience and the literature suggest that there may be some overlap. The purposes of this study were 1) to establish the proportion of overlap cases, 2) to identify any occurrence of DHS in diabetic patients under the age of 30 years (likely type I) and any occurrence of DA in diabetic patients over the age of 60 years (likely type II), 3) to describe clinical factors associated with the development of DA and DHS, and 4) to identify factors that influence the prognosis of DHS. PATIENTS AND METHODS: 613 cases were identified by retrospective chart review, using discharge information from all 15 Rhode Island community hospitals during 1986, 1987, and part of 1988. DA alone [serum glucose (glu) greater than 300 mg/dL, bicarbonate (HCO3) less than 15mEq/L, calculated total serum osmolarity (osm) less than or equal to 320 mOsm/L] was the diagnosis for 134 subjects (22%), DHS alone (glu greater than 600 mg/dL, HCO3 greater than or equal to 15mEq/L, osm greater than 320 mOsm/L), for 278 subjects (45%), and a mixed case (glu greater than 600 mg/dL, HCO3 less than 15 mEq/L, osm greater than 320 mOsm/L), for 200 subjects (33%). Information about serum or urinary ketones was available for 109 subjects who had DA alone [103 had diabetic ketoacidosis (DKA)] and 144 subjects who had mixed DA and DHS (131 had mixed DKA and DHS). All the data were also analyzed using the effective osmolarity and a cutoff of 310 mOsm/L for this alternative case definition. RESULTS: Patients with DA alone were younger (mean age 33 years) and patients with DHS alone were older (mean age 63 years). However, 28 (10%) of the 278 cases of DHS alone and 72 (36%) of the 200 cases of mixed DA and DHS occurred in patients under the age of 30. Eighteen cases (13%) of DA alone and 62 cases (31%) of mixed DA and DHS occurred in patients over the age of 60. The results were not substantially changed when effective osmolarity greater than 310 mOsm/L was used to define hyperosmolarity and when only cases with documented DKA were included. An infection was the most common precipitating factor of DA (30%), DHS (27%), and mixed cases (32%). Other common associated factors included noncompliance with treatment (20% for DA, 12% for DHS, and 22% for mixed cases) and previously undiagnosed diabetes (24% for DA, 18% for DHS, and 10% for mixed cases). Nursing home residents accounted for 0.7% of DA cases, 18% of DHS cases, and 4.5% of mixed cases. Mortality was 4% for DA, 12% for DHS, and 9% for mixed cases. The mortality for DHS is the lowest reported in the literature, continuing a downward trend that began in the 1970s. Nonsurvival was associated with older age, higher osmolarity, and nursing home residence. Survival was associated with the presence of an infection. CONCLUSIONS: 1) many patients experience mixed DA (DKA) and DHS rather than either condition alone, 2) both DA (DKA) and DHS occur in young and old diabetic persons, 3) infection is the most common predisposing factor for either condition, and 4) higher osmolarity, older age, and nursing home residence are associated with nonsurvival in DHS. PMID- 1765865 TI - Management of stage III pressure ulcers in moderately demented nursing home residents. AB - PURPOSE: To determine whether the myocutaneous flap procedure, the preferred treatment for young patients with stage III pressure ulcers, is appropriate for moderately demented nursing home residents. SUBJECTS AND METHODS: A model of the treatment decision was created using the decision-tree format. The probabilities of treatment outcomes in the decision tree were derived from the literature. Utilities for treatment outcomes were obtained from five internists, five geriatricians, six nurse practitioners, five plastic surgeons, and six lay people. RESULTS: A majority in each group of respondents favored surgery, according to the decision analysis. Sensitivity analysis showed that surgery was preferred unless its success rate was less than 30%, or the rate of healing with conservative measures was at least 40%, which are unlikely values. Economic analysis demonstrated that surgery was $17,000 more expensive than conservative therapy. CONCLUSION: The myocutaneous flap procedure is preferred by the majority of relevant decision makers when cost is not a consideration. The relative underutilization of surgery in practice has many possible explanations. The most likely are the failure of providers to appreciate the morbidity of pressure ulcers and the reluctance of practitioners to perform expensive procedures on demented patients. PMID- 1765866 TI - Physician performance and patient perceptions during the rectal examination. AB - OBJECTIVE: To describe internal medicine residents' training and performance as well as patients' attitudes and knowledge regarding the rectal examination. DESIGN: Descriptive survey of university-trained internal medicine residents and general medicine clinic patients. SETTING: General internal medicine residents' longitudinal clinic at a university-affiliated Veterans Affairs Medical Center. PATIENTS/PARTICIPANTS: Ambulatory male veterans attending their general internal medicine clinic, all of whom were over the age of 40 years and had previously had a rectal examination (n = 100), as well as all second- and third-year University of Minnesota internal medicine residents (n = 78) were surveyed using a self administered questionnaire. MEASUREMENTS AND MAIN RESULTS: Residents differed in their training in, practice of, and understanding of indications for the rectal examination. Little formal instruction regarding patient comfort had been provided to residents, and many residents had never received supervised instruction in the rectal examination. Patients frequently were uncertain about why the examination had been performed, lacked understanding of the results of the examination, and often had preferences for examination comfort measures that differed from those utilized by their physicians. CONCLUSIONS: Increased supervised instruction in the rectal examination in medical training programs is recommended. This should emphasize not only appropriate indications for this procedure but also attention to patient communication and comfort. PMID- 1765867 TI - Mismatch of coronary risk and treatment intensity under the National Cholesterol Education Program guidelines. AB - OBJECTIVE: To assess the match between multifactorial risk of coronary heart disease (CHD) and treatment intensity under the National Cholesterol Education Program (NCEP) guidelines for primary prevention of CHD. METHODS: The multiple logistic regression equation from the Framingham Study was used to derive predicted risks for development of CHD over eight years of follow-up for different age-gender groupings, with serum total cholesterol (TC) values chosen in light of the NCEP cutoff points for both TC and low-density-lipoprotein cholesterol levels. Additional risk factors--hypertension, glucose intolerance, and smoking--were considered in combination for each of these values. RESULTS: Controlling for the effects of age and gender, there is little difference in the ranges of absolute CHD risks for persons who would receive interventions of differing intensities (i.e., general dietary advice, dietary treatment, or drug therapy). Those who are candidates for drug treatment because of serum lipids alone are often at low levels of risk for the development of CHD when compared with those of the same age with lower TC values who have other risk factors. Discrepancies in CHD risk are wider still when age is also allowed to vary. Furthermore, in every age grouping, women with high TC levels (e.g., 6.9 mmol/L) and two other risk factors are eligible for drug treatment but have a CHD risk that is no higher, and often much lower, than that of males with one other risk factor and TC levels of 4.8 mmol/L or 5.7 mmol/L who are candidates for dietary advice or dietary therapy, respectively. CONCLUSIONS: Inconsistencies exist in the NCEP guidelines such that persons at low risk for the development of CHD are offered more intensive interventions than are other who actually are at much higher risks, and vice versa. Women in particular tend to be overtreated, relative to men. These findings point out the difficulties of promulgating guidelines that will appropriately match risk to preventive interventions in a complex multifactorial disease. PMID- 1765868 TI - Long-term care preferences of hospitalized persons with AIDS. AB - OBJECTIVE: To determine in a cohort of hospitalized persons with AIDS: 1) their preferences for various postdischarge long-term care settings, 2) the postdischarge settings recommended by primary care providers (doctors, nurses, and social workers), and 3) the impact of these views on the resulting discharge dispositions. DESIGN: Prospective cohort study. SETTING: Medical wards of five Seattle tertiary care hospitals. PARTICIPANTS: 120 consecutive hospitalized persons with AIDS and their primary care providers. MEASUREMENTS AND MAIN RESULTS: Although 70 (58%) of the patients found care in an AIDS long-term care facility acceptable, 87 (73%) preferred home care. Thirty-eight (32%) of the cohort were appropriate for long-term care after hospitalization, according to primary care providers. Eleven of the 38 patients deemed appropriate for long term care were discharged to long-term care settings; among these, three had preferred home care. Likelihood of discharge to long-term care settings increased if patients found it acceptable (OR = 7.1; 95% CI = 3.2, 15.5), if they did not prefer home care (OR = 7.7; 95% CI = 4.7, 13.5), and if providers judged them to be appropriate for long-term care (OR = 29; 95% CI = 13, 64). In unstructured interviews, availability of emotional and medical support and privacy emerged as important factors to persons with AIDS considering long-term care. CONCLUSIONS: Hospitalized persons with AIDS willingly express their desires for various postdischarge care settings. A majority find long-term care in AIDS facilities acceptable, although they generally prefer home care. Discharge disposition is associated with acceptability, preference, and appropriateness for long-term care. PMID- 1765869 TI - Identification of psychosocial distress: a comparison of internal medicine and family medicine residents. AB - OBJECTIVE: To compare the diagnostic accuracies of internal medicine and family medicine residents in identifying psychosocial distress in ambulatory patients. DESIGN: 410 consecutive patients in two hospital-based residency clinics were enrolled. Psychosocial distress was assessed using the General Health Questionnaire (GHQ). Residents, blinded to the goals of the study and the results of the GHQ, documented clinically identified psychosocial distress. MAIN RESULTS: Overall concordance between the residents and the GHQ in identifying the presence or absence of psychosocial distress was 60%. There was no difference in the diagnostic performances of the two resident groups. Sensitivity for the identification of psychosocial distress when the resident groups were combined was 32.3%. CONCLUSIONS: The concordance between a commonly used, well-validated screening test for psychosocial distress and resident diagnosis was 60%. This may reflect the need for more effective training of residents in this area of diagnosis or the need for better screening methods. PMID- 1765870 TI - Efficacy of a one-month training block in psychosocial medicine for residents: a controlled study. AB - STUDY OBJECTIVE: To determine the efficacy of a comprehensive, one-month psychosocial training program for first-year medical residents. DESIGN: Nonrandomized, controlled study with immediate pre/post evaluation. Limited evaluation of some residents was also conducted an average of 15 months after teaching. SETTING: Community-based, primary care-oriented residency program at Michigan State University (MSU). SUBJECTS: All 28 interns from the single-track MSU residency program during 1986/87-88/89 participated in this required rotation; there was no dropout or instance of noncompliance with the study. In the follow-up study in 1989, all 13 available trainees participated. Of 20 untrained, volunteer controls, ten were second/third-year residents in the same program during 1986/87 and ten were interns from a similar MSU program in Kalamazoo, MI, during 1988/89. TEACHING INTERVENTION: An experiential, skill oriented, and learner-centered rotation with competency-based objects focused on communication and relationship-building skills and on the diagnosis and management of psychologically disturbed medical patients. MEASUREMENTS AND MAIN RESULTS: The two subsets of the control group were combined because residents and training programs were similar and because means and standard deviations for the subsets were similar on all measures. By two-way analyses of variance (group x gender), the trainee group showed significantly greater gains (p less than 0.001) on questionnaires addressing knowledge, self-assessment, and attitudes; a mean of 15 months following training, there was no significant deterioration of attitude scores. All trainees were also able to identify previously unrecognized, potentially deleterious personal responses using a systematic rating procedure. Residents' acceptance of the program was high. CONCLUSIONS: Intensive, comprehensive psychosocial training was well accepted by residents. It improved their knowledge, self-awareness, self-assessment, and attitudes, the latter improvement persisting well beyond training. PMID- 1765871 TI - Alumni perspectives comparing a general internal medicine program and a traditional medicine program. AB - OBJECTIVE: To evaluate a primary care internal medicine curriculum, the authors surveyed four years (1983-1986) of graduates of the primary care and traditional internal medicine residency programs at their institution concerning the graduates' preparation. DESIGN: Mailed survey of alumni of a residency training program. SETTING: Teaching hospital alumni. SUBJECTS/METHODS: Of 91 alumni of an internal medicine training program for whom addresses had been found, 82 (90%) of the residents (20 primary care and 62 traditional) rated on a five-point Likert scale 82 items for both adequacy of preparation for practice and importance of training. These items were divided into five groups: traditional medical disciplines (e.g., cardiology), allied disciplines (e.g., orthopedics), areas related to medical practice (e.g., patient education), basic skills and knowledge (e.g., history and physical), and technical procedures. MAIN RESULTS: Primary care residents were more likely to see themselves as primary care physicians versus subspecialists (84% versus 45%). The primary care graduates felt significantly better prepared in the allied disciplines and in areas related to medical practice (p less than 0.01). There was no significant difference overall in perceptions of preparation in the traditional medical disciplines, basic skills and knowledge, and procedures. The same results were obtained when the authors looked only at graduates from the two programs who spent more than 50% of their time as primary care physicians versus subspecialists. There was no significant difference between the two groups in the perceived importance of these areas to current practice. CONCLUSIONS: These results suggest that the primary care curriculum has prepared residents in areas particularly relevant to primary care practice. Additionally, these individuals feel as well prepared as do their colleagues in the traditional medical disciplines, basic skills and knowledge, and procedural skills. PMID- 1765872 TI - A longitudinal description of patterns of certification in internal medicine and the subspecialties. AB - OBJECTIVE: To document the timings, frequencies, and outcomes of attempts at certification in internal medicine and the internal medicine subspecialties in the years following residency training for two cohorts of residents. DESIGN: Residents who had completed residency training and had been admitted to an American Board of Internal Medicine (ABIM) certifying examination in 1982 or 1983 were tracked through the ABIM database for five years. PARTICIPANTS: A total of 10,568 residents were studied. Of the cohort, 79% were men, 21% were women, 79% were graduates of U.S./Canadian medical schools (USMGs), and 21% were graduates of foreign medical schools (FMGs). MAIN RESULTS: Ultimately, 85% of the residents achieved certification in internal medicine. Cumulative pass rates were 87% for men, 81% for women, 92% for USMGs, and 60% for FMGs; rates increased minimally after the second attempt. Most (87%) residents first attempted the internal medicine examination in the year in which training had been completed. Delaying the first examination was associated with lower pass rates. Half of the candidates who had passed the internal medicine examination attempted subspecialty certification. Over all nine subspecialty examinations, the two cycle cumulative pass rate was 87%. Higher percentages of FMGs than of any other subgroup attempted subspecialty certification. CONCLUSIONS: The detailed description extends the body of knowledge about certification in internal medicine and the nine internal medicine subspecialties. Questions are raised, such as why some candidates delay the first internal medicine examination and why some residents never seek certification. Future research could explore these issues as well as explanations for the observed differences in pass rates. PMID- 1765873 TI - Preemployment drug screening in a large metropolitan medical center: a one-month trial. AB - To assess the prevalence of illicit drug use among job applicants, a large metropolitan medical center conducted preemployment drug screening of all applicants during January 1988. Urine samples from 172 preinformed applicants were screened using Enzyme Multiplied Immunoassay Technique (Emit d.a.u.) followed by confirmatory gas chromatography/mass spectrophotometry. 4.1% of tests were positive for marijuana and/or cocaine and none was positive for heroin. Positive findings increased with decreasing socioeconomic status. The findings suggest that applicants for jobs in large medical centers in metropolitan areas are no different from those in other sectors of the economy with respect to illicit drug use. PMID- 1765874 TI - Notes of a small-group teacher. PMID- 1765875 TI - Financing residency education in the ambulatory setting: a private practice model. PMID- 1765876 TI - When life is in overtime: are we spectators, coaches, or players? PMID- 1765877 TI - A private education. PMID- 1765878 TI - Alumni surveys for evaluation of innovations in medical education. PMID- 1765879 TI - Negative likelihood ratios in screening. PMID- 1765880 TI - Waning prestige of internal medicine. PMID- 1765881 TI - Preventing blindness in diabetes. PMID- 1765882 TI - Narcotic blockade. 1966. PMID- 1765883 TI - A brief history of methadone in the treatment of opioid dependence: a personal perspective. AB - Starting at the latter part of the nineteenth century and through the early twentieth century, events are reviewed to provide a sense of the climate and setting in which early methadone research was conducted. The discovery of methadone by the Germans in the later stages of World War II is described. At that time, methadone was not recognized to be a narcotic analgesic. The first report of the properties of methadone published in the United States in 1947 is summarized, and its early use in the treatment of the opioid abstinence syndrome is noted. However, the utility of methadone as a maintenance drug was not recognized until 14 years later. Despite strong resistance from the U.S. Bureau of Narcotics, research progressed from the recognition of the unique properties of methadone to substantial clinical application. Finally, methadone is placed in a current context describing a second wave of acceptance based not solely on the reduction of crime but on the prevention of the spread of AIDS. PMID- 1765884 TI - The use of insulin in the treatment of diabetes: an analogy to methadone maintenance. PMID- 1765885 TI - The National Institute on Drug Abuse and methadone maintenance treatment. PMID- 1765886 TI - Overview of the Office for Treatment Improvement and its philosophy. PMID- 1765887 TI - Methadone treatment: experiment and experience. AB - The relationship between public policy and scientific investigation is explored by a review of the experience with methadone maintenance treatment for narcotic addiction. The implementation of a widespread treatment effort in Hong Kong in the 1970s is contrasted with recent policies in regard to methadone treatment expansion in the United States. In neither case did research findings form the basis for public policy. In Hong Kong, rapid expansion of methadone treatment was initiated before scientific evidence was available to support this course, and in the United States treatment expansion has been rejected despite extensive evidence of its utility and safety. Decisions by government officials and health care providers, as in the case of addiction treatment, may be influenced more by philosophy and intuition than by scientific evidence. Scientists must recognize and address this reality if they are to play a meaningful role in shaping public health policy. PMID- 1765888 TI - Abnormal adrenal gland metabolism in opioid addicts: implications for clinical treatment. AB - Adrenal gland metabolism is markedly altered in heroin addicts. During daytime hours, the addict may suffer corticoid deficiency of the addisonian type, and in the evening, an excess of the cushingoid type. The high plasma levels of cortisol that are found in the evening in addicts antagonize endogenous opioids in a manner similar to naloxone. In the present study, 72% of the heroin addicts who sought treatment demonstrated reduced adrenal cortisol reserve. Effective immune and stress responses are dependent on adrenal cortisol reserve. This finding provides an explanation for the heroin addict's vulnerability to AIDS and other infectious diseases. One of methadone's greatest attributes is that it helps normalize adrenal metabolism. Clinical methods to at least partially correct adrenal metabolism may enhance current opioid addiction treatment modalities. PMID- 1765889 TI - Opioid addiction treatment modalities and some guidelines to their optimal use. AB - Opioid addiction treatment consists of a broad range of treatment modalities, with each playing a valuable role within the overall network of treatment alternatives. Therapeutic communities are often the treatment of choice for addicts who are under legal contingencies and amenable to a rigorous process of life-style change. Methadone maintenance offers the most widely available treatment and is a modality that is compatible with the needs of many injecting heroin users. Outpatient drug-free models offer structure and support to detoxified opioid addicts and nonaddicted opioid abusers. New pharmacotherapies, including clonidine, LAAM, naltrexone and buprenorphine, provide promise for addressing the needs of many opioid abusers who are not currently accessing the treatment system. Furthermore, the treatment system could be better utilized if treatment planning was based more on the needs of the addict than on the ideological bias of the clinician; training efforts could be useful in facilitating change in clinician attitudes. PMID- 1765890 TI - Methadone maintenance treatment: a primer for physicians. AB - The doctor-patient interaction in the methadone maintenance treatment clinic is qualitatively different from general medical settings. The patient presents with a specific request for treatment of opioid dependence, most often having already selected the methadone treatment modality, and the initial contact is centered around obtaining methadone. Addiction and needle use increase susceptibility to life-threatening illnesses, such as syphilis, endocarditis, tuberculosis, and AIDS. The physician is working with counselors, nurses, therapists and 12-Step programs, incorporating the best of the medical, psychodynamic, behavioral, and recovery models into treatment. Federal and state governments also control and regulate methadone treatment. Given this complex picture, the basic techniques of methadone maintenance treatment are reviewed, including the intake examination, the annual examination, dose adjustment, withdrawal from methadone maintenance, management of pregnant patients, dual diagnosis patients, and severely ill or medically disabled patients. PMID- 1765891 TI - Counseling issues in methadone maintenance treatment. AB - This article reviews some of the issues and dilemmas faced by methadone maintenance treatment (MMT) programs counselors. The context in which MMT occurs sets the tone and constraints within which clinicians must find ways to be effective; negative attitudes and tensions with regulatory agencies have a strong impact. Coexisting disorders, particularly depression and thought disorders, are discussed and special medication considerations are noted. Counselor collaboration on medical issues, and dosing policies and practices are explored, as well as the clinical approach to tapering off methadone. The article examines helpful clinical strategies when clients continue to use heroin or other drugs, and explores psychological issues that frequently occur, women's issues, and problems that may arise when patients have human immunodeficiency virus-spectrum disease. It also reconsiders the role of family therapy. Several innovative and promising psychoeducational approaches are described and the potential integration of MMT with 12-Step programs is addressed. Recommendations are offered for training and supervision. PMID- 1765892 TI - Treatment issues for opioid-dependent women during the perinatal period. AB - Opioid dependence has been studied with regard to its effects on the woman, the fetus, and the child for the past three decades, and it continues to be a serious problem that must be recognized and addressed by the health care delivery system in order to provide optimal medical care. The use of pharmacotherapy, such as methadone maintenance treatment (MMT), is only one of a variety of treatment modalities to provide optimal services for opioid-dependent women. The complete schema for treating opioid dependence in the perinatal period is complex and intense, but MMT serves multiple purposes. Primarily, it removes the addicted woman from the drug-seeking environment, eliminates the necessary illicit behavior, and prevents the peaks and valleys in the maternal heroin level that may occur throughout the day. In addition, maternal nutrition is usually improved and MMT patients become amenable to prenatal care and psychosocial rehabilitation. It is evident from the findings of numerous studies that when the physical, psychological, and socioeconomic issues of pregnant opioid-dependent women and their children are coupled with MMT, the potential physical and behavioral effects of psychoactive drugs on the mother, the fetus, the newborn, and the child may be markedly reduced. PMID- 1765893 TI - Treating cigarette smoking in methadone maintenance clients. AB - Substance abusers in treatment have cigarette-smoking rates about three times that found in the general adult population, yet there is a paucity of published studies examining smoking-cessation programs for these clients. Accordingly, a behaviorally based smoking-cessation program for methadone maintenance clients was developed, and the efficacy of a methadone dose increase as a pharmacological adjunct was tested in a double-blind placebo-controlled study. While no significant difference between experimental and control subjects in reported abstinence rates was found, subjects receiving a methadone increase reported significantly more nicotine craving and other withdrawal symptoms during the first week of abstinence than did controls. Measures of smoking rates indicated that experimental subjects smoked significantly more than controls throughout the 10-week study period. Although the initial smoking abstinence rate of 65% was encouraging, most subjects returned to smoking by the end of the study period. These findings indicate that the development of smoking-cessation programs for methadone clients merits further study and that such programs should stress relapse prevention techniques tailored to the specific needs of this population. Also, while the use of a methadone dose increase as a pharmacological adjunct has not been found to be efficacious, other pharmacological strategies involving the use of nicotine should not be ruled out. PMID- 1765894 TI - Human T-cell lymphotrophic virus in California's injection drug users. AB - Human T-cell lymphotrophic virus I (HTLV-I) and human T-cell lymphotrophic virus II (HTLV-II) are closely related retroviruses that are highly prevalent in injection drug users (IDUs). The bulk of infection in this group probably occurs with HTLV-II, with a lower prevalence of HTLV-I. HTLV-I is known to cause adult T cell leukemia/lymphoma and tropical spastic paraparesis. HTLV-II has not been proven to cause any human pathology, but may be immunosuppressive and is almost indistinguishable serologically from HTLV-I. As with human immunodeficiency virus (HIV), infection with these viruses is likely to be lifelong and the disease may have a latent period of many years. Unlike HIV, HTLV-I and/or HTLV-II are not likely to be transmitted from mother to child prenatally, and usually require breast-feeding for vertical transmission. It is likely that HTLV-I and/or HTLV-II has been prevalent in IDUs for far longer than the HIV epidemic. HTLV-I and/or HTLV-II are relevant to the AIDS epidemic in that they may function as biologic markers of behavioral risk status for HIV infection in IDUs or their sexual partners, and they may accelerate the course of HIV infection in persons coinfected with HTLV-I and/or HTLV-II and HIV. Coinfection will be more likely as the HIV epidemic progresses. Pregnant addicts entering outpatient methadone maintenance treatment in San Francisco County or Contra Costa County during 1990 were found to have an HTLV-II prevalence of 21% (n = 24). Important issues in counseling infected methadone patients are described. PMID- 1765895 TI - Medical safety and side effects of methadone in tolerant individuals. PMID- 1765896 TI - Opioid dependence and methadone maintenance treatment. PMID- 1765897 TI - Quantitative determination of carboxymethyl chitin in polymer-coated liposomes. AB - A simple turbidity method for the quantitative determination of carboxymethyl chitin (CM-chitin) in coated liposomes has been developed. Isopropanol:buffer (1:1 v/v) was selected as a good solvent system for dimyristoyl-, dipalmitoyl-, or egg phosphatidylcholines but not CM-chitin. The turbidity of CM-chitin in this solvent system was spectrophotometrically determined at 400 nm without significant interference by these phosphatidylcholines. The dependence of turbidity on the CM-chitin concentration, pH, and ionic strength were determined. It was found that analyses of the coating efficiency of dipalmitoylphosphatidylcholine liposomes by CM-chitin were reproducible within the specified ranges of formulation conditions and enabled differentiation of the effect of order of CM-chitin addition on the coating efficiency. PMID- 1765898 TI - Spontaneous formation of drug-containing acrylic nanoparticles. AB - Nanoparticles containing ibuprofen, indomethacin or propranolol were formed spontaneously after the addition of solutions of the drugs and acrylic polymers (Eudragit RS or RL 100) in the water-miscible solvents, acetone or ethanol, to water without sonication or microfluidization. The colloidal dispersions were stabilized by quaternary ammonium groups and did not require the addition of surfactants or polymeric stabilizers. The nanoparticles were compared to nanoparticles prepared either by a microfluidization-solvent evaporation method with a water-immiscible organic solvent, methylene chloride, or by a melt method with respect to particle size and redispersibility of freeze- or spray-dried samples. Nanoparticles prepared by microfluidization or the melt method were easily redispersed while Eudragit RS nanoparticles prepared by spontaneous emulsification were not redispersible. Flexible films were formed from the nanosuspensions after the addition of 15 per cent triethyl citrate, a water soluble plasticizer. The release of propranolol from the films increased with increasing proportion of RL, but was independent of the order of mixing of the two polymers or nanosuspensions during film preparation. The drug release from indomethacin films was increased by adding water-soluble polymers to the nanosuspension. PMID- 1765899 TI - Poly(hydroxybutyrate-hydroxyvalerate) microspheres containing progesterone: preparation, morphology and release properties. AB - The biodegradable polyesters, poly(hydroxybutyrate) (PHB) and poly(hydroxybutyrate-hydroxyvalerate) (PHBV) were investigated for use as sustained delivery carriers of a model drug, progesterone. Spherical microspheres containing the drug were prepared by an emulsion solvent-evaporation method with gelatin as an emulsifier. Methylene chloride as the polymer solvent yielded smoother microspheres than chloroform. The surface texture was also dependent upon the temperature of the preparation and polymer used. Surface crystals were observed when the drug loading was increased beyond 5 per cent w/w. Thermograms of the microspheres did not show an endotherm corresponding to the melting of the drug because the drug dissolved in the melted polymer while heating. The amount of residual solvent in the microspheres (gas chromatographic assay) ranged from 3.4 to 58.4 ppm and was dependent on the processing temperature, concentration of the polymer in the solvent and the polymer composition. In vitro release of the drug was slowest from microspheres made from copolymer containing 9 per cent hydroxyvalerate. A less porous microsphere matrix was formed by this copolymer. PMID- 1765900 TI - The use of liposomes for the preparation of protein-free lipid emulsions models of chylomicron remnants. AB - Artificial chylomicron remnants were investigated as a new drug carrier system for the targeting of hepatic parenchymal cells. The emulsions presented here are similar in particle size and composition to natural lipoproteins. The preparations contained triolein, phospholipid, cholesterol and cholesteryl oleate. Egg yolk lecithin was either used to form multilamellar or unilamellar liposomes or it was incorporated into a lipid film prior to emulsification. Typically the lipid film contained triolein, cholesterol and cholesteryl oleate. When multilamellar liposomes were used however, cholesterol and cholesteryl oleate were incorporated into the vesicles. The emulsions were prepared by ultrasonication or by means of a microemulsifier. The unilamellar liposomes used with the microemulsifier yielded the best particle distribution, i.e. in the range of 40-60 as determined by quasi-elastic light scattering. The advantage of the method results from the complete emulsification of the components. The particle size remained unchanged during storage, although flocculation was observed. The results show that the synthesis of artificial chylomicron remnants in a microemulsifier is possible and reproducible. PMID- 1765901 TI - Modulation of liposomal lipid peroxidation in presence of nickel by incorporation of alpha-tocopherol in the bilayer. AB - alpha-Tocopherol is a well-known membrane associated chain-breaking phenolic antioxidant which functions as a trap for peroxyl and other free radicals and thus inhibits lipid peroxidation of membranes. Antioxidative effect of alpha tocopherol when incorporated in liposomes was examined by the generation of Thiobarbituric acid (TBA) reacting species in the presence of nickel. The incorporation of alpha-tocopherol in the lipid bilayer resulted in the enhancement of lipid peroxidation at low concentration (1.0 mg) but at higher concentration (2.5 and 5.0 mg) considerably reduced the enhancement in lipid peroxidation of liposomes in the presence of nickel. When alpha-tocopherol was added (unincorporated) to liposomes in the presence of nickel, enhancement in lipid peroxidation was observed compared to nickel alone. Thus the antioxidative effect of alpha-tocopherol in the liposomes may depend on its mode of incorporation in the lipid bilayer. PMID- 1765902 TI - The effect of capsule composition on the biocompatibility of alginate-poly-l lysine capsules. AB - The encapsulation of islets of Langerhans in alginate-poly-l-lysine has been proposed as a method for the immunoprotection of transplanted islets. Although several capsule compositions have been reported, there has been no published study concerning the effect of capsule composition on the severity of the foreign body reaction. Empty capsules were prepared from high mannuronic acid alginate and were coated with: (1) poly-l-lysine alone, (2) poly-l-lysine plus high guluronic acid alginate, or (3) poly-l-lysine plus high mannuronic acid alginate. The capsules were placed in the renal subcapsular space or the peritoneal cavity, and retrieved after three weeks of histological examination. The recipients were WAG/01a, nude (athymic), diabetic BB, and non-diabetes prone BB rats. The severity of reaction to the capsules was determined by measuring the thickness of the pericapsular cell infiltrate or by a scoring system. The severity of the reaction to the capsules was strain-dependent in both the renal and peritoneal sites, with the BB and nude rats displaying the most severe responses. The degree of response was not affected by capsule composition in the renal subcapsular space, but in the peritoneum, the high mannuronic acid alginate capsules provoked the weakest response, and this type of capsule will be used for future transplantation work. The infiltrating cells were characterised by immunohistochemistry and electron microscopy and found to be mostly fibroblasts and macrophages. PMID- 1765903 TI - Development, characterization and evaluation of an auto-regulatory delivery system for insulin. AB - A self-regulatory delivery system for insulin was designed, based on the competitive and complementary binding behaviour of Concanavalin with glucose and glycosylated insulin. By encapsulating the Con-A bound G- insulin in a suitable polymer membrane, which was permeable to both glucose and insulin, the insulin efflux was regulated in response to glucose influx. PMID- 1765904 TI - Release kinetics of drugs from rosin-glycerol ester microcapsules prepared by solvent evaporation technique. AB - Rosin-glycerol ester microcapsules containing sulphadiazine were prepared by solvent evaporation technique. The goodness of fit of the release data was tested with first order, Higuchi matrix model and Hixon-Crowell cube root law. All these models were sufficiently linear. Application of the differential rate treatment showed that release from most of the microcapsules followed first order equation. Whereas up to 40-50 per cent of release, a zero order, membrane controlled kinetics was observed, the release is apparently first order under nonsteady, state conditions. PMID- 1765905 TI - Study of abietic acid glycerol derivatives as microencapsulating materials. AB - Abietic acid (85 per cent pure) was extracted from rosin N Grade and further standardized. Abietic acid derivatives were prepared by heating abietic acid with glycerol and intermediate reaction products with different acid values were collected. Salicylic acid granules were encapsulated using a 10 per cent solution of abietic acid and its derivatives by standard spray pan technique. The coated microcapsules were evaluated for moisture absorption, dissolution and flow properties. The result showed that abietic acid glycerol derivatives, AaG-54 and AaG-20 had better moisture protection properties. Dissolution studies indicate that these derivatives could be used for delayed release of drugs. PMID- 1765906 TI - Respiratory failure due to retained esophagus: a complication of esophageal replacement. AB - Recurrent fistulas occur in about 10% of infants treated for esophageal atresia with distal tracheoesophageal fistula. Failed repair of a recurrent fistula rarely requires esophageal replacement and removal or diversion of the native esophagus. We present a patient who underwent multiple operations for recurrent tracheosophageal fistula whose native esophagus was eventually replaced with a colonic interposition graft. Over the subsequent 9 years he experienced failure to thrive, respiratory distress, and repeated pulmonary infections attributed to chronic aspiration. Eventually, he developed respiratory failure and required endotracheal intubation and mechanical ventilation. He became increasingly difficult to ventilate and, in spite of aggressive efforts, suffered a cardiac arrest from which he could not be resuscitated. At postmortem, a dilated blind segment of native esophagus, which was compressing and obstructing the malacic trachea, was found in the posterior mediastinum. Death was caused by massive air embolus, which was in turn attributed to the high airway pressures needed to ventilate the patient. Tracheal compression by a remnant of native esophagus should be considered in the differential diagnosis of respiratory failure after esophageal replacement. PMID- 1765907 TI - Primary closure of contaminated wounds in perforated appendicitis. AB - We studied the clinical course of 506 children consecutively admitted with appendicitis at The Hospital for Sick Children from 1985 to 1989. One hundred eighty-one children (35%), ranging in age from 1 to 17 years, presented with perforation verified by histological examination. Ninety-six of them (53%) had generalized peritonitis, 47 (26%) had localized peritonitis, and 38 (21%) had abscess formation. Usually, triple antibiotics were begun preoperatively if perforation was suspected; otherwise, cefoxitin was started. Triple antibiotics were used postoperatively for 5 to 7 days in almost all children in the perforated group. Neither abdominal nor subcutaneous drainage was routinely used even in cases of intraabdominal abscess. The skin was closed primarily with steri strips (63%), staples (20%), subcutaneous Dexon (11%), or silk (4%). Postoperative wound infection arose in 20 children (11%). Wound infections were noted from 1 to 14 days postoperatively (mean, 5.9 days). Whereas 9 of these were treated with local therapy only, 11 delayed the child's discharge or necessitated readmission. No patient suffered major complications from wound infection in that there were no cases of necrotizing fasciitis, reoperation for debridement, sepsis, or death. The intraabdominal abscess rate in this group of 181 children was 6% (n = 11). The low rate of infective complications fully justifies the policy of primary closure in contaminated wounds. This policy eliminates the necessity for painful and time-consuming dressing changes, shortens hospitalization, and obviates the trauma of delayed suturing of wounds in children. PMID- 1765908 TI - Management of complex ovarian cysts presenting in the first year of life. AB - With more frequent antenatal and postnatal diagnosis, the management of ovarian cysts has become somewhat controversial. Management protocols for simple ovarian cysts have been proposed. The purpose of this study was to establish a management protocol for complex ovarian cysts presenting antenatally and in the first year of life. We reviewed the records of nine infants who underwent surgical treatment for ovarian cysts over a 10-year period (1980 through 1989). Antenatal ultrasound performed between 24 and 34 weeks of gestation showed ovarian cysts in six infants. All six infants had complex cysts ranging in size from 3 to 10 cm on postnatal ultrasound. Exploration with oophorectomy or salpingooophorectomy was carried out at 2 days to 3 months of age for ovarian torsion. Ovarian cysts measuring up to 7 cm were diagnosed postnatally in three infants from 1 day to 7 months of age with ultrasound confirmation of complex, cystic intraabdominal masses. All patients underwent salpingooophorectomy, two for tuboovarian torsion and the third patient for a juvenile granulosa cell tumor. We recommend that all complex ovarian cysts, regardless of size, be surgically removed because they represent torsion, neoplasm, or alternate diagnoses, and removal can prevent possible complications. PMID- 1765909 TI - The anal sphincter force in the evaluation of postoperative imperforate anus. AB - Eight-four children, all of whom had imperforate anus, were evaluated by measuring the anal sphincter force (ASF). Sixty-three were boys, 46 of whom had a high imperforate anus and 17 of whom had the low anomaly. There were 7 girls with cloacal malformations, 7 girls with high type and 7 with low type of malformation. In all the boys with a high imperforate anus the ASF ranged from 50 to 300 g. Those boys with a low type had an average ASF of 513 g. Normal values vary from 480 to 600 g. Twenty-five of the boys with a high imperforate anus had undergone posterior sagittal anorectoplasty and none were clinically continent. Their ASF measurements were lower than in patients with spina bifida. Patients with a low anomaly, both boys and girls, were continent and had high ASF readings. The ASF is a simple, inexpensive, and objective measurement of fecal incontinence when this is the consequence of muscular inadequacy. A reproducible quantification is now available to compare results of different operations and different centres. PMID- 1765910 TI - The isolated bowel segment (Iowa Model II): absorption studies for glucose and leucine. AB - A model of the isolated bowel segment (IBS, Iowa Model II) was successfully created in experimental animals using a new surgical technique we developed. The IBS is completely free of its mesenteric attachment, yet its viability is preserved. The technique consists of two staged procedures: (1) initial enteropexy between the anterior margin of the liver and the antimesenteric border of the IBS with its ends forming cutaneous stomas; and (2) division of the IBS mesentery 5 weeks later. The IBS is nourished by vascular collaterals that form at the hepatoenteropexy during the interval between these two procedures. Our previous studies demonstrated preserved viability and motility in the IBS. This study was undertaken to test absorption in the IBS. In 25 rats (experimental group), the IBS (Iowa Model II) was created using an 8-cm-long isolated segment of jejunum. In 15 rats (control group), an 8-cm-long segment of jejunum was arranged to form a Thiry-Vella loop. Five weeks later, the IBS mesentery was divided in the experimental group, and sham laparotomy was performed in the control group animals. Absorption of glucose and leucine was studied in 13 rats of the experimental group and 6 of the control group using a constant single perfusion technique at 3, 8, and 11 weeks after the initial operation. The results were compared between the two groups. There was a 25% to 35% reduction in absorption of glucose and leucine in both groups with the advance of time, but no significant difference was observed between the groups except in leucine absorption at 11 weeks after the initial operation. This study concludes that absorption of glucose and leucine is preserved in the IBS after its mesentery is divided, suggesting that the IBS can be used as a functioning bowel for bowel reconstruction. PMID- 1765911 TI - Pneumatosis cystoides intestinalis in children beyond the first year of life: manifestations and management. AB - Beyond infancy, pneumatosis cystoides intestinalis (PCI) is rare. Data concerning pathogenesis and treatment are limited. Our experience with 12 children was examined to define predisposing factors, presentation, treatment, and outcome. Nine children were immunosuppressed, thus identifying an important etiologic subgroup. Presentation was variable but included abdominal pain, distention, diarrhea and hematochezia. Clostridium difficile was found in 3 patients and cytomegalovirus in 1. Radiographs showed free air in 3. Nine were treated with antibiotics and bowel rest, 1 with bowel rest alone, 1 with oral metronidazole, and 1 with observation. PCI resolved in 7 of 9 treated with antibiotics, although 1 child with leukemia had severe hematochezia secondary to colonic ulceration and required hemicolectomy. No other patient required laparotomy. The free air resolved in 2 of 3. There were 2 deaths, both from sepsis. One had free air on admission but no perforation was found at autopsy. Treatment recommendations remain unclear; however, C difficile and cytomegalovirus are important pathogens that should be identified and treated promptly. In symptomatic patients, bowel rest and antibiotics seem beneficial. Operative intervention should be reserved for patients with peritoneal signs, progressive deterioration, obstruction, or persistent, severe bleeding. Free air alone is not an indication for operative management in children with PCI. PMID- 1765912 TI - Intraabdominal pulmonary sequestration. AB - A left upper quadrant fetal abdominal mass was detected at 24 weeks gestation. The mass was again confirmed in a postnatal ultrasound. Pathological analysis of the excised mass demonstrated an intraabdominal lung sequestration with Stocker type II congenital cystic adenomatoid malformation (CCAM). The sonographic characteristic of these lesions are those of a homogeneous echogenic mass with variable shape passing through or arising from the diaphragm. Surgical excision is recommended because of the uncertainty of the preoperative diagnosis and the possibility of malignant changes in CCAM. PMID- 1765913 TI - Pneumatosis and pneumoperitoneum in chronic idiopathic intestinal pseudoobstruction. AB - Chronic idiopathic intestinal pseudoobstruction is a diagnosis of exclusion for the rare patient with severe small bowel atony without any demonstrable organic cause. The very poor prognosis associated with this disease has been somewhat improved with the advent of parenteral nutrition; nevertheless, these patients follow a stormy course characterized by malnutrition, recurrent obstruction, infection, hemorrhage, and perforation. We describe a 16-year-old boy with this disease who presented to us with vague abdominal pain and pneumoperitoneum. Laparotomy showed pneumatosis cystoides intestinalis without intestinal perforation. The presence of free air in the abdominal cavity is an almost pathognomonic sign of intestinal perforation. Pneumatosis cystoides intestinalis is one of the very few nonsurgical causes of pneumoperitoneum. Beyond the neonatal period, in which it is the hallmark of necrotizing enterocolitis, it has been described in patients with severe obstructive lung disease, in collagenous disorders, and in the short-bowel syndrome. In the present case, it may have resulted from chronic intestinal distension, allowing air under pressure to dissect through the bowel wall. The challenge of such a unique association of conditions lies in the avoidance of unnecessary surgery in a chronic, essentially nonsurgical disease while avoiding unnecessary delay in a possibly acute surgical event. PMID- 1765914 TI - Midline cleft of lower lip with cleft of the mandible and midline dermoid in the neck. AB - A female infant presented with a midline cleft of the mandible and a midline dermoid in the neck. Midline clefts are rare craniofacial clefts. Midline mandibular clefts can be associated with midline cleft of upper lip and a dermoid of nose. But a midline mandibular cleft with a midline dermoid in the neck has not been reported before. PMID- 1765915 TI - Lingual dermoid. AB - Dermoid cysts are congenital lesions derived from ectodermal differentiation of multipotential cells. Only 7% of all dermoid cysts occur in the head and neck region and about a quarter of them are seen in the floor of mouth. Dermoids confined to the tongue are rare entities. Only 13 such cases, mostly in infants, have been reported in literature. One such case of an infant with intralingual dermoid and feeding difficulty, relieved following cyst excision, is reported. PMID- 1765916 TI - The midline cervical cleft. AB - The midline cervical cleft is a rare congenital anomaly of the ventral neck. With reference to two patients with a midline cervical cleft, we discuss the clinical picture, the embryology, and the surgical treatment. PMID- 1765917 TI - Successful salvage of an 8-month-old child with an aortoesophageal fistula. AB - Aortoesophageal fistula (AEF) from an impacted esophageal foreign body was first described in 1818 and has been a uniformly fatal condition to this date. We report the salvage of an 8-month-old child with an AEF from ingesting a straight pin. She survived a massive gastrointestinal (GI) bleed and primary esophageal and aortic repairs performed in conjunction with aortic shunting, interposed pleural flap, and a diverting cervical esophagostomy. This represents the first successful outcome of an AEF from a foreign body, many of which have been described in infants and children. History of esophageal foreign body and signal upper GI hemorrhage should mandate aggressive diagnosis and surgical intervention. PMID- 1765918 TI - Familial congenital diaphragmatic defect: transmission from father to daughter. AB - The first well-documented incidences of familial congenital diaphragmatic defects in two generations are reported. The transmission was from father to daughter; both cases showed an almost identical history. These findings are supporting the proposed multifactorial inheritance theory. PMID- 1765919 TI - Congenital biliary atresia and congenital biliary dilatation in siblings. AB - Congenital biliary atresia or congenital biliary dilatation in siblings have been reported, although the genetic influences in these diseases are considered to be obscure. We report a case of congenital biliary atresia and congenital biliary dilatation in sisters. PMID- 1765920 TI - Pseudoadrenal mass: unusual presentation of bronchogenic cyst. AB - Isolated abdominal bronchogenic cysts are extremely rare. We report the fourth such case in an asymptomatic 4-year-old girl who initially presented for evaluation of urinary tract infection and new-onset urinary incontinence. Ultrasound, computed tomography, and magnetic resonance imaging findings were consistent with an adrenal mass. At exploration, the patient was found to have a mass in the area of the gastroesophageal junction and a normal left adrenal gland. The final pathology confirmed the diagnosis of a bronchogenic cyst. Abdominal bronchogenic cysts, although rare, should be considered in the diagnosis of a retroperitoneal mass. PMID- 1765921 TI - Recurrent perforations of viscus due to ventriculoperitoneal shunt in a hydrocephalic child. AB - In this report, we describe the first case of recurrent perforations of viscus due to ventriculoperitoneal shunt for the treatment of hydrocephalus. Based on our own experience and a survey of literature, we suggest that perforation of the gastrointestinal tract should be suspected in patients with ventriculoperitoneal shunt, particularly when abdominal symptoms or ventriculitis are presented. To manage this complication, at the first perforation in the present case, a fibrin sealant was effective for closure of the perforated stomach wall. At the second perforation, when laparotomy was performed, we could not find any abnormality in the abdominal cavity except for a sheath and slight omental adhesions near it. PMID- 1765922 TI - Solitary intestinal fibromatosis: a rare cause of intestinal obstruction in neonate and infant. AB - A 5-month-old white boy infant exhibited remarkable growth retardation and subsequently developed ileal obstruction, which was found to be due to solitary intestinal fibromatosis. This rare lesion has an excellent prognosis if it is completely excised. This is in contrast to cases of congenital fibromatosis with multiple lesions, which carries a poor prognosis. PMID- 1765923 TI - Intrauterine volvulus without malrotation. AB - This report describes two cases of intrauterine volvulus without associated intestinal malrotation. Polyhydramnios was present in one neonate; the presentation was very sudden and catastrophic in the other. Neither plain films nor contrast enema indicated the correct preoperative diagnosis in these infants. A "normal" plain film or enema in a suspected case of volvulus may lead to a delay in surgical management resulting in extensive ischemic necrosis of the bowel, often with extremely high mortality. Bile emesis or aspirate in neonates demands a high index of suspicion of intestinal obstruction. Shock, bloody diarrhea, and tense and distended abdomen are ominous, indicating volvulus often with gangrene. PMID- 1765924 TI - Necrotizing enterocolitis following intrauterine blood transfusion. AB - Intravascular intrauterine transfusion allows a more sophisticated and exact approach to the management of severe Rh hemolytic disease. This technique involves direct manipulation of the fetal umbilical vessels; its hazards include umbilical cord trauma and thrombosis or emboli. The consequences of such events in utero are largely unknown. In this case necrotizing enterocolitis occurred in a full-term infant after three intrauterine intravascular transfusions. PMID- 1765925 TI - Appendicoumbilical fistula as a sequela of perforated appendicitis. AB - This is the first report, we believe, of a 5-year-old boy who developed appendicoumbilical fistula as a sequela of perforated appendicitis. We discuss a proposed explanation of the mechanism in its formation. PMID- 1765926 TI - Neonatal colorectal spindle cell sarcoma. AB - Intestinal spindle cell sarcomas occur very rarely in the neonatal period. There have been 10 previous reported cases. A neonate with colorectal spindle cell sarcoma is reported. The clinical features of the 11 cases and the prognosis of the tumor are discussed. PMID- 1765927 TI - Late recurrence in neuroblastoma. AB - Recurrence in neuroblastoma more than 5 years after diagnosis is extremely rare. One case of neuroblastoma recurring 10 years after complete remission from disseminated neuroblastoma at the 5th month of life is reported. Twelve additional cases in the literature are reviewed. Despite the apparent rarity of this event, it should be considered that the patients with disseminated neuroblastoma induced to complete remission without definitive treatment have a potential for late recurrence and should be followed over long periods of time, especially during puberty. PMID- 1765928 TI - Aortic aneurysm in a 5-year-old boy with tuberous sclerosis. AB - A 5-year-old boy known to have tuberous sclerosis was admitted with an abdominal aortic aneurysm. The aneurysm was resected and replaced by a bifurcation prosthesis. Follow-up, which amounts up to 4 years, has been uneventful. Prompt recognition and surgical treatment are essential in the management of this rare but potentially lethal condition. PMID- 1765929 TI - Abdominal aortic aneurysm in a neonate. AB - This is the second reported case of abdominal aortic aneurysm in neonates to be presented in the English language literature. The first case was reported by Howorth in 1967. In addition to the presence of abdominal aortic aneurysm, this neonate has nesidioblastosis and sequestration of the lungs. The combination of these three rare anomalies in one infant is fascinating and has not been reported. PMID- 1765930 TI - Femorofemoral artery bypass for blunt iliac artery occlusion in a child. AB - Vascular injuries from blunt trauma are rare in children. This report concerns traumatic occlusion of the common iliac artery with limb-threatening ischemia in a 6-year-old boy sustained while wearing a lap belt. Associated injuries included fracture of the third lumbar vertebra, perforation of the sigmoid colon, and disruption of the anterior abdominal wall musculature. Because of fecal contamination from the colon perforation, revascularization using a subcutaneous prosthetic femorofemoral artery bypass was performed and proved successful in limb salvage. As improved prosthetic vascular conduits of smaller caliber are developed, applications in small children with vascular injuries may increase. PMID- 1765931 TI - Scrotal pneumatocele: a rare phenomenon. AB - In contrast to what would be expected in newborns with pneumoperitoneum, pneumoscrotum is a rare phenomenon. A newborn who presented with a pneumoscrotum as first, overt, sign of pneumoperitoneum is described. A perforated Meckel's diverticulum was responsible for the airleak. PMID- 1765932 TI - Scrotoschisis as a mechanism for extracorporeal testicular ectopia. AB - Only one case of a rare anomaly, a congenital defect in the integrity of the scrotal wall permitting egress of the testis to an ectopic extracorporeal location, has been previously reported. A second occurrence of this rare anomally is herein described with a proposed mechanism of occurrence. The condition is termed scrotoschisis. PMID- 1765933 TI - The newborn with hydrops and sacrococcygeal teratoma. AB - The combination of fetal hydrops and sacrococcygeal teratoma (SCT), is considered to be lethal. We report two such babies who survived. Case 1 exhibited oliguric acute renal failure (ARF) immediately after birth, and severe respiratory insufficiency despite maximal ventilatory support and vasodilator infusions. Tumor resection on the 2nd day of life resulted in an immediate improvement in pulmonary function as reflected by the ratio of arterial to alveolar oxygen. Renal function returned in a pattern typical of recovery from acute tubular necrosis. Case 2, less desperately ill, developed nonoliguric ARF, in part due to deliberate fluid restriction during the 7 days that followed birth and preceded surgery. This resolved following liberalization of fluid intake that occurred at the time of tumor removal on the 7th day of life. The baby also had respiratory insufficiency that improved after surgery. Respiratory insufficiency may be a severe and life-threatening complication of SCT and hydrops fetalis. Pulmonary function may improve dramatically by removal of the tumor. Why this improvement occurs is unclear. Improvement of respiratory function may result from the elimination of excess tumor blood volume with an improvement of the ventilation perfusion ratio. Alternatively, the tumor may be a source of vasoactive substances or extremely desaturated blood that leads to pulmonary hypertension and right-to-left shunting. Uncertainties in postnatal fluid shifts and exaggerated fluid compartment volumes demand close attention to details of renal function. PMID- 1765934 TI - Determining the value of a periodontal diagnostic test. AB - The purpose of this analysis is to present a method to determine the value of diagnostic tests for evidence of bacterial activity related to periodontal disease. Five population studies are discussed: 1) screening the general population; 2) screening the patients of a general practice; 3) diagnosing initial patients referred to a periodontist; 4) monitoring periodontal maintenance patients; and 5) monitoring postsurgical refractory patients. A decision tree is constructed in which the primary decision branches are test and no test. Chance branches after the test branch were test positive and test negative. The treatment alternatives in the treatment branches were prophylaxis and oral hygiene, scaling and root planing, and advanced periodontal therapy (including surgical intervention and/or antibiotics or chemotherapies). Probabilities for the prevalence of disease in each population were obtained from epidemiological surveys. Disease activity and outcome states were estimated from clinical studies of periodontal treatment. For initial periodontal patients, using a sensitivity of .87 and a specificity of .84 the value of the test branch is .851 versus .566 for the no test branch. Assumptions on the diagnostic test's sensitivity and specificity and the utility of outcomes were tested with the decision analysis techniques of sensitivity and 2-way threshold analyses. These analyses show that using a test had a greater value than no test for older patients in the general practitioner's office, and for the 3 types of periodontal treatment patients. In contrast, using the test had a lower value than not using the test in younger dental patients in the general practitioner's office and for screening the general population. The diagnostic and treatment schemes proposed here are amendable to rigorous testing to evaluate their reliability and usefulness. PMID- 1765935 TI - Compliance with supportive periodontal therapy. AB - All new patients commencing supportive periodontal therapy (periodontal maintenance) after treatment in a specialist periodontal practice from 1983 to 1986 were identified from practice records. Based on their compliance with the recommended schedule of visits, the patients were classified as either compliant or non-compliant. The results indicated that there were no significant differences between compliant and non-compliant patients with regards to age, sex, number of missing teeth, plaque score, or periodontal disease severity. More non-compliant patients than compliant patients were smokers (P less than 0.05). By contrast, more compliant patients were covered by private dental insurance (P less than 0.01) and more had periodontal surgery during treatment (P less than 0.001). Only 36% of the initial patient sample was found to be compliant at the end of 1989, with the greatest patient loss in the first year of supportive periodontal therapy of about 42%. The annual attrition rate decreased in subsequent years to average about 10% of those remaining in each year, indicating that a patient is more likely to remain compliant if he or she attends for at least 1 year of supportive periodontal treatment. Non-compliant patients were sent a questionnaire seeking reasons for their non-compliance. Forty percent of the questionnaires were returned. The most common reason given for non-compliance was that a general dental practitioner was attending to the patient's periodontal treatment needs. Many considered supportive periodontal therapy to be too expensive, while a significant proportion considered that they no longer required treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765936 TI - The histological investigation of gingiva from patients with chronic renal failure, renal transplants, and periodontitis: a light and electron microscopic study. AB - The clinical and histological appearance of gingiva was evaluated in renal transplant recipients (RTR) receiving immunosuppressive drugs, in patients with chronic renal failure (CRF) undergoing hemodialysis, and systemically healthy individuals with periodontitis. Although the amount of bacterial plaque accumulation was similar among the groups (P greater than 0.05), the gingival inflammation was significantly less in RTR when compared to the other 2 groups (P less than 0.05). In light microscopic investigation the overall appearance of the connective tissue was similar in all of the groups. A mononuclear cell infiltration was present in all of the specimens; however, the number of inflammatory cells in patients with periodontitis was significantly higher than the other 2 groups (P less than 0.05). Prominent epithelial changes in the superficial layers of the oral epithelium; i.e., areas showing desquamation-like appearance, were noticed in patients with CRF. In electron microscopic investigation, fibroblasts and plasma cells with well-developed granular endoplasmic reticulum were found in connective tissue in RTR patients. In patients with CRF, epithelial cells presented swollen granular endoplasmic reticulum cisternae resembling vacuoles, indicating the presence of degeneration. It was suggested that with the use of immunosuppressive drugs the response to bacterial plaque did not diminish completely. PMID- 1765937 TI - No female preponderance in juvenile periodontitis after correction for ascertainment bias. AB - Juvenile periodontitis (JP) is generally recognized to exist in 2 clinical forms: localized and generalized. Historically, females have been reported to be affected by both forms of JP at rates of 2 to 10 times greater than males. However, evidence suggests that females are more likely than males to seek dental care. If this is true, females will be diagnosed with JP more often than males even if juvenile periodontitis is equally prevalent among males and females in the general population. Thus, previous reports of a female predominance for JP may simply reflect this selection bias. The purpose of this study was to test our hypothesis that juvenile periodontitis occurs with equal frequency in males and females after correcting for selection bias. Twenty-four juvenile periodontitis probands were ascertained from the VCU/MCV dental clinics. The families of these individuals were examined to determine the relative prevalence of JP among male and female relatives of these probands. Our results indicate that while females are 3 times more likely than males to be initially ascertained as juvenile periodontitis probands, among relatives of probands the proportion of affected males and females is equal. PMID- 1765938 TI - Root substance removal by scaling and root planing. AB - The amount of root substance removed by scaling and root planing is largely unknown. The present study evaluated in vitro the root substance loss caused by a defined number of working strokes at known forces. Forty extracted teeth with loss of connective tissue attachment into the middle third of the roots were washed and embedded in plaster, leaving one entire corono-apical tooth aspect exposed. The teeth were reproducibly repositioned in a bench-vise, where a profilometer repeatedly measured root surface levels at the same location. In a standard area of the roots a total of 40 working strokes were applied. Low forces were used in 30 teeth and high forces in 10 teeth. The forces were recorded using a piezo-electric receiver built into the upper shank of the curet. Root substance loss was measured after 5, 10, 20, and 40 working strokes. The results showed that the mean low force used per working stroke across all 40 strokes was 3.04 Newtons for the low forces, and 8.48 Newtons for the high forces. Mean cumulative loss of root substance across 40 strokes was 148.7 microns at low forces, and 343.3 microns at high forces. The mean force per stroke increased slightly across the 40 strokes, while substance removal per stroke decreased. Substance removal per stroke during strokes 1 to 5 was 6.8 microns using low forces and 20.6 microns using high forces. During strokes 21 to 40 mean removal per stroke was 2.3 microns at low forces, and 5.6 microns at high forces. These results suggest that high forces remove more root substance, and loss per stroke becomes less with increasing numbers of strokes. PMID- 1765939 TI - The neutrophil: mechanisms of controlling periodontal bacteria. AB - The control of potentially periodontopathic microorganisms by host neutrophils is crucial to periodontal health. Neutrophils may use oxidative or nonoxidative mechanisms and either kill bacteria, influence bacterial growth, or modify bacterial colonization in the periodontium. Delivery of antimicrobial substances by neutrophils involves respiratory burst activity, phagocytosis, secretion, or cytolysis/apoptosis. Neutrophils contain a number of antimicrobial components including calprotectin complex, lysozyme, defensins, cofactor-binding proteins, neutral serine proteases, bactericidal/permeability increasing protein, myeloperoxidase, and a NADPH oxidase system. Many of these components are multifunctional and exhibit several mechanisms of antimicrobial activity. When comparisons are made among periodontal bacteria, differences in sensitivity to different components are observed. A hypothesis of specific defense is presented: That specific periodontal diseases can result from the failure of specific aspects of the host immune system (the neutrophil, in particular) in its interaction with specific periodontal pathogens. Failure may be due to phenotypic variation (pleomorphism) within the host or bacterial evasive strategies. PMID- 1765940 TI - The use of autogenous periosteal grafts as barriers for the treatment of Class II furcation involvements in lower molars. AB - This study clinically analyzed the efficacy of a connective tissue graft including the periosteum used as a barrier to enhance new attachment and osseous regeneration. Fifteen patients, with no systemic diseases, and adult periodontitis including 2 Class II furcation involvements in lower molars comprised the study group. After completion of the initial phase of therapy, all patients were treated with full-thickness periodontal flaps, using sulcular incisions, and thorough scaling and root planing. One furca, selected at random, had a connective tissue graft, obtained from the palate and including the periosteum, placed over the furca with the flap sutured over the top of this graft. Control furcas received no graft and the flap was sutured in its original position. Both molars were treated in the same session. The following presurgical measurements were made: probing pocket depth, attachment level, gingival recession, sulcular bleeding index, and plaque index. The horizontal and vertical dimensions of the osseous defects were recorded after flap elevation and debridement. Six months later all clinical parameters were again measured and reentry flaps were performed to measure the bony defects. No statistically significant differences were found preoperatively between control and experimental molars with respect to soft tissue and osseous measurements. Six months after surgery, the experimental molars showed, in comparison to the controls, significant reduction in pocket depth and gain in attachment level as well as in vertical and horizontal measurements of the inter-radicular osseous defect. PMID- 1765941 TI - The gingival immune response to Actinobacillus actinomycetemcomitans in juvenile periodontitis. AB - The established and advanced lesions of juvenile periodontitis-localized form (JP) are predominated by B-lymphocytes and plasma cells. Local immune processes may participate in protective or immunopathologic roles in the pathogenesis of this disease. Actinobacillus actinomycetemcomitans (A.a.) is implicated as a primary etiologic agent in JP. An in vitro gingival explant culture system was utilized to study the specificity of immunoglobulins produced by diseased JP tissues. A dot-immunobinding assay demonstrated that 46% of the supernatant fluids (SF) from explant cultures of diseased tissues (n = 39) were positive for the presence of antibody to A.a. Y4, while 61% of autologous JP sera (n = 39) tested positive. For rapidly progressive (RP) and adult periodontitis (AP) SF, 50% and 40% were positive for A.a. Y4, respectively. Seventeen percent of SF from healthy tissue were positive for A.a. Y4. There was no significant difference between JP SF reactivities to A.a. Y4 when compared to reactivities of SF from AP and RP patients. Only 10% of JP SF were positive for Porphyromonas asaccharolytica, a non-oral control microorganism. The de novo biosynthesis of antibody in JP tissue, reactive with A.a. Y4, was demonstrated with Staph Protein A isolated 14C-labeled IgG (SPAG) and the use of a dot-immunobinding assay and autoradiography. The in vitro gingival tissue explant culture system described provides a useful model for the study of the synthesis and specificity of localized immunoglobulins produced by diseased tissues of JP patients. PMID- 1765942 TI - National guidelines for the early detection of cancer. PMID- 1765943 TI - Sound the alarm! Entry level on the prowl again. PMID- 1765944 TI - Preceptor programs-everyone benefits. PMID- 1765946 TI - Your role in caring for patients undergoing MRI (magnetic resonance imaging). PMID- 1765945 TI - Examining sexuality in long term care. PMID- 1765947 TI - What to do when the diabetic patient faces surgery. PMID- 1765948 TI - Clinical use of insulin: its types and characteristics (Part I). PMID- 1765949 TI - Where dreams come true. PMID- 1765950 TI - Lactase deficiency: helping patients cope. PMID- 1765951 TI - Diabetes. Interview by Veronica L. Conley. PMID- 1765952 TI - Mullerian tract abnormalities and associated auditory defects. AB - Fifteen women with mullerian defects and a control population of 15 with normal mullerian systems underwent dynamic audiometric testing. The rate of auditory defects in women with mullerian abnormalities (33%) was significantly higher (P less than .05) than in the control population (0%). Those patients manifested mild, moderate and severe sensorineural defects in the high-frequency range. The defects were not accounted for by age or occupation and were associated with renal agenesis in 60% of the cases. One patient with normal audiometric testing and a septate uterus had a family history significant for an identical twin sister with unilateral renal agenesis, ipsilateral congenital deafness and an unevaluated mullerian tract. The results of the study suggest that a spectrum of auditory changes may exist in association with mullerian defects, ranging from previously described congenital deafness to more subtle hearing defects not clinically evident. PMID- 1765953 TI - The shortened premenstrual assessment form. AB - Research on the premenstrual syndrome (PMS) has been impeded by a lack of reliable and valid assessment techniques. The premenstrual assessment form (PAF), although a valid and reliable instrument, consists of 95 questions, requires extensive periods of time to complete and may be inappropriate for some clinical and research purposes. A study was designed to shorten the PAF and to test the validity and reliability of the shortened instrument. Twenty items that were most frequently reported to change during the week prior to menses were selected from the 95-item PAF form. The 20-item PAF form was administered at the baseline and 6 and 12-month follow-up clinic visits. A factor analysis identified three subscales: affect, water retention and pain. Our results showed that a shortened, 10-item version of the PAF had high internal consistency and reliability. A comparison of the symptoms on the 10-item PAF scale to reported nicotine withdrawal symptoms indicated that while the two correlated, the intercorrelation between the PAF subscales and the total PAF over time was higher. Thus, the 10 item PAF appears to measure a somewhat distinct and relatively stable set of symptoms. The 10-item PAF is a reliable and valid instrument that can be used to assess PMS when the study design or clinical need precludes the use of a 95-item PAF. PMID- 1765954 TI - Results of a prenatal screening program for the human immunodeficiency virus in a cross-sectional population. AB - A prenatal screening program for antibody to the human immunodeficiency virus (HIV) was examined prospectively in a cross-sectional population. Routine screening was performed on 3,241 women during the first trimester. Serum samples yielding repeatedly positive results on an enzyme-linked immunosorbent assay (ELISA) (n = 6) were subjected to confirmatory Western blot testing. All the specimens were determined to be false positive with atypical banding regions not consistent with HIV-1 infection. This false-positive rate was higher than in previous reports of screening programs in low-risk populations (P less than .005). Since antibody to HIV may not be detectable for several months after infection, we serially tested 984 of the women in different trimesters of pregnancy to determine whether repeat testing would yield seroconversion undetected at the first screening. No patient who initially tested negative on the ELISA tested positive later in gestation. We therefore recommend that routine screening be performed only once during pregnancy, preferably in the first or early second trimester, in the general population. PMID- 1765955 TI - Routine use of vaginal ultrasonography in the preoperative evaluation of gynecologic patients. An adjunct to resident education. AB - To determine the clinical utility of routine vaginal ultrasound in evaluating gynecologic patients, we prospectively studied 133 women scheduled to undergo elective surgery based upon abnormal clinical findings as determined by residents and faculty in a large, county-based teaching hospital. Patients were examined bimanually by the surgeons and then examined ultrasonographically using a 5.0-MHz vaginal probe. Surgery was scheduled within 48 hours of the clinical examinations. Vaginosonography demonstrated enhanced sensitivity, specificity and predictive value as compared to bimanual pelvic examination. The technique was quickly mastered by resident physicians, with discrepancies between preoperative ultrasound observations and actual surgical findings present in but 15 of 532 instances. Vaginal ultrasonography is an effective routine adjunct to physical examination in the preoperative evaluation of surgical patients. Furthermore, it has diagnostic capabilities superior to those of the bimanual pelvic examination and increases the accuracy of preoperative diagnoses in gynecologic patients. PMID- 1765956 TI - Curettage after midtrimester termination of pregnancy. Is it necessary? AB - We conducted a prospective study to assess the need for curettage after spontaneous expulsion of the placenta in midtrimester termination of pregnancy. The rate of early complications (9.4%) was consistent with previously reported data. A higher incidence of intrauterine adhesions, detected on hysteroscopy, was observed in patients who underwent curettage (38.5% vs. 7.7%, P = .0727). In order to prevent intrauterine adhesions, curettage should be restricted to cases in which retained products of conception are suspected. It should not be performed routinely in every case of midtrimester termination of pregnancy after spontaneous expulsion of the placenta. PMID- 1765957 TI - Ectopic pregnancy resulting from gamete intrafallopian transfer and in vitro fertilization. Role of ultrasonography in diagnosis and treatment. AB - Forty-five cases of ectopic pregnancy occurred after gamete intrafallopian transfer (32 cases) or in vitro fertilization (13 cases). Ultrasonography positively identified ectopic pregnancy in 33 cases (73.4%) and suggested the presence of one in 7 cases (15.6%). There were five false-negative results (11.1%). The incidence of rare types of ectopic pregnancy after assisted fertility procedures, such as ovarian, heterotopic, cervical and ectopic pregnancy, in patients who had undergone a previous salpingectomy was increased. Ultrasound scanning was used to monitor three cases of nonviable ectopic pregnancy; all three required no further treatment. In 14 cases of viable ectopic pregnancy the gestational sac was aspirated and injected with potassium chloride and methotrexate. In seven of those cases no further treatment was needed. Patients who conceive as a result of assisted fertility procedures should be scanned four to six weeks after the procedure or sooner if they are considered at high risk of developing an ectopic pregnancy or if the condition is symptomatic. PMID- 1765958 TI - Amniotic fluid index before and after amnioinfusion of a fixed volume of normal saline. AB - Twenty-one women at term, with an amniotic fluid index (AFI) less than or equal to 5.0 cm and intact membranes, underwent an artificial amniotomy and transcervical amnioinfusion of 250 mL of normal saline at room temperature. The mean (+/- SD) cervical dilation at the time of the transcervical amnioinfusion was 2.6 +/- 1.3 cm (range, 1-6). The mean AFI prior to the amnioinfusion was 3.0 +/- 1.49 cm (range, 0-4.7). The mean AFI after the amnioinfusion was 8.9 +/- 2.9 cm (range, 5.1-14.3). A mean change in the AFI of 5.8 +/- 2.6 cm (range, 0.9 10.6) was noted. Among patients with AFI less than or equal to 5.0 cm and intact membranes, amnioinfusion of 250 mL of normal saline seems to be a safe and simple way to increase the AFI to greater than 5.0 cm. PMID- 1765959 TI - Observations on the postpartum shivering phenomenon. AB - Fifty healthy, nonmedicated, laboring women who had normal spontaneous vaginal deliveries were studied to determine the incidence, time of onset, severity, duration, temperature patterns and relationship of various perinatal factors to the postpartum shivering phenomenon. Axillary temperature was recorded on admission, before delivery, at delivery and every 15 minutes postpartum for 75 minutes. The degree and duration of shivering were quantified visually. The environmental temperature was recorded. Of the 50 women, 22 (44%) commenced shivering during delivery or up to 30 minutes postpartum. Shiverers and nonshiverers exhibited a reduction in the mean axillary temperature during labor, with a rise post-partum (P less than .002). The median axillary temperature of the shiverers at all time points was higher than that of the nonshiverers and was statistically significant 30 (P less than .01), 45 (P less than .003), 60 (P less than .004) and 75 minutes (P less than .001) after delivery. The shiverers tended to raise their postdelivery temperature somewhat later than did the nonshiverers. The temperature pattern of both shiverers and nonshiverers fell during labor, and the temperature pattern of the shiverers differed from that of the nonshiverers postpartum. The mean delivery room temperature for shiverers was lower than for nonshiverers (P less than .009), as was the mean recovery room temperature (P less than .03). Environmental temperature may play a heretofore unsuspected role in the postpartum shivering phenomenon. PMID- 1765960 TI - Lymphangioma circumscriptum of the vulva. A report of two cases. AB - Lymphangioma circumscriptum is an uncommon dermatologic problem that only rarely affects the vulva. It is considered to be a circumscribed developmental defect of lymphatic tissue in the dermis. We encountered two patients whose clinical manifestations required management with extensive vulvar surgery. These cases illustrate the spectrum of presentation of this disorder and its treatment. PMID- 1765961 TI - Sonographic diagnosis of advanced ectopic pregnancy. A case report. AB - The diagnosis of advanced extrauterine pregnancy is made most often sonographically by identification of a uterus separate from the fetus. Leiomyomas or other pelvic masses can make the sonographic diagnosis more difficult. In a woman with an advanced ectopic pregnancy and uterine leiomyoma, the sonographic diagnosis was made by passing a sterile probe through the endocervix with simultaneous, real-time ultrasound observation. PMID- 1765962 TI - Recurrent necrotizing fasciitis of the vulva. A case report. AB - Necrotizing fasciitis most often occurs in the context of prior trauma or surgery. Predisposing medical conditions include diabetes mellitus, arteriosclerosis, obesity, hypertension and prior irradiation. De novo occurrence in the vulva, in the absence of prior injury, surgery or irradiation, has been reported rarely. Necrotizing fasciitis of the vulva in the diabetic patient may have an insidious onset but requires an early diagnosis and aggressive surgical episode of fasciitis occurred in an obese, diabetic woman. Aggressive, wide excision of all infected vulvar, mons and thigh tissue, followed by aggressive medical and surgical postoperative care, resulted in minimal morbidity. Prompt recognition and aggressive care are required to treat this condition. PMID- 1765963 TI - A method of predicting the likelihood of success or failure in a trial of labor in any given set of circumstances is a laudable goal. PMID- 1765964 TI - Report on asymptomatic genital excretion of herpes simplex virus (HSV) in 21.9% of 41 women with clinical buttock herpes. PMID- 1765965 TI - D-penicillamine treatment in systemic sclerosis. PMID- 1765966 TI - Epidemiologic considerations in the primary prevention of osteoarthritis. PMID- 1765967 TI - The microbiological causes of rheumatoid arthritis. PMID- 1765968 TI - Hit and run or permanent hit? Is there evidence for a microbiological cause of rheumatoid arthritis? PMID- 1765969 TI - Morphological localization of hyaluronan in normal and diseased synovium. AB - The morphological distribution of hyaluronan in normal and diseased synovium has been determined using a probe derived from the hyaluronan binding region of cartilage proteoglycan core protein. Normal synovium showed hyaluronan surrounding the lining layer cells with little in deeper layers. Rheumatoid synovium showed intense staining for hyaluronan throughout the tissue, notably associated with blood vessels and areas of dense cellular infiltration. Osteoarthritic tissues varied according to the degree of infiltration present, with inflamed specimens closely resembling rheumatoid tissue. The distribution of hyaluronan in diseased synovium suggests a role in aspects of the inflammatory process such as angiogenesis and cell traffic. PMID- 1765970 TI - Does estrogen replacement therapy protect against rheumatoid arthritis? AB - The incidence of rheumatoid arthritis (RA) was compared in 2 cohorts of women aged 35-64. One consisted of 1,075 estrogen replacement therapy (ERT) users and the other was 3,251 women from general practice registers. Screening detected 32 cases; 8 postmenopausal control and 6 ERT women developed RA during the study period 1982-1986. This produced incidence rates of 19.7/10,000 and 12.3/10,000 years of observation for ERT and controls, respectively. The relative risks for ERT was 1.62 (95% CI 0.56-4.74) and reduced towards unity after adjustment for potential confounders. Despite the wide confidence interval, our data do not support the previous observation of a 4-fold reduction in RA incidence in ERT users. Indeed the incidence rate in the exposed group in this study exceeded current population estimates of RA incidence in postmenopausal women. We believe that the high incidence rates could be best explained by the self-selection for estrogen therapy at the menopause of those with undiagnosed joint symptoms. These findings underscore the difficulties in elucidating the relationship between ERT and RA. PMID- 1765971 TI - Rheumatic diseases in Alaskan Indians of the southeast coast: high prevalence of rheumatoid arthritis and systemic lupus erythematosus. AB - A review of rheumatic diseases in the southeast coastal Indians of Alaska revealed high frequencies of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Both prevalence and incidence rates of RA were significantly higher and the peak age of incidence was younger in the southeast Alaskan Indian population than in Alaskan Eskimo groups and the United States population in general. The prevalence of SLE in the Alaskan Indian population was about twice that reported for most white populations. The frequency of seronegative spondyloarthropathic disorders was similar in the Alaskan Indian and Eskimo populations. Comparable studies of the prevalence of spondyloarthropathy in general have not been carried out in white populations. The prevalence rate of ankylosing spondylitis, one of the major types of spondyloarthropathy, did not differ significantly in the SE Indians from rates in predominantly white US populations. PMID- 1765972 TI - A study of the longterm efficacy and toxicity of cyclosporine A in rheumatoid arthritis. AB - We determined the longterm efficacy and toxicity of cyclosporine A in rheumatoid arthritis (RA) in an open clinical trial, at a single centre, outpatient rheumatology clinic. The initial dose was 5 mg/kg/day increased to 10 mg/kg/day with adjustments for toxicity and plasma cyclosporine A levels. We measured efficacy by the Ritchie articular index, pain and function on a 10 cm visual analog scale, C-reactive protein (CRP) and erythrocyte sedimentation rate. Toxicity was evaluated by patient reports, serum creatinine, cyclosporine A levels and liver function tests. Median treatment duration was 29 months (16.5 38). At 24 months median reduction in Ritchie articular index was 50% (9-79); pain: 49% (21-77), with a 50% (4-76) improvement in function; and CRP fell by 72.5% (22-87). The main side effect was a 40% (27-47) decline in estimated creatinine clearance. We conclude that cyclosporine A at doses below 5 mg/kg/day is associated with clinically significant improvements in indices of disease activity in RA. Renal dysfunction was the most frequent side effect. PMID- 1765973 TI - Relationship between severity of rheumatoid arthritis and serum alpha 1 antitrypsin. AB - We determined serum alpha 1-antitrypsin phenotypes and levels in 281 patients with classical or definite rheumatoid arthritis (RA). The prevalence of the MZ phenotype in our patients with RA was not increased, as there were only 3 MZ cases (1.1% of all cases and 1.4% of seropositive cases) compared to the 3% prevalence in controls. The FM phenotype was detected in 6 cases, a prevalence rate of 2.1%, significantly higher than in controls (prevalence less than 0.4%). Increased serum levels of alpha 1-antitrypsin were independently associated (p less than 0.01) with the presence of wrist joint erosions and the use of gold and/or penicillamine for treatment; this association may represent a serum antitrypsin response to more severe disease. PMID- 1765974 TI - A 15-year prospective study of treatment of rapidly progressive systemic sclerosis with D-penicillamine [see comment]. AB - A 15-year (1973-1988) prospective study was conducted to determine the effectiveness of D-penicillamine (D-pen) in the treatment of rapidly progressive systemic sclerosis (SSc) of recent onset. Sixty-nine consecutive patients fulfilling strict criteria for rapidly progressive diffuse SSc of less than 18 months of duration were enrolled. Sixty received at least 750 mg/day of D-pen for at least 6 months, whereas 9 did not complete 6 months of treatment because of toxicity, noncompliance or death. In 58 of the 60 patients treated for longer than 6 months, there was an arrest in the progression of skin sclerosis followed by regression with softening, increased pliability and reappearance of sweating and hair. In these cases, the extent of sclerotic skin decreased from a maximum of 64.6 +/- 23.1% total body surface to 15.7 +/- 13.2%. In addition, in the group of patients that received D-pen for longer than 6 months, SSc renal disease was uncommon and pulmonary involvement was not progressive. The overall survival in this group was 88.3%. In conclusion, our prospective study showed that the administration of D-pen resulted in significant improvement of skin sclerosis and in prolonged survival of patients with early, rapidly progressive SSc with diffuse cutaneous involvement. PMID- 1765975 TI - Clinical course of patients with anti-RNP antibodies. A prospective study of 32 patients. AB - Thirty-two patients with high and low anti-RNP antibody titers were followed prospectively during a mean observation of 65 months. The following 4 titer patterns were observed: persistently high, low increasing to high, high decreasing to low and persistently low titers. At first admission, 17 of the 23 patients with high anti-RNP titers did not fulfill the criteria of defined connective tissue diseases (CTD). The clinical courses were characterized by the appearance of new organ manifestations and at the end of the study 17/23 fulfilled the criteria for mixed CTD (MCTD). A development towards systemic lupus erythematosus (SLE) was seen in one, concomitant with decreasing anti-RNP titer. None developed symptoms compatible with progressive systemic sclerosis. The 9 patients with a low anti-RNP titer were characterized by a stable clinical course, including 4 with SLE, 2 with Raynaud's phenomenon, and one each with Sjogren's syndrome, discoid lupus erythematosus and rheumatoid arthritis + Sjogren's syndrome. The most frequently occurring clinical manifestations among the patients with MCTD were Raynaud's phenomenon, puffy hands, arthritis, myalgias, and sicca symptoms. Myositis and impaired pulmonary function were also seen, but glomerulonephritis was not. The symptoms were fluctuating and the manifestations clinically different from other well defined CTD. The morbidity was moderate and the mortality low. High anti-RNP titer observed at any time seems associated with a clinical syndrome phenotypically different from other CTD favoring the notion of MCTD being a distinctive clinical syndrome. PMID- 1765976 TI - High resolution computed tomography in early scleroderma lung disease. AB - Seventeen patients with early systemic sclerosis (SSc) underwent high resolution computed tomography (HRCT) of the chest to evaluate dyspnea and/or abnormal pulmonary function tests (PFT). All patients were assigned a dyspnea score and each had routine chest radiography (CXR). Bronchoalveolar lavage (BAL) was performed on 10 patients. HRCT was abnormal in 15 patients (88%), while CXR was abnormal in only 10 patients (59%). Mediastinal lymphadenopathy was detected in 7 patients (41%). Disease duration, dyspnea score, and forced vital capacity (FVC) did not correlate with HRCT score. However, trends toward higher total BAL cell counts and higher BAL neutrophil counts were noted in patients with ground glass opacities on HRCT, and BAL lymphocyte counts were significantly higher in such cases. HRCT is superior to CXR for detecting early interstitial lung disease in SSc, but patient history and FVC correlate poorly with HRCT findings. Ground glass opacities on HRCT may reflect active alveolitis, and mediastinal lymphadenopathy associated with SSc lung disease may be a consequence of pulmonary inflammation. PMID- 1765977 TI - Autoantibody tests in autoimmune thyroid disease: a case-control study. AB - Both positive antinuclear antibody (ANA) and anti-DNA antibodies have been reported in patients with autoimmune thyroid disease. We sought to determine the frequency of ANA and other autoantibodies in autoimmune thyroid disease versus control subjects. We measured ANA by 2 methods (mouse liver, HEp-2), anti-dsDNA, anti-Ro, anti-La, anti-Sm, anti-RNP, and anticardiolipin in 26 patients with Hashimoto's thyroiditis, 26 patients with Graves' disease, and 26 control patients. Positive ANA by either method were more common in patients with Graves' disease than in controls (p = 0.002 and 0.05). Although common (46.2%), ANA by HEp-2 method was not found significantly more often in patients with Hashimoto's thyroiditis than in controls. Evidence for systemic autoimmune diseases was not found: patients with autoimmune thyroid did not have autoantibodies other than ANA and did not differ from controls in rheumatologic symptoms. Positive ANA using the widely accepted HEp-2 method were commonly found in both Graves' disease and Hashimoto's thyroiditis. No evidence of subclinical systemic autoimmune disease was found, either by specific autoantibody tests or by increased frequency of rheumatologic symptoms or signs. PMID- 1765978 TI - Nailfold capillary density as a possible indicator of pulmonary capillary loss in systemic lupus erythematosus but not in mixed connective tissue disease. AB - Nailfold capillary density was measured in 24 patients with systemic lupus erythematosus (SLE), 14 with mixed connective tissue disease (MCTD) and 21 healthy subjects. Pulmonary function tests were performed on all subjects and needle muscle biopsies on 12 patients with SLE and 9 with MCTD. A significant correlation was documented between nailfold capillary density and pulmonary gas transfer (KCO) in patients with SLE (p less than 0.001) but not in patients with MCTD. This suggests that in SLE poor gas transfer may be dependent on alveolar capillary loss and that nailfold capillary density may be a good indicator of alveolar capillary density. There was no significant correlation between skeletal muscle fiber atrophy and nailfold capillary density in SLE or MCTD. Additional studies to optimize the nailfold capillary counting method are described. PMID- 1765979 TI - Presence of a 16/6 related human anti-DNA common idiotype (SA1) in the anticardiolipin antibodies of patients with primary antiphospholipid syndrome. AB - Patients with primary antiphospholipid syndrome (PAPS) have few or no autoantibodies, other than the antiphospholipid antibodies (aPL) that could be natural autoantibodies encoded by germline genes. Some of the autoantibodies marked by the human anti-DNA common idiotype 16/6 have been found to be encoded by unmutated germline genes. Hence, we tested the sera of 19 patients with PAPS for the presence of the 16/6 idiotype which has also been found to be expressed on antibodies that bind cardiolipin. For this we used an ELISA method with antiserum against the SA1 idiotype which recognizes the 16/6. Five of our patients had the idiotype in at least one serum. Among the patients there was one with a variant of PAPS with hemolytic anemia and an IgM antibody to phosphatidylcholine that is akin to the natural autoantibody of normal mice encoded by germline genes VH11 and VH12. Inhibition studies with ssDNA, dsDNA and cardiolipin revealed that all 3 antigens decreased the serum levels of the SA1 idiotype despite absence of detectable anti-DNA antibodies by other methods. Our findings suggest that within the B cell clones that produce aPL in patients with PAPS there are some that produce immunoglobulins bearing 16/6 related idiotypes. This could indicate that some of the aPL present in patients with PAPS derive from natural autoantibody producing cell clones. PMID- 1765980 TI - Gut inflammation in the spondyloarthropathies: clinical, radiologic, biologic and genetic features in relation to the type of histology. A prospective study. AB - Ileocolonoscopy was performed on 354 patients with spondyloarthropathies. Histologically, the population could be divided into 145 patients with normal gut histology, 88 patients with acute inflammatory lesions and 121 patients with chronic inflammatory lesions. A number of clinical, biologic, radiologic and genetic variables were determined before ileocolonoscopy. Chronic gut lesions were associated with a family history of ankylosing spondylitis (AS) and Crohn's disease, several episodes of diarrhea, an increased stool frequency, elevated inflammatory serum variables, reduced axial mobility, the presence of sacroiliitis, bamboo spine, destructive joint lesions, a diagnosis of AS and HLA Bw62 positivity. As the frequency of HLA-Bw62 is also increased in proven Crohn's disease, this would suggest that chronic gut lesions are related to this disease. Acute inflammatory lesions were related to a higher fecal carriage of specific bacteria and to the diagnosis of undifferentiated spondyloarthropathy, especially the enterogenic forms of reactive arthritis. Consequently, these lesions also appear to be related to a bacterially induced gut inflammation. Gut histology was normal in urogenital inflammation and urogenital reactive arthritis, suggesting a different portal of entry for antigens. The 3 histologic pictures of the gut (normal, acute and chronic) inflammation seem to correlate with different clinical, biologic and radiologic manifestations of the disease concept of spondyloarthropathies. PMID- 1765981 TI - Development of preliminary criteria for response to treatment in fibromyalgia syndrome. AB - We developed a set of preliminary response criteria for use in future clinical trials in fibromyalgia syndrome. We determined outcome measures from a previously reported clinical trial which best distinguished patients treated with effective medication from those treated with placebo or ineffective medication, using stepwise logistic regression analysis. Several combinations of outcome measures were identified and plotted in the form of receiver operating characteristic (ROC) curves. The combination of variables possessing the greatest area under the ROC curve included (1) physician global assessment score less than or equal to 4 (0 = extremely well, 10 = extremely poorly), (2) patient sleep score less than or equal to 6 (0 = sleeping extremely well, 10 = sleeping extremely poorly), and (3) tender point score less than or equal to 14 (maximum possible tender point score equalled 20). These criteria accurately distinguished those treated with effective drug from those treated with placebo when tested in an unreported therapeutic trial of cyclobenzaprine. The criteria identified 11 of 14 patients in the amitriptyline trial and 4 of 6 patients in the cyclobenzaprine trial who attained improvement measured independently. The methodology used to define these preliminary criteria may be applied to refine the criteria as additional sensitive and clinically relevant outcomes are developed. PMID- 1765982 TI - Rheumatic manifestations in populations at risk for HIV infection: the added effect of HIV. AB - We assessed the frequency and variability of rheumatologic manifestations in 2 populations with similar risk factors for human immunodeficiency virus (HIV) infection, of which only one was affected. We studied 2 populations at risk for HIV infection (homosexual and intravenous drug users). Group A: 89 individuals carried the virus; and Group B: 80 individuals were HIV negative. In Group A (HIV+) 66.1% had rheumatic manifestations including arthralgias, Reiter's syndrome, arthritis, enthesitis, psoriatic arthritis, Sjogren's syndrome, myopathy, septic arthritis, and lupus-like illness. In contrast, in Group B (HIV ) only 2 had arthralgias, 2 Reiter's syndrome, and 1 rheumatoid arthritis. In summary, rheumatic complaints are common in patients with HIV, and HIV positivity confers an increased susceptibility in populations with similar risk factors for HIV infection. PMID- 1765983 TI - Tender shins and steroid therapy. AB - To quantify previously described shin tenderness in patients receiving chronic steroid therapy, we studied 54 patients, 26 treated with steroid, by dolorimetry at 4 control, 4 "fibrositic," and 4 shin sites. To measure observer variation, assessments were done by 2 or 3 of 10 observers, one of whom examined each subject. The specific increase of tenderness at shin sites associated with steroid therapy was confirmed, with a mean (SD) threshold in the steroid group of 3.0 (1.7) kg, and in the control group 5.6 (2.4). Other effects which were not site specific were found. There was a 2.0 kg increase in control site tenderness associated with steroid therapy, and a similar general increase in tenderness in patients with lupus and in women, independent of steroid therapy, affecting control as well as fibrositic sites. Underlying mechanisms must act generally as well as being site specific. PMID- 1765984 TI - Evaluation of cartilage lesions by magnetic resonance imaging at 0.15 T: comparison with anatomy and concordance with arthroscopy. AB - Recent evidence suggests that pharmacological treatment may alter the rate of progression of cartilage damage in osteoarthritis (OA). However, a lack of accurate and precise noninvasive assessments of cartilage structure makes it difficult to answer this question directly with prospective clinical trials, prevents early diagnosis of OA and restricts assessment of treatment to evaluation of symptoms or joint function. It is important, therefore, to develop precise, noninvasive methods both for diagnosis of early OA before damage is extensive and irreversible and for evaluation of therapeutic effectiveness. Magnetic resonance imaging (MRI) allows for noninvasive, multiplanar body imaging which depends on proton density, flow, and the T1 and T2 relaxation times. Because these variables differ markedly among joint tissues, cartilage erosions are visible with MRI and it should be possible to quantify them. Our objective was to compare MRI with arthroscopy for assessing the depth of lesions in the articular cartilage of human knees to help develop and validate MRI for use in clinical trials designed to assess the effect of therapy on cartilage structure. In the first part of our study, the effect of the MRI pulse sequence variables on the images was evaluated by varying them systematically and comparing the anatomy seen with MRI with that seen at arthroscopy or arthrotomy and with the histology. In the second part, 31 patients were assessed with MRI before arthroscopy. The MRI were graded on a 4-point ordinal scale by 2 observers who were unaware of the clinical diagnosis and compared with findings at arthroscopy which were graded using the same scale.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1765985 TI - Analysis of disability in knee osteoarthritis. Relationship with age and psychological variables but not with radiographic score. AB - Sixty-one women with symptomatic knee osteoarthritis were given the Italian version of Arthritis Impact Measurement Scale which showed a good construct through the factorial analysis. The disability index was then related to the body mass index, the anatomical/radiographic damage, to the severity of pain assessed either through the McGill Pain Questionnaire or a visual analog scale, and finally to the degree of anxiety and depression as obtained from the Zung depression and anxiety inventory scores. A statistically significant relationship was found between radiographic damage and body weight, while disability correlated with the degree of psychological involvement and with the age of the patients. Through the stepwise multiple regression analysis we demonstrated that the pain experience and disability scores are strongly influenced by psychological impact. Our data may have important therapeutic implications. PMID- 1765986 TI - Occupational physical demands, knee bending, and knee osteoarthritis: results from the Framingham Study. AB - We sought to assess occupational joint use and osteoarthritis (OA) longitudinally in a large population with multiple occupations. Subjects were members of the Framingham Heart Study cohort followed over 40 years with occupational status assessed at the beginning of the Heart Study [from Examination 1 (1948-51) through Examination 6 (1958-61)] and knee OA assessed by weight bearing knee radiograph at Examination 18 (1983-85) when mean age of subjects was 73 years. Each subject's job was characterized by its level of physical demand and whether the job was associated with knee bending. Odds ratios (OR) testing the association of job demand with OA were adjusted by logistic regression for age, body mass, knee injury history, smoking, and educational level. Men whose jobs required knee bending and at least medium physical demands had higher rates of later radiographic knee OA (at least definite osteophytes) than men whose jobs required neither (43.4 vs 26.8%; OR of OA = 2.22, 95% CI 1.38, 3.58). Rates of severe radiographic OA (osteophytes and joint space narrowing) and of bilateral radiographic OA were also significantly increased in these men. Few women had jobs requiring knee bending or that were physically demanding and these jobs were generally unassociated with later radiographic OA. Only a small number of men (n = 28) had symptomatic knee OA, and we could not confirm that it was associated with occupation in men. Thus, among men, occupations which combine knee bending and physical demands may be an important cause of radiographic OA. PMID- 1765987 TI - The therapeutic approaches of community based primary care practitioners to osteoarthritis of the hip in an elderly patient. AB - Predispositions to prescribe a pure analgesic, a cyclooxygenase inhibiting nonsteroidal antiinflammatory drug (NSAID) or a nonacetylated salicylate for a fictitious, uncomplicated case of osteoarthritis (OA) were surveyed in a sample of 152 community based primary care practitioners who had been characterized with respect to medical education and practice characteristics. Only 2 respondents (1%) prescribed a pure analgesic; 35% prescribed subantiinflammatory doses of cyclooxygenase inhibiting NSAID. The remainder (64%) recommended nonacetylated salicylates and cyclooxygenase inhibiting NSAID in doses large enough to achieve an antiinflammatory effect. Past participants in postgraduate rheumatology electives prescribed more costly regimens than those who had not participated (p = 0.05). When the case was altered to include a history of previous peptic ulcer, 44% chose cyclooxygenase inhibiting NSAID with adjunctive prophylaxis against NSAID induced gastropathy (e.g., misoprostol). When the complication was changed to renal insufficiency, recommendations for sulindac increased 3-fold over those for the uncomplicated case (34 vs 11%), and were most common among more recent medical school graduates and past participants in rheumatology electives (p less than 0.05 for both). The potential effects of educational and practice variables on the therapeutic strategies and costs of OA care in the community merit further systematic study. PMID- 1765988 TI - Serum concentrations of hyaluronan and proteoglycan in joint disease. Lack of association. AB - Circulating hyaluronan originating from the synovial membrane and circulating proteoglycan released from cartilage were determined by specific assays in patients with osteoarthritis (OA), rheumatoid arthritis (RA), reactive arthritis or juvenile chronic arthritis (JCA). Elevated hyaluronan concentrations were found in OA and RA, suggesting proliferation of the synovial membrane in both diseases. The proteoglycan concentrations were highest in OA and polyarticular JCA indicating increased turnover of cartilage matrix. The concentrations of the macromolecules did not correlate except in the group with JCA. Serum concentrations of hyaluronan and proteoglycan thus differ between disease groups and may reflect different aspects of the arthritic process. PMID- 1765989 TI - Alkaline phosphatase dissolves calcium pyrophosphate dihydrate crystals. AB - We have shown that yeast pyrophosphatase dissolves calcium pyrophosphate dihydrate (CPPD) crystals in solutions. In this investigation we demonstrate that alkaline phosphatase (ALP) effectively dissolves CPPD crystals in vitro. CPPD dissolution by ALP had a pH optimum of 7.4, which is the optimum pH for its pyrophosphatase (PPiase) activity. The CPPD dissolution and PPiase activity by ALP are magnesium dependent, whereas its phosphoester hydrolytic activity is not. Calcium, which inhibited the enzymatic CPPD dissolution and PPiase activity of ALP had no effect on its phosphoester hydrolytic activity. These data indicate that PPiase activity of ALP is responsible for CPPD dissolution and not its phosphoester hydrolytic activity. Matrix molecules such as proteoglycans and chondroitin sulfate had no effect on the enzymatic and nonenzymatic dissolution of CPPD crystals. ALP acted more effectively on CPPD crystals than on soluble pyrophosphate relative to yeast PPiase. Our data suggest that chondrocyte ALP may play an important role in the dissolution of CPPD crystals in cartilage. PMID- 1765990 TI - Active idiopathic systemic lupus erythematosus in a 90-year-old woman requiring corticosteroid therapy. AB - A woman who developed multisystem systemic lupus erythematosus (SLE) at the age 80 improved with therapy, but after a hip fracture her disease flared necessitating corticosteroid treatment at age 90. This is the oldest case of active lupus ever reported, and points out the importance of not excluding active SLE as a cause of symptoms or signs even in advanced age. PMID- 1765991 TI - Induction of systemic lupus erythematosus by interferon-gamma in a patient with rheumatoid arthritis. AB - The development of systemic lupus erythematosus (SLE) after 38 months of therapy with recombinant human interferon gamma (rIFN-gamma) was observed in a patient with rheumatoid arthritis. In addition to glomerulonephritis and a butterfly rash, previously negative tests for antinuclear, anti-dsDNA and anti-Sm antibodies became positive. We assume that rIFN-gamma induced the de novo development of SLE in our patient. PMID- 1765992 TI - An atypical site of osteonecrosis in a patient with systemic lupus erythematosus. AB - We describe a patient with systemic lupus erythematosus who developed osteonecrosis. The case is unusual because the osteonecrosis occurred in an unusual location, in the distal tibia. The patient had earlier developed recurrent pyarthrosis, and biopsy and culture were required to exclude osteomyelitis. PMID- 1765993 TI - Thigh pain and multiple vertebral osteonecroses: value of magnetic resonance imaging. AB - We describe a 74-year-old woman who presented with referred thigh pain associated with multiple osteonecroses of the T12, L1 and L2 vertebrae. Magnetic resonance imaging was found to be a valuable diagnostic aid, revealing signs of spinal cord and nerve root compression related to the collapsed vertebrae. Biopsy of T12 confirmed the benign nature of the vertebral compression fracture. Our patient also showed histologically documented osteoporosis. PMID- 1765994 TI - "Tumoral" enthesopathy: a juxtacortical osteosarcoma simulation. AB - A patient with psoriatic arthritis involving the ankles and feet developed a rapidly progressive large juxtacortical bony proliferative lesion arising from the right proximal radius at the bicipital tendon insertion site. The radiographic pattern was compatible with a juxtacortical periosteal osteosarcoma. We discuss the similar radiographic findings between a surface osteosarcoma and florid inflammatory enthesopathy that was found upon biopsy. PMID- 1765995 TI - Lupus refractory pleural effusion: transient response to intravenous immunoglobulins. AB - A patient with systemic lupus erythematosus complicated by refractory bilateral pleural effusions is described. High dose corticosteroids with azathioprine, as well as intrapleural instillation of corticosteroids, proved ineffective in management. As our patient remained severely symptomatic and required repeated thoracocentesis, a therapeutic trial of intravenous immunoglobulins (IVIG) was attempted. IVIG had a beneficial effect, although of a transient and partial nature. Despite the results achieved, it seems that IVIG has limited value in treating lupus pleural effusion. PMID- 1765996 TI - HLA-B27 and arthritis: back to the future. PMID- 1765997 TI - The coexistence of ochronosis and ankylosing spondylitis. PMID- 1765998 TI - The frequency of side effects in studies of nonsteroidal antiinflammatory drugs. PMID- 1765999 TI - Normal creatine kinase activity in idiopathic inflammatory myopathy: does it have prognostic implications? PMID- 1766000 TI - Cholecystokinin antagonists: (R)-tryptophan-based hybrid antagonists of high affinity and selectivity for CCK-A receptors. AB - The intriguing structural similarities of glutamic acid based cholecystokinin (CCK) antagonists (A-64718 and A-65186) and the benzodiazepine CCK antagonist MK 329 (L-364,718) have been reported. Efforts to include the weak CCK antagonist benzotript into this construct utilizing a similar approach have resulted in a novel series of benzotript-based hybrid antagonists N alpha-(3'-quinolylcarbonyl) (R)-tryptophan di-n-pentylamide (9, A-67396), N alpha-(4',8'-dihydroxy-2' quinolylcarbonyl)-(R)-tryptophan di-n-pentylamide (23, A-70276), and N alpha-(3' quinolylcarbonyl)-(R)-5'-hydroxytryptophan di-n-pentylamide (36, A-71134) which possess respectively binding affinities of 23, 21, and 11 nM for the pancreatic CCK-A receptor and which inhibit CCK8-induced amylase secretion. Compound 9 possesses a selectivity of greater than 500-fold for the pancreatic CCK-A receptor over the CCK-B receptor. PMID- 1766001 TI - Immunostimulation by a partially modified retro-inverso-tuftsin analogue containing Thr1 psi[NHCO](R,S)Lys2 modification. AB - The tuftsin retro-inverso analogue H-Thr psi[NHCO](R,S)Lys-Pro-Arg-OH was synthesized through a novel procedure for the high-yield incorporation of isolated retro-inverso bonds into peptide chains and the use of the new Meldrum's acid derivative (CH3)2C(OCO)2CH(CH2)4NHCOCF3 followed by its efficient coupling in solution to trimethylsilylated H-D-Thr(t-Bu)NH2. Closely related peptide impurities were eliminated both from the crude final peptide and the fully protected tetrapeptide amide precursor via ion-exchange and reversed-phase displacement chromatography, respectively. The tuftsin retro-inverso analogue proved to be completely resistant to enzymatic degradation in vitro, either against isolated aminopeptidases or human plasma proteolytic enzymes. When administered either orally or intravenously, it was significantly more active than normal tuftsin in increasing the number of specific antibody secreting cells in spleen of mice immunized with sheep erythrocytes. Furthermore, the analogue exerted an enhanced stimulatory effect on the cytotoxic activity of splenocytes against YAC-1 tumor cells. Finally, retro-inverso-tuftsin was about 10-fold more potent than the native peptide in reducing rat adjuvant arthritis. The resistance of the retro-inverso analogue to peptidases might explain the increased in vivo activities and allows its further immunopharmacological characterization. PMID- 1766002 TI - Molecular mechanics simulations on covalent complexes of mitomycin C and its analogues with left-handed DNA duplexes. AB - We present molecular mechanics simulations on covalent complexes between d(GCGCGCGCGC).d(GCGCGCGCGC) in the left-handed double helical forms (B and Z) and potent antitumor antibiotics mitomycin C and three of its analogues using the all atom force field in the framework of the program AMBER(UCSF). The energy-refined models of the complexes show interesting networks of hydrogen-bonding interactions between the drugs and DNA groups in the minor groove of the left handed helices. The energy-refined models suggest that mitomycins could bind strongly to left-handed helices. This result might be relevant to the interpretation of earlier experiments which suggested that DNA bound by mitomycin C underwent a transition to a non-Z left-handed structure. PMID- 1766003 TI - Activity of N6-substituted 2-chloroadenosines at A1 and A2 adenosine receptors. AB - Radioligand binding studies of N6-substituted adenosines at the A1 and A2 adenosine receptors of rat brain cortex and rat brain striatum, respectively, show that a 2-chloro substituent does not consistently change the affinity or the selectivity of these analogues for the A1 receptor. A 2-chloro substituent lowers the characteristic stereoselectivity of the A1 receptor toward the R diastereomer of N6-(1-phenyl-2-propyl)adenosine. A 2-chloro substituent consistently increases potency of N6-substituted adenosines as agonists at an adenosine A2 receptor stimulatory to adenylate cyclase in PC12 cell membranes. PMID- 1766004 TI - Synthesis and antibacterial activities of C-21 functionalized derivatives of (9R) 9-amino-9-deoxoerythromycins A and B. AB - Selective protection of (9R)-9-amino-9-deoxoerythromycin A allowed for elimination of the 12-hydroxyl group to afford a versatile 12,21-olefin intermediate. Further modifications of the intermediate led to the syntheses of (9R)-9-deoxo-9-(N,N-dimethylamino)-12,21-epoxyerythromycin B, (9R)-9-deoxo-9-(N,N dimethylamino)-21-hydroxyerythromycin A, and (9R)-9-deoxo-9-(N,N-dimethylamino) 21-hydroxyerythromycin B. All three compounds retained antibacterial activity against several organisms normally susceptible to (9R)-9-deoxo-9-(N,N dimethylamino)erythromycin A. However, the 21-hydroxylated erythromycin A analogue was weaker in potency than the corresponding erythromycin B congener and much weaker than the epoxy derivative. This suggests that while substitution of a polar functionality at C-21 does not abolish antibacterial activity, introduction of vicinal polar groups at both C-12 and C-21 may lead to reduction in potency. Nevertheless, these 21-functionalized derivatives of (9R)-erythromycylamine provide an entry into novel analogues of the important macrolide antibiotic erythromycin. PMID- 1766005 TI - Examination of HIV-1 protease secondary structure specificity using conformationally constrained inhibitors. PMID- 1766006 TI - Delineating the pharmacophoric elements of huperzine A: importance of the unsaturated three-carbon bridge to its AChE inhibitory activity. PMID- 1766007 TI - Novel alkaloids from the tropical plant Ancistrocladus abbreviatus inhibit cell killing by HIV-1 and HIV-2. PMID- 1766008 TI - Basolateral membrane potassium conductance of A6 cells. AB - To study the properties of the basolateral membrane conductance of an amphibian epithelial cell line, we have adapted the technique of apical membrane selective permeabilization (Wills, N.K., Lewis, S.A., Eaton, D.C. 1979b, J. Membrane Biol. 45:81-108). Monolayers of A6 cells cultured on permeable supports were exposed to amphotericin B. The apical membrane was effectively permeabilized, while the high electrical resistance of the tight junctions and the ionic selectivity of the basolateral membrane were preserved. Thus the transepithelial current-voltage relation reflected mostly the properties of the basolateral membrane. Under "basal" conditions, the basolateral membrane conductance was inward rectifying, highly sensitive to barium but not to quinidine. After the induction of cell swelling either by adding chloride to the apical solution or by lowering the osmolarity of the basolateral solution, a large outward-rectifying K+ conductance was observed, and addition of barium or quinidine to the basolateral side inhibited, respectively, 82.4 +/- 1.9% and 90.9 +/- 1.0% of the transepithelial current at 0 mV. Barium block was voltage dependent; the half-inhibition constant (Ki) varied from 1499 +/- 97 microM at 0 mV to 5.7 +/- 0.5 microM at -120 mV. Cell swelling induces a large quinidine-sensitive K+ conductance, changing the inward-rectifying basolateral membrane conductance observed under "basal" conditions into a conductance with outward-rectifying properties. PMID- 1766009 TI - Cl/HCO3 exchange in the basolateral membrane domain of rat jejunal enterocyte. AB - Basolateral membrane vesicles isolated from rat jejunal enterocyte and well purified from brush border contamination were tested to examine Cl and HCO3 movements. Uptake experiments provided no evidence for a coupling between Na and HCO3 fluxes; K-HCO3 and K-Cl cotransports also could be excluded. Transport studies revealed the presence of a Cl/HCO3 exchanger accepting other anions and inhibitable by the disulfonic stilbenes SITS and DIDS. We can exclude that the evidenced HCO3-dependent Cl uptake is due to brush border contamination, since in jejunal brush border membranes this mechanism, if present, has a very low transport rate. Besides the Cl/HCO3 antiporter, a Cl-conductive pathway seems to exist in jejunal basolateral membranes. PMID- 1766010 TI - Noninvasive recording of receptor cell action potentials and sustained currents from single taste buds maintained in the tongue: the response to mucosal NaCl and amiloride. AB - Apical membrane currents were recorded from the taste pore of single taste buds maintained in the tongue of the rat, using a novel approach. Under a dissection microscope, the 150-microns opening of a saline-filled glass pipette was positioned onto single fungiform papillae, while the mucosal surface outside the pipette was kept dry. Electrical responses of receptor cells to chemical stimuli, delivered from the pipette, were recorded through the pipette while the cells remained undamaged in their natural environment. We observed monophasic transient currents of 10-msec duration and 10-100 pA amplitude, apparently driven by action potentials arising spontaneously in the receptor cells. When perfusing the pipette with a solution of increased Na but unchanged Cl concentration, a stationary inward current (from pipette to taste cell) of 50-900 pA developed and the collective spike rate of the receptor cells increased. At a mucosal Na concentration of 250 mM, the maximal collective spike rate of a bud was in the range of 6-10 sec-1. In a phasic/tonic response, the high initial rate was followed by an adaptive decrease to 0.5-2 sec-1. Buds of pure phasic response were also observed. Amiloride (30 microM) present in the pipette solution reversibly and completely blocked the increase in spike rate induced by mucosal Na. Amiloride also decreased reversibly the stationary current which depended on the presence of mucosal Na (inhibition constant near 1 microM). During washout of amiloride, spike amplitudes were first small, then increased, but always remained smaller than the amiloride-blockable stationary current of the bud.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766011 TI - Whole-cell K+ current activation in response to voltages and carbachol in gastric parietal cells isolated from guinea pig. AB - Patch-clamp studies of whole-cell ionic currents were carried out in parietal cells obtained by collagenase digestion of the gastric fundus of the guinea pig stomach. Applications of positive command pulses induced outward currents. The conductance became progressively augmented with increasing command voltages, exhibiting an outwardly rectifying current-voltage relation. The current displayed a slow time course for activation. In contrast, inward currents were activated upon hyperpolarizing voltage applications at more negative potentials than the equilibrium potential to K+ (EK). The inward currents showed time dependent inactivation and an inwardly rectifying current-voltage relation. Tail currents elicited by voltage steps which had activated either outward or inward currents reversed at near EK, indicating that both time-dependent and voltage gated currents were due to K+ conductances. Both outward and inward K+ currents were suppressed by extracellular application of Ba2+, but little affected by quinine. Tetraethylammonium inhibited the outward current without impairing the inward current, whereas Cs+ blocked the inward current but not the outward current. The conductance of inward K+ currents, but not outward K+ currents, became larger with increasing extracellular K+ concentration. A Ca(2+)-mobilizing acid secretagogue, carbachol, and a Ca2+ ionophore, ionomycin, brought about activation of another type of outward K+ currents and voltage-independent cation currents. Both currents were abolished by cytosolic Ca2+ chelation. Quinine preferentially inhibited this K+ current. It is concluded that resting parietal cells of the guinea pig have two distinct types of voltage-dependent K+ channels, inward rectifier and outward rectifier, and that the cells have Ca(2+)-activated K+ channels which might be involved in acid secretion under stimulation by Ca(2+) mobilizing secretagogues. PMID- 1766012 TI - Common emergencies in cancer medicine: cardiovascular and neurologic syndromes. AB - A myriad of multisystem disorders may result from primary malignant disease, metastasis, or treatment. Neoplastic pericardial disease in the form of malignant effusions, tamponade, and pericarditis are not uncommonly seen. Compromise of blood return to the right side of the heart due to the superior vena cava syndrome is a well known entity that is also still undergoing examination of the variety of treatment options available. The central and peripheral nervous systems also may be involved from both primary or secondary malignant disease. The recognition, diagnostic approach, natural history, and therapeutic options will be reviewed. PMID- 1766013 TI - Gilles de la Tourette's syndrome associated with head injury: a case report. AB - A case of Gilles de la Tourette's syndrome in a Kuwaiti woman is described, and the possibility of antecedent head injury as the organic etiological factor is discussed. PMID- 1766014 TI - Absolute CD4 count as a predictor for Mycobacterium avium infection in AIDS patients. PMID- 1766015 TI - Implications of epidemiological studies for the disadvantaged elderly. PMID- 1766016 TI - Quality of health care in the United States. PMID- 1766017 TI - Toward the primary prevention of idiopathic dilated cardiomyopathy. PMID- 1766018 TI - African-American women in the medical profession. PMID- 1766019 TI - Dumping HIV-infected patients from private practice. AB - Physicians in private practice believe they have the freedom to accept or exclude patients. While this may be true on an individual basis, discrimination towards a patient subpopulation violates professional principles and the law. Once the doctor-patient relationship is formed, physicians may not unilaterally and arbitrarily withdraw from the relationship based solely on the patient's human immunodeficiency virus (HIV) serostatus. This article reviews civil and human rights laws along with professional position statements on excluding individuals from care because of their serostatus. PMID- 1766020 TI - Mediastinal masses: magnetic resonance imaging in comparison with computed tomography. AB - Seventy-eight patients with mediastinal abnormalities were imaged with magnetic resonance imaging (MRI) to evaluate mediastinal masses and associated lung, pleural, or chest wall disease. Magnetic resonance images were compared with computed tomography (CT) scans, which were available in 45 patients. While MRI and CT were equally effective in demonstrating mediastinal lesions, CT was superior for displaying calcification within a mass in eight patients and for demonstrating associated lung abnormality in four patients. Computed tomography should remain the imaging procedure of choice after chest radiography to evaluate mediastinal masses, although MRI may be indicated in selected patients. PMID- 1766021 TI - Congenital bowing of the ulna and aggressive fibromatosis. AB - The association of skeletal anomalies and aggressive fibromatosis has been documented. Isolated bowing of the ulna is rare, yet its occurrence, particularly in conjunction with congenital dislocation of the radial head, has been documented. This article presents two cases of ulnar bowing in which the patients subsequently developed aggressive fibromatosis. We feel that aggressive fibromatosis may be a latent manifestation of congenital bowing of the ulna. The course of the disease appears to be of an aggressive nature, and patients who present with bowing of the ulna should be followed for the potential development of this disease. PMID- 1766022 TI - Treatment of cervical carcinoma with ionizing irradiation using moving fields. AB - This study was designed to assess the effectiveness and risk of complications from radiotherapy delivered by the moving field technique as opposed to the more commonly used fixed field technique. Between 1975 and 1985, 131 patients were treated for cervical cancer with a combination of teletherapy and brachytherapy. For teletherapy, 4-MeV photons were used and delivered by moving field technique (120 degrees to 160 degrees arcs, or a 360 degrees rotation). Most patients received one intracavitary radium implant using Fletcher-Suit applicators and the Manchester technique. Twenty-two percent of the patients had stage I disease, 37% stage II, 25% stage III, 13% stage IV, and 2% were unstaged. The cumulative 5 year survival for all patients was 57%. The survival by stage was: stage I, 82%, stage II, 62%, stage III, 53%, and stage IV, 6%. Chronic complications developed in 10 (7.6%) patients. The survival and complication rate of patients treated for cervical cancer with radiation using moving fields compares favorably with that of patients treated with the conventional parallel opposed (AP-PA) fields or the four-field box technique. Further studies are necessary to definitively determine if the moving field technique offers advantages over other techniques. PMID- 1766023 TI - Six years of occult blood screening in an urban public hospital: concepts, methods, and reflections on approaches to reducing avoidable mortality among black Americans. AB - While early cancer detection is frequently overused in high socioeconomic status communities, opportunities for early detection often are overlooked by practitioners serving lower income and minority populations. Review of our patient records in 1980 revealed that only 13% of patients had a record of a rectal examination, and less than 1% had either proctoscopy or fecal occult blood testing. Our program has made a dramatic impact on colorectal cancer detection, performing 8192 fecal occult blood tests in the first 5 1/2 years of our program. As with other programs, stage of cancer is greatly influenced by fecal occult blood testing, with 0 modified Dukes' stage D compared to 33% for the hospital registry, and 35% stage A compared to 0 for the registry. Compliance with diagnostic evaluation has been excellent (89.6%). The program has allowed for increased communication between patients and staff. Education about diet and other prevention has been institutionalized. Patients see our nurses as their advocates and openly express their fears and concerns about their health and health care. We began our fecal occult blood testing program at a time when it was considered the "standard of care" although randomized clinical trial proof was, and is, incomplete. This program provides evidence that "standard of care" is feasible in the public sector. PMID- 1766024 TI - Thin-layer chromatographic detection of glucocorticoids. AB - An adsorption thin-layer chromatography (TLC) is described for the detection of glucocorticoids including triamcinolone, prednisolone, 6 alpha methylprednisolone, betamethasone, dexamethasone, hydrocortisone, prednisone and cortisone. Separation of the glucocorticoids was performed on a silica stationary phase with chloroform-dioxane-methanol (15:4:1, v/v) as a mobile phase. The complete resolution of the epimers of betamethasone and dexamethasone was attained by derivatization of them with (1S)-(-)-camphanic chloride using triethylamine as a catalyst. The application of the method to the analysis of glucocorticoids in various samples is being smoothly developed. PMID- 1766025 TI - A study of blood antioxidants and lipoperoxides: effects of anticoagulants and sex-variation. AB - To study the influences of anticoagulants and sex-related variation on antioxidants, such as vitamins A and E, beta-carotene, and uric acid; and lipid peroxides such as malondialdehyde (MDA), we collected samples from 43 human subjects for research. In this study, it was found that: There were no differences of vitamin E and MDA concentrations and the ratio for tocopherol/total lipids among plasma from liquid EDTA(K3) blood and lithium heparin, or serum (p greater than 0.05). Nevertheless, plasma from liquid EDTA(K3) blood had significantly lower vitamin A. beta-carotene, uric acid, total cholesterol, triglyceride, and total lipids concentrations than did serum or plasma from blood treated with lithium heparin (p less than 0.01). The possible mechanism which reduced the above analytes was either EDTA-induced deterioration or oxidation. In sex-related variation study, sex differences in the plasma levels of vitamins A and E were insignificant (p greater than 0.05). Higher levels of plasma beta-carotene values were found in females (p less than 0.01); whereas, higher levels of plasma uric acid and MDA concentrations were found in males (p less than 0.01). PMID- 1766026 TI - Operative treatment of myasthenia gravis. AB - Although the relationship between the thymus gland and myasthenia gravis is still not clear, it has been recognized for many years that, however, early thymectomy can bring about remission or improvement of the disease. In the past 12 years, 40 myasthenic patients have received total thymectomies in the Department of Surgery, Kaohsiung Medical College Hospital. Their ages ranged from 13 to 68 years. They were classified according to Osserman's classification. After an average follow up period of 4 years, the total remission rate was 32.5%, and the improvement rate was 27.5%. The average interval between thymectomy and onset of remission was 12 months. The operative mortality was 5% and overall mortality 10%. Patients who received thymectomies under 40 years of age, short duration between disease onset and the thymectomy, milder preoperative symptoms and nontumorous thymuses, seemed to have better prognoses. Early thymectomy in childhood myasthenia gravis is still controversial. Although generally the ocular type was treated in a conservative manner, we had a 40% rate of surgical remission in this group. Total longitudinal median sternotomy is our choice of approach because the operative field is larger and the thymectomy is more complete. Thymectomy in immune diseases other than myasthenia gravis is one of our important points for future studies. PMID- 1766027 TI - [A dental anthropological study of Chinese in Taiwan. I). Craniofacial morphology]. AB - The cephalometric films were collected from 30 boys and 30 girls of 12 years of age, and from 36 males and 34 females of 18 years of age; all of whom were Chinese in Taiwan, all possessed acceptable occlusion to survey the craniofacial morphology and characteristics associated with dental anthropology. Data were analysed by the computer program at the Department of Orthodontics of Japan Tokyo Medical and Dental University. Data were compared with Japanese, North American Caucasians, Central and South American Indians from papers. It was concluded that: 1) Chinese in Taiwan were similar to Japanese, Central and South American Indians, in that; all possessed a shorter frontal cranial base and depth of face, and were completely different from North American Caucasians. The direction of growth showed counter-clockwise rotation in the four Mongoloid races; however, Caucasians showed straight--down growth. The four Mongoloid races had more frontal position of A,B point and more labial inclination of anterior tooth axis than Caucasians. 2) Chinese in Taiwan were similar to Japanese, but were different from Central and South American Indians, in having a flatter infraorbital outline, longer facial height, flattened mandibular plane angle and a more frontal position of chin. 3) Chinese in Taiwan were characteristically different from Japanese by having a smaller interincisal angle, lower frontal facial height, mandibular angle and mandibular plane angle. In summary, the results indicated that Chinese in Taiwan are characterized by having a wide but short face pattern, a retroposition of the mandible ramus, a more upright mandible angle and a prominent labial inclination of anterior tooth axis. PMID- 1766028 TI - [The prevalence of amphetamine use in adolescent students: self-reported and urine analysis]. AB - The prevalence of amphetamine use was studied using an anonymous questionnaire given to 3548 adolescent students aged 12--15, with a response rate of 98.6%. This questionnaire was developed and evaluated by the authors. A complete set of data was collected on 3200 subjects, making up 90.2% of all students surveyed. Eighty-five (2.7%) students admitted that they had used amphetamines; that is, 64 of the 1,584 male (4.0%), and 21 of the 1,616 female (1.3%) respondents. The life time prevalence odds ratio estimation was elevated in male (POR = 3.2, 95% CI 1.9 -5.3), as compared to female students. The life-time prevalence rates increased with age only among male students (P trend = 0.01). Seven hundred and twenty four male students were randomly tested for the presence of amphetamines in their urine using thin layer chromatography and fluorescence polarization immunoassay. Of six students who tested positive, five asserted that they had not used amphetamines. The point prevalence rate of amphetamine use based on the urine tests was 0.9% among the 652 students who had completed questionnaires. This rate was higher than on self-reported use of amphetamines (rate difference 0.9%, 95% CI 0.2--1.6%). In this group, 27 (4.1%) admitted that they had used amphetamines. The estimated overall life-time prevalence rate was at least 4.9% (32/652), with 95% CI between 3.2% and 6.6%. PMID- 1766029 TI - [Stress distribution of prefabricated screw posts. Part II: Different designs and materials]. AB - This study compared stress distribution during installation and the functions of prefabricated posts of different designs and materials. When endodontic dowels were installed in standardized models as well as simulated loads were applied, direct comparisons of stress distributing properties were analyzed by photoelastic stress analysis. Based on our findings, we concluded that: 1. During installation and under simulated functional loads, the tapered-end posts produced wedging stresses near the apex. More uniform stress distributions were observed with parallel-sided posts. 2. When the coronal flanges of flange type posts engaged the model around the occlusal portion of the channel preparation, stress concentrations occurred at the flange-dowel-dentin area. Stress levels were reduced toward the apical portion of the dowels. 3. The split shaft of Flexi-Post posts appeared to compress inward, stress concentrations occurred at the cervical and middle third and the other portion of the dowels were reduced. 4. Cementation type posts displayed a low and even distribution of dentinal stress during installation and functional loads. PMID- 1766030 TI - [Clinical experience of the treatment of ipsilateral femoral shaft fractures after hip arthroplasty]. AB - Femoral shaft fracture after hip arthroplasty is a rate problem. Between January 1983 and January 1989, twelve cases were admitted to Taichung Veteran General Hospital. The causes of the fractures were due to (1) a weakening of the bone stock secondary to stress risers from prior surgery, (2) prefracture evidence of loosening, and (3) high velocity trauma. The twelve cases were treated with different methods and were followed up within an average time of 21.6 months (ranging from 12 to 66 months). After the treatment, it was showed that 83.3% of the patients had satisfactory results (33.3% of the patients has good results and 50% of the patients had fair results.) A comparison of the superiority of different treatment methods and the short term results of this study was presented. PMID- 1766031 TI - Cerebellar lipoma: report of a case. AB - A patient with normal motor and intellectual development suffered headache; especially over the occipital area; and, blurring of vision for five months. Computerized tomography and magnetic resonance imaging of the brain showed a lipoma in the quadrigeminal/superior cerebellar cistern compressing of the aqueduct, inferior colliculus, and vermis. Using the modified sitting position, the tumor was almost totally removed via the infratentorial supracerebellar approach. Postoperative headache and blurring of vision had been improved, but ataxic gait and mild diplopia due to right superior oblique palsy was noted. Ataxic gait was disappeared in half a month and diplopia in two months respectively. PMID- 1766032 TI - Contrast cholangiography versus ultrasonographic measurement of the "extrahepatic" bile duct: a two-fold discrepancy revisited. AB - The upper limit of the normal extrahepatic duct diameter when measured by sonography in our institution is less than half that when measured by endoscopic retrograde cholangiopancreatography (ERCP). The objective of this study was to locate possible sources of this discrepancy by comparing measurements obtained on the same patient by sonography, before and after ERCP. Thirty consecutive patients referred for ERCP were entered into a prospective trial; bile duct measurements were obtained independently by both techniques in 19 patients. Correcting for radiographic magnification, the ERCP measurement was more than twice that obtained by ultrasonography. Among the possible reasons for diverse results that we considered, radiographic magnification, ultrasonic underestimation, and distending effects of retrograde cholangiography (ERCP) were not found to be prominent causes for the marked discrepancy that we observed. The most likely explanation is that the duct in individual patients was being measured at a different level by the two techniques. A retrospective comparison of the studies obtained by each method suggests that the sonographic measurement is most often of the right hepatic duct. If this is the case, the two measurements show no statistically significant difference (P greater than 0.05). A prospective trial is needed to test this hypothesis. PMID- 1766033 TI - Popliteal venous aneurysm. PMID- 1766034 TI - The role of preimplantation sonographic exposure in postimplantation development and pregnancy outcome. AB - To determine what, if any, effects exposure to ultrasonic beams has on preimplantation embryos we isolated mouse blastocysts and assessed resorption rate, pregnancy rate, decidual swelling volume, and live birth rate after in vitro exposure with subsequent transfer to surrogate mothers. The blastocyst stage embryos were isolated by flushing the uteri of pregnant animals with a phosphate buffered medium. Blastocysts at a discrete stage of development were pooled and transferred to a PB1-methylcellulose medium. This medium is specifically designed to maintain the embryos in a high viscosity solution during the sonographic exposure to prevent microcavitation. After the exposure, the embryos were washed free of methylcellulose and transferred to the uteri of pseudopregnant surrogate mothers. A total of 660 blastocyst stage embryos were distributed among seven treatment groups. After exposure, the embryos were transferred to 54 surrogate mothers. A total of 199 embryos were implanted successfully for postimplantation evaluation. An additional 427 blastocysts were distributed among four treatment groups and transferred to 46 surrogate mothers to assess the effect of sonographic exposure on birth rate. The results indicate possible deleterious effects (decreased implantation rate, increased resorption rate, decreased decidual swelling volume, and increased stillbirth rate) of short ultrasonic exposures (1 min and 5 min) on mouse blastocyst function. PMID- 1766035 TI - Sister chromatid exchange analysis of human cells exposed to diagnostic levels of ultrasound. AB - Lymphocyte and lymphoblastoid cells were exposed in vitro to diagnostic levels of ultrasonic beams delivered by a Hewlett-Packard CE 30001 and a GE system with a 5 MHz linear transducer for 20 sec, 1 min, 5 min, and 20 min. Temperature and cavitation effects were controlled and there were matched sham exposures. The synergistic effects of theophylline with ultrasonography also were investigated. Small increases in sister chromatid exchange levels were observed after ultrasonic exposure, but increases were so small as to be unlikely to have clinical relevance. Theophylline was found to have no effect and ultrasonography had no effect on cell viability. PMID- 1766036 TI - Influence of the measurement location on the resistance index in the umbilical arteries: a hemodynamic approach. AB - A computer model was used to study the primary factors generating the reduction in resistance index, (S-D)/S, values observed by ultrasonic Doppler measurements in the umbilical artery, from the fetal insertion to the placental insertion (S represents the amplitude of the systolic peak and D the amplitude of the diastolic peak). This hemodynamic approach shows that the placental resistance is the primary factor, the viscosity and the cord length playing secondary roles. Clinically, the position of the measurement along the cord is an important factor. To increase the sensitivity of the index, the Doppler measurement must be performed near the fetal insertion, whereas a measurement near the placental insertion will make the Doppler examination more specific. PMID- 1766037 TI - Vaginal tampon causing anterior displacement of the uterine cervix simulating a retrovesicular mass. PMID- 1766038 TI - Hyperechoic meconium in the third trimester fetus: an uncommon normal variant. AB - Fetal meconium is usually hypoechoic or isoechoic to adjacent abdominal structures on antenatal sonography. Hyperechoic meconium is associated with pathologic conditions, such as meconium ileus, meconium peritonitis, and anorectal malformations. The authors describe three third trimester fetuses with hyperechoic meconium and a normal outcome. Although a prospective study revealed that this finding is very uncommon, hyperechoic meconium can be a normal variant, particularly when it is seen as an isolated finding late in the third trimester. PMID- 1766039 TI - Sonographic measurement of abdominal aortic diameter: interobserver variability. AB - Twenty-eight patients undergoing sonographic evaluation of the abdominal aorta were examined by two separate observers. Three measurements were obtained from each patient: the anteroposterior diameter from an axial image (APA), the right left diameter from an axial image (RLA), and the anteroposterior diameter from a longitudinal image (APL). Calculation of the interobserver variability gave the following results (in mm): APL, 2.22; APA, 2.53; and RLA, 2.84. The calculated 95% confidence intervals for a single measurement (in mm) were APL, 4.35; APA, 4.94; and RLA, 5.58. PMID- 1766040 TI - Ectopic pregnancy: transvaginal color Doppler of trophoblastic flow in questionable adnexa. AB - The purpose of this study was to see if color flow Doppler measurements could aid in the positive diagnosis of ectopic pregnancy when no gestational sac can be seen in the adnexa. We examined 148 women with abdominal pain and suspected ectopic pregnancy by abdominal ultrasonography, followed by vaginal ultrasonography and color Doppler when the diagnosis was still uncertain. Seventy three patients proved to have ectopic pregnancies. Color flow with low resistance and high velocity vascular signals were observed in complex adnexal masses and in some of the corpora lutea. The resistance index for ectopic trophoblast was 0.36 +/- 0.02 SD. Color Doppler had both positive and negative discrimination of adnexal masses (P = 10(-15). The resistance index for the corpora lutea was 0.48 +/- 0.04. A cutoff value of 0.40 or less is proposed as a diagnostic index for suspected trophoblast in the adnexa. In nine cases of ectopic pregnancy, no color flow was noted. In these women, the beta-human chorionic gonadotropin level was less than 1000 mIU/ml. The clinical operative suspicion in these cases was tubal abortion. Sensitivity and specificity were 88% and 97%, respectively, in this highly selective series. Positive and negative predictive values were 97% and 89%. Color Doppler appears to be useful for the positive diagnosis of ectopic pregnancy with ultrasonography when no adnexal gestational sac is observed. Prospective randomized trials will determine the ultimate clinical value of these findings. PMID- 1766041 TI - Color Doppler artifact from metallic carotid clamp. AB - The presence of mirror artifacts in color Doppler has been noted by others. In that report, the artifact arose from scattering at the smooth vessel wall and appeared as signal outside the lumen of the vessel, but with no change in flow direction. As experience increases, recognition of the artifacts of color Doppler will lead to a better understanding and more precise evaluation. This case shows that a band of metal around the carotid artery causes registration errors in color-coded Doppler, and perhaps other metal foreign bodies in the soft tissues have similar potential. The specific appearance of the artifact will depend sensitively on the geometrical configuration of the metal body itself and on its orientation relative to the surrounding anatomy and the ultrasound probe. Appropriate placement of the transducer will reduce such artifact. PMID- 1766042 TI - Diagnosis of ectopia cordis at 12 weeks gestation using transabdominal ultrasonography with color flow Doppler. PMID- 1766043 TI - Antepartum diagnosis and management of multiple fetal cardiac tumors. PMID- 1766044 TI - Ultrasound diagnosis of hepatic Kaposi sarcoma. PMID- 1766045 TI - The prenatal sonographic features of Kniest syndrome. PMID- 1766046 TI - Rhoades Lecture. Effect of infection on nutrient requirements. 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 basal metabolic rate when fever is present. In this way, infection influences 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 inasmuch as they are frequently debilitated by their primary disease, morbidity, and nutritional status. Morbidity and mortality are increased by nosocomial infections to which the poorly nourished individual is more susceptible. PMID- 1766047 TI - Changes of hepatic morphology during parenteral nutrition with lipid emulsions containing LCT or MCT/LCT quantified by ultrasound. AB - Fatty infiltration of the liver with cholestasis is one of the complications of total parenteral nutrition (TPN). The cause has not yet been determined. It seems probable, however, that these alterations could be prevented when a mixture of medium- and long-chain triglycerides (MCT/LCT) is used as a fat component instead of the application of long-chain emulsions (LCT) alone. To determine whether this could also be demonstrated morphologically in man, 14 patients needing TPN (25 kcal/kg BW x day, carbohydrate 45%, fat 35%, protein 20%) were examined by ultrasound in order to compare liver size and gray-scale value before and after 7 days of TPN. Seven of the patients were randomly administered a MCT/LCT emulsion as their fat intake, the other seven were exclusively given LCT. There were no changes in liver size and gray-scale value in the MCT/LCT-group, whereas both parameters showed a significant rise in the patients with LCT (size: 10.4 +/- 1.4 to 11.5 +/- 1.4 cm; gray-scale value: 9.3 +/- 1.0 to 11.6 +/- 0.7). These data suggest that TPN, administered with a mixture of MCT/LCT emulsions as fat components, could reduce the risk of hepatic dysfunction such as cholestasis and fatty infiltration of the liver. PMID- 1766048 TI - Resting energy expenditure in cancer patients before and after gastrointestinal surgery. AB - The aim of this study was to assess the impact of surgical trauma on energy metabolism in cancer patients. Therefore, resting energy expenditure (REE) was determined before and after surgery in patients with newly detection gastric and colorectal cancer. Preoperative REE was measured in 104 patients. In 65 of these 104 patients REE was also measured on the seventh or eighth postoperative day. Postoperative REE was significantly higher than preoperative REE (mean +/- SD: 1471 +/- 238 vs 1376 +/- 231 kcal; p less than 0.001). After surgery 22 patients were hypermetabolic (REE greater than or equal to 115% predicted energy expenditure) compared with seven hypermetabolic patients before surgery. This hypermetabolism in the postoperative state can be explained by the administration of total parenteral nutrition (TPN), by an increased body temperature mainly as a consequence of postoperative complications and by the surgical trauma itself. Patients who received preoperative TPN (n = 12) showed a 10% increase in REE. Thirteen patients suffered from minor and major postoperative complications; postoperative REE in this group was increased by 10%. Forty patients who had undergone uncomplicated surgery showed a slight but significant increase of 3% in REE after operation. We conclude from this study that the increase in REE resulting from surgical trauma itself is modest at the seventh to eighth postoperative day. Therefore, energy requirements for patients undergoing major elective surgical stress are lower than generally presumed. PMID- 1766049 TI - The solubility of calcium and phosphorus in neonatal total parenteral nutrition solutions. AB - Precipitation of calcium phosphate in neonatal total parenteral nutrition (TPN) solutions remains a significant problem. Whereas numerous studies have attempted to establish guidelines for maximum concentrations of various combinations that can be mixed, differences in study design and reliance upon subjective visual assessment severely limit their applicability. The purpose of this study was to quantitatively determine calcium and phosphate compatibility in commonly used neonatal TPN solutions containing a final concentration of either 1 or 2% amino acids. The final dextrose concentration was 10%. Electrolytes, heparin, and pediatric vitamins and trace minerals were also added. Calcium gluconate (10%) and potassium phosphate (mono and dibasic) were added by calibrated micropipetors. Calcium concentrations ranged from 5 to 60 mEq/L and phosphate from 5 to 40 mM/L with a minimum of 84 combinations tested for each amino acid concentration. Calcium concentrations were measured in duplicate for each tested combination. Control solutions containing calcium but no phosphate were included to validate the assay methodology. All samples were stored at room temperature for 23.5 hours and then placed in a water bath at 37 degrees C for 30 minutes to simulate incubator conditions encountered during TPN infusion. Calcium determinations were then repeated and precipitation was judged to have occurred whenever calcium concentrations fell below 90% of the initial measured values. These data allowed plotting a calcium and phosphorus reference curve for TPN solutions containing 1 and 2% amino acids based on quantitative assessment. These reference curves should allow pharmacists to avoid compounding TPN solutions that will precipitate, thus saving considerable cost to the pharmacy and preventing complications. PMID- 1766050 TI - Optimal ratio of individual branched-chain amino acids in total parenteral nutrition of injured rats. AB - In this study, we investigated the optimal ratio of individual branched-chain amino acids (BCAA) in a balanced amino acid infusion in laparotomized rats. The total BCAA contents of four amino acid infusions were fixed at 31% of total amino acids. The weight ratios of individual BCAA (isoleucine:leucine:valine) in the solutions were 1:0.5:1, 1:1:1, 1:2:1, and 1:4:1, respectively. The laparotomized rats were infused with about 140 mg (experiment 1) and 100 mg (experiment 2) of nitrogen and 10 g of glucose daily for 7 days. In both experiments, no marked difference was observed in the mean cumulative 7-day nitrogen balance and the urinary 3-methyl-histidine levels of all the groups. The BCAA concentrations and the molar ratios of individual BCAA in plasma were disarranged by the infusion of the 1:0.5:1 and 1:4:1 solutions. The infusion of the 1:1:1 and 1:2:1 solutions tended, however, to allow the values to approach the preinfusion values. These results suggest that the optimal ratio of individual BCAA in an amino acid infusion lies between 1:1:1 and 1:2:1 for this injured rat model in total parenteral nutrition. PMID- 1766051 TI - Evaluation of the predictive performance of nutritional indicators by receiver operating characteristic curve analysis. AB - Four hundred twenty-two cancer patients who underwent major surgery were studied. At admission, nutritional status was evaluated in all patients by assessing serum albumin (SA), total iron-binding capacity (TIBC), total lymphocyte count (TLC), serum cholinesterase activity (CHE), and weight loss (WL). All patients received perioperative short-term antibiotic prophylaxis and postoperative total parenteral nutrition. Prognostic ability of nutritional indicators was assessed by receiver-operating characteristic (ROC) curve analysis. The area beneath the ROC curve (Az) is an index of predictor performance when its value ranges from 0.5 (chance performance) to 1 (perfect prediction). Specificity, sensitivity, Youden index, and predictive values were determined for each nutritional parameter within a wide range of potential threshold values. Postoperative septic complications were observed in 85 (20.14%) patients. The Az values for the considered nutritional parameters ranged from 0.52 to 0.57 and that showed the low predictive ability of the parameters. When sensitivity and specificity for each nutritional parameter were examined at different thresholds, a clearly more predictive cutpoint was not observed, but ranges of values with a similar predictivity were observed. Significant ranges of predictivity were found for SA (33 to 35 g/L), for TIBC (2200 to 2300 micrograms/L), for TLC (2100 to 2200 million/L), for CHE (1700 to 1900 U/L), and for WL (7% to 12%). The higher values of Youden index were as follows: 1.183 for WL (cutoff 11%), 1.150 for TLC (cutoff 2100 million/L), and 1.145 for SA (cutoff 35 g/L). In conclusion, ROC curve analysis showed that the nutritional parameters had a low predictive ability.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766052 TI - A method for increasing confidence in respiratory gas exchange measurements in mechanically ventilated patients. AB - Measurement of O2 uptake (VO2) and CO2 output (VCO2) with automated instruments can be used to optimize nutritional management of critically ill patients. However, these measurements may be made infrequently because of calibration problems or suspected inaccuracies, especially when the patient is given supplemental oxygen. A simple method is described for periodic testing of automated gas exchange measurements. While a test lung is mechanically ventilated an accurately known mixture of CO2 and nitrogen is introduced into the inspired gas, simulating VO2 by dilution and VCO2 by addition of CO2. The ratio of VCO2:VO2 (respiratory gas exchange ratio, R) in the "expired gas" should be [FGCO2/(1-FGCO2)] x [(1-FIO2)/FIO2], where FGCO2 is the fraction of CO2 in the diluting gas and FIO2 is the fraction of O2 in the inspired gas. R is independent of the flow rate of the diluting gas or the rate of ventilation of the test lung. Using a mixing chamber-mass spectrometer, we found that R calculated from measurement of CO2 and O2 concentrations in the simulated mixed expired gas closely matched the predicted R for FIO2 = 0.21-0.50. On the other hand, when an automated gas exchange measurement device was tested, R was sometimes excessively high, especially for FIO2 greater than 0.35. This method, using a single diluting gas and without precision flowmeters, may be useful for periodic testing of respiratory gas exchange instruments in the intensive care unit. If a discrepancy is found between measured and predicted R, measurements should not be relied upon until further calibration or repairs can be effected. PMID- 1766053 TI - Histopathologic study of cholestasis induced by total parenteral nutrition or intraperitoneal sepsis in rats. AB - Wistar rats were divided into two groups, intraperitoneal sepsis group (group IS) and total parenteral nutrition group (group TPN), to evaluate the characteristics of pathologic alterations in rats with cholestasis. Biochemical assay showed that cholestasis developed in both groups after 10 days. Light microscopic examination of liver specimens revealed that the degeneration in the intermediate and external zone of hepatolobules was the major alteration in group IS, and group TPN showed characteristic dilation of central veins and hepatic sinuses and the proliferation of Kupffer cells with marked phagocytosis. Electron microscopic pictures presented the enlargement of bile canaliculi with altered microvilli in group IS and many highly electron-dense bile particles within cytoplasm and secondary lysosomes near dilated bile canaliculi in group TPN. It is concluded that there were different histopathologic alterations of liver specimens in TPN supported animals and septic animals when cholestasis developed. It is unsuitable to take intraperitoneal sepsis as a unique factor of cholestasis in TPN-supported rats. Bile stasis is only one sign of TPN-induced hepatic lesion, which needs further exploration to determine its causes and mechanisms. PMID- 1766054 TI - Lipid infusion with different triglyceride cores (long-chain vs medium-chain/long chain triglycerides): effect on plasma lipids and bilirubin binding in premature infants. AB - The possible beneficial effects of infusing a lipid emulsion containing 50% by weight of medium-chain triglycerides (MCT) compared with a standard long-chain triglyceride (LCT) emulsion were studied in 18 premature neonates (gestational age less than 34 weeks) requiring parenteral nutrition. The infants were assigned in a double-blind manner to receive one of the two lipid emulsions over 17 hours a day as a supplemental regimen for total parenteral nutrition. A lipid load of 1 g/kg per day was initiated on the third day of life and was increased at the rate of 1 g/kg per day until a maximal dose of 3 g/kg per day was obtained on the fifth day of life and maintained thereafter. Both bound and unbound bilirubin decreased with both infusion regimens during the study period. Despite a marked increase in plasma free fatty acid levels (260% in the MCT/LCT group compared with 210% in the LCT group), the fraction of unbound (free) bilirubin was significantly lower in the MCT/LCT group (34% vs 13%). Free fatty acid levels, corrected to albumin, were positively correlated to the percentage of free bilirubin only for the LCT lipid infusion. The finding of a significant elevation of plasma cholesterol levels only in the MCT/LCT group is now under investigation. Use of the MCT-containing emulsion was not associated with a higher frequency of adverse effects than the commonly used LCT-containing emulsion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766055 TI - Vitamin E status of patients receiving long-term parenteral nutrition: is vitamin E supplementation adequate? AB - Vitamin E status of eight patients receiving total parenteral nutrition (TPN), including 10 IU of all-racemic alpha-tocopheryl acetate daily and Intralipid 20% (500 mL; 12 mg of RRR-alpha- and 92 mg of RRR-gamma-tocopherols) two to three times per week for 69 +/- 45 (mean +/- SD) months was assessed by measuring plasma and adipose tissue tocopherol concentrations. Plasma alpha-tocopherols of TPN patients were similar to controls (17.5 +/- 6.6 mumol/L vs 22.4 +/- 5.1), whereas gamma-tocopherols were significantly reduced (6.0 +/- 3.1 vs 11.2 +/- 3.6, p less than 0.03). The adipose tissue alpha- and gamma tocopherol/triglycerides (TG) were similar (369 +/- 215 nmol/mmol vs 452 +/- 228, and 125 +/- 102 vs 140 +/- 130, respectively), but cholesterol/TG were increased in the TPN patients (7.8 +/- 2.5 mumol/mmol vs 5.1 +/- 3.5, p less than 0.05), suggesting that adipose tissue was relatively TG-depleted and tocopherol/cholesterol measurements better reflect vitamin E status. The mean alpha-tocopherol/cholesterol ratios were significantly lower in the TPN patients than the controls (55 +/- 36 vs 106 +/- 63, p less than 0.04). Thus, current vitamin E supplementation of TPN patients seems insufficient for maintenance of adequate tissue stores. PMID- 1766056 TI - Insulin sensitivity in septic cancer-bearing patients. AB - Resistance to insulin's effect on glucose metabolism is a well-documented phenomenon. The magnitude of resistance to insulin's antilipolytic action is usually less than the resistance to insulin's action on glucose metabolism. In sepsis, resistance to the antilipolytic effect of insulin may be more prominent than resistance to insulin's action on glucose metabolism. Therefore, free fatty acid (FFA) turnover, FFA concentration, glucose tissue uptake, and endogenous glucose production were measured in nine septic cancer-bearing patients and six healthy volunteers during a constant glucose load at two different insulin concentrations. During infusion of glucose alone, plasma insulin concentration in patients and control subjects were, respectively 33 +/- 7 mU/L and 23 +/- 4 mU/L. When plasma glucose was clamped at the low normal range these values were, respectively, 85 +/- 17 mU/L and 28 +/- 5 mU/L (p less than 0.05). Glucose tissue uptake and endogenous glucose production were not significantly different in patients and control subjects in both parts of the study. FFA turnover and FFA concentrations were significantly higher in the patients compared with the control subjects (p less than 0.001) in both parts of the study. It is concluded that in septic cancer-bearing patients, resistance to insulin's effect on FFA turnover is more pronounced than resistance to its inhibiting effect on endogenous glucose production and its stimulating effect on glucose tissue uptake. PMID- 1766057 TI - Malnutrition in tubefed nursing home patients with pressure sores. AB - This study compares the nutritional status and dietary intake of 14 tubefed nursing home patients with pressure sores (age: 70 +/- 5 years, mean +/- SEM) to 12 tubefed patient-controls without sores (age: 60 +/- 7 years). Patients tended to have higher calorie intake (32 +/- 3 kcal/kg) than patient-controls (26 +/- 2 kcal/kg, p = 0.11). Protein intake was significantly higher in patients (1.4 +/- 0.2 g/kg) than patient-controls (0.9 +/- 0.1 g of protein per kg, p less than 0.05). Despite increased calorie and protein intake, biochemical measures of nutritional status were worse in the patients. Serum albumin was lower in patients (33 +/- 1 g/L) than in patient-controls (37 +/- 1 g/L, p less than 0.05) as was level of hemoglobin (patients: 117 +/- 5; patient-controls: 132 +/- 5 g/L, p less than 0.05). Patients with stage IV (severe) sores had lower serum cholesterol levels (3.46 +/- 0.31 mmol/L, n = 5) than patients with stage II/III (milder) sores (4.58 +/- 0.23 mmol/L, n = 9, p less than 0.05). Plasma zinc was low in both patients (11.2 +/- 0.6 mumol/L) and patient-controls (11.5 +/- 0.7 mumol/L, p = NS). Pressure sore surface area was positively correlated with calorie intake per kilogram of body weight (r = +0.59, p less than 0.04) and negatively correlated with body mass index (r = -0.70, p less than 0.03), hemoglobin (r = -0.55, p less than 0.07) and serum cholesterol (r = -0.57, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766058 TI - Insufficient effect of total parenteral nutrition to improve protein balance in peripheral tissues of surgical patients. AB - Previous studies have indicated that unstressed and malnourished patients do not necessarily obtain amino acid balance across peripheral tissues during total parenteral nutrition (TPN) treatment, indicating treatment inefficiency. Therefore, the aim of this study was to evaluate to what extent (prevalence) insufficient therapeutic amino acid balance occurs in surgical patients receiving TPN for standard medical reasons. Thirty-two patients treated in an ordinary surgical ward (n = 17) or in the intensive care unit (ICU) (n = 15) were examined. The arteriovenous balance across the leg of amino acids, glucose, glycerol, lactate, and oxygen was measured in relationship to plasma levels of insulin. All patients had been receiving TPN for at least 7 days before the investigation. All measurements were performed when amino acids had been infused for at least 4 hours and thus expected to support the resynthesis of lean body mass. Patients treated in the ICU and the surgical ward were in positive whole body energy balance (+1127 +/- 121 and +917 +/- 123 kcal, respectively). Glucose uptake and oxygen consumption across the leg were similar in both patient groups. Glycerol release was not different from zero balance, indicating that inhibition of lipolysis across the leg during feeding and lactate was normally released in both groups. However, approximately 50% of the patients treated in the ordinary ward and 80% to 100% of the patients in the ICU remained in negative amino acid balance across the leg as judged from significant release of either methionine, tyrosine, or phenylalanine despite concomitant infusion of amino acids (approximately 0.3 g of N per kilogram per day) and nonprotein calories.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766059 TI - Bilateral pleural and pericardial effusions because of mediastinal placement of a central venous catheter. AB - Pneumothorax, hydrothorax, hydromediastinum, and cardiac tamponade are uncommon, although not unusual, complications of central venous catheter placement. We report a case of hydromediastinum with bilateral pleural and pericardial effusions, occurring in a patient after placement of a Silastic double-lumen central venous catheter for hyperalimentation. PMID- 1766060 TI - Abnormal substrate metabolism and nutritional strategies in cancer management. AB - Impairment of the nutritional state plays a major role in the morbidity and mortality of cancer patients. However, the opportunity of providing artificial nutritional support to these patients is still debated, because of the concern that energy substrates administered to replete the host may concomitantly stimulate tumor growth. A correct nutritional approach to cancer patients should thus be based on a thorough knowledge of both host and tumor metabolic needs and host-tumor metabolic interactions. Specific modifications of plasma levels of glucogenic, aromatic, sulfur-containing and branched-chain amino acids have been demonstrated in cancer patients, indicating a specific influence of the tumor on amino acid metabolism. Little is known about protein metabolism in neoplastic tissue. Interference with tumor growth has been attempted by deprivation of single amino acids with controversial results. Increased gluconeogenesis and insulin resistance are responsible for the two main abnormalities in carbohydrate metabolism in cancer patients, namely increased glucose turnover and impaired glucose tissue disposal. Lipid metabolism is also affected by the neoplasm: soluble factors such as "lipid-mobilizing factor" lead to increased fat mobilization from adipose tissue; plasma elimination of exogenous triglycerides has also been found to be reduced probably because of a tumor-related decrease in lipoprotein lipase activity. The differences in glucose and fat utilization between tumor and host should be considered in the nutritional approach to cancer patients. Data in this respect are controversial and have been obtained only in experimental animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766061 TI - Effect of restricting dietary protein on the progression of renal failure in patients with insulin-dependent diabetes mellitus. PMID- 1766062 TI - Diet and cimetidine induce comparable changes in theophylline metabolism in normal subjects. PMID- 1766063 TI - Measurement of resting energy expenditure in patients with liver disease. PMID- 1766064 TI - Enteral feeding and diarrhea in the hypoalbuminemic patient. PMID- 1766065 TI - Measurement of elemental nitrogen by chemiluminescence. PMID- 1766066 TI - Puerperal psychiatric disorders--who cares? PMID- 1766067 TI - Role of prostaglandin synthesis inhibitors in the passage of ureteric calculus. AB - Diclofenac sodium, one of the prostaglandin synthesis inhibitors was evaluated in terms of passage or movement of ureteric stones upto the size of 0.5 cm in a series of 80 patients. Forty-six (57.5%) patients passed the stone within a period of 4 weeks. This frequency of stone passage was significantly higher when compared with stone passage of similar size in other series (P less than 0.001). In 17 (56.6%) out of 30 patients, stone moved from upper and middle ureter to the lower ureter which is also significant from therapeutic point of view. Complete pain relief was achieved in 67 (84%) patients. No side effects of the drug noted in this series. The sequence of events following ureteral obstruction by the stone, based on recent experimental and clinical studies is discussed and possible mechanism of action of diclofenac sodium was highlighted. PMID- 1766068 TI - The pattern of malignant tumours in northern Pakistan. AB - A retrospective study of 14,018 malignant tumours from northern Pakistan is presented. The data reflects the pattern of cancer distribution in this region. Among males most common sites are lymphnode, leukemia, skin, prostate, colorectal, bone and stomach and in females breast, skin, ovary, leukemia, gall bladder, thyroid and bone. The distribution of malignant tumours in various districts of northern Pakistan and different ethnic groups like Pathans, Punjabis and Urdu speaking have also been outlined. Age standardized cancer ratio (ASCAR) was calculated to compare the data from the neighbouring countries of the region. Prostatic cancer in males and gall-bladder carcinoma in females is more frequent in our material as compared to other countries of the region. Comparison of the pattern of malignant tumours in North and South has also been highlighted. PMID- 1766069 TI - Liver abscess in children--not an uncommon problem. AB - Thirty cases of amoebic liver abscess in children are being presented. Diagnosis was based on clinical presentation, ultrasound examination, detection of E.H. trophozoite in the aspirate and response to therapy. Aspiration of pus along with appropriate medication was found more appropriate management than medical therapy alone. PMID- 1766070 TI - Early experience with fluoxetine. AB - A new antidepressant Fluoxetine, a serotonin re-uptake inhibitor, was tried on 26 resistant depressed patients. There were four drop out due to severe side effects. Improvement was noticeable soon after the first week and was maximum within 3 weeks of medication in 14 (63.6%) patients while in 8 (36.4%) patients it was as late as 6-12 weeks. The decline in improvement after three weeks in 7(31.8%) patients, needs attention in future studies. Bradycardia in 2 patients above the age of sixty indicate that the drug should be used with caution in elderly. GIT disturbance, insomnia, anorexia, restlessness and lethargy were common side effects. A well planned double blind study is recommended before its place is assigned in our patient population. PMID- 1766071 TI - Dietary and serum calcium in pregnant women. AB - Dietary and serum calcium were estimated in 200 normal pregnant women between 37 41 weeks of gestation and in cord blood of their new born. Calcium intake per person per day was low, 11.8mmol/L, as compared with the daily recommended allowance of 30 mmol/L. Mean maternal serum calcium level was also low (1.9 mmol/L) and only 20% of mothers had serum calcium within normal range. Mean calcium value in cord blood was at lower limit of normal range, being 2.3 mmol/L; 38.5% of cord samples (77) were below the normal range. PMID- 1766072 TI - Is the vagotomy complete? AB - Incomplete vagotomy is the single most common cause of ulcer recurrence. Completeness of vagotomy was assessed postoperatively in 17 patients using the congo red test. Various types of vagotomies included truncal vagotomy and gastrojejenostomy in 6, highly selective vagotomy in 5, truncal vagotomy and pyloroplasty in 3 and selective vagotomy with gastrojejenostomy in 3 cases. Congo red test was positive in 13 cases, with 9 of these showing evidence of incomplete vagotomy manifesting as erosions, duodenitis, stomal ulceration or ulcer recurrence. PMID- 1766073 TI - Yet another cause of chronic viral hepatitis? AB - The clinical features, course and histology of liver in 20 patients; mostly middle aged to elderly females, closely resembling chronic Non A Non B hepatitis is presented. They presented quite late in their disease and therefore, complications such as variceal bleeds, ascites and encephalopathy were frequent. Our patients were negative for hepatitis B and C virus serology. Metabolic and immune causes of chronic liver disease were also ruled out. To the best of our knowledge, this is the first study of its kind elaborating the clinical features, course and histology of liver in chronic Non B Non C hepatitis and raises a number of questions as to the nature of the infecting virus and the epidemiology of disease. PMID- 1766074 TI - A new clinical test for postoperative vocal cord paralysis. PMID- 1766075 TI - Enterolithiasis secondary to intestinal tuberculosis. PMID- 1766076 TI - Spectrum of viral hepatitis. PMID- 1766077 TI - Microbiological specimens. PMID- 1766078 TI - Tractor injuries: are they always farm related? PMID- 1766079 TI - Clinical significance of junctional pacemaker automaticity in patients with sick sinus syndrome. AB - This study aimed to examine the characteristics and the clinical significance of atrio-ventricular (AV) junctional automaticity in sick sinus syndrome. Maximum sinus node recovery time (max SRT) or maximum junctional recovery time (max JRT), and AV nodal Wenckebach block rate were evaluated before and after pharmacologic autonomic blockade (AB) in 43 patients with sick sinus syndrome. Max JRT shorter than 3000 msec was obtained after AB in 13 patients (group 1) and apparent enhancement of junctional automaticity after AB was observed in these patients. Thirty patients showed max JRT or max SRT longer than 3000 msec after AB (group 2). The Wenckebach block rate increased significantly after AB in group 1 but did not change significantly in group 2. The Wenckebach block rate after AB in group 1 was significantly higher than that in group 2. Max JRT was obtained only after AB in 8 patients in group 1 (subgroup 1), and in 9 in group 2 (subgroup 2). Max SRT before AB and the intrinsic heart rate were not significantly different between these subgroups. Only one of 8 patients in subgroup 1 had a history of near syncope. On the other hand, syncope was observed in 5 patients, and near syncope in one, in group 2. In conclusion, intrinsic junctional automaticity is preserved in some patients with sick sinus syndrome, and might compensate for sinus node dysfunction to prevent clinical symptoms. Organic impairment should affect conductivity as well as automaticity in the AV junction. PMID- 1766080 TI - Isolated coronary ostial stenosis compared with left main trunk disease. AB - Isolated coronary ostial stenosis (OS) is a rare disease of unknown etiology. Five cases of OS were observed amongst 700 elective coronary bypass patients, and were compared with 111 cases of atherosclerotic left main trunk disease (LMTD) to clarify clinical characteristics. Mean age for LMTD patients was 61.2 years, while, it was 43.0 years for OS patients. 4 patients out of the 5 cases (80%) in the OS group were female, but there were only 10 females (9%) in the LMTD group. 60% of the OS group presented unstable angina without any episodes of myocardial infarction. 69.4% of the LMTD group presented stable angina, and 42% had a previous myocardial infarction. Left ventricular function was well preserved in the OS group compared to the LMTD group. Aorto-coronary bypass grafting was the only surgical method of our choice in both groups. The average number of grafts were 2.2 for the OS group, and 2.4 for LMTD group. Operative mortality was 0% for the OS group and 0.9% for the LMTD group. Clinical and angiographic profiles of ostial stenosis suggest that this group may represent a distinct entity, different from the more common atherosclerotic left main trunk stenosis. Coronary bypass grafting can provide good operative prognosis in ostial stenosis as well as in left main trunk stenosis. PMID- 1766081 TI - Two-dimensional and Doppler echocardiographic findings in a case of subaortic "fibrous sac". AB - We described a 37-year-old man with a subaortic "fibrous sac", admitted for congestive heart failure. On 2-dimensional echocardiography a saccular structure was seen to extend from the left coronary cusp of the aortic valve to the outflow tract of the left ventricle. By color Doppler imaging, a grade 3 aortic regurgitation was recognized. Aortic regurgitant flow was recorded from the left coronary cusp to the saccular lesion. When congestive heart failure became exacerbated, the repeat examination showed the regurgitant flow passing through the perforated bottom of this lesion and reaching the left ventricular cavity. On microscopic examination of the excised valve, capillary proliferation and inflammatory changes were recognized near the annular region of the left coronary cusp. The edge of the valve leaflet and the other 2 cusps were intact. It is likely that our patient had a mycotic aneurysm near the aortic ring. We speculate that aortic regurgitation followed inflammation. It dilated the left ventricular cavity and contributed to congestive heart failure. Inflammation also weakened the tissue near the annulus, causing it to protrude into the subaortic region thus forming a small aneurysm. It may have grown to become a large saccular structure under high aortic pressure. That is, it became a "giant" endocardial pocket with inflammatory process. Finally, the rupture of this sac caused a massive aortic regurgitation, exacerbating congestive heart failure. PMID- 1766082 TI - Primary cardiac hemangiopericytoma causing rupture of the right atrium and chronic cardiac tamponade. AB - A 53-year-old woman presented with symptoms of dyspnea on exertion and edema of lower extremities. Chronic cardiac tamponade caused by the rupture of the right atrial wall was diagnosed by two-dimensional contrast echocardiography. Autopsy findings revealed primary cardiac hemangiopericytoma. PMID- 1766083 TI - The response of left ventricular regional function to afterload stress in patients with old myocardial infarction and ventricular aneurysm. AB - The functional response of the left ventricle with scar to increased afterload, was examined in 15 patients with old myocardial infarction and left ventricular aneurysm (OMI). Interventional cine left ventriculography during elevating left ventricular pressure with methoxamine. Wall motion was assessed by the radial and the centerline method. Augmented afterload didn't change ejection fraction in patients with OMI, but normalized wall motion (Z) increased in the aneurysmal region and decreased in the remote region in both methods. In the remote region in patients with OMI, afterload stress shortened left ventricular pressure-radial length (P-L) loops along length axis, and reduced percent systolic radial shortening (SS). In the aneurysmal region, P-L loops showed systolic elongation of length at rest and the slope of end-diastolic point to end-systolic point became steeper with increased afterload, resulting in a decrease of aneurysmal expansion. In summary, with increasing afterload, wall motion decreased in non infarcted regions and increased in aneurysmal regions, in left ventricles with aneurysm. This mechanism may be interpreted as afterload-induced shifts of P-L loops in each region. PMID- 1766084 TI - Diagnosis and treatment of left ventricular false aneurysm. AB - Three patients are presented in whom a false aneurysm of the left ventricle was surgically treated. False aneurysm of the left ventricle is an unusual consequence of ventricular wall rupture with containment of the resulting hematoma. Most false aneurysms of the left ventricle develop following myocardial infarction. The false aneurysm wall contains no myocardium. The false aneurysm has a great tendency to rupture, regardless of its size. One patient developed progressive congestive heart failure following a myocardial infarction. The other two patients were asymptomatic following myocardial infarction. Preoperative magnetic resonance imaging showed characteristics of a false aneurysm. These included a distinct discontinuance of the myocardium at the neck of the aneurysm and a narrow neck relative to the diameter of the aneurysm. Two patients underwent successful closure of the orifice of the false aneurysms. One patient underwent emergency surgery because of acute rupture while awaiting surgery but died of cerebral damage. Surgical correction of a false aneurysm is clearly advisable even in the absence of symptoms. PMID- 1766085 TI - Infective endocarditis causing acute myocardial infarction by compression of the proximal left coronary artery due to a mycotic aneurysm of the sinus of Valsalva. AB - An extremely unusual case of myocardial infarction associated with infective endocarditis (IE) is described. A 38-year old male with a high fever was transferred to our hospital for further treatment of IE. Two-dimensional echocardiogram showed a large mycotic aneurysm of the sinus of Valsalva in contact with neighbouring structures. The patient had a rapid recovery within several days after administration of antibiotic agents. However, he then developed abrupt onset of severe precordial pain. From the echocardiogram images and biochemical evaluation he was diagnosed as having an acute subendocardial infarction. Serial echocardiograms revealed expansion of the aneurysm, extending from the myocardium of the anterolateral free wall to the lower margin of the proximal left coronary artery. The cause of acute myocardial infarction was thought to be incomplete occlusion of the coronary artery through compression by the enlarging mycotic aneurysm of the sinus of Valsalva. Urgent surgery confirmed compression of the left coronary artery by the large mycotic aneurysm as the cause of acute myocardial infarction. PMID- 1766086 TI - Effect of a new hyperosmotic agent, NIK-242 injection, on brain water content, metabolites and cerebral blood flow in cerebral ischemia in the spontaneously hypertensive rat. AB - We examined the effects of a new hyperosmotic agent (NIK-242inj.) on brain edema, energy metabolites and regional cerebral blood flow (r-CBF) during acute cerebral ischemia. Cerebral ischemia was induced by bilateral common carotid artery ligation (BLCL) using spontaneously hypertensive rats (SHR). The experimental animals were divided into 4 groups, A:20% NIK-242inj., B:20% mannitol, C:10% glycerol in 5% fructose, D:normal saline. All the animals were administered the agent or saline intravenously beginning at 1h after BLCL and continuing for 2h for a total dose of 6.8 ml/kg body weight. Brain water content and metabolites (ATP, lactate, pyruvate) were determined 3h after BLCL. Regional cerebral blood flow (r-CBF) in thalamus was also measured by the hydrogen clearance technique. The brain water content in the NIK-242inj. group was significantly lower than that of saline group. The concentration of brain ATP in the NIK-242inj. group remained higher than those of saline group. Accumulation of lactate in the NIK 242inj. group was less than in the mannitol and saline groups. The lactate/pyruvate ratio of the NIK-242 inj. group was significantly lower than that of the saline and mannitol groups. At 3h after BLCL, the reduction of r-CBF in the NIK-242inj. group was smaller than that of saline group. The present study suggests that NIK-242inj. as well as glycerol could ameliorate brain edema, disruption of brain energy metabolism and reduction of r-CBF in acutely induced cerebral ischemia. PMID- 1766087 TI - [The significance of autologous blood transfusion]. PMID- 1766088 TI - [Anesthesia for abdominal aortic aneurysm surgery]. PMID- 1766089 TI - [Changes in blood sugar levels following infusion of lactated Ringer's solution with various concentrations of potassium and glucose]. AB - Lactated Ringer's solution was prepared, in which concentration of potassium was either 10 or 20 mEq.l-1, and that of glucose was 1.4%. Each preparation was infused into 10 patients who underwent surgical operations under general anesthesia. Effects of this fluid therapy on changes in serum potassium and blood sugar were studied comparing with infusion of lactated Ringer's solution in which concentration of potassium was 10 mEq.l-1, and glucose was 0.7%. Both serum potassium and blood sugar levels were maintained within normal ranges with the lactated Ringer's solution containing 20 mEq.l-1 of potassium and 1.4% of glucose. On the other hand, the former tended to decrease and the latter tended to increase with the lactated Ringer's solution containing potassium 10 mEq.l-1 and glucose 1.4%. We consider that the homeostatic effect with the lactated Ringer's solution containing 20 mEq.l-1 of potassium and 1.4% of glucose would be to lower blood glucose level by concomitant intracellular influx of potassium and glucose. Therefore these high potassium lactated Ringer's solutions balanced adequately with glucose are useful for fluid therapy during surgical procedure under general anesthesia. PMID- 1766090 TI - [The relationship between the deep body temperature and hemodynamics after open heart surgery in children]. AB - The relationships of the forehead-sole deep body temperature difference with the cardiac index (CI), and with the systemic vascular resistance index (SVRI) were studied in 10 pediatric patients (TOF 5, ASD 3, VSD 2) for 24 hours after open heart surgery. A correlation between the deep body temperature difference (X) and CI (Y) was expressed as, Y = -0.49X + 4.51 (r = 0.72), and that between the deep body temperature difference (X) and SVRI (Z) as Z = 152X + 1039 (r = 0.62). The deep body temperature difference was 1.0 degrees C on the average in patients whose CI was more than 3.0 l.min-1.m-2, and was 3.3 degrees C in patients whose CI was less than 3.0 l.min-1.m-2. Conversely CI was less than 3.0 l.min-1.m-2 in patients whose deep body temperature difference was more than 3.0 degrees C. We conclude that the measurement of deep body temperature difference is useful as a circulatory monitor, and that a critical level of deep body temperature difference is 3 degrees C in children. PMID- 1766091 TI - [The effects of arterial blood halothane or enflurane concentration on the circulatory system]. AB - The effects of halothane (H) or enflurane (E) concentration on the circulatory system were studied in dogs. Two hours of halothane or enflurane anesthesia resulted in a linear dose-dependent decrease in circulatory indices including mean arterial pressure (mAP), cardiac index (CI) and left ventricular peak dp/dt/IP (peak dp/dt/IP). Systemic vascular resistance (SVR) was unchanged during either anesthesia. The correlations between the percent change of circulatory indices and the logarithm of the blood anesthetic concentrations were expressed by correlation coefficients (r): mAP, r = -0.718 (H), and -0.650 (E): HR, r = -0. 329 (H), and -0.352 (E): CI, r = -0.597 (H), and - 0.596 (E): SI, r = -0.389 (H), and -0.449 (E): SVR, r = -0.161 (H), and -0.030 (E): peak dp/dt/IP, r = -0.708 (H), and -0.871 (E). Using several indices of anesthetic depth including MAC, MAC EI and MAC-BAR, the percent changes of mAP, CI and peak dp/dt/IP were calculated at the same anesthetic depth using halothane or enflurane. These results indicate that enflurane depresses these circulatory indices more than halothane. The differences were: mAP, 14.51 +/- 1.46%: CI, 8.14 +/- 1.86%: peak dp/dt/IP, 7.38 +/- 3.95% (mean +/- SD). PMID- 1766092 TI - [Composition of cerebro-spinal fluid during enflurane anesthesia]. AB - The compositions of cerebro-spinal fluid (CSF) during enflurane (GOE group; n = 15) and neurolept (NLA group; n = 8) anesthesia were investigated in patients undergoing ventriculo-peritoneal shunt operation. Duration of anesthesia from induction to sampling of CSF was 130 minutes in both groups. Average inhalational concentration of enflurane was 1.6 +/- 0.8%. The concentrations of the electrolytes in CSF and the ratios of them to those in serum were maintained within considerably narrow ranges in both groups without statistical difference. The glucose, protein and osmolarity in CSF or serum were not different between the groups. It is concluded that enflurane does not induce abnormalities in the composition of CSF during clinical anesthesia. PMID- 1766093 TI - [The roles of anesthetics and daily used drugs in cardiovascular changes during normovolemic hemodilution (NVHD)]. AB - The changes of cardiovascular parameters and serum cathecholamine levels associated with normovolemic hemodilution (NVHD) were studied under three different conditions: Group 1; the patients for cardiac surgery who were taking cardiac drugs, and were anesthetized with fentanyl 30 micrograms.kg-1, Group 2; the patients with no-cardiac disease and taking no drugs, who were anesthetized with fentanyl 30 micrograms.kg-1 and Group 3; the patients with no-cardiac disease and taking no drugs, who were anesthetized with 0.75% halothane. Cardiac function was compared among three groups. After NVHD, blood pressure and heart rate of group 3 were significantly higher than those of group 1 and 2. Moreover, serum epinephrine and norepinephrine were elevated significantly after NVHD in only group 3. From this study, we conclude that, (1) daily used drugs do not predict hypotension during NVHD, and (2) high dose fentanyl anesthesia is associated with hypotension during NVHD. PMID- 1766094 TI - [Effects of hypoxia on the brain cholinergic system in the rat]. AB - Effects of mild hypoxic hypoxia on brain cholinergic system in the rat were investigated with choline acetyltransferase (CAT), acetylcholinesterase (AChE) and muscarinic acetylcholine receptor (MR) as indicators of cholinergic system. Hypoxic exposure of 10% oxygen concentration was undertaken for one week. The activity of CAT and AChE was reduced, while MR increased. CAT is known as the specific enzyme of cholinergic neuron, but AChE is contained also in postsynaptic neuron of the cholinergic neuron. Reduction in the activity of both enzymes may mean reduction in the activity of cholinergic system. MR is contained in postsynaptic membrane. The increase in MR may indicate recovery from agonist dependent desensitized receptor. PMID- 1766095 TI - [CO diffusing capacity during continuous negative extra-thoracic pressure]. AB - Eight healthy males were studied to compare CO diffusing capacity (DLCO) during spontaneous breathing with that during continuous negative extra-thoracic pressure (CNETP). Mean DLCO was 33.0 +/- 5.1 ml.min-1.mmHg-1 during spontaneous breathing and 33.5 +/- 4.5 ml.min-1.mmHg-1 during CNETP with an end-expiratory negative extra-thoracic pressure (EENETP) of -20 cmH2O, and there was no significant difference between them (P less than 0.05). Pulmonary capillary blood volume, which was measured only in a male, was 76.7 ml during spontaneous breathing and 80.5 ml during CNETP. This change dose not seem to be significant. The results suggest that the effect of pulmonary diffusing capacity changes during EENETP on improvement of oxygenation may not be significant. PMID- 1766096 TI - [The effect of prostaglandin E1 (PGE1) on body temperature and on postoperative shivering under high dose epidural fentanyl]. AB - Ninety-nine elective abdominal surgeries were performed under high dose epidural fentanyl anesthesia. PGE1 (0.02 microgram.kg-1.min-1 = 0.02 gamma) was administered to 34 patients (0.02 gamma group), and PGE1 (0.05 gamma) was administered to 16 patients (0.05 gamma group). PGE1 was not administered to 49 patients (control group). The effect of PGE1 on body temperature and on postoperative shivering was compared within three groups. In the 0.02 gamma group, the temperature of the fingertip was significantly higher and the rectum fingertip temperature gradient was significantly lower than in the other groups. The forearm-fingertip temperature gradient was lower in the 0.02 gamma and 0.05 gamma groups than in the control group. The incidence of postanesthetic shivering was significantly lower in the 0.05 gamma group than in the other groups. These results suggest that; 1) PGE1 (0.02 gamma and 0.05 gamma groups) affects the peripheral blood flow and peripheral temperature, and 2) PGE1 (0.05 gamma group) significantly affects the incidence of postanesthetic shivering. PMID- 1766097 TI - [A comparison of three drugs (pethidine, magnesium sulfate and droperidol) in patients with post-anesthesia shivering]. AB - Shivering is one of the common complications after general anesthesia. It increases metabolic rate markedly and may cause myocardial ischemia in patients with decreased cardiopulmonary function. We investigated, therefore, the effects of three drugs (pethidine, magnesium sulfate and droperidol) on shivering in 30 patients under enflurane anesthesia. The patients were of ASA class I or II physical status and had no cardiovascular or respiratory disease. For post anesthesia shivering, every patient was administered with pethidine 0.5 mg.kg-1, MgSO4 30 mg.kg-1 or droperidol 0.15 mg.kg-1. Their VO2 and VCO2 were measured for 5 minutes during shivering and 15 minutes after drug administration. We also evaluated the therapeutic efficacy of each drug for the treatment of shivering by examining VO2 and VCO2 before and after drug administration. With pethidine and MgSO4, both VO2 and VCO2 decreased significantly after each drug administration. With pethidine, VO2 and VCO2 decreased significantly more than that in MgSO4 (P less than 0.01 vs P less than 0.05). But with droperidol, there was no significant change. These results suggest that pethidine is most effective followed by MgSO4. PMID- 1766098 TI - [Effect of continuous infusion of diltiazem on cardiovascular responses to laryngoscopy and intubation]. AB - We studied the cardiovascular responses to laryngoscopy and intubation in 30 patients who received continuous infusion of either diltiazem 10 micrograms.kg 1.min-1, 40 micrograms.kg-1.min-1 or saline as control group during 20 min before induction. Heart rate, arterial pressure, rate pressure product (RPP), pressure rate quotient (PRQ) were measured starting 20 min before induction to 3 min after tracheal intubation. The increases in arterial pressure and RPP following tracheal intubation were reduced significantly in patients receiving diltiazem 40 micrograms.kg-1.min-1, but they were not reduced in patients receiving diltiazem 10 micrograms.kg-1.min-1 compared with control. We conclude that continuous infusion of diltiazem during 20 min before induction is effective for preventing the increases in arterial pressure and RPP following tracheal intubation, and the optimal infusion rate is from 10 to 40 micrograms.kg-1.min-1. PMID- 1766099 TI - [Effects of isoflurane on membrane potentials, refractory periods and membrane ionic currents in rabbit single ventricular myocytes]. AB - In order to analyze direct action of isoflurane on myocardium, we studied effects of isoflurane on membrane potentials and transmembrane ionic currents in single ventricular myocytes isolated enzymatically from rabbit hearts. Membrane potentials were recorded with a suction microelectrode technique, and an action potential was elicited by a brief intracellular stimulus. Isoflurane 3% depressed the action potential overshoot, plateau phase and duration without changing resting potential. Isoflurane decreased the refractory period of the action potential and prolonged the time-constant (tau) of the recovery process. In corresponding voltage clamp experiments, isoflurane significantly depressed the Ca2+ current (ICa), which generates the plateau phase. However, isoflurane had no effect on the transient outward current (I(t)), which triggers repolarization of the action potential. In rabbit ventricular cells, the time- and voltage dependent outward K+ current (IK) was nearly absent. In conclusion, the depression of the action potential plateau by isoflurane is due to the decrease of ICa. Since isoflurane has no effect on It, the depression of the plateau phase by isoflurane may explain the shortening in the duration and the refractory period of the action potential. PMID- 1766100 TI - [Midazolam as a premedicant for trigeminal nerve blocks]. AB - Although patients with trigeminal neuralgia can be treated satisfactorily with nerve blocks, the block procedure is sometimes very painful and uncomfortable for them. To investigate the efficacy and adverse effects of midazolam as a premedicant for trigeminal nerve blocks, 19 patients were randomly assigned to receive either midazolam (0.05 mg.kg-1, n = 6), midazolam (0.1 mg.kg-1, n = 7), or saline/placebo (n = 6) before the block. The patients given midazolam (0.1 mg.kg-1) had a significantly lower incidence of recalling the block procedure and had complained of less discomfort when interviewed the following day. No serious adverse effects were observed in any patient given midazolam. Midazolam can be used safely as an effective premedicant for potentially uncomfortable procedures such as trigeminal nerve blocks. PMID- 1766101 TI - [Epidural administration of midazolam with saline or bupivacaine for postoperative pain]. AB - Postoperative pain relief and sedation with epidural midazolam-saline or midazolam-bupivacaine were studied in 46 patients after elective upper abdominal surgery. They were divided into 6 groups. In each group, 10 ml saline, 10 ml saline+midazolam 0.05 mg.kg-1, 10 ml saline+midazolam 0.1 mg.kg-1 (saline group), 0.25% bupivacaine 6 ml, 0.25% bupivacaine 6 ml + midazolam 0.05 mg.kg-1 or 0.25% bupivacaine 6 ml + midazolam 0.1 mg.kg-1 (bupivacaine group) was administered via epidural catheter for complaint of pain. For 120 minutes after epidural injection, blood pressure (BP), heart rate (HR), respiratory rate (RR), sedation score, and serum concentration of midazolam (conc midazolam) were evaluated. The time interval until next complaint of pain (pain relief time) was measured. In midazolam injected group, BP, HR, RR were not changed from preinjection value, but sufficient sedation was obtained and pain relief time was significantly prolonged compared with saline or bupivacaine injected group. Midazolam level was lower than that of sedation level. There were no significant differences between saline group and bupivacaine group, but the pain relief effect was slightly stronger in bupivacaine group. It is concluded that epidural saline - midazolam or 0.25% bupivacaine - midazolam is useful for postoperative pain relief after upper abdominal surgery. PMID- 1766102 TI - [Leukocyte removability of a newly developed filter, RC-100, in rapid transfusion]. AB - Leukocyte-depleted blood products are currently a burning issue in transfusion medicine. As methods for depleting leukocytes, the bedside filters are shown to have a high removal rate and several kinds of them are in use. We investigated the leukocytes removal rate of a new filter RC-100 (Pall Co., Glen Cove, NY) under the condition of rapid rate of transfusion during operations. In flow rates of 30, 60, 100 ml.min-1, the removal rate of leukocytes for CRC were 99.9 +/- 0.06, 100.0 +/- 0.00 and 99.4 +/- 0.20% respectively, and for WB 100.0 +/- 0.00, 99.9 +/- 0.10 and 99.1 +/- 0.70%, respectively. The recovery rates of erythrocytes were not significantly decreased for CRC and for WB in all flow rates. These results suggest that RC-100 could be useful either for CRC and for WB even with the rapid flow rate under 100 ml.min-1. PMID- 1766103 TI - [TDM (therapeutic drug monitoring) for dosing theophylline]. AB - In order to maximize the effectiveness and safety of drug therapy, it is important to individualize the dosage of potent drugs. Some drugs can not be titrated against the intensity of the therapeutic or toxic actions. Determination of the blood concentration of such drugs can be a helpful guide in adjusting the dosage during their therapeutic use. The drug dosing guided by pharmacokinetics is called TDM or therapeutic drug monitoring. In conventional pharmacokinetics, a large number of blood samples are collected from one patient to determine the individual pharmacokinetic parameters. In TDM, the pharmacokinetic parameters obtained from a group of patients who belong to a certain category are used to guide estimation of the individual pharmacokinetic parameters and only a few blood samples from one patient are sufficient to determine the individual parameters. The blood concentration of a drug and the intensity of its pharmacodynamic action, however, is not necessarily correlated. Therapeutic decisions should never be based solely on the blood concentration of a drug. PMID- 1766104 TI - [Drug induced hepatitis following sevoflurane anesthesia in a child]. AB - A new volatile anesthetic, sevoflurane, is widely used in Japan. We first report a patient who developed liver dysfunction following sevoflurane anesthesia. He had a resection of the bilateral extra toes at the age of eleven months. Although no problems occurred during the operation, he had serious liver dysfunction. Fourteen days after operation, serum GOT was elevated to the maximum of 836U. The pathogenesis is considered to be related to sevoflurane anesthesia, because viral hepatitis was excluded, and sevoflurane is considerably positive in lymphocyte stimulation test in contrast with antibiotics. PMID- 1766105 TI - [Survey of cardiac arrests during and following anesthesia and surgery for the past seven years]. AB - Cardiac arrests, excluding those associated with cardiac surgery, occurred in eleven out of 13,278 patients who had general anesthesia in our hospital for seven years from 1983 to 1989. Four of them were successfully resuscitated, while the remaining seven patients were lost. The causes of these cardiac arrests were as follows: massive bleeding in four; cardiac compression by surgeons in two; possible coronary artery spasm in one; hyperpotassemia in one; severe metabolic acidosis in one; myocardial ischemia in one; and unknown cardiogenic origin in one. There is no case in which anesthesia was the primary cause of cardiac arrest. Although we can not be absolutely free from cardiac arrest during anesthesia and surgery, we should do our best to detect and correct any factors leading to perioperative cardiac arrests. PMID- 1766106 TI - [The "Law specifying Emergency Care Specialists"]. PMID- 1766107 TI - [Coronary sclerosis]. PMID- 1766108 TI - [Circulating and tissue renin-angiotensin systems]. PMID- 1766109 TI - [An X-ray study of catheters abnormally placed in the epidural space]. AB - We investigated the roentgenogram of the epidural catheter in 82 patients in whom the injection of local anesthetics had no effect. Contrast medium 0.5 ml was injected through the epidural catheter and antero-posterior roentgenogram was taken. The roentgenograms were categorized into three patterns, according to the relationship of the catheter to the pedicle of lamina, or to the spread of contrast medium. In 43 cases, the catheter passed through the intervertebral foramen. The tip of the catheter was located outside the foramen, and the contrast medium spread outside the vertebra. In 4 cases, the tip of the catheter was located laterally in the vertebral column, and only the catheter itself was contrasted but no spread of medium was observed. The catheter was thought to be misinserted intravascularly. In other 35 cases, catheter ran laterally on the pedicle of lamina, or the spread of medium 2 mins after the injection was indicated by a dumpling-shape even when the tip was in the vertebral column. In these cases, the catheter was thought not to be outside the epidural space. PMID- 1766110 TI - [Comparison of methylprednisolone and droperidol in the prevention of nausea and vomiting following major gynaecological surgery]. AB - The efficacy of methylprednisolone (MP) (500 or 250 mg) or droperidol 2.5 mg administered i.v., was studied in 200 women undergoing major gynaecological surgery. Following a standardised general anaesthesia technique with intrathecal morphine, the incidence of nausea and vomiting was assessed. The frequency of postoperative nausea and vomiting in the non-treated group was 59% and 35%; the group of MP 500 mg has a significant reduction of nausea and vomiting to 21% and 13%. Droperidol 2.5 mg decreased the incidence of postoperative nausea alone (nausea: 36%, vomiting: 19%). MP 250 mg was not effective in reducing either nausea or vomiting (nausea: 44%, vomiting: 38%). It was concluded that, of the drugs studied, MP 500 mg was most effective in preventing nausea and vomiting after major gynaecological surgery. PMID- 1766111 TI - [General anesthesia and surgery inhibited natural killer cell cytotoxicity in patients with cancer or benign disease undergoing upper abdominal surgery]. AB - In this study, effect of enflurane anesthesia combined with epidural analgesia on natural killer cell cytotoxicity (NKCC) was investigated in 20 patients. Patients were divided into two groups: the first group with adenocarcinoma of stomach (Group 1); the second with cholecystolithiasis (Group 2). Four samples were taken; 1) on arrival at operating room; 2) during anesthesia and 1 hour after skin incision; 3) on 1st postoperative day; and 4) on 4th or 5th postoperative day. NKCC was determined with a chromium release assay against K 562 cell. NKCC was already significantly higher before induction in Group 1 compared with Group 2 and normal value. In Group 1, NKCC decreased significantly compared with baseline during operation, but in group 2 NKCC was unchanged during operation. NKCC in group 2 was inhibited significantly less than Group 1 during 5 postoperative days, while NKCC was significantly inhibited postoperatively in both groups compared with the baseline. We conclude that enflurane anesthesia combined with epidural analgesia and surgery did not decrease NKCC below normal value during operation, but it was significantly inhibited during 5 postoperative days in both groups. There were differences in responses to stress of anesthesia and surgery between patients with and without cancer. PMID- 1766112 TI - [Effect of arterial carbon dioxide tension on regional myocardial tissue oxygen tension in the dog]. AB - We investigated the effects of arterial carbon dioxide tension on the myocardial tissue oxygen tensions of subepicardium and subendocardium in the anesthetized dogs. The study was done in fourteen open-chest mongrel dogs, weighing 13 +/- 1 kg, anesthetized with sodium pentobarbital (30 mg.kg-1 iv), and mechanically ventilated with 100% oxygen to maintain normocapnia. End tidal CO2 fraction (FECO2) was monitored continuously by capnograph. Regional myocardial tissue PO2 was measured using a monopolar polarographic needle electrode. Two pairs of combined needle sensors were carefully inserted, one in the epicardial and the other in the endocardial layer of the beating heart. Electromagnetic blood flow probe was applied on the left anterior descending artery (LAD). After a stable normocapnic ventilation, hypocapnia was induced by increasing the respiratory rate, and this mechanical hyperventilation was kept fixed throughout the experiments. To induce hypercapnia, exogenous carbon dioxide was added to the inspired gas step-wise until FECO2 reached 10%. Hypocapnic hyperventilation (PaCO2: 22 mmHg) invariably resulted in a significant reduction of coronary blood flow (LADBF) and left ventricular myocardial tissue PO2 in both epicardial and endocardial layers, while addition of carbon dioxide to the inspired gas (hypercapnic hyperventilation) reversed the change by increased LADBF and arterial PaCO2 in a dose-dependent manner. These results indicate that injudicious and severe hypocapnic hyperventilation may induce impaired myocardial tissue perfusion and oxygenation although normal cardiac output and arterial blood oxygenation are maintained. PMID- 1766113 TI - [Effects of ulinastatin on granulocyte elastase and fibronectin in patients undergoing cardiopulmonary bypass]. AB - We investigated the effects of ulinastatin on the increase of granulocyte elastase (GEL) and the decrease of fibronectin (FN) after cardiopulmonary bypass (CPB) in 30 patients undergoing cardiopulmonary bypass. Ulinastatin 300,000 units were given immediately after the induction of anesthesia (U1) or during CPB (U2). GEL increased by 20 times after CPB. GEL was lower in U2 than those in other groups. FN increased by 7-13% after CPB in U1 but decreased in other groups. FN decreased by 21-13% on the first postoperative day in three groups. There was a close relationship between CPB time and increase of GEL in the control group (no ulinastatin given) (y = 18.5 x -833, r = 0.751), between CPB time and increase of FN in U1 (y = 1.4 x -163.4, r = 0.683) or increases of GEL and FN in the control group (y = 0.068 x -202.6, r = 0.812). From these results, we recommend that ulinastatin should be given after the induction of anesthesia and during CPB, to keep a favorable host defense function after CPB. PMID- 1766114 TI - [Platelet aggregation during hypotensive anesthesia using prostaglandin E1]. AB - We studied platelet aggregation during hypotensive anesthesia using prostaglandin E1 (PGE1) on 22 patients (6 males, 16 female). All the patients underwent operations on head, neck, abdomen, breast, or lower extremities under general anesthesia. They had no history of hematological disease or taking drugs which affected platelet aggregation. The blood was sampled three times under a constant condition of anesthesia with intravenous drip: firstly, before using PGE1, secondly, under hypotensive state during PGE1 infusion at the speed of 0.05-0.3 micrograms.kg-1.min-1, and thirdly, after cessation of PGE1, after the blood pressure had recovered to the level before PGE1 infusion. ADP, collagen and epinephrine were added to the platelet rich plasma as clumping agents; their final concentrations were 0.3 microM, 2 micrograms.ml-1, and 2 micrograms.ml-1 respectively. The aggregating curves were recorded for 7 min. There were no significant differences in platelet aggregation among the three blood samples; neither in platelet count nor in bleeding time. Bleeding did not seem to have increased due to PGE1 infusion. These results suggest that PGE1 at hypotensive dose could be used safely under general anesthesia regarding hemostasis. PMID- 1766115 TI - [Prostaglandin E1 (PGE1) prevents the pressure responses to tracheal intubation in hypertensive patients]. AB - Forty-five hypertensive patients for elective abdominal surgery were investigated regarding the effects of PGE1 on the cardiovascular responses to tracheal intubation. Administration of PGE1 at the dose of 0.10 or 0.20 micrograms.kg 1.min-1 for 10 minutes before tracheal intubation significantly reduced the blood pressure responses immediately after the intubation and 2 minutes later. The increases in heart rate were not altered with and without the administration of PGE1. So the increases in rate pressure products were markedly reduced with PGE1 compared with the control values. Plasma concentration of catecholamines was measured before and after tracheal intubation. Norepinephrine was elevated markedly immediately after the intubation and this change was not affected by the infusion of PGE1. These results demonstrate that PGE1 ameliorates the pressure responses by the release of norepinephrine and thus reduces the increases in rate pressure products immediately after tracheal intubation. PMID- 1766116 TI - [ECG changes associated with PGF2 alpha injection into the basal cistern of rabbits]. AB - In the previous studies by the authors, it was shown that various types of changes in electrocardiograph were produced by injection of a small dose of PGF2 alpha into the basal cistern of rabbits which were studied to examine the mechanisms of those in humans with subarachnoid bleeding. In this study with reference to elucidating nerve pathways of PGF2 alpha produced stimulation, changes in electrocardiograph were examined in three groups of the animals which underwent dissection of the spinal cord either at C2-3, or at Th7-8, or bindings of bilateral suprarenal artery and vein, prior to the administration of PGF2 alpha into the basal cistern. The administration of PGF2 alpha decreased more significantly appearance rate of electrocardiographic alterations in the animals following spinal cord dissection at C2-3, and bindings of the suprarenal vessels than the animals with spinal cord dissection at Th7-8. It was concluded that the development of these electrocardiographic abnormalities was caused by direct autonomic discharges to the heart as well as by increased circulating catecholamines. PMID- 1766117 TI - [Endocrine effects of hypotension induced by diltiazem in rabbits]. AB - Endocrine effects of hypotension induced by diltiazem, a calcium antagonist, were studied in 16 male rabbits under the inhalation of 0.7% halothane in oxygen. They were randomly allocated to one of two groups. Group C (n = 8) received no vasodilator therapy and served as control and group D (n = 8) received infusion of diltiazem. Mean arterial pressure was decreased and was maintained at 60 mmHg for 60 minutes in group D. No change was noted in plasma catecholamines measured in group C throughout the experiment but plasma renin activity decreased progressively. During and after induced hypotension in group D plasma epinephrine showed a dramatic rise compared with the control value. The maximum increase occurred 30 minutes after induction of hypotension but this change was not statistically significant. Plasma norepinephrine in group D was significantly higher than the control value. Compared with the control value (0.19 +/- 0.04 ng.ml-1), plasma norepinephrine was activated 30 and 60 minutes after induction of hypotension (0.71 +/- 0.16 ng.ml-1, P less than 0.05, 0.82 +/- 0.20 ng.ml-1, P less than 0.05, respectively). Plasma renin activity in group D was significantly higher than the control value. The highest level of plasma renin activity was three times the control value 30 minutes after induction of hypotension. In conclusion, our data show that induced hypotension by diltiazem activates the renin-angiotensin-sympathetic nervous system. PMID- 1766118 TI - [Effects of volatile anesthetics on crossbridge mechanism of skeletal muscle- effects on the crossbridge in contraction]. AB - The suppressive effect of enflurane on the maximal activated force in skinned muscle fiber at high Ca2+ concentration was determined in our previous report. This result suggests that the acto-myosin system might be inhibited in the presence of enflurane. Therefore, the present study was performed to identify the sites and to clarify the mechanism of the above mentioned action. For this purpose, the stiffness during Ca2+ contraction was measured using mechanically skinned frog muscle fiber. The force oscillation was given by high frequently sinusoidal length perturbation. The maximum shortening speed, which is considered to be a parameter of crossbridge kinetics, was also measured using the slack method on frog and rat muscle fibers. The results of this study are summarized as follows: 1. The total force was decreased when enflurane or halothane was present, while the stiffness, which is a parameter of the number of attachments (crossbridges), was decreased only by enflurane. Furthermore, the stiffness over force ratio, which is a parameter of the individual force generated by each crossbridge, was increased when enflurane or halothane was present. These results initially seem contradictory. However, the contradiction seems far smaller in light of our assumption that the amplitude of reduction of the force generated by each crossbridge was much higher in the presence of halothane than in the presence of enflurane. 2. The maximum shortening speed was also decreased when enflurane or halothane was present. Therefore, it was suggested that enflurane and halothane have a potentiality to decrease the rate of crossbridge cycling.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766119 TI - [Effects of local anesthetics upon human natural killer cytotoxicity in vitro]. AB - Effects of 3 local anesthetics, bupivacaine, mepivacaine and lidocaine, upon natural killer cytotoxicity were studied in vitro. Mononuclear cell layer was recovered by Ficoll-Paque sedimentation from heparinized venous blood obtained prior to the induction of anesthesia. The mononuclear cells were divided into three groups: control group was incubated in medium only: low concentration group incubated in medium with 2.0 micrograms.ml-1 of mepivacaine (n = 20) or lidocaine (n = 20), or 0.5 micrograms.ml-1 of bupivacaine (n = 21); high concentration group in medium with 20 micrograms.ml-1 of mepivacaine or lidocaine, or 5 micrograms.ml-1 of bupivacaine. These three groups were incubated simultaneously in humidified atmosphere with 5% CO2 in incubator for 2 hours. NK cell cytotoxicity was determined in a chromium release assay against K 562 cell as a target cell. An effector to target cell ratio of 40:1 was used. Comparison among 3 local anesthetics showed no significant difference at high concentration, but a significant difference at low concentration. This was due to the differences between bupivacaine and lidocaine. Neither bupivacaine nor mepivacaine inhibited % NK cytotoxicity at both low and high concentrations compared with control. Lidocaine significantly inhibited % NK cytotoxicity at low concentration, but did not inhibit at high concentration compared with control. We concluded that neither bupivacaine nor mepivacaine inhibited % NK cytotoxicity at concentration of clinical dose compared with control in vitro, but lidocaine inhibited % NK cytotoxicity at a concentration of 2.0 micrograms.ml-1 compared with control. PMID- 1766120 TI - [Effects of high-dose fentanyl on intraductal pressure in the choledochoduodenal junction in dogs]. AB - Changes in intraductal pressure in choledochoduodenal junction were studied following intravenous administration of fentanyl in dogs. The intraductal pressure was measured with constant-rate infusion method. A statistically significant increase in the intraductal pressure was demonstrated after the intravenous administration of fentanyl 5 micrograms.kg-1 and 75 micrograms.kg-1. The increase in intraductal pressure following fentanyl administration at a dose of 75 micrograms.kg-1 persisted for more than 5 hours. We conclude that in case of intravenous high-dose fentanyl administration special attention should be paid to spasm of choledochoduodenal sphincter. PMID- 1766121 TI - [Kyotorphin like substance in human cerebrospinal fluid of patients with persistent pain]. AB - Kyotorphin is an analgesic neuropeptide isolated from the bovine brain in 1979. Further studies showed that kyotorphin produces an analgesia through an increased release of met-enkephalin in the brain and the spinal cord. We showed that it is also found in the human cerebrospinal fluid and the concentrations of kyotorphin in normal human CSF is 1.19 +/- 0.51 pmol.ml-1. We also found that it is lower in patients with persistent pain (0.24 +/- 0.04 pmol.ml-1). Above results suggest that kyotorphin acts as a putative neuromediator and/or an endogenous pain modulator in the human brain. PMID- 1766122 TI - [Effects of ketamine on behavioral responses to somatic and visceral stimuli in rats]. AB - The responses to colorectal distension as a visceral stimulus were observed and tail-flick test was performed in rats, after intraperitoneal administration of ketamine 30 mg.kg-1 (n = 6) or 100 mg.kg-1 (n = 5). After determining control colorectal distension and tail-flick values, both procedures were repeated every 10 minutes for one hour in both groups. The control thresholds for colorectal distension and tail-flick latencies were 20.8 +/- 1.0 mmHg and 4.5 +/- 0.3 sec (mean +/- SD), respectively in ketamine 30 mg.kg-1 group. They were 21.2 +/- 1.1 mmHg and 4.7 +/- 0.4 sec in ketamine 100 mg.kg-1 group. These baseline threshold and latency values in the two groups were not significantly different. Ten minutes after ketamine administration, the colorectal distension thresholds and tail-flick latencies were 43.7 +/- 7.2 mmHg and 6.4 +/- 0.9 sec, respectively in ketamine 30 mg.kg-1 group. They were 53.3 +/- 14.8 mmHg and 7.2 +/- 0.8 sec, respectively in ketamine 100 mg.kg-1 group. These values were significantly greater than the preketamine control values in both groups. The present study demonstrates that ketamine exerts apparent analgesic effects against both visceral and somatic stimuli. These results led us to consider that ketamine may be clinically useful to control visceral pain. PMID- 1766123 TI - [Clinical study on total intravenous anesthesia with droperidol, fentanyl and ketamine--10. Effects of prostaglandin E1 on the hepatic and renal functions following prolonged surgery under total intravenous anesthesia]. AB - Twenty one patients who underwent prolonged surgical procedures over 10 hours under total intravenous anesthesia with droperidol, fentanyl and ketamine were studied to evaluate post-operative hepatic and renal functions as judged by serum levels of GOT, GPT, BUN and creatinine. They were divided into two groups. Ten patients of the PGE1 group were given PGE1 at a rate of 0.035 micrograms.kg-1.min 1 during anesthesia, and the remaining eleven of the control group were not given PGE1. The two groups were comparable concerning, age, body weight, height, operation time and anesthesia time. In the PGE1 group, significantly more intraoperative fluid was given than in the control group. The blood loss was more but insignificantly in the PGE1 group than in the control group. There was no significant difference in urine output and the amount of blood transfused between the two groups. In both groups, post-operative s-GOT and s-GPT levels were increased significantly compared with pre-operative values, but there was no significant difference between the two groups. Serum BUN levels of the 7-10 the post-operative days were increased significantly in the PGE1 group, but those of the control group were not. These data suggest that our method of total intravenous anesthesia with droperidol, fentanyl and ketamine, when applied even for prolonged surgical procedure over 10 hours, would have beneficial effects on the post-operative hepatic and renal functions. PMID- 1766124 TI - [Clinical study on total intravenous anesthesia with droperidol, fentanyl and ketamine--11. Effect on epidural pressure]. AB - We have developed a new method of total intravenous anesthesia using ketamine, fentanyl and droperidol (NLA-FK). There are many reports describing a significant increase in cerebrospinal fluid pressure (CSFP) during ketamine administration, but little is known about changes in CSFP during NLA-FK. As epidural pressure (EP) is considered as a good index for CSFP, we measured it in 12 patients under either NLA-FK or isoflurane anesthesia, who underwent gastrectomy. In the NLA-FK group the EP increased significantly by 26% at the induction of anesthesia as compared with the preinduction level, and it decreased to the preinduction level 30 minutes after the induction. Thereafter the pressure was not appreciably changed. In the isoflurane group EP significantly decreased by 16% at induction, but the pressure significantly increased by 29% 30 minutes after the induction as compared with the preinduction level. The change was similar to that of the NLA FK group. Although the increase in the EP during the induction of NLA-FK is significant, it is considered to be within normal ranges. However, further detailed clinical study is needed to attenuate the significant increase in the EP during the induction of NLA-FK. PMID- 1766125 TI - [The effect of intravenous injection of isosorbide dinitrate on the hypertension during general anesthesia: a multi-center controlled study]. AB - The antihypertensive effect of intravenous injection of isosorbide dinitrate (ISDN) was evaluated in 137 patients undergoing elective surgery during general anesthesia [neuroleptanesthesia (NLA) or enflurane-nitrous oxide-oxygen anesthesia (GOE)]. ISDN in dose of 20 micrograms.kg-1 or 40 micrograms.kg-1 was given as a bolus injection in 30 sec. ISDN produced a significant decrease in arterial pressure and central venous pressure; the maximum decrease was observed in 7 min after administration of ISDN. The antihypertensive effect of ISDN was dose-dependent, but there was no significant difference between two groups of patients given 20 or 40 micrograms.kg-1, or between those anesthetized with NLA or GOE. ISDN did not significantly alter heart rate, thereby causing a significant decrease in rate pressure product which reflects myocardial oxygen demand. The results suggest that a bolus injection of ISDN is a simple, practical and effective means of controlling hypertension during general anesthesia. PMID- 1766126 TI - [Industrial standards of hose assemblies for use with medical gas systems: safety against collapsing loads]. AB - We experienced troubles caused by mounting an anesthesia machine and a pump oxygenator on an oxygen pressure-resistant hose that connected the central piping system with the anesthesia machine. Therefore, we measured the resistance of 9 types of hose assemblies to collapsing loads by the method in the International Standardization Organization (ISO) 5359. Two types of hose made in the U.S. were highly resistant. On the other hand, 7 types of domestic hose tended to be obstructed with collapsing loads, and 3 of them did not fulfill ISO's criteria. To prevent anesthetic accidents, improvements in the property of hose assemblies and the establishment of their industrial standardization are urgently needed. PMID- 1766127 TI - [The changes in total and free catecholamine level in plasma in a patient with status asthmaticus]. AB - Halothane was administered in oxygen to a young man in status asthmaticus whose bronchospasm did not respond to usual treatments. Plasma catecholamine concentrations were measured during and after bronchospasm. Fifteen minute inhalation of halothane produced marked bronchodilatation as reflected in decreased peak airway pressure, decreased wheezing and fall in PaCO2 from 110 mmHg to 45 mmHg. Treatment with halothane was discontinued after 120 min inhalation. Arterial blood samples were obtained to determine free and total catecholamine (CA) on the following four occasions: 1. during status asthmaticus, 2. fifteen minutes after inhalation of halothane, 3. one day after bronchospasm and 4. two days after bronchospasm. During attack, free norepinephrine and epinephrine concentrations were markedly elevated. These values decreased remarkably after administration of halothane. Total norepinephrine and epinephrine were also elevated during bronchoconstriction, and these high concentrations persisted after bronchodilatation. The changes in CA levels suggest that sympathoadrenal hyperactivity elicited by acute asthma can be suppressed by halothane as evidenced by the decreased concentration in free catecholamines, which are physiologically active. The levels in total catecholamine did not correlate with the patient's condition. Therefore, judgement based only on the levels in total CA might lead to misinterpretation in estimating sympathoadrenal activity. PMID- 1766128 TI - [Cerebral infarction during operation on the neck of the femur under epidural anesthesia: a report of two cases]. AB - Cerebral infarction occurred during operation in two cases. An 83-year-old senile demented female underwent osteosynthesis with Ender pins under epidural anesthesia. Soon after Ender pins were inserted, her systolic blood pressure fell from 180 mmHg to 140 mmHg. The patient complained of chest pain and developed disturbed consciousness and right hemiparesis. On the second postoperative day, CT scanning showed the infarction of a left middle cerebral artery region. A 93 year-old female was another patient. She underwent a cup arthroplasty of the right hip bone fracture. Soon after bone cement was applied, she developed a mental confusion and her blood pressure increased from 120/60 mmHg to 160/80 mmHg. CT scanning on the first postoperative day showed the infarction of a left middle cerebral artery region. Sudden changes in systolic blood pressure and changes of mental status are possible signs of cerebral infarction not to be neglected. If elderly patients with any episodes of cerebral function troubles would undergo operation of the hip fracture, it is necessary to pay a particular attention to possible cerebral infarction. PMID- 1766129 TI - [Effect of isoflurane on muscle relaxation in a patient with myotonic dystrophy]. AB - We did anesthetic management by isoflurane for total thyroidectomy under the neuromuscular transmission monitoring in a patient with myotonic dystrophy. In three patients without neuromuscular disorders, T1 was 85% of control and fade was not observed, while in this case T1 was 40% of the control and TOFR was decreased to 50%. We conclude that isoflurane has a good muscle relaxation effect in this disease and, we could manage without administering any muscle relaxants. PMID- 1766130 TI - [Gastric acid response to graded dose of pentagastrin in duodenal ulcer]. AB - To characterize gastric acid response and its age distribution in the patients with duodenal ulcer (DU), we conducted pentagastrin (PG) dose-response study and calculated maximal response (Vmax-c), half maximal dose of PG (Km-c), and the mean response to 0.22 microgram/kg/hr of PG as percent of highest observed response (SI). The mean values of basal secretion (BAO), Vmax-c, and SI in DU were significantly greater than those of normal subjects (N). The mean values of Km-c were significantly less than those of N. The greater BAO, Vmax-c, and SI, and less Km-c were observed in all age groups of DU. The results indicate that DU patients not only secrete more acid but also are more sensitive to stimulation by pentagastrin than N, and that the characteristics are common in all age groups of DU. PMID- 1766131 TI - [Roles of the sympathetic nervous system in the local release of vasoactive intestinal polypeptide (VIP) from the small intestine of anesthetized dogs]. AB - To investigate roles of the sympathetic nervous system in the local release of VIP, pharmacological alpha (phenoxybenzamine), beta (propranolol) adrenergic blockade or surgical sympathectomy by the ganglionectomy of splanchnic plexus was performed in anesthetized dogs. Portal and venous plasma VIP levels during intrajejunal infusion of 0.1 N HCl solution at a rate 1.5 ml/min for 20 minutes were observed before and after these procedures. The plasma VIP levels during the intrajejunal HCl infusion were significantly increased after blocking of alpha adrenoceptors and surgical sympathectomy but showed no change after blocking of beta-adrenoceptors. These results suggest the inhibitory mechanism of the sympathetic nervous system on the local release of VIP from the canine small intestine. In addition, the increase of portal blood flow and bile secretion, and the elevation of bicarbonate concentration in the secreted bile during the intrajejunal HCl infusion were significantly higher after surgical sympathectomy than before, and plasma VIP levels were also significantly higher. PMID- 1766132 TI - [Biological significance of nucleolar organizer region-associated proteins (Ag NOR) in adenomas and carcinomas of the colon]. AB - The biological significance of silver binding nucleolar organizer regions (Ag NORs) had been evaluated in tissue sections from 21 colonic adenomas (11 mild atypia, 10 moderate atypia), 23 primary adenocarcinomas of the colon (12 intramucosal carcinomas, 11 advanced carcinomas) and 5 control cases, by automatic image analysis. A significant difference in the mean number of Ag-NORs per nucleus was found when adenomas with moderate atypia and carcinomas were compared with adenomas of mild atypia and control cases. The mean Ag-NORs area per 1 Ag-NOR of carcinomas tended to be larger than that of the adenomas and control group. The mean value of form factor in carcinomas showed greater pleomorphism in shape than that of adenomas and control group. The mean quotient of number and area of Ag-NOR (Ag-NOR score) of the carcinomas was highest among the cases examined. These results indicate that evaluation of the mean Ag-NOR numbers is of great value, with regard to the cell proliferation, and that of Ag NOR score may give the most accurate estimation of biological character in different groups of colonic neoplasia. PMID- 1766133 TI - [Splenic venous hemodynamics in portal hypertension]. AB - The percentage of splenic blood in portal venous flow (SV%) was measured in 96 patients by using scintiphotosplenoportography and angiography. The patients were divided into two groups: Group 1, without collateral pathways from the splenic vein; Group 2, with collateral pathways from the splenic vein. SV% was significantly lower in patients without liver diseases or in patients of Group 1 with liver cirrhosis (LC). SV% was significantly higher in patients with idiopathic portal hypertension (IPH). A significant correlation was observed between SV% and splenic volume or ICGR15. No significant correlation of SV% was found with etiology of LC in patients of Group 1, esophagogastric varices, Child's criteria, portal venous pressure, cholinesterase, hepaplastin test or prothrombin time. Hence, the local hyperdynamic state of the splenic region was detected in patients with CH, LC and IPH. PMID- 1766134 TI - [Endoscopic manometry of common bile duct and the sphincter of Oddi in patients with biliary tract stones and in controls]. AB - Endoscopic manometry using microtransducer was applied to evaluate the motor activity of the sphincter of Oddi (SO) and common bile duct (CBD) in patients with biliary tract stones and in controls. CBD pressure, SO pressure and the incidence of irregular phasic wave pattern (IRPWP) were relatively higher in patients with biliary tract stones than those in controls. There was no significant difference in CBD and SO pressure between patients with dilated CBD and patients with non-dilated CBD, however the incidence of IRPWP was significant higher in patients with dilated CBD than that in patients with non-dilated CBD. SO pressure and the incidence of IRPWP were significant higher in patients with papillitis than those in patients without it. Patients with valvular orifice of the papilla of Vater showed high incidence of IRPWP, and in such cases it was suggested that SO had different motor functions for CBD and pancreatic duct because these ducts were seen opening onto the papilla separately according to the findings of pancreatocholangiogram. We concluded that endoscopic manometry of CBD and the SO was useful to evaluate the motor activity of SO and provided a basis for the assessment of the motor function mechanism of SO. Our results indicated the motor activity of SO had close relationship with biliary tract stones, CBD dilatation and endoscopic findings of the papilla of Vater. PMID- 1766135 TI - [A clinicopathological study on the proximal border of bile duct carcinoma]. AB - We studied the clinicopathological characteristics of the proximal border of bile duct cancer among 46 cases. In both the superficial and the superficially spreading type, cancer was located within the mucosa and the mucous membrane at its verge was more hypertrophic than the proximal noncancerous mucosa, but they didn't differ from each other in thickness at the fibromuscular and Glisson's fibrous layer. In bile duct cancer without superficial spread, on the other hand, the tumor involve the fibromuscular or Glisson's fibrous layer and fibromuscular or Glisson's fibrous layer at their verge was more hypertrophic than the proximal noncancerous bile duct, which resulted in the narrowing bile duct at the lesion. Percutaneous transhepatic cholangioscopy (PTCS) facilitates the preoperative diagnosis of the extent of the bile duct cancer, which shows a granular change of the mucosa and tumor vessels. The wall irregularity and narrowing of the bile duct demonstrated by the selective cholangiography are also referred to its extent. PMID- 1766136 TI - [Development of pancreatic exocrine function including intestinal negative feedback regulation using oral trypsin inhibitor in rats]. AB - To investigate the development of pancreatic exocrine function and intestinal negative feedback regulation with aging in rats, we measured pancreas weight, content of amylase and trypsinogen in the rat pancreas and plasma CCK concentrations, activity of amylase and trypsin in the small intestine at an hour after oral administration of trypsin inhibitor (TI), and also examined amylase secretory response to CCK-8 in the rat pancreatic acini at various ages in vitro. As a result, amylase content per pancreas weight increased with the age and amylase activity in the small intestine at al ages showed a significant increase in TI group compared to controls. Plasma CCK concentrations were elevated after administration of TI at all ages. Amylase release from pancreatic acini stimulated by CCK-8 responded poorly on days 7, then gradually increased with age, showing a biphasic dose response curve with maximal response of 10(-10) M of CCK-8 from 14-day-old to 66-day-old. The results indicated that the mechanism of pancreatic secretory response to TI already might exist at the stage of sucking rat and secretory response to CCK-8 in vitro showed a low response, and developed with age. PMID- 1766137 TI - [A case of primary malignant lymphoma in transverse colon associated with macroglobulinemia]. PMID- 1766138 TI - [A case report of strangulation ileus caused by a mesodiverticular band of Meckel's diverticulum]. PMID- 1766139 TI - [A case of colon cancer with severe hypoproteinemia due to protein losing gastroenteropathy]. PMID- 1766140 TI - [A case of hepatitis with granulomatous lesions by Rickettsia tsutsugamushi]. PMID- 1766141 TI - [An autopsy case of hepatic reticuloendothelial failure]. PMID- 1766142 TI - [Application of genetic polymorphisms in blood to forensic anthropology]. AB - 1. The Ainu subjects and, as controls, Wajin subjects obtained in the District of Hokkaido, were studied for blood groups, serum groups and red cell enzyme groups. The high n gene and r" gene frequencies seem to be characteristic in the distribution of the Ainu. In considering the high frequencies of Fya and Agx genes, low incidence K gene and Rh negative type, and existence of Di (a+) type, it is conceivable that the distribution of these blood group in the Ainu are closer to those in Mongoloid than to those in Caucasoid. The results of genetic distance analysis were in full agreement with the genetic affinity of the Ainu to the Mongoloid racial stock. According to the phylogenetic tree constructed on the basis of 16 polymorphic loci, it may be concluded that the Ainu are derived from the common stock of Mongoloids, which in turn has common ancestry with American Indians. The Negritos which are thought to be oldest living aborigines of southeast Asia and the western pacific. We investigated for grouping some genetic polymorphic traits from Negrito blood samples collected in the Philippines. A total of more than 500 samples were examined for 20 genetic traits. The most outstanding features of Negritos were as follows: Di (a+) type was found and all individuals were Lu (a-b +) and K-k+ types. Mia, Wra and Jsa genes were absent and all samples were U+ type. The existence of Dia gene and absence of both Lua and K genes are thought to suggest that the distribution of Negritos is quite close to that of Mongoloid populations. Fy (a-b-) and Js (a+) types are not found in our study. These results do not suggest similarity between Negritos and African. 2. The tandem repeat of a 28-base-pair (bp) sequence downstream of the human c-Ha-ras-1 oncogene was studied as a probe for DNA fingerprinting. Multiple hypervariable patterns were observed by Southern hybridization at low stringency. The patterns were specific to individuals, indicating the availability of the 28 bp repeat as a probe for DNA fingerprinting. Moreover, we cloned the tandem repeat of a 33-bp sequence, which cross-hybridized with the 28-bp repeat. This 33 bp repeat detected another set of hypervariable restriction fragments by Southern hybridization at the same stringency. These results suggest that "probe walking" can be employed to develop novel probes that provide different DNA fingerprints.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1766143 TI - [Diagnosis of paternity by deduction of the probable genotype of the deceased person from the relatives--in addition to the examination of the Essen-Moller value and diagnosis of paternity based on the probability distribution of log (Y/X)]. AB - 1) The present paper deals with the general formulas of paternity probability, applicable to any cases where the putative man and/or the plaintive mother are deceased, using the blood types of various relatives. Two typical examples are described. 2) Bayes's theorem is applied to the calculation of probability of paternity using the Essen-Moller's formula, in which a putative father is to be compared with any one of the men in the general population whose blood types are unidentified. Statistically, those men are supposed to have any one of several blood types, depending on the frequency of occurrence of those types. This means that their blood types include the blood type of the putative father. According to Bayes's theorem, however, probability calculations are valid only when the two types to be compared are mutually exclusive. Consequently, the theorem should not be applied to probability calculations using the Essen-Moller's formula. 3) A new basis of judgement for the diagnosis of paternity is proposed using the probability distribution of the relative frequencies of log (Y/X) for true father and that for non-father. PMID- 1766144 TI - Isolation and characterization of liver-specific antigen. AB - The purpose of this work is to develop a method to determine liver injuries using liver-specific substances. Initially, the liver-specific antigen (LSA) was purified from the human liver. The human LSA found in the Sephadex G-100 gel filtration first peak, has been isolated and characterized from normal human liver water-soluble proteins. Purification of LSA was carried out by consecutive gel filtration, ammonium sulfate precipitation, and anion and cation ion exchange chromatography, while simultaneously monitoring its reactivity using the antibody against the first peak fraction of the human liver extract through Sephadex G-100 after absorption with serum and kidney extract. This antigen was found to have a single band in SDS electrophoresis (PAGE) and the M.W. of approximately 52 KD. By IEF electrophoresis, the isoelectric point of some constituents were found to be pI 5.8-5.9. In addition, the antibody to this antigen was examined for organ specificity using the immunoblotting technique against the human kidney, lung, heart, spleen, pancreas, skeletal muscle, brain extracts and serum, respectively. The immunogenicity and characteristics of this antigen were found to be different from other specific antigens in the liver, which have been previously reported. PMID- 1766145 TI - [A bibliographic discussion on the obstruction of arteries and the air passage in hanging]. AB - Since conjunctival petechial haemorrhage and froth can occur when the cervical arteries and air passage are not obstructed or incompletely obstructed, it is useful to know whether they are closed or not in a suspended body when we estimate the cause of its death being due to hanging or being a disguise after killed by strangulation. We discussed their obstruction in hanging after references, as summarized in tables. Arterial obstruction: Classical data on the arterial obstruction (Brouardel, 1897; Schwarzacher, 1928) have not been cited with a definite description that the data were obtained in experiments on typical hanging. In typical hanging, carotid arteries are directly closed with the compression by a ligature. There are three hypotheses on the mechanism of the obstruction of vertebral arteries: They are due to (1) the compression on the posterior and inferior region of the mastoid processes ("posterior compression"), (2) the backward and upward compression at the same time on the thyrohyoid membrane ("anterior compression") and (3) the vertical traction on the neck ("indirect obstruction"). In atypical hanging, carotid arteries can be indirectly closed in certain head positions. Vertebral arteries are not closed by the horizontal compression (hanging in a prone position). The "posterior compression" is effective. The "indirect obstruction" seems to be in existence. In the cases where ligatures do not run on the front of the necks but on the faces, it is advisable to consult the figures prepared by Rauschke (1957) and Brinkmann et al. (1981).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766146 TI - [Changes in lipid peroxides in methamphetamine treated rats]. AB - Methamphetamine (MA) has many pharmacological effects. We measured lipid peroxides of MA treated rat by thiobarbituric acid (TBA) reaction to estimate the relationship between free radical reaction and pharmacological effects of MA. In this study we used rat which were injected 1 mg/kg/day MA for 2-10 weeks as the long term groups and which injected 10 mg/kg MA once as the acute groups. Although the acute groups were not different from the control groups, TBA reacting substance was increased in brains of more than 6 weeks treated rat and decreased in lungs of the same groups. These results indicate that lipid peroxidation might be related to chronic MA effects. PMID- 1766147 TI - [Estimation of age from soft X-ray findings of lumbar vertebrae using image processing]. AB - The age changes that occur in human trabecular bone were examined by calculating the bone density in the soft X-ray films taken from the 3rd lumbar vertebra with an image processing system. The samples were obtained from 177 adult corpses (98 males and 69 females). Loss of the trabecular bone density was found in and after the age group of 30s in both sexes, especially in the age group of 50s in female the decrease in bone density was remarkable. The bone density scattered widely in all age groups, even in the young group. The wide dispersion of bone density in the same age group may produce some unreliable results for estimating the age, so this estimation method should cautiously be applied to actual identification cases. PMID- 1766148 TI - [Positive identification of dental porcelain in a case of murder]. AB - Dental prostheses can provide important evidence for use in personal identification. In recent years, the variety of materials used in prostheses has increased with the diversification of dental treatment. The detailed analysis of these materials can provide significant information to assist in personal identification. This paper reports a case when identification was achieved by the comparative analysis of fragment of fused dental porcelain. In April, 1990, a woman aged 24 years was found murdered in her apartment in Hamamatsu City, Shizuoka Prefecture. Near her body a small mass of fused porcelain was recovered. Subsequently, a 48 year old male suspect was arrested. An examination of his teeth revealed a small fragment of dental porcelain adhering to an abutment tooth. This was removed for testing. The suspect denied the charge of murder. A comparative analysis of the porcelain found in the apartment and the porcelain that was removed from the suspect's abutment tooth, was carried out by scanning electron microscopy (SEM) and electron probe X-ray microanalysis (EPMA). The SEM examination demonstrated remarkable similarity in respect of the structure of the porcelain and the nature and distribution of the air bubbles produced during the baking process in both samples. The EPMA showed the elemental composition of each sample to be identical. This case demonstrated that detailed analysis of dental materials may affords a useful aid for personal identification. PMID- 1766149 TI - Homicide by rectal insertion of a walking stick. AB - A 75-year-old disabled man was killed by a homosexual mental patient by the rectal insertion of a walking stick. The external examination of the body showed only four superficial tears in the skin of the anus. However, there was a 1 cm diameter full thickness perforation in the anterior wall of the rectum and the cause of death was the perforated rectum. The importance of the careful investigation into the circumstances of death, the background of the decreased, and the condition of the anus and rectum is discussed. PMID- 1766150 TI - An autopsy case of a traffic accident accompanied with fibrodysplasia ossificans progressiva: a case report. AB - A report is made on an autopsy case of a 19-year-old man with fibrodysplasia ossificans progressiva, who died in a traffic accident. The cause of death was acute massive haemorrhage from the lacerated liver. There was a bar of paraspinal ossifying lumps, which was hard, ramified throughout his back and restricted the movement of the thoracic vertebral column. Numerous hard swellings were palpable through the skin on the elbows, thighs, and lumbar and gluteal regions. Small bony masses were found in the muscles. According to his clinical records, radiographs and autopsy findings, he might suffer from the later stage of the disease. As a cause of the accident, though suicidal attempt by using the car or dosing was suspected, the influence of the disease itself was also considered. In connection with this case, it seemed that in the traffic death case with a rare disease, the careful investigation of the clinical symptoms and severity of the disease is very important. PMID- 1766151 TI - [Death investigation system in the United States]. AB - In light of recent developments and public interest on the issue of organ transplant and the definition of death by neurological function ("brain death"). A more expansive role of medicolegal investigation of deaths may be needed. This article was presented for the purpose of understanding the medicolegal investigative system in the United States. The traditional coroner system in the United States was taken from the English system and was established as an elected coroner system during a colonial period. The coroner system became more politically involved and the coroner was elected by popular votes. The political aspect was the main driving force and the medicolegal aspect was ignored, thus, the Commonwealth of Massachusetts was the first state to adopt the medical examiner system. In 1991, 41 out of 50 states have adopted the medical examiner system, either state-wide or on a local option. One of the principal differences between coroner and medical examiner systems is the qualification of the head of the agency. The coroner is an elected individual who acts as an administrator and conducts quasi-judicial function of the department. The medical function is delegated to a physician who performs his duty often on a part-time basis. The medical examiner's office is headed by a Board certified Forensic Pathologist who acts as an administrator and directs all functions including medical and scientific investigation. He is a public employee and is protected under the civil service rules, thus, his decision would be less likely influenced by political pressure. The jurisdiction of the coroner and medical examiner is generally the same by law, however a medical examiner's approach and decision making is more medically oriented and tends to be more expansive and ready to adopt to the needs in medicolegal issues arising from scientific progress.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766152 TI - [Interleukin-2 (IL-2) in active pulmonary tuberculosis]. AB - To clarify the precise of cellular immunity mechanism in pulmonary tuberculosis, we investigated the amount of IL-2 in patients with untreated active pulmonary tuberculosis. When serum adenosine deaminase (ADA) activity was examined using enzyme assay, an abnormally high level was observed in all patients (29.0 + 11.6 IU/ml, mean + SD; 4.5-17.8, normal range). Likewise, the level of serum-soluble interleukin-2 receptor (IL-2R) measured by ELISA showed abnormal high level in all patients (844.3 + 584.8 IU/ml; 80-300, normal range). When stimulated using PHA, the peripheral lymphocyte's ability to produce IL-2 revealed no difference between control subjects and patients. It was, however, noted that the lymphocytes of the patients significantly suppressed IL-2 responsiveness when compared to the control subjects (P less than 0.05). The serum IL-2 concentration measured using RIA could not be detected in any of the patients as was the same for control subject. All of the above mentioned results suggest that T-cell activation which caused increment in serum ADA activity and soluble IL-2R occurred in active pulmonary tuberculosis. The suppressed IL-2 responsiveness in the peripheral lymphocytes of patients proposes the possibility of soluble IL-2R reduction by the negative feedback mechanism in IL-2-sensitive lymphocytes. PMID- 1766153 TI - [Twelve cases of laryngeal tuberculosis]. AB - Between 1986 and 1990 we had twelve patients (ten males, two females, 19-65 years of age) with laryngeal tuberculosis who complained hoarseness and whose larynges were examined by fiberscopes. Chest roentgenograms revealed cavities in ten and in seven the lesions were extensive (Grade 3 according to the classification of Japanese Society for Tuberculosis). In all patients sputum smears were positive. Both patient's and doctor's delays were longer than those of patients with pulmonary tuberculosis without laryngeal involvements. Group infection was the source of infection in one patient. Since the diagnosis of laryngeal tuberculosis is difficult to make on clinical basis, it is important to make fiberscopic examinations of the larynx and do biopsies in patients with pulmonary tuberculosis who complain hoarseness. PMID- 1766154 TI - [Identification of Mycobacterium avium and Mycobacterium intracellulare using three DNA probe tests, and their distributions in Japan]. AB - Identification of Mycobacterium avium complex (MAC) was made using three DNA probe tests for MAC: Gen-Probe Rapid Diagnostic System for the MAC (Gen-Probe Inc., San Diego, U.S.A.), AccuProbe MAC Culture Identification or Confirmation Test (Gen-Probe Inc.); and SNAP Culture Identification Diagnostic Kit (MAC) (Syngene Inc., San Diego, U.S.A.). Various strains of MAC belonging to serovars 21 to 28 were identified by the DNA probe tests and showed the following. First, Serovar 21 and 25 belonged to M. avium and M. intracellulare, respectively. Each of them reacted with species-specific probes used in the three DNA probe tests [i.e., either M. avium-probe (in SNAP test; Probe A) or M. intracellulare-probe (in SNAP test; Probe I)]. Second, serovars 22-24 and 26-28 consisted of M. intracellulare, MAC strains that reacted with Probe X of SNAP test but lacked the reactivity with M. avium- and M. intracellulare probes of all the DNA probe tests, M. scrofulaceum that showed no reactivity with M. avium- or M. intracellulare-probe or Probe X, and M. scrofulaceum that had only the reactivity with Probe X. When the disease-associated MAC strains (35 strains), isolated in the Kanto to Kyushu areas in Japan, were identified using AccuProbe test, both the M. avium and M. intracellulare strains identified by the Gen-Probe test reacted with the MAC-probe but not with the M. tuberculosis complex (MTC) probe.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766155 TI - [Clinical backgrounds of six cases of childhood tuberculosis]. AB - Clinical backgrounds of six children who entered Matsue National chest Hospital due to pulmonary tuberculosis and tuberculous pleuritis were investigated and the following results were obtained. 1) Of six children five had not received BCG vaccination. 2) There were two children who developed tuberculosis after the completion of chemoprophylaxis. 3) None was detected by the examination of the household of the source cases. 4) Both patients and doctors were responsible for the delay in detecting the source, which ranged between five and seventeen months in total. 5) Among the source cases there were two patients who were smear negative but culture-positive. In view of the above observations it is suggested that BCG vaccination is important for the prevention of tuberculosis in children and that follow-up examinations should be continued after the completion of chemoprophylaxis. It should also be emphasized that early detection of the source case is imperative for the prevention of tuberculosis. PMID- 1766156 TI - [The role of surgery in cases of diagnostic difficulty]. AB - Pulmonary resections for the treatment of pulmonary tuberculosis are decreasing, and nowadays most of them are for the open lung biopsy to make histological diagnosis, because differentiation between tuberculosis, AM and lung cancer is critical. In 1980-1990 forty-three patients, in whom the diagnosis was not established by conventional diagnostic methods, had pulmonary resections for open lung biopsy because of abnormal chest X-ray shadows. Of these, 31 (72%) were non tuberculous (lung cancer 8, hamartoma 7, lung abscess 5, fungus infection 3, sclerosing hemangioma 2, bronchogenic cyst 2, and others 4, and 12 (28%) were tuberculous or AM. The type of chest film abnormality was solitary pulmonary nodule (coin lesion) in 9 out of 12 patients with tuberculosis or AM, in all eight patients with lung cancer and in 14 out of 23 patients with other diseases. In patients with coin lesions, the incidence of lung cancer was as high as 50% when the diameter was more than 21mm, while it was only 11% when it was 20mm or less. 24 patients with tuberculosis or AM complicated by lung cancer or other diseases were resected. There were 8 smear or culture positive patients with active pulmonary tuberculosis (or AM) (Group 1), of whom 7 had lung cancer and 1 pneumothorax. Of 8 patients who were wrongly diagnosed as active pulmonary tuberculosis (Group 2), there were 5 lung cancers and 3 other diseases. In the remaining 8 patients (Group 3) both old tuberculosis and lung cancer coexisted and in 3 they were found in the same lobe.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766157 TI - [The role of surgery in pulmonary tuberculosis infected by tubercle bacilli with multiple drug resistance]. AB - The first, definition of pulmonary tuberculosis bacilli with multiple drug resistance was decided as "bacilli completely resistant to RFP 50 mcg + SM 20 mcg and/or INH 1 mcg + KM 100 mcg and/or EB 5 mcg and/or another antituberculosis drug" based on 118 cases examined for drug resistance pre-operatively in 35 institutions belonging to the Tuberculosis Research Committee, during the 6 years period 1984 to 1989. Next, 48 pulmonary tuberculous cases with multiple drug resistance were analysed, and the following conclusions were obtained: 1) Pulmonary tuberculosis cases with multiple drug resistance were 36% of 133 cases of positive tuberculosis bacilli before operation. 2) 52% were more than 50 years old. One third showed less than 40 in respiratory index. 3) Most of them did not have effective anti-tuberculosis drug to be used after operation. 4) There was a high rate of pneumonectomy and collapse therapy such as thoracoplasty. 5) Successful rate of treatment was 72.9%, which is rather good for multiple drug resistant tuberculous cases. But bacilli positive rate after operation and mortality were 12.5% and severe complications such as bronchial or pulmonary fistula, thoracic empyema and worsening of tuberculosis after operation was 25%. Therefore surgical treatment for pulmonary tuberculosis with multiple drug resistance needed careful application considering sensitive drug to be used after testing of resistance for all anti-tuberculosis drugs. Surgical treatment should be considered especially if pulmonary tuberculosis cases have complete resistance to RFP and to one drug among SM, INH, KM and EB. PMID- 1766158 TI - [Role of surgical treatment in atypical mycobacteriosis of the lung]. AB - During the 15 year period from January, 1976 to September, 1990, we treated 77 patients with atypical mycobacteriosis (AM) of the lung surgically with satisfactory results. There were 56 men and 20 women, a ratio of 2.9 : 1. The age of the patients ranged from 20 to 76, with an average of 50.7 years. The operative rate was 3.7% against the patients admitted with a diagnosis of atypical mycobacterial infection. The number of the patients and the types of bacilli classified according to Runyon's criteria were 4 for Group I (M. kansasii), 63 for Group III (M. avium complex), 3 for Group IV, and 7 unknown. The operative indications we adopted were, 1) the resistance to most antituberculotics, 2) localized lesion, and 3) progressive deteriorations. Sensitivity study showed that over 90% of the patients had bacilli with complete or incomplete resistance against all antituberculotics except cycloserine. The area of major involvement was localized in the upper lobe in 47, but was bilateral in 14 patients. The period of conservative therapy prior to the surgical treatment ranged from 2 to 164 months, with an average of 28 months. As to the operative procedures, 58 had lobectomy, 12 pneumonectomy , 11 segmentectomy or wedge resection, 12 thoracoplasty, and 17 combined procedures. The incidence of post-operative complication was 16.9%. The recurrences were observed in 8 patients (10.4%), who had multiple and bilateral lesions. Complete cure rate was 83.1% and 64 patients were able to resume normal life. Our results indicate that, if properly selected, time required for the treatment may become shorter and the patients with AM may get better results by surgical treatment. PMID- 1766159 TI - [Role of surgical treatment in thoracic empyema with bronchopleural and/or thoracic empyema]. AB - Sixty-nine patients with thoracic empyema treated surgically were experienced from May, 1978 through December, 1990. Thirty-nine cases had bronchopleural and/or thoracic fistula. Thirty-two patients were associated with pulmonary tuberculosis, of whom fourteen had tuberculous empyema and eighteen were sequelae of pulmonary tuberculosis or tuberculous pleurisy. The remainder were postoperative, postpneumonic, and posttraumatic empyemas. Of fourteen patients who developed postoperative bronchopleural fistula, there were ten patients who had lobectomy or pneumonectomy for lung cancers. Omental pedicle flap method, in which empyema space was filled with the omentum and pedicled muscle flap, was performed on 19 patients with bronchopleural or thoracic fistula or both. Fifteen patients were cured successfully by single-stage procedure, though there was one operative death due to aspiration pneumonia, and two recurrences which were treated by muscle plombages. There was another patient who had multiple surgical procedures in the past resulting in partial recurrences, but the fistula of this patient subsequently closed without reoperation. Postoperative decrease of %VC, FEV1.0/PVC were minimal. Treatment of long standing bronchopleural fistula is a difficult problem, and our omental pedicle flap method is relatively simple and safe which can be most suitably applied to those patients in whom other procedures have failed and to those with poor pulmonary functions. PMID- 1766160 TI - [The role of surgery in the treatment of chronic empyema]. AB - For the last ten years we had 56 patients operated for the empyema which occupied almost all the thoracic cavity. We evaluated their postoperative pulmonary functions and their sequelae. The pathological features of the resected lung and empyema wall were also examined. Surgical procedures consisted of 25 extraperiostal air plombage, 14 pleuropneumonectomy, 8 decortication, and 9 other procedures (lobectomy, muscle-flap, omental flap, and others). Preoperative %VC of patients with extraperiostal air plombage, those with pleuropneumonectomy, those with decortications and those with other procedures were 59.6 +/- 12.6, 46.4 +/- 11.1, 63.0 +/- 10.1, and 53.8 +/- 11.7 respectively. Of 11 patients who developed severe respiratory impairments (%VC less than 40 and/or FEV 1/VC predicted less than 30) post operatively, 4 had extraperiostal air plombage, 4 had pleuropneumonectomy, and 3 had other procedures. In general, degree of respiratory impairment was more severe in patients who underwent multiple surgical procedures. Of 18 patients who survived 5 years or more, %VC was under 50% in 9, and of those nine patients five had 30% decrease in VC compared to the preoperative values and there were 2 patients with extraperiostal air plombage in whom extreme shrinkage and deformity of hemithorax were observed though they had neither additional surgeries nor recurrences. Hemangioma was often seen on the walls of empyema and in some they became so large as to cause mediastinal shift. There were patients with round atelectasis, which, we thought, could have caused abscess or inflammatory granuloma. PMID- 1766161 TI - [Tracheobronchoplasty for endobronchial tuberculosis]. AB - Out of thirty three cases of endobronchial tuberculosis we experienced, tracheobronchoplasty was performed on seventeen patients. The disease had the following characteristics, 1) young female preponderance (80% female and age 38 +/- 11), 2) multiple airway involvements (average 2.3), and 3) left main bronchus most commonly involved (64%). As to the operative procedure, carinal reconstruction (CR) with one stomal anastomosis between trachea and left lobar bronchus after partial carinal resection was initially performed without complications. In five patients with left main bronchus stenosis, pull down method for the subaortic arch anastomosis, a new operative approach for left sided one stomal CR, was attempted. Overall rate of post operative complications was 12%. PMID- 1766162 TI - [The role of surgeon in treatment of chronic respiratory failure after pulmonary tuberculosis operations]. AB - We analyzed pulmonary functions and rib cage-phrenic motions on 296 cases of chronic empyema patients who had surgical treatment. Pulmonary functions were better preserved in patients with a single step than in those with multi-step operations, and in those who had more than five operations the impairment was inevitable. Both %VC and rib cage-phrenic motions improved by decortication, and by air-plombage, but in those who developed multi-rib fractures after the latter procedure, ipsilateral chest wall motion almost disappeared. Since some restriction of rib cage-phrenic motion is inevitable after the surgery, we have developed a cuirass respirator which can synchronize with the respiration to assist the movement of the chest wall. The results attained so far are satisfactory. PMID- 1766163 TI - [Diagnosis and principles of treatment of obstructive purulent cholangitis]. AB - Having substantiated the results of treatment of 425 patients with purulent cholangitis caused by benign obstruction of the bile ducts, the authors suggest their definition of "purulent cholangitis". The two-stage operative interventions were used. At the first stage, the sparing decompression of the bile ducts, and as well rational regional antibacterial therapy were performed. The lethality reduced from 3 to 1.3%, purulent cholangitis was cupped off in 98.7% of the patients. The indications, methods for performance of endoscopic papillotomy, and as well of closed interventions in obstruction of the bile ducts with the use of a transcutaneous transhepatic approach are presented. PMID- 1766164 TI - [Complications and reoperations after peritoneo-atrial shunting in patients with liver cirrhosis and diuretic-resistant ascites]. AB - The analysis of postoperative complications, which developed in 33 patients after peritoneoatrial shunting (PAS), was carried out. The effectiveness of PAS is determined by proper choice of the indications, adequate performance of surgical intervention. The use of intraoperative teleroentgenoscopy for control of the venous catheter situation is recommended. Reoperations for postoperative complications are to be performed in presence of a pressure gradient in the valvular system and in patients with shunt infection after elimination of the inflammatory process. PMID- 1766165 TI - [Results of resection of a small intestinal segment in patients with portal hypertension]. AB - In 4 patients with the portal hypertension syndrome, the forced resection of the small intestine was performed. In all the cases, the stable decrease in pressure in the portal vein system was noted in follow-up of from 1 to 15 years. PMID- 1766166 TI - [Preoperative antibacterial therapy in the comprehensive treatment of patients with external biliary fistulas]. AB - The experience with antibacterial therapy in 120 patients with choledocholithiasis and cicatricial stricture of the bile ducts complicated by the development of an external biliary fistula is summarized. It was established that intravenous administration of antibiotics at the maximum dosages with purposeful sanation of the bile ducts via the external biliary fistula at the preoperative period improved the immediate and long-term results of treatment of the patients. Only in full-value, adequate correction of disorders in the major bile outflow, the reliable elimination of the external biliary fistula is possible. PMID- 1766167 TI - [The role of bacteriologic study of the bile in the surgical treatment of patients with cholangitis]. AB - Bacteriologic study of the intraductal bile was performed in 123 patients operated on for cholangitis: chronic relapsing--in 47, acute--in 59, septic--in 17. Aerobic microflora was revealed in 59%, anaerobic non-clostridial--in 12%, mixed--in 27% of cases. After operation, the reduction in bacteriobilia was noted. The microflora revealed was resistant to antibacterial preparations. The possibility to use the techniques of gas-liquid chromatography and pH-metry of bile in instant diagnosis of cholangitis is shown. PMID- 1766168 TI - [Blood coagulation in patients with ulcerous gastrointestinal hemorrhage]. AB - In 108 patients with ulcerous gastrointestinal hemorrhage, the indices which characterize the coagulative and fibrinolytic systems of the blood were studied. At the moment of admission, in patients with severe blood loss, the moderate manifestations of the disseminated intravascular coagulation, which is the most characteristic in globular volume deficiency of more than 50%, were noted. After the operation, the revealed changes in the system of hemostasis increased. Beginning from the day 5, a tendency for normalization of the indices was noted, however by the moment of discharge of the patients they do not achieve the normal ones. PMID- 1766169 TI - [Surgical treatment of acute cholecystitis complicated by peritonitis]. AB - The analysis of operative interventions performed for acute cholecystitis in 3324 patients was carried out. Local peritonitis was revealed in 149 (52.3%) patients, the diffuse one--in 136 (47.7%). Depending on the character of contents of the abdominal cavity, the authors distinguish purulent, biliary and mixed peritonitis. The general principles of tactics for surgical treatment and its different variants depending on a type of peritonitis are substantiated. PMID- 1766170 TI - [Clinical course and therapy of acute destructive cholecystitis in elderly and very old patients]. AB - In analysis of clinical manifestations and results of surgical treatment of acute destructive cholecystitis in 215 elderly and senile patients, the authors established, that clinical picture of the given pathology was obscure, despite the presence of destructive forms of inflammation. The necessity for early performance of an operation is substantiated. PMID- 1766171 TI - [Diagnosis and treatment of obstructive jaundice of non-neoplastic origin]. AB - The results of surgical treatment of 853 patients with obstructive jaundice of non-tumor genesis and initial bilirubin level in the blood of 100 mumol and higher are analysed. Individualization of therapeutic-tactical approach with the use of preoperative diagnosis of the level of obstruction of the bile ducts and severity of the state of a patient, and as well their preoperative decompression with the use of endoscopic methods permit to accomplish a number of measures aimed at reduction of the incidence of purulent-necrotic complications and lethality, improve the long-term results of treatment of the patients with obstructive jaundice. PMID- 1766172 TI - [The principle of staging in the surgical treatment of acute cholangitis]. AB - In 67 patients ranging in age from 47 to 82 years, the transabdominal surgical (35) and instrumental decompressive (32) staged interventions were performed for acute cholangitis. The indications for staged treatment with regard for general factors calculated by means of the mathematical analysis of prognostic criteria, local factors revealed suboperatively and as well their combination are substantiated. It was established that the most effective method of instrumental decompression was endoscopic papillosphincterotomy performed at a specialized medical department. The transabdominal staged interventions can be performed at the in-patient departments of general surgery. PMID- 1766173 TI - [Surgical treatment of patients with distal common bile duct stones]. PMID- 1766174 TI - [Comprehensive therapy of acute cholecystitis in elderly and very old patients]. AB - A high effectiveness of the use of target transport of antibiotics in the autological erythrocytic shadows in the complex of surgical treatment of acute cholecystitis in 65 elderly and senile patients when compared with that in use of the existing methods of conservative treatment was revealed. The method developed permits to create in the bile a high and prolonged antibiotic concentration, and as well to reduce 4.5-fold the time for cupping off acute cholecystitis, to increase the quality of examination, preoperative preparation and elective operative treatment of the patients. PMID- 1766175 TI - [Surgical interventions for obstruction of the extrahepatic bile ducts]. AB - The results of surgical correction of obstruction of the extrahepatic bile ducts in 279 patients are presented. The operation of choice was choledocholithotomy, which was added by papillosphincterotomy and external drainage of the common bile duct in indications. In obstruction of bile ducts of the tumor genesis, the different biliodigestive anastomoses were created. The postoperative lethality was 4.6%. PMID- 1766176 TI - [Informative value of various methods of diagnosing chronic calculous cholecystitis]. AB - Resulting from comparative study of informative value of the radionuclide scanning, oral cholecystography, intravenous cholegraphy, ultrasound investigation (USI) performed in 316 patients with chronic calculous cholecystitis, it was established that the most effective method of diagnosis was USI: pre- and postoperative diagnosis coincided in 93.4% of cases. PMID- 1766177 TI - [Causes, diagnosis and surgical treatment of complications after cholecystectomy]. AB - The results of surgical treatment of 230 patients with postcholecystectomy syndrome (PCES) have been analysed. There were the following causes of PCES development: stricture of the terminal common bile duct (48.7% of cases), which in 23.4% of patients was associated with choledocholithiasis; cicatricial stricture of the hepatic duct after iatrogenic trauma (23.2%), leaving the long stump of the cystic duct (2.3%). With the aim of PCES diagnosis, the complex of methods was used, which included ultrasound, roentgenologic, endoscopic studies, retrograde and percutaneous cholangiography, laparoscopy, fistulography, computerized tomography. The indications for individual types of operative intervention are substantiated. PMID- 1766178 TI - [Clinical features and operative treatment of ampullary choledocholithiasis]. AB - The results of treatment of 72 patients with ampullary choledocholithiasis (16% of the total number of patients with choledocholithiasis) are presented. In 15 patients, bringing down a concrement was performed, in 3--its retrograde removal via the incision of the common bile duct with subsequent creation of choledochoduodenoanastomosis (CDA), in 24--endoscopic papillosphincterotomy (with subsequent cholecystectomy--in 6, with cholecystectomy and CDA creation--in 18), in 30--cholecystectomy with transduodenal papillosphincteroplasty. After the operation, 5 patients died. PMID- 1766179 TI - [Ischemic heart disease and acute cholecystitis in elderly and very old patients]. AB - The effectiveness of treatment of 127 elderly and senile patients suffering from the ischemic heart disease, who underwent the endoscopic interventions for acute cholecystitis, have been analysed. Atraumaticity of endoscopic interventions, individual approach to the choice of a method for treatment of a patient and agreed with a therapeutist preoperative preparation, including prescription of the coronaro-active agents, cardiac glycosides, permitted in the majority of patients to achieve a positive result of treatment. PMID- 1766180 TI - [Complications and mortality in splenic trauma]. AB - The analysis of complications and lethality in 97 patients with closed splenic trauma was carried out. The main causes of death of the injured were shock, concomitant injuries. The total postoperative lethality was 33%. Of the 60% of patients with associated injuries, 51.7% died. In injury to four and more organs, all the sufferers died. The incidence of postoperative complications was 22.7%. Most frequently (21.6%) the purulent septic complications which caused death in 7.2% of patients were noted. In preservation of a spleen, the incidence of such complications reduced 2.6-fold. PMID- 1766181 TI - [Specifics of surgical approach in purulent cholangitis]. AB - When analysing the results of examination of 773 patients with obstructive jaundice (OJ) of benign genesis, purulent cholangitis (PC) was revealed in 323. In PC diagnosis, the ultrasound study is a valuable adjunctive method. In presence of the clinical signs of PC in patients and absence of the effect from conservative therapy, and as well in preservation of the high indices of bilirubinemia, the early operative treatment performed, as a rule, no later than 48 h after hospitalization is indicated. PC in patients with OJ is most frequently caused by choledocholithiasis. The causative agents of PC are represented by aerobic and anaerobic microorganisms, requiring the use of broad spectrum antibiotics before the operation and 6-12 h after it. Adequate restoration of bile passage and pathogenetically substantiated local influencing upon the inflammatory process in the bile ducts are tasks of operative intervention. Direct administration into the bile ducts of antibiotics and antiinflammatory preparations, in particular of quercitrol, via the external drain of the common bile duct is expedient. PMID- 1766182 TI - [Surgical treatment of acute bacteroid purulent cholangitis]. AB - The results of treatment of 40 patients with acute purulent cholangitis developed against the background of choledocholithiasis are presented. Bacteroid of the kind B. fragilis (67.5% of cases), Fusobacterium, Lactobacillus sp. (30%) are the leading etiological factor of cholangitis. The indications for external and internal drainage of the bile ducts are substantiated. The ineffectiveness of internal drainage in this disease is demonstrated. PMID- 1766183 TI - [Focal segmental resection of the stomach in the surgical treatment of gastric ulcer]. AB - In 60 patients with gastric ulcer, the target segmental resection of the stomach alone, or in combination with selective proximal vagotomy was performed. The long term result of treatment was followed up for the period of from 2 to 5 years. An excellent and good result was noted in 34 cases, a satisfactory one--in 4. PMID- 1766184 TI - [One-stage segmental pylorus-preserving resection of the stomach and duodenum in stenosing duodenal ulcer]. AB - The analysis of the results of surgical treatment of 32 patients with duodenal ulcer disease complicated by postpyloric stenosis of the duodenum, using the original technique--combination of selective proximal vagotomy with segmental pylorus-preserving resection of the stomach and duodenum was carried out. A good immediate and long-term result was noted, there were no ulcer recurrences. Such an operative intervention is expedient in stenosing duodenal ulcer, its combination with a gastric ulcer, and as well in postvagotomy ulcer recurrency developing against the background of high gastric acid production. PMID- 1766185 TI - [The use of low-intensity laser irradiation in the immediate postoperative period in patients with gastroduodenal ulcer]. AB - In patients with an ulcer of the stomach and duodenum at the immediate postoperative period in the complex of treatment, the low intensity laser irradiation of the anastomosis (after gastric resection) and ulcer (after the organ-preserving operations) according to the developed method by means of the modified LG-75 apparatus was used. The use of a helium-neon laser contributed to development of the severe form of anastomositis and subsequent gastrostasis. In study of gastric secretion, no considerable changes in acid formation were revealed. PMID- 1766186 TI - [The use of a nasoduodenal tube for therapeutic drug administration in the comprehensive treatment of duodenal ulcer in elderly patients]. AB - The use of therapeutic endoscopy in the complex of gastric and duodenal ulcer therapy permits to reduce the duration of patient's stay in the hospital 1.5-2 fold. A disadvantage of the method consists in the fact that it is hard for the patients (especially, the elderly) to endure the complete course of treatment. The authors have used a naso-duodenal polychlorvinyl tube of original construction for prolonged irrigation of an ulcer with drug solutions stimulating the reparative processes. In all the patients, a duodenal ulcer has epithelized within 18.3 days. The long-term results of treatment with the use of this method confirmed its high effectiveness (positive result was noted in 91.7% of cases). PMID- 1766187 TI - [Xanthogranulomatous cholecystitis]. PMID- 1766188 TI - [Excision of the common bile duct and a part of the hepatic duct overlooked at cholecystectomy]. PMID- 1766189 TI - [Difficulties in the differential diagnosis of leptospirosis and acute surgical pathology of the bile ducts]. PMID- 1766190 TI - [A method of regional immunotherapy in acute complicated calculous cholecystitis]. PMID- 1766191 TI - [An instrument for cholecysto- and choledochotomy]. PMID- 1766192 TI - [A method for closure of the wounds of the liver and gallbladder bed after cholecystectomy]. PMID- 1766193 TI - [A modification of extramucosal choledochoduodenostomy]. PMID- 1766194 TI - [A method for studying bile formation by the liver in chronic experimentation]. PMID- 1766195 TI - [Surgical approach in acute cholecystitis in a pregnant woman]. PMID- 1766196 TI - [Overlooked concrements of the common bile duct simulating a tumor of the pancreatic head]. PMID- 1766197 TI - [Recurrent obstructive jaundice in the long-term follow-up after cholecysto gastro-anastomosis]. PMID- 1766198 TI - [Acute cholecystitis complicated by the development of a hepatic abscess]. PMID- 1766199 TI - [Recurrent intestinal obstruction in an elderly patient, caused by biliary calculi]. PMID- 1766200 TI - [A differential diagnostic symptom of "emptying" in cystic dilatation of the common bile duct]. PMID- 1766201 TI - [Abscess of the ligamentum teres hepatis]. PMID- 1766202 TI - [The beginnings of scientific surgery in Kiev (150th anniversary of the Kiev Medical Institute)]. PMID- 1766203 TI - [Effectiveness of drainage of the abdominal cavity after surgery of the liver and pancreas]. AB - With the aim to control the effectiveness of drainage of the abdominal cavity after operations on the liver and pancreas in 28 patients, a value of the prognostic coefficient (PC) of the course of wound process (ratio of total protein level in the blood plasma of the patients to its content in wound discharge), content of middle molecular mass peptides in the blood, pH were measured in dynamics, qualitative reaction to gamma-globulins of the wound discharge was performed. The study of these indices in combination with clinical data permits to judge more fully about the effectiveness of the abdominal cavity drainage, to prognosticate purulent complications and to take in time measures for their prevention. PMID- 1766204 TI - [Intragastric pH-metry and ways to raise its informative value]. PMID- 1766205 TI - [Methods of teaching efficient therapy of internal diseases]. AB - An original method of teaching students efficient therapy has been developed basing on the psychological decision theory, conception of stage-by-stage formation of mental actions, method of key signals. The instructor uses the scheme repeatedly when observing the students' clinical activities, at doctor's rounds and conferences. PMID- 1766206 TI - [Professor G. A. Zakhar'in (from the archives of Montenegro)]. PMID- 1766207 TI - [Vladimir Ivanovich Dal' (the 190th anniversary of his birth)]. PMID- 1766208 TI - [A. M. Markov--an outstanding organizer of health services (the 90th anniversary of his birth)]. PMID- 1766209 TI - [Grand Duchess Elena Pavlovna and Russian medicine]. PMID- 1766210 TI - [Orthotopic liver transplantation]. PMID- 1766211 TI - [Current problems in the diagnosis and treatment of ventricular pre-excitation syndrome and its complications]. PMID- 1766212 TI - [A new concept of the development of glucocorticoid dependence in autoimmune diseases]. PMID- 1766213 TI - [Platelet aggregation in different clinical variants of the course of ischemic heart disease]. AB - Dynamic examination for ADP-induced platelet aggregation was performed in coronary patients with angina pectoris, microfocal or macrofocal uncomplicated myocardial infarction, recurrent infarction, cardiogenic shock. Healthy subjects served as control. The unidirectional trend was revealed: a decrease in aggregation and disaggregation capacity of platelets most evident in complicated coronary heart disease. This seems to result from initial platelet hyperactivation and subsequent depletion. Platelet hemostasis correction is feasible under early and accurate diagnosis of the above impairments. PMID- 1766214 TI - [Effects of nicardipine on the functional state of the liver in patients with ischemic heart disease]. AB - Hepatic function was studied in 31 patients with coronary heart disease before and after treatment with nicardipine. Clinical and biochemical findings (enhanced gamma-glutamate transferase and high cholesterol, hepatobiliary syndrome) provide evidence for hepatic function disturbance associated with coronary heart disease. Nicardipine produced a good subjective response, the attenuation of hepatobiliary syndrome. Biochemical indices did not change. PMID- 1766215 TI - [Possibilities of using laser irradiation of venous blood in the treatment of conduction disorders in patients with ischemic heart disease]. PMID- 1766216 TI - [Cerebral complications of antihypertensive therapy]. PMID- 1766217 TI - [Electrocardiographic signs of pulmonary artery thromboembolism]. PMID- 1766218 TI - [Cough syncope syndrome in patients with expiratory stenosis of the trachea and bronchi]. AB - Features of cough syncope were studied in 31 patients with expiratory stenosis of the trachea and bronchi using fiber bronchoscopy, tracheal and esophageal x-ray, external respiration and electrophysiological examinations. Clinical patterns, prevention, treatment, disability expert evaluation are detailed. PMID- 1766219 TI - [Functional state of the diaphragm during several non-drug methods of the treatment of chronic pulmonary insufficiency]. AB - The study compared the effect of conventional therapy of aggravated chronic obstructive bronchitis (COB), inpatient oxygen treatment of large duration (OT), normobaric hypoxic stimulation (NBHS), inspiratory resistance on the diaphragmatic muscle function in COB patients with chronic pulmonary insufficiency. The function was assessed at stimulation electromyography of the diaphragm. The latter reflected enhanced bioelectric activity of the diaphragm in response to OT and inspiratory resistive training as shown by increased time parameters. Conventional COB treatment induced no changes in the myographic picture. Long-term response to NBHS needs further investigations. PMID- 1766220 TI - [Use of captopril in the treatment of chronic cor pulmonale]. AB - Captopril administration in chronic cor pulmonale (CCP) stage I and II produced positive objective and subjective responses evident from a significant improvement of right heart myocardial contractility, external respiration which lower systolic pressure in the artery. Captopril can be introduced in CCP stage I for preventive and CCP stage II for therapeutic purposes. PMID- 1766221 TI - [Functional state of the kidneys in patients with chronic diffuse bronchitis]. AB - Radionuclide renography and enzyme immunoassay used to evaluate renal function and renin--angiotensin--aldosterone system in 95 patients with chronic diffuse bronchitis demonstrate impairment of renal secretion and excretion in all the examinees. There are shifts in plasma renin activity and aldosterone concentration. The above defects depend on cardial--pulmonary insufficiency and respiratory--hemodynamic disorders. PMID- 1766222 TI - [Assessment of the effectiveness of secondary prevention of chronic gastritis with secretory insufficiency]. PMID- 1766223 TI - [Relationship between Helicobacter pylori and antral gastritis and gastroduodenitis]. AB - Morphological data on the biopsies obtained from the antral gastric mucosa of 150 chronic gastritis and gastroduodenitis patients provided grounds for recognition of 3 degrees of gastritis activity. Helicobacter pylori (CP) occurred in the antral gastric portion in 100% of the cases. CP presence and mucosa contamination, plasmocytic infiltration, dystrophic changes in the surface and glandular epithelium were found to correlate. Administration of ampiox in a daily dose of 1.0 g for 10 days resulted in a rapid attenuation of painful and dyspepsia syndromes which ceased on treatment day 7. Endoscopically and morphologically, there were more rapid epithelialization of the erosions and inhibited activity of gastritis compared to the control group. In biopsies obtained on treatment week 3-4 CP was not registered in 67% of cases or was present in much less amounts. The control subjects manifested CP universally, the morphological positive trend was unremarkable. PMID- 1766224 TI - [Effects of anti-ulcer drugs on humoral immunity]. AB - The effect of cholinolytics in combination with antacids, belomet, solcoseryl and enterodes on humoral immunity was evaluated in 134 ulcer patients. Elevated levels of salivary secretory IgA and blood IgG, IgA, lowered blood IgD exhibited in ulcer exacerbation. Antibodies to oligopeptides isolated from the serum of ulcer patients occurred in 80.6% of the patients. Whatever the drug used, after treatment levels of secretory salivary IgA and blood IgA dropped, blood IgD rose. Belomet treatment gave rise to higher titres of antibodies to oligopeptides. Solcoseryl, cholinolytics with antacids led to increased blood levels of IgM and reduced levels of IgG. Recovery of the indices occurred in patients on enterodes. It is stated that changes in immunity depend both on ulcer healing and direct action of antiulcer drugs. PMID- 1766225 TI - [Ultrahigh frequency therapy of duodenal ulcer]. AB - Extremely high frequency (EHF) radiation was performed in 95 outpatients with duodenal ulcer. Individual choice of the exposure site can improve the treatment results. The syndrome-oriented approach of the Chinese conventional medicine warrants an effective choice of the acupuncture loci and the prognosis of the outcome. A clinical syndrome was identified in which healing of the ulcer was achieved on week two of the treatment in 92.3 +/- 7.7% of the patients. It is suggested that EHF therapy provides positive responses in case of a valid exposure zone selection, the frequency being less important. PMID- 1766226 TI - [Experience in health resort rehabilitation of patients in the early period after exacerbation of duodenal ulcer]. AB - Forty-eight patients with duodenal ulcer were examined for the psychological status and that of autonomic nervous system before and after combined treatment. The group subjected to personality-oriented psychotherapy showed significantly higher potential of psychological defence and vegetative tonicity. PMID- 1766227 TI - [Indications for surgical treatment of duodenal ulcer]. PMID- 1766228 TI - [Characteristics of the intellectual-memory function of patients treated by chronic hemodialysis]. AB - The intellectual-memory function of chronically hemodialyzed patients was evaluated according to Wechsler technique. Though intelligence in such patients remains unaffected and there is no dialysis-related dementia, recent memory and attention deteriorate. Psychic adaptation to chronic hemodialysis proved unrelated to mental capacity. PMID- 1766229 TI - [Use of partusisten in prevention of hyperkalemia in patients with chronic glomerulonephritis with initial forms of renal failure]. AB - The studies performed proved the ability of the drug partusisten (in a dose of 10 mg/day) to effectively reduce an elevated potassium level in the serum of chronic sufferers with glomerulonephritis and initial renal insufficiency. Normal concentrations of Ca, K and Na in relevant patients remained unchanged except a slight rise in K urinary excretion this suggesting an extrarenal mechanism of K redistribution consequent to the action of beta 2-adrenergic agents. PMID- 1766230 TI - [Difficulties in the diagnosis of primary and secondary hyperparathyroidism]. PMID- 1766231 TI - [A case of a favorable course of chronic glomerulonephritis in repeated pregnancies and deliveries]. PMID- 1766232 TI - [Gastric shellac bezoar]. PMID- 1766233 TI - [Giant caseoma of the mesentery of the small intestine]. PMID- 1766234 TI - [Abdominal syndrome in aortic coarctation simulating acute appendicitis]. PMID- 1766235 TI - [A case of Pfeiffer-Weber-Christian disease]. PMID- 1766236 TI - [Recurrent Lyell's syndrome with secondary thrombocytopenia]. PMID- 1766237 TI - [Risk factors and stages of disease development]. PMID- 1766238 TI - [Palpable symptom of distinct epigastric fossa in hernias of the esophageal hiatus of the diaphragm]. AB - The paper describes a palpable symptom of a marked pit of the stomach in hiatal hernia. The symptom was registered in 67.9% of patients with such hernia and in 20% of gastroenterological patients without it. The sign is suggested to arise in advanced muscular and connective tissue debility. PMID- 1766239 TI - [The cause of mental illness in women. My encounter with psychiatric patients]. PMID- 1766240 TI - [Psychologic overstress and role conflicts]. PMID- 1766241 TI - [Strategies for changes in future nursing practice]. PMID- 1766242 TI - A report on dementia in South Carolina, 1988-1990. AB - With the over age 65 population growing at a faster rate than the under 65 population, and with the strong effect of age on the incidence and prevalence of dementia, South Carolina faces a major health problem among its elderly residents by the year 2010. This report summarizes data on the 4,283 persons identified by the Statewide Alzheimer's Disease and Related Disorders Registry during the period 1988 to 1990. Sixty-one percent of these cases had a diagnosis of Alzheimer's disease or senile dementia and 62 percent of these were currently institutionalized. The demographic distribution of the AD cases did not change over the three-year period. Compared to community cases, those in institutions were generally older, and more likely to be women, unmarried, and white. The average time from onset of symptoms to diagnosis of AD was about five years. PMID- 1766243 TI - Cytotechnology manpower assessment. AB - The shortages of cytotechnologists in the state of South Carolina are 43 percent, representing an extreme urgency to fill these vacant positions (national average 28 percent). Furthermore, the shortage is expected to rise (52 percent) thereby demanding a solution to the problem. PMID- 1766244 TI - Vascular malformation: case report and literature review. AB - The therapeutic outcome of congenital vascular malformations generally parallels the complexity of the lesion. The less extensive malformations that are prone to regression may be observed. Larger lesions that produce facial asymmetry or have diffuse extremity involvement require a more aggressive approach. Even with the limitations of current treatment methods these extensive malformations can usually be controlled thus affording the patient a better life. PMID- 1766246 TI - Lyme disease in South Carolina. PMID- 1766245 TI - Bleeding secondary to the use of thrombolytic agent in a patient with recent renal lithotripsy. AB - We feel that while our patient succumbed to complications of his extensive anterior myocardial infarction, the devastating renal, subcapsular, and retroperitoneal hemorrhage as well as the cerebral hemorrhage certainly appeared to hasten his demise. From this experience, we now consider recent renal lithotripsy to be a major contraindication to the use of thrombolytic agents. Logically, the time frame for omitting thrombolytic therapy following renal lithotripsy should be similar to that of other major surgical procedures, approximately four to six weeks. PMID- 1766247 TI - Pellagra hospital, Spartanburg. PMID- 1766248 TI - Healthy schools 2000: creating partnerships for the decade. PMID- 1766249 TI - Healthy people 2000: national health promotion and disease prevention objectives and healthy schools. PMID- 1766250 TI - Trends in the 5' vs. 3' flanks of oligonucleotides in eukaryotic and prokaryotic genomes: the asymmetric roles played by cytosine and guanine. AB - Studies of sequence context preferences of oligonucleotides composed of (G/C)n and (A/T)m blocks (n + m = 3,4,5) unravel strong patterns. Comparisons of the 5' and 3' nearest neighbor doublets flanking these oligomers reveal the preference of (G/C)2 to be positioned immediately next to the (A/T)m block, enclosing it by (G/C) nucleotides rather than extending the (G/C)n block. That is, for a (G/C)n(A/T)m oligomer and a (G/C)2 doublet, (G/C)n(A/T)m(G/C)2 greater than (G/C)n + 2 (A/T)m. Similarly for an (A/T)m(G/C)n oligomer, (G/C)2(A/T)m(G/C)n greater than (A/T)m(G/C)n + 2. In an analogous manner, (A/T)2 flanking doublets prefer enclosing the (G/C)n blocks, although these patterns are weaker. Here we show a strong, direct relationship between the magnitude of the trends and the presence of Cs in the (G/C)n block in the (G/C)n(A/T)m oligomer, and the presence of Gs in the complementary (A/T)m(G/C)n oligomers. The trends are stronger in eukaryotic than in prokaryotic sequences. They are stronger for longer (G/C)n and shorter (A/T)m blocks. We suggest that the preference for (A/T)m to be enclosed by (G/C) rather than be flanked by them on only one side is related to DNA structure and DNA-protein interaction. Sequences of the (G/C)(A/T)(G/C) type may have more homogeneous minor groove geometry. In particular, the strong G vs. C asymmetry in the trends may be related to pyrimidine-purine junctions, possibly to CG sequences. PMID- 1766251 TI - Interchange of "altruistic" acts as an epiphenomenon. PMID- 1766252 TI - Reciprocal altruism and the limits of correlational analysis. PMID- 1766253 TI - The influence of side chain structures on the residue-residue associations in globular proteins. AB - The relationship between the physical make-up of the side chain structure of an amino acid and its capacity to associate with other side chains in the crystalline state of protein molecules has been investigated by a linear regression study. Relevant inter- and intra-molecular forces and steric factors are taken to represent the side chain structure, while the observed atom-atom interactions in a set of protein crystals are taken to represent the residue residue association potentials. Correlation equations are set up in such a way that, (i) the dependence of the association potential of a residue on the side chain structures of associating residues, and (ii) the dependence of the association potential of a residue on its own side chain structure are brought out separately. The results show definite quantitative relationships in each of the above two views. Particularly, the behaviour of the charged residues is highly correlated to the structural make of their side chains. It is demonstrated how and to what extent the effects of associating/preferring residues are taken care of when they associate with a certain kind of residue in the protein environment. PMID- 1766254 TI - Biophysical models of protein denaturation. I. An improvement of the model of two states. AB - The model of two states (native and denatured), frequently used for the description of protein denaturation, has been complemented by relations defining, on theoretical grounds, the temperature dependence of the relevant thermodynamic functions. In essence, this was achieved by assuming that the temperature dependence of Gibbs free energies of the native protein and of denaturation can be approximated, within the interval (0 degree C, 100 degrees C), by second-order partial sums of Taylor series. The improved model operates with four parameters: the temperature of denaturation, the heat capacities of the native and denatured protein at the temperature of denaturation, and the entropy of denaturation at that temperature. A theoretical treatment is included of the temperature dependence of total heat capacity, the variable recorded in the form of continuous thermograms by means of differential scanning calorimetry. Our model correctly reproduces experimental thermograms of proteins and provides for the biophysical interpretation of a number of their geometric components. Fitting procedures were complemented by a newly devised method for estimating starting values of model parameters from calorimetric data. The phenomenon of cold denaturation was also reproduced quantitatively by our model, which supplies explicit proof of the exothermal nature of this phenomenon. Finally, the relationship between temperature profiles of thermodynamic functions describing denaturation has been defined by sequences of profile magnitudes at points where the profiles intersect the temperature axis and/or cross each other. Model derived sequences of profile magnitudes, representative of cross-point temperatures and of intervals in between, together constitute a general characteristics of denaturation, uninfluenced by differences in thermodynamic stability between protein species. PMID- 1766255 TI - A mathematical model for protein-induced lipid vesicle leakage: interaction of the intermediate filament protein vimentin and its isolated N-terminus with phosphatidylinositol vesicles. AB - A mathematical model was developed to analyze the leakage of phosphatidylinositol small unilamellar vesicles induced by the intermediate filament protein vimentin and its isolated N-terminal polypeptide. This model describes the kinetic and steady-state characteristics of this vesicle leakage as a direct action of protein on the lipid bilayer. Moreover, qualitative information at the molecular level can be deduced about protein-protein or protein-lipid interactions from the derived initial rate of vesicle leakage and the value of vesicle leakage at steady-state condition as a function of the protein concentration. Additionally, quantitative data on the inhibitory effect of various substances (here Ca2+ or Mg2+) can also be derived. This approach offers a possibility to compare interactions occurring within different protein-lipid systems by determining the characteristic parameters for the respective kinetic and steady-state conditions. PMID- 1766256 TI - Relative sensitivity of myeloid and lymphatic stem cells to mutational and cell killing effects of ionizing radiation. AB - Following exposure to a high dose of ionizing radiation there is a much greater risk of developing myeloid than lymphatic leukaemia. Reasons are given why this difference probably owes more to cell killing than mutational effects of the radiation. PMID- 1766257 TI - Effects of interleukins 1-7 on the proliferation of T-lineage acute lymphoblastic leukemia cells. AB - We investigated the proliferative effects of interleukins 1-7 (IL-1 to -7) on leukemic cells from 10 patients with T-lineage acute lymphoblastic leukemia (T ALL). Five patients had CD7+4-8-acute leukemia, one had CD5+ acute leukemia, and four had CD1+ acute leukemia. To examine the proliferative effect of each interleukin, 3H-TdR incorporation method was used. In the presence of IL-1, no increase in 3H-TdR incorporation was observed for any of the T-ALL cells. With IL 2, 3H-TdR incorporation increased in cells from 5 out of 10 T-ALL patients, including those with CD7+4-8-, CD5+, and CD1+ acute leukemia. In the presence of IL-3 or IL-6, 3H-TdR incorporation increased in cells from 2 out of 5 patients with CD7+4-8- acute leukemia. However, CD5+ or CD1+ acute leukemia cells were not stimulated by IL-3 or IL-6. With IL-4, 3H-TdR incorporation was increased in the cells from 2 out of 5 patients with CD7+4-8- acute leukemia and in the cells of 2 of those with CD1+ acute leukemia. IL-5 increased the 3H-TdR incorporation by cells from 2 out of 5 patients with CD7+4-8- acute leukemia and 1 patient with CD1+ acute leukemia. IL-7 increased 3H-TdR incorporation in cells from all five CD7+4-8- acute leukemia and 2 of those with CD5+ or CD1+ leukemia. No synergistic effect was found when IL-7 and other cytokines were added to cells from the 3 patients with CD7+4-8- acute leukemia who were tested. PMID- 1766258 TI - Partial characterization of protein tyrosine kinase activity in normal and leukemic human myeloid cells. AB - We have examined the expression of the protein tyrosine kinase (PTK) encoding oncogenes fes and abl in normal and malignant human myeloid cells in immunoblotting experiments. fes was markedly present in all cytosolic and most membrane fractions of normal and malignant cells. abl was only visible in normal cells, and occurred mostly in the cytosolic fractions. Molecular weights of identified proteins were different from the known products of fes and abl, possibly by alternative splicing at the mRNA level or by proteolysis. PTKs in myeloid cells were further purified by fast liquid protein chromatography (FPLC). PTK-activities of column fractions were assayed using a solid-phase non radioactive dot-blot assay. Cytosolic and membrane fractions showed a FPLC pattern with a constant as well as a variable part in both normal and malignant cells, possibly indicative for PTKs with specialized functions in normal cell growth and transformation. Partial characterization of PTKs from different eluted peaks of AML-M4 blast cells demonstrated that PTKs from these peaks are kinetically distinct from each other. PMID- 1766259 TI - Histologic, immunophenotypic and genotypic analyses of bone marrow trephines from patients with non-Hodgkin's lymphoma. AB - Marrow involvement in 20 patients with non-Hodgkin's lymphoma (NHL) were studied by histology, immunophenotypic and genotypic methods. Eighteen of these trephines were histologically involved with recognizable lymphomatous infiltrates and five of these were the primary disease site. In the remaining two cases (with histologically involved lymph nodes) the trephines were uninvolved with tumour. Three B-cell cases expressing surface immunoglobulin (sIg) and/or CD37 and one case not analysed phenotypically showed Ig gene rearrangements. The two remaining cases with B NHL showed no gene rearrangements, however, in one of these the trephine was histologically uninvolved with tumour. Twelve out of 14 T-cell cases were characterized by variable or absent expression of one or more T-cell antigens from the tumour population, one case was negative for all T-cell antigens and the remaining case was not histologically involved with tumour. All three lymphoblastic lymphomas and only 4/11 peripheral T-cell lymphomas (PTCL) cases revealed T-cell receptor (TcR) gene rearrangements. One of the latter cases also exhibited Ig JH gene rearrangements. This study demonstrates the usefulness of bone marrow trephines (BMT) in histologic, phenotypic and genotypic analyses. However, although genotypic data confirm clonality in B NHL and the lymphoblastic lymphomas there was genotypic heterogeneity within the PTCL group. PMID- 1766260 TI - Hierarchical regulation of interleukin production: induction of interleukin 6 (IL 6) production from bone marrow cells and marrow stromal cells by interleukin 3 (IL-3). AB - IL-3 stimulated the production of IL-6 from a bone marrow-adherent cell population, macrophages and from hemopoietic supportive stromal cell lines. It also induced IL-6 production from a stem cell-enriched population of bone marrow cells which did not produce IL-6 without stimulation. In contrast, stimulation with IL-6 of all the cell populations studied in the present experiments did not induce IL-3 production. These results indicate a hierarchical network in the regulation of interleukin production, and existence of a positive feedback mechanism; IL-3 induces IL-6 production which in turn stimulates stem cells into cycle and induces stem cells to respond to IL-3. PMID- 1766261 TI - Interleukin 1 production by monocytic leukemia cells and its possible role in coagulation abnormalities. AB - Interleukin 1 (IL-1) production by leukemic cells was studied in 16 patients with myelocytic or monocytic leukemia. Leukemic cells from the patients with monocytic leukemia showed higher IL-1 production than those with myelocytic leukemia. Subclinical coagulation abnormalities were observed more frequently in patients with higher IL-1 producing monocytic leukemia. It is suggested that IL-1 from leukemic cells might play important roles in the establishment of these clinical features. Such observations might be of value in the understanding of the pathophysiology of leukemia-associated paraneoplastic phenomena. PMID- 1766262 TI - Expression of a multidrug-resistance gene in human malignant lymphoma and related disorders. AB - The expression of mdr1 gene was measured to determine whether it plays a role in clinical resistance to chemotherapy of human malignant lymphomas. mdr1 expression was found in 4 of 9 cases resistant to chemotherapy. Expression of mdr1 was not detectable in any of 7 chemotherapy-sensitive tumors. The 2 cases of reactive lymphadenitis and the 3 samples of normal mononuclear cells did not show any expression of mdr1 gene, either. These results indicate that expression of the mdr1 gene is not always detectable in cases of malignant lymphoma resistant to chemotherapy, but the detectable expression of mdr1 gene may predict clinical resistance to chemotherapy. PMID- 1766263 TI - Synergistic effect of retinoic acid and 1,25-dihydroxyvitamin D3 on the differentiation of the human monocytic cell line U937. AB - The human-derived leukemia cell lines HL-60 and U937 are known to differentiate into more mature phagocytic cells in the presence of retinoic acid or 1,25 dihydroxyvitamin D3. We studied the effects of combinations of these two agents on cell growth and differentiation. These treatments were found to increase inhibition of cell proliferation. A dramatic enhancement of functional properties was observed in U937, but not HL-60 cells exposed to combinations of the two inducers. We investigated the conditions required to obtain the highest synergistic effects on the differentiation of U937 cells. These effects were found to be highly dose-dependent. We found that synergism required the simultaneous presence of both inducers and did not occur upon sequential exposure to each agent used separately. PMID- 1766264 TI - Prognostic implication and characterization of the blast cell population in the myelodysplastic syndrome. AB - The bone marrow smears of 18 confirmed cases of MDS were analyzed carefully for the presence of "hypergranular type III blasts", defined as more than 20 fine azurophil primary granules per cells. The concordance was close to 80% among 5 observers. Thirty-nine percent (7 cases) were reclassified as RAEB-t rather than RAEB. The presence of these hypergranular blasts was not suggestive of increased differentiation but rather leukemic cells. The reassignment of cases altered the median survival for the various subcategories, providing a clearer separation with the introduction of type III blasts than without utilizing these cells which were separated from the promyelocyte family. The introduction of this new blast cell definition in a larger series of patients is recommended to confirm these preliminary observations. PMID- 1766265 TI - Remission of monoclonal chronic T-cell expansion associated with severe anemia. AB - A 49-year-old male with an 8 year history of lowered Hb level, granulocytopenia and fatigue presented in 1986 with progressive fatigue, a dramatically reduced Hb level (45 g/l) and an increased lymphocyte count (6.6 x 10(9)/l). Clinical picture and laboratory studies led to the diagnosis of chronic T lymphocytosis with expansion of CD8+ T cells expressing CD16 IgG Fc receptors (Fc gamma RIII). DNA analyzed with T-cell receptor (TcR) gamma and beta probes revealed extra rearranged bands representing a clonal expansion of T lymphocytes. These T lymphocytes expressed T-cell receptor alpha beta as evaluated by staining with monoclonal antibodies. Because of the severe progressive anemia the patient was transfused with packed red cells. He was then treated with cyclophosphamide. After one month of treatment the transfusions could be discontinued and two months later cyclophosphamide treatment was stopped because of normalized Hb level and lymphocyte counts. The patient remained in a hematologically stable condition, though a minor T-cell population representing the clonal expansion, an inverted CD4/CD8 ratio and low immunoglobulin levels persisted. This is the first report of regression of proven monoclonal CD8+ T gamma-cell expansion and the associated anemia following cyclophosphamide therapy. These observations implicate the expanded monoclonal CD8+ lymphocytes in the pathogenesis of the anemia and granulocytopenia. PMID- 1766266 TI - Where does transformation occur in acute leukemia? AB - We studied 43 consecutive cases of acute leukemia for evidence of hybrid leukemia including biphenotypic or bilineal involvement. Twenty-two were initially diagnosed as acute lymphoblastic leukemia (ALL) and 21 as acute myelogenous leukemia (AML). Techniques included morphology, cytochemistry, immune phenotyping and cytogenetics. Thirty-one cases seemed restricted to one lineage. Twelve cases showed involvement of both lymphoid and myeloid cells. Dual staining immune phenotyping showed coexpression of diverse lineage markers. These data indicate a considerable proportion of unselected cases of acute leukemia are hybrid leukemias. These data are consistent with the notion that transformation frequently occurs in a stem or progenitor cell. PMID- 1766267 TI - Nursing care for rural Maine. PMID- 1766268 TI - Collective bargaining--confronting the conflicts. PMID- 1766269 TI - Advance directives. PMID- 1766270 TI - Nursing informatics--a Maine view. PMID- 1766271 TI - Nursing shortage affects students. PMID- 1766272 TI - Collective bargaining: another view. PMID- 1766273 TI - Save our students S.O.S. PMID- 1766274 TI - Resolution approved November 15, 1991 MNA Convention. HIV testing for professionals. PMID- 1766275 TI - The patient had AIDS: facing my fears. PMID- 1766276 TI - AIDS protection is patient's right. PMID- 1766277 TI - Mandatory HIV testing for nurses: yes or no? PMID- 1766278 TI - Testing HCWs: a public misconception. PMID- 1766279 TI - [Prevalence of infection by the human immunodeficiency virus type 1 in drug addicts in Madrid, over a 5 year period]. AB - BACKGROUND: Firstly, to evaluate the annual levels of seroprevalence of antibodies against the type I human immunodeficiency virus in a sample of 1,232 intravenous drug users (IVDU) admitted for treatment to a hospital detoxication unit i Madrid over a period of 5 years. Secondly, attempt to distinguish the existence of variable which differentiate seropositive and seronegative IVDU. METHODS: Data concerning sociodemographic profile and history of addiction were collected. The detection of antibodies vs HIV was carried out by the enzyme immunoanalysis technique which was confirmed by indirect immunofluorescence methods and western blot if positive. RESULTS: There was a diminution in the levels of seropositivity during the 5 years evaluated (74%, 65%, 66%, 62% and 59%, p less than 0.05) with the infection by the HIV being more frequent in those addicted for a longer period of time, with more attempts at treatment, who had initiated drug dependence at an earlier age, had been in prison, and who, apart from heroin, also consumed benzodiacepins++ and/or alcohol. CONCLUSIONS: A decrease in the levels of annual seroprevalence of HIV anti antibodies was found and the group of seropositive IVDU presents particular characteristics emphasizing the need for promoting treatment programs with adequate retention capacity for drug users. PMID- 1766280 TI - [Cryptococcosis of the central nervous system. Clinical and diagnostic characteristics]. AB - BACKGROUND: Evaluation of the clinical features and diagnostic methods in the cryptococcosis of central nervous system (CNS), so as to facilitate a rapid recognition which may result in earlier diagnosis in view of the rapid increase in frequency shown in that condition. METHODS: A retrospective study of 13 patients with CNS cryptococcosis seen during the last 4 years. The isolation of C. neoformans in CSF, cerebral biopsy or other appropriate tissue was required for inclusion. The following were evaluated: 1) Age, sex, and underlying disease; 2) Clinical features; 3) Yield of biochemical, microbiological, pathological and imaging diagnostic procedures; 4) Treatment and evolution. RESULTS: Age (X +/- SD): 37 +/- 20 years (range: 15-81). Sex: 77% males. Underlying disease was identified in 10 cases (77%): HIV infection in 7 (54%), diabetes mellitus in 2, alcohol abuse in 2, systemic erythematous lupus on corticoid and immunosuppressant therapy in 1 and chronic liver disease in 1. Clinical features on admission: abnormal behaviour in 10 (77%), headache in 10, low/high grade fever in 9 (69%), abnormal consciousness in 7, respiratory features in 5 (38%); motor deficit, cranial nerve involvement and visual abnormalities in 4 (31%) each; and meningeal signs in 3. Investigation of CSF was carried out in 12 cases. The biochemical studies were normal in 5 (42%). China ink stain was positive in 55% of cases, and latex agglutination in 80%. CSF culture was diagnostic in 92% of cases and the culture for C. neoformans was positive in 2 cerebral and one pulmonary biopsies and in two urine cultures. All patients were treated with amphotericin B and flucytosine was associated in 9. Two patients were subsequently treated with fluconazole. The outcome was good in 8 patients, and 4 had sequelae. One case relapsed. CONCLUSIONS: 1) HIV infection is the most common underlying disease. 2) There is a high rate of CNS cryptococcosis with normal CSF or with mild biochemical abnormalities. 3) The yield of the microbiological studies of CSF is high, with diagnostic confirmation in 92% of cases. 4) Differences in CNS cryptococcosis were not found between cases with HIV infection and those with other underlying diseases. PMID- 1766281 TI - [Alternatives to traditional cholecystectomy in the treatment of biliary lithiasis]. PMID- 1766282 TI - [Severity and prognostic indexes in intensive care]. PMID- 1766283 TI - [Multi-infarct dementia in giant cell arteritis (temporal arteritis)]. AB - Dementia is an infrequent and little known manifestation of giant cell arteritis or temporal arteritis (GCA-TA). The cases of 2 women with histologically proven GCA-TA are presented in which, together with the most classical symptoms, they presented a brusque mental deterioration on initiation of the disease. One patient developed a severe irreversible dementia which coincided with a rapid reduction in the doses of corticoids; while the other patient demonstrated improvement in cognitive function with steroid treatment and control of the disease. Magnetic resonance studies revealed multiple areas of infarction in both hemispheres in the two patients. The importance of treating multi-infarct dementia is underlined in the context of GCA-TA with high doses of corticoids. It is also emphasized that GCA-TA should be considered in the evaluation of older patients with mental alterations. PMID- 1766284 TI - [Chronic necrotizing pulmonary aspergillosis caused by Aspergillus niger]. AB - Chronic necrotizing pulmonary aspergillosis (CNPA), also known as semi-invasive pulmonary aspergillosis , is a recently defined entity. CNPA is characterized by a pulmonary infiltration with cavitation of chronic evolution in patients with chronic pulmonary disease, slight immunodeficiency or healthy patients. Good evolution is obtained with antimicotic treatment. The isolation of Aspergillus niger as a cause of CNPA is infrequent and may bear worse prognosis. A patient who presented CNPA by Aspergillus niger is described. The patient had received radiotherapy for epidermal carcinoma of the esophagus. Three other cases have been reported in the literature. The diagnostic aspects, treatment and prognostic factors of CNPA are commented upon. PMID- 1766285 TI - [Therapeutic approach to chronic autoimmune thrombocytopenic purpura]. PMID- 1766286 TI - [Intravenous thrombolysis in acute myocardial infarction: expectations and realities]. PMID- 1766287 TI - [Chronic encephalopathy induced by phenytoin]. PMID- 1766288 TI - [Reactive arthritis from Giardia intestinalis]. PMID- 1766289 TI - [Amyloid goiter: clinical presentation form of secondary amyloidosis]. PMID- 1766290 TI - [Determination of steroid hormone receptors in supernatants obtained by low velocity centrifugation. Preliminary study]. PMID- 1766291 TI - [Thrombocytosis as the primary manifestation of an ectopic meningioma]. PMID- 1766292 TI - [Obliterating bronchiolitis in a patient with human immunodeficiency virus infection]. PMID- 1766293 TI - Does intralaryngeal motor nerve sprouting occur following unilateral recurrent laryngeal nerve paralysis? AB - Reinnervation of paralyzed intralaryngeal muscles by axonal sprouting from adjacent intact muscles (the phenomenon of muscular neurotization) has been observed, but the source is uncertain. The potential for laryngeal reinnervation of the posterior cricoarytenoid muscle (PCA) from contralateral PCA motor nerve sprouting in a rabbit model was investigated. Unilateral PCA denervation was produced by vagotomy. The rabbits were examined for signs of PCA recovery for up to 6 months, using fiberoptic endoscopy, electromyography (EMG), and histology. No return of vocal cord abduction, EMG activity, or any nerve sprouting across the midline from the intact PCA was found. We conclude that there is no significant spontaneous intralaryngeal muscular neurotization to the paralyzed PCA. The clinical ramifications of our data will be discussed. PMID- 1766294 TI - Unilateral hearing loss in children. AB - Recent reports suggest that early onset, severe unilateral sensorineural hearing loss (USNHL) in children may be associated with significant deficits in auditory and psycholinguistic skills and school performance. This report reviews a consecutive series of 324 children and adolescents (202 males, 122 females) with documented USNHL evaluated at the Boys Town National Research Hospital. The left ear was affected in 168 (52%) and the right ear in 156 (48%). Based on speech frequency threshold averages (i.e., 500, 1000, and 2000 Hz), the losses were classified by severity as follows: borderline, 43 (13%); mild, 51 (16%); moderate, 40 (12%); severe, 19 (6%); profound, 31 (10%), and anacusic, 50 (15%). The remaining 90 children (28%) had high frequency losses (i.e., above 2000 Hz). The mean and median age of diagnosis were 8.78 years and 7.75 years. Temporal bone imaging studies, auditory brainstem responses (ABRs), and vestibular evaluations were performed on selected cases. Etiology was uncertain in 34.8% of cases, while hereditary factors (12.6%), head trauma (10.8%), and perinatal risk factors (10.7%) were the most commonly identified etiologies. Thirty-one percent of the children had scholastic or behavioral problems in school. A concerted effort aimed at early identification and intervention in cases of USNHL is warranted. PMID- 1766295 TI - The benefits of VII-VII neuroanastomosis in acoustic tumor surgery. AB - Division of the seventh nerve during acoustic tumor removal cannot always be avoided. Direct VII-VII neuroanastomosis is superior to any other neuroanastomosis for facial reanimation. Rerouting of the seventh nerve from the mastoid and neuroanastomosis can be accomplished primarily at the initial surgery. This study reviews 19 patients with a follow-up of greater than 18 months who underwent the procedure at the time of tumor removal because of seventh nerve involvement by tumor, intentional sacrifice or, rarely, unintentional division. A House class IV result or better, without the twelfth nerve neurological deficit produced by a VII-XII neuroanastomosis, was achieved in 16 of 19 patients. Although the technique is not new, surgeons unprepared to manage this surgical complication at primary tumor removal should either learn the technique, work with an associate who can do so, or be prepared to call in someone else to do it. PMID- 1766296 TI - Intraoperative infectious disease exposure to otolaryngology operating room personnel. AB - Health care workers are at risk of exposure to serious infectious diseases. Since the seroconversion rate is approximately 0.4% for human immunodeficiency virus and may be greater than 20% for hepatitis exposure, these risks are substantial. To assess body fluid exposure to otolaryngology operating room personnel, elective operations were prospectively analyzed over 2 months. Statistical evaluation was made between types of cases and length of procedures. Thirty-eight contaminations occurred in 228 operations with 26 torn gloves, 1 soaked grown, 6 skin scratches, 4 skin punctures, and 1 ocular exposure. Exposure was more likely in cases longer than 3 hours. Independent of procedure length, head and neck operations carried the greatest risk, followed by otologic procedures, as compared to general, endoscopic, pediatric, and elective trauma cases. The impact of potential operative exposure and universal precautions is emphasized. PMID- 1766297 TI - The learning curve in stapes surgery. AB - Fewer stapes operations are available to train residents and to maintain individual competence. Most residents in the United States perform 0 to 10 cases during training, and produce results which are not as good as expert results, even with close supervision. After graduation, fewer cases are available to achieve expert results in private or academic practice. The authors' conclusions and recommendations are based on his own learning curve. Residents who have below average skills in middle ear surgery, and residents who do not wish to practice otology, should watch but not perform stapes surgery. Program directors, collectively or separately, should develop more formal guidelines for teaching stapes surgery during residency. PMID- 1766298 TI - Hearing loss and pneumococcal meningitis: an animal model. AB - Clinical studies of predisposing factors in the development of hearing loss secondary to bacterial meningitis have produced conflicting results. An animal model of meningogenic labyrinthitis was developed for more precise study of these parameters. Rabbits were inoculated intrathecally with 10(5) pneumococci to induce meningitis. Hearing thresholds were measured using auditory-evoked responses to 1 kHz, 10 kHz, and click stimuli before infection and every 12 hours thereafter. Profound deafness occurred in all subjects at an average of 48 hours following infection. The incidence and severity of hearing loss was strongly correlated with the duration of meningitis. Temporal bone histology revealed acute inflammation of all perilymphatic spaces including the cochlear aqueduct. This model demonstrated that the risk and severity of hearing loss increase with the duration of meningitis and suggested that the cochlear aqueduct is an anatomic pathway for the extension of infection from the cerebrospinal fluid to the cochlea. The implications for therapy in humans is discussed. PMID- 1766299 TI - Clinical application of saccade-reflex testing in man. AB - Computer-aided measurements of saccade-reflex reaction times, velocities, and accuracies have become important tools in the detection of central nervous system pathology. Because of improved knowledge of the reflex pathways in man, saccade testing can assist in differentiating between brain stem, cerebellar, or cerebral disorders and point toward unilateral lesions. Saccade-reflex testing is also useful in determining disability and measuring over time the course of central nervous system disorders. Further work, correlating lesions observed by high resolution imaging techniques with abnormalities in reflexes, continues to improve the understanding of saccade mechanisms in man. Specific cases are used to show the effects of anatomic lesions on changes in saccade reflexes. The results from 100 consecutive patients evaluated for dizziness are provided in order to illustrate the prevalence of saccade abnormalities and the relationship between abnormalities in vestibular and slow and fast eye-movement reflexes. Patients complaining of disequilibrium and visual disturbances frequently have abnormalities in the saccade system, abnormalities which are often overlooked in present clinical testing of the dizzy patient. PMID- 1766300 TI - Magnetic field changes associated with caloric stimulation of the human vestibular organ. AB - Caloric stimulation of the ear produces a shift of the vestibular resting potential. The current produced by the change in this potential produces a corresponding change in the associated magnetic field. A sensitive magnetic detector (second-derivative gradiometer) was used to detect a large shift in the magnetic field close to the ears of two normal subjects who underwent cold thermic ear stimulation. The shift in the magnetic field tracked the reflex responses in both individuals. This technique could offer a noninvasive direct measure of end-organ function. PMID- 1766301 TI - On the pathomechanism of cochlear dysfunction in experimental perilymph fistulas. AB - The mechanism leading to hearing impairment in perilymph fistulas was investigated in guinea pigs with perforated round window membranes (RWM) by analyzing alterations of inner ear fluid pressure, changes of auditory function following manipulations to get presumed air bubbles out of the cochlea ("positional audiometry"), and temporal bone sections. The instantaneous loss of normal positive inner ear fluid pressure after RWM perforation had no immediate effect on auditory function. Inner ear pressure was restored 4 days following RWM perforation. "Positional audiometry" was negative in guinea pigs with perforated RWM. All ears in which auditory thresholds had increased had additional iatrogenic lesions at the spiral lamina. Fistulas in the RWM per se do not affect auditory thresholds. The question of the surgical repair of fistulas was not directly addressed; it only can be concluded that there are no direct sequelae of an isolated fistula which induce auditory impairment and which could be prevented by surgical repair of the fistula. PMID- 1766302 TI - A model for multidisciplinary data collection for cervical metastasis. AB - A system for multidisciplinary data collection for metastatic neck disease is discussed. Information from 87 neck dissections and 3218 lymph nodes is reported to illustrate the strength of the model. Clinical (endoscopic) assessment under general anesthesia, surgical assessment during the neck dissection, and radiographic (computed tomographic scan) assessment were compared with the pathological evaluation. All disciplines stratified the necks by region and node size. This model provides an effective stratagem for multi-institutional studies. PMID- 1766303 TI - Histopathologic changes in snoring and obstructive sleep apnea syndrome. AB - The pathophysiologic events that lead to the loss of airway compensation in obstructive sleep apnea (OSA) are poorly understood. The development of airway instability may be secondary to changes in neurologic control, airway morphology, or both. To identify potential histopathologic features of pharyngeal tissues that may contribute to OSA, transverse sections of the distal soft palate and uvula were qualitatively compared using light and electron microscopy from 4 severe apneics (greater than 50 apnea/hour), 4 severe snorers (less than 20 apnea/hour), and 4 nonsnorers. Light microscopy of both apneics and snorers revealed mucous gland hypertrophy with ductal dilation and focal squamous metaplasia, disruption of muscle bundles by infiltrating mucous glands, focal atrophy of muscle fibers, and extensive edema of the lamina propria with vascular dilation. Severe snorers did not differ qualitatively from apneics in the characteristic changes found; however, some snorers had less extensive changes. No distinctive histopathologic findings could be associated with the development of apnea. Electron microscopy of severe apneics identified frequent focal degeneration of myelinated nerve fibers and axons. The finding of similar histopathologic changes in apneics and severe snorers supports previous speculation of a common etiology not directly related to apnea, such as vibratory trauma to pharyngeal tissues. Degenerative changes in peripheral nerves, identified on electron microscopy, however, may contribute to airway instability and the development of obstructive apnea by impairing pharyngeal reflexes. PMID- 1766304 TI - Technical modifications of uvulopalatopharyngoplasty: the role of the palatopharyngeus. PMID- 1766305 TI - Intermaxillary fixation with intraoral cortical bone screws. PMID- 1766306 TI - Isolated vestibulocochlear dysfunction of central or peripheral vascular origin. PMID- 1766307 TI - Lipoinjection for vocal cord paralysis. PMID- 1766308 TI - Facial reanimation. PMID- 1766309 TI - Spinal accessory nerve preservation. PMID- 1766311 TI - Magnetic resonance imaging. Proceedings of the First International Meeting on Recent Advances in NMR Applications to Porous Media. Bologna, Italy, 14-16 November 1990. PMID- 1766310 TI - The problem of pediatric laryngotracheal stenosis: a clinical and experimental study on the efficacy of autogenous cartilaginous grafts placed between the vertically divided halves of the posterior lamina of the cricoid cartilage. AB - Acquired laryngotracheal stenosis is a well-documented complication of endotracheal intubation. Severe acquired laryngotracheal stenosis in children responds to surgical reconstruction, including the use of grafts and stents. The most commonly described graft material is autogenous cartilage, placed in the anterior laryngotracheal complex. The role of autogenous cartilaginous grafts sewn between the divided lamina of the posterior cricoid cartilage is less well established. Several authors report good clinical results using autogenous cartilaginous grafts to the posterior larynx; the single reported animal study of grafts to the posterior larynx failed to show significant benefit. This study was undertaken to examine the hypothesis that there is no difference in survival of anteriorly placed or posteriorly placed cartilaginous grafts in the larynx of growing rabbits, and to report on 61 pediatric patients with laryngotracheal stenosis treated with autogenous cartilaginous grafts placed between the vertically divided posterior lamina of the cricoid cartilage. The animal study showed that posteriorly placed grafts survived with viability equal to or better than that of anteriorly placed grafts. The clinical study showed that 59 of the 61 patients were decannulated with satisfactory vocal quality, good exercise tolerance and sleep patterns, and with no mortality. PMID- 1766312 TI - Magnetization transfer contrast (MTC) in flash MR imaging. AB - Magnetization transfer between bound and free protons was used as a source of contrast in high speed MR imaging using the FLASH technique. Contrast in FLASH MR images was found to depend upon the reduced magnetization and the spin lattice relaxation rate of free protons in the presence of bound proton radio-frequency saturation. MTC FLASH imaging was thus used to estimate the variation with saturation frequency of free proton spin-lattice relaxation during magnetization transfer. PMID- 1766313 TI - Investigation of cerebral ischemia using magnetization transfer contrast (MTC) MR imaging. AB - The effects of cerebral ischemia in rat brain were monitored as a function of time using proton MR imaging. Spin-spin relaxation time (T2), proton density, and magnetization transfer contrast (MTC) were measured by MR imaging at various time intervals during a 1-week period following the induction of ischemic damage. Ischemic injury was characterized by a maximization of both T2 value and MTC appearance at 24 hr postischemic injury. These changes were accompanied by a gradual increase in MR observable water density over the first few days of ischemia. A reduction in the magnetization exchange rate between "free" and "bound" water protons as measured by MTC imaging is at least partially responsible for the elevation in T2 values observed during ischemia, and may accompany breakdown of cellular structure. PMID- 1766314 TI - An optimized multislice acquisition sequence for the inversion-recovery MR imaging. AB - An optimized multislice data acquisition scheme for inversion-recovery MR imaging is proposed and experimental results are presented. In this new scheme, instead of forming a set of multislice inversion-recovery sequences in series for a given phase encoding step, 180 degrees inversion pulses corresponding to different slices are interwoven with the spin echo data acquisition sequence in an optimal way depending on the desired inversion-recovery time. For example, between the 180 degrees inversion RF pulse and the spin-echo imaging sequence, a number of imaging and inversion sequences are inserted with different slice combinations, i.e., long inversion-recovery time is effectively utilized for the other slice pre-inversion and data acquisition. With the optimized sequence, imaging time has been reduced by as much as a factor of four compared with the existing methods. PMID- 1766315 TI - 1D spectroscopic imaging with rf echo planar (SIRFEN) methods. AB - A recently developed rf echo planar imaging method has been modified to rapidly generate spectroscopic information along one in-plane axis and spatial information along the other. The method allows the production of one-dimensional chemical shift images (1D CSIs) in acquisition times of 18 sec or less. A specific phase-encode-reordering algorithm provides convenient manipulation of T2 weighting, yielding partial suppression of short T2 species like muscle water. The method is demonstrated in phantoms and in vivo with 1D CSIs of human brain and limbs. Abnormal fat distribution is demonstrated in the calf of a patient with aggressive fibromatosis. The advantages of short acquisition times obtainable with SIRFEN are offset by limited spectral resolution, suggesting that primary applications will be confined to rapid spatial mapping of major spectral components. PMID- 1766316 TI - The application of total vertical projections for the unbiased estimation of the length of blood vessels and other structures by magnetic resonance imaging. AB - A new stereological method has recently been developed to estimate the total length of a bounded curve in 3D from a sample of projections about a vertical axis. Unlike other methods based on serial section reconstructions, the new method is unbiased (i.e., it has zero systematic error). A basic requirement, not difficult to fulfill in many cases, is that the masking of one structure by another is not appreciable. The application of the new method to real curvilinear structures using a clinical magnetic resonance (MR) imager is illustrated. The first structure measured was a twisted water-filled glass tube of known length. The accuracy of the method was assessed: With six vertical projections, the tube length was measured to within 2% of the true value. The second example was a living bonsai tree, and the third was a clinical application of MR angiography. The possibility of applying the method to other scientific disciplines, for example, the monitoring of plant root growth, is discussed. PMID- 1766317 TI - Signal-to-noise improvement in mid-field MRI surface coils: a degree in plumbing? AB - From a series of standard SE imaging sequences, performed on a Bruker 0.28 T imaging system, with the assistance of a healthy volunteer, the image signal-to noise (S/N) ratio obtained from a 23-cm square surface coil has been shown to increase by up to 38% as the tube gauge is increased from 4 to 18 mm. The reason did not lie solely in the much improved Q factor of the unloaded coils. Despite a more than twofold increase in the unloaded Q factor, the loaded coil Q values only increased by 8%. It would appear, however, that the resistive, dielectric and inductive noise components are all reduced, and hence contribute to the observed improved S/N. The reduction in pure ohmic losses accounts for a quarter of the improved S/N, while the reduced inductive and dielectric losses provide the remaining three quarters. No independent quantification of the two latter noise sources was attempted, although a reduced dielectric contribution is confirmed qualitatively by a reduction in the negative frequency shift of the resonance frequency as a function of increasing coil gauge when the coil is loaded. PMID- 1766318 TI - Magnetic resonance imaging with superparamagnetic iron oxide particles for the detection of myocardial reperfusion. AB - The effect of superparamagnetic iron oxide particles on magnetic resonance myocardial signal intensity was examined in order to define the ability of this agent to identify normal, ischemic, and reperfused myocardium. Data were obtained from 6 normal rats (group 1) and from 6 heterotopic isogenic rat heart transplants (group 2) at 4.7 T with a multislice spin-echo sequence. Images were acquired in (a) normal rats before and after the infusion of 36 mumol Fe/kg of AMI-25 (group 1) and (b) rat heart transplants during control, global myocardial ischemia (before and after the injection of 72 mumol Fe/kg of AMI-25), and following reperfusion (group 2). Myocardial signal intensity decreased by 36 +/- 4%, p less than 0.001, following contrast infusion in normal hearts (group 1). The intensity remained constant in the rat heart transplants (group 2) during coronary occlusion, both before and after the infusion of AMI-25 and decreased by 61 +/- 7%, p less than 0.001, upon reperfusion. The larger effect of AMI-25 in reperfused as compared to normal myocardium suggests the presence of ischemia induced hyperemia. There was no significant difference (analysis of variance) among intensities from different myocardial regions in either group at any stage of the experiment. We conclude that the use of AMI-25 permits identification of normal, ischemic, and reperfused myocardium and may therefore be helpful for the early detection of reperfusion following thrombolytic therapy for acute myocardial infarction. PMID- 1766319 TI - Primary lymphoma of the cervix: MRI findings with gadolinium. AB - MRI evaluation of primary cervical lymphoma has not been reported. We report such a case of primary cervical lymphoma, a lesion well seen and well delineated from normal tissue by MRI. Although primary lymphoma of the cervix is a rare entity, the disease does exist and can be well demonstrated by MRI. We evaluated the MR appearance of this lesion with both nonenhanced and gadolinium-enhanced imaging. PMID- 1766320 TI - Osteomyelitis: sensitivity of 0.064 T MRI, three-phase bone scanning and indium scanning with biopsy proof. AB - We compared the ability of magnetic resonance imaging (MRI) using a 0.064 T permanent magnet, three-phase bone scanning, and indium-labeled white blood cell (111In-WBC) scanning, to diagnose osteomyelitis. Twenty-three patients underwent biopsy. All patients were examined at presentation with all three modalities. Sensitivities for each modality were calculated using biopsy as a gold standard. The results were 72% for MRI, 68% for bone scan, and 45% for 111In-WBC. Specificities were not calculated because of lack of negative biopsies. MRI was as sensitive as bone scanning in the diagnosis of osteomyelitis. All modalities had lower than previously reported sensitivities for imaging osteomyelitis. PMID- 1766321 TI - MR imaging of hand and wrist with a dedicated 0.1-T low-field imaging system. AB - We describe the first results of a new magnetic resonance imaging (MRI) system specially developed for hand and wrist imaging. The system uses a small resistive water-cooled magnet with a vertical magnetic field of 0.1 T in an air gap of 15 cm. The console is based on a microcomputer with a vector signal processor and an image-processing board. There is actually no Faraday cage. For the whole hand, the in-plane spatial resolution is less than 1 mm in the 128 x 128-pixels format for typical slice thicknesses of 3 to 5 mm. Solenoidal volume coils for fingers were developed, giving, in the same matrix format, an in-plane high spatial resolution of 0.22 mm for a typical slice thickness of 3 mm. PMID- 1766322 TI - Magnetic resonance imaging of an infected urethral diverticulum: a case report. AB - We present a case report of a urethral diverticulum where magnetic resonance imaging suggested infected contents of the urethral diverticulum besides providing superb detail of periurethral anatomy. The critical clinical question was answered. PMID- 1766323 TI - Effects of radiation therapy on the human normal brain (white matter) visualized by MR imaging. AB - Sequential MR imaging could provide information related to the pathological changes due to the application of external cytotoxic agents such as radiotherapy on the central nervous system. This paper describes the results of our attempt to demonstrate short-term changes associated with normal brain during and immediately following radiotherapy when the whole brain is irradiated for malignant conditions. No observable changes were found in the normal brain parenchyma in any of the patients (n = 8) in T1-, T2-, and proton-density weighted images in the sequential scans in the first and second weeks and immediately following radiotherapy. Also, no changes were observed in the normal brain appearance at 2 mo (n = 6), up to 6 mo (n = 1), and up to 15 mo (n = 1) after completion of radiotherapy. PMID- 1766324 TI - An NMR study of the interaction between melanin free acid and Mn2+ ions as a model to mimic the enhanced proton relaxation rates in melanotic melanoma. AB - The interaction of a soluble Melanin Free Acid (MFA) from Sepia melanin with Mn2+ ions is investigated by measuring the proton water relaxation rates. The similarity between MFA and the parent melanin is assessed by means of their high resolution 13C cross polarization magic angle spinning NMR spectra. The observed marked increase in longitudinal proton relaxation rates and the characteristic 1/T1 NMRD profile are associated to the formation of a macromolecular metal complex. The presence of similar paramagnetic species is expected to cause the high contrast shown by melanotic tissues in MRI. PMID- 1766325 TI - In vivo boron-11 MRI and MRS using (B24H22S2)4- in the rat. AB - In vivo boron-11 magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) were performed on a rat that had been infused with a potential boron neutron capture therapy agent, Na4B24H22S2, using methods for detecting nuclei with a short T2 relaxation time. MRI and MRS were also performed on a euthanized rat that had been similarly infused in vivo. Boron-11 spectral intensities decreased in the living rat over a 25-h period. The results demonstrate the capability of MRI and MRS to noninvasively monitor the distribution and excretion of boron agents in vivo. PMID- 1766326 TI - Comparison of agarose and cross-linked protein gels as magnetic resonance imaging phantoms. AB - Measurements of the magnetic field dependence of spin-lattice relaxation rates and the response of the water-proton signal intensity to off-resonance radio frequency fields show that the commonly used agarose phantom provides a less faithful representation for the magnetic response of tissue than does a cross linked protein system. The origin of these differences lies in the structure and intramolecular dynamics of the macromolecular system used to make the gel. These distinctions will also cause differences in the magnetic response of the water spin system when paramagnetic relaxation agents or contrast agents are incorporated. Use of a thermally cross-linked bovine serum albumin phantom is suggested. PMID- 1766327 TI - Information gathering and integration as sources of error in diagnostic decision making. AB - This research examined the relative importance of information gathering versus information utilization in accounting for errors in diagnostic decision making. Two experiments compared physicians' performances under two conditions: one in which they gathered a limited amount of diagnostic information and then integrated it before making a decision, and the other in which they were given all the diagnostic information and needed only to integrate it. The physicians: 1) frequently failed to select normatively optimal information in both experimental conditions; 2) were more confident about the correctness of their information selection when their task was limited to information integration than when it also included information gathering; and 3) made diagnoses in substantial agreement with those indicated by applying normative procedures to the same data. Physicians appear to have difficulties recognizing the diagnosticity of information, which often results in decisions that are pseudodiagnostic or based on diagnostically worthless information. PMID- 1766328 TI - Modeling time in medical decision-support programs. AB - To derive meaningful conclusions in a changing medical setting, medical decision support systems must represent and reason about the temporal nature of the clinical environments they attempt to model. Because all difficult medical problems have significant temporal features, designers of medical decision support systems must recognize the unique problems caused by representing and reasoning with temporal concepts. This report has three goals: 1) to describe a set of fundamental issues in creating and reasoning with computer models of a changing clinical environment, 2) to present a taxonomy for characterizing the temporal characteristics of computer models of temporal reasoning, and 3) to use this taxonomy to compare the models of time used in some implemented medical decision-support programs. From this examination, it is argued that computational models of time based on a single uniform representational or inferential method are limited by the expressive power of that method. Multiple modeling formalisms that express different temporal properties of the domain task and that work cooperatively are required to capture the subtlety and diversity of temporal features used in expert clinical problem solving. As an example of this approach, the author describes a program called TOPAZ that contains two temporal models that represent different temporal features of the clinical domain. PMID- 1766329 TI - A randomized comparison of alternative formats for clinical simulations. AB - Computer-based clinical simulations for medical education vary widely in structure and format, yet few studies have examined which formats are optimal for particular educational settings. This study is a randomized comparison of the same simulated case in three formats: a "pedagogic" format offering explicit educational support, a "high-fidelity" format attempting to model clinical reasoning in the real world, and a "problem-solving" format that requires students to express specific diagnostic hypotheses. Data were collected from rising third-year medical students using a posttest, attitudinal questionnaire, students' write-ups of the case, and log files of students' progress through the simulation. Student performances on all measures differed significantly by format. In general, students using the pedagogic format were more proficient but less efficient. They acquired more information but were able to do proportionately less with it. The results suggest that the format of computer based simulations is an important educational variable. PMID- 1766330 TI - Verbal expressions of probability in informed consent litigation. AB - Informed consent litigation provides a forum in which probabilistic evidence is elicited from physicians as parties or as expert witnesses. The authors reviewed over 450 medical informed consent opinions reported by both trial and appellate courts in all 50 states over 40 years to determine 1) the extent to which verbal expressions of probability were used by testifying physicians to characterize the risks of medical procedures; 2) when such expressions were used, whether consistent numeric interpretations of the terms were being applied by the physicians; 3) whether the choice of expression was influenced by the severity of the consequences associated with the particular risk; and 4) whether the use of such terms was correlated with trial outcomes, inasmuch as the duty to disclose a risk is said to increase with the magnitude of the risk and probability is one measure of such magnitude. It was found that subjective verbal expressions of probability are used in the litigation setting, and that such expressions represent broad ranges of numeric probabilities. There was some correlation between the expression and the represented numeric probabilities. In general, expressions such as "extremely low" and "low" corresponded to probabilities lower than those represented by terms such as "high" and "very high." Further, verbal expressions appeared to be influenced by the severity of the consequences associated with the risks, but whether this increases or decreases the ambiguity of verbal expressions in the communication process warrants further research. The authors suggest a syntax of verbal expressions of probability as a means to reduce the numeric ambiguity of these terms. PMID- 1766331 TI - Routine neonatal circumcision: a cost-utility analysis. AB - A cost-utility analysis was performed to evaluate the relative importance of each of the various elements in the current circumcision debate. Elements used in the analysis included the cost of the procedure, the pain associated with the procedure, the risk of urinary tract infections, and the risk of penile cancer. The net, discounted lifetime dollar cost of routine circumcision is $102 per person, while the net, discounted lifetime health cost is 14 hours of healthy life. These results suggest that the financial and medical advantages and disadvantages of routine neonatal circumcision cancel each other and that factors other than cost or health outcomes must be used in decision making. PMID- 1766332 TI - Continuous-risk utility assessment in medical decision making. AB - The authors argue that for risky medical treatment decisions, conventional utility assessment techniques are inadequate due to their emphasis on unrealistic risk magnitudes and sure consequences, leading to assessment questions that are unfamiliar to most patients, have little educational value, and do not reliably extend to the application at hand. As an alternative, medical utility assessments should be performed in a continuous-risk domain with risk levels matching those of the actual decision problem. In support of this position, the authors describe an empirical study that compares the responses of subjects under a conventional assessment protocol with those of subjects under a continuous-risk utility assessment protocol. Preliminary results show that conventional assessment protocols result in significantly lower estimates of the degrees of risk aversion compared with a more realistic continuous-risk protocol. PMID- 1766333 TI - Causal and conditional reasoning. PMID- 1766334 TI - Now I know what nursing is all about. PMID- 1766335 TI - A young wrestler with antecedent both-knee Osgood Schlatter's disease and JOCD. AB - A 15-yr-old high school wrestler with an antecedent history of bilateral knee Osgood Schlatter's disease and juvenile osteochondritis dissecans (JOCD) presented with a 6-month complaint of episodic bilateral knee pain. History and physical examination results were consistent with a diagnosis of patello-femoral dysfunction secondary to prior intraarticular knee pathology. Radiographic evaluation demonstrated resolution of the previous osteochondral defects in both femoral condyles. After participating in a short course of supervised rehabilitation, the athlete was able to return to full activity. Review of the patient's record since initial diagnosis of bilateral Osgood Schlatter's disease and JOCD suggested a delay in diagnosis secondary to previously existing knee pathology. Informed consent was obtained from the subject and respective guardian prior to preparation of this case review. PMID- 1766336 TI - Effects of a resistive training program on lipoprotein--lipid levels in obese women. AB - The purpose of this study was to determine the effects of a resistive training program on the time course of changes in strength, body mass index, lipids, lipoproteins, and apolipoproteins in sedentary obese women. Sixteen sedentary obese women strength trained 3 times . wk-1 for 12 wk performing three sets of six to eight repetitions per set with sets 1 and 2 at 60-70% of one-repetition maximum. During set 3, the subjects used the greatest weight possible so that failure occurred between six to eight repetitions. Six sedentary obese women served as controls. Blood samples for serum total cholesterol (TC), high-density lipoproteins (HDL-C), low-density lipoproteins (LDL-C), triglycerides (TG), TC/HDL-C ratio, apolipoprotein A-I (apo A-I), and apolipoprotein B-100 (apo B 100) were obtained pre, and after 4, 8, and 12 wk of training and approximately 3 4 d following the last training session. A 3-d dietary record was obtained on all subjects pre and post, and subjects were instructed not to alter their diet. The 12 wk of resistive training did not result in a significant change in body weight, BMI, or total kilocalories consumed per day but did show a mean improvement of 58% in muscular strength (P less than 0.05). The training program did not significantly alter the TC, HDL-C, LDL-C, TG, TC/HDL-C ratio, apo A-I, or apo B-100 levels, which suggests that this increase in strength owing to resistive training in the absence of body weight loss did not alter the lipid profiles in these sedentary obese women. PMID- 1766337 TI - Bone mineral density of the calcaneus in 70- to 81-yr-old male athletes and a population sample. AB - Bone mineral content (BMC/W) and density (BMD) were studied in 70- to 81-yr-old active male endurance-trained (long-distance runners, cross-country skiers, N = 67), strength-trained (throwers, weight-lifters, N = 14), and speed-trained (sprinters, jumpers, N = 16) athletes. A population sample of similar age (N = 42) served as a control group. The measurements were performed at the calcaneus by single-energy photon absorption. The endurance-trained athletes had higher bone width and depth, and the strength and speed-trained athletes higher bone depth than the control subjects. The three groups of athletes showed 19-28% higher BMC (g.cm-1) and BMC/W (g.cm-2) than the control group (P less than 0.01 0.001). When the results were corrected for bone depth by assessing BMD (g.cm-3), the mean differences between the athletes and controls were 11-16% (P less than 0.05-0.01, not significant for the strength group). The highest BMD values were associated with moderate training for running and cross-country skiing. BMD did not correlate with serum total testosterone, but there was a negative correlation between BMD and sex hormone binding globulin and a positive correlation between BMD and the free androgen index in the endurance group. The results indicate that athletes having a long-term training history and being still active at over 70 yr of age preserve superior trabecular bone mass compared with the average male population of the same age. PMID- 1766338 TI - The cytoskeleton of skeletal muscle: is it affected by exercise? A brief review. AB - The myofibrillar cytoskeleton of skeletal muscle is made up of two distinct sets of filaments, the exosarcomeric cytoskeleton and the endosarcomeric cytoskeleton. The exosarcomeric cytoskeleton consists of intermediate filaments (IF) composed of the proteins desmin, vimentin, and synemin. The IF are arranged both longitudinally and transversely around the fiber. The longitudinal filaments run from Z-disc to Z-disc, enveloping the myofibril in order to serve as attachment sites for mitochondria, nuclei, and the sarcolemma, as well as limiting the sarcomere's extensibility. The transverse filaments link adjacent myofibrils at the Z-disc and are responsible for the fibril's axial register, and thus the striated appearance of muscle. The endosarcomeric cytoskeleton acts as a third filament system that coexists with actin and myosin within the sarcomere. This system is believed to be extensible and is made up of the giant proteins, titin and nebulin. Titin is believed to be responsible for resting muscle elasticity, as well as the central position of myosin in the sarcomere. Nebulin's role is proposed to be the maintenance of actin's lattice array. Following various types of intense exercise, pathological changes in muscle morphology have been documented. These include Z-disc streaming, sarcomerogenesis, and decentralization of myosin filaments within the sarcomere. It is hypothesized that disruption of the transverse IF system may cause Z-disc streaming, whereas degradation of titin filaments may affect myosin's position in the sarcomere. PMID- 1766339 TI - Elevated body temperature in female rats after exercise. AB - Female Sprague-Dawley rats living in basin cages (sedentary rats) under a 12:12 light-dark cycle normally have body temperatures (Tb; measured via telemetry) that vary from a mean peak of 38.1 +/- 0.1 degrees C in the dark to a mean trough of 36.0 +/- 0.1 degrees C C in the light. We have found that if rats are housed in activity wheels, their mean peak Tb in the dark, when they run in the wheels, rises to about 39.5 degrees C. Mean trough Tb in the light also rises, to about 36.5 degrees C, although they never or very rarely run in the wheels in the light. Other rats were rotated through two cycles of wheel-open (WO) and wheel locked (WL) conditions. During the first WO cycle their mean Tb in the dark gradually rose over the first 2 wk, and their mean Tb in the light gradually fell. In the first WL, mean Tb in the dark fell immediately to sedentary levels, and mean Tb in the light fell more gradually. In the second WO condition, both dark and light Tb rose almost immediately. Since rats in locked wheels have Tb similar to sedentary controls, these results support the hypothesis that steady exercise at night results in an upward resetting of a thermoregulatory set-point during the day. PMID- 1766340 TI - Inheritance of acute cardiac changes during bicycle exercise: an echocardiographic study in twins. AB - The inheritance of cardiac changes during acute dynamic physical exercise was studied in 21 pairs of monozygotic and 12 pairs of dizygotic male twins, ages 18 31 yr. Echocardiography was performed in resting conditions and at submaximal supine bicycle exercise at a heart rate of 110 bpm. In resting conditions significant heritability could be demonstrated for end-diastolic mean wall thickness, but not for left ventricular diameter and fractional shortening. Also for the change of mean wall thickness from rest to exercise, no significant heritability could be demonstrated. The increase of end-diastolic left ventricular internal dimension from rest to exercise showed a genetic component of 24% (P less than 0.05). Inheritance accounted for 47% (P less than 0.001) of the total phenotypic variance of the increase of fractional shortening from rest to exercise. In conclusion, the data suggest that the capacity of increasing end diastolic left ventricular internal dimension and increasing fractional shortening during submaximal exercise has, unlike findings at rest, a significant genetic component. PMID- 1766341 TI - Effect of an endurance triathlon on pulmonary function. AB - We assessed the effect of an endurance triathlon consisting successively of a 3.8 km swim, a 180-km bicycle ride, and a 42-km run on the forced expiratory spirogram, indices of inspiratory and expiratory muscle strength (PImax and PEmax), and maximal voluntary ventilation (MVV). Twelve male participants were recruited from competitors in the Cape Cod Endurance Triathlon and underwent studies on the afternoon before the event, after each segment, and on the following morning. Participants averaged 32.9 yr of age. All completed the triathlon with an average finishing time of 12 h 45 +/- 90 min. Following completion of the triathlon, statistically significant declines occurred in FVC (7.1%), FEV1 (8.4%), FEF25-75% (15.2%), and FEF50% (18.6%), but not in MVV. On the morning after the triathlon, only FEV1 remained significantly below baseline. PImax was not significantly reduced after the swim, but significant reductions did occur after the bicycle and running events (26% and 25%, respectively); full recovery had occurred by the following morning. PEmax did not change significantly. We conclude that vital capacity, flow rates at mid-lung volumes, and inspiratory muscle strength decline as a consequence of participation in a triathlon. PMID- 1766342 TI - Effects of endurance training and long distance running on blood viscosity. AB - The effect of endurance training on blood viscosity was studied by comparing blood rheological properties in control subjects (untrained) and endurance trained subjects. The effect of running on blood viscosity was studied in the 33 endurance trained subjects before and after a 48-km mountain race (Sandia Wilderness Crossing Research Run). Runners started at an altitude of 1700 m, ran 26 km to 3300 m, then descended 22 km to finish at 1900 m. Venous blood viscosity (eta b) and plasma viscosity (eta p) were measured at 37 degrees C at shear rates of 11.25, 22.5, 45, 90, and 225.s-1, using a cone-plate viscometer. Endurance trained subjects had significantly higher pre-race blood viscosity at 11.25 and 22.5.s-1 than control subjects but similar plasma viscosity and hematocrits. Following the race, there was no significant change in mean hematocrit, but eta b increased significantly at all shear rates except 225.s-1. Plasma viscosity at 225.s-1 increased significantly from 1.44 to 1.53 cP following the run. Since eta b did not increase, an increase in red cell deformability is inferred. The mechanism of the increase in eta b at lower shear rates in runners is due in part to the higher plasma viscosity. An additional mechanism at lower shear rates is in an increase in red cell aggregation. Increased plasma fibrinogen was measured in six of six resting subjects taken from 1600 m to 3300 m and is speculated to be the mechanism of enhanced aggregation and deformability in the runners. PMID- 1766343 TI - Reexamination of Stewart's quantitative analysis of acid-base status. AB - To provide experimental verification to Stewart's quantitative approach to acid base analysis, the effects of acute maximal treadmill exercise (VO2max test) on venous acid base status were studied in 17 male subjects aged 18-23 yr. Venous CO2 tension (PCO2) total plasma proteins ([PTOT]), [H+], and concentrations of strong ions [( Na+], [K+], [Cl-] and lactate ion concentration ([La-]) were measured before and within 1 min post-exercise. Mean post-exercise PCO2, [PTOT], [K+], and [La-] were significantly higher than the corresponding pre-exercise values (P less than 0.05), there was a strong tendency for a significant change in [Na+] (P less than 0.056), and no changes were found in [Cl-]. Changes in venous acid-base status were analyzed quantitatively by applying relevant physicochemical theory. Altered values measured in the independent variables ([PTOT], PCO2, and net strong ion difference, [SID]) were used to calculate the corresponding changes in the dependent quantities. Comparison of individual measured and calculated values for the only one of these that is normally measured, ([H+]), yielded the theoretically expected agreement. PCO2 and [SID] changes accounted for most [H+] changes. These results demonstrate the usefulness of the quantitative approach (i.e., [H+]-PCO2 diagram) in the analysis and in understanding of plasma acid base changes with exercise and in clinical situations. PMID- 1766344 TI - Estimates of Type A behavior do not predict perceived exertion during graded exercise. AB - Earlier studies have concluded that exercise tolerance during graded stress testing is overestimated in males showing the Type A Behavior Pattern (TABP) because of high motivation and suppressed ratings of perceived exertion (RPE). However, the studies used the Jenkins Activity Survey (JAS) to assess TABP and employed exercise protocols that were unstandardized or uninterpretable for clinical prescription. Because the JAS lacks validity for predicting the criterion Structured Interview (SI) for TABP, the usefulness of concurrent self report estimates of TABP for predicting RPE during standard exercise testing warrants additional study. During clinical treadmill testing of 86 asymptomatic Caucasian men (45 +/- 9 yr), we examined three standard estimates of TABP (JAS, Bortner, Framingham) as predictors of: 1) the covariance (RPE') of RPE (Borg Category Scale) with VO2 (ml.kg-1.min-1) during 5 min of graded walking (5.47 km.h-1, 2.25%.min-1); 2) VO2 and RPE (11.6 +/- 2.2) at a preferred level of exertion (approximately 65% +/- 10% VO2PEAK); 3) VO2PEAK and RPE at VO2PEAK. Multiple linear regression analyses found no relations (P greater than 0.10) between estimates of TABP and treadmill responses. Discriminant analyses of Type A and Type B groups formed from tertiles consistent with population norms showed no differences (P greater than 0.01) for RPE of treadmill performance. Our findings question prior reports of RPE suppression associated with TABP estimates. We conclude that practically implementable estimates of TABP do not offer useful information for clinical predictions of RPE, preferred exertion level, or VO2PEAK in asymptomatic middle-aged Caucasian men. PMID- 1766345 TI - Effects of nicotine on perceived exertion during low-intensity activity. AB - Nicotine may decrease perceived exertion during physical work, which may be a potentially reinforcing effect of tobacco smoking. This study examined the effects of nicotine on ratings of perceived exertion (RPE) during low-intensity physical activity representative of activity normally engaged in by adult smokers. Ten male and 10 female smokers participated in four morning sessions, one for placebo and each of three nicotine doses (7.5, 15, and 30 micrograms.kg 1), which were administered by measured-dose nasal spray. Using a bicycle ergometer, subjects exercised at each of two lower power outputs (30 and 60 W) before and after nicotine dosing, while RPE and cardiovascular measures of heart rate and systolic and diastolic blood pressure were obtained. Results indicated no significant effect of nicotine on RPE for either males or females. In contrast, nicotine significantly increased each cardiovascular measure during activity, confirming that cardiovascular responses during exercise do not mediate RPE. Thus, nicotine did not influence perception of exertion during low-intensity physical activity. PMID- 1766346 TI - Moment-length relations of rectus femoris muscles of speed skaters/cyclists and runners. AB - The purpose of this study was to investigate the possible existence of systematic differences between moment-length properties of the rectus femoris muscle of cyclists/speed skaters and runners. In cycling/speed skating the rectus femoris is used at a shorter length than in running because of the pronounced flexion at the hip joint. It was speculated that using the rectus femoris chronically at different lengths would result in different moment-length relations for the two groups of athletes. Moment-length relations of rectus femoris muscles were determined using an adaptation of procedures outlined in the literature. Four subjects in each group performed 13 isometric knee extensions on a Cybex II dynamometer in each of three testing sessions. Knee and hip angles were varied in a systematic way to allow the determination of moment-length relations over a wide range of normal rectus femoris lengths. It was found that cyclists tended to be stronger at short compared with long rectus femoris lengths, whereas the opposite was true for runners. This finding may be associated with an adaptation of the rectus femoris muscle to the requirements of cycling and running or may show an inherited difference in the muscles of the athletes that existed before they became involved in their respective sports. The data of this study do not allow us to distinguish between these two possible factors. PMID- 1766347 TI - Physiological and kinanthropometric attributes of elite flatwater kayakists. AB - Physical and physiological factors accounting for the variability of performance in 500, 1000, 10,000, and 42,000 m flatwater kayaking were investigated using linear regression. Times achieved for each distance were used as the dependent variable for analysis while the independent variables were the parameters derived from the test battery. The 38 kayakists who participated were categorized as either state team members or nonselected paddlers, based on an objective selection policy. Several of the participant subjects were Australian international representatives. All selected paddlers were grouped together and Student's t-tests performed to determine which variables could distinguish between selected and nonselected paddlers. Simple regression was used to determine the strength of association of each parameter with performance time over each race distance, and multiple regression was used to generate equations for the prediction of performance times. Aerobic power and variables related to the aerobic-anaerobic transition were examined using gas analysis during an incremental workload test on a kayak ergometer. A 1-min all-out test also on a kayak ergometer was used to obtain an indication of anaerobic capacity and power. Muscular strength and fatigue were assessed using a simulated kayak stroke on a Cybex isokinetic dynamometer. Physical characteristics were determined using kinanthropometric tests. Aerobic power, anaerobic power and capacity, muscular strength, resistance to muscular fatigue, and measures of body size were significantly greater in more successful kayakists. All of the parameters measured correlated significantly with performance time over at least one of the four race distances.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766348 TI - Isometric muscle force production as a function of age in healthy 20- to 74-yr old men. AB - Typically, previous studies have focused on one muscle group, the finger flexors, and only one aspect of muscle function, strength, when assessing age-related muscle force production characteristics. In the present study, the maximal voluntary isometric contraction force-time curves of five muscle groups (right hand finger flexors, right thumb abductors, right forearm extensors, right leg dorsiflexors, and right leg plantar flexors) were assessed in men, ranging in age from 20 to 74 yr. One hundred fifty-three volunteers were placed into appropriate 5-yr age groups: 20-24 (N = 14), 25-29 (N = 15), 30-34 (N = 16), 35-39 (N = 13), 40-44 (N = 16), 45-49 (N = 11), 50-54 (N = 16), 55-59 (N = 12), 60-64 (N = 17), 65-69 (N = 13), and 70-74 (N = 10) years. Muscle function was characterized by a number of force-time parameters, including strength, time, rate, and impulse. The data were analyzed both with and without consideration of the influence of physique and body composition. The results indicated that there were significant age group differences in the ability to produce maximal force (strength) (P less than 0.05), to generate maximal rates of force production (P less than 0.05), and in the total forces generated (impulse) (P less than 0.05), with an overall and in the total forces generated (impulse) (P less than 0.05), with an overall decline with increasing age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766349 TI - The cardiovascular and metabolic effects of bench stepping exercise in females. AB - The purpose of this investigation was to measure cardiovascular and metabolic responses to 20 min continuous bouts of "choreographed" bench stepping exercise in healthy females. Four frequently used bench heights were employed in a cross over design: 15.2 cm (6 inches, B-6), 20.3 cm (8 inches, B-8), 25.4 cm (10 inches, B-10), and 30.5 cm (12 inches, B-12). Oxygen uptake (VO2) responses were significantly more pronounced in direct relationship to the bench height: B-12 greater than B-10 greater than B-8 greater than B-6 (P less than 0.05). Mean responses for VO2 ranged from 28.4 ml.kg-1.min-1 for B-6 to 37.3 ml.kg-1.min-1 for B-12. Interestingly, no difference was revealed for heart rate and the respiratory exchange ratio between B-12 and B-10 despite a higher VO2 for B-12 (B 12, B-10 greater than B-8 greater than B-6, P less than 0.05). The incorporation of 0.91 kg (2 lb) hand weights with exercise on the 20.3 cm bench elicited a modest but statistically significant increase in VO2 compared with no hand weights. No significant increase in VO2 was revealed for conditions that employed 0.45 kg (1 lb) hand weights. The results demonstrate that aerobic bench stepping is an exercise modality that provides sufficient cardiorespiratory demand for enhancing aerobic fitness and promoting weight loss in females. PMID- 1766351 TI - Multiorgan transplantation. PMID- 1766350 TI - Malnutrition in a compulsive runner: a case conference. PMID- 1766352 TI - Multiorgan transplantation in the rat: development of a new microsurgical model. AB - Although transplantation of multiple abdominal viscera (MOTx) has been performed in humans, reproducible animal models and extensive laboratory work are needed to explore the physiological and immunological aspects of this new transplant procedure. We therefore developed a microsurgical model that allows en bloc transplantation of three major abdominal viscera. Using isogeneic rat strain combinations, 30% of the liver, pancreas, and duodenum and a segment of small bowel (SB) were heterotopically transplanted. A segment of aorta that included the celiac axis and the superior mesenteric artery provided the blood supply to the graft. Venous outflow occurred via the graft suprahepatic vena cava into the recipient's infrahepatic vena cava. The graft SB was anastomosed to the native SB. After a training period (N = 15), we could achieve a success rate of 83% (N = 23). Mean operation time was 105 minutes. Macroscopic and microscopic appearance of transplanted organs was normal. This study documents the feasibility of MOTx in the rat and provides a microsurgical model that should facilitate preclinical experimental research in this area. PMID- 1766353 TI - A technique for hepatopancreaticoduodenal cluster transplantation in the rat. AB - A new technique for combined hepatopancreaticoduodenal transplantation in the rat is described. The composite cluster graft consists of an orthotopic arterialized liver graft in anatomical continuity with the pancreaticoduodenal part that is placed heterotopically into the recipient. A separate arterial anastomosis of the liver and a bile duct anastomosis are not necessary, since these structures are left intact in the hepatoduodenal ligament. Bile and exocrine pancreas secretions drain over the duodenal conduit of the graft into the recipient jejunum via an end-to-side anastomosis. This model adds a new transplantation technique to existing microsurgical models. PMID- 1766354 TI - Histomorphometric evaluation of intrahepatic changes following portal overflow in the rat. AB - Intrahepatic changes after an end-to-side renoportal arteriovenous shunt were studied in 60 rats. Portal and vena caval pressures did not increase from 3 weeks to 1 year. The number and diameters of the portal and hepatic vein lumens were determined through morphometric evaluation to calculate the relative areas. The proportion of area composed by the portal veins increased 3 weeks after shunt creation (P less than 0.001), reaching its highest level at 1 year (0.08% in control rats vs. 2.45% +/- 0.1% at 1 year). The proportionate area for hepatic veins also increased after 3 weeks (P less than 0.001), reaching its highest value by 12 weeks (0.49% in controls vs. 1.73% +/- 0.08% at 12 weeks). Our results suggest that there was a dramatic drop in the intrahepatic vascular resistance, especially at the portal bed, which may have compensated for the portal overflow. The theories regarding forward overflow compensatory mechanisms are discussed. PMID- 1766355 TI - Experimental study of neurotization of denervated muscles with nerve-to-vein transfer. AB - Neurotization of denervated muscles was attempted by means of coaptation of peripheral nerves to the veins draining these muscles. In Sprague-Dawley rats, the lateral gastrocnemius branch from the tibial nerve was severed and its proximal end was sutured to the distal stump of the lateral gastrocnemius vein. In all animals nerve-muscle communication was confirmed electrophysiologically 2 and 6 months after the operation. However, histological examination revealed that the regenerated nerve fibers were not within the vessel lumen, but ran through the scar tissue in close proximity to the outside of the vessel, to enter the muscle. Control animals, in which only nerve resection was done, did not display nerve reinnervation. These results suggest that, although nerve fibers did not regenerate into the vein, the vein works well as a guide for regenerating nerve fibers to denervated muscle. PMID- 1766356 TI - Morphologic and morphometric analyses of rat femoral arteries after crush injury. AB - Replantation after crush amputation has a relatively low success rate. An arterial crush injury was produced in rats under a range of pressure (8.5 to 2,551 g/mm2) and durations (10 to 60 minutes). The degrees of vessel injury and thrombus formation were evaluated as functions of both crush force and duration, and the healing process was followed for 8 weeks. Crushing resulted in morphologic damage to the arterial wall but did not impair patency. Damage was directly proportional to crush pressure and duration. Intimal denudation caused flat platelet adhesion but no thrombus formation or thrombosis. Re endothelialization was completed by 2 weeks. Intimal hyperplasia appeared at 1 week and consisted of endothelia in the most luminal layers and smooth muscle in the deeper layers. the internal elastic lamina was intact in all specimens and was thought to minimize platelet aggregation on the arterial wall after denudation of the intima. PMID- 1766357 TI - Geometrical approach to the end-to-side anastomosis. AB - We analyzed the procedure of performing an arterio- or venotomy in rats and changed it from parallel to the long axis to perpendicular to the long axis. Simultaneously, geometrical analysis of the shape of an arterio- or venotomy led to a new approach for the end-to-side anastomosis in experimental free flap transplantation. This new method was applied in 268 anastomoses. It necessitated only six sutures and resulted in 100% arterial early and late patency and in 99% venous early and late patency. PMID- 1766358 TI - Diabetic nerve changes following pancreatic allografting. PMID- 1766359 TI - Mhc-DRB genes of the pigtail macaque (Macaca nemestrina): implications for the evolution of human DRB genes. AB - The DRB family of human class II major histocompatibility complex (Mhc) loci is unusual in that individuals differ in the number and combination of genes (haplotypes) they carry. Indications are that both the allelic and haplotype polymorphisms of the DRB loci predate speciation. Searching for the evolutionary origins of these polymorphisms, we have sequenced five DRB clones isolated from a cDNA library of a pigtail macaque (Macaca nemestrina) B lymphocyte line. The clones represent five different genes which we designate Mane-DRB*01-Mane-DRB*05. The genes appears to be approximately equidistant from each other, so that allelic relationships between them cannot be established on the basis of the sequence data alone. If positions coding for the peptide-binding region of the class II beta chains are eliminated from sequence comparisons, the Mane-DRB genes appear to be most closely related to the human (HLA) DRB1 genes of the DRw52 group. We interpret this finding to indicate that the ancestral gene of the DRw52 group of human DRB1 alleles separated from the rest of the HLA-DRB1 alleles before the separation of the Old World monkeys (Cercopithecoidea) from the apes (Hominoidea) in the early Oligocene. After this separation, the ancestral DRB1 gene of the DRw52 group duplicated in the Old World monkey lineage to give rise to genes at three loci at least, while in the ape lineage this gene may have remained single and diverged into a number of alleles instead. These findings suggest that some of the polymorphism currently present at the DRB1 locus is greater than 35 Myr old. PMID- 1766360 TI - The involucrin genes of the white-fronted capuchin and cottontop tamarin: the platyrrhine middle region. AB - In all anthropoid species, the coding region of the involucrin gene contains a segment of short tandem repeats that were added sequentially, beginning in a common anthropoid ancestor. The involucrin coding region of each of two platyrrhine species, the white-fronted capuchin (Cebus albifrons) and the cottontop tamarin (Saguinus oedipus), has now been cloned and sequenced. These genes share with the genes of the catarrhines the repeats added in the common anthropoid lineage (the early region). After their divergence, the platyrrhines, like the catarrhines, continued to add repeats vectorially 5' of the early region, to form a middle region. The mechanism that was established in the common anthropoid lineage for the addition of repeats at a definite site in the coding region was transmitted to both platyrrhines and catarrhines, enabling each to generate its middle region independently. The process of vectorial repeat addition continued in two platyrrhine sublineages after their divergence from each other. PMID- 1766361 TI - Evolution of messenger RNA structure and regulation in the genus Mus: the androgen-inducible RP2 mRNAs. AB - The RP2 gene is one of several genes that are regulated by androgens in the mouse kidney. Previous studies have demonstrated that androgen inducibility of RP2 transcription varies among species within the genus Mus, indicating extensive evolutionary modification of the participating regulatory elements. Thus, while a five-fold induction of transcription occurs in M. domesticus, none is detectable in M. hortulanus or M. caroli. In the present paper, we have sequenced cDNAs representing the RP2 mRNAs of M. caroli and M. saxicola and have compared them with each other and with M. domesticus. Several findings from the sequence comparisons indicate that the encoded 41-kD polypeptide is physiologically functional. First, divergence within noncoding regions of the mRNAs exceeds that within coding regions. Second, the 357-codon open reading frame has been maintained among the species, with approximately 90% of the amino acid replacements being conservative. Finally, substitution rates at synonymous sites within the coding regions are from twofold to threefold greater than those at nonsynonymous sites. The genetic elements responsible for variations in RP2 inducibility among species were studied by cis/trans analyses of mice heterozygous for RP2 alleles, using a primer extension assay to measure expression of species-specific mRNAs. The results show that the absence of transcriptional induction in M. hortulanus is due to a cis-acting genetic element, while that in M. caroli is due to a trans-acting element. Thus, the androgen-resistant RP2 phenotypes of these two species derive from distinct genetic events. PMID- 1766362 TI - Temporal and topological clustering of diverged residues among enterobacterial dihydrofolate reductases. AB - The complete nucleotide and encoded amino acid sequences were determined for the dihydrofolate reductase (DHFR) from the bacteria Enterobacter aerogenes and Citrobacter freundii. These were compared with the closely related Escherichia coli DHFR sequence. The ancestral DHFR sequence common to these three species was reconstructed. Since that ancestor there have been seven, nine, and one amino acid replacements in E. coli, E. aerogenes, and C. freundii, respectively. In E. coli, five of its seven replacements were located in the beta-sheet portion of the protein, and all seven were located in a single restricted region of the protein. In E. aerogenes, all nine of its replacements were located within surface residues, with five clustered in a region topologically distinct from the E. coli cluster. The replaced side chains are sometimes in direct contact but more often are separated by an intervening side chain. It is argued that the temporal clustering of replacements is typical for the evolution of most proteins and that the associated topological clustering gives a picture of how evolutionary change is accommodated by protein structure. PMID- 1766363 TI - The phylogenetic status of arthropods, as inferred from 18S rRNA sequences. AB - Partial 18S rRNA sequences of five chelicerate arthropods plus a crustacean, myriapod, insect, chordate, echinoderm, annelid, and platyhelminth were compared. The sequence data were used to infer phylogeny by using a maximum-parsimony method, an evolutionary-distance method, and the evolutionary-parsimony method. The phylogenetic inferences generated by maximum-parsimony and distance methods support both monophyly of the Arthropoda and monophyly of the Chelicerata within the Arthropoda. These results are congruent with phylogenies based on rigorous cladistic analyses of morphological characters. Results support the inclusion of the Arthropoda within a spiralian or protostome coelomate clade that is the sister group of a deuterostome clade, refuting the hypothesis that the arthropods represent the "primitive" sister group of a protostome coelomate clade. Bootstrap analyses and consideration of all trees within 1% of the length of the most parsimonious tree suggest that relationships between the nonchelicerate arthropods and relationships within the chelicerate clade cannot be reliably inferred with the partial 18S rRNA sequence data. With the evolutionary-parsimony method, support for monophyly of the Arthropoda is found in the majority of the combinations analyzed if the coelomates are used as "outgroups." Monophyly of the Chelicerata is supported in most combinations assessed. Our analyses also indicate that the evolutionary-parsimony method, like distance and parsimony, may be biased by taxa with long branches. We suggest that a previous study's inference of the Arthropoda as paraphyletic may be the result of (a) having two few arthropod taxa available for analysis and (b) including long-branched taxa. PMID- 1766364 TI - The molecular evolution of the alcohol dehydrogenase locus and the phylogeny of Hawaiian Drosophila. AB - DNA sequences in the alcohol dehydrogenase genes of flies representing the major groups of Hawaiian Drosophila are used to clarify the relationships of these groups, among themselves and with mainland Drosophila. The topology of the tree derived from these sequences agrees with karyotypic and morphological data but disagrees, in part, with the results of an earlier study that used immunological comparisons between variants of a larval hemolymph protein. A time scale, derived from a comparison of closely related Hawaiian Drosophila species, provides divergence-time estimates that are substantially more recent than those obtained from the immunological studies, although they are still within the bounds set by fossil and biogeographical evidence. The two major lineages of Hawaiian Drosophila, the scaptomyzoids and the drosophiloids, are shown to be widely separated from one another. The scaptomyzoids appear to have diverged early in the history of the subgenus Drosophila, greater than 25 Mya. While hundreds of scaptomyzoid species are found in the Hawaiian archipelago, many fewer are found elsewhere around the world, suggesting that they could have originated outside Hawaii. The drosophiloid lineage is strictly endemic to Hawaii and originated little more than 10 Mya, according to the alcohol dehydrogenase molecular clock. Thus, Drosophila apparently inhabited the Hawaiian archipelago (greater than or equal to 5 Myr before the emergence of the oldest existing high island, Kauai, 5 Mya. PMID- 1766365 TI - Metabolic control analysis and enzyme variation: nutritional manipulation of the flux from ethanol to lipids in Drosophila. AB - The effect that variation in activities of the enzymes alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH) has on the flux from 14C-ethanol to lipids was examined in third-instar larvae of Drosophila melanogaster and D. simulans. The activities of ADH and ALDH were also nutritionally manipulated by the inhibitor, cyanamide. Feeding larvae cyanamide before the flux test eliminated greater than 98% of the ALDH activity but only 40% of the ADH activity. The mean +/- SD flux control coefficient for ADH activity was 0.86 +/- 0.12, and that for ALDH activity was 0.02 +/- 0.07. This suggests that ADH is the major rate-limiting enzyme for the ethanol-to-lipid pathway in Drosophila larvae under the current experimental conditions. PMID- 1766366 TI - Evidence for replication slippage in the evolution of Oenothera chloroplast DNA. AB - Evolutionary relationships of four plastid genomes (plastomes) from different Oenothera species have been assessed by sequence comparisons of two intergenic regions that separate the ribosomal protein genes rpl16, rpl14, and rps8. Sequence changes include base substitutions, the occurrence of a 29-base tandem duplication, and variation in the length of two poly-A stretches. Additions/deletions in chloroplast DNA may not be useful for evolutionary comparisons more distant than these, particularly if the sequences undergo divergence after the initial event, but the length mutations reported here allow a finer resolution of the phylogeny of the closely related Oenothera plastomes than would have been possible if only base substitutions had been considered. Comparisons with the orthogous sequence from tobacco chloroplast DNA indicate the direction of change at most of the sites. The results suggest that plastomes I and II are closely related to each other, as are plastomes III and IV. Replication slippage is proposed as a mechanism to explain the length mutations. PMID- 1766367 TI - The pathogenic mechanisms of Shiga toxin and the Shiga-like toxins. AB - It is now well documented that some enteric bacteria which cause diarrhoeal and/or dysenteric disease produce, at high levels, one or more of a family of protein toxins referred to as Shiga toxin and Shiga-like toxins (SLTs; alternatively called verocytotoxins or VTs). Within the past few years, there have been considerable advancements made in our understanding of the biochemistry and molecular biology of Shiga toxin and SLTs. However, the precise role of the toxins in mediating colonic disease, as well as their contribution to the development of extra-intestinal sequelae (e.g. the haemolytic uraemic syndrome and neurological disorders), remain less clear. In this MicroReview, we will briefly summarize recent progress in Shiga toxin- and SLT-related research and present evidence supporting the concept that these toxins contribute to pathogenesis by directly damaging vascular endothelial cells, thereby disrupting the homeostatic properties of these cells. We will also discuss data which suggest that toxin-mediated damage in the kidney may not be limited to glomerular endothelial cells but may include tubular epithelial cells. Thus, the role of the toxins in renal disease may not be limited to the glomeruli, as was initially hypothesized when the association of infection with toxin-producing strains and the development of acute renal failure was established. PMID- 1766368 TI - The Entamoeba histolytica rDNA episome: nuclear localization, DNAase I sensitivity map, and specific DNA-protein interactions. AB - Structural and functional features of the extrachromosomal DNA element that contains the ribosomal RNA genes of Entamoeba histolytica were studied using a variety of techniques. Using in situ hybridization, the element was found to be distributed along the inner phase of the nuclear membrane in the trophozoite stage; it appears to be part of the so-called peripheral chromatin. DNAase I sensitive regions on the episome were mapped and found to correspond to the borders of the ribosomal RNA coding region. Other DNAase I-sensitive regions were found to correspond to DNA containing a 145bp sequence that exists in the episome as tandem repeats. Electrophoretic shift assays and footprinting experiments demonstrate the existence of specific nuclear factors that bind specifically to the 145bp repeat. Preliminary analysis of the binding factors showed that a 28 kDa polypeptide is a likely candidate for a specific DNA:protein interaction involving the repetitive element. These results suggest that a protein-binding domain within the 145bp repeat may have a specific function in the episome. PMID- 1766369 TI - Complement activation and antibody binding by pneumolysin via a region of the toxin homologous to a human acute-phase protein. AB - Pneumolysin, a membrane-damaging toxin, is known to activate the classical complement pathway. We have shown that 1 microgram ml-1 of pneumolysin can activate complement, which is a much lower level than observed previously. We have identified two distinct regions of pneumolysin which show homology with a contiguous sequence within acute-phase proteins, including human C-reactive protein (CRP). Site-directed mutagenesis of the pneumolysin gene was used to change residues common to pneumolysin and CRP. Some of the modified toxins had a reduced ability both to activate complement and bind antibody. We suggest that the ability of pneumolysin to activate complement is related to its ability to bind the Fc portion of immunoglobulin G. PMID- 1766370 TI - A Bacillus subtilis dipeptide transport system expressed early during sporulation. AB - Two previously identified Bacillus subtilis DNA segments, dciA and dciB, whose transcripts accumulate very rapidly after induction of sporulation, were found in the same 6.2 kb transcription unit, now known as the dciA operon. Analysis of the sequence of the dciA operon showed that its putative products are homologous to bacterial peptide transport systems. The product of the fifth gene, DciAE, is similar to peptide-binding proteins from Escherichia coli and Salmonella typhimurium (DppA and OppA) and B. subtilis (OppA). A null mutation in dciAE abolished the ability of a proline auxotroph to grow in a medium containing the dipeptide Pro-Gly as sole proline source, suggesting that the dciA operon encodes a dipeptide transport system. PMID- 1766371 TI - Transcriptional regulation of a Bacillus subtilis dipeptide transport operon. AB - The Bacillus subtilis dciA operon, which encodes a dipeptide transport system, was induced rapidly by several conditions that caused the cells to enter stationary phase and initiate sporulation. The in vivo start point of transcription was mapped precisely and shown to correspond to a site of transcription initiation in vitro by the major vegetative form of RNA polymerase. Post-exponential expression was prevented by a mutation in the spo0A gene (whose product is a known regulator of early sporulation genes) but was restored in a spo0A abrB double mutant. This implicated AbrB, another known regulator, as a repressor of dciA. In fact, purified AbrB protein bound to a portion of the dciA promoter region, protecting it against DNase I digestion. Expression of dciA in growing cells was also repressed independently by glucose and by a mixture of amino acids; neither of these effects was mediated by AbrB. PMID- 1766372 TI - The spoIIIA operon of Bacillus subtilis defines a new temporal class of mother cell-specific sporulation genes under the control of the sigma E form of RNA polymerase. AB - We have cloned and characterized a 5 kbp region of the Bacillus subtilis chromosome and show that it contains the promoter-proximal part of the spoIIIA locus. The locus consists of a polycistronic operon containing at least three genes. We show that the operon is regulated at the transcriptional level, from a promoter that is first activated about 80 minutes after the induction of sporulation, immediately after septation. Expression of spoIIIA in different spo mutant backgrounds correlates with the ability of each strain to synthesize the sporulation-specific sigma factor, sigma E. Moreover, synthesis of sigma E in vegetative cells by use of an inducible promoter causes expression of mother-cell specific genes spoIID, spoIIIA, and spoIIID, but not the prespore-specific genes, spoIIIG and spoVA. We suggest that sigma E may be the primary determinant of mother-cell-specific gene expression and that the SpoIIID protein exerts an additional level of regulation on spoIIIA, apparently by acting as a transcriptional repressor. Since the onset of spoIIID expression occurs about 10 minutes after that of spoIIIA, spoIIIA expression is transient. Thus spoIIIA defines a third temporal class of gene controlled by the sigma E form of RNA polymerase. PMID- 1766373 TI - Closely linked genetic loci required for swarm cell differentiation and multicellular migration by Proteus mirabilis. AB - The pathogenic bacterium Proteus mirabilis exhibits a form of multicellular behaviour called swarming migration. This involves the differentiation of vegetative cells at the colony margin into swarm cells which are long, aseptate, multinucleate, hyper-flagellated filaments able to undergo repeated cycles of co ordinated population migration and consolidation (reversion to vegetative cells). Transposon mutagenesis of uropathogenic P. mirabilis strain U6450 with Tn5 generated 4860 chromosomal insertions and, of these, 75 (1.6%) caused visibly abnormal swarming behaviour, indicating that at least 45 genes are involved in directing motility, cell differentiation and multicellular behaviour. While about one fifth of the swarm-defective mutants lacked flagella and were non-motile non swarming (NMNS) the majority were normally flagellated and motile but were unable to form swarm cells (motile non-swarming, MNS), or were motile and able to form swarm cells but displayed aberrant patterns of multicellular migration (dendritic swarming, DS) or consolidation (frequent and infrequent consolidation, FC and IC). Restriction enzyme mapping of representative mutant DNAs by Southern hybridization with transposon DNA probes identified eight different mutated genetic loci within the five phenotypic classes. Subsequent Southern analysis of large restriction fragments separated by pulsed-field electrophoresis showed that these eight mutated loci required for motility, cell differentiation and multicellular migration were clustered on a region of DNA spanning approximately 8% of the 4.2 mbp P. mirabilis chromosome. Further linkage analysis showed that the DS locus involved in the ordered migration of the swarm cell population mapped separately from two main clusters of swarm loci, one cluster containing, within 112 kbp, genetic determinants of motility (NMNS) and also differentiation into swarm cells (MNS1, MNS2), and a second within a neighbouring 95 kbp DNA sequence containing three loci involved in the control of consolidation (FC, IC1, IC2). PMID- 1766374 TI - Regulation of nitrogen fixation in Azorhizobium caulinodans: identification of a fixK-like gene, a positive regulator of nifA. AB - The nucleotide sequence of a 1 kb fragment upstream of Azorhizobium caulinodans fixL was established. An open reading frame of 744 bp was identified as a fixK homologue. A kanamycin cartridge was inserted into the cloned fixK-like gene and recombined into the host genome. The resulting mutant was Nif-Fix-, suggesting that FixK was required for nitrogen fixation both in symbiotic conditions and in the free-living state. Using a pfixK-lacZ fusion, the FixLJ products were shown to control the expression of fixK. Using a pnifA-lacZ fusion, the FixK product was shown to regulate positively the transcription of nifA in bacteria grown in the free-living state. In addition, a double ntrC-fixL mutant was constructed and was shown to be completely devoid of nitrogenase activity. A model of regulation, based on these data, is presented and might explain the unusual ability of A. caulinodans to fix nitrogen both under symbiotic conditions and in the free living state. PMID- 1766375 TI - Interspecies recombinational events during the evolution of altered PBP 2x genes in penicillin-resistant clinical isolates of Streptococcus pneumoniae. AB - Penicillin resistance in pneumococci is due to the appearance of high molecular weight penicillin-binding proteins (PBPs) that have reduced affinity for the antibiotic. We have compared the PBX 2x genes (pbpX) of one penicillin susceptible and five penicillin-resistant clinical isolates of Streptococcus pneumoniae isolated from various parts of the world. All of the resistant isolates contained a low-affinity form of PBP 2x. The 2 kb region of the two penicillin-susceptible isolates differed at only eight nucleotide sites (0.4%) and resulted in one single amino acid difference in PBP 2x. In contrast, the sequences of the PBP 2x genes from the resistant isolates differed overall from those of the susceptible isolates at between 7 and 18% of nucleotide sites and resulted in between 27 and 86 amino acid substitutions in PBP 2x. The altered PBP 2x genes consisted of regions that were similar to those of susceptible strains (less than 3% diverged), alternating with regions that were very different (18 23% diverged). The presence of highly diverged regions within the PBP 2x genes of the resistant isolates contrasts with the uniformity of the sequences of the amylomaltase genes from the same isolates, and with the uniformity of the PBP 2x genes in the two susceptible isolates. It suggests that the altered PBP 2x genes have arisen by localized interspecies recombinational events involving the PBP 2x genes of closely related streptococci, as has been suggested to occur for altered PBP 2b genes (Dowson et al., 1989b). The PBP 2x genes from the resistant isolates could transform the susceptible strain R6 to increased levels of resistance to beta-lactam antibiotics, indicating that the altered forms of PBP 2x in the resistant isolates contribute to their resistance to penicillin. PMID- 1766376 TI - Pseudomonas aeruginosa LasA: a second elastase under the transcriptional control of lasR. AB - The full elastolytic phenotype of Pseudomonas aeruginosa requires lasB, the structural gene for elastase, its transcriptional activator lasR, and lasA. The lasB gene was insertionally inactivated with the omega fragment and this mutated gene introduced into the P. aeruginosa chromosome. Replacement of the wild-type gene with the inactivated gene was verified by Southern analysis and confirmed by lack of elastase antigen on Western blots and lack of activity in liquid assays. The mutant did, however, retain elastolytic activity on elastin plates. This residual activity was abolished by inactivation of lasB in PAO-E64, a lasA deficient mutant, demonstrating that it was due to the lasA gene product. Northern analysis demonstrated that, like lasB, lasA is transcriptionally controlled by the lasR gene product. PMID- 1766377 TI - Characterization of a Legionella pneumophila gene encoding a lipoprotein antigen. AB - A prominent 19 kDa surface antigen of Legionella pneumophila, cloned in Escherichia coli, was found to be intimately associated with peptidoglycan. The DNA region encoding this antigen was mapped on an 11.9 kb plasmid by means of deletion analysis and transposon mutagenesis. PhoA+ gene fusions, gene-rated by TnphoA insertions into this region, confirmed the presence of a gene encoding a secreted protein. PhoA+ transposon insertions were also associated with loss of the 19 kDa antigen in immunoassays using a monoclonal antibody (mAb1E9) and the replacement of the 19 kDa antigen with larger fusion proteins in immunoblots using Legionella immune serum. A 1540bp PstI fragment carrying the gene was sequenced, and the open reading frame encoding the antigen was identified. The gene encodes a polypeptide 176 amino acid residues long and 18913Da in size. The presence of a signal sequence of 22 amino acids with a consensus sequence for cleavage by signal peptidase II indicates that the antigen is a lipoprotein, and striking similarity with peptidoglycan-associated lipoproteins (PALs) from E. coli (51% amino acid homology) and Haemophilus influenzae (55% homology) is noted. We conclude that the 19kDa antigen of L. pneumophila is the structural equivalent of the PAL found in other Gram-negative species and suggest that its post-translational acylation may explain its potency as an immunogen. PMID- 1766378 TI - Transcription of the Vibrio cholerae haemolysin gene, hlyA, and cloning of a positive regulatory locus, hlyU. AB - Transcription of the Vibrio cholerae hlyA gene, which encodes a cytotoxic haemolysin, has been investigated. The hlyA transcript initiates 430 nucleotides (nt) upstream of the translational start site. hlyA-cat transcriptional fusion constructs were active in V. cholerae but not in Escherichia coli. An hlyA-cat fusion was used to select, from a V. cholerae O17 plasmid library, a clone that could activate the hlyA promoter in E. coli. This regulatory locus has been designated hlyU. hlyU appears to be distinct from the previously described hlyR locus. PMID- 1766379 TI - Repression and induction of the nag regulon of Escherichia coli K-12: the roles of nagC and nagA in maintenance of the uninduced state. AB - The nag regulon located at 15.5 min on the Escherichia coli chromosome consists of two divergent operons, nagE and nagBACD, encoding genes involved in the uptake and metabolism of N-acetylglucosamine. Null mutations have been created in each of the genes by insertion of antibiotic resistance cartridges. The phenotypes of the strains carrying the insertions in nagE, B and A were consistent with the previous identification of gene products: nagE, EII(Nag), the N-acetylglucosamine specific transporter of the phosphotransferase system and nagB and nagA, the two enzymes necessary for the degradation of N-acetylglucosamine. Insertions in the nagC result in derepression of the nag genes, which is consistent with earlier observations that the nagC gene encodes the repressor of the regulon. Insertions in nagA also provoke a derepression, implying that nagA has a role in the regulation of the expression of the nag regulon as well as in the degradation of the amino-sugars. N-acetylglucosamine-6-phosphate, the intracellular product of N acetylglucosamine transport and the substrate of the nagA gene product, is shown to be an inducer of the regulon and this suggests how nagA mutations result in derepression: the absence of N-acetylglucosamine-6-phosphate deacetylase allows N acetylglucosamine-6-phosphate to accumulate and induce the regulon. PMID- 1766380 TI - PhoP/PhoQ: macrophage-specific modulators of Salmonella virulence? AB - The regulation of gene expression by the two-component regulatory system PhoP/PhoQ is necessary for Salmonella typhimurium survival within macrophages, defensin resistance, acid resistance, and murine typhoid fever pathogenesis. Salmonella experience multiple environments during mammalian infection and survival requires tightly regulated gene expression. After phagocytosis by macrophages, signal transduction by PhoQ results in the transcription of phoP activated genes (pags) encoding proteins essential to bacterial survival and virulence. One such gene, pagC, encodes an envelope protein with amino acid similarity to an epithelial cell invasion protein of Yersina enterocolitica, Ail, and a bacteriophage lambda outer membrane protein, Lom. The PhoP and PhoQ proteins can also repress the synthesis of proteins, encoded by phoP repressed genes (prgs), when pags are maximally expressed. If prgs encode receptors for toxic compounds, prg repression may protect the cell within macrophages when pag expression is most necessary. At least one prg locus, prgH, is required for full S. typhimurium mouse virulence. Within the macrophage, different environments may stimulate a switch from pag to prg expression that is necessary to Salmonella survival. prg expression may also be necessary for surviving nonmacrophage environments. Study of the PhoP regulon should lead to the discovery of new virulence factors, increase knowledge of how gene regulation is essential to bacterial virulence, and perhaps lead to the development of better vaccines for typhoid fever. PMID- 1766381 TI - Control of maltase synthesis in yeast. AB - Maltose fermentation in Saccharomyces species requires the presence of at least one of five unlinked MAL loci: MAL1, MAL2, MAL3, MAL4 and MAL6. Each MAL locus is complex consisting of at least three genes: a trans-acting activator, a maltose permease, and maltase. All the MAL loci show homology to each other both at the sequence level as determined by Southern transfer analysis and at the functional level as determined by complementation. We describe the organization of the MAL loci in yeast and the basic features of their regulation. The analysis of MAL has contributed to our understanding of the evolution of multigenic families, the global integration of carbohydrate metabolism, and gene regulation. PMID- 1766382 TI - The role of the 'gearbox' in the transcription of essential genes. AB - Regulation of transcription occurs at different levels, one being in the presence of sequences specifically recognized by different forms of RNA polymerase, i.e. the promoters. Three different kinds of promoter are defined according, among other things, to their dependence on the growth rate of the cell: the 'house keeper' promoter of many metabolic genes, the stringent promoter found at several rRNA and ribosomal protein genes, and the 'gearbox' at genes whose products are required at higher relative amounts at lower growth rates. The identified gearbox promoters of Escherichia coli share specific homologies in the -10, -35 and upstream regions. Although there may be different types of gearbox promoters, the -10 sequence of one of these promoters has been found to be essential for functioning as a gearbox. This suggests the existence of specific sigma factors for its transcription. RpoS (KatF) is a likely candidate for being one of these sigma factors. Computer simulation allows us to predict that such sigma factors should, in turn, be expressed following a gearbox mode, which would then imply the existence of self-regulated loops contributing to the expression of some genes of bacterial division. PMID- 1766383 TI - Occurrence and biological function of cytochrome P450 monooxygenases in the actinomycetes. AB - Many species within the order Actinomycetales contain one or more soluble cytochrome P450 monooxygenases, often substrate-inducible and responsible for a variety of xenobiotic transformations. The individual cytochromes exhibit a relatively broad substrate specificity, and some strains have the capacity to synthesize large amounts of the protein(s) to compensate for low catalytic turnover with some substrates. All three of the Streptomyces cytochromes sequenced to date are exclusive members of one P450 family, CYP105. In several instances, monooxygenase activity arises from induction of a P450 and associated ferredoxin, or of a P450 only, suggesting that some essential electron donor proteins (reductase and ferredoxin) are not co-ordinately regulated with the cytochrome. The overall properties of these systems suggest an adaptive strategy whose twofold purpose is to maintain a competitive advantage via the production of secondary metabolites, and, whenever possible, to utilize unusual growth substrates by introducing metabolites from these reactions into the more substrate-specific primary metabolic pathways. PMID- 1766384 TI - Pseudomonas aeruginosa LasB mutant constructed by insertional mutagenesis reveals elastolytic activity due to alkaline proteinase and the LasA fragment. AB - The extracellularly secreted endopeptidase elastase (LasB) is regarded as an important virulence factor of Pseudomonas aeruginosa. It has also been implicated in the processing of LasA which enhances elastolytic activity of LasB. In order to investigate the role of LasB in virulence and LasA processing, a LasB-negative mutant, PAO1E, was constructed by insertional mutagenesis of the LasB structural gene, lasB, in P. aeruginosa PAO. An internal 636 bp lasB fragment of the plasmid pRB1803 was ligated into a derivative of the mobilization vector pSUP201-1. The resulting plasmid, pBRMOB-LasB, was transformed into Escherichia coli and transferred by filter matings to the LasB-positive P. aeruginosa strain, PAO1. Plasmid integration in the lasB site of the chromosome was confirmed by Southern blot analysis. Radioimmunoassay and immunoblotting of PAO1E supernatant fluids yielded no detectable LasB (less than 1 ng ml-1 LasB). The absence of LasB in PAO1E was further proven by the inability of its culture supernatant fluid to cleave transferrin or rabbit immunoglobulin G (IgG) after a 72 h incubation. The residual proteolytic activity of PAO1E culture supernatant fluid was attributed to alkaline proteinase (Apr), since it was totally inhibited by specific antibodies against Apr. Residual elastolytic activity in culture supernatant fluid of PAO1E was due to the LasA fragment and to the combined action of the LasA fragment with Apr on elastin. The sizes of purified LasA from PAO1 and PAO1E were identical (22 kDa). These results show that, besides LasB and the LasA fragment, Apr may also act on elastin in the presence of the LasA fragment and that the proteolytic processing of LasA in P. aeruginosa is independent of LasB. PMID- 1766385 TI - Separate promoters direct expression of phoAIII, a member of the Bacillus subtilis alkaline phosphatase multigene family, during phosphate starvation and sporulation. AB - Alkaline phosphatase (APase) expression can be induced in Bacillus subtilis by phosphate starvation or by sporulation. We have recently shown that there are multiple APase structural genes contributing to the total alkaline phosphatase expression in B. subtilis. The expression of the alkaline phosphatase III gene (phoAIII) was analysed under both phosphate-starvation induction and sporulation induction conditions. phoAII is transcribed from two promoter regions, PV and PS. The PV promoter initiated transcription 37 bp before the translation initiation codon and was used to transcribe phoAIII during phosphate-starvation induction in vegetative cells. The PS promoter initiated transcription 119 bp before the translation initiation codon and was used during sporulation induction. Genes which have previously been shown to affect total vegatative APase, pho regulon genes phoP, phoR and phoS, affected expression of phoAIII during phosphate starvation. Genes known to affect expression of total sporulation APase, i.e. spoIIA, spoIIG and spoIIE, affected phoAIII expression during sporulation induction. Our data show that one member of the APase multigene family, phoAIII, contributes to the total APase expression both during phosphate-starvation induction and sporulation induction, and that the mechanism of regulation includes two promoters, each requiring different regulatory genes. PMID- 1766386 TI - Analysis of an Erwinia chrysanthemi gene cluster involved in pectin degradation. AB - A group of four genes of Erwinia chrysanthemi involved in pectin degradation has been characterized. These four genes form independent transcription units and are regulated by the negative regulatory gene, kdgR. The functions of two of these genes are known: kduD codes for the 2-keto-3-deoxygluconate oxydoreductase and kdul for the 5-keto-4-deoxyuronate isomerase, two enzymes of the pectin degradation pathway. kdgC has 36% homology with pectate lyase genes of the periplasmic family but its product does not seem to have pectinolytic activity. The fourth gene, kdgF, could have a role in the pathogenicity of E. chrysanthemi. A comparison of the regulatory regions of all the genes controlled by kdgR allowed better definition of the KdgR-binding-site consensus. PMID- 1766387 TI - Nucleotide sequence of the ipaBCD structural genes of Shigella dysenteriae. AB - A 9 kb EcoRI and two PstI fragments from the virulence plasmid of Shigella dysenteriae CG097 were shown to contain all ipa genes by probing with Shigella flexneri ipaB, -C, -D and -A gene probes. The DNA sequences of S. dysenteriae ipaBC genes were very similar to those of S. flexneri M90T and S. flexneri YSH6000, but ipaD differed by 22 codons from that of S. flexneri. The differences in ipaD may account for the different in vitro host specificities shown by S. dysenteriae and S. flexneri. The nucleotide composition of ipa genes revealed an unusually large number of codons that are rarely used in Escherichia coli chromosomal genes, indicating a different origin. PMID- 1766388 TI - In vivo analysis of integration of membrane proteins in Escherichia coli. AB - The in vivo process of membrane protein integration was studied by pulse labelling Escherichia coli cells, and assessing integral anchoring of labelled proteins to the lipid bilayer based on their resistance to alkali extraction. To conduct this experiment, conditions for extracting E. coli proteins with alkali were refined, and the immunoprecipitation procedures were improved to allow effective detection of integral membrane proteins. Examination of pulse-labelled, integral membrane proteins, including lactose permease (LacY), SecY, cytochrome omicron subunit II and leader peptidase revealed that all were in the alkali insoluble fraction, indicating that membrane integration of these proteins takes place rapidly in wild-type cells. However, when LacY was synthesized in excess from a multicopy plasmid, significant proportions were found in the alkali soluble fraction, indicating that the solubility in alkali is not an intrinsic property of the protein, and suggesting that LacY depends on some limited cellular factor for membrane integration. The unintegrated species of LacY sedimented slowly through an alkaline sucrose gradient. The secY24 mutant cells accumulated higher proportions of unintegrated LacY molecules at lower levels of overproduction than the sec+ cells. LacY overproduction in wild-type cells was found to inhibit processing (export) of beta-lactamase but not of OmpA and OmpF. These results are interpreted to mean that integration of LacY depends on multiple cellular components, one of which is also involved in export of beta lactamase. PMID- 1766389 TI - Horizontal transfer of multiple penicillin-binding protein genes, and capsular biosynthetic genes, in natural populations of Streptococcus pneumoniae. AB - Multiply antibiotic-resistant serotype 23F isolates of Streptococcus pneumoniae are prevalent in Spain and have also been recovered recently in the United Kingdom and the United States. Analysis of populations of these isolates by multilocus enzyme electrophoresis, and restriction endonuclease cleavage electrophoretic profiling of penicillin-binding protein (PBP) genes, has demonstrated that these isolates are a single clone (Munoz et al., 1991). Here we report studies of non-serotype 23F penicillin-resistant pneumococci isolated in Spain and the United Kingdom. One of the isolates expressed serotype 19 capsule but was otherwise indistinguishable from the serotype 23F clone on the basis of multilocus enzyme electrophoresis, antibiotic resistance profiling, and restriction endonuclease patterns of genes encoding PBP1A, PBP2B and PBP2X, a result which suggests that horizontal transfer of capsular biosynthesis genes had occurred. These same techniques revealed that six other resistant isolates, all expressing serotype 9 polysaccharide capsule, represent a clone. Interestingly, the chromosomal lineage of this clone is not closely related to the 23F clone; however, the serotype 9 and 23F clones harbour apparently identical PBP1A, -2B and -2X genes. To explain these data, we favour the interpretation that horizontal gene transfer in natural populations has distributed genes encoding altered forms of PBP1A, -2B and -2X to distinct evolutionary lineages of S. pneumoniae. PMID- 1766391 TI - Controlling professional liability risk exposure through effective communication. PMID- 1766390 TI - Cloning of a sequence of Aquaspirillum magnetotacticum that complements the aroD gene of Escherichia coli. AB - A 2 kb DNA fragment isolated from a cosmid library of Aquaspirillum magnetotacticum strain MS-1 complements the aromatic-metabolite requirements and iron-uptake deficiencies of Escherichia coli and Salmonella typhimurium strains that lack a functional aroD (biosynthetic dehydrodquinase) sequence. All recombinant cosmids selected for their aroD complementation property carry this sequence. No DNA sequence homology has, however, been detected by Southern hybridization between the cloned fragment and the aroD gene of E. coli or the qa2 (catabolic dehydroquinase) gene of Neurospora crassa. PMID- 1766393 TI - RBRVS? Let's get back to basics. PMID- 1766392 TI - Malpractice defendants can savor sweet victory in recent Michigan Supreme Court decision. PMID- 1766394 TI - Are you covered? PMID- 1766395 TI - Divided by a river, Berrien County physicians are united by their medical society. PMID- 1766397 TI - Utilizing clinical research. PMID- 1766396 TI - GDAHC studies offer new insights into AIDS care. PMID- 1766398 TI - A case in point: contract language. PMID- 1766399 TI - Helping the homeless. Interview by Kelly A Rzepecki. PMID- 1766400 TI - Discussing nursing's vision for reform. Interview by Lynn Hamilton. PMID- 1766401 TI - Reading research critically. PMID- 1766403 TI - Putting an end to the great debate: professionalism vs. unionism. PMID- 1766402 TI - RN unity promotes professional gains. PMID- 1766404 TI - Nurse practitioner survey results. PMID- 1766405 TI - MNA opposes mandatory AIDS testing. PMID- 1766406 TI - Follow-up of trauma care patients. PMID- 1766407 TI - Polycyclic aromatic hydrocarbons initiate carcinogenesis by forming permanent membrane lesions of increased permeability. Other non-viral carcinogens may also form similar lesions. AB - Complexes of carcinogenic polycyclic aromatic hydrocarbons (PAH) and cationic Ah receptors, may be attracted to the cell membrane if its surface is exposed to external negative charge. At the membrane they may be trapped by lipophilic bonding. When the negative charge dissipates, the bound complexes create a local transmembrane charge imbalance. Molecules with organic anions are attracted to the outer surface to restore equilibrium. The two charged species form permanent dipoles (lesions) across the membrane. The membrane at the dipoles is more permeable. Similar permanent lesions involving steroid/receptor complexes may form after the local abnormal surface charge has been long-lived. PMID- 1766408 TI - Hanseniasis and whole body hyperthermia. PMID- 1766409 TI - Oxygen transport: interrelationship between arterial pressure regulation and blood flow autoregulation. AB - An oxygen transport model was used to study the effects of blood flow autoregulation and arterial pressure regulation on tissue oxygen delivery. At low to moderate levels of oxygen consumption, autoregulatory increases in blood flow act in conjunction with increased tissue diffusing capacity to maintain oxygen delivery as oxygen demand becomes increased. However, an increase in the arterial pressure becomes necessary to augment oxygen delivery at higher levels of oxygen usage. At exercise levels approaching the "maximum aerobic oxygen consumption' rate, arterial pressure regulation appears to be as important as autoregulation for maintaining delivery of oxygen to the tissues. The total negative feedback gain for autoregulatory control of tissue oxygenation varies with the rate of tissue oxygen uptake and is almost 2.0 at the maximum aerobic oxygen consumption rate. Furthermore, the feedback gain is only slightly affected by changes in the mean arterial pressure that occur normally during strenuous exercise, which is indicative of the complementary relationship between these two important control mechanisms. PMID- 1766410 TI - Atherosclerosis as an immune disease? AB - Immunology has many effects on atherogenesis. In addition to their usual action risk factors for atherosclerosis have an immunomodulating effect and immunomodulation may be a new treatment of atherosclerosis. PMID- 1766412 TI - Does prolactin play a role in skin biology and pathology? AB - Despite its extensive repertoire of biological activities, which include the growth- and osmoregulation of epithelial tissues as well as immunoregulatory properties, the potential significance of the pituitary hormone prolactin (PRL) for human skin biology and pathology has yet to be fully appreciated. In this essay, the hypothesis is presented that PRL acts as a neuroendocrine modulator of skin epithelial cell proliferation and of the skin immune system by forming a 'prolactin-circuit' between the central nervous system and the skin. Binding to specific skin receptors, modulation of cytokine release in the skin, and stimulation of somatomedin release by mesenchymal cells are among the suggested pathways by which PRL could affect epithelial cell growth in the skin. Potential feedback signals, arising from the skin and modifying pituitary PRL release, are briefly outlined. Centering on the role of PRL in both psoriasis and hair growth as models for studying the proposed PRL-skin connection, clinical and experimental evidence in support of this theory is discussed in the context of a 'neuroimmune-dermatological' perspective. PMID- 1766411 TI - Plasma amino acids and the insulin/glucagon ratio as an explanation for the dietary protein modulation of atherosclerosis. AB - The amino acid composition of the diet influences the postprandial levels of plasma amino acids along with the hormones insulin and glucagon in humans fed single test meals identical in composition except for protein source. Soy protein (hypocholesterolemic), vs. casein (hypercholesterolemic), contains a higher amount of arginine and glycine and induces an increase in postprandial arginine and glycine. Soy protein induces a low postprandial insulin/glucagon ratio in both hypercholesterolemic and normocholesterolemic subjects. Casein induces a high postprandial insulin/glucagon ratio among hypercholesterolemic subjects. Amino acids such as arginine and glycine are associated with a decrease, while lysine and branched-chain amino acids are associated with increased serum cholesterol levels. Our data are consistent with the hypothesis that the control of cholesterol by insulin and glucagon is regulated by dietary and plasma amino acids. From this hypothesis the insulin/glucagon ratio is proposed as an early metabolic index of the effect of dietary proteins on serum cholesterol levels, a risk factor and a common mechanism through which dietary and lifestyle factors influence cardiovascular disease. PMID- 1766413 TI - Cancer promotion in cells initiated by polycyclic aromatic hydrocarbons and other non-viral carcinogens. AB - Permanent membrane lesions that initiate cells to transformation by polycyclic aromatic hydrocarbons and other non-viral carcinogens are inherited by the daughter cells at mitosis. This causes elevation of intracellular pH and suggests promotion mechanisms. PMID- 1766414 TI - Development of concepts of etiology, pathogenesis and treatment of pemphigus vulgaris based on the hypothesis of atavistic origin of the disease. AB - Atavistically dependent expression of pemphigus vulgaris 'immune' antigen (PVIA) on the human epidermocyte surface is hypothetically the key factor of autoimmune aggression onset in pemphigus patients. Normal epidermocytes can express PVIA in response to a putative factor of 'sheding' as well as to certain biologic, chemical and physical effects. Taking into account the fact that the antibodies against 'shedding' factor carry out the function of anti-idiotypic ones, they can be used as blocking antibodies in treatment of pemphigus vulgaris. PMID- 1766415 TI - Evaluating primary practice: proposals for a modified model suited to chiropractic care. AB - Although chiropractic care is not yet considered to have achieved scientific validity, it enjoys widespread public acceptance. It is hypothesised that one of the barriers to chiropractic establishing scientific validity is the propensity of researchers to frame their randomized controlled clinical trials according to a biomedical rather than a biopsychosocial model. It is proposed that while chiropractic care should be required to establish a cause--effect relationship between spinal manipulation and clinical response, subjective patient--valued outcomes should also be monitored. For chiropractic care to be adequately assessed recognition needs to be given to the usefulness of qualitative measurements in health care. Interventions selected solely upon the basis of statistical significance run the risk of overlooking clinically meaningful outcomes. PMID- 1766416 TI - Receptors for angiotensins I and II: their relevance to renal haemodynamics, blood pressure control and hind-limb blood flow. AB - The well established differential pulmonary handling of angiotensins I and II indicates the possibility that vascular receptors for the deca- and octa-peptides do not necessarily involve common sites in the renal vasculature either. Experimental findings involving haemodynamic changes within the kidney in anaesthetised and conscious sheep, with utilization of the angiotensins, and also of noradrenaline, are briefly presented; the implications of the intra-renal water and creatinine transfers are discussed, especially as they concern the possible location of angiotensin receptors in the renal blood vessels. Other aspects of the relationships between the peptides are also taken into account particularly with regard to a postulated angiotensin I [NaCl] dependent peritubular capillary antidiuretic action, angiotensin converting enzyme inhibition, Goldblatt clamp induced hypertension and blood flow through the hind limbs. PMID- 1766417 TI - Oxidative imbalance in HIV infected patients. AB - We present an outline of the complex interplay of oxidants and antioxidants in infectious diseases in general, and in particular with reference to the HIV infection, and subsequent opportunistic infections. Viral and opportunistic infections may directly or indirectly cause an imbalance in prooxidant/antioxidant mechanisms and result in generation of increased steady state concentrations of reactive oxidants. In HIV patients a prooxidant state could lead to a self-perpetuation of infection via stimulated expression of genes carrying the virus genome, and subsequently to immunosuppression, and promotion of initiated cells to neoplastic growth. PMID- 1766418 TI - Theoretical mechanisms for synthesis of carcinogen-induced embryonic proteins: intermediate generalizations. AB - A previous rendition of a mechanism for the induction of embryonic gene activity, derived from the viewpoint of agents capable of such inductions, concluded that a perturbed methylation pattern of DNA and/or chromatin proteins would be an essential feature. A more specific treatment of the mechanism centers on enhancer regions of proto-oncogenes as being the point of modification for any induction of new gene activity. DNA binding type proteins may be involved with deheterochromatization processes after complexing near long terminal repeat segments containing enhancer elements. Chemical carcinogens and steroids would modify the chromatin and directly or indirectly interfere with maintenance DNA methylation. The resulting hypomethylated enhancer and promoter regions would allow for enhancer mechanisms to activate repressed embryonic genes inappropriate to the developmental stage forcing embryonic features to be expressed by differentiating (or differentiated) cells. PMID- 1766419 TI - Immune response: self-foreignness. AB - The classical basic concept of the immune system as a defence system per se and immunological surveillance against neoplasia have never been satisfactorily verified experimentally. The reason for this lies in the historic development of immunology in terms of observations of infectious disease and the interpretation of those observations. Thus, based on a complete lack of understanding of immune events, immunization procedures were developed by Pasteur and his contemporaries. The success of some of these immunization methods, influenced by culture and philosophical thoughts, and based on prima facie evidence allowed the next conceptual step to be taken, culminating in the immune surveillance hypothesis. Central to this hypothesis is selection and tolerance to self-antigens. However, immune reactions to self-antigens are evident and clonal selection is not viable because the number of clones required increases as the frequency of chance of a cell belonging to a particular clone decreases. Also, circadian rhythms in the immune response have not been taken into account. In addition, the problems of haemocytopoiesis have not been addressed, in that it is possible for B lymphocytes to become terminal macrophages and T-lymphocytes to become mast cells, eosinophils and/or basophils constituting 'dead end' cells in an immune response. The initiation of the immune response begins with a tissue-specific T lymphocyte being stimulated and undergoes replication. This gives rise to a dual functional helper/suppressor cell and a B-lymphocyte. These basic concepts explain the necessity for auto-reactive lymphocytes, that is the autologous mixed lymphocyte reaction (AMR). The AMR is a natural consequence of having tissue specific lymphocytes to monitor plasma membrane aberrations. PMID- 1766420 TI - Stress and fatty liver--possible indications for dietary long-chain n-3 fatty acids. AB - The favourable effects of eicosapentaenoic acid (EPA)- and doco-sahexaenoic acid (DHA)-rich diets (marine fish, fish oil) on several risk factors for cardiovascular disease are well established. The present survey describes possible new indications for diets supplemented with long-chain n-3 fatty acids. During a standardized psychophysiological stress test (arithmetic, sentence completion tasks) systolic blood pressure after 2 weeks of diets supplemented with either 60 ml/day of sunflower or linseed oil was significantly decreased. During the sunflower oil-rich diet 45 g/day of linoleic acid (LA) and during the linseed oil-rich period 38 g/day of alpha-linolenic acid (LNA) were ingested. After a 2-week diet supplemented with mackerel (2 cans/day equivalent to 2.2 g/day of EPA and 2.8 g/day of DHA) systolic and diastolic blood pressure within the same test design appeared significantly lower. After a herring diet providing 2 cans/day, equivalent to 1.0 g of EPA and 1.8 g of DHA, the blood pressure lowering effect was minor. The increase of thromboxane B2 (TxB2) during the stress test failed to occur after the fish diets. The results suggest a stress protective effect of polyenoic acid-rich diets, which appears most pronounced and dose-related after long-chain n-3 fatty acids. In human liver an increase of fat droplet size in hepatocytes is associated with a decrease of the percentage of EPA in liver triglycerides. A diminution of plasma free fatty acids (FFA) after a mackerel diet might contribute to a depressed synthesis of liver triglycerides.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766421 TI - Deranged modulatory midbrain opioid and gonadotrophin functions: relevance to Tourette's syndrome. AB - In the following communication we discuss evidence suggesting that an abnormal opioid-gonadotrophin interaction at the midbrain may be essential to the clinical expression of vocal tics in Tourette's Syndrome (TS). Data derived from animal studies and the striking similarity between the symptomatology of TS and encephalitis lethargica (EL) add further support to our hypothesis implicating an abnormal opioid-gonadotrophin interaction in the pathophysiology of TS. PMID- 1766422 TI - Role of programmed cell death in dental anomalies associated with cleft lip and palate. AB - A role of programmed cell death (PCD) is proposed in the production of tooth anomalies occurring in association with cleft lip and palate (Cl + P). Dental anomalies are viewed as a microform of cleft lip and palate, produced by different modulations of the same operating mechanism. PMID- 1766423 TI - Renal function in the preterm neonate: an overview. PMID- 1766424 TI - What do parents need when their infant is a patient in the NICU? PMID- 1766425 TI - Critical care transport of a cardiac infant: a case study. PMID- 1766426 TI - New factors associated with the incidence of hypoglycemia: a research study. PMID- 1766427 TI - Cocaine: a brief history. PMID- 1766428 TI - Do parents of preterm infants suffer chronic sorrow? PMID- 1766429 TI - Nasal prong CPAP: a proven method for reducing chronic lung disease. PMID- 1766430 TI - Discharge teaching in the NICU. PMID- 1766431 TI - Indomethacin. PMID- 1766432 TI - The gene for a halophilic glutamate dehydrogenase: sequence, transcription analysis and phylogenetic implications. AB - We have isolated and sequenced the gene for a putative NADP-dependent glutamate dehydrogenase from the extremely halophilic archaebacterium Halobacterium salinarium. This gene is transcribed as a unique RNA molecule of about 1700 nucleotides. The 5' end of the transcript contains characteristic consensus transcription initiation and promoter sequences observed in halophilic archaebacteria. The encoded polypeptide, with a predicted length of 435 amino acids, shows significant overall homology and conservation of functional domains when compared with different eubacterial and eukaryotic glutamate dehydrogenases. Surprisingly, the archaebacterial protein shares a larger number of identical amino acid residues with homologous polypeptides from higher eukaryotes than with those from unicellular eukaryotes and eubacteria. PMID- 1766433 TI - S-alleles are retained and expressed in a self-compatible cultivar of Petunia hybrida. AB - We identified two S-allele-associated proteins (S-proteins) in a self-compatible cultivar of Petunia hybrida based on their segregation in F1 hybrids between P. hybrida and its self-incompatible relative, Petunia inflata (with S2S2 genotype), and in selfed progeny of P. hybrida. These two S-proteins, designated Sx-protein (24 kDa) and So-protein (31 kDa), are pistil specific, and their expression follows a temporal and spatial pattern similar to that of S-proteins characterized in self-incompatible solanaceous species. Their amino-terminal sequences also share a high degree of similarity with those of solanaceous S proteins. Selfing of P. hybrida yielded plants with SoSo,SxSo, and SxSx genotypes in an approximately 1:2:1 ratio, indicating that the Sx-and So-alleles, though expressed in the pistil, failed to elicit a self-incompatibility response. The S2 allele of P. inflata is expressed in all the F1 hybrids, rendering them capable of rejecting pollen bearing the S2-allele. The So-allele is not functional in the F1 hybrids, because all the F1 progeny with S2So genotype are self-compatible. However, in F1 hybrids with S2Sx genotype, approximately half are self incompatible and half are self-compatible, indicating that the function of the Sx allele depends on the genetic background. These results strongly suggest that the presence of functional S-alleles alone is not sufficient for expression of a self incompatibility phenotype, and reaffirm the multigenic nature of gametophytic self-incompatibility suggested by earlier genetic studies. PMID- 1766434 TI - The uaY positive control gene of Aspergillus nidulans: fine structure, isolation of constitutive mutants and reversion patterns. AB - The product of the uaY gene of Aspergillus nidulans is necessary for the expression of at least eight genes coding for enzymes and permeases of the purine utilisation pathway. A detailed fine structure map has been constructed of this gene involving 13 presumed point mutations and eight deletions. Gene conversion of these deletions was demonstrated. A technique was devised to select for constitutive mutations and two were obtained which map within the uaY gene. We have shown that the most centromere proximal allele reverts to a number of different phenotypes. The properties of this allele suggest that it may map in the open reading frame of the uaY gene, in a domain that could be altered in a way that would differentially affect the expression of genes under uaY control. PMID- 1766435 TI - Molecular cloning of the uaY regulatory gene of Aspergillus nidulans reveals a favoured region for DNA insertions. AB - The cloning of the positive regulatory gene, uaY, which mediates uric acid induction of enzymes and permeases of the purine degradation pathway in the fungus Aspergillus nidulans is described here. The 4 kb uaY transcript is constitutively synthesised, it is not repressed by ammonia and its transcription does not require the AreA wide-domain transcription factor. We have determined that four deletions, which have been genetically characterised, are confined to a segment of 0.9 kb. Two other deletions are double events; each is a deletion of about 1 kb plus an insertion. The positions of the deletions confine 9 out of the 11 mapped putative point mutations within a 1 kb segment. Two other non revertible alleles, which mapped as point mutations, are insertions of at least 11 and 18 kb respectively. The pattern of gene conversion within the uaY gene was described previously. The results reported here demonstrate that conversion of sequences of at least 18 kb can occur in A. nidulans. PMID- 1766436 TI - Bacteriophage T7 morphogenesis and gene 10 frameshifting in Escherichia coli showing different degrees of ribosomal fidelity. AB - Bacteriophage T7 infection has been studied in Escherichia coli strains showing both increased and decreased ribosome fidelity and in the presence of streptomycin, which stimulates translational misreading, in an effort to determine effects on the apparent programmed translational frameshift that occurs during synthesis of the gene 10 capsid protein. Quantitation of the protein bands from SDS-PAGE failed to detect any significant effects on the amounts of the shifted 10B protein relative to the in-frame 10A protein under all fidelity conditions tested. However, any changes in fidelity conditions led to inhibition of phage morphogenesis in single-step growth experiments, which could not be accounted for by reduced amounts of phage protein synthesis, nor, at least in the case of decreased accuracy, by reduced amounts of phage DNA synthesis. Reduction in phage DNA synthesis did appear to account for a substantial proportion of the reduction in phage yield seen under conditions of increased accuracy. Similar effects of varying ribosomal fidelity on growth were also seen with phage T3, and to a lesser extent with phage T4. The absence of change in the high-frequency T7 gene 10 frameshift differs from earlier reports that ribosomal fidelity affects low-frequency frameshift errors. PMID- 1766437 TI - Organisation and functions of the actVA region of the actinorhodin biosynthetic gene cluster of Streptomyces coelicolor. AB - Sequence analysis of the actVA region of the actinorhodin biosynthetic gene cluster of Streptomyces coelicolor revealed a succession of six open reading frames (ORFs), all running in the same direction and extending over 5.32 kb. The protein product of actVA-ORF1 strongly resembles that of another gene, elsewhere in the act cluster (actII-ORF2), which codes for a trans-membrane protein previously implicated in actinorhodin export from the mycelium. This suggests that the two gene products may co-operate in actinorhodin export, perhaps being sufficient for self-protection of the organism against suicide. At least four of the other five ORFs are implicated in the control of the C-6 and C-8 ring hydroxylation reactions, lacking in actVA mutants, that occur at middle to late stages in the actinorhodin biosynthetic pathway. This conclusion was reached by genetic mapping of actVA mutants to actVA-ORF3 and -ORF5 (and perhaps -ORF4), and by the finding of strong resemblances between the protein products of actVA-ORF2 and -ORF6 and the products of genes of the oxytetracycline or tetracenomycin gene clusters that have been implicated in ring-hydroxylation reactions in the biosynthesis of these other aromatic polyketide antibiotics. PMID- 1766439 TI - Nodules elicited by Rhizobium meliloti heme mutants are arrested at an early stage of development. AB - Heme-deficient mutants of Rhizobium and Bradyrhizobium have been found to exhibit diverse phenotypes with respect to symbiotic interactions with plant hosts. We observed that R. meliloti hemA mutants elicit nodules that do not contain intracellular bacteria; the nodules contain either no infection threads ("empty" nodule phenotype) or aberrant infection threads that failed to release bacteria (Bar- phenotype). These mutant nodules expressed nodulin genes associated with nodules arrested at an early stage of development, including ENOD2, Nms-30, and four previously undescribed nodulin genes. These nodules also failed to express any of six late nodulin genes tested by hybridization, including leghemoglobin, and twelve tested by in vitro translation product analysis which are not yet correlated with specific cloned genes. We observed that R. meliloti leucine and adenosine auxotrophs induced invaded Fix- nodules that expressed late nodulin genes, suggesting that it is not auxotrophy per se that causes the hemA mutants to elicit Bar- or empty nodules. Because R. meliloti hemA mutants elicit nodules that do not contain intracellular bacteria, it is not possible to decide whether or not the Fix- phenotype of these nodules is a direct consequence of the failure of R. meliloti to supply the heme moiety of hololeghemoglobin. Our results demonstrate the importance of establishing the stage in development at which a mutant nodule is arrested before conclusions are drawn about the role of small metabolite exchange in the symbiosis. PMID- 1766438 TI - Determination of steady-state mRNA levels of individual chlorophyll a/b binding protein genes of the tomato cab gene family. AB - The steady-state levels of mRNA produced by 14 genes encoding members of the tomato chlorophyll a/b binding protein family were quantified. All genes were found to be expressed in leaf tissue, but the mRNAs accumulated to significantly different levels. The transcripts of cab 1A, cab 1B, cab 3A and cab 3B, encoding the Type I LHC proteins of photosystem II, are abundant, while low levels were measured for mRNAs encoding the Type II LHC II and the LHC I proteins. Sequences from the 5' upstream regions (-400 to translational start) of some cab genes were determined in this study, and a total of 16 tomato cab gene promoters for which sequences are now available were analyzed. Significant sequence conservation was found for those genes which are tandemly linked on the chromosome. However, the level of sequence conservation is different for the different cab subfamilies, e.g. 85% similarity between cab 1A and cab 1D vs. 45% sequence similarity between cab 3A and cab 3C upstream sequences. Characteristic GATA repeats with a conserved spacing were found in 5' upstream sequences of cab 1A-D, cab 3A-C, cab 11 and cab 12. The consensus sequence CCTTATCAT, which is believed to mediate light responsiveness, was found at different locations in the upstream sequences of cab 6B, cab 7, cab 8, cab 9, cab 10A, cab 10B and cab 11. In 11 out of 15 genes the transcription initiation site was found to center on the triplet TCA. PMID- 1766440 TI - Transformation of a methionine auxotrophic mutant of Mucor circinelloides by direct cloning of the corresponding wild type gene. AB - A transformation system has been developed for Mucor circinelloides, by direct cloning of a wild-type methionine gene that complements the auxotrophic mutation. The marker gene isolated was associated with an autonomous replication sequence (ARS) functional in this zygomycete. Southern hybridisation analyses of transformants showed sequence homology both with vector DNA and with Mucor wild type DNA. The transformation frequency (up to 6000 per microgram DNA) and the mitotic instability of the transformed cells were studied. The hybridisation pattern of undigested DNA from the transformants suggests that the inserts contain a novel autonomous replication element for this filamentous fungus. PMID- 1766441 TI - Lipoxygenase gene expression is modulated in plants by water deficit, wounding, and methyl jasmonate. AB - Two classes of lipoxygenase (LOX) cDNAs, designated loxA and loxB, were isolated from soybean. A third lipoxygenase cDNA, loxP1, was isolated from pea. The deduced amino acid sequences of loxA and loxB show 61-74% identity with those of soybean seed LOXs. loxA and loxB mRNAs are abundant in roots and non-growing regions of seedling hypocotyls. Lower levels of these mRNAs are found in hypocotyl growing regions. Exposure of soybean seedlings to water deficit causes a rapid increase in loxA and loxB mRNAs in the elongating hypocotyl region. Similarly, loxP1 mRNA levels increase rapidly when pea plants are wilted. loxA and loxB mRNA levels also increase in wounded soybean leaves, and these mRNAs accumulate in soybean suspension cultures treated with 20 microM methyl jasmonate. These results demonstrate that LOX gene expression is modulated in response to water deficit and wounding and suggest a role for lipoxygenase in plant responses to these stresses. PMID- 1766442 TI - Functional analysis of cis-elements, auxin response and early developmental profiles of the mannopine synthase bidirectional promoter. AB - The dual MAS1'-2' promoter regulating two divergently transcribed mannopine synthase genes has been widely employed in plant expression vectors. As part of an effort towards its rational design as a genetic engineering tool, we have undertaken a functional analysis of the promoter by deletion mutagenesis and by the use of hybrid promoter constructs. Our results indicate that the central region of the intergenic promoter is composed of at least four domains. Three of these contain complementary sequences, which can potentially hybridize to form alternative palindromic structures. These three domains can function cooperatively, and in an orientation-independent manner, in imparting a sevenfold higher expression level at the 2' end relative to the corresponding 1'. The remaining domain is characterized by tracts of repeated A/T-rich elements, and appears to confer the weak activity at the MAS1' promoter end. However, even though this A/T-rich DNA segment is functional, our deletion analysis provided strong evidence that it is completely dispensable for wild-type promoter activity. In addition, the relative distances between these enhancer domains and the 1'-2' TATA-proximal regions can have a pronounced influence on the level of expression in both directions. In young tobacco seedlings, the two promoter ends are expressed in similar, if not identical, tissues in the aerial parts of the plants, but major differences can be observed in roots. Transient expression assays using hybrid promoter constructs showed that cis-elements that can respond to auxin induction signals are redundant in nature, in that they are dispersed throughout the promoter and showed no obvious consensus sequence. PMID- 1766443 TI - Transcription termination in the dnaA gene. AB - The termination of transcription in the dnaA gene of E. coli was analyzed using transcriptional fusions to the galactokinase gene, S1 nuclease mapping and quantification of translation products by Western blots. The majority of transcripts originating from dnaA promoters terminated at several positions within a 200 bp region inside the dnaA reading frame. PMID- 1766444 TI - Judging social issues: difficulties, inconsistencies, and consistencies. AB - The three studies reported in this Monograph examine high school and college students' reasoning about the issues of abortion, homosexuality, pornography, and incest. The studies stemmed from previous research on reasoning in the "prototypical" moral, social conventional, and personal domains. We postulated that abortion, homosexuality, pornography, and incest are nonprototypical issues. We expected that reasoning about nonprototypical and prototypical issues would differ and that reasoning about nonprototypical issues would be inconsistent and involve ambiguities in informational assumptions. Two groups were preselected in Study 1, those who negatively and those who positively evaluated the nonprototypical issues. Assessments were made of criterion judgments (evaluations, rule contingency, and generalizability) and justifications regarding moral, personal, and nonprototypical issues. The groups differed in judgments about the nonprototypical issues but not the moral issues. Both groups gave noncontigent and generalized judgments about moral issues, with justifications of justice and rights. Subjects who evaluated nonprototypical acts negatively used varied and often inconsistent configurations of criterion judgments. Responses coded for general reasoning types often entailed juxtapositions of prescriptive judgments and assertions of personal choice. Subjects who evaluated nonprototypical acts positively judged that they should be legal and nongeneralized and gave justifications based on personal choice. Using similar procedures, Study 2 was conducted with practicing Catholics attending parochial high schools. The findings paralleled those of Study 1, including a split among subjects in their evaluations of the nonprototypical issues. The results suggested a bidirectional relation between individual judgments and group positions. The findings of Studies 1 and 2 suggested that variations in evaluations and judgments about the nonprototypical issues were associated with variations in ambiguously held informational assumptions. Study 3 examined the role of such informational assumptions. It was found that assumptions associated with judgments about abortion and homosexuality were ambiguous and inconsistently applied. Thus, we propose that ambiguity around assumptions is a central component of the nonprototypicality of these issues. PMID- 1766445 TI - Why are nonprototypical events so difficult, and what are the implications for social-developmental psychology? PMID- 1766446 TI - AAEM case report #23: acute paralytic poliomyelitis. AB - A 56-year-old man with acute paralytic poliomyelitis is described. The illness started with fever and diarrhea after an overseas trip, and an enterovirus other than poliovirus was isolated from the patient's stool. The onset of weakness was rapid and asymmetric, with primary involvement of the lower extremities. Nerve conduction studies revealed low amplitude motor responses after the first week, with normal results for sensory studies. Serial electromyographic studies were performed, documenting acute denervation followed later by reinnervation in the distribution of multiple segments. The clinical and electrodiagnostic features of acute poliomyelitis are reviewed. PMID- 1766447 TI - Use of the photoplethysmographic technique to analyze the Valsalva maneuver in normal man. AB - We analyzed the Valsalva maneuver (VM) using a photoplethysmographic technique in 24 normal subjects. We studied the effects of test duration (range 5 to 20 seconds) and magnitude of expiratory pressure (EP, range 20 to 50 mmHg) on maximal (% delta) and time integrated (int) changes in heart rate (HR), and mean (MAP) and pulse (PP) pressures during phases II and IV. At all EPs, there was correlation (P less than 0.01) between % delta MAP in both late phase II and phase IV and duration of the VM. The Valsalva ratio (VR) correlated with test duration only at high EPs. All responses, except the fall in MAP in early phase II and bradycardia in phase IV, correlated with EPs. The VR correlate not only with HR responses in phases II and IV but also with MAP and PP overshoot in phase IV. Correlations between maximal AP and HR changes in either phase II and IV were poor. Our study indicates that the photoplethysmographic technique allows a more rational interpretation of the VM in the clinical setting. The VR cannot be adequately interpreted without comcomitant monitoring of arterial pressure during the VM. PMID- 1766448 TI - Comparison of sensory nerve conduction in the palmar cutaneous branch and first digital branch of the median nerve: a new diagnostic method for carpal tunnel syndrome. AB - Comparison of sensory nerve conductions in palmar cutaneous branch (PCB) and digit I nerves was applied in 50 patients suspected of having carpal tunnel syndrome (CTS) and 40 healthy persons. The abnormalities were defined as the differences in latencies and sensory nerve conduction velocities (SNCVs) of more than mean plus 2.5 SD of controls. Comparing these 2 sensory nerves, statistical differences were seen in 83.7% (36 of 43 patients) of their sensory latencies and 76.7% (33 of 43 patients) of their SNCVs. This excluded 7 patients who had unobtainable sensory nerve action potentials in digit I nerves. This method may serve as an adjunctive technique in the diagnosis of CTS. Its diagnostic sensitivity was high in comparison with other testing methods. PMID- 1766449 TI - Antidystrophin stains triadic junctions in regenerating rat muscles. AB - Dystrophin has biochemically been found in the sarcolemma and in junctional t tubules, but immunocytochemistry shows reactivity at the sarcolemma only. In the present study, normal and regenerating soleus muscles of rat were perfused for 10 minutes with 2% formaldehyde; isolated fibers were stained with polyclonal antidystrophins and HRP and embedded in epoxy. Staining of triadic junctions in normal fibers was ambiguous but, in regenerated fibers, 4 weeks after injury it was distinct. Immature myotubes 3 days after injury showed reactivity at the sarcolemma and at various internal membranes. The nonselective staining of internal membranes may be due to secondary binding of the reaction product, and supports the view that dystrophin is cytoplasmic before it becomes restricted to the sarcolemma and t-tubules. PMID- 1766450 TI - Estimation of conduction velocity of A delta fibers in humans. AB - Conduction velocity of A delta fibers of the human peripheral nerves was measured by using pain-related somatosensory evoked potentials following CO2 laser stimulation. It was found to be approximately 9 m/s in the forearm as well as in the lower leg. Because conventional conduction study using electric stimulation reflects only functions of large myelinated fibers related to deep proprioceptive and tactile sensations, the present noninvasive and simple, novel method is the only laboratory examination currently available to investigate physiological functions of the small diameter fibers mediating pain-temperature sensations. PMID- 1766451 TI - Autosomal recessive Duchenne-like muscular dystrophy: molecular and histochemical results. AB - An autosomal recessive disorder which mimics Duchenne muscular dystrophy has long been suspected as a cause of muscular dystrophy in karyotypically normal girls and in both boys and girls with consanguineous parents. Analysis of dystrophin now allows confirmation of the existence of this disorder. We report the results of this analysis in a brother and sister who have the typical clinical features of Duchenne muscular dystrophy, but no demonstrable abnormality in dystrophin or its gene. PMID- 1766452 TI - Electrophysiologic mapping of the segmental anatomy of the muscles of the lower extremity. AB - Our knowledge of the specific root innervation of skeletal muscles is derived from accumulated clinical experience. While performing selective posterior rhizotomy for treatment of spasticity in children with cerebral palsy, we made direct electrophysiologic measurement of the root innervation of the lower extremity. We stimulated ventral roots from L2 to S2 while recording from all muscles simultaneously. The size of the evoked compound muscle action potential was used as an indication of the amount of innervation derived from stimulation of a given spinal root. We found the major root innervation for the 8 muscles studied to be: adductor longus, vastus medialis, and vastus lateralis, L3; tibialis anterior; L4; peroneus longus, L5; and medial gastrocnemius, lateral gastrocnemius, and gluteus maximus, S1. In general, each muscle received innervation from 3 or more roots. Prefixed or postfixed innervation patterns were found in 27.9% of legs examined, and there was asymmetry of innervation in 29.8%. We conclude that the segmental innervation of lower extremity muscles is broader than previously thought. Anomalous innervation occurs so frequently that caution should be used in attributing any pattern of clinical or EMG findings to a specific spinal level. PMID- 1766453 TI - Ca-, Sr-tension relationships and contraction velocities of human muscle fibers. AB - Muscle fibers from the lateral gastrocnemius or intercostal muscles of 7 normal adult males were chemically skinned (sarcolemma disrupted) and isolated fibers were divided into two parts for histochemical determination of fiber type and physiologic studies. The Ca- and Sr-induced tension relationships and maximum contraction velocities were measured. Slow twitch fibers developed tension at lower concentrations of Ca or Sr than fast twitch fibers. The difference between fast and slow twitch fibers was greatest when Sr was the activating cation. Fast and slow twitch fibers was greatest when Sr was the activating cation. Fast and slow twitch fibers generated similar maximum tensions. The contraction velocities of fast twitch fibers were more than two-fold greater than slow twitch fibers. Fast-oxidative-glycolytic (FOG, type IIA) and fast-glycolytic (FG, type IIB) fibers had similar Ca- and Sr-tension relationships and contraction velocities. PMID- 1766454 TI - Quantitation of the alternate movement rate in normal and diabetic subjects. AB - Functional abnormalities of alternate movement rate (AMR) of finger and foot tapping were quantitated in 162 patients with diabetic neuropathy and 30 control subjects using a simple electronic device. The quantitative AMR (QAMR) averaged 29.5 +/- 3.0 for finger tapping and 20.4 +/- 3.7 for foot tapping in controls, and 27.5 +/- 4.8 (P less than 0.05) and 17.0 +/- 5.6 (P less than 0.005) for finger and foot, respectively, in diabetic patients. Fifty-one patients had abnormal QAMR in the finger and 79 in the foot. The QAMR values correlated with the results of nerve conduction studies of patients. Testing for abnormalities of AMR is a useful addition to the testing of dysfunction secondary to diabetic neuropathy. It provides quantitation of a common, subject-initiated, functional task more accurately than possible by clinical observation. PMID- 1766455 TI - Role of electromyography in amyotrophic lateral sclerosis. AB - We reviewed the role of electrodiagnostic testing in amyotrophic lateral sclerosis (ALS) in a large ALS clinic. Over 31 months, 133 patients with a clinical diagnosis of ALS were tested. In most, nerve conduction studies were normal, and needle electrode examination showed active denervation in the upper and lower limbs or the limbs and bulbar muscles (Lambert's criteria). However, 50 of 133 patients did not fulfill Lambert's criteria at presentation because of abnormal nerve conduction studies (11 patients), abnormal F-wave latencies (6 patients), or insufficiently distributed fibrillation potentials (40 patients). This study reveals that a large proportion of patients with a clinical diagnosis of ALS fail to have classical findings on initial electrodiagnostic studies, and reveals several caveats of electrodiagnostic testing in these patients: (1) Conduction studies may be unreliable in motor nerves with markedly low compound muscle action potential (CMAP) amplitudes. (2) Sensory nerve action potential (SNAP) amplitudes may be abnormal in a small percentage of otherwise typical ALS patients. However, better controls for elderly subjects are needed. (3) Needle electrode examination may not show widespread active denervation early in the disease. (4) Some patients may have a mild polyneuropathy. (5) The classic diagnostic criteria may need to be modified to allow earlier acceptance of many ALS patients into therapeutic trials. PMID- 1766456 TI - Abnormalities in the sensory action potential in patients with amyotrophic lateral sclerosis. AB - Sensory function in patients with amyotrophic lateral sclerosis (ALS) is thought to be normal; however, there is convincing morphologic evidence that sensory systems are affected in addition to motor systems. In this study, compound sensory action potentials were recorded with near nerve electrodes from 18 patients with ALS. Up to 1024 responses were averaged at high gain to determine minimum conduction velocity; that is, the conduction velocity of the slowest conducting component of the sensory action potential. Nine of 18 patients had abnormally reduced minimum conduction velocity, even when peak-to-peak amplitude and maximum conduction velocity (calculated from the latency to the initial positive peak) were normal. Only 3 of 18 patients showed abnormalities in peak-to peak amplitude. Thus, subtle abnormalities in the sensory action potential can be detected in many patients with ALS. PMID- 1766457 TI - Caution in the use of tocainide. PMID- 1766458 TI - An outbreak of blastomycosis in eastern Tennessee. AB - Most cases of blastomycosis are sporadic and only nine outbreaks representing a total of 112 cases have previously been reported. Less than half of these have been culture proven cases. Outbreaks have previously occurred in North Carolina, Minnesota, Illinois, Wisconsin and Virginia. We report three culturally confirmed cases of blastomycosis from Elizabethton, Tennessee, who had onset of illness within a one-week span of time. The patients presented with fever, chest pain, weight loss, poor appetite and myalgia. Each initially had a dry cough which became productive of purulent sputum as the illness progressed. Mild hemoptysis occurred during each patient's course. Serologic testing by immunodiffusion and enzyme immunoassay were positive and testing by complement fixation was negative in each case. The diagnosis was made by histopathology on transbronchial biopsy or transthoracic needle aspiration material. Each patient improved on ketoconazole therapy. PMID- 1766459 TI - Protonation of ketoconazole in relation to fungistatic activity. PMID- 1766460 TI - Sporotrichosis following a rodent bite. A case report. AB - A ten year old boy developed lymphocutaneous sporotrichosis following a wild rodent bite. The infection was successfully treated with potassium iodide. Sporotrichosis in humans has followed bites, pecks and stings inflicted by a variety of animals, birds and insects. Many species of animals are susceptible to infection by Sporothrix schenkii, but transmission from infected animals to man is uncommon. PMID- 1766461 TI - Phylogeny and molecular epidemiology of Sporothrix schenckii in Japan. AB - Mitochondrial DNA(mtDNA) diversity was investigated in 257 clinical isolants of Sporothrix schenckii obtained from 4 districts in Japan. S. schenckii was classified into 10 types based on Hae III restriction profiles. Phylogeny of types constructed by the method of Fitch and Margoliash [1] on the estimated sequence divergence within mtDNA using the methods of Nei and Li [2], showed that S. schenckii are grouped into 2 clusters, one group consisting of types 1, 2 and 3, and the other group consisting of the other seven types. In addition, types 1, 2, and 5 were correlated with their geographic origin, whereas type 4 was present throughout Japan. PMID- 1766462 TI - Upgrading epidemiology training in South Africa. Report of an Epidemiological Society of Southern Africa seminar: Medical Research Council Campus, July 12 1991, Cape Town. PMID- 1766463 TI - Saga of a fund-raising effort (or how to turn grey in a few weeks). PMID- 1766464 TI - [Health care in Taiwan]. PMID- 1766465 TI - Wound care update. PMID- 1766466 TI - Liabilities, issues and safeguards in nursing. PMID- 1766467 TI - [Strikes by nursing personnel]. PMID- 1766468 TI - Sexually transmitted infections on the increase. PMID- 1766469 TI - Nursing one hundred years ago. Part 3. PMID- 1766470 TI - Release of [3H]acetylcholine from the isolated rat or guinea-pig trachea evoked by preganglionic nerve stimulation; a comparison with transmural stimulation. AB - Basal and stimulated outflow of radioactive acetylcholine, phosphorylcholine and choline from rat and guinea-pig isolated tracheae were measured by reverse phase HPLC followed by liquid-scintillation-spectrometry. Tracheae were stimulated either by an electrical field (transmural stimulation) or by a local stimulation of the innervating parasympathetic nerves (preganglionic stimulation). Epithelium was removed in most experiments, as the epithelium inhibits acetylcholine release. The basal tritium efflux (1,600 dpm/3 min) from rat isolated tracheae incubated with [3H]choline consisted of 56% [3H]phosphorylcholine and 38% [3H]choline. Preganglionic stimulation (15 Hz, 1,200 pulses) caused a 2-fold increase in tritium outflow that was abolished by the removal of extracellular calcium or by the addition of tetrodotoxin. The stimulated outflow of tritium induced by preganglionic nerve stimulation was caused by an exclusive release of [3H]acetylcholine, whereas the efflux of [3H]phosphorylcholine and [3H]choline remained unaffected by this stimulation mode. Transmural stimulation of the rat or guinea-pig trachea, however, caused, in addition to the release of [3H]acetylcholine, the outflow of [3H]phosphorylcholine. Hexamethonium (300 mumol/l) or tubocurarine (100 mumol/l) inhibited (80%) the increase in tritium outflow evoked by preganglionic stimulation, but did not affect tritium outflow evoked by transmural stimulation. Oxotremorine reduced [3H]acetylcholine release evoked by both stimulation modes, but oxotremorine was less potent with transmural stimulation. Scopolamine (0.3 mumol/l) enhanced (120%) the release of [3H]acetylcholine evoked by preganglionic nerve stimulation indicating the blockade of an endogenous negative muscarinic feedback mechanism. Epithelium dependent inhibition of [3H]acetylcholine release was evident with both preganglionic and transmural stimulation. The present experiments demonstrate that release of [3H]acetylcholine evoked from the isolated trachea by stimulation of the preganglionic trunk of the parasympathetic cholinergic nerves.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766471 TI - Effect of high single doses of levodopa and carbidopa on brain dopamine and its metabolites: modulation by selective inhibitors of monoamine oxidase and/or catechol-O-methyltransferase in the male rat. AB - The upper limits of striatal and hypothalamic dopamine formation and metabolism in the rat were defined after acute levodopa/carbidopa (100/100 mg/kg) in combination with MAO (clorgyline; 32 mg/kg or pargyline; 100 mg/kg) and/or COMT inhibitors (OR-462, OR-611, Ro 41-0960, 30 mg/kg). Striatal and hypothalamic dopa and 3-OMD levels increased several hundred times after levodopa/carbidopa treatment alone. Dopamine, DOPAC, HVA and 3-MT levels elevated also but noradrenaline and 5-HT did not. Clorgyline further increased 3-OMD, dopamine and 3-MT concentrations while DOPAC and HVA levels decreased. These changes were even more pronounced after pargyline. In the striatum, all COMT inhibitors (with levodopa/carbidopa) blocked 3-OMD formation but elevated neither dopamine nor DOPAC levels. OR-462 increased dopa levels. Only Ro 41-0960, the brain penetrating compound, blunted HVA levels. All three COMT inhibitors decreased high 3-OMD levels evoked by MAO inhibitors (+ levodopa/carbidopa). In pargyline treated rats, COMT inhibitors did not alter dopamine, DOPAC or HVA levels but all of them decreased significantly 3-MT levels, particularly Ro 41-0960. Striatal dopamine levels increased maximally 6 times compared to those in the saline treated controls. In the hypothalamus, COMT inhibitors decreased 3-OMD levels to 1/5-1/30 of those after levodopa/carbidopa alone. COMT inhibitors suppressed 3 OMD formation also in clorgyline and pargyline (+ levodopa/carbidopa) treated rats. After clorgyline, OR-611 and Ro 41-0960 increased high dopamine levels but only Ro 41-0960 suppressed HVA and 3-MT levels. None of the COMT inhibitors changed the high dopamine and low DOPAC levels after pargyline.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766472 TI - Structure-activity studies of new imidazolines on adrenoceptors of rat aorta and human platelets. AB - Potencies of new aromatic substituted fluoro or iodo analogues of catecholimidazolines on functional responses in rat aorta (alpha 1) and platelets (alpha 2) were quantified. (1) When compared either on the basis of EC50 or the dissociation constant (KA), 5-fluorocatecholimidazoline was as potent as the reference alpha 1-adrenoceptor agonist, phenylephrine in the vascular tissue. The maximum contraction of aorta produced by the fluoro analogue was, however, 17% higher than that of phenylephrine. The time required for 1/2 relaxation of the tissue after 5-fluoro hydroxy imidazoline was at least twice as long as that of the phenylephrine. The catechol moiety as well as fluorine substitution at the critical 5-position of the aromatic ring is essential for higher alpha 1 adrenoceptor-mediated potency. (2) As compared to the fluoro analogues, the adrenoceptor-mediated potencies of iodo-analogues were relatively weak on vascular tissue. Naphazoline and its analogues were partial agonists on vascular tissue with dissociation constants which ranged from 110 to 2600 nmol/l. (3) Imidazole analogues were generally less potent agonist than the imidazolines by one order of magnitude. (4) The vacular effects of all agonists were competitively blocked by prazosin with KB values which ranged from 0.04 to 0.48 nmol/l. Since the variation in KB values were within normal limits, the action of new imidazolines on rat aorta appears to be mediated mainly by the activation of the alpha 1-adrenoceptor. Prazosin 10 nmol/l abolished the vascular response of some partial agonists. This indicates a slightly different mode of interaction of agonists with the transduction process. (5) Carbon 4-substituted imidazolines produced little or no alpha 1 adrenoceptor-mediated intrinsic activity, but competitive receptor blocking potency was comparable to that of phentolamine. (6) Medetomidine was a partial agonist on the rat aorta with a KA of 260 nmol/l. When investigated as a blocker, the KB of medetomidine against phenylephrine was approximately 5600 nmol/l. The variation in the latter value was high. (7) In acetylsalicylic acid-treated human platelets, the alpha 2-adrenoceptor-mediated aggregatory effect of all fluoro analogues was weak. Iodo or naphazoline analogues did not initiate platelet aggregation but blocked the aggregation induced by epinephrine. The affinity of naphazoline for the alpha 2-adrenoceptor was 1100 nmol/l. The IC50 of medetomidine for platelet anti-aggregatory effect was 3300 nmol/l, which compares favorably with other imidazoline type of blockers of platelet aggregation. (8) Sympathomimetic vasoconstrictor actions and platelet aggregation effects of these compounds can be dissociated.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1766473 TI - Effects of DPI 201-106, a novel cardiotonic agent, on hemodynamics, cardiac electrophysiology and arrhythmias induced by programmed ventricular stimulation in dogs with subacute myocardial infarction: a comparative study with dobutamine. AB - DPI 201-106 (DPI), a novel and potent cardiotonic agent, exhibits its effects by prolonging the open state of Na+ channels, resulting in an increase in action potential duration, and thus, is supposed to share the class III antiarrhythmic activity. The effects of DPI on the hemodynamics, intraventricular conduction and refractoriness of heart, and the incidence of arrhythmias induced by programmed electrical ventricular stimulation (PES) were compared with (+/-)-dobutamine. Dogs which survived for 5 to 7 days after the induction of myocardial infarction were used as the model. The presence of subacute myocardial infarction caused by occluding the left anterior descending coronary artery elicited a mild left ventricular dysfunction represented by a significant decrease in peak LV dp/dt by about 20%. Both i.v. bolus injection of DPI (1, 3 and 5 mg/kg) and i.v. continuous infusion of dobutamine (3, 5 and 10 micrograms/kg/min), which were administered in a cumulative manner, dose-dependently improved the hemodynamic parameters. At the higher doses of both DPI (3 and 5 mg/kg) and dobutamine (5 and 10 micrograms/kg/min) the control values were reached or even exceeded. DPI dose dependently increased the effective refractory period (ERP) of both non-infarcted and infarcted ventricular myocardia to a similar degree, but the conduction time showed a frequency-dependent increase in the infarcted myocardium to a greater degree than in the non-infarcted myocardium after DPI. In contrast, dobutamine decreased the ERP in both non-infarcted and infarcted myocardia, and slightly increased the difference of refractoriness between the non-infarcted and infarcted zones with no effect on the intraventricular conduction. In the PES study, DPI (3 and 5 mg/kg) produced a significant decrease in the incidence of ventricular tachycardia, whereas dobutamine (5 and 10 micrograms/kg/min) tended to worsen the arrhythmias. These findings suggest that cardiotonic agents with a class III antiarrhythmic property such as DPI may be potentially useful for the management of heart failure accompanied by ischemic heart disease. PMID- 1766474 TI - The influence of 3-ester side chain variation on the cardiovascular profile of nitrendipine in porcine isolated trabeculae and coronary arteries. AB - It has been reported that the lipophilicity of dihydropyridine-type calcium entry blockers may influence both their negative inotropic and their vasodilator activities. The action of nitrendipine and six related 3-ester side-chain derivatives with increasing alkyl and aryl substituents have been investigated in isolated porcine trabecular muscles and coronary artery rings. The lipophilicity of the drugs was determined by high-pressure liquid chromatography. In addition, some sterical parameters of the ester derivatives were considered. For the drugs tested, an increase in 3-ester side chain volume correlated well with increasing lipophilicity. Compared to nitrendipine, vascular selectivity of the ester side chain derivatives, as expressed by the ratio of their negative inotropic and vasodilator activities, was much reduced. Neither vasodilator nor negative inotropic activity was directly related to the corresponding lipophilicity. Based on these results, earlier suggestions about the influence of the ester side-chain in dihydropyridines on their cardiovascular profile are extended. PMID- 1766475 TI - Effect of platelet-activating factor on porcine pulmonary blood vessels in vitro. AB - Platelet-activating factor (PAF) induced contractions of porcine pulmonary vein strips in a concentration-dependent manner, while porcine pulmonary artery strips were unresponsive. Exposure to the specific PAF-antagonists WEB 2086 or BN 52021 antagonized the contractile responses of pulmonary vein strips. Cysteinyl leukotrienes (LT) and thromboxane (TX) B2 were not detected in the bath fluid after stimulation with PAF suggesting that these eicosanoids as well as their precursors are not mediators of PAF-induced contractions of porcine pulmonary vein strips. Furthermore, PAF had no significant effect on 6-keto-prostaglandin (PG) F1a release and flurbiprofen did not affect the PAF response, while it inhibited the release of 6-keto-PGF1a. This indicates that PGI2 or any other cyclooxygenase product is unlikely to modulate or mediate the PAF response. Incubation experiments with fragments of pulmonary vascular tissues demonstrated spontaneous release of small amounts of cysteinyl-LT, TXB2 and 6-keto-PGF1a, which was significantly increased during incubation in the presence of ionophore A23187. While these results demonstrate the synthesizing capacity of the porcine pulmonary vascular tissues for various eicosanoids, PAF failed to stimulate eicosanoid release under these experimental conditions. We conclude that PAF causes contractions of porcine pulmonary vein strips, which are not mediated by cysteinyl-LT or cyclooxygenase products of arachidonate metabolism. The specific contractile effect of PAF on pulmonary veins, but not arteries, could contribute to the disturbances of the pulmonary circulation observed after injection of PAF or release of endogenous PAF, e.g. after administration of endotoxin. PMID- 1766476 TI - Effect of cigarette smoke on pharmacokinetics of oral, intrarectal, or intravenous indomethacin in rats. AB - The effect of cigarette smoke exposure on the pharmacokinetics of indomethacin administered orally, intravenously or intrarectally was investigated in rats. When cigarette smoke exposure was performed for 10 min using a Hamburg II smoking machine immediately after the oral administration of indomethacin (5 mg/kg), the plasma indomethacin concentration was significantly lowered during the first 2 h after administration. However, there was no significant difference in plasma indomethacin concentration between the cigarette smoke-exposed and nonexposed control rats thereafter. Cigarette smoke exposure caused a significant decrease in the area under the concentration-time curve from 0 to 4 h (AUC0-4) and a prolongation of the time to reach the maximum concentration (tmax). The plasma level of O-desmethyl-indomethacin (a major metabolite) was not significantly changed by cigarette smoke. When indomethacin (5 mg/kg) was administered to rats intravenously or intrarectally, cigarette smoke exposure did not have any influence on the pharmacokinetics of indomethacin or 0-desmethyl-indomethacin. The pharmacokinetic effect of cigarette smoke on orally administered indomethacin was mimicked by the subcutaneous injection of nicotine at 0.3 mg/kg but not at 0.1 mg/kg. These results suggest that acute exposure to cigarette smoke decreases the plasma concentration of indomethacin when it is administered orally but not intrarectally or intravenously. PMID- 1766477 TI - Presence of a phosphoramidon-sensitive endothelin-converting enzyme which converts big-endothelin-1, but not big-endothelin-3, in the rat vas deferens. AB - Endothelin-1 (ET-1) enhanced field stimulation-evoked (0.1 Hz), nerve-mediated contractions of the prostatic portion of the rat vas deferens. The human precursor of ET-1, big-endothelin (1-38) (big-ET-1) was only two-fold less potent than ET-1 (pD2 values: 7.30 and 7.49, respectively). The threshold concentrations necessary to elicit an increase of the response to electrical stimulation was lower for ET-1 (5 nmol/l) than for big-ET-1 (25 nmol/l). Endothelin-3 (ET-3) also markedly enhanced the response of the tissue to field stimulation with a potency similar to ET-1 (pD2 value: 7.59). In contrast, the precursor of ET-3, big endothelin (1-41) (big-ET-3), was inactive at concentrations up to 0.5 mumol/l. Treatment of the preparations with phosphoramidon (50 mumol/l) markedly reduced the twitch enhancement by big-ET-1 without affecting the response to ET-1. Our results suggest the presence of a specific phosphoramidon-sensitive endothelin converting enzyme which converts big-ET-1 to ET-1 in the rat vas deferens. PMID- 1766478 TI - Model rehab program for college students on dialysis struggling to survive. PMID- 1766479 TI - The patient's patient. Interview by Teena Chadwell. PMID- 1766480 TI - Transporting ESRD patients can be done at reasonable cost. PMID- 1766481 TI - A new class of potential carcinogenesis inhibitors: hindered p-benzoquinones. AB - The investigation of the mechanisms of action by which phenolic antioxidants (i.e. BHA, BHT, etc.) protect DNA against interaction with activated BaP, led us to the finding that oxidated aminophenols are much more potent in this respect, being also powerful inhibitors of cytochrome P-450 dependent monooxygenases. However, the quinoneimine structures probably involved in this effect are chemically unstable reactive species and therefore difficult to handle. Based on these observations, we extended this study on several types of benzoquinones. We demonstrated that 2,6-di-t-butylbenzoquinone exerted a very good protective effect at DNA level (in standard conditions) as compared to the "classical" BHA (i. e. 91.3% and 34.4%, respectively). This hindered quinone is nontoxic (DL50 = 3085 mg/kg b. w.) and also did not exhibit inhibitory activity against GST. In contrast, the nonsubstituted p-benzoquinone is a powerful inhibitor of this last enzyme. Recently, 2,6-di-t-butylbenzoquinone was isolated from mutagenic depressing food and was considered one of the factors responsible for this effect. PMID- 1766482 TI - Comparison of the effect of hydroxyurea and methotrexate on DNA fragmentation at various reaction conditions. AB - Using the changes in DNA breakage as a marker of DNA damage, the direct action of hydroxyurea (HU) and methotrexate (MTX) on DNA was examined. The experimental design was to expose isolated DNA to HU and MTX alone or HU and MTX with accelerators of free radical reaction (H2O2, Fe..) and to determine DNA fragmentation assessed by electrophoresis. The results indicated that HU can damage DNA, but to demonstrate this ability it needs H2O2, Fe.. or prolonged incubation in solution. Unlike HU, MTX with H2O2 was ineffective; MTX with Fe.. at certain degree protected DNA against lesions induced by Fe.. alone. It is concluded that despite several common features of HU- and MTX-induced toxic side effects in the cells suggesting interference of these drugs with free radical reactions, their direct effect on DNA under oxidizing conditions is quite different at least at the concentrations used by us. PMID- 1766483 TI - Effect of new purine analog 6-purinyl-N-[2-chloroethyl] thiocarbamate (Cloturin) on immune system of mice. AB - The effect of purine analog 6-purinyl-N-[2-chloroethyl] thiocarbamate (Cloturin) was studied in a battery of immunological tests in mice. Cloturin exhibited pronounced suppressive nonselective effect on immune system and its functional capacity. Cloturin decreased cellularity of spleen and bone marrow, elicited leukocytopenia in peripheral blood, suppressed phagocytosis, graft-versus-host reaction and specific antibody production. In comparison with azathioprine, Cloturin had more pronounced activity. The immunosuppressive effect of Cloturin on T-dependent specific antibody production suggests that Cloturin possesses both alkylating and antimetabolic properties. For its properties Cloturin could be useful not only as a cytostatic drug, but also as an immunosuppressive agent. PMID- 1766484 TI - Response of human chronic myeloid leukemia cells to mitoxantrone cytotoxicity: potentiation by bepridil, a calcium channel antagonist. AB - The ability of bepridil, a calcium channel blocker, to potentiate the antitumor activity of mitoxantrone (MITO) in human chronic myeloid leukemia (CML) cells was evaluated. MITO and bepridil, when incubated alone with the CML cells for 4 h, indicated a dose-dependent increase in the inhibition of 3H-thymidine incorporation. Incorporation rate of the radiolabeled thymidine into DNA was used as a measure of cell growth. When the CML cells were exposed to MITO (1 microgram/ml) in the presence of bepridil (1 and 5 micrograms/ml), an enhancement in the inhibition of DNA biosynthesis was observed in 14 out of 17 human CML samples studied. This significant inhibition (p less than 0.001) of 3H-thymidine incorporation due to the combination was found to be completely irreversible. Bepridil was identified predominantly in the octanol phase in the octanol/water partitioning studies. This lipophilic property of drug response modulators was implicated in the observed increase in the intracellular uptake of anticancer drugs, which in turn led to an enhanced cytotoxicity correlating well with the MITO activity observed in this study. The results are suggestive of clinical utility of bepridil as an adjuvant to enhance the anticancer ability of MITO in the treatment of CML. PMID- 1766485 TI - Antitumor effect of combination of cyclophosphamide, adriamycin and platinum (CAP) versus cyclophosphamide, adriamycin and 5-fluorouracil (CAF) in metastatic breast cancer. AB - The aim of the present study was to evaluate the antitumor effect of two drug combinations in disseminated breast cancer. Eighty-one patients divided into two groups entered this nonrandomized study. Group 1 included 32 patients treated with CAP combination: Cyclophosphamide--200 mg/m2 on days 1, 3 and 5 + adriamycin -40 mg/m2 on day 1 + cisplatin--30 mg/m2 on days 1, 3 and 5. Group 2 included 49 patients treated with CAF combination: Cyclophosphamide--100 mg/m2 on days 1 to 14 + adriamycin--30 mg/m2 on days 1 and 8 + 5-fluorouracil--500 mg/m2 on days 1 and 8. All patients had at least 2 courses of chemotherapy. In Group 1 the remission rate was 50% (16 patients) including 3 complete (9%) and 13 partial remissions (41%). In Group 2 the remission rate was 39% (18 patients) with 8 complete (16%) and 10 partial remissions (23%). The analysis of duration of the remissions showed a tendency towards longer duration after treatment with CAP combination (25 versus 15 months for the complete remissions, and 14 versus 11 months for the partial remissions). PMID- 1766486 TI - Hyperfractionated radiotherapy for Burkitt-type lymphoma. Radiobiological aspects. AB - A case of Burkitt-type lymphoma treated by accelerated hyperfractionated irradiation combined with the COP chemotherapy is presented. The effectiveness of treatment was evaluated on the basis of the growth curve and the radiobiological aspects are discussed. During the treatment, the initial volume doubling time (Td) of 15 days was shortened to 4.5 days suggesting accelerated tumor growth. From dose response curve estimated for clinical data taken from literature, an effDo of 1.37 Gy was calculated. Surviving fraction after 58 Gy given in the twice-a-day regimen (b. i. d.) was 10(-19) suggesting local tumor control. However, only partial remission was observed. This nonradical effect may likely result in accelerated repopulation of surviving tumor clonogenic cells. This suggests that such a fast growing tumor as Burkitt-type lymphoma (Tpot = 1 day) should be irradiated using three instead two fractions per day combined with adjuvant or concomitant chemotherapy with a short intervals between cycles. PMID- 1766487 TI - Interleukin 2 enhances the efficiency of immunotoxins in the treatment of mice with ascitic tumors. AB - Two multivalent immunotoxins (ITs) with cytotoxic potential against Thy 1.2 expressing tumor cells were used in association with mouse interleukin 2 (IL2) for treatment of mice bearing ascitic EL4 lymphomas. The combined treatment, ITs + IL2, induced an enhanced antitumor effect revealed by a significant prolongation of the survival time of mice as compared to the simple treatment with ITs or IL2 alone. According to the survival of mice treated by combined therapy, the proportion of killed tumor cells rose up to 94% as resulted from the dose-dependent curve of the survival of nontreated mice versus the number of tumor cells inoculated. PMID- 1766488 TI - Carcinoembryonic antigen, neuron-specific enolase and creatine kinase-BB as tumor markers for carcinoma of the lung. AB - Carcinoembryonic antigen (CEA), neuron-specific enolase (NSE) and creatine kinase BB (CK-BB) were estimated in blood serum of 75 patients with primary lung carcinoma and of 20 patients with nonmalignant lung diseases. CEA and NSE were determined by immunoenzymatic method using monoclonal antibodies (Abbott CEA-EIA and Roche NSE-EIA) and CK-BB was assayed using kits supplied by Boehringer Mannheim (Monotest CK-NAC aktiviert). Enhanced levels of CEA were observed in 64% of patients with lung carcinoma, mainly with adenocarcinoma. Increased activities of NSE and CK-BB were obtained in 47% and 39% of patients, respectively, principally of those with small cell carcinoma. The CEA level was dependent on the stage of advanced NSCLC carcinoma and of NSE and CK-BB on the stage of advanced SCLC carcinoma. The complex analysis of the three markers has given 100% specificity of test. PMID- 1766489 TI - [Obsessive compulsive disorder. A scientific symposium. Hamburg, 19 October 1991]. PMID- 1766490 TI - Cell biology and glomerulonephritis. PMID- 1766491 TI - Bone metabolism in patients with functioning kidney grafts: increased serum levels of osteocalcin and parathyroid hormone despite normalisation of kidney function. AB - In order to study bone metabolism after renal transplantation we measured serum levels of parathyroid hormone (PTH) and osteocalcin (OC), a specific biochemical parameter of bone formation, in 30 patients with functioning kidney grafts and 30 sex- and age matched control subjects. Serum levels of OC and PTH were markedly elevated in the kidney transplantation patients when compared with the control subjects (p less than 0.0001). Elevated levels of OC and PTH were present even in patients with very well functioning transplants. In the kidney transplantation patients, a significant positive correlation between serum OC and serum PTH levels could be found. Our data give evidence of persistent hyperparathyroidism and increased bone turnover in patients after renal transplantation. PMID- 1766492 TI - The impact of ciclosporin in patients with adult polycystic kidney disease following transplantation. AB - In order to evaluate the impact of ciclosporin in patients with adult onset polycystic kidney disease (ADPKD) following renal transplantation, we performed a single-center study of all (n = 65) patients with this disorder since 1978, 43 of whom received CSA (PC-CSA) with the remaining 22 treated with azathioprine (PC AZA). An additional group of 45 age- and time-matched group of non-polycystic CSA treated patients (nonPC-CSA) were used as a separate control group. Patient and graft survivals at 1 and 5 years were similar in PC-CSA when compared to nonPC CSA. The commonest causes of death in both groups were cardiovascular related. The incidence of posttransplant hypertension and acute rejection were also similar. Urinary tract infections (UTIs) were, however, more frequent among PC CSA (11 and 33% pre- and posttransplant respectively) when compared to the nonPC CSA (2 and 17% pre- and posttransplant respectively). The PC-CSA cohort showed improved 1-year patient and graft survivals when compared to PC-AZA (94 and 70% vs. 72 and 34%) with less rejection episodes (42 vs. 88%) during the first year posttransplant but a higher mean serum creatinine at the end of the first year (2.0 vs. 1.6 mg/dl, 176.6 vs. 141.3 mumol/l). Posttransplant hypertension (67 vs. 70%) and UTIs (33 vs. 33%) were, however, similar in both groups. In summary, renal transplantation in ADPKD in the CSA era is associated with equal patient and graft survivals when compared with nonpolycystic patients of comparable age, but superior results when compared with the earlier azathioprine era. PMID- 1766493 TI - Serum IgA class anti-IgA antibody in IgA nephropathy. AB - IgA class anti-IgA antibody was sought by an immunoabsorbent technique in sera from patients with IgA nephropathy (IgA-N, n = 62), other forms of primary glomerulonephritis (PGN, n = 41), seropositive rheumatoid arthritis (RF-positive, n = 18) and normal controls (c, n = 50). IgA-N (31%) and RF-positive (56%) patients showed a significant increase in IgA anti-IgA antibody levels. The subclass of IgA anti-IgA antibody was predominantly IgA1 in both IgA-N and RF positive patients. Size analysis revealed the dimer/monomer ratio to be significantly increased in IgA-N patients compared with that of RF-positive patients (p = 0.03). These results indicate the possible existence of the dimeric form of IgA class anti-IgA antibody in the circulation of IgA-N patients. PMID- 1766494 TI - Mucosal immunity in primary glomerulonephritis: II. Study of the serum IgA subclass repertoire to food and airborne antigens. AB - IgA specific for 7 food and 6 airborne antigens were sought in the serum of 30 adult patients with IgA mesangial nephropathy (IgA GN), 23 with membranous nephropathy (MGN), 20 with idiopathic nephrotic syndrome (INS), 11 with membranoproliferative GN (MPGN) and 22 healthy controls by means of an enzyme linked immunoassay. The IgA subclass was determined using monoclonal antibodies. Increased levels of IgA specific for gliadin, bovine serum albumin (BSA), ovalbumin, lysozyme and alpha-lactalbumin were found in IgA GN, while increased levels of IgA to BSA, ovalbumin, lysozyme and alpha-lactalbumin were observed in MGN; IgA specific for alpha-lactalbumin were increased in INS, and MPGN patients had reduced levels of IgA to BSA and increased levels of IgA to beta lactoglobulin and alpha-lactalbumin. These specific IgA to food antigens were restricted to the IgA1 subclass. Patients with IgA GN had significantly increased levels of IgA specific for Dermatophagoides pteronyssinus (DP) and Dactil while the MGN group showed increased levels of IgA specific for DP, feathers, Dactil and mold. INS patients had increased levels of IgA specific for DP, feathers, Dactil, mold and dog hairs, while MPGN patients had increased levels of IgA specific for feathers, Dactil, dog hairs and mold. All these specific IgA to airborne antigens were restricted to the IgA1 subclass. Patients with the four types of primary glomerulonephritis had decreased IgA specific for cat hairs which were of both the IgA1 and IgA2 subclasses. We conclude that anomalies of the IgA repertoire to environmental antigens are also encountered in primary glomerulonephritis other than IgA GN. PMID- 1766495 TI - Evaluation of platelets and hemostasis during hemodialysis with six different membranes. AB - Hemodialysis induces thrombocytopenia and activation of coagulation. The severity of this reaction depends on the kind of membrane. In this study, we present the results of determination of platelet count, and of different factors of coagulation in 10 stable dialysis patients. Measurements were performed at the start and after 15 and 45 min of dialysis. Samples were taken before and after the dialyzer. All 10 patients were treated consecutively and in a random order during 14 days with the following membranes: polyacrylonitrile (Filtral 12, Hospal), hemophan (GFS 120 Plus, Gambro, and Bio-Nephros HF Andante, Organon), polysulfone (F6, Fresenius), cuprammonium (AM50-BIO, Asahi) and cellulose acetate (Duo-Flux, Cordis-Dow). The cellulose acetate membrane induced a small but significant drop of mean platelet count [results are mean (SEM)]: from 245,000 (17,000) to 224,000 (16,000)/microliters after 15 min. With the same membrane a dramatic increase after 15 min was noted of 6-keto-PGF1 alpha from 56.3 (9) to 146.7 (35.7) pg/ml. The other membranes did not influence significantly prostanoid levels and platelet count. During dialysis no significant changes of fibrinopeptide A (FPA) and von Willebrand factor (VWF) were observed. Nevertheless, predialysis FPA and beta-thromboglobulin (beta TG) concentrations were lowest after 14 days of treatment with cellulose acetate and polyacrylonitrile membranes. It is concluded that the activation of coagulation depends on the membrane used. The activation may be dominated by one single system (e.g. prostanoids). The different predialysis concentration of some of the factors suggests interference of the dialysis membrane with the activation of coagulation during the interdialytic period. PMID- 1766496 TI - Intraglomerular monocytes in human glomerulonephritis. AB - A total of 246 cases of 166 primary glomerulonephritis (GN) and 80 secondary GN were examined for the presence of intraglomerular monocytes using nonspecific esterase reaction of alpha-naphthyl butyrate methods. The high score of monocyte index (MI) as the numbers of monocytes per glomerulus was found in crescentic GN (n = 5, MI = 3.72 +/- 1.98), endocapillary proliferative GN (n = 8, MI = 2.17 +/- 2.13), lupus nephritis (n = 43, MI = 2.21 +/- 3.35), and cryoglobulinemia-related GN (n = 1, MI = 11.5). The intermediate score of MI was observed in IgA nephropathy (IgA-N, n = 64, MI = 0.63 +/- 0.42) and Henoch-Schonlein purpura nephritis (HSP-N, n = 11, MI = 1.09 +/- 0.87). Out of IgA-N and HSP-N, the scores of MI in patients with more severe proliferation and/or with segmental lesions were higher than those without this histological finding. However, there was not a significant correlation between the glomerular monocytic infiltration and clinical findings in each group. In primary GN including minor glomerular abnormalities, focal glomerular sclerosis and membranous GN, and in secondary renal diseases except for SLE, HSP, and cryoglobulinemia, the score of intraglomerular monocytic infiltration was of little value. The participation of monocytes was predominant in extra- and intracapillary GN, lupus nephritis, and cryoglobulinemia-related GN, as previously reported. Moreover, in some types of proliferative GN, especially IgA-N and HSP-N, some parts of glomerular hypercellularity result from the participation of monocyte-macrophage series, although the main parts of cell proliferation are intrinsic mesangial cells. PMID- 1766497 TI - Effect of converting enzyme inhibitor captopril on T cell functions in essential hypertension. AB - T cell function tests were performed in 6 patients with uncomplicated essential hypertension (EH) before and after treatment with captopril, an angiotensin converting enzyme inhibitor. Total T and T cell subsets were within normal range and were not affected by the drug. The response of PBL to lectin stimulation was significantly impaired. While the stimulation index (SI) was almost normal when washed PBL were used (32.2 +/- 6.90 with PHA and 20.17 +/- 4.1 with Con A) or after their incubation with serum taken from normal subjects (40.42 +/- 10.9 and 15.53 +/- 3.4, respectively), autologous serum significantly reduced the SI (15.04 +/- 5.9 with PHA, p less than 0.05 and 6.68 +/- 1.45 with Con A, p less than 0.005). While captopril seemed to suppress the SI of washed PBL after 1 week of treatment, it enhanced the SI from 32.21 +/- 6.91 to 55.32 +/- 10.76 for PHA and from 20.17 +/- 4.13 to 30.63 +/- 5.41 for Con A (p less than 0.001). This effect was more obvious when the stimulations were performed with normal serum (from 40.42 +/- 10.9 to 96.47 +/- 17.51 for PTH and from 15.53 +/- 3.43 to 40.02 +/- 8.0 for Con A, (p less than 0.001). These results confirm previous reports indicating that the cellular immune response is impaired in EH. It seems that an inhibitory factor found in the serum of these patients is responsible for this impairment. Our findings may suggest that this factor may be angiotensin II. PMID- 1766498 TI - Blood and urinary aggregator and inhibitor composition in controls and renal stone patients from northeastern Thailand. AB - Renal-stone disease (RSD) is common in the rural communities of northeastern Thailand. We report the biochemical composition of blood and urine in 25 healthy city dwellers (G1), 12 healthy village dwellers (G2) and 25 village dwellers who had RSD (G3). They were male with a range of ages between 20 and 50 years and were free of renal failure, urinary infection, urinary obstruction and systemic illness. The results showed that hypocitraturia, hypokalemia and hypokaliuria were more common in the latter 2 groups. The 24-h urinary citrate excretion correlated significantly with urinary potassium in G3 cases (r = 0.704, p = 0.0002). After potassium chloride supplementation, serum and urinary potassium increased remarkably (p less than 0.003 and p = 0.002, respectively), whereas urinary citrate remained unchanged. Our results suggest that the predominant abnormality in our RSD patients were hypocitraturia and potassium deficiency and that these may be related. PMID- 1766499 TI - Prevalence of Helicobacter pylori in patients with end-stage renal failure and renal transplant recipients. AB - The prevalence of Helicobacter pylori was determined using an ELISA technique for IgG antibodies to H. pylori in 76 patients with end-stage renal failure who were receiving regular haemodialysis and 202 patients with functioning renal transplants. Twenty-seven (34%) of the haemodialysis group and 58 (29%) of the transplant group were positive for H. pylori IgG antibodies, and the prevalence did not differ significantly from that in 247 age-matched healthy controls. In the haemodialysis group, patients positive for H. pylori were older, median age 60 years (range 22-73), compared to those patients without H. pylori antibodies, median age 52 years (range 22-75), p less than 0.05, more suffered from dyspeptic symptoms, 35 vs. 10% (p less than 0.01), yet fewer had been prescribed aluminium containing antacids, 38 vs. 78% (p less than 0.01). In the transplanted group, those positive for H. pylori were more symptomatic for dyspepsia, 30 vs. 11% (p less than 0.01), and had lower serum creatinine values, 136 +/- 10 mumol/l (mean +/- SEM) vs. 172 +/- 12 mumol/l (p less than 0.05), compared to those without H. pylori antibodies. Almost all the transplant patients with H. pylori antibodies were taking steroids (98%) compared to 84% of those without antibodies (p less than 0.05). The prevalence of antibodies to H. pylori in this study was increased in symptomatic dyspeptic subjects and reduced in those patients prescribed aluminium-containing phosphate binders. PMID- 1766500 TI - Acute renal failure in the medical intensive care unit: predisposing, complicating factors and outcome. AB - The factors predisposing to and complicating acute renal failure (ARF) in the medical intensive care unit (ICU), and their relative influence on outcome during ARF are unclear. We retrospectively evaluated the relative importance of age, prior chronic disease (including chronic renal failure), sepsis and organ system failure, for development and outcome of ARF in the medical ICU. Of 487 consecutively admitted patients, 78 (16%) had ARF, in 63% treated with renal replacement therapy. Mortality was 63%. Independently from each other, advancing age, prior chronic disease, and cardiovascular and pulmonary failure directly related to the development of ARF, while neurological failure related inversely. Sepsis only contributed to ARF prediction from these variables if cardiopulmonary failure was excluded. Advancing age, cardiovascular failure before and after onset of ARF, pulmonary failure before ARF and use of renal replacement therapy were the major independent factors directly related to ARF mortality, while prior chronic renal failure related inversely and sepsis did not contribute. Hence, the outcome of ARF in a medical ICU is largely dependent on factors predisposing to ARF, even though the severity and complications of ARF may partly contribute. Our results may help in deciding on the prevention and therapy of ARF in a medical ICU. PMID- 1766501 TI - Incidence and mortality patterns of malignancy and factors affecting the risk of malignancy in dialysis patients. AB - A questionnaire study was performed among 23,209 dialysis patients in 589 institutions together with a retrospective study at Keio University Hospital to determine the risk of malignancy and factors affecting the risk ratio in dialysis patients. The incidence and mortality were 1.4-fold and 1.9-fold higher in dialysis patients than the expected rates in the general population. Incidence and mortality were 1.9-fold and 2.6-fold higher in males than in females. The risk ratios were remarkably high in university hospitals, followed by public hospitals. However, there was no significant difference between those in private hospitals and in the general population. The incidence was very high during the first 6 months of dialysis treatment and rather low in the 7th-10th year. The risk ratio of malignancy was higher in younger patients. Beyond the age of 60, the influence of age was greater than that of renal failure. Malignancies of the digestive organs were frequent and constituted 56% of all malignancies. Frequencies of malignancy in the liver, colon, rectum, bladder and kidney were higher than expected, whereas in the pancreas the frequency was lower than expected. Metastasis of malignancy was observed in 30% of the cases. Our study demonstrated a slight to moderate overall increase in the risk of malignancy and a widely differing risk ratio of malignancy by organ involved, sex, age, hospital group, epidemiological index and length of dialysis treatment in a large single racial population of maintenance dialysis patients. PMID- 1766502 TI - Assessment of creatinine clearance in healthy subjects over 65 years of age. AB - Eighteen healthy people over 65 years of age were studied to compare the 99mTC diethylenetriamine pentaacetic acid (DTPA) clearance, the measured 24-hour creatinine clearance and the assessed creatinine clearance using the Cockcroft and Gault (C-G) formula to measure their glomerular filtration rate. Significant correlations were found between the isotopic method and the measured creatinine clearance (r = 0.71; p less than 0.001); the measured creatinine clearance and the C-G formula (r = 0.81; p less than 0.001), and the isotopic method and the C G formula (r = 0.70; p less than 0.001). The C-G formula correlated better with both the 99mTc-DTPA clearance and the measured creatinine clearance when the female correction factor was used. This study has shown that in healthy, elderly people, the C-G formula for assessing the creatinine clearance correlated extremely well with the standard clinical tests for measuring the glomerular filtration rate. Whilst the formula has clinical value and allows rapid and accurate assessment of renal function in the elderly, the clinician must be aware that the formula relatively underestimates the true renal clearance. PMID- 1766503 TI - Glomerular alterations in rat neonates after transplacental exposure to gentamicin. AB - Alterations of tubules and glomerules have been reported previously in kidneys of rat neonates after aminoglycosides were given to the mother during gestation. Here, we have studied the effects of gentamicin on the development of the glomerular basement membrane (GBM). Pregnant Wistar female rates were treated with gentamicin. Deliveries occurred normally. Using electron microscopy, we looked at the deepest glomerules of the kidneys of 1-day-old neonates: myeloid bodies were found in podocytes, and the GBM appeared thicker and denser than in controls. Anionic ferritin, injected intravenously crossed the GBM in prenatally gentamicin-exposed animals, but not in controls. Furthermore, urine electrophoresis showed the presence of proteins normally found only in the urine of fetuses 2 days before birth. We suggest then, that in utero exposure to gentamicin leads to a delay of renal maturation and that the GBM is altered in juxtamedullary nephrons while it is normally differentiated and functioning in controls. Thus exposure to drugs before birth could be harmful to the GBM. PMID- 1766504 TI - Glomerular nonenzymatic glycosylation and lipid peroxide are increased in the early phase of streptozotocin-induced diabetic rats prior to major histopathologic alterations. AB - Levels of glomerular nonenzymatic glycosylation and lipid peroxide in streptozotocin (STZ)-induced diabetic rats were examined. Isolation of glomeruli was performed using a sieving technique. The levels of nonenzymatic glycosylation in the glomeruli of these rats were measured by the thiobarbituric acid (TBA) method. Measurement of lipid peroxide, i.e., malondialdehyde (MDA), levels in the renal cortex, medulla and isolated glomeruli was performed by the TBA test. Light microscopic and immunofluorescent examinations were also performed. An increase in nonenzymatic glycosylation in the glomeruli was observed in the early phase, i.e., after 4 and 12 weeks, in STZ-induced diabetic rats. The levels of MDA in the renal cortex of 12-week-old STZ-induced diabetic rats were also significantly increased compared with those of control rats at the same age. Levels of MDA in the glomeruli of 12-week-old STZ-induced diabetic rats were slightly increased compared with those of control rats, but there was no statistical significance. In immunofluorescence, IgG or IgM was deposited in the glomerular mesangial areas and capillary walls in 12-week-old diabetic rats. However, there was no significant change in renal tissues after 4 and 12 weeks in STZ-induced diabetic rats. It was concluded that glomerular nonenzymatic glycosylation and lipid peroxide were already increased in the early phase of STZ-induced diabetic rats prior to the appearance of marked histologic alterations. PMID- 1766505 TI - Epidermal growth factor in renal hypertrophy in streptozotocin-diabetic rats. AB - Epidermal growth factor (EGF) concentrations in the plasma, kidneys and urine of 31 streptozotocin-diabetic rats and 21 insulin-treated diabetic rats were measured to study the role of EGF in initiating renal hypertrophy in the diabetic rats. Renal hypertrophy occurred from day 7 in the diabetic rats, but not in the insulin-treated rats. Renal EGF was not different between the diabetic and control rats, while that in the insulin-treated rats was significantly less than in the diabetic rats. There were no significant changes in plasma EGF in any of the rats. Urine EGF was 119 +/- 7.9 ng/day at day 7 in the control rats but it was significantly increased from day 2 in the diabetic rats (320 +/- 52.9 ng/day at day 2 and 298 +/- 18.4 ng/day at day 7), while in the insulin-treated rats it was significantly less than that in the diabetic rats (134 +/- 8.34 ng/day at day 2 and 220 +/- 15.2 ng/day at day 7). Since the kidney is the main source of urine EGF and EGF has been shown to induce renal growth both in vitro and in vivo, we conclude that EGF may have initiated renal hypertrophy in diabetic rats. PMID- 1766506 TI - Actinomycin D blocks the hepatic functional albumin mRNA increase in aminonucleoside-nephrotic rats. AB - Hepatic functional albumin-mRNA was measured in the following groups of rats: (a) puromycin aminonucleoside (PAN)-nephrotic rats, (b) PAN-nephrotic rats treated with actinomycin D prior to sacrifice, (c) control rats, and (d) control rats treated with actinomycin D. Albumin mRNA was translated in an mRNA-dependent cell free system from rabbit reticulocyte lysate. Albumin-mRNA increased about 2-fold in PAN-nephrotic rats. This increase was abolished in vivo in PAN-nephrotic rats treated with actinomycin D. Albumin mRNA was not significantly modified in control rats treated with actinomycin D. These data suggest that the increased level of hepatic functional albumin mRNA observed in PAN-nephrotic rats in vivo was due mainly to the increased rate of albumin gene transcription. PMID- 1766507 TI - Thrombotic microangiopathic nephropathy in scleroderma and lupus anticoagulant. AB - A 47-year-old woman with overlap scleroderma-polymyositis syndrome and positive circulating lupus anticoagulant developed scleroderma nephropathy, characterized by rapidly progressive renal failure caused by thrombotic microangiopathy with widespread thrombi in small arteries and glomeruli. The possible relationship between lupus anticoagulant and the development of thrombosis at the small renal vessels level with the triggering of the scleroderma crisis is discussed. PMID- 1766508 TI - Destructive spondyloarthropathy with beta 2-microglobulin amyloid deposits in a uremic patient before chronic hemodialysis. AB - We report a case of erosive arthropathies discovered radiologically before dialysis in a uremic patient with Alport syndrome. This patient had no hereditary amyloidosis or causes of acquired generalized amyloidosis (no chronic infections or inflammatory disease, neoplasia, lymphoma or monoclonal gammapathy). Erosive spondyloarthropathies of the cervical spine at the C5-C6 and C6-C7 levels, erosive arthropathy of the right acromioclavicular joint, metacarpal lacuna of the right hand, and lacuna of the left femoral neck were discovered 24 months before starting dialysis in this patient with chronic renal insufficiency of 17 years duration. Puncture of the vertebral disc before starting dialysis took a fragment showing amyloid deposits with permanganate-sensitive Congo red staining and positive staining with anti-beta 2-microglobulin antibodies. This observation suggests that beta 2-microglobulin amyloidosis in uremia may not be exclusively related to chronic kidney replacement therapy, but to uremia per se, especially when the latter is of long duration. PMID- 1766510 TI - Decreased albuminuria by pravastatin in hyperlipidemic diabetics. PMID- 1766509 TI - Renal tubular defect in nephrotic syndrome associated with focal segmental glomerulosclerosis. PMID- 1766511 TI - Amphotericin B for visceral leishmaniasis in hemodialysis. PMID- 1766512 TI - Acute cardiac and renal failure after 5-FU and cisplatin treatment. PMID- 1766513 TI - Aluminium and dialysis associated arthropathy. PMID- 1766514 TI - Nifedipine does not inhibit ciclosporin A uptake into human cultured proximal tubular cells. PMID- 1766515 TI - Renal perfusion with non-blood media. PMID- 1766516 TI - Vitamin B6 deficiency on hemodialysis causing sideroblastic anemia. PMID- 1766517 TI - Bordetella bronchiseptica septicemia in a hemodialysis patient. PMID- 1766518 TI - Frequent abnormalities of renal function in patients with rheumatoid arthritis. PMID- 1766519 TI - Acute interstitial nephritis induced by ethambutol. PMID- 1766520 TI - Interaction between ciclosporin and ceftriaxone. PMID- 1766521 TI - Prescription of calcium carbonate to nondialyzed patients with a supranormal serum 1,25(OH)2D3 concentration. PMID- 1766522 TI - Application of the confocal scanning laser microscope for observing biological specimens: detection of glomerular bleeding. PMID- 1766523 TI - Endothelin in hemodialysis-resistant hypertension. PMID- 1766524 TI - Effect of low doses of recombinant human erythropoietin on the anemia in hemodialyzed patients. PMID- 1766525 TI - Chronic cisplatin tubulopathy in humans and animals: clear-cut discrepant findings. PMID- 1766526 TI - Single-injection inulin clearance using only one blood sample as a suitable procedure to measure glomerular filtration rate. PMID- 1766527 TI - McArdle's disease presenting with acute renal failure. PMID- 1766528 TI - [Factor D of complement: Uremic toxin?]. AB - Factor D is an essential enzyme of the alternative pathway of complement. Its catabolism is mainly renal. The concentration of factor D increases with renal failure, and is approximately 10-fold higher in patients with end-stage renal disease. The accumulation of factor D is responsible for an enhancement of alternative pathway activation. Whether this excess of factor D has pathophysiological consequences remains to be determined, however, complement activation might participate in adverse effects during hemodialysis and in the progression of renal injury. PMID- 1766529 TI - [A severe epidemic of Streptococcus group G infection in hemodialysis: epidemiologic survey by molecular biology and preventive measures]. AB - An outbreak of group G streptococci infection affected 6 patients of an hemodialysis unit. Group G streptococci were isolated from patients and from numerous atmospheric specimens, different parts of two dialysis machines, and two blankets, but from only one nurse on the hospital staff. Typing of group G streptococci by an improved method of DNA fingerprinting showed that the isolates from one patient, the nurse and the two blankets differed from one another. The group G streptococci were probably transmitted to patients by dialysis machines with defective microporous filters. No further case of group G streptococci infection was reported three years later since microporous guard filters were systematically doubled. PMID- 1766530 TI - [Vertebral tuberculosis in a chronic hemodialysis patient with polycystic kidney disease]. AB - We report a case of vertebral tuberculosis in a female patient with polycystic kidney disease (PKD) who had been treated with maintenance hemodialysis for six years. Diagnosis of lumbar bacillary spondylitis was particularly difficult, owing to proximity of polycystic kidneys and spine. After removal of one kidney in which no bacterial focus was found, pain and inflammation persisted. Two months later CT scan and RMN evidence of 4th lumbar vertebral lysis led to performing open vertebral biopsy. Tuberculous lesions were found on this material and antibacillary treatment was begun. This case illustrates the difficulty of diagnosing vertebral tuberculosis in dialysis patients, especially in those with PKD. PMID- 1766531 TI - [Dilated cardiomyopathy during post-partum hemolytic and uremic syndrome (HUS)]. AB - A 24-year-old woman presented a severe HUS followed 3 months later by a cardiac failure diagnosed echographically as a dilated cardiomyopathy. The patient was hemodialysed and successfully transplanted. Later course of dilated cardiomyopathy was favourable. Review of literature confirms the rare and severe nature of cardiac lesions occurring in the course of HUS. We suggest a related pathophysiology concerning these two entities. PMID- 1766532 TI - [Neurotoxicity of acyclovir in peritoneal dialysis apropos of 1 case]. AB - We report a case of reversible myoclonic encephalopathy which appeared after intravenous acyclovir treatment in a patient in CAPD for which pharmacological dosages have been made in serum, peritoneal dialysate and cerebrospinal fluid (CSF). Encephalopathy appeared after two intravenous doses of 7.33 mg/kg (doses higher than recommended), administered on admission and 16 hours later. Pharmacological dosages indicated that acyclovir peritoneal clearance was negligible, and that acyclovir persisted a long time in plasma and CSF. Neurological symptoms persisted although serum concentrations returned to normal value. The diagnostic value of pharmacological dosages in serum and CSF is discussed. In addition, neurological symptoms disappeared following two consecutive hemodialysis procedures. Hence we suggest that hemodialysis could be used for drug removal in case of acyclovir overdose in CAPD patients. PMID- 1766533 TI - [What position to take for Kaposi's sarcoma in organ transplantation?]. AB - Kaposi's Sarcoma (KS) is a tumor of multicentric origin, accounting for 4% of the observed neoplasia among organ transplant recipients. Its exact pathogenesis is still unknown. The diagnosis must be suspected in view of skin and/or subcutaneous tumor lesions with potential visceral involvement, which are easily confirmed by histological examination. Initial staging of the disease in 4 subgroups allows to guide therapy and prognosis. Therapeutic options depend on the transplanted organ and on results of early staging at time of diagnosis and treatment may associate: decrease and/or cessation of immunosuppression, laser therapy, radiotherapy and/or chemotherapy. PMID- 1766534 TI - [Importance of anti-idiotype antibodies in candidates for a renal graft]. AB - Anti-idiotypes antibodies neutralize, some T lymphocytes clones, others cytotoxic antibodies carrying corresponding idiotypes. Anti-idiotypes antibodies are found in about 45% of patients with chronic renal failure which have received blood transfusions. Some antibodies favourize the kidney graft tolerance, others at the contrary augment the rejection reaction. It is possible to detect antibodies which protect graft by relatively simple and rapid technics. This research merits to be added to the classic cross match. When donor and recipient study reveals a positive cross match with an ancient serum and a negative cross match with an actual serum, the absence of protective antibodies is a contra-indication for kidney graft, but their presence authorize the transplantation. PMID- 1766535 TI - [An operative approach to tumors of the medulla oblongata]. PMID- 1766536 TI - [Surgical treatment of hypertensive cerebellar hemorrhage; stereotactic aspiration surgery vs suboccipital craniectomy]. AB - Patients with severe types of hypertensive cerebellar hemorrhage have been treated usually by suboccipital craniectomy and hematoma evacuation. However, since 1981, we have treated such patients with stereotactic aspiration surgery. The purpose of this study was to evaluate the prognosis of patients treated by stereotactic aspiration surgery for cerebellar hemorrhage in comparison with those who underwent suboccipital craniectomy. Between May 1976 and December 1989, 246 patients with hypertensive cerebellar hemorrhage were admitted to our university hospital and affiliated hospitals. The patients were classified into four categories according to the grading of hypertensive cerebellar hemorrhage proposed by Matsumoto in 1982; benign, moderate, severe, and fulminant. Then we decided the most appropriate therapy according to this grading. Fifty-nine patients (24.0%) underwent suboccipital craniectomy and 38 (15.4%) underwent stereotactic aspiration surgery. There was no significant difference in the postoperative outcome between suboccipital craniectomy and stereotactic aspiration surgery in the overall study. However prognosis of the fulminant type was significantly better with stereotactic aspiration surgery than with suboccipital craniectomy. Possible reasons for this include: 1) All patients of this type who underwent aspiration surgery had this procedure within 12 hours after the onset of cerebellar hemorrhage. 2) The hematoma volume of most patients of this type who had aspiration surgery was under 30ml. 3) The age of all patients of this type with aspiration surgery was under 70 years old. In conclusion, we suggest that aspiration surgery for hypertensive cerebellar hemorrhage is indicated for all patients with moderate, severe and fulminant types of hemorrhage. PMID- 1766537 TI - [DNA analysis of meningiomas using paraffin-embedded surgical specimens in connection with clinical recurrence]. AB - Meningioma includes some clinically malignant cases which grow multifocally or recur rapidly. To develop methodology to distinguish clinically malignant cases, we examined the nuclear DNA of meningiomas by flow cytometry using paraffin embedded specimens. 52 surgical specimens were studied from 52 cases of meningioma. Among these cases, 3 multiple meningiomas that recurred multifocally within 3 years were included. Malignancy was assessed by the proliferative index (%S + %G2/M) and DNA ploidy of the specimens. Six cases were histologically malignant, while aneuploidy was observed in only 2 (33.3%). No significant correlation was observed when analyzing the 23.9% aneuploidy rate among benign cases. Moreover, three cases of clinically malignant meningiomas were all diploid. In contrast, the proliferative index of 19.82 +/- 9.45% among histologically malignant cases was significantly higher as compared to that for benign cases (11.50 +/- 5.49%). The proliferative index was 15% or more (average 22.02 +/- 6.01%) for patients with clinically malignant meningioma. This was considerably higher than the corresponding value for clinically benign meningiomas. Our analysis indicated that the assessment of benignancy or malignancy of meningioma on the basis of DNA ploidy alone is difficult. The proliferative index so obtained relates significantly to prognosis, apparently providing a useful prognostic assessment. PMID- 1766538 TI - [Measurements of CSF biochemical tumor markers in patients with meningeal carcinomatosis]. AB - CSF beta--glucuronidase, polyamines and carcinoembryonic antigen (CEA) were analyzed in 16 patients with meningeal carcinomatosis from solid tumors in systemic organs, 27 with benign brain lesions, 11 with primary brain tumors, 14 with metastatic brain tumors and 5 with leptomeningeal dissemination of other malignant diseases. beta--glucuronidase levels in all cases of meningeal carcinomatosis, meningeal gliomatosis and meningeal lymphoma were higher than 100 micrograms/dl/hr. On the other hand, levels in all cases of benign brain lesions were below 100 micrograms/dl/hr. Levels of beta--glucuronidase in the cases of metastatic brain tumors returned to normal levels after tumor resection. Levels of beta--glucuronidase and polyamines were not high in the cases with positive cytology in CSF after tumor resection. The polyamine level seemed to be dependent on the growth rate of the disease and was shown to below 0.05 nmol/ml in all cases after resection of the metastatic brain tumors. Cystic fluid of both benign and malignant tumor showed high levels of beta--glucuronidase and polyamines except for spermidine and spermine levels in a suprasellar cyst. Some cases of meningeal carcinomatosis with high levels of serum CEA did not always show high levels of CSF CEA. In the surgical cases with a metastatic brain tumor, the cases with leptomeningeal, especially dural attachment showed high levels of beta- glucuronidase and CEA preoperatively, but they returned to normal after surgery. In 2 cases of meningeal carcinomatosis treated by intrathecal chemotherapy with MTX and Ara-C, CSF beta--glucuronidase and CEA showed clinical condition better than the cell count in CSF decreased rapidly following chemotherapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766539 TI - [Cerebral vasospasm after subarachnoid hemorrhage, and inhibitory effect of nicardipine investigated by means of transcranial Doppler ultrasonography]. AB - Cerebral vasospasm is a major complication associated with subarachnoid hemorrhage (SAH). However, real-time evaluation of vasospasm is very difficult via angiography, CT scan, and cerebral blood flow. In this study, for the evaluation of the arterial narrowing, the flow velocity in the middle cerebral artery (MCAFV) was measured with transcranial Doppler ultrasonography (TCD) in 41 patients with ruptured cerebral aneurysms which were repaired surgically within 48 hours after SAH. MCAFV was measured daily until the 25th day after onset. All patients underwent CT scan, angiography, and neurological assessments upon admission. To clarify the morphological changes of the cerebral vessels due to SAH, angiography was performed again about 10 days after surgery. For evaluation of the efficacy of treatment for vasospasm, 21 out of 41 cases were administered a calcium antagonist (4mg of nicardipine) through the cisternal drain every 12 hours for an average of 10 days. The other 20 cases did not receive nicardipine and served as controls. 15 patients with clinical symptoms had a rapid increase in MCAFV from the 3rd to 6th day after onset, and a high velocity of more than 150cm/sec continued for 7.6 +/- 3.6 days on the average. In marked contrast, 26 patients without clinical symptoms showed only a small increase in MCAFV of less than 110cm/sec. There was a significant correlation between the arterial narrowing of MCA and MCAFV (gamma = 0.72, p less than 0.01) except for 5 cases (12%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766540 TI - [The factors influencing posttraumatic epilepsy; multicentric cooperative study. Japan Follow-up Group for Posttraumatic Epilepsy]. AB - A multicentric cooperative study was performed to investigate the factors influencing posttraumatic epilepsy. The patients with fresh head injury from 1983 through 1990 were entered in this study. The cases were divided into two groups and followed-up for five years; the patients with severe head injury and who satisfied the criteria belonged to group I. Those with mild head injury were classified into group II. The criteria for group I was that the patients had one or more of the following risks; disturbance of consciousness, bloody cerebrospinal fluid, focal neurological sign, depressed fracture or basal fracture, abnormal CT, dural tear, early convulsion and/or linear fracture. After drop-out cases were excluded, 191 cases out of 241 were analyzed. The number of cases was 126 (66.0%) for group I and 65 (34.0%) for group II. Sixteen patients (12.7%) of group I developed seizure, whereas nobody of group II experienced seizure. The difference between the patients with and without seizures was analyzed. The statistical significant difference was discovered in the following factors; disturbance of consciousness (GCS and the duration), focal and generalized neurological sign, abnormal CT, multiple risks, intracerebral hematoma, surgery, alcohol drinking and abnormal EEG a month after the injury. The relative risk rates were calculated. The highest risk for posttraumatic seizure was disturbance of consciousness extending over more than one month. This was followed by five other indicators of risk; abnormal EEG at one month, surgery, focal neurological sign, alcohol drinking, generalized neurological sign, and intracerebral hematoma.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766541 TI - [A case of disproportionately large communicating fourth ventricle after resection of temporal astrocytoma that evolved an isolated fourth ventricle]. AB - The isolation and enlargement of the fourth ventricle after a ventriculoperitoneal (V-P) shunt was classified as "isolated fourth ventricle (IFV)". The term, "disproportionately large communicating fourth ventricle (DFV)" was first introduced by Scotti et al as being an enlarged fourth ventricle communicating with the third ventricle. The authors present a case of DFV after the resection of an astrocytoma. Upon recurrence of the tumor a second resection was carried out 5 years later. It was found that IFV had evolved because a cyst in the right temporal lobe was obstructing the aqueduct. After shunting of the tumor cyst, the aqueduct was again found to be patent and the fourth ventricle gradually decreased in size. A 34-year-old female presented headache, nausea, and a mild left hemiparesis. An initial CT scan demonstrated a fourth ventricle of approximately normal size and a right temporal mass. The first craniotomy revealed an astrocytoma. A CT scan after the surgical procedure showed enlargement of all ventricles, especially the fourth, resulting from the blockage of the foramina of Luschka and Magendie. The insertion of a V-P shunt was followed by a reduction in size of all ventricles. The diagnosis of DFV was thus confirmed because the fourth ventricle had a demonstrated communication with the third ventricle. After a second craniotomy for tumor recurrence five years later, a CT scan revealed the enlargement of the fourth ventricle and a cyst in the right temporal lobe. A metrizamide CT scan revealed that the cyst was isolated and an RI ventriculogram confirmed obstruction of the aqueduct.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766542 TI - [A case of chondrosarcoma in the cavernous sinus]. AB - A 24-year-old female patient complained of headache and right abducens nerve paralysis. No abnormality was found in plain CT scan, but a ring-like enhanced mass was disclosed behind the right posterior clinoid process in enhanced CT scan. MRI revealed a low intensity mass in T1-weighted image and a ring-like enhanced mass in gadolinium-DTPA enhanced image. It was a circumferential high intensity mass in T2-weighted image and an isointensity mass in proton image. Cerebral angiography indicated that it was avascular. Preoperative diagnosis was trigeminal neurinoma or petroclival meningioma. The tumor was removed almost completely by orbitozygomatic infratemporal approach. Histologically, it was low grade chondrosarcoma. Postoperatively, neither radiation therapy nor chemotherapy was added. Differential diagnosis and treatment was discussed. It was suggested that MRI was the most useful diagnostic tool to distinguish chondrosarcoma from other skull base tumors. PMID- 1766543 TI - [A case of what was regarded as isolated benign cerebral vasculitis]. AB - A 55-year-old man came to us with dysarthria and right hemiparesis. The cerebral angiography showed segmental narrowing and irregularity of the left anterior cerebral artery. The patient responded well to corticosteroid therapy and there was later angiographic evidence of healing. After systemic angiitis and central nervous system infection were excluded, the diagnosis of isolated benign cerebral vasculitis was made. According to past reports, at least 13 patients have been described as having isolated benign cerebral vasculitis. The common features of isolated benign cerebral vasculitis are as follows: 1) benign evolution, 2) sensitiveness to corticosteroids, 3) absence or minimal change of CSF findings, 4) angiographic pattern of arteritis, 5) the most common symptom is headache. We suggest that early corticosteroid therapy is necessary in any case of cerebral vasculitis. PMID- 1766544 TI - [A case of cerebral arteriovenous malformation revealed at repeated subcortical hematoma with initially normal angiogram]. AB - An 18-year-old male admitted to our hospital suffered left temporal subcortical hemorrhage. No abnormality was demonstrated on carotid or vertebral angiography at that time. On the day following the onset, left frontotemporal craniotomy was performed and the subcortical hematoma was evacuated. No vascular malformation was found despite careful investigation. On 30th day after the onset, the repeat cerebral angiography was performed but failed to show any vascular abnormalities. After discharge he was in good health, and had had some follow up, CT were normal except for the hematoma cavity. Just two years after the first operation he suffered a second left temporal hemorrhage. Cerebral angiography was repeated and a temporal arteriovenous malformation (AVM) was found with feeding vessels from the M-1 and M-2 portion of the left middle cerebral artery and from the left anterior choroidal artery, and draining veins to vein of Rosenthal and the straight sinus. One month after the second hemorrhage, left frontotemporal craniotomy was performed and complete excision of the AVM was carried out. Only five cases of AVMs in patients with normal angiograms several years before have been reported previously in the literature. But there are no cases in which surgery has been performed. Differently to those cases, in this case it was investigated operatively whether there was a vascular abnormality at the first hemorrhage. We didn't think, however, that the AVM demonstrated at the second hemorrhage had developed spontaneously because there had been a hemorrhage of unknown origin previous to it. It was assumed that a small angiographically occult AVM connected to the hematoma cavity existed at the time of the first hemorrhage but it was too small to be found even during surgical procedure. Such an angiography occult AVM had been growing for two years, and its growth had probably been facilitated by the presence of the hematoma cavity left after the first operation. PMID- 1766545 TI - [A case of multiple myeloma (biclonal type) associated with an intracranial mass invading the skull base and oculomotor palsy]. AB - A case of multiple myeloma forming an intracranial mass which invaded the skull base was reported. A 72-year-old woman was admitted to the hospital because of left oculomotor paresis. Plain craniograms showed multiple punched out lesions. A CT scan demonstrated a mass lesion, which was homogeneously slightly enhanced with contrast medium, in the middle cranial fossa. MRI, both T1 and T2 weighted images, showed an isodensity mass. In the carotid angiograms the tumor was fed by the right branches of the cavernous portion of the internal carotid artery and the maxillary artery. Laboratory data were as follows: ESR: 132mm/30min, serum TP: 9.0g/dl, IgG: 4670mg/dl, IgA: 430mg/dl, and urinary Bence-Jones protein was detected. Bone marrow biopsy of the illiac bone demonstrated myeloma cells. During hospitalization oculomotor paresis disappeared, and the patient was treated with intramuscular interferon-alpha. Multiple myeloma which invades the skull base is rare, and only 10 cases have been reported since 1977. Moreover, the biclonal type is only 0.5% of all multiple myelomas. PMID- 1766546 TI - [A case of spinal epidural hematoma associated with idiopathic thrombocytopenic purpura]. AB - Spinal epidural hematoma is a rare clinical entity, and the literature provides reports of 29 cases so far in Japan. A case of spinal epidural hematoma associated with idiopathic thrombocytopenic purpura diagnosed by CT scan and MRI is reported in detail with references to the literature. A 56-year-old female was admitted to our hospital on April 22, 1990, because of sudden onset of nuchal pain and right hemiparesis. Her consciousness was alert, but the deep tendon reflex was depressed, and pathological reflex such as Babinski's reflex was positive on the right side. Nuchal stiffness was observed. CT scan of the head revealed no abnormality, but the scan of cervical area showed an abnormal high density area in the right posterior region of the spinal cord at C2 - 3 level. MRI also revealed a low intensity area in the same region both in T1 and T2 weighted images. On admission, the platelet count was 10,000/microliters, and the bone marrow aspirate showed abundant megakaryocytes. The patient was diagnosed as having spinal epidural hematoma associated with idiopathic thrombocytopenic purpura. The patient was initially treated with a corticosteroid and a hyperosmotic agent. About 15 hours after the onset, her motor function began improving. Conservative therapy was continued, and she could walk 2 weeks after the onset. Spinal epidural hematoma is an uncommon disease commencing with back and radicular pain, paraplegia and rectovesical insufficiency. Early diagnosis and surgical decompression is generally imperative, although an exceptional remission without operation such as was observed in this case may occur. PMID- 1766547 TI - Suprachiasmatic nucleus lesions abolish photoperiod-induced changes in the testis function and GnRH immunoreactivity in the mink, a short-day breeder. AB - Testicular activity (testis volume and plasma testosterone) and immunoreactive GnRH hypothalamic system were examined after suprachiasmatic nucleus (SCN) lesion in the mink, a short-day breeding mammal, whose sexual activity is inhibited by day lengths exceeding 10 h. In animals maintained under a natural photoperiod, SCN destruction performed during the period of maximum sexual activity (February) was shown to have no effect on onset of the testicular inactive period which begins at the end of winter and continues through spring. On the other hand, while gonadal activity began again at the end of autumn in intact animals, minks that had undergone SCN destruction remained sexually inactive until the end of the experiment period (February). The SCN could thus be crucial to the onset of sexual activity triggered by the reduction of day length, whereas onset of sexual inactivity is a spontaneous phenomenon. This was confirmed in a second experiment demonstrating that a short photoperiod (4 L:20 D), highly gonadostimulatory in intact animals, had no effect on testicular activity after SCN destruction. An immunocytochemical study of the hypothalamic GnRH system (staining intensity and number of labeled perikarya and immunoreactive endings in the external layer of the median eminence) also showed consistent by very low rates of immunoreactivity and number of labeled perikarya and endings in operated animals. PMID- 1766548 TI - Adrenalectomy and experimental hypercorticalism modulate the basal, corticotropin releasing-hormone- and arginine-vasopressin-stimulated release of hypothalamic beta-endorphin. AB - Recent in vitro studies have shown that the release of hypothalamic beta endorphin (beta-END), like that of adenohypophysial origin, is enhanced by both corticotropin-releasing hormone (CRH) and arginine vasopressin (AVP). However, whereas AVP merely synergizes with CRH in the pituitary, it seems to be essential for the release of hypothalamic beta-END by CRH. The present paper reports on the effects of long-term adrenalectomy (ADX) and subsequent replacement with supraphysiological doses of corticosterone (compound B, CB) upon the in vitro basal and CRH- and AVP-stimulated release of beta-END from the rat hypothalamus. Basal release of beta-END was significantly elevated by ADX, and returned to control levels following CB overdosage. Both ADX and CB replacement significantly reduced the stimulatory effect of CRH (10(-8) M) upon beta-END release. ADX caused no significant change in the AVP (10(-6) M)-induced release of beta-END. However, the AVP-stimulated release of beta-END was completely abolished in ADX rats treated with a high dose of CB. The hypothalamic content of beta-END was also measured following ADX and subsequent CB treatment. Compared with control tissues, those from ADX animals had significantly greater contents of beta-END; the hypothalami from rats with experimentally induced hypercorticalism had markedly reduced concentrations of the opioid peptide. Measurements of basal release and content of AVP in the hypothalamus following long-term ADX and CB treatment revealed that AVP neuronal activity is also subject to manipulations of the glucocorticoid hormone environment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766549 TI - A sex-specific cytochrome P-450(F-1) colocalized with various neuropeptides in the paraventricular and supraoptic nuclei of female rats. AB - Numerous cells containing P-450(F-1) were detected in the magnocellular and parvocellular neurons of the paraventricular nucleus of the hypothalamus. Electron microscopic analysis of immunoreactive neurons has shown that P-450(F-1) immunoreactivity is present on the Golgi apparatus and rough endoplasmic reticulum. In the paraventricular nucleus, the P-450(F-1)-positive magnocellular neurons frequently contained oxytocin and some of them also contained CRF. Vasopressin was colocalized with P-450(F-1), but these neurons did not express CRF. In the supraoptic nucleus, P-450(F-1) was colocalized with oxytocin or CRF in single neurons, but not with vasopressin. No cells exhibiting the colocalization of both P-450(F-1) and somatostatin were observed in these nuclei. The results of the present study concerning colocalization of P-450 and peptides suggest that P-450(F-1) is involved in the hypothalamo-hypophyseal neuroendocrine function in the female rat. PMID- 1766550 TI - Is reverse triiodothyronine a physiological nonactive competitor for the action of triiodothyronine upon the electrical properties of GH3 cells? AB - The electrical properties of GH3 cells, a transformed line from the rat pituitary, were studied with a current-clamp technique in the presence of triiodothyronine (T3) and reverse triiodothyronine (rT3) and compared with the known effects of T3. rT3 had an effect only in a concentration of 1 microM; action potentials were suppressed, and changes in the slope conductance were similar to those seen in response to T3. Membrane resistance RI decreased, and the resting membrane potential VM hyperpolarized. The action of rT3 is a 1,000 times less potent than that of T3 and is unlikely to have a physiological significance. When a cell was beforehand superfused with rT3 (10 nM), the effect of T3 was prevented even in a concentration of 10 nM. The specificity of T3, the prevention of the effect of T3 by rT3, and the small dose needed suggest a binding site for T3. The short latency of its action implies an extranuclear binding site, probably in or near the plasma membrane of the GH3 cell. PMID- 1766551 TI - Release of luteinizing hormone-releasing hormone, beta-endorphin and noradrenaline by the nucleus infundibularis/median eminence during periovulatory period in the sheep. AB - The relationships between the release of LHRH, beta-endorphin (beta-END) and noradrenaline (NA) from the hypothalamic infundibular nuclei/median eminence (NI/ME) during the periovulatory period in the ewe was studied. Neurohormone release was assayed in perfusates collected from the NI/ME via push-pull cannulae. LHRH concentrations in perfusates ranged from below detectable values (5 pg) to 50 pg and from 15 to 240 pg/20 min perfusate on the days of proestrus and estrus, respectively. beta-END concentrations in perfusates ranged from 320 to 6,000 pg on the day of proestrus and fell to a range between 100 and 380 pg/20 min perfusate on the day of estrus. The NA content of perfusates ranged from an undetectable level to 0.9 x 10(4) pg/perfusate during proestrus, and rose from 1.0 x 10(4) to 6.6 x 10(4) pg/perfusate shortly before the preovulatory release of LHRH and LH. On the basis of the present observations, the following sequence of events leading to the massive LH ovulatory surge in the sheep is suggested: (1) increased secretion of beta-END in the NI/ME on the day of proestrus generates an increase in the releasable pool of LHRH through inhibition of LHRH release; (2) on the day of estrus a decreased release of beta-END allows the expression of NA activity in the NI/ME and the augmentation of NA tone facilitates the release of newly accumulated LHRH; (3) the resultant intensified LHRH output with its significantly changing pattern of release triggers the preovulatory surge of LH. PMID- 1766552 TI - Comparative distribution of immunoreactive pituitary adenylate cyclase activating polypeptide and vasoactive intestinal polypeptide in rat forebrain. AB - Pituitary adenylate cyclase activating polypeptide (PACAP) and vasoactive intestinal polypeptide (VIP) are structurally similar, share the same high affinity site in same peripheral tissues and increase the intracellular content of adenylate cyclase. To establish which neural circuits are signaling with each of these two peptides, we systematically compared the immunohistochemical distribution of PACAP and VIP in selected rat forebrain regions using previously characterized antiserum. The PACAP antiserum recognized both PACAP27 and PACAP38, and PACAP immunoreactivity was unaffected by preincubation with various other peptides. PACAP-immunoreactive perikarya and fibers were observed in both hypothalamic and extrahypothalamic regions. In the hypothalamus PACAP perikarya were located in the supraoptic, paraventricular, anterior commissural, periventricular, and perifornical nuclei. In intact rats PACAP immunolabeled fibers were present in the internal zone of the median eminence and posterior pituitary. One week after hypophysectomy the intensity of staining in the internal zone was enhanced and immunoreactive fibers appeared in the external zone of the median eminence. Two or 3 weeks later a dense fiber network was observed around the portal capillaries in the external zone, and immunoreactive material further accumulated in the fibers of the internal zone. PACAP immunoreactive perikarya and fibers were also observed in several extrahypothalamic regions including central thalamic nuclei, amygdaloid complex, bed nucleus of stria terminalis, septum, hippocampus and cingulate, and entorhinal cortices. In the lateral septum and entorhinal cortex PACAP fibers surrounded unstained neuronal cell bodies and small blood vessels. In intact rats, VIP-immunoreactive perikarya were present in all regions of the cerebral cortex, hippocampus, amygdaloid complexus and in the suprachiasmatic nucleus, but not in the paraventricular and supraoptic nuclei. In colchicine-treated rats the VIP perikarya appeared in the preoptic area and paraventricular nucleus. The fibers were organized in two main pathways: the stria terminalis and an ascending pathway from the suprachiasmatic nucleus to the paraventricular area. Hypophysectomy induced the appearance of VIP-immunoreactive fibers in the internal zone of the median eminence and perikarya in the supraoptic and paraventricular nuclei in addition to the suprachiasmatic nucleus. The dissimilar distributions of PACAP and VIP suggest that PACAP neural circuits are independent of that of VIP in the rat forebrain. These findings support possible multifunctional roles for PACAP as a posterior pituitary hormone, a hypophysiotrophic factor, and a neurotransmitter/neuromodulator. PMID- 1766553 TI - Possible involvement of endogenous opioid peptides in the inhibition of arginine vasopressin release by gamma-aminobutyric acid in conscious rats. AB - We examined the effects of gamma-aminobutyric acid (GABA) and naloxone, a potent opioid antagonist, on arginine vasopressin (AVP) secretion in conscious rats in order to study the relationship of GABA and endogenous opioid peptides in the regulation of AVP secretion. Intracerebroventricular administration of GABA caused a time- and dose-dependent decrease in the plasma concentration of AVP that was elevated by hypertonic saline injection, whereas it did not affect the basal AVP. Pretreatment with naloxone (10 mg/kg) significantly attenuated the inhibitory effect of GABA (100 micrograms) on AVP release. These results suggest that GABA produces an inhibition of AVP release stimulated by hypertonic saline, and that this inhibitory effect may be mediated at least in part by the endogenous opioid systems. PMID- 1766554 TI - Amygdaloid lesions: differential effect on conditioned stress and immobilization induced increases in corticosterone and renin secretion. AB - The purpose of this study was to examine the contribution of the central nucleus of the amygdala to the expression of stress-induced increase in corticosterone and renin secretion. Neurons in the central amygdaloid nucleus of male rats were destroyed by bilateral injections of ibotenic acid, a neurotoxin that destroys cells but leaves fibers of passage intact. Two weeks later, the rats were subjected to immobilization for 20 min or to a conditioned stress (conditioned emotional response) procedure. Central amygdala lesions inhibited the increases in plasma corticosterone after exposure to both conditioned stress and immobilization. Lesions in the lateral amygdala had no effect on the corticosterone response to either stressor. Lesions in the central amygdala attenuated the renin response to conditioned stress but not to immobilization. In contrast, lateral amygdala lesions potentiated the renin response to immobilization but did not affect the renin response to conditioned stress. The results confirm previous studies that demonstrate the importance of the central amygdaloid nucleus in the expression of corticosterone to immobilization stress. In addition, the results show that neurons within the central amygdaloid nucleus are necessary for the full expression of conditioned stress-induced increase in corticosterone and renin secretion. The results are discussed with respect to the potential pathways that mediate stress-induced increases in corticosterone and renin secretion. PMID- 1766555 TI - Delayed puberty in the male Djungarian hamster: effect of short photoperiod or melatonin treatment on the GnRH neuronal system. AB - The effect of short days or timed melatonin treatments on the number and neuroanatomical location of gonadotropin-releasing hormone (GnRH) neurons was studied in the brain of the pubertal male Djungarian hamster. At the beginning of the rapid phase of testicular growth and onset of peak gonadotropin secretion (15 days of age), males were treated for 10 days with either short days (10 L:14 D; n = 6), or remained in long days (16 L:8 D; n = 5) and injected each afternoon with melatonin. These treatments arrested testicular growth compared to the gonadal development that occurred in long-day controls (n = 9). Every brain section (60 microns) from the olfactory bulb to the anterior hypothalamus was processed for GnRH immunocytochemistry and viewed under brightfield light microscopy. GnRH cell bodies had smooth contours and were morphologically bipolar or unipolar. The number of bipolar neurons was similar regardless of treatment (about 170/brain). However, fewer unipolar GnRH cell bodies (p less than 0.05) were found in males in short days (73 +/- 11) or in males administered melatonin (72 +/- 14) compared to the unipolar number in hamsters in long days (132 +/- 14). With respect to neuroanatomical distribution, significantly fewer unipolar GnRH neurons were found in the medial preoptic area of males treated with short days or melatonin (55-70% decrease) compared to cell numbers in long-day controls. The melatonin treated hamsters also had reduced numbers of unipolar GnRH neurons in the diagonal band of Broca relative to the number of unipolar neurons in long-day controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766556 TI - [Treatment of tumors of the oral cavity. Long-term follow up of 1223 cases. Clinico-experimental computerized processing using BMDP program]. AB - The study assesses a series of 1223 patients treated for oral cavity neoplasm at the Institute of Oncology of Turin. It confirms the proportional deterioration of the survival rate in correlation with the advanced stage of the carcinoma. It shows the influence of the different types of treatment on survival, particularly referring to tumor site and stage at the time of first treatment. PMID- 1766557 TI - [Tactics and therapy in colonic obstructions]. PMID- 1766558 TI - [Paraganglioma of the neck. Analysis of 32 operated cases]. AB - Between january 1965 and november 1990, 32 operations for neck paraganglioma were performed: 29 chemodectomas (carotid body tumors) and 3 paragangliomas of the vagus nerve. Seven subjects were affected with bilateral chemodectomas and one of them showed concurrent unilateral vagal paraganglioma. Two paragangliomas were malignant, with invasion of the latero-cervical lymphnodes revealed at operation. Four individuals came to observation from two different families, suggesting familiarity. Preoperative diagnosis was correctly made in 12 of 18 asymptomatic chemodectomas (66.6%), ten of whom observed during the last decade: angiography is the gold standard for diagnosis but CT scan, ultrasound and NMR imaging are going to earn the confidence of physicians for precise evaluation of latero cervical masses. Surgery is to date the treatment of choice, and the results are dependent on the size of the tumor and the involvement of the neighbouring vascular, nervous and visceral structures. According to the majority of the literature, the 29 chemodectomas were classified in the three groups of Shamblin: I: 4 cases; II: 10; III: 15. Twenty out of the 24 transient or permanent postoperative complications took place in the third group: in five instances some procedures of internal carotid artery reconstruction were needed. Fourteen complications for chemodectomas and 2 for vagal paragangliomas affected the cranial nerves; three transient and one permanent ischemic central neurological deficits occurred in the group III chemodectomas. Not any operative mortality was registered in this series. PMID- 1766559 TI - [Surgical treatment of hemorrhoids using Milligan-Morgan technique. Survey of 366 cases]. AB - After a careful review of the Author's own case list and of the literature on this subject, Milligan-Morgans' technique is assessed and compared with different surgical techniques as far as early and late complications are concerned. The Authors conclude that the Milligan-Morgan technique is to be preferred because of its simplicity, safety and flexibility, particularly if associated with sphincterectomy, with or without rhagade, in order to prevent the cicatricial scars. PMID- 1766560 TI - [Plication of the sapheno-femoral junction]. AB - Plication of the long saphena at the sapheno-femoral junction (SFJ) is an alternative to flush ligation and stripping. This technique abolishes reflux at the SFJ without altering the vein which may be used for arterial surgery or coronary grafting. The selection of the candidate for plication is done with ambulatory venous pressure measurements and duplex scanning which indicate and quantify the superficial incompetence. The plication of the SFJ reduces the calibre of the vein to 60-70% for a length of 1.5 cm allowing the valvular cusps to close when flow in the femoral vein is reversed. In this study we evaluated 20 limbs (in 20 patients) 6, 12 and 24 months after plication. Venous reflux was significantly reduced with improvement of signs and symptoms. In conclusion, SFJ plication seems to be an effective physiological alternative to flush ligation. However long term results (greater than 5 years) must be still evaluated. PMID- 1766561 TI - [Palma's operation]. PMID- 1766562 TI - [Association of pheochromocytoma and renovascular hypertension]. AB - The case of a 47-year-old woman affected with right adrenal pheochromocytoma and right renal artery stenosis is presented. The concurrence of these two diseases is rarely reported in the literature, as shown by the review presented. Nevertheless, this association carries some problems as far as diagnosis is concerned, because missing renal artery lesion can lead to the maintenance of the hypertensive disease after surgical excision of the adrenal pheochromocytoma. Anyway, the extensive use of angiography is not justified for pheochromocytoma alone, because an excellent imaging of the mass can be achieved by means of non invasive technologies, such as CT, echo B-mode, NMR. A careful evaluation of clinical features and non-invasive imaging and the presence of elevated plasma renin activity, although not determinant in surgical decision making, can support the suspicion of renovascular hypertension in the presence of pheochromocytoma and suggest to carry out renal angiogram and selective renal veins reninemia. PMID- 1766563 TI - [An unusual case of hydatid cyst with adrenal localization]. AB - The paper reports a case of hydatid cyst with a primary adrenal location. Having underlined the rarity of this finding and reviewed the literature on the topic, the Authors discuss the epidemiological, pathogenetic and clinico-diagnostic aspects. In conclusion they underline the difficulty of arriving at a precise diagnosis prior to surgery in spite of the fact that new imaging diagnostic methods enable diagnostic hypotheses regarding this pathology to be advanced. PMID- 1766564 TI - [Nephrobronchial fistula]. AB - Nephrobronchial fistula is a rare pathology both in absolute terms and in relation to the complications of renal inflammatory processes. Clinical symptoms may be varied but pulmonary complications, which may mask renal symptoms, are generally predominant; cough, hemoptysis and the expectoration of calculi are rarely found. Occasionally, as in the case reported here, the most evident sign is an infective process due to the contemporaneous fistulization of subcutaneous tissues. Instrumental diagnosis is based on chest and abdomen X-ray, fistulography, retrograde pyelography and abdominal CT. CAT may be useful above all in the study of pararenal abscesses. PMID- 1766565 TI - [Neoplasms of the small intestine. Clinical cases and review of the literature]. PMID- 1766566 TI - [AIDS in Italy]. PMID- 1766568 TI - [Erythrocyte viscosity-deformability-aggregation. A clinical reality]. AB - Current clinical practice and indications for drug therapy for vascular pathologies of different etiology reveal the need to measure blood viscosity, either on the spot or at the site of greatest impact. The Authors propose as easily performed method of calculation using Reid's well-known technique, which, based on the measurement of hematic filterability using filters with different sized pores, gives the viscosity of the various fractions which make up overall viscosity but which have a different impact on areas of the circulation and their functions: total blood viscosity, corpuscolar viscosity, plasma-erythrocytic viscosity. These are quantified in cP as a values which is independent of the degree of sanguification and are markers of a functional flow datum. Erythrocytic deformability, expressed as a percentage of the inverse viscous impact of red cells on total blood viscosity, is restricted to a narrow range in the control population, and is therefore a very reliable parameter for the assessment of pathological and pharmacological changes. In addition to normal values, changes in subjects suffering from thalassemia are used as a paradigmatic example of structural and morphological erythrocytic changes without other associated diseases. A model table illustrates the methods of calculation used to obtain the degree of filtration in cP from filtration data. PMID- 1766567 TI - [Several aspects of HIV infections]. PMID- 1766569 TI - [Alveolar macrophage subpopulations and circulating monocytes. Immunophenotypic study in healthy non-smokers]. AB - Peripheral blood monocytes of 10 non-smoker normal subjects and the macrophages of their bronchoalveolar lavage fluid (BAL) were investigated with two commercially available monoclonal antibodies (MAC 387, CD14). Surface membrane monocyte cells show simultaneously both markers. Instead alveolar macrophage (MA) can be divided in three different phenotype groups by the expression of the two markers (MAC 387+/CD14-, MAC 387+/CD14+, MAC 387-/CD14+). Particularly, MA with MAC 387+/CD14+ phenotype are adherent cells and morphologically lack anthracosis. Their alveolar presence in non-smokers can be due to normal turnover of monocytes from blood into alveoli. By contrast MA with MAC 387+/CD14- phenotype are non adherent cells without anthracosis. At last MA with MAC 387-/CD14+ phenotype are non-adherent cells but different amounts of anthracosis in their cytoplasm can be observed. PMID- 1766570 TI - [Prevalence of biliary lithiasis in chronic liver disease]. AB - The prevalence of cholelithiasis was determined by ultrasound in 168 patients affected by chronic liver disease and compared to 828 subjects of the general population. We found an increase of cholelithiasis in chronic liver patients (p less than 0.004). This difference persisted separating the subjects in males (p less than 0.003) but not in females (p less than 0.08). Examined by age groups, patients demonstrated, like in the control group, an increase of frequency with the increase in age. We did not find any association with BMI, cholesterolemia, triglyceridemia, albuminemia and gammaglobulinemia levels. A significant association was found in the total (p less than 0.003) and indirect (p less than 0.0001) bilirubinemia. Finally, there was no significant association with the etiology of the liver disease. Even though there was a greater association with alcoholic and cryptogenetic liver disease. PMID- 1766572 TI - [Bone marrow scintigraphy with 99mTc nanocolloid. A complement to bone scintigraphy with 99mTc MDP in oncologic diagnosis]. AB - We compared the results of bone marrow scintigraphy (SMO) with those of conventional bone scintigraphy (SO) obtained in patients suffering of malignant neoplasms. SMO was carried out using nanometer-sized particles (nanocolloid) labelled with 99mTc, known to target the phagocitic properties of the medullar reticulo-endothelial cells. The results of the two investigations carried out in 148 patients agreed with each other. Notwithstanding the lesser definition of SMO images compared to SO and the masking effect of the high hepatosplenic activity, the two diagnostic methods were found to agree in 81.1% of all cases. SMO is easy to perform, can be compared well with SO and was demonstrated to be complementary to the latter. The SMO/SO confrontation has been found to be useful for better defining the extension of neoplastic lesions, which in turn has led to better staging of the disease. The investigation provides information about the entire distribution of the central bone marrow and its possible pathologic peripheral expansion. A remarkably reduced nanocolloid uptake cannot only be found in the osseous structure subjected to radiotherapeutic doses in excess of 30 Gy, but also in the case of longer standing high-dosage cytostatic treatments. The latter finding does not have its correlate in SO, hence it could be of considerable interest in validating the continuation of antineoplastic therapies. PMID- 1766571 TI - [Lipolysis and ketosis during swimming in thermal water]. AB - Plasma free fatty acids, blood glucose, beta-hydroxybutyrate and acetoacetate variations were studied in rats during swimming. Rats were forced to swim for 30 min in thermal water (source of Abano Terme) at 35 degrees and in normal water at 25 degrees. During swimming in thermal water plasma free fatty acids were increased, the glycemia remained unaffected, the beta-hydroxybutyrate and acetoacetate decreased. The swim in normal water induced a sharp increase of plasma free fatty acids, a decrease of blood glucose, an increase of blood beta hydroxybutyrate and a marked decrease of acetoacetate. From these data, some indications of clinical interest are presented and discussed. PMID- 1766573 TI - [Biologic effects of total body irradiation with single dose administered with various dose-rate]. AB - Total body irradiation (TBI) is used in conditioning regimens prior to bone marrow transplantation (BMT) in haematologic diseases to achieve the objective of eradicating bone marrow stem cells. The dose deliverable to the whole body is limited by the radiation tolerance of the normal tissues, especially of the lung, which is the major dose limiting organ because of the high incidence of interstitial pneumonia. The dose rate is important to successfully affect the therapeutic ratio of TBI and BMT; two different dose-rate schedules have been compared to define radiation damages in all tissues. Twenty mini-pigs were lethally irradiated, TBI was performed with 750 cGy total dose, but with two different midplane dose rates: a low dose rate (LDR) of 5 cGy/min and a quite high dose rate (HDR) of 25 cGy/min. In mini-pigs lethally irradiated with HDR, microscopic examination showed severe hemorrhagic changes in bone marrow, lymphonodes, lung parenchyma and other tissues, more prominent than in LDR mini pigs. Hystologic pictures showed moderate changes in kidney and liver parenchyma, in thyroid and brain tissue both in HDR and in LDR group. Tissue radiation damages are related not only to TBI total dose, but to the dose-rate; the selection of a low dose-rate is useful to reduce radiation cell killing by accumulation of lethal injury to normal tissues, especially to the lung. PMID- 1766574 TI - [Computerized management of therapy protocols in oncology. Evaluation of a decision support for breast carcinoma]. AB - A computerized system for assisted clinical decisions in breast cancer was evaluated, comparing the therapeutic strategies suggested bt the program with those actually used in an oncology Division. One hundred patients treated at the Medical Oncology Department of the National Institute for Cancer Research of Genoa, Italy, were entered into the study. Results, showing a 95% concordance, are discussed. PMID- 1766575 TI - [Computerized graphic techniques in the interdisciplinary information communication in geriatrics]. AB - Geriatric research shows that multidimensional assessment (MA) is the best method of approaching the complex functional problems of elderly subjects which are characterized by a close interdependence of clinical, social and mental factors. A correct and standardized communication of the results and the indications deriving from this complex interdisciplinary system is essential to enable the operators, despite their different professional backgrounds, to become involved in ensuring the health and welfare of their patients using integration and coordination criteria which are appropriate to the patient's individual situation. In this context, a computerized MA programme, known as "Senior", has been designed. The programme provides two communication sheets of data with different professional orientations: I) geriatric assessment sheet for doctors and other medical staff; II) graphic geriatric assessment sheet for non-medical operators. In practice, these assessment sheets are a useful backup in providing continuity between in- and out-patient programmes. PMID- 1766576 TI - [Effects of etozoline in patients with acute cardiac failure]. AB - Fifteen patients (10 M, 5 F; mean age 68.3 years) with acute heart failure III-IV NYHA class, were treated with etozoline (mean daily dose 666 mg) for 7 days. Symptoms of cardiac decompensation disappeared; no changes of blood pressure and heart rate were recorded. Daily urine volume increased from 790.9 +/- 327.0 ml to 1622.7 +/- 220.6 ml and body weight decreased from 71.5 +/- 5.8 kg to 69.6 +/- 5.2 kg. No changes of serum Na+, urinary Na+ excretion, appeared, but K+ excretion increased and serum K+ fell from 4.1 +/- 0.4 mEq/l to 3.6 +/- 0.45 mEq/l. No subjective side effects were reported. Renal-liver function and glyco lipid balance were not affected. In conclusion, etozoline is a safe and effective diuretic agent in the treatment of acute cardiac failure. PMID- 1766577 TI - [The use of reduced glutathione in alcoholic hepatopathy]. AB - The aim of the study was to assess the efficacy and tolerance of the use of reduced GSH in patients suffering from alcoholic diseases of the liver. Eighty patients were randomly divided into two matched groups and treated for 30 days with 300 mg of reduced GSH or 10 mg of vitamin K. Clinical symptoms and the main indices of hepatic function were assessed before and after treatment. At the end of the study all patients had improved, but the group treated with reduced GSH showed a greater improvement of hepatic function indices (SAT, ALT, gamma-GT) which was statistically significant in comparison to that found in the vitamin K treatment group. PMID- 1766578 TI - [Bipolar affective disorders and role of intraneuronal calcium. Therapeutic effects of the treatment with lithium salts and/or calcium antagonist in patients with rapid polar inversion]. AB - Treatment with lithium salts produces improvements in bipolar affective disorders. Up to date, the relationship between neurochemical and behavioural effects of lithium and its actions on intraneuronal free calcium ions is not well known. Some calcium antagonist drugs resulted active in the treatment of bipolar affective syndromes, with therapeutic effects similar to lithium salts. Some studies suggest that also lithium salts act as calcium antagonist at intraneuronal level. In this preliminary open study the activity of nimodipine, a selective neuronal calcium antagonist drug, was evaluated alone and in association with lithium salts in the treatment of rapid cycling bipolar manic depressive illness. During three periods of 6 months 12 rapid cycling patients were treated with lithium salts, lithium salts plus nimodipine 30 mg x 3/day, nimodipine 30 mg x 3/day. The association of lithium with nimodipine resulted more effective than lithium alone or nimodipine alone in the reduction of episodes of affective disorder. These results suggest a probable sinergic activity of both treatments. Further studies will be necessary to confirm the mechanism of action, perhaps calcium antagonism, at the basis of therapeutic effects of both treatments. The results seem to confirm the hypothesis that a calcium-ionic disorders play a role in the pathogenesis of bipolar affective disorders. PMID- 1766579 TI - [Malignant mesothelioma of the tunica vaginalis of the testis. Here again asbestos?]. AB - Malignant mesothelioma of the tunica vaginalis testis is a fairly rare disease, but it seems to have become more common in the last few years, according to epidemiological data. At least 45 cases have been reported in medical literature, 29 of which originating from Anglo-Saxon countries. Asbestos is the aetiological factor that is becoming more apparent also in this location of mesothelioma. From Fligiel's first case to the latest published by Tyagi, there have been 11 established cases of exposure to asbestos, which is equivalent of at least 31.5% among those affected by the illness. In many cases, furthermore, this noxious substance has not even been investigated. PMID- 1766580 TI - [Serology study for HBV and HIV-1 in a cohort of parenteral drug addicts]. AB - We studied 335 subjects, all drug addicts for the presence of the following serological markers: HIV1 antibody, HBsAg, HBsAb, HBcAb totals. We conclude that subjects HIV1 positive (n. 149) present HBsAb in a significantly lower number (p greater than 0.001) than HIV1 negative subjects (n. 95). The presence of HBcAb isolated is significantly higher (p greater than 0.001) in subjects HIV1 positive. They show an altered serological response to HBV compared to subjects HIV1 negative. PMID- 1766581 TI - [Resources and subsidies of scientific nature of the Instituti di Ricovero e Cura by geographic areas: inequalities between Center-North and South]. AB - The Authors assess investments and resources appropriated for research and technological innovation and highlight the imbalance existing between the areas of Central-Northern and Southern Italy. In particular, data relative to Comprehensive Health Care Institutes (IRCCS) fully confirm the diversity between the Central-North and the South; indeed, in terms of economic resources and personnel, totals in this latter region amount to 13.8% and 10.5% of national figures respectively. The role that IRCCSes might assume within the framework of an effective program of the re-qualification and development of scientific research and health care in Italy, especially in Southern areas, is thus confirmed. PMID- 1766582 TI - [A case of primary non-Hodgkin's lymphoma of the adrenal gland]. AB - The paper reports a case of non-Hodgkin's primary lymphoma of the adrenal gland which is justified by the rarity of this pathology as can be seen from the literature. Following adrenalectomy and subsequent polychemotherapy, a complete remission of the disease was obtained. The Authors report that, in the absence of particular symptoms, diagnosis is generally based on X-ray examinations performed to clarify the causes of aspecific symptoms such as, for example, fever and asthenia. Lastly, it is underlined that the disease may be diagnosed during surgery when CT reveals the presence of an adrenal mass with a diameter of more than 3 centimetres. PMID- 1766583 TI - [AIDS in Italy]. PMID- 1766584 TI - [AIDS in the world]. PMID- 1766585 TI - [Various aspects of the therapy of HIV infections]. PMID- 1766586 TI - [Postoperative infections and antibiotic prophylaxis in radical hysterectomy. Review of the literature]. AB - Postoperative infectious complications are a frequent cause of morbidity and mortality in the surgical patient. The septic events usually involve the urinary or respiratory tracts or occur at the operative site. The incidence depends on the surgeon's experience, the surgical procedure applied and the clinical status of the patient. Radical hysterectomy with pelvic lymphadenectomy is associated with a high risk of postoperative infections. Factors that influence the risk are prolonged preoperative hospitalization, duration of operation, younger age, obesity, estimated blood loss and lack of antibiotic prophylaxis. Appropriate administration of prophylactic antibiotics requires awareness of the following considerations: the choice of antibiotic agent, the dosage and the timing of administration for maximum benefit without adverse effects. In this review we evaluate the results of studies that use different regimens of antibiotic prophylaxis for prevention of infectious morbidity after radical hysterectomy. PMID- 1766587 TI - [Postoperative infections and antibiotic prophylaxis in radical hysterectomy. Retrospective study]. AB - Radical hysterectomy is associated with a high risk of postoperative infectious morbidity. A series of 73 patients who underwent abdominal radical hysterectomy with pelvic lymphadenectomy is presented. Hospital charts were reviewed to determine the influence of surgical characteristics and of different antibiotic prophylaxis regimens on postoperative septic complications. The overall incidence of postoperative infections was 31.5%; in 13 patients had urinary tract infections (17.7%), 3 surgical site-related infections (4.1%) and 6 febrile morbidity (8.2%). There were also 3 cases of phlebitis and 3 infectious events at distant sites. No interaction was observed between the examined risk factors and the overall infectious morbidity. Time of surgical procedure and average blood transfusion show a trend toward increased values in patients with complications compared to patients with regular postoperative course. The most important current controversy about the use of prophylaxis in radical hysterectomy concerns the duration of postoperative treatment. In this series the major part of the subjects received a long-term antibiotic prophylaxis regimen (greater than 72 hours), and only 18% received a perioperative prophylaxis. Women without postoperative complications were more frequently treated with a long-term antibiotic prophylaxis (82%) compared to women with infectious morbidity (65%). Moreover, in patients with complications, the proportion of cases who needed an additional antibiotic therapy was lower in the group receiving long-term prophylaxis (20%) compared to the short-term group (83%). PMID- 1766588 TI - [Ambulatory hysteroscopic diagnosis. Analysis of 425 cases]. AB - The use of outpatient diagnostic hysteroscopy is discussed with reference to a series of 425 women. The test was performed in an outpatient setting with no form of analgesia, anesthesia or premedication in 385 patients (90.6%); the degree of acceptability was very low (intolerable) in 5.5%, supportable in 15.8% and excellent in 78.7% of patients. Fourty-two per cent of patients were aged between 45 and 54 years old, and the mean age was 47.5 years with a range between 18 and 83 years. The indication for the test was pre- or postmenopausal anomalous uterine bleeding in 74% of patients. Hysteroscopic diagnosis was normal in 56% of cases; endometrial polyps were diagnosed in 11.4% of patients; myomas in 11%; low risk hyperplasia in 9.9% and malignant tumours in 3.6%. The correlation between hysteroscopic diagnosis and histological tests was above 95% in cases of malignant tumours, atrophy and functional endometrium, whereas it was 67% in cases of low-risk hyperplasia. No accidents or complications related to hysteroscopy were reported. PMID- 1766589 TI - [Percutaneous localization of breast lesions. Personal experience]. AB - A critical analysis is made of a series of percutaneous localisations of radiological breast lesions. The Authors underline the importance of close collaboration between the various specialists in order to obtain an early diagnosis which, in breast cancer, ensures a better prognosis and also avoids the necessity of radical surgery which affects the woman's attitude towards cancer. PMID- 1766590 TI - [HELLP syndrome]. AB - The Hellp syndrome is a rare complication of hypertension in pregnancy, characterized by haemolysis, elevated liver enzymes and thrombocytopenia. Since the disease progresses very rapidly, it is important for successful treatment, to make an early diagnosis, evaluating the typical laboratory data changes, which are evident prior to clinical manifestations. Means of diagnosis and therapeutic approach are described, on the basis of personal experience. PMID- 1766591 TI - [Diagnosis and treatment of cervical pregnancy. A clinical case]. AB - A personally observed case of cervical pregnancy is reported. The opportunity is taken to discuss the most recent views on the aetiopathogenesis and treatment of this rare but threatening pathology. PMID- 1766592 TI - [Intrauterine death of one fetus in twin pregnancy]. AB - A case of twin pregnancy complicated by intrauterine death of a foetus is reported. The most recent literature data on incidence, aetiology, diagnostic and monitoring difficulties (improved over the past few years thanks to echography) are discussed. Finally, prevention problems and the choice of therapy are examined, it being stressed that it is by now a widespread habit to close these pregnancies with Caesarean section as soon as the maturity of the surviving twin so permits. PMID- 1766593 TI - [AIDS in Italy]. PMID- 1766594 TI - [AIDS around the world]. PMID- 1766595 TI - The lycopodium alkaloids. PMID- 1766596 TI - Diterpenoid alkaloids. PMID- 1766597 TI - Testicular, prostate and penile cancers in primary care settings: the importance of early detection. AB - Male testicular, prostate and penile cancers will be responsible for 32,625 deaths in 1991. Fortunately, prevention and early detection of cancer can decrease mortality and morbidity. Armed with knowledge of the incidence of testicular, prostate and penile cancers, risk factors, and clinical presentations, the clinician will be better able to implement primary and secondary prevention. Recommended screening schedules are reviewed in this article, and suggestions for assessment, differential diagnosis and practice are discussed. PMID- 1766598 TI - New protection against Haemophilus influenzae type b infections in infants and young children. AB - Invasive Haemophilus influenzae type b (Hib) infections carry high morbidity and mortality, primarily due to meningitis among infants less than 1 year of age. Two new vaccines, HbOC and PRP-OMP, have been developed and licensed to prevent invasive Hib infections in infants and young children. New recommendations advise clinicians to begin immunization for Hib at 2 months of age and to complete the designated series. This article details the new Hib immunization schedule for all pediatric clients between 2 months and 5 years. Additionally, public-health measures toward the prevention of serious pediatric morbidity and mortality are covered. PMID- 1766599 TI - Potential psychological attachments formed by donors involved in fertility technology--another side to infertility. AB - Donor participation has become an integral component in the treatment of infertility. While the donors' reproductive capabilities continue to be utilized to support fertility technology, little effort has been directed at understanding the experience of these participants. Based on attachment theory, it can be argued that donors have the potential to form parent-offspring attachments. This bonding may result in psychological sequelae from the separation inherent in technology that disconnects the genetic, gestational and social functions of parenthood. Implications for health care providers involved in infertility care are discussed. PMID- 1766601 TI - Disorderly conduct. PMID- 1766600 TI - A practical approach to writing successful grant proposals. AB - Success in the planning and writing of grant proposals for health care services is enhanced by using a methodical approach. First, explore the problem and the resources. Obtaining direct experience is superior to a library-based literature review in understanding the problem. Second, identify funding sources and begin to plan the project, matching community needs to organizational strengths and funding priorities. Third, write the proposal and finish planning. Plans are refined as the proposal is written. This article provides practical information on commonly needed documents, characteristics of successful proposals and sources of information on funding. PMID- 1766602 TI - Rising to the challenge. PMID- 1766603 TI - The politics of community nursing. PMID- 1766604 TI - A double innovation. PMID- 1766605 TI - Healthier eating on shifts. PMID- 1766606 TI - Assessing leg ulcers. PMID- 1766607 TI - Working together for quality care. PMID- 1766608 TI - Helping nurses to stop smoking. PMID- 1766609 TI - Extending the extended role. PMID- 1766610 TI - The future of nursing in the community. PMID- 1766611 TI - Tribute to Cleave--forgotten prophet. AB - The late Surgeon Captain T.L. Cleave (1906-1983) completed his life-long RN professional service by promotion to the post of Director of Medical Research to the Royal Navy. His voyaging as a medical officer gave him unique understanding of patterns of disease throughout the world. He concluded that many of the degenerative illnesses which during this century have become so common in advanced countries have a simple basic dietary cause--the consumption of ever increasing quantities of refined carbohydrates; human beings were not, in Cleave's opinion, adapted to the use of these artificially concentrated foods. He suggested the term "Saccharine Disease" to denote many diverse manifestations, including dental decay, obesity, diabetes and coronary thrombosis, of one master disease having one simple cause. The neglect of this concept by most authorities today repeats the attitudes of the 'medical establishment' towards one of Cleave's distinguished eighteenth century naval predecessors, James Lind, whose advocacy of citrus fruit juice for the prevention of scurvy was greeted with derision. PMID- 1766612 TI - What is pellagra? PMID- 1766613 TI - Use, problems and prospects of soybean in infant weaning practices in Africa. AB - Access to nutritious food by poor people is being increasingly hindered by the failure of the food security system, and diminishing real income value, in most African countries undergoing Structural Adjustment Programme. Hence, nutritional disorders such as protein energy malnutrition, xerophthalmia, anaemia, low birth weight, stunting and wasting are on in the increase. Although soybean is used in quite a number of African countries as a weaning food, there are still problems such as lack of technical know-how for its processing into infant foods, cultural practices which favour the use of cereal rather than legumes for weaning infants and the long cooking time. In spite of this, the prospects for the crop as infant food is becoming brighter, and some ways of achieving this are discussed. PMID- 1766614 TI - Milk. PMID- 1766615 TI - What is pellagra? PMID- 1766616 TI - The historical background to modern agriculture. PMID- 1766617 TI - Calcium hydroxide and sporadic clinical mycotoxicosis. PMID- 1766618 TI - Let's start solving problems. PMID- 1766619 TI - One standard of care--gastroenterology. PMID- 1766620 TI - Brainpower at your fingertips: the National Library of Medicine. PMID- 1766621 TI - Mr. Secretary Sullivan's speech to nurses. PMID- 1766622 TI - Staffing and productivity. PMID- 1766623 TI - Differentiating nursing practice to improve service outcomes. PMID- 1766624 TI - INVEST: a plan for developing new managers. PMID- 1766625 TI - Bringing the Patient Self-Determination Act into practice. PMID- 1766626 TI - Group dynamics: handling subgroups. PMID- 1766627 TI - The workplace: on good mothers and good managers. PMID- 1766628 TI - People have been at work a long time. PMID- 1766629 TI - Forget that meeting! PMID- 1766630 TI - Grasping significant trends. PMID- 1766631 TI - Hospital-wide CPR committees: a decade of development. PMID- 1766632 TI - Healing the spirit. PMID- 1766633 TI - Our good will toward the people of Ohio. PMID- 1766634 TI - Indirect costs on research grants and contracts. PMID- 1766635 TI - Anatomical consideration for dacryocystorhinostomy. AB - To understand better the regional anatomy of the bony nasal window in dacryocystorhinostomy (DCR), anatomical dissections were performed on 28 cadaver specimens with an average age of 80.1 years. The distance between the point which is located 10 mm posterior to the medial canthus and the anterior cranial fossa floor was measured. The distance ranged from 1 to 30 mm with an average of 8.3 mm. There was no difference between males and females. Six cadavers out of 28 (21.4%) showed 3 mm or less in the distance. When a chisel was inserted through the medial canthus, the tip appeared near the anterior cranial fossa floor in cases with a short distance and a small frontal sinus but not in cases with a long distance and a large frontal sinus. It is obvious that, if a posterior nasal window is enlarged more than 3 mm above the medial palpebral tendon, a bony opening will be formed in the anterior cranial fossa floor in these 6 cases, resulting in cerebrospinal fluid leakage. In conclusion DCR should be done without severing the medial palpebral tendon to make a bony nasal window under the tendon. PMID- 1766636 TI - Determination of cadaveric antibody against HIV in vitreous humor of HIV-positive patients: potential use in corneal transplantation. AB - The authors suggest the determination of antibody against HIV in vitreous humor as a screening technique for AIDS carriers, specially in cases of corneal transplantation when the eye bank could make the examinations required and in cases when drawing blood after death becomes difficult. Ten eyes of patients having died of AIDS-related causes were studied and 100% of the samples tested were found to be positive. False-positive results were eliminated by the study of a group of 90 eyes of patients dead from nonrelated causes; the results were all negative. Therefore, no discrepancy was noticed between the examination of the blood and the vitreous humor. A description is made of a technique which uses a special trocar that enables the examination to be made without contamination with blood. The authors conclude that the determination of antibodies in vitreous humor is a choice to be considered as a postmortem examination because it can be easily obtained and its results are reliable. PMID- 1766637 TI - Bacteriological study of 92 cases of proven infectious endophthalmitis treated with pars plana vitrectomy. AB - 92 cases of proven infectious endophthalmitis underwent pars plana vitrectomy first to identify the responsible agent and directing the antibiotherapy, second to remove the abscess and third to make room for intravitreal injection of antibiotics. A wide spectrum of organisms was isolated (16 different agents). Prognosis of endophthalmitis depends on (1) the responsible agent and (2) the reason for developing the endophthalmitis. The prognosis after lens implantation was rather favorable, whereas after vitrectomy the results were disastrous. Good results were obtained if the infecting agent was Staphylococcus epidermidis. Results after Streptococcus, Staphylococcus aureus, Bacillus or Pneumococcus were bad. Of the mycotic cases, only half of the Candida cases were cured. Other mycotic infections had a worse outcome. PMID- 1766638 TI - [Anti-inflammatory treatment after argon laser trabeculoplasty]. AB - After argon trabeculoplasty procedures in patients with chronic open angle glaucoma, the protein appearance and cell circulation were observed within the anterior chamber. Flare and cell measurements of the anterior compartment are parameters of aqueous blood barrier break down. This investigation was performed in 50 patients suffering from elevated intraocular pressure and treated with argon laser trabeculoplasty. Two different anti-inflammatory drugs (prednisolone acetate and cyclooxygenase inhibitor) were applied to the treated eyes and checked for their effect on inflammation reduction. The protein and cell concentrations within the anterior chamber were measured before and 6 and 24 h after trabeculoplasty with a flare cell meter (KOWA) and compared to a control group. Argon laser trabeculoplasty induces an increase in protein concentration within the anterior chamber. This investigation demonstrates a clear drop in the inflammatory reaction of treated eyes during prednisolone acetate and cyclooxygenase inhibitor application. The intraocular pressure was reduced to about 6 mm Hg in treated eyes from an average pressure of 26 mm Hg. PMID- 1766639 TI - Pseudophakic retinal detachment. AB - We reviewed 165 cases of non-referred pseudophakic retinal detachment. Fifty three eyes (32%) had sustained significant complications due to cataract surgery prior to retinal detachment; 45 eyes (27%) presented with grade B, C or D proliferative vitreoretinopathy. The overall reattachment rate was 84%. This was significantly higher in the posterior chamber lens group than in the iris-fixated lens or anterior chamber lens groups (93 vs. 69 and 81%). Our data show that uneventful extracapsular cataract extraction plus posterior chamber lens implantation offers the best chance of successful detachment surgery. PMID- 1766640 TI - Immunocytology of cellular components in vitreous and subretinal fluid from patients with proliferative vitreoretinopathy. AB - Proliferative vitreoretinopathy accounts for most of failures in retinal detachment surgery. It results from the formation of membranes spreading onto inner and outer surfaces of the detached retina and within the vitreous body, but the nature of the growing cells and the mechanisms of proliferation remain speculative. A cytological study was thus undertaken on 35 specimens of vitreous and subretinal fluid obtained surgically in patients with proliferative vitreoretinopathy. Various types of cells were identified: typical pigment epithelial cells, lightly pigmented and large totally unpigmented macrophage resembling cells, smaller unpigmented cells and lymphocytes. Immunocytological procedures with 10 different monoclonal antibodies directed against different markers of epithelial and immunocompetent cells showed the epithelial nonmacrophagic origin of the intravitreal and subretinal cells, as most of these cells were positive for cytokeratin but remained negative for macrophage markers. Examination of intravitreal pigment granules, using autofluorescence analysis by epi-illumination and toluidine blue staining, showed two distinct populations of pigmented cells, one containing melanin and the other lipofuscin, suggesting that pigmented cells could originate from the retinal and ciliary pigment epithelia. As concerns lymphocyte identification, only B cells were seen, whereas no T lymphocyte could be found. Fibronectin was found on a minority of cells in 4 vitreous specimens, but cells positive for glial fibrillary acidic protein could not be seen. These results confirm the involvement of pigment epithelial cells and the strong morphological changes they undergo during the course of proliferative vitoretinopathy, but the mechanisms of proliferative phenomena after retinal detachment remain to be determined. PMID- 1766641 TI - Lipid-containing eye drops. PMID- 1766642 TI - Presumed iris metastasis from abdominal neuroblastoma. AB - A 2-month-old infant had a retroperitoneal tumor and increased levels of vanillylmandelic acid and homovanillic acid in the urine, indicating an abdominal neuroblastoma. Two whitish masses that were noted on the left iris regressed in synchrony with the primary tumor mass as therapy was administered. We believe that our patient represents the third reported case of iris metastasis from abdominal neuroblastoma. PMID- 1766643 TI - Clinical assessment of corneal hydration control in Fuchs' dystrophy. AB - The diagnosis and monitoring of Fuchs' disease is typically based on information obtained from patient symptoms and a slitlamp examination. Although this clinical information provides a basis for diagnosis, it does not give a quantitative method for charting the progression of the disease systematically or a reliable basis for predicting the cornea's capacity to remain transparent after stress (e.g., cataract extraction). However, it is possible to quantify overall corneal hydration control by inducing corneal swelling and then monitoring the deswelling rate expressed as percent recovery per hour (PRPH). We have tested subjects with Fuchs' dystrophy and found that the PRPH provides a reasonable estimate of corneal hydration control. Unfortunately, the PRPH procedure involves considerable time and technical assistance and therefore is not convenient for clinical practice. In this report, we document the results of an initial effort to explore the relations between PRPH and six clinical measures consisting of five biomicroscopic indices and a subjective synthesis of clinical information called the probability of decompensation (POD) based on these indices. PRPH was significantly related to striae (p less than 0.001), stromal haze (p = 0.025), microcysts (p less than 0.001), and the POD (p less than 0.001) and not significantly related to guttae (p = 0.252) or Descemet's folds (p = 0.185). An empirically weighted predictor of PRPH was constructed from a statistical analysis of five slitlamp assessments and age. This approach for synthesizing clinical information produced a result at least as good as that obtained from the POD summary. These results show an important link between a quantitative laboratory assessment of corneal function and a clinical evaluation of corneal status and suggest that with continued refinement, clinical assessment may provide more quantitative information on Fuch's dystrophy and other diseases that affect corneal status. PMID- 1766644 TI - Stereopsis, accommodative and vergence facility: do they relate to dyslexia? AB - The relation between visual functions and reading performance has been the subject of conflicting opinion over the years. The purpose of this study is 2 fold: first, to examine factors other than visual acuity, i.e., stereopsis, accommodative facility and vergence facility, which might show a greater impact on reading achievement; and second, to utilize well defined dyslexic and normal controls to ensure that the reading deficits were not caused by overt neurological, psychological, educational, or environmental factors. Thirteen normal readers and 13 dyslexics were carefully matched by rigorous quantitative criteria. The performance of both groups on tests of visual acuity and stereopsis was similar. The dyslexic readers tended to show better accommodative facility. Dyslexics performed significantly worse than the matched normal readers on a test of vergence facility. These results, in agreement with those reported by other studies, indicate that less efficient dynamic vergence facility may contribute to reading impairment, unlike other static functions such as visual acuity and stereopsis. It may be that the vergence problems of the dyslexics are related to sequential oculo-motor abnormalities. The dyslexics' vergence problems may also be partly responsible for their large number of small eye movements. PMID- 1766645 TI - Role of accommodation in experimental myopia in chicks. AB - We compared the morphology of the accommodative apparatus in myopic and control chicks using light microscopy and scanning and transmission electron microscopy. Results indicate no significant difference in ciliary muscle and ciliary fold structure between control chick eyes and eyes in which at least 10 D of myopia was induced by the application of a translucent goggle. Based on the assumption that sustained tonic contraction of the accommodative apparatus in the myopic eye would lead to morphological differences, we conclude that the myopic eye is not accommodating excessively during development. These results, in combination with previous findings concerning the role of accommodation in experimental myopia, strongly indicate that accommodation does not play a significant role in this type of experimental myopia in chicks. PMID- 1766646 TI - Corneal immune ring as a complication of soft extended wear contact lens use. AB - Corneal immune ring (CIR) appeared in the eyes of three patients who wore their extended wear contact lenses while sleeping. CIR's have not been reported as a complication associated with the wear of soft extended wear lenses. The CIR appeared within days of an episode of ulcerative keratitis with an infiltrative component. Treatment with topical antibiotic and anti-inflammatory agents produced resolution of the corneal lesions. The clinical appearance of the lesions as well as the time frame involved suggest that the immune response that produced the CIR was triggered by bacterial endotoxin through the properdin mediated complement pathway. PMID- 1766647 TI - Lipid adsorption onto hydrogel contact lens materials. Advantages of Nile red over oil red O in visualization of lipids. AB - An artificial tear solution containing the major types of proteins, glycoproteins, and lipids represented in human tears has been developed. The adsorption of lipids onto various hydrogel lens materials (polymacon, lidofilcon A, phemfilcon A, etafilcon A) was examined by exposing the lenses to our artificial tear solution for 18 h. The adsorbed lipids were detected using Nile red stain. The patterns of deposits obtained in vitro were similar to those obtained with human worn lenses. The Nile red stain appeared far more sensitive in detecting lipids adsorbed to hydrogel lenses than the oil red O stain. It was found that lipids adsorb to hydrogel materials quite readily either in a pure state or combined with mucin or other proteins. In view of this work more attention should be given to the role of lipids in the etiology of various contact lens wear complications. PMID- 1766648 TI - Quantitative analysis of protein deposits on hydrophilic soft contact lenses: I. Comparison to visual methods of analysis. II. Deposit variation among FDA lens material groups. AB - Patient-worn lenses (N = 1058) were evaluated using both the Rudko method for deposit typing and a quantitative assay for adsorbed protein. The visible deposit typing results were compared to the values obtained by the quantitative assay. The Rudko method for deposit classification was found to be a poor quantitative measure of deposited protein. Statistical differences were found between protein levels on lenses with identical Rudko scores among the FDA lens groups. In many cases, no meaningful correlation was found between Rudko scores and protein levels for lenses within the same FDA lens group. Significant differences in the distribution of visible deposits (Rudko scores) were found among the four FDA lens groups. Significant differences were also found in the quantity of adsorbed protein among FDA lens groups. PMID- 1766649 TI - The generalized Prentice equation and the matrix equation for lens thickness solved simultaneously for dioptric power. AB - This paper solves the problem of finding the power of a lens which has given prismatic effect and thickness at a given point. Depending on the conditions there may be no solution or an infinity of solutions. An equation for all the solutions (when they exist) is derived. The paper makes use of matrix results that are new and that are likely to have more general application in ophthalmic optics and vision science. In particular the matrix Sp of Fang and Xu is introduced. PMID- 1766650 TI - Daytime edema levels with plus powered low and high water content hydrogel contact lenses. AB - Eleven unadapted contact lens wearers wore a high (74%) water content hydrogel lens (Permaflex, CooperVision) of oxygen transmissibility Dk/Lav 14 x 10(-9) in one eye and a low (43%) water content hydrogel lens (Aquaflex Superthin) of Dk/Lav 4 x 10(-9) in the other eye under open-eye conditions for 8 h. After 8 h, average corneal edema for the lower water content lens was 7.9 +/- 2.6%, which was significantly more than that for the higher water content lens, 1.7 +/- 1.6%. Significantly fewer corneal striae and folds were also seen in the eyes wearing the higher water content lens. Subjective ratings of lens comfort were significantly better for the higher water content lens. Low water content positive power hydrogel lenses of the thicknesses used in this study place unacceptable hypoxic stress on the cornea and therefore should not be used for all-day wear. PMID- 1766651 TI - Evaluation of a clinical glare test based on estimation of intraocular light scatter. AB - A glare test based on psychophysical estimation of intraocular light scatter and using a flickering, annular glare source was evaluated. The parameters determining the accuracy of the test were studied. In particular the influence of background light and flicker frequency were investigated and optimum values for best accuracy were found. Based on these findings a versatile and simple apparatus was constructed. Forty patients with various degrees of cataract were investigated in a clinical study. Patients, who subjectively experience severe glare problems, indeed show high glare values as measured with the apparatus. No obvious relation between visual acuity and glare score was found. In comparison with glare tests using a stationary glare source the use of a flickering glare source is advantageous in terms of sensitivity and accuracy. PMID- 1766652 TI - Effect of visual display unit use on blink rate and tear stability. AB - In the literature, there is evidence supporting the notion that visual display unit (VDU) use decreases the blink rate and possibly reduces the stability of the precorneal tear film. In this investigation the blink rate and tear stability were measured using noninvasive techniques, in relation to VDU use. In normal healthy subjects, the results show an average 5-fold drop in blink rate during VDU use but tear stability appears to be unaffected. During VDU use a significant relation was found to exist between the interval between blinks and the stability of the precorneal tear film. PMID- 1766653 TI - Influence of ocular gaze and head position on 4 m heterophoria and fixation disparity. AB - Four-meter heterophoria and fixation disparity measurements were taken from a sample of 40 young adults in primary gaze, 33 degrees left and right lateral gaze, and in 2 head/gaze positions related to golf putting. Comparisons using analysis of variance were made between the mean values in each gaze position and between the test-retest range of values in each gaze position. Mean heterophoria was more eso (p less than 0.05) in the two head/gaze positions related to golf putting than in other gaze positions, whereas mean fixation disparity was more eso (p less than 0.05) in rightward than in primary gaze. Phoria test-retest range was less (p less than 0.05) in all nonprimary gaze positions than in primary gaze. One of the putting-related gaze positions showed smaller (p less than 0.05) fixation disparity ranges than the primary or leftward position of gaze. All measures were highly variable among subjects. Trends present in the data suggested greater esophoria and eso fixation disparity mean values, and lesser heterophoria and fixation disparity test-retest range values in all nonprimary positions relative to primary gaze. The behavior of exophoric and esophoric subjects differed only in regard to changes in heterophoria associated with left and right lateral gaze. These data indicate differences in oculomotor postural tendencies relative to position of gaze. Relevance of the results to athletes is discussed. PMID- 1766654 TI - New options for aniseikonia correction: the use of high index materials. AB - The increased popularity of refractive surgery, intraocular lenses, and penetrating keratoplasty has resulted in larger numbers of anisometropes with aniseikonia. We have analyzed the effects of the new high index glass and plastic spectacle lens materials on the design of eikonic lenses sometimes used for these patients. Our results demonstrate that high index materials allow thinner and flatter lens designs. Thus, higher levels of aniseikonia correction and improved cosmetic appearance of eikonic spectacle lenses can be achieved. We present shape magnification nomographs that facilitate eikonic lens design with these materials. PMID- 1766655 TI - A definitive case of paradoxical stereopsis. AB - Author JF had perfect stereoacuity but was unaware that he did not make much use of stereopsis under everyday conditions of seeing, i.e., his stereopsis was paradoxical. We describe how this condition was diagnosed and everyday depth perception restored. The objective of this report is to demonstrate convincingly that paradoxical stereopsis exists as a clinical entity. A combination of signs and symptoms is presented as a syndrome for the diagnosis of paradoxical stereopsis. PMID- 1766656 TI - [Endoscopic papillotomy (sphincterotomy) in the 1990-s]. AB - This review summarizes the past history and presence of endoscopic papillotomy (EPT, sphincterotomy) in the treatment of biliary and pancreatic tract diseases. The indications of the different techniques used, and the comparison of the effectiveness of EPT with that of the traditional surgical treatment is also discussed. Based on the results, EPT is an up-to-date technique with good effectiveness, low risk for patients and widening indication range. EPT in the future, will play a determining role in the effective treatment of biliary and pancreatic tract diseases. PMID- 1766657 TI - [New possibilities in the management of gallbladder calculi]. AB - The new nonsurgical methods of treating gallstone disease in gallbladder rely on fragmentation with extracorporeal shock wave lithotripsy (ESWL) and on dissolution of stones with ursodeoxycholic acid (UDCA) and chenodeoxycholic acid (CDCA). Fragmentation alone is usually insufficient for gallbladder stones, and dissolution is only possible for cholesterol stones. Although oral dissolution with or without ESWL is an attractive alternative of surgery, only 25 percent of the patients are candidates for this therapy. Dissolution of the gallbladder stones by topical application of methyl-tertbutyl ether (MTBE) is an other option whose safety is still open to question. Therefore, cholecystectomy will remain the principal treatment for symptomatic gallbladder stones. PMID- 1766658 TI - [Diagnosis of femoral pseudoaneurysm and factors contributing to its incidence after heart catheterization]. AB - Two-hundred patients who underwent heart catheterization between 30 November 1989 and 30 September 1990, were followed up to establish the frequency of the vascular complications (mainly femoral pseudoaneurysm) of the procedure. Factors were evaluated which may promote the occurrence of femoral pseudoaneurysms. This complication was diagnosed in 6 cases. Two-dimensional and Doppler echocardiography (conventional and colour-coded) played an important role in the diagnosis. Systemic hypertension, anticoagulant therapy, obesity and technical difficulties (multiple punctures and catheter guidance problems) proved to be factors promoting femoral pseudoaneurysms. Serial echocardiograms revealed a tendency to spontaneous healing even in cases of relatively large pseudoaneurysms. PMID- 1766659 TI - [Prospective hemorheological study in the third pregnancy trimester]. AB - The prospective hemorheological study was performed in the third trimester of pregnancy. Whole blood viscosity, haematocrit, plasma viscosity and haemoglobin were measured. They did not find significant changes of these parameters in healthy pregnancy. The rheological parameters in the macrosomic group (75%) were same than in the normal group at 37th weeks, but later were significantly higher. Higher blood viscosity has been found in those pregnant women, who delivered retarded fetuses. They suggest, that the progressively increasing blood viscosity in the third trimester of pregnancy causes the disturbances in the intervillous microcirculation, and produces intrauterine growth retardation. PMID- 1766660 TI - [Initial experience with ultrasonic examination of the rectum]. AB - The authors report their initial results obtained by the use of transrectal sonography in examination of known or suspected rectal and perirectal masses. 42 patients were examined with commercially available endosonographic probes. 22 patients had known rectal cancer. 13 patients underwent surgical exploration. Malignant infiltration of perirectal fat were detected as accurately with US as with histology in 9 cases. Lymph node involvement was accurately identified in 11 cases. They recommend this new technique for the assessment of invasion of rectal tumours and lymph node involvement, for postoperative follow-up and for examination of benign diseases of the rectum. PMID- 1766661 TI - [Purulent meningitis, caused by Corynebacterium xerosis, after spinal anesthesia]. AB - A previously healthy 25 year old sportsman is reported who developed Corynebacterium xerosis meningitis with coma and seizures after spinal anaesthesia. The adequate therapy (dexamethason, penicillin, ampicillin, mannitol, intensive care, hyperventillation) resulted in a complete recovery. To the authors' knowledge this is the first case of Corynebacterium xerosis meningitis and the first bacterial meningitis reported after spinal anaesthesia in Hungary. PMID- 1766662 TI - [Remembering Tibor Verebely]. PMID- 1766663 TI - [Remembering Janos T. Fabini (1791-1847)]. PMID- 1766664 TI - [Comment on the question of consultation with the medical specialist]. PMID- 1766665 TI - [Observations on the pathomechanism of tetany reaction]. PMID- 1766666 TI - The helix-loop-helix protein rE12 and the C/EBP-related factor rNFIL-6 bind to neighboring sites within the c-fos serum response element. AB - We show that members of two major families of transcription factors, the helix loop-helix and C/EBP families, interact with the c-fos serum response element (SRE). Two cDNA clones encoding SRE binding factors (clones 9 and 21) were isolated by the direct screening of a PC12 lambda gt11 cDNA library using SRE oligonucleotide sequences as probes. Clone 9 encodes the rat homolog of the human HLH transcription factor, E12 (called here rE12). Clone 21 encodes a b-zip domain polypeptide that is related to the liver transcription factor C/EBP, and is homologous to the human NFIL-6 transcription factor (called here rNFIL-6). Using in vitro-translated products we show that rNFIL-6 recognizes a 'CCAATT' motif which overlaps the c-fos dyad symmetry element (DSE), the binding site for serum regulatory factor (SRF). Factor rE12 binds to an E-box enhancer sequence, 'CATCTG', immediately adjacent to the rNFIL-6 site, within the SRE. Antibodies specific to rE12 and rNFIL-6 disrupt nucleoprotein complexes with these DNA binding sites, confirming the interaction of native in vivo factors. We present evidence that rNFIL-6 and SRF binding are mutually exclusive, consistent with the overlap of their binding sites. The demonstration that rE12 and rNFIL-6 bind to the SRE at sites adjacent to the major c-fos regulatory element, the DSE, raises the possibility that helix-loop-helix and C/EBP families regulate the SRE and provide a new basis for the multifunctional properties of the SRE, including possible tissue specificity of expression. PMID- 1766667 TI - Fos is phosphorylated by p34cdc2, cAMP-dependent protein kinase and protein kinase C at multiple sites clustered within regulatory regions. AB - The proto-oncogene c-fos encodes a nuclear protein (Fos) that functions in transcriptional regulation in response to extracellular signals. Fos is extensively modified in the nucleus by serine and threonine phosphorylation. It has been suggested that phosphorylation may play an important role in regulating Fos function in normal and transformed cells. As a first step in addressing this issue, we have used purified Fos as a substrate for several serine-threonine protein kinases, including cAMP-dependent protein kinase (PKA), protein kinase C (PKC) and p34cdc2. Each of these kinases phosphorylated Fos at several unique sites. These sites were located within two regions that were previously shown to reduce the transcriptional activity of Fos in vitro. Several of the sites modified in vitro were also shown to be phosphorylated in serum-stimulated fibroblasts. These findings demonstrate that Fos is a target for several protein kinases involved in signal transduction and suggest that phosphorylation could regulate the transcriptional properties of Fos. PMID- 1766668 TI - p53 transgenic mice: accelerated erythroleukemia induction by Friend virus. AB - Mutations in the p53 tumor-suppressor gene have been implicated in the pathogenesis of a significant proportion of human cancers and in a dominantly inherited familial cancer syndrome (Li-Fraumeni syndrome). Frequent rearrangements and point mutations have also been detected in the p53 gene in the murine erythroleukemias induced by Friend leukemia virus. We have previously reported that transgenic mice overproducing a mutated p53 protein are predisposed to the development of lung carcinomas, bone and soft-tissue sarcomas, as well as lymphoid malignancies. Here we report that p53 transgenic mice infected with the polycythemia-inducing strain of Friend virus (FV-P) progress to the late stage of erythroleukemia more rapidly than do normal mice. In addition, Friend leukemic cell lines derived from p53 transgenic mice overproduce mutant p53 protein and show a high frequency of rearrangement of the ets-related Spi-1 oncogene, as previously reported in Friend cell lines derived from non-transgenic animals. These results suggest that the same genetic changes involved in the evolution of Friend leukemia in normal mice are also required in mice with an inherited predisposition to cancer. The data also indicate that p53 transgenic mice provide an animal model in which to analyse the role that genetic and environmental factors play in influencing cancer predisposition. PMID- 1766669 TI - Repression of the chicken c-rel promoter by vRel in chicken embryo fibroblasts is not mediated through a consensus NF-kappa B binding site. AB - To understand the regulation of expression of the chicken c-rel gene, we cloned genomic sequences upstream of the start site of transcription of c-rel. Sequence analysis shows that the c-rel promoter is a GC-rich promoter that lacks a TATA box. In addition, there are putative binding sites for several transcription factors, including an NF-kappa B consensus binding site. Primer extension showed that there is one major start site (site 1) for transcription in chicken embryo fibroblasts and two major start sites in a v-rel-transformed chicken spleen cell line. In transient assays using c-rel promoter sequences and the CAT reporter gene, we found that vRel repressed expression from the c-rel promoter. Other viral oncoproteins and a non-transforming v-rel deletion mutant did not repress the c-rel promoter. Repression occurred through sequences located within 125 bp of the start of transcription. However, mutation of the consensus NF-kappa B binding site did not affect the level of transcription from the c-rel promoter, nor did it interfere with repression by vRel, even though vRel could bind to the wild-type, but not the mutant, version of this sequence in vitro. These results suggest that the vRel protein can repress transcription through an indirect mechanism. PMID- 1766670 TI - Evidence for human DNA-mediated transfer of the suppressed phenotype into malignant Chinese hamster cells. AB - Genetic suppression of the neoplastic phenotype has been demonstrated in somatic cell hybrids between tumor and normal cells. Suppression in whole-cell and microcell hybrids cannot, as yet, be attributed to specific elements defined at the molecular level. To identify a gene capable of suppressing the neoplastic phenotype, we have introduced DNA of normal human cells into tumorigenic Chinese hamster Wg3-h-o cells. Primary and secondary transfectants which exhibit the suppressed phenotype similar to Wg3-h-o x embryonic fibroblast hybrids were selected. The cells require serum growth factors and anchorage for proliferation in vitro and show a reduced tumorigenicity in nude mice. Transferred human DNA segments were molecularly cloned from a secondary transfectant. Indirect evidence suggests that the cloned human DNA is associated with the expression of the suppressed phenotype. PMID- 1766671 TI - Mutations in the p53 gene in myelodysplastic syndromes. AB - We have examined p53 alleles in 151 DNAs from patients with myelodysplastic syndrome using single-strand conformation polymorphism analysis of polymerase chain reaction products. We focused our study on the four highly conserved regions of the p53 gene and detected five patients with aberrantly migrating fragments. We confirmed the putative mutation in each case by direct sequencing analysis. Of these five patients, three had chromosome 17 monosomy associated with p53 mutation, one patient showed one mutated p53 allele and one wild-type allele, and the last patient demonstrated only the mutant allele, suggesting a homozygous state. Unlike many other types of human cancers, point mutations in the p53 tumor-suppressor gene appear to be a rare event in myelodysplastic syndromes. PMID- 1766672 TI - High-affinity DNA-protein interactions of the cellular ETS1 protein: the determination of the ETS binding motif. AB - ETS1 protein purified from CEM cells was used to select its optimum DNA-binding sequence (pu) G/CCaGGA-AGTc (py). The sequence CCGGAAGT (ETS1-3) was preferred 5:1 over CAGGAAGT (PEA3). Quantitative electrophoretic mobility-shift assays (EMSA) indicated that the purified ETS1 protein binds to either ETS1-3 or PEA3 oligonucleotide probes with high affinity (Ka = 0.5-4.0 x 10(10) M-1) and that the purified ETS1 has different binding capacities for ETS1-3 and PEA3 oligonucleotide probes. The ETS1 protein binds 2-5 times more ETS1-3 than PEA3. Competitive binding experiments showed that the ETS1-3 and PEA3 probes effectively compete for the binding of ETS1-3. However, changing the core DNA binding sequence from GGAA to AGAA eliminates competition. Since the human ETS1 protein selected the same DNA sequence from a mixture of random oligonucleotides as did the Drosophila E74A protein (one of the most divergent members of the ETS family), this strongly suggests that all proteins containing the ETS 85 amino acid domain (sequences which define the ETS family) will bind to the same sequence. PMID- 1766673 TI - A new variant 15; 16 translocation in mouse plasmacytoma leads to the juxtaposition of c-myc and immunoglobulin lambda. AB - Mouse plasmacytomas (MPCs) induced by pristane oil, or by a combination of pristane oil and Abelson virus, carry one of two chromosomal translocations. The typical 12; 15 translocation leads to the juxtaposition of c-myc and immunoglobulin heavy-chain sequences, whereas the 6; 15 translocation links the kappa light-chain locus with the pvt-1 (plasmacytoma variant translocation) locus, located at least 75kb 3' of c-myc [Cory, S., Graham, M., Webb, E., Corcoran, L. & Adams, J. (1985). EMBO J., 4, 675-681]. Unlike the human Burkitt's lymphoma-associated translocation, the lambda/myc juxtaposed variant translocation has not been found previously in MPCs. Using unconventional MPC induction systems in which the tumor precursor cell was induced to proliferate in a secondary host, we have recently identified a 15; 16 translocation in six of the derived MPCs [Wiener, F., Silva, S., Sugiyama, H., Babonits, M. & Klein, G. (1990). Genes Chromosomes Cancer, 2, 36-43]. Chromosome 16 harbors the lambda light-chain gene. To explore whether the 15; 16 translocation represents the lambda/myc juxtaposition, we have mapped the breakpoints on chromosomes 15 and 16 by pulsed-field gel electrophoresis (PFGE). The pvt-1 region was mapped to approximately 220 kb 3' of c-myc. The breakpoint on chromosome 15 in ABPC-Ch-163 10, one of the six 15; 16 translocation-carrying MPCs, was situated approximately 80 kb 3' of c-myc and 140 kb 5' of pvt-1b, the major breakpoint cluster region of the previously analysed 6; 15 variant MPCs. The breakpoint on chromosome 16 was found to cut between the V1 and C3 regions of the lambda locus. Co-migration experiments showed that the C3 and the myc gene were juxtaposed head to tail on the 15; 16 translocation chromosome. On the reciprocal product V1 was juxtaposed to pvt-1. PMID- 1766674 TI - Bcl-2/JH rearrangements in benign lymphoid tissues with follicular hyperplasia. AB - The t(14; 18)(q32;q21) chromosomal translocation, characteristic of follicular lymphoma, couples the bcl-2 protooncogene on chromosome 18 to the immunoglobulin heavy-chain joining region (JH). This results in a deregulated transcription rate of bcl-2, suggesting a major role of the t(14;18) translocation in lymphomagenesis. By using a sensitive polymerase chain reaction technique specific for the major breakpoint region t(14;18), we now demonstrate the presence of bcl-2/JH rearrangements in lymph nodes and tonsils with follicular hyperplasia in 13 of 24 cases (54%). The approximate frequency was one translocation-positive cell in 10(5) cells. No bcl-2/JH rearrangements were detected in reactive lymph nodes without follicular hyperplasia or in bone marrow cells. Sequence analysis showed the amplified bcl-2/JH fragments to be unique to each individual sample and distinct from 24 sequenced follicular lymphoma-derived t(14;18) junctions, thus excluding contamination artifacts. The presence of random nucleotide insertions at the breakpoint junctions suggests a pre-B-cell origin of the t(14;18) translocation, in analogy with follicular lymphomas. We conclude that the t(14;18) translocation can occur in non-malignant tissue and will not, on its own, lead to malignancy. PMID- 1766675 TI - erg, an ets-related gene, codes for sequence-specific transcriptional activators. AB - E26 is a replication-defective avian acute leukemia virus which causes erythroblastosis and myeloblastosis in chickens. It carries two distinct oncogenes, v-myb and v-ets, both of which contribute to its transforming properties. Several genes related to the ets oncogene (c-ets-1, ets-2, erg, elk 1, elk-2, PU.1/Spi-1, E74 and Fli-1) have been described. Previously we have shown that the erg gene (ets-related gene) codes for at least two proteins (erg-1 and erg-2) because of alternative splicing and alternative usage of the initiation codon. We have expressed erg-1 and erg-2 proteins in Escherichia coli and have used these recombinant proteins to show that they bind to DNA in a sequence-specific manner. erg proteins exhibited different sequence specificity and affinity for the oligonucleotides recognized by c-ets-1, ets-2, some of PU.1/Spi-1 and elk-1, suggesting that the DNA-binding specificities of erg and other members may overlap but are not necessarily identical. The erg gene was found to transactivate a reporter gene that was linked to erg target sequences. These results suggest that erg-1 and erg-2 are sequence-specific transcriptional activators like the other members of the ets oncogene superfamily which represent a distinct class of transcriptional activators. PMID- 1766676 TI - Dominant inhibitory Ras mutants demonstrate the requirement for Ras activity in the action of tyrosine kinase oncogenes. AB - Two inhibitory Ras mutant proteins [(Asn 17) Ras and RAST] were microinjected into NIH3T3 cells in order to compare their inhibitory activity with that of a neutralizing anti-ras antibody. Both mutants were able to block efficiently the mitogenic effects of serum added to quiescent NIH3T3 cells. Furthermore, each of the inhibitors blocked cell cycle progression at the same point as the injected anti-ras antibody, just prior to the initiation of a new round of DNA synthesis. Finally, as with the injected anti-ras antibody, each of the inhibitors was efficiently able to block proliferation and reverse the transformed morphology of cells transformed by tyrosine kinase oncogenes, while cells transformed by serine kinase oncogenes were unaffected. Therefore, results with all three reagents clearly indicate that cellular Ras activity is required in the late G1 phase of the cell cycle and is essential for the maintenance of the transformed phenotype induced by tyrosine but not serine kinase oncogenes. These studies demonstrate the utility of dominant inhibitory mutants as a means of interfering with the activity of cellular oncogenes. PMID- 1766677 TI - Loss of heterozygosity at the RB locus is frequent and correlates with muscle invasion in bladder carcinoma. AB - Studies of second, non-ocular tumours in surviving retinoblastoma patients and their families have reported a higher than expected incidence and lower age at diagnosis of bladder tumours. This suggests that RB mutations may predispose to bladder cancer. To determine whether this gene is involved in the development of sporadic bladder tumours we have examined 162 bladder tumours for evidence of structural alterations to the RB gene. Ninety-four patients were informative with one or more intragenic RB probes, and 28 of these (29%) showed loss of heterozygosity (LOH). Of these, two tumours showed homozygous deletions with the 5' intragenic probe p123M1.8. The probe p68RS2.0, which recognizes a variable number of tandem repeats site in intron 17 of the RB gene, detected new alleles in 5 of 162 tumours, one of which also showed LOH at another polymorphic site within the gene. The 28 tumours with RB LOH were screened with the RB cDNA probes pR3.8 and pR0.9, which revealed two homozygous deletions and one rearrangement. The tumours with RB LOH were also screened for loss of three markers which flank RB, D13S1 which maps proximal and D13S2 and D13S3 which map distal to RB on chromosome 13q. Two tumours showed retention of heterozygosity for flanking markers on one side of RB and another for markers on both sides. These results suggest that RB is the target gene on 13q in these bladder tumours. When RB loss was compared with tumour grade and stage, an association between high tumour grade and RB loss (0.005 greater than P greater than 0.001) and between muscle invasion and RB loss (P greater than 0.001) was found. Twenty-six of the 28 tumours with LOH were muscle-invasive. This represents 56% of invasive tumours. Only 2/48 (4%) superficial tumours showed RB allele loss, and one of these has progressed rapidly to invasive disease. These results show that LOH at the RB locus is a frequent genetic event in bladder tumours and may identify a subset of more aggressive tumours. PMID- 1766678 TI - Expression of the ret proto-oncogene in human neuroblastoma cell lines and its increase during neuronal differentiation induced by retinoic acid. AB - Previously we observed specific expression of the ret proto-oncogene (proto-ret) in human neuroblastoma cell lines. A neuronal subline and non-neuronal sublines were isolated from the SK-N-SH cell line, which is composed of a heterogeneous cell population. Expression of proto-ret was detected in the neuronal subline, named SH-4305, but not in three non-neuronal sublines. Expression of proto-ret in the SH-4305 cells increased markedly after treatment with retinoic acid for 1 day, with concomitant morphological change, namely neurite outgrowth, and induction of neurofilament mRNA expression. Induction of proto-ret expression seemed to be correlated with neurite outgrowth and increase of neurofilament mRNA expression. These data suggest that the proto-ret product plays a role in neuronal differentiation. PMID- 1766679 TI - HTLV-1 Tax has distinct but overlapping domains for transcriptional activation and for enhancer specificity. AB - Tax1 of human T-cell leukemia virus type 1 (HTLV-1) activates viral transcription dependent upon three 21-bp enhancer elements in the long terminal repeat. Difficulties in detecting any association of Tax1 with the viral enhancer have hampered elucidation of the molecular mechanisms of Tax1-mediated transcriptional activation. By constructing a fusion protein with the heterologous DNA-binding domain of yeast GAL4, Tax1 was shown to be a potent transcriptional activator dependent on the presence of GAL4-binding sites. Deletions of the Tax1 portion of the fusion protein revealed that almost the entire region of Tax1 (amino acids 2 337) is required for activation, and the activity correlated well with that of the viral enhancer. The GAL/Tax1 mutant lacking 41 residues of the C-terminus of Tax1, GAL/Tax1(2-312), was inactive for the viral enhancer, but activity was recovered by adding the heterologous activation domain of herpes simplex virus VP16. These results indicate that Tax1 has two distinct but overlapping functional domains for transcriptional activation and for enhancer specificity. Thus, Tax1 is thought to be a transcription factor acting in the enhancer complex rather than as a catalytic or allosteric modifier of pre-existing cellular transcription factors. PMID- 1766680 TI - Loss of heterozygosity and mutational alterations of the p53 gene in skin tumours of interspecific hybrid mice. AB - Functional alterations or loss of tumor-suppressor genes are an important feature of neoplastic progression in humans. The employment of suitable animal model systems would greatly facilitate the detection and manipulation of such genes. We describe here an experimental approach to this problem based on the analysis of skin tumors induced in F1 hybrids between Mus musculus and Mus spretus mice. The results show that loss of heterozygosity on chromosome 11 occurred in 4/13 mouse skin carcinomas, but not in premalignant papillomas. Since the murine p53 gene is located on this chromosome, immunoprecipitation and DNA-sequencing studies were carried out on tumorigenic cell lines and primary tumor DNA respectively to determine the status of p53 alleles. These studies revealed the presence of p53 mutations, both frameshifts and missense, some of which are identical to those found in human tumors. Loss of normal p53 function is found in well differentiated squamous-cell carcinomas and thus does not appear to be directly responsible for further progression to an undifferentiated spindle cell phenotype. PMID- 1766681 TI - A 3' truncation of myc caused by chromosomal translocation in a human T-cell leukemia is tumorigenic when tested in established rat fibroblasts. AB - We have previously identified in human T-leukemia cells a myc gene with an unusual 3' rearrangement, and we have shown that expression of the gene is deregulated by stabilization of mRNA. Here we report that the rearranged gene transforms established rat fibroblasts to a tumorigenic phenotype. In hybrid genes, the transforming capability segregates with the 3' rearrangement. Transformation is apparently due to a more than fivefold enhancement in myc expression, attributable to stabilization of mRNA. The rearranged allele of myc also contains a point mutation in a region upstream of the gene, identified previously as a potential negative regulator of myc expression. The mutation may increase expression of myc, but not sufficiently to cause cellular transformation. Our findings enlarge the variety of genetic lesions that may activate myc to an oncogene and sustain the view that augmented expression of an otherwise normal allele of myc can be pathogenic. PMID- 1766682 TI - A practice based study of factors influencing intra-ocular pressure. AB - Many factors are claimed to influence the pressure measured by the tonometer. This study analyses intra-ocular pressure data collected over 10 years on 500 'normal' individuals using a non-contact tonometer. It attempts to analyse which patient variables are relevant and considers the effects of age, sex, laterality and refractive status on intra-ocular pressure, using various statistical techniques. No significant relationship was found for age, sex or refractive error, but axis of astigmatism and laterality were found to be significant factors. PMID- 1766683 TI - Referrals for vascular hypertension in a group of 45-64-year-old patients. AB - Two hundred and ten consecutive 45-66-year-old patients underwent a routine eye examination and a decision was made whether to refer each patient on the basis of fundus appearance and other non-sphygmomanometric criteria. Blood pressure was then measured and the referral decision was reviewed. Of the 33 (15.7%) patients finally referred, only 5 (2.4%) would have been referred on the non sphygmomanometric findings. It is suggested that optometrists include a protocol of blood pressure measurement as part of the eye examination routine. PMID- 1766684 TI - Tinted lenses and related therapies for learning disabilities--a review. AB - Research relating to the use of Irlen tinted lenses and coloured overlays for underachievers is reviewed. Many of the studies were not published in refereed journals and were methodologically poor. The weaknesses of the Irlen argument are discussed, including the absence of evidence to support the claims that these tints need to be uniquely prescribed and manufactured. Syntonics is another form of visual colour therapy that has been applied to those with a learning disability. Research on this is reviewed, and is also shown to have procedural irregularities which preclude firm conclusions. Owing to the poor quality of much of this research the claims of the protagonists of these therapies cannot be proved or disproved. A proposed new therapy is normally preceded by a valid theoretical hypothesis; this has been lacking in the present topic. Recently, a feasible explanation has been proposed in terms of 'pattern glare' resulting from mild hypersensitivity to epileptogenic patterns. This, together with potential alternative theories, is discussed. In the conclusion of this review, advice is given for eye-care practitioners who may be consulted on these therapies. PMID- 1766685 TI - A comparison of clinical acuity and contrast sensitivity charts: effect of uncorrected myopia. AB - We have examined the effect of corrected and uncorrected myopia on visual acuity and contrast sensitivity using a standard acuity chart and two commercially available printed contrast sensitivity charts (Vistech and Pelli-Robson). We tested 140 eyes of 70 young adults. Most subjects were myopic and were tested with and without their optimum spectacle or contact lens correction. We found no effect of myopia, if well corrected, on acuity or contrast sensitivity. All three test scores were sensitive to uncorrected myopia. The Pelli-Robson contrast sensitivity chart, which was designed to be insensitive to defocus, required more than three diopters of refractive error to elicit a two line change in performance, and it was generally very insensitive to uncorrected myopia. Although the Vistech chart was sensitive to uncorrected myopia, the large step sizes used in the chart, and the higher inter- and intra-subject variability in scores reduces its potential value for refraction. The Snellen letter chart gave the most sensitive and reliable changes in performance with uncorrected myopia. PMID- 1766686 TI - Autosomal recessive inheritance of myopia in Hong Kong Chinese infants. AB - Hong Kong Chinese infants were refracted by retinoscopy at regular intervals between the age of approximately 10 and 40 weeks. Cyclopentolate 1% was used to obtain cycloplegia. The spherical equivalent of the refractive error was calculated for each child and analysis of variance carried out according to the refractive status of the parents. From approximately 20 weeks of age a significant difference was found between the mean spherical equivalent of the refractive error of infants of parents both of whom were myopic and that of infants of parents neither of whom was myopic. At 40 weeks of age a good fit with an autosomal recessive probability model was obtained. PMID- 1766687 TI - Protection from acute exposure to ultraviolet radiation by ultraviolet-absorbing RGP contact lenses. AB - One eye in each of 12 female pigmented rabbits was irradiated with UVB while wearing an EqualensR I rigid gas-permeable contact lens. The other eye served as a control. The irradiance level was 625 microW cm-2 (285-315 nm total bandpass) with exposure times up to 2364 s. Eyes were evaluated 24 h and 48 h after exposure by biomicroscopy and pachometry, and later by scanning electron microscopy (SEM). The contact lens was found to protect the central cornea from radiant exposures up to 60 times threshold. The exposed areas of cornea showed characteristic ultraviolet damage with an arc of demarcation indicating the position of the lens. With time the area formed a ridge of damaged cells (confirmed by SEM). At radiant exposure over 0.75 J cm-2 some oedema was seen in the 'protected' region, apparently by extension rather than as a direct effect. These findings suggest that in the human being exposed to ultraviolet radiation this ultraviolet-absorbing RGP lens would permit nasal and temporal photoketatitis with sparing of the central cornea and provide some protection of more posterior ocular structures. PMID- 1766688 TI - What radius does the conventional keratometer measure? AB - The reflected mire images used in conventional keratometry suffer from oblique astigmatism, resulting in separated sagittal and tangential image planes. Further complications arise if the cornea is assumed to be aspherical. To investigate the consequential effects on the readings--hitherto largely neglected--ray tracing methods were applied to two hypothetical models. One was representative of modern variable-doubling constructions and the other of the Javal-Schiotz design. Both are seen to require the tangential image plane to be focused. Given a spherical cornea, the measured tangential image height can be converted into an accurate radius reading by means of a linear calibration formula. In the Javal-Schiotz design, a non-linear correction is needed for this. Appropriately calibrated in these ways, each model is shown to give readings extremely close to the sagittal radius of curvature at the point of incidence when applied to corneae of conicoidal form. Extensive numerical results are tabulated and the detailed calculating schemes illustrated by worked examples. PMID- 1766689 TI - Weight of edged spectacle lenses. AB - Uncut spectacle lenses of various powers and materials were edged to three different eye shapes and three box eye sizes. Their weights were measured. This demonstrated that the eye shape has very little effect on the weight of edged lenses and that there is very little difference in weight for neighbouring eye sizes. The density of the lens material is of major importance, but other characteristics also influence the edged lens weight. PMID- 1766690 TI - Influence of peripheral degradation on the identification of eccentric targets (revised). AB - When the peripheral field is degraded, or 'modulated', as occurs with certain corrective lenses, identification of a peripheral image requires combined head and eye movements to place the image within a relatively clear section of the field. In such cases the time required to identify a peripheral object increases systematically. Previous experiments involving severely restricted peripheral fields (slit viewing) have indicated that the increase in identification time is primarily determined by the dynamics of the head movement. Head movement characteristics, in turn, are related to the nature of the peripheral distortion. To describe more complex peripheral distortions, a 'modulation' function is developed which provides a realistic, quantitative measure of the deficit induced by a given distortion. Modification in head movement can be traced directly to the influence of this modulation function. PMID- 1766691 TI - Statistical inference on mean dioptric power: asymmetric powers and singular covariance. AB - Methods have been developed recently for testing hypotheses on mean dioptric power and for constructing confidence regions in situations that are most likely to be encountered. In this paper the methods are extended to make the analysis complete. A new situation covered specifically is that of dioptric power not of the form sphere/cylinder x axis. Such powers, termed asymmetric powers because the dioptric power matrices are asymmetric, include the equivalent power of a thick obliquely crossed bitoric lens. A second situation is that in which the covariance matrix of the sample of powers is singular. Symmetric dioptric power (the more familiar form of power) can be represented by a point in three dimensional space. In general, however, dioptric power is four dimensional in character. Singularity of covariance arises when variation in the sample is limited to a subspace of dimension less than the full three or four. The space spanned by the sample is called the range space of the sample. The dimension of the range space may be four, three, two, one or zero. Each case is considered in turn. Numerical examples of hypothesis testing are presented in range spaces of dimension four to one. The test statistic devised for each case also gives the equation of the confidence region about the mean of a sample of dioptric powers. Singularity can sometimes be avoided merely by taking larger samples and by taking more accurate readings. The problem of near singularity is briefly discussed. The paper allows basic hypothesis testing on mean dioptric power and the construction of confidence regions in all possible circumstances. PMID- 1766692 TI - The Optical Services Audit Committee (OSAC) and UK optometry. AB - In 1989, following a series of legislative moves by the UK Government to remove the 'monopoly' within optical services, a proposal was made to introduce a two tier system of eye care. Within the two tiers would be a cheap, rapid spectacle prescription assessment that took no account of binocularity or ocular health. The initial response to this within professional groups involved was split, dispensing opticians keen to see the arrival of the system, the optometric profession concerned over the possible health consequences. In order to provide an overview of the situation the General Optical Council proposed the establishment of the Optical Services Audit Committee to investigate the whole of UK eye care services and recommend direction for future developments. The main conclusions of the report produced by this committee are discussed here. PMID- 1766693 TI - Linear model of accommodation and vergence can account for discrepancies between AC/A measures using the fixation disparity and phoria methods. AB - The AC/A ratios obtained previously by the fixation disparity method were in most cases greater than those by the phoria method. An earlier study analysed a simplified linear model of the accommodation and vergence system. It was determined that the equations corresponding to the two methods were equal, indicating that such a model could not account for the discrepancy found experimentally. However, two important components--tonic accommodation and tonic vergence--were omitted from this simplified model. In the present study, an analysis of the complete linear model showed that the equations corresponding to the two methods are different. In addition, calculation of the error between the cross-link gain and the overall accommodative input--convergence output values indicated that the AC/A should be higher using the fixation disparity than the phoria method. Therefore, the predictions of the complete linear model are consistent with the data obtained experimentally. PMID- 1766694 TI - Leonard A. Swann: optometric pioneer. PMID- 1766695 TI - Obstetric care of chemically dependent women requires more than 'doctor stuff'. PMID- 1766696 TI - Organ transplantation: a difficult road to travel. PMID- 1766697 TI - Renal transplantation in children. PMID- 1766698 TI - Bone marrow transplantation for pediatric leukemia. AB - The ability to deliver high-dose chemotherapy with or without radiotherapy followed by marrow rescue has made marrow transplantation the treatment of choice for children with AML in first remission, juvenile CML, and adult-type CML in chronic phase. For patients with ALL or NHL who relapse, transplantation in second remission represents a reasonable therapeutic option. The role of marrow transplantation for patients in the advanced stages of their disease will continue to be explored to develop promising new therapies, which may improve results of transplantation earlier in the disease course. Development of transplant preparative regimens that have the same or improved therapeutic efficacy with less late effects is especially important for growing and developing children. In the meantime, all children who have received a marrow transplant must be followed for development of delayed effects, which may not appear until years after the transplant procedure. Children who are cured of their leukemia continue to occasionally visit the pediatric hematologist/oncologist, but they do so less often with increasing time after curative therapy. Thus, it is necessary for the primary care pediatrician to be familiar with the details regarding the child's previous therapy in order to anticipate and to be prepared to treat the delayed effects. Attention to school performance is of particular importance for early identification of those children who may need special educational attention. Advances in the treatment of children with leukemia continue to be made both with chemotherapy and with marrow transplantation that should result in greater numbers of children being cured.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766699 TI - Bone marrow transplantation for genetic diseases. PMID- 1766700 TI - Bone marrow transplants in patients lacking an HLA-matched sibling donor. PMID- 1766701 TI - Liver transplantation in children: a pediatrician's perspective. PMID- 1766702 TI - Clinical efficacy of measles vaccine during the 1990 measles epidemic. AB - Because of increased measles incidence in the United States during 1989 and 1990 and the recent finding of genomic differences between vaccine virus and contemporary wild measles viruses, we conducted a study to determine whether the current measles vaccine had become less effective. Household secondary attack rates for 203 California children ages 1 to 5 years were 4.2 and 77.8% for vaccinated and unvaccinated children, respectively, and the vaccine efficacy was 95% (95% confidence interval: 89%, 97%). The protective efficacy for postexposure vaccination and use of IG were both low, 4% (95% confidence interval: less than 0, 36%) and 8% (95% confidence interval: less than 0, 59%), respectively. The measles vaccine efficacy found in this study is similar to those obtained in previous years and indicates that the measles epidemic of 1989 to 1990 occurred despite high vaccine effectiveness. PMID- 1766703 TI - Disseminated fungal infections in children infected with human immunodeficiency virus. AB - A retrospective review of charts of 156 human immunodeficiency virus-infected children cared for during a 7.5-year period revealed 11 episodes of disseminateed candidiasis (DC) occurring in 11 patients (7%). All 11 patients developed the fungal infection in the context of advanced human immunodeficiency virus infection. All but one were hospital-acquired, occurring at a mean of 2.3 months after admission. Ten patients had been febrile for more than 14 days before diagnosis. Previous oral thrush and central venous catheters (73 and 82% of patients) represented major predisposing factors for development of DC. Neutropenia (2 of 11 patients) did not represent a major risk factor for DC. Candida albicans was isolated in 9 patients, Rhodotorula minuta in 1 patient and 1 fungal isolate could not be identified. Sources of isolation were blood (8 of 11 patients), central venous catheters (3 of 11) and urine (2 of 11). Lungs (6 of 11 patients), esophagus (5 of 11) and brain, heart and kidneys (3 patients each) were the organs most often involved in DC. Antemortem diagnosis was achieved in only 7 (64%) patients; none of the 4 patients with DC diagnosed postmortem had been treated before death. Seven patients were treated with amphotericin B; 6 of them died but only 3 were treated for more than 7 days of therapy. The overall mortality was 90% (10 of 11 patients). In all 20% of the 50 human immunodeficiency virus-infected children who died at our hospital during the study period had an episode of DC in close proximity to their death. DC was considered the direct cause of death in 4 of 10 children. PMID- 1766704 TI - Chronic suppurative otitis media without cholesteatoma in children in southern Israel: incidence and risk factors. AB - The incidence and risk factors for chronic suppurative otitis media without cholesteatoma in children in Southern Israel were determined by comparing 88 children with the disease to 76 controls with similar age distribution who visited 3 clinics serving representative populations of the region. Data were collected during the child's visit to the clinic by means of a structured interview with the parents and by extracting information from medical records. The calculated yearly incidence was 39/100,000 children 0 to 15 years of age. Significantly increased risk for chronic suppurative otitis media was associated with a history of acute and recurrent otitis media, a parental history of chronic otitis media, larger families and more siblings, a higher crowding index and care in large daycare centers. The sex, parental age and education, allergy, sinusitis and recurrent upper respiratory tract infections were not associated with chronic suppurative otitis media. PMID- 1766705 TI - Comparative efficacy of erythromycin-sulfisoxazole, cefaclor, amoxicillin or placebo for otitis media with effusion in children. AB - We randomly assigned children with otitis media with effusion to receive either erythromycin-sulfisoxazole, cefaclor, amoxicillin or placebo for a 2-week period, primarily to determine whether either erythromycin-sulfisoxazole or cefaclor would have greater short term efficacy than that found previously for amoxicillin, and secondarily to supplement earlier data on outcomes in placebo treated subjects. Interim analyses showed no statistically significant (P less than 0.05) differences between the three antimicrobial treatment groups in the primary outcome measures, i.e. the prevalence of middle-ear effusion 2 and 4 weeks after entry, and indicated that postulated differences favoring the erythromycin-sulfisoxazole and cefaclor groups over the amoxicillin group were unlikely to be found even if the originally calculated sample size were attained. Subject accrual was therefore terminated. Final analysis showed no significant between-group differences in other outcome measures as well. In antimicrobial vs. placebo comparisons neither erythromycin-sulfisoxazole nor cefaclor gave more favorable outcomes than placebo, whereas more children were effusion-free in the amoxicillin group than in the placebo group at 2 weeks (31.6% vs. 14.1%, P = 0.007), but not at 4 weeks. We conclude that when antimicrobial treatment for otitis media with effusion is deemed advisable, neither erythromycin sulfisoxazole nor cefaclor should replace amoxicillin as first line treatment. PMID- 1766706 TI - Giardia lamblia and Cryptosporidium infections in child day-care centers in Fulton County, Georgia. AB - Risk factors for the introduction, spread and persistence of Cryptosporidium and Giardia lamblia infections in child day-care centers are not well understood. In 1989 and 1990 stool specimens were obtained from 292 diapered children attending 17 randomly selected day-care centers in Fulton County, GA; 8 (2.7%) children in 2 centers were infected with Cryptosporidium and 21 (7.2%) children in 7 centers were infected with Giardia. In 1986 the prevalence of Cryptosporidium and Giardia in these same centers had been 0.4 and 11.0%, respectively; the prevalence of Cryptosporidium, but not Giardia, increased significantly (P = 0.04) between 1986 and 1989 to 1990. Risk factors for Giardia infection included day-care attendance for greater than 3 months, the presence of toddlers in the classroom and the presence of other children in the household. Day-care centers with a Giardia positive child in 1986 were not more likely to have an infected child in 1989 to 1990. Cryptosporidium, like Giardia, may be endemic in day-care centers in Fulton County. PMID- 1766707 TI - Imipenem compared with ceftazidime plus vancomycin as initial therapy for fever in neutropenic children with cancer. AB - Two antibiotic regimens were assessed, imipenem as monotherapy and ceftazidime plus vancomycin as combination therapy, for initial empiric therapy in febrile neutropenic children with cancer. In a prospective randomized trial of 89 evaluable consecutive episodes, 45 were treated with imipenem and 44 with ceftazidime-vancomycin. In 87% of the episodes the neutropenia was severe. Of the 89 episodes 20% were bacteremias, 10% were clinically defined focal infections and 70% were considered fevers of unknown origin. The initial treatment was successful in 82% of the imipenem group and 59% of the ceftazidime plus vancomycin group. Both regimens were well-tolerated. There was no mortality, probably owing to the prompt admission and institution of antimicrobial therapy. All of the patients were treated until neutrophil recovery; no recurrent infections were seen. In conclusion imipenem monotherapy was well-tolerated and effective as initial therapy for fever in neutropenia in children. PMID- 1766708 TI - Serum C-reactive protein in childhood meningitis in countries with limited laboratory resources: a Chilean experience. AB - Quantitative C-reactive protein (CRP) was determined sequentially by nephelometry and photometry from a finger prick serum sample in 67 children with bacterial meningitis (BM) and 16 children with aseptic meningitis (AM). The initial mean CRP value of 180 mg/liter in children with BM differed significantly from the 12 mg/liter found in those with AM (P less than 0.001). In BM a slow descent instead of rapid normalization or a secondary increase in sequential CRP values were early indicators of complications during recovery, such as resistance to the antibiotic. A significant difference in the mean CRP values between uneventful and complicated courses of BM was observed from the fourth day on (P less than 0.001). The measurements obtained with nephelometry correlated reliably with the more widely available photometry (r = 0.99). Easily performed rapid CRP determinations can considerably improve the quality of care in meningitis patients, especially in those situations where facilities for performing bacterial cultures or antibiotic susceptibility testing are not available. PMID- 1766709 TI - Pseudooutbreak of Candida guilliermondii fungemia in a neonatal intensive care unit. AB - During a 3-week period multiple blood cultures obtained from 14 Neonatal Intensive Care Unit infants and 3 Newborn Unit babies grew Candida guilliermondii, a yeast rarely associated with infections in humans. At the time of detection of positive cultures, most infants had been hospitalized for days or weeks for serious perinatal conditions and treated with antibiotics and intravenous hyperalimentation. Two critically ill premature infants from whom the yeast was isolated were given amphotericin B. In 7 other infants, however, yeasts were recovered on the day of birth, raising the question of pseudofungemia. Exhaustive interrogation on the blood culture practices revealed that when drawing blood for a culture from small infants, "butterfly" needles were often flushed with a diluted heparin solution to prevent blood clotting. Culture of a single lot of diluted heparin vials, prepared at the hospital pharmacy and distributed to the Neonatal Intensive Care Unit and Newborn Unit shortly before the onset of the epidemic, grew between 10,000 and 15,000 colony-forming units of Candida guilliermondii/ml. Removal of contaminated heparin vials and discontinuation of heparinization of needles used for blood cultures resulted in cessation of the epidemic. The present outbreak illustrates the difficulties in recognizing pseudoinfections in sick premature infants and the importance of intensive investigation and intervention during such an outbreak. PMID- 1766710 TI - Arcanobacterium haemolyticum: biology of the organism and diseases in man. PMID- 1766711 TI - Multifocal skeletal tuberculosis presenting as osteomyelitis of the jaw. PMID- 1766712 TI - Capnocytophaga species infections in children. PMID- 1766713 TI - Reported use of antimicrobial agents in children attending a pediatric emergency department. PMID- 1766714 TI - Mycoplasmal infections of cerebrospinal fluid in children undergoing neurosurgery for hydrocephalus. PMID- 1766715 TI - Pneumocystis carinii pneumonia in a human immunodeficiency virus 1-infected neonate with meconium aspiration. PMID- 1766716 TI - Fatal adenovirus type 35 infection in newborns. PMID- 1766717 TI - Chlamydia pneumoniae (TWAR) in neonates. PMID- 1766718 TI - Aerosolized pentamidine in young children. PMID- 1766720 TI - Office cultures for group A streptococci. PMID- 1766719 TI - Group A streptococcal toxic shock-like syndrome. PMID- 1766721 TI - Management of a six-week-old febrile infant. PMID- 1766722 TI - The future roles of oral polio vaccine and enhanced potency inactivated polio vaccine. PMID- 1766723 TI - Poliomyelitis in France: epidemiology and vaccination status. AB - In France, infants are immunized against paralytic poliomyelitis with enhanced potency inactivated poliovirus vaccine (eIPV) combined with the diphtheria tetanus-pertussis vaccine (DTP). Ninety-five percent of all infants in France have received four doses of DTP-eIPV by 24 months of age. No cases of vaccine associated paralysis, among either recipients or those in contact with recipients, have been reported since 1983, when eIPV became the vaccine of choice. Only three wild indigenous cases have been reported among unvaccinated children in 1988 and 1989, with no cases reported in 1990. Although paralytic poliomyelitis has been virtually eliminated in France, vaccination programs as well as active surveillance of the community and environment for poliovirus circulation should be reinforced to reach the goal of wild poliovirus eradication. PMID- 1766724 TI - Efficacy and safety of oral poliovirus vaccine and inactivated poliovirus vaccine. AB - Inactivated poliovirus vaccine (IPV) is the vaccine of choice for protection against paralytic poliomyelitis provided that it is used within the context of a program to increase and sustain the level of uptake to as close to 100% as possible. This means targeting the disadvantaged in society as well as those who have their own pediatrician. The reasons are that enhanced-potency killed polio vaccine is safe, whereas oral poliovirus vaccine (OPV) is associated with a low, but definite, risk of paralysis, especially after the first dose. The immunity, as measured by antibody concentrations, is at least as good as and, in some circumstances, such as in the tropics or for booster doses, better than that provided by OPV. IPV reduces the replication of living poliovirus and produces herd immunity, as exemplified by experience in Sweden and Holland. The immunity, whether induced by OPV or IPV, involves memory cells and is long lasting, as seen by the rapid secondary response to a booster dose. IPV also can be mixed with other vaccine components to provide immunity against an increasing range of childhood infections. PMID- 1766725 TI - Results of a clinical study of polio vaccine: the Buffalo experience. AB - Serum-neutralizing, nasopharyngeal-neutralizing and nasopharyngeal IgA antibodies were determined in 123 infants immunized with either live (oral) poliovirus vaccine (OPV-OPV-OPV) (Group A), inactivated poliovirus vaccine (IPV-IPV-IPV) (Group B) or combinations of the two trivalent poliovirus vaccines: IPV-OPV-OPV (Group C) or IPV-IPV-OPV (Group D). Nearly 100% of individuals formed serum neutralizing antibodies. The highest geometric mean titer of antibody to polioviruses 1, 2 and 3 occurred in groups D, C and B, respectively. Local neutralizing and IgA antibody responses were detected in 41 to 88% and 75 to 100%, respectively. Peak geometric mean titer of nasopharyngeal antibodies differed minimally between immunization groups. Based on these data, it appears that a vaccine schedule with the combination of IPV and OPV would be ideal. It is uncertain whether a combination schedule is feasible in a highly mobile and heterogeneous population, such as that found in the United States. PMID- 1766726 TI - Mucosal immunity following oral poliovirus vaccine and enhanced potency inactivated poliovirus vaccine immunization. AB - Mucosal immunity is considered to be an important barrier for inhibiting person to-person transmission of naturally occurring (wild type) poliovirus infection. This review briefly summarizes the results of a previously published study in which 79 oral poliovirus vaccine (OPV) vaccinated children and 93 enhanced potency inactivated poliovirus vaccine (IPV) children were challenged with one of two doses of type 1 OPV virus to test the oropharyngeal and gastrointestinal mucosal immunity conferred by each type of poliovirus vaccine. Although both OPV and IPV produced excellent oropharyngeal immunity, OPV was clearly superior in decreasing fecal shedding of the challenge virus. PMID- 1766727 TI - Current issues in evaluating the efficacy of oral poliovirus vaccine and inactivated poliovirus vaccine immunization. AB - Although epidemic poliomyelitis in the United States has been eliminated, there are a number of current issues that concern the use of oral attenuated poliovirus vaccine in comparison with the new enhanced-potency inactivated vaccine. Although wild-type poliovirus is almost eradicated in developed nations, vaccine-induced polio exists, at a low but persistent rate. This article reviews the current issues and suggests a return to the Institute of Medicine's 1988 recommendations concerning combined immunization with inactivated poliovirus vaccine and oral poliovirus vaccine. PMID- 1766728 TI - [Evolution of drug treatment of rhabdomyosarcoma in children]. AB - Rhabdomyosarcoma is the most frequently occurring type of malignant solid tumors in children. The tumor site, aggressive growth, proneness to recurrence, metastatic spreading, and high neglect predetermine the negligible share of the surgical method in multimodality treatment of rhabdomyosarcomas. Of importance are the development and the use of different types and schemes of drug therapy which can be employed in combination with radiotherapy. Drug therapy of rhabdomyosarcomas has large practical potentialities which rise from year to year. PMID- 1766729 TI - [Short- and long-term results of multimodal treatment program of lymphogranulomatosis (Hodgkin's disease) in children and adolescents]. AB - Short- and long-term results of combined treatment of 440 children and adolescents afflicted with lymphogranulomatosis (Hodgkin's disease) were traced. A group of 104 children received treatment in 1964-1973. Complete effect was attained in 72.1% of the patients (in 75 out of 104); the 5-year survival was 72.5%, the 10-year 61.1%, the 15-year 52.75%. The long-term results are described in detail. Analysis of the results allowed basing the necessity of the three stage combined chemoradiation therapy in children with lymphogranulomatosis. In 1976-1980, the treatment according to the first combined program was provided to 193 children and adolescents aged 2.5 to 16 years suffering from lymphogranulomatosis. In 1979-1983, the treatment according to the second combined program was provided to 143 children and adolescents aged 3 to 15 years suffering from the same disease. In patients treated according to the first and second programs, the 5-year survival amounted to 81.3 and 93.3%, respectively. The total number of lethal outcomes was 20.2 and 4.2%, respectively, during the whole observation period. PMID- 1766730 TI - [Clinical significance of lipid metabolism in patients with chronic glomerulonephritis]. PMID- 1766731 TI - [Functional state of the respiratory tract in children with gastroesophageal reflux]. PMID- 1766732 TI - [Significance of therapeutic pathomorphosis in the treatment and prognosis of osteogenic sarcoma in children]. AB - To decide the problem of adequacy of preoperative treatment and postoperative special therapy, it is necessary to determine the degree of therapeutic pathomorphosis of primary osteogenic sarcoma. According to the materials of the children's clinic of the All-Union Cancer Research Center, USSR AMS, the degree of impairment is dependent on the size of the neoplasm, nature of the treatment and the x-ray-morphological variant. In a group of patients given preoperative chemoradiation treatment for degrees III and IV of therapeutic pathomorphosis, the 5-year survival amounted to 37.9 and 67.2% of cases, respectively. In a weak degree of tumor lesion (I-II), only 7% of the patients survive the 5-year period without metastases. The degree of therapeutic pathomorphosis is of great importance for correcting postoperative therapy as well as for predicting the course of osteogenic sarcoma in children. PMID- 1766733 TI - [Monoclonal antibodies of the ICO series in immunologic classification of lymphoblastic tumors in children]. AB - The specificity of monoclonal antibodies (MoAbs) ICO in normal T and B cell differentiation has been described. The use of standard MoAbs CD19, CD5, CD7 was taken into account in modification of immunologic classification of lymphoblastic tumors. Analysis in 336 patients with ALL has been done to compare the use of E rosettes, xenogeneic antisera and MoAbs in T-cell leukemia and lymphoma diagnosis. There are evident differences in the frequencies of some immunological subvariants of lymphoblastic leukemia as compared to lymphoma. PMID- 1766734 TI - [Immunoenzyme cytochemical methods, monoclonal antibodies and lectins in the diagnosis of tumors of the lymphoid tissue in children]. AB - ICO, IPO and LT series monoclonal antibodies, lectins, PAP and APAAP methods were used to study blood, bone marrow and lymph node cells in children with acute lymphoblastic leukemia (ALL), non-Hodgkin's malignant lymphomas and Hodgkin's disease. The immunological phenotype of malignant lymphoid cells has been characterized and cytological variants of ALL and lymphomas of T and B cell origin have been distinguished. PMID- 1766735 TI - [Role of cytological research methods in the diagnosis of lymphoproliferative diseases in children]. AB - Emphasis is laid on the role and high information content of cytological research methods in early diagnosis of oncohematological diseases in children. The Soviet cytoimmunological classification scheme of lymphosarcomas is presented. The use of the scheme will be helpful in unifying the estimation of the tumor substrate in different clinics of this country and will make it possible to carry out cooperative studies. A detailed cytological analysis of differential diagnostic differences in histoproliferative diseases of tumorous and reactive nature is provided. The difficulties of differential diagnosis in cases of bone marrow lesion in neurogenic tumors and acute lymphoblastic leukemia are related. The necessity is stressed of the training of skilled personnel and employing cytologists on the staff of the laboratories of large children's hospitals. PMID- 1766736 TI - [Significance of morphological, cytochemical and immunological identification of tumor cells in acute leukemia in children]. AB - The authors discuss the reported data and the results of own studies characterizing the current state of the problem of the phenotyping of leukemic cells. Emphasize the necessity of the use of a complex of morphological, cytochemical and immunological research methods for identification of tumor cells in children suffering from acute leukemia. PMID- 1766737 TI - [Effects of immunologic markers on prognosis in acute lymphoblastic leukemia in young children]. AB - Altogether 77 children aged up to 3 years with acute lymphoblastic leukemia (ALL) were examined for the immunological phenotype of blast cells. L1, L1/L2, L2/L1, L2 variants of ALL and the undifferentiated one were established in accordance with criteria of the FAB classification. T1, zero and Ia immunosubvariants were recorded most frequently. Mature cell T2 and pre-B variants (3 and 2 cases, respectively) were rare; B-cellular acute lymphoblastic leukemia was lacking; the "common" subvariant was revealed in 28 patients. The patients' age produced the highest effect on the prognosis: the significantly least disease standing and remissions were noted in a group of children under 2 years as compared to those aged 2 to 3 years. As for immunological markers, expression of Thy1-antigen exerted an unfavourable effect on the prognosis and duration of the first remission. PMID- 1766738 TI - [Clinico-cytological parallels in acute myeloid leukemia in children]. AB - Based on a comprehensive study of the morphofunctional parameters of blast cells by means of morphological, cytochemical, immunological and cytogenetic research methods, 8 types of blast cells and leukemic variants were identified in 200 children suffering from acute myeloid leukemia. In these children, the clinico hematological parameters differed depending on the leukemic variant. Verification of the diagnosis of acute myeloid leukemia variants in children will favour further perfection of the individualized treatment programs. PMID- 1766739 TI - [Significance of different "tracing systems" in the assessment of remission and prerecurrence states in acute leukemia in children]. AB - The authors provide the world reported data and materials of their own observations regarding the use of the "tracing systems" to control the residual pool of leukemic cells as a source of potential relapses. An attempt has been made to classify the techniques available; they are discussed from the stand point of the information content and feasibility in hematological practice. The necessity of developing studies into this problem in the USSR is emphasized. PMID- 1766740 TI - [Perspectives of pediatric oncology]. PMID- 1766741 TI - [State of stromal microenvironment of the bone marrow during remission of acute lymphoblastic leukemia in children]. AB - It has been established that bone marrow stroma integrally participates in acute lymphoblastic leukemia (ALL) reparation in children. The regularities of changes in its function were revealed over time and during remissions as was the sensitivity to polychemotherapy carried out during ALL remission. Studies into the function of stromal precursors of fibroblasts provide important information for estimation of hemopoiesis in children undergoing ALL remission. PMID- 1766742 TI - [Diagnosis and treatment of leukemia in children at present]. PMID- 1766743 TI - [Treatment of acute lymphoblastic leukemia in children according to the Berlin Frankfurt-Munster Program]. PMID- 1766744 TI - [Glucocorticoid receptors in acute lymphoblastic leukemia in children]. AB - Glucocorticoid receptor (GR) levels were quantitated in leukemic blasts from bone marrow aspirates of 53 children with acute lymphoblastic leukemia (ALL) and compared to the clinical and immunological features of the disease and its prognosis. GR levels did not correlate with the patients' sex, peripheral white blood cell count and cellular immunophenotype, but depended on the patients' age and histological type of leukemia. 43 patients were monitored during 3 or more years. The relapse-free and overall survival of ALL patients receiving standard courses of polychemotherapy including glucocorticoids was highly dependent on the GR level in bone marrow blasts. The best prognosis (67% relapse-free and 73% overall 3-years' survival) was observed in patients with GR levels over 6,000 sites/cell and patients with GR levels under 3,000 sites/cell had poor prognosis (31% relapse-free and 50% overall survival; median 1st remission duration 12 months). These correlations were most pronounced in ALL patients with "common" antigen. PMID- 1766745 TI - [Results of neuroleukemia prevention in children with acute lymphoblastic leukemia]. AB - The follow-up of 318 children with acute lymphoblastic leukemia given program therapy that included different treatments including chemo- and radioprevention of neuroleukemia demonstrated the high efficacy of the measures carried out, which reduced the incidence of neuroleukemia to 5.6%. No gross changes on the part of the neuropsychic status were revealed in the course of the follow-up of children who received the combined prophylaxis of neuroleukemia. The derangement of the CNS was recorded in 17 patients and ran its course in the form of leukemic meningitis and meningoencephalitis. PMID- 1766746 TI - [Prospects of the use of modifiers in children's oncologic radiology]. AB - Problems of radiotherapy of malignant tumors in children are discussed. The treatment included the use of different radiation modifiers with the aid of which radiosensitivity of normal and tumorous tissues may be selectively altered, thereby reducing radiation load of normal tissues and organs adjacent to the tumor. The data are given on the treatment of 45 children with soft tissue sarcomas. In these children, radiotherapy was carried out in combination with local microwave hyperthermia. PMID- 1766747 TI - [Bioelectric activity of the brain of children with long-term remission of acute lymphoblastic leukemia receiving chemoradiation prevention of neuroleukemia]. AB - Investigation of the bioelectrical activity of the brain (EEG, echoEG) in 60 patients aged 8 to 20 years with a long relapse-free course of acute lymphoblastic leukemia (6-10 years) made it possible to distinguish 3 groups of patients in accordance with the changes seen on the EEG. A reverse relationship was noted between the characteristics of the leukemic process during disease diagnosis and neurophysiological disorders after intensive therapy including chemoradiation prophylaxis of neuroleukemia. It is recommended that the dose of radiation of the brain of children with acute lymphoblastic leukemia may be reduced, if there are no risk factors of the development of disease relapses. PMID- 1766748 TI - [Use of alpha interferon preparations in acute lymphoblastic leukemia in children during remission]. AB - The Soviet alpha-interferon drugs (human leukocytic interferon, reaferon) were used in the program of the treatment of children with acute lymphoblastic leukemia (during remission). The treatment was found to be more effective with an increase of its duration, relapse-free course of the disease (69.4-82.3%) and survival (70.1-93.1%) of patients with an unfavourable disease prognosis (over 5 years). PMID- 1766749 TI - [Differential diagnosis of acute leukemia and hematosarcoma in children]. AB - Comparative analysis of hemopoiesis and study of the morphofunctional characteristics of blast cells in 89 children with hematosarcomas and in 152 children afflicted with acute leukemia revealed significant differences both in the nature of blast metaplasia of bone marrow and in the degree of inhibiting erythro- and thrombocytopoiesis in acute leukemias and hematosarcomas in the stage of leukemization. Study of the function of blast cells allowed one to distinguish specific features of tumor elements similar in their cytological parameters. The differences in the character of hemopoiesis derangement in different forms of hemoblastoses can be used under clinical conditions for differential diagnosis of the leukemic stage of hematosarcomas and leukemias. PMID- 1766750 TI - [Treatment and prognosis of lymphoblastic lymphosarcoma in children]. AB - Analysis was made of the results of the treatment of 18 children afflicted with lymphoblastic lymphosarcoma, with estimation of predictors influencing the patients' survival (from 1980 to 1986). The most important predictors influencing the 2-year relapse-free survival were found to be the stage, localization of the process, the presence of the symptoms of intoxication and biological activity. The data obtained were used later in the treatment of 160 children during 1986 to 1989. The results of the 2-year survival of this patients' group appreciably differ from those derived before. PMID- 1766751 TI - [Clinical aspects and treatment of recurrences of lymphosarcoma in children]. AB - Overall 392 patients with lymphosarcoma were under observation from 1980 to 1989 at the department of childhood hematology, All-Union Cancer Research Center, USSR AMS. The patients were characterized by the moment of the disease diagnosis. During treatment, 70 patients (31%) developed disease relapses. The relapses were characterized, possible causes of their development were analyzed. The results of relapses treatment according to two programs are discussed. No increase of the survival of the patients with relapses due to the intensification of the treatment programs was noted. PMID- 1766752 TI - [Lymphosarcoma of the oropharynx and nasopharynx in children]. AB - From 1983 to 1989, 22 patients aged 3 to 15 years with oro- and rhinopharyngeal lymphosarcomas were under observation. This number accounted for 10% of the total children's population with the same disease, with the observation period being the same. As a result of the examination, stage II was diagnosed in 13, stage III in 5, and stage IV in 4 patients. All the patients received chemo- and radiotherapy for 6-18 months. The relapse-free survival amounted to 50 months on the average, the total one to 52 months. It is stressed that early diagnosis and adequate therapy allow the cure of the majority of children with oro- and rhinopharyngeal lymphosarcomas. PMID- 1766753 TI - [Clinico-morphological characteristics of lymphogranulomatosis in young children]. AB - Cases of lymphogranulomatosis underwent a clinico-morphological analysis in 67 children aged 1 year to 3 years 11 months. The morphological features of the process and distinctive traits of the clinical picture of the disease in infants were defined. The 5-year survival in patients undergoing the current treatment programs was estimated. PMID- 1766754 TI - [Treatment of lymphogranulomatosis in children]. AB - The authors analyze the results of the treatment of 366 children afflicted with lymphogranulomatosis. All the patients received treatment from 1976 to 1990 according to three combined programs. The necessity is demonstrated of the individual treatment with regard to the predictors. Immunocorrection by means of taktivin was employed in patients with immunity disorders. The perfection of a complex of treatment measures favoured an increase of the survival to over 5 years in 93.8% of cases. PMID- 1766755 TI - Aging and memory for dreams. AB - This study investigated the influence of aging on memory for home drams and the extent to which cognitive variables such as visual memory, visuospatial IQ, and verbal IQ could account for possible differences herein. Subjects were 80 men and women of ages 45 to 75 years. Memory for dreams was measured by narrative length and frequency of recall. With respect to both measures no significant age differences were noted. Over-all differences in dream recall seemed best explained by visual memory scores. Partial correlational analyses, however, indicated that the small age differences memory or on any of the other cognitive variables. Dream contents were scored for aggression, friendliness, emotion, activities, and the number of characters and objects. The incidence of emotions among women appeared to be lower beyond the age of 60. Comparisons with previous data for young adults indicated that large reductions in aggression, friendliness, and emotion occur before the age of 45. PMID- 1766756 TI - Immediate effect of weight training as compared to aerobic exercise on free-throw shooting in collegiate basketball players. AB - This study empirically assessed the effect weight training has on the accuracy of free-throw shots immediately following a weight-training session. On On alternating days of the week for eight weeks, 14 members of a women's varsity intercollegiate basketball team engaged in a weight-training program and an aerobics exercise program. Each day immediately following the conditioning, the players shot two sets of 10 free throws. Analysis indicated no significant difference in free-throw shooting accuracy as a function of weight training when compared to the aerobic exercise, suggesting that the immediate effects of weight training are no more detrimental or beneficial for free-throw shooting than aerobic exercise. PMID- 1766757 TI - Effectiveness of filler items in disguising scale purpose. AB - Subjects (n = 246) were asked to identify the trait(s) measured by Rotter's Interpersonal Trust Scale with and without filler items, either by responding freely or by circling traits listed on a sheet. Half the subjects were informed prior to filling out the questionnaire that their task was to identify the traits being measured by the questionnaire; the remaining half of the subjects were informed of their task after they completed the questionnaire. Very few subjects were able to identify correctly the trait being measured by Rotter's scale regardless of the experimental condition. Most subjects named multiple traits. It was concluded that the use of filler items per se was not the key factor in disguising the true purpose of Rotter's test; rather item wording may have produced multiple interpretations. PMID- 1766759 TI - Relationships among attributes, physical fitness, and self-concept development of elementary school children. AB - The purpose of the investigation was to examine the relationships among children's selected attributes, health-related physical fitness; and self-concept development. Subjects were 97 elementary school children in Grades 1 through 6. Correlations were examined for significance and effect size among the attributes of age, weight, body mass index, four scores from the Health Related Physical Fitness Test, and the total score from the Martinek-Zaichkowsky Self-concept Scale for Children. A max R2 forward stepwise multiple regression analysis was performed to assess which attribute and physical fitness variables were the best predictors of self-concept scores. Analysis indicated that the one-variable model of weight was the best predictor of self-concept. PMID- 1766758 TI - Defining clinically significant changes in the treatment of child stutterers. AB - This study established a clinically significant criterion to evaluate outcomes of children's stuttering therapy. 30 stutterers, ages 6 to 15 years, and 30 non stutterers served as subjects. Speech samples were recorded and the percentage of stuttered syllables and rate of speech analyzed. According to Jacobson and Revenstorf's procedure, 3% of stuttered syllables and 160 syllables per minute should become the target behaviors in the treatment of children's stuttering. PMID- 1766760 TI - Revised scoring system and norms for the Physical Activity Stereotyping Index. AB - Protocols of 768 children, ages 6 to 12 years, provided the basis for revision of scoring and development of norms. PMID- 1766761 TI - Reading, spelling, and recognition of briefly exposed words and nonwords. AB - Four groups distinct in terms of English reading comprehension and spelling skills were identified among 141 Japanese college students: 5 good readers and spellers, 6 good readers but poor spellers, 3 poor readers but good spellers, and 4 poor readers and poor spellers. They were then tested on instantaneous recognition of words and nonwords. Analysis showed that the recognition performance was more strongly associated with spelling than with reading comprehension. Immediate memory and "sophisticated" guessing, which were associated with spelling, were considered to be critical for the recognition task, but the hypothesis that a common processing mechanism is involved in instantaneous word recognition and spelling was rejected. PMID- 1766762 TI - Symptoms of prosopagnosia in intoxicated subjects. AB - Two experiments were made to test whether a blood ethanol concentration of about 1 g ethanol per kg blood influences the ability to recognize faces which were shown 24 hours earlier. 18 subjects who saw the faces for the first time when sober and whose task it was to recognize the faces when under the influence of alcohol, recognized the faces significantly less frequently than controls. The controls saw the faces for the first time when sober and their task was to recognize the faces later when also in a sober state. When 20 sober subjects had to recognize faces which they had seen 24 hours earlier under the influence of alcohol, they recognized the faces significantly less frequently than controls. 18 subjects to whom visual forms were shown when under the influence of alcohol and who had to recognize these forms 24 hours later when sober again performed like subjects who had to recognize faces under identical experimental conditions. Subjects who saw the forms, however, in a sober state and who had to recognize these forms when intoxicated performed significantly better than subjects who had to recognize faces under identical experimental conditions. In additional experiments, it was shown that alcohol did not influence ability to compare simultaneously presented faces. Intoxicated subjects' reduced abilities to recognize faces is regarded as a symptom of prosopagnosia since it cannot be explained by a reduced ability to recognize forms or to compare faces. PMID- 1766763 TI - Environmental print as strategy for developmental literacy of young atypical children. AB - 12 children with handicapping problems were taught various strategies during a two-year period. These programs, designed to enrich their appreciation and awareness of the sounds of letters and how they are used, increased the children's attention span, parental participation with children and teacher, and promoted active involvement in reading. PMID- 1766764 TI - Age differences in children's pain. AB - A cross-sectional study of venipuncture pain and anxiety was conducted with 180 consecutively referred children and their parents. Analysis indicated that younger children report more venipuncture pain than older children. Anxiety was related to both age and pain. As well, anxiety was lowest among children with no previous venipuncture experience and among those with the greatest experience. PMID- 1766765 TI - Short-term stability of three-month-old infants' vocal response to mother vs stranger. AB - 20 3-month-old infants' differential vocal responses (DVR) to their mother vs a female stranger were assessed during two sessions about 4 days apart. Significant test-retest reliabilities were found for the infants' combined DVR responses and for their responses to both mother and stranger. PMID- 1766767 TI - Perceptions of health among lay consumers. AB - The incongruent perceptions of health by consumers and health professionals may contribute to low rates of adherence to medical regimens and few health promotion behaviors. This study of 65 adults, 21 men and 44 women, examined adults' views of health to identify gender, age, and education differences in health perceptions. A questionnaire with 34 items in 12 health categories was developed, based on the work of Woods and associates. Self-concept, fitness, and role performance were rated highest by all groups. Women rated social involvement and harmony significantly higher than men. Education groups rated body-image, fitness, and self-actualization significantly differently. PMID- 1766766 TI - A new implementation of Sheedy's visual grating task. PMID- 1766768 TI - Note on education and self-worth among AngloAmerican, black American, and Mexican American men in San Antonio. PMID- 1766769 TI - Relations among mental capacity, Short-term Storage Space, and operational efficiency. AB - According to R. Case, a subject's Total Processing Space is the sum of his Short term Storage Space (STSS) and Operating Space (OS). Case has hypothesized a trade off between the two, that is, an increase in operational efficiency leads to a decrease in operating space, and consequently more short-term space is available for information processing. To test Case's hypothesis 52 freshman students were tested to estimate operational efficiency (time taken to finish the Figural Intersection Test, when administered with a time limit), Pascual-Leone's Structural M-capacity, Ms (i.e., STSS), and Functional M-capacity, Mf. A zero correlation was obtained between operational efficiency and Ms/STSS, which suggests that subjects find it difficult to distribute attentional load from one reserve (OS) to another (STSS). This study supports Pascual-Leone's construct of Ms and Mf. It is concluded that subjects with high operational efficiency seem to be operating with the field-independent cognitive style rather than using a strategy of decreasing operating space. PMID- 1766770 TI - Prognostic indicators for successful use of "talking" tracheostomy tubes. PMID- 1766771 TI - Comparison of self-concepts of students identified as gifted and regular students. AB - The purpose of the present study was to compare the self-concepts of 40 eighth grade students identified as gifted and 40 regular eighth grade students using the Piers-Harris Children's Self-concept Scale. A t test indicated a significant group difference on the behavior component only and no significant differences by gender. More similarities than differences were noted in self-concepts of these students identified as gifted and regular students. PMID- 1766772 TI - Three-dimensional trajectory analysis of congenital mirror movements in a single subject. AB - Mirror movements are involuntary movements executed by one side of the body that occur with voluntary activation of homologous muscles of the other side. Although such movements have been described qualitatively and with surface EMG recordings, the spatial and temporal characteristics of these movements remain relatively unexplored. We studied selected simple and complex upper limb movements in a 20 yr.-old woman with congenital mirror movements and no other neurological disorder. Movements were digitized in three-dimensional space, reconstructed computergraphically, and analyzed numerically and graphically. Mirror movements had smaller amplitudes than did the corresponding voluntary movements, and there was, in general, temporal coupling between mirror and voluntary movements. Nonetheless, mirror movements were not always a perfect mirror image of the corresponding voluntary movements and sometimes differed in timing and trajectory shape from the original movement. Substantially larger mirror movements were elicited by distal than by proximal movements, and mirror movements were enhanced when loads were applied to the hand executing the voluntary movement. These data support the proposal that congenital mirror movements are produced by a partial failure of decussation of the pyramidal tract. We suggest that the variability in the extent to which mirror movements correspond to the voluntary movements is due to propriospinal and descending extrapyramidal input. PMID- 1766773 TI - Application of nasometry to speech samples of hearing-impaired children. AB - Nasalance measurements from speech samples of 19 hearing-impaired children (12 boys, 7 girls, of M age 8.0 yr.) were computed via a Nasometer 6200 for three speaking conditions: unaided, aided, and FM amplification. The nasalance scores for each condition were compared with the device norms. Scores for each condition were correlated and then ranked by age for additional comparisons. PMID- 1766774 TI - Development of critical thinking among students in kindergarten through grade 4. AB - A test to measure critical thinking ability in early elementary grades was designed and used to assess the development of one aspect of critical thinking, the detection of bias, in 102 students in kindergarten through fourth grade. The test was administered in a story-telling format. Analysis showed an age-related increase in critical thinking ability, with differences becoming significant at Grade 4. PMID- 1766775 TI - How does the visual system distinguish between illuminance and reflectance? AB - The experiments in which the strengths of pattern and of fusion differing in kind from brightness were used as measures indicated that the visual system could distinguish between illuminance and reflectance. From this result and an observation of gray papers by a microscope, it is assumed that luminance has two aspects, one refers to the macroscopic density of photons and another to the proportion of the reflected microscopic areas to the absorbed microscopic areas so that brightness constancy occurs in relation to each of the patterns of the various sizes from a macroscopic pattern visible to the naked eye to a microscopic pattern not visible. It is also mentioned that the strength of fusion is rare but promising as a measure for analyzing brightness. PMID- 1766776 TI - Contributions to the history of psychology: LXXXII. Authors, perceived color, and light intensity. AB - Two eponyms, the Purkinje phenomenon and the Bezold-Brucke phenomenon, are sometimes confused in discussions of the effect of light intensity upon perceived color. The former refers to a change in apparent brightness; the latter refers to a change in perceived hue. PMID- 1766777 TI - Secondary-task assessment of workload: neuropsychological considerations for applied psychology. AB - The secondary-task paradigm has enjoyed considerable success as an assessment technique for operators' workload. However, during the past several years experimental neuropsychologists have employed an almost identical paradigm in their research investigating cerebral lateralization of function. To date, these areas of literature have existed as relatively isolated bodies of work, largely due to the differences between the disciplines. In the present manuscript is a brief review of the results from neuropsychological secondary-task studies and a consideration of these results in terms of their implications for the measurement of operators' workload. PMID- 1766778 TI - Head-injury prevalence among community college students. AB - 835 community college students were surveyed to establish the prevalence of head injury or illness. Results are compared to prevalence rates among 4-year college students. PMID- 1766779 TI - Sexual aggression: perceptions of its likelihood of occurring and some correlates of self-admitted perpetration. AB - 175 college undergraduate students completed a questionnaire which contained dating scenarios and questions designed to assess the participants' perceptions about the likelihood that sexual aggression would occur in the described dating situations and how justified sexual aggression would be in those situations. Also included were items to assess self-admitted sexual aggression, self-reported sexual victimization, attitudes toward certain affectionate behaviors, and enjoyment of several magazines including the "soft-core" sexually oriented publication Playboy. Analysis indicated that women made significantly higher estimates of the chances of sexual aggression occurring in the described dating situations. Relative to nonvictimized women, victimized women gave significantly higher estimates of the likelihood of sexual aggression and believed that sexual aggression was significantly more justified. Men rated sexual aggression as significantly more justified in a relationship in which the male had been paying all dating expenses relative to one in which dating expenses were shared. Women's ratings were not significantly different. Also, correlates of self-admitted male sexual aggression included greater rated enjoyment of Playboy magazine and less agreement with an item designed to measure attitudes toward physical affection. PMID- 1766780 TI - Size of youth cohort and suicide rate in Japan. PMID- 1766781 TI - Contributions to the history of psychology: LXXXIII. J.E. Purkinje and Mathias Klotz: who first described "the phenomenon"? AB - In 1825 Purkinje described the effects of increasing ambient illumination at early dawn, beginning with darkness, on the perception of spectral colors. The blues were seen first. When reds became visible, they appeared less bright than the blues. The usually dependable Brockhaus Encyclopedia stated (1972) that the phenomenon was described in 1816 by Mathias Klotz and rediscovered ("erneut entdeckt") by Purkinje. As it turns out, Klotz correctly described the effects of low ambient illumination on the relative brightness but his report on visibility contradicts Purkinje's observations, amply confirmed by subsequent investigators and known, in fact, prior to Purkinje's report. PMID- 1766782 TI - A study of schizophrenic outpatients with the Defense Mechanism Test. AB - Intrapsychic defensive strategies are allegedly expressed on the Defense Mechanism Test through the presentation, at increasing tachistoscopic exposure times, of a picture in which a central figure is threatened by a peripheral person. Several types of perceptual alterations of the stimulus configuration are coded as defenses in the subjective reports. A number of test variables have already been shown to differentiate significantly between nonclinical controls and nonpsychotic psychiatric patients. In the present study, after a review of the pertinent percept-genetic literature, nonpsychotic patients (n = 57) were compared with a group of schizophrenic outpatients in the active phase (n = 21). As predicted, significantly more schizophrenics than controls were coded for projection and regression and for certain variants of these signs. Four subcodings of repression, three of isolation, the sign of reaction formation, and several variants of identification differentiated in the same direction. Reports in which the central figure was too old and changed from a correct to an incorrect sex attribution were highly characteristic of the schizophrenic sample. No defensive variable was significantly linked with nonpsychotic pathology. Two variants, one of regression and one of identification, allowed a correct diagnostic placement for all schizophrenics and for 82.4% of the nonpsychotic patients. The findings, besides being a further clinical validation of the Defense Mechanism Test, provide a preliminary distinction between high- and low level defenses. It is suggested that they are congruent with an hierarchical model which implies inclusive nonreflexive relationships between classes of mental disorders. PMID- 1766783 TI - Effects of auditory disruption of lingual tactile sensitivity in skilled and unskilled speaking conditions. AB - The purpose of this study was to investigate the effect of disruption of the auditory feedback channel on lingual vibrotactile thresholds obtained under skilled and unskilled speaking conditions. Each of 22 adults was asked to read an English (skilled) and French (unskilled) passage under conditions of normal and altered auditory feedback. Bilateral presentation of masking noise was utilized to disrupt auditory feedback. Before each of the experimental sessions and immediately following a reading, lingual vibrotactile thresholds were obtained. Analysis indicated that the mean differences in the pre- and postvibrotactile threshold measurements of the skilled auditory disrupted condition varied significantly from the mean differences in the pre- and postvibrotactile threshold measurements of the three other conditions. The role of feedback in the speech production of skilled and unskilled speakers is discussed. PMID- 1766784 TI - Normative data for a brief neuropsychological screening battery. Multicenter AIDS Cohort Study. AB - This study reports normative data for a group of 733 homosexual/bisexual men stratified by age (range 25 to 54 years) and by education on the following six neuropsychological tests: (1) Digit Span (WAIS-R), (2) Rey Auditory Verbal Learning Test, (3) Symbol Digit Modalities Test, (4) Controlled Oral Word Association Test, (5) Grooved Pegboard, and (6) The Trail Making Test. Analysis demonstrates that both age and education are important determinants of performance for several of these measures. PMID- 1766785 TI - Olfactory function in chronic alcoholics. AB - 8 patients participating in an outpatient program for chronic alcohol abuse and 8 age-matched controls were tested for olfactory function. There was a significant difference between the two groups on a match-to-sample test using uncommon odors but not on a smell identification test using common odors. Ability to detect and identify common odors does not appear to be impaired by chronic alcohol abuse. Deficits on the odor-matching task may be related to difficulty in encoding olfactory information rather than a primary olfactory deficit. PMID- 1766786 TI - Neuropsychological sequelae of stroke as a function of handedness. AB - The preservation of visuospatial ability relative to verbal ability following right middle cerebral artery stroke was assessed in 19 left- and 19 right-handed male patients who were group-matched on the basis of age, education, and time elapsed since stroke. Analysis of covariance (covarying education) indicated that the left- and right-handed groups were significantly different with regard to the discrepancy between Verbal IQ and Performance IQ, with the left-handed patients showing a smaller difference than the right-handers. These results provide further evidence that sinistrality may be associated with less hemispheric specialization. PMID- 1766787 TI - Relationship of fitness to depression, state and trait anxiety, internal health locus of control, and self-control. AB - Aerobic forms of exercise have been suggested as one approach to reducing the costly effects of excessive or chronic stress, yet the results of some studies related to this assumption have been mixed. The purpose of this study was to estimate the correlation between emotional states and fitness level among 8 women and 9 men who were recreational cyclists. Fitness was determined by cycle ergometric testing (VO2 max). Psychometric measures included the short version of the Beck Depression Inventory, the internal portion of the Multidimensional Health Locus of Control Scale, Spielberger's State-Trait Anxiety Inventory, and the Self-control Questionnaire. Significant correlations were observed between fitness and the depression scores, internal locus of control, and self-control measures. These results tend to support previous findings regarding the possible link between physical fitness and improved emotionality. PMID- 1766788 TI - Double response to Stroop stimuli. AB - To reexamine Klein's 1964 findings we carried out two experiments on the double response made to Stroop stimuli. In Exp. 1 incongruent color-word stimuli were presented on a CRT online with a microcomputer. A color-word card was used in Exp. 2. Subjects were asked to read words before naming colors or, conversely, to name colors before reading words. An analysis of variance (the task x the type of task) was performed on response times in both experiments. Two main effects and interactions were nonsignificant. Some subjects made an error-like reverse-order response on the double-response task. The present findings do not support Klein's findings or the competition explanation of the Stroop effect. PMID- 1766789 TI - The taste of desserts' packages. AB - This article reports an experiment on expressing the behavioural meaning of designed objects. Can a designer express the taste of a desert in the form of its packaging and can consumers match these forms when tasting the desserts? Analysis of responses of 12 adults indicates positive answers to these questions. PMID- 1766790 TI - Effects of gender and competitive coaction on motor performance. AB - The purpose of this study was to assess the relations between competitive, cooperative, and noncompetitive coaction on the pursuit rotor performance of 108 male and female university students. Analysis indicated that men compared with women had the higher performance scores, regardless of the induced situation. In particular, the competitive men's performance indicated the greatest facilitation in a coaction situation. PMID- 1766791 TI - Describing sport grounds: an investigation of 'functional' and 'acquaintance' familiarity. AB - The present research was designed to investigate the concept of familiarity and how different kinds of familiarity could affect the coding and memory of places having specific and strong functional significance, i.e., sport courts. Tennis and basketball were selected. Users and nonusers of such sport courts had first to describe a sport court taking the necessary information from their stored schematic knowledge and then to describe a sport court previously seen in a photograph. Subjects' verbal reports showed a certain superiority of users' performance, a commonly found place effect, and the presence of errors only on the second task and mainly by the users group. The results are discussed in terms of the environmental schemata theory and of the different kinds of familiarity considered. PMID- 1766792 TI - Meaningfulness values of words: relation to concreteness, imagery, emotionality, and interest. AB - We estimated that, contrary to previous studies, there was a positive correlation between ratings of meaningfulness and of emotionality of words. The correlation was .36 between ratings of meaningfulness and emotionality obtained by Campos and Gonzalez but .03 with ratings obtained in 1990 by Campos. Hypothesized positive correlations for ratings of meaningfulness with ratings of concreteness, imagery, and interest were significant. PMID- 1766793 TI - Color preference in sport shoes: an informal look. AB - Observations on five workdays at a large terminus for a number of commuter rail lines indicated that among 4731 passengers 5% of 2794 men and 31% of 1937 women wore white sport shoes. Questions relative to interpretation are raised. PMID- 1766794 TI - Canonical correlation of a temporal lobe signs scale with schizoid and hypomania scales in a normal population: men and women are similar but for different reasons. AB - The relationships between four relevant Minnesota Multiphasic Personality Inventory variables and temporal lobe signs and symptoms were determined separately for 70 university men and 86 women. Canonical correlations were similar in magnitude (0.55 to 0.60) but indicated sex-specific construction of the roots. For men the significant variables were the schizoid and complex partial epileptic-like signs; for women the significant variables were hypomania and all three temporal lobe clusters: complex partial seizure experiences, interictal-like signs, and religious/psi phenomenology. PMID- 1766795 TI - Effect of geometric parameters of perspective on judgements of spatial information. AB - 15 university students performed an exocentric judgement task in which they estimated the azimuth and elevation separating two computer-generated cubes, using a perspective display. The perspective displays were created by varying two geometric parameters of perspective, the geometric field of view and station point distance. Further, the radial distance separating the computer-generated images was varied. Analysis indicated that azimuth errors varied as a function of geometric field of view, radial distance, and station-point distance, while elevation errors varied as a function of geometric field of view and radial distance. PMID- 1766796 TI - Influence of age, sex, hearing loss, and balance on development of running by deaf children. AB - 130 deaf boys and girls, ages 3 to 14 years, were tested on development of mature running form. The mature form in this skill was associated with chronological age and performance of static and dynamic balance. Sex and hearing loss do not appear to affect development of running. PMID- 1766797 TI - Illusion of rotary motion reversal in a sphere is facilitated by increased rotational speed. AB - A rotating sphere with an artistically painted surface may appear to reverse its direction of rotation and at the same time reverse its curvature from convex to concave (the Termes Illusion). This study tested the effects of 4 rotational speeds (stationary, 1 rpm, 2.5 rpm, and 3.75 rpm) in producing this illusion. Analysis indicated that the number and duration of reversals increased with speed of rotation and successive viewing sessions. Latency of reversal decreased with successive sessions. Explanations in terms of satiation theory, learning theory, instructions, and perceptual bias were discussed. PMID- 1766798 TI - Application of tetra-ataxiametric posturography in clinical and developmental diagnosis. AB - Tetra-ataxiametric posturography is based on the measurement and computerized elaboration of electronic signals emitted by four footplates, one for each heel and toe, respectively. These are sensitive to vertical pressure produced by a subject standing straight but in various positions (feet parallel, in tandem, eyes closed, on pads, etc.). The method yields additional parameters not obtained by the traditional monoplate stabilometers, namely, weight-distribution patterns and correlations among six combinations of paired outputs from the two heels, two toes, heel/toe of each foot, and the two diagonals (tetra-ataxiametric synchronisations). Comparing age-matched learning disabled, mentally retarded, autistic, and hearing impaired (with and without labyrinthine hypofunction) with normal children, significant and clinically meaningful differences were detected between the tetra-ataxiametric measures of stability, interaction between Fourier Spectral Power Ranges of body sway, weight distributions, and synchronisations of toe parts. The same parameters correlated significantly with cognitive school readiness in normal populations. While the stability and spectral quotients show significant developmental changes, weight distribution and toe synchronisations are stable from 5 years onwards. The method is suitable for young subjects and attractive to children who may ordinarily be reluctant to cooperate, such as the autistic ones. The equipment is portable and tests can be conveniently carried out in a child's familiar educational setting. PMID- 1766799 TI - Effects of aerobic exercise on transient mood state. PMID- 1766800 TI - Differences in interpersonal distance among nonoffenders as a function of perceived violence of offenders. AB - A group of 39 female and 15 male undergraduate students took part in a study of the relationship between perceived violence of criminal offenders and interpersonal distance preferred by nonoffenders. Preferred interpersonal distance, measured for subjects informed that the person with whom they would be sitting in a room was either a violent offender, nonviolent offender, or nonoffender, was the number of seats subjects chose to sit from the person. Analysis of variance shows subjects preferred significantly less mean distance in the nonoffender condition versus either the nonviolent or violent offender conditions. PMID- 1766801 TI - Human pinch-force discrimination. AB - Pinch-sustaining tasks such as holding a pencil, fork, or key require the exertion of different levels of force. There is little information concerning normal subjects' ability to discriminate differences in their pinching force, so the purpose of this study was to evaluate the ability of 24 normal young women to discriminate differences in their self-generated isometric tip and lateral pinching force. Resistance forces of 10, 25, 50, and 75% of known normal maximum pinching force were selected as standards. Subjects were presented a series of paired resistance settings of which the first resistance in each pair was the standard and the second resistance a comparator of some greater amount. This procedure of paired comparisons was continued until subjects' threshold of discrimination between two pinching forces was established. The results indicated that subjects' pinch-force discrimination at the standard of 50% of reported maximum pinching force was significantly better for the tip condition than for the lateral condition. This study has described an instrumentation and the methodology for assessing individuals' ability to discriminate differences in their pinching force at submaximal levels. PMID- 1766802 TI - Effect of equal and random amounts of varied practice on transfer task performance. PMID- 1766803 TI - Body-size judgments and eye movements associated with looking at body regions in obese and normal weight subjects. AB - Eye movements of 20 male and 20 female obese and nonobese subjects were monitored during two body-size estimation tasks using a computer-based video technology. Analysis indicated no differences in body-size estimation between subjects using the staircase method. All subjects slightly underestimated body size; however, obese subjects were more sensitive than normal-weight subjects in detecting size distortion when a signal-detection task was employed. Eye-movement data indicated subjects looked longest at the chest, followed by waist, head, thighs, and calves/feet, in both the staircase and the signal-detection methods. Women viewed the waist region longer than men. On a signal-detection task subjects were better at detecting body-size distortion when viewing the body from the back than from front or profile. PMID- 1766804 TI - Sex of figure drawings and self-esteem. AB - This study examined the relationship between sex order of human figure drawing and self-esteem. Undergraduates (N = 440) drew a person and completed the Rosenberg Self-esteem Scale. Female subjects (n = 255) drew the opposite sex 39.2% of the time (n = 100), while 185 men drew females first only 6.5% of the time (n = 12). Using median scores derived from the sample, men who drew females first were more likely to have low self-esteem than were the men over-all. Self esteem judged on the sex of their drawing was not significantly different for women. These findings reinforce the importance of accounting for sex differences in personality assessment and support the hypothesis that drawing of the opposite sex by women may reflect social role rather than psychological conflict. PMID- 1766805 TI - Validation of a pictorial recall test in three visual formats. AB - This study describes the validation of a visual recall test which was constructed using three different levels of visual complexity, line drawing, monochrome photographic, and color photographic. For a sample of 111 college students, the test was significantly correlated (.42 and .92) with two recognized tests of visual memory. PMID- 1766806 TI - Calibration of "pokes": psychophysical measurement of computer-generated temporal intervals. AB - To answer questions raised about the accuracy of temporal intervals used to produce perception of apparent motion, interstimulus intervals generated by a computer were measured using physical and psychophysical procedures. Calibration of such devices was assumed initially to be routine but search of the literature indicated that calibration has been ignored in studies of motion and masking. Direct/physical methods of calibration proved unfeasible for assessing the accuracy of a computer programmed through "poke" procedures because signals for temporal intervals could not be differentiated from the output controlled by the machine's "hardwired" program. The results of psychophysical measurement of temporal intervals indicated that, on the average, differences, "constant errors" between expected/programmed intervals and matches of those intervals generally were less than six milliseconds. PMID- 1766807 TI - Sex differences in performance on a combined manual and decision task. AB - This report describes results of an experimental study of the differences in response time between 10 male and 10 female undergraduate operators performing a combined manual and decision task. Analysis indicated that the performance times of women on such tasks were shorter than those of the men as expected. PMID- 1766808 TI - The Claims/U.S. Patent Abstracts database and technological research in psychology. PMID- 1766809 TI - Reflections on a nurse becoming a psychoanalyst. AB - An increasing number of nurses have become psychoanalysts in the past few years. The author discusses the process of psychoanalysis and issues related to this expanded role for nurses from her own personal experience in analytic training. PMID- 1766811 TI - The PPC nurse-therapists directory. PMID- 1766810 TI - Cotherapists: learning to work together. AB - Communication in enhancing cotherapists' therapeutic effectiveness in family/couples work is of vital importance. Drawing on interactional communication theory, the author stresses the symmetrical relationship necessary for a therapeutic cotherapy relationship. Two illustrations demonstrate the potential advantages of employing the Group Coleader's Inventory as a formal communication tool to facilitate an egalitarian relationship between therapists. PMID- 1766812 TI - Supportive therapy: the other therapy. AB - Nurses have a long history of caring for clients with chronic mental illness. A primary treatment modality used with these clients is supportive psychotherapy. Often this approach is not well understood, even by those who purport to practice it. While supportive therapy tends not to enjoy the prestige associated with other forms of individual psychotherapy, the author contends that supportive psychotherapy can be an interesting and challenging treatment modality for working with clients with chronic mental illness. PMID- 1766813 TI - Empowerment through referrals. PMID- 1766814 TI - Prescriptive authority. PMID- 1766815 TI - Third party reimbursement for nurses in advanced practice. AB - The author contends that nursing has a challenge ahead: to educate consumers, legislators, and insurance companies that nurses in advanced practice are cost effective and provide quality care. The author describes her own legislative struggle with Blue Cross/Blue Shield. She urges nurses to attain the potential inherent in the clinical nurse specialist role by becoming actively involved in advocation for third-party reimbursement. PMID- 1766816 TI - [MRI of discoid lateral meniscus]. AB - We retrospectively reviewed the MR examinations of 10 patients (17 knees) with surgically documented discoid lateral meniscus of the knee joint. As MRI of the knee is being used more often, the criteria for diagnosis of this entity with MRI need to be established. We tried to define MRI criteria for the detection of discoid menisci by performing numerical measurements of MR images on a display screen. The transverse diameter of the midbody of a discoid lateral meniscus averaged 21.9 mm (normal control: 8.6 mm), and its proportion to the transverse width of the tibia averaged 29.4% (normal control: 12.0%). The measurable difference in height between the discoid and the medial meniscus was negligible. The number of sagittal sections on which the anterior and posterior horns connected varied from two to five in cases of discoid lateral meniscus, and from zero to two in normal controls. Among these parameters, the transverse diameter and its proportion of the transverse width of the tibia proved to be the most reliable. We concluded that a discoid meniscus is indicated if a transverse diameter of a lateral meniscus exceeds 15 mm (proportion to the tibia: 20%). PMID- 1766817 TI - [An animal experiment on arterial wall reaction to stents coated with gold, silver and copper]. AB - Expandable metallic stents coated with gold, silver, and copper, and bare stainless steel stents were implanted into the abdominal aorta of eight dogs to determine their effect on the vessel wall. The animals were observed for two weeks. Abdominal angiograms were taken every week. The dogs were then killed for macroscopic and histopathological examination. The results were as follows. (1) The stents coated with gold and the noncoated stainless steel stents showed less histopathologic change than the other stents. (2) The stents coated with copper were associated with severe erosion of the vessel wall and marked thrombus formation. PMID- 1766818 TI - [Three-dimensional MR imaging of the knee joint--diagnostic value for meniscal tears]. AB - The value of a three-dimensional (3D) imaging system was evaluated using a newly developed workstation. Fifteen knee joints with meniscal tears confirmed by arthroscopic examinations underwent 3D magnetic resonance (MR) imaging. These 3D data sets were processed into 3D display by multiplanar reformation (MPR) and the volume rendering technique, and the features of the meniscal tears were compared with those on conventional two-dimensional (2D) MR images. The 3D images with MPR provided higher detectability and more descriptive delineation of the meniscal tears than the 2D images. With its powerful image processing capacity, the workstation facilitated high-speed, high-quality 3D display and provided precise views of meniscal cleavages for the planning of surgical treatment. The independent processing system permitted efficient throughput of the MR data and eliminated wasteful filming processes. PMID- 1766819 TI - [Evaluation of pneumoconiosis by high-resolution CT]. AB - Forty-eight patients with pneumoconiosis (47 males and 1 female) were evaluated by high-resolution computed tomography (HRCT), which was compared with chest radiography and pulmonary function studies. 1) HRCT was superior to chest radiography in detecting small nodular shadows. There was a good correlation between HRCT and chest radiography in evaluating nodule quantity and size. 2) HRCT was superior to chest radiography in detecting emphysematous changes, and the difference was significant. HRCT and chest radiography were closely correlated in their evaluation of the grade of emphysema. 3) The grade of emphysema on HRCT was negatively correlated with the number of nodules. Subpleural curvilinear shadow (SCLS) on HRCT was correlated with the grade of emphysema, but not with the number of nodules. 4) The comparison with pulmonary function studies showed that emphysematous change on HRCT alone was correlated with %DLCO, while SCLS was correlated with FEV1.0%, RV/TLC and %DLCO. HRCT of the lung is useful for complementing chest radiography and pulmonary function studies in the evaluation of pneumoconiosis. PMID- 1766820 TI - [Changes in the cartilaginous contour of Legg-Calve-Perthes disease: calculation on T1-weighted MR images]. AB - T1-weighted MR images of Legg-Calve-Perthes disease (LCPD) were classified into three groups on the basis of radiographic stage, and morphological differentiation for staging was attempted. In the stage of fragmentation, both enlargement and flattening of the cartilaginous contour surrounding the epiphysis could be recognized on MRI, and the growth plate showed more curvature than normal. This produced flattening of the epiphysis in the shape of a crescent. We confirmed these findings using four indexes for the measurement of cartilaginous outline, and the stage of avascular necrosis and fragmentation could be clearly differentiated. Cartilaginous deformities on MRI are very useful for differentiating between the stage of avascular necrosis and fragmentation. PMID- 1766821 TI - [Clinical trial of color-hybrid images for assessment of Gd-DTPA contrast enhancement]. AB - Gd-DTPA (Gd) has been shown to provide effective contrast enhancement in MR imaging. However, it is sometimes impossible to evaluate Gd contrast enhancement (C.E.) in high intensity tissues like fat and bone marrow. To solve this problem, color-hybrid images (hybrid images) were generated by the use of an RGB mixing method. A total of 54 lesions, including 30 bone and soft tissue lesions and 24 gynecological lesions, were studied. In most cases, the hybrid images were superior to the original ones in terms of both morphologic and temporal evaluation of Gd C.E. The hybrid images helped to define the localization and extent C.E., by providing better visualization through the use of color display. PMID- 1766822 TI - [Noninvasive quantitative measurement of cerebral blood flow with 123I-IMP--a study concerning the input function]. AB - For the noninvasive quantitative measurement of cerebral blood flow (CBF) using N isopropyl-[123I]p-iodoamphetamine (IMP), we studied the usefulness of the lung clearance curve obtained by a single probe detector as the input function for brain as an alternative to arterial blood activity. In four patients, we compared the time-activity curve of the lung and serial arterial blood activity for approximately 20 minutes following an IV bolus injection of IMP. Significant positive correlations were observed between lung clearance and the integral of arterial blood activity of IMP. In addition, a study to identify the best region for monitoring lung activity with the probe detector was performed in six patients using a gamma camera and region of interest (ROI) management. The central region of the right lung was found to be the best position for monitoring lung radioactivity. This study suggests that the lung clearance curve of IMP can be used as the input function for brain in the quantitative assessment of CBF. PMID- 1766823 TI - [Evaluation of coronary artery calcification by ultrafast CT]. AB - A preliminary study was performed to determine whether ultrafast computed tomography (UFCT) is useful as a noninvasive screening examination for predicting coronary artery disease (CAD). UFCT was used to detect coronary artery calcification in 31 patients with angina pectoris (AP) without myocardial infarction. Except for six patients with vasospastic AP, 22 out of 25 patients had detectable calcification in at least one vessel. SVD, DVD and TVD were detected in six of nine patients (67%), seven of seven (100%) and nine of nine (100%), respectively. Based on the findings of coronary calcification by UFCT, the sensitivity, specificity and predictive accuracy of angiographically significant stenosis (greater than 75%) were 94%, 71% and 78% for all branches, respectively. The calcification score for vessels with significant stenotic lesion (n = 48) was statistically higher (p less than 0.01) than that for vessels without stenotic lesion (n = 45). In conclusion, UFCT appears to be useful noninvasive screening examination for detecting CAD, although a prospective study in a large number of patients will be necessary to establish the value of this new method more reliably. PMID- 1766824 TI - [Clinical evaluation of life size image of Fuji computed radiography for detection of diffuse interstitial lung diseases]. AB - To evaluate the diagnostic accuracy of Fuji Computed Radiography (FCR) in the detection of interstitial pulmonary infiltrates, FCR life-size images at a pixel size of 0.1 mm were compared with conventional radiographs taken on the same day. Seventeen radiologists assessed the radiographs and FCR images of 56 cases, including 39 cases of various interstitial lung diseases such as interstitial pneumonia, pulmonary abnormalities associated with collagen disease, sarcoidosis, multiple pulmonary metastases, diffuse panbronchiolitis and pulmonary emphysema, and 17 normal controls. All of the pulmonary abnormalities were confirmed by high resolution CT. Observer performance tests were carried out using receiver operating characteristic analysis. In 21 cases of increased pulmonary density revealed by high resolution CT, FCR was significantly superior to conventional radiographs in the detection of reticular or linear shadows. In 11 cases of subtle interstitial abnormalities, there was no difference between FCR and conventional radiographs in the detection of any pulmonary abnormality, ground glass opacities and reticular or linear shadows. There was also no difference between the two images in the detection of diffuse nodular shadow and pulmonary emphysema. These results indicate that FCR life-size images at a pixel size of 0.1 mm are useful for the detection of diffuse interstitial lung diseases. PMID- 1766825 TI - [Magnetic resonance imaging of aneurysmal subarachnoid hemorrhage]. AB - Magnetic resonance imaging of subarachnoid hemorrhage (SAH) due to aneurysm rupture was evaluated in relation to CT findings in nine patients. Six patients were studied within 3 days and the other three patients were studied 4 to 6 days from the ictus of SAH using a 0.5 Tesla superconducting unit. In all of the patients, hematoma in the subarachnoid space and ventricles was demonstrated by the proton density-weighted spin echo sequence, which showed that bloody cerebrospinal fluid (CSF) had a higher signal intensity than brain tissue or normal CSF. Magnetic resonance imaging was more sensitive in detecting SAH and more informative as to the site of the ruptured aneurysm than CT. Despite some limitations in applying it to patients with acute SAH, magnetic resonance imaging has clear advantages in the diagnosis of SAH. PMID- 1766826 TI - [Clinical experience of expandable metallic stent placement for malignant biliary obstruction]. AB - Expandable metallic stents of modified Gianturco design were used in nine cases of malignant biliary obstruction. Stents were placed through a percutaneous transhepatic approach without any severe complications. Initial patency was obtained seven of nine patients. Of these seven patients, recurrent jaundice was observed in three within four weeks. One patient had recurrent stenosis after four months due to ingrowth of the tumor. Although the expandable metallic stent offers several theoretical advantages over currently available stents, a disadvantage is that tumors may grow through the spaces between the legs of the wire or grow over the stent. We found that multi-modal treatment combined with radiation therapy was indispensable to maintain the patency of the stent in malignant biliary obstruction. PMID- 1766827 TI - [MR imaging of adrenal masses smaller than 5 cm. Characterization with T2 relaxation time at 1.5 T]. AB - The T2 relaxation times of 28 adrenal masses smaller than 5 cm obtained using a 1.5 Tesla MR imaging system were analysed to evaluate the ability of this parameter to characterize the tissue masses. The adrenal masses included 13 nonhyperfunctioning adenomas, five hyperfunctioning adenomas, five metastatic tumors, two pheochromocytomas, one nodular hyperplasia, one ganglioneuroma, and one cyst. The mean T2 value of nonhyperfunctioning adenomas was almost the same as that of hyperfunctioning adenomas. A significant difference was found in T2 (p less than 0.01) between nonhyperfunctioning adenoma (50 msec +/- 7 msec; mean +/- S.D.) and metastatic tumor (63 msec +/- 11 msec), whereas there was no significant difference in mass size between them. The two pheochromocytomas and the ganglioneuroma, which were derived from adrenal medulla, had relatively long T2 of over 70 msec. The T2 values of nodular hyperplasia and adrenal cyst were 58 msec and 123 msec, respectively. Although the T2 values of metastatic tumors tended to be longer than those of nonhyperfunctioning adenomas, differentiation between them with a T2 of 60 msec was not necessarily possible, especially in smaller masses. The T2 values of two metastatic tumors of less than 2 cm indicated 50 msec levels. There seemed to be a correlation between mass size and T2 in metastatic tumors. In adenomas, however, no significant correlation was demonstrated. We conclude that the characterization of small adrenal masses by T2 at 1.5 Tesla is unsatisfactory in differentiating metastatic tumors from nonhyperfunctioning adenomas. PMID- 1766828 TI - [Evaluation of renal function by dynamic CT]. AB - Dynamic CT scans of the kidney were conducted in 57 persons with varied renal function. The results of dynamic CT were used to obtain time-density curves for renal cortex, medulla and aorta. Various parameters were calculated from these time-density curves. Among them, CA ratio, the ratio of the area under the renal cortex curve to the area under the aortic curve, showed the best correlation with creatinine clearance. With these parameters, dynamic CT studies are believed to be useful in evaluating renal function. PMID- 1766829 TI - [Alteration ratio of lung field CT numbers of full inspiration to end expiration scans in chronic obstructive pulmonary diseases]. AB - The alteration ratio of lung field CT numbers in different respiratory phases was studied in 52 patients with chronic pulmonary obstructive disease (COPD) and 20 subjects with normal lung. The 52 patients with COPD consisted of 30 with clinically diagnosed chronic pulmonary emphysema (CPE), 15 with suspected CPE (sCPE) and seven with bronchial asthma (BA). The 20 subjects with normal lung were divided into two groups according to age. CT images were obtained in each case under different respiratory conditions, i.e., full inspiration and end expiration. The following parameters were employed for numerical evaluation: %(I E)Apex = (MLDApexI-MLDApexE/MLDApexE x 100 %(I-E)Mid = (MLDMidI-MLDMidE)/MLDMidE x 100 %(I-E)Base = (MLDBaseI-MLDBaseE)/MLDBaseE x 100 %(I-E)Whole = (MLDWholeI MLDWholeE)/MLDWholeE x 100 where MLD is mean lung density and the letters I and E stand for full inspiration and end expiration, respectively. The small letters Apex, Mid, Base and Whole stand for apex cut, mid-thorax cut, base cut and whole lung, respectively. The values of %(I-E)Whole were significantly different between disease groups except for those between the sCPE and BA groups. The values of %(I-E)Whole showed a good positive correlation with FEV1.0% (r = 0.79) and V25/H (r = 0.80) and a good negative correlation RV/TLC (r = -0.75). Diagnostic differentiation of COPDs by %(I-E)Whole values identified 80% of CPE cases and 91% of normal lung cases. In the sCPE group, the values of %DLco in patients with %(I-E)Whole above 9% were smaller than those in patients with %(I E)Whole under 9%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766830 TI - Clinical evaluation of a teleradiology system utilizing personal computers and public telephone line. AB - Practical usefulness of a teleradiology system using CCD camera, personal computer and telephone line was evaluated in a daily clinical practice. Image quality of this system is diagnostic for the majority of abnormalities on radiological images including plain radiographs. Radiological consultation between hospitals in the same city as well as between distant cities using this moderately priced system was thought to be useful in 90% of cases. Teleradiology using compact systems like ours is expected to be useful in the urban clinical environment as well as in distant areas. PMID- 1766831 TI - [Ultrasonic tissue characterization using pattern analysis of backscattered signal. The first report--outline of the system]. AB - Ultrasonic B-mode examination is widely used. However it is unsuitable for quantitative evaluation because of modification during the image processing procedure. The authors constructed amplitude images and mean frequency images using ultrasonic backscattered signals directly and judged the image patterns quantitatively by texture analysis. As the probabilistic distribution of amplitude is solved mathematically, we could evaluate amplitude images quantitatively, unlike B-mode images. We also used mean frequency images which display frequency information to compensate for B-mode image (also directly constructed amplitude images) constructed with only amplitude information. This work describes the outline of the system and results of some clinical applications. As application, the data were collected from testes of healthy young males and azoospermic patients. On B-mode images, no difference between these groups could be found. But there were differences on image appearance of amplitude and mean frequency images between them, and the difference was proved quantitatively using texture analysis. It is suggested that this system provides useful information about the differential diagnosis of diffuse disease of the organs showing so-called solid pattern. PMID- 1766832 TI - [Demonstration of the architecture of the tracheobronchial wall by MR imaging: an experimental study]. AB - To study the potential of MRI to demonstrate the architecture of the tracheobronchial wall, resected tracheobronchi of rabbits were examined with MRI. As a result, epithelium and cartilage were demonstrated as relatively low intensity bands on T1- and T2-weighted images (T1WI and T2WI). The subepithelium was of intermediate-high intensity on T1WI and of markedly high intensity on T2WI and Gd-DTPA enhanced T1WI. Peritracheobronchial fat was of markedly high intensity on T1WI and of relatively low intensity on T2WI. In conclusion, MRI was found to have the potential to demonstrate the architecture of the tracheobronchial wall as 4 layers on each sequence. PMID- 1766833 TI - [Fracture of percutaneously inserted IVC filters--two cases of Gunther's filter]. AB - During the period from 1988 to 1990, percutaneous insertion of Gunther vena caval filters were performed in ten patients in our institution. In two of them, fracture and partial migration of anchoring limbs were observed. Gunthter's filter is an attractive device for interventional radiologist because of its technical ease of percutaneous placement and relative stability within the vein. However, our experience suggests that this device is not entirely safe and reliable. The patients should be carefully followed up with a possibility of distal migration in mind. Further structural improvement seems necessary. PMID- 1766835 TI - [Somatic gene transfer and gene therapy in hematology]. PMID- 1766834 TI - Abnormalities of antigen receptor gene rearrangements in human B-lineage acute lymphoblastic leukemias. AB - In this short review, we analyse some recent data describing T-cell receptor gene rearrangement abnormalities occurring specifically in B-lineage ALLs. Numerous studies have shown that the lineage specificity of TCR gene rearrangements is lacking in malignant pre-B cells. The resulting inappropriate TCR gene recombinations use the recombinase machinery common to normal B and T cells and, with the exception of the TCRb locus, are similar to gene rearrangements associated with early stages of T-cell ontogeny. In most cases, these rearrangements are not efficiently transcribed. There is no clear selection for in-frame recombinations. As these rearrangements are clonal and found in all tumor cells, it may be hypothesized that they may reflect some cellular dysfunctions contemporary of the initiation of transformation before the step of clonal expansion. We favor the hypothesis that inappropriate rearrangements are due to a defective control of germline TCR gene segment transcription. This defect may reflect a more severe transcriptional dysregulation potentially involved in some alterations of cell phenotype and more generally in ALL oncogenesis. PMID- 1766836 TI - Anti-phospholipid auto-antibodies and thrombosis. PMID- 1766837 TI - Antiphospholipid antibodies: laboratory identification and clinical significance. PMID- 1766838 TI - Importance of a specialized registry of haematopoietic malignancies. PMID- 1766839 TI - Biochemistry and function of glycosyl phosphatidylinositols anchoring membrane proteins. PMID- 1766840 TI - [Molecular and genetic analysis of antigenic Rh structures]. PMID- 1766841 TI - [Physiology and pathology of erythrocytic band 3 protein]. PMID- 1766842 TI - Genetic diagnosis of qualitative and quantitative antithrombin III deficiencies. PMID- 1766843 TI - [Mastery of the automated laboratory]. PMID- 1766844 TI - The Leiden Thrombosis Centre. Organization, computer-assisted dosage control and therapeutic quality control. PMID- 1766845 TI - [Myelodysplastic syndromes]. PMID- 1766846 TI - [Cytogenetics and myelodysplastic syndromes (MDS)]. PMID- 1766847 TI - Growth and differentiation factors in megakaryocytopoiesis. PMID- 1766848 TI - [The superfamily of hematopoietin receptors]. PMID- 1766849 TI - Tools for detection of minimal residual disease in acute leukemia. PMID- 1766850 TI - All trans retinoic acid in acute promyelocytic leukemia. PMID- 1766851 TI - [Current trends in hemoglobin genetic diseases]. AB - The current aspects of genetic diseases of hemoglobin are as follows. (1) The localisation and the dimension of at-risk populations for sickle cell disease and thalassemia in metropolitan France are not exactly known. However, some recent epidemiological studies and preliminary results of studies being currently underway allow to delimitate the problem. The at-risk populations are localized in the parisian area, in Provence-Cote d'Azur, in the Lyon and Grenoble areas, in Lorraine, Alsace and the Northern part of France. The number of heterozygotes for these diseases is situated between 250,000 and 350,000. The number of homozygotes born each year is between 100 and 150. More than 250 homozygous thalassemia patients and probably 2,000 to 3,000 sickle cell patients are living at this time in metropolitan France. (2) The transgenic mouse model is an experimental tool which allowed important advances in the knowledge of the hemoglobin human genome. Thus, we now have lines of mice expressing human fetal (g genes) and human adult (b genes) hemoglobins. Recently, enhancer sequences have been identified in 5' to the embryonic gene epsilon. When this region, named locus-region-control (LCR), is inserted along with g and b globin genes, their expression is observed at a very high level. The main objective of this technique is to obtain mouse model for sickle cell disease and thalassemia for studies on the pathophysiology and the therapy of these diseases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766852 TI - Molecular biology of chronic myelogenous leukemia. PMID- 1766853 TI - [Treatment of chronic myeloid leukemia with alpha interferons]. PMID- 1766854 TI - Intermediary analysis of a French protocol of treatment of polycythemias (1980 1990): 253 patients. The French Group for the Study of Polycythemias. PMID- 1766855 TI - Obstruction of the portal or hepatic veins and primary myeloproliferative disorders. PMID- 1766856 TI - Haemostatic and proteolytic markers in acute non lymphoid leukemia: a source of multiple informations. PMID- 1766857 TI - The genetic disorders of the red cell skeleton. AB - The genetic disorders of the red cell skeleton encompass hereditary spherocytosis, hereditary elliptocytosis and an array of ill-defined haemolytic anaemias. Protein chemistry and molecular genetics have illuminated the supramolecular arrangement of the skeleton, the sequence and three-dimensional structure of its protein components, the exon-intron organization of the corresponding genes, the complex splicing undergone by their transcripts. Basically, hereditary spherocytosis is often due to a defect of ankyrin, hereditary elliptocytosis usually results from alterations of spectrin or protein 4.1. Other conditions are related to changes in the anion transporter or protein 4.2. The heterogeneity of the genomic changes, their ultimate consequences at the protein level open windows on fundamental problems concerning alternative splicing of mRNAs and structure-function relationships in proteins. PMID- 1766858 TI - [Molecular basis of thrombosis]. AB - Tremendous progress have been performed during the last 25 years in thrombosis. Thrombotic disease can result either from increased deposition or decreased dissolution of fibrin. Since the first observation of a familial antithrombin III deficiency, numerous inherited defects of antithrombotin III, protein C, protein S, heparin cofactor II and plasminogen have been described and were assumed to be responsible of a thrombophilic state. However a disparity in the clinical expression of heterozygous deficiency in coagulation inhibitors or molecular abnormalities of coagulation does exist. On one hand, the prevalence of such molecular diseases is not yet perfectly known and on the other hand, contributory factors (acquired environmental insults or other genetic abnormalities) could play a role in individuals already predisposed to thrombosis. The molecular genetics of deficiencies is going to help us to establish specific gene lesions and thromboembolic history relationships. The analysis of structural or regulatory mutations in the genes of the different coagulation inhibitors, of the molecules of the fibrinolytic system, and of the fibrinogen molecule will greatly increase our knowledge of the molecular basis of thrombosis. The influence of the genetic polymorphism of these molecules on the risk of thrombosis should be studied. Finally, cellular aspects of thrombosis including the role of blood cells and endothelial cells will bring lot of informations on the comprehension of thrombotic diseases. PMID- 1766859 TI - [Update of strategies for the use of automation in hematology]. PMID- 1766860 TI - Hemophilia in 1991. PMID- 1766861 TI - Molecular cytogenetics of acute lymphoblastic leukemia. AB - From a fundamental research point of view, malignancies may be viewed as opportunities that deregulate cell growth and differentiation, thus providing the possibility to find new genes and understand how these genes act. Acute lymphoblastic leukemia (ALL) is one of the best examples of malignant proliferation that has benefited by considerable advances of molecular cytogenetics for the ten past years. Three types of chromosome abnormalities may be considered in ALL. Clonal anomalies may be more or less specific for a cellular type of leukemia, such as the t(8;14)(q24;q32) and t(9;22)(q34;q11) translocations related with Burkitt type of leukemia and Philadelphia-positive ALL (Ph1+ ALL) respectively, and for this reason are often designated as recurrent abnormalities. They are mainly structural chromosomal abnormalities, often translocations. A second type of clonal abnormalities consists of nonrandom alterations which are not apparently related with the differentiation type. They are the solely detected chromosomal changes (trisomy for instance) or may be associated with other anomalies and have been often considered as "secondary" abnormalities. Finally, nonclonal cytogenetic anomalies are the third type of anomalies. They may be present even prior any treatment and characterize a minority of ALL. This aspect of chromosomal instability of unknown mechanism will not be discussed here. PMID- 1766862 TI - Transcription regulators altered in hematologic malignancy. AB - Many hematologic malignancies are associated with recurrent cytogenetic abnormalities. Often these rearrangements result in gene fusion, leading to altered gene expression and/or activity. As the gene affected by these rearrangements are characterized at the molecular level, one particular group, the DNA binding transcriptional regulatory genes, are becoming more prominent. In this communication, we review how these genetic rearrangements effect the structure and expression of transcriptional regulatory proteins, and discuss how these abnormalities may be used quantitative diagnostic markers to analyze disease activity. PMID- 1766863 TI - From genes to antibodies: the antipeptide approach to the immunocytochemical study of human malignant lymphoproliferative diseases. PMID- 1766864 TI - Paul Berg, on his 65th birthday. PMID- 1766865 TI - A special issue honouring Dr Paul Berg on the occasion of his sixty-fifth birthday. PMID- 1766866 TI - The ste4+ gene, essential for sexual differentiation of Schizosaccharomyces pombe, encodes a protein with a leucine zipper motif. AB - Ste4- mutants of Schizosaccharomyces pombe are unable to undergo both mating and meiosis. We have cloned the ste4+ gene and its cDNA. The gene encodes a 264 amino acid protein with a typical leucine zipper motif homologous with the jun family. However, unlike the jun family, this protein does not have a typical basic region that precedes the leucine zipper. The transcription of this gene absolutely depends on the ste11+ gene and increases several fold upon nitrogen starvation, a general signal for sexual differentiation. Whereas ste4+ is essential for mating and meiosis, its overexpression inhibits these processes. PMID- 1766867 TI - Molecular analysis of 11 galactosemia patients. AB - Galactosemia is a human inborn error of galactose metabolism due to deficiency of galactose-1-phosphate uridyl transferase. In this paper, I describe the molecular analysis of genomic DNA, mRNA and protein from 11 different galactosemic patients by Southern, Northern and Western blotting. The results of these experiments lead me to conclude that galactosemia is caused mostly by missense mutations. The unusual preponderance of missense mutations in galactosemia led me to investigate its cause. I demonstrate that all 9 patients I investigated have detectable residual enzyme activity (ranging from 0.7-6.9% of normal). This finding is of potential importance in addressing the long-term complications of galactosemia. PMID- 1766868 TI - The anaerobic responsive element contains two GC-rich sequences essential for binding a nuclear protein and hypoxic activation of the maize Adh1 promoter. AB - We have identified a protein (GCBP-1) in nuclear extracts from maize suspension cell cultures that binds to specific sequences within the Anaerobic Responsive Element (ARE) of the maize Adh1 promoter. Competition analyses show that the GCBP 1 binding activity distinguishes ARE sequence motifs from other enhancer elements or pUC19 sequences. The binding activities of several mutant ARE sequences define two regions of the ARE important for GCBP-1 binding in vitro, between nucleotides -135 to -131 and nucleotides -120 to -112 of the maize Adh1 promoter. Both regions are required for efficient GCBP-1 binding to occur in vitro. The minimum consensus binding site for GCBP-1 is 5'-GC(G/C)CC-3'. This sequence is similar to a part of the binding site of the human transcription factor Sp1 (1). We demonstrate that maize GCBP-1 and human Sp1 have similar recognition properties. Using ARE mutants in a transient assay in maize protoplasts we have shown that mutation of the GCBP-1 binding sites prevents significant hypoxic activation of the maize Adh1 promoter. These results suggest a direct role for GCBP-1 in the hypoxic activation of Adh1 gene expression. GCBP-1 is present in both uninduced and induced nuclei, indicating that inducible gene expression is not dependent upon synthesis of GCBP-1 and suggesting that post-translational modification of bound GCBP-1 may be important for enhanced transcription to occur. PMID- 1766869 TI - A paradigm for local conformational control of function in the ribosome: binding of ribosomal protein S19 to Escherichia coli 16S rRNA in the presence of S7 is required for methylation of m2G966 and blocks methylation of m5C967 by their respective methyltransferases. AB - We have partially purified two 16S rRNA-specific methyltransferases, one of which forms m2G966 (m2G MT), while the other one makes m5C967 (m5C MT). The m2G MT uses unmethylated 30S subunits as a substrate, but not free unmethylated 16S rRNA, while the m5C MT functions reciprocally, using free rRNA but not 30S subunits (Negre, D., Weitzmann, C. and Ofengand, J. (1990) UCLA Symposium: Nucleic Acid Methylation (Alan Liss, New York), pp. 1-17). We have now determined the basis for this unusual inverse specificity at adjacent nucleotides. Binding of ribosomal proteins S7, S9, and S19 to unmodified 16S rRNA individually and in all possible combinations showed that S7 plus S19 were sufficient to block methylation by the m5C MT, while simultaneously inducing methylation by the m2G MT. A purified complex containing stoichiometric amounts of proteins S7, S9, and S19 bound to 16S rRNA was isolated and shown to possess the same methylation properties as 30S subunits, that is, the ability to be methylated by the m2G MT but not by the m5C MT. Since binding of S19 requires prior binding of S7, which had no effect on methylation when bound alone, we attribute the switch in methylase specificity solely to the presence of RNA-bound S19. Single-omission reconstitution of 30S subunits deficient in S19 resulted in particles that could not be efficiently methylated by either enzyme. Thus while binding of S19 is both necessary and sufficient to convert 16S rRNA into a substrate of the m2G MT, binding of either S19 alone or some other protein or combination of proteins to the 16S rRNA can abolish activity of the m5C MT. Binding of S19 to 16S rRNA is known to cause local conformational changes in the 960-975 stem-loop structure surrounding the two methylated nucleotides (Powers, T., Changchien, L.-M., Craven, G. and Noller, H.F. (1988) J. Mol. Biol. 200, 309-319). Our results show that the two ribosomal RNA MTs studied in this work are exquisitely sensitive to this small but nevertheless functionally important structural change. PMID- 1766870 TI - Subtractive cDNA cloning using oligo(dT)30-latex and PCR: isolation of cDNA clones specific to undifferentiated human embryonal carcinoma cells. AB - The human embryonal carcinoma cell line NEC14 can be induced to differentiate by the addition of 10(-2)M N,N'-hexamethylene-bis-acetamide (HMBA). A subtractive cDNA library specific to undifferentiated NEC14 cells was constructed using oligo(dT)30-Latex and polymerase chain reaction (PCR). The method was designed to improve the efficiency of subtraction and the enrichment of cDNA clones corresponding to low abundance mRNAs. The single strand of cDNA was made from mRNA prepared from the HMBA-treated NEC14 cells using an oligo(dT)30 primer covalently linked to Latex particles. After removal of the mRNA template by heat denaturation and centrifugation, the subtractive hybridization was carried out between the cDNA-oligo(dT)30-Latex and mRNA from untreated NEC14 cells. Unhybridized mRNA collected by centrifugation was hybridized repeatedly to the cDNA-oligo(dT)30-Latex and subtractive mRNA was converted to cDNA. The subtractive cDNA was then amplified by PCR and cloned into pBluescript II KS-. The cDNA library thus constructed consisted of approximately 10,000 independent clones with cDNA inserts of 1.7 Kb on average. Differential hybridization of these transformants indicated that approximately 3% of them contained cDNA inserts specific to the undifferentiated EC cells, some of which were derived from low abundance mRNAs. PMID- 1766871 TI - A highly efficient directional cDNA cloning method utilizing an asymmetrically tailed linker-primer plasmid. AB - A new procedure using an asymmetrically tailed linker-primer plasmid has been developed to prepare extremely high complexity cDNA libraries. This procedure yields plasmid primed libraries with a final form equivalent to those made by the procedure of Okayama and Berg. However, the number of steps involved in library preparation is decreased. The form of the vector is such that one end of the linearized linker-primer plasmid has a 3' terminal extension of 40 deoxythymidylate residues (the dT end). The other end has a 3' terminal extension of 10 deoxycytidylate residues (the dC end). The dC end of the plasmid is blocked to further 3' extension by a 3' phosphate group. This configuration enables one to prime first strand cDNA synthesis at the dT end, tail the 3' end of the cDNA with deoxyguanylate residues without tailing the dC end (due to the 3' phosphate block). The plasmid primed cDNA can then be self-annealed and the 3' phosphate blocking group removed during the synthesis of double stranded cDNA. The efficiency of this procedure is significantly higher than other methods (including phage based libraries): linker-primer libraries have 15 to 900-fold higher complexity than libraries prepared by other methods. A cloning efficiency of 9 x 10(8) colonies per microgram of linker-primer DNA was achieved. This method should be useful for the cloning of cDNAs corresponding to extremely rare mRNAs. PMID- 1766872 TI - Isolation and characterization of a species-specific DNA probe for Candida albicans. AB - As a model for the isolation of species-specific sequences of DNA, we isolated and characterized a species-specific DNA fragment from the Candida albicans genome. We used a series of differential colony hybridization experiments, in which a C. albicans genomic library was hybridized with genomic DNA probes from related organisms to minimize the number of potentially specific C. albicans DNA fragments to be tested. Six clones were tested by dot blot analysis, and one of them, a 1348 bp EcoRI DNA fragment, was confirmed as specific for C. albicans. This species-specific fragment could be utilized as a DNA probe for rapid, sensitive, and specific diagnosis of C. albicans DNA in clinical specimens. PMID- 1766873 TI - Mapping of the human casein kinase II catalytic subunit genes: two loci carrying the homologous sequences for the alpha subunit. AB - The human serine/threonine protein casein kinase II (CK II) contains two distinct catalytic subunits, alpha and alpha 1, which are encoded by different genes. A combination of segregation analysis of rodent-human hybrid cells and chromosomal in situ hybridization have localized the human CK II-alpha DNA sequence to two loci: 11p15.5-p15.4 and 20p13. In contrast, the CK II-alpha' gene has been mapped to chromosome 16 by somatic cell hybrid analysis. Taken together with our previous assignment of the CK II regulatory beta-subunit gene to 6p12-p21, these results indicate that although the products of these genes form a single biological complex, they are encoded on different human chromosomes. Further analysis should determine whether both loci of CK II-alpha are functional, or perhaps one of the two constitutes a pseudogene. PMID- 1766874 TI - Parallel-stranded DNA under topological stress: rearrangement of (dA)15.(dT)15 to a d(A.A.T)n triplex. AB - DNA oligonucleotides with appropriate sequences can form a stable duplex in which the two strands are paired in a parallel orientation instead of as the conventional antiparallel double helix of B-DNA. In parallel-stranded DNA (ps DNA) base pairing is noncanonical with the glycosidic bonds in a trans orientation. The two grooves are equivalent. We have synthesized DNA duplexes consisting of a central parallel-stranded (dA)15.(dT)15 tract flanked by normal antiparallel regions, and ligated them into the pUC18 plasmid. The effect of negative supercoiling on the covalently closed circular molecules was studied by two-dimensional agarose gel electrophoresis and by chemical modification with OsO4-pyridine (Os,py) and diethylpyrocarbonate (DEPC). The following results were obtained: (i) The ps insert, and by inference ps-DNA in general, adopts a right handed helical form. (ii) Upon increasing the negative superhelix density ( sigma) to greater than 0.03 the 15 bp ps insert undergoes a major transition leading to a relaxation corresponding to a reduction in twist of approximately 2.5 helical turns. The transition free surgery is approximately kcal/mol. (iii) The chemical modification pattern of the resulting structure suggests that the purine strand folds back and associates with the pyrimidine strand, forming a novel intramolecular triplex structure consisting of d(A.A.T) base triplets. A model for the triplex conformation is proposed and its thermodynamic properties are analyzed by statistical mechanics. PMID- 1766875 TI - A polymerase chain reaction mediated by a single primer: cloning of genomic sequences adjacent to a serotonin receptor protein coding region. AB - Under appropriate conditions, specific double-stranded DNA product was generated after amplification of genomic DNA sequences in a polymerase chain-like reaction that contained only a single primer. This type of amplification reaction was performed with a variety of primers and substrate DNAs. In addition to nonspecific heterogeneous products, 5 of 11 primers reproducibly directed synthesis of double-stranded DNA that corresponded to the region of the template that contained the authentic primer annealing site. Three of these amplified products were cloned and their ends were sequenced. All three contained a copy of the primer at both 5' ends, and the position of one of the primers represented the authentic primer binding site. In each case, the location of the second copy of the primer indicated that it had initially hybridized to a partially homologous sequence in the template DNA. This single primer reaction makes it possible to amplify and clone a DNA region of unknown sequence that is adjacent to a known DNA sequence. One of the single primer reaction products described here included sequence to the 5' side of the coding region of a serotonin receptor gene that contained a functional promoter. PMID- 1766876 TI - Detection of gene targeting by co-conversion of a single nucleotide change during replacement recombination at the immunoglobulin mu heavy chain locus. AB - A method is described for detecting targeted events at the mu heavy chain gene which relies on co-conversion (or co-exchange) of a point mutation with a selectable marker contained on a replacement vector. The vector, designed for application to IgM producing hybridomas, contains a single nucleotide change within the region of homology with the target gene which encodes a different allotypic determinant of IgM. In a model system where homologous recombination corrected a defective mu gene, the length of homology between this nucleotide change and the position of the double strand break in the vector was found to have a critical influence on the co-conversion frequency. In the vector design ultimately used for targeting in hybridomas, one in 1000-2000 stable transformants produced IgM with the allotype encoded by the exogenous DNA, and Southern blot analysis confirmed that these were derived by targeted integration. The sensitivity of the screening procedure using a monoclonal antibody specific to this allotype enabled a targeted clone to be detected in a pool of stable transformants when present at a frequency at least as low as one per cent. Several different modifications of the target locus were obtained as a consequence of alternative crossover positions and, in some cases, vector DNA concatenation. PMID- 1766878 TI - The RhsD-E subfamily of Escherichia coli K-12. AB - The Escherichia coli K-12 chromosome contains a family of five large, unlinked sequences known as the Rhs elements. They share several complex homologies, the most prominent being a 3.7 kb Rhs core. The elements are divided into two subfamilies, RhsA-B-C and RhsD-E, according to the sequence similarities of the cores. The RhsD core is 3747 bp long compared to 3714 bp for RhsA. Despite a 22% sequence divergence, the RhsD core conserves features previously noted for RhsA. Similar to RhsA, the RhsD core maintains a single ORF, the start codon coinciding with the first nucleotide of the homology. The RhsD core-ORF continues 177 codons beyond the homology, resulting in a carboxy terminal extension unrelated to that of RhsA. The RhsD core retains all 28 copies of the repeated motif GxxxRYxYDxxGRL(I/T) seen in RhsA. The other member of the RhsD-E subfamily, RhsE, has been mapped to minute 32 of the E. coli map. It appears defective in that it contains only the last 1550 bp of the 3.7 kb core. Its sequence is more closely related to that of RhsD than RhsA. In addition, RhsE and RhsB share a 1.3 kb homology, known as the H-repeat. The H-repeats from RhsE and RhsB are more closely related than their cores, showing only 1% nucleotide divergence. PMID- 1766877 TI - Mouse embryonic stem cells exhibit high levels of extrachromosomal homologous recombination in a chloramphenicol acetyltransferase assay system. AB - Mouse embryonic stem (ES) cells were compared to COS1 and CV1 cells for their ability to perform extrachromosomal homologous recombination. RSVCAT plasmid substrates consisting of overlapping chloramphenicol acetyltransferase (CAT) gene fragments were transiently transfected into cells and extracts were assayed for CAT activity. Approximately 10% activity, relative to transfection with a complete CAT gene, was recovered for the recombination substrates in each of the cell lines tested. ES cells, therefore, as other cell lines, are capable of high levels of extrachromosomal recombination. PMID- 1766879 TI - The plasmacytoma J558L lacks constitutively active NF-kappa B and is deficient in early response gene activation. AB - In mature B cells the nuclear factor NF-kappa B which binds within the kappa enhancer is constitutively present in the nucleus. However, the lambda light chain producing myeloma J558L has been found to lack constitutively functional NF kappa B. Deoxycholate released functional NF-kappa B from cytoplasmic extracts and functional NF-kappa B was present in J558L following cycloheximide but not phorbol ester treatment. J558L was also unable to respond to phorbol ester stimulation with synthesis of mRNA from the early response gene TIS11. J558L differs from S107, another myeloma which was found to be deficient in the synthesis of NF-kappa B but not in the activation of TIS11. Somatic cell hybrids were used to further define the defect in J558L; hybrids were made with the myelomas S107 and S194 and the pre-B cell line 70Z/3. In general, complementation of the defect in J558L was observed; however there was not a direct correlation between the levels of TIS11 mRNA and NF-kappa B expression in the somatic cell hybrids, suggesting that the pathways of activation of these genes, while possibly sharing common elements, are not identical. The defect in J558L was surprising given that it has frequently been used for the expression of transfected light chain genes. PMID- 1766880 TI - Recognition of the CDEI motif GTCACATG by mouse nuclear proteins and interference with the early development of the mouse embryo. AB - We have reported previously (1) two unexpected consequences of the microinjection into fertilized mouse eggs of a recombinant plasmid designated p12B1, carrying a 343 bp insert of non-repetitive mouse DNA. Injected at very low concentrations, this plasmid could be established as an extrachromosomal genetic element. When injected in greater concentration, an early arrest of embryonic development resulted. In the present work, we have studied this toxic effect in more detail by microinjecting short synthetic oligonucleotides with sequences from the mouse insert. Lethality was associated with the nucleotide sequence GTCACATG, identical with the CDEl element of yeast centromeres. Development of injected embryos was arrested between the one-cell and the early morula stages, with abnormal structures and DNA contents. Electrophoretic mobility shift and DNAse foot printing assays demonstrated the binding of mouse nuclear protein(s) to the CDEl like box. Base changes within the CDEl sequence prevented both the toxic effects in embryos and the formation of protein complex in vitro, suggesting that protein binding at such sites in chromosomal DNA plays an important role in early development. PMID- 1766881 TI - Routines for endoscopes. PMID- 1766882 TI - Working out a philosophy to meet relatives' needs. PMID- 1766883 TI - State secrets. PMID- 1766884 TI - Hitting rock bottom. PMID- 1766885 TI - Nursepower. PMID- 1766886 TI - Safe motherhood. PMID- 1766887 TI - Take your partners. PMID- 1766888 TI - Case management. Responding to need. PMID- 1766889 TI - Case management. The right approach for Roy. PMID- 1766890 TI - Reducing infant trauma. PMID- 1766892 TI - Artistic endeavours. PMID- 1766891 TI - Reassuring Miss Davies. Care study. PMID- 1766893 TI - Paint and perseverance. PMID- 1766894 TI - Sexuality in later life. PMID- 1766895 TI - The needs of patients' relatives. PMID- 1766896 TI - Training opportunities for informal carers. PMID- 1766897 TI - Comparing endotracheal suction regimes. PMID- 1766899 TI - Onus on workers to get help for HIV. PMID- 1766898 TI - Systems of life. Bone and bones. 1. PMID- 1766900 TI - Infection control. Building barriers against infection. PMID- 1766901 TI - Infection control. Fruitful liaison. PMID- 1766902 TI - Infection control. A student's eye view. PMID- 1766903 TI - Infection control. Road to success. PMID- 1766904 TI - Effects of a school nurse prenatal counseling program. AB - To determine the effects of a school-based, nurse-run prenatal counseling program, records of prenatal care visits of students and their infants' birth weights (i.e., cases) were obtained from the state live birth certificate tape for 1985-1987. From the same tape, a mother residing in the same community but not enrolled in the program was matched with each case on eight criteria to serve as a control. A total of 288 matched case-control pairs were obtained. Using McNemar's test, a significantly higher percentage of the cases received adequate prenatal care than did the controls. PMID- 1766906 TI - Restructuring the role of school nurse in health promotion. AB - For more than two decades an enduring relationship between years of formal schooling and improved health status has been emerging as noteworthy. School nurses are currently in place to focus more attention on refining how this relationship can be maximized in clinical practice. A brief review of the theoretical framework, modeling and role-modeling, is presented, including application to a case study depicting how the school nurse used theory-driven nursing process for health promotion. PMID- 1766905 TI - Maladaptive mother-child relationships: a pilot study. AB - The primary purposes of this pilot study were to identify maternal psychosocial correlates of unrealistic expectations of children and of child abuse potential, and to investigate the relationships of these factors with child behavior. A cross-sectional, two-group design was used. One group consisted of 20 low-income mothers whose preschool children were referred to a family care center for suspected abuse or neglect. A comparison group was made up to 20 low-income mothers whose children attended a university-based pediatric clinic and who were not referred for abuse or neglect. Data were collected during structured in-home interviews with the mothers. Measures of parental bonding, maternal depressive symptoms, unrealistic expectations of children, child abuse potential, and child behavior were obtained. Preschool teachers of the children also rated the children's behavior. Mothers with high depressive symptoms reported more unrealistic expectations of children and had greater child abuse potential scores than those with fewer symptoms. The more child behavior problems mothers reported, the greater their unrealistic expectations of the children and the higher their score for child abuse potential. Maternal depressive symptoms were not directly related to child behavior. Teacher reports of child behavior were moderately correlated with maternal reports, but no study variable was associated with teacher reports. PMID- 1766907 TI - Determinants of home care nursing hours for technology-assisted children. AB - In the 1980s home care, in contrast to hospital care, was reported substantially to reduce costs for third-party payers who provided funding for technology assisted children. Savings were realized primarily because parents substituted for nurses, eliminating or reducing those costs. Third-party payers' savings thus were directly related to the number of hours parents assumed care. Because home care relies on parents doing some of the work of nurses, decisions regarding nursing hours must consider family factors in addition to medical factors. We evaluated the number of nursing hours 31 Minnesota families with technology assisted children received, as well as the factors that determined the allotment of nursing hours. Most families (96.8%) received some hours of nursing hours. Most families (96.8%) received some hours of professional nursing care per day, and 16.1% received 24-hour care. Multiple regression, however, showed that family factors, rather than the child's medical condition, influenced the number of hours, with married, lower-income families with a younger child receiving the fewest. Further discussion and study are recommended to understand more fully the impact family factors have on the allotment of nursing hours and home care costs. PMID- 1766909 TI - Analysis of a home health agency's productivity system. AB - Productivity is an important issue in home care. Employee perceptions of an equitable system are crucial and have been linked to job satisfaction, motivation, and production. Ten staff nurses, and all supervisors and program directors were interviewed to elicit perceptions of the productivity system. Staff nurses' time sheets for seven months were evaluated retrospectively for visit length, number of visits per day, payer source, mileage per day, and travel time per day. Mean time in minutes spent in the patient's home on intravenous visits (n = 58 visits) was approximately twice as long as that of home care visit (n = 11,573 visits). Mean length of hospice visits (n = 368 visits) was 25 to 29 minutes longer than that of mean home care visits. The proportion of Medicare reimbursement was negatively correlated with productivity bonus point achievement (when two high and two low bonus point outliers were removed). Recommended changes were based on both qualitative analysis of employee perceptions of the productivity system and quantitative analysis of time sheets. PMID- 1766908 TI - Assessing for abuse: self-report versus nurse interview. AB - Estimates are that 1.8 million women are physically abused each year by their husbands. To prevent abuse and promote physical safety, routine assessment is essential. Planned Parenthood of Houston and Southeast Texas added four self reported abuse assessment questions to their standard intake form completed by all initial and annual-visit clients. After one month of self-report by 477 women, the prevalence of physical abuse was 7.3%. To compare self-report to nurse interview assessment, the same four questions were asked of 300 women coming to the same clinic for initial or annual visits. The reported prevalence of abuse after a nurse interview was 29.3%. PMID- 1766910 TI - Rationale and design for health promotion with older adults. AB - The paper underscores the relevance of preventive and well health practices for older adults, given the current potential for extended life spans. One model for health promotion interventions consists of self-care skills, emotional and spiritual integration, and social integration. It was based on research in which older adults identified dimensions of everyday well-being. PMID- 1766911 TI - County nursing service assessment tool: an overview. PMID- 1766912 TI - Screening for psychosocial distress: implications for prevention and health promotion. AB - The importance of identifying the mental as well as physical health needs of individuals served in primary care settings has been documented in the United States, Great Britain, and developing countries. This study compared the prevalence of psychosocial distress across four demographically diverse ambulatory care clinics, and described the relationship among selected demographic characteristics (age, gender, marital status, race, education, and income) and psychosocial distress in order to develop a profile of high-risk clinics and patients. The sample was drawn from consecutive clinic attendees in two geographic regions of the United States. Psychosocial distress was measured with the Goldberg 28-item general health questionnaire (GHQ). As a group, 64% of the subjects had GHQ scores of less than 5, indicating they were not at risk; 26.5% were moderately distressed and 9.5% were highly distressed. The distressed tended to be chronically physically ill patients who attended two clinics. Multivariate nominal scale analysis (NMA) indicated that the sociodemographic variables accounted for 11% of the variance in GHQ scores. Younger (less than 60 yrs), white, low-socioeconomic subjects had a higher probability of falling into the high-risk category. Contrary to previous research findings, gender was not associated with distress. PMID- 1766913 TI - Prevalence of hypertension risk factors among Hispanic Americans. AB - A program of blood pressure screening, education, and follow-up was established to meet concerns that Hispanics were at risk for hypertension and related health problems, including access to health care and information. The program provided opportunities to gather data on hypertension risk factors and general health status of the Hispanic population. Bilingual community workers provided blood pressure screening through a door-to-door survey of 3399 adults. In addition, the workers provided general and preventive hypertension education, obtained health histories, and referred identified health problems. All 203 persons identified with hypertension were assessed further and followed by public health nurses. Of these, 67 were referred to physicians for care. Referrals for other types of health problems were made for 1603 persons. Significant risk factors identified for hypertension were excessive alcohol intake, obesity, and frequent use of processed foods. A total of 871 persons reported at least one symptom of stress. PMID- 1766914 TI - 2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD) and related compounds as antioestrogens: characterization and mechanism of action. AB - In the female Sprague-Dawley rat uterus 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and related compounds exhibited a broad spectrum of antioestrogenic responses. For example 2,3,7,8-TCDD inhibited the 17 beta-oestradiol-induced uterine wet weight increase, peroxidase activity, oestrogen and progesterone receptor levels, epidermal growth factor (EGF) receptor binding, and EGF receptor and c-fos protooncogene mRNA levels. The aryl hydrocarbon (Ah) receptor was identified in the rat uterus and the antioestrogenic activities of TCDD and related compounds were structure-dependent. In parallel studies, the effects of TCDD as an antioestrogen in MCF-7 human breast cancer cells was also investigated. TCDD inhibited the 17 beta-oestradiol-induced proliferation of these cells and the secretion of the 34-, 52- and 160-kDa proteins. Treatment of MCF-7 cells with 1 nM [3H]-17 beta-oestradiol resulted in a rapid accumulation of nuclear oestrogen receptor (ER) complexes. Pretreatment of the cells with TCDD caused a rapid decrease in nuclear ER binding activity and immunoreactive protein; moreover, the structure-dependent potencies of TCDD and related compounds as antioestrogens were similar to their Ah receptor binding affinities. TCDD also caused a decrease in nuclear ER levels in wild-type Ah-responsive Hepa 1c1c7 cells but was inactive in Ah non-responsive mutant Hepa 1c1c7 cells. Moreover, in the wild-type cells, both actinomycin D and cycloheximide blocked the effects of TCDD. 6-Methyl-1,3,8-trichlorodibenzofuran (MCDF) has previously been characterized as a TCDD antagonist in rodents and in transformed rodent cell lines. However, like TCDD, MCDF also exhibited a broad spectrum of antioestrogenic activities in both the female Sprague-Dawley rat uterus and MCF-7 cells. MCDF is relatively non-toxic compared to TCDD and is being investigated as a compound which may be clinically useful for the treatment of mammary cancer. PMID- 1766915 TI - The use of 2,4,5,2',4',5'-hexachlorobiphenyl (6-CB) as an unmetabolizable lipophilic model compound. AB - 2,4,5,2',4'5'-Hexachlorobiphenyl (6-CB)--a polychlorinated biphenyl (PCB) congener resistant to metabolism in most species--has become a major residue in the biosphere including human adipose tissue. Its use as a model of unmetabolizable lipophilic compounds and as a tool in toxicokinetics in the last two decades is reviewed. This extremely water-insoluble compound is transported in plasma by albumin and lipoproteins. Binding to these plasma proteins appears to be important for uptake and release processes in different tissues. The redistribution kinetics of 6-CB as well as its pronounced adipose tissue storage and a very slow excretion with the faeces has been established in long-term animal studies. Excretion is strongly influenced by an increasing or diminishing adipose storage compartment size. Other minor pathways of elimination, e.g., via hair, become also important in the absence of metabolism and renal excretion. 6 CB has revealed the possibility of an almost quantitative transfer of the maternal body burden to the offspring via milk. The use of 6-CB in studies with tissue preparations in vitro is providing insight into transport mechanisms of uptake and release. PMID- 1766916 TI - Inhibition of dye transfer in rat liver WB cell culture by polychlorinated biphenyls. AB - In the present investigation the scrape loading/dye transfer assay and microinjection technique are used in order to investigate inhibition of cell-cell communication induced by different polychlorinated biphenyl (PCB) congeners. In these in vitro assays, inhibition of intercellular communication is directly measured as decreased transfer of a fluorescent dye (Lucifer Yellow CH) from donor cells loaded with the dye to surrounding recipient cells. The results show that substitution in the ortho position from the carbon bridge is essential and at least one chloro substituent in ortho position is necessary for the ability to inhibit intercellular communication. The results also suggest that an increase in the number of ortho substituted chlorine atoms in the PCB molecule enhances the ability to inhibit intercellular communication. On the other hand, the total number of substitutions may not be crucial for the ability to inhibit intercellular communication. Our results suggest that PCB-induced down-regulation of intercellular communication is a result of a specific mechanism and not due to unspecific membrane perturbation. PMID- 1766917 TI - Effects of a technical PCB preparation and fractions thereof on ethoxyresorufin O deethylase activity, vitamin A levels and thymic development in the mink (Mustela vison). AB - Clophen A50, a technical preparation of polychlorinated biphenyls (PCBs), was separated into four fractions; three containing chlorobiphenyls with 0, 1, or 2 to 4 ortho chlorines and one containing di- and tricyclic impurities such as naphthalenes and dibenzofurans. Clophen A50, the four fractions, and a synthetic mixture of the biologically most active non-ortho-chlorinated congeners (3,3',4,4'-tetra-, 3,3',4,4',5-penta-, and 3,3',4,4',5,5'-hexachlorobiphenyl), were separately mixed in the feed and given to female mink during the reproductive season. The concentration of a given compound in the feed mixture was equivalent to its concentration in the feed mixed with Clophen A50. Hepatic 7 ethoxyresorufin O-deethylase (EROD) activity in adults was enhanced 2-3 times by Clophen A50, the fractions containing non- or mono-ortho-chlorinated congeners, and the synthetic mixture. In neonatal kits delivered by females treated with non or mono-ortho-chlorinated congeners, EROD was enhanced to about 30 times the control value. No live kits were delivered by the females treated with unfractionated Clophen A50. The fractions containing congeners with two to four ortho chlorines or di- and tricyclic compounds did not significantly induce EROD in either adults or kits. Clophen A50 reduced hepatic and pulmonary vitamin A contents in adult mink, while renal vitamin A was unaffected. Responses to the fractions containing the non- and mono-ortho-chlorinated congeners were similar to those obtained with Clophen A50. Their effects were, however, less pronounced, particularly with respect to the hepatic vitamin A reduction. The fractions containing congeners with two to four ortho chlorines and the di- and tricyclic compounds had no significant effects on tissue vitamin A contents.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1766918 TI - TCDD decreases rapidly and persistently serum melatonin concentration without morphologically affecting the pineal gland in TCDD-resistant Han/Wistar rats. AB - The highly toxic environmental contaminant, 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) was recently reported to decrease serum melatonin levels throughout the circadian cycle in the most TCDD-susceptible strain of rat, Long-Evans. To find out whether this effect is related to the mechanism of acute lethality of TCDD, serum melatonin levels were measured at the nocturnal peak phase in the most TCDD resistant rat strain variant, Han/Wistar rats, 6 hr to 28 days after TCDD exposure. The same dose as used in the previous study, 50 micrograms/kg, decreased serum melatonin levels to approximately half the control values by the first day after the treatment. Melatonin concentrations remained at this reduced level over the whole observation period. In an auxiliary experiment, Han/Wistar rats were dosed with 1000 micrograms/kg TCDD and killed on day 3. Neither light nor electron microscopic examination of their pineal glands revealed any alteration attributable to TCDD treatment. These findings might indicate that the reduction of serum melatonin levels in the rat by TCDD is not related to its lethal effect and is not due to a direct damage of the pineal gland. PMID- 1766919 TI - Characterization of the enhanced responsiveness to postingestive satiety signals in 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD)-treated Han/Wistar rats. AB - Previous studies have shown that under free-feeding conditions, TCDD-treated Han/Wistar (H/W) rats consume less sucrose solution but ingest more saccharin solution than their controls thus implying hyperresponsiveness to postingestive satiety signals. In this study, nutrient preloads were employed to further elucidate this phenomenon. Male H/W rats were given a single high but usually non lethal intraperitoneal dose (1000 micrograms/kg) of TCDD. Feed intake was stimulated by 24 hr feed deprivation at various time points after TCDD exposure. When TCDD-dosed rats were allowed to drink either a 20% sucrose or a 0.25% saccharin solution and then given access to feed, those that had had sucrose ate only about 50% of the amount consumed by the saccharin group. Although the preloads were similar in control rats, no such difference in subsequent feeding occurred. The sucrose solution also produced a longer-lasting suppression of feed intake in TCDD-treated compared with control rats when infused directly into the stomach. By contrast, TCDD-treated H/W rats failed to exhibit an augmented satiety response to parenterally applied glucose independent of testing time. Oral corn oil reduced feed intake in both control and TCDD-exposed rats, but the inhibition was slightly larger in TCDD-treated animals. TCDD did not markedly affect the responsiveness of H/W rats to the suppression of feeding by CCK-8 or bombesin. It is concluded that gastrointestinal factors appear critical to the exaggerated response of TCDD-treated H/W rats to nutrient energy. PMID- 1766920 TI - Swedish dioxin survey: evaluation of the H-4-II E bioassay for screening environmental samples for dioxin-like enzyme induction. AB - The H-4-II E enzyme induction bioassay was used for testing both pure reference substances and extracts of wildlife samples. Polychlorinated naphthalenes were found to be as active as enzyme inducers as certain coplanar polychlorinated biphenyls (PCBs). Also a mixture of polybrominated diphenyl ethers (Bromkal 70 5DE) was shown to induce enzyme activity. In extracts of herring, containing polychlorinated dibenzo-p-dioxins (PCDDs) and dibenzofurans (PCDFs), bioassay and chemically derived TCDD-equivalents (TEQs) were nearly identical. When extracts containing other types of dioxin-like compounds as well were tested, the bioassay TEQs for most of them agreed well with chemical TEQs calculated for PCDDs, PCDFs and non-ortho PCBs. However, for ringed seal and whitefish, TEQs obtained from the bioassay were higher than those from the chemical analysis. Our results indicate that this bioassay is an excellent complement to chemical residue analysis and a useful tool in understanding the complex interactions of halogenated hydrocarbons. For risk assessment, such results should, however, be used most carefully as they are measured in vitro. PMID- 1766921 TI - Relative liver tumour promoting activity and toxicity of some polychlorinated dibenzo-p-dioxin- and dibenzofuran-congeners in female Sprague-Dawley rats. AB - The polychlorinated dibenzo-p-dioxins/dibenzofurans 1,2,3,7,8-pentachlorodibenzo p-dioxin (PeCDD), 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) and 2,3,4,7,8 pentachlorodibenzofuran (PeCDF) were studied for liver tumour promoting activity in a medium-term altered foci assay in nitrosamine-initiated female Sprague Dawley rats. The congeners under study were administered by weekly subcutaneous injections at three dose levels for 20 weeks. Evaluation of gamma glutamyltranspeptidase (GGT+), altered hepatic foci development, showed that all congeners studied acted as potent promoters of hepatocarcinogenesis. TCDD and PeCDD were virtually equipotent as enhancers of foci development while PeCDF displayed approximately ten per cent of the activity of the dioxins. Analysis of the dioxin- and furan-congeners by gas chromatography/mass spectroscopy (GC/MS) technique showed that the retention of PeCDD and PeCDF in liver tissue was approximately 7 and 20 times, respectively, as high as the retention of TCDD. Based on the concentration of the respective congener in liver tissue, PeCDD and PeCDF were 0.14 and 0.007 times as active as TCDD as promoters of foci development. The dose related enhancement of GGT+ foci development induced by the PCDD/PCDF congeners was accompanied by an increased incidence of histological changes in the liver. PMID- 1766922 TI - In vivo and in vitro toxicity of fractionated fish lipids, with particular regard to their content of chlorinated organic compounds. AB - Six different lipid matrices (the intact lipid (IL), four lipid fractions with different polarity, and the free fatty acids (FFAs) obtained by hydrolysis of the triacylglycerol (TAG) containing fraction) were obtained from salmon (Salmo salar) and eel (Anguilla anguilla), each collected at a contaminated and a comparatively uncontaminated catch site along the coast of Scandinavia. The lipid matrices were studied in toxicological test systems representing various biological functions of different organ systems from several species and trophic levels. The results were evaluated with particular respect to the concentrations of extractable organically bound chlorine (EOC1) in the matrices tested. In some test systems, the specimens with a higher EOC1 concentration appeared to be more toxic. For example, the TAG containing fraction (F2) from Idefjord eel, having a higher EOC1 content than F2 from Oslofjord eel, reduced the number and hatchability of eggs laid by zebrafish. Both IL and F2 of Idefjord eel increased mortality and reduced the oxygen/nitrogen-ratio in blue mussels. Non-polar compounds (F1) from Bothnian Sea salmon induced 7-ethoxyresurofin O-deethylase (EROD) activity in rainbow trout hepatocytes, whereas F1 from Senja salmon did not. F1 from Bothnian Sea salmon also reduced the number of T-cells in foetal mouse thymus analagen in vitro compared with the cell number in anlagen exposed to F1 from Senja salmon. A positive correlation between EOC1 concentration and test response was found for EROD activity in rainbow trout hepatocytes and for ATP-leakage in Erlich ascites tumour cells when testing the phospolipid containing fraction (F4). However, in most test systems the fish oils, irrespective of EOC1 content, were of low toxicity, and the observed effects need to be verified in future studies. PMID- 1766923 TI - Early prenatal diagnosis. PMID- 1766924 TI - Preimplantation diagnosis: a patient perspective. AB - A new dimension in the prevention of birth defects will be achieved when genetic diseases can be routinely diagnosed in embryos prior to implantation. The impressions and attitudes towards preimplantation diagnosis were studied in prospective patients, women at high reproductive risk for a genetic disease. Their perspective highlighted not only the advantages and disadvantages of this new approach, but also those changes necessary in order for preimplantation diagnosis to become a useful and practical technique. The data presented are based on information obtained by a mailed questionnaire answered by 58 women. The main benefit of preimplantation diagnosis for these high-risk women would be the ability to undertake a pregnancy without having to be subjected to the physical and/or emotional trauma of elective termination. Their major concerns related to possible damage to the embryo following biopsy, the cost of the procedure, and the low success rate of completed pregnancies. Other issues to be addressed before preimplantation diagnosis could begin to compare favourably with existing forms of prenatal testing were that the methods of obtaining oocytes or embryos should be simple, well tolerated, highly efficient, and low in maternal risk, and that the genetic analysis of embryonic or extraembryonic cells should be unequivocally accurate. PMID- 1766925 TI - Chromosome analysis of multipronuclear human oocytes after in vitro fertilization. AB - Multipronuclear human eggs are frequent after in vitro fertilization. Their chromosome analysis can provide useful information. Before cleavage it can confirm the suspected polyploidy. Among the cleaved multipronuclear eggs it provides an estimation of the incidence of the possible return to diploidy. Ninety-four multipronuclear eggs were fixed at the first, second, or third cleavage according to the air-drying method of Tarkowski with or without colchicine exposure: 60 were successfully analysed. Twelve were stopped before cleavage (six without colchicine treatment and six with colchicine treatment). They were polyploid, confirming the cytological observation. Forty-eight eggs cleaved and were stopped by colchicine treatment and karyotyped. Seventeen eggs (35 per cent) had produced diploid embryos. Mosaicism was frequent (15 cases, 31 per cent). Triploidy was not frequent (8 eggs, 17 per cent). Haploidy constituted the remaining cases (8 eggs, 17 per cent). Our data indicate that the initial count of pronuclei is a reliable test. Multipronuclear one-cell oocytes were confirmed to be polyploid. Furthermore, the developmental capacity of the multipronuclear oocytes is variable. Most of them cleaved. However, many multipronuclear oocytes led to diploid cleaving eggs. PMID- 1766926 TI - Beta-glucuronidase activity in mouse oocytes, mouse preimplantation embryos, and human gametes. AB - A microfluorimetric assay was designed to monitor beta-glucuronidase (beta-gluc) activity during the early development of mouse embryos and was also applied to measure beta-gluc activity in human sperm cells and single human oocytes. Mouse oocytes and preimplantation embryos at different stages of development, failed fertilized human oocytes, and human sperm cells were collected, and beta-gluc activity was analysed. In the mouse, beta-gluc activity could be measured starting from the morula stage on in a pooled sample of 15 embryos and at blastocyst formation in one single embryo. beta-Gluc activity was low in human sperm cells. The enzyme could be readily demonstrated in 87 per cent of non fertilized human oocytes. Considerable variation in beta-gluc activity was noticed between individual oocytes. PMID- 1766927 TI - Superovulation fails to increase human blastocyst yield after uterine lavage. AB - Uterine lavage affords the potential for non-invasive human blastocyst recovery, with obvious potential for preimplantation genetic diagnosis. In an effort to duplicate in women the multiple blastocyst recovery per cycle that can be achieved in several other species, we initiated a programme in which fertile women underwent superovulation, followed by lavage and embryo collection. We superovulated 15 fertile women, aged 21-40, in 29 cycles using one of four regimens. Insemination was by either intercourse or artificial intracervical donor insemination with cryopreserved sperm from men of proven fertility. In 28 of 29 cycles, the uterus was lavaged daily for 1, 2, or 3 days between 5 and 10 days after human chorionic gonadotropin (hCG) administration or luteinizing hormone (LH) surge. Almost total fluid volume was recovered in every lavage. There were no retained pregnancies and no complications. Surprisingly, only two morulae, one blastocyst, and four unfertilized ova were recovered. Thus, alterations in ovulation induction, insemination timing, or lavage techniques must be contemplated in order to increase the blastocyst yield and thus fulfil the potential of uterine lavage for preimplantation diagnosis. PMID- 1766928 TI - Possible effect of gestational age on the detection of fetal nucleated erythrocytes in maternal blood. AB - Maternal venous blood samples, obtained from six pregnant women, were used as a source of fetal nucleated erythrocytes (NRBC). Fetal cell enrichment was potentiated by flow sorting with the monoclonal antibodies TfR, Leu-4, and Leu M3. Single copy Y chromosomal DNA sequences were detected in samples obtained from two women at 11 and 12 weeks' gestation. Y DNA sequences were absent in a subsequent sample from one of these women at 19 weeks and in two other women at 16 and 20 weeks. All four women delivered males. Y DNA sequences were not detected in two women who delivered females. By combining these results with prior data on the detection of Y chromosomal DNA sequences in maternal blood from male-bearing pregnancies, a relationship between gestational age and feto maternal transfer of NRBC is suggested. PMID- 1766929 TI - Risk of miscarriage after transcervical and transabdominal CVS in relation to bacterial colonization of the cervix. AB - Cervico-genital colonization with micro-organisms poses a potential threat to the pregnancy when transcervical (TC) CVS is performed. In order to evaluate this threat, cervical swabs in 478 patients were obtained and cultured for bacteria, yeasts, and mycoplasmas; chlamydias were detected by an enzyme immunology test. Two hundred and seventy-one patients had CVS done transvaginally and 207 underwent transabdominal (TA) CVS. Transvaginal specimens were obtained in 61.6 per cent by forceps biopsy. Overall in 29.9 per cent of patients micro-organisms were detected, the rate and distribution of different species being the same in both groups. There were 36 (7.5 per cent) miscarriages up to 28 weeks of gestation in the combined groups, 29 (10.7 per cent) in the TC-CVS group and 7 (3.4 per cent) in the TA-CVS group. When miscarriages occurred after TC-CVS, bacteria/yeasts were involved in 10.3 per cent of cases and mycoplasmas in 37.9 per cent, this proportion being almost the same in early (less than 2 weeks) and late (greater than 2 weeks) miscarriages. After TA-CVS, in 28.6 per cent only mycoplasmas, and this only in late miscarriages (greater than 2 weeks), were involved, accounting for 40 per cent of late miscarriages. PMID- 1766930 TI - Transcervical (TC) and transabdominal (TA) CVS for prenatal diagnosis in Rotterdam: experience with 3611 cases. AB - Data from 3611 consecutive CVS (TC, N = 1780; TA, N = 1831) were analysed with emphasis put on influence of maternal and gestational age at CVS on the fetal loss rate less than 28 weeks. For TC-CVS the gestational age varied from 9.3-11.6 weeks, for TA-CVS from 9.3-20 weeks. Sampling efficacy at first attempt was 86.5 per cent and 95 per cent respectively. In 4.6 per cent an abnormal result was established. In older mothers (N = 2362) the fetal loss rate was significantly higher (p = less than 0.05) when sampled before 12 weeks (TC-CVS 6.2 per cent, TA CVS 5.8 per cent). When the CVS (TA) was performed after 12 weeks the fetal loss rate decreased to 2.4 per cent. In 1079 younger women the fetal loss rate remained low (TC 2.8 per cent; TA less than 12 weeks 1.8 per cent; TA greater than 12 weeks 1.7 per cent) and was not influenced by gestational age at the time of sampling. We concluded both methods safe and reliable when the choice of application considers maternal age. PMID- 1766931 TI - Trisomy 18 in chorionic villus sampling: problems and consequences. AB - Among 1547 patients undergoing first-trimester prenatal diagnosis, 100 fetal chromosome aberrations were detected. Thirteen of these involved chromosome 18. In two structural abnormalities of chromosome 18, the aberration could be excluded in amniotic fluid cells and two healthy infants were born. Trisomy 18 was not confirmed in amniotic fluid cells in three trisomy 18 mosaics. In eight non-mosaic trisomy 18 first-trimester diagnoses, the diagnosis was excluded by amniotic fluid cells or fetal cultures in four, and confirmed in the remaining four. Diagnosis of chromosome 18 aberrations in the direct preparation should be confirmed in the long-term culture of the chorionic villus sample or by amniotic fluid cultures. PMID- 1766932 TI - Uncommon chromosomal mosaicism in chorionic villi. AB - Three cases of unusual chromosomal mosaicism are reported for which the cytogenetic data show inconsistent findings between CVS and AC or fetal tissue, and which cannot be explained simply by non-disjunction. For case 1, in CVS the karyotype was 46,XY, whereas lymphocytes and fibroblasts revealed 69,XXY. DNA fingerprinting indicated one paternal and two maternal chromosome sets, the latter most probably due to omission of maternal meiosis II. For case 2, in CVS mos 46,XX/47,XX,+ mar de novo was observed. Amniotic fluid cells had the karyotype 46,XX. The origin of the marker chromosome might be explained by at least two events of unknown order (a somatic chromosome/chromatid deletion and non-disjunction of the homologous chromosome). In case 3 (CVS: mos 46,XY/46,XY,19q+ de novo; amniotic fluid cells, lymphocytes, and fibroblasts: 46,XY), the surplus of chromosome material in 19q+ might be explained on the basis of a somatic translocation. The idea of a chimera is less convincing, as the mosaic finding is restricted to one tissue. Furthermore, there was no hint of a vanishing twin. Hitherto, no case of structural chromosome mosaicism in CVS has been reconfirmed in fetal tissues. PMID- 1766933 TI - Follow-up and pregnancy outcome after a diagnosis of mosaicism in CVS. AB - In 2103 consecutive diagnostic chorionic villus samples, examined in a 4-year period in our clinical genetics unit, 26 samples (1.2 per cent) presented chromosomal mosaicism in the direct and/or long-term culture preparations. Only once (46,XX/47,XX,+9) was the mosaicism confirmed in the fetus. In the cytogenetic follow-up studies of the remaining 25 pregnancies, in no cases could the aberration be confirmed in amniotic fluid or fetal tissue. One patient requested a termination after the CVS result. Of the remaining 24 pregnancies, four (16.7 per cent) ended in a spontaneous abortion. These findings suggest an association between placental mosaicism and fetal loss. PMID- 1766934 TI - Mosaicism and accuracy of prenatal cytogenetic diagnoses after chorionic villus sampling and placental biopsies. AB - Discrepant chromosome findings in placenta and fetus (false negative and false positive) after chorionic villus sampling (CVS) are mainly due to confined mosaicism. Non-mosaic normal or abnormal chromosome counts after direct preparation and culture nearly always correctly reflect the fetal chromosome constitution. False-negative results have almost exclusively been restricted to cytotrophoblast cells not representing a fetal chromosome abnormality. Diagnosis of placental mosaicism definitely requires an adequate follow-up by amniocentesis, fetal blood sampling, or sonography before a pregnancy is terminated. When direct preparations and cultured cells are used for cytogenetic diagnoses and placental mosaicism is not taken as proof for a chromosomal abnormality in the fetus, CVS is an accurate diagnostic tool. PMID- 1766935 TI - Proliferation kinetics in native chorionic villus cells. AB - In accordance with observations by other groups direct CVS preparations reveal only a few mitoses, whereas semi-direct cultures (overnight incubation) give good results. By monitoring the BrdU uptake with an immunological method, a delay in the proliferation activity in native villi could be observed up to 7 h after biopsy. PMID- 1766936 TI - Incidence of abortion after genetic amniocentesis in twin pregnancies. AB - Fetal outcome after genetic amniocentesis (AC) in viable twin pregnancies was analysed in a retrospective study at three centres in order to estimate the rate of fetal loss after AC. The maternal age ranged from 33 to 45 years (mean 36.7 years). The gestational age varied between 15 and 20 weeks of gestation (mean 17.1). In 98 viable twin pregnancies with complete follow-up, spontaneous abortion of both fetuses occurred within 28 completed weeks of gestation in eight pregnancies and six women aborted within 20 completed weeks of gestation after AC, corresponding to a rate of fetal loss of 8.1 and 6.1 per cent, respectively (excluding the loss of five twins with viable outcome of the co-twin in five pregnancies). PMID- 1766937 TI - Vitamins, folic acid and neural tube defects: comments on investigations in the United States. AB - No clear answer concerning whether multivitamin/folate supplementation prevents neural tube defects (NTDs) is provided by three studies in the United States. All these studies are occurrence in nature, no recurrence studies having been conducted. The Atlanta Birth Defects Study is subject to pronounced memory and recall biases, the length between event and interview being as long as 16 years. In a second study (Boston University), objections can be raised to certain aspects of the experimental design, and the claim that 22 per cent of women started vitamins sufficiently early after pregnancy diagnosis to influence NTD formation is suspicious. Our NICHD case control study of 541 women in California and Illinois revealed no evidence for multivitamins or folic acid preventing NTDs. U.S. public policy-makers face difficulties in applying results of recurrence or occurrence studies in high-risk areas to low-risk areas in the U.S. PMID- 1766938 TI - Ethical and legal implications in IVF and prenatal diagnosis in the U.K. AB - The natural desire for couples to be parents and the medical practitioner's inability to treat most genetic diseases have been responsible for some of the most exciting research into infertility and genetic disorders. This has led in the United Kingdom to the establishment of the Warnock Committee of Inquiry into Human Fertilization and its report in 1984, and to a Review of the guidance on Research Use of Fetuses and Fetal Material published in 1989 and known as the Polkinghorne Report. The Warnock Report, among other ethical issues, considers the most fundamental question which has been debated for thousands of years, namely, What is life and when does it begin? More recently, the report has been responsible for new legislation which imposes ethical and legal restrictions on the scientific and medical community. The Polkinghorne Report recommends a voluntary code of practice which is morally and ethically acceptable within our society. We are also fortunate in the U.K. to have a parliamentary structure which allows debate on such important human issues and is prepared to impose ethical restrictions. PMID- 1766939 TI - Prenatal diagnosis of cystic fibrosis by simultaneous analysis of two different mutations. PMID- 1766940 TI - Race and gender differences in serum lipoproteins of children, adolescents, and young adults--emergence of an adverse lipoprotein pattern in white males: the Bogalusa Heart Study. AB - METHODS: Serum lipoprotein profiles in 4,231 individuals, ages 5-26 years, were studied cross-sectionally in a biracial community to describe the race- and gender-specific changes from adolescence into young adulthood. RESULTS: White children and adolescents of both genders showed significantly higher covariates- adjusted triglycerides (9-11 mg/dl) and very-low-density lipoprotein cholesterol (1-2 mg/dl)--and lower total cholesterol (3-14 mg/dl) and high-density lipoprotein cholesterol (6-10 mg/dl) levels than their black counterparts. These black-white differences persisted among young adults of both genders with the exception of total cholesterol levels (higher triglycerides: 23-32 mg/dl; higher very-low-density lipoprotein cholesterol: 5-7 mg/dl; lower high-density lipoprotein cholesterol: 9-11 mg/dl); in addition, white young adult males began to show higher levels of low-density lipoprotein cholesterol (14 mg/dl) than black young adult males. A consistent gender-related pattern emerged only among white young adults with males showing higher triglyceride levels (22 mg/dl), very low-density lipoprotein cholesterol (5 mg/dl), and low-density lipoprotein cholesterol (10 mg/dl) and lower high-density lipoprotein cholesterol (10 mg/dl) than females. Lipoprotein changes from adolescence into young adulthood were more pronounced among white males than other race-gender groups, resulting in higher triglyceride, very-low-density lipoprotein cholesterol, and low-density lipoprotein cholesterol, a higher total cholesterol/high-density lipoprotein cholesterol ratio, and a lower high-density lipoprotein cholesterol in their young adulthood. According to the National Cholesterol Education Program criteria, a relatively higher proportion of young adult white males was classified as borderline-high (22.6%) or high (9.1%) for low-density lipoprotein cholesterol. Adiposity was the major contributor to the adverse lipoprotein pattern, especially among white males. Sexual maturation and age influenced the lipoprotein levels to a greater extent among white males. Cigarette smoking, alcohol intake, and oral contraceptive use began to emerge as minor but significant factors contributing to the lipoprotein levels in adolescents and young adults. CONCLUSION: These results underscore the desirability of early targeting for primary prevention. PMID- 1766941 TI - The effects of a health education intervention program among Cretan adolescents. AB - BACKGROUND: An educational intervention program for the prevention of cardiovascular disease among 171 Cretan school students (13- and 14-year-olds) is assessed. Three schools from the province of Agios Vassilios acted as the intervention group while two schools from a neighboring province (Amari) formed the control group. METHODS: Variables measured included: systolic and diastolic blood pressures, body mass index, triceps skinfold thickness, serum total and high-density lipoprotein cholesterol, triglycerides, and smoking habits. The intervention, based upon social learning theory, consisted of 10 sessions of theoretical and practical instruction on health issues in the classroom, supplemented with discussion, in the classroom, of the issues raised by different sessions. RESULTS: At the end of 1 academic year of intervention the results showed, after adjusting for age, sex, baseline value, height, and weight, an increase in total serum cholesterol of 0.70 mg/dl in the intervention group and 17.91 mg/dl in the control group (P less than 0.0001). Diastolic blood pressure (fourth phase) decreased by 2.95 mm Hg in the intervention group and by 0.48 mm Hg in the control group (P less than 0.05). Similar changes were observed in the body mass index (P less than 0.05). The proportion of school children starting smoking was significantly lower in the intervention group (6%) than in the control (20%) (P less than 0.01). The results indicate that this health education program in schools is effective in decreasing some of the major CVD risk factors. The long-term effect remains to be evaluated. PMID- 1766942 TI - Correlates of high-density lipoprotein cholesterol in a sample of healthy workers. AB - METHODS: Correlates of high-density lipoprotein cholesterol are analyzed in a sample of 797 male workers in southern Italy participating in the Olivetti Heart Study. At the univariate level high-density lipoprotein cholesterol concentrations are positively related to alcohol consumption (r = 0.127; P less than or equal to 0.001) and sport activity (r = 0.074; P less than or equal to 0.05) and inversely related to body mass index (r = -0.160; P less than or equal to 0.001), serum triglycerides (r = -0.349; P less than or equal to 0.001), cigarette smoking (r = -0.227; P less than or equal to 0.001), and coffee consumption (r = -0.153; P less than or equal to 0.001). RESULTS: In the group as a whole, body mass index, alcohol consumption, cigarette smoking, and serum triglycerides remain significantly related to high-density lipoprotein cholesterol in the multivariate model, while the association with coffee intake and sport activity loses statistical significance. A significant negative interaction is reported between physical activity and cigarette smoking, and a positive significant linear trend between high-density lipoprotein cholesterol and sport activity is observed only in nonsmokers. CONCLUSION: These findings suggest that body mass index, alcohol consumption, cigarette smoking, serum triglycerides, and sport activity are important correlates of high-density lipoprotein cholesterol but that the positive significant association between sport activity and high-density lipoprotein cholesterol is absent in smokers. PMID- 1766943 TI - Tracking of serum HDL-cholesterol and other lipids in children and adolescents: the Cardiovascular Risk in Young Finns Study. AB - BACKGROUND: We have studied the tracking (i.e., the correlation between subsequent measurements) of serum lipids in a cohort of 2,236 children and adolescents (ages initially 3-18 years). METHODS: Determinations of the serum variables were made 3 and 6 years apart. Six-year tracking values (Spearman's r) were 0.63, 0.66, 0.58, and 0.36 for serum total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and triglycerides, respectively. Boys were found to track better than girls. Subjects who remained persistently in the highest (total cholesterol, low-density lipoprotein cholesterol, and triglycerides) or lowest (high-density lipoprotein cholesterol and high-density lipoprotein ratio) quintile tended to become obese and smoked cigarettes more frequently than the others. CONCLUSION: The tracking of high density lipoprotein cholesterol was higher than in previous studies, but differences in methodology may account for this. We conclude that total cholesterol and low-density as well as high-density lipoprotein cholesterol measurements in childhood and adolescence are predictive of adult values. PMID- 1766944 TI - Cardiovascular health knowledge in the United States: findings from the National Health Interview Survey, 1985. AB - Knowledge of the risk precursors to cardiovascular disease is thought to be a key component of health decision making. Many intervention programs have been aimed at increasing the nation's general knowledge of risk factors for cardiovascular disease, although the determinants of the level of cardiovascular disease knowledge are not thoroughly understood. We examined cardiovascular knowledge in a nationally representative sample of the United States population with data from the 1985 Health Promotion and Disease Prevention supplement of the National Health Interview Survey. Interviews with 12,551 white women, 770 Hispanic women, 2,547 black women, 9,832 white men, 576 Hispanic men, and 1,440 black men were used in this analysis. We constructed a seven-item index for cardiovascular disease knowledge. After adjustment for age and education, white men and women scored higher on the cardiovascular disease knowledge index than either their Hispanic or black counterparts. We also examined the relationships of age, education, income, marital status, access to medical care, geographic region, and seven self-reported cardiovascular disease risk factors to the levels of cardiovascular disease knowledge. Education was the strongest predictor of cardiovascular disease knowledge. The variables examined accounted for a small portion of the variance in knowledge. Levels of cardiovascular disease knowledge were lower among respondents with less education and income, those who were not married, those with less access to medical care, and those who were smokers or physically inactive. Therefore, efforts to improve levels of cardiovascular disease knowledge should be directed toward subgroups. PMID- 1766945 TI - Social support for exercise: relationship to physical activity in young adults. AB - BACKGROUND: Physical inactivity is an independent risk factor for cardiovascular disease, yet little is known concerning factors which influence participation in physical activity or exercise. Two studies assessed the relationships between self-reported physical activity and social support for exercise. METHOD: One study involved a biracial sample of middle-class male and female teachers (mean age = 38.5 +/- 8.9 years) and one involved a biracial sample of lower- to middle class males and females (mean age = 35.8 +/- 5.1 years). RESULTS: In both studies the social support scales had high internal consistencies and a two-component solution identical to the original validation study. In both studies, social support for exercise positively correlated with physical activity, but the relationships were mediated by race, gender, specific types of support (i.e., family, friend), and dimensions of physical activity (i.e., global, work, sports, and leisure). In both studies, regardless of work status and race, women's overall activity, particularly during leisure time, was positively related to family support for exercise. In both studies white women's overall activity levels, especially sports and leisure activities, were positively related to friend support. In both studies, black women's sports activity was positively associated with family support. Among white men in both studies, sports activities and total energy expenditure were positively related to family and friend support. Black men's sports-related activity was positively related to family support among the teachers and to friend support among subjects in the second study. CONCLUSION: Findings are discussed in terms of future research directed toward identification of other familial and sociocultural variables which might influence individuals' involvement in physical activity. PMID- 1766946 TI - Differences in cancer-risk-related behaviors in Latino and Anglo adults. AB - METHODS. Latino (n = 358) and Anglo (n = 113) adults living in the San Diego area were surveyed on nutrition, smoking, and cancer screening behaviors. The Latino respondents were dichotomized into a low (L-Latino) or high (H-Latino) acculturation group according to a median split of an acculturation index. RESULTS. After controlling for age, years of education, gender, marital status, and income, significant cross-cultural differences were found in saturated fat/cholesterol avoidance, and fiber and high calorie food consumption. L-Latino respondents had the lowest degree of saturated fat/cholesterol avoidance, followed by H-Latinos and Anglos. A pattern of decreasing consumption with increasing acculturation was observed for fiber and high calorie foods. Significant differences were found among women in the prevalence of Pap smear exams, with L-Latinas having the lowest prevalence of ever and in the past year having had a Pap smear, followed by H-Latinas and Anglos. A similar significant pattern was observed among women 50 years of age or older with respect to the prevalence of ever having had a mammogram. PMID- 1766947 TI - Composition of popular tobacco products in Thailand, and its relevance to disease prevention. AB - BACKGROUND: This report presents new findings on the composition of the three best-selling brands of commercially produced Thai cigarettes, representing about 80% of market share in Thailand, and six best-selling tobacco products, including hand-rolled cigarettes and cigars. RESULTS: With one exception, all Thai cigarettes yielded higher levels of tar and nicotine than U.S. brands sold in Thailand. High levels of tar, nicotine, and carbon monoxide (CO) were found in the smoke of popular Thai cigars (Khiyo) and Burmese cigars sold in Thailand. All tobacco products tested were ranked in order of smoke yields of tar (cigarettes, 4.5 to 40.8 mg/cigarette), nicotine (0.19 to 5.77 mg/cigarette), and CO (3.1 to 9.5 mg/cigarette). The labels "very strong," "strong," and "mild," used in rating the tobacco quality by the growers in Thailand, were not found to reflect the relative nicotine and tar yields. From 1985-1990, per capita consumption of cigarettes in Thailand increased 1.4-fold. CONCLUSION: This report provides information that may prove helpful in the evaluation of the tar, nicotine, and carbon monoxide yields of cigarettes and cigars in Thailand compared with levels in U.S. cigarettes. It is our goal to offer the scientific basis for voluntary and/or regulated reduction of the smoke yields of tobacco products in Thailand. PMID- 1766948 TI - A 5-year evaluation of a smoking cessation incentive program for chemical employees. AB - BACKGROUND: This 5-year study of the Dow Chemical Texas Operations 1984-1985 Smoking Cessation Incentive Program (SCIP) evaluated the smoking habits of 1,097 participants and 1,174 nonparticipants. RESULTS: We observed, via questionnaire and saliva cotinine data, that participants were 2.3 times more likely to be long term (greater than or equal to 5 years) nonusers of tobacco than nonparticipants (10.2% vs 4.4%, P less than or equal to 0.01). However, smoking cessation rates for 3-4 years, 1-2 years, and less than 1 year were similar for participants who remained smokers at the conclusion of SCIP and nonparticipants. Age and the interaction between the management job category and having quit smoking for at least 30 days sometime prior to the worksite program were important predictors of smoking cessation among participants. Thirty-six percent of the participants who were considered exsmokers of 6 months duration at the conclusion of the program in 1985 remained long-term quitters 5 years later. Stress and enjoyment of smoking were the two most important reasons provided by participants for recidivism. CONCLUSIONS: The results of this 5-year evaluation demonstrate the heterogeneity of employee participation and success with a worksite smoking cessation program. PMID- 1766949 TI - [Bilateral chylothorax--case report and literature review]. AB - A bilateral chylothorax developed in a woman patient during recurrence of a non Hodgkin's lymphoma, originally treated by laminectomy and telecobalt irradiation. Almost simultaneously there was a thrombosis of the brachial vein in the right arm. On the basis of this particular case, attention is drawn to the difficulty in pathogenetic classification. The possible causes, especially of the bilateral nature of the chylothorax, are discussed while referring to the relevant literature. PMID- 1766950 TI - [Preneoplasias and early carcinoma of the lungs--histogenetic aspects of bronchial carcinoma]. PMID- 1766951 TI - [Roentgen diagnosis of pulmonary complications following allogeneic bone marrow transplantation--application of and experience with digital luminescence radiography]. AB - Pulmonary complications exercise a decisive influence on the prognosis of leukaemia patients after bone marrow transplantation. Very early diagnosis is a mandatory prerequisite to successful therapeutic intervention. Of great importance besides the clinical findings and bronchoalveolar lavage is the analysis of the x-ray morphology of pneumonic infiltrates to narrow down the differential diagnostic spectrum. Since the patients are at high risk of infection, they are under isolated care, so that x-ray examinations can only be performed by means of projection radiography using mobile units. Due to these difficulties in performing relevant radiography the required optimal and constant image quality cannot be achieved by means of conventional x-ray film, so that very early detection of pulmonary complications is not always possible. The use of digital luminescence radiography (DLR) with luminescent storage foils enables a highly constant and hence comparable image quality thanks to increased image dynamics, a larger area of the examined object, and histogram evaluation of the image data for determining the optimal parameters for assessment. In addition, details can be better identified to supply answers to specific questions, because the image can be reprocessed to select relevant image parameters by monitoring. Pulmonary complications in 86 patients were analysed retrospectively. These patients had received an allogeneic bone marrow transplant for acute myeloic leukaemia, after they had been treated with high-dose radio-/chemotherapy. The x ray morphology, clinical and sometimes autopsy findings were correlated with the occurrence of pulmonary complications subsequent to bone marrow transplant. PMID- 1766952 TI - [Ciliary function in bronchopulmonary infections in childhood]. AB - It was the aim of this study to examine the influence of bacterial or viral infections of the airways on the ciliary beat rate in childhood. In 21 children with bacterial bronchopulmonary infections a mean ciliary beat rate of 9.1 +/- 2.4. Hz was found that did not differ significantly from that of the group of the healthy subjects (9.9 +/- 1 Hz). In 7 of the 21 patients we could identify an infection of the respiratory tract with Haemophilus influenzae; in those children there was a marked reduction of the mean ciliary beat rate at 8 Hz. 13 children with viral bronchopulmonary infections had a mean ciliary beat rate of 11.8 +/- 1.8 Hz, which is significantly enhanced when compared with that of the healthy group. Compared with the mean ciliary beat rate of bacterial infections of the respiratory tract there is a significant difference. In viral infections of the airways no value below 9 Hz was found. In case of markedly reduced ciliary beat rate a bacterial infection must be assumed. PMID- 1766953 TI - [Value of non-plethysmographic methods in determining airway resistance]. AB - To examine whether the complicated method of body plethysmography can be replaced by non-plethysmographic methods, such as oscilloresistometry (Ros), the closing pressure method (Run) or the forced expiration volume method (FEV1), the authors studied the results obtained with 247 hospitalised patients between 18 and 81 years of age suffering from, or free from, airway obstruction. Although satisfactory correlations were obtained by linear and curvilinear regression analysis, considerable differences were seen in individual patients suffering from obstructions to a higher degree. Oscilloresistometry showed at the standard value limit of the airway resistance applicable in body plethysmography (0.30 kPa/l/s) a sensitivity of 89%, whereas the specificity was only 62%. Almost identical values of sensitivity (92%) and specificity (61%) were attained by the closing pressure method only if the standard value limit was set a little higher, namely, at 0.35 kPa/l/s. FEV1, which is easiest to measure, was able to objectivate an airway obstruction in a manner comparable to that of Ros and Run; there was in fact even a closer statistical correlation between the body plethysmographic resistance mographic methods are suitable for screening examinations on account of their sensitivity. However, if the results on the examination are not in keeping with the overall clinical findings, further diagnostic clarification must be sought by performing a body plethysmographic measurement. PMID- 1766954 TI - [Tracheobronchial stents--indications and possibilities]. AB - 16 silicone stents and 9 expandable metallic stents (Strecker-stents) were implanted in 22 patients (16 x tumors of central bronchial tree, 6 x stenosis of benign conditions). The silicone stents were mainly implanted in the trachea and main bronchi, the metallic stents in lobar bronchi. In all cases we succeeded in implantation without complications. With both stent models an immediate relief of dyspnea and respiratory failure was achieved in all cases. The average period of follow-up is 65 days, the longest 105 days (silicone stents) respectively 306 days (metallic stents). All stents were tolerated well besides one with a feeling of intrathoracic pressure. Complications were dislocation (1 x), occlusive tumor growth (1 x), granulations (1 x), suppurative bronchitis (2 x), growth of tissue through the wall of metallic stents (1 x) and restenosis by indurated secretions (2 x). Though the long term results were well with different types of stents, which are available today, the expandable stent woven of metallic wire, seems to fit best to clinical needs. PMID- 1766955 TI - Brave new worlds: perspectives on the American experience of eugenics. PMID- 1766956 TI - Billing for physicians in training: educational subsidy or fraud? PMID- 1766957 TI - A perspective on medical education: a return to clinical residency. PMID- 1766958 TI - Bellevue Hospital patient casebook: September 8, 1866-February 3, 1868. PMID- 1766959 TI - "You have a good sense of humor. You should be a doctor". PMID- 1766960 TI - Taoism and the quest for immortality. PMID- 1766961 TI - Healing and havoc in the works of T.S. Eliot and William Carlos Williams. PMID- 1766962 TI - A dreadful dilemma: individual versus global health perspectives. PMID- 1766964 TI - Health care crisis. PMID- 1766963 TI - Evangelistic medicine. PMID- 1766966 TI - Quality of medical education. PMID- 1766965 TI - Telling patients their diagnoses. PMID- 1766968 TI - Perioperative assessment and nursing implications for the elderly. PMID- 1766967 TI - International perspectives for today's physician. PMID- 1766969 TI - Reconstructive surgery in the elderly. PMID- 1766970 TI - Teaching the older adult. PMID- 1766971 TI - Gynecomastia. PMID- 1766972 TI - Moral dilemmas in clinical practice. PMID- 1766973 TI - Qualities of successful managers. PMID- 1766974 TI - [Pharmacokinetic testing of patients with bronchial asthma]. AB - The study represents the investigation on pharmacodynamic lung function testing in 40 patients (21 with extrinsic asthma and 19 with intrinsic asthma). Skin prick tests on common inhalation allergens, IgE antibodies, spirometry, flow volume curve, body plethysmography and pharmacodynamic testing with salbutamol spray were performed in each person. The greatest changes after beta 2 agonist were established by plethysmographic parameters SGaw (mean increase 117%) and Raw (mean decrease 45%), than by the expiratory flow rates from flow-volume curve: FEF25%-75% and FEF50% (mean increase 26%), than the FEV1 (+ 15%), the PEF (also + 15%), the RV (mean decrease 17%) and the FVC (mean increase 8%). The aim of this study was to represent the necessity of the complex analysis and interpretation of the results of pharmacodynamic testings because of many factors that might change the values of the tests. PMID- 1766975 TI - [Comparative analysis of bronchoalveolar lavage and transbronchial biopsy in pulmonary sarcoidosis]. AB - This study was carried out in 59 patients with histological evidence of pulmonary sarcoidosis. In all patients, bronchoalveolar lavage (BAL) and transbronchial biopsy (TBB) were performed simultaneously. In histologic specimens of TBB, 24/59 (41%) patients had luminal alveolitis, 36/59 (61%) mural alveolitis, 41/59 (69%) granulomas 11/59 (15%) diffuse fibrosis and 24/59 (41%) focal fibrosis. Cytological examinations of BAL revealed 22/59 (37%) patients without alveolitis, 20/59 (34%) with low intensity alveolitis and 17/59 (29%) with high intensity alveolitis. Comparative analysis of these patients showed the association of the alveolitis in BAL and the mural alveolitis or granulomas in TBB (p less than 0.01). The conclusion of this study is that cytological findings in BAL represent interstitial cells very well. PMID- 1766976 TI - [Efficacy of the inhalation of warm mineral water from Moravci well MT-6 in patients with chronic obstructive lung disease]. AB - In 20 patients with chronic obstructive pulmonary disease (COPD) the effects of inhalation of Bisolvon (BS) were compared with the inhalations of thermomineral water of the well MT.6 of thermal spring Moravci (TMW). It was found that mean maximal expiratory flow during inhalations of TMW was statistically significantly higher from that during inhalation of BS (P less than 0.05). By visually analogous scale the patients during inhalations of TMW were found to have statistically smaller dyspnea (P less than 0.001) and after inhalation of TMW they could expectorate much better (P less than 0.01) in comparison with the period of inhalations with BS. The authors consider the inhalations of TMW to be a good method of therapy of patients with COPD. PMID- 1766977 TI - [Significance of the alveolo-arterial PO2 gradient in the diagnosis of pulmonary thromboembolism]. AB - The diagnostic value of alveolar-arterial PO2 gradient P(A-a)O2 in pulmonary thromboembolism is tested. The significance of alveolar-arterial PO2 gradient in acute pulmonary thromboembolism was determined in prospective study. The study group consisted of 7 patients with pulmonary thromboembolism documented by digital-subtraction angiography (DSA) and lung scans and ten healthy subjects with normal alveolar-arterial PO2 gradient. Hypoxemia was present in 3 patients, hypocapnia in 4 patients and an increased P(A-a)O2 gradient in all 7 patients. The results suggest that a normal P(A-a)O2 gradient in patients during room air breathing can be used as evidence against the presence of pulmonary emboli. P(A a)O2 gradient is a very sensitive diagnostic parameter in acute pulmonary embolism but procedure is fast. PMID- 1766978 TI - [Rare causes of bronchial asthma]. AB - Historical perspectives, incidence, clinical presentation, immunopathogenesis, aspirin challenge and sulfiting provocation test are presented together with the hyposensitization, complications, diagnosis and differential diagnosis and treatment of these forms of bronchial asthma. Many patients with aspirin bronchial asthma can tolerate acetaminophen. Over 90% of patients with allergic bronchopulmonary aspergillosis have extrinsic form of bronchial asthma. Criteria for the diagnosis of allergic bronchopulmonary aspergillosis are described. About 5-10 percent of all asthmatic patients may have some degree of sulfite sensitivity. The principle of etiologic differentiation is reasonable when the therapy is indicated by confirmed bronchial asthma. In some cases the invasive methods of diagnostics should be applied (provocation, BAL, transbronchial biopsy, transthoracic biopsy). PMID- 1766979 TI - [Effect of ethanol on tone of isolated smooth muscle of the the pulmonary artery]. AB - The response of the pulmonary artery smooth muscle tone to ethanol, and the effects of haloperidol (a dopaminergic receptor blocker), propranolol (a beta adrenergic receptor blocker) and verapamil (a calcium channel blocker) on the response to ethanol were studied using the dog pulmonary artery smooth muscle. The results have shown that ethanol consistently induces a dose-dependent contraction of pulmonary artery smooth muscle which is not substantially modulated by the prior administration of haloperidol, but is partially blocked by propranolol, suggesting that catecholaminergic receptors are partly involved in the mediation of the ethanol induced pulmonary artery smooth muscle contraction. However, the results of this study have shown that ethanol induced contraction of pulmonary smooth muscle is not altered by verapamil in doses which blocked the contractil response of airway smooth muscle to ethanol. Due to these studies it can be concluded that ethanol, acting directly on pulmonary vasculature, might contribute to development of pulmonary hypertension and cor pulmonate chronicum. PMID- 1766980 TI - [Hyposensitization and antihistamines in the treatment of bronchial and allergic rhinitis]. AB - The control of symptoms in patients with allergic rhinitis and bronchial asthma can not be always attained with hyposensitization. This may be achieved with more success with additional treatment with H1 antagonists of histamine receptors. By hyposensitization statistically significant decrease of the total IgE was achieved. Contrary to this, in cases in which the symptoms could not be controlled with hyposensitization, only antihistamines were additionally administered, no significant decrease of IgE took place. These were, probably, more severe cases in which the symptoms could not be controlled with the hyposensitization only. No significant effect on the values of blood eosinophiles was registered with hyposensitization or additional administration of antihistamines. PMID- 1766981 TI - [Evaluation of the results of radiotherapy in planocellular bronchial carcinoma]. AB - The analysis comprised 23 patients with planocellular bronchial carcinoma in whom monoradiotherapy was used. Stage III dominated in the studied group (56.6%). Positive response to therapy was achieved in 60.9% of the patients. The effect was maintained for 9 months and after that the disease continued to progress. In 17.4% of the patients the findings remained unchanged, while in 21.7% uninterrupted progression of the disease was noted. Therapeutical doses of 45 Gy and 60 Gy were applied in 52.2% and 47.8% patients, respectively. Survival of one year was achieved in 26.1% while 4.3% survived for two years. Advanced stage of the disease dominating in the studied group could be the reason for the low survival rate. The results presented as well as the referential ones suggest the better response to therapy and longer survival of patients with planocellular bronchial carcinoma in whom higher therapeutical irradiation dose was applied (60 Gy). PMID- 1766982 TI - [Planocellular bronchial carcinoma--patho-anatomic characteristics, tumor growth rate and possibilities of modern diagnosis]. AB - Basic features of squamous cell bronchial carcinoma are reviewed since this is one of the most common histologic forms of this malignoma. Referential data reveal pathoanatomic features of squamous cell bronchial carcinoma and classification according to degree of differentiation to well, moderately and poorly differentiated histologic type. Data on the growth rate of squamous cell bronchial carcinoma are presented and correlated to other histologic groups of bronchial carcinoma. The most commonly applied diagnostic measures and their efficacy have also been discussed. PMID- 1766983 TI - [Possibilities of diagnosis of bronchial obstruction]. AB - The functional parameters Raw, Rrs, FEV1, RV, FEF25 and FEF50 have been examined in 1000 patients with bronchial obstruction. Measurement of airway resistance is the precise examination for bronchial obstruction. For the routine clinical examination the interruptional measurement of Rrs is sufficient (correlation test + 0.56). Resistance may be measured indirectly by dynamic pulmonary volume testing (correlation FEV1: Raw = -0.55; FEF50: Raw = -0.63). PMID- 1766985 TI - [The effect of the length of exposure and smoking on respiratory function in workers exposed to asbestos-cement dust]. AB - Respiratory function tests were performed in 110 workers who were occupationally exposed to asbestos-cement dust in the period from 7 to 34 years. Due to the results obtained, the following groups of patients were analysed according to years of asbestos-cement exposure and the habit of cigarette smoking. The analysis of the years of exposure to asbestos-cement dust revealed that the workers with the exposure longer than 16 years had significantly lower FVC and FEV1 (P less than 0.001) than the workers whose exposure was less than 16 years. In view of increasing age this deterioration proved to be significantly higher than it had been expected. Of all the subjects included in this study 7% of them were found to have a partial respiratory insufficiency. The phenomenon could not be explained either by the length of exposure or by the habit of cigarette smoking. In the smoking subjects with the longest exposure, a markedly lower SaHbO2 was found as compared to the smokers with the shortest exposure (P less than 0.05). PMID- 1766984 TI - [Treatment of chronic resistant tuberculosis]. AB - Two groups of patients with chronic pulmonary tuberculosis are presented. The first group of 92 patients were unsuccessfully treated according to current principles of treatment of chronic, resistant pulmonary tuberculosis. In the second group of 11 patients, unsuccessfully treated according to current methods, a new combination of drugs was applied so that a drug of the aminoglycoside group or chinolon group (Amikacin 1000 mg every second day or Ciprofloxacin 750 mg daily) was added to conventional therapy. Applying such therapy during 4 months encouraging results have been obtained. PMID- 1766986 TI - Diaphragm dysfunction and respiratory insufficiency after upper abdominal surgery. AB - This study was designed to determine the contribution of diaphragm dysfunction and pain to respiratory insufficiency after upper abdominal surgery. Respiratory insufficiency and postoperative pain in humans were evaluated by pulse oximetry, pulmonary function tests, and a visual analog scale. Diaphragm shortening in dogs was evaluated with biplane videoroentgenography. In humans, despite reasonable pain control, pulmonary function, as reflected in forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and arterial oxygen saturation (SpO2) were significantly reduced on the first postoperative day. Improved pain control was not associated with improvements in FVC or FEV1. In the dogs, diaphragm shortening and tidal volume were significantly reduced in the immediate postoperative period. Phrenic nerve stimulation immediately after surgery resulted in supramaximal diaphragm shortening, which indicated neither the diaphragm nor phrenic nerves were significantly injured by surgical manipulation. Diaphragm dysfunction has a major role in postoperative pulmonary insufficiency; an afferent-mediated reflex inhibition of the phrenic nerves may be responsible. PMID- 1766987 TI - [The effect of occupational exposure to respiratory noxae in the tobacco industry on the status of pulmonary ventilation]. AB - The study from the working environment prevailing in two departments of tobacco factory (DIN) Nis together with the study of the employees (95) working in these departments were carried out. The workers were divided into two sub-groups: smokers (62) and non-smokers (33) and the results of the lung function tests were compared to normal values. The results found point out to the presence of the tobacco dust in these departments and the values exceeding MAC might have caused the obstructive changes of airways in the workers exposed. PMID- 1766988 TI - [Roentgenologic characteristics of bronchopulmonary carcinoma]. AB - The roentgenologic characteristics of bronchopulmonary carcinoma were studied in 578 patients in whom the disease had been diagnosed by bronchoscopy and confirmed by cytopathologic finding. Each of the pulmonary disease may imitate bronchopulmonary carcinoma and vice versa. Since there is no roentgenologic patognomonic sign for bronchopulmonary carcinoma the sorts and distribution of characteristic X-ray signs were examined. In our group of patients in 67% of cases the right side was involved. The leading point in X-ray was in 52.8% of cases the pathologically enlarged hilus unilaterally and bilaterally. In patients with periphery located bronchopulmonary carcinoma the most frequent X-ray sign was unclearly limited shadow in 41.3% of cases. In patients with centrally located bronchopulmonary carcinoma in 6.4% of cases the normal X-ray sign was found. However, in none of 177 patients with periphery bronchopulmonary carcinoma the normal X-ray was found. PMID- 1766990 TI - [Pulmonary adiaspiromycosis]. AB - A 54-yr old male patient with a history of dyspnea and cough is presented. Due to the clinical course of disease and the radiological changes in the chest a diagnosis of sarcoidosis was established. However, the open lung biopsy revealed the true nature of the pulmonary disease: pulmonary adiaspiromycosis, only secondary to asbestosis, siderosis and silicosis as due to the well known occupational exposure to asbestos and other dusts. PMID- 1766989 TI - [Procollagen type 111 peptide levels in patients with bronchial asthma and COPD]. AB - The aim of these study was to evaluate if the inflammatory injury of parenchymal cells can lead to proliferation of fibroblasts and deposition of increased amounts of collagen, measured by the increased concentration of procollagen in blood, in patients with asthma and COPD. We evaluated 22 patients with asthma that has lasted more than 5 years, 18 patients with COPD and 20 healthy subjects. RIA-gnost method (Behring) was used to measure the procollagen peptide concentrations in blood. Our results showed that the concentration of procollagen peptide in blood samples from patients with asthma was 5.8 +/- 2.4, 4.9 +/- 1.8 in patients with COPD and 11.1 +/- 3.6 in healthy subjects. There was no significant difference between patients with asthma, COPD and healthy subjects (p less than 0.01). It can be concluded that there is no increased deposition of collagen in patients with long lasting asthma and COPD. Further studies of active collagen deposition in the early acute forms of these diseases are in progress. PMID- 1766992 TI - [Primary malignant melanoma of the trachea]. AB - The paper gives a case report of the primary malignant melanoma of the trachea in a 61 years old patient with micrometastasis in the right upper lobe of the lung. The diagnosis was made after autopsy. Macroscopically, a polypoid, greyish, partly dark brown tumor was found 6 cm above the tracheal bifurcation on the site of connection between the membranous and cartilaginous part. The tumor was fixed to the trachea wall with a very narrow long stalk, causing long dispnoic attacks worsening in a back lying position particularly. Histologically, both the primary tumor and its secondary deposit in the right lobe were found to have similar appearance as a malignant melanoma elsewhere. Melanin pigment was found in abundance here and there and easily detected already in preparations stained by the hematoxylin--eosin method. The large polypoid tumor caused an obstruction of the trachea and finally suffocation. PMID- 1766991 TI - [Exogenous lipoid pneumonia with abscess mimicking a lung tumor]. AB - A case of abscessing exogenous lipoid pneumonia is reported. After the onset of respiratory symptoms, 68-year-old male was admitted to our hospital. Physical and X-ray examination suggested malignant lung tumor. After false positive finding of fine needle transthoracic biopsy, the right middle lobectomy was performed. Histological examination showed an unexpected finding of lipoid pneumonia and thereafter information of accidental petroleum aspiration was obtained. PMID- 1766993 TI - [Tracheobronchomegaly (Mounier-Kuhn syndrome)]. AB - A case report is presented of a man with pronounced tracheobronchomegaly who has had respiratory symptoms since childhood. In spite of numerous medical examinations a disease remains undetected for many years. Authors bring up different standpoints about etiology and the most often accepted hypothesis about the autosomal recessive inheritance. They also point their attention to a small number of diagnosed cases despite high prevalence (0,4-1%) and typical symptoms. PMID- 1766994 TI - [Intrathoracic extramedullary hematopoiesis]. AB - The authors report on 29 cases of intrathoracic localization of extramedullary hematopoiesis. Out of them, 26 cases were confirmed by cytomorphologic examination of the aspirate specimens obtained by transtracheal biopsy of carina while in 3 cases the specimens for cytologic analysis were obtained by transthoracic fine needle aspiration of solitary shadows in the lung parenchyma. The cytomorphologic finding of the hematopoietic cells of the specimens obtained by transtracheal biopsy was unexpected in patients with an active pulmonary tuberculosis, primary bronchial carcinoma, broncho and pleuropneumonia, lung abscess, sarcoidosis, chronic bronchitis, rheumatoid arthritis as well as in patients with hemoptysis. PMID- 1766995 TI - [Bronchial asthma and methemoglobinemia caused by milk allergy]. AB - Bronchial asthma and methemoglobinemia due to the allergy on milk was described in 34-year old man. Very marked cyanosis with 15.3% methemoglobin, E--7.2, 272% hemoglobin, 52% hematocrit, severe form of bronchial asthma with PaO2--7.63 kPa, 89% saturation, PaCO2--4.46 kPa were found. Sternal and bone biopsy showed myeloproliferative disease. Allergy testing showed positive early and late reaction on milk. Serum IgE was 1670 mu/ml, RAST and precipitin test were positive on milk. Bronchoprovocation test on milk showed positive asthmatic reaction. After elimination of milk products from food all findings were soon normalised and the patient has not had bronchial asthma and cyanosis for two years now. PMID- 1766996 TI - [Noninvasive diagnosis in the detection of pulmonary hypertension and chronic cor pulmonale as a late sequelae of pulmonary embolism]. AB - A patient with symptoms of coronary artery disease is presented. ECG changes, chest X-ray, echocardiography as well as ventilation-perfusion study excluded coronary artery disease and confirmed cor pulmonare chronicum and pulmonary hypertension. Patophysiological aspects and clinical symptoms are also discussed. PMID- 1766997 TI - [The effect of ranitidine on theophylline pharmacokinetics in patients with obstructive lung disease]. AB - The study was performed in 20 patients with mild and moderately severe forms of bronchial asthma or chronic obstructive bronchitis. Theophylline for oral use (sustained release form) and ranitidine was used in the first group of patients (7 females and 3 males, mean years of age 37.9). Dosage of theophylline from patients' sera was monitored prior and at 3, 6, and 12 hours beginning with the initial morning dose. The second group of patients (9 females and 1 male, mean age 46.3 years) were on ranitidine therapy along with 250 mg intravenous theophylline-ethylene-diamine. Fractionated dosage of theophylline was made within 12 hours. Pharmacokinetic parameters were calculated according to the concentration of theophylline in the sera of patients in the second group. In the sera of patients in the first group significantly higher concentrations of theophylline were found at 3 and 6 hour of the initial morning dose (p less than 0.05). In the second group a significant difference was not registered for the assessed pharmacokinetic parameters. This investigation indicates that there are individual differences of the metabolism of theophylline drugs with concommitant use of ranitidine. PMID- 1766998 TI - [Effect of vitamin C on exercise-induced bronchoconstriction]. AB - The effect of vitamin C on exercise-induced airway constriction was studied. Pretreatment with ascorbic acid prevented the significant alteration in airway geometry induced by exercise asthmatic patients. These results suggest that vitamin C deficiency might augment airway responses to exercise and other bronchospasmogenic factors, and treatment with vitamin C may decrease airway hyperresponsiveness. PMID- 1766999 TI - [Biological standardization of the allergenic extract of Ambrosia elatior]. AB - Allergenic activity of allergen extract Ambrosia elatior (AE) was tested in fifteen volunteers extremely sensitive to the allergen. The research was performed by using the quantitative prick (P) and the intradermal (ID) test. The results were analyzed by the parallel line assay method. Allergenic activity of the specimen was estimated: by the number of the allergen units (AU) in 1 ml of the undiluted specimen according to the results of the P (prick) test; by the number of the allergen units (AU) in 1 ml of the undiluted specimen according to the results of the I. D. test, and by the in vitro standardized method of the RAST inhibition. These preliminary results show that allergen extract Ambrosio elatior has 100,000-130,000 Bu/ml and ca 1000 AU/ml while allergenic activity of the extract measured by the RAST inhibition method has ca 57,000 IU/ml. PMID- 1767000 TI - AIDS vaccines. PMID- 1767001 TI - 8th Duncan Memorial Lecture. Childhood cancer and nuclear installations. AB - So where are we now? I think the first thing to say is that there is a well established excess around Sellafield of childhood leukaemia, although excesses around other nuclear sites are of a lower magnitude. The excess near Sellafield is strongly associated with fathers having high exposure to external whole-body penetrating radiation while working at the installation before their child's conception. But is this association pointing towards a causal mechanism? One possibility is genetic damage, but most geneticists and radiobiologists would consider that the levels of occupational exposure, even at Sellafield, are too low for this to be a plausible pathway on current knowledge. This is based to some extent on the lack of any similar effect among children born subsequently to Japanese survivors of the atomic bombs--however, the scenario is somewhat different contrasting a high short-term exposure with a lower long-term exposure. As well, some workers at Sellafield will also be exposed to radionuclides, such as plutonium, which we have not yet been able to analyse for. In addition, there are other exposures in a complex environment which may or may not be relevant. One experimental study in the laboratory using animals supports the idea that a pathway through irradiation of the parents is plausible, although this one result needs replication. Other causes have been suggested for the excess childhood leukaemia levels in particular around nuclear establishments--these include population movement, implicating viruses that have long been considered to be associated with childhood leukaemia, high rates in isolated communities, and also selection of areas for nuclear sites that have a natural propensity to high rates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767002 TI - Use of acute hospital services by homeless children. PMID- 1767003 TI - The age of identification of childhood deafness--improvements since the 1970s. AB - The validity of hearing screening programmes undertaken within the Community Child Health Services is currently being critically reviewed. The study of 198 children with permanent hearing loss born between 1973 and 1988 confirms the prevalence of different degrees of deafness in an East London district of urban deprivation. Within this district the expansion of community audiology services has resulted in a significant reduction in the age of identification of those children with a moderate, severe or profound bilateral deafness, measured over a 15 year period. However, despite these improvements, the modal age of identification of those children with a unilateral deafness or with a bilateral deafness of mild degree remains at the age of primary school entry. The implications of this for planning future screening programmes is discussed. PMID- 1767005 TI - Deaths from road traffic accidents in Scotland: 1979-1988. Does it matter where you live? AB - The purpose of this study was to calculate and compare the geographical distributions of male and female deaths from road traffic accidents in Scotland. A retrospective, nationwide study of deaths from road traffic accidents was undertaken; all road traffic deaths between 1979 and 1988 were included. Deaths were abstracted from the Annual Reports of the Registrar General for Scotland. Standardized mortality ratios (SMRs) for males and for females were calculated for 1979-83 and 1984-88. Maps showing the distributions of high SMRs (SMR greater than 135 or P less than 0.05) and low SMRs (SMR less than 65 or P less than 0.05) were prepared for males and females separately. The geographical distributions of deaths from road traffic accidents in Scotland were dissimilar to those of England and Wales. For both sexes, high mortality was predominantly in the sparsely populated regions of the north and south of Scotland; whereas low mortality was found in the cities and the populous central belt. Possible reasons for this pattern are discussed: speed, response time (both of notification of the accident and of arrival of the ambulance), distance to nearest hospital with suitable emergency facilities, and road conditions. PMID- 1767004 TI - Differences in dental caries in 5-year-old children within and between adjacent districts on the south coast of England. AB - Examination of the differences in caries patterns in 5-year-old children between adjacent English South Coast districts prompted a more specific study using larger samples in more discrete localities. Although the overall caries levels varied significantly between the two districts, no significant differences were found between two defined areas of social deprivation. The children in one area were predominantly of Indian or Pakistani background and in the other mainly white Caucasian and it is suggested that differences in caries experience are related to indicators of social deprivation, rather than ethnicity. Even in relatively affluent districts, where caries levels are no longer a general problem, the dental needs of vulnerable groups of children may remain unidentified within a more favourable overall picture, and thus unmet, unless specific areas are monitored closely taking into account indicators of social deprivation. PMID- 1767006 TI - Pedal cyclists, crash helmets and risk. AB - As a rate per million kilometres travelled, the 'risk' of cycling appears to be high in relation to other forms of transport. Yet, in absolute numbers, there are far fewer cyclist deaths than pedestrian or motor vehicle occupant deaths, and most deaths and serious injuries to pedal cyclists are caused by other road users -principally motor vehicles. The large majority of pedal cyclist deaths are due to head injuries after collision with a motor vehicle. It is therefore commonly proposed that cyclists should wear crash helmets for their own 'safety'. Helmets may protect against fall injuries, but current models are not designed to withstand the impact of collisions with motor vehicles. Evidence for the benefit of pedal cyclists wearing helmets is limited: the existing studies cannot exclude the possibility of different risk-taking behaviour, either by cyclists or by motor vehicle drivers, for helmet wearers compared with non-wearers. A public health policy towards reducing pedal cyclist deaths should seek prevention of accidents, rather than protection from their consequences. Cycling in greater safety would reduce the 'risk' per kilometre travelled, but more cycling might not reduce total cyclist deaths or injuries--because of greater exposure. The 'risk' of cycling--the risk of injury or death--is a complex mix of exposure, 'danger' of the environment, and the perceived risk affecting our precautionary preventive behaviour. PMID- 1767007 TI - The prevalence of Toxocara canis ova in soil samples from parks and gardens in the London area. AB - Toxocara canis is an ascarid parasite of the dog. Human infection is acquired when ova of T. canis are ingested. Parks and play areas contaminated with dog faeces are recognised as potential sources of infection. Five hundred and twenty one soil samples were examined from fifteen parks and gardens in the greater London area to establish the prevalence of soil contamination in those facilities. Samples were examined using a magnesium sulphate floatation method. T. canis ova were found in 6.3% of the samples. Positive samples were commonly found in lawns, playing fields and children's play areas. The authors believe that this may constitute a significant health risk, particularly to children. PMID- 1767008 TI - [Chernobyl radionuclides outside the boundaries of the USSR. The European continent]. AB - The reports on radiation sequels of Chernobyl disaster outside the country are scanty in the USSR. The present paper meets the lack, reporting the scale and the nature of the radioactive fall-outs outside the USSR. The analysis is made of possible radiological consequences of such fall-outs and the preventive measures taken by the governments of some European countries. PMID- 1767009 TI - [The cytogenetic and hematotoxic effect of cesium-137 incorporated in the rat body]. AB - The influence of incorporated 137Cs on peripheral blood cells was studied at different times after a single per os administration to rats. Moderate lymphopenia occurred in 26 days. A 30-70% increase in the number of aberrant lymphocytes was revealed throughout the entire period of observation (up to 547 days). Rats are suggested to develop a pronounced immune depression and chronic radiation sickness. PMID- 1767010 TI - [The phenomenon of adaptive response in radiobiology]. AB - Consideration is given to various adaptive reactions to low-level radiation, their association with an absorbed dose, dose rate, radiation quality and time interval between exposures, as well as with a cell cycle phase. Possible mechanisms of the adaptive response and the character and role of DNA damages, that can induce gene expression of the adaptive response, are discussed. The data on the influence of a preliminary long-term exposure to low-level radiation on the radiosensitivity of biological objects are analyzed with due regard for the adaptive cell response. It is concluded that the adaptive response of cells to ionizing radiation is a particular case of the phenomenon of cell adaptation to the effect of genotoxic factors of the environment. PMID- 1767012 TI - [Evaluation and correction of the vitamin C status in relation to the problem of the experimental modification of long-term radiation effects]. AB - A lognormal double-peak pattern of ascorbic acid content distribution within rat daily urine and the presence in the population of vitamin C hypo-, hyper-, and normally producing individuals have been established. Radiation-induced changes in the C-vitamin status of rats during their lifetime were assessed by average geometrical levels of acid excretion. A 1.5-3-fold decrease in providing vitamin C producing animals with vitamin C was demonstrated a year after intrapulmonary incorporation of 239PuO2. PMID- 1767011 TI - [The dynamics of the ornithine decarboxylase activity in chronically gamma irradiated rats]. AB - Ornithine decarboxylase activity changes in some tissues of chronically gamma irradiated rats (0.54 cGy/h). The radiation effect is a function of the life span of continuously exposed animals. The data obtained indicate that adaptation is possible, at a metabolic level, with the restricted chronic gamma-irradiation of animals. PMID- 1767013 TI - [The late effects of radiation on hematopoietic stem cells and the possibility of their modification]. AB - In experiments with mice it has been found that a radioprotective agent, mexamine (two different forms), administered prior to a whole-body single exposure at a dose of LD0/30 increases the average life of animals and the number of exoCFUs 8 days and has no influence on the number of exoCFUs 12 days. Mexamine does not modify the decrease of haemopoietic colonies in sizes in recipients, mice survived acute radiation sickness being used as donors. The share of CFUs 8 days at the stage of DNA synthesis has been shown to increase with age, as well as in animals which lived for 14 months after irradiation. PMID- 1767014 TI - [Stimulation of the post-irradiation recovery of hemopoiesis in rats using a cobalt preparation]. PMID- 1767015 TI - [The state of the erythrocyte antioxidant system during gamma irradiation following prior prolonged overheating]. AB - A study was made of the influence of preliminary long-term heating on the state of the antioxidant system of erythrocytes after gamma-irradiation. The activity of antioxidant protection enzymes (catalase, superoxide dismutase, and glutathione peroxidase) in erythrocytes varied in different directions depending on the preliminary long-term overheating schedule and perhaps on the structure and intracellular localization of the enzyme. PMID- 1767016 TI - [Increasing the radioprotective therapeutic efficacy of typhoid vaccine using sexta-anatoxin in combination with the antimetabolite methotrexate]. AB - A typhoid vaccine with sexta-anatoxin delivered to mice 4.5-5 h after gamma irradiation has a pronounced therapeutic effect: survival rate is 42% with radiation dose of 8.2 Gy (LD85/30) and 19% with radiation dose of 8.7 Gy (LD95/30). The vaccine of 2.5 and 5 mg/kg combined with methotrexate has a more pronounced therapeutic effect increasing the survival rate up to 65% (LD85/30) and up to 35-40% (LD95/30). PMID- 1767017 TI - [The effect of membrane-active compounds on the radiation-modifying effect of glucose in x-irradiated ascitic tumor cells]. AB - A study was made of the influence of membrane-active agents with different mechanisms of action (quercetin, amiloride, valinomycin, and digitonin), that modify the transmembrane transfer of inorganic ions, on a modifying effect of a glucose loading in X-irradiated Ehrlich ascites tumor cells. The combination of digitonin with glucose increased the damaging effect of radiation on tumor cells by 1.8-2.2 times as compared to glucose alone. Merely insignificant changes in the radiation-modifying effect of glucose were observed when it was combined with other membrane-active agents. PMID- 1767018 TI - [The radioprotective effect of a hypoxic respiratory mixture (8% O2) for intestinal epithelial stem cells during single and fractionated irradiation of mice]. AB - The method of intestinal "microcolonies" was used to study the radioprotective effect of a gas mixture, containing 8% of O2, on mice subjected to single and fractionated (5 fractions for 30 min) irradiation. The protective effect was indicated by a decreased slope of dose curves of the stem cell injury; the extrapolation number decreased simultaneously. So the values of dose modifying factors (DMF) were higher, when calculated by D0 ratio (where they amounted to 1.76 and 1.39 for single and fractionated exposure respectively), than those determined by equally effective doses (1.19 and 1.26 for single and fractionated effects respectively, which corresponded to LD50/4 when calculated at lg N = 1.9). It is suggested that the radiation response of certain stem cell populations of intestinal epithelium are different: this is attributed to different degrees of hypoxia in cells and to different directions of the hypoxia effects on the injury and the ability of postirradiation repair. PMID- 1767019 TI - [Chromosome mutagenesis and cytogenetic monitoring]. AB - A model of formation of radiation-induced cytogenetic damage is proposed on the basis of our own and literature data. The model postulates that localization of DNA damage and repair process play an important role in the final effect. PMID- 1767020 TI - Computer skills course integrates AIDS education. AB - Health professionals play an important role in educating the public about AIDS and HIV patient and community health education. This article describes an innovative approach incorporating AIDS education into a basic skills course covering statistical computing, computerized literature searches and modeling. PMID- 1767021 TI - Worksheets simplify use of Wisconsin Test Cassette. AB - The Wisconsin Test Cassette, long the standard for non-invasive evaluation of kilovoltage, isn't known for its simplicity or convenience during use. The author presents a computer-generated worksheet that simplifies kilovoltage accuracy checks and customizes cassettes according to calibration curve data. PMID- 1767022 TI - Radiography of patients who don't speak English. AB - Radiographic examinations of non-English speaking patients need not be difficult. This article describes a communication style of pantomime, translation and touching that radiology department staff can employ to effectively communicate with non-English speaking patients. PMID- 1767023 TI - Educating the public about AIDS. PMID- 1767024 TI - Showing acetabular trauma with more clarity, less pain. AB - Standard radiographic projections may not provide a complete diagnosis of acetabular fractures, which often are the result of an automobile accident or other injury applying severe force to the femur. The Judet oblique projection of the pelvis and a variation described by the authors reduces patient risk and discomfort while demonstrating fractures not clearly seen on routine radiographs. PMID- 1767025 TI - Dose Good Samaritan immunity continue after crisis? PMID- 1767026 TI - CRNA gives anesthesia without approval: death results. Case in point: Briggins v. Shelby Medical Center (585 So. 2d 912--AL (1991)). PMID- 1767027 TI - Must nurses perform tests not ordered? Case in point: Northeast Ala. Reg. Med. Ctr. v. Owens (584 So. 2d 1360--AL (1991)). PMID- 1767028 TI - The internist's expectation from diagnostic imaging and Doppler US in the pathophysiology of splanchnic vessels. PMID- 1767029 TI - Combined diagnostic imaging and Doppler US of portal venous system. PMID- 1767030 TI - Combined diagnostic imaging and Doppler US of large splanchnic vessels. PMID- 1767031 TI - Combined diagnostic imaging and Doppler US in renovascular hypertension. PMID- 1767032 TI - Combined diagnostic imaging and Doppler US in organ transplantation. PMID- 1767033 TI - [Uveitis, glaucoma and hemorrhage syndrome caused by hard lenses in the posterior chamber]. AB - A study was made of twelve cases with uveitis, glaucoma and hyphema (UGH) caused by rigid intraocular posterior chamber implants. Three of these patients were female and nine were males. The syndrome started in 75% of the cases two years after having been operated. The patients were followed for an average time of 42 months. Four patients responded to medical treatment. Eight patients required surgery. This syndrome is caused by the irritation and escoriation of the ciliary body at the inferior point which supports the hard lens. Serious complications arise from the removal of the lens. The author obtained good results in treating these patients with selective diathermy of the ciliary body under a scleral flap. PMID- 1767034 TI - [Development of a rehydration therapy in diarrheic disease. 1980]. AB - Intravenous rehydration is required only in patients with severe diarrhea due to V. cholerae who are in shock, with absent peripheral pulse and blood pressure; when the shock has been corrected, rehydration can be completed using an oral rehydration solution. The intravenous solution to be used is 5:4: 1 (5g of sodium chloride, 4g of sodium bicarbonate and 1g of potassium chloride per liter) or a comparable commercial alkaline solution. For oral rehydration a solution is used containing 3.5 g sodium chloride, 2.5g sodium bicarbonate, 1.5g potassium chloride and 20g of glucose (or 40g of sucrose) per liter. These fluids are administered in a volume replacing the amount lost before treatment was initiated and the fluids lost in the continuing diarrhea. With this management, a case fatality rate of 50% in the untreated falls to less than 1%. The addition of antibiotics such as tetracycline and furazolidone reduces the duration of diarrhea and the need for continuing fluid balance observation. Intravenous rehydration of severe diarrhea cases with normal saline solution or with 5% glucose solution increases the acidosis with resulting veno-constriction, which favors the pooling of blood in the heart and the pulmonary circulation leading to cardiac overload and then failure and circulatory peripheral collapse. When acidosis is corrected by the sodium bicarbonate solution and with adequate fluid replacement, normal hemodynamics are reestablished and the patient immediately recovers from the collapse. In cases of mild or moderate diarrhea, replacement entirely by oral rehydration of the estimated volume of lost fluid alone is usually sufficient. This management of diarrhea is applicable for diarrhea from any cause, including enterotoxigenic Escherichia coli, Rotavirus, Salmonella and Shigella as well as Vibrio cholerae. PMID- 1767035 TI - [Immunologic evaluation of 246 HIV patients]. AB - The authors report the results of the immunological studies carried out on 246 individuals infected with the human immunodeficiency virus (HIV) in order to compare these data with those obtained in a previous study. They demonstrate an appreciable increase in the number of women with HIV infection and the change of the major cause of infection, in men as well as in women, from transfusions to heterosexual relations with promiscuous and/or bisexual men. They emphasize the danger of HIV infection in pregnant women because of the possibility of infection in their children. PMID- 1767036 TI - [Evaluation of interleukin-2 soluble receptor in patients with trypanosomiasis americana in Panama]. AB - The quantitative determination of Interleukin-2 Receptor (sIL-2R) in the serum of patients with acute or chronic Chagas disease is compared with values found in normal individuals. The mean value of soluble IL-2R in patients with acute Chagas' disease was found to be 3,282 +/- 171 U/ml. The mean value of sIL-2R in serum samples from chronic chagasic patients was 511 +/- 207 U/ml, while in the control or "normal" group of persons the mean value for sIL-2R was 366 +/- 108 u/ml. In patients with early or acute infections with T. cruzi, the serum levels of sIL-2R was usually above 1000 u/ml. However, the correlation with anti-T. cruzi antibodies and levels of sIL-2R was not always directly proportional. Specific antibodies anti-T. cruzi in serum from chronic chagasic patients, shown at low or high levels, did not reveal a proportional correlation with serum levels of sIL-2R which tend to be significantly lower than in early or acute infections. It is considered that high values for sIL-2R are related with the parasite activity and its pathologic interaction with the host. It is possible that high levels of sIL-2R could serve as an indicator of early or acute Chagas' disease and be useful in assessment of disease conditions and response to therapy. PMID- 1767037 TI - [Normal pressure hydrocephalus]. AB - We studied the clinical records of 18 patients (11 female and 7 male), from 42-83 years old (average 66.1) who were operated for Normal Pressure Hydrocephalus. The etiology was idiopathic in 9 (50%), post-subarachnoid hemorrhage in 6 patients (33.3%), post-cerebral trauma in 2 (11.1%) and post-meningitis in 1. The patients were divided in 4 categories according to their symptoms, as follows: Group A: 9 patients (50%) with dementia, ataxia and incontinence. Group B: 1 patient (5.6%) with dementia-ataxia. Group C: 4 patients (22.2%) with ataxia and incontinence. Group D: 4 patients (22.2%) with ataxia only. 6 patients had a ventriculo peritoneal shunt, and 12 had a ventriculo-atrial shunt placed. All received a Hakim valve of low, medium or high pressure, according to the pre-op ventricular pressure. According to Stein and Langfitt scale for recovery 12 patients (66%) improved and 6 (33.3%) did not change. None was worse. There were no complications. PMID- 1767038 TI - [Ureteroscopy. Experience and results]. AB - Ureteroscopy is an Endo-urological procedure which has been practiced around the world in all teaching centers of Urology. It presents obvious advantages. Our experience has been satisfactory, not only due to the coordinated and joint work, but for the results obtained in behalf of our patients who went back to their regular activities shortly after. As all the new procedures, it has a learning curve which is given after the initial training has been acquired but its performance will give expertise, same as radiologic technology and the development of new instruments with smaller diameter and accessories which allow the easier access to ureter and lithotripsy. PMID- 1767039 TI - [Deep cerebral stimulation in the management of deafferentation pain]. AB - The authors studied the clinical records of 42 patients with deafferentation who were treated with deep brain stimulation and electrodes placed in the ventral basal complex of the thalamus and/or in the central grey matter by the stereotactic method used in the University of Toronto. They describe the selection criteria, the surgical technique used and the results obtained, including the complications and successful outcomes. This procedure is usually the only alternative for patients who have undergone diverse medical and surgical therapies, and it is not a destructive method, as are other surgical techniques. PMID- 1767040 TI - [Arteriovenous fistula of the superficial temporal artery]. AB - A case of an post-traumatic arteriovenous fistula of the right temporal superficial artery in a diabetic child is reported. In absent of a cranial fracture, the lesion was notorious for the first time, ten months after a simple head injury. The progressive increase in size and the beginning of a frequent parietal right headache were the initial symptoms and important signs. The malformation was clipped on both sides and removed completely. The diagnosis and treatment are discussed as well as the theory on the pathogenesis of the lesion. PMID- 1767041 TI - [Cholecystectomy without drainage]. AB - The authors report the results of cholecystectomies, with and without drainages performed at the Arnulfo Arias Madrid Metropolitan Medical Complex from May 1986 to May 1990. There were 150 patients in each group. The patients who were not drained (87%) were women, had fever less frequently and, on the average, for not more than 24 hours, whereas in the group with drainage more patients (54%) had fever, which lasted from one to three days. Eighty three per cent of the patients without drainage ate a regular meal within the first 24 hours after the operation and only 31% of those drained were able to do so. Forty six per cent of the patients without drainage were able to leave the hospital on the second, and 34%, on the third post operative day. Only 23% of the patients with drainage were able to leave the hospital on the third, and 35%, on the fourth post operative day. The authors conclude that drainage with cholecystectomy should be used selectively and only in patients with empyema of the gallbladder, pericholecystic abscess, perforation of the gallbladder, persisting bleeding, failure to remove the gallbladder because of severe inflammatory reaction and damage to the gallbladder bed. PMID- 1767042 TI - [Symmetric, seronegative, remittent with edema synovitis. Presentation of a case]. AB - A 67 year old female patient from the capital with acute onset of a severe symmetrical synovitis affecting the flexor digitorum tendon sheaths, wrists and hand joints with pitting edema of the dorsum of both hands is described. She was seronegative for latex test and improved with low doses of prednisone. This syndrome described previously went into complete remission although stopping therapy. PMID- 1767043 TI - [The contribution of gadolinium to the magnetic resonance diagnosis of spondylodiscitis]. AB - To determine the contribution of Gd-DTPA to the evaluation of vertebral infections 16 MR examinations with i.v. Gd-DTPA injection were performed on 12 patients with diagnosis of spondylodiscitis. All patients were examined with both SE T1- and SE T2-weighted sequences. The SE T1-weighted sequence was repeated following i.v. Gd-DTPA injection (0.1 nmol/kg). Signal intensities and visibility of the lesions were evaluated with MR. For each lesion the grade of visibility on SE T1-weighted sequence was compared with the grade of visibility on SE T2 weighted sequence. Moreover, for each study the information obtained by the combined evaluation of SE T1-weighted sequence without and with Gd-DTPA was compared with the information obtained by combined SE T1- and SE T2-weighted sequences. Gd-DTPA was useful in the evaluation of lesions of the discal space, showing in all cases an area of low signal intensity with peripheral enhancement; this finding allowed, in some cases, to differentiate mild spondylodiscitis from degenerative features. Gd-DTPA was also very useful in determining the extent of the disease: in comparison with MR study without contrast media, the combined evaluation of SE T1-weighted sequence without and with Gd-DTPA better showed the extent of the disease in 7/8 cases (88%). PMID- 1767044 TI - [Computer-assisted reporting. Experience with the use of a departmental information system]. AB - Since April 1989, a departmental information system has been working at the Radiology Dept. of Desio Hospital, Desio, Milan. The system has six work stations, connected in a local network. The Proram program (Metrika, Verona) is employed, which allows the computerized management of departmental activities. After a short description of Proram's functions and of their advantages, a special attention is paid to the reporting activity, as limited to normal reports. The latter can be made either as free or as codified and previously stored texts. The percentage of use of codified reports (49%) is evaluated on the basis of about 8,000 X-ray exams per year. Through the analysis of percentage data of codified reports, according to exam categories, previously stored reports appeared to be more frequent for inpatients and for emergency examinations (58% of overall figure). Codified reporting appeared to be proportionally less employed in the most specialized diagnostic examinations. On the whole, considerable time was saved, and the number of misprints decreased; moreover, higher language standardization was achieved. More detailed information was thus available for the clinician. PMID- 1767045 TI - [Cerebrovascular pathology. Comparison of magnetic resonance and magnetic resonance angiography]. AB - After making the visualization of the intracranial circulation possible without contrast media, the radiologist is now evaluating the diagnostic role of the different techniques of MRA. Attempts are also being made to characterize the main patterns of intracranial vascular diseases. The authors examined, with 3D TOF MRA, 40 patients presenting with 50 vascular lesions on MRI scans. Twenty of 40 patients were also studied with angiography. Seventeen aneurysms were detected, together with 3 stenoses of the cerebral arteries, 13 arteriovenous malformations, 12 dolichobasilar arteries, 3 postoperative and 2 post embolization controls. MRI was performed with a superconductive magnet (1.5 T), a dedicated coil and gradient-echo 3D TOF FT sequences. The refocused sequence for flux, FISP 3DFT, required the following parameters: TR = 0.04 s, TE = 10 ms, flip angle = 15 degrees, 256 x 256 matrix, 1 acquisition. The 64-80 mm volume along the axial plane was divided so that an actual 1-mm thickness was excited. In post processing, the maximum-intensity projection was employed on the axial plane 0 degrees-90 degrees (15 degrees interval). In the various conditions, the results obtained with MRA were correlated and compared with MRI findings. MRA provided useful additional information in 27.4% of cases in the study of aneurysms, arteriovenous malformations, vascular occlusion and dolichobasilar arteries, as well as in the follow-up of these lesions. MRA is currently suggested in the evaluation of cerebral circulation and is considered a complementary technique to MRI. MRA is also to be used preliminary to angiography. PMID- 1767046 TI - [Dynamic imaging with magnetic resonance in the diagnosis of breast disease]. AB - MR imaging was employed for the identification and tissue characterization of nodular lesions in the breast. The study had poor outcome, but the clinical introduction of a paramagnetic contrast medium, Gd-DTPA, allowed better results to be obtained. This study was aimed at evaluating the possibilities of Gd-DTPA enhanced MRI in differentiating benign from malignant breast nodules and in staging cancer. Final diagnosis was made by means of either histology, in the patients who underwent surgery, or cytology. Sixty-one patients with nodules at mammography and US were examined with MRI. The results of US, mammography, and MRI were blindly evaluated and proved that combined mammography and US, together with Gd-DTPA enhanced MRI, correctly identified all nodular lesions. Moreover, enhanced MRI allowed benign lesions to be distinguished from malignant nodules. MRI with Gd-DTPA correctly assessed both T parameter and pectoral muscle infiltration. MRI cannot replace mammography, which is a quick and inexpensive examination, but it should be performed as an adjunct in the cases of questionable radiographic and US findings and to stage breast cancer. PMID- 1767047 TI - [Imaging of the breast treated with quadrantectomy and radiotherapy. Interpretative difficulties in diagnosing asymptomatic recurrences]. AB - This study was aimed at evaluating the incidence of breast carcinoma recurrences in a group of female patients treated with QU.A.RT. July 1989 to December 1990, 111 asymptomatic patients underwent physical examination, mammography (in both cranio-caudal and 45 degrees oblique projections), and US with 7.5 and 10 MHz probes. The study population was made of patients operated between 1984 and 1989 and subsequently treated with radiotherapy. Twenty-seven cases with suspect mammographic and US findings were selected and submitted to cytology with needle biopsy under US or stereotaxic guidance. Ten of them exhibited recurrences (9%) at cytology. Of the extant 17 cases, 5 had inflammatory lesions, 1 had liponecrosis, and 11 patients presented with no pathologic cells. The interpretative difficulties of mammographic and US findings were also examined. Problems were found to be related to both correct execution of the technique due to the treatment the breast is submitted to (volumetric reduction and structural distortion) and to correct image interpretation. Therefore we conclude that the two diagnostic methods be combined for they are complementary in the early detection of breast carcinoma recurrence. PMID- 1767048 TI - [The role of computerized tomography in the diagnosis of hydatid disease]. AB - The Echinococcus granulosus disease, or hydatidosis, is endemic in Italy; it has high incidence in Sardinia, Latium and Apulia. The CT findings were examined of 120 patients with hydatid cysts in the liver, lungs, kidney, spleen, peritoneal cavity, retroperitoneal space, and spine. The smallest cyst demonstrated by CT had diameter = 1 cm; CT was also more sensitive than conventional radiology and US in demonstrating unusual localizations of hydatid cysts. CT findings alone allowed a correct diagnosis of the nature of the cyst to be made in 61.5% of cases and, when combined with immunodiagnostic tests for hydatid disease, in 94.5% of patients. Moreover, CT is essential not only for a correct treatment planning, but also during follow-up. PMID- 1767049 TI - [Current role of conventional tomography in the staging of pulmonary neoplasms. Reflections based on the comparison of tomography-magnetic resonance in 81 cases]. AB - The preoperative conventional tomographic and Magnetic Resonance images were reviewed of 81 patients affected with bronchogenic carcinoma; all patients underwent surgery 1986 to 1988. Radiological findings were compared with surgical and pathological results to evaluate the actual role of conventional tomography in the staging of bronchogenic carcinoma. MR Imaging proved to be more useful in the evaluation of mediastinal and hilar lymph nodes. As for mediastinal node status, conventional tomography had 23.5% sensitivity, 90.6% specificity, and 76.5% overall accuracy; MR Imaging had 82.3% sensitivity, 84.4% specificity, and 84% overall accuracy. As for hilar adenopathies, tomographic sensitivity, specificity and overall accuracy were 53.3%, 72.5%, and 65.4% versus 50%, 82.3% and 70.4% with MR Imaging. Tomography was slightly superior in identifying the primary tumor (97.5% versus 92.6% for MR), as well as in the demonstration of central bronchial involvement (100% for conventional tomography versus 50% for MR Imaging). Conventional tomography is useful as a complementary technique to MR Imaging in the preoperative staging of bronchogenic carcinoma when information on central bronchial involvement is needed. PMID- 1767050 TI - [Advanced carcinoma of the thoracic esophagus: CT, MR, and echo-endoscopy in the staging after chemotherapy]. AB - Thirteen patients affected with advanced epidermoid carcinoma of the thoracic esophagus were examined by means of CT, MR and endoscopic US (EUS) before and after chemotherapy. Eleven patients underwent esophagectomy and esophagogastroplasty. An intraesophageal prosthesis was positioned in 2 patients since chemotherapy had not modified tumour stage. Post-chemotherapy CT, MR and EUS parameters were compared with the corresponding pathologic findings. As for MR imaging, post-chemotherapy signal intensity variations in T1 and T2 sequences were also evaluated. MR imaging was more accurate than CT in depicting the involvement of mediastinal fatty layers, the relationships between mass and cardiovascular structures, and the cellularity. CT and MR exhibited limitations in identifying metastatic mediastinal lymph nodes, in which case EUS proved to be the most accurate technique. Both CT and MR failed to satisfactorily assess the infiltration of tracheobronchial tree, which was best demonstrated by endoscopy. PMID- 1767051 TI - [The role of computerized tomography in the study of duodenal carcinoma]. AB - Seven patients suffering from carcinoma of the lower portion of duodenum were examined by means of CT. Water was used as oral contrast medium. In all patients CT showed parietal thickening in the lesion site, with hyperdense (4 cases) or isodense (3 cases) patterns with respect to adjacent normal walls; irregularities on the inner surface were also demonstrated. CT correctly staged the tumor in 5/7 patients (70%), showing pancreatic infiltration in 5 cases--in 1 case associated with hepatic metastases--, vena caval infiltration in 1 patient, and right anterior pararenal fascia involvement in 1 case. In 2 patients the relationship between duodenal carcinoma and pancreas could not be evaluated. CT is suggested for the patients with suspected neoplastic pathologic conditions of the duodenum thanks to its capabilities of showing extraparietal lesion spread, as well as adjacent organs infiltration, adjacent vessels involvement, and distant metastases. PMID- 1767052 TI - [Is there a role for double-contrast radiology in the characterization of patients with non-ulcer dyspepsia?]. AB - Nun-ulcer dyspepsia (NUD) is a very common disorder: about 30% of subjects may suffer from this syndrome, with a subsequent increase in sanitary cost. NUD is diagnosed by means of both an accurate anamnesis and instrumental investigations like double-contrast upper gastrointestinal X-rays, endoscopy, and US of the biliary tract. Our study was aimed at evaluating the actual capabilities of double-contrast radiology in the characterization of NUD patients. One-hundred consecutive outpatients (53 males and 47 females, age range 15-84 years) with clinical symptoms of NUD were submitted to double-contrast gastric radiological examination. X-rays were performed without pharmacological hypotonicity to better depict functional disorders (i.e., impaired esophageal motility, gastroesophageal and duodenogastric reflux, gastric hypotonicity, and delayed gastric emptying) even though this prevented the though evaluation of morphological features, which are better identified by gastrointestinal endoscopy. 42% of patients, especially middle-aged ones, exhibited only functional disorders. Double-contrast X-rays might therefore be suggested as a useful investigation technique in young patients with clinical symptoms of NUD: it is capable of showing functional disorders and therefore can support upper gastrointestinal tract endoscopy in the pathophysiological characterization of NUD patients. PMID- 1767053 TI - [Percutaneous therapy of hydatid cyst of the liver with ultrasound-guided double puncture-aspiration and alcoholization]. AB - Fourteen patients (9 females, 5 males; age range: 22-80 years) with 16 univesiculated hydatid cysts of the liver (O ranging 4.2-14 cm) underwent two sessions of puncture-aspiration-alcohol injection (D-PAI) under real-time US guidance at 3-day intervals. Two patients had postoperative recurrences. One patient was pregnant (9 weeks' gestation): her cyst doubled its volume over 2 months. One patient had HBV chronic hepatitis treated by means of interferon: also in this case the cyst doubled its volume. The remaining were high-risk patients for surgery or had refused operation. At US follow-up (ranging 4-24 months) 6 cysts exhibited complete reconstitution of liver parenchyma. In the extant patients two different US patterns were observed: 1) liquid areas with detached inner membranes (4 cysts); 2) solid inhomogeneous areas (6 cysts). In these cases the volume was reduced by 50-80%. No allergic complication occurred either during or after the procedure. Two patients only were affected with vomiting and fever, which resolved in a few hours. Our results indicate D-PAI of univesiculated hydatid cysts of the liver to be an effective alternative to surgery. PMID- 1767054 TI - [Diseases detected with defecographic examination in 300 patients]. AB - Defecography is a radiological examination providing morphological details of the anorectal tract. Over almost 3 years, 300 patients were examined. The authors report on the method and the pathologic conditions they observed. The patients were seated in latero-lateral position on a radiolucent water-filled commode: lead marks were taped to define perianal skin. 150 ml of high-density barium paste were introduced into the rectum and radiographs were then acquired, at rest and during squeezing and straining. All examination phases, especially the study of dynamic evacuation, were recorded on a videotape connected to a brilliance intensifier. From their experience, the authors conclude that defecography is a valuable tool in the diagnosis and evaluation of: rectocele, occult rectal prolapse, and elevator ani tone. The technique proved less useful in the evaluation of fecal incontinence. The authors strongly suggest that the patient be previously examined by a coloproctologist. Defecography is thought to help the surgeon in the choice of therapy, together with other diagnostic procedures and with clinical history. PMID- 1767055 TI - [Magnetic resonance in the evaluation of parametrial involvement in carcinoma of the cervix uteri]. AB - Cervical carcinoma is one of the most frequent gynecologic malignancies. Its prognosis depends on both tumor volume at diagnosis and its stage. Staging accuracy is important not only for prognosis but also for optimal treatment planning. According to FIGO criteria, carcinomas without parametrial involvement (stage I and limited stage IIA disease) can be surgically treated. For more advanced stages, treatment, in most cases, consists of radiation therapy or chemotherapy alone. The authors evaluated MR accuracy in the diagnosis of parametrial involvement; to this purpose, 32 patients with histologically proven lesions were referred for MR imaging, which was performed with a 0.5 T superconductive magnet. Transverse and sagittal SE images were obtained with T2 weighting (TR 1800 ms, TE 30-100 ms); transverse and sometimes sagittal images were obtained with T1 weighting (TR 450/300 ms, TE 20/30). T1-weighted images distinguished neoplasm from cervical stroma or dense parametrial connective tissue in 40% of cases only. T2-weighted images, instead, demonstrated the difference in all cases, showing tumor as a hyperintense area in 90% of patients. Neoplastic involvement of pericervical connective tissue was diagnosed, with those sequences, on the basis of focal disruptions of the outer hypointense fibrous cervical stroma; findings were correlated with those from a previous clinical staging and in 26/32 patients with pathologic findings. MR accuracy in demonstrating parametrial involvement was 88%, sensitivity was 77% and specificity was 94%. Clinical staging accuracy in the evaluation of this parameter was 66%. In 6 cases with no surgical findings, MR confirmed extensive parametrial and vesical or rectal neoplastic involvement, as diagnosed at clinics. MR imaging, thanks to its multiplanar and multiparametric imaging capabilities is a very reliable technique in the preoperative staging of cervical carcinoma. Moreover, since clinical staging can sometimes underestimate pericervical connective spread, the higher accuracy of MR imaging can help avoid useless interventional procedures. PMID- 1767056 TI - [Comparison of iopamidol 150 and 370 with the same iodine dosage (37 g) in urography]. AB - Two different volumes of iopamidol (250 and 100 ml, respectively) containing 37.5 and 37 g of iodine in different concentrations (150 mgI/ml and 370 mgI/ml) were injected in the same time (10 minutes) with varying injection rates, to compare diagnostic effectiveness, image quality, distension of the collecting system, and influence of the better iodine concentration. Sixty patients of both sexes were randomly subdivided into two groups. Their renal function, blood pressure and pulse rate were normal. Their weight ranged 55-85 kg, not to change the distribution volume of the contrast medium. None of them had been given iodine compounds recently. Radiographs were taken 2, 5, 15, 25, and 30 minutes after the end of the injection. The image quality of nephrograms, pyelograms, bladder views and the degree of collecting system filling were evaluated by a blind study, using grading scores (0 to 3). In both groups image quality and degree of filling were satisfying; the volume of injected iopamidol had poor significance. The clinical findings confirm that, with a nonionic contrast medium, iodine concentration in the collecting system is the most important factor for image quality. PMID- 1767057 TI - [Intravascular echography in interventional vascular radiology]. AB - Intravascular US studies were performed with a 20 MHz rotating transducer mounted on a long flexible shaft in 14 patients undergoing interventional vascular procedures--i.e. percutaneous transluminal angioplasty (PTA), atherectomy with a Simpson device, and Palmaz stent placement. Intravascular US was used immediately before the procedure to assess the lesion characteristics and during and after the procedure to verify its results. In PTA, intravascular US clearly shows the fracture of the plaque, its separation from the medial layer, and the total longitudinal extension of the intimal flaps. Palmaz stents are clearly shown and their correct positioning on the arterial wall is therefore precisely evaluated. After atherectomy, intravascular US shows the changes in wall thickness and identifies the areas where more tissue needs to be removed. Intravascular US appears to be a very promising technique for monitoring and directing revascularization procedures by helping select the correct interventional procedure. The initial limitation of use of intravascular ultrasound catheters to straight arterial segments has been resolved by the development of over-the-wire catheters. Further technical development and clinical research are needed. PMID- 1767058 TI - [Radiotherapy, radiotherapy combined with surgery, radiotherapy combined with chemotherapy in the treatment of carcinoma of the pyriform sinus. A retrospective study]. AB - A rectrospective analysis was performed of the results of 104 consecutive patients with carcinoma of the pyriform sinus, who underwent radiation therapy. Thirty-four patients underwent radical surgery and postoperative radiation therapy (group 1); 36 patients received radical radiation therapy alone (group 2); neoadjuvant chemotherapy was administered prior to full-dose radiation to 20 patients (group 3); 14 patients received palliative radiation therapy (group 4). Loco-regional control and survival rates at 5 years were 60.4% and 34.3% in group 1, 23.8% and 23.8% in group 2, 17.5% and 23.8% in group 3; no patients in group 4 survived at 5 years. Patients in group 1 experienced significantly better survival and local control than those in groups 2 and 3. No differences were observed between groups 2 and 3. Loco-regional recurrence was the main cause of failure in group 2 (69.4%) and 3 (70.0%). In group 1, 20.3% of cases developed distant metastases. Overall 5-year survival rate was 23.7%, confirming the poor prognosis of this disease. These results provide further support to the need of improving prevention and early diagnosis to improve both results and outcome in patients with carcinoma of the pyriform sinus. PMID- 1767059 TI - [Conservative treatment of early breast carcinoma. Localization of the booster field]. AB - The definition of the methods for localizing the booster field used in the conservative treatment of early breast cancer is often blurred in several studies in the current literature. This paper is aimed at reporting a surgical radiological method more objective than the clinico-anamnestic one used, so far, for planning the booster field. To this purpose 33 patients underwent conservative surgery in healthy tissue and radiopaque clips were inserted at the margins of the excision cavity. The booster field as defined with clinico anamnestic standards was then simulated and later verified by a radiation therapy simulator. The clinical fields thus set up were correct in 15/33 cases. The authors discuss their results and compare them with literature data. The importance of the use of the surgical-radiological method to localize the booster field is stressed. PMID- 1767060 TI - [The use of cisplatin as radiosensitizing agent in advanced tumors of the head and neck. Randomized study]. AB - This study was aimed at assessing whether c-DDP administration immediately before radiotherapy could increase frequency and duration of objective responses, as well as survival, in patients affected with locally advanced stages of squamous carcinomas of the head and neck. All patients had already undergone two induction cycles according to the CABO schedule. Ninety-six of 108 treated patients could be evaluated. Treatment schedule consisted in: 1) randomized distribution of patients into two groups before induction chemotherapy; 2) two cycles of induction chemotherapy according to the CABO schedule in all patients; 3) radiation therapy: the patients in group A were given 5 mg/mq of i.v. cisplatin, 30-60 minutes before each session. The results from the two groups were compared and no significant differences were observed regarding objective response (82.5% in group A vs. 86% in group B), response duration and overall survival rates. Even though toxicity was higher in the patients in group A, therapeutic protocol never needed be modified. PMID- 1767061 TI - [Normal ranges of bone mineral content of the distal radius determined with single photon absorptiometry. Study of 1521 cases]. AB - The normal ranges and mathematical equations of bone mineral content (BMC), normalized to radial width (BMC/W) vs. age at the distal radius, were obtained by single photon absorptiometry (SPA), and compared in two different normal populations, one of postmenopausal females and the other of control males. The female population included 1359 postmenopausal women, aged 35 to 75 years; normal control males were 162, of the same age. The results obtained in the two groups of patients show a statistically significant (p less than 0.001) correlation between age and BMC/W, expressed in a polinomial third-degree regression. The slope of the regression curves is quite different between males and females: the mean decrement, evaluated from regression polinomial fits, results 0.5% per year for normal females, and 0.3% per year for normal males. The maximum decrement (1% per year) is observed at the mean age of 51 years, which is the average age of peri-menopausal women in our province (Ferrara). The authors believe SPA to be a simple and reliable technique in measuring peripheral bone loss rate. SPA may be useful in the diagnosis and treatment of postmenopausal women, but is not recommended in the short-term follow-up of osteoporosis. PMID- 1767062 TI - [Abdominal Doppler ultrasonography. Physical and interpretative principles]. PMID- 1767063 TI - [Computerized tomography in brain lesions caused by acute poisoning with carbon monoxide. Description of 3 cases]. PMID- 1767064 TI - [Embolization of popliteal artery aneurysm with Gianturco coils and angiographic guide wires]. PMID- 1767065 TI - [Post-traumatic pulmonary fat embolism: advantages of digital radiology]. PMID- 1767066 TI - [Duodenal lipoma]. PMID- 1767067 TI - [Arterio-portal intrahepatic pseudoaneurysm secondary to fetal trauma. Diagnostic and therapeutic considerations]. PMID- 1767068 TI - [Solitary spleen metastasis detected by ultrasonography]. PMID- 1767069 TI - [Usefulness of echography and clinical experience with complications in Crohn disease. Description of 3 cases]. PMID- 1767070 TI - [Unusual echographic features of the infantile polycystic kidney]. PMID- 1767071 TI - [Infantile abdomino-scrotal hydrocele. Role of ultrasonography]. PMID- 1767072 TI - [Non-Hodgkin's lymphoma of the kidney. Presentation of an unusual case]. PMID- 1767073 TI - [Retroperitoneal cystic lymphangioma: non-surgical therapy]. PMID- 1767074 TI - [Primary osteosarcoma in bladder diverticulum. Description of a case]. PMID- 1767075 TI - Physical modalities of therapy in pediatric rheumatic diseases. AB - The approach to rehabilitation management of childhood rheumatic disease differs in many ways from that of adult disease. Among the special considerations are the effects of chronic musculoskeletal inflammation in a growing and developing individual and the tendency of children to tighten their joints into positions of comfort, with fewer problems resulting from ligamentous laxity and instability. A comprehensive management approach includes much more than simply using medications--the tendency for the disease to exert deforming forces on the limbs must be constantly fought by a vigorous program of rehabilitation; education and psychologic support must be provided to the patient and family; potential problems must be discussed with the school; financial and vocational issues must be addressed. PMID- 1767076 TI - The immunogenetics of juvenile rheumatoid arthritis. AB - Recent major advances in understanding the genetic structure of the human leukocyte antigen (HLA) region and how HLA molecules contribute to immune responses have been paralleled by more precise identification of specific HLA genes conferring susceptibility to the various forms of juvenile rheumatoid arthritis (JRA). This article presents current models for HLA-associated autoimmune disease susceptibility and summarizes the HLA Class II alleles currently known to be associated with JRA: primarily DR8, DR5, DR6, and DPw2.1 in pauciarticular onset JRA; and DR4 in rheumatoid factor-positive polyarticular onset JRA. Rheumatoid factor-negative polyarticular onset JRA and systemic onset JRA are variously associated with several of these same genes. Gene interactions and the clinical utility of HLA typing in this disease are also discussed. PMID- 1767077 TI - Immune abnormalities in the pathogenesis of juvenile rheumatoid arthritis. AB - Juvenile rheumatoid arthritis (JRA) is the most common rheumatic disease of childhood. Although the etiology remains unknown, immunoregulatory imbalances are thought to be important in the pathogenesis of JRA. Numerous immunologic abnormalities have been described in these patients, but it remains unclear which are fundamental to the pathogenesis of the disease and which are secondary. In this article, the authors review lymphocyte and lymphokine abnormalities in children with JRA with emphasis on the possible role of these immune abnormalities in the pathogenesis of JRA. PMID- 1767078 TI - Current status of the medical treatment of children with juvenile rheumatoid arthritis. AB - Based on clinical experience and the aforementioned studies, a number of opinions can be entertained concerning the historically traditional conservative management of children with JRA. 1. Because the inflammatory changes of JRA on the bones and joints once established are irreversible in most children, there are ample theoretical reasons to start more effective therapy (if available) early. 2. Most of the currently available drugs control inflammation only partially or temporarily. 3. Most children stop taking the various SAARDS after approximately 2 years of disease because of lack of efficacy or the development of toxicity. 4. Whereas corticosteroids are the most potent and effective anti inflammatory agents, long-term use in children, even in low dosage, is severely limited, especially by their effect on growth. 5. Methotrexate appears to be the most effective of the alternative agents and much safer than expected when used in the currently recommended protocol. 6. More effective therapy must await a better understanding of the pathogenesis of JRA, although currently available medications might be used more rationally by taking into consideration available pharmacologic studies. PMID- 1767079 TI - Juvenile rheumatoid arthritis: outcome and treatment for the 1990s. AB - There has been much discontent with the hazards and the uncertain responses of patients with juvenile rheumatoid arthritis (JRA) to time-honored modalities of management. The treatment of JRA is often thought of as a pyramid with the base formed by nonsteroidal anti-inflammatory drugs, patient and family education, physical therapy, occupational therapy, and family support. Mechanisms of human disease have begun to open the gates to understanding the why and when of connective tissue diseases; they also offer the prospect of direct therapeutic intervention. In this article, the authors scrutinize the paradigms that guide our treatment strategies, review current practices, update data derived from those practices, and propose reassessment of therapy in the 1990s. PMID- 1767080 TI - Kawasaki disease. Epidemiology, late prognosis, and therapy. AB - Kawasaki disease is an immunologically mediated diffuse vasculitis of childhood of unknown etiology. While most of the clinical features--including diffuse mucosal inflammation, indurative edema, rash, and lymphadenopathy--are self limiting, coronary artery aneurysms and the possibility of thrombotic occlusion occurs in up to 20% of children. The epidemiologic and clinical features of this disease suggest an infectious etiology; however, a specific organism has not been consistently identified. An abnormal immune response to this as yet to be defined organism plays a critical role in the progression of this disease. The morbidity and mortality of this disease are related primarily to the potential cardiovascular complications. The natural history of the coronary artery aneurysms is that most lesions regress with time. Factors leading to a higher probability of regression include age less than 1 year, female sex, fusiform aneurysm, and maximum diameter less than 4 mm. Current recommendations for therapy include aspirin and IVIG. The range of dosages regimens for each medication are discussed in the text. PMID- 1767081 TI - Long-term outcome of systemic lupus erythematosus in childhood. What is the prognosis? AB - Projections of an 80% rate of 10-year survival are little comfort to the parents of a child diagnosed with systemic lupus erythematosus. Parents' hope is for a normal life expectancy. This must be the physician's goal. Although physicians cannot tell parents that systemic lupus erythematosus can be cured, they can, however, tell them that considerable progress in the management of this condition. True long-term survival measured in decades is likely for children without high-risk findings and increasingly anticipated even for those who have them. PMID- 1767082 TI - Juvenile dermatomyositis. AB - Juvenile dermatomyositis is a multisystem disease characterized by muscular inflammation affecting primarily the skin and muscle; it presents as a nonsuppurative myositis causing symmetrical weakness and typical skin rashes that affect the face and hands in particular, but can occur at any site. In the last few years, a number of reviews have been published, this article only highlights some points of interest. PMID- 1767083 TI - Facial reconstruction consideration in rheumatic diseases. AB - In conclusion, the management of facial involvement in JRA, Romberg disease, and scleroderma is dictated by the degree of severity of the disease, age of onset, and length of activity. Functional occlusal abnormalities are best addressed through a team approach consisting of initial orthodontics followed by orthognathic surgery if needed. In all types of scleroderma, surgical facial reconstruction is best delayed until the disease is quiescent for at least a year. The ideal option for facial skeletal and soft-tissue augmentation has not yet been realized. Careful surgical planning and choice of grafts, flaps, or implants are critical to obtain the desired result. PMID- 1767084 TI - Arthroplasty of the hip and knee in juvenile rheumatoid arthritis. AB - The primary reason for total hip and total knee replacement in patients with juvenile rheumatoid arthritis is marked functional impairment. Secondary reasons are severe disabling pain and deformity. By the time a patient is ready for arthroplasty, alternatives to surgery have already been considered; synovectomies, soft-tissue releases, and osteotomies have already been performed, or the destructive process is too advanced for any form of therapy to have a considerable effect. PMID- 1767085 TI - [Therapeutic advances in glomerular nephropathies]. PMID- 1767086 TI - [Nosocomial infections in an urology department: temporal tendencies of the accumulated incidence during the period 1984-1988]. AB - The yearly changes in the accumulated incidence (AI), localizations and responsible microorganisms of nosocomial infections (NI) which occurred over the period from 1984 to 1988 in the Urology Department of the Ramon y Cajal Hospital are described and a study of the seasonal tendency of such infections is carried out with data obtained from the Watch Out System by means of the annual AI rates to a ponderate regression curve. The yearly decrease in the risk of suffering a NI (expressed as the slope of the graph line) was 2.05% which was statistically significant. The most frequent localizations of NI were urinary, superficial postoperative wounds and bacteremia, representing the three of them almost 90% of the total number of infections each year. Urinary infection was the localization which presented the greatest annual decrease in risk (2.21%). Bacteremia also presented a decrease, although this was not significant. On the contrary, the risk of acquiring an infection in a superficial postoperative wound experimented during this period a significant annual increase (0.36%). E. coli, S. marcescens, and P. aeruginosa were the microorganisms most frequently isolated in NI. PMID- 1767087 TI - [Epidemiological observations on the evolutive tendency of asthma mortality in Spain]. AB - We have studied asthma mortality in Spain from 1951 to 1985, applying epidemiological descriptive methodology. A global decrease in the tendency is observed when comparing it to other countries. We have observed, however, an increased mortality in the four age groups proposed (5-19, 5-39, 40-64 and 5-64), based on previous international publications which avoid interferences with other causes of death. We have also observed that when applying the method of mortality related to natality rate, there was a decrease in mortality, specially in older generations. Finally, several hypothesis related to risk factors which would explain this tendency are presented. PMID- 1767088 TI - [Craniocervical dystonia and facial hemispasm: clinical and pharmacological characteristics of 52 patients]. AB - The results obtained in a retrospective study on clinical and pharmacological aspects of 41 patients suffering craniocervical dystonia (24 with blepharospasm, 17 with torticollis) and 11 with spasm are here presented. Mean age of symptoms onset was 57.4, 43.8 and 55.8 years old respectively; this variable was comparatively higher in females than in males with torticollis. The prevalence of blepharospasm and hemifacial spasm was higher in females. A 38.7% of patients suffering blepharospasm also presented oromandibular dystonia (Meige's syndrome). Other abnormal movements less frequently associated were cephalic tremor, postural hand tremor and larynx dystonia. In three cases with blepharospasm there was family history of Parkinson's disease and in two cases with torticollis there was family history of essential tremor. The mean age of onset was lower in patients with clonic torticollis and the evolution time of symptoms was longer than in those who presented the tonic type. Clonic torticollis were less frequently associated to pain. Trihexyphenidyl (anticholinergic) was the most efficient drug in craniocervical dystonia, and clonazepam in facial hemispasm. In general, as earliest the age of onset was, as better the therapeutical response was. PMID- 1767089 TI - [Is the biopsy of the temporal artery necessary? A study of 204 biopsies]. AB - Due to the controversy on the need of performing temporal artery biopsies for the diagnosis of giant cell arteritis (GCA), we have reviewed 204 biopsies of temporal arteries as well as the clinical histories of the 190 patients. Patients without local manifestations were excluded from this study. From the 173 remaining patients, 54 presented a diagnostic biopsy of GCA. The 119 patients with a negative biopsy were divided into different groups according to the final diagnosis. From our data we could not find a clinical pattern which could permit the prediction of biopsy positiveness. We could not find either any clinical entity in the nondiagnostic group which would permit to exclude a diagnosis before performing the biopsy. We consider that the biopsy of the temporal artery can not be avoided nowadays and that it represents the only decisive diagnostic method of GCA. PMID- 1767090 TI - [Plasma cell leukemia: our experience in 4 cases]. AB - Clinical findings and response to treatment in four cases with plasma cell leukemia (PCL) out of 152 patients of multiple myeloma diagnosed at the Hospital La Paz from 1969 to 1988 are studied. Three of the four plasma cell leukemia cases presented a primary form, and one a secondary form. Our cases had a lower incidence of lymphadenopathy and splenomegaly than reported in previous series. The incidence of serum M band in PCL was similar to that found in multiple myeloma. The four patients received combination chemotherapy; one of them attained PR lasting for 2 months, and the remaining three failed to respond to similar therapy. The mean duration of survival was less than 8 months. Current treatments are reviewed. PMID- 1767091 TI - [Pulmonary involvement in familial amyloid polyneuropathy type I]. AB - Familial amyloid polyneuropathy type 1 or Corino Andrade's disease (FAP 1) is classified amongst the hereditary systemic amyloidosis, being autosomically dominant and preferably affecting the peripheral nervous system. Our country is the fourth world focus with regard to incidence, preceded only by Portugal, Japan, and Sweden. Amyloid involvement is rare, generally following primary forms. There are only three cases described of these hereditary forms, none of which is of the FAP type 1. Our goal is to present a patient diagnosed of FAP type 1 who developed hemoptysis during the course of her disease, observing an amyloid bronchial infiltrate in the samples obtained by bronchoscopy. This is the first case described of pulmonary involvement in this type of amyloidosis according to the literature reviewed. PMID- 1767092 TI - [Experience in rationalization and use of drugs in military primary health care]. AB - We describe a pharmacologic revision program in a military primary health-care facility, following the criteria of efficacy and safety proposed in the Spanish "Pharmacological guide for primary health care". After the revision, the number of products used dropped from 133 to 63, and the monthly expenditure in medicines from 940 to 300 pesetas/person. We have also calculated the daily defined dose per 1.000 inhabitants/day (DHD) in some drugs and compared them to others previously published. Some of our DHD were higher than those of other primary health care groups. Therefore, we think that in rationalization programs on the use of medicines, the reduction of products to be prescribed is only the first part. Afterwards, DHD should be calculated, and, in case of being unjustifiably high, a revision of the indications should be undertaken. PMID- 1767093 TI - [Use of bromocriptine during pregnancy and appearance of partial empty sella turcica in women with prolactinoma]. PMID- 1767094 TI - [Cushing's syndrome secondary to nasal instillation of dexamethasone]. PMID- 1767095 TI - [Empty sella turcica associated with diabetes insipidus]. PMID- 1767096 TI - [Pathogenesis of empty sella turcica associated with diabetes]. PMID- 1767097 TI - [Cough as secondary effect of ACE inhibitors]. PMID- 1767098 TI - [Standard tuberculin test]. PMID- 1767099 TI - [Headache caused by ergotamine addiction]. PMID- 1767100 TI - [Bilateral rupture of the quadriceps tendon in uremia]. PMID- 1767101 TI - [Schonlein-Henoch purpura in a patient with hemophilia A]. PMID- 1767102 TI - [Episodic polyarthritis in a patient with severe hypogammaglobulinemia]. PMID- 1767103 TI - [Cardiovascular surgery in Spain in 1990. The registry of operations of the Spanish Society of Cardiovascular Surgery]. AB - The Spanish Society of Cardiovascular Surgery has sent a questionnaire to all 37 cardiovascular surgical groups to know the number and type of cardiovascular operations carried out in our country during 1990. The questionnaire was answered by 36 our of 37. In the year 1990, 20.806 cardiovascular patients have been operated upon and 10.065 interventions with extracorporeal circulation have been carried out: 43% in valvular disease, 37% in coronary and 11% in congenital. The number of operations was 5.541 for vascular disease, 4.364 for valvular, 3.917 for coronary, 2.019 for congenital and 4.617 for pacemaker implantation. The number of operations in 1990 is similar to the previous years. There is an increase of about 500 operations under extracorporeal circulation per year in the latest 2 years, mainly due to coronary bypass surgery. The number of vascular operations has slightly been reduced. PMID- 1767104 TI - [Ischemic cardiopathy in women]. AB - Life expectancy in western women is 8 years larger compared to men. This is due to the higher incidence of ischemic heart disease in men at least before reaching 45 years of age. This may also be due to differences in blood lipoprotein levels, differences in smoking habits, use of hormonal contraceptives, plasma iron levels, parity and other risk factors also found in men. After menopause the difference in the incidence of ischemic heart disease progressively decreases, basically because of a decrease in estrogen secretion. However, the role of estrogen supplement treatment in this group of women in the prevention of ischemic heart disease has not yet been clearly defined. The objectives of this study are to review the risk factors involved in the development of ischemic heart disease in women, the changes brought about by menopause and the possible beneficial effects of supplemental estrogens in the postmenopausal period. PMID- 1767105 TI - [The long-term results of aortocoronary bypass surgery in patients with a severe preoperative left ventricular dysfunction]. AB - We analyze retrospectively the short- and long-term results of coronary artery bypass surgery in 50 patients with severe left ventricular dysfunction operated in a period of 11 years. Sixty-six percent of patients had unstable angina and 12% of total presented angina post-acute postmyocardial infarction. Thirty-eight percent of patients were in preoperative functional class III-IV of NYHA. Three vessel disease was present in 70% of the patients, two-vessel in 30%, and the main trunk was affected in 12% of the global. Hospital mortality was 4% (2/50) due to low cardiac output syndrome. Follow-up was available in all the survivors and ranged 6 months-11 years (mean: 4.8 +/- 3.1). During follow-up, 13 patients died, but in only six was due to cardiac cause. The 35 patients followed were in functional class I-II of NYHA. Eighty-eight percent of the patients were angina free at follow-up. Actuarial analysis, after exclusion of 3 patients who died of causes no directly related to the heart, showed an intrahospital survival rates of 96%; at first year was 92, at 3rd was 78%, and 5th year survival rates were 75%. In conclusion, patients with symptomatic angina and preoperative severe left ventricular dysfunction, coronary artery bypass graft has a low hospital mortality, is effective in improving angina and heart failure, and the long-term survival is acceptable. PMID- 1767106 TI - [The cardiac anatomical and functional changes in a group of young type-1 diabetics without microangiopathy]. AB - We study 71 type I diabetics and 25 controls, trying to analyze the anatomical and functional changes due to diabetes. The diabetics, with a mean age of 18.4 +/ 8.2 years, were strictly selected excluding any disease and treatment besides insulin. In 66, and echocardiographic M mode and 2D study was done to calculate wall thickness, cavity dimensions and systolic function indexes; in all, Eco Doppler analyzing 9 diastolic function indexes. The results showed an increase in septal thickness in diabetics (p less than 0.01 in diastole and less than 0.001 in systole). There was no difference in systolic function or posterior wall thickness, having the diabetics a significant increase of the T 1/2 (p less than 0.001), a decrease of the deceleration of E and the ratio E/A (p less than 0.001). As a group, 12.5% of the diabetics had anatomical abnormalities, and 18.3% diastolic abnormalities at least in two indexes. The only significant correlation was established between the evolution time and the T 1/2 (p less than 0.01). We conclude that in this group of selected diabetics, the anatomical and functional abnormalities found were only imputable to the diabetic abnormality. PMID- 1767107 TI - [Guided coronary atherectomy: preliminary results]. AB - Coronary atherectomy implies removing atheromatous material from the diseased coronary arterial wall. This technique has emerged as an attractive alternative to conventional percutaneous transluminal coronary angioplasty procedures, in an attempt to diminish both initial procedural failure and restenosis rate. Among different technologies, the Simpson's atherotome provides a means of performing directional (i.e. selective) coronary atherectomy (DCA). This device implements a coaxial catheter which is advanced into the lesion over a steerable guidewire. Its distal tip includes a hollow metallic cylinder with a lateral window. Removal of the material is accomplished by a rotating cutter which can be moved distally, once the device's window has been orientated facing the lesion. We have performed 14 DCA in 14 patients. Mean age was 58 years and 12 patients were male. The technique was indicated for unstable angina (7 patients), stable angina (4 patients) and silent myocardial ischemia (3 patients). Fifteen lesions were attempted (13 original and two with restenosis), located as follows: nine in the left anterior descending coronary artery, three in the right coronary artery and three in the left circumflex artery. Eleven lesions were proximal and four were located in mid coronary segments. Twelve lesions (80%) were eccentric, and five (33%) were irregular. Initial angiographic success (residual stenosis less than 50%) was obtained in all 15 lesions (100%). Pre-DCA stenosis was 84 +/- 5% and post-DCA stenosis was 16 +/- 6%. There was no need for urgent coronary artery by pass surgery and no patient developed an acute myocardial infarction in relation to the procedure. A 82-year-old woman died after the procedure in cardiogenic shock.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767108 TI - [Aortic coarctation in the first 3 months of life. Surgical results]. AB - Between January 1973 and September 1989, 51 patients younger than 3 months with coarctation of the aorta underwent surgery. All of them had atrio-ventricular and ventriculo-arterial concordance with well developed ventricular cavities. Thirty four were male and 17 female. Thirty five had associated anomalies and catheterism was done in 36 before surgical correction. The surgical procedures we used were 19 subclavian plasty (Waldhausen), 13 end-to-end anastomosis, 13 Alvarez technique and three goterex parch. Twelve died (23.5%), three during surgery and the others in a period of 3 to 20 days after surgery. Eight were younger than 17 days, seven had aortic arch hypoplasia associated and six had ventricular septal defect (five with pulmonary hypertension). Other ten developed recoarctation (gradient greater than 20 mmHg) between 10 days and 8 months after first intervention (media = 3 months). Five had previously end-to-end correction (41.6%), two angioplasty with parch (66%), two Alvarez (20%) and one Waldhausen (7%). The correction of the recoarctation required surgery in 4 patients (three with angioplasty with parch and one with end to end correction), and the other six underwent angioplasty with catheter-balloon. None of the 15 patients without previous catheterism died, and neither did those who underwent surgery during the last 4 years. The associated anomalies required a second time surgery. We conclude that morbimortality is related to the aortic arch hypoplasia, pulmonary hypertension and surgery during the first 2 weeks. We recommend surgery without previous catheterism. The recoarctation is more frequent in patients with end to end correction, without an increase of the mortality. PMID- 1767109 TI - [Fixed subaortic stenosis in childhood. The surgical correction of 28 cases]. AB - Between January 1976 and December 1989, 28 patients with fixed subaortic stenosis underwent surgical correction. Twenty-one were male and seven female. The mean age when surgery was performed was 7.4 years (range 14 months to 14 years). Angiography was not done in 8 patients (28.5%). Fourteen had a subaortic stenosis due to a fibrous shelf and the other 14 to a fibromuscular one. Fifteen had associated anomalies, seven aortic stenosis, three aortic regurgitation and four mitral disturbances. Three surgical procedures were carried out: resection in 16 patients (57.1%), resection and myotomy in ten (35.7%), and resection with myectomy in two (7.1%). In 5 patients a residual stenosis was detected, one of whom required repeated surgery, and 2 other patients developed recidive of the stenosis (both required repeated surgery). Prosthetic valves (five aortic and one mitral) were inserted in 6 patients (21.4%). One of these required an aortic valve conduct. Pacemaker was placed in other 4 patients (two with prosthesis). No patient died and 20 (71.4%) are normal, nowadays, with a mean follow-up of 5.5 years. We conclude that fixed subaortic stenosis is a serious disease which requires correction at the time of diagnosis, independently of gradient. The type of surgical procedure influences in recidive. The older patients with the fibromuscular type and associated anomalies are candidates for a prosthetic valve. PMID- 1767110 TI - [Chronic cardiac insufficiency (II). Left ventricular failure with a normal ejection fraction]. PMID- 1767111 TI - [The management by medical treatment of an intracranial mycotic aneurysm in a patient with infectious endocarditis with negative blood cultures and hypertrophic myocardiopathy]. AB - A case of intracranial mycotic aneurysm due to culture-negative infective endocarditis involving a patient with hypertrophic cardiomyopathy is reported. The patient, a 22-year-old woman with no history of known prior disease, had fever, headache and focal neurologic symptoms 3 days before admission. An echocardiogram performed after admission disclosed an obstructive hypertrophic cardiomyopathy and a gross vegetation on septal leaflet of mitral valve. Cerebral angiography revealed a mycotic aneurysm involving a peripheral branch of the left middle cerebral artery. Causal agent was not identified, and empiric treatment with penicillin G and streptomycin achieved medical cure and disappearance of the aneurysm 2 weeks later. Four months after endocarditis had been cured, the patient was electively operated because of progression of mitral regurgitation. Six months later, she is asymptomatic. PMID- 1767112 TI - [A sinus of Valsalva aneurysm ruptured into the right atrium secondary to aortic endocarditis. The usefulness of transthoracic and transesophageal echocardiography]. AB - We present a case of a sinus of Valsalva aneurysm ruptured into right atrium secondary to aortic endocarditis. Early surgical procedure was indicated bases on transthoracic echocardiography. This technique demonstrated a abscess image enlarged into the right atrium and color Doppler showed a turbulent flow from aortic valve to right atrium. Cardiac surgery was performed with transesophageal echocardiography monitoring. This technique allowed anatomical and functional aortic valve evaluation and the abscess location and extension. This case shows the value of transthoracic and transesophageal color Doppler echocardiography in the diagnosis and management of patients with complications secondary to infective endocarditis. PMID- 1767113 TI - [Mitral valve aneurysm. Its diagnosis by transesophageal echocardiography]. AB - Aneurysm of the mitral valve is a rare complication of infectious endocarditis. We report a 65-years-old woman with left heart failure and mitral regurgitation secondary to a mitral valve aneurysm. The diagnosis was made by transesophageal echocardiography. PMID- 1767114 TI - [Respiratory manifestations of hemorrhagic rectocolitis]. AB - Several respiratory complications have been described in patients with ulcerative colitis (UC), and are the subject of this review. Involvement of the bronchial tree is the most frequent of them. Chronic bronchitis (16 patients) and bilateral bronchiectasis (16 patients) are responsible for chronic disabling bronchial suppuration. Symptoms related to the bronchial disease most often develop in patients in whom the diagnosis of ulcerative colitis is already established (88% of cases). Occurrence before the diagnosis of UC is possible, but unusual. Bronchial involvement can develop in patients whose UC is in complete remission, or who have undergone coloproctectomy up to several years earlier. Impressive improvement of cough and sputum production commonly occur following inhaled steroids. This is of great diagnostic and therapeutic significance. Other complications include subacute asphyxiating tracheal obstruction due to intralumenal inflammatory overgrowth (1 patient), small airways disease and panbronchiolitis (2 patients), BOOP (4 patients), pulmonary angiitis (6 patients), desquamative interstitial pneumonitis and granulomatosis (2 and 3 patients respectively), biapical pulmonary infiltrates (2 patients) and serositis. In addition, UC patients can develop less specific pulmonary problems such as pulmonary edema, pulmonary embolism and sulfasalazopyridine-induced pneumonitis and fibrosis. PMID- 1767115 TI - [Management and follow-up of asthma patients]. AB - The reasons for the good management of asthma are explained and the underlying factors for the poor observance of their disease by patients and/or inadequate prescriptions are discussed. The author recalls the principal objectives of management and in passing mentions those necessary demands to guarantee successful management. These demands are: 1) a good relationship between the medical team, the patient and the family 2) the information and education of the patient and his family, which should dwell on a) the disease b) precipitating factors c) subjective factors without forgetting the equivalents of crises d) therapeutic methods and their correct usage stressing the importance of teaching good aerosol technique e) the potential progress of the disease. Benefit will flow from the education of the patients so that they will automatically take their medication in a better understood fashion and will assume their responsibilities more consistently, and the therapy will be controlled and readjusted by the medical team. 3) a good appreciation of the severity of the asthma and also of the degree of importance of any impending crisis. 4) This type of follow up of the asthmatic implies that the responsibility is not only that of the doctor but of the patient too. 5) A healthy system with quality assurance a) a good medical and paramedical team b) good accessibility to health care c) structures of health care within and without hospital which are sufficient both in quantity and quality d) a good public information service. The assessment of studies based on shared care of patients has shown an improvement in well being vis a vis their disorder.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767116 TI - [Mediastinal lymphatic spread of bronchopulmonary cancer]. AB - The mediastinum may be divided into 4 zones divided by the tracheo-bronchial axis in which are situated the lymphatic chains involved in the lymphatic drainage of the lungs. In the upper right zone there are 2 chains which are frequently involved, the right paratracheal chain (PTD) and the tracho-oesophageal chain (TO) and 2 lymphatic chains which are less often involved, the superior right phrenic chain (PH Dt) and the lymphatic chain which crosses the Azygos vein (AZM). In the superior left zone are found 2 chains which are frequently infiltrated: The pre-aortic carotid chain (AO) and the left superior bronchial chain (BSG) and 2 chains which are more rarely involved: The left superior phrenic (PHG) and the chain which crosses the aorta (the minor aorta Azygos; AOmi). At the level of the right and left inferior zones are found important groups of lymphatic ganglia at the intratracheo-bronchial bifurcation (ITB) and of one other part of the tracheo-oesophageal axis, the juxta-oesophageal ganglia (OE) and those of the triangular ligament (LT). The lymph coming from the pulmonary segments crosses the ganglia (LN) of the segments of the lobe and of the hilum before reaching the mediastinum and then at the final stage the lymph nodes situated on the margins of the mediastinum considered as N3 in cancer assessment. This schema is not the rule. In less than 5% of cases the lymph may drain without any lymph node relay either to the subclavicular hollow or to the thoracic duct in the mediastinum. More frequently (in 20-35% cases according to the segment considered) the lymph returns directly to the mediastinum ganglia without relaying through the intrapulmonary ganglia. Finally there are those cases where only the perilobar LN are involved. In these cases it is not necessarily the LN of the lobe drained but sometimes of another pulmonary lobe. These direct paths (N2) confirmed in study of cancer, demand and justify the need for a systematic cure of mediastinal LN. It is equally important to achieve a cure in the remaining lobes in the case of a lobectomy and not to fail to recognise an N1 state.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1767117 TI - [Percutaneous parietal pleurectomy using video-endoscopy. Modern treatment of spontaneous recurrent pneumothorax]. AB - The best prevention of recurrent spontaneous pneumothorax is obtained with a parietal pleurectomy, the recurrence rate being below 0.5%. The sequelae on the muscles and the aesthetic result of a thoracotomy favour a pleurodesis using a closed chest technique. Video-endoscopy enables us to perform 16 percutaneous parietal pleurectomies (PPP) without thoracotomy in 14 patients. 11 cases were idiopathic spontaneous recurrent pneumothoraces and in 3 cases the recurrent pneumothorax occurred in patients suffering from AIDS with progressive pulmonary lesions. PPP was performed under general anaesthetic with selective intubation. The posterior incision of 2-3 cm did not involve any muscular section and the dissection was performed throughout using video-endoscopy which enabled perfect control of haemostasis. PPP achieves a sub-total pleurectomy. The hospital stay was on average for five days. Those operated on did not suffer from immediate post operative pain and shoulder mobility was excellent from the moment at which the patient awoke. The advantages of PPP are: perfect haemostasis and the absence of muscular sequelae or unpleasant aesthetic sequelae. These benefits now make us consider that percutaneous parietal pleurectomy may be the treatment of choice in spontaneous recurrent pneumothoraces. PMID- 1767118 TI - [Skin sensitivity to respiratory allergens in agricultural workers and wage earners]. AB - Prick tests were performed with "pneumallergerns" (mites, cereal dusts, animal dander, pollens, moulds--totalling 35 allergens) among 742 agricultural workers of the Meuse department (North East of France) as part of an epidemiological study on respiratory and immuno-allergological problems. Among those with positive skin tests, 47.9% had positive skin tests for mites, 22.4% for cereal dusts, 10.7% for animals, 12.7% for pollens and 7.8% for moulds. Polysensitization was frequent (19.5% of the population). When the skin test was positive for main house dust mites it frequently was positive for storage mites, too. Among vegetal dusts sensitization, soy bean allergy yielded the highest frequency (6.5%). As for animal sensitization, cow dander was the most frequently observed positive test. Sensitization to pollens and moulds was comparatively rare. This study shows the large frequency and diversity of "latent allergy" to pneumallergens among agricultural workers. PMID- 1767119 TI - [260 cases of tuberculosis death at the Institute of Pneumophysiology of Bucharest 1976-1985]. AB - The case notes of all deaths due to tuberculosis registered at the Institute of Pneumophysiology at Bucharest have been reviewed. Out of 273 patients registered, the diagnosis of tuberculosis was retrospectively confirmed 260 times on either bacteriology or histology and was not confirmed by analysis of the medical notes on 13 cases. Of the 260 cases (70% males) the ages range from 18 to 75. There was 95 new cases of tuberculosis, 68 were relapses and on 97 occasions it was chronic form. Resistant bacilli were isolated 79 times (63%). Intolerance to treatment was noted in 95 patients (36%) and an incomplete treatment occurred in 84 patients (32%). The death occurred before treatment could be instituted in 33 patients. Tuberculosis was multicavitatory in 192 cases (74%), was bilateral in 214 cases (82%). From the last admission on 140 patients whose bacteriology was available for studies 112 (80%) were positive on direct examination. Compared to another enquiry carried out in Bucarest between 1961 and 1968 on 350 deaths due to tuberculosis, it appeared that the patients in the more recent period were suffering from a more severe form of tuberculosis. The above facts witness the efforts made in Rumania to achieve an early diagnosis and treatment in the management of tuberculosis. PMID- 1767120 TI - [Prolonged mechanical nasal ventilation. Apropos of 27 case of myopathy]. AB - We report the results of a retrospective study of a group of 27 patients with a myopathy who were ventilated at home using a nasal mask over a period of 5 years. Twelve patients were ventilated in a preventive fashion before any orthopaedic surgical intervention and 15 out of necessity because of respiratory failure and/or hypercapnia. There was a statistically significant improvement in the PaO2 while the PaCO2 remained stable. The vital capacity (CV) was unaltered. Side effects were relatively frequent but did not lead to this method of ventilation being stopped. One patient died from a very advanced cardio-myopathy after having stopped his own assisted ventilation. Another patient died at home of bronchial congestion. One patient had a tracheotomy after 3 years of ventilation. The treatment was judged overall as positive amongst the 19 patients who responded to a questionnaire anonymously. We are able to confirm the efficacy of this mode of ventilation by the nasal route as much therapeutically as prophylactically, which is against the recently reported results in a multi-centre study. PMID- 1767121 TI - [Wegener's granulomatosis. Therapeutic indications and follow-up course. Apropos of 5 cases]. AB - Five cases of Wegener's granulomatosis treated with cyclophosphamide (CPM) and prednisolone are reported. Four of these patients received intermittent intravenous boluses of cyclophosphamide with the aim of improving the prognosis and renal function and at the same time to attenuate any haematological or vesical toxicity of CPM. The initial response to treatment by boluses of CPM was favourable in all cases but three patients presented with relapses, which were sometimes repeated and boluses of CPM did not enable a remission to be maintained at the time. Recourse to continuous oral therapy in place of bolus therapy proved viable for the maintenance of remission in two cases. The bladder and haematological tolerance to the bolus was satisfactory but an episode of severe neutropenia led to an adaptation of the dose of CPM. The intermittent administration above all the low cumulative dose of CPM obtained with the boluses will explain the better vesical and haematological tolerance observed depending on the capacity to maintain a prolonged remission. The indications for boluses of CPM in the treatment of Wegener's granulomatosis remain uncertain and do not seem to be totally without inconvenience. PMID- 1767122 TI - [Pulmonary histoplasmosis due to Histoplasma capsulatum. A case]. AB - The authors report a case of benign multinodular pulmonary histoplasmosis, occurring in a 65 year old woman coming back from Guatemala. The disease presented with both fever and cough. The diagnosis was made on a lung biopsy (by thoracotomy) that showed granulomas with giant cells, lymphocytes and central necrosis, and histoplasma capsulatum yeasts on Gomori Grocott coloration. The authors recall the main radiological forms of the disease, and the difficulties of the diagnosis. When not disseminated, histoplasmosis usually has a good prognosis and does not require any treatment. PMID- 1767123 TI - [Pleural and subsequent peritoneal effusions of pancreatic origin. Pleural talc treatment as a cause?]. AB - A new case is described of a recurrent pleural effusion during the course of chronic pancreatitis. The diagnosis of the effusion was not established and a pleural talcage was performed. The pleurisy did not recur but a peritoneal effusion subsequently appeared. The potential responsibility of the pleural talcage was discussed. PMID- 1767124 TI - [Pleuro-pericardial cyst in children]. AB - We report the case of 3 1/2 year old child presenting a left pleuropericarditic cyst causing febrile cough and an opacity of the left lower lobe of the lung. We underline the importance of computed tomography of the thorax allows differential diagnosis with encysted effusion. Surgical treatment rarely indicated in pleuropericarditic cysts has stopped respiratory symptoms. PMID- 1767125 TI - [Bilateral diaphragmatic paralysis, the cause of acute insufficiency in chronic obstructive bronchopathy. The value of nasal mechanical ventilation]. AB - A 57 year old man with chronic bronchitis sought a consultation for dyspnoea at rest associated with an absolute inability to lie flat. Examination revealed paradoxical respiration and respiratory function testing revealed a mixed ventilation disturbance, which was predominantly obstructive and was aggravated in the dorsal decubitus position. Radiology revealed bilateral diaphragmatic paralysis, which was confirmed on measurement of transdiaphragmatic pressure. The patient benefited from assisted ventilation by the nasal route with an excellent result in both the short and the medium term. Investigation into the cause was negative, in particular there was no evidence of any neuromuscular abnormality. This case recalls the role of the diaphragm in acute respiratory failure and shows the value of mechanical ventilation by the nasal route in the treatment of certain types of diaphragmatic paralysis. PMID- 1767126 TI - [An unusual miliary pattern]. AB - Syndromes presenting with interstitial radiological signs are often difficult to diagnose aetiologically. Surgical biopsy prevents certain rare cases being neglected notably when there are atypical manifestations. We describe a case of bronchiolitis obliterans with an organising pneumonia which was classical as regards the histology and its response to treatment but unusual as regards the clinical presentation and the aetiology. PMID- 1767127 TI - [Mediastinal tumors and costo-vertebral groove]. PMID- 1767128 TI - [Rehabilitation in the former GDR]. AB - Basic lines of rehabilitation in the former GDR are described, stating the legal bases. It is shown how connected functioning of rehabilitation measures (medical, educational, occupational, social) was made possible by organisational structures on the regional level (local rehabilitation commissions, local rehabilitation centres) and by the responsibility of all levels of society including employing establishments. Difficulties are mentioned which resulted from political and ideological points of view (non-educable children and adolescents, e.g.) and inadequate financial and material resources. PMID- 1767129 TI - [Adaptation and quality assurance of rehabilitation in all federal states- outline of a challenge]. AB - Though based on a uniform definition of rehabilitation, the rehabilitation services provided and the rehabilitative procedures applied have taken very different courses of development in the old and new states of the Federal Republic of Germany. Taking into account the varying approaches, considerations are presented in view of optimized rehabilitation in the Federal states, old and new. PMID- 1767130 TI - [Rehabilitation from a socio-epidemiological viewpoint--what should and what must be changed?]. AB - Rehabilitation, along with curative treatment and prevention, is a function within a social system of comprehensive measures and services aimed at the maintenance and restoration of good health. Rehabilitation at the same time, however, is a task assigned to specific social service administrations within the structured system of social security. This entails deficits in the effectiveness and efficiency of rehabilitation measures. A working group on "reorientation in health care" has developed proposals for reducing these deficits, bearing reference, in its proposals, to the course of chronic diseases and pointing out the measures that would, in the various disease stages, be capable of securing care continuity as well as of improving the quality of care. Key factors involved are the rehabilitation competence of the primary-care physicians, as well as the competencies of patients themselves. PMID- 1767131 TI - [In memory of Drs. Berta and Karel Bobath]. PMID- 1767132 TI - [Supplemental remarks on the concept paper "Vocational rehabilitation of mentally handicapped" of the Labor Committee "Professional and occupational handicapped" of the German Society for the Rehabilitation of Handicapped" printed in "Instructions for Counseling Services..." No.9, Issue 3 (1991) of this journal]. PMID- 1767133 TI - Polycystic kidney disease. PMID- 1767134 TI - The genetics of cystic diseases of the kidney. PMID- 1767135 TI - Understanding human cystic disease through experimental models. PMID- 1767136 TI - Inherited polycystic kidney disease in children. PMID- 1767137 TI - Renal manifestations: complication management and long-term outcome of autosomal dominant polycystic kidney disease. PMID- 1767138 TI - Pathogenesis of hypertension in autosomal dominant polycystic kidney disease. AB - Autosomal dominant polycystic kidney disease is a common (approximately 1 in 400 individuals in the United States) inherited disorder, in which hypertension is the most often associated disorder. Although the development of hypertension originates with expansion of renal cysts, it most likely has its pathogenesis in the renal vasculature. Evidence is now accumulating that the renin-angiotensin aldosterone system is important in the development and maintenance of hypertension in this disorder. End-organ damage including left ventricular hypertrophy and progressive renal insufficiency appear to be related to the presence of hypertension in ADPKD. A focus on early detection and adequate control of hypertension in ADPKD, therefore, may be associated with improved cardiovascular and renal outcomes as well as increased patient survival in ADPKD. PMID- 1767139 TI - Extrarenal manifestations of autosomal dominant polycystic kidney disease. PMID- 1767140 TI - Acquired cystic disease: mechanisms and manifestations. PMID- 1767141 TI - Patients' perceptions of nursing practice. A rationale for a qualitative research approach. AB - The discipline of nursing is, in Sweden, in the early stages of discovering and expanding specific knowledge embedded in nursing practice. This is a challenging as well as a problematic venture. It is important to evaluate nursing practice within the specific cultural context before applying terminology and meaning of concepts used. The purpose of this paper is to present a basis for the study of perceptions of nursing practice as experienced by the patient himself in a specific cultural context. The historical context, the terminology commonly used, and relevant research in this domain of inquiry is critically examined as a means of determining appropriate research methods for further study in the domain of nursing practice. PMID- 1767142 TI - The fine balancing act of managing diabetes. AB - A major problem for people with insulin-dependent diabetes mellitus is to manage their self-care satisfactorily while living a normal life. This paper deals with the management of diabetes from the perspective of people with diabetes. It is based on the analysis of qualitative data, collected by means of informal interviews. This analysis made it apparent that the entire life of most people with diabetes is dominated not only by the fact that they have to maintain a metabolic balance but also that they have to find an equilibrium in their relationships with others. Walking a fine line was the data-based core category, which analysis of the data singled out as being the most important for the understanding of the meaning and the management of diabetes. PMID- 1767143 TI - The development of a measure of job satisfaction for use in evaluating change in the system of care delivery. AB - The aim of the study was to produce a reliable, valid measure of job satisfaction in order to monitor the effect of a change in the method of care delivery. Principal components analysis of questionnaire responses by 121 nurses yielded two scales labelled "Intrinsic Job Satisfaction" and "Patient Focus". Cronbach's alpha was 0.88 and 0.82 respectively. Further analyses revealed significant differences in scores on both scales for different grades of staff and significant differences in scores on "Patient Focus" for nurses working in different specialties. Significant increases in scores on both scales were found for registered nurses following changes in organisation on a surgical ward. This increase was maintained over time. For enrolled nurses an increase in "Intrinsic Job Satisfaction" was less well maintained and no differences were found over time on "Patient Focus". The two scales are reliable and sufficiently sensitive to monitor the relationship between job satisfaction and system of care delivery for different grades of staff working in different specialties. PMID- 1767144 TI - The oldest old: patterns of adjustment and life experiences. AB - A qualitative method was used to study the life experiences and the adjustment to very old age of a non-institutionalized population of 129 85-year-olds living in Gothenburg, Sweden. In-depth interviews were analyzed and categorized and seven patterns of adjustment emerged: Self-Realizing, Mature Aging, Adapting, Dependent, Resignedly Accepting, Despairing and Withdrawing. Additionally, a coping strategy--ritualization of time and occupations--was revealed in the interviews. These results reflect the heterogeneity among this age group and indicate that the subjective reality should be seriously considered both in further research and in the care of the elderly. PMID- 1767145 TI - Family dynamics and infant temperament in urban Iceland. AB - Pregnancy is a time of transition and crisis when many families are challenged with the addition of an infant. Studies of this challenge are unknown for Icelandic families. The purpose of this study was to investigate the effects of pregnancy and the young infant on family dynamics and the relationship between family dynamics and the infant's developing temperament. Fifty families completed the Family Dynamics Measure during the third trimester of pregnancy and when the infant was eight months old. Mothers also completed the Revised Infant Temperament Questionnaire. Mothers perceived a decrease in role reciprocity across this transition. More stable organized families had more rhythmic infants. There was no association between family structure and either family dynamics or infant temperament. After the birth of the child, fathers perceived more role reciprocity while mothers perceived more individuation and mutuality. Mothers of second infants reported greater individuation than mothers with first infants. PMID- 1767146 TI - [Still's disease in adults]. AB - Retrospective case series for the last five years have focussed the attention of the authors on some clinical and biological patterns of adult onset Still's disease. Its diagnosis is made difficult because of the great diversity of clinical and biological signs. Organ failures complicate sometimes the disease, and may be fatal. Major high levels of plasma ferritin associated with an haemophagocytic syndrome occur in 20 percent of the acute cases: this association could eventually respond well to an immunodepressive therapy. PMID- 1767147 TI - [Non-neoplastic hypercoagulability states]. AB - Patients with proven recurrent venous or arterial thrombosis should be investigated for a predisposing cause corresponding to a hypercoagulable state. The latter is made up of two broad categories: the first consists of inherited thrombotic disorders; the second of a heterogeneous array of acquired clinical disorders, some of which are illustrated by clinical reports encountered in our department of internal medicine. Although the development and application of specific tests have provided valuable information about the pathogenesis of intravascular thromboses, these assays are currently able to provide aetiological diagnoses in fewer than 20 percent of young patients with recurrent venous thromboembolism. PMID- 1767148 TI - [Behcet's disease]. AB - The different clinical aspects of Behcet disease are reviewed. This systemic disease is related to vasculitis involving small vessels. New diagnostic criteria have been established and new therapeutic approaches can be applied. PMID- 1767149 TI - [Polydactyly]. AB - Polydactyly is one of the hand's most frequent congenital deformities. Classification of this deformity distinguishes radial or thumb duplication, central duplication that is almost constantly associated with syndactyly (called polysyndactyly) and ulnar duplication. The latter is important especially in caucasian people because it can be part of a syndrome. Surgical techniques are briefly mentioned for the different forms. PMID- 1767150 TI - [Chronic abdominal pain. Diagnosis: peritoneal mesothelioma]. PMID- 1767151 TI - [Spinocellular epithelioma]. PMID- 1767152 TI - [Current aspects in locomotor pathology: specialized podiatry consultation. II: Significance and therapeutic results]. PMID- 1767153 TI - [Independent observations on the imputability of accidents in the medico-legal evaluation of nervous depression]. PMID- 1767154 TI - [The toxicity of aluminum]. PMID- 1767155 TI - [The surgical treatment of superficial thrombophlebitis]. PMID- 1767156 TI - [The surgical treatment of deep venous thrombosis]. PMID- 1767157 TI - [Surgical treatment of chronic venous insufficiency]. PMID- 1767158 TI - [Milwaukee shoulder syndrome]. PMID- 1767159 TI - [Asthma, allergy, current aspects. Tachykinins: clinical and therapeutic implications. Report of the 3A of 22 June 1991]. PMID- 1767160 TI - [Psychiatric medley or post-congressional black humor]. PMID- 1767161 TI - [Haemorheology and gynecology-obstetrics. 1st international meeting, Geneva, October 5-6, 1990]. PMID- 1767162 TI - [Hemorrheology, microcirculation and oxygenation. Physiopathological and therapeutic aspects]. AB - The oxygen transport chain in mammalians depends on adequate oxygen uptake, oxygen transport and oxygen delivery. In diseases with underlying perfusion disorders, for example chronic occlusive arterial disease, the oxygen uptake by the lungs is not altered and thus the oxygen saturation of arterial blood is normal. In this case however the reduced blood flow does impair the oxygen transport to tissue. Blood flow depends on several factors. In diseases with low flow states, the flow properties of blood play a major role because the viscosity of blood increases in the sense of a vicious circle at low flow rates. Since the hematocrit is one of the determining factors of blood viscosity, one possibility to improve microcirculatory blood flow is to decrease the hematocrit value. The problem is however to reach a hematocrit range whereby the viscosity of blood is markedly improved but without reduction in the oxygen transport capacity. Other methods to increase microcirculatory blood flow at constant hematocrit values are the improvement of red cell deformability and the reduction of erythrocyte aggregation. All these methods are nowadays used in a number of diseases, in which a "hyperviscosity syndrome" is present. In general, an improvement of hemorheological factors like blood and plasma viscosity, erythrocyte deformability and erythrocyte aggregation will improve microcirculatory flow and enhance oxygen supply to tissue. PMID- 1767163 TI - [Influence of sex hormones on hemorrheology and plasma proteins during the menstrual cycle]. AB - Our study was undertaken to verify the relation among sex hormone profile, hemorheologic pattern, blood lipids and plasma proteins throughout the menstrual cycle. In effect, the estrogenic activity has been related to blood hypercoagulability, thromboembolic disorders and to cardiovascular complications in normal women and in several diseases. The protocol study concerns 15 healthy young women (mean age 25 years), with normal body weight, investigated on day 7 (follicular phase), day 14 (ovulatory phase), and days 21, 25, 27 (mid-and late luteal phase) of menstrual cycle. We evaluated: blood, plasma and serum viscosity (at shear-rate of 450; 90; 4.5; 2.25 s-1), erythrocyte deformability, haematocrit, plasma fibrinogen and fibronectin, apolipoprotein A-A1-B, triglycerides, total-HDL and LDL-cholesterol, FSH, LH, 17-beta-estradiol, progesterone, testosterone, androstenedione, DHEA, DHEA-sulfate and the estradiol/progesterone ratio (E2/P ratio). Higher blood, serum and plasma viscosity (p less than 0.01), and lower erythrocyte deformability (p less than 0.01) were demonstrated during follicular and ovulatory phase, than in mid- and late luteal phases of menstrual cycle. Plasma fibrinogen (p less than 0.01) and fibronectin (p less than 0.001) were also significantly increased in ovulatory and follicular phases; whereas haematocrit, blood lipids and apolipoproteins remained unchanged throughout the menstrual cycle. Positive correlations among E2/P ratio, plasma viscosity, fibrinogen and fibronectin, and negative correlations between E2/P ratio and erythrocyte deformability, were found on day 21 (p less than 0.05) and day 25 (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767164 TI - [Hemorrheological modifications during normal pregnancy]. AB - To investigate whole blood viscosity and its determinants during normal pregnancy we measured the changes in haematocrit, red cell aggregation, plasma viscosity and whole blood viscosity in 24 women during the course of their normal pregnancy. Red cell aggregation was measured by means of a syllectometer, plasma and whole blood viscosity by means of a Contraves LS 30 rotational viscometer. Red cell aggregation was found to increase during the whole course of normal pregnancy in spite of the physiological haemodilution. This increase could be attributed--to a great extent--to the increase in fibrinogen concentration during pregnancy. Plasma viscosity increased during the second and especially the third trimester of normal pregnancy, after a small decrease during the first trimester. Plasma viscosity represents a balance between the rising fibrinogen and the falling serum protein concentration. During normal pregnancy we found a decrease in whole blood viscosity at all shear rates until the 30th week, followed by a smaller increase between 30 and 37 weeks. The changes in whole blood viscosity were largely determined by the changes in haematocrit and to a smaller extent by the changes in plasma viscosity. The influence of plasma viscosity on the resulting whole blood viscosity increased at higher shear rates. At lower shear rates haematocrit was the most important determinant of whole blood viscosity. We did not find any influence of the increase in red cell aggregation on low shear blood viscosity as measured in a rotational viscometer. In our opinion the decrease in haematocrit during normal pregnancy not only compensates for the enhanced red cell aggregation, but even diminishes the resistance to flow in the intervillous space.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767165 TI - [Hemorrheological parameters during normal labor and uterine contraction]. AB - Considering the modified fluidity of blood during numerous kind of stress, the authors studied blood rheology during delivery as an example of a particularly severe stress. The authors measured blood and plasma viscosity and erythrocyte aggregation in 77 pregnant at the following stages of delivery: below 4 cm dilatation; more than 4 cm dilatation; during fetus expulsion, during after birth delivery. Apparent blood viscosity and viscosity adjusted to 45% hematocrit rose to reach a peak during expulsion (p less than 0.01) then to become normal again during placenta delivery (p less than 0.01). Hematocrit and plasmatic viscosity showed no changes during labour and expulsion. In addition erythrocyte aggregation was lowering during expulsion and delivery (stage with physiological defibrination). Rising blood viscosity might be explained by a red blood cell rigidification measured by the increasing of "Tk" (p less than 0.01) and by a nonsignificant increase of the filterability index measured by hemorheometer. In conclusion, delivery is accompanied by a blood hyperviscosity essentially related to a transient red blood cell rigidification. PMID- 1767166 TI - [Hemorrheological characteristics of fetal blood drawn in utero from the cord]. AB - Extensive studies of hemorheology of cord blood (drawn just after delivery) have evidentiated a peculiar rheological pattern: less filterable red cells, reduced erythrocyte aggregation, lowered plasma viscosity. This pattern has been suggested to be important for maintaining a sufficient O2 supply to fetal tissues, by avoiding hyperviscosity despite increased RBC rigidity. However, cord blood at birth is not exactly fetal blood and we are not yet aware of studies of fetal blood drawn in utero several weeks before delivery. For this reason, we investigated the rheological properties of fetal blood during intrauterine cord venepunctures in 27 pregnant women (25-30 week's gestation) who were explored for detection of fetal genetic or infectious diseases. Fetuses have lower plasma viscosity (p less than 0.001), lower RBC flexibility (measured by filterability on the Hemorheometre) (p less than 0.01) and higher hematocrit/viscosity ratio (p less than 0.01) than their mothers. While no temporal modification during the studied period (20-40 wk) was detected for hematocrit and plasma viscosity, RBC filterability (rigidity) seems to exhibit a 'U shaped curve' with a nadir between 25 and 30 weeks. This pilot study supports the hypothesis that the previously reported rheological properties of cord blood at birth reflect to some extent those of intra-uterine fetal blood. PMID- 1767167 TI - [Physiopathological elements of pre-eclampsia and the role of the main complementary tests]. AB - The origin of pre-eclampsia lies in uteroplacental ischemia due to an anomaly of the "vascular insertion" of the placenta. Although the cause of this anomaly remains unknown, it would appear to include both a genetic and an immunological origin possibly favourised by special underlying conditions and certain obstetric circumstances. Prostaglandin imbalance (in particular prostacyclins and Thromboxane A2) appears to be one of the chief factors governing these anomalies. One of the consequences of these mechanisms is the onset of hypertension but other disturbances are essential features. In particular, disseminated intravascular coagulation may occur leading to the release of numerous microthrombi which cause placental (leading to chronic fetal distress), renal, hepatic and cerebral lesions. PMID- 1767168 TI - [Correlation between the results of Doppler velocimetry with spectral analysis and the viscosity of cord blood]. AB - The contribution of rheological factors to be impedance of blood flow in the umbilical artery as determined by continuous wave Doppler ultrasound was investigated. Of the 51 pregnancies recruited, six were complicated by pre eclampsia, 10 by intrauterine growth retardation, 15 by both pre-eclampsia and fetal growth retardation, and there were 20 controls. A significant correlation was demonstrated between both plasma viscosity and gestational age and the resistance index used to characterize the Doppler waveform. Multiple regression analysis demonstrated that changes in plasma viscosity explained 55 p. cent of the variance seen in the resistance index and that this was statistically significant. This finding is, however, unlikely to be of clinical significance as whole blood viscosity had an insignificant effect on the impedance in the umbilical artery. We postulate that vascular factors such as the number and calibre of the placenta arterioles are a more important determinant of umbilical artery impedance. PMID- 1767169 TI - [Venous blood flow in the lower limbs during pregnancy]. AB - From the standpoint of vascular mechanics, the distribution of total circulating blood volume, increased during pregnancy occurs to the advantage of the uterine circulation and the detriment of the venous circulation of the lower limbs. Varicose veins, often found in the legs, are due to compression by the pregnant uterus and changes in hormonal secretions. Many clinical findings still remain unexplained. PMID- 1767170 TI - [Venous insufficiency of the lower limbs in pregnancy]. AB - Pregnancy is a circumstance which may trigger, reveal or aggravate venous insufficiency of the legs. This association (venous insufficiency and pregnancy) is characterized by the rapidity of the onset and aggravation of the signs and by the spectacular nature of the regression which can occur after childbirth. The treatments administered during pregnancy are intended to control the symptoms and prevent complications. After childbirth, a phlebological assessment is carried out to evaluate the sequelae and the therapeutic possibilities. PMID- 1767171 TI - [Vulvar varicosity and pregnancy]. AB - Poorly recognised, despite being common, in particular during pregnancy and above all in multipara, this familial condition falls within the context of venous disease in general. Slight during a first pregnancy, vulval varicosities develop all the earlier and are larger as the number of pregnancies increases. They cause discomfort, heaviness in the pubic region, sometimes pruritus or even pain, which is most often relieved by lying flat. Complications, which are uncommon, may give rise to exacerbation of the clinical symptoms described above in relation with a notable increase in size and, more rarely, traumatic ruptures which respond to compression. They disappear completely post-partum. Often poorly tolerated during successive pregnancies, the symptoms of vulval varicosities of pregnancy are significantly relieved by phlebotonic agents. PMID- 1767172 TI - [Venous insufficiency and oral contraception]. AB - Varicose veins are commoner in women than in men. The recrudescence of venous symptoms during pregnancy or premenstrual syndrome indicate the preponderant role of sex hormones in their etiology. Oral contraception may thus have effects on the veins. These effects can be broadly divided into two groups: risks of thromboembolism (clotting disorders, venous wall changes and hemodynamic abnormalities). These risks are rare but serious, venous pathology (loss of venous tone, slowing of blood flow, valve insufficiency, trophic lesions, etc.) Since the availability of low dose oral contraceptives, and since improved knowledge of contraindications, vascular repercussions have almost disappeared except when there is a vascular past history which must be routinely sought. PMID- 1767173 TI - [Uterine phlebography in pelvic venous stasis]. AB - Pelvic veins opacification is very helpful in the diagnosis of vascular pelvic pain. First applied to intrauterine vascularisation and hypoplasia research, hysterophlebography allow the venous side of stasis to be obvious. 1) Normally, a fine intra-parietal network draining in intrauterine peripheric vein (arcuate network) is patterned by the contrast medium. For that 4 vessels roots are leaving: 2 lumbo-ovarian pedicles joining uterine venous side und tubal veins and extending over lumbo-ovarian pedicle; 2 uterine pedicles resulting from 2 uterine veins and receiving vesical veins located in the base of broad ligament. Contrast medium empties very quickly and almost the whole uterus emptying is lasting less than 10 seconds. 2) From a pathological point of view: a) in stasis, intrauterine veins pattern features are: intra-parenchymatous pictures of dilated venous network, local alterations pictures often secondary to thrombosis (9/10 on the left side) with intra-parenchymatous stasis and oblique anastomatic main vessels characterizing uterine veins thrombosis, more than 20 seconds emptying delay. Hysterographic and phlebographic times take advantage to be paired by visualizing mucous lesions (hypoplasia and polyp. endocervical and corporeal) in intra parenchymatous stasis phenomena. b) Extrauterine stasis signs are characterized by preferentially right pedicles dilatation. Standing in upright position enhances stasis (proclive radiographies at 70 degrees). Dilatation is particularly located at the base of the broad ligament and gives to uterine veins with wide smeets a flexuous feature with wide contrasted clusters. Hence here emptying is slow and belayed. PMID- 1767174 TI - [Hemorrheology in clinical practice. Applications in an in vitro study of troxerutin]. AB - It is now well established that blood behaves like a non Newtonian fluid varying with the shear rate. Blood viscosity pattern relative to various shear rates shows a high viscosity at low shear rate (due to rouleau formation or erythrocyte aggregation) with a decrease at high shear rate. This high blood viscosity will be of a great importance only while pathological blood flowing with low output or stasis. Pathological variations of one factor determining blood viscosity and clinical signs define hyperviscosity syndrome. From an hemodynamical point of view, the appearance of an hyperviscosity syndrome, may, as a result of feedback mechanism, aggravate the disorders leading to a slowing down and even to a stop in local blood flow, subsequently encouraging ischemia. Moreover hyperviscosity also leads to a theoretical lowering capacity of oxygen transport by blood approximatively in proportion with the haematocrit/blood viscosity ratio. With regard to therapeutic aspect, the pharmacology of rheological influence drugs must be displaced into the wider outline proposed by Virchow. So we could distinguish between therapeutic action of drugs upon haematocrit, plasmatic proteins level, red blood cell deformability and erythrocyte aggregation. Among this last category disaggregating effect of rutosides has been first pointed out by Schmid-Schoenbein and Col. Our results of an in vitro study of troxerutine effect with ranging concentrations from 10(-5) to 10(-2) M upon blood viscosity and erythrocyte aggregation are reported. PMID- 1767175 TI - [Venous insufficiency in the pregnant woman. Rheological correction by troxerutin]. AB - We realized a double-blind randomized study in 26 pregnant with clinical symptoms of lower limbs venous insufficiency. Both groups were similar and received either (n = 12) troxerutine (4 g/day) or placebo (n = 14), during 30 days. Evaluation at J0 and J30 was both clinical and rheological by mean of Myrenne aggregometer. After blood shear rate of 600 s-1, two parameters were determined: M after roughly stopping shear rate, M1 after diminishing to shear rate of 3 s-1. Results exhibited steady values in patients receiving troxerutine while a significant increasing values in patients receiving placebo for the two parameters M and M1. That result in erythrocyte antiaggregating action of troxerutine, hence lowering viscosity action, in venous insufficiency during pregnancy. PMID- 1767176 TI - [Clinical and rheological efficacy of troxerutin in obstetric gynecology]. AB - The success of treatment aimed at improving manifestations of venous insufficiency appears today to be closely linked to a therapeutic impact on blood viscosity and the macrorheological parameters upon which it depends. This double blind placebo-controlled trial of troxerutine was designed to evaluate changes during treatment in rheological abnormalities in 60 women with vulval varicosities and venous insufficiency of the lower limbs, half in the context of premenstrual syndrome and half in pregnant women from the 4th month on. Initial examination revealed no significant difference between the treated and control groups from a clinical and rheological standpoint in the gynecological and obstetric categories. Analysis of results showed that a high dose of troxerutine was associated with a very marked improvement in symptomatic parameters by the first month of treatment with a significant correlation between clinical criteria and rheological parameters in pregnant women as well as in those with a premenstrual syndrome. These data were confirmed by excellent acceptability as well as subjective assessment by patients after 4 months' treatment at the dosage of 4 g/d. PMID- 1767177 TI - ["I" ... as in incest]. PMID- 1767178 TI - [What purpose does occupational medicine have?. Interview by Odile Burrus]. PMID- 1767179 TI - [Ergotherapists leave the hospital]. PMID- 1767180 TI - [Shortage of nurses: the consequences are becoming alarming]. PMID- 1767181 TI - [Hospitals without walls. At Vaugirard, gerontology grows a new skin]. PMID- 1767182 TI - [Hospitals without walls. The heart of the network]. PMID- 1767183 TI - [Hospitals without walls. Helping the sick child and his family]. PMID- 1767184 TI - [Complications of tick bites]. PMID- 1767185 TI - [The emergency cart]. PMID- 1767187 TI - [Programmed autologous transfusion]. PMID- 1767186 TI - [Thoracic pain of esophageal origin]. PMID- 1767188 TI - [Rights and duties of the infant and the fetus]. PMID- 1767189 TI - [Regional technical councils for nursing care: the missing link in nursing service]. PMID- 1767190 TI - [Of mice and men]. PMID- 1767191 TI - [The health care system in Switzerland]. PMID- 1767192 TI - [Being a nurse in Switzerland. For a personalized nursing care]. PMID- 1767193 TI - [Being a nurse in Switzerland. The canton has its nurse consultants]. PMID- 1767194 TI - [Infirmiere, infirmiera, krankenschwester]. PMID- 1767195 TI - [Being a nurse in Switzerland. Health is promoted at home]. PMID- 1767196 TI - [Being a nurse in Switzerland. Personnel shortage in Switzerland too!]. PMID- 1767197 TI - [Lead poisoning in children]. PMID- 1767198 TI - [Technical note no. 105. Extracorporeal lithotripsy]. PMID- 1767200 TI - [Terminal phase: hydrating without perfusing]. PMID- 1767199 TI - [Clinical research. Another string to our bow]. PMID- 1767201 TI - [Risk of exposure to blood]. PMID- 1767202 TI - [Health in Bourgogne]. PMID- 1767203 TI - [Promoting the profession. Interview by Agnes Montloin]. PMID- 1767204 TI - [The nurse in the year 2000]. PMID- 1767205 TI - [Peroperative autologous transfusion]. PMID- 1767206 TI - [A museum of Tonnerre de Dieu]. PMID- 1767207 TI - [Towards total quality]. PMID- 1767208 TI - [Women and children first!]. PMID- 1767209 TI - [Nurses fight for their hospice]. PMID- 1767210 TI - [Rodeo nurse with two horsepower]. PMID- 1767211 TI - [A day hospital for elderly persons]. PMID- 1767212 TI - [Tranquil days at Pasori]. PMID- 1767213 TI - [A nurse at Kleber's. Interview by Claire Manicot]. PMID- 1767214 TI - [Patients, attention: danger. Interview by Claire Manicot]. PMID- 1767215 TI - [Nurse administrators at a crossroads]. PMID- 1767216 TI - [Special diploma (continued). Simply a nurse]. PMID- 1767217 TI - [The point of the program of medicalization of information systems]. PMID- 1767218 TI - [Nursing care information systems, an integrated part of hospital information systems]. PMID- 1767219 TI - [Start with the needs. Interview by Anne Bergogne]. PMID- 1767220 TI - [Rehabilitation of coronary patients undergoing anticoagulant treatment]. PMID- 1767221 TI - [Cancer of the ovary]. PMID- 1767222 TI - [AIDS: the difficult elaboration of a vaccine]. PMID- 1767223 TI - [Trichloroethylene intoxication]. PMID- 1767224 TI - [Technical note no. 106. Prefilled insulin syringes]. PMID- 1767225 TI - [Let's respect the identity of the patient]. PMID- 1767226 TI - [Drug therapy observation]. PMID- 1767227 TI - [The early detection of cancer]. PMID- 1767228 TI - [Drug addicts with AIDS. The nurse facing conflict situations]. PMID- 1767229 TI - [On evaluation in primary care]. PMID- 1767230 TI - [Hospitalization at home. Another alternative]. PMID- 1767231 TI - [Caring for those who care: the case of dementias]. PMID- 1767232 TI - [Informatics technology in the health sector of the 90s (II)]. PMID- 1767233 TI - [The concepts of death. Their importance for the hospital environment]. PMID- 1767234 TI - [The elimination of refuse. A primary care experience]. PMID- 1767235 TI - [Gravity intravenous infusion equipment]. PMID- 1767236 TI - [Continuing education. 64. Subject: medicine-surgery. Topic: nursing care for patients with a pressure ulcer]. PMID- 1767237 TI - [About the April report]. PMID- 1767238 TI - [Usefulness of neuropsychological studies in the documentation of functional damage in a case of deep frontal lesion]. AB - A case of patient with deep frontal brain haemorrhage is reported. The lesion is in the striato-caudate region extended to the anterior arm of the internal capsule. The neuropsychological survey is reported: it shows an impairment in functions implying the central processing while not so markedly spoiled are functions classically considered depending on the damaged areas. A SPECT investigation shows an extension of the functional impairment corresponding to the neuropsychological data. PMID- 1767239 TI - [Cerebral ischemia in patients with thrombocytopenia: description of 2 cases with reduction of protein C activity in chronic liver disease and splenomegaly]. PMID- 1767240 TI - Category-specific semantic disorders in Alzheimer's disease. AB - A striking dissociation between the inability to identify living things plus food, along with a preserved ability to identify inanimate objects has been observed in patients who are recovering from herpes simplex encephalitis. In order to find out if a similar dissociation is also present in Alzheimer's disease (where the suspected initial site of parenchymal atrophy involves the same areas affected by herpes simplex virus), we carried out five experimental linguistic tasks to compare Alzheimer's patients' performance therein with that of vascular dementia patients and controls. Our results indicate a constant parallel between the category-specific semantic impairment of Alzheimer's patients and that described in patients recovering from herpes simplex encephalitis. The dissociation of living things+food vs inanimate objects in Alzheimer's disease appears to be of diagnostic value: it is not present in vascular dementia. PMID- 1767241 TI - Language disturbances from paramedian thalamic infarcts: a CT method for lesion location. AB - The authors describe the case of three patients suffering from language disorder secondary to mesencephalo-thalamic infarcts. One of them showed the clinical features of transcortical motor aphasia, while the other two presented the typical pattern of the so-called "thalamic aphasia". The CT-stereotaxic method for lesion localization disclosed that the dorso-medial was the mostly involved thalamic nucleus in each case. Since this nucleus is connected both with Broca's and Wernike's areas, the authors suggest that the more or less extensive involvement of the fibres connecting these structures may be responsible for the different aphasic features presented in these cases. PMID- 1767242 TI - [Efficacy and tolerance of aniracetam in elderly patients with primary or secondary mental deterioration]. AB - The study was carried out on 60 patients (mean age 69.9 +/- 10.3 years) suffering from slight-moderate brain pathology primary or secondary to vascular forms. Patients were treated with 1500 mg/day per os of Aniracetam or placebo. Drug efficiency evaluation was performed utilizing the following psychometric tests: Blessed Scale, figures repetition test, Benton test, Corsi test, Rey test, Pieron test, phrases construction test, verbal fluency test. They were carried out during basal visit after two and four month treatment. In Aniracetam treated group the score showed a significant improving during the first and second control. In placebo treated group no change statistically considerable happened in any test. Aniracetam has proved to be a useful drug in slight-moderate brain decay treatment of the elderly. PMID- 1767243 TI - Hyperglycaemia but not hyperinsulinaemia prevents the secretion of glucagon-like peptide-1 (7-36 amide) stimulated by fat ingestion. AB - The effect of insulin and glucose on fat-induced gastric inhibitory polypeptide (GIP) and glucagon-like peptide-1 (7-36 amide) (GLP-1 (7-36 amide)) was studied in five healthy subjects during continuous glucose infusion (Protocol 1) and during hyperinsulinaemic euglycaemic blood glucose clamp (Protocol 2). In Protocol 1, 50 g fat was orally ingested and glucose was infused at a rate of 0.7 g/kg/h for 2 h continuously from the time of fat ingestion. Either glucose infusion alone or fat ingestion alone was carried out in the same subjects as the control. The release of GIP and GLP-1 (7-36 amide) was suppressed in the hyperglycaemic hyperinsulinaemic state. In protocol 2, 50 g of fat was ingested and insulin was infused at a rate of 0.1 U/kg/h with an artificial pancreas system to obtain the normoglycaemic hyperinsulinaemic state. The release of GIP was significantly suppressed in the normoglycaemic hyperinsulinaemic state as well as in the hyperglycaemic hyperinsulinaemic state. However, the release of GLP-1 (7-36 amide) was suppressed in the hyperglycaemic hyperinsulinaemic state but not in the euglycaemic hyperinsulinaemic state. Thus, it is concluded that insulin inhibits fat-induced GIP, but not GLP-1 (7-36 amide), secretion and that glucose is likely to inhibit GLP-1 (7-36 amide) secretion. PMID- 1767244 TI - Toxicity of sitosterol to human umbilical vein endothelial cells in vitro. AB - The pathogenesis of the early development of atherosclerosis in sitosterolaemia is unknown. The effect of sitosterol on vascular endothelial cells in vitro was investigated by culturing human umbilical vein endothelial cells in the presence of up to 0.7 mmol l-1 of sitosterol. Liposomes were used to supply the high sterol concentrations. Exposure to 0.7 mmol l-1 of sitosterol for 72 h caused contraction of the endothelial cells and increased release of intracellular lactate dehydrogenase. After 96 h incubation the cells were partly detached from the substrate. At this time-point 0.35 mmol l-1 of sitosterol also caused perturbation of the endothelial cells. However, we could not confirm previous reports that tissue plasminogen activator production was enhanced by sitosterol. PMID- 1767245 TI - Clinical usefulness of serum tartrate-resistant acid phosphatase activity determination to evaluate bone turnover. AB - The study was carried out to evaluate the clinical validity and usefulness of serum tartrate-resistant acid phosphatase (TRAP) activity determined using an improved spectrophotometric assay. Enzyme activity was measured in 84 normal subjects and in 109 patients with common metabolic bone diseases. Mean values of serum TRAP activity in male subjects (n = 19; 10.4 +/- 2.15 U l-1) were not significantly different from those found in female subjects (n = 65; 10.8 +/- 1.8 U l-1). In the latter group mean values were significantly raised in post menopausal subjects (10.5 +/- 2.0 U l-1; p less than 0.01) compared with mean values in pre-menopausal women (8.45 +/- 1.8 U l-1). We found a significant inverse correlation between serum TRAP activity values and bone mineral density (BMD) measured both at an ultradistal radial point (n = 33, r = -0.506; p less than 0.01), and at the lumbar spine (n = 57, r = -0.261; p less than 0.05). Mean serum TRAP activity values in patients with metabolic bone diseases were: primary hyperparathyroidism, n = 30: 14.2 +/- 4.89 U l-1, p less than 0.001 vs normal subjects; chronic maintenance haemodialysis, n = 19: 17.4 +/- 6.7, p less than 0.001; metastatic cancer, n = 13: 21.2 +/- 6.3, p less than 0.001; post-surgical hypoparathyroidism, n = 10: 9.9 +/- 1.8, NS; involutional osteoporosis, n = 20: 12.5 +/- 2.3 p less than 0.001; Paget's disease, n = 10: 16.8 +/- 3.5, p less than 0.001; osteomalacia, n = 7: 19.5 +/- 3.31, p less than 0.001.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767247 TI - Distribution and elimination of intravenously injected urinary trypsin inhibitor. AB - Elimination of human urinary trypsin inhibitor (UTI) after intravenous injection of 125I-labelled UTI was followed by serial plasma and urine samples in three male volunteers. The plasma half-life of 125IUTI during 0-3 h after injection was 33 min and during the following 4 hours the half-life was 2 hours. Free, biologically active inhibitor was found in the urine during the first four hours after injection. Most of the radioactivity in the urine, however, corresponded to free 125I probably released during the degradation of UTI in the kidney. The distribution of UTI was studied after injection of 125IUTI in rats by measurement of radioactivity in excised organs. Fifteen min after the injection 44% of the radioactivity was found in the kidneys and 9% in the liver, implying that the kidneys are the primary site of UTI metabolism. PMID- 1767246 TI - Intracellular free calcium concentration and thromboxane A2 formation of vascular smooth muscle cells are influenced by fish oil and n-3 eicosapentaenoic acid. AB - The effect of fish oil and n-3 eicosapentaenoic acid (EPA) on intracellular free calcium concentration ([Ca2+]i) and thromboxane B2 (TXB2) formation in resting and stimulated cultured rat vascular smooth muscle cells (VSMC) was examined. In resting control cells [Ca2+]i was 147 +/- 15 nmol l-1 (mean +/- SEM, n = 4). After pretreatment of the cells with fish oil or EPA for 24 days the resting [Ca2+]i was decreased to 126 +/- 10 nmol l-1 and 84 +/- 8 nmol-1, respectively. After stimulation of untreated control cells with either 100 nmol l-1 angiotensin II (AII), 40 micrograms ml-1 low-density lipoprotein (LDL), or 100 ng ml-1 of recombinant platelet-derived growth factor (PDGFAB), [Ca2+]i was (in nmol l-1) 306 +/- 31, 217 +/- 25 and 213 +/- 16. Treatment of cells with fish oil or EPA reduced the stimulatory effect of the agonists, and the following [Ca2+]i values (in nmol l-1) were found: 199 +/- 21, 131 +/- 10, 148 +/- 13; and 175 +/- 11, 98 +/- 12, and 103 +/- 6, respectively. PDGFAB induced a four fold increase in TXB2 generation (270 +/- 28 pg mg-1 cell protein compared with 61 +/- 8.2 pg mg-1 in unstimulated control cells) within 6 min. In cells pretreated with fish oil or EPA, TXB2-formation was reduced by 54% and 44%, respectively. IN CONCLUSION: in rat VSMC stimulated by a variety of vasoactive agonist, fish oil and EPA can markedly attenuate intracellular mechanisms related to changes of cytosolic calcium concentration and eicosanoid production.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767248 TI - A simple and rapid method for purification of rat haptoglobin for production of antiserum. AB - Plasma from rats with acute inflammatory response was fractionated on Blue Sepharose CL 6B, to separate haptoglobin from albumin and lipoproteins. Affinity chromatography on Blue Sepharose proved to be a convenient method for crude fractionation of plasma. Pure haptoglobin was obtained by the subsequent affinity chromatography on a rabbit-haemoglobin Sepharose column. Minor amounts of rabbit haemoglobin co-eluted from the haemoglobin Sepharose column but did not influence the monospecificity of the antiserum raised in rabbits. By use of the antiserum in single radial immunodiffusion, the concentration of haptoglobin in plasma from normal rats was measured to be 0.5 g/l. PMID- 1767249 TI - A survey of acute and chronic disease associated with Yersinia enterocolitica infection. A Norwegian 10-year follow-up study on 458 hospitalized patients. AB - The aim of the present study was to further elucidate acute and chronic manifestations of Yersinia enterocolitica infection. During the period 1974-83, 458 hospitalized patients were diagnosed by antibody response and/or isolation of the microorganism. 64 patients had suffered from chronic conditions as rheumatic disease, inflammatory bowel disease, hepatitis, nephritis or thyroid disease for some time. Acute hepatic, renal, cardiac, pulmonary, pancreatic or neurologic involvement were observed in a substantial portion of patients; several had multiorgan disease. Acute insulin-dependent diabetes was seen in 2 patients, malignant mesothelioma in 2, and specific lymph node inflammation in 1. The patients were followed for 4-14 years (1987). 36/160 readmitted patients had abdominal pain and 26 had diarrhea; chronic colitis was demonstrated in 4. Some patients developed rheumatic conditions; others developed chronic disease of liver, kidneys, heart, pancreas, thyroid or nervous system. Chronic liver disease, in 22 patients, was correlated with positive tests for antinuclear antibody and rheumatoid factor; and might influence development of malignant disease, and mortality. A variety of acute and chronic clinical pictures may be associated with Y. enterocolitica infection, and further clinical research is required in this field. PMID- 1767250 TI - HBsAg/IgM complexes as a prognostic marker of chronicity in acute hepatitis B virus infection. AB - A simple radioimmunoassay for the detection of HBsAg/IgM complexes is described. 52 patients with acute hepatitis B infection were tested, 35 with self-limiting disease (group I) and 17 who became chronic carriers (group II). In the first sampling, taken during the early clinical phase, 24/35 patients (69%) in group I and 16/17 (94%) impending chronic carriers had detectable HBsAg/IgM complexes. The mean s/n values were significantly higher (p less than 0.01) in the group of chronic carriers. In the second sampling, taken with a mean of 31 and 39 days after the first samples in the first and second group, respectively, 2/35 (6%) and 15/17 (88%) were positive for HBsAg/IgM complexes (p less than 0.001). A comparison of HBsAg/IgM complexes results with the detection of HBeAg/anti-HBe showed that 7/14 (50%) patients with acute self-limiting disease lost their complexes before converting to anti-HBe. In the group of chronic carriers, HBeAg was generally lost before or at the same time as the HBsAg/IgM complexes (2.5 months to greater than 9 years after the onset of infection). The method described is easy to perform and could be entered into routine testing of patients with a newly acquired hepatitis B virus infection as an additional prognostic marker, complementing the HBsAg/anti-HBs and the HBeAg/anti-HBe systems. PMID- 1767252 TI - Plasmid-identified Staphylococcus saprophyticus isolated from the rectum of patients with urinary tract infections. AB - Among 15 strains of Staphylococcus saprophyticus of various origin, 13 presented different plasmid patterns, making plasmid identification a useful epidemiological marker. In a consecutive study of 14 young female patients with urinary tract infection caused by S. saprophyticus, 6 patients were simultaneously positive for the same bacterium in the stools. Three paired samples contained the identical plasmid-identified clone of S. saprophyticus indicating that the rectum may be a reservoir of this urinary pathogen. PMID- 1767251 TI - Phenoxymethylpenicillin two or three times daily for tonsillitis with beta haemolytic streptococci group A: a blinded, randomized and controlled clinical study. AB - In relation to compliance problems it was investigated whether phenoxymethylpenicillin dosed twice or 3 times daily was equally effective in tonsillitis due to beta-haemolytic streptococci group A. In a randomized, controlled and single blind multicentre study 206 patients older than 5 years with a positive culture of group A streptococci were treated with phenoxymethylpenicillin for 7 days. 101 patients received the daily dosage divided in 2 doses and 105 patients divided in 3 doses a day. The cure rate (a combination of bacteriological and clinical cure) was 82.0% in the 2-dosage regimen, and 88.2% in the 3-dosage regimen. The difference was not statistically significant. In conclusion, phenoxymethylpenicillin dosed 2 or 3 times daily seems to be equally effective in tonsillitis due to group A streptococci. PMID- 1767254 TI - Laboratory diagnosis of catheter-related bacteremia. AB - Semiquantitative culture of the external surface of catheter tips has become the currently most used method to detect catheter colonisation and catheter-related bacteremia; however, this method may fail to detect significant colonisation of the internal lumen of catheters, and several quantitative methods have been described for this purpose. Although 15 and 1000 CFU are used to define positive catheters, the sensitivity and specificity are not yet well known, and the definitive cut-off level for a positive result remains to be established. We studied prospectively 91 intravascular catheter tips removed because a catheter related infection was suspected. The result of external and internal cultures with different cut-off levels, alone or combined, were correlated with clinical data in 22 bacteremic episodes which occurred in these patients, 12 of which were catheter-related. The semiquantitative culture of the external surface alone with a cut-off level of 25 CFU provided the best means of detecting catheter-related bacteremia. This method has 100% sensitivity and 81.1% specificity. We conclude that semiquantitative culture technique of the catheter tip alone is sufficient and this method should be employed for diagnosing catheter-related bacteremia in unselected populations. PMID- 1767253 TI - Bacteriuria in patients treated with clean intermittent catheterization. AB - Bacteriuria has been studied in 407 patients treated with clean intermittent catheterization (CIC) during 1 year. Significant bacteriuria was found in 50.6% of 1413 analyzed urine samples. Escherichia coli was the dominating species (54.8%). The relative distribution of species was different in males and females, but there were no differences between the CIC patients and a reference group of outpatients. On the other hand, a higher frequency of resistance among enterobacteria was found in samples from CIC patients compared to the reference group. The majority of CIC patients with bacteriuria had no symptoms, and bacteriuria per se does not seem to be an indication for treatment in most of these patients. PMID- 1767256 TI - Resistant strains isolated from bacteremia patients in northern Norway. AB - Bacterial isolates from blood cultures in 1985 and 1989 (227 and 258 isolates, respectively), were compared as regards resistance to a series of antimicrobial agents including the more recent beta-lactams and quinolones. An increase in the number of coagulase-negative staphylococcal strains and a decrease in Staphylococcus aureus strains were detected, otherwise there were no significant differences in the bacterial patterns in 1985 compared to 1989. Except for chloramphenicol, there was no major increase in antimicrobial resistance among Gram-negative species. An increase in the number of multiresistant enterobacteriaceae strains was due to an increased number of klebsiella strains and a decrease in Proteus mirabilis. S. aureus showed an increased resistance to sulfonamides. No methicillin-resistant strain was found. Coagulase-negative staphylococci were significantly more often multiresistant in 1989 than in 1985, and significant increase in resistance to gentamicin, sulfonamides and fusidic acid was found. PMID- 1767255 TI - Septicemia in patients with hematological disorders and neutropenia. A retrospective study of causative agents and their resistance profile. AB - In order to identify the cause of septicemia and the resistance patterns of bacteria in Swedish patients with hematological disorders, all positive blood cultures collected at a hematological ward during 1980-1986 were evaluated retrospectively. 198 episodes of septicemia in 129 patients were recorded. 54% were males and 46% women with a median age of 67 years (range 16-88). Patients with acute leukemia (46%), lymphoma (19%) and myeloma (19%) dominated. The absolute neutrophil count (ANC) was less than 0.5 x 10(9)/l in 76% of the bacteremic episodes. A total of 253 consecutive isolates were found with 53% Gram negatives and 47% Gram-positives. The dominating pathogens were Escherichia coli (27%), klebsiella/enterobacter (15%), pseudomonas (7%), coagulase negative staphylococci (13%), alpha-streptococci (13%), Staphylococcus aureus (10%) and anaerobes (6%). Coagulase negative staphylococci showed a significant increase in isolation rate during the study period. The majority of E. coli were resistant to ampicillin. The susceptibility of klebsiella/enterobacter to ceftazidime and cefuroxime was reduced, while no imipenem resistant strains occurred. Among coagulase negative staphylococci 61% were resistant to isoxazolylpenicillin, none to vancomycin. No dramatic changes in the etiology of septicemia or the susceptibility pattern during the study period were noticed. Coagulase negative staphylococci, S. epidermidis in particular, constitute an increasing problem among granulocytopenic patients. PMID- 1767257 TI - Interleukin-1 production from peripheral blood monocytes in septic infections in children. AB - Interleukin-1 (IL-1) production from peripheral blood mononuclear cells (MNC) was studied in 18 children with septic infection. IL-1 activity was measured from the supernatants of MNC cultures at various times after infection. At the acute stage of infection the IL-1 activity was low (depressed) but rose in early convalescent stage and was normalized at late control after infection. In prolonged infections lasting for 11-25 days the IL-1 activity showed further decline. Rising IL-1 production of MNC in septic infection may be regarded as a good prognostic sign, whereas a declining IL-1 activity may be suggestive of prolonged or complicated course of infection. PMID- 1767258 TI - Neonatal omphalitis is still common in eastern Turkey. AB - 88 newborns with omphalitis diagnosed at a University Hospital in Eastern Turkey from January 1988 to December 1990 were reviewed. The yearly incidence was 7.7% in inpatient newborns. Risk factors including septic delivery (especially home delivery), prematurity, and being small for gestational age appeared to be important. Clinical manifestations, white blood cell and absolute neutrophil counts were non-specific and non-pathognomonic. Bacteriologic analysis revealed that Gram-positive bacteria (68%) predominated over Gram-negative isolates (60%). Staphylococcus aureus and Escherichia coli were the most frequent microorganisms. Mortality rate was 15%; all deaths occurred in patients presenting with systemic symptoms. The following poor prognostic factors were identified: septic delivery (particularly at home), prematurity, being small for gestational age and the development of systemic symptoms. PMID- 1767260 TI - Effect of intramuscular ceftriaxone on aerobic oral and faecal flora of 11 healthy volunteers. AB - 11 volunteers received 1 g ceftriaxone i.m. every 24 h for 5 consecutive days. Volunteers were selected on the basis of the "ceftriaxone inactivating capacity" of their faeces, which should be 250 mg/kg faeces. The effect of treatment on the aerobic oral and faecal flora was studied. In the oral flora a temporary suppression of the viridans streptococci occurred, which normalised already during treatment. More spectacular was the effect on the faecal flora: suppression of aerobic Gram-negative bacilli with overgrowth of yeasts and enterococci. Two weeks after treatment the results of the faecal cultures were almost the same as before treatment in most of the volunteers. One volunteer experienced severe diarrhoea, starting the day after completion of ceftriaxone treatment and lasting 2 days. PMID- 1767261 TI - Immunity and immunization of children against tetanus in sweden. AB - Tetanus antitoxin titres were determined in sera of 457 children, 6-, 10- and 16- year-old. Primary vaccination against tetanus had been given as 3 doses of DPT or DT vaccine at intervals of 4-6 weeks beginning in the 2nd or 3rd month of life. A booster dose is offered to schoolchildren at 8-10 years of age. As boosters, the children were given 0.1, 0.25 or 0.5 ml of diphtheria/tetanus toxoid (DT) containing 7.5 Lf/ml tetanus toxoid. The antitoxin titres against tetanus were much higher than those against diphtheria found in previous studies. Blood samples tested from 68 children, 5-year-old, who had been given basic immunization according to a spaced time schedule showed that 97% of the children had levels greater than 0.1 IU/ml. Prior to booster injection of the 6-year-old children, 1% lacked protective titre levels (greater than or equal to 0.01 IU/ml). 53% had antitoxin titre levels of greater than or equal to 0.01 - less than 0.1 IU/ml and 46% had levels of 0.1 IU/ml. The corresponding figures for the 10-year-old were 6, 65 and 29%, and for the 16-year-old 2, 7 and 91% respectively. After a booster injection high antitoxin levels were seen in all children. 95% had levels greater than 1 IU/ml irrespective of vaccine dose. PMID- 1767259 TI - Efficacy of cloxacillin prophylaxis in craniotomy: a one year follow-up study. AB - A previous prospective double-blind placebo-controlled study showed that cloxacillin prophylaxis significantly reduces the rate of infection after craniotomy. The purpose of the present follow-up study was to find out whether the data on routine cloxacillin prophylaxis would confirm the decreased infection rate after craniotomy. During this 1-year study, 8 infections occurred after 201 operations (4.0%) in 175 patients. No prophylaxis was given during 17 operations in 15 patients; 4 infections occurred in this group. The most frequently isolated microorganisms were Staphylococcus aureus, S. epidermidis, and Propionibacterium acnes, all of which were sensitive to cloxacillin. We conclude that cloxacillin is beneficial as prophylaxis in patients undergoing craniotomy. PMID- 1767262 TI - Fulminant neonatal sepsis due to Haemophilus influenzae. AB - A case of fulminant neonatal Haemophilus influenzae sepsis is presented. A 29 year-old woman presented at 34 weeks gestation with premature labor but with intact membranes. The male infant died 8 h after delivery due to respiratory insufficiency. Ante-mortem blood cultures and post-mortem blood and lung cultures yielded H. influenzae (biotype II) which could not be serotyped. H. influenzae was cultured from the mother's cervix 5 days after delivery. This strain was of the same biotype and also nonserotypable. Serum obtained from the mother exhibited reduced bactericidal activity against the isolates. We suggest the use of selective media in routine cervix cultures from pregnant women to detect H. influenzae, which might be responsible for neonatal septicemia. PMID- 1767263 TI - Treatment of symptomatic enteric aeromonas hydrophila infection with ciprofloxacin. AB - As a part of local sporadic outbreak of Aeromonas hydrophila gastroenteritis, 3 symptomatic patients required hospitalisation. Treatment with ciprofloxacin appeared to accelerate recovery from severe or persistent diarrhoea due to this organism. All the isolates from the outbreak were sensitive to this drug. PMID- 1767264 TI - Evaluation of different catheter parts for identification of pulmonary artery catheter colonisation. AB - A prospective study was conducted over 18 months to evaluate the accuracy of the semiquantitative culture technique performed from different catheter parts for detection of catheter colonisation in critically ill patients with pulmonary artery catheters. Semiquantitative culture of the tip catheter segment alone detected 66% of catheter colonisations. Semiquantitative culture of the other intravascular catheter segments (atrial or intradermal) provided similar yield. A combination of intradermal and atrial or tip catheter segment cultures provided the best means of detecting catheter colonisation. PMID- 1767265 TI - Breakdown of mefloquine prophylaxis in central Africa. PMID- 1767266 TI - Carcinoma of the prostate. Views and recommendations. PMID- 1767267 TI - Carcinoma of the prostate. Histopathological examination and grading. PMID- 1767268 TI - Carcinoma of the prostate. Staging and evaluation procedures. PMID- 1767269 TI - Carcinoma of the prostate. Transrectal ultrasound. PMID- 1767270 TI - Carcinoma of the prostate. Response criteria. PMID- 1767271 TI - Carcinoma of the prostate. Prognostic factors. PMID- 1767272 TI - Carcinoma of the prostate. Early diagnosis--screening. PMID- 1767274 TI - Carcinoma of the prostate. Classification. PMID- 1767273 TI - Carcinoma of the prostate. Treatment philosophy in cancer of the prostate- primary treatment. PMID- 1767275 TI - Carcinoma of the prostate. Secondary treatment. PMID- 1767276 TI - Carcinoma of the prostate. Treatment of pain. AB - Treatment of different types of pain Type A: 1. Diflunisal 500 mg b.i.d./naproxen 500 mg b.i.d. or another NSAID. Satisfactory effect: Continue Partial effect: Continue, but add step 2 No effect: Proceed to step 2 2. Morphine. Conventional tablets/mixture or slow release morphine. Dosage as described above. Nausea is treated with haloperidol 1-5 mg at night. Some patients do better t.i.d. 3. Glucocorticosteroid, as described above 4. Epidural morphine/local anaesthetic Type B: 1. Amitriptyline. Starting dose: 10 mg at night. Increase by 10 mg every other night until the patient has pain relief or experiences unacceptable side effects 2. Nerve blocks, if possible 3. Glucocorticosteroids 4. Strong opioids 5. Epidural opioids/local anaesthetics Type C: 1. Carbamazepine in increasing doses to 200-400 mg t.i.d. 2. Proceed as described for type B Type D: 1. Urinary colic: flavoxolate (Urispadol) 200-400 mg t.i.d. or emepronium bromide (Cetiprin) 200 400 mg t.i.d. 2. Opioids perorally 3. Epidural local anaesthetic (sympathetic block)/opioids. PMID- 1767277 TI - [Performance development in the Engadin ski marathon]. AB - All competitions of the Engadin Ski marathon were analyzed in order to pursue the development of the participants' performances over time. Of special interest was the influence of the recently introduced free skating technique on the finish times. Statistical computations are based on quantiles (x0.1, x0.25, x0.5, x0.75, x0.9). Since the first competition in 1969, there is a continuous increase of performance. The introduction of the fast freestyle-technique didn't lead to a visible improvement of the performances. Probably, other variables like growing importance of leisure-time sport-leading to greater performance capability of the participants- and considerable progress in the development of the equipment contributed to the performance progress over time. PMID- 1767278 TI - Hyperbaric oxygen therapy: treatment for spinal cord decompression sickness. AB - Spinal cord injury (SCI) may result from decompression sickness associated with sport and commercial diving. Decompression sickness is caused by the formation of gas bubbles in the vessels and tissues secondary to a reduction in ambient pressure. A complete or incomplete spinal cord injury may result from decompression sickness. Recompression and hyperbaric oxygen therapy is the primary treatment. The use of hyperbaric oxygen therapy (HBO) as a treatment for these injuries can greatly influence the patient's outcome. Early intervention in a recompression chamber may result in complete recovery. If treatment is delayed however, the prognosis for recovery is poor. PMID- 1767279 TI - The household production of nutrition. Introduction. PMID- 1767280 TI - Development of a nutritionally adequate and culturally appropriate weaning food in Kwara State, Nigeria: an interdisciplinary approach. AB - A nutrition education program was undertaken in Kwara State, Nigeria to improve infant feeding practices and nutritional status of weaning-aged children. A series of ethnographic, market survey, epidemiological, dietary, clinical, and communications research studies were implemented to develop a culturally acceptable, yet nutritionally adequate, weaning food. A premise of the project was that the development and introduction of any new weaning food should be based upon ingredients available in the community and to households, at a low cost and with minimum preparation time, and that would be culturally acceptable by mothers for feeding young children. Initially, research was conducted to define the problem in both nutritional and anthropological terms. Data was collected to describe: (1) present patterns of infant feeding and their determinants; and (2) dietary intake and nutritional status of infants in the intervention area. This paper focuses on the process of defining the problem and developing an intervention from an interdisciplinary perspective. The development of the new weaning food, Eko-Ilera, a fortified pap based on the traditional weaning food, is described. PMID- 1767281 TI - Migration, cash cropping and subsistence agriculture: relationships to household food expenditures in rural Mexico. AB - The relationship between income and food expenditure patterns is influenced by a number of factors, including personal tastes, source and frequency of income, male/female control over income, home food production, and other demographic factors. In this study, the relationship of household resource allocation to each of the following is examined: (1) source of income (i.e. wage labor, cash cropping, migrant remittances, and other private sources); (2) women's contribution to income; and (3) subsistence production level. The overall study design involved a cross-sectional survey of 178 households in three rural Mexican communities on two occasions spanning both agricultural seasons. On each occasion, data were collected on the following: (1) income by source and by earner; (2) migrant remittances; (3) gifts and loans; (4) subsistence and cash crop production, expenses, and earnings; (5) major nonfood purchases; (6) household composition; and (7) household food use (during the previous week). Stepwise multiple regression was used to determine the factors associated with the percentage of income allocated to food (PFX) and the percentage of the food budget allocated to (1) maize, beans, and chile (TRAD); (2) meat, milk, and fruit (LUX); and (3) bread, pasta, and snack foods (PROC). All regressions were run controlling for income. The proportion of income from migrant remittances was negatively associated with PFX (winter). Subsistence score was positively related to PFX (summer). Migrant remittances (winter) and subsistence score (both seasons) were negatively associated with TRAD. Subsistence score was positively related to LUX (both seasons). Father's absence (both seasons), store ownership (winter), and private source of income (summer) were all positively linked to PROC. Mother's contribution to total income and cash cropping income were not significantly related to any of the dependent variables. The findings support the idea that resource allocation patterns are influenced not only by income level but also by the household economic strategies through which income is generated. PMID- 1767282 TI - Household-level strategies for protecting children from seasonal food scarcity. AB - Although it has been widely argued that children are most severely affected during periods of food scarcity, there is little quantitative data to support this claim. The present study uses dietary intake and anthropometric data from the Andean community of Nunoa, Peru to evaluate age-related differences in the impact of and responses to seasonal variation in food availability. Children ages 12 years and under experience smaller seasonal fluctuations in energy intake and have a more adequate pre-harvest diet than adults. Anthropometric measures (weight-for-age and skinfold thicknesses) also indicate better nutritional status in children. Protection of children against severe pre-harvest stress is important because (1) they are more vulnerable to nutritional deprivation and (2) they make substantial contributions to household production. Gender differences, however, are not apparent as nutritional adequacy is comparable in males and females. Protection of children against nutritional stress represents just one of a suite of adaptive responses to limited pre-harvest food availability exhibited within this population. PMID- 1767283 TI - Household size, food intake and anthropometric status of school-age children in a highland Mexican area. AB - Large household size is widely regarded as a risk factor for malnutrition in developing countries, particularly for infants and young children. This study examines the extent to which household size is related to nutritional status in school-age children in the Solis Valley in highland Mexico. The relationships of food intake, anthropometric measures, and household size are assessed in a sample of 110 children (7-9 years of age), who were followed longitudinally for a minimum of one year as part of the Collaborative Research Support Program on Food Intake and Human Function. Diets in the valley are characterized by very low intake of animal food products and are heavily dependent on maize, which is primarily home-produced. Growth faltering is pervasive; the mean Z score for height-for-age in the sample is--1.6 of the NCHS reference standard. Children from larger households are significantly shorter and consume diets of poorer quality, as assessed by intake of foods from animal sources. These relationships remain statistically significant in regression analyses that control for household economic status. It therefore appears that the resources available to households in the Solis Valley are inadequate to buffer children in even more advantaged households from the stresses of maintaining large families. PMID- 1767284 TI - Opening the box: intrahousehold food allocation in rural Nepal. AB - The study examined intrahousehold food behavior in six villages in a rural hill area of mid-Western Nepal. Qualitative and quantitative methodologies taken from both anthropology and nutritional sciences were used to collect data on food belief systems, household allocation of food resources, and the effect of these features on diet and anthropometric status in a sample of 767 individuals in 115 households. Background data were also collected on socioeconomic status and demographic variables such as education levels, occupation, and migration patterns. The core methodological approach used direct structured observations of meals to examine how food is distributed within households. The results document a variety of mechanisms by which some individuals are favored over others through household food distribution, including serving order, serving method, refusing to serve foods, channeling foods and substituting low status foods for high status foods. No differences were observed in mechanisms of food distribution or nutrient intake between male and female children, contrary to evidence in the literature suggesting that male children will be favored. On the other hand, adult women were less likely to meet their nutrient requirements for energy, beta carotene, riboflavin, and vitamin C than men of the same age. Women's late position in household serving order, channeling of special foods to males and children, and lower total intake of food accounts for these findings. PMID- 1767285 TI - Social disintegration and the spread of AIDS: thresholds for propagation along 'sociogeographic' networks. AB - Previous work on the asymptotic spread of HIV infection along a low dimensional 'sociogeographic' network--a social network characteristically embedded within a limited geographic area--is extended to explore threshold conditions under which the infection extends widely beyond an initial set of infected individuals or communities. Results for one dimension suggest that threshold behavior is analogous to a chain reaction with criticality determined conjointly by the susceptibility of individuals within a community to a nexus of behavior conducive to rapid HIV spread and by the probability of transmission between susceptible communities. Once threshold is exceeded, a stochastic reformulation finds the asymptotic rate of transmission between communities may be markedly raised by positive correlation between susceptibility to rapid disease spread within a community and the transmissibility between communities, for example outmigration driven by social disintegration or residential instability arising from inherent structural factors associated with community susceptibility, as with male prostitution. Examination of threshold conditions for higher dimensional sociogeographic networks most likely characteristic of disease spread beyond the 'deep ghettos' now suffering the highest burden of infection suggests it is at least as, and likely more, effective to decrease the fraction of population susceptible to the high risk behavioral nexus as it is to lower the probability of disease transmission between susceptible individuals or communities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767286 TI - International standards in medical education or national standards/primary health care--which direction? AB - This paper examines the concept of 'international standards' in undergraduate medical education and concludes that, with one material exception, these do not exist. It also examines the two major forces which sustain these non-existent standards. It contends that programmes of undergraduate medical education are only likely to become relevant to people's health needs, health policies and priorities if and when the concept of 'international standards' is jettisoned and replaced by the concept of 'national standards'. The final section of the paper identifies five strategies which might be used to 'unfreeze' programmes of medical education and render these more responsive to both 'planning in relation to national needs' and to assist these programmes to become more responsive to 'educational innovation and change'. PMID- 1767287 TI - Hostility and its association with behaviorally induced and somatic coronary risk indicators in Finnish adolescents and young adults. AB - The association of hostility to behaviorally induced (i.e. smoking behavior, alcohol consumption and physical activity) and somatic coronary risk indicators (i.e. LDL- and HDL-cholesterol, systolic and diastolic blood pressure and obesity) was studied in a randomly selected representative sample of healthy adolescents and young adults (n = 1609). The question was whether the association, previously found between hostility and CHD incidence could be confirmed between hostility and CHD risk level in healthy young subjects. Results indicate that hostility is unrelated to somatic coronary risk factors, while an association with behaviorally induced risk factors was found. This association was, however, mediated by gender: current and heavy smoking, and physical inactivity were reported more commonly by hostile women, while frequent drinking by hostile men. These findings were replicated in a 3-year follow-up. PMID- 1767288 TI - Occupational stress and job satisfaction among physicians: sex differences. AB - The present study provides empirical findings from a national survey of physicians and addresses issues of sex differences in the nature of occupational stress experienced by physicians, and the sources of satisfaction in medical practice. Data were collected using questionnaires from 2584 physicians. The sample was randomly selected to represent physicians in all Canadian provinces. About 10% of the respondents were female. Measures included self-reports of stress and satisfaction, demographic variables, practice characteristics, and attitudes about health care. Major sources of stress indicated by female and male physicians were time pressures on the job, and major sources of satisfaction were relationships with patients and colleagues. Sex differences were found in terms of the specific variables that predicted job stress and satisfaction. However, for both women and men, various work setting variables positively predicted occupational stress and negatively predicted job satisfaction. Significant sex differences were present in both demographic and situational variables as well as measures of occupational stress and attitudes about health care. Correlations indicate that for both female and male physicians, high levels of occupational stress was associated with less satisfaction with medical practice and more negative attitudes about the medicare system and health care in general, and high job satisfaction was related to fewer specific work stressors and more positive attitudes about health care. Several methodological limitations necessitates caution in interpreting the findings. Nevertheless, the results may have some implications for future health care policies and procedures. PMID- 1767289 TI - Social networks and longevity. A 14 year follow-up study among elderly in Denmark. AB - The hypothesis of the study was that social contacts to close friends and relatives and perceived social integration was able to delay mortality in general and cardiovascular mortality in particular. Altogether 1752 males and females, aged 70-100 years were interviewed by trained nurses in 1972 to 1974. The study group was based upon a random sample of all elderly in the town of Odense, Denmark. More than 80% participated in the survey which included data collection on social networks and health at the time of interviewing. By means of linking the study group to national registries on mortality and causes of mortality practically all in the cohort were traced until 1987. During follow-up 1501 persons died. Most of the association between social networks and mortality were weak and statistically insignificant but had the expected sign. After adjusting for initial health status only the interviewer's assessment of the quality of the network was statistically significant associated with longevity. A feeling of loneliness was found to be associated with cardiovascular mortality, especially for males. PMID- 1767290 TI - Roles, work, health perceptions and health resources of women: a study in an Egyptian delta hamlet. AB - Women's health needs can only be described and programs to address them implemented with an understanding of women's multiple roles and responsibilities. A life-cycle approach to examining women's roles and responsibilities provides a useful framework to achieve such understanding. This paper describes the results of a study conducted in a rural village in Egypt that examines the daily life experiences of women, their work, their family responsibilities, their health perceptions and their health resources. We argue that programs designed to address women's health needs must consider these critical aspects of their lives. This argument is based on the premise that women's health needs have been neglected and efforts to ameliorate this situation should be a top priority in the international health care agenda of the 1990s. PMID- 1767291 TI - Sociodemographic and clinical factors affecting recognition of childhood diarrhea by mothers in Kwara State, Nigeria. AB - Early diagnosis of infant and child diarrhea by family members is the key to timely treatment. Factors that influence the caregiver's recognition of diarrhea have not been systematically studied, but may include characteristics of the caregiver, the child, or the illness itself. This paper examines the relationships between the caregivers' diagnoses of diarrhea during the previous 24 hr and the reported frequency and consistency of their children's bowel movements during the same period of time, using information from a representative sample of 2655 children less than 3 years of age in Kwara State, Nigeria. Diarrheal point prevalence based on maternal diagnosis (10.0%) was about half that based on the clinical criteria of three or more liquid or semi-liquid stools (18.8%). Only 36% of the mothers recognized a recent episode of diarrhea defined by the clinical criteria. Mothers were more likely to recognize diarrhea when a greater number of stools of watery consistency were excreted or when the stools contained blood or mucus. Mothers were least likely to recognize diarrhea when the child was a girl or less than 2 months of age. These results suggest that cross-cultural comparisons of diarrheal rates should use consistent, objective evidence of illness to compare rates rather than maternal diagnosis alone. Also, diarrheal disease control programs should explore those factors affecting recognition of illness in local contexts to assure that treatment recommendations can be applied in a timely fashion. PMID- 1767293 TI - [Capillary glycemia]. PMID- 1767292 TI - [Calcitonin]. PMID- 1767294 TI - [Treatment of common osteoporosis]. PMID- 1767295 TI - [Bone biopsy]. PMID- 1767296 TI - [Physiopathology of osteoporosis]. PMID- 1767297 TI - [Dynamics of a team concerned with a service project]. PMID- 1767298 TI - [Professional behavior. Evaluation and evolution methods for individuals. 1]. PMID- 1767299 TI - [Project of computerization. A new working tool in the nursing unit]. PMID- 1767300 TI - [Night in the hospital. The training]. PMID- 1767301 TI - [Nursing project]. PMID- 1767302 TI - [Supervision of the nursing probation time. Method of education and of indirect supervision of probation time]. PMID- 1767303 TI - [The nurse and hazardous waste]. PMID- 1767304 TI - [Diagnosis of osteoporosis]. PMID- 1767305 TI - [Acid-excretion function of the kidneys in hypothyroidism]. AB - Impairment of renal acid excretion characterized by reduced excretion of titrated acids, ammonia and ammonia coefficient, occurs in clinically decompensated hypothyroidism. Disturbed urinary acidification accompanies severe hypothyroidism. Administration of thyroid hormones brings about normalization of titrated acids excretion, urinary acidification, ammoniogenesis undergoes positive changes. It is shown that capacity of the kidneys to maintain acid-base homeostasis under acid loading in hypothyroidism is limited. PMID- 1767306 TI - [Characteristics of cerebrovascular circulation and its regulation in early stages of cerebrovascular disorders]. AB - Cerebral circulation studied in 121 patients with early signs of cerebrovascular insufficiency exhibited typical asymmetric slowing down which started in distal compartments of the cerebral vascular bed and advanced to predominance in the vertebrobasilar circulation. Autoregulation of the circulation was preserved though hemodynamic requirements of emotional, mental and physical activity were not met completely. Initial discirculatory encephalopathy involves generalization of dysgemic shifts with progressive circulatory slowing down along the internal carotid arteries. In this case autoregulation gets disturbed in inhibited cerebrovascular reactivity. PMID- 1767307 TI - [Polymer-drug complexes in the treatment of extensive ovarian cancer]. AB - The paper presents the results of intracavitary chemotherapy with deposited cytostatics of advanced ovarian cancer as well experimental, morphological, biochemical and pharmacological data. Intraabdominal introduction of microspheres filled with cyclophosphamide, 5-fluorouracil, doxorubicin can be a variant of drug therapy in multimodality treatment of ovarian cancer. Combination of intracavitary chemotherapy with a systemic one has the advantage of local and regional effect which is not inhibited by mediated action of the deposited cytostatics via the systemic blood flow. The method is indicated in residual tumor dissemination after cytoreductive surgery and ovarian cancer with ascites. PMID- 1767308 TI - [High-energy lasers in the treatment of breast tumors]. AB - In 1989 the P. A. Hertzen Moscow Research Cancer Institute initiated a trial of high-energy CO2-laser in surgical treatment of breast cancer. Altogether 180 operations were performed. The data are presented on specific features of the laser incision and related breast tissue destruction, factors responsible for variations in the above parameters, laser scalpel advantages. PMID- 1767309 TI - [Use of spirometry and bicycle ergometry in the assessment of the stability of mitral valve bioprosthesis]. AB - Muscular and cardiac performance was assessed a spirometry and bicycle ergometry in two groups of patients aged 25-55 with mitral xenobioprostheses functioning normally. 36 patients were examined 1-3 years following surgery (group I), 23 patients in 3.5-8 years. Functional results were found not inferior in group II. Stable parameters were more characteristic for patients having preoperative functional classes I-III. PMID- 1767310 TI - [Transitory global amnesia syndrome]. PMID- 1767311 TI - [Porphyrins and laser irradiation in the diagnosis and therapy of malignant tumors]. PMID- 1767312 TI - [Quality and effectiveness of health care at home and in outpatient clinics of patients with cardiovascular diseases]. PMID- 1767313 TI - [Organization of specialized medical care of disaster victims]. PMID- 1767314 TI - [Structure and ways of lowering disability after burns]. PMID- 1767315 TI - [Cardiomyopathies in the clinical practice]. PMID- 1767316 TI - [Long-term prazosin treatment of arterial hypertension in ambulatory care]. PMID- 1767317 TI - [Use of ultrasonic inhalation of isoket in patients with ischemic heart disease associated with chronic obstructive bronchitis]. PMID- 1767318 TI - [Myocardial lesions in diphtheria]. PMID- 1767319 TI - [Characteristics of autonomic regulation in the postoperative period after traumatic intracranial hematoma in alcoholic intoxication]. PMID- 1767320 TI - [Effects of ponderal on the state of carbohydrate metabolism and insulin secretion in type 2 diabetes mellitus]. PMID- 1767321 TI - [Mechanisms of the development of diabetic angiopathies]. PMID- 1767322 TI - [Mild forms of multi-infarct dementia: effectiveness of cerebrolysin]. AB - The randomized double-blind placebo-controlled study of the effectiveness of cerebrolysin in a mild form of multi-infarct dementia was carried out. Sixty patients were divided in two equal groups differing significantly at the beginning of the study by none of the compared parameters. They received for 28 days daily drop intravenous doses of cerebrolysin (15 ml of the drug in 200 ml of a 0.85% NaCl solution: 10 ml in the morning and 5 ml in the evening) or placebo in the same amount of the solution. The control of the therapy effectiveness was instituted clinically (by means of a special scale), electroencephalographically, and using the psychological test of Arnold-Kohlmann and the test for response time. The study found a significant improvement of the memory (p-0.01), abstract thinking and time of reaction in the patients on cerebrolysin, confirmed also by the EEG-mapping. It is believed advisable to use the drug cerebrolysin in mild forms of multi-infarct dementia. PMID- 1767323 TI - [Errors in the diagnosis of old lesions of the knee joint ligaments]. PMID- 1767324 TI - [Significance of Campylobacter pylori in the surgical treatment of stomach and duodenal ulcer]. PMID- 1767325 TI - [Ultrasonic characteristics of metastatic lesions of the lymph nodes in esophageal cancer]. PMID- 1767326 TI - [Characteristics of present-day course of Addison-Biermer anemia]. PMID- 1767327 TI - [Chronic primary gastroduodenitis and Helicobacter pylori--their relationship]. PMID- 1767328 TI - [Methods of selection of immunocorrecting means in chronic osteomyelitis]. PMID- 1767329 TI - [Diagnosis of male genital tuberculosis]. PMID- 1767330 TI - [Early and late neurological complications of diphtheria]. PMID- 1767331 TI - [Tetanic convulsions in vasculitis]. PMID- 1767332 TI - [Mesothelioma of the pericardium]. PMID- 1767333 TI - [Effects of sleep deprivation in patients with parkinsonism]. AB - The paper is concerned with a pilot detailed study of a single 24-h sleep deprivation (SD) in parkinsonism patients (n-35). The score estimation of the disease clinical signs demonstrated diminution of rigidity, bradykinesia, gait defects as well as of the total score of the patients condition severity. The clinical observations were verified by computer processing of motor tests. SD proved antidepressant in parkinsonism patients. The combination of drug treatment with SD permits a 2-fold and 50% decrease in the treatment duration and daily dose, respectively. A test is proposed for assessing tonicity of facial muscles. PMID- 1767334 TI - Nonrandom chromosome losses in tumorigenic revertants of hybrids between isogeneic immortal and neoplastic human uroepithelial cells. AB - Somatic cell hybrid analysis was used to examine the role of recessive cancer genes in tumorigenic transformation in vitro of human uroepithelial cells (HUC). Hybrids between nontumorigenic pseudodiploid SV40-immortalized HUC (SV-HUC) and two aggressive grade III transitional cell carcinomas (TCC) produced in nude mice after in vitro exposure of SV-HUC to 3-methylcholanthrene (MC) were completely suppressed for tumorigenicity at early passage. Tumorigenic reversion occurred after five or more passages in culture and was always accompanied by chromosome losses. Overall, the tumorigenic revertants showed statistically significant losses of chromosomes 1, 4, 5, 9q, 12, 14q, and 17 (all P less than or equal to 0.05) as compared to losses in suppressed hybrids. In addition, hybrid reversion was accompanied by losses that left specific tumors with a single remaining homolog of certain chromosomes (i.e., 3, 5q, 11p, 17p, and 18q). These losses were also considered significant because of the likelihood that genes on these chromosomes were reduced to homozygosity. Many of the significant losses (i.e., 5q, 9q, 11p, and 17p) were of chromosomes that are frequently lost in clinical TCC. Thus, these results support the hypothesis that these chromosomes contain genes whose loss leads to HUC tumorigenesis. PMID- 1767335 TI - Genetic analysis of resistance to total bromodeoxyuridine substitution in mammalian cell hybrids. AB - Somatic cell hybrids derived from the fusion of Chinese hamster ovary cells (CHO) and mutant Syrian hamster melanoma cells (2E) were tested for their ability to grow with all of the thymidine (dThd) in their DNA replaced with 5-bromo-2' deoxyuridine (BrdU), a phenotypic capability of the 2E cells but not of the CHO cells. Under these conditions, the 2E cells survived and grew, all of the hybrid clones survived and grew to varying degrees, and the CHO cells did not survive at all. When 2E cells were tested, they were also found to be resistant to the toxic effects of BrdU substitution and white light irradiation, relative to CHO cells. Thus, when the DNAs of 2E and CHO cells were equally (50%) substituted with BrdU, and the two cell lines irradiated with identical doses of white light, the survival of CHO cells was reduced to less than 1% of that of unirradiated cells, while 40% of the 2E cells survived. The 2E x CHO hybrid clones were found to survive at values from 10% to 40% under these identical conditions. Thus, the phenotypic characteristics of 2E cells involving total substitution and resistance to the toxic effects of BrdU substitution and white light irradiation appear to be expressed in a codominant fashion in somatic cell hybrids. PMID- 1767336 TI - Transfer of the human HPRT and GART genes from yeast to mammalian cells by microinjection of YAC DNA. AB - DNA of two yeast artificial chromosomes (YACs) containing selectable human genes was transferred by microinjection to rodent cells in tissue culture. The human hypoxanthine phosphoribosyltransferase (HPRT) gene, spanning 45 kb, is contained on the 660-kb YAC yHPRT as described elsewhere. The human phosphoribosylglycinamide formyltransferase (GART) gene, spanning approximately 40 kb, is contained on the 590-kb YAC yGART2 as described previously. YAC DNA was isolated from pulsed-field gels and microinjected into mammalian cells in which the human HPRT and GART genes can be selected. The cell lines that were selected contain the entire human genes. Some of the cell lines contain multiple copies of the genes integrated at the same chromosomal position. The YAC yGART2 could not be purified away from natural yeast chromosomes of similar size, and the cell lines into which the human GART gene was introduced contain variable amounts of yeast DNA in addition to the human DNA. PMID- 1767337 TI - Towards liver-directed gene therapy: retrovirus-mediated gene transfer into human hepatocytes. AB - Liver-directed gene therapy is being considered in the treatment of inherited metabolic diseases. One approach we are considering is the transplantation of autologous hepatocytes that have been genetically modified with recombinant retroviruses ex vivo. We describe, in this report, techniques for isolating human hepatocytes and efficiently transducing recombinant genes into primary cultures. Hepatocytes were isolated from tissue of four different donors, plated in primary culture, and exposed to recombinant retroviruses expressing either the LacZ reporter gene or the cDNA for rabbit LDL receptor. The efficiency of gene transfer under optimal conditions, as determined by Southern blot analysis, varied from a maximum of one proviral copy per cell to a minimum of 0.1 proviral copy per cell. Cytochemical assays were used to detect expression of the recombinant derived proteins, E. coli beta-galactosidase and rabbit LDL receptor. Hepatocytes transduced with the LDL receptor gene expressed levels of receptor protein that exceeded the normal endogenous levels. The ability to isolate and genetically modify human hepatocytes, as described in this report, is an important step towards the development of liver-directed gene therapies in humans. PMID- 1767338 TI - The gonadotropin-releasing hormone (Gnrh) gene maps to mouse chromosome 14 and identifies a homologous region on human chromosome 8. AB - The murine gonadotropin-releasing hormone (Gnrh) locus has been mapped to mouse chromosome 14 using a mouse x Chinese hamster somatic cell hybrid panel. The equivalent human locus, known as luteinizing hormone-releasing hormone (LHRH), has been previously mapped to 8p21-8p11.2. Four other loci mapping to the human chromosome 8 short arm have been mapped to mouse chromosome 8; two of these (PLAT, GSR) lie proximal to LHRH, and two (LPL, DEF1) lie distal to LHRH. The localization of Gnrh, the murine homolog of LHRH, to mouse chromosome 14 therefore defines a hitherto unrecognized block of homology between man and mouse. Furthermore, it indicates that the region of homology between the human chromosome 8 short arm and mouse chromosome 8 is composed of two separate blocks. PMID- 1767340 TI - [For conquest of rheumatoid arthritis]. PMID- 1767339 TI - Loss of expression of the uvomorulin gene in compaction-defective embryonal carcinoma cells. AB - The lack of uvomorulin protein in the 6B(NG)C25 subline of H6 embryonal carcinoma cells is due to loss of expression of the uvomorulin gene, without evidence of gross alteration in the gene itself. This suggests that the dominant mutation in 6B(NG)C25 may involve a trans-acting factor involved in the regulation of uvomorulin gene expression. PMID- 1767341 TI - [Anti-cardiolipin antibody and renal microthrombi in lupus nephritis]. AB - To evaluate the relationship between anticardiolipin (ACL) antibody and microthrombi in renal tissue, we examined sera and renal biopsies from 47 patients of systemic lupus erythematosus (SLE) with lupus nephritis (LN). ACL antibody was measured by an enzyme-linked immunosorbent assay (ELISA). Their renal tissues were examined for histological types of lupus nephritis according to the WHO classification and appearance of renal microthrombi. Positive ACL had been shown in 28 of 47 patients (60%) with LN and in 15 of 18 patients (83%) with WHO IV (diffuse proliferative LN: DPLN). Incidences of renal microthrombi were significantly higher in patients with DPLN (61%) than in patients with all LN (34%) (p less than 0.01). The prevalence of renal thrombosis in patients with ACL (46%) was significantly higher than without ACL (16%) (p less than 0.05). Incidence of positive ACL was 81% in the cases with renal microthrombi and 48% in the cases without them. These findings suggest that there is strong association between ACL and the renal microthrombi in active LN. PMID- 1767342 TI - [The respiratory function in children with collagen disease]. AB - Respiratory function tests were performed on 60 children with collagen disease. Twenty-seven cases (45%) showed abnormalities in the respiratory function. These abnormalities were restrictive in 14 cases (52%), obstructive in 6 cases (22%), and mixed type in 7 cases (26%). Eight out of 14 SLE patients (57%) showed abnormalities of various types. Abnormalities were seen in 9 out of 25 JRA patients (36%) including 6 cases (67%) with restrictive type changes. Four out of 6 MCTD (67%) and 3 out of 9 DM (33%) patient showed functional abnormalities. Most of patients with these two types of collagen disease showed restrictive changes. Investigations performed by a research group of the Ministry of Health and Welfare showed the incidence of restrictive type changes (% VC less than 80) in adult patients of collagen disease to be in the following descending order: PM/DM greater than PSS greater than MCTD greater than SLE. Though small in number, our investigation revealed that a considerable proportion of MCTD and SLE patients showed restrictive changes in respiratory function. In evaluating the clinical course of the disease, it was thus considered to be important to follow up the progress of respiratory functions in children with collagen disease. PMID- 1767343 TI - [Relationship between serum interleukin-4 or interferon-gamma level and B cell abnormality in patients with collagen vascular diseases]. AB - The role of interleukin-4 (IL-4) and interferon-gamma (IFN-gamma) in the pathogenesis of the collagen vascular diseases was studied. The serum level of IL 4 was decreased in patients with systemic lupus erythematosus (SLE) and mixed connective tissue disease (MCTD), and was variable in patients with rheumatoid arthritis (RA). The serum level of IFN-gamma was increased in patients with SLE, MCTD and RA. In patients with SLE, there was an inverse correlation between the levels of IL-4 and IFN-gamma. The proliferation and immunoglobulin production of the high-density-B cells in response to IL-4 was suppressed in normal controls, although the degree of suppression was less in patients with SLE. Cell cycle analysis using ethidium bromide demonstrated the similar findings. These data suggest that IL-4 and IFN-gamma might participate in regulating both of growth and differentiation of B cells in vivo. However, immunoglobulin production by whole B cells in response to IL-2 or PHA-induced T-cell factor was extensively facilitated by IFN-gamma in patients with SLE. It is possible that IFN-gamma enhances the differentiation of already-activated B cells, and that polyclonal B cell activation is promoted. Therefore, the failure of the regulatory mechanism by these cytokines might be related to the pathogenesis of these diseases. PMID- 1767344 TI - [Measurement of quality of life in rheumatoid arthritis]. AB - This study was designed to explore the health status or quality of life (QOL) in 366 patients with rheumatoid arthritis in Japan. Physical, social, and emotional functions of the patients, namely the QOL, were measured by the modified health assessment questionnaire, the quality of well-being score, and the face scale, respectively. These functions were also evaluated by the new methods using visual analogue scales. The longer the duration of rheumatoid arthritis, the worse the QOL measures in these patients. A similar result was observed in the relationship between the stage classification of progression of rheumatoid arthritis and the QOL measures. In contrast, the traditional medical process measures, such as Lansbury activity index, sedimentation rate, and serum CRP concentration did not correlate with the duration of the disease. We conclude that the QOL measures in this study are useful for evaluation of the functional status and well-being of patients with rheumatoid arthritis. However, the clinical usefulness of these measures for evaluation of effectiveness and/or side effects of anti-rheumatic drugs still remains unknown. PMID- 1767345 TI - [Comparison of clinical features of childhood and adult onset Still's disease]. AB - Physical findings, laboratory data, treatments and prognosis were investigated in detail using 26 Japanese childhood Still's disease (CHSD) patients and 19 Japanese adult onset Still's disease (AOSD) patients as the subjects. High spiking fever and arthritis were present in all the patients. Seventy and seven percent of CHSD and 53 percent of AOSD had polyarthritis (the number of joints involved being 5 or more during the first 6 months of the disease). A comparison of the groups showed no significant difference in the initial systemic manifestations except for sore throat (CHSD: AOSD; 19%: 68%). Initial laboratory data were the same for these groups except for serum iron levels (CHSD: AOSD; 20.8 +/- 13.7 micrograms/dl: 83.0 +/- 54.2 micrograms/dl). As to joints and physical prognosis, the results were also the same for CHSD and AOSD under the similar treatment. On the basis of these data, we conclude that CHSD and AOSD are of the same disease entity so far as the present clinical features are concerned. PMID- 1767346 TI - [A case of aortitis syndrome complicated with amyloidosis, type AA]. AB - We recently saw a patient who had aortitis syndrome associated with secondary amyloidosis. To our knowledge, she is the fourth report of this complication occurring in aortitis syndrome. In November 1985, the patient, a 18 year-old woman, was admitted to our hospital because of a high fever, back pain, abdominal pain and general fatigue. On physical examination, bruit was audible on the abdomen, bilateral radial artery was weakly palpable. Angiography showed the stenosis of bilateral carotid artery, subclavian artery, renal artery and superior mesenteric artery. From the above findings, she was diagnosed aortitis syndrome, and treatment was begun with prednisolone. However, she developed recurrently a high fever, chest pain, abdominal pain and exertional dyspnea. Laboratory findings at the active stage revealed the marked elevation of leukocytes, erythrocyte sedimentation rate and C-reactive protein. On her clinical course, the number of circulating thrombocytes was paralleled with the activity of the disease. On June 1988, she developed suddenly a high fever and severe pain of abdomen. Pathological findings of her stomach showed the deposition of amyloid protein A. Laboratory findings depicted the marked increment of thrombocytes, beta-thromboglobulin and platelet factor 4. These results suggest that circulating thrombocytes may play a role in product ion of amyloid protein. PMID- 1767347 TI - [A case of polyangiitis overlap syndrome]. AB - A 25 year old man was admitted to our hospital on June 1, 1989 because of general fatigue and pleural effusion. He had noticed purpuras and nodules on his bilateral lower legs in July 1988. He was admitted to Nihon University Hospital and was diagnosed as allergic granulomatous angiitis. Methylprednisolone was administered. In March, 1989, a nodular shadow was detected in his lung CT films. From the findings of TBLB a granulomatous lesion was suspected. However, his clinical course was rather stable so he was discharged from the hospital. Two months later, he was suffered from fever and general fatigue. On his chest X ray film pleural effusion was detected in the lower part of his left lung. The nodular shadow was increasing gradually. Laboratory findings on his admission showed leukocytosis, thrombocytosis, elevated CRP and a high titer of RA factor. He was diagnosed as hypersensitivity angiitis in a broad sense based on his biopsy findings of the skin lesion. Furthermore, the diagnosis of an early stage of Wegener's granulomatosis (WG) or limited type of WG was also made from the clinical course of his lung lesion. The combination therapy with cyclophosphamide and methylprednisolone was started. It was so effective that the nodule of his left lung was almost disappeared. It seems that this case is one of the polyangiitis overlap syndrome proposed by Fauci. PMID- 1767348 TI - [Methotrexate therapy in rheumatoid arthritis]. PMID- 1767349 TI - [Evaluation of misoprostol's clinical utility for gastric/duodenal ulcers seen under long-term use of non-steroidal anti-inflammatory drugs (NSAID)--I. Evaluation of mucosal prophylactic effects by a placebo-controlled double blind comparative study]. PMID- 1767350 TI - [Evaluation of misoprostol's clinical utility for gastric/duodenal ulcers seen under long-term use of non-steroidal anti-inflammatory drugs (NSAID)--II. Evaluation of therapeutic effects on ulcers under continuous use of NSAID]. PMID- 1767351 TI - [Respiratory problems in a 5 months old infant]. PMID- 1767352 TI - [Pathological pregnancies. Preclinical investigations]. PMID- 1767353 TI - [The nursing movement. A question of meaning]. PMID- 1767354 TI - [Vaccination of children. A resounding success from the 1980's]. PMID- 1767355 TI - [Arterial hypertension and pregnancy: detection and monitoring]. PMID- 1767356 TI - [The threat of premature labor. Surveillance and detection]. PMID- 1767357 TI - [Prenatal diagnosis. Indications and modalities]. PMID- 1767358 TI - [Sequels of delivery. Surveillance]. PMID- 1767359 TI - [High-risk pregnancies. Supervision at home]. PMID- 1767360 TI - [Importance of preparation for birth]. PMID- 1767362 TI - [High risk in obstetrics]. PMID- 1767361 TI - [Encounter with a child]. PMID- 1767363 TI - [Children's rights in the family]. PMID- 1767364 TI - [One out of five people suffer from micronutrient deficiencies]. PMID- 1767365 TI - [Monitoring of normal pregnancies]. PMID- 1767366 TI - On the clinical performance of a glass ionomer cement. PMID- 1767367 TI - Malpractice reports in prosthodontics in Sweden. AB - Prosthodontics is the branch most often involved in dental malpractice cases in Sweden. The number of cases has increased with the growing production of fixed prosthodontics after the introduction of the National Dental Insurance Scheme and the increase in the number of dentists. Prosthodontic treatment accounted for one third of the working hours of private practitioners but two-thirds of the sanctions during the period 1974-78. The patients' complaints are often justified in some parts. The most common faults are elementary and have been similar throughout the whole period 1947-1988. Bridges (2-4 units), complete dentures and single crowns are the constructions most often involved in complaints. The maxillary frontal and premolar regions are in this order the regions most often involved. There are no differences between different age groups of dentists concerning the quantity of faults, but there is probably concerning the quality of faults because older dentists get more severe sanctions than younger. PMID- 1767368 TI - A comparative study of plaque removing efficiency using rotary electric and manual toothbrushes. AB - Plaque removing efficiency was compared between rotary electric and manual toothbrushes. The first part of the study included 19 dental hygiene students randomly assigned to a "rotary" or a "manual" brushing group. The subjects were instructed to brush their teeth three minutes twice a day for three weeks either with rotary electric or with manual brushes. Then for another period of three weeks brushing techniques were reversed. The results showed that the median plaque index for all sites and for buccal and lingual sites was significantly lower in the rotary brushing group (28% vs 39% and 3% vs 6%, p less than 0.05). During the second part of the study 10 of the students refrained from all oral hygiene procedures for four weeks in the anterior mandibular region, i.e. from 33 to 43. They were then randomly assigned to a "rotary" or a "manual" brushing group. Registrations of accumulated plaque were made from photographs at baseline and after 15, 30 and 60 seconds of brushing. ANOVA analysis of the plaque scores showed a significant difference in reduction of plaque in favour of the rotary electric brush (p less than 0.01). The results suggest that the rotary electric toothbrush removes plaque more efficiently than the conventional manual toothbrush. PMID- 1767369 TI - A new experimental model for studies of local inflammatory reactions. AB - The aim of the present study was to develop and evaluate a method for studies of the early phase of the local inflammatory reaction, based on continuous diffusion of an inflammatory inducing agent. 25 rats were used. Four sterile teflon tablets were implanted subcutaneously in the back of each animal. After 3 weeks, when a connective tissue capsula had formed, the tablets were replaced by two test tablets, containing 35 micrograms lipopolysaccaride, one placebo and one teflon tablet. Five rats were sacrificed on day 0, 4, 7, 14, 21, respectively, and biopsies comprising tablet and surrounding tissue were harvested and exposed to routine histologic treatment. The number of leucocytes was assessed in four defined areas adjacent to each tablet. During the first seven days an increase in the number of leucocytes was seen in the tissues adjacent to test tablets. After 14 and 21 days the number of leucocytes was still high but lower as compared to day 7. In the tissues bordering the placebo and teflon tablets only few inflammatory cells were found. The results suggest that the tested method is suitable for studies of local inflammatory reactions during a 21 day period in experimental animals. PMID- 1767370 TI - Influence of tube voltage on radiographic diagnosis of caries in premolars and molars. AB - The influence of tube voltage on radiographic diagnosis of caries in extracted premolars and molars was examined. Five combinations of dental X-ray machines and kV-settings were used (Philips Oralix 65 kV; Siemens Heliodent EC 60 kV; Siemens Heliodent 70 kV; Soredex Minray DC 60 kV and 70 kV). The diagnostic accuracy was evaluated with the ROC-technique. The results showed no significant differences in the diagnostic accuracy between premolars and molars. However, the diagnostic accuracy tended to be better with low kilovoltage for radiography of premolars and high kilovoltage for radiography of molars. PMID- 1767371 TI - 200 kD neurofilament protein and synapse elimination in the rat soleus muscle. AB - We studied the distribution and appearance of the phosphorylated form of the 200 kD neurofilament protein in the rat soleus muscle during the period of postnatal synapse elimination. Unlike many muscles, the appearance of singly innervated muscle cells in soleus occurs well after myogenesis has been completed, so that synapses are eliminated from a stable population of muscle cells. Immunoreactivity to the 200 kD neurofilament protein is present in the terminals of neuromuscular synapses of animals at all postnatal ages from 0 to 21 days. Before postnatal day 10, when physiological studies indicate that all soleus muscle cells receive more than one synaptic input, as many as 30% of soleus muscle cells contain phosphorylated 200 kD neurofilament protein immunoreactivity in only one synaptic terminal. At older ages the number of polyneuronally innervated muscle cells observed using immunostaining is similar to that observed physiologically. These findings suggest that not all developing neuromuscular synapses contain phosphorylated 200 kD neurofilament protein, and that those terminals lacking it comprise most of those eliminated early in the postnatal period. We conclude that the presence of phosphorylated 200 kD neurofilament protein might be highly correlated with the survival of motor nerve terminals during postnatal neuromuscular synapse elimination. PMID- 1767372 TI - [Child abuse--they have seen the most]. PMID- 1767373 TI - [Media--honors for critical articles]. PMID- 1767374 TI - [Welcome to the new education]. PMID- 1767375 TI - [Romania--milk powder, penicillin and books]. PMID- 1767376 TI - [Communication--mature nurses do not show feelings]. PMID- 1767377 TI - [Fewer cases of hepatitis as a result of improved hygiene]. PMID- 1767378 TI - [Education made interesting]. PMID- 1767379 TI - [Nursing--dare to say I]. PMID- 1767380 TI - [Home help--more elderly get fewer hours]. PMID- 1767381 TI - [Nursing home--a struggle for words and funds]. PMID- 1767382 TI - [Reorganization--nurses as guards. Interview by Teddy Osterlin Koch]. PMID- 1767383 TI - [Sanctuary for HIV-positive patients]. PMID- 1767384 TI - [Executive Board--Health policy without a chief]. PMID- 1767385 TI - [Executive Board--stress at work is physical as well as psychological]. PMID- 1767386 TI - [Wise persons in the EEC]. PMID- 1767388 TI - [Starting with problems]. PMID- 1767387 TI - [Nurses in the Gulf war]. PMID- 1767390 TI - [Education--Danish-Swedish exchange]. PMID- 1767389 TI - [Liver transplantation--comprehensive clinical and psychological nursing care]. PMID- 1767391 TI - [Education--can be warmly recommended]. PMID- 1767392 TI - [AIDS--a spoke in the system]. PMID- 1767393 TI - [Need for specially educated nurses]. PMID- 1767394 TI - [Reorganization--colleagues' own recipe]. PMID- 1767395 TI - [Denmark's Nursing College--a new chapter]. PMID- 1767396 TI - [Leadership--a courageous nurse. Interview by Lars Peter Bergqvist]. PMID- 1767398 TI - [Working environment--safety chief in a train factory. Interview by Jens Rossen]. PMID- 1767397 TI - [Education--studies with EEC means]. PMID- 1767399 TI - [Big steps need planning]. PMID- 1767400 TI - [Fired up for a good working environment. Interview by Lars Peter Bergqvist]. PMID- 1767401 TI - [Orthopedic surgery. Nursing care starts with admission]. PMID- 1767402 TI - [Home nursing--fortunate reorganization]. PMID- 1767403 TI - [WHO--life style threatens world health]. PMID- 1767405 TI - [Professional nursing's guideline group]. PMID- 1767404 TI - [Up from the easy chair]. PMID- 1767406 TI - [Is it ethically proper?]. PMID- 1767407 TI - [Primary care--the ailing marriage]. PMID- 1767408 TI - [Workplace--Caribbean night watch. Interview by Sascha Amarasinha]. PMID- 1767409 TI - [Education--qualifications and professional level]. PMID- 1767410 TI - [Degree certificate. Women lack women's knowledge]. PMID- 1767411 TI - [Education--new regulations for scholarship fund]. PMID- 1767412 TI - [Eastern Europe--pass on what we have]. PMID- 1767413 TI - [Hygiene--does mopping floors clean them? "Yes, if ..."]. PMID- 1767414 TI - [Hygiene--avoid contaminating moisture]. PMID- 1767415 TI - [Nursing in developing countries. A working day in Mozambique]. PMID- 1767416 TI - [Relief activities--easier to give than to receive. Interview by Mette Ellegaard]. PMID- 1767417 TI - [The problem Aalborg. An attack on a nurse's professional freedom]. PMID- 1767418 TI - [WHO--health for world's people]. PMID- 1767419 TI - [Nursing diagnosis--powerful tool with many shortcomings]. PMID- 1767420 TI - [Nursing diagnosis--quick shortcuts and necessary documentation]. PMID- 1767421 TI - [Education--can we use it in clinical practice?]. PMID- 1767422 TI - [Rationalization--saving profits from the allotment]. PMID- 1767423 TI - [Discharge--need for cooperation]. PMID- 1767424 TI - [Discharge--home visits intercept problems]. PMID- 1767425 TI - [Local wages for acute effort]. PMID- 1767426 TI - [Education--organizational plan with built-in new ideas]. PMID- 1767428 TI - [Pension Fund--new offer and strategies]. PMID- 1767427 TI - [Health center--the third network]. PMID- 1767429 TI - [France--from hospital to hotel]. PMID- 1767430 TI - [Discharge--a success with expenses. Interview by Kirsten Bjornsson]. PMID- 1767431 TI - [Education--practice is just as important as theory]. PMID- 1767432 TI - The Patient Self-Determination Act: implications for Texas nurses. PMID- 1767433 TI - Leadership. Nurses can coach, too! PMID- 1767434 TI - An open letter to my friend, Mary. PMID- 1767436 TI - Nursing research: we should be using in practice. PMID- 1767435 TI - One morning I woke up. PMID- 1767437 TI - Mandatory continuing education is here. PMID- 1767438 TI - Jack: a man who demanded to be in charge of his health. PMID- 1767439 TI - Lessons in quality from other industry experiences. PMID- 1767440 TI - Total quality management. PMID- 1767441 TI - The relationship among quality, cost, and market share in hospitals. PMID- 1767442 TI - The physician's role in quality assessment and improvement. PMID- 1767443 TI - Managing nursing quality. PMID- 1767444 TI - An approach to assessing resource utilization and clinical outcomes in a hospital setting. PMID- 1767445 TI - Marketing hospital quality. PMID- 1767446 TI - Quality measurement and management in an HMO setting. PMID- 1767447 TI - Quality research initiatives. PMID- 1767448 TI - Information requirements for assessing quality of care. PMID- 1767449 TI - A systemwide approach to quality management. PMID- 1767450 TI - The interrelationship between quality and information systems. PMID- 1767451 TI - [Significance of shape differences between medial and lateral knee joint menisci for functional change of position]. AB - The attachments of the anterior and posterior horn of the menisci to the tibial plateau are of a most important functional value. At the medial meniscus the circumference is more widely configurated, because of the greater distance between anterior and posterior horns. The areas of sagittal cuts through the menisci slightly differ regarding medial and lateral side. A higher area momentum of inertia of the medial meniscus, related to a vertical axis within the examinated sagittal plane, is found. It derives from a geometrical distribution of partial areas more distant from the axis. The medial meniscus therefore has a higher stiffness against sagittal bending stress. Experiments and theoretical stress simulation prove these results. According to them, the medial meniscus is less mobile in comparison to the lateral. These findings are discussed as a basic geometrical cause for the higher incidence of injuries of the medial meniscus. PMID- 1767452 TI - [Risk of fracture of regenerated bone and metal implant following bone lengthening osteotomy]. AB - Many problems may arise, jeopardize and spoil the outcome of lengthening osteotomies. Fracture of the plate and the newly formed bone bridging the gap between the fragments is only one of the possible complications. Overload is its cause in all the cases. Following the theory of Pauwels the paper analyses the high stresses in hollow bone and the relationship to their principles of construction. Accurate knowledge of bone stressing and correct assessment of bone strength in the X-rays may help to reduce the incidence of fatigue fractures after limb lengthening. PMID- 1767453 TI - [Concurrent vascular injuries in fractures in childhood]. AB - Ten-year-analysis of blood vessel lesions present in eleven children with bone fractures revealed two major localizations: 1. In the lower extremity we observed vascular lesions in both open and closed fractures of femur and tibia. In cases with (complete) ischemia emergency operation had to be performed. 2. In the upper extremity the prevalent fracture localization was the supracondylar fracture of the elbow. Incomplete ischemia present in fractures with severe dislocation (Felsenreich III) could be salvaged by closed reposition and transcutaneous fixation by means of Kirschner wires. In those few cases open reposition was necessary, both exposure of vessels and fixation of the fracture was possible when medial incision was performed. Postoperative evaluation of patients included angiography (DSA) and ultrasound (Doppler). PMID- 1767454 TI - [Bridging tension band fixation in the reconstruction of ruptured amphiarthrosis of the pelvic girdle]. AB - Two different surgical techniques to treat rupture of the symphysis or the sacroiliac joint, which were introduced at the beginning of the seventies and were modified later, are presented in regards to their methodology and their results. In a lot of cases after surgery they enable a normal spring-suspension of the pelvis. PMID- 1767456 TI - [Local muscle flap in soft tissue reconstruction following fracture and osteitis of the lower limb]. AB - 17 local muscle flaps were used to cover soft tissue defects in 13 open fractures (1 degree to 4 degrees) of the lower limb and in four patients with chronic ostitis associated with instable scar forming. The Musculus soleus was used in 16 cases exclusively or in combination with the Musculus gastrocnemius (three times), Musculus hallucis longus (one time) or Musculus tibialis anterior (one time). In one case the Musculus flexor digitorum was used. In 13 of 17 cases the local muscle flap was curing the soft tissue defect and contributed to the salvage of the limb. PMID- 1767455 TI - [The use of Debrecen plates in the management of acromioclavicular dislocation]. AB - Since surgical treatment of the ruptured acromio-clavicular ligaments is still requiring an improvement, a new implant, the Debrecen-plate, was devised. Its application necessitates only a small exposure, soft tissue covers the plate favourably and spares the joint surface from immediate damage. The authors describe the surgical procedure and report on the outcome of 39 Tossy II and III injuries treated in this way. PMID- 1767457 TI - [Dorsal technique of vertebral body reconstruction using cortico-cancellous bone chips]. AB - Grafting of cortico-cancellous bone is firmly established in trauma surgery especially as concerns surgical stabilization of the spine. Early references to that procedure can be traced back to Magerl's reports, but it was Daniaux who decisively improved spongiosa reconstruction and published the results. Further modifications were introduced by Thielemann and Holz as well as by Arnold. All techniques applied so far are essentially based on the implantation of cancellous bone. The method presented employs cortico-cancellous grafts. PMID- 1767458 TI - [Oropharyngo-spinal gunshot wounds]. AB - Two cases of bullet injuries inflicted in suicidal intention are represented. In the first instant the barrel of a rifle in the second the barrel of a revolver was inserted to the oral cavity before the shot was fired. PMID- 1767459 TI - [Simultaneous dislocation-fracture of both ends of the clavicle]. AB - A case of simultaneous dislocation-fracture of both ends of the right clavicle in a 17-year old patient is being described. Treatment consisted in operative reduction of both injuries. The sterno-clavicular joint was stabilized by a transarticular K-wire, the acromioclavicular injury was treated by extraarticular tension-band-wiring. Healing was without complications and the result 37 months after injury was excellent. PMID- 1767460 TI - [The status of trauma surgery continued education in the new federal states]. PMID- 1767461 TI - [Comment on H. Habernek, L. Schmid: Modified approach to anterior acromioplasty]. PMID- 1767462 TI - Pet avian medicine. Sources of information. AB - This article is intended to serve as a guide to sources of information on avians. College and university libraries, abstract and index services, bookstores, journals, and veterinary literature are listed. Avian conferences, computer search services, natural history libraries and museums, and places to obtain video and audio tapes and slides are included. PMID- 1767463 TI - Pet avian medicine. PMID- 1767464 TI - Avian practice tips. AB - This article reviews the therapy of the sick bird. Common differential diagnoses, inpatient versus outpatient therapy, preventive medicine, and post-purchase examinations are discussed. The importance of client education is stressed. PMID- 1767465 TI - Basic history taking and the avian physical examination. AB - As one may readily see, the basic avian physical examination should be an extensive, thorough procedure. A wide array of diseases and conditions can be detected during the examination. A flow sheet or checklist should be instituted to maintain consistency and cover all aspects of the history and physical examination. I highly recommend as an adjunct to the basic physical examination Gram stains of the choanae, crop, and cloacae or feces. Owing to the fact that a great number of compromised avian patients either are ill because of gram negative bacteria or have become more compromised by opportunistic organisms such as yeast or gram-negative bacteria, identification of these conditions greatly facilitates treatment and recovery of the avian patient. Other ancillary tests, such as fecal flotation, complete blood count, culture and sensitivity, Chlamydia test, chemistry profile, radiology, and laparotomy/laparoscopy, are available to the practitioner to aid in the diagnosis of various diseases involving the avian patient. [Editor's note: The editors suggest that the complete blood count be done before an extensive physical examination is undertaken to avoid a stress hemogram.] PMID- 1767466 TI - Laboratory testing in pet avian medicine. AB - The importance of employing laboratory diagnostics in the examination of avian patients cannot be overemphasized. The physical examination alone is grossly insufficient. Many avian illnesses do not display external signs, and laboratory work is imperative in detecting them. Only after the assessment of various laboratory parameters can an examination be considered complete. PMID- 1767467 TI - Basic techniques in pet avian clinical pathology. AB - An understanding of clinical pathology is extremely important for the pet avian clinician. The basics are often poorly understood by the busy practitioner. This article has served as a review for clinicians wanting the basics but having neither the time nor the resources to examine large volumes of material. This information has been designed to enable the veterinarian to understand better the limitations of the tests and the difficulties encountered by the avian technician in performing the tests so important in clinical avian practice. PMID- 1767468 TI - ELISA testing for avian chlamydiosis. AB - Studies of Chlamydia antigen ELISA and BELISA assays are reviewed. This article includes descriptions of university studies and clinical laboratory usage of assays. A guide to clinical interpretation of tests is included. PMID- 1767469 TI - Pet avian conditions and syndromes of the most frequently presented species seen in practice. AB - This article describes the most frequent conditions seen in clinical practice in the United States. The authors' clinical experiences and impressions are emphasized, and the experiences of many other veterinarians are included. PMID- 1767470 TI - Common infectious diseases of psittacine birds seen in practice. AB - The "average" small animal practitioner who sees pet birds in practice comes across a variety of bacterial, fungal, protozoal, viral, and chlamydial diseases. Diagnosis and treatment of some are relatively uncomplicated, but many psittacine diseases remain enigmatic. Ante-mortem diagnosis of some diseases is extremely difficult. The clinician must often rely on combinations of clinical signs, clinical pathology, and experience to diagnose many bird diseases correctly. Many viral diseases are devastating to collections and have no cure, preventive program, or even well-documented modes of transmission. Some psittacine syndromes have yet to be definitively associated with a particular infectious agent. Get to know your local federal, state, and private diagnostic laboratories. Good relationships with other avian practitioners, both locally and through the Association of Avian Veterinarians can be extremely helpful. (See the article on sources of information.) PMID- 1767471 TI - Newcastle disease. AB - Since 1926, there have been three epizootics of ND. The latter two have been directly linked with psittacine species and Racing Pigeons. The modern poultry industry is extremely vulnerable to the effects of NDV, once it gains entry to any facet of the industry. Consequently considerable expense and effort are expended to keep the virus at bay. The main threat continues to come from psittacine species and racing pigeons. The considerable international trade in these birds, together with rapid air transport, can allow virulent NDV to gain entry to a country while exotic birds are incubating the disease. It is hoped that quarantine barriers and requirements will prevent the virus from entering a country, but smuggling continues and constitutes the biggest risk. Domestic avian pets are also vulnerable to the virus. It is hoped that new in vitro testing procedures, such as monoclonal antibody and oligonucleotide fingerprinting techniques, may be used to identify rapidly and characterize emergent virulent strains, so that appropriate measures may be taken to prevent infection of commercial poultry and domestic pets. PMID- 1767472 TI - The pharmacokinetics of avian therapeutics. AB - The knowledge of drug disposition and metabolism in various avian species is rapidly expanding. Allometric scaling, as a new method for extrapolating a dose from one species to the other, is a mathematical characterization of the functional consequences of change in mass. Special attention, in addition, has been paid to interspecies differences in relation to metabolic elimination, anatomy, and physiology of the digestive and respiratory systems and differences in drug distribution. Intraspecies differences attributable to physiochemical aspects of the drug preparation and physiologic conditions of the avian patient can also influence drug efficacy. The consequences of the choice of a particular method of drug administration in relation to avian therapy are also considered. PMID- 1767473 TI - Practical avian therapeutics with dosages of commonly used medications. AB - This article reviews the practical aspects of medicating individual avian pets in a practice situation. General principles are discussed, and specific doses for the most commonly used medications are given. PMID- 1767474 TI - Parrot psychology and behavior problems. AB - Behavior modification training, like veterinary medicine, is an exacting science, requiring a knowledge of not only wild avian behavior, but of child and adult human behavior as well. It is important to note that absolutely any changes in a bird's or its owner's environment may trigger a vast assortment undesirable behaviors. Some behavior problems are simple, but most have multiple causes and each of those causes must be determined and corrected before a high rate of success is evident. As in veterinary medicine, some birds respond to general "shotgun" techniques; however, parrots are intelligent and complex creatures. They consider themselves an integral part of their human "flock" and respond as such. Most commonly seen negative behaviors can be altered, at least to some extent, and, in most cases, they can be alleviated completely. Yelling at the bird, striking it, or any other type of confrontational behavior modification technique is virtually useless and can actually worsen most situations. A high percentage of success involves extensive history taking, an understanding of human and wild animal flock behavior, and the time to create a complete program for each individual and its owner. PMID- 1767475 TI - Zoonotic diseases of birds. AB - Numerous diseases are shared by birds and humans. Many of them are true zoonosis. Chlamydiosis, salmonellosis, and tuberculosis are the primary infectious diseases. Allergic alveolitis in humans, induced by exposure to bird dander and protein, is also of great significance. The other diseases are of less common occurrence or represent oddities. [Editor's note: However, the increased incidence of AIDS and the increased use of immune system-compromising medications in humans have resulted in a drastic increase in the zoonotic diseases. Formerly rare diseases are becoming more common.] PMID- 1767476 TI - Pet avian medicine. Case reports. AB - Four case reports are presented. The first involves chronic lead toxicity in a Yellow-naped Amazon Parrot, which presented for a shoulder injury. The second discusses Aspergillosis in an African Grey Parrot following smoke inhalation and systemic antibiotic use. The third describes Chlamydiosis in a recently imported Amazon Parrot, and the final case concerns rhinitis/sinusitis in a cockatiel. PMID- 1767477 TI - Disorders of the avian integument. AB - The avian integument consists of highly specialized structures that show extreme variations between species. Feathers are the most obvious part of the integument, and their color and beauty forms an important basis for the attraction of birds to humans. Any disorder in the feathers can be distressing for a client and frustrating for the avian practitioner. The cause of some disorders may be apparent, but others have a complex pathogenesis involving management, human-bird interaction, malnutrition, psychologic factors, disease, or hormone imbalances. PMID- 1767478 TI - Avian toxicology. AB - Owing to the unique physiology of birds, most toxicities are life-threatening and require prompt, well-informed action. It is often hard to ascertain which specific toxin or the amount of toxin to which the bird has been exposed. Therefore, the most important action is to treat the bird, not the poison. This article discusses the steps in diagnosing and treating toxicoses, from both natural and man-made toxins, that have been reported in avian species. PMID- 1767480 TI - Introduction to psittacine pediatrics. AB - These few subjects are only a small fragment of the scope of pediatric medicine but are critical in their impact. The depth of material needed to cover the subject adequately should fill a textbook. If, however, aviculturists could master these seven areas, the numbers of babies requiring medical or surgical therapy would decrease dramatically. The entire purpose of preventive medical management is actually the elimination of medicine as it is practiced today. That goal, as desirable as it is, is quite some time off, and education remains the key to improving the quality of the lives and future of our patients. Attention to detail and the comprehension of normal physiology of these nondomestic (and generally tropical zone origin) birds will lead to great inroads in understanding the true underlying cause of pediatric problems; improved patient recovery rates; and a better appreciation of the nebulous but critical relationships among potential pathogens, infection, disease, performance, and productivity. Given our truly limited technical position, the veterinarian who learns to use the environment for the patient's health is light years ahead of what you can purchase for the purpose of actively forcing the direction of a complex situation. PMID- 1767479 TI - Avian reproductive endocrinology. AB - Hypothalamic-releasing factors regulate the secretion of anterior pituitary hormones. The anterior pituitary gland secretes the same six hormones as found in mammals: FSH, LH, prolactin, GH (somatotropic hormone), ACTH, and TSH, plus the melanotropic hormone. The endocrine hormones of the avian posterior pituitary gland concerned with reproduction are mesotocin and AVT. The pineal gland, through the secretion of the hormone melatonin, modulates the periodic autonomic functions of the central nervous system. The ovary produces estrogens, progestogens, and androgenic compounds. The testes produce testosterones and progesterone. The thyroid glands produce two hormones, T4 and T3. The avian adrenal glands produce corticosterone and aldosterone. The bursa of Fabricius is considered an endocrine organ since it is involved in the production of humoral factors. The male reproductive system undergoes hormonal changes associated with puberty, the breeding season, and molt. Some avian species undergo a type of disintegration and seasonal reconstruction of the testis and epididymis. The relationship of the ovarian follicular hormones and the plasma hormones varies depending on the stage of the reproductive cycle and the seasonal photostimulation. Female birds may conceive in the absence of a mate as a result of the fertile period phenomena. The blood chemistry of laying birds is different from that seen in nonlaying hens. Domestication has had a definite influence on the hormone cycles of some avian species. This may lead to certain reproductive problems. PMID- 1767481 TI - Avicultural medical management. An introduction to basic principles of flock medicine and the closed aviary concept. AB - The purpose of this article is not to set out definitive management protocols for breeding flocks. These protocols must be individually designed and executed by the aviculturalist and attending veterinarian. The success of an avicultural medical management effort depends on the enthusiasm and competence of the veterinarian, the management expertise of the aviculturalist, and demonstrable progress through improved performance. The responsibility for avian veterinarians to enter this field with proper orientation beyond the individual bird and to document their individual management programs as they evolve is immense. Documentation and publication of successes and failures allow a more accurate and factual evolution of the discipline of avicultural medical management. As a profession, we as veterinarians hold one of the keys to the future success or failure of many avicultural efforts. It is sincerely hoped that these basic principles serve to orient and focus better our efforts in the future. PMID- 1767482 TI - Development of an opiate-based anaesthetic technique for use in dogs with cardiomyopathy. AB - An opiate-based anaesthetic technique has been developed for use in dogs with end stage heart failure due to dilated cardiomyopathy. It has been used in dogs undergoing translocation of the left latissimus dorsi around the descending thoracic aorta to create an autologous counterpulsation system. Anaesthesia was induced with barbiturate (10 mg/kg thiopentone) and fentanyl (500 micrograms) and maintained by an infusion of fentanyl (0.5 micrograms/kg/minute) [corrected] in addition to halothane (0.1 to 0.5 per cent) and nitrous oxide (20 to 60 per cent). This technique provided safe anaesthesia for major intrathoracic surgery. PMID- 1767483 TI - Observation on bovine congenital erythrocytic protoporphyria in the blonde d'Aquitaine breed. AB - Three blonde d'Aquitaine calves (one male and two females) about four months old, exhibited skin lesions just after birth, the site and nature of which suggested photosensitisation. Their porphyrin metabolism indicated a marked decrease in the activity of lymphocytic ferrochelatase, leading to a diagnosis of congenital erythrocytic protoporphyria. The associated nervous disorders of the 'recurrent epileptiform seizure' type are discussed in the light of complementary histological and biochemical tests. PMID- 1767484 TI - Breed prevalence and sites of haemangioma and haemangiosarcoma in dogs. PMID- 1767485 TI - East Coast fever: Africa's stubborn problem. PMID- 1767486 TI - Transmission of salmonellae to veterinarians. PMID- 1767487 TI - Homoeopathic remedies. PMID- 1767488 TI - Animal welfare on the farm. PMID- 1767489 TI - Optimal spatial displacement for direction selectivity in cat visual cortex neurons. AB - Responses of single neurons in cat visual cortex were measured in response to sinewave grating stimuli. Firstly, a neuron's spatial frequency tuning was determined, and subsequent stimuli were set at the optimal spatial frequency for that neuron. Then a "jumping grating" stimulus was used: a sinewave grating subjected to a series of abrupt spatial displacements, while remaining stationary for a fixed exposure time between displacements. The amount of direction selectivity elicited by this stimulus was measured as a function of the amount of spatial displacement. Visual cortex neurons generally showed an optimal spatial displacement, corresponding to somewhat less than one quarter of a spatial period of the neuron's optimal spatial frequency (close to, but systematically less than, "quadrature phase"). In a majority of neurons tested, this optimal displacement was not affected by increasing the exposure time between displacements, indicating that the measurements were not a simple consequence of temporal frequency tuning. These results closely parallel recent human psychophysical data obtained from measurements of motion aftereffect or direction discrimination elicited by jumping grating stimuli. PMID- 1767490 TI - Occipital lobe morphology in normal individuals assessed by magnetic resonance imaging (MRI). AB - The topography of visual evoked potentials (VEP) is dependent on occipital lobe morphology. Using magnetic resonance imaging we examine the sulcal pattern (the calcarine and parieto-occipital sulci), and assess the size of the cuneus and the asymmetry of the occipital lobes, computed separately for its ventral and dorsal segments. No differences were found for either the cuneus or the sulci pattern. In contrast, hemispheric asymmetry values appeared to be substantial. The predominance of the left occipital area was seen distinctly in the ventro-caudal portion of the occipital lobe. It was frequently reversed in the dorsal aspect of the lobe, notably in more rostral cuts. Such complexities may lead to ambiguities in interpreting VEP asymmetries. PMID- 1767491 TI - Influence of remote objects on local depth perception. AB - The perceived relative depth of two test dots displayed within the fovea is shown to be influenced by other features in the surrounding area. These features can be as far apart as 51 deg and can have relative disparities as large as 20 deg, much larger than the disparities of the test dots. Since this effect is seen for stimuli presented for 100 msec or less, changes in direction of gaze cannot play a role. The effect varies inversely as the spatial separation between the test dots and the remote features, and is insensitive to the relative disparities of these remote features when they are greater than 2 deg. Observers sometimes differ significantly from each other in their responses to various configurations of the outlying features. This appears to rule out response mechanisms which depend only on the stimulus; some characteristics of the observer must be involved in determining the response. For these briefly presented stimuli, observers are unable to report accurately the relative depth of the central foveated test items if they are also required to report the depths of distant peripheral features. PMID- 1767492 TI - Segregation of some mesh-derived textures evaluated by free viewing. AB - Beginning with a hexagonal mesh, a family of equiluminous geometric textures can be formed by rotating each line segment by a fixed amount. Such textures vary both in line orientation and in the sizes of the intervening spaces or "holes". In the Fourier domain the textures have the same discrete two-dimensional frequency components but the amplitudes vary. The segregation of texture pairs as figures in grounds has been assessed for free viewing by the ratings of 10 subjects. Line segment orientation information alone cannot explain the results. Linear regression techniques were used to examine the correlation between the subjects' ratings and physical differences between figures and grounds. Significant correlations were found with (a) the amplitudes of the low-frequency Fourier harmonics of the textures and (b) maximum hole size, but not with the third harmonics or line segment orientation. Patterns composed of mirror-image pairs are very poorly discriminated; in these cases line orientation information may be used. PMID- 1767493 TI - Infant eye movements: quantification of the vestibulo-ocular reflex and visual vestibular interactions. AB - The gain of the infant vestibulo-ocular reflex (VOR) was determined when infants were rotated either in total darkness or while they viewed visual targets consisting of a stationary spot or a full field of black and white stripes. The average VOR gain in the dark was 1.03 +/- 0.014 for 1-4-month-old infants and 0.59 +/- 0.03 for adult subjects tested with appropriate controls for psychological "set". Longitudinal studies showed no significant change in gain over the first 4 months of life. Although the presence of the spot or full-field striped background increased adult compensatory gains from 0.59 to 1.0, the same visual targets had no effect on infant gains. Thus, an infant's VOR gain of nearly 1.0 apparently reduces reliance on the poorly developed smooth pursuit and optokinetic systems that, in adults, help the VOR provide perfect ocular stabilization. PMID- 1767494 TI - Seeing "ghost" planes in stereo vision. AB - I have studied particular ambiguous random dot stereograms where multiple matches (that are equally possible) are available at each point. The human visual system resolves these ambiguities in two qualitatively different ways. In some cases a few transparent surfaces are perceived corresponding to all the ambiguous matches. In other cases a single dominant opaque surface is perceived. The conditions under which each behavior occurs are described. Additional experiments, designed to explore whether a number of modified stereo matching algorithms can predict human perception, are described, and their theoretical implications are discussed. PMID- 1767495 TI - Psychophysical measurement of spectral sensitivity and color vision in red-light reared tree shrews (Tupaia belangeri). AB - The role of the spectral lighting environment on the post-natal development of spectral sensitivity and color vision was studied in tree shrews (Tupaia belangeri) that were born and reared to adulthood in cyclic red light. Normal tree shrews are dichromats, possessing short-wavelength-sensitive (SWS) and long wavelength-sensitive (LWS) cone receptors and a small population of rods. Red light-rearing (RLR) produced differential stimulation of the cone types by effectively eliminating photic stimulation of the SWS cones, without depriving the LWS cones. Spectral sensitivity and color vision were measured behaviorally for RLR shrews and normal shrews under different ambient light levels. Spectral sensitivity functions were deutan-like, exhibiting maxima at ca 450 and 550 nm and a minimum at 510 nm. No significant differences in spectral sensitivity were observed between RLR and control animals. Furthermore, all animals demonstrated deutan-type dichromatic color vision evidenced by their ability to discriminate monochromatic lights from equally-bright achromatic lights except for a "neutral point" near 505 nm. These results demonstrate that a population of functional SWS cones survived the lack of post-natal photic stimulation. However, RLR shrews differed from controls in that they were poorer at making chromatic/achromatic discriminations. While no severe disorganization of color vision was evident, the poorer discrimination displayed by the RLR animals is likely the result of changes in post-receptoral visual mechanisms. PMID- 1767496 TI - The effects of contrast, spatial scale, and orientation on foveal and peripheral phase discrimination. AB - We examined the effects of contrast, spatial scale, and orientation, on phase discrimination thresholds. In expt I, the ratio of thresholds for 180 deg shifts in F + 2F gratings remained invariant across a wide range of fundamental contrasts. Experiment II demonstrated that random fluctuations in overall pattern contrast did not affect discrimination. Experiment III found that foveal, but not peripheral, thresholds were roughly independent of spatial scale; foveal peripheral differences in phase sensitivity could not be eliminated by scaling stimulus size. Finally, expt IV found that thresholds for some phase shifts varied significantly with orientation in the periphery; in general, peripheral sensitivity was greatest for radially-oriented gratings. The implications of these findings for models of phase discrimination are discussed. PMID- 1767497 TI - Interocular differences in transverse chromatic aberration determine chromostereopsis for small pupils. AB - Chromostereopsis has been attributed previously to interocular differences in foveal transverse chromatic aberration (TCA). We tested this hypothesis by measuring chromostereopsis as a function of the separation of small artificial pupils. We also measured the monocular transverse chromatic aberration under the same conditions. Our results show that chromostereopsis with small pupils can be precisely accounted for by the interocular difference in monocular transverse chromatic aberration. This relationship is closely predicted by a simple water eye model. PMID- 1767498 TI - Color vision following intense green light exposure: data and a model. AB - Hue discrimination, spectral sensitivity, and mathematical models of both are presented for a rhesus monkey which was exposed to intense green light. One of the monkey's eyes was blue-blinded in a previous experimental procedure and the other was color normal. The results of green light exposure showed a loss of sensitivity on both measures, with greater loss in the blue-blinded eye. Although there was considerable loss of hue-discrimination in the blue-green spectral regions, hue-discrimination at the point of best discrimination, 590 nm, remained unaffected. This pattern of results poses difficulties for models of hue discrimination, and has resulted in the proposed model employing three opponent color channels. The number of free-parameters are minimized and the integration between spectral sensitivity and hue discrimination enhanced by deriving parameters used in modeling hue discrimination from spectral sensitivity or vice versa. PMID- 1767499 TI - Psychophysical evidence for low-level processing of illusory contours and surfaces in the Kanizsa square. AB - Increment thresholds were measured on either side of one of the illusory contours of a white-on-black Kanizsa square and on the illusory contour itself. The data show that thresholds are elevated when measured on either side of the illusory border. These elevations diminish with increasing distance of the target spot from the white elements which induce the illusory figure. The most striking result, however, is that threshold elevations are considerably lower or even absent when the target is located on the illusory contour itself. At an equivalent position in a control figure where no illusory contour is visible, such a threshold decrease does not occur. The present observations add empirical support to low-level explanations of illusory contour perception. PMID- 1767500 TI - Quick phase programming and saccadic re-orientation in congenital nystagmus. AB - Horizontal single-step stimuli were presented to 19 subjects with congenital nystagmus (CN). When the stimulus jump was in the same direction as the waveform beat, spatial and temporal measurements of the responses revealed that saccades occurring between 90 and 180 msec after the stimulus were directed to an average of the spatial locations of the initial and final target positions. Transition functions of response end position against delay resembled those collected from normal subjects responding to either double-step staircase or pulse-overshoot stimuli, according to the stimulus direction. An analogy is drawn between the response to a single-step stimulus in the presence of CN and responses made by normal subjects to double-step stimuli. These findings suggest that pathways involved in the computation of amplitude of visually guided saccades also participate in programming CN quick phases and that the time taken to programme CN quick phases is similar to that for voluntary saccades. Evidence of saccadic parallel processing was demonstrated in some, but not all, of the subjects. Responses to steps in the same direction as the nystagmus beat frequently overshot the target. The mean overshoot was proportional to the amplitude and intensity of the nystagmus. Responses to stimuli presented in a direction opposite to the nystagmus beat were as accurate as the responses of a normal control group. PMID- 1767501 TI - Visual field asymmetries in pattern discrimination: a sign of asymmetry in cortical visual field representation? AB - A visual field asymmetry is described relative to the discrimination of mirror symmetric bars with ramp-like luminance profiles. Along the vertical meridian the discrimination is better performed for patterns oriented parallel to the meridian than for patterns oriented orthogonally at all eccentricities tested (2-8 deg). Along the horizontal meridian, the preference for radially oriented stimuli is present at 2 deg from the fovea, but vanishes at larger eccentricities. The meridional asymmetry thus revealed psychophysically may reflect asymmetries in the representation of the vertical and horizontal meridians in the human visual cortex. PMID- 1767502 TI - Transmission of light across the adult and neonatal eyelid in vivo. AB - Light transmission characteristics of the human adult and neonatal eyelid were measured in vivo. Light was delivered via a grating monochromator through a fibre optic mounted onto a contact lens placed under the eyelid, and detected using a photodiode on its external skin surface. Data from 5 adult and 9 preterm neonatal subjects indicate that the eyelid acts as a predominantly red-pass filter, with mean transmissions at 700 nm of 14.5% in the adult and 21.4% in the neonate, declining to less than or equal to 3% in both groups below 580 nm. The relevance of this data to clinical electrophysiology and to estimates of retinal irradiance is discussed. PMID- 1767503 TI - [Report on the activities of the journal Voprosy Onkologii in 1989 and 1990]. PMID- 1767504 TI - [Neutron teletherapy in head and neck neoplasms]. PMID- 1767505 TI - [Activation of erbB-2 oncogene and prognosis of the course of human breast cancer]. PMID- 1767506 TI - [Relationship between cancer of the large intestine and beta-glucuronidase activity]. PMID- 1767507 TI - [Immunophenotype of lymphocytes of patients with malignant melanoma and its dynamics during immunotherapy with interleukin-2]. AB - A Mab set was used to study immunological phenotype of lymphocytes of five patients bearing stage IV malignant melanoma and its changes developing in the course of interleukin-2 (Euro cetus) immunotherapy. Patients were shown to have lowered counts of T cells (mainly due to T-helper/inducers), B cells and lymphocytes expressing adhesion and activation molecules as well as abnormal immunoregulatory cell ratio. Two patients receiving interleukin-2 achieved a response. Follow-up of antigen expression revealed a rise in natural killer and immunoregulatory T lymphocyte levels in the responders whereas activation antigens and B cell levels were increased in all the patients. PMID- 1767508 TI - [Laminin and heparan sulfate proteoglycan of the basal membrane in basal cell cancer (an immunohistochemical study using monoclonal antibodies)]. AB - Levels of laminin and heparan sulfate proteoglycan (basal membrane components) were studied immunohistochemically in samples prepared from 18 basal-cell carcinomas using indirect immunoperoxidase technique. In the majority of cases, the basal membrane surrounding tumor foci remained unaltered. Some areas of solid basaliomas revealed defects in the membrane as well as deposits of laminin (but not heparan sulfate proteoglycan) in tumor tissue. It was suggested that areas of basalioma are surrounded by chemically defective membrane. PMID- 1767509 TI - [Malignant neoformations of the hematopoietic and lymphoid tissues in the personnel of the 1st plant of atomic industry]. AB - Rates of mortality from hemopoietic and lymphoid malignancies for 1948-1987 were studied in male staff of industrial atomic reactors and radiochemical industry for irradiated uranium processing versus dose of external gamma radiation. An increase in mortality due to radiation--induced acute leukemia was registered in the radiochemical industry staff 5-10 years following the start of exposure and was associated with high dose of external radiation. The risk of acute leukemia for this period was 1.65 x 10(-3) x Sv-1 cases during 5 years whereas within the other 30-35 years of follow-up the risk of death from hemolymphoblastosis or acute leukemia was less than 1 x 10(-3) x Sv(-1) during 5 years. PMID- 1767510 TI - [Prognostic significance of natural cytotoxicity of lymphocytes in chronic leukemia]. PMID- 1767511 TI - [The 1st case of adult T-cell leukemia (ATL) with expressed immune response to HTLV in the USSR]. AB - The first of case of adult T-cell prolymphocytic lymphosarcoma is reported which according to the natural course, cell composition of tumor, cell surface markers as well as expressed immune response to a wide spectrum of HTLV-1 gag an env encoded proteins can be classified as HTLV-associated adult T-cell leukemia. Diagnosis of the tumor alongside with identification of HTLV-1-infected individuals in the USSR emphasizes the need to stimulate research in HTLV-1 associated carcinogenesis in this country. PMID- 1767512 TI - [Level of plasma fibronectin and its biological activity in patients with ovarian cancer]. AB - Plasma level of fibronectin and its biological activity were assessed in 33 females suffering ovarian cancer; 13 cases had stage I or II disease whereas 20 stage III or IV tumors. Fibronectin level, as measured by immunoelectrophoresis, proved normal. This was accompanied by a statistically significant (p less than 0.05) rise in gelatin--binding activity of the glycoprotein in patients with stage I-II cancer which accounted for an increased value registered for the entire group studied. However, no such rise was observed in cases of stage III and IV disease. PMID- 1767513 TI - [Recurrence and regional metastasizing of breast cancer after surgical treatment]. AB - Frequency and time of relapse and regional spreading following surgery were studied in 1516 cases of breast cancer. Recurrence was observed in 10.4% of patients whereas regional metastasis--in 10.7%. Risk of relapse was found to depend upon stage and pattern of tumor rather than type of mastectomy. Mastectomy after Patey proved no inferior to that after Halsted for early breast cancer. PMID- 1767514 TI - [Improvement of ultrasonographic diagnosis of stomach cancer]. AB - A method for abdominal ultrasonographic diagnosis of gastric cancer is suggested which includes evaluation of the gastric wall and regional lymph nodes, and search for distant metastases. Gastric tumors were visualized in 92.9% of cases. The procedure should be performed both in cancer suspects and cases with reliably established gastric neoplasm to assess local extent of tumor and detect regional and distant metastases. PMID- 1767515 TI - [Analysis of the surgical treatment of rectal cancer]. AB - Radical surgery was performed in 242 cases of rectal cancer. Female patients made up 60.3% of the group. Stage distribution was as follows: T1-13.3%, T2-21, T3 53.7 and T4-12% of patients. Lower ampullar part of the rectum was affected in 21.5% of cases whereas mid- and upper ampullar and rectosigmoid parts--in 28.1, 30.6 and 19.8% of cases, respectively. Exophytic tumors were registered in 49.6% of patients. Sphincter-saving surgery was performed in 68.2% of cases. In a group of 73 patients in whom abdomino-anal resection was performed prior to introduction of revascularization of withdrawn intestine, withdrawal was carried out in 65.8% of cases whereas in 34.2% anus preternaturalis was formed. Subsequently, local necrosis was encountered in 14.6% of cases while extensive one--in 8.3%. After the advent of revascularization, withdrawal was carried out in 95.4% of 44 operated patients. No necrotic changes were observed. PMID- 1767516 TI - [Ways toward improvement of the results of cystectomy in bladder cancer]. AB - Cystectomy with derivation of urine into large bowel reservoir was performed in 35 cases of bladder cancer including five females. Four patients (11.4%) died postoperatively. In patients with partial or complete ileocecal valve failure, the best functional results were obtained with formation of intussusceptum in the area of the ileum stoma. The reservoir volume increased with time, reaching 750 +/- 57.9 ml by the end of the second year. Within the same period, pressure in the totally filled reservoir decreased from 32 +/- 1.7 to 18 +/- 4.3 un. Postoperative monitoring of anatomic structure of the kidneys showed improvement in urine passage. Wide integration of the procedure discussed with practice will improve results of bladder cancer treatment. PMID- 1767517 TI - [Time of restoration of menstrual cycle in the puerperium and risk of development of breast cancer]. PMID- 1767518 TI - [Autologous venous prosthesis of the internal jugular vein in bilateral Crile's operation]. PMID- 1767519 TI - [Treatment of synchronous-metachronous cancer of 3 visceral organs]. PMID- 1767520 TI - [Invagination ileus in sigmoid cancer]. PMID- 1767521 TI - [Cytological diagnosis of nodular tenosynovitis]. PMID- 1767522 TI - Tourette's syndrome and treatment with clomipramine hydrochloride. AB - Clomipramine hydrochloride, a tricyclic antidepressant that blocks serotonin and norepinephrine reuptake, is indicated in the treatment of Obsessive-Compulsive Disorder. It has been reported that patients with Obsessive-Compulsive Disorder and a concomitant diagnosis of Tourette's Syndrome respond well to treatment with clomipramine (1). It has also been reported that these dually-diagnosed patients, when treated with clomipramine, receive relief from the symptoms of both disorders (2). Published reports of Tourette's patients, without a concomitant Obsessive-Compulsive Disorder, successfully responding to treatment with clomipramine are rare. To the authors' knowledge, no such report has been published since 1975. This article reports the case of a 41-year-old male Tourette's patient, without a dual diagnosis of Obsessive-Compulsive Disorder, who successfully responded to clomipramine therapy. PMID- 1767523 TI - Conquest of the gout. AB - With students such as Hippocrates, Galen, Paracelsus, Sydenham, Herberden, Harvey, Cheyne, Boerhaave and Pare, the history of "The Gout" (L. gutta-drop), more than any other disorder, parallels the history of Western medicine. It also played important parts in modifying American and European culture and history. Such was the fear and honor it commanded in the last 3,000 years, that over a score of saints and holy men are credited with its cure. Long stated to be a disease of the upper class, at one time, it was considered so stylish that it was said that the only thing worse than having it was to be cured. PMID- 1767524 TI - Politics and the extra effort. PMID- 1767525 TI - Campaign of misinformation about new nursing technician rules. PMID- 1767526 TI - Ask the nurse attorney. Nursing malpractice liability. PMID- 1767527 TI - Medicaid: women & children. PMID- 1767528 TI - What to do when you believe staffing is unsafe. Part 1. Assignment despite objection. PMID- 1767529 TI - The Board of Nursing explains guidelines, rules and advisory opinions. PMID- 1767530 TI - At what level of preparedness are they? PMID- 1767531 TI - Ask the nurse attorney. To report or not to report--that is the question. PMID- 1767532 TI - Cellular physiology and pathophysiology of the parathyroid glands. AB - This report provides insight into parathyroid gland physiology and the pathophysiology of hyperparathyroidism (HPT). Increases in the extracellular calcium concentration constitute the primary physiological signal for inhibition of parathyroid hormone (PTH) release. Transduction of the external signal into a cellular response involves activation of a cation receptor mechanism on the plasma membrane with rapid rise in the cytoplasmic calcium concentration of the cells. This recently discovered parathyroid calcium receptor has been characterized as a glycoprotein of unusually high molecular weight, which may play a key role in calcium homeostasis since it is also expressed in the kidney and placenta. Binding of external calcium to the receptor is associated with mobilization of intracellular calcium as well as calcium influx into the cells and phosphoinositol hydrolysis. These events rapidly interfere with the release process through essentially unknown mechanisms and probably also at sustained stimulation inhibit PTH gene transcription. The relative calcium insensitivity of the PTH release in HPT is associated with a deranged regulation of cytoplasmic calcium within pathological parathyroid cells. The molecular basis for this disturbance comprises down regulation of the cation receptor, whereby external calcium is translated into abnormally low levels of cytoplasmic calcium and insufficient inhibition of PTH release. Studies on expression of the functionally important cation sensing glycoprotein and its associated cellular signal systems may provide novel means for interference with the pathophysiological derangements of HPT. PMID- 1767533 TI - Primary hyperparathyroidism: epidemiology, diagnosis and clinical picture. AB - Primary hyperparathyroidism (HPT) is a common disorder that mainly afflicts elderly women. It can be diagnosed in at least 1% of all postmenopausal females and autopsy studies indicate an even higher frequency. Although the widespread use of automated serum calcium analyses has increased the awareness of HPT, only 10% of all cases seem to be identified. The diagnosis relies on the demonstration of an inappropriately elevated serum concentration of parathyroid hormone (PTH) relative to the serum calcium value, which need not be markedly raised. Measurements of intact PTH with immunometric methods have considerably improved the diagnostic precision but it is still difficult to evaluate patients with only marginal hypercalcemia. Few patients with diagnosed HPT are completely without symptoms. Symptoms commonly encountered are psychiatric and neuromuscular disturbances. Subclinical bone disease might be relevant but there is insufficient information about its importance in otherwise asymptomatic individuals. Various cardiovascular risk factors appear more commonly in patients with HPT and untreated disease is associated with an increased risk of premature death. PMID- 1767534 TI - Surgical treatment of primary hyperparathyroidism: an institutional perspective. AB - Three hundred and eighty-four consecutive patients with primary hyperparathyroidism (HPT) were surgically treated at a single institution during the 2 year period 1983 through 1984. Two patients were found to have benign familial hypocalciuric hypercalcemia and a single patient had parathyroid carcinoma. In the remaining 379 patients, the cure rate was 99.5%, the operative mortality 0.3%, persistent vocal cord paralysis 0.8%, and permanent hypocalcemia 0.3%. This data supports a liberal policy regarding cervical exploration in patients with HPT and questions any policy of observation without surgical intervention. PMID- 1767535 TI - The role of the pathologist in diagnosis and surgical decision making in hyperparathyroidism. AB - Hyperparathyroidism has been diagnosed with increasing frequency in recent decades. The concomitant awareness that the disease may be the cause of a concealed morbidity and even an increased mortality has resulted in more liberal indications for surgery. Many patients currently undergo surgery on the grounds of only mild hypercalcemia and in the absence of any apparent clinical symptoms. This policy of early surgical treatment has emphasized the importance of a histopathological parathyroid diagnosis, since many of these patients exhibit chief cell hyperplasia and minimal glandular enlargement. Light microscopic examination of frozen sections stained with hematoxylin-eosin and with stains for demonstration of cytoplasmic fat in the parathyroid chief cells, and appropriate weight estimates of the parathyroid glands, constitute the conventional, intra operative basis for the diagnosis. The use of specific antiparathyroid antibodies is an important new tool in the histopathological parathyroid examination, mainly because of the ability to demonstrate the cause of increased parathyroid hormone release from the pathological parathyroid tissue. A careful histopathological examination in combination with gross inspection of the parathyroid glands by an experienced eye should contribute to adequate surgical treatment and minimize errors in operative management in patients with hyperparathyroidism. PMID- 1767536 TI - Pre-operative localization and interventional treatment of parathyroid tumors: when and how? AB - A variety of diagnostic tests are currently used for parathyroid localization. In patients who have not had previous surgery, none of these are as sensitive or specific for the localization of abnormal parathyroid glands as an experienced surgeon. In these patients, no pre-operative localization procedures are normally needed. Patients who have had previous thyroid or parathyroid surgery require pre operative localization. Noninvasive imaging procedures (ultrasound, scintigraphy, computed tomography, magnetic resonance imaging) should be performed until an abnormal gland is identified in the same location on at least 2 examinations. The order in which these studies are performed is not important. In the 50% to 70% of patients in whom noninvasive studies are inconclusive, suspicious lesions may be aspirated or biopsied with imaging guidance. If this cannot be done or is nondiagnostic, angiography and, if necessary, parathyroid venous sampling should be done. Intra-operative ultrasound examination of the neck is helpful during re operations. In selected patients, parathyroid tumors may be ablated by injection of contrast material through an angiographic catheter into the artery supplying the gland, or by percutaneous injection of alcohol into the gland itself. Angiographic ablation is best used for mediastinal glands supplied by the internal thoracic artery or by a descending branch of the inferior thyroid artery. Percutaneous alcohol injection may injure the recurrent laryngeal nerve permanently and should be limited to the rare patient with a neck lesion who has a prohibitive surgical risk. Neither technique is as effective as surgery. PMID- 1767537 TI - Management of patients with persistent or recurrent primary hyperparathyroidism. AB - The surgical management of patients with persistent or recurrent primary hyperparathyroidism is reviewed. The several factors allowing the surgeon to formulate a correct working diagnosis and to successfully remove all abnormal parathyroid tissue are individually discussed and recent results of re-operative parathyroid surgery are presented. In particular, direct surgical exploration based on aggressive pre-operative localization studies, the use of intra operative ultrasound to facilitate intra-operative dissection, cryopreservation of excised parathyroid tissue with potential for delayed autograft to avoid permanent hypoparathyroidism, and the use of intra-operative monitoring of urinary cyclic adenosine monophosphate levels in patients with parathyroid hyperplasia in whom the surgeon is uncertain whether all abnormal parathyroid tissue has been removed, each contribute to a high rate of successful management (greater than 95%) for patients with the difficult problem of persistent or recurrent primary hyperparathyroidism. PMID- 1767538 TI - Asymptomatic primary hyperparathyroidism. AB - The criteria used in selecting patients with asymptomatic hyperparathyroidism (HPT) for surgery remain controversial. Do patients with asymptomatic HPT have less severe disease (smaller glands and less derangement of biochemistry) than those with symptoms? We studied a consecutive series of 111 patients with HPT surgically treated and compared the symptomatic patients (n = 83) and asymptomatic patients (n = 28). There were no significant differences between the two patient groups with respect to age, serum calcium, PTH (intact 1-84), and excised gland weights (adenomas). Hypercalcemia was cured in all patients. The natural history of mild or asymptomatic HPT is unknown, but we summarize the current knowledge relating to mortality, cardiovascular/renal disease, psychiatric and neuromuscular disorders, and bone disease. Symptoms of HPT do not correlate with the degree of biochemical and pathological derangement. Furthermore clinical assessment does not predict severity of disease and should not be the sole basis of selection for surgery. The results of surgery for primary HPT permit us to advocate a liberal approach to the selection of asymptomatic patients for operation. PMID- 1767539 TI - Management of hyperparathyroid patients with grave hypercalcemia. AB - During recent years the total number of patients undergoing surgery for hyperparathyroidism has markedly increased, but the annual number of cases with substantial hypercalcemia has remained unchanged. Parathyroid carcinoma and water clear cell hyperplasia cause more severe hypercalcemia than other kinds of hyperparathyroidism. Grave hypercalcemia due to hyperparathyroidism is more common among the elderly, but can occur during pregnancy and also among children. Occasionally, a patient with hyperparathyroidism can also have another cause of the hypercalcemia and does not become normocalcemic until adequately treated for both. The suspicion of grave hypercalcemia should arise due to its clinical features. Determination of serum calcium and intact parathyroid hormone concentrations establishes the diagnosis. The basic treatment of grave hypercalcemia is to rehydrate the patient and to restore the sodium losses. To further lower the serum calcium value we have found bisphosphonates to be very effective. The definitive treatment of grave hypercalcemia due to hyperparathyroidism is surgery. As a last resort, frail patients with grave hyperparathyroidism can undergo surgery under local anesthesia. Repeat operations can improve the prognosis of patients with metastatic parathyroid carcinoma. Selective venous catheterization with blood sampling for determination of intact parathyroid hormone can be helpful in localizing recurrent disease. PMID- 1767540 TI - Diagnosis and treatment of patients with parathyroid carcinoma: an update and review. AB - Parathyroid carcinoma is a rare cause of primary hyperparathyroidism. However, to our best knowledge, at least 163 cases of functioning parathyroid carcinoma appeared in the English literature from 1981 to 1989. We summarize the available information obtained from the reports of those patients and compare it with previous descriptions of the disease. The etiology of parathyroid carcinoma is usually obscure, but the possibility of a radiation-induced malignant change in the parathyroid gland became evident in a few patients. Clinical manifestations, including age, sex, symptoms, and biochemical findings in this review were comparable to those in previous reviews. Noninvasive localization studies such as ultrasonography may offer a diagnostic clue to parathyroid carcinoma. Measurement of DNA content is a useful adjunct for making the histologic diagnosis of parathyroid carcinoma and prediction of the clinical outcome. Since the initial operation offers the best chance for cure, pre-operative suspicion and intra operative recognition of the parathyroid cancer are essential. The initial operation should be en bloc resection of the tumor, avoiding rupture of the tumor capsule and spillage of tumor cells. As parathyroid carcinoma is a slow-growing but tenacious malignancy, repeated resection of local recurrent tumors or even distant metastases is effective for palliation of recurrent hypercalcemia and occasional cure. When hypercalcemia is refractory to surgical therapy or no recurrent tumor can be identified, other modalities of therapy must be considered. New drugs to control hypercalcemia by inhibiting bone resorption may hold promise in patients with recurrent parathyroid carcinoma. PMID- 1767541 TI - Subtotal parathyroidectomy versus total parathyroidectomy and autotransplantation in secondary hyperparathyroidism: a randomized trial. AB - In a randomized study subtotal parathyroidectomy (sPTX) was compared with total parathyroidectomy and autotransplantation of fresh tissue (PTX + AT) in 40 patients with severe secondary hyperparathyroidism (HPT). After surgery both groups were followed at 19 +/- 6 months (PTX + AT) and 19 +/- 7 months (sPTX) and at 43 +/- 9 months (PTX + AT) and 40 +/- 7 months (sPTX). There were 17 patients alive in each group at the time of the second follow-up. After sPTX, 2 patients required re-operation because of recurrent disease originating from the remaining parathyroid gland in the neck and another 2 patients were hypercalcemic at follow up. After PTX + AT both serum calcium and alkaline phosphatase normalized significantly more often (p less than 0.03) than after sPTX. Re-operations were not required in this group. Radiological signs also improved significantly more after PTX + AT, as did clinical signs like pruritus (p less than 0.005) and muscle weakness (p less than 0.04). These results and the fact that in recurrent disease a re-operation at the autograft in the forearm is simpler than a re operation in the neck, lead to the recommendation that PTX + AT should be considered as the method of choice in the surgical treatment of secondary HPT. PMID- 1767542 TI - Replantation of cryopreserved human parathyroid tissue. AB - Twenty-five patients with permanent postoperative hypoparathyroidism received cryopreserved parathyroid autografts. Twelve patients had undergone cervical re operations due to persistent or recurrent hyperparathyroidism and 10 patients had malfunction of a fresh autograft after total parathyroidectomy. Hypoparathyroidism occurred in 2 patients after subtotal parathyroidectomy and in 1 after the resection of a solitary adenoma following previous thyroid resection. The viability of the tissue was examined histologically prior to replantation in 22 patients and the amount of tissue needed for transplantation was determined by the ratio of necrotic cells vs. viable cells in the material. The patients were examined between 6 months and 125 months (median: 40 months) after replantation. Pre-operatively each patient required high doses of calcium and vitamin D metabolites to establish normocalcemia. This medication was reduced postoperatively, with 16 patients requiring no supplemental treatment. Nine patients still needed low doses of calcium and/or vitamin D. At follow-up all patients were free of hypocalcemic symptoms. Our results demonstrate that replantation of autologous cryopreserved parathyroid tissue is safe and effective therapy for permanent postoperative hypoparathyroidism. Thus, we regard it as an essential part of today's parathyroid surgery. PMID- 1767543 TI - A new technique of "Marlex-peritoneal sandwich" in the repair of large incisional hernias. AB - Repair of a large abdominal wall incisional hernia is a difficult surgical problem with recurrence being a common complication. In addition, other complications such as hematomas, seromas, and sinus formation result from the use of foreign material. A new technique to obviate these complications was used in 60 patients with large incisional hernias repaired over the last 15 years. Marlex polypropylene mesh was used for repair, sandwiched between 2 layers of peritoneum of the overstretched hernia sac. There was no operative mortality and no recurrence in follow up from 3 years to 7 years. Postoperative complications encountered could be managed conservatively, without necessitating any major surgical procedure or mesh removal. PMID- 1767544 TI - Prognostic factors in primary gastrointestinal leiomyosarcoma: a retrospective study. AB - Thirty-six patients who were admitted for surgical resection of leiomyosarcomas of the gastrointestinal tract to the Department of Surgery II, Kanazawa University Hospital, Kanazawa, Japan and its affiliates are included in the study. Follow-up data on survival is available for 32 patients. The clinico pharmacologic variables, such as tumor site, tumor size, cellularity, mitotic index, and DNA ploidy pattern were analyzed and the results proved to correlate with the prognosis. Thirteen (41%) of the patients presented with distant metastases and/or recurrences, with hematogenous metastasis being the predominant type of recurrence. Local recurrences and/or distant metastases were significantly correlated with survival (p less than 0.001), as was tumor site (p less than 0.03), tumor size (p less than 0.04), surgical treatment (p = 0.05), and DNA ploidy pattern (p = 0.06). Neither the mitotic index nor the cellularity proved to be significantly correlated with survival. Furthermore, some of the patients with local recurrences or distant metastases survived long after resection of recurrent tumors. In view of the results, aggressive surgical resection may be an efficient treatment of recurrences. PMID- 1767545 TI - Cytogenetic studies in patients with gastric cancer. AB - Banded cytogenetic studies of gastric carcinoma are still relatively scarce, comprised of only a small number of patients. This study was performed on peripheral blood lymphocytes and malignant cells of 16 patients with gastric carcinoma. The lymphocytes were analyzed by standard techniques. All patients had a normal constitutional karyotype; 90% of the patients presented an increased breakage rate and nonrandom chromosomal instability mainly in the heterochromatic regions of chromosomes 1, 9, and 16. Decreased response to phytohemagglutinin was observed in 6 (38%) patients. The tissue specimens were analyzed using direct techniques. Normal ploidy was observed in only one patient, 3 tumors were near diploid, 4 hyperdiploid, 4 near-triploid, and 4 near-tetraploid. Those with the near-triploid or near-tetraploid constitution were in a more advanced pathological stage, most of them with a more complex cytogenetic profile. Particular involvement was found for chromosomes 1 to 4, 7 to 9, 17, and 20, but the more specific nonrandom changes seemed to involve chromosomes 7, 8, 9, and 17. PMID- 1767547 TI - [What are hepatitis-B mutants?]. PMID- 1767546 TI - Foreign body ingestion: management of 167 cases. AB - We reviewed the management of 167 patients with foreign body ingestion from 1980 to 1986. Two patients (1.1%) refused treatment. Nonoperative management was attempted in 14 (8.4%) patients. Endoscopy was performed on 117 patients with an overall success rate of 85.5% and a complication rate of 1.7%. Surgical treatment was required in 51 (30.0%) patients, 14 of whom had previous unsuccessful endoscopy. PMID- 1767548 TI - [Vision assessment]. PMID- 1767549 TI - [Clinical experiences in the use of diclofenac (Rewodina) in the symptomatic treatment of nephrotic syndrome]. PMID- 1767550 TI - [Application of electronic endoscopy with special reference to pneumonology and gastroenterology]. PMID- 1767551 TI - [Headache and eyes: temporal arteritis]. PMID- 1767552 TI - [Prevention, inclusion and therapy of congenital toxoplasmosis in the Basel region (Switzerland)]. PMID- 1767553 TI - [Which symptoms appear first: iron deficiency or geophagia?]. PMID- 1767554 TI - [American classification the basis for utilization of ambulatory treatment]. PMID- 1767555 TI - [Knowledge gain for medical methodology from the history of medicine]. PMID- 1767556 TI - [Radiologic and sonographic screening study of shoulder joints of patients with rheumatoid arthritis]. AB - In the course of a prospective study at our department the shoulder joints of 50 RA-patients were examined. Two criteria have been applied: only righthanded patients have been examined in order to ascertain any prevalence of changes in the dominant extremity, and only patients who were primarily admitted to our department because of complaints other than those of the shoulder. Examination consisted of anamnesis, clinical tests, radiography and sonography. Reports in the literature concerning involvement of 60%. This percentage was confirmed in our clinical and radiological examinations. If, however, sonography is used, it increases to 96%. Lesions of the rotator cuff can be demonstrated, beginning on the synovial side above bone erosions, without any clinical signs or radiographic changes. Radiographic changes have been rated according to Larsen stages 0-5. Upward migration of the humeral head already before massive bone destruction of the shoulder seems to confirm an early involvement of the rotator cuff. Involvement of the acromioclavicular joint begins with Larsen stage 2 and often includes a distension of the joint cavity. The dominant extremity was not found to be affected predominantly. The therapeutic consequences resulting from this examination are discussed. PMID- 1767557 TI - [Significance of blood Ca(++) determination for assessment of the current status of calcium homeostasis]. AB - Out of the blood calcium fractions know only the ionized calcium is biologically active. From the height of the total calcium level despite significant dependence no secure conclusion to the Ca++ concentration can be drawn. The level of the total calcium spreads further than that one of the ionized calcium. The up to now used mathematical approaches for the estimation of the blood Ca++ concentration also proved unsuitable; none of them provides a really better statement than the total calcium level. Thus even they represent no acceptable alternative to the Ca++ determination by means of ion-selective electrodes. The investigation by means of ion-selective electrodes. The investigation of various paraclinical sizes (total calcium, total protein, albumin, creatinine, alkaline phosphatase) in a group of patients and a control group in quality and quantity resulted in a different influence on the Ca++ level by the influential factors tested. Only by measurement of the ionized calcium the real actual condition of the calcium homoeostasis can be reflected. Therefore it is no more justified to draw diagnostically and therapeutically relevant consequences from the exclusive determination of the total calcium level. PMID- 1767558 TI - [Changes in indications for liver biopsy]. AB - The author tries to analyse the modification of the indication to the needle biopsy of the liver. The clinician still only rarely demands from the pathologist the verification of an acute hepatitis and the proof of an obstruction. On the other hand a differentiation of persisting and aggressive hepatitis is possible only by a morphological investigation. Nowadays the tasks of the pathologist are mainly the confirmation or the exclusion of liver lesions caused by alcohol or pharmaceutical products and chemicals, respectively, and the diagnosis of a pseudo-alcoholic hepatitis. PMID- 1767559 TI - [The activity of serum cholinesterases following experimental choledochus ligation in the rat]. AB - The activity of serum cholinesterase was measured over three days after ligature of the common bile duct in female Wistar rats. A specific effect of the ligature was observed on the third day postop.: the activity decreased. The delayed reaction can be explained by the long half-life of the enzyme. Further, in all operated rats (sham-operated, too) a decrease of activity on the first postop. day was noticed. Possible causes are an influence of the anesthetics or sequels of the operative trauma. PMID- 1767560 TI - [A viatorium medico-historicum. VI. Historical highlights in university cities of the Saxony-Anhalt area]. AB - This part of a viatorium medico-historicum dealing with the region of Saxony Anhalt, which finishes the series of contributions, leads into the cities and towns of the country where colleges are located. Thereby points of memory and recollection from the history of medicine, pharmaceutics and natural sciences were written down. Briefly entered were life and work of personalities, in whom life and work are connected with the facts mentioned. PMID- 1767561 TI - [Legal code for public health physicians and compensation]. AB - The complete, updated laws governing doctors subject to the National Health Insurance System are to be found in volume V of the Social Legislation Statutes which went into effect on 1 January 1989. In this work there ist a description of the structure and the mission of the Association of National Health Insurance Doctors and of the Medical Board. Claims fur services rendered by doctors are to be forwarded to the Association for collection from the insurance carriers. To monitor said services both financial and technical control procedures have been established by the Association. Medicines prescribed by the doctors are also subject to control by the carriers and/or a commission of the Association to ascertain whether a medicine prescribed is the most appropriate for the particular situation and whether such medicine is really required in said situation. PMID- 1767562 TI - [What is the current attitude on treatment of euthyroid struma? What is the status of triiodothyronine in therapy?]. PMID- 1767563 TI - [Clinical aspects of consequences of the Chernobyl AES accident during 1986-1990 (main trends of scientific studies)]. PMID- 1767564 TI - [Rehabilitation of persons who had acute radiation sickness]. PMID- 1767565 TI - [Evaluation of the health status of pregnant women and newborn infants exposed to radiation as consequence of the Chernobyl AES accident]. PMID- 1767566 TI - [Dynamics of functional changes in the body of children in the period after the Chernobyl disaster]. PMID- 1767567 TI - [Realization of stochastic and nonstochastic effects of thyroid gland irradiation in the course of 5 years after the Chernobyl AES accident]. PMID- 1767568 TI - [Health status of persons who participated in the elimination of consequences of the Chernobyl AES accident]. PMID- 1767569 TI - [The field session of the USSR AMS Presidium on the results of the implementation of the complex specialized scientific-technical program in the area of medicine in the liquidation of the consequences of the Chernobyl AES accident in 1986-1990 and prospects of further studies in radiation medicine]. PMID- 1767570 TI - [Psychoneurological and psychological aspects of the consequences of the Chernobyl AES accident]. PMID- 1767571 TI - [Radiation-epidemiologic analysis of the data of State Registry of persons exposed to radiation due to the Chernobyl AES accident]. PMID- 1767572 TI - [Results of the implementation of experimental radiobiological studies according to the C.27 program and prospects of further studies]. PMID- 1767573 TI - [The status and prospects of research at the Institute of Experimental Radiobiology of the All-Union Research Center of Radiation Medicine, AMS USSR]. PMID- 1767574 TI - [The way of life of the population exposed to radiation as a health-forming factor]. PMID- 1767575 TI - [Immunological indicators in the workers of the 30-kilometer zone of the Chernobyl AES]. PMID- 1767576 TI - [State of the organ of vision in persons exposed to radiation in connection with the Chernobyl AES accident]. PMID- 1767577 TI - [Chernobyl: psychosocial aspects of medical consequences]. PMID- 1767578 TI - [Characteristics of stomach and duodenal diseases in the framework of high radiation exposure]. PMID- 1767579 TI - [Study of regional differences in the population morbidity and mortality from the standpoint of geographical latitude syndrome]. AB - Based on a large material of international and Soviet investigations as well as on the data of official statistics, the authors analyze the main characteristics of the population morbidity and mortality depending on the geographic latitude. It has been demonstrated that with the moving away from the equator, the intensive growth of the general mortality is observable both in the USSR and in the countries of Europe and America as is of the lethality due to malignant neoplasms, circulatory diseases together with an increase of the lethality because of suicides. At the same time there is a dramatic lowering of the infantile death rate and of the mortality from infectious and parasitic diseases. It has been revealed that the incidence of arterial hypertension, alcoholism and drug addiction associated with the geographic latitude. Different factors that may underlie the regularities established are under analysis. An idea is advanced of the geographic latitude syndrome which is of paramount methodological importance for preventive medicine. PMID- 1767580 TI - [Interferon therapy in chronic hepatitis B and delta infection in children]. PMID- 1767581 TI - [Immunosorption of individual HIV proteins and virions]. AB - Immunosorbents specifically binding native (gp160, gp120, gp41) and recombinant env proteins and HIV-I virions were synthesized on the basis of Sepharose 4B and Silica with immobilized ligands such as gamma-fraction of rabbit antiserum to HIV I proteins and purified antibodies to env proteins of HIV-I. The possibility was shown of selective extraction of HIV-I virions and individual HIV proteins both in vitro and in vivo. The titer of virus antigens (in ELISA) after perfusion via an immunosorbent of patterns with a high content of virions and HIV-I proteins was 8 times as low as the starting titer (after perfusion via the control sorbent it was 2-fold decreased). Extracorporeal immunosorption in animals after intravenous injection of recombinant env protein permitted the latter's titer to be 5 times lower. After perfusion via the control sorbent the titer dropped by at least 20% as compared with the starting titer. The possibility of using immunosorption in multimodality therapy of AIDS is under discussion. PMID- 1767582 TI - Cell-free expression of the coxsackievirus 3C protease using the translational initiation signal of an insect virus RNA and its characterization. AB - We have expressed the 3C protease of coxsackievirus B3 (CVB3) in a cell-free system. This expression system employs the translational initiation signal of an insect virus RNA, black beetle virus (BBV) RNA 1, to direct CVB3-specific protein synthesis. Using this expression system, we demonstrate that a biologically active 3C protease is synthesized which possesses both cis and trans processing capabilities. This in vitro-synthesized 3C protease is analogous to the native 3C, which was obtained from cytoplasmic extracts of CVB3-infected HeLa cells, in all biological parameters that were evaluated. In addition, antibody prepared against the 3C protease purified from extracts of CVB3-infected HeLa cells cross reacts with the 3C protease produced in this cell-free system. Using the translational initiation signal from BBV RNA 1, we also have expressed the CVB3 capsid precursor and part of the P2 region in vitro, and have shown that the capsid precursor is cleaved between 1C (VP3) and 1D (VP1) by the proteolytic activity of in vitro-synthesized 3C in trans. Evidence also is presented to implicate the 2A protein of CVB3 as having proteolytic function. PMID- 1767583 TI - Structural comparison of the Autographa californica nuclear polyhedrosis virus induced RNA polymerase and the three nuclear RNA polymerases from the host, Spodoptera frugiperda. AB - A partial subunit structure has been determined for the novel RNA polymerase that is induced in fall armyworm (Spodoptera frugiperda) cells upon infection with the Autographa californica nuclear polyhedrosis virus (AcNPV). The putative structure includes nine polypeptides; the complexity of this structure is in accord with the high sedimentation coefficient (15S) estimated for this enzyme. A comparison of the putative structure of the virus-induced polymerase with those of the three host nuclear RNA polymerases shows that the structure of the viral polymerase is apparently unlike any of the host nuclear polymerases. This conclusion is reinforced by immunoblot experiments that show no cross-reactivity between the virus-induced polymerase and an antiserum directed against Drosophila RNA polymerase II. The virus-induced RNA polymerase appears at the onset of the late phase of infection and still appears when viral DNA synthesis is blocked by aphidicolin. Thus, the virus-induced polymerase seems to be composed of early viral products. PMID- 1767584 TI - Structure and morphogenesis of Dugbe virus (Bunyaviridae, Nairovirus) studied by immunogold electron microscopy of ultrathin cryosections. AB - We have studied the structure and morphogenesis of Dugbe (DUG) virus (Bunyaviridae, Nairovirus) in cultured porcine kidney (PS) cells and a tick cell line (Ra 243) using immunogold electron microscopy. DUG virus is a tickborne arbovirus, considered to be a low health hazard, that is antigenically and genetically related to Crimean Congo haemorrhagic fever (CCHF) virus (Marriott et al., 1990). We have investigated the maturation and intracellular transport of DUG virus particles as a model for other more pathogenic nairoviruses using monoclonal antibodies for immunogold labelling of ultrathin cryosections and immunofluorescence techniques. The spherical DUG virus particle measures about 90 nm in diameter, with a 5 nm thick membrane covered by 5-7 nm long projections or "spikes". These projections form hollow cylindrical morphological units, about 5 nm in diameter. DUG virus infection caused only a slight cytopathogenic effect in mammalian cells and none in tick cells. DUG virus particles assembled by budding from the Golgi complex, where the DUG virus glycoprotein G1 accumulated in vesicles originating from Golgi cisternae. The nucleocapsid protein N accumulated in scattered foci throughout the cytoplasm, and this appears to be related to the limited maturation of DUG virus particles that occurred. The reduced number of budding virus particles observed in tick cells was correlated with the reduced cytopathology observed. PMID- 1767585 TI - The determinants of heat-shock element-directed lacZ expression in Saccharomyces cerevisiae. AB - Heat-shock induction of heat-shock protein genes is due to a specific promoter element (the heat-shock element, HSE). This study used lacZ under HSE control (HSE-lacZ) to characterize HSE activity in Saccharomyces cerevisiae cells of different physiological states and differing genetic backgrounds. In batch fermentations HSE-lacZ induction by heat shock was maximal in exponential growth, and showed marked decline with the approach to stationary phase. Expression in the absence of heat shock was unaffected by growth phase, indicating that the growth-dependent expression of many yeast heat-shock genes uses promoter elements in addition to the HSE. Heat-induced expression was strongly influenced by the temperature at which cultures were grown. While basal, uninduced expression was constant during growth at different temperatures to 30 degrees C, induction by transfer to 39 degrees C was reduced by increases in growth temperature as low as 18-24 degrees C. Maximal HSE-lacZ induction (30- to 50-fold) was in cultures grown at low temperatures (18-24 degrees C), then heat shocked at 39 degrees C. Ethanol was a poor inducer. Mutations having little effect on HSE-lacZ expression included a respiratory petite; ubi4 (which inactivates the poly-ubiquitin gene); also ubc4 and ubc5 (which each inactivate one of the ubiquitin ligases involved in degradation of aberrant protein). pep4-3 increased both basal and induced beta galactosidase about two-fold, probably because of slower turnover of this enzyme in pep4-3 strains. PMID- 1767586 TI - The ade6 gene of the fission yeast Schizosaccharomyces pombe has the same chromatin structure in the chromosome and in plasmids. AB - We have analysed the chromatin structure of the ade6 gene of Schizosaccharomyces pombe and its flanking regions both in the chromosome and in plasmids. The chromatin structure is independent of the chromosomal or extrachromosomal location. The ade6 gene contains eight precisely positioned nucleosomes on the 5' half, 'not positioned' nucleosomes around the 3' end and a nuclease-sensitive promoter region. Precisely positioned nucleosomes, but no nuclease-sensitive region were also detected on the ura4 gene in the chromosome and on a plasmid. The results show that S. pombe chromosomal and extrachromosomal genes have chromatin structures similar to those of S. cerevisiae and higher eukaryotes. PMID- 1767587 TI - Yeast flocculation: Flo1 and NewFlo phenotypes and receptor structure. AB - Flocculation characteristics of 42 flocculent strains of Saccharomyces cerevisiae were examined. Two entirely distinct 'lectin-like' mechanisms of flocculation were distinguished by sugar, salt, and low pH inhibitions, protease sensitivity, and selective expression of flocculation. One group, termed Flo1 phenotype, was inhibited by mannopyranoses and contained all strains bearing known genes affecting flocculation. The other group, termed NewFlo phenotype, contained the majority of brewery ale stains and was inhibited by manno- and glucopyranoses. Detailed sugar-inhibition work revealed the probable receptor identity of both Flo1 and NewFlo flocculation, as being non-reducing termini of alpha-(1-3)-linked mannan side branches, two or three mannopyranose residues in length. PMID- 1767588 TI - The use of proline as a nitrogen source causes hypersensitivity to, and allows more economical use of 5FOA in Saccharomyces cerevisiae. AB - The use of proline as a nitrogen source causes hypersensitivity to 5-fluoro orotic acid (5FOA) and allows up to 40-fold less of this drug to be used to select for the loss of URA3 function in Saccharomyces cerevisiae. 5FOA hypersensitivity is presumably due to the absence of nitrogen catabolite repression when proline is substituted for (NH4)2SO4 as a nitrogen source. There are two constraints to the use of the proline-5FOA combination: (1) S288c genetic background strains are hypersensitive to 5FOA when grown in proline as a nitrogen source but at least one other genetic background is resistant to low levels of 5FOA under these conditions. (2) The addition of some nutritional supplements confers phenotypic resistance to the 5FOA-proline combination. PMID- 1767589 TI - A family of low and high copy replicative, integrative and single-stranded S. cerevisiae/E. coli shuttle vectors. AB - We describe a set of replicative, integrative and single-stranded shuttle vectors constructed from the pUC19 plasmid that we use routinely in our experiments. They bear a yeast selectable marker: URA3, TRP1 or LEU2. Replicative vectors carrying different yeast replication origins have been constructed in order to have plasmids based on the same construction with a high or low copy number per cell and with different mitotic stabilities. All the vectors are small in size, provide a high yield in Escherichia coli and efficiently transform Saccharomyces cerevisiae. These plasmids have many of the unique sites of the pUC19 multicloning region and many of them allow for the screening of plasmids with an insert by alpha-complementation. The nucleotide sequence of each of them is completely known. PMID- 1767590 TI - Intracellular expression of Kluyveromyces lactis toxin gamma subunit mimics treatment with exogenous toxin and distinguishes two classes of toxin-resistant mutant. AB - The Kluyveromyces lactis toxin is a heterotrimeric protein which irreversibly arrests proliferation of sensitive Saccharomyces cerevisiae cells in the G1 phase of the cell cycle. By expressing the gamma subunit of the toxin in sensitive yeast cells from a conditional promoter, it was previously demonstrated that it alone is required for inhibition (Tokunaga et al. (1989). Nucleic Acids Res. 17, 3435-3446). Here we show that, like native exogenous toxin, intracellular gamma subunit expression promotes a striking arrest of sensitive cells in G1. However, unlike the G1 arrest caused by native toxin, that induced by the gamma subunit alone does not result in reduced cellular viability and is fully and rapidly reversible, suggesting that the G1 arrest and the irreversibility of action may reflect different aspects of the toxin's interaction with sensitive cells. We have selected a large number of S. cerevisiae mutants which are highly resistant to the toxin in order to study its mode of action in more detail. Complementation analysis demonstrated that all but one of the mutants were recessive and these defined four separate genes. Members of two complementation groups concurrently acquired resistance to intracellular gamma subunit expression, suggesting that they contain a modified toxin target site. The other two genes appear to be required for entry of the gamma subunit into the sensitive cells since these mutants, while refractory to exogenous toxin, were fully sensitive to intracellular gamma subunit expression. PMID- 1767591 TI - Cytochrome P450 lanosterol 14 alpha-demethylase (ERG11) and manganese superoxide dismutase (SOD1) are adjacent genes in Saccharomyces cerevisiae. AB - DNA sequencing and analysis of genomic DNA using the polymerase chain reaction were used to demonstrate that SOD1 and ERG11 are adjacent genes in Saccharomyces cerevisiae S288c and to establish the correct intergenic sequence of this segment on chromosome VIII. PMID- 1767593 TI - The open reading frame YCR101 located on chromosome III from Saccharomyces cerevisiae is a putative protein kinase. PMID- 1767592 TI - Cloning and sequencing of the yeast Saccharomyces cerevisiae SEC1 gene localized on chromosome IV. AB - The SEC1 gene of yeast Saccharomyces cerevisiae was cloned by complementing the temperature-sensitive mutation of sec1-1 at 37 degrees C, and its nucleotide sequence was determined. SEC1 is a single copy gene and encodes a protein of 724 amino acids and 83,490 daltons with a predicted pI value of 6.11. Hydrophobicity plotting showed no clearly hydrophobic regions suggesting a soluble nature for the protein. Amino acid sequence comparisons revealed no obvious homologies with the proteins in the SWISSPROT databank. Two consensus sequence for the cdc2 encoded protein kinase recognition site were revealed within Sec1p. The codon usage suggests a low expression level for SEC1. The 5' non-translated region contains two TATA-like sequences at -52 and -215 nucleotides from the translation start site. Two potential regulatory sequences for DNA binding proteins were found in the non-coding 5' region: a HAP2/HAP3 consensus recognition sequence at nucleotide-154 and a BAF1 consensus recognition sequence at nucleotide-136. The SEC1 specific probe detected a 2400 nucleotides long transcript, which was in reasonable agreement with the 2172 nucleotides long open reading frame. PMID- 1767594 TI - Inhibitors of human and bovine trypsin and chymotrypsin in fenugreek (Trigonella foenum-graecum L.) seeds. Reaction with the human and bovine proteinases. AB - The reaction between the three Bowman-Birk proteinase inhibitors isolated from fenugreek seeds (TFI-B2, TFI-N2 and TFI-A8) and the human and bovine proteinases was investigated by studying the complexes formed and their properties. TFI-B2, the Lys-Leu trypsin chymotrypsin inhibitor, can bind 1.9 mol human trypsin (HT), 1.3 mol bovine trypsin (BT) and/or 0.4 mol human (HCT) or bovine (BCT) chymotrypsin per mole of inhibitor. HT was bound at the two reactive sites and BT mainly at the lysine-containing trypsin-reactive site, whereas HCT and BCT were only bound at the leucine-containing chymotrypsin-reactive site. TFI-N2, the Arg Leu trypsin chymotrypsin inhibitor, could bind 1 mol BT and BCT, but 1.3 mol HT and 1.2 mol HCT per mole of inhibitor. In addition to the usual binding, the human enzymes could also be bound at the respective "wrong" reactive site. TFI A8, the Arg-Arg trypsin inhibitor, binds 2 mol HT or BT per mole of inhibitor at the two trypsin-reactive sites, whereas HCT and BCT (about 0.2 mol/mol) are bound to one of the two "wrong" reactive sites. PMID- 1767595 TI - [Gas chromatographic method for the analysis of residues of seven penicillins in food of animal origin]. AB - A capillary gas chromatographic method is described for the determination of residues of benzylpenicillin, phenoxymethylpanicillin, methicillin, oxacillin, cloxacillin, dicloxacillin and nafcillin in bovine muscle, liver, kidney, adipose tissue and milk. The samples are extracted with acetonitrile under slightly acidic conditions, the co-extracted water is separated with the addition of sodium chloride and dichloromethane and discarded. Clean-up is performed by liquid/liquid partitioning steps and anion exchange chromatography. The penicillin residues are methylated with diazomethane. After derivatization, only the extracts from liver and kidney needed further clean-up using cartridges with a polar diol sorbent. The gas chromatographic procedure is based on split/splitless injection, programmed temperature vaporization, separation on a methyl silicone fused silica column and nitrogen-specific thermionic detection. Internal standardization is used for quantification. The limits of detection for all penicillins are well below 3 microgram/kg in milk and all tissues. Recoveries of spiked samples at 3 and 10 micrograms/kg are in the range of 65-80% for milk and 50-70% for bovine tissues. PMID- 1767596 TI - Some elements in domestic and imported fresh fruits marketed in The Netherlands. AB - Sodium, potassium, arsenic, selenium and tin have been determined in 38 different types of domestic and imported fresh fruits. All samples (n = 242) were analysed for Na und K whereas a limited number of samples (n = 85) of each fruit type was selected for the determination of As, Se and Sn. The median contents, in mass fractions of the edible portion, found for fresh fruits are: Na less than 0.001%; K 0.17%; As 4 micrograms/kg; Se 2 micrograms/kg and Sn less than 0.05 mg/kg. The corresponding 90th percentile values are: Na 0.002%, K 0.34%; As 12 micrograms/kg; Se 10 micrograms/kg and Sn 0.10 mg/kg. Results for selenium reported here differ substantially from those given for a number of fresh fruits in the German Food Composition Tables 1986/1987. The average consumption of 129 g fresh fruit by Dutch citizens in the age category of 22-75 years contributes, in general, marginally to the total daily dietary intake of sodium, arsenic, selenium and tin. Fresh fruit can contribute substantially, up to 23%, to the average oral daily intake of potassium. PMID- 1767597 TI - [Various possibilities for the psychogenic origin of organic diseases]. PMID- 1767598 TI - [Psychological interpretation of organic diseases and psychoanalytic speculation on the past]. AB - By using examples of psychotherapy applications the author critically analyzes a tendency of speculative psychoanalytical explanation of organic illnesses on the basis of the patient's biography. Typical clinical pictures are described. Probable causes of this tendency of speculation in a psychoanalytical manner are discussed. The author also refers to the tradition of speculative theories in psychoanalysis, the meaning of behavorism for psychoanalysis as well as the denial of hereditary-genetic factors. The imponderableness of the causal meaning of biographical events is demonstrated. Impulses for training are given. PMID- 1767599 TI - [Ulcerative colitis. A contribution to the discussion of causes]. AB - A group of patients with a sure diagnosis of colitis ulcerosa (n = 17) was compared with a same-sized group with eating disorders (anorexia nervosa/adipositas) and a group of neurotic patients who also had great physical complaints (n = 169) in regard to their strain experienced during childhood and youth. The groups are homogenous concerning age and sex. The results show that the colitis patients have a corresponding strain score to that of healthy persons and therefore lie far above the average strain score of neurotic people. We interpret this result as an indication that we have to view colitis ulcerosa as a somatic psychosomatosa and that the variance share of psychogenic influences should be judged as being rather low. PMID- 1767600 TI - [Psychiatric and Social Communication Inventory--a psychoanalytically based instrument for patient self-assessment]. AB - In 1979 the PSKB, an instrument for standardized neurosis description, was published; we now have a great variety of evaluation procedures at our disposal. This article describes the development, application and evaluation of the PSKB Se, an instrument which in great accordance with the PSKB makes a self description of patients possible. The PSKB-Se is a psychoanalytically based self assessment instrument which not only beholds a complaint list, but also especially registers therapy relevant intrapsychic and interactional attitudes. By applying the PSKB and the PSKB-Se in parallel one can especially investigate the connections between therapist assessment and patient self-assessment. This article furthermore also describes the factor analytical scale construction and the validity as well as various standardization measures. Each of the scales are interpreted on the basis of their clinical relevance and the correlation with other results. Effect examples from psychotherapy research illustrate the application possibilities of the instrument. PMID- 1767601 TI - [7 years follow-up after termination of analytic group psychotherapy]. AB - The results of a seven-year catamnestic, follow-up of a stationary-ambulant group psychotherapy are described. The further course and the stability of the treatment results are especially examined. Three case examples are looked at more closely individually on a quantitative and a qualitative basis using the statistical results of the entire group as a background. PMID- 1767602 TI - [Prognosis and spontaneous follow-up of psychological health and psychogenic disease]. AB - Being able to look ahead, being able to make a correct prediction of events and developments has been of great interest to mankind since biblical times and with good reason. Due to his profession one expects from a doctor that he can make a prognosis. In the realm of psychogenic illnesses or of healthy persons certain barriers arise because of the lacking epidemiologic knowledge. We had to overcome these barriers in our cohort study conducted in Mannheim: In a random sample of 600 adults from a mostly healthy population, after conducting thorough psychoanalytic interviews a prognostic judgment was given for each person regarding the further course of psychic health or psychogenic illness (diagnosed for 26% of the persons). The spontaneous course and the accuracy of the prognosis was reexamined after three years. The quota of accuracy as well as occurring problems and considerations and a case oriented analysis of the prognostic misjudgements are discussed. PMID- 1767603 TI - [Psychosomatic medicine and psychotherapy in transition. The ecological change in progress to a new definition]. PMID- 1767604 TI - [The taxonomy of the genera of Alternaria (Nees: Fr)]. AB - The identification of species in Alternaria (Nees:Fr.) is mainly based on shape, size and septation of conidia. Because of the great variances in these marks a reliable determination of species in that genus sometimes is difficult. 137 strains of Alternaria isolated from forage are attempted to identify. Various macro- and micromorphological methods used are described as well as their sources of errors. It is emphasized that a stringent standardization of all determination methods is necessary. Beyond it there are discussed some molecular biological and biochemical characteristics to complete the data of taxonomy in the genus of Alternaria. PMID- 1767605 TI - [Alternaria infestation of corn silage and hay]. AB - The numbers of fungi and the portions of Alternaria species in silage maize before harvesting and in hay stored were determined. Alternaria is present in growing maize with 18.3 percent of the total numbers of fungi. It occurs mainly on leaves and husks. Fungi of the genus Alternaria also were found in hay, that has been stored for 8 months when total numbers of fungi have been decreased slowly. More than 80 percent of all Alternaria strains isolated were determined systematically as Alternaria alternata Fries (Keissler) and A. tenuissima (Kunze:Fr.) Wiltshire. Based on these results there is discussed the potential hazard of a contamination of the roughages with Alternaria mycotoxins. PMID- 1767606 TI - [Suitability of support materials for the fixation of microfungi]. AB - Saccharomyces cerevisiae Muller-Thurgau F and Aspergillus spec. NH, a producer of glucoamylase, were cultivated in the presence of various supporting materials (three microspherical zeolitic particles, alpha-alumina and foam corundum). The supports were microscopically tested to find out whether they are settled by microfungi or not. Whereas the yeast cells lay on the supports only loosely the hyphae of Aspergillus grew around the supports and with the exception of foam corundum enclosed them in mycelial spheres. This phenomenon may favour the separation of fungal biomass in biotechnological processes. PMID- 1767607 TI - [A comparison of the cDNA of the sequences of signal receptor proteins]. AB - The method of cDNA sequences comparison is suggested. The method consists of constructing the dot matrixes for each codon position separately. The fastest disappearance of the information about relationship is observed when the third nucleotides in codon are compared, and the comparison of the second nucleotides in codon turned out to be effective so as the comparison under acids. PMID- 1767609 TI - [The recovery of the reactivity of the auditory system in the dolphin Tursiops truncatus to paired acoustic stimuli with different spectra]. AB - Recovery cycles of the auditory brainstem responses were studied in the bottle nosed dolphin, Tursiops truncatus, using paired acoustic clicks. The recovery time was longer if both clicks had identical spectra (50% recovery at 0.9 ms), as compared with that of different spectra (50% recovery at 0.35 ms). These results can explain a different recovery time of evoked responses after an artificial sound and after own locating one. PMID- 1767608 TI - [Osmotic and ionic homeostasis in insects and vertebrates under extreme influences on water-salt metabolism]. AB - Dehydration which is accompanied by the decrease in the body mass of frogs and pigeons approximately by 10%, results in the corresponding increase in osmolality of the blood serum, as well as in the increase of sodium content of the latter. Under the same conditions, the increase in osmolality and sodium level in rats does not exceed 2% which is associated with the effective renal function. In caterpillars of the insect Vanessa urticae whose haemolymph is rich in organic osmotically active substances and potassium ions, in spite of dehydration and loss of the body mass, osmolality of the haemolymph slightly decreases, while cation concentration in the latter remains essentially constant. Experiments with injections of hyperosmotic solutions to rats and caterpillars, showed that these animals, belonging to different phylogenetic branches, exhibit highly effective physiological mechanisms of ionic and osmotic homeostasis. PMID- 1767610 TI - [The effect of microwaves on the neuronal activity of the hyperstriatum in chick embryos at the critical developmental period]. AB - Studies have been made on multineuronal activity in the dorsal hyperstriatum of chick embryos exposed to microwave radiation (2.375 MHz) at critical stage of development of the structure (19th day of incubation). One day after microwave exposition, activation of neurones was observed in a form of the increase in the discharge frequency and the increase of outburst form of the activity. Cyclic form of outburst activity was absent in experimental animals being present in control embryos of the same age and associated presumably with self-organization of microsystems of neurones in the developing brain. Changes in multineuronal activity were found only in the left hyperstriatum, which is probably due to different levels of the development and functional activity of the right and left hyperstriatum at this stage resulting from asymmetric intensity of visual afferentation which depends on the position of embryo inside the egg. PMID- 1767611 TI - [The phenomenon of the functional dissolution of the wakefulness-sleep cycle in white rats under the influence of immobilization]. AB - Studies have been made on functional dissolution of the sleep cycle in albino rats due to immobilization of various duration. It was shown that 1-day immobilization increases microactivational representation in the EEG, facilitates rhythmic movements of the lower jaw, affects relative duration of the diurnal and nocturnal sleep, increases sleep fragmentation, and in some of the animals decreases the EEG amplitude. It is suggested that strong stress results in the return of sleep mechanisms to a more ancient level. PMID- 1767612 TI - [The stimulation of organic acid secretion in the kidneys of the frog Rana temporaria with the repeated administration of para-aminohippurate and triiodothyronine]. AB - Investigating possible ways of the increase in the rate of organic acid transport in the kidney of frogs, it has been demonstrated that animals which passed hypobiosis exhibit the increase in maximum capacity of the kidney to secretion of paraaminohippurate during substrate stimulation evoked by the injection of this salt twice a day within three days, as well as by the injection of triiodthyronine once a day within three days. The effect produced is similar to kidney reaction in adult mammals. PMID- 1767613 TI - [The skin sensitivity of the frog Rana temporaria to chlorides]. AB - Analysis of total impulse reactions evoked in skin branches of the spinal nerves by application of 0.1-1.0 mol/l solutions of KCl, NaCl, NH4Cl, and CaCl2 to the skin in the grass frog showed that the reaction of the peripheral nervous elements depends not only on the concentration of a test-solution, but on the nature of the cation as well. The problem of specificity of acidic and saline sensitivity of the skin in amphibians is discussed. PMID- 1767614 TI - [The central effect of digoxin]. PMID- 1767615 TI - [The formation of ideas in the orangutan]. PMID- 1767616 TI - [The formation of the ideas of "color" and "form" in anthropoids]. PMID- 1767617 TI - Ontogeny of corticocortical projections of the rat somatosensory cortex. AB - Rhodamine-coated microspheres (RCMs) were injected into the primary somatosensory cortex (SI) of rats ranging in age from postnatal (PN) day 1 to adulthood. Ipsilateral corticocortical and callosal projections within the SI were identified as early as PN day 1. At the end of the first PN week, ipsilaterally projecting neurons located in sublayer VIb were the first to assume an adult-like pattern of connectivity. Injections at subsequent postnatal ages revealed that an adult pattern of lamination of ipsilateral corticocortical projections within the SI is established between PN weeks 2 and 3, comprising projection neurons from layers II/III, layer V, and sublayer VIb. Therefore, local interactions in the rat SI are mediated not only by pyramidal neurons of layers III and V, derived from the cortical plate, but also by a subpopulation of ontogenetically older neurons located in the sublayer VIb, which may correspond to the subplate neurons of other species. Overall, these results suggest the existence of three independent short-range corticocortical systems of projections within the rat SI, which differ in terms of the laminar distribution and ontogenetic origin of their cells. PMID- 1767619 TI - Evidence for GABA-mediated control of putative nociceptive modulating neurons in the rostral ventromedial medulla: iontophoresis of bicuculline eliminates the off cell pause. AB - This study was undertaken to test the hypothesis that gamma-aminobutyric acid (GABA) is an endogeneous neurotransmitter regulating the activity of a class of putative nociceptive modulatory neurons (termed "off-cells") in the rostral ventromedial medulla (RVM) of the barbiturate-anesthetized rat. Off-cells, which are believed to correspond to the RVM output neuron that inhibits nociceptive processing at the level of the spinal cord, exhibit an abrupt pause in firing that begins immediately prior to the occurrence of the tail flick response (TF), a nocifensive reflex evoked by application of noxious heat to the tail. Single unit recording and iontophoretic techniques were used to examine the ability of the GABAA receptor antagonist bicuculline methiodide (BIC) to antagonize selectively the characteristic off-cell pause. Iontophoretic application of BIC (5-30 nA) blocked the TF-related pause in each of the off-cells tested. This effect of BIC was generally slow in onset, and outlasted the period of application by several minutes. BIC iontophoresis also eliminated the cyclic alternation between active and silent periods that is often displayed by off cells in lightly anesthetized rats. BIC application did not have a consistent effect on the firing of two other classes of RVM neurons ("on-cells" and "neutral cells"). Iontophoretically applied BIC antagonized the inhibitory effect of iontophoretically applied GABA, but not that produced by glycine. The glycine receptor antagonist strychnine did not mimic the action of BIC on off-cell activity. These data demonstrate antagonism of a synaptically evoked response using iontophoretic application of BIC, and provide strong evidence that the inhibitory neurotransmitter GABA mediates the TF-related off-cell pause. Taken together with behavioral experiments demonstrating that a GABA-mediated inhibitory process within RVM is crucial in permitting execution of the TF response, the present observations point to the significant functional relevance of GABA transmission within RVM in modulation of nociception. PMID- 1767618 TI - Chronic effects of total or partial digit denervation on raccoon somatosensory cortex. AB - Electrophysiological recordings were made in the primary somatosensory cortex of anesthetized raccoons 14 to 169 days following digit amputation or 60 to 129 days after transection of the two nerves innervating the ventral surface of the fourth digit. The incidence of inhibitory responses decreased from 50% of the penetrations immediately after amputation to 35% over the first 3 weeks and to almost zero after 2 months. The number of sites with low-threshold excitatory responses increased from 4% to 14% to 50% during these same intervals. Initially, the excitatory fields were small and located over the nerve stumps, and were therefore probably due to direct stimulation of the damaged nerves. At 2 months after amputation, the excitatory receptive fields were large and diffuse. Although the size of receptive fields decreased during the later period (when the thresholds were also decreasing), there was no recovery of any precise somatotopic organization in the deafferented cortex. The reorganization process in the raccoon thus consists of at least two stages: The early stage is dominated by inhibitory connections, whereas the second involves a recovery and restructuring of excitatory inputs. From 2 to 4 months after partial digit denervation, there were only minor changes in response properties or somatotopic organization in the deafferented cortex as compared to immediately after nerve transection. Thus, few of the characteristics of reorganization induced by digit amputation were elicited by this treatment, which leaves some of the digit innervation intact. There was, however, an unexpected increase in the portion of the ventral digit that was able to activate the cortex, suggesting complexities in the peripheral innervation of the digit that need to be resolved. PMID- 1767620 TI - Tactile discrimination of gratings: psychophysical and neural correlates in human and monkey. AB - Human and monkey performance on discriminating tactile gratings revealed comparable cross-species Weber functions. Neural data obtained while monkeys performed discriminations revealed some matching of neural and psychometric functions. Nearly constant firing rate differences occurred at discrimination threshold for unequal groove widths. Firing rate differences of some cells decreased on trials preceding discrimination errors, and thus predicted performance. PMID- 1767621 TI - Immediate expansion of receptive fields of neurons in area 3b of macaque monkeys after digit denervation. AB - The short-term effect of total or partial single-digit denervation on receptive fields (RFs) of neurons in somatosensory cortex (area 3b) was examined in five macaque monkeys. In two animals, after denervation by amputation, it was found that electrode positions that initially recorded neurons with RFs on the amputated digit had new RFs extending from the wound. Often the new fields were on adjacent digits. Neurons with initial RFs that were partially amputated, or in some cases close to but not on the amputated digit, showed considerable expansion of the remaining RF. In three monkeys local anesthesia was used to provide a temporary denervation. In these experiments electrodes were placed in equivalent positions in both cortices. The effect on cortex contralateral to the denervation was similar to that seen with amputation. However, after anesthesia returned to the digit, the expanded RFs contracted. In cortex ipsilateral to the denervation, RFs were on the opposite unaffected hand. These also rapidly expanded and then contracted, with the same time course as their counterparts in cortex contralateral to the denervation. Because of the rapidity of the expansion and its temporary nature with short-term denervation, the basis of the effect is probably an unmasking of existing but normally unexpressed connections, which are normally inhibited by the intact output from the denervated area. The wide arborization fields of thalamocortical afferents provide a potential source for the unmasked sensitivity. A mechanism for the inhibition that normally suppresses the expression of large RFs is not readily apparent. However, work in other species suggests that peripheral C fibers provide the primary source of input to central inhibitory circuits. PMID- 1767622 TI - Response properties of periodontal mechanosensitive neurons in the trigeminal spinal tract nucleus of the cat. AB - Periodontal mechanosensitive (PM) units were recorded from the trigeminal spinal tract nucleus (Vst) of the cat. The Vst is divided into three subnuclei: oralis (Vo), interpolaris (Vi), and caudalis (Vc). The receptive fields of PM units in Vo and Vi were arranged in a dorsoventral sequence in the mandibular to maxillary divisions, and those in Vc were arranged in a mediolateral sequence. The majority of Vo units were single-tooth ones, whereas more than half the Vi units and all the Vc ones were multitooth units. The PM units in each subnucleus were predominantly responsive to canine tooth stimulation. Most of the PM units in Vo and Vi gave sustained responses to pressure applied to the tooth, were directionally selective, and were most actively excited by canine tooth stimulation in the caudomedial or rostrolateral direction. Vc units, however, were transient. The threshold intensity for firings by canine tooth stimulation was less than 0.05 N. These findings indicate that only the response properties of PM units in the rostral part of Vst resemble those of the trigeminal main sensory nucleus neurons and primary afferent nerves. PMID- 1767623 TI - Psychophysical studies of the itch sensation and itchy skin ("alloknesis") produced by intracutaneous injection of histamine. AB - Psychophysical measurements of itch and itchy skin ("alloknesis"--itch produced by innocuous mechanical stimulation) were obtained in human volunteers following intracutaneous or subcutaneous injections of histamine or papain into the volar forearm. Histamine and papain were given in doses of 0.1, 1, or 10 micrograms in 10 microliters of saline. The effects of the depth of injection and of skin temperature on the latency, magnitude, and duration of itch were examined. Also, dose-response functions were obtained for the area of alloknesis produced by intracutaneous injections of histamine. Finally, the neural mechanisms underlying the spread of alloknesis were investigated via local anesthesia of the skin. Intracutaneous and subcutaneous injections of histamine, but not papain, produced a sensation of itch without pain. The latency of itch was shorter after an intracutanous than after a subcutaneous injection of histamine. The mean latencies of itch produced by a 1-microgram dose were 9.5 and 23.0 sec for intracutaneous and subcutaneous injections, respectively. No differences were observed in the magnitude or duration of itch. Similarly, the latency of itch was increased when the skin temperature at injection site was lowered to 15 degrees C, whereas the magnitude and duration of itch were unaffected. Intracutaneous and subcutaneous injections of histamine produced similar areas of alloknesis. However, the magnitude and duration of alloknesis were dependent on dose. The mean maximum areas of alloknesis produced by intracutaneous injections of 0.1, 1, and 10 micrograms of histamine were 28.3, 47.2, and 43.8 cm2, respectively. Alloknesis was present at 2 min after injection, increased to a maximum area without 10 min, and then gradually decreased during the next 25-40 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767624 TI - Locomotion induced by spinal cord stimulation in the neonate rat in vitro. AB - The present studies employed the neonate rat brain stem-spinal cord preparation to determine whether electrical stimulation of the lumbosacral enlargement (LE) of the spinal cord itself can be used to elicit locomotion, and whether or not such stimulation persists in inducing locomotion following midthoracic spinal cord transection or hindlimb deafferentation. Results suggest that (1) stimulation of the dorsal columns or ventral funiculus of the LE is effective in inducing airstepping in the neonatal rat brain stem-spinal cord limb-attached preparation; (2) central disconnection by midthoracic spinal cord transection does not alter LE-stimulation-induced airstepping and may lead to an increase in stepping frequency if suprathreshold stimulation is used; and (3) dorsal root section also leads to an increase in the frequency of suprathreshold LE stimulation-induced locomotion, but there is not further increase in frequency if a spinal cord transection is performed in addition to dorsal rhizotomy. PMID- 1767625 TI - Mortality and morbidity conferences in a teaching anesthesia department. AB - In our anesthesia department, Morbidity and Mortality conferences (M & M's) evolved from a well established system of voluntary reporting of anesthesia related incidents. They were however not restricted to accidents solely attributable to anesthesia. Between May 1983 and December 1989, 160 cases were presented, usually by the resident or consultant in charge of the patient at the time of event. The format of conferences is described in detail in this paper. Despite an active selection process, the case mix of presentations closely reflected that of major epidemiological surveys of complications in anesthesia. Residents attending regularly M & M's during the five years of their specialty training got an accurate picture of anesthesia-related mishaps, their mechanisms of onset and their outcome. In particular, the important role played by human intervention was clearly underlined. Due to the selection process, interaction with other physicians or health professionals were described with great frequency in the genesis of accidents anesthetists had to deal with. M & M's proved a valuable teaching tool, but also contributed to improve patient care by revealing faulty routines. PMID- 1767626 TI - The effects of acute changes in renal function on the pharmacokinetics of midazolam during long-term infusion in ICU patients. AB - This study investigated the pharmacokinetics of midazolam and its main metabolite, 1-hydroxymethylmidazolam glucoronide, during long-term i.v. infusion in 39 mechanically ventilated ICU patients of whom 6 were in acute renal failure (ARF). The mean infusion rate of midazolam was similar (9.4 vs 8.7 mg/h) in the control patients and those with ARF. The renal clearance of 1 hydroxymethylmidazolam glucuronide was much lower in the ARF group than in the control group (3.9 vs 136 ml/min). Consequently, its plasma elimination half-life after discontinuation was also greatly prolonged, but this shouldn't cause very prolonged sedative effects since this metabolite is much less active than the parent drug. However, the half-life of midazolam itself was also significantly longer in patients with ARF than in the control group (13.2 vs 7.6 h). Apparently, this was caused by a combination of a slightly lower total clearance and a higher volume of distribution. Therefore, regular reassessment of the degree of sedation and appropriate adaptation of the infusion rate of midazolam are recommended in ICU patients with ARF. PMID- 1767627 TI - Influence of chest physiotherapy on arterial oxygen saturation. AB - Two groups of ventilated patients were compared for chest physical therapy on an ICU: respiratory insufficient patients on one side and a control population on the other were submitted either to percussion or vibration therapy, and to postural drainage. Our data show a decrease in arterial oxygen saturation after CPT and after 2h monitoring; the lateral position results in a better SaO2 in the pneumonia group while SaO2 tend to decrease in the control population. However, no significant therapeutic influence of vibration nor percussion was found. Our data suggest CPT does not result in a short term respiratory benefit. Further investigations with prolonged sessions of postural drainage are required. PMID- 1767628 TI - The creation of modern anesthesia in Belgium. PMID- 1767629 TI - Intracranial subdural hematoma after spinal anesthesia. AB - We describe a 68-year old male patient with late onset signs of an intracranial subdural hematoma after repetitive spinal anesthesia procedures for urethral dilatation. The proposed mechanism is that of cerebrospinal fluid efflux. The potential for the development of such complications is so important, that it must be considered in every patient. PMID- 1767630 TI - Response of the axon and barrier endothelium to experimental allergic neuritis induced by autoreactive T cell lines. AB - Experimental allergic neuritis was induced in Lewis rats by inoculation with autoreactive T cell lines sensitized to residue 57-81 of P2 myelin protein. Control rats received cells derived from immunization to complete Freund's adjuvant alone. Endoneurial fluid pressure (EFP) was measured in both sciatic nerves at 0, 3, 5, 7, 9, and 11 days post-inoculation (PI). The temporal evolution of inflammatory disease was studied by correlating EFP with a morphometric analysis of the nerve microenvironment and with electron microscopic observations. Both edema, as evidenced by increased endoneurial extracellular space, and inflammation paralleled the time course of the EFP increase, reaching peak values at 7 days PI and declining to near-normal values after 11 days. Wallerian degeneration was detectable at 7 days and increased 9 days after inoculation. Axonal damage appeared at the height of the inflammatory process, when edema and increased EFP were maximal. Evidence of demyelination was apparent by 7 days and persisted through 11 days. The onset of edema was associated with changes in venular endothelial cells which tended to lose their normal scaphoid appearance and assumed rhomboid configurations reminiscent of high endothelial venules. At that point, the barrier endothelium was visibly disrupted with the loss of tight junctions and separation of adjacent cells. Specific cell-cell interactions took place between endothelial cells and infiltrating leukocytes as they immigrated into the endoneurial compartment. There was evidence of altered perineurial permeability with fibrin deposition and leukocyte infiltration between the layers of the perineurial sheath. PMID- 1767632 TI - Stimulation of human fetal astrocyte proliferation by bacterial lipopolysaccharides and lipid A. AB - This report concerns the effect of bacterial endotoxin [lipopolysaccharide(LPS) and lipid A] on cultured human fetal astrocytes. Exposure to 1 micrograms/ml LPS or lipid A caused a striking stimulation of the rate of proliferation of the cells. The effect was most pronounced with exponentially growing cultures. Stimulation was associated with enhance DNA synthesis as ascertained by [3H]thymidine incorporation. These findings at the cellular level may be of relevance in the elucidation of the effects of bacterial endotoxins on the developing human brain. PMID- 1767631 TI - Experimental autoimmune neuropathy with anti-GM1 antibodies and immunoglobulin deposits at the nodes of Ranvier. AB - Antibodies to GM1 or Gal(beta 1-3)GalNAc are associated with motor or sensorimotor neuropathy and with motor neuron disease. To investigate the role of these antibodies in the neurological disorder, rabbits were immunized with GM1 or with Gal(beta 1-3)GalNAc-BSA, and studied serologically, electrophysiologically and pathologically. Development of antibodies to the immunizing antigens was associated with a fall in the ratio of the amplitudes of the compound muscle action potential evoked by proximal versus distal stimulation of the sciatic nerve. Pathological studies revealed mild axonal degeneration and immunoglobulin deposits at the nodes of Ranvier in peripheral nerve, resembling those reported in a patient with motor neuropathy, motor conduction block and anti-GM1 antibodies. These studies provide evidence that anti-GM1 or anti-Gal(beta 1 3)GalNAc antibodies cause conduction abnormalities and indicate that the antibodies may exert their effect, in part, by binding at the nodes of Ranvier in peripheral nerve. PMID- 1767633 TI - The relationship between Ki-67 labeling and mitotic index in gliomas and meningiomas: demonstration of the variability of the intermitotic cycle time. AB - The monoclonal antibody (mAb) Ki-67 is a marker for the growth fraction (GF) of tumor cells. The exact relationship between the Ki-67 labeling index (LI) and the conventional diagnostic criterion of the proliferative activity of brain tumors, the mitotic index (MI), is unknown except for some general references. On serial frozen sections Ki-67 LI and MI were determined in nearly identical areas of 32 glioblastomas, 20 grade III astrocytomas, 21 grade II astrocytomas and 20 selected cases of meningioma. The data not only clearly showed different median values of LI and MI for the various malignancy grades, but also similar regression coefficients for each glioma type. A non-linear relationship between the two indices was found for all glioma cases with high significance and high correlation coefficient; (LI) = 5.6 (MI)0.59. This results from differing intermitotic cycle times, the variability of which can be estimated from the data given. PMID- 1767634 TI - Intramedullary secretory gangliocytoma. AB - An 8-year-old boy developed severe systemic hypertension during resection of an intramedullary tumor. The histological, ultrastructural and immunocytochemical characteristics of the tumor are those of a gangliocytoma. Based on the demonstration of tyrosine hydroxylase in neuronal tumor cells, it is postulated that catecholamine secretion was responsible for the systemic hypertension. PMID- 1767635 TI - Fulminant blastomycosis with blastomycotic infection of a cerebral glioma. Light microscopic and ultrastructural observations. AB - Except for isolated case reports, blastomycosis has not been identified as a significant problem in immunosuppressed patients. We describe an unusual case with blastomycotic infection of a cerebral glioma in a 56-year-old man who underwent radiotherapy for his tumor and died of fulminant blastomycotic pneumonia. This is believed to be the first reported case of Blastomyces dermatitidis infection of a cerebral glioma. The light microscopic and ultrastructural features of B. dermatitidis, the giant forms of which were encountered in our patient, are described, and thr role of immunosuppression due to steroid therapy in the pathogenesis of this fulminant infection are reviewed. PMID- 1767636 TI - Bloodless field and tourniquet compression. PMID- 1767637 TI - Vertebral resection and fusion for paralytic kyphosis. 9 patients followed up for 6 (2-14) years. AB - Nine patients with a thoracolumbar, progressing, paralytic kyphosis, pressure sores from gibbus, an inability to lie on the back, and deterioration of the sitting balance were operated on with resection of two to three vertebrae and a thoracolumbar fusion. One child died from intracranial bleeding caused by a halo screw. There were no implant loosenings or non-unions. Pressure sores healed, sitting improved, and lying on the back became possible. A mild scoliosis above the fusion level developed in 2 patients, but neither of them needed any treatment. PMID- 1767638 TI - Fusion of scoliosis by Harrington distraction rod. Interspinous process and sublaminar wiring compared in 42 cases. AB - Forty-two consecutive patients with scoliosis who between 1981 and 1988 underwent posterior Harrington distraction rod and interspinous process or sublaminar wiring were retrospectively reviewed. No difference was found between the techniques with respect to age, sex, curve pattern, curve magnitude, levels fused, operative time, blood loss, correction, and loss of correction at the 1 year and 2-year follow-up. The interspinous process wiring was superior to the sublaminar wiring as regards ease of technique, early ambulation, few complications, and a more effective means for maintaining the correction without postoperative immobilization. PMID- 1767639 TI - Functional splinting versus plaster cast for ruptures of the ulnar collateral ligament of the thumb. A prospective randomized study of 63 cases. AB - In a prospective randomized study that included 63 consecutive thumbs with injuries of the ulnar collateral ligament of the metacarpophalangeal (MCP) joint of the thumb, plaster cast immobilization was compared with functional treatment with a splint. The splint allowed flexion and extension of the MCP joint, but prevented ulnar and radial deviation of the thumb. The study included both operated on and nonoperated on cases where surgery was performed only when the torn ligament was regarded as displaced. Of 40 thumbs treated nonsurgically, 21 were treated with a cast and 19 with a splint. Of 23 thumbs treated surgically, 10 were immobilized postoperatively in a plaster cast and 13 were treated with the splint. At the follow-up examination after 15 (11-41) months, there was no difference between the treatment groups as regards stability, range of motion, strength of the injured thumb, and length of sick leave. However, the patients considered the splint more comfortable than plaster cast immobilization. We conclude that immobilization of the thumb after a ligamentous injury with a movable splint is strongly preferred by the patients and that the functional results of this technique are equal to plaster cast immobilization after both surgical and nonsurgical treatment. PMID- 1767640 TI - Intraarticular fractures of the distal end of the radius in young adults. A 16 (2 26) year follow-up of 42 patients. AB - Forty-two patients, aged 29 (17-42) years when they sustained an intraarticular fracture of the distal end of the radius, were reexamined after 16 (2-26) years. More than two thirds of the fractures were caused by high-energy trauma. Subjectively, 34 patients had excellent or good results, while only 8 had fair or poor results; 6 patients had changed their occupation owing to disability from the wrist. Almost half of the patients had residual deformity at the follow-up clinical examination. Slightly more than half of the patients had radiographic arthrosis. Subjective evaluation correlated with residual deformity and arthrosis, but not with radiographic displacement or intraarticular step off. Arthrosis correlated with residual deformity and intraarticular step off, but not with radiographic displacement. Clinical residual deformity included soft-tissue changes in contrast to radiographic displacement. More interest should be directed to soft-tissue changes following this type of fracture. PMID- 1767641 TI - Tibial periosteal reactions in soldiers. A scintigraphic study of 29 cases of lower leg pain. AB - Twenty-two soldiers with tibial pain along the posteromedial tibial border (29 painful tibias) entered the study. The tibias were evaluated using radiographs and scintigraphs. Follow-up scintigraphs of 12 tibias were performed. The scintigraphic lesions were classified as Stages 0-V depending on the percentage of bone thickness involved. No attempts were made to differentiate between shin splints and stress fractures. Twenty-four symptomatic lesions and five asymptomatic lesions were found by scintigraphy. Radiographic changes were found in all the lesions classified as Stage III or higher, in some Stage II lesions, but never in Stages 0 and I lesions. Because intense scintigraphic uptake is seen in bone tumors, radiographs are needed to exclude this diagnosis. Radiographs were, however, not as sensitive as scintigraphs for differentiating the periosteal injuries seen in this study. The initial scintigraphs can be used to classify the lesions. Follow-up scintigraphs are not useful because they take months to return to normal. Consequently, the clinical symptoms and the level of pain should be the guidelines for treatment. PMID- 1767642 TI - Joint slippage in the Hoffmann external fixator. No effect of loading rate in bench experiments. AB - For tibial fractures, half-frames, such as the Hoffmann fixation device, sometimes fail when subjected to weight-bearing loads. Because the joints of the Hoffmann system are known to slip, which could lead to frame failure, three interfaces of the standard Hoffmann joint were tested at different clamp torques and different rates of load application. No difference in mean slippage values was noted for any interface at similar clamp torques. Joint slippage and any subsequent frame failure are thus not related to rate of load application, but to the magnitude of the load alone. PMID- 1767643 TI - Ankle arthrodesis in rheumatoid arthritis. 30 cases followed for 5 years. AB - We have reviewed the results of 30 ankle arthrodeses performed on 26 patients with rheumatoid arthritis. This procedure was associated with a high morbidity, with wound breakdown and infection occurring in 12 cases. Eighteen ankles had fused, six had pain-free fibrous union, and six required further surgery for nonunion. Clinical evaluation, at an average follow-up of 5 years, was based on a modified ankle-grading system with good or excellent results in 14, fair results in nine, and poor in two. Only 4 patients had some residual pain in the ankle, and so, despite the high complication rate, arthrodesis is an effective method of treating the painful, rheumatoid ankle. PMID- 1767644 TI - Weight bearing after arthrodesis of the first metatarsophalangeal joint. A randomized study of 61 cases. AB - We performed a prospective randomized study of 61 cases of arthrodesis of the first metatarsophalangeal joint in 56 patients. In the first group, full weight bearing was allowed after 2-4 days and in the second group at 4 weeks. Radiographic union of the arthrodesis in the two groups did not differ. PMID- 1767645 TI - A method for bone-cement interface thermometry. An in vitro comparison between low temperature curing cement Palavit, and Surgical Simplex P. AB - Previous temperature measurements at the bone-cement intreface have all shown large variations. To evaluate more precisely the temperature profiles during cement curing, a new experimental model was developed. Eight thermocouple electrodes at the bone-cement interface for each test specimen were used for continuous temperature recordings. Temperature profiles of Palavit was compared with those of Surgical Simplex P in an in vitro model using isolated pig femurs. Defects of 12 x 17 mm in the femoral metaphysis were filled with cement. In six tests with each type of cement, Palavit peaked at a temperature of 50 +/- 0.5 degrees C, whereas Surgical Simplex P peaked at 60 +/- 0.7 degrees C. Core temperatures reached peak values of 70 +/- 0.8 degrees C and 95 +/- 2.2 degrees C for Palavit and Surgical Simplex P, respectively. PMID- 1767646 TI - Intertrochanteric varus osteotomy for Perthes' disease. Radiographic changes after 2-16-year follow-up of 126 hips. AB - We analyzed various prognostic factors in 112 children operated on for Perthes' disease (Catterall's groups II-IV); special attention was paid to acetabular changes and postoperative containment. The radiographic results of 126 intertrochanteric femoral varus osteotomies were analyzed 2-16 years postoperatively. Catterall's grouping or head-at-risk phenomenon, bicompartmentalization of the acetabulum, and preoperative subluxation of the femoral head did not correlate with the result. The result was worse in cases operated on in the healing phase of the disease and in patients operated on at the age of 9 years or older. The strongest prognostic factor was containment of the femoral head after osteotomy. PMID- 1767647 TI - Removal torque for bone-cement and titanium screws implanted in rabbits. AB - Screw-shaped implants of commercially pure titanium and polymerized methyl methacrylate were inserted into the rabbit tibia. The animals were divided into two groups, and the implants were unscrewed after 5 weeks and 9 months, respectively. After both intervals, removal torque was greatest for the titanium implants. This difference was probably due to lower biocompatibility for the plastic material. PMID- 1767648 TI - Intraoperative autotransfusion in primary hip arthroplasty. A randomized comparison with homologous blood. AB - To study the quality and effect of blood produced by the cell saver compared with homologous blood in total hip arthroplasty, 40 patients were randomly divided into two groups. One group received autologous blood using the cell saver, whereas the second group served as a control, and received homologous bank blood. Hematologic and coagulation parameters of the patients were assessed both preoperatively and postoperatively. Samples from the autologous and the homologous blood were obtained before reinfusion, and were assessed as regards hematologic and biochemical parameters. The autologous blood satisfied all the intraoperative transfusion requirements of the autologous group and 75 percent of the total transfusion requirements. The operative and postoperative blood losses- hence, the total blood loss--were less in the autologous than in the control group. The autologous blood had a high hemoglobin, white blood cell, and plasma hemoglobin content and MCV compared with the homologous blood. Postoperatively, there were no differences as regards the hematologic parameters studied. There was no evidence of intravascular hemolysis in the autologous group. Postoperatively, in both groups, AT III, plasminogen, and protein C decreased. Other coagulation parameters were within normal limits in both groups. Intraoperative autotransfusion is safe and effective, and should be considered in hip arthroplasty to reduce the risks associated with homologous blood transfusion. PMID- 1767649 TI - Early discharge after hip fracture. Prospective 3-year study of 645 patients. AB - The effectiveness of providing additional community resources to enable early discharge following hip fracture surgery has been prospectively evaluated in a consecutive series of 645 patients. For those discharged under the scheme, the average hospital stay was 9.3 days, and this resulted in a substantial saving of hospital bed days. PMID- 1767650 TI - How predictable is rehabilitation after hip fracture? A prospective study of 134 patients. AB - In a prospective study of 134 consecutive patients treated for hip fracture, rehabilitation was influenced by sociomedical factors, but not by fracture type or treatment. Success of rehabilitation was to a large extent predictable using mental and general health status. Discharge of the patients to their prefracture residence was accurately predicted in 80/89 of successful and 11/28 of failed rehabilitations. Four months after the fracture, 86/92 successful and 11/17 failed rehabilitations were predicted. More accurate prediction of rehabilitation is limited by the complexity of the rehabilitation process. PMID- 1767651 TI - Subtrochanteric femoral fractures treated with locked intramedullary nails. Experience from 31 cases. AB - We treated 31 proximal femoral shaft fractures, where the trochanteric area was intact, with Grosse-Kempf locked intramedullary nails. There were 19 men and 12 women with a median age of 24 (14-79) years. Sixteen fractures were comminuted and 11 were a component of severe multiple injury. No infections or other serious complications occurred. All the fractures healed within 40 weeks, with 16 results graded as excellent, 7 as good, 7 as fair, and 1 as poor. Six fair results were due to difficulties in aligning the short proximal fragment. One patient with a fair and 1 with a poor result had excessive shortening of the femur. We conclude that locked intramedullary nailing is a good alternative in these fractures and that the static variant is preferable whenever the stability is uncertain. PMID- 1767652 TI - Release of prostaglandins from bone and muscle after femoral osteotomy in rats. AB - In rats after nonstabilized femoral osteotomies, the changes in the release of prostaglandins (PGs) during bone healing (from bone and surrounding muscle tissue) were determined for PGE2, PGF2 alpha, 6-keto-PGF1 alpha, and thromboxane B2. A unilateral osteotomy, with contralateral soft-tissue dissection, was performed. After 4 or 10 days, the rats were killed and soft tissue and femoral bone were incubated, and the release of PGs was measured with specific radioimmunoassays. The release of PGs from rat femurs without previous surgery and from the sham-operated on side did not differ after 180 minutes' incubation. The release of PGE2, 6-keto-PGF1 alpha, and thromboxane-B2 from the osteotomy site was increased for bone on Day 4 and for muscle on Day 10 when compared with the controls. The release of PGF2 alpha from bone and muscle was about the same on both days, but increased as compared with the controls on Day 10 for bone. On Day 10, the other PGs for muscle and bone tissue were decreased as compared with Day 4. The most pronounced release of PGs occurred during the early healing phase after osteotomy; as early as 10 days after surgery, most of the PGs were not increased when compared with the sham-operated on side. PMID- 1767653 TI - Effects of intramedullary reaming and nailing of rat femur. A mechanical and chemical study. AB - This study was undertaken to explore the association between mechanical and chemical effects of intramedullary reaming and nailing. The right femora of 80 rats were reamed and nailed with steel nails. Forty rats were evaluated from 3 days to 24 weeks postoperatively. The other 40 rats had the nail removed after 12 weeks, and they were then followed from 3 days to 24 weeks after nail extraction. Evaluation consisted of in vivo strain recording, geometric measurements, mechanical three-point bending test, and chemical analyses of hydroxyproline and calcium contents. Reaming and nailing caused immediate weakening of the bone as measured by in vitro mechanical tests, but within 3 weeks the mechanical properties were fully restored, whereas in vivo strain remained reduced throughout the experimental period in rats with nails. Removing the nail increased in vivo strain to a level close to that of the intact femur. Remodeling of the bone resulted in greater external anteroposterior diameter, cross sectional area, area moment of inertia, and amount of hydroxyproline and calcium in the operated on femur as compared with the intact side. This indicates that the repair processes resulted in greater bone mass of the operated on femur than of the intact femur. Thus, there is evidence that nailing techniques effectively assist tissues by repair and remodeling. PMID- 1767654 TI - Gentamicin-collagen sponge for local applications. 10 cases of chronic osteomyelitis followed for 1 year. AB - A bovine collagen sponge containing gentamicin was applied locally in 10 patients with chronic osteomyelitis who were then followed for 1 year postoperatively. No adverse effects or recurrence of infections was observed. The release of gentamicin from the sponge was more complete and rapid than has been reported with polymethyl methacrylate (PMMA) beads. Compared with previous reports on PMMA beads, a much higher gentamicin concentration in the wound exudate can be expected after implantation of the collagen sponge, which is easy to apply and does not require a second operation for removal. PMID- 1767655 TI - Fusobacterium pyomyositis of the shoulder after tonsillitis. Report of a case of Lemierre's syndrome. AB - A case of nontropical pyomyositis is reported in a young male without predisposing factors. The disease was preceded by a tonsillitis, and the presentation initially suggested a septic arthritis of the shoulder. Fusobacterium, a highly unusual pathogen in pyomyositis, was isolated from an abscess in the infraspinatus muscle. The increasing frequency of the disease in areas with a temperate climate and the pathogenesis are discussed. Our case had the classic features of Lemierre's syndrome: invasion of the bloodstream by Fusobacterium species from a tonsillitis. PMID- 1767656 TI - Spread of Streptococcus pneumoniae between artificial joints in a rheumatoid patient. PMID- 1767657 TI - Compression of the cervical spine cord after reduction of fracture dislocations. Report of 2 cases. AB - Two cases of severe neurologic damage after open reduction of locked facet joint dislocations of the cervical spine are described. Both patients had progressive neurologic deterioration after the accident. In both cases, the cause of the neurologic injury was sequestrated disk material compressing the spinal cord. One patient, who was reoperated on as an emergency, recovered after removal of the sequestra, whereas the other patient, who was reoperated on later, remained tetraplegic. PMID- 1767658 TI - Osteoblastoma causing rigidity of the elbow. Case report. AB - A 21-year-old man complained of pain and rigidity of the elbow with a flexion contracture of 100 degrees. A radiographic examination revealed an 1.5-cm osteolytic injury in the center of a sclerotic lesion in the distal humerus. The diagnosis of an osteoblastoma was later confirmed histologically. Once the tumor had been excised, the pain disappeared and functional mobility was reestablished. PMID- 1767659 TI - Isolated fracture-dislocation of the second cuneiform bone. Case report. PMID- 1767660 TI - A case of multiple epiphyseal dysplasia complicated by unilateral Perthes' disease. PMID- 1767661 TI - Accessory soleus muscle mimicking a soft tissue tumor. A report of 2 patients. AB - An accessory soleus muscle is rare, and may present as a soft tissue tumor at the ankle. We report 2 patients in whom the diagnosis was not considered until after surgical exploration. Magnetic resonance imaging (MRI) after biopsy clearly identified muscle tissue, and electromyography showed normal motor unit activity. PMID- 1767662 TI - Recurrent common peroneal palsy in association with the Ehlers-Danlos syndrome. A case report. AB - We report a patient with type III Ehlers-Danlos syndrome, presenting with recurrent footdrop, who had electrophysiologic evidence of a conduction block of the common peroneal nerve followed by complete resolution. We feel that this case supports the possible link between Ehlers-Danlos syndrome and multiple pressure sensitive neuropathy (tomaculous neuropathy), alluded to by Schady and Ochoa (1984). PMID- 1767663 TI - Markers of cartilage metabolism in arthrosis. A review. AB - The mechanisms involved in the disease process in arthrosis are largely unknown, with genetics, joint malalignment, overload or trauma, obesity, and aging as some of the known or suspected contributing factors. Even less well known is how these general factors are translated into disease mechanisms at the cell and tissue levels. However, it may be argued that degradation of cartilage matrix is a key event at some time in the development of arthrosis. During this process, fragments of matrix molecules and other chondrocyte products are released into the joint fluid and eventually into other body fluids. These molecules can be used as markers of cartilage metabolism to monitor joint disease. In addition, by identifying the proteases and the structure of the released matrix fragments, we may improve our understanding of the cellular mechanisms active in cartilage degradation. Such information offers improved diagnostic and prognostic tools for rational treatment aimed at retarding cartilage destruction in arthrosis. PMID- 1767664 TI - Fixation and loosening of hip prostheses. PMID- 1767665 TI - The problem of middle ear cholesteatoma: etiology, genesis and pathobiology. A review. AB - This review provides an overview of the problem of middle ear cholesteatoma, and encompasses the following areas: the definition, the light and ultramicroscopic structure, the etiology, the pathogenesis (with special emphasis on the congenital or "embryonic rest" theory, immigration, invagination and papillary ingrowth, traumatic or iatrogenic implantation and metaplastic origin), and finally the pathology of cholesteatoma including bone erosion. An attempt is made to distill the actual and leading thoughts concerning this intriguing entity. PMID- 1767666 TI - Cholesteatomas of the temporal bone: a comparison of CT and operative findings. AB - In a series of 45 consecutive cases with proven cholesteatoma, the correlation between the preoperative CT findings and observations made at surgery was evaluated. On the preoperative CT protocol 11 parameters of the anatomical and pathological features of the temporal bone were correlated with the operation report. Except for the ossicles, a high degree of correlation was noted between CT findings and those at the operation. PMID- 1767667 TI - [Otological manifestations of Wegener's granulomatosis]. AB - The authors report an observation of Wegener's disease, clinically isolated as a secretory otitis media on the left side followed by a right sudden deafness. Resistance to the usual treatment and the evolution of the disease with association of pulmonary manifestation and fever have lead to the diagnostic of Wegener granulomatosis confirmed by ANCA test and renal punction. PMID- 1767668 TI - [Evoked acoustic emissions. Normal findings in a normal population of newborn infants and adults]. AB - We tested the availability of the commercial oto-acoustic device "ILO88" on adults and neonates. We describe a simple method to quickly obtain reliable results with this material. We also tested the possibility of recording evoked oto-acoustic emissions on ears with grommets tubes. PMID- 1767669 TI - The tilting room and posturography. AB - The tilting room examination technique is detailed. The advantages of posturography with the tilting room as an additional tool in the clinical vestibular examination are described for patients with uni- and bilateral loss of vestibular function, for patients with an acoustic neurinoma and for patients suffering from cervical ataxia. Some illustrations are also given of other applications of the tilting room. PMID- 1767670 TI - Cranio-corpo-graphy. A neurootological screening test. AB - Cranio-corpo-graphy affords a photographic representation of the patient's "radar like" movement patterns as he performs the standing (Unterberger, Fukuda) and stepping (Romberg) tests. Of the various parameters used for analysis, a wide angular deviation, i.e., where the patient deflects more than circa 60 degrees away from the sagittal axis, is taken to signify a peripheral dysfunction, usually involving the side of deviation. In addition, broad lateral sway values and standing tests sways suggest a central pathology. In this study, three data banks were created. One consisting of 500 patients tested in our department over the last ten years, all showing a normal cranio-corpo-graphic pattern; the second made up of 500 patients showing a clear peripheral pattern, i.e., abnormal angular deviation with normal sway values and the third (650 patients) with a typical central disturbance, i.e. a broad lateral sway. These groups were then submitted to a detailed statistical analysis. PMID- 1767671 TI - The use of a rigid nasal endoscope in children--with special interest in the middle meatus. AB - Forty children (1-12 years) underwent under general anesthesia a nasal endoscopy, prior or after adeno(tonsillec)tomy and/or the insertion of ear grommets. The endoscopy was mainly performed with a rigid pediatric endoscope (Wolf Company panoview 25 degrees angle; phi 2.7 mm). All data were recorded on video. Special interest was taken in examining the middle meatus. The authors evaluated the presence of septal deviations, the type and presence of secretions in the nasal cavity or middle meatus, the shape of the inferior and middle turbinate as well as the aspect of the ethmoidal bulla and uncinate process. Anatomical findings are discussed for different age groups. PMID- 1767672 TI - [Statistical value of the various mathematical models in rhinomanometry]. AB - By means of rhinomanometry, analogue physiological transnasal pressure and corresponding flow signals are simultaneously recorded during quiet nasal breathing. In order to describe the sigmoid shaped pressure/flow curves or relationship, several mathematical models have been developed. In this study, the authors wanted to demonstrate which model best describes the curvilinearity of the pressure/flow curves. By their approach, they found that polynomial models like delta p = K0 + K1V + K2V2 as well as the Broms' polar coordinate model best fit the recorded pressure/flow data. Since the parameters and exponents of such a model characterize the degree of laminar and turbulent behaviour of transnasal flow, a diagnostic potential may be offered in the future, to qualify and quantify the phenomenon of nasal obstruction. PMID- 1767673 TI - [Microsurgical approach to the lacrimal ducts. Technical aspects--indications- reasons for failure]. AB - The dacryocystorhinostomy is an operation that connects directly the lacrymal sac to the nasal cavity. In 1904, Toti described the external approach but one had to wait until the development of the sinus surgery to have a new interest in the endonasal approach. It appears to be a safe, efficacious and a less traumatizing procedure preserving the lacrymal function without skin incision. It allows a procedure in a non-scarred field. A good relationship between the ENT and the ophthalmologist is required. PMID- 1767674 TI - [Permanent tracheotomy in respiratory insufficiency]. AB - Assisted ventilation at home for breathing insufficiencies requires long-term tracheotomy. Standard tracheotomy is frequently complicated by granuloma and tracheostomy stenosis. We have designed a permanent opening technique that we report on 9 patients. The technique prevents, as far as possible, granuloma and stenosis formation and provides a sufficiently large opening to reduce irritation during tracheotomy tube change. Surgery must be done under general anesthesia. High-dose long-term corticosteroid treatment can induce skin breakdown. PMID- 1767675 TI - [Premalignant lesions of the laryngeal epithelium]. AB - At the Academic Hospital of the Free University of Brussels 243 patients underwent microlaryngoscopy over a period of 11 years (1978-1989). Histologic examination disclosed premalignant lesions in 55 patients. 26 patients had a follow-up (mean follow-up time was 5 years) and were selected for this study. The patients with premalignant lesions were divided into 3 groups: group 1 = hyperplasia and/or keratosis with or without mild dysplasia (11 patients); group 2 = mild dysplasia (7 patients); group 3 = severe dysplasia and carcinoma in situ (8 patients). In group 1 no malignant transformation was seen. In group 2 one invasive carcinoma developed after a period of 5 years (14%) and in group 3 two malignant transformations appeared 14 and 15 months after the initial diagnosis (25%). The treatment of choice was a total excision biopsy or stripping. A life time follow-up with an interval period of 6 months is recommended. The patients were also motivated to change their smoking habits. PMID- 1767676 TI - [Microperturbation of vocal cord vibrations, jitter and shimmer]. AB - The cycle-to-cycle variability of the period duration (jitter) and the period amplitude (shimmer) are measures for the micro-instability of vocal fold vibrations. A short survey is presented of the definition of jitter and shimmer, a number of calculation methods, the normal values, and the effects of age and voice pathology. PMID- 1767677 TI - Second branchial cleft-pouch set fistulae, sinuses and cysts in children. AB - A perfect understanding of the embryology of the branchial apparatus and the cervical anatomy is absolutely essential for the classification and treatment of branchial fistulae, sinuses and cysts, particularly with respect to those of the second cleft-pouch set. Some of our recent cases provide evidence of the need for precise dissection, a condition sine qua non to avoid surgical failures. PMID- 1767679 TI - Of practitioners, reviewers, and the future of family practice research. PMID- 1767678 TI - [Laryngeal amyloidosis]. AB - Laryngeal amyloidosis is a rare, benign disease of the larynx. An update on the pathology and clinical implications of this affection, along with the actual treatment modalities are discussed. PMID- 1767680 TI - Believing everything you read. PMID- 1767681 TI - Incorporating feminist perspectives into family medicine research. PMID- 1767682 TI - A practical application of reliability theory to family practice research. AB - The practical need for short instruments to assess constructs such as general health results in potentially imprecise measurement. According to reliability theory, a consequence of this imprecision is the inclusion of random error in the observed measurement of any construct. To the extent that measures are unreliable, clinicians may find that large changes in obtained measurements must be seen before one can have confidence that a true change in behavior has occurred. Discussion of the standard error of measurement and its application to functional assessment research is included. PMID- 1767683 TI - Possible modification of metastasis from adenocarcinoma of the prostate by colchicine: a case report. AB - Laboratory data indicate that colchicine has an antimetastatic effect in tissue culture and in tumor-transplantation experiments in animals. The present case report reveals a lack of perineural and capsular invasion as well as distant metastases from a large adenocarcinoma of the prostate in a 63-year-old patient who had taken colchicine daily for 25 years prior to lesion discovery. Failure to demonstrate metastasis was unexpected both because of lesion size (estimated volume 4.4 ml) as well as its histopathology (Gleason pattern 3S, grade 6). Colchicine may have inhibited metastasis of activated Ki-ras oncogenes during oncogenesis along neural microtubules in the area because of the known inhibitory effect of this drug on particle transport along the microtubule component of the cytoskeleton. Colchicine at therapeutic doses for gout may simultaneously inhibit metastasis of other types of malignancies in man. PMID- 1767684 TI - Recurrent otitis media: a cost-utility analysis of simulated treatment using tympanostomy tubes vs antibiotic prophylaxis. AB - Using a cost-utility analysis, the effectiveness of tympanostomy tubes was compared to that of antibiotic chemoprophylaxis in young patients with recurrent otitis media. The tympanostomy approach (T-tubes) consisted of placement of a polyethylene grommet in the tympanic membrane, with systemic and local antibiotics administered for one week. The chemoprophylaxis approach consisted of antibiotics in full doses for seven to ten days, followed by continuous antibiotic chemoprophylaxis for six months. Because the T-tube strategy under the model assumptions was more expensive ($396.44 vs $281.30) and yielded slightly less benefit (net utility of .9325 vs. .9476 for initial antibiotic therapy), the chemoprophylaxis option was preferred. We conclude that the initial treatment for recurrent otitis media should consist of acute antibiotics followed by chemoprophylaxis, with T-tubes reserved for treatment failure. Extreme changes in the baseline probabilities of cure or recurrence with antibiotic therapy or in the cost of antibiotic therapy or tympanostomy surgery were required to alter this conclusion. Varying therapy preference (utility) values did not materially alter the conclusions. PMID- 1767685 TI - Maternal aerobic exercise: newborn effects. AB - Maternal aerobic exercise during pregnancy may affect the experience of labor for the mother or fetus. Forty-four women who had given birth in the preceding 7 months responded to questions about their exercise habits during pregnancy. Using an exercise prescription formula, respondents were dichotomized into exercise or nonexercise groups. Maternal exercise was associated with a significant decrease in the duration of the second stage of labor (27 minutes vs 59 minutes, p = 0.04) and a reduction in the incidence of obstetric complications (8 vs 19, p = 0.058). The groups showed no significant differences in the number of weeks gestation, duration of the first or third stage of labor, birth weight, birth length, or neonatal Apgar scores at one and five minutes. PMID- 1767686 TI - Age- and sex-biased underdetection of hypertension in a rural clinic. AB - A process-of-care audit to assess completeness of hypertension detection among practice users was conducted by a rural family practice. For the two-year period 1983-1984, there were 5,620 practice users, ages 18-74. A cross-sectional study of the frequency of the diagnosis hypertension in these patients was carried out. Age-sex specific rates were calculated and compared to expected rates based on national prevalence estimates. Completeness of detection varied in direct proportion to age, from a low of 7% in the 18-24 group, to a high of 95% in the 65-74 group. For every age group women had a higher detection rate than men. The overall practice detection rate was 71%. Despite a practice emphasis on hypertension, detection appeared incomplete, especially among young men. Possible explanations are infrequent visits by young men, systematic error in blood pressure measurement, and definitional differences between primary care practice and national prevalence studies. PMID- 1767687 TI - Interlaboratory variability in serum lipid measurements. AB - Identification of elevated blood cholesterol has become a priority in the effort to reduce coronary heart disease. Previous data indicate that considerable laboratory variability in lipid testing exists in the United States. To determine the interlaboratory variability of serum lipid measurements in the Little Rock area, split serum samples from three subjects were sent to ten area laboratories. The average coefficient of variation among the ten local laboratories was 3.20% for total cholesterol, 9.46% for HDL-cholesterol, 7.73% for triglycerides, and 5.95% for calculated LDL-cholesterol. The results indicate that clinicians cannot assume that adequate standardization for lipid determinations exists for all laboratories. Without accuracy and precision data for the specific laboratory, caution should be used in the strict application of guidelines for classification and treatment of patients with abnormal serum-lipid measurements. PMID- 1767688 TI - Patient satisfaction with gynecologic care provided by family practice resident physicians. AB - This study assessed the impact on patient satisfaction of second-year family practice residents participating in a one-month gynecology rotation at a university-owned satellite ambulatory care facility. Its purpose was to examine whether residents can be incorporated into university-operated satellite health centers for patient care and resident education without decreasing patient satisfaction. With the exception of one item on the patient satisfaction questionnaire, results showed no significant difference in patient satisfaction ratings between one family practice faculty physician and five family practice residents. This finding supports increased efforts to incorporate residents into academic ambulatory care satellites in limited direct patient care roles similar to those described in this report. PMID- 1767690 TI - Prevalence of cocaine and marijuana use among pregnant women in a military health care setting. AB - BACKGROUND: Illicit drug use is common in the United States. The degree of substance abuse among pregnant women, its prevention, and treatment are currently matters of great concern. METHODS: We conducted a blinded cross-sectional study on the prevalence of cocaine and marijuana metabolites in the urines of an obstetric population served by a military community hospital. Ninety percent of patients screened were nonactive-duty family members. RESULTS: An overall illicit drug use prevalence of 1.6 percent was found. This contrasts to prevalences of 10 to 15 percent reported in civilian obstetric populations. CONCLUSIONS: Job site drug screening of the active-duty soldier may be the reason for differences between the military and nonmilitary populations. PMID- 1767689 TI - Hemorrhoids: associated pathologic conditions in a family practice population. AB - BACKGROUND: Hemorrhoidal disease is an affliction that in referral populations coexists with other significant anorectal diseases. Published texts recommend aggressive procedures to diagnose associated pathologic conditions and as an aid for planning the extirpation of these diseases. Procrastination in management is said to be characteristic of both patient and primary care physician. The purpose of this study was to ascertain whether patients with hemorrhoids in the general population are truly at high risk for significant anorectal disease. METHODS: Charts of 173 patients with hemorrhoids from a nonselected population were reviewed for treatment management, associated anorectal disease, and sequelae. RESULTS: A small subpopulation of persons aged more than 55 years was identified who may be at higher risk for colon polyps. Anoscopy, barium enema, fecal occult blood testing, and complete blood counts had very low yields. These findings differ significantly from data collected on highly selected populations that suggest hemorrhoids rarely exist alone. CONCLUSIONS: It appears that family physicians have not been cavalier in their attitudes toward and management of this common ailment. Clinical investigation of hemorrhoids should be initiated based on clinical impression from evaluating symptoms and signs combined with age specific screening recommendations. PMID- 1767691 TI - Practice style differences between family physicians and internists. AB - BACKGROUND: Because an estimated 70 percent of all medical care expenditures are generated by physicians, evaluation of specialty practice styles is essential to learn what changes in policies governing physician training, service delivery, and patterns of medical practice would promote cost containment. METHODS: We examined the 1981 and 1985 National Ambulatory Medical Care Survey for seven primary care diagnoses to compare practice style differences between family physicians and internists and to look for changes in family physicians' practice styles between 1981 and 1985. RESULTS: Family physicians referred fewer patients in 1985 and spent 3 to 10.5 minutes less per patient encounter than internists. Clinical laboratory testing, electrocardiogram (ECG) ordering, and radiographic examinations differed significantly between the two groups in 1981 and 1985 for some diagnoses. In 1981, family physicians did Papanicolaou smears 2.2 times more often than internists during general medical examinations; however, in 1985, there was no difference. Between 1981 and 1985, family physicians ordered significantly more laboratory tests and ECGs for some diagnoses but had no change in the number of radiographs ordered or referrals. For six diagnoses, they spent more time with a patient encounter in 1985 than in 1981. CONCLUSIONS: Family physicians and internists appear to be more alike in practice style, but significant differences remain. These differences, as well as changing practice styles of family physicians, have implications for training and health care resource distribution. PMID- 1767692 TI - Pharmaceutical expiration dating advice given by retail pharmacists. AB - BACKGROUND: There is presently no uniform legislation requiring or standardizing the expiration labeling of prescription drug containers dispensed to patients by retail pharmacies, and most communities in the United States do not require such labeling. Expired medications can suffer changes in toxicity, potency, or palatability. Inadvertent use because of incomplete labeling can impact negatively on good patient care. METHODS: A telephone survey of 124 retail pharmacists in a community suburban to New York City was conducted using a prepared script. RESULTS: When a caller requested "do not use later than" advice for 10-mg propranolol tablets said to have been purchased 6 months earlier, responses ranged from 3 to 60 months. Most pharmacists recommended discarding medications 1 year (31 percent) or 2 years (27 percent) following purchase, but fewer than one-fourth of those responding attempted to verify expiration dates before answering. CONCLUSIONS: Physicians counseling patients to use prescription medicines within 1 year of purchase are giving advice consistent with that offered by 85 percent of the responding pharmacists, but physicians should be aware of the limitations of this recommendation. In the absence of uniform expiration-dating policies, physicians can minimize potential risks to patients by printing the instruction "label expiration date" on prescription blanks. PMID- 1767693 TI - Impact of a patient education intervention on appropriate utilization of clinic services. AB - BACKGROUND: Patient education interventions have been identified as a means of decreasing the utilization of ambulatory services; however, research on the impact of self-care initiatives should also assess changes in the appropriateness of patient visits. METHODS: New patients to the Family Practice Clinic at a university medical center were randomized into control and experimental groups. Experimental patients received the Family Practice Clinic Patient Medical Advisor Booklet and an educational presentation. Controls received the booklet without the educational intervention. RESULTS: Over the subsequent year, there were no significant differences in the total number of visits or telephone calls to the Family Practice Clinic by either group. The total number of visits to other medical center clinics and the emergency department was also similar. The experimental group, however, showed a statistically higher percentage of appropriate Family Practice Clinic visits, and their telephone calls to the clinic for advice tended to be more appropriate. Finally, experimental group patients had a significantly higher percentage of appropriate visits to the emergency department than did control group patients. CONCLUSIONS: Although this educational intervention did not change the total number of patient visits or telephone calls, it did have an impact on the appropriateness of patient utilization of health care services. PMID- 1767694 TI - Fundamentals of electrosurgery. AB - Electrosurgery uses electricity to remove tissue, coagulate bleeding, or destroy tumors. Modern units, first developed for application in neurosurgery, are now available in office models that are most commonly used by the family physician for cutaneous surgery. Electrosurgery can accomplish cutting, coagulation, desiccation, and fulguration. Electrosurgical equipment for the office is relatively inexpensive and portable. The main advantage of this surgical modality is rapid completion of the procedure with minimal surgical time, because hemostasis occurs at the time of the incision. After some basic instruction and initial practice on animal tissue, which are provided through the guidance of several excellent texts or continuing education courses, the family physician can readily apply electrosurgery in an office-based practice safely, efficiently, and with satisfying results. PMID- 1767695 TI - Success strategies for departments of family medicine. AB - Strong departments of family medicine in academic medical centers help assure the future scope and quality of family practice patient care, the ongoing evolution of family medicine as a scholarly discipline, and a continued flow of qualified medical school graduates into family practice residency programs and eventually into practice. This report presents key strategies of six successful departments of family medicine and describes the methods and skills considered important by the leaders of these departments. Common themes that emerge are (1) recruit and mentor the best faculty, (2) build a reputation for clinical excellence of faculty and residents, (3) become part of schoolwide curriculum activities, (4) establish a scholarly presence, and (5) develop networks of support. PMID- 1767696 TI - How effective is drug treatment of hypercholesterolemia? A guided tour of the major clinical trials for the primary care physician. AB - BACKGROUND: Drug treatment of hypercholesterolemia remains controversial. Central to the debate are the results of the major placebo-controlled clinical trials of pharmacologic treatment of hypercholesterolemia. METHODS: Conventions and principles of clinical epidemiology are used to review the four major clinical trials of drug treatment of hypercholesterolemia. The review translates the results of these large, epidemiologically oriented experiments into terms that are applicable to managing patients at the individual level. RESULTS: Clofibrate is an ineffective treatment. Primary prevention with gemfibrizol or cholestyramine requires treating approximately 50 middle-aged men for 10 years to avert one adverse outcome. Secondary prevention with niacin for men with a prior myocardial infarction requires treatment of 10 to 15 patients for 10 years to prevent one adverse outcome. CONCLUSIONS: While drug treatment of hypercholesterolemia in middle-aged men can prevent death and morbidity, the magnitude of the effectiveness is modest. Because a critical factor influencing the magnitude of benefit is the underlying risk of adverse events in the population under treatment, physicians should target interventions to populations that may benefit the most. In populations for whom the magnitude of effectiveness is likely to be modest, physicians should exercise clinical judgment when deciding what degree of benefit justifies treatment in individual cases. PMID- 1767697 TI - Anxiety and substance use disorders: the treatment of high-risk patients. AB - Primary care physicians routinely treat patients with various anxiety disorders. These patients may have a substance use disorder or may be at high risk for abuse or addiction. Routine treatment of anxiety disorders with psychoactive drugs is successful in many patients, but it can lead to iatrogenic dependence in high risk patients. This article describes addiction risk factors, drug pharmacodynamics, environment and environmental cues, and genetics. With these addiction risk factors in mind, the physician can apply a stepwise treatment protocol described in three progressive levels: conservative, nonpharmacological approaches; nonpsychoactive pharmacotherapy; and psychoactive pharmacotherapy. In addition, proper prescribing practices for high-risk patients are described in terms of diagnosis, dosage, duration, discontinuation, dependence, and documentation. PMID- 1767698 TI - Septic arthritis associated with chickenpox. PMID- 1767699 TI - Occult hereditary spherocytosis and human parvovirus infection. PMID- 1767700 TI - Vasa previa: an unusual cause of fetal distress. PMID- 1767701 TI - Genograms, generalizability, quantities, and qualities. PMID- 1767702 TI - Measures of clinical effectiveness: the numbers needed to treat. PMID- 1767703 TI - Reflections of an "AIDS doctor". PMID- 1767704 TI - Post-transfusion purpura. PMID- 1767706 TI - The best ideal in family practice. PMID- 1767705 TI - Dietary calcium and hypertension. PMID- 1767707 TI - [Carotid artery surgery in extracranial occlusive disease and cerebral ischemia. Early and late results]. AB - Carotid artery surgery became an established procedure for the treatment of cerebrovascular insufficiency associated with carotid artery stenosis and for the prevention of Stroke. 180 patients were consecutively treated because of occlusive disease of the carotid arteries: 152 (84%) had TIA's or reversible deficits, 11 (6.1%) had strokes with partial recovery, 16 (8.8%) asymptomatic carotid disease and 1 patient (0.5%) had global cerebral ischemia. The severity of occlusive disease was assessed by ECHO-DOPPLER, with or without colour mapping and by angiography: 21 had minimal lesions (less than 20%), 58 stenosis between 21-75%, 92 stenosis between 76-99% and 7 had complete occlusion of the carotid artery; 2 patients had aneurysmal disease 196 operations were performed; early mortality (less than 30 days) was 2.2% (4/180) and neurological morbidity 1.6% (3/180), the operative risk being 3.8%. Longterm results were assessed during a follow-up period extending to 132 months and were assessed by life-table analysis. Survival was 52.5%, 79.3% of the patients were fully asymptomatic during the follow-up but 89.2% were stroke-free, the incidence of stroke being 0.97%/year. These results compare favorably with data available from the natural history and confirm the efficacy of carotid artery reconstructive surgery for the prevention of stroke. PMID- 1767708 TI - [Sleep disturbances in patients with generalized anxiety: a clinical and EEG sleep study]. AB - All night EEG sleep recordings and clinical evaluations of sleep were performed in order to compare patients with generalized anxiety and normal controls. Patients were selected according to DSM III-R criteria and went through a two weeks phase treatment with placebo before the sleep evaluation. As compared to normals, anxious patients showed a fragmented and superficial sleep with no changes of REM sleep features. Further to disturbances of sleep continuity and duration, they had a higher percentage of wake and stage 2, as well as a reduction of slow wave sleep (SWS) mainly due to a diminished percentage of stage 4. Several EEG sleep measures--related both with the amounts of SWS and sleep duration and continuity--are significantly correlated with symptoms severity. The pathogenic significance of sleep disturbances in generalized anxiety is discussed. PMID- 1767709 TI - [Visual screening in children]. AB - The Early Visual Screening (EVS) before verbal communication and, certainly, before one year old, is essential to prevent strabismus and/or amblyopia. We consider the PREFERENTIAL LOOKING (PL) for visual acuity determination and screening of the amblyopia and the PHOTOREFRACTION (VIDEO-REFRACTION: VPR-1) for refractive screening, adequated methods for Early Visual Screening. We suggest that these two technics are used as EVS methods, four times in childhood (newborn, 6-8 weeks, 6-8 months, 18-24 months) performed by an Ophthalmologist at a Pilot Health Center of the National Health Service. The classic methods of visual screening such as: child's reaction to the eye occlusion, pursuit movements, STYCAR balls and miniature toys, Cover test, Hirschberg test, red fundus reflex, anterior segment examination, each of these used according to the child's age, must be performed by an Ophthalmologist. We think they are a positive alternative until we are able to use the PREFERENTIAL LOOKING and VIDEO REFRACTION in Early Visual Screening. In the kindergarten and primary school the ASTENOPIC complaints due to hipermetropia, minor astigmatism and convergent deficit as well as chronic inflammation of the anterior segment eyelids and anexus, can be related with poor school performance more than with strabismus or myopia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767710 TI - [Pubic hair in children and late onset congenital adrenal hyperplasia]. AB - Before the age of 8 in females and 9 in males, the presence of pubic hair can be the first sign of a gonadal or adrenal disease. In order to identify the late onset type of congenital adrenal hyperplasia in premature pubescence, we did the adrenal short stimulation test with Synacthen, on 30 children. Five girls and one boy showed a 21-hydroxylase deficiency, in which the seric 17-OH Progesterone at 60 minutes is 28.8 +/- 15.2 ng/ml, being in a control group 2.30 +/- 0.8 ng/ml [p less than 0.01]. The 20% incidence we have found, justifies the testing of every premature pubescent child. PMID- 1767712 TI - [Prognostic factors and survival model for decompensated hepatic cirrhosis]. AB - A group of 207 consecutive patients admitted for decompensated liver cirrhosis of different etiologies (alcoholic, HBsAg-associated and cryptogenic), was studied in order to assess the independent long-term (up to 5 years) prognostic value of 13 clinical, biochemical and etiological factors. These were analyzed by the Cox Regression Model using a step-wise backward procedure. The final model included bilirubin (p = 0.003), HBsAg (p = 0.006), encephalopathy (p = 0.010) and a factor comprising urea and albumin (p less than 0.001). The model was validated by a split-sample testing technique and may be used to predict survival in decompensated cirrhosis. A comparison with Child-Pugh's score in terms of survival prediction was carried out and was favorable to our model. We conclude that this model can be useful for predicting short and long-term survival in the three most common types of liver cirrhosis and that the additional overhead to calculate it seems justified in view of the large availability of microcomputers where simple programs can be run to perform this task and draw the predicted survival curves. PMID- 1767711 TI - [Prospective study of duodenal ulcer. Analysis of prognostic factors]. AB - We conducted a prospective clinical trial of 154 patients with duodenal ulcer disease, which was divided in two different steps: healing phase and post-healing phase. In the first phase, the patients were randomly assigned to treatment with H2 blockers (Ranitidine 300 mg or Famotidine 40 mg), in a single bedtime dose. Endoscopy was performed after 4 and 12 weeks of treatment and the healing rate was 70% and 90%. There were no significant differences between the two drugs. After 12 weeks of treatment there were sixteen patients with non-healed duodenal ulcer, considered as refractory duodenal ulcer disease, in which we started therapy with a double dose of H2 receptor antagonists or sucralfate (4 gr/day). Endoscopic follow-up after 12 weeks of this regimen revealed ulcer healing in about half of them; the cummulative healing rate in 6 months was 96.4%. Persistent lesions after 6 months of follow-up were found in 5 patients. Omeprazole 40 mg, single dose, was given and all of them were healed during the first 4 weeks of treatment. In the second phase, 137 patients healed during the first 3 months of treatment, were followed for 12 months and randomized in two groups: 61, with maintenance therapy--ranitidine 150 mg or famotidine 20 mg; 76, without treatment. In the patients without maintenance therapy, the recurrence rate was significantly higher (p less than 0.55), than in the group with maintenance therapy. In this group several parameters were evaluated--clinical, biochemical and psychosocial--to try to identify some prognostic markers of healing, relapse.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767713 TI - [Familial peripheral neuropathy caused by susceptibility to entrapment (tomaculous neuropathy)]. AB - The authors describe a case of hereditary neuropathy with liability to pressure palsies (entrapment), and compare it to reports from literature. The main characteristics are: autosomal dominant inheritance, recurrent mononeuropathies (ulnar, median, peroneal, brachial plexus), and specific features at nerve biopsy. The sensory nerve reveals predominantly demyelinating alterations, having the remaining myelin fibres focal thickenings, the so called tomaculous, and shows numerous subperineural structures named Renaut Bodies. The EMG findings show a slowing of the nerve conduction velocities and an increase of distal latencies. PMID- 1767714 TI - [Essential thrombocythemia. Therapy with interferon alfa]. AB - A clinical case of essential thrombocythaemia is presented to demonstrate good therapeutic response to subcutaneous Alpha-2b Interferon in a dosage of 3 x 10(6) units, three times a week. Based on this case and on a literature research we propose that Alpha-2b Interferon is a legitimate alternative to alkylating agents or radioactive phosphorus (32P), showing identical efficacy and less Leukemogen effect. PMID- 1767715 TI - [Diffuse tracheo-bronchial amyloidosis]. AB - The case of a 52 year old man, whose initial clinical manifestations were dyspnea, bloodstained sputum and malaise is reported. After the initial cancer hypothesis, a diagnosis of diffuse primary tracheo-bronchial amyloidosis was made. The amyloid substance present was not of A A type and the plasma cells next to the deposits were polyclonal. The piece-meal removal of the masses by bronchoscopy led to profuse bleeding. The patient died with sepsis. The clinical, pathological and therapeutical aspects of lower respiratory tract amyloidosis are reviewed. PMID- 1767716 TI - [Acute renal insufficiency as presentation form of multiple myeloma]. AB - Multiple Myeloma (MM) causes a wide range of serious clinical, alterations, including acute renal failure (ARF) often present and contributing to the global mortality of this neoplasm. ARF usually occurs well after MM is diagnosed. We describe a case of ARF in a 42 years old male patient requiring urgent hemodialysis that subsequently proved to have MM. The singularity of this case lead us to review cases of ARF admitted to the Nephrology Department between 1978 and 1990. We describe 7 patients (4 male) with ARF as presenting form of MM. Their mean +/- SD age was 60.0 +/- 10.6 (range 42-73). ARF with conserved diuresis was the presenting form in 6, 5 has systemic infection, and none was hypertensive. Replacement therapy with hemodialysis was needed in 6 patients and plasmapheresis was performed in 3. 4 patients died while admitted, 2 were discharged on chronic hemodialysis and there was recovery of renal function in 1 patient. PMID- 1767717 TI - [Role of endarterectomy in the secondary prevention of cerebrovascular accidents: results of the European Carotid Surgery Trial (ECST)]. PMID- 1767718 TI - Advances in child development and behavior. PMID- 1767719 TI - The structure of developmental theory. PMID- 1767720 TI - The role of cognition in understanding gender effects. AB - Cognitive approaches, such as schematic processing theory, have been heuristic in a number of ways for bettering our understanding of how and why gender effects are so apparent in childhood. First, they provide a new and different perspective. Rather than concentrating on discovering all the instances of gendered information in our worlds and then assuming that this overwhelming amount of information accounts for children's behavior and thinking, cognitive theorists studying gender have reversed the emphasis. That is, we assume that thinking processes influence the world of information that is available to children. Furthermore, the nature of that world of information is then seen to influence behavioral choices. Second, cognitive approaches have been heuristic in providing some understanding of the mismatches that occur between available information and children's gender cognitions. More broadly stated, such approaches have been useful for discovering the reasons that gender cognitions are inaccurate--why some information is misperceived, misremembered, and selectively learned. Third, cognitive approaches have been useful for elaborating the development of children's gender knowledge. Finally, cognitive approaches have been useful for illustrating how cognition may influence behavior. If we go beyond gender for a moment, we see that cognitive approaches can also be useful for our understanding of the broader realm of all types of stereotypes. For instance, they are helpful in understanding the early origins of stereotypes. Why do children and adults develop stereotypes? Given the overwhelming amount of information we must deal with every day, how do we ever notice real but usually minor co-occurrences of group membership and attributes? Furthermore, why do stereotypes contain information that is not grounded in reality? To begin to answer these questions, we need to move cognitive approaches to a higher order of generality, that is, away from the specifics of gender and on to the broader case of concept formation about social groups. When cognitive notions are used in this way, children and adults appear to form higher order schemas concerning the nature of social groups. One such schema is the "if they differ in one way, they differ in other ways" schema. Another such schema represents the flip side: "If they are in the same group, they are the same in many other ways." Exposure to information about groups surely must lead to the formation of these higher order schemas. Once formed, they surely must influence how new information about specific groups is acquired by increasing perceivers' vigilance in noticing and creating supportive information.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1767721 TI - Development of processing speed in childhood and adolescence. PMID- 1767722 TI - Contextualism and developmental psychology. PMID- 1767723 TI - Horizontality of water level: a neo-Piagetian developmental review. PMID- 1767724 TI - Questions a satisfying developmental theory would answer: the scope of a complete explanation of development phenomena. AB - The good theory of human development is a complete theory, a theory that addresses the 10 points cited above. While the good theory cannot be about a set of a priori and objective facts, it is nevertheless about a set of facts that control the degree to which theory and interpretation correspond to them and are also consistent with other propositions in the theory and with other theories. Correspondence and consistency are compatible attributes of the good theory and are achieved through a dialectical exchange between a community of investigators that demands, in the end, that some theories and accounts be discarded because they fail to conform to the facts, as they were established in the theory, or because they lead to a reductio absurdum with regard to other established propositions. They fail, in other words, because they fail to sustain a sentiment of rationality. PMID- 1767725 TI - The development of world views: toward future synthesis? PMID- 1767726 TI - Metaphor, recursive systems, and paradox in science and developmental theory. AB - The contradictions found at any level of abstraction among concepts such as subject-object, whole-part, synthesis-analysis, metaphor-observation, organicism mechanism, and interpretationism-realism cannot be eliminated or resolved at that level. They can, however, be reconciled into productive paradoxes by recognizing them as components of recursive systems. The resolution of the paradox occurs only at the next higher level of abstraction where a synthesis can be established. However, this synthesis at the next higher level entails its own contradictions. These can again be reconciled into productive paradoxes through the recognition of broader recursive systems. This progressive solution continues at each iteration, or level or recursion, and it is illustrated in Fig. 5. In the figure, the innermost cycle represents the knowing organism, knowing in the paradoxical cycle of metaphor-assumptions-concepts-observations. This knowing organism is explained and hence understood, and the paradoxes reconciled, only by moving to the next level of recursive cycle. At this next level, the first level of abstraction, psychological theories operate to explain the phenomenological knowing organism of the first cycle. In fact, it is only by moving to this level that we transcend the paradox of man knowing and explaining himself. And only by moving to this level do we avoid the vicious circularity that could befall the use of recursive systems. However, the theories themselves involve a new paradoxical cycle of metaphor-assumptions-concepts-observation. Thus, explanation of this level requires movement to the next level of abstraction or next outer cycle. Here metatheoretical assumptions provide the transcendence and the opportunity to reconcile the paradoxes of psychological theory. But this level too operates in a cycle of paradoxes and consequently the process continues as it does for any dialectic process. In closing, I should in fairness note that I have outlined only one type of solution to contradictions that are found among approaches to the game called science and the game called developmental psychology. It is a solution that draws heavily on the categories of dialectical method, and it is just this method that is both the reason for, and the consequence of, the organismic metaphor. Thus, my solution generates its own contradiction for I have again, as Scholnick argues, based my solution at some level of organicism: a point that will not escape the discerning realist or, for that matter, the discerning rationalist. PMID- 1767727 TI - Children's iconic realism: object versus property realism. PMID- 1767728 TI - Structural and regulatory aspects of the human genes encoding IGF-I and -II. PMID- 1767729 TI - Single sc administration of insulin-like growth factor I (IGF-I) in normal men. AB - Total and free form of IGF-I in plasma increased in a dose dependent manner after sc IGF-I administration. Peak values of total IGF-I were obtained at 3-4 h after the administration, and then the values decreased gradually. However, peak values of free form of IGF-I were obtained at 2 h, and then rapidly decreased thereafter. The blood glucose, serum insulin and C-peptide levels decreased until 4 h after IGF-I administration in a dose dependent manner. Plasma IGF-II values significantly decreased at 4-12 h after IGF-I administration. Urinary urea nitrogen and sodium excretion decreased after IGF-I administration. Urinary GH excretion also decreased after 0.06 mg/kg IGF-I administration. These data demonstrate that IGF-I may play a role in glucose, protein and electrolyte metabolism, and plasma IGF-II levels and GH secretion might be regulated by IGF-I in man. PMID- 1767730 TI - Molecular heterogeneity of insulin receptors in rat tissues. PMID- 1767731 TI - Mutations in the insulin receptor gene in patients with genetic syndromes of insulin resistance. PMID- 1767732 TI - Role of receptor internalization in insulin signalling. PMID- 1767733 TI - Endogenous substrates of the insulin receptor: studies with cells expressing wild type and mutant receptors. PMID- 1767734 TI - Regulation of the glucose transporter in animal models of diabetes. PMID- 1767735 TI - Early events in the hormonal regulation of glial gene expression: early response genes. PMID- 1767736 TI - Trophic actions of IGF-I, IGF-II and insulin on cholinergic and dopaminergic brain neurons. PMID- 1767737 TI - Second messengers mediating gene expression essential to neurite formation directed by insulin and insulin-like growth factors. PMID- 1767738 TI - A review of insulin/insulin-like peptide in the central nervous system. PMID- 1767739 TI - Glucose transporters in central nervous system glucose homeostasis. PMID- 1767740 TI - The mammalian brain glucose transport system. PMID- 1767741 TI - IGF-I mRNA localization in trigeminal and sympathetic nerve target zones during rat embryonic development. PMID- 1767742 TI - Neuroactive products of IGF-1 and IGF-2 gene expression in the CNS. PMID- 1767743 TI - Extinction of human insulin-like growth factor II expression in somatic cell hybrids. PMID- 1767744 TI - The growth hormone-insulin-like growth factor I axis: studies in man during growth. AB - Several major differences are noted between males and females in their patterns of growth at puberty. Accelerated pubertal growth in both males and females depends upon the integrity of the GH-receptor system. In males, acceleration of growth results primarily from enhanced sensitivity of the GH-receptor-IGF I system to GH brought about by testosterone. Whether testosterone itself is responsible for this observation is still unclear. Perhaps the initial GH, IGF I peak present in males and absent in females occurs at the time when sleep-related rises of gonadotropins and testosterone begin just prior to puberty. Though the pygmy data certainly supports a relationship between testosterone and the GH receptor-IGF I axis, the undisputed tall stature of eunuchs remains a puzzle. It is possible that the maturing male gonad secretes another growth factor and/or growth inhibitor in conjunction with testosterone and that it is this unidentified factor which modulates growth. At any rate, acceleration of growth in males results from sensitization or the GH-receptor-IGF I system while growth acceleration in females results almost solely from increased secretion of GH and not sensitization of the system. PMID- 1767745 TI - Recombinant human insulin-like growth factor I: effects in normal subjects and implications for use in patients. PMID- 1767746 TI - ANCA: a class of vasculitis-associated autoantibodies against myeloid granule proteins: clinical and laboratory aspects and possible pathogenetic implications. PMID- 1767747 TI - Mechanisms of neutrophil and macrophage motility. PMID- 1767748 TI - Neutrophil carbohydrate metabolism in patients with essential hypertension and uremia. PMID- 1767749 TI - C5a receptors on neutrophils and monocytes from chronic dialysis patients. PMID- 1767750 TI - Respective influence of uremia and hemodialysis on whole blood phagocyte oxidative metabolism, and circulating interleukin-1 and tumor necrosis factor. PMID- 1767751 TI - Phagocyte function in uremia. PMID- 1767752 TI - New aspects on oxidative metabolism of neutrophils during hemodialysis on different dialyzer membranes. PMID- 1767753 TI - Blood flow dependent granulocyte activation in membranes with and without complement activation. AB - Synthetic membranes activate the complement system to some degree but also clear complement fragments from the circulation by adsorption and/or filtration and dialysis, PAN and PMMA even lower preexisting plasma levels of C3a. Activation of granulocytes measured as elastase release does occur with all membranes and might be due to complement activation. However, in synthetic membranes no correlation exists between levels of complement fragment C3a and elastase release. Instead, even when PMMA membrane lowered preexisting plasma levels of the C3a below baseline, activation of granulocytes to a similar degree as known from cuprophane membranes was observed. This activation did occur with blood flow of 200 ml/min during recirculation, but not without blood flow during incubation of membrane material. We conclude that granulocyte activation in synthetic membranes does not require an activated complement system, but may be a blood flow dependent phenomenon. PMID- 1767754 TI - Diversity in motile responses of human neutrophil granulocytes: functional meaning and cytoskeletal basis. AB - Different agonists induce motility and shape changes, but only a specific polarized shape is correlated with directed migration. An intact and dynamic actin network appears to be important for motility and migration. Motility is usually associated with an increased level of F-actin, and a specific location of F-actin into surface protrusions. For locomotion, a specific location of F-actin, rather than a large net increase in F-actin appears to be of importance. Three major groups of responses can be distinguished on the basis of the type of shape changes, functional activity and organization of F-actin. 1. Agents capable of polarizing cells, such as chemotactic peptides, and microtubule-disassembling agents elicit, at appropriate concentrations, a marked chemokinetic response, but little if any fluid pinocytosis. F-actin shows a polar location, being concentrated mainly in the protrusions at the leading front. Chemotactic peptide also induces an increase in the level of F-actin and cytoskeleton-associated actin. It is, however, not clear if front-tail polarity and locomotion, induced by chemotactic peptide after longer time of stimulation, correlate with an actual increase in the level of cytoskeleton-associated actin. 2. Activators of protein kinase C such as PMA and diacylglycerols, induce nonpolar cells with surface projections. PMA and diacylglycerols stimulate pinocytosis substantially. All three agents tend to inhibit locomotion or chemotaxis as an immediate response. They also increase the percentage of cytoskeletal actin, and induce an enrichment of F-actin in surface projections. 3. Circus movement may occur in response to D20. These cells show little or no stimulation of locomotion or pinocytosis. Thus the functional significance of this motor response remains to be elucidated. We conclude that different agonists can induce motility and shape changes, but not necessarily chemotaxis. Only a polarized shape is correlated with directed locomotion. An intact and dynamic actin network appears to be important for motility including locomotion. Motility is usually associated with an increased level of F-actin, and a specific location of F-actin into surface protrusions. The actin-associated proteins alpha-Actinin, myosin and actin-binding protein appear also to be important for pseudopod formation. For locomotion, a specific location of F-actin, rather than a large net increase in F-actin may be of importance. PMID- 1767755 TI - Role of platelet activating factor in the adhesion process of polymorphonuclear neutrophils to endothelial cells. PMID- 1767756 TI - Mechanisms of lipopolysaccharide priming for enhanced respiratory burst activity in human neutrophils. PMID- 1767757 TI - Clinical evaluation of hematopoietic growth factors. PMID- 1767758 TI - [Diagnosis of male infertility]. AB - The diagnostic methods for male infertility in our clinic are reviewed, and the following are emphasized. In azoospermia, examinations for obstructive azoospermia such as testicular biopsy should be made focussing on patients with 10 ml or higher testicular volume and with 20 mIU/ml or lower serum FSH level. In hypospermic patients, examination of post-ejaculated urine and ultrasonotomography examination of prostate are necessary for the diagnosis of incomplete retrograde ejaculation and obstruction or stenosis of the ejaculatory ducts. PMID- 1767760 TI - [Diagnosis of penile erectile dysfunction: simultaneous recording of nocturnal penile rigidity and circumferential expansion]. AB - This paper briefly reviews diagnostic examinations for penile erectile dysfunction and mainly refers to a newly developed ambulatory system of RigiScan which enables simultaneous recording of penile circumferential expansion and rigidity, introducing the latest values of variables of penile tumescence and rigidity in the Japanese without erectile dysfunction. PMID- 1767759 TI - [Treatment of male infertility: current situation and problems]. AB - We evaluated the results of treatment for male infertility in 883 patients who visited our clinic. The efficacy rate and pregnancy rate after varicocele operation were higher than those after drug therapy. Drug therapy was effective only in patients with a sperm count of 10-40 x 10(6)/ml. The percentage of swollen sperm in hypoosmotic swelling test elevated after operation in varicocele patients. The hypoosmotic swelling test seems to be useful to show the improvement of sperm function by treatment. PMID- 1767761 TI - [Non-surgical treatment of impotence]. AB - Non-surgical treatment of impotence comprises psychotherapy, drug oral administration and injection, drug intracavernous injection and penile vacuum extraction. Concerning psychotherapy, functional impotence is indicated, but urologists find difficulty in treating patients by themselves, thus requiring the co-operation of a psychiatrist, psychosomatic physician, psychologist and others. Concerning drug therapy, functional impotence is the main target, but is practically unbenefit with the reserve of endocrinally effective hormone. For drug intracavernous injection, papaverine hydrochloride and prostaglandin E1 are mainly used. At our Department, 51 patients have so far had successful self injections according to this method. However, the self-injection requires strict control of drugs, syringes, etc. and proper selection of indicated cases and that includes an incidence of priapism of ca. 10%, making it necessary to take quick countermeasures. This method is targeted mainly for organic impotence, but is also indicated partially dysfunctional impotence. Penile vacuum extraction is indicated for all kinds of impotence and has no side effect, but is actually too expensive (ca. 130,000 yen) though noteworthy. PMID- 1767762 TI - [Surgical treatment of impotence]. AB - In recent years, several procedures have been successfully employed for the treatment of patients with impotence. Implantation of penile prosthesis is favored for organic impotence. Surgical revascularization of penile artery is attempted for arteriogenic impotence and surgery for producing a mechanical obstruction in the penile venous outflow for venous impotence. Here in, the current surgical procedures for the treatment of erectile dysfunction are reviewed and our experience on the treatment of venous impotence is described. PMID- 1767763 TI - [Statistic analysis of pediatric urological operations for patients under one year-old]. AB - A statistic analysis was made on urologic patients under 1 year of age operated at our Department between July, 1973 and December, 1989. The incidence of patients under 1 year of age was 2.7% of the total patients operated on during the same period. Prenatal diagnosis has been responsible for increasing frequency of perinatal urologic abnormalities. Congenital urinary tract obstruction accounted for the most important disorder encountered in this age group. PMID- 1767764 TI - [Recent advances of pediatric urology--diagnosis and treatment of urinary tract diseases detected in the new-born infant period]. AB - Recent technological advances of diagnostic modalities, such as ultrasonography, have realized the early detection of urinary tract diseases in the neonate and new-born infant. Accordingly, it is very important to study the problems deriving under such a situation. In this symposium, the views for diagnosing and treating urinary tract diseases detected in the early infant period are proposed and discussed. PMID- 1767765 TI - [Urinary tract anomalies detected in prenatal diagnosis]. AB - Advances and spread in ultrasonography in obstetrics have resulted in the increase in the number of reports of congenital anatomical anomalies that have been diagnosed prenatally. We present 56 patients with congenital urinary tract anomalies, which were found by prenatal USG. These anomalies included pelvi ureteric junction stenosis in 19, multicystic kidney in 12, primary megaureter in 6, ureterocele in 4, posterior urethral valve in 3, polycystic kidney in 2, vesicoureteral reflux in 2, urogenital sinus anomaly in 2 and others in 4. There were 9 oligohydramnios: posterior urethral valve in 2, polycystic kidney in 2, bilateral multicystic kidney in 2, urogenital sinus anomaly in 2 and vesicoureteral reflux in 1. In the neonatal period, urological treatment was performed on 13 patients; indwelling catheter on 4, vesicostomy on 2, ureterocutaneostomy on 2, TUR cele on 2 and others on 3. Among the cases, 25 have been operated on after the various intervals of follow-up periods. Pyeloplasty was performed on 9 patients with pelvi-ureteric junction stenosis, total reconstriction on 4 with ureterocele, ureterocystoneostomy on 3 with megaureter and others on 9. There were 7 lethal cases; polycystic kidney in 2, multicystic kidney in 2, posterior urethral valve in 1, megaureter in 1 and urogenital sinus anomaly in 1. It seems likely that various kinds and increasing number of urinary tract abnormalities will be diagnosed through prenatal USG. It is now important to make a consensus for the timing and management of the therapy of these anomalies. PMID- 1767766 TI - [Upper urinary tract obstruction diagnosis and treatment of congenital hydronephrosis in children]. AB - Twenty nine children under 2 years old with congenital hydronephrosis have been treated in the last 14 years in our department. We report 4 cases which we found difficult to diagnose and treat. The diagnosis and the treatment of congenital hydronephrosis in children are discussed, especially concerning those patients under the age of 2 years. Pyeloplasty has been performed in 28 renal units out of 35 renal units. The results of the procedure were good in 82.1%, fair in 10.7%, no change in 3.6% and a lost case in 3.6%. The Aderson-Hynes dismembered technic was employed except for one renal unit in which the extrarenal pelvis was resected. Hydronephrosis in two renal units and one with nephrostomy for one year and one month improved spontaneously. Endopyelotomy was performed in 2 renal units and will be performed in one renal unit. Nephrectomy was carried out in one renal unit with renal dysplasia. A kidney with dysplasia excreted urine of several ml/day. Post-enhanced-X-ray computed tomography and T1-weighted image of magnetic resonance presented loss of function in the kidney. Degree of stenosis, position of stenosis and function of pelvis and ureter were different in each child. Children are constantly growing up and the condition of stenosis was changed in some cases. In conclusion, we should estimate the stenosis in children using several examinations. PMID- 1767767 TI - [Cystometric examination for neurogenic bladder of neonates and infants]. AB - We examined 38 neonates and infants with spina bifida using cystometry and cystography. Among 18 cases with myelomeningocele, only 1 case was evaluated as normal, 15 cases were abnormal on cystometry and 2 cases were unable to be evaluated. In the 15 abnormal cases, 8 had low-compliance and high pressure pattern which suggested future deterioration of upper urinary tract. Clean, intermittent catheterization was started in 3 cases. In 20 cases with spina bifida occulta associated with lipoma, 14 were evaluated as normal but 5 were abnormal and 1 case was unable to be evaluated. One of the 4 cases with low compliance and high pressure was treated with clean, intermittent catheterization. Cystometric examination is a simple and useful modality in neonates and infants with neurogenic bladder not only to evaluate the function but also to predict the future deterioration of the upper tract, and to select the proper treatment. PMID- 1767768 TI - [Clinical study in infants with vesicoureteral reflux]. AB - A clinical study was performed on 52 infants up to 2 years old with vesicoureteral reflux. We treated 12 of them conservatively. Half of them dropped out within 1 year. It was very difficult to follow up the infants over a long time in the conservative treatment group. As a result of the conservative treatment, reflux disappeared spontaneously in only 2 infants. Forty infants underwent antireflux operations. The reflux disappeared in all cases. However, we injured the peritoneum in 2 cases when the Politano-Leadbetter method was applied. A modified Politano-Leadbetter method was adopted because of the peritoneum injury. As an antireflux operation on infants, the modified Politano Leadbetter method is desirable. Renal function and growth were studied. Renal function was assessed with 99m-Tc-DTPA renograms. Renal ratio was evaluated by intravenous pyelography. The function of refluxing kidneys Severely damaged was not improved after the antireflux operations. The small kidneys with a high grade or the atrophic kidneys did not demonstrate normalization of renal growth after antireflux operations. In conclusion, it is important to detect the reflux at the early infant stage and perform the antireflux operation at an early stage in the case of high grade or renal impairment. PMID- 1767769 TI - Subcostal transabdominal incision with midline extension for tumors of the kidney, adrenal gland or retroperitoneal cavity. AB - Subcostal transabdominal incision with midline extension is excellent for removal of large renal or adrenal tumors, or bilateral or retroperitoneal tumors. This incision is simple and gives a wide surgical field without involving the pleural cavity. No troublesome complications resulting from this approach have occurred. PMID- 1767770 TI - [The diagnostic value of flow cytometric DNA analysis in bladder cancer- comparison with conventional cytology]. AB - The aim of this research was to assess the clinical value of flow cytometry (FCM) compared with conventional cytology in the detection and diagnosis of bladder cancer. The practical application of FCM combined with cytology was also investigated. Seventy patients with bladder cancer and 50 without neoplastic disease of the urinary tract were studied. The exfoliated cells used for FCM-DNA analysis and cytology by the Papanicolaou technique were obtained from voided urine and subsequent bladder irrigation specimens. The false negative rates for urine cytology, irrigation cytology, urine FCM, and irrigation FCM were 36%, 38%, 14% and 13%, respectively. Corresponding false positive rates were 2%, 0%, 14%, and 18%. When the above-mentioned examinations were paired, the combination of urine cytology and urine FCM appeared to be the most acceptable way to secure a correct diagnosis. Using this combination, the false negative and false positive rates were 4%, and 16%, respectively. When three or four examinations were combined, the false negative fate could not be improved despite the fact that the false positive rate worsened. It is noteworthy that FCM-DNA analysis seems to be less reliable in patients who have inflammatory diseases of the urinary tract or a history of intravesical chemotherapy. PMID- 1767771 TI - [Young-Dees-Leadbetter's posterior urethral lengthening procedure for urinary incontinence: report of three cases]. AB - Urinary incontinence caused by functional or anatomical incompetence of the urethral sphincter is one of the most challenging problems in urological surgery. Posterior urethral lengthening accomplished by tubularization of the trigonum, which was proposed by H. H. Young, J. E. Dees and G. W. Leadbetter, has been shown to improve the outcome in epispadia patients with incontinence. We report our experiences of Young-Dees-Leadbetter's operation in three patients. Case 1 was a 55-year-old woman who had undergone removal of the external genitalia to treat genital Paget's disease, resulting in total incontinence. About one half of the urethra had been removed, resulting in a shortened urethral length of 2.5 cm. Case 2 was a 6-year-old boy with penile epispadia, who had leadage of about a third of the total urine volume. Case 3, an 18 year-old female patient, suffered from total urinary incontinence which had resulted from a defect in the entire urethra and bladder neck following a motor vehicle accident. Posterior urethral lengthening together with ureteral reimplantation was performed on these three patients according to Leadbetter's or Dees' method. Subtotal continence was achieved in cases 1 and 3, and incontinence was completely cured in case 2. Based on our results with these three cases, we feel that Young-Dees-Leadbetter's operation is a useful method for treating sphincteric incontinence, particularly in female patients with an anatomical urethral defect. PMID- 1767772 TI - [Preliminary report on the effect of etoposide or etoposide and CDDP on recurrent prostate cancer]. AB - Eight patients with recurrent prostate cancer were treated with Etoposide and CDDP or Etoposide alone. Etoposide was administered at a dose of 20 approximately 50 mg/m2/day for 5 consecutive days and CDDP was administered at a dose of 30 approximately 50 mg/m2 on the first day. Treatment was repeated every 3 or 4 weeks. Patients who were treated with combination chemotherapy (Etoposide + CDDP) were those with no hematological abnormalities, no renal dysfunction and good performance status. Three patients were treated with Etoposide and CDDP and five were treated with Etoposide alone. Clinical evaluation was as follows: 3 patients (2 with Etoposide and CDDP, 1 with Etoposide alone) had PR (37.5%) and 5 patients had PD (62.5%). We obtained the impression that lesions of soft tissue metastasis responded well to this chemotherapy and that this combination chemotherapy was more effective than Etoposide alone. Major complications were myelosuppression, gastrointestinal upset and loss of hair. However, they were tolerable in patients with good performance status. This combination chemotherapy (Etoposide + CDDP) seems to be worth further clinical trials to patients who were tolerable. PMID- 1767773 TI - [Clinical studies on endocrine therapy for prostatic carcinoma (4): Initial response to endocrine therapy and prognosis]. AB - We have already pointed out by the use of multivariate analysis that local response of the prostate is one of the important prognostic factors in patients receiving endocrine therapy. Herein, we investigated how the local response to endocrine therapy affects the survival rate or the survival period. We also studied the relationship between the local response and histopathological findings. The local response of prostate was not correlated with the stage progression. Sixty-seven percent of the patents in each stage had an initially favorable local response of the prostate, in which the primary tumor became flattened or reduced by endocrine therapy. By contrast, the local response of the prostate was well correlated with the prognosis in each stage. Patients with a flattened or reduced primary lesion following endocrine therapy showed a higher survival rate or a longer survival period than those with the unchanged lesion. This result has confirmed that the local response of prostate to endocrine therapy is useful in predicting clinical courses of patients. Grade of structural atypism (SAT), one of the pathological findings, had a correlation with local response of the prostate. With an elevation of the SAT grade, the proportion of patients with unchanged primary lesion was increased. PMID- 1767774 TI - [Clinical studies on endocrine therapy for prostatic carcinoma (5): Analyses of relapse from endocrine therapy]. AB - Prostate carcinomas are well known to be initially responsive to endocrine therapy. However, a significant number of the patients experience a relapse from endocrine therapy during the follow-up period. We clinically analyzed various aspects of the relapse which indicate a limitation in the effectiveness of endocrine therapy for prostate carcinoma. In a total of 372 patients, 117 (31.5%) had some evidence of local relapse such as regrowth of the primary lesion, or a generalized relapse such as re-elevation of total acid phosphatase, reactivation of previously present metastasis or the new appearance of metastasis, during endocrine therapy. Of these, one-fourth had local relapse alone and the remainder showed generalized relapse. The interval from the start of the treatment to the time of relapse tended to become shorter; 45.9 months (mean) in stage B, 36.8 in stage C and 29.3 in stage D, according to the stage progression. As to the non relapse rate of the primary lesion, no differences were found among the stage, with the rate being approximately 90% at the fifth year in each stage. However, the generalized relapse-rate tended to increase with the stage progression. In the generalized relapse, the patients of stage C or D showed a non-relapse rate of 71.7% or 67.4%, respectively. Most of the generalized relapse appeared within five years following start of endocrine therapy in these advanced stages. The interval from relapse to prostate carcinoma-related death in patients with the generalized relapse was 9 approximately 21 months, and those in stage D tended to show a a poorer prognosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767775 TI - [A resected case of renal cell carcinoma with metastasis to pancreas]. AB - We report a case of renal cell carcinoma with metastasis to the pancreas, treated by radical nephrectomy and total pancreatectomy. A 56-year-old man visited our hospital because of macrohematuria and right low backache. An intravenous pyelography, ultrasonography and a CT scan of the abdomen revealed right renal tumor at the upper portion, about 11 cm in diameter, but no abnormal findings of the pancreas. Aortic and celiac angiograms demonstrated multifocal lesions, 1 or 2 cm in size, compatible with a metastatic tumor in the region of the pancreas. The patient underwent right radical nephrectomy and open biopsy of the pancreas. The right renal tumor was histologically revealed to be renal cell carcinoma without nodal or venous extension. Histological examination of the pancreas biopsy specimen confirmed it to be a renal cell carcinoma metastatic to the pancreas. Therefore, he underwent total pancreatectomy 1 month after the previous surgery. Three months after the second surgery, a CT scan of the brain revealed metastasis to the pituitary gland. He is still under therapy. PMID- 1767776 TI - [Two cases of 2.8-dihydroxyadenine stone with a partial deficiency of adenine phosphoribosyltransferase]. AB - We report two cases of 2.8-dihydroxyadenine stones due to partial deficiency of adenine phosphoribosyltransferase. The first patient is a 41-year-old female. Radiologic examination revealed left radiolucent renal stones and contracted kidney. Left nephrectomy was performed. Infrared spectrometric analysis of the stones revealed 2.8-dihydroxyadenine calculi. The adenine phosphoribosyltransferase activity in lymphocyte (T cell) was 19.5% of the control level. After the operation, the patient was given 300 mg/day of alloprinol. There have been no signs of recurrence. The second patient was a 52 year-old male. Radiologic examination revealed radiolucent stones of the right kidney and the urine bladder. Percutaneous nephrolithotomy and cystolithotripsy were performed. Infrared spectrometric analysis of the stones revealed 2.8 dihydroxyadenine calculi. The adenine phosphoribosyltransferase activity in the lymphocytes (T cell) was 21% of the control level. After the operation the patient was given 200 mg/day of alloprinol and put on a low purine diet. There have been no signs of recurrence. PMID- 1767777 TI - [Disseminated intravascular coagulation after transurethral ureterolithotripsy: a case report]. AB - We experienced a case of disseminated intravascular coagulation (DIC) following transurethral ureterolithotripsy (TUL). A 78-year-old woman was referred to our hospital with the complaints of fever and urinary tract infection. Urine culture showed positive E. coli and antibiotics were given. Radiologic findings revealed a left renal stone. The patient underwent TUL. After the operation acute renal failure occurred. Laboratory data revealed DIC on the next day. In spite of intensive therapy the patient died. Pathological findings showed that acute renal failure was caused by DIC. It is important that we should note the risk of DIC after TUL. PMID- 1767778 TI - [Two cases of traumatic bladder rupture with multiple organ failure]. AB - We report two cases of traumatic bladder rupture complicated by multiple organ failure (MOF). The first patient had an extraperitoneal bladder rupture and right femoral bone fracture, which were treated conservatively. However, intrapelvic abscess and adult respiratory distress syndrome (ARDS) which was caused by fat embolism resulted in MOF. The second patient who had been under treatment for malignant lymphoma for three years had an intraperitoneal bladder rupture with ruptures of spleen, intestine and diaphragm. We closed the defects in the bladder, intestine, diaphragm and performed splenectomy. We also provided suprapubic cystostomy and a urethral catheter. However, wound abscess and hepatic failure occurred postoperatively. She died of MOF 20 days after the operation. We stress that in the treatment of bladder rupture, intensive chemotherapy for infection must be done when there are complications of other visceral injuries. PMID- 1767779 TI - [A case of a foreign body in the urinary bladder--a surgical suture needle was found in urinary bladder]. AB - We report a case of an unusual foreign body in the urinary bladder. A 66-year-old male had undergone an operation of rectal cancer 6 years previously. He visited our hospital with irritative urinary symptoms. Urinalysis showed hematopyuria, and X-ray examination revealed a curved fine shadow (about 2 cm in length and 3 mm in width) at the vesical region. In cystoscopic examination, a calcified surgical suture needle was identified on the trigonal region. The needle was removed transurethrally by a stone crushing forceps. Thus, it was assumed that the needle had been left in the abdominal cavity at the operation 6 years ago and it had migrated into the bladder during these 6 years. Many cases of foreign bodies in the urinary bladder have been reported. However, to our knowledge, this is the first report of a surgical suture needle, in the bladder. PMID- 1767780 TI - Intratesticular leiomyoma: a case report. AB - A case of leiomyoma of the testis is reported. The origin of the intratesticular leiomyoma is controversial, but recently it is thought to arise from the contractile cells in the tunica propria of the seminiferous tubules. This is the first case reported in Japan and the fifth in the world literature. PMID- 1767781 TI - [A case of penile cavernitis following a penile prosthesis implantation]. AB - A 25-year old man, who had an inferiority of having a small penis and normal potency, underwent intracavernous implantation of hand-made silicone rods by a cosmetic surgeon in order to enlarge his penis. He had pyrexia and swelling of the penis 2 days after the implantation, and penile cavernitis developed. The penile symptoms improved by drainage and strict chemotherapy, and then the silicone rods were removed from his penis. Histopathological findings of the corpus cavernosum showed marked inflammatory and granulomatous changes. The patient lost his potency due to poor blood flow into the cavernous. PMID- 1767782 TI - [Clitoral enlargement caused by prepucial hemangioma: a case report]. AB - A 4-year-old girl visited with the chief complaint of clitoral enlargement which was first pointed out when she was one year old. She has received excision of the femoral tumor, which was histologically an arteriovenous hemangioma, at 4 years old. The prepuce was darkly purplish and the clitoral neck was enlarged without enlargement of the clitoral glans. The external genitalia otherwise were normal and there were no virilizing signs. The mass was excised at the preoperative diagnosis of prepucial hemangioma. The mass was enclosed in the prepuce and adherent to its skin and there was no enlargement of the clitoris itself. The histopathological diagnosis was arteriovenous hemangioma. PMID- 1767783 TI - [Clinical statistics on the patients operated at the Department of Urology, Kinki University Hospital during three years from 1987 to 1989]. PMID- 1767784 TI - [Clinical studies of terodiline hydrochloride and clenbuterol hydrochloride for urinary frequency and incontinence]. AB - The clinical effectiveness and safety of terodiline hydrochloride and clenbuterol hydrochloride were studied on 51 patients with neurogenic bladder, stress incontinence, unstable bladder and others, the chief complaints of which were urinary frequency or urinary incontinence. Overall improvement was graded as marked in 6 patients (11.8%), moderate in 20 patients (39.2%), slight in 11 patients (21.6%), unchanged in 13 patients (25.5%) and aggravated in one. The patients impression was "good" or better in 56.9%. There were a total of 13 cases (25.5%) of adverse reactions, namely, 7 cases of finger tremor, 3 cases of dry mouth and others. These reactions disappeared rapidly after the discontinuance of drug administration. The clinical efficacy in the treatment of subjective symptoms was 71.4% for urinary incontinence, 56.4% for diurnal pollakisuria. The examination of lower urethral functions demonstrated a significant (p less than 0.01) increase in bladder capacity at first desire and maximum desire to void. However, we found no significant increase in urethral clossure pressure. The findings of this study suggest that terodiline hydrochloride and clenbuterol hydrochloride are very useful for the treatment of urinary frequency and incontinence. PMID- 1767785 TI - How the relative value scale could save medicine. PMID- 1767786 TI - Refining the designs of the future American health care system. PMID- 1767787 TI - Rabies, raccoons, and suburbs. PMID- 1767788 TI - Our saintly legacy. PMID- 1767789 TI - When electricity was a panacea. PMID- 1767790 TI - Aquatic hazard Mycobacterium marinum infection. AB - We describe two patients with Mycobacterium marinum infection and review the pertinent literature. M. marinum infection follows trauma, often trivial, in water or from marine life. Clinical manifestations include superficial cutaneous lesions which are either solitary or multiple in a sporotrichoid distribution, involvement of the deeper structures of the hand and wrist and disseminated disease. Biopsy of infected tissue reveals a mixed suppurative-granulomatous reaction with sparse to absent acid-fast bacilli. Definitive diagnosis is achieved by growing the organism from appropriate specimens. Suggested therapeutic regimens consist of rifampin and ethambutol for advanced disease and infection invading the deeper structures of the hand and wrist and one of the tetracyclines or trimethoprim-sulfamethoxazole for early or minimal disease. Surgical debridement is advised when there is persistent pain, a discharging sinus or previous local injection of corticosteroids. PMID- 1767791 TI - Development of the low impedance points in the auricular skin of experimental peritonitis rats. AB - Electrical impedance of the auricular skin was measured in experimental peritonitis rats. Constant voltage pulses (10ms, 4V) were applied to the skin, then the impedance was estimated. Low impedance points were gradually increased after the operation for 7-14 days then they returned to the control level. The pseudo-sweating responses accompanied by the development of peritonitis were also observed. Histological study could not find any sweat glands in the auricular skin. These results suggest that the activation of the sweat glands is not the major cause of the formation of the low impedance points. Other possibilities of these phenomena were discussed. PMID- 1767792 TI - Cytotoxic activities of tanshinones against human carcinoma cell lines. AB - Fifteen tanshinone analogues isolated from the chloroform extract of Danshen roots (Salviae Miltiorrhizae Radix) by chromatographic procedures were tested for their cytotoxic activities against KB, Hela, Colo-205 and Hep-2 carcinoma cell lines. Several of them were effective at concentrations below 1 micrograms/ml concentrations. Tanshinone analogues with either hydroxy substitutions or olefinic feature in ring A demonstrated higher biologic activities. Analysis of structure-activity relationship indicate that the basic requirement for activity is the presence of a furano-o-naphthoquinone in the molecule. Compounds which lack an intact furan ring were found to be inactive. It is suggested that the planar phenanthrene ring of the tanshinones may be essential for interaction with DNA molecule whereas the furano-o-quinone moiety could be responsible for the production of reactive free radicals in the close vicinity of the bases to cause DNA damage. PMID- 1767793 TI - Effects of hachimijiogan on dopamine, serotonin and vasoactive intestinal peptide in plasma and hypothalamus in sulpiride-induced hyperprolactinemic rats. AB - Effect of Hachimijiogan (HJ) on dopamine (DA), serotonin (5-HT) and vasoactive intestinal peptide (VIP) was examined in plasma and hypothalamic tissue of sulpiride-induced hyperprolactinemic rats (SHR). Similar to bromocriptine (BR), HJ, in combination with sulpiride, suppressed plasma prolactin levels raised by sulpiride alone. Furthermore, HJ, together with sulpiride, increased plasma DA levels decreased by sulpiride alone, while 5-HT in plasma was increased by sulpiride and HJ, individually or in combination. However, plasma VIP levels were under detection limits on some occasions after HJ treatment. Successively, DA, 5 HT and VIP levels in the hypothalamus were determined. Similar to the effect caused by BR, DA and 5-HT levels in hypothalamic tissue reduced by sulpiride alone were also significantly increased by HJ together with sulpiride, while VIP levels were sometimes under detection levels with or without HJ. These results suggest that HJ stimulates the hypothalamus to increase DA and 5-HT in SHR, providing evidence for the clinical efficiency of HJ in combating hyperprolactinemia. The effect of HJ on VIP in plasma or hypothalamic tissue is, however, questionable. PMID- 1767794 TI - Pharmacological studies on aerial parts of Calotropis procera. AB - The decoction of the aerial part of Calotropis procera is commonly used in Saudi Arabian traditional medicine for the treatment of variety of diseases including fever, joint pain, muscular spasm and constipation. The present investigation was undertaken to confirm its claimed activity in traditional medicine. The ethanol extract of the plant was tested on laboratory animals for its antipyretic, analgesic, anti-inflammatory, antibacterial, purgative and muscle relaxant activities. The results of this study showed a significant antipyretic, analgesic and neuromuscular blocking activity. On smooth muscle of guinea pig ileum, the extract produced contractions which was blocked by atropine supporting its use in constipation. The extract failed to produce significant anti-inflammatory and antibacterial activities. Our phytochemical studies on the aerial parts of C. procera showed the presence of alkaloids, cardiac glycosides, tannins, flavonoids, sterols and/or triterpenes. However, the chemical constituents responsible for the pharmacological activities remains to be investigated. The safety evaluation studies revealed that the use of extract in single high doses (up to 3 g/kg) does not produce any visible toxic symptoms or mortality. However, prolong treatment (90 days) causes significantly higher mortality as compared to control group. PMID- 1767795 TI - Anticancer effects of a Chinese herbal medicine, juzen-taiho-to, in combination with or without 5-fluorouracil derivative on DNA-synthesizing enzymes in 1,2 dimethylhydrazine induced colonic cancer in rats. AB - Juzen-taiho-to (JTT; [Shi-quan-da-bu-tang], a Japanese modified Chinese herbal prescription) in combination with an anticancer drug UFT (5-fluorouracil derivative) prevented the body weight loss and the induction of the colonic cancer in rats treated with a chemical carcinogen 1,2-dimethylhydrazine (DMH), and suppressed markedly the activity of thymidylate synthetase (TS) involved in the de novo pathway of pyrimidine synthesis in colonic cancer induced by DMH. PMID- 1767796 TI - Effect of tokishakuyakusan on corpus luteum endothelin. AB - The presence of endothelin-1 (ET) and effect of Tokishakuyakusan (TS) on ET in rat corpora lutea (CL) was investigated in superovulated ovaries, induced with pregnant mare's serum gonadotropin and human chorionic gonadotropin. A high concentration of ET was found in the CL. The level of ET was significantly lower in the CL from TS-treated rats than that in TS-untreated rats (402.68 versus 575.60 pg/g wet weight, p less than 0.05). In contrast, the ET levels in plasma were by far lower than those in CL. These data indicate an inhibitory effect of TS on ET, an intraovarian peptide, production or accumulation in the CL. PMID- 1767797 TI - Successful treatment of a senile diabetic woman with cataract with goshajinkigan. AB - A 65-year-old woman with diabetes mellitus (DM) and suffering a cataract in the left eye, that was resistant to Western medical treatment, was treated with goshajinkigan (GJ), a herbal medicinal drug, in combination with eye drops. This treatment remarkably improved the visual disturbance due to the senile cataract. Ten days after commencement of the GJ treatment, her visual acuity did not deteriorate any further. There was also no further deterioration of DM condition. These results suggest that GJ may be valuable in the treatment of diabetic women with cataracts. PMID- 1767798 TI - Anatomical and histological studies of Bupleuri radix. AB - Three kinds of Bupleuri Radix were found in Taiwan. To clarify their origins, histological studies were carried out to identify their internal and external structures. It was found that Bupleuri Radix or "Chai-hu" of Taiwan is derived from roots of the following species" 1, Bupleurum chinense which was imported from China, 2, Bupleurum falcatum var. komarowi a cultivated production of Japanese origin, and 3, Bupleurum kaoi which is indigenous to Taiwan. These Bupleuri Radix were easily assigned by anatomical characteristics and their qualitative analysis of active principle - saikosaponin were established by TLC. PMID- 1767799 TI - Preliminary study on antiradiation effect of kuei-pi-tang. AB - In order to evaluate the potential action of Kuei-Pi-Tang as an antiradiation agent, colony forming units of bone marrow cells in the spleen (CFUs) were used. Different sequences of X-ray irradiation with or without Kuei-Pi-Tang administration in the groups of ICR strain mice were intraperitoneally injected 10mg/20g or 20mg/20g, once a day, for consecutive seven days before or after 4Gy X-ray irradiation. After the different treatments, whole blood was collected from the tail endings to observe the fluctuation of leukocytes, erythrocytes and thrombocytes. The administration of 20mg/20g was more effective than that of 10mg/20g. Lower radiosensitivity was observed with the treatment of 20mg/20g of Kui-Pi-Tang than that of 10mg/20g. The injection of Kuei-Pi-Tang accelerated the recovery of blood cell counts of leukocytes, erythrocytes and thrombocytes in mice irradiated with 4Gy, especially for leukocytes under the treatments with 20mg/20g of Kuei-Pi-Tang administered after irradiation. PMID- 1767800 TI - Effect of emitted bioenergy on biochemical functions of cells. AB - The 3-5 microns infrared spectra of the external "Qi" generated by a "Qigong" master from his palm was measured using a III-V compound semiconductor InSb detector. It was found that certain Qigong master can emit two opposite kinds of "Qi": the "facilitating" (beneficial) and "inhibiting" (destroying) "Qi". During the facilitating "Qi" emission, large amount of infrared wave were detected by a temperature rise of the air in the vicinity. When the inhibiting "Qi" was emitted, the infrared wave was absorbed from the environment resulting in a cooling of the air. The temperature rise or drop possibly reflects the fact that the blood flow to the palm was increased or decreased by dilating or constricting the blood vessels through parasympathetic or sympathetic nerves. The biochemical effects of emitted "Qi" from the same Qigong master on the human fibroblast FS-4 were investigated. The facilitating "Qi" caused 1.8% increase of the cell growth in 24 hrs, 10-15% increase of DNA synthesis and 3-5% increase of protein synthesis of the cell in a 2-hr period; while inhibiting "Qi" caused 6% decrease of cell growth in a 24 hr period, 20-23% decrease of DNA synthesis and 35-48% of protein synthesis in a 2-hr period. In addition, we found that the respiration rate of boar sperm increased 12.5-13.0% after receiving 5 min exposure in facilitating "Qi," and a decrease to 45-48% by exposure to 2-min of inhibiting "Qi." The results could be attributed to the effects of emitted "Qi" or energy containing infrared light (wave) and possibly some other types of energy. PMID- 1767801 TI - Current concepts in the treatment of urinary tract infections and prostatitis. AB - Urinary tract infection is a common medical diagnosis. The decision to treat is based on presenting signs and symptoms, bacterial colony counts in urine, and the nature of the infection. Escherichia coli is the single most frequent cause of urinary tract infections, although, depending on the clinical presentation and presence of risk factors, other pathogens may also be implicated. A variety of antimicrobial agents are available for the treatment of urinary tract infections. Fluoroquinolones are useful because these agents have broad-spectrum antimicrobial activity, resistance to these agents is minimal, and they achieve high concentrations in the urinary tract, have long elimination half-lives in urine, and are well tolerated. PMID- 1767802 TI - Recent developments in the treatment of sexually transmitted diseases. AB - Recent changes in the treatment of sexually transmitted diseases include recognition of penicillin-resistant Neisseria gonorrhoeae, identification of Chlamydia trachomatis as the leading cause of bacterial genital infection in the United States, and the realization that the urethritis syndrome is often associated with multiple pathogens. There is currently no monotherapy that eradicates all STD pathogens. The role of fluoroquinolones in the treatment of STDs is still evolving. The investigational agent, temafloxacin, has good activity against gonococci, nongonococcal organisms, and, unlike other quinolones, against Bacteroides fragilis and other anaerobes. Norfloxacin, ciprofloxacin, enoxacin, ofloxacin, and temafloxacin single-dose therapy have demonstrated clinical efficacy for gonococcal infections in non-comparative and comparative trials, including bacterial eradication of isolates resistant to other agents. PMID- 1767803 TI - Overview of fluoroquinolone safety. AB - The safety of the fluoroquinolone antimicrobial agents is reviewed, discussing documented and potential clinical and laboratory adverse effects and drug-drug interactions. In prospective, randomized, double-blind clinical trials comparing fluoroquinolones to nonquinolone drugs or placebo, the fluoroquinolones were not significantly different (22 studies) or were superior (5 studies) to comparison agents but were only rarely more toxic (2 studies). Adverse effects included mild gastrointestinal toxicities and less common but more problematic central nervous system toxicities. Clinically important interactions occurred with coadministration of antacids and all fluoroquinolones and with theophylline and enoxacin and to a lesser extent ciprofloxacin and pefloxacin but not other fluoroquinolones. Potential adverse effects such as cartilage damage, DNA damage, teratogenicity, and crystalluria, while of concern, have not as yet been shown to be of clinical importance. Therapy of bacterial infections in children and adolescents is relatively contraindicated, but growing clinical experience with treatment of these patients has not so far revealed serious bone or cartilage toxicity. The fluoroquinolones thus far have exhibited a favorable safety profile, but our clinical experience is still limited, and monitoring for as yet unappreciated toxicities is warranted. PMID- 1767804 TI - Current trends in bacterial respiratory pathogens. AB - The relationship of virulence and antimicrobial susceptibility with morbidity due to bacterial respiratory pathogens is complex and evolving. Ultimately, decreasing the incidence of pneumonia due to bacterial pathogens will be dependent on successful preparation and distribution of effective vaccines. Until effective vaccines are widely available, control of a majority of respiratory infections will depend on promotion of rational therapeutic strategies. Though limited to a few specific serotypes and strains, changes in virulence of bacterial respiratory pathogens have been noted. Co-infections due to multiple respiratory pathogens may increase morbidity; however, the epidemiology of co infections is not clear. Relationships between respiratory viruses and bacteria may exist that increase virulence of both agents, but information regarding these relationships awaits further investigation. Resistance of respiratory pathogens to the more commonly used antimicrobials, such as penicillin, erythromycin, chloramphenicol, and cotrimoxazole, is being documented globally with increasing frequency. The evolution of antimicrobic resistance, especially among strains of Streptococcus pneumoniae, the most common and deadly agent of lower respiratory tract infections, provides impetus to develop and promote effective pneumococcal vaccines and to search for new and effective antimicrobials. PMID- 1767805 TI - Quinolone toxicity: methods of assessment. AB - The newer quinolones, the fluoroquinolones, are represented by norfloxacin, ciprofloxacin, ofloxacin, and newer agents such as temafloxacin. These agents represent an improvement over their quinolone counterparts in many ways, including a wider spectrum of antimicrobial activity, improved pharmacokinetic properties, clinical efficacy against a wider range of diseases, and fewer and less severe adverse effects. The focus of preclinical evaluation of fluoroquinolone toxicity is guided by earlier data gathered from the quinolones on the juvenile joint, the kidney, the eye, and the central nervous system (CNS). Animal studies with the fluoroquinolones (norfloxacin, ciprofloxacin, ofloxacin, and temafloxacin) show similar arthropathic damage to the joints of young animals as did the earlier investigations with quinolones. Effects on the kidney that have been reported with quinolones and fluoroquinolones include mild interstitial nephritis, occult blood in urine, decreased renal function, increased renal weight, and crystalluria. These effects are not believed to be a direct toxic effect, but secondary to precipitation of foreign material in the kidney with a neutral or alkaline urine. Because human urine is not normally alkaline, related toxicities should theoretically not be a problem, and clinical data to date generally support this thesis. Ocular toxicity consisting of lenticular opacities in rats and dogs, electrical and histopathologic changes in cats, and electrical changes in dogs have been reported after fluoroquinolone administration; this toxicity does not appear to be a problem in human use. CNS effects have been noted in both animals and humans. Convulsions have been observed with concomitant administration of enoxacin and fenbufen. PMID- 1767806 TI - Pharmacodynamics and pharmacokinetics of antibiotics with special reference to the fluoroquinolones. AB - The pharmacodynamic and pharmacokinetic properties of antibiotics have received increased attention in recent years, leading to optimization of dosage regimens. In view of these characteristics, certain fluoroquinolones may prove advantageous compared with other antimicrobials for treatment of selected infections. Several new fluoroquinolone antimicrobial agents have potency equal to or greater than that of beta-lactam antibiotics against gram-negative aerobic bacilli, including Pseudomonas aeruginosa. In vitro bactericidal activity of these compounds is more rapid than that of the beta-lactams, often resembling that for the aminoglycosides. Like the aminoglycosides, but in contrast to the beta-lactams, fluoroquinolones exert a significant in vitro postantibiotic effect against some strains of P. aeruginosa and Enterobacteriaceae. However, unlike many beta-lactam and aminoglycoside antimicrobial agents that have similar in vitro activity, fluoroquinolones are often effective both after oral and parenteral administration. Important pharmacokinetic properties of fluoroquinolones include differences in the extent and variability in oral absorption and clearance, which determine the extent of in vivo exposure to drug. Drugs and dosage regimens that result in a high degree of exposure, particularly high peak levels of drug, may be preferable because of a greater extent of bacterial killing and less selection of drug-resistant bacteria. PMID- 1767807 TI - Drug interactions with fluoroquinolones. AB - The fluoroquinolones are a new class of antimicrobial agents that are now widely prescribed for a number of bacterial infections. Because of their complex pharmacokinetics, there is a potential for several types of drug interactions. Currently, only two drug interactions have been well studied. These involve a decrease in absorption when fluoroquinolones are given in combination with multivalent metal cations and an inhibition in the metabolism of methylxanthines by fluoroquinolones such as ciprofloxacin, enoxacin, and norfloxacin. These drug interactions can be easily avoided. Significant decreases in the absorption of fluoroquinolones by metal cations can be prevented by staggering the doses of these drugs. To avoid alterations in methylxanthine metabolism, newer fluoroquinolones, such as lomefloxacin, ofloxacin, and temafloxacin, should be utilized; alternatively, theophylline serum levels can be carefully monitored. Several other potentially serious drug interactions involving cyclosporine, warfarin, and nonsteroidal anti-inflammatory drugs have been reported, but additional investigations are required before their overall clinical significance can be fully determined. Since the use of fluoroquinolones will continue to escalate over the next decade, continued patient surveillance is necessary so that potential drug interactions can be recognized, described, and prevented. PMID- 1767808 TI - Treatment of acute exacerbations of chronic bronchitis: state of the art. AB - Effective treatment of acute bacterial exacerbations of chronic bronchitis (ABE) reduces the number of such exacerbations in such patients and may decrease or eliminate background symptoms and improve pulmonary function. The pathologic and physiologic abnormalities of the bronchial system in chronic bronchitis that predispose to bacterial infection probably include impaired mucociliary clearance, obstructed bronchioles, and bacterial infections of the bronchial epithelium. Exacerbations of bronchopulmonary symptoms are usually observed with ABE, although these symptoms are not unique to ABE. While culture and sensitivity testing is not usually required, microscopic examination of sputum is critical to determine the presence of bacterial infection. Bacteria in numbers significantly above the levels present when the patient's condition is stable and at least a doubling of the sputum neutrophil inflammatory level are essential criteria. Bacterial species observed with ABE include Haemophilus influenzae, Haemophilus parainfluenzae, Streptococcus pneumoniae, Moraxella catarrhalis, and Neisseria species, with a lesser incidence of Klebsiella and Pseudomonas species. One or more elements of background therapy for ABE should accompany antimicrobial therapy, for example, physiotherapy, bronchodilators, and so forth. Ampicillin is effective, safe, economical, and thus remains the drug of choice for ABE. Quinolones are an effective alternative when ampicillin cannot be tolerated or if organisms are resistant. Dosing is at the upper range of recommendations, and the chosen drug should be given for a 10-14-day regimen. Patients should be reevaluated if symptoms and physical findings do not return to baseline after 5-7 days. PMID- 1767809 TI - Effect of gap junction number and permeability on intercellular coupling in rat myometrium. AB - Gap junctions (GJ) increase between myometrial cells immediately before labor. To provide evidence of their role in cell-to-cell coupling, we evaluated input resistance (Ro) and intercellular spread of Lucifer yellow (LY) in intact preparations of rat longitudinal myometrium of preterm, term, and antiprogesterone-treated preterm delivering animals. LY injected into cells from either term or preterm delivering rats (many GJ) spread rapidly to neighboring cells by 60 s, but in preparations from nondelivering controls required 4-6 min to become detectable in adjacent cells. Ro of cells in preterm nondelivering preparations was 24.1 +/- 0.8 (SE) M omega, but dropped to 12.0 +/- 0.4 M omega (P less than 0.05) at delivery, similar to preterm delivering tissues at 13.8 +/- 0.6 M omega. The putative GJ uncoupling agent octanol reversibly increased Ro of term- and preterm-delivering tissues fourfold (P less than 0.01) within 60 s, and Ro of preterm-nondelivering tissue was further increased so that Ro values were similar among the three classes. These increased Ro values are interpreted as decreased coupling. Both K+ depolarization and oxytocin (10(-8) to 10(-6) M) increased Ro of delivering tissues (P less than 0.05), suggesting that high levels of contractile agonists may lead to reduced cell-to-cell coupling. Therefore, myometrial coupling can be modulated over seconds via GJ permeability as well as over hours by GJ number. PMID- 1767810 TI - Microprobe analysis of maturation-related elemental changes in rat parotid secretory granules. AB - Electron probe X-ray microanalysis was use to quantitate the elemental and mass changes that take place during the secretory granule maturation process. A single injection of isoproterenol stimulated the depletion of secretory granules from rat parotid acinar cells. Granules at different stages of maturation were analyzed as they reaccumulated within the cells over time. Dry mass measurements revealed that secretory material becomes concentrated about twofold within maturing granules. Nearly all of the increase in mass concentration could be attributed to a reduction in water space. Data are presented that indicate that Na, K, Cl, and water all efflux from secretory granules during maturation. In contrast, granule S content is positively correlated with maturation. Hence, significant changes in granule elemental and water contents occur during the maturation process. PMID- 1767811 TI - Pentose phosphate pathway in cellular trophoblasts from full-term human placentas. AB - Glucose metabolism was investigated in cellular trophoblasts isolated from full term human placentas. The specific yields of 14CO2 from D-[1-14C]glucose and D-[6 14C]glucose were used to determine glucose metabolism via the pentose cycle for cells freshly isolated or cells grown in culture for 1 and 3 days. Cells were mononucleated on day 1 but fused to form multinucleated syncytiotrophoblasts by day 3. The principal product of glucose metabolism under all conditions was lactate, accounting for approximately three-fourths of recovered 14C in products. Pentose cycle activity contributed 0.57 +/- 0.01, 0.39 +/- 0.06, and 0.21 +/- 0.05% of the glucose metabolized by cells freshly isolated, cultured for 1 day, and cultured for 3 days, respectively. In the presence of the electron acceptor methylene blue, pentose cycle activity increased to 16.5 +/- 2.1, 13.8 +/- 1.5, and 18.2 +/- 1.7% for cells freshly isolated, cultured for 1 day, and cultured for 3 days, respectively. Trace amounts of 14C were recovered in other products including amino acids and glycogen. These data suggest that pentose cycle activity in cellular trophoblasts from full-term placenta, like those in full term villous tissue, is a minor component of glucose metabolism. However, these cultured cells maintain a capacity to oxidize glucose via the pentose cycle at relatively high rates. PMID- 1767812 TI - Mitogen-induced early increase in cytosolic free Mg2+ concentration in single Swiss 3T3 fibroblasts. AB - Events related to the early mobilization of Mg2+ in mammalian cells in response to external stimuli are not well characterized. We examined changes in cytoplasmic free Mg2+ concentrations ([Mg2+]i) after mitogenic stimulation in single mouse Swiss 3T3 fibroblasts, using digital ratio imaging microscopy of the fluorescent probe mag-fura-2. Stimulation with bombesin or epidermal growth factor (EGF) in combination with insulin led to a significant increase in mean [Mg2+]i levels from basal 0.22 mM to 0.29-0.35 mM after 30-60 min. The response showed some heterogeneity among individual cells with respect to the extent of the increase; approximately 10% of the cells showed no [Mg2+]i response. Bombesin or EGF alone induced a significant increase in [Mg2+]i but was less effective than when combined with insulin. In medium without added Mg2+, the increase in [Mg2+]i was considerably decreased, either with bombesin plus insulin or EGF plus insulin. These results provide direct evidence for the mobilization of Mg2+ as an early cellular response to growth factors. PMID- 1767813 TI - Control of myosin heavy chain expression: interaction of hypothyroidism and hindlimb suspension. AB - The aim of this study was to contrast competing influences, hypothyroidism and hindlimb suspension, on myosin heavy chain (MHC) expression studied at the protein level and mRNA level. Female Sprague-Dawley rats were assigned to either normal control (NC), normal suspended (NS), or hypothyroid (thyroidectomized) control (TC) and suspended (TS) groups. NS and TS animals were suspended for 14 days following which myofibrils and total RNA were purified from the hindlimb muscles. In the soleus and vastus intermedius (VI), there was an increase in type I MHC and a decrease in type IIa MHC in both the TC and TS groups and a decrease in type I and increase in type IIa MHC in the NS group. At the mRNA level, similar shifts were observed with the exception that 1) the increased type IIa MHC seen in the soleus and VI of the NS animals was not accompanied by an increase in IIa mRNA and 2) type IIb mRNA was increased in the NS soleus without concomitant changes in IIb protein levels. These data suggest the following: 1) a hypothyroid state predominates over mechanical unweighting factors in the control of MHC distribution in slow muscles; and 2) translational or posttranslational factors may be important in the regulation of type IIa and IIb MHC expression during hindlimb suspension. PMID- 1767814 TI - Adenosine reduces the Ca2+ transients of isoproterenol-stimulated rat ventricular myocytes. AB - Adenosine in the heart attenuates the contractile and metabolic effects of beta adrenergic stimulation. The effect of adenosine on changes in intracellular Ca2+ concentration [( Ca2+]i) elicited with electrical stimulation was studied in rat ventricular myocytes in the absence and presence of isoproterenol (ISO). Fura-2 was utilized as a Ca2+ indicator. Autofluorescence was determined, and in vivo calibration was conducted, for each myocyte. Phenylisopropyladenosine (PIA; 10( 7) M; 5 min), an adenosine A1 receptor agonist, had no effect on the Ca2+ transient magnitude (TM) or the rate of Ca2+ transient decline determined at 150 nM Ca2+(i) (RD150). ISO (10(-8) M; 1 min) in the continued presence of PIA resulted in a 16% increase in the TM, but no change in the RD150. Inhibiting the PIA with 8-cyclopentyl-1,3-dipropylxanthine (DPCPX; 10(-7) M; 3 min) in the continued presence of ISO plus PIA resulted in a further 51% increase in the TM and a 57% increase in the RD150. In PIA-treated myocytes, ISO-induced spontaneous high-frequency Ca2+ transients occasionally were observed after the inhibition of PIA by DPCPX. The results of this study suggest that adenosine attenuates myocardial contractile responses to beta-adrenergic stimulation, in part, by reducing the beta-adrenergic-induced changes in the Ca2+ transients occurring in the contracting ventricular myocyte. PMID- 1767815 TI - Potassium transfer assay for cell communication: effects of phorbol esters, retinoic acid, and furosemide. AB - Using a mass culture assay for the contact-dependent transfer of potassium among cells with intrinsic differences in ability to concentrate it, we have investigated the ability of several drugs to influence this form of cell communication. We concentrated on 12-O-tetradecanoylphorbol-13-acetate (TPA), which is known to interfere with gap junction-mediated communication and ion transport in several other systems, and compared its effects with those of its inactive derivative, 4-O-methyl-TPA. We found that the communication between mouse BALB/c 3T3 cells and human diploid fibroblasts was reduced in the presence of TPA but not O-methyl-TPA and that this inhibition was not obscured by small but measurable influences of TPA on steady-state content and transport of 86Rb+. We confirmed these findings using an autoradiographic assay for transfer of uridine derivatives among cells in contact. We also showed that retinoic acid had no effect on communication in the ion transfer assay but that furosemide, an inhibitor of Na(+)-K(+)-2Cl- cotransport, stimulated ion transfer dramatically both in the presence and absence of TPA. These results indicate both the promise and the limitations of the potassium transfer assay for identifying potential modulators of gap junction-mediated cell communication. PMID- 1767816 TI - Regulation of functional muscarinic receptor expression in tracheal smooth muscle cells. AB - Recent studies have shown that cultured tracheal smooth muscle cells (TSMCs) do not respond to muscarinic agonists with a significant increase in intracellular Ca2+ concentration. This may be due to a downregulation of muscarinic receptors (mAChRs) in TSMCs. We report here that the individual component of growth factors or hormones at the concentration used is not sufficient to stimulate growth of TSMCs in the primary culture with 1% fetal bovine serum (FBS). In the presence of 1% FBS, TSMCs withdraw from the cell cycle and express high levels of cell surface mAChRs. Furthermore, insulin-like growth factor I (IGF-I) and insulin (Ins), alone or in combination, could stimulate the expression of mAChRs on the cultured TSMCs in 1% FBS without changing the affinity of receptors. Heparin could inhibit these stimulatory effects on mAChR expression. The pharmacological response of functional mAChRs, determined as accumulation of inositol phosphates induced by carbachol, is greater in the medium containing IGF-I and Ins than those cultured in 1% FBS. This action may be partially mediated through a cholera toxin-sensitive protein. The results conclude that IGF-I and Ins are necessary for TSMCs to express functional mAChRs. PMID- 1767817 TI - Acute cell volume changes in anisotonic media affect F-actin content of HL-60 cells. AB - To investigate the possible role of the cytoskeleton in volume regulatory responses of human promyelocytic leukemic (HL-60) cells, we monitored and modulated the F-actin content of these cells undergoing volume regulation in anisotonic media. Initial volume changes of HL-60 cells suspended in hypertonic media followed a Van't Hoff relationship, and intracellular F-actin content during volume regulatory responses in anisotonic media changed concomitantly as an inverse function of the volume shifts. These F-actin changes were shown to be an explicit function of cell volume and not tonicity of the medium. The data fit with the idea that changes in affinity of actin-binding proteins (ABPs) for actin and/or changes in the overall effective critical concentration of actin occur during acute cell volume changes, producing shifts in the relative amounts of G- and F-actin. Treatment of HL-60 cells with dihydrocytochalasin B (DHB), which perturbs cellular actin assembly, lowered resting levels of intracellular F-actin but did not prevent volume-associated F-actin changes in anisotonic media. Despite the lowered F-actin levels, HL-60 cells in the presence of DHB still undergo normal volume regulatory responses. Thus the absolute amount of intracellular F-actin does not appear to be critical for volume regulation in HL 60 cells. PMID- 1767818 TI - Inhibition of sucrose-isomaltase expression by EGF in the human colon adenocarcinoma cells Caco-2. AB - To investigate the role and mechanism of action of epidermal growth factor (EGF) in the intestinal epithelium, we have studied its influence on proliferation and differentiation of Caco-2 cells, a human colon adenocarcinoma cell line exhibiting several characteristics of adult small intestinal enterocytes. A clone of Caco-2 cells synthesizing minimal amounts of transforming growth factor-alpha (TGF-alpha)/epidermal growth factor (EGF)-like activity was used in these studies. Cells grown in the presence of 20-200 ng EGF/ml exhibited increased DNA synthesis and proliferation; formation of morphologically poorly differentiated multilayers was observed at 200 ng EGF/ml. At all concentrations tested EGF produced a significant and marked reduction in sucrase activity, whereas other brush-border enzymes (aminopeptidase N, alkaline phosphatase, dipeptidylpeptidase IV) were only marginally affected. EGF influenced sucrase expression at two different levels. At 20 ng/ml, it affected primarily sucrase-isomaltase processing in the endoplasmic reticulum and/or increased its degradation. At 200 ng EGF/ml, a significant and marked reduction in sucrase-isomaltase mRNA levels and biosynthesis was observed. These results demonstrated that EGF has important and selective effects on Caco-2 cell proliferation and differentiation and may affect different cellular activities depending on its concentration. PMID- 1767819 TI - Simple harmonic motion of tropomyosin: proposed mechanism for length-dependent regulation of muscle active tension. AB - A simple harmonic theory is proposed to describe the regulatory mechanism of tropomyosin in the activation of muscle contraction. The theory proposes that activation-associated displacement of tropomyosin is inherent to tropomyosin, a consequence of the molecule's large-scale vibrational motion (5-10 A root mean square displacement). In association with thin filament the vibrational motion may become less complex, approaching the ideal case of simple harmonic motion. The degree of activation increases as the amplitude of the simple harmonic motion increases, causing tropomyosin to shorten lengthwise, shiftings its position from the periphery of thin filament (OFF) to the actin groove (ON). The amplitude may be regulated in a rectilinear manner by the thick filament electrostatic force, the thin filament hydrophobic force, and the Ca(2+)-dependent force of the troponin complex. The radial and tangenital components of the resultant force may vary as the muscle is stretched, regulating maximum active tension and Ca2+ sensitivity, respectively. This may represent the molecular basis for Starling's law of the heart. The mechanism may be important for describing the regulatory mechanism of tropomyosin in smooth muscle and nonmuscle cells and may facilitate a clinically relevant understanding of the effects of pH, Mg2+ concentration, ionic strength, and ethanol on the regulation of active tension. PMID- 1767820 TI - A spectroscopic method for assessing confluence of epithelial cell cultures. AB - We describe a convenient nonelectrophysiological technique for assessing cell proliferation and subsequent tight junction formation for epithelial monolayers grown on permeable supports. The method involves the use of phenol red (PR), a standard pH indicator in most cell culture media. In addition, we report a systematic error in a commercially available system for measuring transepithelial electrical properties. Briefly, the flux of PR across the epithelium was measured from the serosal solution into the mucosal solution. The mucosal solution was first replaced with a PR-free solution and then collected at timed intervals. The PR concentration was measured using a spectrophotometer set at the isosbestic point for PR (479 nm). PR flux was then calculated and used as an index of the permeability of the epithelium to PR. This method was tested using the renal epithelial cell line A6. After cell seeding, PR flux decreased in two phases: an initial large decrease, associated with cell growth and monolayer confluence, and a second decrease associated with tight junction formation [assessed by measuring transepithelial conductance (Gt)]. In addition to monitoring tight junction formation, PR flux measurements were also used to estimate the net movement of solution by the epithelial cells between the mucosal and serosal compartments. For convenience, Gt was initially measured in culture dishes using a commercially available "chopstick" electrode system. However, the chopstick system yielded Gt values that were on average 51% lower than values for the same preparations when measured in standard Ussing-type chambers. The discrepancy was due to a nonuniform current field produced by the chopstick electrodes. PMID- 1767821 TI - Muscarinic inhibition of single KCa channels in smooth muscle cells by a pertussis-sensitive G protein. AB - Application of a muscarinic agonist to the extracellular surface of membrane patches from airway smooth muscle cells resulted in an inhibition of calcium activated potassium (KCa) channels in outside-out patches. Methacholine (50 microM) inhibited channel activity at physiological cytosolic calcium concentrations and resulted in a marked shift in channel open-time kinetics. In inside-out patches, KCa channels were inhibited upon addition of GTP (100 microM) when methacholine was present in the patch pipette. Muscarinic inhibition was blocked when guanosine 5'-O-(2-thiodiphosphate) was used to compete with endogenous GTP in outside-out or inside-out experiments. Pretreatment of dissociated cells with pertussis toxin (0.1 micrograms/ml) blocked muscarinic inhibition of the channel in a time-dependent fashion. These results demonstrate, at the single-channel level, a coupling between muscarinic receptor stimulation and inhibition of KCa in smooth muscle and demonstrate the guanine nucleotide dependence of this coupling. PMID- 1767822 TI - Firefly luciferase-luciferin-ATP mixtures respond to etheno-ATP with an increased and steady production of light: a partial explanation of the Limulus ventral photoreceptor controversy. PMID- 1767823 TI - Characteristics of homogeneously small keratinocytes from newborn rat skin: possible epidermal stem cells. AB - The aims of the present study were to characterize the phenotype, growth kinetics, and proliferative activation in culture of a population of poorly differentiated homogeneously small (HS) keratinocytes. These slow-cycling cells were separated by unit gravity sedimentation from a population of actively proliferating basal keratinocytes in newborn rat skin. This population (approximately 1% of the total basal keratinocytes) consisted of extremely small cells with little cytoplasm or RNA. Their positive KL4 staining demonstrates that they were keratinocytes. HS keratinocytes did not, however, contain epidermal calcium binding protein. Acridine orange, bivariate Hoechst, and ethidium bromide flow cytometry of in vitro bromodeoxyuridine-labeled cells as well as Ki67 staining showed that HS keratinocytes were in the G0 stage of the cell cycle and did not actively proliferate in vivo. [3H]thymidine label-retaining cells were found only in the HS cell population, showing that HS cells may originate from a central position in the epidermal proliferative unit. Growth of HS cells in vitro was characterized by a delayed but progressive increase in RNA before entry into the cell cycle. The clonogenic efficiency of HS cells in primary culture was much less than that of larger cells. Subclones of HS cell colonies exceeded primary colonies in their cloning efficiency and proliferative potential, suggesting that HS cells, although normally prevented from dividing, retain a high self-renewal capacity. They also maintain the ability to differentiate. The results are consistent with the concept that HS cell population may represent the epidermal specific progenitor cells which act as stem cells in this tissue. PMID- 1767824 TI - Permanent hexose transport upregulation in a respiration-deficient human fibroblast cell strain. AB - The regulation of hexose transport was studied in a human diploid fibroblast respiration-deficient cell strain (WG750). Transport of 2-deoxy-D-glucose (2-DG) was greater than sixfold higher compared with an in vivo age-matched normal cell strain (MCH55). In addition, 3-O-methylglucose transport and 14CO2 production were elevated in the mutant cell strain. Kinetic analysis revealed that the increased sugar transport in mutant cells was due to an average 5.7-fold increase in the 2-DG maximal transport rate, with no observed differences in the transport Michaelis constant for both normal and mutant cells. Also, the inhibitor constants for D-glucose inhibition of 2-DG transport were nearly identical for both cell types. Glucose deprivation led to a similar time-dependent increase in hexose transport in both cell strains. Serum refeeding of glucose-fed serum deprived cultures led to a progressive increase in 2-DG transport in normal cells, whereas mutant cells displayed a time-delayed increase in 2-DG transport. Exposure to 67 and 670 nM insulin stimulated 2-DG transport on average 1.99 +/- 0.25- and 2.33 +/- 0.26-fold, respectively, over basal transport in the normal cells, whereas the mutant cells were significantly less sensitive to the stimulatory effects of the hormone. Insulin binding and amino acid transport (i.e., alpha-aminoisobutyric acid uptake) in the normal and mutant cells were not different. Data obtained using Western blot analysis showed that WG750 (mutant) cells expressed an increase (approximately 4-fold) in total cellular HepG2 (erythroid-brain) transporter protein compared with normal cells, thus reflecting the changes seen in hexose transport.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767825 TI - High-affinity binding of PDGF-AA and PDGF-BB to normal human osteoblastic cells and modulation by interleukin-1. AB - Bone has the capacity for repair and regeneration. The repair process is thought to be locally regulated by growth factors. One of the growth factors that potentially plays a significant role in these processes is platelet-derived growth factor (PDGF). Two different PDGF genes have been identified, PDGF-A and PDGF-B, whose gene products give rise to biologically active dimers. We now report that PDGF-AA and PDGF-BB exhibit saturable binding to normal human osteoblastic cells. By Scatchard analysis we estimate that there are approximately 43,000 PDGF-AA binding sites per cell, with a dissociation constant (Kd) of 2.2 x 10(-10)M, and 55,000 high-affinity PDGF-BB binding sites per cell, with a Kd of 1.2 x 10(-10)M. The functional consequence of PDGF binding was also assessed. PDGF-AA and PDGF-BB both stimulated migration of normal human osteoblastic cells and stimulated thymidine incorporation. To gain insight into potential transmodulation of the PDGF response, we investigated the capacity of interleukin-1 beta (IL-1 beta), a cytokine that induces bone resorption, to modulate PDGF binding and PDGF-induced biological activity. IL-1 beta significantly reduced PDGF-AA binding and significantly decreased both PDGF-AA mediated cell migration and thymidine incorporation. In contrast, IL-1 beta had only a small effect of PDGF-BB binding and PDGF-BB-induced biological activity in normal human osteoblastic cells. PMID- 1767826 TI - Production of transforming growth factor-alpha by normal rat small intestine. AB - Transforming growth factor-alpha (TGF-alpha) and epidermal growth factor (EGF) are similar in structure and biological activity. In the present study, the distributions of TGF-alpha mRNA, TGF-alpha immunoreactivity, and TGF-alpha-EGF receptor mRNA were examined in epithelial and nonepithelial compartments of the jejunum, and the effect of TGF-alpha on growth of a jejunal crypt cell line (IEC 6) was determined. Epithelial cells eluted from the rat jejunal cryptvillus axis expressed TGF-alpha mRNA at twofold higher levels in the villus tip than in the crypt and EGF receptor mRNA at sevenfold higher levels in the villus tip. Expression of these two mRNA transcripts in the subepithelium was low. Immunohistochemical staining showed TGF-alpha immunoreactivity predominantly in the epithelium and muscularis. Immunostaining of villus cells was uniform, whereas crypt cells did not stain. IEC-6 cells bound 125I-EGF to a single class of high-affinity (dissociation constant = 833 pM) receptors. EGF and TGF-alpha (10 ng/ml) only modestly stimulated IEC-6 cell growth in the presence of 5% serum but increased expression of the protooncogenes c-jun and c-myc threefold over control cells. These findings suggest that, among the potential physiological roles for TGF-alpha produced by the jejunal epithelium, promotion of cell migration and modulation of fluid and electrolyte transport may be as relatively important as stimulation of cell proliferation. PMID- 1767827 TI - Determination of skeletal muscle calpain and calpastatin activities during maturation. AB - Our objectives were to characterize events underlying changes in skeletal muscle calpain and calpastatin activities, using maturation as a model. Muscle samples were taken from rabbits of four ages (newborn and 1, 2, and 5 mo old). Concentrations of RNA and protein and activities of calpains I and II and calpastatin were determined. Steady-state concentrations of mRNAs encoding calpain I, calpain II, calpastatin, alpha- and beta-tubulin, and beta-actin were determined using Northern blot analysis. Calpain and calpastatin activities declined markedly between birth and 1 mo of age and remained unchanged thereafter. Several factors accounted for the neonatal losses of calpains and calpastatin. First, muscle protein concentration increased between birth and 1 mo of age and diluted calpain and calpastatin specific activities. Second, there was a marked reduction of muscle RNA concentration between birth and 1 mo of age, which indicates that protein synthetic capacity declined with age. Finally, calpastatin mRNA concentration declined between birth and 1 mo of age and further contributed to developmental losses of calpastatin activity. Calpain I mRNA concentration was unaffected by age, and although calpain II mRNA concentration declined with age, losses were not detected between birth and 1 mo; hence age related changes in calpain I and II activities are not mediated at the mRNA level. The age-related reductions in calpain II and calpastatin mRNA concentrations resembled age-related changes in alpha- and beta-tubulin and beta actin mRNA concentration.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767828 TI - Insulin resistance is associated with high sodium-lithium countertransport in essential hypertension. AB - The nature of the association between essential hypertension and insulin resistance remains unknown. We measured plasma glucose and insulin levels after an oral glucose tolerance test (OGTT), as well as insulin sensitivity (using a euglycemic hyperinsulinemic clamp), glucose turnover (Rd; using [6,6-2H2]- and [3 3H]glucose isotopic dilution), and forearm net balance of glucose (using arterial venous difference) in 22 hypertensive patients with high (H2) red blood cell (RBC) sodium-lithium countertransport (Na(+)-Li+ CT; greater than 0.41 mmol.l RBC 1.h-1), 21 hypertensive patients with normal (H1) Na(+)-Li+ CT, and 22 normotensive controls (C). After OGTT, H2 patients had higher plasma glucose and insulin levels than H1 and C. During euglycemic hyperinsulinemia (approximately 100 microU/ml) Rd was lower in H2 [21.7 +/- 1.4 (SE) mumol.kg-1.min-1] than in H1 (44.3 +/- 2.9; P less than 0.01) and C (48.1 +/- 3.0; P less than 0.01), and an inverse correlation was found between rates of Na(+)-Li+ CT and Rd in H1 and H2 (rs = -0.76; P less than 0.01). Forearm glucose uptake was 40-50% lower in H2 compared with H1 and C (P less than 0.01). Lactate concentration increased more in C (from 511 +/- 24 to 1,207 +/- 69 microM) and in H1 (from 564 +/- 40 to 1,122 +/- 99) than in H2 (from 581 +/- 42 to 950 +/- 102, P less than 0.05 vs. both). Forearm blood flow increased more in C (31%, P less than 0.05) and H1 (22%, P less than 0.05) than in H2 (12%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767829 TI - Insulin resistance and blood pressure in Dahl rats and in one-kidney, one-clip hypertensive rats. AB - In normal rats, sucrose feeding results in insulin resistance and an elevation of arterial pressure. The purpose of this study was twofold: 1) to evaluate the effect of sucrose feeding on blood pressure in a genetic model and in an acquired model of hypertension and 2) to determine whether these models of hypertension are associated with insulin resistance. In Dahl salt-resistant (Dahl-R) rats on both a 0.45 and a 3% NaCl intake, systolic blood pressures were higher (P less than 0.01) in sucrose-drinking than in water-drinking animals. In contrast, blood pressure was not affected by dietary sucrose in Dahl salt-sensitive (Dahl-S) rats. Blood pressure was also not affected by sucrose in the one-kidney, one-clip (1K,1C) hypertensive rat. In response to an oral glucose load, serum glucose was similar in Dahl-R and Dahl-S rats, although serum insulin was higher (P less than 0.05) in Dahl-S rats, suggesting that Dahl-S rats are insulin resistant. In contrast, glucose and insulin responses were similar in hypertensive 1K,1C animals and normotensive controls. In conclusion, sucrose feeding increased blood pressure in Dahl-R but not in Dahl-S or 1K,1C hypertensive rats. Additionally, Dahl-S rats, but not hypertensive 1K,1C rats, are insulin resistant. PMID- 1767830 TI - 31P-NMR study of different hypothyroid states in rat leg muscle. AB - Using phosphorus nuclear magnetic resonance spectroscopy, this study was undertaken to determine the effects of experimental hypothyroidism on muscle bioenergetics. The peaks of phosphocreatine (PCr), Pi, phosphodiesters (PDE), sugar phosphomonoesters, and ATP were obtained at rest, during a 2-Hz hindleg muscle stimulation, and during a subsequent recovery period from four groups of anesthetized rats as follows: one control and three hypothyroid (HT) groups treated by propylthyouracil during 2, 4, and 6 wk, respectively. Resting spectra showed a significant rise in Pi by 30% and decreased intracellular pH and PCr/Pi in all three HT groups. PDE progressively increased to 200% of its initial value with hypothyroidism duration. Muscle stimulation did not lead to significant differences in PCr depletion. The percentage of PCr recovery is less in HT muscle than in control muscle. An abnormal H+ metabolism is obvious in all three HT groups. These results indicate abnormal bioenergetics in HT muscle and suggest an impairment of mitochondrial metabolism and of the H+ efflux. They also evoke a high sensitivity of cellular energetics to thyroid deficiency. PMID- 1767831 TI - Glutamine nitrogen kinetics in insulin-dependent diabetic humans. AB - To assess the effect of insulin deficiency on whole body glutamine kinetics, five young adults with type I (insulin-dependent) diabetes received 4-h primed continuous infusions of L-[1-13C]leucine and L-[2-15N]glutamine in the postabsorptive state after blood glucose had been clamped overnight at either a normoglycemic level (approximately 85 mg/dl) or a moderate hyperglycemic level (approximately 260 mg/dl) by means of an automated glucose control insulin infusion system. The hyperglycemic state was associated with a significant rise in leucine level [from 165 +/- 23 to 242 +/- 62 (SD) microM], appearance rate (from 125 +/- 11 to 142 +/- 17 mumol.kg-1.h-1), and oxidation (from 27 +/- 10 to 31 +/- 10 mumol.kg-1.h-1). In contrast, neither the plasma level nor the appearance rate of glutamine (333 +/- 51 vs. 318 +/- 58 mumol.kg-1.h-1) was affected. We conclude that insulin deficiency resulting in moderate hyperglycemia induces a 13% rise in whole body proteolysis and yet does not stimulate glutamine de novo synthesis, despite increased precursor availability. PMID- 1767832 TI - Biogenesis of dicarboxylic acids in rat liver homogenate studied by 13C labeling. AB - The aim of this investigation is to assess whether long-chain fatty acids can be a substrate for omega-oxidation and the subsequent beta-oxidation to produce medium-chain dicarboxylic acids normally found in urine. Isolated rat liver 10,000 g supernatant and pellet fractions were used as the source of enzymes. The metabolism of palmitate was studied using [1,2,3,4-13C4]hexadecanoic acid as tracer. Selected ion monitoring mass spectrometry was utilized for the determination of isotope enrichments in precursor and products. Palmitate was found to be a good substrate for omega-oxidation; the rate was only slightly slower than decanoate. The beta-oxidation of [1,2,3,4-13C4]hexadecanedioic acid yielded labeled adipic, suberic, and sebacic acids. Isotope distribution in these dicarboxylic acids consisted mostly of unlabeled molecules (M + 0) and molecules labeled with four 13C (M + 4), in agreement with a beta-oxidation initiated equally from both carboxyl ends of the precursor. Significant enrichments (1-8%) with only two 13C labels (M + 2) indicate a partial bidirectional beta-oxidation. The direct metabolic conversion of hexadecanedioate to succinate was documented by the significant enrichment (1.40-1.90%) in M + 4 of succinate. These data indicate that long-chain fatty acids can be a substrate for the production of medium-chain dicarboxylates and the eventual direct conversion to succinate. PMID- 1767833 TI - Contribution of adrenergic mechanisms to glucose counterregulation in humans. AB - To assess the role of adrenergic mechanisms during prolonged hypoglycemia, eight normal subjects were studied on six occasions. In study 1, insulin was infused subcutaneously (15 mU.m-2.min-1 for 12 h), and plasma glucose concentration (PG) decreased from 89 +/- 2 to 50 +/- 1 mg/dl. In study 2 (insulin as in study 1 + propranolol and phentolamine + variable glucose to maintain PG as in study 1), the rate of hepatic glucose production (HGO, [3-3H]glucose) was approximately 30% lower after 1.5 h, and the rate of peripheral glucose utilization (GU) was approximately 15% greater after 5 h. To quantitate the effects of adrenergic mechanisms on glucose counterregulation, in a control study (study 3), glucoregulatory hormone secretion was blocked, and the hormones were reinfused to reproduce study 1. When alpha- and beta-blockade plus variable glucose were superimposed to study 3 (study 4), HGO was approximately 25% lower (after 2 h), and GU was approximately 10% greater (after 6 h) vs. study 3. When glucose was not infused to match PG of study 3 (study 5), severe hypoglycemia developed (PG at 7 h 36 +/- 2 vs. 62 +/- 3 mg/dl). Finally, when glucose was not infused during alpha- and beta-blockade of study 2 (study 6), PG was 49 +/- 3 mg/dl at 7 h vs. 65 +/- 3 mg/dl of the control study (study 1), despite greater secretion of glucagon, growth hormone, and cortisol. It is concluded that adrenergic mechanisms play a key counterregulatory role, even in the presence of appropriate responses of glucagon and that greater increases in glucagon (and other counterregulatory hormones) cannot compensate fully for absent contribution of adrenergic mechanisms to counterregulation. PMID- 1767834 TI - ATP and phosphocreatine changes in single human muscle fibers after intense electrical stimulation. AB - The recovery pattern of adenine nucleotides and glucolytic intermediates after short-lasting anaerobic exercise was studied. Biopsies were obtained from the vastus lateralis muscle at rest, immediately after intermittent electrical stimulation with occluded circulation (total time 166 s), and after 20 s, 60 s, 5 min, and 15 min of recovery. ATP in single fibers decreased from 23.9 +/- 1.41 to 14.2 +/- 3.20 in type I fibers and from 25.01 +/- 1.20 to 13.1 +/- 2.65 mmol/kg dry muscle in type II fibers postexercise. After 15 min of recovery, ATP was resynthesized to 95 and 76% in type I and type II fibers, respectively. The phosphocreatine (PCr) content in type I fibers at rest was 72.3 +/- 4.50 and 83.3 +/- 9.76 mmol/kg dry muscle in type II fibers. After exercise, PCr was depleted in both fiber types. After the 60 s of recovery the PCr content in type I fibers was significantly higher (P less than 0.05) compared with type II fibers, but, after 5 min of oxidative recovery, the PCr levels were equal in the two fiber types. Fifteen minutes postexercise, type II fibers demonstrated a significantly higher content (97.8 mmol/kg dry muscle) compared with its resting value (P less than 0.05). PMID- 1767835 TI - Reduced phospholipid contents of brain synaptosomes in phosphate depletion. AB - The effects of 6 wk phosphate depletion (PD) and pair-weight feeding (PW) without and with treatment with verapamil (PD-V and PW-V, respectively) on phospholipid (PL) and cholesterol content and on resting levels of cytosolic calcium concentration ([Ca2+]i) of brain synaptosomes of rats were examined. PD was associated with significantly (P less than 0.01) lower synaptosomal content of total PL, phosphatidylinositol (PI), phosphatidylserine (PS), and phosphatidylethanolamine (PE) and with significant (P less than 0.01) elevation in [Ca2+]i. Verapamil treatment of PD rats prevented the rise in [Ca2+]i of brain synaptosomes and the fall in PI and caused significant (P less than 0.01) improvement in the synaptosomal content of PS and PE; values of PS and PE in PD-V rats, however, were still significantly (P less than 0.01) lower than those of PD rats. Verapamil treatment of PW rats did not affect synaptosomal content of the various PL or resting levels of [Ca2+]i. Cholesterol content of brain synaptosomes of the various groups was not significantly different, but cholesterol-to-total PL ratios were significantly (P less than 0.01) higher in PD and PD-V rats than in PW or PW-V animals. Results indicate that PD affects metabolism of total phospholipids, PI, PS, and PE of brain synaptosomes, and these derangements are due to reduced availability of phosphorus and to the rise in [Ca2+]i. The data are consistent with the proposition that PD-induced changes in PL render the synaptosomal membrane more permeable to calcium, an event that may lead to a rise in [Ca2+]i. PMID- 1767836 TI - Altered partition of threonine metabolism in pigs by protein-free feeding or starvation. AB - Kinetic aspects of threonine (Thr) metabolism were examined in growing pigs fed a well-balanced diet (C), an isocaloric protein-free diet (PF), or starved (S) for 48 h. With the use of continuous simultaneous infusion of L-[1-13C]Thr, [1 14C]sarcosine, and 2-[1-14C]ketobutyrate (KB) for 10 h, estimates were made of rates of Thr incorporated into protein (S), released from body proteins (B), and oxidized through the catabolic pathways of L-Thr 3-dehydrogenase (TDG) and threonine dehydratase (TDH). In the C group S was 185, B was 138, Thr disposal to glycine (DRThr-Gly) was 47, and Thr disposal to KB (DRThr-KB) was 7 mumol.h-1.kg 1. Consequently, Thr balance was +48 mumol.h-1.kg-1. In the PF-fed pigs, S, B, DRThr-Gly, and DRThr-KB were significantly reduced by 38, 15, 74, and 75%, respectively. In the S group, S, B, and DRThr-Gly were significantly reduced by 47, 17, and 55%, respectively, but DRThr-KB was similar to the C group. DRThr-Gly in all groups was highly correlated with TDG enzyme activity measured in liver homogenates. By contrast with in vivo results, TDH enzyme activity was increased by 88% (P less than 0.05) in the S group and decreased by 27% (not significant) in the PF group compared with the C group. The TDH pathway accounted for 13, 12, and 27% of total Thr oxidation in the C, PF, and S groups, respectively. These results suggest that Thr conservation in protein-depleted states (PF and S groups) occurred mainly by a decrease of Thr oxidation and that the partition through these pathways was only altered when energy was completely withdrawn. PMID- 1767837 TI - Regulation of glucose metabolism by norepinephrine in conscious dogs. AB - The effects of norepinephrine (NE) at levels present in the circulation and synaptic cleft during stress on glucose metabolism were examined in overnight fasted conscious dogs with fixed basal levels of insulin and glucagon. Plasma NE rose from 132 +/- 14 to 442 +/- 85 pg/ml and 100 +/- 20 to 3,244 +/- 807 pg/ml during 3 h of low (n = 6) and high (n = 5) NE infusion, respectively. Plasma glucose and glucose production rose only with high NE infusion (from 108 +/- 4 to 159 +/- 15 mg/dl and 2.78 +/- 0.24 to 3.41 +/- 0.38 mg.kg-1.min-1, respectively). NE infusion caused dose-dependent net hepatic lactate consumption, but net hepatic alanine uptake fell only with high NE infusion (31%). Alanine conversion to glucose rose by 67 +/- 13, 136 +/- 20, and 412 +/- 104%, and intrahepatic gluconeogenic efficiency rose by 42 +/- 27, 299 +/- 144, and 212 +/- 21% with saline and with low and high NE infusion, respectively. In conclusion, NE enhances gluconeogenesis by stimulating peripheral precursor release, by increasing substrate movement into the hepatocyte, and by increasing intrahepatic gluconeogenic efficiency. However, only the higher NE levels affected glucose metabolism profoundly enough to stimulate glucose production and to elevate the glucose level. PMID- 1767838 TI - Role of glucagon in countering hypoglycemia induced by insulin infusion in dogs. AB - The aim of the present study was to characterize the role of glucagon in countering the prolonged hypoglycemia resulting from insulin infusion and to determine whether its effect is manifest through glycogenolysis and/or gluconeogenesis. Two groups of 18-h fasted somatostatin-treated dogs were given intraportal insulin at 5 mU.kg-1.min-1. In one group (SimGGN; n = 6), glucagon was infused intraportally so as to mimic the normal response to hypoglycemia. In a second group (BasGGN; n = 6), glucagon was infused at a basal rate. Glucose turnover and gluconeogenesis were assessed by combining tracer and hepatic balance techniques. Exogenous glucose was infused as needed to maintain equivalent hypoglycemia at approximately 45 mg/dl in the two groups. Although glucagon concentrations were significantly different, the levels of other counterregulatory hormones were equivalent in both experimental protocols. Endogenous glucose production (EGP) in SimGGN doubled from 2.4 +/- 0.2 to 5.4 +/- 0.8 mg.kg-1.min-1 by 1 h before dropping to 4.5 +/- 0.2 mg.kg-1.min-1 in the 3rd h of insulin infusion. EGP in BasGGN was initially 2.5 +/- 0.1 mg.kg-1.min-1, unchanged by 1 h, and increased to 3.9 +/- 0.2 mg.kg-1.min-1 by the 3rd h of insulin infusion. In the 1st h of insulin infusion, the rise in gluconeogenesis in both groups was equal and represented only a small part of total EGP. By the 3rd h, gluconeogenesis was the major contributor to total EGP, and gluconeogenic efficiency increased significantly more in SimGGN than BasGGN (261 vs. 140%, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767839 TI - Altered expression of muscle glucose transporter GLUT-4 in diabetic fatty Zucker rats (ZDF/Drt-fa). AB - We examined GLUT-4 glucose transporter protein and mRNA in muscle tissue from a new rodent model of non-insulin-dependent diabetes mellitus (NIDDM), the male obese Zucker diabetic fatty (ZDF) rat [ZDF/Drt-fa(F10)]. We also determined whether prevention of hyperglycemia might affect GLUT-4 expression by feeding the intestinal alpha-glucosidase inhibitor acarbose (40 mg/100 g diet) in the diet of male ZDF rats for 19 wk, starting at least 1 wk before the onset of diabetes. Fasting glucose was four- to sixfold greater in diabetic ZDF rats (24.1 +/- 6.7 mM) compared with lean or obese nondiabetic rats. Fasting insulin in diabetic ZDF rats (0.5 +/- 0.1 ng/ml) was similar to lean rats (0.4 +/- 0.1) but greatly reduced compared with obese nondiabetic rats (18.7 +/- 4.0 ng/ml). Acarbose treatment significantly reduced fasting glucose levels to 13.4 +/- 1.4 mM, while insulin levels increased to 1.6 +/- 0.3 ng/ml. GLUT-4 protein levels in diabetic ZDF rats were reduced approximately 40% in red quadriceps and mixed gastrocnemius muscles but were unchanged in white quadriceps muscle. Acarbose treatment was associated with a twofold increase in GLUT-4 protein and mRNA in mixed gastrocnemius muscle. These data indicate that, in this obese model of NIDDM without hyperinsulinemia, there is reduced muscle GLUT-4 protein in red but not white muscle fiber types. The decrease in muscle GLUT-4 expression in this model of NIDDM can be prevented by acarbose treatment, which reduces hyperglycemia and increases beta-cell responsiveness. PMID- 1767840 TI - Islet cell responses to glucose in human transplanted pancreas. AB - Postsurgery, pancreas transplantation results in alterations of carbohydrate metabolism. Additionally, immunosuppressive therapy impacts on glucose regulation. We evaluated the hormonal and metabolic responses of pancreas allografts, utilizing the hyperglycemic clamp technique coupled with the tritiated glucose methodology, in 11 volunteers who had received simultaneous pancreas-kidney transplantation (P-K) with systemic drainage. Their responses were compared with seven volunteers who had received only a kidney (K) graft and with seven normal control (C) volunteers. Although basal glucose and hepatic glucose output were similar in all three groups, basal insulin, C-peptide, glucagon, and pancreatic polypeptide were highest in the P-K group and lowest in normal subjects. During hyperglycemia, all groups showed a similar characteristic, initial complete suppression of hepatic glucose production, with recovery followed by a later suppression. Peripheral glucose uptake was similar in P-K and C subjects but decreased in K patients. Systemic insulin levels were fourfold higher in the pancreas transplant patients than in healthy subjects. Thus, under basal and hyperglycemic stimulation, 1) hepatic glucose homeostasis is regulated normally, even with pancreatic drainage into the systemic circulation; 2) overall glucose disposal is normal in P-K patients because of marked hyperinsulinemia; and 3) there is loss of tonic inhibition of endocrine pancreatic function secondary to pancreatic denervation. PMID- 1767841 TI - Proteolysis in skeletal muscle and whole body in response to euglycemic hyperinsulinemia in normal adults. AB - To simultaneously assess the relative antiproteolytic effect of insulin on both skeletal muscle and in the whole body, phenylalanine rates of appearance (Ra; reflecting proteolysis) were measured across the leg (reflecting skeletal muscle) and in the whole body, utilizing a constant tracer infusion of [2H5]phenylalanine in the basal state and during euglycemic hyperinsulinemia (2,600 microU/ml) in seven normal adults. Phenylalanine Ra in the leg was significantly decreased during hyperinsulinemia (6.11 +/- 0.83 vs 3.59 +/- 0.70 mumol/min, P less than 0.001). In contrast, leg phenylalanine rate of utilization (Rd) was not significantly changed (4.88 +/- 0.77 vs. 3.86 +/- 0.92 mumol/min). Phenylalanine Ra in the whole body was significantly decreased during hyperinsulinemia (49.4 +/ 2.2 vs. 41.9 +/- 2.3 mumol/min, P less than 0.001). However, phenylalanine release was suppressed to a significantly greater degree in release was suppressed to a significantly greater degree in the leg than in the whole body during hyperinsulinemia (43 +/- 7 vs. 15 +/- 2%, P less than 0.01). These results suggest that insulin suppresses proteolysis in the whole body and in skeletal muscle, even in the face of hypoaminoacidemia. In addition, the substantially greater degree of suppression of proteolysis by insulin in skeletal muscle compared with the whole body suggests that, at least under these conditions, insulin may have a greater antiproteolytic effect on skeletal muscle compared with other tissues. PMID- 1767842 TI - Glucose regulation of lipid metabolism in humans. AB - The role of plasma glucose in the regulation of lipid metabolism in humans, independent of associated changes in hormone concentrations, is controversial. Therefore we examined the role of glucose in the regulation of lipolysis and free fatty acid (FFA) reesterification in six healthy lean male volunteers. Blood glucose concentration was clamped at either 5 or 10 mM during 2-h pancreatic pituitary clamps. Glycerol and palmitate turnover were measured by isotope dilution ([1-14C]palmitate and [2H5]-glycerol). All hormone concentrations were the same during the euglycemic and hyperglycemic studies. FFA turnover, which represents the difference between lipolysis and FFA reesterification, was reduced 30% by hyperglycemia (29 +/- 2 vs. 20 +/- 3 mumol.kg fat mass-1.min-1, P less than 0.05). Glycerol turnover, which represents lipolysis only, was reduced to a similar extent (9.4 +/- 0.9 vs. 6.2 +/- 0.7 mumol.kg fat mass-1.min-1, P less than 0.05). We conclude that glucose regulates lipid metabolism, independently of changes in hormone concentrations. The equivalent suppression of glycerol and FFA turnover indicates that the effect is mediated by suppression of lipolysis and not by stimulation of FFA reesterification. PMID- 1767843 TI - Serotonin receptors on submucous neurons in guinea pig colon. AB - Intracellular microelectrodes were used to investigate the neuropharmacology of 5 hydroxytryptamine (5-HT) in the submucous plexus of the distal colon of the guinea pig. Three effects resulted from application of 5-HT to submucous neurons. Two of the effects were components of a biphasic depolarization mediated by receptors on the neuronal cell body. The third was suppression of acetylcholine release at nicotinic synapses on the cell bodies and was mediated by presynaptic 5-HT receptors. The initial component of the biphasic depolarization was a rapidly activating response characterized by increased ionic conductance and a tendency for rapid desensitization. Pharmacological analysis with selective agonists and antagonists suggested mediation of this response by the 5-HT3 receptor subtype. The second component of the depolarizing response was a slowly activating and long-lasting depolarization associated with decreased ionic conductance. Analysis of this response suggested it was mediated by the 5-HT1P receptor subtype. Identification of the presynaptic receptors for 5-HT was equivocal. These receptors did not behave like 5-HT3 or 5-HT1P receptor subtypes. The putative 5-HT4 agonist 5-methoxytryptamine was equipotent with 5-HT in producing presynaptic inhibition at the fast nicotinic synapses. PMID- 1767844 TI - Neutral amino acid transport by isolated small intestinal cells from guinea pigs. AB - Neutral amino acid transport was examined by using isolated enterocytes. Cells transport L-alanine by at least three different mechanisms: two Na(+)-dependent systems (A and ASC) and one Na(+)-independent mechanism (system L), in addition to passive entry. System A was characterized acterized by measuring the Na(+) dependent alpha-(methylamino)isobutyric acid (MeAIB) uptake. Na(+)-dependent MeAIB uptake was concentrative and saturable. Vmax was obtained at 80mM Na+ in the incubation medium and Kt app for Na+ was 21.5 mM. Kt app for MeAIB was 6.75 +/- 0.37 mM and the Vmax was 14.2 +/- 0.3 nmol.mg-1.min-1. System ASC was studied by evaluating the Na(+)-dependent L-alanine uptake, insensitive to MeAIB and inhibitable by L-serine and L-cysteine. Uptake by this mechanism was also concentrative and saturable. Maximal uptake was obtained with 80 mM Na+ in the incubation medium and Kt app for Na+ was 29.7 mM. Kt app for L-alanine was 7.02 +/- 0.61 mM and Vmax was 5.44 +/- 0.19 nmol.mg-1.min-1. The Na(+)-independent system L was studied by measuring cycloleucine uptake in Na(+)-free medium. It had a saturable and a nonsaturable component. Only the saturable component was concentrative; it was inhibited by 2-amino-2-norbornanecarboxylic acid and was capable of mediating exchange diffusion. Kt app for cycloleucine was 4.05 +/- 0.72 mM and the Vmax was 31.9 +/- 1.3 nmol.mg-1.min-1. These results confirm the existence of Na(+)-dependent systems A and ASC and Na(+)-independent system L in isolated enterocytes. PMID- 1767845 TI - Mechanism of aggravation of mucosal injury by intravenous nicotine in rat stomach. AB - Endogenous prostaglandins and injury-induced hyperemia are important defense mechanisms in the gastric mucosa. In the rat stomach, we tested the hypotheses that an ulcer-promoting dose of intravenous nicotine 1) reduces ex vivo prostaglandin generation and 2) aggravates mucosal lesions by impairing injury induced hyperemia. Anesthetized rats were given intravenous control or 4 or 40 micrograms.kg-1.min-1 nicotine infusion. In study 1, ex vivo generation of prostaglandin E2 and 6-ketoprostaglandin F1 alpha (stable metabolite of prostacyclin) was determined by vortexing the mucosal tissue, followed by radioimmunoassay. No significant difference in prostaglandin generation was found between the control and experimental groups. In study 2, intravenous nicotine (40 micrograms.kg-1.min-1) produced a significant rise (19 +/- 3%) in mean blood pressure and completely abolished the gastric hyperemia produced by intragastric saline (2 M). The extent of the associated gastric mucosal injury was significantly increased (from 5.3 +/- 0.8 to 17.4 +/- 5.2% of the corpus mucosa), while the maximum depth of the largest lesions was not affected by intravenous nicotine. The data confirm that the gastric hyperemia associated with gastric mucosal exposure to hypertonic saline plays an important role in limiting the extent of gastric mucosal damage. We conclude that in the rat stomach 1) an ulcer promoting dose of intravenous nicotine does not significantly inhibit cyclooxygenase activity, and 2) the same does of intravenous nicotine exacerbates hypertonic saline-induced gastric mucosal injury by a mechanism that involves inhibition of injury-induced hyperemia. PMID- 1767846 TI - Neutrophil-induced liver cell injury in endotoxin shock is a CD11b/CD18-dependent mechanism. AB - To investigate the role of neutrophils (PMNs) and PMN-dependent adhesion molecules in the pathogenesis of liver injury in a model of endotoxin shock, male ICR mice received a dose of 700 mg/kg galactosamine and 100 micrograms/kg Salmonella abortus equi endotoxin. PMNs accumulated continuously in the liver, reaching values of 446 +/- 71 PMNs/50 high-power fields at 9 h (basal value 18 +/ 7). Plasma alanine aminotransferase activities as index of parenchymal cell injury did not change up to 5 h posttreatment (basal value 35 +/- 5 U/l) but increased to 1,950 +/- 460 U/l at 9 h. The formation of glutathione disulfide (GSSG) in plasma as an index of an extracellular oxidant stress also increased only at 9 h. Pretreatment of animals with monoclonal antibodies against the CD11b and CD18 subunits of the CD11/CD18 integrin family on the surface of the PMN reduced the number of PMNs in the liver by 50% and significantly attenuated liver injury and GSSG formation. An anti-CD11a and a nonbinding control antibody were ineffective. It is concluded that PMNs are actively involved in the pathogenesis of galactosamine and endotoxin shock and that at least in part the accumulation of PMNs, the subsequent oxidant stress, and the tissue injury in this model of experimental hepatitis are CD11b/CD18 (Mac-1) dependent. PMID- 1767847 TI - Hepatic and ileal transport and effect on biliary secretion of norursocholic acid and its conjugates in rats. AB - The enterohepatic circulation of norursocholic acid (nUC) and its glycine (nUCG) and taurine (nUCT) conjugates was investigated in the rat; cholic acid (C) was studied as control. The biliary recovery of intravenously infused 14C-labeled bile acids was high: nUC, 88%; nUCG, 80%; nUCT, 99%, and C, 90%. Biliary recovery after the same bile acids were infused intraduodenally was similar: nUC, 90%; nUCG, 66%; nUCT, 97%; and C, 99%. The two conjugated bile acids, nUCG and nUCT, were not biotransformed during intestinal or hepatic transport; nUC was also secreted largely unchanged, but approximately 10% was secreted as an unknown conjugate or sulfate; C was completely conjugated with taurine or glycine. To compare the rates of active ileal transport, biliary recovery was measured after an in situ ileal perfusion technique. The rate of absorption of nUC, nUCG, and nUCT was one-fourth to one-half that of cholyltaurine, which served as control. Competition experiments indicated that the same transport system was involved. When infused intravenously, nUC, nUCG, and nUCT induced far less biliary lipid secretion than an identical dose of C; the secretion of both phospholipid and cholesterol was decreased, cholesterol to a greater extent than phospholipid. It is concluded that nUC and its conjugates are well transported by the ileum, are efficiently secreted into bile without undergoing appreciable hepatic biotransformation, and induce bile flow as other hydrophilic bile acids, but in contrast to C induce little phospholipid and cholesterol secretion into bile. PMID- 1767848 TI - Bacterial deconjugation and enterohepatic circulation of norursocholic acid conjugates in rats. AB - Experiments were performed to define the metabolism of norusocholic acid (nUC) conjugates and to quantify to what extent the bile acid pool can be enriched in these bile acids. In vitro incubations of norusocholylglycine (nUCG) and -taurine (nUCT) with small intestinal or cecal content showed deconjugation with only cecal content. Cholylglycine (CG) was deconjugated by small intestinal and cecal content. Infusion of nUCG and CG showed that only a small proportion of nUCG was deconjugated after 24 h of enterohepatic circulation, whereas all CG was deconjugated. When nUCT was administered orally, deconjugation was shown to take place mainly in the cecum. Chronic feeding of nUCT enriched the bile acid pool with only 20% nUCT. We conclude that nUC conjugates are deconjugated primarily by bacteria in the cecum and colon, in contrast to CG, which, in addition to cecum and colon, is deconjugated in the distal small intestine. nUCT and its metabolites do not enrich in the circulating bile acid pool mainly for the following reasons: 1) nUC conjugates have a low affinity for the ileal transport system; 2) nUC, even if formed by deconjugation, is not passively absorbed at a sufficient rate; 3) the small amount of norursodeoxycholic acid formed from nUC is glucuronidated in the liver and glucuronide conjugates do not undergo enterohepatic circulation; and 4) nUC conjugates do not suppress bile acid biosynthesis. PMID- 1767849 TI - Postoperative course after portacaval anastomosis in rats is determined by the portacaval pressure gradient. AB - Variability in experimental results have led to criticism regarding the validity of the rat after portacaval anastomosis (PCA) as a model of changes induced by portal-systemic shunting (PSS). A nonsuture technique using cyanoacrylate glue has been reported to yield a better experimental preparation. To investigate if variations in splanchnic hemodynamics could explain different outcomes after the procedure, male rats received either an end-to-side PCA or sham operations (16 rats each). The PCA was constructed using the "suture" or "glue" technique (8 rats each). Beginning on postoperative day 24 under methoxyflurane and ketamine anesthesia, pressures were recorded from the portal vein, inferior vena cava, and femoral artery. Blood flow to the splanchnic organs and the percent PSS were assessed using the microsphere technique. The rate of delivery of NH3 from the portal vein to the systemic circulation and the concentration of glutamine in the cerebrospinal fluid were determined. In PCA rats, weight gain was significantly impaired, and all animals had evidence of liver atrophy (in both suture and glue groups) when compared with sham animals; a trend toward greater weight gain was seen in glue rats. Portal vein inflow, PSS, NH3 delivery, and CSF glutamine were significantly increased in both PCA-suture and PCA-glue animals compared with sham rats, although no significant differences were seen between the two PCA techniques. When PCA rats from either technique were grouped according to the pressure gradient between portal vein and inferior vena cava, striking differences between animals were now evident.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767850 TI - Free fatty acid uptake by polyethylene: what can one learn from this? AB - Previous experiments have shown that fatty-acid uptake by isolated hepatocytes is inhibited by albumin, but this inhibition was less than expected from the decrease in the equilibrium concentration of fatty acid. The possible explanation of this observation by the effects of codiffusion of protein-bound and unbound fatty acid across the unstirred layer surrounding these isolated cells has recently been challenged on the basis of experiments in which uptake by monolayers of hepatocytes was compared with that by a polyethylene sheet [F.J. Burczynski et al., Am. J. Physiol. 257 (Gastrointest. Liver Physiol. 20): G584 G593, 1989]. In the present report, we reevaluate the theoretical basis for interpretation of these experiments by solving the differential equations describing diffusion into a sheet behind a linear barrier. The diffusion coefficient for palmitate in polyethylene is estimated to be approximately 10(-9) cm2/s. We conclude that when proteins are absent from the aqueous phase, diffusion across the unstirred layer is rate limiting for removal of fatty acids by cellular monolayers, and also rate limiting for net flux across the water polyethylene interface. In contrast, if the aqueous phase contains either 5 microM albumin or 125 microM beta-lactoglobulin, diffusion within the polyethylene sheet will become rate limiting. The net flux of fatty acids into a polyethylene sheet becomes insensitive to an increase in protein concentration if the latter rises above a certain threshold. The polyethylene data provide no additional insight into the manner in which hepatocytes take up free fatty acids. PMID- 1767851 TI - Dietary calcium phosphate inhibits cytotoxicity of fecal water. AB - The effects of dietary steroid and CaHPO4 supplementation on the solubility of bile acids and cytotoxicity of fecal water were studied in rats. Dietary steroid supplementation increased the bile acid concentration of both feces and fecal water. CaHPO4 supplementation produced a slight increase in total fecal bile acid concentration but resulted in a drastic decrease in soluble bile acid concentration. Cytotoxicity of fecal water on control and steroid-supplemented diets decreased with CaHPO4 supplementation analogous to the decrease in soluble bile acid concentration. The concentrations of precipitated Ca and Pi were highly correlated (r greater than 0.90) with the concentration of precipitated bile acids and with inhibition of cytotoxicity. However, there was no significant correlation between the logarithms of soluble calcium and soluble bile acids, indicating that solubility of bile acids is not determined by soluble calcium. Concentrations of calcium and phosphate in fecal water indicated the formation of insoluble calcium phosphate in the intestine. Thus dietary CaHPO4 causes a decrease in soluble bile acid concentration, which is probably due to the formation of an insoluble bile acid calcium phosphate complex. Consequently, cytotoxicity of fecal water is inhibited, which might have implications for the protective effect of dietary calcium with regard to colonic cancer in humans. PMID- 1767852 TI - Impaired alanine uptake by basolateral liver plasma membrane vesicles from rats consuming ethanol. AB - Chronic ethanol consumption reduces alanine transport by rat basolateral liver plasma membrane (blLPM) vesicles; however, the mechanism for this effect remains uncertain. It may be related to the ethanol-induced changes in blLPM fluidity and lipid composition; alternatively ethanol might reduce the number of transporters in the blLPM. To investigate the effect of blLPM fluidity and lipid composition on Na(+)-dependent alanine uptake these parameters were altered in vitro. Increasing the blLPM fluidity had no effect on Na(+)-dependent alanine uptake by blLPM vesicles or the activity of amino acid transport systems, A and ASC. Because ethanol is known to reduce the blLPM cholesterol content, the influence of altering blLPM cholesterol on alanine transport by these membranes was investigated next. Neither an increase nor a decrease of the cholesterol content of the blLPM altered Na(+)-dependent alanine uptake or the activity of system A or ASC. Finally, the influence of chronic ethanol consumption on the specific binding of [3H]alanine to blLPM was studied. The dissociation constant for alanine binding to blLPM from ethanol-fed rats and their pair-fed controls was similar (1.9 +/- 0.2 vs. 2.0 +/- 0.3 mM); however, the maximal binding capacity for alanine was significantly (P less than 0.05) lower in the blLPM from ethanol fed rats (316 +/- 53 pmol/mg protein) compared with their pair-fed controls (527 +/- 79 pmol/mg protein). These studies do not support the hypothesis that ethanol induced changes in blLPM fluidity are responsible for the impaired alanine transport; they do suggest that ethanol may reduce the PMID- 1767853 TI - Antioxidant defenses of cultured gastric cells against oxygen metabolites: role of GSH redox cycle and endogenous catalase. AB - Gastric mucous epithelial cells may represent a first line of defense against reactive oxygen species that are generated within the gastric lumen. However, little is known about their defenses against oxidant species. This study examined the importance of the glutathione (GSH) redox cycle and of endogenous catalase as antioxidant defenses in cultured gastric mucous cells. Cultured rat gastric mucous cells were exposed to H2O2 generated by glucose oxidase acting on glucose or to nascent H2O2 for 5 h. Cytotoxicity was quantified by measuring 51Cr release from prelabeled cells. The effects of inhibition of the GSH redox cycle and of endogenous catalase were examined. Glucose oxidase caused a dose-dependent increase of 51Cr release. Similarly, nascent H2O2 damaged the cells dose dependently. Pretreatment with 1,3-bis(chloroethyl)-1-nitrourea (inhibitor of GSH reductase) dose dependently increased glucose oxidase-induced 51Cr release. Preincubation with buthionine sulfoximine (inhibitor of gamma-glutamyl-cysteine synthetase), which lowered intracellular GSH content, enhanced glucose oxidase induced damage in a dose-dependent manner. Pretreatment with diethyl maleate, which covalently binds GSH as catalyzed by GSH transferase, also enhanced the sensitivity to lysis by glucose oxidase. However, inhibition of endogenous catalase activity by 3-amino-1,2,4-triazole did not significantly alter glucose oxidase- or nascent H2O2-induced 51Cr release. These results suggest that the GSH redox cycle rather than endogenous catalase plays a critical role in intracellular antioxidant defense in cultured gastric mucous cells. PMID- 1767854 TI - Myosin light chain phosphorylation and contraction of guinea pig gallbladder smooth muscle. AB - These experiments were designed to determine 1) whether acetylcholine (ACh) stimulation is accompanied by changes in myosin light chain phosphorylation in gallbladder smooth muscle and 2) whether dephosphorylated noncycling cross bridges (latch bridges) exist in gallbladder smooth muscle. Isometric stress, isotonic shortening velocity, and myosin light chain phosphorylation were determined under conditions of contraction and relaxation in ACh-stimulated guinea pig gallbladder smooth muscle. Unstimulated muscle contained 6.8 +/- 2.0% phosphorylated myosin light chain. ACh stimulation (5 x 10(-5) or 10(-4) M) was associated with a rapid increase in myosin light chain phosphorylation to a value that was maintained throughout the tonic contraction. In contrast, isotonic shortening velocity was maximal at 30 s of stimulation and then declined over time to a steady-state level that was 25-30% of the peak velocity. Upon agonist washout (relaxation), dephosphorylation of the myosin light chain occurred at about the same rate as the decline in shortening velocity and preceded the decline in isometric stress. These data suggest that ACh stimulation is accompanied by changes in myosin light chain phosphorylation but that dephosphorylation of cross bridges is not necessary for the slowing of cross bridge cycling rates in gallbladder smooth muscle. PMID- 1767855 TI - Protection against ethanol injury in the canine stomach: role of mucosal glutathione. AB - The present study determined the role that mucosal glutathione (GSH) levels play in mediating the protective effects of a prostaglandin and a mild irritant against alcohol-induced gastric injury. An in vivo canine chambered stomach preparation was used in which the exteriorized mucosa was partitioned into two equal halves, one serving as control. Animals (5-8/group) received a subcutaneous injection of either normal saline (NS) or the GSH depletor N-ethylmaleimide (NEM; 50 mg/kg) and then were assigned to one of a variety of groups based on the perfusate used to bathe the experimental side of the chamber; NS bathed the control mucosa. At completion of the studies, mucosa from each side of the chamber was assayed for total GSH (mumol/g wet wt) and evaluated for microscopic damage. Both 16,16-dimethyl prostaglandin E2 (PGE2) (1 microgram/ml) and the mild irritant 8% ethanol, when topically applied to the gastric epithelium, increased mucosal GSH levels by approximately 20% compared with control values, and elicited no deleterious effects to the mucosa. Treatment of animals with NEM prevented these GSH effects by PGE2 and 8% ethanol without damaging the mucosa. Application of 40% ethanol to the mucosa markedly reduced levels of GSH and caused significant injury to the mucosal surface, much of it extending to the level of the gastric glands. When mucosa was pretreated with PGE2 or 8% ethanol before 40% ethanol exposure, deep gastric gland injury was virtually abolished. In animals receiving NEM, the protective effects of these agents against injury by 40% ethanol were prevented. Perturbations in tissue levels of GSH under these various experimental conditions failed to correlate histologically with the status of gastric mucosal integrity. PMID- 1767856 TI - Fractal geometry: a design principle for living organisms. AB - Fractal geometry allows structures to be quantitatively characterized in geometric terms even if their form is not even or regular, because fractal geometry deals with the geometry of hierarchies and random processes. The hypothesis is explored that fractal geometry serves as a design principle in biological organisms. The internal membrane surface of cells, or the inner lung surface, are difficult to describe in terms of classical geometry, but they are found to show properties describable by fractal geometry, at least sectionwise and within certain bounds set by deterministic design properties. Concepts of fractal geometry are most useful in characterizing the structure of branching trees, such as those found in pulmonary airways and in blood vessels. This explains how the large internal gas exchange surface of the lung can be homogeneously and efficiently ventilated and perfused at low energetic cost. It is concluded that to consider fractal geometry as a biological design principle is heuristically most productive and provides insights into possibilities of efficient genetic programming of biological form. PMID- 1767857 TI - Alveolar size, number, and surface area: developmentally dependent response to 13% O2. AB - Nonpregnant female rats were kept in 13% O2 for greater than 3 wk before being bred, throughout pregnancy, and, with their pups, after birth; control rats were only in air. The average volume (v), number (N) and surface area (Sa) of gas exchange structures (saccules or alveoli) were estimated by stereological means. Saccule conversion to alveoli by septation between age 2 and 14 days was impaired in 13% O2 rats; there was less decrease in v (signifying less septation) and less increase in N (indicating the formation of fewer alveoli) in 13% O2 pups than in air pups. Between age 14 and 40 days, v rose 2-fold in air pups and 1.3-fold in 13% O2 pups; N increased 1.7-fold in air rats and 2.8-fold in 13% O2 rats. In other experiments, 23-day-old rats, previously only in air, were continued in air or were placed in 13% O2 until 44-days-old. At age 44 days, Sa was 25% and v 27% greater in 13% O2 rats than in air rats, but N was the same in both groups. We conclude there are multiple mechanisms for forming alveoli and increasing Sa and these mechanisms exhibit a developmentally dependent response to 13% O2. PMID- 1767859 TI - Alterations in surfactant protein gene expression associated with premature birth and exposure to hyperoxia. AB - Steady-state levels of mRNAs for the three surfactant-associated proteins, SP-A, SP-B, and SP-C, were measured in a primate model of premature birth and survival. These values were determined by Northern and quantitative slot blot analyses of total lung RNA during both in utero and extrauterine development of the fetus as well as in response to hyperoxic exposure. The composition and surface properties of surfactant were also analyzed to determine the effect of differential expression of the surfactant proteins on the overall composition and function of surfactant. The data clearly demonstrate that the regulation of surfactant mRNA levels in the premature fetus is under complex physiological control. Interruption of in utero development by premature birth results in increased levels of all three surfactant mRNAs, presumably in response to precocious initiation of air breathing. Within the first 24 h after parturition both SP-B and SP-C mRNA levels are increased beyond the levels found in the full-term fetal controls. Expression of mRNA for these genes peaks on day 2 and thereafter drops to levels below that found on day 1. However, response of the SP-A gene to premature birth is slow and transcripts from this gene lag considerably behind values found in the full-term fetus. Furthermore, exposure of the premature fetus to hyperoxia results in an increase in the steady-state levels of SP-B and SP-C mRNA without significant changes in SP-A. Defects in the ability of the SP-A gene to respond to extrauterine exposure and hyperoxia may be contributing to development of bronchopulmonary dysplasia, a common clinical complication of premature birth in humans. PMID- 1767858 TI - Modulation of bFGF in lung fibroblasts by TGF-beta and PDGF. AB - Growth factors produced by alveolar macrophages are thought to promote the fibroblast proliferation within interstitial spaces of fibrotic lungs. This study investigated the possibility that the macrophage-produced growth factors might modulate the expression of basic fibroblast growth factor (bFGF) by lung fibroblasts. To evaluate this question, bFGF gene expression and protein production were evaluated in normal adult human lung fibroblast cell lines. Under normal culture conditions, the fibroblasts expressed the bFGF gene as two major transcripts (7.1, 3.7 kb). The addition of fetal calf serum (FCS) to serum starved fibroblasts caused a 5- to 10-fold increase in bFGF expression. Steady state bFGF expression was increased 108% by platelet-derived growth factor (PDGF) and 602% by transforming growth factor-beta (TGF-beta). Insulin-like growth factor-1 had no significant effect on bFGF expression. Nuclear runoff studies demonstrated that both PDGF and TGF-beta increased the relative rates of bFGF transcription in the fibroblasts. Western blot analysis of lysates from fibroblasts treated with either PDGF or TGF-beta had no detectable increase in bFGF protein above unstimulated controls. However, the simultaneous addition of PDGF and TGF-beta, or FCS, produced a marked increase in bFGF. These experiments show that two growth factors present in the alveolar airspace compartment of fibrotic lungs can promote the expression of bFGF within lung fibroblasts. PMID- 1767860 TI - Related expression of arachidonate 12- and 15-lipoxygenases in animal and human lung tissue. AB - We examined the immunohistochemical distribution of the arachidonate 12- and 15 lipoxygenases in animal and human lung tissue using a polyclonal anti-12/15 lipoxygenase antibody. Immunoblotting of whole cell extracts from bovine and human tracheal epithelial cells or from bovine leukocytes with the antibody (raised originally against purified porcine leukocyte 12-lipoxygenase) showed immunoperoxidase staining of a single protein band (Mr = 72,000), which comigrated with purified bovine 12-lipoxygenase. The antibody also immunoprecipitated both 12- and 15-lipoxygenase activities from cytosolic fractions of bovine and human tracheal epithelial cells. Immunohistochemistry of formaldehyde-fixed and paraffin-embedded bovine (and ovine and canine) trachea using the same polyclonal antibody and an indirect biotin-avidin-peroxidase detection system demonstrated specific staining of tracheal epithelium, polymorphonuclear and mononuclear leukocytes, and perineural cells. Less intense staining of submucosal glands and blood vessels was also observed. Lung sections demonstrated that the level of lipoxygenase antigen decreased markedly by the level of the bronchi and was absent in more distal airways. A similar pattern of immunostaining was found in human lung, except that airway smooth muscle was also weakly reactive, and polymorphonuclear (neutrophilic) leukocytes were unstained (in accordance with the low 12/15-lipoxygenase activity in this cell type). We conclude that animal and human epithelial 12/15-lipoxygenases share enzymatic, antigenic, and regional distribution characteristics and may therefore possess a common function in the pulmonary airway. PMID- 1767861 TI - Comparison of response of bovine and porcine pulmonary arterial endothelial cells to monocrotaline pyrrole. AB - Monocrotaline (MCT)-induced vascular injury in liver and lung may be caused by interaction of MCT metabolites such as monocrotaline pyrrole (MCTP) with vascular cells. Responses of bovine and porcine pulmonary artery endothelial cells (BECs and PECs, respectively) to a single administration of MCTP were compared. MCTP caused a delayed and progressive release of lactate dehydrogenase (LDH) activity from BECs and a gradual decrease in monolayer cellularity. Surviving cells became markedly hypertrophic. PECs were less sensitive to the cytolytic effects of MCTP, showing minimal cell detachment and little release of LDH activity. However, monolayer cellularity, as assessed by PEC enumeration, decreased in a dose dependent manner. Hypertrophy of surviving PECs was less pronounced than in BECs. MCTP caused enhanced release of prostacyclin from monolayers of BECs and PECs exposed to 10 micrograms MCTP/ml, and concentrations of 0.5 microgram/ml or greater caused equivalent reduction in colony-forming efficiency in both cell types. In summary, whereas BECs were more susceptible to the cytolytic and hypertrophic effects of MCTP, BECs and PECs responded similarly with regard to prostacyclin release and were equally sensitive to the cytostatic effects of this compound. PMID- 1767862 TI - Effect of protein kinase C activating agents on respiratory glycoconjugate release from feline airways. AB - Abnormal regulation of airway glycoprotein secretion may underlie many respiratory diseases. Experimental activation of the protein kinase C (PKC) family of cytosolic enzymes has been shown to induce a secretory response in many tissues. To estimate the effect of PKC activation on airway secretion, alteration in the amount of radiolabeled respiratory glycoconjugate (RGC) released into culture media was determined following feline airway explant exposure to PKC activating agents. Exposure to two known activators of PKC, phorbol 12-myristate 13-acetate (PMA) and mezerein (MEZ), resulted in profound increases in respiratory glycoconjugate release over a seven day experimental period. The response evolved over several hours and was dose dependent. Maximal RGC release, 90% above control, occurred 2 days after exposure to either PMA or MEZ. Pharmacological inhibition of the PKC effect using two PKC inhibitors, 1-(5 isoquinolinylsulfonyl)-2-methylpiperazine and sphingosine, resulted in dose dependent antagonism of the maximal PMA (10(-7) M)-stimulated RGC release, suggesting altered PKC activity was responsible for augmenting RGC release. Since altered arachidonic acid metabolism has been implicated in mediating some PKC effects, eicosanoids were assayed in airway explant supernatants following PMA exposure. Enhanced release of both cyclooxygenase and lipoxygenase pathway products was detected by radioimmunoassay. Cotreatment of explants with PMA and an inhibitor of oxidative arachidonic acid metabolism, nordihydroguaiaretic acid, blocked RGC release. These data demonstrate prolonged augmentation of respiratory glycoconjugate release from airway explants following exposure to PKC-activating agents. PMID- 1767863 TI - Spatial and temporal differences in fibroblast behavior in fetal rat lung. AB - Fibroblast-epithelial interactions were investigated in cells from late-gestation fetal rat lung. Fibroblasts from the pseudoglandular stage of lung development stimulated epithelial cell proliferation, whereas fibroblasts from the saccular stage promoted epithelial cell differentiation. The developmental switch from proliferation to differentiation seemed to be controlled by both cell types. Fibroblast-derived epithelial cell growth-promoting activity, evident in cells from the pseudoglandular period, decreased during development and almost disappeared in cells from the saccular stage. Interestingly, the response of epithelial cells to this growth-promoting activity declined with advancing gestational age as epithelial cells became more responsive to fibroblast-derived differentiation factor(s). Production of differentiation factor(s) by fibroblasts increased during the canalicular stage of lung development. Platelet-derived growth factor (PDGF) and low concentrations of transforming growth factor-beta (TGF-beta) stimulated epithelial cell proliferation. PDGF did not affect differentiation, whereas TGF-beta was inhibitory. Dependent on their proximity to the epithelium, two subpopulations of fibroblasts that differed in their ability to promote epithelial cell proliferation or differentiation were isolated. Fibroblasts in close proximity to the epithelium mainly produced differentiation factors, whereas more distant fibroblasts primarily stimulated proliferation. PMID- 1767864 TI - Surfactant lipid uptake and secretion in type II cells in response to lectins and secretagogues. AB - Secretion of surfactant phospholipids can be inhibited by the surfactant associated protein SP-A. SP-A was reported to stimulate lipid uptake by type II cells, whereas surfactant secretagogues were reported to have the same effect in isolated perfused lungs. We examined the effect of such secretagogues on uptake of liposomes containing L-alpha-[2-palmitoyl-9,103H(N)]-dipalmitoyl phosphatidylcholine in primary cultures of type II cells. As SP-A contains a lectinlike domain and other lectins were reported to inhibit surfactant secretion, we also examined the effect of such lectins on lipid uptake. At concentrations at which they maximally stimulate phosphatidylcholine secretion in type II cells, several secretagogues had no effect on liposome uptake. Maclura pomifera agglutinin (MPA) stimulated uptake approximately 10-fold with a concentration eliciting 50% maximum stimulation (EC50) of 17 micrograms/ml. The effect of MPA on uptake was considerably greater than that of SP-A. However, although the stimulatory effect of ATP on phosphatidylcholine secretion was almost completely antagonized by SP-A, it was maximally inhibited only 75% by MPA. The concentration eliciting 50% maximum inhibition (IC50) for MPA inhibition of secretion was 0.5 micrograms/ml. Concanavalin A, another lectin, had no effect on lipid uptake but completely inhibited secretion. These data show that a lectin other than SP-A can stimulate phospholipid uptake by type II cells cultured on plastic and suggest that surfactant secretion and reuptake are independently regulated processes. PMID- 1767865 TI - Mucosal histamine inhibits Na absorption and stimulates Cl secretion across equine tracheal epithelium. AB - When the equine tracheal epithelium is mounted in Ussing chambers and bathed in plasma-like Ringer solution, the tissue generates a lumen-negative transepithelial potential (PD) of 22 mV and a short-circuit current (Isc) of 70 200 microA/cm2. Mucosal addition of 10 microM histamine produces a transient increase in the Isc followed by a return to baseline or below. Mucosal addition of 2 microM diphenhydramine inhibits the Isc response to mucosal histamine, whereas 100 microM mucosal cimetidine produces no effect. The average initial increases in Isc over time for mucosal vs. serosal histamine addition are significantly different (17.32 +/- 2.8 and 3.76 +/- 0.69 microA/min, respectively). Pretreatment with mucosal amiloride significantly prolongs the effect of mucosal histamine on Isc over a 20-min period from 4.73 +/- 0.33 to 15.48 +/- 3.16 microA. When Cl is replaced by gluconate, mucosal histamine addition results in a gradual decrease in Isc and significantly reduces the effect of mucosal amiloride on Isc from 80.8% to 54.9%. Mucosal histamine inhibits the net transepithelial Na flux by 42% and stimulates the secretion of Cl by 106%. Subsequent addition of serosal bumetanide decreases net Cl secretion by 70% These results suggest that histamine stimulates bumetanide-sensitive Cl secretion and inhibits amiloride-sensitive Na absorption; these effects are mediated by H1 receptors at the apical membrane surface. PMID- 1767866 TI - Phagocytosis of surfactant by alveolar macrophages in vitro. AB - Because of their localization and function as phagocytes, alveolar macrophages could take part in the catabolism of surfactant, including surfactants used for treatment. Conditions of the ingestion of the surfactant preparation AWD 56-02 by alveolar macrophages in vitro are described in this paper. The surfactant was labeled with rhodaminyl phosphatidylethanolamine and incubated with alveolar macrophages lavaged from rat lungs. Membrane binding and phagocytosis were evaluated by fluorescence microscopy and quantified fluorimetrically after extraction of the dye. The surfactant was phagocytosed only in the presence of rat serum. The opsonins in the serum are related to complement and Fc receptors as demonstrated by the heat lability of the factor and the inhibition by aggregated gamma-globulins. Furthermore, the phagocytosis depends on calcium and on a factor in the surfactant preparation. Experiments with inhibitors and competition with unlabeled surfactant show that the phagocytosis is a specific and energy-dependent process. Catabolism by alveolar macrophages might be an important step in the metabolism of surfactant, especially when administered in pathological conditions characterized by the presence of serum in the airspaces. PMID- 1767867 TI - Ion transport by cultures of human tracheobronchial submucosal glands. AB - Acini of human tracheobronchial submucosal glands were isolated by enzymatic disaggregation, and, when plated on flasks coated with human placental collagen (HPC) in media containing Ultroser G serum substitute (USG) and a variety of growth factors (GF), they became confluent after 14-20 days. The cells were then isolated by trypsinization and replated in media containing USG and GF at 10(6) cells/cm2 on porous-bottomed inserts coated with HPC. Confluent monolayers formed on day 1 after replating and were studied on day 10. Transepithelial resistance and short-circuit current (Isc) were 578 +/- 89 omega.cm2 and 12.9 +/- 1.9 microA/cm2 (means +/- SE, n = 23 cell sheets). The potency sequence for stimulation of Isc by mediators was methacholine greater than bradykinin greater than isoproterenol approximately or equal to phenylephrine. Amiloride decreased baseline Isc by 42 +/- 9% (n = 6 cell sheets) but had little effect on the Isc response to mediators. Diphenylamine-2-carboxylic acid, however, had no effect on baseline Isc but markedly inhibited the Isc response to all mediators. These results show that submucosal gland cells from human trachea can be grown in culture to produce epithelial sheets of high resistance, which secrete Cl in response to bradykinin and alpha- and beta-adrenergic and cholinergic agents. PMID- 1767868 TI - Altered ion transport by tracheal glands in cystic fibrosis. AB - Acini of tracheal glands from 12 humans without cystic fibrosis (CF) and from two CF patients were isolated by enzymatic digestion. They were plated on flasks coated with human placental collagen (HPC) in media containing Ultroser G serum substitute and a variety of growth factors. Confluent cell sheets formed after 20 days. Cells were then isolated by trypsinization and replated at 10(6) cells/cm2 onto porous-bottomed inserts coated with HPC. Confluent sheets formed on day 1 after replating and were studied on day 10 in Ussing chambers. Transepithelial resistance (Rte) and baseline short-circuit current (Isc) of CF cultures (171 +/- 67 omega.cm2, 3.8 +/- 0.8 microA/cm2; n = 5) were significantly less than non-CF (541 +/- 116 omega.cm2, 9.9 +/- 2.3 microA/cm2; n = 14). Responses in Isc to mediators were also significantly reduced in CF: isoproterenol (10(-5)M) = 0.04 +/- 0.04 vs. 1.9 +/- 0.6; methacholine (10(-5)M) = 0.2 +/- 0.1 vs. 7.1 +/- 1.7; bradykinin (10(-6)M) = 0.4 +/- 0.1 vs. 5.0 +/- 1.0 microA/cm2; n = 5 for CF, n = 14 for non-CF. When CF and non-CF cells were matched for baseline Isc and Rte, the responses of CF cells to mediators still remained statistically lower than normal. The reduced responses of CF cells to bradykinin and methacholine, in addition to isoproterenol, suggest that both Ca-dependent and adenosine 3',5' cyclic monophosphate-dependent regulation of Cl secretion are defective in CF tracheobronchial glands. The resulting reduction in fluid secretion by glands may contribute to the accumulation of airway mucus in CF. PMID- 1767869 TI - Vestibulo-ocular reflex in eccentric rotation in squirrel monkeys. AB - In addition to angular acceleration, eccentric rotation (ECR) imparts linear acceleration to the head positioned eccentric to the axis of rotation. Using ECR in squirrel monkeys, the effects of otolith organ stimulation by linear acceleration on vestibulo-ocular reflex (VOR) gain were investigated. With the animal's head facing away from the rotation axis, ECR significantly enhanced VOR gain over that seen in centric rotation (CR) at 1.0 Hz, but not at 0.5 Hz. However, no enhancement of VOR gain at 1.0 Hz was observed in eccentriclateral rotation when the animal faced tangentially. After bilateral ablation of the otolith organs (sacculectomy and utricular neurectomy), the ECR did not increase VOR gain, even at 1.0 Hz. In animals in which the lateral and posterior semicircular canals were plugged bilaterally, horizontal sinusoidal eye movements were induced by ECR at 1.0 Hz; no clear compensatory eye movement occurred during CR at 1.0 Hz. These findings demonstrate that during ECR, tangential acceleration along the interaural axis stimulates the utricular maculae, inducing horizontal eye movements in addition to those induced by the semicircular canal, thus resulting in an enhancement of VOR gain. Our results also suggest synergistic interactions of the otolith organs and semicircular canals. We conclude that ECR is a useful clinical test of the function of the otolith organs. PMID- 1767870 TI - Effects of carbonic anhydrase inhibitor on the otolithic organs of developing chick embryos. AB - Carbonic anhydrase appears to be involved in the process of otoconial formation. The purpose of this investigation was to observe the morphologic change in the surface structure of the otolithic organ in developing chick embryos after injection of the carbonic anhydrase inhibitor, acetazolamide. Acetazolamide (1.5, 3, or 6 mg/0.06 mL/egg) was injected into the yolk sac of the embryo of the fifth day of incubation. Embryo specimens were collected on the 11th, 13th, and 18th days of incubation. The chicks were killed on the third day posthatching, and the surfaces of the otolithic organs were observed under a scanning electron microscope. A marked disturbance in otoconial formation was noted in both utricle and saccule, marked by a decrease or absence of otoconia. A widely exposed meshwork structure of otolithic membrane was observed, with sensory cilia penetrating the meshwork small holes in many instances. There were also several otoconial abnormalities, such as the appearance of only a single giant otoconium, or from several to dozens of giant otoconia, and rough, spongy-surfaced global substances entirely covering the maculae. Clearly, carbonic anhydrase inhibitor (acetazolamide) injected into the yolk sac of developing chick embryos alters and inhibits normal otoconial morphogenesis. PMID- 1767871 TI - Stabilometry in balance assessment of dizzy and normal subjects. AB - Normal adults and patients referred to the Dizzy Clinic at the Medical College of Ohio had their standing balance assessed during combinations of normal and altered visual and somatosensory orientation conditions using a fixed-force platform to measure center-of-pressure translations. Significant differences were identified between normal subjects and dizzy patients, depending on the particular diagnostic category, the sensory condition tested, and the particular sway component being measured. Patients with central and peripheral vestibular dysfunctions had significantly greater sway than all other categories in most test conditions, especially with eyes closed and with a visual conflict dome while standing on a foam surface. The central vestibular dysfunction and peripheral vestibular dysfunction groups could be differentiated statistically under eyes-closed and visual conflict-foam conditions. The normal and psychogenic groups could not be differentiated statistically for any test conditions except one: there was significantly greater mean anterior/posterior sway displacement in the psychogenic group compared with all other diagnostic categories for the eyes open foam test condition. Our results indicate that static stabilometry recordings of postural sway can be used to evaluate and quantify a dizzy patient's ability to receive and process vestibular, visual, and somatosensory proprioceptive cues for postural stability. It can also be used to monitor patients with vestibular disorders and to document their responses to rehabilitation programs. PMID- 1767872 TI - Distribution and incidence of North American pollen aeroallergens. AB - Using standardized aerosampling procedures, ambient pollen samples were collected at 15 locations in six regions of North America. The results provide baselines for examining human exposure to inhalant pollen allergens throughout the year on a broad geographic scale. In eastern temperate areas, pollen shed was closely linked to plant flowering seasons, with trees releasing pollen in the spring, grasses in the early summer, and weeds in the later summer and fall. Variations to this fundamental pattern were observed to the south and west; understanding these differences is essential if atopic persons suffering from allergic symptoms are to be assisted. For example, highly diverse tree pollen was found in North Carolina and Georgia for prolonged periods at high levels. These data suggest that a more sensitized population in the southeastern United States manifests allergic symptoms longer. Further south and southwest, pollen was captured throughout the year and sometimes at unexpected times. For instance, bimodal releases of grass pollen in both the spring and fall allow dual exposures of atopic persons, extending possible hypersensitivity to multiple seasons. Enhancing pollen exposure further, our data show limited overall variation in morning and afternoon levels, implying a continuous absorption of all major pollen types during daylight hours. PMID- 1767873 TI - Radiation recall supraglottitis in a child. PMID- 1767874 TI - The current status of corrective surgery for laryngomalacia. AB - When the airway obstruction related to laryngomalacia becomes significant, surgical correction of the underlying laryngeal deformity is indicated. The three elements of the supraglottic soft tissue that prolapses, namely, the corniculate mounds on the arytenoid cartilages, the shortened ary-epiglottic folds, and the omega shaped epiglottis, can all be appropriately "trimmed" using either conventional instruments or the surgical laser. Relief of symptoms is dramatic and, provided surgery is performed precisely and not during episodes of infection, complications should not occur. The aid of specialized, skillful anesthesia is required for this type of surgery. We present a series of 40 children with significant obstruction: 30% had neuromuscular disorders, 68% had an infantile epiglottis, seven required airway support prior to surgery, all had laser "supraglottic trimming," and 13 required airway support after surgery. Relief of stridor and airway obstruction was generally rapid. There was only one complication: croup developing 4 days after surgery. PMID- 1767875 TI - Clinical radiology quiz. PMID- 1767876 TI - Temporal bone histopathology: residents' quiz. Intracanalicular acoustic neuroma. PMID- 1767877 TI - [The ethics of the hunger strike]. PMID- 1767878 TI - [Leukotrienes: role in allergy and inflammation]. PMID- 1767879 TI - [Human myiasis: a problem of today]. PMID- 1767880 TI - [The early diagnosis and treatment of ovarian cancer. A paper awarded the Prize of the Academia. The year 1990]. PMID- 1767881 TI - [The etiological treatment of vertical dysmorphism]. PMID- 1767882 TI - [The introduction of the Historia de la Composicion del Cuerpo Humano of Juan Valverde]. PMID- 1767883 TI - [The epidemiology of human and animal listeriosis]. PMID- 1767884 TI - [In memoriam D. Ciriaco Laguna Serrano]. PMID- 1767885 TI - [Innervation of the elbow joint]. PMID- 1767886 TI - [The operating procedure in the surgery of stomach cancer]. PMID- 1767887 TI - [Current view of the endothelial cell]. PMID- 1767888 TI - [Evolution of ideas in the surgery of mitral stenosis]. PMID- 1767889 TI - [Homage to Prof. Julio Palacios Martinez in the centenary of his birthday]. PMID- 1767890 TI - [Remembrance and praise of the great work carried out for health]. PMID- 1767891 TI - [Palpebral demodicidosis: epidemiologic study]. PMID- 1767892 TI - [Uncertain future for the planet Earth?]. PMID- 1767893 TI - [Estrogen therapy in postmenopause and cancer of the endometrium]. PMID- 1767894 TI - [The 1877 Rubio Prize and homeopathy. A polemic in the Academy]. PMID- 1767895 TI - [Axonal regeneration, formation and persistence of synaptic connections in the retinocollicular system of adult mammals]. PMID- 1767896 TI - Trendelenburg's Cone and Cannula. PMID- 1767897 TI - The lumbosacral epidural block: a modified Taylor approach for abdominal urologic surgery in children. AB - We describe the lumbosacral epidural approach in 97 children undergoing abdominal urologic surgical procedures. Due to the rudimentary spinous process of the first sacral vertebra and the less prominent sacral angle, an appropriate upward inclination of the Tuohy needle in the midline is always possible in infants and small children. A catheter was easily inserted in every case and the technique was shown to be useful and safe for providing adequate intraoperative and postoperative pain control. PMID- 1767898 TI - Postoperative analgesia for oesophageal surgery: a comparison of three analgesic regimens. AB - Sixty-four patients undergoing oesophageal surgery were randomly allocated to receive either a continuous lumbar epidural infusion of morphine or fentanyl, or, intramuscular morphine for postoperative analgesia. There was no statistical difference in analgesic requirements between the patients who underwent a thoracotomy for their procedure (n = 50) and those who did not (n = 14), as assessed by the total dose of opioid administered, visual analogue scale (VAS) and pain score (PS) comparison. However, by these criteria, epidural morphine infusion provided the most satisfactory analgesia (P less than 0.05). Despite the variable quality of analgesia achieved with the three regimens, the postoperative lung function tests were similar for all groups, and we conclude that routine lung function tests are not an appropriate method of comparing analgesic efficacy. Prophylactic administration of loratadine to 15% of our patients was not shown to be effective in diminishing the incidence of pruritus. PMID- 1767899 TI - Studies on Australian snake venoms, Part II: The haematological effects of brown snake (Pseudonaja) species in the dog. AB - The haematological effects of Brown Snake (Pseudonaja) species (textilis, affinis, nuchalis) were studied in anaesthetised, mechanically ventilated dogs. Marked thrombocytopenia, depletion of serum fibrinogen and prolonged prothrombin and activated partial thromboplastin time, were recorded at 5 to 10 and 30 to 40 minutes after intravenous envenomation. Fibrin degradation products were not elevated. Because these haematological effects occurred simultaneously with cardiovascular depression (previously reported), we postulate that hypotension sometimes observed in human envenomation may be due to intravascular coagulation with myocardial ischaemia. PMID- 1767900 TI - Thickly and thinly applied lignocaine-prilocaine cream prior to venepuncture in children. AB - EMLA cream (Astra Pharmaceuticals) which contains lignocaine and prilocaine, is widely used in a thick layer to reduce the pain associated with venepuncture. Application of smaller amounts of cream lowers cost and may reduce side-effects. The efficacy of a thick layer (using 2.0 ml) and a thin layer (using 0.5 ml) of lignocaine-prilocaine cream prior to venepuncture was compared in a randomised study of one hundred children. Pain with venepuncture was assessed using a behavioural rating scale as none, slight, moderate or severe. Children in the thin layer study group experienced slight pain more often than children in the thick layer study group (P less than 0.01). No child in either group experienced moderate or severe pain. It is concluded that a thin layer of lignocaine prilocaine cream is not as effective as a thick layer in producing the pain-free venepuncture which is desirable in children. PMID- 1767901 TI - The influence of rectal cisapride on morphine-induced gastric stasis. AB - The effect of a new formulation of the gastric prokinetic agent cispride on opioid-induced gastric stasis was investigated. Forty patients were randomly allocated to one of four therapies administered as premedication; group A, placebo suppositories only; group B, placebo suppositories and intramuscular morphine 10 mg; group C, rectal cisapride 30 mg and intramuscular morphine 10 mg and group D, rectal cisapride 60 mg and intramuscular morphine 10 mg. Gastric emptying was assessed from the small bowel absorption of paracetamol following oral absorption. The kinetics of the suppository formulation were determined from venous blood samples. Rectal cisapride in the two doses used did not prevent opioid-induced gastric stasis. This may reflect an inability of this formulation to produce adequate plasma concentrations. PMID- 1767902 TI - Haemodynamic effects of ketanserin following coronary artery bypass grafting. AB - The haemodynamic effects of ketanserin were studied consecutively in seventeen patients in the intensive care unit following coronary artery bypass grafting. Hypertensive patients (Group 1, systolic blood pressure (SBP) greater than or equal to 150 mmHg following discontinuation of nitroprusside, n = 10) received intravenous ketanserin 10 mg and infusion of 0.1 mg.kg-1.hr-1 with additional boluses as required to maintain SBP less than or equal to 130 mmHg for one hour. Non-hypertensive patients (Group 2, SBP less than 150 mmHg, n = 7) received a 5 mg bolus and the same infusion. Ketanserin significantly decreased arterial blood pressure (P less than 0.001) in all patients in Group 1. Heart rate was decreased but not significantly. Cardiac index, systemic and pulmonary vascular resistance and pulmonary shunt fraction were not significantly altered from pre-ketanserin values when blood pressure was controlled with nitroprusside. Normotensive patients in Group 2 did not show any undesirable hypotension or significant haemodynamic changes. Mean nitroprusside dose requirements following ketanserin therapy were significantly reduced by 91.6% in Group 1 and 78.4% in Group 2 (P less than 0.05). Ketanserin is effective in treating hypertension following coronary artery bypass grafting with an advantage of lack of reflex tachycardia. PMID- 1767903 TI - Does combined epidural lignocaine and fentanyl provide better anaesthesia for ESWL than lignocaine alone? AB - The efficacy of epidural fentanyl combined with lignocaine 1.5% with adrenaline 1:200,000 was studied in a randomised, double-blind, controlled trial of two hundred patients undergoing extracorporeal shock wave lithotripsy with or without ancillary procedures. The quality of anaesthesia was assessed using linear analogue pain scores, the patient's impression, and the rate of intra-operative intervention by the anaesthetist. Postoperative symptomatology was also recorded. The only significant difference lay postoperatively in that the fentanyl ancillary procedure sub-group had less pain approximately one hour postoperatively (P = 0.01). In the context of this study and in the presence of an adequate autonomic and somatic local anaesthetic blockade, the addition of epidural fentanyl does not appear to confer any significant advantage other than to enhance postoperative analgesia. PMID- 1767904 TI - A comparison of oral midazolam solution with temazepam as a day case premedicant. AB - Seventy-five women undergoing elective day case gynaecological surgery were randomised into one of three groups to receive an oral formulation of midazolam IV solution 10 mg, temazepam 20 mg or placebo for premedication. The two treatment groups showed a significant reduction in anxiety score compared with placebo (P less than 0.002 and P less than 0.04 for placebo compared with temazepam and midazolam respectively). Similarly the treatment groups showed a significantly greater sedation score compared with placebo. Recovery as assessed by letter deletion and memory tests was no worse for the treatment groups than for placebo. Patient acceptance of the two treatment groups was significantly greater than that of placebo. There was no significant difference between treatment groups with respect to anxiolysis, sedation or recovery. As a day case premedicant, midazolam IV solution 10 mg orally was found to be as effective as temazepam 20 mg and superior to placebo, in terms of anxiolysis and sedation, but did not offer any clinical advantage over temazepam in this setting. PMID- 1767905 TI - Acute carbon monoxide exposure and cerebral blood flow in rabbits. AB - Carbon monoxide (CO) 1% was administered to anaesthetised rabbits for 15 minutes. Despite a 28% +/- 5.8 (SEM) fall in mean arterial blood pressure during the CO exposure, cerebral blood flow increased by 236% +/- 36.5 in the left and 287% +/- 28.9 in the right cortex. Cerebrovascular resistance was reduced by 70.6% +/- 2.8 in the left and by 76.2% +/- 3 in the right cortex. These changes were accompanied by an increase in intracranial pressure, a drop in body temperature and ventilation requirement, and a metabolic acidosis. When the CO was withdrawn all these parameters returned to normal over three hours. Hence, these vascular effects are reversible and consistent with the natural history of CO intoxication in humans. Carboxyhaemoglobin levels correlated well with hemispheric cerebral blood flow (r = 0.90; r = 0.98) and cerebrovascular resistance (r = 0.87; r = 0.97). PMID- 1767906 TI - N-Trifluoroacetyl-ethanolamine: a proposed urinary metabolite of halothane: validation and measurement in children. AB - It has been postulated that trifluoroacetyl chloride, a halothane metabolite, can bind covalently with the phosphatidylethanolamine component of the hepatic cell membrane and cause cell necrosis. Breakdown of the necrotic hepatocyte would release N-trifluoroacetyl-ethanolamine (TFAE) into the serum with subsequent urinary excretion. An original High Performance Liquid Chromatography (HPLC) method for the measurement of TFAE is described. In six children 1% halothane was administered for one hour and the halothane uptake measured. Urinary excretion of TFAE was measured for up to eight days and found to be 0.09 +/- 0.07% or less of the absorbed halothane. In children TFAE is not a major urinary metabolite of halothane. PMID- 1767907 TI - Quality of blood prepared for autotransfusion in primary cemented total hip replacement. AB - We have measured levels of contaminants (products of cell lysis and other substances) in blood salvaged from patients undergoing primary cemented total hip replacement. Washing of this blood removed an average of 91.4% of the free haemoglobin mass, reduced white cell lysozyme concentrations by 86% and almost totally eliminated fats and particulate matter. Osmotic fragility was significantly improved by washing although not to control levels. PMID- 1767908 TI - A survey of epidural analgesia practice in Western Australian obstetric units. AB - A survey of epidural practices in all obstetric units in this state was conducted to obtain information regarding epidural analgesia services, epidural conduct and management, management of complications and staff education. The survey revealed a diversity of practice and in some instances standards of care. While reflecting the regionalisation of services in this geographically vast state, the problems identified appear universal and are likely to be relevant on a broader and national scale. Practices are discussed and recommendations made with respect to improvement of management and continuing education. PMID- 1767909 TI - The King Edward Memorial Hospital 1,000 mother survey of methods of pain relief in labour. AB - A survey of one thousand women having a vaginal delivery in an obstetric teaching hospital was conducted in order to ascertain maternal opinions of various methods of pain relief in labour. Women were questioned on the day following delivery as to their pain experience, the degree of analgesia obtained, their satisfaction with and criticisms of the analgesic method or methods used, and their overall satisfaction with their childbirth experience. More pain than expected was reported significantly more often by primiparous women (P less than 0.001) and those having induced or augmented labour (P less than 0.04). Epidural analgesia was significantly more effective and resulted in greater satisfaction than other methods alone, or when used in combination (P less than 0.0001). 'Inadequate analgesia' was also reported less frequently by women using non-pharmacological methods alone (P less than 0.0001). Dissatisfaction with their experience was reported by 5% of women and was most frequently related to inadequate pain relief. Although uncommonly cited as a reason, instrumental delivery was statistically associated with dissatisfaction (P less than 0.003). The incidence of dissatisfaction did not significantly differ with respect to the analgesic method or methods used. PMID- 1767910 TI - Modern medicine and the rejection of death. PMID- 1767911 TI - Does regional block improve outcome after surgery? AB - Seventy-five years have elapsed since the first claim that the use of local anaesthetics improved surgical outcome. Despite extensive research, the literature provides contradictory views of the role of regional block in improving outcome. This paper attempts to reconcile these contradictions by examining biological hypotheses underlying the research question and reviewing relevant epidemiological clinical research methodology. The paper concludes with recommendations to prospective investigators for strategies in design, planning and execution of randomised trials to assess the efficacy of regional block in determining outcome after surgery. PMID- 1767912 TI - Patient-controlled analgesia: can it be made safer? AB - Patient-controlled analgesia (PCA) has been shown to provide superior pain relief when compared with standard therapy options for postoperative analgesia. If PCA is to be implemented widely in teaching, private and country hospitals, its effectiveness needs balanced with a high safety profile. This can be achieved by consideration of patient selection, comprehensive education of patients, medical and nursing staff and equipment familiarisation. Continuous clinical audit allows identification of problem areas along with monitoring analgesic efficacy. PMID- 1767913 TI - Measuring the efficiency of an artificial lung: 1. Carbon dioxide transfer. AB - The performance of a hollow fibre artificial lung ('Capiox E') was analysed by measurement of the 'parallel deadspace' of the device under varying conditions in 21 patients. The efficiency with which carbon dioxide was exchanged was determined by the time available for equilibration between the blood and gas phases. When this equilibration coefficient was less than 12 seconds per litre of blood flow per litre of gas flow, there was a marked reduction in the efficiency of gas exchange. Under certain conditions, the 'counter-current' design of the device apparently permitted the clearance of carbon dioxide at a partial pressure greater than that which was found in the mixed venous blood. This anomalous behaviour may represent in vivo confirmation of the Haldane effect. PMID- 1767914 TI - Data recording and trend display during anaesthesia using 'MacLab'. AB - A single screen display of variables monitored during anaesthesia may be ergonomically superior to the 'stack' of monitors seen in many anaesthetising locations. A system based on a MacLab (Analogue Digital Instruments) analogue-to digital convertor used in conjunction with a Macintosh computer was evaluated. The system was configured to provide trend displays of up to eight variables on a single screen. It was found to be a useful adjunct to monitoring during anaesthesia. Advantages of this system are low cost, flexibility, and the quality of the software and support provided. Limitations of this and other similar systems are discussed. PMID- 1767915 TI - The functional deadspace of needle-free injection ports. AB - This study examined six needle-free injection ports comprising three taps (Sorenson Intralock, Top type L, Viggo Connecta), a one-way valve (Braun RV 1000) and two cannulae with integral injection ports (Vasofix, Venflon 2) with regard to deadspace, protection against blood spillage, and potential difficulties in use. A conventional bung (Baxter), requiring needle use for drug administration, was included for comparison. Where necessary, ports were combined with cannulae in order to simulate clinical practice and allow fair comparison with the Vasofix and Venflon cannulae. Total deadspace was then calculated by filling with normal saline and measuring weight increase. Deadspace (0.10 to 0.43 ml) varied with injection port type and cannula size. Such volumes can contain significant amounts of drug and may be hazardous if not flushed after injection. Only the Vasofix and Venflon Cannulae and the Braun RV1000 protected adequately against blood spillage. Costs varied widely (A$0.19 to A$2.20 excluding cannula). The Vasofix and Venflon 2 cannulae were found to be nearest the ideal. PMID- 1767916 TI - Improving agreement between thoracic bioimpedance and dye dilution cardiac output estimation in children. AB - The measurement of thoracic electrical bioimpedance (TEB) offers a continuous, non-invasive method for monitoring cardiac output (CO). For clinical use, agreement with a current standard should be demonstrated. We describe a modification to the manufacturer's suggested data entry into the NCCOM3-R6 TEB monitor (BoMed Medical Manufacturing), which results in improved agreement with indocyanine green dye dilution (DD) CO estimation in paediatric patients. The manufacturer's instructions for the NCCOM3-R6 include an estimation of the volume of electrically participating thoracic tissue (VEPT) based on body weight. We also estimated the VEPT from direct anatomical measurement of thoracic length and circumference. The mean difference between paired DD and TEB CO using the manufacturer's weight-based instructions was 0.69 l/min with 95% confidence limits 2.34 to -0.96 l/min. The mean difference between the two CO techniques using our calculated VEPT was 0.35 l/min with 95% confidence limits 1.50 to -0.80 l/min. The linear regression correlation coefficient between the two techniques was 0.88 using VEPT estimated from the manufacturer's instructions and 0.94 using our calculated VEPT from measurement of thoracic dimensions. The range of DD CO was 0.41 to 8.35 l/min. PMID- 1767917 TI - Performance of BOC Ohmeda Tec 3 and Tec 4 vaporisers following tipping. AB - The introduction of systems to facilitate the changing of vaporisers on the back bar of the anaesthetic machine has increased the risk of a vaporiser being tipped or inverted prior to attachment. The performance of three Ohmeda Tec 3 and three Ohmeda Tec 4 vaporisers following tipping to 30 degrees, 90 degrees and inversion to 180 degrees was measured using a calibrated Datex Capnomac AGM-103 analyser. Both types of vaporiser when switched off tolerated tipping and inversion without alteration of the anaesthetic concentration subsequently delivered. The same was true for the Tec 3 after tipping to 30 degrees and 90 degrees with the dial set at zero or above. However, after inversion of the Tec 3 vaporiser with the dial at zero or higher, the anaesthetic concentration delivered was much greater than shown on the dial, initially exceeding 12% for all agents. Should a Tec 3 vaporiser be inverted with the dial at any setting other than OFF, it is necessary to adequately flush it with fresh gas and check its output prior to use. PMID- 1767918 TI - Epidural gelatin (Gelfoam) patch treatment for post dural puncture headache. PMID- 1767919 TI - Massive adrenaline doses in labetalol overdose. PMID- 1767920 TI - The 15th Australian and New Zealand scientific meeting on intensive care, Adelaide, S.A., September 1990. Abstracts of papers. PMID- 1767921 TI - External chest compression in acute severe asthma. PMID- 1767922 TI - Swollen tongue and nebulized adrenaline. PMID- 1767923 TI - Combined use of laryngeal mask airway and fibreoptic laryngoscope in difficult intubation. PMID- 1767924 TI - LMA in awake fibreoptic bronchoscopy. PMID- 1767925 TI - LMA for fibreoptic bronchoscopy. PMID- 1767926 TI - Awake intubation with Brain laryngeal airway. PMID- 1767928 TI - Nitrous oxide pin indexed conversion program. PMID- 1767927 TI - Overfull nitrous oxide cylinders. PMID- 1767929 TI - PCA administration set failure. PMID- 1767930 TI - Painless local anaesthesia for cataract surgery. PMID- 1767931 TI - Sprotte spinal needle. PMID- 1767932 TI - Obstetric spinal headache. PMID- 1767933 TI - Pre-oxygenation with halothane in asthma. PMID- 1767934 TI - Rectal indomethacin to supplement opioid infusion. PMID- 1767935 TI - Tryptase in anaphylaxis. PMID- 1767936 TI - Ultratrace dioxin and dibenzofuran analysis: 30 years of advances. PMID- 1767937 TI - Indirect detection of mercury-199 nuclear magnetic resonance spectra of methylmercury complexes. AB - Measurement of 199Hg NMR spectra of methylmercury species by the heteronuclear multiple quantum coherence (HMQC) indirect proton detection method and its application to the study of the solution chemistry of CH3HgII-thiol ligand complexes are described. A sensitivity enhancement factor of 16 is obtained for measurement of the 199Hg NMR spectrum of a 4 mM solution of the CH3HgII glutathione complex by the indirect detection method, as compared to a theoretical enhancement of 74. The less-than-theoretical enhancement is attributed to loss of signal by relaxation during the HMQC pulse sequence. Longitudinal relaxation of the 199Hg in CH3HgII-thiolate complexes is fast at the field strength used in this research (11.7 T) due to efficient relaxation by the chemical shift anisotropy mechanism. This in turn causes the transverse relaxation rate for the 199Hg spin-coupled methyl protons to be fast due to efficient relaxation by another mechanism, scalar relaxation of the second kind. Depending on the rate of exchange of CH3HgII among its complexed forms, the 199Hg line width can also include a large contribution from exchange broadening. In such cases, it is shown that extremely broad 199Hg resonances, which would be difficult to detect by direction observation, can be observed by the indirect detection method. For example, 199Hg resonances with exchange-broadened line widths up to 8000 Hz are observed by the indirect detection method for CH3HgII in mixtures of CH3HgOD and the CH3HgII-mercaptoethanol or CH3HgII-glutathione complex. The chemical shift of 199Hg in CH3HgII-thiolate ligand complexes is found to be extremely sensitive to the nature of the thiolate ligand.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767938 TI - Monobromopolychlorodibenzo-p-dioxins and dibenzofurans in municipal waste incinerator flyash. AB - Capillary column gas chromatography/high-resolution mass spectrometry was used in two different selected-ion monitoring modes to analyze trace levels of monobromopolychlorodibenzo-p-dioxins and dibenzofurans (BPCDD/Fs) in municipal waste incinerator (MWI) flyash. The mass profile monitoring mode is well-suited for identification of unknown compounds in uncharacterized matrices because it has superior diagnostic capability. Owing to its high sensitivity, conventional peak top monitoring was used to quantify, on the basis of polychlorodibenzo-p dioxin and dibenzofuran (PCDD/F) standards, the BPCDD/Fs in the sample. The results were compared with those obtained by using two commercial BPCDDs as standards, and the latter results are 4 times greater, indicating the need for appropriate standards. The high certainty and sensitivity obtained from these two mass spectrometric techniques combined with the resolving power of capillary gas chromatography enabled us to compare for the first time the isomer distribution patterns between BPCDD/Fs and their PCDD/F analogues at a high confidence level. The comparison indicates BPCDD/Fs and PCDD/Fs found in MWI flyash are closely related and that many BPCDD/Fs with a 2,3,7,8-substitution configuration may be present in MWI flyash. PMID- 1767939 TI - Regioselective chloride ion loss from chlorine-37 enriched polychlorodibenzofurans by negative-ion mass spectrometry. AB - Regiospecific chlorine-37 enriched dichloro-, trichloro-, tetrachloro-, and pentachlorodibenzofuran isomers were investigated under electron capture negative ion mass spectrometry (ECNIMS) conditions. The relative chloride ion loss from the enriched positions was determined from the chloride-37 and chloride-35 ion abundances after correcting for the isotopic enrichment. Regioselective chloride anion losses were observed with the carbon 3-chlorine bond (beta-chlorine) generally found to be the most labile. The carbon-chlorine bond cleavages can be loosely associated with calculated carbon-chlorine bond residual charges. PMID- 1767940 TI - Conductivity response of porous electrodes supported on perfluorosulfonic acid membranes to acidic gas mixtures. AB - Gold or platinum films deposited on a Nafion membrane were used to measure surface conductance of the membrane. Acidic gases such as HCI or SO2, introduced as mixtures with an inert gas, were found to affect the conductance of the membrane surface facing this mixture while the other side of the membrane was constantly supplied with a moist inert gas. The relative conductance (G/Go) is most affected within the 0-0.5 and 3-4.5 vol % ranges both for HCI and SO2. The effect is higher for the Pt-deposited than it is for the gold-deposited membrane: for an HCI concentration of 1.5 vol %, G/Go is 5 for Pt deposited on Nafion while it is only 1.3 for gold deposited on Nafion. This is attributed to different geometries and porosity of the Pt and Au electrodes. No conductance response was observed for CO2 which yields with water a much weaker acid than those formed by HCI and SO2. PMID- 1767941 TI - Pulse voltammetry at microcylinder electrodes. AB - Microcylindrical electrodes are easier to construct and maintain than microdisk electrodes. In the normal-pulse mode, ranges of time parameters and electrode sizes can be found such that depletion of reactant is unimportant and the response to the analysis pulse is predicted by theory for planar conditions. Similarly, ranges of parameters are found for reverse-pulse voltammetry such that the potential-dependent response can be treated as a sequence of individual double-pulse responses. Cylindrical diffusion and convection act to replenish reactant quickly near the electrode and thus permit overall experiment times in the range of seconds. For square-wave voltammetry the shape and position of the net current response are independent of the extent of cylindrical diffusion. PMID- 1767942 TI - Improved separation of nucleic acids with analyte velocity modulation capillary electrophoresis. PMID- 1767943 TI - Estimation of effective diffusion coefficients of model solutes through gastric mucus: assessment of a diffusion chamber technique based on spectrophotometric analysis. AB - A diffusion chamber technique based on spectrophotometric analysis to determine effective diffusion coefficients for solutes with various relative molecular mass (Mr) values and properties, passing through native mucus gel, is reported. For all solutes studied, a reduction in effective diffusion coefficients is observed with a retardation of solute flux by a factor of at least two. For the solutes investigated (with Mr values ranging from 126-14,400 u), no consistent effect of solutes of low Mr was evident with regard to the retarding effect of mucus; however, at high Mr values (greater than 4000 u) the retardation was greatly enhanced. A possible relationship between charged solutes of low Mr and the degree of retardation was observed, which possibly suggests the presence of ionic interactions of the solutes with the largely negatively charged mucus gel. The results provide further evidence for the suggestion that mucus is acting more than simply as a gel support for an unstirred water layer and is perhaps a more potent diffusion barrier to specific solutes. PMID- 1767944 TI - Co-fluorescence of europium and samarium in time-resolved fluorimetric immunoassays. AB - In the presence of an excess of Y3+, the fluorescence intensities of Eu3+ and Sm3+, chelated with benzoyltrifluoroacetone (BTA) or thenoyltrifluoroacetone (TTA) in an aqueous solution containing 1,10-phenanthroline, were increased by factors ranging from 209- to 811-fold. This co-fluorescence phenomenon was used in a highly sensitive time-resolved fluorimetric detection of the lanthanides, Eu3+ and Sm3+. The detection limits of Eu3+ in the BTA- and TTA-based solutions were 4 and 15 fmol dm-3, respectively. The detection limits of Sm3+ were 0.11 and 0.12 pmol dm-3, respectively. The co-fluorescence enhancement systems were also applied in the double-label time-resolved fluorimetric immunoassay of luteinizing hormone and follicle stimulating hormone using specific antibodies labelled either with Eu3+ or Sm3+. The co-fluorescence enhancement solution was superior as compared with the commercial 'direct' fluorescence enhancement solution based on the acidic solution of beta-naphthoyltrifluoroacetone, trioctylphosphine oxide and Triton X-100, in respect to the signal level obtained and the sensitivity. It is suited to time-resolved fluorimetric immunoassays in which particularly high detection sensitivities are required, and it can also be used in double-label assays employing Eu3+ and Sm3+ chelate labels. PMID- 1767945 TI - [Hemofiltration in the adult respiratory distress syndrome in patients with diffuse suppurative peritonitis]. AB - Hemofiltration (HF) potentials are presented in complex treatment of 12 patients with disseminated suppurative peritonitis in the phase of polyorgan failure with signs of adult respiratory distress syndrome (ARDS). It has been shown that HF reduces the amount of extravascular fluid in the lungs, increases right-to-left pulmonary shunt, eliminates mediators causing higher permeability of pulmonary vessels, and other medium-molecular toxins. Death was recorded in 6 out of 12 patients. In 3 of the dead patients HF had an obvious positive effect, and death was caused by acute hepatorenal failure. Thus, HF seems promising for the treatment of ARDS in patients with peritonitis. PMID- 1767946 TI - [Immune shifts and their correction in the extremely severe course of diffuse suppurative peritonitis in children]. AB - Clinical and immunological studies of 65 patients with extremely severe disseminated suppurative peritonitis have revealed profound disturbances in their immune status. A considerable (2.5-3-fold) decrease in phagocytosis and complement activity, a drastic drop in T-, B-lymphocyte and T-helper content and a depression in T-lymphocyte functional activity have been observed. All this was accompanied by the activation of allergic and autoimmune reactions. Single transfusion of extracorporally X-ray-irradiated autoblood (5-7% of circulating blood volume) promoted an earlier normalization of the patients' critical condition and a prompt correction of the immune shifts. PMID- 1767947 TI - [Characteristics of the development of respiratory insufficiency in the early postoperative period following surgery of cancer of the esophagus and the cardia]. AB - Acute respiratory failure (ARF) in the earliest postoperative period after radical surgery for esophageal cancer is characterized by staged development. Its severity is determined by the degree of ventilation-perfusion disorders and the accompanying diffusion disturbances. The following factors are considered to be ARF-provoking: postaggressive circulation centralization, predominant administration of crystalloid plasma substitutes, persistence of hypoproteinemia in the earliest postoperative period, as well as extended lymph dissection involving cardiopulmonary plexus located in the area of bifurcation. The latter factor is the peculiarity of surgery caused by oncological considerations, while three former factors should be taken into account during management of patients in the intra- and postoperative periods. PMID- 1767948 TI - [The status of the receptor-controlled calcium metabolism of the thrombocytes in patients in the early postoperative period]. AB - Basic changes in receptor-controlled platelet calcium metabolism that occur in the early postoperative period under the effect of aggregation-inducing hormones- platelet activation factor (PAF), adenosine phosphate (ADP) and vasopressin--are reviewed. Patients after lung surgery and patients with ischemic heart disease after aortocoronary bypass surgery have been examined. Patients operated on for malignant lung tumours developed increased postoperative sensitivity to ADP, while in patients after aortocoronary bypass surgery the early postoperative period was characterized by decreased sensitivity to PAF and vasopressin. PMID- 1767949 TI - [Preservation by anesthesia management of the normal functioning of the external respiration system following surgery of the upper abdominal organs]. AB - The impact of different variants of neuroleptanalgesia (NLA) on respiration immediately after gastric resection and cholecystectomy has been studied in two homogeneous groups of patients (30 persons each) after operations on the upper abdominal organs. In patients of group I NLA was performed using fentanyl (initial dose--7.5 micrograms/kg, maintenance dose--100 micrograms) supplemented with epidural blockade and isovolemic hemodilution. In patients of group II NLA was performed with graded administration of 100-200 micrograms fentanyl. In patients of group I right after surgery gas exchange during room air inhalation was unimpaired, while in patients of group II hypoxemia due to inadequate ventilation and metabolic acidosis were registered. It is concluded that the type of anesthesia management suggested has a protective effect on respiration in the earliest postoperative period. PMID- 1767950 TI - [The evaluation of the prognostic significance of the concentration of free myoglobin in the blood of oncologic patients in the early postoperative period]. PMID- 1767951 TI - [The status of the central hemodynamics in patients with acute renal insufficiency]. AB - A complex approach to the investigation of circulation system, using central hemodynamic and homeostasis parameters, made it possible to detect in due time compensatory and pathogenetic circulatory changes that differ quantitatively and qualitatively, in patients with acute renal failure of different etiology. The changes are most marked in patients with sepsis during oligoanuria. Timely differential and directed intensive therapy, using conservative and extracorporeal techniques, helps normalize homeostasis and eliminate the signs of circulatory failure at the early stages of therapy. PMID- 1767952 TI - [A comparative evaluation and clinical experience in the use of 4 pulse oximeters]. PMID- 1767953 TI - [Changes in the amino acid spectrum of the blood in patients with sepsis in the process of complex intensive therapy]. AB - Amino acid fund has been studied during complex therapy of 25 patients with sepsis. In 15 patients complex therapy included detoxicating hemosorption (3-5 sessions), in 10 patients hemosorption was supplemented by ultraviolet blood irradiation (5-10 sessions). Complex therapy employing hemosorption led to a decrease in serine plasma level. Changes in the amino acid fund of the whole blood were insignificant. Leucine, isoleucine, threonine and phenylalanine blood levels were significantly increased. The introduction of ultraviolet blood irradiation into complex therapy of patients reduced traumatic effect of sorption detoxication on blood cells and enhanced detoxicating effect. PMID- 1767954 TI - [Feasibility of the use of a new liquid suction pump in resuscitation]. AB - A new mechanical suction device for aspiration of body liquids containing tough and solid particles has been suggested for use during resuscitation in emergency conditions, in pits, destroyed houses and other places difficult of access. The device can be also used for controlled lung ventilation with oxygenation and analgesia. PMID- 1767955 TI - [The use of acupuncture in the complex anesthesiologic management of extracorporeal lithotripsy]. PMID- 1767956 TI - [A splint for fixation of the arm during infusion therapy]. PMID- 1767957 TI - [The inguinal paravascular technique of lumbar plexus block--anatomical pretests were unsuccessful]. AB - Using 28 anatomic preparations, the boundaries of dye expansion in tissues adjacent to nervous stems have been experimentally studied during the application of lumbar plexus local anesthesia technique via inguinal paravascular approach according to A. Winnie. It has been established that the above technique is not associated with anatomic conditions for simultaneous contact of a model dye solution with 3 basic derivates of the lumbar plexus both at the level of formation and further on. There is massive dye diffusion from femoral nerve perineural space into the intermuscular connective tissues. Compact structure of perineural spaces in musculus psoas major prevents lumbar plexus infiltration. The junction of lumbar and obturator fascia, forming the fascial node between large and small pelvis, excludes any possible contacts between the dye solution and the obturator nerve. PMID- 1767958 TI - [The Soviet colloid modegel as a component of a perfusion medium used in surgery with extracorporeal circulation]. AB - The results of the application of a new Soviet colloid solution modegel in cardiopulmonary bypass surgery in 50 patients have been analysed. The data obtained have been compared to those of control patients who were administered gelatinol instead of modegel. Modegel ensures optimal basic plasma electrolyte content, colloid-osmotic pressure and osmolality during perfusion. PMID- 1767959 TI - [The use of prolonged epidural analgesia with morphine for relief of the pain syndrome in patients with acute myocardial infarct]. AB - Nociceptive effect of conventional and morphine-prolonged epidural analgesia (MPEA) has been compared in 60 patients with acute myocardial infarction (AMI). In 30 patients of the test group pain was relieved with MPEA used during 7 days, while in 30 control patients analgesia was performed with the intravenous administration of morphine or fentanyl, or neuroleptanalgesia was used. MPEA was shown to produce a more prompt and reliable anesthetic effect, thus improving the clinical course of AMI. As regards all the parameters, the effect of MPEA was higher compared to conventional analgesia techniques. PMID- 1767960 TI - [A rare complication of epidural anesthesia]. PMID- 1767961 TI - [Analgesia and intensive therapy during hemicorporectomy]. AB - The first successful hemicorporectomy performed in this country is described. Clinical data are presented and specific features of anesthesia, infusion transfusion therapy and management of the postoperative period are reviewed in detail. PMID- 1767962 TI - [Severe hemodynamic disorders in combination with disorders of the acoustic stem evoked potentials during excision of brain stem tumors]. PMID- 1767963 TI - [Ultrasonic imaging as a control method during catheterization of the subclavian vein]. PMID- 1767964 TI - [A possible complication of therapeutic plasmapheresis]. AB - Possibility of citric intoxication as a complication of therapeutic plasmapheresis is being discussed on the basis of two clinical observations. Hemodynamic reactions to sodium citrate administration have been noted during reinfusion of auto red cell mass. It is suggested that the development of collapsoid reaction, accompanied by a significant decrease in the total peripheral resistance at a stable cardiac output and cardiac index, is determined by the transition of the ionized calcium of the blood into calcium citrate, and thus the violation of the processes regulating the excitement and constriction of the muscular cells in the peripheral arteries. On the basis of further observations (360 therapeutic plasmapheresis procedures) gradual injections of small calcium quantities are recommended for the prevention of citric reactions during reinfusion of auto red cell mass. PMID- 1767965 TI - [Prolonged high-frequency mechanical ventilation of the lungs in the adult respiratory distress syndrome (a clinical case)]. PMID- 1767966 TI - [Balanced anesthesia and the adult respiratory distress syndrome]. PMID- 1767967 TI - [Changes in the cerebral blood flow in neurosurgical patients during general anesthesia using antihypoxic agents]. AB - Cerebral blood flow (CBF) and central hemodynamics (CH) have been studied during anesthesia and after surgery in patients with tumours located in brain hemispheres. CBF and CH were determined by radiography. GOBA, diazepam and sodium thiopental were used for anesthesia. It has been shown that GOBA fails to normalize CBF both during and after surgery, diazepam normalizes blood flow in both brain hemispheres. Sodium thiopental leads to further CBF depression up to critical level in the affected hemisphere with parallel blood flow ingress in the intact brain hemisphere. It is concluded that the use of diazepam is advisable for anesthesia during surgery for tumours located in brain hemispheres. PMID- 1767968 TI - [Anesthesia in disorders of heart rhythm and conductivity]. PMID- 1767969 TI - [Activated coagulation time during surgery with extracorporeal circulation]. PMID- 1767970 TI - [The effect of low-intensity laser irradiation on the basic biological processes and homeostasis in patients]. PMID- 1767971 TI - [Impairment of the fibrinolytic function of the lungs in the respiratory distress syndrome in patients with peritonitis]. AB - Adult respiratory distress syndrome (ARDS) is accompanied by disseminated intravascular coagulation syndrome (DICS), its development causing progressing signs of the shock lung. The loss of the so far high pulmonary fibrinolytic activity promotes the onset of DICS in mixed venous and arterial blood. This metabolic pulmonary function is retained in patients with ARDS, stage I, is slightly damaged in patients with ARDS, stage II and is completely impaired in patients with ARDS, stages III and IV. PMID- 1767972 TI - Serum tumor necrosis factor activity in horses with colic attributable to gastrointestinal tract disease. AB - Over a 24-month period, serum tumor necrosis factor (TNF) activity was determined in 289 horses with colic attributable to gastrointestinal tract disease. Serum TNF activity was quantitated by use of a modified in vitro cytotoxicity bioassay, using WEHI 164 clone-13 murine fibrosarcoma cells. Causes for colic, determined by clinical and laboratory evaluation, exploratory celiotomy, or necropsy included: gastrointestinal tract rupture (GTR); ileal impaction; small intestinal strangulating obstruction (SIO); proximal enteritis (PE); transient small intestinal distention; large-colon displacement; large-colon volvulus; large colon impaction; colitis; small-colon obstruction; peritonitis; and unknown. Each diagnosis was placed into 1 of 3 lesion categories: inflammatory disorders (GTR, PE, colitis, peritonitis); strangulating intestinal obstruction (SIO, large-colon volvulus); and nonstrangulating intestinal obstruction (ileal impaction, transient small intestinal distension, large-colon displacement, large-colon impaction, small-colon obstruction, unknown). The prevalence of high serum TNF activity and/or mortality were evaluated. Differences were tested at significance level of P less than 0.05. Approximately 20% of the 289 horses has serum TNF activity greater than that found in clinically normal horses (greater than 2.5 U/ml). Twenty-three horses (8%) had marked increase in serum TNF activity (greater than or equal to 10 U/ml) which was more prevalent among horses with SIO and PE than in horses of other diagnostic groups, except those with GTR. Mortality and marked increase in serum TNF activity were greater in horses with intestinal inflammatory disorders or strangulating intestinal obstruction than in horses with nonstrangulating intestinal obstruction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767973 TI - Canine corneal thickness measured by ultrasonic pachymetry. AB - Ultrasonic pachymetry was used to measure central, superior peripheral, and temporal peripheral corneal thicknesses of 75 dogs (150 eyes) with normal corneas, anterior chambers, and intraocular pressure. Mean corneal thickness averaged over the 2 eyes, 3 locations, and 75 dogs was 562 +/- 6.2 microns. The peripheral cornea was thicker on average than the central cornea by 49.43 +/- 8.45 microns and this difference increased with age at 6.97 +/- 1.3 microns/month of age. Mean corneal thickness changed with age (14.23 +/- 2.26 microns/month), and weight (1.83 +/- 0.38 microns/kg). Females had significantly thinner corneas (22.43 +/- 11.03 microns than males) after adjusting for age and weight. PMID- 1767974 TI - Urine metabolite values in fed and nonfed clinically normal beagles. AB - Twenty-four-hour excretion of urine metabolites was determined in 33 clinically normal Beagles during periods of consumption of a standard diet and when food was withheld. The goal was to determine normal canine values for urine analytes incriminated in the genesis of calcium oxalate uroliths. During periods when dogs consumed food, dairy urinary excretion of calcium, uric acid, sodium, potassium, magnesium, ammonium, and hydrogen ions were significantly (P = 0.0004, 0.0038, 0.001, 0.0001, 0.0004, 0.0001, and 0.024, respectively) higher than when food was withheld. Urinary excretion of phosphorus, oxalate, and citrate were not significantly different between samples obtained during periods of food consumption and when food was withheld. Male dogs excreted significantly higher quantities of urine oxalate than females during fed (P = 0.003) and nonfed (P = 0.003) conditions. When food was withheld, urinary uric acid excretion was significantly higher in males than females (P = 0.01). Females excreted significantly more urine calcium than males when food was withheld (P = 0.003). Our results indicated that dietary conditions influence the quantity of sodium, potassium, calcium, magnesium, and uric acid excreted in the urine of clinically normal dogs; therefore, dietary conditions should be considered when measuring the concentration of these analytes in urine. PMID- 1767975 TI - Prevalence of calcium oxalate uroliths in miniature schnauzers. AB - Epidemiologic data were evaluated from all dogs admitted to the University of Minnesota, Veterinary Teaching Hospital (UMVTH) between June 1981 and November 1989. Of 69,890 admissions, 2,077 were Miniature Schnauzers. Uroliths were retrieved from 63 of the 2,077 Miniature Schnauzers admitted. In 20 of the 63 urolith episodes, calcium oxalate was the predominant mineral identified. By comparison, calcium oxalate uroliths were identified in only 56 of the remaining 67,813 non-Miniature Schnauzer canine admissions. The odds that uroliths from Miniature Schnauzers were composed of calcium oxalate was 11.8 times greater than for other canine breeds evaluated at the UMVTH (95% confidence interval = 6.8 to 20.1). Data also were evaluated from files of uroliths retrieved from dogs and submitted to the Minnesota Urolith Center for quantitative mineral analysis, between June 1981 and November 1989. Of 3,930 uroliths analyzed, 615 (15.6%) uroliths were obtained from Miniature Schnauzers. of the 615 uroliths, 175 (28.4%) were calcium oxalate. By comparison, only 550 (16.6%) of the remaining 3,315 from dogs of breeds other than Miniature Schnauzers were calcium oxalate. The odds that uroliths submitted for analysis were composed of calcium oxalate was 2 times greater for Miniature Schnauzers than for dogs of other breeds (95% confidence interval = 1.6 to 2.4). Calcium oxalate uroliths were retrieved more frequently in males than females. The risk for males developing calcium oxalate uroliths was greater than 3 times the risk for females in both groups of data evaluated. The mean age of all Miniature Schnauzers admitted to the UMVTH with calcium oxalate uroliths was 9 years. Calcium oxalate uroliths were not detected in Miniature Schnauzers younger than 1.7 years. PMID- 1767976 TI - Evaluation of urine and serum metabolites in miniature schnauzers with calcium oxalate urolithiasis. AB - To evaluate underlying causes of calcium oxalate urolithiasis, 24-hour excretion of urine metabolites was measured in 6 Miniature Schnauzers that formed calcium oxalate (CaOx) uroliths during periods when they were fed a standard diet and during periods when food was withheld. Serum concentrations of parathyroid hormone and 1,25-dihydroxyvitamin D also were evaluated. Serum calcium concentrations were normal in all 6 affected Miniature Schnauzers; however, during diet consumption, mean 24-hour urinary excretion of calcium was significantly (P = 0.025) higher than calcium excretion when food was withheld. In 1 dog, urinary calcium excretion was lower during the period of food consumption, compared with the period when food was withheld. Compared with clinically normal Beagles, Miniature Schnauzers that formed CaOx uroliths excreted significantly greater quantities of calcium when food was consumed (P = 0.0004) and when food was withheld (P = 0.001). Miniature Schnauzers that formed CaOx uroliths excreted significantly less oxalate than clinically normal Beagles during fed (P = 0.028) and nonfed (P = 0.004) conditions. Affected Miniature Schnauzers also excreted abnormally high quantities of uric acid. Excretion of citrate was not different between Miniature Schnauzers with CaOx urolithiasis and clinically normal Beagles. In 5 of 6 Miniature Schnauzers with CaOx urolithiasis, concentrations of serum parathyroid hormone were similar to values from age- and gender-matched Miniature Schnauzers without uroliths. The concentration of serum parathyroid hormone in 1 dog was greater than 4 times the mean concentration of clinically normal Miniature Schnauzers. Mean serum concentrations of 1,25 dihydroxyvitamin D in Miniature Schnauzers with calcium oxalate urolithiasis were similar to concentrations of clinically normal Miniature Schnauzers. PMID- 1767977 TI - Changes in linear dimensions of the heart, relative to body weight, as measured by M-mode echocardiography in growing dogs. AB - The growth of the heart, relative to body weight, was measured by M-mode echocardiography in dogs during the first year of life. Echocardiographic measurements were obtained from 16 English Pointers at 1, 2, 4, and 8 weeks of age and at 3, 6, 9, and 12 months of age. Left atrial (LA), aortic (AO), left and right ventricular internal dimensions, interventricular septal and left ventricular wall thickness measurements increased in curvilinear fashion relative to increasing body weight. Least-squares regression analysis, performed on logarithmically transformed data, was used to develop power-law equations describing the relationship of echocardiographic measurements to body weight. Linear dimensions of the LA, AO, left and right ventricular internal dimensions and interventricular septal and left ventricular wall thickness changed proportionally to slightly differing exponential powers of body weight (BW), varying from 0.31 to 0.45 (BW0.31 to BW0.45). Fractional shortening and the LA to AO ratio decreased slightly, but significantly, as body weight increased. Indexing echocardiographic measurements to BW1/3 was more appropriate than indexing such measures linearly to body weight, offering a practical method for developing accurate normative graphs or tables for M-mode echocardiographic dimensions in growing dogs. PMID- 1767978 TI - Static thoracic compliance as a measurement of pulmonary function in dogs. AB - Thoracic compliance measurements by use of readily available equipment were determined to be practical and safe in dogs. Twenty healthy dogs (age 1 to 16 years, weight 2.3 to 49.5 kg) were anesthesized for routine procedures such as dentistry or neutering. The animals were first hyperventilated to reduce pulmonary atelectasis, to check for leakage at the endotracheal tube cuff, and to induce mild hypocarbia, thus minimizing voluntary respiratory efforts. Total thoracic compliance measurements were calculated as the difference between exhaled volumes at static inspiratory pressures of 15 and 20 cm of H2O, divided by the pressure difference, and expressed as a function of body weight. The procedure was easy, took 5 to 10 minutes, and caused no recognizable ill effects in any of the dogs studied. Mean total thoracic compliance was 42.25 +/- 32 ml/cm of H2O. There was a significant correlation with weight, but no significant relationship was seen between compliance and age, or gender. The mean weight adjusted total thoracic compliance was 1.85 +/- 0.56 ml/cm of H2O/kg. In studies in a small group of dogs with documented respiratory tract disease, 4 of 7 had a mean compliance greater than 2 SD below the normal range. Thus, this test may become part of the routine workup of any animal being anesthetized for procedures such as bronchoscopy to evaluate respiratory tract disease. Routine monitoring of animals on ventilators could provide early warning of complications such as pneumonia, pleural effusion, or pulmonary edema. PMID- 1767979 TI - Hemodynamic response of calves to tiletamine-zolazepam-xylazine anesthesia. AB - Six healthy Holstein calves were anesthesized with isoflurane in O2 and instrumented for hemodynamic studies. A saphenous artery was catheterized for measurement of blood pressure and withdrawal of blood for determination of the partial pressure of carbon dioxide (PaCO2), oxygen (PaO2), and arterial pH (pHa). Respiration was controlled throughout the study. The ECG and EEG were monitored continuously. A thermodilution catheter was passed via the right jugular vein into the pulmonary artery for determination of cardiac output and measurement of central venous pressure, pulmonary arterial pressure, and pulmonary capillary wedge pressure. Baseline values (time 0) were recorded following recovery from isoflurane. Tiletamine-zolazepam (4 mg/kg)-xylazine (0.1 mg/kg) were administered IV immediately after recording baseline values. Values were again recorded at 5, 10, 20, 30, 40, 50, and 60 minutes after injection. Changes in left ventricular stroke work index, PaCO2, and pHa were insignificant. Arterial blood pressure and systemic vascular resistance increased above baseline at 5 minutes and then gradually decreased below baseline at 40 minutes, demonstrating a biphasic response. Values for pulmonary capillary wedge pressure, pulmonary arterial pressure, central venous pressure, and PaO2 were increased above baseline from 5 to 60 minutes. Stroke volume, stroke index, and right ventricular stroke work index were increased from 20 or 30 minutes to 60 minutes. Pulmonary vascular resistance increased at 10 minutes, returned to baseline at 20 minutes, and was increased again at 60 minutes. Heart rate, cardiac output, cardiac index, and rate pressure product were decreased at 5 minutes, and with the exception of cardiac output, remained so for 60 minutes. Cardiac output returned to the baseline value at 30 minutes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767980 TI - Use of nonimaging nuclear medicine techniques to assess the effect of flunixin meglumine on effective renal plasma flow and effective renal blood flow in healthy horses. AB - The effect of flunixin meglumine on renal function was studied in 6 healthy horses by use of nonimaging nuclear medicine techniques. Effective renal plasma flow (ERPF) and effective renal blood flow (ERBF) were determined by plasma clearance of 131I-orthoiodohippuric acid before and after administration of flunixin meglumine. Mean ERPF and ERBF was 6.03 ml/min/kg and 10.7 ml/min/kg, respectively, before treatment and was 5.7 ml/min/kg and 9.7 ml/min/kg, respectively, after treatment. Although ERPF and ERBF decreased after flunixin meglumine administration, the difference was not statistically significant. PMID- 1767981 TI - Influence of polysulfated glycosaminoglycan on equine articular cartilage in explant culture. AB - Articular cartilage explants from 3 horses were maintained in tissue culture to test the effects of a polysulfated glycosaminoglycan on proteoglycan biosynthesis. Cultures were exposed to concentrations of 0, 50, or 200 micrograms of the drug/ml for either 2 days or 6 days, and labeled with 35S, before measuring the content of sulfated proteoglycan in the culture media and in extracts of cartilage. In a second experiment, the explants were incubated with the isotope and subsequently exposed to the same concentrations of the polysulfated glycosaminoglycan for 4 days. Subsequently, the amount of remaining labeled proteoglycan was determined. Gel filtration chromatography was used to compare the hydrodynamic size of proteoglycans from the cartilage explants in each experiment. Polysulfated glycosaminoglycan caused a dose-dependent depression of sulfated proteoglycan synthesis, which was statistically significant after 6 days of exposure. Radioactive proteoglycan content in explants was similar in the experiment involving isotopic labeling prior to exposure to the drug. Proteoglycan monomer size was similar in all treatment groups. It was concluded that polysulfated glycosaminoglycan caused a modest depression in proteoglycan synthesis, had little effect on endogenous proteoglycan degradation, and did not influence the size of sulfated proteoglycans synthesized by normal equine chondrocytes in explant culture. PMID- 1767982 TI - Pharmacokinetics of rifampin in adult sheep. AB - Pharmacokinetics and bioavailability of rifampin in adult sheep were investigated by use of high-performance liquid chromatography for determination of serum concentrations. Eight adult ewes were given rifampin PO at the rate of 50 mg of rifampin/kg of body weight. Three weeks after the first experiment, the sheep were given rifampin PO and IV at the rate of 20 mg/kg in a cross-over design, with 1 week between treatments. Serum obtained over a 36-hour period was analyzed for rifampin and a potential metabolite, 25-desacetyl-rifampin, using reverse phase chromatography with UV detection at 254 nm. Data were analyzed by compartmental and noncompartmental models. Analysis by the noncompartmental model of rifampin serum concentrations after IV administration yielded a mean +/- SD total body clearance of 1.16 +/- 0.21 ml/min/kg, apparent volume of distribution at steady state of 0.45 +/- 0.06 L/kg, and terminal elimination rate constant of 0.15 +/- 0.04 hour-1. The harmonic mean of the elimination half-life was 4.56 hours. Because of incomplete and continuing absorption, bioavailability was extremely variable after oral administration. Desacetyl-rifampin was not detected. On the basis of pharmacokinetic values, serum concentrations measured in this study, and published minimal inhibitory concentrations, the dosage of 20 mg of rifampin/kg, PO, every 24 hours should provide adequate serum concentrations for treatment of rifampin-susceptible bacterial infections in sheep. PMID- 1767983 TI - Pharmacokinetic properties of doxorubicin encapsulated in glutaraldehyde-treated canine erythrocytes. AB - Canine erythrocytes were loaded with the antineoplastic drug doxorubicin and then treated with 0.16% glutaraldehyde. This procedure has been previously shown to slow down the efflux of doxorubicin from erythrocytes and to result in the selective targeting of the carrier erythrocytes to liver. Three dogs were treated each with 2 different schedules of IV bolus administration of doxorubicin (0.4 mg/kg of body weight): free drug and doxorubicin encapsulated in glutaraldehyde treated erythrocytes. The 2 treatments yielded consistent differences in the plasma pharmacokinetic properties of doxorubicin and of its only metabolite, doxorubicinol. A triphasic exponential decay of doxorubicin plasma concentrations was observed on injection of the free drug. Conversely, in the case of erythrocyte-encapsulated doxorubicin, 4 phases of plasma concentrations of doxorubicinol were found. The plasma concentrations of doxorubicinol, after a steady increase during the first hour, followed patterns of decay comparable to those of the parent drug. On the basis of the kinetic variables calculated with the 2 administration schedules, area under curve concentrations of plasma doxorubicin were 136 micrograms.h/L (free infusion) and 734 micrograms.h/L (erythrocyte-encapsulated drug). Significant alterations of hematologic and hematochemical factors were not observed in the 3 dogs during and after the 2 treatments. On the basis of our findings, doxorubicin-loaded and glutaraldehyde treated erythrocytes may potentially be used in the treatment of systemic and hepatic tumors in dogs. PMID- 1767984 TI - Preclinical evaluation of L-asparaginase and methotrexate administered at intermediate doses in dogs. AB - The role of L-asparaginase (L-ASP) in limiting signs of methotrexate (MTX) toxicosis was studied. Eight dogs were randomly allotted to 2 groups of 4 dogs. All dogs were given 400 IU of L-ASP/kg of body weight IM, on day 1. On day 10, group-1 dogs were given 3 mg of MTX/kg, IV, and group-2 dogs were given 6 mg of MTX/kg, IV. All dogs were given 400 IU of L-ASP/kg, IM, 24 hours later (on day 11). One group-2 dog was euthanatized on day 16 because of severe gastrointestinal signs that were unresponsive to treatment. A second dose of MTX, identical to that given on day 10, was given on day 20 to each surviving dog, followed by L-ASP on day 21. On day 67, the 7 surviving dogs were given 3 mg of MTX/kg, IV. Adverse reactions observed were vomiting, diarrhea, and weight loss. Gastrointestinal side effects of MTX were not attenuated with L-ASP and would be a serious limitation to use of MTX administered at an intermediate dose in the treatment of lymphoma in dogs. PMID- 1767985 TI - Effect of vaccination with a monovalent Leptospira interrogans serovar hardjo type hardjo-bovis vaccine on type hardjo-bovis infection of cattle. AB - Effectiveness of 2 concentrations of a monovalent vaccine containing Leptospira interrogans serovar hardjo type hardjo-bovis was evaluated for protection of heifers from infection with type hardjo-bovis. Nine heifers were given 2 doses of low-dose vaccine (8.32 x 10(8) cells/dose); 9 heifers were given 2 doses of high dose vaccine (8.32 x 10(9) cells/dose); and 1 steer and 1 heifer were maintained as nonvaccinated controls. Groups of vaccinated cattle were challenge-exposed with serovar hardjo type hardjo-bovis at 7 (n = 6), 11 (n = 6), or 15 (n = 6) weeks after completion of vaccination. All cattle were challenge-exposed by conjunctival instillation of 1 x 10(5) hardjo-bovis cells on 3 consecutive days. Both control and all vaccinated cattle became infected and shed serovar hardjo type hardjo-bovis in their urine. Leptospires were detected in 15 of 16 (94%) urine samples from control cattle and in 124 of 143 (87%) samples from vaccinated cattle. Leptospires were detected in kidneys of 17 of 18 vaccinated cattle and 2 of 2 control cattle and in the uterus or oviducts of 13 of 18 vaccinates and the 1 control heifer. PMID- 1767986 TI - Electrophoretic profiles of Pasteurella multocida isolates from animals with hemorrhagic septicemia. AB - We determined that the protein profiles of 14 isolates from animals with hemorrhagic septicemia were relatively homogeneous and could be placed in 2 distinct groups on the basis of their country of origin. Such differences correlated with the serotypic properties of the individual isolates; hemorrhagic septicemia isolates of Asian and North American origin (Carter B) had a major protein band with an apparent molecular mass of 32 kDa, whereas those of African origins (Carter E) had a major protein band with an apparent molecular mass of 37 kDa. The possession of a major 32-kDa protein band appeared to be unique to Carter B isolates, suggesting that electrophoresis may be a useful nonserologic technique for the identification of organisms of this serotype. Other major bands with apparent molecular masses of 27, 45, and 47 kDa were shared by all strains, regardless of their serotype. The lipopolysaccharides were of low molecular mass and relatively uniform from 1 isolate to the next. PMID- 1767987 TI - Resistance to antimicrobial agents and prevalence of R plasmids in Pasteurella multocida from swine. AB - Twenty-nine field isolates of porcine Pasteurella multocida were characterized for their capsular and somatic types and were evaluated for their susceptibility to 10 antimicrobial agents. Plasmid DNA-screening experiments were conducted to determine whether a relationship existed between the presence of plasmids and antibiotic resistance. Field isolates of P multocida were susceptible to most of the antimicrobials tested, but all isolates were resistant to clindamycin. Eleven isolates of serogroup D were resistant to 1 or 2 antimicrobial agents. Resistance to sulfonamides and streptomycin was observed in 7 isolates. These isolates contained R plasmids conferring resistance to streptomycin and sulfonamides. The R plasmids belonged to 2 groups, one of 5.6 kilobase and the other of 5.9 kilobase. Restriction endonuclease mapping and DNA hybridization revealed that these R plasmids were related to RSF1010 from Salmonella panama, which also confers resistance to streptomycin and sulfonamides. PMID- 1767988 TI - Effect of endocytic and metabolic inhibitors on the internalization and intracellular growth of Brucella abortus in Vero cells. AB - Uptake, transfer to rough endoplasmic reticulum, and intracellular growth of Brucella abortus were studied in Vero cells treated with endocytic and metabolic inhibitors. Infection of Vero cells was suppressed when inhibitors of energy metabolism (iodoacetate, dinitrophenol), receptor-mediated endocytosis (monodansylcadaverine, amantadine, methylamine), or endosomal acidification (chloroquine, ammonium chloride, monensin) were added to the inoculum. Inhibition was not observed when these drugs were added after the inoculation period. Infection of Vero cells by B abortus was inhibited by dibutyryl-cyclic adenosine monophosphate and Vibrio cholerae enterotoxin, but was stimulated by dibutyryl cyclic guanosine monophosphate and escherichia coli heat-stable enterotoxin a. Uptake of B abortus by Vero cells was not prevented by colchicine, but was abolished by cytochalasin B. Uptake of heat-killed B abortus and noninvasive E coli was similar to that of viable brucellae. Intracellular growth of B abortus was not affected by cycloheximide. Results indicate that: B abortus may be internalized by a receptor-mediated phagocytic process; transfer of B abortus from phagosomes to rough endoplasmic reticulum may require endosomal acidification; and replication of B abortus within the rough endoplasmic reticulum may not depend on protein synthesis by the host cell. PMID- 1767989 TI - Pulmonary particle deposition and airway mucociliary clearance in cold-exposed calves. AB - Effect of cold-induced changes in respiratory pattern on pulmonary particle deposition was investigated in 10 male Holstein calves between the ages of 1 and 3 months. Deposition of intranasally instilled fluorescence-enhanced Pasteurella haemolytica was significantly higher (P less than 0.05) for cold-exposed calves and appears to be caused by the cold-induced respiratory pattern change. Deposition was greater in apical and mediastinal lung lobes, but the reason for this preferential deposition is uncertain. Nasal mucus velocity was measured in 4 nonanesthetized calves at ambient temperature of 2 to 4 C and 16 to 18 C, using tantalum-paraffin oil droplets and serial radiography. Nasal mucus velocity was 24% lower during cold exposure. In addition, the effect of mucosal temperature on tracheal mucus velocity was determined in excised tracheas from 7 calves. A direct relationship existed between mucosal temperature and tracheal mucus velocity within the mucosal temperature range studied (35.0 to 39.5 C). Tracheal air temperature measurements in calves at ambient temperatures of -10.4 C (n = 4) and 18.5 C (n = 5) indicated that conditioning of inspired air is not complete at the tracheal level during extreme cold exposure. Therefore, cold air may directly influence tracheal mucociliary clearance. It is speculated that cold exposure increases pulmonary deposition of pathogens, while simultaneously decreasing mucociliary clearance of the upper airways, thus predisposing cold-exposed calves to respiratory tract infection. PMID- 1767990 TI - Dynamic baroreflex sensitivity in anesthetized horses, maintained at 1.25 to 1.3 minimal alveolar concentration of halothane. AB - Dynamic baroreflex sensitivity for increasing arterial pressure (DBSI) was used to quantitatively assess the effects of anesthesia on the heart rate/arterial pressure relationship during rapid (less than or equal to 2 minutes) pressure changes in the horse. Anesthesia was induced with IV administration of xylazine and ketamine and maintained with halothane at a constant end-tidal concentration of 1.1 to 1.2% (1.25 to 1.3 minimal alveolar concentration). Systolic arterial pressure (SAP) was increased a minimum of 30 mm of Hg in response to an IV bolus injection of phenylephrine HCl. Linear regression was used to determine the slope of the R-R interval/SAP relationship. During dynamic increases in SAP, a significant correlation between R-R interval and SAP was observed in 8 of 8 halothane-anesthetized horses. Correlation coefficients between R-R interval and SAP were greater than 0.80 in 5 of 8 horses. Mean (+/- SD) DBSI was 4.8 +/- 3.4 ms/mm of Hg in anesthetized horses. A significant correlation between R-R interval and SAP was observed in only 3 of 6 awake horses during dynamic increases in SAP. Lack of correlation between R-R interval and SAP in 3 of 6 awake horses indicated that rapidly increasing SAP with an IV phenylephrine bolus is a poor method to evaluate baroreceptor-mediated heart rate changes in awake horses. Reflex slowing of heart rate in response to a rising arterial pressure appeared to have been overridden by the effects of excitement. Mean (+/- SD) DBSI (3 horses) was 7.3 +/- 3.3 ms/mm of Hg in awake horses. PMID- 1767991 TI - Effect of whole-body potassium depletion on plasma, erythrocyte, and middle gluteal muscle potassium concentration of healthy, adult horses. AB - The effects of whole-body potassium depletion induced by food deprivation on plasma, erythrocyte, and middle gluteal muscle K concentrations was quantified in 16 healthy, adult horses before, during, and at the end of a 7-day period of food deprivation during which water and sodium chloride were available ad libitum. Potassium concentrations were determined by atomic absorption spectroscopy. Plasma K concentration remained constant (3.49 +/- 0.09 mM K/L of plasma; mean +/ SEM) throughout the study. Erythrocyte potassium concentration decreased from 93.10 +/- 1.94 mM K/L of erythrocytes on day 0 to 88.63 +/- 2.39 mM K/L of erythrocytes on day 2 (decrease of 4.8%; P less than 0.05) and thereafter did not change. The K concentration of the middle gluteal muscle decreased from 91.06 +/- 2.96 microM K/g of muscle (wet weight) to 79.61 +/- 2.09 microM K/g of muscle (decrease of 12.6%; P less than 0.05) on day 4 and decreased further on day 7 to 73.62 +/- 1.85 microM K/g of muscle (decrease of 19.2%; P less than 0.05). There was no correlation between the plasma and erythrocyte K concentrations (r = 0.066), the erythrocyte and middle gluteal muscle K concentrations (r = 0.167), or the plasma and middle gluteal muscle potassium concentrations (r = -0.018). The water content of the middle gluteal muscle remained constant (73.23 +/- 0.36%) throughout the study. Erythrocyte membrane potential did not change ( 99.26 +/- 0.87 mV) during the study, whereas the magnitude of the membrane potential of the middle gluteal muscle decreased from -105.84 +/- 1.67 mV on day 0 to -100.93 +/- 2.10 mV on day 7 (P less than 0.05). PMID- 1767992 TI - Effect of a passive heat and moisture exchanger on esophageal temperature in tumor-bearing dogs during whole-body hyperthermia. AB - The effect of a passive heat and moisture exchanger on tracheal and large airway temperature, as reflected by esophageal temperature at the thoracic inlet, was determined for 12 anesthetized and ventilated tumor-bearing dogs undergoing whole body hyperthermia at 42 C. Delivered thermal dose to the esophagus and rectum during 120 minutes of whole-body hyperthermia was quantified as the thermal dose summary measure EQ43. The heat and moisture exchanger significantly increased esophageal EQ43 from 7.3 minutes to 12.1 minutes. Esophageal EQ43, however, remained lower than rectal EQ43. Although use of a heat and moisture exchanger improved esophageal temperature during whole-body hyperthermia, presumably through improved airway temperature, additional methods will be necessary to increase esophageal and airway temperature to the target value of 42 C. PMID- 1767993 TI - Mass screening of cattle sera against 14 infectious disease agents, using an ELISA system for monitoring health in livestock. AB - Mass screening ELISA methods were developed for testing cattle serum for antibodies against 14 common livestock diseases simultaneously. The absorbance values were transformed to a %ELISA (spectrophotometric antibody end point) by a computer interfaced with a microplate reader. A histogram indicating a cutoff point and a report for the veterinarian also was generated. The computer program produced a print-out of the antibody profile for each animal tested, the antibody concentration against each disease, and a histogram (antibody profile) showing the prevalence of each disease in the herd. Serum samples were obtained from 1,953 cattle, including 880 dairy cattle from 10 herds and 1,073 beef cattle from 20 herds. These samples were obtained from June 1988 through June 1989. The highest antibody prevalence was against bluetongue virus. Of the 1,953 cattle tested, 1,223 (63%) were seropositive for bluetongue virus, including 502 (57%) of the dairy cattle and 721 (67%) beef cattle. Other antibody prevalences, in descending order, were: rotavirus (44%), Pasteurella spp (25%), Leptospira spp and Haemophilus spp (22%), Mycoplasma spp (18%), parainfluenza virus (17%), Campylobacter spp (16%), Anaplasma marginale (15%), bovine leukosis virus (13%), Brucella spp (8%), Mycobacterium paratuberculosis (8%), bovine viral diarrhea virus (3%), and infectious bovine rhinotracheitis virus (3%). Major differences in antibody prevalence between dairy and beef cattle were that only 4% of the dairy cattle were seropositive for A marginale, compared with 25% of the beef cattle, and conversely, 29% of the dairy cattle were seropositive for bovine leukosis virus, compared with 1% of the beef cattle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1767994 TI - Pathophysiologic effects of Ostertagia ostertagi in calves and their prevention by strategic anthelmintic treatments. AB - Pathophysiologic effects of Ostertagia ostertagi infection and their prevention by strategic anthelmintic treatments were studied in 3 groups each of 6 steer calves. Group-1 calves were noninfected controls. Group-2 calves were inoculated with 100,000 third-stage larvae on the 1st and 28th days of the experiment and grazed on pasture initially free of contamination. Group-3 calves were on a similar regimen as those in group 2, but were also treated with ivermectin 9 days after each larval inoculation. Group-2 calves had increased plasma pepsinogen and gastrin values and decreased weight gains, and total serum protein and albumin concentrations from the 2nd week of infection onward. They were anemic at 10 to 12 weeks and had lower carcass and meat quality at slaughter. Strategic anthelmintic treatments were effective in preventing these effects and calves in groups 1 and 3 had similar performances. On the basis of our findings, high pepsinogen values were related to worm burdens, whereas high gastrin concentrations were related to gastric lesions. PMID- 1767995 TI - Epizootiology of helminth parasitism in a beef cow/calf herd in Minnesota. AB - To test the effect of a parasite control program for cattle, 2 groups of similar composition were grazed on separate, but equivalent, improved pastures. Cattle in 1 group were treated with fenbendazole at 5.0 mg/kg of body weight at the time they were turned out on pasture in the spring and again at midsummer, when the cattle were moved to a new pasture. The control group was not treated. Parasite egg counts were significantly (P less than 0.04) lower in the treated group. Trichostrongyle-type eggs were the most prevalent throughout the year, except in the month of May, when Strongyloides papillosus eggs were predominant. The number of worms recovered from tracer calves was lower for those on pastures where the treated group grazed than for those on the control group's pasture. The most consistently recovered parasite was Ostertagia ostertagi, and hypobiosis was observed. PMID- 1767996 TI - Pathologic changes, tissue distribution, and extent of conversion to ethylenethiourea after subacute administration of zinc ethylene-bis dithiocarbamate (zineb) to calves with immature rumen function. AB - The toxicity of zinc ethylene-bis-dithiocarbamate (zineb), a widely used fungicide, was studied in four 4-week-old Friesian calves with immature rumen function. Calves were first subjected to liver biopsy, and thereafter, 3 of them were orally administered 200 mg of zineb/kg of body weight daily for 80 days, whereas the fourth calf served as control and remained untreated. Clinical, hematologic, and pathologic (including ultrastructural) findings were recorded. The distribution in body fluids and tissues of the parent compound and one of its main metabolites, ethylenethiourea (ETU), also was examined. Treated calves had unthrifty appearance and reduction in weight gain. They also had remarkable impairment of thyroid function, as reflected by reduction in serum concentrations of triiodothyronine and thyroxine and increase in weight of the thyroid gland associated with epithelial vacuolization and foci of hyperplasia. Moderate increase in liver glycogen content and impairment in maturation of germ cells were recorded consistently. Whereas zineb was widely distributed in body tissues, ETU accumulated mainly in the liver and the thyroid gland, although noticeable concentrations also were attained in muscle. Data were consistent with involvement of ETU mainly in the pathogenesis of thyroid gland lesions, and indicate that unweaned calves given zineb develop a clinicopathologic syndrome that does not differ qualitatively from that already described in adult cattle exposed to zineb. PMID- 1767997 TI - Association of environmental air contaminants with disease and productivity in swine. AB - A cross-sectional epidemiologic study associating air quality with swine health was conducted on 28 swine farms in southern Sweden. Correlation of housing air environment to swine diseases and productivity (data collected over the preceding 12 months) were investigated. The most prevalent swine health problems detected at slaughter were pneumonia and pleuritis. In farrowing and nursery operations, the most prevalent problem was neonatal pig mortality. Several air contaminants (dust, ammonia carbon dioxide, and microbes) were found to be correlated with these swine health problems. Maximal safe concentrations of air contaminants were estimated on the basis of dose-response correlation to swine health or human health problems. Recommended maximal concentrations of contaminant were: dust, 2.4 mg/m3; ammonia, 7 ppm; endotoxin, 0.08 mg/m3; total microbes, 10(5) colony forming units/m3; and carbon dioxide, 1,540 ppm. The overall quality of the ventilation system was correlated with lower concentration of ammonia, carbon dioxide, microorganisms, and endotoxin, but not with dust concentrations. High animal density was related to high ammonia and air microbe concentrations. Animal density measured as kilograms of swine per cubic meter (compared with kilograms of pig weight or swine per square meter) had the highest correlation to animal health and air contaminants. PMID- 1767998 TI - Evaluation of the instantaneous centers of rotation of the stifle before and after repair of torn cruciate ligament by use of the over-the-top technique in dogs. AB - Seven dogs with torn cruciate ligament were used to evaluate the "over-the-top" repair procedure, using instantaneous center of rotation (ICR). Normal and cruciate-torn stifles of dogs were radiographed before surgery, using an image intensifier videotape system. The injured stifle was reradiographed 6 weeks after surgery. Images of the stifles were photographed from video monitor. Photographs were analyzed by a digitizer hooked to a computer to find the ICR at various angles. Data were analyzed, using multivariate analysis of variance. Relative to those of normal stifles, ICR of the damaged stifles were located significantly (P less than 0.05) proximal and caudal. After surgery, the ICR were still proximal and caudal, but not significantly so. We conclude that the cruciate-torn stifle deviates significantly from normal and that such deviation is restored to normal limits by use of the over-the-top procedure. PMID- 1767999 TI - Haptoglobin and ceruloplasmin as determinants of inflammation in dogs. AB - Assay procedures for determining serum haptoglobin concentration and ceruloplasmin oxidase activity in dogs were validated, and reference values were established. Serum haptoglobin concentration is reported as milligrams per deciliter of cyanmethemoglobin binding capacity, whereas serum ceruloplasmin oxidase activity was determined by use of p-phenylenediamine as substrate. Both assays were used to analyze serum samples from 288 dogs. In each dog's case record, clinical history and final diagnosis were evaluated to determine whether the dog had an inflammatory condition. Complete blood cell counts were performed in 265 dogs, using simultaneously collected blood samples. Plasma fibrinogen concentration was determined for 161 dogs. A positive correlation (P less than 0.01) for serum haptoglobin concentration and for ceruloplasmin oxidase activity, compared with WBC counts, segmented neutrophil and band neutrophil counts, and plasma fibrinogen concentration. Ceruloplasmin oxidase activity and haptoglobin concentration were up to 6 times more sensitive than fibrinogen concentration or leukocyte counts in detecting inflammation. Specificity of ceruloplasmin oxidase activity was comparable to fibrinogen concentration and leukocyte counts, whereas haptoglobin concentration was found to be slightly less specific. Specificity of haptoglobin concentration improved slightly (from 0.82 to 0.88) when dogs with a history of glucocorticoid administration were excluded from analysis. Predictive value of a negative test result (haptoglobin concentration less than 125 mg/dl; ceruloplasmin oxidase activity less than 20 IU/L) and predictive value of a positive test result for haptoglobin concentration and ceruloplasmin activity were comparable to or better than fibrinogen concentration or various oxidase leukocyte counts in detection of inflammation in a variety of disease conditions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768000 TI - Effects of diet on acidic and neutral goblet cell populations in the small intestine of early weaned pigs. AB - Effects of dietary manipulation on Alcian blue-positive (AB+) and periodic acid Schiff-positive (PAS+) goblet cell populations were determined for the villi and intestinal crypts in the small intestine of early weaned pigs. Pigs were weaned at 21 days of age and samples from the distal portions of the duodenum and the middle and distal portions of the jejunum were obtained when pigs were 21, 24, 27, 30, 33, and 36 days old. Pigs were assigned to 1 of 3 dietary treatments; all diets contained 20% protein, on the basis of hydrolyzed casein, soybean meal, or corn-soybean meal. By day 24, three days after weaning, the populations of AB+ and PAS+ goblet cells were markedly decreased, regardless of diet. Goblet cell populations in the villi tended to increase from 3 to 15 days after weaning, whereas those in the intestinal crypts remained low throughout the study. Differences between any of the dietary treatments were not apparent for AB+ or PAS+ goblet cell populations in the villi or in the intestinal crypts. It appeared that early weaning per se, and not diet, was the primary cause for decreases in goblet cell populations. PMID- 1768002 TI - Statements from the International Committee of Medical Journal Editors. PMID- 1768001 TI - Histopathologic features, environmental factors, and serum estrogen, progesterone, and prolactin values associated with ovarian phase and inflammatory uterine disease in cats. AB - Forty-four female American Shorthair cats with inflammatory uterine disease or infertility were evaluated. Data collected included age, month of diagnosis, housing, reproductive history, results of bacteriologic culture of uterine specimens, serum concentrations of estrogen, progesterone, and prolactin and histopathologic features of the ovaries and uterus. Histologically, the ovaries of 19 cats were dominated by active or cystic follicles, whereas 25 cats had luteal-phase ovaries. Of the 25 cats with active corpora lutea, 20 had either recently weaned litters (n = 11) without subsequent exposure to a male cat, or had been housed individually for lengthy periods (n = 9). The finding of active corpora lutea under these circumstances indicates that in queens, ovulation may occur by mechanisms not involving coitus. Prominent, active corpora lutea on the ovaries were associated with adenomatotic proliferative changes in the superficial and glandular epithelium of the uterus and with myometrial hyperplasia, compared with the uterus of cats with follicular ovaries (P less than 0.01). Serum progesterone concentration greater than or equal to 1.87 ng/ml was consistently associated with luteal-phase ovaries. Serum progesterone values less than or equal to 0.15 ng/ml were consistently associated with follicular phase ovaries. Escherichia coli was the organism most commonly isolated from uterine contents. PMID- 1768003 TI - Recurrent acute pancreatitis as a complication of cystic fibrosis: report of one case treated surgically. AB - We present the case of a young woman previously diagnosed with cystic fibrosis (CF) manifested primarily by respiratory symptoms and pancreatic exocrine insufficiency. Only 0.5% of these patients suffer from episodes of recurrent acute pancreatitis, the majority of which respond to conservative treatment. In this case, recurrent episodes of acute pancreatitis made it necessary to perform a surgical pancreatic drainage procedure. PMID- 1768004 TI - [Adenocarcinoma of the cardia: results of resection with nic interposition]. AB - The incidence of cancer of the cardia is increasing. Surgical treatment, in a small percentage of patients in early stage, consists in esophagectomy and total gastrectomy, followed by colon interposition. The operation can be performed through the thorax or by an abdominal and cervical approach. From 1982 to 1989 twenty-five patients were operated on. Between 1980 and 1982 the cancer was resected opening the thorax in 9 patients (group A), while from 1983 to 1989 the esophagus was removed through diaphragmatic hiatus in 16 patients (group B). All cases were analyzed as for histology, staging and resection margin. Average clinical follow-up was 22 +/- 32.7 months (range 1-102). Morbidity was 77.7% in group A and 68% in group B. Mortality dropped to 14% in the last 7 patients. Mean survival time was 23 +/- 34 months in group A and 11.2 +/- 13.7 months in group B (p = N.S.). Follow-up controls showed that all patients, in whom the esophagus was replaced with colon, were able to feed adequately. PMID- 1768005 TI - [Human allogeneic cultured epidermis: medico-legal considerations]. AB - The possibility of cultivating in vitro human kerathinocytes has opened new prospectives in the surgical treatment of major burns and, generally, in patients with extensive skin loss (degloving, etc.). Epidermidal sheets, obtained in vitro, have been used initially, successfully, as autografts. Later, their peculiar immunological characteristic (absence of Langerhans cells expressing class II MHC antigens and inability of evocating omograft rejection) has allowed it's use as allograft without the need of resorting to treatment with immunosuppressive drugs. Medico-legal problems raised by the use of human epidermys cultivated as allograft are described hereafter. PMID- 1768006 TI - [Bibliographic information retrieval. Bibliographic Information Service care of the Central Library of the CNR]. PMID- 1768007 TI - Extrapolating from toxicity data to occupational exposure limits: some considerations. AB - This paper evaluates procedures relevant to extrapolating from toxicity data in man and animals to Occupational Exposure Limits. It examines effects at or around the "No Observed Adverse Effect Level' (NOAEL) and the magnitude of safety factors which can be applied in developing occupational exposure limits for non stochastic effects. The relationship between incidence of stochastic effect and occupational exposure limit is also discussed. PMID- 1768008 TI - Environmental study of firefighters. AB - A study of firefighter exposures was undertaken at the request of the U.S. Fire Administration. This work was part of a larger study which included field evaluation of the performance of the self-contained breathing apparatus (SCBA) worn by firefighters during structural firefighting. Measurements were made for a variety of contaminants including CO, CO2, benzene, HCN, HCl, H2SO4, HF, acrolein, CH4, formaldehyde and PNAs. Many of the analyses were performed by collection of bag samples followed by Fourier transform infrared spectroscopy using a field mobile spectrometer. Measurements were also made using solid sorbent tubes and direct-reading meters. Sampling was done both during the knockdown and during overhaul phases of structural firefighting. Also, in order to estimate exposures including those when the SCBAs were worn, measurements were made both inside and outside the SCBA facepiece. Carbon monoxide was the most common contaminant found during knockdown, and about 10% of the samples were greater than 1500 ppm. Formaldehyde, acrolein, hydrogen chloride, hydrogen cyanide, sulphuric acid and hydrogen fluoride all exceeded their respective short term exposure limits (STEL) on some occasions. Approximately 50% of the knockdown samples for acrolein exceeded the STEL. During overhaul, when masks were usually not worn, many of the contaminants found during knockdown were detected, but typically at much lower concentrations. Inside-mask sampling data suggest that exposure to low concentrations of a variety of compounds is occurring but this is believed to be principally the result of early mask removal or of non-use during knockdown rather than of leakage. The three basic sampling approaches (bag sampling, sorbent tubes and direct-reading meters) proved in this study to be complementary and served to maximize our ability to detect and quantify a wide range of combustion products. PMID- 1768009 TI - Validation of a high-performance liquid chromatography/fluorescence detection method for the simultaneous quantification of fifteen polycyclic aromatic hydrocarbons. AB - A high-performance liquid chromatography/fluorescence method using multiple wavelength shift for simultaneous quantification of different PAH compounds was developed. The new method was superior to the methods of DONG and GREENBERG [J. Liquid Chromatogr. 11, 1887-1905 (1988)] and WISE et al. [Polycyclic aromat. Hydrocarb. (in press)] with respect to sensitivity of detection of the majority of 15 PAH compounds, and in particular of naphthalene, acenaphthene, fluorene and benzo(b)fluoranthene. The method of validation analysis employed showed that the new method is in statistical balance meaning that no systematic errors, and only small unsystematic errors, could be demonstrated. Furthermore, the method had a good reproducibility and a high sensitivity. PMID- 1768010 TI - Relation between vibration levels and perceptive and appreciative judgements of overhead crane operators. AB - The objective of the study was to determine what conditions of exposure to vibrations were responsible for the complaints by workers and what the maximum acceptable vibration levels should be. Vibration was characterized by the unweighted intensity exceeded during 10% of the time (L10) and by the global weighted equivalent intensity (Leqw) during displacement phases and phases involving successive starts and stops or successive hookings and unhookings of the load. The opinions of the workers concerning the intensities of vibration and of shock, and their appraisal of the vibration, were collected. Results show that workers hardly discriminate between vibrations and shocks, and appear more sensitive to horizontal (X and Y axes) than to vertical (Z axis) vibration. Perception as well as appraisal votes are slightly better correlated with intensities of vibration not weighted according to frequency than with weighted intensities, and more with peak intensities (L10) than with r.m.s. values. The vibration intensity weighted globally, which was normally encountered and unpleasant, appears to be about 115 dB(w), which corresponds to the limit value for the intermediate criterion (efficiency reduced by fatigue) proposed by ISO 2631 (1978). PMID- 1768012 TI - Linear systems dynamics in toxicokinetic studies. AB - Linear systems dynamics are introduced to study kinetics particularly in experimental exposure to toxic agents and to extrapolate the experimental results to the field of occupational exposure. The relationship between the agent input (e.g. dose, external exposure) and the concentration-time curve [C(t)] in biological media plays a central part. When this relationship has been established the C(t) can be predicted or the dose as function of time can be estimated retrospectively on an individual basis. Linear systems dynamics offer a kinetic model-independent approach which means that no assumptions are required about compartments, bloodflows, partition coefficients, etc. The systems dynamics appear to be a powerful tool to predict the time courses of an agent or toxic metabolites in, for example, blood or a target organ on the basis of a short-term experimental exposure. The power of systems dynamics becomes obvious especially in the case of non-constant rates of inputs (dose) into systemic blood at, for example, dermal exposure. Also the systems approach appears to be suitable to determine the metabolic rate of entrance into the system blood as function of the parent agent or a second agent. The paper emphasizes the value of human exposure experiments under controlled conditions in order to verify the outcomes of physiologically based simulation models and to provide experimental data for these models. PMID- 1768011 TI - Survey of chemical exposures in a viscose rayon plant. AB - Measurements of carbon disulphide and hydrogen sulphide in a Belgian viscose rayon plant, using personal monitoring with charcoal tubes for carbon disulphide and impingers for hydrogen sulphide, showed considerable differences in the average exposure for the different jobs (3-147 mg m-3 for carbon disulphide and 0 9 mg m-3 for hydrogen sulphide). Air pollutants such as mercury and sulphuric acid, which have been reported in some other studies, were not present. The lead in blood concentration found in four plumbers ranged from 28 to 49 micrograms 100 ml-1. The implications of these findings for industrial hygiene and epidemiology are discussed. PMID- 1768013 TI - Elemental composition of airborne dust in the Shale Shaker House during an offshore drilling operation. AB - During 2 days of an offshore drilling operation in the North Sea, 16 airborne dust samples from the atmosphere of the Shale Shaker House were collected onto filters. During this operation, drilling mud composed of a water slurry of barite (BaSO4) together with minor amounts of additives, among them chrome lignosulphonate and chrome lignite, was circulated between the borehole and the Shale Shaker House. The concentration of airborne dust in the atmosphere was determined and the elemental composition of the particles analysed by both PIXE (proton-induced X-ray emission) and ICP-MS (inductively coupled plasma-mass spectrometry). The total amount of dust collected varied from 0.04 to 1.41 mg m-3 with barium (Ba) as the single most abundant element. The open shale shakers turned out to be the major cause of generation of dust from the solid components of the drilling mud. PMID- 1768014 TI - N-nitrosodiethanolamine in commercial cutting fluids without nitrites. AB - We have determined the concentration of N-nitrosodiethanolamine (NDELA) in 11 commercial 'nitrite-free' cutting fluids in Sweden in 1989. The concentrations in diluted fluids after use were 0.02-0.51 ppm. The concentrates contained 0.02-17 ppm. There was no correlation between the occurrence of formaldehyde-releasers, boramines or bacteria and the concentrations of NDELA. An additive in one fluid contained 140 ppm NDELA. The concentration of nitrite in the diluted fluids after use varied between 0 and 40 ppm. There was a correlation between the concentration of nitrite and NDELA. It is concluded that the concentration of NDELA can be low if the suppliers check their additives with regard to NDELA and the users check the concentration of nitrite. PMID- 1768015 TI - The Joint Education and Training Committee of the BOHS, IOH and BEBOH--a discussion on the future of occupational hygiene education and training in the U.K. AB - This paper begins by drawing a clear distinction between the principles of occupational hygiene, which may be used by many occupational safety and health practitioners, and the profession of occupational hygiene. A new definition of occupational hygiene, which focuses on the objective of promoting health by intervention in the workplace, is proposed. Occupational hygiene professionals should be able to carry out a wide range of activities allied to this objective, from recognizing factors which may affect workers' health to setting priorities for risk management. A description of the competence of a professional hygienist, based on a document produced by the World Health Organization, is presented. The interaction between the various occupational safety and health practitioners is explored and the increasing interaction between the different skill groups recognized. The changing pattern of hazards in the workplace and the changing role of the hygienist are also discussed. In particular, the necessity for hygienists to develop management skills is highlighted. The paper concludes that occupational hygiene education and training must reflect the changing hazards in the workplace and the current approaches to the management of the risks. PMID- 1768016 TI - Assessment of long-term exposures to toxic substances in air. PMID- 1768017 TI - [Tracheobronchial healing in lung or heart-lung transplantation. An anatomical study of forty anastomoses in men]. AB - The post operative evaluation and endoscopic follow-up of 34 tracheal or bronchial anastomoses after lung or heart-lung transplantation show some aspects of the tracheobronchial healing and difficulties in the healing process: primary type I mucomucosal healing in only 6 cases, secondary type II mucosal healing in 15, delayed type III healing after mucosal or deep parietal necrosis in 13, type IV distant ulcerations of mucosa and spur lesions in 12. Type III difficulties of healing mainly occur after double-lung transplantations which always suffer from ischemia. Autologous tracheal or bronchial sutures in 3 transplanted patients submitted to standard immunosuppressive therapy including corticosteroids were uneventful and type I. This experience suggests that among all factors having an influence on bronchial healing, ischemia of the donor tracheobronchial tree is predominant, justifying all attempts of bronchial revascularization after double lung transplantation. The efficacy of the arterial revascularization is verified in 3 cases of tracheal anastomosis after double-lung transplantation with type I or II tracheal healing. PMID- 1768018 TI - [A new technique for double lung transplantation. "The bilateral single lung transplantation". Apropos of ten operations]. AB - The technique of enbloc double lung transplantation described by the Toronto team, with cardiopulmonary bypass, cardioplegia, and tracheal suture is complicated by problems of tracheal anastomosis for its authors. Single lung transplantation has a more straight forward postoperative course and bronchial complications are moderate. We present a new technique of lung transplantation, the "bilateral single lung transplantation". It consists, via a single anterior horizontal incision, of successively performing two single lung transplantations without bypass. This operation has been performed ten times since November 1989. As expected, bronchial healing has been excellent. PMID- 1768019 TI - [Coronary revascularization by long endarterectomy and reconstruction]. AB - Endarterectomy and reconstruction of the coronary arteries is a technique for patients with diffuse coronary disease and in whom coronary bypass grafting is contraindicated. In a serie of 418 patients undergoing coronary bypass between May 1988 and April 1990, 55 had endarterectomy and reconstruction of a coronary artery. The mean age was 62.2 years (44-80 years). Twenty-five patients had class III (NYHA) angina and 30 had class IV angina. On the coronary angiogram, 10 patients had double-vessel disease and 45 had triple vessel disease. Endarterectomy and reconstruction were performed on one coronary artery in 53 patients and on two coronary arteries in 2 patients. At mean of 2.6 grafts per patient were performed. Four patients died during the perioperative period. Ten had a perioperative myocardial infarction. No other complications were noted. No residual postoperative angina was present. Five patients had a follow-up angiogram during the first postoperative month. All grafts were patent and correctly revascularised the endarterectomised artery and branches. These satisfactory preliminary results suggest that endarterectomy and reconstruction of the coronary arteries is a reliable and reproducible technique for coronary grafting. It is indicated in patients with diffuse atheromatous coronary disease who were previously not considered for surgery. PMID- 1768020 TI - [Aneurysm of a saphenous vein aortocoronary graft. Apropos of a case presenting with a presternal mass and review of the literature]. AB - A 61 year old man was admitted with a pulsatile pre-sternal swelling ten years after saphenous vein coronary-artery bypass grafting. The precise diagnosis of this vascular tumor was not established despite various investigations. At reoperation, an aneurysm of the saphenous vein graft, eroding the sternum, was found. This rare complication of saphenous vein coronary artery bypass grafting is described and a review of the literature is presented. Reoperation is mandatory for this uncommon alteration of the saphenous vein graft. PMID- 1768021 TI - [One year results of sequential mammary artery anastomoses. 120 clinical cases. Angiographies: 71 patients]. AB - From 1985 to november 1989, 270 patients underwent sequential anastomosis with left internal mammary artery (LIMA) on left descending artery (LDA) and diagnonal artery (DA). The first 120 cases have 100% one year follow-up. The perioperative status was: angina stage III or IV: 59%; myocardial infarction (MI): 45%, stenosis of 3 vessels: 52.5%; stenosis of main coronary artery: 10.8%. 2.25 anastomoses were performed per patient. Side-to-side anastomosis (kissing) were not diamond anastomoses but axial and longitudinal. The use of fibrin gllude provides regular curves of the graft between anastomosis. Mortality was 0.8%, morbidity was: MI: 4.2% (2 small infarcts in anterior vessels, 3 others in non grafted vessels); mediastinitis: 1%; severe bleeding (reoperation): 1%. At one year 93% of patients are free from angina and 71 patients underwent angiographic assessment (145 LIMA anastomosis). Results are as follow: side-to-side anastomosis patency: 98.5%; distal anastomosis obliteration: 3%; LDA anastomosis patency: 95.7% overall sequential anastomosis patency: 97.6%. These results have led our cardiologist in Brest to naturally prefer a surgical approach than percutaneous angioplasty when LDA and DA are involved. PMID- 1768022 TI - [Non-aplastic N2 operated bronchial cancers. Multifactorial analysis of the prognosis]. AB - The marked disparity of the published 5-year survival rates (0 to 3%) for non anaplastic, operated N2 lung cancers would suggest the marked heterogeneity of the patients studied. We prospectively studies 97 N2 tumours for which "curative" resection was performed between 1983 and 1986. The overall survival rate was 28% at 3 years, 19% at 4 years and 12% at 5 years. Survival was studied on the basis of several parameters concerning the tumour: histological type and degree of differentiation, T (TNM), modality of invasion (circumscribed, infiltrating), the quality of the stroma (absent, fibrotic, cellular), the mitotic index, the necrosis rate, presence or absence of microscopic invasion of blood vessels; and concerning the nodes: site, number (solitary, multiple), size of the metastasis (massive, microscopic), macroscopic or microscopic invasion of the capsule. We know the outcome for all of our patients: 81 have died and 16 are still alive. Sixty-one have developed metastases, 5 have developed local and regional recurrences and 3 have both a recurrence and metastases. Univariate analysis demonstrated that a small number of parameters significantly influence survival: microscopic invasion of blood vessel (chi 2 = 5.24, p less than 0.02), macroscopic and microscopic invasion of the lymph node capsule. In order to more clearly define the prognostic factors, we used Cox's multidimensional model. This model was applied to the three significant parameters to which we added two other variables which non-significantly tended to be related to survival: tumour necrosis and number of lymph nodes involved.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768023 TI - [Stage III bronchial cancers. Results of a series in surgery]. AB - The aim of this study was to determine immediate and long term prognostic factors after resection of stage III lung cancer. From 1981 to 1987, 188 consecutive patients (136 stage III A and 52 stage III B) underwent resection of a primary lung cancer. Mortality (5.8 per cent) and morbidity were not influenced by age of the patient, the type of procedure (lobectomy or pneumonectomy) or the stage A or B of the cancer. But mortality was significantly increased by alteration of four ventilatory parameters. Actuarial survival was significantly better for stage III A (56%, 34 or 7 at 1, 2 and 5 years) than for stage III B (35, 18, 0 respectively). Survival was also influenced by: the quality of the resection: 15 months median survival if curative, 5 months if palliative; the tumour volume: 65%, 47, 18 at 1, 2 and 5 years if the diameter of the tumour was less than 5 cm, and 49, 31, 0 respectively if the diameter was greater than 5 cm. The authors conclude that identification of these factors is determinant to discuss prognosis and to plan treatment. PMID- 1768024 TI - [Acute neoplastic arterial embolism after pneumonectomy for primary bronchial cancer. Clinical and therapeutic consequences apropos of a case]. AB - We report a case illustrating the therapeutic consequences of an intravenous metastasis to the left superior pulmonary vein following resection of a voluminous primary lung carcinoma. Arterial spread of malignant cells occurred because the size of the tumor did not allow immediate clamping of the left superior pulmonary vein. The embolism was situated at the aortic bifurcation and lower limb ischemia persisted despite also emergency embolectomy. Distal (lower popliteal) embolectomy was also unsuccessful, and lower limb amputation was inevitable. This case illustrates the problems encountered in surgical treatment of pulmonary vein invasion by lung carcinoma and the role of adjuvant chemotherapy and radiotherapy. PMID- 1768025 TI - [Reduction in the incidence of postoperative diaphragmatic paralysis by using a phrenic nerve protector]. AB - A prospective study of a consecutive series of 100 patients in whom a phrenic nerve protector was used during cardiac surgery under CPB demonstrated the existence of one case of postoperative left phrenic nerve palsy and three cases of postoperative right phrenic nerve palsy. Comparison with a previous series taken as the control revealed a very significant reduction in the incidence of left phrenic nerve palsy which decreased from 8% to 1%. The incidence of right phrenic nerve palsy was not significantly decreased which corroborates the role of pericardial cooling in the aetiology of these palsies and the absence of protection of the right phrenic nerve by the system used. PMID- 1768026 TI - [Danger to spinal cord arterial vascularization during surgery for neurogenic tumors of the posterior mediastinum]. AB - The authors report one case of posterior mediastinal neurinoma with a Adamkiewicz artery arising at an atypical site. They stress the spinal cord complications following thoracic surgery. The value of spinal cord arteriography during preoperative examinations and for prevention of complications is discussed. PMID- 1768027 TI - [Rare tumor of the posterio-superior mediastinum. Therapeutic approach. Apropos of a case. Review of the literature]. AB - The authors report an exceptional case of giant cell tumour of the third thoracic vertebra revealed by its mediastinal development. Despite intimate involvement of the large mediastinal vessels, a double surgical approach, starting with sternotomy to ensure vascular control then anterolateral thoracotomy, allowed curative resection of this tumor. Treatment was completed by a second neurosurgical operation followed by 5,000 rads of radiotherapy. Based on a review of the literature, the authors discuss the pathogenesis and consider the various therapeutic problems raised by giant cell tumours of the vertebrae (situated above the sacrum). PMID- 1768028 TI - [Dumbbell neurogenic tumors of the posterior mediastinum. Apropos of five cases]. AB - The authors present 5 cases of dumbbell neurogenic tumors with intraspinal extension. There were 4 neurilemmomas in four adults and 1 ganglioneuroma in one child. These tumors were benign. Neurological signs were observed in two cases. Widening of the intervertebral foramen at the level of the tumor is a very suggestive sign of dumbbell tumor confirmed by CT-Scan or MRI. Precise morphologic features must be assessed before embarking on the operation. The procedures used were: thoracotomy only in two cases, laminectomy then thoracotomy because of neurological signs in two cases, thoracotomy then laminectomy to fully remove tumor remnants in one case. No major morbidity was noted. The neurological symptoms resolved in two cases. A combined two-team approach with thoracic and neurosurgeons working together has not been used so far, but this possibility is probably the best choice for the future. PMID- 1768029 TI - [Place of thoracotomy in thoracic complications of hydatid cysts of the liver]. AB - The authors present 16 cases of hydatid cyst of the liver with rupture into the thorax, operated by thoracotomy. In 15 cases, the cyst ruptured into the right hemithorax and in one case, it ruptured into the left hemithorax. We adopted the classification proposed by our master S. Mestiri, which completes that proposed by Deve. The diagnosis is essentially based on thoraco-abdominal ultrasonography, which visualises the hydatid cyst, reveals intrathoracic collections, demonstrates the diaphragmatic tear and studies the biliary tract looking for obstruction or dilatation. The diagnosis was established in 12 out of 16 cases. There were 3 postoperative deaths (18.7%): two from septic shock and one from cerebral vein thrombosis. Only one patient had to be operated via an abdominal incision one month after thoracotomy for cholangitis secondary to stones in the common bile duct which were not seen on the preoperative ultrasonography. Laparotomy is required whenever there is a biliary problem and may be sufficient in type 1 lesions. Thoracotomy is necessary whenever there is an intrathoracic collection (types II, III, IV) and is sufficient in the absence of any biliary tract lesions. PMID- 1768030 TI - [Thoracopleuromyoplasty as definitive cure for chronic pleural empyemas, after preparation by open thoracostomy]. AB - Between 1979 and 1986, 30 patients with chronic pleural empyema (19 with pyothorax secondary to tuberculosis and 11 with pleural empyema following pulmonary resection) underwent two-stage treatment. The first stage consisted of open thoracostomy and was followed, 2 to 7 months later, by thoracopleuromyoplasty with latissimus dorsi, serratus anterior and pectoralis major muscles either alone or in combination. There was no operative mortality in this series of 30 operated patients. Definitive obliteraion of the pleural cavity and closure of the bronchial fistulae were obtained in 26 of the 30 patients. Partial necrosis of the muscle graft in the other 4 patients required further open drainage and an additional myoplasty. The long-term functional results in the cases of post-resection empyema were compatible with the restriction created by the pulmonary resection and, in the cases of empyema with a residual lung, with the restriction of the volume and perfusion of pulmonary parenchyma. PMID- 1768032 TI - [Pulmonary metastasis of a dermatofibrosarcoma]. AB - Progressive and recurrent dermatofibrosarcoma, described by Darier and Ferrand in 1924, is a fibrous skin tumour with essentially local malignancy. The authors report a case with pulmonary metastasis, a rare event as only 13 cases of visceral metastases have been reported in the literature. The clinical course of this case was favourable (follow-up of 5 years), in contrast with the usually pejorative nature of metastatic disease (death after several months to one year following the discovery of the first metastasis). PMID- 1768031 TI - [Use of a biological glue in partial pulmonary excision surgery. Results of a controlled trial in 50 patients]. AB - A controlled study concerning the surgical use of a fibrin glue was conducted in 50 patients undergoing partial pulmonary excision. In 25 of these patients, chosen at random, hemostasis and aerostasis of the fissural, and/or intersegmentary dissection planes were achieved by electrocoagulation, in the other 25 by the application of fibrin glue. The statistical study did not show any significant difference between the two groups in terms of the surgical indication, the type of excision and the associated surgical procedures (pleurectomy and parietectomy). No significant statistical difference was observed concerning the quality of aerostasis, the post-operative drainage, the persistance of residual collection or faulty reexpansion after removal of the latter, and the necessity for repeated drainage. The same applied to the length of post-operative hospital stay. This study seems to demonstrate that the surgical application of fibrin glue on the fissural and/or intersegmentary dissection planes is feasible but, as compared to electrocoagulation, does not significantly improve the quality of the surgical results for partial pulmonary excision; however its use could reduce the duration of post-operative drainage. PMID- 1768033 TI - [Massive hemoptysis ten days after bronchial extraction of an accidentally inhaled tablet of ferrous sulfate]. AB - Fatale haemoptysis occurred as a result of circumferential caustic erosion to the right intermediate bronchus caused by a tablet of ferrous sulphate which remained in contact for 4 days. The necrotic process continued, after removal of the foreign body, in the bronchial wall and its vessels. We suggest local bronchial lavage with 1% bicarbonate saline during extraction of the tablet and subsequent follow-up fibroscopies. The discovery of a necrotic ulceration of the bronchus requires strict medico-surgical surveillance in order to rapidly intervene under cover of selective intubation when necessary. PMID- 1768034 TI - [Heparin-induced thrombocytopenia. Practical management of vascular complications]. AB - The authors report 23 cases of heparin-induced thrombocytopenia with vascular complications. The clinical presentation consisted of arterial ischaemia in 16 cases, hemiplegia in 1 case, 4 cases of blue thrombophlebitis, 1 case of bilateral thrombophlebitis, 1 case of pulmonary embolism. The vascular surgeon faced with such emergency complications must be aware of the difficulties of clinical (atypical forms) and laboratory diagnosis (unreliability of platelet aggregability tests). Arterial occlusions are generally accessible to treatment with a Fogarty catheter during an operation performed without the use of heparin. The excessively frequent delay in diagnosis explains the severity of these complications and 2 deaths, 1 case of paraplegia, 4 cases of amputation secondary to arterial occlusion, 4 cases of severe postphlebitis disease, including 2 cases requiring transmetatarsal amputation and one case of pulmonary sequelae after pulmonary embolism were observed in our series of 23 patients. The diagnosis of heparin-induced thrombocytopenia requires immediate discontinuation of heparin therapy. Replacement by low molecular weight heparin is not devoid or risks and can only be considered with a negative platelet aggregability test (in the presence of low molecular weight heparin). As these test can be rarely performed as an emergency procedure, the use of rapid-acting oral anticoagulants appears to be the most reliable solution. The place of platelet antiaggregants and partial interruption of the inferior vena cava is discussed. PMID- 1768035 TI - [Continuous blood gas monitoring in intensive care units]. AB - The measurement of O2 and CO2 transport in the arterial and venous mixed blood constitutes the intersection between haemodynamic data and expiratory-inspiratory gases. The arterial-venous difference in O2 (a-v-DO2) and the venous arterial difference in CO2 (v-a-DCO2) calculated from the data of PA, PO2, PCO2 (read by an ABL4 Radiometer) revealed a close correlation with a a-v-DO2 measured directly by means of the LEXO2 (r = 0.99) or with VCO2 measured in expired gases by a capnograph (r = 0.99). In heart surgery the "on-line" monitoring of VCO2, a-v-DO2 and related parameters (REE = Resting Energy Expenditure) in the operating room and in ICU by means of a PDMS (Patients Data Management System) provides very useful information which, when integrated with haemodynamic parameters, allows a better understanding and better care of critical patients. PMID- 1768036 TI - Expression of carcinoembryonic antigen in ulcerative colitis, tubular adenomas and hyperplastic polyps: correlations with the degree of dysplasia. AB - Sections of tubular adenomas (n = 40), ulcertive colitis (n = 97) and hyperplastic polyps (n = 31) were examined by immunoperoxidase staining to carcinoembryonic antigen (CEA) in order to assess its potential diagnostic value in predicting malignant potential of these lesions. We compared the degree of epithelial abnormality in these mucosal specimens with the extent of immunoperoxidase staining for CEA. We found that CEA staining correlated with the degree of epithelial alteration in tubular adenoma and ulcerative colitis groups. Scattered weakly positive staining was found in eight of 31 hyperplastic polyps. High tissue expression of CEA, when combined with histologic dysplasia, may prove to be an additional factor in the evaluation of malignant potential in ulcerative colitis specimens and adenomas. PMID- 1768037 TI - TAG 12 expression as a prognostic factor in female breast cancer. AB - The expression of a novel tumour marker TAG 12 was immunohistochemically determined in paraffin embedded biopsies of 79 female breast carcinomas, with special emphasis on its potential prognostic value. The mean (+/- SD) age of the patients at the time of diagnosis was 58.1 (+/- 13.1) years and all women had been prospectively followed-up for a mean of 12.4 years (range 11.5-13.3 years). All except one tumour were TAG 12 positive. In the normal breast, TAG 12 expression was localized at the apical (secretory) cytoplasm of the epithelial cells. Accordingly, TAG 12 was present in abundance in the intraductal secretions as well. TAG 12 positivity was weakly related to histological grade (p = 0.178) and significantly to tubular grade (p = 0.021) of the tumours. TAG 12 positivity was not significantly related to the following parameters: menopausal status, tumour size, axillary lymph node involvement, histological type of the tumour, DNA ploidy, S-phase fraction or irregularity of tumor cell nuclei. The prediction of lymph node involvement and metastasis was not possible in either pre- or postmenopausal women. Similarly, crude survival, breast cancer survival or disease-free survival were not significantly related to TAG 12 expression. The results indicate that quantitation of immunohistochemically determined TAG 12 expression has no prognostic value in breast cancer. At best, TAG 12 might be of some assistance in discriminating malignant breast lesions from benign conditions. PMID- 1768038 TI - Fluorescent location of tumour cells in fine needle aspirates. AB - Cells obtained by fine needle aspiration of breast lumps were spread onto microscope slides, defatted with xylene and stained with a fluorescent probe for a cell surface protease. In these aspirates, carcinoma cells possess an active cell surface protease, guanidinobenzoatase (GB), very similar to plasminogen activator (1), which binds the fluorescent probe as a competitive inhibitor. Cells obtained from benign and normal breast lack this active GB and can be distinguished easily from the carcinoma cells by fluorescent microscopy. We use this simple technique to examine breast lumps containing carcinoma cells and to demonstrate the similarity of GB on these carcinoma cells to tissue type plasminogen activator (t-PA). PMID- 1768039 TI - Hormone receptor status and mitotic activity as risk factors for recurrence and death in female breast carcinoma. AB - The estrogen (ER) and progesterone (PR) receptor status, volume corrected mitotic index (M/V index) and other classical prognostic factors were related to disease outcome in a series of 281 women with breast cancer followed up for over 8 years. The M/V index predicted recurrence only in ER+ or PR+ patients (p = 0.002-0.006). Similarly, the recurrence-free survival was related to M/V index only in ER+ (p = 0.0005) or PR+ (p less than 0.0001) patients. In survival analysis, ER+ (p = 0.0037) and PR+ (p less than 0.0001) patients were accurately divided into different prognostic groups by the M/V index, whereas in ER- and in PR-tumours the M/V index had only suggestive predictive value (p = 0.06-0.5). In N-tumours the M/V index predicted recurrence-free survival only in ER+ (p = 0.0228) and in PR+ (p = 0.0087) tumours. In survival analysis of N-tumours, the M/V index predicted cancer-related survival in ER+ (p = 0.0102) and in PR+ (p = 0.0014) tumours. In ER-/PR-, N-tumours, none of the variables tested had any prognostic value. The present results suggest that adjuvant hormone treatment might be indicated in ER+ or PR+ tumours with a M/V index greater than 10, regardless of the axillary lymph node status. The prognosis of ER+ or PR+ tumours with a M/V index less than 10 is favourable, the risk of recurrence being of the order of 15% only during the 10-year follow-up. Thus, the expensive and distressing adjuvant treatments could be omitted for these women with an inherently favourable disease outcome. PMID- 1768040 TI - Relative tumor inhibitory and stimulatory activities of BCG vaccine preparations, lots and substrains in a quantitative mouse sarcoma bioassay. AB - A quantitative in vivo assay for BCG anticancer efficacy was developed to maximize detection of tumor-antagonistic mechanisms. Cultured S180 sarcoma cells admixed with various quantities of Mycobacterium bovis-BCG organisms were injected subcutaneously into CFW Swiss-Webster mice and response was measured as tumor incidence 14 days after injection. Assay of various BCG substrains, lots and killed preparations revealed characteristic patterns of BCG dose-dependent tumor inhibition and enhancement that suggest the existence in the vaccine of multiple active components, the relative concentrations of which vary among cultures. Inhibition of tumor growth by high doses of BCG (greater than 10 micrograms dry weight) was found to be a function of total cell mass and not of the bacterial viability, suggesting that this activity is dependent upon one or more heat-stable components. PMID- 1768041 TI - Phorbol ester promotes growth and transformation of carcinogen-exposed nonhuman primate cells in vitro. AB - Kidney cells established in vitro from a white-lipped marmoset (106) were exposed to N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) alone or in combination with 12-O tetradecanoyl-phorbol-13-acetate (TPA). Low (0.1 micrograms/ml, 4 times), intermediate (1 microgram/ml) and high (1 microgram/ml, 4 times) doses of MNNG resulted in 100%, 50% and 2.8% of cell survival, respectively. High and low doses of MNNG had no effect on cell transformation. Upon exposure of cells to an intermediate dose of MNNG, 106 cells ecquired immortality and evolved into permanent cell line, 106-1M. However, the cells retained normal morphology and anchorage dependence. Chronic applications of TPA (0.1 micrograms/ml, 13 times) promoted 106-1M cells to morphological transformation and anchorage-independent growth but not to tumorigenicity in nude mice (106-1MT cell line). Chromosome analysis revealed only numerical changes in 106 cells and both numerical and structural aberrations in transformed 106-1MT cells. These changes in marmoset cells usually reflected cell culture instability leading to either senescence or to longer survival of cells in vitro. Chronic treatment with TPA did not result in downregulation of protein kinase C (PKC) in transformed 106-1MT cells. Instead, an additional species of PKC appeared in these cells. PMID- 1768042 TI - Lectin-binding patterns in transplantable mouse mammary tumors and their metastases. AB - Lectin binding was assessed in a transplantable pregnancy-dependent mouse mammary tumor line (TPDMT-4), its autonomous sublines (T4-0196 and T4-01165) and their artificial metastases (lung colonies), using the avidin-biotin-peroxidase technique. Soybean agglutinin (SBA) and peanut agglitinin (PNA) bound to the luminal surfaces of TPDMT-4 tumor cells, while dolicos biflorus agglutinin (DBA) showed no binding. In T4-0196 and T4-01165 tumors as well as their lung metastases, SBA and PNA binding was mixed and both positive and negative cells were detected, indicating that these lectins were not associated with the metastatic phenotype. Although the T4-0196 and T4-01165 sublines had a mixture of DBA-positive and DBA-negative cells, all the metastatic T4-0196 subclones contained only DBA-positive cells and all the metastatic T4-01165 subclones had DBA-negative cells. Thus DBA-positive, and DBA-negative subclones had respectively metastasized to the lungs from these autonomous sublines, implying that the carbohydrate moieties detected by DBA were not associated with metastatic potential but that the lung metastases were clonal in origin. PMID- 1768043 TI - Cytotoxicity and DNA cross-linking induced by peptide conjugated m-L-sarcolysin in human melanoma cells. AB - Peptichemio is a complex of six peptides containing m-L-sarcolysin which is used in cancer chemotherapy. One of the peptides, L-propyl-m-sarcolysyl-L-p fluorophenylalanine (PSF), is highly toxic to melanoma cells. We have compared the effects of melphalan, m-L-sarcolysin and PSF on human melanoma cell lines. PSF was 35-fold and 28-fold more toxic to RPMI 8322 melanoma cells than melphalan and m-L-sarcolysin, respectively. Similar differences in the cytotoxic effects of PSF and m-L-sarcolysin were also seen with two other melanoma cell lines. The cytotoxicity of both PSF and m-L-sarcolysin to RPMI 8322 melanoma cells was potentiated by depletion of cellular glutathione. Both PSF and m-L-sarcolysin caused a protracted induction of DNA cross-links in RPMI 8322 cells, with maximum at 24 hours after drug exposure. PSF induced 9-fold higher levels of DNA interstrand cross-links than m-L-sarcolysin, indicating that the increased cytotoxicity of this drug is associated with a more efficient induction of DNA damage. PMID- 1768044 TI - A mutational model of carcinogenesis. AB - A model of carcinogenesis based on spontaneous somatic mutation in expanding cell clones is presented and compared with previous mathematical treatments of this concept. The model shows that if cancer is purely a consequence of gene mutation then four independent mutations are required. To explain the marked increase in the incidence of cancer with age it is necessary to postulate that stem cells with a subset of the four key mutations show some loss of growth suppression and expand relative to unaffected stem cells. The model also predicts that for carcinogens acting during extrauterine life the incidence of cancer will be proportional to the dose of carcinogen raised to a power between one and two, even though the carcinogen increases the chance of all four mutations. This power relationship accords with data on human cancer and experimentally induced tumours in animals, but is hitherto unexplained. PMID- 1768045 TI - Benign parotid oncocytoma with the chromosomal abnormality trisomy 7. AB - This report concerns the first cytogenetical study of a benign salivary gland oncocytoma. The cultured tumor was studied in five consecutive preparations. The first three were dominated by cells with a normal karyotype. In the two subsequent preparations a hyperdiploid stemline characterized by trisomy 7 had taken over. Trisomy 7 has previously been observed in a number of different, benign, premalignant and malignant conditions. We interpreted trisomy 7 in the salivary gland oncocytoma, as in these other conditions, to be a neoplasia related, probably primary, gross chromosomal change and not an expression of aging or comparable events in normal cells. PMID- 1768046 TI - Carcinogenesis and the response of tumours to anticancer drugs. AB - Tumour development is the consequence of a multistep process involving the activation of oncogenes and loss of tumour suppressor gene function. The study of molecular alterations which accompany carcinogenesis and distinguish the tumour from its normal cellular counterpart, may provide a basis for the in vivo development of drug resistance and facilitate the rational design of anticancer drugs which exploit these differences. In this review we shal discuss some of the effects of carcinogen exposure in relation to how this may influence the response of a tumour to chemotherapy. PMID- 1768047 TI - Inhibition of tumor necrosis factor-stimulated human peripheral blood polymorphonuclear cell iodination by sera from various cancer patients. AB - Tumor necrosis factor (TNF) dose- and time-dependently stimulated the iodination (incorporation of radioactive iodine into an acid-insoluble fraction) of human peripheral blood polymorphonuclear cells (PMN). The addition of sera obtained from patients with brain tumors, or gastric, pancreatic, hepatocellular, common bile duct or lung carcinoma significantly inhibited TNF-stimulated PMN iodination, whereas sera of normal volunteers were, in general, not inhibitory. TNF-stimulated iodination of human peripheral blood monocytes was almost eliminated by brain tumor patient sera, but was significantly enhanced by normal human sera. Specific [135I] TNF binding to the PMN receptors was significantly increased in the presence of either patient sera or normal sera. These data suggest some mechanism other than modification of TNF receptor binding for expression of the inhibitory action of cancer patient serum. PMID- 1768048 TI - Serial transplantation and characterization of a canine diffuse large cell lymphoma grafted in nude mice. AB - A continuous canine lymphoma cell line (DL. 24N) was established by serial transplantation from a diffuse large cell lymphoma into athymic nude mice, yielding subcutaneous tumours at the injection site associated with lymph node metastasis. The transplanted tumour cells, of canine origin as assessed by the karyotype, appear comparable to the large non-cleaved and immunoblastic human cells, as did the initial tumour cells. Immunological studies show reactivity with antibodies to dog immunoglobulins, DT-2 and Thy-1, to MHC-class II antigens, and to both CD10 (CALLA) and CD21 (CR2) human antigens. Such a cell line, showing similarities with some of the human diffuse large cell lymphomas, will thus provide a new tool for further comparative studies of malignant lymphomas. PMID- 1768049 TI - Flow-cytometric DNA ploidy analysis in primary and metastatic canine thyroid carcinomas. AB - DNA ploidy was measured by flow cytometry in 36 primary malignant thyroid neoplasms (including 6 bilateral tumours which were considered as separate neoplasms) from 30 dogs. In addition, DNA ploidy was determined in local recurrences in 3 dogs, and in 18 metastatic sites from 14 dogs. Aneuploidy was found in 21 of 36 (58%) primary sites. Eighteen of the 21 (86%) aneuploid tumours contained hypodiploid cell populations, with 12 having single hypodiploid peaks, and 6 being multiploid. Three other tumours had single aneuploid peaks with a DNA index (DI) greater than 1.0. The DIs in local recurrences were identical to those in the original neoplasms. Ploidy status (diploid vs. aneuploid) was identical in primary and metastatic sites in 10 out of the 14 dogs. Aneuploidy was more frequent in carcinomas from dogs with distant metastases (78%) than from dogs with less advanced stages of disease (53%), although this difference was not significant. There was no significant correlation between DNA ploidy and histopathological variables. From the strikingly high frequency of hypodiploidy in canine tumours, it is concluded that ploidy evolution in canine neoplasms may differ from that in human tumours. PMID- 1768050 TI - Functional maturation of monocytes/macrophages induced by PSK subfractions. AB - When mouse resident peritoneal macrophages were cultured with PSK (Krestin), a protein-bound polysaccharide extracted from Coriolus versicolor, they became enlarged and elongated and expressed higher NBT-reducing activity. PSK stimulated the production of differentiation-inducing factor and cytotoxic factor by the mouse macrophage-like cell line J774.1, and iodination (incorporation of radioactive iodine into an acid-insoluble fraction) and interleukin-1-like factor production by human peripheral blood monocytes. Among four different PSK subfractions, the highest molecular weight fraction (MW greater than 200 kD) was the most potent. Natural and chemically modified glucans had little or no activity. The data suggest that some unique structure of the highest molecular weight fraction of PSK directly stimulates the monocytes/macrophages. PMID- 1768051 TI - Hybrid anticancer compounds. Steroidal lactam esters of carboxylic derivatives of N,N-bis (2-chloroethyl) aniline (review). AB - For the rational design of more specific alkylating agents, we suggested new biological platforms able to deliver the alkylating moieties to specific target site and on the other hand we hoped to lead in compounds with synergistic activity. As biological platforms have been used steroidal lactams of A and D- ring and as alkylating agents carboxylic derivatives of N,N-bis (2-Chloroethyl) aniline which combine to the steroid by an easily cleaved ester bond. These homo aza-steroidal esters gave satisfactory results in early and advanced P388, L1210 leukemias and solid tumors. Whereas unmodified steroidal esters have generally been reported to be inactive in treatment of L1210 leukemia. The steric arrangement of the alkylating moiety greatly effects toxicity and activity of the drugs, while the steric arrangement of the hydrogen atom at position 5 influences these parameters. Isosterism of alkylating agent is the factor for biological action. The amide group of the lactam molecule may be essential for activity. PMID- 1768052 TI - Feline mammary tumors: a case-control study of hormonal factors. AB - Feline mammary carcinomas are, like human breast cancers, spontaneous, locally infiltrative and metastasizing tumors. Therefore, this tumor disease in the cat can serve as a pathogenetic and experimental-therapeutic model for the human counterpart. In the cat, as in the woman, little is so far known with certainty about the hormonal background of mammary tumors. In order to elucidate the role of endogenous and exogenous hormonal factors, a case-control study was conducted. Data on age, history of castration, parity and progestogen administration were compared in cats with malignant or benign mammary tumors on one hand, and in a control group on the other. The statistical relative risks and their significance were assessed using conditional logistic regression analysis. In our study there was a tendency for mammary carcinomas to be found in cats that were older than those bearing benign mammary tumors. Ovariectomy was found to protect against mammary carcinomas but not against benign mammary tumors. No association between parity and mammary tumor risk was found. Regular administration of progestogens was associated with an increased risk of both mammary carcinoma and benign mammary tumors. However, this was not true of irregular progestogen administration and, in general, the administration of progestogens was not associated with an earlier appearance of mammary tumors. PMID- 1768053 TI - Comparative studies on the polyamine metabolism and DFMO treatment of MCF-7 and MDA-MB-231 breast cancer cell lines and xenografts. AB - In order to characterize the estrogen receptor (ER)-positive MCF-7 and ER negative MDA-MB-231 human breast cancer cells and xenografts, their growth kinetic parameters and some biochemical characteristics concerning the receptor status and polyamine metabolism were determined and compared. The doubling times calculated from the growth curves showed higher proliferation rate of MDA-MB-231 cells, both in culture (21 hours) and in xenograft (9.7 days), in comparison to the MCF-7 cells which had values of 32 hours and 11.6 days, respectively. Growth dependent changes observed in the intracellular putrescine, spermidine and spermine concentrations indicated a higher activity of polyamine metabolism in the MDA-MB-231 cells and xenograft as well. However, biosynthetic key-enzyme ornithine decarboxylase activity (ODC, EC 4.1.1.17) showed neither characteristic differences between the two types of breast cancer, nor consistent relationship with their proliferation rate. Metabolic alterations of the MCF-7 and MDA-MB-231 cell lines grown in vitro were also reflected in the polyamine composition of their culture medium. Independently of their receptor status, both types of breast cancer were responsive to difluoromethylornithine (DFMO) treatment. DFMO inhibited the ODC activity totally and depleted the cellular polyamine levels. MCF-7 cells in culture were more sensitive to the antitumoral effect of DFMO than the MDA-MB-231 line, while the rate of growth inhibition did not differ significantly in the xenografts. The present results provided further evidence on the different polyamine metabolism of ER-positive MCF-7 and ER-negative MDA-MB 231 human breast cancer cells in vitro and in vivo, suggesting a correlation of hormonal modulation with polyamines as a determinant group of biological response modifiers. PMID- 1768054 TI - Cytotoxicity of liver macrophages against liver tumours. Influence of betamethasone, indomethacin and allopurinol. AB - Macrophage activation with zymosan has an inhibitory effect on tumour take and initial tumour growth in the rat liver. 91 rats with syngeneic transplanted hepatoma in the liver were treated with zymosan (46) or saline (45). Betamethasone (glucocorticoid), indomethacin (prostaglandin synthesis inhibitor), allopurinol (oxygen radical scavenger) or saline were administered concomitantly. Tumour take, tumour growth and relative spleen weight were used as in vivo parameters of liver macrophages cytotoxicity and general macrophage activation. Zymosan inhibition of tumour take was counteracted by betamethasone, indomethacin and allopurinol. Betamethasone increased the growth rate of the non-zymosan treated tumours during seven days. Indomethacin decreased the growth rate of the tumours in non-zymosan treated rats up to 14 days. Allopurinol significantly blocked the zymosan inhibition of tumour take and tumour growth after 7 and 14 days. Allopurinol blocked zymosan induced increased relative spleen weight. It is proposed that the liver macrophage cytotoxicity induced by zymosan is in part mediated via production of oxygen radicals. PMID- 1768055 TI - Responsiveness of human monocytes to Ru 41.740 (Biostim). Influence of preincubation in vitro. AB - Biostim, which is a glucoprotein extract of Klebsiella pneumoniae, is known to trigger human monocytes to increased secretion of metabolites, which inhibit lymphocyte mitogenesis and which augment NK-activity of lymphocytes. Some aspects of this monocyte activation have been examined in this study. The conclusion of the present investigation is that preincubation of human monocytes for 6-24 h in serum-free medium at 37 degrees C renders them unresponsive to Biostim, as assessed by secretion of the above factors. Monocytes which were preincubated in 100% serum or in serum-free medium at 3 degrees C retained their responsiveness to Biostim. Loss of Biostim responsiveness could not be prevented by interferon alpha, beta, gamma or by granulocyte-monocyte and granulocyte colony stimulating factors. One interpretation of these results is that human monocytes possess distinct receptors for Biostim whose expression is lost under suboptimal culture conditions. Expression of these receptors is a prerequisite for responsiveness to the drug. PMID- 1768056 TI - Toxicity of 3'-deamino-3'-(3-cyano-4-morpholinyl) doxorubicin and doxorubicin in nude mice bearing human tumour xenografts. AB - The toxicity of the intensely potent anthracycline 3'deamino-3'-(3-cyano-4 morpholinyl)doxorubicin (MRA-CN) has been evaluated in nude mice bearing human colonic cancer xenografts. In addition to dose related toxicity manifested as weight loss and effects on the haematology profile, we obtained evidence of cardiotoxicity with MRA-CN, which has not been reported previously. Even a single dose of 0.012 mg kg-1 could induce significant myocardial changes as seen by electron microscopy. Our results suggest that nude mice bearing human tumour xenografts may offer a very sensitive model for the evaluation of anthracycline induced cardiomyopathy. In view of the potential of MRA-CN in cancer treatment, these results need to be confirmed and extended. PMID- 1768057 TI - Effects of L-histidinol on the proliferation and anticancer drug susceptibility of cultured B16f10 melanoma cells. AB - L-Histidinol, a structural analogue of the essential amino acid L-histidine, is able to enhance the toxicity of a wide variety of anticancer drugs to tumor cells both in vitro and in vivo. In this study, the effects of L-histidinol on the viability, cell cycle traverse and anticancer drug susceptibility of B16f10 melanoma cells in culture have been examined. L-Histidinol inhibited the transit of B16f10 melanoma cells through the cell cycle in a dose-dependent manner. In spite of its capacity to slow cell cycle progression, L-histidinol nevertheless increased the capacity of several antineoplastic agents of varying modes of action to kill B16f10 melanoma cells. PMID- 1768058 TI - Spontaneous endometrial hyperplasia. The prognostic significance of steroid receptor concentration. A two year follow-up of patients treated with abrasio only. AB - The steroid receptor concentrations were measured in 63 patients. The patients were part of a prospective randomized study and were treated with abrasio only. With respect to Cystic Glandular Hyperplasia (43 patients) 16 out of 25 with PgR values less than 10,000 (fmol/mg DNA) were normalized compared to only 4/14 with higher PgR conc (p = 0.03). No limit could be identified regarding patients with Adenomatous Hyperplasia and Atypical Hyperplasia (29 patients). Consequently patients with CGH and a high PgR concentration are recommended for high dose gestagen therapy. PMID- 1768059 TI - Different effects of L-histidinol and homoharringtonine on 5-fluorouracil and bis chloroethylnitrosourea activity in a murine model. AB - A comparison of the effects of L-histidinol and homoharringtonine (HHT) on the activity of 5-fluorouracil (FUra) and bis-chloroehtylnitrosourea (BCNU) in C57/BL mice, without or with disseminated B16f10 melanoma, was carried out. Although L histidinol and HHT are both protein synthesis inhibitors with apparently identical modes of action, these two compounds had very different effects in the test systems. HHT failed to prevent the body weight lose and subsequent death of C57/BL mice treated with supralethal doses of FUra; it was also unable to prevent the toxicity of FUra for bone marrow cells. In contrast, L-histidinol prevented the weight loss, death and bone marrow damage otherwise resulting from identical doses of FUra. Furthermore, L-histidinol was far more effective than HHT in its ability to improve the management of disseminated B16f10 melanoma in C57/BL mice by BCNU, both in terms of reducing pulmonary foci and extending survival. PMID- 1768060 TI - Neuronal cell differentiation of human neuroblastoma cells by inducing agents in combination. AB - The antineoplastic drug 4'-iodo-4'-deoxydoxorubicin (IDX), a new halogenated anthracycline (1), was examined as a differentiation inducing agent on the human neuroblastoma cell lines TS12 and SK-N-MC. IDX induced morphological and biochemical differentiation and growth inhibition. The effect of a combined treatment of IDX with retinoic acid (RA) and with nerve growth factor (NGF) respectively was then investigated. The responses of neuroblastoma cells to IDX alone and to these combined treatments were compared, with respect to neuritic outgrowth, acetylcholinesterase activity and cellular growth. The data obtained indicate that the combination of differentiation-inducing drugs may be able to enhance the effects of the same drugs given alone. PMID- 1768061 TI - Interferon induced increases in c-myc expression in a human breast carcinoma cell line. AB - Previous studies from our laboratory have indicated that interferon-gamma inhibits the growth of a human breast carcinoma cell line, MDA 468. We measured steady state levels of c-myc mRNA to determine if the antiproliferative effect of IFN-gamma was mediated by changes in the expression of this proto-oncogene. C-myc message levels increased after 24 hours of IFN treatment, peaked at 48 hours, but remained elevated through 96 hours of treatment. The increase in c-myc mRNA was observed with as little as 10 U/ml of IFN-gamma. The stability of mRNA was enhanced in interferon treated cells. These data suggest that IFN-gamma increased expression of c-myc mRNA, but decreased cell growth, and point out the complexities of the relationship of the expression of this protooncogene to cell growth. PMID- 1768062 TI - Interrelation between western type cancers and non-western type cancers as regards their risk variations in time and space. III. A contrast between bladder cancer and stomach cancer. AB - The present study attempted to get insight into the etiology of bladder cancer by investigating the relation of this neoplasia to other 4 cancers as regards their risk variations in time and space. The results obtained are as follows: 1) Caucasians in Western countries were more inclined to develop bladder cancer than other ethnic groups, as compared among 43 population units of the world in terms of the age-adjusted incidence rate (AAIR). 2) In the same 43 comparison sets, male populations were always higher than female populations in their bladder cancer risks. The male to female ratio for the majority of the populations ranged from 3 to 4. In some population units, the ratios were much higher. In both male and female populations, the cancer risk increased with age. 3) Bladder cancer incidence in the world has been rising during the past 20 years, as detected in the follow-up study of 16 population units. 4) A negative linear relationship was detected for both sexes between bladder cancer and stomach cancer (non-Western type) regarding their log-transformed AAIRs, as calculated with data of the same 16 population units from 1960 through 1980. The same calculation with the esophagus cancer-bladder cancer pair gave marginally negative and no correlations respectively in the male and female populations. A positive linear relationship was detected in the comparison of bladder cancer with 2 Western type cancers (cancers of the colon and lung). 5) Japanese immigrants to the US were just in between Whites in the US (high-risk populations) and native Japanese (low-risk populations) in their bladder cancer risks. The same Japanese immigrants were again just in between Whites in the US (low-risk populations) and native Japanese (high-risk populations) in their stomach cancer risks. In conclusion, bladder cancer is a Western type cancer with sex and age discriminations in its occurrence. The cancer risk also varies depending on the life style of a population (environment dependent). The results obtained are discussed from the point of view of endocrinological oncology. PMID- 1768063 TI - Experimental antitumor agents from Solanum indicum L. AB - beta-Sitosterol (SI-0), beta-sitosterol glucoside (SI-1), dioscin (SI-2), methyl protoprosapogenin A of dioscin (SI-3), methyl protodioscin (SI-4) and protodioscin (SI-5) were isolated and characterized from the whole plant of Solanum indicum L. (Solanaceae). Except for beta-sitosterol, these compounds have not been previously isolated from Solanum indicum L. Both CHCl3 soluble (SI-IV) and insoluble (SI-V) fractions of the ethanolic extract (SI-I) showed cytotoxicity on seven cancer cell lines: Colo-205 (colon), KB (nasopharynx), HeLa (uterine cervix), HA22T (hepatoma), Hep-2 (laryngeal epidermoid), GBM8401/TSGH (glioma) and H1477 (melanoma). The purified constituents, SI-2 and SI-4 showed more potent effects by DEA and MTT assay. SI-2,3,4 and 5 also demonstrated cytotoxicity on cultured C6 glioma cells by PRE assay, ans SI-3,4 and 5 showed a tumor inhibitory effect in vivo in C6 glioma cells. In addition, SI-2 had an inhibitory effect on the DNA synthesis of C6 glioma cells at 10 micrograms/ml. PMID- 1768064 TI - Heterogeneous nuclear RNA from hairy cell leukemia patients activates 2',5' oligoadenylate synthetase. AB - Interferon treatment of cells induces double-stranded RNA (dsRNA)-dependent 2',5' oligoadenylate (2-5A) synthetase, an enzyme which has been implicated in the mechanism of growth arrest in tumour cells. Since interferon (IFN) can inhibit the growth of cells that are not infected with virus, natural non-viral dsRNAs should be present in these cells which can activate 2-5A synthetase. If such nuclear dsRNAs are associated with the mechanism of growth control, cells inherently sensitive to growth inhibition by IFN should contain significant levels of 2-5A synthetase-activating dsRNAs. We measured the ability of size fractionated nuclear dsRNAs isolated from patients with hairy cell leukemia (HCL) to activate purified 2-5A synthetase. Peripheral blood mononuclear cells from HCL patients were utilized because of the inherent sensitivity of these patients to IFN treatment. The heterogeneous nuclear RNA fraction from four out of five HCL patients showed high levels of 2-5A synthetase-activating dsRNAs. The 2-5A formed contained biologically active trimers, tetramers, pentamers and hexamers as demonstrated by HPLC analysis and their ability to activate RNase L. In contrast, the nuclear RNA fraction from three out of four healthy controls were unable to activate 2-5A synthetase. These results indicate that natural, nuclear dsRNAs inherently exist in IFN-sensitive cells and imply that these molecules may play a role in the inhibition of cellular growth. PMID- 1768065 TI - Coadministration of dimethyl sulfoxide reduces cisplatin nephrotoxicity. AB - The administration of dimethyl sulfoxide with cisplatin at a mole ratio of 200:1 results in a considerable reduction in the nephrotoxicity produced when cisplatin alone is administered to Sprague-Dawley rats at 7.5 mg/kg. Observed measures of nephrotoxicity which were significantly improved by the coadministration of cisplatin and DMSO over the values found for cisplatin alone include BUN, serum creatinine, creatinine clearance and histopathological evidence of renal damage. The weight loss associated with cisplatin administration was also significantly reduced by DMSO coadministration. The use of DMSO did not result in any observable loss in antitumor activity of cisplatin against the Walker 256 carcinosarcoma. PMID- 1768067 TI - HIV guidelines may spur lawsuits. PMID- 1768066 TI - DNA--cytometric studies on xenografts of squamous cell carcinomas of the head and neck. AB - The primary tumors of four human head and neck carcinomas and their xenografts in nude mice were analysed with respect to their histological features and DNA ploidy level using DNA-flow and DNA-image cytometry. The histological characteristics of the xenografts and the DNA-index did not differ from those of the parent tumors, whereas the growth rate remained unchanged during serial passaging. DNA-flow cytometric analysis revealed the presence of both aneuploid and euploid cells in both parent tumors and their xenografts. During passaging the proportion of aneuploid cells increased. Analysis of the different cell populations by DNA-image cytometry revealed the presence of aneuploid tumor cells and euploid host cells. This study demonstrates that the characteristics of the original tumors in terms of histological features and DNA-ploidy are retained after xenografting. PMID- 1768068 TI - Flexible ureteroscopy. Patient care, indications. PMID- 1768069 TI - Physiologic amputation. Preliminary cryoamputation of the gangrenous extremity. PMID- 1768070 TI - Mastocytosis. Perioperative considerations. AB - Mastocytosis, an uncommon clinical disorder, can present a variety of clinical manifestations ranging from an asymptomatic state to one characterized by recurrent episodes of severe vasodilatation. Even the patient whose disease appears to be well controlled and is asymptomatic preoperatively can develop serious intraoperative problems. Knowledge of the pathogenesis and treatment, avoidance of known provoking factors, and adherence to established precautionary measures, in particular the constant availability of IV epinephrine infusion throughout the perioperative period, enables members of the surgical team to safely support the patient throughout the operative experience. PMID- 1768071 TI - Perioperative nursing on the Amazon River. An experience that made a difference. AB - We held a conference at the end of the team's visit. We concluded that there was a continuum of learning in both directions from both countries. Some of the problems and frustrations in medicine are the same worldwide. Leaving the US medical system to work in a remote area is a fascinating and exciting experience. Clean water, electricity, transportation, and food are not taken for granted in this area of the world. The next decade in an area like this holds many different plans, hopes, and projects. Nothing can be taken for granted. All that has been developed could be lost tomorrow. What we do makes a difference, whether it is in the jungles of Brazil or an OR in the United States. To see the health of the general population so markedly improved from our previous visit emphasized that point. Your skills as an OR nurse can be translated to other countries. An instrument may have a different name, but the use is the same. Operating room nursing on the Amazon River is the same, and it is different. You can and do make a difference to your patients each day. We found that the difference is less subtle in an area that has so little. PMID- 1768072 TI - Proposed recommended practices. Sanitation in the surgical practice setting. PMID- 1768073 TI - The effect of humorous distraction on preoperative anxiety. A pilot study. PMID- 1768074 TI - An integrated care plan. Developing an innovative guideline for patient care. PMID- 1768075 TI - Alzheimer's disease: communication techniques to facilitate perioperative care. AB - Extensive, progressive deterioration in cognition affects the Alzheimer's patient's ability to receive, store, retrieve, and send information. An Alzheimer's patient who will undergo surgery may be overwhelmed by the increased number and rapidity of changes. To help the individual comprehend the situation, nurses' communication with the patient should be slow, simple, concrete, and repetitive. A supportive, positive approach and the use of nonverbal channels facilitate communication with an Alzheimer's patient. Knowledge of the patient's past and customary modes of communication also will help nurses understand his or her attempts to communicate. These techniques will not transform the Alzheimer's patient into an accurate historian or a knowledgeable, fully informed patient. They will, however, assist nurses in reaching the patient, and they make caring for the Alzheimer's patient a far more satisfying experience for both nurses and the patient. PMID- 1768076 TI - Liability exposure in ambulatory surgery settings. PMID- 1768077 TI - Issues surrounding laparoscopic cholecystectomy. PMID- 1768078 TI - Evaluating computer-assisted instructional software for the OR. PMID- 1768079 TI - Immobilization of penicillin acylase in porous beads of polyacrylamide gel. AB - A procedure is described for the immobilization of benzylpenicillin acylase from Escherichia coli within uniformly spherical, porous polyacrylamide gel beads. Aqueous solutions of the enzyme and sodium alginate and of acrylamide monomer, N,N'-methylene-bis-acrylamide, N,N,N,N'-tetramethylethylenediamine (TEMED) and sodium alginate are cooled separately, mixed, and dropped immediately into ice cold, buffered calcium formate solution, pH 8.5, to give calcium alginate-coated beads. The beads are left for 30-60 min in the cold calcium formate solution for polyacrylamide gel formation. The beads are then treated with a solution of glutaraldehyde and the calcium alginate subsequently leached out with a solution of potassium phosphate. Modification of the native enzyme with glutaraldehyde results in a slight enhancement in the rate of hydrolysis of benzylpenicillin at pH 7.8 and 0.05M substrate concentration. The enzyme entrapped in porous polyacrylamide gel beads shows no measurable diffusional limitation in stirred reactors, catalyzing the hydrolysis of the substrate at a rate comparable to that of the glutaraldehyde-modified native enzyme. The immobilized enzyme preparation has been used in batch mode over 90 cycles without any apparent loss in hydrolytic activity. PMID- 1768080 TI - Production of exocellular polysaccharide by Azotobacter chroococcum. AB - Environmental conditions affect the production of extracellular polysaccharide by Azotobacter chroococcum ATCC 4412. Production of exocellular polymer from a variety of carbon sources depended on the air flow rate. A high sucrose concentration in medium (8%) markedly favored expopolysaccharide production, which reached 14 g/L in about 72 h. In cell suspensions incubated in the presence of 8% sucrose in a nitrogen-free medium, biopolymer final concentration of 9 g/L corresponds to 68 g/g biomass. Maximum efficiency of sucrose conversion into exopolysaccharide peaked at 70% for initial disaccharide concentration of 6%. High performance liquid chromatography and gas liquid chromatography of acid hydrolysates of the exopolymer revealed the presence of mannuronosyl, guluronosyl, and acetyl residues, but not neutral sugars. The infrared spectrum corroborated the presence of carboxylate anions and O-acetyl groups in the exopolymer. Though the presence of more than one kind of polysaccharide cannot be ruled out, these data suggest that, under the experimental conditions used in this work, only a type of alginate-like exopolysaccharide is produced by A. chroococcum ATCC 4412. PMID- 1768081 TI - Adsorption and expression of penicillin G acylase immobilized onto methacrylate polymers generated with varying pore generating solvent volume. AB - Adsorption and expression of penicillin G acylase was studied on macroporous methacrylate polymer beads of differing pore volume, generated with kerosene. The absorption and expression of the penicillin G acylase was dependent on pore volume. Maximum expression of 57% of adsorbed enzyme was obtained on beads synthesized with 40 mL of kerosene, indicating minimum pore-diffusion limitations. PMID- 1768082 TI - Comparison of cold enrichment and U.S. Department of Agriculture methods for isolating Listeria monocytogenes from naturally contaminated foods. The Listeria Study Group. AB - We compared the cold enrichment (CE) and U.S. Department of Agriculture (USDA) methods for isolating Listeria monocytogenes by examining 402 food samples. The food samples were collected from refrigerators of listeriosis patients as part of a multistate active surveillance project to determine the role of foods in sporadic listeriosis in the United States. L. monocytogenes was isolated from 51 food samples (13%). The USDA method was significantly better (P less than 0.001) than the CE method. The isolation efficiencies of the USDA and CE methods were 96 and 59%, respectively. Quantitation of L. monocytogenes in the food samples revealed that many food samples containing less than 0.3 CFU/g were negative as determined by the CE method but positive as determined by the USDA method. PMID- 1768083 TI - Conjugal transfer of a shuttle vector from the human colonic anaerobe Bacteroides uniformis to the ruminal anaerobe Prevotella (Bacteroides) ruminicola B(1)4. AB - Prevotella ruminicola (formerly Bacteroides ruminicola) is an anaerobic, gram negative, polysaccharide-degrading bacterium which is found in the rumina of cattle. Since P. ruminicola is thought to make an important contribution to digestion of plant material in rumina, the ability to alter this strain genetically might help improve the efficiency of rumen fermentation. However, previously there has been no way to introduce foreign DNA into P. ruminicola strains. In this study we transferred a shuttle vector, pRDB5, from the colonic species Bacteroides uniformis to P. ruminicola B(1)4. The transfer frequency was 10(-6) to 10(-7) per recipient. pRDB5 contains sequences from pBR328, a cryptic colonic Bacteroides plasmid pB8-51, and a colonic Bacteroides tetracycline resistance (Tcr) gene. pRDB5 was mobilized out of B. uniformis by a self transmissible Bacteroides chromosomal element designated Tcr Emr 12256. pRDB5 replicated in Escherichia coli as well as in Bacteroides spp. and was also mobilized from E. coli to B. uniformis by using IncP plasmid R751. However, direct transfer from E. coli to P. ruminicola B(1)4 was not detected. Thus, to introduce cloned DNA into P. ruminicola B(1)4, it was necessary first to mobilize the plasmid from E. coli to B. uniformis and then to mobilize the plasmid from B. uniformis to P. ruminicola B(1)4. PMID- 1768084 TI - Carboxylation of o-cresol by an anaerobic consortium under methanogenic conditions. AB - The metabolism of o-cresol under methanogenic conditions by an anaerobic consortium known to carboxylate phenol to benzoate was investigated. After incubation with the consortium at 29 degrees C for 59 days, o-cresol was transformed to 3-methylbenzoic acid, which was not further metabolized by the consortium. Proteose peptone in the culture medium was essential for the transformation of o-cresol. In addition, a transient compound detected in the culture was identified as 4-hydroxy-3-methylbenzoic acid. o-Cresol-6d was transformed by the consortium to deuterated hydroxy-methylbenzoic acid and deuterated methylbenzoic acid. These results demonstrate that o-cresol is carboxylated in the para position relative to the phenolic hydroxyl group and dehydroxylated by the anaerobic consortium. PMID- 1768085 TI - Propachlor degradation by a soil bacterial community. AB - Soil from a pesticide disposal site was used to enrich for microorganisms that degraded the acylanilide herbicide propachlor (2-chloro-N-isopropylacetanilide). After seven transfers of the enrichment, the culture contained about six strains. The highest yield of microbial biomass occurred if just two of these isolates, strains DAK3 and MAB2, were inoculated into a mineral salts medium containing propachlor. When only strain DAK3 was grown on propachlor, a metabolite (2-chloro N-isopropylacetamide) was released into the medium. Strain MAB2 could grow on this metabolite. The results of morphological and physiological tests suggest that strains DAK3 and MAB2 most closely resemble species belonging to the genera Moraxella and Xanthobacter, respectively. Strain DAK3 can respire and grow on N substituted acylanilides containing methyl, ethyl, or isopropyl substitutions, but is incapable of respiration or growth on acetanilide, aniline, or the acylanilide herbicides alachlor and metolachlor. Strain DAK3 appears to use the aromatic C atoms of propachlor for growth, as suggested by the growth yield on propachlor and the induction of catechol 2,3-oxygenase activity in acylanilide grown cells. PMID- 1768086 TI - Ecology of bacteriophages infecting activated sludge bacteria. AB - Little is known about the endemic bacteriophages of activated sludge. In this investigation 49 virus-host systems were studied by isolating co-occurring bacteria and bacteriophages from the aeration basin of a sewage treatment plant during 5 successive weeks. The phage titers were high and fluctuated during the time period. The occurrence of phage-sensitive and -resistant hosts did not depend on the presence or absence of phages. Several phage-host systems expressed variable plating efficiencies. In addition, phages with broad host ranges were observed. These results show that phages are an active part of this ecosystem and that they may exert selection pressure for phage resistance on their bacterial host populations. PMID- 1768087 TI - Cholera enterotoxin production in Vibrio cholerae O1 strains isolated from the environment and from humans in Japan. AB - Vibrio cholerae O1 strains isolated from various sources in Japan over the years 1977 through 1987 were examined to confirm the presence or absence of the cholera enterotoxin (CT) gene and production of CT and to determine the kappa-phage type. The CT gene was detected in none of 225 isolates from natural waters but was present in all of the 10 isolates from environmental waters implicated in domestic cholera cases, in 64 strains (26.6%) of the 241 isolates from imported seafoods, in 43 strains (95.6%) of the 45 isolates from domestic cholera cases, and in 119 strains (93.7%) of the 127 isolates from imported cholera cases. The results suggest that the CT gene-positive strains of V. cholerae O1 have been imported into Japan through seafoods and/or by travelers. Sporadic cholera cases have resulted in contamination of the surrounding environment, but the CT gene positive strains may not have persisted in natural waters to serve as a reservoir for epidemic cholera. The commercially available VET-RPLA kit (a latex agglutination kit for immunological detection of CT) detected production of CT in all of the CT gene-positive strains, indicating that there was no silent CT gene in the test strains. There was a strong correlation between the kappa-phage type and the presence or absence of the CT gene, suggesting a significant clonal difference between CT gene-positive and -negative strains. Five CT gene-negative strains isolated from imported cholera cases (travelers with mild diarrhea) induced a considerable amount of fluid accumulation in rabbit and/or suckling mouse intestines, indicating production of an enterotoxic factor(s) other than CT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768088 TI - Occurrence of plasmids in Danish isolates of Vibrio anguillarum serovars O1 and O2 and association of plasmids with phenotypic characteristics. AB - Two hundred and twenty-eight isolates of Vibrio anguillarum serovar O1 (125 isolates) and serovar O2 (103 isolates) have been characterized with regard to plasmid contents, biochemical properties, and in vitro hemagglutination and hydrophobic properties. Among 74 V. anguillarum isolates from diseased fish, 63 carried only a 67-kb plasmid (pJM1), 9 carried an additional 98-kb plasmid, and 1 isolate carried only the 98-kb plasmid. Only one isolate was without plasmids. In V. anguillarum serovar O1 from nondiseased fish (mucus and gills), plasmids of the same sizes were present in 29 isolates (58%), whereas 21 isolates (42%) were plasmid free. Based on hemagglutination and biochemical properties, V. anguillarum serovar O1 isolates were divided into eight biovars. The plasmid carrying strains (102 isolates) all fell within biovars 1 and 2, whereas the 23 strains of biovars 3 to 8 were without plasmids. It was tentatively concluded there are two populations of V. anguillarum serovar O1. One population contains plasmid(s), is hemagglutination negative and trehalose negative, and does not form pellicles in broth cultures, whereas the other population is plasmid free and has the opposite characteristics. The former group is the one related to disease in fish. All 20 V. anguillarum serovar O2 isolates from the environment were without plasmids, whereas 54 (65%) of the isolates from fish (trout and cod) carried plasmids. The biochemical diversity within serovar O2 was pronounced; 13 different biovars were demonstrated. No correlation between the presence of plasmids and biochemical properties was observed. PMID- 1768089 TI - Effects of organic matter on virus transport in unsaturated flow. AB - The effects of natural humic material and sewage sludge organic matter (SSOM) derived from primary treated sewage sludge on virus transport by unsaturated flow through soil columns were evaluated. Bacteriophage MS-2 was applied to loamy fine sand columns 0.052 m in diameter and 1.05 m long. Virus concentrations in the influent and effluent were measured daily for 7 to 9 days. In the first experiment, virus transport through two fresh soil columns was compared with that through a column previously leached with more than four pore volumes (T) of well water. The soil water organic matter concentrations in the leachate of the fresh soil declined with time. Relative virus concentrations (C/Co) from one fresh soil column reached 0.82 in 0.9 T and then declined to 0.51 by 2.1 T. The other fresh soil column reached and maintained a steady-state relative virus concentration [(C/Co)s] of 0.47 from 1.5 to 2.5 T. The leached column reached and maintained a (C/Co)s of 0.05. Concentrations measured at 0.2-, 0.4-, 0.8-, and 1.05-m depths indicated that most virus particles were removed in the surface 0.2 m. In the second experiment, one leached column was pretreated with SSOM derived from primary treated sewage sludge and the other leached column was untreated. SSOM concentrations declined with depth. A suspension of virus and SSOM in well water was applied to both columns. Although the (C/Co)s values were similar (0.41 for the pretreated column and 0.47 for the untreated column), breakthrough was delayed for the untreated column. Both natural humic material and sewage sludge derived SSOM increased the unsaturated-flow transport of MS-2. PMID- 1768090 TI - Concentration of viruses and dissolved DNA from aquatic environments by vortex flow filtration. AB - Vortex flow filtration (VFF) was used to concentrate viruses and dissolved DNA from freshwater and seawater samples taken in Florida, the Gulf of Mexico, and the Bahamas Bank. Recoveries of T2 phage and calf thymus DNA added to artificial seawater and concentrated by VFF were 72.8 and 80%, respectively. Virus concentrations determined by transmission electron microscopy of VFF-concentrated samples ranged from 3.4 x 10(7)/ml for a eutrophic Tampa Bay sample to 2.4 x 10(5) for an oligotrophic oceanic surface sample from the southeastern Gulf of Mexico. Viruslike particles were also observed in a sample taken from a depth of 1,500 m in the subtropical North Atlantic Ocean. Filtration of samples through Nuclepore or Durapore filters (pore size, 0.2 micron) prior to VFF reduced phage counts by an average of two-thirds. Measurement of dissolved-DNA content by Hoechst 33258 fluorescence in environmental samples concentrated by VFF yielded values only ca. 35% of those obtained for samples concentrated by ethanol precipitation (the standard dissolved-DNA method). However, ethanol precipitation of VFF-concentrated extracts resulted in an increase in measurable DNA, reaching 80% of the value obtained by the standard method. These results indicate that a portion of the naturally occurring dissolved DNA is in a form inaccessible to nucleases and Hoechst stain, perhaps bound to protein or other polymeric material, and is released upon ethanol precipitation. Viral DNA contents estimated from viral counts averaged only 3.7% (range, 0.9 to 12.3%) of the total dissolved DNA for samples from freshwater, estuarine, and offshore oligotrophic environments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768091 TI - 3,4-Dihydroxyxanthone dioxygenase from Arthrobacter sp. strain GFB100. AB - Bacterial extradiol ring-fission dioxygenases play a critical role in the transformation of multiring aromatic compounds to more readily biodegradable aromatic or aliphatic intermediates. Arthrobacter sp. strain GFB100 utilizes an extradiol meta-fission dioxygenase, 3,4-dihydroxyxanthone dioxygenase (DHXD), in the catabolism of the three-ring oxygen heterocyclic compound xanthone. In this paper, we show that DHXD is a cytosolic enzyme, induced by growth on xanthone and maximally expressed during the stationary phase of growth. In addition, we characterize the DHXD activity in terms of its basic enzymological properties. 1,10-Phenanthroline and H2O2 treatments eliminated DHXD activity, indicating that the enzyme required Fe2+ ions for activity. Other divalent cations were either inhibitory or had no effect on activity. DHXD had a temperature optimum of 30 degrees C and a pH optimum of 7.0. DHXD followed typical saturation kinetics and had an apparent Km of 10 microM for 3,4-dihydroxyxanthone. The dye celestine blue served as a noncompetitive DHXD inhibitor (Ki, 5 microM). Several other structural analogs served neither as substrates nor inhibitors. DHXD was thermally labile at temperatures above 40 degrees C. The half-life for thermal DHXD inactivation was 5 min at 40 degrees C. DHXD activity was completely stable through one freeze-thaw cycle, and about 80% of the DHXD activity remained after 2 days of incubation at 0 degree C. The apparent tight binding of the Fe2+ cofactor to DHXD may be a factor contributing to the stability of this extradiol dioxygenase when it is stored. PMID- 1768092 TI - Isolation and characterization of turbot (Scophtalmus maximus)-associated bacteria with inhibitory effects against Vibrio anguillarum. AB - More than 400 isolates from the intestine and the external surface of farmed Scophtalmus maximus as well as from fish food and hatchery water were screened for inhibitory effects against the fish pathogen Vibrio anguillarum HI 11345 and seven other fish pathogens. The bacteria with inhibitory effects were then characterized with regard to their sites of colonization, especially the intestinal regions and sites within each region. Of the total number of bacterial isolates from the intestine, 28% were inhibitory against V. anguillarum HI 11345. A marine biochemical assay was used to order the inhibitory strains into different phena. Most inhibitory bacteria were found in the rinse and mucus fractions of the gastrointestinal tract. No correlations among the different phena, site of colonization, and inhibitory effect could be found; however, a biochemical diversity was noted in the strains with an inhibitory effect. Of the isolates with an inhibitory effect against V. anguillarum HI 11345, 60% had an inhibitory effect on five other fish-pathogenic serotypes of V. anguillarum. Inhibitory effects of the isolates were also shown against Aeromonas salmonicida and Aeromonas hydrophila. PMID- 1768093 TI - Growth kinetics of coliform bacteria under conditions relevant to drinking water distribution systems. AB - The growth of environmental and clinical coliform bacteria under conditions typical of drinking water distribution systems was examined. Four coliforms (Klebsiella pneumoniae, Escherichia coli, Enterobacter aerogenes, and Enterobacter cloacae) were isolated from an operating drinking water system for study; an enterotoxigenic E. coli strain and clinical isolates of K. pneumoniae and E. coli were also used. All but one of the coliforms tested were capable of growth in unsupplemented mineral salts medium; the environmental isolates had greater specific growth rates than did the clinical isolates. This trend was maintained when the organisms were grown with low levels (less than 1 mg liter-1) of yeast extract. The environmental K. pneumoniae isolate had a greater yield, higher specific growth rates, and a lower Ks value than the other organisms. The environmental E. coli and the enterotoxigenic E. coli strains had comparable yield, growth rate, and Ks values to those of the environmental K. pneumoniae strain, and all three showed significantly more successful growth than the clinical isolates. The environmental coliforms also grew well at low temperatures on low concentrations of yeast extract. Unsupplemented distribution water from the collaborating utility supported the growth of the environmental isolates. Growth of the K. pneumoniae water isolate was stimulated by the addition of autoclaved biofilm but not by tubercle material. These findings indicate that growth of environmental coliforms is possible under the conditions found in operating municipal drinking water systems and that these bacteria could be used in tests to determine assimilable organic carbon in potable water. PMID- 1768094 TI - Manganese regulation of manganese peroxidase expression and lignin degradation by the white rot fungus Dichomitus squalens. AB - Extracellular manganese peroxidase and laccase activities were detected in cultures of Dichomitus squalens (Polyporus anceps) under conditions favoring lignin degradation. In contrast, neither extracellular lignin peroxidase nor aryl alcohol oxidase activity was detected in cultures grown under a wide variety of conditions. The mineralization of 14C-ring-, -side chain-, and -methoxy-labeled synthetic guaiacyl lignins by D. squalens and the expression of extracellular manganese peroxidase were dependent on the presence of Mn(II), suggesting that manganese peroxidase is an important component of this organism's lignin degradation system. The expression of laccase activity was independent of manganese. In contrast to previous findings with Phanerochaete chrysosporium, lignin degradation by D. squalens proceeded in the cultures containing excess carbon and nitrogen. PMID- 1768095 TI - Production of the siderophore aerobactin by a halophilic pseudomonad. AB - A bacterial strain, isolated from a cyanobacterial culture, was identified as Pseudomonas sp. strain X40. Under iron-limiting conditions, the Pseudomonas sp. produced aerobactin, a dihydroxamate siderophore previously found only in the family Enterobacteriaceae. Aerobactin was identified by electrophoretic mobility, spectrophotometric titration, proton nuclear magnetic resonance spectroscopy, mass spectrometry, acid hydrolysis, and biological activity. Aerobactin was used as a siderophore in the Pseudomonas sp. and Escherichia coli. Two iron-repressed outer membrane proteins were observed in the Pseudomonas sp., neither of which had electrophoretic mobility identical to that of the aerobactin outer membrane receptor protein from E. coli. DNA hybridization assays showed no hybridization to the aerobactin genes from the E. coli plasmid pColV, indicating that the genetic determinants for aerobactin production by Pseudomonas strain X40 differ substantially from those found in the archetypic enteric plasmid pColV-K30. PMID- 1768096 TI - Detection and identification of groundwater bacteria capable of escaping entrapment on 0.45-micron-pore-size membrane filters. AB - Rural drinking water systems supplied by untreated groundwater were examined to determine whether coliform or heterotrophic plate count bacteria are capable of escaping entrapment on standard porosity (0.45-micron-pore-size) membrane filters. Filterable bacteria were present in 42% of the 24 groundwater sources examined by using nonselective media (R2A, full strength m-HPC, and 0.1x m-HPC agars). Pseudomonads were the most frequently identified group of filterable bacteria detected. Flavobacterium, Alcaligenes, Acinetobacter, and Achromobacter isolates were also identified. Total coliforms were not recovered from any of the 24 groundwater samples following filtration through 0.45-micron-pore-size membrane filters by using selective M-Endo LES agar or mT7 agar. In addition, none of the isolates identified from nonselective media were coliforms. Similarly, neither total coliforms nor specifically Escherichia coli were detected in these filtrates when Colilert P/A medium was used. PMID- 1768097 TI - Transcription of the Escherichia coli fliC gene is regulated by metal ions. AB - luxAB gene fusions in the Escherichia coli genome were used to screen for clones displaying transcriptional changes in the presence of aluminum. One clone was found that contained a luciferase gene fusion in which transcription was increased in the presence of aluminum and which was subsequently shown to be induced by copper, iron, and nickel. Cloning of the metal-regulated gene, hybridization to the ordered phage lambda bank of the E. coli chromosome, and sequencing of DNA adjacent to the luxAB fusion revealed that the insertion occurred within the fliC (hag) gene of E. coli. This gene encodes flagellin, the filament subunit of the bacterial motility organ, and is under the control of several regulatory cascades. These results suggest that environmental metals may play a role in the regulation of the motility potential of E. coli and that this bioluminescent gene fusion clone (or derivatives thereof) may be used to prepare a biosensor for the rapid detection of metal contamination in water samples. PMID- 1768098 TI - Biodegradation of organic compounds in vadose zone and aquifer sediments. AB - The microbial processes that occur in the subsurface under a typical Midwest agricultural soil were studied. A 26-m bore was installed in November of 1988 at a site of the Purdue University Agronomy Research Center. Aseptic collections of soil materials were made at 17 different depths. Physical analysis indicated that the site contained up to 14 different strata. The site materials were primarily glacial tills with a high carbonate content. The N, P, and organic C contents of sediments tended to decrease with depth. Ambient water content was generally less than the water content, which corresponds to a -0.3-bar equivalent. No pesticides were detected in the samples, and degradation of added 14C-labeled pesticides (atrazine and metolachlor) was not detected in slurry incubations of up to 128 days. The sorption of atrazine and metolachlor was correlated with the clay content of the sediments. Microbial biomass (determined by direct microscopic count, viable count, and phospholipid assay) in the tills was lower than in either the surface materials or the aquifer located at 25 m. The biodegradation of glucose and phenol occurred rapidly and without a lag in samples from the aquifer capillary fringe, saturated zone, and surface soils. In contrast, lag periods and smaller biodegradation rates were found in the till samples. Subsurface sediments are rich in microbial numbers and activity. The most active strata appear to be transmissive layers in the saturated zone. This implies that the availability of water may limit activity in the profile. PMID- 1768099 TI - Mitochondrial DNAs and plasmids as taxonomic characteristics in Trichoderma viride. AB - Mitochondrial DNA (mtDNA) was purified from 12 isolates of the Trichoderma viride aggregate and found to be, on the average, 32.7 kb in size. Plasmids were present in the mtDNA preparations from 8 of 12 strains of T. viride examined. Plasmids in four of the strains produced ladderlike banding patterns on gels, and these plasmids were studied in detail. The ladderlike patterns were produced by single molecules that were supercoiled to various degrees. Plasmids from two of the strains do not have homology with the mtDNA but do have a limited amount of homology with each other. No phenotype could be associated with the presence of a plasmid. Restriction endonuclease digestion of the mtDNAs produced patterns in which the presence or absence of certain fragments correlated with the classification of the strains into T. viride group I or II. Phenetic cluster analysis and parsimony analysis of the fragment patterns produced groups that corresponded to T. viride groups I and II. The fragment patterns were very diverse, with nearly all strains having a unique pattern. However, two strains of T. viride group I from widely different geographical locations did have identical restriction patterns for all the enzymes used in this study. This result indicates that it may not be possible to use mtDNA restriction patterns alone to identify Trichoderma strains. PMID- 1768100 TI - Toxicity of Bacillus thuringiensis to laboratory populations of the olive fruit fly (Dacus oleae). AB - A survey of Bacillus thuringiensis recovered from the environments of olive groves in Greece was carried out. Of 80 soil samples, 24 were found to contain B. thuringiensis with parasporal crystal inclusions; these were tested for toxicity against the olive fruit fly (Dacus oleae). Mortality levels of larvae caused by the different isolates varied from 7 to 87%. Higher levels of mortality were observed if a mixture of relatively pure crystals and spores was used compared with the mortality resulting from either fraction alone. We were able to show that the toxicity of the most active isolate is likely to be specific for D. oleae. PMID- 1768101 TI - Reductive dechlorination of high concentrations of tetrachloroethene to ethene by an anaerobic enrichment culture in the absence of methanogenesis. AB - Tetrachloroethene, also known as perchloroethylene (PCE), is a common groundwater contaminant throughout the United States. The incomplete reductive dechlorination of PCE--resulting in accumulations of trichloroethene, dichloroethene isomers, and/or vinyl chloride--has been observed by many investigators in a wide variety of methanogenic environments. Previous mixed-culture studies have demonstrated that complete dechlorination to ethene is possible, although the final dechlorination step from vinyl chloride to ethene is rate limiting, with significant levels of vinyl chloride typically persisting. In this study, anaerobic methanol-PCE enrichment cultures which proved capable of dechlorinating high concentrations PCE to ethene were developed. Added concentrations of PCE as high as 550 microM (91-mg/liter nominal concentration; approximately 55-mg/liter actual aqueous concentration) were routinely dechlorinated to 80% ethene and 20% vinyl chloride within 2 days at 35 degrees C. The methanol level used was approximately twice that needed for complete dechlorination of PCE to ethene. The observed transformations occurred in the absence of methanogenesis, which was apparently inhibited by the high concentrations of PCE. When incubation was allowed to proceed for as long as 4 days, virtually complete conversion of PCE to ethene resulted, with less than 1% persisting as vinyl chloride. An electron balance demonstrated that methanol consumption was completely accounted for by dechlorination (31%) and acetate production (69%). The high volumetric rates of PCE dechlorination (up to 275 mumol/liter/day) and the relatively large fraction (ca. one-third) of the supplied electron donor used for dechlorination suggest that reductive dechlorination could be exploited for bioremediation of PCE contaminated sites. PMID- 1768102 TI - Regiospecific dechlorination of pentachlorophenol by dichlorophenol-adapted microorganisms in freshwater, anaerobic sediment slurries. AB - The reductive dechlorination of pentachlorophenol (PCP) was investigated in anaerobic sediments that contained nonadapted or 2,4- or 3,4-dichlorophenol (DCP) adapted microbial communities. Adaptation of sediment communities increased the rate of conversion of 2,4- or 3,4-DCP to monochlorophenols (CPs) and eliminated the lag phase before dechlorination was observed. Both 2,4- and 3,4-DCP-adapted sediment communities dechlorinated the six DCP isomers to CPs. The specificity of chlorine removal from the DCP isomers indicated a preference for ortho-chlorine removal by 2,4-DCP-adapted sediment communities and for para-chlorine removal by 3,4-DCP-adapted sediment communities. Sediment slurries containing nonadapted microbial communities either did not dechlorinate PCP or did so following a lag phase of at least 40 days. Sediment communities adapted to dechlorinate 2,4- or 3,4-DCP dechlorinated PCP without an initial lag phase. The 2,4-DCP-adapted communities initially removed the ortho-chlorine from PCP, whereas the 3,4-DCP adapted communities initially removed the para-chlorine from PCP. A 1:1 mixture of the adapted sediment communities also dechlorinated PCP without a lag phase. Dechlorination by the mixture was regiospecific, following a para greater than ortho greater than meta order of chlorine removal. Intermediate products of degradation, 2,3,5,6-tetrachlorophenol, 2,3,5-trichlorophenol, 3,5-DCP, 3-CP, and phenol, were identified by a combination of cochromatography (high-pressure liquid chromatography) with standards and gas chromatography-mass spectrometry. PMID- 1768103 TI - Isolation and characterization of p-coumaroyl esterase from the anaerobic fungus Neocallimastix strain MC-2. AB - An extracellular p-coumaroyl esterase produced by the anaerobic fungus Neocallimastix strain MC-2 released p-coumaroyl groups from 0-[5-0-((E)-p coumaroyl)-alpha-L-arabinofuranosyl]-(1----3)-0-beta -D-xylopyranosyl-(1----4)-D xylopyranose (PAXX). The esterase was purified 121-fold from culture medium in successive steps involving ultrafiltration column chromatography on S-sepharose and hydroxylapatite, isoelectric focusing, and gel filtration. The native enzyme had an apparent mass of 11 kDa under nondenaturing conditions and a mass of 5.8 kDa under denaturing conditions, suggesting that the enzyme may exist as a dimer. The isoelectric point was 4.7, and the pH optimum was 7.2. The purified esterase had 100 times more activity towards PAXX than towards the analogous feruloyl ester (FAXX). The apparent Km and Vmax of the purified p-coumaroyl esterase for PAXX at pH 7.2 and 40 degrees C were 19.4 microM and 5.1 microM min(-1), respectively. p-Coumaroyl tetrasaccharides isolated from plant cell walls were hydrolyzed at rates similar to that for PAXX, whereas a dimer of PAXX was hydrolyzed at a rate 20-fold lower, yielding 4,4'-dihydroxy-alpha-truxillic acid as an end product. Ethyl and methyl p-coumarates were hydrolyzed at very slow rates, if at all. The purified esterase released p-coumaroyl groups from finely, but not coarsely, ground plant cell walls, and this activity was enhanced by the addition of xylanase and other cell wall-degrading enzymes. PMID- 1768104 TI - Risk factors for contamination of domestic hot water systems by legionellae. AB - To assess risk factors associated with the contamination of the domestic environment by legionellae, 211 houses in the Quebec City area were randomly selected and water samples were collected from the hot water tank, the shower heads, and the most frequently used faucet. After centrifugation, concentrated samples were seeded in triplicate on BCYE and GPV media. Data on the characteristics of the hot water system and plumbing in the house and on the personal habits of the occupants were collected for each house. Among these 211 houses, hot water was provided by either an oil or gas heater in 33 and by an electric heater in 178. Legionellae were isolated from none of the samples from houses with oil or gas heaters and from 39% (69 of 178) of those with electric water heaters (P less than 0.0001). This association remained highly significant after control for water temperature and other variables in a stratified analysis. In the 178 houses with an electric heater, 12% of the faucets, 15% of the shower heads, and 37% of the water heaters were contaminated. Legionella pneumophila serogroups 2 and 4 were the most frequently isolated strains. Logistic regression showed that factors associated with electric water heater contamination were (i) location of the house in older districts of the city (P less than 0.0001), (ii) old age of the water heater (P = 0.003), and (iii) low water temperature (P = 0.05). Contamination of the water heater was the only factor significantly associated with the contamination of peripheral outlets (P less than 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768105 TI - Role of manganese peroxidases and lignin peroxidases of Phanerochaete chrysosporium in the decolorization of kraft bleach plant effluent. AB - The role of lignin peroxidases (LIPs) and manganese peroxidases (MNPs) of Phanerochaete chrysosporium in decolorizing kraft bleach plant effluent (BPE) was investigated. Negligible BPE decolorization was exhibited by a per mutant, which lacks the ability to produce both the LIPs and the MNPs. Also, little decolorization was seen when the wild type was grown in high-nitrogen medium, in which the production of LIPs and MNPs is blocked. A lip mutant of P. chrysosporium, which produces MNPs but not LIPs, showed about 80% of the activity exhibited by the wild type, indicating that the MNPs play an important role in BPE decolorization. When P. chrysosporium was grown in a medium with 100 ppm of Mn(II), high levels of MNPs but no LIPs were produced, and this culture also exhibited high rates of BPE decolorization, lending further support to the idea that MNPs play a key role in BPE decolorization. When P. chrysosporium was grown in a medium with no Mn(II), high levels of LIPs but negligible levels of MNPs were produced and the rate and extent of BPE decolorization by such cultures were quite low, indicating that LIPs play a relatively minor role in BPE decolorization. Furthermore, high rates of BPE decolorization were seen on days 3 and 4 of incubation, when the cultures exhibit high levels of MNP activity but little or no LIP activity. These results indicate that MNPs play a relatively more important role than LIPs in BPE decolorization by P. chrysosporium. PMID- 1768106 TI - Efficient biodegradation of high-molecular-weight polyethylene glycols by pure cultures of Pseudomonas stutzeri. AB - Biodegradation of polyethylene glycols (PEGs) of up to 13,000 to 14,000 molecular weight has been shown to be performed by a river water bacterial isolate (strain JA1001) identified as Pseudomonas stutzeri. A pure culture of strain JA1001 grew on PEG 1000 or PEG 10000 at 0.2% (wt/vol) as a sole source of carbon and energy with a doubling time of 135 or 150 min, respectively. Cultures metabolized 2 g of polymer per liter in less than 24 h and 10 g/liter in less than 72 h. The limit of 13,500 molecular weight in the size of the PEG sustaining growth and the presence of a PEG-oxidative activity in the periplasmic space indicated that PEGs cross the outer membrane and are subsequently metabolized in the periplasm. PEG oxidation was found to be catalyzed by PEG dehydrogenase, an enzyme that has been shown to be a single polypeptide. Characterization of PEG dehydrogenase revealed glyoxylic acid as the product of the PEG-oxidative cleavage. Glyoxylate supported growth by entering the cell and introducing its carbons in the general metabolism via the dicarboxylic acid cycle, as indicated by the ability of strain JA1001 to grow on this compound and the presence of malate synthase, the first enzyme in the pathway, in extracts of PEG-grown cells. PMID- 1768107 TI - Pathogenicity of nonstressed, heat-stressed, and resuscitated Listeria monocytogenes 1A1 cells. AB - The pathogenicity of nonstressed, heat-stressed, and resuscitated cells of Listeria monocytogenes 1A1 was assayed in immunocompromised mice. Cells were stressed by heating them at 56 degrees C for 20 min and were resuscitated by incubation in tryptic soy broth at 25 degrees C. A dose of 10(2) nonstressed and resuscitated cells per mouse was required for pathogenicity; a dose of 10(4) heat stressed cells per mouse was considerably less pathogenic. Loss of hemolytic activity accompanied the decreased virulence. PMID- 1768108 TI - Characteristics of an inulinase produced by Bacillus subtilis 430A, a strain isolated from the rhizosphere of Vernonia herbacea (Vell Rusby). AB - Bacillus subtilis 430A, isolated from the Vernonia herbacea (Vell Rusby) rhizosphere, produced an exocellular inulinase that fits the requirements for the production of syrups on an industrial scale. The partially purified enzyme, obtained by acetone precipitation, displayed a higher specificity for inulin (Km, 8 mM) than for sucrose (56 mM) and a total invertase/total inulase ratio of 0.62. In addition, it is stable at an optimal temperature of 45 to 50 degrees C for at least 7 h and is inhibited by the end product, fructose, at 14 mM. PMID- 1768109 TI - Fate of 2,2,2-trichloroacetaldehyde (chloral hydrate) produced during trichloroethylene oxidation by methanotrophs. AB - Four different methanotrophs expressing soluble methane monooxygenase produced 2,2,2-trichloroacetaldehyde, or chloral hydrate, a controlled substance, during the oxidation of trichloroethylene. Chloral hydrate concentrations decreased in these cultures between 1 h and 24 h of incubation. Chloral hydrate was shown to be biologically transformed to trichloroethanol and trichloroacetic acid by Methylosinus trichosporium OB3b. At elevated pH and temperature, chloral hydrate readily decomposed and chloroform and formic acid were detected as products. PMID- 1768110 TI - Biodegradation of monoaromatic hydrocarbons by aquifer microorganisms using oxygen, nitrate, or nitrous oxide as the terminal electron acceptor. AB - Microcosms were prepared from aquifer material, spiked with monoaromatic hydrocarbons, and amended with oxygen, nitrate, and nitrous oxide. Benzene and alkylbenzenes were degraded to concentrations below 5 micrograms/liter within 7 days under aerobic conditions, whereas only the alkylbenzenes were degraded when either nitrate or nitrous oxide was used. With limited oxygen, monoaromatic hydrocarbons were degraded but removal ceased once oxygen was consumed. However, when nitrate was also present, biodegradation of the alkylbenzenes continued with no apparent lag. Although benzene was still recalcitrant, levels were reduced compared with levels after treatment with nitrate or limited oxygen alone. PMID- 1768111 TI - Determination of Giardia lamblia cyst infective dose for the Mongolian gerbil (Meriones unguiculatus). AB - The purpose of this study was to determine the 50% infective dose for Giardia lamblia (CDC:0284:1) cysts in Mongolian gerbils (Meriones unguiculatus). The log10 50% infective dose results calculated by probit analysis and the Spearman Karber method were 2.45 and 2.50, respectively. PMID- 1768112 TI - Production of fumonisins by Fusarium moniliforme strains from various substrates and geographic areas. AB - Strains of Fusarium moniliforme from different geographic areas and from corn and other substrates were tested for the ability to produce fumonisins in culture. The test results indicate that the potential exists for production of fumonisins by such strains in agricultural commodities and other substrates in widespread geographic areas. PMID- 1768113 TI - Cloning and nucleotide sequence of the Lactobacillus casei lactate dehydrogenase gene. AB - An allosteric L-(+)-lactate dehydrogenase gene of Lactobacillus casei ATCC 393 was cloned in Escherichia coli, and the nucleotide sequence of the gene was determined. The gene was composed of an open reading frame of 981 bp, starting with a GTG codon and ending with a TAA codon. The sequences for the promoter and ribosome binding site were identified, and a sequence for a structure resembling a rho-independent transcription terminator was also found. PMID- 1768114 TI - Detection of bifidobacteria by using propionic acid as a selective agent. AB - This study introduces the use of the filtration membrane technique and the enrichment method to detect and enumerate bifidobacteria from various animal species. PMID- 1768115 TI - Cloning and expression of a chitinase gene from Aeromonas hydrophila in Escherichia coli. AB - An extracellular secreted chitinase gene from Aeromonas hydrophila was cloned in Escherichia coli, and the gene product was detected in the culture medium. Like the natural chitinase protein, the excreted chitinase had a molecular weight of approximately 85,000 and was subject to catabolite repression by glucose. PMID- 1768116 TI - Detection of coliform bacteria and Escherichia coli by multiplex polymerase chain reaction: comparison with defined substrate and plating methods for water quality monitoring. AB - Multiplex polymerase chain reaction (PCR) and gene probe detection of target lacZ and uidA genes were used to detect total coliform bacteria and Escherichia coli, respectively, for determining water quality. In tests of environmental water samples, the lacZ PCR method gave results statistically equivalent to those of the plate count and defined substrate methods accepted by the U.S. Environmental Protection Agency for water quality monitoring and the uidA PCR method was more sensitive than 4-methylumbelliferyl-beta-D-glucuronide-based defined substrate tests for specific detection of E. coli. PMID- 1768117 TI - Effect of C6 to C9 alkenals on aflatoxin production in corn, cottonseed, and peanuts. AB - The effect on aflatoxin production in Aspergillus flavus-inoculated corn, cottonseed, and peanuts in static culture in the presence of gaseous phase C6 to C9 alkenals was investigated. Aflatoxin B1 production was stimulated in corn at the lowest alkenal concentration (1-microliters level) tested. Aflatoxin B1 was completely eliminated at the highest alkenal concentrations (20-microliters level) tested in both treated corn and cottonseed cultures. PMID- 1768118 TI - DNA probes for detection of copper resistance genes in Xanthomonas campestris pv. vesicatoria. AB - The copper resistance (Cur) genes encoded on pXV10A, a 190-kb plasmid in Xanthomonas campestris pv. vesicatoria XV10, were isolated on a 44-kb cosmid clone designated pCuR1. Tn5 mutagenesis of pCuR1 indicated that a 4.0-kb region was required for copper resistance. Three restriction fragments located within the 4.0-kb region demonstrated high specificity for the Cur genes present in X. campestris pv. vesicatoria and will be useful in monitoring the presence of these genes in the environment. PMID- 1768119 TI - Casein utilization by lactococci. PMID- 1768120 TI - Distribution and survival of motile Aeromonas spp. in brackish water receiving sewage treatment effluent. AB - The spatiotemporal distributions of Aeromonas spp. and fecal coliforms in a cove receiving sewage treatment effluent and draining into a brackish lagoon were studied for 34 months with sampling at six stations. A total of 452 strains of Aeromonas spp. were isolated and identified at the outflow of the treatment system and at stations in the cove. Hemolytic activity of 289 Aeromonas strains was determined. The Aeromonas spp. and fecal coliform distributions showed seasonal cycles in the pond effluent. These seasonal bacterial cycles were persistent in effluent, at the discharge point, and in the cove. However, the abundance levels of these bacterial distributions decreased gradually from the coast to the open lagoon. A dilution model showed that the Aeromonas spp. and fecal coliform distributions in the cove water were subject not only to dilution effect but also to other environmental factors, such as salinity. A. sobria is the most common species identified in the Aeromonas population present in the cove water. Survival studies confirmed that Aeromonas spp., especially A. sobria, were more sensitive to saline and/or marine stress than fecal coliforms. Among the Aeromonas hydrophila and A. sobria strains, 96 and 97%, respectively, produced hemolysin, whereas among the Aeromonas caviae strains, 95% were nonhemolytic. PMID- 1768121 TI - Rapid identification of genetic variation and pathotype of Leptosphaeria maculans by random amplified polymorphic DNA assay. AB - Canadian isolates of Leptosphaeria maculans, the causal agent of blackleg of crucifers, were examined for genetic relatedness by the random amplified polymorphic DNA assay. DNA polymorphisms amplified with random decamer primers were used to distinguish three groups of isolates. Group 1 contained all isolates of the virulent pathotype, group 2 contained isolates of the avirulent pathotype from western Canada, and group 3 contained avirulent pathotype isolates from Ontario. These results agreed with other reports which showed many genetic differences between pathotypes and were consistent with the hypothesis that the virulent pathotype was recently introduced into Canada and has diverged relatively little. In contrast, the avirulent pathotype has probably been present in Canada for a longer time and has diverged with geographic isolation. In addition to establishing genetic relationships, DNA fingerprints generated by the random amplified polymorphic DNA assay have potential applications in pathotype identification and blackleg disease management. PMID- 1768122 TI - Variants of Aspergillus alutaceus var. alutaceus (formerly Aspergillus ochraceus) with altered ochratoxin A production. AB - The present studies, using Aspergillus alutaceus var. alutaceus Berkeley et Curtis (formerly A. ochraceus Wilhelm) NRRL 3174 along with three other wild-type strains, were undertaken in an attempt to understand the effects of irradiation and other treatments on mycotoxin production in grain. Bedford barley was inoculated with spores of NRRL 3174, gamma irradiated, and incubated at 28 degrees C and 25% moisture. After 10 days of incubation, two colony types, ochre (parental) and yellow (variant), were isolated from the grain. Further culturing of the yellow variant resulted in the spontaneous appearance of a white variant that exhibited greatly enhanced fluorescence under UV light. In subsequent work, we have also isolated variants producing a soluble red pigment. In addition, in model experiments involving irradiation (1 kGy) of pure cultures, induction frequencies ranging between 2 and 4% (survival basis) were observed for the yellow and red variants. Inoculation of these variants into wheat and incubation for 14 days at 28 degrees C and 32% moisture resulted in ochratoxin A production in the relative amounts of 0.09:1:4.6:9.3 for the red, ochre (parental), yellow, and white variants, respectively. Additional characteristics of these isolates are described. Confirmation that the white high-ochratoxin-A-producing variants were derived from the parental strain was demonstrated by obtaining revertant sectors in monoclonal cultures of the variants. PMID- 1768123 TI - Role of the competitive microbial flora in the radiation-induced enhancement of ochratoxin production by Aspergillus alutaceus var. alutaceus NRRL 3174. AB - The radiation sensitivity and the toxigenic potential of conidiospores of the fungus Aspergillus alutaceus var. alutaceus were determined after irradiation with 60Co gamma rays and high-energy electrons. Over the pH range of 3.6 to 8.8, the doses required for a 1 log10 reduction in viability based on the exponential portion of the survival curve ranged from 0.21 to 0.22 kGy, with extrapolation numbers (extrapolation of the exponential portion of the survival curve to zero dose) of 1.01 to 1.33, for electron irradiation, and from 0.24 to 0.27 kGy, with extrapolation numbers of 2.26 to 5.13, for gamma irradiation. Nonsterile barley that was inoculated with conidia of the fungus and then irradiated with either electrons or gamma rays and incubated for prolonged periods at 28 degrees C and at a moisture content of 25% produced less ochratoxin A with increasing doses of radiation. Inoculation of barley following irradiation resulted in enhanced ochratoxin levels compared with unirradiated controls. In these experiments, inoculation with 10(2) spores per g produced greater radiation-induced enhancement than inoculation with 10(5) spores per g. There was no radiation induced enhancement when the barley was surface sterilized by chemical means prior to irradiation. These results are consistent with the hypothesis that a reduction in the competing microbial flora by irradiation is responsible for the enhanced mycotoxin production observed when nonsterile barley is inoculated with the toxigenic fungus A. alutaceus var. alutaceus after irradiation. PMID- 1768124 TI - Use of modified diatomaceous earth for removal and recovery of viruses in water. AB - Diatomaceous earth was modified by in situ precipitation of metallic hydroxides. Modification decreased the negative charge on the diatomaceous earth and increased its ability to adsorb viruses in water. Electrostatic interactions were more important than hydrophobic interactions in virus adsorption to modified diatomaceous earth. Filters containing diatomaceous earth modified by in situ precipitation of a combination of ferric chloride and aluminum chloride adsorbed greater than 80% of enteroviruses (poliovirus 1, echovirus 5, and coxsackievirus B5) and coliphage MS2 present in tap water at ambient pH (7.8 to 8.3), even after filtration of 100 liters of tap water. Viruses adsorbed to the filters could be recovered by mixing the modified diatomaceous earth with 3% beef extract plus 1 M NaCl (pH 9). PMID- 1768125 TI - Effects of surfactant adsorption and biodegradability on the distribution of bacteria between sediments and water in a freshwater microcosm. AB - A microcosm containing resuspended river sediment was used to investigate the effect of anionic surfactants on the distribution of bacteria between planktonic and attached populations. Freshwater river sediment containing viable bacteria was preequilibrated in the microcosm, which was subsequently supplemented with biodegradable or recalcitrant surfactants and a non-surface-active carbon and energy source. Population dynamics of both free-living and attached bacteria were measured by epifluorescence microscopy with simultaneous analysis of the residual solution concentration of the xenobiotic carbon source. The addition of the readily biodegradable anionic surfactants sodium decyl sulfate and sodium dodecyl sulfate in separate experiments caused an increase in the number of attached bacteria and a concomitant decrease in the number of free-living bacteria. As biodegradation of the surfactants progressed, these trends reversed and the bacterial populations had returned to their preaddition values by the time when biodegradation was completed. In contrast, sodium tetradecyl sulfate or sodium dodecane sulfonate did not stimulate bacterial association with sediment, nor were they biodegraded in the microcosm. Sodium pyruvate, a non-surface-active carbon and energy source, was readily utilized but caused no bacterial attachment to the sediment. These results indicate that for an anionic surfactant to induce bacterial attachment to river sediment, it must be biodegradable. The bacterial attachment to the sediment appears to be reversible and may be dependent on the accumulation of the surfactant at the surface or as a result of alteration of the surface free energies. PMID- 1768126 TI - Properties of the glucose phosphotransferase system of Clostridium acetobutylicum NCIB 8052. AB - The glucose phosphotransferase system (PTS) of Clostridium acetobutylicum was studied by using cell extracts. The system exhibited a Km for glucose of 34 microM, and glucose phosphorylation was inhibited competitively by mannose and 2 deoxyglucose. The analogs 3-O-methylglucoside and methyl alpha-glucoside did not inhibit glucose phosphorylation significantly. Activity showed no dependence on Mg2+ ions or on pH in the range 6.0 to 8.0. The PTS comprised both soluble and membrane-bound proteins, which interacted functionally with the PTSs of Clostridium pasteurianum, Bacillus subtilis, and Escherichia coli. In addition to a membrane-bound enzyme IIGlc, sugar phosphorylation assays in heterologous systems incorporating extracts of pts mutants of other organisms provided evidence for enzyme I, HPr, and IIIGlc components. The HPr was found in the soluble fraction of C. acetobutylicum extracts, whereas enzyme I, and probably also IIIGlc, was present in both the soluble and membrane fractions, suggesting a membrane location in the intact cell. PMID- 1768127 TI - Production and characterization of N-acyl-D-glutamate amidohydrolase from Pseudomonas sp. strain 5f-1. AB - N-Acyl-D-glutamate amidohydrolase from Pseudomonas sp. strain 5f-1 was inducibly produced by D isomers of N-acetylglutamate, glutamate, aspartate, and asparagine. The enzyme has been purified to homogeneity by DEAE-cellulose, (NH4)2SO4 fractionation, and chromatofocusing followed by gel filtration on a Sephadex G 100 column. The enzyme was a monomer with molecular weight of 55,000. The enzyme activity was optimal at pH 6.5 to 7.5 and 45 degrees C. The isoelectric point and the pH stability were 8.8 and 9.0, respectively. N-Formyl, N-acetyl, N-butyryl, N propionyl, N-chloroacetyl derivatives of D-glutamate and glycyl-D-glutamate were substrates for the enzyme. At pH 6.5 in 100 mM N-2-hydroxyethylpiperazine-N'-2 ethanesulfonic acid (HEPES) buffer at 30 degrees C, a Km of 6.67 mM and a Vmax of 662 mumol/min/mg of protein for N-acetyl-D-glutamate were obtained. None of the metal ions stimulated the enzyme activity. Na+, K+, Mg2+, and Ba2+ acted as stabilizers. Hg2+, Cu2+, Zn2+, Fe3+, and EDTA were strongly inhibitory. PMID- 1768128 TI - Lactococcal plasmid pWV01 as an integration vector for lactococci. AB - A Bacillus subtilis strain was constructed that contained the repA gene of the lactococcal plasmid pWVO1 in its chromosome. This strain was used to construct the pWVO1-based integration vector pINT1, which lacked the repA gene. The 3.6-kb plasmid pINT1 was not able to replicate in Lactococcus lactis MG1363 but integrated into the chromosome via a Campbell-like mechanism when a lactococcal chromosomal DNA fragment was incorporated in the plasmid. Transformants were obtained that carried between one and four plasmid copies, in stable tandem arrangement on the chromosome. The results indicate that pWVO1 can be used for the development of a Campbell-like integration system fully derived of lactococcal DNA, with which stable multiple copies of any gene of interest can be generated in the lactococcal chromosome. PMID- 1768129 TI - Chromosomal stabilization of the proteinase genes in Lactococcus lactis. AB - The plasmid-encoded proteinase genes prtP and prtM of Lactococcus lactis subsp. cremoris Wg2 were integrated by a Campbell-like mechanism into the L. lactis subsp. lactis MG1363 chromosome by using the insertion vector pKLG610. Two transformants were obtained that differed in the number of amplified pKLG610 copies in head-to-tail arrangements on their chromosomes; MG610 contained approximately two copies, and MG611 contained about eight copies. The amplifications were stably maintained during growth in milk in the absence of antibiotics. The proteolytic activity of strain MG611 was approximately 11-fold higher than that of strain MG610 and about 1.5 times higher than that of strain MG1363(pGKV552), which carried the proteinase genes on an autonomously replicating plasmid with a copy number of approximately 5. All three strains showed rapid growth in milk with concomitant rapid production of acid. The results suggest that a limited number of copies of the proteinase genes prtP and prtM per genome is sufficient for good growth in milk. PMID- 1768130 TI - Sensitive and specific detection of Listeria monocytogenes in milk and ground beef with the polymerase chain reaction. AB - A sensitive and specific method for detection of Listeria monocytogenes in milk and ground-beef samples is described. It consists of culturing samples in listeria enrichment broth (LEB) and subculturing them from LEB to listeria plating media, followed by DNA extraction and species-specific detection of the organism by using the polymerase chain reaction (PCR). In developing the L. monocytogenes PCR assay, five oligonucleotide primers complementary to the nucleotide sequence of the listeriolysin O gene were synthesized and used in amplification experiments. PCR products of the predicted size, based on nucleotide sequence information, were generated with DNA from all of 72 L. monocytogenes strains with five different primer pairs. DNA from Listeria ivanovii, Listeria innocua, Listeria seeligeri, Listeria welshimeri, Listeria grayi, and Listeia murrayi strains and a panel of 47 bacterial strains representing 17 genera did not generate PCR products with the primer pairs employed. As little as 1 pg of L. monocytogenes DNA could be detected with the assay. To determine the most sensitive culture protocol to use in conjunction with the PCR assay, milk (10 ml) and ground-beef (25 g) samples were inoculated with L. monocytogenes at concentrations ranging from 0 to 10(5) CFU ml-1 or g-1, as appropriate for the sample. PCR assays on DNA extracted from growth on listeria plating media, inoculated with 24-h LEB samples cultures, were most sensitive, allowing detection of as little as 0.1 CFU of L. monocytogenes ml-1 or g-1 of milk and ground beef, respectively. PMID- 1768131 TI - Factors affecting the production of eremofortin C and PR toxin in Penicillium roqueforti. AB - Eremofortin C (EC) and PR toxin are secondary metabolites of Penicillium roqueforti. Of 17 strains from the American Type Culture Collection that were studied for their ability to produce EC and PR toxin, 13 produced these metabolites. Toxin production by strains grown in solid media (10 cereals and 8 other agricultural products) was also investigated. Production of EC and PR toxin by fungi grown on cereals was greater than production of EC and PR toxin by fungi grown on legumes; fungi grown on corn produced the greatest amount of PR toxin. Addition of corn extracts to the culture medium greatly increased the production of EC and PR toxin in a coordinated manner, with no significant change in mycelial dry weight. The fungi produced the highest levels of EC and PR toxin at 20 to 24 degrees C depending on the strain. Toxin production was higher in stationary cultures than in cultures that were gently shaken at 120 rpm. The optimum pH for production of both EC and PR toxin was around pH 4.0. With regard to spore age, toxin levels did not change significantly when we used spores obtained from fungi that were grown at 24 degrees C for 3 up to 48 days. PMID- 1768132 TI - Overproduction of lignin-degrading enzymes by an isolate of Phanerochaete chrysosporium. AB - Phanerochaete chrysosporium is a white rot fungus which secretes a family of lignin-degrading enzymes under nutrient limitation. PSBL-1 is a mutant of this organism that generates the ligninolytic system under nonlimiting conditions during primary metabolism. Lignin peroxidase, manganese peroxidase, and glyoxal oxidase activities for PSBL-1 under nonlimiting conditions were 4- to 10-fold higher than those of the wild type (WT) under nitrogen-limiting conditions. PSBL 1 was still in the log phase of growth while secreting the enzymes, whereas the WT had ceased to grow by this time. As in the WT, manganese(II) increased manganese peroxidase activity in the mutant. However, manganese also caused an increase in lignin peroxidase and glyoxal oxidase activities in PSBL-1. Addition of veratryl alcohol to the culture medium stimulated lignin peroxidase activity, inhibited glyoxal oxidase activity, and had little effect on manganese peroxidase activity in PSBL-1, as in the WT. Fast protein liquid chromatography (FPLC) analysis shows production of larger amounts of isozyme H2 in PSBL-1 than in the WT. These properties make PSBL-1 very useful for isolation of large amounts of all ligninolytic enzymes for biochemical study, and they open the possibility of scale-up production for pratical use. PMID- 1768133 TI - Plasmids and phase variation in Xenorhabdus spp. AB - Three strains of Xenorhabdus nematophilus (A24, F1, NC116) and strain Dan of Xenorhabdus bovienii were tested to evaluate whether the phase variation observed in these bacteria was in any way connected with plasmids. The plasmid patterns of both phases of A24 and F1 strains were the same, whereas the two NC116 phases had only one band each. No difference was observed between the undigested or digested plasmid patterns of the two phases from the three strains. No plasmid was detected in either phase of strain Dan. The plasmid probes were prepared from the six bands of A24 phase 1. By hybridization studies, three plasmids in two forms (open circular and supercoiled) were detected in the strain A24. Two were estimated at 12 kb, and the smallest was about 4 kb. Attempts to hybridize plasmid probes with either undigested or digested chromosomal DNA of the two phases of strain A24 were unsuccessful. The results suggest that neither a difference in plasmid content nor a plasmid recombination with the chromosome is involved in phase variation. The hybridizations revealed homologous DNA sequences among the three plasmids of strain A24 and among the plasmids of strains such as A24 and NC116, which were isolated from geographically distant countries, suggesting that plasmids may encode similar proteins. PMID- 1768134 TI - Design and testing of a functional group-specific DNA probe for the study of natural populations of acetogenic bacteria. AB - The acetogens, although phylogenetically diverse, can be characterized by their possession of the acetyl coenzyme A (acetyl-CoA) pathway for autotrophic CO2 fixation. The gene encoding formyltetrahydrofolate synthetase, a key enzyme of the acetyl-CoA pathway, was previously cloned from the thermophilic acetogen Clostridium thermoaceticum and has now been tested as a group-specific probe for acetogens. Stable hybrids were formed between the probe and single DNA fragments from eight known acetogens representing six genera. A hybrid was also formed between the probe and a DNA fragment from one sulfate reducer known to be capable of both autotrophic CO2 fixation and acetate catabolism. No such hybrid was formed between the probe and DNA from a homoacetate fermenter not known to use the acetyl-CoA pathway, with two known formyltetrahydrofolate synthetase producing purine fermenters, or with DNA from 27 other species representing 16 genera of organisms that do not use the acetyl-CoA pathway. DNA purified from cells extracted from horse manure was also screened with the acetogen probe. Six hybrids, indicating at least six detectable acetogen "strains," were observed. PMID- 1768135 TI - Giardia and Cryptosporidium spp. in filtered drinking water supplies. AB - Giardia and Cryptosporidium levels were determined by using a combined immunofluorescence test for filtered drinking water samples collected from 66 surface water treatment plants in 14 states and 1 Canadian province. Giardia cysts were detected in 17% of the 83 filtered water effluents. Cryptosporidium oocysts, were observed in 27% of the drinking water samples. Overall, cysts or oocysts were found in 39% of the treated effluent samples. Despite the frequent detection of parasites in drinking water, microscopic observations of the cysts and oocysts suggested that most of the organisms were nonviable. Compliance with the filtration criteria outlined by the Surface Water Treatment Rule of the U.S. Environmental Protection Agency did not ensure that treated water was free of cysts and oocysts. The average plant effluent turbidity for sites which were parasite positive was 0.19 nephelometric turbidity units. Of sites that were positive for Giardia or Cryptosporidium spp., 78% would have been able to meet the turbidity regulations of the Surface Water Temperature Rule. Evaluation of the data by using a risk assessment model developed for Giardia spp. showed that 24% of the utilities examined would not meet a 1/10,000 annual risk of Giardia infection. For cold water conditions (0.5 degree C), 46% of the plants would not achieve the 1/10,000 risk level. PMID- 1768136 TI - Degradation of substituted indoles by an indole-degrading methanogenic consortium. AB - Degradation of indole by an indole-degrading methanogenic consortium enriched from sewage sludge proceeded through a two-step hydroxylation pathway yielding oxindole and isatin. The ability of this consortium to hydroxylate and subsequently degrade substituted indoles was investigated. Of the substituted indoles tested, the consortium was able to transform or degrade 3-methylindole and 3-indolyl acetate. Oxindole, 3-methyloxindole, and indoxyl were identified as metabolites of indole, 3-methylindole, and 3-indolyl acetate degradation, respectively. Isatin (indole-2,3-dione) was produced as an intermediate when the consortium was amended with oxindole, providing evidence that degradation of indole proceeded through successive hydroxylation of the 2- and 3-positions prior to ring cleavage between the C-2 and C-3 atoms on the pyrrole ring of indole. The presence of a methyl group (-CH3) at either the 1- or 2-position of indole inhibited the initial hydroxylation reaction. The substituted indole, 3 methylindole, was hydroxylated in the 2-position but not in the 3-position and could not be further metabolized through the oxindole-isatin pathway. Indoxyl (indole-3-one), the deacetylated product of 3-indolyl acetate, was not hydroxylated in the 2-position and thus was not further metabolized by the consortium. When an H atom or electron-donating group (i.e., -CH3) was present at the 3-position, hydroxylation proceeded at the 2-position, but the presence of electron-withdrawing substituent groups (i.e., -OH or -COOH) at the 3-position inhibited hydroxylation. PMID- 1768137 TI - Chemotaxis of Bradyrhizobium japonicum to soybean exudates. AB - The chemotactic response of Bradyrhizobium japonicum toward soybean seed and root exudates was examined. Assays using various isoflavones and fractionated exudate indicated that isoflavones are not the principal attractants in exudates. Likewise, induction of nod genes with isoflavones or seed exudate before assay did not enhance chemotaxis. Screening of numerous compounds revealed that only dicarboxylic acids and the amino acids glutamate and aspartate were strong attractants. The presence of glutamate, aspartate, and dicarboxylic acids in appreciable concentrations in soybean seed and root exudates indicates that these compounds likely represent natural chemoattractants for B. japonicum. PMID- 1768138 TI - Formation of nonculturable Vibrio vulnificus cells and its relationship to the starvation state. AB - Entry into the viable but nonculturable state by the human bacterial pathogen Vibrio vulnificus in artificial seawater microcosms was studied. In contrast to the long-term culturability exhibited by cells incubated under these starvation conditions at room temperature, cells exposed to a temperature downshift to 5 degrees C exhibited an immediate decrease in culturability. Cells incubated at low temperature exhibited a morphological change from rods to cocci but demonstrated no reductive division. Of 10 factors studied which might affect the nonculturable response in V. vulnificus, only the physiological age of the cells was found to significantly affect the rate at which cells became nonculturable. The nonculturable response appears to be related to the starvation response, as prestarvation at room temperature for 24 h was found to eliminate the nonculturable response of cells subsequently incubated at 5 degrees C. This observation suggests that the synthesis of starvation proteins may repress the viable but nonculturable program displayed during low-temperature incubation. The possible ecological significance of these findings is discussed. PMID- 1768139 TI - Amplification, cloning, and sequencing of a nifH segment from aquatic microorganisms and natural communities. AB - By use of the polymerase chain reaction and degenerate oligonucleotide primers for highly conserved regions of nifH, a segment of nifH DNA was amplified from several aquatic microorganisms, including an N2-fixing bacterium closely associated with the marine filamentous cyanobacterium Trichodesmium sp., a heterotrophic isolate from the root/rhizome of the seagrass Ruppia maritima, and the heterocystous freshwater cyanobacterium Anabaena oscillarioides. nifH segments were amplified directly from DNA extracted from the rhizosphere of roots of the seagrass Halodule wrightii. The nifH fragments were then cloned and sequenced. The DNA and deduced amino acid sequences were compared with known sequences, revealing distinct differences between taxonomic groups. This technique was shown to be useful for (i) the detection of N2-fixing microorganisms and (ii) rapidly obtaining the DNA sequence of the nifH gene, which provides information about general taxonomic groups of N2-fixing microorganisms. PMID- 1768140 TI - Use of the polymerase chain reaction in detection of culturable and nonculturable Vibrio vulnificus cells. AB - Vibrio vulnificus is a human pathogen associated with consumption of raw oysters. During the colder months the organism apparently enters a viable but nonculturable state and thus cannot be cultured by ordinary bacteriological methods. For this reason, another means of detecting this bacterium is necessary. In the present study we utilized the polymerase chain reaction (PCR) to detect V. vulnificus DNA, thus eliminating the problem of nonculturability. DNA from both culturable and nonculturable cells of V. vulnificus was amplified by PCR with primers flanking a 340-bp fragment of the cytotoxin-hemolysin gene. As little as 72 pg of DNA from culturable cells and 31 ng of DNA from nonculturable cells could be detected. Fifty cycles of a two-step reaction (30 s [each] at 94 and 65 degrees C) were found to be optimal as well as more time efficient than the three step PCR. The total procedure from the point of DNA extraction to observation on a gel required less than 8 h. Possible reasons for the difficulties encountered in amplifying DNA from nonculturable cells, e.g., gene rearrangement or loss of the hemolysin gene, are discussed. PMID- 1768141 TI - Utility of phenomenological models for describing temperature dependence of bacterial growth. AB - We compared three unstructured mathematical models, the master reaction, the square root, and the damage/repair models, for describing the relationship between temperature and the specific growth rates of bacteria. The models were evaluated on the basis of several criteria: applicability, ease of use, simple interpretation of model parameters, problem-free determination of model parameters, statistical evaluation of goodness of fit (chi 2 test), and biological relevance. Best-fit parameters for the master reaction model could be obtained by using two consecutive nonlinear least-square fits. The damage/repair model proved to be unsuited for the data sets considered and was judged markedly overparameterized. The square root model allowed nonproblematical parameter estimation by a nonlinear least-square procedure and, together with the master reaction model, was able to describe the temperature dependence of the specific growth rates of Klebsiella pneumoniae NCIB 418, Escherichia coli NC3, Bacillus sp. strain NCIB 12522, and the thermotolerant coccobacillus strain NA17. The square root and master reaction models were judged to be equally valid and superior to the damage/repair model, even though the square root model is devoid of a conceptual basis. PMID- 1768142 TI - Light sensitivity of methanogenic archaebacteria. AB - Representatives of four families of methanogenic archaebacteria (archaea), Methanobacterium thermoautotrophicum delta H, Methanobacterium thermoautotrophicum Marburg, Methanosarcina acetivorans, Methanococcus voltae, and Methanomicrobium mobile, were found to be light sensitive. The facultative anaerobic eubacteria Escherichia coli and Salmonella typhimurium, however, were tolerant of light when grown anaerobically under identical light conditions. Interference filters were used to show that growth of the methanogens is inhibited by light in the blue end of the visible spectrum (370 to 430 nm). PMID- 1768143 TI - Autoregulatory response of Phaseolus vulgaris L. to symbiotic mutants of Rhizobium leguminosarum bv. phaseoli. AB - In Rhizobium-legume symbiosis, the plant host controls and optimizes the nodulation process by autoregulation. Tn5 mutants of Rhizobium leguminosarum bv. phaseoli TAL 182 which are impaired at various stages of symbiotic development, were used to examine autoregulation in the common bean (Phaseolus vulgaris L.). Class I mutants were nonnodulating, class II mutants induced small, distinct swellings on the roots, and a class III mutant formed pink, bacterium-containing, but ineffective nodules. A purine mutant (Ade-) was nonnodulating, while a pyrimidine mutant (Ura-) formed small swellings on the roots. Amino acid mutants (Leu-, Phe-, and Cys-) formed mostly empty white nodules. Each of the mutants was used as a primary inoculant on one side of a split-root system to assess its ability to suppress secondary nodulation by the wild type on the other side. All mutants with defects in nodulation ability, regardless of the particular stage of blockage, failed to induce a suppression response from the host. Only the nodulation-competent, bacterium-containing, but ineffective class III mutant induced a suppression response similar to that induced by the wild type. Suppression was correlated with the ability of the microsymbiont to proliferate inside the nodules but not with the ability to initiate nodule formation or the ability to fix nitrogen. Thus, the presence of bacteria inside the nodules may be required for the induction of nodulation suppression in the common bean. PMID- 1768144 TI - Rapid procedure for detecting enterohemorrhagic Escherichia coli O157:H7 in food. AB - A sensitive, specific procedure was developed for detecting Escherichia coli O157:H7 in food in less than 20 h. The procedure involves enrichment of 25 g of food in 225 ml of a selective enrichment medium for 16 to 18 h at 37 degrees C with agitation (150 rpm). The enrichment culture is applied to a sandwich enzyme linked immunosorbent assay (ELISA) with a polyclonal antibody specific for E. coli O157 antigen as the capture antibody and a monoclonal antibody specific for enterohemorrhagic E. coli of serotypes O157:H7 and O26:H11 as the detection antibody. The ELISA can be completed within 3 h. The sensitivity of the procedure, determined by using E. coli O157:H7-inoculated ground beef and dairy products, including different varieties of cheese, was 0.2 to 0.9 cell per g of food. A survey of retail fresh ground beef and farm raw milk samples with this procedure revealed that 3 (2.8%) of 107 ground beef samples and 11 (10%) of 115 raw milk samples were positive for E. coli O157:H7. Most-probable-number determinations revealed E. coli O157:H7 populations of 0.4 to 1.5 cells per g in the three ground beef samples. In addition to being highly specific, sensitive, and rapid, this procedure is easy to perform and is amenable to use by laboratories performing routine microbiological testing. PMID- 1768145 TI - Purification and properties of 4-hydroxybutyrate coenzyme A transferase from Clostridium aminobutyricum. AB - A new coenzyme A (CoA)-transferase from the anaerobe Clostridium aminobutyricum catalyzing the formation of 4-hydroxybutyryl-CoA from 4-hydroxybutyrate and acetyl-CoA is described. The enzyme was purified to homogeneity by standard techniques, including fast protein liquid chromatography under aerobic conditions. Its molecular mass was determined to be 110 kDa, and that of the only subunit was determined to be 54 kDa, indicating a homodimeric structure. Besides acetate and acetyl-CoA, the following substrates were detected (in order of decreasing kcat/Km): 4-hydroxybutyryl-CoA, butyryl-CoA and propionyl-CoA, vinyl acetyl-CoA (3-butenoyl-CoA), and 5-hydroxyvaleryl-CoA. In an indirect assay the corresponding acids were also found to be substrates; however, DL-lactate, DL-2 hydroxybutyrate, DL-3-hydroxybutyrate, crotonate, and various dicarboxylates were not. PMID- 1768146 TI - Survival of Legionella pneumophila in the cold-water ciliate Tetrahymena vorax. AB - The processing of phagosomes containing Legionella pneumophila and Escherichia coli were compared in Tetrahymena vorax, a hymenostome ciliated protozoan that prefers lower temperatures. L. pneumophila did not multiply in the ciliate when incubated at 20 to 22 degrees C, but vacuoles containing L. pneumophila were retained in the cells for a substantially longer time than vacuoles with E. coli. Electron micrographs showed no evidence of degradation of L. pneumophila cells through 12 h, while E. coli cells in the process of being digested were observed in vacuoles 75 min after the addition of the bacterium. T. vorax ingested L. pneumophila normally, but by 10 to 15 min, the vacuolar membrane appeared denser than that surrounding nascent or newly formed phagosomes. In older vacuoles, electron-dense particles lined portions of the membrane. Acidification of the phagosomes indicated by the accumulation of neutral red was similar in T. vorax containing L. pneumophila or E. coli. This ciliate could provide a model for the analysis of virulence-associated intracellular events independent of the replication of L. pneumophila. PMID- 1768148 TI - Cloning vectors, mutagenesis, and gene disruption (ermR) for the erythromycin producing bacterium Aeromicrobium erythreum. AB - Genetic systems for study of Aeromicrobium erythreum, a gram-positive, G + C-rich (72%) bacterium with the capacity for erythromycin biosynthesis, are described. High-copy-number plasmids suitable as gene cloning vectors include derivatives of the Streptomyces plasmids pIJ101, pVE1, and pJV1. pIJ101 derivatives with missense substitutions at the rep gene BamHI site do not replicate in A. erythreum. Ethyl methanesulfonate treatment generated several amino acid auxotrophs and non-erythromycin-producing (Ery-) strains. Using the Ery- strain AR1807 as a recipient for plasmid-directed integrative recombination, the chromosomal ermR gene (encoding 23S rRNA methyltransferase) was disrupted. Phenotypic characterizations demonstrated that ermR is the sole determinant of macrolide antibiotic resistance in A. erythreum. PMID- 1768147 TI - Characterization of Vibrio anguillarum and closely related species isolated from farmed fish in Norway. AB - A total of 264 bacterial strains tentatively or definitely classified as Vibrio anguillarum were examined. The strains were isolated from diseased or healthy Norwegian fish after routine autopsy. With the exception of five isolates from wild saithe (Pollachius virens), the strains originated from nine different species of farmed fish. The bacteria were subjected to morphological, physiological, and biochemical studies, numerical taxonomical analyses, serotyping by slide agglutination and enzyme-linked immunosorbent assay, DNA plasmid profiling, and in vitro antimicrobial drug susceptibility testing. The results of the microbiological studies were correlated to anamnestic information. The bacterial strains were identified as V. anguillarum serovar O1 (n = 132), serovar O2 (n = 89), serovar O4 (n = 2), serovar O8 (n = 1), and not typeable (n = 1) as well as Vibrio splendidus biovar I (n = 36) and biovar II (n = 1), Vibrio tubiashii (n = 1), and Vibrio fischerii (n = 1). V. anguillarum serovar O1 or O2 was isolated in 176 out of 179 cases of clinical vibriosis in Atlantic salmon (Salmo salar). V. anguillarum serovar O1 was the only serovar isolated from salmonid fish species other than Atlantic salmon, while V. anguillarum serovar O2 was isolated from all marine fish suffering from vibriosis. A 48-Mda plasmid was isolated from all V. anguillarum serovar O1 isolates examined. Serovar O2 isolates did not harbor any plasmids. Resistance against commonly used antibiotic compounds was not demonstrated among V. anguillarum isolates. Neither V. splendidus biovar I nor other V. anguillarum-related species appeared to be of clinical importance among salmonid fish.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768149 TI - Recovery of an integration shuttle vector from tandem repeats in Methanococcus maripaludis. AB - Transformation of Methanococcus maripaludis by using an integration vector, pKAS102, is described. Selection and subsequent growth at high concentrations of puromycin caused pKAS102 to develop tandem repeats within the genome. As a result, total DNA isolated from the transformant could be used to recover the intact vector by direct transformation of competent Escherichia coli. PMID- 1768150 TI - Complementation of the inability of Lactobacillus strains to utilize D-xylose with D-xylose catabolism-encoding genes of Lactobacillus pentosus. AB - The inability of two Lactobacillus strains to ferment D-xylose was complemented by the introduction of Lactobacillus pentosus genes encoding D-xylose isomerase, D-xylulose kinase, and a D-xylose catabolism regulatory protein. This result opens the possibility of using D-xylose fermentation as a food-grade selection marker for Lactobacillus spp. PMID- 1768151 TI - Enhancement of soybean nodulation by Bacillus cereus UW85 in the field and in a growth chamber. AB - Seed treatments with Bacillus cereus UW85 increased nodulation of soybeans in three field seasons and in three different sterilized soils in the growth chamber. In the field, 28 and 35 days after planting, UW85-treated plants had 31 to 133% more nodules than untreated plants. From 49 days after planting until seed harvest, there were no significant differences between nodulation of UW85 treated plants and untreated control plants. In the growth chamber, in sterilized soil-vermiculite mixtures, at 28 days after planting, UW85 seed treatments enhanced nodulation by 34 to 61%, indicating that the increase in nodulation was not dependent on the soil flora. PMID- 1768152 TI - Resuscitation effects of catalase on airborne bacteria. AB - Catalase incorporation into enumeration media caused a significant increase (greater than 63%) in the colony-forming abilities of airborne bacteria. Incubation for 30 to 60 min of airborne bacteria in collection fluid containing catalase caused a greater than 95% increase in colony-forming ability. However, catalase did not have any effects on enumeration at high relative humidities (80 to 90%). PMID- 1768153 TI - Dyes as fungal inhibitors: effect on colony diameter. AB - The effects of a wide range of concentrations of 13 dyes on the colony diameters of nine fungal strains (including members of the Deuteromycetes and Zygomycetes) were evaluated. Auramine at a concentration of 50 ppm (50 micrograms/ml), methylene blue at a concentration of 500 ppm, gentian violet at a concentration of 5 ppm, and phenol red at a concentration of 50 ppm performed as well as the commonly used dyes dichloran at a concentration of 2 ppm and rose bengal at a concentration of 50 ppm in that they allowed adequate colony development of the Deuteromycetes strains tested and controlled rapidly spreading fungi. PMID- 1768154 TI - Sex hormone modulation in systemic lupus erythematosus: still a therapeutic option? PMID- 1768155 TI - Systemic lupus erythematosus patient guide: influence on knowledge of the disease. AB - The knowledge of patients with systemic lupus erythematosus about their disease before and after reading a patient guide was tested. The scores for incorrect answers decreased from 28 to 24% after reading the guide, showing that it increased the patients' knowledge of the disease. The patients with an academic background had the best scores before reading the guide, but they did not improve their scores as much as patients with lower educational qualifications. The differences between the groups studied were not significant in a one way analysis of variance. Forty seven questions about the psychology and coping mechanisms of the patients were factorized. These factors, together with data on the duration and severity of SLE and the age of the patient, were used in multiple linear regression analysis, but had no significant predictive value for an improvement in knowledge. The scores in psychological tests were the same before and after reading the guide. It is concluded that the patient guide for SLE increases knowledge of the disease, but does not affect the psychological response of the patient. The improvement in knowledge cannot be predicted on the basis of various psychological and clinical factors or the social background of the patient. PMID- 1768156 TI - Inhibitory effects of anticardiolipin antibodies on lymphocyte proliferation and neutrophil phagocytosis. AB - Anticardiolipin antibodies purified from serum from patients with systemic lupus erythematosus (SLE) by cardiolipin micelles were studied for their effects on lymphocytes and neutrophils. At a concentration of 160 micrograms/ml they markedly suppressed the [3H]thymidine incorporation of mononuclear cells stimulated by phytohaemagglutinin (4.9 (SEM 1.9%) of the control) and pokeweed mitogen (26.7 (10.5%) of the control). In addition, anticardiolipin antibodies changed the cell cycle of phytohaemagglutinin stimulated lymphocytes such that the S and G2+M phases were significantly diminished (G0/G1 = 64.62%, S = 20.59%, G2+M = 14.78% in the presence of normal human IgG v G0/G1 = 86.07%, S = 10.32%, G2+M = 3.59% in the presence of anticardiolipin antibodies). The suppression of lymphocyte proliferation by anticardiolipin antibodies was shown not to be caused by an alteration of T cell subpopulations. However, the interleukin 2 receptors on the cell surface and the soluble interleukin 2 receptors in the supernatant of phytohaemagglutinin stimulated mononuclear cells were decreased in the presence of anticardiolipin antibodies. On the other hand, the phagocytic activity of neutrophils was 40% inhibited at a higher concentration of anticardiolipin antibodies (300 micrograms/ml) through suppression of C3b/C4b and Fc receptors on polymorphonuclear leucocytes. These results suggest that anticardiolipin antibodies exert inhibitory effects on both lymphocytes and phagocytes in addition to the coagulation cascade. These newly found activities of anticardiolipin antibodies were mediated by the non-specific membranotropic property of the antibodies. PMID- 1768157 TI - Immunopathology of subcutaneous rheumatoid nodules. AB - Nodules obtained from five patients with classical seropositive rheumatoid arthritis were studied by an immunofluorescence technique using polyclonal antibodies to IgG, IgA, IgM, C3c, and fibrin, and monoclonal antibodies to the terminal (C5b-9) complement complex (reaction with a neoantigen in C9 revealed during activation), DR antigens, T cells, macrophages, and interdigitating cells. In all instances the central necrotic areas stained strongly for fibrin and more weakly for IgG, IgA, IgM, C3, and terminal complement complex. The surrounding palisading cells reacted with antibodies to DR and macrophages. In the peripheral granulomatous tissue most of the lymphocytes reacted with the antibodies to T cells, whereas various amounts of the larger mononuclear cells were stained by antibodies to DR antigens, macrophages, and interdigitating cells. In all instances the walls of some of the smaller vessels in the granulomatous tissue stained for fibrin, C3, and terminal complement complex. Plasma cells were not seen except for scattered IgM cells in one nodule. These results support the view that the palisading cells are derived from macrophages, and indicate that there is vasculitis with activation of C3 and the terminal complement pathway in the granulomatous tissue. PMID- 1768158 TI - Exacerbation of rheumatoid arthritis in patients treated with methotrexate after administration of folinic acid. AB - A double blind, placebo controlled trial examined the effects of folinic acid on the efficacy and toxicity of methotrexate in 27 patients with rheumatoid arthritis. Clinical and laboratory indices of disease activity worsened significantly in the 13 patients treated with folinic acid after four weeks of treatment, but not in the 14 patients treated with placebo. Exacerbation of rheumatoid arthritis led to withdrawal of the test drug in seven of the patients treated with folinic acid but in none of those treated with placebo. It is concluded that excerbation of rheumatoid arthritis is likely when folinic acid is given shortly after the weekly dose of methotrexate. PMID- 1768159 TI - Inactivation of the elastase inhibitory activity of alpha 1 antitrypsin in fresh samples of synovial fluid from patients with rheumatoid arthritis. AB - The proteinase inhibitory ability of alpha 1 antitrypsin was measured in 23 samples of rheumatoid arthritis synovial fluid, eight osteoarthritic synovial fluids and nine normal control serum samples. For each sample a detailed kinetic analysis was performed with porcine pancreatic elastase as the target proteinase. Samples were stored for less than 24 hours at 4 degrees C before analysis, which does not significantly alter the proportion of inactive alpha 1 antitrypsin. In rheumatoid synovial fluid the elastase inhibitory ability was disproportionately depressed relative to the immunochemically determined concentrations of alpha 1 antitrypsin. PMID- 1768160 TI - Comparative study of intra-articular pressure dynamics in joints with acute traumatic and chronic inflammatory effusions: potential implications for hypoxic reperfusion injury. AB - It has been proposed that the process of hypoxic-reperfusion injury contributes to the persistence of synovitis in the inflamed human joint. The generation of pathological, exercise induced, intra-articular pressure leading to occlusion of the synovial microcirculation is central to this mechanism. However, acute traumatic inflammatory joint effusions rarely result in chronic synovitis, suggesting that either the basic hypothesis is incorrect, or that joints with acute traumatic effusions show different intra-articular pressure dynamics. In this study the intra-articular pressure was measured at rest and during isometric exercise in five patients with acute traumatic joint effusions and in nine patients with chronic inflammatory joint effusions. The generation of intra articular pressure in the patients with acute traumatic effusions was significantly lower at rest (mean 2.0 v 19.6 mm Hg) and during exercise (mean 13.7 v 222.5 mm Hg) than in the patients with chronic effusions. This was due to reflex muscular inhibition around the joint, which inhibited the pathological generation of intra-articular pressure. This difference in the ability to generate intra-articular pressure might mitigate against hypoxic-reperfusion injury in joints with acute traumatic effusions, thereby explaining the paradoxical clinical observation that patients with acute traumatic inflammatory joint effusions rarely develop chronic synovitis. PMID- 1768161 TI - Thermography in the detection and follow up of chondromalacia patellae. AB - Although diagnostic criteria for chondromalacia patellae exist, the disease is often accompanied by physical signs which are limited or non-diagnostic. Thermographic examination was performed in 157 patients with clinical diagnosis of chondromalacia patellae in 86 patients after surgical treatment for chondromalacia, and in 308 controls. Thermography can help the clinicians in establishing the diagnosis of chondromalacia patellae, but by itself is not sufficiently specific. The specificity of thermography was dependent on age, ranging from 90% for the 15-24 year age group to 65% for the 45-54 year age group. Sensitivity of the method was 68%. Thermography can disclose other knee disorders which imitate chondromalacia patellae. PMID- 1768162 TI - Referrals to a rheumatology unit: an evaluation of the views of patients, general practitioners, and consultants. AB - One hundred and twelve randomly selected patients referred to a rheumatology unit were studied, using structured questionnaires, to gain the views of patients, general practitioners (GPs), and the consultants. There were differences in perception between these respondents on the reason for referral. Major diagnostic changes were made in less than 10% of cases. Nearly all patients claimed that some aspect of their disease had been improved as a result of the appointment. Satisfaction with the communication aspects of the appointment contributed more to patients' overall satisfaction than did improvement in pain or disability. General practitioners' objectives were also met if communication with patients was satisfactory. In the management of chronic disease communication is important and should be recognised as such. PMID- 1768164 TI - Rheumatic symptoms following an outbreak of campylobacter enteritis: a five year follow up. AB - Eighty six of 106 (81%) guests attending a party were followed up after an outbreak of Campylobacter jejuni enterocolitis. Acute diarrhoeal illness was reported in 35 subjects (33%), of whom seven showed acute rheumatic symptoms either alone or with other symptoms of infection with C jejuni. The antibody response to C jejuni corresponded well with the intensity of the disease. In the early phase of the gastrointestinal disease the patients with acute rheumatic symptoms displayed significantly higher IgM antibody levels in serum samples than the other patients in this study. Levels of antibodies to C jejuni were increased in serum samples from 31 patients (29%) without symptoms of infection with C jejuni. At a follow up after five and a half years, four of these patients suffered from chronic rheumatic disorders. One HLA-B27 positive woman developed reactive arthritis with a relapse seven years later. The remaining 20 subjects (19%) remained healthy and their antibody tests and stool cultures were negative for C jejuni. It is concluded that C jejuni enterocolitis is significantly associated with rheumatic symptoms in the early phase and may also cause chronic rheumatic disorders. PMID- 1768163 TI - Clinical experience with pamidronate in the treatment of Paget's disease of bone. AB - Bisphosphonates have been shown to be effective in treating the increased bone turnover associated with Paget's disease of bone. In this study two groups of patients were treated with pamidronate by intravenous infusion. In group 1 (n = 15) 30 mg of pamidronate was given once a week for six weeks. A subgroup (group 1A, n = 6) of more severely affected patients (pretreatment serum alkaline phosphatase (ALP) greater than 1000 U/l, normal range 80-280 U/l) received a further 60 mg weekly for three weeks. Group 2 (n = 24) received 45 mg of pamidronate every three months for one year. In both groups the level of ALP in serum samples decreased steadily throughout the year. In group 1 the level decreased to a mean value of 230 U/l (95% confidence interval 188-281) and in group 2 to 297 U/l (227-389). Four of the six patients in group 1A achieved normal ALP, whereas ALP remained at an increased level in all of the 10 patients in group 2 whose pretreatment ALP was greater than 1000 U/l, suggesting that a dose-response effect exists. The lowest hydroxyproline to creatinine ratios (normal ratio less than 0.033) were observed at the end of treatment in group 1, with a mean ratio of 0.022 (range 0.015-0.033) and at three months after the start of treatment in group 2 with a mean ratio of 0.029 (range 0.022-0.037). There was a significant decrease in the turnover of bone, as measured by whole body retention of radiolabelled bisphosphonate, from a mean of 49.3 to 41.0% (p less than 0.01). These data confirm that pamidronate is effective in the management of Paget's disease of bone. For patients with levels of ALP in serum samples of up to four times above the upper limit of the normal reference range, an effective and convenient regimen is 45 mg every three months for one year. For patients with higher levels of ALP higher doses may be more effective. PMID- 1768165 TI - Survival of calcium pyrophosphate crystals in stored synovial fluids. AB - Eleven synovial fluids containing calcium pyrophosphate dihydrate (CPPD) were examined repeatedly over an eight week period to assess whether storage conditions and duration influenced the number of crystals present. Aliquots of each fluid were stored at room temperature, 4 degrees C, and -70 degrees C. At 70 degrees C there was no change in crystal count after eight weeks' storage. At room temperature and 4 degrees C crystal counts declined slowly over the eight week period, though CPPD crystals were still readily apparent after eight weeks in 10/11 (4 degrees C) and 8/11 (room temperature) fluids. No change in crystal morphology was detected and, apart from one fluid kept at room temperature in which fungal hyphae were noted at six weeks, no new crystals were seen. Calcium pyrophosphate dihydrate crystals in synovial fluid can be maintained for prolonged periods by freezing. PMID- 1768166 TI - Treatment of polymyalgia rheumatica with intramuscular injections of depot methylprednisolone. AB - Although the treatment of patients with polymyalgia rheumatica by corticosteroids given by mouth is effective, it is often accompanied by multiple side effects. Various studies have shown that the steroid related complications are proportional to the cumulative dose of steroids administered. In a prospective study of 16 patients with polymyalgia rheumatica the effects of regular intramuscular injections of methylprednisolone over 12 months were evaluated. Remission of disease was achieved with injections of 120 mg of methylprednisolone every three weeks for 12 weeks. Subsequent disease remission was maintained by monthly injections of methylprednisolone on a reducing schedule of dose. The treatment was efficacious, safe, well tolerated over one year, and showed no suppression of the hypothalamic pituitary adrenal axis at 12 weeks after initiation of treatment. Such a mode of steroid treatment results in a considerably lower cumulative steroid dose than with conventional doses of prednisolone given by mouth. These results will be further evaluated in a controlled trial using intramuscular injections of methylprednisolone and prednisolone given by mouth for the treatment of polymyalgia rheumatica. PMID- 1768167 TI - Deposition of eosinophil cationic protein in vascular lesions in temporal arteritis. AB - The possible role of the eosinophil and its cytotoxic granule proteins in the vascular lesions seen in temporal arteritis was elucidated. Sixteen sections of biopsy specimens from arteria temporalis showing giant cell arteritis were stained for eosinophil cationic protein (ECP) by polyclonal antibodies and the immunoperoxidase method. Activated eosinophils were identified by monoclonal antibodies linked to alkaline phosphatase. Activated eosinophils and secreted ECP were seen in all layers of the inflamed vessels and were most evident in necrotic lesions and thrombi. Only a small number of granulocytes seen in the adventitia were immunoreactive for cathepsin G, and no extracellular deposits of this neutrophil granule protein were seen. A few immunoreactive eosinophils were found in the adventitia in two of five negative temporal artery biopsy specimens from patients with polymyalgia rheumatica. All eight coronary artery biopsy specimens with atherosclerotic lesions showed no activated eosinophils or secreted ECP. These findings indicate that eosinophils are involved in the vascular lesion in temporal arteritis and suggest that cytotoxic eosinophil granule proteins may contribute to the necrotic lesions and the development of thrombi. PMID- 1768168 TI - Deposition of calcium pyrophosphate dihydrate crystals in a soft tissue chondroma. AB - Calcium pyrophosphate dihydrate (CPPD) crystal deposits were found in an extraarticular chondroma of the soft parts overlying the distal phalanx of the right middle finger. The lesion appeared to arise from the flexor tenosynovium. The pathogenesis of soft tissue chondroma and the relation of cartilage metaplasia to the process of CPPD crystal deposition were investigated. PMID- 1768169 TI - Coexistent Felty's syndrome and palindromic rheumatism. AB - Palindromic rheumatism is a syndrome of intermittent abrupt onset monoarthritis with asymptomatic intercritical periods of variable duration, which commonly evolves into rheumatoid arthritis. Felty's syndrome consists of leucopenia (selective neutropenia) and splenomegaly, usually occurring in longstanding classic rheumatoid arthritis. Felty's syndrome can be confused with the more recently recognised rheumatoid arthritis associated large granular lymphocyte proliferative disease. This paper describes a patient with palindromic rheumatism presenting with Felty's syndrome in whom large granular lymphocyte proliferative disease was ruled out by lymphocyte phenotyping. PMID- 1768170 TI - Bronchiolitis obliterans in systemic lupus erythematosus: beneficial effect of intravenous cyclophosphamide. AB - A 49 year old white woman with systemic lupus erythematosus and bronchiolitis obliterans was treated with prednisone (1 mg/kg daily), which led to a transitory improvement in pulmonary status. Cyclophosphamide was then added--4 mg/kg daily intravenously for five days, then 2 mg/kg daily orally--and this was followed by a dramatic and prolonged improvement. PMID- 1768171 TI - Management of the antiphospholipid syndrome. PMID- 1768172 TI - Mozart's death. PMID- 1768173 TI - Rheumatoid arthritis in sub-Saharan Africa. PMID- 1768174 TI - Degradation of human cartilage by cytokines in vitro. PMID- 1768175 TI - Septic arthropathy complicating apatite associated destructive arthritis. PMID- 1768176 TI - Long term evolution of adult onset Still's disease seen in an infectious diseases department. PMID- 1768177 TI - Septic arthritis due to Nocardia caviae. PMID- 1768178 TI - Sex ratios in HLA related autoimmune disease. PMID- 1768179 TI - Nanocolloid scintigraphy for rheumatic diseases of the hands. PMID- 1768180 TI - Spondyloarthropathies and IgA deficiency. PMID- 1768181 TI - [Reactivity of the arterial wall to atherogenic stimuli]. AB - Our understanding of the biological mechanism implicated in spontaneous or accelerated atherogenesis is steadily increasing. The vascular response to atherogenic stimuli implies activation of endothelial cells making possible the adhesion and then the migration of circulating mononuclear cells. When these cells are present in the intima they participate in the production of a number of factors liable to activate the migration and proliferation of the underlying smooth muscle cells (cytokines, growth factors, physiologically active lipids). The rupture of parietal homeostasis is discussed with reference to some experimental models in terms of intimal cellular recruitment and formation of foam cells which are the cardinal points of the initial pathogenic process. PMID- 1768182 TI - [Anticardiolipin antibody in peripheral arterial diseases]. AB - Antiphospholipid antibodies can be detected by three methods; agglutination reactions with a cardiolipid antigen (VDRL, Kline, Kolmer) as observed in false positive syphilitic serologies; secondly coagulation reactions using thromboplastin (activated cephalin time, diluted thromboplastin time, Stipven time...). These cases are called lupus-like or, better, antiprothrombinase circulating antibody; finally, solid phase immunological tests (ELISA, RIA) with purified phospholipids, usually cardiolipin. The antiphospholipid antibodies detected by this method are not the same and the percentage of concordance between the two tests does not exceed 50 per cent. These antibodies are present in 30 to 60 per cent of patients with disseminated lupus erythematosus and also, less frequently, in other connective tissue disorders. They are always found in the so-called primary antiphospholipid syndrome, featuring recurrent venous or arterial thrombosis, repeated abortion, thrombocytopenia, and often a livedo reticularis and leg ulceration. Arterial thrombosis may occur in any part of the body (eye, central nervous syste, visceral or peripheral arteries). Mortality is related to neurological or coronary complications. The pathogenicity of antiphospholipid antibodies has not been formally demonstrated, but they could interact with membrane phospholipids of the vascular endothelium and/or platelets. Immuno-suppressor therapy is not very effective and long-term anticoagulant and/or platelet antiaggregant therapy is usually required. PMID- 1768183 TI - [Role and limits of x-ray computed tomography and magnetic resonance imaging in acquired diseases of the aorta]. AB - The introduction of computed tomography (CT) and the more recent magnetic resonance imaging (MRI) has radically changed the means of investigating acquired aortic disease by association the visualisation of the blood flow, previously available with angiography, with that of the aortic wall and the surrounding structures of this vessel. The popularity of CT scanning, being nearly non invasive though dependent on ionising radiation and requiring the injection of contrast, and its diagnostic performance have raised it to the status of a primary investigation for diagnosing aortic aneurysm, especially abdominal, of aortic dissection, its acute complications and postoperative follow-up. However, CT scanning remains unsatisfactory for the examination of collateral and bypass vessels issuing from the aorta and for detailed analysis of aortic trauma and aortitis. MRI, though providing significant diagnostic advantages by the 3 dimensional visualisation of the aorta, the presence of spontaneous contrast between the lumen and vessel wall and cine MRI, is still relatively little used because of the small number of installations dealing with this indication in France. Despite the limitation, this totally non-invasive and non-irradiating investigation is progressively extending its use for the diagnosis of certain subacute or chronic aortic diseases. MRI is the best non-invasive investigation for the diagnosis of thoracic aortic aneurysms, chronic or subacute aortic dissection and for repeated postoperative follow-up after thoracic aortic surgery. Technological advances of this new imaging method and the multiplication of the number of installations suggest that the field of application of MRI for disease of the aorta will steadily increase in the future. PMID- 1768184 TI - [Role of Doppler echography in the diagnosis of venous thrombosis]. AB - The diagnosis of deep vein thrombosis (DVT) by non-invasive techniques is usually based on the haemodynamic changes detected by doppler ultrasound and plethysmography. These two investigations are not very sensitive in the diagnosis of non-occlusive proximal thrombosis or distal (infrapopliteal) and isolated thromboses. Ultrasonic Duplex Scanning (B mode and Doppler) is a new method of investigation of DVT which visualises the anatomy of the veins and surrounding structures and also provides assessments of the venous circulation. The diagnosis of DVT is made on the finding of an abnormal endoluminal image, the absence of venous compressibility and doppler changes. Duplex ultrasonography differentiates DVT from extrinsic compression, enables diagnosis of even nonocclusive or isolated proximal thrombosis irrespective of its site and of distal thrombis. The site, extension and age of the thrombosis may also be estimated. It is very competitive with phlebography and is even superior in some indications. This method has been evaluated mainly in patients with clinically suspected DVT. The mean values of diagnostic sensitivity and specificity compared with phlebography are over 95% in the examination of popliteal and femoral veins; iliac veins, inferior vena cava and calf veins have correctly rarely been studied but with good results: the sensitivity of diagnosis of distal DVT is approximately 90%. Duplex ultrasonography is a non-invasive, cost-effective and reliable method which is widely used, though requiring further validation both in the diagnosis of symptomatic and asymptomatic DVT and its surveillance. The diagnostic value of the investigation is operator dependent and is also influenced by the equipment and protocol of examination. The value of color flow imaging has not yet been well established. PMID- 1768185 TI - [Diagnostic strategy of vascular diseases of the lower limbs]. AB - Peripheral arterial disease requires different diagnostic strategies according to the clinical presentation: tissue ischemia, asymptomatic disease or polyarterial disease. In the presence of resting or effort ischemia, complementary investigations are indicated: arteriography should be reserved for indications of arterial reconstruction: ankle systolic pressure may be measured by all physicians to quantify the distal repercussions of the lesions. Asymptomatic peripheral disease is becoming more widely recognised and may be detected with flowmeter tests. Polyarterial disease is associated with increased mortality of patients with peripheral arterial disease. Symptoms of coronary artery disease are an indication for coronary angiography and myocardial scintigraphy. Patients with cerebrovascular events will require ultrasonic, CT scanning and cardiac investigations. The diversity of the diagnostic approach to peripheral arterial disease is creating a need for a new profile of vascular physicians. PMID- 1768186 TI - [Search for emboligenic heart disease in case of ischemic cerebral accidents]. AB - The demonstration of a cardiac source of systemic embolism in patients who have suffered a cerebral ischemic event may have important therapeutic implications. This explains the large demand for echocardiography and Holter monitoring in these patients. The frequency of cerebral embolism of cardiac origin, the simplification of the diagnostic approach by non-invasive investigations and the precision of ultrasound techniques explains the tendency towards the indiscriminate generalisation of this attitude. However, the large number of potential patients for investigation, the limited facilities of investigation and the incertitude over the responsibility of certain cardiac abnormalities with respect to the context and age, are arguments in favour of a more selective investigative approach. The keystone of diagnosis is careful history taking and clinical examination with interpretation of the ECG and chest X-ray. Three clinical situations may then be identified: 1) A cardiac abnormality known to be highly embolic is diagnosed from the outset (e.g. mitral stenosis, valve prosthesis, endocarditis, myocardial infarction). The diagnostic work-up is no longer etiological: echocardiography may show intracardiac thrombi or a valvular vegetation, reinforcing the causal relationship, but the complementary investigations are mainly useful for evaluation the cardiac disease and for deciding on curative or preventive therapy. 2) A cardiac abnormality is diagnosed but its responsibility is doubtful due to its high prevalence and low embolic potential. This is the case of patients with mitral valve prolapse, mitral annular calcification, calcific aortic stenosis and VVI pacing. Complementary investigations are not discriminative for the etiological diagnosis of the cerebral embolism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768187 TI - [Which coronary investigation should be performed in patients with peripheral arterial diseases?]. AB - In the context of peripheral vascular disease, the clinical history provides a means of evaluating coronary risk. The key features are: age, previous myocardial infarction especially when recent (under 6 months), anginal pain, smoking, diabetes and ventricular arrhythmias. Treadmill testing, often limited by symptoms of claudication, may reveal severe coronary ischemia and thereby the patients at very high risk. Upper limb exercise stress testing gives results similar to standard protocols of non-atherosclerotic patients when correctly performed and a reliable detection and evaluation of coronary lesions. Thallium dipyridamol myocardial scintigraphy is a very useful diagnostic method but requires special radionuclide facilities. This technique demonstrates the site of ischemia. Coronary angiography should be reserved for special cases because the risks of the procedure are always greater in patients with peripheral vascular disease. PMID- 1768188 TI - [Angioscopy in peripheral vascular diseases]. AB - Angioscopy is a useful investigation in patients referred for vascular surgery. The material has been improved over the last few years to make available angioscopes with external diameters ranging from 0.55 to 3.2 mm. The angioscopes are either rigid, composed of two groups of fibre optics (image and light transmission) or orientable and more complex. Both systems may carry operating channels. The angioscopy may be performed peroperatively or percutaneously. Other essential equipment includes catheter guides, balloon catheters, counterpulsation balloons or perfusion pumps. This investigation is used for diagnostic evaluation but when used peroperatively it may also help guide therapeutic intervention. Angioscopy is complementary to ultrasonic and radiological methods of vessel imaging. PMID- 1768189 TI - [Current indications for inferior vena cava interruption]. AB - Clinical indications of vena cava interruption are reviewed. During the last few years pulmonary embolism frequency remained high and many new percutaneous vena caval filters became available. These facts probably explain the increasing use of these filters reaching about 10,000 filters each year in France. Existing data show that: embolic risk with antithrombotic agents is less than 5%, probably not far greater than embolic risk with cava filters (about 2%); complications encountered with the filters are caval thrombosis in 8%, and more or less than 4% other major complications; there is no controlled study comparing antithrombotic treatment associated with caval filters to antithrombotic treatment alone; there is no controlled study comparing new cava filters among them or to the Greenfield filter; economical implications of caval filters are mostly unknown. The only admitted indications of vena cava interruption, in case of proximal venous thrombosis, are contraindications to anticoagulation. In other situations no data allow to recommend a cava filter; indication will be discussed on a case by case basis. Prospective controlled studies are greatly encouraged. PMID- 1768190 TI - [Childhood asthma. Increased frequency and severity. How to reverse the trend?]. PMID- 1768191 TI - [Pediatric specialties in University Hospital Centers. A nearly 20 years' experience]. PMID- 1768192 TI - [Dumbbell neuroblastoma. Experience at the Gustave Roussy Institute in 38 cases treated from 1982 to 1987]. AB - Among the 282 neuroblastomas treated at the Institut Gustave-Roussy between 1982 and 1987, 38 dumbbell forms were observed. Therapeutic approaches included: 1) An initial laminectomy in forms with neurological deficit; 2) Surgical excision of the primary tumor; 3) Preoperative chemotherapy for metastatic forms and non metastatic forms in which primary tumors considered unresectable at diagnosis; 4) Radiation therapy on macroscopic residual disease. Twenty three of 38 children presented with a neurological deficit. A laminectomy was performed in 21 cases. Neurological recovery was good in 8 cases, partial in 5 cases and absent in 5 cases. Three patients were aggravated after the procedure. The event free survival was 76%. This high survival rate is linked with: 1) The predominantly non metastatic stages (25/38); 2) A high proportion of children under 1 year of age (25/38); 3) A high proportion of thoracic locations. Out of the 29 survivors, there were 10 cases of major neurological sequelae (34%) and 9 cases of major orthopedic sequelae (31%). The coexistence of a serious functional prognosis and an excellent vital prognosis led us to analyse the therapeutic modalities and reevaluate the necessity of routine initial neurosurgical excision by laminectomy, and using a first line chemotherapy in selected indications. PMID- 1768193 TI - [Determination of the ratio of serum concentrations of tobramycin between fetus and mother at birth. A model of small scale pharmacokinetics]. AB - Thirty women at term presenting with fever greater than or equal to 38 degrees C during labour were given a synergic combination of tobramycin-amoxicillin. Gestational ages ranged from 37 6/7 to 41 2/7 weeks. A single dose of 3 mg/kg of tobramycin was given every day intravenously. Feto-maternal tobramycin concentrations (F/M ratios) were systematically determined at birth and allowed to make a small scale pharmacokinetic study. Two curves were plotted from the pharmacokinetic analysis of maternal and fetal measurements, showing an intravenous and an intramuscular profile respectively. A high positive linear correlation (R = 0.82) was found between the F/M ratios and the time (delta T, hours-) measured from the last administration to the mother to the time of delivery. Elimination of the aminoglycoside was slowed down in newborns (t1/2 lambda z = 5.1 hours). In newborns tobramycin levels were always less than or equal to 6 mg/l and still greater than or equal to 1 mg/l 6 hours after the last maternal injections. Measurement of F/M ratios allowed to study and compare the fetal and maternal pharmacokinetics facilitating (when necessary) the initial posologic adjustment in newborns. Such small scale pharmacokinetics could be extended, for a given gestational age, to other drugs with narrow therapeutic ranges. However, the size and the homogeneity of the population seem to be most important. PMID- 1768194 TI - [Congenital malformations in a series of 131,760 consecutive births during 10 years]. AB - Registration of congenital malformations began in 1979 in the French department of Bas-Rhin. The results of the first 10 years of functioning of this register are presented after description of the objectives and methodology used. 131,760 consecutive births were analysed: 2.66% of infants presented with malformations. The most frequent malformations consisted of congenital heart defects (11.6%). The increase in incidence of congenital malformations was not the result of an absolute increase in malformations but to improvement of prenatal and postnatal diagnosis allowed by the technical progress in this field. In utero diagnosis of congenital malformations, especially of multiple malformations, was more and more often performed. PMID- 1768195 TI - [Erythermalgia: a rare vascular acrosyndrome]. AB - A case of erythermalgia with arterial hypertension that appeared in a 13 year-old boy is described. This condition led to a loss of weight of 10 kg within one month. None of the diseases known as a cause of this rare condition was found. Clinical manifestations were only improved when extremities were placed in cold water: treatment with pizotifene was also effective suggesting the role of serotonine in the mechanism of the crises. PMID- 1768196 TI - [Neonatal proteus mirabilis adrenal gland abscess]. AB - The authors describe a case of unilateral adrenal abscess in a neonate, which was diagnosed at 13 days of age by abdominal ultrasonography. The newborn presented with persistent high white blood cells after Proteus mirabilis omphalitis. Magnetic resonance imaging and needle aspiration confirmed the diagnosis. This is the second case of Proteus mirabilis neonatal adrenal abscess reported in the literature. Percutaneous drainage allowed complete recovery. PMID- 1768197 TI - [Iconographic rubric: ORL non Hodgkin's lymphoma disclosed by bilateral blindness and anterior hypopituitarism]. PMID- 1768198 TI - [Iconographic rubric: esophageal perforation in a very small premature infant]. PMID- 1768199 TI - [Interventional digestive endoscopy in pediatrics]. PMID- 1768200 TI - [Recent progress in hereditary metabolic diseases]. PMID- 1768202 TI - [Convulsions caused by deep hyponatremia during treatment of enuresis with nasal desmopressin]. PMID- 1768201 TI - [Multidrug resistance of solid tumors in children]. PMID- 1768203 TI - [Digital clubbing and childhood Crohn disease]. PMID- 1768204 TI - [Severe viper venom poisoning. Apropos of 7 pediatric cases]. PMID- 1768205 TI - [Treatment of acute lymphoblastic leukemia in children. Results of the FRALLE 83 protocol]. PMID- 1768206 TI - Interinstitutional comparison of frozen-section consultation. A College of American Pathologists Q-Probe study of 79,647 consultations in 297 North American institutions. AB - In 1989, the College of American Pathologists Q-Probes Quality Assurance Program studied intraoperative frozen-section consultations performed in 297 institutions with mean bed size of 316 (range, 0 to 1351 beds) in North America during 5 consecutive months. The aggregate database was composed of 933,751 surgical cases (mean, 3144 per institution); 52,464 frozen-section cases (mean, 177); and 79,647 individual frozen sections performed (mean, 268). The rate of frozen sections per all surgical case accessions was 5.6% (cases with frozen section) and 7.3% (individual frozen sections performed), with an average of 1.5 frozen sections per case. Frozen-section rate increased proportional to bed size, from less than 5% in institutions with bed size below 150 to 15% in institutions with bed size above 600. Of all frozen sections performed, 4.2% were deferred. Deferrals to paraffin sections in pathologists' opinions were 92.6% appropriate, 1.2% inappropriate, and 6.2% not stated. When frozen-section diagnoses were compared with permanent section diagnoses, there was a 98.3% diagnostic concordance, adjusted for deferred diagnoses, but including the performance of frozen sections on mammographically directed biopsy specimens with no gross abnormalities in 80% of institutions. This practice accounted for 11.8% of the discordant frozen section diagnoses. The reasons for diagnostic discordances were gross tissue sampling (44.8%); misinterpretation (40%); sectioning (12.7%); inadequate history (5.6%); staining (1.5%); labeling (0.5%); and other (3%). Assessment of diagnostic discordance on patient outcomes by the reviewing pathologist showed that patient management was unaffected in 74%, minimally affected in 20%, and greatly affected in 2.5%. PMID- 1768207 TI - The role of the blood bank in transplantation. AB - Blood transfusion supportive care is essential to successful organ, tissue, and bone marrow transplantation, thus making the blood bank an integral part of these programs. The impact of clinical transplantation on the blood bank can be considered in the following categories: (1) use of blood and blood components for transfusion support; (2) special blood component needs; (3) red blood cell serologic needs; (4) collection, processing, and preservation of bone marrow and peripheral blood stem cells; (5) hemotherapy for bone marrow donors, (6) recruitment of bone marrow donors; and (7) the special procedures that must be available for managing patients undergoing transplantation therapy. PMID- 1768208 TI - Screening for hyperthyroidism. PMID- 1768209 TI - Estrogen-receptor protein in thyroid neoplasms. An immunohistochemical analysis of papillary carcinoma, follicular carcinoma, and follicular adenoma. AB - Epidemiologic features of well-differentiated thyroid tumors and experimental evidence suggest that female sex hormones may exert effects on this gland and its neoplasms. This possibility was addressed by investigating the expression of estrogen-receptor protein in 80 thyroid neoplasms. Patients with papillary carcinomas, follicular carcinomas, and follicular adenomas were selected from each of the following groups: (1) postpubertal-premenopausal women (who are associated with the most favorable prognosis and greatest incidence of these neoplasms); (2) postmenopausal women; and (3) men of various ages. Sections from formalin-fixed paraffin-embedded tumors were stained with antiestrophilin antibody (clone H222) and the avidin-biotin-peroxidase complex method. In addition, other markers were included to distinguish thyroidal from other estrogen-receptor protein-reactive neoplasms; an anticytokeratin mixture, antithyroglobulin, and anti-gross cystic disease fluid protein-15 were applied in all cases. The expression of estrogen-receptor protein was detected in eight of 10, six of 10, and nine of 10 papillary carcinomas; four of eight, two of seven, and one of five follicular carcinomas; and none of 10, none of 10, and two of 10 follicular adenomas, in groups 1, 2, and 3, respectively. Nuclear staining was regional or multifocal in distribution. Cytokeratin and thyroglobulin were detected in all tumors. In contrast, none displayed anti-gross cystic disease fluid protein-15 immunoreactivity. These results indicate that the estrogen receptor may be detected immunohistochemically in thyroid neoplasms. However, no differences that could account for possible estrogen-related epidemiologic and prognostic variation in such tumors could be ascertained. Other discriminating immunostains, primarily including anti-gross cystic disease fluid protein-15 and thyroglobulin, are effective in distinguishing between thyroidal and extrathyroidal tumors that may express estrogen-receptor protein. PMID- 1768210 TI - Misleading elevation of the free thyroxine index in nursing home residents. AB - The significance of an elevated free thyroxine index (FTI) as an indicator of hyperthyroidism was studied while screening 651 elderly nursing home residents. Eleven subjects had FTI elevations. Most of these patients were chronically ill and/or malnourished. Clinical assessment, repeated FTI determinations, and subsequent measurements of levels of triiodothyronine, free thyroxine by equilibrium dialysis, and thyrotropin (thyroid-stimulating hormone) by sensitive assay showed that all subjects with FTI elevation were euthyroid. The FTI elevation in the chronically ill institutionalized elderly patient is not necessarily an expression of hyperthyroidism. PMID- 1768211 TI - Improving the reliability of total and high-density lipoprotein cholesterol measurements. Four testing strategies compared in a high-risk population. AB - Four testing strategies for assessing total and high-density lipoprotein cholesterol are compared in a homogeneous group of male outpatients at increased risk for cardiovascular disease: (1) a single measurement at one occasion; (2) the mean of duplicate measurements at one occasion; (3) the mean of single measurements in specimens collected 1 week apart; and (4) the overall mean of duplicate measurements at two occasions 1 week apart. Results of strategy 1 were comparatively less reliable as demonstrated by lower intraclass correlation coefficients and higher within-subject variance components. Use of strategy 3 decreased within-subject variance by 50% and improved the 95% confidence interval by 30% for both total and high-density lipoprotein cholesterol, compared with strategy 1. Duplicate testing on either one or two occasions resulted in a nominal improvement in reliability and confidence. Calculating the mean of single measurements in specimens collected 1 week apart is clinically useful because: (1) it reduces the risk of misclassification, (2) it improves intervention monitoring, (3) it supports the National Cholesterol Education Program guidelines for total cholesterol, and (4) it improves the use of high-density lipoprotein as an independent risk factor. PMID- 1768212 TI - Results of a province-wide quality assurance program assessing the accuracy of cholesterol, triglycerides, and high-density lipoprotein cholesterol measurements and calculated low-density lipoprotein cholesterol in Ontario, using fresh human serum. AB - To evaluate laboratory performance, eight to 13 samples of fresh human serum from volunteers were sent to 250 laboratories in the Canadian province of Ontario licensed to perform lipid analysis. Fresh human specimens were used because of potential matrix effects with processed materials. We show that on all survey samples, 71% (range, 63% to 82%) of participating laboratories are within +/- 5% of the target cholesterol value and that 93% are within +/- 10%. The goal of the National Cholesterol Education Program for 1992 is total error of no more than +/ 9% for 95% of results. The unblanked triglycerides results show that on all samples 40% (14% to 59%) of participants are within +/- 5% and 68% (range, 31% to 86%) are within +/- 10% of the target value. For triglycerides results from 0.9 to 2.0 mmol/L, 80% or more are within +/- 0.2 mmol/L. Between 2.0 and 3.0 mmol/L, 90% are within +/- 0.3 mmol/L of the target values. For high-density lipoprotein cholesterol, for all samples 35% (range, 24% to 50%) of laboratories are within +/- 5% and 68% (range, 55% to 88%) are within +/- 10%. A range of 80% to 95% of participants are within +/- 0.2 mmol/L of the target values. For calculated low density lipoprotein cholesterol, 51% and 62% of the laboratories surveyed are within +/- 5%, with 83% and 89% within +/- 10% of the target values. We conclude that the laboratory measurement of lipids is approaching the degree of accuracy and precision required for clinical purposes, and that the use of fresh human serum samples is a viable approach to their proficiency testing. PMID- 1768213 TI - Separation and detection of DNA polynucleotides using capillary electrophoresis. Application to detection of polymerase chain reaction-amplified human immunodeficiency virus and HLA DNA. AB - The polymerase chain reaction (PCR) is a technique for rapid amplification of target DNA sequences. During the past several years, a large number of research applications of PCR have appeared, many of which may prove to be useful clinically. We report the use of capillary electrophoresis, a fully automated technique, as an alternative to polyacrylamide gel electrophoresis for the detection of PCR-amplified viral and cellular DNA. We describe conditions for rapid separation, detection, and discrimination of PCR products from the human immunodeficiency virus type 1 gag gene and the HLA-DQ-alpha gene amplified from the human immunodeficiency virus provirus-containing U1.1 cell line. The sensitivity achieved with the use of capillary electrophoresis analysis was roughly equivalent to that of ethidium bromide staining of polyacrylamide gel electrophoresis gels. Further refinement of capillary electrophoresis for automated detection and quantitation of PCR-amplified products should expedite more widespread application of PCR analysis in the clinical laboratory. PMID- 1768214 TI - Antimicrobial testing using oxygen consumption as the indicator of susceptibility. AB - In the presence of inhibitory concentrations of antibiotics, a decrease in oxygen consumption precedes and predicts changes in growth rates, bacterial stasis, or death of bacteria. The susceptibility of bacteria to various antibiotics was determined by growing the microorganisms in liquid media in the presence of varying concentrations of antibiotics. The oxygen consumption was then measured with an electrode at a specified time at each concentration of the antibiotic plus a positive and negative control. The decrease in oxygen consumption by the bacteria inhibited by the antibiotic precedes changes in numbers of bacteria and is predictive of the outcome of the standard minimum inhibitory concentration. This method determines antibiotic susceptibilities in approximately 3 hours and the minimum inhibitory concentration obtained corresponds with literature values and current minimum inhibitory concentration techniques. PMID- 1768215 TI - Elastosis in the normal aging breast. A histopathologic study of 140 cases. AB - The incidence and pattern of elastosis of the breast was studied in tissue specimens taken at autopsy from 140 women with clinically normal breasts, ranging in age from 19 through 101 years. Elastosis, presence of excess elastic fibers, while less common in younger women, may be found in nearly half of all women over age 50 years with no breast disease. Elastosis occurs in three sites: diffusely in the stroma, around vessels, and around ducts. In the first two sites, it bears little relationship to age, while periductal elastic tissue appears to accumulate with age, probably reflecting parity, until about age 50 years. Thereafter, it is found at a more or less constant incidence and degree. While it may be associated with breast cancer, periductal elastosis by itself is not a cause for concern. Marked perivascular elastosis is, however, uncommon at any age, and its presence should suggest a special search for carcinoma, if not already evident. PMID- 1768216 TI - Thymoma with abundant L26-positive 'asteroid' cells. A case report with an analysis of normal thymus and thymoma specimens. AB - A case of thymoma is presented that was referred for consultation with the differential diagnosis of thymoma and non-Hodgkin's lymphoma. Immunoperoxidase studies performed on fixed, paraffin-embedded sections demonstrated the presence of numerous epithelial cells, supporting the diagnosis of thymoma. However, the pan-B-cell antibody L26 also demonstrated abundant staining, an unexpected finding that may be a potential source of diagnostic confusion. The L26 antibody stained cells with elongate cell processes that interdigitated between and surrounded thymocytes. We pursued this observation by performing immunoperoxidase studies on three thymoma and seven normal thymus specimens using fixed sections. Each thymoma had occasional cells or small clusters of L26-positive cells scattered throughout the neoplasm. In sections of normal thymus, L26-positive cells were also found, almost exclusively in the medullary regions. These cells tended to congregate around Hassall's corpuscles and had elongate cell processes that often surrounded medullary lymphocytes. Occasional small lymphocytes also appeared to be positive for L26. Our results demonstrate that cell populations that express B-cell antigens are consistently found in the thymic medulla and that these cells may be numerous in occasional thymomas. The presence of many L26 positive cells in a mediastinal mass should not dissuade one from making the diagnosis of thymoma if all other findings are consistent with that interpretation. PMID- 1768217 TI - Pulmonary lymphangioleiomyomatosis. Report of a case with associated multiple soft-tissue tumors. AB - We describe a 55-year-old woman with pulmonary lymphangioleiomyomatosis. The patient died of respiratory failure 9 years after diagnosis. An autopsy confirmed the diagnosis and disclosed multiple soft-tissue tumors, including a large solitary fibrous tumor of the lung, a huge cavernous hemangioma of the liver, a meningioma of the right pontocerebellar angle, and a focus of nodular stromal hyperplasia of the ovary. In addition, endocrine tumors, including a papillary carcinoma of the thyroid gland and a parathyroid adenoma, were also found. There was no evidence of tuberous sclerosis or angiomyolipoma of the kidney. The connection between pulmonary lymphangioleiomyomatosis and tuberous sclerosis is discussed. PMID- 1768218 TI - Visualization of the ribosome-lamella complex in plastic-embedded biopsy specimens as an aid to diagnosis of hairy-cell leukemia. AB - Hairy-cell leukemia is a lymphoid leukemia of B-cell lineage, the cells of which are characteristically tartrate resistant acid phosphatase positive on blood and bone marrow smears. However, because hairy-cell leukemia is frequently associated with abundant marrow stroma, dry marrow taps, and peripheral pancytopenia, the diagnosis may rest on the appearance of the bone marrow biopsy specimen alone. The ribosome-lamella complex has been associated with hairy-cell leukemia, and can be visualized by light microscopy using l-micron sections of plastic-embedded bone marrow specimens stained with toluidine blue. We describe the findings in a case in which bone marrow and liver biopsy specimens were positive for hairy cells containing ribosome-lamella complex, which were visualized with both electron microscopy and light microscopy. Reliable light microscopic identification of ribosome-lamella complex may provide an easy and inexpensive method of aiding in the diagnosis of hairy-cell leukemia when aspirate material is not available for tartrate-resistant acid phosphatase stain. PMID- 1768219 TI - Primary osteosarcoma of the kidney. Report of a case studied by immunohistochemistry, electron microscopy, and DNA flow cytometry. AB - A case of primary osteogenic sarcoma of the kidney is presented. The patient, a 75-year-old man, presented with flank pain, weight loss, and a lower lip lesion. Biopsy of the lip lesion showed metastatic sarcoma and nephrectomy revealed a primary osteogenic sarcoma. Ultrastructural and immunohistochemical studies confirmed the mesenchymal nature of the lesion and helped exclude sarcomatoid renal cell carcinoma from the differential diagnosis. Multiple samples of the primary tumor and metastatic deposits analyzed by DNA flow cytometry all showed a diploid DNA content. Clinically the tumor has pursued a slowly progressive course, with metastases. PMID- 1768220 TI - The female sexual response revisited: understanding the multiorgasmic experience in women. AB - Although it has been almost 20 years since recorded evidence of multiple orgasms among women emerged, there have been few recent investigations of this phenomenon. The purpose of this study was to understand further the female multiorgasmic experience in relationship to the method of stimulatory activity, namely, masturbation, petting, and sexual intercourse. In addition, single orgasmic and multiorgasmic women were compared by examination of various sexual and orgasmic behaviors, the role of sex partners, and perceptions of physiological and psychological sexual satisfaction. An anonymous 122-item questionnaire was utilized to obtain the responses of 805 college-educated female nurses, chosen for their perceived ability to verbalize data regarding the anatomical structures and physiological processes associated with sexual responsiveness. The findings indicated that 42.7% of the respondents had experienced multiple orgasms and that several significant differences existed between single-orgasmic and multiorgasmic women. PMID- 1768221 TI - Depressed affect and male sexual arousal. AB - We investigated the effects of elated and depressed affect on sexual arousal in 15 sexually functional males. Subjects received elation and depression mood inductions in a repeated-measures design. Immediately following each induction, subjects viewed a brief erotic film during which penile tumescence and subjective sexual arousal were recorded continuously. Following depression induction there was a trend toward diminished subjective sexual arousal in the early portion of erotic exposure, and achievement of maximum subjective arousal was delayed; however, penile tumescence was unaffected. Multiple regression analysis indicated that tumescence during erotica was predictive of posterotica affect, independent of pre-erotica effect. The findings of delayed subjective arousal with no diminution in tumescence, although contrary to predictions, are consistent with previous research with sexually dysfunctional men. The study provides partial support for the role of depressed affect in the etiology of erectile dysfunction. PMID- 1768222 TI - Erotic gender differentiation in pedophilia. AB - Five groups of males were compared on penile volume changes elicited from viewing short movie strips and slides of nude children and adults of both genders. Subject groups were sex offenders against adult females, volunteer controls who erotically preferred adult females, volunteer controls who erotically preferred adult males, heterosexual pedophiles, and homosexual pedophiles. Pedophiles differentiated erotically between females and males less than males who erotically preferred physically mature partners. PMID- 1768224 TI - Condemnation of homosexuality in the black community: a gender-specific phenomenon? AB - While it is commonly accepted that homosexuality finds less tolerance in the black community, little or no research has addressed this issue empirically. In the context of an epidemiological investigation of AIDS-related attitudes, 2006 state employees were surveyed to compare the condemnatory orientation of blacks and whites towards homosexuality. One item measured endorsement of a hostile proposition concerning the deleterious impact of AIDS on the homosexual population. Greater relative endorsement was found of the proposition by blacks confirming the hypothesis that less social tolerance of homosexuality exists in the black community. Analyses of gender, educational achievement, religious preference, and marital status revealed that the racial difference in condemnation of homosexuality was derived almost exclusively from a difference in attitude between black and white females. The primary source of this difference may stem from the black female perception that homosexuality exacerbates the developing problem of a decreasing pool of available black males already affected by integration, racially disproportionate incarceration rates, and relatively high rates of premature death among black males from heart disease, cancer, AIDS, substance abuse, and violence. PMID- 1768223 TI - Menstrual cycle phase and sexual arousability in women. AB - Sexual arousability of women has not been consistently found to vary significantly over phases of the menstrual cycle. We studied changes in the temperature of a labium minus and subjective sexual and genital arousal recorded on semantic scales while watching erotic video in 12 women with natural menstrual cycles and 12 women using low-dose estrogen oral contraceptive pills. Natural cycle phase was ascertained by blood progesterone. Subjects were tested twice, with an interval of about 2 weeks. Half of each group had their first test during their luteal phase, the others during their follicular phase. Women tested for the first time in their follicular phase were sexually more aroused than women tested for the first time during their luteal phase. This was true for both objective (i.e., a labium minus change in temperature) and subjective genital arousal. When these women were retested in their alternative phase of the menstrual cycle, those who were then follicular did not score higher than those who were then luteal. On the contrary, the latter group scored as high as when tested during their follicular phase. This phenomenon was observed both in women with and without oral contraception. The nature of the menstrual phase (i.e., natural or pill-induced) seems irrelevant in this respect. Sexual arousal achieved during the first session appeared to be correlated with an increase in desire for making love during the rest of the day and night. Only 1 of 12 women tested during their luteal phase indicated an increase in desire to make love, while 6 of 12 women tested during their follicular phase indicated an increase. Apparently the menstrual cycle phase during the first test determines the immediate response and indirectly affects the response during the second test approximately 10 days later. In a random block design the difference in sexual response between follicular and luteal phase of the menstrual cycle disappears. PMID- 1768225 TI - Substituting speculation for research. PMID- 1768226 TI - Response to Joseph Harry's review of Sex and Morality in the U.S. PMID- 1768227 TI - Immunocytochemical detection of S-100 protein in rat mandibular condylar cartilage. AB - Light and electron microscopic immunocytochemistry was used to localize S-100 protein. It was demonstrated in chondrocytes of the proliferative and hypertrophic zones but none could be found in the fibrous articular layer. The staining intensity for S-100 protein was stronger in the hypertrophic cells than in chondrocytes from the proliferative zone. Ultrastructurally, immunoreactive gold particles were detected in the cytosolic region, closely apposed to the profiles of endoplasmic reticulum with occasional dense aggregations. A few gold particles were seen on the nuclear chromatin and on condensing vacuoles of Golgi complexes. Because of the calcium-binding and possibly fatty acid-binding properties of the protein molecule, the immunocytochemical expression of S-100 protein in the chondrocytes may be involved in cartilage cell differentiation, metabolism and mineralization. PMID- 1768228 TI - A study of the relationship between trace elements in saliva and dental caries in children. AB - About 8 ml of saliva were collected from each of 272 children, living in rural areas in North India, equally distributed into age groups 4-7 and 12-16 yr and stratified into low, moderate and high caries groups. The salivas were analysed for Zn, Cu, Fe, Mn by atomic absorption spectrophotometry and for F with a fluoride-sensitive electrode. The elements Cu and F had a consistent, inverse relationship with caries experience. The concentration of Zn, Fe and Mn in saliva did not have any consistent relationship with caries experience. PMID- 1768229 TI - The number and distribution of fungiform papillae and taste buds after lingual nerve injuries in cats. AB - Taste buds and the papillae that carry them are trophically dependent upon an intact innervation. The number and size of fungiform papillae and the number of taste buds on their surface were determined 3 months after crushing or sectioning the combined trunk of the chorda tympani and lingual nerves. After crushing there were fewer fungiform papillae but their size and number of taste buds were similar to that on the unoperated side. After nerve section there were considerably fewer recognizable fungiform papillae on the operated side and each carried a reduced number of taste buds. PMID- 1768230 TI - Association between surface electromyography of human jaw-closing muscle and quantified food breakdown. AB - Simultaneous recordings of the activity of the masseter and anterior temporalis and of jaw movement were made on 10 healthy dentate volunteers while they chewed roasted peanuts in their habitual manner. The quantity of food taken was altered by varying (a) its total weight (mouthful) between 8 and 1 g, but with a fixed initial particle size and (b) by varying its initial particle size between median sizes of 9.2 and 2.4 mm, but keeping the mouthful constant. Significant differences were found in the peak and mean (r.m.s.) estimates of muscle activity (particularly in the masseter), and the dimensions of jaw movements. These differences were associated with the variation in both the size of the mouthful and of the initial particles but were much greater with changes in the mouthful. A dimensional argument treating both the weight of food in the mouth and initial particle size as volumes showed that initial particle volume had been varied by approximately 50 times as much as mouthful volume and therefore that the mouthful was a far more critical factor in masticatory physiology than was the particle size of the food. The reasons for this probably lie in an understanding of mechanisms of food comminution. PMID- 1768231 TI - Facilitatory effect of jaw opening on somatosensory (SI) cortical neurones sensitive to tooth pressure in the cat. AB - In anaesthetized cats, an upper canine tooth was stimulated mechanically at two different levels of jaw opening, the resting position and an open position with 20 +/- 2 mm between the upper and lower canines. The evoked field potentials and neuronal discharges were recorded from the caudal part of the contralateral coronal gyrus (SI cortex). The waveforms of the evoked potentials appeared in a positive-negative sequence. There were no significant changes in them when the jaws were open. Discharge patterns elicited in the cortical neurones by mechanical stimulation of the teeth consisted of initial 'burst' discharges, inhibitory pauses and/or large after-discharges. Jaw opening did not influence any phases of these responses to suprathreshold stimulation, spontaneous activities, or the sizes of the receptive fields. However, jaw opening did affect the initial 'burst' phase of the response to threshold stimulation, i.e. that which caused the neurones to fire with a probability of 30-50% with the jaw closed. Jaw opening enhanced this response probability in half (6/12) of the units that had very small receptive fields restricted to the canine tooth, but did not influence it in the majority (21/24) of the units that had larger receptive fields including the oral mucosa and the facial skin. There was no difference in distribution in the coronal gyrus between the two groups of neurones categorized by whether or not they were influenced by jaw position. PMID- 1768232 TI - Prolonged effects of hypofunction on the mechanical strength of the periodontal ligament in rat mandibular molars. AB - The ultimate loads required to extract three mandibular molars in the dissected jaw were examined after elimination of the antagonistic teeth for up to 64 days. The ultimate loads in the experimental first and second molars decreased rapidly in the first few days, while those in the third molar remained low during the same period in both experimental and control groups. The ultimate loads in all three molars of the experimental animals then increased gradually towards the end of the experiment at rates similar to those in controls. Maximum relative reductions of the ultimate load were observed within the first 8 days in all three molars. An increase in the length of roots was also found in all hypofunctional molars. Daily rates of root elongation ranged from 13 to 19 microns/day in the control and from 18 to 26 microns/day in the experimental molars during the whole experiment. The greatest value (80 microns/day) was obtained during the first 8 days in the third molars of both control and experimental animals. Thus the mechanical strength of the periodontal ligament estimated in vitro may be increased by the development of teeth and by non functional occlusal contacts with the opposing gingiva-covered alveolar ridge deprived of its tooth crowns. The ligament of the third molar was apparently immature at the beginning of the experiment. PMID- 1768233 TI - Stimulation by carrageenan of arachidonate 12-lipoxygenase activity in dog gingival tissue. AB - At 4 h after injection of carrageenan into the gingiva, the 12-lipoxygenase activity of the gingival homogenate was markedly increased. Activity in the cytosol and microsomal fractions was markedly increased when assessed as the specific activity based on nmol/min/mg of protein, and in the cytosol fraction as the percentage distribution of total activity. The 12-lipoxygenase activity in the homogenate from carrageenan-treated gingiva was not affected by either EDTA or calcium ion, or a combination of the two. 12-lipoxygenase activity in both carrageenan-treated and untreated gingiva was inhibited dose-dependently by AA861, a striking difference from its effect on platelet 12-lipoxygenase. There was a marked increase of 12-lipoxygenase activity in experimentally inflamed gingiva compared to the non-inflamed gingiva. PMID- 1768235 TI - A histological and histometric study of the periosteum in mandibular ramal and condylar areas of the rabbit. AB - These structures were investigated with various histological stains and by polarization microscopy. The width of the periosteal layers was measured in nine ramal and condylar areas at five different ages (0, 2, 6, 12 and 30 weeks). The total periosteal width changed during growth, as did the absolute and relative thickness of its cellular and fibrous layers. The results suggest that in these areas periosteal tension may influence growth of the condylar cartilage, and that this may vary during growth. PMID- 1768234 TI - Dental pulp lipids from Bos taurus during odontogenesis. AB - During the fetal development of the dental pulp, the various lipid classes show no substantial differences in their relative ratios but differences occur between deciduous and permanent teeth. By chromatography, the amount of free cholesterol was found decreased in deciduous and permanent teeth as compared to fetal teeth. Esterified cholesterol increased in permanent teeth and triglyceride levels were high only in developing permanent teeth. Phosphatidylcholine, sphingomyelin and phosphatidylserine were present in higher concentration in permanent unerupted teeth, while phosphatidylethanolamine was at first constant but then decreased during development in the permanent unerupted teeth. These data suggest that lipid changes are related to the assembly of plasma membranes and to the establishment of the innervation during ontogeny and postnatal development of dental pulp. PMID- 1768236 TI - Competency based training: Australia moves to a competency based system of training and education. PMID- 1768237 TI - Benign and malignant skin lesions: spot the difference. PMID- 1768238 TI - Haemochromatosis: an iron overload disorder. PMID- 1768239 TI - Discharge planning: whose role? PMID- 1768240 TI - Marketing of breast milk substitutes to be reviewed. PMID- 1768242 TI - The third age. Documentation for the standards. PMID- 1768241 TI - Nurse and the law. Pre-natal neglect results in action in negligence. PMID- 1768243 TI - OH and S in the health industry: project to develop a draft strategy for a national policy. PMID- 1768244 TI - Isoproterenol induced rat endomyocardial damage in relationship to local capillary geometry. AB - Isoproterenol (2 mg/kg) injected subcutaneously into male Sprague-Dawley rats elicited morphological damage in the endomyocardium which was analyzed 16 h following injection. Our aim was to study the relationship between damaged individual myocytes and their capillary supply. Myocardial tissue sections were differentially stained in order to distinguish arteriolar (AC) and venular (VC) capillary portions. Tissue areas surrounding individual capillaries and the position of the capillaries with respect to the damaged individual myocytes were established by using the method of "capillary domains". In multicellular necrotic lesions 84% of the capillaries located within the necrotic foci and 77% of the capillaries in the surrounding tissue area were identified as the distal, venular portion with presumably low O2 content. The proportion of VCs related to necrotic lesions was significantly higher than in surviving endomyocardial regions. In the case of individual necrotic myocytes, we found 88% to be supplied by VCs, while the adjacent normal myocytes were supplied by 61% VCs. Both values were significantly higher when compared to control hearts (42%). These results strongly support the crucial role of a lack of oxygen delivery in the pathogenesis of isoproterenol-induced necrosis. PMID- 1768245 TI - Vasomotor coronary oscillations: a model to evaluate autoregulation. AB - A simple model was proposed to characterise the oscillatory and nonoscillatory pattern of canine coronary circulation responses induced by a small dose of a vasodilator adenosine or the Ca2+ channel blocker diltiazem. This model consists of two differential equations describing the interaction of dilating (D) and constricting (C) resistance components. With the assumption that the rate constants associated with (D) were dependent on adenosine concentration and those associated with (C) were a function of Ca2+ channels, the model predicted: a) a damped oscillation of resistance to flow at low dose of adenosine, b) a predominant vasodilation at high dose of adenosine, and c) a sustained vasodilation in response to diltiazem. Parameters characterising the coronary resistance were evaluated by fitting the model results to calculated resistance from measured coronary flow and aortic pressure. As well, the model predicted accurately the peak resistance to great cardiac and coronary sinus venous flow in patients. This study indicates that the oscillation frequency of coronary resistance induced by a low dose of adenosine (0.01 mg/kg) is indicative of the uptake rate of adenosine by the heart and the coronary resistance provides considerable information on vasomotor control of the coronary circulation. PMID- 1768246 TI - The effect of coronary perfusion pressure and preload on left ventricular systolic wall stress parameters. AB - The effect of coronary perfusion pressure (i.e., mean aortic pressure) and of left-ventricular preload (i.e., left-ventricular enddiastolic wall stress) on left-ventricular peak developed wall stress (sigma max) and the maximum rate of stress development (d sigma/dtmax syst) and relaxation (d sigma/dtmax diast) was examined in anesthetized rats under open-chest conditions. Pulmonary flow, aortic pressure, and left-ventricular pressure amplitude, as well as enddiastolic pressure and dP/dt were measured and the respective wall stress parameters were calculated from the measured pressure and volume data, assuming a thick-walled sphere. Aortic pressure and right-ventricular filling pressure could be adjusted independently of each other via two header tanks. A primary increase in coronary perfusion pressure results in a linear rise in sigma max, d sigma/dtmax syst, and d sigma/dtmax diast. With increasing preload, however, the systolic wall stress parameters only increase initially, run through a maximum and then decrease with further elevation of the leftventricular enddiastolic wall stress. These results are interpreted such that, at a given mean aortic pressure the wall stress developed in the left ventricle rises with increasing preload and, consequently, the difference between mean aortic pressure and mean left-ventricular intramural wall stress declines. With decreasing difference between mean aortic pressure and mean intramural wall stress, the coronary flow is reduced. This interplay between left-ventricular wall stress on the one hand and coronary flow on the other is expressed in the critical value of enddiastolic wall stress, at which a further increase in preload leads to a marked reduction in coronary flow and, hence, to a fall in the systolic wall stress parameters. PMID- 1768247 TI - Three-dimensional computer model of the entire human heart for simulation of reentry and tachycardia: gap phenomenon and Wolff-Parkinson-White syndrome. AB - A computer model of the entire human heart has been developed for simulation of the excitation and repolarization process. Spatial distribution of refractory periods and conduction velocities in the different cardiac tissues, the anisotropy of conduction in the ventricles, and the cycle length dependence of refractory periods and conduction velocities are taken into account. The algorithm calculating the activation process is based on a modified version of Huygen's principle for constructing wavefronts. This study presents simulations concerning the gap phenomenon of the conduction system and the initiation of tachycardias in a heart with Wolff-Parkinson-White syndrome. Results are compared for different basic cycle lengths and for normal and prolonged refractory periods in the His-Purkinje system. The gap phenomenon was found to be present only when using the prolonged refractory periods in the His-Purkinje-system at a cycle length of 700 ms. Induction of tachycardia by a single extrastimulus in the high right atrium in a heart with a bidirectionally conducting accessory pathway is possible by properly timed extrastimuli. The coupling interval of the stimulus for initiating a reentrant tachycardia depends on the cycle length, the conduction velocities and the set of refractory periods used. The same parameters determine whether or not a gap phenomenon in atrioventricular conduction occurs. The model may be useful for investigating similar questions concerning the reentry phenomena of tachycardia. PMID- 1768248 TI - Kinetic properties of phenylalanine ammonia-lyase from sunflower (Helianthus annuus L.) hypocotyls. AB - Phenylalanine ammonia-lyase (PAL) from sunflower hypocotyls has been partially purified by selective precipitation with ammonium sulfate and molecular gel filtration on Sephacryl S-300. Kinetic assays carried out with this partially purified PAL preparation revealed that the enzyme did not show a homogeneous kinetic behaviour. The observed kinetic pattern and parameters (Km and Vmax) depended on the assay conditions used and the protein concentration added to the assay mixture. PAL displayed Michaelian or negative cooperativity kinetics. Such behaviour can be explained by the existence of an association-dissociation process of PAL-protein subunits. The presence of mono-, tri- and tetrameric forms of PAL has been assessed by molecular gel filtration on Sephacryl S-200, using different elution conditions. PMID- 1768249 TI - Enhancement of rat liver mitochondrial function by portal branch ligation secures subsequent extended hepatectomy. AB - We have examined the effects of portal branch ligation on liver mitochondrial function and on subsequent extended hepatectomy in rat. In the occluded lobes, mitochondrial function was depressed immediately after the ligation. In the unoccluded lobes, mitochondrial function was enhanced and reached the maximum two days after the ligation. This enhancement was associated with increases in the enzymic activities and subunit amounts of the energy-transducing complexes, and with increase in mitochondrial DNA content. The ligation improved both survival rate and mitochondrial redox state monitored by the ratio of acetoacetate to beta hydroxybutyrate after hepatectomy. These results suggest that the enhancement of mitochondrial function by portal branch ligation fills the energy demand for liver regeneration. PMID- 1768251 TI - Do rhizobia produce cytokinins? AB - Two Rhizobium strains were cultured on a defined medium; one was a normal strain of the cowpea group (ANU240) while the other (IC3342) was an unusual but related strain of the same group which induced abnormal shoot development, including proliferation of lateral buds, in nodulated plants. Culture supernatants were examined for the presence of cytokinins by mass spectrometry using deuterium labelled internal standards and by radioimmunoassay. In culture supernatants of both strains a range of cytokinins was detected and quantified, but N6-(2 isopentenyl)adenine (iP) and zeatin (Z) were the dominant cytokinins. The levels of Z and iP in supernatants of strain IC3342 were 26 and 8 times, respectively, those in supernatants of the strain ANU240. These results appear to provide the first unambiguous identifications of cytokinins in Rhizobium culture media. The cytokinin level in xylem sap of pigeonpea plants inoculated with strain IC3342 was markedly greater than that in plants inoculated with a normal nodulating strain. The abnormal proliferation of lateral buds in the former plants is probably linked to the elevation of cytokinin level in xylem sap caused by strain IC3342. PMID- 1768250 TI - Preferential stimulation by glucose of its oxidation relative to glycolysis in purified insulin-producing cells. AB - A rise in extracellular D-glucose concentration increases to a greater relative extent the conversion of both D-[5-3H]glucose to 3HOH and D-[6-14C]glucose to 14CO2 in rat purified insulin-producing cells than previously observed in pancreatic islets. In the pure B-cells, the ratio between D-[6-14C]glucose oxidation and D-[5-3H]glucose utilization increases, in a sigmoidal manner, as a function of the hexose concentration. The preferential stimulation by D-glucose of mitochondrial oxidative events is proposed to represent an unusual but essential feature of the metabolic and, hence, functional response of these fuel sensor cells. PMID- 1768252 TI - Protease inhibitors from ripened and unripened bananas. AB - The proteolysis of casein by trypsin, chymotrypsin and papain was inhibited by ripened and unripened bontha, poovan, nendran, cavendish and rasthali bananas. The inhibition of trypsin, chymotrypsin and papain by different ripened banana cultivars was much more than that of unripened banana cultivars. The trypsin and chymotrypsin inhibitory activity of ripened poovan was heat stable, resistant to pronase and partly stable to trypsin but the trypsin and chymotrypsin inhibitory activity of unripened poovan was stable to heat and resistant to pronase only. The partial stability of trypsin inhibitory activity and instability of papain inhibitory activity of ripened poovan to alkaline pH suggests that the inhibitory factors of trypsin and papain were dissimilar. The probable role of unripened banana papain inhibitors in curing stomach ulcers and antinutritional role of ripened banana trypsin inhibitors is discussed. PMID- 1768253 TI - Micro-determination of L-gulono-gamma-lactone oxidase activity. AB - Highly sensitive assay method of L-gulono-gamma-lactone oxidase (GLO) was constructed. In this method, L-ascorbic acid formed in the enzymatic reaction was converted to its bis(dinitrophenyl)hydrazone derivative, and the amount of the latter was determined by high-performance liquid chromatography. Twenty picomoles of ascorbic acid was detected, which makes this method 25 times more sensitive than the previously used dipyridyl one. By the present method, a minute activity of GLO in liver microsomes prepared from rats of the Osteogenic Disorder Shionogi strain (ODS-od/od) could be measured. PMID- 1768254 TI - Induction of ornithine decarboxylase by sialagogues in a human parotid gland adenocarcinoma cell line. AB - Ornithine decarboxylase in a human parotid gland adenocarcinoma cell line was induced by both cholinergic (carbachol) and beta-adrenergic (isoproterenol) sialagogues. The enzyme protein level, measured with anti-peptide antiserum, as well as the enzyme activity, was found to be high in unstimulated cells and to increase approximately 2-fold on stimulation, while the mRNA level increased 3-4 fold, as revealed by Northern hybridization. The rise in activity was completely blocked by the simultaneous addition of antagonists or actinomycin D. These results suggest that receptor-mediated stimulation of ornithine decarboxylase activity by sialagogues involves alterations in the level of mRNA and that the proliferative responses of human parotid cells to these sialagogues resemble those of the murine parotid gland. PMID- 1768255 TI - Lipoamide dehydrogenase from Trypanosoma cruzi: some properties and cellular localization. AB - Lipoamide dehydrogenase (E.C. 1.6.4.3) was found in Trypanosoma cruzi, Tulahuen strain, stocks Tul-2 and Q501, and CA-1 strain. After differential centrifugation of epimastigote homogenates, ammonium sulfate fractionation of the 105,000 g supernatant yielded a partially purified preparation which precipitated between 0.40 and 0.80 ammonium sulfate saturation. The enzyme (a) catalyzed the oxidation of dihydrolipoamide by NAD+ and the reduction of lipoamide by NADH, the forward reaction being 2.5-fold faster than the reverse reaction; (b) exhibited hyperbolic dependence on substrate concentration and (c) possessed diaphorase activity which was less than 5% of the lipoamide reductase activity. The NADH reduced enzyme was inhibited by arsenite, cadmium and p-chloromercuribenzoate in a concentration-dependent manner. Substrate specificity allowed lipoamide dehydrogenase to be differentiated from T. cruzi trypanothione reductase and other NADPH-dependent flavoenzymes. After cell disruption, lipoamide dehydrogenase was found mostly in the cytosolic fraction and no evidence for association with the plasma membrane was obtained. PMID- 1768256 TI - Characterisation of an ionisable group involved in binding and catalysis by sialidase from influenza virus. AB - The effect of pH on the kinetics of sialidase purified from influenza virus (A/Tokyo/3/67, H2N2) was investigated. A pK of 9.0 for inhibition of the enzyme by three competitive inhibitors, due to an ionisable group in the active site, was observed. A similar pK was observed for V/Km for the fluorogenic substrate 2 (4-methylumbelliferyl)-N-acetyl-alpha-D-neuraminic acid. However, the shape of the V/Km profile indicates that this substrate is sticky. Solvent perturbation experiments indicated that the observed ionisable active site group is likely to be a cationic amino acid. The results provide evidence against the hypothesis that Glu 276 acts as a proton donor in the enzyme reaction and supports the proposal of a role for one of the active site cationic amino acids in binding and catalysis. PMID- 1768257 TI - Contractile activity of Trimeresurus flavoviridis phospholipase A2 on guinea pig ileum and artery. AB - Trimeresurus flavoviridis phospholipase A2 (PLA2) induced strong contractions of the smooth muscles of guinea pig ileum and artery in a concentration-dependent manner (10(-10)-10(-6) M). When the same dose of PLA2 was administered in repetition to the ileal preparation, the contraction diminished progressively and was no longer recovered even by consecutive washings. The enzymatically inactive derivative of PLA2, in which His-47 was p-bromophenacylated, was unable to elicit contraction. Also, no activity was observed when the Ca(2+)-free medium was used. The contraction induced by PLA2 was inhibited completely by 1.0 x 10(-6) M indomethacin, but not by nordihydroguaiaretic acid. These results imply that the PLA2-induced contraction is due essentially to the hydrolytic action of the enzyme against phospholipid membranes to liberate arachidonic acid that is then converted to pharmacologically active prostaglandins. In guinea pig artery, PLA2 caused both contraction and relaxation. PMID- 1768258 TI - Antifolates induce primary inhibition of the de novo purine pathway prior to 5 aminoimidazole-4-carboxamide ribotide transformylase in leukemia cells. AB - Polyglutamated dihydrofolate, accumulated as a result of potent inhibition of dihydrofolate reductase (DHFR), has been postulated to directly inhibit the purine pathway at 5-aminoimidazole-4-carboxamide ribotide (AICAR) transformylase (reaction 9) in leukemia cells exposed to methotrexate (MTX). We have observed that 25 microM MTX or piritrexim, a "non-classical" antifolate, induce several fold accumulations of AICAR and N-succino-AICAR to a combined cellular concentration of 89 microM in mouse L1210 leukemia cells after 2 h. By contrast, complete inhibition of reaction 4 by 25 microM azaserine results in accumulation of N-formyl-glycinamide ribotide (FGAR) polyphosphates to a combined cellular concentration of greater than 10 mM. MTX prevented azaserine-induced accumulation of FGAR polyphosphates. Hence, these antifolates induce primary inhibition of the de novo purine pathway at, or prior to, glycinamide ribotide transformylase (reaction 3). PMID- 1768259 TI - Purine nucleoside phosphorylase from human erythrocytes: a kinetic study of the fully separated isoenzymes. AB - Human red cell lysates contain at least seven electrophoretically distinct isoenzymes of purine-nucleoside phosphorylase (PNPase); the proportion of more anodal bands increases as the erythrocyte ages, suggesting that the native enzyme is subjected to progressive post-translational modifications. The age dependent electrophoretic changes observed in the hemolysate are associated with the downward curvature of the Lineweaver-Burk double reciprocal plot at high inosine substrate concentrations unlike the single-banded PNPase from tissue cultures of rapidly dividing cells. Thanks to the high resolution power of the ion-exchange HPLC technique utilized we have been able to fully separate all the seven isoenzymes and correlate structural to functional modifications in PNPase from human erythrocytes. Our results indicate that the downward curvature of Lineweaver-Burk plot is not due to a mixture of isoforms with low and high Km for inosine but that the allosteric activation by the inosine substrate is the direct consequence of structural modification(s) on the "primary" form of the enzyme. PMID- 1768260 TI - Stimulation of prostaglandin synthesis in rabbit gastric antral mucosal slices by desferrioxamine in vitro. AB - Desferrioxamine is an iron-chelating agent used in the treatment of iron overload. It is a powerful inhibitor of iron-dependent radical reactions. The effect of desferrioxamine of prostaglandin (PG) synthesis and metabolism in rabbit gastric antral mucosal slices has been examined. Desferrioxamine significantly enhanced the production of PGE2 and PGF2 alpha. The formation of 13,14-dihydro-15-keto PGE2 and 13,14-dihydro-15-keto PGF2 alpha was also increased slightly by desferrioxamine. The addition of Fe3+ or Al3+ blocked the stimulatory action of desferrioxamine on PGE2 and PGF2 alpha production. Desferrioxamine appears to be stimulating the activity of PG cyclooxygenase through the removal of endogenous antral mucosal iron. These results suggest that desferrioxamine has the potential to increase the PG levels in gastric mucosa by primarily stimulating PG biosynthesis. The possibility that desferrioxamine may be of therapeutic value in the treatment of ischemic injury in the stomach is discussed. PMID- 1768261 TI - Identification of gastric mucosal mucus glycoprotein sulfotransferase. AB - Sulfation of mucus glycoproteins, reaction catalyzed by Golgi resident sulfotransferase, is an important event in posttranslational processing of gastric mucins. Here we report the purification of mucus glycoprotein sulfotransferase enzyme from the microsomal fraction of rat gastric mucosa. The enzyme was released from the membrane with 0.5% Triton X-100 and precipitated from the 100,000xg supernatant with 90% ice-cold acetone. The enzyme activity (44.7 pmol/mg/45 min) in the precipitate was enriched nearly 10-fold compared to Triton X-100 extract of microsomal membrane (4.2 pmol/mg/45 min). On SDS-PAGE, the enzyme gave a single 43 kDa protein band, which was active towards mucin, but did not catalyze the sulfation of galactosylceramide. The study is the first to report the characteristics of a sulfotransferase enzyme specific for gastric mucin. PMID- 1768262 TI - The structural features of beef heart mitochondrial creatine kinase. AB - Two forms of mitochondrial creatine kinase (Mi-CK) having Mr 320 kDa and 240 kDa as determined by gel-filtration on Sephacryl S-300 in 0.1 M Tris-HCl pH 7.4 were investigated. The sedimentation coefficient values for these two forms were found to be identical and equal to 12.3 S. When studied by electron microscopy the main type of images for the 320 kDa and 240 kDa Mi-CK appeared as annular particles, 12-14 nm in diameter, with a well-detected subunit structure and a central hollow, 3-4nm in diameter filled with the dye. The results of the averaging of the main type of individual Mi-CK images and particles of the two-dimensional crystal layer point to the overall geometry of the Mi-CK molecule structure as containing eight subunits arranged by a 4-fold symmetry around the central hollow. It may be that the eight identical subunits of crystalline Mi-CK are arranged with a P422 symmetry. However in both cases the averaged main images do not show a mirror symmetry. The multiplicity of the observed projections close to annular one provides additional evidence in favour of the great lability and structural mobility of the Mi-CK subunits. It allows to assume that two forms (320 kDa and 240 kDa) are not the different oligomers but they are two functionally distinct conformational states of octameric molecule of Mi-CK. PMID- 1768263 TI - In vitro effect of nonsteroidal ecdysone agonist RH 5849 on fat body acid phosphatase activity in rice moth, Corcyra cephalonica (Insecta). AB - Nonsteroidal ecdysone agonist stimulates acid phosphatase activity in the fat body in vitro cultures obtained from ligated late-last instar larvae of Corcyra cephalonica. The agonist also stimulates general protein synthesis. This stimulation is both time as well as dose dependent (up to a dose of 1000 ng of the agonist). However, still higher concentrations (1500-4000 ng) tend to depress the degree of stimulation. PMID- 1768264 TI - Differential hormone regulation of acid DNase activity in the testes and fat body of Spodoptera litura (Lepidoptera-Insecta). AB - Acid DNase activity in the testes and fat body is high during the early larval instars which may be correlated with the extensive cell division seen in both the tissues during these stages. The increased enzyme activity, observed in the testes of the pupal stage, might be involved in the in vivo degradation of DNA in a large number of degenerating spermatocysts which occur during this stage. Total activity of acid DNase in the fat body is highest in pupal stage. Like acid phosphatase, this enzyme may also be involved in the process of remodelling of the fat body during metamorphosis. 20-Hydroxyecdysone (20-HE) does not have any effect on acid DNase activity in the testes but it alters the enzyme activity in the fat body. Juvenile hormone-I (JH-I) has no effect on the enzyme activity in the fat body. PMID- 1768265 TI - The isolation and amino acid sequences of echidna (Tachyglossus aculeatus) milk lysozyme I and II. AB - Comparative studies of monotreme proteins are of particular value in gaining an understanding of the origin of mammals and their interrelationships. The presence of two lysozyme variants, echidna lysozyme I and II, has been confirmed in mature milk samples of Tachyglossus aculeatus multiaculeatus and Tachyglossus aculeatus aculeatus respectively. A simplified procedure is described for their isolation. Their amino acid sequences, the first determined for a monotreme secretory protein, are unusual. They are shown to be c-type lysozymes, each consisting of a single chain of 125 residues (terminating at Cys 125). The only other known c type lysozyme with this termination is that of pigeon eggwhite. Echidna lysozyme is unique in having no Cys at position 6, but at position 9. It has precisely the residues relevant to the binding of Ca(II), and most of the residues implicated in the galactosyl transferase modifier action of alpha-lactalbumin. However, the weak modifier action previously observed for variant I, prepared by a different method, was not found for the present preparation. The evolutionary significance of the results is discussed. PMID- 1768267 TI - Molecular basis for binding promiscuity of antagonist drugs. PMID- 1768266 TI - Activity of some proteinases and glycosidases in human leukemic lymphoid cells at various stages of differentiation. AB - Activities of some glycosidases and proteinases in human leukemic lymphoid cells at various stages of differentiation have been compared. It was found that cells with different immunological phenotypes gave different enzymic spectra. Glycosidases and proteinases in lymphoid cell precursors had higher activity level than the enzymes in mature T- and B- cells. In cells of B- lineage, all activities were lower than in common precursor of lymphoid cells. In T-cells at the earlier stages of thymic differentiation, activities of all proteinases and most of glycosidases were higher than in common precursor cells whereas in mature T-helpers and T-suppressors the activities were markedly lower. Most of hydrolases in mature T-cells were twice more active than the enzymes in mature B cells. The opposite-directional changes in activities of some hydrolases at the earlier stages of differentiation of lymphoid cells along B- or T- cells pathways are suggested. PMID- 1768268 TI - Muscarinic receptors in diabetic rat prostate. AB - To investigate the effects of experimentally-induced diabetes on prostatic muscarinic cholinergic receptors, the binding characteristics of [3H]quinuclidinyl benzilate ([3H]QNB) to prostatic membrane particulates were examined in four groups of rats: control, diabetic, diabetic insulin treated, and diabetic myo-inositol treated. Diabetes was induced by i.v. injection of streptozotocin (STZ), 65 mg/kg. Diabetic and diabetic myo-inositol-treated rats had hyperglycemia, hypoinsulinemia, glucosuria, polydipsia, and polyuria as well as significantly smaller prostates and lower body weights compared to control and diabetic insulin-treated animals. The densities of muscarinic receptors (Bmax) as determined by saturation studies with [3H]QNB in the prostatic plasma membranes of control, diabetic, diabetic insulin-treated and diabetic myo-inositol-treated rats were 80 +/- 8, 51 +/- 5, 78 +/- 3, and 47 +/- 7 fmol/mg of protein, respectively. [3H]QNB binding to muscarinic receptors was inhibited by muscarinic antagonists with the following rank order of Ki values: atropine much less than pirenzepine less than AF-DX 116. The pharmacological profile of the muscarinic receptors was similar in all groups examined and was consistent with the predominance of the M3 muscarinic receptor subtype in prostatic membrane particulates. Our data indicate that STZ-induced diabetes caused a variety of abnormalities including a down-regulation in the density of M3 muscarinic receptors in the rat prostate and that insulin, but not myo-inositol could prevent the development of these abnormalities. PMID- 1768269 TI - DNA damage induced in HT-29 colon cancer cells by exposure to 1-methyl-2 nitrosoimidazole, a reductive metabolite of 1-methyl-2-nitroimidazole. AB - Exposure of HT-29 colon carcinoma cells to 1-methyl-2-nitrosoimidazole (INO), a reductive metabolite of a model 2-nitroimidazole, induced concentration-dependent DNA damage detectable by conventional alkaline (single-strand breaks) and neutral (double-strand breaks) filter elution techniques. Elution of DNA from the filters under alkaline conditions was distinctly biphasic. No evidence of DNA damage was detected when cellular DNA was incubated directly with INO prior to filter elution. DNA damage was enhanced markedly in HT-29 cells incubated with buthionine sulfoximine to deplete intracellular glutathione levels prior to INO treatment. The biphasic shape of the elution profiles was not attributable to loss of labeled thymidine mononucleotides or to the formation of DNA-protein crosslinks. Rather, the data suggest the existence of two subpopulations of cells differing in sensitivity to the DNA-damaging effects of INO exposure. Based upon differential adherence, two populations of cells, differing with respect to the rate and extent of elution from the filters during alkaline elution assays, were detected, although they could not be purified sufficiently by this technique to permit biochemical characterization. The results suggest that the nitroso intermediate is either an active metabolite, or a proximate form of the ultimate DNA-reactive species, responsible for DNA damage in cells exposed to 2 nitroimidazoles under reducing conditions. PMID- 1768270 TI - Mechanism of inhibition of hepatic bile acid uptake by amiloride and 4,4' diisothiocyano-2,2'-disulfonic stilbene (DIDS). AB - The mechanisms by which amiloride and 4,4'-diisothiocyano-2,2'-disulfonic stilbene (DIDS) inhibit hepatic uptake of cholate and taurocholate (TC) were investigated in isolated rat hepatocytes. Amiloride inhibited Na(+)-dependent uptake of cholate and TC only when hepatocytes were preincubated with amiloride, indicating an indirect effect of amiloride. Time-dependent studies showed that the inhibition of bile acid uptake was associated with a parallel increase in intracellular Na+ concentration ([Na+]i). Although amiloride decreased intracellular pH, this decrease preceded amiloride-induced inhibition of bile acid uptake and increase in [Na+]i. Amiloride inhibited bile acid uptake, decreased membrane potential, and increased [Na+]i with comparable concentration dependency. DIDS inhibited Na(+)-dependent uptake of cholate and TC non competitively. Neither DIDS nor amiloride inhibited Na(+)-independent uptake of cholate and TC. These results indicate that amiloride inhibits Na(+)-dependent cholate and TC uptake by decreasing the transmembrane Na(+)-gradient, and further support the hypothesis that two different transporters may be involved in hepatic bile acid uptake by Na(+)-dependent and Na(+)-independent mechanisms. PMID- 1768271 TI - Induction of cytochrome P450 isozymes in rat liver by methyl n-alkyl ketones and n-alkylbenzenes. Effects of hydrophobicity of inducers on inducibility of cytochrome P450. AB - The effects of methyl n-alkyl ketones and n-alkylbenzenes on hepatic cytochrome P450s in vivo and in vitro were investigated. Male rats were treated with acetone, methyl ethyl ketone, methyl n-propyl ketone, methyl n-butyl ketone, benzene, toluene, ethylbenzene, n-propylbenzene, or n-butylbenzene. The methyl n alkyl ketones induced the metabolic activities of hepatic microsomes toward aminopyrine, 7-ethoxycoumarin, and aniline. n-Alkylbenzenes induced aminopyrine and 7-ethoxycoumarin metabolic activities. Testosterone 2 beta- and 6 beta hydroxylation activities were induced by ketones with a long side chain such as methyl n-butyl ketone. Testosterone 2 alpha-hydroxylation activity was decreased by treatment with methyl n-butyl ketone. Testosterone 16 beta-hydroxylation activity was induced by treatment with methyl n-alkyl ketones. The inducibility was dependent on the length of the side chain. Testosterone 16 beta-hydroxylation activity also was induced by n-alkylbenzenes. These results indicate that the levels of multiple forms of cytochrome P450 were changed by treatment with these chemicals. P450IIE1, an acetone-inducible form, was induced by methyl n-alkyl ketones or n-alkylbenzenes. The inducibility did not depend on the length of the side chain of these chemicals. P450IIB1 and IIB2, both phenobarbital-inducible forms, were induced with methyl n-alkyl ketones and n-alkylbenzenes to an extent depending on the length of the side chain of these chemicals. Thus, the hydrophobicity of the inducer affected phenobarbital-type induction but not the induction of P450IIE1. We further investigated the interactions of ketone and benzene derivatives with cytochrome P450 in vitro. Testosterone hydroxylation activities of hepatic microsomes were measured in the presence of methyl n-alkyl ketones and n-alkylbenzenes. Methyl n-alkyl ketones inhibited testosterone 16 beta-hydroxylation activity. n-Alkylbenzenes inhibited 2 beta-, 6 beta-, 15 alpha , 16 alpha-, and 16 beta-hydroxylation activities. Testosterone hydroxylation activities were inhibited by these chemicals depending on the length of the side chain. n-Alkylbenzenes were stronger inhibitors than methyl n-alkyl ketones, n Butylbenzene was the strongest inhibitor of these activities. These results indicate that hydrophobicity was important in the interaction of these chemicals with cytochrome P450, and that there is some relationship between the inducibility of cytochrome P450 and its interaction with inducers. PMID- 1768272 TI - Accumulation of amiodarone and desethylamiodarone by rat alveolar macrophages in cell culture. AB - Amiodarone is a clinically effective antiarrhythmic drug shown to cause lung damage in humans and animals. While the mechanism of this pulmonary toxicity is unknown, it may be associated with the accumulation of amiodarone and its principal metabolite, desethylamiodarone, by alveolar macrophages. In the present study, characteristics of the uptake of these drugs by rat alveolar macrophages in vitro were examined. The alveolar macrophages were collected by pulmonary lavage from male Fischer 344 rats. Amiodarone and desethylamiodarone were incubated separately (2.5 microM) with the cells in culture for 1, 2, 4 and 18 hr. High performance liquid chromatography was used to measure drug uptake. At 1 and 2 hr, the uptake of desethylamiodarone by alveolar macrophages was significantly greater (P less than 0.05) than that of amiodarone, but over time, the accumulation of amiodarone began to approach that of desethylamiodarone and was not significantly different by 4 hr. To simulate a more physiological situation, plasma levels achieved in the adult male rat after 1 week of amiodarone treatment (150 mg/kg) were used. Amiodarone (1.95 micrograms/mL) and desethylamiodarone (0.80 microgram/mL) were added together into the cell culture. At 1 and 18 hr, the ratio of desethylamiodarone/amiodarone uptake was significantly greater (P less than 0.05) than in incubation medium containing no cells, indicating an enhanced uptake of desethylamiodarone. Metabolic inhibitors (KCN, 2,4-dinitrophenol, and ouabain) and other cationic, amphiphilic drugs (chlorcyclizine, chlorphentermine, and imipramine) were added individually to the cell cultures containing amiodarone or desethylamiodarone. During 1 hr of incubation, these agents had no effect in blocking the accumulation of amiodarone and desethylamiodarone in the cells. The efflux of amiodarone or desethylamiodarone was measured from cells following incubation for 4 hr with each drug. After this time, the medium was replaced with drug-free medium, and the cells were incubated for another 24 hr. Sixty-three percent of amiodarone was lost as compared to only 31% of desethylamiodarone over the 24-hr period (P less than 0.05). The results of this study are suggestive of a preferential uptake and retention of desethylamiodarone as compared to amiodarone. The accumulation of the drugs appears not to be due to active transport or associated with any carrier protein involved in the transport of other structurally-related compounds. PMID- 1768273 TI - Nitric oxide generation from nitroprusside by vascular tissue. Evidence that reduction of the nitroprusside anion and cyanide loss are required. AB - Nitric oxide (NO) was produced from sodium nitroprusside in the presence of vascular tissue but was not released spontaneously from the nitroprusside anion. In the absence of tissue in the dark nitroprusside did not release NO. When solutions of nitroprusside alone were irradiated with visible light, nitric oxide was released at rates linearly proportional to nitroprusside concentration and light intensity. Nitric oxide was produced from solutions of nitroprusside in the dark after the addition of vascular tissue, including lengths of rabbit aorta, subcellular fractions of aorta, and human plasma. NO was also released from nitroprusside after reaction with various reducing agents including cysteine and other thiols, ascorbic acid, sodium dithionite, ferrous chloride, hemoglobin, myoglobin, and partially purified cytochrome P450 with an NADPH-regenerating system. HCN was simultaneously produced in these solutions, and addition of KCN blocked NO release. Iodine oxidized intermediate cyanoferrates and blocked nitric oxide release. KCN or iodine also blocked NO production by tissue, but had no effect upon photochemical NO release. These results show that, apart from photolysis which makes no physiological contribution, release of nitric oxide from nitroprusside, in simple solutions and in biological tissue, occurs after nitroprusside has undergone reduction and lost cyanide. PMID- 1768274 TI - Simulation of kinetic data on the influx and efflux of chloroquine by erythrocytes infected with Plasmodium falciparum. Evidence for a drug-importer in chloroquine-sensitive strains. AB - Literature data on influx and efflux kinetics of chloroquine (CQ) with erythrocytes infected with the malaria parasite Plasmodium falciparum were simulated using a four-compartment model with first-order exchange between the compartments. The four compartments represent (1) the buffer surrounding the infected erythrocyte; (2) the cytosol of the host erythrocyte; (3) the parasite cytosol; and (4) the food vacuole. Simulations showed that basal membrane transport of CQ, estimated from data on influx of CQ into uninfected red cells, largely accounts for uptake and release of CQ by erythrocytes infected with two different CQ-resistant (CQ-R) parasite strains. In contrast, the rate of uptake of CQ by erythrocytes infected with a CQ-sensitive (CQ-S) strain is substantially higher than predicted by uptake with membrane transfer by basal diffusion of CQ. Simulations also indicate that the difference in kinetics of CQ uptake by erythrocytes infected with the CQ-S and CQ-R strains can be explained by a net increase in the inward permeability coefficient at the host erythrocyte membrane, the composite membrane surrounding the parasite or the food vacuole membrane. The results are consistent with the presence of a drug-importer for CQ in erythrocytes infected with sensitive strains, which is absent in those infected with resistant strains. They are not consistent with the hypothesis that CQ resistance is attributable to a drug-exporter in resistant cells which is lacking in sensitive cells. PMID- 1768275 TI - Primary culture of rat hepatocytes in the presence of dimethyl sulphoxide. A system to investigate the regulation of cytochrome P450 IA. AB - Primary cultures of adult rat hepatocytes would provide a suitable system for the study of hepatic drug metabolism/toxicity provided that the drug-metabolizing enzymes could be maintained at levels approaching those seen in vivo. It has been reported that culture of adult rat hepatocytes in the presence of 2% (v/v) dimethyl sulphoxide (DMSO) allowed partial maintenance of total cytochrome P450 content. However, the levels of the individual isozymes were not determined. Culture of rat hepatocytes in the presence of DMSO did maintain the total cytochrome P450 content at 65% of the fresh cell value after 7 days of culture. This was accompanied by high cytochrome P420 levels suggesting that the solvent was stimulating de novo synthesis rather than maintaining existing enzyme. In the presence of DMSO the level of ethoxyresorufin-O-deethylase (EROD) rose 4-fold in culture, whilst that of pentoxyresorufin-O-dealkylase fell rapidly indicating that the isozyme pattern was altered significantly. The increases in total cytochrome P450 content and EROD activity were prevented by cycloheximide confirming that de novo protein synthesis was occurring. Haem oxygenase activity was significantly reduced and aminolaevulinic acid synthetase was significantly increased in the presence of solvent, suggesting increased haem availability for incorporation into cytochrome P450. However increased haem availability is insufficient in explaining the isozyme specificity of cytochrome P450 induction. Hepatocytes cultured in the presence of 2% (v/v) DMSO were markedly more responsive to 1,2-benzanthracene, with EROD increasing approximately 40-fold. PMID- 1768276 TI - Mercury-induced H2O2 production and lipid peroxidation in vitro in rat kidney mitochondria. AB - Mercuric ion (Hg(II)) causes oxidative tissue damage in kidney cortical cells. We studied the in vitro effects of Hg(II) on hydrogen peroxide (H2O2) production by rat kidney mitochondria, a principal intracellular target of Hg(II). In mitochondria supplemented with a respiratory chain substrate (succinate or malate/glutamate) and an electron transport inhibitor (antimycin A (AA) or rotenone), Hg(II) (30 nmol/mg protein) increased H2O2 formation approximately 4 fold at the ubiquinone-cytochrome b region (AA-inhibited) and 2-fold at the NADH dehydrogenase region (rotenone-inhibited). Concomitantly, Hg(II) increased iron dependent lipid peroxidation 3.5-fold at the NADH dehydrogenase region, but only by 25% at the ubiquinone-cytochrome b region. The mitochondrial concentration of reduced glutathione (GSH) decreased both with incubation time and Hg(II) concentration. Hg(II), at a concentration of 12 nmol/mg protein, caused almost complete depletion of measurable GSH in substrate-supplemented mitochondria after a 30-min incubation. In electron transport-inhibited mitochondria, Hg(II) caused greater depletion of GSH in rotenone-inhibited than in AA-inhibited mitochondria, consistent with the effects of Hg(II) on lipid peroxidation. These results suggest that Hg(II) at low concentrations depletes mitochondrial GSH and enhances H2O2 formation in kidney mitochondria under conditions of impaired respiratory chain electron transport. The increased H2O2 formation by Hg(II) may lead to oxidative tissue damage, such as lipid peroxidation, observed in mercury-induced nephrotoxicity. PMID- 1768277 TI - Heterogeneity of carbonyl reduction in subcellular fractions and different organs in rodents. AB - The pattern and distribution of carbonyl reduction in liver, kidney and adrenal gland subcellular fractions of NMRI mice, Wistar rats and Hartley guinea pigs were examined using the ketone compound metyrapone (2-methyl-1,2-di(3-pyridyl)1 propanone) commonly used as a diagnostic cytochrome P450 inhibitor. A direct HPLC method for alcohol metabolite determination instead of the indirect spectrophotometric recording of pyridine nucleotide oxidation at 340 nm was applied. All the tissues examined in these species rapidly reduced the employed compound but at the subcellular level no general distribution scheme of specific activity was found, although in all fractions metyrapol formation could be attributed to aldo-keto reductases. Cytosolic and microsomal metyrapone reducing enzymes are distinguished by their inhibitor sensitivity to phenobarbitone and quercitrin and thus can be characterized as aldehyde and ketone reductases according to the inhibitor subclassification of the aldo-keto reductase family. Moreover, the enzymes also differ with respect to their immunological cross reactivity to anti-microsomal mouse liver metyrapone reductase antibodies. Immunological homologies were found between metyrapone reductases of liver microsomes from all species and kidney and adrenal gland microsomes from guinea pig. However, the protein of all the cytosolic fractions as well as that of kidney and adrenal gland microsomes from mouse and rat did not cross-react with the antibodies, indicating the absence of common antigenic determinants. From catalytic properties and functional data it is concluded that hydroxysteroid dehydrogenases present in the suspected subcellular fractions form a structurally and functionally related enzyme family which may have been conserved during evolution. PMID- 1768279 TI - The metabolism of tamoxifen by human liver microsomes is not mediated by cytochrome P450IID6. PMID- 1768278 TI - A comparison of proteins S-thiolated by glutathione to those arylated by acetaminophen. AB - This study was designed to evaluate whether the same proteins that irreversibly bind reactive electrophiles of drugs also bind glutathione (GSH) under oxidative conditions. Specifically, proteins that can be arylated by acetaminophen were compared to those that form glutathione-protein mixed disulfides (PSSG) after incubation with diamide. Data are presented which suggest that both GSH and acetaminophen bind to a subset of N-ethylmaleimide (NEM)-reactive protein thiols. To evaluate the pattern of proteins that bind GSH, PSSGs were formed in vitro by incubating cytosolic proteins with GSH and diamide. A sensitive procedure was developed in which PSSGs were first reduced with 0.1 mM dithiothreitol (DTT), and the newly exposed protein thiols were labeled with either [3H]NEM (for quantitative analysis) or with fluorescein-5-maleimide (for visual detection). Acetaminophen binding was achieved by incubating cytosolic proteins in vitro with the reactive acetaminophen metabolite, N-acetyl-p-benzoquinoneimine (NAPQI). Proteins from both assays were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and transferred to nitrocellulose for Western blot analysis. Acetaminophen binding was detected by immunoblotting with an affinity-purified antibody against acetaminophen, and PSSGs were visualized using anti-fluorescein antibodies. In both instances, binding to proteins was observed to be selective. A comparison of the proteins modified by GSH binding with those that bind acetaminophen indicates that the major cytosolic acetaminophen-binding protein of 58 kDa may also be modified by glutathiolation under oxidative conditions. PMID- 1768280 TI - Effects of benfluron and its two metabolites on respiratory processes in P388 murine leukemia and Ehrlich ascites cells. AB - This paper presents data on the effects of benfluron and its two metabolites DBF and NOBF on both endogenous and exogenous, respiration in the presence of succinate as substrate, of both P388 murine leukemia and Ehrlich ascites carcinoma cells. The most efficient inhibitors of endogenous and exogenous respiration were benfluron and DBF. NOBF did not interfere with respiratory processes in Ehrlich cells, even at quite high concentration. BF and DBF exert an almost identical inhibitory effect on exogenous respiration, the least effective being NOBF (Ehrlich cells). The decrease in the respiratory rates in cancer cells might be due to the effects of benfluron and its metabolites on the cell membrane. P388 murine leukemia cells are less "sensitive" than Ehrlich ascites cells. PMID- 1768281 TI - Depolarization produces an acidification of adrenal gland perfusates. AB - Stimulation of adrenal glands with a variety of agonists or high potassium produced an acidification of the perfusion medium. The magnitude of the transient pH decrease was similar to that found in other nervous structures, and depended on the buffering capacity of the perfusion medium. However, no alkaline transient could be detected in this tissue. This acidification required Ca2+ and occurred under conditions producing catecholamine release. Since firstly the acidification could not be directly correlated with the amount of catecholamine released and secondly the time-course of both phenomena was different, suggesting that the acidification did not only result from the exocytosis of the acidic content of the chromaffin vesicles. The extracellular acidification may in addition originate: (a) partly from the proton release from acidic proteins, (b) from an output of acid equivalents from the cytoplasmic medium, either by the Na+/H+ antiporter present in all animal cells [24], or another mechanism yet to be determined. PMID- 1768282 TI - Antimalarial activity of optical isomers of quinacrine dihydrochloride against chloroquine-sensitive and -resistant Plasmodium falciparum in vitro. AB - Both enantiomers of quinacrine and the racemic form of the drug showed equal activity in vitro against chloroquine-sensitive and -resistant strains of Plasmodium falciparum, without detectable stereoselectivity. This contrasts with observations on chloroquine, where a similar lack of stereoselectivity in vitro is accompanied by a 10-fold loss of activity against the resistant strain. The observed in vivo differences reported for the enantiomers of chloroquine and the observations on the optically active metabolites of chloroquine and quinacrine may therefore be ascribed to a difference in the pharmacokinetics of their enantiomers. PMID- 1768283 TI - Pharmacological profile of inhibition of 2',7'-bis(2-carboxyethyl)-5(6) carboxyfluorescein efflux in human HCT-8 intestinal epithelial cells. AB - The efflux of 2',7'-bis(2-carboxyethyl)-5(6)-carboxyfluorescein (BCECF) from human HCT-8 intestinal epithelial cultured cells was time-dependent, and after 5 hr 76% of the fluorochrome was extracellular. The pharmacological profile for inhibition of this efflux has been investigated, focusing on agents which modulate anion transport. BCECF efflux was sensitive to inhibition by 0.5 mM indomethacin (50% inhibition at 20 microM) which reduced efflux to values observed after depletion of ATP with azide and 2-deoxy-D-glucose. Indomethacin inhibition of BCECF efflux was not reversed with prostaglandin. The stilbene derivatives 4-acetamido-4'-isothiocyano-2-2'-disulphonic stilbene and 4,4' diisothiocyano-2,2'-disulphonic stilbene only resulted in partial inhibition of BCECF efflux, even at 1 mM. Furosemide, bumetamide, probenecid and 5-nitro-2-(3 phenylpropyl-amino)-benzoate only reduced BCECF efflux at 1 mM. The cationic agent vinblastine was as active as indomethacin as an inhibitor of BCECF efflux (50% inhibition) with 10 microM) while actinomycin D was also a good inhibitor (50% inhibition with 100 microM). Several other cationic agents, including nifedipine, amiloride and reserpine, were ineffective as inhibitors of BCECF efflux in concentrations up to 1 mM. Thus, the pharmacological profile for inhibition of BCECF efflux does not fully equate with any recognised transport system. Agents such as cytochalasin B and chloroquine did not fully equate with any recognised transport system. Agents such as cytochalasin B and chloroquine did not effect BCECF efflux suggesting accumulation and subsequent discharge from endosomes is not a pathway for secretion. BCECF may be a substrate for a cellular secretory detoxifying system in epithelial cells. PMID- 1768284 TI - Uptake, cytotoxicity and metabolism of m-azidopyrimethamine and related lipophilic antifolates in SV-K14 human keratinocytes in vivo. AB - The growth-inhibitory properties of a series of lipophilic diaminopyrimidine antifolates were evaluated in comparison with methotrexate (MTX) against SV-K14 human keratinocytes in vitro under folate-dependent and folate-independent conditions. Under folate-dependent conditions metoprine (DDMP) proved more cytotoxic than MTX, despite the greater inhibitory activity of the latter compound against mammalian dihydrofolate reductase (DHFR), possibly reflecting differences in cellular accumulation. The significantly lower activity of both compounds under folate-independent conditions indicated DHFR as the primary target. Pyrimethamine (PYM), m-azidopyrimethamine (MZP) and m-aminopyrimethamine (MAP), a metabolite of MZP, were approximately equiactive but less cytotoxic than MTX or DDMP. The unexpected activity of MAP, an inferior DHFR inhibitor, suggests differences in the mechanism of action or cellular transport of the drug, although the reduction of cytotoxicity observed under folate-independent conditions indicate folate metabolism as the cytotoxic locus. In contrast, the cytotoxicity of PYM or MZP was not reduced under folate-independent conditions implying an alternative mechanism of action. The uptake of 2-[14C]pyrimethamine by SV-K14 keratinocytes was rapid with steady-state intracellular concentrations being observed after approximately 100 min, partition of drug into the plasma membrane preceding redistribution and extensive accumulation within the particulate cell components. The previously reported NADPH-dependent metabolism of MZP to MAP by murine liver microsome preparations was not observed with SV-K14 keratinocytes nor with murine skin homogenates in the present study. PMID- 1768285 TI - Protection by cysteine esters against chemically induced pulmonary oedema. AB - Perfluoroisobutene (PFIB) is a hydrophobic reactive gas produced by the pyrolysis of polytetrafluoroethane which induces pulmonary oedema similar to that induced by phosgene when inhaled. When a lethal dose is inhaled by Porton strain rats total non-protein thiol (NPSH) and glutathione (GSH) in the lung are reduced by between 30 and 49%, respectively. If the endogenous levels of thiols in the lung are reduced by pretreatment with buthionine sulfoximine (BSO) 16 hr before exposure to PFIB, the rats become more susceptible to the effects of the gas. The effect of BSO pretreatment on toxicity was prevented by pretreatment 30 min before exposure, with 5 mmol/kg N-acetylcysteine (NAc). NAc increased the levels of cysteine (CySH) in the lung by 150% and GSH was unaffected. Similarly pretreatment with 3 mmol/kg CySH also protected against toxicity and raised CySH levels by 100%. A series of cysteine esters and cystine dimethyl ester (CDME) have been synthesised which selectively raise lung levels of CySH in the rat lungs after intraperitoneal (i.p.) injection. The methyl ester and CDME raised lung levels of CySH by 4000 and 2000%, respectively, 10 min after i.p. injection whilst GSH levels remained unchanged. Cysteine isopropyl ester raised lung levels of CySH by 10,600% but liver levels by only 1400%. All esters except the t-butyl ester (CTBE) also raised maximal plasma levels of NPSH by up to 500%; however, when NAc was injected plasma levels increased by over 1500%. Rats treated with these esters at 3 mmol/kg and with NAc at 5 mmol/kg were protected against lethal doses of PFIB in all cases except when CTBE was used. It appears that these cysteine esters may distribute preferentially into the lung, unlike NAc. The selective enhancement of pulmonary CySH levels may provide a method for the protection of lungs against inhaled reactive toxicants by increasing intracellular CySH. Levels of CySH may also be raised in epithelial lining fluid thus reducing access of gaseous toxicants to pulmonary tissue. PMID- 1768286 TI - Influence of morphine concentration on detergent activation of rat liver morphine UDP-glucuronosyltransferase. AB - The effect of two detergents, Triton X-100 and Brij 58, on the production rate of morphine-3-glucuronide by rat hepatic microsomes has been investigated over a range of detergent and substrate concentrations, using a specific HPLC assay. Activation of morphine-UDP-glucuronosyltransferase (morphine-UDPGT) by Triton X 100 was more complex than that shown by Brij 58. At the optimal concentration of Triton X-100 (0.1-0.125 mg Triton X-100/mg microsomal protein), relative metabolic activity (activity of morphine-UDPGT in the activated state/activity of morphine-UDPGT in the native state; RMA) was 0.9, 1.3 and 2.5 at morphine concentrations of 0.05, 0.5 and 2.5 mM, respectively. Analysis of results from six individual rats in the native and maximally activated state (0.125 mg Triton X-100/mg microsomal protein) showed that RMA was highly dependent upon substrate concentration (P less than 0.0001). Activation produced by the optimal concentration of Brij 58 (0.15 mg Brij 58/mg microsomal protein) was also dependent upon substrate concentration with values for RMA of 3.3, 6.4 and 9.3 at morphine concentrations of 0.05, 0.5 and 2.5 mM, respectively. Analysis of kinetic data is complicated by substrate concentration-dependent detergent activation. It is proposed that factors contributing to substrate concentration dependent variable activation may include micellar solubilization of substrate by detergent and/or the presence of at least two enzyme forms capable of glucuronidating morphine with differential effects of detergents on these forms. PMID- 1768287 TI - The ability of cationic amphiphilic compounds to depress the transition temperature of dipalmitoylphosphatidic acid liposomes depends on the spatial arrangement of the lipophilic moiety. AB - The hypothesis was tested with the help of model compounds that the ability of cationic amphiphilic drugs to depress the phase-transition temperature Tt of dipalmitoylphosphatidic acid (DPPA) liposomes depends on the spatial arrangement of the lipophilic moiety. The main structure of the compounds with identical cationic side chain was 1-dimethylamino-3-phenylpropane (compound I). A further phenyl ring was introduced either at C3 of the propane chain (compound II) to broaden the lipophilic moiety, or in para-position of the phenyl ring (compound III) to elongate it. As shown by differential scanning calorimetry, the reduction of Tt (control 64 degrees) amounted for compound I to 29 degrees, for compound II to 28 degrees and for compound III to 53 degrees. In order to assess the binding affinity of the compounds to DPPA, their inhibitory effect on 45Ca(2+)-binding to DPPA films was measured. The IC50 values were 2100 microM for compound I, 40 microM for compound II, and 9 microM for compound III. Thus, binding affinity corresponded with the hydrophobicity of the compounds. In contrast, the depressing effect on the transition temperature was only augmented by the additional phenyl ring when substituted in the elongating position. PMID- 1768288 TI - Effect of ethanol on cadmium-induced lipid peroxidation and antioxidant enzymes in rat liver. AB - We have investigated the effects of the intragastric administration of cadmium (10 mg/kg body weight) and ethanol (5.56 g/kg body weight) alone as well as in combination on hepatic lipid peroxidation, the antioxidant defense system, and the morphology of liver in rats. Cadmium given in combination with ethanol led to a marked increase in cadmium accumulation in liver compared to the level in rats treated only with cadmium. Further, cadmium and ethanol coexposure produced a more pronounced elevation in lipid peroxidation (L-px), which was associated with a significantly greater inhibition of antioxidant enzymes, glutathione peroxidase (GSH-px; EC 1.11.1.9), glutathione reductase (GR; EC 1.6.4.2) and superoxide dismutase (SOD; EC 1.15.1.1), than cadmium treatment alone. The levels of glutathione (GSH) and total thiols (TSH) also decreased significantly after cadmium and ethanol coexposure. On histopathological examination, it was observed that the livers of rats coexposed to cadmium and ethanol showed a marked degeneration of hepatocytes which was not seen in rats treated only with cadmium. PMID- 1768290 TI - [Conformational-functional relationships of tetragastrin analogs]. AB - Sets of low-energy backbone conformations of the active tetragastrin analogue Boc Trp-Leu-Asp-Phe-NH2 and two competitive antagonists Boc-Trp-Leu psi (CH2NH)-Asp Phe-NH2 and Boc-Trp-Leu-Asp-O-CH2-CH2-C6H5 were obtained using theoretical conformational analysis methods. Groups of the conformations were selected for the three analogues, allowing a spatial matching of Trp, Asp and Phe residues responsible for the gastrin receptor binding. Three conformations possessing the lowest energies among the geometrically similar structures of these three peptides are suggested as a model for the "receptor-bound" conformations of these analogues. Backbone spatial folding resembling an alpha-helix turn is characteristic of these conformations. The correspondence of the proposed model to the available data on structure--activity relationships for tetragastrin analogues is discussed. Orientations of the putative receptor-bound conformations in a "water--lypophylic medium" two-phase system were investigated. PMID- 1768289 TI - [Enzymes for studying the carbohydrate structure of glycoproteins]. AB - Major types of oligosaccharides linked to protein and glycosidases used for carbohydrate cleavage and analysis are reviewed. Approaches to partial or complete separation of the protein and carbohydrate moieties of glycoproteins are suggested. Some date on the chemical deglycosylation are also presented. PMID- 1768291 TI - [Chemical-enzymatic synthesis of the amplifier of the T7 phage gene 10 and function of its structural elements]. AB - The translational enhancer (TREN) sequence of the phage T7 gene 10 (in full and also its proximal or distal parts) have been obtained by chemical-enzymatic synthesis and cloned into the plasmids immediately before the human interleukin 3 (hIL3) artificial gene. Expression levels of the hIL3 gene in E. coli in these constructions show that the region controlling the specific activity is placed in distal part of TREN more than 40 nucleotides upstream from the initiation codon. PMID- 1768292 TI - [Molecular forms of alpha-1-acid glycoprotein in human blood serum. Differences in levels of di-, tri-, and tetra-antennary N-linked carbohydrate chains]. AB - alpha 1-Acid glycoprotein isolated from healthy individuals blood was separated on Con A-Sepharose into three fractions: non-bound (AGP-1, 84%, 43.5 kDa), Con A bound (AGP-2, 14%, 41.3 kDa), and Con A-tightly bound (AGP-3, 2%, 39.6 kDa). Amino acid compositions of these fractions were similar but carbohydrate ones differed. HPLC analysis of 7-amino-4-methylcoumarin derivatives of the oligosaccharides in combination with their sequential exoglycosidase digestion showed that AGP-1, AGP-2, and AGP-3 have the same set of oligosaccharides and differ only by their proposition. A minor quantity of agalacto-oligosaccharides (with a terminal GlcNAc residue) was identified. PMID- 1768293 TI - [Preparation of C'-methyl-2'-deoxynucleoside-5'-triphosphates and their substrate properties in DNA synthesis reactions, catalyzed by DNA polymerases]. PMID- 1768294 TI - [Directed introduction of amino groups by internucleotide phosphate group during solid-phase synthesis of oligodeoxyribonucleotides. Preparation of biotinylated oligonucleotide probes]. AB - An efficient procedure for solid-phase synthesis of amino-oligonucleotides has been developed, leading to direct introduction of an aliphatic primary amino group at the internucleotide phosphate. Amino-oligonucleotides were successfully used for preparation of biotinylated oligonucleotides. PMID- 1768296 TI - Autism and peptides. PMID- 1768295 TI - [Interaction of alpha-(125)latrocrustotoxin with nerve cell membranes from the river crab Astacus astacus]. AB - alpha-Latrocrustatoxin, the crustacean-specific neurotoxin from the venom of the black widow spider Latrodectus mactans tredecimguttatus was radioactively labelled with Bolton-Hunter reagent to the specific activity of 160 Ci/mmol with retention of the biological activity. A highly specific binding of radioactive toxin on plasmatic membranes from the crayfish Astacus astacus nerve cells with Bmax = 0.04 pmol binding toxin/mg membrane protein and Kd = 0.7 x 10(-10) M was demonstrated. PMID- 1768297 TI - Professional practices perspective on ... consumerism. PMID- 1768298 TI - Contracting speech-language pathology services to Medicare providers--Part II. PMID- 1768299 TI - Focus. Victor Garwood. PMID- 1768300 TI - The role of age and ageism in the "80% barrier". PMID- 1768301 TI - Hearing aids at my age: why bother? PMID- 1768302 TI - Autonomy: the road directly to the public. PMID- 1768303 TI - What this industry needs is a Marlboro man. PMID- 1768304 TI - Computers and professional uses. PMID- 1768305 TI - Early identification of speech-language delays and disorders. PMID- 1768306 TI - ASHA: diversity is our strength. PMID- 1768307 TI - Digestion and absorption of polyunsaturated fatty acids. AB - Polyunsaturated fatty acids play an important part in the structure and function of cellular membranes and are precursors of lipid mediators which play a key role in cardiovascular and inflammatory diseases. Dietary sources of essential fatty acids are vegetable oils for either linoleic or alpha-linolenic acids, and sea fish oils for eicosapentaenoic and docosahexaenoic acids. Because of the specificity of the pancreatic lipid hydrolases, triglyceride fatty acid distribution is an essential parameter in the digestibility of fats. The efficiency of the intestinal uptake depends on the hydrolysis and especially on their micellarization. n-3 polyunsaturated fatty acid ethyl ester digestion is recognized to be impaired, but n-3 polyunsaturated fatty acid triglyceride hydrolysis remains a controversial point, and to some authors explains differences observed between vegetable and fish oil absorption. So additional studies are required to investigate this intestinal step. In enterocytes, morphological and biochemical absorption processes involve reesterification of long-chain fatty acids and lipoprotein formation. At this level, specific affinity of I- and L-FABPc (cytosolic fatty acid binding proteins) to polyunsaturated fatty acids requires further investigation. A better understanding of the role of these FABPc might bring to light the esterification step, particularly the integration of polyunsaturated fatty acids into phospholipids. With reference to differences published between fish and vegetable oil absorption, longer-term absorption studies appear essential to some authors. Polyunsaturated fatty acid absorption is thought to be not very dissimilar to that of long-chain mono-unsaturated fatty acid absorption. However, several digestion and absorption specific steps are worth studying with reference to the crucial role of polyunsaturated fatty acids in the organism, and for example adaptation of possible dietary supplements. PMID- 1768308 TI - [The effect of glucocorticoids on the diluting capacity of the kidney of a desert rodent: Gerbillus campestris]. AB - The ability to excrete a water load was studied in Wistar rats and in gerbils (Gerbillus campestris). The rat excreted the entire water load in less than 2 h whereas Gerbillus campestris excreted less than 60% of the water load in 4 h. The gerbils which had received a dose of 15 micrograms/100 g body weight dexamethasone improved their rate of excretion which attained 92 +/- 6% in 2 h 30 min. The antidiuretic hormone (ADH) measured by radioimmunoassay at the time of maximum diuresis was undetectable in rats; in contrast, in gerbils the level of ADH remained relatively high (55.4 +/- 6.7 pg/ml). We conclude that the partial inability of the gerbil's kidney to excrete a water load is due to a high ADH level and probably to a low concentration of glucocorticoids. PMID- 1768309 TI - [Homeorrhetic modifications produced by a beta-agonist in the muscle and adipose tissues of the rat]. AB - A repartitioning effect was observed in young rats after a chronic treatment with a nonselective beta-agonist administered subcutaneously. An increase in carcass protein (P less than 0.05) accompanied by a reduction in fat stores (P less than 0.01) and an increase in back fat oxygen consumption (P less than 0.05) were found in treated animals. The muscle mass accretion should be attributed to a reduction in muscle protein degradation, based on lower activity of the proteolytic enzyme cathepsin A in treated rats, rather than to changes in protein synthesis, assessed by an amino-acid incorporation technique. The anabolic actions of this compound apparently involve changes in muscle prostaglandin E2 and reduction-oxidation state. PMID- 1768310 TI - Development of the rumen digestive functions in lambs placed in a sterile isolator a few days after birth. AB - The development of the rumen digestive functions was studied in lambs placed in sterile isolators at 1, 4, 8 or 9 days of age to define the role of the bacterial species that colonize the rumen just after birth. The values of the main rumen digestive parameters (pH, concentrations of volatile fatty acid, ammonia, lactic acid) in these lambs were close to those observed in conventional controls. Likewise, the digestive utilisation of the dry matter and starch was comparable in isolated and control animals but the digestibility of crude cellulose was higher in isolated lambs, which harboured only Fibrobacter succinogenes as the sole cellulolytic bacterial species. These results suggest that the rumen flora of the very young lamb play an essential role in the establishment of the rumen ecosystem and in the setting up of the digestive functions. PMID- 1768311 TI - [The effect of the nutritional energy concentration on embryonic and fetal losses in the female rabbit]. AB - The laparoscopy technique was used to examine the effects of feeding 2 concentrations of energy and protein on the reproductive parameters in the doe rabbit. Forty-one does were laparoscopized on day 12 of gestation in order to estimate the ovulation rate and embryo number. Diets 1 and 2 contained 13.0 and 9.7 MJ digestible energy per kg DM and 159 and 135 g crude protein per kg DM respectively. The ovulation rate, number of implanted embryos at 12 d and total litter size at birth were similar for diets 1 and 2 (13.4 vs 14.2, 12.6 vs 12.8 and 9.1 vs 10.8), but the live litter size at birth was higher for diet 2 (7.1 vs 9.8). Laparoscopy is invaluable in determining the effects of diets on oestrus and birth rates in living and sexually active does. PMID- 1768312 TI - [Osmolality and secretion of vasopressins during pregnancy in Meriones crassus]. AB - Endocrine and renal parameters were measured in a desert rodent, Meriones crassus. In virgin females, the urine and plasma osmolality was 2018 +/- 136 and 325 +/- 3 mosm/kg (m +/- SEM), the level of circulating vasopressin, 162 +/- 22 pg/ml and the plasma renin activity 14.3 +/- 0.9 ng/ml per h. During pregnancy, the renin-angiotensin system was activated, and the plasma vasopressin values remained similar to those of virgin animals in spite of a lower blood plasma osmotic pressure. During this period, the regulation of the hydromineral balance was modified. These data suggest a lowering of the osmotic thresholds for vasopressin and possibly also for thirst during pregnancy in this desert rodent. PMID- 1768313 TI - Effect of the increase of steroid binding plasma levels after passive immunization against testosterone on the control of luteinizing hormone (LH) secretion in ovariectomized underfed dairy heifers. AB - The ability of passive immunization against testosterone to increase sex steroid binding levels in plasma and thus to overcome the negative feedback of oestradiol 17 beta (E2) on LH secretion in underfed heifers was investigated. Dairy heifers were ovariectomized and divided in 3 groups: high energy diet (H group, n = 4), low energy diet (L group, n = 3) and low energy diet + E2 implants (LE2 group, n = 4). Twenty-four h before injection of bovine immunoglobulins, the mean concentrations of LH were not different between H and L groups. LH baseline was lower (0.8 vs 1.1 ng/ml, P less than 0.03) and the median number of LH pulses was higher (10 vs 5, P less than 0.03) in H than in L group. E2 markedly decreased (P less than 0.01) the mean and basal concentrations of LH (0.27 ng/ml), and number of LH pulses (0) in the LE2 group (P less than 0.05). After injection of anti testosterone immunoglobulins in the L group, mean and basal LH concentrations tended to decrease. The median number of LH pulses in the L group rose 8 days after immunization (5 vs 7 on day -1 and day +8, P less than or equal to 0.05). Amplitude of pulses tended to decrease after injection (P = 0.08). In the LE2 group, the mean concentration and baseline of LH were not affected by passive immunization against testosterone, while pulses of LH appeared at day +1 and rose (P = 0.07) at day +8 after immunization with 3.5 pulses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768314 TI - [Variability of reproduction examined in the laboratory between natural populations of Helix aspersa Muller from the Brittany region]. AB - Laboratory experiments were conducted to investigate the effects of geographical localization of natural populations and sampling dates on the reproduction of the garden snail Helix aspersa Muller. In Brittany, reproductive variability between populations shows the adaptive flexibility of characters describing reproductive activity and the relative stability of reproductive ability. PMID- 1768315 TI - Exogenous and endogenous contributions to nitrogen fluxes in the digestive tract of pigs fed a casein diet. II. Ileal and faecal digestibilities and absorption of amino acids. AB - The present work aimed at quantifying nitrogen (N) and amino acid (AA) fluxes in the digestive tract of growing pigs fed a casein diet. In this paper we report on digesta passage at the terminal ileum, on apparent balances at the ileal and faecal levels, and on nutrients appearance in the portal vein. Digesta flow-rate at the terminal ileum was maximum between 6 and 12 h after the meal. About 10% of N and 5% of total AA ingested were recovered within 24 h. AA absorption started 30 min after the meal, and was measurable until 13 to 14 h. The total AA absorbed in 24 h accounted for 128% of the AA ingested. The AA composition of ileal digesta was very different from that of casein, closely resembling that of endogenous proteins. The AA composition of faeces was very close to that of bacterial proteins. The ileal digestibilities of AA, though lower than their faecal values, were very high. This was confirmed by AA absorption balances greater than 100%. These data suggest that casein was almost totally digested by the terminal ileum, and that endogenous AA were substantially reabsorbed. These findings are supported by data on endogenous N recycling (15N), reported in a following paper. PMID- 1768316 TI - In situ evaluation of the ruminal and intestinal degradability of extruded whole lupin seed nitrogen. AB - The effect of whole lupin seeds (Lupinus albus cv Lublanc) at 120, 150 and 195 degrees C on in situ nitrogen degradability (Dg.N) was measured by the nylon bag technique using fistulated non-lactating Holstein cows. The N degradation was evaluated in nylon bags suspended in the rumen; heating the seeds at 120, 150 and 195 degrees C decreased the Dg.N value: 83.9, 72.9 and 53.0 respectively vs 95.3% (rumen outflow rate of 0.06/h). To estimate the total N disappearing in the digestive tract, bags were incubated in the rumen for 16 h, then in a pepsin bath for 2 h and then introduced into the duodenum for subsequently recovery in feces. The whole tract degradability of N was always high, approximately 98.3%. The amounts of N which disappeared in the intestine increased from 3.1 (untreated seeds) to 15.1, 26.3 and 44.7% as the temperature rose to 120, 150 and 195 degrees C respectively. The PDIN and PDIE contents (g/kg of DM) of the raw whole lupin seeds were 224 and 84 respectively; extrusion elevated these values by 10 32% for PDIN and 57-194% for PDIE. The augmentation in the supply of dietary proteins to the postruminal parts as a result of extrusion could rapidly benefit high yielding cows. PMID- 1768317 TI - A functionally active complement system is present in uterine secretion of the mouse prior to implantation. AB - Sephadex beads were placed carefully in the uterus on days 2 and 3 and left for 6 to 8 h to absorb uterine secretion. The beads were then removed with volatile silicon oil and mounted on small pieces of nitrocellulose paper. Immuno-staining of these bead blots showed they contained the complement components C1q, C3, C4, and C5. We demonstrated that complement component C3 in the uterine secretion could be activated and deposited on model immune complexes, and also that antibody-coated erythrocytes were lysed in utero, that is, a membrane attack complex was produced. Thus, the mouse uterine secretion at the preimplantation stage contains a functionally active complement system. PMID- 1768318 TI - Positive immunoselection--a method of isolating leukocytes from leukocytic reacted human cervical mucus samples. AB - In this brief communication we report a simple and accurate method of isolating and quantifying specific leukocytes from midcycle human cervical mucus, using monoclonal antibody-coated magnetic beads. Cervical mucus samples (pre- and postinsemination) were broken down enzymatically and incubated with a series of these beads. This method of positive immunoselection consistently retrieved representative levels of leukocytes (means = 73.8% +/- 1.59%; mean leukocyte retrieval rate +/- S.E.) from the cervical mucus samples. Significantly more leukocytes (P less than 0.0001) were isolated from the postinsemination samples, the predominant leukocyte of which was the neutrophil, which comprised 83% of the leukocyte population. These results reaffirm that a leukocytic influx is initiated across the human uterine cervix following the introduction of semen samples, the function of which is possibly phagocytic clearance of the nonfertilizing population of sperm. PMID- 1768319 TI - Peritoneal fluid interleukin-1 beta and tumor necrosis factor in patients with benign gynecologic disease. AB - The levels of interleukin 1 beta (IL-1 beta) and tumor necrosis factor (TNF) in peritoneal fluid (PF-IL-1 beta and PF-TNF) and production of IL-1 beta and TNF by peritoneal macrophages were determined in patients with benign gynecologic disease. The level of PF-IL-1 beta was elevated in the acute pelvic inflammatory disease (PID) and stages I and II endometriosis (E I/II) groups compared with the normal pelvis group, but not in the myoma of the uterus, ovarian cyst, and postinflammatory pelvic adhesion groups. The level of PF-TNF was elevated in the PID, EI/II and stages III and IV endometriosis (EIII/IV) groups. There was no correlation between the levels of PF-IL-1 beta and PF-TNF. Neither the level of PF-IL-1 beta nor that of PF-TNF was correlated with the concentration of peritoneal macrophages. Peritoneal macrophages produced IL-1 beta and TNF in vitro in the absence of stimulants. The levels of PF-IL-1 beta and PF-TNF are presumably linked to the activation of peritoneal macrophages. PMID- 1768320 TI - Monitoring of smooth muscle antibodies in hypertensive complications during pregnancy. AB - Smooth muscle antibodies (SMA) were monitored in terms of titer, immunoglobulin class and staining pattern by indirect immunofluorescence assay during the pregnancies of 32 women with pregnancy induced hypertension (PIH), 21 with essential hypertension (EH), and 43 with a normal pregnancy. The mean SMA titer was higher both in PIH and EH than in normal pregnancy. SMA were mainly of the IgG class and gave a "vessel wall" staining pattern in immunofluorescence. The tendency for the mean SMA titer to increase was observed in PIH, whereas a falling tendency was found in EH and normal pregnancy. These tendencies suggest that hypertension, the duration of which has been shorter in PIH, induces SMA production. The observed staining pattern suggests the same kind of non-actin specificity for SMA as in our previous study of complications in early pregnancy. PMID- 1768321 TI - Predictors of pregnancy success in repeated miscarriage. AB - Factors that may have a bearing on subsequent pregnancy success or failure in patients with recurrent abortion were examined in 165 women with a history of three or more consecutive miscarriages in the first trimester. The overall success rate was 67.9%. Factors that were found to correlate significantly with success rate were length of abortion history, total number of abortions, interval from last miscarriage to present pregnancy, and whether there was any degree of subfertility. Logistic regression analysis showed that the abortion x years index and maternal age accounted for all the variation observed in our data. Where all other known causes of abortions are excluded, recurrent aborters can be subdivided into two populations--namely, those with a relatively good prognosis characterized by a short abortion history and absence of subfertility problems, compared to those with a poor prognosis namely those with a long abortion history or presence of subfertility problems. These data clearly demonstrate major differences in success rates in women depending on the number of abortions and the length of abortion history (abortion x year index), particularly in women over the age of 30 years. PMID- 1768322 TI - Complete Freund adjuvant treatment of pregnant females influences resorption rates in CBA/J x DBA/2 matings via progesterone-mediated immunomodulation. AB - Treatment of pregnant CBA/J females with CFA at day 0.5 and 7.5 of pregnancy significantly reduced the fetal resorption rates from 45% to 29% (P less than 0.05). Supernatants of progesterone-treated spleen cells from CFA treated CBA/J females pregnant of DBA/2 males significantly reduced natural cytotoxicity, while those of untreated identically pregnant mice had no effect. Supernatants of CFA treated virgin mice blocked natural cytotoxicity to the same extent as those of CFA-treated pregnant mice. These data suggest that nonspecific immunostimulation induces progesterone receptors in spleen cells of CBA mice and that these receptors allow a progesterone dependent suppressive pathway to exert an antiresorptive effect. PMID- 1768323 TI - The lack of direct effects of a monoclonal antibody against murine T-cell suppressor factor on murine embryo development in vitro. AB - In previous studies, we reported that the injection of monoclonal antibody 14-30, specific for a T-cell suppressor factor (TSF), into mice during early stages of pregnancy could decrease the percentage of females that maintained pregnancy. In addition, further work has demonstrated the presence of an immunoreactive protein in fetal and maternal tissues with physiochemical properties similar to TSF. However, one alternate explanation for the antipregnancy effects of the injections of monoclonal antibody, not related to a specific role for TSF in early pregnancy, is the possibility of direct effects upon the embryo or embryonic antigens that prevent continued embryonic development. In the present studies, early preimplantation embryos were incubated with the monoclonal antibody 14-30 specific for TSF and the subsequent development of the embryos examined. The results of these studies demonstrate that monoclonal antibody, which has been shown to bind T-cell suppressor factor and has antipregnancy effects when injected in vivo, does not interfere with development of preimplantation or implantation stage mouse embryos in vitro. PMID- 1768324 TI - Report from the Ethics Committee for Immunotherapy, American Society for the Immunology of Reproduction. PMID- 1768325 TI - Non-attendance for appointments in an out-patients' x-ray department. AB - A total of 5,323 appointments from July 1987 to June 1988 was entered into the study. They showed that for the 12 month period the rate of non-attendance was 5%. The non-attender was most likely to have been referred from a GP for a barium meal and be from the age group 16-25. The district the patient came from had little influence. Non-attendance is not affected by the number of appointments given and if compared to the previous year shows a similar monthly pattern. This pattern does not appear to be influenced by the weather but would seem affected to some extent by holiday periods. Reasons for non-attendance were collected on 51 patients. The main reason given was illness. A large group had had no further contact with the referral source. The cost of staffing for non-attendance was considered to be low when compared to the whole budget. The effect of non attendance on the waiting list is now minimal. Taking this into account the main recommendations are that: a specified senior member of staff should be responsible for the appointment system and inter-departmental liaison; instruction/appointment confirmation sheets should be reviewed; and the counselling service should be improved. Now the population served has been demographically recorded we can look towards providing for its needs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768326 TI - A comparison of imaging techniques for leg lengthening osteotomies. PMID- 1768327 TI - By-pass graft of tibial pseudarthrosis in a case of neurofibromatosis. PMID- 1768328 TI - Silver recovery--an evaluation of existing disposal methods in a district general hospital. PMID- 1768329 TI - The development of the radiography degree course at the University of Ulster. PMID- 1768330 TI - Adolescent idiopathic scoliosis. PMID- 1768331 TI - Scattered radiation and the lumbar spine. PMID- 1768332 TI - Developing study skills in undergraduate, student radiographers. PMID- 1768333 TI - Use of three-dimensional CT scanning in the lumbar spine. PMID- 1768334 TI - Pre-natal diagnosis of lethal dwarfism using ultrasound. PMID- 1768335 TI - Customer care in the imaging department of a district general hospital. PMID- 1768336 TI - Modern imaging for complex scoliosis. PMID- 1768337 TI - Poison in the air: next steps. PMID- 1768338 TI - The educational needs of radiotherapy patients. PMID- 1768339 TI - Clinical tuition--a new perspective. PMID- 1768340 TI - The development of protocols for trans-vaginal sonography. PMID- 1768341 TI - Experiences with contracting. PMID- 1768342 TI - A comparison of acute effects and patient acceptability of high dose rate with low dose rate after-loading in intra-vaginal radiotherapy. PMID- 1768343 TI - Intrauterine treatment of thyroid goiters. AB - A fetal thyroid goiter detected by ultrasonography at 20 weeks of amenorrhea (WA) was diagnosed at 23 WA by a second ultrasound examination and a TSH assay in amniotic fluid. Since a sample of fetal blood at 27 WA showed that hypothyroidism was compensated and that goiter size and amniotic fluid volume were stable, intra amniotic injection of 300 micrograms of L-thyroxine was delayed until 36 WA. This injection was performed before delivery to avoid potential perinatal complications (dystocia and neonatal respiratory distress) caused by large goiters. PMID- 1768344 TI - Twin-twin transfusion syndrome during the 2nd trimester is associated with small intertwin hemoglobin differences. AB - In four twin pregnancies presenting with acute 2nd-trimester polyhydramnios due to presumed twin-twin transfusion syndrome, the fetal hemoglobin concentration was measured in samples obtained by cordocentesis. In no instance did the twin pair difference in the hemoglobin concentration exceed 2.7 g/dl. PMID- 1768345 TI - Routine examination by ultrasound for the detection of fetal malformations in a low risk population. AB - A low risk population was offered screening for malformations in the second and third trimesters of pregnancy. Of 16,763 scans of pregnancies in the second trimester, 61 malformations were identified (0.36%). In the third trimester, scanning of 10,752 pregnancies revealed 24 malformations (0.22%): in all, in a low risk population 0.58% major malformations were found. The sensitivity for noncardiac malformations of the second trimester scanning was 54.3 with a specificity of 99.9%. The malformations overlooked was a more benign spectrum than the cases diagnosed. The sensitivity for cardiac malformations was less than 20%. PMID- 1768346 TI - Fetal nuchal cystic hygromata: associated malformations and chromosomal defects. AB - During a 6-year period (1985-1990), blood karyotyping was performed in 44 fetuses with septated, bilateral, dorsal, cervical cystic hygromata. This condition constitutes a different entity from nuchal oedema. There were 33 (75%) chromosomal abnormalities, including Turner's syndrome (n = 31), trisomy 18 (n = 1) and trisomy 21 (n = 1). Congenital heart defects (CHD), mainly coarctation of the aorta, were present in 15 of the fetuses with Turner's and in 1 of the chromosomally normal fetuses. The incidence of CHD was higher in the fetuses with ultrasonographic evidence of moderate/severe hydrops (41%; 13 of 32 cases) than in those with mild or no hydrops (25%; 3 of 12 cases). Although both the biparietal diameter (BPD) and femur length (FL) were reduced in all fetuses, the FL to BPD ratio was below the 5th percentile in 29 of the 33 (88%) chromosomally abnormal fetuses, but in only 4 of the 11 (36%) chromosomally normal ones. In the chromosomally normal group, 3 of the fetuses had multiple pterygium syndromes, and in such cases the risk of recurrence may be high. In contrast, in the group of mutant chromosomal disorders with monosomy or trisomy, the risk of recurrence is in the order of 1%. PMID- 1768347 TI - Doppler study of uterine artery blood flow: comparison of findings in the first and second trimesters of pregnancy. AB - In 55 women with singleton pregnancies, colour flow mapping and pulsed wave velocimetry were used to measure impedance to flow in the uterine arteries at 10 13 weeks gestation and again at 19-22 weeks. In the first trimester, examinations were performed both transabdominally and transvaginally and in the second trimester transabdominally only. There were significant associations between the first- and second-trimester measurements obtained with both Doppler techniques. These associations were higher when transvaginal than transabdominal Doppler was used and when the measurement of impedance was the pulsatility index (PI) rather than the resistance index. These data suggest that impedance to flow in the uteroplacental circulation in the second trimester is dependent on impedance in the first trimester. In any prospective, first-trimester, uterine artery Doppler screening study for pregnancy complications, it may be preferable to use transvaginal Doppler and measure PI. PMID- 1768348 TI - Using ultrasonic measurement of cardiac size in predicting congenital heart defect. AB - A Duplex Color apparatus equipped with real-time imaging and Doppler sector scanner was used to scan fetal hearts, ranging from 17 to 41 weeks gestational age. A total of 323 normal fetuses were studied. The four-chamber view was obtained in a horizontal section just above the level of the fetal diaphragm. Five variables of the Chinese fetal heart in relation to the width of the right ventricle, width of the left ventricle, ratio of right ventricle/left ventricle (RV/LV), length of the fetal heart and the cardiac volume of a four-chamber view were set against gestational age in weeks and expressed in regression equations. The ratio of RV/LV is quite constant in relation to the gestational age. The mean ranges between 0.9916 for 17 weeks gestation and 1.0045 for a term fetus. In 10 abnormal cases with congenital cardiac defects, using the 5th and the 95th percentiles of this normal data as cutoff points, the RV/LV ratio had the highest sensitivity rate of 70% (7/10) in predicting fetal cardiac anomaly. The width of the left ventricle was the second most sensitive parameter with a sensitivity of 4/10 (40%). The RV/LV ratio of a four-chamber view is a simple, time-saving screening parameter for predicting congenital cardiac defects antenatally. PMID- 1768349 TI - Study on Doppler waveforms from the fetal cardiovascular system. AB - In order to see whether Doppler parameters from the fetal cardiovascular system change with fetal growth and to compare Doppler values from the various sites, a total of 274 Doppler studies on 73 human fetuses were analyzed. With advancing gestation, the heart rate decreased, the diastolic filling period of both atrioventricular valves increased, and the systolic ejection time of both semilunar valves remained unchanged. Most of the Doppler parameters from the 4 cardiac valves, the aortic arch, the branch pulmonary artery, and the ductus arteriosus increased with increasing gestation. Doppler waveforms from the branch pulmonary artery, the ductus arteriosus, and the aortic arch each had a distinct shape. More study is needed to define the exact relationship between the gestation period and the Doppler parameters and to determine whether Doppler parameters will be useful in assessing fetal heart function. PMID- 1768350 TI - Why cell culture is successful after early amniocentesis. AB - The current interest in early amniocentesis as a possible alternative to chorion villus sampling has driven many centres to attempt cell culture from first trimester amniotic fluid. This study examines the cellular content of 125 amniotic fluid specimens collected between 8 and 18 weeks of gestation and shows that there is a higher proportion of viable cells at the time of early amniocentesis than at traditional amniocentesis. Although there is a small increase in viable cell number from 8 to 18 weeks of gestation, this is not as dramatic as the exponential rise in total cell number seen over the same period. The similar concentration of viable cells in early pregnancy to that in the second trimester is sufficient to explain the unexpected culture success after early amniocentesis. PMID- 1768351 TI - Cordocentesis (funipuncture) by maternal-fetal fellows: the learning curve. AB - One hundred cordocenteses were attempted at the University of Mississippi Medical Center between July 1, 1989, and June 1, 1991. There were 1.3 attempts for each successful umbilical blood sampling. The overall success rate was 94%. The first year fellows-in-training attempted 61 procedures with a 90.2% success rate within two attempts and an overall success rate of 95.1%. Second-year fellows attempted 32 procedures with a 93.8% success rate within two attempts and an overall success rate of 93.8%. Procedure-related complications included five episodes of fetal bradycardia (one resulting in a stillbirth at 20 weeks) and a single case of chorioamnionitis. Of the three perinatal deaths, two were associated with severe congenital anomalies resulting in a corrected procedure-related mortality rate of 1%. The morbidity and mortality associated with cordocentesis appears to be relatively low and fellows-in-training can perform such procedures with no apparent increase in complications if appropriately supervised. PMID- 1768352 TI - The fetus as patient: implications for directive versus nondirective counseling for fetal benefit. AB - The authors provide an ethical account of the fetus as patient and identify the implications of that account for directive versus nondirective counseling for fetal benefit. They argue that such an account cannot be grounded in the independent moral status of the fetus. Instead, the concept of the fetus as patient is best understood in terms of the principle of beneficence. On the basis of this principle, the fetus is a patient depending on whether links can be established between the fetus and the child it can become. The viable fetus is a patient. Directive counseling for fetal benefit of the viable fetus is appropriate, provided that it takes account of the presence and severity of fetal anomalies, extreme prematurity, and obligations to the pregnant woman. The previable fetus, including the in vitro embryo and the near-viable fetus, is a patient solely as a function of the pregnant woman's autonomous decision to confer such status. If she confers such status, the fetus is a patient and directive counseling is appropriate, provided that it takes account of the factors noted above. If she denies such status, the fetus is not a patient and nondirective counseling is appropriate. PMID- 1768353 TI - [The treatment of hyperkalemia with salbutamol]. AB - For several years now, it has been known that the administering of adrenergic beta antagonists, especially of the beta-2 type, induce hypokalemia as a result of the entering of potassium into the skeletal muscle cells. This fall in kalemia occurs independently from the effect of insulin, aldosterone or kidney excretion, is mediated by the beta-2 receptors and require the intervention of cAMP joined at the cell membrane and the subsequent stimulation of the Na-K-ATPase which bring the potassium into the striated muscle cell. Among the most outstanding drugs with beta-2 effect is salbutamol, which maintains the hypokalemic effect whether administered intravenously or inhaled. It has been used in cases of hyperkalemia, in both children and adults. The initially used intravenous dosage (0.5 mg) caused several side-effects, especially rapid heart beat, seen more in children. It has been recently found that the use of doses as low as 4 micrograms/kg lower the kalemia to values averaging 1.4 to 1.6 mEq/L (mmol/L); in addition, using these dosages intravenously in an average of 20 minutes, no side effects were seen, even when administered to newborns. For the above, we considered that salbutamol, in the suggested dosages, constitutes an efficient and secure therapeutic method for the initial treatment of severe hyperkalemic patients. PMID- 1768354 TI - [The incidence of dengue virus infection in children 8 to 14 years old residing in the urban and rural areas of the city of Merida, Yucatan]. AB - A prospective type study was conducted with two school cohorts from the urban and rural municipal area of Merida, with the purpose of finding the incidence of infection due to the dengue virus, in a 4 month period when transmission was expected to be the highest. The serologic tests of the paired samples were done using the inhibition hemagglutination technique (IHA). We found the incidence of dengue virus infections in the city of Merida was 4.56%, while that for the rural area was 5.67%. The prevalence of serological reactive against the same virus during the second sampling was 56.84% for the urban area and 63.70% for the rural area. No significant statistical different were found among the urban and rural incidences nor among the prevalences. The average hematocrit value found in school children from the urban area was 41.7 mL/dL and 40.4 mL/dL in the rural area. When comparing the median results of the hematocrit values, were found that there was significant statistical differences. PMID- 1768355 TI - [The causes of perinatal death in the health institutions of Mexico City]. AB - We determined the main causes of death in 798 perinatal deaths which took place among 32,701 births at several health institutions in Mexico City during the summer of 1984, in accordance with the Wigglesworth Classification. We evaluated the concordance among the codifiers of the causes, with a 92% result (P less than 0.0001). The main causes of death were: conditions associated to asphyxia and prematurity in all health institutions (public assistance, social security and private hospitals). The distribution according to birth weight showed that, in almost 50% of the deaths due to asphyxiation, the child's birth weight was greater than 2,500 g, which suggests that their were deficiencies in the medical attention given to those children. PMID- 1768356 TI - [Prognostic factors in a pediatric intensive care unit]. AB - OBJECTIVES: To identify the mortality prognostic factors from a pediatric intensive care unit. STUDY DESIGN: Retrolective cohort study with an analysis of cases and controls (ambidirectional design). PLACE OF STUDY: The intensive care unit at a Pediatric Third Level Hospital. STUDY UNITS: All of the patients admitted into the I.C.U. for a year (August 1989 to August 1990). MAIN MEASUREMENTS: The patients were identified when admitted into I.C.U., while evaluating their clinical course through their charts. Afterwards, they were placed into two groups, those who died while in I.C.U. (n = 49) and those in the control group which constituted the initial cohort survivors (n = 115). The prognostic factors evaluated were age, sex, diagnosis when admitted, organic failure, changes in diagnosis and treatment. MAIN RESULTS: 164 patients were studied, with a slight predominance of the male sex (53%). The patient's age fluctuated between 1 day and 17 years of age, with a mean age of 10 months. The diagnosis established when admitted were predominantly dealing with infectious problems (n = 54, 32%). The most important prognostic factors seen during the bivaried analysis were the peritoneal dialysis (RM = 12.71, IC 95% = 2.41-98.29, P less than 0.01); a Glasgow index less than or equal to 10 points (RM = 7.33, IC 95% = 1.25-47.26, P less than 0.01), respiratory organic failure (RM = 6.32, IC 95% = 2.46-16.8, P less than 0.01) and assisted mechanical ventilation (RM = 5.61, IC 95% = 2.52-12.68, P less than 0.01). CONCLUSIONS: The mortality rate in I.C.U. was 30%. The most important prognostic factors associated to mortality after adjusting for severity were having a cardiovascular ailment, the need to administer blood products, a Glasgow index less than or equal to 10 points, heart and hematologic organic failure and when respiratory mechanical assistance was provided. PMID- 1768357 TI - [Brain tumors in nursing infants]. AB - The purpose of this study was to determine the anatomical-pathological distribution of brain tumors in children under two years of age and their clinical characteristics (age, sex, time span from the start of symptoms or signs to the time the tumor was diagnosed, main clinical manifestations, evolution and prognosis). From 1981 to 1989, 16 children with brain tumors, under two years of age, were studied. The tumors arose in 13 patients during first year of life and during the second, in the remaining three. In 50% of the patients, the tumors were supratentorial. The histological diagnosis was made in all cases, finding the ependymoma the most frequent tumor, followed by the astrocytoma and other tumors: teratoma, choroid plexi papilloma. The increase in size was within the cephalic perimeter, with a risen fontanelle, irritability, vomiting and convulsive episodes, as main clinical manifestations. In 15 of the patients a partial or total resection of the tumor was performed, 6 were given radiotherapy and 2 chemotherapy. The prognosis correlated with the greatest surgical risk, the anatomical-pathological characteristics and the lateness in its diagnosis. We emphasize the greater morbi-mortality rate with respect to other pediatric ages. PMID- 1768358 TI - [Irregular antierythocytic antibodies outside of the ABO system in the perinatal period]. AB - Included in this study are the results of the tests done with irregular anti erythrocytic antibodies outside of the ABO system of women in reproductive stage. In 2,623 cases considered, 279 samples positive for the antibodies were found (10.6%). In 184 cases (65.9%), the antibodies were classified as "immune irregular". The most frequently found antibodies from this group were the anti-D (63.08%), followed by the anti-c (1.07%), the anti-Kell (0.72%), anti-C, anti-E and an anti-Rh system (0.36% for each one). In 52 cases (18.6%) there were irregular "natural" antibodies, predominantly the anti-Lewis (9.68%), followed by anti-P (5.02%), the anti-I (3.2%), an anti-M and an anti-N (0.36% each one). In 43 (15.4%) cases, we were not able to identify the specificity of the antibody found. We include a discussion and a comparison of the frequency of these antibodies in our population. Based on these data, we recommend the clinician to consider the existence and specificity of the irregular anti-erythrocytic antibodies in their obstetric patients, candidates to transfusional therapy, as well as those newborn with hemolytic diseases. PMID- 1768359 TI - [Hospital infections in children in a general hospital]. AB - INTRODUCTION: The following is a summary of what was found after setting into motion an epidemiological surveillance system of nosocomial infections occurring in the Pediatrics Ward of a 2nd level general hospital. MATERIAL AND METHODS: The rate of interhospital infections was 7.6 episodes per 100 patients discharged; the most frequent infections were diarrheas (40.6%), urosepsis (14.3%) and pneumoniae (12.1%). The mortality rate was 0.33 deaths per 100 episodes. The average number of days spent in the hospital by the general population is 7.3 days and for infected patients, 24. The germs most frequently found were Klebsiella and E. coli. CONCLUSIONS: The control of nosocomial infections requires more efficient surveillance systems for all hospitals. PMID- 1768360 TI - [The intelligence quotient and malnutrition. Iron deficiency and the lead concentration as confusing variables]. AB - This study gave us the opportunity to know the roles iron deficiency and the presence of lead in blood play, as confounding variables, in relation to the state of malnutrition and the intellect of those children. A sample of 169 school children were classified according to their state of nutrition, their condition in reference to serum iron and lead concentrations. In addition, their intelligence was evaluated. The results confirmed that those children with lower weights and heights registered lesser points of intelligence; in fact, iron deficiency cancels out the difference in favor of those taller and weighing more. Lead did not contribute as a confounding variable, but more than half of the children showed possible toxic levels of this metal. PMID- 1768361 TI - [Anomalies of the oral cavity in Mexican neonates]. AB - The results of 1,200 physical oral cavity examinations in neonates born at the National Institute of Perinatology (INPer) are reported here, finding the frequency of occurrence of inclusion cysts, natal and neonatal teeth. We found that 46% (551 neonates) of those examined had inclusion cysts, among which the Bohn nodules were the most frequent (36 cases); a case of natal teeth was found as well as 30 cases of neonatal teeth. We emphasize the importance of these findings to both the pediatrician and the dentist since they constitute a frequent motive for visits during the perinatal period. PMID- 1768362 TI - [The transfusion of blood and its derivatives in the neonate]. AB - Blood and its products are valuable therapeutic resources for the pediatrician who care for newborns with severe illnesses. The use of blood and its products requires for the hospital personnel working at neonatal care units to be precise and up to date on the indications and complications of total blood, the globular package, albumin, plasma, the concentration of granulocytes, platelets and immunoglobulins for intravenous use. This review gathers, on the one hand, accumulated experiences by the members of the Commission of Blood and its Products from the Pediatric Hospital of the National Medical Center and on the other hand, a selection of the more important concepts which have been judged so by the authors and expressed in the current medical literature. PMID- 1768363 TI - Cancer research: a public trust. PMID- 1768364 TI - Interferon (IFN) alpha inhibits cell proliferation of UWOV2 cells without down regulation of transferrin receptors. AB - It has been suggested that growth inhibition of cells by interferons may be mediated through interferon induced down-regulation of transferrin receptor expression. We describe a continuously growing cell line UWOV2 (pf) which expresses cell surface transferrin receptor but is able to grow in the absence of transferrin. This cell line is sensitive to the growth inhibitory effects of interferon alpha. Interferon alpha induced growth inhibition is not, however, accompanied by modulation of transferrin receptor expression suggesting that transferrin receptor modulation is not an essential component of the growth inhibitory effect of interferons. PMID- 1768365 TI - Inhibition of AIDS virus replication by acemannan in vitro. AB - Acemannan (ACE-M), a beta-(1,4)-linked acetylated mannan, was evaluated for in vitro activity against human immunodeficiency virus type 1 (HIV-1). Castanospermine (CAS), deoxymannojirimycin (DMN), swainsonine (SWS), azidothymidine (AZT), and dideoxythymidine (DDC) were tested in parallel as control compounds. In vitro antiviral efficacy of ACE-M was evaluated in a variety of cell lines including human peripheral mononuclear, CEM-SS1 and MT-2(2) cells. The virus strain, number of infectious units per cell, and target cell line were important factors in determining the degree of inhibition of viral cytopathic effect in the presence of ACE-M and other control compounds tested. Maximum inhibitory effect was observed in CEM-SS cells infected with the RFII strain of HIV-1. This inhibitory effect was determined to be concentration dependent. Assay design included primary screening to measure cell viabilities of infected target cells in the presence and absence of test compounds. When tested on HIV-1/RFII-infected CEM-SS cells, the 50% inhibitory effect of CAS (IC50 = 28), an inhibitor of alpha-glucosidase I, was determined to be similar to that observed for ACE-M (IC50 = 45). However, DMN and SWS, inhibitors of mannosidase I and II, tested in parallel to CAS and ACE-M, exhibited no IC50 values. Antiviral potential of ACE-M as an inhibitor of syncytia formation was also explored using CEM-SS cells. Suppression of syncytia formation was observed at an ACE-M concentration of 31.25 micrograms/ml, and complete inhibition was observed at 62.5 micrograms/ml. In addition, HIV-1 RNA levels were studied to establish the antiviral potential of ACE-M in vitro.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768366 TI - Custom-tailored drug immunoconjugates in cancer therapy. AB - Forty-three patients with disseminated refractory malignancies each received an individually specified combination of either Adriamycin (n = 24) or mitomycin-C (n = 19) conjugated to a cocktail of murine monoclonal antibodies (mAb). Cancers were typed with both immunohistochemistry and flow cytometry using a panel of antibodies. Cocktails of up to six antibodies were selected based on total binding of greater than 80% of the malignant cells in the biopsy specimen. These mAb cocktails were then drug conjugated, safety tested, and administered intravenously. The Adriamycin immunoconjugates were well tolerated in 22/24 patients, with 17/24 having significant side effects. Fever, chills, pruritus, and skin rash were by far the most common transitory reactions. All were well controlled with premedication. A total of up to 1 g Adriamycin and 5 g mAb were administered to each patient. The limiting factor appeared to be a variable dissociation of active Adriamycin from the antibody that unpredictably caused hemopoietic depression. Similar findings were noted among 19 patients treated with mitomycin-C conjugates. Thrombocytopenia at a 60-mg dose of mitomycin-C in this schedule was dose limiting. Serological evidence suggested that the development of an immunoglobulin M antibody specific against the mouse mAb had the specificity and sensitivity to predict clinical reactions. These antibodies were quantitatively less in mitomycin-C-treated patients. Selected patients were retreated. One patient with chronic lymphocytic leukemia was treated on three occasions with regression of peripheral lymph nodes. Two patients with breast carcinoma had definite improvement in ulcerating skin lesions, and two patients with tongue carcinoma had shrinkage of their lesions. No responses were seen with mitomycin-C conjugates but binding was noted to tumors. Drug-induced colitis was seen at higher doses with some binding of these conjugates to normal colon epithelium. This study demonstrated the feasibility of preparing individually specified drug immunoconjugate cocktails for patients with refractory malignancies. Cocktail formulation and antibody delivery to the tumor in vivo was accomplished. There was limited antigenic drift among various biopsies within the same patient over time. The major technical hurdle continues to be the selection of effective drug conjugation methods to optimally bind drugs to mAbs for targeted cancer therapy. PMID- 1768367 TI - Cell binding and tumor inhibiting functions of a new antihuman melanoma murine monoclonal antibody. AB - Murine, antihuman melanoma cell monoclonal antibody (mAb) 16.C8 was generated by fusing the murine myeloma cell line P3X63/Ag8.653 with splenocytes from a nude mouse bearing a human melanoma xenograft, after reconstitution with splenocytes from syngeneic immunocompetent BALB/c mice. The antibody reacted strongly with fresh human melanoma cells and exhibited preferential reactivity with established human melanoma and neuroectodermal tumor cell lines. Electrophoresis and Western blotting experiments indicated that 16.C8 is directed against a sialoglycoprotein antigen with a molecular weight of 110-120 kDa. mAb 16.C8 mediated lysis of melanoma cells in vitro in antibody-dependent cellular cytotoxicity assays using human mononuclear effector cells isolated from normal volunteers or malignant melanoma patients. In addition, the administration of mAb 16.C8 to nude mice bearing established human melanoma lung and liver metastases resulted in significant inhibition of tumor growth as shown by gross and histologic examination. In contrast, animals treated with Hanks' balanced salt solution or nonspecific immunoglobulin exhibited a large tumor burden. These results suggest that mAb 16.C8 may be of value in treatment of metastatic melanoma in humans. PMID- 1768369 TI - Applications of gamma-interferon in cancer therapy. AB - This review focuses on the use of gamma-interferon (gamma-IFN) in cancer therapy. Although clinical trials using gamma-IFN have yet to identify a treatment niche for this cytokine, these studies have led to a greater understanding of the pleiotropic effects of this molecule on the human immune response, as well as identification of the dose range required for optimal biologic response modification. Thus, continued efforts to clinically develop gamma-IFN are warranted. PMID- 1768368 TI - Phase I evaluation of coumarin (1,2-benzopyrone) and cimetidine in patients with advanced malignancies. AB - Fifty-four patients with advanced malignancies were treated on this phase I trial of coumarin and cimetidine. The dose of coumarin was escalated, with three patients treated at each dose level, while the cimetidine dose was held constant at 300 mg four times daily. Patients received coumarin alone as a single daily oral dose for 14 days; on day 15, cimetidine was added and both drugs were continued until progression of disease. This trial was initiated with patients receiving coumarin at 400 mg daily and closed at 7 g daily with four of five patients on this dose experiencing nausea and vomiting. Treatment was generally well tolerated over a wide range of coumarin doses. Symptomatic side effects were few, mild, and usually self limited. Side effects included insomnia, nausea, vomiting, diarrhea, and dizziness. Two patients withdrew from therapy because of daily nausea and vomiting. Typically, nausea, vomiting, and dizziness occurred 2.5-3 hours after a dose of coumarin. In most patients, these side effects abated spontaneously with continuation of therapy. There was no significant hematologic or renal toxicity. Hepatotoxicity occurred in only one patient and was manifested by asymptomatic abnormal elevations of serum hepatic transaminases. This toxicity was reversible upon interruption of therapy. Objective tumor regressions were observed in six patients with renal cell carcinoma. Responses occurred at coumarin doses ranging from 600 mg to 5 g daily. Coumarin is a relatively nontoxic, oral, outpatient therapy that warrants further investigations for the treatment of human malignancies. Because of its low toxicity, there is potential for combining coumarin with chemotherapeutic and/or biological agents in an attempt to improve on efficacy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768370 TI - Single-dose murine monoclonal antibody ricin A chain immunotoxin in the treatment of metastatic melanoma: a phase I trial. AB - To determine the maximally tolerated dose of a ricin A chain-conjugated antimelanoma antibody (XomaZyme-Mel), 20 patients with metastatic melanoma were treated with escalating doses of the murine immunotoxin given as single intravenous infusion over 30 minutes. The starting dose was 0.6 mg/kg and was escalated in five groups to a maximum of 1.6 mg/kg. The maximally tolerated dose was 1.25 mg/kg as three of six patients treated at 1.6 mg/kg developed unacceptable toxicity. The dose-limiting toxicity consisted of profound fatigue, myalgias, and arthralgias. These occurred within 4 days and resolved in 7 to 10 days. Other non-dose-limiting toxicities encountered consisted of hypoalbuminemia, weight gain, peripheral edema, mild hypotension, and flu-like syndrome; the severity of these was also dose related. In addition, two allergic reactions occurred, one severe. There was one durable complete response of 12+ months' duration and one brief mixed response lasting 3 months. We conclude that the maximum tolerated single dose of XomaZyme-Mel is 1.25 mg/kg. Phase I studies evaluating 1.25 mg/kg given in multiple doses at 2- to 4-week intervals and phase II studies to determine the response rate of a single 1.25 mg/kg dose are warranted. PMID- 1768371 TI - Comparative biodistribution and antibody-dependent cellular cytotoxicity of native and heavy chain chimeric antibody. AB - We have recently chimerized the heavy chain of the pan-carcinoma monoclonal antibody (mAb) B72.3. Studies were undertaken to compare the IgG1 chimeric antibody, B72.3-1-3 with native murine B72.3 (nB72.3). Using fluorescence activated cell sorting analysis, B72.3-1-3 demonstrated specific binding to fresh LS174T tumor cells. Biodistribution of 131I B72.3-1-3 was similar to 131I nB72.3 in nude mice bearing LS174T xenografts. Peak radiolocalization indices were noted on day 6 for B72.3-1-3 and day 8 for nB72.3. Both antibodies were capable of imaging LS174T tumors by radioimmunoscintigraphy. Antibody-dependent cellular cytotoxicity of LS174T by human peripheral blood lymphocytes was tested in 8h 51Cr release assays. With either no antibody or nB72.3, lymphocytes were not capable of killing LS174T cells. However, B72.3-1-3 at a concentration of 5 and 50 micrograms/ml mediated significant lysis of tumor cells by human lymphocytes. These results suggest that chimeric antibodies retain their binding properties to tumor cells and display biodistribution patterns similar to their unmodified counterparts. Such modifications may reduce the deleterious human antimouse antibody response to murine mAbs as well as augment antibody-dependent cellular cytotoxicity of tumor cells by human effectors. PMID- 1768372 TI - Coumarin (1,2-benzopyrone) enhances DR and DQ antigen expressions by peripheral blood mononuclear cells in vitro. AB - Coumarin (1,2-benzopyrone) is a natural substance that appears to have some clinical activity against renal cell carcinoma and malignant melanoma. Preliminary evidence from in vitro and in vivo studies suggests that coumarin possesses immunomodulatory activity. It was reported previously that coumarin therapy resulted in augmented DR antigen expression by peripheral blood monocytes in cancer patients. The purpose of the present study was to examine the effects of coumarin on DR and DQ antigen expression by normal donor peripheral blood mononuclear cells in vitro. Using monoclonal antibody labeling techniques and FACS analysis, it was shown that both DR and DQ antigen expression by peripheral blood mononuclear cells were enhanced over controls after 48 hours of exposure to coumarin. While monocytes normally express these antigens, enhanced expression is consistent with an activated state. These results support the hypothesis that coumarin acts, at least in part, through immune augmentation. PMID- 1768373 TI - Efficacy of acemannan in treatment of canine and feline spontaneous neoplasms. AB - Forty-three dogs and cats with spontaneous tumors were treated with the immunostimulating polysaccharide acemannan by intraperitoneal and intralesional routes of administration. Tumors from 26 of these animals showed histopathological evidence of immunological attack as shown by marked necrosis or lymphocytic infiltration. Thirteen showed moderate to marked tumor necrosis or liquefaction. Twenty-one demonstrated lymphoid infiltration, and seven demonstrated encapsulation. Twelve animals showed obvious clinical improvement as assessed by tumor shrinkage, tumor necrosis, or prolonged survival; these included five of seven animals with fibrosarcomas. It is believed that acemannan exerts its antitumor activity through macrophage activation and the release of tumor necrosis factor, interleukin-1, and interferon. PMID- 1768374 TI - Intratumoral tumor necrosis factor induction in tumor-bearing mice by exogenous/endogenous tumor necrosis factor therapy as compared with systemic administration of various biologic response modifiers. AB - The relationship between the induction of tumor necrosis factor (TNF) (as an indicator of inflammatory reaction) in tumor tissues and its antitumor effect was investigated in tumor-bearing mice by using nine biologic response modifiers (BRMs) and by exogenous/endogenous TNF therapy following a previously reported protocol. Close correlation between the induction of TNF-rich inflammation in tumor tissues and the antitumor effect of BRM were observed. The results of this study suggest that the conditions necessary for exerting antitumor effects of biologic response modifiers may be the induction of TNF (50 to 200 U/g) at the tumor lesions at an early stage after BRM administration and maintenance of the detectable amount of TNF (approximately 10 U/g) for more than 6 hours. Tumor necrosis factor should also be induced in the liver and spleen so that its activity can be maintained in the tumor lesions. PMID- 1768375 TI - Evaluation of a biologic response modifier derived from Serratia marcescens: effects on feline macrophages and usefulness for the prevention and treatment of viremia in feline leukemia virus-infected cats. AB - Normal feline bone marrow-derived macrophages released maximum concentrations of interleukin-6, tumor necrosis factor, and interleukin-1 when stimulated with ImuVert (Cell Technology Inc, Boulder, CO, USA) at dosages of 1.0 microgram/ml, 5.0 micrograms/ml, and 10.0 micrograms/ml, respectively. When ImuVert was administered to healthy adult cats, significant elevations in rectal temperature and neutrophil counts were observed 10 and 24 hours after each treatment. Weekly treatment with ImuVert failed to prevent or reverse viremia in cats when initiated prior to or 6 weeks after inoculation with feline leukemia virus. PMID- 1768376 TI - The natural history of HIV and AIDS in women. PMID- 1768377 TI - Identification of mixed HIV-1/HIV-2 infections in Brazil by polymerase chain reaction. AB - Analysis of sera from hospitalized Brazilian patients by whole-virus lysate-based enzyme immunoassay and Western blot indicated that 0.4% were reactive to HIV-2 alone while 4% were reactive to both HIV-1 and HIV-2. When these sera were tested for HIV antibody by type-specific peptide enzyme immunoassays, dual seropositivity was confirmed in only 0.4% of patients. To define genetically the HIV strains within the population, we analyzed peripheral blood mononuclear cells from selected seropositive patients for the presence of HIV-1 and HIV-2 proviral DNA using the polymerase chain reaction (PCR). Independent primers/probes sets were used for the amplification and detection of viral sequences from the long terminal repeat (LTR), gag, and protease (prt) gene regions. Our findings confirmed the serologic evidence of HIV-2 in Brazil and determined the extent of mixed HIV-1 and HIV-2 infections. Detailed evaluation of the amplified viral protease sequences by endonuclease restriction analysis and DNA sequencing independently confirmed mixed HIV-1 and HIV-2 infections in the two patients seropositive for HIV-1 and HIV-2. The data further indicated that these isolates are distinct from the HIV laboratory standards. We interpret the combination of culture and PCR findings to demonstrate the presence of both HIV-1 and HIV-2 in Brazil. PMID- 1768378 TI - HIV-1 Nef protein exhibits structural and functional similarity to scorpion peptides interacting with K+ channels. AB - The persistent infection of human glial cells with HIV-1 is characterized by prominent expression of the Nef protein. In order to evaluate the possible role of Nef in the development of HIV-1-associated neurological disorders, we compared Nef with known neuroactive proteins. We found that HIV Nef shares sequence and structural features with scorpion peptides known to interact with K+ channels. Sequence similarity encompasses two distinct regions of scorpion peptides. Based on crystallography data, both regions in scorpion peptides cooperate in forming a common domain stabilized by ion pairs between charged amino-acid residues. Recombinant Nef protein, as well as a synthetic part of a scorpion channel active peptide (M10), reversibly increased the total K+ current of chick dorsal root ganglions in patch-clamp experiments without killing the cells. These results indicate that a region conserved in HIV Nef and scorpion peptides concurs in both structure and electrophysiological activity and suggest that Nef, like scorpion peptides, may affect neuronal cell function. PMID- 1768379 TI - Immunoglobulin G3-specific antibodies as a marker for early diagnosis of HIV infection in children. AB - Early diagnosis of HIV infection in the child of an HIV-infected mother may be difficult as HIV-specific immunoglobulin (Ig) G antibodies are transmitted to the fetus transplacentally. In an attempt to provide a new, simpler tool for early identification of HIV-infected children we analysed the HIV-specific IgG subclass pattern during the first year of life. One hundred and one samples were collected from 35 children born to HIV-seropositive mothers, among whom 18 seroreverted during follow-up and 17 were HIV-infected (two P1 and 15 P2 according to the Centers for Disease Control classification). Serum HIV-specific IgG3 was detectable at least in one sample in 26 out of 35 children. All 17 HIV-infected children showed persistently detectable specific IgG3, both with stable or progressive disease. Out of the 18 uninfected children who seroreverted during follow-up, nine were HIV-specific IgG3-negative when first tested and nine lost HIV-specific-IgG3 within 28 weeks after birth. The correlation of the serological results with clinical information and any other diagnostic tool on each child suggests that the clearance of specific-IgG3 antibodies heralds seroconversion in uninfected passive antibody-carrier children. This observation provides the basis for a new, simple and effective method for early diagnosis of HIV infection in children born to seropositive mothers. PMID- 1768380 TI - Serum interleukin-6 concentrations are elevated and associated with elevated tumor necrosis factor-alpha and immunoglobulin G and A concentrations in children with HIV infection. AB - Hypergammaglobulinemia is one of the most consistent, and usually the first observable abnormality in infants vertically infected with HIV. We have analyzed serum interleukin (IL)-4, IL-6, tumor necrosis factor (TNF)-alpha, and immunoglobulin (Ig) concentrations in 23 HIV-infected and 21 uninfected children. IL-6 and TNF-alpha concentrations in HIV-infected children were significantly higher than those in uninfected children, and mutually correlated. No differences in serum IL-4 levels between infected and uninfected children were observed. There was a correlation between serum IL-6 and IgG and between IL-6 and IgA concentrations. Furthermore, during follow-up changes in IL-6 levels were usually accompanied by corresponding changes in IgG levels. Our data indicate an association between HIV, IL-6, TNF-alpha and hypergammaglobulinemia. Regardless of the source and initial stimulus, continued production of IL-6 and TNF-alpha may result in augmentation in an auto-feedback manner, accompanied by increases in Ig synthesis and, more importantly, HIV replication. Thus, elucidation of the mechanisms responsible for overproduction of these two cytokines in HIV-infected patients is not only interesting from a biologic point of view, but is likely to have important clinical implications as well. PMID- 1768381 TI - Differences in the expression of histocompatibility antigen-DR and in anti mycobacterial activity of monocytes from HIV-infected individuals. AB - This study assesses the changes in the expression of histocompatibility antigen (HLA)-DR by mononuclear phagocytes from HIV-infected individuals. Overnight culture of monocytes resulted in an increase in HLA-DR expression by monocytes from uninfected individuals. In contrast, the expression of HLA-DR by monocytes from HIV-infected patients decreased spontaneously and was most pronounced in patients with clinical AIDS. We also found that Mycobacterium avium grew within monocytes from patients infected with HIV. The correlation between major histocompatibility complex (MHC) class II expression and Mycobacterial growth which has been reported in mice was not observed in monocytes from HIV-infected patients. PMID- 1768382 TI - Oral candidiasis in HIV infection: pseudomembranous and erythematous candidiasis show similar rates of progression to AIDS. AB - Candidiasis is the most common oral fungal infection seen in association with HIV infection. It may present in a number of clinical forms, including pseudomembranous and erythematous candidiasis. To determine whether erythematous candidiasis, like the pseudomembranous form, is predictive of the development of AIDS, we reviewed the records of 169 HIV-seropositive patients seen at clinic of the Oral AIDS Center, University of California, San Francisco who were diagnosed with pseudomembranous or erythematous (or both) forms of oral candidiasis at their first examination. Kaplan-Meier analysis showed a rapid rate of progression to AIDS (median, 25 months) and to death (median, 43.8 months) in all three groups. We conclude that erythematous candidiasis is as serious a prognostic indicator as pseudomembranous candidiasis. Because the erythematous form is more difficult to recognize and hence is underdiagnosed, efforts should be made to teach non-dental clinicians who care for HIV-infected patients to diagnose and treat this lesion. PMID- 1768383 TI - Lack of compensatory megakaryocytopoiesis in HIV-1-seropositive thrombocytopenic individuals compared with immune thrombocytopenic purpura patients. AB - In this study we demonstrate that HIV-1-seropositive thrombocytopenic individuals, in contrast with immune thrombocytopenic purpura (ITP) patients, fail to have a compensatory increase of megakaryocytopoiesis. The in vitro growth of bone-marrow megakaryocyte progenitors (CFU-MK) and the production of granulocyte/macrophage colony-stimulating factor (GM-CSF), interleukin (IL)-1 and IL-6 by bone-marrow mononuclear adherent cells and peripheral blood (PB) light density mononuclear cells were studied in 12 HIV-1-seropositive thrombocytopenic individuals with respect to 12 ITP patients and 15 normal controls. In HIV-1 seropositive thrombocytopenic individuals, CFU-MK size (number of megakaryocytes per colony) was similar to normal controls but significantly lower (P less than 0.05) than in ITP patients. IL-1 and IL-6 production was similar in the three groups of subjects. On the other hand, GM-CSF production by bone-marrow mononuclear adherent cells in HIV-1-seropositive thrombocytopenic individuals was similar to normal controls but significantly (P less than 0.05) lower than in ITP patients, whereas GM-CSF production by PB light-density mononuclear cells was markedly (P less than 0.05) defective compared with both normal controls and ITP patients. The positive correlation between number and size of CFU-MK and production of GM-CSF by bone-marrow mononuclear adherent cells, observed in all three groups of subjects, demonstrates the central role of GM-CSF in the control of megakaryocytopoiesis. PMID- 1768384 TI - HIV-seropositive thrombocytopenia: the action of zidovudine. AB - The action of zidovudine when administered to individuals with severe HIV thrombocytopenia was investigated. Four individuals with platelets less than 50 x 10(9)/l and CD4 cells greater than 200 x 10(6)/l were treated with 600 mg zidovudine per day for 6 weeks, no drug for 6 weeks, 1200 mg zidovudine per day for 6 weeks, then no drug for 6 weeks. Glycocalicin, a platelet protein which correlates inversely with platelet survival, was assayed before and after treatment. Glycocalicin indices were also measured in four additional individuals with HIV thrombocytopenia. Platelet counts rose 2.5-fold [95% confidence interval (Cl), 2.0-3.0)] for four subjects who received 600 mg zidovudine per day and 4.9 fold (95% Cl, 4.0-5.8) for three subjects receiving 1200 mg zidovudine per day. Platelet counts declined during drug-free intervals. Plasma glycocalicin indices were elevated in all with untreated HIV thrombocytopenia. Indices fell after zidovudine treatment in six of seven individuals, suggesting that zidovudine prolonged platelet survival. Analysis of 170 HIV-seropositive asymptomatic individuals [mean CD4 count 474 x x 10(6)/l, standard deviation (s.d.) 245 x 10(6)/l] revealed that 14 (8%) had less than 125 x 10(9)/l platelets but only 2 (1%) had less than 50 x 10(9)/l platelets. Platelet counts increased spontaneously in eight individuals with mild HIV thrombocytopenia among the 10 for whom repeat counts were available. PMID- 1768385 TI - The long-term use of zidovudine in patients with severe immune-mediated thrombocytopenia secondary to infection with HIV. AB - Various treatments for HIV-related thrombocytopenia have been reported. Since etiologies of the thrombocytopenia may differ with regard to risk group treatment outcomes may also vary. We have recently studied the long-term use of zidovudine in individuals with sexually transmitted HIV infection and severe thrombocytopenia. Twenty-five men, median age 34 years (range, 23-51 years), were treated with zidovudine (1000 mg/day) for a median duration of 12 months (range, 2.5- less than 26 months). Nineteen patients (76%) had had episodes of symptomatic bleeding secondary to thrombocytopenia prior to study entry. All patients bleeding symptoms resolved with therapy. Six (24%) achieved a complete response, with normalization of platelet counts, while 11 patients (44%) achieved a partial response, giving an overall response rate of 68%. The median time to partial or complete normalization of platelet counts was 12 weeks (range, 4-62 weeks). Toxicities were minimal during the study period. Only one patient developed an AIDS-defining diagnosis while on therapy. We conclude that patients with sexually transmitted HIV infection and immune thrombocytopenia may need a prolonged period of therapy with zidovudine to achieve a platelet response. Other treatment modalities may be required for the 30% of patients who do not respond to zidovudine. PMID- 1768386 TI - Toxoplasma serology, parasitemia and antigenemia in patients at risk for toxoplasmic encephalitis. AB - In order to further characterize the pathogenesis of Toxoplasma gondii infection in patients with AIDS and AIDS-related complex (ARC), a cohort of HIV- and Toxoplasma-infected individuals were identified and prospectively followed. Four hundred and 10 HIV-infected individuals followed in the San Francisco General Hospital AIDS Clinic were screened for antibodies to Toxoplasma between November 1986 and November 1988. Of the 67 (16%) individuals seropositive for Toxoplasma antibodies, 33 (49%) were followed monthly for a mean duration of 7.5 months. One hundred and 11 follow-up blood samples were obtained in order to determine Toxoplasma serology and the incidence of parasitemia. In general, Toxoplasma immunoglobulin (Ig) G antibodies remained stable over time. Detection of Toxoplasma antigenemia and parasitemia was uniformly negative, including those specimens obtained from two individuals within 45 days of their developing toxoplasmic encephalitis. PMID- 1768387 TI - AIDS in rural eastern North Carolina--patient migration: a rural AIDS burden. AB - A descriptive retrospective study on the AIDS and HIV patients of rural eastern North Carolina was performed. Our data show what appears to be a 'second wave' of HIV-related disease (HRD) in this area. Although most of our AIDS and HIV patients migrated from urban areas such as New York State, our patient population is now largely being replaced by locally infected or 'home-grown' patients. The epidemiological characteristics of rural HRD are significantly different to those of urban HRD: rural patients are more likely to be female, heterosexual, non white, and younger. These epidemiological differences, along with limited medical and social services in a poor economic base, will make treating HRD a more difficult problem in rural areas than in traditional urban centers. PMID- 1768388 TI - The need for rigorous molecular epidemiology. PMID- 1768389 TI - Differential effect of serum on syncytium formation and virus production in cells chronically infected with HIV in vitro. PMID- 1768390 TI - The inhibitory effects of suramin on HIV-1 are attenuated in the presence of albumin. PMID- 1768391 TI - Field evaluation of immunoglobulin G antibody capture tests for HIV-1 and HIV-2 antibodies in African serum, saliva and urine. PMID- 1768392 TI - Respiratory insufficiency from dapsone-induced methemoglobinemia. PMID- 1768393 TI - Microsporidiosis detected in association with AIDS-related sclerosing cholangitis. PMID- 1768394 TI - Zidovudine-associated hypertrichosis and nail pigmentation in an HIV-infected patient. PMID- 1768395 TI - Interrater reliability of the Karnofsky Performance Status in an HIV-infected sample. PMID- 1768396 TI - Statistical approaches to evaluating prognostic indices in HIV infection. The Transfusion Safety Study Group. PMID- 1768397 TI - [Reducing the duration of revoked driving permit penalty in alcoholic drivers following psychological remedial traffic education]. AB - 1) Also new facts--driver improvement, longstanding good reputation in road traffic (minimum 25 years)--are only conditionally acceptable to substantiate a reduction in the blocking period in terms of section 69 a section 7 StGB. 2) A high blood alcohol level (as from 0.2 g %) precludes the reduction in the blocking period for obtaining a driving licence of drunken drivers. 3) Attending a post-schooling course may, in individual cases, as a new fact able to justify a reduction of blocking period. 4) In many cases the court is insisting behind own behaviour prognosis on a specialist for psychological selection tests. PMID- 1768398 TI - [Quality assurance of blood alcohol determination]. AB - There are many statistical problems connected with the reduced safety increase (BGH 4 StR 297/90). They are discussed in detail and point out the importance of quality assurance whose practical procedure should be regulated in a new prescription of the methods used for blood alcohol determination. PMID- 1768399 TI - [Reducing the serum volume for forensic blood alcohol determination]. AB - It is possible to reduce the necessary volumes of samples for the determination of blood alcohol to a high degree. The available analysing and filling instruments allow this in enzymatic and gaschromatographic methods without a loss of precision. The instructions of the German federal health employment for blood alcohol determinations for forensic purposes are observed. PMID- 1768400 TI - [Methanol kinetics in chronic alcoholism]. AB - Blood tests from 39 persons, who had been admitted to a local hospital for alcoholics, were analysed. The methanolconcentrations at the reception time lay between 10 and 82 mg/kg and the BAC between 2.00 and 3.83%. In all cases, when Ethanol existed in a sufficient concentration the Methanolconcentration showed a horizontal trend. A Methanolelimination was not observed. Only after exceeding a limiting value of Ethanol, which fluctuated between 0.8 and 0.2%, in most of the cases under 0.2%, the Methanolcurves increased significantly. An Ethanolelimination was observed between 0.15 and 0.25% per hour, the average was about 0.19%. PMID- 1768401 TI - The effects of low alcohol beers on the blood alcohol concentration. AB - Drinking of 3 liters of so called low alcohol beer (0.5 vol.% as well as 0.9 vol.%) within 2 hours leads only to very low or no blood alcohol values during a drinking experiment (19 persons). These results are expected considering the kinetics of resorption and elimination of alcohol in human body. Consumption of low alcohol beers instead of traditional beer should have a positive effect on traffic safety. PMID- 1768402 TI - [Long-term follow-up of the accuracy of blood alcohol determination (GC and ADH method) with test sera (about 0.6 and 1.5 g/L) with reference to safety recommendations regarding 0.1 promille]. AB - For the precision and accuracy testing of the gaschromatographic and the ADH enzymatic ethanol determination respectively, we used two commercially available control sera (approximately 0.6 g/L and 1.5 g/L respectively). During one year of testing during 1990 at 200 different days, they were daily and routinely used together with the specimen analysed. The mean serum ethanol concentration obtained for both sera was less than the value stat-ed by the manufacturer. Our investigation also aimed at a possible lower threshold value from 0.8 promille to 0.5 promille (BAK) as a consequence of the german "Wiedervereinigung". The combination of GC- with ADH-method always performed the safety-value set up as judged by the german "Bundesgerichtshof" (= 0.1 promille). Even if quality criteria could be hold in this study, some doubt is remaining concerning a sufficient accuracy of blood alcohol measurements in the more complex matrices of individual blood samples to which the results can not be transferred. PMID- 1768403 TI - Ethanol elimination in man under influence of hepatoprotective silibinin. AB - The effect of a single dose of hepatoprotective silibinin on blood alcohol elimination was investigated. Neither influence on the blood alcohol curve, nor detectable increase in the beta 60 value was found, although biochemical considerations suggest such an effect. Though silibinin has a protective effect on chronic alcohol liver injury, it does not influence acute alcohol elimination, and is therefore not suitable for use as a "sobering-up" agent. PMID- 1768404 TI - Late cortical auditory potentials evoked by electrostimulation in deaf and cochlear implant patients. AB - Deaf or residually hearing patients without sufficient auditory communication by conventional hearing aids are candidates for the implantation of a cochlear prosthesis. In addition to objective audiometry (electrophysiological evaluation and assessment of the degree and type of hearing loss), preoperative electrostimulation tests should be performed. In so doing, it is reasonable to employ late cortical potentials for preoperative patient selection as well as for postoperative follow-ups. In contrast to early potentials (such as, brain stem evoked potentials), late cortical potentials offer technical, physiological, medical and psychological advantages. This approach to testing has been used successfully in 70 patients (including children over the age of 3 years). PMID- 1768405 TI - A laryngeal pacemaker for inspiration-controlled, direct electrical stimulation of the denervated posterior cricoarytenoid muscle in sheep. AB - Bilateral recurrent nerve palsies were induced in four sheep and unilateral nerve palsy in one sheep. Vocal cord abductions were achieved by direct electrical stimulation of the posterior cricoarytenoid muscles (PCMs). By means of the diaphragmatic myogram, respiratory synchronous activation of the glottis opening musculature was shown possible. In all cases an adequate glottis opening for respiratory function was achieved during a maximum period of stimulation of 5-8 h in each animal. Abductor movements of the vocal cords were documented with video laryngoscopy. Using digital image processing, the areas of the open glottis were measured at rest and during bilateral direct electrical stimulation of the PCMs. PMID- 1768406 TI - Infrared laser stapedotomy. AB - A pulsed holmium: YAG laser (lambda = 1980 nm) was used to perform 0.4 mm stapedotomy fenestrations in human stapes footplates from freshly dissected cadavers under simulated surgical conditions. The energy was coupled into a 400 microns core diameter nylon fiber. Thermal gradients were then measured following laser applications and tissue responses examined by light microscopy. The results of this study suggest the feasibility of using a surgical holmium: YAG laser in middle ear surgery. PMID- 1768407 TI - The laryngeal vestibule, voice quality and paralinguistic markers. AB - The laryngeal component of voice quality markers has been quantified in the present study, suggesting that the laryngeal vestibule and lower pharynx play an important role in voice quality. Findings also show that voice quality can be partly described in terms of laryngeal configurations and that a knowledge of these configurations may be useful to the laryngologist, speech pathologist and singer. Twenty-five voice qualities were videorecorded, using a nasal fiberscope. Still photographs were taken for each voice quality and distance measurements made on each one for 15 laryngeal parameters. The raw data were normalized, sorted from high to low, turned into scalar values and processed to establish which parameters exhibited similar functions, which photographs were essentially identical, and in what respect any two photographs were different. Each voice quality was seen to be associated with a different, describable and quantifiable laryngeal configuration. PMID- 1768408 TI - Relationship between cochlear blood flow and perilymphatic oxygen tension. AB - To clarify the characteristics of the blood circulation in the cochlea, we correlated cochlear blood flow and perilymphatic oxygen tension at various blood pressures. Cochlear blood flow was measured in guinea pigs by laser Doppler flowmetry, and perilymphatic oxygen tension by polarography. Blood pressure changes were induced by angiotensin II injection, trimetaphan camsylate injection and blood withdrawal. Cochlear blood flow generally paralleled systemic blood pressure, indicating a close correlation. In contrast, perilymphatic oxygen tension was slower to increase and decrease. However, when systemic blood pressure was lowered more gradually, perilymphatic oxygen tension did not show the same lag. These findings indicate that perilymphatic oxygen tension parallels systemic blood pressure when changes induced are slower and in a physiological range. PMID- 1768409 TI - Autoregulation of cochlear blood flow. A comparison of cerebral blood flow with muscular blood flow. AB - The cochlear blood flow of healthy adult guinea pigs was measured with a laser Doppler flowmeter and flow dynamics were analyzed on the basis of autoregulation. Angiotensin II infusion was used to raise blood pressure, while phlebotomy was done to lower blood pressure. The characteristics of autoregulation of cerebral blood flow and muscular blood flow were also investigated. Cochlear blood flow was considered to have some autoregulation but was less than brain blood flow, which showed significant regulation. Muscular blood flow seemed to have no similar regulatory mechanism. PMID- 1768410 TI - Tubeless translaryngeal superimposed jet ventilation. AB - Microsurgical endoscopic interventions of the larynx offer an optimal approach to the surgeon by providing an unrestricted operative field. During such operations, ventilating the patient should in no way be impaired. For this reason we have developed a new type of tubeless jet ventilation which consists of both low frequency and superimposed high-frequency jet ventilation. In addition, we have integrated two specifically sized jets into a Kleinsasser laryngoscope, placing them at different sites. This technique guarantees adequate ventilation with an oxygen-air blend. Due to the Venturi effect, air and tidal volumes are also enhanced when passing through the external open end of the laryngoscope. This type of tubeless jet ventilation was applied to more than 60 patients, using a prototype jet. Anesthesia consisted of a continuous intravenous administration of propofol, with sufentanil and vecuronium given as needed. Clinical results revealed optimal ventilation of all patients without hypercapnia or other complications. Operative conditions for the surgeon were also very satisfactory. Findings demonstrated that this type of tubeless jet ventilation is also particularly suited for laryngeal laser surgery, thus avoiding flammable tubes and noxious anesthetics. PMID- 1768411 TI - The presence of laminin in the fetal human inner ear. AB - The expression of laminin was analyzed in the human fetal inner ear using immunohistochemical methods. In the 11-week-old human fetus, the presence of laminin was found in the basement membrane of the immature cochlea, endolymphatic sac and vestibular end organs. The reaction of the basement membrane of the endolymphatic sac was strong in the 15-week-old human fetus. A laminin reaction was seen in the cochlea, Reissner's membrane, epithelial cells of the limbus spiralis, the basilar membrane and the stria vascularis. In particular, the capillaries and basement membrane of the stria vascularis were strongly positive. These results suggest that laminin may be an essential component in the development of the inner ear and may possibly be related to filtration of the endolymph. PMID- 1768412 TI - The immunological role of the outer membrane proteins of non-typable Hemophilus influenzae in otitis media with effusion in children. AB - Specific IgG and IgA antibodies against the outer membrane proteins of non typable Hemophilus influenzae were investigated in otitis media with effusion in children. Amounts of these antibodies were determined in middle ear effusions (MEEs) and in sera by enzyme-linked immunosorbent assay. At the same time the amounts of total IgG and IgA antibodies in MEEs in comparison with those in sera were analyzed by laser nephelometry. The amounts of specific and total IgG and IgA in the MEEs were higher than those in the sera. The MEEs/sera ratios of IgG and IgA antibodies in the children with mucoid effusions were higher than those in the children with serous effusions. The exception involved IgG determined by laser nephelometry. These data support the hypothesis that bacterial infections and the subsequent immune response contribute to the prolongation of otitis media with effusion in children, especially when effusions become mucoid. PMID- 1768413 TI - The resting potential of marginal cells in stria vascularis explants. AB - In order to examine the intracellular potential of stria vascularis marginal cells (MCs) under direct visual control, a short-term organ culture of guinea pig stria vascularis (SV) was developed. The experimental conditions allowed exposure of the luminal surface of the SV to artificial endolymph or perilymph. Using conventional microelectrodes and inverted bright-field microscopy, impalement of MCs from the endolymphatic side through the luminal cell membrane was achieved. With artificial perilymph at the luminal side a small positivity at the cell surface and low negative intracellular potentials were recorded at room temperature (23 degrees C). The initial recording was -6.5 +/- 5.0 mV while the stable recording was -4.0 +/- 3.6 mV. Similar results were obtained at a bath temperature of 37 degrees C. Furthermore, subtotal exposure of the luminal cell surface to artificial endolymph did not result in a significant potential change. PMID- 1768414 TI - Capillary filtration-absorption balance reconsidered in light of dynamic extravascular factors. AB - The evidence for the functional importance of extravascular Starling pressures now seems overwhelming, and when these terms are taken into account it is difficult to uphold the traditional conception that upstream microvascular filtration is largely matched by a sustained downstream reabsorption. Transient absorption can occur, however, during spontaneous vasomotion cycles, during sympathetic-induced vasoconstriction and during hypovolaemic hypotension. Sustained absorption is possible in specialized tissues where the interstitium is 'flushed' by an independent stream (intestinal mucosa, renal cortex, lymph nodes). Both theory and experiment show, however, that absorption cannot be maintained across most low-pressure exchange segments due to the finite permeability of microvessels to plasma protein, which leads to a rise in pericapillary interstitial oncotic pressure with time around absorbing microvascular segments. Extravascular hydraulic resistance may be a further determinant of net fluid transfer rate in situations where capillary wall resistance is low. PMID- 1768415 TI - Permeability of blood-brain and blood-nerve barriers in experimental diabetes mellitus in the anaesthetized rat. AB - Diabetes was induced with streptozotocin in rats weighing about 160 g. These were maintained with age-matched controls for up to 14 months, blood glucose being periodically monitored. Half the diabetic and control rats received the aldose reductase inhibitor, Ponalrestat, in their diet. At 3 weeks, 6-7 months and 13-14 months, the vascular permeability in regions of brain, and in optic and sciatic nerves, were measured by maintaining radiotracers in the bloodstream--125I albumin (100 min), [14C]sucrose (60 min) and 131I-albumin (5 min)--followed by tissue sampling and counting at termination. 131I-albumin estimated residual intravascular plasma. Diabetes of up to 13-14 weeks caused no measurable increase in the sucrose permeability of microvessels in eight different brain regions, in optic or in sciatic nerve. At 3 weeks of diabetes, sucrose permeability in all brain regions and in optic nerve was reduced relative to that in controls. Extravascular albumin entry into different regions of brain and optic nerve was insignificant and insensitive to diabetes, except in the hypothalamus and optic nerves where it was raised with increasing duration of diabetes. In sciatic nerve, extravascular albumin distribution was markedly increased by diabetes, but sucrose permeability was not demonstrably affected. At the level used in the diet, Ponalrestat reduced the sorbitol content of diabetic sciatic nerve but did not protect again the increased permeability to albumin. PMID- 1768416 TI - A two-dimensional morphometry-based model of interstitial and transcapillary flow in rabbit synovium. AB - The synovial lining of a joint is a layer of specialized connective tissue, containing fenestrated capillaries, that regulates the volume and composition of fluid in the joint cavity. The hydraulic conductance of the synovial lining and of the plasma-to-cavity pathway is increased by high intra-articular pressures (IAP greater than 9 cmH2O) and this is accompanied by an increase in the interstitial pathway's area/pathlength ratio. In order to assess the contribution of the altered pathway geometry to the conductance changes, and also to evaluate the conductivity of the synovial interstitial matrix (Ki) and local flow patterns, a two-dimensional model of trans-synovial flow was developed from morphometric data at low IAP (5 cmH2O) and high IAP (25 cmH2O). Darcy's law was applied to finite elements within a 'unit cell' of synovium to compute a steady state pressure field. Elements adjacent to limited discrete porous regions of the capillary wall were additionally subjected to the Starling principle. Appropriate values of Ki and capillary wall conductance were obtained by iteration to match the experimentally measured net conductances. The value of Ki that matched the data at low IAP was 1.4-2.1 x 10(-12) cm4 s-1 dyn-1 (1.4-2.1 x 10(-15) m4 s-1 N 1). This is in the range reported for some other fluid-confining tissues, namely scleral stroma and aortic wall. Comparison between a capillary model with localized porous regions and one with a uniformly distributed permeability showed that the uniformity assumption (commonly used in mathematical modelling) leads to severe underestimation of the local pericapillary pressure gradients. At high IAP, synovial deformation was found to account for 24-50% of the increased hydraulic conductances. To explain the remainder, it was necessary to postulate a rise in Ki, especially in the zone between the joint cavity and capillary wall. Possible mechanisms involving tissue hydration and/or glycosaminoglycan wash-out at high IAP are discussed. The model highlights a need for quantitative biochemical analysis. PMID- 1768417 TI - Glucagon 1-21 reduces intestinal epithelial cell proliferation in parenterally fed rats. AB - The hypothesis that glucagon 1-21 (G1-21) is trophic to the gastrointestinal tract was investigated in the hypoplastic intestine of intravenously maintained rats. Three groups of eight rats were fed parenterally for three days and then were infused with either 0, 20 or 80 micrograms rat-1 day-1 of G1-21 for 3 days. No significant effect on the weight of the stomach, caecum or colon was observed, but both the weight and crypt cell production rate of the small intestine were significantly decreased by G1-21. Plasma enteroglucagon was also decreased by G1 21 treatment. It is concluded that G1-21 does not have a trophic effect on the gastrointestinal tract, and, in fact, has an antiproliferative effect on the small intestine, which could in turn be modulated by decreased levels of endogenous enteroglucagon. PMID- 1768418 TI - Evidence for volume regulatory increase by Na-K-Cl co-transport in rat arterial smooth muscle. AB - A component of K efflux (86Rb as tracer) from rat femoral arterial smooth muscle was blocked by loop diuretics. Following hypertonic challenge with 100 mM sucrose, K efflux increased but not in the presence of loop diuretics. This is taken as evidence for a volume regulatory increase mediated by Na-K-Cl co transport. PMID- 1768419 TI - Stretch-induced increase of resting intracellular calcium concentration in single guinea-pig ventricular myocytes. AB - Single guinea-pig ventricular myocytes were loaded with the fluorescent Ca2+ indicator Indo-1 AM and stretched by carbon fibres. Stretching increased resting tension. Sarcomere lengths were increased by 2-18%. It was observed that a stretch increased resting [Ca2+]i in seven out of eight cells. The change in [Ca2+]i increased with the size of the stretch and returned to pre-stretch levels on return to resting cell length. These observations suggest a means by which changes in resting muscle length can modify the contractile state of cardiac muscle. PMID- 1768420 TI - Segmental heterogeneity of rat colonic electrogenic secretion in response to the bacterial enterotoxin Escherichia coli STa in vitro. AB - The effects of the bacterial toxin Escherichia coli STa on electrogenic secretion in proximal, mid and distal rat colon were examined in vitro using the short circuit current (Isc) as an index of secretion. All areas showed toxin-elevated Isc which was reduced by bumetanide. The proximal colon was the most sensitive (lowest ED50) but displayed the lowest maximal increase in Isc, the mid colon had the largest maximal electrogenic response while the distal colon proved to be the least sensitive (highest ED50). Atropine (1 microM) and tetrodotoxin (1.25 microM) reduced the maximum Isc response to STa by up to 42%, indicating that the enteric nervous system may be partly involved in the response. PMID- 1768421 TI - The effect of intracisternal injection of thyrotropin-releasing hormone on gastric and duodenal motility in the urethane-anaesthetized rat. AB - Intracisternal injection of thyrotropin-releasing hormone (TRH; 1-3 micrograms) caused an increase in gastric motility and usually an inhibition of duodenal motility. These effects were abolished by vagotomy and atropine. No inhibition was seen even after tone and motility had been restored to a point at which vagal stimulation could evoke profound inhibition of gastric and duodenal motility. It is concluded that TRH is a specific activator of enteric excitatory pathways and that duodenal inhibition seen in control animals is a consequence of gastro duodenal inhibitory reflexes. PMID- 1768422 TI - Opioidergic inhibition of reflexes evoked by selective stimulation of sural nerve C fibres in the rabbit. AB - Reflexes were evoked in the gastrocnemius medialis (GM) muscle nerve by selective electrical stimulation of the non-myelinated C fibres of the ipsilateral sural nerve of decerebrated, spinalized rabbits. The opioid antagonist (-)-quadazocine (555 micrograms/kg i.v.) enhanced responses to sural C fibre stimulation to an average of 236% of pre-drug levels. In addition, C fibre-evoked reflexes were depressed for 7-9 min after repetitive activation of the high threshold axons of the common peroneal nerve, and this effect was reversed after quadazocine. Thus, GM responses to stimulation of non-myelinated sural afferent fibres are suppressed by endogenous opioid peptides, but the degree of inhibition does not appear to be as profound as that previously reported for reflexes evoked by myelinated fibres. PMID- 1768423 TI - Topical retinoid treatment for skin cancer: a review. AB - There is laboratory and clinical evidence to suggest that retinoids have a potentially important place in the management of neoplastic and preneoplastic disorders of the epidermis. Topical administration avoids the side-effects of orally administered retinoids, but doubts remain over their efficacy. Evidence from clinical studies suggests that although topical retinoids have some effect in treating established skin cancers, alternative treatments are more effective. Topical retinoids appear more effective in the treatment of solar keratoses and epidermal dysplasia in photodamaged skin. PMID- 1768424 TI - Binding of synthetic analogues of retinol and retinoic acid (CD-270 derivatives) to retinoid-binding proteins. AB - Cellular retinoid-binding proteins play an important physiological role in the mode of action of retinoids upstream from the nuclear receptors. Tritiated analogues of retinol (ROL) and retinoic acid corresponding to substituted benzo[b]thiophene (CD-270) alcohol and carboxylic acid, respectively, were used for the binding studies of the cellular retinoic acid-(CRABP-) and retinol-(CRBP ) binding proteins in human epidermal cells and serum retinol-binding protein (RBP). We show that [3H]CD-270 carboxylic acid binds specifically to CRABP, whereas the alcohol derivative binds strongly to CRBP. However, the low amount of CRABP present concomitantly with CRBP suggests that [3H]CD-270 alcohol might be oxidized into minute amounts of the corresponding carboxylic acid derivative. The acidic character of the alcohol goup due to the aromatic ring of CD-270 might also support a possible binding to CRABP. In contrast, both derivatives show no affinity to RBP. These results suggest that the binding site of RBP is more restrictive to the retinoyl moiety than the binding site of cellular retinoid binding proteins and therefore tolerates less chemical modification on the hydrophobic part of the ROL molecule. Moreover, when using these derivatives as ligands 2.4 times more CRABP and 3.9 times more CRBP could be measured with the PAGE technique as compared when using the natural [3H]ligands. The CD-270 derivatives might therefore be used as stable ligands for the study of both CRBP and CRABP. Since CD-270(OH) binds to the CRBP this may lead to the development of new synthetic analogues of ROL which could be used as tools for the study of the role of CRBP in the transport and metabolism of ROL. PMID- 1768425 TI - Retinol uptake and metabolism to 3,4-didehydroretinol in human keratinocytes at various stages of differentiation. AB - The concentration of 3,4-didehydroretinol, an epidermal metabolite of retinol, is changed both in association with keratinizing disorders and during treatment with certain synthetic retinoids. To delineate further the factors regulation biosynthesis of 3,4-didehydroretinol, keratinocytes from three different layers of normal epidermis were prepared by trypsinization and incubated with [3H] retinol for 20 h. Cell-bound [3H]-retinol and 3,4-[3H]-didehydroretinol were separated by high-performance liquid chromatography. The results indicate that the uptake of retinol and the synthesis of 3,4-didehydroretinol occur predominantly in undifferentiated cells from the basal and spinous layers of the epidermis. PMID- 1768426 TI - Long-term cultured adult human keratinocytes secrete granulocyte-macrophage colony-stimulating factor but not interleukin-3 after cytokine exposure in vitro. AB - To investigate the secretion of granulocyte-macrophage colony-stimulating factor (GM-CSF) and of interleukin-3 (IL-3) by human keratinocytes in vitro, adult human keratinocytes (aHKc) from 3 different donors and a spontaneously transformed keratinocytic line (HaCaT) were cultured and exposed to various cytokines and to the protein kinase C-activating agent phorbol-12-myristate-13-acetate (PMA). GM CSF and IL-3 were measured by highly specific and sensitive immunoassays. Our findings showed that long-term cultured aHKc and HaCaT cells are capable of secreting GM-CSF but not IL-3 upon cytokine and PMA stimulation. Both interleukin 1 and tumor necrosis factor alpha, which are known to be present in human epidermis, particularly during cutaneous inflammatory processes, were found to stimulate GM-CSF release. Therefore, we conclude that increased GM-CSF levels may play an important role in the interactions between epidermal keratinocytes and blood cells in vivo. PMID- 1768427 TI - In vitro generation of smooth muscle-contracting leukotrienes from isolated epidermal cells. AB - Single-cell suspensions of murine and human epidermal cells were studied for the presence of peptidoleukotrienes (LTs), using in vitro guinea pig ileum contraction as bioassay and a commercial radioimmunoassay. The calcium ionophore A23187 at 5 x 10(-6) M alone or in combination with arachidonic acid at 10(-4) M caused release of LTC4/D4 within 10-30 min and for up to 18 h. LTB4, as was measured in the chemotaxis assay, was released at different levels and with different kinetics from the same cells. Epidermal cells may thus regulate cutaneous inflammation by secreting potent vasoactive and muscle-contracting in addition to chemotactic lipid mediators. PMID- 1768429 TI - The role of growth factors in wound healing. AB - Numerous growth factors are involved in the regulation of tissue repair and remodelling processes. The repair process is initiated by inflammation, a phenomenon that is regulated by components of the immune response such as cytokines, matrix elements and growth factors. These locally released growth factors or cytokines induce the recruitment, activation, mitogenesis and differentiation of various other cell types. It is improbable that all of them play a key role in the tissue repair process. Obviously, each of these factors may also influence normal tissue homeostasis. Therefore, the possible use of these factors for therapeutic intervention has to be considered carefully. Some of the important aspects of growth factors with regard to this topic will be discussed. PMID- 1768428 TI - The effect of platinum complexes on human skin cells in vivo and in vitro. AB - The effects of platinum complexes on human fibroblasts and keratinocytes have been investigated. Cytotoxic effects were observed at approximately 4 microM (cisplatin), 10 microM (carboplatin) and 15 microM (JM9) when cells were grown continuously in these agents. When applied topically to hairless mouse skin in vitro carboplatin was shown to penetrate the skin and give levels where a cytotoxic effect would be apparent. Using an in vivo model of epidermal hyperproliferation in the mouse, an antimitotic effect of a 1% and 5% topical carboplatin preparation was demonstrated. These results suggest that topical platinum complexes are of potential in the therapy of hyperproliferative skin diseases. PMID- 1768430 TI - Induction and inhibition of NAD(P)H: quinone reductase in murine and human skin. AB - The purpose of this study was to characterize the human cutaneous NAD(P)H: quinone reductase (NQR) activity by known inhibitors of different reductases and to compare it with the murine skin and liver NQR activity. This enzyme plays a major role in the defence of cells against oxygen stress because it inhibits the 1-electron reduction of quinones to semiquinones and their subsequent oxidation to quinones termed as quinone redox cycle. It belongs to the aromatic hydrocarbon responsive (Ah) battery. This gene battery includes Cyp1a1 (cytochrome P-450 IA1), Cyp1a2 (cytochrome P-450 IA2) and Nmo-1 [NAD(P)H: quinone reductase]. In the skin cytochrome P-450 IA1-dependent activity is about 1-5% compared to the corresponding activity in the liver, whereas NQR has the same activity in skin and liver. NQR was determined in the cytoplasm of murine skin, liver, and human keratinocytes using 2,6-dichlorophenolindophenol as the substrate. The Ah receptor binding compounds, such as coal tar constituents, or 3 methylcholanthrene induce cytochrome P-450-dependent activities such as aryl hydrocarbon hydroxylase or 7-ethoxyresorufin-O-de-ethylase and NQR, whereas butyl hydroxytoluol, which does not bind to the Ah receptor, induces only NQR. For inhibition studies several known inhibitors of dihydrodiol dehydrogenase, aldo keto and carbonyl reductase activities were used. There was a similar pattern of inhibition of the basal and induced activity in all tissues investigated. Pyrazole, progesterone and phenobarbital did not inhibit, whereas dicoumarol, rutin and indomethacin inhibited NQR activity in murine skin and liver as well as in human keratinocytes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768431 TI - Potency assessment of topical corticoids in the vasoconstrictor assay and on tuberculin-induced inflammation. AB - The topical anti-inflammatory activity of potent and very potent corticoids was studied in normal and inflamed skin using the vasoconstriction assay and tuberculin-induced inflammation in four double-blind intraindividual comparison trials. Instrumental techniques in addition to visual scores and several time points were applied to get better insight into the reliability of the models and the sensitivity of the different variables. Beta-methasone-17-valerate and two concentrations of prednicarbate were used as potent corticoids, clobetasol-17 propionate, betamethasone-17,21-dipropionate and different biopharmaceutical forms of desoximetasone (DOM) as very potent corticoids. Visual scores, the reactive skin hyperemia after arterial occlusion and skin colorimetry were used to quantify vasoconstriction; erythema scores, surface area of infiltration and changes in skin colorimetry, skin blood flow and skin temperature for the tuberculin reaction. The time courses of blanching (n = 20) and of the tuberculin reaction (n = 10) were described by orthogonal polynomials and the coefficients were statistically analyzed by nonparametric tests, the discriminative variables in tuberculin inflammation in addition by the parametric multiple analysis of variance. Important differences in the release rates of corticoids demand several assessment times and not just one as often used. The potency ranking may otherwise be misleading. In general, ointments released corticoids slowlier than the cream which in turn liberated slowlier than the gels. The DOM gel declined rapidly after an apparent peak at 5.5 h in terms of its blanching effect, but was nevertheless comparable after once-daily application to other very potent corticoids in its activity against delayed-type inflammation. Such differences may explain discrepancies found for some corticoid preparations between their blanching response and clinical efficacy. The more potent a corticoid the more the erythema is reduced, the less pronounced the cell infiltration and the more delayed the peak seems from 24 to 48 h in the tuberculin reaction. The inflammatory response is diminished in the following manner: very potent greater than potent corticoids; erythema greater than infiltration. Visual scores were the most reliable parameters in normal and inflamed skin and they correlated well with skin colorimetry which shows greater variability. Reactive hyperemia after arterial occlusion gave poor results in terms of ranking in the vasoconstriction assay as did resting skin blood flow in inflamed skin. Changes in the temperature of inflamed skin are sensitive enough to discriminate the active drugs from the controls, but have a somewhat different time course, reflecting perhaps a higher impact of the amount of mediator release in the early phase relative to the cell invasion in the later phase. PMID- 1768432 TI - In vitro methods for the assessment of primary local effects of topically applied preparations. AB - Three 'alternative' methods for the screening of the primary irritation potentials of topically applied preparations and raw materials are presented as a test battery and their in vitro endpoints are compared with in vivo data. The first method is the intermediate test on the chorioallantoic membrane of hens' fertilized eggs, which is generally proposed for the prediction of the irritation potential of chemicals. Relevant test parameters, such as the time-dependent appearance of hemorrhages, vascular lysis and coagulation, are used to classify the test substances. Secondly, cytotoxicity tests with Balb/c 3T3 fibroblasts are used to characterize the influence of test materials on cellular homeostasis and viability, which is quantified by the dose-dependent uptake of Neutral red. As a second parameter changes in the cellular protein level can be easily measured by subsequent staining with Kenacid blue. Finally, the third approach to in vitro evaluation is presented in the form of the red blood cell assay, a rapid photometric assay which permits distinguishing basically between damage to the membrane and to proteins as endpoints which correlate with lesions observed on the conjunctiva, iris and cornea in the eye and the acute inflammatory responses evoked during epicutaneous irritancy testing. Changes in the optical behavior of oxyhemoglobin are used as the inherent indicator for monitoring both endpoints and their interrelations. These methods are proposed and can be used advantageously for testing newly developed topical preparations and their ingredients in view of their local irritation potential without further use of animal testing. Moreover, they can also be used for screening chemicals. PMID- 1768433 TI - Serum-free culture of enriched murine haemopoietic stem cells. II: Effects of growth factors and haemin on development. AB - A serum-free culture system was used to determine the effects of growth factors on the clonogenic development of a population of cells highly enriched for multipotential day 12 spleen colony forming cells (CFU-S) (FACS-BM). Under these conditions, interleukin-3 (IL-3) was found to be primarily a proliferative stimulus, the progenitor cells developing in the clonal assay systems produced colonies of morphologically undifferentiated cells for up to 20 days. No such induction of proliferation without maturation was observed with other growth factors (eg. granulocyte-macrophage colony stimulating factor (GM-CSF)). However, combinations of IL-3 plus secondary growth factors such as GM-CSF, macrophage colony stimulating factor (M-CSF), granulocyte colony-stimulating factor (G-CSF) or interleukin-1 (IL-1) led to the formation of colonies containing mature haemopoietic cells of the granulocytic, megakaryocytic or monocytic lineages. In contrast, erythroid development did not occur unless the protoporphyrin, haemin, was added to the cultures. Under these conditions mature erythroid cells were produced in cultures containing either IL-3 or GM-CSF (with or without erythropoietin (epo)). In replating experiments it was determined that the FACS BM cells were able to generate large numbers of clonogenic cells for up to 30-40 free cultures. Such cultures, therefore, may be useful for investigating the biological and basis of the generation of clonogenic cells and of haemopoietic cell differentiation and development in response to growth factors. PMID- 1768434 TI - The effects of insulin and basic fibroblast growth factor on fibre differentiation in rat lens epithelial explants. AB - We have shown that fibroblast growth factors (FGFs) induce epithelial cells throughout lens explants to progressively divide, migrate and differentiate into fibres as the concentration of FGF is increased. We now report the effects of insulin and insulin-like growth factor-1 on rat lens epithelial explants, alone or in combination with the basic form of FGF. Fibre cell-specific beta- and gamma crystallins were localised in explants by immunofluorescence or determined by ELISAs. For insulin, high doses induced limited beta-crystallin accumulation, much less than for FGF and mostly restricted to the explant periphery. When insulin was included with a low concentration of FGF, fibre differentiation was substantially enhanced. Both beta- and gamma-crystallin accumulation were affected synergistically, the effect being greater for gamma- than for beta crystallin, and epithelial cells in both the central and peripheral region of the explant participated in the synergistic response. Insulin-like growth factor-1 at a concentration of 50 ng/ml mimicked the effects of insulin. PMID- 1768435 TI - Cyclosporine A inhibits induction of DNA synthesis by PDGF and other peptide mitogens in cultured rat aortic smooth muscle cells and dermal fibroblasts. AB - The immunosuppressive drug cyclosporine A was recently shown to inhibit smooth muscle proliferation in the vascular response to injury. To examine if this may be due to a direct effect of the drug on the smooth muscle cells (SMCs), we have studied its influence on the phenotypic modulation of rat aortic SMCs in primary cultures and on the induction of DNA synthesis by peptide mitogens in serum starved subcultures. The results demonstrate that cyclosporine A does not interfere with the transition of the SMCs from a contractile to a synthetic phenotype, an early step in the preparation for cell division. On the other hand, it inhibits induction of DNA synthesis by recombinant platelet-derived growth factor-BB (PDGF-BB), basic fibroblast growth factor (bFGF), epidermal growth factor (EGF), and insulin-like growth factor-I (IGF-I). Maximum effect was obtained at a concentration of 1-3 micrograms/ml and the drug could be added 4-6 h after the growth factors with full inhibitory effect. No distinct effect on the stimulation of overall RNA and protein synthesis by PDGF-BB was observed, indicating that the drug was not of general cytotoxicity at the concentrations used. Throughout this part of the investigation, similar results were obtained with rat dermal fibroblasts. The findings indicate that cyclosporine A inhibits induction of DNA synthesis by peptide mitogens, and suggest that the inhibitory effect of cyclosporine A on smooth muscle proliferation in vivo at least in part may be due to a direct action on these cells. PMID- 1768436 TI - Growth inhibitory effects of transforming growth factor-beta 1 in vivo. AB - Transforming growth factor-beta (TGF-beta) can reversibly inhibit the in vitro proliferation of murine and human haemopoietic progenitors and some of their more developmentally restricted progeny. Using an assay for measuring day 8 and day 11 CFU-S, TGF-beta caused a gradual decline in the number of CFU-S undergoing DNA synthesis so that after 5 days of daily treatment only quiescent cells were found. Release of this growth inhibition was seen within 24 hours post-treatment with recovery of all progenitors to normal levels. Similar inhibitory effects of TGF-beta were seen on the cells of the intestinal epithelium, indicating that TGF beta is a general stem cell growth inhibitor. These results suggest that TGF-beta can be used as a cytostatic agent to protect normal stem cells in patients being treated with cell cycle-specific cytotoxic agents. PMID- 1768437 TI - Aortic smooth muscle cells express and secrete vascular endothelial growth factor. AB - We examined whether cultured bovine aortic smooth muscle (ASM) cells express VEGF. RNA blot analysis of total cellular RNA derived from ASM cells demonstrates the expression of the VEGF gene. ASM cells release in the medium a VEGF-like endothelial cell mitogen which binds to heparin-sepharose and has an apparent molecular weight of 40-45 kDa as assessed by an HPLC gel filtration column. Consistent with VEGF, this mitogen does not stimulate the proliferation of ASM cells. Immunoblot analysis of the bioactive material with an antibody specific for VEGF demonstrates the presence of a major immunoreactive band with an apparent molecular mass of 23 kDa and a minor band with a molecular mass of approximately 18 kDa, in reducing conditions. The major band has very similar apparent molecular weight as the 165 amino-acid species of human recombinant VEGF of folliculo-stellate cells derived VEGF. These data demonstrate the expression and synthesis of VEGF by cultured ASM cells and suggest that the 164 amino-acid species is the predominant molecular form of the growth factor secreted by such cells. VEGF released by ASM cells may play a paracrine role in the maintenance of the integrity of the endothelial lining or in the abnormal proliferation of the vasa vasorum which takes place in atherosclerosis. PMID- 1768438 TI - Vascular cell responses to TGF-beta 3 mimic those of TGF-beta 1 in vitro. AB - The vascular cell responses to the type 3 isoform of transforming growth factor beta (TGF-beta 3) were studied using bovine aortic endothelial (BAECs) and smooth muscle cells (BASMCs) as well as rat epididymal fat pad microvascular endothelia (RFCs). Four distinct bioassays indicated that TGF-beta 3 elicits results that do not differ significantly from those of the TGF-beta 1 isoform in all three cell populations. Inhibition of proliferation by TGF-beta 3 at a 5-day time point ranged from 85% on BAECs, to 55% and 53% on RFCs and BASMCs, respectively. The effects of TGF-beta 3 and TGF-beta 1 on cell migration were also found to be similar; migration of large vessel endothelial cells was inhibited 35%, while migration of smooth muscle cells was enhanced 30%. TGF-beta 1 and TGF-beta 3 also had equivalent effects on neovascularization while a 10-fold higher concentration of TGF-beta 2 was required to elicit a similar response. 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 upon the cell type examined. In summary, both the TGF-beta 1 and TGF-beta 3 isoforms of the transforming growth factor-beta family evoke comparable responses in proliferation, migration, angiogenic and cell surface binding assays using three distinct vascular cell types, while the biofunctions of TGF-beta 2 on these cells are distinct. PMID- 1768439 TI - Cloning, characterization and developmental regulation of two members of a novel human gene family of neurite outgrowth-promoting proteins. AB - This report describes the cloning, expression and characterization of two members of a novel human gene family of proteins, HBNF and MK, which exhibit neurite outgrowth-promoting activity. The HBNF cDNA gene codes for a 168-residue protein which is a precursor for a previously described brain-derived heparin-binding protein of 136 amino acids. The second human gene identified in this study, called MK, codes for a 143-residue protein (including a 22-amino acid signal sequence) which is 46% homologous with HBNF. Complementary DNA constructs coding for the mature HBNF and MK proteins were expressed in bacteria and purified by heparin affinity chromatography. These recombinant proteins exhibited neurite outgrowth promoting activity, but lacked mitogenic activity. The HBNF gene is expressed in the brain of adult mice and rats, but only minimal expression of MK was observed in this tissue. Different patterns of developmental expression were observed in the embryonic mouse, with MK expression peaking in the brain between days E12 and E14 and diminishing to minimal levels in the adult, while expression of HBNF mRNA was observed to gradually increase during embryogenesis, reaching a maximal level at birth and maintaining this level into adulthood. Expression of these genes was also observed in the human embryonal carcinoma cell line, NT2/D1. Retinoic acid induced the expression of HBNF and MK 6- and 11-fold, respectively, in this cell line. Our studies indicate that HBNF and MK are members of a new family of highly conserved, developmentally regulated genes that may play a role in nervous tissue development and/or maintenance. PMID- 1768440 TI - [Multiple sclerosis and a fat-poor diet]. PMID- 1768441 TI - [Changes in the small cerebral vessels in the acquired immunodeficiency syndrome]. AB - In the necropsy exam of the brains of 13 patients with acquired immune deficiency syndrome (AIDS) cerebrovascular lesions were seen in 5 cases, three of them having AIDS encephalopathy. Hyalinosis was noted in 3 cases, and endarteritis obliterans and fibrinoid necrosis in one case each; both of them had associated perivascular lymphocytic infiltrates. Cerebral infarction was observed in one case, but no hemorrhages were seen. The neuropathological anomalies in four children affected with the AIDS are reported too, being an extensive calcified vasculopathy and changes suggesting active AIDS encephalopathy the main findings. PMID- 1768442 TI - [Visual evoked potentials in benign intracranial hypertension]. AB - In 20 patients with benign intracranial hypertension (BIH) a study of the P100 latency of visual evoked potentials (VEP) was carried out. At admission only 5 patients showed abnormal latencies. The mean of the P100 latencies in patients was significantly increased as compared with controls. Latencies persisted relatively prolonged once the funduscopy had become normal. In the last investigation, one year after BIH had disappeared, the latencies in patients were already similar to those in the control group. On the other hand, no patient with normal latencies had visual sequelae. Sequelae also did not develop in patients in whom initially prolonged latencies progressively returned to normal during the evolution. Sequelae developed in one patient in whom latencies became progressively prolonged. In that case the increased latencies preceded the fall in visual acuity. These data may be useful to evaluate visual function in patients with BIH. PMID- 1768443 TI - [Reduction of the mortality from acute subdural hematoma. Comparison of 2 series (1979-1982 and 1987-1989) of patients operated on at the Hospital de la Vall d'Hebron]. AB - Several clinical variables from a series of 101 patients with acute subdural hematoma (ASDH) operated on during the period 1979-1989 were compared with those from another group of 43 patients who were operated on during the period 1987 1989. Twenty-seven patients (26.7%) in the earlier period and 15 (34.8%) in the later one were younger than 40 years. The difference was not significant. There was a higher proportion of patients, 41 (40.5%), in the earlier period (1979 1982) who had traffic accidents than in the 1987-1989 period, where trauma was the mechanism in 15 patients (38.8%). However, the difference was not significant. Seven patients (6.9%) from the earlier group and 18 (41.9%) from the later group had a lucid interval. This difference was significant (p less than 0.001). During the 1979-1982 period 80 patients (79.2%) were comatose on admission as compared with 27 (62.7%) during 1987-1989. The difference was significant (p less than 0.05). A small group of 11 patients (10.8%) from the earlier series were operated on by means of craniotomy or trephine; by contrast, this approach was used in 35 (81.3%) patients from the later series. The difference was significant (p less than 0.001). Seventy-nine (78.2%) and 26 (60.4%) patients died in the periods 1979-1982 and 1987-1989, respectively. The difference between the mortality rates of both groups were significant (p less than 0.05). Our data suggest that the earlier diagnosis and the use of wider surgical procedures have contributed to the reduction in mortality. PMID- 1768444 TI - [The mitochondrial genome and its relation to human pathology]. PMID- 1768446 TI - [Congenital atonic-sclerotic muscular dystrophy (Ullrich disease)]. AB - A case of congenital atonic-sclerotic muscular dystrophy is described, with a combination of proximal joint rigidity and distal hypotonia and hyperextensibility, besides torticollis and kyphoscoliosis. These severe congenital defects usually prevent walking and are followed by chronic respiratory insufficiency, with a fatal outcome in the long term. An autosomal recessive type of heredity is implied. There is not sensory or intellectual impairment, therefore it can be distinguished from other congenital muscular dystrophies, that usually have CNS abnormalities associated. PMID- 1768445 TI - [Anterior spinal artery syndrome caused by cervical disc protrusion. Diagnosis by magnetic resonance]. AB - The syndrome of the anterior spinal artery is a rare disease with a diagnosis based an its characteristic clinical features. Until the widespread use of the Magnetic Resonance (MR) the lesional confirmation required an anatomopathological study. We report a 49-years-old male with lacinating interscapular pain and sudden asymmetrical tetraparesia, in whom MR scan disclosed a plurisegmental anterior spinal lesion and a posterolateral disk protrusion at C6-C7 level. We discuss the etiological and pathogenetical relation between degenerative vertebral disk disease and spinal infarctions. PMID- 1768447 TI - [Benign intracranial hypertension with facial myokymias]. PMID- 1768448 TI - [Chorea and lupus anticoagulant]. PMID- 1768449 TI - [Frequency and prognosis of hematomas of the mesencephalon]. PMID- 1768450 TI - [Subarachnoid hemorrhage caused by fenproporex consumption]. PMID- 1768451 TI - [Conduction aphasia]. PMID- 1768452 TI - [Distribution of phenotypes of ACP in ten ethnic groups in Yunnan of China]. AB - The distribution of phenotypes of red cell phosphatase (ACP) in ten ethnic groups in Yunnan Province was investigated by starch gel electrophoresis. Three phenotypes A, AB and B were found. The gene frequencies of ACPA and ACPB in Han, Yi, Bai, Dai, Yao, Wa, Hani, Bulang, Jino and Lahu were 0.2067, 0.7933; 0.2406, 0.7594; 0.2341, 0.7659; 0.3750, 0.6250; 0.2300, 0.7700; 0.2727, 0.7273; 0.3594, 0.6406; 0.3036, 0.6964; 0.2381, 0.7619; and 0.4474, 0.5526, respectively. The ACPC gene and other rare genes were not found. The analysis showed that the distribution of phenotypes of ACP1 have some differences in different races and ethnics. PMID- 1768453 TI - [Preliminary studies of the relationship between micronucleus formation and cell cycle]. AB - For the study of the relationship between micronucleus formation and chromosome aberration. Lymphocytes of human peripheral blood were treated with MMC and chromosome aberrations and micronuclei which produced at various phases of cell cycle were observed. For the study of the main results are as follows: (1) the MMC induced increase in the frequency of aberration cells at metaphase (ACF), that of the frequency of micronucleated cells at G1, S and G2 phases (cultured in vitro, C-MNCF) and that of the frequency of micronucleated cells at G0 phase (Non cultured, NC-MNCF) are all dose-dependent and their dose-response relation can be described by power regression; (2) the MMC-induced micronucleus formation at G0 phase is not related to chromosome aberration, but the change of NC-MNCF is positively related to the change of CAF as same as C-MNCF; (3) the MMC-induced MNCFs detected in binucleated cells by the cytokinesis block method increase slightly as compared with C-MNCFs, and the ratio of MNCF/ACF is less (about 0.1) and decreases along with the increase of MMC concentrations. The results suggest that the relationship between micronucleus formation and chromosome aberration may be quite complex, that chromosome aberration could be one of the cause of micronucleus formation. PMID- 1768454 TI - [Influence of population fusion on genotypic variance]. AB - Effect of population fusion on genetic variance was explored. Without dominance the genotypic variance is greater after fusion than that before fusion. When dominance is complete, the genotypic variance is greater after fusion than that before fusion if [formula: see text], and the genotypic variance is smaller after fusion than that before fusion if [formula: see text]. In overdominance the genotypic variance is greater after fusion than that before fusion. PMID- 1768455 TI - [Exploration of the application of harmonic analysis in the study of genetics]. AB - Taking the accumulation process of protein and oil in rapeseed as an example, the paper explores the possibility of application of harmonic analysis to describing the quantitative change process of biological characters. Some genetic rules involved in the phenotype processes of characters are discovered through decomposing genetic quantity from the dynamic change processes of the characters. The preliminary conclusion is that there are two prevailing simple-harmonic oscillators in the accumulation processes of protein and oil in rapeseed, which are inheritable. This shows that harmonic analysis opens up a new explorative way by which genetic rules of the phenotype processes of biological characters can be revealed. PMID- 1768456 TI - [Through homologous recombination pathway recA gene takes part in chromosome replication of E. coli initiated by integrated plasmid]. AB - We have reported in our previous paper that replication of E. coli chromosome initiated by the integrated F' plasmid depends on the recA gene. Here we report on work dealing with the role played by recA, recB, recC, lexA alleles in chromosome replication. Our results show that the recA gene takes part in chromosome replication through homologous recombination rather than SOS pathway and that Chi hot spot is not concerned with. They also show that the ATP dependent dsDNA exonuclease activity of the RecBC enzyme has nothing to do with the recA gene in chromosome replication. PMID- 1768457 TI - [Synthesis and molecular cloning of the cDNA of TuMV-RNA]. AB - TuMV particles were purified from artificially infected leaves of Brassica juneaen, and TuMV-RNA was extracted from these particles. The virus thus purified showed typical nucleoprotein absorbent peak under UV light scanning, and the ratio of A260/A280 was 1.21. The RNA thus prepared showed typical ribonucleic acid absorbent peak, and the ratio of A260/A280 was 2.2. The RNA was then used as template of oligo (dT) 12-18 together with the end product of DNase digested calf thymus DNA were used as primer for the synthesis of cDNA. The length of double stranded cDNAs synthesized were distributed continuously with the sizes between 500-4300 bp. The ds-cDNA repaired by Klenow fragment was inserted into the Small site of pUC19 by blunt-end ligation. Then the recombinant molecules were used to transform E. coli strain DH5 alpha. Rapid electrophoresis of plasmid prepared by alkali method, EcoRI-HindIII digestion and in situ hybridization with 32P labeled TuMV-RNA showed that inserted fragments were with various sizes and complement to TuMV-RNA. PMID- 1768458 TI - [Cloning and sequencing of spinach chloroplast DNA fragments with promoter activities in E. coli]. AB - Sau3A partially digested spinach cDNA fragments were cloned in BgIII restriction site of a E. coli promoter probing vector pGA46. The cloned fragments with promoter activities in E. coli were found by the abilities of recovering tetracycling resistance of their host cells. The promoter functions of the two fragments and their different strengths are deciphered by analyzing their DNA sequences. PMID- 1768459 TI - HTLV-I infection in high-risk groups in Vizcaya, northern Spain. PMID- 1768460 TI - Direct binding of complement component C1q to human immunodeficiency virus (HIV) and human T lymphotrophic virus-I (HTLV-I) coinfected cells. AB - Previous studies have shown that coinfection of the human T lymphotrophic virus type I (HTLV-I) chronically infected cell line MT4 with human immunodeficiency virus type 1 (HIV-1) results in cells which spontaneously activate complement via the classical pathway. This complement activation was antibody independent, yet required C2, suggesting either direct C1, C4, or C2 activation. Because some animal retroviruses have been shown to bind human C1q directly, the present study investigated the possible direct binding of C1q by HIV coinfected MT4 cells. Coinfected cells bound both C1q present in serum and highly purified C1q. Binding of C1q resulted in formation of active C1 on the cell surface, which could in turn activate complement as shown by C4 consumption. The C1q binding was not HIV isolate specific since infection of MT4 cells with any of three diverse isolates all induced C1q binding. Purified collagen-like region (CLR) and globular region (GR) fragments of C1q both bound to coinfected cells, suggesting a mechanism of binding by C1q similar to that of fibronectin-C1q binding. However, culture of coinfected cells in serum-free (fibronectin-free) medium did not reduce C1q binding. A second HTLV-I chronically infected line, SLB-1, also displayed increased binding of C1q after HIV infection. The H9 cell line, which is not HTLV I infected, did not bind C1q after HIV infection. These results suggest that a retrovirus protein expressed by coinfected cells directly binds C1q resulting in classical complement activation. This type of activation may have profound biological effects in persons coinfected with HIV-1 and HTLV-I. PMID- 1768461 TI - Alteration of HIV-1 infectivity and neutralization by a single amino acid replacement in the V3 loop domain. AB - The V3 loop (residues 303-338) of the human immunodeficiency virus type 1 (HIV-1) gp120 envelope protein represents a principal neutralizing determinant for the virus. An HIV-1 proviral clone containing a mutation in the V3 loop was constructed in which the proline residue at position 313 was changed to an alanine (P313-A). This mutation alters the conserved GPGR sequence that is found in the V3 loop sequences of different HIV-1 isolates. The P313-A clone produced virus particles, which were infectious for a number of T-cell lines including MOLT-4, CEM, and SupT1, but demonstrated a relatively low infectivity on the AA5 B-cell line when compared with wild-type viruses, HTLV-IIIB, HXB2/10 (a chimeric molecular clone), and another mutant virus (Q290-T). V3 loop-specific neutralizing polyclonal sera and the 9284 monoclonal antibody, which recognizes the amino side of the V3 loop sequence, effectively blocked infectivity and syncytia formation of all viruses tested. In contrast, the 0.5 beta monoclonal antibody, which is biologically more potent than 9284 and recognizes a different V3 loop determinant, failed to neutralize the P313-A virus. These results suggest that the proline residue in the relatively conserved GPGR "turn" region of the V3 loop is crucial for recognition by the 0.5 beta antibody. The observed variation in sensitivity of the B-cell line to the P313-A virus may reflect the presence of cell-specific factors which could be important in establishing an HIV-1 infection. PMID- 1768462 TI - Sequence analysis of the V3 loop regions of the env genes of Ugandan human immunodeficiency proviruses. AB - Ugandan strains of human immunodeficiency virus type 1 (HIV-1) were isolated by cocultivation of peripheral blood lymphocytes from infected individuals with cord blood lymphocytes. Sequences from the V3 region of the env gene were amplified by the polymerase chain reaction (PCR) from chromosomal DNA obtained from low passage virus cultures. The PCR products from 13 Ugandan isolates were cloned into a phagemid vector and sequenced. Many isolates contained divergent V3 loop sequences and adjacent regions: diversity was associated with codon deletions or duplications and with nucleotide substitutions, especially G----A transitions. Proviruses from some of the cultures showed extensive diversity within the V3 loop sequences but others were more homogeneous. The V3 loop apices were conserved in 6 of the Ugandan proviruses and these were very similar to the equivalent regions of several Zairean proviruses. The V3 loop apices of African isolates of HIV-1 are divergent from those of North American isolates. The possible biological consequences of this divergence are discussed. PMID- 1768464 TI - Cross-neutralizing antibodies to HIV-1 in mice after immunization with gp160 iscoms. Dissection of the immune response. AB - Gp160 expressed in vaccinia and produced in vero cells was integrated into iscoms. Gp160 iscoms elicited a high serum antibody response in mice, and after two immunizations a ceiling was reached. The serum antibody response was dissected by the use of defined recombinant DNA products, representing different regions of the gp160 molecule. High antibody titers to the peptid RP135 (a.a. 296 332) correlated with induction of neutralizing serum antibodies. In some animals, gp160 (IIIB) iscoms elicited cross-neutralizing antibodies that also neutralized the distantly related RF isolate. PMID- 1768463 TI - Neutralizing antibodies against HIV-1 BRU and SF2 isolates generated in mice immunized with recombinant vaccinia virus expressing HIV-1 (BRU) envelope glycoproteins and boosted with homologous gp160. AB - Anti-human immunodeficiency virus type 1 (Anti-HIV-1) antibody response was compared in four groups of mice following inoculation with HIV-1 gp160, with live recombinant vaccinia virus expressing HIV-1 envelope glycoproteins, or with both immunogens in alternate orders for primary or secondary immunizations. Both subunit and recombinant virus immunogens induced similar levels of antibody response following primary immunization. However, after secondary immunization, mice primed with live recombinant virus and then boosted with subunit gp160 immunogen showed significantly higher antibody response than those in the other three groups. Neutralizing antibodies were generated only in this group of mice and were shown to neutralize both the homologous virus (BRU) and a divergent isolate (SF2) of HIV-1. On the other hand, their reactivities to peptide sequences from the principal neutralizing determinant (PND) of gp120 were limited to the BRU isolate, not SF2 or MN, indicating that the cross-neutralizing activities were directed against determinants other than the linear epitope(s) within the PND. These results also indicate that combined immunization by priming with liver recombinant virus and boosting with subunit immunogen may be more effective than immunization by either immunogen alone. PMID- 1768465 TI - Event-related potentials in HIV-infected outpatients. AB - Event-related potentials (ERP) were determined in 138 human immunodeficiency virus (HIV)-infected outpatients and 92 healthy controls of a corresponding age. Of the HIV-infected patients, 31.8% showed an abnormal latency of the P3 component of ERPs (P3-ERP), exceeding the mean value + 2 SD of P3-ERP latencies from age-matched healthy subjects. From the untreated patients in stage Walter Reed (WR) = 6, 71.4% had abnormal P3-ERP latencies, whereas in WR = 2, only 19.6% of P3-ERPs were abnormal. Fourteen patients were observed over a period of 3-16 months. P3-ERP latencies were shortened in 7 patients under treatment with zidovudine. A marked increase in P3-ERP latencies was observed in 7 untreated HIV infected patients. It is assumed that ERPs are a useful neurophysiological method to detect early cerebral dysfunction in HIV-infected patients. PMID- 1768467 TI - [The behavior of visceral proteins in digestive surgery patients undergoing total peripheral parenteral nutrition enriched with branched-chain amino acids (BCAA)]. AB - The objective of this study, is to confirm a clear benefit of protein synthesis after administration of branched amino acids in parenteral nutrition solutions. Particularly, on a parenteral total hypocaloric nutrition including lipids. Eighty one digestive surgical patients, were included in this study. Fifty with neoplastic disease and thirty one without. Patients in both study groups received a similar peripheral vein nutritional support regimen one week after surgical treatment. To evaluate the effects of the branched chain amino acid enrichment on total parenteral nutrition, we observed the behavior of short middle life proteins such as transferrin, prealbumin, and retinol binding protein, for their reliability as indexes of protein synthesis. PMID- 1768466 TI - [The short-, median- and long-term changes of mastocyte degranulation in the gastric submucosa of rats following truncal vagotomy]. AB - We study the effect of the truncal vagotomy on the degranulation activity of mast cell population in the submucosa of the rumen and fundus of the stomach of the rat after 7, 30, 60, 90 and 120 days of the surgical procedure. Also we analyze if the observed variations are connected with the existence or not of secretory activity in the studied area. The degranulation activity decreases in 7 days in the fundic secretory area with statistic significance, but not in the rumen. A significant increase of the degranulation is seen in both areas, after 90 days. We conclude that the effects of the vagotomy on mast cell degranulation in the submucosa of the stomach of rats depend on the presence or not of secretory activity in the studied area and the length of time after the surgical procedure. PMID- 1768468 TI - [Acute appendicitis in the elderly patient]. AB - Presentation of 55 patients aged more than 65 years, appendectomized with the diagnosis of acute appendicitis. After histological study, we saw 6 normal cecal appendixes (10.9%), so the real number of acute appendicitis operated was 49 out of 435 (11.2%) interventions. The clinical history was typical in most of the patients and, nevertheless, we noticed a diagnostic delay greater than 24 hours in 31 (63.2%), and greater than 48 hours in 17 patients (34.6%). We verified the existence of a high percentage of perforated appendicitis (36.7%) closely related to a long evolution time, not being able to show, in the group studied, an increase of early appendix perforations in comparison with the rest. These results suggest that the high morbidity of acute appendicitis in old patients is due, to a great extent, to a delay in the performance of the appendectomy. PMID- 1768469 TI - [The treatment of primary biliary cirrhosis with ursodeoxycholic acid. The short- and median-term results and their relation to the study of the disease]. AB - We present the results of the treatment with ursodeoxycholic acid (UDCA, 7-9 mg/kg body weight daily) of 17 patients with primary biliary cirrhosis (8 in stages I-II; 9 in stages III-IV). At two months the mean values of alkaline phosphatase, gammaglutamiltranspeptidase, alanine and aspartate aminotransferase were reduced (p less than 0.001, p less than 0.001, p less than 0.01 and p less than 0.01 respectively). This improvement persisted without increase during the first year. At two months the total bilirubin value was reduced (p less than 0.01) associated with a reduction in the conjugated fraction (p less than 0.05). Cholesterol and gammaglobulin mean values also decreased at two months (p less than 0.05). We found no changes in IgM levels and antimitochondrial antibody titers. The improvement was similar in both groups (early I-II and advanced III IV stages) and the treatment showed no undesirable effects either in early or advanced stages. Almost all the patients with pruritus (6 out of 7) improved with the treatment and the use of cholestyramine was reduced in all. PMID- 1768470 TI - [Intraoperative echography in the diagnosis of obstructive jaundice of undetermined cause]. AB - Intraoperative ultrasonography was performed in a consecutive series of 11 patients with obstructive jaundice. On two occasions, the examination modified the preoperative diagnosis, diagnosing liver metastasis in a patient with hydatid cysts and in another by detecting gallstones in the main biliary duct in which ERCP was suggestive of an ampullary tumor. Ultrasound made a definitive diagnosis of choledocholithiasis in one case, and pancreatic carcinoma in three cases all of which had a preoperative diagnosis of biliary obstruction of undetermined cause. The examination defined accurately the level of obstruction and the extent of a carcinoma of the bile ducts in two patients and it helped in obtaining cytological samples from a pancreatic tumor mass. Its use is recommended when the cause of biliary obstruction cannot be accurately diagnosed preoperatively. PMID- 1768471 TI - [Endoscopic choledochoduodenostomy in the treatment of impacted calculi in Vater's papilla]. AB - In a series of 204 patients with common duct stones, sphincterotomy was not possible in 10, due to an impacted stone in the papilla. An endoscopic choledocho duodenostomy was performed which was effective in all cases. One patient suffered a retroperitoneal perforation which was managed medically. This technique is an effective alternative to sphincterotomy in the treatment of impacted papillary stones. Retroperitoneal perforation is a major risk to be taken into account. PMID- 1768472 TI - [The treatment of primary biliary cirrhosis. Its current status]. PMID- 1768473 TI - [Kaposi's sarcoma located in the upper digestive tract. Apropos a case]. AB - A case of rectal and gastric location of Kaposi's sarcoma is reported. Although the typical location is cutaneous, gastrointestinal involvement of Kaposi's sarcoma is not an uncommon finding. Usually, it is detected when endoscopic, radiologic and autopsy studies are performed in patients with previous AIDS diagnosis. The patient we herein report ignored to be affected by the human immunodeficiency virus (HIV). He had not shown any sign or symptom for AIDS to be suspected. Presenting symptoms were weight loss, asthenia, loss of appetite, diarrhea and rectal bleeding. This case report underlines the importance of differential diagnosis with other rectal neoplasms that call for a totally different therapeutic approach. PMID- 1768474 TI - [An appendicular villous adenoma]. AB - Villous adenomas of the vermiform appendix are uncommon. Their malignant potential is unknown and their treatment is controversial. Because of a reported association between adenomas of the appendix and other gastrointestinal neoplasms, long-term surveillance is recommended. A new case of appendicular villous adenoma is reported. PMID- 1768475 TI - [Crohn's disease and amyloidosis. An association to be considered]. AB - Two instances of Crohn's disease and amyloidosis are presented. The time elapsed between the diagnosis of Crohn's disease and that of amyloidosis was 2 and 8 years respectively. The first case had hepatosplenomegaly and moderate proteinuria; the other one, severe proteinuria in the nephrotic syndrome range. One patient had ileocolic disease and the other disease limited to the terminal ileum. In both cases renal functional was normal. The diagnosis was made by liver biopsy in one patient and by repeated renal biopsy in the one with nephrotic syndrome. Ileocolic resection was undertaken in one patient without complications. Screening for amyloidosis is important in patients with Crohn's disease. PMID- 1768476 TI - [Mesenteric fibromatosis]. AB - We report a patient with mesenteric fibromatosis, a rare entity in our environment resulting in rectal stenosis which required resection and a Hartman operation. The features of this disease are reviewed. PMID- 1768478 TI - [The analysis of a basic legacy. Hippocrates and proctology]. PMID- 1768477 TI - [Adenoma of the gallbladder. Another cause of recurrent biliary colic]. AB - Here is presented the case of a young man with a biliary adenoma whose only symptoms were always those of biliary colics which were related to his diet. This case illustrates the mechanisms which play an important role in the obstruction of the cystic duct, and at the same time we will show the characteristics of this tumor and the investigative methods in its diagnosis. PMID- 1768479 TI - [Leiomyoblastoma. A tumor of disputed histogenesis]. PMID- 1768480 TI - [Emphysematous cholecystitis]. PMID- 1768481 TI - [Choleperitoneum following the removal of a Kehr tube]. PMID- 1768482 TI - [Hepatotoxicity due to erythromycin ethylsuccinate]. PMID- 1768483 TI - Myocardial mechanics and energetics revisited. PMID- 1768484 TI - Can our society afford mechanical hearts? AB - Congestive heart failure afflicts 4 million people in the United States, with 400,000 deaths annually. Very little can be done for individuals with this condition, which is increasing in prevalence. The only hope is the promise of intervention with permanent circulatory support systems. Can we as a society afford the $3.1 billion that would be required to support every patient needing such a system? This cost represents an increase of 1/2 of 1% of the $662 billion per year expended for medical care. Fortunately, circulatory support systems do not necessarily represent an expense, but rather an investment that has a reasonable payback period. An investment in an individual of $100,000 for the device and implantation cost, coupled with an ongoing maintenance cost of $4,000 per year, can return to society an income greater in value than the investment. The payback period is strongly dependent on the earning power of the individual, as well as the amount of medical attention or complications experienced. An individual with an annual salary of $40,000 per year becomes a positive financial force in our society and increases the gross national product (GNP) within 5 years. The same individual with extensive medical complications and intermittent loss of salary can extend the payback period by an additional 2 years. Circulatory support systems have the potential of increasing our GNP, leading to a higher standard of living for the populace. PMID- 1768485 TI - Use of umbilical vessels for neonatal ECMO cannulation: possibilities and precautions. AB - Extracorporeal membrane oxygenation (ECMO) is being employed with increasing frequency for the treatment of neonates with severe cardiac or respiratory failure. The risks related both to carotid artery and jugular vein ligation continue to cause concern. Use of umbilical vessels for vascular access in ECMO could eliminate many of these risks. The experience to date with this approach is summarized, along with case reports of three patients treated at our center in whom the umbilical vein was cannulated to augment venous drainage. One patient died of causes unrelated to umbilical vein cannulation. One had an uneventful ECMO course and is a normal survivor, and one developed a tension hemopericardium as a complication of the umbilical vein cannulation, but is a normal survivor. Potential risks and benefits of this approach are reviewed. PMID- 1768486 TI - Cost and reimbursement rates for investigational circulatory support. AB - The clinical evaluation of investigational circulatory support devices has, for the most part, been financed with private funds. St. Louis University initiated a system in 1986 to bill for investigational circulatory support devices and care related to their use. Charges for hospitalization and rates of reimbursement were reviewed in 32 patients who received Thoratec (Thoratec Laboratories Corp., Berkeley, CA [N = 26]), Novacor (Baxter Healthcare Corp., Oakland, CA [N = 4]), or Symbion (Symbion Inc., Tempe, AZ [N = 2]) total artificial heart devices. Duration of support ranged from 0.2 to 440 days (mean 32). Total charges ranged from $43,115 to $1,335,691 (mean $221,716). Charges for the devices and technical support relating directly to their use ranged from $10,305 to $96,030 (mean $28,246). The mean percentage of reimbursement (total charges/total paid) was 67%. Whereas it was uncertain in some patients whether or not the devices were paid for, commercial insurers are willing to reimburse at a high percentage for the total cost of care. PMID- 1768488 TI - Management of postcardiotomy cardiogenic shock with a new pulsatile ventricular assist device. Initial clinical results. AB - The authors began ventricular assist pumping as treatment for postcardiotomy cardiogenic shock in November 1988 with a new automated pulsatile support system, the ABIOMED BVS 5000 Bi-Ventricular Support System. Five patients (0.6% of total cardiac surgery patients) have been placed on support, four after coronary artery bypass grafting, and one after bypass grafting and mitral valve repair. All patients were refractory to pharmacologic and intraaortic balloon pump therapy. Three patients had left ventricular support and two had biventricular support. Four patients were successfully weaned, and three are long-term survivors. Duration of support ranged from 39 to 118 hours (mean, 89.4 hours). Resternotomy was performed in four patients: twice for hemostasis, once for tamponade, and once for inadequate left ventricular drainage. Three patients, two nonsurvivors and one survivor, had perioperative myocardial infarctions. No device related thromboembolic complications, hemolysis, or infection were experienced. Follow-up at more than 1 year demonstrated that all patients are in NYHA Class 1. Ventricular assist pumping with the ABIOMED BVS 5000 Bi-Ventricular Support System is an effective treatment for postcardiotomy cardiogenic shock. PMID- 1768487 TI - Electronic pacing of incapacitated head and neck structures. AB - Paralysis in the head and neck can affect any motor or mixed cranial nerves and the cervical roots. Most conspicuous deficits, however, involve the larynx and the face. The capacity for denervated striated muscle to undergo reinnervation, and the presence of remaining sources of information, have allowed coordinated rehabilitation of incapacitated cervical neuromuscular systems. The object of further related research should focus on the long-term efficacy of the reinnervated muscle machinery and the potential complexities of electronic integration. PMID- 1768489 TI - Extracorporeal membrane oxygenation as a means of stabilizing and transporting high risk neonates. AB - Term or near term newborns whose severity of cardiac or respiratory failure makes them candidates for extracorporeal membrane oxygenation (ECMO) are often too unstable to be safely transported to an ECMO-competent center. Faced with a large military and civilian referral population that is distributed across the entire continental United States, the authors have addressed this dilemma by developing a transportable ECMO system that can be taken to the referring hospital in a small transport aircraft. This system was on hand, but was not required, to stabilize and transport the infant in question in four cases. All had uneventful transports. Thirteen infants were placed on ECMO at their referring hospitals, one of whom died shortly after the institution of bypass. The remaining 12 infants were stabilized and transported successfully on ECMO over distances ranging from 17 to 1,437 miles, with 11 of these being long distance air transports. Four patients are long-term survivors. The authors conclude that a properly configured and managed ECMO system can effectively stabilize and transport even extremely ill neonates if the pertinent physiologic and aeromedical considerations are addressed. PMID- 1768491 TI - Comparison of pressure-volume-flow relationships in centrifugal and roller pump extracorporeal membrane oxygenation systems for neonates. AB - Theoretical advantages and risks exist for the use of both the centrifugal and roller pump systems in neonatal extracorporeal membrane oxygenation (ECMO). The authors studied the pressure-volume-flow relationships in clinically configured ECMO systems using these two pumps and a simulated patient to characterize differences in the circuit mechanics of the two systems, and thereby improve the design of subsequent clinical comparative trials of the pumps themselves. The relationship between flow and pressure generated across the pump was identical for the two systems. Within the range of clinically used flows, there was a direct relationship between pump revolution and flow with the roller pump, and between pump revolution and pressure generated for the centrifugal pump. Flow was limited in both systems by restrictions on negative pressure generating capacity. In the roller pump circuit, the venous reservoir (bladder box) assembly interrupted flow when negative pressure exceeded -20 mmHg; in the centrifugal pump system, forward flow stopped when negative pressure exceeded -100 mmHg. Volume had no detectable effect on the patient-pump inlet pressure gradient until critically low volumes were reached. At that point, removal of a few milliliters of volume led to large increases in the pressure gradient. The authors conclude that differences in pressure-volume-flow relationships between roller and centrifugal pump ECMO systems are due to the presence of the bladder box in the roller pump circuit. The advantages and disadvantages of the greater negative pressure in the centrifugal pump system require further study. PMID- 1768490 TI - Monitoring of factor XII activity and granulocyte elastase release during cardiopulmonary bypass. AB - Monitoring of the influence of cardiopulmonary bypass (CPB) on hematologic parameters is relevant to an improved understanding of the pathophysiology produced, as well as for the development of improved methods. The selection of suitable parameters is highly important. In this study, both contact phase activation and leukocyte response have been studied. Contact activation was determined by a novel assay for the measurement of Factor XII activity (FXIIA), and leukocyte response was measured by the release of granulocyte elastase. Five patients undergoing elective coronary artery surgery using a bubble oxygenator and pulsatile perfusion were studied. A notable feature of this study was the gradual increase of FXIIA during the study period, with granulocyte elastase levels following a similar pattern. Both FXIIA and granulocyte elastase are appropriate parameters for monitoring CPB, and could be useful in studying alternative bypass procedures and antithrombotic agents. PMID- 1768492 TI - Long-term extracorporeal blood bypass in dogs at low flows without systemic heparinization. Heparin-coated versus uncoated circuits. AB - A blind, randomized study of the effects of a heparin-coated bypass circuit on thromboembolus formation and hematologic and hemostatic parameters was carried out on 12 dogs. The dogs were anesthetized and bypassed for 24 hours using a centrifugal pump circuit with a mean flow of 475 ml/minute. Six of the dogs were bypassed with a heparin coated circuit and six with an uncoated circuit. No systemic heparin was administered to any of the dogs at any time during the procedure. Both the coated and uncoated circuits remained patent at low flows. Thrombus formation, however, primarily around the pump axis, was observed in both groups. Four of the dogs (two from either group) had no evidence of lung emboli. The remaining eight dogs all showed pulmonary emboli. Thromboemboli did not lead to clinical complications or hemodynamic disturbances. Hematologic and hemostatic parameters showed a reduction in hemoglobin, erythrocytes, thrombocytes, leukocytes, and antithrombin III, which was most pronounced in the uncoated group. This study showed that a low flow bypass circuit remains patent for 24 hours whether or not the circuit is coated with heparin. Although the heparin coating limits the reduction in antithrombin III and blood elements, it does not eliminate the risk of thromboembolus formation. PMID- 1768493 TI - Extracorporeal circulation in sheep with normal bleeding time using a surface heparinized circuit. AB - Bleeding due to systemic heparinization represents the major side effect of extracorporeal respiratory support. In the present animal study, a surface heparinized system (Carmeda Biological Active Surface) was applied to assess the feasibility of prolonged perfusion at low circulating heparin levels. Eight sheep divided into two groups: group A (5 animals) and group B (3 animals) underwent venovenous bypass using a heparin coated surface circuit. The following protocol was used: a) 24 hours at high heparin dose (30 to 100 U/kg/hr with an ACT [activated coagulation time] three to four times normal); b) 24 hours at low heparin dose (3 to 8 U/kg/hr with an ACT within the normal range); c) 24 hours at high heparin dose. Group B animals also received fresh frozen sheep plasma (14 ml/kg/day). During Period b, the clotting times were within baseline range. The bleeding time showed a dramatic decrease after change from a to b (27.9 +/- 3 minutes vs. 10.2 +/- 5.6 minutes). There was a negative relationship between antithrombin III (AT III) and thrombin coagulase time (TC); the latter is considered to be an aspecific indicator of circulating fibrin(ogen) degradation products. Maintaining AT III over 70%, TC changes were only minor. The use of the bioactive heparin surface allowed the performance of a 24 hour bypass, with normal coagulation times, at low circulating heparin levels. PMID- 1768494 TI - Illness in hemodialysis patients after exposure to chloramine contaminated dialysate. AB - In September 1987, patients at an outpatient dialysis center were exposed to chloramine contaminated dialysate when the carbon filter in a recently modified water treatment system failed. Forty-one patients required transfusion to treat the resultant hemolytic anemia. Epidemiologic investigation demonstrated that the mortality rate among dialysis center patients increased during the 5 months after chloramine exposure when compared with the 12 months before chloramine exposure, but no deaths could be attributed to the exposure. Chloramine is commonly used as a disinfectant in municipal water supplies, and has previously been reported to cause hemolytic anemia in patients undergoing dialysis. Hemodialysis centers in cities that use chloramine in water supplies must design water treatment systems with adequate means for removing chloramine and must monitor processed water closely to ensure that chloramine contamination does not occur. Dialysis centers that make changes in their water processing systems should evaluate all components of the system before changes are made, and must ensure that after modifications are made, processed water meets the standards set by the Association for Advancement of Medical Instrumentation. PMID- 1768495 TI - In vitro flow characteristics of a new pump with a high inherent sensitivity to venous return. AB - A new type of pump, the differential displacement pump, has recently been developed. The new pump and a conventional pneumatic displacement pump were evaluated with respect to pump flow, filling pressures, stroke frequency, and inflow pattern under equivalent test conditions. The pumps were connected via inlet and outlet cannulas to a Donovan hydraulic circulation analogue. The differential displacement pump showed a high sensitivity to filling pressure in the range of 2.3-9.6 L/min/mmHg, and a high efficiency as long as the stroke volume was submaximal. The inflow was continuous and pulsatile with a maximal forward flow velocity during systole as long as the maximal stroke volume was not employed. In contrast, the conventional displacement pump showed low sensitivity to filling pressures, a discontinuous inflow, with a maximal inlet cannula forward flow during diastole and a substantial flow reversal during systole. These results indicate that the differential displacement pump is a better concept with respect to sensitivity to venous return, and that it provides an inflow pattern and regulation of pump flow similar to that of the biologic heart. PMID- 1768496 TI - The influence of dialysis treatment modality on the decline of remaining renal function. AB - A retrospective investigation was undertaken in which the rate of decline of residual renal function (RRF), estimated from creatinine clearance, was compared in 55 continuous ambulatory peritoneal dialysis (CAPD) and 57 hemodialysis (HD) patients for whom a minimum of four (mean of 7.6) well-spaced historic measurements of residual clearance were available. Because of the intrinsic variability that attends such data, specialized nonlinear, growth curve statistical methods were employed. Residual function was found to decline exponentially after the onset of therapy in both cohorts. The rate of decline in the HD group was twice that of the CAPD group (5.8% +/- 0.4% per month for HD vs 2.9% +/- 0.3% per month for CAPD; difference significant at p less than 0.0001). This difference remained highly significant (p less than 0.01) when corrected for other potential risk factors such as age, gender, hypertensive status, and use of angiotensin converting enzyme inhibitors in patients with diabetic or other forms of glomerular nephropathy. Differences between cohorts were not significant for patients with other diagnoses (p greater than 0.1) although the size of some of these subsets was very small. The physiologic mechanism for the more rapid fall off of RRF on HD remains speculative, but could be related to renal ischemia secondary to intratreatment hypovolemia and/or to nephrotoxic effects of the inflammatory mediators of extracorporeal circulation. PMID- 1768497 TI - Continuous pH and HCO3 monitoring during hemodiafiltration without blood sampling. AB - The correction of acid-base balance during hemodialysis, especially in high efficiency techniques, could present some problem related to the lack of an adequate monitoring of pH and blood gases. During hemodiafiltration (HDF), performed with the two-chamber technique (paired filtration dialysis, PFD), the ultrafiltrate (Uf) is continuously available, unmixed with the dialysate. Connecting a pH electrode (as Ag/C1Ag) to the Uf circuit, the authors made 40 determinations on 16 different PFD patients, and they correlated the Uf values obtained with those measured on arterial blood with standard methods. The one sample analysis gave a t = 10.145 (p = 0.0), and the linear regression analysis an r = 0.931 (p = 0.0). At 30 min, in 8 PFD patients, the HCO3 values obtained from Uf, pH and transcutaneous PCO2, gave a t = 6.37 (p = 0.0004), and an r = 0.939 (p = 0.00052). In conclusion, during HDF performed with PFD, continuous pH monitoring of the patient is possible without blood sampling. Moreover, correlation with the transcutaneous PCO2 measurement could provide HCO3 values in real time. PMID- 1768498 TI - Three-dimensional interface geometry of the human heart with the artificial heart. AB - The interface geometry of human and artificial hearts was defined. It included: 1) the approximate mitral orifice and mitral orifice planes; 2) the approximate tricuspid orifice and tricuspid orifice planes; 3) the long and short diameters of the aorta; 4) the long and short diameters of the pulmonary artery; and 5) the angles between the mitral orifice and tricuspid orifice planes, as well as the axes of the aorta and pulmonary artery. The orifice plane was defined as a plane such that the sum of the squared distances between the plane and points on the orifice contour was minimized. A standard coordinate system was also defined, whose origin was the centroid of the approximate mitral orifice. Its X-Y plane was the approximate mitral orifice plane. One set of interface parameters was determined using magnetic resonance images of a volunteer's heart. The angle between the approximate mitral orifice plane and tricuspid plane was found to be 19.9 degrees. The areas of the approximate mitral and tricuspid orifices were 1020 and 1655 mm2, respectively. The approximate mitral orifice was covered by a 44 x 40 mm rectangle and the approximate tricuspid orifice was covered by a 59 x 41 mm rectangle. This interface geometry is important, not only in the manufacture of artificial hearts of precise dimensions, but also in avoiding complications due to their long-term use. PMID- 1768500 TI - Biofilm formation on peritoneal catheters does not require the presence of infection. AB - The presence of biofilm is thought to accompany infection or colonization of chronic peritoneal dialysis (PD) catheters, and to be an important pathogenetic factor in the recurrence or persistence of peritonitis. In the current study, the characteristics of identifiable biofilm associated with the PD catheter were studied using scanning and transmission electron microscopy in six consecutive cases requiring catheter removal for a variety of indications. Biofilm characteristics in each case were rated in blinded fashion by three independent observers, and findings were then correlated with the clinical histories and microbiologic findings. Surprisingly, two of the three cases with the most severe biofilm formation occurred in patients with no history or microbiologic findings of recent infection, and the positive findings of leukocytes, macrophages, fibrillar matrix, and other structures on these catheters did not correlate with detectable infection. In addition, extracellular spherical lipoid structures and intracellular lipoid vacuoles in mesothelial-like cells were prominent in four of six cases, did not correspond to the presence of infection, and suggested possible mesothelialization of the catheter. The findings of this study do not necessarily controvert the microbial origin of some components of the biofilm, or the possible role of biofilm in some cases of persisting peritoneal infection. However, it is clear that many important components of the biofilm arise, not from microorganisms, but rather from host origin in the absence of detectable infection. Moreover, such "endogenous" biofilm production can result in extensive accumulation of catheter-associated matrix. PMID- 1768499 TI - Renal allograft outcome in the cyclosporine era: comparison between intermediate term failure and long-term survival. AB - A single center experience of 160 cyclosporine-treated renal allografts that survived longer than 1 year was reviewed in an attempt to analyze the contribution of selected parameters to long-term survival. Sixty-one grafts were lost between 1 and 5 years, with the remaining functioning for longer than 5 years. Parameters with a significant influence on long-term survival included both quality of early graft function, with 13% of long-term survivors having delayed function, compared to 52% among the short-term survival group, and the incidence of acute rejection in the first year posttransplant (31% in long-term survivors compared to 63% in the short-term survival group). A marker for long term survival (greater than 5 years) was a lower serum creatinine at 1 year (1.9 +/- 0.1 mg/dl, compared with 2.6 +/- 0.2 mg/dl in the short-term survival group). Recipient race, original renal disease, number of transplants and/or transfusions, panel reactive antibodies, and human leukocyte antigens matching did not appear to influence long-term outcome. PMID- 1768501 TI - Skeletal surveys in renal osteodystrophy. AB - The authors reviewed the clinical usefulness of routine comprehensive skeletal surveys in monitoring renal osteodystrophy in 66 patients on chronic maintenance hemodialysis. Only fourteen (22%) of the 66 patients had roentgenographic evidence of hyperparathyroid bone disease. There were no significant differences in serum calcium, phosphate, or aluminum levels between patients with and without evidence of phalangeal subperiosteal bone resorption in the hands. However, serum levels of parathyroid hormone (PTH) (both intact and mid-molecule) and alkaline phosphatase values were significantly higher in the group with subperiosteal bone resorption (p less than 0.01 and p less than 0.02, respectively). Serum intact PTH correlated with alkaline phosphatase better than the mid-molecule assay. Neither intact nor mid-molecule PTH values correlated with serum calcium, phosphate, or aluminum. Hand roentgenograms were most sensitive in detecting early changes of hyperparathyroidism; symphysis pubis was the next best. Other skeletal roentgenographic findings were less revealing, and in a subset of 20 patients, roentgenograms correlated poorly with bone histology. During this study the authors found an 8% prevalence of vertebral compression fractures; all in postmenopausal white women. PMID- 1768502 TI - Hand gangrene in diabetic patients on chronic dialysis. AB - To determine whether any potentially reversible variables are related to the development of hand gangrene in diabetic patients on dialysis, the authors compared 15 patients with hand gangrene (group A) to three control groups of diabetics on dialysis: 20 patients with foot gangrene (group B); 31 patients without gangrene of the extremities (group C); and 20 patients without hand arterial calcifications (group D). All patients in groups A-C had medial arterial calcifications of the hands. Group A patients started dialysis at an earlier age (p less than 0.05), were treated for end-stage renal disease (ESRD) for a longer time period (p less than 0.05), and had a lower mean serum albumin concentration during the dialysis period (p less than 0.05) than the patients in the control groups. Hand gangrene also appeared to be associated with the presence of a functioning arterio-venous fistula in the extremity with the gangrene, with loss of function of renal transplant, and with hyperaluminemia. Other variables, including serum parathormone, were not different for the four groups. Logistic regression showed that the following were risk factors for hand gangrene: hypoalbuminemia, long duration of ESRD treatment, hyperphosphatemia, high insulin dose, hypercholesterolemia, and hypoglycemia. In diabetics on dialysis, gangrene develops in hands with medial arterial calcifications, but does not correlate with measures of calcium or phosphorous metabolism. Predictors of hand gangrene include certain potentially reversible clinical and biochemical variables. PMID- 1768504 TI - Comparison of 50% dextrose water, 25% mannitol, and 23.5% saline for the treatment of hemodialysis-associated muscle cramps. AB - Hypertonic solutions of dextrose (D), mannitol (M), and saline (S) are effective treatments for hemodialysis-associated muscle cramps, but have not been directly compared to one another. Concern exists that postdialysis retention of M and S may lead to increased thirst, interdialytic weight pain (IDWG), and elevated blood pressure. The authors performed a prospective, randomized, double-blind crossover study to compare the efficacy of D, M, and S in 24 chronic hemodialysis patients. Cramps were treated with 50 ml (126 mOsm) D, 100 ml (138 mOsm) M, and 16 ml (126 mOsm) S. All patients were assigned to each regimen for a 2 week period. For the entire patient group (n = 24), mean cramp duration (+/- SD) was less for M compared to D (9 +/- 5 vs 13 +/- 12 min, p less than 0.05), but not to S (10 +/- 6, p = NS) although not every patient had a cramp episode during each 2 week period of study. In a subgroup of 11 patients with a mean of 3.7 (range 1-6) cramps during each 2 week period, the efficacy of D, M, and S was similar. In both patient groups, IDWG, blood pressure control, and the frequency of adverse effects was similar with the use of all three agents. Mild postdialysis hyperglycemia and hypernatremia during D and S, respectively, were the only significant laboratory abnormalities. The authors conclude: 1) the safety and efficacy of D, M, and S are equivalent, and 2) the nonmetabolized osmotic agents M and S do not lead to increased IDWG or decreased blood pressure control. PMID- 1768503 TI - Effect of nafamostat mesilate on bradykinin generation during low-density lipoprotein apheresis using a dextran sulfate cellulose column. AB - The dextran sulfate (DS) cellulose column usually used for low-density lipoprotein (LDL) apheresis, is an activator of the contact phase of intrinsic coagulation pathway. Hageman factor (factor XII), high-molecular-weight kininogen (HMWK) and prekallikrein (PK) form a complex on the surface of this activator, and bradykinin is released from HMWK by the action of kallikrein converted from PK. Heparin, a frequently used anticoagulant, has no effect on this process, whereas a protease inhibitor, nafamostat mesilate (FUT-175) is thought to inhibit the process. Five patients with severe hypercholesterolemia were treated with LDL apheresis using heparin or FUT-175, each on a different day. During treatment with heparin, factor XII, HMWK, and PK were markedly decreased by passing through the DS column. A distinct generation of bradykinin was observed by passing through the DS column, which led to an increase of blood bradykinin levels from 12.5 +/- 5.3(Mean +/- SEM) pg/ml to 127.3 +/- 67.1 pg/ml after 1000 ml plasma treatment. FUT-175 almost completely suppressed this bradykinin generation. Because bradykinin generated during LDL apheresis seems to have some vasodilative effect, FUT-175 might be preferred in cases with unstable hemodynamics, although this presumption remains to be demonstrated. PMID- 1768505 TI - Reuse of "highly permeable" dialyzers with peroxyacetic acid as sole cleansing and disinfecting agent. AB - In the past few years, dialyzer reuse has gained increased clinical acceptance. This has been due both to the availability of automated reconditioning machines and powerful chemical cleaning and disinfecting agents. In this study the authors evaluated the effectiveness of a newly available peroxyacetic acid solution (PAS) (Dialox) as the dual cleaning and disinfecting agent in the reuse of highly permeable dialyzers. An in vivo study was conducted with ten patients already involved in our center's reuse program using the Renatron reprocessing machine and PAS at various dilutions. One hundred forty dialyzers of three different brands and membrane types (HF80 used for hemodiafiltration [HDF], Filtral 16 used for hemodialysis [HD], and FH88 used for hemofiltration [HF]) were employed for a total of 1182 treatments, giving an average 8.4 uses per module. Significantly more uses were obtained with the HF80 and Filtral 16 dialyzers (9.7 and 9.4, respectively) than for the FH88 modules used by the HF patients (6.7 uses per module). Compromised cleaning by backfiltration due to the lack of a second dialysate port on the FH88 may be a possible explanation. Greater membrane plugging due to higher ultrafiltration rates in HF may be another factor. Patient variability was found to be another factor in dialyzer reuse. The cleaning effectiveness of various dilutions of PAS was also tested in this study. The number of uses achieved was not found to vary significantly with PAS strength; however, a greater frequency of second or third reprocessing was required with more dilute cleaning solution. The authors found the dilution achieved on the Renatron reprocessing machine using the currently marketed PAS concentrate to be the most cost effective. PMID- 1768506 TI - Influence of centrifugal blood pumps on the elasticity of erythrocytes. AB - The influence of centrifugal blood pumps on the elasticity of erythrocytes was tested in an in vitro set-up. Fresh bovine blood was pumped by vaneless and impeller blood pumps with low and high hemolytic potential (1L priming volume, flow 5 L/min versus 150 mmHg, pumping time 6 hours). The elasticity of the red blood cells was measured by laser diffraction. Starting with an elasticity of 238 +/- 39, the overall change during 6 hours was 12 +/- 38 compared to a change of the control value of -13 +/- -58. Even a pump with very high hemolytic potential (Hemolysis index 21.9) did not cause relevant changes of elasticity. It is concluded that 1) elasticity is not a useful parameter to use in the evaluation of centrifugal pumps, and 2) the mechanical trauma caused by centrifugal pumps produces no relevant permanent alteration of the elastic properties of red blood cells, at least under in-vitro conditions. PMID- 1768507 TI - Causes of intraaortic balloon leaks. PMID- 1768508 TI - Poswillo--the beginning of the end? PMID- 1768509 TI - General anaesthesia, sedation and resuscitation in dentistry. AB - In the eyes of the public there is a traditional link between general anaesthesia and dental practice. After 150 years' experience the link may be broken by Government's acceptance of the Poswillo Report and its major recommendations. PMID- 1768510 TI - 'Maxillofacial surgery should become a specialty of medicine'. PMID- 1768511 TI - 'Cancelled operations. A current problem in oral and maxillofacial'. PMID- 1768512 TI - An unusual dentition from medieval Canterbury. PMID- 1768513 TI - Finger-mounted tooth cleaning aids. PMID- 1768514 TI - 'HIV transmission via blood and saliva splashes to the face'. PMID- 1768515 TI - AIDS and the dental environment. PMID- 1768516 TI - Waiting for operations. PMID- 1768517 TI - 'A cautionary tale of toothbrushing'. PMID- 1768518 TI - 'The frequency of dental attendance of Scottish dentate adults between 1978 and 1988'. PMID- 1768519 TI - What is not unexpected? PMID- 1768520 TI - Is digit sucking of significance? AB - A brief review of the literature of digit sucking is followed by the report of a study of 68 treated Class II division 1 malocclusions, designed to attempt to clarify the significance of digit sucking in their aetiology. Case histories of two of the patients from the study are briefly discussed to illustrate the range of changes seen. PMID- 1768522 TI - Epithelioid angiomatosis affecting the oral cavity as a first sign of HIV infection. AB - Oral lesions are frequently the first manifestation of HIV infection and accurate diagnosis may be important in determining the management of individual patients. Lesions may be relatively common but non-specific, such as candidosis, or may be indicative of AIDS, such as Kaposi's sarcoma. Epithelioid angiomatosis is a recently described vascular lesion which may be clinically and histologically similar to Kaposi's sarcoma, but which is infective in origin. Usually it is a manifestation of AIDS and presents as multiple cutaneous lesions but has rarely been reported in the mouth. In this report a patient presented with lesions of epithelioid angiomatosis which were confined to the oral mucosa and which were associated with HIV infection, but not with AIDS. Differentiation from Kaposi's sarcoma is important, since epithelioid angiomatosis may be treated with antibiotics and a mistaken diagnosis of Kaposi's sarcoma may wrongly categorise an individual as having AIDS. PMID- 1768521 TI - Changes in the Community Periodontal Index of Treatment Needs (CPITN) after periodontal treatment in a general dental practice. AB - The result of a study of the effectiveness of treatment of chronic periodontal disease in a general dental practice using CPITN and the time required to treat patients with differing CPITN scores indicated that although there were significant reductions in calculus and shallow pockets, the treatment did not eliminate positive CPITN scores; 41% scored 1, 24% scored 2, and 34% scored 3 or 4 after treatment. Very few patients had 'healthy' periodontal sextants at the first visit; the most frequent CPITN category was 3. Patients in this category took up most of the treatment time. The treatment times per patient were much lower than the estimates of the World Health Organisation for similar treatments. PMID- 1768523 TI - Dental restorations and artificial teeth in a Georgian population. AB - In the recent exhumation of a predominantly Georgian population at Christ Church, Spitalfields, 12 skulls showed evidence of dental restorations or artificial teeth. These have been described in some detail and the findings discussed in the light of current knowledge about practical dentistry in England up to the year 1852. PMID- 1768524 TI - Anguilla: tranquility wrapped in blue. AB - Anguilla is the most northerly of the Leeward Islands, situated at 63.05 W, 18.12 N for those of my colleagues still able to afford a boat with transatlantic capability after the new contract, and wishing to visit. Sixteen miles long and three and a half miles wide at its widest point, Anguilla is an independent British Crown Colony, and home to around 7000 citizens, mainly of African descent and some of Irish descent. It is an uncrowded, easy-to-explore island with a spinal road running the length of the island, and 'natural' roads leading to the beaches and some villages. There are 12 miles of beaches where white sand (VMK A1) meets crystal clear, turquoise blue water, at a comfortable 75 degrees F. Is this the answer to 'Ski with occlusion', the ultimate postgraduate course venue? Probably, until another dentist from deep in the Pacific writes in to the Journal with a view from his/her surgery. PMID- 1768525 TI - [Accidents involving bicycles: pattern of injuries and costs in relation to type of vehicle]. AB - This review comprises all 641 patients subjected to inpatient treatment in 1976, 1980 and 1984 at the Basel university hospital after accidents involving bicycles or motorcycles. A study of the case histories--supplemented by 'phone conversations--yielded the following results: Accidents involving bicycles or motordriven bicycles were seen in all age groups, but motorcycle accidents occurred exclusively among the younger generation. Whereas motorcycle accidents mostly happened during joyrides, accidents with bicycles or mobikes mainly occurred on the way to work. The incidence rate was highest during summertime and in the rush hours at noon or in the evening. Motorcycle accidents resulted in more severe injuries, longer hospitalisation, longer periods of disability and higher costs than bicycle or mobike accidents the latter being mainly characterised by mostly slight head injuries and the former by injuries of the legs and arms. PMID- 1768526 TI - [Multiplicity of accident insurance in Switzerland: a challenge for the physician]. PMID- 1768527 TI - [Private accident insurance in Switzerland with reference to liability insurance as a part of social security]. AB - On the Swiss market there exist various different accident insurance schemes and systems. Private accident insurance which is offered by the private insurers, date back to the middle of the 19th century. Since 1912 accident insurance is compulsory for all employees working in particularly dangerous industries, since 1984 it covers all employees in the country. In Switzerland there exists no general compulsory accident insurance. To perform as insurance carriers are qualified: private insurance companies, the Swiss Accident Insurance Company, and a number of the social health (sickness) insurers. Depending on the insurance system there are different approaches to renumerate the health costs. In the various social insurance systems the patient is rather free to chose his doctor and hospital (among those who have a contract with the insurer); in private insurance he is completely free. Yet the billing systems and the applicable rates and tarifs differ considerably. There are trends to simplify these systems and bring them more into mutual accordance. Due to the important rise of the health costs in Switzerland, there exists the danger that possible simplifications will bring about more public influence yet less private initiative and less incentives to really control costs without lessening the patients' possibilities. PMID- 1768528 TI - [Statutory accident insurance--obligatory social accident insurance in Switzerland]. AB - According to the new Accident Insurance Law, in Switzerland it is mandatory for all employees to be insured against accidents and occupational diseases. The legal bases, organization and implementation of this mandatory social accident insurance are described. Discussed in particular are the specific Swiss features, such as the inclusion of non-occupational accidents (leisure-time accidents), and special medical aspects in the assessment of incapacity, injury and occupational diseases. PMID- 1768529 TI - [Biomechanical aspects of collisions in street traffic]. AB - Injuries are still severe on average at Delta-v-values as low as 50 km/h with belted occupants and as low as 30 km/h with struck pedestrians. Therefore, all technical developments improving safety should not blind us to the fact that lowering vehicle speed remains the first priority in injury prevention. Small light weight cars of low energy consumption (e.g. electromobiles) constitute a major occupant safety problem unless advanced safety engineering will be applied. The extensive improvements over the last decades, both in active and passive safety, including newly developed steering systems, anti-blocking brake systems, seat belts, head restraints, etc. however have masked drivers sense and peception of danger. In research and development of sophisticated electronic warning and controlling systems, designed to help in driving, possible secondary effects of risk homoeostasis or compensation of risk reduction have to be taken into account at an early stage. Psychological and ergonomical knowledge has to complement the purely technical and biomechanical approach. PMID- 1768530 TI - [Analysis of health care needs and evaluation five years after severe brain injuries]. AB - Five years after severe head injury with persistent and extensive deficits of brain functions and loss of working capacity, an assessment and analysis of demand was performed with 31 patients and their relatives. The main impairments consist in the severe changes of personality and in cognitive deficits; they contrast with the spare physical handicaps. A main demand of the relatives are local family groups which are still lacking in many parts of the country. PMID- 1768531 TI - [Outcome prognosis in severe craniocerebral trauma: important predictors in the early phase]. AB - An early prognosis may influence the management of severely head-injured patients. Clinical aspects (age, Glasgow Coma Score, pupil reaction) and neuroradiological findings (basal cysternes, midline shift) are the most important facts for prognosis; evoked potentials, stress parameters and the quality of resuscitation also correlate with definitive outcome. Despite a clear correlation between these single factors and outcome, prognosis during the first 48 hours remains too uncertain to justify an influence on initial management. PMID- 1768532 TI - Hydrolysis of substrate analogues catalysed by beta-D-glucosidase from Aspergillus niger. Part II: Deoxy and deoxyhalo derivatives of cellobiose. AB - The hydrolysis of sixteen mainly deoxy and deoxyhalo derivatives of celloboise catalysed by beta-D-glucosidase from Aspergillus niger has been studied by means of 1H NMR spectroscopy and progress-curve enzyme kinetics in both single substrate and competition experiments. In the non-reducing ring of cellobiose it was found that the hydroxy groups at positions 2', 3', and 4' are essential for the enzymatic hydrolysis. The primary hydroxy group on 6' in this ring is, although important for the hydrolysis, not essential. The analogues modified at positions 3' and 4' and the 6'-bromo-6'-deoxy derivative were not inhibitors, whereas the 2'-deoxy derivative inhibited the enzymatic hydrolysis of methyl beta cellobioside to some extent. Of the analogues modified in the reducing ring, some were hydrolysed faster (e.g. the deoxy compounds) and some slower than methyl beta-cellobioside in single-substrate experiments, but all derivatives were hydrolysed at a lower rate than this reference substrate in direct competition and displayed relatively weak inhibitory effects. The results are interpreted qualitatively with respect to changes in the free binding energies of the substrates and catalytic transition states based on the Michaelis-Menten mechanism, and some mechanistic implications of these findings are discussed. PMID- 1768533 TI - Solid-phase synthesis and spectroscopic studies of TRH analogues incorporating cis- and trans-4-hydroxy-L-proline. AB - An efficient solid-phase synthesis of the TRH analogue Glp-His(Nim-Trt)-Hyp-OH is described. Na-Fmoc protected amino acids and DCC/HOBt activation were employed. The bulky and mild-acid-sensitive 2-chlorotrityl resin, utilised as the solid support, completely suppressed dioxopiperazine formation. The tripeptide is a key intermediate in the synthesis of TRH analogues incorporating cis- and trans-4 hydroxy-L-proline. The tripeptide was converted, with inversion of configuration at C-4 of the Hyp residue, to Glp-His(Nim-Trt)-cHyp lactone in the presence of triphenylphosphine-diethyl azodicarboxylate (TPP-DEAD). One-pot MeOH-TPP-DEAD transesterification of the lactone, followed by Nim-detritylation, provided Glp His-cHyp-OMe. This ester gave the corresponding amide and acid on ammonolysis and saponification, respectively. A high-field 1H NMR investigation of Glp-His-cHyp OH and its diastereomer Glp-His-Hyp-OH, obtained by Nim-detritylation of the key tripeptide, showed that the configuration at C-4 of the prolyl residues is critical for the determination of the preferred three-dimensional structure of the molecules. PMID- 1768534 TI - Multicomponent polyanions. 45. A multinuclear NMR study of vanadate(V)-oxalate complexes in aqueous solution. AB - The two complexes formed in the aqueous vanadooxalate system, V(Ox)- and V(Ox)2(3 ), have been characterized using 51V, 13C and 17O NMR. For the V(Ox)2(3-) complex, two peaks are observed in 13C NMR and four in 17O NMR. This leads to the conclusion that each oxalate ligand has two different distances to the VO2 group. This fact, together with the peak integrals and the chemical shifts, indicates strongly that the hexacoordinate complex [VO2(C2O4)2]3- found in single-crystal X ray structure determinations persists in aqueous solution. The dependence of the 13C NMR linewidths upon temperature reveals two types of dynamic processes: (1) a rearrangement in which the two different V-Oox switch places and (2) an exchange of the oxalate ligands in the [VO2(C2O4)2]3- complex with free oxalate, probably through a dissociative process. Rate constants and activation parameters for the two dynamic processes involving [VO2(C2O4)2]3- have been calculated from the shape of the 13C NMR signals. For the V(Ox)- complex, only one relatively narrow peak is obtained in 13C NMR and three peaks in 17O. This fact, as well as the relative positions of these peaks, is in accordance with a pentacoordinate complex [VO2(C2O4)H2O]-, where the two V-O distances to the oxalate ligand are equal. We also show that, in the pH range 0.8-6.6, there is no protonation of the studied complexes, in agreement with previous potentiometric results. PMID- 1768535 TI - Assessment of the placental circulation. PMID- 1768536 TI - Headache after spinal anaesthesia. PMID- 1768537 TI - Effects of extradural bupivacaine with adrenaline for caesarean section on uteroplacental and fetal circulation. AB - We have studied the effects of an extradural block using bupivacaine with adrenaline 90-100 micrograms on blood flow in the maternal uterine and placental arcuate arteries and the fetal umbilical, renal and middle cerebral arteries, using a colour Doppler technique in eight healthy parturients undergoing elective Caesarean section. Fetal myocardial function was investigated simultaneously by M mode echocardiography. Maternal heart rate increased and diastolic arterial pressure decreased after extradural administration of bupivacaine with adrenaline. The latter effect was relieved by increasing the infusion rate in every case and none of the patients required vasopressors. There were no significant differences in maternal or fetal blood velocity waveforms, and no significant changes were found in any of the fetal myocardial measurements relative to control values. These observations suggest that extradural anaesthesia using bupivacaine with adrenaline does not have an adverse effect on vascular resistance in the uteroplacental or fetal circulations or on fetal myocardial function in normal pregnancy when bupivacaine-adrenaline is administered fractionally and maternal hypotension is prevented by rapid crystalloid volume loading. PMID- 1768538 TI - Effect of adrenaline on extradural anaesthesia, plasma lignocaine concentrations and the feto-placental unit during elective caesarean section. AB - Extradural anaesthesia was induced with either 2% lignocaine or 2% lignocaine with adrenaline 1:200,000 in 20 patients undergoing elective Caesarean section. With the adrenaline-containing solution, a smaller dose of lignocaine was required to produce an adequate block and the lignocaine concentrations in both mother and neonate were significantly smaller compared with the plain solution. Arterial pressures were less in the adrenaline group, but there was no difference in umbilical flow velocity waveform, fetal heart rate or fetal outcome. Neither feto-placental circulation nor fetal outcome were affected adversely by episodes of hypotension or the ephedrine used for treatment. PMID- 1768539 TI - Effect of i.v. low-dose adrenaline and phenylephrine infusions on plasma concentrations of bupivacaine after lumbar extradural anaesthesia in elderly patients. AB - Thirty patients undergoing primary total hip replacement under lumbar extradural anaesthesia with 0.75% bupivacaine 25 ml were allocated randomly to receive either low-dose adrenaline or phenylephrine infusions i.v. throughout surgery. Haemodynamic measurements and arterial blood samples were obtained before the extradural injection and at 10, 20, 30, 40, 50, 60 and 90 min thereafter. Peak arterial plasma concentrations of bupivacaine were observed 10 min after extradural anaesthesia and were significantly lower in patients receiving adrenaline infusions. Cardiac output was significantly greater in patients receiving adrenaline infusions (P less than 0.01). It is postulated that the smaller circulating concentrations of bupivacaine observed in patients receiving adrenaline were caused by increased cardiac output and a greater volume of distribution than in patients receiving phenylephrine. PMID- 1768540 TI - Patterns of oxygenation after thoracotomy. AB - We have studied patterns of oxygen saturation (SpO2) before and after thoracotomy in 20 patients monitored nightly from the preoperative night to the fourth postoperative night. After operation, 10 patients received paravertebral bupivacaine (PVB) infusion and 10 received paravertebral saline (PVS) infusion. Papaveretum was given as required. Before operation the SpO2 profiles formed two groups: stable with SpO2 greater than 94% and stable with a median SpO2 less than 94% (hypoxaemia). During the first night after operation SpO2 profiles formed four groups: stable, not hypoxaemic (2/20); stable, hypoxaemic but improving (8/20); stable and constant hypoxaemia (5/20); unstable, hypoxaemic and deteriorating (5/20). Eleven patients remained hypoxaemic as late as the fourth night after operation. All patients who were hypoxaemic before operation were hypoxaemic after operation. Postoperative hypoxaemia was predicted in only 50% of cases. Papaveretum requirement was reduced in the PVB group, but regional analgesia did not affect the proportion of patients showing each SpO2 profile. Papaveretum caused a decrease in SpO2 in both analgesic groups. PMID- 1768541 TI - Screening for antibodies associated with halothane hepatitis. AB - The diagnosis of halothane hepatitis (HH) may be assisted by detection of antibodies reacting to trifluoroacetylated proteins (anti-TFA antibodies). An enzyme-linked immunosorbent assay (ELISA) utilizing trifluoroacetylated rabbit serum albumin (TFA-RSA) as antigen detected anti-TFA antibodies in 67% of sera from patients for whom a clinical diagnosis of HH was made. Anti-TFA antibodies were detected in 33% of sera when using an ELISA with liver microsomal protein from halothane-treated rabbits as antigen. Absorption of the sera with untreated rabbit liver microsomal protein before using the microsomal protein ELISA resulted in detection of anti-TFA antibodies in 42% of sera. Using the presumptive hapten N-epsilon-trifluoroacetyl-1-lysine to block antibody binding in an ELISA resulted in positive detection in 50% of sera: the results did not always agree with the other ELISA methods. The TFA-RSA ELISA was the most sensitive method and, combined with the TFA-lysine blocking ELISA, resulted in 92% of sera from HH patients testing positive for HH-associated antibodies. PMID- 1768542 TI - Protein metabolism after abdominal surgery: effect of 24-h extradural block with local anaesthetic. AB - We have studied the effect of intraoperative and postoperative (24 h) extradural block with local anaesthetic on whole body protein turnover (stable isotope methodology) and urinary excretion of urea nitrogen, adrenaline, noradrenaline and cortisol in a group of well nourished elderly patients undergoing colorectal surgery who received a constant nutritional intake before (7 days) and after (4 days) surgery. One group (control, n = 8) received routine anaesthetic and surgical care. Patients in the test group (extradural, n = 9) received extradural bupivacaine, and sensory block (T4-S5) was maintained during and after surgery for a period of 24 h. Whole body protein breakdown and amino acid oxidation increased significantly after surgery in both groups (P less than 0.05), but the increase in protein breakdown in the extradural group was significantly less than that in the control group. Urinary excretion of urea nitrogen, adrenaline and noradrenaline increased in the control group after surgery, whilst the increase in the extradural group was very small. In contrast, urinary excretion of cortisol increased significantly in both groups after surgery. We conclude that extradural block maintained for 24 h after surgery significantly minimized postoperative protein breakdown without compromising whole body protein synthesis. PMID- 1768543 TI - Effects of low concentrations of cyclopropane and halothane on peak velocity of saccadic eye movements. AB - We have investigated the effect of 4.7 and 8.8% MAC of cyclopropane, and 5.3 and 9.3% MAC of halothane on the peak velocity of saccadic eye movements (PSV) in six healthy volunteers. Both concentrations of cyclopropane and halothane significantly depressed PSV (P less than 0.01) compared with air, in a dose related fashion. Halothane depressed PSV significantly more than cyclopropane (P less than 0.05). PSV returned to baseline within 5 min after discontinuation of the agents. There was no significant difference between cyclopropane, halothane and air in subjective assessment of sedation. PMID- 1768544 TI - Attenuation of the pressor response to tracheal intubation by magnesium sulphate with and without alfentanil in hypertensive proteinuric patients undergoing caesarean section. AB - The pressor response to tracheal intubation is known to be exaggerated in patients with gestational proteinuric hypertension (GPH). We have studied the effect of pretreatment with magnesium sulphate 40 mg kg-1 or 30 mg kg-1 with alfentanil 7.5 micrograms kg-1 on this pressor response in 38 patients with moderate to severe GPH. The magnesium-alfentanil combination produced better control of arterial pressure and heart rate than magnesium alone, although both techniques provided good cardiovascular control. There was no significant difference in fetal outcome between groups. Both pretreatment methods produced satisfactory control of catecholamine release. PMID- 1768545 TI - Effect of sublingual buprenorphine on gastric emptying of a liquid meal. AB - The effect of buprenorphine 0.2 mg sublingually on gastric emptying of a liquid meal in 10 volunteers was compared with placebo. Gastric emptying was measured by applied potential tomography and was delayed significantly by buprenorphine (P less than 0.001). PMID- 1768546 TI - First pass lung uptake of bupivacaine: effect of acidosis in an intact rabbit lung model. AB - The first pass uptake, metabolism and recovery of bupivacaine were examined in an intact rabbit lung model using a multiple indicator technique with rapid sequential sampling. The rabbits were allocated to an acidotic group (pH 7.0-7.1) (n = 8) and a control group (n = 10) with normal pH. Bupivacaine recovery rates were not significantly different: median 93.2% (range 48.9-116.5%) and 94.5% (54.9-123.1%) in control and acidotic groups, respectively. Median peak percentage fractional concentrations of bupivacaine were greater in the acidotic group: 6.22% (2.5-7.65%) vs 4.1% (2.5-6.7%) (P less than 0.05). Median maximum instantaneous pulmonary percentage extraction was less in the acidotic animals than in animals with normal pH: 81.2% (47.1-91.9%) vs 91.0% (82.6-94.5%) (P less than 0.01). Median normalized mean percentage transit time was less in the acidotic group (245.3% (163.4-465.3%)) than in the control group (423.9% (313.9 740.4%)) (P less than 0.01). There was no evidence for bupivacaine metabolism by the lung. The results suggest that acidosis reduced bupivacaine lung uptake and increased its rate of passage through the lung, but did not influence overall drug recovery rates. This has clinical implications for bupivacaine related cardiac and cerebral toxicity. PMID- 1768547 TI - Pathogenesis of suxamethonium-induced muscle damage in the biventer cervicis muscle in the chick. AB - Muscle damage induced by suxamethonium, and the influence of halothane on it, has been examined by measuring the efflux of creatine kinase (CK) in the biventer cervicis muscle of the chick. Whereas halothane and suxamethonium alone did not increase the enzyme efflux significantly, the combination of the two was associated with significant increase in the concentration of CK in the bathing medium by 59-157%. The increase in CK was prevented by adding chlorpromazine 100 mumol litre-1 to the medium, suggesting the involvement of phospholipases in the pathogenesis of suxamethonium-induced muscle damage. PMID- 1768548 TI - Comparison of contemporaneous and retrospective assessment of postoperative pain using the visual analogue scale. AB - We have assessed postoperative pain in 50 patients who had undergone total abdominal hysterectomy, using repeated contemporaneous and single retrospective visual analogue scores. There were significant correlations between the median, mean and greatest contemporaneous scores, and the single retrospective scores, but there was a wide scatter of results among and within individual patients. We conclude that the wide variability between the two methods of assessment suggests that the two techniques should not be used interchangeably. PMID- 1768549 TI - Anaesthesia for patients with transplanted hearts and lungs undergoing non cardiac surgery. AB - Heart and lung transplantation is now accepted as a means of treating some end stage cardiopulmonary diseases. These patients may present with a wide variety of non-cardiopulmonary conditions requiring anaesthesia and surgery, possibly at a place distant from their original transplant centre. In general, for much elective, acute or even emergency surgery, if the allograft is functioning satisfactorily, these patients should present few problems during anaesthesia, provided the anaesthetist has some understanding of the pathophysiology of the transplanted organ and recognizes the differences (potential and specific to cardiopulmonary transplantation) between such patients and any other subject. PMID- 1768551 TI - Management of labour and delivery in patients with intracranial neoplasms. AB - The presence of an intracranial neoplasm (ICN) during pregnancy has serious implications for the anaesthetic management of labour and delivery. The physiological changes of pregnancy and labour are potentially hazardous to women with ICN, but the provision of adequate pain relief during labour reduces the risk to the mother. Extradural anaesthesia is the only technique that provides pain-free labour reliably, but it carries added risks. Three patients are reported who were managed with extradural anaesthesia: two delivered per vaginam and one by Caesarean section. None suffered any complication related to the anaesthetic technique. At present, there are no published data on the influence of anaesthetic management on outcome of labour and delivery in patients with ICN. Anaesthetists should report such cases so that the relative risks of different management strategies may be assessed. PMID- 1768550 TI - P6 acupuncture and postoperative vomiting after tonsillectomy in children. AB - We have studied the effect of P6 acupuncture on postoperative vomiting in 45 children undergoing tonsillectomy. After induction of anaesthesia and before the start of surgery, 50% of the patients received P6 acupuncture (in the middle of the ventral surface of the wrist) for 5 min. There was no difference in the incidence of vomiting between the acupuncture (39%) and non-acupuncture (36%) groups. We conclude that, when administered after induction of anaesthesia, P6 acupuncture is ineffective in reducing vomiting after tonsillectomy in children. PMID- 1768552 TI - Non-invasive measurement of cardiac output by thoracic electrical bioimpedance: a study of reproducibility and comparison with thermodilution. AB - The performance and reproducibility of the BoMED NCCOM3 thoracic electrical bioimpedance cardiograph (TEB) has been evaluated in volunteers and patients. In resting supine volunteers, we determined the coefficient of variability over short time periods (30 min) and over several days, and examined the effects of differences in electrode type and electrode placement. The mean (range) intra subject coefficients of variation (CV) for thoracic fluid index (TFI) and stroke volume (SV) were 1.0% (0.4-1.8%) and 4.7% (2.1-8.5%), respectively over a 30-min period. The corresponding CV were 5.6% (2.3-10.9%) and 10.9% (6.1-14.8%) for measurements made at rest on four separate occasions. Use of different electrode types (RedDot and Medicotest) resulted in differences in TFI (P less than 0.01), but not in mean values for SV or cardiac output (Q); their use in individual subjects revealed differences of up to 20% in SV and Q. Alterations in electrode placement by 5 cm in the horizontal and diagonal planes produced no significant changes in TFI, SV or Q; changes in the longitudinal plane produced a graded change. Increases of 5 cm and 10 cm in thoracic length produced mean increases in TFI of 9.8% and 39.8%, respectively, and mean decreases in Q of 8.4% and 16.7% and SV of 7.5% and 15.8%. TEB measurements of Q and SV were compared with thermodilution (TD) in 16 intensive care patients. Mean (SEM) Q by TEB was 5.63 (1.10) litre min-1 compared with TD 4.38 (0.72) litre min-1 (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768553 TI - Pressure support ventilation using a new tracheal gas injection tube. AB - In order to explore new types of jet ventilation, we tested a tracheal gas injection tube (TGIT) which included six thin capillaries and provided high pressure injection. The driving pressure was chosen to yield a plateau of inspiratory tracheal pressure of 10 cm H2O. An original controller was built to monitor spirometry and trigger injection in order to deliver both pressure controlled ventilation (PCVTGIT) and a new mode of inspiratory pressure support jet ventilation (IPSTGIT). The PVCTGIT mode maintained the same end-tidal carbon dioxide concentration as conventional ventilation with the same tidal and minute ventilation. We studied 10 patients after abdominal surgery. During spontaneous breathing, the patients were allowed to breathe through the tube, successively with and without IPSTGIT. IPSTGIT, compared with spontaneous breathing increased minute ventilation (from 5.7 (SD 1.6) to 7.1 (1.7) litre min-1) (P less than 0.001). It reduced the total work of breathing (from 0.625 (0.223) to 0.263 (0.151) J litre-1, respectively) (P less than 0.01) and the occlusion pressure (from 2.62 (1.28) to 1.36 (0.74) cm H2O, respectively) (P less than 0.01). It is concluded that this TGIT used with a specific system for sensing and triggering ventilation allows inspiratory pressure support during low frequency jet ventilation. PMID- 1768554 TI - Venous sequelae after i.v. diclofenac. PMID- 1768555 TI - Intra-arterial regional analgesia. PMID- 1768556 TI - Tracheal intubation with the patient in the sitting position. PMID- 1768557 TI - Population pharmacokinetics: theory and practice. PMID- 1768558 TI - Ethics of volunteer research: the role of new EC guidelines. PMID- 1768559 TI - Clinical pharmacology of prochlorperazine in healthy young males. AB - 1. The pharmacokinetics and pharmacodynamics of prochlorperazine (PCZ) have been studied in healthy young males following single 12.5 mg i.v. and 50 mg oral doses, and during repeated doses (25 mg twice daily) for 14 days. 2. Oral bioavailability was low and an N-desmethyl metabolite was detected. Plasma clearance was high (0.98 1 kg-1 h) and the volume of distribution was large (12.9 1 kg-1) after i.v. dosing. 3. The terminal elimination half-life of PCZ was 9 +/- 1 h and 8 +/- 2 h after i.v. and single oral dosing, respectively. The urinary recoveries of drug and metabolite were low. 4. Accumulation of PCZ and its metabolite occurred following repeated dosing. The half-life at the end of 14 days therapy was 18 +/- 4 h. 5. Postural tachycardia, decreased salivary flow, impaired psychomotor function and a diminished level of arousal were observed after intravenous PCZ. Similar effects, but of lower magnitude were observed after single oral doses. During chronic dosing postural tachycardia and antihistaminic effects were observed, the latter not being observed after single doses. 6. After single intravenous dosing the maximal drug effects occurred 2-4 h after peak plasma drug concentrations for all measures except for plasma prolactin and self-scored restlessness 7. An antagonist action at dopamine (D2), muscarinic-cholinergic and alpha-adrenoceptors is postulated after single doses, with antihistaminic effects during chronic dosing, possibly indicating the presence of an active metabolite. PMID- 1768560 TI - Lack of systematic effects of the 5-hydroxytryptamine 3 receptor antagonist ICS 205-930 on gastric emptying and antral motor activity in patients with primary anorexia nervosa. AB - 1. The 5-hydroxytryptamine 3 receptor antagonist, ICS 205-930, has been reported to have potent effects on gastric smooth muscle and to enhance gastric emptying in animals, but findings in man have been inconsistent. 2. This study investigated the effects of ICS 205-930 on gastric emptying of an isotopically labelled semisolid 1168 kJ meal and on antral contractility in patients with primary anorexia nervosa, a condition frequently associated with impaired gastric motor function. 3. Thirteen female patients (age 18-39 years, median 22 years; percentage of ideal body weight 52-90%, median 66%) participated each in two studies, in which 0.15-0.18 mg kg-1 ICS 205-930 or placebo were infused i.v. in crossover, double-blind fashion. Gastric emptying and antral contractility were recorded scintigraphically for 50 min. 4. ICS 205-930 did not affect gastric emptying: the mean percentage of meal remaining in the stomach after 50 min (69.6% +/- 3.2 s.e. mean) was nearly identical to that after placebo (70.7 +/- 3.3%). 5. Amplitude, frequency and propagation velocity of antral contractions differed only little after ICS 205-930 and placebo, respectively. 6. The results show that ICS 205-930 has no effect on the impaired gastric motor activity in primary anorexia nervosa and thus provide further evidence that the compound does not have prominent prokinetic effects in man. PMID- 1768561 TI - Gastric emptying in healthy volunteers after multiple doses of levodopa. AB - 1. Oral levodopa frequently produces an episodic delay in gastric emptying which leads to multiple peak concentrations of the drug in plasma. We have studied the effects of multiple dosing of levodopa on gastric emptying and levodopa absorption in eight healthy young volunteers in a randomised two-way cross-over study. 2. The plasma concentration-time curves for levodopa were measured after three oral doses of 125 mg given at 2 h intervals and compared with the concentration-time curve for levodopa following administration of two doses of placebo and a single oral dose of 125 mg. 3. A low incidence of multiple peak plasma concentrations of levodopa was detected after all doses of levodopa. The area under the plasma concentration-time curves (AUC) for the final dose of levodopa (150.8 +/- 22.0 micrograms ml-1 min) was lower than for the two preceding doses (205.7 +/- 41.8 and 199.5 +/- 51.8 micrograms ml-1 min) but not different from that of the single dose given at the same time of day (141.7 +/- 29.1 micrograms ml-1 min). This indicates that the lower AUC of the final dose of levodopa was related to the time of administration and not a result of the two preceding doses. 4. The absence of any significant effects of preceding doses of levodopa on gastric emptying was confirmed a) by co-administration of soluble paracetamol, as a marker of gastric emptying, with the second dose of levodopa or placebo and b) by co-administration of radiolabelled DTPA and gamma-camera imaging with the final dose of levodopa on the multiple dosing day and the single dose of levodopa on the placebo day.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768562 TI - Assessment of hepatic blood flow in healthy subjects by continuous infusion of indocyanine green. AB - 1. The applicability of a continuous infusion of indocyanine green (ICG) to detect changes in apparent hepatic blood flow (HBF) was investigated in six healthy subjects. 2. High-performance liquid chromatography was used to measure ICG concentrations, and the effect of intravenous propranolol (10 mg in 10 min) on HBF was investigated. 3. During 150 min infusions of ICG (1.0 mg min-1) steady state was reached within about 30 min and thereafter the plasma dye concentration remained essentially constant until the end of infusion. 4. Blood clearance (CLb) of ICG (15.9 +/- 2.2 ml min-1 kg-1; mean +/- s.d.), calculated as infusion rate/blood dye concentration over three time periods (30-50, 80-100 and 130-150 min) during the 150 min infusion, was not different from that obtained with three 1-min infusions (0.5 mg kg-1) administered at corresponding times of the day (CLb = 14.0 +/- 2.2 ml min-1 kg-1, P = 0.06). 5. The pharmacokinetics of ICG were shown to be linear up to plasma concentrations of at least 3 micrograms ml-1 using variable infusion rates (0.5, 1.0 and 2.0 mg min-1). 6. Propranolol had little effect on ICG concentrations during continuous infusion. The AUC of ICG from the start of propranolol infusion up to 125 min thereafter was increased by 12% +/- 17% (P = 0.21) compared with placebo. PMID- 1768563 TI - Effect of enalapril on allergen-induced cutaneous hypersensitivity reaction. AB - 1. To test the hypothesis that the in vivo inhibition of angiotensin converting enzyme in a patient who presents atopy, results in a significant increase in cutaneous bradykinin and prostaglandin production, the effect of enalapril on the cutaneous hypersensitivity reaction was examined in 10 atopic volunteers. 2. A crossover study design was used and volunteers were randomly allocated to treatment with either enalapril (10 mg) alone, or in combination with indomethacin (75 mg), with and without ketotifen (1 mg). Drugs were administered twice daily for 2 days. 3. Allergen (Southern Grass Mix) was administered intradermally 2 h after last drug dosage and the surface areas of the immediate wheal-and-flare-reactions were measured 15 min later. The late phase of the cutaneous response was evaluated 6 h later by determining skinfold thickness and surface area. 4. Enalapril alone had no effect on any of the parameters measured. 5. The cutaneous hypersensitivity reaction was significantly reduced with regard to both immediate and late cutaneous responses when the indomethacin and ketotifen combination was added to enalapril therapy. 6. When only indomethacin was added to enalapril pretreatment the flare reaction was significantly reduced, but whealing was unaffected. 7. This study presents further evidence that mast cell mediators other than prostaglandins are involved in the cutaneous hypersensitivity reaction. Furthermore, that endogenous bradykinin production after enalapril pretreatment either never reaches the supraphysiological concentrations used in previous experiments, or that bradykinin is rapidly and effectively broken down to inactive peptides by other carboxypeptidase enzymes. PMID- 1768564 TI - Magnesium status and digoxin toxicity. AB - 1. Eighty-one hospital patients receiving digoxin were separated into groups with and without digoxin toxicity using clinical criteria. Serum digoxin, sodium, potassium, calcium, creatinine, magnesium and monocyte magnesium concentrations were compared. 2. Subjects with digoxin toxicity had impaired colour vision (P less than 0.0001, Farnsworth-Munsell 100 hue test) and increased digoxin levels (1.89 (1.56-2.21) vs 1.34 (1.20-1.47) nmol l-1, P less than 0.01) (mean (95% confidence limits], though there was considerable overlap between two groups. 3. Subjects with digoxin toxicity had lower levels of serum magnesium (0.80 (0.76 0.84) vs 0.88 (0.85-0.91) mmol l-1, P less than 0.01) and monocyte magnesium (6.40 (5.65-7.16) vs 8.76 (7.81-9.71) mg g-1 DNA, P less than 0.01), but there were no significant differences in other biochemical parameters. A greater proportion of toxic subjects were receiving concomitant diuretic therapy (20/21 vs 37/60, P less than 0.05). 4. Magnesium deficiency was the most frequently identified significant electrolyte disturbance in relation to digoxin toxicity. In the presence of magnesium deficiency digoxin toxicity developed at relatively low serum digoxin concentrations. PMID- 1768565 TI - Exercise performance during captopril and atenolol treatment in hypertensive patients. AB - 1. Maximal aerobic exercise capacity, submaximal endurance exercise performance, and exercise haemodynamics have been studied in sixteen patients with mild to moderate essential hypertension during treatment with captopril and atenolol. 2. Administration of atenolol (1 x 100 mg day-1) or captopril (1 x 100 mg day-1) for 6 weeks resulted in similar supine and erect systolic and diastolic blood pressures. Heart rate was significantly lower during atenolol treatment. 3. Exercise heart rate and systolic blood pressure were significantly lower during atenolol than during captopril treatment, exercise diastolic blood pressure (at 100W) did not differ significantly. With atenolol exercise cardiac output was significantly lower and exercise stroke volume significantly higher than with captopril. 4. Maximal work rate, maximal oxygen consumption and maximal heart rate were significantly lower during atenolol than during captopril treatment (respectively 6%, 8% and 25%). Maximal respiratory exchange ratio and lactate concentration did not differ. 5. No statistically significant difference in submaximal endurance time between atenolol and captopril was found. Endurance time was reduced by 19% during atenolol and by 13% during captopril as compared with placebo. No difference in rating of perceived exertion between atenolol and captopril was present. 6. The results indicate that atenolol will reduce blood pressure during exercise more effectively than captopril in patients with hypertension. The limitation of submaximal endurance exercise performance by both agents is of similar magnitude. This may be regarded as an unwanted side effect in certain physically active patients with hypertension. PMID- 1768566 TI - Pharmacogenetics of human erythrocyte thiopurine methyltransferase activity in a French population. AB - 1. A genetic polymorphism in human erythrocyte thiopurine methyltransferase activity (RBC TPMT) resulting in a trimodal phenotypic distribution has been demonstrated both in a North American population and in British children. 2. We studied whether such a polymorphism may be also present in a white French population by testing RBC TPMT activity in 303 randomly selected blood donors. 3. We found a large inter-individual variation in RBC TPMT activity which ranged from 2 to 40 nmol ml-1 packed RBC h-1, with a mean value of 15.4 +/- 7.0 nmol ml 1 packed RBC h-1. The enzyme activity was not significantly influenced by the sex and age of the subjects. 4. In our population sample, we found no subject with undetectable enzyme activity. However, the probit plot of the log RBC TPMT activity showed a highly significant change in slope at a TPMT activity of 7.5 nmol ml-1 packed RBC h-1. Thirty four subjects (11% of our population) had TPMT activities below 7.5 nmol ml-1 packed RBC h-1. 5. These data are consistent with the view that the genetic polymorphism of TPMT activity described in populations from North America and the United Kingdom is also present in a French population, with about 89% of subjects exhibiting a high activity and 11% an intermediate activity. PMID- 1768567 TI - Age-dependent stereoselective increase in the oral clearance of hexobarbitone isomers caused by rifampicin. AB - 1. The disposition of hexobarbitone enantiomers before and after rifampicin treatment (600 mg daily for 14 days) was investigated in six young (29 +/- 3 years old) and six elderly (71 +/- 4 years old) healthy male volunteers. Hexobarbitone was given as a single 500 mg oral dose of the racemate. 2. The mean (+/- s.d.) oral clearance of S-(+) hexobarbitone was 1.9 +/- 0.3 and 1.8 +/- 0.2 ml min-1 kg-1, respectively, in young and elderly subjects and increased approximately six fold following 14 days of rifampicin treatment in both young (to 11.9 +/- 2.2 ml min-1 kg-1) and elderly (to 10.7 +/- 2.8 ml min-1 kg-1) subjects. 3. In contrast, rifampicin treatment produced a larger and a differential increase in the oral clearance of R-(-) hexobarbitone in young and elderly subjects; an 89 fold change in the young (15.6 +/- 16.4 to 1146.7 +/- 1478.0 ml min-1 kg-1) and a 19 fold change (10.3 +/- 3.0 to 199.9 +/- 98.1 ml min 1 kg-1) in the elderly. PMID- 1768568 TI - Carbamazepine-hypersensitivity: assessment of clinical and in vitro chemical cross-reactivity with phenytoin and oxcarbazepine. AB - 1. Seven patients clinically diagnosed as being hypersensitive to carbamazepine and one patient hypersensitive to both carbamazepine and oxcarbazepine have been identified. They have been compared with a control group (hereafter referred to as 'control subjects') comprising five patients on chronic carbamazepine therapy without adverse effects and 12 healthy volunteers who have never been exposed to anticonvulsants. 2. An in vitro cytotoxicity assay employing mononuclear leucocytes as target cells has been used first, to determine the ability of 10 different human livers to bioactivate carbamazepine to a cytotoxic metabolite, and secondly, to compare the cell defences of carbamazepine-hypersensitive patients and control subjects to oxidative drug metabolites generated by a murine microsomal system, using a blinded protocol. 3. With human liver microsomes, the metabolism-dependent cytotoxicity of carbamazepine increased with increasing microsomal protein concentration. At a protein concentration of 2 mg per incubation, the cytotoxicity of carbamazepine with human liver microsomes (n = 10 livers) increased from 7.2 +/- 0.8% (baseline) to 16.4 +/- 2.1% (with NADPH; P = 0.002). 4. In the presence of phenobarbitone-induced mouse microsomes and NADPH, the mean increase in cytotoxicity above the baseline with carbamazepine was significantly greater (P less than 0.001) for the cells from the carbamazepine hypersensitive patients (7.9 +/- 0.8%) than from control subjects (2.6 +/- 0.3%). 5. In the presence of phenobarbitone-induced mouse microsomes and NADPH, there was no significant difference in cytotoxicity between the cells from carbamazepine hypersensitive patients and from control subjects in the presence of either phenytoin or oxcarbazepine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768569 TI - Excretion of indomethacin in breast milk. AB - 1. The excretion of indomethacin into breast milk and subsequent exposure of infants was studied in 16 women and seven of their infants. The median milk:plasma ratio in seven patients where there were measurable drug concentrations in both milk and plasma was 0.37. 2. Total infant dose, assuming a daily milk intake of 150 ml kg-1 and 100% absorption, ranged from 0.07% to 0.98% (median = 0.18%) of the weight adjusted maternal dose. 3. Plasma samples were obtained in seven infants. In six of these, indomethacin concentrations were below the sensitivity of the assay (less than 20 micrograms l-1), while one infant had a plasma indomethacin concentration of 47 micrograms l-1. 4. No adverse effects due to indomethacin were reported in the infants. PMID- 1768570 TI - Ouabain and responses to endothelium-dependent vasodilators in the human forearm. AB - Ouabain inhibits endothelium-dependent vascular relaxation in vitro, but has not been studied in this regard in vivo. We have therefore measured blood flow responses to carbachol, bradykinin and sodium nitroprusside (endothelium dependent and endothelium-independent vasodilators) infused into the brachial artery with and without co-infusion of ouabain (2 micrograms min-1). Six healthy male volunteers were each studied on two occasions. Ouabain reduced basal forearm blood flow, by 18.0 +/- 4.1% (mean +/- s.e. mean, 2P less than 0.05), but had no significant effect on responses to any of the three vasodilators. These results indicate that effects of ouabain on endothelium-dependent relaxation in vitro must be interpreted with caution. PMID- 1768571 TI - Single and multiple dose pharmacokinetics of ticlopidine in young and elderly subjects. AB - The pharmacokinetics of orally administered ticlopidine hydrochloride, a novel inhibitor of platelet aggregation, were determined both after a single dose and after 21 days of twice daily dosing in 12 young (mean 28.6 years) and 13 elderly (mean 69.5 years) subjects. Concentrations of unchanged ticlopidine in plasma were measured by g.l.c. After a single 250 mg dose of ticlopidine, the mean area under the curve, AUC (0-12 h) was 1.11 micrograms ml-1 h in young subjects and 2.04 micrograms ml-1 h in old subjects (P = 0.002). Mean values of t1/2,z in young and elderly subjects were 7.9 h and 12.6 h, respectively (P = 0.01). Steady state plasma drug concentrations were attained after 14 days of dosing with ticlopidine. After the final dose on day 21, AUC values in elderly subjects were 2-3 times those in young subjects (P less than 0.001). The plasma t1/2,z averaged 4.0 days for young subjects and 3.8 days for elderly subjects (P = 0.7). The longer t1/2,z and higher AUC values after multiple dosing probably reflect an increase in bioavailability of ticlopidine after repeated dosing, saturation of metabolism or insufficient analytical sensitivity to characterize the terminal elimination phase after single dose. PMID- 1768572 TI - Interethnic differences in drug glucuronidation: a comparison of paracetamol metabolism in Caucasians and Chinese. AB - Paracetamol disposition following a single oral 1 g dose of the drug was compared in groups (n = 12) of healthy young adult male Caucasians and Chinese. There was no difference between the groups in terms of paracetamol oral clearance, elimination half-life, or partial metabolic (glucuronidation, sulphation, oxidation) and renal clearances. The results demonstrate that drug glucuronidation is not universally impaired in Chinese and, together with previously published data, that paracetamol glucuronidation is minimally affected by race. PMID- 1768573 TI - The effect of age on glucuronidation and sulphation of paracetamol by human liver fractions. AB - Glucuronidation and sulphation were studied in vitro in human liver samples from 22 subjects aged 40-89 years using paracetamol as substrate. There was no significant correlation with age for the activity of either enzyme pathway. These results provide further evidence that age per se does not have a major effect on the activities of hepatic metabolising enzymes. PMID- 1768574 TI - Oral amino acids and gastric emptying: an investigation of the mechanism of levodopa-induced gastric stasis. AB - To investigate possible mechanisms of levodopa-induced gastric stasis, we have studied the effect of other amino acids on gastric emptying. The large neutral amino acid tryptophan delays gastric emptying in the dog at molar concentrations below those required to stimulate duodenal osmoreceptors. In healthy volunteers, we have shown that neither tryptophan nor the small neutral amino acid glycine delayed gastric emptying when given in concentrations similar to those of levodopa which produce gastric stasis. The study suggests that levodopa does not inhibit gastric emptying by an effect on duodenal amino acid receptors or via osmoreceptors. PMID- 1768576 TI - What treatment do you advise for bilateral or unilateral renal thrombosis in the newborn, with or without thrombosis of the inferior vena cava? PMID- 1768575 TI - Gentamicin interval in newborn infants as determined by renal function and postconceptional age. AB - We evaluated the relationship between gentamicin pharmacokinetics and glomerular filtration rate in newborn infants to estimate the appropriate interval of administration in neonates with renal insufficiency. Gentamicin half-life (Gt1/2) could be predicted from plasma creatinine concentration (PCr) (r = 0.78); the prediction was minimally but significantly increased (r = 0.81) by adding post conceptional age to a multiple regression analysis. Infants with a postconceptional age of 29 weeks or more and a PCr of 1 mg/dl or more had significantly greater through and peak gentamicin levels than those with a PCr less than 1 mg/dl. If gentamicin is indicated in a patient with renal insufficiency, the interval of administration should be 2-3 Gt1/2, which can be estimated from PCr (Gt1/2 = 2.0 + 7.7 PCr). The interval can then be adjusted according to peak and trough gentamicin levels. PMID- 1768577 TI - A neonate with idiopathic hyperaldosteronism. AB - A boy with functional abnormalities of the gastro-intestinal tract, hyponatraemia, hypokalaemia and hypertension is described. All symptoms developed within the first 2 months of life. Increased aldosterone levels were associated with suppressed values in the renin-angiotensin system. The diagnosis of idiopathic hyperaldosteronism was made because of adrenal hyperplasia and the failure to suppress aldosterone to undetectable levels with glucocorticoids. Treatment with spironolactone alone, or in combination with either intravenous dopamine or ibopamine orally, amiloride, enalapril, hydralazine or clonidine corrected serum potassium values but failed to normalize blood pressure and to correct plasma renin activity and plasma aldosterone. However, the combination of spironolactone with nifedipine decreased blood pressure. Abnormal gastro intestinal motility was corrected by low doses of oral magnesium hydroxide. To assess intracellular calcium homeostasis, the patient's peripheral blood mononuclear cells were incubated with increasing concentrations of calcium. As these cells failed to maintain physiological calcium concentration, a defect in intracellular calcium homeostasis was suspected. PMID- 1768578 TI - Asymptomatic siblings or children of patients with genetic diseases. PMID- 1768579 TI - Prolonged reversible renal failure with nephrotic syndrome. AB - Steroid nonresponsive nephrotic syndrome in a 15-year-old girl with reversible renal failure required dialysis and aggressive nutritional therapy for 1 year. Severe interstitial edema and foot process fusion were the only processes identified to explain the renal failure. Diabetes-like alterations of the glomerular capillary wall basement membrane may have been an outcome of the intense alimentation. PMID- 1768580 TI - Spatial association of renin-containing cells and nerve fibers in developing rat kidney. AB - The development of renin-containing cells and nerve fibers was studied in Sprague Dawley rat kidneys during the last third of gestation and the first 15 days of postnatal life. Kidney tissue sections were stained for nerve fibers or double stained employing an anti-rat renin polyclonal antibody and a monoclonal antibody (TUJ1) directed against a neuron-specific class III beta-tubulin isotype. Renin containing cells and nerve fibers were detected at 17 days of gestation, in close spatial relationship along the main branches of the renal artery. During fetal life, renin-containing cells and nerve fibers were spatially associated along arcuate and interlobular arteries, renin-containing cells being also present throughout the entire length of afferent arterioles supplying juxtamedullary glomeruli. During postnatal life the distribution of renin-containing cells progressively shifted to a restricted juxtaglomerular position in afferent arterioles. Simultaneously, density and organization of nerve fibers increased with age along the arterial vascular tree. Our results suggest that innervation of renin-containing cells is present in fetal life and follows the centrifugal pattern of renin distribution and nephrovascular development. PMID- 1768581 TI - Severe rickets in Lowe syndrome: treatment with continuous nasogastric infusion. AB - A boy with Lowe syndrome who manifested renal Fanconi syndrome by severe hypophosphatemic rickets, failure to thrive, and metabolic acidosis failed to improve with conventional bolus therapy of phosphate and bicarbonate. He was then placed on home continuous nasogastric infusion of phosphate and bicarbonate in addition to caloric supplementation. Rapid reversal of metabolic acidosis and hypophosphatemia was achieved. There was significant improvement in clinical and radiological signs of rickets and in bone mineral content. After 9 months therapy, his ponderal age improved dramatically from 7.5 to 29.5 months and his statural age from 16 to 26 months. We conclude that continuous nasogastric infusion of phosphorus and bicarbonate is a useful alternative mode of therapy in patients with renal Fanconi syndrome who are resistant to conventional bolus therapy. PMID- 1768582 TI - High lead content of deciduous teeth in chronic renal failure. AB - Lead is suspected to contribute to the progression of kidney disease. Lead content of blood and deciduous teeth was determined in 22 children aged 5-14 years at different stages of chronic renal failure (CRF). In addition, individual lead exposure was estimated from histories. The results were compared with a control group of 20 siblings or neighbours of patients living in the same environment (C1), and to a group of children known to be free of excessive lead exposure (C2). The mean blood lead concentration of patients was normal (mean 2.9 micrograms/dl, range 1.1.-10.1). Mean dental lead content was 2.8, 1.7 and 1.4 micrograms/g in CRF, C1 and C2, respectively. It always exceeded that of healthy peers. Increased dental lead content was associated with a high risk of exposure. It is suggested that both an increased lead uptake and renal dysfunction may contribute to the increased lead burden in children with CRF. PMID- 1768583 TI - Renal transplantation in 22 children with nephropathic cystinosis. AB - In 1989, 22 children (11 boys, 11 girls aged 8-23 years) with nephropathic cystinosis, who had received a total of 28 renal allografts over the previous 14 years, were reviewed. Nineteen were alive, of whom 17 had functioning grafts 5 months to 13 years after transplantation. The mean serum creatinine level in these 17 was 135 mumol/l. Patient and graft survival did not differ from non cystinotic children. Persistent hypothyroidism was found in 3 patients, transient diabetes mellitus in 1, severely disturbed vision in 1 and brain atrophy in 11. Arterial hypertension was present in 16 patients. Growth retardation was universal, although in 4 patients on cyclosporin A post-transplant catch-up growth occurred. Five patients over 15 years completed puberty. Readjustment in terms of school performance was good but was less good for psychosocial development. None of the patients had ever been treated with cystine-depleting agents; the data will therefore provide a historical control group with which to compare the results from a group treated with these agents. PMID- 1768584 TI - Peritoneal dialysis for acute renal failure in children. AB - Fifty infants and children with acute renal failure were treated with acute peritoneal dialysis between 1987 and 1990. The patients were dialyzed using either a catheter introduced percutaneously over a guide-wire (n = 40) or a Tenckhoff catheter (n = 10). The cause of the acute renal failure was primary renal disease in 17 children, cardiac disease in 19, and trauma/sepsis in 14. Peritoneal dialysis succeeded in controlling metabolic abnormalities, improving fluid balance, and relieving the complications of uremia. The procedure had few major complications. Overall mortality was 50%, reflecting the serious nature of the underlying diseases. We conclude that acute peritoneal dialysis is a safe and effective treatment in most pediatric patients with acute renal failure. Our series of patients treated with acute peritoneal dialysis serves as a basis of comparison for the evaluation of new modalities of therapy in childhood acute renal failure. PMID- 1768585 TI - Recombinant human erythropoietin therapy in pediatric patients receiving long term peritoneal dialysis. AB - We evaluated the impact of (s.c.) recombinant human erythropoietin (r-HuEPO) therapy on the hematological status, exercise capacity, and dietary intake of nine pediatric patients (mean age 12.4 +/- 3.2 years) receiving long-term peritoneal dialysis. Five children without medical illness served as controls for the exercise testing portion of the study. Following 7.9 +/- 2.8 weeks of twice weekly r-HuEPO (50 units/kg per dose), the hematocrit increased from 21.9 +/- 3.5% to 31.3 +/- 2.5% (P less than 0.001). A further increase to 33.2 +/- 3.0% occurred after 2 months of once weekly therapy. The blood transfusion requirement decreased from 0.5 transfusions per patient-month to 0.05 transfusions per patient-month (P less than 0.01). Graded exercise testing demonstrated an increase in peak oxygen consumption from 17.8 +/- 5.2 to 24.0 +/- 7.6 ml/kg per min (P less than 0.01). The oxygen consumption at anaerobic threshold increased from 13.1 +/- 3.9 to 17.1 +/- 3.5 ml/kg per min (P less than 0.02). Treadmill time increased from 5.3 +/- 1.2 to 7.5 +/- 1.3 min (P less than 0.001). In each case, the percentage improvement was significantly greater than the improvement seen in the control population. Dietary evaluation revealed no significant change in caloric or protein intake, despite a subjectively improved appetite. r-HuEPO, given by the s.c. route, corrects the anemia and improves the exercise capacity of pediatric patients receiving long-term peritoneal dialysis. PMID- 1768586 TI - IgA nephropathy in a child with human immunodeficiency virus type 1 infection. AB - Infection with the human immunodeficiency virus type 1 (HIV-1) can cause a spectrum of renal disease, termed acquired immunodeficiency syndrome (AIDS) nephropathy. The most common clinical manifestations of kidney involvement in HIV 1-infected patients are proteinuria and/or nephrotic syndrome, and the histopathological pattern usually reveals focal segmental glomerulosclerosis. We describe an 8-year-old child with AIDS who presented with recurrent gross hematuria. A kidney biopsy demonstrated IgA nephropathy. This unique case indicates that the range of kidney disease in HIV-infected children may be broader than originally thought, and that these patients warrant a complete evaluation of any renal abnormality. PMID- 1768587 TI - Anesthesia and ventilation for the uremic child. AB - This article reviews the management of the uremic child from the perspective of an anesthesiologist and cardiopulmonary clinician. The acute stresses of anesthesia, surgery, and mechanical ventilation mandate a systematic, functional approach to addressing rapidly progressing complications that may occur in these patients. Chronic renal failure may be the result of many different renal diseases, but most share common implications during anesthesia. Furthermore, anesthesia can be associated with acutely decreased function of both normal and diseased kidneys. PMID- 1768588 TI - Cell volume regulation: a review of cerebral adaptive mechanisms and implications for clinical treatment of osmolal disturbances. I. AB - Control of cell size within defined limits is vital for maintenance of normal organ function. This important feature of cell physiology can be disturbed by changes in membrane transport in epithelial cells. In addition, fluctuations in the osmolality of the extracellular fluid, caused by an abnormal plasma concentration of sodium, glucose, or urea can lead to derangements in cell size. Cell volume regulation is especially important in the brain because the brain is confined within a non-compliant vault and cannot tolerate significant perturbations in cell size. Therefore, brain cells have developed a coordinated array of adaptive mechanisms designed to modulate the cytosolic content of osmotically active solutes in response to alterations in the osmolality of the extracellular fluid. This process is controlled by various hormones including arginine vasopressin, insulin, and estrogen, and is subject to changes during development. The bulk of the change in cell content of osmolytes involves inorganic electrolytes. However, excessive variation in the cytosolic ionic strength has deleterious effects on protein structure and enzyme function. Therefore, brain cells have developed the capacity to accumulate or extrude various organic osmolytes in order to adjust the cytosolic osmolality without adversely affecting cell function. These solutes are termed non-perturbing osmolytes and belong to one of three classes of molecules: amino acids, carbohydrates and polyhydric sugar alcohols, or methylamines. Cerebral cells regulate the cytosolic content of organic osmolytes primarily by altering the transmembrane flux of these solutes. There are features of the cell volume regulatory response that are shared by the brain and kidney cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768589 TI - Molecular approaches for analyzing differential gene expression: differential cDNA library construction and screening. AB - Complementary deoxyribonucleic acid (cDNA) libraries can be used as a means to isolate and identify cell-specific messenger ribonucleic acid (mRNA) sequences. The basic elements of cDNA library construction and screening are reviewed in the context of analyzing differentially expressed mRNAs. A brief overview of the recombinant DNA systems applied to cDNA library construction and the principles of screening cDNA libraries by plaque hybridization are provided. Methods for comparing mRNA populations by differential screening and by competition hybridization are discussed, and methods for constructing subtracted cDNA libraries, enriched in differentially expressed sequences, are presented. Also reviewed are the analysis of differentially expressed cDNAs by Southern and Northern hybridization, RNase protection, polymerase chain reaction, and sequencing. PMID- 1768590 TI - Clinical quiz. Lesch-Nyhan syndrome. PMID- 1768591 TI - Recurrent febrile urinary tract infections with normal voiding cystography. Absent or elusive vesico-ureteric reflux? PMID- 1768592 TI - Primary hyperoxaluria: a frequent cause of renal failure in Tunisian childhood. PMID- 1768593 TI - Recombinant human erythropoietin: duplicate publication. PMID- 1768594 TI - The scientific "literature explosion". PMID- 1768595 TI - Duplicate publication. PMID- 1768596 TI - Prevention of blindness. Prevalence and causes of blindness and low vision. PMID- 1768597 TI - Maternal mortality. Surveillance in Puerto Rico, 1989. PMID- 1768598 TI - WHO/UNDP Programme for Vaccine Development. PMID- 1768599 TI - Formation of the extracellular matrix during the epimorphic anterior regeneration of Owenia fusiformis: autoradiographical and in situ hybridization studies. AB - During post-traumatic regeneration of the polychaete annelid Owenia fusiformis, the extracellular matrix (ECM) formation was studied by light and electron microscopy and by histoautoradiography after incorporation of tritiated proline as marker for collagenic proteins. Three days after amputation, a new basement membrane was reformed in the blastema between the ectoderm and the mesoderm. At the same time, the cytoskeleton and the anchoring structures (hemidesmosomes) were differentiated in the basal part of the ectodermal cells. Four days after amputation, collagen fibers appeared in the extracellular matrix newly reformed between the ectodermal and mesodermal layers. The existence of a proximo-distal gradient in the organization of the new extracellular matrix and the accumulation of molecules labeled by 3H-proline was shown. This accumulation started at the level of the injured segment of the stump. Differences in labeling intensity were seen in the regenerate. Within specific organogenetic zones, i.e. the epidermal gland analagen, the branchial buds and the stomodeal invagination, the labeling between the ectodermal and mesodermal layers was less intense than in other parts of the regenerate. In the mesodermal connective septa (dissepiments), located between consecutive segments, the labeling and the accumulation of extracellular material occurred later than the formation of the ectodermal basement membrane. In situ hybridization of a DNA molecular probe corresponding partially to the coding region of the collagen-like gene Ocg8, showed a spatio-temporal expression of this gene. Northern blot analysis showed a single transcript of 6.6 kb. Four days after amputation the accumulation of this transcript was exclusively localized at the level of the ectodermal layer during differentiation of the regenerate. The ectoderm was thus shown to play a dynamic role during the first stages of traumatic regeneration, although it did not seem to be directly involved in the early events of the metameric process. PMID- 1768600 TI - Embryonic development of the shell in biomphalaria glabrata (Say). AB - During embryogenesis of the fresh water snail Biomphalaria glabrata (Say) (Pulmonata, Basommatophora) shell formation has been studied by light and electron microscopical techniques. The shell field invagination (SFI), the secretion of the first shell layers, the development of the shell-forming mantle edge gland and spindle formation have been investigated. During embryonic development at 28 degrees C environmental temperature, the shell field invaginates after 35 h. After 40 h the SFI is closed apically by cellular protrusions and scale-like precursors of the periostracum. The first electron translucent layer of the periostracum stems from electron dense vesicles of the cells which lie at the opening of the SFI. A second electron dense layer appears some hours afterwards. When the shell appears birefringent in the polarizing microscope (45 h of development) calcium can be detected in it using energy dispersive x-ray analysis. As calcification occurs the intercrystalline matrix appears under the periostracum and the SFI begins to open. In embryos of 60 h the mantle cavity appears at the left caudal side. When the mantle edge groove develops (65 h of development) lamellate units are added to the outer layer of the periostracum, but no distinct lamellar layer is formed in B. glabrata. In addition to the lamellar cell and the periostracum cell, a secretory cell can be observed in the developing groove. After 65 h of development, spindle formation starts and the shell begins to coil in a left hand spiral. After 5 days of development the embryos are ready to leave the egg capsules. PMID- 1768601 TI - Effects of prepubertal manipulation with androgens on the development of sexual differences in the harderian glands of Syrian hamsters. AB - The onset of sexual differences in the metabolism of porphyrins and melatonin in the Harderian glands of Syrian hamsters was studied. Three weeks after birth, the porphyrin concentrations were already higher in glands of females than in those of males. Castration of 22-day-old male hamsters led to an increase in Harderian porphyrin concentrations, although the levels of intact females were not reached. The administration of testosterone to 22-day-old female hamsters resulted in a marked decrease in porphyrin concentrations. Study of the development of sexual differences in the enzymes involved in melatonin synthesis, N-acetyltransferase (NAT) and hydroxyindole-O-methyltransferase (HIOMT) indicated that not all the sexual differences observed in these glands begin at the same time. Thus, while differences in NAT activity were detected after the age of 3 weeks, male-female differences in HIOMT activity were only observed after 7 weeks. Castration of prepubertal male hamsters lowered NAT but not HIOMT activities. The administration of testosterone to prepubertal female hamsters led to male activity levels in both enzymes. Although circulating androgens seem to have a crucial role in maintaining sexual differences, other hormones including those from the pituitary and thyroid glands are probably also important for generating these sexual differences. PMID- 1768602 TI - Surface area/volume ratio and growth equation of the human early embryo. AB - A study of the S/V ratio and growth equation of 49 oocytes and 120 human embryos was carried out. The S/V ratio of the internal and external limits of the zona remains unchanged during successive cleavages. The mean blastomere increases 22% its S/V ratio after each division. The mean blastomere growth equation for the 2 cell to 8-cell stages follows the expression y = 1.271 x1.021 (y = longest and x = smallest diameter), but the results obtained for the whole embryo do not coincide with those resulting from the application of the growth equation. PMID- 1768604 TI - Standards for education and training in phototherapy: unanswered questions. PMID- 1768603 TI - Localization of regenectin in regenerates of American cockroach (Periplaneta americana) legs. AB - The localization of regenectin, a sucrose-binding C-type lectin, in the regeneration of the cockroach leg was investigated by immunoblotting and immunofluorescence studies. Regenectin was found to appear transiently around developing muscle cells in regenerating legs in the late stage of regeneration. With maturation of the muscles, it disappeared and was not detectable in completely regenerated legs. These findings suggest that regenectin is a cementing substance connecting developing muscle cells. Regenectin was not detected in embryos or nymphal legs at various developmental stages, suggesting that it might not be involved in normal development of embryos and legs. PMID- 1768605 TI - Sunscreens with low sun protection factor inhibit ultraviolet B and A photoaging in the skin of the hairless albino mouse. AB - We examined the chronic effect of long daily suberythemal, fluorescent solar stimulated radiation (FSSR; ultraviolet B (UVB)+A(UVA)) and UVA alone on female Skh-1 hairless albino mouse skin. Mice were dorsally irradiated 8 h every weekday for 16 weeks with FSSR or UVA, or 32 weeks with UVA alone. Various topical, low concentration, UVB and/or UVA sunscreens were applied before irradiation. Damage was assessed by skin-fold thickness, histology and biochemically by changes in the proportion of type III collagen. All FSSR-exposed mice showed increased skin thickening, elastic fibre hyperplasia, collagen damage and an increased proportion of type III collagen. Application of the UVB sunscreen (2.00%) resulted in marked protection for all nonbiochemical endpoints. There was no obvious advantage of adding 0.75% UVA sunscreen to the UVB sunscreen, but adding 2.00% UVA sunscreen reduced biochemical changes and connective tissue damage. Sixteen weeks of UVA irradiation caused skin thickening and laxity but the histology and biochemistry were indistinguishable from the controls. The mice irradiated with UVA for 32 weeks showed slight elastic fibre hyperplasia and collagen damage histologically, and increased skin thickening and laxity; these changes were unmodified by the 0.75% UVA sunscreen. These mice showed a significant increase in the proportion of type III collagen against which the UVA sunscreen offered protection. Our data suggest that UVA may be important in photoaging and that the use of low sun protection factor UVB+ UVA sunscreens on a day-to-day basis may offer some protection from solar photoaging. PMID- 1768606 TI - Effects of ultraviolet A and B irradiation on lipid peroxidation and activity of the antioxidant enzymes in keratinocytes in culture. AB - Human keratinocytes (NCTC 2544) in culture were exposed to various combinations of ultraviolet A (UVA) and UVB irradiation and at 0.5 h postirradiation the level of lipid peroxidation and activities of antioxidant enzymes were measured. The results suggest that UV irradiation is capable of inducing lipid peroxidation reactions, as parameters of which the amount of thiobarbituric acid-reactive material and the number of conjugated diene double bonds were measured. Both UVA and UVB irradiation were also found to affect the activities of antioxidant enzymes. Following UVB irradiation the activity of superoxide dismutase (Cu/Zn form) was decreased, and combination of increasing doses of UVA irradiation to a given dose of UVB irradiation decreased the activity of both catalase and superoxide dismutase. In summary, this study suggests that both UVA and UVB irradiation are capable of inducing lipid peroxidation reactions and an impairment of the enzymic antioxidant system in human keratinocytes in culture. PMID- 1768607 TI - Cutaneous response to ultraviolet radiation-induced erythema in patients with type A dysplastic nevi. AB - The effects of an exposure to 6 times the minimal erythemal dose of ultraviolet radiation (UV) were studied using a visual scale and a tri-stimulus colorimeter in 12 sun-tolerant (skin types III and IV) patients with type A dysplastic nevus syndrome. In such individuals, the melanocytic system would be susceptible to neoplastic transformation induced by sunlight. The cutaneous response to a marked UVB erythema has been shown to identify the high-risk patients prone to light induced skin cancer. This study indicates that the UVB cutaneous susceptibility of patients with type A dysplastic nevi is not significantly different from control subjects, in terms of erythemal and tanning response. PMID- 1768608 TI - Protective effect of tissue ferritins in experimental Escherichia coli infection of mice in vivo. AB - The effect of ferritins from horse (FH) and bovine (FB) spleen and murine liver (FM) on the survival rate of CFW mice lethally infected with Escherichia coli (strain 8440-78 K 80/B) was evaluated. Ferritins given intravenously 24 h before intravenous inoculation of bacteria, protected mice most effectively from death due to infection. The effect was dose dependent. At 500 micrograms of ferritin per mouse, the maximum survival rates were 86% (FH), 81% (FM) and 79% (FB), while only 5% of the control mice survived up to the 30th day. The survival rates of animals injected with bovine serum albumin (BSA) and heat-inactivated FB were 8 and 25%, respectively. Intraperitoneal injection of FB was as effective as intravenous in enhancing the resistance of mice against bacteria. These data provide evidence for the beneficial role of tissue ferritins in nonspecific antibacterial resistance. PMID- 1768609 TI - Haloalkylamine-induced renal papillary necrosis: a histopathological study of structure-activity relationships. AB - The haloalkylamine 2-bromoethanamine (BEA) causes necrosis of renal papillae of rats within 24 h of a single intraperitoneal dose greater than or equal to 100 mg/kg. Nine structural analogues of BEA, differing by halide substitution, alkyl chain elongation or amine substitution, were tested for their ability to induce renal papillary lesions in rats. Three compounds (2-chloroethanamine, 3 bromopropanamine and 2-chloro-N,N-dimethylethanamine) induced lesions which were morphologically indistinguishable from those of BEA. All the molecular structural variations investigated reduced papillotoxicity compared with BEA, the parent compound. A variety of non-renal lesions including hepatic, adrenal, testicular and lymphoid necroses were also encountered. The most toxic compound was 2 fluorethanamine, a 5 mg/kg dose of which was lethal and induced renal corticomedullary mineralization and centrilobular hepatic necrosis. One analogue, 3-bromo-2-hydroxypropanamine, caused rapid and extensive necrosis of the adrenal pars fasciculata and reticularis, simulating human Waterhouse Friderichsen syndrome. The three newly identified renal papillotoxins are all theoretically capable of generating direct-acting alkylating species in solution and their activity as direct-acting mutagens in the Ames bacterial mutagenicity test with TA100 (indicating base pair substitution) closely correlated with their potency as papillotoxins. We therefore hypothesize that non-enzymically formed direct acting alkylating species mediate these papillary lesions, and that the target selectivity of haloalkylamine toxicity most probably results from the accumulation of these alkylating species in papillary tissue. PMID- 1768610 TI - The relationship between donor age and the growth characteristics of human smooth muscle cultures of aorta and stomach. AB - The relationship between donor age and the growth characteristics of normal human smooth muscle cell cultures derived from aorta and stomach was examined in a series of growth studies. A negative correlation was demonstrated between donor age and growth potential of both cell types in primary culture. This decreased growth potential of cultures derived from older donors was maintained in later passage cultures. The results suggest that the culture of human aortic and gastric smooth muscle cells from older donors is more difficult and that any cell cultures established may be limited by poor growth characteristics. PMID- 1768611 TI - Effects of simultaneous diabetes and hypertension in an insulin dependent diabetic model. AB - Several lines of evidence suggest that hypertension is a contributing factor to diabetic nephropathy, a major cause of mortality in diabetes mellitus patients. The present study tested the hypotheses (1) that insulin dependent diabetes (IDD) causes hypertension, and (2) that simultaneous hypertension and IDD causes greater renal damage than would be expected from the independent contributions of each disease. IDD was induced by injection of streptozotocin (STZ, 65 mg/kg i.p.) into male Wistar rats, causing severe hyperglycaemia within 4 days. Seven days after the STZ treatment, hypertension was initiated by subcutaneous implantation of deoxycorticosterone acetate and administration of 1% saline in the drinking water (DOCA-NaCl). IDD rats not receiving DOCA-NaCl displayed a small elevation of blood pressure one week after STZ treatment, but thereafter displayed significant hypotension. The IDD rats receiving DOCA-NaCl displayed elevated systolic arterial pressure throughout the study, but by the end of the experiment, their mean systolic arterial pressure was significantly lower than that of the rats treated with DOCA-NaCl alone. Only the IDD/DOCA-NaCl rats displayed significant signs of renal dysfunction, i.e. greatly increased proteinuria and morphological renal damage, including marked distension of distal tubules and occasional casts. No other group displayed these abnormalities. PMID- 1768612 TI - A simple method of separation of Pneumocystis carinii from rat lung. AB - Existing methods for purification of Pneumocystis carinii are unsatisfactory. Dialysis is a simple, non-stressful treatment which aided purification of organisms from rat cells. Yields were quantitated using a Petroff-Hausser chamber and nuclear staining. Following dialysis overnight, three times the yields of similar, undialysed preparations were obtained, with less than 0.2% contamination by lung cells. Overnight incubation at 4 degrees C also improved separation, but yields were only half those following dialysis. Dialysis is now used routinely in the preparation of pure Pneumocystis carinii suspensions. PMID- 1768613 TI - Effects of ancrod and rtPA on fibrin accumulation, glomerular inflammation and renal function in nephrotoxic nephritis. AB - We have compared the effects of ancrod and recombinant tissue plasminogen activator (rtPA) on nephrotoxic nephritis induced in pre-immunized rabbits by the administration of nephrotoxic globulin (NTG; sheep anti-rabbit glomerular basement membrane). We used three different doses of NTG: in each experiment three groups of six rabbits were preimmunized with normal sheep globulin and given NTG: group A received no further treatment; group B received rtPA, 2 mg/kg 12 hourly; group C received ancrod 2 U/kg 12 hourly. Animals were bled daily for estimation of plasma fibrinogen and serum creatinine, then killed on day 5 and kidneys removed for histology. 1 ml/kg of NTG caused massive glomerular necrosis, all three groups having severe renal failure. With 0.5 ml/kg of NTG, ancrod and rtPA both effectively prevented fibrin deposition in Bowman's space, but all animals had severe proliferative glomerulonephritis and marked renal failure. With 0.25 ml/kg of NTG, control animals developed severe proliferative nephritis and advanced renal failure, ancrod provided almost complete protection, and the rtPA group had renal injury and functional impairment intermediate between the other two groups. We conclude that renal failure in severe nephrotoxic nephritis is fibrin-independent, but in less fulminant nephritis renal function can be protected by defibrination with ancrod. rtPA is capable of reducing glomerular fibrin accumulation as effectively as ancrod, but provides inferior protection of renal function. PMID- 1768614 TI - An ultrastructural study of spontaneous and phenobarbitone-induced nodules in the mouse liver. AB - Male C3H/He mice were given 0 (control) or 85 mg/kg/day phenobarbitone (PB) in the diet. At 40, 60 and 93 weeks, groups of mice were killed and the ultrastructure of spontaneous and PB-induced liver nodules was examined. Treated mice showed typical centrilobular hypertrophy and eosinophilic nodules which may be considered as an end stage lesion. The nodule cells were similar in appearance to those in areas of centrilobular hypertrophy except for the presence of convoluted membranes which are considered to be indicative of proliferation. The incidence of carcinoma was not increased by PB treatment. The carcinomas from control and treated animals differed in their ultrastructure in that increased levels of smooth endoplasmic reticulum (SER) were seen in the carcinomas of the PB animals. The presence of SER proliferation in the carcinomas of PB animals suggests that carcinoma may respond to the enzyme-inducing effects of PB. PMID- 1768615 TI - Intracellular location of mycoplasmas in cultured cells demonstrated by immunocytochemistry and electron microscopy. AB - Mycoplasma fermentans (strain 'incognitus') was incubated with HeLa cells for up to 96 h. After 24 h, mycoplasma organisms were demonstrated intracellularly by immunocytochemistry using mule anti-M. fermentans antiserum and gold labelling on ultrathin sections of both Lowicryl K4M and Araldite-embedded HeLa cells, the latter being treated with hydrogen peroxide. The Araldite-embedded cells were fixed with glutaraldehyde and osmium tetroxide in the presence of ruthenium red to stain the mucopolysaccharide surface components of both the procaryotic and eucaryotic cells. Intracellular localization of some M. fermentans organisms was confirmed by exclusion of ruthenium red from their membranes. Various numbers of mycoplasma organisms were seen per cell and occasionally some were within vacuoles, the membranes of which were also unstained by ruthenium red. The PG18 strain of M. fermentans and a strain of M. hominis were also detected intracellularly using similar methodology and homologous mule or rabbit antisera. The occasional presence of both apparently normal and some denser degenerate mycoplasmas in the same cell may indicate gradual degradation by phagolysosomal digestion. PMID- 1768616 TI - Evaluation of experimental carcinogenicity studies for human risk assessment. PMID- 1768617 TI - Zinc finger proteins: what we know and what we would like to know. PMID- 1768619 TI - Analysis of a foot regeneration deficient strain of Hydra oligactis. AB - A foot regeneration deficient strain of Hydra oligactis with altered size regulation was investigated. Analysis of the concentration of four morphogenetically active substances in Hydra oligactis showed that the foot regeneration deficiency was mainly due to a drastically reduced foot activator concentration. Foot activator was distributed as a very steep gradient in Hydra oligactis leading to a more severe impairment of foot regeneration the closer to the head cutting was done. The concentration of foot inhibitor was comparable, that of head activator slightly increased and that of head inhibitor reduced compared to Hydra vulgaris. Studies at the cellular level implied that the enlarged gastric region was due to an elevated level of inhibition hinting at a shift in the ratio between bound and free head inhibitor in this animal. PMID- 1768618 TI - Structure, expression and chromosomal location of the Oct-4 gene. AB - The map position of Oct-4 on mouse chromosome 17 is between Q and T regions in the Major Histocompatibility Complex (MHC), and it is physically located within 35 kb of a class I gene. Several Oct-4-related genes are present in the murine genome; one of them maps to chromosome 9. The genomic structure and sequence of Oct-4 determined in t-haplotypes reveals five exons, and shows no significant changes in the t12 mutant haplotype making it unlikely that Oct-4 and the t12 early embryonic lethal are the same gene. By in situ hybridization, detectable onset of zygotic Oct-4 expression does not occur until compaction begins at 8 cells, suggesting that there might be other regulatory factors responsible for initiating Oct-4 expression. PMID- 1768620 TI - Cellular specificity of expression and regulation of Drosophila vitelline membrane protein 32E gene in the follicular epithelium: identification of cis acting elements. AB - In this paper we analyze the expression in follicular cells and regulation of the vitelline membrane protein gene we identified in region 32E of the second chromosome of D. melanogaster (VMP32E). We report germ line transformation results obtained with different kinds of gene fusion leading to the identification of a follicular cell subpopulation involved in the expression of the VMP32E. We have characterized two 5' non-transcribed regions (-465/-249; 135/-39) where the cis-acting transcriptional regulatory sequences, directing tissue and temporal specificity, are contained. The region between -465 and -249, which appears to control transcriptional high efficiency, does not behave as an enhancer as it is incapable of conferring any expression to a reporter gene. The region between -135 and -39 can confer temporal specificity of expression of the VMP32E gene, albeit at a very low level. Most interestingly, sequence similarities to ecdysone response elements raise the possibility of hormonal control also for VMP gene expression. PMID- 1768621 TI - Control and function of terminal gap gene activity in the posterior pole region of the Drosophila embryo. AB - We have studied the genetic requirement for the normal expression of the terminal gap genes huckebein (hkb) and tailless (tll) and their possible function in the posterior pole region of the Drosophila embryo. At the early blastoderm stage, both genes are expressed in largely coextensive expression domains. Our results show that in the posterior region of the embryo both the activation and the control of the spatial limits of tll and hkb expression are critically dependent on torso (tor) activity, which is thought to be a crucial component of a cellular signal transduction pathway provided by the terminal maternal system. Furthermore, the spatial control of hkb and tll expression does not require mutual interactions among each other, nor does it require regulatory input from other gap genes which are essential for the establishment of segmentation in the trunk region of the embryo ("central gap genes"). Therefore, the terminal gap genes have unique regulatory features which are distinct from the central gap genes. In the absence of terminal gap gene activities, as in hkb and tll mutant embryos, the expression domains of the central gap genes expand posteriorly, indicating that the terminal gap gene activities prevent central gap gene expression in the posterior pole region of the wildtype embryo. This, in turn, suggests that the terminal gap gene activities prevent metamerization by repression of central gap genes, thereby distinguishing the segmented trunk from the nonsegmented tail region of the embryo. PMID- 1768622 TI - The maternal gene product D7 is not required for early Xenopus development. AB - The Xenopus D7 gene codes for a novel protein whose expression is restricted to early development. D7 protein is synthesized for the first time during oocyte maturation (1988, Genes Dev. 2, 1296-1306). Injection of D7 RNA into the full grown oocyte and its subsequent translation into D7 protein neither induced oocyte maturation nor affected the kinetics of hormone-induced maturation. Overexpression of D7 protein by 20-fold in the early Xenopus embryo by injection of D7 RNA into fertilized eggs did not affect subsequent development. Oocytes specifically lacking D7 mRNA were generated by oligodeoxynucleotide-mediated RNA destruction within the oocyte. Unfertilized eggs generated from such oocytes lacked detectable D7 protein, but nevertheless could be activated and fertilized. Embryos generated from such eggs, estimated to contain less than 5% of wildtype levels of D7 protein, developed normally up to the tailbud stage. Thus the D7 protein, the product of a maternal mRNA that is under strict translational repression in oocytes, appears not to be required for oocyte maturation, activation, fertilization or early embryonic development in Xenopus. PMID- 1768623 TI - Acute promyelocytic leukemia: an update. PMID- 1768624 TI - The clinical relevance of epidemiology: an overview. AB - Epidemiology is one of the areas of medical research which by definition should have immediate clinical implications, since its inferences are based on and apply to humans and should in theory be directly transferable to clinical and preventive measures. However, interchange of information has not always been easy, and this has constituted a substantial drawback to both the epidemiologist and the clinician. This review paper will provide some points for discussion, with special emphasis on cancer epidemiology and aspects of specific interest to the clinician, i.e., quantification and risk assessment for primary prevention and cost/benefit evaluation for secondary prevention and cancer treatment. Quantitative assessment is of major importance for the oncologist in at least three areas: cancer trends (descriptive epidemiology), cancer risks (analytical epidemiology), and preventive and therapeutic measures (clinical epidemiology). PMID- 1768625 TI - Overprolonged adjuvant tamoxifen therapy in breast cancer. AB - While adjuvant tamoxifen therapy given continuously for 2-3 years can lead to a modest improvement in survival rates in early breast cancer, there is no evidence that prolonging tamoxifen administration beyond that time is likely to improve survival rates any further in unselected cases. In the case of advanced disease, an alternating tamoxifen/progestagen regimen has been shown to increase the response rate and also its duration, beyond that to be expected from either agent alone. The next generation of adjuvant trials in breast cancer needs to explore the potential of an alternating tamoxifen/megestrol regimen. PMID- 1768626 TI - Epidemiology of acute promyelocytic leukemia in Italy. APL Collaborating Group. AB - This retrospective epidemiologic study on 256 cases of Acute Promyelocytic Leukemia (APL) observed in 20 Italian hematology centers between 1980 and 1988 demonstrated that APL is different from the other acute non-lymphocytic leukemias (ANLL). The male/female ratio was 0.9; median age at diagnosis was 40 years (with 80% of patients between 15 and 54 years of age). The minimal annual incidence of APL in Italy per 1,000,000 inhabitants was estimated to be 0.6; an increased incidence was observed in spring and in autumn. The overall median survival duration of APL patients was 12.6 months. From an epidemiological point of view APL is a distinctive subtype of ANLL. PMID- 1768627 TI - Radioimmunolocalization of colorectal carcinoma. A correlation among RIL results, surgical findings, serum tumor marker levels and the presence of CEA and CA 19.9 in tumor tissue: the experience of the Hospital de la Santa Creu i Sant Pau. AB - We report a prospective study in two groups of colorectal cancer patients carried out by radio-immunolocalization (RIL) with F(ab') fragments of monoclonal antibodies against CEA and CA 19.9 labeled with 131-I. Twenty-two patients were studied before radical surgery and 12 patients after initial surgery, when progressive increase in CEA was registered. Scintigraphic images obtained in vivo in RIL studies were compared with scintigraphic images of the corresponding surgical specimens. Results were compared with known serum marker levels and with the presence and localization of markers in the excised specimens. RIL images correctly identified 13 of 23 (52%) primary tumors, with only one false positive image. Scintigraphy of surgical specimens correlated with RIL findings in 14 of 19 cases (74%). Four specimens which showed antibody uptake had not been visualized preoperatively in the RIL study. Two of them were retrovesical and were obscured by residual activity in the bladder. Nine of 13 (64%) patients with at least one elevated tumor marker were imaged. Staining pattern or intensity of antigen staining in the specimens did not correlate with RIL findings. Recurrent disease was confirmed by laparotomy or other exploration in 10 of the 12 patients with progressive CEA elevation during follow-up. Spontaneous normalization of CEA levels was observed in the remaining 2 patients. RIL studies were positive in 7 of the 10 patients with confirmed recurrent disease. Of the 3 false negative patients 2 had liver metastases and one developed clinical lung, bone and adrenal metastases 11 months later. No false positive studies were observed in this group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768628 TI - Two simple indexes used to evaluate the impact of therapy on the quality of life of patients receiving primary chemotherapy for operable breast cancer. AB - The psychometric characteristics of two indexes used to evaluate the subjective morbidity of chemotherapy regimens were analyzed. Both indexes assessed the duration of discomfort as perceived by the patient throughout therapy. The first index asked patients to state the number of days spent with 'discomfort', and the second index asked them which days they would like to eliminate altogether because of the unbearable symptoms experienced on those days. While the first index gives some idea of the duration of suffering, without defining it, the second highlights a specific time when the quality of her life was unacceptable to the patient. We studied these indexes in the form of a questionnaire completed by 168 women who had entered a cancer clinical trial. This trial evaluated the efficacy of primary chemotherapy in rendering conservative surgery feasible in women with operable breast cancer, but whose tumor size was greater than 3 cm. Four different treatment regimens were used: CMF, FAC, FEC, FNC (C = cyclophosphamide, M = methotrexate, F = fluorouracil, A = adriamycin, E = epirubicin, N = mitoxantrone). Seventy-nine patients were interviewed during chemotherapy and 89 during follow-up visits. Initial assessment of the reliability, discriminant and concurrent validity of the two indexes produced satisfactory results. Finally, we analyzed the responses given by 168 patients for a total of 600 treatment cycles. The average value of 'discomfort' was 3 days, whereas the average value of days 'to be eliminated' was 1. The range of subjective morbidity (for every cycle of treatment: 'discomfort = 0-30 days; 'to be eliminated' = 0-20 days) was very broad.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768629 TI - An analysis of prognostic factors in stage III and IV Hodgkin's disease treated at a single centre with MVPP. AB - Two hundred and twenty seven patients with stage IIIA-IVB Hodgkin's disease have been treated at a single centre with MVPP chemotherapy followed by radiotherapy to sites of previously bulk disease. The median follow up is 58 months. 119 patients (52%) had stage IV disease. Overall complete remission (CR) rate was 72%. Discriminant analysis of factors predictive for complete remission showed that low albumin was the only independent factor that predicted a significantly lower chance of CR. Overall five year survival was 73%. A Cox multivariate analysis demonstrated that age greater than 40 years, stage IV disease, presence of bulk disease, low serum IgG and male sex to be variables which independently predicted poorer prognosis in terms of overall survival. Stage IV and lymphocyte depleted or unclassified histologies were independently predictive for poorer progression-free survival. Patient weight greater than 70 kg and stage IV disease were adverse prognostic factors for relapse free survival. Results are compared to other published multivariate analyses of prognostic factors in advanced Hodgkin's disease. PMID- 1768630 TI - Intra and interobserver variability in cancer patients' performance status assessed according to Karnofsky and ECOG scales. AB - The Karnofsky (K) and ECOG (E) performance status (PS) scales are widely used to evaluate the functional status of cancer patients to determine their eligibility for clinical trials and their prognosis, but knowledge of inter and intraobserver variability of these scales is scarse. We therefore planned a prospective study on 209 consecutive cancer patients to evaluate this critical point. Two independent observers evaluated the KPS and EPS of each patient by interviewing them on the same day. After their interviews the patients were asked to fill in, again on the same day, a self-evaluation scale concerning their ability to perform the routine activities of daily life. The 209 patient self-evaluation scales were presented twice, randomly and blinded, to the two observers who had participated in the evaluation of PS as well as to one other observer who had not. The interobserver correlation for both scales was very high (K = 0.921 for KPS and K = 0.914 for EPS) as was the intraobserver correlation (for KPS: K = 0.993, K = 0.960, and K = 0.959 and, respectively, for EPS: K = 0.982, K = 0.970, and K = 0.920). On the basis of these results, it appears that evaluation of PS made by a clinical oncologist using K or E scales can be very reliable and is a guarantee of optimal selection of cancer patients for inclusion in clinical trials. PMID- 1768631 TI - Combination of rubidazone and cytosine arabinoside in the treatment of first relapse in acute myelocytic leukemia. AB - This study tested the efficacy of rubidazone and cytosine arabinoside in 35 patients (13 children and 22 adults) with acute myelocytic leukemia in first relapse. Induction consisted of 1-2 courses of rubidazone 200 mg/m2 days x 4 days plus cytosine arabinoside 100 mg/m2 x 7 days in CI followed by 2 consolidation courses of 3 days and 5 days. Nineteen patients (54%) achieved complete remission, 8 failed to respond, and 8 died. Twelve patients relapsed after 1 to 9 months, at a median of 4 months, 1 patient died of cardiac failure and 1 remains in complete remission at 12 months. Five patients underwent bone marrow transplantation, 3 of them autologous, 1 was still in complete remission at 29 months, 1 relapsed, and 1 died of sepsis. Two received allogeneic marrow transplants and died at 3 and 4 months afterwards of VOD and graft failure. The main toxicity was severe and prolonged myelosuppression. PMID- 1768632 TI - Phase II trial of vinblastine plus nifedipine (VN) in patients with advanced renal cell carcinoma (RCC). Brazilian Oncology Trials Group. PMID- 1768633 TI - Phenytoin-induced benign lymphadenopathy with solid spleen lesions mimicking a malignant lymphoma. PMID- 1768634 TI - The direct determination of protein concentration for proteins immobilized on polystyrene microspheres. AB - In this paper we show how the Lowry method, designed for the determination of proteins in solution, can be used for the determination of proteins immobilized on the surface of microspheres (for protein concentrations higher than 10 micrograms/ml). Measurements were made for human serum albumin (HSA) and for immunoglobulins [rabbit immunoglobulins--antibodies against human fibrinogen (IgGF) and against fragment D of human fibrinogen (IgGFgD)] immobilized on the surface of polystyrene microspheres. PMID- 1768635 TI - Calculation of solvation interaction energies for protein adsorption on polymer surfaces. AB - Of the interactions that govern protein adsorption on polymer surfaces, solvation interactions (repulsive hydration and attractive hydrophobic interactions) are thought to be among the most important. The solvation interactions in protein adsorption, however, have not been dealt with in theoretical calculation of the adsorption energy owing to the difficulties in modelling such interactions. We have evaluated the solvation interaction energies using the fragment constant method of calculating the partition coefficients of amino acids. The fundamental assumption of this approach is that the partition coefficients of amino acids between water and organic solvent phases are related to the free energies of transfer from bulk water to the polymer surface. The X-ray crystallographic protein structures of lysozyme, trypsin, immunoglobulin Fab, and hemoglobin from the Brookhaven Protein Data Bank were used. The model polymer surfaces were polystyrene, polypropylene, polyethylene, poly(hydroxyethyl methacrylate) [poly(HEMA)], and poly(vinyl alcohol). All possible adsorption orientations of the proteins were simulated to study the effect of protein orientation on the solvation interactions. Protein adsorption on either hydrophobic or hydrophilic polymer surfaces was examined by considering the sum of solvation and other interaction energies. The results showed that the contribution of the solvation interaction to the total protein adsorption energy was significant. The average solvation interaction energy ranged from -259.1 to -74.1 kJ/mol for the four proteins on the hydrophobic polymer surfaces, such as polystyrene, polypropylene, and polyethylene. On the other hand, the average solvation interaction energies on hydrophilic surfaces such as poly(HEMA) and poly(vinyl alcohol) were larger than zero. This indicates that repulsive hydration interactions are in effect for protein adsorption on hydrophilic polymer surfaces. The total interaction energies of the proteins with hydrophobic surfaces were always lower than those with more hydrophilic surfaces. This trend is in agreement with the experimental observations in the literature. This study suggests that consideration of the solvation interaction energies is necessary for accurate calculation of the protein adsorption energies. PMID- 1768636 TI - Surface-modulated skin layers of thermal responsive hydrogels as on-off switches: I. Drug release. AB - Thermosensitive co-polymers of isopropyl acrylamide (IPAAm) with butyl methacrylate (BMA) are capable of 'on-off' regulation of drug release in response to external temperature changes due to skin formation with increasing temperature. To clarify the role of the surface-modulated skin and controlled pulsatile drug release patterns, the surface shrinking process was regulated by changing the length of the methacrylate alkyl side-chain. Release of indomethacin in response to stepwise temperature changes between 20 and 30 degrees C from co polymers of IPAAm with BMA, hexyl methacrylate (HMA), and lauryl methacrylate (LMA) was studied. The drug release rate during the 'on' state (20 degrees C) remained constant before and after the 'off' state (30 degrees C) when the period of the 'off' state was increased. These results suggest that the drug in the polymeric matrices diffused from the inside to the surface during the 'off' state even when no drug release was seen. The length of alkyl side-chain was found to be an important parameter in controlling the thickness and density of the surface skin layer. PMID- 1768637 TI - Endothelial cell growth on oxygen-containing films deposited by radio-frequency plasmas: the role of surface carbonyl groups. AB - Polystyrene substrates were modified by radio-frequency plasma deposition from mixtures of various organic vapors (acetone, methane, methanol, and formic acid) and oxygen. The resulting surfaces exhibited a wide range of surface oxygen concentrations, as measured by electron spectroscopy for chemical analysis (ESCA). The surface hydroxyl, carboxyl, and carbonyl groups were derivatized with trifluoroacetic anhydride, trifluoroethanol, or hydrazine, respectively, and their concentrations subsequently determined by ESCA. The growth of bovine aortic endothelial cells was found to increase with the surface carbonyl concentration but did not appear to correlate with the hydroxyl or carboxyl concentrations. PMID- 1768638 TI - Protein adsorption on biomedical polymers with a phosphorylcholine moiety adsorbed with phospholipid. AB - The effects of phospholipid adsorption onto the polymer surface during adsorption of plasma proteins were investigated. When a polymer with the phosphorylcholine moiety, 2-methacryloyloxyethyl phosphorylcholine (MPC) co-polymer, was treated with dipalmitoylphosphatidylcholine (DPPC) liposome solution, an organized adsorption layer of DPPC was formed on the MPC co-polymer surface, which was confirmed by differential scanning calorimetric analysis and X-ray photoelectron spectroscopy. On the other hand, an organized layer of DPPC on poly(n-butyl methacrylate) and poly(2-hydroxyethyl methacrylate) could not be found. The amount of albumin adsorbed on the polymer surfaces was decreased by pretreatment of the surface with DPPC liposome solution in every polymer case. The smallest amount of adsorbed proteins was found on the MPC co-polymer. Protein adsorption on the surface of MPC co-polymers from the plasma was also small. The difference in protein adsorption on the polymers probably reflects the difference in the orientation of the phospholipid molecules which cover the polymer surface. PMID- 1768639 TI - (+-)-Octahydro-2-methyl-trans-5 (1H)-isoquinolone methiodide: a probe that reveals a partial map of the nicotinic receptor's recognition site. AB - A new, semirigid, nicotinic agonist (+-)-octahydro-2-methyl-trans-5 (1H) isoquinolone methiodide was synthesized. The disposition of this agonist's nitrogen and carbonyl group conforms well to the prevailing notion of a pharmacophore for the nicotinic receptor. Comparing its structure and electrostatic potential surfaces, we predicted that its activity would be similar to that of carbamylcholine at the frog neuromuscular junction. Instead, the potency of the isoquinolone was only 0.015 times as potent as (+) carbamylcholine. We conclude, after eliminating other possibilities, that the vicinity of the carbonyl group of an agonist must be planar to fit a confined space within the receptor's recognition site. The isoquinolone is a weak agonist because its methylene group beta to the carbonyl intrudes on this space. PMID- 1768640 TI - Stereo viewing on the PC/AT with EGA graphics. AB - Tachystoscopic stereo can be used to greatly enhance the performance and usability of low-cost molecular graphics systems. Here, a simple way to connect and control three-dimensional liquid-crystal glasses from a PC/AT with EGA graphics capabilities is described. The method makes elegant use of the screen's vertical retrace for synchronization purposes, allowing left and right views to be alternated every refresh cycle. PMID- 1768641 TI - Novel method for the display of multivariate data using neural networks. AB - A neural network has been used to reduce the dimensionality of multivariate data sets to produce two-dimensional (2D) displays of these sets. The data consisted of physicochemical properties for sets of biologically active molecules calculated by computational chemistry methods. Previous work has demonstrated that these data contain sufficient relevant information to classify the compounds according to their biological activity. The plots produced by the neural network are compared with results from two other techniques for linear and nonlinear dimension reduction, and are shown to give comparable and, in one case, superior results. Advantages of this technique are discussed. PMID- 1768642 TI - HAMOG: molecular graphics program for chemistry, biochemistry, molecular biology and enzyme research. AB - HAMOG is a computer graphics program written in C for personal computers. Clear menus and a context-sensitive help option make the program easy to operate for occasional users. HAMOG provides a flexible environment for displaying and manipulating molecules and molecular systems. Special functions allow the investigation of structure-activity relationships of biologically active molecules. These include the calculation of molecular electrostatic potentials and fields, the superposition of molecules and the calculation of steric accessibilities. The visualization and manipulation of protein structures immediately readable from the Brookhaven Protein Data Bank files are also possible using HAMOG. The construction of any peptide or protein structure is very simple. PMID- 1768643 TI - TEQUILA: displaying molecular distance maps. PMID- 1768644 TI - Efficient method for the generation and display of electrostatic potential surfaces from ab-initio wavefunctions. AB - A cost effective color graphics representation of molecular electrostatic potential surfaces employing the cumulative atomic or bond multipole moments has been described. A general description of the method used to obtain cumulative multipole moments directly from ab-initio wavefunctions is given, along with an outline of the algorithm for generating electrostatic potential surfaces in the molecular graphics programs MOL17 (FORTRAN 77, Silicon Graphics 3130 and 4D series workstations) and PCMCAMM (Turbo Pascal, IBM PC and PS/2 computers). Examples are given that illustrate the convergence of the multiple expansion, the degree of basis-set dependence compensated by the use of higher atomic moments, and the effect of placing additional expansion centers along the bonds. PMID- 1768645 TI - Number of residues in a sphere around a certain residue can be used as a hydrophobic penalty function of proteins. AB - A novel hydrophobic penalty function of proteins is proposed and assessed with several test cases. The number of residues in a defined sphere around a certain residue is averaged over the data set proteins. Differences between the standard values thus obtained and calculated values are summed up, residue by residue, with the weight of standard deviations to give the penalty value. This penalty function is applied to the structures of randomly shuffled sequences, incorrectly folded structures and partially denatured structures displayed on a graphics terminal, and is shown to discriminate the native structure from others fairly well, although the present parameter set is tuned for proteins of about 100-150 residues. From the results of present study and the known correlation with other hydrophobic parameters of amino acids, the penalty function can be considered as a practical amino acid residue-level hydrophobic penalty function. PMID- 1768646 TI - Program for the visualization of inorganic crystals. AB - A program has been developed to manipulate images of inorganic structures and organic molecules on ALLIANT VFX/40 using the PHIGS + standard. This article reviews algorithms for representing spheres, ellipsoids and various polyhedrons involved in inorganic chemistry. The program also supports the display and manipulation of animated frames from dynamics simulations. Many graphical facilities have been implemented and we discuss their interest in the field of molecular graphics. PMID- 1768647 TI - Model structure for the human blood coagulation agent beta-factor XIIa. AB - An improvement to the human blood coagulation agent beta-factor XIIa three dimensional model is proposed. The sequence alignment as well as the modeling procedures are presented and the minimized energy of the new model is reported before and after solvation of the active center. PMID- 1768649 TI - Bridging the gap between top-down and bottom-up. Allan C. Wilson, 1934-1991. PMID- 1768648 TI - A yeast transcription assay defines distinct rel and dorsal DNA recognition sequences. AB - Recent data have demonstrated that vRel, cRel, Dorsal, and NF-kappa B are members of a larger family of DNA-binding regulatory proteins. Rel proteins interact to form homo- and heterodimers that recognize specific sites on DNA, and it is likely that such protein-protein and protein-DNA interactions contribute to proper regulation of target gene expression by these proteins. Here we describe the use of a yeast transcription activation assay to study binding of three Rel family proteins to their native binding sites. These results show that the vRel and cRel proteins recognize two known NF-kappa B binding sites; the Dorsal protein does not recognize NF-kappa B sites, but does recognize related sites upstream of the Drosophila zerknullt gene. Our experiments demonstrate that the members of this protein family recognize similar, but not identical, sites in the promoters of target genes, and we are able to identify a particular nucleotide that is apparently involved in the DNA-protein interaction. We exploit the properties of LexA fusion proteins to study the dimerization and DNA-contacting domains of cRel. Our results suggest that the cRel protein forms homodimers and that dimer formation may be necessary for cRel to bind DNA. Finally, our results show that transcription activation by these proteins is cooperative; such cooperativity may be important for correct temporal and spatial regulation of target gene expression. PMID- 1768650 TI - Molecular requirements for cell fate determination during T-lymphocyte development. AB - Antigen-specific T lymphocytes recognize peptide antigens in conjunction with the products of the self major histocompatibility complex (MHC). In addition, they are immunologically self-tolerant. To acquire these characteristics, thymocytes undergo a stringent cellular selection process during development. The study of thymocyte development at the molecular level is impeded in mammalian systems by the heterogeneity of the thymocyte population in each individual. However, the use of mice transgenic for the T-cell receptor successfully circumvented this problem and made it possible to elucidate some of the requirements for positive selection, which leads to thymocyte differentiation, survival, and MHC restriction, and negative selection, which leads to programmed cell death, clonal deletion, and self-tolerance. T-cell fate is determined primarily by the nature of the interaction between a complex composed of the T-cell receptor and CD4 or CD8 molecules on the T-cell surface and the peptide antigens that are bound to MHC products and are displayed by other nonlymphoid cells present in the thymus. The molecular analysis of the receptor-ligand interactions involved in this process in transgenic mice provides opportunities to dissect cell fate determination in an intact mammalian system and to understand the molecular basis for immunological self-tolerance and MHC-restriction. PMID- 1768651 TI - DNA CpG methylation inhibits binding of NF-kappa B proteins to the HIV-1 long terminal repeat cognate DNA motifs. AB - The regulation of cellular or viral gene expression is directly influenced by the pattern of methylated cytosine residues localized in the DNA of enhancer/promoter sequences. The mechanism of transcriptional silencing has been explained on the basis of either an indirect model, in which densely methylated DNA is recognized by proteins that may displace crucial transcription factors, or a direct model, in which binding of a single transcription protein is prevented by the presence of a methylated CpG dinucleotide localized in a sensitive region of a DNA motif. In this study, we have determined that methylation of the core CpG dinucleotide located within the NF-kappa B repeated motifs of the human immunodeficiency virus type 1 (HIV-1) long terminal repeat can inhibit the binding of the NF-kappa B protein complex from crude nuclear extracts or from purified bovine spleen and specifically inhibit the binding of recombinant p50 protein. We have used the electrophoretic mobility shift assay (EMSA) and DNaseI footprinting analysis to demonstrate that binding of the NF-kappa B proteins to their cognate motifs can be inhibited via the direct model proposed for methylation-mediated inhibition of DNA-protein interaction. PMID- 1768652 TI - Kappa B-specific DNA binding proteins are differentially inhibited by enhancer mutations and biological oxidation. AB - Kappa B (kappa B) enhancer binding proteins isolated from the nuclei of activated human T cells produce two distinct nucleoprotein complexes when incubated with the kappa B element from the interleukin-2 receptor-alpha (IL-2R alpha) gene. These two DNA-protein complexes are composed of at least four host proteins (p50, p55, p75, p85), each of which shares structural similarity with the v-rel oncogene product. Nuclear expression of these proteins is induced with distinctly biphasic kinetics following phorbol ester activation of T cells (p55/p75 early and p50/p85 late). DNA-protein crosslinking studies have revealed that the more rapidly migrating B2 complex contains both p50 and p55 while the more slowly migrating B1 complex is composed of p50, p55, p75, and p85. Site-directed mutagenesis of the wild-type IL-2R alpha kappa B enhancer (GGGGAATCTCCC) has revealed that the binding of p50 and p55 (B2 complex) is particularly sensitive to alteration of the 5' triplet of deoxyguanosine residues. In contrast, formation of the B1 complex, reflecting the binding of p75 and p85, critically depends upon the more 3' sequences of this enhancer element. DNA binding by all four of these Rel-related factors is blocked by selective chemical modification of lysine and arginine residues, suggesting that both of these basic amino acids are required for binding to the kappa B element. Similarly, covalent modification of free sulfhydryl groups with diamide (reversible) or N-ethylmaleimide (irreversible) results in a complete loss of DNA binding activity. In contrast, mild oxidation with glucose oxidase selectively inhibits p75 and p85 binding while not blocking p50 and p55 interactions. These findings suggest that reduced cysteine thiols play an important role in the DNA binding activity of this family of Rel-related transcription factors. PMID- 1768653 TI - Tax responsiveness of the GM-CSF promoter is mediated by mitogen-inducible sequences other than kappa B. AB - The mechanism by which the human T-cell leukemia viruses type I and II (HTLV-I and -II) transform T cells is unknown, but the nonstructural Tax protein that these viruses produce is known to be essential for viral replication and to have the capacity to trans-activate cellular gene expression. The HTLV-I and -II Tax proteins have been shown to activate the promoter of both the human and mouse granulocyte-macrophage colony-stimulating factor (GM-CSF) genes in mature T-cell lines. T-cell-specific Tax-responsive sequences were previously localized to the 90-bp region extending from base pairs -53 to +37 in the human GM-CSF promoter. In this study, a series of site-directed and deletion mutations were created in the human GM-CSF promoter, which was linked to the chloramphenicol acetyltransferase (CAT) gene, and the constructs were assayed for their response to Tax by using a Tax-expressing plasmid in transient cotransfection assays. The results demonstrated that both copies of the repeated sequence CATTA (A/T), located between base pairs -48 and -36, are required for Tax responsiveness in T cells and that these sequences bind nuclear factors present in T cells. The Tax responsiveness of other sequences located 5' of base pair -53 was also examined, including an NF-kappa B consensus sequence and the CK1, CK2, and GC-rich regions identified in both the mouse and human GM-CSF promoters. These sequences did not have Tax-responsive regulatory activity when they were examined in the context of the intact human GM-CSF promoter in T cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768654 TI - Propionibacterium acnes endophthalmitis. PMID- 1768655 TI - Prandial presbyopia: the muffin man. AB - Transient blurring of near vision can be due to a variety of causes. We report the case of a 35-year-old man with a 10-year history of blurring of near vision that begins 30 to 45 seconds after he starts to eat and that lasts until 10 to 15 minutes after he stops eating. Magnetic resonance imaging and computed tomography of the brain and orbits did not reveal any abnormality, and stimulation of individual cranial nerves did not result in a loss of near vision. Retinoscopic refraction revealed the loss of 1.5 dioptres of accommodative power in each eye one minute after he began to eat. To the best of our knowledge such blurring of vision at near, immediately after initiating a meal, has not been previously reported. The neuroanatomy of the accommodation and of the gustatory pathways are discussed, as they may relate to this patient's visual complaint. PMID- 1768657 TI - Anatomical factors influencing development of trichiasis and entropion in trachoma. AB - There has been no published investigation into the reasons why some patients with severe trachomatous conjunctival scarring develop entropion and trichiasis while others do not. In a population of leprosy patients with severe trachomatous conjunctival scarring the authors found that lagophthalmos correlated with the absence of trichiasis and entropion. We suggest that orbicularis oculi muscle function, as well as other anatomical variations among individuals, may contribute to the development of trachomatous entropion and trichiasis in patients with conjunctival scarring. PMID- 1768656 TI - Posterior lens capsule abscess due to Propionibacterium acnes and Staphylococcus epidermidis following extracapsular cataract extraction. AB - A case of posterior lens capsular abscess occurring many months after an extracapsular cataract extraction is presented. This was caused by a mixed infection involving Propionibacterium acnes and Staphylococcus epidermidis. The significance of Staph epidermidis after such a long postoperative period is uncertain, but the case shows features typical of secondary endophthalmitis due to P acnes, including a long delay in onset and a grumbling course not brought under control by medical treatment. It supports the theory that the nidus of infection is localised in the posterior lens capsule by showing development of a visible capsular abscess with associated vitreous involvement. The subsequent removal of the capsule and vitreous, despite leaving the intraocular lens in place, led to complete resolution of the inflammation. Both organisms have previously been found to be sequestered in the posterior lens capsule by histological and microbiological examination of excised capsular specimens. It is important to consider them as possible causative agents in the formation of a postoperative capsular abscess. PMID- 1768658 TI - Treatment of juxtapapillary melanomas. AB - Thirty nine patients suffering from juxtapapillary choroidal melanoma were treated with Ru-106/Rh-106 beta-ray plaques. The tumoricidal dose was 100 Gy at the apex of the tumour within 7-14 days. Additional photocoagulation was performed in 12 eyes. The irradiated eyes of three patients had to be enucleated, seven patients died, five of them (12.8%) from metastases. Thirty two (82%) patients are alive and 29 (74%) have a seeing eye. From the whole series 20 (51%) developed flat scars and 11 (29%) patients retained a visual acuity of 0.5-1.0. Radiogenic late complications with damage to the optic nerve and macula were the main causes of visual deterioration. PMID- 1768659 TI - Phototherapy of posterior uveal melanomas. AB - The results of phototherapy on a small series of 19 patients with uveal melanomas are presented. Laser radiation at a wavelength of 620 to 630 nm was used in conjunction with a 5 to 7.5 mg/kg dose of haematoporphyrin derivative administered 24 hours before treatment, with total doses/treatment averaging 960 J/cm2. Eleven patients received two treatments, and one received a third. The longest duration of tumour control to 30 September 1990 was 31 months. Of the 19 patients treated six had complete regression of the tumour, while another five had minor to significant regression. A strong correlation between degree of regression and degree of tumour pigmentation was found, the lighter tumours responding much better than darker tumours. There were also strong indications that if a tumour did not respond to the initial phototherapy it was very unlikely that subsequent phototherapy would provide any further benefit. PMID- 1768660 TI - Orbital lymphoma versus reactive lymphoid hyperplasia: an analysis of the use of computed tomography in differential diagnosis. AB - Computed x ray tomography (CT) studies of 40 patients with proptosis or periorbital swelling, in whom biopsy showed lymphoma in 23 and reactive lymphoid hyperplasia in 17, were analysed in an attempt to identify radiological differences between the two conditions. The results indicate that homogeneity of an orbital mass is a sensitive but non-specific indication of lymphoma, 75% of lymphomatous masses and only 23% of reactive lesions being homogeneous. Bone destruction was seen only in cases of lymphoma, but was rare. Other radiological features of the mass or the affected orbital structures did not allow discrimination of tumour from a reactive lesion. PMID- 1768661 TI - Nitrous oxide and internal tamponade during vitrectomy. AB - We analysed the nitrous oxide composition of the intraocular gas bubble following vitrectomy and fluid-air exchange in 12 patients. Samples were taken under standardised conditions at 20 minutes after completion of the fluid-air exchange. Analysis was conducted by a Medishield MS2 mass spectrometer. The percentage composition of nitrous oxide in the samples varied between 4 and 21% (mean 9%). This influx of nitrous oxide was associated with an increase of intraocular pressure. Pressure rises of greater than 20 mm Hg were not seen owing to venting of gas through the sclerostomies. An inverse relationship was noted between the extent of retinal detachment preoperatively and the amount of nitrous oxide entering the eye. A possible explanation for this relationship is proposed. The importance of nitrous oxide movement is stressed. PMID- 1768662 TI - Daycase cataract surgery. AB - The increasing demand for cataract surgery, combined with limited resources, has created renewed interest in daycase admission. We have audited the results of all daycase and inpatient cataract surgery in a large unit over a six-month period to determine the factors influencing daycase admission and surgical outcome; 34% of cataract patients were admitted as daycases in the study period. Neither distance travelled by the patient nor age appear to influence daycase admission. However, the differing policies of the individual consultant surgeons resulted in a wide variation in the number of operations performed on a daycase basis by each firm. The rate of preoperative complications was unaffected by daycase admission, by the grade of surgeon operating, or by the type of anaesthetic employed. Only 2.1% of daycase admissions resulted in unplanned inpatient admission on the day of surgery, with another 2.1% being readmitted within six months of surgery. Late cancellation of surgery was much lower for daycases (0.4%) than for inpatients (5.1%). PMID- 1768663 TI - Climatic droplet keratopathy, exfoliation syndrome, and cataract. AB - During a countrywide survey we assessed the prevalence of climatic droplet keratopathy (CDK) in a randomised sample of 2446 subjects representative of the population of the Republic of Djibouti. The investigation of the relationship between CDK and two diseases considered to be related to exposure to ultra-violet light--namely, exfoliation syndrome and cataract--was planned as a case control study. In the rural area prevalence of CDK was five times higher than in the urban one (2.8% vs 0.5%) and varied according to districts. The highest rates were observed where the inhabitants' activities were related to the sea. The case control study revealed that the opacification of the lens was about three times commoner in patients with CDK than in patients without CDK (p = 0.03) and that the exfoliation syndrome was about six times commoner in patients with CDK than in controls of similar age, sex, climatic conditions, and lens status (p = 0.02). Moreover, we noticed that the sequelae of corneal perforations were about 30 times commoner in patients with CDK than in controls of similar age (p less than 0.00001). PMID- 1768664 TI - Natural history of treatment of facial dyskinesias with botulinum toxin: a study of 50 consecutive patients over seven years. AB - To determine the long-term efficacy of botulinum toxin injections for the treatment of facial dyskinesias we studied 50 consecutive patients with blepharospasm, hemifacial spasm, and Meige syndrome. All received their first injection between September 1983 and June 1984. A total of 520 injections were given; the average number of injections per patient was 10.4 over the seven-year period ending September 1990. Twenty-six (52%) of the patients continued to return for periodic injections, while three patients no longer receive injections since they failed to respond adequately to treatment. Three patients with blepharospasm were in remission and required no further treatment, after a series of six, four, and three injections. Six patients were treated until they died of causes unrelated to facial dyskinesia or its treatment. Six patients are still being treated elsewhere because they could obtain injections closer to their homes. Five of the original 50 patients have been lost to follow-up. A patient with hemifacial spasm had one injection with good result but was not sufficiently bothered by her disease to return for reinjection. Complications were transient, minimal, well tolerated, and did not increase with increased number of injections. PMID- 1768665 TI - More than meets the eye: a study of the time lost from work by patients who incurred injuries from corneal foreign bodies. AB - A prospective study was carried out to establish the time lost from work due to corneal foreign body injury. Data were collected over a 5 month period on a total of 504 patients attending a busy district hospital eye casualty department. The median time lost through injury was 4 hours and 148 patients (30%) took no time off work. Corneal foreign bodies are known to be painful injuries but in spite of this few patients take more than half a day off work. PMID- 1768666 TI - A simplified technique for removal of orbital hydatid cysts. AB - A surgical technique is described for cryoextraction of the inner germinal layer of orbital hydatid cysts. The technique was adopted in two cases. It is simple and effective and causes minimal postoperative reaction or complications. There were no recurrences over a period of 24 and 18 months respectively. PMID- 1768667 TI - Visual development in the blepharophimosis syndrome. AB - One hundred and one cases of the blepharophimosis syndrome presenting over a decade are reviewed with particular attention to the factors influencing their visual development. Three distinct clinical patterns emerge--severe bilateral ptosis, moderate bilateral ptosis, and asymmetric ptosis--and their differing incidence of amblyopia and strabismus is discussed. The risk of amblyopia is much higher than previously believed (56.4% in our series) and preventive management is discussed. PMID- 1768668 TI - Neurilemoma of the caruncle: a clinicopathological report. AB - We report a case of a neurilemoma (schwannoma) arising from the lacrimal caruncle. The clinical and light and electron microscopic features are described. PMID- 1768669 TI - Intraocular lens in a fighter aircraft pilot. AB - A pseudophakic pilot of the Israeli air force flying an F-15 (Eagle) aircraft was followed up for three years. He experienced about 100 flying hours, 5% of the time under high g stress. The intraocular lens did not dislocate and no complications were observed. It seems that flying high performance fighter aircraft is not contraindicated in pseudophakic pilots. PMID- 1768670 TI - Tranexamic acid-associated ligneous conjunctivitis with gingival and peritoneal lesions. AB - A considerable number of agents have been proposed as causing ligneous conjunctivitis. We report the first case to arise as a side effect of tranexamic acid (Cyclokapron), an anti-fibrinolytic drug used in the treatment of menorrhagia. In addition to the typical conjunctival changes our patient had lesions affecting the gingiva and the peritoneum the last causing considerable protein loss into the peritoneal cavity. PMID- 1768671 TI - Use of leeches in a case of severe periorbital haematoma. AB - A case of severe penetrating eye injury and resulting periorbital haematoma is described. Leeches applied to the eyelids enabled examination of the globe to be carried out and improved the surgical approach. Leeches provide a speedy and efficient means of reducing a periorbital haematoma. PMID- 1768672 TI - Adoptively transferred tumor-infiltrating lymphocytes can cure established metastatic tumor in mice and persist long-term in vivo as functional memory T lymphocytes. AB - Tumor infiltrating lymphocytes (TILs) are derived from solid tumors by culturing single cell suspensions of the tumors in low dose interleukin-2 (IL-2) and intermittent tumor stimulation. We have investigated the survival of TILs after intravenous injection into tumor-bearing mice. Using several murine transplantable sarcomas, we examined the in vivo survival of TILs derived from B6.PL Thy 1a/CY mice (Thy-1.1), which were used to treat established experimental metastases in C57BL/6N (Thy-1.2) mice. Donor and host lymphoid cells could be clearly distinguished by fluorescence-activated cell sorting. We found that TILs or TILs + IL-2 could extend the survival of and, in some instances, cure established experimental hepatic and pulmonary metastases. Donor TILs could be recovered from treated animals at all time points tested; in mice cured of pulmonary metastases donor TILs could be detected as late as 119 days after intravenous injection even in the absence of exogenous IL-2. The administration of a relatively low dose of IL-2 in vivo to mice receiving TILs increased the number of donor TILs recovered from the lungs of cured animals 5-10-fold at all time points but did not change the period of time during which donor TILs could be detected in vivo. Additionally, TILs could be recovered from animals cured of established metastases and such cells retained their antitumor activity in vivo. Finally, when mice cured of pulmonary metastases by TILs or TILs + IL-2 were rechallenged with tumor, donor TILs specifically accumulated at the site of tumor rechallenge up to 4 months after adoptive transfer of TILs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768673 TI - A comparison of the immunomodulating properties of two forms of monophosphoryl lipid A analogues. AB - This investigation compared the immunomodulating activities of two forms monophosphoryl lipid A, which are analogues of bacterial lipopolysaccharides with little or no toxicity. Tested were a synthetic compound designated 504 and a purified compound, isolated from bacterial cell walls designated MPL. Both of these clinical adjuvant candidates were effective in mice in exerting strong immunomodulating activity in the following areas: (a) enhancing antibody production in young and aging mice; (b) suppressing antibody formation under different experimental conditions; (c) activating macrophages to secrete interleukin 1, hydrogen peroxide, and superoxide anion; and (d) stimulating proliferation of spleen cells from C3H/HeN mice. Both exhibited considerably reduced toxicity in LD50 assays when compared to native lipopolysaccharides (LPS). The LD50 for MPL was 225 times and that of compound 504, 40 times that of native LPS in the exquisitely sensitive, galactosamine-loaded C57BL/6 murine strain. PMID- 1768674 TI - High-fold expansion of human cytotoxic T-lymphocytes specific for autologous melanoma cells for use in immunotherapy. AB - We set up a culture protocol that consistently allows high-fold expansion of tumor-specific T-lymphocytes from most melanoma-invaded biopsies with low doses of recombinant interleukin-2 (rIL-2). Between 2-60 x 10(6) T-lymphocytes could be obtained and cryopreserved from 12 out of 13 patients, by culturing only 50 mm3 tumor tissue with rIL-2. Thawed lymphocytes from 11 of these patients could then be expanded by a median factor of 32,800 by culturing them successively in microplates on irradiated feeder cells with rIL-2 for approximately 2 weeks and then in culture bags or flasks with only rIL-2 for 1-2 additional weeks. Dead feeder cells disappeared during the last phase of the lymphocyte culture with rIL 2. Interestingly, each time they were expanded under these conditions, tumor infiltrating lymphocytes (TIL) or lymph-node lymphocytes developed a lytic activity apparently restricted to the autologous melanoma line. Tumor-specific lysis, which was maximum at around the end of T-lymphocyte expansion, ranged between 31-63% lysis at an effector:target (E:T) ratio of 20:1. This culture method would thus appear to be suitable for reliable production of over 10(10) T lymphocytes with good tumor-specific lytic activity from most melanoma-invaded biopsy. It should permit analysis of the immunotherapeutic potential of these populations reinjected into cancer patients. PMID- 1768675 TI - Antiproliferative effect of interleukin-4 in B chronic lymphocytic leukemia. AB - Recombinant interleukin-4 (IL-4) profoundly inhibits the proliferative response of chronic lymphocytic leukemic B cells (B-CLLs) to recombinant interleukin-2 (IL 2). In the present study, we confirmed and extended these data by showing that IL 4 strongly suppresses the [3H]thymidine incorporation by B-CLLs stimulated by recombinant tumor necrosis factor alpha, recombinant interferon alpha, IL-2, and low molecular weight B cell growth factor in the absence of costimulant. Recombinant interleukin-4 inhibits spontaneous DNA synthesis suggesting that it also interferes with the autocrine proliferation of these cells. Kinetic studies indicate that IL-4 suppresses rather than shifts the peak of cytokine-induced DNA synthesis. Moreover, IL-4 blocks the progression of B-CLLs in or into G1 stage of the cell cycle as shown by the inhibition of cytokine-induced [3H]uridine incorporation. Finally, IL-4 pretreatment of B-CLLs prevents their subsequent proliferative response to the above cytokines, indicating that IL-4 confers to the B-CLLs a state of resistance to numerous stimulatory cytokines. The antiproliferative effects of IL-4 suggest that this lymphokine may have important therapeutic implications for the B-CLL patients. PMID- 1768676 TI - Phase II studies of recombinant human tumor necrosis factor alpha in patients with malignant disease: a summary of the Southwest Oncology Group experience. AB - From June 1988 to November 1990 the Southwest Oncology Group initiated nine protocols for the phase II evaluation of recombinant human tumor necrosis factor alpha (rhuTNF alpha) in cancer patients. Patients with diverse metastatic malignancies including breast, colon, gastric, pancreatic, endometrial, and bladder cancers, as well as multiple myeloma and various sarcomas received 150 micrograms/m2 of rhuTNF alpha daily for 5 days every other week. Of 147 patients entered in the study, 127 were eligible and were evaluated for toxicity and response. Of 124 patients known to have completed treatment, 92 (74%) went off study for progression, 21 (17%) for toxicity, and 12 (10%) for other causes, mainly that of worsening medical condition. Thirteen percent of patients experienced grade 4 or fatal toxicity. The most serious toxicities were pulmonary failure and coagulopathies. The predominant grade 3 toxicities were symptomatic (chills, fever, malaise, headache, myalgia, and nausea or vomiting). Only one partial remission was seen in a patient with metastatic bladder cancer lasting 4 months (rate 0.8%, exact 95% confidence interval 0-4%). At the study dose and schedule, rhuTNF alpha does not appear to have significant antitumor activity. The biological basis for this finding is discussed. PMID- 1768677 TI - Phase I trial of continuous infusion interleukin-2 and doxorubicin in patients with refractory malignancies. AB - A phase I trial was performed to assess the immunomodulatory activities, maximum tolerated doses, and the toxicity of recombinant interleukin-2 (rIL-2) administered in combination with doxorubicin to patients with refractory malignancies. Therapy was administered to successive cohorts of four to six patients who were treated at three different dose levels (1A, 1B, 2A). Levels 1-2 refer to doxorubicin (40 or 60 mg/m2) given as an intravenous (i.v.) bolus on day 1, and levels A-B refer to rIL-2 (1.0 or 3.0 x 10(6) U/m2) given as a continuous i.v. infusion on days 2-5, 9-12, and 16-19. Cycles were repeated every 28 days. Seventeen patients were entered in the trial. Dose limiting toxicity consisted of neutropenia, and the maximum tolerated dose (MTD) of the combination was doxorubicin 40 mg/m2 and rIL-2 3.0 x 10(6) U/m2. No objective responses were observed. Lymphocytosis related to rIL-2 occurred and flow cytometry demonstrated significant increases in the following subsets: CD3+CD25+HLADr+ and CD11b CD16c+CD8-. Natural killer cell activity and lymphokine-activated killer (LAK) cell precursors were increased in patients treated at dose levels 1A and 1B (40 mg/m2 doxorubicin), but no consistent changes in LAK activity were noted. No clinical responses were seen and the overall toxicity of this combination was moderate to severe. Administration of doxorubicin prior to rIL-2 does not enhance the immunologic effects of rIL-2. PMID- 1768678 TI - A phase I trial of 21-day continuous venous infusion of alpha-interferon at circadian rhythm modulated rate in cancer patients. AB - The toxicity and/or the stimulation of natural killer cell activity that resulted from exposure to alpha-interferon varied according to circadian dosing time, both in mice and in human beings. Ten patients with advanced renal cell carcinoma or melanoma were treated with recombinant alpha-interferon-2b using a continuous 21 day intravenous schedule at circadian modulated rate. Patients received 15-20 MU/m2/day in an ambulatory care program. The drug was delivered via an external programmable-in-time pump. Thirty-nine courses of therapy were given (2-12 courses per patient). Severe side effects included World Health Organization grade III somnolence (one patient, 1 course) and grade III-IV neutropenia (five patients, 10 courses). Karnofsky performance status decreased by 40% in 3 patients (five courses). Two of these patients were withdrawn from the study because of toxicity. Disease was stabilized in four of the seven patients evaluable for response. Seven of the 10 patients are alive at 15 months' median follow-up. Two have continued with chronotherapy for 9+ and 13+ months, respectively. A large interpatient variability characterized the maximally tolerated dose. Two patients led their usual activities while receiving 20 MU/m2/day for three courses or more. Conversely, two patients exhibited severe side effects with 10 MU/m2/day. As compared with schedules of standard administration or continuous flat infusion, this circadian schedule of infusion allowed a large increment in total daily dose and dose intensity. A starting dose of 15 MU/m2/day was well tolerated by 8 of 10 patients and can be recommended using this circadian modulated schedule. PMID- 1768679 TI - Thyroid function abnormalities associated with the chronic outpatient administration of recombinant interleukin-2 and recombinant interferon-alpha. AB - We prospectively examined thyroid function during and following chronic, outpatient therapy with recombinant interleukin-2 (rIL-2) and Roferon-A (rIFN alpha 2a). Twenty-two of 30 patients with advanced renal cell carcinoma treated on a phase II open pilot study of concomitant rIL-2 and rIFN-alpha 2a were included. Serum levels of thyroxine, triiodothyronine, free thyroxine index, thyrotropin, antithyroid antibodies, and thyrotropin (TSH) receptor binding antibodies were measured before therapy and after every other cycle. Selected patients underwent studies after every cycle and following completion of therapy. Twenty patients (91%) developed laboratory evidence of thyroid dysfunction, 11 (50%) developed hypothyroidism, five (23%) had a biphasic pattern, and four (18%) had hyperthyroidism. The incidence of thyroid dysfunction increased with increased number of treatment cycles. Transient hyperthyroidism was noted in six of the 11 patients studied after the first cycle and persisted after cycle three in only two patients. Hypothyroidism was not observed after cycle 1, but became increasingly frequent between cycles 2 (56%) and 6 (90%). Thyroid function normalized following therapy in nine of 12 patients tested. Antithyroid antibodies were identified pretherapy in five patients (23%) and de novo in none; TSH receptor binding antibodies were not detected. This study demonstrates a remarkably high frequency of reversible thyroid dysfunction in patients with advanced renal cell carcinoma treated with repeated cycles of rIL-2 plus rIFN alpha 2a. We conclude that chronic therapy with rIL-2 and rIFN-alpha 2a produces thyroid dysfunction in virtually all patients most likely secondary to a nonspecific, nonautoimmune, toxic manifestation of prolonged treatment. IL-2 therapy may, therefore, produce thyroid dysfunction by more than one mechanism. PMID- 1768680 TI - Lack of antihypertensive effect of interleukin-2 administration in humans. AB - A recent study reported that a single bolus dose of interleukin-2 (IL-2) decreased blood pressure to normal in adult hypertensive rats and prevented the development of spontaneous hypertension in young rats. The Surgery Branch of the National Cancer Institute has had extensive experience with the administration of IL-2. A review was performed focusing on the experience of IL-2 administration to cancer patients with established preexisting hypertension. Seventeen evaluable patients were identified. Sixteen of the patients experienced a return of their hypertension with the completion of therapy. One patient was able to stop his antihypertensive medications and remain normotensive for 3 months' follow-up. One normotensive patient developed hypertension after initiating IL-2 therapy. Our data do not demonstrate significant reduction in blood pressure in previously hypertensive patients undergoing high-dose IL-2 therapy. PMID- 1768681 TI - [Diagnostic possibilities of conjunctival biopsy]. AB - Conjunctival biopsy was found to play a major role in neuropathological and ophthalmopathological diagnosis. Quite a number of general and systemic diseases have proved to be reflected in the conjunctiva, although the latter was not necessarily conspicuous in clinical examination or slit-lamp microscopy. No review papers have so far become available to give a summarising account of the most important findings from ultrastructural and immunohistochemical investigations or optical light microscopy. A brief description of both conjunctival anatomy and the technique of conjunctival biopsy, including impression cytology is followed, in this paper, by an account of 40 pathological patterns. Particular attention is given to the most common indications, juvenile thesaurismosis, sarcoidosis, oculocutaneous diseases, and Sicca syndrome. PMID- 1768682 TI - [Pathology of the placenta. VI. Circulation disorders of the placenta. Maternal circulation (intervillous space)]. AB - Disorders of intervillous circulation are covered in this sixth part of the account of Pathology of the Placenta. Proposed in this paper are a new setup and modified nomenclature in which the term of "infarction" is definitely abandoned, as there can be neither genuinely anaemic nor haemorrhagic infarction in the placenta. Alterations which we consider as a formally pathogenetic chain are discussed by the order of focus of villous collapse, reticular intervillous fibrin deposition, and chronic disorder of intervillous circulation. These should be distinguished from subchorionic fibrin deposition, a special case of chronic circulatory disorder. Reference is finally made to intervillous haemorrhage and retroplacental haemorrhage (premature detachment of the placenta). An attempt is made, in conclusion, to give an account of the causative genesis of impairment to intervillous circulation together with various pathologic-anatomic findings recordable from myometrial and decidual arteries. PMID- 1768683 TI - [Heart alterations in chronic polyarthritis]. AB - Described in this paper are pathomorphological alterations to the heart postmortem recorded from 100 deceased with rheumatoid arthritis. Vasculitis of subepicardial or intramural rami of coronary arteries was recorded from twelve cases and had caused multiple myocardial necrosis in ten of these. These developments had led to progressive cardiac insufficiency which actually then was the direct cause of death. Formal pathogenesis of vasculitis-related multifocal myocardial necrosis in concomitance with rheumatoid arthritis had never been described in the literature before, although such reference would have been justified for the clinical consequences for which it deserves to be emphasised as a nosological entity in its own right. Isolated rheumatic nodes were detected in the myocardium of five of the decreased and could be attributed to rheumatic arteritis in two cases. Those myocardial rheumatic nodes, according to the author's view, represent the severest form of necrotising rheumatic vasculitis. Pathognomonic pericarditis was found in four cases (2 pericarditis nodularis and 2 pericarditis rheumatica). Pathognomonic nodular valvulitis was identified in another four cases. Systemic secondary amyloidoses were found to be present in 24 of the above 100 deceased with chronic polyarthritis. The heart was involved in 23 of these 24 cases (95.8%). PMID- 1768684 TI - Atherometric system. A suitable methodology to characterize atherosclerotic lesions in any artery or group of patients. AB - The atherometric system (AS) is a set of methods and procedures derived from a group of interdependent and strongly interrelated variables, resulting from certain biophysical (rheological, geometrical, hemodynamic) and mathematical considerations and reasonings. The variables of the AS are divided into two groups: the arterial and the organ-related variables. Each of them is subdivided into (a) descriptive variables, since correct use of them and their different combinations will enable proper examination of all pathomorphological and pathophysiological alterations to arteries and to atherosclerotically affected organs and (b) weighting indices which yield accurate prediction of the atherosclerotic process, its severity and consequences. The AS is a tool for medical and biological investigations in relation with any vascular disease due to atherosclerosis. It is useful for etiological, pathogenetical, pathomorphological, morphometrical, pathophysiological, biochemical, and epidemiological studies. Also it has proved its facilities for experimental studies with a view to elucidating possible effects of therapeutic action and effectiveness of pharmaceuticals to which anti-atherogenetic or anti atherosclerotic activities are attributed. PMID- 1768685 TI - Metastatic calcification due to hypercalcemia in adult T-cell leukemia-lymphoma (ATLL). AB - Four cases of metastatic calcification due to hypercalcemia in adult T-cell leukemia-lymphoma (ATLL) are reported. Serum calcium was at high levels, 15.4 19.4 mg/dl (normal range 8.4-10.4 mg/dl). In our cases, metastatic calcification was detected by v. Kossa's silver nitrate method for calcium in tubules of kidneys (100%), pulmonary alveolar septa of lungs (100%), myocardium (75%), muscular layer of stomach (50%), lower portion of aortic media (50%), gastric mucosa (25%), testicular tubules (25%), and in the liver (25%). Scattered osteoclasts were seen around the cortex of the bone. Therefore, hypercalcemia in ATLL may have been caused by bone-resorption-stimulating factors which promote differentiation of osteoclast cells, resulting in calcium increase in the serum. PMID- 1768686 TI - Progesterone receptor expression in human cervix uteri. AB - Progesterone receptor (PR) expression was studied in human cervix uteri from 21 cases. The study was performed on fresh frozen material with application of mouse anti-rabbit PR antibody and the immunoperoxidase method. Most cervical PR-s were present in the glandular epithelium and in smooth muscle cells. The results suggest that PR expression in the cervical glands is hormone-dependent; it was strongest in the presence of estrogen-stimulated endometrium, weaker with progesterone stimulation and absent in atrophy. The ectocervical epithelium contained relatively few progesterone receptors. PMID- 1768687 TI - [Immunohistochemical studies of bronchial carcinoma using monoclonal antibody A63 C/A3]. AB - An immunohistological study was undertaken, using paraffin sections of 22 cases of lung carcinoma and a number of reference tissue samples, to clear up the reactivity of A63-C/A63 monoclonal antibody (IgM) which was capable of identifying a carcinoma-associated carbohydrate antigen. Following neuraminidase pretreatment of those sections, positive response to the above antigen was produced by more than 90% of all bronchial carcinoma samples, notwithstanding the histological type involved (squamous-cell carcinoma or adenocarcinoma). Columnar epithelium of the bronchi, not involved in the neoplastic process gave a positive immunoreaction with the antibody A63-C/A3 in 64% of the cases. PMID- 1768688 TI - [Tritium-thymidine autoradiography of the rat pancreas after alloxan-induced diabetes mellitus]. AB - Knowledge of pancreatic cells and their proliferation has proved to be essential to better understanding of the pathogenesis, clinical course, and prognosis of pancreatic diseases. Studies had been conducted by means of in vivo autoradiography into pancreatic cell proliferation in normal rats of various age groups (Laucke and Muller 1988; Muller et al. 1990). Described in this paper are investigations by means of in vivo autoradiography, using tritium-thymidine, which were conducted with a view to clearing up proliferation of pancreatic cells in rat under conditions of alloxan-induced diabetes. Labelling of the acinar, islet, and duct cells were found to undergo initial elevation, after two days of alloxan-induced diabetes. Labelling indices rose by three to four times, as compared to those recordable from normal rats (Laucke und Muller 1988; Muller et al. 1990). Labelling indices of acinar and islet cells went down along with the length of diabetes and, subsequently, stayed nearly constant at a level of less than one thousandth, on the 14th and 28th experimental days. Labelling of duct cells decreased the same way up to the 14th day of the experiment, though increase was recordable, especially from the small pancreatic ducts, on the 28th day. Initial elevation of labelling indices of acinar, islet, and duct cells was followed by "exhaustion". Experimental findings appeared to suggest physiological regeneration of islet cells and their replacement after injury in the adult pancreas to originate from small pancreatic ducts by "ductular proliferation". This conclusion seemed to be supported by the increase on the 28th day of the experiment of the labelling index of pancreatic duct cells, as described in this paper.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768689 TI - Light chain deposition nephropathy in necropsy material. AB - The clinical and necropsy findings on 7 patients with monoclonal immunoglobulin light chain deposition nephropathy are described (4 cases with a myelomatous and 3 with a non-myelomatous background). All patients had moderate proteinuria and progressive azotemia. Three myelomatous and all three non-myelomatous patients died from uremia after a mean time of 12 and 23 months, respectively, from the first presentation. Immunohistochemically, 6 patients had kappa, and one had lambda light chain deposition. Light microscopically, interstitial fibrosis, tubular atrophy and arteriolar hyalinosis were present in all cases. The glomeruli showed no changes (1 case), or displayed patterns of mesangial widening: mild (1 case), nodular (mesangial nodules, 4 cases) or global lobular expansion (1 case). Mesangial nodules were observed either with or without lamellation. Around the nodules, microaneurysms were seen in 2 cases. Mesangial nodular expansion was accompanied by crescents in 56% of the glomeruli in a male patient suffering from kappa light chain deposition nephropathy without myeloma. The present findings and a review of the literature indicate the following mesangial changes in light chain deposition nephropathy: 1. no changes, 2. mild expansion, 3. nodular expansion with and without lamellation, and 4. lobular expansion. Subtypes 2, 3 and 4 may be present in parallel, may occur with or without cellular proliferation, and may be accompanied by crescents. The term nodular glomerulosclerosis to describe mesangial nodular expansion is not completely correct, and hence its use is not recommended. PMID- 1768690 TI - [Primary carcinoid of the testis]. AB - A primary carcinoid tumour of the testicle without carcinoid syndrome was recorded from a patient aged 48 years. The tumour was made up of solid and acinar structures which exhibited strongly pronounced argyrophilia. Teratogenic structures were not established. Neuron-specific enolase (NSE) and chromogranin were immunohistologically recorded from tumour cells. The carcinoid had not spread metastases. Semi-castration was chosen as therapeutic approach. Orchidectomy was not followed by complications. PMID- 1768691 TI - [Spongious glioneuronal dystrophy with diffuse fatty degeneration of the liver]. AB - Reported in this paper are autopsy findings recorded from a boy who had died at the age of eight month. They included a spongy dystrophic tissue syndrome of the central nervous system associated with diffuse fatty degeneration of the liver. The case is considered to be in the category of glioneuronal dystrophy and is discussed under aspects of differential diagnosis. PMID- 1768692 TI - How do we improve the quality of research in adolescent health? A program for reviewing new investigators' research proposals. PMID- 1768693 TI - Licit and illicit drug patterns and problems among Kibbutz young adults. PMID- 1768694 TI - The adolescent childbirth rate in Hungary. AB - The rate of childbirth of adolescents in Hungary is reviewed. The rate of childbirth increased among teenagers during the last half century. PMID- 1768695 TI - Adolescent medicine among pediatricians in Catalonia. AB - To ascertain if Catalan pediatricians were seeing adolescent patients, an anonymous self-administered questionnaire was mailed to 188 members of the Catalan Society of Pediatrics. The instrument included questions about training in adolescent medicine, type of practice, office and clinical practices pertinent to adolescents, and opinions and perceptions regarding adolescent care. Of 188 physicians, 69 (36.7%) responded. Respondents see an average of 12 patients (mean age of 16 years) in a 5-hr office day. The reported mean duration of a first visit for an adolescent was longer than for a child (39.7 +/- 15.4 min versus 33.5 +/- 11.3, respectively; p less than 0.001), but there were no differences in length of time spent for follow-up visits. Only 20% of the pediatricians had different schedules for adolescents than for children, and 16% provided a separate waiting room; 29% preferred dealing with infants, 4.3% with children, 4.3% with adolescents, and 52.2% had no preference. Most (74%) believe that the pediatrician is the physician of choice to treat adolescent patients. Major perceived obstacles to providing comprehensive care to teens include not having different schedules or waiting rooms, confidentiality, and the patient's perception of them as a "children's doctor." One-third think that they have the skills needed to give medical advice, 14.5% that they can offer comprehensive care, 1.5% are not interested in treating adolescents, and 43.4% would like to improve their knowledge and skills.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768696 TI - A human immunodeficiency virus peer education program for adolescent females. AB - Black adolescent females living in urban environments are at high risk for human immunodeficiency virus (HIV) infection. Our objectives were to develop an HIV peer education program and to pilot-test its effect on knowledge and sexual behavior. Between September 1989 and March 1990, all females aged 12-19 years attending an inner-city, hospital-based adolescent clinic were invited to meet individually with trained peer educators (10 females aged 16-19 years) to discuss acquired immunodeficiency syndrome (AIDS) and its prevention. Each participant completed a modified version of the AIDS Knowledge and Attitudes Survey immediately before and 2-6 weeks after the counseling session. Of the 283 counseled patients, 241 (85%) completed the follow-up questionnaire and comprised the study sample. Mean age was 15.6 years, mean Hollingshead (parental occupational) score was 3.4, and 216 (90%) patients were black. Baseline knowledge about routes of transmission was high and did not improve on follow-up. Comparison of individual baseline and follow-up responses revealed improvements (p less than 0.05) in routes by which HIV is not transmitted, methods of prevention, individuals at risk, and general information about AIDS. The improvement in total score between baseline and follow-up was 38% for patients with low baseline scores, 13% for middle scores, and 3% for high scores (p less than 0.05). At baseline, 50 (21%) patients reported sexual intercourse within the preceding 2 weeks, compared to 33 (14%) at follow-up (p less than 0.05). Of the sexually active patients, 22 (44%) reported no condom use at baseline, compared to 11 (33%) at follow-up (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768697 TI - Attitudes, knowledge, and training of medical residents regarding adolescent health issues. AB - This study examined attitudes, knowledge, and training relating to adolescent health issues, of medical residents in six different specialties who provide care to adolescents, at a southern, rural medical school without an organized curriculum in adolescent medicine. An original 18-item questionnaire was developed which examined four broad health care categories: general medicine, sexuality, high-risk behaviors, and development. Of 118 residents 91 (77%) responded. For any health care area, residents reported managing fewer than 10 adolescent patients and often fewer than 3 patients. However, they reported comfort and confidence and little desire for additional training in most of these areas. There were few differences between specialties or year of training. Almost one-half (42%) believed that pediatric care should end by age 16 years; 32% thought it should end at age 18 years. However, there was little support for pediatricians providing prenatal care to pregnant teens. These findings are useful for planning curriculum in ambulatory adolescent health and developing strategies for encouraging residents to understand and embrace the challenge of adolescent health care. PMID- 1768698 TI - Reorganizing health care for adolescents: the experience of the school-based adolescent health care program. PMID- 1768699 TI - Incubating syphilis in an adolescent female rape victim. AB - The risk of infection after rape is believed to be low. The use of presumptive treatment is, therefore, controversial. Some experts recommend treatment of all patients, and others suggest treatment if the doctor suspects infection, if the patient requests it, if follow-up examination of the victim cannot be ensured, or if the assailant has a known infection. No regimen will cover all possible pathogens. The Centers for Disease Control's empiric regimen for victims of sexual assault is effective against gonorrhea, chlamydia, and, most likely, syphilis. We present a case of incubating syphilis following rape, that did not respond to ceftriaxone. PMID- 1768700 TI - Collisionally induced fragmentation of protonated oligoalanines and oligoglycines. AB - In a hybrid instrument under minimal multiple-collision conditions, the collision induced fragmentation of the [M + H]+ ions of tetraalanine and tetraglycine are dominated by the gamma 2 fragment, in distinction to the fragmentation of the [M + H]+ ions of hexa- and octaalanine and -glycine; these latter fragmentations are instead a distribution of b and y ions, and to a lesser extent a ions. This difference may be rationalized on the basis of control of the fragmentation by the most basic site in the peptide, which may be identified by taking internal hydrogen bonding into account. On increasing the collision energy from 10 to 150 eV, a, b and y ions of lower mass appear; and in several cases a peak due to a smaller b ion becomes the base peak. The ion distribution in the spectra of these protonated peptides serves as a baseline from which the effects of conformation on side-group rearrangements and other fragmentations may be explored. PMID- 1768701 TI - Mass isotopomer analysis: theoretical and practical considerations. AB - A theory of mass isotopomer analysis based on the well-known principle of isotope dilution mass spectrometry is reviewed. An algorithm for the determination of isotope incorporation into a metabolic substrate from a labeled precursor using mass isotopomer analysis is presented. The steps include the determination of the contribution of the derivatization reagent to the observed spectrum of the derivatized substrate and the correction of contribution from 13C natural abundance using multiple linear regression analysis. Examples of the application of this theory to determine the spectrum of the trimethylsilyl derivative of the 'pure unlabeled' or mononuclidic cholesterol, and the calculation of mass isotopomer distribution in cholesterol due to tracer incorporation using this 'pure unlabeled' spectrum, are also provided. PMID- 1768702 TI - The analysis of trenbolone and the human urinary metabolites of trenbolone acetate by gas chromatography/mass spectrometry and gas chromatography/tandem mass spectrometry. AB - The electron impact mass spectrometric properties of trimethylsilyl ether and fluoroacyl ester derivatives of trenbolone, combined or not combined with a methoxime group, are presented. Some derivatization problems were observed and were due to the formation of enol derivatives at the 3C-position in several tautomeric forms, which in their turn were not stable and lost two or four hydrogens under the conditions studied. The enolization could be minimized by carefully selecting the reaction conditions or could be prevented by the introduction of a methoxime group at the 3C-position. The limits of detection and identification of the methoxime heptafluorobutyryl ester and the methoxime trimethylsilyl ether derivative of trenbolone were determined using a mass selective detector in the electron impact mode and a triple-stage quadrupole in the methane positive chemical ionization mode. Selected reaction monitoring in tandem mass spectrometry did not improve the limit of detection, but because of the gain in selectivity did improve the limit of identification. The glucuronides of trenbolone and epitrenbolone could be identified in three urine specimens out of 200 samples in routine doping control. PMID- 1768703 TI - Deuterium-labelling and quantitative measurement of ketotifen in human plasma by gas chromatography/negative ion chemical ionization mass spectrometry. AB - A gas chromatographic/mass spectrometric assay for the anti-anaphylactic agent Ketotifen is described. The method is based on negative ion chemical ionization, utilizing the electrophoric nature of the underivatized drug. A simple procedure for deuteration of the intact target molecule is presented, thus enhancing specificity by internal standardization via stable isotope dilution. The assay was applied to pharmacokinetics of the drug in man. PMID- 1768704 TI - Mass spectrometric analysis of metabolite excretion in five Japanese patients with the late-onset form of glutaric aciduria type II. AB - The variability of clinical and biochemical features in five Japanese patients with the late-onset form of glutaric aciduria type II (GAII) was studied using mass spectrometric procedures. The age at onset ranged from 5 months to five years, presenting acute episodes such as lethargy, hypotonia, hyperammonaemia, hypoglycaemia or Reye's syndrome-like illness, while one of the five cases was asymptomatic at 1 year of age. Organic acid analysis as oxime-trimethylsilyl derivatives by gas chromatography/mass spectrometry revealed the presence of several abnormalities characteristic of GAII in clinically asymptomatic conditions of three patients but not of the two others. Quantitative acylglycine analysis using a stable isotope dilution method and qualitative acylcarnitine analysis by fast atom bombardment mass spectrometry provided diagnostic information in all five patients, regardless of their clinical conditions. However, significant differences in the respective metabolite profiles as well as in their clinical pictures were noted. Although an increased excretion of both isovalerylglycine and isovalerylcarnitine was found in four patients, the fifth showed normal isovalerylglycine excretion during both the acute stage and in remission, despite the increased amount of isovalerylcarnitine in urine. From these results, it was suggested that the variations in clinical severity and metabolite excretion among GAII patients may be attributed not only to the residual enzyme activity at the defective site but also to differences in the capability to conjugate accumulated acyl-coenzyme A. PMID- 1768705 TI - Identification of several human urinary metabolites of 6-benzoyl benzoxazolinone by gas chromatography/mass spectrometry. AB - The biotransformation of 6-benzoyl benzoxazolinone (6-BB), a non-narcotic peripheral analgesic, was studied in eight healthy volunteers after oral administration of a single dose of 1 g. Urinary metabolites were extracted either with ethyl acetate at different pH values or by percolating at pH 5 through Amberlite XAD 2 ion-exchange resin. Eluates were concentrated under vacuum, purified by thin-layer chromatography and analysed by gas chromatography/mass spectrometry or direct insertion probe mass spectrometry. Metabolites were identified with reference to the mass spectra of various synthesized compounds assumed to be metabolites of 6-BB, as N-methylated or monohydroxylated compounds. Another metabolic pathway was cleavage of the benzoxazolinone heterocycle giving 2-amino-5-benzoyl phenol after hydrolysis and decarboxylation. N-methyl, N-acetyl and hydroxylated metabolites having an amino-5-benzoyl phenol structure were also found. PMID- 1768706 TI - Determination of kerosene and light oil components in blood. AB - A sensitive and rapid method to analyse fuel components in blood from rats exposed to kerosene or light oil vapour was developed by making use of capillary gas chromatography/mass spectrometry. The aliphatic hydrocarbons with carbon numbers 8-10 and aromatics such as toluene, xylene, 3- and 4-ethyltoluene and trimethylbenzenes were clearly detected in blood from rats exposed to kerosene or light oil vapour, using the head-space method combined with the salting-out technique. The concentration ratio of pseudocumene to toluene in blood exposed to light oil was higher than that in the case of exposure to kerosene. The lower limits of detection were 50 pg and 1 ng in toluene and pseudocumene, respectively. Our suggestion is that this method is useful in forensic investigations to detect fuel components in blood and for the purposes of differentiating kerosene and light oil in blood tissues. PMID- 1768707 TI - Chemical modification of DNA: quantitation of O6-methyldeoxyguanosine by tandem mass spectrometry. AB - Methodology is described which allows quantitation of O6-methyldeoxyguanosine generated as a product of in vitro methylation of calf thymus DNA by methyl methanesulfonate (MeMS). Quantitative precision of 10% is achieved on samples of 10(-11)-10(-12) mol generated in 0.02% yield (expressed as O6 methyldeoxyguanosine versus deoxyguanosine) when DNA is treated with the weak carcinogen MeMS. These results show the potential application of this method to the analysis of DNA chemical modifications at the low levels that are relevant to the induction of biological effects of many alkylating agents. The methodology utilizes enzymatic degradation, reverse-phase chromatography and finally analysis by tandem mass spectrometry using desorption chemical ionization. Multiple reaction monitoring was used to increase sensitivity and the CD3-labeled nucleoside was used as an internal standard for quantification. PMID- 1768708 TI - Perceptual rivalry between illusory and real contours. AB - The interactions between illusory and real contours have been investigated under monocular, binocular and dichoptic conditions. Results show that under all three presentation conditions, periodic alterations, generally called rivalry, occur during the perception of cognitive (or illusory) triangles, while earlier research had failed to find such rivalry (Bradley and Dumais 1975). With line triangles, rivalry is experienced only under dichoptic conditions. A model is proposed to account for the observed phenomena. PMID- 1768709 TI - Noise effects on spike propagation in the stochastic Hodgkin-Huxley models. AB - Effects of membrane current noise on spike propagation along a nerve fiber are studied. Additive current noise and channel noise are considered by using stochastic versions of the Hodgkin-Huxley model. The results of computer simulation show that the membrane noise causes considerable variation of the propagation time of a spike (thus changes in interspike intervals) for a small unmyelinated fiber of radius 0.1 approximately 1 micron. PMID- 1768710 TI - Saccade control in a simulated robot camera-head system: neural net architectures for efficient learning of inverse kinematics. AB - The high speed of saccades means that they cannot be guided by visual feedback, so that any saccadic control system must know in advance the correct output signals to fixate a particular retinal position. To investigate neural-net architectures for learning this inverse-kinematics problem we simulated a 4 deg of-freedom robot camera-head system, in which the head could pan and tilt and the cameras pan and verge. The main findings were: (1) Linear nets, multilayer perceptrons (MLPs) trained by backpropagation, and cerebellar model arithmetic computers (CMACs) all learnt rapidly to 5-10% accuracy when given perfect error feedback. (2) For additional accuracy (down to 2%) two-layer nets learnt much faster than a single MLP or CMAC: the best combination tried was to have a CMAC learn the errors of a trained linear net. (3) Imperfect error signals were provided by a crude controller whose output was simply proportional to retinal input in the relevant axis, thereby providing a mechanism for (a) controlling the camera-head system when the feedforward neural net controller was wrong or inoperative, and (b) converting sensory error signals into motor error signals as required in supervised learning. It proved possible to train neural-net controllers using these imperfect error signals over a range of learning rates and crude-controller gains. These results suggest that appropriate neural-net architectures can provide practical, accurate and robust adaptive control for saccadic movements. In addition, the arrangement of a crude controller teaching a sophisticated one may be similar to that used by the primate saccadic system, with brainstem circuitry teaching the cerebellum. PMID- 1768711 TI - An evaluation of sensory noise in the human visual system. AB - It is assumed that the activity of a visual channel may be represented as V(t) = g(t) + xi(t), where g(t) is the deterministic response of the channel due to the presentation of a stimulus and xi(t) is the trajectory of a wide-sense stationary Gauss process. The stimulus is detected if the event (V(t) greater than S for at least one t epsilon[0, T]) occurs. Two approximations for the probability of this event are proposed, and it is demonstrated how they may be employed to estimate (i) the value of the second spectral moment lambda 2 of the noise process xi t, where lambda 2 reflects the speed of the fluctuations of the trajectories xi(t), and (ii) the value of the internal threshold S. The commonly made assumption of peak--detection is shown to serve as a very good first approximation in particular if the channel is of transient type or--in case of detection by a channel of sustained type--if the stimulus durations are not too long. PMID- 1768712 TI - The path integral for dendritic trees. AB - We construct the path integral for determining the potential on any dendritic tree described by a linear cable equation. This is done by generalizing Brownian motion from a line to a tree. We also construct the path integral for dendritic structures with spatially-varying and/or time-dependent membrane conductivities due, for example, to synaptic inputs. The path integral allows novel computational techniques to be applied to cable problems. Our analysis leads ultimately to an exact expression for the Green's function on a dendritic tree of arbitrary geometry expressed in terms of a set of simple diagrammatic rules. These rules providing a fast and efficient method for solving complex cable problems. PMID- 1768713 TI - Asymmetric Boltzmann machines. AB - We study asymmetric stochastic networks from two points of view: combinatorial optimization and learning algorithms based on relative entropy minimization. We show that there are non trivial classes of asymmetric networks which admit a Lyapunov function L under deterministic parallel evolution and prove that the stochastic augmentation of such networks amounts to a stochastic search for global minima of L. The problem of minimizing L for a totally antisymmetric parallel network is shown to be associated to an NP-complete decision problem. The study of entropic learning for general asymmetric networks, performed in the non equilibrium, time dependent formalism, leads to a Hebbian rule based on time averages over the past history of the system. The general algorithm for asymmetric networks is tested on a feed-forward architecture. PMID- 1768714 TI - The spectral dynamics and its applications in EEG. AB - The method of spectral dynamics is introduced to process slow changes in EEG. This method is based on evaluation of distance between EEG spectra. The typical application field is pharmaco-EEG after single dose drug administration, where distances between pre and post drug EEG spectra are computed. The distance between two spectra may be, however, defined in several different ways. The paper deals with the well known Lp metrics and with the metrics alpha that plays an important role in discriminating stationary processes with different spectra. The Lp and alpha metrics are non-equivalent and their properties, consistency and robustness, are studied in a simple statistical model. PMID- 1768717 TI - Signal transmission through a metabolic cycle follows the compression hypothesis or a weak Weber's law. AB - Biological signal transduction often involves a metabolic cycle in which the flux at one point is driven by the input signal and the concentration of one of the metabolites of the cycle serves as the output signal. A kinetic analysis of such a metabolic cycle is made under an assumption that the law of mass action applies. The resultant kinetic model can produce a response that overshoots, quickens, and eventually saturates as the input intensity is increased. The possible model behavior ranges parametrically from non-adaptive (compression hypothesis) to weakly adaptive (limited Weber's law). PMID- 1768715 TI - Local adaptations of two naturally occurring neuronal conductances, gK + (A) and gK + (Ca), allow for associative conditioning and contiguity judgements in artificial neural networks. AB - Features of two potassium conductances implicated in the acquisition of conditioned reflexes, the slow calcium dependent conductance (gK + (Ca] and the fast transient conductance (gK + (A], were incorporated into a 6 x 6 element artificial neural network. Adaptive algorithms derived from observations of cortical neurons during associative learning changed gK + (A) in proportion to the product of this current and an EPSP-induced second messenger concentration, and changed gK + (Ca) as a function of a spike-induced second messenger concentration. This network concurrently acquired two distinct representations in response to presentation of stimuli: one resembled associative conditioning (defined in terms of its sensitivity to forward pairing vs. simultaneous or backward pairing); the other reflected contiguous pairings of stimuli. The acquisition of one representation did not markedly interfere with acquisition of the other. This network may accordingly serve as an example of a self-organizing system which minimizes the postulated inherent cross talk between functionally dissiminar representations (Minsky and Papert 1988). PMID- 1768716 TI - Optimization behavior of brainstem respiratory neurons. A cerebral neural network model. AB - A recent model of respiratory control suggested that the steady-state respiratory responses to CO2 and exercise may be governed by an optimal control law in the brainstem respiratory neurons. It was not certain, however, whether such complex optimization behavior could be accomplished by a realistic biological neural network. To test this hypothesis, we developed a hybrid computer-neural model in which the dynamics of the lung, brain and other tissue compartments were simulated on a digital computer. Mimicking the "controller" was a human subject who pedalled on a bicycle with varying speed (analog of ventilatory output) with a view to minimize an analog signal of the total cost of breathing (chemical and mechanical) which was computed interactively and displayed on an oscilloscope. In this manner, the visuomotor cortex served as a proxy (homolog) of the brainstem respiratory neurons in the model. Results in 4 subjects showed a linear steady state ventilatory CO2 response to arterial PCO2 during simulated CO2 inhalation and a nearly isocapnic steady-state response during simulated exercise. Thus, neural optimization is a plausible mechanism for respiratory control during exercise and can be achieved by a neural network with cognitive computational ability without the need for an exercise stimulus. PMID- 1768718 TI - Simulated bipolar cells in fovea of human retina. IV. Resolution. AB - The ability of simulated bipolar cells (BC) of the human central fovea to resolve images is studied with a two-bar stimulus using a resolution index (RI) as a measure of resolvability. RIs are determined for intensity and chromatic contrasts using all combinations of white, black, red, yellow, green, and blue lights. Various cone matrixes and BC receptive field organizations are studied for orientation preference by using two-bars oriented either 0, 45, 90, or 135 degrees to the horizontal axis of the retina. Nonpreference for orientation, i.e. RI does not change with bar orientation, varies with matrix type, and receptive field organization. For a given orientation RI increase asymptotically as bar width or length, or gap between the bars increases. Systematic changes in RI occur with systematic changes in contrast. For most color pairs there are residual RIs at isoluminance. PMID- 1768719 TI - Simulated bipolar cells in fovea of human retina. V. Use of Fourier analysis to determine resolution. AB - Fourier analysis is used to study resolution of images processed by the matrix of simulated red-center (BCR) and green-center (BCG) bipolar cells (BC) of the human central fovea. Simulated achromatic and chromatic sine and square waves, and a two-bar stimulus are used to activate the BCs. Due to the "honeycomb" packing of the cones and BC matrices Fourier transforms are computed row by row using a one dimensional FFT. Resolution computed by the Fourier transform is compared with the resolution index (RI), which is a method for determining resolution based on two-point discrimination in the space domain. In general the harmonic with the maximum amplitude gives the best correlation with RI for the three stimuli. Amplitudes at all spatial frequencies are enhanced by increasing the number of cycles in the sine and square wave gratings. Results with simulated BCs compare favorably with human and macaque psychophysics measuring contrast sensitivity. Square wave gratings are better than sine wave greetings for studying resolution. PMID- 1768720 TI - Non-linear and linear forecasting of the EEG time series. AB - The method of non-linear forecasting of time series was applied to different simulated signals and EEG in order to check its ability of distinguishing chaotic from noisy time series. The goodness of prediction was estimated, in terms of the correlation coefficient between forecasted and real time series, for non-linear and autoregressive (AR) methods. For the EEG signal both methods gave similar results. It seems that the EEG signal, in spite of its chaotic character, is well described by the AR model. PMID- 1768721 TI - A neural network model for the intersensory coordination involved in goal directed movements. AB - A neural network model for a sensorimotor system, which was developed to simulate oriented movements in man, is presented. It is composed of a formal neural network comprising two layers: a sensory layer receiving and processing sensory inputs, and a motor layer driving a simulated arm. The sensory layer is an extension of the topological network previously proposed by Kohonen (1984). Two kinds of sensory modality, proprioceptive and exteroceptive, are used to define the arm position. Each sensory cell receives proprioceptive inputs provided by each arm-joint together with the exteroceptive inputs. This sensory layer is therefore a kind of associative layer which integrates two separate sensory signals relating to movement coding. It is connected to the motor layer by means of adaptive synapses which provide a physical link between a motor activity and its sensory consequences. After a learning period, the spatial map which emerges in the sensory layer clearly depends on the sensory inputs and an associative map of both the arm and the extra-personal space is built up if proprioceptive and exteroceptive signals are processed together. The sensorimotor transformations occurring in the junctions linking the sensory and motor layers are organized in such a manner that the simulated arm becomes able to reach towards and track a target in extra-personal space. Proprioception serves to determine the final arm posture adopted and to correct the ongoing movement in cases where changes in the target location occur. With a view of developing a sensorimotor control system with more realistic salient features, a robotic model was coupled with the formal neural network. This robotic implementation of our model shows the capacity of formal neural networks to control the displacement of mechanical devices. PMID- 1768722 TI - Difference in excitability along geometrically inhomogeneous structures and occurrence of "hot spots". AB - The differences in excitability along geometrically inhomogeneous, electrically excitable structures as well as the possibility of occurrence of "hot spots" at certain branch points were theoretically analysed on the basis of the Hodgkin Huxley model assuming uniform specific membrane parameters along the structure length. It was shown that the "hot spots" conditioned by geometrical inhomogeneities should be not only morphological but also functional formations. The excitability at the branch point could be higher than that at the rest of the structure when the branch point was an electrical equivalent of a step decrease in the cable diameter. The stronger the diameter decrease, the higher the excitability at the branch point and thus the higher is the possibility of observation of "hot spots" in the nerve cells whose dendrites have a profuse branching. The realization of the "hot spots", however, depended on the distance from the site of the stimulus application (synapse) to the branch point and on the stimulus (synaptic current) strength, as well. The closer the synaptic current strength to the threshold value, and the shorter the synapse-branch point distance, the higher was the possibility of a propagating action potential origin at the branch point but not at the site of the stimulus application and thus the higher was the possibility of realization of "hot spots". The conclusion that the geometrical position of the initial segment contributes to its higher excitability (as compared to the rest of the cell) in the case of orthodromic activation of the neuron was also made. PMID- 1768723 TI - A simulated human fovea: the L-type cells of the magnocellular pathway. AB - A static model of the human fovea is used to study the properties of L-type amacrine cells (L-AC) that link the cones with the magnocellular pathway. Sine and square wave gratings are used to obtain response spectra of L-ACs and C-type bipolar cells (C-BC); these two types of cells are compared in both central fovea, where there are no blue-sensitive cones and parafovea, where the blue sensitive cones 12% of the population. Three dispersion conditions are used: no, aberration-free, and chromatic dispersions. The abilities of L- and C-type cells to resolve a two-bar image are also compared. The findings are consistent with the magnocellular pathway having higher contrast luminance and chromatic sensitivity gains than those of the parvocellular pathways, but under specified conditions. And under specified conditions the findings are also consistent with both pathways being involved in the detection of chromatic and achromatic signals. Nevertheless when all factors are considered the parvocellular pathway appears to be involved with fine spatial and chromatic tuning while the magnocellular pathway appears to deal with coarser tuning. PMID- 1768724 TI - The effect of variable mechanical impedance on the control of antagonistic muscles. AB - Most models of muscle have assumed that the series elastic element has a constant stiffness, although experimentally this is not true, either at the level of individual cross-bridges or that of the whole muscle. In this paper elastic and viscous elements are introduced whose properties vary systematically with activity levels as has been found experimentally. The effects of these nonlinear variations on the methods for optimally controlling a pair of antagonistic muscles are calculated. Although the nonlinearities add some complexity to the derivation and are important to the mechanism of force generation in the muscle, they do not qualitatively change the overall control of movement. PMID- 1768725 TI - Two-neurons network. I. Integrate and fire pacemaker models. AB - The behavior of two pacemakers simulated by integrate and fire oscillators reciprocally connected by synapses is studied. The activation of each synapse produces a sudden potential shift in the post-synaptic neuron. Two sorts of behaviour may occur when at least one synapse is excitatory. Phase-locking occurs for almost every set of parameters, and given certain initial conditions. Repetitive patterns in indifferent equilibrium appear in the presence of a given set of parameters and certain other initial conditions. Quasi-periodic behaviour corresponds to almost every set of parameters when both synapses are inhibitory, although repetitive patterns of firing in indifferent equilibrium occassionally occur. PMID- 1768726 TI - Lectin binding pattern in the testes of several tetrapode vertebrates. AB - The glycoconjugates of the testes of four species of vertebrates including amphibians (Bufo calamita), reptiles (Mauremys caspica), birds (Columba livia) and mammals (Mesocricetus auratus) were investigated by means of lectin histochemistry. Spermatogonia of the animals studied were labelled by Con A and WGA. DBA showed a specific affinity for the spermatogonia Aal of the hamster indicating that DBA might be an useful marker for this cell type. The acrosomes of the hamster spermatids were strongly reactive to PNA, SBA and WGA. LTA and UEA I did not show affinity for the acrosomes of any of the species studied. Lectin reactivity of spermatids and spermatozoa was similar in pigeon and hamster. Sertoli cells were reactive to Con A in all species studied. Affinity to WGA of the spermatozoa tails suggests the addition of the glycoprotein SMA4 in the testis, instead of the epididymis as has been indicated in the mouse. The present results suggest an increase in the glycosylation processes with the differentiation of the spermatogenic lineage being more marked in amphibians and reptiles in the spermatid-spermatozoa step, while in mammals the differences are greater in spermatocyte-spermatid step. The low reactivity to the lectins in the bird studied suggests a low content of glycoconjugates in the testis of this avian species. PMID- 1768727 TI - Study of the rat TSH-producing cells after met-enkephalin treatment: effects of dopamine antagonists. AB - The effects of single and repeated doses of met-enkephalin (Met-E) on the ultrastructure and TSH-like immunoreactivity (IR) of pituitary TSH-producing cells, and TSH plasma levels in male rats and the influence of pretreatment with a dopamine antagonist, haloperidol, on these, were evaluated. Both acute and repeated Met-E administration produced changes in TSH cells consisting of: an increase in TSH-like IR, enlargement and dilation of RER and Golgi apparatus, size-increase of secretory granules, and the presence of a variable number of cytoplasmic vacuoles. The ultrastructural changes were more evident in the chronically treated animals, whereas no differences were found in IR-intensity between both Met-E treated groups. Haloperidol alone modifies neither ultrastructure nor TSH-like IR of TSH producing cells, but it prevented the Met-E produced changes. On the other hand, Met-E treatment resulted in a decrease of TSH plasma levels, but being significant only in the acutely injected animals. No variations were produced by haloperidol alone, but it prevented the decrease of TSH plasma levels stimulated by Met-E. Our results suggest that Met-E plays a role in the release of TSH, and that dopamine is implicated in this process. The possible mechanisms through which Met-E influences TSH secretion are discussed. PMID- 1768728 TI - Immunocytochemical localization of the storage protein phaseolin in the embryo suspensor of Phaseolus coccineus. AB - Antibodies against the bean storage protein, phaseolin, were induced in rabbits. Sections of bean embryos of various age were incubated with the antibodies, and exposed to fluorescein isocyanate (FITC) conjugated goat anti-rabbit immunoglobulin. Distinct positive signals were found in vacuoles of the suspensor giant cells. Immunofluorescent staining of protein bodies in cotyledon cells, histochemical staining reactions of the sections, as well as gel electrophoretic analysis of the proteins, isoelectric focusing and Western blotting confirmed the specificity and reliability of the immunochemical staining of the suspensor cells. The results give evidence for synthesis of storage proteins in the embryo suspensor and indicate a function so far not detected of this embryonal nutritive organ. PMID- 1768729 TI - The effect of ethanol and other alcohols on morphometric parameters of rat small intestinal microvillous vesicles. AB - We have assessed the morphometric parameters of rat small intestinal microvillous vesicles, prepared by a Ca(2+)-precipitation method, from normal, long term ethanol-treated and pair-fed saccharose -treated control rats. The vesicles from normal rats were also directly exposed to ethyl, butyl and benzyl alcohols, respectively. Computerized morphometric analysis was carried out on electron micrographs of microvillous vesicles. The size of vesicles from ethanol-treated rats, as well as control rats, was significantly reduced as compared to normals. Direct exposure of vesicles to alcohols significantly increased vesicle dimensions, with a potency order reflecting the liposolubility of alcohols. These data support the hypothesis that variations in vesicle diameter may be ascribed at least in part to the fluidizing effect of alcohols. Thiamin transport by the vesicles has been measured in the presence of ethanol. The time course of thiamin uptake was not affected by ethanol. PMID- 1768730 TI - Evidence of abnormal differentiation of Paracentrotus lividus fertilized eggs contamined by zincethylenebisdithiocarbamate. AB - Embryos of the Sea Urchin Paracentrotus lividus were incubated for different periods of time in various concentrations of Zinc-ethylenebisdithiocarbamate (ZINEB) in artificial (or natural) sea water. Dramatic developmental modifications have been observed after 48 hour treatment with 0.4 ug/ml ZINEB solution. The abnormalities concern the formation of spiculae. PMID- 1768731 TI - [Microorganisms oxidizing maleic acid in sewage]. AB - The bacteria of genera Pseudomonas oxidizing maleic, fumaric, italic acids and their anhydrides in sewage of industry of maleic anhydride have been isolated from active sludge. During the autoselection a strain of P. stutzeri 832 capable to oxidize 12.5 - 25.0 g/l of maleic acid on 90 - 70% correspondingly in 3 days has been isolated. Destructive activity of isolated strain was retained after 5 year storage in lyophylized state and under vaseline oil. PMID- 1768732 TI - [The separation of true coagulases from other enzymes of the extracellular proteolytic complex of Aspergillus ochraceus by using affinity chromatography]. AB - A complex of proteases has been isolated from the cultural broth of fungi Aspergillus ochraceus HP-19 by precipitation ammonium sulfate. Using the method of affinity chromatography on the biospecific sorbents the conditions for separation of proteases into ones with coagulase activity and with fibrinolytic activity have been found. PMID- 1768733 TI - [The strategy of submissive behavior in male mice: the effect of the genotype and the experience of preceding agonistic encounters]. AB - The male mice of two strains with experience of 2 or 10 defeats in intermale agonistic confrontations significantly differ in pattern of submissive behavior (balance of upright and sideways defensive postures, withdrawal, freezing, "on the back" posture). In mice with experience of 20 defeats genetic differences have not been found. The acquisition of consequent experience of defeats does not change the pattern of CBA mice submissive behavior, but significantly increases the share of immobile submissive postures in behavior of C57BL mice. Among submissive males of C57BL strain animals with more active strategy of behavior keep capability for aggressive response to weaker partner. The influence of genotype and previous social contact experience on formation of adaptive in experimental situation strategy of submissive behavior is discussed. PMID- 1768734 TI - [The enhancement of body resistance to combined exposure to immobilization and cold with thyroid hormones]. AB - In experiments on 123 male rats have been found that the combination of immobilizing and cold (4 degrees C) stresses during 6 hours results in the formation of 4.5 gastric mucosa ulcers in every rat, marked activation of lipoperoxidation and depression of antioxidant activity of myocardium, significant increase of relative mass of adrenal glands, decrease of spleen mass and death of 80% animals accompanied by the reduction of concentration of thyroid hormones in blood serum and hypothermia (to 28 degrees C). The prestress injection of small doses of thyroidine decreased of mucosa defect rate and the number of ulcers to 2.8, made less marked the changes of relative mass of adrenal glands and spleen and the changes of concentration of thyroid hormones in blood serum, significantly limited the activation of lipoperoxidation, depression of power in antioxidant systems of myocardium, hypothermia (to 32.5 degrees C) and significantly increased the survival rate (to 70%). PMID- 1768735 TI - Effects of transforming growth factor beta (TGF-beta) on the lymphocyte- and cytokine-mediated destruction of islet cells in the BB/Wor rat. AB - The objective of this study was to determine whether transforming growth factor beta (TGF-beta) can inhibit the destruction of islet cells by either spleen cells from acutely diabetic BB/Wor rats, or by the cytokines tumor necrosis factor (TNF) and interferon gamma (IFN-gamma). It has previously been reported that effector spleen cells from diabetic BB/Wor rats and humans can specifically lyse islet cell targets in a 51Cr release assay; further evidence in BB rats suggests that these cells are natural killer (NK) cells. Similarly, TNF and IFN-gamma have been shown to act synergistically to destroy islet cell monolayers. TGF-beta inhibits NK cell generation and activity, and was shown to inhibit the production and/or activity of various cytokines. A 51Cr release assay was used to evaluate the effects of TGF-beta on both the lymphocyte- and cytokine-mediated destruction of islet cells. Results showed that TGF-beta specifically inhibits lymphocyte mediated islet cell lysis at concentrations of 10 and 1 ng/ml. Preincubation of islets with TGF-beta for 24 h prior to the addition of 51Cr-labeled target cells markedly increased the percent inhibition of islet cell lysis. TGF-beta (10 ng/ml) was also shown to significantly inhibit the TNF and IFN-gamma-induced lysis of islet cell monolayers. These findings demonstrate that TGF-beta can significantly reduce both the diabetic spleen cell, and cytokine-mediated lysis of islet cells and suggest that it may play a role in preventing islet damage in vivo. PMID- 1768736 TI - Enhanced release of TNF-alpha, but not IL-1 beta, from uremic blood after endotoxin stimulation. AB - Aberrant immunologic host defenses associated with uremia may be a cause of the high incidence of sepsis in chronic hemodialysis (CHD) patients. This investigation determined the cytokine response of blood from five nondialyzed chronic renal failure (CRF) patients, five CHD patients, and five healthy controls (HC) after in vitro stimulation with 1 ng/ml Escherichia coli 0113 endotoxin. Concentrations of the cytokines TNF-alpha and IL-1 beta were determined by ELISA and were similar in all baseline and unspiked samples. TNF alpha concentrations in CRF and CHD spiked samples were similar to each other but significantly greater (p less than 0.01) than in HC spiked samples. IL-1 beta concentrations in CRF, CHD, and HC-spiked samples were not significantly different. We conclude that CRF and CHD patients have enhanced TNF-alpha response, which may be related to uremia and not dialysis-related factors. Uremia does not potentiate IL-1 beta release. PMID- 1768737 TI - Influence of age and caloric restriction on macrophage IL-6 and TNF production. AB - Aging is correlated with a plethora of immunological changes resulting in both decreased immunity to exogenous antigens and increased autoreactivity. Immunosenescence is generally believed to primarily affect the B- and T-cell compartments, leaving macrophage (M phi) function relatively intact. However, several recent reports show diminished presentation of certain antigens and decline in interleukin 1 (IL-1) production by aged M phi s suggesting the need for more extensive assessment of M phi function. In the present study we demonstrate that aged murine M phi s show diminished IL-6 and TNF production. In addition, we show that dietary caloric restriction, a regimen which extends life span and improves many immunological functions, has no effect on the declining TNF production. PMID- 1768738 TI - The antiviral activity of immune CD8+ T cells is dependent on interferon-gamma. AB - Vaccinia virus (VV) is a cytopathic virus that in normal mice exhibits only low virulence. However, when mice were treated throughout the course of the infection with mAb to IFN-gamma, the virus was lethal. The inability of these mice to clear the infection was not due to inhibition of effector T cell development since equally high numbers of cytotoxic T cells were generated in mAb- or control treated mice. Instead, the data presented show that the defect was at the level of effector T cell activity. When immune CD8+ T cells were transferred to virus infected recipients the infection was readily cleared. In contrast, effector cell function was totally blocked in mAb-treated recipients. We have considered these findings in view of our earlier observations that T cell deficient mice were able to resolve an otherwise lethal vv infection if infected with recombinant vv that encoded the genes for IL-2 or IFN-gamma. We propose a unifying concept such that antiviral T cells, which recognize infected cells in the context of class I MHC molecules, act to focus antiviral cytokines at the site of virus infection. PMID- 1768739 TI - In vitro selection of NIH-3T3 cells for resistance to lymphotoxin induces resistance to activated macrophages and enhances tumorigenicity in vivo. AB - It is well known that expression of certain growth factors leads to tumorigenesis. However, the role of growth inhibitory molecules in this process is less certain. During the last few years several cytokines with growth inhibitory properties have been identified. In spite of the production of these cytokines by the body's immune system, the growth and progression of the tumor continue. In order to understand the mechanisms by which tumor escapes the host defense system, we have used lymphotoxin (LT), a lymphocyte-derived cytokine that is known to selectively inhibit the growth of certain tumor cells. The effect of LT was investigated on NIH-3T3 mouse fibroblast cells that are highly sensitive to its cytotoxic effects and are also tumorigenic in nude mice. On exposure to 10 units/ml of LT, 50% of these cells are killed within 24 h. A stable variant of NIH-3T3 cells that is completely resistant (LT-R) to even 10,000-fold higher concentration of the cytokine than that of sensitive cells (LT-S) was isolated in vitro by repeated exposure to LT. Both LT-S and LT-R displayed similar characteristics when grown both as a monolayer and in soft agar. No significant difference in LT receptor number or affinity between the two cell types was observed. It was not possible to overcome the resistance to LT by the addition of interferon-gamma but the resistance could be overcome by the presence of various chemotherapeutic agents suggesting a difference in the mechanism of action of these two agents.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768740 TI - Terminal differentiation of myeloleukemic M1 cells induced by IL-6: role of endogenous interferon. AB - During terminal differentiation of myeloleukemic M1 cells triggered by IL-6, an induction of IFN-activated genes, such as IRF-1, class I MHC, and (2'-5')-A synthetase, is observed. Antibodies to murine type I IFN, inhibit most (2'-5')-A synthetase induction but do not inhibit IL-6-induced growth-arrest and differentiation. IL-6 induction of (2'-5')-A synthetase subforms, however, differs from that of IFN. IL-6 in fact induces a cell surface form of (2'-5')-A synthetase that is not induced by IFN. PMID- 1768741 TI - Localization of transforming growth factor-alpha in adult Syrian hamster tissues. AB - Using the cheek pouch of the Syrian hamster as an experimental model for oral carcinogenesis, it has been shown that the expression of transforming growth factor-alpha (TGF-alpha) is consistently associated with the malignant transformation process. We have recently shown that production of TGF-alpha has been localized to normal hamster oral epithelium and bone marrow eosinophils. In this study we investigated the production of this cytokine in other normal hamster adult tissues. By using an EGF-radioreceptor assay, immunohistochemistry, Northern blot analysis, and in situ hybridization we have now further detected the presence of TGF-alpha mRNA and/or protein in the kidney, stomach, and pancreas of normal adult hamster. Together with the previously reported detection of TGF-alpha in oral mucosa and bone marrow eosinophils, these adult normal tissue/cellular sources can serve as sites of TGF-alpha production. The availability of hamster specific reagents (cDNA and monoclonal antibodies) and the delineation of the various adult tissues that could produce TGF-alpha make the Syrian hamster a suitable model for the study of how this multifunctional cytokine can influence normal and pathological processes. PMID- 1768742 TI - Murine T cell hybridoma-derived products regulate the growth of skeletal muscle myoblasts. AB - We have analyzed the effects of T cell products on the growth of murine myoblasts. Supernatants from some T cell hybridomas were shown to have either growth factor activity or growth inhibitory activity on two myoblast lines raised in our laboratory from two different strains of mice and also on the C2C12 myoblast line. The hybridoma-derived growth factor activity was shown not to require cofactors contained in serum as its effects could be demonstrated in assays done in serum-free media. Further studies on the effects of purified lymphokines on myoblasts using recombinant IL-2, IL-3, IL-4, IL-6, and GM-CSF showed these lymphokines not to have any growth stimulatory activity indicating that factor(s) other than the ones tested may be operative. Characterization by dialysis and column chromatography of hybridoma supernatants revealed the presence of a low-molecular-weight inhibitor and a higher-molecular-weight growth factor that was found in several hybridoma supernatants. PMID- 1768743 TI - Differential regulation of interleukin-1 alpha and interleukin-1 beta mRNA expression in human monocytes: evidence for protein kinase C-dependent and independent pathways. AB - The expression of mRNA coding for IL-1 alpha and IL-1 beta was examined in human peripheral blood monocytes (PBM) to determine if the two genes are under the same mechanisms of transcriptional control and whether or not they can be regulated independently. In response to E. coli lipopolysaccharide (LPS), PBM express approximately 10-fold more IL-1 beta-specific mRNA than IL-1 alpha. However, treatment of these cells with phorbol myristate acetate (PMA) resulted in the expression of IL-1 beta mRNA. Likewise, treatment of PBM with phorbol dibutyrate (PdBu), phorbol diacetate (PDA), or mezerein, which, similar to PMA, were able to induce the translocation of protein kinase C (PKc) to the monocyte plasma membrane, resulted in predominantly IL-1 beta mRNA expression. The inactive tumor promoter 4 alpha-phorbol didecanoate (4 alpha-PDD) did not cause the translocation of PKc or induce the expression of either form of IL-1 mRNA. Following 18 h pretreatment with PMA to downregulate PKc activity, LPS was capable of inducing the expression of both forms of IL-1 mRNA, demonstrating that at least part of the response of PBM to LPS is PKc independent. These results suggest that the activation of PKc alone is sufficient to induce a high level expression of IL-1 beta but not IL-1 alpha mRNA. Furthermore, the possibility exists that another, as yet unknown, signal transduction mechanism is involved in inducing the expression of both IL-1 alpha and IL-1 beta mRNA in response to LPS. PMID- 1768744 TI - Studies on the biological effects of ozone: 2. Induction of tumor necrosis factor (TNF-alpha) on human leucocytes. AB - The effect of ozone as a probable inducer of tumor necrosis factor (TNF-alpha) has been investigated on human blood and on Ficoll-purified blood mononuclear cells (PBMC). Samples were exposed at different ozone concentrations ranging from 2.2 to 108 micrograms/ml and incubated at 37 degrees C in an 95% air-5% CO2 atmosphere. At predetermined times, all cell supernatants were tested for TNF activity and some PBMC cultures were examined for DNA synthesis. We have shown that ozone concentration is critical in terms of TNF production and of cell mitogenesis and that, owing to the presence of erythrocytes, higher ozone concentrations are required to be effective in blood than in PBMC. Because ozonization of blood is a procedure followed in several European countries for the treatment of viral diseases and tumors, the release of factors with antiviral and immunomodulatory activities by leukocytes may explain the mechanism of action of ozone and of autohemotherapy. PMID- 1768745 TI - [Detection of hepatitis B virus DNA in peripheral blood mononuclear cells from patients with various hepatopathies using in situ hybridization]. AB - We have investigated, by "in situ" hibridisation, the presence of hepatitis B virus (HBV) DNA in peripheral blood mononuclear cells (PBMC) from 45 patients with acute and chronic hepatic disorders directly related with HBV or with some seric HBV marker. Results has been related with serological markers and the different types of hepatopaties. The HBV-DNA was detected in PBMC more frequently in patients with hepatic alterations more prolongated (chronic active hepatitis, chronic persistent hepatitis and cirrhosis) than in acute hepatitis patients. It was not detected in any asymptomatic patient with HBV serological markers. As regards HBV serological markers, HBV-DNA was detected in PBMC in 8/11 HBsAg positive patients and in 11/34 HBsAg negative patients: 3 antiHBc positive, 5 antiHBc and antiHBs positive and 3 without conventional seric markers. The detection of HBV-DNA in antiHBc and/or antiHBs positive subjects means the virus may persist after recovery of infection and suggests PMBC could serve as additional reservoirs for reinfection of hepatocytes leading to a reactivation of the liver disease. Our results suggest that HBV infection of PBMC is a frequent event during HBV infection and can have important consequences fundamentally with respect to pathogenic mechanisms of HBV induced liver disease and to the transmission of the virus. PMID- 1768746 TI - [Diagnosis using monoclonal antibody imaging in the clinical follow-up of colorectal cancer]. AB - A total of 44 patients with a range of ages between 34 and 72 were studied by immunoscintigraphy. They have surgical treatment for colon and rectum carcinomas. The immunoradiotracer used was a cocktail of F(ab')2 monoclonal-antibodies anti CEA and CA 19.9. Planar images were obtained 4th, 6th, and 10th days postinjection. In some cases we used digital subtraction of image. Both CEA and CA 19.9 tumor markers were measured in patients serum. The method shows a global high sensitivity (88%), and specificity (92%). PMID- 1768747 TI - [Epidemiological study of prisoners at risk for AIDS in a Spanish prison]. AB - Different proportions of the several AIDS risk practices in a Spanish prison during 1988 were studied. Also a epidemiologic study of the infectious diseases of the prisoners with some risk of this type was carried out. Of 135 prisoners with risk of AIDS, it was found that 91.2% of them were drug addicts. The index of positive HIV in all the population study was of 65.2%. 81.5% of the sample had at least one B hepatitis marker and 11.1% had HBs-Ag. 15.4% of the last group also showed HBe-Ag positive. Histories of non-A, non-B hepatitis were not evaluated in 9.6% of all the patients studied. 53.3% had sexually transmitted diseases. It is important to mention the high index of active tuberculosis found (12.6% of the sample), which is higher than the maximum values found in various similar papers. We did not find any differences in the grade of affectation between HIV+ and HIV-. PMID- 1768748 TI - [Brucellosis with nervous system involvement]. AB - Cases of brucellosis with involvement of the nervous system which was diagnosed in the Miguel Servet Hospital during the period 1985-1987 are retrospectively studied. The total quantity of affected patients of brucellosis was 132. Of this quantity, 9 patients (6.8%) had neurological complications under the following clinical forms: epidural abscess (2), meningoencephalitis (1), meningitis (2), encephalitis (1), myelitis (1) and polyradiculitis (2). The most important epidemiological and clinical characteristics are analysed, pointing out the diagnostic difficulties we found when the neurological manifestations are predominant in the brucella infection. PMID- 1768749 TI - [Austrian's syndrome and infection with human immunodeficiency virus]. AB - A case of a patient diagnosed of Austrian' syndrome associated to HIV infection is presented. Our aim is to highlight the frequent but not enough described association to pneumonia, endocarditis and meningitis caused by Streptococcus pneumonia to increased its knowledge and permit a correct and early treatment, improving the bad prognosis of this association. PMID- 1768751 TI - [Bone involvement in systemic mastocytosis: report of 3 cases]. AB - Systemic mastocytosis is a rare disease, with symptoms produced by the accumulation of mastocytes on skin and other tissues as well as the release of biologically active substances. Bone is the more frequent extracutaneous involvement, its being clinically difficult to detect, even though the radiological findings detects them in at least 70% of the cases. It is necessary to notice the great variety of presentation, from localized to disseminated and osteoporotic to condensed or mixed as it is in this cases. These are reasons for diagnosis delay. The elective test in those cases with general involvement is bone biopsy; its processing the sample with blue toluidine. PMID- 1768750 TI - [Pulmonary fibrosis as a presentation form of the Jo-1 syndrome]. AB - Jo-1 syndrome is a disease recently described, included on the list of connective tissue diseases. Its clinical features are myositis and/or pulmonary fibrosis associated to the presence of precipitant antibodies against intracellular enzyme call histidine T-RNA synthetase. This antibody is related to pulmonary fibrosis associated to myositis and some scientist gave predictive value on the onset of pulmonary fibrosis in patients with myositis. However, isolated association of pulmonary fibrosis have been exceptionally described. A patient with severe interstitial pulmonary affliction and positive Jo-1 antibody without myositis is presented. The actual knowledge of the disease and its association is reviewed. PMID- 1768752 TI - [Agranulocytosis induced by captopril after 4 months of treatment]. AB - A case of a patient treated by captopril who developed agranulocytosis and sepsis from pulmonary origin is presented. Shortly, we reviewed the pathogenesis of this complication and highlight the fact that in this patient this adverse reaction to captopril was late. PMID- 1768753 TI - [HIV infection and tuberculosis]. PMID- 1768754 TI - [Function tests and the peak flow measurement in the diagnosis of obstructive diseases in the elderly]. PMID- 1768755 TI - [Severe thrombocytopenia: a rare complication of infectious mononucleosis]. PMID- 1768756 TI - [Chronic juvenile arthritis and minimal change glomerulonephritis (MCGN), the same pathogenic basis?]. PMID- 1768757 TI - [Syncope as the presentation form of pulmonary embolism]. PMID- 1768758 TI - [Graves-Basedow disease revealed by severe hypercalcemia and myopathy]. PMID- 1768759 TI - [Pneumonia caused by respiratory syncytial virus in the adult]. PMID- 1768760 TI - [Chronic lymphatic leukemia and multiple myeloma in the same patient]. PMID- 1768761 TI - [Nutrition in the elderly]. PMID- 1768762 TI - Fibrinogen Kiel: a congenital dysfibrinogenaemia with (A alpha-16 Arg----His) substitution characterized by HPLC without prior isolation of fibrinogen. AB - A congenital fibrinogen variant in a German family is described which has been identified as a substitution of His in position 16 of the A alpha-chain for Arg, manifested over three generations in heterozygous form. The characterization is based on the reaction of the variant fibrinogen with thrombin and reptilase, on the HPLC-chromatographic properties and the amino acid composition of the abnormal fibrinopeptide A. Clinical observations in the affected family members (neither haemorrhagic nor thrombophilic tendencies), the results of routine coagulation tests (normal global clotting tests, prolonged thrombin and thrombin coagulase time, decreased fibrinogen concentration in functional as opposed to immunological tests), and the autosomal co-dominant modus of inheritance of the fibrinogen variant are all in complete agreement with other reports in the literature concerning the same amino acid exchange. The results of our experiments with fibrinogen Kiel allow no definite conclusion regarding the question of whether it consists of pure homodimers or as of a mixture of homo- and heterodimers. PMID- 1768763 TI - Intracerebral haemorrhage due to acquired factor XIII inhibitor--successful response to factor XIII concentrate. AB - A 63-year-old woman presented with extensive bruising. An inhibitor to factor XIII was detected. Subsequent subcutaneous bruising and soft tissue haemorrhage into the left foot were treated with infusions of pasteurized factor XIII concentrate with good effect. Immunosuppression with cyclophosphamide was attempted but in spite of this she suffered a right cerebral haemorrhage necessitating further intensive therapy with factor XIII concentrate. This overcame the inhibitor, adequate post-infusion factor XIII levels were achieved and she made an excellent recovery. Factor XIII concentrate was well tolerated with no evidence of transmission of hepatitis or HIV infection. The inhibitor appeared to interfere with haemostasis by hindering the fibrin binding site of factor XIII, resulting in interference in clot-solubility tests. Subsequently the inhibitor resolved. PMID- 1768764 TI - Serum enriched with n-3 polyunsaturated fatty acids inhibits procoagulant activity in endothelial cells. AB - Nine healthy male volunteers (mean age 24.3 years, range 21-27 years) ingested 25 ml cod liver oil (CLO) daily for 8 weeks. Blood samples were collected before and after the intervention period. A slight increase in total serum cholesterol (+ 12.2%, P less than 0.01) and high density lipoprotein cholesterol (+ 16.9%, P less than 0.01) were calculated to have a non-significant effect on the high/low density lipoprotein ratio. Polyunsaturated fatty acids in serum were displaced from the n-6 family to the n-3 family, reflected by an eight-fold increase of the eicosapentaenoic (20:5 n-3)/arachidonic (20:4n-6) acid ratio. Human umbilical vein endothelial cells were grown in a medium to which 30% sterile filtered serum, collected before and after CLO supplementation for 72 h, was added. After 2 h exposure to lipopolysaccharides the thromboplastin activity in endothelial cultures incubated with serum enriched with n-3 fatty acids was 43% lower than in cultures containing serum collected before the intervention (1.86 +/- 0.48 10( 3)/10(6) cells vs 3.26 +/- 0.85 10(-3)/10(6) cells). It is suggested that serum prepared from subjects given n-3 fatty acids may support the thromboresistence of endothelial cells. PMID- 1768766 TI - Genetics and molecular biology of haemophilias A and B. AB - The development of rapid procedures for the characterization of mutations is advancing the knowledge of the molecular biology of the haemophilias and transforming the strategies for the diagnoses required for genetic counselling. In haemophilia B more than 300 mutants have been fully characterized. These comprise complete and partial deletions, rare insertions, and 'point' mutations. The latter may impair transcription (promoter mutations), RNA processing (splicing mutations) and translation (frameshifts and stop codons) or cause single amino acid (aa) changes. Eighty-four residues are involved in the 105 presumed detrimental aa substitutions reported so far and these are usually conserved in the factor IX homologues (factors VII, X and protein C) and/or the factor IX of different mammalian species. There are clear correlations between the mutation and clinical features. In addition mutations causing gross physical or functional loss of coding information appear to predispose to the development of antibodies against therapeutic factor IX. Hotspots of mutations have been identified and are usually associated with CpG sequences. In haemophilia A the size and complexity of the factor VIII gene has hindered the analysis of mutants. Most of the studies published so far have analysed only a small fraction of the essential region of the factor VIII gene and this led to the repeated observation of specific types of mutation. The recent development of a rapid method to analyse RNA splicing and the whole coding region of the factor VIII gene should unblock this situation. With regard to genetic counselling, the direct detection of gene defects has increased the proportion of haemophilia B families that can be helped from 60% to virtually 100% and similar expectations may now be formulated for haemophilia A. In the UK a national database of haemophilia B mutations is being constructed to optimize genetic counselling. This should offer a model for a similar development in haemophilia A. PMID- 1768765 TI - Effect of phosphopyridoxylation on thrombin interaction with platelet glycoprotein Ib. AB - The purpose of this study was to determine the effect of chemical modification of lysyl residues on thrombin interaction with platelet membrane proteins. Modification of lysyl residues by pyridoxal-5'-phosphate affected two different sites on thrombin and resulted in a greatly decreased binding to platelets. Using a crosslinking bifunctional reagent [bis(sulphosuccinimidyl) suberate (BS3)], we show that modified thrombin retained the ability to form high molecular mass (greater than or equal to 400 kDa) complexes with yet unidentified platelet proteins and to bind to platelet protease nexin I, but had lost the ability to bind to platelet glycoprotein Ib (GPIb). As previously reported by others, heparin protected one of the two sites from phosphopyridoxylation. In contrast modified thrombin, heparin-protected modified thrombin retained the ability to bind to GPIb, indicating that the lysyl residue(s) protected by heparin from the modification are essential for GPIb binding. While unprotected modified thrombin failed to bind hirudin, heparin-protected modified thrombin retained its ability to bind the carboxy-terminal hirudin peptide H54-65. Tritium-labelling of the modified lysyl residues and degradation of modified thrombins by CNBr or trypsin confirmed that the lysyl residue(s) protected by heparin and essential for GPIb binding are located in the thrombin binding domain for the carboxyl-terminal tail of hirudin, within the sequence 18-73 of the thrombin B chain. PMID- 1768767 TI - Discrepant increase in factor VIII: C and von Willebrand factor after DDAVP infusion in a patient with variant von Willebrand's disease. AB - We have studied a patient with von Willebrand's disease (vWd) whose von Willebrand factor (vWf) multimer patterns showed significant decreases of all but the major fast moving vWf multimer (promoter). Bleeding time (BT) was very prolonged, there was almost no ristocetin-induced platelet aggregation (RIPA) and vWf levels were very low. The factor VIII: C/vWf: Ag ratio appeared to be higher than normal because of the relatively increased concentration of factor VIII: C. The infusion of DDAVP normalized BT, improved RIPA and restored normal factor VIII: C levels, these effects lasted for 5 h even though only a slight increase of vWf: Ag and vWf: RCoF was observed. RIPA was completely inhibited by an anti glycoprotein (GP) Ib monoclonal antibody that recognizes the ristocetin-induced vWf binding site. Plasma vWf multimer analysis revealed only slight increases of all components and an additional, more pronounced representation of vWf protomer. These data suggest that the patient has an abnormal vWf molecule characterized by a greater ability to carry factor VIII than would be expected from the vWf levels. Furthermore, since the vWf protomer was the only significant vWf component present both before and after DDAVP infusion we hypothesize that some of the haemostatic functions of the patient's vWf may depend on it. PMID- 1768768 TI - Identification of EEG patterns occurring in anesthesia by means of autoregressive parameters. AB - In EEG analysis an automatic pattern recognition is of interest. In this paper the usefulness of autoregressive parameters to classify EEG segments recorded during anesthesia is examined. Assuming that the AR parameters are multivariate normally distributed, parametric methods of discriminant analysis can be applied. The results show that AR parameters have high discriminating power and that the lowest error classification rate (smaller than 3%) is obtained by using quadratic discriminant functions. Consequently autoregressive parameters are efficient for classifying EEG segments into general stages of anesthesia. PMID- 1768769 TI - [Variance, factors of influence and clinical relevance of plasma viscosity]. AB - The problem of measuring plasma viscosity has been solved through the use of capillary and falling-ball viscosimeters which have a determination variance of less than 1%. On account of the influence of overeating, forced thirst, psychological and physical stress plasma viscosity should be determined in the morning; the patient should be fasting and well hydrated. Plasma viscosity is influenced by diseases with alterated plasma protein composition. An elevated viscosity also significantly increases the risk of developing an arterial occlusion. Since the physician can both decrease and increase plasma viscosity, it should be determined parallel to therapy. Accordingly, plasma viscosity is one of the most important rheological parameters. PMID- 1768770 TI - [Non-contact measuring of small translations and rotations in all degrees of displacement]. AB - The investigation of biomechanical problems often makes it necessary to measure displacements and rotations in space. An easy-to-handle optical measuring system has been developed that permits non-contact simultaneous determination of small translations and rotations in all degrees of freedom. Three two-dimensional light sensitive sensors (PSD [position sensing detector] elements) were arranged spatially to form a measuring sensor. After processing in a computer, the signals definitively determine relative shift and rotation. Thus it is possible, for example, to measure the relative movement between two adjacent spinal vertebrae under different loads. PMID- 1768771 TI - [Eyeglass frame for detection of eye, head movements and pupillary diameter]. AB - Up till now, the simultaneous recording of the movements of the eyes, the movements of the head and the diameter of the pupil required the combined use of several apparatus. In this paper we present a new apparatus developed for the simultaneous recording of the movements of the eyes and of the head, and the diameter of the pupil. The apparatus consists of a portable frame (weight 215 g) a 19" rack containing electronics, and a PC for storing and analyzing the recorded data. In comparison with other systems providing similar measuring possibilities the present apparatus has the advantage of smaller dimensions and lower weight. PMID- 1768772 TI - [CO2 angiography: studies of gas filling of vessels and assessing the factors of influence on the injection process with a cardiovascular model]. AB - Following the advent of digital subtraction angiography (DSA), carbon dioxide gas has become a useful contrast agent for arterial angiography. Former manual injection methods had precluded accurate dosing and reproducibility. An original gas injector was therefore developed and tested in a circulatory system model. This permitted an accurate evaluation of vascular gas-filling. it also proved possible to measure the injection parameters taking different influencing factors into account. It was shown that vessels up to 10 mm in diameter are virtually completely filled with gas. In vessels larger than 10 mm in diameter, a residual fluid level remains, which in turn reduces the possibility for complete vessel imaging. The injection flow is dependent primarily on the vascular circulation rate, vessel diameter and the inclination of the vessel. With respect to other factors examined, neither catheter size, number of holes nor the direction of the injection have any relevant influence. PMID- 1768773 TI - [Ion-selective electro-analyser with tubular solid contact flow-through sensors for continuous bioelectrochemically controlled hemodialysis of K+, Na+, Ca2+, Cl- and pH]. AB - An ion-selective electroanalyzer for bio-electrochemically controlled hemodialysis will be described. The bedside analysers are solid-contact flow through electrodes based on tubular carrier-PVC-membranes for potassium, sodium, calcium and chloride. This multi-measurement system with series-connected biosensors in modular construction is provided with a chemosensor for pH measurements. Besides the technical aspects of the apparatus, the quantitative electrode characteristics and the fundamental basis for the application of ion activities in clinical analytic measurement will be described. PMID- 1768774 TI - [Continuous registration of the filling volume of the human urinary bladder]. AB - A sensing system for continuous recording of bladder volume is described. The system is intended for use in particular in patients with paraplegia or bladder plastique. Owing to the very simple measuring procedure employed the implantable components can be designed for very low power consumption. Also, there is no need for an additional data transfer from inside the body to the exterior, because measurement and telemetry are physically the same procedures. PMID- 1768775 TI - [Clinical morphology of the sternum]. AB - The length, width and thickness of the sternum were measured in 74 adult specimens with the aim of optimizing the dimensions of staples used after sternotomy. This article describes the experimental procedure and presents the results. Sex differences were confined mainly to the length, with males measuring 16.5 cm, and females 15 cm. Width and thickness maxima (7.4 cm and 1.7 cm, respectively) are measured at the proximal and distal ends of the manubrium, while the width and thickness of the corpus (2.7-3.5 cm and 1.0-1.4 cm, respectively) show relatively minor differences. PMID- 1768776 TI - Macrophage stimulation activity of antimicrobial N,N-dimethylaminoethyl paramylon. AB - Pretreatment with N,N-dimethylaminoethyl (DMAE) paramylon significantly protected mice from infection by various microorganisms. When mouse peritoneal macrophages were cultured with DMAE-paramylon, they showed morphological change (spreading) and elevated NBT-reducing activity. Macrophages prepared from DMAE-paramylon treated mice had higher NBT-reducing activity than those from control mice. On the other hand, carboxymethyl paramylon and paramylon sulfate, which did not induce appreciable antimicrobial activity, failed to stimulate macrophage functions. The data suggest a significant role of macrophages in antimicrobial activity induction by cationized glucans. PMID- 1768777 TI - Induction of uterine adenomyosis by pituitary grafting and retardation of its development by bromocriptine-mesilate (CB-154) in BALB/c mice. AB - Development of uterine adenomyosis was examined in BALB/c mice. Anterior pituitary (AP) isografting at 8 weeks of age significantly increased the incidence of adenomyosis in mice by 36 weeks of age as compared to that in control mice bearing no AP isograft. However, in mice with AP grafting, daily administration of 0.2 mg bromocriptine-mesilate (CB-154) between 4 and 8 weeks of age decreased the incidence of adenomyosis at 36 weeks of age to the level of control mice. These results suggest that in mice AP grafting stimulates the development of adenomyosis and that pretreatment with CB-154 during youth can suppress the development. PMID- 1768778 TI - Cause of pregnancy-dependent mammary tumour-induced suppression of lactation in GR/A mice. AB - To clarify the cause of pregnancy-dependent mammary tumour (PDMT)-induced suppression of lactation due to the retardation of mammary gland growth, we studied the following: (I) mammary gland growth at the end of pregnancy in mice with PDMT [PDMT(+)] in comparison with mice without PDMT [PDMT(-)] and (II) effects of PDMT removal at the end of pregnancy on mammary gland growth and function. In Experiment I, little difference was observed between PDMT(-) and PDMT(+) groups in mammary DNA content and plasma level of lactogenic hormone or progesterone at the end of pregnancy, indicating that the retardation of mammary gland growth by PDMT does not occur during pregnancy. In Experiment II, the surgical removal of PDMT 1 or 2 days before parturition resulted in a complete restoration of mammary gland growth and lactation. All results strongly suggest that PDMT has a deleterious effect on mammary gland growth during their abrupt regression after parturition, perhaps by secreting some mammary growth inhibitory factor(s). PMID- 1768779 TI - Protection by tree-peony (Paeonia suffruticosa Andr) of obesity in (SLN x C3H/He) F1 obese mice. AB - Water extracts of 10 medicinal plants were checked for protection against obesity in female and male (SLN x C3H/He) F1 obese mice. Each extract was given as drinking water at the concentration of 0.5% between 3 and 32 weeks of age. Among agents examined, only the root extract of tree-peony (Paeonia suffruticosa Andr) retarded growth, especially in males. In males, the treatment with tree-peony resulted in a significant decline in food intake and of the Lee index, an index of obesity, and an increase in glucose tolerance. While no significant difference was observed between the experimental and the control groups in serum free fatty acid levels, the range of the levels was much larger in female and male mice given tree-peony. There was little difference between groups in the weights of heart, liver, kidney, lung, spleen and major endocrine organs in both sexes and in the pattern of oestrous cycles in females. All results indicate that tree peony can protect against obesity, especially in males, at least partly by a decrease in food intake and an increase in glucose metabolism. PMID- 1768780 TI - Preliminary experience with intraperitoneal catheters in the treatment of ovarian cancer. AB - Twenty-nine patients with ovarian carcinoma were treated with intraperitoneal cisplatin. Insertion of an intraabdominal catheter was performed during second look laparotomy. Only one serious complication occurred with abdominal pain, ileus and local peritonitis. Otherwise, the major problems were of a technical nature with separation of the plastic tube from the metallic part of the catheter in 3 cases. In 8 of 29 patients intraperitoneal treatment was discontinued mainly due to local problems at the site of the pot. The procedure is otherwise safe and well tolerated by patients. PMID- 1768781 TI - Distribution of m-IBG in nude mice bearing LAN-5 neuroblastoma xenografts and in vitro cell culture. AB - BACKGROUND: Neuroblastoma is the commonest extra-cranial solid tumour of childhood and has a poor clinical outcome in patients with disseminated disease. Animal xenografts of this tumour offer a useful method of studying new diagnostic and therapeutic strategies for the tumour, prior to consideration of clinical trials. METHODS: 131I m-IBG was injected into nude mice bearing xenografts of the human neuroblastoma line LAN 5 in several sites. Animals were sacrificed at 24 (n = 6) and 48 hours (n = 5) and the biodistribution of the agent as well as uptake into the xenografted tumours was determined in a gamma well counter. In-vitro uptake of m-IBG into suspensions of LAN 5 cells was also determined in order to confirm the animal studies. RESULTS: There was no preferential accumulation of m IBG in the xenografted tumours in any of the sites considered. Similarly, the in vitro uptake of m-IBG showed the typical Michaelis-Menten kinetics of simple diffusion with no evidence of active uptake. CONCLUSIONS: The human neuroblastoma line LAN 5 failed to enrich m-IBG in either the xenograft or in-vitro situation. This may be related to the poor degree of differentiation of the tumour as evidenced by its unusual ease of growth in the sub-cutaneous site. PMID- 1768782 TI - Cell cycle time, growth fraction and cell loss in xenografted head and neck cancer. AB - In a previous cell kinetic study with DNA flow cytometry (FCM) on xenografted human squamous cell carcinoma of the head and neck (HNSCC), there were significant variations in cell cycle phase distribution during early growth of the transplanted tumors. The object of the present study was to investigate further the cell kinetic mechanisms associated with variation in the growth rate of HNSCC. Xenografts from the same tumor line were examined on three different occasions: 12, 25 and 36 days following transplantation into nude mice. Cell cycle time "Tc", tumor growth fraction (GF) and cell loss factor were determined by computerized curve-fit analysis from percentage labelled mitoses curves. The mean growth curve of the tumors was logistic, with tumor doubling time (Td) ranging from 7.39 days to 8.86 days, and increasing as tumor volume increased. Although growth rate was higher in younger tumors, the cell cycle was longer with a median "Tc" of 69 hours on day 12 versus 34 hours on day 36. There were only minor variations in cell cycle phase distribution as measured by FCM. The growth fraction decreased slightly from 80% to 69% between day 12 and day 36, whereas cell loss factor increased markedly from 49% on day 12 to 78% on day 36. The results of the study emphasize the fact that cell loss is one of the most important cell kinetic determinants of tumor growth rate. This should be borne in mind when calculating proliferative cell kinetics in HNSCC. PMID- 1768783 TI - Hypoglycemic activity of Eugenia jambolana and Ficus bengalensis: mechanism of action. AB - The extract of jaman pulp from fruit of Eugenia jambolana showed hypoplycemic activity. This report is the first evidence of such activity in relation to pulp. The effect of pulp was seen in 30 min, while the seeds of the same fruit required 24 hr. The extracts of bark of Ficus bengalensis caused reduction in blood sugar level. These results were confirmed in streptozotocin-induced diabetic animals. The oral administration of the extract resulted in enhancement in serum insulin levels in normoglycemic and diabetic rats. The incubation of isolated islets of Langerhans from normal as well as from diabetic animals with each of these plant extracts stimulated insulin secretion. These extracts inhibited insulinase activity from liver and kidney. PMID- 1768784 TI - The in vivo effects of recombinant human erythropoietin on cisdiamminodichloroplatinum-induced anemia in golden Syrian hamsters. AB - Recombinant human erythropoietin given subcutaneously is able to accelerate hematopoietic recovery in hamsters affected by cisplatin-induced anemia, increasing hemoglobin and hematocrit levels. The increase in hemoglobin and hematocrit levels. The increase in hemoglobin and hematocrit levels is not accompanied by an increase of platelet or granulocyte counts in the peripheral blood. However, an increase in the marrow concentration of burst and colony forming units--erythroid (BFU-E, CFU-E) is observed after recombinant human erythropoietin treatment. This increase in the concentration of marrow erythroid progenitors was accompanied by an increase in the percentage of these stem cells in DNA synthesis as assessed by exposure to ARA-Cyt. Recombinant human erythropoietin seems highly effective in ameliorating and/or preventing cisplatin induced anemia in experimental animals. PMID- 1768785 TI - An evaluation of two animal models for dietary influences on reproductive toxicology. AB - Chronic protein deficiency (8 weeks) was examined in marmosets (Callithrix jacchus) and sub-acute (1 week) methionine- and choline-deprivation was investigated in F344 rats. The marmosets were considered to have become protein deficient but there was no alteration in sperm morphology, either at the end of the diet or 5 weeks later. Weight loss was also observed in rats on the methionine- and choline-free diet and they had significantly decreased sperm counts 4 weeks after the end of treatment. However, there was no effect on sperm morphology, or on the proportion of cytosine residues that were methylated in the sperm DNA. PMID- 1768786 TI - Possible patterns of nuclear rotation in binucleate hepatocytes in vivo: static examination with fluorescence and electron microscopy. AB - To demonstrate nuclear rotation in the intact organism, we induced the formation in vivo of internuclear chromatin bridges in binucleate hepatocytes and examined their morphological arrangement in static conditions. Fixed isolated hepatocytes were observed by fluorescence microscopy and solid liver tissue by electron microscopy. The morphological patterns provided information about different modalities of nuclear rotation, related to equatorial (stationary nuclei), peripheral (nuclei rotating in opposite direction) or oblique (nuclei rotating in the same direction) dispositions of chromatin bridges. Moreover, data indicate that the entire nucleus can rotate. The independence of the bridge arrangements from the cell cycle phases (G1, S, G2) suggests that the nuclear rotation is probably not due to exchange of substances between the active chromatin and the cytoplasm. PMID- 1768787 TI - Effect of reserpine and calcium antagonists on doxorubicin storage in various organs of young and senescent rats. AB - Reserpine pre-treatment causes a considerable decrease in typical red-orange doxorubicin fluorescence of the organs examined (kidney, large intestine, spleen) and a similar picture is observed after calcium antagonists administration. This effect is far more evident in the spleen and large intestine than in the kidney; moreover, it seems more marked in young rats compared with aged ones. An inhibitory action of these drugs on the anthracycline transport carrier through the cell membrane is hypothesized. PMID- 1768789 TI - A model for in vivo serial investigation of hepatic metabolism using 31P nuclear magnetic resonance spectroscopy. AB - We have developed an animal model which allows serial, in vivo, evaluation of high energy phosphate metabolism in rat liver, using 31P nuclear magnetic resonance spectroscopy (MRS). In seven rats, the left lobe of the was surgically relocated into a subcutaneous position. The animals recovered quickly from the surgery and continued to thrive. Localization of the liver was obtained using simple surface coil technology. Typical MRS data acquisition times were less than 45 minutes. After the 28 days, the livers showed both normal histology and 31P metabolic measures. PMID- 1768788 TI - Effect of extra-genital Schistosoma mansoni and Echinostoma caproni infections on serum levels of pregnancy-associated murine protein-1 during murine pregnancy. AB - Maternal plasma levels of pregnancy-associated murine protein-1 (PAMP-1) were measured by rocket immunoelectrophoresis in BALB/cABom mice experimentally infected with the two intestinal parasites Schistosoma mansoni and Echinostoma caproni. In the first half of pregnancy the PAMP-1 level was significantly lower in the infected females compared with the healthy controls, indicating that PAMP 1 is not essential for implantation and early gestation. In the latter half of pregnancy a rapid increase in the plasma levels of PAMP-1 in the infected females was recorded. This might suggest that pituitary GH secretion is restored in the infected animals during the second half of gestation. PMID- 1768790 TI - Progression of human endometrial adenocarcinoma heterotransplanted into nude mice from hormone-sensitive to hormone resistant growth. AB - We have used a human tumor nude mouse model involving heterotransplantation and serial passage of an estrogen receptor (ER) positive, progesterone receptor (PgR) negative human endometrial adenocarcinoma. The effects of estradiol treatment on tumor growth, ER activation and PgR induction were investigated two and four years after heterotransplantation. In Experiment I, two years after initial heterotransplantation, tumor growth and proliferative rate showed a dose-related decrease, ER was activated by estradiol treatment (measured through an increased amount of ER bound with high affinity to nuclear element(s) (ERhs) and PgR was induced. Two years later (Experiment II), the amount of ER1s (ER measured in cytosolic fraction) as well as of ERhs was lower than at the beginning of Experiment I. ER could again be activated by estradiol treatment and PgR was also induced. However, in this experiment no effect either of tumor growth or of proliferative rate was observed during the estradiol treatment. Our study therefore indicates that an estrogen non-sensitive growth can develop during serial passages in intact, non-treated female nude mice, although the capacity for ER activation and PgR induction is maintained. PMID- 1768791 TI - Tumor cell lysis and tumor growth inhibition by the isotype variants of MAb BR55 2 directed against Y oligosaccharide. AB - IgG3 murine MAb BR55-2 is directed against adenocarcinoma associated Y oligosaccharide. Isotype IgG1, IgG2b and IgG2a switch variants of the BR55-2 antibody were compared in antibody dependent-cell mediated cytotoxicity (ADCC) and complement mediated cytotoxicity (CDC) assays in the murine system. IgG3, IgG2a and IgG2b isotypes mediated ADCC with murine macrophages. Murine splenocytes mediated low levels of ADCC, with IgG3 and IgG2a being always more effective than IgG1 and IgG2b isotypes. All four isotypes were ineffective in CDC with murine serum as a source of complement. In the in vivo experiments, growth of human tumors xenotransplanted into nude mice was best inhibited by both IgG3 and IgG2a isotypes while IgG1 protein was the least effective. Thus, IgG3 and IgG2a isotypes are the most efficient proteins for cancer immunotherapy since they mediate the highest tumoricidal activities in vitro and in vivo. PMID- 1768792 TI - Carcinogenesis in rats by substituted dialkylnitrosamines given by gavage. AB - A number of nitrosamines that have been studied by administration to rats as solutions in drinking water have been examined by gavage administration of similar doses, for assessment of the role of pharmacokinetics in organ-specific carcinogenesis. Methylnitrosoethylamine was more effective as a liver carcinogen by gavage than in drinking water and gave rise to tumors of the lung and nasal mucosa by the former route, but not the latter. By gavage, methylnitroso-2 oxopropylamine and methylnitroso-2-hydroxypropylamine induced mainly tumors of the esophagus, as they did when given to rats in drinking water, but the potency was greater by gavage. At a higher dose rate (85 micromoles per week) methylnitrosohydroxypropylamine induced a high incidence of mesenchymal tumors of the kidney and lung tumors, in addition to esophageal tumors, but methylnitrosooxopropylamine did not. The tobacco-specific carcinogen NNK induced tumors of the liver, and to a lesser extent, of the lung and nasal mucosa when given by gavage to rats, as it did by other routes of administration. The similarly basic nitrosamine methylnitroso-N, N-dimethylaminoethylamine was equally potent, whether administered by gavage or in drinking water to rats, and gave rise only to tumors of the esophagus. The cyclic nitrosamine nitrosomorpholine was equally effective by gavage and in drinking water, but induced in rats more esophageal tumors by gavage in addition to a high incidence of liver tumors. Its 2-hydroxy derivative, a postulated metabolic intermediate of nitrosodiethanolamine, was a very much weaker carcinogen than either the latter or nitrosomorpholine, and induced low incidences of liver and lung tumors toward the end of the lifespan of the rats. PMID- 1768793 TI - Red blood cell polyamine evolution during normal growth in mouse. AB - Red blood cell (RBC) polyamine levels were studied at different ages in growing mice. Contrary to RBC from adult mice, high levels of the three polyamines Putrescine, Spermidine (Spd), Spermine (Spm) were detected in erythrocytes from newborn mice. These levels progressively decreased during growth. As previously reported in experimental and clinical studies related to tumor progression or normal tissue regeneration, a statistical correlation between Spd and Spm was noticed in this study concerning normal growth. As regards this correlation, two separate periods appeared during development. The slope values of the straight regression line were calculated for these periods and showed highly significant differences. PMID- 1768794 TI - Carcinogenic fungal hydrazines. AB - The carcinogenic, mutagenic and teratogenic activity of 11 hydrazine analogues and diazonium ions are described. These chemicals are ingredients of 22 mushroom species. Of these, one is cultivated, while the remaining 21 are wild fungi. To date, many of these mushrooms are considered to be edible. The appropriate chemistry and biochemistry investigations of the mushroom chemicals are summarized briefly. Human consumption estimates also are provided in as much as possible. PMID- 1768795 TI - Models of pattern formation in insect oocytes. AB - Pattern formation in early insect development is dominated by coordination of the germ lines polarity with the polarity of the follicle cell layer. The production of an elaborate protective chorion, covering the ovulated oocyte, has made establishing parallel polarity of germ line and soma absolutely essential. Genetics and molecular biology, particularly on Drosophila melanogaster, have identified numerous signals passed from follicle cell to oocyte and vice versa. The physiological basis of this communication is beginning to be established with the identification of several membrane receptors and potential signal transduction steps. The contributions of three physiological models of pattern formation are discussed as they relate to the growing genetic model. Evidence for and against ionic currents as factors in polarity determinations is particularly emphasized. PMID- 1768796 TI - The molecular basis of positional information. AB - Embryologists have dreamed of their own particular philosophers stone for 100 years. During that time they have repeatedly demonstrated the likely existence of signalling molecules or morphogens that control the pattern of development in the embryo. Now at last seems possible that some of these morphogens may have been identified. We review current evidence for the molecular basis of positional information. PMID- 1768797 TI - The amphibian embryo: an experimental model for the in vivo analysis of interactions between embryonic cells and extracellular matrix molecules. AB - The early amphibian embryo provides an attractive model for the in vivo analysis of cell interactions with extracellular matrix components. During gastrulation, mesodermal cells use an anastomosing network of extracellular fibrils as substratum for their migration. These fibrils contain glycosaminoglycans and non collagenous proteins including laminin and fibronectin. The function of these extracellular components in the mesodermal cell migration process has been inferred from grafting experiments and microinjection of probes such as specific antibodies or GRGDS-containing peptides. Using the amphibian embryo as an experimental system, combination of microsurgical, cell behavioral and molecular approaches will provide new insights into cell-extracellular matrix interactions directing morphogenetic cell movements. PMID- 1768798 TI - Alkaline phosphatases as reporters of developmental and cancerous events. AB - Alkaline phosphatases comprise a family of isozymes whose expression is associated with important oncodevelopmental events. This presentation summarizes the relationship between alkaline phosphatase isozyme expression and specific developmental and disease processes, including malignancy. Several experimentally testable hypothesis are proposed that should help clarify the significance of these disease associations and the in vivo function of this interesting group of molecules. PMID- 1768799 TI - Cellular interactions with fibronectin as a model for redundant binding of cells to other extracellular matrix proteins. AB - Perhaps the most studied property of fibronectin (Fn) is its ability to bind to cells. Interestingly, there are multiple mechanisms by which cells can bind Fn involving as many as ten different cell surface molecules and perhaps six distinct sites within Fn. This apparent redundant binding system is not only restricted to Fn since cells bind other extracellular matrix proteins such as laminin, vitronectin and fibrinogen in a similar manner. The many binding interactions between cells and Fn may serve as a model for understanding redundant binding between cells and other matrix proteins. PMID- 1768800 TI - Programmed cell death (apoptosis) in murine blastocysts: extracellular free radicals, polyamines, and other cytotoxic agents. AB - Programmed cell death can also be caused by extracellular, soluble factors, some of which are not physiologic. In vivo in the murine blastocyst, apoptosis eliminates redundant cells of unneeded phenotypes (pre-trophectoderm) from the inner cell mass. Although only a few cells die and many survive, all of the cells are exposed to the extracellular H2O2 in blastocele fluid. The specific control of life versus death is due to the developmental expression of glutathione dependent protective mechanisms in the surviving cells. Based on recent results, a model is proposed in which apoptosis and necrosis reflect different temporal points along a single cell death program. PMID- 1768801 TI - The macrophage: hunter and gatherer. AB - Macrophages are known to perform a wide variety of different tasks in both the developing and the mature mammalian organism. It has been suggested that one developmental task of the macrophage is the removal of superfluous cells during the processes of cell growth, migration and death which comprise tissue formation. This review discusses the question of whether during tissue remodelling the macrophage has an active role and can elicit the death of a target cell or is a passive partner and merely cleans up after the target cell has undergone an autonomous cell death. PMID- 1768802 TI - Cadherins and associated proteins. AB - Cadherins comprise a family of cell surface, calcium-dependent cell-cell adhesion glycoproteins widely distributed in developing and mature multicellular organisms. Here we show that three distinct cadherins, (E-, P-, and N-cadherin) associate with a group of non-cadherin-related proteins, termed catenins, postulated to link cadherins to the actin-based cytoskeleton. We present evidence that the catenin repertoire is identical when different members of the cadherin family are isolated from the same cell and similar, but distinct, when isolated from different cell types and different organisms. The association of catenins with cadherins is not dependent upon cadherin assuming its calcium-dependent conformation and appears to occur prior to expression of mature, functional cadherin at the cell surface. PMID- 1768803 TI - Decision making in interstitial stem cells of Hydra. AB - Interstitial stem cells in Hydra are a continuously proliferating and differentiating cell population. They represent a useful model system for studying mechanisms controlling stem cell differentiation. Here we review our current knowledge of the differentiation potential of these cells. Interstitial stem cells are multipotent and able to differentiate into several different cell types. The differentiation decisions appear to be controlled by positional signals and by the composition of the cellular environment. Since interstitial stem cells can be cultured in an in vivo environment and appear to be accessible to experimental manipulation by a range of new molecular techniques, an in vivo analysis of the molecular mechanisms underlying stem cell decision making can now be approached. PMID- 1768804 TI - The molecular genetics of tail development in Drosophila melanogaster. AB - The formation of the telson in the Drosophila embryo, which encompasses all structures posterior to abdominal segment 7, is under the control of the "terminal class" genes. These maternally expressed genes are organized in a signal transduction pathway which implicates cell-cell interactions between the germ cell derivatives (the nurse cells and oocyte) and the surrounding follicle cell epithelium. Activation of this localized signal transduction pathway at the termini of the embryo is believed to specify the domains of activation and repression of a set of zygotic genes whose interactions specify the various cell states required for the proper formation of tail structures. PMID- 1768805 TI - Late events in chondrocyte differentiation: hypertrophy, type X collagen synthesis and matrix calcification. AB - During endochondral bone formation chondrocytes pass through several stages of differentiation which are characterized by cell proliferation, matrix synthesis and cell hypertrophy. Type X collagen is synthesized in vivo after chondrocytes have become hypertrophic, but before abundant mineral accumulates in the cartilage extracellular matrix. The molecule is also present in the uncalcified membranes of the avian eggshell. Type X collagen synthesis increased with the concentration of calcium phosphate deposited in the cell layer of chondrocyte cultures. The addition of calcium chloride to chondrocyte cultures increased the synthesis of type X collagen in a dose-and time-dependent manner. PMID- 1768806 TI - Amphibian limb regeneration. AB - The Field of amphibian limb regeneration is reviewed. Molecular biology techniques are beginning to explain old experiments and to provide the means of a better understanding of this phenomenon. The major experimental problems of the field are discussed. PMID- 1768807 TI - Recombinant human growth hormone therapy in renal insufficiency: new hope for children. PMID- 1768808 TI - The origins of American nephrology (1800-1850). AB - Within a few years of its occurrence, American clinicians became aware of the discovery by Bright in 1827 that albuminuria in edematous patients was associated with granular degeneration of the kidney. Yet, there was a paucity of important original observations in nephrology from American in the first half of the 19th century. By the mid-19th century, however, the primitive concepts of clinical nephrology, renal physiology, and renal pathology were becoming established in the United States, after enlightenment from Europe. Because of the dreadful course of anasarca and uremia and stimulated by the advantages of innovations in microscopy, renal disease began at that time to attract the attention of eminent American clinician-pathologists. Their early observations would add to the knowledge base on which later developments such as bacteriology, radiology, clinical chemistry, and other scientific advances would build. PMID- 1768809 TI - Growth hormone and the kidney: the use of recombinant human growth hormone (rhGH) in growth-retarded children with chronic renal insufficiency. AB - Hypothalamic production of growth hormone releasing hormone stimulates the anterior pituitary gland to release growth hormone (GH). The clinical manifestations of GH on tissues are either direct or are mediated by insulin-like growth factors (IGF). Both the somatic effects of GH and the renal manifestations of an increase in glomerular filtration rate and renal plasma flow are mediated by IGF. The increase in glomerular filtration rate/renal plasma flow that occurs with either exogenous or endogenous GH is not apparent in patients with chronic renal failure (CRF); therefore, it is unlikely that recombinant human growth hormone (rhGH) treatment of patients with CRF will result in glomerular hyperfiltration. Longitudinal studies are required to determine if the glomerulosclerosis and renal functional impairment occurring in GH and growth hormone releasing hormone transgenic mice occurs after rhGH treatment of growth retarded uremic rats with GH resulted in an improvement in growth velocity. This led to preliminary studies in growth-retarded children with CRF by using rhGH. The acceleration of growth velocity was dramatic despite the fact that GH levels are elevated in uremia. The elevated IGF carrier proteins in uremic children may contribute to the growth retardation. Treatment with rhGH may be efficacious by stimulating a net increase in the free (unbound) IGF levels. Hyposecretion of GH may contribute to the failure to achieve optimal growth after successful renal transplantation. Treatment with rhGH may be efficacious in improving the growth velocity of renal allograft recipients. PMID- 1768810 TI - Biochemical and histochemical characterization of a murine tubular antigen. AB - Cellular components of the developing fetal nephron express certain cell surface antigens at discrete stages of nephron development. To further evaluate the expression of antigens by tubular epithelium, a rat monoclonal antibody (BL26) was developed against murine fetal kidney. BL26 identified a differentiation antigen expressed by epithelial cells of the ureteric bud and late S-body in developing nephrons and by endothelium, mesangium, and distal tubular epithelium in mature nephrons. The polypeptide identified by BL26 was shown to be synthesized by fetal kidney and renal adenocarcinoma cells. The polypeptide contained no detectable carbohydrate modifications but was found in two isoforms, an acylated (26,000-Da) form and a nonacylated (24,000-Da) form. The murine antigen recognized by BL26 and the human CD9 moiety, an acylated polypeptide with a tissue distribution similar to that of the BL26 antigen, comigrated in polyacrylamide gels. We speculate that expression of the BL26 antigen and CD9 reflects processes relating to the activation of epithelial cells. PMID- 1768811 TI - Chronic parathyroid hormone excess in vivo increases resting levels of cytosolic calcium in brain synaptosomes: studies in the presence and absence of chronic renal failure. AB - It has been suggested that excess parathyroid hormone (PTH) in chronic renal failure (CRF) or chronic administration of PTH to normal rats caused derangements in norepinephrine and phospholipid metabolism of brain synaptosomes, because of an increase in their resting levels of cytosolic calcium which may induce a decrease in synaptosomal content of ATP. In the study presented here, the resting levels of cytosolic calcium in brain synaptosomes were measured in six groups of rats including: (1) normal rats; (2) rats with CRF of 21-days duration; (3) normocalcemic parathyroidectomized rats with CRF of 21-days duration; (4) rats with CRF of 21-days duration treated with verapamil from day 1 of CRF; (5) normal rats treated with verapamil for 21 days; and (6) normal rats treated with PTH for 21 days. Resting levels of cytosolic calcium of brain synaptosomes of CRF rats (437 +/- 18.0 nM) and normal rats treated with PTH (428 +/- 5.6 nM) were significantly (P less than 0.01) higher than those of normal rats (345 +/- 9.0 nM), normal rats treated with verapamil (354 +/- 8.7 nM), CRF rats treated with verapamil (361 +/- 12.9 nM), or CRF-parathyroidectomized rats (363 +/- 8.2 nM). There were no significant differences between the values of the last three groups of rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768812 TI - Beneficial effects of dietary mineral restriction in dogs with marked reduction of functional renal mass. AB - Although studies in partially nephrectomized rats have identified a progressive nephropathy that is altered by dietary restriction of phosphorus intake, the response of dogs to similar perturbations has not been established. Functional renal mass was reduced by 15/16 in dogs to determine its long-term effects on renal function and to evaluate the effects of two levels of dietary mineral (calcium and phosphorus) intake (0.44% phosphorus/0.57% calcium versus 1.50% phosphorus/1.91% calcium). Following a 3-month stabilization period, dogs were fed either the lower mineral diet (group 1, N = 12) or the higher mineral diet (group 2, N = 12) for 24 months. Loss of renal function with the passage of time was observed in 10 of 12 dogs maintained on the higher mineral diet, with an average decrease in exogenous creatinine clearance of 11.1 +/- 6.3%/month, leading to a survival rate of 33% in this group. Restriction of dietary mineral intake slowed (P less than 0.05) the rate of decline of exogenous creatinine clearance in group 1 to 2.6 +/- 1.1%/month and improved 24-month survival to 75% (P less than 0.01). Deterioration of renal function was associated with renal calcium accumulation and histologic evidence of nephrocalcinosis, tubular atrophy and dilatation, and interstitial fibrosis. These events were more readily apparent in female than in male dogs. A role for glomerulosclerosis was not apparent, and neither glomerular pathology nor glomerular volume was related to the observed decrements in renal function. PMID- 1768813 TI - Anemia ameliorates progressive renal injury in experimental DOCA-salt hypertension. AB - To explore the role of systemic hematocrit in the vascular adaptations which characterize desoxycorticosterone-salt hypertension, studies were performed in three groups of rats with uninephrectomy, desoxycorticosterone administration, and 1% saline in the drinking water. One group received recombinant human erythropoietin to increase hematocrit, and another group was subjected to phlebotomy and fed a low-iron diet to induce anemia. Control rats exhibited systemic and glomerular capillary hypertension, proteinuria, and substantial glomerular sclerosis at 8 wk. Erythropoietin modestly increased hematocrit and blood pressure and substantially aggravated glomerular capillary pressure, proteinuria, and glomerular sclerosis. In contrast, reduction of hematocrit with a low-iron diet significantly attenuated systemic and glomerular hypertension, proteinuria, and sclerosis. It was concluded that the pace of progression of glomerular injury can be limited by chronic reduction in hematocrit, which effectively ameliorates both systemic and glomerular hypertension in this model of salt-sensitive hypertensive renal disease. PMID- 1768814 TI - The loop displayed before your eyes could one day tell you the secrets of the heart. PMID- 1768815 TI - Systolic and diastolic pressure-volume relationships during cardiac surgery. AB - Seven patients undergoing elective coronary artery bypass surgery were studied to assess left ventricular (LV) performance by pressure-volume loops. LV pressure was measured by micromanometry and instantaneous LV volume by a conductance catheter. Continuous pressure-volume relationships were determined during preload reduction before and after cardiopulmonary bypass (CPB). End-systolic elastance (Ees), as the slope of the end-systolic pressure-volume relationship (ESPVR), and diastolic elastance (Ed) were calculated from these interventions. Changes in position of the Ees were assessed at V75, the value of LV end-systolic volume at 75 mm Hg of LV pressure. From pre-CPB to post-CPB, Ees increased in three patients with a decrease of V75 in two patients, and Ees decreased in four patients with a concomitant increase in V75. Ed increased significantly (P less than 0.01) following CPB, demonstrating a decrease of ventricular distensibility. It is concluded that continuous measurement of LV pressure-volume relationships using the conductance catheter is feasible and may be a useful tool to estimate LV performance during cardiac surgery. PMID- 1768816 TI - Postsystolic shortening as an index of regional myocardial ischemia in an experimental model. AB - This study explored the relationship between regional myocardial postsystolic shortening (PSS) and myocardial tissue oxygenation in an open-chested animal model subjected to halothane anesthesia. Regional function was examined with reference to the ventricular pressure-length loop and tissue oxygenation gauged from regional arterial-venous lactate dynamics. Coronary blood flow was decreased in steps by application of an external constriction to the left anterior descending coronary artery. Results indicate that a significant change in PSS (from 7.46% +/- 2.14%, mean +/- SEM to 17.74% +/- 3.31%; P less than 0.00001) was associated with a reduction in coronary blood flow from 81.48 +/- 8.85 to 56.94 +/- 7.12 mL/min/100 g tissue (P less than 0.0012), but lactate extraction across the myocardium did not change (10.54% +/- 3.20% to 12.17% +/- 2.43%). A further reduction in coronary blood flow to 39.84 +/- 5.63 mL/min/100 g resulted in severe PSS (50.62% +/- 6.14%) and lactate production (183.81% +/- 28.80%). The correlation between PSS and lactate production was significant (r = 0.873; SEE = 50.49; P = 0.000001). PMID- 1768817 TI - Left ventricular end-systolic pressure estimated from measurements in a peripheral artery. AB - Aortic and radial arterial pressure measurements were compared after cannulation and before cardiopulmonary bypass in 26 patients scheduled for coronary artery bypass grafting. The radial artery blood pressure range was 89 to 147 mm Hg systolic and 44 to 75 mm Hg diastolic. A difference was found between the central and peripheral dicrotic notch pressures, the former being 7.9 +/- 2.7 (SD) mm Hg higher than the latter. When 8 mm Hg was added to the notch pressure measured in the radial artery to construct a calculated end-systolic pressure, there was good agreement with the centrally measured notch pressure. The mean difference was 0.15 mm Hg with a 95% confidence interval of -1.2 to 0.9 mm Hg. It was not possible to calculate peak systolic aortic pressure with the same accuracy from the systolic and diastolic pressure measurements in the radial artery. It is concluded that left ventricular end-systolic pressure measured as the aortic dicrotic notch pressure can be calculated from the dicrotic notch pressure in the radial artery with reasonable accuracy. PMID- 1768818 TI - Computer software for the on-line measurement of the left ventricular end systolic pressure-dimension relationship. AB - A microcomputer system was designed to measure the end-systolic pressure dimension relationship (ESPDR), an index of cardiac contractility that is independent of preload, afterload, and heart rate. To test the system, pressure dimension data were obtained from swine left ventricles and from a mathematical model of the heart. Algorithms for filtering, location of end-systole, selection of the measurement interval, and calculation of the ESPDR were evaluated on the basis of speed, precision, accuracy, and robustness. The resulting program runs on an IBM-AT and measures ESPDR on-line within 60 seconds of the start of data acquisition. By reducing the time spent in data analysis and providing rapid feedback of information, the on-line software has increased productivity and facilitated improvements in experimental technique. PMID- 1768819 TI - A comparison of etomidate and thiopental anesthesia for cardioversion. AB - Sixteen ASA class II or III male patients (aged, 52 to 66 years) undergoing elective cardioversion were randomly assigned to receive either thiopental or etomidate according to an observer-blinded, parallel study design. The appropriate drug was administered in 2-mL aliquots every 15 seconds until the patient no longer responded to verbal commands, at which time cardioversion was attempted. The total dose for induction was 0.22 +/- 0.2 mg/kg and 3.2 +/- 0.4 mg/kg for etomidate and thiopental, respectively. The cardiorespiratory data after induction were evaluated for maximal percent change from baseline. The baseline heart rate was 106 +/- 6 beats/min and 98 +/- 8 beats/min for the etomidate and thiopental groups, respectively (mean +/- SEM). The heart rate decreased 5% after induction with etomidate and increased 7% with thiopental (P less than 0.05). The baseline mean arterial pressure (MAP) was 96 +/- 3 mm Hg and 105 +/- 11 mm Hg for the etomidate and thiopental groups, respectively (mean +/- SEM). The MAP decreased 4% with etomidate and 3% with thiopental. Respiratory rate was significantly increased by 22% after etomidate compared with a 22% decrease in respiratory rate with thiopental (P less than 0.05). Seven of eight patients in the thiopental group required only one countershock, whereas four of eight patients in the etomidate group required only one shock. One patient in each group could not be successfully cardioverted. Recovery time and clinical side effects were similar between groups except for mild myoclonus in the etomidate group. Titration to effect of either etomidate or thiopental provided satisfactory anesthesia for elective cardioversion in hemodynamically stable patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768820 TI - Anesthesia for elective cardioversion: a comparison of four anesthetic agents. AB - Elective cardioversion is a short procedure performed under general anesthesia for the treatment of cardiac dysrhythmias. Selection of the anesthetic agent is important, because a short duration of action and hemodynamic stability are required. Forty-four patients scheduled for elective cardioversion in the coronary care unit were studied prospectively. All patients were randomly assigned, according to the last digit of their clinical record number, to receive one of the four anesthetic agents studied: group 1, 12 patients who received 3 mg/kg of sodium thiopental; group 2, 10 patients who received 0.15 mg/kg of etomidate; group 3, 12 patients who received 1.5 mg/kg of propofol; and group 4, 10 patients who received 0.15 mg/kg of midazolam. All patients also received 1.5 micrograms/kg of fentanyl 3 minutes before induction. All four drugs provided satisfactory anesthesia for cardioversion and there were no major complications. Midazolam produced a more prolonged duration of effect and more interindividual variability. Propofol was associated with hypotension and a higher incidence of apnea, and its duration of action was similar to that of etomidate or thiopental. Etomidate produced myoclonus and pain on injection; however, it was the only agent that did not decrease arterial blood pressure. Thiopental reduced blood pressure but otherwise seemed an appropriate anesthetic for this procedure. In conclusion, all four anesthetic agents were acceptable for cardioversion, although their pharmacological differences suggest specific indications for individual patients. PMID- 1768821 TI - Neuropsychological dysfunction after cardiopulmonary bypass: a comparison of two institutions. AB - The authors compared perioperative neuropsychologic dysfunction in patients participating in two studies conducted in institutions using different strategies to manage cardiopulmonary bypass. These differences included hypothermia versus normothermia, presence versus absence of arterial microfilters, and the presence versus absence of glucose-containing solution in the pump prime. Other differences between the two institutions included the type of surgery (intracardiac v extracardiac), the mean duration of cardiopulmonary bypass, and degree of low perfusion pressure during bypass. Despite these major differences, perioperative neuropsychologic dysfunction measured by the two-part Trail-Making psychometric test was similar in the two institutions. Several factors were analyzed for their possible contribution to development of dysfunction, including institution, anesthetic management, age, sex, degree of low perfusion pressure during bypass, and duration of bypass; only age was significant. These results suggest that differences in surgical procedure and management of cardiopulmonary bypass previously thought to contribute to the development of subtle cognitive deficits after cardiac surgery may have been overemphasized. PMID- 1768822 TI - Use of transcutaneous electrical nerve stimulation in the control of postoperative chest pain after cardiac surgery. AB - The effect of continuous transcutaneous electrical nerve stimulation (TENS) on postoperative pain following median sternotomy was evaluated in 89 patients with severe chest pain who underwent cardiac surgery in a prospective, randomized, blinded trial. Pain was assessed by visual analog pain scores before and during treatment in each group. In the active TENS group, 79% of the patients were completely free of chest pain during rest at the end of 180 minutes (P less than 0.001). Among the remaining patients with TENS, 16% had slight pain not needing narcotic analgesics and 5% still had chest pain requiring narcotics. In the control group in which inactive TENS was used, the intensity of pain was reduced in 44% of the patients at the end of 90 minutes (P less than 0.001). However, this early placebo effect was noted to diminish with time and at the end of 180 minutes, 80% of the patients complained of severe chest pain and needed narcotics. These data suggest that TENS can be effective in controlling postoperative chest pain due to median sternotomy after cardiac surgery and its continuous application in the early postoperative period can reduce the need for narcotics. PMID- 1768823 TI - Radiographic pulmonary abnormalities after different types of cardiac surgery. AB - One aim of this study was to determine the incidence of new radiographic pulmonary abnormalities during hospitalization after cardiac surgery. Another aim was to determine if such abnormalities are more common among patients who had left internal mammary artery (LIMA) grafting. The predictive value of radiographic abnormalities for clinically important pulmonary morbidity was also determined. The anteroposterior chest radiographs of 152 patients obtained by portable equipment were evaluated to determine the incidence of new postoperative radiographic pulmonary abnormalities such as atelectasis, consolidation, infiltrate, and pleural effusion. Clinically important pulmonary morbidity was defined as a delay in tracheal extubation or discharge from the hospital because of a pulmonary reason. Among the 89 patients who had LIMA grafting and left pleurotomy, there was an 88% incidence of left-sided pulmonary abnormalities; a 73% incidence of left-sided atelectasis; and a 55% incidence of left-sided effusion. Among the 63 patients who had saphenous vein grafting only and/or valvular surgery, the respective incidences were 68%, 54%, and 35%, which were lower (P less than or equal to 0.05) than those in the patients who had LIMA grafting. There was no significant difference in abnormalities between the saphenous vein grafting and the valvular surgery groups. The 35% incidence of left-sided pleural effusion when LIMA grafting and pleurotomy were not performed was unexpectedly high. There was no association between radiographic abnormalities and age, the duration of cardiopulmonary bypass, and the duration of aortic occlusion, indicating that cardiopulmonary bypass was not a primary etiology of these radiographic abnormalities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768824 TI - Anesthesia and glucose-6-phosphate dehydrogenase deficiency in a child with congenital heart disease. PMID- 1768825 TI - Perioperative myocardial ischemia: early diagnosis using the pulmonary artery catheter. PMID- 1768826 TI - Desaturation of the left upper limb only as an indication of postoperative pulmonary hypertension with congenital heart disease. PMID- 1768827 TI - Preoperative cardiopulmonary exercise testing: determining the limit to exercise and predicting outcome after thoracotomy. AB - Over the past 15 years evaluation of the patient with exertional complaints has changed from a simple qualitative estimate of overall fitness to a detailed assessment of cardiovascular and pulmonary pathophysiology. By quantifying exercise impairment and identifying the physiological limit to exercise, CPEx can help direct and evaluate the efficacy of medical and surgical interventions. Although no clear consensus has emerged, an objective determination of the etiology of exercise intolerance may also help identify the patient at increased risk for postthoracotomy complications. PMID- 1768828 TI - Case 6--1991. A 58-year-old man had a massive air embolism during cardiopulmonary bypass. PMID- 1768829 TI - Pro: deep hypothermic circulatory arrest is preferable to low-flow bypass. PMID- 1768830 TI - Con: deep hypothermic circulatory arrest must be used selectively and discreetly. PMID- 1768831 TI - Transesophageal echo-guided placement of coronary sinus, retrograde cardioplegia catheter. PMID- 1768832 TI - Nonsurgical removal of a knotted pulmonary artery catheter. PMID- 1768833 TI - Pulmonary artery catheter displacement during cannulation for CPB. PMID- 1768834 TI - The cardiac cycle. PMID- 1768835 TI - Guinea pig tracheal epithelial cells in primary culture: morphological and metabolic characterization. AB - The tracheo-bronchial epithelial cells are the first cells of the respiratory tract to encounter inhaled pathogens or allergens. In order to study these interactions in vitro we developed a culture of epithelial cells from guinea pig trachea which were kept as a primary culture for 3-13 days. Electron microscopy showed that the specific ultrastructure of epithelial cells was maintained, particularly cytokeratin intermediate filaments detected by immunofluorescence. The cells in culture produced eicosanoid metabolites, mainly leukotriene B4 and prostaglandin E2 spontaneously and upon calcium ionophore A23187 stimulation. PMID- 1768836 TI - Evidence for the possible involvement of protein kinase C in the activation of non-specific phospholipase A2 in human neutrophils. AB - In this article, we provide mass data on released fatty acids in neutrophils stimulated with A23187 in the presence and absence of phorbol 12-myristate 13 acetate (PMA). A23187 alone caused a highly selective accumulation of non esterified arachidonic acid (AA) relative to other saturated (palmitic and stearic acids) and unsaturated fatty acids (oleic and linoleic acids). However, the absolute levels of non-esterified arachidonic acid, oleic acid and linoleic acid were significantly increased (by twofold) in response to the action of A23187 in the presence of PMA. We also noted a further twofold increase in the non-esterified arachidonic acid in the presence of BW755C, a dual inhibitor of cyclooxygenase and lipoxygenases, with no apparent change in the levels of oleic and linoleic acids and other saturated fatty acids. These results suggest that PMA potentiates not only the release of AA but also the release of oleic and linoleic acids from neutrophil phosphoglycerides. This is possibly due to the activation of non-specific phospholipase A2 (PLA2). Our data also suggest a possible role for the 5-lipoxygenase metabolites in PMA-induced synergism with regard to the release of AA through AA-specific and PMA-sensitive PLA2. Protein kinase C appears, therefore, to play a role in the regulation of both AA-specific and non-specific PLA2 in human neutrophils. PMID- 1768837 TI - Inhibitory effect of new PAF antagonists on PAF-induced rabbit platelet aggregation in vitro and ex vivo. AB - The effect of BN 50739, a recently developed PAF antagonist, on PAF-induced rabbit platelet aggregation in vitro and ex vivo was investigated. BN 50739 caused a right shift in PAF dose-response curves of platelet aggregation both in vitro and ex vivo. The amplitude of maximum aggregation, however, did not change as the concentration of PAF was increased indicating that BN 50739 is a competitive inhibitor. In vitro, in the presence of 10, 33 and 66 nM of BN 50739, the EC50 of PAF inducing aggregation increased 3.7, 11.1 and 50 times, respectively, and platelet disaggregation was promoted. The IC50 of BN 50739 for 2.5 nM PAF-induced platelet aggregation was 13.8 nM. Under the same condition, the IC50s of BN 50741, BN 50730, BN 50726, SRI 63-441 and BN 52021 were 18.3, 33.1, 63.4, 712 and 24,600 nM, respectively. BN 50739 given i.p. at 1, 3 or 10 mg/kg increased the concentration of PAF inducing 50% maximal platelet-rich plasma aggregation 3.4, 28 and 134 times, respectively. The apparent biological half-life of BN 50739 at 3 and 10 mg/kg i.p. was 2.5 and 5.4 h, respectively. BN 50739 had no effect on arachidonic acid (AA)- or collagen-induced platelet aggregation at concentrations effectively inhibiting PAF-induced platelet aggregation; however, moderate inhibition on AA- and collagen-induced aggregation was observed as the concentration of BN 50739 exceeded 100 nM. The results indicate that BN 50739 is the most potent and competitive PAF antagonist. PMID- 1768838 TI - PAF-acetylhydrolase, predominantly present in LDL in healthy subjects, is associated with HDL in a patient with LDL deficiency. AB - The degradation of platelet-activating factor (PAF) in plasma is catalyzed by PAF acetylhydrolase resulting in lyso-PAF which is biologically inactive. Normally, most of the PAF-degrading activity is associated with low-density lipoproteins (LDL). The enzyme activity was measured in the plasma of a patient with abetalipoproteinemia, a disorder characterized by the absence of apolipoprotein-B containing lipoproteins (chylomicrons, VLDL and LDL). Here we report that the plasma of the patient has a normal activity of PAF-acetylhydrolase. The enzyme activity is bound to high-density lipoproteins (HDL) and shows the kinetic properties of the LDL-associated enzyme of healthy subjects. Following administration of artificial triglyceride-rich particles (ATRP), part of the enzyme activity is found associated with ATRP, indicating that PAF acetylhydrolase can transfer from HDL to triglyceride-containing lipid complexes in vivo. PMID- 1768839 TI - Lysophosphatidylserine-induced activation of mast cells in mice. AB - Intravenous injection of lysophosphatidylserine (2.5-25 mg/kg) increases the blood histamine level in mice. Lysophosphatidyl-D-serine, alkyl lysophosphatidylserine and glycerophosphorylserine show little or no activity. As shown by the similar efficacy of the analogue lacking the OH group in the C-2 position of glycerol conversion into phosphatidylserine is not required. The age of mice influences the activity of lysophosphatidylserine. Thus, the increase in blood histamine is greater in adult mice (8-10 weeks) than in young mice (4-6 weeks). In old mice (50-60 weeks) the tolerance to lysophosphatidylserine is reduced. Repeated parenteral administrations induce depletion of histamine stores with concomitant desensitization to lysophosphatidylserine. Well-perfused organs containing connective tissue mast cells (tongue) are more affected. When [3H] histidine is injected into lysophosphatidylserine-treated mice, the highly radioactive histamine detected in the tongue indicates the preservation of histidine decarboxylase activity after degranulation. The data suggest that lysophosphatidylserine specifically activates connective tissue mast cells in mice. PMID- 1768840 TI - Anti-inflammatory properties of tixocortol 17-butyrate,21-propionate (JO 1222), a novel, locally acting corticosteroid. AB - Tixocortol 17-butyrate,21-propionate (JO 1222) is a novel, locally acting, C-21 thioester-linked corticosteroid with significant activity in a number of models of inflammation. In models of acute inflammation, JO 1222 had an ED30 of 3 micrograms in carrageenan-induced oedema, an ED50 of 5 ng in croton oil-induced inflammation, and 4 micrograms and 2 micrograms/pleural cavity in carrageenin induced pleurisy in the rat and mouse respectively. In a model of subchronic inflammation JO 1222 had an ED50 of 39 micrograms/pellet (cotton pellet-induced granuloma) and an ED50 of 13 ng in oxazolone-induced hypersensitivity. The overall relative potency was found to be beclomethasone DP greater than betamethasone DP = JO 1222 greater than hydrocortisone 17-butyrate,21-propionate greater than hydrocortisone acetate. In contrast to any of the other corticosteroids, including beclomethasone DP, JO 1222 did not have any marked systemic effects in any of the above models following oral or local administration. Furthermore, in contrast to other locally acting corticosteroids such as beclomethasone DP, JO 1222 had little or no effect on the thymus or body weight. These findings suggest that JO 1222 is a novel, potent, locally acting corticosteroid with little or no systemic effects and thus has therapeutical potential in diseases such as asthma, arthritis, ulcerative colitis and rhinitis. PMID- 1768841 TI - Hexadecylphosphocholine: determination of serum concentrations in rats. AB - A sensitive and quantitative determination of the concentration of hexadecylphosphocholine in serum is described. After HPLC separation, the concentration of hexadecylphosphocholine is determined by phosphate analysis. According to this method, the half-life of hexadecylphosphocholine in serum rats is about 96 h. A steady-state serum concentration of 110 microM is reached after 2 weeks of daily treatment with 10 mg/kg hexadecylphosphocholine. The described method has general application for other compounds with similar structures. For instance, serum levels of alkyllysophosphocholines such as 1-0-octadecyl-2-0 methyl- racglycero-3-phosphocholine can be determined using this method. PMID- 1768842 TI - Effects of the serine analogues isoserine and serinol on interleukin-2 synthesis and phospholipid metabolism in a human T cell line Jurkat. AB - Phosphatidylserine has been implicated both in the regulation of protein kinase C activity and in the regulation of T lymphocyte activation. Taking into account the fact that some serine analogues modify the activity of the base exchange enzyme system responsible for the synthesis of phosphatidylserine and to a lesser extent the synthesis of phosphatidylcholine and phosphatidylethanolamine, in vitro, we have tested the ability of both isoserine and serinol to modify phospholipid synthesis in the T cell line Jurkat. It was found that serinol was able to decrease by 75% the amount of phosphatidylserine synthesized by the cells and also to decrease the synthesis of phosphatidylcholine and phosphatidylethanolamine, while phosphatidylinositol synthesis was not affected. Concomitantly, in serinol-treated Jurkat cells, interleukin-2 production was markedly inhibited. Monitoring the production of second messengers generated by T cell activators showed that in serinol-treated cells the production of diacylglycerol was impaired while Ca2+ mobilization remained unaffected. Serinol thus appeared to be a potential immunoregulatory molecule active at the level of protein kinase C regulation either through its interaction with phosphatidylserine or through diacylglycerol production. PMID- 1768843 TI - Fibronectin binding by brain synaptosomal membranes may not involve conventional integrins. AB - Synaptosomal plasma membranes (SPMs) from adult rat brain tested for fibronectin binding and antigenicity toward antibodies against integrin-type fibronectin receptors. Binding (1-10 pmol mg-1 protein) was considerably greater in SPMs than in homogenates for hippocampus and neocortex but not for brain stem. The tetrapeptide L-arginyl-glycyl-L-aspartyl-L-serine blocked up to 90% of the binding indicating that integrin-type receptors are present. Antibodies against two sub-classes of integrins detected high Mr integrin subunits in homogenates but not in SPMs. However, antibodies against hamster ovarian fibronectin receptor reacted intensely with polypeptides of 55,000 and 40,000 Mr that were concentrated 20 to 40-fold in SPMs compared to homogenates. These peptides may constitute a new class of matrix receptor involved in synaptic adhesion. PMID- 1768844 TI - Activation of immediate early genes after acute stress. AB - We used in-situ hybridization to study the effect of acute stress on induction of the immediate early genes (IEGs), c-fos and zif/268, in the rat brain. After one hour of restraint plus intermittent tail shock, messenger RNA (mRNA) levels for both genes were significantly increased bilaterally in the neocortex, particularly in layers IV, V and VI, and in the CA1 region of the hippocampus. This regionally-specific response suggests that IEGs may have a role in the mediation of acute stress responses in the central nervous system. PMID- 1768845 TI - Influence of innervation of myogenic factors and acetylcholine receptor alpha subunit mRNAs. AB - The mRNA levels of the acetylcholine receptor alpha-subunit gene and of four members of the MyoD1 gene family, which code for candidate transcriptional activators of the former gene, were compared in the mouse during post-natal development and after denervation in the adult. During post-natal development, mRNA levels of myogenin, MyoD1, and Myf5 decrease in parallel with alpha-subunit mRNA whereas MRF4 mRNA level remains nearly constant. After denervation, increases in the levels of mRNAs coding for myogenin, MyoD1 and MRF4 accompany that of alpha-subunit mRNA, while Myf5 mRNA level varied little. A possible role of these myogenic genes in mediating nerve influence on the state of muscle differentiation and AChR alpha-subunit gene expression is discussed. PMID- 1768846 TI - Tetanus and botulinum A toxins inhibit stimulated F-actin rearrangement in chromaffin cells. AB - Tetanus and botulinum A neurotoxins block exocytosis of noradrenaline in chromaffin cells. During exocytosis vesicles fuse with the plasma membrane. This requires an intact cytoskeleton. The cytoskeleton can be displayed by rhodamine labelled phalloidin binding to F-actin. When chromaffin cells are stimulated with carbachol, F-actin forms clusters close to the plasma membrane. On withdrawal of the secretagogue the stimulated cells revert to their original appearance. The conversions, like exocytosis, depend on the presence of Ca2+, indicating the association of exocytosis with F-actin arrangement. When exocytosis is blocked in chromaffin cells by tetanus or botulinum A neurotoxins, F-actin fails to cluster during nicotinic stimulation. Thus, the toxins act somewhere between the rise in intracellular free Ca2+ and the rearrangement of F-actin. PMID- 1768847 TI - Effects of laminin on functional reinnervation of target organs by regenerating axons. AB - Reinnervation of sweat glands, skeletal muscle and skin was studied in the mouse paw after section of the sciatic nerve and repair by entubulation with collagen conduits, with and without a coating of laminin. After operation, sweat glands activated by pilocarpine reappeared at 32 days and increased in number to 67% of control counts. Muscle action potentials (during sciatic nerve stimulation) were recorded from the interosseus muscle at 39 days. The potential amplitudes increased to 30% of controls. The first withdrawal response from pin prick to the paw was observed at about 34 days, the response score increasing to 66% of control. There were no significant differences at any test interval between the control group and the group with laminin added. PMID- 1768848 TI - Ventromedial hypothalamic regulation of brown adipose tissue. AB - The central control of brown fat thermogenesis was evaluated in seventeen rats with moveable electrodes implanted in the ventromedial hypothalamus (VMH) and adjacent structures. Brown adipose tissue and core body temperatures were monitored in response to VMH stimulation; sites which elicited a rise in brown fat temperature were observed in the dorsomedial and anterior ventromedial hypothalamus, with BAT temperature profiles varying widely in duration and peak values. Given the complexity of BAT responses to endogenous VMH signals, these varied profiles may be mediated by dissimilar VMH signals, which remain to be characterized. PMID- 1768849 TI - Intracerebroventricular dermorphin, but not dermenkephalin, is epileptogenic in the rat. AB - The effects of intracerebroventricular administration of dermorphin (mu agonist) and dermenkephalin (delta agonist) were studied at the electrocorticographic (ECoG) and electromyographic (EMG) levels in free-moving rats. A very low dose of dermorphin (125 pmol) induced ECoG spiking, occasional myoclonic jerks, wet-dog shakes and catalepsy. In addition, electrical seizures were triggered with doses of 250 to 500 pmol. These signs were reversed by an i.p. injection of naloxone (1 mg kg-1). However, no epileptic-like phenomena were seen after administration of dermenkephalin up to 1 nmol. These results indicate that mu but not delta receptors are involved in the epileptogenic effect of intraventricularly administered opiates. PMID- 1768850 TI - Caffeine exposure sensitizes rats to the reinforcing effects of cocaine. AB - The present study examined the effect of pre-exposure to a moderate dose of caffeine (20 mg kg-1) on the acquisition of self-administration of cocaine (0.125 mg kg-1/infusion or 0.25 mg kg-1/infusion) in the rat. Rats pre-exposed to caffeine acquired self-administration more rapidly. Furthermore, sensitization to cocaine's reinforcing effects was accompanied by an increase in the neurochemical response of the mesolimbic dopamine system to an acute injection of cocaine (10 mg kg-1, i.p.) as measured by in vivo microdialysis. Thus, the data suggest that exposure to caffeine can increase the reinforcing effects of cocaine, possibly via an enhanced response to the mesolimbic dopamine system. PMID- 1768851 TI - A magnetic resonance image study of age-related changes in human putamen nuclei. AB - Putamen nuclei were assessed in 36 normal volunteers using magnetic resonance imaging and a systematic sampling method. There was a significant decrease in the volume of the putamen nuclei with advancing age (r = -0.74, p less than 0.0001), and an associated decline in the volume of the caudate nuclei (r = 0.60, p less than 0.0001). The implications of these findings in age-associated motor abnormalities are discussed. PMID- 1768852 TI - Phosphamidon neurotoxicity: protection by acetylhomocysteine thiolactone. AB - The present study was undertaken to evaluate the neurotoxic effects of the organophosphate, phosphamidon, on glutathione-S-transferase (GST) activity and concentration of sulphhydryl groups, and to study the possible protection against these effects by the simultaneous administration of the antioxidant, acetylhomocysteine thiolactone, commonly known as citiolone. Significant depletion was observed in the GST activity as well as in the level of total and non-protein bound sulphhydryl groups in various CNS regions of phosphamidon intoxicated rats. When citiolone was administered alone, there was a remarkable elevation in GST activity. However, significant protection against GST inhibition was observed when phosphamidon and citiolone were administered simultaneously. PMID- 1768853 TI - Profilin and profilin mRNA in the cerebellum of the developing rat. AB - Profilin and profilin mRNA concentrations were determined in the cerebellum of the developing rat. Profilin represented nearly 0.1% of total Triton-soluble protein both at birth and at the end of the developmental period. During brain maturation, the profilin concentration was regulated at the transcriptional level. A transient increase of profilin mRNA and profilin was observed at the end of the first postnatal week, a period of intense cell proliferation, neuritic outgrowth and synaptogenesis. We propose that profilin may act by forming, during the critical period of cerebellar development, a reserve pool of monomeric actin that can easily be mobilized in cell regions such as growth cones or synaptic junctions where filamentous actin is highly concentrated. PMID- 1768854 TI - Acetylcholine stimulates GTP binding to G proteins in rat striatum. AB - To evaluate the role of G proteins in acetylcholine (ACh)-mediated signal transduction, a novel assay to measure [35S]GTP gamma S binding to rat striatal membranes was standardized. ACh and carbamylcholine (CCh) stimulated the high affinity [35S]GTP gamma S binding to striatal membranes by up to 45% in a concentration-dependent manner. A time course study revealed that 0.1 microM CCh stimulated [35S]GTP gamma S binding by 26% at 4 min and 20% at 15 min. CCh stimulated [35S]GTP gamma S binding was inhibited by atropine, N methylscopolamine and pirenzepine. Oxotremorine (1 microM), a partial muscarinic agonist, maximally stimulated the binding to striatal membranes by only 25%. PMID- 1768855 TI - Immunohistochemical localization of N-acetylaspartate in rat brain. AB - N-acetylaspartate (NAA) is one of the most prevalent compounds in the mammalian nervous system. As such, NAA largely contributes to the major peak on water suppressed proton magnetic resonance spectra. Highly specific antibodies to NAA demonstrate that this compound is discretely localized in a substantial number of neurons throughout the extent of the rat CNS. N-acetylaspartylglutamate (NAAG) is a structurally related neuronal dipeptide which is less widely distributed than NAA. NAAG and NAA immunoreactivities were extensively colocalized in many brainstem areas, where NAAG containing neurons were more numerous than in forebrain structures. PMID- 1768856 TI - Behavioural effects of selective A2 adenosine receptor antagonists, CGS 21197 and CGS 22706, in mice. AB - The present data show that selective A2 adenosine receptor antagonists tended to increase locomotor and rearing activities in mice confronted with a free exploratory test. These findings support the hypothesis that the behavioural effects of adenosine antagonists can be linked to their actions at adenosine A2 receptors. PMID- 1768857 TI - Strain differences in convulsive response to the excitotoxin kainic acid. AB - We describe a strain of rats (Wistar-Furth) that is highly susceptible to the neurotoxic effects of kainic acid (KA) and presents a reliable and quantifiable (with low within-group variability) animal model of status epilepticus. Wistar Furth rats are more sensitive and demonstrate a less variable convulsant response than Sprague-Dawley and Long-Evans rats when tested for total time in seizure activity, latency to onset of first seizure, latency to status epilepticus, seizure severity scores, and percentage exhibiting behavioral seizures and status epilepticus. Results suggest that significant heterogeneity exists in the rodent population with regard to neuronal sensitivity to an excitotoxic amino acid and indicate that strain differences are an important consideration in studies using KA. PMID- 1768858 TI - Expression of amyloid beta-protein precursor mRNAs in familial Alzheimer's disease. AB - The amyloid beta-protein precursor (APP) gene and its products are implicated in the pathogenesis of Alzheimer's disease. The differential expression of APP transcripts may contribute to this process. In the present study, the distribution of mRNAs encoding APP variants has been determined in the brain of three cases of familial Alzheimer's disease (FAD) using in-situ hybridization histochemistry. One FAD case was associated with a mutation in the APP gene. No differences in distribution or quantity of APP transcripts were observed between FAD cases and controls. Overexpression of APP mRNAs is therefore an unlikely explanation for the deposition of the beta-amyloid (beta/A4) peptide in FAD brains. PMID- 1768859 TI - Acute heat exposure causes cellular alteration in cerebral cortex of young rats. AB - The possibility that prolonged heat exposure resulting in a failure of central thermoregulatory mechanism may induce cellular damage in brain was examined in young rats. Children exposed to Indian summer heat can develop sudden pathophysiological symptoms. Subjection of young animals to similar acute systemic heat exposure at 38 degrees C (relative humidity, 46%) for 4 h resulted in a profound hyperthermia, and behavioral stress symptoms e.g. salivation and prostration. Subsequent morphological examination of the brain tissue revealed profound cellular changes. In the cerebral cortex, dark neurons, swollen astrocytes, and expanded white and gray matter were quite frequent. At the ultrastructural level, collapse of microvessels, perivascular edema, vacuolation and damage to postsynaptic membrane was very common. Thus, profound hyperthermia can induce cellular changes by some direct or indirect (e.g. neurochemical) mechanism. PMID- 1768860 TI - Screening protein and nucleic acid sequences against libraries of patterns. AB - We describe programs that can screen nucleic acid and protein sequences against libraries of motifs and patterns. Such comparisons are likely to play an important role in interpreting the function of sequences determined during large scale sequencing projects. In addition we report programs for converting the Prosite protein motif library into a form that is compatible with our searching programs. The programs work on VAX and SUN computers. PMID- 1768861 TI - A method for DNA sequencing by hybridization with oligonucleotide matrix. AB - A new technique of DNA sequencing by hybridization with oligonucleotide matrix (SHOM) which could also be applied for DNA mapping and fingerprinting, mutant diagnostics, etc., has been tested in model experiments. A dot matrix was prepared which contained 9 overlapping octanucleotides (8-mers) complementary to a common 17-mer. Each of the 8-mers was immobilized as individual dot in thin layer of polyacrylamide gel fixed on a glass plate. The matrix was hybridized with the 32P-labeled 17-mer and three other 17-mers differing from the first one by a single base change. The hybridization enabled us to distinguish perfect duplexes from those containing mismatches in 32 out of 35 cases. These results are discussed with respect to the applicability of the approach for sequencing. It was shown that hybridization of DNA with an immobilized 8-mer in the presence of a labeled 5-mer led to the formation of a stable duplex with the 5-mer only if the 5- and the 8-mers were in continuous stacking making a perfect nicked duplex 13 (5+8) base pairs long. These experiments and computer simulations suggest that continuous stacking hybridization may increase the efficiency of sequencing so that random or natural coding DNA fragments about 1000 bases long could be sequenced in more than 97% of cases. Miniaturized matrices or sequencing chips were designed, where oligonucleotides were immobilized within 100 x 100 micron dots disposed at 100 micron intervals. Hybridization of fluorescently labeled DNA fragments with microchips may simplify sequencing and ensure sensitivity of at least 10 attomoles per dot. The perspectives and limitations of SHOM are discussed. PMID- 1768862 TI - Experience in shotgun sequencing a 134 kilobase pair DNA molecule. AB - Until now, large DNA sequences have been obtained by cloning fragments of the target molecule into plasmid, cosmid or bacteriophage lambda vectors. The 134 kbp DNA sequence of channel catfish virus was determined with relative ease by shotgun cloning of random fragments of genomic DNA directly into a bacteriophage M13 vector, sequencing by dideoxynucleotide chain termination, and compilation of the data using Staden's database handling programs. Experience gained during this endeavour indicates that sequences substantially larger than 134 kbp may be obtained using this approach. PMID- 1768863 TI - Cloning of the cDNA encoding human histidine decarboxylase from an erythroleukemia cell line and mapping of the gene locus to chromosome 15. AB - The biogenic amine histamine is an important modulator of numerous physiological processes, including neurotransmittance, gastric acid secretion and smooth muscle tone. The biosynthesis of histamine is catalyzed by the enzyme, L-histidine decarboxylase (HDC). We have previously reported the cloning and sequence of the cDNA encoding rat HDC. Utilizing the rat HDC cDNA as probe the full-length cDNA encoding human HDC was identified and characterized. The encoded protein of 662 amino acid residues has a molecular weight of 74,148. Homology comparisons of the deduced amino acid sequence with rat HDC and dopa decarboxylases from three species have revealed highly related regions. These comparisons have identified domains of amino acid decarboxylases that are highly conserved and are likely important for enzyme-substrate interaction. A dissimilar region in human and rat HDC primary translated protein near the C-terminus would appear not to be important for catalysis and may be removed by proteolysis. This processing phenomenon could be in part responsible for regulation of HDC activity. The human HDC cDNA was also utilized to map the chromosomal location of the human HDC gene locus (HDC). Analysis of human-rodent cell hybrids revealed that the HDC gene segregates with Chromosome 15. No restriction length polymorphisms in the human population were detected after cleavage of the DNAs with 12 restriction endonucleases. PMID- 1768864 TI - Sequence and expression of a mouse U7 snRNA type II pseudogene. AB - The U7 snRNP functions in the 3' processing of histone pre-mRNAs of the replication variant class. The U7 snRNA is apparently the only RNA component of this minor snRNP particle. So far, the only U7 snRNA genes that have been isolated are a cluster of 5 from sea urchin. The function of the sea urchin U7 snRNP has been examined by microinjection experiments using Xenopus oocytes and the expression of these sea urchin U7 snRNA genes has been analysed by microinjection into sea urchin eggs. In our studies of U7 snRNA genes in mouse, we have isolated one of only 3 detectable U7 snRNA pseudogenes in the mouse genome and have determined its nucleotide sequence. Sequence comparisons and transcription analysis following microinjection of the gene into Xenopus oocytes supports our assignment of this isolate as a U7 snRNA type II pseudogene. PMID- 1768865 TI - A novel divergently transcribed human histone H2A/H2B gene pair. AB - A genomic clone containing a novel closely linked human histone H2A/H2B gene pair has been isolated and sequenced along with extensive 5' and 3' flanking regions. Both genes are devoid of introns and code for core histone proteins. The nucleotide sequences are 84% and 87% homologous to the coding regions of a human genomic H2A and H2B gene, respectively. A comparison of the nucleotide-derived amino acid sequences shows that the histone H2A protein corresponds to the human H2A.1 subtype, whereas the H2B histone gene predicts an H2B protein sequence which is almost identical to the histone H2B.2 variant from human and bovine obtained by direct protein sequencing. The 3' flanking regions contain previously identified conserved sequence elements thought to be involved in transcription termination and processing of replication-dependent histone gene poly(A)- mRNAs. Primer extension analyses of the histone mRNAs encoded within this clone demonstrate that both genes are divergently transcribed from a 313 bp intergene promoter region. The spatial arrangement and orientation of two TATA-boxes, four CAAT-boxes, and one H2B-box within this region suggests that the linked genes share common promoter elements for transcriptional regulation. PMID- 1768866 TI - Effects of stimulus phase on the latency of the auditory brainstem response. AB - Auditory brainstem responses were measured in five normal-hearing subjects, using single-cycle sinusoids at octave frequencies ranging from 250 to 2000 Hz. These sinusoids, gated with Blackman functions, were presented either at 0 or 180 degree phase and were varied in level from 90 dB SPL to threshold in 10-dB steps. Stimulus phase affected wave V latencies for low-frequency stimuli, with the effect decreasing as frequency increased. These data are thought to represent an evoked potential manifestation of known phase-locking abilities within the auditory system. PMID- 1768867 TI - Pediatric ABR screening: pass-fail rates in awake versus asleep neonates. AB - The auditory brainstem response (ABR) is commonly used as a neonatal hearing screening tool. The degree to which myogenic and/or movement artifact can confound the ABR in neonates, and the effect this has on screening pass-fail rates, although widely recognized, have not been reported. This study addressed these aspects in a clinical setting. Fifty-two high-risk neonates were screened in various states of activity (asleep, awake-calm, awake-active). Pass-fail rates between asleep and awake babies were significantly different (p less than 0.5), with the awake group displaying a much higher failure rate. There was no significant difference between the awake-calm and awake-active groups. Results indicate that activity state should be noted and considered along with the other factors that are generally blamed for false-positive results in neonatal ABR screenings. PMID- 1768868 TI - Prevalence of hearing impairment among university students. AB - The prevalence of hearing impairment in university students was determined from a 6-year, pure-tone hearing screening conducted at 20 dB HL for the octave frequencies from 500 to 4000 Hz. Of the 18,424 students tested, 1.2 percent failed the screening. The ratio of unilateral to bilateral hearing impairment was found to be approximately 1:1. Sensorineural hearing loss was four times more prevalent than conductive hearing loss in this population and significant hearing loss at 4000 Hz was evident in 61 percent of the males who failed the screen. PMID- 1768869 TI - Central auditory processing disorder: a case study. AB - We carried out extensive audiologic, electrophysiologic, and neuropsychologic testing on a young woman who complained that she had difficulty hearing in her educational environment. Conventional audiometric results, including pure-tone, speech, and immittance audiometry, were all within normal limits. The subject performed normally on tests involving the processing of rapidly changing temporal information, interaural time and intensity difference detection, and both absolute and relative sound localization. Early, middle, late and task-related auditory evoked potentials were essentially normal, although some asymmetry was observed in the middle latency (MLR) and late (LVR) responses. There was, however, a consistent left-ear deficit on dichotic sentence identification, on threshold and suprathreshold speech measures in the left sound field when various types of competition were delivered in the right sound field, and on cued-target identification in the left sound field in the presence of multitalker babble. Results suggest a central auditory processing disorder characterized by an asymmetric problem in the processing of binaural, noncoherent signals in auditory space. When auditory space was structured such that the target was directed to the left ear, and the competition to the right ear, unwanted background was less successfully suppressed than when the physical arrangement was reversed. PMID- 1768870 TI - Insert earphones for speech recognition testing. AB - Performance-intensity functions for PB word lists were run on 19 normal-hearing subjects and 15 subjects with sensorineural hearing losses. Comparisons were made between standard supra-aural earphones (TDH-49P) and insert phones (ER-3A). Results showed that, at least for the higher sensation levels where word recognition tests are usually performed, the phones may be used interchangeably. Using insert earphones for word recognition tests can have several beneficial effects with respect to cross hearing and masking. PMID- 1768871 TI - Differences in superficial and deep source contributions to middle latency auditory evoked potential Pa component in normal subjects and patients with neurologic disease. AB - Multichannel brain-mapped middle latency auditory evoked potential (MLAEP) data obtained from 15 normal subjects and three neurologically impaired subjects using the common average reference (CAR) were converted off-line to source current density (SCD). This technique is sensitive to activity generated in the superficial cerebral cortex. The SCD maps were subtracted from the CAR maps (CAR SD). The derived CAR-SD maps are believed to represent the proportion of scalp recorded activity that is generated deep to the cerebral cortex. Topographic analysis of this data manipulation technique supports the hypothesis that Pa originated from within the temporal lobes bilaterally as well as from a deeper subcortical system. PMID- 1768872 TI - Reliability of evoked responses to high-frequency (8-14 kHz) tone bursts. AB - Instrumentation to evaluate the auditory brainstem response to high-frequency (8 14 kHz) tone bursts has been developed in the Auditory Research Laboratory, Portland, Oregon VA Medical Center. This system is intended to monitor the audition of patients receiving ototoxic drugs who are unresponsive to behavioral test procedures. The reliability of responses obtained with the high-frequency tone-burst system was studied in 30 normal ears. Intrasubject variability of intersession data from response waves I, III, and V to tone bursts of frequencies 8, 10, 12, and 14 kHz was not significantly different from click response variability. The results of this study demonstrate the reliability of the ABR to these high-frequency tone-burst stimuli. This technique may provide early identification of hearing loss in unresponsive subjects receiving treatment with potentially ototoxic agents, thus allowing alternative treatments to minimize or prevent communicative handicap. PMID- 1768873 TI - Considerations in design and use of scales in rehabilitative audiology. AB - Self-assessment questionnaires in rehabilitative audiology typically possess the measurement characteristics of scales based on forced-choice and rank-order. Data from these ordinal scales neither support arithmetic analysis nor arithmetic interpretation. However, powerful nonparametric statistics are available for application to data from ordinal level questionnaires. Thus, methodologic principles influence the way self-assessment scales are designed, constructed, and analyzed. They also influence the way clinicians interpret responses from individual patients. Within these constraints, well constructed questionnaires can provide information on a wide range of topics in rehabilitative audiology. Suggestions are given for generating interval level questionnaires that are more precise than existing, ordinal level scales. PMID- 1768874 TI - Implantable bone-conduction hearing device: practical considerations. AB - An implantable bone conduction hearing device can be of significant benefit to carefully selected patients with noncorrectable conductive hearing losses. However, for some patients the device has significant limitations. This paper presents several practical issues that need to be considered before a decision is made regarding implant surgery. It is recommended that, whenever possible, air conduction hearing aids remain the first option considered when a patient's conductive hearing loss cannot be resolved through traditional medical management. PMID- 1768875 TI - Understanding the speech-understanding problems of the hearing impaired. AB - This article presents a tutorial overview of the speech-recognition difficulties of the hearing impaired. Much recent research indicates that the primary problem underlying the speech-recognition difficulties of the hearing impaired is the loss of hearing sensitivity and accompanying loudness recruitment. This tutorial demonstrates why loss of hearing sensitivity plays such an important role and why hearing aids fitted with contemporary fitting strategies provide only limited benefit in noise for many of these individuals. In addition, low-pass noise is often said to present the hearing-impaired listener with greater difficulties than broad-band noise. This observation is also explained quite simply by careful consideration of the loss of hearing sensitivity. Finally, two clinical articulation index (AI) calculation schemes, designed to quantify the effects of hearing loss on speech understanding, are reviewed and evaluated. PMID- 1768876 TI - Practical method for quantifying hearing aid benefit in older adults. AB - Self-assessment handicap scales are gaining recognition as objective measures of audiologic intervention, including benefit derived from hearing aid use. A short form of the Hearing Handicap Inventory for the Elderly (HHIE-S) comprised of 10 items (5 emotional and 5 social/situational) was administered to 91 new hearing aid users prior to and 3 weeks following hearing aid provision. A significant reduction in perceived emotional and social/situational effects of hearing impairment was observed following this brief interval of hearing aid use. The magnitude of hearing aid benefit was not affected by pure-tone sensitivity or word recognition ability. Further, a 95 percent confidence interval was established for the HHIE-S (9.3 points) in order to determine a true change in self-perceived handicap and pre- and post-hearing aid fitting for a given subject. Our findings support the use of the HHIE-S as an expedient approach for quantifying hearing aid benefit in a busy clinical practice. PMID- 1768877 TI - Auditory brainstem response to clicks in quiet, notch noise, and highpass noise. AB - Auditory brainstem responses to clicks in quiet, notch noise, and highpass noise were recorded from 10 normal-hearing adults. Contrary to some reports, the latency of wave V increased as the center frequency of the notch decreased. Response identifiability and wave V amplitudes were similar for the notch and highpass noises. Thus, the additional frequencies below the notch did not contribute sufficiently to the response to alter identifiability or amplitude. Notch noise, as compared to the highpass noise, is advantageous because of the increased frequency-specificity provided by the low-frequency masking noise. Presenting clicks in highpass or notch noise centered at 500 Hz is of limited value for assessing auditory sensitivity. This is because the range of testable hearing levels is restricted by (1) a high normal ABR threshold (approximately 65 dB nHL) and (2) the high noise levels required to mask the click. This limited dynamic range for assessing hearing loss is a major limitation of click in noise testing, particularly for 500 Hz. Generating a two-point audiogram by presenting clicks in noise with notches centered around 1000 Hz and 4000 Hz may prove promising for assessing auditory sensitivity. PMID- 1768878 TI - Perceptual features for normal listeners' phoneme recognition in a reverberant lecture hall. AB - Johnson et al (1988) found that normal-hearing listeners' consonant recognition scores on a nonsense syllable test were significantly better when they were seated within versus beyond the critical distance of a typical lecture hall. The present study used a Sequential Information Analysis (SINFA) to document a priori perceptual features for Johnson et al's subjects' confusion errors to the initial and medial consonant portions of the stimuli. The features and the percent of information transmitted for them differed as a function of consonant position in the stimulus and whether the subjects were seated within or beyond the critical distance of the room. Generally, more information was transmitted within rather than beyond the critical distance for both initial and medial consonants. However, less information was transmitted for features for the medial than for the initial consonant position. Beyond the critical distance, high-frequency features (e.g., sibilant) were transmitted somewhat better than those based more on low-frequency energy (e.g., voicing). Place of articulation features were not transmitted as well for the initial as for the medial position and they suffered in both positions as distance increased. The effects of reverberation on the subjects' perception are discussed and compared to results of other studies. PMID- 1768879 TI - Masked high-frequency bone-conduction audiometry: test reliability. AB - The present study examines the reliability of masked high-frequency bone conduction threshold measurements in 95 normal-hearing subjects. High-frequency pure-tone air-and bone-conduction thresholds were measured with a dedicated laboratory high-frequency auditory evaluation system using matched, modified Koss Pro/4X Plus earphones, and the Pracitronic KH 70/5 bone vibrator. A 400-Hz wide band masking noise centered at the frequency of the test tone was used to mask the nontest ear. Monaural masked bone-conduction threshold measurements were obtained at the ipsilateral mastoid of the ear with better high-frequency hearing. Two measurements were performed in each session, and each subject participated in two sessions. In several comparisons for test-retest consistency, high-frequency bone-conduction threshold measurements were as repeatable as air conduction thresholds of identical frequency, or bone-conduction thresholds for frequencies of 4 kHz and less. High-frequency bone-conduction threshold measurement appears to be a sufficiently reliable tool for diagnosis of auditory disorders. PMID- 1768880 TI - Expectations of older adults regarding the use of hearing aids. AB - A 48-item questionnaire was administered to 100 older adults to determine their expectations regarding hearing aid use. The sample consisted of volunteers from a variety of senior citizen organizations and ranged in age from 55 to 92 years. Only individuals who reported no prior hearing aid usage were included in the sample. Expectations for the following factors were considered: cosmetics, acoustics, communication benefits, comfort, ease of use, cost and upkeep, and attitudes toward hearing aid use. In general, the older adults in this sample appeared to have very positive expectations regarding the use of hearing aids. Eighty-seven percent apparently have medium to high expectations for hearing aid use. Since the older adult's satisfaction with amplification may be influenced by original expectations and attitudes, the information provided in this study may be useful in improving the pre-fitting counseling of older hearing-impaired adults. PMID- 1768881 TI - Comparison of two questionnaires for patient-assessed hearing aid benefit. AB - Two questionnaires, the Profile of Hearing Aid Benefit (PHAB) and the intelligibility Rating Improvement Scale (IRIS), were developed to measure self assessed hearing aid benefit. The response format differed in the two instruments: the PHAB required estimation of the proportion of time that certain situations presented communication problems, whereas the IRIS required estimation of the percentage of speech that could be understood in the same situations. The purpose of the study was to evaluate the potential of each questionnaire for clinical and research applications. They were compared in terms of the amount of self-assessed benefit they produced and their sensitivity to benefit differences in different listening situations. Both questionnaires were completed by 42 hearing aid wearers. Analyses of the results indicated that (1) the PHAB produced a significantly lower overall estimate of hearing aid benefit than the IRIS; (2) the PHAB was more sensitive than the IRIS to benefit differences in different listening situations; and (3) the pattern of self-assessed benefit determined with the PHAB was in agreement with previous investigations, whereas the pattern derived from the IRIS scores was not. PMID- 1768882 TI - Speech recognition in noise for hearing-impaired subjects: effects of an adaptive filter hearing aid. AB - Speech-recognition thresholds (SRTs) were obtained in nine sensorineural hearing impaired subjects wearing an adaptive-filter hearing aid under four separate listening conditions. The SRT was obtained with the filter in and out of the circuit in order to relate the effects of noise reduction to speech recognition performance. The noise level was held constant while the speech level varied (transformed up-down method). For the majority of the subjects tested, the activation of the noise-suppression circuit in the aid resulted in performance equivalent to or worse than that obtained without the circuit activated. For the group, a significant improvement (less than 0.05) in recognition was observed only in low-frequency noise competition. PMID- 1768883 TI - Effect of UCL on aided Articulation Index calculation. AB - Nine hearing threshold patterns and uncomfortable loudness level combinations were used in comparing three hearing aid prescriptive procedures by means of a modified Articulation Index. In a minority of the comparisons a small dynamic range required a reduction from the gain that would have been prescribed. For these cases reducing the real-ear gain, in turn, resulted in a mean lowering of the Articulation Index by 0.03 for POGO and 0.08 for the Berger Method. PMID- 1768884 TI - Effect of reference microphone location and loudspeaker azimuth on probe tube microphone measurements. AB - The effects of loudspeaker azimuth and reference microphone location on probe tube microphone measures were assessed. The real ear unaided response (REUR), real ear aided response (REAR), and real ear insertion response (REIR) were obtained on a KEMAR. Aided measures were obtained with both a behind-the-ear and an in-the-ear hearing aid. All three measurements were affected by changes in the loudspeaker azimuth and reference microphone location. Responses obtained with a 90 degree loudspeaker azimuth or with the reference microphone located at-the-ear revealed greater disparity than those obtained under other conditions. Most of the differences occurred at frequencies above 2000 Hz, with measurements utilizing the behind-the-ear hearing aid showing greater dispersion. These results suggest that the location of the loudspeaker and the reference microphone are important variables when utilizing probe tube microphone measurements. PMID- 1768885 TI - Communication Self-Assessment Scale Inventory for Deaf Adults. AB - The Communication Self-Assessment Scale for Deaf Adults (CSDA) evaluates difficult communication situations, their importance to the respondent, communication strategies, and communication attitudes. Scale items use simple descriptive language in active declarative form. Each scale is comprised of three or more subscales. The subject responds using a three point semantic differential based on frequency of occurrence or degree of importance. Item analysis, factor analysis, internal consistency reliability studies, and collection of normative data have been performed on a population of 290 deaf adults. PMID- 1768886 TI - Audiologic findings in a set of fraternal twins with CHARGE association. AB - CHARGE association refers to a constellation of congenital malformations of unknown etiology that includes ocular Coloboma, Heart defects, choanal Atresia, Retarded growth/development, Genital hypoplasia, and Ear anomalies and/or hearing loss. This paper discusses audiologic results in a set of fraternal twins with a diagnosis of CHARGE. Both infants exhibit external ear defects and audiologic patterns characteristic of CHARGE and demonstrate the variable and often asymmetric findings associated with this disorder. Early identification and evaluation are imperative for appropriate audiologic management of individuals with a diagnosis of CHARGE and for persons with CHARGE-like anomalies. PMID- 1768887 TI - Determining latency and amplitude for multiple peaked P300 waveforms. AB - The P300 is characterized by a large positive peak occurring approximately 300 msec post stimulus onset. When a single peak is present, the P300 latency is easily identifiable. However, in cases where the P300 waveform is broadly or multiply peaked, ambiguity exists when attempting to determine the latency of the waveform. Amplitude, while less ambiguous, has also been variously measured as baseline to peak, or peak-to-peak, using either N200 or N300 as the trough. The present study was undertaken to evaluate a method for precisely and consistently determining the latency and amplitude characteristics of the P300 waveform. Three independent raters examined 40 records to determine P300 latency and amplitude according to prescribed criteria. Results indicated that the suggested techniques yield good inter-rater agreement on the latency and amplitude characteristics of the P300 waveform regardless of P300 morphology. PMID- 1768888 TI - Ectoparasites of commensal rodents in Sulawesi Utara, Indonesia, with notes on species of medical importance. AB - Ectoparasite records are presented for four species of commensal murid rodents (Rattus rattus palelae Miller & Hollister, R. argentiventer (Robinson & Kloss), R. exulans (Peale) and Mus musculus castaneus Waterhouse) in Sulawesi Utara, with particular reference to the potential for these arthropods to bite and transmit pathogens to humans. The flea, Xenopsylla cheopis (Rothschild), was most common on R.r. palelae and is capable of transmitting plague and other pathogens to humans although no current foci for these diseases are known in Sulawesi. Hoplopleura pacifica Ewing and Polyplax spinulosa (Burmeister) sucking lice parasitized all three Rattus species although H. pacifica was mainly associated with R. exulans and P. spinulosa with R.r. palelae. These lice do not bite humans but may be intramurid vectors of murine typhus and other zoonoses. The mites Laelaps echidnina Berlese and L. nuttalli Hirst were both collected; the latter was recorded from all four murid species, mainly R. exulans. The mite Ornithonyssus bacoti Hirst was rare. Only one chigger mite, Walchiella oudemansi (Walch), was retrieved from murids (from R. exulans) and a single Leptotrombidium deliense (Walch) chigger was taken from a human subject. Although L. deliense is a significant vector of scrub typhus, a disease known from Sulawesi, the L. deliense-R. argentiventer relationship frequently noted in the ecology of this rickettsial disease, was not evident in this survey. Other ectoparasites collected from murids were the ticks, Ixodes granulatus Supino (first record for Sulawesi), Haemaphysalis sp. and Dermacentor sp., the mites Myocoptes musculinus (Koch) and Listrophoroides cucullatus (Trouessart), acarids and a uropodid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768889 TI - The louse Trinoton anserinum (Amblycera: Phthiraptera), an intermediate host of Sarconema eurycerca (Filarioidea: Nematoda), a heartworm of swans. AB - The role of the louse Trinoton anserinum (F) as an intermediate host of Sarconema eurycerca (Wehr) was investigated in swans. 8.3% of healthy swans carried one to twelve lice per bird, dispersed contagiously. Injured and lead-poisoned swans were more heavily infected. The mouthparts appear designed to penetrate the hosts' skin; the mandibles are robust and asymmetric, and the maxillae have a serrated intercutting surface. 22% fed exclusively on blood and 33% on both blood and feather. All life-cycle stages fed upon blood and the barbs and barbules from down feathers; hooklets from contour feathers were only found in adults. 9% of lice were infected with developing nematode larvae in the head, thorax or abdomen. Lice labelled with Technetium 99 m moved towards the scapulas and the wings. Lice were found to be highly active and were mobile. PMID- 1768890 TI - Glossina fusca group tsetse as vectors of cattle trypanosomiasis in Gabon and Zaire. AB - 1. The significance of Glossina fusca group tsetse flies as vectors of cattle trypanosomiasis was examined using biconical traps to survey tsetse populations at one site in Gabon and two sites in Zaire. 2. Mean trypanosome infection rates in G.tabaniformis Westwood over the study period ranged from a minimum of 8.9% at one site to a maximum of 17.7% at another. The mean infection rate in G.nashi Potts was 6.0%. 3. Up to 49% of bloodmeals of G.tabaniformis were from cattle. Trypanosome prevalence in cattle where G.tabaniformis appeared to be the main vector was 9.5% and 5.4% at the Mushie and OGAPROV ranches, respectively. 4. A highly significant positive correlation was found between tsetse challenge and trypanosome prevalence in N'Dama cattle across sites. Tsetse challenge was defined as the product of tsetse relative densities, trypanosome infection rates in the flies and the proportion of feeds taken by them from cattle. Thus, G.tabaniformis can be an important vector of pathogenic Trypanosoma species in cattle. PMID- 1768891 TI - Control of tsetse and trypanosomiasis transmission in Uganda by applications of lambda-cyhalothrin. AB - The pyrethroid insecticide lambda-cyhalothrin was evaluated in field trials against Glossina f.fuscipes and sleeping sickness transmission in Iyolwa sub county, Tororo District, Uganda. The insecticide was applied selectively to the resting-sites of tsetse, by bush-spraying, using 10% wettable powder (10WP) formulation at an application rate of 11.6 g a.i./ha over an area of 28 km2, or by a 2% Electrodyn formulation (2ED) applied at 0.9 g a.i./ha over 30 km2. In a third trial area of 32 km2, 215 pyramidal traps treated with lambda-cyhalothrin 100 mg/m2 were set. The best impact was obtained with 10WP lambda-cyhalothrin which eliminated tsetse within 1-2 months, whereas G.f.fuscipes persisted at very low density in part of the area treated with 2ED lambda-cyhalothrin. In both treated areas the numbers of human sleeping sickness cases fell to no more than one per month, compared with four to twelve per month previously. The overall rate of cattle trypanosomiasis (T.brucei and T.vivax) was also reduced slightly. Insecticide-treated traps remained fully effective for at least 6 months under field conditions and catches were reduced 20-90-fold. These results in the control of tsetse and trypanosomiasis transmission lead us to recommend lambda cyhalothrin for tsetse control operations. PMID- 1768892 TI - Yellow jacket wasps can damage cows' teats by biting. PMID- 1768893 TI - Phlebotomine sandflies of Djibouti: recent surveys. PMID- 1768894 TI - Growth of Chrysomya putoria blowfly larvae in relation to dietary casein concentration. PMID- 1768895 TI - Spiroplasmas from European Tabanidae. PMID- 1768896 TI - Evaluation of monoclonal antibodies against Plasmodium vivax sporozoites for ELISA development. AB - Nine monoclonal antibodies (MAbs) developed against Plasmodium vivax (Grassi & Feletti) salivary gland sporozoites were evaluated for use in an enzyme-linked immunosorbent assay (ELISA), using sporozoites developed in Anopheles dirus Peyton & Harrison An. gambiae Giles and An.maculatus Theobald. Four of the antibodies were unsuitable due to the low sensitivity of the resulting assays or the requirement for high concentrations of capture antibody. An additional two MAbs were rejected because they resulted in assays with high background absorbance, attributed to self-binding. Of the three remaining MAbs, the use of Navy vivax sporozoite (NVS) 3 resulted in an ELISA with the highest sensitivity and the lowest concentration requirement for capture antibody. Assay sensitivity varied with sporozoite strain indicating possible quantitative epitope heterogeneity. None of the MAbs cross-reacted with the heterologous sporozoites tested by immunofluorescence antibody assay (IFA). The IFA activity was not an indicator of ELISA sensitivity. The use of MAb NVS 3 in a standardized ELISA method resulted in an assay 10 times more sensitive than reported previously for P. vivax sporozoites, with a detection limit of fewer than 100 sporozoites per mosquito. PMID- 1768897 TI - Responses of tsetse to ox sebum: a video study in the field. AB - The behaviour of tsetse (mainly Glossina pallidipes Austen) around odour-baited targets, with or without a coating of ox sebum, was recorded in the field using video. The addition of sebum increased the total time a fly was in contact with the target, as well as the time spent flying around and landing on it. When carbon dioxide was released as part of the attractant odour plume, the presence of sebum on the target increased the number of landings made by each fly, but did not significantly affect the duration of each contact. When carbon dioxide was absent from the odour plume, sebum did not affect the number of landings made by flies but the duration of each contact with the target did increase. Evidence for an interactive effect of sebum and carbon dioxide was obtained. In addition, the presence of sebum on the target increased the percentage of landed flies which walked on its surface; such behaviour may represent an 'inspection' of the artificial host. The potential tsetse control application of the current findings are discussed. PMID- 1768898 TI - Development of resistance in laboratory animals to adults of the tick Rhipicephalus evertsi evertsi. AB - Acquired resistance to adults of the two-host tick Rhipicephalus evertsi evertsi Neumann has been demonstrated in guinea-pigs and rabbits. Four infestations of both hosts with R.e.evertsi adults resulted in a significant reduction in the mean weight of the engorged females. A decline in the mean weight of the female ticks was also observed in ticks which fed on a rabbit previously injected with serum taken from a rabbit resistant to R.e.evertsi. This suggests that humoral immunity may have an important role in the acquired resistance to ticks. In both hosts an increase in the level of serum globulins was recorded. In rabbits the level of gamma globulin was affected, while in guinea-pigs an increase was observed in the concentration of alpha 1 and beta globulins. The differences in host responses to the R.e.evertsi adults are discussed. PMID- 1768899 TI - Trypanosoma vivax in Glossina palpalis gambiensis do not appear to affect feeding behaviour, longevity or reproductive performance of the vector. AB - Feeding behaviour of Glossina palpalis gambiensis Vanderplank infected with Trypanosoma vivax Ziemann was studied and compared with that of uninfected control tsetse. The parameters measured were: total number of probes into the ear skin of rabbits; rate of bloodmeal engorgement; weight of freshly ingested blood; survival; and mean weight of pupae. The results showed that the rosettes of T.vivax parasites in the labrum did not interfere with the feeding behaviour of the vectors. Furthermore, mean survival of T. vivax-infected males was significantly higher (82.2 +/- 4.2 days) compared with that of uninfected ones (70.5 +/- 3.1 days). However, with the female tsetse, mean survival of those infected was lower (98.8 +/- 4.0 days) compared to the uninfected controls (102.2 +/- 5.6 days), but the difference was not significant. A few infected males and females lived a little longer than the uninfected ones. Fecundity of the female tsetse remained unaffected by the infection, and furthermore the mean weight of pupae from the infected females was not significantly different from that of pupae from the uninfected control group. Thus the physiology of pregnant female tsetse in terms of nourishment of intra-uterine larva was unaffected by T.vivax infection. Two successive probes into the skin of two different goats followed by feeding on a third goat by each of four infected tsetse resulted in successful transmission of the infection to eleven out of twelve goats. Thus probing alone into the skin of this host can result in the transmission of T.vivax infection. PMID- 1768900 TI - The decline of a Glossina morsitans submorsitans belt in the Egbe area of the derived savanna zone, Kwara State, Nigeria. AB - In the the early 1970s the Egbe area of Nigeria was known to be one of high trypanosomiasis risk, with four Glossina species G. morsitans submorsitans Newstead, G.longipalpis Wiedemann, G.palpalis palpalis Robineau-Desvoidy and G.tachinoides Westwood present. Grazing by Fulani pastoralists used to be short term and only in the dry season. In recent years these pastoralists have grazed their cattle in the area throughout the year and this has prompted a reappraisal of the tsetse situation. Tsetse populations were sampled for 3 years using hand net catches from man or an ox and biconical traps. Resident livestock, slaughter cattle and some of the flies were examined for trypanosome infection. Of the four tsetse species previously reported from the area, only the riverine species, G.p.palpalis and G.tachinoides, were encountered during the investigation. None of the 152 G.p.palpalis and 52 G.tachinoides examined was infected with trypanosomes. No infection was detected in 101 slaughtered cattle, 65 live Muturu, twelve goats and two pigs by wet film examination. However, a 14.3% Trypanosoma vivax infection rate was detected by Haematocrit Centrifugation Technique (HCT) examination in twenty-one slaughtered cattle. Increased human activities over the years had destroyed much of the vegetation and depleted the wild-life population to an extent that resulted in the disappearance of G.m.submorsitans and G.longipalpis, resulting in turn in a greatly reduced trypanosomiasis risk. It is likely that a similar trend is occurring in other areas of the Derived Savanna and Forest zones of West Africa as the human population expands.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768901 TI - Temperature-dependent variation in Anopheles merus larval head capsule width and adult wing length: implications for anopheline taxonomy. AB - Seasonal variations in mosquito larval head capsule width and adult female wing length were investigated in a field population of Anopheles merus Donitz at Nceswana Lake, Ophansi, within the endemic malaria area of Natal, South Africa. An inverse relationship was detected between each of these morphological characters and seasonal fluctuations in air/water temperatures. Mean head capsule width in all larval instars decreased by 4.8-7.9% in summer, while mean wing length decreased by 19.6%. These changes are discussed in relation to the annual range in mean air temperature in southern Africa and the distribution of An.merus. Implications for the use of such morphological characteristics in existing taxonomic keys are discussed. PMID- 1768902 TI - Quantitation of malaria sporozoites in the salivary glands of wild Afrotropical Anopheles. AB - The number of malaria sporozoites in the salivary glands was determined microscopically for 1137 wild, naturally infected Anopheles from western Kenya. Infective Anopheles gambiae Giles sensu lato (n = 874) contained a geometric mean (GM) of 962 sporozoites and An.funestus Giles (n = 263) contained 812. No significant differences were detected in geometric mean numbers of sporozoites between species, collection techniques or sites. Of the infective An.gambiae, 1.7% (15/874) contained more than 41,830 sporozoites, the maximum observed for An.funestus. Microscopic techniques were found to be more sensitive than enzyme linked immunosorbent assays (ELISA) for detecting low-grade sporozoite infections in salivary glands. Salivary gland sporozoites from 83.6% of the 1137 gland infections were identified by ELISA as either Plasmodium falciparum Welch (n = 910), P.ovale Stephens (n = 7), P.malariae Grassi & Feletti (n = 3) or mixed (n = 30). The 187 gland infections which could not be identified by ELISA contained significantly fewer sporozoites (GM = 242) than those which could be identified (GM = 1200). PMID- 1768903 TI - Quantitation of malaria sporozoites transmitted in vitro during salivation by wild Afrotropical Anopheles. AB - The malaria transmission potential of wild, infective Anopheles from western Kenya was evaluated by determining the number of sporozoites transmitted in vitro by salivation when their mouthparts were inserted into capillary tubes containing either sucrose or blood. With sucrose, 86.6% of 102 infective Anopheles transmitted a geometric mean (GM) of 3.84 sporozoites (range 1-34). With blood, 23.1% of 104 infective Anopheles, tested on the day of collection, transmitted a GM of 2.30 sporozoites (range 1-117). For Anopheles held 5 days postcapture before testing with blood, 53.6% of 56 transmitted a GM of 6.04 sporozoites (range 1-420). Transmitting Anopheles contained significantly more salivary gland sporozoites than non-transmitters. No significant differences were detected between Anopheles gambiae Giles sensu lato and Anopheles funestus Giles in sporozoite transmission by individuals with sporozoites in their salivary glands. Sporozoites were detected microscopically in the salivary duct from heads in 80.3% of 117 infective Anopheles (GM = 11.2, range 1-71). Sporozoite detection in mosquito heads by ELISA was 25% less efficient than microscopic detection. Over 98% of the infective Anopheles transmitted less than twenty-five Over 98% of the infective Anopheles transmitted less than twenty-five sporozoites. Transmitted sporozoites represented only about 3% of the total sporozoites in the salivary glands suggesting that sporozoite transmission may be restricted to sporozoites in the salivary duct at the time of feeding. Results are discussed in relation to anti-sporozoite vaccine development. PMID- 1768904 TI - Anatomical dissemination of circumsporozoite protein in wild Afrotropical Anopheles affects malaria sporozoite rate determination by ELISA. AB - The head, thorax, wings, legs and abdomen of 320 wild-caught Anopheles gambiae Giles sensu lato and 115 An.funestus Giles were tested by an enzyme-linked immunosorbent assay (ELISA) for Plasmodium falciparum Welch to determine how anatomical dissemination of circumsporozoite (CS) protein could affect the estimation of malaria sporozoite rates by ELISA. Of fifty-three Anopheles with CS protein detected in any body part, positive reactions were observed for 58.5% of heads, 67.0% of thoraces, 39.6% of wings, 52.8% of legs and 60.4% of abdomens. Mean absorbance values (range 0-2.00) were highest in thorax samples (1.17), followed by heads (0.80), abdomens (0.67), wings (0.48) and legs (0.46). Circumsporozoite protein was present in the wings or legs, but not in the head or thorax, in 11.3% (6/53) of the infected Anopheles. The ELISA infection rate of 12.8% (41/320) for An.gambiae would have increased to 14.7% (47/320) by inclusion of six mosquitoes with CS protein in wings or legs alone. The slight overestimation of the proportion of infective mosquitoes due to disseminated CS protein would have little effect on estimates of relative infection rates by ELISA for field-collected Anopheles, with abdomens removed prior to testing. However, the widespread dissemination of CS protein indicates that sporozoite load estimates by ELISA, for mosquitoes without abdomens, may not provide adequate measurements of the numbers of sporozoites in the salivary glands. Operationally, careful processing of mosquito samples for the determination of infectivity rates by ELISA is necessary to prevent the mixing of wings or legs among samples representing individual mosquitoes. PMID- 1768905 TI - Response of the sandfly Lutzomyia longipalpis to an oviposition pheromone associated with conspecific eggs. AB - Response of female Lutzomyia longipalpis Lutz & Neiva (Diptera: Psychodidae) to an oviposition attractant and/or stimulant associated with conspecific eggs was investigated in the laboratory. Females of two populations laid significantly higher mean number of eggs on sites with 160 eggs already present than on bare control sites. This response was lost when eggs placed on test sites were previously washed in organic solvents and distilled water. Age of eggs placed on test sites, 1-6 days after being laid, did not seem to affect the oviposition response of the females. Comparing effects of different numbers of eggs, positive responses were obtained when 80, 160 or 320 eggs were placed on test sites. No significant differences between mean egg numbers laid on test sites and controls were detected when batches of only 20 or 40 eggs were used. PMID- 1768906 TI - Leishmaniasis vector potential of Lutzomyia spp. in Colombian coffee plantations. AB - Potential vectors of Leishmania braziliensis Vianna were assessed at four study sites in the mountainous Valle del Cauca, western Colombia, from March to June 1989. In an active focus of transmission at 1450 m altitude, a coffee plantation at Versalles, there were high densities of antropophilic phlebotomines: Lutzomyia columbiana (Ritorcelli & Van Ty) and Lu.townsendi (Ortiz), both in the verrucarum species group, and of Lu.pia (Fairchild & Hertig). At a comparable altitude in a forest reserve at Yotoco where leishmaniasis is unknown, Lu.pia was the prevalent species and Lu.townsendi was absent. In two localities at 1150 m altitude, there were plentiful Lu.lichyi (Floch & Abonnenc) plus both species in the verrucarum group, but Lu.pia was absent. One of these localities, a coffee plantation at Villa Hermosa where a leishmaniasis outbreak occurred in 1986, was compared with a leishmaniasis-free, partly wooded nature reserve at Mateguadua. No natural infections of Leishmania were found in a total of 1896 wild-caught female phlebotomines belonging to at least seven species. It remains unclear why Leishmaniasis transmission is associated with coffee plantations in this part of Colombia. Laboratory-bred Lu.lichyi females were invariably autogenous, and blood seeking females of this species were always parous. Parity rates in wild-caught females of other species were 55% Lu.pia, 24% Lu.columbiana and 14% Lu.townsendi. Female Lutzomyia infected artificially with Le.braziliensis promastigotes developed peripylarian infections. Higher proportions of Lu.townsendi (96%) and Lu.columbiana (78%) became infected but these species developed lower rates of stomodaeal infections (P less than 0.1) than Lu.lichyi (37%) or Lu.pia (44%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1768907 TI - Automatic recording of flea activity. AB - An Insect Activity Monitor was created to measure the behavioural responses of fleas (Siphonaptera). The apparatus allows for a range of visual, chemo- and mechanoreceptor cues to be presented. The jumping response is detected by counting amplified pulses produced as the fleas land on a stretched membrane held over a microphone. Horizontal movements are detected using a system of infra-red beams and phototransistors which, when broken, are counted as a measure of activity. The apparatus was tested using Ceratophyllus hirundinis (Curtis), Ceratophyllus farreni (Rothschild) and Ceratophyllus rusticus (Wagner), co inhabiting species from the nests of the house martin (Delichon u.urbica L.). No unaided emigration or immigration has been demonstrated in these species (Clark, 1988) and much of their time is spent confined to the darkness of the nest. In addition to species contrasts, females were more active than males and fleas were more active at 25 degrees C than at 18 degrees C. The more active bird flea Ceratophyllus garei (Rothschild) from the nest of pheasant (Phasianus colchicus L), was tested for responses to light of varying intensity. Activity was stimulated by white light, but not proportional to light intensity. PMID- 1768908 TI - Reproductive compatibility and mitochondrial DNA restriction site analysis of New World screwworm, Cochliomyia hominivorax, from North Africa and Central America. AB - The reproductive compatibility of New World screwworms, Cochliomyia hominivorax (Coquerel), from North Africa and a strain being mass produced for the Mexican eradication programme was examined to assess the feasibility of using flies from the Mexican screwworm mass production facility for a sterile insect technique eradication programme in North Africa. Males from the production strain mated randomly with females from North Africa and from the production strain when both were present. Neither strain of males discriminated between cuticular extracts of North African and production strain females containing a contact sex pheromone. Interstrain crosses between North African flies and production flies were fertile and produced fertile progeny. Chromosome morphology did not differ significantly between the two strains and homologue pairing was normal in hybrid meiotic and polytene nuclei. Mitochondrial DNA restriction site analyses indicated that the genetic divergence of the North African strain from Mexican and Central American strains was within the range of the diversity observed in Central American, Mexican and Caribbean populations. Test results indicate that New World screwworms from North Africa are reproductively compatible with the strain currently being mass produced in Mexico. Mating barriers should not impede the progress of an eradication programme using the sterile insect technique in North Africa with sterile screwworms from the Mexican mass production facility. PMID- 1768909 TI - Development of a low-cost tsetse trap and odour baits for Glossina pallidipes and G. longipennis in Kenya. AB - Experiments were carried out to improve the NG2B tsetse trap (Brightwell et al., 1987), baited with acetone and cow urine, for use by rural communities to control G.pallidipes Austen and G.longipennis Corti. Modifications included a lower dose rate of acetone, a new cage design and raising the trap about 15-20 cm. Research on different trap cone materials showed that the degree of light transmission of the netting, rather than its colour, was the crucial factor affecting the catch of G.pallidipes. Adding an additional metre of blue cloth to one side of the trap increased catches of females of both species by about 60%. Traps baited with synthetic phenols yielded similar numbers of G.pallidipes and significantly more G.longipennis than those baited with natural cow urine. The latter difference was not apparent when octenol was also used, so cow urine was retained as one of the odour baits in preference to the imported phenols. Although octenol increased catches of G.pallidipes by only about 30%, catches of G.longipennis were increased 2-4-fold, making it a very useful attractant for the latter species. The cost of the trap/odour-bait system was estimated to be US$8.5 per unit per annum. The economics of this method of tsetse control are discussed. PMID- 1768910 TI - Genetic variation in Glossina brevipalpis, G.longipennis and G.pallidipes, and the phenetic relationships of Glossina species. AB - Glossina brevipalpis Newstead, G.longipennis Corti, and G.pallidipes Austen maintained at ILRAD, Nairobi, Kenya, were examined for genetic variation of fourteen enzyme loci, using polyacrylamide gel electrophoresis. G.brevipalpis had six polymorphic loci, an average of 1.46 effective alleles per locus and a mean heterozygosity per locus of 20.0 +/- 7.1%. The figures for the same parameters in G.longipennis were 3, 1.16 and 8.2 +/- 4.9%, and for G.pallidipes the figures were 7, 1.40 and 22.3 +/- 6.3%. Seven rare alleles were lost from the G.brevipalpis colony during a 1-year period, but no statistically significant changes were observed in the genetics of the colony during this period. Using allele frequency data for ten of the enzymes studied, and frequencies for these enzymes in other taxa, a phenogram was constructed that indicated that the subgenus Austenina (i.e. the fusca group) is the oldest of the three subgenera within the genus Glossina, and that the subgenus Glossina s.str. (i.e. the morsitans group) may be paraphyletic. PMID- 1768911 TI - Induction of dominant lethal mutations for control of the facefly, Musca autumnalis DeGeer. AB - 1. Application of the sterile insect technique (SIT) to the facefly, Musca autumnalis DeGeer, is considered. 2. Six-day-old pupae were exposed to ionizing irradiation at doses in the range 100-1600 rads, each treatment being replicated six times. 3. Eclosion was unaffected but fecundity and fertility was inversely proportional to the radiation dose. 4. 1600 rads gave 97% dominant lethality of sperm in treated males and suppressed ovarian development in females. Irradiated flies did not recover fertility. 5. Irradiation of males and females did not affect insemination rates. 6. Sterile males showed a decline in longevity and reduced mating competitiveness. 7. Local eradication of M. autumnalis is considered to be feasible if sufficient diapausing sterile flies are stockpiled and released in early spring, followed by additional releases of non-diapausing flies in late spring and early summer, with further releases of diapausing sterile flies in late summer and autumn. PMID- 1768912 TI - Malathion and pyrethroid resistance in Culex quinquefasciatus from Cuba: efficacy of pirimiphos-methyl in the presence of at least three resistance mechanisms. AB - Use of malathion for mosquito control in Cuba for 7 years up to 1986 has selected for elevated non-specific esterase and altered acetylcholinesterase (AChE) resistance mechanisms in populations of the pest mosquito Culex quinquefasciatus Say. These mechanisms are still present in relatively high frequencies in the Havana area, despite the replacement of malathion by pyrethroid insecticides for the last 3 years in the mosquito control programme. Samples of Culex quinquefasciatus populations from within a 100 km radius of Havana had high levels of resistance to malathion and lower levels of resistance to propoxur, but there was little or no cross-resistance to the organophosphorus insecticide pirimiphos-methyl. Selection with malathion for twenty-two consecutive generations in the laboratory increased the level of malathion resistance to 1208 fold and propoxur level to 1002-fold, but the maximum level of pirimiphos-methyl resistance was only 11-fold. Pirimiphos-methyl is still operationally effective, despite the resistance mechanisms segregating, so this insecticide if used for control is unlikely to select either of the known resistance factors directly in the field population. Since 1986, pyrethroids have been used extensively, and low levels of pyrethroid resistance were detected in two of five field population samples tested. Malathion selection did not increase the level of pyrethroid resistance, which indicates that one or more distinct pyrethroid resistance factors are now being selected in the field populations of Culex quinquefasciatus. PMID- 1768913 TI - Pathogenicity of Spiroplasma taiwanense for larval Aedes aegypti mosquitoes. AB - Helical replicative forms, but not the persistent non-replicative forms, of Spiroplasma taiwanense Abalain-Colloc et al. (isolated from the mosquito Anopheles sinensis Wiedemann in Taiwan) were shown to reduce significantly the survival of Aedes aegypti (L.) mosquito larvae reared in 10 ml of water with 0.3 ml of S.taiwanense suspensions added on days 0 and 3. The suspensions contained, respectively, helical forms at a concentration of 10(9) Colour Change Units (CCU)/ml and persistent forms at 10(6) CCU/ml. It is suggested that S.taiwanense, or toxins produced from it, are potentially useful for use in integrated mosquito control programmes. PMID- 1768914 TI - Comparative use of bendiocarb and DDT to control Anopheles pseudopunctipennis in a malarious area of Mexico. AB - The state of Sinaloa has one of the highest and most persistent malaria transmission levels in Mexico. Due to this situation, with resistance of the vector Anopheles pseudopunctipennis Theobald to DDT, the carbamate insecticide bendiocarb was evaluated as an alternative to DDT for residual house-spraying in village-scale trials during 1985-87. Application rates of the active ingredient per square metre of sprayable surface (ai/m2) were 0.4 g bendiocarb 80% wettable powder (80WP) and 2 g DDT 75% WP. Both insecticides failed to control mosquito populations. Human-bait mosquito densities were not altered as a result of insecticide spraying and human-bait collected mosquito mortality rates were low, suggesting little pre-biting insecticide contact due to avoidance or insufficient resting time indoors. Lower densities of indoor-resting mosquitoes were observed with DDT as opposed to bendiocarb treated houses. Anopheline mortality was higher (98-100%) when exposed for 1 h to 1% bendiocarb in standard WHO susceptibility tests and wall bioassays. Mortality-rates of 15-48% due to 1 h exposure to 4% DDT indicated that this insecticide may continue to be partially effective. House curtain and mark-recapture mosquito studies indicated that DDT produced higher excito-repellency than bendiocarb, as reflected by more mosquito landings but lower feeding rates, shorter resting period and earlier exit time from DDT sprayed houses. In the absence of insecticide, more than 50% of blood-fed An.pseudopunctipennis females exited from houses within 2-4 h of release, showing exophilic behaviour. The outdoor/indoor density ratio indicated that the majority were exophagic. These behavioural characteristics limit the usefulness of any residual insecticide against An.pseudopunctipennis. PMID- 1768916 TI - A model for estimating abundance of cattle grub (Diptera: Oestridae) from the proportion of uninfested cattle as determined by serology. AB - A model is presented for determining the abundance of cattle grubs in the backs of calves from the proportion of uninfested calves in a herd. The distribution of grubs in calves' backs was compared with the negative binomial, but no relationships were found among the distribution parameters, suggesting that the negative binomial is an inappropriate choice for the basis of a sampling model. The relationship between the mean number of grubs per animal (mean), variance (delta 2), and proportion of uninfested calves (p0) in a herd was determined and used as the basis for the sampling model. The relationship between p0 and p0e [determined using serology (ELISA)] was evaluated. The variance of estimates of mean grubs per animal based on the regression model and uncertainty due to using p0e as an estimate of p0 was examined. A test of the model indicated that p0e could be used to obtain a reliable estimate of mean grubs per animal and that the method would be applicable for monitoring grub populations, assessing chemical control programmes, and determining release rates of sterile insects for control. PMID- 1768915 TI - Prehibernation diet and reproductive condition of female Anopheles messeae in Sweden. AB - 1. Blood and sugar feeding in the mosquito Anopheles messeae Falleroni were investigated near Uppsala, Sweden, from 1981 to 1985, with emphasis on prehibernation diet. 2. Fructose, indicating plant feeding, was present in females of all ovarian stages, from April to October, and contributed to fat body development in non-gonoactive females before hibernation. 3. An.messeae males and females (inseminated and uninseminated) were observed feeding on floral nectaries of the plants Achillea millefolium L. and Tanacetum vulgare L. at night during August. 4. Gonotrophic dissociation started in some females in July, and by the end of September all females were inseminated and nulliparous but non-gonoactive. 5. Animal sheds were used as diurnal resting sites of non-gonoactive, prehibernating female An.messeae. Among recently fed mosquitoes in that group, 85% were gut positive for fructose and 15% for blood. Most of them showed negative host tropism, indicating that bloodfeeding is not a prerequisite for hibernation. 6. Survival rates of bloodfed (48 +/- 31 days) and non-bloodfed (42 +/- 21 days) females, collected from a cattle shed in September and kept caged without food or water in a store house, were not significantly different. This indicates that bloodfeeding may occur facultatively before hibernation but does not affect longevity and survival. 7. If overwintering is possible for bloodfed An.messeae females, they would be more likely vectors of pathogens such as Batai virus. PMID- 1768917 TI - New records for Rhipicephalus bursa, Boophilus microplus, B.decoloratus and Hypoderma lineatum from Libya. PMID- 1768918 TI - DDT resistance in Anopheles gambiae declines with mosquito age. AB - Adult Anopheles gambiae Giles mosquitoes from Zanzibar were tested on a standard discriminating dose of DDT which reliably kills susceptible mosquitoes. Adults from wild-caught larvae reared in the laboratory, and from the F1 progeny of wild caught adults, showed less than 5% test mortality when newly-emerged, but mortality rose with age to over 90% when they were 12-14 days old. Wild-caught mixed-age adults showed an intermediate mortality rate of 25%, close to the rate predicted from laboratory results for a fully resistant population with an age structure typical of this species in natural conditions. It is inferred that older, genetically resistant insects may be scored as susceptible, so that routine susceptibility tests with wild-caught adults underestimate the frequency of resistance. In Zanzibar, such tests probably helped to persuade spraying authorities to continue spraying DDT in spite of resistance. Resistance which is restricted to younger insects may nonetheless reduce the effectiveness of spraying. PMID- 1768919 TI - Pupal parasitoids (Hymenoptera: Pteromalidae) of muscoid filth flies in Israel. AB - Pupal parasitoids of muscoid flies were collected monthly on three farms in southern Israel in preparation for an IPM programme for the control of filth breeding flies. 50% and 25.5% of viable puparia collected during 1985 and 1986/87, respectively, were parasitized. Three species of Spalangia Latreille and two species of Muscidifurax Girault & Saunders (Hymenoptera: Pteromalidae) accounted for 82.0% and 94.2% of parasitoids recovered in the two seasons. Variation in the seasonal abundance and distribution of the leading parasite species are discussed in connection with their conservation and possible use for augmentative releases within IPM projects. PMID- 1768920 TI - Life history of Spalangia gemina Boucek (Hymenoptera: Pteromalidae), a fast breeding microhymenopteran pupal parasitoid of muscoid flies. AB - Laboratory studies at 25.5 degrees C and 70-75% r.h. demonstrated that the average daily survival rate for females of the parasitoid Spalangia gemina Boucek (Hymenoptera: Pteromalidae) was 0.907 over a 20-day period, with 50% mortality in 17.3 days. Mean immature developmental time of S.gemina was 22 days and the population growth rate was c. 40-fold per generation. The females successfully parasitized 1-, 2- and 3-day-old pupae of Musca domestica L. and parasitism of 98 100% was obtained at parasitoid to host ratios of 1:0.5-2.5. Parasitism of 81-87% was obtained at parasitoid to host ratios of 1:10. The male to female sex ratio was 1:1.59. S.gemina appears to have advantages over other Spalangia spp., which have immature development times of 28-32 days under comparable conditions, for the biological control of Muscidae. PMID- 1768921 TI - A simple larval diet for population studies on the blowfly Lucilia sericata (Diptera: Calliphoridae). AB - 1. A simple artificial diet was devised for larvae of Lucilia sericata Meigen. 2. A basic diet of 20 g/l agar with 20% horse blood and added yeast sustained normal growth and development, as compared with a lamb meat control. 3. When yeast was added to the blood agar diet at 50 g/l, both peak and final larval weights were increased by 25-50% at higher larval densities (2-8 larvae/g diet) and the hatchling-adult development period was reduced by about 3 days. 4. No adult insects emerged on an agar-yeast diet without blood. Increasing the concentration of blood from 10% to 20% increased adult weight at emergence by 50%, though developmental period was not significantly affected. 5. Increasing larval density significantly reduced the weights of pupae and emergent adults (by up to 50%), both on the blood-agar-yeast diet and the lamb meat control. Percentage survival fell from 80-90% to below 10% on the blood-agar-yeast diet at the highest densities of 4 or 8 larvae/g diet, though survival on lamb was not significantly affected by density. PMID- 1768922 TI - Development of Onchocerca volvulus microfilariae injected into Simulium species from Cameroon. AB - Microfilariae (mff) of the savanna and forest strains of Onchocerca volvulus (Leuckart) were injected intrathoracically into adult females of Simulium damnosum Theobald sensu stricto, S.sirbanum Vajime & Dunbar, S.squamosum Enderlein and S.mengense Vajime & Dunbar. Nine days post infection (pi) 27-29% of the savanna mff and 31-38% of the forest strain had developed to third-stage larvae (L3), irrespective of the fly species, size or injection dose (5, 10 or 15 mff). Savanna flies supported the development of forest O.volvulus better than forest flies, in contrast to the results after per os infections. Therefore, in these four species of the S.damnosum complex from Cameroon, the peritrophic membrane is considered to be the main factor limiting the success rate of microfilarial development following the ingestion of blood infections, while the fly's haemolymph and intracellular environment play minor roles. PMID- 1768923 TI - Evaluation of the water fern Azolla microphylla for mosquito population management in the rice-land agro-ecosystem of south India. AB - The floating water fern Azolla microphylla Kaulfess was evaluated as a biocontrol agent against mosquitoes breeding in rice fields in Tamil Nadu, South India. Anopheles subpictus Grassi, Culex pseudovishnui Colless and Culex tritaeniorhynchus Giles were the predominant species of mosquitoes, with peak densities of late instar larvae and pupae occurring during the second week after transplantation of rice seedlings of short-term (c. 80 days from transplantation to harvest) or medium-term (c. 95 days) varieties. Immature mosquito populations were reduced by mats of Azolla microphylla covering more than 80% of the water surface. However, since 80% coverage by Azolla was achieved only 13-14 days after rice transplantation, its usefulness for mosquito control was limited. Azolla may have a greater potential in an integrated control programme, or in areas where long-term varieties of rice are predominantly grown. PMID- 1768924 TI - The biting rate of Triatoma infestans in Argentina. AB - 1. The daily proportion of fed individuals in a population of the reduviid bug Triatoma infestans (Klug), maintained under natural climatic conditions in experimental chicken houses in central Argentina, was estimated from the proportion of bugs retaining colourless urine in the rectum. 2. From the estimates of feeding frequency throughout a 1 year period, it was shown that temperature has a dominant effect on biting rate, but density-dependent effects became apparent during the warmest months. 3. These and other data on the determinants of blood consumption by T. infestans, were incorporated into a detailed hypothesis of density regulation in this species. PMID- 1768925 TI - The feeding behaviour, activity and trappability of wild female Glossina pallidipes in relation to their pregnancy cycle. AB - Female Glossina pallidipes Austen trapped with baited NG2B traps were subjected both to detailed ovarian dissection and to nutritional analysis. Using a calibration curve derived from dissected wild-caught, laboratory-held flies, the field females were assigned by discriminant analysis to each day of the pregnancy cycle. Field females were most available to NG2B traps while carrying the first instar larva. The nutritional characteristics of trapped field females over the pregnancy cycle lead to the following main conclusions. (i) Fat levels increase most rapidly during the egg in utero stage, while CRDW increases significantly only during the larval stages, culminating in a 4 mg increase during the last day of the third larval instar. (ii) The haematin content of the flies indicates that females feed at approximately 3-day intervals and may feed on any day of the pregnancy cycle. (iii) The estimated time of feeding during the day corresponds with the observed time of peak activity, both of which are earlier in the day later in the pregnancy cycle. (iv) The rate of fat usage reveals significantly greater flight activity on day 5 of the cycle than on other days, agreeing with the high trappability on this day, and overall females appear to use fat at twice the rate of males. Reproductive data provide a much more accurate picture of the relative sampling efficiency than do nutritional data, although the latter reveal the general trends correctly. PMID- 1768926 TI - Oviposition habits of a univoltine blackfly, Prosimulium kiotoense (Diptera: Simuliidae), in Kyushu, Japan. AB - Oviposition habits of a univoltine mammalophilic blackfly, Prosimulium kiotoense Shiraki, were investigated at a stream in Kyushu Island, Japan. The flies oviposited on bryophyte mosses growing on river bank rock surfaces. The eggs were laid singly, but large irregular egg masses were often formed because many females oviposited within the same small areas. Wet sites with dense bryophyte cover at heights between 0 and 15 cm above water level were selected for oviposition. Oviposition activity was observed in the latter half of April. P. kioteonse females came to the site to lay eggs after 11.00 hours in the morning, when air temperature rose to about 15 degrees C. Peak ovipositional activity occurred between 12.00 and 14.00 hours. PMID- 1768927 TI - Residual activity of microencapsulated permethrin against stable flies on lactating dairy cows. AB - Emulsifiable concentrate and microencapsulated formulations of permethrin were evaluated for residual activity against stable flies on lactating dairy cows. Cows were treated in the field with each formulation and hair was clipped from the leg and shoulder area, and bioassayed at 1, 2, 3, 4, 7 and 14 days after treatment. Significantly more stable flies died when exposed to hair sampled 3, 4 and 7 days after treatment from the shoulder than from the lower leg. Analysis with gas chromatography of hair samples showed no detectable permethrin residues on shoulder or leg hair 72 h after treatment with the emulsifiable concentrate formulation. Microencapsulated permethrin was still detectable on hair sampled from both locations 7 days after treatment. The permethrin concentration on the leg hair was approximately 50% of the shoulder hair concentration after 3 days, with the leg hair residue dropping to 31% of shoulder level after 7 days. PMID- 1768928 TI - Control of the haematophagous fly Hippobosca maculata, a series pest of equines, by deltamethrin. AB - This study reports the results of both a small-scale and a large-scale field treatment to assess control of the haematophagous fly Hippobosca maculata Leach a serious pest of equines in a stud in India using a deltamethrin based formulation, Butox. In the small-scale field trial application of 2 litres of deltamethrin at 0.001-0.003% concentration gave 90-100% control over 30 days. At 0.004% and 0.005% concentrations complete control was recorded for 45 and 90 days respectively. Mass application of 2 litres of 0.005% deltamethrin to equines and bovines controlled infestations of H. maculata for 1 year. PMID- 1768929 TI - Indicators of sexual maturation and regression in the female cat flea, Ctenocephalides felis. AB - Differences in the salivary glands, mesenteron epithelium and reproductive organs of female cat fleas, Ctenocephalides felis Bouche (Siphonaptera: Pulicidae), are related to the degree of reproductive maturation or regression. Contrary to previous ideas, blue bodies in the ovarioles are degenerate oocyte nuclei and their presence denotes failure of ripening oocytes to reach full maturity. A distinction between true corpora lutea and pseudo-corpora lutea is established, the presence of the former indicates successful oviposition, and of the latter, failure to complete maturation of eggs. Accurate indicators of sexual maturation and reproductive success are of potential value in assessing relative suitability of various hosts for a given flea species and therefore in assessing the degree of host specificity among fleas. PMID- 1768930 TI - Identification of reduced fitness associated with an insecticide resistance gene in Culex pipiens by microtitre plate tests. PMID- 1768931 TI - Maternal anti-Hypoderma antibodies in calves. PMID- 1768932 TI - [Soft physicians and hard oncologists]. PMID- 1768933 TI - [Is it possible to avoid hematologic toxicity of radiotherapy in Hodgkin's disease (HD)?]. PMID- 1768934 TI - [Cancer stroma]. AB - The cancer stroma is made of cellular and non cellular formations which grow along with cancer cells to build up a tumor. It comes from inflammatory cells and mesenchymal tissue which are mobilized and modified by factors released by cancer cells which bring about inflammatory cell accumulation, angiogenesis, fibroblast mitosis and extracellular matrix production. The extracellular matrix is altogether a barrier against and supporting to cancer cells. The extracellular matrix is also involved in the storage of growth factors which are bound to glycosaminoglycans. Although they are antinomic in vitro, peptidic factors released by tumor cells seem to have an enhancing effect on tumor growth in vivo. The cancer invasion is mediated through diverse enzyme activities, particularly proteases, which degrade the matrix whose degradation products can facilitate the tumor progression. The anti-cancer activity which is exhibited in vitro by macrophages and lymphocytes is expressed at a low level by tumor-macrophages and lymphocytes in vivo. The cancer associated inflammation has no particular feature which could help to screening or to follow up patients. Several elements of the cancer stroma could be selected as targets for investigative cancer therapy. PMID- 1768935 TI - [Modification of taste in cancer patients]. AB - This paper is a review about the relationship that may exist between taste alterations in cancer patients and cancer itself, surgery, chemotherapy, radiotherapy or symptomatic treatments. Therapeutic strategies dealing with patients with taste alterations are also discussed. PMID- 1768936 TI - [Unproven treatments in cancerology]. AB - A socio-ethnologic study of 21 patients localized or metastatic cancer with which consisted of 8-hour in-depth interview and family interviews determined 3 categories of cancer patients which used unproven methods. The first category (No 5) decided to use unproven methods immediately after classical treatment in order to improve the possibility of cure. These patients had already used unproven methods for benign illness. The second category (No 11) used unproven treatments a certain while after the completion of all classical treatment, to reduce the adverse effects of radiotherapy or chemotherapy and to prevent recurrences. The last category (No 5) used the unproven treatments before any classical treatment was treatment carried out, due to fear or lack of confidence in classical treatment. The frequency of unproven treatment among cancer patients is estimated at 52%. In most cases patients who were not representative of a specific socioeconomic level used classical treatment in parallel with unproven methods prescribed either by non medical (No 12) or medical doctors (No 9). Among these very few are permanent prescriptor and advice patient to take exclusively the unproven methods. A better information of patients and better relationships between patient and doctor can improve the chance of cure. PMID- 1768937 TI - [Immediate hematologic tolerance of extended irradiations after chemotherapy. Apropos of 78 cases of Hodgkin's disease stage III and IV without marrow involvement treated at the Gustave-Roussy Institute]. AB - Early hematotoxicity following 4 to 8 courses of polychemotherapy has been analysed in 78 patients (mean age 32.5 years) treated for advanced stage Hodgkin's disease (53 stages III, 25 stages IV). Toxicity occurred in a third of the patients, and led to interrupt the treatment in one case out of 7, definitively in half of them. The thrombocyte lineage appeared the most sensitive to irradiation. Toxicity was proportional to the target volume (42% of upper and infra-diaphragmatic field versus 11.5% of one sided irradiation, P = 0.01). Toxicity was more frequent after infra-diaphragmatic irradiation (32% of para aortic field, 43.75% of inversed Y field) than after mantle field (12.3%, P = 0.01). Tolerance to extended field irradiations seemed better in young patients. Sex, stage, type of chemotherapy did not influence toxicity in our series. Abnormalities of the blood count before irradiation was predictive of toxicity. While expecting development of megakaryocytic growth factors of autologous bone marrow transplantation, we suggest: 1) to achieve total lymphoid irradiation in three periods (mantle field then lombo-aortic field-/+ spleen, then iliac and inguinal fields); 2) to wait, if possible, until normalization of the hemogram before starting the irradiation. PMID- 1768938 TI - T lymphocytes bearing histamine receptors in patients with digestive neoplasm. AB - The inverse relationship between allergic diseases, particularly bronchial asthma, and cancer has been much debated these past years. This inverse relationship may be due to different levels of blood and tissue histamine, and its effect on lymphocytes with H2 receptors. A clinical study was performed on circulating histamine-bearing T cells and on in vivo and in vitro immune response to PPD and histamine in patients with a newly diagnosed digestive neoplasm and in patients with allergic bronchial asthma. The mean percentage of T lymphocytes with histamine receptors was significantly decreased in patients with digestive neoplasm and with allergic bronchial asthma as compared to healthy controls. PMID- 1768939 TI - [Heterogeneity of nucleolar distribution in prostatic cancer. Comparison with the cytological grade and DNA content]. AB - Thirty seven prostatic carcinomas at a D2 metastatic stage were studied after transrectal fine-needle aspiration in a prospective multicentric study. The number and the distribution of nucleoli were compared, in each cytological grade, to the flow cytometric nuclear DNA content. In 9 grade I, 13 grade II and 15 grade III the proportion of bimodal DNA profiles was 11%, 30.7% and 66.7%. The total number of nucleoli per 100 nuclei was respectively 114.11 (SD = 8.12), 158.31 (SD = 47.97) and 194.40 (SD = 58.42). A statistically significant difference (t = 2.78; P = 0.009) was found between the total number of nucleoli of unimodal (22 cases) and bimodal DNA profiles (15 cases). However, no significant difference in nucleolar parameters was found between unimodal (14 cases) and bimodal DNA profiles (14 cases) in cytological grades II and III. These results suggest that the nucleolar parameters do not necessarily parallel the increase in the nuclear DNA content, and that the two factors are independent of one another. PMID- 1768940 TI - [Histological and immunohistochemical diagnosis of bone marrow metastases of neuroblastomas]. AB - A retrospective, morphological and immunochemical study was performed on 60 bone marrow biopsies (BOM) and 12 tumor specimens surgically excised, from 9 patients with neuroblastoma (NB). Immunochemistry concerned "neuron-specific enolase" (NSE), chromogranin A (CGA) and synaptophysin (SP). The results of immunochemical stains and the study of reticulin network on the argentic stain were compared to the results of morphological evaluation on the routine stain. NSE, CGA and SP staining of tumor cells (part or all of them) was obtained from all surgical specimens. 17/75 BOM (20%) were discarded because of poor material. NB cells were observed in 24 BOM from 3 patients. Tumor cells formed large strands (1 patient) or nests (2 patients) associated with segregated cells. Diagnosis of metastatic BM involvement was negative or doubtful for 6 BOM (3 obtained at the same time, 2 patients), in which NB cells were clearly demonstrated by immunochemical staining of NSE and/or CGA. Reticulin and/or collagen myelofibrosis was present in 32/35 BOM from the 3 patients metastatic in bone marrow (BM+) even if NB cells could not be demonstrated in these samples. PMID- 1768941 TI - Diagnosis of thyroid cancer in southwestern Greece. AB - A prospective study of 1,200 patients with thyroid disease was performed from 1983 to 1988 to appraise the reliability of various diagnostic techniques in patients with thyroid cancer. Histologic confirmation was obtained in 201 patients. By assuming that only solid lesions, single or multiple, represented malignancy, the sensitivity and specificity of ultrasonography was 4.64 and 52.2%, respectively. Findings of fine needle aspiration (FNA) cytology and of carcinoembryonic antigen (CEA) serum concentration were also evaluated. The sensitivity and specificity of these two methods (91.2% and 84.1% for FNA and 89.7% and 81.3% for CEA, respectively) were found to be high enough to permit surgical intervention after a diagnosis of malignancy was made. It appears that the combination of FNA cytology and CEA serum measurement represents the most accurate method for the pre-operative detection of thyroid cancer. PMID- 1768942 TI - [Recognition of predictive prognostic factors in recurrent colonic cancer. Apropos of a retrospective series of 178 cases]. AB - Prognostic factors influencing the outcome of colon cancer were studied retrospectively in 178 patients who underwent curative resection between 1975 and 1985. Monovariate and multivariate analysis have been performed. Median follow-up was 8.7 years. Three factors increased the risk of recurrences: age when equal or greater than 70, poorly differentiated tumor and advanced Duke's stage. Two factors increased the risk of intra-abdominal recurrence: age when equal or greater than 70 and advanced Duke's stage. Two factors increased the risk of metastasis (including the liver): poorly differentiated tumor and advanced Duke's stage. Multivariate analysis showed that the risk of recurrences was correlated to Duke's stage, age and histological differentiation. Patterns of failure and prognostic factors reported in the literature are reviewed and implications of these prognostic factors on adjuvant treatment indications are discussed. PMID- 1768943 TI - [Locoregional extension of advanced cancer of the uterine cervix:prospective evaluation of results of clinical examination, endocavitary ultrasonography, TDM, MRI and histology]. AB - Between January 1988 and January 1991, 37 advanced cervical cancer patients were operated and explorated by: clinical examination and endoluminal ultrasonography under general anesthesia (endovesical, endovaginal and endorectal US); tomodensitometry (26 cases); MR imaging (14 cases) and cytoscopy (33 cases). Results of these explorations have been compared with post-operative histopathology. Sensitivity, specificity, predictive values and accuracy of each exploration were calculated for several anatomical structures. Vesical posterior wall has been analysed in about 37 cases, vesico-vaginal structure in about 36 cases, rectal anterior wall and recto-vaginal structure in about 36 cases, parametrium and pelvic sides walls in about 35 cases. Accuracy for clinical examination, endoluminal US, TDM and IRM were respectively: 76, 85, 73, 86%, and respectively 85% by cytoscopy for vesical posterior wall; 72, 88, 65, 78% for vesico-vaginal structure; 92, 97, 83, 64% for rectal anterior wall; 78, 94, 74, 57% for recto-vaginal structure; 84, 89, 69, 73% for vagina; 81, 78, 81, 81% for parametrium; 94%, 93% and 87.5% by TDM and IRM for pelvic side wall. Contribution of endoluminal US is effective for advanced cervical cancer loco-regional staging. Endoluminal US have a good accuracy, are realised under general anesthesia without any discomfort for patients and are little expensive. PMID- 1768944 TI - Determination of domoic acid in serum and urine by immunochemical analysis. PMID- 1768945 TI - Sample weight and digestion temperature as critical factors in mercury determination in fish. PMID- 1768946 TI - Influence of silicic acid on in vitro depurination of DNA. PMID- 1768947 TI - In vitro interaction of selected phospholipid species with mercuric chloride using Fourier transform 1H-NMR. PMID- 1768948 TI - Pyrethroid insecticides and formulations as factors in residues remaining in apparel fabrics after laundering. PMID- 1768949 TI - Residues of alachlor in soil after application of controlled release and conventional formulations. PMID- 1768950 TI - Temporal variation of ethylene dibromide (EDB) in an unconfined aquifer, Whatcom County, Washington, USA: a twenty-seven month study. PMID- 1768951 TI - Degradation of parent compounds of nine organophosphorus insecticides in Ontario surface and ground waters under controlled conditions. PMID- 1768952 TI - Residues of organochlorine pesticides and polycyclic aromatic hydrocarbons in drinking water of Ahmedabad City, India. PMID- 1768953 TI - Hydrocarbons in seawater, sediment, and oyster from the Omani coastal waters. PMID- 1768954 TI - Disappearance of trichlorfon from cultures with different cyanobacteria. PMID- 1768955 TI - Toxic polychlorinated biphenyl congeners in Sheboygan River (USA) sediments. PMID- 1768956 TI - Cycling of indoor air concentrations of d-trans-allethrin following repeated pesticide applications. PMID- 1768957 TI - Lichens as bioindicators of aerial fallout of heavy metals in Zaria, Nigeria. PMID- 1768958 TI - Determination of transferable insecticide from surfaces painted with insecticide incorporated paint. PMID- 1768959 TI - Doses and residues of acephate baits used to eradicate undesirable honey bees: a hazard assessment. PMID- 1768960 TI - Cytotoxicity of aflatoxin on red blood corpuscles. PMID- 1768961 TI - Air pollution effects on the leaf structure of two injury resistant species: Eucalyptus camaldulensis and Olea europaea L. PMID- 1768962 TI - Assimilation and loss of 109Cd and 65Zn by the terrestrial isopods Oniscus asellus and Porcellio scaber. PMID- 1768963 TI - Toxicity of nickel and nickel electroplating water to the freshwater cladoceran Moina macrocopa. PMID- 1768964 TI - Neurobehavioral changes in freshwater fish Channa punctatus exposed to fenitrothion. PMID- 1768965 TI - Acute toxicity to juvenile Pacific northwest salmonids of basacid blue NB755 and its mixture with formulated products of 2,4-D, glyphosate, and triclopyr. PMID- 1768966 TI - Remission induction of adjuvant arthritis in rats by total body irradiation and autologous bone marrow transplantation. AB - Following the demonstration that adjuvant arthritis in rats can be cured with total body irradiation (TBI) and allogeneic or syngeneic bone marrow, the efficacy of autologous bone marrow was investigated in the experiments reported here. Bone marrow from arthritic rats, harvested at the same time that the recipients were irradiated, and real autologous bone marrow were found to be similarly effective as bone marrow grafts from naive syngeneic donors. Sublethal TBI with lower doses was less effective, but the highest tolerated doses of 8 Gy approached the effect of 9 Gy and bone marrow rescue. In contrast, partial body irradiation of either the affected limbs, or of the whole body except the limbs, resulted in only partial and temporary regression of the arthritis. PMID- 1768967 TI - The reappearance of 10 differentiation antigens on peripheral blood lymphocytes after allogeneic bone marrow transplantation. AB - Ten monoclonal antibodies and flow cytometry were applied to characterize the recovery of lymphocyte subsets in peripheral blood after allogeneic bone marrow transplantation (BMT). Ten patients were first followed for 150 days (short-term survey) and then analysed 2 years after BMT on average (long-term analysis). Eight of the 10 recipients showed increased relative and absolute numbers of CD8+ cells and reduced numbers of CD4+ cells resulting in an inverse helper/suppressor ratio. In these eight patients the CD8+ cell predominance was long-lasting and still detectable in the long-term analysis. Two patients had a normal helper/suppressor ratio throughout the study but otherwise a similar reconstitution. Despite the slow recovery of CD4+ cells, CD4+ Leu8- and CD4+ CD45RA- helper subsets were in a normal range already on day 30 and their proportions stayed higher than those of CD4+ Leu8+ and CD4+ CD45RA+ helper cells for the whole short-term survey. The number of activated suppressor cells (CD8+ HLA-DR+) increased markedly after BMT. Similarly, in eight patients high numbers of cytotoxic CD8+ CD57+ cells were found from day 50 onwards. An early and sharp rise of NK cells (CD16+, CD56+) was observed in all recipients, and seven recipients also showed an early increase in CD20+ B cells. Later on, normal or slightly elevated numbers of these cells occurred. PMID- 1768968 TI - Lymphocyte subset reconstitution following human allogeneic bone marrow transplantation: differences between engrafted patients and graft failure patients. AB - To define the relationship between hematopoietic reconstitution and lymphocyte subset analysis in human allogeneic bone marrow transplantation (BMT), we compared lymphocyte subset reconstitution during the first 4 weeks after BMT in nine engrafted patients with that in three graft failure patients using flow cytometry. Marked differences were observed between the two groups. In graft failure patients, the percentage of CD3+ lymphocytes had increased 2 weeks after BMT by over 90% (p less than 0.05). The percentage of CD16+ lymphocytes and CD16+ CD57- lymphocytes did not increase (CD16+ at 3 and 4 weeks: p less than 0.05, CD16+ CD57- at 3 weeks; p less than 0.05, at 4 weeks: p less than 0.01), nor did the percentage of CD8+ 11b+ lymphocytes. The percentage of CD8+ 11b- lymphocytes had increased markedly 2 weeks after BMT (at 2 weeks: p less than 0.05, at 3 and 4 weeks: p less than 0.01). Of particular interest is the difference in the percentage of CD3+, CD16+, and CD8+ CD11b- T cells between the two groups. These cells may play a role in allogeneic bone marrow cell engraftment. PMID- 1768969 TI - Effect of mafosfamide (ASTA-Z-7654) on the clonogenic cells in precursor-B acute lymphoblastic leukaemia: significance for ex vivo purging of bone marrow for autologous transplantation. AB - Lymphoblasts from 11 patients with acute lymphoblastic leukaemia (ALL) of precursor-B type were exposed to the cyclophosphamide derivative mafosfamide (ASTA-Z-7654), and examined for growth inhibition using an in vitro colony assay. Leukaemic clonogenic cells were significantly more resistant to this cytotoxic drug (mean IC50 29.2 micrograms/ml, IC90 64.8 micrograms/ml) compared with myeloid progenitors from seven normal bone marrow samples (mean IC50 9.0, IC90 19.9) (p less than 0.0001). This effect was most pronounced in the four previously treated cases examined (mean IC90 84.4 micrograms/ml). The implications of these findings for bone marrow purging with ASTA-Z in patients with ALL for autologous marrow transplantation are discussed. PMID- 1768970 TI - Graft-versus-host disease in children receiving HLA-identical allogeneic bone marrow transplants with a low adjusted T lymphocyte dose. AB - Fourteen children with high risk leukaemia received allogeneic bone marrow transplants from HLA-identical MLC-compatible sibling donors. All bone marrows were T cell depleted and a T cell addback was prepared from the donor's peripheral blood so that the mean total number of CD3+ cells given was 2.6 (1.0 4.1) x 10(5)/kg recipient body weight. This was administered as a short infusion prior to the bone marrow. The children were conditioned with 1440 cGy fractionated total body irradiation and cyclophosphamide 120 mg/kg and were not given cyclosporin A or methotrexate. All patients engrafted and none showed late graft rejection. Acute graft-versus-host disease (GVHD) developed in nine of 14 children and required treatment with steroids. Two children with grade IV GVHD and one with grade I acute GVHD who subsequently developed severe chronic GVHD died. There have been two relapses (both fatal) and one death from cytomegalovirus pneumonitis. Survival is currently 57% (8/14) with a mean follow up of 548 days (range 384-810). A high incidence of GVHD which was fatal in three patients can occur despite infusion of low T cell numbers in the absence of post graft immunosuppression. PMID- 1768972 TI - High-dose thiotepa with autologous bone marrow rescue in pediatric solid tumors. AB - High-dose thiotepa was given as a single agent at a total dose of 1125 mg/m2 with autologous bone marrow rescue to nine patients with recurrent/refractory/poor risk pediatric malignancies (primitive neuroepithelial tumor (PNET), two; neuroblastoma, one; Wilms' tumor, one; osteosarcoma, one; Ewing's sarcoma one, Hodgkin's disease one, high-grade glioma, two). The response rate in these heavily pretreated patients was 71% (five out of seven evaluable patients) including two complete responses (Wilms', glioma), three partial responses (osteosarcoma, Ewing's sarcoma, Hodgkin's disease), and two with stable disease (PNET, glioma). The median duration of response was 2.5 months. The extramedullary toxicity was acceptable with symptoms mainly of skin and gastrointestinal tract. The data indicate that high-dose thiotepa is effective in several types of recurrent pediatric solid tumors, and merits further evaluation in combination regimens. PMID- 1768971 TI - An assessment of the efficacy of antimicrobial prophylaxis in bone marrow autografts. AB - Fifty-three patients undergoing autologous bone marrow transplantation received antimicrobial prophylaxis with ciprofloxacin with or without erythromycin and low dose intravenous amphotericin B. Eight patients remained afebrile throughout the neutropenic period. All other patients had one or more febrile episodes. The median time to fever after the onset of neutropenia was 7 days. There were no gram-negative organisms isolated from blood cultures during any of these episodes whereas gram-positive organisms were isolated in 28. There was one death in this series associated with sepsis. The use of low-dose prophylactic parenteral amphotericin did not prevent the subsequent successful use of full dose amphotericin for antibiotic-resistant fever. Ciprofloxacin effectively prevents gram-negative sepsis. The addition of erythromycin does little to prevent gram positive sepsis. The use of regimens with agents with activity against gram positive organisms is appropriate initial treatment of all febrile neutropenic episodes. PMID- 1768973 TI - The prognostic significance of chromosomal findings in patients with acute myeloid leukemia in a study comparing the efficacy of autologous and allogeneic bone marrow transplantation. AB - In a prospective study designed to assess the efficacy of autologous bone marrow transplantation (BMT) and allogeneic BMT in patients with acute myeloid leukemia, we analysed the prognostic significance of chromosomal findings for obtaining complete remission (CR), disease-free survival and survival. Patients with a normal karyotype were more likely to achieve CR than patients with an abnormal chromosomal analysis (p = 0.02). There was no difference observed in survival from CR between patients with or without chromosomal abnormalities, nor was there a difference if the analysis was restricted to subgroups of allogeneic or autologous BMT treated patients. Applying prognostic cytogenetic criteria as defined by Keating et al. (remission induction: good risk: t(8;21) or inv(16), intermediate risk: normal or 45,X,-Y or t(15;17) and poor risk: all other; remission duration: good risk: t(15;17) or inv(16), intermediate risk: normal, 45,X,-Y or t(8;21) and poor risk: all other) no differences were observed between good and intermediate prognosis groups, although the poor prognosis group had a reduced CR rate. PMID- 1768974 TI - T cell receptor diversity in severe combined immunodeficiency following HLA haploidentical bone marrow transplantation. AB - We have studied T cell receptor (TCR) diversity in a group of six patients with severe combined immunodeficiency (SCID) previously treated by HLA-haploidentical bone marrow transplantation (BMT). At the time of study, all patients had developed stable T cell chimerism and full reconstitution of T cell functions in the absence of acute or chronic graft-versus-host disease. Peripheral blood lymphocytes (PBL) were analysed by immunofluorescence using a panel of monoclonal antibodies (MoAb) against TCR variable (V) region epitopes including V beta 5, V beta 6, V beta 8, V beta 12, and V alpha 2. Our results showed that in each patient studied a low but significant portion of PBL reacted with each anti-TCR V region epitope MoAb used, in a manner that was, on statistical grounds, indistinguishable from results obtained with PBL from healthy controls. We conclude that within the experimental resolution of a limited number of anti-TCR V region epitope MoAb, T cell reconstitution following BMT for SCID, even when performed across a full HLA-haplotype barrier, leads to an apparently normal TCR diversity. These novel findings may be relevant in the evaluation of functional capacities of T cells that have differentiated from transplanted precursor cells in an HLA-haplodifferent environment. PMID- 1768975 TI - Neurologic complications in allogeneic bone marrow transplant patients receiving cyclosporin. AB - Regimens using cyclosporin (CSP) and either methylprednisolone (MP) or methotrexate (MTX) have been useful in the prophylaxis of acute graft-versus-host disease (GVHD) after allogeneic bone marrow transplantation (BMT). However, CSP produces a number of side effects, including neurologic toxicity. A retrospective review of recipients of 239 BMTs given CSP-based prophylactic regimens revealed that 10 patients (4.2%, 95% confidence interval 0% to 10.4%) experienced a syndrome characterized by hypertension, severe visual disturbances, seizures and occipital lobe density changes on brain computed tomography (nine patients) or nuclear magnetic resonance imaging (one patient). Neurologic findings were reversible in all cases, usually after temporary discontinuation of CSP. Univariate analysis identified the following risk factors for neurotoxicity: use of unrelated or HLA-mismatched related donors, administration of etoposide (VP 16) or total body irradiation as part of conditioning, use of corticosteroids for prophylaxis or treatment of acute GVHD, or development of either acute GVHD or clinically significant microangiopathic hemolytic anemia (MAHA) post-BMT. In multivariate analysis, the most important predictors were the use of VP-16 (p = 0.008), the use of a continuous infusion CSP plus MP prophylactic regimen for GVHD (p = 0.003) and the development of MAHA after BMT (p less than 0.001). The strong association with MAHA suggests that endothelial damage is related to the development of this complication. PMID- 1768976 TI - Expression of human glucocerebrosidase following retroviral vector-mediated transduction of murine hematopoietic stem cells. AB - The human glucocerebrosidase (GC) gene has been expressed in the progeny of murine hematopoietic stem cells following transduction of marrow with a retroviral vector (G2) containing the human GC cDNA. Murine marrow was transduced via co-cultivation following prestimulation in the presence or absence of recombinant IL-3 and IL-6. A high rate of gene transfer and expression (95%) was demonstrated in primary day 12 CFU-S foci following bone marrow transplantation (BMT) of G2-transduced marrow into lethally irradiated syngeneic recipient mice. Immunoreactive human GC protein was also documented in the CFU-S foci. Primary recipient mice were examined 4-6 months following BMT. A higher rate of gene transfer (87%) was seen in hematopoietic organs of recipients of prestimulated donor marrow compared with organs from initially unstimulated marrow (25%). A high rate of expression of human GC was also documented in the prestimulated organs (50%) when compared with the unstimulated group (25%). Secondary BMT was performed using marrow from the long-lived primary recipients. The human GC gene was present in 88% of secondary day 12 CFU-S foci examined in the prestimulated group versus 23% in the unstimulated group. Expression of the human GC gene was documented in secondary day 12 CFU-S foci, providing strong evidence of initial hematopoietic stem cell transduction. PMID- 1768977 TI - Persistence of systemic mastocytosis after allogeneic bone marrow transplantation in spite of complete remission of the associated myelodysplastic syndrome. AB - A myelodysplastic syndrome (MDS), type 5 (RAEB-t), and systemic mastocytosis affecting the spleen, the splenic lymph nodes, the bone marrow and the liver were diagnosed in a 38-year-old woman. The clinical course was complicated by splenic vein thromboses and iliac artery embolism. The thrombotic episodes might be secondary to mast cell mediator release. A complete remission of the MDS was obtained by allogeneic bone marrow transplantation, but the mastocytosis persisted. Thus, the possibility that the mast cell originates from a common myeloid precursor cell may be questioned. PMID- 1768978 TI - Orthotopic liver transplantation for life-threatening veno-occlusive disease of the liver after allogeneic bone marrow transplant. AB - Veno-occlusive disease (VOD) of the liver is a serious and often lethal sequela to bone marrow transplantation. Although a history of prior hepatitis moderately increases the risk of VOD, reliable screening methods for identifying high risk patients are not available. New approaches to managing patients who develop serious VOD are needed. One approach may be the use of orthotopic liver transplantation in selected patients who are likely to die of the disease. In this report we describe a patient who underwent liver transplantation for life threatening VOD following allogeneic transplantation for CML. Although this patient died early from interstitial pneumonitis, the orthotopic liver functioned well up to her death. Other reports describing successful liver transplants in patients with advanced VOD or graft-versus-host disease of the liver are discussed and the possible indications for liver transplantation for VOD after marrow transplantation are considered. Taken together, these reports suggest that orthotopic liver transplantation may be a feasible and potentially effective approach to managing select patients with life-threatening liver dysfunction after marrow transplantation. PMID- 1768979 TI - An alternative method for bone marrow filtration using a sterile gauze filter. PMID- 1768980 TI - Anti-endotoxin antibody for prevention of acute GVHD. PMID- 1768981 TI - Morbidity and mortality of reoperation for coronary artery bypass grafting: significance of atheromatous vein grafts. AB - Reoperation ('redo') for coronary artery disease shows a significant increase in morbidity and mortality compared to primary surgery. Some technical approaches have been advocated to decrease myocardial injury, presumably due to coronary artery embolization from atheromatous vein grafts. From 1984 to 1989, 321 'redo' operations were performed at the Montreal Heart Institute. Patients with patent and atherosclerotic vein grafts at preoperative coronary angiography (239 patients) were compared to those with normal or occluded grafts (82 patients). Perioperative myocardial infarction and death rates were 19% and 13%, respectively. They were particularly high among patients with three or more patent and atherosclerotic vein grafts at reoperation (32% and 29%, respectively). Among the 239 patients with patent atherosclerotic grafts, the results of three different surgical techniques were studied retrospectively. A first group of 66 patients had early ligation of patent atheromatous grafts before cardioplegia was administered by antegrade infusion during single aortic clamping for coronary anastomoses, and maintained for the confection of aortic anastomoses. In a second group of 35 patients, early ligation of diseased graft, antegrade cardioplegic delivery, and partial aortic cross clamping for aortic anastomoses of vein grafts was done. In the third group of 138 patients, venous grafts were not interrupted before antegrade cardioplegic infusion and partial aortic cross clamping for aortic anastomoses of vein grafts was used. No significant difference in hospital mortality or perioperative myocardial infarction rate was observed between the three groups of patients. Thus, the modified techniques so far recommended for repeat coronary artery bypass grafting, such as early ligation of patent atherosclerotic grafts, have failed to improve the early results of 'redo' operations. PMID- 1768982 TI - Recent advances in pericyte biology--implications for health and disease. AB - This review highlights the contributions of recent pericyte research towards our understanding of normal and pathological functioning of microvessels. Pericytes are implicated in a variety of microvascular alterations, including wound healing, diabetes, inflammation, hypertension and neoplasia. They are capable of changing into other mesodermally derived cell types, including smooth muscle cells, osteoblasts and chondrocytes. The contractile properties of pericytes are being systematically examined in vitro; in addition to their tendency to contract spontaneously, pericytes can contract further in response to mediators of inflammation. In vivo studies indicate pericytes are concentrated near endothelial cell junctions along venules where they likely participate in inflammatory events. As agents are identified which modify pericyte responses to disease states, better therapeutic approaches will become possible. PMID- 1768983 TI - Pediatric cardiac investigation and surgery in Canada. The Canadian Pediatric Cardiology Association, The Canadian Cardiovascular Society. PMID- 1768984 TI - Effect of prednisolone on myocardial infarct healing: characteristics and comparison with indomethacin. AB - OBJECTIVE: To characterize retardation of myocardial infarct healing by corticosteroid administration, and to examine the role of suppression of prostaglandin production in its effect. DESIGN: The left circumflex coronary artery of the rabbit was occluded for 30 mins and reperfused for 72 h. Rabbits were divided into four groups: a control group, a low dose prednisolone group (L PSL) that was treated with 5 mg/kg/24 h prednisolone, a high dose prednisolone group (H-PSL) that was treated with 10 mg/kg/24 h prednisolone, and an indomethacin group that received a 5 mg/kg intravenous bolus of indomethacin followed by 10 mg/kg/24 h. The status of infarct healing and infarcted wall thinning was assessed 72 h after ischemia by the percentage of infarct mass organized (%O/I) and the ratio of infarcted wall thickness to noninfarcted wall thickness (thinning ratio). MAIN RESULTS: The %O/I was 61.4 +/- 4.2% (mean +/- SEM) in the control group. The L-PSL and H-PSL groups had %O/Is of 48.3 +/- 3.7% and 29.1 +/- 2.1%, respectively, which were significantly lower than the control value. The difference in %O/I between the H-PSL and L-PSL groups was also significant. However, the %O/I of the indomethacin group (55.1 +/- 3.3%) was not significantly different from control. When the myocardial infarcts were retrospectively subgrouped into small infarcts (infarct volume less than 0.31 cm3) and large infarcts (greater than or equal to 0.31 cm3), infarct healing delay in large infarcts was evident only for H-PSL and not for L-PSL, while both L-PSL and H-PSL treatment retarded healing of small infarcts. No significant difference was observed in the thinning ratio for any group. CONCLUSION: Infarct healing delay by prednisolone is dosage dependent, and smaller infarcts may be more sensitive to its effect. Retardation of infarct healing by prednisolone is unlikely to be mediated by suppression of prostaglandins from the cyclo-oxygenase pathway. PMID- 1768985 TI - Reactions to contagion. PMID- 1768986 TI - Vitamin D deficiency and cancer of the breast: an unprovocative ecological hypothesis. AB - It has been stated recently that atmospheric acid haze containing sulfur dioxide and sulfate crystals may lead to vitamin D deficiencies in exposed populations and increase breast cancer mortality, especially in Montreal. In view of the implications of this hypothesis, we have done a case-control study within the same cohort of women attending the Canadian National Breast Screening Study to check whether a depletion of vitamin D could be detected in the diet of breast cancer patients (n = 108) as compared to controls (n = 322) or a random sample of 1,141 women in our Montreal centre as well as 40 breast cancer cases for which precise food intake data were available by way of a 24-hour dietary journal. The mean daily intake of vitamin D of breast cancer cases was 1.65 +/- 2.48 I.U./kg while in 322 controls matched for age the mean intake was 1.34 +/- 1.17 (S.D.). It has to be pointed out that in the 5 years before diagnosis, cancer patients had not increased significantly their consumption of foods rich in vitamin D, namely milk, cheese, yoghurt, butter and fish. It has also to be stressed that, in relation to the recommended daily intake, twice as many breast cancer patients than controls had a higher consumption of vitamin D. PMID- 1768987 TI - Lung cancer in women in the Niagara Region, Ontario: a case-control study. AB - A case-control study of the etiology of lung cancer in women was conducted in the Niagara Region of Ontario, because of local concerns about a high incidence of lung cancer. 51 female patients with lung cancer and 45 matched controls were interviewed. Information was collected about active and passive smoking, occupation and residential history. There was a strong association between active cigarette smoking and lung cancer (ever/never odds ratio 10.0; p less than .001) and 85% of the cases of lung cancer were attributed to active cigarette smoking. No other factors were significantly associated with lung cancer; there was weak evidence of an association between urban environment during childhood and lung cancer (p = 0.07). Associations between lung cancer and air pollution, and residential history, were not demonstrated, contrary to public perception. Thus, a previously reported excess of lung cancer in Niagara females is most likely attributable to cigarette smoking. PMID- 1768988 TI - Evaluation of the reorganization of a public health nursing division. AB - From 1986 to 1988, the Nursing Division of the Hamilton-Wentworth Department of Public Health Services undertook an analysis of our present organizational structure, incorporating knowledge from current literature, community trends and staff perceptions. From this analysis, a division-wide reorganization was implemented from the current practice in which the Public Health Nurse (PHN) delivered nursing care across all ages and stages (generalist role) to one organized by target populations. These events were described in an earlier article. As part of the plan for reorganization, the nurse management team implemented an evaluation process which included five components: 1) an internal staff survey; 2) an external agency survey; 3) a program-specific activity analysis; 4) a program-specific measure of knowledge change and; 5) a longitudinal job satisfaction survey. This article describes this evaluation and presents implications for the future. PMID- 1768989 TI - Self-reported illness and risk behaviours amongst Canadian travellers while abroad. AB - 403 travellers who attended The University of Calgary International Travel Clinic between August 1, 1987 and June 1, 1988, were asked to return a questionnaire detailing health, illness and risk factors while abroad. Of the 296 respondents, most travelled for fewer than 6 weeks time; destinations were primarily areas where chloroquine-resistant Plasmodium falciparum had been reported. Diarrhea was experienced by 57.3% of respondents; eating food purchased from street vendors was found to be a significant risk factor. Travellers who made trips exceeding 60 days' duration were significantly more likely to experience skin rashes, fevers or diarrhea, although it could not be determined whether this was due to their higher likelihood of undertaking high-risk behaviours, or to a higher number of person-days at risk. The findings of this high rate of illness while abroad underscores the need for specific advice on appropriate risk avoidance behaviours when pre-travel medical visits occur. Further prospective studies to determine effectiveness of such advice, and the patterns of illness based on person-days at risk, are required. PMID- 1768990 TI - Mental health of community residents in the metropolitan Montreal area: some results of the "Sante Quebec Survey". AB - In 1987, the "Sante Quebec Survey" reached 2,696 individuals over 15 years old, living in the Montreal area. A self-administered questionnaire included two scales that measured the positive and negative aspects of mental health. Controlling for the effects of socio-demographic factors and global health status indicators, a multidimensional analysis computed the odds of being at risk of psychological wellbeing and psychological distress if exposed to social isolation or stressful life events. Results show that the quality of integration to the social environment is a better predictor of mental health than poverty by itself. PMID- 1768991 TI - [Factors of successful breast feeding in New Brunswick: information and compatible working conditions]. AB - Although breastmilk is the best food source for the first six months of life, breastfeeding rates at three and six months of age in New Brunswick are quite low. To determine action priorities to increase the duration of breastfeeding, we tried to identify its most important determining factors. Data were obtained from the 431 breastfeeding mothers in a representative sample of 777 infants born after a normal pregnancy. The mother's knowledge about breastfeeding is the most valuable factor that explains breastfeeding duration, followed by the compatibility of the mother's employment with breastfeeding. Interventions directed at improving either of these two factors should be encouraged particularly among mothers of lower socioeconomic status who breastfeed for shorter periods of time. PMID- 1768992 TI - Meat and its place in the diet. AB - Canadians are becoming increasingly aware of the importance of nutrition in their long-term health prospects. With this increased awareness, however, has come an abundance of misconceptions including the notion that meat is "bad" for you. In their haste to avoid saturated fat, physicians and the public alike have lost sight of the fact that lean meat in reasonable serving sizes poses no threat to health and is an extremely important source of many nutrients. The mistaken notion that only animal fats are saturated has resulted in a change in the source of fat but not the quantity. Health professionals must work together to educate the public about the many nutrient-dense, low-fat food choices available in a well-balanced diet. PMID- 1768993 TI - [Socio-demographic and soci-professional profile of holistic therapists in Quebec]. AB - A descriptive study of practitioners of holistic therapies in Quebec was done using a questionnaire mailed to the 954 therapists advertising publicly their services. The response rate was 37.9%. This paper presents the sociodemographic and socio-professional data collected. According to the findings, holistic therapists can be found in almost all regions of Quebec with higher concentrations in large urban centers. Their group is almost equally composed of men (51.7%) and women (48.0%) with an age mean of 40.1 years and with a mean of 7 years of experience in their practice. The practice of holistic therapies is the main occupation of most of these practitioners who use a very wide variety of therapies. Acupuncture and its derivatives followed by various types of massotherapies and naturopathy are the most commonly advertised therapies. The great majority of these therapists work in private practice and their average income before deductions was $21,856.38. Due to the legal status of these practices, 10.3% of the respondents declared they had been the object of lawsuits on the part of a professional corporation. PMID- 1768994 TI - [Relation between global health and care consumption in Quebec immigrants]. AB - This article examines the relationship between global health and care consumption in immigrants and native Quebecers. Care consumption is defined as the percentage of the population who consulted a health professional, while global health is represented by the ridit index. Mean values for ridit and care consumption do not differ significantly between immigrants and native Quebecers. The ridit increases significantly with age in native Quebecers and immigrants, indicating a progressive deterioration of global health for both groups. However, the relation between ridit values grouped for age and health professional consultation do not differ significantly between immigrants and native Quebecers. These results suggest a close link between global health and care consumption. The recently established immigrants represent an exception however. Those persons who arrived between 1980 and 1987 enjoy a better global health than native Quebecers, but consult health professionals in an identical manner. PMID- 1768995 TI - Survey of exercise and dietary knowledge and behaviour in persons with type II diabetes. AB - A survey was conducted to assess the potential for an exercise and weight control program for persons with Type II diabetes. Questionnaires were sent to 1,000 individuals with diabetes, who were randomly selected from the provincial health records office. Physicians and dietitians were the primary sources of information about both exercise and diet. Although few respondents participated in organized (7.7%) or informal (36.8%) exercise programs, or expressed an interest in participating (36.8%), the majority (84.0%) believed that they should get more exercise. This points to a gap between attitude and behaviour. Activity preferences were similar to those reported previously for all Canadians, however, barriers to participation differed in the present group. It was concluded that barriers must be assessed, and behaviour modification included, if diet and exercise programs are to be successful in this population. PMID- 1768996 TI - Survey of dentists in the Ottawa-Carleton region concerning nursing bottle syndrome. PMID- 1768997 TI - An outbreak of rotaviral gastroenteritis in a nursing home for senior citizens. PMID- 1768998 TI - Increasing response rates in community health surveys. PMID- 1768999 TI - Human Genome Project. PMID- 1769000 TI - Injection drug use and risk of HIV. PMID- 1769001 TI - Effect of 72 Hz pulsed magnetic field exposure on macromolecular synthesis in CCRF-CEM cells. AB - Cells from the T-lymphoblastoid cell line, CCRF-CEM, have been exposed in vitro to a quasirectangular, asymmetric electromagnetic field pulsed at 72 Hz at 37 degrees for periods of 30 min to 24 h. RNA synthesis, assessed by incorporation of 3H-uridine, increased (relative to control cells) 2-fold after 30 min in exposed cells and achieved its greatest increase of 3.2-fold relative to controls after 2 h exposure. Increased precursor incorporation was observed at all subsequent exposure times up to 24 h. Synthesis of mRNA was similar, but not identical to that observed with total cellular RNA. Additionally, protein synthesis, determined by incorporation of radioactive precursor into acid precipitable material, was increased 2.8-fold, compared to controls, after 2 h exposure. Longer exposure times resulted in an exponential decrease in precursor incorporation to 1.1-times control levels after 24 h. Using a dye reduction assay, mitochondrial activity was also found to be increased over a 24 h exposure period. No effect of electromagnetic field exposure was found on cellular synthesis of DNA. These data are generally consistent with other reports documenting effects of electromagnetic field exposure on macromolecular synthesis in vitro. PMID- 1769002 TI - Synthesis and release of cell surface-derived and sulfated lactosaminoglycans by human ovarian carcinoma cells. AB - Ovarian carcinoma cell clusters were isolated from patient effusions. Cell surface glycoconjugates were radiolabelled by a galactose oxidase-borotritide method. The surface-labelled glycoconjugates and metabolically labelled glycoconjugates released to culture medium were characterized. The surface derived glycoconjugates were highly heterodisperse and had the same molecular weight distribution as the metabolically labelled components. Lectin precipitation assays showed that both classes of glycoconjugates contained N linked oligosaccharides bearing N-acetyllactosamine moieties. A121 ovarian carcinoma cells also synthesized and released a heterodisperse array of glycoconjugates to culture medium. Ricinus communis agglutinin I (RCAI) precipitated glycoconjugates of MW greater than 100 kDa for both A121 cells and cells from effusions. Cells of different ovarian carcinoma histology yielded similar results. Metabolic labelling experiments with 35SO4 showed that the RACI bound glycoconjugates released by A121 cells were sulfated. The RCAI-bound sulfated lactosaminoglycans may be associated with malignant transformation and/or metastasis since similar components were not produced by mesothelial cells isolated from effusions [Allen, H.J., M. Gamarra M.S. Piver and E.A.Z. Johnson (1989). Cancer Biochem. Biophys. 10, 219-226]. PMID- 1769003 TI - Method of purification of thiol proteinase inhibitors from human urine. AB - Urinary thiol proteinase inhibitors (UTPI) had been isolated from their complex with papain. Almost 90% of these inhibitors, previously inactivated by native or immobilized papain, were recovered after heating the complex to 80 degrees C at pH 2.0 for 20 min. Two protein inhibitors with molecular weights of 76,000 (UTPI 76) and about 45,000 (UTPI-45) were isolated from urine of patients with malignant colorectal tumor. UTPI-fraction consisted of about 40% of UTPI-76 (probably light form of kininogen) and of 60% of UTPI-45 fraction. The inhibitors differed in affinity to Concanavalin A. No electrophoretic mobility changes of both UTPI, before and after isolation by described affinity chromatography were observed. PMID- 1769004 TI - Lipolytic activity in adipose tissue of mice bearing Ehrlich ascites carcinoma. AB - The hormonal background of lipid mobilization in mice bearing Ehrlich ascites tumor (EAT) was investigated. Glycerol production rates were measured in adipose tissues from healthy and tumor-bearing (TB) animals being in early and late stages of tumor growth. The basal rate of lipolysis was enhanced significantly in the epididymal fat pads from mice with EAT. The catecholamine- and theophylline stimulated activity was also higher in the tumorous animals, and the hormone stimulated lipolysis was more effectively repressed by insulin and propranolol in adipose tissue from TB mice, compared to healthy ones. Susceptibility of adipose tissues to hormonal manipulations suggested that an imbalance in the concentration of lipolytic and antilipolytic hormones in the blood might promote the lipid depletion in the TB host organism. The low glucose and insulin concentrations and high catecholamine levels found in the sera of the tumorous animals seem to support this conception. PMID- 1769005 TI - Levels of O6-methylguanine acceptor protein in extracts of human breast tumor tissues. AB - We have measured the abilities of extracts of tissues from human breast tumors to demethylate adducts of O6-meG in exogenous DNA by transfer of the methyl group to an acceptor protein. The results have shown that all 21 specimens examined (including 5 non-neoplastic, 11 malignant tumors and 5 benign growth) contained significant amounts of O6-meG acceptor activity, removing on average 221.1 +/- 2.1 (SEM) fmol O6-meG per mg protein or 10.07 +/- 0.98 (SEM) fmol O6-megG per microgram DNA in the extracts. There were also wide interindividual variations, which were not age-dependent, and there were no significant differences between the non-neoplastic and neoplastic tissues obtained from individuals with benign or with malignant disease. It was estimated that the average number of O6-meG acceptor molecules per cell in normal human breast tissues was calculated as 46,000 +/- 7000 (SEM). PMID- 1769006 TI - New nitrosoureas and their spin-labeled derivatives influence dopa-oxidase activity of tyrosinase. AB - Tyrosinase is a key enzyme in melanine biosynthesis. The modulating effect of cytostatic agents on DOPA-oxidase activity of tyrosinase could be linked with the drug treatment of melanoma tumors. Two groups of nitrosoureas which influence DOPA-oxidase activity of tyrosinase were studied: new nitrosoureas and their spin labeled derivatives synthesized in our laboratory. Using Burnett's spectrophotometric method (Burnett et al., 1967) the following effects were established: inhibition by CCNU, inhibition and the activating effects of the other investigated nitrosoureas depend on their physicochemical half-life. The predominant activating effect of the spin-labeled derivatives is due to the nitroxyl radical present in these compounds. PMID- 1769007 TI - Characterization of glycoconjugates released in vitro by human ovarian carcinoma cells isolated from effusions. AB - Ovarian carcinoma cell clusters were isolated from patient effusions. The glycoconjugates released to culture medium in vitro were characterized by electrophoretic, immunoassay and gel filtration procedures. Metabolically radiolabelled glycoconjugates were heterodisperse with respect to molecular weight and this heterodispersity was independent of incubation time in vitro. This heterodispersity was also characteristic of mixed Mullerian tumor cells of endometrial origin whereas mesothelial cells released a discrete glycoconjugate of MW 65-70 kDa. Multiple Coomassie blue-stained polypeptides were released by the carcinoma cells. These polypeptides were not adsorbed serum components as assessed by immunodiffusion analyses. Periodic acid-Schiff-reactive macromolecules appeared only at the top of electrophoresis gels. The high molecular weight glycoconjugates synthesized by ovarian carcinoma cells precipitated with an effusion globulin fraction at low ionic strength, but the low molecular weight components (40-70 kDa) were soluble. Immunoprecipitation with anti-Ig failed to precipitate carcinoma glycoconjugates. Antisera raised against the released carcinoma macromolecules precipitated carcinoma glycoconjugates and normal ovarian polypeptides. Antisera raised against normal ovarian macromolecules precipitated ovarian polypeptides but reacted only slightly with carcinoma glycoconjugates. Immunodiffusion analyses showed the presence of alpha 1-acid glycoprotein and carcinoembryonic antigen (CEA)-like components in the carcinoma glycoconjugates. The presence of CEA-like glycoconjugates was confirmed by immunoprecipitation. The antigens and antisera for different histologic types of ovarian carcinoma were cross-reactive. The presence of beta 2-microglobulin suggested that some of the glycoconjugates were shed from the cell surface. PMID- 1769008 TI - Effect of insulin receptor down regulation on insulin-stimulated thymidine incorporation in cultured human fibroblasts and tumor cell lines. AB - Insulin receptors in transformed tissue are relatively resistant to down regulation by insulin, and although receptor downregulation reduces rapid onset biologic responses to insulin in normal tissue, this is not observed in tumor cells. The present study compares longterm insulin responses (thymidine incorporation and cell growth) in normal human fibroblasts with responses in human tumor cell lines (MCF-7, T-47D and HCT-8) to determine whether these responses are also resistant to the effects of receptor down regulation. Thymidine incorporation into fibroblasts was more responsive to insulin than was incorporation into tumor cells, although stimulation of uptake into fibroblasts was not paralleled by changes in cell replication. In contrast, physiological insulin concentrations inhibited, and high concentrations of insulin stimulated, thymidine incorporation and cell replication in MCF-7 and T-47D cells. All insulin concentrations inhibited thymidine incorporation in HCT-8 cells without affecting cell replication. The responsiveness of fibroblasts, MCF-7 and HCT-8 cells to insulin was unaltered by down regulation of insulin receptors prior to measuring thymidine incorporation, whereas receptor down regulation paradoxically increased the responsiveness of T-47D cells to insulin. Exposure of fibroblasts to 5 x 10(-8) M dexamethasone for 24h increased their responsiveness to insulin but did not influence the response of MCF-7 or HCT-8 cells, whereas insulin stimulated incorporation of thymidine in T-47D cells was inhibited. Thus, receptor down regulation does not influence the longterm biologic response to insulin in normal cells, and paradoxically increases responsiveness in one of three tumor cell lines. These changes may contribute to the well-described stimulatory effects of insulin on tumor cell growth and inhibition of this response with dexamethasone may be relevant to cancer treatment programs. PMID- 1769009 TI - Enzymic composition and growth rate of human pleural mesothelioma transplants in nude mice. AB - The enzymic composition of 7 human mesothelioma lines propagated in nude mice was compared with 4 of the original and 15 additional mesotheliomas sampled during the patients' surgery. The xenografts exhibited several-fold higher thymidine kinase (TK), uridine kinase (UK), phosphoserine phosphatase (PSP) and peptidyl proline hydroxylase (PPH) concentrations than the fresh human samples, while their DNA, gamma-glutamyl transpeptidase (GGT) and beta-galactosidase (Bgal) contents remained similar. The volume growth rate of the xenografts (doubling time, DT = 9.23 +/- 1.25 days) was much faster than that of tumors in the human host, and the decline of this rate with increasing nodule size was accompanied by decreases in TK and PSP concentrations. This first quantitative biochemical study of xenografted human neoplasms indicates that 1) pleural mesotheliomas, though preserving their histological characteristics after heterotransplantation, show considerable increases of enzymes in nucleic acid, collagen, and nonessential amino acid synthesis, and that 2) the concentration of TK is a good indicator of the different growth properties of tumors in a mouse rather than in the human host. PMID- 1769010 TI - Proteins secreted by Caco-2 cells support growth of other tumor cells in Chee's Essential Medium without supplements. AB - The growth promoting effect of several hormones and growth factors on two human colon tumor cell lines (Caco-2 and SW 48) was studied using six different chemically defined serum-free media (SFM). Caco-2 grew in a simple SFM [GF3: Chee's Essential Medium (CEM) plus insulin, transferrin and selenium], whereas, SW 48 cells did not grow in GF3 medium. This suggested that Caco-2 cells probably secrete proteins in SFM which influence attachment and growth of Caco-2 and other tumor cells. Lyophilized Caco-2 conditioned medium and substratum, when added to plain CEM, supported growth of SW 48 and SW 948 cells. The substratum material was more effective than conditioned medium in promoting growth of the cell lines. The substratum material helps attachment and spreading of the cells and, thus, improves growth of the cells over conditioned medium. Caco-2 conditioned medium and substratum were analyzed for their components using SDS-PAGE system and gel filtration chromatography. The substratum was analyzed for the presence of fibronectin and laminin by the ELISA technique. The conditioned medium does not contain TGF alpha and TGF beta. The growth stimulating activity of the conditioned medium is due to a protein component, approximately 58Kd in size. PMID- 1769011 TI - Alterations in epidermal sulfated proteoglycan production following topical application of the tumor promoter 12-O-tetradecanoyl phorbol-13-acetate to mouse skin. AB - Topical application of the phorbol ester tumor promoter 12-O-tetradecanoylphorbol 13-acetate (TPA) to mouse skin causes marked changes in epidermal cell growth and differentiation. In the present studies we characterized the production of sulfated proteoglycans in the epidermis following treatment with TPA since these macromolecules are important structural and functional components of the tissue. We found that 35S-sulfate was readily incorporated into mouse epidermal proteoglycans. Sepharose CL-4B column chromatography revealed one major peak of sulfated proteoglycans in this tissue (Kav = 0.4-0.5). Approximately 65% of these proteoglycans were heparan sulfate and 10-20% chondroitin sulfate. Using specific monoclonal antibodies and flow cytometry, we found that the epidermal cells produced chondroitin-4-sulfate, chondroitin-6-sulfate and chondroitin-O-sulfate. Within 24 hr of application of TPA to mice, an increase in glycosaminoglycan content of the epidermis was observed. This was associated with a decrease in 35S sulfate uptake into the tissue. Although TPA had no effect on the size or relative distribution of the epidermal sulfated proteoglycans, an increase in chondroitin-4-sulfate expression was observed in treated skin. Changes in the production of proteoglycans following TPA treatment may underlie structural alterations that occur in the epidermis during tumor promotion. PMID- 1769012 TI - Electric field stimulation of human osteosarcoma-derived cells: a dose-response study. AB - In vitro electrical stimulation of human osteosarcoma-derived cells resulted in increased cell adherence and current directed cell migration. We have developed an electrical exposure system in which two steel electrodes imbedded in media based agar, poured in a standard culture dish, are used to apply electric field signals to cells in culture without ion contamination from the electrodes. The cells were exposed to a 100 Hz pulsed DC electric signal at peak field strengths of 1, 10, 100, and 625 mV/cm in the culture media. The data showed no change in cell adherence at 1 and 10 mV/cm, an increase in adherence at 100 mV/cm, and a decrease in both adherence and cell proliferation at 625 mV/cm. Electric field stimulation in vivo has been found useful in accelerating the healing of fractures and non-unions, and the repair of surgical and cancer-related skeletal defects. PMID- 1769013 TI - A facile total synthesis of ganglioside GM1b and its positional analog. PMID- 1769014 TI - Ring-opening kinetics of the D-pentofuranuronic acids. AB - The ring-opening reactions of the furanose forms of the penturonic acids D arabinuronic acid (1), D-lyxuronic acid (2), D-riburonic acid (3), and D xyluronic acid (4) in aqueous solution have been studied as a function of temperature and solution pH by 13C saturation-transfer n.m.r. (s.t.-n.m.r.) spectroscopy using 1-13C-substituted compounds. Unidirectional rate constants of ring-opening (kopen) have been determined for the cyclic forms of 1-4 in their protonated (pH 1.5) and ionized (pH 4.5) forms, and have been compared to the k values measured previously for structurally related furanose sugars. At 50 degrees and pH 1.5, kopen values decrease as follows: alpha-xyluronic acid (2.57 s-1) greater than alpha-riburonic (1.65 s-1) greater than beta-arabinuronic (1.52 s-1) greater than beta-xyluronic (1.09 s-1) greater than beta-riburonic (0.76 s 1) greater than beta-lyxuronic (0.55 s-1) greater than alpha-arabinuronic (0.46 s 1) greater than alpha-lyxuronic (0.40 s-1). At 50 degrees and pH 4.5, this order changes significantly (e.g., beta-arabinuronate is most reactive); in general kopen values for beta anomers appear to be enhanced relative to those for corresponding alpha anomers, suggesting the involvement of intramolecular catalysis in which the carboxylate anion assists in abstracting the hydroxyl proton from O-1. Activation energies of ring-opening, determined for the alpha and beta anomers of 1-4, were found to depend on ring configuration and solution pH. PMID- 1769015 TI - Synthesis of a spacer-containing repeating unit of the capsular polysaccharide of Streptococcus pneumoniae type 23F. AB - The synthesis is reported of 3-aminopropyl 4-O-(4-O-beta-D-glucopyranosyl-2-O alpha-L-rhamnopyranosyl-beta-D- galactopyranosyl)-beta-L-rhamnopyranoside 3' (glycer-2-yl sodium phosphate) (25 beta), which represents the repeating unit of the capsular polysaccharide of Streptococcus pneumoniae type 23F (American type 23) [(----4)-beta-D-Glcp-(1----4)-[Glycerol-(2-P----3)] [alpha-L- Rhap-(1----2)] beta-D-Galp-(1----4)-beta-L-Rhap-(1----)n). 2,4,6-Tri-O-acetyl-3-O-allyl-alpha-D galactopyranosyl trichloroacetimidate (5) was coupled with ethyl 2,3-di-O-benzyl 1-thio-alpha-L-rhamnopyranoside (6). Deacetylation of the resulting disaccharide derivative, followed by benzylidenation, and condensation with 2,3,4-trio-O acetyl-alpha-L-rhamnopyranosyl trichloroacetimidate (10) afforded ethyl 4-O-[3-O allyl-4,6-O-benzylidene-2-O-(2,3,4-trio-O-acetyl- alpha-L-rhamnopyranosyl)-beta-D galactopyranosyl]-2,3-di-O-benzyl-1-thio - alpha-L-rhamnopyranoside (11). Deacetylation of 11, followed by benzylation, selective benzylidene ring-opening, and coupling with 2,3,4,6-tetra-O-acetyl-alpha-D-glucopyranosyl trichloroacetimidate (15) gave ethyl 4-O-[3-O-allyl-6-O-benzyl-4-O-(2,3,4,6- tetra-O-acetyl-beta-D-glucopyranosyl)-2-O-(2,3,4-tri-O-benzyl-alpha-L- rhamnopyranosyl)-beta-D-galactopyranosyl]-2,3-di-O-benzyl-1-thio-alpha-L - rhamnopyranoside (16). Deacetylation of 16 followed by benzylation, deallylation, and acetylation yielded ethyl 4-O-[3-O-acetyl-6-O-benzyl-4-O-(2,3,4,6-tetra-O benzyl-beta-D-glucopy ran osyl)- 2-O-(2,3,4-tri-O-benzyl-alpha-L-rhamnopyranosyl) beta-D-galactopyranosyl ]-2,3- di-O-benzyl-1-thio-alpha-L-rhamnopyranoside (20). The glycosyl bromide derived from 20, when coupled with 3-benzyloxycarbonylamino 1-propanol, gave the beta-glycoside (21 beta) as the major product. Deacetylation of 21 beta followed by condensation with 1,3-di-O-benzylglycerol 2 (triethylammonium phosphonate) (27), oxidation, and deprotection, afforded 25 beta. PMID- 1769016 TI - Analysis of a pyruvic acid acetal-containing polysaccharide by the reductive cleavage method. AB - The applicability of the reductive-cleavage method to the analysis of polysaccharides bearing pyruvic acid acetals has been demonstrated. Direct reductive cleavage of fully methylated gum xanthan yielded the expected products, including 1,5-anhydro-4,6-O-[(S)-1-methoxycarbonylethylidene]-2,3-di-O-methy l-D- mannitol. The latter product was not observed when reductive cleavage was performed subsequent to reduction of ester groups in the fully methylated polysaccharide and mild hydrolysis to remove pyruvic acid acetal substituents. Instead, the latter experiment yielded 1,5-anhydro-2,3-di-O-methyl-D-mannitol, establishing the presence in the polysaccharide of terminal (nonreducing) D mannopyranosyl groups bearing 4,6-O-(1-carboxyethylidene) substituents. The products of reductive cleavage were characterized, where appropriate, by comparison of the gas chromatographic retention times and chemical ionization- and electron ionization-mass spectra of their acetates to those of authentic standards. Alternatively, the products of reductive cleavage could be characterized without resort to comparison with authentic standards by analysis of the 1H-n.m.r. spectra of their benzoates, which were obtained in pure form by high-performance liquid chromatography. By either method of product characterization, this two-step procedure of analysis reveals the presence of pyruvic-acetal residues in polysaccharides and establishes both the identity of the sugar residue to which they are attached and their positions of attachment. PMID- 1769017 TI - [Conformational analysis of N-terminal O-glycopeptide sequences of interleukin 2]. AB - The preferred conformations of eight O-glycopeptide sequences from the N-terminus of interleukin-2 containing two to ten amino acids, monoglycosylated at Thr3 with a 2-acetamido-2-deoxy-alpha-D-galactopyranosyl group, were determined by means of n.m.r. spectroscopic methods. The preferred conformation of the N-terminal sequence, L-Ala-L-Pro-[alpha-D-GalpNAc-(1----3)]-L-Thr-L-Ser, including the O glycosidically linked 2-acetamido-2-deoxy-alpha-D-galactopyranosyl group is not substantially influenced by the linkage of additional amino acids at the C terminal end. Extended conformations were observed for all peptide units. Measurements of the relaxation times of the 13C atoms showed that the 2-acetamido 2-deoxy-D-galactose bound to the central amino acids has the lowest mobility, whereas the terminal amino acid residues and peptide side-chains are flexible. Calculations with the force-field program AMBER yielded conformations of minimized energies that were in good agreement with the n.m.r. spectroscopic data. This was only true when n.m.r. parameters that can be used as starting values for the calculations were available. Comparison with a nonglycosylated, N terminal tetrapeptide sequence analog did not suggest changes in the peptide conformation when Thr3 is glycosylated with a 2-acetamido-2-deoxy-alpha-D galactopyranosyl group. PMID- 1769018 TI - [Conformation analysis of D-xylose-containing O-glycopeptide sequences]. AB - The preferred conformations of the sequences of O-glycopeptides containing a beta D-xylosyl group linked to an L-seryl residue, found in the N-terminus of proteodermatan sulfate, show an almost extended peptide chain with the sugar unit in a specific position. The results of force-field calculations with the AMBER program have been confirmed, by n.m.r.-spectroscopic experiments, for a minimum conformation. PMID- 1769019 TI - Further structural studies of the carbohydrate moiety of the allergen Ag-54 (Cla h II) from the mould Cladosporium herbarum. AB - The carbohydrate moiety of the glycoprotein allergen Ag-54, isolated from the mould Cladosporium herbarum, has been characterised partly, using acetolysis, methylation analysis, and n.m.r. spectroscopy. Ag-54 contained a highly branched galactoglucomannan and two branched mannogluco-oligosaccharide chains. The oligosaccharides contained terminal, (1----4)-, and (1----4,6)-linked alpha-Glc residues and terminal, (1----2)-, and some (1----3)-linked alpha-Man residues. The n.m.r. data indicated the galactoglucomannan to have a main chain made up of (1----6)-linked alpha-Man and (1----4)-linked alpha-Glc residues, with the latter attached to position 6 of alpha-Man residues. Oligosaccharides with (1----6) linked beta-Galf and (1----2)-linked alpha-Man were attached to the main chain. Acetolysis of the galactoglucomannan yielded linear and branched oligosaccharides. The presence of (1----2,3)-linked alpha-Man residues indicated either that other than (1----6) linkages were present in the main chain or that there was 2,3-branching in the side chains. PMID- 1769020 TI - Structural studies of a rhamnogalacturonan from the stipules of Musanga cercropoides. AB - The major water-soluble polysaccharide isolated from the stipules of Musanga cercropoides has been investigated, using n.m.r. spectroscopy, methylation analysis, and solvolysis in liquid hydrogen fluoride as the main methods. It is concluded that the polysaccharide is of the rhamnogalacturonan type and is, at least mainly, composed of tetrasaccharide repeating-units having the following structure [formula: see text] The polysaccharide further contains approximately two O-acetyl groups per repeating unit, which have not been located. PMID- 1769021 TI - Structure of the O-antigen of Francisella tularensis strain 15. AB - The O-specific polysaccharide, obtained by mild acid degradation of the lipopolysaccharide of Francisella tularensis strain 15, contained 2-acetamido-2,6 dideoxy-D-glucose (D-QuiNAc), 4,6-dideoxy-4-formamido-D-glucose (D-Qui4NFm), and 2-acetamido-2-deoxy-D-galacturonamide (D-GalNAcAN) in the ratios 1:1:2. Tri- and tetra-saccharide fragments were obtained on treatment of the polysaccharide with anhydrous hydrogen fluoride and partial hydrolysis with 0.1 M hydrochloric acid, respectively. On the basis of 1H- and 13C-n.m.r. spectroscopy of the polysaccharide and the saccharides, it was concluded that the O-antigen had the structure: ----4)-alpha-D-GalpNAcAN-(1----4)-alpha-D-GalpNAcAN-(1----3) -beta-D QuipNAc-(1----2)-beta-D-Quip4NFm-(1----. This O-antigen is related in structure to those of Pseudomonas aeruginosa O6, immunotype 1, and IID 1008, and Shigella dysenteriae type 7. PMID- 1769022 TI - Structure and solution properties of tamarind-seed polysaccharide. AB - The major polysaccharide in tamarind seed is a galactoxyloglucan for which the ratios galactose:xylose:glucose are 1:2:25:2.8. A minor polysaccharide (2-3%) contains branched (1----5)-alpha-L-arabinofuranan and unbranched (1----4)-beta-D galactopyranan features. Small-angle X-ray scattering experiments gave values for the cross-sectional radius of the polymer in aqueous solution that were typical of single-stranded molecules. Marked stiffness of the chain (C infinity 110) was deduced from static light-scattering studies and is ascribed partially to the restriction of the motion of the (1----4)-beta-D-glucan backbone by its extensive (approximately 80%) glycosylation. The rigidity of the polymer caused significant draining effects which heavily influenced the hydrodynamic behaviour. The dependence of "zero-shear" viscosity on concentration was used to characterise "dilute" and "semi-dilute" concentration regimes. The marked dependence on concentration in the "semi-dilute" region was similar to that for other stiff neutral polysaccharide systems, ascribed to "hyper-entanglements", and it is suggested that these may have arisen through a tenuous alignment of stiffened chains. PMID- 1769023 TI - Water-soluble polysaccharides as carriers of paramagnetic contrast agents for magnetic resonance imaging: synthesis and relaxation properties. AB - Water-soluble, carbohydrate-based, paramagnetic metal chelate derivatives have been investigated as potential organ-selective contrast media for magnetic resonance imaging (m.r.i.). The in vitro proton spin-lattice relaxation properties of compounds with different paramagnetic metals, chelating agents, and carbohydrate matrixes have been studied. Typically, these complexes were 60-260% more efficient proton-relaxation agents than the corresponding low-molecular weight metal chelates at 10 MHz, but less efficient than the corresponding protein derivatives. As expected, carbohydrates that contained manganese or gadolinium were more effective relaxation agents than iron, copper, erbium, or nickel derivatives. PMID- 1769025 TI - [Scientific specialization and nothingness]. PMID- 1769024 TI - Cross-linked, degradable starch microspheres as carriers of paramagnetic contrast agents for magnetic resonance imaging: synthesis, degradation, and relaxation properties. AB - Biodegradable particles were produced by the cross-linking of starch with epichlorohydrin. Diethylenetriaminepenta-acetic acid (DTPA) was covalently linked to the particles by using DTPA bisanhydride. The small, gadolinium-labelled particles were 40-260% more efficient in vitro proton relaxation agents than the corresponding unbound chelate gadolinium-DTPA. The relaxation properties were dependent on the metal chelate, the particle size, the metal content, and the degree of substitution (d.s.). For the small gadolinium-DTPA particles, an increased d.s. decreased the rate of degradation by alpha-amylase. PMID- 1769026 TI - [The prognosis of the patient with heart failure: an analysis of the most significant clinical and instrumental parameters]. AB - Despite the progress of the medical and surgical therapy of cardiac failure, the prognosis of this syndrome remains severe. We studied in a group of cardiac failure patients (n = 203; 18-74 years old) admitted in our division from 1982 to 1987 the most significant clinical and instrumental parameters of prognostic importance. The clinical parameters considered were: age, sex, heart rate, blood pressure, NYHA class, presence of mitral insufficiency, episodes of acute heart failure. The instrumental parameters were: presence of complete left bundle branch block (LBBB), atrial fibrillation, episodes of ventricular tachycardia, cardiothoracic index (C/T), end-diastolic and end-systolic diameters, ejection fraction (EF). Statistical analysis was performed in order to correlate single parameters with mortality. The total survival at 5 years was 50%, being higher in patients with coronary artery disease than in patients with primary dilated cardiomyopathy. The parameters worsening the prognosis were: mitral insufficiency, III-IV NYHA class, occurrence of repeated episodes of acute heart failure in the last year, complete LBBB, C/T greater than 0.55 and EF less than 20%. In conclusion, considering instrumental parameters high risk patients are detected with a precision of 80%. PMID- 1769027 TI - [The transcatheter modulation of the AV node as a possible treatment of choice in nodal re-entrant tachycardia]. AB - Transcatheter modification of the AV node with radiofrequency energy (RF) was performed in 6 patients (mean age 24 years) with inducible AV node reentry tachycardia (AVNRT). Although tachycardia could be controlled with antiarrhythmic drugs in each patient, the option was offered to eliminate the arrhythmia by means of RF catheter technique. A 7F catheter with 2 mm interelectrode distance and a large tip electrode was positioned to record the maximal His deflection, then withdrawn until the smallest possible His and ventricular potentials with a large atrial signal could be recorded. RF energy was delivered at this site in unipolar mode in incremental steps, until AVNRT was no longer inducible or VA block occurred. The procedure resulted in non-inducibility of tachycardia in 5/6 patients. The fast and the slow pathways were abolished in 2 and 1 patients, respectively, while the AV node duality persisted in 2 in spite of non inducibility. VA block occurred in 2 patients, while the anterograde conduction was preserved in all. During the follow-up (mean 4.5 months) 5/6 patients remained free of AVNRT without drugs. It is concluded that transcatheter RF modulation of the AV node can be advised, provided that similar results will be obtained in larger series with longer follow-up, as the first line therapy in patients with AVNRT. PMID- 1769028 TI - [The disappearance of the circadian rhythm of the heart rate in heart transplantation in the presence of acute rejection]. AB - The present study is aimed to investigate the circadian rhythm (CR) of heart rate (HR) in acute rejecting and non-rejecting heart transplanted patients (HTP). The purpose is to provide evidence that an impairment in the HR CR may have a role in predicting episodes of acute rejection in HTP. The study was carried out on 32 Holter monitorings of 13 patients: 9 Holter monitorings were carried out during an episode of acute rejection documented by endomyocardial biopsy. Time data series were analyzed by Cosinor method in order to validate the occurrence of HR CR. The Cosinor analysis found a highly statistically significant HR CR in non rejecting HTP. The occurrence of the HR CR was not statistically validated in acute rejecting HTP. These findings suggest that the lack of a periodic variability in the 24-hour HR pattern may be useful to diagnose acute heart rejection. PMID- 1769029 TI - [The acute, chronic continuous after treatment and chronic intermittent with a variable therapeutic window (4 and 6 hours) hemodynamic effects induced with transdermal nitroglycerin in patients with congestive heart failure]. AB - The aim of this study was to assess the minimum time interval necessary to avoid the development of tolerance during nitroglycerin patch application. We studied 24 patients, aged 23 to 73 years, with ischemic or idiopathic dilated cardiomyopathy (LV EF less than 0.40) and stable clinical conditions during 30 days before the study. All patients had significant reduction of systemic and pulmonary arterial pressure after sublingual nitroglycerin. After the hemodynamic assessment of the response to the first dose of the nitroglycerin patch, the patients were randomized to 1 of 3 chronic treatment groups: continuous patch application (Group A), intermittent application with 4 hours intervals (Group B), intermittent application with 6 hours intervals (Group C). All patients were studied by right heart Swan-Ganz catheterization; the hemodynamic response to a 10 mg multilayer matrix nitroglycerin patch was assessed before and every hour, in the next 4 hours, after both the first application of the patch and after 1 month of therapy; after chronic intermittent therapy, hemodynamic parameters were also measured 24 hours after drug withdrawal. Hemodynamic parameters were significantly changed after the first nitroglycerin patch application: particularly, mean systemic arterial (MAP), right atrial (RAP) and pulmonary wedge pressures (PWP) declined from 96 +/- 10, 8.9 +/- 1.8 and 20.1 +/- 5 to 81 +/- 6, 4.7 +/- 1.5 and 12.2 +/- 3 mmHg (-15.6, -47.2 and -59.3%, respectively); systemic vascular resistance (SVR) and heart rate (HR) were reduced from 1645 +/- 121 to 1288 +/- 89 dyne.s.cm-5 and from 85 +/- 7 to 81 +/- 7 b/min; lastly, cardiac index (CI), stroke volume (SVI) and stroke work index (SWI) increased from 2.3 +/- 0.3, 28.2 +/- 5 and 28.7 +/- 9 to 2.7 +/- 0.3 l/min/m2, 33.3 +/- 5 ml/min/m2 and 31.5 +/- 8 g.m/m2 (+17.4, 18.1 and 9.7%). After 1 month of either continuous or intermittent patch application with 4 hours intervals, hemodynamic parameters returned to control values with no significant change after patch application. In contrast, after intermittent patch application with 6 hours intervals, a persistent hemodynamic response to nitroglycerin patches was still present.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1769030 TI - [THe surgical treatment of aneurysmatic lesions of the ascending aorta: the immediate and long-term results in 40 patients]. AB - From January 1981 to January 1991, 40 patients underwent operation for acute ascending aorta dissection (AAD, 14 patients), chronic ascending aorta dissection (CAD, 9 patients) or aortic ectasia (AE, 17 patients), with simultaneous aortic valve replacement in 30 cases (75%). Average age was 54 years with a 3:1 M/F ratio. In 20 cases (50%) a composite graft bearing a mechanical bileaflet valve was inserted with coronary artery reattachment (Bentall operation). In 16 cases (40%) the ascending aorta was replaced by a woven dacron graft alone (7 cases) or associated with aortic valve substitution (7 cases) or resuspension (2 cases). In 1 case (2.5%) a sutureless ring graft replacement of ascending aorta was carried out and 3 patients (7.5%) underwent aortoplasty with aortic valve substitution. Postoperative mortality rate was 21% for AAD group, 11% for CAD group and 6% for AE group. Non-fatal postoperative complications developed in 36% of AAD patients and in 78% and 29% of CAD and AE patients respectively. These complications occurred in 45% of patients who underwent Bentall operation, in 44% of those who underwent ascending aorta replacement associated with aortic substitution or resuspension, and in 14% of those operated of simple ascending aorta replacement. Average follow-up was 41.6 months (range 1.7-107.4 months). During this period 5 deaths occurred for a long-term mortality rate of 14.2%. Out of 30 survivors 21 (70%) underwent CT-study to evaluate the natural course of the false channel and the risk of redissection or late aneurysm formation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769031 TI - [Coronary angioplasty in the presence of a myocardial bridge: a clinical case]. AB - Percutaneous transluminal coronary angioplasty (PTCA) is a widely used technique of myocardial revascularization. The number of patients treated by PTCA is continuously growing in spite of its major drawback, represented by restenosis in approximately 30% of patients. We report here the case of a PTCA performed on a tight left anterior descending lesion in the presence of a muscular bridge involving the stenotic area. The procedure was completely successful by both the angiographic and clinical side. Good patency of the vessel with nearly complete disappearance of the lesion was confirmed at 6-month angiographic follow-up. In conclusion, the presence of a muscular bridge involving the stenotic area does not seem to represent a contraindication to PTCA. PMID- 1769032 TI - [Intravascular ultrasonography: the state of the art and future prospects]. PMID- 1769033 TI - Evaluation of cardiac structures and function in systemic sclerosis by Doppler echocardiography. AB - Ventricular diastolic filling was investigated in a series of 51 consecutive patients with systemic sclerosis by means of Doppler echocardiography. Peak flow velocity in early (peak E) and late (peak A) diastole, E/A ratio, slope of the early diastolic flow velocity and isovolumic relaxation period were calculated. Nine out of the 51 patients showed abnormalities of ventricular filling dynamics in the absence of left ventricular systolic dysfunction at rest and after provocation. The abnormal diastolic filling pattern in these patients was detected in spite of the absence of systemic hypertension, left ventricular hypertrophy or other clinically evident myocardial disease. These diastolic abnormalities might represent an isolated evidence of the underlying myocardial fibrosis not yet clinically apparent. PMID- 1769034 TI - Transient myocardial perfusion abnormalities in diabetic patients: a prospective study using thallium exercise tolerance testing. AB - To determine whether diabetic patients without known cardiovascular disease have exercise-induced perfusion abnormalities without symptoms, we performed thallium 201 exercise tolerance testing (ETT) on 16 subjects with diabetes mellitus (8 men and 8 women; mean age = 51 +/- 2 years). To compare these patients to another group at risk for coronary disease and painless myocardial infarction, 13 hypertensive (7 men and 6 women; mean age = 50 +/- 2 years) patients without symptoms of atherosclerotic disease served as controls. Diabetic and hypertensive patients were similar with regard to age, sex, years since diagnosis and other cardiac risk factors. Abnormal exercise thallium testing was more common among diabetic patients (11/16 = 69%; p less than 0.05) as compared to hypertensive patients (4/13 = 31%). None of the patients reported chest pain or its equivalent. There was no difference between diabetic and hypertensive subjects in the number of minutes exercised, percentage of maximal heart rate attained or final heart rate achieved. Diabetic subjects as a group had greater evidence of peripheral neuropathy but no abnormality of autonomic nerve function. Using ETT with thallium scintigraphy, diabetic patients without known cardiovascular disease were more likely to have transient myocardial perfusion defects than were hypertensive patients. PMID- 1769035 TI - Seminars in thrombosis, thrombolysis and vascular biology. 4. Fibrinolysis. AB - In general terms, thrombotic disorders of the cardiovascular system are characterized by poorly regulated, nonphysiologic thrombus formation. Considered more specifically, however, pathologic thrombosis represents a critical imbalance, frequently at both the systemic and vascular levels, of coagulation, anticoagulation and fibrinolysis. Indeed, the balance is shifted toward coagulation, preventing normal physiologic blood flow. Anticoagulants have been a mainstay in the treatment of thrombotic disorders. However, emerging strategies have focused primarily on thrombus dissolution (fibrinolysis), which can be efficiently achieved with the administration of extrinsic plasminogen activators. Clearly, thrombolytic therapy is currently the most direct means of restoring blood flow, vital organ perfusion and hemostatic balance among patients with thrombotic disorders of the cardiovascular system. PMID- 1769036 TI - Effect of serum total cholesterol on hemorrhagic complications following thrombolytic therapy for acute myocardial infarction. AB - Despite the well-known and widely publicized adverse effects of hypercholesterolemia on the cardiovascular system, cholesterol is a vital component of cellular membranes, maintaining vascular integrity and normal platelet activatability. To test the hypothesis that a low serum total cholesterol concentration increases bleeding risk following thrombolytic therapy, a comparison of in-hospital hemorrhagic events was made between 132 patients with myocardial infarction divided into three distinct groups. Group 1 patients (n = 44) had an admitting serum total cholesterol of less than 200 mg/dl, while group 2 (n = 57) and group 3 (n = 31) patients had cholesterol levels of 200-249 and greater than or equal to 250 mg/dl, respectively. There were no significant differences between groups in either minor hemorrhagic events (p = 0.85), major hemorrhagic events (p = 0.73) or transfusion requirements (p = 0.45). In addition, the primary sites of bleeding did not differ. Over the 2-year study period, a total of four intracerebral events were identified. As with minor and other major hemorrhagic events, an association with serum total cholesterol and intracerebral hemorrhage was not observed (p = 0.29). However, advanced age (greater than 65 years; p = 0.04) and a total dose of recombinant tissue-type plasminogen activator in excess of 1.5 mg/kg body weight (p less than 0.001) were identified by multivariate analysis as risk factors for intracerebral hemorrhage. Thus, although cholesterol is vital for maintaining vascular integrity and normal hemostasis, relatively low serum levels are not a risk factor for hemorrhagic complications following thrombolytic therapy. PMID- 1769037 TI - Should 18F deoxyglucose scans be indicated for care of patients with coronary artery disease? PMID- 1769038 TI - Electrocardiographic findings according to sex in athletes and controls. AB - We have previously compared the electrocardiogram of 1,299 male and female students of physical education and sports with 151 age- and sex-matched sedentary controls and found that the former had lower heart rate, longer conduction times and increased voltages. The same material of 1,450 young adult subjects was split according to sex into 617 females and 833 males in order to analyze the influence of gender on the resting 12-lead electrocardiogram. We found that females had a significant higher heart rate, shortened conduction times (PQ, Q, ventricular activation time and QRS) and a prolonged repolarization time (QTc), decreased P, Q and T amplitudes as well as indices of right, septal and left hypertrophy, and ST elevation in precordial leads were lower in females than in males. These differences were highly significant with p values less than 0.0001 for almost all parameters. Sinus bradycardia was more common in men and sinus tachycardia in women. The prevalence of other rhythms and supraventricular and ventricular premature beats was low in both sexes. AV block grade I was found in 1% of females and 3% of males (p less than 0.02). Notching of R/S in V1-V2 and incomplete right bundle branch block were less common in females (p less than 0.0001). The differences in ECG parameters between the two sexes in the total material persisted also when the athletic and control groups were investigated separately. Gender seems to be highly important for most ECG parameters in the resting ECG. This points to the necessity of discussing different upper normal limits for ECG parameters according to gender. PMID- 1769039 TI - Catecholamine-sensitive right ventricular tachycardia in the absence of structural heart disease: a mechanism of exercise-induced cardiac arrest. AB - A case of exercise-induced cardiac arrest secondary to catecholamine-sensitive right ventricular tachycardia in the absence of apparent structural heart disease is presented. Amiodarone therapy prevented tachycardia induction, symptoms and clinical events despite a return to vigorous exercise. PMID- 1769040 TI - Coronary-subclavian steal syndrome following coronary bypass. PMID- 1769041 TI - [Coronary surgery in patients with severely impaired left ventricular function]. AB - Views on surgical treatment of patients with coronary disease and severely restricted left ventricular function are still controversial. In the present work the authors compare the results of direct reconstruction of the coronary arteries in 184 patients with satisfactory or medium restricted left ventricular function (SLV) with a group of 77 patients with severely restricted left ventricular function (RLV). Twenty-three clinical, angiographic, peroperative and postoperative indicators were compared. Patients with RLV had more frequently a myocardial infarction before operation, on average a more restricted functional capacity and lower ejection fraction of the left ventricle than patients with SLV. The mortality during hospitalization was 1.1% in patients with SLV and 5.2% in patients with RLV. These results confirm that reconstruction of the coronary arteries is safe also in patients with a significantly restricted left ventricular function. An essential prerequisite of successful operation is perfect peroperative protection of the heart muscle by the method of continuous local cooling. PMID- 1769042 TI - [Physical medicine and sports]. AB - In the treatment of sportsmen where one of the essential requirements is a rapid and accurate diagnosis with effective therapy which reduces the period of rest and immobilization, knowledge from the sphere of manual medicine is a great asset. In addition to manipulation procedures proper which call for accurately defined conditions and practice, it is possible to apply a wide range of reflex methods and mobilization to achieve favourable therapeutic results in predominantly functional disorders of the locomotor apparatus. These efforts have their limitations and possibilities and in some instances it is necessary to seek in addition to impaired function also more serious diseases or damage caused by repeated microtraumas. PMID- 1769043 TI - [Qualifying criteria in cardiology]. AB - The author presents a review of requirements of the American Heart Association, the American College of Cardiology and American College of Physicians to obtain qualification in the discipline of monitoring of haemodynamics, in echocardiography of adults, percutaneous transluminal coronary angioplasty and ECG loading tests. He mentions also requirements essential for maintenance of the acquired qualification. In the conclusion the author reflects on the possible application of these criteria under local conditions. PMID- 1769044 TI - [Helicobacter (Campylobacter) pylori in stomach and duodenal biopsies]. AB - In bioptic specimens of the gastric mucosa of 57 patients with dyspeptic complaints and/or a duodenal ulcer Helicobacter pylori was detected under the microscope in 82,4% of chronic active gastritis and in 28,6% and 61,5% resp. of chronic gastritis grade I and II. The finding of helicobacteria depended on the number of collected specimens. They were never found at sites with intestinal metaplasia and their numbers did not correspond to the intensity and character of the inflammatory changes. As compared with the antrum, in the corpus of the stomach helicobacteria were found more frequently not only in mild forms of the inflammation but also in the normal mucosa. In the duodenum the finding was negative and the inflammatory changes were only mild. In all patients with a duodenal ulcer and a scar after ulceration in the antrum chronic active or inactive gastritis grade II was found with helicobacteria in 84,6% of the observations. Cultivation was consistent with microscopic evidence in 50 patients (87,7%). PMID- 1769045 TI - [Basic communication skills]. AB - Communication skills comprises components of interpersonal activities which have as a rule are favourably affected. They include listening, which means to perceive sensitively all components of the patient's verbal manifestations; the ability of empathy is very important. We characterize it in Rogers sense i.e. trying to understand the mental state of the other subjects. The fundamental communication skill of the doctor is manifested understanding. Some skills are to a certain extent non-verbal such as interest in the patient or respect of him. Finally the author deals with the role of specific advice given to the patient when psychological problems have to be resolved. PMID- 1769046 TI - [The effect of decreased thromboxane synthesis on proliferative glomerulonephritis]. AB - The authors investigated in 19 patients with chronic proliferative glomerulonephritis the effect of 100 mg acetylsalicylic acid (ACA) administered for 12 months and the effect of 50 mg ACA administered for the same period. They evaluated the effect of the two doses on the urinary excretion of PGI and TXA2 metabolites as well as the effect on proteinuria and glomerular filtraction (GF). The authors provided evidence that small and very small amounts of ACA did not affect the excretion of the PGI metabolite, while they reduced significantly the excretion of the TXA2 metabolite and of proteinuria, and significantly increased GF. PMID- 1769047 TI - [Discrimination analysis in the differential analysis of pleural effusions]. AB - The authors applied the mathematical method of discrimination analysis in the differential diagnosis of tumourous and other pleural exudates, as well as for the differentiation of malignant and paramalignant exudates. The basis for the investigation were data obtained during a four-year prospective study of pleural exudates at the Second Clinic of Tuberculosis and Respiratory Diseases in Prague. The analysis was made using a programme elaborated by RNDr. Tomasek, CSc. on a Hewlett-Packard 2100S computer in IHE Prague. After processing of 38 parameters- from 138 patients (without data on the cytology of the exudate, biopsy of the parietal pleura, bronchoscopy and thoracoscopy) the computer selected nine parameters with the greatest discrimination value which made it possible to differentiate tumorous exudates from others in 84%. This concerned the following data: skiagram of chest on admission, CEA in the exudate, temperature, exudate known already before admission to Clinic, LDH in serum on logarithmic scale, general impression of disease during physical examination, red cell sedimentation rate on admission, volume of exudate, alkaline phosphatase in exudate. When it was possible to add to the analyzed parameters also examination of the tissue polypeptide antigen (TPA), the analysis could be performed in 61 subjects. In that case the discriminating capacity rose to 95%. Subsequently we entered in the programme 38 parameters from 88 patients with a tumourous exudate and sought the most suitable ones for differentiation of malignant and paramalignant exudates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769048 TI - [A decrease in magnesium in the serum and blood lymphocytes after intravenous infusion of glucose]. AB - The authors assessed in a group of 10 healthy volunteers the Mg content of serum, in erythrocytes (Er) and lymphocytes (Ly) before infusion and during three hours after infusion of 400 ml 10% glucose without added Mg and with addition of 10 ml 20% MgSO4 (magnesium sulphate, Spofa). It was revealed that glucose infusion without Mg reduces significantly serum magnesium as well as Mg in lymphocytes and the reduced values persist for at east three hours after termination of the infusion. In 3 of 10 volunteers the values dropped beneath the lower range of reference values; two of these three volunteers developed also clinical manifestations of Mg deficiency. Mg in Er was not affected by the glucose infusion. The glucose infusion with Mg raised significantly the serum Mg and Mg in Ly; Mg in Er did not change. Based on the submitted results the authors recommend prevention of Mg deficiency induced by glucose infusion by Mg supplementation, in particular in patients with cardiovascular diseases. PMID- 1769049 TI - [HLA antigens on erythrocytes. An attempt to determine the origin of HLA-A, B antigens]. AB - HLA sera were absorbed with erythrocytes with proved HLA antigens and blood cells with HLA-A, B antigens absorbed in vitro from serum. Both types of red cells were 5x to 15x washed in saline and exposed for two hours to the action of 15% chloroquine. The degree of absorption of HLA antibodies and the decline of the score were equal or slightly different after absorption with erythrocytes with own or quinked HLA antigens. Washing in saline or processing of blood cells with chloroquine did not affect the resulting absorption. From the results of the experiment ensues that the link of HLA-A, B antigens is equally firm blood cells isolated from the peripheral blood stream and blood cells where the antigens were linked to them in vitro from serum. This suggests that the view is justified that the majority of HLA-A, B antigens detected in blood cells is secondarily linked from plasma. PMID- 1769050 TI - [Discussion of the article by J. Sobra: Nutrition and metabolic disorders of high incidence]. PMID- 1769051 TI - [The quality of demographic development in Czechoslovakia from the European viewpoint]. AB - Forty years of a totalitarian regime imply economic, cultural and moral devastation. Statistical analyses reveal, however, also demographic devastation in particular in the sphere of health and social aspects. This means that the basic indicators of the quality of demographic development in Czechoslovakia during the last 25 years are remarkably close to the indicators of the former socialist system and that they deteriorate and lag behind when compared with other countries, in particular developed industrial countries. This trend can be also called "balkanization" because Czechoslovakia which belonged before the war among the eight most highly developed industrial countries dropped at the end of the eighties to the level of demographic indicators of Bulgaria, Jugoslavia, Hungary, Roumania etc. In the submitted investigation the authors demonstrate these facts based on the analysis of selected coefficients of quality of the demographic development such as infant mortality, specific mortality of the male and female population aged 55-59 years and the mean life expectancy of men and women at birth, on the background of the general European demographic situation. For analyses only the latest data published by UNO were used. PMID- 1769052 TI - [Continuous ambulatory peritoneal dialysis in the treatment of end-stage renal insufficiency. Current status in 1991]. AB - CAPD was introduced in the U.S.A in 1978 as a new technique of peritoneal dialysis and as a self-treatment method and new possibility of renal replacement therapy in patients with end-stage renal failure. Up to this time peritoneal dialysis stood in the shade of hemodialysis, so that the new technique brought about a true renaissance of peritoneal dialysis. Owing to its advantages CAPD rapidly expanded worldwide and the number of CAPD patients is still increasing. Patients who could not be taken into consideration for renal replacement treatment because of shortage of facilities, could now be accepted in increasing number; a new era of renal replacement therapy began. The article describes the technique, the advantages, disadvantages and the problems regarding the indications for CAPD as is the status in the year 1991. PMID- 1769053 TI - [Dietary habits in a group of middle-aged women]. AB - The authors made a pilot nutrition survey in a group of 75 women working in the Skoda plant in Plzen. They analyzed the dietary intake during a three-day period. It was revealed that the intake of the investigated group is grossly at variance with principles of rational nutrition. The total energy intake (almost 10,000 kJ/day) comprised 44% fat, 42% carbohydrate and 14% protein. The P/S ratio was 0.36. The nutritional parameters did not correlate significantly with blood lipid levels or other investigated data. Only the total energy intake and total fat intake correlated positively with the BMI. PMID- 1769054 TI - [Incidence and characteristics of bronchial asthma in a selected region in the Slovak Republic]. AB - In a selected area comprising five districts with a population of 744,762 the authors analyzed a group of 2168 cases of confirmed bronchial asthma. The number of women predominated (61.10%). The highest frequency of asthma was in the age group between 35 and 44 years. As to the type, the mixed type of asthma predominated (61%). Impaired pulmonary function was recorded in 46% of the patients. The condition was found most frequently in workers (40.5%). 62% of the investigated group of patients was treated with Intal, Zaditen, Berotec or a combination of these drugs. PMID- 1769055 TI - [The effect of dipyridamole on hippurate excretion in healthy volunteers and in patients with renal insufficiency]. AB - Organic anions retained in patients with renal failure participate in a substantial way in the metabolic acidosis and thus also the catabolism in renal failure. The basic disorder is the reduced capacity of the transport system of organic ions. Therefore drugs are sought to enhance its activity. Acute investigation of healthy volunteers revealed that 150 mg dipyridamol increased the urinary hippurate excretion, while the serum hippurate concentration declined. In patients with renal failure there is the same tendency, though less marked, and due to the variability of functions of individual patients this trend is insignificant. It is assumed that this hitherto not described action of dipyridamol may be of therapeutic importance when administered to patients with impaired renal function. PMID- 1769056 TI - [The importance of plasma lipids and apolipoproteins in the assessment of risk of myocardial infarction in the most common types of primary hyperlipoproteinemias]. AB - In a group of 60 men after myocardial infarction (IM) with primary hyperlipoproteinaemia (HLP), type IIA, IIB and IV the authors revealed on comparison with a control group of 71 men with similar types of HLP where ischaemic heart disease (IHD) was not detected, significantly higher concentrations of total plasma cholesterol (TC), low density lipoproteins (LDL C), apolipoprotein (apo)B in LDL; in the hyperlipidaemic subjects after IM the concentration of HDL-C was significantly lower as well as the ratio of cholesterol and apo-B in the LDL fraction. In patients with hypercholesterolaemia (HLP IIA and IIB) for estimation of the risk of IHD LDL-C, HDL-C and apo-B in LDL are useful. In patients with hypertriglyceridaemia (HLP IIB and IV) subjects with a history of IM have in addition to a higher concentration of apo-B in LDL a lower ratio of cholesterol to apo-B in LDL and in those with HLP IV also a lower plasma concentration of apo-A-I. By the discriminating function the variable of which is in HLP IIB the apo-B concentration in LDL and in HLP IV apo-B in LDL and apo-A-I in plasma in HLP IIB 77.8% subjects and in HLP IV 82.9% subjects with an increased risk of IHD can be detected. PMID- 1769057 TI - [Dermatoglyphic characteristics of the Czech population]. AB - Statistical processing of results obtained from dermatoglyphic digital patterns of the Czech population--110 women and 130 men of a reference group--revealed the tendency of more complex pattern formation in men and a tendency of simple pattern formation in women. As regards the frequency of vortices, the differences are significant at the 1% level (in men they form 24.15% patterns, while in women 14.27%). There is also a significant difference in the ratio of arches (1% level of significance)--frequency in men, 5.85%, is lower than in women--11.69%. In the general evaluation the ulnar loops differ only at the 5% level of significance (in men 58.85% and in women 63.18%). The frequency of radial loops and double loops differ insignificantly. The results indicate a greater trend of asymmetrical patterns in men than in women. In investigations of the sexual dimorphism the attained numbers of statistical differences differ by fingers--the most widely different values are recorded in the index fingers and the least different ones in the middle fingers. The number of statistical differences by sex differs also by patterns: most in vortices and arches and least in double loops. PMID- 1769058 TI - [Peroxidative effects of tetracycline antibiotics]. AB - After six-day administration of rolitetracycline (RTC) in the cardiac mitochondria of old rabbits the rate of oxygen consumption (glutamate-malate as well as 2-oxoglutarate) declines, while the malonic dialdehyde (MDA) rises. This provides evidence of more intense lipoperoxidation due to rolitetracycline. However, the ATP-ase activity increases and therefore this parameter is unsuitable in this experimental set-up (presence of tetracycline antibiotic) as an indicator of impaired integrity of mitochondrial membranes. After administration of RTC the activity of superoxide dismutase (SOD) increases markedly, but in case of concurrent administration of vitamin E it declines which is evidence of the prooxidative action of tetracyclines. Tetracycline itself and its metabolites which are formed during the biotransformation and degradation of epianhydrotetracycline (ETC) do not alter significantly the oxygen consumption nor the ATP-ase activity in cardiac mitochondria of old rabbits in vitro. Of these metabolites only anhydrotetracycline (ATC) and in particular epianhydrotetracycline (EATC) inhibit both parameters. From experiments in vitro ensues the relationship between the action and structure of the antibiotic and its metabolites the structure of cycle C and the nature of the substituents in positions C6 and C1 of this tetracycline cycle, as prerequisites are created for the formation of prooxidative structures. PMID- 1769059 TI - [The effect of a single administration of magnesium sulfate on glucose tolerance and insulinemia in healthy volunteers]. AB - The effect of 2.0 g magnesium sulfate on glucose tolerance and immunoreactive insulin (IRI) response to glucose application was studied in 10 healthy normomagnesemic volunteers: a) Serum magnesium concentration (Mg) increased markedly and remained on the increased values during the study. Total erythrocyte Mg concentration did not change. b) The infusion application of 40 g glucose increased glykemia which returned promptly to fasting levels after the infusion termination. Mg did not influence the glycemic response. c) IRI concentration increased even more than glucose to the glucose load. Mg decreased the IRI response and even IRI/glucose ratio significantly. In conclusion, Mg increased insulin sensitivity even in healthy normomagnesemic subjects. PMID- 1769060 TI - [The history of medical terminology. VI. K.R.A. Wunderlich and medical terminology]. PMID- 1769062 TI - Intracellular free calcium concentration in the blowfly retina studied by Fura-2. AB - The retinal tissue of blowflies was loaded with the fluorescent Ca2+ indicator Fura-2 by incubating cut heads in saline solutions which contained the membrane permeable acetoxymethylester of Fura-2 (Fura-2/AM). The spectral analysis of the tissue fluorescence showed that Fura-2/AM was intracellularly hydrolysed to Fura 2. In order to monitor the intracellular free Ca2+ concentration ([Ca2+]i) the Fura-2 fluorescence was excited by short light flashes. The fluorescence was calibrated by incubating the tissue in Ca2+ buffers of high buffering capacity and subsequent disruption of the cell membranes by freeze/thawing, which gave a dissociation constant for the Ca(2+)-Fura-2 complex of 100 nM. When the extracellular Ca2+ concentration ([Ca2+]o) was altered [Ca2+]i reversibly changed. The changes were most pronounced when [Ca2+]o was varied in the millimolar range, e.g. [Ca2+]i increased from 0.07 microM at [Ca2+]o = 0.1 mM to 1 microM at [Ca2+]o = 10 mM. When extracellular Na+ was replaced by Li+ or other monovalent ions, [Ca2+]i rapidly increased which supports the view that electrogenic Na+/Ca2+ exchange contributes to the control of [Ca2+]i. However, [Ca2+]i decreased again when the tissue was superfused with Na(+)-free media for longer periods, which points to a Ca(2+)-transporting system different from Na+/Ca2+ exchange. Light adaptation had only a small effect on [Ca2+]i. Even after intense stimulation [Ca2+]i increased by a factor of 1.5 only, which is in line with results obtained in the photoreceptors of Balanus and Apis. PMID- 1769061 TI - Neural regulation of calmodulin in adult Xenopus leg muscle. AB - Two Ca(2+)-binding proteins important in regulating muscle responses to Ca2+ flux are differentially expressed following denervation of Xenopus laevis gastrocnemius. Levels of parvalbumin (PV) RNA transcripts and proteins decrease in abundance, while calmodulin (CaM) transcript and protein levels increase. Our studies on PV kinetics in Xenopus follow a pattern observed in other species, however, our observation of a concomitant increase in CaM has not been documented in any system. Molecular analyses of the Xenopus CaM gene indicate that its structure and upstream sequences are highly conserved across several vertebrate species and implicate several transcription factors in the regulation of its expression. PMID- 1769063 TI - Perspectives in S-100 protein biology. Review article. AB - The S-100 protein family constitutes a subgroup of Ca(2+)-binding proteins of the EF-hand type comprising three dimeric isoforms, S-100a0, S-100a and S-100b, plus a number of structurally related proteins displaying 28-55% homology with S-100 subunits. S-100 protein was discovered in 1965; yet, its biological functions have not been fully elucidated. The present report will review the putative biological roles of S-100 protein. Both intracellular and extracellular roles have been proposed for S-100 protein. Within cells, S-100 protein has been reported to regulate protein phosphorylation, ATPase, adenylate cyclase, and aldolase activities and Ca(2+)-induced Ca2+ release. Also, cytoskeletal systems, namely microtubules and microfilaments have been reported to be regulated by the protein in the presence of Ca2+. Some molecular targets of S-100 protein within cells, have been identified. This is the case with microtubule proteins, caldesmon, and a brain aldolase. S-100 protein has been reported to be secreted; extracellular S-100 protein can stimulate neuronal differentiation, glial proliferation, and prolactin secretion. However, the mechanisms by which S-100 is secreted and stimulates the above processes are largely unknown. Future research should characterize these latter aspects of S-100 biology and find out the linkage between its intracellular effects and its extracellular activities. PMID- 1769064 TI - Compartmental analysis of 45Ca2+ efflux in perfused rat liver: effects of hormonal stimulation. AB - The kinetics of calcium movements in the isolated perfused rat liver were examined using compartmental analysis of the efflux profiles of 45Ca2+ from 45Ca(2+)-equilibrated livers under a variety of calcium concentrations and hormonal treatments. From the 45Ca2+ efflux profiles, we determined that a three compartment model was appropriate to describe the movements of calcium in the liver on the time scale of the experiments. Hormonal treatment with the alpha adrenergic agonist, phenylephrine, or the vasoactive peptide, vasopressin, during the efflux period lowered significantly the rate of transfer of Ca2+ between the internal compartments at all of the calcium concentrations employed. Also, phenylephrine treatment leads to increased transfer of Ca2+ into the liver from the perfusate. The temporal characteristics of the phenylephrine and vasopressin sensitive Ca2+ pools were examined by pulsing livers, loaded for variable periods of time with 45Ca2+, with the two hormones during the efflux of 45Ca2+ to measure the kinetics of Ca2+ exchange in the hormone-sensitive pools. Results from these experiments indicate that the rate of unstimulated Ca2+ efflux, k2, for the phenylephrine and vasopressin sensitive Ca2+ pools, modeled as a one compartment system, are the same, 0.074 and 0.078 min-1 for phenylephrine and vasopressin respectively, corresponding to half times for turnover of the pool(s) of 9.3 and 8.9 min, respectively. PMID- 1769065 TI - Cell cultures as models for drug absorption across the intestinal mucosa. AB - This review deals with cell culture models for studies of drug absorption across the intestinal mucosa. The selection of appropriate cells and cell culture conditions is discussed, guidelines for the characterization of the cell models are presented, and the intestinal barriers to drug absorption are discussed and compared with those in the cell culture models. Finally, recent applications of the cell culture models in drug and peptide absorption and metabolism studies are reviewed. PMID- 1769066 TI - Recent progress in protein and peptide delivery by noninvasive routes. AB - Much progress has been made in the last 5 years toward delivery of protein and peptide drugs by noninvasive routes. The obstacles of instability, poor absorption, rapid metabolism, and nonlinear pharmacokinetics are great challenges for which some solutions are now emerging. Structural modifications of the protein by chemical or recombinant means have improved stability and minimized enzymatic cleavage in some cases. Protection of the protein or peptide drug via liposomes or polymers also offers a means for increasing stability and prolonging half-life. Novel permeation enhancers, which show minimal irritation to mucosal membranes, have become available and show promise for increasing absorption of proteins delivered by a number of noninvasive routes. There are examples in which several of these methods have been used concomitantly to achieve maximum effect; for instance, a bioadhesive microsphere formulation containing a novel permeation enhancer was used to maximize nasal delivery of insulin. Therefore, general methods exist whereby delivery by any noninvasive route may be improved. In some cases, choice of the best route of delivery for a particular drug makes the difference between success and failure. A comparison of the enzyme activity at the various sites of delivery is helpful and, fortuitously, the enkephalins, model peptides whose rate of cleavage and type of degradation products offer information about the type and activity of enzymes present, have been studied extensively. This work is reviewed for each delivery site as are the effects of coadministration of enzyme inhibitors. Permeation enhancers and examples for their use at each site of delivery are presented. The use of polymers for bioadhesion and for protection from metabolism at various sites is reviewed. Since systemic delivery of proteins via the pulmonary route is now receiving more attention, special emphasis is given to that work. Generally, the focus is on work published or presented since 1988, since publications prior to that date have already been thoroughly reviewed. The studies presented indicate that the problems of delivering protein and peptide drugs by noninvasive means can be minimized; although delivery by these routes still may not be bioequivalent to invasive methods, the convenience to the patient will, in some cases, outweigh the demand for complete bioequivalence. PMID- 1769067 TI - Hydrophilic matrix sustained release systems based on polysaccharide carriers. AB - The hydrophilic matrix (HM) continues to be a popular and widely used strategy for sustained-release drug delivery, with polysaccharides and their derivatives being the polymers of choice as the rate-controlling carriers for these systems. This review provides an appraisal of the more recent developments in the design and in our understanding of the behavior of HM systems. It also focuses on areas of current interest not encompassed by previous reviews. PMID- 1769068 TI - Filtering centrifugation through two layers of silicone oil: a method for the kinetic analysis of rapid metabolite transport in organelles. AB - Kinetic studies of ATP uptake in amyloplasts from sycamore (Acer pseudoplatanus L.) have been performed with a newly developed method of centrifugation through a double layer of silicone oil; the results are compared with the frequently used method of centrifugation through a single layer. The present technique employs two separate silicone layers: the upper one prevents mixing of the organelle preparation with the incubation layer, which contains the metabolites, and the lower one prevents mixing of the incubation and pelleting layers. Incubation of the organelles takes place in the incubation layer after the upper layer of silicone inverts during centrifugation. Depending on the speed of centrifugation, incubation periods as short as 1 sec and as long as 2 min can be achieved. High reproducibility and accuracy, acquisition of multiple data in a single centrifugation, and maintenance of structural integrity and metabolic activity of the organelles make the technique advantageous for the analysis of metabolite transport in amyloplasts and other kinds of organelles. PMID- 1769069 TI - Flow effects on cultured vascular endothelial and smooth muscle cell functions. AB - Cultured vascular endothelial cells were exposed to fluid shear stress by means of a rotary-disc shear-loading device, and the physiological effects of the conditioned medium (CM) and the homogenate (HM) of the cells on migration, adhesion and growth of endothelial cells (EC) or smooth muscle cells (SMC) were studied. Effects of shear stress on the production and secretion of collagen, one of the extracellular matrices of EC, were also studied. CM stimulated the adhesion and growth of SMC, but not of EC themselves. The ability to stimulate SMC adhesion and growth was similar in CM obtained from the static and shear loaded cells. HM of the shear-loaded EC stimulated SMC migration. Further, HM of the shear-loaded EC contained increased amounts of collagen compared with the static EC. These results suggest that: 1) EC produce and secrete accelerators for the adhesion and growth of SMC, 2) EC react to the physical stimulus of fluid shear stress to produce stimulators of SMC migration, and 3) EC produce collagen, the production of which is enhanced by fluid shear stress. PMID- 1769070 TI - Elevation of transforming growth factor beta 1 mRNA level in ES-D3 mouse embryonic stem cells cocultured with Balb/c3T3 A31 fibroblasts. AB - Embryonic stem (ES) cells are a pluripotent cell line derived from the inner cell mass of the mouse blastocyst. The mRNA levels of several growth-related genes were examined in ES cells by Northern blot analysis under several different growth conditions. In a coculture of ES cells with the mouse fibroblast cell line, Balb/c3T3 A31, the expression level of transforming growth factor beta 1 (TGF-beta 1) mRNA was elevated for 1 to 3 days. In a coculture of ES cells with primary embryonic fibroblasts, only slight accumulation of TGF-beta 1 mRNA was observed for 6 to 24 h and soon attenuated. In situ hybridization analysis revealed that TGF-beta 1 transcripts accumulated first in the masses of ES cells and subsequently in Balb/c3T3 A31 cells adjacent to ES cells' masses. The ability of ES cells to induce TGF-beta 1 in Balb/c3T3 A31 cells was not mediated by soluble factors and was lost upon differentiation. ES cells on primary embryonic fibroblasts grew in undifferentiated form, but those on Balb/c3T3 A31 cells stopped growing and formed embryoid cystic bodies. We suggest that TGF-beta 1 mRNA induction in a coculture is triggered by an interaction between differentiating ES cells and Balb/c3T3 A31, and that this activity is limited to undifferentiated ES cells. PMID- 1769071 TI - Mutants of Dictyostelium discoideum with altered carbohydrate moieties of contact site A. AB - Mutants of Dictyostelium discoideum were isolated and found to be defective in the epitope recognized by the monoclonal antibody 120 against the carbohydrate moieties of an integral membrane glycoprotein, contact site A, with the apparent molecular mass of 80 x 10(3). One mutant, HG764, did not express any contact site A and had lost cell contact resistant to EDTA. The others, including HG794, expressed a 68-kDa form of contact site A. In comparison with the parental strain HG592, HG794 showed weaker EDTA-resistant cell contact and the same degree of EDTA-sensitive cell contact. This suggested that the moieties which HG794 lacked were involved in EDTA-resistant cell contact. The 68-kDa contact site A in HG794 could be labeled with wheat germ agglutinin and incorporated [35S] sulfate. The modB mutant HL220 also expresses 68-kDa contact site A, although it cannot be labeled with wheat germ agglutinin. Therefore, the mutants HG794 and HL220 were compared by a complementation test. The diploid strain DG701 expressed 80-kDa contact site A and showed the same degree of EDTA-resistant cell contact as strain HG592. In its EDTA-resistant cell contact, HG794 was stronger than HL220. These results suggest that HG794 is a new mutant, and that there might be at least two processes in the glycosylation of 68-kDa contact site A to the 80-kDa form. The carbohydrate moieties recognized by monoclonal antibody 120 and by wheat germ agglutinin might be involved in EDTA-resistant cell contact. PMID- 1769072 TI - Inhibition of cell adhesion by type V collagen. AB - Human umbilical vein endothelial cells grew well in dishes coated with collagen types I, II, III, or IV. However, the same cells tended to detach themselves from dishes coated with type V collagen, and cell proliferation in these dishes was inhibited. Such anti-adhesive activity was partially retained by heat-denatured type V collagen or by its alpha 1 chain, but not by its alpha 2 chain. Several other cell types did not adhere to the type V collagen substratum even in the presence of 10% serum. The cell types strongly inhibited from adhering by type V collagen included Swiss mouse 3T3 cells and their MSV-transformants, BALB/c 3T3 cells and their methylcholanthrene-transformants, NIH 3T3 cells and their ras transformants, BHK cells, CHO-9 cells, CHO-K1 cells, and mouse melanoma B16-F10 cells. Using Swiss mouse 3T3, we studied the effects of type V collagen on cell adhesion to fibronectin in serum-free medium. When the culture dishes were coated with a mixture of fibronectin with various concentrations of type V collagen, the adhesion of the cells was inhibited depending on the concentration of type V collagen. The inhibition of cell adhesion by type V collagen was competitively overcome by increased concentrations of fibronectin. The activity that interferes with the effects of fibronectin was retained mainly by the alpha 1 chain of heat denatured type V collagen. PMID- 1769073 TI - Ca2+ dynamics in rat pancreatic AR-42J and AR-IP cells. AB - Spatiotemporal change of the cytosolic free Ca2+ concentration ([Ca2+]i) in response to a variety of secretagogues was examined in rat pancreatoma AR-42J and AR-IP cells by microspectroflurometry and digital imaging microscopy after loading with fura-2. In the presence of external Ca2+, carbachol, CCK-OP (cholecystokinin-octapeptide), gastrin, norepinephrine or high K+ evoked a large transient increase in [Ca2+]i in AR-42J cells which declined to a sustained level before slowly declining towards the resting level. In the absence of external Ca2+, a transient increase in [Ca2+]i were evoked by all the ligands except for high K+ stimulation, which declined rapidly towards the resting level. The [Ca2+]i increase caused by carbachol and high K+ treatment was inhibited by muscarinic receptor antagonist, atropine, and by L-type Ca2+ channel blocker, nifedipine, respectively. The transient [Ca2+]i increase induced by gastrin stimulation was not blocked by Ca2+ channel blocker, lanthanum. In the AR-IP cells, which are non-differentiated pancreatoma cell line, all stimulations including high K+ treatment have failed to evoke [Ca2+]i response. These intracellular Ca2+ mobilizations in response to ligands in AR-42J cells were displayed by digital imaging microscopy. From these results we conclude that AR 42J cells has an alpha-adrenergic receptor, in addition to muscarinic acetylcholine receptor, CCK-OP receptor, gastrin receptor and voltage dependent Ca2+ channel. In marked contrast, AR-IP cells have neither any hormone receptor for the above ligands nor voltage dependent Ca2+ channel. PMID- 1769074 TI - [Acquired copper deficiency]. PMID- 1769075 TI - [The cardiovascular program in adolescent health care]. PMID- 1769076 TI - [Experience with a handwashing regimen in the neonatal unit]. PMID- 1769077 TI - [Use of the Limulus amebocyte lysate (LAL test) for the early and rapid diagnosis of peri- and neonatal infections]. PMID- 1769078 TI - [Primary pulmonary hypertension]. PMID- 1769079 TI - [New findings on maintenance of the acid-base equilibrium]. PMID- 1769081 TI - [The recurrently ill (infected) child in ambulatory practice]. PMID- 1769080 TI - [Extra-alveolar air in the neonatal period]. PMID- 1769082 TI - [Gypsy children are not placed in foster care homes]. PMID- 1769083 TI - [Regional differences in the prevalence of congenital heart defects]. AB - Prevalence of congenital heart diseases was studied prospectively in all 664,218 infants live born in Bohemia from 1977 to 1984. All children who died were autopsied and those suspected of having a heart disease were examined at the specialized center. In total, 664/100,000 infants were born with a heart defect, most of them in Prague (957,9/100,000) and in Central Bohemia (739.4) and in Northern Bohemia (619.3). The lowest prevalence was found in West Bohemia (515.1/100000 live births). The relative frequency of congenital heart defect categories differed significantly among regions. Evidence of regional differences in prevalence of congenital heart diseases and their forms suggests that environmental factors can play an important role in the etiology of congenital heart defects. PMID- 1769084 TI - [Long-term ECG monitoring (Holter) in a group of healthy 14-to-18-year-old adolescents]. AB - Using 24-hour Holter ECG examinations, the authors assessed ECG changes in a group of 86 healthy students of a Bratislava secondary school. The students were 14-18 years old. Their mean age was 15.8 years. As to ECG changes, the authors evaluated changes of the heart rate, ectopic disorders of the cardiac rhythm and right bundle branch block. Almost in all students the authors detected one or several disorders of the heart rhythm. Extreme changes were recorded in particular in the heart rate, i. e. tachycardia and bradycardia. Sinus arrhythmia was present in 80.2% of the adolescents, right bundle branch block in 57%, and as to ectopic disorders, ventricular extrasystoles were present in 51.2% of the students and supraventricular ones in 34.9%. PMID- 1769085 TI - [Use of the heart rate during exercise for the determination of anaerobic threshold in children]. AB - Ethical, economic and other reasons prevent assessment of the anaerobic threshold in children by invasive methods such as estimation of the lactate concentration in blood or ventilation parameters. Conconi developed a non-invasive field test which can be used to assess the anaerobic threshold by analysis of a heart rate curve during a graded load. Although this test was originally used only in adults top sportsmen, it can be applied according to the most recent findings also in children and not only under field conditions but also in the laboratory. By using standard test protocols a high correlation can be obtained with the anaerobic threshold assessed by the lactate method. PMID- 1769086 TI - [Minimal brain dysfunction in a population sample of children monitored on a long term basis]. AB - A group of 66 14-year old children with mild cerebral dysfunction were examined within the framework of long-term follow up of children at risk. The group was formed mostly by boys. It was revealed that the families of these children are not significantly more frequently incomplete or dysfunctional, the number of children in the family is within the normal range. The progress in school of these children is poorer than could be expected with regard to their abilities although their intelligence is somewhat reduced, in particular as regards the percentage of above-average children. The symptoms of the disorder and secondary complications were consistent with theoretical assumptions. In children mild cerebral dysfunction secondary complications such as neurotic complaints and behavioural disorders develop more frequently. The time when mild cerebral dysfunction was detected and the dynamics of the development of the disorder were very variable and comprised the entire period of school attendance. PMID- 1769087 TI - [Serum lipid and apolipoprotein levels in 11-to-14-year-old children]. AB - Estimation of serum lipids and apolipoproteins drew attention to some important changes of their values during this age period. In both sexes there is a marked decline of LDL cholesterol (and thus also of total cholesterol) and of apo B. Girls have higher values of serum triacylglycerols and as compared with boys, their apo A is more closely related to total cholesterol levels than to HDL cholesterol. The different skinfold thickness of the children did not affect the values of the assessed parameters. The authors consider for the group of examined children the following values as pathological: cholesterol greater than 5.2 mmol/l, HDL cholesterol less than 0.9 mmol/l, triacylglycerols greater than 1.5 mmol/l, apo A less than 1.6 g/l and apo B greater than greater than 1.2 g/l. The results are consistent with recent results of other local authors. PMID- 1769088 TI - [Lipoprotein profiles in 6-year-old children breast fed for different periods of time]. AB - The authors submit results of investigations of the lipoprotein profile in six year-old children fed a different diet during infancy. It is the continuation of previous results of a long-term longitudinal investigation of this group of healthy children which revealed a favourable effect of breastfeeding on the cholesterol distribution in lipoprotein fractions. Throughout the investigation the children were divided into four groups according to the breastfeeding period. At the age of six serum cholesterol was assessed and cholesterol in lipoprotein fractions, levels of apolipoproteins A1 and B and risk for the genesis and development of atherosclerosis were calculated. The most favourable lipoprotein profile was found in the group of children, breastfed for three months and with this corresponded also the lowest values of the risk indexes. The serum cholesterol concentration, levels of serum apolipoproteins A1 and B in different groups of children did not differ significantly. PMID- 1769089 TI - [Infantile cortical hyperostosis (the Caffey-Silvermann syndrome)]. AB - In 1984-1989 at the First Paediatric Clinic of the Motol Faculty Hospital six patients with the diagnosis of infantile cortical hyperostosis (Caffey-Silvermann syndrome) were hospitalized. Non-familial concurrence of the disease was involved. All children developed the disease before the age of 4.5 months, four before the age of three months. Among the six patients was only one girl. As to pathological findings there was a markedly elevated FW in 5/6, leucocytosis in 5/6, thrombocytosis in 3/4, eosinophilia in 3/6, elevated alkaline phosphatases in 2/6. The affection was four times on the mandible, once in the area of the hip joints and in one instance it was multifocal. The authors present one detailed case-history with extreme affection of the clavicle which was originally taken for a bone tumour. PMID- 1769090 TI - [Severe Vicedrin poisoning in a 17-month-old girl]. AB - The child ingested 7 tabl. of VICEDRIN (a combination of phenacetin, ephedrin, chinin, acid. ascorbicum), the total dose of phenacetin was 140 mg/kg of b.w. Lethal doses of phenacetin vary between 100-200 mg/kg, the sensitivity to phenacetin being increased in infants. Toxicological examination in this case revealed a high concentration of phenacetin in urine. The clinical signs of intoxication were vomiting (hematemesis), methemoglobinemia and somnolence. 2 hemoperfusions were performed lasting 6 hrs and 5 hrs resp. (HEMASORB 400 A 4), the second one were combined with hemodialysis because after the first perfusion a high concentration of metabolic products of phenacetin was detected in urine. After the second perfusion the status of the child rapidly improved and we could discharge the patient of the 10th day after admission. Hemoperfusion is recommended in severe intoxication with phenacetin, the combination with, hemodialysis is possible to remove its metabolic product. PMID- 1769091 TI - [A rare case of colonic invagination due to leiomyosarcoma]. AB - The authors report on a case of leiomyosarcoma with intussusception of the large bowel. They stress the importance of the clinical suspicion in targeting preoperative instrumental instrumental investigations. PMID- 1769092 TI - [Tumors of the glomus caroticum (clinical cases)]. PMID- 1769093 TI - [The clinical picture of pseudomyxoma peritonei]. AB - The authors describe two cases of pseudomyxoma peritonei, one of which with a lengthy clinical course and the other with a rapidly fatal outcome. The clinical picture in pseudomyxoma peritonei is associated with a variety of benign or malignant mucus-secreting tumours, mainly originating in the appendix or ovaries. Survival is generally long owing to the lack of visceral invasion or metastases. An accurate prognostic assessment can only be achieved on the basis of identification of the primary tumours and its degree of malignancy. PMID- 1769094 TI - [The ileocecal valve as a prognostic factor in extensive resection of the small intestine]. AB - The aim of the study was to examine the role of the ileocaecal valve in relation to the nature and extent of symptoms following extensive bowel resection (EBR) in 13 patients with short bowel syndrome (SBS) referred to our department over the period 1962-1988. The results obtained do not allow us to assess the effective role of the ileocaecal valve in determining the severity of SBS. The factors conditioning the extent of the aftermath of EBR and effectively affecting prognosis are, in fact, multiple and act in various interrelated ways, thus making it difficult to define the precise role of any one of them. The ileocaecal valve, however, does play a substantial role, in that, on the one hand, it performs sphincter and barrier functions against ileocolic reflux of bacteria, while, on the other, its removal involves excision of the right colon (reserve area for reabsorption of water and ions) and of the terminal ileum (a site specialized in absorption of vitamin B12 and bile salts). PMID- 1769095 TI - Long-term ethanol-exposure markedly changes the cellular composition of cerebral glial cultures. AB - The vulnerability of morphologically distinct glial subpopulations to ethanol toxicity was surveyed in tissue culture. Secondary cultures of rat glia were examined at intervals during 56 days of ethanol treatment for changes in growth and cellular characteristics. Beginning at 6 days in vitro (DIV), the experimental cultures were treated with either 0.2% or 0.5% (w/v) ethanol in the medium; control cultures received ethanol-free medium. Relative to control cultures, the ethanol-treated cultures exhibited a consistent and dose-dependent suppression in cell number. The development of these cultures was documented with sequential phase-contrast photomicrography. Prior to treatment day 5 (11 DIV), the preponderance of cells were epithelioid in configuration; the astrocytic character of these cells was verified by the immunocytochemical localization of glial fibrillary acidic protein. In control cultures, a subpopulation of process bearing cells was acquired gradually during the first 3 weeks in culture. The majority of these process-bearing cells were considered to be oligodendrocytes due to their position above the astrocytic carpet and by the immunocytochemical localization of galactocerebroside. Exposure to 0.5% ethanol markedly suppressed the acquisition of process-bearing cells. This ethanol-related suppression of process-bearing cells was apparent in the photomicrographic records of culture development and was confirmed by differential cell counts after 50 days of treatment. These results suggest a possible differential sensitivity of oligodendrocytes of their precursors to ethanol toxicity at elevated (0.5% w/v) concentrations. PMID- 1769096 TI - Differential modulation of the cholinergic activity of rat CNS neurons in culture. AB - Treatment of septal cultures prepared from 17-day-old embryos with two different antimitotic agents, cytosine arabinoside (ara C) and 5'-fluoro-2'-deoxyuridine (FUdR), caused a 2-fold increase in the level of choline acetyltransferase (CAT) activity and no change in the glutamic acid decarboxylase (GAD) activity. In these cultures, there was also a large decrease in the number of astrocytes as determined by immunofluorescence for glial fibrillary acidic protein (GFAP). Furthermore, when epidermal growth factor (EGF) was added to the septal cultures to increase the astrocyte population, the CAT activity decreased. Therefore, it would appear that the astrocytes are responsible for producing this down regulation on cholinergic neurons. In order to determine whether all CNS cholinergic neurons can be inhibited in this manner, cultures were prepared from two other CNS regions that contain a high percentage of cholinergic neurons, i.e. the striatum and the ventral spinal cord. When these cultures were treated with the antimitotic agents, there was little modification of the CAT or GAD activities. These results suggest that the astrocytic microenvironment of the septal neurons exerts an inhibitory effect on the CAT activity either via a soluble factor or via cell-cell contact. Such studies are an important demonstration that non-neuronal cells may alter cholinergic properties during CNS development. PMID- 1769097 TI - Development of choline acetyltransferase-immunoreactive neurons in normal and intracranially transplanted retinas in rats. AB - Retinas from embryonic day 14 (E14) Sprague-Dawley rats were transplanted to the tectum of newborn (P0) recipient rats, and the distribution pattern of choline acetyltransferase immunoreactivity (ChAT-I) in developing transplants was studied and compared with those observed in the retinas of normal developing rats. In normal retinas, ChAT-I cells were first identified in restricted regions in the ganglion cell layer (GCL) at P4, but were found to cover the entire GCL by P6. A second population of ChAT-I cells was detected in the inner nuclear layer (INL) at P8, and they were observed in most parts of the INL on P10 when two immunoreactive sublaminae began to appear in the inner plexiform layer (IPL). The adult pattern of having two distinct populations of ChAT-I cells, organized in mirror symmetrical fashion in the inner retinal layers was basically established by P12. The time course of development and overall distribution pattern of ChAT-I cells in developing retinal transplants on the whole were very similar to those observed in normal retinas. The first identification of these cells and the establishment of their final distribution pattern were made at stages corresponding to P4 and P12 of normal developing retinas respectively. However, ChAT-I somata were located in the INL at a much earlier stage compared with their counterparts in the normal retina, and a transient population of immunoreactive cells with their processes extending to retinal layers other than the IPL was observed in some transplants from P6 to P10. These features were not observed in normal developing retinas. These results suggest that the development of cholinergic neurons, especially the expression of their characteristic antigen and their final distribution pattern is largely determined by programmes which are intrinsic to the original retinal tissue, despite some minor deviation or variation in the developmental process which may occur under certain abnormal conditions. PMID- 1769098 TI - Postnatal development of cat hind limb motoneurons supplying the intrinsic muscles of the foot sole. AB - The postnatal development of dendrite anatomy in alpha-motoneurons intracellularly labeled with horseradish peroxidase (HRP), innervating the intrinsic muscles of the sole of the foot (IFS MNs) in the cat, was investigated. The number of dendrites per neuron was about 11 and did not change from birth to adult. The number of branches per dendrite decreased during the same period by 20 25%. The net elimination of dendritic branches appeared to occur at distal branching points, as revealed by topological analysis. The dendritic branching pattern tended to be asymmetric at birth and the net decrease in dendritic branching postnatally did not alter this pattern. The length of preterminal branches (PTB) increased by a factor of 2, while terminal branch (TB) length increased by a factor of 3.3 postnatally. The large increase in TB length was attributed to both longitudinal growth and an apparent lengthening caused by resorption of distal branches during development. Dendritic length in the transverse spinal cord plane increased in parallel with the overall growth of the parent spinal cord segment, while dendritic growth along the rostro-caudal axis exceeded, by about one order of magnitude, dendritic growth in the transverse plane. Average branch diameter doubled from birth to adult. The decrease in branch diameter across branching points did not obey satisfactorily to the 'power rule' of Rall. However, the 1.5 power ratio of daughters-to-parents branch dropped from 1.18 to 1.08 between 3 weeks of age and adult. Tapering was evident in both PTBs and TBs. The rate of taper did not change postnatally. From birth onwards, 'local' branch diameter correlated closely with amount of membrane area and combined length of the dendritic branches located distal to the 'supporting' parent branch. These relations were similar in all age groups and are suggested to be properties intrinsic to the IFS MNs. The local branch diameter also co varied with the number of distal dendritic branches, but in this case there was a systematic shift in the relationship with increasing postnatal age. It appears that the local diameter in IFS MN dendrites is a key indicator of the size of the distal dendritic arborization. PMID- 1769099 TI - Immunoaffinity purification and dose-response of cholinergic neuronal differentiation factor. AB - A glycoprotein from heart cell-conditioned medium, cholinergic neuronal differentiation factor (CDF), causes a transition from noradrenergic to cholinergic phenotype in cultured rat sympathetic neurons. Although the transition has been known to occur in a dose-dependent manner and CDF has been purified, the examination of a complete dose-response of neurons to CDF has not been possible because sufficient quantities of pure CDF have not been available. A complete dose-response curve is essential for evaluating the biological response of the neurons, for assessing the physiological role of CDF and for understanding the mechanism of action of CDF. We report here an immunoaffinity purification procedure for CDF with a 73.1% recovery using antibodies raised against a synthetic peptide homologous with the N-terminal region of CDF. This method produced pure CDF in quantities sufficient for examination of the full dose-response range of the neurons. Our main findings are the following. The dose responses of acetylcholine and catecholamine metabolisms to CDF are different, although the same molecule affects both transmitters. While the half-maximal concentrations for acetylcholine induction (0.20 nM) and for catecholamine suppression (0.28 nM) are similar, the response of catecholamine metabolism begins slowly and saturates at a CDF concentration (5-20 nM) considerably higher than that of acetylcholine (0.6 nM). This may indicate that CDF affects multiple processes in catecholamine metabolism. PMID- 1769100 TI - Differential development of insulin-like growth factor-I binding in the hypothalamus of hamster and rat. AB - We investigated the binding of [125]insulin-like growth factor-I ([125I]IGF-I) within the hamster suprachiasmatic nucleus (SCN) and median eminence (ME) by quantitative autoradiography and compared the development of binding to the same regions in the rat. Binding in the hamster SCN was to a single class of sites (estimated Kd = 6 x 10(-10) M). Binding in the ME was approx. 1.5-fold that of the SCN. Full displacement of binding from the SCN and ME of adults and neonates was achieved by 10(-8) M IGF-I, 10(-8) M IGF-II or 10(-6) M insulin. Binding within the hamster SCN was evident by E15, peaked between P5 and P7 and decreased to adult levels by P20 while binding in the rat SCN peaked perinatally and declined to adult levels by P6. Binding in the hamster ME was evident at P4, peaked by P12 and decreased to adult levels by P20 while binding in rat ME was present by P2, peaked by P7 and declined to adult levels by P9. These results demonstrate a different developmental time course for [125I]IGF-I binding between the SCN and ME of hamster and rat. The peak binding in the SCN of each species correlates with previously reported time courses for onset of retinohypothalamic innervation of the SCN. Further study of IGFs in these regions may help elucidate the developmental role of brain IGFs. PMID- 1769101 TI - Developmental change of cholinergic activity in the forebrain of the zebra finch during song learning. AB - Song learning in the male zebra finch closely correlates with the development of song-control nuclei, the high vocal center (HVc), the robust nucleus of the archistriatum (RA) and the lateral magnocellular nucleus of the anterior neostriatum (IMAN). We previously found that acetylcholine (ACh) content increases transiently in the RA during the sensitive period of song learning. In the present experiment, development of cholinergic neurons by immunohistochemical methods using monoclonal choline acetyltransferase (ChAT) antibodies, and enzymic activity of ChAT and acetylcholinesterase (AChE) were examined in the RA during the sensitive period of song learning. The developmental change of ChAT activity in the RA was closely parallel to that of the ACh concentration. On the other hand, the density of ChAT-immunoreactive fibers changed little in the RA. This indicates that the transient increase of ACh content during the sensitive period is due to ChAT activity, but not to the increasing density of the cholinergic fibers. The ACh in the RA might be related to plastic changes in the synapse of RA neurons. PMID- 1769102 TI - Differential expression of the beta I- and beta II-PKC subspecies in the postnatal developing rat brain; an immunocytochemical study. AB - Differential expression of protein kinase C subspecies, beta I- and beta II-PKC, derived from a single gene by alternative splicing was evidenced in the postnatal developing rat brain. Immunoblot analysis of the PKC subspecies in the whole developing brain showed that beta I-PKC was present at birth and then gradually increased, while beta II-PKC was not present at birth or on postnatal day 3, then increased rapidly from day 7 to the maximum value seen in the adult brain. Under light microscopy, beta I-PKC immunoreactivities seen at birth were the most intense in the brainstem and intense in the diagonal bundle and globus pallidus. beta I-PKC immunoreactivities in these neurons weakened from day 7 and disappeared in the adult brain, while in the cerebral cortex, triangular septal nucleus and pontine nucleus beta I-PKC immunoreactivities were week at birth and then gradually increased. beta II-PKC immunoreactivities were first visible in neurons on day 7 and increased progressively. beta I- and beta II-PKCs were not co-localized in a neuron, as far as examined. The immunoreactivities of beta I PKC at birth were localized in growth cone-like structures as well as in the dendrites and perikarya. Similarly, alpha-PKC was also present at birth in the growth cone-like structure. Immunoblot analysis revealed that beta I-PKC was present at birth in the growth cone-rich fraction from the hindbrain but not in that from the forebrain, while alpha-PKC was found in the growth cone-rich fraction from both the forebrain and the hindbrain. beta II- and gamma-PKC were not detected in the growth cone-rich fraction from either forebrain or hindbrain. These findings suggest that beta I- and beta II-PKC play a role in different stages of development and in different neurons; both beta-subspecies may be involved in postnatal developing neuronal functions while only beta I-PKC plays functional roles in the growth cone, in the prenatal developmental stage. PMID- 1769103 TI - Characterization of opioid-dependent glial development in dissociated and organotypic cultures of mouse central nervous system: critical periods and target specificity. AB - Opioid-dependent changes in glial growth were characterized in primary dissociated and organotypic explant cultures of the developing mouse central nervous system (CNS) continuously grown in the presence of an endogenous opioid, [Met5]enkephalin, or an opiate drug, morphine. The glia in dissociated, astrocyte enriched cultures derived from the cerebra of postnatal day 1, 3, or 5 mice, respectively, displayed age-dependent reductions in glial numbers that occurred at 3, 7, or 9 days in vitro (DIV) in response to continuous [Met5]enkephalin (10( 6) M) exposure. In contrast, in cultures derived from gestational day 19 mice, glial numbers were not reduced following continuous exposure to 10(-6) M [Met5]enkephalin during the first 7 days in vitro. An examination of [3H]thymidine incorporation by glial fibrillary acidic protein-(GFAP) immunoreactive astrocytes with flat (type 1) morphology in dissociated cultures derived from postnatal day 1 mice revealed that the reduction in glial numbers at 3 DIV was not immediately preceded by a reduction in the rate of [3H]thymidine incorporation at 2 DIV, although previous studies have shown that opioids inhibit the rate of [3H]thymidine incorporation by more mature astrocytes at 4 or 6 DIV. Early (i.e., at 2 to 3 DIV) changes in glial numbers may result from an inhibition of the proliferative rate of non-GFAP-containing glia or astrocyte precursors, or an enhanced rate of glial death. The rate of [3H]thymidine incorporation by GFAP-immunoreactive astrocytes with process-bearing (type 2) morphology was unchanged by opioid treatment. In separate experiments, a comparison of the area of growth of GFAP-immunoreactive astrocytes in paired symmetrical (right vs left) organotypic explant cultures demonstrated that opiates (i.e., 10(-5) M morphine) can inhibit astrocyte growth when the normal histiotypic organization of neurons and glia are maintained, and that there are regional differences in astrocyte responsiveness. Opioid-dependent alterations in astrocyte growth were mediated through specific opioid receptors since they were prevented by simultaneous treatment with (-)naloxone. The results suggest that the ability of opioids to modify glial growth is highly selective and varies depending on astrocyte type, as well as temporal and regional factors. Spatial and temporal differences in the response of developing glia to opioids may determine critical periods of CNS vulnerability to opioids in the maturing brain. PMID- 1769104 TI - Effects of basic fibroblast growth factor on survival and choline acetyltransferase development of spinal cord neurons. AB - To investigate the biological role of basic fibroblast growth factor (bFGF) for the development of the spinal cord we studied the in vitro and in vivo effects of this protein on survival and choline acetyltransferase (ChAT)-activity of embryonic chick and rat spinal cord neurons. In vitro, bFGF (ED50 1-2.8 ng/ml) supported the survival of embryonic neurons from the ventral part of the rat spinal cord (ventral spinal cord, vsc), including motoneurons. Addition of bFGF (100 ng/ml) increased the ChAT-activity in embryonic chick vsc cultures to 150% as compared to untreated cultures (100%). The effect of bFGF was dose-dependent. In vivo-application of bFGF resulted in a similar increase of ChAT-activity in chick spinal cord. Since bFGF stimulates the ChAT-activity of spinal cord neurons in vivo and in vitro we therefore conclude that this protein may have a physiological function for the transmitter development of cholinergic spinal cord neurons. PMID- 1769105 TI - Afterpotential characteristics and firing patterns in maturing rat hippocampal CA1 neurones in in vitro slices. AB - The postnatal evolution of depolarizing after-potentials (DAPs) and after hyperpolarizations (AHPs) was studied in rat CA1 hippocampal neurones (5-68 days of age) using in vitro slices. Results were pooled into 4 age groups: P5-9, P10 16, P17-24 and P26-68. In P5-9 cells, DAPs were seen as passive signals, with a time constant similar to the time constant of the membrane. The evolution of the DAP was characterized by a decrease in amplitude, an increase in duration and a change in contour. In P10-16 and P17-24 cells, the DAPs often had a plateau or a hump-like shape which increased the probability of firing and the occurrence of spike doublets. The firing pattern and bursting behaviour of P10-16 CA1 neurones differed from the pattern typical of the adult. P5-9 and P10-16 cells had post burst AHPs with a smaller amplitude and a more prolonged early phase than at late stages of development. PMID- 1769106 TI - Striatal dopamine release in vitro from immature male rats shows enhanced responsiveness to pulsatile, but not continuous, infusions of L-dopa. AB - In the present experiment we compared the effects of continuous versus pulsed infusions of L-beta-3,4,dihydroxyphenylalanine (L-DOPA) upon dopamine and 3,4 dihydroxyphenylacetic acid (DOPAC) release in vitro from superfused corpus striatal tissue fragments of immature (25-32 day) and adult (90-120 day) male rats. In response to two pulse infusions of L-DOPA (5 microM) a significantly greater amount of dopamine and DOPAC was released from the striatal fragments of immature vs adult males. In contrast, when L-DOPA was infused continuously throughout the superfusion virtually identical amounts of dopamine and DOPAC were obtained for immature and adult male rats. No differences in postsuperfusion dopamine tissue content were obtained between adult and immature rats following the two pulses or continuous infusion of L-DOPA. These results suggest that the corpus striatum of the immature rat has an enhanced capacity to convert and release dopamine in response to a submaximal pulsatile infusion of L-DOPA. PMID- 1769107 TI - Methylmercury induced alterations in the nerve growth factor level in the developing brain. AB - Pre- and early postnatal stages in the development of the central nervous system (CNS) are very sensitive to the toxic effects of methylmercury. The influence of methylmercury on the level of nerve growth factor (NGF) during the development of CNS was studied. Sprague-Dawley rats were exposed indirectly throughout the fetal and suckling periods until weaning on postnatal day 25 (P 25) via their dams given methylmercury in the diet (3.9 mg/kg diet). In addition, after weaning offsprings were exposed directly to methylmercury via the diet until postnatal day 50 (P 50). The level of NGF was analyzed in cortical areas and in the septum with a sensitive enzyme immunoassay. The pups exposed to MeHg exhibited a 50% elevation in the level of NGF in the hippocampus on P 25 and P 50 compared to control animals. Concomitantly, the level of NGF decreased by 30% in the septum on P 25 and P 50, suggesting that the retrograde transport of NGF from hippocampus to septum could be affected by the exposure of methylmercury. The exact mechanism by which the low level of mercury is affecting the NGF concentration in the developing brain is yet unknown. The increase of NGF in the hippocampus and the decrease of NGF measured in the septum could reflect altered conditions for neurotrophic support in these areas of the brain as a result of the exposure to heavy metal. Thus, this finding might indicate a connection between exposure of heavy metals and neurodegeneration, such as that found in the basal forebrain in Alzheimer's disease. PMID- 1769108 TI - Immunological studies of plasma cholinesterase during pregnancy and the puerperium. PMID- 1769109 TI - O-(2,3,4,5,6-pentafluorobenzyl)oxime-trimethylsilyl ester derivatives for sensitive identification and quantitation of aldehydes, ketones, and oxoacids in biological fluids. PMID- 1769110 TI - Affinity electrophoresis of alkaline phosphatase using polyacrylamide gels. AB - A method is described for the separation of liver and bone isoenzymes of alkaline phosphatase in serum using wheat germ lectin affinity electrophoresis in a polyacrylamide gel matrix. The electrophoretic mobilities of liver and intestinal isoenzyme are essentially not affected by lectin, but the bone enzyme is retarded and separated from the liver fraction. Affinity electrophoresis in polyacrylamide gel, combined with agarose gel electrophoresis, and a solid-phase linked antibody precipitation procedure for intestinal alkaline phosphatase allowed the various isoenzyme fractions, biliary, liver, bone and intestinal, to be quantitated. PMID- 1769111 TI - Spectrofluorimetric determination of urinary p-aminobenzoic and p-aminosalicylic acids in the BT-PABA/PAS test of pancreatic function. AB - Spectrofluorimetry was investigated as an alternative to HPLC for determining p aminobenzoic acid and p-aminosalicylic acid in the N-benzoyl-L-tyrosyl-p aminobenzoic acid/p-aminosalicylic acid test of pancreatic exocrine function. Urine specimens were hydrolysed for 30 min in 4 M NaOH at 100 degrees C. The fluorescence of p-aminobenzoic acid was measured in dimethyl sulphoxide solution (lambda ex = 300 nm, lambda em = 340 nm) and that of p-aminosalicylic acid in sodium acetate buffer, pH 4.0 (lambda ex = 297 nm, lambda em = 394 nm). The linear range was 0.038-8 mM for p-aminobenzoic acid and 0.051-12 mM for p aminosalicylic acid, within-batch precision was 2.2% and 5.5%, respectively, and the entire analysis could be completed within 40 min. Although not eliminated, drug interference was greatly reduced in comparison with colorimetry. In 23 consecutive pancreatic function tests there was an excellent correlation between the p-aminobenzoic acid/p-aminosalicylic acid excretion index obtained by fluorimetry and the results from HPLC analysis (y = 0.914x + 0.070, r = 0.987, p less than 0.001). The method is simple, cost-effective and may be particularly valuable in developing countries having a high incidence of chronic pancreatitis. PMID- 1769112 TI - Studies on the effects of aminopterin and methotrexate on the release of prostaglandin PGE2, PGD2, and PGI2 from small intestine in the rat in vivo. PMID- 1769113 TI - Bile acid and phospholipid fatty acid composition in bile of patients with cholesterol and pigment gallstones. AB - It has been previously reported that patients with cholesterol gallstones have increased biliary deoxycholate and arachidonate content as compared with normal subjects without gallstones. Increased biliary deoxycholate and arachidonate content might be a primary factor in the pathogenesis of cholesterol gallstones or merely an epiphenomenon due to the presence of gallstones. We therefore compared biliary bile acid composition in 46 patients with cholesterol gallstones and 22 patients with pigment stones. In addition, biliary phospholipid fatty acid composition was determined in 44 of these patients (30 cholesterol and 14 pigment stone patients). No significant differences were detected. In particular, the percentage deoxycholic acid (mean +/- SD: 20.3 +/- 8.8% and 21.5 +/- 10.9% respectively) and the percentage arachidonic acid (4.4 +/- 2.0% and 4.5 +/- 2.2%, respectively) were very similar. A significant correlation between age and biliary cholesterol saturation index was found only for the group of patients with pigment stones (R = 0.52, p less than 0.02). In conclusion, the present study does not support a primary role for increased biliary deoxycholic acid or arachidonic acid in the pathogenesis of cholesterol gallstones. PMID- 1769114 TI - A photometric assay for hydrogen peroxide production by polymorphonuclear leucocytes. PMID- 1769115 TI - Isotransferrins and pregnancy: a study in the guinea pig. AB - During pregnancy the serum isotransferrin pattern changes towards transferrins with more complex carbohydrate chains. The main pregnancy-related isotransferrin (TfFast) and the most common isotransferrin in the non-pregnant guinea pig (TfSlow) were isolated and characterized. TfSlow had one biantennary- and TfFast one triantennary glycan chain. Is there a functional explanation for this pregnancy-related shift towards more complex glycan chain structure? We studied this question in the context of maternal and fetal erythropoiesis. In vitro incubations of maternal bone marrow cells (MBMC) and fetal erythroid liver cells (FELC) with doubly labelled TfSlow and TfFast revealed only slight differences in affinities for the transferrin receptor. Ka(TfSlow) = 0.17 mumol/l; Ka(TfFast) = 0.15 mumol/l. MBMC and FELC had equal Vmax values both for TfSlow and TfFast. Vmax = 100 Fe atoms/transferrin receptor.hour. Irrespective the cell population TfSlow and TfFast showed equal rates for endo- and exocytosis. kendo. = 0.3750 min-1, kexo. = 0.1450 min-1. It is concluded that the described shift in isotransferrin pattern is not functionally related to maternal or fetal erythropoiesis. PMID- 1769116 TI - Further data on an RIA kit for the direct measurement of free testosterone in plasma. PMID- 1769117 TI - Micromethod for the assay of glutamate: glyoxylate aminotransferase and modifications of a micromethod for the assay of alanine: glyoxylate aminotransferase. Implications for the prenatal diagnosis of type I hyperoxaluria by fetal liver biopsy. PMID- 1769118 TI - Specific diagnosis of medium-chain acyl-CoA dehydrogenase (MCAD) deficiency in dried blood spots by a polymerase chain reaction (PCR) assay detecting a point mutation (G985) in the MCAD gene. AB - The discovery of a point-mutation, adenine-to-guanine, at position 985 in the gene coding for MCAD (G985), gave the basis for an easy and specific polymerase chain reaction test. We tested the specificity of such a PCR based assay and detected correctly G985 and A985 in sequence verified cDNA clones. We showed that the G985 mutation is present in genomic DNA from 48 of 50 patients with confirmed MCAD deficiency, originating from various European countries, Australia and the USA. On the basis of this high frequency of the G985 mutation among patients, we improved and optimized the assay with respect to reliability and convenience for routine diagnostic and screening purposes. As little as 2 microliters blood from filter-paper blood-spots (Guthrie spots) is sufficient for the test. PMID- 1769119 TI - Interest of zinc determination in leucocyte fractions for the assessment of marginal zinc status. AB - In order to test the sensitivity of leucocyte zinc determination in the assessment of zinc status, an isolation procedure of mononuclear (MNC) and polymorphonuclear (PMNC) cell fractions was developed. Zinc concentrations in cells from healthy subjects were (mean +/- SD, in mumol/10(10) cells): 0.81 +/- 0.24 in MNC and 0.55 +/- 0.06 in PMNC. In patients suffering from several diseases known to be associated with a marginal impairment in zinc status (cirrhosis, cancer, obesity, endocrine and rheumatic diseases), these concentrations did not differ from those in controls except in rheumatic patients in whom MNC zinc was increased (1.05 +/- 0.42 mumol/10(10) cells) and correlated with erythrocyte sedimentation rate (r = 0.41, P less than 0.01). This relation was also significant in the whole study population (r = 0.39, P less than 0.01). Leucocyte zinc therefore appears to have a limited value in the assessment of marginally impaired zinc status, except in inflammatory states. PMID- 1769120 TI - Aminoterminal propeptide of type III procollagen in cerebrospinal fluid. Variation with age and in childhood leukemia. AB - Analyses of the aminoterminal propeptide of type III procollagen (PIIINP) in the cerebrospinal fluid (CSF) of 55 children and five young adults without any structural central nervous system (CNS) lesion are reported. The concentration was age-dependent, in that infants and small children had quite high values, whereas the concentration remained relatively constant after the age of 1.5 years. The concentrations of PIIINP in the CSF of 44 children with acute lymphoblastic leukemia (ALL) were prospectively determined at the time of diagnosis and during treatment, since deposition of type III collagen is known to occur during fibroproliferative responses triggered by inflammation. Chemical arachnoiditis is known to be associated with intrathecal methotrexate therapy in children with leukemia. The mean concentration in these children at diagnosis (5.8 micrograms/l +/- SD 2.8 micrograms/l) did not differ from that in age matched controls (6.7 micrograms/l +/- SD 3.2 micrograms/l). Depending on type of the disease, the children were treated according to two different protocols. PIIINP concentrations were significantly higher during the therapy phases which included intrathecally administered methotrexate (P less than 0.001) than at diagnosis of the disease. Corticosteroid treatments were always associated with a significant decrease in PIIINP concentrations (P less than 0.01 and P less than 0.001 in the two groups, respectively), irrespective of the therapy phase. The results suggest that an increase in PIIINP concentration in the CSF of children with ALL is an indicator of a fibroproliferative response in the arachnoid. Corticosteroids may repress this response and possibly also prevent the development of adhesions in the arachnoid. PMID- 1769121 TI - Increased concentrations of endogenous 13-cis- and all-trans-retinoic acids in diffuse idiopathic skeletal hyperostosis, as demonstrated by HPLC. AB - Endogenous 13-cis- and all-trans-retinoic acids have been quantitated in human serum using a solvent extraction procedure followed by isocratic reversed phase high performance liquid chromatography and UV detection. In healthy adults, after an overnight fasting period, the concentrations of 13-cis- and all-trans-retinoic acids yielded 5.3 +/- 2.43 nmol/l and 11.8 +/- 3.3 nmol/l, respectively (mean +/- SD). The method has been successfully applied to the analysis of both isomers in serum from patients with idiopathic skeletal hyperostosis in whom, the 13-cis- as well as all-trans-retinoic acid levels were raised as compared to the control group. PMID- 1769122 TI - Synthesis of 13C-labeled chenodeoxycholic, hyodeoxycholic, and ursodeoxycholic acids for the study of bile acid metabolism in liver disease. AB - In order to study the glycosidic conjugation of chenodeoxycholic, hyodeoxycholic, and ursodeoxycholic acids in patients with cholestasis after oral administration of pharmacological amounts of the respective bile acids avoiding the application of radioactive tracers we synthesized [24-13C]chenodeoxycholic, [24 13C]hyodeoxycholic, and [24-13C]ursodeoxycholic acids. The reaction intermediates of the bile acid syntheses were characterized by infrared spectroscopy. Purity was confirmed using thin-layer chromatography as well as gas chromatography-mass spectrometry. The 13C atom excess of approximately 90% of the synthesized bile acids was the same as the 13C atom excess of the sodium [13C]cyanide used for the labeling reaction confirming the successful synthesis. After oral administration of 0.5 g of [24-13C]ursodeoxycholic acid to a healthy volunteer, 13C label was detected in the nonamidated and glycine- or taurine conjugated glucosides and the N-acetylglucosaminide of ursodeoxycholic acid in urine. This establishes ursodeoxycholic acid as the first bile acid so far known to undergo both of the recently described glycosidic conjugation reactions in humans. PMID- 1769123 TI - Refinement of a specific assay for hydroxyproline in urine. PMID- 1769124 TI - Rapid quantitation of serum myoglobin by latex agglutination turbidimetry. PMID- 1769125 TI - A discrepancy between in vivo and in vitro lipoprotein lipase activity in a patient with Tangier disease. PMID- 1769126 TI - Growth hormone and adult bone remodelling. PMID- 1769127 TI - The effect of growth hormone (GH) therapy on urinary pyridinoline cross-links in GH-deficient adults. AB - OBJECTIVE: The aim was to study the effect of growth hormone (GH) on new markers of bone resorption (fasting urinary excretion of pyridinium cross-links (pyridinoline and deoxypyridinoline)) in GH-deficient adults. DESIGN: Randomized, double-blind, placebo-controlled cross-over study. The treatment periods (GH 2 IU/m2 subcutaneously, or placebo daily for 4 months) were separated by a 4-month washout period. PATIENTS: Twenty GH-deficient adults (aged 18-39). MEASUREMENTS: Blood and fasting urine samples were collected at the end of each 4-month treatment period. Plasma bone Gla protein was measured by radioimmunoassay and urine pyridinoline and deoxypyridinoline were measured by spectrofluorometry after high performance liquid chromatography and corrected for urinary creatinine. RESULTS: GH increased fasting urinary excretion of pyridinoline (287 +/- 123%, P less than 0.001) and deoxypyridinoline (313 +/- 140%, P less than 0.001). The GH-induced increment in these parameters correlated with the increase seen in plasma bone Gla protein (r = 0.83-0.86, P less than 0.001). CONCLUSION: Four months of GH substitution in GH-deficient adults increases bone resorption as well as bone formation. The effect on bone mass has yet to be assessed. PMID- 1769128 TI - Influence of sodium valproate on late follicular phase pulsatile LH secretion in normal women. AB - OBJECTIVE: To study whether modulation of the GABAergic system (with sodium valproate) affects pulsatile LH secretion in the late follicular phase of normal women. DESIGN: Fifteen normal women volunteers were studied over an 8-hour period in the late follicular phase of two successive menstrual cycles. On each occasion, blood samples were taken every 10 minutes between 1000 and 1800 h. Nine of the volunteers--the short treatment group--were administered 400 mg of sodium valproate every 8 hours on the two days preceding their second session, and a further 400 mg at 0900 h on the day of the session. The other six--the long treatment group--were administered 400 mg of sodium valproate every 8 hours on the seven days preceding their second session and at 0900 and 1400 h on the day of the session. MEASUREMENTS: LH, oestradiol and progesterone were determined by radioimmunoassay, and sodium valproate by repolarization fluorescence spectrophotometry. Pulse detection was carried out both by the program ULTRA and by a method developed by the authors. RESULTS: There were no significant differences in LH pulse amplitude or relative pulse amplitude between records taken in the first and second menstrual cycles, i.e. without or with prior sodium valproate treatment. Short treatment did change interpulse interval and mean secretion period, but the changes, though statistically significant, were small (about 10 minutes), so that the values for both post-treatment and control sessions were within the normal range; these parameters were unaffected by long treatment. CONCLUSIONS: Activation of the GABAergic system with sodium valproate had no biologically significant effect on the late follicular phase pulsatile LH secretion of these normal women. PMID- 1769129 TI - Corticosteroid-induced growth hormone secretion in normal and obese subjects. AB - OBJECTIVE: In normal subjects, corticosteroids stimulate growth hormone (GH) secretion at 3 hours. Obesity is associated with blunted GH secretion. In order to clarify both the deranged mechanism of GH secretion in obesity and the corticosteroid mechanism of action we have assessed in normal and obese subjects the effects of dexamethasone, pyridostigmine (a drug capable of suppressing somatostatin release) and GHRH. We also compared in normal subjects the stimulatory effect of three different corticosteroids on plasma GH levels. DESIGN: In both normal and obese subjects the following tests were carried out: placebo; dexamethasone alone (4 mg i.v. at 0 minutes); and dexamethasone plus pyridostigmine (120 mg p.o. at 60 minutes). In normal subjects we also studied the effects of hydrocortisone (100 mg i.v. at 0 minutes) and deflazacort (a corticosteroid that does not cross the blood-brain barrier) (60 mg i.v. at 0 minutes). In obese subjects we also assessed the effect of dexamethasone plus GHRH (100 micrograms i.v. at 150 minutes) on plasma GH levels. PATIENTS: Ten normal subjects and 22 obese subjects were studied. Normal controls were within 10% of their ideal body weight. Obese subjects had a body mass index of 37.1 +/- 1.1 (mean +/- SEM). MEASUREMENTS: Plasma GH levels were measured by radioimmunoassay. RESULTS: Dexamethasone-induced GH secretion in normal subjects (28.6 +/- 7.8 millimicron/l, P less than 0.05). Corticosteroids did not alter GH levels in obese subjects. Pretreatment with pyridostigmine increased dexamethasone-induced GH release in normal subjects (40.8 +/- 6.8 millimicron/l) but this did not achieve statistical significance. Dexamethasone plus pyridostigmine did not alter GH levels in obese subjects (8.0 +/- 1.6 mU/l). In some subjects, dexamethasone pretreatment potentiated GHRH-stimulated GH secretion, while in half the subjects the basal GH levels were not altered. In control subjects, hydrocortisone and deflazacort caused GH release similar to dexamethasone. CONCLUSIONS: Corticosteroids are a new and selective stimulus of GH secretion. They do not cause GH release in obese subjects. Their relative independence from cholinergic control suggest that they act by reducing somatostatin secretion. PMID- 1769130 TI - Effects of pyridostigmine on spontaneous and growth hormone-releasing hormone stimulated growth hormone secretion in children on daily glucocorticoid therapy after liver transplantation. AB - OBJECTIVES: We aimed to investigate both nocturnal spontaneous and morning growth hormone (GH)-releasing hormone (GHRH)-induced GH secretion in children on daily glucocorticoid treatment after liver transplantation and to evaluate the effect of pyridostigmine (an acetylcholinesterase inhibitor thought to reduce hypothalamic somatostatin tone) on GH secretion in these patients. DESIGN: We performed a randomized, single-blind, cross-over study. PATIENTS: We studied three male and three female juvenile patients, within a year of orthotopic liver transplantation and under immunosuppressive glucocorticoid therapy (mean dose +/- SEM, 5.92 +/- 0.63 mg/day) and five normal children (four males, one female). MEASUREMENTS: Both nocturnal spontaneous and morning GHRH-induced GH secretion were evaluated after administration of placebo, 1 tablet p.o., or pyridostigmine, 2 mg/kg p.o. RESULTS: Spontaneous GH. Placebo: in liver transplanted children nocturnal GH secretion (mean GH level 10.8 +/- 2.0 mU/l) was not significantly different with respect to normal children (mean GH level 12.8 +/- 1.2 mU/l); pyridostigmine: nocturnal GH secretion was significantly increased as compared to placebo in subjects with liver transplantation but not in normal children. GHRH test. Placebo: liver transplanted patients showed a blunted GH response to GHRH with respect to normal children; pyridostigmine: the GH responses to GHRH (P less than 0.05) increased as compared to placebo and did not differ significantly in the two groups. CONCLUSIONS: Our data suggest a steroid-mediated increase in hypothalamic somatostatin tone in liver transplanted children. PMID- 1769131 TI - Effects of ambient glycaemic state on growth hormone responsiveness in insulin dependent diabetes. AB - OBJECTIVE: We wished to examine the effects of ambient glycaemia on hypothalamic somatostatinergic tone in insulin-dependent diabetes mellitus. DESIGN: After 6 hour periods of either euglycaemia (5 mmol/l) or hyperglycaemia (15 mmol/l), exercise-induced GH secretion was measured. PATIENTS: Seven insulin dependent diabetics with no evidence of complications were recruited. RESULTS: There was no significant difference between basal GH levels during euglycaemia and hyperglycaemia (5.50 vs 5.53 mU/l). Nor was there a significant difference when mean delta GH levels (33.9 vs 27.4 mU/l) or mean area under GH curve (2331 vs 4038 mU min/l) during euglycaemia or hyperglycaemia were compared. CONCLUSIONS: We find no evidence therefore to support short-term effects of ambient glucose concentration on GH responsiveness, and by inference no direct effect of short term changes in glycaemic control on hypothalamic release of somatostatin in the aetiology of GH hypersecretion in insulin-dependent diabetes mellitus. PMID- 1769132 TI - Naloxone does not modify fenfluramine-induced prolactin increase in obese patients. AB - OBJECTIVE: To evaluate whether the supposed physiological interaction between serotoninergic and opioidergic pathways in the modulation of PRL release is preserved in human obesity, a pathological condition in which these two systems are greatly impaired. DESIGN: According to a single-blind randomized procedure, three tests were performed: test A (oral placebo + saline infusion over 5 hours), test B (fenfluramine, a well known serotoninergic drug, 60 mg orally + saline infusion over 5 hours) and test C (fenfluramine at the same dose + naloxone, an opiate receptor antagonist, infusion over 5 hours at a dose of 3 mg/h). PATIENTS: Ten obese women (body mass index 34.4 +/- 2.3 kg/m2, mean +/- SE) and ten normal weight sex and age-matched subjects (body mass index 22.3 +/- 2.4 kg/m2) volunteered for the study. MEASUREMENTS: At each test, blood samples for PRL determination were collected in basal conditions (time 0) and every hour for 5 hours. Plasma PRL was determined by radioimmunoassay. RESULTS: In controls, naloxone significantly reduced the clear-cut PRL increase induced by fenfluramine. In obese patients, serotoninergic stimulation caused an increment in PRL levels similar to that in the controls, but opioid receptor blockade by naloxone did not affect this response. CONCLUSIONS: These findings confirm that there is a physiological relationship between the serotoninergic and the opioidergic systems in the control of PRL secretion and show that this interaction is not present in obese subjects. Our data provide indirect proof of the functional impairment of these two systems in human obesity. PMID- 1769133 TI - Insulin secretion, insulin sensitivity and glucose-mediated glucose disposal in Cushing's disease: a minimal model analysis. AB - OBJECTIVE: We wished to assess the contributions of insulin secretion, insulin sensitivity and glucose-mediated glucose disposal to glucose tolerance in subjects exposed to chronic glucocorticoid excess. DESIGN: Patients with Cushing's disease were subjected to a frequently sampled intravenous glucose tolerance test before and at least 3 months after curative surgery and compared to a control group. PATIENTS: Seven patients with clinical and biochemically proven pituitary dependent Cushing's disease and 10 healthy control subjects were studied. MEASUREMENTS: Paired glucose and insulin plasma profiles were analysed by the Minimal Model method of Bergman, which provided simultaneous estimates of the glucose decay rate, insulin secretion, insulin sensitivity and glucose mediated and non-insulin-mediated glucose disposal. Data were evaluated by non parametric statistical analysis and reported as median and interquartile ranges. RESULTS: Basal glucose, insulin, C-peptide and glucagon levels were significantly raised preoperatively and fell towards normal post-operatively. Glucose tolerance assessed as glucose decay rate was reduced significantly preoperatively (pre: 1.3 (0.8-2.0) vs post: 1.6 (1.5-2.6) per min x 10(2), P less than 0.05). First phase insulin release was similar in the Cushing's disease and control subjects. In contrast, second phase insulin release was significantly greater preoperatively and remained high post-operatively compared to control subjects (pre: 18.8 (16.7 23.6) vs post: 16.7 (8.5-18.8) vs control 11.1 (4.5-15.4) mU/g/min2 x 10(-2), P less than 0.002). Median insulin sensitivity was reduced by 60% preoperatively in the Cushing's disease subjects compared to the post-operative Cushing's disease and control subjects (pre: 2.1 (1.3-4.2) vs post: 5.0 (3.2-7.3) vs control 5.1 (2.2-7.2) per min/mU/l x 10(4)). Median glucose-mediated glucose disposal was reduced by 40% in the pre and post-operative Cushing's disease subjects compared to the control group (pre: 1.1 (0.6-2.1) vs post: 1.1 (0.6-2.1) vs control 1.9 (1.4-2.6) per min x 10(2)), but this was not statistically significant. However, non-insulin-mediated glucose disposal was significantly reduced in the preoperative Cushing's disease subjects (pre: 0.55 (0.08-1.59) vs control 1.43 (0.94-2.27) per min x 10(2), P less than 0.05). In the Cushing's disease subjects, glucose tolerance correlated with both insulin sensitivity (rs = 0.84, P less than 0.01) and non-insulin-mediated glucose disposal (rs = 0.56, P less than 0.05). The fractional clearance rate of insulin was unaltered by Cushing's disease. CONCLUSIONS: Cushing's disease subjects are characterized by impaired glucose tolerance due to both reduced insulin sensitivity and non-insulin mediated glucose disposal, in the presence of enhanced insulin secretion. PMID- 1769134 TI - Serum thyroglobulin measurements in thyroid cancer: evaluation of 'false' positive results. AB - OBJECTIVE: Serum thyroglobulin (Tg) should be undetectable in patients successfully treated for thyroid carcinoma. We have examined the course of disease in 19 patients with raised serum Tg (greater than 5 micrograms/l) on initial measurement but no other evidence of residual, recurrent or metastatic cancer. DESIGN: 416 patients from several centres were followed for periods between 1 and 9 years. Serum Tg was measured at 6-12-month intervals. PATIENTS: All had differentiated thyroid cancer, treated by partial or total thyroidectomy and/or 131I ablation, and were receiving suppressive thyroxine therapy. MEASUREMENT: Serum Tg was measured and clinical, X-ray and scan assessment made of presence or absence of residual, recurrent or metastatic cancer. RESULTS: Of 416 patients initially assessed, only 19 had Tg greater than 5 micrograms/l but no clinical or radiological evidence of disease. At follow-up, 11 patients had developed overt signs of malignancy; one had been treated with 131I with a subsequent fall in Tg; five had Tg between 5 and 20 micrograms/l with incompletely suppressed TSH levels; two subjects remained with slightly elevated Tg and undetectable TSH. CONCLUSION: Patients with elevated Tg require careful follow-up even in the apparent absence of disease. Moderate elevation of serum Tg may be due to inadequate thyroxine suppression therapy, assessed by detectable TSH values measured in a sensitive assay. PMID- 1769135 TI - Androgen dependent stimulation of aromatase activity in genital skin fibroblasts from normals and patients with androgen insensitivity. AB - OBJECTIVE: To measure the effect of androgens or aromatase activity as an index of androgen responsiveness in patients with androgen insensitivity. DESIGN: Genital skin fibroblasts were established in culture using primary skin explants obtained from normal males at the time of circumcision and from androgen insensitive patients who had surgery either for gonadectomy (complete androgen insensitivity syndrome) or for reconstruction of the external genitalia (partial androgen insensitivity syndrome). PATIENTS: Foreskin samples were obtained at the time of circumcision in 27 normal males. Scrotal or labia majora skin was obtained at the time of surgery from 14 patients with the complete and 22 with the partial forms of the androgen insensitivity syndrome. MEASUREMENTS: Basal and stimulated levels of aromatase activity were measured in genital skin fibroblasts following preincubation with natural and synthetic, nonmetabolizable androgens. RESULTS: Following a 48-hour preincubation with testosterone or dihydrotestosterone, there was a five to six-fold stimulation of aromatase activity in normal fibroblasts. Mibolerone, a synthetic androgen, produced similar results. The stimulatory effect was blocked by anti-androgens. Seven patients with partial androgen insensitivity, of whom four were either receptor deficient or showed a qualitative defect in androgen binding, had reduced mibolerone induced stimulation of aromatase activity. All ten patients with receptor negative complete androgen insensitivity had an absent response. There was no aromatase induction in a further three patients with complete androgen insensitivity who were receptor positive. Two siblings in the latter group had an exon deletion encoding for part of the DNA binding domain of the androgen receptor. CONCLUSIONS: Androgens stimulate aromatase activity in genital skin fibroblasts from normals. The response is mediated via the androgen receptor and can be decreased or absent in patients with the androgen insensitivity syndrome. This may be a useful in-vitro marker of androgen responsiveness in such patients. PMID- 1769136 TI - Recommendations for a revised nomenclature of thyroid autoantigens and autoantibodies. PMID- 1769137 TI - Interleukin-1 production by monocytes from patients with glomerulonephritis after stimulation in vitro with soluble immune complexes. AB - Monocytes from 30 patients with glomerulonephritis (GN) were stimulated with soluble immune complexes (IC). In order to neutralize the effect of prostaglandins, some cultures were incubated in the presence of indomethacin. Interleukin-1 (IL-1) activity was assessed by the comitogenic activity of the crude monocyte supernatants on phytohemagglutinin (PHA)-stimulated murine thymocytes. Our results demonstrate that, upon stimulation with the soluble IC monocytes from GN patients possess an enhanced capacity to produce IL-1, and the levels of IL-1 correlate with disease activity only in one case of acute poststreptococcal GN (AGN), not in all other patients. This enhanced production of IL-1 may contribute to the disordered immunoregulation in GN. PMID- 1769138 TI - Do limited changes in phosphate intake modulate 1,25(OH)2D3 levels in early renal failure? AB - A high dietary phosphate load relative to GFR is thought to explain, at least in part, diminished renal 1-alpha hydroxylase activity in early renal failure (RF). To assess the role of dietary phosphate/GFR ratio in more detail, we examined the response of 1,25(OH)2D3 concentration to a controlled isolated reduction of dietary phosphate intake for up to 10 days with no change of Ca, Na and energy intake. We studied 7 healthy controls (2 male, 5 female, median age 45 years) and 6 non-nephrotic patients with early renal failure (RF) (3 males, 3 females, median age 55 years; median Cin 60.5ml/min/1.73 m2; 41-69). During an initial 3 day period of controlled diet with usual phosphate intake no difference of UVPi (median 27.6 mmol/day, 18.9-43.8) was found between controls and RF. A diet with 15 mmol Pi/day (confirmed by duplicate meal analysis) significantly reduced median UVPi (controls: 27.7 to 11.9 mmol/d; RF 27.4 to 14.1 mmol/d) with no change of median UVCa. Median day to day variation of 1,25(OH)2D3 levels (by RIA) in controls was 15.4%. Lowering dietary phosphate intake did not significantly change median 1,25(OH)2D3 levels in controls (45.7 vs. 38.3 pg/ml) and patients with RF, respectively (23.5 vs. 19.1 pg/ml). No changes of intact iPTH values were found. The experiment had a 68% power to detect a 15% change and a 99% power to detect a 30% change at a significance level of p less than 0.05.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769139 TI - Lithium clearance in patients with chronic renal diseases. AB - The clearance of lithium was analyzed in relation to the glomerular filtration rates and the effective renal plasma flow in 41 patients with renal disease and variable degree of renal functional impairment and in 40 normal subjects. In the patients, there was on average a 35% decrease of glomerular filtration rates (109 +/- 64 [SD] ml/min) and renal plasma flow (490 +/- 275 ml/min) and a 25% decrease of lithium clearance (22 +/- 12 ml/min); the lithium clearance correlated closely with the glomerular filtration rates and renal plasma flow (r = 0.69; p less than 0.001). The absolute proximal reabsorption of fluid was decreased by 38% (89 +/- 56 ml/min) while the distal absolute reabsorption of sodium (21 +/- 12 ml/min) was unchanged. Individual values of fractional proximal or distal reabsorption as related to glomerular filtration rates or renal plasma flow were equally distributed between normal and renal subjects, except in the presence of a severe renal function impairment, where both variables decreased exponentially. This suggests that in renal failure, sodium balance is maintained by a proportional decrease of proximal and distal sodium reabsorption in relation to glomerular filtration. Only in the presence of severe renal failure (GFR less than 30 ml/min) both variables are concomitantly readjusted to lower values. PMID- 1769140 TI - Uremic autonomic dysfunction evaluated by pattern recognition analysis. AB - A pattern recognition analysis of six cardiovascular reflex tests was performed with the aim to increase their diagnostic efficiency. A normal model was defined by SIMCA method using log-transformed values of 85 healthy subjects. The model was tested with data from 60 patients with chronic renal failure. Specificity resulted 94% and sensitivity 96%. 55% of the uremics were recognized affected by autonomic damage. The method allowed a better definition of autonomic function in those patients defined as "borderline" on conventional evaluation of the tests. Pattern recognition analysis of autonomic tests provides a global assessment of all the tests performed. Its use should be encouraged as a diagnostic tool. PMID- 1769141 TI - Experience of pain after subcutaneous administration of different preparations of recombinant human erythropoietin: a randomized, double-blind crossover study. AB - Subcutaneous erythropoietin (SCEPO) is considered to be more effective than intravenously administered erythropoietin. Patient compliance with SC injections will be important in long-term therapy as there have been reports of pain associated with SCEPO. A double-blind randomized study was performed upon 18 ESRD hemodialysis patients receiving regular subcutaneous erythropoietin replacement therapy for treatment of their anemia. The study involved pain assessment by a visual analogue scale VAS and a verbal descriptive scale VDS following 2 subcutaneous injections of preparation A: rhEPO 2000 IU in 1 ml (Cilag), preparation B: rhEPO 2000 IU in 1 ml (Boehringer Mannheim) and 0.9% saline 1 ml (placebo) over a two-week period. The injections were all administered by the same person and replaced the normal EPO injections for the patient during the study period. Results by VAS and VDS based upon 107 responses showed that preparation A was significantly more painful than preparation B (p less than 0.001) or saline (p less than 0.01). An unexpected finding was that preparation B was less painful than the placebo for VAS (p less than 0.05). It seems unlikely that the erythropoietin itself was responsible for the difference. Further work will be necessary to determine the pain causing factor in preparation A, and the possible local anaesthetic factor in preparation B. PMID- 1769142 TI - Surgical treatment of massive hydrothorax complicating continuous ambulatory peritoneal dialysis. AB - Acute hydrothorax is a well-recognized complication of continuous ambulatory peritoneal dialysis and is often regarded as a contraindication to its use. We report three cases treated by surgical closure of a communication between the peritoneal and pleural cavities enabling CAPD to continue successfully. This is a simple, safe and effective procedure which merits wider use as an alternative to transferring the patient to permanent hemodialysis. PMID- 1769143 TI - X-ray microanalysis of the fingernails of uremic patients treated by hemodialysis. AB - The element content of the fingernails of 16 patients with chronic renal failure (CRF) treated by hemodialysis was examined by dispersive microanalysis. In comparison with matched controls, the results showed a statistically significant decrease in the percentage of Cu, Fe and Zn and an increase in S. The Al content did not differ significantly from that of the controls. There was no correlation between the serum values of Al, Fe and Zn and their content in the fingernails of the patients. On the other hand, Cu was found to be low both in the sera and in the fingernails of the CRF patients. PMID- 1769144 TI - Two cases with mild spontaneous peripelvic extravasation. PMID- 1769145 TI - Aztreonam for renal graft pyelonephritis. PMID- 1769146 TI - Sputum-positive lung tuberculosis after instillation of BCG for bladder cancer. PMID- 1769147 TI - [Persistent amnestic syndrome due to infarction of the genu of the left internal capsule]. AB - An 85-year-old housewife was admitted owing to the sudden onset of amnestic syndrome on June 27, 1986. There was no history of abulia or somnolence. Though she showed severe amnesia, her understanding was not impaired. There was no aphasia, no dysarthria or other focal sings. The CT showed a low density area in the genu of the left internal capsule. The patient's amnestic syndrome did not improve during the following four years and thus she was readmitted for further examination in July, 1990. Although her WAIS scores were fairly good and intelligence was considered normal, she showed very poor performance on the Wechsler memory scale-R and Benton visual retention test. MRI of the brain showed infarction which extended from the genu to the anterior limb of the left internal capsule. The longstanding amnesia in the present case was induced probably by the infarction of the genu of the left internal capsule, where some fibers of memory pathways, such as the anterior thalamic peduncle, ansa peduncularis, and stria terminalis, may pass. PMID- 1769148 TI - [A case of unilateral lingual atrophy and ipsilateral muscular atrophy supplied by trigeminal nerve--in relation to progressive facial hemiatrophy]. AB - A 39-year-old man was admitted to our hospital because of atrophy of the right side of the tongue of 6 years' duration. Neurological examination showed atrophy and fasciculations in the right side of the tongue. Magnetic resonance imaging showed atrophy and high signal intensity areas on T1 and T2 weighted images in the right masseter, temporal, lateral and medial pterygoid muscles. Electromyography showed fibrillations and positive sharp waves at rest, high amplitude polyphasic motor unit potentials with weak contraction in the right tongue and masseter muscles. Examination of autonomic functions suggested postganglionic lesion of right facial sympathetic nerves. We believe that this case may be related to progressive facial hemiatrophy. PMID- 1769149 TI - [Juvenile-onset dystonia with bilateral atrophy of the basal ganglia on MRI]. AB - A 40-year-old man was hospitalized for tremor of the right upper limb, gait disturbance and dysarthria. His course of development had been normal until the age of 14, when difficulties in speaking and walking, and tremor of the upper limb became evident following an episode of fever. His symptoms have been gradually worsening for the past 25 years. His elder sister showed similar clinical symptoms and progressive course of illness. The patient showed no indication of mental retardation. Neurological examination showed dysarthria, slow dyskinetic movement of the tongue, dystonic posture of the left hand, tremor of irregular frequency of the right upper limb, diminished tendon reflex, positive Romberg's sign, diminished vibratory and position sense in the lower limbs and pyramidal signs. Cystometry indicated defective voiding of the bladder. Magnetic resonance imaging of the brain showed bilateral atrophy of the putamina, globus pallidus, caudate nuclei and substantia nigra. MRI showed similar findings in her sister. By electrophysiological and pathological examination, disorders of other systems were evident, such as upper motor neurons, and sensory tract. GM1 and GM2 gangliosidosis appeared the most likely diagnosis, but were ruled out on the basis of the result of lysozomal enzyme assay and rectal biopsy. The present patient's condition may possibly be the result of an unknown metabolic disorder, or a new disease entity affecting various components of the nervous system. PMID- 1769150 TI - [One-and-a-half syndrome due to a brain tumor--a case report and review of the literature]. AB - A 69-year-old woman was admitted to our hospital on March 13, 1990, with a 1 month history of progressive gait disturbance. She had been operated on for colon cancer in May 1987. Examination in March 1989 revealed that she had metastatic liver tumor. On neurological examination, slight right abducens palsy, gaze evoked horizontal nystagmus to the left, upbeat nystagmus and mild left hemiparesis were noted. Two weeks after admission, right lateral gaze palsy developed. Right MLF syndrome became apparent in the 3rd week. She was diagnosed as having one-and-a-half syndrome. Left hemi-hypesthesia and left limb ataxia were noted at that time. CT scan revealed ring-enhancing mass lesions in and around the right pontine tegmentum. Two weeks after development of the one-and-a half syndrome, she became comatose with her eyes' conjugate deviation to the left and died on April 24, 1990. The metastatic lesions in both paramedian pontine reticular formation and medial longitudinal fasciculus were considered to be causative of her one-and-a-half syndrome. Clinical characteristics of 13 reported cases with one-and-a-half syndrome caused by brain tumor were reviewed. Half of them were caused by metastatic brain tumor. PMID- 1769151 TI - [A case of progressive myoclonus epilepsy with the first and second branchial syndrome]. AB - A 22-year-old woman with progressive myoclonus epilepsy associated with the first and second branchial syndrome is described. Clinical features included generalized convulsive seizure, myoclonus, cerebellar ataxia and intellectual deterioration with micrognathia and malformation of auricles. She was initially suspected of mitochondrial encephalomyopathy, but the analysis of muscle biopsy and mitochondrial enzyme activities was negative. Her micrognathia and malformation of auricles were diagnosed as the first and second branchial syndrome. The case of progressive myoclonus epilepsy associated with this syndrome has never been reported, and the relationship between them remains unknown. PMID- 1769152 TI - [A case of multiple mononeuropathy associated with pustulosis palmaris et plantaris (PPP)]. AB - A 41-year-old man with PPP since in 1982 was admitted in May, 1987, because of the progressive asymmetric sensory disturbance in the hands and feet over 4 months, accompanied by an exacerbation of PPP. On admission, eruptions of PPP were observed in the palms and soles. Asymmetric and mildly decreased sensations of touch and pain were present in the distal part of the four extremities as well as in his trunk, accompanied by paresthesia and dysesthesia. Mild to moderate weakness was noted in the hand muscles, and slight muscular atrophy was present in the right lower leg. A work-up for collagen vascular disease was within normal limits. T lymphocyte subset showed a decreased ratio of OKT 4/OKT 8. Left sural nerve biopsy showed axonal degeneration and moderate decrease of myelinated fibers, and the vasculitis was not found. The neurological signs and symptoms as well as the skin eruptions improved with methylprednisolone 40 mg/day. A causal relationship between the multiple mononeuropathy and PPP of our patient was indicated by the almost simultaneous onset of the neuropathy and the exacerbation of PPP as well as the improvement of these two conditions with corticosteroid therapy. Such combination of multiple mononeuropathy and PPP has not so far been reported. PMID- 1769153 TI - [Central motor conduction time in the pseudopolyneuritic form of amyotrophic lateral sclerosis]. AB - Central motor conduction time (CMCT) from the cerebral motor cortex to the cervical segment of the spinal cord (C-CMCT) and CMCT from the cortex to the lumbar segment of the spinal cord (L-CMCT) were estimated using percutaneous electrical cortical, cervical and lumbar stimulation in 8 patients with pseudopolyneuritic form of amyotrophic lateral sclerosis (ALS). The results were compared to those in 18 patients with bulbar and common forms of ALS and 13 normal control subjects. Both the C-CMCT and the L-CMCT were remarkably prolonged in pseudopolyneuritic form of ALS as well as in bulbar and common forms of ALS. These results were consistent with the morphological findings that the large myelinated fibres in the corticospinal tract are depleted in pseudopolyneuritic form of ALS in which deep tendon reflexes are hypoactive and pyramidal sings are not obvious. The evaluation of CMCT is suggested to be useful for diagnosis of ALS in which upper motor neurone disorder is not manifested. PMID- 1769154 TI - [A case report of a patient with sequelae of SMON and painful tonic seizure]. AB - We reported a case with sequelae of SMON and painful tonic seizure (PTS). The patient was a 50-year-old woman. Onset of SMON was when she was 28 years old. She has been suffering from decreased sensation and dysesthesia below C8 cord level to a severe degree, gait disturbance to a moderate degree and visual disturbance to a slight degree. Since January 1990, she experienced stereotyped tonic seizures of all extremities and trunk without consciousness disturbance, preceded by tingling sensation ascending from bilateral distal legs, several times a day. During hospitalization, epilepsy, tetany and multiple sclerosis were ruled out and its seizures were completely depressed by oral administration of a small amount of carbamazepine. PTS which is said to be characteristic of multiple sclerosis is seldom found in SMON patients. This is a very important and interesting case to suggest a certain relation between the mechanism of PTS and the cord lesions of SMON. PMID- 1769155 TI - [Bilateral occipital infarction with central homonymous hemianopia]. AB - A 45-year-old man of bilateral occipital infarction with central homonymous hemianopia is reported. He was admitted to our hospital with complaints of visual loss and large central scotoma on both eyes. Pupillary light reaction and ocular fundi were normal. On admission, bilateral retrobulbar optic neuritis was suspected. However, congruous, irregular central scotomas with vertical step were observed in both eyes with Goldmann perimetry. X-ray computed tomography (CT) and magnetic resonance imaging (MRI) revealed the infarction in bilateral occipital tips. Bilateral central homonymous hemianopia is considered to be rare and a case in which occipital lobe lesions were detected with X-ray CT and MRI has not been reported. We stress that bilateral central scotomas with vertical step indicate bilateral occipital lesions. PMID- 1769156 TI - [A case of cervical dural arteriovenous malformation showing the dumbbell type growth]. AB - A rare case with cervical dural arteriovenous malformation was reported. A 46 year-old female was admitted to our hospital because of progressive gait disturbance. Neurological examination revealed muscle weakness and sensory disturbance in the upper and lower limbs. Cervical X-ray showed destruction of the C5 vertebral body an enlarged C5-6 intervertebral foramen. Cervical CT showed a dumbbell type lesion resembling spinal tumor. On MRI, a signal area was observed posterior to the C5 spine on T1 and T2 weighted images. Myelography showed worm-like appearance. Selective spinal angiography revealed dural arteriovenous malformation fed by bilateral radicular arteries, thyrocervical and costocervical trunks. The authors emphasize significance of dural arteriovenous malformation as a cause of tumor-like lesions. PMID- 1769157 TI - [A new type of complicated form of hereditary spastic paraplegia showing mental deterioration, quadriplegia with muscular atrophy, sensory disturbance, extrapyramidal disorders, and epilepsy]. AB - This study proposes a new type of complicated form of hereditary spastic paraplegia (HSP) and some problems on a clinico-pathological classification of HSP. The present study includes three male and two female patients from two families (A and B). In the family A, four siblings (two males and two females) were affected. Spastic paraplegia developed as an initial symptom. In the family B, a man was affected with spastic paraplegia which had started at the age of eleven. His two half-sisters are normal. All parents in two pedigrees are healthy. The parents in the family B are first cousins. CLINICAL FEATURES: Their physical development was normal, but all of them showed mild mental retardation. Gait disturbance due to spastic paraplegia and mental deterioration developed at the age of high teens. At the age of high 20's, they became unable to walk, because of progressive spastic paraplegia and other complicated neurological impairments including pyramidal disorders in the upper limbs, generalized neurogenic muscular atrophy, sensory disturbance and bradykinesia. Some cases showed rigidity and/or spasticity. At the age of high 30's, they became bed ridden, because of quadriplegia with generalized muscular atrophy. Three cases in the family A suffered from convulsions which started at the high 30's. Mild athetoid movement in the face and neck was observed in three cases in the family A. All patients became apathetic and indifferent at least by the age of 40. Laboratory findings and data: CT scan yielded brain atrophy and dilatation of the lateral ventricles, atrophy of the corpus callosum and hyperostosis of the cranium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769158 TI - [X-ray CT of Duchenne muscular dystrophy skeletal muscles--chronological study for five years]. AB - To clarify when and how rapidly individual muscles are damaged in the course of Duchenne muscular dystrophy (DMD), we followed X-ray CT of whole body skeletal muscles from 29 cases of DMD patients (age ranging 3 to 23 years) for a period of 2 to 6 years. Each patient had 2 to 5 scans with an average of 3.3. We evaluated chronological changes of 23 muscles from the entire body using the muscle damage stage defined as follows. The stages were classified into the following 5 stages: stage 0; normal, 1; area of fatty replacement less than 10% of whole muscle area, 2; area of fatty replacement between 10 to 50%, 3; area of fatty replacement 50 to 90%, 4; almost complete fatty replacement. Each muscle had its own period of rapid degeneration starting at 5 to 10 years of age and, continuing 5 to 10 years. In some muscles such as gluteus maximus or quadriceps femoris, fatty replacement started at 5 years or earlier and progressed for five years, while other muscles such as splenius capitis, damage started much later, e.g. around 10 years of age and the progression was much slower. There was a variation of at least 5 years among individual patients in any muscle damage stage, reflecting the variability of clinical severity in each patient. On the basis of the above results we defined the whole body muscle damage index as a summation of the muscle damage stages of the following five muscles: gluteus maximus, quadriceps femoris, gracilis, medial head of gastrocnemius and splenius capitis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769159 TI - [A clinicopathological study of familial amyotrophic lateral sclerosis with special reference to the mode of motoneuron loss in the spinal ventral horn]. AB - The authors analyzed clinicopathologically eight patients with familial amyotrophic lateral sclerosis (F-ALS). We performed the morphometric analysis on size and topographical distribution of the fourth lumbar spinal ventral horn cells, and correlated thus obtained results with the clinical, genetic and neuropathological features of these cases. The patients were consisted of six men and two women with age ranged between 40 and 58 years old. Six cases among them were involved predominantly in the lower-legs with generalized hyporeflexia and no Babinski's sign, which were compatible with the "pseudopolyneuritic" as a clinical form. Two other cases were involved in the upper limbs as the initial symptom and were considered to be "common form". Pathologically, five cases showed multiple system degenerations including the middle root zone of the posterior columns, Clarke's nuclei and posterior spinocerebellar tracts as well as the ventral horns and pyramidal tracts, which were designated as the form of "multiple system degeneration". In addition, three in these five cases were also associated with an extensive neuron loss and marked gliosis in the Onuf's nuclei, subthalamic, red and cerebellar dentate nuclei, suggesting that the involvement in certain F-ALS cases with a form of multiple system degeneration is more extensive in topography than ever believed. In other three cases, the neuronal degenerations were considerably restricted in the somatic motor efferent system, which were consistent with the classical pathology of the sporadic ALS, and were designated as "classical form". Five of seven cases showed a severe motoneuron loss in both the large and small neurons in the ventral horn. These five cases were heterogeneous in the pathological forms "multiple system degeneration" or "classical", but all were "pseudopolyneuritic" in clinical form. Moreover, these extensive motor neuron loss including small ones in the spinal ventral horn was similarly observed in the sporadic pseudopolyneuritic form of ALS cases. In two cases of F-ALS with "common" in clinical form, large motoneurons were fairly well preserved as are in the common form of sporadic ALS cases. Our tentative conclusion is that mode of motoneuron loss in the spinal ventral horn of F-ALS is more correlated to the clinical manifestations rather than the pathological or genetic background. PMID- 1769160 TI - [Hemodynamics of the vertebral artery in subclavian steal syndrome and subclavian steal phenomenon]. AB - To evaluate hemodynamics of the vertebral artery (VA) in subclavian steal syndrome (SSS) and subclavian steal phenomenon (SSP), blood flow velocities of the bilateral VAs were measured by duplex ultrasonography in four patients with SSS and eight patients with SSP. The reversal of flow in the VA was noted in both systolic and diastolic phases in all of the SSS group, and was recorded only in a systolic phase in all but one of the SSP group. The antegrade mean flow velocities in the VA on the unaffected side in the SSS group were significantly higher than those in the SSP group. This indicates that collateral blood flow through the VA in the SSS group is still insufficient to compensate the blood requirement of the upper extremity on the affected side. In conclusion, hemodynamics of the VA in the SSS group could be distinguished from those in the SSP group by duplex ultrasonography. PMID- 1769161 TI - [The effect of sex hormones on tubular aggregates in normal mouse skeletal muscles]. AB - Although tubular aggregates (TAs) are nonspecific findings observed in various neuromuscular disorders, they are specifically recognizable in the muscles of patients with periodic paralysis. However, their function and significance are still unknown. We have previously reported that TAs were observed in normal male, but not in female mouse muscles. To clarify the effects of sex hormones on morphogenesis of TAs, the following studies were performed. In normal male mice (ICR/JCL, N = 102), TAs began to appear at 3-4 months, and were seen in all animals above 6-7 months of age. On the other hand, in normal female mice (N = 50), TAs were observed in only 2 mice, at 14 and 18 months of age. When mice were castrated (N = 69: male 34/female 35), TAs were not found in either males or females. The results suggested that there is a close relationship between TA formation and male hormone. Testosterone propionate (TP) was administered to both castrated and un-castrated mice (N = 167: male 84/female 83). TAs were not found in castrated, TP 10 mg/2M implanted mice (N = 22: male 12/female 10). When TP was increased to 20 mg/1M, TAs began to appear in both male and female, castrated and un-castrated mice at 3 months, and were observed in 100% of mice, except female un-castrated mice, older than 4-5 months of age. Accordingly, a fairly large amount of TP above a certain threshold and a long incubation time of at least 3 months is necessary to induce TAs in the skeletal muscle.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769162 TI - [Chronic progressive external ophthalmoplegia (CPEO); mitochondrial DNA deletion, brain MRI and electrophysiological studies]. AB - To evaluate the correlation of clinical symptoms and deletion of mitochondrial DNA (mtDNA) in CPEO, we examined brain MRI, lower limb SSEP and mtDNA in 19 patients (nine men, ten women) with CPEO averaging 44.9 years of age. Of these patients, three had typical Kearns-Sayre syndrome (KSS) as defined by the presence of the invariable triad of CPEO, retinitis pigmentosa and an onset before the age of 20, as well as at least one of the followings: heart conduction block, cerebellar ataxia and elevated CSF protein. One patient was diagnosed as having probable KSS because the symptoms had begun at the age of 33. All patients with typical and probable KSS had one or more of the following common manifestations: mental retardation or dementia, hearing loss, short stature, and endocrinological disorder. All other 15 patients had ocular myopathy with limb muscle weakness. Total DNA was isolated from 19 biopsied muscles, and analyzed by the methods of Southern blot hybridization and PCR. Thirteen patients has heteroplasmy with the deleted and normal mtDNA, and six patients who had ocular myopathy did not have mtDNA deletion. The age of onset in the patients with mtDNA deletion averaged 23.0 years of age, while that without mtDNA deletion averaged 39 years of age. All KSS and two ocular myopathy patients shared the common site in mtDNA deletion, while nine with ocular myopathy showed the different sizes of deletion ranging from 2.3 to 9.5 kb in the different sites. Brain MRI was obtained from 12 of the 19 patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769163 TI - [An autopsy case of Gerstmann-Strausser-Scheinker's disease with spastic paraplegia as its principal feature]. AB - A 38-year-old woman developed slowly progressive gait disturbance. At age 39 years she was admitted to our department because she could not walk without assistance. On neurological examination she was alert with normal mental functions. Horizontal nystagmus on both sides, minimal clumsiness in the left upper extremity on the finger-to-nose test and moderate degree of spasticity in bilateral lower extremities without evident motor weakness were present. The gait was spastic with small steps on a wide base. There was no sensory abnormalities. The deep tendon reflexes were hyperactive on both sides, on the lower extremities, with positive Babinski's sign. The sphincter functions were intact. During the following 5 years she gradually deteriorated and pseudobulbar palsy, emotional incontinence and the progressive dementia appeared in addition to severe spastic paraplegia. At age 45 years she was admitted to our nursing home and she died 3 months later, of pneumonia, on 6 years after the onset of her illness. Two elder sisters of her 7 siblings had the similar neurologic illness. The brain weighed 1,060 g. There was mild atrophy of cerebrum, cerebellum and brainstem. There were neuronal loss and gliosis in layers IV-VI of cerebral cortex with no evidence of the spongy state. Cerebellar cortex, cerebellar peduncles and spinocerebellar tracts were preserved. There was marked degeneration of corticospinal tract from cerebral peduncle to lateral funiculus of lumbar spinal cord. The most prominent feature was appearance of numerous multicentric amyloid plaques, which were marked in layers I-III of cerebral cortex and to a lesser extent in corpus striatum, hippocampus and the white matters of cerebrum and cerebellum.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769164 TI - [Primary pulmonary artery sarcoma showing multiple HDA on the brain CT--an autopsy case report]. AB - A 67-year-old female suddenly developed a speech disturbance and right hemiplegia. She was diagnosed as having cerebral infarction. Then 2 months later, she had a fever and disturbance of consciousness. She died of respiratory insufficiency. The brain CT showed multiple high density areas with niveau. The autopsy revealed primary pulmonary artery sarcoma and multiple metastasis to the brain, the small intestine, etc. Primary pulmonary artery sarcoma is a very rare tumor which can occur in the pulmonary trunk of a person from any age groups. This case is a very rare one with cerebral metastasis. PMID- 1769165 TI - [A case of rigid spine syndrome associated with severe respiratory failure]. AB - Rigid spine syndrome (RSS) is clinically characterized by progressive limitation of flexion of the spine and contractures of other joints. We herein report a 27 year-old man with RSS, who underwent tracheotomy because of severe restrictive respiratory failure. He had limitation of neck flexion and proximal muscle weakness from early childhood and was diagnosed as having muscular dystrophy at 16 years old. He was suffered from dyspnea and his first tracheotomy was performed at 24 years old. Two years later, the second tracheotomy was done because his respiratory failure was aggravated. He had limitation of spine flexion, scoliosis, but no limited range of elbow and wrist joints movement except mild contracture of ankle joints. Serum CK level was elevated to 590 IU/L. Repeated ECG examinations showed negative T wave but no conduction block. In his family, his parents and brother had neither similar clinical symptoms nor heart block. Chest X-ray study showed elevated diaphragm and enlarged heart shadow (CTR = 65%). Percent VC and FEV1 in sitting position were 14.6% and 100%, respectively. Arterial blood gas analysis showed PaO2 of 34.2 mmHg and PaCO2 of 77.2 mmHg. The density of paraspinal muscle in CT scan was severely decreased. Needle EMG showed myogenic change. Muscle biopsy from left biceps brachii showed myopathic change with mild type 2 fiber grouping. After the second tracheotomy, he was on a respiratory during sleep but mostly off in the daytime. His clinical features are different from Emery-Dreifuss muscular dystrophy because he had no heart conduction block and no family history, but progressive respiratory failure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769166 TI - False-positive Tl-201 SPECT studies in patients with left bundle branch block. Frequency and clinical significance. AB - This study reports on the frequency and clinical significance of false-positive thallium studies in the interventricular septum in patients with left bundle branch block. In a 3-year period, 93 studies were performed on patients with complete left bundle branch block and sinus rhythm. Of these, 29 had a reversible septal defect; 17 are scored false-positive although only six had angiographic proof of normal left anterior descending coronary arteries. We conclude that thallium scintigraphy is indicated in patients with left bundle branch block, but caution is justified when reversible ischemia is demonstrated scintigraphically. PMID- 1769167 TI - Radioiodine uptake following thyroidectomy for thyroid cancer. Recurrence or ectopic tissue? AB - Post-thyroidectomy I-131 sodium iodide scans revealed foci of uptake outside the thyroid bed in two patients. In each case, these areas corresponded to sites where ectopic or aberrant thyroid tissues could be found. The presence of metastatic disease significantly affects the appropriate therapy, as well as the overall prognosis. An appreciation of the potential locations of ectopic thyroid tissues that may mimic metastatic disease and potentially confound diagnosis are stressed. PMID- 1769168 TI - Quantitative assessment of cerebral blood flow in partial epilepsy using Xe-133 inhalation and SPECT. AB - The Xe-133 inhalation method was used to study rCBF in 12 patients with partial epilepsy during the interictal phase. SPECT images evidenced a focal CBF defect in 10 out of 12 patients, while quantitative analysis showed CBF abnormalities in all the patients. The focal CBF defect corresponded to the site of EEG abnormalities in nine patients. Additional low-flow areas beyond the EEG focus were found. Five patients presented a significant CBF decrease in the cerebellar hemisphere contralateral to the EEG focus. In five patients with unilateral EEG abnormalities, a CBF reduction was found in the contralateral cerebral hemisphere, mirror to the EEG focus. Finally, a widespread CBF decrease involving one or both cerebral hemispheres was observed in seven patients. Global and rCBF values were not correlated with age, duration of disease, frequency of seizures, secondary generalization, or specific therapy. SPECT may be useful in evaluating EEG epileptic foci, and quantitative SPECT allows the detection of functional effects of the epileptic focus on anatomically connected remote areas, probably due to the decrease of afferent inputs (diaschisis phenomenon). PMID- 1769170 TI - Detection of miliary tuberculosis by Ga-67 scintigraphy. AB - Two patients are presented in whom pulmonary accumulation of Ga-67 led to an early diagnosis of miliary tuberculosis and its prompt treatment. Their chest radiographs were unremarkable and thus noncontributory to the diagnostic process. PMID- 1769169 TI - Malrotation simulating gallbladder perforation on Tc-99M IDA scintigraphy. Pitfall to avoid. AB - A patient with upper abdominal discomfort had Tc-99m IDA scintigraphy performed for suspected gallbladder disease. In addition to filling of the bile ducts and the gallbladder, tracer collected in the right side of the abdomen and was thought at first to be the right paracolic gutter, indicating a gallbladder rupture. Discussion with the surgeon and radiographic correlation indicated that the patient did not have gallbladder perforation but, rather, a malrotation of the bowel. This diagnosis became clear on delayed images. PMID- 1769171 TI - Lung scintigraphy in pulmonary capillary hemangiomatosis. A rare disorder causing primary pulmonary hypertension. AB - The authors report the results of lung scintigraphy in two patients with primary pulmonary hypertension caused by pulmonary capillary hemangiomatosis, a rare disorder resulting from the proliferation of histologically normal capillaries in the lung. Perfusion studies revealed a nonhomogeneous pattern with some focal defects, similar to that seen with some other histologic types of primary pulmonary hypertension. The mechanisms underlying this perfusion pattern are unknown. PMID- 1769172 TI - Functional results of gastric interposition following total esophagectomy. AB - Functional results of gastric interposition were evaluated in 35 patients at 3 to 84 months following esophagectomy. All patients were satisfied with the results of surgery, although 14 (40%) still experienced some degree of dysphagia. Transit times for radiolabeled solids across the cervical esophagus and anastomosis were not significantly different for the 14 symptomatic patients (mean 77 seconds) versus 21 asymptomatic patients (mean 55 seconds). Spontaneous emptying of the vagotomized intrathoracic stomach appeared complex, with mean percentage radionuclide clearances at 30 minutes (semisolid meal) calculated at 37% for 23 patients with early satiety (versus 42% asymptomatic) and at 38% for nine patients with reflux (versus 39% asymptomatic), all values comparable to emptying of the normal intra-abdominal stomach (35% clearance at 30 minutes). Our data suggest that the interposed stomach appears to retain its gastric identity rather than act as an inert conduit, and that although little correlation exists between postoperative symptoms and objective findings, the stomach remains a satisfactory esophageal substitute. PMID- 1769173 TI - Metastatic prostatic carcinoma presenting as an anterior mediastinal mass on gallium imaging. AB - A great majority of mediastinal lymph node metastases originate from primary neoplasms within the thorax. Mediastinal metastases from other malignancies are not infrequently encountered but are uncommon from a prostatic primary site. Since prostatic metastases may mimic lymphomatous nodes, it is important to be aware that mediastinal adenopathy occurring in a patient with prostatic carcinoma may be caused by metastases from that site rather than from lymphoma, or be secondary to some unknown primary malignancy elsewhere in the body. The author presents a case of metastatic prostatic carcinoma in the anterior mediastinum that was detected on Ga-67 citrate imaging and confirmed on a CT scan. PMID- 1769174 TI - Familial dysalbuminemic hyperthyroxinemia associated with multinodular goiter and elevated radioiodine uptake. A case report. AB - Familial dysalbumenic hyperthyroxenemia characterized by elevations in serum total thyroxine (T4) and free-thyroxine index and normal free T4 and radioiodine uptake has been previously described. This syndrome is secondary to an autosomal dominant inheritance in which affected individuals are mistakenly diagnosed as thyrotoxic because of the elevation of serum levels of total T4 and free T4. The excess T4 level is caused by the presence of an abnormal serum protein that binds excess T4, thereby raising the level of total T4. The authors report the case of a patient with familial dysalbumenic hyperthyroxenemia who presented with superimposed multinodular goiter and an elevated 24-hour radioiodide uptake. PMID- 1769175 TI - Tl-201 uptake in brown tumors of hyperparathyroidism. AB - Tl-201 chloride bone scans were performed on nine patients with primary hyperparathyroidism just after Tl-201 and Tc-99m parathyroid subtraction scintigraphy. Bone lesions accumulate Tl-201, especially in sites of brown tumor formation. This was proven by the histopathologic examination of two patients. Eight patients had bone scans with Tc-99m MDP. The lesion-to-background ratio was quantified in seven patients for Tl-201 and in four patients for Tc-99m MDP. Tl 201 uptake of the lesions were quantified in two patients. The lesion-to background ratio was 1.63 +/- 0.21 and 2.51 +/- 0.88 for Tl-201 and Tc-99m MDP, respectively. A Ga-67 citrate scan was performed on one patient, and the lesion to-background ratio was 1.49 +/- 0.06. The accumulation of Tl-201 in brown tumors of bone might be due to increased blood flow and local metabolic activity. Tl-201 chloride was inferior to Tc-99m MDP in lesion detection. It is concluded that bone imaging with Tl-201 can easily be performed following parathyroid subtraction scintigraphy to delineate the sites of brown tumor formation. PMID- 1769176 TI - CAPD catheter site uptake during RBC gastrointestinal bleeding scan. PMID- 1769177 TI - Nuclear penogram can quantitate and record the effect of pharmacologic treatment of impotence. PMID- 1769178 TI - Scintigraphic findings in a case of variant Mirizzi syndrome. PMID- 1769179 TI - 'Resolving' splenic uptake of Tc-99m MDP in aplastic anemia. PMID- 1769180 TI - Angioscintigraphic image of a tongue hemangioma. PMID- 1769181 TI - Giant rhabdomyosarcoma with necrosis visualized with Tl-201 chloride. PMID- 1769182 TI - Tc-99m HMPAO SPECT appearance of an atypical laminar heterotopia. PMID- 1769183 TI - A case of medullary thyroid carcinoma with adenomatous nodule. PMID- 1769184 TI - Regional variations in nocturnal fluctuations in subcutaneous blood flow rate in the lower leg of man. AB - The purpose of the study was to investigate possible regional variations in recently discovered nocturnal fluctuations in subcutaneous blood flow rates. Approximately 90 min after going to sleep, a 100% blood flow rate increment, lasting about 100 min, has been demonstrated in the distal and medial aspect of the right lower leg of normal human subjects. In the present study subcutaneous adipose tissue blood flow rates were measured simultaneously in the right and left lower legs of 16 normal human subjects over 12-20 h ambulatory conditions. The 133Xe wash-out technique, portable CdTe(Cl) detectors and a portable data storage unit were used. The tracer depots were applied on the medial aspects of the right lower leg and on the medial (series 1) and lateral (series 2) aspect of the left lower leg 10 cm proximal to the malleolar level by means of the epicutaneous, atraumatic labelling technique. A nocturnal hyperaemic response was demonstrated at both the medial and lateral aspect of the leg. As for the degree of hyperaemia and the absolute blood flow rates in the different phases, there were some deviations between the medial and the lateral locations. However, a highly significant positive correlation was observed in both series concerning the duration of the period from going to bed until the hyperaemia phase (P less than 0.001). The mechanisms involved in the nightly subcutaneous hyperaemia are at present unknown. The sudden, synchronized increase in nocturnal subcutaneous blood flow points to a central nervous or humoral elicitation, although local metabolic factors might participate as well. PMID- 1769185 TI - Skin perfusion patterns (fluorescein perfusography) during reactive hyperaemia in peripheral arterial occlusive disease. AB - From the pathophysiological point of view the regional distribution of blood flow is of special importance in ischaemic tissues. Within this study foot sole skin perfusion was investigated by means of fluorescein perfusography at rest and during reactive hyperaemia in patients with peripheral arterial occlusive disease confined to one limb (Fontaine stage II). Ambient temperatures were maintained around 21 degrees C. Mean fluorescein appearance times on the one side and their standard deviations (SD) and coefficients of variation (CV) on the other side were taken as measures of overall blood supply and homogeneity of flow, respectively. At rest no differences in these parameters could be detected between diseased legs and controls. After a 3-min supra-systolic circulatory arrest at the thigh, a significant reduction of fluorescein appearance times was observed for both groups but was statistically more pronounced in the controls. Furthermore, during reactive hyperaemia standard deviations as well as coefficients of variation decreased significantly only in normal limbs whereas they either remained constant (SD) or even increased (CV) in those with arterial obstructions. All effects associated with reactive hyperaemia showed statistically significant correlations with systolic ankle pressure indices. From these results it is concluded that haemodynamically effective arterial obstructions are followed by not only a restriction of overall hyperaemic blood supply but also a failure to homogenize microcirculatory perfusion in the case of increased flow requirements. PMID- 1769186 TI - Cardiac contractility, central haemodynamics and blood pressure regulation during semistarvation. AB - Eight obese patients were studied before and after 2 weeks of treatment by a very low-calorie diet (VLCD). Cardiac output and central blood volume (pulmonary blood volume and left atrial volume) were determined by indicator dilution (125I albumin) and radionuclide angiocardiography (first pass and equilibrium technique by [99Tcm]red blood cells). Cardiac output decreased concomitantly with the reduction in oxygen uptake as the calculated systemic arteriovenous difference of oxygen was unaltered. There were no significant decreases in left ventricular contractility indices, i.e. the ejection fraction, the peak ejection rate and changes in end-systolic volume. Also the diastolic function evaluated by the peak filling rate remained normal. Furthermore, no sign of backward failure could be demonstrated since the central blood volume was not significantly increased. Both systolic and diastolic blood pressure (BP) declined. The fall in BP was caused by the reduction in cardiac output as the total peripheral resistance was unchanged. Finally, the decline in total blood volume was not significant. These findings together with a reduction in heart rate indicated that a reduced sympathetic tone via increased capacitance of the venous bed was the main operator of a reduced venous return. Thus, the haemodynamic alterations in obese patients during short term semistarvation may be caused by the fall in oxygen uptake and produced mainly by changes in the sympathetic tone. PMID- 1769187 TI - Effect of coronary bypass surgery on anaerobic myocardial lactate metabolism during pacing-induced angina pectoris. AB - Myocardial lactate metabolism was studied by coronary sinus catheterization in nine patients before and 8-12 months after coronary bypass surgery. Measurements were performed at rest and during atrial pacing increased to a heart rate which produced strong chest pain. The estimation of myocardial lactate extraction and release was facilitated by a constant rate infusion of 14C lactate and coronary sinus blood flow (CSBF) was measured by thermodilution. Pre-operatively strong chest pain could be elicited in all patients and isotope data indicated a significant myocardial lactate release in all of them, although the net a-cs difference was negative in only half of them. After bypass surgery the maximum tolerable heart rate was increased by 23 beats min-1 and chest pain both at heart rate 110 beats min-1 and at the highest heart rate achieved was reduced or absent in eight of the nine patients. The increase in chest pain during pacing was quantitatively related to the increase in myocardial lactate release, and the correlation between these two variables followed the same course after the operation as it did before. It is concluded that the improvement in chest pain limited cardiac performance after bypass surgery is well correlated with the improvement in myocardial aerobic metabolism. PMID- 1769188 TI - Autonomic nerve function in children and adolescents with insulin-dependent diabetes mellitus. AB - Autonomic nerve function was assessed in 67 insulin-dependent diabetic children and adolescents and in 30 control subjects of the same age. The heart rate and blood pressure reactions to a deep breathing test (E/I ratio) and a tilt table test (acceleration and brake indices) were used. The E/I ratio, 1.54 +/- 0.21, and the acceleration index, 25 +/- 7.7, in the diabetic children were not significantly different from those of the control children, 1.51 +/- 0.16 and 24 +/- 7.5, respectively. Neither was any difference observed between the mean brake index values; 24.3 +/- 14.6 vs 23.5 +/- 7.5. However, the variance of the brake index in diabetic children was significantly higher than in control children (P less than 0.005). The brake index was negatively correlated to age in the healthy control children (r = -0.48, P less than 0.1). The acceleration index, but not the E/I ratio, also tended to be age related (r = -0.32, P less than 0.01 NS). No correlation was observed between sex, glycaemic control or duration of diabetes and the autonomic nerve function. Neither were severe hypoglycaemic episodes in diabetic children related to the autonomic nerve function. It is concluded that autonomic neuropathy is uncommon in diabetic children and adolescents and that age-related index values should be used when autonomic nerve function is evaluated in children of different ages. PMID- 1769190 TI - Ultrasound measurement of wall thickness in the carotid artery: fundamental principles and description of a computerized analysing system. AB - A B-mode [two-dimensional (2D)] image from the carotid artery may be described as containing seven echo zones. The aim of the present work is to discuss how lumen diameter and wall thickness can be measured from these zones, and to review some of the basic principles of ultrasound physics and imaging. Simple experiments were performed to identify the echoes defining intima-lumen interfaces. The results showed that: (1) The intima-media thickness of the near wall cannot be measured in a valid way. (2) The lumen diameter of a blood vessel is defined by the distance from the leading edge of the intima-lumen interface of the near wall (echo zone 3) to the leading edge of the lumen-intima interface of the fall wall (echo zone 5). (3) Previously published studies have validated the intima-media complex of the far wall as the distance from the leading edge of the lumen-intima interface of the far wall to the leading edge of the media-adventitia interface of the far wall (echo zone 7). We suggest that if measurements on the near wall are performed, measurements from the far wall should also be presented separately, and if lumen diameter is measured, that this measurement is carried out according to the leading edge principle. We describe a computerized analysing system for the measurement of wall thickness and plaque area on the carotid and femoral arteries. The system is based on a low-cost PC and a frame grabber board and calculates minimum, maximum and mean values of lumen diameter and wall thickness from a section of the artery. PMID- 1769189 TI - Plasma lipid and lipoprotein profile in elderly female runners. AB - Plasma lipid and lipoprotein profiles were compared in elderly female runners (RU: n = 15, aged 66 +/- 5 years, body fat 20 +/- 4%, training distance 35 +/- 15 km week-1, VO2max 36 +/- 4 ml kg-1 min-1, mean +/- SD) and age-matched untrained women (UT: n = 28, 66 +/- 4 years, body fat 26 +/- 6%, VO2max 26 +/- 3 ml kg-1 min-1). There were insignificant differences in total cholesterol (RU: 5.04 +/- 0.60 vs. UT: 5.48 +/- 0.85 mmol l-1), HDL-cholesterol (RU: 1.97 +/- 0.41 vs. UT: 1.91 +/- 0.36 mmol l-1) and LDL-cholesterol (RU: 2.72 +/- 0.59 vs. UT: 3.03 +/- 0.80 mmol l-1) between the two groups. Plasma triglyceride concentration of the runners was significantly lower than that of the untrained women (RU: 0.80 +/- 0.27 vs UT: 1.14 +/- 0.36 mmol l-1, P less than 0.01). No difference was observed in the LDL-cholesterol/HDL-cholesterol ratio between the two groups (RU: 1.45 +/- 0.51 vs UT: 1.64 +/- 0.53 units). These results suggest that regularly performed running of 35 km week-1 in elderly women does not further elevate their HDL cholesterol level which is already high compared to the levels found in elderly men. However, elderly female runners appear to be protected against age-related increases in the levels of triglyceride and LDL-cholesterol. PMID- 1769191 TI - Reliability of impedance cardiography in measuring central haemodynamics. AB - The purpose of the study described here was to investigate the reliability of impedance cardiography (IC) in measuring cardiac output (CO) and central blood volume. Absolute values and changes in these variables obtained by impedance cardiography and by isotope- or thermodilution techniques were compared. The reproducibility of IC within the same day was compared with that of isotope dilution and the reproducibility in IC from day to day was derived. Finally, the effects of the readings of impedance tracings by different observers were quantified. The results are based on 270 measurements in 37 healthy subjects and in 25 unmedicated patients with ischaemic heart disease. We obtained significant correlations between absolute values (y = 0.68x + 1.48) and changes (y = 1.00x + 0.0003) in CO measured by IC and isotope- or thermodilution. IC significantly overestimated absolute values of CO (P less than 0.001). We found a qualitative but no quantitative correlation between thoracic fluid volume measured by IC and central blood volume measured by isotope dilution. IC was highly reproducible both when studies were repeated within the same day (SD on differences in CO = 0.36 1 min-1 for IC; SD on differences in CO = 0.30 1 min-1 for isotope dilution) and on different days (SD on differences in CO = 0.45 1 min-1). A low intra observer variability was found (SD on differences in CO = 0.12 1 min-1). We conclude that impedance cardiography is reliable in measuring changes in cardiac output and thus suitable for repeated measurements in studies on the haemodynamic effects of physiological or pharmacological intervention. Impedance cardiography is sufficiently reliable for comparison of absolute values of CO between different groups of patients. We cannot recommend impedance cardiography for quantitative studies of central blood volume. PMID- 1769192 TI - Central haemodynamics in patients with severe postural hypotension. AB - Central haemodynamics in the supine and head-up tilted positions were studied in 24 patients with severe postural hypotension with and without supine hypertension. Results were compared with those obtained in eight normotensive and eight untreated hypertensive controls. In the supine position the patients had higher vascular resistances, lower stroke volumes and longer left ventricular ejection time indexes compared to controls, whereas left ventricular ejection fractions did not differ significantly. The patients with supine hypertension had significantly higher vascular resistance compared to those with supine normotension. The highest supine blood pressure levels were found in patients with multiple system atrophy. During tilt, vascular resistance and heart rates were increased and stroke volumes and left ventricular ejection time indexes were decreased in the controls. The patients were unable to increase their vascular resistance, but increased their heart rate and decreased their left ventricular ejection time indexes to a degree similar to the controls. The reductions in stroke volume were smaller in the patients compared to the controls. Changes in haemodynamics in response to head-up tilting did not differ significantly between patients with supine hypertension and supine normotension. It is concluded that patients with postural hypotension have higher supine vascular resistance and are unable to contract peripheral arteries and arterioles during head-up tilting. Contractility of the left ventricle is preserved and the baroreceptors are partially intact. Postural hypotensive patients with supine hypertension differ from those with supine normotension only with respect to supine vascular resistances. PMID- 1769193 TI - Vulvovaginitis: diagnosis and management. AB - Successful treatment of vaginitis is based on a specific diagnosis and therapy (Table 2). The diagnostic category of nonspecific vaginitis is not helpful in therapy or in prevention and should be abandoned. In addition, sulfonamide creams and other broad-spectrum vaginal preparations have not been effective in treating vaginitis and should not be used for empiric treatment. The goal of therapy is not only to relieve symptoms, but also to achieve high cure rates and to prevent recurrence or transmission of the condition. PMID- 1769194 TI - Prevention of infectious diseases in children. PMID- 1769195 TI - Current problems in control of infections. PMID- 1769196 TI - Recent advances in the diagnosis and treatment of infectious diseases. PMID- 1769197 TI - Recent advances in viral hepatitis. PMID- 1769198 TI - The role of Helicobacter pylori in gastroduodenal disease. AB - Peptic ulcers are the result of a wide variety of factors, with H. pylori probably being one of the more significant. H. pylori has been most strongly associated with gastritis and duodenal ulcer disease. The relationship of H. pylori to gastric ulcers is less substantial. The eradication of H. pylori can be achieved in the majority of patients with triple antibiotic therapy. However, resistance to metronidazole occurs readily. Eradication of H. pylori can change the course of duodenal ulcer disease by decreasing recurrence rate from 80% to zero. Nonetheless, treatment for H. pylori should only be done in randomized trials at the current time because of the lack of completely effective therapy and the high risks of side effects. The mechanism by which H. pylori influences duodenal ulcer recurrence is unclear. Pathogenic mechanisms of the organism also need to be further elucidated. PMID- 1769199 TI - HIV infection in the elderly. PMID- 1769200 TI - Mammalian alpha-L-fucosidases. AB - Mammalian alpha-L-fucosidases are a ubiquitous group of relatively large multimeric lysosomal glycosidases involved in the degradation of a diverse group of naturally-occurring fucoglycoconjugates. These enzymes are closely related structurally as indicated by immunochemical cross-reactivity and cloning studies. Mammalian fucosidases are sialoglycoproteins and the carbohydrate, particularly sialic acid, contributes to producing multiple isoforms which can differ in various species as well as in different tissues within a given species. alpha-L Fucosidases exhibit maximal activity at pH values between 4 and 7, have similar kinetic properties with synthetic substrates (PNP-fucoside and 4-MU-fucoside), and exhibit broad substrate specificity on natural substrates. Numerous linkages (alpha 1-2, alpha 1-3, alpha 1-4, alpha 1-6), primarily to galactose and N acetylglucosamine, can be hydrolyzed but preference is often seen for small mol. wt water-soluble substrates with fucose in alpha 1-2 linkage to galactose. The importance of alpha-L-fucosidase in mammalian metabolism is evidenced by deficiency or absence of its enzymatic activity leading to a fatal genetic disease, at least in humans and English Springer Spaniels. PMID- 1769201 TI - Purification of alkaline phosphatase from the intestinal content of common seal (Phoca vitulina larga) by immunoaffinity chromatography. AB - 1. A monoclonal antibody APP, 1 against harp seal alkaline phosphatase has been prepared. It was found that the antibody was cross-reacted with the intestinal alkaline phosphatase of common seal Phoca vitulina larga. 2. Purified antibody was linked to Sepharose 4B and used for immunoaffinity chromatographic purification of alkaline phosphatase from the intestinal content of common seal. A spec. act. of the purified enzyme was 7300 units per mg of protein. 3. The enzyme in 7.5% polyacrylamide gel in the presence of 2-mercaptoethanol and SDS was migrated as a single band of Mr 67,000. The value of the apparent Km for common seal alkaline phosphatase was equal to 3.7 mM. PMID- 1769202 TI - Characterization of glutathione transferase from Gammarus italicus. AB - 1. By using affinity chromatography and chromatofocusing analysis at least two major glutathione transferases, named GST II and GST III can be isolated from Gammarus italicus. 2. GST II has an isoelectric point at pH 5.0 and is composed of two subunits with an apparent molecular mass of 28 KDa. 3. GST III which has an isoelectric point at pH 4.6 was found to be an heterodimer of 27 KDa and 28 KDa. 4. The 28 KDa subunit cross-reacted in immunoblotting analysis with antisera raised against pi class GST, whereas none of the antisera raised against alpha, mu and pi class GSTs cross-reacted with the 27 KDa subunit. PMID- 1769203 TI - Purification and characterization of a calsequestrin-like calcium-binding protein from carp (Cyprinus carpio) sarcoplasmic reticulum. AB - 1. A calsequestrin-like calcium-binding protein was purified from carp sarcoplasmic reticulum by column chromatographies using DEAE-cellulose and Butyl Toyopearl 650S. 2. The mol. wt was estimated to be 50 kDa, which was larger than that of rabbit calsequestrin (42 kDa). 3. Carp calsequestrin-like protein bound Ca2+ with a higher affinity (apparent Kd = 400 microM) and lower capacity (25 mol/mol) compared with rabbit calsequestrin (1 mM and 40-50 mol/mol, respectively). 4. Anti-carp calsequestrin-like protein rabbit antiserum reacted with rabbit calsequestrin in immunoblotting analysis. 5. Carp calsequestrin-like protein was rich in acidic amino acids, as was rabbit calsequestrin. PMID- 1769204 TI - Isoforms of turkey prolactin: evidence for differences in glycosylation and in tryptic peptide mapping. AB - 1. Three isoforms of turkey pituitary prolactin have been isolated, including a nonglycosylated isoform of 22,500 mol. wt and two glycosylated isoforms of 24,500 mol. wt. 2. The glycosylated turkey prolactins differed in carbohydrate composition, with one isoform apparently containing only O-linked carbohydrate. 3. Tryptic peptide maps showed a few peptides distinctly different among the three prolactin isoforms. 4. Amino acid sequencing of the first 40 residues of the three prolactin isoforms showed arginine at position 24 and histidine at position 27, for the nonglycosylated form, but no identifiable amino acids were detected at this position for the glycosylated isoforms. PMID- 1769205 TI - Acclimatization to hypoxia modulates the tryptophan 2,3-dioxygenase activity in rats exposed to simulated high altitude. AB - 1. Exposure of rats to an 8000 m altitude increased the hepatic tryptophan 2,3 dioxygenase (EC 1.13.1.12) activity. 2. Acclimatization to hypoxia by a repeated exposure to an altitude of 5000 m induced a marked decrease in liver tryptophan dioxygenase activity after the rats were subjected to an 8000 m altitude, but a pre-exposure to 4000 m altitude showed no effect on the enzyme activity. 3. Plasma tryptophan was rapidly decreased by exposure to 8000 m altitude to the same extent in the acclimatized and non-acclimatized rats. 4. Plasma tryptophan may be utilized as the substrate for tryptophan dioxygenase in liver of the non acclimatized rats under highly hypoxic conditions; however, acclimatized rats can reserve tryptophan as the substrate for the alternative metabolism other than the degradation pathway in liver. PMID- 1769206 TI - 1H NMR spectroscopic survey of plasma and erythrocytes from selected marsupials and domestic animals of Australia. AB - 1. 1H NMR spectra were acquired from whole plasma, intact erythrocytes, and ultrafiltrates of erythrocytes from nine native and eight introduced (domestic) Australian animals; single-pulse, spin-echo and 2-dimensional spectra were obtained. The aim was to detect and at least semi-quantify metabolites in the samples and compare the profiles amongst the species. 2. The Australian natives that were studied were all marsupials: greater brown bandicoot; bettong; eastern grey kangaroo; red kangaroo; koala; possum; red necked pademelon; Tammar wallaby; and wombat. The introduced mammals that were studied were: cat; cattle; dog; goat; horse; pig; rabbit; and sheep. 3. Because of the range of habitats and diets amongst the animals, it was postulated that the concentrations of the common metabolites in the blood would show marked differences and that there would also be some metabolites that were peculiar to a given animal. There were several major differences in the spectra: in the spectra of plasma, the glycoprotein and lipoprotein resonances showed the largest inter-species variation, whereas the most dramatic finding from the spectra of erythrocytes was a very high concentration of lysine in the cells from the Tammar wallaby. PMID- 1769207 TI - Studies on the carotenoids in the muscle of salmon--V. Combination of astaxanthin and canthaxanthin with bovine serum albumin and egg albumin. AB - 1. Bovine serum albumin (BSA) and/or egg albumin were bound to astaxanthin or canthaxanthin easily and the spectroscopic characteristics of these complexes were similar to those of astaxanthin or canthaxanthin in the salmon muscle. 2. This result indicates that astaxanthin-BSA, -egg albumin, canthaxanthin-BSA and egg albumin complexes were basically similar to astaxanthin-actomyosin and/or canthaxanthin-actomyosin complex in the salmon muscle. 3. The binding of salmon actomyosin to astaxanthin or canthaxanthin is not specific. PMID- 1769208 TI - Comparative analysis of propionyl-CoA carboxylase from liver and mammary gland of mid-lactation cow. AB - 1. Propionyl-CoA carboxylase from mid-lactation cow liver and mammary gland has been purified. 2. In both organs, the molecular mass was estimated to be approximately 450 kD, and two molecular subunits of 77 and 64 kD could be observed. 3. Physico-chemical and kinetical properties for the enzyme from both organs were similar, showing an allosteric behaviour in relation to ATP and Mg2+. 4. The presence of propionyl-CoA carboxylase in mid-lactation cow mammary gland with similar properties to the liver enzyme, could indicate the existence of a gluconeogenic metabolism in this organ exactly when a high demand of glucose for milk lactose is required. PMID- 1769209 TI - Isolation and properties of a fatty acid-binding protein from the Pacific lamprey (Lampetra tridentata). AB - 1. A survey of 12 vertebrate species showed that palmitate was bound by an albumin-like serum protein in all classes tested except the dogfish and the lamprey. 2. The major palmitate-binding protein of the Pacific lamprey was isolated and found to be of molecular mass 19,000. 3. The amino acid composition of this protein indicates that it is not a member of the albumin superfamily. 4. The 19-kDa lamprey protein binds bilirubin, cortisol and tryptophan only weakly, but binds palmitate with KA = 25 microM-1, comparable to the first long-chain fatty acid site of bovine albumin (KA = 34 microM-1). PMID- 1769210 TI - The galactan-degrading enzymes in the snail Biomphalaria glabrata. AB - 1. Embryonic snails incorporate from the perivitelline fluid in which they are embedded a polysaccharide, called galactan, which is composed entirely of D-, or D- and L-galactose. In this investigation the p-nitrophenyl-beta-D-galactoside degrading enzyme of Biomphalaria glabrata which was assumed to be involved in the degradation of the galactans was purified almost to homogeneity and its specificity was studied. 2. It has a mol. wt of 135,000 and is composed of two identical subunits. 3. It could be shown that p-nitrophenyl-beta-D-fucoside was hydrolysed eight times faster, but native galactan was neither decomposed nor was it inhibitory for the hydrolysis of p-nitrophenyl-glycosides. 4. Thus, it is most likely that this galactosidase is not involved in the galactan metabolism. 5. However, a membrane-bound enzyme complex was revealed which was able to metabolize the native galactan of Biomphalaria glabrata completely and which showed graded reactivity towards galactans of other species. 6. Since no intermediate degradation products were found it must be assumed that they were metabolized further in the mitochondria. PMID- 1769211 TI - Hematologic and biochemical observations in Gazella dama, G. dorcas and G. cuvieri. AB - 1. Blood samples obtained from 114 animals of three species of the genus Gazella (Gazella dama, Gazella dorcas and Gazella cuvieri) were analyzed from hematology (osmotic fragility, red blood cells morphology and hemoglobin electrophoresis) and biochemical values (glucose-6-phosphate dehydrogenase, pyruvate kinase and glutathione reductase deficiencies and superoxide dismutase activity). 2. Standard methods were used. Hemoglobin polymorphism was found. 3. There was no abnormality in the osmotic fragility and red blood cells morphology. 4. The biochemical results are compared with information from the literature and with the normal human range. PMID- 1769212 TI - Fatty acid composition and lipoxygenase metabolism in blood cells of the lesser spotted dogfish, Scyliorhinus canicula. AB - 1. The fatty acid composition of erythrocytes and leucocytes of the elasmobranch, Scyliorhinus canicula, was determined so as to indicate substrate availability for eicosanoid formation. 2. Leucocytes showed a greater degree of fatty acid unsaturation than the erythrocytes, with particularly high levels of docosahexaenoic acid (22:6,n-3). 3. The major eicosanoid precursors, arachidonic acid (20:4,n-6) and eicosapentaenoic acid (20:5,n-3), represented 13.9% and 5.2% of the total fatty acid, respectively, in erythrocytes compared with 10.7% and 6% in leucocytes. 4. Whole blood and isolated leucocytes were stimulated with calcium ionophore, A23187 and the resulting lipoxygenase products separated by reverse phase high performance liquid chromatography. 5. The main lipoxygenase products formed were 6-trans-leukotriene B4, 6-trans-12-epi-leukotriene B4, 5(S),6(R) dihydroxyeicosatetraenoic acid and 5- and 15-hydroxyeicosatetraenoic acid. 6. No leukotriene B4, leukotriene B5, or lipoxins were detected. PMID- 1769213 TI - Acid proteinases of the fore-gut in metamorphosing tadpoles of Rana catesbeiana. AB - 1. Two types of acid proteinases were found in the adult stomach of the bullfrog, Rana catesbeiana. 2. The first type of enzyme appeared in the developing stomach and esophagus and contained more than two kinds of acid proteinases. 3. These enzymes were identified as pepsin-type enzymes. 4. The second type of enzyme existed from the larva to adult stage and was also present in the adult duodenum. 5. This enzyme was different from pepsin and thought to be cathepsin E. PMID- 1769214 TI - Milk composition in an American marsupial (Monodelphis domestica). AB - 1. Twenty one sequential milk samples from an American marsupial (Monodelphis domestica) were analyzed. 2. The solids fraction was relatively low initially (10% w/w) and then increased to about 30% at mid-lactation where it remained until lactation ceased. 3. During the first 50 days of lactation the relative proportions of protein, fat and carbohydrate were 36, 28 and 34%, respectively, of the solids fraction. 4. Sodium and magnesium concentrations were constant; however levels of potassium and magnesium varied substantially. 5. The milk of M. domestica exhibits a similar pattern of quantitative and qualitative changes to that seen in Australian marsupials. PMID- 1769215 TI - Comparative studies on the distribution of rhodanese in different tissues of domestic animals. AB - 1. The activity of rhodanese in different tissues of some domestic animals was measured. 2. Rhodanese was present in all tissues studied. 3. The activity of rhodanese in most tissues of sheep was higher than other animals studied. 4. In sheep and cattle the epithelium of rumen, omasum and reticulum were the richest sources of rhodanese. Significant activity of rhodanese was also present in liver and kidney. 5. In camel the liver contained the highest level of rhodanese followed by lung and rumen epithelium. Camel liver contained a third of the activity of sheep liver. 6. Equine liver had a third of the activity of sheep liver. Other tissues showed low levels of rhodanese activity. 7. Dog liver contained only 4% of the activity of sheep liver. In this animal, brain was the richest source of rhodanese. 8. The results are discussed in terms of efficacy of different tissues of animals in cyanide detoxification. PMID- 1769216 TI - Isolation and characterization of circulating low molecular weight peptides in steer, sheep and rat portal and peripheral blood. AB - 1. Low mol. wt peptides in plasma were isolated by reverse-phase HPLC from steer and sheep carotid arterial and rat heart blood and portal blood from all three species. 2. Elution profiles for peptide fractions were similar but the concentration of peptide-bound amino acids (PBAA) in fractions corresponding to different mol. wt peptides was not constant across species. 3. PBAA contributed between 65 and 78% to the plasma amino acid pool in steer and sheep but only 52% in the rat (P less than 0.05). 4. The percentage of many individual amino acids present in either free amino acid (FAA) or PBAA pools was different for ruminant compared with rat plasma but it was similar for steer and sheep apart from branch chain amino acids (P less than 0.05). PMID- 1769217 TI - Glucose dehydrogenase, glucose-6-phosphate dehydrogenase and hexokinase in liver of rainbow trout (Salmo gairdneri). Effects of starvation and temperature variations. AB - 1. Activities of trout liver glucose dehydrogenase (GDH, EC 1.1.1.47) and glucose 6-phosphate dehydrogenase (G6PD, EC 1.1.1.49) were increased after a sudden drop in water temperature, but not in long-time cold acclimated as compared with warm acclimated trout. 2. Possibly, the activities of GDH and G6PD were temporarily increased in connection with metabolic adaptation to the lower temperature. 3. The activities of GDH and G6PD were not changed by the stress of handling. 4. Partially purified trout liver GDH has a lower activation energy with glucose than with glucose-6-phosphate as substrate, and the Km (glucose) decreases with decreasing assay temperature. 5. At low temperatures, the activity of trout liver GDH with glucose as substrate may be comparable to that of glucose-6-phosphate. 6. Partially purified beef liver GDH has a high activation energy with glucose as substrate, and the Km (glucose) does not change with the assay temperature. 7. Hexokinase (HK, EC 2.7.1.1) and GDH activities were unchanged when trout were deprived of food for 4 weeks. Apparently, the trout liver glucose utilization did not adapt to the starvation. PMID- 1769218 TI - Isolation and characterization of a lectin from the cephalochordate Branchiostoma lanceolatum (Pallas). AB - 1. A lectin was isolated from an extract of Branchiostoma lanceolatum by affinity chromatography using an asialo-A-peptone-cellulose column. 2 The lectin is a glycoprotein with a carbohydrate content of 2.7%. The mol. wt is 392,000 +/- 28,000. Two subunits of identical size (183,000 +/- 3000) are linked by non covalent bonds. 3. The lectin agglutinates a variety of erythrocytes including human A, B, O red blood cells as well as human lymphocytes. 4. Hemagglutination activity is inhibited best by N,N',N"-triacetylchitotriose, followed by N,N' diacetylchitobiose, which is half as inhibitory. 5. Lectin activity is constant between pH 5 and 10. Divalent cations are not required for binding reactions. Activity is totally destroyed by heating to 60 degrees C for 30 min. 6. The lectin is precipitated from the extract by 30-40% ammonium sulfate saturation. PMID- 1769219 TI - Endometrial arylamidase activity in the guinea pig: changes during the oestrous cycle, decidualization and ovarian steroid hormone treatment. AB - 1. As suggested by comparative studies done in various species, amino acid arylamidases (amino peptidases) may play a role in blastocyst implantation. 2. Histochemical studies of the guinea pig endometrium indicate that arylamidase increases in the stroma during pregnancy but is depleted in the vicinity of the blastocyst during implantation. 3. To further explore the possible significance of arylamidases in uterine function, endometrial arylamidase activity was measured in guinea pigs during the reproductive cycle, decidualization and after ovariectomy with and without estrogen (E) and/or progesterone (P) treatment. Arylamidase activity was maximal during pro-oestrus-oestrus (40.0 +/- 10.0 mu/mg protein). 4. Enzyme activity was markedly depleted in decidualized endometrial stroma (12.3 +/- 1.6, P less than 0.01); reduced by ovariectomy (20.5 +/- 2.7); and stimulated by E (29.2 +/- 1.2); P had little effect (21.9 +/- 3.5). 5. The physiological significance of modulation of endometrial arylamidase activity by steroid hormones is discussed. PMID- 1769220 TI - An automated, video tape-based image archiving system. AB - We have developed an image storage and retrieval system that makes use of a Super VHS video tape recorder, and a personal computer fitted with an interface board and a video frame grabber. Under PC control, video images are acquired into the frame grabber, a numeric bar code is graphically superimposed for identification purposes, and the composite images are recorded on video tape. During retrieval, the bar code is decoded in real-time and the desired images are automatically retrieved. This video tape-based system, enables the images to be previewed and retrieved much faster than if stored in digital format. PMID- 1769221 TI - Segmentation of high-frequency ultrasound images of atherosclerotic coronary arteries. AB - High-frequency epicardial echocardiography (HFE) is an ultrasound imaging technique capable of visualizing coronary arteries in cross-section. Use of this imaging technique in the intra-operative setting can provide information about the structure of coronary arteries. As a result of time constraints imposed in this setting, there is a need for rapid, on-line analysis of HFE images. An algorithm for segmenting HFE images of coronary arteries into wall and luminal regions is described in this paper. The algorithm is more objective and time efficient than manual methods. A validation study with post-mortem human hearts demonstrated an excellent correlation (r = 0.99 for luminal areas, r = 0.99 for wall areas) between HFE images segmented with the algorithm and by manual methods, and a good correlation (r = 0.90 for luminal areas, r = 0.86 for wall areas) between HFE images segmented with the algorithm and manually segmented images of histological samples of the corresponding coronary arterial segments. Use of the algorithm for intra-operative HFE image segmentation may reduce the amount of time required for HFE image analysis and allow for an increased amount of data collection and analysis in the operating room. PMID- 1769222 TI - A computational study of convoluted back projection algorithm. AB - Image reconstruction by computerized tomography is a complex mathematical process. This paper describes the practical implementation of a tomographic reconstruction algorithm on different types of computers (micro to mainframe) and in different programming languages (BASIC to OCCAM) and performance studies were made. PMID- 1769223 TI - XECT--a least squares curve fitting program for generalized radiotracer clearance model. AB - The program uses the joint Monte Carlo-Simplex algorithm for fitting the generalized, non-monoexponential model of externally detected decay of radiotracer activity in the tissue. The optimal values of the model parameters (together with the rate of the blood flow) are calculated. A table and plot of the experimental points and the fitted curve are generated. The program was written in Borland's Turbo Pascal 5.5 for the IBM PC XT/AT and compatible microcomputers. PMID- 1769224 TI - Process for analysis of an area delimited by a nonparametric curve and divided into microdomains, and for localization of possible constituents: exploitation by "digisector" software. AB - The process presented here was designed and developed for study of various cell parameters in electron microscopy photographs and analysis of the location of certain differentiated cell-constituents relative to plasma membrane. It can also be used for many other applications, for example, in metallurgy, petrography and geostrategy. A photograph is analyzed using a plotting table interfaced with a microcomputer. PMID- 1769225 TI - PNM: a program for parametric and nonparametric mapping of multidimensional data. AB - A program named PNM is presented for the mapping of multidimensional data within a two-class classification problem. A novel mapping method is used for the purpose. The computing procedure implemented in the program is described in detail. Definitions and examples of the control instructions of the program are given at length. An application of PNM for classifier design concerning differential diagnoses of the cerebrovascular accident is presented. It confirms the efficiency of the program in solving classification problems of relatively large size on a small computer. PMID- 1769226 TI - Testing life-cycle theory by computer simulation--I. Introduction of genetical structure. AB - Computer simulation was used to relax assumptions of analytical life-cycle theory about the eventual outcome of evolution in a constant environment. The computer simulation models, of diploid one-locus genetic systems, are described in detail. Good agreement was obtained between the analytical and simulation outcomes, except in some cases of discrepancy between the male and female life cycles. PMID- 1769227 TI - Testing life-cycle theory by computer simulation--II. Bet-hedging revisited. AB - Analytical and computer models were used to reexamine bet-hedging, the reduction in fecundity that is evolutionarily advantageous in conditions of greater variation in juvenile survivorship or less variation in adult survivorship. The computer simulation models represent diploid one-locus genetic systems with semidominance. Schaffer's (1974) predictions proved remarkably robust when variations were symmetrical, and a simple modification allowed successful prediction for the asymmetries that occurred in the computer simulations when variations were large. PMID- 1769228 TI - On analytical methods and inferences for 2 x 2 contingency table data from medical studies. AB - Analysis of 2 x 2 contingency tables is not as trivial as it appears. The choice of the statistical test can affect the inferences resulting from data analysis, especially at small sample sizes. Canned statistical programs do not necessarily lead to an appropriate test. These points are demonstrated using examples from the literature. PMID- 1769229 TI - Formulas for threshold computations. AB - Given a continuous variable S, which density functions on two subgroups omega + and omega - of a population omega are known (with for instance a higher mean value on omega + than on omega -), we first define two strategies for classification in these groups; the first one (MWC) consists in determining a threshold alpha such that classifying in omega + when S greater than or equal to alpha, in omega - otherwise, leads to the highest percentage of well-classed elements. The second one consists in choosing the most probable group, given the observed value of S. We give mathematical formulas for the thresholds involved in these two strategies when the density functions, determined by the application of the maximum entropy principle, are those of normal distributions. These formulas prove that the two considered strategies are frequently equivalent, and we give simpler formulas when the partial variances of S on omega + and omega - are unknown or approximately equal. All the formulas are adapted to the case where a cost coefficient is introduced to display the unequal seriousness of the two possible errors (misclassification in omega + or omega -). Then we consider an example, where we see that the computed thresholds can be graphically validated from empirical curves and have the same performances on the learning sample and on a test sample. PMID- 1769230 TI - Methods for knowledge extraction from a clinical database on liver diseases. AB - We performed exploratory data analysis (EDA) to examine the hidden structure in liver disease data. The purpose was to demonstrate the potential of statistical techniques for extracting knowledge from an active HIS (hospital information system) database with decision support. The goal is to give strong support to the creation of new rules or "tuning" of old rules in the knowledge base. This would facilitate utilization of large patient databases, now commonly available, to help build/update decision support systems for improved patient care. Several statistical techniques were investigated. Stepwise discriminant analysis was found to be a good method in discriminating among different disease classes. Results showed that classification strength of a few (3) variables was similar to all the available (19) variables. Other important issues in the work are treatment of missing values as well as atypical values in medical databases. In estimating missing values we utilized both statistical methods and artificial intelligence approaches. Both these approaches were promising in the estimation of missing values. The study showed that several statistical approaches are possible for knowledge extraction from clinical data collected retrospectively. PMID- 1769231 TI - Internodal pathways in the human atria: a model study. AB - An electrophysical/anatomical computer model of human atrial excitation was used to investigate the controversy over specialized internodal pathways. The only atrial pathways that have been thoroughly described in the literature are those that connect the sinoatrial (SA) and atrioventricular (AV) nodes, and the right and left atria. By incorporating pathways of rapid propagation representing the internodal and interatrial tracts, anisotropy was introduced into an otherwise isotropic atrial model. Simulated epicardial isochrone maps, heart vector loops, and electrograms were calculated for both the isotropic and anisotropic atrial models, and the simulations were compared with observed normal data. Although the simulations using the anisotropic model compare more favorably with real data, the results suggest that there are more pathways of rapid propagation in the atria than those described and that a global anisotropy based on morphology and fiber direction is a more likely explanation than rapid propagation confined to a few specialized pathways. PMID- 1769232 TI - A method for prediction of phenytoin levels in the acute clinical setting. AB - Phenytoin (PHT) administration is complicated by saturation kinetics within the therapeutic range, causing marked changes in drug concentration with small changes in dose. The "half-life" increases with concentration, varying from 8-24 hr up to weeks, making it difficult to obtain the steady state levels needed by most prediction algorithms and nomograms. A Bayesian prediction program (Epidose) is presented which explicitly models PHT absorption and elimination kinetics in the non-steady state. The algorithm accounts for the interdependency of closely spaced sequential samples. Estimates of future PHT concentration were made on 20 hospital inpatients, most of whom were acutely ill and received other medications. Future (mean = 4 day) PHT concentrations were predicted over a range from 4 to 22 micrograms/ml (mean 13.9 micrograms/ml) with a median absolute error of 1.0 microgram/ml. These data demonstrate that the program can be used for accurate PHT concentration predictions in sick patients. PMID- 1769233 TI - Computer graphics representation of a statistical model used with computer-aided diagnosis. AB - A description of computer graphics of a multidimensional model that is used with computer-aided diagnosis or prognosis is presented. The model is discussed and computer graphics of the model are developed. The computer graphics are suitable as visual supplements for presenting the computer-aided diagnostic model to individuals who may be inexperienced in multivariate statistics. PMID- 1769234 TI - Vitamin K-dependent carboxylation in articular chondrocytes. AB - A nonhepatic vitamin K-dependent protein, matrix Gla protein, has recently been identified in cartilage where it may play an important role in the control of mineralization or matrix development. We have investigated the vitamin K cycle in chondrocytes isolated from bovine and rabbit articular cartilage and examined these cells for their ability to synthesize vitamin K-dependent proteins. Chondrocytes were found to have an active vitamin K-dependent carboxylation system. Preincubation of the cells with warfarin resulted in a significant increase in the measured carboxylase activity. Both vitamin K epoxide reductase and DT-diaphorase (EC 1.6.99.2) activity were present indicating that chondrocytes are capable of producing reduced vitamin K1H2, the cofactor for the vitamin K-dependent carboxylase. Specific 14C-labeling of microsomal vitamin K dependent protein precursors demonstrated synthesis of several vitamin K dependent proteins by chondrocytes. 35S-labeling of chondrocyte proteins provided evidence that matrix Gla protein is synthesized by these cells. PMID- 1769235 TI - Connective tissue metabolism in bone and cartilage of adjuvant arthritic rat. AB - The metabolism of connective tissue matrix components such as glycosaminoglycans and glycoproteins was investigated in normal as well as pathological tissues of bone and cartilage associated with adjuvant arthritis using rat as animal model of the disease. The inflammatory process of adjuvant arthritis was induced in rats with the inoculation of Freund's adjuvant containing heat killed Mycobacterium tuberculosis suspended in paraffin oil. The changes in the metabolism of matrix components in bone and cartilage were examined using radioactive isotopic labeling measurements during the acute as well as chronic phases of arthritic disease. The glycosaminoglycans were fractionated into sulfated and non-sulfated glycosaminoglycans by chemical and enzymic modifications. The biosynthesis of sulfated glycosaminoglycans was evaluated using radioactive labeled (35S)-sulfate. Alterations were demonstrated in the metabolism of connective tissue in the bone and cartilage tissues of arthritic rat. The results obtained showed an increased incorporation of radioactive sulfate in specimens of bone and cartilage during the process of adjuvant arthritis. The contents of sulfated as well as non-sulfated glycosaminoglycans were found to be increased in both the tissues of arthritic rat. Similarly, the amount of total glycosaminoglycans was also found to be increased significantly in the diseased tissues. In addition, various components of tissue glycoproteins such as fucose, sialic acid and total hexose were found to be elevated in insoluble fractions of bone and cartilage during the diseased state. The effects of experimentally induced adjuvant arthritis on the connective tissue were discussed in the light of changes taking place in the metabolism of glycosaminoglycans and glycoproteins in bone and cartilage of arthritic rat. PMID- 1769236 TI - Inhibition of tropoelastin expression by 1,25-dihydroxyvitamin D3. AB - Elastin production is modulated by steroid hormones and is dependent on calcium. Because vitamin D3 is involved in the regulation of calcium metabolism and influences the expression of various extracellular matrix proteins, we investigated whether vitamin D3 influences tropoelastin expression. Three elastin producing, bovine cell types, auricular chondroblasts, nuchal ligament fibroblasts and arterial smooth muscle cells, were treated with the principal active metabolite of vitamin D3, 1,25-dihydroxyvitamin D3 (1,25[OH]2D3), and with 24,25 dihydroxyvitamin D3 (24,25[OH]2D3). Tropoelastin levels in culture media and cell layers, as measured by an enzyme-linked immunoassay, decreased in a dose and exposure dependent manner after treatment with 1,25(OH)2D3; 24,25(OH)2D3 had no effect on tropoelastin production relative to solvent-treated controls. The maximal effective dose of 1,25(OH)2D3 was 10(-7) M for 48 hr, which resulted in a severalfold reduction of tropoelastin production, and decreased tropoelastin levels were detected at 8 hr after treatment. Reduction of tropoelastin protein production was paralleled by a decrease of equal magnitude in the steady-state levels of tropoelastin mRNA. Vitamin D3 metabolites had no effect on DNA or total protein synthesis. These results suggest that vitamin D3 may be an important modulator of elastin expression. PMID- 1769237 TI - The influence of aminoguanidine on borohydride reducible collagen cross-links and wound strength. AB - The mechanical strength of skin wounds as well as the deposition of hydroxyproline and KB3H4 reducible hydroxylysinonorleucine (HLNL) and dihydroxylysinonorleucine (DHLNL) cross-links in subcutaneously implanted cellulose sponges have been investigated in rats treated with aminoguanidine (AG) or beta-aminopropionitrile (BAPN). Treatment with AG (25 mg/kg BW/day) did not influence the mechanical strength of the wounds, the deposition of hydroxyproline or the pattern of reducible collagen cross-links, whereas AG (125 mg/kg BW/day) reduced the maximum load by 17%, but did not influence the deposition of hydroxyproline or reducible cross-linking pattern. Treatment with BAPN (333 mg/kg BW/day) reduced the strength of the wounds by 59%, the HLNL by 50% and the DHLNL 57%, whereas the deposition of hydroxyproline did not seem to be influenced by BAPN treatment. In conclusion, AG at moderate dosage does not seem to influence the formation of lysyl oxidase dependent reducible cross-links of collagen. PMID- 1769238 TI - Effects of hormonal perturbations on the small dermatan sulfate proteoglycan and mechanical properties of the uterine cervix of late pregnant rats. AB - Rats at 16-18 days of pregnancy were treated with various hormones in attempts to accelerate cervical softening and dilatation. Mechanical properties and biochemical components of the extracellular matrix were quantified at day 19. PGF2 alpha treatment significantly increased cervical wet weight, inner circumference, total amount and concentration of small dermatan sulfate proteoglycan, and the ratio of small proteoglycan to collagen; it decreased the concentration of collagen. Fluprostenol increased the extensibility and the rate of creep and decreased the collagen concentration. The progesterone antagonist ZK 98.734 (11 beta-(4-dimethylaminophenyl)-17 beta-hydroxy-17 alpha-(3-hydroxy-prop (Z)- enyl)-4,9,(10)-estradiene-3-one) increased the inner circumference and the ratio of small proteoglycan to collagen; it decreased the collagen concentration. Treatment with 17 beta-estradiol increased the amount of medium-sized proteoglycans and decreased the concentration of the small proteoglycan. The results support the hypothesis advanced in our earlier study that the inner circumference of the cervix, a measure of dilatation, is dependent upon the ratio of small dermatan sulfate proteoglycan-II (decorin) to collagen. These studies also suggest that changes in the inner circumference and the extensibility of the cervix involve two distinct processes of connective tissue alteration. PMID- 1769239 TI - Laser balloon angioplasty. AB - Unlike conventional transluminal percutaneous angioplasty (PTCA), which applies only intraluminal pressure, laser balloon angioplasty (LBA) employs simultaneous heat and pressure to reopen heavily occluded arterial lumens. The circumferential irradiation of Nd:YAG (1.06 microns) laser light is directly absorbed by approximately 1 to 2 mm of arterial tissue immediately adjacent to the inflated balloon. Such heating by LBA is able to seal disrupted luminal flaps, thermally remodel the luminal surface topology, reduce arterial recoil, selectively (partially) dehydrate thrombus, and possibly even reduce thrombogenicity at atherosclerotic sites. Criteria for successful LBA are defined based on earlier fundamental in vitro experiments to determine effective welding temperature, laser power doses, and exposure period; in addition, the derivation and validity of a three-part optical-thermal model and its application in parametric dosimetry analysis are presented. Though the lumen remodeled by LBA is acutely satisfactory, recurrence of the lesion is problematic chronically. Because of this, LBA is currently most useful as an adjunctive procedure whenever PTCA fails to produce optimal results or causes acute vessel closure. Perhaps, another potential application of the LBA system is to aid localized delivery of pharmacologic agents and their thermal adhesion to superficial tissue at angioplastied sites. PMID- 1769240 TI - The protocols and codes of practice used for the determination of absorbed dose in megavoltage photon and electron beams. AB - Air kerma-to-dose and exposure-to-dose conversion factors for megavoltage photon beams and electron beams are derived for a variety of commonly used ionization chambers, using the various dosimetry protocols and codes of practice currently in use. It is found that differences in the resultant values are present for both photon and electron beams. For example, for a NE2571 graphite-walled thimble ionization chamber, the maximum variation in the air kerma-to-dose conversion factor for photons, Cw,lambda, occurs at a "nominal" energy of 25 MV, when the difference between the maximum and minimum value of Cw,lambda is 5.4%, whereas the maximum difference between different protocols in the air kerma-to-dose conversion factor for electrons, Cw,e, occurs at Eo = 9 MeV, when the spread between maximum and minimum Cw,e values is 2.7%. An analysis of the conversion factors is undertaken to examine if the numerical or theoretical data are the cause of the discrepancies, and it is found to be a combination of both, although the major contribution to this difference arises from the use of different sets of stopping power ratios in the different protocols. PMID- 1769241 TI - Exercise-responsive cardiac pacemakers: review and performance evaluation. AB - The various aspects of the state of the art of exercise, or physiological responsive pacemakers (PM) are discussed. Models are used to assess the performance of PM controllers already on the market or in experimental stages. Emphasis is placed on comparison between open-loop and closed-loop controllers in light of the anticipation that future PM will have more sophisticated multiparameter expert system controllers. PMID- 1769242 TI - Magnetic studies on mechanical activity of the heart. AB - Magnetic measurement offers a new noninvasive technique for monitoring cardiac mechanical activity and for evaluation of important hemodynamic parameters, e.g., heart volume changes and cardiac output. The magnetic signal is observed with a sensitive magnetometer when an external magnetic field is applied to the thorax. The magnitude of the signal is usually in the order of a few picoteslas when an applied magnetic field of about 250 A/m is used. This signal is due to the differences in magnetic susceptibilities of intracardiac blood, heart muscle, and surrounding lung tissues. In the present paper, the origin of the magnetic susceptibility signal is theoretically analyzed and various measurement techniques are reviewed. The measurement results reported by different authors are compared and discussed. The spatial variation of the magnetic signal is analyzed in terms of mathematical models and its temporal behavior is compared with the results obtained from other measurement techniques. Three independent experimental methods are proposed in order to separate the magnetic plethysmogram from the other components in the total magnetic susceptibility signal recorded above the heart. The results suggest that usually about 65 to 80% of the signal originates directly from cardiac volume changes, and that the cardiac plethysmogram can be separated easily by surrounding the thorax with the medium whose magnetic susceptibility is about -5.10(-6), or by preventing motion of the chest wall of the subject. PMID- 1769243 TI - Isokinetic strength aspects of human joints and muscles. AB - The need to develop objective methods for determining muscle strength has been a major concern in rehabilitation, biomechanics, work physiology, and other related research areas for several decades. Because of the growing need for better standardization and control of resistive exercises in dynamic conditions, not only in clinical but in research settings also (as training/testing devices, and as a method for scientific evaluation of the force-velocity relationship), development of special devices or dynamometers using computerized techniques became relevant. This article examines the perspectives of muscle function with respect to the particular characteristics of strength and velocity in general and to isokinetic strength aspects in particular in human joints and muscles. The "isokinetic" movement condition as a tool for assessing and rehabilitating strength, clinical, and ergonomic applications, and the limitations of the methodology, is critically reviewed. PMID- 1769244 TI - Dental radiology and oral pathology. AB - This article represents an overview of normal and pathological findings of the oral structures for the practicing radiologist. Some of the disease processes discussed are of dental etiology, whereas others are manifestations of systemic diseases. Normal tooth development is described followed by an overview of radiolucent, radiopaque, and mixed lucent-opaque lesions. In the radiolucent category, normal anatomical landmarks of the jaws include the mental foramen, manidbular canal, incisive canal and maxillary sinuses. Other lucencies that represent normal structures or variations include developing tooth buds and root apices, healing dental extraction sites, prominent submandibular fossae and nutrient canals. In the radiopaque category, normal anatomical landmarks of the jaws include the genial tubercle, mental ridge, external oblique ridge, walls of the submandibular canal, walls of the maxillary sinus, nasal septum, stylohyoid ligament, and zygomatic process. Other opacities that represent normal structures or variations include dental restoration material, dental endodontic material, retained roots, sialoliths, salivary duct calculi, calcified lymph nodes, recent extraction sites, hypercementosis, and foreign bodies. Pathological entities which present radiographically as lucencies, opacities, and mixed lucent-opaque areas include inflammatory lesions, cysts, fibro-osseous disease, benign neoplasms, malignant neoplasms, and lesions secondary to metabolic disorders. PMID- 1769245 TI - Recantation in child sexual abuse cases. AB - This article pulls together coherently a rather sparse literature on children's not infrequent retraction of their earlier disclosure of having been sexually abused. Evidence to date indicates that very few originally lied. The pressures and circumstances that underlie recantation are multiple, and suggestions are made for mitigating them. PMID- 1769246 TI - Criteria for placement decisions with cocaine-exposed infants. AB - This study explored the criteria for placement decisions concerning cocaine exposed infants used by child protection workers in three suburban Chicago counties. Content analyses uncovered a complex decision-making process that demonstrated consistency across geographic regions. A number of primary factors influence decisions for in-home or out-of-home care for the infant, with the availability of support systems for the parents and infants a critical factor in deciding placement. PMID- 1769247 TI - [The physician and the law. Responsibility after a liability incident--what can, what should be done from the legal viewpoint?]. PMID- 1769248 TI - [Scheduling and compensation of overtime in the hospital]. PMID- 1769249 TI - [Request of a physician for granting release from continuing education]. PMID- 1769250 TI - [Legal aspects of ambulatory surgery]. PMID- 1769251 TI - [Arthroscopic surgery possibilities in surgical practice]. PMID- 1769252 TI - [Possibilities of operative proctologic therapy in surgical practice]. PMID- 1769253 TI - [Hand surgery in ambulatory practice]. PMID- 1769254 TI - [Ambulatory surgery in pediatric surgical practice--results of a questionnaire review of 467 children]. PMID- 1769255 TI - [Ambulatory surgery at a surgical university polyclinic in central Germany]. PMID- 1769256 TI - [The principle of hemodilution]. PMID- 1769257 TI - [Traumatic hemorrhagic shock]. PMID- 1769258 TI - [Abdominal sonography versus peritoneal lavage in shock site diagnosis in polytrauma]. AB - Diagnostic peritoneal lavage (DPL) and abdominal sonography (AS) were prospectively evaluated in emergency room diagnostics of blunt abdominal trauma in 106 multiple injured patients (ISS 40 pts). The incidence of intraabdominal lesions was 38.7%. 82 DPL and 64 AS were performed. In 45 patients both procedures were done, in 19 patients only AS and in 37 patients only DPL. The over-all accuracy of DPL and AS was 95% and 88%, respectively. Sensitivity was 91 vs. 74%, specificity 98 vs. 95%. The combined use of both procedures increased accuracy to 98%. We conclude that AS is the initial screening method for the detection of intraabdominal lesions in multiple injured patients. In any case of negative AS and hemodynamic instability or ambiguous AS, DPL should be performed immediately to improve diagnostic accuracy without delaying treatment. PMID- 1769259 TI - [Elective-selective Warren splenorenal shunt operation. Prognosis of liver function and esophageal varices hemorrhage after repeat sclerotherapy in liver cirrhosis]. AB - From March 1st, 1982 to March 1st 1990 399 patients were admitted to the Heinz Kalk-Hospital with recurrent bleeding from esophageal varices. Therapy of first choice was acute or elective endoscopic sclerotherapy. Early recurrences and uncontrollable hemorrhage were treated by Linton-Nachlas tube or if unsuccessful by devascularisation procedure. Two early or late bleeding recurrences were defined as sclerotherapy failures and choosen after passing a selection analysis (liver volume 1000 to 2500 ml, portal perfusion more than 30%, liver biopsy without activity or progression, exclusion of stenosis in the arterial supply of the liver and Child-Pugh classification A and B) for a selective-elective splenorenal Warren shunt (SRS). In 10 of 44 selected patients (11%) with an underlying disease of intrahepatic block in 95%, mostly alcoholic origin (65%) intraoperatively the performance of an SRS was technically problematic or impossible. Therefore, a mesocaval interposition shunt was carried out. Early mortality of 34 SRS was 5.9% (2 patients) and late mortality 17.6% (6 patients). No encephalopathy and shunt thrombosis were recorded. Postoperative angio- and sequential scintigraphies proved that portal perfusion was preserved during the first two years, but diminished. Liver function remained stable, too. One case of early rebleeding could be successfully managed by emergency endoscopic sclerotherapy. Five- and eight-years survival rate, according to the method of Kaplan-Meier is about 70%. We conclude that the SRS is the treatment of choice for elective management of recurrent bleeding of esophageal varices refractory to sclerotherapy. Its performance should be not enforced; in case of technical difficulties narrow-lumen mesocaval interposition shunt is an excellent alternative. PMID- 1769260 TI - [Esophageal perforation--indications for surgical therapy]. AB - From January 1, 1970 to April 1, 1990, we treated 32 patients with esophageal perforations. 19 patients underwent surgical repair by bilateral closing suture (n = 10), mucosal suture, extramyotomy and semifundoplication in the presence of achalasia (n = 6). Three patients had subtotal esophagus resection with esophageal graft. Four of these patients died postoperatively, the site of intervention being unremarkable. We lost 7 out of 13 patients from the group subjected to conservative therapy. These results suggest a low risk in the surgical treatment of esophageal perforations when carried out at early stage. The conservative approach on the other hand constitutes an uncalculable risk factor. It should be thus be employed with utmost precaution, e.g. in case of minor perforation only, or in patients with incurable carcinoma. PMID- 1769261 TI - [Detection of tumor cells in bone marrow: a deciding aid for adjuvant therapy in node negative patients with breast cancer. Concept for a multicenter study and results of the pilot phase]. AB - In node-negative breast cancer some 30% of patients will suffer a tumor relapse, despite primary curative therapeutic intervention. An adjuvant therapy is therefore in discussion, especially in presence of risk factors. Immunocytochemical staining of cytokeratin-positive cells in bone marrow aspirates with monoclonal antibodies offers a chance to detect tumorcell dissemination at an early stage of single tumor cells. In 103 consecutive patients 50% showed a positive bone marrow aspirate, in node negative patients still 34%. Based on the literature and tumor biology this method may be valid in selecting node-negative breast cancer patients for adjuvant therapy. In a prospective multi-center trial the prognostic value will be evaluated in regard to other prognostic factors. Additionally the benefit of an adjuvant therapy will be studied in a randomized prospective trial. PMID- 1769262 TI - [Treatment of symptomatic non-parasitic liver cysts using percutaneous drainage and irrigation with hypertonic saline solution]. AB - In 7 patients with a total of 20 symptomatic larger liver cysts an instillation therapy with 20% saline solution was performed via a sonographically placed sump drainage. No clinically relevant complications were observed. After a median follow-up period of 18 months in two patients with cystic livers asymptomatic residual cysts measuring less than 4 cm were found only. In comparison to the instillation therapy using a sclerosing agent the presented technique seems to be equally effective but less traumatizing. Surgical procedures are restricted to a few, otherwise not treatable patients. PMID- 1769263 TI - [Does covered tibial intramedullary nailing promote formation of a compartment syndrome? Perioperative and intraoperative continuous monitoring of compartmental pressure in covered tibial intramedullary nailing]. AB - Between October 1988 and October 1989 we performed a continuously pressure monitoring with the infusion technique in the tibialis anterior and deep posterior compartment of the lower leg during the nailing of the tibia in complete fractures of the lower leg in 16 patients. We set up 2 groups of patients because of different pathophysiological conditions: patients, who were operated on a few days after trauma (Group A) and patients operated on months after the trauma (Group B) because of non-union of the tibia. The effects of the preoperative, intraoperative, and postoperative manipulations were recorded. In no case we saw a beginning compartmental syndrome, although very high pressures of 100 mmHg in Group A and 55 mmHg in Group B in the deep posterior compartment during reduction of the fracture were registrated. The registrated pressures correlated very well with the manipulations during the operation and were absolutely reversible after the ending of these manipulations. In our observation the closed tibia nailing does not favorize the development of a compartmental syndrome, if not done during the vulnerable phase after the first days after trauma, in blunt multiple trauma patients and during bleeding complications. PMID- 1769264 TI - [Differential diagnosis of dysphagia--intramural pseudodiverticulosis of the esophagus]. PMID- 1769265 TI - [Acute occlusion of an aorto-iliac bifurcation prosthesis after abdomino-perineal excision of rectum]. PMID- 1769266 TI - [Simultaneous and subsequent bilateral spontaneous Achilles tendon ruptures after steroid therapy and in diabetes mellitus]. PMID- 1769267 TI - [Invasive measurement of compartment pressure based on piezo-resistance principles]. PMID- 1769268 TI - The cytogenetic and molecular architecture of chromosome 1R--one of the most widely utilized sources of alien chromatin in wheat varieties. AB - Chromosome 1R of rye (Secale cereale) is one of the most intensively used sources of alien chromatin in bread wheat. It provides a source of valuable disease resistance genes and its widespread use has stimulated the development of genetic maps incorporating protein and DNA markers. Published data as well as new mapping data were combined into a consensus map by using common markers in the different mapping studies to orient the various data sets relative to each other. The consensus map provides a tentative order, and relative distances, between the genetic markers. A summary of the dispersed repetitive sequences that are now available for the detection and characterization of chromosome 1R segments in wheat is also provided. PMID- 1769270 TI - New evidence for tandem chromosome fusions in the karyotypic evolution of Asian muntjacs. AB - A clone of highly repetitive DNA, designated C5, was isolated from DNA of female Chinese muntjac cells. The nucleotide sequence of this clone is 80%-85% homologous to that of the satellite IA clone and other highly repetitive DNA clones previously obtained from the Indian muntjac. Using C5 as a probe for in situ hybridizations to chromosome preparations of cells of both the Chinese and Indian muntjacs, we were able to show that these repeated sequences occur in centromeric heterochromatin of the chromosomes of both Chinese and Indian muntjac species. More significantly, non-random clusters of hybridization signals were detected on the arms of chromosomes of the Indian muntjac. These latter hybridization sites are postulated to be regions of interstitial heterochromatin and could be the remnants of centromeric heterochromatin from ancestral Chinese muntjac chromosomes. Our observations provide new supportive evidence for the tandem chromosome fusion theory that has been proposed for the evolution of the Indian muntjac karyotype. PMID- 1769269 TI - Immunofluorescent localization of triplex DNA in polytene chromosomes of Chironomus and Drosophila. AB - Purine.pyrimidine (pur.pyr) DNA tracts are prevalent in eukaryotic genomes. They can adopt a triplex conformation in vitro under conditions that may exist in vivo, suggesting that triplex (H-) DNA may exist naturally in chromosomes. To explore this possibility and gain insight concerning potential functions, the distribution of triplex DNA was studied in fixed polytene chromosomes of Chironomus tentans and Drosophila melanogaster by indirect immunofluorescence microscopy using an anti-triplex DNA monoclonal antibody (Jel 318). Chromosomes stained with this antibody exhibited immunopositive regions corresponding to condensed chromatin bands; interbands were less immunofluorescent. These results imply that there is more triplex DNA in bands than in interbands. In Chironomus, nucleolar organizer regions and Balbiani rings were immunonegative, indicating that triplex DNA is not present in decondensed, transcriptionally active chromatin. A few specific bands in both Chironomus and Drosophila were intensely immunofluorescent. In Drosophila, one such region was 81F on chromosome 3R. Competition during staining with exogenously added sequences corresponding to a constituent 1.672 g/cm3 satellite DNA in region 81F failed to abolish the immunofluorescence, suggesting that the satellite DNA does not fortuitously react with Jel 318 and implying that unidentified pur.pyr sequences forming triplex DNA are also present at this location. Region 81F exhibits ectopic pairing with nonrelated chromosome regions that have also proven to be intensely immunopositive; this suggests that the formation of triplex DNA between common, shared pur.pyr sequences in these otherwise nonhomologous bands might account for the ectopic pairing phenomenon. Together with our previous results, these data are consistent with the hypothesis that triplex DNA may play a role in chromosome organization by participating in regional chromatin condensation. PMID- 1769272 TI - Distribution of the rDNA and three classes of highly repetitive DNA in the chromatin of interphase nuclei of Arabidopsis thaliana. AB - The distribution of the ribosomal RNA (rRNA) genes and three classes of highly repetitive DNA in the chromatin of interphase nuclei of Arabidopsis thaliana was studied for the first time through non-isotopic in situ hybridization and luminescence digital imaging microscopy. Each of the three classes of highly repetitive DNA exhibited a characteristic hybridization pattern, and one class was seen to be primarily localized on two chromocentres, which would allow it to distinguish a particular chromosome. The rDNA was consistently localized on the two largest chromocentres and on one or two smaller chromocentres. A limited number of nuclei exhibited more than four labelled chromocentres, indicative of either polypoidy or differential amplification of the rDNA. In nuclei where the nucleolus could be clearly observed, the nucleolar associated chromocentres (NACs) were seen to be labelled by the ribosomal DNA (rDNA) probe. PMID- 1769271 TI - The organization, localization and nucleotide sequence of the histone genes of the midge Chironomus thummi. AB - Several histone gene repeating units containing the genes for histones H1, H2A, H2B, H3 and H4 were isolated by screening a genomic DNA library from the midge Chironomus thummi ssp. thummi. The nucleotide sequence of one complete histone gene repeating unit was determined. This repeating unit contains one copy of each of the five histone genes in the order and orientation mean value of H3 H4 mean value of H2A H2B H1 mean value of. The overall length is 6262 bp. The orientation, nucleotide sequence and inferred amino acid sequence as well as the chromosomal arrangement and localization are different from those reported for Drosophila melanogaster. The codon usage also shows marked differences between Chironomus and Drosophila. Thus the histone gene structure reported for Drosophila is not typical of all insects. PMID- 1769273 TI - Molecular organization of the Drosophila melanogaster Pig-1 gene. AB - The Pre-intermoult gene-1 (Pig-1) of Drosophila melanogaster maps on the X chromosome, at polytene bands 3C11-12, and is nested within the 79 kb intron of the dunce gene. Pig-1 has so far been characterized only preliminarily and its function is still unknown. We analysed the molecular organization of the gene by cDNA clone isolation and sequencing as well as S1 mapping and primer extension analyses. The results obtained reveal that the gene is colinear with its genomic sequence and define the usage of both 5' and 3' alternative sites for Pig-1 transcription; two continuous open reading frames (ORFs) are fully contained within the Pig-1 transcribed region, although several lines of evidence suggest that only the longer ORF is likely to be translated. We also report that the level of Pig-1 transcript is nearly fourfold reduced in a variant strain carrying a deletion within the Pig-1 upstream sequence, thus identifying a regulatory element required for high level gene expression. PMID- 1769274 TI - Cytogenetic and molecular aspects of position effect variegation in Drosophila melanogaster. IV. Underreplication of chromosomal material as a result of gene inactivation. AB - A chromosomal region subjected to position effect variegation was analysed for possible DNA under-replication. DNA clones from the vicinity of the euheterochromatin junction and from a distance of hundreds of kilobase pairs were used as probes. Formation of compact blocks of chromatin is regarded as a characteristic feature of position effect variegation. It was shown that in T (1;2) dorvar7 males undergoing position effect variegation clones representing the DNA nearest to the breakpoint in 2B7 hybridized normally in situ to the compact blocks, providing evidence against DNA underreplication. In females the same clones did not hybridize to the compact blocks. These variations in hybridization may be related to different degrees of compaction of chromosome regions in males and females. A correlation between the degree of underreplication and the level of cell polyteny was shown by Southern-blot hybridization of a DNA probe from the 2B region to DNA from an X/O strain carrying Dp (1;1)pn2b displaying position effect variegation and compaction in 94% of salivary gland cells. Almost complete underreplication of the DNA of this region was found in salivary gland cells (with a maximal degree of polyteny), intermediate underreplication was found in fat body cells (with an intermediate degree of polyteny), and replication was not disturbed in diploid cells of the larval cephalic complex. PMID- 1769275 TI - Comparative mapping of a gorilla-derived alpha satellite DNA clone on great ape and human chromosomes. AB - We have isolated an alpha satellite DNA clone, pG3.9, from gorilla DNA. Fluorescence in situ hybridization on banded chromosomes under high stringency conditions revealed that pG3.9 identifies homologous sequences at the centromeric region of ten gorilla chromosomes, and, with few exceptions, also recognizes the homologous chromosomes in human. A pG3.9-like alphoid DNA is present on a larger number of orangutan chromosomes, but, in contrast, is present on only two chromosomes in the chimpanzee. These results show that the chromosomal subsets of related alpha satellite DNA sequences may undergo different patterns of evolution. PMID- 1769276 TI - An overview of gene activity in the fat body of Drosophila gibberosa. AB - In the larval fat body of Drosophila gibberosa, polytene chromosome structure and activity exhibit cytological differences from chromosomes of midgut and salivary glands. These differences include long-persisting puffs, transient puffs and long persisting band modulations. Some early ecdysteroid-induced puffs are present in all three organs but few late puffs are present in the fat body. Comparative studies reveal, therefore, that late larval-early pupal puffing is enhanced in salivary glands relative to gut, fat body and Malpighian tubules. After the fat body breaks up in the prepupa, the rate of programmed cell death and the corresponding slow decline of chromosomal activity also differ from cell to cell and from other organs. PMID- 1769277 TI - Chromosome banding in Amphibia. XVI. High-resolution replication banding patterns in Xenopus laevis. AB - High-resolution replication banding patterns were induced in prometaphase and prophase chromosomes of Xenopus laevis by treating kidney cell lines with 5 bromodeoxyuridine (BrdU) and deoxythymidine (dT) in succession. Up to 650 early and late replicating bands per haploid karyotype were demonstrated in the very long prophase chromosomes. This permits an exact identification of all chromosome pairs of X. laevis. Late replicating heterochromatin was located by analysing the time sequence of replication throughout the second half of S-phase. Neither heteromorphic sex chromosomes nor sex chromosome-specific replication bands were demonstrated in the heterogametic ZW females of X. laevis. A detailed examination of the BrdU/dT-labelled prometaphases and prophases revealed that the X. laevis chromosomes can be arranged in groups of four (quartets), most of which show conspicuous similarities in length, centromere position, and replication pattern. This is interpreted as further evidence for an ancient allotetraploid origin of X. laevis. PMID- 1769278 TI - Mammalian sex chromosomes: evolution of organization and function. AB - Comparisons of chromosome size, morphology and gene arrangements between mammals of different species permit us to deduce the genome characteristics of the common ancestor, and to chart the changes that have occurred during the divergence of the two lineages. The more distantly related are the species compared, the more remote the common ancestor whose characteristics can be deduced. This means that, providing there are sufficient similarities to warrant comparison, the more divergent the species compared, the more significant the contribution to our understanding of the organization of an ancestral mammalian genome and the process of mammalian genome evolution. One of the genetic surprises of the last decade was the discovery that, although gross karyotypes of distantly related orders of eutherian mammals (e.g. cat, cow, rabbit, man) have diverged extensively, gene mapping studies reveal the presence of large chromosome segments conserved across at least 60 million years (O'Brien et al. 1988). This finding makes it worthwhile to extend genetic comparisons to the two groups of mammals most distantly related to eutherian mammals--marsupials and monotremes. Here we will review comparisons of the sex chromosomes in these three major groups of extant mammals, and show how they have led us to a new view of the evolution of mammalian sex chromosome organization and function in sex determination and X chromosome inactivation. PMID- 1769279 TI - Tissue distribution of two major components of synaptonemal complexes of the rat. AB - In this paper we describe an analysis of the tissue distribution of two recently identified components of synaptonemal complexes (SCs), an Mr 125,000 and an Mr 190,000 protein, in the male rat by immunoblot analysis and immunocytochemical techniques. We compared the tissue distribution of these antigens with that of two earlier identified SC components, an Mr 30,000 and an Mr 33,000 polypeptide. For this purpose we used monoclonal antibodies (Mabs) that react exclusively with SCs in lysed spermatocytes, and that recognize the above mentioned antigens specifically in immunoblots of SC proteins or of nuclear proteins from spermatocytes; these were Mab IX9D5 (anti-190,000), Mab IX5B2 (anti-125,000), Mab II52F10 (anti-30,000 + 33,000), and Mab IX8G9 (anti-30,000 + 33,000). In the immunoblot experiments, we could detect the Mr 190,000 and 125,000 antigens exclusively in blots of SC proteins or nuclear proteins from spermatocytes; these antigens were not detectable in blots of nuclear proteins from liver, brain, spermatogonia or spermatids or in blots of proteins from mitotic chromosomes or nuclear laminae. With the anti- 30,000 + 33,000 Mabs we obtained essentially the same result, except that Mab IX8G9, but not II52F10, recognizes a small amount of Mr 30,000 antigen in blots of nuclear proteins from spermatids and spermatogonia. Although this might be ascribed to contamination of the isolated spermatids and spermatogonia, we cannot exclude that a small amount of Mr 30,000 antigen is present in these cells. In the immunofluorescence analysis, the testis was the only tissue that reacted detectably with the above antibodies. Within the testis, spermatocytes and some early spermatids were the only cell types that contained detectable amounts of antigen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769281 TI - Bethesda System of reporting: a Canadian viewpoint. PMID- 1769280 TI - Structure, mitotic and meiotic behaviour, and stability of centromere-like elements devoid of chromosome arms in the fly Megaselia scalaris (Phoridae). AB - Minute elements detected in Megaselia scalaris (Phoridae, Diptera) lack chromosome arms but carry centromeres and possess kinetochore microtubules in mitosis as well as in meiosis. These centromere-like elements (CLEs) were present in two geographically independent strains of the fly. This indicates that their origin is not a recent event in the karyotype evolution of M. scalaris and that they are rather stable constituents of the karyotype. Most often, two CLEs were found in gonial and somatic mitosis. Spermatocytes contained one CLE. Two individuals examined deviated from this rule in that a metaphase spermatogonium showed three and an anaphase spermatogonium eight CLEs. These animals are believed to have been aneuploid relative to the CLEs. An analysis of spermatogonial division revealed that the CLEs behave like the centromeres of the regular chromosomes but seem to separate precociously, since they were closer to the spindle poles in late anaphase cells. Whereas the size of the CLEs was not significantly different between mitotic cells and secondary spermatocytes, the CLEs in primary spermatocytes were larger in volume by a factor of about 4.5 than those in mitosis and meiosis II. The additional material is interpreted as a glue that holds two CLEs together. This, in turn, is a prerequisite for orderly segregation. The function of the CLEs is not known. They are considered as B chromosomes reduced to the minimum required for segregation, the centromere. PMID- 1769283 TI - Quality assurance in a fine-needle aspiration biopsy service. AB - Fine-needle aspiration biopsy (FNAB) is an increasingly popular tool for the evaluation of a variety of palpable and nonpalpable masses. Its acceptance has been based on its simplicity, safety, and accuracy. It is its accuracy that is crucial and that requires careful clinical and/or histologic follow-up. In order to satisfy our own department's quality assurance requirements, we developed a computer-based searching program that effectively identifies FNAB cases in which there was histologic follow-up and retrieves the necessary information to produce a meaningful quality assurance report. PMID- 1769282 TI - Metastatic nasopharyngeal carcinoma: cytologic features of 18 cases. AB - The cytologic features of 18 fine-needle aspirates (FNAs) of metastatic nasopharyngeal carcinoma from 17 patients were examined. The 12 males and 5 females had a median age of 45 years (range 17-75 years). Six were white, five Oriental, four Hispanic, and two black. All patients had mid- or upper-cervical lymphadenopathy (14 bilateral, 3 unilateral). Seven developed widespread metastasis (bone, 5; lung, 2; liver 1; adrenal, 1; soft tissue, 1). The FNAs were from cervical lymph nodes (15), liver (1), adrenal (1), and soft tissue (1). Most aspirates showed similar cytologic features. Tumor cells were present singly and in syncytial groups with overlapping moderately pleomorphic oval to spindle shaped nuclei with thin, slightly irregular nuclear contours, moderately hyperchromatic chromatin, and usually one or two prominent nucleoli. The cytoplasm was scant and pale with ill-defined borders. Mitoses were frequent. Mature lymphocytes were common in the background of lymph node aspirates. Electron microscopy and immunocytochemistry confirmed the epithelial nature of the tumor in four cases. Although the cytologic features of metastatic nasopharyngeal carcinoma (NPC) are characteristic, other poorly differentiated neoplasms need to be considered. Clinical and radiologic data are helpful in supporting the cytologic diagnosis. PMID- 1769284 TI - Quantitative analysis of sputum cytologic differences between smokers and nonsmokers. AB - An exploratory analysis of sputum cytology was conducted to determine the extent and nature of cytomorphologic differences between smokers and nonsmokers. Specifically, alveolar macrophages, pigmentation of macrophages, neutrophils, mucus, mucous spirals, columnar cells, metaplastic cells, and dysplastic cells were analyzed and compared in 349 smokers and 93 nonsmokers. Results indicate that smokers have significantly higher scores on all components than do nonsmokers. Pigmentation of macrophages, alveolar macrophages, and mucous spirals were the major components discriminating between smokers and nonsmokers. A comparison of the nonsmoking sample with a different group of smokers (n = 466) revealed similar findings. Using the cytomorphologic parameters as the basis for classification, discriminant function analysis was able to classify correctly 94 percent of the nonsmokers and 91% of the smokers, a finding confirmed in the second group of smokers. These data indicate that smokers differ reliably from nonsmokers with respect to their cytomorphologic profile. PMID- 1769285 TI - The determination of Papanicolaou smear adequacy using a semiquantitative method to evaluate cellularity. AB - To examine the influence of sample cellularity and the presence of endocervical columnar cells on the detection of cervical dysplasia, Papanicolaou (Pap) smears taken from patients with biopsy-proven CIN II and III were analyzed retrospectively. Adequacy was semiquantitated by dividing each smear into 15 equal areas using a lined template and assigning an adequacy index (AI) of 0 to 15. The total false-negative (FN) rate was 15.8 percent, with 6.1% representing interpretive error and 9.7% representing sampling error. For FN slides truly lacking abnormal cells, the average AI was significantly lower than that of true positives (TP), even when endocervical columnar cells were present. The entire group was then blindly re-evaluated using a subjective application of the Bethesda System, classifying slides as satisfactory, less than optimal, and unsatisfactory. Although correlation of AI with the rapid Bethesda System categorization was imperfect, the exclusion of less than optimal and unsatisfactory smears also lowered the FN rate, but less effectively. An AI scoring technique, therefore, may be useful in the routine evaluation of Pap smear adequacy. PMID- 1769286 TI - Cytologic differentiation between proliferative and nonproliferative breast disease in mammographically guided fine-needle aspirates. AB - Fine-needle aspiration biopsy (FNAB) is considered a valid diagnostic procedure in management of patients with breast lesions. It is also important to differentiate benign nonproliferative change from proliferative breast changes, since the risk of development of breast carcinoma in patients with atypical hyperplasia is 4-5 times that of general population. Therefore, the recognition of proliferative breast disease with atypia significantly impacts on the patient's subsequent management. To assess the feasibility of a cytologic grading system to further characterize benign breast lesions, cytologic preparation of 87 mammographically guided FNABs were studied. Cellular aspirates were evaluated for the cellular arrangement, the degree of cellular pleomorphism and anisonucleosis, presence of myoepithelial cells and nucleoli and the status of the chromatin pattern. Values ranging from 1 to 4 were assigned to each cytologic criterion, and a score based on the sum of the individual values was calculated for each case. The minimum score attainable was thus 6. In our chosen criteria cytologic diagnosis of nonproliferative disease was entertained when the total score ranged from 6 to 10. Proliferative disease without atypia was diagnosed with a total score ranging from 11 to 14. Atypical hyperplasia was reported when the total score ranged from 15 to 18. A cytologic diagnosis of malignancy was entertained when the total score ranged from 19 to 24. The cytologic diagnosis was then compared to the reported histologic diagnosis from the excisional biopsies and the data were statistically analysed. A high degree of concordance was found between the cytologic findings and the histologic diagnosis. This study suggests that it is possible to apply a cytologic grading system to further subclassify benign breast disease and distinguish these forms from neoplastic lesions. PMID- 1769287 TI - Cytologic assessment of tumor cell kinetics: applications of monoclonal antibody Ki-67 to fine-needle aspiration smears. AB - Rates of tumor-cell proliferation often provide prognostic information about a given neoplasm. Previously available methods for accessing cell kinetics are time consuming and expensive, and often require special equipment or radioactive reagents. Monoclonal antibody Ki-67 binds a nuclear antigen expressed in proliferating but not in resting cells. We studied Ki-67 immunostaining of fine needle aspiration smears from 40 benign and malignant masses. Labeling indices ranged from 0 (thyroid follicular adenoma) to 75 percent (pulmonary oat-cell carcinoma). Frozen section immunostaining (11 cases) and flow cytometric assessment of cell proliferation (8 cases) were in good agreement with Ki-67 labeling indices on smear material. We suggest that this method provides a rapid, inexpensive, and dependable means of assessing tumor-cell kinetics in cytologic preparations. PMID- 1769288 TI - Leydig cell tumor of the testis: a case diagnosed by fine-needle sampling without aspiration with histologic, immunohistologic, and electron microscopic analysis. AB - Fine-needle sampling without aspiration was performed in a patient with a testicular mass. The cytologic diagnosis was consistent with Leydig cell tumor. Cytologic features included abundant grey-blue cytoplasms with spherical or oval nuclei in May-Grunwald-Giemsa-stained smears. Intranuclear inclusions were observed but no Reinke's crystals were detected. Histologic findings confirmed the diagnosis and tumor cells were positive for vimentin. Electron microscopic analysis of the tumor showed abundant smooth endoplasmic reticulum and mitochondria with tubulovesicular cristae but no Reinke's crystals. PMID- 1769289 TI - Diagnosis of endometriosis by fine-needle aspiration cytology. AB - Endometriosis is a fairly common disease found in a variety of extrauterine locations. It primarily affects reproductive age women and has symptoms varying from occult to more specific complaints. Occasionally the lesions produce solid nodules and/or cysts that are clinically palpable and easily evaluated by fine needle aspiration (FNA). We describe three cases of endometriosis diagnosed by FNA. The patients ranged in age from 32 to 38 and reported cyclic symptoms of pain, bleeding, or change in mass size. Two patients presented with subcutaneous masses (one along the upper pubic ramus, the other in the lower abdomen) and had ultrasonically guided FNA. The third patient had a vaginal cuff mass sampled by transvaginal FNA. All cytologic smears contained characteristic sheets of epithelial cells and fragments of loosely arranged spindled stroma. One case also showed mild epithelial atypia and plump stromal cells. Hemosiderin-laden macrophages were found in only one case. The cytologic diagnoses were confirmed by tissue in all patients. Endometriotic nodules must be evaluated for possible malignant transformation and differentiated from other benign and malignant masses, especially when clinical symptoms are vague. FNA offers a safe and effective tool for identification of endometriosis and obviates the need for diagnostic surgical procedures in some patients. PMID- 1769290 TI - Cytologic characteristics of clear-cell sarcoma of the kidney (CCSK) in fine needle aspiration biopsy (FNAB): a report of 4 cases. AB - The cytologic findings observed in fine-needle aspiration biopsy (FNAB) of four cases of clear-cell sarcoma of the kidney (CCSK) are reported. Smears contained a monomorphic population of cells exhibiting non-descriptive cytoplasm and almost nude round to oval nuclei with smooth contour, evenly dispersed fine chromatin granules, and one or two small nucleoli. Some nuclei (approximately 40%) had a bar resulting from grooving or folding of the nuclear membrane. Comparison with smears of classical Wilms' tumor and malignant rhabdoid tumor allowed to recognize a distinctive pattern, different from other tumors of the kidney in infancy. The recognition of the CCSK cytologic pattern justifies the usage of aggressive preoperative chemotherapy protocols or the indication of surgery avoiding delays. PMID- 1769291 TI - Pneumocystis carinii in FNA of the thyroid. AB - We report the diagnosis of Pneumocystis carinii (PC) in a fine-needle aspirate (FNA) from the thyroid of a human immunodeficiency virus infected (HIV+) male receiving aerosolized pentamidine as prophylaxis for Pneumocystis carinii pneumonia (PCP). The clinical diagnosis prior to FNA was multinodular goiter. The patient did not have pulmonary symptoms nor previous diagnosis of PCP at the time of the aspirate diagnosis. Recently, extrapulmonary Pneumocystis carinii (EPC) has been reported with increasing frequency in HIV+ patients receiving prophylactic aerosolized pentamidine. Awareness of extrapulmonary presentations of Pneumocystis carinii infection is a prerequisite for accurate cytologic diagnosis. PMID- 1769292 TI - Role of fine-needle aspiration biopsy in the assessment of sacrococcygeal masses. AB - While fine-needle aspiration (FNA) allows the diagnosis of deep masses, it does not always permit histologic classification. In the case of sites such as the sacrococcygeal region, in which a large number of benign or malignant, epithelial or connective, primary or secondary tumors may arise, it is necessary to choose between conservative treatment and radical surgery. This means that preoperative diagnosis must be as certain as possible. In order to increase the diagnostic accuracy of the method, when even immunohistochemistry is of no aid, it is useful to examine the histologic architecture of the specimen by preparing cell blocks from the aspirates. We report the comparative findings from the examination of the histologic architecture of tissue fragments embedded in methacrylate prepared from the aspirates of four cases of tumors: two chordomas, one metastasis of renal clear-cell carcinoma, and one of mucus-secreting carcinoma, all of them arising in the sacrococcygeal region. PMID- 1769293 TI - Cytologic diagnosis of cavernous hemangioma of the liver with fine-needle biopsy. AB - We present the cytopathologic findings in seven cases of cavernous hemangiomas of the liver diagnosed by direct "squash" smears made on tissue obtained through image-guided fine-needle biopsy. The diagnosis in each case was confirmed histologically. Utilizing this simple cytologic technique, the morphologic findings in these common hepatic lesions are as accurate and diagnostic as histologic examination. PMID- 1769294 TI - Cervicography: an alternative modality of cervical screening. PMID- 1769295 TI - Extrapulmonary inflammatory myofibroblastic pseudotumor: a potential cytologic trap in childhood. AB - A previously healthy 20-mo-old infant presented with a right leg limp and was discovered to have a palpable intra-abdominal mass. Radiographic studies showed the mass arising from the right psoas muscle. Preoperative clinical diagnosis was probable sarcoma. Percutaneous fine-needle aspiration biopsy of the mass was interpreted as a sarcoma based on the abundant cellularity of spindled shaped mesenchymal cells. Exploratory laparotomy showed the mass to be unresectable. Histologic and ultrastructural examination of biopsy fragments, however, revealed an inflammatory myofibroblastic pseudotumor. Radiographic follow-up showed a gradual disappearance of the mass. The infant was clinically well at a clinic visit one year following surgery. This case serves to illustrate the aspiration cytology of an uncommon benign tumor-like proliferation that, when located in an unusual anatomic site, has the potential to mislead the cytopathologist into a malignant interpretation. PMID- 1769296 TI - The diagnostic impact of needle aspiration cytology of the breast on clinical decision making with an emphasis on the aspiration cytodiagnosis of male breast masses. AB - Our experience with a total of 7,231 needle aspirates of the breast was reviewed. Ninety-nine cases from the total of 7,231 aspirates studied were from male patients. While an aspiration cytodiagnosis of gynecomastia was made in most of these cases, carcinoma was diagnosed in four cases. Although a clinical distinction between male breast cancer and gynecomastia is often difficult, we found needle aspiration cytology a very useful initial investigation for making this distinction. PMID- 1769297 TI - Black thyroid: a pitfall for aspiration cytology. AB - Black thyroid discoloration following long-standing use of minocycline has been reported. Morphologic findings of aspiration cytology of these lesions was first reported from The Ohio State University. This abstract describes a second case of black thyroid that was preceded by aspiration cytology. In both cases, thyroidectomies were performed based on "indeterminate" fine-needle aspiration cytology (FNAC). Degenerative changes in follicular epithelial cells in black thyroid causes nuclear hyperchromasia and chromatin clumping, which may be mistaken for neoplasia. Pigment present in follicular epithelial cells and macrophages may be obscured by pigments with similar microscopic appearances, such as hemosiderin. A clinical history of the chronic use of a tetracycline derivative should alert the pathologist to the possibility of black thyroid. Diagnosis may be made by applying special stains on the cell block. The pigment stains with Melanin stain (Fontana) and bleaches with potassium permanganate. In the light of increasing use of FNAC of the thyroid gland and the large number of patients who received tetracycline therapy in the last two decades, it is likely that some practicing cytopathologists may experience this pitfall. PMID- 1769298 TI - A simple time-saving device for urine specimen preparation. PMID- 1769299 TI - New frontiers in cytology: the diagnostic process with emphasis on prognosis. PMID- 1769300 TI - Pseudoepitheliomatous proliferation, a pitfall in sputum cytology. PMID- 1769301 TI - Theodor Leber's studies in Paris (1864-1867) as an assistant of Richard Liebreich. PMID- 1769302 TI - A German oculist in Russia. PMID- 1769303 TI - The wanderings of a literary ophthalmologist: A. Conan Doyle, Houdini, and Ada Besinnet. AB - Sir Arthur Conan Doyle, the creator of Sherlock Holmes and Dr. Watson, was a general practitioner, then studied ophthalmology. Doyle and Houdini, the famous magician, shared an interest in Spiritualism. They began as friends, but ended on opposite sides of a controversy over Spiritualism. Their differing viewpoints clashed with Besinnet, a well known medium, was involved. PMID- 1769304 TI - Herman Snellen (1834-1908) and Muller's 'reform-auge'. A short history of the artificial eye. AB - The shell prothesis, originally meant to be placed over the atrophic eye, caused serious problems when used after enucleation, which became more common practice in the second half of the last century. In the nineties of the last century Snellen Sr. tried to solve these problems by designing a light prothesis that filled up the empty space. At the insistence of Snellen, the Muller brothers in Wiesbaden succeeded in 1892 to blow a hollow artificial eye which proved to be a real success. PMID- 1769305 TI - Willem Vrolik on cyclopia. AB - One of the founders of the Museum Vrolikianum, Professor Willem Vrolik (1801 1862), was very interested in teratology, especially in a congenital malformation termed cyclopia. In 1834 he published a paper on cyclopia. This work was mainly based on studies of cyclopic specimens present in the collection of his father, Professor Gerardus Vrolik. In this study he proposed a classification system for cyclopes, in which he divided them into five main types. This study also formed the basis for the chapters on cyclopia in his Handbook of pathological anatomy (1842-1844) and his Tabulae ad illustrandam embryogenesin hominis et mammalium (1844-1849). In these studies the specimens of cyclopes of man and mammals, still present in the collection of the Museum Vrolik in the Department of Anatomy and Embryology of the University of Amsterdam, were described and illustrated with beautiful lithographs. The collection consists of five human cyclopes and nineteen other cyclopic mammals. These mammals are pigs, lambs and a cat. PMID- 1769306 TI - The terms glaucoma and cataract in the ancient Greek and Byzantine writers. AB - The authors deal with the meaning of the terms glaucosis and hypochyma, in the texts of ancient Greek and Byzantine medical writers. The analysis of these texts shows us that the meanings of these terms do not correspond to the modern ones. In the texts the term glaucosis corresponds to the modern cataract, and the term hypochyma to the pathological formation of a kind of membrane which appears in the space of the pupil, due to coagulation of a fluid. PMID- 1769307 TI - Ophthalmological therapy in hospitals (xenones) in Byzantium. AB - Based on the typikon of the Imperial Monastery of the Pantocrator of Constantinople (12th century) and the manuscripts used in the Byzantine hospitals as well as the published Lives of the Saints and other related sources, it is undeniable that special ophthalmological departments existed in the xenones of Byzantium. It is also proven, that specific ophthalmological therapy was practised here including surgery and particularly in the cataract operation. This last operation is attested to, not only by the medical writings of Byzantine writers but also from the therapies of the physician-saints Cosmas and Damian. PMID- 1769308 TI - [Photoreactivity of premutation damage caused by UV irradiation at the suppressor locus of Escherichia coli chromosomes]. PMID- 1769309 TI - [Similarity in changes in electrophoretic mobility of murine T-lymphocytes under the effect of concanavalin A and calcium ions]. PMID- 1769310 TI - [Size of amphotericin pores in the erythrocyte membrane]. PMID- 1769311 TI - [Kinetics of the interaction of subfragment 1 of myosin from rat skeletal muscles with F-actin studied by a stopped flow method]. PMID- 1769312 TI - [Anisotropy of the human visual field and functional asymmetry of the brain]. PMID- 1769313 TI - [Reaction of guppy Mauthner neurons on return to earth after a stay under weightless conditions]. PMID- 1769314 TI - [Study of the effect of phenophtorazole on the calcium ion concentration in rat thymocyte cytoplasm and on changes of this parameter, induced by concanavalin A]. PMID- 1769315 TI - [Effect of syngenic H-2K(sup k)-antigens on the functional activity of thymocytes detected in autologous and allogeneic mixed lymphocyte cultures]. PMID- 1769316 TI - Diuretic profile of a novel loop diuretic torasemide in rats and dogs. AB - In the present study, the authors have examined the diuretic action of a novel loop diuretic torasemide and compared it to those of other diuretics, employing normal rats and dogs. Oral administration of torasemide elicited a dose-dependent increase in urine volume and electrolyte excretion, and elevated the urinary Na/K ratio in rats. These effects were more potent than those of the other diuretics furosemide, trichlormethiazide, indapamide and spironolactone. Moreover, torasemide exhibited a similar or higher urinary Na/K ratio than the combination of these diuretics and spironolactone. In a study employing anaesthetized dogs, i.v. injection of torasemide resulted in a higher urinary Na/K ratio in comparison to furosemide, in addition to potent and long-lasting diuretic activity. PMID- 1769317 TI - Anaerobic osteomyelitis--treatment with metronidazole in an experimental rabbit model. AB - Anaerobic micro-organisms are important agents in chronic bone infections. Their pathogenic role, however, is still unclear partly because of methodological reasons. In this paper an experimental model of osteomyelitis is used for studies of metronidazole treatment of bone infections induced by Bacteroides fragilis. The proximal tibial metaphyses of ten New Zealand white rabbits were excavated and filled with sheets of polyvinyl alcohol, into which a suspension of B. fragilis cells was injected on the right side, while saline was used on the left side. Within a month the animals showed immunological and radiological signs of an established bone infection. After 25 weeks of observation, four animals were treated with subcutaneous injections of metronidazole at a dosage of 10 mg/kg body weight twice daily for three weeks and five animals received saline. After 37 weeks the animals were killed. Radiological, histological and microbiological evaluation showed bilateral osteomyelitis in all animals. Prolonged raised titres of antibodies suggested an established infection, and not merely a colonization. There were no differences between the animals treated with metronidazole and the animals not treated. PMID- 1769318 TI - Cefixime shows good effects on group A and group B beta-haemolytic streptococci. AB - There is continued interest in the development of oral beta-lactam compounds, which can be used clinically to treat various bacterial infections, particularly those caused by beta-haemolytic streptococci. Cefixime is a new orally active cephalosporin, with a broad spectrum of antibacterial activity, including Enterobacteriaceae, Haemophilus influenzae, Branhamella catarrhalis, Streptococcus pneumoniae and Streptococcus pyogenes. Cefixime is highly resistant to hydrolysis by most beta-lactamases. In this study the authors examined the effects of this molecule on Group A and Group B beta-haemolytic streptococci, recently isolated from clinical specimens in the authors' laboratory. MICs and the growth curves of 36 strains of Group A streptococci and the effects of sub MICs on buccal cell adhesion were evaluated. The results show that concerning the sub-MIC cefixime effect on streptococci adherence, the treatment led to a decrease in adherence to the cells of the strains studied. Moreover cefixime showed good activity with 86.1% of the strains with MIC less than or equal to 0.5 microgram/ml, and the growth curves demonstrated that the molecule possesses a bactericidal effect after 3 h. Concerning Group B streptococci, 70.3% of the strains showed a MIC less than or equal to 2 micrograms/ml. In conclusion cefixime demonstrates good activity on beta-haemolytic streptococci, particularly those of Group A. PMID- 1769319 TI - Pharmacokinetics of alpha-dihydroergokryptine in monkeys after oral administration. AB - The pharmacokinetic profile of a single dose (6 mg/kg) of alpha dihydroergokryptine (alpha-DHEK) was established after oral administration in monkeys using a radio-immunoassay technique for non-metabolized drug. alpha-DHEK showed a plasma profile according to an open three-compartment pharmacokinetic model with a long half-life (mean = 5.787 h). The disposition of alpha-DHEK involves a fast absorption, a slow distribution phase and a slow elimination phase. alpha-DHEK showed an high total clearance and distribution volume; the drug is largely metabolized, as concluded from the very low urinary excretion. PMID- 1769320 TI - Lithium and rubidium activities on platelet aggregation. AB - Lithium (Li) has been shown to increase the platelet number after chemotherapy. The present paper suggests that Li may increase the platelet aggregation induced by sub-optimal concentrations of ADP. Conversely, rubidium does not modify platelet aggregation in the present experiments. PMID- 1769321 TI - The effects of L-sulpiride on reflux oesophagitis. AB - Prokinetic drugs are commonly used for treatment of reflux oesophagitis. Although much data has been collected in clinical trials, their therapeutic effects are still uncertain. In this study the effects of L-sulpiride, if any, were examined when used to treat reflux oesophagitis in thirty patients. The patients were divided into two groups: a control group and a group given 25 mg t.i.v./day, p.o. of L-sulpiride for 30 days. They were treated as outpatients and had endoscopic, histological and ultrastructural examinations on the 30th and 60th days of treatment. It was found that the symptoms of patients with reflux oesophagitis were alleviated and the endoscopic and ultrastructural lesions of patients with minor oesophagitis were also decreased. In other patients, symptoms improved without resolution of the lesions. The authors conclude, therefore, that L sulpiride would be appropriate treatment for Grade I cases. PMID- 1769322 TI - Patterns of microtubule polymerization relating to cortical rotation in Xenopus laevis eggs. AB - Following fertilization, the Xenopus egg cortex rotates relative to the cytoplasm by 30 degrees about a horizontal axis. The direction of rotation, and as a result the orientation of the embryonic body axes, is normally specified by the position of sperm entry. The mechanism of rotation appears to involve an array of aligned microtubules in the vegetal cortex (Elinson and Rowning, 1988, Devl Biol. 128, 185-197). We performed anti-tubulin immunofluorescence on sections to follow the formation of this array. Microtubules disappear rapidly from the egg following fertilization, and reappear first in the sperm aster. Surprisingly, astral microtubules then extend radially through both the animal and vegetal cytoplasm. The cortical array arises as they reach the vegetal cell surface. The eccentric position of the sperm aster gives asymmetry to the formation of the array and may explain its alignment since microtubules reaching the cortex tend to bend away from the sperm entry side. The radial polymerization of cytoplasmic microtubules is not dependent on the sperm aster or on the female pronucleus: similar but more symmetric patterns arise in artificially activated and enucleate eggs, slightly later than in fertilized eggs. These observations suggest that the cortical microtubule array forms as a result of asymmetric microtubule growth outward from cytoplasm to cortex and, since cortical and cytoplasmic microtubules remain connected throughout the period of the rotation, that the microtubules of the array rotate with the cytoplasm. PMID- 1769323 TI - Migration and proliferation of cultured neural crest cells in W mutant neural crest chimeras. AB - Chimeric mice, generated by aggregating preimplantation embryos, have been instrumental in the study of the development of coat color patterns in mammals. This approach, however, does not allow for direct experimental manipulation of the neural crest cells, which are the precursors of melanoblasts. We have devised a system that allows assessment of the developmental potential and migration of neural crest cells in vivo following their experimental manipulation in vitro. Cultured C57Bl/6 neural crest cells were microinjected in utero into neurulating Balb/c or W embryos and shown to contribute efficiently to pigmentation in the host animal. The resulting neural crest chimeras showed, however, different coat pigmentation patterns depending on the genotype of the host embryo. Whereas Balb/c neural crest chimeras showed very limited donor cell pigment contribution, restricted largely to the head, W mutant chimeras displayed extensive pigmentation throughout, often exceeding 50% of the coat. In contrast to Balb/c chimeras, where the donor melanoblasts appeared to have migrated primarily in the characteristic dorsoventral direction, in W mutants the injected cells appeared to migrate in the longitudinal as well as the dorsoventral direction, as if the cells were spreading through an empty space. This is consistent with the absence of a functional endogenous melanoblast population in W mutants, in contrast to Balb/c mice, which contain a full complement of melanocytes. Our results suggest that the W mutation disturbs migration and/or proliferation of endogenous melanoblasts. In order to obtain information on clonal size and extent of intermingling of donor cells, two genetically marked neural crest cell populations were mixed and coinjected into W embryos. In half of the tricolored chimeras, no co-localization of donor crest cells was observed, while, in the other half, a fine intermingling of donor-derived colors had occurred. These results are consistent with the hypothesis that pigmented areas in the chimeras can be derived from extensive proliferation of a few donor clones, which were able to colonize large territories in the host embryo. We have also analyzed the development of pigmentation in neural crest cultures in vitro, and found that neural tubes explanted from embryos carrying wt or weak W alleles produced pigmented melanocytes while more severe W genotypes were associated with deficient pigment formation in vitro. PMID- 1769324 TI - The ability of hamster oolemma to fuse with spermatozoa: its acquisition during oogenesis and loss after fertilization. AB - To determine when the growing hamster oocyte gains the ability to fuse with the spermatozoon, oocytes at various stages of development were collected from ovaries, and zona-pellucida-free oocytes were inseminated in vitro with acrosome reacted spermatozoa. Very small primary oocytes were unable to fuse with spermatozoa. Oocytes first became competent to fuse with spermatozoa when they had grown to about 20 microns in diameter. The acquisition of fusibility coincided with the first appearance of zona pellucida material and oolemma microvilli. The fusibility of the oolemma increased as the oocyte grew, reaching a maximum when the oocyte reached the metaphase of the second meiosis. The fusibility of the oolemma was reduced drastically after fertilization, and was lost completely by the 8-cell stage. The appearance and subsequent disappearance of a putative fusion-mediating molecule in the oolemma is proposed. Since this molecule is fairly resistant to proteinase digestion, at least in the hamster, it could be a cryptic protein or a glycolipid. PMID- 1769325 TI - Gap-junctional permeability in early and cleavage-arrested ascidian embryos. AB - Using the whole-cell voltage clamp technique, we have studied junctional conductance (Gj), and Lucifer Yellow (LY) coupling in 2-cell and 32-cell ascidian embryos. Gj ranges from 17.5 to 35.3 nS in the 2-cell embryo where there is no passage of LY, and from 3.5 to 12.2 nS in the later embryo where LY dye spread is extensive. In both cases, Gj is independent of the transjunctional potential (Vj). Manually apposed 2-cell or 32-cell embryos established a junctional conductance of up to 10 nS within 30 min of contact. Furthermore, since we did not observe any significant number of cytoplasmic bridges at the EM and Gj is sensitive to octanol, it is probable that blastomeres in the 2-cell and 32-cell embryos are in communication by gap junctions. In order to compare Gj in the two stages and to circumvent problems of cell size, movement and spatial location, we used cytochalasin B to arrest cleavage. Gj in cleavage-arrested 2-cell embryos ranged from 25.0 to 38.0 nS and remained constant over a period of 2.5 h. LY injected into a blastomere of these arrested embryos did not spread to the neighbour cell until they attained the developmental age of a 32- to 64-cell control embryo. Our experiments indicate a change in selectivity of gap junctions at the 32-cell stage that is not reflected by a macroscopic change in ionic permeability. PMID- 1769326 TI - Changes in neural and lens competence in Xenopus ectoderm: evidence for an autonomous developmental timer. AB - The ability of a tissue to respond to induction, termed its competence, is often critical in determining both the timing of inductive interactions and the extent of induced tissue. We have examined the lens-forming competence of Xenopus embryonic ectoderm by transplanting it into the presumptive lens region of open neural plate stage embryos. We find that early gastrula ectoderm has little lens forming competence, but instead forms neural tissue, despite its location outside the neural plate; we believe that the transplants are being neuralized by a signal originating in the host neural plate. This neural competence is not localized to a particular region within the ectoderm since both dorsal and ventral portions of early gastrula ectoderm show the same response. As ectoderm is taken from gastrulae of increasing age, its neural competence is gradually lost, while lens competence appears and then rapidly disappears during later gastrula stages. To determine whether these developmental changes in competence result from tissue interactions during gastrulation, or are due to autonomous changes within the ectoderm itself, ectoderm was removed from early gastrulae and cultured for various periods of time before transplantation. The loss of neural competence, and the gain and loss of lens competence, all occur in ectoderm cultured in vitro with approximately the same time course as seen in ectoderm in vitro. Thus, at least from the beginning of gastrulation onwards, changes in competence occur autonomously within ectoderm. We propose that there is a developmental timing mechanism in embryonic ectoderm that specifies a sequence of competences solely on the basis of the age of the ectoderm. PMID- 1769327 TI - Decrease in DNA methylase activity during preimplantation development in the mouse. AB - During early mouse development, there are large-scale changes in DNA methylation. These changes may be due to the availability or stability of the enzyme, DNA methyltransferase (methylase), which is responsible for maintenance of DNA methylation. A microassay for methylase activity in preimplantation embryos shows that the level of maternally inherited enzyme is extremely high in the egg and that this activity is stable for the first three cleavage divisions. However, from the 8-cell to the blastocyst stage, there is a marked and absolute decrease in enzyme activity. PMID- 1769328 TI - Integrin expression during human epidermal development in vivo and in vitro. AB - In order to investigate the role of extracellular matrix receptors of the integrin family in establishing the spatial organization of epidermal kerotinocytes, we used immunofluorescence microscopy to examine the expression of a range of integrin subunits during development of human palm and sole skin. All of the integrins expressed during development were also present in mature epidermis and were largely confined to the basal layer of keratinocytes in a pericellular distribution. The alpha 3 and beta 1 subunits were expressed prior to the initiation of stratification and did not change in abundance or distribution during subsequent development. alpha 4 and beta 3 were not detected at any time in the epidermis. Every other subunit examined showed spatial or temporal changes in expression. Staining for alpha 1 was strong before stratification and until mid-development, but was greatly decreased in neonatal epidermis. alpha 2 was first detected in small patches of basal cells prior to stratification, and thereafter was found in the entire basal layer, with greater staining in developing sweat glands. alpha 5 was not expressed until mid development, and then primarily in developing sweat glands, with faint expression in neonatal epidermis. alpha v was detected following stratification, in developing sweat glands, and occasionally in neonatal epidermis. alpha 6 and beta 4 were peribasally expressed before stratification, but thereafter became concentrated at the basal cell surface in contact with the basement membrane, co localizing with hemidesmosomes as determined by staining with bullous pemphigoid antiserum. We also examined the distribution of three known ligands for keratinocyte integrins: laminin and collagen type IV were present in the basement membrane zone at all stages of development, whereas fibronectin was only evident there until about 13 weeks estimated gestational age. Finally, we found that the changes in integrin expression that occur on initiation of stratification in vivo could be reproduced in organ cultures of developing skin; such cultures therefore provided a useful experimental model for further studies of the role of integrins in epidermal stratification. PMID- 1769329 TI - Inductive differentiation of two neural lineages reconstituted in a microculture system from Xenopus early gastrula cells. AB - Neural induction of ectoderm cells has been reconstituted and examined in a microculture system derived from dissociated early gastrula cells of Xenopus laevis. We have used monoclonal antibodies as specific markers to monitor cellular differentiation from three distinct ectoderm lineages in culture (N1 for CNS neurons from neural tube, Me1 for melanophores from neural crest and E3 for skin epidermal cells from epidermal lineages). CNS neurons and melanophores differentiate when deep layer cells of the ventral ectoderm (VE, prospective epidermis region; 150 cells/culture) and an appropriate region of the marginal zone (MZ, prospective mesoderm region; 5-150 cells/culture) are co-cultured, but not in cultures of either cell type on their own; VE cells cultured alone yield epidermal cells as we have previously reported. The extent of inductive neural differentiation in the co-culture system strongly depends on the origin and number of MZ cells initially added to culture wells. The potency to induce CNS neurons is highest for dorsal MZ cells and sharply decreases as more ventrally located cells are used. The same dorsoventral distribution of potency is seen in the ability of MZ cells to inhibit epidermal differentiation. In contrast, the ability of MZ cells to induce melanophores shows the reverse polarity, ventral to dorsal. These data indicate that separate developmental mechanisms are used for the induction of neural tube and neural crest lineages. Co-differentiation of CNS neurons or melanophores with epidermal cells can be obtained in a single well of co-cultures of VE cells (150) and a wide range of numbers of MZ cells (5 to 100). Further, reproducible differentiation of both neural lineages requires intimate association between cells from the two gastrula regions; virtually no differentiation is obtained when cells from the VE and MZ are separated in a culture well. These results indicate that the inducing signals from MZ cells for both neural tube and neural crest lineages affect only nearby ectoderm cells. PMID- 1769330 TI - Formation and regeneration of rhombomere boundaries in the developing chick hindbrain. AB - Development in the chick hindbrain is founded on a segmented pattern. Groups of cells are allocated to particular segmental levels early in development, the cells of each segment (rhombomere) mixing freely with each other, but not with those of adjacent segments. After rhombomere formation, cells in the boundary regions become increasingly specialised. Rhombomeres are thus separate territories that will ultimately pursue different developmental fates. We are investigating the mechanisms that establish and maintain the pattern of rhombomeres and their boundaries. Donor-to-host transplantation experiments were used to confront tissue from different axial levels within the hindbrain. The frequency of boundary regeneration and patterning in the hindbrain was then assessed, based on gross morphology, arrangement of motor neurons and immunohistochemistry. We found that when rhombomeres from adjacent positions or positions three rhombomeres distant from one another were confronted, a normal boundary was invariably reconstructed. Juxtaposition of rhombomere 5 with 7 also yielded a new boundary. By contrast, donor and host tissue of the same positional origin combined without forming a boundary. The same result was obtained in combinations of rhombomeres 3 and 5. Confrontation of tissue from even-numbered rhombomeres 4 with 6 or 2 with 4 also failed to regenerate a boundary in the majority of cases. These results suggest that cell surface properties vary according to rhombomeric level in the hindbrain, and may support the idea of a two-segment periodicity. PMID- 1769331 TI - Two homologous regulatory genes, lin-12 and glp-1, have overlapping functions. AB - Two homologous genes, lin-12 and glp-1, encode transmembrane proteins required for regulatory cell interactions during C. elegans development. Based on their single mutant phenotypes, each gene has been thought to govern a distinct set of cell fates. We show here that lin-12 and glp-1 are functionally redundant during embryogenesis: Unlike either single mutant, the lin-12 glp-1 double mutant dies soon after hatching. Numerous cellular defects can be observed in these Lag (for lin-12 and glp-1) double mutants. Furthermore, we have identified two genes, lag 1 and lag-2, that appear to be required for both lin-12 and glp-1-mediated cell interactions. Strong loss-of-function lag mutants are phenotypically indistinguishable from the lin-12 glp-1 double; weak lag mutants have phenotypes typical of lin-12 and glp-1 single mutants. We speculate that the lin-12 and glp 1 proteins are biochemically interchangeable and that their divergent roles in development may rely largely on differences in gene expression. PMID- 1769332 TI - Homologous patterns in the embryonic development of the peripheral nervous system in the grasshopper Schistocerca gregaria and the fly Drosophila melanogaster. AB - To determine the generality of developmental mechanisms involved in the construction of the insect nervous system, the embryonic development of the peripheral nervous system in the grasshopper Schistocerca gregaria was characterized at the level of identified neurons and nerve branches and then compared to that previously described from the fly Drosophila melanogaster. For this, immunocytochemistry using a neuron-specific antibody was carried out on staged grasshopper embryos. Our results show that initially a simple peripheral nerve scaffolding is established in each segment of the animal. This scaffolding consists of a pair of intersegmental nerves that are formed by identified afferent and efferent pioneer neurons and a pair of segmental nerves that are formed by afferent pioneers situated in limb buds. Subsequently, identified sets of sensory neurons differentiate in a stereotyped spatiotemporal pattern in dorsal, lateral and ventral clusters in each segment and project their axons onto these nerves. Although segment-specific differences exist, serial homologs of the developing nerves and sensory neurons can be identified. A comparison of these results with those obtained from Drosophila shows that virtually the same pattern of peripheral nerves and sensory structures is formed in both species. This indicates that the construction of the peripheral nervous system in extremely divergent modern insects relies on conserved developmental mechanisms that evolved in ancestral insects over 300 million years ago. PMID- 1769333 TI - In situ analysis of fetal, prepuberal and adult XX----XY chimaeric mouse testes: Sertoli cells are predominantly, but not exclusively, XY. AB - The testes of fetal, prepuberal and adult XX----XY chimaeras were examined using in situ hybridisation to identify the beta-globin transgenic marker contained in one component of each chimaera. This enabled the proportion of XX and XY cells contributing to the major cell lineages of the testis to be estimated from sectioned and air-dried material. A few XX Sertoli cells were found in all three age groups, but the XX contribution was always much lower than in other somatic cell types. Significantly, in fetal XX----XY testes, Sertoli cells were the only cell type to show a bias in favour of the XY component. This strengthens the view that Tdy acts solely in the lineage that gives rise to Sertoli cells. However, the finding of some fetal XX Sertoli cells means that one of the steps in the Tdy initiated process of Sertoli cell determination is capable of locally recruiting XX cells. PMID- 1769334 TI - Cell rearrangement during gastrulation of Xenopus: direct observation of cultured explants. AB - We have analyzed cell behavior in the organizer region of the Xenopus laevis gastrula by making high resolution time-lapse recordings of cultured explants. The dorsal marginal zone, comprising among other tissues prospective notochord and somitic mesoderm, was cut from early gastrulae and cultured in a way that permits high resolution microscopy of the deep mesodermal cells, whose organized intercalation produces the dramatic movements of convergent extension. At first, the explants extend without much convergence. This initial expansion results from rapid radial intercalation, or exchange of cells between layers. During the second half of gastrulation, the explants begin to converge strongly toward the midline while continuing to extend vigorously. This second phase of extension is driven by mediolateral cell intercalation, the rearrangement of cells within each layer to lengthen and narrow the array. Toward the end of gastrulation, fissures separate the central notochord from the somitic mesoderm on each side, and cells in both tissues elongate mediolaterally as they intercalate. A detailed analysis of the spatial and temporal pattern of these behaviors shows that both radial and mediolateral intercalation begin first in anterior tissue, demonstrating that the anterior-posterior timing gradient so evident in the mesoderm of the neurula is already forming in the gastrula. Finally, time-lapse recordings of intact embryos reveal that radial intercalation takes places primarily before involution, while mediolateral intercalation begins as the mesoderm goes around the lip. We discuss the significance of these findings to our understanding of both the mechanics of gastrulation and the patterning of the dorsal axis. PMID- 1769335 TI - Common precursors for neural and mesectodermal derivatives in the cephalic neural crest. AB - The cephalic neural crest (NC) of vertebrate embryos yields a variety of cell types belonging to the neuronal, glial, melanocytic and mesectodermal lineages. Using clonal cultures of quail migrating cephalic NC cells, we demonstrated that neurons and glial cells of the peripheral nervous system can originate from the same progenitors as cartilage, one of the mesectodermal derivatives of the NC. Moreover, we obtained evidence that the migrating cephalic NC contains a few highly multipotent precursors that are common to neurons, glia, cartilage and pigment cells and which we interprete as representative of a stem cell population. In contrast, other NC cells, although provided with identical culture conditions, give rise to clones composed of only one or some of these cell types. These cells thus appear restricted in their developmental potentialities compared to multipotent cells. It is therefore proposed that, in vivo, the active proliferation of pluripotent NC cells during the migration process generates distinct subpopulations of cells that become progressively committed to different developmental fates. PMID- 1769336 TI - Pathfinding in the central nervous system and periphery by identified embryonic Drosophila motor axons. AB - We have studied the pattern of axon outgrowth from the identified embryonic Drosophila motorneurons, RP1, RP3, RP4 and RP5, from the onset of axonogenesis to the time of arborization over target muscles. Lucifer Yellow was intracellularly injected into each of these neurons to obtain a detailed description of the morphology of their growth cones and of the pathways that they follow. We have divided the sequence of axon growth from these neurons into five major phases. In the first phase, the growth cone of each RP axon grows medially along its contralateral homologue along the anterior commissure. Each RP axon follows a separate path across the midline in the anterior commissure. After crossing the ventral midline, the axons wrap around specific contralateral RP somata. In the second phase, each axon grows posteriorly and dorsally down the contralateral longitudinal connective, fasciculating with the other RP axons. In the third phase, the axons turn into the intersegmental nerve via the anterior nerve root, then cross over to the segmental nerve, before contacting the external surfaces of intermediate muscles 15/16. They do not fasciculate with the pioneering aCC and RP2 axons at this time. In the fourth phase, the axons advance laterally across the ventral muscle group. During this phase, each axon extends processes over a number of inappropriate muscles as well as contacting its correct, target muscle. In the final phase, the processes to inappropriate muscles are withdrawn, generating the mature pattern of motor axon projections. There is no consistent, clear difference between the RP motorneurons in the relative timing of axon outgrowth. PMID- 1769337 TI - Normal segmentation and size of the primary sympathetic ganglia depend upon the alternation of rostrocaudal properties of the somites. AB - Metameric organization of the dorsal root ganglia (DRG) and ventral roots depends on the alternation of rostrocaudal properties within the somites. In addition, the size of DRG is likely to be regulated by the adjacent mesoderm, because unilateral creation of a paraxial mesoderm with only rostral somitic (RS) halves, leads to the development of non-segmented DRG that are larger and contain more cells than the sum of the contralateral, control DRG. We have now extended our studies of the role of the paraxial mesoderm in the morphogenesis of the peripheral nervous system (PNS) to another metameric PNS component, the sympathetic ganglia (SG). The development of the primary sympathetic chain was studied in chick-quail chimeras with multiple half-somite grafts using quantitative morphometric analysis. In the presence of an exclusively rostral or caudal somitic mesoderm, segmentation of the initially homogeneous primary sympathetic chain into ganglia is prevented. Therefore, the SG, like the DRG and ventral roots, require the normal rostrocaudal alternation of the somitic mesoderm for segmental morphogenesis. On embryonic day 4 (E4), there is a 38% average decrease in the volume of the primary sympathetic chain opposite a RS mesoderm, compared with the primary chain on the unoperated side. This is in contrast to the average increase of 27% in the volume of the DRG opposite the grafted mesoderm in the same embryos. Our results, and classical observations, have led us to propose a model in which the mesoderm controls DRG and SG size by modulating the partition of migrating NC precursors between the anlage of these two ganglion types. According to this model, the reduction in SG volume and concomitant increase in DRG volume observed opposite RS grafts, results from the arrest in the DRG anlage of neural crest cells that normally migrate to the SG. PMID- 1769338 TI - Spontaneous immortalisation of Schwann cells in culture: short-term cultured Schwann cells secrete growth inhibitory activity. AB - In the developing peripheral nerve, Schwann cells proliferate rapidly and then become quiescent, an essential step in control of Schwann cell differentiation. Cell proliferation is controlled by growth factors that can exert positive or inhibitory influences on DNA synthesis. It has been well established that neonatal Schwann cells divide very slowly in culture when separated from neurons but here we show that when culture was continued for several months some cells began to proliferate rapidly and non-clonal lines of immortalised Schwann cells were established which could be passaged for over two years. These cells had a similar molecular phenotype to short-term cultured Schwann cells, except that they expressed intracellular and cell surface fibronectin. The difference in proliferation rates between short- and long-term cultured Schwann cells appeared to be due in part to the secretion by short-term cultured Schwann cells of growth inhibitory activity since DNA synthesis of long-term, immortalised Schwann cells was inhibited by conditioned medium from short-term cultures. This conditioned medium also inhibited DNA synthesis in short-term Schwann cells stimulated to divide by glial growth factor or elevation of intracellular cAMP. The growth inhibitory activity was not detected in the medium of long-term immortalised Schwann cells, epineurial fibroblasts, a Schwannoma (33B), astrocytes or a fibroblast-like cell-line (3T3) and it did not inhibit serum-induced DNA synthesis in epineurial fibroblasts, 33B cells or 3T3 cells. The activity was apparently distinct from transforming growth factor-beta, activin, IL6, epidermal growth factor, atrial natriuretic peptide and gamma-interferon and was heat and acid stable, resistant to collagenase and destroyed by trypsin treatment. We raise the possibility that loss of an inhibitory autocrine loop may contribute to the rapid proliferation of long-term cultured Schwann cells and that an autocrine growth inhibitor may have a role in the cessation of Schwann cell division that precedes differentiation in peripheral nerve development. PMID- 1769339 TI - Gene regulatory factors of the sea urchin embryo. I. Purification by affinity chromatography and cloning of P3A2, a novel DNA-binding protein. AB - The P3A2 regulatory protein interacts with specific sites in the control region of the CyIIIa actin gene. Previous studies showed that this interaction is required to confine expression of a CyIIIa.CAT fusion to the aboral ectoderm, the embryonic territory in which CyIIIa is normally utilized. P3A2 also binds specifically to similar target sites located in the regulatory region of the SM50 gene, which is expressed only in skeletogenic mesenchyme lineages. The P3A2 factor was purified by affinity chromatography from nuclear extracts of 24 h sea urchin embryos, and partial peptide sequences were used to isolate a cDNA clone encoding the complete protein. There are no significant similarities between P3A2 and any other protein in existing sequence data bases. P3A2 thus includes a novel type of DNA-binding domain. To examine the differential utilization of P3A2 in CyIIIa and SM50 genes, we measured the specific affinity of this protein for the various target sites in the regulatory DNAs of each gene, and identified the core target site sequences. The stability of P3A2 complexes formed with SM50 target sites is 50-100 times greater than that of the complexes formed with CyIIIa target sites, though the factor binds to very similar core sequence elements. P3A2 is one of at least twelve different proteins whose interaction with CyIIIa regulatory DNA is required for correct developmental expression. The results reported demonstrate that it might be possible to purify most of these regulatory proteins, or any other specific DNA-binding proteins of the sea urchin embryo, by using the simple procedures described for P3A2. PMID- 1769340 TI - Gene regulatory factors of the sea urchin embryo. II. Two dissimilar proteins, P3A1 and P3A2, bind to the same target sites that are required for early territorial gene expression. AB - Previous work demonstrated that a negative regulatory interaction mediated by factor(s) termed 'P3A' is required for correct territory-specific gene expression in the sea urchin embryo. A probe derived from a P3A target site in the skeletogenic SM50 gene of Strongylocentrotus purpuratus was used to isolate a cDNA clone coding for a factor that binds specifically to this site. This factor, called P3A1, contains two sequence elements that belong to the Zn finger class of DNA-binding motifs, and in these regions is most closely similar to the Drosophila hunchback factor. The P3A1 factor also binds to a similar target sequence in a second gene, CyIIIa, expressed in embryonic aboral ectoderm. Another sea urchin embryo protein factor, P3A2, has been isolated by affinity chromatography and cloned, as described in Calzone et al. Development 112, 335 350 (1991). P3A2 footprints the same target sites in the SM50 and CyIIIa genes as does P3A1, but lacks the Zn finger sequence motifs and in amino acid sequence is almost entirely dissimilar to P3A1. A deletion analysis of P3A2 delimited the DNA binding region, revealing that five specific amino acids in the first P3A1 finger region and four in the second P3A1 finger region are also present in equivalent positions in P3A2. The P3A1 and P3A2 factors could function as regulatory antagonists, having evolved similar target specificities from dissimilar DNA binding domains. PMID- 1769341 TI - Developmental expression of the axonal glycoprotein TAG-1: differential regulation by central and peripheral neurons in vitro. AB - TAG-1 is a 135,000 Mr axonal glycoprotein of the immunoglobulin superfamily that promotes axon extension in vitro. One distinguishing feature of TAG-1 is its transient expression on subsets of axons in the developing nervous system. To examine the mechanisms that regulate TAG-1, we have monitored the expression of this protein by developing central and peripheral neurons in vitro. TAG-1 was detected on the surface of a subset of E11 to E13 spinal cord neurons in vitro and was also released by these neurons. Expressions of TAG-1 on the cell surface was transient but it was possible to detect a released form of TAG-1 at all times in vitro. Spinal cord neurons isolated from older embryos did not express surface TAG-1 when they regenerated axons in vitro. Changes in the environment of spinal cord neurons did not alter the time course of TAG-1 expression, suggesting that regulation of the protein is cell autonomous. In contrast to these results with spinal cord neurons, surface expression of TAG-1 by DRG neurons persisted in vitro and adult DRG neurons re-expressed TAG-1 when grown in vitro. The cell surface and released forms of TAG-1 therefore appear to be regulated differently by central and peripheral neurons. PMID- 1769342 TI - Analysis of high PSA N-CAM expression during mammalian spinal cord and peripheral nervous system development. AB - Using a monoclonal antibody that recognizes specifically a high polysialylated form of N-CAM (high PSA N-CAM), the temporal and spatial expression of this molecule was studied in developing spinal cord and neural crest derivatives of mouse truncal region. Temporal expression was analyzed on immunoblots of spinal cord and dorsal root ganglia (DRGs) extracts microdissected at different developmental stages. Analysis of the ratio of high PSA N-CAM to total N-CAM indicated that sialylation and desialylation are independently regulated from the expression of polypeptide chains of N-CAM. Motoneurons, dorsal root ganglia cells and commissural neurons present a homogeneous distribution of high PSA N-CAMs on both their cell bodies and their neurites. Sialylation of N-CAM can occur in neurons after their aggregation in peripheral ganglia as demonstrated for dorsal root ganglia at E12. Furthermore, peripheral ganglia express different levels of high PSA N-CAM. With in vitro models using mouse neural crest cells, we found that expression of high PSA N-CAM was restricted to cells presenting an early neuronal phenotype, suggesting a common regulation for the expression of high PSA N-CAM molecules, neurofilament proteins and sodium channels. Using perturbation experiments with endoneuraminidase, we confirmed that high PSA N-CAM molecules are involved in fasciculation and neuritic growth when neurons derived from neural crest grow on collagen substrata. However, we demonstrated that these two parameters do not appear to depend on high PSA N-CAM molecules when cells were grown on a fibronectin substratum, indicating the existence of a hierarchy among adhesion molecules. PMID- 1769343 TI - The effect of age on motor neurone death following axotomy in the mouse. AB - The ability of mouse motor neurones to survive axotomy during the first month of life was studied. The motor neurones that lie in the dorsolateral columns of spinal segments C7 and C8 and supply the flexor muscles of the forepaw were axotomized by cutting and removing part of the median and ulnar nerves above the elbow. The number and position of cell bodies with axons in these nerves were confirmed by retrograde labelling of the cut axons with horseradish peroxidase. The ability of these neurones to survive axotomy varies with the age of the animal at the time of axotomy. When the axons are sectioned within the first four postnatal days, 80-90% of the cell bodies will die, more than half of this death occurring in less than one week after axotomy. If the animals are one week old at the time the nerves are cut, a significantly smaller number (50%) die (P = 0.013), and the time-course of death is different, with eight to ten days elapsing before half the death has occurred. 40% of the neurones will die if sectioned at two weeks of age, and it is not until four weeks of age that more than 90% of the cells can survive axotomy. We conclude, therefore, that the kinetics of motor neurone death, as well as the final extent of neuronal loss, are affected by the age at which the animal is axotomized. PMID- 1769344 TI - Cyclic changes in amphibian egg microvilli occur during the division cycle: implication of MPF. AB - The microvilli (MV) of Pleurodeles (amphibian) eggs were examined following fertilization and compared with those of artificially activated eggs and enucleated eggs using scanning and transmission electron microscopy. The MV pattern in fertilized eggs was found to undergo a cyclic transformation during the course of the first few division cycles. Similar changes also occurred in the MV of artificially activated eggs and enucleated eggs. The reorganization of the MV was sensitive to cycloheximide and cytochalasin B, but was unaffected by colchicine. Thus, this MV alteration requires protein synthesis and microfilaments but microtubules are not implicated in this process. In addition, the effects on the MV pattern of the maturation or mitosis promoting factor (MPF) were tested. Injection of MPF into eggs at different times during the first division cycle nearly always induced an elongation of the MV. This observation suggests that MPF could regulate either directly or indirectly, via a MPF sensitive factor, the cyclic transformation of amphibian egg MV. PMID- 1769345 TI - The roles of pyruvate, lactate and glucose during preimplantation development of embryos from F1 hybrid mice in vitro. AB - Embryos of certain inbred mouse strains, and their F1 hybrids, are able to develop from the 1-cell to blastocyst stage in simple chemically defined media containing lactate (L), pyruvate (P) and glucose (G). The individual roles of these substrates in supporting complete preimplantation development in vitro was examined with 1-cell F2 embryos from B6CBF1 hybrid mice. Embryos collected between 26 and 27 h post hCG were cultured in medium containing L, P, LP or LPG. After 50 h in culture, the proportions developing to the morula stage were 1%, 83%, 94% and 100%, respectively. In combination, lactate and pyruvate appeared to act synergistically and both the rate and level of development to the morula stage were unaffected by the absence of glucose. After a further 46 h in culture, only the embryos grown in the presence of glucose developed into blastocysts. In LP medium, embryos arrested at the compacted morula stage late on day 3 of development. As culture continued in the absence of glucose, embryos decompacted (approximately 82 h post hCG) and subsequently degenerated. Exposure to medium containing glucose for the first, second or third 24 h period in culture was sufficient to support the morula-to-blastocyst transition. Glucose still supported this transition when embryos were transferred to LPG medium 3 h after the completion of compaction (76 h post hCG), but was ineffective 6 h later (82 h post hCG) once decompaction had commenced. We conclude that lactate and pyruvate together are able to support normal development of 1-cell F2 embryos to the morula stage in vitro, but that glucose is an essential component of the culture medium for development to the blastocyst stage. PMID- 1769346 TI - Study of dependency between culture growth and photosynthetic efficiency measured by fluorescence induction in Selenastrum capricornutum inhibited by copper. AB - Fluorescence parameters were reported earlier to be reliable indicators in the determination of heavy metal toxicity in algal cultures (Samson and Popovic, 1988). In this report, the effects of copper on Selenastrum capricornutum culture growth and photosynthetic efficiency were studied at different copper concentrations. By using the complementary area of variable fluorescence kinetics and the cell counting method, we determined the level of toxicity at different copper concentrations and the ability of algal populations to adapt to inhibitory effects. Algae exposed to copper concentrations higher than 0.5 mg/liter were incapable of recovering biochemical and physiological processes related to photosynthesis after 96 hr. A recovery process in algal culture intoxicated with 0.5 mg/liter was revealed only by fluorescence induction phenomena. Here, the authors justify the use of fluorescence induction parameters in the investigation of copper stress effects on algal populations and their short-term adaptation phenomena. PMID- 1769347 TI - Rapid estimation of chromosomal damage in yeast due to the effects of environmental chemicals using pulsed field gel electrophoresis. AB - We present a procedure to rapidly estimate the damage to yeast chromosomes by toxic chemicals. This procedure employs the following steps: incubation of yeast cells with the chemicals, DNA preparation in an agarose matrix, separation of chromosome-sized DNA molecules into reproducible band patterns by pulsed field gel electrophoresis, and quantification of the intensity of chromosomal bands by densitometry. Saccharomyces cerevisiae cells have been treated with N-methyl-N' nitro-N-nitrosoguanidine (MNNG) and cis-Platinum(II) diamminedichloride (cisPT), both of which are known to interact with DNA, and trichlorethylen (TCE), for which such an effect has not been shown in yeast. Treatment of cells with MNNG and cisPt led to an impairment of the intensity of the band pattern to an extent dependent on the concentration of the chemicals applied. For TCE a similar effect could not be discerned. This procedure will be useful as a screening test for the estimation of the biological hazards of toxic chemicals. PMID- 1769348 TI - Histopathological changes induced by acute toxicity of mercuric chloride on the epidermis of freshwater catfish--Heteropneustes fossilis (Bloch). AB - The toxic effects of 0.3 ppm (96-hr LC50 value) of mercuric chloride solution on the epidermis of Heteropneustes fossilis at different time intervals have been studied. The epidermis reacts instantaneously by secreting a profuse amount of slime, especially due to hyperactivity of the goblet mucous cells which subsequently degenerate and get lost. Later, all other cell types also get entangled in the degenerative process. The damaged cells, especially the club cells, get sloughed at the surface, forming a thick crust of debris from the degenerating cells. Side-by-side regeneration of the epidermis also continues from the lower layers of the intact tissue with the addition of all the cell types. However, even before attaining maturity, these budding cells, especially the club cells, show signs of degeneration, their degeneration occurring faster than their regeneration. Thus most of the space left behind by the degenerated club cells gets quickly filled with haphazardly arranged polygonal epithelial cells, giving the epidermis an altogether different morphology. PMID- 1769349 TI - Accumulation and depuration of chlorinated phenolics in the freshwater mussel (Anodonta anatina L.). AB - Uptake from ambient water and the depuration of five chlorinated phenolics, two chloroguaiacols (3,4,5-tri- and tetrachloroguaiacol), and three chlorophenols (2,4,6-tri-, 2,3,4,6-tetra-, and pentachlorophenol) were studied in the duck mussel (Anodonta anatina). Groups of animals were exposed at four acclimiation temperatures (3, 8, 13, 18 degrees C) to four chlorophenolic concentrations (total 6-56 micrograms/liter). The depuration was monitored for 72 hr. For the analysis of individual chlorophenolics by the GC/ECD technique, the soft tissue of mussels was homogenized, spiked with internal standard, acetylated, and extracted with n-hexane. The bioconcentration factors (BCF) (concn. in animal wet wt./concn. in water) were determined for mussel soft tissue. The highest BCF was found for pentachlorophenol (81-461) and the lowest for trichlorophenol (14-125). Neither water temperature nor exposure concentration affected the BCFs. The compounds studied were depurated rapidly and their depuration half-lives (T1/2) in soft tissue were generally less than 24 hr. PMID- 1769350 TI - Prediction of heavy metal behavior in soil by means of simple field tests. AB - Binding and retention against uptake by plants, and groundwater pollution of the metal ions Cd, Mn, Ni, Co, Zn, Cu, Cr(III), Pb, Hg, Fe(III), and Al by soils in relation to pH, redox potential, texture, organic matter, and iron oxide contents can be diagnosed in the form of rough relative values with simple field methods. A comparison with the results of some pot and field trials showed the practicability of this method. PMID- 1769351 TI - Relative sensitivity of early life stages of Arctic grayling, Coho salmon, and rainbow trout to nine inorganics. AB - The acute toxicity of nine inorganics associated with placer mining sediments to early life stages of Arctic grayling (Thymallus arcticus), coho salmon (Oncorhynchus kisutch), and rainbow trout (O. mykiss) was determined in soft water (hardness, 41 mg liter-1 CaCO3) at 12 degrees C. The relative toxicities of the inorganics varied by four orders of magnitude; from most toxic to least toxic, the rank order was cadmium, silver, mercury, nickel, gold, arsenite, selenite, selenate, and hexavalent chromium. In general, juvenile life stages of the three species tested were more sensitive to these inorganics than the alevin life stage. Among juveniles, no single species was consistently more sensitive to the inorganics than another; among alevins, Arctic grayling were generally more sensitive than coho salmon and rainbow trout. Based on the results of the present study, estimated no-effect concentrations of arsenic and mercury, but not cadmium, chromium, gold, nickel, selenium, or silver, are close to their concentrations reported in streams with active placer mines in Alaska. Thus, arsenic (as arsenite(III)) and mercury may pose a hazard to Arctic grayling and coho salmon in Alaskan streams with active placer mines. PMID- 1769352 TI - Quantitative structure-activity relationships for chemical toxicity to environmental bacteria. AB - Quantitative structure-activity relationships (QSARs) were developed for nonreactive chemical toxicity to each of four groups of bacteria of importance in environmental engineering: aerobic heterotrophs, methanogens, Nitrosomonas, and Microtox. The QSARs were based on chemicals covering a range of structures and including important environmental pollutants (i.e., chlorinated and other substituted benzenes, phenols, and aliphatic hydrocarbons). QSARs were developed for each chemical class and for combinations of chemical classes. Three QSAR methods (groups of chemical describing parameters) were evaluated for their accuracy and ease of use: log P, linear solvation energy relationships (LSER), and molecular connectivity. Successful QSARs were found for each group of bacteria and by each method, with correlation coefficients (adjusted r2) between 0.79 and 0.95. LSER QSARs incorporated the widest range of chemicals with the greatest accuracy. Log P and molecular connectivity QSARs are easier to use because their parameters are readily available. Outliers from the QSARs likely due to reactive toxicity included acryls, low pKa compounds, and aldehydes. Nitro compounds and chlorinated aliphatic hydrocarbons and alcohols showed enhanced toxicity to the methanogens only. Chemicals with low IC50 concentrations (log IC50 mumol/liter less than 1.5) were often outliers for Nitrosomonas. QSARs were validated statistically and with literature data. A suggested method is provided for use of the QSARs. PMID- 1769353 TI - A toxicological perspective on ecosystem characteristics to track sustainable development. VII. Ecosystem health. AB - "Ecosystem health," an emerging science paralleling human and veterinary medicine, has as its goals the systematic diagnosis and treatment of stressed ecosystems. Ecosystems are stressed by physical factors such as boat traffic, biological factors such as introduction of an exotic species, and chemical factors such as pH change. Even if these classes of stressors affect the same trophic levels, the resulting ecosystem disease states have different etiologies because the stress is introduced and propagated by different mechanisms. This paper presents a toxicological perspective on ecosystem sustainability. I discuss how classical toxicological concepts have to be modified when the experimental unit is an ecosystem. When exposures are high, effects are acute and are often measurable (e.g., fish kill). However, when exposures are low and chronic, effects are often hard to separate from the background. Evidence of high risk for lack of sustainable development is the exceeding of ecosystem "threshold criteria." PMID- 1769354 TI - Performance of on-line chemical property estimation methods with TSCA premanufacture notice chemicals. AB - CHEMEST is an interactive on-line system for estimating chemical properties important in environmental fate assessment. In 1988 we described an extensive validation study of CHEMEST. That study showed that for existing chemicals, most properties could be estimated with accuracy sufficient for screening-level assessment. Reported here are the results of a study of system performance with "new" chemicals, for which Premanufacture Notices (PMNs) must be submitted under the Toxic Substances Control Act. Measured values of key properties were retrieved for more than 300 PMN chemicals having discrete structures, which represented the majority of notices with submitted data that were received by the U.S. Environmental Protection Agency during the period 1979-1990. The measured values were compared to estimates from AUTOCHEM, an automated version of CHEMEST. Errors were generally greater than those for existing chemicals, as expected. Water solubility and the octanol/water partition coefficient (Kow) were estimated with acceptable accuracy, but the results for melting point and boiling point indicate that additional effort is needed to improve the estimation methods. PMID- 1769355 TI - Morphological basis of pulmonary edema in mice with cytokine-induced vascular leak syndrome. AB - Patients injected systemically with recombinant human interleukin-2 (rhIL-2) for treatment of solid tumor develop a vascular leak syndrome (VLS), characterized mainly by pulmonary edema whose pathogenesis is unknown. We have examined the structure of pulmonary vessels in mice with severe VLS induced by systemic injections of rhIL-2 and recombinant human interferon-alpha-A/D (rhIFN-alpha), which has a synergistic effect with IL-2. The pulmonary edema was associated with lesions of venous and capillary endothelia, alveolar basement membrane, and type I epithelial cells. These changes were more severe and diffuse than those seen in mice systemically injected with rhIL-2 alone, and in beige mice (deficient in NK cells and certain enzymes of polymorphonuclear leukocytes) injected with rhIL-2 and rhIFN-alpha. The endothelial lesions were comparable to those seen when leukocytes activated by cytokines react with activated endothelial cells in vitro, or at the site of injection of cytokines in vivo. The observations are in agreement with the interpretation that the severe lesions occurring in mice systemically injected with rhIL-2 with rhIFN-alpha result from the interaction of leukocytes with the endothelium. The results confirm the validity of previous studies performed in vitro or in animals injected intradermally with cytokines and extend their significance. PMID- 1769356 TI - Localization of pulmonary surfactant proteins using immunohistochemistry and tissue in situ hybridization. AB - Surfactant, a complex mixture of lipids and proteins, is produced by the type II alveolar epithelial cells. Numerous studies have localized surfactant protein A (SP-A) to type II cells of the lung, and recent studies have shown that the type II cells in the human lung are also the site of synthesis of SP-B, one of the hydrophobic surfactant proteins. There have been conflicting reports about additional sites of SP-A production. We have studied the localization of the mRNAs for SP-A, SP-B, and SP-C in the rat and for SP-C in the human lung by tissue in situ hybridization using cRNA probes. The mRNAs for all three rat surfactant proteins and for human SP-C were found in type II alveolar epithelial cells. In addition, the mRNAs for rat SP-A and SP-B were found in nonciliated bronchiolar cells. SP-C mRNA was not detectable in the bronchiolar cells of both rat and human lung tissue. Immunohistochemical studies in the rat lung with antisera to SP-A and SP-B confirmed the presence of the protein in cell types where the mRNA was found, as well as in some alveolar macrophages. Alveolar macrophages in both rat and human lung tissue were negative for all mRNAs. Further studies are required to ascertain whether there are differences in the processing, function, and regulation of these proteins in the different cell types that produce them. PMID- 1769357 TI - Effect of long-term cigarette smoke exposure on pulmonary vascular structure and function in the guinea pig. AB - To investigate the effect of chronic exposure to cigarette smoke on the structure and function of the pulmonary vasculature, we used a guinea pig model of cigarette smoke-induced emphysema, in which groups of guinea pigs were exposed to smoke for periods of 1, 3, 6, and 12 months. We found that the mean pulmonary artery pressure in smokers was increased at one month, a time at which there was no evidence of emphysema. Although the vascular pressures remained elevated, they did not progressively increase, even though there was progressive lung destruction. Pulmonary hypertension was associated with muscularization of the arterioles, seen as an increase in the percentage of small pulmonary vessels with double elastic lamina. We conclude that chronic exposure to cigarette smoke will produce pulmonary hypertension in the guinea pig, and that the hemodynamic changes are accompanied by alteration of the structure of the small pulmonary arterioles and arteries. The apparent dissociation of pulmonary hypertension and emphysema suggests that the pulmonary hypertension is not due to destruction of the lung capillary bed. The etiology of this process may be smoke-induced inflammation with release of vasoactive substances as well as proteolytic enzymes. PMID- 1769358 TI - The delta-aminolevulinate dehydratase polymorphism: higher blood lead levels in lead workers and environmentally exposed children with the 1-2 and 2-2 isozymes. AB - The erythrocyte delta-aminolevulinate dehydratase (ALAD) isozyme phenotypes and the blood lead levels were determined in a population of 202 lead factory workers in Germany and an environmentally exposed population of 1278 children in New York who had elevated free protoporphyrin levels. In both population, individuals with the ALAD 1-2 or 2-2 isozyme phenotype had levels of blood lead statistically higher than those individuals with the ALAD 1-1 isozyme phenotype (lead workers: P greater than 0.004; children: P greater than 0.0001). Homozygotes and heterozygotes for the ALAD2 allele who expressed the 2-2 or 1-2 isozyme phenotype had median blood lead levels that were about 9 to 11 micrograms/dl greater than similarly exposed individuals who were homozygous for the ALAD1 allele. These findings support the hypothesis that the ALAD2 polypeptide binds lead more effectively, and therefore that individuals with the ALAD2 allele may be more susceptible to lead poisoning. PMID- 1769359 TI - Immunological and respiratory findings in swine farmers. AB - The prevalence of respiratory symptoms and ventilatory capacity abnormalities in relation to immunological status was studied in 32 swine farmers and in 39 controls. A large number of swine farmers reacted to swine confinement building antigens (swine hair, 34%, swine confinement agents, 28%) but also to other extracts such as animal food (78%) and corn flour (37%). Control workers also reacted to these antigens in similar frequencies. Increased serum IgE levels were found in 3 swine farmers (9.4%) and all 3 had positive skin tests to at least one of the swine antigens. Among control workers one (2.6%) had an increased serum IgE level; this worker exhibited a positive skin reaction to swine food antigen. Swine farmers with positive skin reactions had across-shift reductions of FEF50 and FEF25 significantly larger than those with negative skin tests (P less than 0.01). Preshift measured ventilatory capacity data (FEV1, FEF50, FEF25) in swine farmers with positive skin tests were significantly lower (compared to predicted) than in those with negative skin tests. Additionally, we showed that a water soluble swine confinement building antigen causes a dose-related contraction of nonsensitized guinea pig trachea smooth muscle studied in vitro. Our data indicate significant differences in lung function between swine workers with positive and negative skin tests. We suggest that skin testing may be helpful in identifying workers at risk for developing lung disease. PMID- 1769360 TI - Epidemiologic investigation of a cancer cluster in professional football players. AB - In 1976, the New York Giants professional football team relocated to the newly constructed Meadowlands Sports Complex (MSC) in East Rutherford, NJ. Between 1980 and 1987 four team members developed cancer: one case each of non-Hodgkin's lymphoma, glioblastoma, angiosarcoma, and Hodgkin's disease. Because the surrounding area contains three superfund sites, concern was widespread that the cancers were related to environmental contamination. To assess for a possible environmental etiology, we conducted clinical, environmental, and epidemiologic studies at the MSC. Measurements of volatile organic compounds were all below occupational exposure limits and were similar to ambient levels in nearby Lyndhurst, NJ. Outdoor AM radio broadcast field strengths were in the uppermost 0.1% of field strengths measured in urban areas of the United States. Proportionate mortality ratio and proportional cancer incidence ratio studies of the MSC workforce found no excesses of cancer deaths or of incident cancer cases either for all sites combined or for any specific site. No significant differences in cancer incidence or mortality were found between indoor and nonindoor workers. Based on examination of all available data, the four cancer cases were judged most likely to have been clustered by chance and not to have been caused by environmental conditions at the MSC. PMID- 1769361 TI - Ozone absorption into excised porcine and sheep tracheae by a bolus-response method. AB - The absorption of ozone (O3) into excised porcine and sheep tracheae was characterized by a bolus-response experiment in which a bolus with a peak O3 concentration of 1 ppm was rapidly injected into a steadily flowing airstream entering the trachea. Using a fast-responding chemiluminescent analyzer of our design, the O3 concentration curves at the proximal end (i.e., the bolus input) and at the distal end (i.e., the response) of the trachea were monitored. Each concentration curve was numerically integrated, and the fraction of O3 absorbed in the trachea was obtained by subtracting from unity the ratio of the response integral to the bolus input integral. Average values of ozone-absorbed fraction decreased from about 0.50 to 0.15 at increasing airflows from 50 to 200 ml/sec. A diffusion theory that includes the effects of bulk convection, axial dispersion, and first-order absorption was developed to relate the fractional absorption to an overall mass transfer coefficient (K). The results indicate that K is independent of airflow, suggesting that the diffusion resistance in mucus is much greater than that in the gas phase. The time-weighted integrals of the concentration curves were also computed, allowing the mean residence time of O3 in the trachea (delta tau) to be determined. As predicted by the diffusion theory, delta tau was inversely related to the rate of O3 absorption. PMID- 1769362 TI - Effects of long-term treatment with methyl mercury on the developing rat brain. AB - Sprague-Dawley rats were exposed to low doses of methyl mercury (3.9 mg mercury/kg diet), via their dams during gestation and lactation and directly via their diet until sacrifice at 50 days postpartum, in order to study possible detrimental effects on CNS development. The methyl mercury exposure of the rats resulted in a brain concentration of 1.45 +/- 0.06 mg mercury/kg wet weight (mean +/- SEM). No general toxic effects were observed; body weight was not affected, brain weight was only slightly increased. No discernible general morphological alterations were seen in the brain as evaluated using cresyl violet histology. Furthermore, no effects on GFA-positive astrocytes in brain sections were observed and computerized morphometry of smeared astrocytes from frontal cortex, hippocampus, and cerebellum did not reveal any effects of the methyl mercury treatment. The noradrenaline (NA) and dopamine (DA) systems were also studied. In cerebellum the NA levels were increased (117% of controls, P = 0.008), whereas in other regions analyzed NA and DA levels were unchanged. Thus, long-term low dosage exposure of methyl mercury in rats during development does not appear to exert any major effects on the morphological maturation of neurons and astrocytes. However, the results indicate that effects may occur in specific transmitter-identified systems, such as the NA input to cerebellum. The results therefore underline the need for detailed biochemical analyses to study the effects of long-term low-dosage exposure to neurotoxic compounds. PMID- 1769363 TI - Reproductive effects in Long-Evans rats exposed to chlorine dioxide. AB - Long-Evans rats, 4-6 weeks of age, were dosed with 0.0, 2.5, 5.0, or 10.0 ml/kg chlorine dioxide (ClO2) in deionized water for up to 73 days. Males were exposed for 56 days and females for 14 days prior to breeding, and throughout the 10-day breeding period. Males were killed and evaluated for sperm parameters and reproductive tract histopathology following the breeding period. Females continued to be dosed throughout gestation and lactation until weaning on lactation day 21, when both dams and selected pups were necropsied. Neither clinical signs of toxicity nor adverse effects on any reproductive parameter examined were observed in the parental animals. Litter size, pup viability, and pup weight were unaltered by chlorine dioxide exposure. F0 reproductive tract organ weights and F1 organ weights for testis, epididymis, uterus, and ovaries were not different between groups, but vaginal weight was significantly decreased (P less than 0.03) for female weanlings in the high dose (10.0 mg/kg) group relative to controls. There were no changes in thyroid hormone parameters that appeared to be attributable to chlorine dioxide treatment. PMID- 1769364 TI - The immediate effects of silicon carbide whiskers upon ciliated tracheal epithelium. AB - Considering the relationship between toxicity of dust and particle geometry, as exhibited by asbestos, we have examined short-term biological effects of SiC whiskers (SiCW) in vitro and in vivo. Cultured explants of tracheal epithelium were exposed to a range of SiCW concentrations. There were no dramatic effects on ciliary function as measured by an optical spectrum analysis system that provided discrete ciliary frequencies. Particles were swept by ciliary activity into nonciliated regions where foci of extensive cell damage and death were observed with whiskers penetrating epithelial layers into the underlying tissues. Similar necrotic foci were observed in tracheae from rats exposed by intratracheal instillation to SiC whiskers in vivo. PMID- 1769365 TI - Particulate air pollution and daily mortality in Detroit. AB - Particulate air pollution has been associated with increased mortality during episodes of high pollution concentrations. The relationship at lower concentrations has been more controversial, as has the relative role of particles and sulfur dioxide. Replication has been difficult because suspended particle concentrations are usually measured only every sixth day in the U.S. This study used concurrent measurements of total suspended particulates (TSP) and airport visibility from every sixth day sampling for 10 years to fit a predictive model for TSP. Predicted daily TSP concentrations were then correlated with daily mortality counts in Poisson regression models controlling for season, weather, time trends, overdispersion, and serial correlation. A significant correlation (P less than 0.0001) was found between predicted TSP and daily mortality. This correlation was independent of sulfur dioxide, but not vice versa. The magnitude of the effect was very similar to results recently reported from Steubenville, Ohio (using actual TSP measurements), with each 100 micrograms/m3 increase in TSP resulting in a 6% increase in mortality. Graphical analysis indicated a dose response relationship with no evidence of a threshold down to concentrations below half of the National Ambient Air Quality Standards for particulate matter. PMID- 1769366 TI - Facilitation of dopamine release in vivo by serotonin agonists: studies with microdialysis. AB - Using microdialysis, changes in extraneuronal levels of dopamine (DA), and the metabolites of DA and serotonin (5-HT), were monitored concurrent with perfusion of 5-HT1 agonists into the anterior striata of anesthetized rats. Perfusion of 5 HT facilitated DA release in a dose dependent manner, and to a greater extent than any other agonist tested. Extraneuronal DA levels increased 34% with perfusion of 0.04 nmol 5-HT and 18-fold with perfusion of 4.0 nmol 5-HT. Perfusion with multiple doses of either 1-(m-chlorophenyl)piperazine (m-CPP) or trifluoromethylphenylpiperazine (TFMPP) also resulted in a dose-dependent facilitation of DA release with a 40% increase in extracellular DA produced by either 0.4 nmol m-CPP or 10.0 nmol TFMPP. A 50-fold increase in DA followed 40.0 nmol m-CPP, while 160 nmol TFMPP enhanced DA 11-fold. Local application of either 5-methoxy-3(1,2,3,6-tetrahydro-4-pyridinyl)-1H indole succinate (RU24969) or 8 hydroxy-2-(di-n-propylamino)tetralin hydrobromide (8-OH-DPAT) (2.0 nmol perfused over 20 min) increased extracellular DA by 300 and 40%, respectively. RU24969 (2.0 nmol) also facilitated DA release following systemic pretreatment with 8-OH DPAT (100 micrograms/kg). Perfusion with fenfluramine to release endogenous 5-HT also increased extraneuronal DA in a dose-dependent manner, and this facilitation was prevented by pretreatment with the 5-HT reuptake inhibitor fluoxetine. The facilitation of DA release by 0.4 nmol 5-HT was reduced by pretreatment with the 5-HT1 antagonist pindolol (4.0 nmol). These results suggest that serotonergic innervation of the anterior striatum may exert a facilitatory influence on DA release. PMID- 1769367 TI - Attenuation of insulin-induced drinking by beta-adrenoceptor antagonists. AB - Insulin-induced drinking (IID) in male Wistar rats, evoked by administering 5 U/kg of crystalline porcine insulin i.p., was significantly decreased by propranolol (0.1 and 0.5 mg/kg s.c.) after 1 and 2 h. The blood glucose of rats treated with a much higher dose of propranolol (10 mg/kg body weight) and insulin did not differ from that of rats treated solely with insulin after 30 and 120 min. Atenolol (0.5 mg/kg s.c.) caused a reduction in IID after 1 and 2h. Butoxamine (1 mg/kg s.c.) also reduced IID after 1 and 2h, and at 0.5 mg/kg after 1h. The alpha-blocker, phenoxybenzamine (10 mg/kg s.c.), had the opposite effect, stimulating IID after 2h. There is no direct evidence that insulin activated the sympathetic system at the doses used in these experiments. Nevertheless, the results reported here seem to be compatible with the involvement of the sympathetic system in IID, possible through the renin-angiotensin system. PMID- 1769368 TI - Tedisamil (KC 8857) differentially inhibits the 86Rb+ efflux-stimulating and vasorelaxant properties of cromakalim. AB - Tedisamil, a blocker of cardiac K+ channels, potently inhibited cromakalim induced 86Rb+ efflux from rat aorta with a pIC50 = 7.3, a value similar to that obtained with the sulphonylurea glibenclamide. However, tedisamil was approximately 30 times less potent than glibenclamide in inhibiting the vasorelaxant effects of cromakalim. The data suggest that tedisamil can dissociate between the efflux-inducing and vasorelaxant effects of cromakalim and may therefore prove to be an important tool in elucidating the mechanism of action of this vasorelaxant. PMID- 1769369 TI - Mechanisms of platelet-activating factor-induced electrolyte transport in the rat jejunum. AB - Platelet-activating factor (PAF) is known to cause chloride secretion in the small and large intestine in vitro. The present study investigated the mechanism of action of PAF-induced electrolyte transport in stripped rat jejunal segments mounted in standard Ussing chambers. Short circuit current was monitored as the indicator of active transport. PAF caused a concentration-dependent increase in short circuit current, whereas its precursor, lyso-PAF, did not. The response to 0.2 microM PAF was inhibited by 92% when chloride ion in the bathing solution was replaced. The response was also significantly inhibited by the PAF receptor antagonist, WEB 2170, the cyclooxygenase inhibitor, indomethacin, the phospholipase A2 inhibitor, mepacrine, and the calcium channel blocker, verapamil. In other in vitro experiments, PAF was shown to stimulate jejunal synthesis of prostaglandin E2, but not 6-keto-prostaglandin F1 alpha or the peptidoleukotrienes C4, D4 or E4. In similar experiments, 0.2 microM PAF enhanced the depletion of jejunal mucosal free arachidonic acid as measured by gas chromatography. These results show that platelet-activating factor stimulates chloride transport in the rat jejunum in vitro, and that the response is dependent upon extracellular calcium, the stimulation of phospholipase A2 and the cyclo-oxygenase catalyzed metabolism of arachidonic acid to prostaglandin E2. PMID- 1769370 TI - HOE 140, a new highly potent and long-acting bradykinin antagonist in conscious rats. AB - The inhibitory effects of the new bradykinin antagonist HOE 140 (D-Arg-Arg-Pro Hyp-Gly-Thi-Ser-D-Tic-Oic-Arg) on depressor responses to exogenous bradykinin were investigated in conscious rats and compared with those of the bradykinin antagonist B4146 (D-Arg-Hyp-Pro-Gly-Thi-Ser-D-Pro-Thi-Arg). HOE 140 showed a 250 700-fold higher potency in vivo and a much longer biological half-life than B4146. Plasma catecholamines were not increased after application of HOE 140, indicating that this compound did not interfere with catecholamine release. HOE 140 proved to be a highly potent, specific and long-acting bradykinin B2-receptor antagonist. PMID- 1769371 TI - Membrane stabilising properties of the selective 5-HT2 receptor agonist, (+/-) DOI. AB - The effects of (+/-)-1-(2,5-dimethoxy-4-iodophenyl)-2-aminopropane (DOI), a selective 5-HT2 receptor agonist, on nerve conduction in the isolated frog sciatic nerve trunk were examined. Compound action potential amplitude was concentration dependently decreased by (+/-)-DOI (EC50 = 1.2 mM), an effect that was not altered by the presence of ketanserin and with a similar potency to lignocaine. (+/-)-propranolol and disopyramide. The results indicate that (+/-) DOI has membrane stabilising properties, in addition to its reported 5-HT2 agonist actions. PMID- 1769372 TI - Influence of aging on the contractile response to endothelin of rat thoracic aorta. AB - Age-related changes in the contractile response to endothelin-1 and ACh were assessed in thoracic aortas isolated from 2-, 6- and 24-month-old male Fischer 344 rats. In aortic strips with an intact endothelium, the maximal contractile response to endothelin-1 decreased with development to maturity. Removal of the endothelium did not affect the contractile response to endothelin-1. Endothelin-1 did not elicit a relaxant response in phenylephrine-precontracted strips. The ACh induced relaxation decreased in senescent rats. These results indicate that the contractile response of aortic smooth muscle to endothelin-1 decreases with age, and that the endothelial vasorelaxant factors do not contribute to this age induced modulation. PMID- 1769373 TI - Characterization of muscarinic receptors mediating endothelium-dependent relaxation of bovine coronary artery. AB - In order to identify the receptor subtype responsible for acetylcholine (ACh) induced relaxation of bovine coronary artery, we determined the affinity of six subtype-selective muscarinic antagonists and compared them with affinity estimates obtained for bovine left atria. At low concentrations, ACh potently relaxed circular strips of coronary artery with endothelium (EC50 0.15 microM), but contracted them at higher agonist concentrations with potencies that depended on the presence or absence of endothelium: EC50 1.8 microM (without endothelium); 4.6 microM (with endothelium). The pA2 values obtained for antagonism of relaxant responses to ACh were: pirenzepine (M1-selective) 7.38 +/- 0.12; AF-DX 116 (11-[2 (diethylamino-methyl)-1-piperidinyl-acetyl]-5,11- dihydro-6H-pyrido(2,3-b)1,4 benzodiazepine-6-one; M2-selective) 5.79 +/- 0.09; and 4-diphenylacetoxy-N-methyl piperidine-methobromide (4-DAMP; M3/M1-selective) 9.07 +/- 0.12. The corresponding Schild slopes were 0.98 +/- 0.07 for pirenzepine, 1.17 +/- 0.09 for AF-DX 116 and 1.01 +/- 0.04 for 4-DAMP. For the following three antagonists, pKB values were determined at two different antagonist concentrations: dicyclomine (M1-selective) 7.49 +/- 0.10, cyclohexylphenyl-(2-piperidinoethyl)-silanol (CPPS; M3-selective) 8.0 +/- 0.10, and parafluoro-hexahydrosila-difenidol (pFHHSiD; M3 selective) 7.87 +/- 0.10. For comparison, the antagonism of methacholine-induced negative inotropy in left atria was determined for three antagonists, yielding the following pA2 values: pirenzepine 5.98 +/- 0.14; AF-DX 116 6.81 +/- 0.14 and 4-DAMP 7.99 +/- 0.14. The slopes of the corresponding Schild plots were 1.05 +/- 0.10, 1.14 +/- 0.12 and 1.08 +/- 0.08, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769374 TI - Comparison of adenosine receptor agonists with other vasodilators on noradrenaline-, potassium- and phorbol ester-contracted rabbit aorta. AB - Isometric contractions of rabbit isolated aortic spirals were induced by noradrenaline (1 microM), potassium chloride (51 mM) or phorbol-12,13-dibutyrate (1 microM). A cumulative concentration-response curve for adenosine, N ethylcarboxamidoadenosine (NECA), verapamil, sodium nitroprusside, isoprenaline or forskolin was then constructed. Sodium nitroprusside displayed selectivity towards noradrenaline- compared with potassium-contracted tissues. In contrast, verapamil selectively relaxed the potassium-contracted tissues. Adenosine preferentially relaxed the noradrenaline-contracted aorta. Adenosine, in the presence of the transport inhibitor dipyridamole (10 microM), and NECA were without effect upon potassium-contracted tissues. This absolute selectivity for noradrenaline-contracted aortas indicates that adenosine A2-receptor agonists do not interfere with calcium influx through voltage-operated channels but inhibit calcium influx via receptor-operated channels or its intracellular release. The inhibition by dipyridamole of a small relaxation by adenosine in potassium contracted tissues indicates that this was due to stimulation of an additional intracellular site. The selectivity profile of adenosine and NECA was similar to that of forskolin and isoprenaline indicating that their relaxations were due to a common activation of adenylate cyclase and cAMP accumulation. Only sodium nitroprusside- and forskolin-relaxed aortas contracted with phorbol dibutyrate. Adenosine and NECA also failed to cause relaxation of noradrenaline-contracted aortas preincubated with the phorbol ester indicating that it may desensitize A2 receptors. PMID- 1769375 TI - Pressor effects of L and D enantiomers of NG-nitro-arginine in conscious rats are antagonized by L- but not D-arginine. AB - The effects of NG-nitro-L-arginine (L-NNA) and NG-nitro-D-arginine (D-NNA) on mean arterial pressure (MAP) were studied in conscious, unrestrained rats. I.v. bolus of either L-NNA (1-64 mg/kg) or D-NNA (2-64 mg/kg) dose dependently increased MAP to similar maximum values of 55 +/- 7 and 52 +/- 4 mm Hg and with ED50 values of 4.0 +/- 0.9 and 8.9 +/- 1.2 mg/kg (P less than 0.05), respectively. The time course of the MAP response to a single dose (32 mg/kg i.v. bolus) of L-NNA and D-NNA were also obtained. The pressor effects of L-NNA and D NNA each lasted greater than 2 h with the rise phase t 1/2 of 5 and 27 min (P less than 0.05), respectively. I.v. infusions (10 mg/kg per min) of L-arginine (L Arg) and D-arginine (D-Arg) did not alter the pressor response to noradrenaline nor angiotensin II. L-Arg but not D-Arg attenuated the pressor responses to both L-NNA and D-NNA. Therefore, both L-NNA and D-NNA are efficacious and long-lasting pressor agents; the pressor effects of both can be antagonized by L-Arg but not D Arg. Our results suggest that the pressor effects of both L-NNA and D-NNA involve the L-Arg/nitric oxide pathway. PMID- 1769376 TI - Vasopressin modulates male squirrel monkeys' behavior during social separation. AB - The central administration of arginine-vasopressin (AVP) in rodents has been associated with the modulation of a number of categories of behavior including social recognition and learning, aggression, grooming, and feeding. Concentrations of AVP in brain have also been functionally related to gonadal steroid hormone manipulations. In the current experiments we investigated the behavioral effects of centrally administered AVP on the behavior of pair-housed male squirrel monkeys during brief social separations. Prior to treatment, pairs of male squirrel monkeys established reliable and persistent dominance relationships measured as different patterns of social behavior and plasma levels of testosterone. Central administration of AVP increased scent-marking and grooming behaviors during the social separation test, however these effects were not influenced by the social status of the treated monkey. The effects of AVP on these measures were not mimicked by doses of oxytocin (OT). Both AVP and OT decreased the frequency of vigilance-checking and 'isolation-peep' calls. The data are consistent with a facilitatory role for AVP in the stress response and also suggest that these particular effects are not influenced by differences in testosterone associated with social dominance. PMID- 1769377 TI - Different mechanisms of homologous and heterologous desensitization of thrombin induced endothelial prostacyclin production. AB - Several workers have described desensitization of endothelial prostacyclin production but conflicting evidence has been published regarding the mechanism of desensitization, whether it is homologous (agonist specific) or heterologous, and whether inactivation of cyclooxygenase is involved. The purpose of the present study was to determine the relation between the intensity of a first thrombin stimulus and the subsequent response to a repeat thrombin, histamine, ionophore A23187 or aluminium fluoride (AlF4) stimulation and to determine possible targets of desensitization. Following thrombin stimulation of confluent cultured human umbilical vein endothelial cells (HUVEC) only homologous desensitization of inositol phosphate production was observed. Both homologous and heterologous desensitization of arachidonic acid release and prostacyclin production occurred, the latter towards both histamine and the ionophore A23187. For any given dose of the first stimulant there was a much greater effect on the homologous response than on the heterologous response. These differences suggest different mechanisms. The homologous desensitization probably involves the receptor whereas the present results suggest that the target of heterologous desensitization is distal to calcium mobilization in the signal transduction pathway. The possibilities include decreased activity of phospholipase A2 or a decreased pool of accessible arachidonic acid. PMID- 1769378 TI - Species-dependent attenuation of adenosine A1 agonist binding by guanine nucleotides. PMID- 1769379 TI - Optokinetic response of cells in the nucleus reticularis tegmenti pontis of the pigmented rabbit. AB - In immobilized pigmented rabbits anesthetized with N2O (70%) and halothane (2 4%), extracellular spikes were recorded from neurons in the nucleus reticularis tegmenti pontks (NRTP) and their responses to optokinetic stimulation (OKS) were examined. OKS was delivered using constant-velocity (0.1-4.0 degrees/s) movements of a random dot pattern (60 degrees x 60 degrees) at 0 degree, 45 degrees, 90 degrees or 135 degrees to the horizon. With OKS delivered to the contralateral eye (n = 43), the preferred directions of NRTP cells were forward (F, n = 10), backward (B, n = 7), downward (D, n = 5), and the remaining cells showed no response (N, n = 21). With OKS delivered to the ipsilateral eye (n = 43), the preferred directions were F (n = 8), B (n = 8), upward (U, n = 2), D (n = 1) and N (n = 24). The majority of cells which responded to OKS (17/22 for contralateral, and 16/19 for ipsilateral OKS) preferred the horizontal orientation. The optimum velocity ranged from 0.2 to 1 degree/s. The results suggest that the NRTP cells mainly transfer horizontal optikinetic signals to the flocculus and control horizontal optokinetic eye movements. PMID- 1769380 TI - Intracellular recordings from rat thalamic VL neurons: a study combined with intracellular staining. AB - Intracellular recordings from thalamic neurons receiving cerebellar inputs were performed under urethane anesthesia in the rat. A total of 64 neurons were recorded intracellularly with micropipettes filled with 4% biocytin solution (dissolved in 0.5 M K-acetate), and cerebellar-induced EPSPs (CN-EPSPs), the membrane resistance and firing properties were analyzed with intracellular current injections. The mean latency of CN-EPSPs was 1.9 +/- 0.8 ms and the mean input resistance measured in 10 neurons was 17.6 +/- 5.0 M omega. Thirty-two out of 35 stained neurons were analysed morphologically; 28 of these neurons were located in the VL, and 26 received CN-EPSPs. Their somata were round or polygonal in shape and the mean size was 22.5 x 15.2 microns. They had radially extending spinous dendrites, and the mean radii of the dendritic fields were 214.7 microns in the frontal and 171.4 microns in the sagittal planes. These morphological features were similar to those observed in the sensory relay nucleus of the thalamus. PMID- 1769381 TI - Latencies of response of eye movement-related neurons in the region of the interstitial nucleus of Cajal to electrical stimulation of the vestibular nerve in alert cats. AB - Recent studies have shown that the interstitial nucleus of Cajal (INC) in the midbrain reticular formation is involved in the conversion of vertical semicircular canal signals into eye position during vertical vestibulo-ocular reflexes. Secondary vestibulo-ocular relay neurons related to the vertical canals, which constitute the majority of output neurons sending signals from the vestibular nuclei directly to the oculomotor nuclei, have been shown to project axon collaterals to the region within and near the INC. To understand how the INC is involved in the signal conversion, latencies of response of neurons in the INC region to electrical stimulation of the vestibular nerve were examined in alert cats. The responses of 96 cells whose activity was clearly modulated by sinusoidal pitch rotation (at 0.31 Hz) were analyzed. These included 41 cells whose activity was closely correlated with vertical eye movement (38 burst-tonic and 3 tonic neurons), and 55 other cells (called pitch cells as previously). Twenty nine of the 96 cells (30%) were activated at disynaptic latencies following single shock stimulation of the contralateral vestibular nerve. Disynaptically activated cells were significantly more frequent for pitch cells than for eye movement-related cells (25/55 = 45% vs 4/41 = 10%; p less than 0.001, Chi-square test). Conversely, cells that did not receive short-latency activation (less than 6 ms) were more frequent among eye movement-related cells than pitch cells (26/41 = 63% vs 13/55 = 24%; p less than 0.001, Chi-square test).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769382 TI - Enkephalin mRNA production by cochlear and vestibular efferent neurons in the gerbil brainstem. AB - Preproenkephalin mRNA production by efferent neurons projecting to the gerbil inner ear was assessed using combined in situ hybridization and retrograde labeling with fluorescent tracers. Virtually all vestibular efferent neurons were positive for preproenkephalin mRNA. Of the cochlear efferents, one-half of the medial olivocochlear neurons were positive for enkephalin. All lateral olivocochlear neurons were negative for enkephalin. The results suggest that there are two, biochemically distinct subpopulations of medial olivocochlear efferents in the gerbil. PMID- 1769383 TI - Minimal stimulus parameters and the effects of hyperpolarization on the induction of long-term potentiation in the cat motor cortex. AB - The aim of the research program of which the present work is a part is to understand the neural mechanisms involved in motor learning and memory. One of the mechanisms postulated to be involved in this process is the induction of long term potentiation (LTP) in the motor cortex. LTP can be induced in motor cortical neurons by tetanic stimulation of their afferents from the somatosensory cortex. In the present study, the effects of different stimulating parameters on the induction of LTP were examined, using in-vivo, intracellular recordings from anesthetized cats. The expression of LTP was documented by measuring the amplitude and rise-time of excitatory postsynaptic potentials (EPSPs) before and after tetanic stimulation. The minimal tetanic stimulation capable of systematically inducing LTP was found to consist of a train of stimuli at 50 Hz, 5 s. Shorter trains of stimulation produced only a short-lasting, transient potentiation. In different cells, identical stimulation parameters resulted in different degrees of potentiation of synaptic responses. Following all the stimulation trains examined, EPSP amplitudes were transiently depressed before reaching potentiated levels. The duration of this depression was directly correlated with the duration and the frequency of the tetanic stimulation. In all the cells in which LTP was induced, the variability in the amplitudes of potentiated EPSP was significantly greater than that of control EPSP amplitudes. Hyperpolarization of the postsynaptic cell, during the delivery of the tetanic stimulation, inhibited the induction of LTP. These phenomena are discussed in relation to the postulated mechanisms of LTP induction in the cortex. PMID- 1769384 TI - Relationships of nucleus reticularis pontis oralis neuronal discharge with sensory and carbachol evoked hippocampal theta rhythm. AB - The activity of 72 neurons recorded in the reticularis pontis oralis nucleus (RPO) was examined in anesthetized and curarized rats during hippocampal theta (theta) rhythm elicited by either sensory stimulation or carbachol microinjections. During hippocampal theta rhythm evoked by sensory stimulation, 63.9% of RPO neurons increased their discharge rate while the firing rate decreased in 20.8%. In all cases, the RPO neurons maintained a non-rhythmic discharge pattern. In 44% of the neurons the discharges tended to occur on the positive wave of the theta rhythm. Similar firing patterns were seen in 18 RPO neurons recorded during theta rhythm elicited by both, sensory stimulation and a carbachol microinjection; this effect was blocked by atropine. These results indicate that the RPO region contributes to the generation of hippocampal theta rhythm with a tonic and nonrhythmic outflow through a cholinergic system which may be muscarinic. PMID- 1769385 TI - Ocular dominance plasticity restored by NA infusion to aplastic visual cortex of anesthetized and paralyzed kittens. AB - We studied the ocular dominance distribution in visual cortex of kittens which had been monocularly exposed to moving-pattern stimuli under anesthesia and paralysis. 1. We did not obtain any discernible changes in ocular dominance, confirming the previous reports that anesthesia and paralysis prevent ocular dominance plasticity from occurring. 2. The plasticity, however, was restored under the acute experimental condition by a cortical infusion of 1-noradrenaline (1-NA). In the 1-NA-infused visual cortex, the ocular dominance distribution was clearly shifted to the open eye after monocular exposure for about 20-24 h. 3. We also studied how quickly and to what extent the changes were induced when the duration of the combined treatment was varied. The results were: (i) the earliest change was observed in approximately 12 h with disappearance of binocular cells, (ii) the treatment was most effective after 20-24 h in inducing the shift of ocular dominance, and (iii) the treatment longer than 24 h (up to 45 h) did not necessarily enhance the shift, though the state of reduced binocularity was sustained throughout. 4. The effects of the cortical 1-NA infusion combined with monocular exposure became less with increasing the age of experimental animals, suggesting the presence of the "susceptible period" in the acute experiments. 5. The effects seemed to become smaller toward the end of a given recording session, suggesting that the restored plasticity wanes with time. The present results further support the idea that the direct activation of the NA system enhances cortical plasticity, in principle, independent of general conditions of experimental animals. PMID- 1769386 TI - Discharge properties of neurones in the hand area of primary somatosensory cortex in monkeys in relation to the performance of an active tactile discrimination task. I. Areas 3b and 1. AB - The present experiments were designed to characterize the discharge patterns of single cortical neurons within the cutaneous representation of the hand in postcentral cortex (areas 3b and 1) in awake monkeys during the performance of an active tactile discrimination task. The task consisted of making a single scanning movement over a surface (first half smooth; second half smooth or rough); the texture encountered over the second half of the surface was indicated by the animal, respectively, pushing or pulling a lever. Unitary discharge was recorded from 118 cells receiving input from the hand or distal forearm of two monkeys. Units with cutaneous fields on the digit tips in contact with the surfaces to be discriminated showed an increase in discharge (58%), a decrease in discharge (11%) or no change (31%) during the task. Units with cutaneous fields not in contact with the discriminanda were much more likely to show decreased discharge during the task (25%), suggesting that there is some selection of cutaneous inputs in this task. Cutaneous units in areas 3b and 1 were equally likely to signal differences in texture (respectively, 18% and 26% of those with digital receptive fields (RFs] and most of the texture-related units (78%) had a large RF, spanning several digits. The discharge patterns of single texture related cells did not reliably signal whether or not the animal successfully discriminated the surfaces: unitary responses were occasionally absent even though the animal correctly identified the surface or they were present when an incorrect response was made. This observation suggested that information derived from a population of cells is required for the performance of the task, since no single cell's discharge contained sufficient information upon which the animal could base its behavioural response. A group of cells with digital RFs (24% of area 3b cells and 15% of area 1 units) were classified as movement-related. Their discharge signalled precisely the onset and/or end of movement, and they were generally insensitive to the texture of the surfaces scanned. Such cells may serve as an independent source of information for primary somatosensory cortex related to the physical parameters of movement. Most cells with digital RFs were more responsive during active tactile discrimination than during passive movement of the digits over the surfaces (monkey no longer required to discriminate the surface texture). For area 3b units, peripheral factors (RF orientation, speed of movement) were likely responsible for this observation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1769387 TI - Regional central serotonin receptor binding in rats treated chronically with high dose 5-hydroxy-L-tryptophan. AB - The serotonin (5-HT) precursor 5-hydroxy-L-tryptophan (L-5-HTP) exerted differential regional effects on central 5-HT receptors in rats treated chronically by intraperitoneal injections of large incremental doses (50-200 mg/kg). There were significant reductions in Bmax of agonist-labelled (-35%) and antagonist-labelled (-20%) 5-HT2 sites in cortex but no changes in brainstem. KD and nH were unaffected by L-5-HTP. Bmax of 5-HT1 sites (unsubtyped) was reduced 16% in cortex and 18% in spinal cord, but the changes were not significant. Brainstem 5-HT1 sites were unaffected. Studies at a single isotope concentration in other regions revealed significant reductions of antagonist-labelled 5-HT2 specific binding in diencephalon (-26%) but not septum, and of 5-HT1 binding in diencephalon (-25%) and cerebellum (-30%) but not in hippocampus or striatum. Absence of L-5-HTP-evoked changes in 5-HT receptors in brainstem may have implications for L-5-HTP-responsive and brainstem-mediated human myoclonic disorders. PMID- 1769388 TI - Role of medial preoptic GABA neurones in regulating luteinising hormone secretion in the ovariectomised rat. AB - The role of GABA neurones in the medial preoptic area (MPOA) in regulating the activity of the luteinising hormone-releasing hormone (LHRH) neurones projecting to the median eminence was investigated in the conscious ovariectomised rat. Plasma luteinising hormone (LH) concentrations were measured while (1) endogenous GABA release from the MPOA was monitored with the technique of microdialysis, or (2) activity at the GABA receptor was modulated by local infusions into the MPOA. Microdialysis studies revealed a fluctuating level of GABA release in the MPOA which did not correlate with pulsatile LH secretion. Infusion of 10 microM GABA (n = 8) or bicuculline methiodide (BMI, n = 6) into the MPOA, at a rate of 1 microliter/30 min, significantly inhibited mean LH concentrations (P less than 0.05-0.001) and LH pulse frequency (P less than 0.05-0.001) compared with controls (n = 8). LH pulse amplitude was not significantly altered by infusion of GABA (P greater than 0.05) while too few pulses were found after BMI treatment to enable statistical analysis. Infusions of GABA into the ventral half of the MPOA had a more significant inhibitory effect upon LH secretion compared with dorsal infusions (P = 0.012). A similar relationship did not exist for BMI infusions. These results show that acute changes in preoptic GABA receptor occupancy result in disruption of pulsatile LH secretion in the ovariectomised rat. This suggests that GABA neurones provide a tonic input important for the functional integrity of the neural network controlling LH secretion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769389 TI - Heterogeneous visceral nerve changes in acrylamide intoxication. AB - A variety of visceral nerves were studied by intermediate filament immunocytochemistry in rats intoxicated with acrylamide. In such animals, oesophageal and diaphragmatic motor end-plates were invaded and deformed by neurofilament protein-like material, while afferent fibres of diaphragmatic neuromuscular spindles and myelinated sensory fibres of the iris showed striking terminal accumulation of similar material. Conversely, the rich population of thin afferent fibres of the iris showed no obvious abnormality, while pre terminal changes were seen along the extrinsic nerve fibres supplying the cornea and myenteric ganglia. Multiple lesions were demonstrated in gut nerves of acrylamide-treated rats, while scattered "enteric glial cells" showed abnormally coarse morphology and a striking increase in glial fibrillary acidic protein immunoreactivity. A distinct, delicately varicose appearance was revealed by neurofilament protein-immunostaining in bladder nerve fibres of normal rats, which was changed to one of coarse dilations by acrylamide. In conclusion, apparently selective changes were found along different types of axons, indicating marked heterogeneity in cytoskeletal organisation among visceral nerves. Taken together with the proposed inhibition by acrylamide of neurofilament proteins degradation, the above findings may suggest a non-uniform distribution of neurofilament degradation sites along distal regions of different axons. PMID- 1769390 TI - Corticobulbar and corticospinal projections to neck muscle motoneurons in man. A functional study with magnetic and electric transcranial brain stimulation. AB - The cortical projections to neck muscle motoneurons were studied in normal subjects by electrical and magnetic transcranial brain stimulation. After magnetic stimulation with a large coil, motor evoked potentials were present in about 20% of relaxed and 100% of contracting neck muscles. The latency of these responses was short: about 7 ms in the sternomastoid and splenius and 9 ms in the trapezius muscles. Subtraction of the M-wave latency after stimulation of the accessory nerve at the skull base resulted in a central latency of about 4.5 ms. We suggest that rapid cortical projections connect with neck muscle motoneurons mono or disynaptically. The latency difference between the responses after electrical and magnetic stimulation was smaller in neck than in limb muscles but similar to that seen in masticatory muscles. A small magnetic coil was used to study the pattern of functional lateralization of cortical projections to neck muscle motoneurons; the projections for the sternomastoid and splenius are bilateral but predominantly contralateral, whereas those for the trapezius are exclusively contralateral. PMID- 1769391 TI - Selective perturbation of visual input during prehension movements. 2. The effects of changing object size. AB - 1. Subjects were instructed to reach and grasp cylindrical objects, using a precision grip. The objects were two concentric dowels made of translucent material placed at 35 cm from the subject. The inner ("small") dowel was 10 cm high and 1.5 cm in diameter. The outer ("large") dowel was 6 cm high and 6 cm in diameter. Prehension movements were monitored using a Selspot system. The displacement of a marker placed at the wrist level was used as an index for the transport of the hand at the location of the object. Markers placed at the tips of the thumb and the index finger were used for measuring the size of aperture of the finger grip. 2. Kinematics of transport and grasp components were computed from the filtered displacement signals. Movement time (MT), time to peak velocity (TPV) and time to peak deceleration (TPD) of the wrist, time to peak velocity of grip aperture (TGV), time to maximum grip aperture (TGA) were the main parameters used for comparing the movements in different conditions. Spatial paths of the wrist, thumb and index markers were reconstructed in two dimensions. Variability of the spatial paths over repeated trials was computed as the surface of the ellipses defined by X and Y standard deviations from the mean path. 3. Computer controlled illumination of one of the dowels was the signal for reaching toward that dowel. Blocks of trials were made to the small dowel and to the large dowel. Mean MT during blocked trials was 550 ms. The acceleration phase of the movements (measured by parameter TPV) represented 33% of MT. About half of MT (52%) was spent after TPD in a low velocity phase while the hand was approaching the object. This kinematic pattern was not influenced by whether movements were directed at small or large dowels. 4. Grip aperture progressively increased during transport of the hand. TGA corresponded to about 60% of MT, that is, maximum grip aperture was reached during the low velocity phase of transport. Following TGA, fingers closed around the object until contact was made. This pattern of grip formation differed whether the movement was directed at the large or the small dowel: TGA occurred often earlier for the small dowel, and the size of the maximum grip aperture was larger for the large dowel. Variability of both the wrist and finger spatial paths was larger during the first half of MT, and tended to become very low as the hand approached the dowels.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1769392 TI - Impairment of visual perception and visual short term memory scanning by transcranial magnetic stimulation of occipital cortex. AB - Transcranial magnetic stimulation (TMS) of occipital cortex was performed using a magneto-electric stimulator with a maximum output of 2 Tesla in 24 normal volunteers. The identification of trigrams, presented for 14 ms in horizontal or vertical arrays was significantly impaired when the visual stimulus preceded the occipital magnetic shock by 40 to 120 ms. The extent of impairment was related to TMS intensity. The latency of perceptual impairment was shorter for more intense TMS. No perceptual impairment was obtained by "sham" stimulation when TMS shocks were applied to the upper cervical region rather than the occipital region to rule out unspecific startle reactions affecting attention possibly responsible for the observed reduction in performance. Occipital TMS did not evoke systematic eye movements except for blink responses at latencies beyond 40 ms which were too late to interfere with visual input. Depending on the required serial order of readout of the trigram perceptual impairment was more marked for the second and third part of the trigram. This demonstrates that TMS interferes with the internal serial processing of visual input. To elucidate this further, TMS was used in a Sternberg short term visual memory scanning task. TMS caused a marked decrease in memory scanning rates whereas visual stimulus encoding and storage remained unaffected when tested at various TMS delays. TMS appears to be a useful method to study processes of visual perception and short term memory handling in the occipital cortex. Advantages over classical visual masking techniques especially regarding topical localisation are discussed. PMID- 1769393 TI - Early responses to double-step targets are independent of step amplitude. AB - We used a double-step paradigm to examine saccadic responses occurring at short intervals (50-150 ms) after the presentation of a 2-8 degrees step. Saccades occurring 60-110 ms after the second step had amplitudes independent of the step size. The amplitudes scaled to step size for intervals greater than 110 ms. These findings suggest that there is an early period of saccadic goal processing during which only information about the hemispheric location, but not the amplitude, of the target motion is available. PMID- 1769395 TI - Perception of forearm angles in 3-dimensional space. AB - The purpose of this study was to determine a preferred coordinate system for representation of forearm orientation in 3-dimensional space. In one experiment, the ability of human subjects to perceive angles of the forearm in 3-dimensional space (forearm elevation and yaw--extrinsic coordinate system) was compared to their ability to perceive elbow joint angle (intrinsic coordinate system). While blindfolded, subjects performed an angle reproduction task in which the experimenter first positioned the upper limb in a reference trial. This was followed, after movement of the subject's entire upper limb to a different position, by an attempt to reproduce or match a criterior angle of the reference trial by motion of the forearm in elbow flexion or extension only. Note that matching of the criterion forearm angle in the new upper limb position could not be accomplished by reproducing the entire reference upper limb position, but only by angular motion at the elbow. Matching of all 3 criterion angles was accomplished with about equal accuracy in terms of absolute constant errors and variable errors. Correlation analysis of the perceptual errors showed that forearm elevation and elbow angle perception errors were not biased but that forearm yaw angle matching showed a bias toward elbow angle matching in 7 of 9 subjects. That is errors in forearm yaw perception were attributed to a tendency toward a preferred intrinsic coordinate system for perception of forearm orientation. These results show that subjects can accurately perceive angles in both extrinsic and intrinsic coordinate systems in 3-dimensional space. Thus, these data conflict with previous reports of highly inaccurate perception of elbow joint angles in comparison to perception of forearm elevation. In an attempt to resolve this conflict with previous results, a second experiment was carried out in which perception of forearm elevation and elbow joint angles with the forearm motion constrained to a vertical plane. Results of this experiment showed that during a two-limb elbow angle matching task, four of five subjects exhibited a clear bias toward forearm elevation angle. During a one-limb angle reproduction task only two of five subjects exhibited such a bias. Perception of elevation angles show little bias toward elbow angle matching.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1769394 TI - Habituation to repeated painful and non-painful cutaneous stimuli: a quantitative psychophysical study. AB - Repeated stimuli elicit progressively smaller responses and elevated sensory and/or pain thresholds (habituation). The present experiments were designed to determine the rate of habituation of perceptual responses to supraliminal painful and non-painful cutaneous stimuli. Changes in the perceived intensity of electrical stimuli applied to the digital nerves of the index finger were determined by a matching procedure in which subjects set the current applied to the index finger of one hand to match the perceived intensity of a stimulus train (5 pulses at 20 Hz) applied to the other index finger. Twenty-five volunteers took part in 7 experiments in which both non-painful (2.5 times the sensory threshold Ts) and painful (1.2 times the pain threshold Tp) stimulus trains were presented. Subjects were required to match the stimuli at 30 s intervals over a period of 7.5 min. The percentage change in matching current (Y) was fitted by the function Y = -20.7*[1-exp(-0.56*t)] for both painful and non-painful stimuli repeated at 2 Hz. Responses recovered completely within 2 min of cessation of the stimulation. The degree of habituation increased or decreased with the rate of stimulus presentation. These results did not depend on changes in afferent fibre recruitment or fatigue because the afferent volley on the median nerve remained constant throughout the period of stimulation. Thus perceptual responses to the perceived intensity of supraliminal painful and non-painful stimuli delivered to the index finger habituate to the same extent, and the extent of the habituation is a function of the frequency of presentation of the stimulus. PMID- 1769396 TI - Cervico-ocular reflex enhancement in labyrinthine-defective and normal subjects. AB - The cervico-ocular reflex (COR) was elicited in 12 normal and 30 labyrinthine defective (LD) subjects, lacking a vestibulo-ocular reflex (VOR) in the usual laboratory tests, by sinusoidal horizontal rotation of the body at 30 degrees amplitude and frequencies of 0.1, 0.2 and 0.4 Hz. The head was fixed in space and the eyes were open in total darkness. The gain of the COR was measured by relating the maximum slow phase velocity (MSPV) of the eyes to the maximum input velocity (19, 38 or 75 degrees/s) and by relating the cumulative eye displacement per hemicycle to the peak-to-peak amplitude of 60 degrees. The COR gain was below 0.25 in the normal subjects. In the LD subjects, a clear COR was observed with a gain of about 0.7 (SD 0.3) at 0.1 Hz, decreasing to about 0.4 (SD 0.2) at 0.4 Hz. There was no appreciable phase lag in 11 of the LD subjects. In 17 other LD subjects, the phase lag was close to 0 degrees at 0.1 Hz and increased to about 20-30 degrees at 0.4 Hz. Testing 4 additional normal subjects with the special instruction to attempt fixation of the knee during trunk rotation in the dark, resulted in an enhanced COR showing many "catch-up" saccades with a gain close to unity; the smooth component was also enhanced. The pattern with catch-up saccades was different from the pattern observed in most LD subjects, which closely resembled the normal VOR elicited by sinusoidal rotation. The special instruction to attempt fixation of the knee was also given to one LD subject during stimulation at 0.2 Hz.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769397 TI - Influences of object weight and instruction on grip force adjustments. AB - This study investigated the influence of object weight and instructions on grip force responses in humans. Using a precision grip, subjects lifted a small instrumented test object to a predetermined height. Prior to each set of 40 trials, subjects were verbally instructed to either "hold" or "let go" of the object in response to any change in weight. Unpredictably on some trials (less than 20%), a sudden sustained increase (load) or decrease (unload) in vertical load was applied to the object. Grip responses to these induced weight changes were evaluated by measuring grip force, object position, and associated electromyographic (EMG) activity. Grip force changes for a load were over three times greater than those for an unload. Such asymmetry may reflect everyday grasp and manipulation in a gravity-influenced world. Grip force adjustments to loads following "hold" instructions were on the average somewhat larger than those following "let go" instructions, but there was no influence of instructions on responses to unloads. These findings contrast with more robust influences of verbal instruction on automatic postural and proximal upper limb responses and also may suggest that grip force adjustments are influenced to a greater extent by intrinsic task variables than by extrinsic volitional intent. Such organization appears tailored to functional task requirements in natural environmental contexts. PMID- 1769398 TI - Smooth pursuit eye movements obey Listing's law in the monkey. AB - We have tested Listing's law in the monkey using the dual search coil technique to record 3-dimensional eye positions during smooth pursuit and during spontaneous eye movements in the light. Our results indicate that during smooth pursuit the eye positions obey Listing's law with a least the same accuracy as during spontaneous eye movements or during periods of fixations. PMID- 1769399 TI - The young adult years: diversity, structural change, and fertility. PMID- 1769400 TI - Recent trends in the timing of first births in the United States. AB - We use vital registration data published since 1979 to update trends in the timing of first births. Two important trends are documented. First, the likelihood that childless women over age 30 will have a first birth has increased since the 1970s. This change shows that women born in the 1950s are "catching up" on fertility postponed at younger ages. Second, racial differences in the timing of first births are very large. For those born in the 1950s, nonwhites have first births much earlier, and far fewer nonwhite than white women will remain permanently childless. In the second part of the paper, we use these data for recent years to assess earlier projections of childlessness based on cohort and period approaches. We also assess the accuracy of stated intentions to have no children. PMID- 1769401 TI - New evidence on the fertility transition in Ireland 1880-1911. AB - Recent analyses of Ireland's marital fertility transition based on the Princeton Ig and the Stanford CPA measures are reassessed. Revised county estimates of Ig are subjected to regression analysis, and added insight into CPA is offered by comparing Ireland with Scotland and applying the measure to three specially constructed local data sets. PMID- 1769402 TI - Gender and changing generational relations: spouse choice in Indonesia. AB - Many Asian societies are undergoing a nuptiality transition that is not only tied integrally to other aspects of family organization, but is also often more complex than standard studies of female age at marriage can reveal. To comprehend some of this complexity, we focus on the patterns of spouse choice for both men and women in central Java. The extent of parental control over mate selection is examined for change over time, gender differences, and likely determinants, including family class, education, premarital work, and residence. It is argued that the current marriage transition in Indonesia reflects both gender and generational hierarchies in the Javanese family system. The analysis is conducted using a multinomial logit model; in general, it yields results strongly supportive of the argument that the determinants of spouse selection differ by gender. The results also show that although there is a dramatic shift towards self-choice marriages, it is occurring within the context of historical and institutional factors specific to Javanese society. PMID- 1769403 TI - Legal status and the stability of coresidential unions. AB - Using data from the National Longitudinal Study of the High School Class of 1972, we examine the effect of the legal status of coresidential unions on the likelihood of dissolution. We find that legal unions are much more stable than nonlegal unions. In addition, current legal status is more important for predicting stability of union than is legal status at the initiation of the union. We also find that the effect of current legal status remains constant over various durations of unions and that legalizing a nonlegal union has little effect beyond that expected on the basis of a occupying a particular legal status. PMID- 1769404 TI - Patterns of entry into cohabitation and marriage among mainland Puerto Rican women. AB - This paper adds to our limited knowledge of racial and ethnic variation in union formation by describing and analyzing the first unions of mainland Puerto Rican women. Retrospective history data show that Puerto Ricans have shared in the post 1970 shift toward cohabitation. Puerto Rican women, however, are much more likely to enter informal first unions than the general population, and have a low propensity to transform informal unions into legal marriages. The paper examines the influence of family background and current activities on union timing and type. The relationship between partner attributes and the choice between formal and informal coupling is also considered. PMID- 1769405 TI - The use of own-child checks to determine remarriage status. AB - The 1900 Federal Census of the United States did not ask currently-married women whether they had been married previously. This note uses the direct report on remarriage in the 1910 census to evaluate the performance of the "own-child checks" that several researchers have used with the 1900 census to substitute for direct information on remarriage. Accurate information on remarriage status is important for fertility and mortality estimation methods that rely on marital duration. The checks detect fewer than two-thirds of wives who report they are remarried. The use of these checks, however, does not introduce large amounts of error in an analysis of either fertility or mortality. The checks work better for white women than for black women. PMID- 1769406 TI - Are cohort mortality rates autocorrelated? AB - In this paper the author examines the proposition that heterogeneity in individual frailty leads to autocorrelation in cohort mortality rates. A simple model is used to construct analytic expressions for the covariance of cohort mortality rates at different ages under a number of alternative assumptions about the stochastic process generating shocks in mortality. The model then is used to construct a procedure that uses correlations in cohort mortality rates to estimate the extent of heterogeneity in a population without relying on strong assumptions about the distribution of frailty or the shape of the underlying hazard. The procedure then is used to show that cohort mortality data from France are consistent with a generalized random-effects model in which frailty is gamma distributed. PMID- 1769407 TI - Spanish surname and Anglo infant mortality: differentials over a half-century. AB - Using a half-century of death records from San Antonio/Bexar County, Texas, we examine the timing and cause structure of Spanish surname and Anglo infant mortality. Our findings show that despite the substantial disparities between ethnic-specific infant mortality rates in the early years of the study, there have been consistent declines in overall, neonatal, and postneonatal mortality for both groups, as well as a major convergence of mortality rates between Spanish surname and Anglo infants. Further, we demonstrate that the convergence is of relatively recent origin and is due primarily to shifts in postneonatal mortality. Finally, we examine the transition reflected in the cause structure of ethnic-specific infant mortality and show that the convergence was largely the result of reductions in deaths from exogenous causes. Implications for research into the "epidemiologic paradox" are discussed. PMID- 1769408 TI - Expression of c-myc in cutaneous lymphomas and pseudolymphomas. AB - The expression of the proto-oncogene c-myc was studied in tumorous skin lesions of (cutaneous) lymphoproliferative diseases (3 cases of pseudolymphoma, 8 cases of non-Hodgkin lymphoma and 1 case of lymph node involvement in mycosis fungoides) in a total of 12 patients. c-myc mRNA levels were quantified by Northern blot analysis followed by densitometric evaluation of the specific bands. Higher levels of c-myc mRNA expression were observed in lymphomas as compared with pseudolymphomas (p greater than 0.05). No significant differences in c-myc mRNA values were detected between B and T cell pseudolymphomas. Our results suggest that c-myc mRNA overexpression is associated with malignant lymphomas of the skin. We conclude that the measurement of c-myc mRNA levels may contribute to further characterize cutaneous lymphoproliferative diseases. PMID- 1769409 TI - Serological profiles as prognostic clues for progressive systemic scleroderma: the Italian experience. AB - Ninety-one patients with progressive systemic sclerosis have been examined both clinically and serologically in order to have a better prognostic insight. Three main serological profiles have been isolated. The patients with anticentromere antibodies (ACA) represented one third of the cases, developed skin sclerosis rather later and rarely exhibited ankyloses and ulcerations. The esophagus was commonly involved while the lung, heart and kidneys were not. ACA-positive patients were not identified with the CREST syndrome, as the latter disclosed other profiles with the same frequency. Patients with anti-Scl-70 antibody represented one fourth of the cases and had the fastest progression, developing sclerosis in less than 5 years after the onset of Raynaud's phenomenon. Ankyloses and lung fibrosis, as well as joint, heart and kidney involvement, were found in most of them. Patients with anti-SSA/Ro antibodies were uncommon, but corresponded to a severe subset, having a fast progression and a constant involvement of the lung. Probably due to the rougher definition of their serology, patients with antinuclear, antispeckle-patterned and anti-Ku antibodies or without any detectable antibody could be defined less easily and corresponded to an intermediate position between ACA- and anti-Scl-70-positive patients. Though it is probably premature to trust it completely, a serological classification may provide the prognostic clues clinical classifications cannot. PMID- 1769410 TI - Papaverine hydrochloride in the treatment of atopic dermatitis: a double-blind, placebo-controlled crossover clinical trial to reassess safety and efficacy. AB - In a double-blind crossover study, oral papaverine hydrochloride in doses of 150 300 mg t.i.d. was compared to placebo as an adjunctive treatment of atopic dermatitis. Twenty patients completed both 2-week phases of the crossover during which time the physician's weekly evaluation included an estimate of percentage skin involvement with disease, global evaluation and the grading of the erythema, scale and lichenification of a representative plaque. The patients' evaluation included their assessment of the degree of pruritus, and an estimate of the percentage of the day pruritus was present as well as a global evaluation of disease. Papaverine demonstrated no statistically significant advantage over placebo for any of the parameters measured and was noted to cause transient asymptomatic liver function test abnormalities in 3 of the study patients. PMID- 1769412 TI - Repeated cultured epidermal allografts in the treatment of chronic leg ulcers of various origins. AB - Twelve patients with 16 leg ulcers, existing for at least 3 months and not responsive to conventional inpatient therapy of at least 3 weeks, were treated with repeated applications of cultured allogenic keratinocyte sheets. A marked decrease in size was seen in all ulcers but 2. Complete closure of the ulcer was seen in 62% of the ulcers within 8 weeks. Healing was due to enhanced granulation and increased epithelialization, starting from the periphery of the wound. This edge effect suggests that the epidermal allografts act by stimulation of migration and/or multiplication of the acceptor's keratinocytes, rather than by take of the allograft. PMID- 1769411 TI - Adjuvant treatment in stage I and II malignant melanoma: a randomized trial between chemoimmunotherapy and immunotherapy. AB - A randomized trial comparing chemoimmunotherapy (bacillus Calmette-Guerin + chemotherapy) and immunotherapy (bacillus Calmette-Guerin alone) was carried out in high-risk stage I and II malignant melanoma patients. Eight-two evaluable patients were included. The follow-up median duration was 11 years. Recurrent melanoma developed in 28 patients (34%). The overall survival rate was 76% at 5 years and 65% at 10 years. There were no statistical differences in survival probability or disease-free survival (DFS) probability between the two treatment groups. Survival and DFS were also analyzed in relation to various prognostic factors. Statistically significant differences were only seen in a subset of 33 patients with lower limb malignant melanoma, the prognosis being better for the chemoimmunotherapy group in this location. Because of the small number of patients in each group, a week positive effect of either of these two treatments cannot be ruled out. Chemoimmunotherapy only seems to improve the prognosis of stage I or II malignant melanoma of the legs. PMID- 1769414 TI - Nail changes as the first sign of systemic amyloidosis. AB - A 68-year-old man had had for 3 years a severe onychodystrophy involving all fingers and toes which clinically mimicked nail lichen planus. The nail biopsy showed amyloid deposits in the superficial dermis of the nail matrix. Physical, pathological and laboratory examinations confirmed the diagnosis of primary systemic amyloidosis. At the time of the diagnosis the patient did not present any other cutaneous sign of systemic amyloidosis. PMID- 1769413 TI - Clinical comparison of cefuroxime axetil, cephalexin and cefadroxil in the treatment of patients with primary infections of the skin or skin structures. AB - This study was designed to compare the clinical and bacteriological efficacy of three oral cephalosporins, cefuroxime axetil, cephalexin and cefadroxil, in the treatment of patients with mild to moderate infections of the skin or skin structures. A total of 330 patients were enrolled at 10 centers and were randomly assigned to receive cefuroxime axetil 250 mg (n = 107), cephalexin 500 mg (n = 111) or cefadroxil 500 mg (n = 112), twice daily for 10 days. Patients were assessed for their clinical and bacteriological responses once during treatment (3-5 days) and twice after treatment (1-3 and 10-14 days). A total of 353 bacterial isolates were obtained: Staphylococcus aureus (41%), Staphylococcus epidermidis (33%) and Streptococcus pyogenes (5%). A satisfactory clinical outcome (cure or improvement) was achieved in 97% (89/92), 89% (80/90) and 94% (82/87) of the clinically evaluable patients treated with cefuroxime axetil, cephalexin or cefadroxil, respectively (p = 0.047, cefuroxime axetil vs. cephalexin). With respect to the eradication of the bacterial pathogens, a satisfactory outcome (cure or presumed cure) was obtained in 96% (69/72), 85% (60/71) and 93% (63/68) of bacteriologically evaluable patients treated with cefuroxime axetil, cephalexin and cefadroxil, respectively (p = 0.026, cefuroxime axetil vs. cephalexin). All three study drugs were well tolerated, with adverse events affecting the gastrointestinal system most commonly reported. There were no significant differences between treatment groups in the incidence of drug related adverse events. PMID- 1769415 TI - Rapid development of multiple squamous-cell carcinomas during chronic granulocytic leukemia. AB - We report a 65-year-old patient who presented a rapid eruption of keratoses on sun-exposed areas and an explosive transformation into several squamous-cell carcinomas, occurring during the accelerated phase of a chronic granulocytic leukemia. Clinical findings resembled those usually described in xeroderma pigmentosum. The role of immunosuppression, chemotherapy and possible genetic predisposition is discussed. PMID- 1769416 TI - Coexistence of pemphigus vulgaris, malignant melanoma and low-grade lymphoma. AB - A 53-year-old female patient with pemphigus vulgaris under continuous immunosuppressive therapy for about 2 years presented a superficial spreading malignant melanoma on a pre-existing melanocytic naevus. After surgical removal of the inguinal lymph node group, a diffuse low-grade polymorphous immunocytoma was proved both histologically and immunocytochemically. The possible induction mechanisms are discussed. PMID- 1769417 TI - Pemphigus in Sikhs. PMID- 1769418 TI - Macular amyloidosis, notalgia paresthetica and pruritus: three sides of the same coin? PMID- 1769419 TI - Possible influence of growth hormone on sebum excretion in man. PMID- 1769420 TI - Anticentromere antibody and Raynaud's phenomenon. PMID- 1769421 TI - Urinary neopterin and kynurenine in herpes gestationis. PMID- 1769422 TI - L-tryptophan-induced eosinophilia-myalgia syndrome. I. Report of two cases with pseudoxanthoma-elasticum-like skin changes. AB - Two female patients who fulfilled the criteria for L-tryptophan-induced eosinophilia-myalgia syndrome (EMS) had, together with morphea-like and fasciitis like sclerotic changes of the skin, lesions that clinically mimicked pseudoxanthoma elasticum (PXE). Histology was compatible with the diagnosis; electron microscopy did not reveal calcium deposits. PXE-like changes may represent an additional feature of the pleomorphic L-tryptophan-induced EMS. PMID- 1769423 TI - Tumor of follicular infundibulum. AB - Tumor of the follicular infundibulum is a rare, benign proliferative follicular disorder. A case of multiple lesions in a 37-year-old woman is reported. The diagnosis was made histologically. PMID- 1769424 TI - Immunohistochemical expression of epidermal growth factor receptors in nuclei of a subpopulation of keratinocytes and sweat gland cells. AB - We have raised a polyclonal antibody to the 170-kD epidermal growth factor receptor. We found an intercellular pattern of immunoreactivity in the epidermis as well as a positivity of the cytoplasm of keratinocytes and eccrine secretory cells. In some samples, a nuclear labelling was evidenced in these type of cells. There is a close resemblance in the topographical distribution of these cells with nuclear labelling and those synthesizing DNA under phytohaemagglutinin stimulation. PMID- 1769425 TI - Neutrophilic eccrine hidradenitis. AB - We report an additional typical case of neutrophilic eccrine hidradenitis, which was observed in a 57-year-old man with acute myelogenous leukemia. He developed this eruption following chemotherapy with cytarabine and mitoxantrone. A short review of the literature is presented. PMID- 1769426 TI - Nodular cutaneous mucinosis--an unusual multiple type of euthyreotic focal mucinosis. AB - A 32-year-old Turkish man with a progressive appearance of indolent, skin-colored nodules on the trunk and proximal extremities is presented. Clinical and laboratory examinations did not reveal any other relevant abnormalities. Histological specimens showed focal, ill-defined depositions of acid mucopolysaccharides mainly in the reticular dermis. Collagen fibers were split up and separated. Ultrastructurally, activated fibroblasts and an increased synthesis of collagen fibrils and elastic microfibrils as well as numerous macrophages were noticed. Diagnostically, an unusual multiple type of cutaneous focal mucinosis is most likely. PMID- 1769427 TI - Detection of antibody to calmodulin in chronic viral hepatitis: lack of correlation with virus replication and hepatocellular damage. AB - We have analyzed the presence of IgG and IgM anti-calmodulin antibodies (anti CaM) by ELISA in patients with chronic hepatitis due to B, delta and C viruses as well as in patients with other liver diseases. The specificity of the assay was demonstrated by preadsorption of positive serum with calmodulin (CaM) but not with myosin light chain. Among 164 patients with chronic viral hepatitis (B, delta and C) and 50 with non-viral hepatitis, 27 and 26%, respectively, had auto antibodies against CaM. There was a significantly increased frequency (37%) of these auto-antibodies in chronic delta infection as compared to that (21%) of patients with chronic B hepatitis (p less than 0.05). An intermediate incidence of anti-CaM, (24%) was found in chronic C infection. The frequency of anti-CaM was not related to the level of hepatitis B virus (HBV) or hepatitis delta virus (HDV) replication. A high occurrence of anti-CaM in the presence of liver membrane antibody (p less than 0.03) was observed. During follow-up of patients with chronic delta-hepatitis, the presence of anti-CaM was consistently observed, when the isotype was IgM, but transiently when it was IgG. The occurrence of anti CaM correlated neither with ALT levels nor with histological diagnosis. Antibodies to CaM, are present in liver diseases especially in chronic delta hepatitis, and do not play a pathogenic role on hepatocellular damage. PMID- 1769428 TI - Gastric electrical dysrhythmia following cholecystectomy in humans. AB - In order to observe the incidence of dysrhythmia in 20 patients who had undergone cholecystectomy, we recorded gastric electrical activity by means of serosal electrodes from the day of surgery to the 6th postoperative day. The difference between the incidence of dysrhythmia on the day of the operation and the other days is statistically significant (t test: p less than 0.001). Bradygastria was the most frequently observed dysrhythmia, both on the day of surgery and on the following days. It had a frequency of around 1.0-1.5 cpm and the episodes lasted for a minimum of 10 min to a maximum of 105 min (mean duration 32.6 min). Episodes of tachygastria were of varying duration, ranging from a minimum of 3 min to a maximum of 60 min (mean duration 18.5 min), whereas episodes of gastric tachyarrhythmia lasted between 2 min and 21 min (mean duration 5.4 min). Only 1 patient had an episode of nausea and biliary vomiting, associated with an episode of gastric tachyarrhythmia on the 1st postoperative day. None of the other patients had symptoms of impaired gastric function, such as nausea, vomiting, bloating and epigastric pain, at any time during the recording sessions. These findings suggest that in most cases, gastric electrical rhythm returns to normal within 24 h of cholecystectomy and further that gastric dysrhythmia is not related to symptoms of impaired gastric function. The etiological mechanism and clinical significance of gastric dysrhythmia, therefore, are still unclear. PMID- 1769429 TI - Intragastric pH in the gastroprotective and ulcer-healing activity of aluminum containing antacids. AB - Antacids containing aluminum have been shown to stimulate the protective processes in the gastric mucosa and to enhance the healing of chronic gastroduodenal ulcerations, but the mechanisms of these effects are still unexplained. This study was designed to compare the protective effects of unmodified and acidified (pH 2.0) Maalox 70 and Al(OH)3 on the formation of acute gastric mucosal lesions induced by absolute ethanol, taurocholate, acidified aspirin and stress, and to determine the role of gastric acid in healing of chronic gastroduodenal ulcerations by these antacids in rats. Acidified Maalox 70 and Al(OH)3 were significantly more potent than unmodified agents against all four tested types of acute mucosal lesions, and this action was probably due to their 'mild irritant' effect as evidenced by extensive exfoliation of the surface epithelial cells observed microscopically after the exposure of the mucosa to these agents. Mucosal generation of prostaglandins does not appear to be involved in the gastroprotection by acidified Maalox because the pretreatment with indomethacin did not affect this protection. In contrast to the protective effect, the ulcer-healing capacity of Maalox or Al(OH)3 does not appear to be dependent upon the presence of gastric acid because the reduction or elimination of endogenous acid by the pretreatment with ranitidine or omeprazole did not affect the healing of gastroduodenal ulcerations. We conclude that aluminum containing antacids induce the mucosal protection that is enhanced in the presence of luminal acid but exhibit an ulcer-healing property that appears to be unrelated to gastric acid secretion or mucosal generation of prostaglandins. PMID- 1769430 TI - Increased iron absorption in uroporphyrin-treated rats. AB - Rats were given 59Fe (28 micrograms) together with doses of 0, 2 and 200 micrograms of uroporphyrin III in paired observations. Absorption of 59Fe was determined by comparing whole body counts of the rats 30 min and 7 days after dosing. Prior treatment with 200 micrograms of uroporphyrin twice daily for 3 days was associated with significantly increased 59Fe absorption of 6.2% compared to the absorption of 4.6% without uroporphyrin (control) and 4.6% with a 2 micrograms dose (p less than 0.05). PMID- 1769431 TI - Effects of cisapride on the esophageal motor function of patients with progressive systemic sclerosis or mixed connective tissue disease. AB - In a double-blind crossover study lower esophageal sphincter pressure and distal esophageal motility were studied in 10 patients with progressive systemic sclerosis or mixed connective tissue disease, following a single intravenous dose of cisapride or placebo. The measurements were carried out under basal conditions and 30 min after intravenous administration of 10 mg cisapride or placebo. No effects on lower esophageal sphincter pressure or distal esophageal motility were observed. PMID- 1769432 TI - Dynamic study of the rectal detrusor activity at defecation. AB - The dynamics of the rectal detrusor at defecation was studied in 29 normal and 10 constipated subjects. The rectal pressure was measured by a ureteral catheter with terminal side holes, while the intra-abdominal pressure was measured by a Foley catheter introduced into the urinary bladder. Simultaneous recording of fecal flow was performed by fecoflowmetry. Assessment of the findings in normal subjects has shown a pre-evacuation rectal pressure elevation which reached its peak with the start of fecal flow and then fell gradually as the flow increased. This was in contrast to the constipated patients in whom the elevated pre evacuation rectal pressure continued through the whole act of evacuation. Quantitative analysis of the rectal pressure curve could also differentiate between normal and constipated subjects. The significant parameters are the opening pressure and time, the pressure time and the evacuation pressure. The simultaneous recording of the intra-abdominal pressure demonstrates its share in the increase of the rectal pressure. PMID- 1769433 TI - Oxygen free radicals and lipid peroxidation in the pathogenesis of gastric mucosal lesions induced by indomethacin in rats. Relation to gastric hypermotility. AB - The relationship of gastric hypermotility to mucosal hemodynamics, lipid peroxidation and vascular permeability changes was investigated in the pathogenesis of indomethacin-induced gastric lesions in rats. Subcutaneous administration of indomethacin (25 mg/kg) produced an increase in both the amplitude and frequency of stomach contraction from 30 min after treatment, resulting in hemorrhagic damage 2 h later. Gastric mucosal blood flow measured by a Laser flowmetry showed oscillatory fluctuations under hypercontractile states: a decrease during contraction followed by an increase during relaxation. Mucosal lipid peroxidation and vascular permeability were significantly increased with time after indomethacin treatment, and these changes preceded the appearance of hemorrhagic damage. All these events were prevented when gastric hypermotility was inhibited by atropine or 16,16-dimethyl prostaglandin E2. Pretreatment of the animals with allopurinol and hydroxyurea or continuous infusion of superoxide dismutase and dimethyl sulfoxide during a test period also attenuated these functional changes and mucosal lesions induced by indomethacin, without affecting the motility response. We conclude that oxygen free radicals may play a role in the development of mucosal lesions associated with gastric hypermotility in indomethacin-treated rats. PMID- 1769435 TI - Intraglomerular fibronectin accumulation and degradation in obese Zucker rats. AB - The obese Zucker rat is a classic model of non-immune mediated spontaneous focal glomerulosclerosis. An important initiating hallmark of glomerulosclerosis in this model is mesangial matrix expansion. Fibronectin, a highly biologically active glycoprotein, is a normal constituent of mesangial extracellular matrix. Using a quantitative method based on enzyme immunoassay we assessed the intraglomerular fibronectin content and its degradation in obese Zucker rats and their lean littermates. In the obese Zucker rats the glomerular fibronectin content was significantly higher in comparison to the controls (88 +/- 6 vs 48 +/ 4 ng/10(3) glomeruli). Furthermore, proteinase activity against fibronectin was significantly reduced in the glomeruli of obese Zucker rats when compared to control animals (at pH 5.4: 186 +/- 6 U/mg protein vs 286 +/- 14 U/mg protein, at pH 7.4: 152 +/- 12 U/mg protein vs 193 +/- 12 U/mg protein). These data demonstrate that in obese Zucker rats there is a glomerular accumulation of fibronectin which we propose is at least partly due to diminished proteolytic digestion. Whether accumulation of intraglomerular fibronectin contributes to progressive glomerulosclerosis remains a matter of debate. PMID- 1769434 TI - Structural domains and molecular lifestyles of insulin and its precursors in the pancreatic beta cell. AB - Insulin is both produced and degraded within the pancreatic Beta cell. Production involves the synthesis of the initial insulin precursor preproinsulin, which is converted to proinsulin shortly after (or during) translocation into the lumen of the rough endoplasmic reticulum. Proinsulin is then transported to the trans cisternae of the Golgi complex where it is directed towards nascent secretory granules. Conversion of proinsulin to insulin and C-peptide arises within secretory granules, and is dependent upon their acidification. Granule contents are discharged by exocytosis in response to an appropriate stimulus. This represents the regulated secretory pathway to which more than 99% of proinsulin is directed in Beta cells of a healthy individual. An alternative route also exists in the Beta cell, the constitutive secretory pathway. It involves the rapid transfer of products from the Golgi complex to the plasma membrane for immediate release, with, it is supposed, little occasion for prohormone conversion. Even if delivered appropriately to secretory granules, not all insulin is released; some is degraded by fusion of granules with lysosomes (crinophagy). Each event in the molecular lifestyles of insulin and its precursors in the Beta cell will be seen to be governed by their own discrete functional domains. The identification and characterisation of these protein domains will help elucidate the steps responsible for delivery of proinsulin to secretory granules and conversion to insulin. Understanding the molecular mechanism of these steps may, in turn, help to explain defective insulin production in certain disease states including diabetes mellitus. PMID- 1769436 TI - The circulating molecular weight forms of infused recombinant insulin-like growth factor-I and effects on glucose and fat metabolism in lambs. AB - We have investigated the relationship between the plasma distribution of infused recombinant insulin-like growth factor-I across the insulin-like growth factor binding proteins and the resultant effects on glucose and fat metabolism. The studies were performed in 24-h fasted ram lambs which received primed constant infusions of 3H labelled glucose tracer. When isotopic equilibrium had been reached, the animals received 90-min infusions of human insulin-like growth factor-I at various doses (2.5, 20, 40 and 120 micrograms.kg-1.h-1, n = 3 for each dose). Total plasma insulin-like growth factor-I was significantly elevated by infusion at a rate of 40 micrograms.kg-1.h-1 (from 185 +/- 14 micrograms/l to 442 +/- 41 micrograms/l, p less than 0.05) and 120 micrograms.kg-1.h-1 (from 181 +/- 2 micrograms/l to 953 +/- 39 micrograms/l, p less than 0.005). The plasma concentrations of insulin-like growth factor-I not associated with binding proteins remained undetectable (less than 15 micrograms/l) at the end of the 2.5 and 20 micrograms.kg-1.h-1 doses, but were significantly elevated at the end of the 40 and 120 micrograms.kg-1.h-1 infusions (to 71 +/- 14 micrograms/l, p less than 0.05 and 176 +/- 55 micrograms/l, p less than 0.01 respectively). The infused insulin-like growth factor-I associated primarily with 35-60 kilodalton binding proteins. Glucose kinetics were significantly altered only by the highest dose infusion, during which there was a fall in plasma glucose concentration from 3.5 +/- 0.2 mmol/l to 1.9 +/- 0.2 mmol/l (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769437 TI - Islet cell antibodies and other markers of autoimmunity and diabetes mellitus in Nauruans. AB - Among the population of Nauru there is a high prevalence of diabetes with onset in early adult life. To ascertain whether autoimmunity to islet cell antigens contributes to this diabetes, a population survey of serum autoantibodies was performed. Subjects were grouped into euglycaemic control subjects, those with impaired glucose tolerance, and those with diabetes subdivided according to duration of disease. No subject was positive by immunofluorescence for islet cell autoantibodies. Various other autoantibodies to nuclear, thyroid and gastric autoantigens were detectable, at comparable frequencies in the three groups. This population study on Nauruan subjects selected to include those in the early phases of disease negates a contribution from islet cell autoimmunity, and thus supports the concept that the disease is the Type 2 (non-insulin-dependent) type. PMID- 1769439 TI - Changes in cholinergic sweat gland activation in diabetic neuropathy identified by computerised sweatspot analysis. AB - Peripheral small-fibre denervation has been reported to result in decreased activation of eccrine sweat glands to muscarinic cholinergic agents. Using computerised image-analysis of pilocarpine-activated sweatspot prints of a 4 cm2 area of the dorsum of the foot in 79 randomly selected diabetic patients we have identified a group of neuropathic patients (18%) with decreased sweatspot activation (less than 20/cm2), and a smaller group (6%) of younger patients with less marked neuropathy who had increased activation (greater than 132/cm2), probably resulting from denervation supersensitivity. The associations between sweatspot density and other conventional tests of peripheral nerve function were weak. The prevalence of abnormal sweatspot density, 24%, was similar to that of other tests, except thermal thresholds at the feet (35-37%), which were not correlated with sweatspot activation, suggesting that diabetic neuropathy has differing effects on afferent and efferent small fibres. The method is rapid and reproducible (median coefficient of variation 14%) and its ability to identify patients with increased, as well as decreased, peripheral nerve function may be of value in the characterisation and longitudinal follow-up of small-fibre abnormalities in diabetes. PMID- 1769438 TI - Abnormal glucagon response to arginine and its normalization in obese hyperinsulinaemic patients with glucose intolerance: importance of insulin action on pancreatic alpha cells. AB - An excessive glucagon secretion to intravenous arginine infusion was found in obese hyperinsulinaemic patients with glucose intolerance. This study was designed to determine whether the glucagon hyperresponsiveness to arginine in these patients would improve by insulin infused at a high enough dose to overcome insulin resistance. By infusing high dose insulin during arginine infusion, the previously exaggerated glucagon response to arginine could be normalized. To normalize the abnormal glucagon response, insulin doses of 4.2 +/- 0.7 and 3.8 +/ 0.5 IU were required during arginine infusion in obese hyperinsulinaemic patients with impaired glucose tolerance and Type 2 (non-insulin-dependent) diabetes mellitus, respectively. This achieved plasma peak insulin levels 3 to 4 times higher than those observed in non-obese healthy subjects. Furthermore, we clarified whether or not the effect of normalizing insulin action and/or glycaemic excursions contributed to normalizing the exaggerated glucagon response to arginine in these patients. Blood glucose was clamped while high dose insulin was infused at the same levels as observed during the arginine infusion test with no insulin infusion. As a result, normalization of the exaggerated plasma glucagon response was achieved, whether hyperglycaemia existed or not. These results clearly demonstrate that, similar to non-obese hypoinsulinaemic Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) diabetic patients, the exaggerated Alpha-cell response to arginine infusion in obese hyperinsulinaemic patients with glucose intolerance is secondary to the reduction of insulin action on the pancreatic Alpha cell, and that the expression of insulin action plays an important part in normalizing these abnormalities. PMID- 1769440 TI - The increase in albuminuria induced by exercise is not associated with preferential excretion of glycated albumin in type 1 (insulin-dependent) diabetic patients. AB - The increase in urinary albumin excretion induced by acute exercise in Type 1 (insulin-dependent) diabetic patients is associated with the urinary excretion of cationic proteins. To test whether the renal excretion of glycated albumin (more anionic than non-glycated albumin) is affected by exercise, we submitted seven normoalbuminuric (albumin excretion rate less than 30 mg/24 h) Type 1 diabetic patients and six well-matched healthy subjects to an exercise test (600 kpm/min for 20 min) on a bicycle ergometer, preceded and followed by a 1-h resting period. The selectivity index (renal clearance of non-glycated/glycated albumin) was not significantly different among the pre-exercise, exercise and post exercise periods, either in the normal subjects (1.01 +/- 0.03 vs 1.08 +/- 0.06 vs 1.08 +/- 0.05) or in the diabetic patients (1.25 +/- 0.09 vs 1.20 +/- 0.07 vs 1.20 +/- 0.06), whereas it was significantly higher (p less than 0.05) in diabetic patients compared to healthy subjects during pre-exercise. These results are not consistent with the hypothesis that acute exercise may induce a preferential excretion of glycated albumin. PMID- 1769441 TI - The natural history of somatosensory and autonomic nerve dysfunction in relation to glycaemic control during the first 5 years after diagnosis of type 1 (insulin dependent) diabetes mellitus. AB - The natural evolution of neural dysfunction was studied prospectively over 5 years following diagnosis of Type 1 (insulin-dependent) diabetes in 32 patients aged 12-36 years. Motor and sensory nerve conduction velocities, heart rate variation at rest and during deep breathing, and pupillary function were measured at diagnosis and after 3, 12, 24, 48, and 60 months. Thermal and vibration sensation thresholds were determined after 24, 48, and 60 months of diabetes. Mean HbA1 levels of months 3-60 within the normal range of less than 8.3% (7.3 +/ 0.2%) were observed in 13 patients (Group 1), while a mean HbA1 of months 3-60 greater than or equal to 8.3% (10.0 +/- 0.3%) was found in 19 patients (Group 2). Mean nerve conduction was significantly diminished in Group 2 as compared with Group 1 in at least 4 out of 6 nerves tested during months 12-60 (p less than 0.05). Both tests of heart rate variation were significantly impaired in Group 2 as compared with Group 1 after 24 and 60 months (p less than 0.05), but no differences in pupillary function were observed between the groups. Thermal discrimination but not vibration perception thresholds on the foot were significantly higher in Group 2 than in Group 1 at 40 and 60 months (p less than 0.05). Abnormalities in nerve conduction, thermal discrimination, and heart rate variation, but not vibration perception threshold and the pupillary function tests were significantly more frequent in Group 2 than in Group 1 at 60 months (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769442 TI - Proinsulin autoantibodies are more closely associated with type 1 (insulin dependent) diabetes mellitus than insulin autoantibodies. AB - The disease association of autoantibodies to proinsulin and insulin was compared in patients with Type 1 (insulin-dependent) diabetes mellitus and first-degree relatives. Following the recommendation of the Fourth International Workshop on the Standardization of insulin autoantibodies, autoantibodies were determined by fluid-phase radioimmunoassay using equimolar concentrations of mono-125I-A14 insulin or -proinsulin to detect insulin or proinsulin autoantibodies, respectively. A higher prevalence of proinsulin autoantibodies vs insulin autoantibodies was found in 97 patients with Type 1 diabetes prior to insulin treatment (34.0% vs 22.7%, p less than 0.05) and in 16 islet cell antibody positive relatives (43.8% vs 31.3%, NS). There was only one serum positive for insulin and proinsulin autoantibodies in 110 islet cell antibody-negative first degree relatives (0.9%). None of 88 normal sera contained proinsulin autoantibodies or insulin autoantibodies. There was a close correlation of proinsulin autoantibody and insulin autoantibody titres in individual sera (r = 0.95, p less than 0.01) due to crossreaction of all insulin autoantibodies with proinsulin. However, some proinsulin autoantibodies did not crossreact with insulin. Background binding in normal sera was lower for proinsulin autoantibodies. We conclude that proinsulin autoantibodies have a higher association to acute Type 1 diabetes than insulin autoantibodies. PMID- 1769443 TI - High ascorbic acid content in the rat endocrine pancreas. AB - The peptidyl alpha-amidation of biologically active peptides (a number of which are found in the endocrine pancreas) requires several co-factors, including ascorbic acid. In the present study, tissue contents and developmental changes of ascorbic acid in the rat endocrine pancreas were measured using a highly sensitive HPLC system. High concentrations were found in neonatal rats, with the highest value, 42.5 nmol/mg protein, in 2-day-old rats. The concentration decreased gradually with age to 19.4 nmol/mg in 5-week-old rats. The exocrine pancreas had a lower concentration, but a peak was also observed in 2-day-old rats. In freshly isolated islet cells, an intracellular concentration of 7.5 mmol/l was estimated in 5-7-day-old rats. Secretory granules isolated from 4-6 day-old rat islets contained 10.6 nmol/mg protein. Culturing islets or cells in ascorbic acid free medium resulted in a marked decrease in their contents. Ascorbic acid in secretory granules from such islets decreased at a relatively lower rate. Addition of ascorbic acid to cultured cells or islets reduced the loss markedly. Increasing the glucose concentration in islet culture medium in the presence of 100 mumols/l ascorbic acid increased the islet ascorbic acid concentration. PMID- 1769444 TI - Effect of captopril on renal functional reserve in type 1 (insulin-dependent) diabetes mellitus. PMID- 1769445 TI - Diabetic retinopathy: preventing blindness in the 1990's. PMID- 1769446 TI - [Peptide growth factors in the myocardium]. PMID- 1769448 TI - [Biplanar transesophageal echocardiography: clinical usefulness of longitudinal sections]. PMID- 1769447 TI - [Doppler estimation of the stenotic mitral valve area. Direct application of the continuity equation to the flow convergence region]. AB - The continuity equation, applied to the flow convergence region (FCR), fournishes a simple alternative to calculate stenotic valve area. The flow rate in the FCR can be calculated by multiplying the hemispheric isovelocity surface area by the velocity of the isovelocity surface. Since according to the continuity principle the flow rate through any isovelocity surface equals the flow rate through the stenotic orifice, the stenotic orifice area can be calculated as: 2 pi r2Vr/Vm, where 2 pi r2 is the hemispheric isovelocity area, Vr is the velocity at the radial distance r from the orifice and Vm is the peak jet velocity. This study was designed to analyze the validity of application of the continuity equation to the FCR for estimating mitral orifice area by Dopler ultrasound. We studied 35 consecutive patients with rheumatic mitral stenosis. Three patients were excluded; the final study population consisted of 32 patients (8 men and 24 women; mean age 56 years). Nine patients were in normal sinus rhythm and 23 in atrial fibrillation. Doppler examination was performed from the apical approach within 24 hours of cardiac catheterization. On color Doppler image Vr was defined as the first aliasing limit (lowered to 38 cm/s to increase FCR r); r represented the maximal early diastolic distance between the first alias and the stenotic orifice in a direction parallel to that of the transducer; Vm was the early diastolic peak jet velocity by continuous wave Doppler.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769449 TI - [The "preconditioning" phenomenon. Experimental and clinical aspects]. PMID- 1769450 TI - [Ventricular pre-excitation disclosed by an episode of high-frequency atrial fibrillation: the role of frequency-dependent variations in the bundle of Kent conduction]. AB - The presence of a ventricular pre-excitation, which becomes evident only during episodes of atrial fibrillation, is a very rare event. The authors report a case of ventricular pre-excitation revealed by an access of atrial fibrillation with high ventricular frequency and hemodynamic failure. The ventricular pre excitation signs were not evident after the sinus rythm had been restored. The electrophysiological study has shown that such behaviour is not related to a different input of the stimulus in the bypass tract during the passage from the sinus rhythm to the atrial fibrillation, as other authors have recently suggested, but to rate-dependent variations of the conduction in the Kent bundle: in the bypass either a phase-4 block of the conduction is present, or a supernormal conduction. PMID- 1769451 TI - [Aortic valve insufficiency in aortic dissection: an unusual case]. AB - An unusual case of aortic valvular regurgitation due to a type A aortic dissection is described: using transesophageal echocardiography a large intimal flap is shown prolapsing into the left ventricle outflow tract during diastole causing aortic regurgitation. PMID- 1769453 TI - [Nuclear cardiology 1991]. PMID- 1769452 TI - [Familial dissecting aortic aneurysm]. AB - A family is described in which two brothers (44 and 48 years old) had aortic dissecting aneurysms (the first one died, the other one underwent surgical treatment and is still living) in the absence of clinical features of Marfan syndrome and of systemic hypertension. Two of the six living siblings have aortic dilation on echocardiography. Histologic examination of the aortic wall at autopsy or surgery revealed a loss of elastic fibers, deposition of mucopolysaccaride-like material and medionecrosis. We can postulate a genetically determined disease of connective tissue usually described as "Marfan's forme fruste". PMID- 1769454 TI - [Radioisotope techniques in ischemic cardiopathy: planar methods]. PMID- 1769455 TI - [Radioisotope techniques in ischemic cardiopathy: tomographic methods]. PMID- 1769456 TI - [Provocative tests in transient myocardial ischemia: ergometry]. PMID- 1769457 TI - [Provocative tests in transient myocardial ischemia: the other stimulation tests]. PMID- 1769458 TI - [Diagnosis of transient myocardial ischemia: nuclear methods]. PMID- 1769459 TI - [Diagnosis of transient myocardial ischemia: non-nuclear methods]. PMID- 1769460 TI - [Diagnosis of transient myocardial ischemia and functional evaluation of the post infarction patient: thallium-201]. PMID- 1769461 TI - [Physiopathology and clinical classification of left ventricular dysfunction]. PMID- 1769462 TI - [The role of balanced angiocardioscintigraphy in the evaluation of patients with left ventricular dysfunction]. PMID- 1769463 TI - [The viable myocardium as seen with thallium-201]. PMID- 1769464 TI - [New radiopharmaceuticals and imaging of the heart receptors]. PMID- 1769465 TI - [Organizational aspects of a department of nuclear cardiology]. PMID- 1769466 TI - [What are the indications for defecography in 1991?]. PMID- 1769467 TI - [Contribution of 131I MIBG scintigraphy in the diagnosis of carcinoid tumors of the digestive tract. Experience of 14 cases]. AB - 131I MIBG scintigraphy is of great value in the diagnosis and the treatment of several tumors derived from the neural crest. But, its role in the assessment of carcinoid tumors remains to be evaluated. It was the aim of this prospective study. Between 1987 and 1989, 14 consecutive patients with carcinoid tumors were studied. Planar scintigrams were obtained 24 and 48 hours after the intravenous injection of 74 MBq of 131I MIBG. At least one scintigraphy was performed in every patient; at that time one or several abdominal tumor sites (a total of 22 sites) were found and histologically proven. Scintigram was judged as positive in 9 of 14 patients (64 p. 100); 68 percent of the 22 tumor sites and 86 percent of the 14 extra-hepatic tumor sites took up 131I MIBG. Liver metastases were overlooked on scintigrams in 5 of 8 patients. Scintigraphy was the only positive examination in 3 patients. No false positive scintigrams were noticed. These results emphasize the value of 131I MIBG scintigraphy in the assessment of carcinoid value tumors. PMID- 1769468 TI - [Prospective study of a predictive scoring system for the diagnosis of appendicitis in patients with right lower quadrant pain. Long-term outcome]. AB - The results of prospectively determined scoring system for the diagnosis of appendicitis (sex, age, duration of symptoms, contracture, hyperleucocytosis) are reported. Between 1984 and 1989, 492 patients with suspected appendicitis were examined. Among the 208 operated patients, 169 had acute appendicitis (81.25 percent). Diagnosis of the abdominal pain was established in one of 3 patients without appendicitis (105/323; non operated patients or operated patients with normal appendix). Eighty-five percent of the non operated patients and 92 percent of the patients operated on with normal appendix have been followed (mean follow up 26 months). Ten percent of the non operated patients (24/237) have been operated on during follow up; 13.9 percent of the operated patients with normal appendix (5/36) and 22.8 percent of the non operated patients (54/237) still complained of persistent right lower quadrant pain (no significative difference). In conclusion, a clinical scoring system is of help in suspected acute appendicitis. This attitude requires the cooperation of the general practitioner and must be well explained to families of patients. PMID- 1769469 TI - [Effects of biliary lithogenesis in acromegalic patients with long-term octreotide (SMS 201-995) treatment]. AB - This study was performed to evaluate the risk of gallstone formation during long term treatment with the long-acting somatostatin analog octreotide (SMS 201-995). Twelve patients (8 men, 4 women--mean age 43 years) treated with continuous subcutaneous octreotide infusion for acromegaly (mean duration 26.5 months, mean dose 541 micrograms/day) were included. Bile collection by duodenal intubation was performed before, during, and 45 days after octreotide treatment in 3, 12, and 8 patients, respectively. Abdominal ultrasonography and/or oral cholecystrography were also performed before (n = 9 patients), during (n = 12), and after treatment (n = 10). Bile examination was normal in the 3 patients controlled before treatment but showed that 58.3 percent of the treated patients had cholesterol monohydrate crystals. After discontinuation of octreotide only 25 percent of patients had cholesterol crystals. In 3 patients (25 percent) treated longer than 6 months, cholesterol crystals occurred prior to the occurrence of small radiolucent gallstones: one patient underwent cholecystectomy because of biliary colic, while in the two others, complete dissolution of stones was obtained after 10 months of treatment with ursodeoxycholic acid given in association with octreotide. None of the 9 other acromegalic patients (including 7 treated more than 20 months) developed stones. Cholesterol gallstone formation seems to be increased in acromegalic patients during long-term octreotide treatment but the exact incidence remains to be determined in larger series of patients. PMID- 1769470 TI - [Practical role of ultrasonography and clinical examination for the diagnosis of acute appendicitis. Prospective study]. AB - The aim of this 100-patient prospective study was to compare three types of investigations in the diagnosis of acute appendicitis: initial clinical examination, initial appendicular ultrasound examination, and final results of repeated clinical examinations carried out within the first 48 hours. Final results included initial evaluation, obvious clinical results and definitive results from patients under 48 hour observation for uncertain diagnosis. Clinical initial or appendicular ultrasound examinations were poorly contributive to diagnosis (overall accuracy: 76 percent). On the contrary, repeated clinical examinations yielded a 100 percent sensitivity, a 94 percent specificity, a 94 percent positive predictive value, a 97 percent negative predictive value and a 97 p. 100 overall accuracy. No morbidity was noted in observing patients for 48 hours. Unwarranted appendectomies were carried out in 3 percent of cases. Ultrasonography of the appendix seems useful for the differential diagnosis of acute appendicitis. PMID- 1769471 TI - [Paf-acether and digestive tract]. PMID- 1769472 TI - [The "watermelon stomach". A misunderstood syndrome]. PMID- 1769473 TI - [Prevention of recurrent hemorrhage in patients with cirrhosis. Results of a controlled trial of propranolol versus endoscopic sclerotherapy]. AB - Between July 1984 and March 1986, we conducted a prospective randomized trial comparing propranolol and endoscopic sclerotherapy in the prevention of recurrent variceal hemorrhage in a group of non selected alcoholic cirrhotics. Seventy-six patients with variceal hemorrhage were randomized to receive propranolol (P) (34 patients), or sclerotherapy (S) (42 patients) approximately 12 days after initial bleeding. The 2 groups were similar as concern age, sex, etiology of cirrhosis, severity of liver failure, the number of previous hemorrhages, and the severity of initial hemorrhage. No side effects were observed in the P group; 20 patients (48 percent) in the group S had at least one side effect although minor. After an average follow-up of 36 months, 18 patients in group P (53 percent) and 23 in group S (55 percent) had hemorrhagic recurrence. Rebleeding occurred from other sources than esophageal varices in 5 patients, in the group S only. Five patients in group P and 8 patients in group S died of rebleeding. During the follow-up period, 8 patients in group P (23 percent) and 13 patients in group S (31 percent) died. No significant difference could be demonstrated between the 2 groups as regards the percentages of patients without variceal rebleeding or survival, calculated according to the Kaplan Meier method. In conclusion, in this trial, no significant difference could be demonstrated between propranolol and endoscopic sclerosis in the prevention of recurrent variceal hemorrhage in alcoholic cirrhotic patients. PMID- 1769474 TI - [Prognosis and prognostic factors of hemorrhage by rupture of varices in cirrhotic patients in the era of endoscopic sclerotherapy]. AB - The aim of this study was to evaluate the prognosis and the determinants of survival in cirrhotics presenting with variceal bleeding. One hundred and ninety one consecutive patients with cirrhosis (alcoholic 93 percent) were enrolled between 1983 and 1988. Treatment was principally but not exclusively based on early endoscopic sclerotherapy. At admission all patients were classified according to Child-Pugh's classification (class A = 16 percent; class B = 53 percent; class C = 31 percent). The rebleeding rates at 48 hours and for the entire hospitalisation were 11 and 30 percent respectively. Actuarial survival rates were 45, 40, and 37 percent at 12, 18, and 36 months, respectively. Prognostic factors, as determined by uni- and multivariate analysis (Cox model), corresponded to Child-Pugh's score, to the five components, and the occurrence of early bleeding recurrence. This study also showed that: i) the role of Child Pugh's classification on long-term prognosis is determined during the 3 months following index bleeding; ii) early rebleeding is a significant prognostic factor, particularly in Child-Pugh's class B patients; iii) there are few indicators of early rebleeding (serum albumin level, presence of gastric varices at initial endoscopy). Prognosis of variceal bleeding is still severe in cirrhosis but efforts made to prevent early bleeding recurrence seem to be fully justified. PMID- 1769475 TI - [Definitions and assessment criteria of acute drug-induced hepatitis. Conclusions of an International Consensus Meeting]. PMID- 1769476 TI - [Duodenal sarcoidosis with selective IGA deficiency and lymphoid nodular hyperplasia]. AB - Coexistence of IgA deficiency with sarcoidosis has been reported occasionally. Enteropathy occurs exceptionally in this association. We report the case of a 45 year-old woman experiencing disseminated sarcoidosis which involved mediastinum, chest, lymph nodes, liver, bone marrow, and skin. Immunoglobulin deficiency involving essentially IgA was found 15 years later. Digestive investigations showed gastroduodenal specific localizations associated with lymphoid nodular hyperplasia without villi atrophy. PMID- 1769477 TI - [Gazeous necrosis of the liver due to hepatic artery thrombosis after liver transplantation]. AB - An emergency liver transplantation was performed in a 22 year-old female for fulminant hepatitis. The donor had had splenectomy with portal vein thrombosis which was diagnosed and removed during portoscopy. Nineteen days later, abdominal pain with shock and hepatic failure occurred. X-rays showed pneumoperitoneum and aeric images in the liver area. Laparotomy disclosed massive liver necrosis with gaz under the Glisson's capsula. The hepatic artery was thrombosed. In spite of emergency retransplantation, the patient died 8 days later, due to systemic aspergillosis. Thrombosis of hepatic artery was particular by the importance of gaz-forming infection, and emphasizes the role of rejection. The discovery of portal thrombosis allows to outline the precautions necessary in case of splenectomized donors. The severeness of aspergillosis is underscored. PMID- 1769478 TI - [Nodular regenerative hyperplasia and primary biliary cirrhosis]. AB - We report two cases of nodular regenerative hyperplasia of the liver associated with primary biliary cirrhosis. Cholestasis and presence of antimitochondrial antibodies were noted in both patients. In one patient, the diagnosis of nodular regenerative hyperplasia was supported by the demonstration of disseminated small hepatic nodules without perinodular fibrosis. Twelve years later, the histopathological picture was one of primary biliary cirrhosis. The other patient presented an histological picture of regenerative hyperplasia of the liver and primary biliary cirrhosis. The association of regenerative hyperplasia of the liver and primary biliary cirrhosis is discussed. PMID- 1769479 TI - [Gastric metastasis revealing an epidermoid carcinoma of the mouth]. PMID- 1769480 TI - [Pancreatitis, hypocalcemia and myositis associated with primary HIV infection]. PMID- 1769481 TI - [Listeria monocytogenes ascites infection in a patient with peritoneal carcinosis]. PMID- 1769482 TI - [Acute rhabdomyolysis due to fenoverine]. PMID- 1769483 TI - [Esophageal ulcer related to ingestion of Inod'Ail (allyl sulfide)]. PMID- 1769484 TI - [Helicobacter pylori and duodenal ulcer. Long-term results of triple sucralfate antibiotic therapy]. PMID- 1769485 TI - [Gastric tuberculosis and immunodepression]. PMID- 1769486 TI - [Liver steatosis revealing Cushing's syndrome]. PMID- 1769487 TI - [Postoperative peritoneal cyst ... or hazards of a biochemical study of ascitic fluid]. PMID- 1769488 TI - [Colorectal cancer in patients under 40 years of age: what is new in 1991?]. PMID- 1769489 TI - [Ultrasonographic characteristics of the liver in chronic and acute leukemia]. AB - Parenchyma of the liver and blood flow in the portal system were studied in patients with acute and chronic leukemias. Ultrasonic investigations of the liver with the use of Doppler's method were conducted in 82 leukemia patients. It has been found that in most cases of leukemia not only the size but also ultrasonic characteristics of parenchyma of the liver are changed. The echo-structure of the liver depends, first of all, on the duration of the disease and chemotherapy conducted, and, to a lesser degree, on the clinico-morphological forms of leukemias. At the same time a rise is observed in the portal blood flow rate that may be compensatory in response to anemia. Pronounced dilatation of the splenic vein and of the main stem of the hepatic vein, as well as an increased minute blood volume in hepatic vein of chronic leukemia patients, are, probably, caused by increased venous outflow from the enlarged spleen. PMID- 1769490 TI - [Therapeutic plasmapheresis in chronic diffuse diseases of the liver]. AB - The results of the clinico-laboratory investigations conducted in time course have evidenced a high therapeutic effectiveness of plasmapheresis in the complex treatment of patients with chronic active hepatitis and biliary cirrhosis of the liver. Plasmapheresis use has been validated and indicated in patients with a manifest biliary component, a high degree of the process activity and ineffectiveness or low effectiveness of the previous treatment. PMID- 1769491 TI - [Heat-shock gene expression in murine erythroid cells]. AB - The effect of the heat-shock stress factor on protein synthesis in Rauscher virus transformed murine erythroblasts with blocked hemoglobin synthesis was studied. The most pronounced heat-shock protein (HSP) synthesis was observed at 43 and 45 degrees C. Under conditions of heat shock the cells examined demonstrated enhanced (or new) synthesis of HSP with relative mol. mass of approximately 70-80 kD, approximately 50 kD and approximately 15-25 kD. No stable induction of 90 kD heat-shock protein was observed. The characteristic feature of transformed erythroblasts was a sufficiently stable appearance of low-molecular HSP with mol. mass from 14 kD to 25 kD, among which there were proteins with relative mol. mass corresponding to that of globin chains. PMID- 1769492 TI - [Effect of exogenous neoplasm DNA on the course of Swetz leukemia in non-inbred rats of different age groups]. AB - Experiments on 150 non-inbred white rats have shown that preliminary administration of high polymer native DNA isolated from Swetz leukemia tumor suppresses the tumor growth. Tumor DNA combined with BCG vaccine in young animals suppresses and in old ones stimulates the tumor growth. These results correlate with DNA and CIC content in the blood serum. Due to the tumor growth suppression the animals' life increases by 40%. Administration of BCG vaccine only does not prevent the development of tumor in usual terms. PMID- 1769493 TI - [Comparative characteristics of the effectiveness of oxygen delivery to the tissues by human erythrocytes preserved with glugicir and citroglucophosphate]. AB - The main parameters of hemodynamics and oxygen regimen were investigated in isolated rat heart (130 tests) during its perfusion with red blood cells preserved in glugicir (GGC) and citroglucophosphate (CGP). Short-term storage red blood cells did not show disorders in O2 transport to tissues. Long-term storage red blood cells (both in GGC and CGP) showed disorders in hemodynamics that were associated with appearance of free hemoglobin in the perfusion medium due to disruption of some red blood cells by the perfusion apparatus. PMID- 1769494 TI - [Morphological characteristics of peripheral blood erythrocytes in the normal state and in pathology (fluorescence microscopy)]. PMID- 1769496 TI - [Cryopreservation of thrombocytes using dimethyl sulfoxide]. PMID- 1769495 TI - [Criteria of differential diagnosis of chronic myeloproliferative diseases]. AB - The authors have searched for immunological and biochemical criteria for differential diagnosis of chronic myeloid leukemia and idiopathic myelofibrosis. Some features of functional activity of cells as well as the content of circulating immune complexes and polyamines characteristic for each of these disease have been revealed. PMID- 1769497 TI - [Isolation of factor IX concentrate from cryosupernatant of donor's plasma]. AB - Soviet anion-exchangers were comparatively studied to specify an optimal carrier useful for isolation of factor ix of the blood coagulation system from donor's blood cryosupernatant. The main criteria of gel selection were the yield and purification degree of factor IX, as well as its specific activity and concentration in eluates. It has been shown that DEAE-agarose 6B-CL, possessing pronounced activity with respect to specific sorption of factor IX, meets these requirements to the greatest degree. PMID- 1769498 TI - [Value of complex hematologic examination for early diagnosis of iron deficiency and iron deficiency anemia]. PMID- 1769499 TI - [Interactions of peripheral blood lymphocytes and neutrophils in the stimulation of lymphokine production in chronic leukemia]. AB - Inclusion of T-activin into the combined therapy of patients with chronic myelo- and lympholeukemia promotes intensified lymphokine production by peripheral blood lymphocytes. Lymphokine stimulates neutrophil phagocytic activity, therefore ++T activin is recommended for prevention and treatment of infectious complications. PMID- 1769500 TI - [Ultrasonographic examination of the liver and abdominal lymph nodes in patients with chronic lymphocytic leukemia]. AB - Echography of the liver, gallbladder and abdominal lymph nodes was conducted in 85 patients with chronic lymphoid leukemia (CLL). An increased size of the liver, splenic vein, thickening of the gallbladder wall were recorded at the initial stage of the disease. Echogenicity of the liver was lowered. A growth in the size of the right and left lobes of the liver with simultaneous proportional distention of the splenic vein lumen were observed in CLL patients at the stage of extended clinical symptoms of the disease; the diameter of vena cava inferior was increased and lost its capacity to change during respiration; the margins of the liver became rounded, the common bile duct was expanded, the gallbladder wall was thickened. The detection of enlarged abdominal lymph nodes is important in the diagnosis of CLL. The data obtained are of great significance in the diagnosis of the disease for verification of CLL stages. The ultrasonic method of investigation of the liver and gallbladder in CLL patients is of high information content, it is noninvasive, safe, and therefore should be widely used in the clinical practice. PMID- 1769501 TI - [Morphologic and functional properties of blood cells and blood rheologic parameters after plasmapheresis in patients with unstable angina pectoris]. AB - The state of surface membrane of red blood cells and blood platelets, blood platelet adhesion to glass, red blood cell deformability, viscosity of the whole blood and plasma were studied in patients with coronary heart disease who had been subjected to blood gravitation surgery correction in the combined treatment. Normalization of all the parameters studied was recorded after inclusion of the methods of extracorporeal regulation of blood aggregation into the combined treatment. An attempt has been made to explain the mechanisms of gravitation surgery effect on the morphological and functional properties of blood cells and rheologic parameters. PMID- 1769502 TI - [Response of the pro- and antioxidant systems to plasmapheresis in patients with advanced atherosclerosis obliterans of the legs]. AB - The effects of fractional apparatus plasmapheresis in a volume of 25% of circulating blood plasma on the processes of lipid peroxidation and on the antioxidant defence system parameters were studied in 31 patients with ischemia of the lower limbs, stage III-IV. It has been shown that plasmapheresis induces elevation of ceruloplasmin activity and superoxide dismutase activity of blood plasma, lowers the ratio of lipid oxidation to lipid peroxidation products simultaneously with intensification of lipid peroxidation that leads to regeneration of biological membranes of the body. PMID- 1769503 TI - [Changes in the hemostatic system after administration of the mycotoxin deoxynivalenol (vomitoxin) to rhesus monkeys]. AB - The toxic effect of deoxynivalenol was studied in experiments on 8 test and 3 control Macaca rhesus monkeys. It has been found that differences in the hemostasis parameters depend on the frequency of deoxynivalenol administration. Normalization of the blood coagulation process is recorded after 1.5-2 months. Early diagnosis of intoxication with mycotoxins, deoxynivalenol in particular, is of great prognostic significance and may help prevent the development of irreversible changes in the body. PMID- 1769504 TI - [Study of whole blood leukocyte functional activity with the use of chemiluminescence during plasmapheresis]. AB - Repeated plasmapheresis sessions attended by chemiluminescent evaluation of cellular immunity parameters lead to the recovery of the whole blood leucocyte activity in patients with unhealing gastroduodenal ulcers. The kinetic analysis of the cellular chemiluminescent response has shown that, among all the components of the plasmapheresis procedure, hemorrhage is the most important factor increasing the functional activity of phagocytes. PMID- 1769505 TI - [Experience in the use of apheresis-psoralen-ultraviolet therapy in lympholeukemia and immune diseases]. PMID- 1769506 TI - [Rheologic and coagulational disorders and their correction with heparin in patients with autoimmune thrombocytopenic purpura treated with antilymphocytic globulin]. AB - Rheologic and hemocoagulation parameters were studied in 26 patients with autoimmune thrombocytopenic purpura (AITP). It has been shown that disorders in red blood cell rheologic properties detected in these patients aggravate the hemostasis disturbances and promote the development of disseminated intravascular blood coagulation (DIVBC). After infusion of antilymphocytic globulin (ALG) to 20 AITP patients improvement of general condition, as well as positive changes in the rheologic and hemocoagulation parameters were recorded in 15 of them. However, progressing DIVBC syndrome was observed in 5 patients, rheologic shifts being in the basis of its mechanism. To prevent or correct arising disorders, besides ALG infusions, heparin administration was used in a dose of 2000 IU/day. Rheologic and coagulation parameters significantly improved, hemorrhagic symptoms disappeared. Heparin administered in time to AITP patients who received ALG will permit conduction of a full course of treatment with this preparation. PMID- 1769507 TI - [Hematologic engineering in modern transfusiology]. AB - Three groups of hematological engineering methods have been considered: (1) blood gravitation surgery, (2) sorption methods, (3) blood irradiation methods. They were comparatively characterized with respect to their effectiveness. Combined employment of various methods of hematological engineering permits one to avoid shortcomings and intensify the effectiveness of each group of methods. It is shown that new internal environment of the body is developed in the process of hematological engineering operations. It is stressed that hematological engineering combines methods of blood reconstruction. PMID- 1769508 TI - [Hematologic parameters in the peripheral blood of cosmonauts]. AB - The main hematological parameters of the peripheral blood were analyzed in a large group of normal males--cosmonauts. The observation period comprised from 10 to 28 years. A total of 22 parameters were used to obtain the criterion for the interpretation of the results of peripheral blood investigation. PMID- 1769509 TI - [Long-term study of hemoblastosis incidence in a representative cohort of workers occupationally exposed to hemotoxic factors]. PMID- 1769510 TI - [Biochemical and clinical role of iron]. PMID- 1769511 TI - [Quantity of platelets in various regimens of hemosorption]. PMID- 1769512 TI - [How to improve results of chemotherapy of acute myeloid leukemia in adults: research of the cooperative group for studying acute myeloid leukemia in West Germany]. PMID- 1769513 TI - [Effects of gravitation plasmapheresis]. AB - More than 400 gravitation plasmapheresis operations conducted in patients with coronary heart disease (CHD) have been analyzed. Plasmapheresis was combined with thrombocytapheresis, erythrocyte oxygenation, plasma sorption and plasma filtration. Removed plasma was substituted for rheologically active solutions and albumin. Gravitation plasmapheresis was used in critical cases when alternative therapeutic methods had failed to provide a favourable outcome. Inclusion of gravitation plasmapheresis into the combined treatment of CHD patients was conductive to decreasing lethality in complicated forms of acute myocardial infarction attended by circulatory insufficiency, stage III-IV, from 82 to 33%. Hypoxia and acytosis are eliminated as a result of normalization of blood circulation and the system of blood aggregation regulation, the functions of the lungs and other internal organs were improved, that was manifested in the clinical course of CHD: pain symptoms disappear, stress tolerance increases, sensitivity to drug therapy rises, lethality decreases. PMID- 1769514 TI - [Effect of blood gravitation surgery on lipid metabolism in patients with ischemic heart disease]. AB - Gravitation plasmapheresis (GP) used in coronary heart disease patients with unstable angina pectoris of the III-IV functional class, in the presence of dyslipoproteinemia, leads to a significant decrease of high levels of cholesterol (Ch), triglycerides (TG), cholesterol in low-density lipoproteins (Ch-LDLP) and an increase of cholesterol in high-density lipoproteins (Ch-HDLP) followed by gradual recovery of these parameters up to the initial level in the whole group of patients during 6 months of observation. In patients with dyslipoproteinemia (DLP), types IV and II A, the initial level was recovered earlier (during one month), in those with type II B--after 6 months, although the levels of Ch and TG were high, that does not exclude the presence of progressing coronarosclerosis. The duration of clinical remission comprised on the average 7.4 months, in patients with type II A it was 5 months, with type IV--6.5 months. It has been suggested that pathogenetic features of DLP types formation are responsible for varying effects of GP on different types of DLP. PMID- 1769515 TI - Effect of spectrin on structure properties of lipid bilayers formed from mixtures of phospholipids. Fluorescence and microcalorimetric studies. AB - Effect of spectrin from human erythrocytes on structure properties of lipid bilayers formed from a mixture of phosphatidylethanolamine/phosphatidylserine (PE/PS) and/or phosphatidylethanolamine/phosphatidylcholine (PE/PC) was studied with the use of fluorescence and microcalorimetric methods. Spectrin did not affect the order parameter of lipids in PE/PS vesicles. However, spectrin binding to liposomes did influence temperature, half-width and enthalpy of phase transitions in mixtures of dimyristoylphosphatidylethanolamine (DMPE) and dimyristoylphosphatidylcholine (DMPC), and this effect was dependent on DMPE to DMPC weight ratio. A change in miscibility of the components in the presence of spectrin was observed and it might be due to spectrin-PE interactions. PMID- 1769516 TI - Propeller-twisted adenine.thymine and guanine.cytosine base pairs tend to buckle and stagger in opposite directions. AB - Base pairs are propeller-twisted, buckled and staggered in DNA fragment crystals. These deformations were analyzed with isolated Watson-Crick base pairs using empirical potentials and buckle was found to almost linearly correlate with propeller. Interestingly, the thymine.adenine pair favours negative buckling for propellers mostly observed in DNA crystals while positive buckling is preferred by the cytosine.guanine pair. The propeller also induces opposite staggers in the adenine.thymine and guanine.cytosine base pairs. PMID- 1769517 TI - Effects of N-tricyanovinylamines on oxidative phosphorylation and level of SH groups in rat liver mitochondria. AB - The effects of N-substituted tricyanovinylamines on oxidative phosphorylation as well as on glutathione and total SH group concentrations in rat liver mitochondria was studied. The N-TCVA derivatives studied (N-cyclohexyl; N isobutyl; N-benzyl; N-phenyl; N-4-Br-phenyl; N-3-nitrophenyl) had an uncoupling effection on the oxidative phosphorylation. They stimulated the respiration of mitochondria and influenced their membrane potential. In their property as SH agents, the N-TCVA derivatives reduced the level of TSH groups of the mitochondria present in concentrations of 2 mumol/mg protein. The activity of succinate dehydrogenase was decreased by N-TCVA by 13%. N-TCVA derivatives changed the redox state of glutathione in mitochondria. This effect was observed at the concentration 0.3 mumol/mg protein. The results obtained in the present study support the view that the glutathione status is more sensitive than the total level of SH groups to incubation of mitochondria with SH agents such as N TCVA derivatives. PMID- 1769518 TI - Thermodynamical characteristics and volume compressibility of dipalmitoylphosphatidylcholine liposomes containing bacteriorhodopsin. AB - The effects of bacteriorhodopsin (BR) interaction with large dipalmitoylphosphatidylcholine (DPPC) liposomes (approx. 100 nm in diameter) were examined at various BR/DPPC ratios, using differential scanning calorimetry (DSC) and ultrasonic velocimetry (USV). On DSC, the lipid phase transition temperature, Tc, and the half-width of the phase transition peak, delta T1/2, showed significant non-monotonic changes with the increasing BR concentration. Two exponential segments could be distinguished in the dependence of the transition enthalpy change per mol of lipid (delta H/nL) on the BR/DPPC ratio: one corresponding to ratios between 0:1 and 1:64, and another corresponding to ratios between 1:44 and 1:16. A maximal value of delta H/nL was observed for BR/DPPC ratio 1:44, probably corresponding to maximal BR-lipid ordering with each BR molecule being surrounded by two layers of lipid molecules. The nonmonotonic changes of thermodynamical parameters suggest long-distance interactions between regions of altered bilayer structure which form around each BR molecule. The results obtained with USV provided support for the above conclusions. The dependence of ultrasound velocity increment A on BR concentration supplies information on relative changes of membrane volume compressibility. Decreasing volume compressibility is reflected in increasing values of parameter A. Within T less than Tc, the values of A increased with the increasing BR concentration; saturation was observed at BR/DPPC ratio 1:500 (A = A(BR/DPPC]. No significant BR concentration dependent changes of A were observed at T greater than Tc. From these values the average diameter of the distorted region of lipid bilayer was estimated to be approximately 20 nm. PMID- 1769519 TI - Monitoring of potassium-stimulated catecholamine changes in striatal synaptosomal preparations and in corpus striatum of rats: a comparative voltammetric study. AB - Voltammetric techniques were used to compare the effects of K(+)-induced depolarization on catecholamine levels in in vitro synaptosomal preparations of the corpus striatum with those in the in vivo corpus striatum of anaesthetized animals. In vitro, the catechol-oxidation currents could be recorded only in dopamine-preloaded synaptosomes. In isolated synaptosomes prepared in the presence of elevated concentrations of Ca2+ (1 mmol.l-1) and Na+ (135 mmol.l-1), K(+)-induced depolarization had variable effects on catechol-oxidation current. The stimulatory effect of K(+)-induced depolarization (a short transient increase of catechol-oxidation current lasting for 30 s) could be observed after the addition of dopamine loaded synaptosomes in EGTA into the medium with elevated K+ concentration (90 mmol.l-1) and decreased concentrations of Na+ (75 mmol.l-1) and Ca2+ (0.75 mmol.l-1). These results suggest that experimental procedures and parameters of ionic composition of incubation media have to be carefully controlled, owing to an enhanced in vitro permeability of membranes of isolated synaptosomes for Ca2+ and Na+. In in vivo experiments, microinjection of KCl (3 microliters of 0.5 mol.l-1 KCl in 10 mmol.l-1 HEPES, pH 7.4) resulted in the appearance of several phases of catechol-oxidation current: the current increased (to severalfold of the control values) followed by a decrease or even total disappearance, with a gradual return to control values. Under conditions of depletion of extracellular calcium by EGTA (5 microliters of 0.5 mol.l-1 KCl + 0.25 mol.l-1 EGTA in 10 mmol.l-1 HEPES, pH 7.4) K(+)-induced depolarization confirmed the key role of calcium in the release of catecholamine transmitters as well as that in processes regulating the uptake and metabolism of these transmitters. The voltammetric techniques used in the present study may be a useful tool in extending of our knowledge about the cellular mechanisms of stimulus-response coupling in nerve cells. PMID- 1769520 TI - Isolation of nuclei from Aspergillus nidulans protoplasts. AB - Intact nuclei were isolated from the protoplasts of the filamentous fungus Aspergillus nidulans. The large amounts of protoplasts required for such nuclear preparations were produced from young mycelia grown in liquid culture. For final purification of the crude nuclear fraction, a Nycodenz density-gradient centrifugation was applied. The resulting nuclei were of good purity and morphological state, as demonstrated by fluorescence microscopy and electronmicroscopy. The weight ratio of DNA:RNA:protein was 1:3.0:10.8 in the nuclear fraction. PMID- 1769521 TI - Isolation and purification of cell wall polysaccharide of Bacillus anthracis (delta Sterne). AB - A polysaccharide fraction was isolated form sodium-dodecyl-sulfate (SDS) treated cell walls of Bacillus anthracis (delta Sterne) by hydrofluoric acid (HF) hydrolysis and ethanolic precipitation. The polysaccharide fraction was subsequently purified by several washings with absolute ethanol. Purity of the isolated polysaccharide was tested using the anthrone assay and amino acid analyzer. The molecular mass of the polysaccharide fraction as determined by gel filtration chromatography was about 12000 Da. Preliminary analyses of the polysaccharide was done using thin layer chromatography and amino acid analyzer, and results obtained from these analyses were further confirmed by gas liquid chromatography and 13C-NMR spectroscopy. Results showed that the polysaccharide moiety contained galactose, N-acetylglucosamine, and N-acetylmannosamine in an approximate molar ratio of 3:2:1. This moiety was devoid of muramic acid, alanine, diaminopimelic acid, glutamic acid, and lipid, thus indicating that the isolated polysaccharide was of pure quality. PMID- 1769522 TI - The derepression of enzymes of de novo pyrimidine biosynthesis pathway in Brevibacterium ammoniagenes producing uridine-5-monophosphate and uracil. AB - A mutant of Brevibacterium ammoniagenes producing large quantities of UMP and uracil is described. The mutations render bacteria braditrophic for arginine, sensitive to adenine, resistant to rifampicin and pyrimidine analogues 5 fluorouracil, 5-fluorouridine, azauracil and thiouracil. The activities of enzymes involved in the UMP biosynthesis, i.e. orotate phosphoribosyltransferase, orotate-5-monophosphate decarboxylase, dihydroorotate oxidase, are 4-, 3.5- and 4.5-fold higher in the mutant than in the parent strain when grown in minimal medium. The synthesis of these enzymes in mutant cells is not repressed in the presence of exogenous Ura. True revertants, which completely restore the wild type phenotype, occur among the Arg+ clones. The nature of the mutation is discussed. PMID- 1769523 TI - DNA of some anaerobic rumen fungi: G + C content determination. AB - The nuclear DNAs from five species of anaerobic rumen fungi have been isolated and purified by means of two extraction methods (with and without 8 M urea). Their G + C contents have been characterized by the thermal denaturation procedure of Marmur and Doty. As has already been shown in Neocallimastix frontalis, the results obtained by the two techniques demonstrated a very low G + C content (less than 20%) and the constant presence of satellite DNA. PMID- 1769524 TI - A recombinant Escherichia coli heat-stable enterotoxin (STa) fusion protein eliciting anti-STa neutralizing antibodies. AB - A recombinant fusion protein consisting of native Escherichia coli heat-stable enterotoxin (STa) and a dimer of a synthetic IgG-binding fragment (ZZ), derived from Staphylococcus aureus protein A was produced in E. coli. The fusion protein (ZZSTa) was secreted in large quantities into the growth medium and recovered by affinity chromatography on IgG-Sepharose. Rabbits immunized with the fusion protein responded by producing high serum levels of anti-STa antibodies that also effectively neutralized STa toxicity in infant mice. The fusion peptide ZZSTa had a substantially decreased toxicity as compared with native STa. A polymeric form of ZZSTa separated by size fractionation was about 100 times less toxic than the monomeric fusion protein, yet both forms had the same capacity to induce neutralizing antibodies. This suggests that modified non-toxic forms of ZZSTa with retained immunogenicity may be produced and tested for their usefulness as functional components in a vaccine against diarrhoea caused by enterotoxigenic E. coli. PMID- 1769525 TI - The nucleotide sequence of Schwanniomyces occidentalis alpha-amylase gene. AB - The nucleotide sequence of the coding and regulatory regions of the alpha-amylase encoding gene (AMY) of Schwanniomyces occidentalis has been determined. This sequence contained an open reading frame of 512 codons, from which a protein with Mr of 53,723 could be predicted. A putative signal sequence encoding for 25 amino acids was proposed for the 5' end of the open reading frame. Regulatory sequences, such as TATA box, CCAAT box and a signal sequence for polyadenylation and transcription termination could be found in the flanking regions of AMY gene. The deduced amino acid sequence also contained four common conserved regions characteristic of other alpha-amylase proteins. PMID- 1769526 TI - A chloramphenicol-streptomycin-resistance plasmid from a clinical strain of Staphylococcus sciuri and its structural relationships to other staphylococcal resistance plasmids. AB - A 5.1-kb plasmid, designated pSCS12, isolated from a naturally occurring Staphylococcus sciuri conferred resistance to chloramphenicol (CmR) and streptomycin (SmR). Restriction endonuclease analyses of pSCS12 revealed partial structural homologies to the CmR-plasmids pC221 from S. aureus and pSCS1 from S. intermedius, to the SmR-plasmids pSAI-1 from S. hyicus and pS194 from S. aureus, as well as to the CmR/SmR plasmid pSK68 from S. aureus. Southern-blot hybridization with specific CmR- and SmR-gene probes confirmed these similarities and allowed the mapping of the CmR- and SmR-determinants in the S. sciuri plasmid pSCS12. These observations lead to the suggestion that CmR/SmR-plasmids, such as pSCS12, may have evolved from CmR- and SmR-plasmids by interplasmidic recombination. PMID- 1769527 TI - The influence of carbon and nitrogen nutrition on fusarin C biosynthesis by Fusarium moniliforme. AB - The influence of various carbon and nitrogen sources on fusarin C synthesis was examined in submerged cultures of Fusarium moniliforme NRRL 13616. Using a zinc deficient, synthetic medium, highest levels of fusarin C were produced by cultures grown with urea or ammonium sulfate as the nitrogen source and fructose, sucrose, or glucose as the carbon source. In media supplemented with various concentrations of glucose and ammonium sulfate, glucose concentrations which provided excess carbohydrate significantly increased fusarin C synthesis, regardless of the ammonium sulfate concentration. PMID- 1769528 TI - Isolation of ribosomal RNA operons of Streptomyces lividans and sequence analysis of a 5S-rRNA gene. AB - Three clones containing rRNA genes have been isolated from a gene library of Streptomyces lividans. Two clones carried entire but different rRNA-operons. The third clone comprised the 3'-end of a 23S-rRNA gene, the entire 5S-rRNA gene and the spacer region between them. The nucleotide sequence starting within the 23S rRNA gene beyond the putative transcription terminator downstream the 5S-rRNA gene has been determined (EMBL acc. no X58874). PMID- 1769529 TI - Amino acid uptake as a function of differentiation in Candida albicans: studies of a non-germinative variant. AB - The transport of four amino acids (L-methionine, L-phenylalanine, L-lysine and L alanine) was studied during pH-regulated dimorphism in Candida albicans and its stable, non-germinative variant. The permeases responsible for uptake responded differently to differentiation and the transport activities varied during the course of morphogenesis. An increase in uptake around the time of evagination was observed in all four amino acids in both the strains studied. The uptake rates of L-methionine and L-phenylalanine were greater in fully differentiated hyphae, while the rate of L-lysine was higher in fully differentiated buds. Uptake rates of L-alanine, however, did not show any morphotypic related variation. The possible implication of these transport activities in relation to differentiation is discussed. PMID- 1769530 TI - Analysis of the molecular mass heterogeneity of the transferrin receptor in Neisseria meningitidis and commensal Neisseria. AB - Peroxidase-conjugated transferrin was used to detect transferrin receptors both in intact outer membrane vesicles (OMVs) from Neisseria species in a dot blot assay, and in SDS-PAGE-separated OMV proteins after transferring to nitrocellulose membranes. All N. meningitidis strains produced transferrin receptors after culturing in either iron sufficiency or iron restriction although expression was higher in the latter case, whereas only six N. lactamica and two N. sicca (among 20 commensal species) were able to bind transferrin. Molecular mass (MM) of the receptors were mainly between 78 kDa and 85 kDa (87.5% of strains), 12.5% had receptors with MM close to 70 kDa, and 5% showed receptors with MM over 85 kDa. Our results confirm the molecular mass heterogeneity of the transferrin receptors in N. meningitidis, completely disagree with the 'universal' 98 kDa receptor proposed by some authors, and show a low expression of the receptor in commensal Neisseria. PMID- 1769531 TI - Dimethyl sulfoxide reductase is not required for trimethylamine N-oxide reduction in Escherichia coli. AB - Deletion mutants of Escherichia coli lacking dimethyl sulfoxide (DMSO) reductase activity and consequently unable to utilize DMSO as an electron acceptor for anaerobic growth have been isolated. These mutants retained the ability to use trimethylamine N-oxide (TMAO) as an electron acceptor and the TMAO reductase activity was found to be unaltered. Heating the cell-free extract of the wild type strain at 70 degrees C for 15 min selectively inactivated the DMSO reductase activity while the TMAO reductase activity remained unchanged for at least 1 h. PMID- 1769532 TI - Near on-line detection of enteric bacteria using lux recombinant bacteriophage. AB - The potential for a revolution in microbial testing can be perceived with the near on-line detection of indicator microorganisms. By definition, these are microorganisms present in significant numbers within a food which, while not pathogenic, can be related through increasing count to the increased probability of pathogen contamination. We have used recombinant lux+ bacteriophage to detect enteric indicator bacteria without recovery or enrichment in 50 min, provided that they are present at levels greater than 10(4) g-1 or cm-2. After a 4-h enrichment, samples having enteric counts of 10 g-1 or cm-2 can be distinguished from background. PMID- 1769533 TI - Cytotoxicity of a cloned Bacillus thuringiensis subsp. israelensis CryIVB toxin to an Aedes aegypti cell line. AB - A cloned CryIVB toxin was purified from a cured strain of Bacillus thuringiensis (BT) containing the cryIVB gene on the recombinant plasmid Cam135. Solubilized protoxin was treated with Aedes gut extract or trypsin for varying times and tested for toxicity in vitro on three dipteran and one lepidopteran cell line. Treatment with the Aedes extract but not trypsin, produced an active toxin which lysed only Aedes aegypti cells out of those tested. This activation was time dependent reaching a maximum after 6 h. Both the Aedes extract-treated and trypsin-treated toxin killed A. aegypti larvae, but this toxicity declined rapidly with increasing time of exposure to the proteolytic preparations. PMID- 1769534 TI - Development of a new host vector system in mycobacteria. AB - The hybrid plasmid pYT72/pYT92 constructed from an Escherichia coli plasmid pACYC177 and mycobacterial plasmid pMSC262 isolated from Mycobacterium scroflaceum strain W262 transformed both E. coli and BCG. Phage-sensitive mutants S-10 and S-20 isolated from BCG Tokyo strain showed higher frequency of transformation than the wild-type strain. Frequency of transformation was dependent on age of the culture and the electroporation condition used. Several deletion mutants were generated from pYT72/92 to determine the minimum region for the replication in the mycobacteria. A 2.3-kb fragment of pMSC262 was found to contain an essential region. Using this fragment and pACYC177, a small shuttle vector pYT937 containing two drug-resistance markers, kanamycin- and ampicillin resistance, was constructed. pYT937 contains AatII, BamHI, BbvII, GsuI, HincII, PstI, ScaI and XbaI cloning sites. PMID- 1769535 TI - Exocellular and intracellular accumulation of lead in Pseudomonas fluorescens ATCC 13525 is mediated by the phosphate content of the growth medium. AB - Pseudomonas fluorescens appears to elicit disparate lead detoxification mechanisms in phosphate-rich and phosphate-deficient media. When grown in the presence of 0.1 mM Pb2+ complexed to citrate, the sole source of carbon, only a slight diminution in cellular yield was observed in the former medium. However, in a phosphate-deficient milieu, lead imposed approximately a 30% reduction in bacterial multiplication. At stationary phase of growth, 72% of the metal was found in the bacterial cells from the phosphate-deficient medium, while that from phosphate-rich broth contained only 12.5%. The latter medium was characterized by an insoluble pellet that accounted for 73.5% of the lead. Although no citrate was detected in the phosphate-rich media after 40 h of incubation, only 72% of citrate was consumed even after 70 h of growth in the phosphate-deficient cultures. The inclusion of lead did not appear to enhance the production of either extracellular proteins or carbohydrates. PMID- 1769536 TI - Isolation and characterization of bacteriophage FC3-10 from Klebsiella spp. AB - FC3-10 is a Klebsiella spp. specific bacteriophage isolated on a rough mutant (strain KT707, chemotype Rd) of K. pneumoniae C3. The bacteriophage receptor for this phage was shown to be the low-molecular mass lipopolysaccharide (LPS) fraction (LPS-core oligosaccharides), specifically the heptose content of the LPS inner-core. This is the first phage isolated on Klebsiella, the receptor for which is the LPS-core. This phage was unable to plate on Salmonella typhimurium LPS mutants with chemotypes Rd2 or Re showing incomplete or no heptose content on their LPS-core, respectively. Spontaneous phage-resistant mutants from different Klebsiella strains were deep-rough LPS mutants or encapsulated revertants from unencapsulated mutant strains. PMID- 1769537 TI - Molecular cloning of a gene region from Bradyrhizobium japonicum essential for lipopolysaccharide synthesis. AB - The gene region cloned from a lipopolysaccharide (LPS) mutant carrying the Tn5 and flanking DNA sequences was used as a probe to screen a gene bank prepared from wild-type Bradyrhizobium japonicum strain 61A101C and to isolate the corresponding wild-type LPS-gene region. By cross-hybridization experiments the LPS-gene region did not appear to be closely linked to previously cloned nodulation genes. A detailed restriction map of the LPS-gene region (5.5-kb EcoRI genomic fragment) was established and the mutation site was localized to be in a 300-bp PvuI/PstI restriction fragment. In genomic Southern-blot analysis of various rhizobia, the LPS-gene region was found to be conserved among all the slow-growing bradyrhizobia, but not the fast-growing rhizobia. The different groups of slow-growing bradyrhizobia are polymorphic for restriction-fragment length at the LPS-gene region. PMID- 1769538 TI - Multiple xylanases of Cellulomonas fimi are encoded by distinct genes. AB - Cellulomonas fimi genomic DNA encoding xylanase activity has been cloned and expressed in Escherichia coli. As judged by DNA hybridization and restriction analysis, twelve xylanase-positive clones carried a minimum of four different xylanase (xyn) genes. The encoded enzymes were devoid of cellulase activity but three of the four bound to Avicel. PMID- 1769539 TI - pSAR1, a natural plasmid from Streptomyces arenae, shows rapid increase and decrease of copy numbers on changes of growth media. AB - A natural plasmid, pSAR1, was isolated from the antibiotic producer Streptomyces arenae TU469. Its size is estimated to approx. 80 kbp by restriction analysis. pSAR1 occurs in two copy-number states differing by a factor of at least 10, depending on culture conditions. The high copy-number state is strongly correlated with the production of the antibiotic pentalenolactone. The decrease of copy numbers after change of culture conditions is completed within 1 h. These unusually rapid kinetics and the occurrence of degradational intermediates suggest the participation of specific catalytic mechanisms in copy number regulation. PMID- 1769540 TI - Construction of two stable bifunctional plasmids for Streptomyces spp. and Escherichia coli. AB - Two bifunctional plasmid vectors pZG5 (7.45 kb) and pZG6 (6.95 kb), for gene transfer between Streptomyces spp. and Escherichia coli have been constructed by fusion of the multicopy broad-host-range Streptomyces plasmid pIJ350 with E. coli plasmids Bluescribe M13- (pZG5) or pUC18 (pZG6). Both plasmids possess several unique restriction sites suitable for DNA cloning. Stable transformants of Streptomyces rimosus R6 and S. lividans 66 were obtained, harboring intact plasmids regardless of colony age or multiple subculturing. Moreover, pZG5 and pZG6 were successfully used to introduce several homologous transfer RNA genes into S. rimosus. PMID- 1769541 TI - Shigella dysenteriae 60R strain adheres to and invades tissue culture cells in the absence of virulence plasmid. AB - Evidence is presented that a high level Shiga toxin-producing strain Shigella dysenteriae 60R adheres to and invades the epithelial cell lines Hct8 and Henle 407. The invasive phenotype of S. dysenteriae 60R differs in four ways from the heretofore studied invasive Shigella phenotypes. First, S. dysenteriae 60R lacks the virulence plasmid characteristic of other invasive Shigella spp. and enteroinvasive Escherichia coli. Second, hybridization studies show that the known ipa genes are neither present in the chromosome nor in the small plasmid of 60R. Third, 60R adheres to and invades Hct8 and Henle 407 cells at 37 degrees C as well as at 30 degrees C. Fourth, the phenotype of adherence and invasion of 60R is remarkably stable, even during prolonged growth in laboratory media and storage. PMID- 1769543 TI - Lithotrophic growth and hydrogen metabolism by Clostridium magnum. AB - Clostridium magnum, originally described as a non-autotrophic homoacetogenic bacterium, was found to be able to grow with H2/CO2, formate, or methanol with stoichiometric acetate formation, provided that the growth medium contained at least 0.025% (w/v) yeast extract. Hydrogen was also formed as a byproduct of glucose fermentation, and was consumed again after glucose consumption. Hydrogen formation from glucose was independent of growth conditions and reached similar maximal concentrations in mineral media with or without ammonia added as well as in non-growing cultures or in the presence of carbon monoxide. PMID- 1769542 TI - Detection of penicillin-binding proteins immunologically related to penicillin binding protein 5 of Enterococcus hirae ATCC 9790 in Enterococcus faecium and Enterococcus faecalis. AB - Penicillin-binding protein (PBP) 5 of Enterococcus hirae ATCC 9790 belongs to the class of the high-molecular mass, low-affinity PBPs which have been correlated with penicillin resistance in most Enterococcus species. Polyclonal antibodies were raised against PBP 5 and used to detect immunologically related membrane proteins in E. faecium and E. faecalis strains. Several strains of both species were found to have a membrane protein of similar molecular mass to E. hirae PBP 5 which reacted with the antibodies. Some E. faecium strains did not react with antibodies but their derivatives with increased penicillin minimal inhibitory concentrations did. In some E. faecalis strains the lack of a PBP 5-related protein was associated with failure to select stable penicillin-resistant derivatives. PMID- 1769544 TI - The novel gene trs1 encodes an essential protein for the transition from mitotic cell cycle to resting state in Schizosaccharomyces pombe. AB - A novel gene trs1 in the fission yeast Schizosaccharomyces pombe has been genetically defined. The trs1 mutant showed several intriguing phenotypes. Cells were sensitive to starvation and rapidly lost viability in the stationary phase; cells in the stationary phase were sensitive to heat shock. Some heat-shock proteins were not induced and the heat-shock response in log-phase cells was defective. These mutant phenotypes strongly suggest a vital function of the trs1 gene product for transition from the G1 to G0 phase on starvation and for the normal heat-shock response. PMID- 1769545 TI - Survival of the fish pathogen Aeromonas salmonicida in seawater. AB - Survival of Aeromonas salmonicida in natural (non-sterile) seawater, as determined from colony counts on marine agar, was found to be influenced by the presence of potentially inhibitory organisms, i.e., Acinetobacter, Aeromonas hydrophila, Chromobacterium, Escherichia coli, Flavobacterium and Pseudomonas, and their metabolites. Yet, samples, thought to be devoid of culturable A. salmonicida, were found to contain cells, which were filterable through 0.22 and 0.45 microns Millipore Millex porosity filters, and were recoverable on a specialised medium for L-forms, i.e. L-F medium. PMID- 1769546 TI - Genomic investigation of phenotypic variation in Campylobacter jejuni flagellin. AB - Western blots of whole-cell sonicates of 10 different clones of a faecal isolate of Campylobacter jejuni 533 detected the expression of flagella antigens of either 59 or 62 kDa. Other antigenic proteins appeared identical both in the parent and all the clones. The mechanism for this phenotypic variation was studied using Southern blotting with a flagellin-specific gene probe and products of a polymerase chain reaction (PCR) using flagellin-gene primers. Restriction enzyme digestion and Southern blotting did not detect any genomic rearrangements in the flagellin genes of the different phenotypes nor did restriction-enzyme analysis of the PCR products. PMID- 1769547 TI - Adherence of Vibrio parahaemolyticus to rabbit intestinal epithelial cells in vitro. AB - Kanagawa positive strains of Vibrio parahaemolyticus showed adherence whereas most of the Kanagawa negative strains were non-adhering to rabbit intestinal epithelial cells. Anti-hemolysin antisera did not inhibit the adherence of V. parahaemolyticus strains. Moreover, the adhesive capacity of non-adhering strains was not enhanced by purified hemolysin. Cell surface hydrophobicity remained the same in both Kanagawa positive and negative strains of V. parahaemolyticus. Fetuin strongly inhibited the adherence to rabbit intestinal epithelial cells followed by -mannose and D-glucose. PMID- 1769548 TI - Characterization of staphylococcal plasmids hybridizing with the fosfomycin resistance gene fosB. AB - The distribution of the fosB gene, coding for fosfomycin resistance, in 105 fosfomycin-resistant isolates of Staphylococcus from various geographical areas, was studied by Southern blot hybridization. Nucleotide sequences related to fosB were detected in 36 strains belonging to five species. Plasmids bearing fosB were often of a size similar to that of pIP1842 (2.54 kb) in S. epidermidis, most often small (2.4 to 4.1 kb) in other species including S. aureus where a 2.7-kb plasmid was found in 16 out of the 18 strains studied. The fosB gene was geographically dispersed since it was present in six different locations in France and also in Japan. The weak hybridization observed with plasmid DNA of certain strains of S. aureus, S. epidermidis, S. haemolyticus, S. saprophyticus, and S. warneri may indicate gene heterogeneity for fosfomycin resistance in Staphylococcus spp. PMID- 1769549 TI - Growth, sporulation and enterotoxin production by Clostridium perfringens type A in the presence of human bile salts. AB - The effect of human bile juice and bile salts (sodium cholate, sodium taurocholate, sodium glycochenodeoxycholate and sodium chenodeoxycholate) on growth, sporulation and enterotoxin production by enterotoxin-positive and enterotoxin-negative strains of Clostridium perfringens was determined. Each bile salt inhibited growth to a different degree. A mixture of bile salts completely inhibited the growth of enterotoxin-positive strains of this organism. Human bile juice completely inhibited the growth of all the strains at a dilution of 1:320. A distinct stimulatory effect of the bile salts on sporulation was observed in the case of C. perfringens strains NCTC 8239 and NCTC 8679. The salts also increased enterotoxin concentrations in the cell extracts of the enterotoxin positive strains tested. No effect on enterotoxin production was detected when an enterotoxin-negative strain was examined. PMID- 1769550 TI - Characteristics of extracellular protein production by a plasmidless derivative of Staphylococcus simulans biovar staphylolyticus. AB - A derivative of Staphylococcus simulans biovar staphylolyticus cured of all five plasmids present in the wild-type organism was developed, and the characteristics of extracellular protein production by this plasmidless strain were compared to those of the wild type. Although staphylolytic endopeptidase (lysostaphin) and beta-lactamase are known to be plasmid encoded, analysis of this cured strain revealed that most other extracellular proteins are chromosomally encoded. PMID- 1769552 TI - Isobutyrate as a precursor of n-butyrate in the biosynthesis of tylosine and fatty acids. AB - Labelled sodium isobutyrate [(CD3)2-CHCOONa] was added to the culture medium of Streptomyces fradiae and up to 14 atoms of deuterium were found to be incorporated into a molecule of tylosin aglycone (tylactone). This observation is in accordance with the data in the literature. When fatty acids were analyzed, as much as 34% of the isobutyrate incorporated into the cell was formed to be transformed into butyrate that was used for the synthesis of even, straight-chain fatty acids; 57% of the labelled isobutyrate was incorporated into the even isoacids, whereas 9% was degraded to propionate and further used for the synthesis of the odd acids. PMID- 1769551 TI - Virulence of non-beta-lactamase-mediated ampicillin-resistant Haemophilus influenzae. AB - We questioned whether strains of ampicillin-resistant, non-beta-lactamase producing (AmpR NBLP) Haemophilus influenzae with lower affinity penicillin binding proteins (PBPs) might have altered virulence. The virulence of resistant transformant strains and the susceptible recipient was compared using infant rats. Following intraperitoneal inoculation, there was a significantly lower mortality rate and incidence and magnitude of bacteremia with two of three transformants compared to the recipient strain. Reduced virulence was not associated with greater bactericidal activity of serum or human neutrophils or faster clearance of the transformant following intravenous injection. Heated rat or human plasma supported exponential growth of the recipient, but not the transformant, suggesting deficient in vivo multiplication. We conclude that H. influenzae with altered PBPs are less virulent in an infant rat model which may be related to differences in in vivo growth. PMID- 1769553 TI - Elimination of broad-host range plasmid vectors in Escherichia coli by curing agents. AB - A comparative study was made of the susceptibility of broad-host range vector plasmids belonging to Inc P1 and Q groups in Escherichia coli to various curing agents. Plumbagin and SDS eliminated RP4 (Inc P1 group) plasmid whereas pKT231 (Inc Q) and pRK2013 (having ColE1 replicon) were eliminated by hexamine ruthenium (III) chloride, alpha-santonin, coumermycin A1 and cis-dichloro diamine platinum (II). The curing activity of these agents was specific. PMID- 1769554 TI - Enzyme-linked immunosorbent assay for rapid detection of toxins from Clostridium perfringens. AB - An enzyme-linked immunosorbent assay (ELISA) with antibodies specific to beta, epsilon and iota ib toxins of Clostridium perfringens was developed to detect beta, epsilon and iota ib toxins, respectively. The ELISA was sensitive enough to detect as little as 1.0 ng/ml of purified beta and iota ib toxins and 0.1 ng/ml of purified epsilon toxin. By means of the ELISA method, 192 isolates of C. perfringens from food samples in Japan and Thailand, and 58 isolates from patients suffering from gas gangrene or gastroenteritis were examined. One isolate from food samples in Japan, three from food samples in Thailand and five from stools of patients with gastroenteritis were C. perfringens type D. One type B and one type C were detected from the stools of patients with gastroenteritis. PMID- 1769555 TI - Effect of ferric and ferrous iron chelators on growth of Bacteroides fragilis under anaerobic conditions. AB - Growth of Bacteroides fragilis under anaerobic conditions in the presence of either haemin or protoporphyrin IX was inhibited by the ferrous iron chelator bipyridyl. The ferric-iron chelator desferrioxamine inhibited growth in the presence of protoporphyrin but not haemin, suggesting that even under anaerobic conditions Fe3+ is involved in uptake of non-haem iron, which is required in the absence of haemin. However, the ferric iron chelators 1,2-dimethyl-3-hydroxy pyrid-4-one (L1) and pyridoxal isonicotinoyl hydrazone (PIH) were only weakly inhibitory. Apotransferrin, which also binds Fe3+, inhibited growth, but this was not simply due to binding of iron in the medium, as under the reducing conditions present, transferrin was unable to bind iron. This study suggests that even under anaerobic conditions, uptake of non-haem iron by B. fragilis may involve conversion of Fe2+ to Fe3+. PMID- 1769556 TI - Evaluation of the proposed interaction of nucleic acid with Clostridium difficile toxins A and B and the effects of nucleases on cytotoxicity. AB - Both DNA and RNA were found to co-purify with Clostridium difficile toxin B but not toxin A. DNAase treatment greatly reduced the cytotoxicity of toxin B but not of toxin A. RNAase had no effect on either toxin. The effects on toxin B were shown to be due to a contaminating protease and could be inhibited by the serine protease inhibitor phenylmethylsulphonyl fluoride. PMID- 1769557 TI - Identification of a new mutation in Escherichia coli that suppresses a pbpB (Ts) phenotype in the presence of penicillin-binding protein 1B. AB - Analysis of the functional role of penicillin-binding protein 1B (PBP1B) of Escherichia coli led us to find a new mutation able to suppress thermosensitive growth of the pbpB2158(Ts) mutant strain, which harbors a thermosensitive PBP3 protein only in the presence of a ponB+ background. The mutation, originally isolated in a strain with a high dosage of PBP1B, could also suppress the pbpB(Ts) phenotype when a single copy of the ponB gene was introduced. These results clearly give further support to the implication of PPB1B in the septation process in Escherichia coli. PMID- 1769558 TI - DNA sequence of the ribosomal protein genes rp12 and rps19 from a plant pathogenic mycoplasma-like organism. AB - A segment of a ribosomal protein operon from a plant-pathogenic mycoplasma-like organism (MLO) was cloned and sequenced, to provide supplemental molecular data pertinent to the question of MLO phylogeny. Comparisons of the deduced amino acid sequences indicate an ancient divergence of the MLOs from the animal-pathogenic mycoplasmas. Furthermore, although both the plant and animal pathogens have A-T rich genomes, a fundamental difference was apparent in their usage of the UGA codon. PMID- 1769559 TI - Activity of different 'killer' yeasts on strains of yeast species undesirable in the food industry. AB - Killer strains of the genera Saccharomyces, Hansenula and Kluyveromyces were tested for killing activity against yeasts that cause trouble in the food industry (in the genera Zygosaccharomyces, Kloeckera, Saccharomycodes and Schizosaccharomyces). Saccharomyces strains killed only Zygosaccharomyces rouxii strains, while non-Saccharomyces strains showed a wider anti-yeast spectrum. The Kluyveromyces phaffii killer strain was of particular interest because of its killer action against Kloeckera apiculata, Saccharomycodes ludwigii and Zygosaccharomyces rouxii. PMID- 1769560 TI - A constitutive, heat shock-activated neutral trehalase occurs in Schizosaccharomyces pombe in addition to the sporulation-specific acid trehalase. AB - Trehalase was studied in Schizosaccharomyces pombe cells growing vegetatively on minimal medium and in sporulating cultures. Acid trehalase activity, measured at pH 4.2, was absent in vegetative cells and occurred only in asci, indicating that this activity represented the sporulation-specific trehalase reported previously. In contrast, neutral trehalase, measured at pH 6.0, was constitutively present in vegetative cells during the exponential and stationary growth phase as well as in asci. In vegetative cells, neutral trehalase did not sediment with cell walls, suggesting a cytoplasmic localization. Its activity increased ten-fold when growing cells were subjected to heat treatment of 2 h. Neutral trehalase from heat-treated cells had a pH optimum of 6.0 and was almost completely inhibited by 3 mM ZnCl2. Acid trehalase activity could be measured in intact asci, indicating that it is localized in the ascus cell walls, while neutral trehalase was not detectable in intact asci and appeared to be present primarily in the walls of ascospores and in the ascus epiplasm. PMID- 1769562 TI - Genetic and environmental factors in the resistance of Drosophila subobscura adults to high temperature shock. III. Chromosomal-inversion and enzymatic polymorphism variation in lines selected for heat shock resistance. AB - Two replicate selection experiments to increase and decrease heat shock resistance of Drosophila subobscura adults were carried out maintaining control lines. In the present paper, the chromosomal-inversion and enzymatic polymorphism variation with selection is analyzed. The results indicate an erratic variation of chromosomal arrangement frequencies for practically all the chromosomes in the selected lines, showing a loss of the less frequent arrangements especially in sensitive lines. Only the A chromosome and the O + 4 arrangement show a behaviour that may not be due to random effects, which points to the possible existence of heat shock factor(s) in these chromosomes. Similarly, an erratic variation of allele frequencies is observed for all the enzymes studied (Aph, Pept-1) except for the Hk-1 enzyme. We cannot establish the possible participation of this locus in heat shock resistance from the results obtained up to now. A significant decrease in heterozygosity is detected in sensitive lines from chromosomal inversion polymorphism. PMID- 1769561 TI - Micro-spatial population differentiation in activity of glycerol-3-phosphate oxidase (GPO) from mitochondria of Drosophila melanogaster. AB - Replicate mass-bred laboratory populations of D. melanogaster were derived from females collected in the Tahbilk winery cellar and from females collected outside but from within two kilometers of the cellar. When mitochondrial extracts from larvae were assayed for specific activity of glycerol-3-phosphate oxidase the cellar populations had levels only 50% of those from the outside area, confirming an earlier report of such a difference among isofemale lines derived from these same areas. This micro-spatial differentiation occurred when larvae were raised on a medium supplemented with both sucrose (5% w/v) and ethanol (4% v/v), known to effect high GPO activity, but was not detected when the larvae were raised on unsupplemented medium. A heritable basis for larval GPO activity variation was confirmed in a set of 32 isogenic second chromosome substitution lines and measured in a subset of 4 of these lines about 25 generations later. A reciprocal cross using two isogenic substitution lines with the highest and lowest activities suggested the difference was attributable to genes acting additively and that there were no maternal or paternal effects. The detection of a collection site difference in GPO enzyme activity in the isogenic lines suggests that polymorphic variation on the second chromosome is responsible for the differentiation at the winery. Variation in adult GPO activity did not show a dependence on the winery location from where the isogenic lines were derived nor was there an effect of line. Adult GPO activity was significantly higher than that detected in larval tissues and did not show a dependence on the sugar/ethanol level in the growth medium. PMID- 1769563 TI - Time-dependent AluI action on human chromosomes. AB - We have analyzed the pattern of AluI digestion over time on human chromosomes in order to monitor the evolution of the in situ enzyme action. Short treatments followed by Giemsa staining produce a G-like banding effect, whereas longer treatments produce a C-like banding pattern. However, when Propidium iodide staining is used, it reveals a uniform bright fluorescence after short AluI digestions and C bands when longer treatments are developed. We propose that C banding is the result of a uniform DNA removal in non centromeric regions taking place after a critical time point, the initial G like banding being produced by changes in the DNA-proteins interactions. PMID- 1769565 TI - Physical mapping of the Esterase-6 locus of Drosophila melanogaster. AB - The Esterase-6 gene locus of Drosophila melanogaster although well-characterized, has not been definitely mapped by in situ hybridization. In this paper, a high resolution in situ hybridization protocol using an avidin/biotinylated horseradish peroxidase/diaminobenzidine system was adopted to refine the physical map position of the Esterase-6 locus. Clarity of signal, detail of banding pattern and absence of background allowed the assignment of a 1.8 kb cDNA encoding Esterase-6 to three bands within subsections 69 A1-A3 on the left arm of polytene chromosome 3. These data refine earlier deletion mapping and low resolution in situ hybridization results, which assigned Esterase-6 to 69A1-A5. The potential use of this high resolution in situ hybridization technique in the analysis of the physical organization of the Esterase-6 gene duplication and surrounding region is discussed. PMID- 1769566 TI - [Effect of air pollution on the morphofunctional parameters of the placenta]. AB - Atmospheric air pollution can cause the oppression of the placentae fine structures development and of the adaptive abilities. These changes and its expression co-related with the level of air pollution. PMID- 1769564 TI - Plasmid macro-evolution: selection of deletions during adaptation in a nutrient limited environment. AB - Under conditions where plasmid-carriage is deleterious to the cell, evolutionary changes may be expected which result in an attenuation of the deleterious effect of the plasmid. During long-term growth in glucose-limited continuous culture, initiated with a single clone of Escherichia coli containing a derivative of the plasmid pBR322, a structural change arose in the plasmid and predominated in the plasmid-containing sector of the population. This variant possessed a 2.25 kb deletion encompassing the tetracycline resistance operon as well as a region of about 1.5 kb upstream from this operon. Competition experiments involving strains carrying the plasmid with the spontaneous deletion, and strains carrying plasmids with artificially constructed deletions, revealed that deletion of this region of the plasmid, involving loss of tetracycline resistance, resulted in an increment in fitness of between 10 and 20%. From the magnitude of the growth advantage, we conclude that the attenuation of the deleterious effect of the plasmid was mainly due to a reduction in the plasmid mediated interference in the metabolism of the cell caused by a deletion of the tetracycline resistance gene. PMID- 1769567 TI - [Dynamics of the changes in the basic protective systems of an organism under the influence of unicellular protein]. AB - In the present work the results of study in functional and metabolic reactivity of protective systems are summarized. The early stages of the biological actions of protein-vitamin concentrates obtained from ethanol utilizing yeasts by means of unified test-system were studied. PMID- 1769568 TI - [Effect of freon-114B2 (1,2-dibromotetrafluoroethane) on the seasonal rhythm of energy activity in rat liver mitochondria]. AB - In the experiments with white rats it was found, that the inhalation of freon 114B2 at CL16, CL50, CL84 levels caused the changes in seasonal values of the energy activity in mitochondria. The action of the freon 114B2 caused disturbances in regulation of the mitochondria activity and desynchronization of seasonal rhythms of their energy activity. PMID- 1769569 TI - [Evaluation of nitrate and nitrite accumulation in drinking water supplies]. AB - Levels of the nitrate and nitrite content in water sources of Kiev and Cherkassy regions were studied. Highest concentrations of nitrite (1.33 mg N/l) and nitrate (168 mg N/l) were defined in local water sources. Peculiarity of nitrate and nitrite distribution is discussed. PMID- 1769570 TI - [Hygienic evaluation of sediments as a secondary source of water pollution in areas near cellulose and paper mills]. AB - Sanitary-chemical, bacteriological and toxicological characterization of sediments in the regions of the pulp and paper mills sewage letting out are given. Methods of the analytical control are offered. PMID- 1769571 TI - [Viability of Bacillus and Pseudomonas bacteria in nitrate-polluted marine and river water]. AB - Influence of nitrates on some bacterial species development was strictly depended on temperature and levels of water pollution. The bacterial activity in the river water increased with nitrate concentrations from 0.2 to 2 g/l. The concentrations of nitrates 20 g/l inhibited the bacterial development. PMID- 1769572 TI - [Central and cerebral hemodynamics in air traffic controllers on the night shift]. PMID- 1769573 TI - [Plasma phospholipids and parameters of immunity in people working in the Northern Tiumen' district]. PMID- 1769574 TI - [Morbidity with temporary disability of agricultural workers in the districts reclaimed by sewage]. PMID- 1769576 TI - [Hygienic aspects of planting greenery in fields of the lower Volga district]. PMID- 1769575 TI - [Air sanitation of poultry farms with the forest balm mark A]. AB - The new oxygenium derivate of terpenes, named as the forest balm A, was successfully used for the air sanitation at a large poultry farm. This balm is less toxic than the extensively used three-iodine ethylene glycol. PMID- 1769577 TI - [Metric index in the evaluation of body composition in 7-8-year-old children]. AB - The classification of the body constitution of then 7-8 years old school children in Moscow and Berlin (416 persons) was carried out using the metric index. The metric index, based on the data of the body length, transversal and sagittal diameters of the chests and the age sex of children, clearly indicated the common tendency in the distribution of body constitution types in connection with the lepto- and picnomorphy. Correlation of the body constitution with the physical development was also found, its coefficients are 0.624--for girls and 0.500--for boys. PMID- 1769578 TI - [Health effectiveness of various exercise programs for elementary school children]. PMID- 1769579 TI - [A sample of daily exercises for healthy 7-9-year-old children]. PMID- 1769580 TI - [Effect of age when school begins on the physical development of urban and rural school children]. PMID- 1769581 TI - [Analysis of the effects of radioactive and chemical pollution on the health of newborn babies in areas with atomic industry]. PMID- 1769582 TI - [Evaluation of radiation pollution in the non-uranium underground exploration and extraction industry]. PMID- 1769583 TI - [Hygienic evaluation of new light sources for prophylaxis of ultraviolet deficiency]. AB - The effectiveness of new fluorescent lightings, which generated visible and UV light for the UV-deficiency prophylaxis was demonstrated. PMID- 1769585 TI - [Improvement of the functional structure of health services in a large city under the new economic conditions]. PMID- 1769584 TI - [Role of the immunoreactivity of an organism in immediate and delayed allergic reactions and resistance to infection]. PMID- 1769586 TI - [Hygienic evaluation of hazardous materials]. AB - The appearance of the toxicity phenomenon in the mixture with the simultaneous analysis of the characters of the combined actions of the elements were studied in experiments using as a model incredop composition to determine the significance of each components and quantitative interactions. It was found, that elimination from this mixture even of a single element or changing in the quantitative interactions between elements caused the changes in the toxicity, levels of the sumulation and characters of the combined actions of the components. Therefore the mixtures must be studied as the single object with the establishment of according standards which may not correlate with that in the individual compounds. PMID- 1769588 TI - [Analysis of the development of hygienic scientific problems using informatics modeling]. PMID- 1769587 TI - [Classification of hazardous materials by the level of toxicity in acute experiments]. PMID- 1769589 TI - [Features of virulence and antibiotic resistance of pathogenic Escherichia circulating in the environment]. PMID- 1769590 TI - [Hygienic evaluation of woodshaving plates]. PMID- 1769591 TI - [Hygienic aspects of the use of new polyurethane-based polymeric compounds for the production of consumer goods]. PMID- 1769592 TI - [Nitrite concentration in the saliva]. AB - 320 persons were tested on the nitrate content in saliva. In experiments were accounted the profession, age, sex, particularities of nourishment, drinking water, habits, diseases, taking medicines, vitamins, contact with toxic substances and so on (29 parameters). The average level of nitrates in saliva of estonians is 4.9 +/- 0.3 mg/l. The purity of teeth has the most significant influence on the nitrate content in saliva. PMID- 1769593 TI - [Training of students in the field of economy under the reorganization of graduate medical education and health services]. PMID- 1769594 TI - [Organization of the state control of hygiene regarding the activities of childhood physical education cooperatives and ways for its improvement]. PMID- 1769595 TI - [The USSR sanitary code of 1939]. PMID- 1769596 TI - [Methodical aspects of a lecture course teaching a healthy life style]. PMID- 1769597 TI - [Hygiene education and training of students in public elementary schools]. PMID- 1769598 TI - [Essence and possibilities of syndrome analysis]. PMID- 1769599 TI - [Evaluation of lipid concentrations in the lung tissues of experimental animals]. PMID- 1769600 TI - [Gas chromatographic determination of epichlorohydrin in skin washings]. PMID- 1769601 TI - [Method of determining benzo(a)pyrene in oil and oil products]. PMID- 1769602 TI - [Legal status of the health service and its role in health promotion to the population]. PMID- 1769603 TI - [Management of severe pre-eclampsia in the puerperium. Comparative study of sublingual nifedipine and hydralazine]. AB - At random, two therapeutic schemes for severe preeclampsia during the puerperium, were evaluated. Group A (n = 20) was left without antihypertensive medication and sublingual nifedipine was used only in case of diastolic pressure of 110 mmHg or more. Group B (n = 18) receive Hydralazine 40 mlg. per os, every 6 hrs.; in this group also, nifedipine was administered in case of diastolic pressure of 110 mmHg or more. The only differences were that in group B the intervals for the administration of nifedipine were much shorter than in group A; also, in the same group the need for another antihypertensive was more frequent (5 of 18 vs 1 of 20 patients). PMID- 1769604 TI - [Prenatal diagnosis using chorionic villi]. AB - Chorionic villus sampling (CVS) has a promising future about early detection of fetal abnormalities. It has the potential to become a major tool in the prenatal diagnosis and therapy of genetic disorders. Villus samples can be analyzed by means of cytogenetic, biochemical or molecular technics. Information available at present indicates fetal loss rate should be in the same proportion than amniocentesis. CVS appears to be a reasonably safe and reliable method of prenatal diagnosis in the first trimester of pregnancy. This procedure is setting as fast as it is possible like an excellent alternative to amniocentesis. PMID- 1769605 TI - [Hellp syndrome. Presentation of a case and review of the literature]. AB - A severe case of preeclampsia with Hellp Syndrome is reported. Clinical findings, laboratory abnormalities and pathogenesis, were discussed. We concluded that severe preeclampsia and Hellp Syndrome are not different diseases, but the natural course of preeclampsia per se. PMID- 1769606 TI - [Comparative study of the morpho-functional features of the sperm of fertile and infertile men and their relation to fertilizing ability]. AB - The recent advances in assisted reproduction procedures have helped to the better understanding of the female reproductive physiology and pathology, however, male infertility remains as a poor explained medical problem, nevertheless it occurs in almost 50% of infertile couples. Oligoasthenozoospermia is one of the more common causes of male infertility, therefore we measured in 10 patients with this diagnosis and in 10 fertile euspermic men, besides the parameters included in the standard semen analysis, the quantitative motility (photography method), capacitation-acrosome reaction and the sperm ability to fertilize zona-free hamster oocytes, with the aim to correlate the morphofunctional characteristics of the male gametes with their fertilizing capacity. The results showed significant differences in every parameter studied, including the correlation analysis. In relation with the in vitro induction of the acrosome reaction in both groups, we found significant correlations of the sperm fertilizing ability and the progressive sperm motility with this parameter (fertile group: RS = 0.834, P less than 0.005 & RS = 0.612, P less than 0.05; infertile group: RS = 0.986, P less than 0.001 & RS = 0.536, P less than 0.05 respectively), nevertheless the sperm rate which completed this process was low in relation to the total sperm population even in the fertile men (9.4 +/- 2.0% & 4.4 +/- 2.5% acrosome reacted cells after 18 h of incubation, in the fertile and infertile males respectively). The results also showed the presence of fully capacitated spermatozoa in both groups, since they penetrated the zona-free hamster eggs and decondensed their chromatin (73.9 +/- 13.4% & 10.4 +/- 7.7% penetrated eggs in the euspermic and oligoasthenozoospermic individuals respectively), however, the spermatozoa from the oligoasthenozoospermic men showed low polyspermy indexes too (0.1 penetrated spermatozoa/inseminated oocyte). In this last group we found, in addition, that the mean sperm velocity and the abnormal sperm morphology rate showed significant correlations with the fertilizing ability of the male gametes too (RS = 0.986, P less than 0.005 & RS = -0.942, P less than 0.005. respectively). These data allow us to suggest that before an infertile man is involved in any assisted reproduction program, the presence of possible morphofunctional alterations in the spermatozoa be analyzed, with the aim to be able to make a better prognosis about the success with these patients. PMID- 1769607 TI - Developmental aspects of experimental pulmonary oxygen toxicity. AB - One of the more fascinating aspects of in vivo research on pulmonary O2 toxicity is the striking difference in the response of the neonatal versus the adult animal to hyperoxia. In general, neonatal animals are much more resistant to the characteristic O2-induced lung pathology seen in adult animals in hyperoxia. Neonatal animals are also able to rapidly mount a protective lung biochemical response to high O2 exposure [increased pulmonary antioxidant enzyme (AOE) activities], an adaptive response which adult animals have lost the ability to manifest in greater than 95% O2. This review focuses on the disparate AOE responses of the neonatal versus adult animal in hyperoxia. It also explores other possible explanations for the striking O2 tolerance of young versus adult animals, including comparative O2 free radical production rates, inflammatory cell responses, lung lipid composition, repair capabilities, etc. Discussion also centers on a less well studied toxic complication associated with hyperoxic exposure in the neonatal animal, i.e., the marked inhibitory effect of O2 exposure on normal lung growth and development of an alveolarized lung with an expanded respiratory exchange surface area. Finally, effective experimental means of protecting adult (and neonatal) animals from pulmonary O2 toxicity are reviewed. A closing section considers the enlightening new information that molecular biology has revealed about the regulation of AOE gene expression during normal development and under conditions of hyperoxidant challenge. PMID- 1769608 TI - Potential role of free radicals in benzene-induced myelotoxicity and leukemia. AB - Occupational exposure to benzene, a major industrial chemical, has been associated with various blood dyscrasias and increased incidence of acute myelogenous leukemia in humans. It is established that benzene requires metabolism to induce its effects. Benzene exposure in humans and animals has also been shown to result in structural and numerical chromosomal aberrations in lymphocytes and bone marrow cells, indicating that benzene is genotoxic. In this review we have attempted to compile the available evidence on the role of increased free radical activity in benzene-induced myelotoxic and leukemogenic effects. Benzene administration to rodents has been associated with increased lipid peroxidation in liver, plasma, and bone marrow, as shown by an increase in the formation of thiobarbituric-acid reactive products that absorb at 535 nm. Benzene administration to rodents also results in increased prostaglandin levels indicating increased arachidonic acid peroxidation. Other evidence includes the fact that bone marrow cells and their microsomal fractions isolated from rodents following benzene-treatment have a higher capacity to form oxygen free radicals. The bone marrow contains several peroxidases, the most prevalent of which is myeloperoxidase. The peroxidatic metabolism of the benzene metabolites, phenol and hydroquinone, results in arachidonic acid peroxidation and oxygen activation to superoxide radicals, respectively. These metabolites, upon co-administration also produce a myelotoxicity similar to that observed with benzene. Recently, we have found that exposure of human promyelocytic leukemia (HL-60) cells (a cell line rich in myeloperoxidase), to the benzene metabolites, hydroquinone and 1,2,4 benzenetriol results in increased steady-state levels of 8-hydroxydeoxyguanosine a marker of oxidative DNA damage. Peroxidatic metabolism of benzene's phenolic metabolites may therefore be responsible for the increased free radical activity and toxicity produced by benzene in bone marrow. We thus hypothesize that free radicals contribute, at least in part, to the toxic and leukemogenic effects of benzene. PMID- 1769609 TI - The lens is canned?! PMID- 1769610 TI - The oxyradical-scavenging activity of azelaic acid in biological systems. AB - We have previously shown that azelaic acid, a C9 dicarboxylic acid, as disodium salt (C(9)2Na) is capable of inhibiting significantly the hydroxylation of aromatic compounds and the peroxidation of arachidonic acid due to reactive hydroxyl radicals (HO.). In this paper we have investigated the ability of C(9)2Na to inhibit the oxyradical induced toxicity towards two tumoral cell lines (Raji and IRE1) and normal human fibroblasts (HF). Oxyradicals were generated either by the addition of polyphenols to the medium, or by direct irradiation of phosphate buffered-saline in which cells were incubated from 15 min prior to incubation in normal medium. The effects of C(9)2Na were compared with those obtained by mannitol (MAN), superoxide dismutase (SOD) and catalase (CAT). C(9)2Na, MAN, SOD and CAT significantly decreased the polyphenol toxicity towards cell lines cultured up to 24 h. After 48 h of incubation the above compounds lost the capability of protecting cells from polyphenol toxicity. This suggests that the toxic role of oxyradicals (O2-., H2O2, HO.) persists for about 24 h and, subsequently other toxic mechanisms must be involved, which are not affected by oxyradical scavengers. SOD and CAT did not show any protective effect on UV induced cytotoxicity, while both C(9)2Na and MAN were capable of reducing significantly the UV damage towards cell lines, even after 48 h incubation. This can be explained by the fact that UV cytotoxicity depends mainly on the generation of HO., that can be "scavenged" by C(9)2Na or MAN, but not by SOD or CAT. C(9)2Na and MAN were not significantly degraded in the period during which they afford protection against HO.. PMID- 1769611 TI - Inhibitory effects of isomers of tocopherol on lipid peroxidation of microsomes from vitamin E-deficient rats. AB - NADPH-induced lipid peroxidation of hepatic microsomes from vitamin E-deficient rats has been used to assess the antioxidant effectiveness of dl alpha, d alpha- and gamma-tocopherol. When the tocopherols were added in ethanol to microsomes, the degree of inhibition of formation of thiobarbituric acid reactive substances (TBARS) decreased in the order dl alpha- greater than d alpha- greater than gamma tocopherol. This reflected the difference in the solubility of the tocopherols in the microsomes, dl alpha-tocopherol being the most soluble and gamma-tocopherol the least. Using inhibition of TBARS produced per tocopherol content in microsome as a measure of antioxidant potency, the effectiveness of the isomers was gamma- greater than d alpha- greater than dl alpha. Despite addition of pharmacological concentrations of the isomers, it was not possible to inhibit lipid peroxidation to the same levels as were found in microsomes from vitamin E sufficient animals. Use of ethanol as a vehicle may not allow optimum orientation of the tocopherols into the lipid bilayer. PMID- 1769612 TI - Vitamin E and the peroxidizability of erythrocyte membranes in neonates. AB - We showed the increased susceptibility of neonatal biomembranes to oxidation by a kinetic analysis using an azo compound as a free-radical initiator and red blood cell (RBC) ghosts as a model membrane. When the RBC ghosts were oxidized, oxygen consumption was suppressed during the induction period in which membrane tocopherol was consumed at a constant rate, while increased oxygen uptake was observed after the tocopherol was exhausted. The total tocopherol content was similar in cord, maternal, and adult RBC ghosts, and there were no differences in the induction period (tinh) among the three types of ghosts. While the oxygen uptake rate during the induction period (Rinh) was similar in cord and adult ghosts, the rate in the subsequent phase (Rp) was considerably faster in the cord ghosts. Fatty acid analysis in the membrane lipids showed that the active bisallylic hydrogen (active H) content was greater in cord ghosts than in adult ghosts. The active H content closely correlated with the Rp, but did not with the Rinh. The kinetic chain length (KCL), i.e., the ratio of the rate of propagation to that of initiation, was calculated from Rp and tocopherol consumption rate and KCL values were higher in cord ghosts than in adult ghosts. The faster Rp and the higher KCL of the cord ghosts were attributable to a greater active H content rather than to the tocopherol content. PMID- 1769613 TI - Measurement of lipid hydroperoxides in normal human blood plasma using HPLC chemiluminescence linked to a diode array detector for measuring conjugated dienes. AB - A modification of a method using high-performance liquid chromatography (HPLC) with chemiluminescence (CL) detection for the measurement of lipid hydroperoxides (LOOH) in human blood plasma has been developed. The system involves separation of different classes of LOOH using reverse-phase HPLC, and post-column detection of CL produced by isoluminol oxidation during the reaction of LOOH with microperoxidase. Complete ultra-violet absorption spectra are collected with an in-line diode-array detector and used to confirm a positive CL response due to LOOH, or other compounds, by the presence or absence, respectively, of the LOOH conjugated diene chromophore. We have used the method to investigate the stability of exogenous 15(S)-HPETE (a hydroperoxide of eicosatetraenoic acid) and conjugated dienes (of both 15(S)-HPETE and its reduced metabolite, 15(S)-HETE) in human plasma stored at various temperatures. A large and rapid loss of the hydroperoxide occurred in plasma incubated at 0 degrees C or 27 degrees C, whereas only a small reduction in the level of conjugated dienes was found. 15(S) HPETE in PBS was stable under the same conditions, and zero time recovery of the hydroperoxide from denatured plasma and from buffer containing albumin was identical to that of fresh plasma. Our data suggest that the observed temperature dependent loss of exogenous hydroperoxide from fresh plasma results from a combination of enzymatic degradation to the hydroxy derivative and binding to plasma albumin. 15(S)-HPETE was found to be stable in plasma stored at -70 degrees C for up to 2 weeks and in liquid nitrogen for 3 months in the presence of the antioxidants butylated hydroxytoluene (BHT) and desferal, with no significant loss of conjugated dienes. PMID- 1769614 TI - Elder abuse. PMID- 1769615 TI - National health line. PMID- 1769616 TI - Broadening the definition of scholarship: practice and action research. PMID- 1769617 TI - AIDS, older people, and social work. AB - The acquired immune deficiency syndrome (AIDS) epidemic is significantly affecting older people. Older people themselves may be HIV positive, or they may be the caregiving spouse, partner, parent, or grandparent of a person with AIDS. In addition, older people may share housing or institutional space with people with AIDS. Concerns about the allocation of long-term care resources may create conflict between the needs of older people and people with AIDS. Social workers are particularly suited to lead the discussion of the impact of AIDS on older people, a role the profession has not yet embraced. Four areas of social work leadership are discussed: education, direct service, research, and advocacy. PMID- 1769618 TI - Social support networks of white and black elderly people at risk for institutionalization. AB - The literature examining the role of social network size and support in moderating the relationship between stress and illness in the aged population has not taken racial differences into account. This study compares the potential moderating influence of social network size and support on the relationship between life stress and depressive symptoms for black and white community dwelling elderly people at increased risk for institutionalization. Study data come from in-person interviews with a sample of 191 old-old (75 years and older) and poor residents of a three-census-tract area in Pittsburgh. Approximately 50 percent were white and 50 percent were black. Results indicate that the moderating effects of social network size and support were different for the black people than for the white people in this sample. For white aged people, having greater social support and a larger social network reduces the association between stress and depressive symptoms, as expected. For black elderly people, however, having more network members and receiving support from them is associated with a stronger relationship between stress and depressive symptomatology. PMID- 1769619 TI - Informal helpers of elderly home care clients. AB - Most functionally impaired elderly people rely exclusively on family and other informal helpers. This article examines whether elderly people who turn to formal service providers also receive help from informal sources. A sample of 100 clients of a statewide home care program were interviewed about the informal help they received. Most had family, friends, or neighbors who helped. However, the helping networks were fragile. Only 18 percent of clients had a helping spouse. Only half had more than one helper. Several had only nonkin helpers. Few had a helper living with them. The fragility of these helping networks, compared with those identified in other studies, may explain why these elderly people applied for services. Implications for the respective roles of social services programs and natural support networks are discussed. PMID- 1769620 TI - Accommodation and relocation decision making in continuing care retirement communities. AB - Accommodations and relocations in continuing care retirement communities (CCRCs) affect the lives of staff and residents. This article defines the CCRC concept and reviews the literature relevant to accommodation and relocation changes within CCRCs. Implications for health and human services practitioners who work with older CCRC residents, along with specific issues, are discussed. PMID- 1769621 TI - Hospice social work: a search for identity. AB - This article describes social work's contribution to hospice philosophy and practice, calls attention to the lack of a distinct social work function on hospice teams, and examines various ways to resolve the problem of social work identity in hospice care. Insights from recent peer discussions of hospice social workers tend to support Kulys and Davis's (1986) earlier findings that psychosocial care is provided regularly by hospice team members other than social workers. Options for strengthening the hospice social work role are discussed, including the development of more specific therapeutic techniques and social work leadership in conducting applied research. The importance of maintaining a value based, critical perspective is stressed. PMID- 1769622 TI - Understanding patient satisfaction and dissatisfaction with health care. AB - Patient satisfaction or dissatisfaction is a complicated phenomenon that is linked to patients' expectations, health status, and personal characteristics, as well as health system characteristics. This article presents a cross-sectional study of the relationship among these factors using data collected from a large sample of university employees. The primary hypothesis, that patients' expectations would be the best predictor of satisfaction, was supported by the data. Health status, personal characteristics, and health system characteristics were not strong predictors. The findings suggest that patients may base their evaluations on sophisticated expectations and that those expectations vary from one sociodemographic group to another. Implications for social work practice in health care are highlighted. PMID- 1769623 TI - The social worker's role with a fetal demise and stillbirth. AB - When an unborn life suddenly becomes a fetal demise or stillbirth, family members are profoundly affected. Often the mother feels guilt or shame and cannot come to terms with such a loss. Counseling a grieving family may involve such matters as assisting the family in making arrangements for burial or disposition of the body. Additionally, the social worker may become directly involved preparing the body of a stillborn baby or fetal demise for viewing and holding. This article explains the procedures for assisting the family through the grief and mourning process. It offers details for preparing the baby for viewing and holding, describes burial arrangements, and provides information on hospital policies for the disposal of a fetal demise or stillbirth. PMID- 1769624 TI - [Orthodontic and orthophonic neonatal guidance in facial cleft]. AB - Babbling, which prepares pronunciation, the first articulatory movements and the most important 'imitation-interchange mechanism' with the parents, appears as early as age 3 months. According to the method that we proposed in Toronto in 1977, the soft palate is closed at age 3 months, whereas the hard palate remains open till 6 months of age. We think now that the fact of allowing the timely development of these primordial functions by provisional closure of the hard palate with a thin palatal plate and by parental guidance as early as 3 months of age should bring about additional progress. PMID- 1769625 TI - Place of articulation in articulatory speech disorders of different sounds in a group of Finnish first-graders. PMID- 1769626 TI - [In vivo nuclear magnetic resonance tomography measurement of vocal cord temperature during phonation]. AB - In the glottal area, a series of transversal sections was recorded by means of a nuclear magnetic resonance tomograph using the technique of fast FLASH recording. During the record, the subject uttered the vowel [a:] with 180 Hz and 80 dB(A). The flip angle (35 degrees C) was chosen so as to get maximum contrast in the tissue tomogram due to a temperature shift. The tissue temperature was evaluated by the measurement of the dependence of the relaxation time on the temperature in a gelatinized and doped test solution which was similar in relaxation times to the tissue. In the vocal folds, the temperature increased by about 4 degrees C after prolonged phonation (20 x 20 s). The importance of this technique and the result is discussed with reference to the phonatory function of the larynx. PMID- 1769627 TI - Inflammatory changes as a risk factor in the development of phononeurosis. PMID- 1769628 TI - [Cervical dysphonia]. AB - In patients with dysphonia, an increased tension of the muscles of the neck as well as of the prelaryngeal muscles is well known to all phoniatrists. Usually the cause of this tension is only seen in pathological phonation or in a psychic base. In the present report it could be demonstrated that this tension causes itself a functional dysphonia. This tension is produced by a functional deficit of the upper cervical spine. Chiropractic manipulation of the cervical spine can unlock the stiffness of the spine and normalize the voice within a few minutes. PMID- 1769629 TI - Nasalance scores in normal Finnish speech. PMID- 1769630 TI - [Weather-induced effects on pain perception]. AB - The most important studies on weather-related pain have been analysed and their results compared. Since different medicometeorological classifications were used, and individual reactions to the weather vary considerably, it is possible to recognize unequivocal, universally valid relationships only with difficulty. Rheumatic pain arises mainly in a cold front area, in unstable polar air, and in thunderstorms. Amputation- and scar-related pain is similarly dependent upon changes in the weather. Headaches and migraine are typical signs of an imminent change in the weather. The question as to whether or not the endorphin concentration is of significance for meteorogenic pain is discussed, and possible influences of atmospherics activity noted. PMID- 1769631 TI - [Compliance problems in type I diabetic patients]. AB - Using a newly developed interview concept, 49 type I diabetics were questions about "obstacles to compliance". The patients were asked to identify, in nine different areas of life, any common concrete obstacles to compliance with self treatment in terms of dietary measures, injections and self monitoring. Emotional barriers and the structuring of everyday activities proved to be of particular importance for compliance with dietary measures, and aspects of the doctor patient relationship for insulin injection. The results obtained indicate a need both for abandoning the classical term of compliance, and for the use of psychological measures to support the instruction of diabetics. PMID- 1769632 TI - [Diagnosis of gastroenterologic diseases with sonography. Part 2: Gallbladder and bile ducts]. AB - The anatomical position of the gallbladder makes it readily accessible to ultrasonographic visualization. Gallstones, gravel and sludge present no diagnostic problems. Acute cholecystitis, empyema and perforation may be more difficult to detect. In the presence of large or numerous stones in the gallbladder, there is a danger of overlooking a carcinoma of the gallbladder. Bile duct carcinomas are difficult to detect by ultrasonography. While bile duct dilatation and the site of an occlusion are readily detected, the cause of the occlusion is usually not revealed by ultrasonography. PMID- 1769633 TI - [Effects of cyclosporin A dose on the function of the transplanted kidney. Peripheral mononuclear cells and histological findings in the transplant]. PMID- 1769634 TI - [Interactions with anabolic steroids. Part 2: Individual drugs, estrogens and glucocorticoids]. PMID- 1769635 TI - [Nifedipine-clonidine combination in essential hypertension. Hemodynamic and neurohumoral findings of the combination in comparison with the effect of the individual substances]. AB - In 10 patients with moderate essential hypertension, the neurohumoral and hemodynamic effects of 4 days' treatment with 2 x 75 micrograms clonidine (C), 2 x 20 mg nifedipine retard (N), and a combination of the two (C/N) were studied and compared with baseline values. The heart rate decreased significantly from a mean of 79 to 67 bpm (p less than 0.05) under C, increased again to 73 bpm (p greater than 0.05) under N, and decreased once more to 68 bpm (p less than 0.05) under C/N. The systolic blood pressure decreased from a mean of 184 to 171 under C, 168 after N, and 161 (p less than 0.01) under C/N; significant decreases of diastolic blood pressure were also observed (from 113 to 104 under C, 107 under N, 100 mmHg under C/N (p less than 0.05). Norepinephrine decreased from 440 to 281 under C (p less than 0.01), increased to 391 (p greater than 0.05) after N, and measured 404 pg/ml (p less than 0.05) under C/N. PRA decreased significantly under C, increased under N, and remained unchanged under C/N. These findings demonstrate that combined treatment with lowdose nifedipine and clonidine leads to an additive reduction of blood pressure. The disadvantage of neurohumoral counterregulation of nifedipine are neutralized by clonidine. PMID- 1769636 TI - [HIV pneumonia: a change in attitude? Cotrimoxazole is favored for prevention]. PMID- 1769637 TI - [Chernobyl: the sequelae cannot be eliminated, only lessened]. PMID- 1769638 TI - [Swyer-James syndrome. Differential diagnosis of unilateral "radiolucent" lung]. AB - The Swyer-James syndrome is diagnosed on the basis of its characteristic radiological appearance. The rapid diagnostic differentiation from the much more common condition of pulmonary embolism is described on the basis of a case report. PMID- 1769639 TI - [Diagnosis of gastroenterologic diseases with sonography. Part 3: Pancreas and spleen]. AB - Ultrasonic assessment of the pancreas is rendered difficult by interposed gas containing loops of bowel and stomach. In 50% of the cases, meteorism and ileus prevent the diagnosis of acute pancreatitis. In the case of chronic pancreatitis, focal pancreatitis and carcinoma of the pancreas, too, further diagnostic procedures (CT, ERCP, fine-needle aspiration) are required. As a rule, the caliber of the pancreatic duct can readily be assessed, and may, for example, indicate a carcinoma in the head of the pancreas. Splenomegaly and focal or diffuse parenchymal lesions are detectable by ultrasonography, although an etiological differentiation is not usually possible. The most common lesions are the so-called "bland" splenic cysts. Of importance is the diagnosis of rupture of the spleen, which requires immediate treatment. PMID- 1769640 TI - [Rational diagnosis of urinary tract infections]. AB - The basis for a rational diagnostic work-up of urinary tract infections is a detailed history and a maximally standardised examination of the urine, with test strips measuring, measurement of specific density, microscopic examination of the sediment, and determination of the bacterial count in the urine employing dipstick procedures are recommended for use in the doctor's office. Isolation and identification of pathogens and the preparation of an antibiogram require a special knowledge of microbiological techniques. A requirement for the evaluation of the urine and its constituents is a knowledge of how the urine was collected; we recommend spontaneously passed urine in men and young children, and catheter urine in the case of women. Chronic inflammation of the male adnexa and chronic recurrent urinary tract infections requires radiological studies by the urologist, including a urogram, a urethrocystogram, a miction cystogram, urethropyelography and ultrasonography. Occasionally, nuclear-medical investigations and angiography or computed tomography may be necessary to obtain further clarification. In the case of outflow obstructions in the region of the lower urinary tract or urge or stress incontinence, uroflowmetry and cystometry should be performed. With the aid of this "stepwise diagnostic evaluation", both optimal clarification of the urinary tract infection and a saving of costs are possible. PMID- 1769641 TI - [Current chemotherapy of urogenital infections. Part 1: Comprehensive overview- special section: penicillins]. PMID- 1769642 TI - [Localization accuracy of biomagnetic signals]. PMID- 1769643 TI - [Therapy of orthostatic disorders of cardiovascular regulation. Placebo controlled double-blind study with oxilofrine]. AB - In a double-blind study, the antihypotensive agent oxilofrine was compared with placebo in patients suffering from orthostatic circulatory regulation disorders of the sympathicotonic type. After a washout period of one week, 30 patients were treated for two weeks with oxilofrine and 30 with placebo. The area of the blood pressure amplitude determined with the Schellong test between the 8th minute prone and the 15th minute erect, increased during treatment with oxilofrine from 126 +/- 21 mmHg x min. to 187 +/- 39 mmHg x min. (increase: 48%). The increase under placebo was only 20.8%. The difference in the primary variable was significant. The systolic pressure at the end of treatment with oxilofrine in the Schellong test was virtually constant; under placebo, the systolic pressure decreased. PMID- 1769644 TI - ["I don't see medical reasons for a change". Dr. H. Busch, Munster, takes a position on prevention of pneumocystis carinii pneumonia with pentamidine aerosol. Interview by Wilma Mahler]. PMID- 1769645 TI - Aberrant splicing of phenylalanine hydroxylase mRNA: the major cause for phenylketonuria in parts of southern Europe. AB - We report a mutation within the phenylalanine hydroxylase (PAH) gene that causes aberrant splicing of the mRNA and that is in tight association with chromosomal haplotypes 6, 10, and 36. Because of the high frequency of these particular haplotypes in Bulgaria, Italy, and Turkey, it appears to be one of the more frequent defects in the PAH gene causing classical phenylketonuria in this part of Europe. The mutation is a G to A transition at position 546 in intron 10 of the PAH gene, 11 bp upstream from the intron 10/exon 11 boundary. It activates a cryptic splice site and results in an in-frame insertion of 9 nucleotides between exon 10 and exon 11 of the processed mRNA. Normal amounts of liver PAH protein are present in homozygous patients, but no catalytic activity can be detected. This loss of enzyme activity is probably caused by conformational changes resulting from the insertion of three additional amino acids (Gly-Leu-Gln) between the normal sequences encoded by exon 10 and exon 11. PMID- 1769646 TI - Physical mapping at a potential X-linked retinitis pigmentosa locus (RP3) by pulsed-field gel electrophoresis. AB - A genetic locus (RP3) for X-linked retinitis pigmentosa (XLRP) has been assigned to Xp21 by genetic linkage studies and has been supported by two Xp21 male deletion patients with XLRP. RP3 appears to be the most centromeric of several positioned loci, including chronic granulomatous disease (CGD), McLeod phenotype (XK), and Duchenne muscular dystrophy (DMD). In one patient, BB, the X-chromosome deletion includes RP3 and extends to within the DMD locus. Using a DMD cDNA, the centromeric endpoint of this patient was cloned and used as a starting point for chromosome walking along a normal X chromosome. A single-copy probe, XH1.4, positioned near the centromeric junction but deleted in BB, was used along with a CGD cDNA probe to establish a refined long-range physical map. Both probes recognized a common SfiI fragment of 205 kb. As the CGD gene covers approximately 30-60 kb, the RP3 locus has been restricted to approximately 150-170 kb. A CpG island, potentially marking a new gene, was identified within the SfiI fragment at a position approximately 35 kb from the deletion endpoint in BB. PMID- 1769647 TI - The distal region of 11p13 and associated genetic diseases. AB - The distal region of human chromosome band 11p13 is believed to contain a cluster of genes involved in the development of the eye, kidney, urogenital tract, and possibly the nervous system. Genetic abnormalities of this region can lead to Wilms tumor, aniridia, urogenital abnormalities, and mental retardation (WAGR syndrome). Using 11 DNA markers covering the entire distal region of 11p13, including the WAGR region, we have carried out molecular studies on 58 patients with one or more features of this syndrome and patients with other diseases or structural cytogenetic abnormalities associated with 11p13. Cytogenetic analyses were performed in all cases. In 12 patients we were able to demonstrate deletions of this region. In 2 patients balanced translocations and in 2 additional patients duplications of this region were characterized. In total, 5 chromosomal breakpoints within 11p13 were identified. One of these breakpoints maps within the smallest region of overlap of WAGR deletions. Moreover, we were unable to demonstrate constitutional deletions in a candidate sequence for the Wilms tumor gene or any other marker in 2 patients with aniridia and urogenital abnormalities, 4 patients with Wilms tumor and urogenital abnormalities, 5 patients with bilateral Wilms tumors, and 3 familial Wilms tumor cases. We suggest that the molecular techniques used here (heterozygosity testing for polymorphic markers mapping between AN2 and WT1 and deletion analysis by dosage, cytogenetic analysis, or in situ hybridization) can be employed to identify sporadic aniridia patients with and without increased tumor risk. PMID- 1769648 TI - Hybridization methods for DNA sequencing. AB - I have conducted a general analysis of the practicability of using oligonucleotide hybridization to sequence DNA. Any DNA sequence may be sequenced by hybridization with a complete panel of oligonucleotides. However, sequencing DNA segments over 2 kb long requires an unrealistic number of hybridization reactions. The optimal protocol is to hybridize 7-mer or 8-mer mixed oligonucleotide probes to immobilized DNA fragments 80 bp long: should this prove impractical, hybridization of labeled 270-bp fragments to immobilized mixed 10 mers is a potential alternative. Both protocols require no more experiments to sequence large regions of DNA than conventional m13-based sequencing and are much easier to automate, thus reducing the requirements for skilled personnel. In the ideal case, hybridization sequencing reduces the number of experiments required to sequence megabase DNA by 90%. PMID- 1769649 TI - Chromosome mapping of the murine syndecan gene. AB - The chromosomal localization of the murine syndecan gene was determined by analysis of DNA from a panel of mouse-hamster cell hybrids containing various mouse chromosomes, detection of immunoreactive syndecan in culture medium of these cells, and linkage analysis of a mouse interspecific backcross. Southern analysis of the mouse-hamster cell hybrid DNA shows two distinct hybridizing sequences, one on mouse Chromosome 12 and the other on the X chromosome. Localization of the syndecan gene to mouse Chromosome 12 was determined by detection of immunoreactive syndecan in the culture medium of cell hybrids containing mouse Chromosome 12. Hybrids containing other mouse chromosomes were negative. Linkage analysis by Southern hybridization of DNA from a mouse interspecific backcross using a syndecan-specific probe localized the syndecan gene locus, Synd, to the proximal end of Chromosome 12, tightly linked to the Pomc-1 and Nmyc loci. The syndecan gene is likely on human Chromosome 2 because this region shows conservation of synteny between mouse and human chromosomes. PMID- 1769650 TI - Genes on the short arm of the human X chromosome are not shared with the marsupial X. AB - Eight genes located on the short arm of the human X chromosome (MAOA, SYN1, OAT, OTC, CYBB, DMD, ZFX, POLA) have been mapped in several marsupial species by cell hybrid analysis and/or in situ hybridization using probes derived from human cDNA. Seven appear to be autosomal in all marsupial species examined. The eighth, CYBB, detected a site on the X, as well as major autosomal sites. Although these genes are not conserved on the X chromosome in marsupials, at least some of them are arranged together in autosomal clusters. The autosomal location of human Xp genes in marsupials could mean that this region either was lost from a large ancestral X chromosome in the marsupial lineage or was acquired by a small ancestral X (and perhaps Y) in the eutherian lineage. Either explanation demands that the region was not subject to X chromosome inactivation in a common ancestor 120-150 MyrBP. PMID- 1769651 TI - Localization of the fibrillin (FBN) gene to chromosome 15, band q21.1. AB - Fibrillin (FBN), a large extracellular matrix glycoprotein, is an important component of structures called microfibrils. Because fibrillin microfibrils appear to be abnormal in patients with the Marfan syndrome, fibrillin is a candidate for the gene defect in the Marfan syndrome. Derived clones from fibrillin cDNA were used as probes in isotopic and nonisotopic in situ hybridization studies to map the chromosomal location of the fibrillin gene. Fluorescent signals were found on chromosome 15 band q21.1; an excess of silver grains was noted over a similar region of chromosome 15 following in situ hybridization with a tritium-labeled probe. These results are consistent with linkage studies that localize the Marfan gene to chromosome 15. PMID- 1769652 TI - Laser microdissection and single unique primer PCR allow generation of regional chromosome DNA clones from a single human chromosome. AB - We have developed an argon laser chromosome microdissection technique in conjunction with a polymerase chain reaction (PCR) approach to directly amplify microdissected chromosomes. The single 22-mer primer used in PCR, although unique in sequence (5'-TAGATCTGA-TATCTGAATTCCC-3'), randomly primed and amplified any target DNA. These methods were applied to the distal half of the short arm of human chromosome 4 containing the Huntington disease (HD) locus. Forty-four percent of representative clones from this library identify single-copy DNA sequences. This calculation suggests that the resulting chromosome-specific DNA library contains approximately 600 nonoverlapping sequences with an average size 350 bp at an average spacing of 30 kbp along chromosome 4. This microdissection and PCR cloning procedure is a simple and general approach for constructing a chromosome region-specific DNA library from a single metaphase spread. PMID- 1769653 TI - A physical map of human chromosome 10 and a comparison with an existing genetic map. AB - A physical map for 13 loci on chromosome 10 was developed by determining the dosage of the corresponding DNA sequences in cell lines with unbalanced chromosome 10 rearrangements. Nine of the sequences were assigned to a smaller segment of the chromosome than previously and four sublocalizations were confirmed. The physical map covers most of chromosome 10, from 10p13 to 10q23. The linear order of loci within the physical map agrees with existing linkage maps of chromosome 10. A comparison between the physical map and existing genetic maps indicate an uneven distribution of recombination for chromosome 10. There appear to be hot spots of recombination in the regions defined by q21.1 and q22 q23. In addition, there is a suppression of recombination in the pericentromeric region in males which is not evident in females. PMID- 1769654 TI - A new multisequence family in human. AB - By hybridizing total human DNA with probes derived from the extrachromosomal circular DNA fraction of cultured cells, we detected a human multisequence family, called chAB4, previously unknown. Approximately 50 copies of this sequence are located in the haploid human genome. The repetition units of chAB4 are 35 kb long and the units are tandemly arranged. DNA sequence analysis of parts of the chAB4 unit revealed no direct evidence for a possible function of the family, but possibly chAB4 harbors a gene. Family members are located on human chromosomes 1, 3, and 9 and on the short arms of chromosomes 13-15, 21, and 22. Therefore, in addition to the rDNA, chAB4 is the second class of clustered repetitive sequences with a relatively long repetition unit localized on the short arms of all acrocentric chromosomes. Some evolutionary aspects arising from the structure of chAB4, the established parts of its DNA sequences, and the chromosomal localization of this new multisequence family are discussed. PMID- 1769656 TI - A deletion map of the human Yq11 region: implications for the evolution of the Y chromosome and tentative mapping of a locus involved in spermatogenesis. AB - A deletion map of Yq11 has been constructed by analyzing 23 individuals bearing structural abnormalities (isochromosomes, terminal deletions and X;Y, Y;X, or A;Y translocations) in the long arm of the Y chromosome. Twenty-two Yq-specific loci were detected using 14 DNA probes, ordered in 11 deletion intervals, and correlated with the cytogenetic map of the chromosome. The breakpoints of seven translocations involving Xp22 and Yq11 were mapped. The results obtained from at least five translocations suggest that these abnormal chromosomes may result from aberrant interchanges between X-Y homologous regions. The use of probes detecting Yq11 and Xp22.3 homologous sequences allowed us to compare the order of loci within these two chromosomal regions. The data suggest that at least three physically and temporary distinct rearrangements (pericentric inversion of pseudoautosomal sequences and/or X-Y transpositions and duplications) have occurred during evolution and account for the present organization of this region of the human Y chromosome. The correlation between the patient' phenotypes and the extent of their Yq11 deletions permits the tentative assignment of a locus involved in human spermatogenesis to a specific interval within Yq11.23. PMID- 1769655 TI - Molecular structure and functional testing of human L1CAM: an interspecies comparison. AB - The rodent, avian, and insect L1-like cell adhesion molecules are members of the immunoglobulin superfamily that have been implicated in axon growth. We have isolated an L1-like molecule from human brain and found that it also supports neurite growth in vitro. We have also cloned and sequenced the entire coding region of human L1CAM and found that it shows a very high degree of homology to mouse L1cam, with 92% identity at the amino acid level. This similarity suggests that L1CAM is an important molecule in normal human nervous system development and nerve regeneration. Overall, there is substantially less homology to chick Ng CAM; they are 40% identical at the amino acid level but many regions are highly conserved. Comparison of the sequences from human, mouse, chick, and Drosophila indicates that the L1 immunoglobulin domain 2 and fibronectin type III domain 2 are strongly conserved and thus are likely functionally important. PMID- 1769657 TI - The cloned butyrylcholinesterase (BCHE) gene maps to a single chromosome site, 3q26. AB - Human tissues have two distinct cholinesterase activities: acetylcholinesterase and butyrylcholinesterase. Acetylcholinesterase functions in the transmission of nerve impulses, whereas the physiological function of butyryl-cholinesterase remains unknown. An atypical form of butyrylcholinesterase or the absence of its activity leads to prolonged apnea following administration of the muscle relaxant suxamethonium. Inheritance of these butyrylcholinesterase variants is consistent with the enzyme activity being encoded in a single autosomal locus, BCHE (formerly CHE1 and E1), which has been assigned to chromosome 3. Previous in situ hybridization of a BCHE cDNA probe gave evidence of homologous sequences at 3q26 and 16q11-q23, raising the possibility of more than one locus coding for butyrylcholinesterase [H. Soreq, R. Zamir, D. Zevin-Sonkin, and H. Zakut (1987) Hum. Genet. 77: 325-328]. Using a different cDNA probe hybridized in situ to 46,XX,inv(3)(p25q21) metaphase chromosomes, we report here the localization of BCHE to a single autosomal location: 3q26. PMID- 1769658 TI - Refinement of the localization of human butyrylcholinesterase to chromosome 3q26.1-q26.2 using a PCR-derived probe. AB - The gene for butyrylcholinesterase (EC 3.1.1.8) has been previously localized to three sites in the human genome, at 3q21, 3q26, and 16q21. In situ hybridization using a PCR-derived probe including the active site region gives a single hybridization signal and refines the localization to 3q26.1-q26.2. PMID- 1769659 TI - Complete nucleotide sequence of the human RCC1 gene involved in coupling between DNA replication and mitosis. AB - Total genomic DNA of the human RCC1 gene was isolated from HeLa DNA and its complete nucleotide sequence (34,641 bp) was determined by the shotgun sequencing method. The exon-intron junctions were precisely assigned to this sequence by comparing the nucleotide sequence of RCC1 genomic DNA with that of its cDNA. The RCC1 gene was found to have 14 exons, 8 of which (starting from the seventh one) coded the seven repeated sequences of RCC1 protein. A single exon corresponded roughly to each repeat of the RCC1 protein except for the middle one, indicating that the RCC1 gene was generated through amplification of a primordial exon. Primer extension analysis revealed the presence of an internal promoter. PMID- 1769660 TI - The human ICAM2 gene maps to 17q23-25. AB - The intercellular adhesion molecules ICAM1 and ICAM2 are the cell-surface ligands for the lymphocyte function-associated antigen LFA-1 (CD11a/CD18) and are thought to mediate cell-cell adhesion interactions required by the immune system. However, differences in tissue distribution, inducibility of expression, and overall structure of the two ICAMs may point to their having distinct functional roles. We have used a panel of somatic cell hybrids and chromosome-mediated gene transfectants to establish the chromosomal location of the gene for ICAM2. Hybridization of an ICAM2 cDNA clone to Southern blots from this panel indicates that the human ICAM2 gene maps to chromosome 17 region q23-25. PMID- 1769661 TI - Minisatellite "isoallele" discrimination in pseudohomozygotes by single molecule PCR and variant repeat mapping. AB - The D1S8 hypervariable minisatellite MS32 has a heterozygosity of 97.5% based on detectable differences in allele length using standard Southern blot analysis. It has previously been shown that the basic repeat unit is in itself variable and that this may be used to map the internal structure of an allele. This method has already been used to establish that alleles of the same length may have differing internal structures between nonrelated individuals. We now extend this approach to demonstrate that two apparently homozygous individuals are in fact heterozygotes. For each individual the two comigratory alleles were separated, without cloning, using single molecule dilution (SMD) of genomic DNA and recovery with PCR. Mapping of the variant repeat units revealed highly diverged internal structures and, for one individual, a size difference of one repeat unit (29 bp). SMD and PCR recovery provide an efficient system for separating comigratory alleles without prerequirement for knowledge of sequence differences. PMID- 1769662 TI - The human homolog of the mouse brown gene maps to the short arm of chromosome 9 and extends the known region of homology with mouse chromosome 4. AB - The mouse brown locus encodes a tyrosinase-related protein, TRP-1. The human homolog of TRP-1 was recently cloned from a melanoma cDNA library and sequenced. We have made oligonucleotide primers corresponding to the human TRP1 3' untranslated region and used them to map the human TRP1 gene by species-specific PCR in human/rodent somatic cell hybrids. By this means, the human TRP1 gene has been mapped to the short arm of chromosome 9. PMID- 1769663 TI - Molecular heterogeneity of beta-thalassemia in mestizo Mexicans. PMID- 1769664 TI - Localization of the human O6-methylguanine-DNA methyltransferase gene to chromosome 10q24.33-qter. PMID- 1769665 TI - Assignment of the human Ki-67 gene (MK167) to 10q25-qter. PMID- 1769666 TI - Mapping of the gene encoding the alpha subunit of the stimulatory G protein of adenylyl cyclase (GNAS1) to 20q13.2----q13.3 in human by in situ hybridization. PMID- 1769667 TI - The human gene for an epidermal surface antigen (M17S1) is located at 17q11-12. PMID- 1769668 TI - Probe St35-239 (DXYS64) reveals homology between the distal ends of Xq and Yq. PMID- 1769669 TI - Polymorphisms in the transcribed 3' untranslated region of eukaryotic genes. AB - In this review we present preliminary evidence for a new class of polymorphism that may be used in a systematic way to map cDNAs efficiently and to expedite the construction of a high-resolution genetic map of the human genome. Ultimately, transcribed 3' untranslated polymorphisms will warrant further study because they should be widely distributed throughout the genome within transcribed sequences, and they can be readily identified as a result of cDNA cloning and sequencing. Furthermore, these markers should be universally available on the basis of the sequence data and highly useful in linkage analyses. PMID- 1769670 TI - Call for a worldwide survey of human genetic diversity: a vanishing opportunity for the Human Genome Project. PMID- 1769671 TI - Visual requirements for safety and mobility of older drivers. AB - Efforts to assess visual deterioration with increasing age, coupled with new mechanisms proposed to limit the exposure of visually impaired drivers to driving risks, have emerged in response to the increase in older drivers. Visual functions discussed in this context include static acuity (photopic, mesopic, and in the presence of glare), dynamic visual acuity, visual field, contrast sensitivity, and motion perception. Exposure control mechanisms discussed include alternative periodic vision testing strategies, visual training, and environmental and vehicular modifications to accommodate the older driver. Finally, relevant research needs are addressed. PMID- 1769672 TI - Age-related eye disease, visual impairment, and driving in the elderly. AB - As people age, a number of visual functions such as acuity, visual field, and night vision deteriorate. This decline in vision is associated in part with an increase in vehicular accidents per mile driven by the elderly. Four age-related ocular conditions--cataract, macular degeneration, open-angle glaucoma, and diabetic retinopathy--are primarily responsible for the decline in visual acuity and visual field in the elderly. Few epidemiologic data are available about these diseases, and at present they cannot be prevented. There is need for more information about visual decline and how it affects driving performance and for development of pragmatic approaches for detecting and assessing the elderly driver with functional visual deficits. PMID- 1769673 TI - Dementia and the older driver. AB - The association between dementia and driving errors in older adults has been anecdotally noted by clinicians and caregivers. However, until recently, little empirical documentation of this association existed. This paper provides a critical review of available research on dementia and driving and discusses issues that must be considered in attempting to apply this developing body of research to practical problems, such as the relicensing process for selected drivers. This is followed by a discussion of recent research relevant to the development of potential procedures for screening patients with dementing illness -particularly Alzheimer's disease--for probable driving risk. PMID- 1769674 TI - Attention and driving skills in aging and Alzheimer's disease. AB - The number of older drivers with dementia is rising with the aging of the adult population. A public health issue is growing because of concerns about the motor vehicle accident risk posed by drivers with dementia of the Alzheimer's type (DAT) and other progressive, degenerative dementias. However, little is known about the specific perceptual/cognitive deficits contributing to impaired driving in DAT. The present paper proposes, on both theoretical and empirical grounds, that attentional skills in relation to driving should be examined in older adults with and without DAT. Such investigations should focus on normal older adults and those in the mild, early stages of dementia because the latter are the most likely among the dementia population to be still driving. Evidence is presented indicating (1) that motor vehicle accident rates are related to performance on information-processing measures of different components of attention; (2) that this relationship is greatest for measures of the switching of selective attention and less for that of divided and sustained attention (vigilance); and (3) that many of these same attentional functions, and particularly the switching of visual selective attention, are impaired in the early stages of DAT and thus may contribute to increased accident risk. Further studies of cognitive and driving performance in older drivers are necessary to establish that the attentional impairments found in mild DAT contribute to increased accident risk. Implications of these findings for driver assessment, education, and training are discussed. PMID- 1769675 TI - A cognitive engineering approach to improving signalized left turn intersections. AB - This research evaluated the effect of providing advanced left turn information to individuals faced with deciding whether or not it is safe to turn at a signalized intersection. Younger (mean age 37 years) and older (mean age 71 years) drivers were tested in simulations of approaching an intersection with and without advanced cueing. Experiment 1 used a featureless background; Experiment 2 used an animated presentation of traffic control displays. In both experiments the subjects had to determine whether or not they had right-of-way to make a left turn. Exaggerated error rates and increased decision latencies for displays conveying unprotected turn status occurred in both studies. Cueing drivers with advanced notice of the decision rule through a redundant upstream posting of sign elements improved both accuracy and latency of younger and older drivers' decisions. PMID- 1769676 TI - Divided attention in experienced young and older drivers: lane tracking and visual analysis in a dynamic driving simulator. AB - A simulated driving task that required the simultaneous execution of two continuous visual tasks was administered to 12 healthy young (mean age 26.1 years) and 12 healthy older (mean age 64.4 years) experienced and currently active drivers. The first task was a compensatory lane-tracking task involving a three-dimensional road display. The second task was a timed, self-paced visual analysis task involving either a vocal or manual binary response to dot patterns projected within the road display. Using adaptive tasks, single-task difficulty was individually adjusted for each subject. To control for individual differences in attention allocation strategy, the dual task was performed according to three different sets of instructions based on the relative importance of each task. Compared with young adults, older adults showed a significantly decreased ability to divide attention. This effect was apparent in lane tracking and in the accuracy of visual analysis. The impairment of divided attention was less pronounced in the vocal condition than in the manual one. This suggests that difficulty in integrating responses may be an important determinant of poor dual task performance in old age. PMID- 1769677 TI - Identifying correlates of accident involvement for the older driver. AB - Most older adults rely on the automobile to maintain their mobility and independence, in spite of the fact that age-related behavioral and biomedical changes may make driving more difficult. Indeed, accident and fatality rates begin to rise after age 55. One research goal, therefore, is to identify functional measures that differentiate older adults who drive safely from those who do not. This paper discusses conceptual and methodological issues involved in addressing this question, considers why earlier research has been largely unsuccessful, presents a working model for approaching the problem, and argues the need for large-sample, prospective research in this area. PMID- 1769678 TI - Recent changes in driving among older adults. AB - Driving statistics comparing drivers aged at least 65 years with all drivers are examined for the years 1980 and 1989. In that time older driver fatalities had increased substantially despite a decrease in total driver fatalities. Analyses of size of population, numbers of licensed drivers, estimates of miles driven, and crash rates for these two years imply that the rise in total older driver deaths is related to increasing numbers of older adults who are licensed to drive and an increase in likelihood of fatality following a motor vehicle crash. This latter effect may be associated with a very substantial rise in the numbers of licensed drivers age 70 and older. PMID- 1769679 TI - Peripheral nerve sheath tumours: an ultrastructural study of 30 cases. AB - This report deals with the ultrastructural observations of 30 peripheral nerve sheath tumours [PNST], which include 25 schwannomas of acoustic nerve, one schwannoma of cauda equina, one neurofibroma from a case of Von Recklinghausen's disease, one pigmented neurofibroma of spinal nerve root and a malignant schwannoma of frontal region. Interdigitating slender cytoplasmic processes covered with a continuous layer of basal lamina constitute the single most important ultrastructural attribute of Schwann cells. Myelin formation was encountered in the cell processes of four out of 25 acoustic schwannomas. In four cases Microtubular arrays identical to that in an axon were seen in Schwann cells. These two observations require further support by additional cases of PNST studies by electron microscopy. The neurofibroma consisted only of Schwann cells and no ultrastructurally identifiable perineurial cells or fibroblasts were detected. The cells in the pigmented neurofibroma revealed submicroscopic features of both Schwann cell and melanocyte, indicating their common ancestry. A unique case of malignant schwannoma arising from frontal meninges is illustrated and it is emphasized that electron microscopy is mandatory for a correct histogenetic diagnosis of malignant tumours which occur at unexpected anatomical sites. PMID- 1769680 TI - Methoxyphenyl maleamic acid augments the activity of cytotoxic drugs against murine tumours. AB - The anti-tumour effects of methoxyphenyl maleamic acid (MPMA) and cytotoxic drugs, in combination were investigated on P388 leukaemia and S180 (ascites) tumours. Simultaneous administration of MPMA with CTX or HN2 resulted in enhancement of anti-tumour activity. The increased activity was observed against P388 leukaemia, whereas S180 (ascites) tumour was not responsive to the combined treatment. The possible mechanism (s) of action, responsible for the modulation of activity of CTX and HN2 against P388 tumour have been postulated. PMID- 1769681 TI - Secondary leukemias following radiotherapy for carcinoma cervix uteri--two case reports. PMID- 1769682 TI - An association of acute myeloid leukaemia and multiple myeloma: a case study. AB - A case of denovo presentation of acute myeloid leukaemia with multiple myeloma is reported in a 32 years old male. He presented with pancytopenia and aleukaemic leukaemia. Bone marrow examination revealed presence of acute myeloid leukaemia and sheets of plasma cells. Serum electrophoresis showed a M protein which was characterised to be Ig lambda with decrease in normal immunoglobulin levels. PMID- 1769683 TI - Priapism, complicating chronic myeloid leukemia--a case report. PMID- 1769684 TI - A comparative study of dextran coated charcoal (DCC) and enzyme immunoassay (EIA) methods for oestrogen receptor (ER) estimation in breast cancer. AB - Oestrogen receptor (ER) concentrations were measured in 100 breast cancer cytosols using both the dextran coated charcoal assay (DCC with 6--point scatchard plot) and a newly developed enzyme linked immunoassay (EIA) using a monoclonal antibody against ER. The efficiency of the two methods was compared. A highly significant correlation was observed between the ER levels determined by DCC and EIA methods (r = 0.94, p less than 0.001). The mean ER-EIA value (43.25 +/- 74.77) was, however, significantly higher than the mean ER-DCC value (18.00 + 37.27) (p less than 0.001); in both pre- menopausal (p less than 0.001) and post menopausal (p less than 0.001) groups. Using a cut-off point at 10 fmo/mg protein for ER-EIA and 3 fmol/mg protein for ER-DCC/to distinguish ER +ve and -ve tumours, a 97% concordance between the two assays was achieved. The EIA method appears to be preferable to the DCC method because it is easy to perform, rapid, requires less tissue and does not involve the use of radioactive substances. PMID- 1769685 TI - The role of C5a in interleukin-6 production induced by lipopolysaccharide or interleukin-1. AB - We investigated the effects of recombinant C5a on interleukin-6 (IL-6) production by peripheral blood mononuclear cells (PBMC) in vitro and compared them with the release of interleukin-1 (IL-1) and tumour necrosis factor (TNF). In a virtually lipopolysaccharide (LPS)-free culture system, C5a by itself did not induce any significant IL-6 translation. The IL-6 release in response to low amounts of LPS (500 pg/ml) or IL-1 beta, however, was markedly increased by the complement fragment. This enhancement of IL-6 synthesis was dose-dependent, reached its optimum at 5.8 x 10(-9)M rC5a and occurred regardless of the presence of serum components. At the level of transcription C5a by itself did not induce IL-6 gene expression, but in the presence of low amounts of LPS the stimulation of monocytes with C5a yielded an increase in IL-6 mRNA. The transcription of IL-1 beta, however, can be induced by C5a alone. These data are interesting, since they indicate a different regulation of IL-1 beta and IL-6 by the complement fragment C5a. Furthermore, we could show that the C5a-mediated IL-6 production influenced the synthesis of IgG rather than IgM in vitro. These results may be relevant for an understanding of the potentiating role of C5a in cytokine dependent disease processes. PMID- 1769686 TI - Induction of active immunological hypo/non-responsiveness to C5 in adult C5 deficient DBA/2 mice. AB - Injection of C5-sufficient BALB/c serum rendered DBA/2 mice (C5-deficient) immunologically hypo- or non-responsive to C5. This was indicated by C5 elimination studies in the C5-deficient mice showing similar half-lives for C5 upon single and repeated BALB/c serum injection. Concrete evidence for C5 non responsiveness came from experiments showing that C5-injected DBA/2 mice were unable to mount an anti-C5 antibody response after active immunization with C5 sufficient serum in Freund's complete adjuvant. C5 hypo/non-responsiveness could be induced in DBA/2 mice via the intravenous as well as the intraperitoneal route, provided the C5-sufficient serum was administered in the very narrow dose range of 10-100 microliters (approximately 0.3-3 micrograms of C5). Upon i.v. C5 injection, C5 non-responsiveness was nearly complete on Day 4 and lasted about 3 weeks. Hyporesponsiveness was still present 6 weeks after serum injection. C3-/C5 depleting cobra venom factor reversed tolerization for C5, at least when applied within 48 hr after i.v. C5 injection. Similarity between the acquired C5 hypo/non responsiveness of DBA/2 mice and the established C5 tolerance of BALB/c mice was suggested by adoptive cell transfer experiments: spleen cells from naive DBA/2 mice stimulated B cells of C5-sufficient nude mice to produce C5-neutralizing antibodies. In contrast, splenocytes from C5-tolerized DBA/2 mice, like those of BALB/c mice, did not decrease haemolytic C5 levels in C5-sufficient nude mice. PMID- 1769687 TI - Stress-induced modulation of antigen-presenting cell function. AB - The effect of two means of inducing a stress response, heat and oxygen radicals, on the ability of an HLA-DR1 B-cell line to stimulate DR1-restricted and anti-DR1 auto- and alloreactive T-cell clones has been examined. Both forms of stress enhanced the ability of B cells to stimulate auto- and alloreactive T-cell clones and to present peptide to an influenza-virus specific T-cell clone. Furthermore, the ability of the B-cell line to present whole influenza virus was augmented by heat stress. The stress-induced enhancement of T-cell responses coincided with a modest increase in the cell-surface expression of major histocompatibility class II products. This was, however, insufficient to account for the observed functional effects. In contrast to these effects, presentation of whole antigen was inhibited by the oxygen radical intermediate, hydrogen peroxide (peroxide), in a dose-dependent manner. When analysed by SDS-PAGE, it was found that whilst overall protein synthesis decreased following both types of stress, increased synthesis of heat-shock proteins (HSP), and in particular the 70,000 MW HSP, was only evident following heat stress. The absence of an increase in the synthesis of HSP 70, in the antigen-presenting cells (APC) following the uptake of UV treated influenza virus, however, implied that HSP 70 induction was not necessary for the presentation of whole antigen. The effects of peroxide stress appeared to be qualitatively different in several respects. First, peroxide treatment did not cause the induction of any stress proteins; second, peroxide abolished the presentation of whole antigen. In addition, heat stress of APC was unable to protect from the adverse effects of peroxide treatment, in that cells treated sequentially with heat, followed by peroxide, were unable to present whole influenza virus. In order to determine the stage of antigen presentation at which peroxide was causing inhibition, APC were treated at varying time-points after pulsing with antigen. The kinetics of the peroxide effect paralleled those of aldehyde fixation. Taking these results together it would appear that peroxide interferes with some aspects of the antigen-processing pathway. PMID- 1769688 TI - The endo/lysosomal protease cathepsin B is able to process conalbumin fragments for presentation to T cells. AB - The protein antigens conalbumin (CA) and ovalbumin (OVA) are known to require uptake into antigen-presenting cells (APC) for their presentation to major histocompatibility complex (MHC) class II-restricted T cells. In both cases proteolytic cleavage is thought to be a necessary step for the generation of the respective antigenic peptides. A specific inhibitor of the endosomal protease cathepsin B, Cbz-Phe-Ala-CHN2, blocks the presentation of both CA and OVA, whereas this inhibitor has no effect on the presentation of a processing independent OVA peptide. Furthermore, the presentation of insulin, an antigen that needs processing but no proteolytic cleavage, is enhanced when cathepsin B is inhibited during antigen pulsing. When the APC were treated with an inhibitor of acid proteases, the CA response was not affected, while the presentation of OVA was diminished under these conditions. To estimate the relevance of these findings for the generation of the antigenic CA peptide, extracellular digestions of CA by cathepsin B were carried out. The fragment(s) present in these digests was recognized by T cells without further processing. Furthermore, the time course of intra- and extracellular CA processing with respect to the capacity to stimulate T cells was similar. Taken together these data suggest that degradation by cathepsin B may be sufficient in vivo to generate the antigenic CA fragment. On the other hand, the blocking of cathepsin B does not appear to have an adverse effect on the general mechanisms of antigen presentation. PMID- 1769689 TI - Primary proliferative and cytotoxic T-cell responses to HIV induced in vitro by human dendritic cells. AB - In earlier studies, primary proliferative and cytotoxic T-cell (CTL) responses to influenza virus were produced in vitro by using mouse dendritic cells (DC) pulsed with virus or viral peptide as the stimulus for syngeneic T cells in 20 microliters hanging-drop cultures. We have now adapted this system for producing primary responses with cells from non-immune donors to produce primary proliferative and CTL responses to human immunodeficiency virus I (HIV) and to HIV peptides in vitro using cells from normal human peripheral blood. All donors in this study were laboratory personnel with no history of HIV infection. DC enriched from peripheral blood were exposed to HIV in vitro and small numbers were added to T lymphocytes in 20-microliters hanging drops. Proliferative responses to virus-infected DC were obtained after 3 days in culture. After 6 days, CTL were obtained that killed virus-infected autologous--but not allogeneic -phytohaemagglutinin (PHA)-stimulated blast cells. Proliferative and CTL responses were obtained using cells from 14 random donors expressing a spectrum of major histocompatibility complex (MHC) types but the CTL, once produced, showed killing restricted by the MHC class I type. Treatment of cultures with monoclonal antibody (mAb) to CD4-positive cells at the beginning of culture blocked the development of both proliferative and CTL responses, but treatment after 5 days had no effect on the CTL activity. Treatment with MCA to CD8 positive cells at the beginning of culture did not block proliferation significantly, but treatment either before or after the 5-day culture period blocked CTL responses. Collaboration between proliferating CD4-positive cells and CD8-positive cells may thus be required to produce CTL of the CD8 phenotype. DC exposed to HIV also produced CTL that killed autologous blast cells pulsed with gp120 envelope glycoprotein. However, DC infected with whole virus did not produce CTL that lysed target cells pulsed with a synthetic peptide, which included a known T-cell epitope of gp120 (representing amino acids 111-126). DC pulsed with gp120 were a poor stimulus for the development of CTL. In contrast, DC pulsed with the peptide (111-126) stimulated both proliferative and CTL responses. The latter killed not only target cells pulsed with the peptide itself or with gp120 but also killed virus-infected autologous blast cells. CTL were again obtained reproducibly with this peptide using donors expressing a spectrum of MHC types.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1769691 TI - Vitamin D3 binding protein required for in vitro activation of macrophages after alkylglycerol treatment of mouse peritoneal cells. AB - In vitro treatment of peritoneal cells with dodecylglycerol (DDG) in 10% foetal calf serum (FCS) supplemented medium RPMI-1640 results in a greatly enhanced Fc receptor-mediated phagocytic activity of macrophages. This macrophage activation process requires a serum factor in the alpha 2-globulin fraction. When mouse peritoneal cells were treated with 50 ng DDG/ml in a serum-free 0.1% egg albumin supplemented medium RPMI-1640 (EA medium) for 30 min and cultured in EA medium containing electrophoretically fractionated alpha 2-globulin for 3 hr, a markedly enhanced activation of macrophages was observed. To improve fractionation of alpha 2-globulin, FCS was first precipitated with 50% saturated ammonium sulphate and then the supernatant electrophoretically fractionated. The resultant alpha 2 globulin fraction was unable to support activation of macrophages. Vitamin D3 binding protein (DBP) of the alpha 2-globulin fraction is known to be precipitable by 50% saturated ammonium sulphate. When human alpha 2-globulin was treated with antiserum against human DBP and used in a medium for cultivation of DDG-treated peritoneal cells, no significant activation of macrophages was observed. Cultivation of DDG-treated peritoneal cells in a medium containing a low concentration of purified human DBP (group specific component, Gc) produced a greatly enhanced ingestion activity of macrophages. Purified human Gc protein, when used in an EA medium for step-wise cultivation of DDG-treated B and untreated T cells, was efficiently converted to a macrophage-activating factor. PMID- 1769690 TI - MHC class II expression by Langerhans' cells and lymph node dendritic cells: possible evidence for maturation of Langerhans' cells following contact sensitization. AB - Following exposure of mice to contact sensitizing chemicals, dendritic cells (DC) rapidly accumulate in the draining lymph nodes. A proportion, at least, of the DC which arrive in the nodes bear significant amounts of antigen and are derived from epidermal Langerhans' cells (LC). It is of interest that although LC are relatively inefficient antigen-presenting cells, the antigen-bearing DC found within draining nodes are potent accessory cells and induce immune responses both in vitro and in vivo. Previous in vitro studies have shown that during culture in the presence of granulocyte/macrophage colony-stimulating factor (GM-CSF), LC are subject to a functional and phenotypic maturation characterized by the development of effective accessory cell function and elevated membrane Ia antigen expression. We have hypothesized previously that LC may undergo a similar maturation in vivo as they move to the draining lymph nodes following receipt of the stimulus to migrate. As maturation in vitro is accompanied by increased Ia, we have examined the expression of this molecule on epidermal LC and lymph node DC during the induction phase of contact sensitization. The data reported provide evidence that peripheral lymph node DC, irrespective of whether they are derived from draining or resting nodes, and irrespective of whether or not they bear antigen, express comparable high levels of Ia antigen. In contrast, compared with DC, freshly isolated LC have considerably less (on average five times less) Ia antigen. These results indicate that during migration from the skin to lymphoid tissue LC are subject to a phenotypic maturation, comparable with that observed in vitro, and consistent with the acquisition of active antigen-presenting cell function. PMID- 1769692 TI - Molecular cloning and characterization of ovine IL-1 alpha and IL-1 beta. AB - Interleukin-1 (IL-1) is a cytokine with a wide range of effects on a variety of cell types. By hybridization with human IL-1 alpha and IL-1 beta cDNA probes, the corresponding ovine cDNAs were isolated from a stimulated alveolar macrophage cDNA library. The sequences of these cDNAs showed that ovine IL-1 alpha and IL-1 beta encode proteins of 268 and 266 amino acids, respectively, with both the nucleotide and amino acid sequences showing a high degree of homology with their human, mouse and bovine equivalents. In a mammalian COS cell-expression system these cDNAs produced biologically active IL-1. Further experiments demonstrated the importance of sequences within the 3' untranslated portion of the cDNAs in determining the level of expression of these molecules. The analysis of expression of IL-1 alpha- and IL-1 beta-specific mRNA in response to endotoxin, phorbol myristic acid (PMA) or PMA plus ionomycin revealed a distinct pattern of differential regulation of the two genes. From genomic analysis both IL-1 alpha and IL-1 beta appear to exist as single copies in the ovine genome. PMID- 1769693 TI - Murine immune response to HIV-1 p24 core protein following subcutaneous, intraperitoneal and intravenous immunization. AB - The murine immune response to baculovirus-produced human immunodeficiency virus type-1 (HIV-1)p24 was examined after injection by three different routes: subcutaneously (s.c.), intraperitoneally (i.p.) and intravenously (i.v.). Both antigen-specific T-cell proliferation and serum antibody were induced by i.p. injection. In contrast, s.c. and i.v. injection of antigen resulted in specific antibody generation alone. Lympho-proliferative responses seen after i.p. injection were confined to splenocytes, and were greater after a low dose of antigen than after a high dose. p24-specific proliferation was not detected in lymph node cells. CD4:CD8 ratios were normal in lymph nodes and spleen at all times, irrespective of the dose or route of administration. p24-specific serum IgG antibodies were detected in all animals after the second injection of antigen. After s.c. and i.v. administration of high doses of antigen, the median antibody titres continued to rise after a third injection, but plateaued in animals injected by the i.p. route. In contrast, low doses of antigen given i.p. increased the median titre during and after the course of four injections. A low antigen dose given s.c. resulted in a plateau of median titre between the third and fourth injections. In i.v.-injected animals the median titre decreased between the third and fourth injections. IgG1 p24-specific antibodies were detected in all immunized mice, whereas IgM antibodies were detectable only following i.p. injection of antigen. PMID- 1769694 TI - Role of monocyte fucose-receptors in T-cell fibronectin activity. AB - T-cell fibronectin (FN) is a lymphokine produced by antigen- and mitogen activated T cells that agglutinates human monocytes at femtomolar concentrations. This extreme degree of activity derives from co-operative interactions between multiple FN domains and multiple monocyte integrin protein receptors. T-cell FN, like other FN, is a glycoprotein. The role interactions between T-cell FN carbohydrate and lectin-like monocyte surface receptors play in mediating T-cell FN activity was studied by determining the ability of monosaccharides to inhibit T-cell FN activity. L-Fucose and L-rhamnose significantly inhibited T-cell FN mediated monocyte agglutination at concentrations as low as 0.01 mM; D-glucose, D or L-galactose, D- or L-mannose and D-fucose were not inhibitory at 10-100 mM. This inhibition appeared to be due to interference with the binding of T-cell FN fucose residues to monocyte fucose receptors since: (i) treatment of T-cell FN with alpha-L-fucosidase abolished its agglutinating activity for human monocytes, while treatment with beta-D-galactosidase or with alpha-L-fucosidase in the presence of L-fucose had no effect; (ii) treatment of monocytes with alpha-L fucosidase did not affect their response to T-cell FN; and (iii) L-fucose or L rhamnose did not alter the expression of monocyte integrin FN receptors under conditions where T-cell FN-mediated monocyte agglutination was completely inhibited. In vivo, 1 mumol intracutaneous L-fucose inhibited expression of delayed hypersensitivity by 30% (P much less than 0.001); similar doses of L rhamnose inhibited responses by 10% (P less than 0.02). These data implicate a fucose receptor in monocyte response to T-cell FN, and suggest that T-cell FN is only one of the mediators involved in initiating delayed hypersensitivity reactions in vivo. PMID- 1769695 TI - Tissue-specific homing receptor mediates lymphocyte adhesion to cytokine stimulated lymph node high endothelial venule cells. AB - Lymphocytes bind to high endothelial venule (HEV) cells as the first step in the migration of these cells into lymph nodes (LN) and Peyer's patches (PP). In this study we isolated and cultured HEV cells from rat LN and investigated the effects of cytokines on the adhesiveness of these cells for lymphocytes. The results showed that lymphocytes from thoracic duct, spleen and LN adhered preferentially to the cultured LN HEV cells compared to cells isolated from the thymus and bone marrow. The adhesiveness of LN HEV cells for thoracic duct lymphocytes (TDL) was significantly increased in a dose- and time-dependent manner by pretreatment of the HEV cells with tumour necrosis factor-alpha (TNF-alpha), interferon-gamma (IFN-gamma) or interleukin-4 (IL-4). In contrast, pretreatment of HEV cells with IL-1, IL-6 or IL-7 did not alter the capacity of LN HEV cells to adhere lymphocytes. Furthermore, incubation of LN HEV cells with suboptimal doses of TNF and IL-4, IFN-gamma and IL-4, or TNF-alpha and IFN-gamma increased significantly the endothelial adhesiveness. Interestingly, although IL-1 alone did not promote the adhesiveness of HEV cells, the cytokine synergized with suboptimal doses of IL-4 and TNF-alpha to increase the adhesiveness. The adhesion of TDL to non stimulated and IL-4-stimulated LN HEV cells could be blocked specifically by treatment of lymphocytes with the LN homing-receptor-specific A.11.5 monoclonal antibody (mAb). In contrast, lymphocytes pretreated with the PP-homing receptor specific 1B.2.6 mAb or the antileucocyte common antigen (OX1) mAb adhered normally to the HEV cells. Taken together, these results indicate that the baseline and cytokine-stimulated bindings between lymphocytes and LN HEV cells are mediated by adhesive mechanisms that regulate lymphocyte migration into LN in vivo and provide strong evidence that cytokines are central mediators of organ specific lymphocyte migration. PMID- 1769696 TI - Genetic control of rat T-cell response to Staphylococcus aureus enterotoxins (SE). AB - Rat T cells, like those of mouse and human origin, respond strongly to superantigens (SAg) derived from Staphylococcus aureus enterotoxins A and B (SEA, SEB). Lewis and ACI are high responders, whereas Brown Norway (BN) is a low responder. Congenic and back-cross rat studies indicate that the degree of responsiveness is controlled by at least one non-MHC gene. The action of these genes may reside in the antigen-presenting cells (APC), since both Sephadex G10 non-adherent BN spleen cells and purified BN T cells in the presence of Lewis APC can respond well to SE. Responses to concanavalin A (Con A) and SEA generally segregate together in back-cross rats. Surprisingly, the degree of responsiveness to Con A and SEA is not correlated with the susceptibility to experimental allergic encephalomyelitis (EAE) either in independently derived inbred rat strains or in (Lewis x BN) x BN back-cross rats. PMID- 1769697 TI - Growth inhibition of tumour cells by a liposome-encapsulated, mycolic acid containing glycolipid, trehalose 2,3,6'-trimycolate. AB - In vivo growth of syngeneic tumour cells in the peritoneal cavity was strongly inhibited by intraperitoneal injection of a liposome-encapsulated, mycolic acid containing glycolipid, trehalose 2,3,6'-trimycolate (TTM), derived from a non pathogenic, acid-fast bacterium. Gordona aurantiaca. Peritoneal macrophages from mice after this treatment lysed tumour cells in vitro at a low effector/target ratio, and their culture supernatant inhibited tumour cell growth. The supernatant inhibited growth of not only tumour necrosis factor (TNF)-sensitive tumour cells, but also TNF-insensitive tumour cells. This inhibitory activity was enhanced by addition of lipopolysaccharide (LPS) to the culture medium of the macrophages. The macrophages released more superoxide (O2-), TNF and interleukin 1 (IL-1) on LPS triggering, and the releases of these compounds were further increased by addition of recombinant interferon-gamma (IFN-gamma) to the medium. Moreover, splenic T cells of TTM liposome-primed mice were found to produce eight times more IFN-gamma upon stimulation with LPS. These results indicated that priming with TTM liposomes resulted in strong activation of macrophages, which lysed tumour cells directly and also inhibited tumour cell growth by released factors. PMID- 1769698 TI - Flow cytometric studies of IL-4-stimulated expression of the CD25 antigen by quiescent human B lymphocyte subpopulations. AB - The membrane immunoglobulin (mIg) phenotype of high-density human tonsillar B lymphocytes which display elevated levels of the CD25 marker in response to treatment with interleukin-4 (IL-4) has been investigated. IL-4 promotes elevation of CD25 levels in B lymphocytes expressing membrane IgM (mIgM), mIgD, mIgG and mIgA. Three-colour flow cytometric analyses indicate that 25-35% of high density tonsillar B cells are simultaneously positive for mIgM, mIgD and CD25 following IL-4 stimulation. The hypothesis that B cells could respond to IL-4 by up-regulation of either CD23 or CD25, but not both simultaneously, was evaluated. Three-colour flow cytometric studies indicated that approximately one-third of the B-lymphocyte population was simultaneously positive for the CD19, CD23 and CD25 antigens following stimulation with IL-4. These data are consistent with the proposal that IL-4 can promote expression of CD23 and CD25 antigens in the same B lymphocyte. PMID- 1769699 TI - Suppression of the antigenic response of murine bone marrow B cells by physiological concentrations of glucocorticoids. AB - Data presented here indicate that the immature B cells of murine bone marrow (BM) may be as sensitive to glucocorticoids (GC) as are immature thymocytes, since physiological levels of the steroids significantly inhibited the response of these cells to trinitrophenylated lipopolysaccharide (TNP-LPS) in short-term culture. The in vitro response of B cells of the marrow to TNP-LPS was reduced more than 50% by concentrations of corticosterone and cortisol analogous to that found in plasma during stress and trauma. The more potent synthetic GC, dexamethasone (DX), caused a 50-80% decrease in plaque-producing cells at concentrations of 10(-6) and 10(-8) M. The same pattern of inhibition was noticed regardless of whether DX was added 24 hr prior or up to 48 hr after addition of antigen to culture. However, no inhibition in the response of B cells was noted when DX was added 72-96 hr after stimulation of the cultures. These effects were found to be specific for GC since neither testosterone nor progesterone at physiological concentrations inhibited the response, while the glucocorticoid receptor antagonist RU 38486 provided protection. A greater than 80% reduction in the proportion of B cells present in the DX-treated cultures was noted after 5 days, corresponding to the 80% inhibition of plaque-forming cell production observed at that time. This reduction in B cells was rapid since almost 40% of the B220+ cells were depleted within 12 hr of DX addition. These data indicate that physiological levels of GC can readily inhibit the capacity of BM to respond to antigen by depleting the cultures of immature B cells. PMID- 1769700 TI - Developmental expression of autoimmune target antigens during organogenesis. AB - A common factor existing among autoimmune target antigens was sought in association with their developmental expression during organogenesis. Autoimmunity against a certain organ was experimentally induced in rats by deliberate immunization with whole tissue extract of the respective organ. Histopathological changes in a target organ of the immunized rats were recorded, and tissue specificity of the raised autoantibodies was immunohistologically examined with tissue sections of normal adult rats. These immune sera were also reacted with tissue sections of a target organ in each stage of organogenesis, and the time of first expression of the target antigen was determined for each immune serum. As a result, induced autoantibodies were directed only to a limited number of tissue antigens, such as thyroid follicular antigens [gestation day 17 (17 GD)], salivary ductal antigens (18 GD), anterior pituitary antigens (21 GD), gastric parietal cell antigens (22 GD), neural myelin antigens (2 days after birth), retinal photo-receptor cell antigens (3 days after birth) and testicular germ cell antigens (4 weeks after birth). They were first expressed on the day indicated in parentheses. Comparing with the development of the immune system, which was monitored by demonstrating CD4- and/or CD8-positive cells in the developing thymus and spleen, a common feature of these potential autoimmune target antigens was found to be that they were expressed either in parallel with, or after, but never before, the development of the immune system. This observation might suggest why only a limited number of self antigens can be autoimmune target antigens among the enormously large number of antigen determinants existing in the whole extract of each organ. PMID- 1769701 TI - Intestinal mucus entrapment of Trichinella spiralis larvae induced by specific antibodies. AB - Entrapment of muscle larvae (ML) occurred in vitro when antibodies specific for Trichinella spiralis were added directly to intestinal mucus from normal non immunized rats or when mucus was collected from pups suckling a T. spiralis infected dam. Normal rat serum immunoglobulins failed to promote mucus entrapment and complement did not appear to play a part in the entrapment process. Differences were not observed in the efficiency of entrapment of ML by mucus harvested from different regions of the small intestine. Employing a panel of monoclonal antibodies (mAb) specific for excretory-secretory antigen (ESA), we attempted to dissociate antibody-mediated protection from mucus entrapment. We assessed mucus entrapment and rapid expulsion by these mAb in vivo, and observed protection in the absence of significant, immediate mucus entrapment in two cases. In addition, we measured mucus entrapment of ML in two in vitro assays. One assay employed intestinal mucus harvested from pups suckling dams that had been injected i.v. with a mAb. Results confirmed those obtained in vivo and indicated that antibodies were present in the intestinal lumina of passively immunized pups. In the second in vitro assay, mAb were added individually to mucus from pups suckling non-immunized dams. Results from these assays suggested that certain antibody isotypes may be processed in vivo in ways that influence, either positively or negatively, their abilities to cause mucus entrapment. PMID- 1769702 TI - The role of the antibody Fc region in rapid expulsion of Trichinella spiralis in suckling rats. AB - When an IgG2c monoclonal antibody specific for Trichinella spiralis muscle stage larvae was cleaved with pepsin to yield F(ab')2 fragments, the latter retained their capacity to cause mucus entrapment and rapid expulsion of larvae from the intestines of suckling rats. When fed to pups, the F(ab')2 fragments of this antibody and the F(ab')2 fragments of a similarly prepared IgG2a antibody caused mucus entrapment of muscle larvae (ML), demonstrating that trapping is not dependent upon the Fc region of the antibody molecule. Despite the fact that these two antibodies had similar specificities and that their F(ab')2 fragments caused larval entrapment in mucus, F(ab')2 fragments of the IgG2a antibody failed to protect rat pups. Fragments of the IgG2c antibody caused rapid expulsion when injected into pups, but the distribution of larvae was dramatically different from when the fragments were delivered orally. These results indicate that entrapment of T. spiralis in mucus is not in itself the cause of the expulsion. The more likely possibility is that antibody impedes a function of Trichinella spiralis that is related to the capacity of the parasite to reside in its epithelial niche. PMID- 1769703 TI - The first monoclonal anti-G1m(x) antibody: production and usefulness in haemagglutination-inhibition assay. AB - Murine monoclonal anti-human Ig allotype antibodies have been described for a limited number of specificities. Now the first monoclonal anti-G1m(x) antibody has been produced by fusion of lymph gland cells of a mouse injected with G1m(zax)-positive myeloma proteins with cells of the myeloma cell line SP2/0. Several limiting dilutions resulted in one antibody-producing hybridoma, clone 3A12. The specificity of monoclonal antibody (mAb) 3A12 in the direct haemagglutination assay, as well as in the haemagglutination-inhibition (HAI) assay, is described. Neither cross-reactivity nor nonspecific inhibition with G1m(x)-negative Ig was seen. Typing for the G1m(x) allotype with mAb 3A12 gave results which are identical to those obtained with the conventional human antisera. With the production of this mAb, it now is possible to discriminate between the four main G1m alleles not only by HAI assay but also by other assay systems, of which the preliminary results are promising. PMID- 1769704 TI - Iron chelators and lymphocyte proliferation. PMID- 1769706 TI - Dendritic cells and dinitrochlorobenzene (DNCB): a new treatment approach to AIDS. AB - Recent studies suggest that antigen-presenting cells (dendritic cells) may play a key role in the pathogenesis of human immunodeficiency virus (HIV) infection. This observation makes new immunomodulatory treatment strategies desirable. Topical dinitrochlorobenzene (DNCB) is discussed as a possible treatment modality in the context of its proven therapeutic uses and its immunomodulatory effect on dendritic cells. DNCB may be a safe, inexpensive, and widely available treatment option for HIV disease. PMID- 1769705 TI - MHC antigens on human tumors. AB - MHC class I antigens on tumor cells are expected to play an important role because they regulate the sensitivity to antitumoral immunological mechanisms. Overall or selective qualitative or quantitative changes in MHC molecules may modify the recognition of tumor cells by components of the immune system. It seems clear that MHC antigen expression on tumor cells is important in triggering the immune response by autologous lymphocytes. A deficiency in or lack of MHC class I antigens may have profound effects on T and NK cell activity. In experimental models, variation in the expression of MHC class I antigens has been shown to exert a decisive influence on local tumor growth and metastasis. However, there is little information about the influence of selective loss of individual locus products on the behavior of human tumor cells. Total and selective HLA losses have been found in a large variety of tumors, and different mechanisms have been shown to be responsible for these changes. In some examples, HLA losses are associated with a poor degree of tissue differentiation and poor prognosis. In other tumors, however, no such association has been found. We do not know whether HLA class II expression in neoplastic cells plays an immunological role, although, with the exception of melanoma, HLA class II expression is more frequently observed in tumors with a more favorable prognosis. Finally, there is no doubt that we need to learn more about how to manipulate the expression of MHC class I and II antigens in human tumors, in order to stimulate immune response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769707 TI - Antigen activation of human B lymphocytes bearing artificial antigen receptors. AB - When highly purified human and murine B cells are challenged in vitro with certain so called "T cell-independent" activators such as the polyclonal B cell activator lipopolysaccharide (LPS) or the clonally specific B cell activator dinitrophenyl-conjugated polymerized flagellin (DNP-POL), mouse, but not human, cells differentiate into immunoglobulin-secreting cells. However, results from this study show that DNP-POL can cause human B cell differentiation in a T cell independent manner when the antigen is concentrated onto the cells via artificially incorporated palmitate-modified anti-DNP mouse IgA molecules. This response is comparable in magnitude to that induced by a T cell-dependent polyclonal B cell activator, pokeweed mitogen, in unfractionated mononuclear cell cultures, suggesting that DNP-POL induced polyclonal B cell differentiation. DNP POL binding to the artificial receptor molecules on B cells did not cause cellular proliferation, even in unfractionated mononuclear cell populations. These results are similar to those obtained in previous studies using mouse B cells in which the artificial receptor was unable to act as a transmembrane signaling element. From these studies, we conclude that B cells express clonally unrestricted, presumably low-avidity, endogenous receptor for POL, and that signaling through this receptor activates B cell differentiation but not cell proliferation. PMID- 1769708 TI - Splenic immunomodulation with swimming-induced stress in rats. AB - In order to determine the effects of swimming-induced stress, young male Wistar rats swam for a single session of 2 h duration, or for one 2-h session a day for five consecutive days. The absolute number of splenic mononuclear cells and the in vitro proliferation of mitogen-stimulated (PHA) T lymphocytes were studied. A single swimming session did not significantly diminish the number of splenic mononuclear cells, but it did significantly reduce splenic T-lymphocyte proliferation. This effect on T-lymphocyte proliferation was significantly blocked, in part, by subcutaneous injection of naltrexone before a swimming session. It was not significantly blocked by pre-exercise oral administration of aminoglutethimide. Repeated swimming sessions induced no significant changes in immune parameters. In conclusion, these data suggest that immunosuppression seen with a single swimming-induced stress period may partly be due to endogenous opioids, and that repetition of the swimming session reduced swimming-induced immunomodulation. PMID- 1769709 TI - Usefulness of bronchoalveolar cell profile in early detection of canine lung allograft rejection. AB - To evaluate the value of a bronchoalveolar cell profile in the early detection of canine lung allograft rejection, bronchoalveolar lavages were done serially in mongrel dogs before and after single lung transplantation. The dogs were divided into 3 groups. In group 1, neither donor nor recipient dogs were treated with cyclosporine. In group 2, only donors were treated with cyclosporine, orally at a single dose of 20 mg/kg/day for 3 days prior to single lung transplantation. In group 3, only recipients were treated with cyclosporine (20 mg/kg/day) for 9 days after single lung transplantation. A marked increase in the number of bronchoalveolar cells and their cell differentials, and of major histocompatibility complex (MHC) class II-positive cells obtained from the grafted lungs after lung transplantation, was seen in groups 1 and 2. The changes in bronchoalveolar cell profile obtained from the rejecting grafted lungs were significantly different from those obtained from the normal and native lungs (P less than 0.05). In group 3, the bronchoalveolar cell profile obtained from the grafted lungs did not significantly differ from those present in normal and native lungs during the period of cyclosporine treatment after lung transplantation. On various days after withdrawal of cyclosporine treatment, bronchoalveolar cell profiles obtained from the grafted lungs showed similar changes to those observed in groups 1 and 2. Abnormal changes in bronchoalveolar cell profiles obtained from the grafted lungs heralded the appearance of abnormalities detected by chest X-ray films. Our results indicate that serial measurements of bronchoalveolar cell profile may serve as a useful means for early detection of canine lung allograft rejection. PMID- 1769710 TI - Two different Fc gamma receptor-dependent cytotoxic mechanisms triggered by monoclonal immunoglobulins. AB - It is known that the receptors for the Fc portion of IgG molecules (Fc gamma R) are widely distributed in cells of the immune system. The expression of Fc gamma R enables monocytes and neutrophils to destroy antibody-coated target cells through the antibody-dependent cell-mediated cytotoxicity (ADCC) mechanism. In addition, the interaction of immune complexes or aggregated IgG with monocytes or neutrophils led to the lysis of nonsensitized target cells in a process known as nonspecific cytotoxicity (NSC). Despite that ADCC and NSC are both triggered through Fc gamma R, the cytolytic mechanism involved in each reaction is different. In this paper we analyze the ability of human monoclonal IgG1, IgG2, IgG3 and IgG4 to induce ADCC and NSC. Our results demonstrate that each IgG subclass is able to induce both, NSC and ADCC, mediated by monocytes or neutrophils, indicating that there is no correlation between IgG subclass specificity and the ability to activate both mechanisms. PMID- 1769711 TI - New possibilities in the therapy of immunodeficiency diseases. PMID- 1769712 TI - Gastroduodenal mucosal defence and mucosal protective agents. PMID- 1769713 TI - De novo biosynthesis and localization of inhibin in marmoset (Callithrix jacchus) and rat epididymis. AB - Using specific polyclonal antibodies generated against a 13 Kd human testicular inhibin, immunocytochemical localization was carried out in epididymis of intact and castrated marmoset monkey and rat epididymis. Inhibin was found to be present in the cytoplasm of epithelial cells of caput, corpus and cauda epididymis. The intensity of staining and pattern of distribution did not change following castration. Further, the in vitro biosynthesis of inhibin studied by incorporating 3H-leucine and precipitating it with specific antibody indicated maximum biosynthesis in the corpus epididymis in case of marmosets and cauda in case of rats. Following castration in rats, the epididymal tissue still retained the capacity to biosynthesize inhibin. These studies indicate that marmoset and rat epididymis are capable of biosynthesizing/absorbing inhibin and whose synthesis does not depend on androgens. PMID- 1769714 TI - Isolation and analysis of surface antigens of filarial nematode Setaria digitata. AB - Surface antigens of adult filarial parasite S. digitata was isolated by employing techniques from manual dissection to treatment with detergents. Among the surface antigen preparations (SAPs), the activities of marker enzymes such as alkaline phosphatase, adenosine triphosphatase and 5' nucleotidase were higher with that isolated by triton X-100 technique (SAP2). On SDS-PAGE, the SAP2 has three major proteins with molecular weights 17, 29 and 36 KD which were consistent with the PBS soluble cuticular proteins (SAP1). Besides these, few other minor protein bands were also observed with the other SAPs. All SAPs were antigenic and showed positive reaction against antiserum to SAP2, and the results confirmed the SAP2 as a better preparation. The release of 29 KD surface protein during in vitro culture of adult parasite and its cross-reactivity with antiserum to surface antigens revealed the possible natural shedding of surface molecules into the host system. PMID- 1769715 TI - Mutagenic activity of south Indian food items. AB - Dietary components and food dishes commonly consumed in South India were screened for their mutagenic activity. Kesari powder, calamus oil, palm drink, toddy and Kewra essence were found to be strongly mutagenic; garlic, palm oil, arrack, onion and pyrolysed portions of bread toast, chicory powder were weakly mutagenic, while tamarind and turmeric were not. Certain salted, sundried and oil fried food items were also mutagenic. Cissus quadrangularis was mutagenic, while 'decoctions' of cumin seeds, aniseeds and ginger were not. Several perfumes, essential oils and colouring agents, which are commonly used were also screened and many of them exhibited their mutagenic potential by inducing the 'reverse mutation' in Salmonella typhimurium tester strains. PMID- 1769716 TI - Carcinogenic potential of Indian alcoholic beverage (country liquor). AB - Epidemiological studies reveal that alcohol consumption is a risk factor for the cancer of the mouth, larynx, esophagus and various other organs. Of the various alcoholic beverages consumed in India, country liquors are widely consumed and that too by the economically weak section of the society. The present paper describes the experiments designed to investigate the effect of one brand of country liquor from Maharashtra State, India (which was found to be more potent in our earlier mutagenicity studies) for its carcinogenicity in two strains of mice and Syrian golden hamsters. The experimental animals received 10% liquor in drinking water from 2 months of age for 16 months. One percent ethanol treated animals served as positive controls. Together with long term bioassays, the transplacental carcinogenic effect of country liquor in the offspring of treated mothers, as well as in the breeders themselves was also investigated. Pregnant mothers were fed 10% liquor through drinking water from 12th day of gestation till weaning of the progeny. Then offspring were allowed to live without further treatment and mothers continued to get liquor treatment. In long term bioassays, liquor caused 22% total tumor incidence in male BALB/c mice and 28% in male Swiss mice. In female Swiss mice and in hamsters, liquor did not show any pronounced effect on tumor incidence. Similar negative results were obtained in case of offspring of treated mothers, but the offspring of liquor treated mothers had higher mortality prior to weaning as compared to those of untreated mothers. PMID- 1769717 TI - Influence of adenosine receptor antagonists, aminophylline and caffeine, on seizure protective ability of antiepileptic drugs in rats. AB - Interaction of methylxanthines, aminophylline (AMP) and caffeine (CAF) on seizure protective ability of various antiepileptic drugs (AEDs), diphenylhydantoin (DPH), phenobarbitone (PB), diazepam (DZP), sodium valproate (SV) and ethosuximide (ESM) was investigated in rats. In the maximal electroshock seizure (MES) test, ED100 doses (mg/kg, ip), against hind limb tonic extension (HLTE) were DPH, 20; PB, 10; DZP, 10 and SV, 300. The interaction of AEDs with AMP (100 mg/kg, ip) reduced the seizure protection afforded by DPH, PB and DZP to 20%, while the efficacy of SV remained unimpaired. Interaction with CAF (200 mg/kg, ip) abolished the seizure protection by DPH and DZP, reduced that by PB to 20%, while the protective effect of SV was unchanged. In pentylenetetrazole (PTZ, 70 mg/kg, sc) induced seizure test, ED100 doses (mg/kg, ip) against clonic convulsions were PB, 10; DZP, 1; SV, 300 and ESM, 200. Complete seizure protection against clonic convulsions following SV or ESM was not significantly influenced by either AMP or CAF, whereas the protective effect of PB and DZP was reversed. SV and ESM showed a qualitative departure in their anti-seizure activity profiles following interaction with either AMP or CAF when compared with the other AEDs. PMID- 1769718 TI - Influence of cerebro-spinal fluid of picrotoxin kindled rats on seizure susceptibility and locomotor activity of recipients. AB - Repeated picrotoxin administration (ip) in subthreshold doses in rats resulted in kindling of generalized seizures. Decrease of locomotor activity in kindled rats occurred in interictal periods. Intra-cerebroventricular microinjection to intact recipients of cerebrospinal fluid (CSF) of kindled but not intact rats or those after acute picrotoxin-induced convulsions, induced a decrease of locomotor activity and severity of acute picrotoxin induced seizures. These effects of CSF were blocked by naloxone pretreatment and were absent after injection of CSF to which protease inhibitors were not added. It is concluded that the release of endogenous opioid peptide substance(s) takes place in CSF of kindled animals which cause the interictal decrease of locomotor activity and may play the role of endogenous anticonvulsive factors controlling epileptic activity induction. PMID- 1769719 TI - Agrobacterium mediated genetic transformation of chickpea, Cicer arietinum L. AB - In leaf and stem explants of chickpea, wild type strains of Agrobacteria were able to induce tumors. These tumors were capable of phytohormone independent growth. A supervirulent strain A281 was found to be most effective. Thus, using an agrobacterium R1601, which carries genes conferring supervirulent phenotype along with a plant selectable marker gene (npt II), transformed calli of chickpea were selected in the presence of 100 micrograms/ml level of kanamycin. Molecular analyses of genomic DNA from transformed calli confirmed the integration of the marker gene into chickpea genome. PMID- 1769720 TI - Immunosuppression due to chronic Lantana camara, L. toxicity in sheep. AB - Five sheep were intoxicated with powdered L. camara, leaves at the rate of 200 mg/kg body weight daily for 110 days and another group of four sheep were drenched with distilled water daily for equal number of days which acted as control. The cell mediated immunity of intoxicated and control sheep was assessed with the help of 2,4-dinitrofluorobenzene skin sensitivity test and graft-versus host reaction and the antibody forming potential of both the groups of animals was measured by haemagglutination against chicken red blood cells antigen. In addition, the phagocytic activity of splenic reticulo-endothelial cells was analysed by nitro blue tetrazolium test. The results indicated significant reduction of both cellular and humoral immunity due to L. camara toxicity. The non-specific phagocytic activity of splenic reticulo-endothelial cells also showed significant reduction due to L. camara, L. intoxication. The present communication constitutes the first report of in vivo immunosuppression due to chronic lantana poisoning in sheep. PMID- 1769721 TI - Alterations in plasma sodium and potassium levels following chronic oral ingestion of lead, mercury and cadmium in male albino rats. AB - Adult male albino rats were orally administered 0, 25, 50 and 100 ppm of lead nitrate, mercuric chloride and cadmium chloride for 60, 120 and 180 days. The plasma sodium levels were decreased in rats exposed to varying doses of lead and mercury up to 180 days, while animals which consumed cadmium chloride showed an increase in sodium levels. In lead and mercury treated animals, plasma potassium levels were increased up to 180 days. The levels were decreased in cadmium exposed rats. These observations suggest that chronic exposure to these heavy metals considerably influences plasma sodium and potassium levels depending on the dose and duration of exposure. PMID- 1769722 TI - Experimental pathogenicity of mollicutes from bovines with reproductive disorders in rabbit fallopian tube organ culture. AB - Mollicutes (10) belonging to Mycoplasma and Acholeplasma isolated from various reproductive disorders were tested in rabbit fallopian tube (FT) organ culture. Parameter for describing pathogenic status of Mollicutes in rabbit FT organ culture included multiplication of organisms, and its effect on ciliary activity along with histopathological changes in FT explants. M. mycoides (LC, Y-Goat), M. bovoculi, M. bovigenitalium, Mycoplasma sp. and A. oculi were categorized as pathogenic; A. axanthum and A. laidlawii as mildly pathogenic; and M. bovis, M. arginini. and A. granularum, as nonpathogenic to rabbit FT organ culture. Thus, rabbit FT organ culture is recommended for use as a suitable and economical in vitro model to assess the pathogenicity of Mollicutes of reproductive tract origin. PMID- 1769723 TI - Non-linear pattern of radiation induced lipid peroxidation is not affected by vitamin E, Fe2+ ions and molecular oxygen. AB - Results of the present study on liposomes have clearly shown that non-linear pattern of radiation-induced lipid peroxidation was not changed even in the presence of vitamin E, Fe2+ ions or molecular oxygen. These results are important from biological point of view as lipid peroxidation is used as a measure of membrane damage. PMID- 1769724 TI - Effect of alpha-tocopherol on doxorubicin-induced changes in rat liver and heart microsomes. AB - Rats were treated with doxorubicin (2.5 mg/kg body wt, iv) once a week for 8 weeks. Alpha-Tocopherol (400 mg/kg body wt/day) was co-administered orally for 2 months. Cytochrome-P450 (Cyt-P450) and Cytochrome-b5 (Cyt-b5) levels decreased significantly in doxorubicin treated rats. Significant decreases were observed in glucose-6-phosphatase, Cyt-P450 and Cyt-b5 reductase activities. In vitro lipid peroxidation study showed that alpha-tocopherol significantly minimises the lipid peroxide formation by doxorubicin. There was a significant change in microsomal cholesterol and phospholipid levels. Alpha-Tocopherol co-administration reduced the alterations in xenobiotic metabolising system and microsomal lipid levels. The results were discussed with reference to drug metabolising enzymes, lipid peroxidation and antioxidant nature of alpha-tocopherol. PMID- 1769725 TI - Ancylostoma ceylanicum: immunological consequences after anthelmintics therapy in hamsters (Mesocricetus auratus). AB - Alterations in immunological response before and after chemotherapy were investigated in hamsters infected with A. ceylanicum. Four reference anthelmintics mebendazole, albendazole, levamisole and pyrantel pamoate and one newly synthesized anthelmintic compound 81-470 were used. Drugs in curative doses were administered on day 30 post infection and the humoral response was assessed by counter immunoelectrophoresis and ELISA and cell mediated immunity by delayed type of hypersensitivity reaction. In infected untreated animals the precipitins appeared on day 30 and remained prominent till day 250 post infection. However with ELISA the antibodies could be demonstrated as early as day 3 post infection and peaked on day 40. Delayed type of hypersensitivity could not be demonstrated during the course of infection. All the drugs including Comp. 81-470 were effective in removing the parasites. Precipitin antibodies were only demonstrable till day 60 post treatment. ELISA depicted gradual depletion of antibody titre following treatment with mebendazole, albendazole and pyrantel pamoate. In levamisole treated hamsters the initial fall in serum antibody was restored by day 20 post treatment. With Compound 81-470, immediately after the treatment there was sharp rise in antibodies concentration followed by gradual fall and on day 60 post treatment the titre was still higher than the pretreated titre. Thus the study denotes that effective therapy will bring down immune responses of the host if the drug possess no immunopotentiating action. Therefore the immune parameters may be used as supportive indicator to successful therapy particularly in systemic parasites where parasitic forms are nondemonstrable in excreta or blood. PMID- 1769726 TI - Relationship between acetylcholinesterase and monoamine oxidase in brain regions of Oreochromis mossambicus exposed to phosalone. AB - The level of acetylcholinesterase (AChE) in brain regions of O. mossambicus at different intervals showed the extent of phosalone toxicity. Significant inhibition of AChE at the end of 96 hr in the brain regions was observed. In contrast to AChE inhibition, the monoamine oxidase (MAO) activity showed significant increase in the regions of cerebral hemispheres, dien/mesencephalon, cerebellum and medulla oblongata. The increase of MAO activity in the brain regions under phosalone toxicity is considered to be one of the mechanisms to maintain the amines level in O. mossambicus. PMID- 1769727 TI - Human xeroderma pigmentosum AC gene product contains a zinc-finger domain. PMID- 1769728 TI - AGG----AGT mutation in the codon number 249 of p53 gene is the frequent cause of liver cancers in China and South Africa. PMID- 1769729 TI - Selection of Saccharomyces cerevisiae mutants that overexpress heterologous proteins. PMID- 1769730 TI - Polymerase chain reaction amplification of messages for growth factors in cells from human bronchoalveolar lavage fluids. AB - Genetic messages for polypeptide growth factors were assessed in human alveolar macrophages, obtained by bronchoalveolar lavage (BAL) from normal subjects (N = 3) and from patients with pneumonia (N = 3), pulmonary lymphoma (N = 3), and idiopathic pulmonary fibrosis (N = 3). Complementary DNAs (cDNAs) were prepared by reverse transcription of the RNA extracted from alveolar macrophages before and after culture on a plastic surface. The cDNAs encoding 10 different growth factors were amplified for electrophoretic analysis by polymerase chain reaction with a pair of 3' and 5' primers specific for each factor. Alveolar macrophages from all normal subjects and patients expressed the messages for interleukin-1 beta and transforming growth factor-beta. Alveolar macrophages from some normal subjects also contained message for insulin-like growth factor-1. Alveolar macrophages from six of nine patients with lung diseases also expressed messages for one or more additional growth factors, including epidermal growth factor, transforming growth factor-alpha, interleukin-1 alpha, and platelet-derived growth factor. The polymerase chain reaction technique thus permits determination of the profile of growth factors contributed to pulmonary reactions by alveolar macrophages, which may be important in pulmonary healing and fibrosis. PMID- 1769731 TI - Saturability of esterification pathways of major monohydroxyeicosatetraenoic acids in rat basophilic leukemia cells. AB - The principal monohydroxyeicosatetraenoic acids (HETEs), 5-, 12-, and 15-HETE, which can be produced by rat basophilic leukemia (RBL-1) cells, are also esterified by these cells. Exogenously added 5-, 12-, and 15-HETE were rapidly incorporated as esters in RBL cells, reaching plateau levels within 25 min. In incubations in culture medium with protein added, all three HETEs were essentially completely metabolized within 24 h. 5-HETE was esterified more rapidly and to a greater extent than 12-HETE or 15-HETE when these were incubated together with RBL cells, indicating some degree of selectivity in the esterification pathways. When arachidonic acid (AA) was incubated in increasing concentrations with constant concentrations of 15-HETE and RBL cells, the free 15 HETE concentration increased and esterified 15-HETE concentration decreased markedly at AA: 15-HETE molar ratios above 9. 15-HETE esterification in RBL cells was also markedly inhibited by the polyunsaturated fatty acids, eicosatetraynoic and eicosapentanoic acids, but not by oleic or linoleic acids. In separate experiments with unlabeled and radiolabeled substrates, the extent of incorporation of esterified HETE in RBL cells decreased at higher concentrations of 15-HETE and AA, which showed that the pathway was saturable. The shapes of the curves for these fatty acid inhibitors suggest a concentration-dependent two compartment pathway of esterification. These data indicate that the HETEs and other 20 carbon fatty acid substrates probably compete for activity of a specific arachidonyl-CoA synthetase, which is the first and rate-limiting step for esterification of arachidonic acid by many human cells. Esterified 15-HETE was found to be predominantly in the phosphatidylethanolamine fraction of RBL cell lipids. PMID- 1769732 TI - Acid-stable protease inhibitor in chronic phase of carrageenin-induced inflammation in rats. AB - The activity and kinetics of acid-stable protease inhibitor (ASPI) were investigated in the chronic phase of carrageenin-induced inflammation in rats. The ASPI activity was 19.6 +/- 3.1 units/ml in the plasma and 15.4 +/- 2.1 units/ml in the inflammatory exudate. The plasma value was significantly higher than that of the control (11.6 +/- 1.3 units/ml). A kinetics study was performed using purified and radiolabeled rat plasma ASPI, whose NH2-terminal amino acid sequence was Ala-Val-Leu-Pro-Gln-Glu-Asn-Glu-Gly-X-Gly-Ser-Glu-Pro-Leu-Ile-Thr Gly-Th r-Leu- Lys-Lys-Glu-Asp-Ser-Asn-Gln-Leu-Lys-Tyr-Ser-Glu-Gly-Pro. The half life of the distributive phase was 4.3 +/- 0.4 min and that of the postdistributive phase (biological half-life) was 42.2 +/- 9.2 min in inflammation. There was no significant difference compared with the values in the control (3.9 +/- 0.4 min and 40.7 +/- 6.5 min, respectively). It appeared that the increase in ASPI in inflammation was not due to prolonged excretion of the inhibitor but to an increased production of it, and ASPI was rapidly distributed to the fluids and tissues. PMID- 1769734 TI - [Etiology, pathophysiology and clinical significance of hereditary fructose intolerance]. AB - Due to repeatedly described incidents in patients with undiscovered hereditary fructose intolerance, the application of fructose and sorbit-containing parenteral solutions is a topic vehemently discussed. This paper presents a survey of the literature dealing with the inborn defect of fructose-1-phosphate aldolase. The physiology and pathophysiology of fructose metabolism are described as well as the clinical appearance and diagnostic possibilities. The acute course of a fructose incompatibility is determined by a threatening decrease in the blood glucose level, which is attributed to the inhibition of several enzymes of glycolysis and gluconeogenesis by an intracellular accumulation of fructose-1 phosphate. Within hours a global functional breakdown of organs, which normally have the enzyme, occurs. The impairment of the liver function finds expression in a severe coagulopathy, the damage of the kidney leads to anuria. In chronic oral fructose supply, damage of the liver and small intestinal mucosa with corresponding gastrointestinal symptoms determine the clinical course. Concerning diagnosis, contrary to the liver biopsy and the fructose tolerance test, the mucosal biopsy with determination of fructose-1-phosphate aldolase activity has the advantage of greater specificity and is better tolerated by the patient. A total abstinence to fructose and sorbitol-containing solutions is not considered to be necessary when the rarity of the illness is taken into account and certain precautions are taken. These include a specific anamnesis of nutrition as well as a total abstinence from fructose and sorbitol in infants and in the unconscious patient. For clinical routine a simple fructose tolerance test is suggested. PMID- 1769733 TI - Kojic acid scavenges free radicals while potentiating leukocyte functions including free radical generation. AB - The effects of kojic acid, a compound that suppresses melanogenesis and is widely consumed in the Japanese diet with the belief that it is beneficial to health, were investigated on several aspects of leukocyte function. Kojic acid significantly decreased the levels of reactive oxygen species (ROS) (O2-, H2O2, OH.) generated by neutrophil and by a cell-free ROS-generating system. In contrast, it significantly enhanced neutrophil phagocytosis and ROS generation, and lymphocyte proliferation stimulated by phytohemagglutinin. In addition, calcium concentration, [Ca2+]i in human neutrophils was increased in the presence of kojic acid. These results suggest that kojic acid is a favorable agent in terms of host defense in that it enhances a number of activities of leukocytes, but scavenges ROS excessively released from cells or generated in the tissues or blood vessels that are potentially injurious to host tissues. PMID- 1769735 TI - [Effect of L-carnitine supplementation on lipid metabolism of renal failure, dialysis-dependent children and adolescents]. AB - In six renally insufficient children and adolescents (age: 8-21 years) on hemodialysis the effect of L-carnitine supplementation at two dose levels (10 mg/kg/d vs. 100 mg/kg/d) on parameters of lipid metabolism was investigated. L Carnitine substitution was carried out over four weeks per dose level. Under this regime a significant increase of the serum carnitine concentration occurred together with a decrease in the AC/FC-ratio (x: 1.59 to x:0.83). During the same period a significant decrease in serum triglyceride levels as well as an increase in serum HDL-cholesterol were observed. An inverse correlation (r = -0.63; p less than 0.0008) was found between HDL-cholesterol and the AC/FC-ratio. L-carnitine supplementation and its increasing effect on HDL-cholesterol in patients with renal insufficiency may be considered as antiatherogenic. PMID- 1769736 TI - [Free fatty acids as an indicator of preoperative stress and effects of premedication with flunitrazepam, morphine and promethazine on blood fatty acid level]. AB - We investigated the influence of different oral premedication given to 50 male and 50 female patients on the plasmaconcentration of free fatty acids (FFA) as an indicator of preoperative stress and compared them with patients given no premedication at all. FFA are measured with a gaschromatographic method. FFA were measured four times: Time 1 (t1): the first day in hospital, t2: After the anesthesiologist's visit, t3: In the morning of the operation, t4: Before starting anesthesia. The groups are: I. 20 male and 20 female patients without any premedication; II. every 10 patients of both sexes given 2 mg Flunitrazepam (p.o.) on the preoperative night; III. every 10 patients given Morphium (0.15 mg i.m.) and Promethazin (50 mg i.m.) and, last, IV. every 10 patients getting the same premedication as group II and IV. 98 patients had a significant decrease of FFA from t1 to t2. The FFA of all increased from t2 to t3. Moreover, there was an increase from t3 to t4. We conclude from this that no premedication we had investigated is able to lower the physiological and biochemical stress-response as far as shown by FFA. Apart from myristic-acid, there was no difference in the groups. However, with no statistic significance, both 'Flunitrazepam-groups' showed the lowest increase. Further, in 28 from 32 cases, females had a higher FFA-level than males (in 16 cases with statistical significance). PMID- 1769737 TI - [Postoperative small intestinal motility after abdominal surgery]. AB - After abdominal surgery there is a postoperative small bowel ileus. We evaluate whether the duration of the small bowel ileus is depending on the kind of surgery or not. Over a needle catheter jejunostomy a 3-tip transducer was placed into the distal jejunum. At the end of the operations a pressure detector was connected to measure the intraluminal pressure continuously over five days. Group A consisted of three patients undergoing explorative laparotomy because of inoperable gastric cardia cancer, and group B of eight patients who underwent gastrectomy. In none of the patients a normal empty stomach motility pattern, determined by the activity of a migrating myoelectric complex (MMC) was detectable. In group A the normal MMC-activity returned after 24 +/- 4.5 h and in group B after 82 +/- 25 h. Therefore the duration of the loss of the interdigestive myoelectric complex appeared to be dependent upon the type of surgery. PMID- 1769738 TI - [Thrombocytapheresis with the (Baxter) A 201 cell separator--initial data of biocompatibility]. AB - The cell separator A 201 was a new platelet pheresis prototype designed to carry out a discontinuous apheresis while platelet-rich plasma (PRP) is sampled continuously. After donation, a platelet concentrate (PC) and a fresh frozen plasma was collected from the PRP by the plasma cell-C device. The PC contained 2.6 +/- 0.7 x 10(11) platelets with a leucocyte contamination of 3.9 +/- 3.9 x 10(8) and an erythrocyte contamination of 3.0 +/- 3.0 x 10(8). The fresh frozen plasma was nearly cell-free. Prior, during and after apheresis we analysed hemolysis and coagulation parameters. There was no evidence for hemolysis. The analysis of the coagulation factors and of the Thrombin-Antithrombin III-complex, however, gave a hint of an activation of coagulation. PMID- 1769739 TI - [M. Wiesel, et al: Tumor cell separation using the cell saver and membrane filter passage]. PMID- 1769740 TI - Tumor necrosis factor production by human granulocytes. AB - Human polymorphonuclear leukocytes kill WEHI 164 cells in an 18-hour 51Cr release assay. Antibody to human tumor necrosis factor (TNF) blocks the lysis of targets mediated by human granulocytes. Resting granulocytes produce an undetectable amount of TNF, if any. Granulocytes stimulated with Staphylococcus aureus release 250-500 U/ml TNF alpha. The specificity of the released TNF in the WEHI 164 cytotoxicity assay was confirmed by using neutralizing anti-TNF alpha monoclonal antibodies. The thymidine uptake of endothelial cells was inhibited by granulocyte-derived TNF. The identity of TNF alpha was further confirmed by molecular weight determination, by gel filtration on Sephacryl S-200, with a result of approximately 44,000. Besides their antimicrobial capacity, therefore, granulocytes may contribute to tumor rejection, inflammation and septic infections by releasing TNF. PMID- 1769741 TI - Induction of auto-antibody formation in C3H/HeJ mice by cobra venom factor. AB - Recently, we demonstrated that lipopolysaccharide (LPS)-hyporesponsive C3H/HeJ mice show a very high background number of splenic antibody-forming cells with specificity for bromelain-treated isologous erythrocytes. This background level was not or only slightly enhanced by LPS injection. In this paper it is reported that the existing response of C3H/HeJ mice is about doubled by treatment of the animals with cobra venom factor (CVF). This increase is very similar to the LPS induced potentiation of the auto-antibody response of C3H/Tif and other LPS responder mice. The absence of auto-antibodies in the sera of CVF-treated C3H/HeJ mice, however, points at a different mechanism of B cell activation. The mediation of the CVF-induced stimulation of the B cells of C3H/HeJ mice by covalent C3-glycoprotein complexes and the need for an additional stimulus is discussed. PMID- 1769742 TI - Experimental lung injury induced by trimellitic anhydride inhalation on guinea pigs. AB - Trimellitic anhydride (TMA) causes lung injury by inhalation exposure in humans. In order to investigate more precisely the mechanism of lung injury by TMA, an experimental animal model of TMA-induced lung injury was established. Guinea pigs were intramuscularly injected with trimellitylated bovine serum albumin (TM BSA) with complete Freund's adjuvant (CFA). Appreciable amounts of antibodies against TM epitopes were detected in the sera of these animals. Guinea pigs that were passively sensitized with anti-TM antisera as well as the actively immunized animals developed hemorrhagic pneumonitis after TMA inhalation. It is well recognized that hyperimmune antisera of guinea pigs contain two subclasses of IgG antibodies, IgG1 and IgG2, which are known as homocytotropic and heterocytotropic antibodies, respectively. To determine the role of these antibodies in the airway injury with alveolar hemorrhages, they were isolated by gel filtration and by ion exchange column chromatography, and the guinea pigs that were sensitized with each of these antibodies were exposed to TMA inhalation. The extent of lung injury in these animals was quantitatively determined by the measurements of lung extravasation of Evans blue dye injected intravenously after TMA inhalation. Significant increases in the extravasation of dye were observed in both animal groups sensitized with IgG1 and IgG2 antibodies. In addition, results obtained with heat-treated antisera and IgG1 antibody did not significantly differ from those obtained with untreated samples. These results suggest that the lung injury resulting from TMA inhalation exposure can be induced with humoral antibodies, not only IgG1 but also IgG2, and that at least two types of allergic reactions are involved in the pathogenesis of lung injury. PMID- 1769743 TI - Characterization of a monoclonal antibody (RJ5) against the immunodominant 41-kD antigen of Candida albicans. AB - A 41-kD component of Candida albicans was identified to be the major antigen radioimmunoprecipitated by antibodies with increased titers in the sera of patients with invasive candidiasis. A mouse monoclonal antibody (RJ5) was generated which, by immunoblotting, showed positive reactivity to the immunoprecipitated 41-kD component. By two-dimensional gel electrophoresis and immunoblotting, MoAb RJ5 was shown to react with different isoforms of the 41-kD component with pI values from 6.1 to 6.9. Furthermore, MoAb RJ5 showed positive reactivity to cytoplasmic antigens of C. albicans by frozen section and immunoperoxidase staining. By SDS-polyacrylamide gel electrophoresis and immunoblotting, MoAb RJ5 showed no cross-reactivity to antigens of Candida tropicalis and Candida parapsilosis. The epitope of the 41-kD molecule recognized by MoAb RJ5 was susceptible to treatment of proteinase K at concentrations of greater than or equal to 5 micrograms/ml, and was relatively resistant to periodate oxidation with concentration of NaIO4 up to 20 mM. This MoAb may be useful in the purification and characterization of the immunodominant 41-kD antigen of C. albicans, and as a probe in the detection of Candida antigens in the sera of patients with invasive candidiasis. PMID- 1769744 TI - Immunocytochemical determination of the role of alveolar macrophages in endotoxin processing in vitro and in vivo. AB - Endotoxin (lipopolysaccharide or LPS) inhalation has been implicated in increased pulmonary edema, most likely due to activation of an inflammatory response. The purpose of this study was to determine the cell types in the lung responsible for binding inhaled lipid A from Enterobacter agglomerans LPS. Five-hour exposures of aerosolized lipid A resulted in measurable pulmonary edema in hamsters, as determined by the accumulation of lung water. Immunocytochemistry was used to localize the inhaled lipid A in the cell types in the lung. Alveolar macrophages had decreased levels of lipid A as compared to unexposed controls, suggesting a possible metabolism by the macrophages. In vitro exposure of macrophages to lipid A resulted in a time-dependent clearance of lipid A which was inversely related to its concentration. Alveolar macrophages thus appear to be responsible for the removal of inhaled lipid A in this model and may initiate the physiological events which bring about pulmonary edema. PMID- 1769745 TI - Delayed-type hypersensitivity antigens detected in culture supernatants of Salmonella typhimurium. AB - Protein antigens eliciting delayed type hypersensitivity (DTH) were analyzed and purified from the supernatants of protein-free cultures in which Salmonella typhimurium TV148 organisms had grown. DTH activity was measured by the footpad swelling test in mice immunized with living organisms of S. typhimurium TV148 or Escherichia coli K-12. DTH activity in the culture supernatant was specific to TV148-immunized mice. This activity was destroyed by pronase. DTH activity was unable to pass through an ultrafilter with an exclusion limit of 10 kD. After condensation of the supernatant and following centrifugation (100,000 g for 1 h), the DTH activities of the sediment and the supernatant were examined, and both showed DTH activity. Further analyses of DTH antigens in the supernatant by HPLC gel filtration separated the activity into three portions. The most active portion was further fractionated by hydroxyapatite HPLC, revealing the presence of two DTH antigens, with molecular weights of 65 and less than 10 kD. These results indicate that the culture supernatant of S. typhimurium TV148 organisms contains a variety of macromolecular protein DTH-eliciting antigens, and one of the antigens is 65 kD, which is dissociated partly by organic solvents into a low molecular weight (less than 10 kD) antigen. PMID- 1769746 TI - Mast cell hyperplasia in experimental hypersensitivity pneumonitis. AB - We investigated the presence of mast cells in a model of experimental hypersensitivity pneumonitis (EPH). Guinea pigs exposed to 8 weekly intratracheal challenges with Micropolyspora faeni exhibited significant increases in the number of mast cells within the lung as compared to controls and animals challenged only 2 or 4 times. The number of cells in M. faeni-challenged animals were increased around bronchi, bronchioles, blood vessels and in alveolar septa. There appeared to be contraction of peribronchial, peribronchiolar and vascular smooth muscle. Ultrastructural examination of lung tissue revealed the presence of degranulating mast cells. Bronchoalveolar lavage histamine levels were increased after 8 but not after 2 or 4 weekly challenges. Serum anti-M. faeni antibody was present in all M. faeni-exposed animals but not in control animals. We conclude that mast cells and histamine levels in bronchoalveolar lavage fluid are increased in a model of EHP caused by repetitive, intratracheal injection of M. faeni particulate antigen. PMID- 1769747 TI - Serum eosinophil cationic protein in patients with atopic dermatitis. AB - Atopic dermatitis (AD) is a chronic inflammatory disease of the skin, frequently associated with a family history of atopy, raised serum IgE levels and other immunological abnormalities. Both eosinophils and their basic proteins have been detected in the skin lesions of AD patients. We measured the levels of eosinophil cationic protein (ECP) in sera of 24 children with AD and found them to be increased, compared to nonatopic controls, both children and adults. High ECP values were also obtained in 3 patients with the hyper-IgE syndrome. However, no direct relationship between IgE and ECP serum levels could be established. We found no correlation between serum ECP and the number of circulating eosinophils, suggesting that part of ECP was produced by cells infiltrating the tissues. Measurement of ECP might represent a noninvasive tool to assess the activity of AD in relation to eosinophil involvement in this disease. PMID- 1769748 TI - Successful induction of allergic contact dermatitis to mercury and chromium in mice. AB - Availability of reproducible mouse models for allergic contact dermatitis (ACD) to the metal allergens nickel, mercury and chromium, would be of great value for pathogenetic and preventive studies. We explored epicutaneous sensitization to nickel, mercury and chromium in mice in which oral grooming of the sensitization site was prevented by a plaster cast around the abdomen and lower thorax. This procedure was based on earlier findings that oral ingestion of allergen could prevent contact sensitization. The present results show that BALB/c mice can be readily sensitized to mercury and chromium using this epicutaneous casting method, without the further use of adjuvants. With nickel, however, neither this method, nor conventional methods involving the use of Freund's complete adjuvant (FCA) were effective. PMID- 1769749 TI - Production and the welfare state: the political context of reforms. AB - This article is an analysis of the political context of reforms in the production process and in the welfare state. The theories of legitimation and Fordism are criticized for considering the capitalist class the main force behind the reforms. The working class and the process of class struggle are primarily responsible for changes in production and for the establishment of the welfare state. The author then shows that the changes in production and in the state that occurred after World War II were a response to political events triggered by labor's rebellions and capital's need to respond to those rebellions. Post Fordism and the political practice that derives from it are criticized for their hasty dismissal of class and class practices by the dominated forces in society. The article ends by offering an alternative strategy for change. PMID- 1769750 TI - Emerging trends in the Swedish health system. AB - The Swedish health care system has embarked upon a broad process of organizational reform. Confronted by increasing pressures from an aging population, intensive new medical technology, and tightly constrained public sector budgets, Swedish county councils have begun to experiment with new models of health service delivery that incorporate specific elements adapted from market oriented approaches. This article briefly reviews two of the more influential organizational models presently in place or under development in different counties, and assesses the revised role for health planning that these reforms will require at both county and national levels. PMID- 1769751 TI - Working the markets: purchaser/provider separation in English health care. AB - In 1991 the U.K. health system embarked upon a series of apparently radical changes in its organization, centering upon the notion of "purchaser/provider separation." After summarizing these changes, and their ostensible rationale, this article reports early experiences of the new system and outlines the alternative proposals of the main opposition Labour Party. Early experience suggests that the new system is unlikely to function as ostensibly intended. The Labour alternative, however, fails to address crucial organizational issues. PMID- 1769752 TI - Ethics and equity in U.S. health care: the data. AB - Access to and equality in health care has deteriorated in the 1980s, as shown by the data on racial differences in reducing infant mortality rates, in life expectancy, and in the incidence and economic burden of AIDS. Various health status measures indicate significant declines with decreasing income, and the use of medical care services is higher for low-income groups. The growing number of uninsured and underinsured persons has exacerbated the problem. A consensus is emerging among diverse groups that health care should be extended to those who do not have access to it and that providing universal and affordable health care is a major national health priority. PMID- 1769753 TI - Politics and equity in policy-making for the medically uninsured. AB - A sizable number of Americans (many of low income) lack health insurance, and their ranks grew over the 1980s. One might expect to find vigorous political efforts to redress this inequity. In fact, conflicting normative and practical images of equity have blunted the sense of urgency of the problem, inhibited agreement on the proper division of labor between the market and government, and blocked consensus on strategic models for public policy for the uninsured. PMID- 1769754 TI - Social and economic disparities under Canadian health care. AB - Central to the objectives of Canadian national health insurance were the principles that health is a basic right that should be open to all and that all Canadians, regardless of their ability to pay, would be provided with publicly financed comprehensive hospital and medical services. During the two decades that this program has been in place, substantial gains have been realized in making insured services more accessible to all Canadians, in the reduction of regional mortality disparities, and in a leveling out of earlier sharp differences in the supply of health resources across Canada. These changes have not been matched by any significant realignment of the health status of Canadians relative to their economic circumstances, nor as yet by the full removal of economic constraints affecting accessibility to health services. The Canadian experience raises the fundamental concern of whether a reasonable level of equity can be achieved in nations having distinctive regional priorities, a federal structure linking people of different cultural identities, and where a sharp gradient of economic opportunities is entrenched. PMID- 1769755 TI - Ethics and equity in Canadian health care: policy alternatives. AB - Four interrelated phenomena are at work in Canadian health care. First, in Canada as all over the world, there is growing momentum toward greater cost containment and imposition of tighter ceilings on health expenditures. Second is the demography of a falling birth rate and a greater number of elderly. Third, the failure of ratification by the provinces of the Canadian Meech Lake accord has created a constitutional structure that strongly favors provincial and not federal powers, and further guarantees widened regional and local disparities. Fourth, the economic union implicit in the United States-Canada free trade agreement of late 1988 will serve to weaken east-west ties within Canada in favor of north-south ties, and is likely to lead to taxation policy in Canada to favor the rich, with pressures toward privatization and restrictions on universal entitlement programs. PMID- 1769756 TI - Prudence in international comparisons: insights for the United States from the Canadian health insurance experience. AB - Canadian social insurance for medical care started in the province of Saskatchewan in 1946, when conditions were very different from those in the United States today. The Cooperative Commonwealth Federation political party has no counterpart in the United States today. Voluntary insurance was weak in the Canadian priaries, but currently strong in the United States. The U.S. Medicare and Medicaid programs help elderly and poor people, but Saskatchewan lacked such programs. Separation of executive and legislative powers in the United States differs from unified powers in Canada. However, there are several similarities between the U.S. federation of states, and the Canadian provinces. The U.S. Democratic Party has a progressive wing. Voluntary insurance in the United States grew weaker in the 1980s. The U.S. health care crisis on costs today is equivalent to post-Depression conditions in Canada. Both countries are dominated by private fee-for-service medical care, but access to that care has been promoted by compulsory insurance laws in several U.S. states. Therefore, the United States could well emulate Canada by action of the states, which would lead eventually to federal action. Coverage should be universal, with limited benefits initially; gradually, benefits would be broadened. PMID- 1769757 TI - An analysis of the American Medical Association's recommendations for change in the medical care sector of the United States. AB - In several recent publications, the American Medical Association has provided explanations of the current crisis in the medical sector of the United States. This article presents empirical information that questions the basic assumptions behind the AMA's explanations of the U.S. realities and the AMA's recommendations on how to solve the current crisis. The author also critically reviews some of the major proposals--such as employer mandated coverage--that are being put forward by several forces in the United States, including the AMA, for resolving the twin problems of high costs and limited health benefits coverage for the U.S. population. The political context in which the AMA's calls for reforms are being made is also discussed. PMID- 1769758 TI - Control during corporate crisis: asbestos and the Manville bankruptcy. AB - Chapter 11 bankruptcy provides an opportunity for addressing issues of power and control during corporate crisis. A broad notion of power is essential in understanding the complex events that led to the Chapter 11 filing of the Manville Corporation, formerly the nation's leading asbestos manufacturer. The theory of finance hegemony places this case in an entirely new light by taking into account the power of the financial community. The Manville bankruptcy illuminates several mechanisms by which this hegemony operates. From this perspective, Chapter 11 bankruptcy is viewed as a choice made from a set of options severely constrained by other powerful institutions, rather than a result of managerial incompetence or market failure. PMID- 1769759 TI - State mediation of conflicts over work refusals: the role of the Ontario Labour Relations Board. AB - A key feature of occupational health and safety legislation is that it has sought to compartmentalize health and safety issues by creating structures and processes that depart from "typical" social relations of production. The Ontario Labour Relations Board, in adjudicating disputes concerning work refusals, faces the difficult, if not impossible, task of defining and maintaining a sphere in which workers have an uncommon latitude and power. Analysis of cases before the Board during the 1980s shows how it errs on the side of caution and uses criteria related to "typical" social relations of production to define convincing testimony and assess workers' entitlement to redress. Similarly, employers' interests and the requirements of the labor process are a reference point in the Board's definition of the scope of workers' rights and what constitute legitimate penalties for the "abuse" of these. Yet decisions are not wholly biased toward employers; dissenting opinions reveal important differences and progressive rulings establish precedents that could be a basis for future decisions. PMID- 1769760 TI - Sterilization of workers from pesticide exposure: the causes and consequences of DBCP-induced damage in Costa Rica and beyond. AB - Public health hazards from the use of agricultural pesticides have received increasing attention in developing as well as industrial nations. This article examines a remarkable case of massive sterilization of approximately 1,500 workers in Costa Rica, due to exposure to a toxic nematicide called DBCP 1,2 dibromo-3-chloropropane), applied in large commercial banana plantations. Although the product was used during the 1970s, sterile victims have continued to be diagnosed through the 1980s. The effects include psychological trauma as well as permanent infertility. The case has international repercussions because several hundred workers have filed law suits against the U.S.-based transnational DBCP manufacturers, and because DBCP use was continued during the 1980s in other developing nations. The author analyzes the causes behind this serious impairment. It is argued that the contributing factors include not only biomedical processes and technical dimensions (i.e., how DBCP was used), but most importantly, political-economic factors that explain how and why DBCP was used despite the severe hazard. The crucial determinants pertain to the dominance of short-term profit motives, and the control over information and technology by the manufacturers (who concealed early toxicological research evidence of the reproductive hazards) and by the managers of the banana producer-companies. This case well illustrates problems and injustices from labor exploitation and resource extraction from transnational agro-industries. The article concludes with a brief summary of policy implications from the case. PMID- 1769761 TI - Transboundary movements of hazardous wastes: the case of toxic waste dumping in Africa. AB - Developed and developing countries are in the throes of environmental crisis. The planet earth is increasingly being literally choked by the waste by-products of development. Of major concern, especially to industrialized countries, is the problem of what to do with the millions of tons of waste materials produced each year. Owing to mounting pressure from environmental groups, the "not-in-mu backyard" movement, the close monitoring of the activities of waste management agents, an increasing paucity of repositories for waste, and the high cost of waste treatment, the search for dumping sites for waste disposal has, in recent years, extended beyond regional and national boundaries. The 1980s have seen several attempts to export hazardous wastes to third world countries. Africa, for example, is gradually becoming the prime hunting ground for waste disposal companies. This article seeks to examine, in the context of the African continent, the sources and destinations of this form of relocation-diffusion of pollution, factors that have contributed to international trade in hazardous wastes between developed and developing countries, the potential problems such exports would bring to African countries, and measures being taken to abolish this form of international trade. PMID- 1769763 TI - Is the Canadian health care system more effective at expenditure control than previously thought? A reply to Peter Coyte. AB - In an article published by the Journal of Public Health Policy (Summer 1990), Peter C. Coyte argues that it is not empirically valid to say that the introduction of universal medical insurance in Canada successfully contained the growth in the share of society's resources devoted to the health care industry. During the period under consideration, both Canada and the United States witnessed several major policy changes in the provision and regulation of health services. Coyte's decision to apply a simple time trend to the data assumes away these changes, especially the introduction of universal medical insurance in Canada in 1971, whose influence on health expenditures is itself the primary subject of inquiry of this paper. We conclude that both the unadjusted and the adjusted data suggest that the Canadian universal health system has been a resounding success economically, once the appropriate periodization is applied to the data, reflecting the institutional and policy changes that took place. Finally, we propose suggestions for future research with respect to measuring resource usage in the Canadian and U.S. health care systems. PMID- 1769762 TI - Private health care in South Africa: should the unions intervene? AB - The South African state's policy of privatization of health services has led to deterioration of public-sector health care and increased costs of access to this sector. This has generated an increasing demand for private health insurance among the predominantly black organized working class. These demands pose a dilemma for the progressive trade unions; negotiation of private-sector health insurance will have deleterious consequences for the equity and efficiency of the health services in general. Current trends in the private health sector also indicate that rapid cost increases will make most regular insurance packages unaffordable to the majority of workers within a few years. On the other hand, trade unions are obliged to meet the material demands of their members, and to intervene to stem the flow of individual workers to the private health sector. This article describes these trends, and the authors argue the case for intervention in this process by trade unions, in the form of union-negotiated and union-controlled "managed care" schemes. Such schemes will allow for the delivery of an adequate and appropriate package of health services at affordable rates. Union control will also allow for such structures to become the building blocks of a future national health service, and for incorporation into that service. Finally, the political implications of such interventions are addressed. The authors argue that the potential for undermining broader political campaigns and for creating divisions within the working class are important problems, but that many of these may be overcome through appropriate interventions. PMID- 1769764 TI - Toxic epidermal necrolysis. PMID- 1769765 TI - Benzoyl peroxide. Carcinogenicity and allergenicity. PMID- 1769766 TI - Cutaneous blood flow. Laser Doppler velocimetry. PMID- 1769767 TI - Interferon-gamma. A potential role in the treatment of severe atopic dermatitis. PMID- 1769768 TI - Overlap syndromes. PMID- 1769769 TI - Epidermolysis bullosa and aplasia cutis. AB - Recessive dystrophic epidermolysis bullosa with aplasia cutis occurring in a male infant is described. The association of these two rare conditions is reviewed. Reports of the concurrence of large areas of congenital absence of skin, particularly on the lower limbs, in patients with several different types of epidermolysis bullosa suggest that areas of congenital absence of skin in these patients are an initial manifestation of the bullous disease rather than a distinctive entity. PMID- 1769770 TI - Facial contact dermatitis. Pathogenetic factors in China. AB - In 107 cases of facial contact dermatitis, routine Finn chamber epicutaneous tests with TROLAB European Standard Allergens (ESAs) were performed. Sixty-one (57%) had positive reaction. The most frequent contact allergens were paraphenylenediamine dihydrochloride (16%), followed by fragrance mix (15%), and nickel sulfate (13%). The major sensitized contactants were rims of spectacles, hair dyes, cosmetic creams, and topical medications. Among the cases caused by cosmetic cream, the positive allergens were fragrance mix, formaldehyde, wood alcohols, and balsam of Peru. In ten season-incidence cases in which ESAs and cosmetic cream epicutaneous tests were negative, the chamber and scratch-chamber tests were performed using five kinds of pollen. The results show that all chamber tests were negative, but two cases with scratch-chamber tests were positive. PMID- 1769771 TI - Papulonecrotic tuberculid. Necessity of long-term triple regimens. AB - Eleven cases of papulonecrotic tuberculid (PNT) were seen at the Institute of Dermatology, Bangkok, over a 2-year period (1985 to 1986). The diagnosis was supported clinically by symmetric, scattered, papulopustular necrotic lesions, healed with atrophic scars; strongly positive tuberculin test; histopathologic findings; and a rapid improvement after antituberculous therapy. Despite multiple drug therapy, three cases had recurrences after discontinuation of treatment. Long-term treatment is recommended for the treatment of PNT. PMID- 1769772 TI - Lupus vulgaris simulating discoid lupus erythematosus. PMID- 1769773 TI - Lyme disease. PMID- 1769774 TI - Erythema annular centrifugum in Q fever. PMID- 1769775 TI - Lobular panniculitis terminating in acute myeloid leukemia. PMID- 1769776 TI - Solitary sclerotic fibroma of the skin. PMID- 1769777 TI - Multiple eruptive dermatofibromas localized exclusively to the buttock. PMID- 1769779 TI - 8-Methoxypsoralen serum levels in poor responders to photochemotherapy. Importance of drug formulation and individual factors. AB - 8-Methoxypsoralen (8-MOP) serum levels of psoriatic patients poorly responsive to photochemotherapy (PUVA) treatment (problem cases) were determined by the HPLC method with 11 single blood probes over 8 hours. Abnormally low or deviated serum levels were found in 7 of 11 PUVA problem patients. There was a great interindividually different first-pass effect for 8-MOP in dependence on the galenic formulation of the 8-MOP brand; therefore, the change to another 8-MOP brand with a modern galenic formulation led only to a slight increase of serum levels, and consequently an increase in the 8-MOP dosage was necessary. It is important to be cautious at this point because patients may show an unproportional increase of 8-MOP serum levels due to the individually limited capacity of biotransformation. The studies of the authors reaffirm the necessity of the determination of 8-MOP serum levels in problem cases of PUVA therapy. PMID- 1769780 TI - Successful treatment of nodular migratory eosinophilic panniculitis (human gnathostomiasis) with phenilbutazone. PMID- 1769781 TI - Senile erythroderma syndrome with hyper IgE. PMID- 1769782 TI - Pediculosis and ethnic groups. PMID- 1769783 TI - The origin and causes of struvite stones. AB - The aim of this paper is to evaluate the possible causes of the origin of "infection stones". The main differences between the ordinary biochemical parameters of a group of patients with this type of stones was analyzed and compared with a group of oxalocalcic stone-formers and with a group of healthy subjects. The importance of persistent basic urinary pH values is pointed out as possible origin of "infection stones" in some instances. The main urinary citrate concentration in patients with "infection stones" was significantly lower than in healthy subjects, this being an important factor that favours this kind of stone formation. PMID- 1769784 TI - Results of selected Zeiss basket applications during transurethral interventions and open surgery. AB - Between 1981 and 1990, 151 patients with lower ureteral calculi received 163 applications of Zeiss basket (ZB) transurethrally. In the mean time we employed ZB in 17 patients who were operated for various causes. The success rate of 163 ZB applications was 88% and of 17 open surgical applications 94%. PMID- 1769785 TI - An unusual presentation of upper tract urothelial carcinoma: a visible abdominal mass. AB - Upper tract urothelial carcinoma is rare when compared to frequent vesical involvement. An unusual case of upper tract transitional cell carcinoma who presented with a visible abdominal mass is reported. PMID- 1769786 TI - Histological changes of the bladder mucosa following the administration of BCG adriamycin and RO 10-9359. AB - Three groups of Wistar rats have been treated with intravesical Adriamycin and BCG and oral retinoids. The main effect on the bladder seen on histological sections was mononuclear infiltration in the Adriamycin group, polymorphonuclear infiltration in the BCG group and minimal mononuclear and polymorphous infiltration in the retinoid group. The results are discussed in relation to the existing theories on the protective action of these agents against bladder tumour recurrences. PMID- 1769787 TI - The efficacy of intravesical BCG in the treatment of patients with high risk superficial bladder cancer. AB - Sixty-two patients with superficial bladder cancer stage T1 with or without dysplasia or carcinoma in situ and 34 patients with stage TA associated with dysplasia or carcinoma in situ were treated by TUR and TUR + BCG, respectively, and were followed up for an average of 46 months (6-192) and 32 months (6-72), respectively, after therapy. The recurrence rate (61%), progression (37%) and tumour death (19%) were unfavourably high in the group of patients treated by TUR only. On the contrary, the effect of intravesical BCG therapy was excellent. Recurrence rate was as low as 20.5%, and progression and tumour death were not detected in any patient. Intravesical BCG seems to be the best choice for treatment of high risk superficial bladder cancer. The authors recommend their effective modified treatment schedules. PMID- 1769788 TI - Carcinoma of the prostate and HLA antigens. AB - A possible association between HLA antigens and carcinoma of the prostate was searched for in 20 patients and 200 healthy kidney donors. HLA antigens A26, A28, B13, B14, B40, Bw4 and Cw4 were more common in patients with carcinoma of the prostate. The relative risk for HLA B14 was 7.78 (95% confidence interval 7.60 8.13). The relative risk for patients carrying the above antigens (except A28) was higher than 2. This study shows that certain HLA antigens may be more frequent in patients with carcinoma of the prostate. Before drawing any conclusions from these findings, they have to be confirmed by other studies. PMID- 1769789 TI - Adenocarcinoma of the prostate with endometrioid features. AB - Two cases of prostatic carcinoma with papillary features resembling the so-called "endometrioid carcinoma" are presented. Immunohistochemical studies, response to therapy and review of the literature support the ductal origin of the tumour, probably multifocal, as it is commonly seen in conjunction with acinotubular carcinoma. PMID- 1769790 TI - Long-term follow-up results of the MAGPI (meatal advancement and glanuloplasty) operations in distal hypospadias. AB - Between 1985 and 1989, 54 boys underwent a MAGPI procedure. Excellent cosmetic and functional results were achieved in 94% of our cases in the early period. In order to assess the long-term results of this procedure, 41 boys attended long term re-evaluation between 6 and 40 (mean 29) months postoperatively. MAGPI was a very satisfactory procedure for micturition function. We observed in 22% of cases partial and in 15% complete regression. On the long term, excellent cosmetic results were achieved in all glanular cases but in only 65% of coronal and 15% of subcoronal cases. We believe that the MAGPI procedure is not a suitable operation for subcoronal hypospadias. PMID- 1769791 TI - Treatment of morbus Peyronie--how I do it? Twenty years of experience. AB - Non-operative treatment of morbus Peyronie with 1000 mg of vitamin E daily is warranted as long as the penetration of the penis into the vagina is not hindered. As soon as sexual problems occur, depending on the age, either a corporaplasty (Nesbit-Kelami) or implantation of penile prostheses without plaque surgery (Kelami) is performed with an excellent late result rate of 96%. PMID- 1769792 TI - Sclerosing lipogranuloma of the penis. A case report. AB - Sclerosing lipogranuloma of the male genitalia is a rather uncommon condition presenting with subcutaneous masses of the penis and the scrotum. The masses are composed of granulomatous tissue formed around an either exogenous or endogenous lipomatous substance. In case of incomplete resection the masses show a rapid recurrence, thus mimicking a neoplastic lesion. On the basis of a case report a review of this entity in the literature is presented here. PMID- 1769793 TI - Dynamic cavernosography in the evaluation of impotence. AB - Dynamic cavernosography before and after papaverine injection into the corpus cavernosum of 6 sexually normal volunteers and 44 impotent patients was performed with digital subtracting angiography technique. The average infusion rates in 26 patients with venous leakage were 325.5 ml/min for induction of erection and 161 ml/min for maintenance. The results for the remaining 18 impotent patients without venous leakage were 128.8 ml/min for induction and 56.9 ml/min for induction and 58.3 ml/min for maintenance. After papaverine injection the average infusion rates decreased to 131 ml/min (induction) and 59 ml/min (maintenance) in patients with venous leakage, 38.4 ml/min and 14.6 ml/min in the impotent patients without venous leakage and 35 ml/min and 14.1 ml/min in the control group, respectively. It was also noticed that in the control group filling of the superficial and deep veins may occur during the flaccid phase which disappeared with induced erection. Therefore we suggest intracavernous papaverine injection with dynamic cavernosography. The digital subtracting technique eliminates unnecessary images, providing a more accurate diagnosis of venous incompetence. PMID- 1769794 TI - A case of 17 alpha-hydroxylase deficiency with chromosomal karyotype 46,XY and high plasma aldosterone concentration. AB - A 15-year-old female case of 17 alpha-hydroxylase deficiency with 46,XY chromosomal karyotype is reported. High plasma aldosterone concentration (285 pg/ml) with low plasma renin activity (less than 0.1 ng/ml/h) and the absence of organs derived from Mullerian ducts with immature testes were recognized. Bilateral orchiectomy was done after hormonal control by the administration of dexamethasone. The basic characteristics, mechanism of high plasma aldosterone concentration, steroid modification of Mullerian inhibiting substance and rationality of castration in a case of 17 alpha-hydroxylase deficiency are discussed. PMID- 1769795 TI - Focal sclerosing glomerulopathy. Risk factors of progression and optimal mode of treatment. AB - Focal sclerosing glomerulopathy and especially focal segmental glomerulosclerosis (FSGS) have been recognized as a distinct clinical entity, however, there still exist controversies in terms of prognostic risk factors of progression and optimal mode of treatment. A total of 32 patients (2 with focal global sclerosis; FGS, the remainder with FSGS) were followed up for a mean period of 82 months (3 240 months). Fourteen presented with nephrotic syndrome and 18 had proteinuria with or without hypertension. Thirteen patients, all of whom except 1 were nephrotic, received steroid treatment with or without other immunosuppressive agents (cyclophosphamide/cyclosporin A/azathioprine). Three of the steroid treated remained stable in complete remission; 5 nephrotic non-responders had renal death. The mean slope of 1/creatinine versus time for steroid-treated and non-treated groups was -0.23 and -0.043, respectively (p = 0.04), suggesting that nephrotic range proteinuria might be prognostically important. However, for the population of FSGS/FGS as a whole, only the initial serum creatinine predicted renal survival (p = 0.001 by Cox's regression model). Hypertension and hypercholesterolaemia were not important variables by themselves. Nevertheless, we found that the 9 patients treated with antihyperlipidaemics (gemfibrozil/probucol/cholestyramine/maxEPA) fared better, mean slope being 0.023 versus -0.103 for non-treated, though not reaching statistical significance (p = 0.96). Controlled prospective study involving a larger number of patients might be worthwhile. PMID- 1769796 TI - [Thoracic pain]. PMID- 1769797 TI - [Vasculitis of the lung]. PMID- 1769798 TI - [The respiratory tract and immediate allergic reaction]. PMID- 1769799 TI - [Allergic alveolitis]. PMID- 1769800 TI - [Mechanisms of bronchopulmonary resistance in the lung]. PMID- 1769801 TI - [Cough]. PMID- 1769802 TI - [Differential diagnosis in "fever of unknown origin"--an unusual disease course with long latency]. PMID- 1769803 TI - [Anaphylactic shock with respiratory arrest after spontaneous rupture of echinococcal cyst in a 15-year-old patient]. PMID- 1769804 TI - [201Tl myocardial scintigram in coronary and non-coronary heart disease]. PMID- 1769805 TI - [Infections and prevention of infection after splenectomy]. PMID- 1769806 TI - [Vasoactive substances and growth. Workshop of the work group on vasodilator agents. Fall meeting of the German/Austrian/Swiss Society for Cardiac and Circulatory Research. Stein or Rhein, 10 October 1991]. PMID- 1769807 TI - Langerhans cell histiocytosis--a 31 year review. AB - Forty-one patients with Langerhans Cell Histiocytosis (LCH) were treated over a thirty-one year period in our institution. These children were classified according to the number of systems involved: twenty-two had unisystem disease while nineteen had multisystem disease. A histological diagnosis was reached in 82% of cases, the remainder being diagnosed on both radiological and clinical grounds. 68% of those with multisystem disease had a rash at diagnosis whilst 64% had a persistent ear discharge. The diagnosis was established accidentally in 25% of those with unisystem disease. The mortality rate was 21% and was confined to those who were under two years of age at diagnosis, all of whom had multisystem disease. Morbidity was 20% and was restricted to patients with multisystem disease. Only one patient died within the last 10 years; there were no therapy related deaths. Treatment related morbidity was seen in only three children. In keeping with other series, our review has identified the following adverse prognostic factors a) age under 2 years at presentation, b) multisystem disease and c) major organ dysfunction. In view of the natural history of the disease, it is suggested that chemotherapy only be used in those patients who have major organ dysfunction or progressive disease and that radiotherapy is rarely indicated. PMID- 1769808 TI - Multiple isolated brain metastases from a Duke's B colon carcinoma. AB - Brain metastases from colorectal carcinomas are very uncommon and are almost uniformly seen in the setting of advanced, systemic disease. We describe a unique case of multiple, isolated brain metastases occurring from a Duke's B carcinoma of the sigmoid colon. Careful staging at two intervals at which clinical brain metastases were found did not disclose additional evidence of systemic disease. The cascade mechanism thought to be involved in the development of systemic metastases is reviewed, and a possible alternate route is suggested for direct access by tumor cells to the brain via Batson's vertebral plexus. PMID- 1769809 TI - Sudden infant death syndrome: a crisis for parents and health professionals. AB - A study of the social impact of Sudden Infant Death Syndrome (SIDS) in 40 families in Ireland (40 mothers: 29 fathers and 78 siblings) revealed a profound influence on family function. Less than half the parents felt an acceptance of the loss at a mean interim of 2.9 years post SIDS. Family dysfunction was manifested by marital problems and prolonged grief reactions. Interpersonal support through family, friends, relatives or neighbours appropriately assisted a third of families. Medical information when provided to parents contributed to a more normal grief process, but lack of postmortem information contributed to pathological or unresolved guilt in a third of parents and anger in nearly half the sample. Health professional and voluntary aftercare at community level was inconsistent in meeting parents' need for information, advice and support. A primary, preventive health care approach, based on a co-ordinated policy of aftercare to SIDS families, at hospital and community level is recommended to facilitate parents' resolution of grief, and counteract the onset of adverse psychosocial effects. PMID- 1769811 TI - Period prevalence of allergic bronchopulmonary mycosis in a regional hospital outpatient population in Ireland 1985-88. AB - The period of prevalence, 1988 inclusive, of Allergic Bronchopulmonary Aspergillosis (ABPA) and Allergic Bronchopulmonary Candiasis (ABPC), the two most frequently reported forms of allergic Bronchopulmonary Mycosis (ABPM), was investigated in an Irish regional hospital respiratory medicine outpatients, catchment area population 536,000. ABPM was defined by the presence of a majority of seven criteria: asthma, eosinophilia, elevated IgE, antibodies to Aspergillus Fumigatus or Candida Albicans, immediate skin test reaction to either fungus, culture of either fungus in sputum, and otherwise unexplained transient or permanent lung field x-ray abnormalities. New referrals were investigated for ABPM if they had asthma and eosinophilia, or asthma and lung field x-ray abnormalities. Fourteen patients with ABPM were identified from a total of 1390 new referrals, a period prevalence of just over one per cent. It is concluded that (1) ABPM is a relatively common disorder in an Irish regional hospital respiratory medicine outpatient population and (2) ABPC constitutes a higher proportion of this disorder than previously considered. PMID- 1769810 TI - Long term efficacy of a pen injector. AB - We assessed the long term efficacy of Novopen as a form of insulin administration. Records were obtained on 48 patients who were treated with Novopen between January '86 and October '88. Six patients were excluded due to insufficient data. The study group of 42 patients comprised 22 females and 20 males of average age 33 years (range 17-66). Mean Hb.A1 rose from 10.6% to 12.1% after Novopen therapy, a rise of 14.1%. This rise is both clinically and statistically significant (p less than 0.001; 99% confidence limits 0.59-2.78). Increases in weight and insulin dose were also noted, but did not reach statistical significance. The majority of patients felt Novopen was superior to twice daily insulin in terms of ease of administration (81%) and flexibility of lifestyle (95%), and all who were using Novopen wished to continue with it. More than 50% of patients admitted to altering their dietary habits while using Novopen. Despite continuing patient satisfaction with this form of insulin administration, its long-term use may be associated with sub-optimal metabolic control. PMID- 1769812 TI - Mediastinoscopy as a predictor of resectability in patients with bronchogenic carcinoma. AB - Eighty consecutive mediastinoscopies, performed for assessment of patients with bronchogenic carcinoma, were reviewed with regard to accuracy and complications. Thirty patients had mediastinal lymph node metastases: 26 were considered inoperable and thus saved non-therapeutic thoracotomy, 4 were considered operable of whom 3 had a curative resection, and one was inoperable at thoracotomy. Of 50 patients with negative mediastinal nodes 43 had thoracotomy; 42 were resectable and one was unresectable. Seven did not have thoracotomy because of other contraindications. In total of 47 patients undergoing thoracotomy on the basis of mediastinoscopy, 45 were resectable, giving mediastinoscopy a positive predictive value for resectability of 95.7%. There was no mortality and two superficial wound infections occurred giving a morbidity of 2.5%. Mediastinoscopy is a safe, reliable and accurate predictor or resectability in patients with bronchogenic carcinoma and continues to have a major role in the management of these patients. PMID- 1769813 TI - The Hawaii Medical Fellowship Mission to China. AB - The Hawaii Medical Fellowship Foundation is a non-profit Hawaii corporation to provide and exchange medical fellowship, knowledge, care, cooperation and service, and to support other humanitarian causes here in Hawaii and abroad. The Foundation plans a mission to China in October 1991. Hawaii physicians, at their own expense and time, will be spending a week in Shantou, China, providing medical service to and sharing techniques with their Chinese counterparts. The Foundation also plans to establish scholarships for students in Hawaii who wish to pursue health careers and to establish clinic/health fairs for the immigrants. It is willing to entertain ideas and suggestions for additional projects. PMID- 1769814 TI - Birth of the first 100 babies in Hawaii after conception in-vitro: experience at the Pacific In-Vitro Fertilization Institute. AB - This paper reports on the first 100 infants delivered consecutively the result of 63 pregnancies after conception in-vitro at the Pacific In-Vitro Fertilization (IVF) Institute. These pregnancies were established prior to the introduction of embryo-cryopreservation into the program. Ninety-seven percent (97%) of singleton pregnancies delivered after 36 weeks; only 5/31 (16%) required tocolytic therapy. The overall multiple gestation rate was 51%, higher than in many other IVF centers. Maternal complications and neonatal morbidity were associated primarily with these multiple gestations. Forty-one percent (41%) delivered in less than 36 weeks, and tocolytics were administered in 22/27 (81%) of twin and 5/5 (100%) of triplet gestations. Neonatal morbidity was noted in 39 infants (33 from multiple gestations); 28 neonates were admitted to the intensive care unit (27 from multiple gestations). Nine births had or developed minor abnormalities (hernias, pyloric stenosis). One case of Trisomy 21, and one infant death at 11 months occurred in the group. The caesarean section rate for all IVF deliveries was 65%. It is concluded that IVF is clearly established in Hawaii for infertility refractory to other methods of treatment. The risk associated with IVF stem from the possibility of multiple gestations, not whether the pregnancy was initiated in-vitro. In the future, embryo cryopreservation may help to reduce the risk of multiple pregnancy. PMID- 1769815 TI - Tuberculosis. PMID- 1769816 TI - The mortality rate from the first recognized subarachnoid hemorrhage (SAH) remains near 50%. PMID- 1769817 TI - Caveat doctor! Tuberculosis in physicians. AB - Physicians long have been a high-risk group for developing tuberculosis. The progressive decline in the incidence of tuberculosis in the United States over most of the second half of the 20th century led to less tuberculosis and less awareness of tuberculosis among physicians. Recent changes, however, have led to an increase in the incidence of tuberculosis in the U.S. and may lead to more physicians being affected. Two physicians in Hawaii were diagnosed as having active tuberculosis in 1990. Physicians should take steps to prevent its spread and should consider the disease in the differential diagnosis when physicians or their patients are ill. PMID- 1769818 TI - Psychiatry and molecular genetics: a paradigm shift. AB - The late 20th century is witnessing an explosion of biomedical knowledge in the discipline of molecular genetics. In this regard many medical specialties will be transformed in terms of diagnosis and treatment. The technology and the recent clinical research in psychiatry is one of these. PMID- 1769819 TI - Grateful Med: gateway to world-wide literature. AB - Grateful Med is a computer software package developed by the National Library of Medicine which provides access to MEDLINE and other medical databases. The program is available for both IBM and Macintosh computers, is inexpensive, easy to install and has excellent documentation. Health professionals in all areas find Grateful Med to be a user-friendly, cost-effective way to search current, world-wide medical literature. PMID- 1769821 TI - "Symptomatic migraine": intracranial lesions mimicking migrainous headache--a report of three cases. AB - Case reports of three headache patients, two with intracerebral meningioma and one with hydrocephalus are presented, in whom the clinical picture fulfilled the criteria of the International Headache Society (IHS) for the diagnosis of migraine. The symptomatic (ie, lesional) nature of the headaches could be detected by neither clinical neurological examination nor routine investigations such as EEG and skull x-ray. On the other hand, brain imaging techniques (CT, MRI) were found to be of particular in value diagnosing the lesions. Our cases indicate that neuroimaging with CT or MRI in the assessment of headache patients should not be handled too restrictively. Compared to CT, however, the additional diagnostic value of MRI in headache seems to be limited. PMID- 1769820 TI - Flunarizine versus metoprolol in migraine prophylaxis: a double-blind, randomized parallel group study of efficacy and tolerability. AB - The prophylactic effect of flunarizine and metoprolol was studied in a multi center randomized, double-blind trial of 149 patients with migraine with or without aura. After a 4-week placebo run-in period, patients were randomly allocated to treatment with flunarizine 10 mg daily or metoprolol 200 mg daily for 16 weeks (parallel group design). Both drugs reduced the number of migraine days per month by 37% (95% confidence interval 21-53%) compared with the placebo run-in period. All efficacy parameters were significantly reduced by both drugs and no significant difference was found between the two drugs at any time of the treatment period. However, calculation of the 95% confidence limits showed that each drug may have a superiority of more than 100% on a single main effect parameter. The most common adverse experiences were day-time sedation (both drugs) and weight gain (flunarizine). Depression was the most serious side-effect occurring in 8% on flunarizine and 3% on metoprolol. We conclude that both drugs are effective in the prevention of migraine attacks but a higher number of dropouts occurred on flunarizine because of depression or weight gain. PMID- 1769822 TI - Antiphospholipid antibodies in migraine. AB - We studied the presence of serum antiphospholipid antibodies (APA) in 35 patients with migraine and 75 controls. None of the controls showed APA, while we found these antibodies in five patients out of the 35 studied (p = 0.003). The clinical features of migraineurs with APA were similar to those of patients without them. After a follow-up of one to two years, no patient suffered any neurological complications or developed any clinical features that would suggest the presence of autoimmune disease. Our results suggest that APA are not prominent in the pathogenesis of migraine attacks, or significant in the course of otherwise healthy migraine patients. PMID- 1769823 TI - Cervical sympathetic deficit in unilateral migraine headache. AB - Pupil diameter was measured during the headache-free interval in 38 migraine sufferers selected from the general community. In each case, at least 70 percent of attacks recurred on the same side. Anisocoria was greater than in 40 control subjects, but miosis was not consistently greater on the usual side of headache. Average pupil diameter was similar in migraine sufferers and controls. In patients with pupillary dilation lag on the usual side of headache, miosis persisted after 4% cocaine eyedrops. These findings suggest that cervical sympathetic outflow was lower on the usual side of headache in a subgroup of migraine sufferers. Pupillary dilatation to tyramine eyedrops was greater in control subjects than in migraine sufferers, consistent with decreased function of post-ganglionic cervical sympathetic fibres. Pupillary dilatation to 1% phenylephrine eyedrops did not differ consistently between the headache and headache-free sides, and was similar in migraine sufferers and controls. Thus, adrenergic supersensitivity of the pupils was not evident in this community sample of migraine sufferers. Vasodilatation or swelling of the arterial wall in the carotid canal could cause minor cervical sympathetic deficit in patients with frequent or severe attacks of migraine. Loss of sympathetic vascular tone could increase vasodilatation and pain during attacks. PMID- 1769824 TI - Migraine in Nigerian children--a study of 51 patients. AB - This study was undertaken to determine the profile of migraine in Nigerian children, as earlier reports on migraine from Africa dealt mostly with the adult population. Migraine constituted 5.7% of all new referrals seen in the Child Neurology Clinic over a 44 month period. The overall profile is not different from that reported for other racial groups. Haemoglobin AS was found to be more frequent among children with migraine than in the general population, although this difference did not attain statistical significance. Childhood migraine is probably commoner than this study indicates. This may be partly due to the fact that practitioners in the less developed countries have to deal with the more pressing problems of malnutrition, infections, chronic motor handicaps, mental retardation and epilepsy. PMID- 1769825 TI - Epidemiology of headache in the Thai elderly: a study in the Bangkae Home for the Aged. AB - The problem of headache in the elderly, especially in Thailand, has yet to be probed, fully. The prevalence, clinical characteristics and precipitating correlates of headache in this population may be different from other groups. The objective of this study was to examine the epidemiology of headache in a selected subgroup of the elderly, in order to create a foundation for further studies in the general population. The data were gathered by an interviewer-administered questionnaire method. The study population consisted of 241 persons (male:female = 1:5.7). The reported prevalence of headache over a 1-year period was 54.8% (132/241 cases). The prevalence of migraine, episodic tension headache, chronic tension headache and unclassified headache were 2.9, 16.2, 2.1 and 33.6%, respectively. The reported prevalence tended to decline with increasing age. Physical disorders, including pain in the paracranial structures, chest pain and arthralgias, as well as depression, were all significantly associated with the occurence of headache. The prevention and treatment of these aggravating factors should be considered as one strategy for management of this problem. PMID- 1769826 TI - Ear pain due to cervical spine arthritis: treatment with cervical facet injection. AB - Two patients with cervical spine arthritis and ear pain were recently evaluated at our clinic. Injection of the C1-2 facet joints with local anesthetic plus corticosteroid resulted in relief of the pain. Therapeutic cervical facet injections may be indicated in cases of recalcitrant head and neck pain due to cervical spine arthritis. PMID- 1769827 TI - Cluster-like headache and a median intracranial calcified lesion: case report. AB - A 69 year old man complaining of a cluster-like headache is reported. CT scan showed a median intracranial calcified lesion. Two main considerations are: 1) the importance of searching for an underlying structural lesion in patients with an "atypical" cluster headache; 2) the possible significance of a lesion localized close to the midline structures in the pathogenesis of cluster headache. PMID- 1769829 TI - Bringing treatment to a head. PMID- 1769828 TI - Treatment of chronic tension-type headache with hypnotherapy: a single-blind time controlled study. AB - We investigated the effectiveness of a special hypnotherapy technique in the treatment of chronic tension-type headache. A waitinglist control group was used to control for the changes in headache activity due to the passage of time. The results showed significant reductions in the number of headache days (p less than 0.05), the number of headache hours (p less than 0.05) and headache intensity (p less than 0.05). The improvement was confirmed by the subjective evaluation data gathered with the use of a questionnaire and by a significant reduction in anxiety scores (p less than 0.01). PMID- 1769830 TI - [Recent findings in physiology and pathology of endothelial cells of the skin]. AB - Perivascular cell infiltrates with concomitant changes of the endothelium represent a histological hallmark of numerous inflammatory dermatoses. Therefore, the pathophysiology of dermal endothelial cells is of particular importance for the understanding of inflammatory processes within the skin. In recent years, the development and refinement of endothelial cell culture techniques have facilitated investigations in cell biology and molecular biology, which complement histological observations, so leading to sounder knowledge of endothelial cell pathophysiology. The following review will discuss characteristic features of endothelial cells as well as in-vitro culture techniques. Focussing on endothelial cell interactions with leukocytes and with the extracellular matrix, recent developments in this area of research will be presented. PMID- 1769831 TI - [The incidence of atopic symptoms in patients with psoriasis]. AB - Retrospective studies have repeatedly shown that patients with psoriasis rarely suffer from concomitant atopic dermatitis. Recently conflicting results have been published. To see whether the predisposition to psoriasis and that to atopic disease influence each other, we performed a prospective study to investigate the prevalence of atopy in patients suffering from psoriasis. Atopy was diagnosed in 8 of 68 psoriasis patients (11.8%), indicating that its frequency is the same in patients with psoriasis as in the general population. The dynamic aspects of atopic dermatitis, which is mainly a disease of children, and of psoriasis, which is mainly a disease of adults, mean that concomitant manifestation of both entities should be observed in less than 0.01% of the population. PMID- 1769832 TI - [The value of symptoms and clinical findings in cervical Chlamydia trachomatis infection]. AB - The frequency of symptoms in the case histories of 68 female patients with and of 313 without Chlamydia trachomatis infections was investigated. Dysuria, vaginal discharge and/or burning/itching in the genital region were reported by 50% (n = 34) of chlamydia-positive women and 53.7% (n = 168) of chlamydia-negative women. Clinical investigation of the chlamydia-positive patients revealed discharge in 83.8% (n = 57), contact bleeding in 38.3% (n = 26) and ectopia in 27.9% (n = 19). The corresponding investigations in chlamydia-negative women disclosed discharge in 72.8% (n = 228) women, contact bleeding in 19.8% (n = 62) and ectopia in 16.8% (n = 52). The results were significantly different as far as contact bleeding and ectopia were concerned. Only when yellow or whitish yellow discharge was distinguished from clear discharge was the difference between the two groups significant (66.7% vs 43.9%). Significant numbers of polymorphonuclear leucocytes (greater than 4 per high power field with oil immersion) were found in 52.9% of the chlamydia-positive women, as against 23% of the chlamydia-negative women. Overall, 48.7% of the women with a C. trachomatis infection were found to have notes of symptoms in the history and signs of cervicitis revealed by clinical investigation. Symptoms only were found in 1 woman, while in 36.8% of the patients signs only were found. Neither symptoms nor signs were mentioned by 13.3% of the women. These results indicate that microbiological detection of the infectious agent is obligatory for the diagnosis of C. trachomatis cervicitis. PMID- 1769833 TI - [Polymerase chain reaction with subsequent direct gene sequence analysis. A possibility for molecular analysis in dermatology]. AB - Molecular analyses are of increasing importance in clinical research as well as for diagnostic evaluations. Gene alterations are involved in the pathogenesis of numerous diseases and are described in an increasing number of conditions. A method is presented which allows for rapid and detailed nucleotide sequence analysis of a segment of a gene. Buccal epithelial cells of a patient are obtained by means of a mouth wash with 10 ml water. DNA molecules are amplified in vitro using the polymerase chain reaction, followed by direct sequence analysis of the product. Using this technique, a sequence analysis of a gene segment is possible within 1-2 days. As an example, the analysis of a segment of the gene for uroporphyrinogen decarboxylase of patients with cutanea tarda is described. PMID- 1769834 TI - [Detection of proviral HIV DNA with polymerase chain reaction in the epidermis]. AB - The infection of cells of the epidermis with HIV can still not be taken as proved, since the demonstration of HIV in Langerhans cells has not been universally accepted. In our study, the polymerase chain reaction was used to look for proviral HIV-DNA in epidermal cells collected by the suction blister technique. The primers flanked sequences of the gp41-encoding region of the env gene and hybridized with highly conserved HIV-DNA sequences. Amplified sequences were detected by the dot-blot technique. The PCR revealed HIV-DNA in epidermals cells of four HIV patients. In addition, HIV-DNA was detected in the mononuclear cells of the blood in the same patients by the PCR. These results strongly support the notion that in addition to blood cells, epidermal cells of HIV patients are also infected with HIV. PMID- 1769835 TI - [Balloon-cell variant of the Spitz nevus]. AB - We report on a 2-year-old male patient with a Spitz naevus on the left lower leg. In addition to the characteristic histological features of a Spitz naevus, a balloon cell component was found. PMID- 1769836 TI - [Periorbicular trichophyton verrucosum infections]. AB - Three patients with periorbicular infections by Trichophyton verrucosum are described. This type of fungal infection is much less common as compared to the usual kerion formation. The main characteristics of Trichophyton verrucosum and of the epidemiology and clinical course of infections with Trichophyton verrucosum are summarized. In this condition the identification of the causative agent as well as the therapeutic regimen chosen to eliminate fungal growth deserve careful attention. PMID- 1769837 TI - [Werner syndrome with torpid trophic ulcera cruris]. AB - Werner's syndrome is a rare, autosomal recessive inherited disorder with a distinctive clinical picture. The characteristic physiognomy, shortness of stature with thin extremities, and large trophic ulcers are the key signs for the diagnosis. Premature greying of the hair and baldness, juvenile cataracts, a tendency to diabetes mellitus, hypogonadism, calcifications of the blood vessels, osteoporosis, metastatic calcifications of the soft tissue and an elevated incidence of neoplasms are further important features. We describe two patients with this disorder. PMID- 1769838 TI - [Contraceptives and systemic lupus erythematosus]. PMID- 1769839 TI - [Castleman tumor, lichen ruber and pemphigus vulgaris: paraneoplastic association of immunologic diseases?]. PMID- 1769840 TI - [Surgical therapy of penis shaft induration in congenital penis deviation and induratio penis plastica]. AB - The therapy of Peyronie's disease is an operative one primarily. Indication for the operative treatment is the penile deviation which prevents the patient from intercourse. The method of choice is plaque excision and subsequent corporoplasty with dermal graft. Good long-term results can also be achieved with a sole straightening of the penile shaft without plaque excision. However, this procedure (Nesbit's operation) results in a shortening of the length. In patients who are suffering from an additional erectile dysfunction an implantation of a penile prosthesis is done accompanied by plaque excision and a corporoplasty with alloplastic material (Dacron, Goretex). In 80% of all cases good postoperative results can be achieved with the operative treatment of Peyronie's disease. Patient's satisfaction is very good with all procedures described above. The exact diagnosis of the erectile quality seems to have a prognostic value for the postoperative result. PMID- 1769841 TI - [The transsexual after sex change. Evolution and prognosis]. AB - Sex reassignment surgery is at the present time the most acceptable solution which can be offered to the transsexuals. Diagnosis, postoperative status, prognostic factors and outcome are taken into account, with the purpose of having a better assessment for these patients. PMID- 1769842 TI - [Risk oriented urologic preparation of children for kidney transplantation]. AB - Among 1050 consecutive renal transplants (Rtx) performed in Heidelberg since 1967 we have gained experience with 163 children and adolescents under the age of 16, receiving a Rtx since 1969. 30% of these were terminally renal insufficient due to congenital obstructive uropathy, mainly infravesical obstruction and/or reflux nephropathy. A special diagnostic work-up (flow chart) for evaluating and eliminating potential pre- and posttransplant risk factors consisted of noninvasive screening methods (ultrasonography and uroflow) followed step by step by more invasive imaging procedures (MR, MCU) and finally invasive methods of evaluating upper urinary tract and voiding disorders (complete urodynamic work up). We emphasize the preservation or rehabilitation of urinary bladder function, eradication of significant UTI and pre-Rtx surgical treatment of otherwise hard to handle nephrogenic hypertension. Unnecessary psychologically and somatically traumatizing pretransplant diagnostic and therapeutic procedures can be avoided in pediatric non-obstructive nephropathy patients. PMID- 1769843 TI - [Preventive use of pedicled omentum majus within the scope of kidney transplantation]. AB - The interposition of the greater omentum was used for treatment of lymphoceles in combination with peritoneal fenestration and for prevention of urinary fistulas in cases of lower pole renal artery lesions and feared ureteral necrosis as well as for protection of pyeloureterostomics and pyelovesicostomics, secondary to ureteral necrosis postrenal transplantation. Especially the combination of peritoneum fenestration with interposition of the greater omentum proved to be the procedure of choice for treatment of posttransplant lymphoceles. The incidence of lymphoceles following renal transplantation is in the range of 5 15%. Even by meticulous surgical technique--ligature of donor and recipient lymph vessels--they cannot be prevented totally since perioperative anticoagulation plays a significant role. Following unsuccessful repeated punctures for decompression, external drainage, local application of tetracycline or fibrinogen glue, internal marsupialisation to the peritoneal cavity is the established ultimate treatment. Inherent risks and difficulties of this procedure can be reduced, if peritoneal fenestration of the lymphoceles is combined with the interposition of the greater omentum. This technique described in details gave totally satisfactory results in 14 cases. PMID- 1769844 TI - [Differential diagnosis of transplant function disorders in therapy with monoclonal antibodies OKT3]. AB - The use of OKT3 monoclonal antibodies has improved the immunosuppressive therapy. Due to the high efficiency of this treatment there is an increased risk of overimmunosuppression and occurrence of life-threatening viral infections. Therefore a cautious application of OKT3 is mandatory, a reliable differential diagnosis of the deteriorating graft function essential. In this study the high diagnostic value of urinary neopterin in the early and reliable diagnosis of CMV infection under OKT3 therapy in contrast to serum amyloid A as a marker of rejection could be shown. A differential therapy, supporting or reducing the immunosuppression, might be facilitated by daily monitoring of the neopterin and serum amyloid A. PMID- 1769845 TI - [Experience with uretero-neocystostomy in 338 kidney transplantations]. AB - In 338 consecutive human kidney transplants since 1972 uretero-neocystostomy was performed in a typical manner. The technique is a modification of Leadbetter's ureterosigmoid anastomosis and it is used for all cases of ureteral reimplantation at our institution. The rate of operative complications belonging to the urinary tract is 4.8%. In 29% out of 31 reexamined patients a vesico ureteral reflux to the transplant appeared. We believe that the demonstrated method is useful for reconstruction of the urinary tract in renal transplants. PMID- 1769846 TI - [Interventional sonography after kidney transplantation]. AB - In cases of urinary fistulae as well as lymphoceles the only ultrasound-guided percutaneous nephrostomy has led to a good result. In cases of ureterostenosis and distal fistulae the renal function could be preserved by percutaneous nephrostomy. The anterograde pyelography was exact in demonstrating localization of the stenosis which led to a better operative procedure. The interventional ultrasound therefore represents an important option in the treatment of operative complications after kidney transplantation. PMID- 1769847 TI - [Urologic complications of kidney transplants. Geneva cases, 1981-1990- observations on 200 transplantations]. AB - Between 1981 and 1990, 200 kidney transplantations were performed at the Cantonal Hospital of Geneva. Overall, 11% of patients developed a urological complication in this series. Of these complications, 40.9% were ureteral stenosis, 22.7% urinary leakages, 13.6% infected vesico-ureteral reflux, 13.6% genitourinary tumors and 9.2% other urological complications. The authors compare their series with the literature. PMID- 1769848 TI - [Therapy of urologic complications in 210 consecutive kidney transplantations]. AB - The results of 210 consecutive renal transplant operations between 1969 and 1989 were assessed with respect to urological complications. 17 patients had urological problems. 4.7% of the patients had ureteric complications (obstruction or leakage). 2.8% of this series showed other general urological complications like bladder bleeding, extravasation at the ureterovesical anastomosis and bladder leakage. One patient had interstitial cystitis and an anastomosis of the transplant ureter with an ileal conduit was performed. Ureteric complications were managed in all cases by revisional surgery, excision of the affected segment followed by ureteroneocystostomy or uretero-/pyeloureterostomy. Bladder bleeding and extravasation at the ureterovesical anastomosis were treated by transurethral and percutaneous drainage procedures. Open surgery was necessary for great bladder leakage. In all cases the function of the transplant kidney could be maintained. PMID- 1769849 TI - [Cutaneous reconstruction of external genital organs: an older method still in current use]. AB - The authors present four patients with cutaneous defects of the genital organs, one with a degloving injury to the penis, one with Fournier's gangrene, one with massive lymphoedema and one with a full thickness burn. In those four cases, a stable coverage was obtained through skin grafts, maintained by an external splint. The use of this older method gave an excellent esthetic and functional result. PMID- 1769850 TI - [Reconstruction of external genitalia of the girl with adrenogenital syndrome]. AB - Congenital adrenal hyperplasia (CAH) is the most common cause for female pseudohermaphroditism. In these patients uterus and Fallopian tubes are present and also in severe cases the clitoris cannot function as penis later in life. Therefore, a neonate with ambiguous genitalia due to CAH should be raised as female. To assess the degree of masculinization, a modification of Prader's classification was used. In 23 girls with ambiguous genitalia reduction clitoroplasty preserving the neurovascular bundle and creating a dorsal preputial skin flap and vaginoplasty with a perineal skin flap were performed. The phallic skin was used to create the labia minora and the anterior vaginal wall. The patients were reevaluated 1 to 14 years after the operation. The cosmetic and functional results have been excellent. PMID- 1769851 TI - [Replantation surgery of the penis. A case report]. AB - By the case of a subtotal traumatical amputation of the penis seen in our services, we discuss the advantages of a replantation by microsurgical technique. After presentation of the operational procedure and the management of the postoperative course the results of a thorough examination by questioning, physical examination, neurological examination including EMG testing of the bulbo cavernous-reflex, Rigiscan NTM and angiography of the penal arteries are discussed. A review of the literature shows the advantages of the microsurgical technique but also the astonishing results by the former, conventional technique which still presents a possibility if microsurgery is not available. PMID- 1769852 TI - [First clinical evaluation of the CHUV ballistic lithoclast]. AB - The authors present the first clinical evaluation of the ballistic lithoclast CHUV based upon results of 55 treated patients. Their conclusion is that the lithoclast CHUV is a simple, reliable, easy to use, efficient and patient friendly machine. PMID- 1769853 TI - [First clinical results using a pulsed dye laser Rhodamine 590 lithotripter in treatment of ureteral calculi]. AB - A collaborative study about a pulsed dye laser Rhodamin 590 was undergone, 2 years ago, between the laser application center of EPFL and both urological departments of the university of Geneva and the university of Lausanne. First clinical results are presented. Ten patients have been treated for various ureteral stones, mainly calcium oxalate stones. Laser fragmentation was successful in seven cases. No serious complication was noted. Fragmentation efficiency seems better with a 320 microns fiber than with a 200 microns fiber. PMID- 1769854 TI - [Primary hyperparathyroidism: studies of 4,000 urinary calculi patients treated with extracorporeal shockwave lithotripsy]. AB - The incidence of primary hyperparathyroidism was determined in 4000 renal stone formers treated by ESWL at our institution from 1983 to 1990. Based on repeated measurements of serum calcium and serum parathyroid hormone an incidence of 2.8% was found. In 60% of patients with primary hyperparathyroidism stone disease occurred for the first time. The majority of patients (68%) were more than 50 years of age. 56% of patients were men, 44% were women. PMID- 1769855 TI - [Renal cell carcinoma: DNA cytometry and its clinical significance. An 8 year survival study]. AB - In 157 patients with renal cell carcinoma, the ploidy, DNA heterogeneity and the phases of the cell cycle occurring in the tumors were determined by means of single-cell DNA cytophotometry, in order to establish further prognostic factors in addition to the ones known so far (stage/grade). Patients with aneuploid tumors or tumors with more than one DNA frequency peak were found to have lymph node metastases intraoperatively and died earlier than patients with diploid tumors. Patients who had tumors with low proliferative activity survived longer than patients with highly proliferative tumor activity (p = 0.001). PMID- 1769856 TI - [Initial experiences with prostaglandin E1 and PGE1 prepared injections]. AB - Between April and August 1989 we treated 50 patients with an erectile dysfunction. 23 patients (46%) had an organic, 17 (34%) a psychogenic and 7 patients (14%) a mixed origin of their impotence. In 3 patients the diagnosis has yet to be made. To induce pharmacological erections we used 20 micrograms of prostaglandin-E1 in a ready to use syringe. 64% (32 patients) achieved a full erection. Of the 18 patients insufficiently responding, 12 (67%) had an organic (in 11 patients vascular), 4 a psychogenic and 1 patient a mixed erectile dysfunction. In one patient the diagnosis has not been established at present. 14% (7) of the patients complained to have painful erections disturbing intercourse. The mean erection time was 2.5 hours (range 0.5-5.5). In one patient the intracavernous injection of prostaglandin-E1 resulted in a prolonged erection of more than seven hours, which was successfully treated by aspiration of blood from the corpora cavernosa and intracavernous injection of phenylephrine hydrochloride. Nevertheless prostaglandin-E1 appears to be more physiological and to have less side-effects than papaverin-chloride. PMID- 1769857 TI - [Major surgery of the thoracic wall: preoperative preparation, peri-and postoperative care]. AB - Major chest wall surgery causes significant changes in respiratory function during the peri- and postoperative phases. These are predominantly due to lateral position, use of a double lumen endotracheal tube, one-lung anesthesia, loss of functional intrathoracic volume, postoperative pain and local hypoventilation, pulmonary superinfection and right heart dysfunction. In the present short review pathophysiological mechanisms, appropriate monitoring techniques and some therapeutic modalities are discussed. PMID- 1769858 TI - [Rectal cancer: need for radiotherapy in determining the treatment plan]. AB - Postoperative radiotherapy is highly effective in the prevention of local recurrence in rectal cancer. Nevertheless, the results remain disappointing for Locally Advanced Rectal Cancer. New approaches include introduction of chemotherapy to postoperative radiotherapy or combined radiotherapeutic treatment with preoperative irradiation, surgery and intraoperative irradiation, along with elective postoperative treatment in function of surgical and pathological data. Based on recent advances in radiobiology we are able to modify treatment parameters to enhance efficacy without increasing the toxicity. The reduction of dose per fraction, the application of radiosensitizers, the optimal protection of healthy tissue will increase the therapeutic ratio while keeping results constant or even reduce the incidence of local failure. PMID- 1769859 TI - [Ruptured aneurysm of the lienalis artery as a cause of acute abdomen. Case report and review of the literature]. AB - The case of a 82-year-old lady with acute abdominal pain is reported. Intraoperatively we find a ruptured aneurysm of the splenic artery. Splenectomy with resection of the aneurysm is performed. An overview of the newer literature is presented. Epidemiology, etiology, clinical findings, diagnosis, prognosis and treatment of splenic artery aneurysms are discussed. PMID- 1769860 TI - Immunohistochemical localization of basic fibroblast growth factor in A431 human epidermoid carcinoma cells. AB - The intracellular location of basic fibroblast growth factor (bFGF) was determined in A431 human epidermoid carcinoma cells both on immunofluorescence and on immunoelectron microscopy using a monoclonal anti-bFGF antibody. The immunofluorescence was located in the cytoplasm in quiescent cells. Following the addition of FCS to the culture medium of quiescent sparse cells the growth factor was translocated to and accumulated in the nucleolus. Immunogold particles were dense near the ribosomes, but were not recognized in the cytoplasmic structures concerned with the usual secretory pathway such as the rough endoplasmic reticulum, the Golgi apparatus, and secretory granules. These results suggest that endogenous bFGF undergoes intracellular sorting and enters the nucleoli in A431 cells according to an extracellular growth signal. PMID- 1769861 TI - Demonstration of dopamine in electron-dense synaptic vesicles in the pars intermedia of Xenopus laevis, by freeze substitution and postembedding immunogold electron microscopy. AB - The presence of dopamine in the pituitary of the clawed toad Xenopus laevis was studied by light and electron microscope immunocytochemistry, using pre- and postembedding techniques. Light microscopy showed the presence of an intricate, anti-dopamine-positive fibre network throughout the pars intermedia. In preembedded stained material, dopamine appeared to occur in varicosities which make synaptic contacts with both folliculo-stellate cells and melanotrope cells. Post-embedding immunogold staining of freeze-substituted material permitted the localization of anti-dopamine reactivity in electron-dense vesicles in these varicosities. This finding supports the hypothesis that dopamine is involved in the (inhibitory) control of melanotrope cell activity in X. laevis. PMID- 1769862 TI - The tissue distribution of rat chromogranin A-derived peptides: evidence for differential tissue processing from sequence specific antisera. AB - The distribution of chromogranin A and related peptides in rat tissues was investigated using sequence specific antisera. N- and C-terminal antisera and a presumptive C-terminal rat pancreastatin antiserum immunostained an extensive neuroendocrine cell population throughout the gastro-entero-pancreatic tract, anterior pituitary, thyroid and all adrenomedullary cells. However, mid- to C terminal antisera immunostained a subpopulation of chromogranin A positive cells. Most notable of these was with the KELTAE antiserum (R635.1) which immunostained discrete clusters of adrenomedullary cells and antiserum A87A which immunostained a subpopulation of cells in the anterior pituitary and throughout the gastrointestinal tract. The present study has demonstrated the widespread occurrence of chromogranin A and related peptides in rat neuroendocrine tissues and provides evidence of tissue and cell specific processing. PMID- 1769863 TI - [ENT antibiotic therapy: therapeutic guidelines. Part II]. PMID- 1769864 TI - [Current antibiotic treatment of ENT infections in the child]. AB - Most acute infections of the upper respiratory tract are primary viral infections. Bacterial infections and superinfections in the head and neck in children require appropriate antibiotic therapy to prevent complications. No essential change of the bacterial spectrum of ENT infections of children has been seen in recent years. Penicillins and macrolides are important antimicrobial agents in current therapy. Beta-lactams are an important therapeutic advance. PMID- 1769865 TI - [Computer-assisted placement for after-loading procedures with iridium 192]. AB - Extremely high precision is needed to place radiation sources in the after loading technique, but localisation techniques so far described do not offer the required accuracy. We used the computer-assisted surgery (CAS) localising system for the placement of after-loading probes in patients with head and neck carcinoma. Surgical instruments can be positioned without visual control using the CAS system. Since 1989 after-loading tubes have been placed using the CAS method. We evaluated the accuracy to be better than 1 mm. Ten after-loading treatments with iridium 192 of head and neck carcinomas were carried out between August 1989 and February 1991 with exact placement of the after-loading tubes in the nasopharynx. It seems feasible to treat cerebral tumours as well as tumours of the pelvic region by computer-assisted after-loading brachytherapy. PMID- 1769866 TI - [Postoperative inhalation treatment after paranasal sinus interventions. A placebo-controlled, double-blind and randomized study]. AB - A placebo-controlled, double-blind study with Ems brine inhalations as postoperative treatment after endoscopic endonasal sinus surgery was conducted on 30 patients. After informed consent had been obtained, the patients were treated with either Ems brine or saline solution (200 ml) 3 times a day for 10 days. The parameters measured were rhinomanometry, X-ray films of the sinuses, endoscopy, saccharin clearance and a subjective evaluation by the physician and by the patient based on a visual analogue scale. The difficulty of choosing parameters for assessing the treatment was that comparable clinical studies and a single predictive parameter were not available. The bacteriological test and the saccharin clearance test were not significantly different between the two groups. Recovery, swelling, crusting, bleeding and signs of inflammation, opacity on sinus X-ray films, and nasal flow as measured by rhinomanometry were all significantly better in the group inhaling brine solution (P less than 0.05). PMID- 1769867 TI - [Nasal mucosa in tropical climate]. AB - Morphological and functional results of the factors influencing the nasal mucous membranes of 150 persons living in a tropical zone are presented. In particular, an increased rate of hyperplastic mucosa was found in comparison with a group of 850 subjects from central Germany. The macroscopic results correlated with exfoliative cytological examination. On the other hand, the rates of moderate and severe hyposmia (9.3%) as well as moderate and extreme nasal obstruction (34%) were lower. PMID- 1769868 TI - [Dysphagia in the elderly]. AB - The prevalence of dysphagia in the elderly ("presbyphagia") is probably still underestimated, though this disorder represents a major geriatric problem; special attention is necessary to prevent malnutrition, dehydration and aspiration pneumonia. Primary presbyphagia due to physiological, age-related changes of the swallowing mechanism must be differentiated from secondary presbyphagia attributable to diseases which are more frequent in the elderly. Transnasal pharyngo-laryngo-fiberendoscopy, videofluoroscopy and the "modified barium swallow" are of particular value in the diagnostic approach to presbyphagia. The possibilities of treatment are limited. They are aimed at dietary adjustments, compensatory mechanisms based on the properties of the volume and consistency of the food, proper feeding position and help by other persons. Individual swallowing exercises by a speech therapist are particularly valuable. Surgical procedures for the treatment of underlying organic disorders are less often indicated in presbyphagia. PMID- 1769869 TI - [Video-endoscopic findings in playing various wind instruments]. AB - The function of the larynx and tongue of 15 subjects playing different wind instruments was examined. Whichever instrument was played, no variations of the vocal cord positions were found. A sustained note produced by the singing voice, or by playing an instrument, or by singing synchronously was observed by stroposcopy. Laryngeal functions did not change between these three types of use of the larynx. Vibrato was indirectly produced by the vocal cords. Laryngeal disorders influence the playing of wind instruments and the use of the singing voice. PMID- 1769870 TI - Corrosion potential of steel bird shot in dogs. AB - Each year many dogs are accidentally or purposely wounded with shotguns. When lead pellets were used exclusively in the past, clinical problems from chronically embedded shot seldom developed except for rare cases of lead toxicosis. However, because expended lead shot ingested unintentionally by waterfowl and other avian species is fatal, the US Fish and Wildlife Service mandated exclusive use of steel shot for waterfowl hunting beginning in 1991. To discover the effects of implanted steel shot in a biological system, in vitro and in vivo studies were performed. Severe surface corrosion was evident when steel shot was placed in physiologic saline solution and sterile canine plasma. Eight laboratory dogs were surgically implanted with sterile steel shot in various superficial locations for intervals of 2 to 26 weeks. Corrosion of implants and tissue inflammation was observed in all biopsy specimens examined. It has been shown that steel shot embedded in tissues will corrode and result in a severe inflammatory response. If the accompanying inflammation is complicated by bacterial contamination, foreign body reactions resulting in infected, draining tracts could develop. Veterinarians and dog owners should be aware that treatment and prognosis for wounds caused by steel shot may differ from those for similar wounds caused by lead shot. PMID- 1769871 TI - Dedication to avian studies. PMID- 1769872 TI - Giving advice--some liability angles. PMID- 1769873 TI - Safety of foods of animal origin: responsibilities of veterinary medicine. PMID- 1769874 TI - Safety of foods of animal origin: model for elimination of Salmonella contamination of turkey meat. PMID- 1769875 TI - Endocrine changes associated with cystic ovarian degeneration in sows. AB - Endocrine changes in sows with ovarian cysts were determined to be comparable with those in sows in diestrus. Blood samples were collected at frequent intervals from 5 sows affected with cystic ovaries. Concentrations of serum luteinizing hormone, progesterone, estradiol-17 beta, and cortisol were determined by use of established radioimmunoassays. The development of ovarian cysts has been proposed to be associated with a deficiency of luteinizing hormone rather than an intrinsic ovarian abnormality. In contrast, the results of this study demonstrated that tonic and pulsatile luteinizing hormone release were not affected adversely in sows with cystic ovaries. PMID- 1769876 TI - Effects of stage of gestation and breed on bovine responses to vaccination with Brucella abortus strain 19. AB - Eighty-eight cattle were injected SC with 2.5 x 10(8) viable cells of Brucella abortus strain 19. All but 1 heifer became seropositive on the basis of the results of 7 brucellosis tests, and the proportion positive decreased with time. The proportion of cattle that were seropositive during a 20- to 67-week period after vaccination was as follows, in decreasing order: hemolysis-in-gel, 59%; buffered-acid plate antigen, 39%; ELISA, 16%; card, 10%; rivanol, 8%; cold complement-fixation, 7%; and automated complement-fixation, 5%. Using the serologic classification in Uniform Methods and Rules for brucellosis eradication, 7 cattle tested brucellosis-positive (2 suspects and 5 reactors). None of the 27 nonpregnant heifers tested positive. Of 18 heifers that were 84 to 135 days in gestation when vaccinated, 6 (33%) tested positive for brucellosis, compared with 0 of 13 and 1 (3%) of 30 heifers that were 11 to 78 and 145 to 253 days in gestation at vaccination, respectively (X2 = 12.07; 2 df; P less than 0.01). Neither breed (Angus, Hereford, Jersey, and Brahman) nor calf survival was related to brucellosis-positive results. Postpartum milk samples from 61 heifers and 24 tissues from 2 reactor cattle were culture-negative for B abortus. PMID- 1769877 TI - Prognostic value of surgical and postoperative findings in cattle with abomasal volvulus. AB - A prospective study evaluating the prognostic value of surgical and postoperative findings in 80 cattle with abomasal volvulus was performed. Surgical correction of abomasal volvulus was performed in all animals. After surgery, cattle were categorized into 3 groups: productive (acceptable milk production or appetite, n = 59), salvaged (poor milk production or appetite, n = 10), and nonsurvivors (n = 11). Cattle with omasal-abomasal volvulus had a significantly (P less than 0.005) worse prognosis than cattle without omasal involvement. Large abomasal fluid volume, venous thrombosis, and blue or black abomasal color before decompression were all indicative of a poor prognosis. Most cattle had poor or fair appetites the first day after surgery; productive animals had marked improvement in appetite over the next 3 days. All cattle observed to have a good appetite within 3 days after surgery were later determined to be productive animals. The heart rate decreased in all groups after surgery; however, tachycardia (heart rate greater than 80 beats/min) was sustained in cattle that were later salvaged for slaughter. Diarrhea was observed after surgery in 54% of cattle. The duration of diarrhea was significantly shorter (P = 0.009) in productive cattle than in salvaged and nonsurviving cattle. The presence or absence of diarrhea was only of predictive value when considered in conjunction with the estimated abomasal fluid volume. PMID- 1769878 TI - Acute renal failure associated with contrast medium administration in a dog. AB - Intravenous administration of an ionic radiographic contrast medium was believed to have caused acute oliguric renal failure in a young dog. Intravenous pyelography was done on a healthy 14-month-old female Lhasa Apso prior to reconstructive surgery for pseudohermaphroditism. Within 24 hours of the radiographic procedure, acute oliguric renal failure developed. Cause for the renal failure was not found other than the recent IV administration of radiographic contrast medium. Treatment with fluids, furosemide, and dopamine was successful in returning renal function to normal. Various adverse reactions to IV administration of contrast media in human beings and animals have been reported; however, to our knowledge, acute renal dysfunction induced by IV administration of contrast material has not been reported in dogs. PMID- 1769879 TI - Management of apparent luteal insufficiency in a bitch. AB - Serum progesterone concentration in a pregnant bitch with suspected luteal insufficiency was monitored by use of a commercially available ELISA kit, and exogenous progesterone was administered as needed to enable the bitch to deliver normal-term pups. Progesterone in oil was administered at a dosage of 2 mg/kg of body weight at 72-hour intervals. The bitch delivered 2 clinically normal male pups and 1 mummified female pup within 12 hours after the exogenous progesterone was calculated to have been metabolized. PMID- 1769880 TI - Branchial cleft cyst in a bull. AB - Branchial cleft cyst was diagnosed in a 6-month-old Angus bull with a large swelling in the distal ventral neck region. A definitive diagnosis could not be attained from results of the clinical examination, radiography, and ultrasonography. Diagnosis was made from histologic examination of the surgically removed mass. Branchial cleft cysts are remnants of the branchial apparatus and are considered rare in domestic animals. The differential diagnosis should include the thymic form of bovine viral leukosis, thymoma, abscess, goiter, and thyroid gland tumors as well as other rare cysts that can develop in the same location. PMID- 1769881 TI - T-plate repair of fracture of the nasal bones in a horse. AB - A 5-hole T-plate was used to repair an unstable compound depression fracture of the nasal bones in a horse. Substantial bone loss was evident as a result of severe trauma. Satisfactory bone healing, facial contour, and airway function were achieved. The use of a T-plate can be an alternative means of repair of a nasal bone fracture in a situation in which instability and/or bone loss exists. PMID- 1769882 TI - Positive end-expiratory pressure during colic surgery in horses: 74 cases (1986 1988). AB - Positive end-expiratory pressure (PEEP) was applied in 74 anesthetized, ventilated horses during colic surgery, to attempt to increase arterial oxygen tensions. In 28 horses with an initial PaO2 less than 70 mm of Hg, PEEP increased PaO2 values to a mean of 173 +/- 24 mm of Hg. Arterial oxygen content increased from 14.1 +/- 0.05 ml/dl to 17.2 +/- 0.05 ml/dl. In the remaining 46 horses, PEEP increased PaO2 from a mean value of 101 +/- 6 mm of Hg to 194 +/- 15 mm of Hg, and arterial oxygen content increased from 14.9 +/- 0.09 ml/dl to 16.9 +/- 0.07 ml/dl. Cardiovascular depression and decrease in arterial blood pressure was observed after the application of PEEP in 54 horses. These 54 horses required use of pressors (n = 8), inotropes (n = 32), or both (n = 14) to keep the mean arterial blood pressure greater than 60 mm of Hg. Combined with pharmacologic support of blood pressure, PEEP could be a useful clinical treatment of arterial hypoxemia in horses. PMID- 1769883 TI - What is your diagnosis? Deep fistula with possible foreign body. PMID- 1769885 TI - Glycocalyx carbohydrates of uterine epithelial cells increase during early pregnancy in the rat. AB - Carbohydrates were studied on the surface of uterine epithelial cells by lectin avidin-ferritin histochemistry. The lectins, wheat germ agglutinin, fucose binding protein, soy bean agglutinin and the lectin from Phytolacca americana were used in the study. Statistically significant increases in three carbohydrates on day 6 of pregnancy--the day of blastocyst implantation--were found when compared with oestrus. These increases could contribute to the mechanism of blastocyst attachment to uterine epithelium. PMID- 1769884 TI - Functional anatomy of the thymic microenvironment. AB - This paper presents a review of our current understanding of the nature of the thymic microenvironment, after briefly considering the major role of the gland. The epithelial cells and their products are of fundamental importance, and other cells of the macrophage series are implicated in most functional events. The embryological origin of the epithelium is still not clear, although disease conditions would suggest a single origin. Immigration and emigration of thymocytes is considered, and also the passage of antigens into the gland. The events within the thymus are under the control of the CNS acting through the innervation or via hormonal pathways. Both of these areas are considered in detail, especially thymic hormone origins, functions and interactions. PMID- 1769886 TI - Expression of major histocompatibility complex and leukocyte common antigens in amoeboid microglia in postnatal rats. AB - The expression of major histocompatibility complex (MHC) antigen and leukocyte common antigen (LCA) was observed in the amoeboid microglial cells in postnatal rat brain. Considerable MHC class I surface antigen was detected at the plasma membrane and its tubular invaginations in the amoeboid microglia in the corpus callosum using the monoclonal antibody OX-18. In early postnatal (2 and 5 day) rats, the OX-18 positive cells were mostly round but a few possessed stout processes. With increasing age (9 and 15 days) the OX-18 positive amoeboid microglia assumed an oval or elongated form. By the time of weaning (21 days) and in older animals, the immunoreactivity was extremely weak and was detectable only on some branched microglia bearing fine processes. The presence of MHC class Ia antigens with OX-3 and OX-6 was hardly detectable except for a few weakly stained cells in the corpus callosum and cavum septum pellucidum in early postnatal rats. The expression of LCA was observed in amoeboid microglial using the monoclonal antibody OX-1 and this followed a similar temporal pattern to that with OX-18. The additional phenotypic features of amoeboid microglial cells in the present study support their monocytic origin. These cells are endowed with MHC class I antigens which may serve as the restriction elements for T lymphocytes, at least in the early postnatal brain. PMID- 1769887 TI - Quantitative differences in the histology of the attachment zones of the meniscal horns in the knee joint of man. AB - The attachment zones of the meniscal horns of 7 dissecting room cadavers were examined by routine histology. All the knees were devoid of gross pathological change and no discoid menisci were included. Significant differences are reported in the thickness of the zones of uncalcified fibrocartilage and cortical calcified tissue (calcified fibrocartilage and underlying lamellar bone) and in the percentage of bone:bone marrow. There was a thicker zone of uncalcified fibrocartilage and a greater quantity of calcified tissue at the horns of the lateral than the medial meniscus. The differences in uncalcified fibrocartilage were largely attributable to the posterior horns, but the variations in calcified tissue mainly reflected differences between the anterior horns. It is suggested that the greater mobility of the lateral meniscus and the blending of its anterior horn with the anterior cruciate ligament are important factors accounting for the quantitative differences in the meniscal attachment zones. PMID- 1769888 TI - Morphometric analysis of the developing murine molar tooth in vivo and in vitro. AB - A morphometric technique is described which has been used to measure morphogenesis and matrix synthesis of developing murine teeth in vivo and in vitro. The growth of bud and cap stage tooth germs in vitro was reduced considerably compared with in vivo. There was no growth of tooth germs explanted and cultured in vitro at the bell stage. The onset of dentine and enamel synthesis were however only slightly delayed in vitro compared with in vivo. The technique had been designed to be insensitive to orientation or artefactual folding of the cultured tissue. PMID- 1769889 TI - Haemopoietic phagocytes in the early differentiating avian retina. AB - The existence of specialised phagocytic cells is described in regions of the retinal neuroepithelium undergoing intense cell death during early differentiation of the avian embryo retina (2.5-5 days of incubation). These results were obtained using routine techniques for light microscopy, acid phosphatase histochemistry and immunocytochemical staining with antibodies MB-1 and QH-1, both specific for quail endothelial cells and all blood cells except mature erythrocytes. Specialised phagocytes were distinguishable from neuroepithelial cells on the basis of morphological criteria: in the former, the nucleus was not oval in shape and was not oriented perpendicular to basement membrane neuroepithelium. The cytoplasm of the specialised phagocytes was often filled with dead cell fragments. In contrast to neuroepithelial cells, the specialised phagocytes showed acid phosphatase activity and were labelled with both MB-1 and QH-1 antibodies in normal quail embryos and chick----quail yolk sac chimeras. Moreover, some acid phosphatase positive and MB-1/QH-1 positive cells also appeared in the presumptive vitreous body, at the edges of the optic cup and in the surrounding mesenchyme. As the vitreal cells and the specialised phagocytes of the neural retina were immunolabelled in chick----quail yolk sac chimeras, we conclude that they are derived from haemopoietic cells in the yolk sac. Some images suggest that these cells enter the vitreous body from the surrounding mesenchyme and traverse the basement membrane of the neuroepithelium in the optic disc region to give rise to the specialised phagocytes of the retinal neuroepithelium. PMID- 1769890 TI - The effects of paralysis on skeletal development in the chick embryo. I. General effects. AB - In order to investigate further the effects of paralysis on skeletal development in the chick embryo, paralysis was induced at 6 days of incubation by dropping 0.2% solution of decamethonium bromide onto the chorioallantoic membrane and maintaining paralysis through to 20 days of incubation. General effects of paralysis included lower body weight, marked subcutaneous oedema, twisting of the neck to the right with marked rigidity, and protrusion of the lower beak beyond the upper. Skeletal abnormalities included cartilaginous and later bony fusion between cervical vertebrae and distortion of scapula and pubis. Long bones were normal in their general form but showed marked reductions in full length and in length of the calcified diaphysis. The patella occasionally underwent chondrification, unlike the tibial cartilage at the tarsus. Reduction in length of the bones of both jaws occurred but was substantially greater in the upper, resulting in the protrusion of the lower. Ossification times of most skeletal elements were little affected by paralysis but some centres appearing nearer the end of incubation showed slight delay in their times of appearance. PMID- 1769891 TI - The effects of paralysis on skeletal development in the chick embryo. II. Effects on histogenesis of the tibia. AB - In order to study the effects of paralysis on the development of bone, chick embryos were paralysed at 6 days of incubation and the pattern of histogenesis of the tibia was compared with that of control embryos by histology, scanning electron microscopy and morphometry. Up to 11 days of incubation the histological features of chondrification, initial perichondrial ossification and invasion by the vascular bud showed no differences. After this time the paralysed embryos exhibited a reduction in the formation of bone tissue and a reduced development of the fibular crest. The spread of cartilage resorption was also markedly reduced. In addition, scanning electron microscopy suggested a reduction in resorption of the innermost layers of bone. Blood vessels in the marrow cavity appeared smaller and those within developing osteones appeared larger than in the controls. In the paralysed embryos, morphometry confirmed a significant reduction in total volume of the tibia together with changes in its volumetric composition resulting from reduction in bone formation, cartilage formation and cartilage resorption. PMID- 1769892 TI - Methods of estimation of spine density--are spines evenly distributed throughout the dendritic field? AB - Dendritic spines are small protrusions extending from the dendrites of nerve cells, which bear the majority of synapses. In the past, researchers quantified spine density as the number of visible spines per estimated micrometre of dendrite. This estimate ignores all those spines hidden from view due to their position on the dendrite. Dendrites vary in diameter and the underestimation in some will be greater than others. Estimation of dendritic length is also subjective and difficult in those which are tortuous. The Felman & Peters (1979) geometrical equation takes account of these criteria and provides a method of estimating 'true' spine numbers which does not involve slow and laborious reconstruction. This study compares ratios derived from both methods of estimation (spine density 2:1) at three loci in three experimental groups. Mean values of dendritic diameters and spine dimensions show the major cause for variation in the ratios between loci to be the shaft diameter of the dendrite. However, the greater ratio for apical as compared with basal and oblique dendrites is not as great as expected, bearing in mind that apical dendrites are approximately 2.5 times larger than oblique and basal dendrites. Therefore the spine distribution may not be the same throughout the dendritic field. Estimations of spine density based on visible spine counts are quicker, easier and sufficient for comparisons within the same locus. 'True' estimates (spine density 2) are more accurate and should be used when comparisons are being made between loci, cell types and species. PMID- 1769893 TI - Ultrastructure of the mink parotid gland. AB - Acini in the parotid gland of the North American mink (Mustela vision) are composed of seromucous cells that contain secretory granules of peculiar morphology. Many of the granules consist of a light matrix in which is embedded an inclusion made up of dense, frequently parallel rodlets in a fibrillar material of moderate density. Like the submandibular gland of the same animal, the tall cells of the parotid striated ducts contain numerous polygonal, often rhomboidal, crystalloids in their apical cytoplasm. These crystalloids are present equally in both sexes and are as abundant in the parotid as in the submandibular gland. PMID- 1769894 TI - Variability of fibroblast morphology in vivo: a silver impregnation study on human digital dermis and subcutis. PMID- 1769895 TI - A tubercle at the anterior margin of the foramen magnum. PMID- 1769896 TI - Structural and functional reserve of steroidogenic membranes in stimulated luteal cells of pregnant rats. AB - A comparison was made of the ultrastructural features of the remaining corpora lutea (CL) of five unilaterally ovariectomised and five control pregnant rats. Unilateral ovariectomy (ULO) was carried out on Day 8 of gestation; this treatment has been shown to double the normal rate of progesterone secretion by the remaining ovary within 8 days. On Day 16, the ovaries from both ULO and control rats were examined stereologically. The mass of luteal tissue remaining in ULO rats was only 44% of that in the controls, but their plasma progesterone concentration was 81% and not significantly different from the control value. The CL were 10% heavier in ULO rats and the amount of luteal cell cytoplasm per CL was 21% greater. The percentage of the CL occupied by luteal cells was 15% greater in ULO rats but the interstitial space was 50% less. There was no significant change in the percentage of the luteal cell cytoplasm occupied by cytosol, agranular endoplasmic reticulum (AER), mitochondria and electron-dense granules. The surface area per unit cytoplasmic volume of AER and outer and inner mitochondrial membranes (OMM and IMM, respectively) was not affected. However, expressed per CL, both the AER and IMM membrane surface areas were increased by around 30%. These morphometric changes would only account for about 30% of the reported increase in hormone secretion by the CL of ULO rats, and they suggest that the CL of Day 16 pregnant rats may have reached their optimal structural condition. PMID- 1769897 TI - The peritoneal elastic lamina. AB - The structure and extent of the submesothelial elastic tissue of the peritoneum, tentatively termed the peritoneal elastic lamina (lamina elastica peritonei, LEP), was studied in autopsy and biopsy material by light microscopy. The investigation confirms the presence of a well-defined network of elastic fibres just beneath the basement membrane of the visceral and parietal peritoneum in man. The LEP is claimed to be analogous to similar elastic tissue in other serosal cavities, the pleura and the pericardium, as previously described. The LEP may be useful for normal anatomical as well as pathoanatomical investigations. PMID- 1769898 TI - Perinatal androgen administration and the maintenance of sexually dimorphic and nondimorphic lumbosacral motor neuron groups in female Albino Swiss rats. AB - Motor neuron groups in the L5-S1 region of the spinal cord were examined in male and female Albino Swiss rats and in females treated with 5 alpha dihydrotestosterone benzoate (DHTB) either prenatally or postnatally. The spinal nucleus of bulbocavernosus (SNB) contained some five times more neurons in males than females. Perinatal DHTB treatment to females increased SNB numbers; prenatal treatment was less effective than postnatal. Within the same part of the cord, males possessed more motor neurons in the dorsolateral nucleus (DLN) than females. Perinatal DHTB treatment to females (both prenatal and postnatal) increased DLN neuron numbers. The perineal muscles (the normal target for SNB and DLN motor neurons) are absent in adult female rats; they are maintained by postnatal (but not prenatal) DHTB treatment. Two other motor neurons groups within the same region of cord, the retrodorsolateral nucleus (RDLN) and the ventromedial nucleus (VM) show no sex differences and are not affected by perinatal androgen treatment. PMID- 1769899 TI - Topography of functional subpopulations of neurons in the superior cervical ganglion of the rat. AB - This study describes the distribution patterns of neurons in the rat SCG that project to a number of spatially separated and functionally different target tissues. Fluorescent dyes were used to label retrogradely neurons that project to the pineal gland, iris, nictitating membrane, Muller's smooth muscle of the eyelid, submaxillary gland, thyroid gland, tongue, buccal mucosa, and skin in several areas of head and neck. The numbers of neurons in the various subpopulations were quantified and, in several instances, postganglionic nerve transection was used to correlate the topography of subpopulations with the exit site/s of their projections from the ganglion. Individual neurons were found to have very limited projection fields and contralateral innervation of bilateral targets appeared to be minimal. Neurons with specific functions or projection fields were not highly localised within the SCG, but there was a general rostrocaudal organisation of neurons with respect to the position of their targets along the rostrocaudal axis of the body and this was correlated with the exist sites of the neurons from the ganglion. PMID- 1769900 TI - Topography of the major superficial lymph nodes and their efferent lymph pathways in the koala (Phascolarctos cinereus). AB - The koala has an inguinoaxillary lymph trunk on either side of the ventral midline, and this carries efferent lymph from the superficial inguinal lymph node directly to the deep axillary lymph node. The superficial lymph nodes are large and soft compared with those of the domestic species, and each lymph centre usually contains only one or two large lymph nodes. Koalas have a rostral mandibular lymph node which has not been described in other species, but lack popliteal and subiliac lymph nodes. The superficial lymph nodes which are readily palpable in the live koala are the facial, rostral mandibular, mandibular, superficial axillary and superficial inguinal. All superficial lymph pathways terminate at the confluence of the common jugular and subclavian veins. PMID- 1769901 TI - The structure of corpuscular nerve endings in the limbal conjunctiva of the human eye. AB - Corpuscular nerve endings were found to be numerous within a narrow, 1.00 mm wide, annular zone of limbal conjunctiva, located approximately 0.5 mm from the corneoscleral margin. A light and electron microscopic study was carried out on these nerve endings found within samples of human eye-bank material. Corpuscular endings were found immediately under the epithelium, often within the stromal elevations which make up the limbal palisades of Vogt. They were round to oval in shape, and varied in size, with a mean maximum diameter of 30 microns. The afferent nerve fibre lost its myelin sheath soon after entry, and subsequently branched to give rise to a variable number of axon terminal varicosities, which were characterised by an accumulation of mitochondria. Neural elements within the nerve ending were invested by the cytoplasmic lamellae of Schwann-like accessory cells. The corpuscle was demarcated from the surrounding connective tissue by a delicate fibrocyte capsule. The corpuscular nerve endings described here in the conjunctiva share features common to corpuscles found in other mucosae. The function of such complex sensory nerve endings is as yet unknown, but the possibility that they represent receptors for particular sensory modalities should be explored. PMID- 1769902 TI - Histogenesis and organogenesis of the gonad in human embryos. AB - The histogenesis and organogenesis of the human gonad in 12 embryos and 6 fetuses of ovulational ages 5 to 18 weeks was investigated by histological and ultrastructural examination, including observation of almost complete serial Epon embedded sections of entire gonads of 10 embryos. This investigation revealed that the main constituent cells of the gonads are derived from the mesonephros, and that the coelomic epithelium is not involved in the formation of the main component at any stage. With the migration of the primordial germ cells into the gonadal ridge, the coelomic epithelium becomes stratified to form a moderate protrusion of the gonad into the coelomic cavity and the coelomic epithelial cells develop into short pillars which form cord-like structures, the so-called primary sex cords. Shortly afterwards, concomitantly with the development into the subsequent prominent protrusion of the gonad into the coelomic cavity, cells emerging from the mesonephros are incorporated into the gonad to form 'primordial sex cords'. At this stage, a stratified, pile-like arrangement of coelomic epithelium flattens into monolaminar or oligolaminar structures. In the testis, the 'primordial sex cords' differentiate into seminiferous sex cords by elaborating a surrounding basal lamina. In the ovary, these 'primordial sex cords' become displaced towards the peripheral regions of the gonad by the enlargement of these cords, as well as by the formation of the interstitium, or so-called medulla, at the base of the ovary; they differentiate into 'folliculogenous sex cords' which give rise to follicular cells. PMID- 1769903 TI - Regression and stagnation. AB - In this paper regression is discussed as a process that can occur both in neurosis and in personality disorder. Regression is contrasted with the phenomenon of stagnation, which is a state characteristic of personality disorder. The aetiology of both regression and stagnation is based on Fordham's theory of deintegration. His concept of the defences of the primal self explains the phenomenon of stagnation. Clinical material is presented. Emphasis is laid on the difference between the treatment of neurotic and stagnated patients. The significance of specific archetypal images that arise in the analysis of stagnated patients is stressed. PMID- 1769904 TI - Overview of enzyme inhibitors and anti-androgens in prostatic cancer. AB - Surgical castration and estrogen therapy for prostate cancer were developed in 1941, and have been shown to improve both quality of life and survival. Little change in the therapeutics of prostate cancer has occurred over the subsequent three decades. In the 1970s, the progestational anti-androgens, ketoconazole and flutamide, were introduced as androgen-blocking agents, and have been shown to block at least partially both adrenal and testicular androgens. Gonadotropin releasing hormone (GnRH) agonists were shown in the 1980s to produce medical castration without the cardiac and cerebrovascular risks of standard dose estrogen. In the 1980s, large-scale, multicenter, double-blind studies were done to compare the effect of combined androgen blockade, using multiple drugs, to single-drug blockade of gonadal androgen with regard to time to progression and survival in stage D2 cancer. These studies were done to test theories regarding the role of adrenal androgens and their effects on androgen-sensitive tumor clones in prostate cancer. The theory of clonal heterogeneity, particularly with regard to androgen sensitivity, has led to the continuation of three major controversies about the management of prostate cancer: Is combined blockade of testicular and adrenal androgens in stage D2 prostate cancer more effective than gonadal androgen blockade alone? What is the optimal secondary or tertiary therapy for relapsed prostate cancer? Is there any advantage for combined androgen blockade at the start of therapy in stage D2 prostate cancer as compared to sequential therapy with blockade of testicular androgens first, and then adrenal androgens at the time of relapse? PMID- 1769905 TI - Developmental changes of frequency representation in the rat cochlea. AB - The place-frequency map of the developing rat cochlea was measured by iontophoretic HRP-injections into the ventral cochlear nucleus at electrophysiologically characterized positions. Distribution of retrograde HRP transport in cochlear spiral ganglion cells was analysed by means of a three dimensional reconstruction of the cochlea. Cochlear place-frequency maps were derived in rats of two ages groups: 13 to 22 days, and 36/37 day old animals. These maps were compared with the place-frequency map of adult rats (Muller, 1991). No systematic difference in the place-frequency map between 36/37 day old and adult rats was observed. In animals of the younger age group the place frequency map (for frequencies above 4 kHz) was shifted towards lower frequencies for a given place along the basilar membrane. The morphological and physiological basis for this frequency shift during development is discussed. PMID- 1769906 TI - Spontaneous otoacoustic emissions in the guinea pig. AB - Measurement of spontaneous otoacoustic emission (SOAE) in a large number of animals was conducted in the guinea pig. A remarkably high incidence of SOAE (51 ears out of 248 ears; 20.6%) was observed in the animals that were raised under unexceptional conditions. The frequencies of SOAE were distributed between 0.7 kHz and 2.3 kHz (average: 1.16 kHz). The emission signals disappeared with hypoxia and with furosemide injection, and recovered after certain periods with some frequency fluctuations. Their electrical correlates that behaved in exactly the same manner as SOAE were clearly distinguished by FFT analysis of the AC potential from the cochlear surface. The signals could be divided into 4 types: (1) emission with pure and stable frequency spectrum and steady level, (2) emission with stable frequency and fluctuating level, (3) emission alternating between two closely situated frequency points, (4) emission having an irregular, wide spectrum band. Light microscopy revealed no abnormalities in the organ of Corti that have been widely accepted to be SOAE-related, i.e., patchy lesions of the organ of Corti and/or irregularities in hair cell arrangement. This suggests that the spontaneous oscillation within the guinea pig cochlea can be generated by some minor, functional, and probably reversible disturbances of the active cochlear transduction mechanism, without major structural derangement of the organ of Corti. PMID- 1769907 TI - Specializations for sharp tuning in the mustached bat: the tectorial membrane and spiral limbus. AB - The sense of hearing in the mustached bat, Pteronotus parnellii, is specialized for fine frequency analysis in three narrow bands that correspond to approx 30, 60 and 90 kHz constant frequency harmonics in the biosonar signals used for Doppler-shift compensation and acoustic imaging of the environment. Previous studies have identified anatomical specializations in and around the area of the cochlea that processes the dominant second harmonic component, but similar features have not been found in areas related to sharp tuning and high sensitivity for the first or third harmonics. In this report we call attention to the large size of the tectorial membrane and spiral limbus in all three areas that appear to process the harmonically related constant frequency components. These structures are especially pronounced in the regions of the cochlea that respond to the approx 61 kHz, second harmonic and 91.5 kHz, third harmonic bands; they correspond specifically to areas where the density of afferent nerve fibers is high and where very sharply tuned neurons occur. These data for cochleae with multiple specializations lend strong support to the idea that the mass of the tectorial membrane can be an important factor in establishing the response properties of the cochlea. PMID- 1769908 TI - Electrical stimulation of the auditory nerve in deaf kittens: effects on cochlear nucleus morphology. AB - The present study examines the effects of long-term electrical stimulation of the auditory nerve on the morphology of neurons in the cochlear nucleus in young, sensorineural deaf animals. Kittens, systemically deafened using kanamycin and ethacrynic acid, received bilateral cochlear implants and were stimulated unilaterally for periods of up to four months. After sacrifice, cross-sectional areas of neuron somata were measured with an image-analysis system and compared using nonparametric statistics. The areas of cell somata within the anteroventral cochlear nucleus (AVCN) on the stimulated side were significantly larger than those of corresponding somata on the control, unstimulated side (P less than 0.001). However, there was no statistically significant difference among dorsal cochlear nucleus (DCN) neurons. These results indicate that long-term electrical stimulation of the auditory nerve can at least partially negate some effects of early postnatal auditory deprivation at the level of the cochlear nucleus. PMID- 1769909 TI - Preservation of mRNA during in situ hybridization in the cochlea. AB - Specific nucleic acid sequences can be identified within cells using in situ hybridization. Hybridization for mRNA can document the distribution and amount of specific gene transcripts. Decalcification protocols used for immunohistochemistry in the cochlea were evaluated for use with in situ mRNA hybridization. No loss of mRNA was detected following the use of decalcification solutions at 4 degrees C when paraformaldehyde was added to the EDTA solution. The primary determinant of mRNA preservation was paraformaldehyde. PMID- 1769910 TI - Rate and synchronization measures of periodicity coding in cat primary auditory cortex. AB - Periodicity coding was studied in primary auditory cortex of the ketamine anesthetized cat by simultaneously recording with two electrodes from up to 6 neural units in response to one second long click trains presented once per 3 s. Trains with click rates of 1, 2, 4, 8, 16 and 32/s were used and the responses of the single units were quantified by both rate measures (entrainment and rate modulation transfer function, rMTF) and synchronization measures (vector strength VS and temporal modulation transfer functions, tMTF). The rate measures resulted in low-pass functions of click rate and the synchrony measures resulted in band pass functions of click rate. Limiting rates (-6 dB point of maximum response) were in the range of 3-24 Hz depending on the measure used. Best modulating frequencies were in the range of 5-8 Hz again depending on the synchrony measure used. It appeared that especially the VS was highly sensitive to spontaneous firing rate, duration of the post click suppression and the size of the rebound response after the suppression. These factors were dominantly responsible for the band-pass character of the VS-rate function and the peak VS frequency was nearly identical to the inverse of the suppression period. It is concluded that the use of the VS and to a lesser extent also the tMTF as the sole measure for the characterization of periodicity coding is not recommended in cases where there is a strong suppression of spontaneous activity. The combination of entrainment and tMTF appeared to characterize the periodicity coding in an unambiguous way. PMID- 1769911 TI - The effect of noise exposure on the aging ear. AB - The effect of noise exposure on auditory sensitivity and inner ear morphology was compared in aged and young mature mice. Hearing thresholds were obtained by auditory evoked brain stem responses (ABR) before and after noise exposure, and hair cell loss was quantified. The study was done in two parts: first to assess the effect of noise exposure on subjects with presbycusis, and second to assess its effect on aged subjects without measurable presbycusis. In the first experiment C57BL/6 mice, with an age-related hearing loss, were used as a model for presbycusis. C57BL/6 mice exhibiting presbycusis were more susceptible to noise injury than age-matched CBA/Ca mice. In the second experiment CBA/Ca mice were used. These mice retain normal hearing even with advancing age. The aged CBA/Ca mice had the same susceptibility to noise injury as young CBA/Ca mice. PMID- 1769912 TI - Morphology of corticothalamic terminals arising from the auditory cortex of the rat: a Phaseolus vulgaris-leucoagglutinin (PHA-L) tracing study. AB - Phaseolus vulgaris-leucoagglutinin (PHA-L) injection in the auditory cortex of the rat labeled anterogradely corticothalamic axons whose trajectory, morphology of terminals and their distribution were analyzed in light microscopy. From the primary auditory cortex, corticofugal axons ran in a rostral direction in the white matter (external capsule), and reached the internal capsule by crossing the caudate putamen. Then, they turned caudally, crossed the reticular nucleus (RE) of the thalamus, where some of them were seen to give off collaterals, ramifying in the 'auditory sector' of RE. From RE, the parent corticofugal axons continued in a caudal and medial direction to enter in the medial geniculate body (MGB). Corticofugal axons from the auditory cortex gave rise to 2 distinct types of terminals in the thalamus. First, small boutons (about 1 micron in diameter) were observed in the ventral division of the MGB (v-MGB; the main auditory relay nucleus in the thalamus), in RE, in the lateral part of the posterior thalamic nucleus, in the dorsal division of the MGB (d-MGB), as well as occasionally in the medial division of the MGB. Giant terminals (5-10 microns in diameter) formed the second type of cortical terminals, only present in a restricted zone of the ventral portion of d-MGB. Both types of terminals were observed as boutons 'terminaux' and 'en passant'. The zone of termination in v-MGB and RE varied as a function of the site of cortical injection. The similarity in the morphology and distribution of the terminals of corticothalamic axons arising from the primary auditory cortex with those of the primary somatosensory cortex of the mouse is striking and points to the existence of a basic pattern of connectivity used in corticothalamic processing of sensory information in rodents. PMID- 1769913 TI - Frequency representation and spiral ganglion cell density in the cochlea of the gerbil Pachyuromys duprasi. AB - The tonotopic map of the cochlea in the gerbil Pachyuromys duprasi was analysed by local iontophoretic HRP-application into physiologically defined regions of the cochlear nucleus and mapping of subsequent HRP transport patterns in cochlear spiral ganglion cells. Furthermore the spiral ganglion cell density along the cochlear duct was determined. The cochlear tonotopic map was established in the frequency range between 0.6 and 17.5 kHz. These frequencies corresponded to locations between 86 and 3% basilar membrane length (0% = cochlear base). It was found that the slope of the place-frequency map varied with frequency, the maximum slope being found between 1 and 4 kHz. This frequency range corresponds to the frequency range of highest auditory sensitivity as determined from cochlear microphonic recordings (Plassmann et al., 1987). The density of spiral ganglion cells also varied along the cochlear duct. A pronounced maximum (1927 cells/mm) was located at around 70% basilar membrane length, compared to values of 800 cell per mm near the cochlear apex and base. This region of high ganglion cell density also corresponds to the frequency range of highest auditory sensitivity. PMID- 1769914 TI - Frequency-specific enhancement of the cochlear compound action potential: influence of the forward masker. AB - Under restricted frequency and intensity conditions, forward masking can result in the amplitude of the CAP being increased above its unmasked value (Henry, 1991). The present study provides a quantitative analysis of this enhancement effect. In response to forward maskers having the same frequency as the probe stimulus, central frequency (CF) enhancement varies as a function of the level of the forward masker: the lowest masker level at which it can reliably be detected is often well below the visual detection threshold of the CAP generated by the unmasked probe stimulus; the highest masker level at which it can reliably be detected corresponds to approximately 10 dB above the probe stimulus CAP threshold. A second low frequency (LF) enhancement region also exists, encompassing a narrow range of more intense maskers. CF enhancement can double the amplitude of the CAP, whereas LF enhancement is less pronounced. The magnitude of CF enhancement varies as a function of the duration of the forward masker, with longer durations generally increasing the magnitude of the effect. This duration effect, however, interacts with the level of the stimulus. Decreasing the interval between the end of the forward masker and the beginning of the probe increases the magnitude of CF enhancement. PMID- 1769915 TI - Hair cell regeneration in the chicken cochlea following aminoglycoside toxicity. AB - Hair cell loss in the avian cochlea partially recovers following both acoustic trauma and aminoglycoside intoxication. DNA labeling with tritiated thymidine has shown that the restoration of cell number following acoustic trauma results from the production of new hair cells by mitotic division. The purpose of the present study was to determine if mitosis also contributes to the recovery of hair cell number which occurs following aminoglycoside intoxication. Chickens received daily injections of either gentamicin sulfate or distilled water for 10 consecutive days. During the latter 7 days of this period, all birds were also injected with [3H]thymidine. Following postinjection survival periods of 3 or 6 days, one papilla from each bird was processed for autoradiography and the other for scanning electron microscopy (SEM). Incorporation of [3H]thymidine was seen over hair cells and support cells in experimental papillae in regions of hair cell loss. No labeling was seen outside of damaged regions or in the papillae of control birds. SEM showed that damaged regions in experimental birds contained cells similar in appearance to developing auditory hair cells in avian embryos. These results show that the restoration of hair cell number following aminoglycoside toxicity results from the production of new cells by mitosis. PMID- 1769916 TI - The potassium concentration in the cochlear fluids of the embryonic and post hatching chick. AB - The potassium concentration was measured in the perilymphatic and endolymphatic spaces of the chick's cochlea using ion-specific microelectrodes. The mean values in post-hatching chicks were 8.1 and 161 mM/l, respectively and are thus the same as in mammals. The high potassium concentration is reached at the latest at stage E42, and thus before the tegmentum vasculosum is fully developed. The endocochlear potential of chicks was maximally + 13 mV and thus somewhat below the published values for birds. Positive potentials in the endolymphatic space of 5 mV or more were already present in animals of age E41 and E42 and the developmental process is complete at the latest one day after hatching. PMID- 1769917 TI - Enhancement of the cochlear nerve compound action potential: sharply defined frequency-intensity domains bordering the tuning curve. AB - Forward masking can either decrease or increase the response to a subsequent stimulus. In the gerbil, frequency-intensity domains of the maskers that decrease the amplitude of the compound action potential (CAP) can be plotted as the sharply defined CAP tuning curve (TC). Regions were also found over which masking increases (enhances) the amplitude of the CAP. Center-frequency (CF) enhancement domains were found in approximately 2/3 of the animals tested, in response to maskers having frequencies very near that of the probe stimulus, at levels ranging from below the CAP detection threshold to just below the tip threshold of the TC. Approximately 2/3 of the animals showing CF enhancement also displayed low-frequency (LF) enhancement, in response to a domain which borders the low frequency tail of the TC. PMID- 1769918 TI - Chronic intracochlear electrical stimulation in the neonatally deafened cat. II. Temporal properties of neurons in the inferior colliculus. AB - The major focus of this study was to define the effects of chronic intracochlear electrical stimulation (ICES) on single unit responses in the inferior colliculus from three experimental groups: 1) normal adults 2) neonatally deafened/unstimulated adults; and 3) neonatally-deafened/chronically stimulated adults. The major findings include: 1) IC neurons in normal adults showed a diversity of perstimulus responses to ICES which were qualitatively similar to those evoked by acoustic stimuli. They responded with: an onset burst, a sustained discharge, a decrease in their spontaneous activity, or a strong post stimulus response. The excitatory responses showed either a monotonic or a nonmonotonic increase in activity with increasing stimulus intensity. Response latencies ranged from 5 to over 40 ms. 2) Responses to ICES in normal and deafened/unstimulated animals were virtually indistinguishable from one another. 3) In contrast, responses to ICES in neonatally deafened stimulated animals were different from normal and from deafened, unstimulated animals. Their perstimulus response latencies were significantly shorter, their late response latencies were significantly longer, and the frequency of occurrence of inhibitory and late responses were significantly higher. From these results we conclude that the responses to intracochlear electrical stimulation are directly comparable to those observed following normal acoustic stimulation; that development of cochleotopic organization of the inferior colliculus is not affected by the almost complete lack of normal acoustic input experienced by neonatally deafened animals; and that the basic response properties of IC units are likewise unaffected by neonatal deafening. Moreover, the results suggest that, although the limited regime of electrical stimulation employed in these studies produced no major qualitative distortions in the perstimulus response patterns of IC neurons, it did result in some quantitative changes in those responses. PMID- 1769919 TI - The effects of Carbogen, carbon dioxide, and oxygen on noise-induced hearing loss. AB - An investigation into the effect of Carbogen (95% O2/5% CO2), 5% CO2/air, and 100% oxygen on cochlear threshold shifts caused by noise was undertaken. Five groups of eight pigmented guinea pigs were exposed to 105 dB broad band noise for 6 h per day for five consecutive days with each group receiving the various gaseous mixtures either during noise exposure or for 1 h immediately after noise exposure. A control group received the same noise exposure but respired air. Auditory threshold shifts, as measured by the auditory evoked brainstem response, were measured at 2,4,8,12,16, 20 and 24 kHz. Recordings were taken pre-exposure and at Day 1, 3, 5, and Weeks 2 and 3 after noise exposure. Carbogen, given during noise exposure, resulted in a trend toward less post noise exposure threshold shift (as compared to controls) which reached statistical significance by Week 3 at all frequencies except 2 and 20 kHz. Subjects given Carbogen after exposure also showed a general trend toward decreased noise induced threshold shifts, as compared to controls, but this was not statistically significant. The mixture of 5% CO2/air given during noise exposure yielded no difference in threshold shifts as compared to controls. When 100% oxygen was administered during noise exposure, a marked decrease in noise induced threshold shifts could be seen as compared to controls, with differences reaching statistical significance by day 5 at most frequencies. These results indicate that oxygen (i.e. cochlear-oxygenation) is a more important factor than CO2 (i.e., as a vasodilator) in protection of the cochlea from noise induced damage. PMID- 1769920 TI - Sound frequency and binaural response properties of single neurons in rat inferior colliculus. AB - Sound frequency and binaural response properties were determined for single neurons in the rat's inferior colliculus. Nerve cell responses in the central nucleus of the inferior colliculus were narrowly tuned and had clearly defined characteristic frequencies (CF). The central nucleus was tonotopically organized with low frequencies represented dorsolaterally and high frequencies ventromedially from 0.87 to 45 kHz. Sharpness of tuning, as indicated by Q10, covered a wide range of values for neurons with the same CF, but the maximum Q10 at each frequency increased monotonically with CF. Maximum Q10s were larger than previously reported for auditory cortex at the same CF. Binaural responses were classified as either suppression, summation or mixed. Most of the units encountered exhibited binaural suppression but there were substantial numbers of both summation and mixed responses. Each major binaural response type was distributed broadly across sound frequencies within the rat's hearing range. Binaural suppression responses were most numerous at high frequencies and summation responses at low frequencies. The binaural response types, their relative proportions and their distribution by CF were similar for neurons in the central nucleus of inferior colliculus and primary auditory cortex of the albino rat. PMID- 1769921 TI - Histochemical evidence that cochlear efferents are carried with the inferior vestibular nerve in guinea pigs. AB - Histochemical methods were employed to determine the course of the olivocochlear bundle (OCB) within the vestibular nerve of guinea pigs. Following transection of the inferior vestibular nerve, cholinesterase staining in the cochlea was greatly reduced. Transection of the superior vestibular nerve, however, yielded no detectable change in staining. It is concluded that the cochlear efferent innervation in guinea pigs is carried in the inferior vestibular nerve, at the point of entry into the medial bulla. PMID- 1769922 TI - Radial communication between the perilymphatic scalae of the cochlea. I: Estimation by tracer perfusion. AB - The degree to which radial exchange between scala tympani (ST) and scala vestibuli (SV) can occur has not previously been quantified. We have measured the amount of cross-communication in the third turn of the guinea pig cochlea using an ionic tracer, trimethylphenylammonium (TMPA). TMPA was perfused through one scala while TMPA concentrations were measured simultaneously in the perfused and non-perfused scalae. On the basis of the time course of TMPA increase recorded in the non-perfused scala, we were able to calculate rate constants for cross-leak and clearance. Cross-leak in the third turn occurred remarkably rapidly with a rate constant from ST to SV of 0.049 min-1 and from SV to ST of 0.031 min-1. These correspond to transfer half times of 14.2 and 22.4 min respectively. This result demonstrates that ST and SV in the third turn cannot be regarded as independent compartments. PMID- 1769923 TI - Radial communication between the perilymphatic scalae of the cochlea. II: Estimation by bolus injection of tracer into the sealed cochlea. AB - Radial communication between ST and SV was measured in the sealed cochlea by monitoring the dispersal of an ionic tracer, trimethylphenylammonium (TMPA) injected in the form of a minute bolus. Tracer movements were recorded by a pair of ion-selective electrodes sealed into the injected and non-injected scalae close to the injection site. Measurements were made in the basal or third turn of the guinea pig cochlea. In the third turn, radial communication occurred rapidly with a ST half time from ST to SV of 25 min and from SV to ST of 26 min. In the basal turn the communication was markedly slower, with a ST half time from ST to SV of 170 min and from SV to ST of 240 min. However, the difference between the basal and third turns can be shown to arise almost totally from differences in cross-sectional area of the perilymphatic scalae. When normalized with respect to scala cross-section, the process of tracer movement across the spiral ligament is similar in the basal and third turns. These results demonstrate that radial communication between scala tympani and scala vestibuli is an important route which must be considered in studies involving perilymph. PMID- 1769924 TI - Auditory evoked cortical magnetic field (M100-M200) measurements in tinnitus and normal groups. AB - Recently, Hoke et al. (1989) and Pantev et al. (1989) demonstrated that the auditory evoked cortical magnetic field (AECMF) M100 component was larger, and M200 was smaller and occurred later in subjects with unilateral tinnitus compared with normal subjects. These group amplitude differences resulted in an M200/M100 amplitude ratio that was smaller for the subjects with tinnitus. The purposes of the present investigation were to: 1) extend the observations of Hoke et al. (1989), and, 2) determine whether contralateral AECMF differences existed following stimulation of the non-tinnitus and tinnitus ears of patients with tinnitus. Neuromagnetic AECMF recordings were recorded from 25 young normal hearing and 14 patients with unilateral tinnitus and hearing loss. The results failed to support the findings of Hoke et al. (1989). Specifically, there is no evidence suggesting that the M100 amplitude is larger, the M200 latency later, or, the M200/M100 amplitude ratios smaller, when the two samples are compared. Additionally, there were no differences in the amplitudes or latencies of M100 or M200 when results from stimulation of the tinnitus and non-tinnitus ears of tinnitus subjects were compared. PMID- 1769925 TI - Development of resistance to hearing loss from high frequency noise. AB - The effect of interrupted exposure on the development of progressive resistance to hearing loss from exposure to high frequency noise was studied using monaural chinchillas. The animals were exposed to an octave band noise centered at 4 kHz at 85 dB SPL for 6 h a day for ten consecutive days. Hearing thresholds were measured using evoked potential recording before and after each exposure. Results indicated a reduction in threshold shift with repeated exposures. This reduction in threshold shift or 'toughening' was more rapid for the high frequency exposures than the 'toughening' from similar low frequency exposures. PMID- 1769926 TI - Cochlear and CNS tonotopy: normal physiological shifts in the mustached bat. AB - The ear of the mustached bat (Pteronotus parnellii) shows marked cochlear resonance near 60 kHz and many sharply tuned neurons throughout the brain have best frequencies (BF) near the cochlear resonance frequency (CRF). Controlled changes in the normal physiological range of body temperature (approx 37-42 degrees C) were used to change the CRF and to study the tuning properties of neurons in the cochlear nucleus (CN) and inferior colliculus (IC). In all cases there were concomitant shifts in the CRF and the BFs. Results were the same for single and multi-units, and for CN and IC units. Although the BF reliably changed with shifts in the CRF, the majority of the units showed no change in minimum threshold or the sharpness (Q10 dB) of tuning. The temperature-induced effects on cochlear tuning were similar to those previously described in nonmammalian vertebrates. The physiological data reveal that, within a narrow frequency band, cochlear and CNS tonotopy are labile in the mustached bat. The lability of tuning is further substantiated by adaptations of biosonar emission behavior with shifts in CRF (Henson et al., 1990). PMID- 1769927 TI - Auditory image perception and analysis: the basis for hearing. AB - The premise of this paper is that the auditory system's primary function is its ability to determine the sources of sound. Auditory image perception and analysis are defined as the basis for sound source determination. Few studies in the literature have focused on understanding these abilities and the paper argues that more attention should be paid to auditory image perception and analysis. Four questions are posed for understanding auditory image formation and seven physical variables are described which might be used for auditory image perception. The paper relates auditory image perception and analysis to a number of other topics in the hearing sciences in order to reinforce the argument that auditory image perception and analysis are the basis of hearing. PMID- 1769928 TI - The influence of DC-polarization of the endocochlear potential on single fibre activity in the pigeon cochlear nerve. AB - The endocochlear potential (EP) in the pigeon ear was altered by injecting current into the scala media. Simultaneous recordings from afferent fibres in the cochlear ganglion were performed. The mean rate of spontaneous activity was little affected by current injection and the consequent shifts in EP. In contrast to this lack of effect, the preferred intervals seen in some fibres in birds were accentuated by positive current injection and reduced or in some cases suppressed by negative current injection. The threshold of the tuning curve was raised by injection of negative current but the characteristic frequency showed little change. Sharpness of tuning decreased. Analysis of the results shows that current injection in the scala media produces significant changes in the filter characteristics of the cochlea, as well as altering the driving force for the transduction process (difference between EP and hair cell membrane potential). PMID- 1769929 TI - The Garrod Lecture. The enterococcus: a classic example of the impact of antimicrobial resistance on therapeutic options. PMID- 1769930 TI - Aztreonam therapy in children with febrile neutropenia: a randomized trial of aztreonam plus flucloxacillin versus piperacillin plus gentamicin. AB - In a prospective, randomized trial in 100 febrile neutropenic children, aztreonam plus flucloxacillin was compared with piperacillin plus gentamicin. At the 72 h clinical assessment there was no statistically significant difference between the two groups. However, in microbiologically documented infections there was a higher response rate in the piperacillin/gentamicin group (57%) than in the aztreonam/flucoxacillin group (41%). This was contributed to by the poorer Gram positive cover of the aztreonam/flucloxacillin combination. In clinically documented infections and unexplained fevers the response rate of the two antibiotic regimens was identical. There were two deaths; one early death (in the piperacillin/gentamicin arm) and one late death. At the final assessment a successful outcome was obtained in the remaining patients. In the aztreonam/flucloxacillin group 75% of the episodes required modification compared with 59% in the piperacillin/gentamicin group. PMID- 1769931 TI - Biotype and antibiotic sensitivity of 100 clinical isolates of Yersinia enterocolitica. AB - One hundred clinical isolates of Yersinia enterocolitica were biotyped, serotyped and tested for in-vitro sensitivity to seven beta-lactam antibiotics and six other antibiotics. Twenty-four of the isolates belonged to Nilehn's and Wauters' biotype 1A, 12 to biotype 3 and 64 to biotype 4. No biotypes 1B or 2 strains were found. All isolates were sensitive to chloramphenicol, ciprofloxacin, gentamicin, tetracycline, trimethoprim and all but one to sulphafurazole. All were resistant to ampicillin with MIC's ranging from 32 to 256 mg/L, but were susceptible to ticarcillin/clavulanic acid and imipenem. With other beta-lactam agents there were different patterns of sensitivity, specific to each of the three biotypes. All biotype 4 strains were resistant to carbenicillin and ticarcillin but sensitive to amoxycillin/clavulanic acid and cefoxitin. Biotype 3 strains, by contrast, were sensitive to carbenicillin and ticarcillin but resistant to amoxycillin/clavulanic acid and cefoxitin, whilst biotype 1A strains were resistant to each of these four beta-lactam agents. PMID- 1769932 TI - Low dose intraperitoneal ciprofloxacin for the treatment of peritonitis in patients receiving continuous ambulatory peritoneal dialysis (CAPD). AB - Ciprofloxacin at a dose of 25 mg/L of dialysate was administered intraperitoneally for five days as a single agent for the empirical treatment of CAPD peritonitis. One hundred and seventeen consecutive episodes of peritonitis occurred in 65 patients during the study period, and 100 episodes were entered in the study. This therapy was successful in 79% of episodes. Resistant organisms (MIC greater than 4 mg/L) all of them coagulase-negative staphylococci, were isolated in nine (7.8%) of the 117 episodes. Mean ciprofloxacin concentrations in dialysate and serum on the last day of treatment were 6.1 mg/L (range 0.3-15.7) and 0.3 mg/L (range 0-0.9) respectively. No adverse effects were reported. PMID- 1769933 TI - Cefaclor in the treatment of chronic bronchitis. PMID- 1769934 TI - Susceptibility testing methods: why use the MIC? PMID- 1769935 TI - SDD and the novel extended-broad-spectrum beta-lactamases. PMID- 1769936 TI - Lack of standardization of in-vitro susceptibility testing of the Bacteroides fragilis group to amoxycillin-clavulanic acid. PMID- 1769937 TI - Comparison of agar media used for determining antimicrobial susceptibility of Neisseria gonorrhoeae. PMID- 1769938 TI - The effect of subinhibitory concentrations of metronidazole and tetracycline on the ultrastructure of periodontopathic bacteria. PMID- 1769939 TI - Combined resistance to erythromycin and tetracycline in streptococci. PMID- 1769940 TI - A study of the beta-lactamases of 100 clinical isolates of Yersinia enterocolitica. AB - The intracellular beta-lactamases of 100 distinct clinical isolates of Yersinia enterocolitica were examined, to investigate the effect of selected beta-lactam agents on the enzymes. The enzyme inhibition profiles obtained were specific to each of the three biotypes 1A, 3 and 4. Biotype 4 strains elaborated only one beta-lactamase with a pI of 8.3 corresponding to the carbenicillin-hydrolysing beta-lactamase enzyme A of Cornelis & Abraham. Biotype 3 strains also produced a single beta-lactamase with a pI of 5.4-5.6 corresponding to enzyme B, the chromosomally mediated inducible cephalosporinase. Two beta-lactamases were found in biotype 1A strains, one was identical to enzyme A and the other, although showing a slight difference in pI to enzyme B, was similar to this enzyme in other respects. The differences in the distribution of enzyme A and enzyme B in strains of Y. enterocolitica belonging to the biotypes 1A, 3 and 4 isolated in Australia, explain the different patterns of susceptibility to beta-lactam antibiotics. PMID- 1769941 TI - Synergic post-antibiotic effect of amikacin in combination with beta-lactam antibiotics on gram-negative bacteria. AB - The post-antibiotic effect (PAE) of amikacin alone and in combination with ceftazidime, ceftriaxone and piperacillin was studied for two strains each of Pseudomonas aeruginosa and Serratia marcescens using a bioluminescent assay of bacterial ATP. Two models were used for combining beta-lactam antibiotics and amikacin: in one model the cultures were incubated with 32 mg/L of ceftazidime, 128 mg/L of ceftriaxone or 32 mg/L of piperacillin for 1 h. Different concentrations of amikacin (0.5-64 mg/L) were then added. Incubation of the combinations continued for one more hour. The antibiotics were eliminated by dilution. In the second model tested, one strain of S. marcescens was simultaneously exposed to amikacin and a beta-lactam antibiotic for 2 h. The PAEs produced by the drugs in combination were longer than the sum of the individual effects of the drugs when they were used alone. Results were equally good with both models. A synergic PAE was also found with amikacin concentrations close to the MIC in combination with low concentrations of ceftazidime, ceftriaxone and piperacillin. PMID- 1769942 TI - Lactate dehydrogenase activity as a cause of metronidazole resistance in Bacteroides fragilis NCTC 11295. AB - Enzymes acting on pyruvate as a parameter of the ATP regeneration system were studied as a cause of metronidazole resistance in Bacteroides fragilis NCTC 11295. The resistant strain had higher lactate dehydrogenase activity and produced more lactate than susceptible strains, suggesting that the enzyme is more active in lactic acid fermentation. Furthermore, the reaction catalysed by lactate dehydrogenase occurred up to 48 mg/L metronidazole, whereas the reaction catalysed by pyruvate: ferredoxin oxidoreductase reaction stopped at 2 mg/L. The mechanism of metronidazole resistance in B. fragilis NCTC 11295 may be due to the high activity of lactate dehydrogenase which compensates for the decreased activity of pyruvate: ferredoxin oxidoreductase in the presence of metronidazole. PMID- 1769943 TI - Comparative susceptibility of cefminox and cefoxitin to beta-lactamases of Bacteroides spp. AB - The susceptibility of the new cephamycin antibiotic, cefminox, to hydrolysis by various types of beta-lactamase produced by organisms of the Bacteroides fragilis group was compared with that of cefoxitin. Several enzymes were able to achieve complete hydrolysis of both drugs during overnight incubation, but no marked difference between the rates of inactivation of cefminox and cefoxitin was observed. Susceptibility of the cephamycins to crude extracts of beta-lactamases from the test strains of Bacteroides spp. did not correlate with the results of conventional minimum inhibitory concentration titrations. Possible reasons for these discrepancies are discussed. PMID- 1769944 TI - An in-vitro and in-vivo comparison of the activity of beta-lactamase inhibitor combinations with imipenem and cephalosporins against Escherichia coli producing TEM-1 or TEM-2 beta-lactamase. AB - Reference strains of Escherichia coli (ampicillin-susceptible and -resistant ATCC strains, and known TEM-1 and TEM-2 beta-lactamase producers) were tested in vitro and in the in-vivo mouse thigh infection model against four beta-lactamase inhibitor compounds (BICs: amoxycillin/clavulanic acid, ampicillin/sulbactam, ticarcillin/clavulanic acid, and piperacillin/tazobactam), selected cephalosporins, and imipenem. The ATCC strains (ampicillin-susceptible and resistant) were susceptible to the BICs in disc and MIC tests. Three or more logs of killing were observed at the NCCLS breakpoint concentrations. However, the TEM 1 and TEM-2 producers were resistant in disc tests to ampicillin/sulbactam and amoxycillin/clavulanic acid, and showed intermediate susceptibility to ticarcillin/clavulanic acid. MICs were at or near the breakpoint, but bactericidal activity was only noted at the probable breakpoint concentration of piperacillin/tazobactam. Cefoxitin, cefotaxime, cefpirome and imipenem, but not cephalothin, showed greater bactericidal activity and lower MICs for the TEM producing strains than the BICs. The viable count of the TEM-1 producer was not reduced in the mouse thigh model by ampicillin/sulbactam or amoxycillin/clavulanic acid, but cefpirome and cefotaxime reduced the viable count by approximately three logs. There was a 50% mortality rate in mice receiving the two BICs. The ampicillin-susceptible ATCC strain of E. coli was killed to a similar degree by all agents tested. Overall, the BICs appeared inferior, in both in-vivo and in-vitro tests to selected cephalosporins and imipenem when tested against reference strains of E. coli producing TEM-1 or TEM 2 beta-lactamase. The large inoculum effect and poor bactericidal activity observed with the BICs suggest they could be less effective in certain clinical situations. PMID- 1769945 TI - Isolation and identification of bacteria from subgingival plaque with low susceptibility to minocycline. AB - Twenty subgingival plaque samples from patients with chronic periodontitis were screened for the presence of three periodontal 'pathogens'--Porphyromonas gingivalis, Fusobacterium nucleatum and Eikenella corrodens. Nineteen of the samples were found to contain at least one of the three organisms and six samples contained all three. The subgingival plaque samples were cultured in the presence of various concentrations of minocycline, and those organisms which appeared to be least susceptible to the antibiotic were isolated and identified. A total of 40 isolates were obtained and these consisted of 18 different species, only one of which, Fusobacterium nucleatum, is generally recognized as being associated with chronic periodontitis. The minimum inhibitory concentrations of minocycline for many of the organisms isolated were greater than the concentration of attainable in gingival crevicular fluid following routine parenteral administration of the antibiotic. PMID- 1769946 TI - The penetration of cefpirome into the potential sites of pulmonary infection. AB - The concentrations of cefpirome, a new semi-synthetic cephalosporin, in the bronchial mucosa and serum were assessed after a single 1 g intravenous dose in 37 patients. Bronchoalveolar lavage allowed epithelial lining fluid (ELF) concentrations to be measured in eight subjects. The mean concentration for serum was 34.5 mg/L (S.E.M. 3.3), for bronchial mucosa 19.3 mg/kg (S.E.M. 1.9) and for ELF 7.2 mg/L (S.E.M. 1.1). The progressive reduction in cefpirome concentration in serum compared to that in bronchial mucosa and ELF is consistent with the permeability characteristics of beta-lactam antimicrobials and the barriers to movement of antimicrobial agents present in the lung. PMID- 1769947 TI - Pharmacokinetics of ceftazidime in patients with liver cirrhosis and ascites. AB - The pharmacokinetics of ceftazidime were studied in 18 male individuals, including six healthy volunteers and 12 patients with liver cirrhosis and ascites. Each participant received 1 g of ceftazidime as a single intravenous bolus injection. The elimination half-life was longer in cirrhotic than in control patients (5.40 +/- 1.02 h) vs. (1.98 +/- 0.24 h), P less than 0.01; probably due to slow return from the ascitic compartment. Nevertheless, total body clearance did not differ significantly between the two groups (81.4 +/- 30.3 ml/h/kg vs. 83.6 +/- 24.9 ml/h/kg). Dose reduction is not necessary when treating systemic infection in cirrhotics. Ceftazidime attained a concentration of 1 microgram/ml in the ascitic fluid in most patients 15 to 30 min after the injection, and maintained this level, which is higher than the MIC90 of Enterobacteriaceae, for 24 h. An intravenous bolus injection of 1 g ceftazidime every 24 h is sufficient to treat patients with spontaneous bacterial peritonitis caused by a susceptible organism other than Pseudomonas aeruginosa. PMID- 1769948 TI - Photographing electrophoresis gels for reproduction. PMID- 1769949 TI - An interview with Dr. Peter Hansell. Interview by A. R. Williams. PMID- 1769950 TI - 1991 Louis Schmidt Award to Robert F. Sisson, RBP, FBPA [corrected]. PMID- 1769951 TI - Creer Service Award presented to E. Lynn Baldwin, RBP, FBPA. PMID- 1769952 TI - First presentation of H. Lou Gibson Award for Journal papers made in Tampa. PMID- 1769953 TI - A triggering modification for synchronous multi-camera exposures. PMID- 1769954 TI - Some artistic techniques in photomicrography. PMID- 1769955 TI - Protease II from Escherichia coli: sequencing and expression of the enzyme gene and characterization of the expressed enzyme. AB - Protease II gene of Escherichia coli HB101 was cloned and expressed in E. coli JM83. The transformant harboring a hybrid plasmid, pPROII-12, with a 2.4 kbp fragment showed 90-fold higher enzyme activity than the host. The whole nucleotide sequence of the inserted fragment of plasmid pPROII-12 was clarified by the dideoxy chain-terminating method. The sequence that encoded the mature enzyme protein was found to start at an ATG codon, as judged by comparison with amino terminal protein sequencing. The molecular weight of the enzyme was estimated to be 81,858 from the nucleotide sequence. The reactive serine residue of protease II was identified as Ser-532 with tritium DFP. The sequence around the serine residue is coincident with the common sequence of Gly-X-Ser-X-Gly, which has been found in the active site of serine proteases. Except for this region, protease II showed no significant sequence homology with E. coli serine proteases, protease IV and protease La (lon gene), or other known families of serine proteases. However, 25.3% homology was observed between protease II and prolyl endopeptidase from porcine brain. Although the substrate specificities of these two enzymes are quite different, it seems possible to classify protease II as a member of the prolyl endopeptidase family from the structural point of view. PMID- 1769956 TI - Purification and characterization of genetically polymorphic deoxyribonuclease I from human kidney. AB - Deoxyribonuclease I (DNase I) was purified about 850,000-fold from human kidney using a rabbit anti-human urine DNase I antibody and sensitive DNase I activity assay. On SDS-PAGE, the purified kidney DNase I gave a single major band, and its molecular mass was estimated to be 38,000 Da. The activity of purified kidney DNase I was dependent on the presence of Mg2+ and Ca2+. G-Actin inhibited the activity, as did the anti-urine DNase I antibody. The properties of the kidney DNase I were the same as those of urine DNase I. PMID- 1769957 TI - Activation of the osmoregulated ompC gene by the OmpR protein in Escherichia coli: a study involving synthetic OmpR-binding sequences. AB - Expression of the Escherichia coli outer membrane proteins, OmpC and OmpF, is regulated in response to the medium osmolarity. The OmpR and EnvZ proteins are transcriptional factors involved in this osmotic regulation of the ompC and ompF genes. In particular, expression of the ompC gene is activated by the positive regulator, OmpR, in response to high osmolarity of the medium. In this study, we succeeded in defining a functional OmpR-binding sequence by analyzing a set of synthetic oligonucleotides, and propose a consensus motif for OmpR-binding. It was also demonstrated that the asymmetric OmpR-binding sequence, thus identified, can activate the canonical ompC promoter in an orientation independent-manner, providing that this sequence is placed closely and stereo-specifically with respect to the -35 region. PMID- 1769958 TI - Conversion of endoglycoceramidase-activator II by trypsin to the 27.9 kDa polypeptide possessing full activity: purification of activator for endoglycoceramidase by trypsin treatment followed by trypsin-inhibitor agarose column application. AB - Endoglycoceramidase (EGCase) cleaves the linkage between oligosaccharides and ceramides of various glycosphingolipids [Ito, M. & Yamagata, T. (1986) J. Biol. Chem. 261, 14278-14282]. A detergent was required for EGCase to express full activity, possibly due to its hydrophobic nature. Recently, activator proteins responsible for stimulating EGCase activity in the absence of detergents were isolated from the culture supernatant of Rhodococcus sp. [Ito, M., Ikegami, Y., & Yamagata, T. (1991) J. Biol. Chem. 266, 7919-7926]. The activity of activator II specific for EGCase II was heat-labile but insensitive to trypsin-treatment. This activator (69.2 kDa) was converted to the 27.9 kDa polypeptide via the 42 kDa intermediate by exhaustive trypsination, and the stimulatory activity of 27.9 kDa polypeptide on EGCase II was identical to that of the native form toward asialo GM1 and cell-surface GM3 of horse erythrocytes as substrates. This observation was successfully applied to obtain the purified activator without contamination with EGCase activity, which is abolished completely following treatment with trypsin. PMID- 1769959 TI - Purification and characterization of Streptomyces griseus metalloendopeptidases I and II. AB - Two metalloendopeptidases, designated as Streptomyces griseus metalloendopeptidases I and II (SGMPI and SGMPII), were isolated from a commercial Pronase P by a method including affinity chromatography on carbobenzoxy-L-alaninyl-triethylenetetraminyl-Sepharose (Z-Ala-T-Sepharose). The two enzymes differed from each other in behavior on ion-exchange chromatography but showed the same amino-terminal sequence at least up to the 20th residue. Their molecular weights were both estimated to be 37,000 by SDS-polyacrylamide gel electrophoresis. Elemental and amino acid composition analyses indicated that both of them contained about 1 g atom of zinc and one cystine residue per mol of protein. Cleavage specificities of the two enzymes toward synthetic peptide substrates were very similar to those observed with thermolysin. EDTA, o phenanthroline, and phosphoramidon strongly inhibited these enzymes, while typical serine-protease inhibitors and cysteine-protease inhibitors had no effect. The findings clearly indicate that SGMPI and SGMPII can be classified into the family of zinc-endopeptidases. It was unexpectedly found, however, that these metalloendopeptidases were strongly inhibited by protein serine-protease inhibitors produced by Streptomycetes, such as Streptomyces subtilisin inhibitor (SSI), alkaline protease inhibitor-2c' (API-2c'), and plasminostreptin (PS). PMID- 1769960 TI - Application of bimane-peptide substrates to spectrofluorometric assays of metalloendopeptidases. AB - A spectrofluorometric method for sensitive determination of metalloendopeptidase activity has been developed by using a bimane-peptide containing a tryptophan residue, i.e. 1,7-dioxo-2,5,6-trimethyl-1H,7H-pyrazolo[1,2-alpha]pyrazol-3-yl methyl- thiomethylcarbonyl-phenylalanyl-tryptophanyl-leucine (Bim-SCH2CO-Phe-Trp Leu-OH). Such an "intramolecularly quenched" substrate was originally designed for a sensitive assay of angiotensin I converting enzyme (ACE) [Sato, E. et al. (1989) Chem. Pharm. Bull. 37, 145-147]. All the typical metalloendopeptidases tested, such as thermolysin, Pseudomonas aeruginosa (Ps.) elastase, Streptomyces griseus metalloendopeptidases I and II (SGMPI and SGMPII), and alkinonase A, a metalloendopeptidase from Streptomyces violaceorectus, cleaved this substrate strictly at a Phe-Trp bond, leading to a marked increase in fluorescence. Kinetic parameters of the enzymatic hydrolyses of five kinds of analogous bimane substrates were compared to examine how the nature of neighboring amino acid residues on either side of the cleavable bond affects the catalytic efficiency of each of the metalloendopeptidases. Bim-SCH2CO-Phe-Trp-Leu-OH was most efficiently hydrolyzed by all of these enzymes. The use of this substrate made it possible to determine minute amounts of metalloendopeptidases, especially those originating from Streptomycetes (for example, as little as 10 fmol of SGMPII). PMID- 1769961 TI - Interactions of Streptomyces serine-protease inhibitors with Streptomyces griseus metalloendopeptidase II. AB - Streptomyces griseus metalloendopeptidase II (SGMPII) was shown to form tight complexes with several Streptomyces protein inhibitors which had been believed to be specific to serine proteases, such as Streptomyces subtilisin inhibitor (SSI), plasminostreptin (PS), and alkaline protease inhibitor-2c' (API-2c'), as well as with Streptomyces metalloprotease inhibitor (SMPI). The dissociation constants of complexes between SGMPII and these inhibitors were successfully determined by using a novel fluorogenic bimane-peptide substrate. The values ranged from nM to pM. The results of studies by gel chromatographic and enzymatic analyses indicated that SGMPII is liberated from the complex with SSI by the addition of subtilisin BPN'. SGMPII and subtilisin BPN' proved, therefore, to interact with SSI in a competitive manner, despite the difference in the chemical nature of their active sites. PMID- 1769962 TI - Vesiculation induced by hydrostatic pressure in human erythrocytes. AB - When human erythrocytes were subjected to hydrostatic pressure (1.1-2.0 kbar), it was found that membrane vesicles were released from the red cells above 1.4 kbar. As with hemolysis under high pressure, the amount of released vesicles was increased with increasing pressure but decreased by the cross-linking of membrane proteins with diamide. Vesicles obtained at 2.0 kbar were heterogeneous in size but similar to intact erythrocytes in phospholipid composition. Although it has been reported that spectrin-free vesicles are released by echinocytogenic agents, pressure-induced vesicles did contain considerable and similar amounts of spectrin irrespective of the difference in size. These results suggest that vesiculation by high pressure is associated with the disruption of the membrane skeleton, as previously seen in pressure-induced hemolysis [Yamaguchi et al. (1989) J. Biochem. 106, 1080-1085]. PMID- 1769963 TI - Crystal structure of basic fibroblast growth factor at 1.6 A resolution. AB - We have determined the crystal structures of two types of human basic fibroblast growth factor, the serine analogue and the wild-type, at 1.6 and 2.5 A resolution, respectively. Two good heavy atom derivatives were found and used for multiple isomorphous replacement phasing. The atomic coordinates were refined using the Hendrickson & Konnert program for stereochemically restrained refinement against structure factors. The crystallographic R factors were reduced to 15.3% for the serine analogue structure and 16.0% for the wild-type structure. The serine analogue and wild-type structures have been found to be almost identical, the root-mean-square deviation between the corresponding C alpha atoms being 0.11 A. Their structures are composed of twelve beta-strands forming a barrel and three loops. Their molecules have an approximate threefold internal symmetry and are similar in architecture to that of interleukin-1 beta. A possible heparin-binding site, which comprises five basic residues, Lys119, Arg120, Lys125, Lys129, and Lys135, has been revealed by calculating the electrostatic potential energy. PMID- 1769964 TI - H1 histone stimulates limited proteolysis of protein kinase C subspecies by calpain II. AB - Limited proteolysis of protein kinase C (PKC) subspecies with Ca2(+)-dependent neutral protease II (calpain II) was remarkably stimulated by basic polypeptides, such as H1 histone and poly-L-lysine. This stimulatory effect was observed for proteolysis of the active form of PKC, which was associated with phospholipid and diacylglycerol. The inactive form of PKC was far less susceptible to proteolysis, both in the presence and absence of the basic polypeptides. The basic polypeptides did not appear to interact with calpain II, but made the PKC molecule more susceptible to proteolysis. The relative rates of cleavage of type I (gamma), II (beta), and III (alpha) PKC were 2:2:1. The available evidence suggests that, like calpain I, calpain II may also contribute to the down regulation or depletion of PKC. PMID- 1769965 TI - A cytolysin, theta-toxin, preferentially binds to membrane cholesterol surrounded by phospholipids with 18-carbon hydrocarbon chains in cholesterol-rich region. AB - We have previously suggested the existence of two distinctive states of cholesterol in erythrocyte and lymphoma cell membranes as revealed by high- and low-affinity binding sites for theta-toxin of Clostridium perfringens [Ohno Iwashita, Y., Iwamoto, M., Mitsui, K., Ando, S., & Nagai, Y. (1988) Eur. J. Biochem. 176, 95-101; Ohno-Iwashita, Y., Iwamoto, M., Ando, S., Mitsui, K., & Iwashita, S. (1990) Biochim. Biophys. Acta 1023, 441-448]. To understand factor(s) which determine membrane cholesterol heterogeneity, we analyzed toxin binding to large unilamellar liposomes composed of cholesterol and phospholipids (phosphatidylcholine/phosphatidylglycerol = 82:18, mol/mol). Liposomes containing phospholipids with 18-carbon hydrocarbon chains at both positions 1 and 2 of the glycerol have both high- and low-affinity toxin-binding sites with Kd values similar to those of intact erythrocytes, whereas liposomes with hydrocarbon chains containing 16 or fewer carbons at either position 1 or 2 have only low affinity toxin-binding sites. The cholesterol/phospholipid ratio, in addition to the length of phospholipid hydrocarbon chain, also determines the number of toxin binding sites, indicating that at least these two factors determine the topology of membrane cholesterol by creating distinctively different affinity sites for the toxin. Since theta-toxin binding detects specific populations of membrane cholesterol that are not detectable by the measurements of susceptibility to cholesterol oxidase and cholesterol desorption from membranes, the toxin could provide a unique probe for studying the organization of cholesterol in membranes. PMID- 1769966 TI - Amino acid sequence of the hemerythrin alpha subunit from Lingula unguis. AB - The amino acid sequence of the alpha subunit of the allosteric hemerythrin from Lingula unguis was determined. It consists of 117 amino acid residues. Compared with other non-allosteric hemerythrins consisting of identical subunits of 113 amino acid residues, this protein has the deletion of the N-terminal amino acid and the insertion of five amino acids in the same region as in the case of the monomeric myoerythrin from Themiste zostericola. As the amino acid sequence of the beta subunit has also been determined [Yano, H., Satake, K., Ueno, Y., & Tsugita, A. Protein Sequence and Data Analysis, in press], the complete sequence analysis of an allosteric hemerythrin has been accomplished for the first time. The difference in the octameric structures of allosteric and non-allosteric hemerythrins are discussed. PMID- 1769967 TI - Artificial cell adhesive proteins engineered by grafting the Arg-Gly-Asp cell recognition signal: factors modulating the cell adhesive activity of the grafted signal. AB - An artificial cell adhesive protein could be engineered by grafting the RGDS tetrapeptide, the core sequence of the major cell adhesive site of fibronectin, to a truncated form of Staphylococcal protein A (tSPA) via cassette mutagenesis of the tSPA expression vector pRIT2T [T. Maeda et al. (1989) J. Biol. Chem. 264, 15165-15168]. We synthesized a panel of tSPA derivatives grafted with various RGDS-containing oligopeptides to address the problem of how the cell adhesive activity of the resulting tSPA derivatives was affected by the length and amino acid sequence of the grafted oligopeptides and by the sites on tSPA where the extra oligopeptides were inserted. The results showed that (i) the amino acid residues flanking the RGDS core sequence played a key role in modulating the cell adhesive activity of the grafted RGDS signal; (ii) at least two sites on tSPA, each corresponding to on e of the two HindIII sites of pRIT2T, were competent in sustaining the cell adhesive activity of the grafted signal; and (iii) the divalent tSPA containing the RGDS signal at both sites was more active than monovalent derivatives containing only one signal at either site. These results provide a strategic basis for engineering of artificial cell adhesive proteins by grafting the RGDS signal. PMID- 1769968 TI - Arginine-specific ADP-ribosyltransferase and its acceptor protein p33 in chicken polymorphonuclear cells: co-localization in the cell granules, partial characterization, and in situ mono(ADP-ribosyl)ation. AB - We have reported the purification and characterization of arginine-specific ADP ribosyltransferase from hen liver nuclei [Tanigawa, Y. et al. (1984) J. Biol. Chem. 259, 2022-2029] and the DNA-dependent mono(ADP-ribosyl)ation of p33, an acceptor protein in the nuclei [Mishima, K. et al. (1989) Eur. J. Biochem. 179, 267-273]. In the present study, we obtained evidence that among various tissues and cells from chicken, polymorphonuclear cells, so-called heterophils, possess both the ADP-ribosyltransferase and p33 at high levels. Percoll density gradient centrifugation of the postnuclear fraction of the heterophils revealed the co localization of ADP-ribosyltransferase with p33 in the granule fraction. The enzyme and p33 were purified approximately 219- and 3.77-fold, respectively, from postnuclear pellet fraction to apparent homogeneity. The properties of heterophil ADP-ribosyltransferase and p33 were compared with those of the liver enzyme and p33. The molecular mass of the heterophil enzyme was estimated by SDS polyacrylamide gel electrophoresis to be 27.5 kDa. The enzyme activity was stimulated by a sulfhydryl agent and inhibited by lysolecithin, NaCl, and inorganic phosphate. The mono(ADP-ribosyl)ation of p33 was markedly enhanced by polyanion, such as DNA, RNA, or poly(L-glutamate). SDS-polyacrylamide gel electrophoretic analysis after limited trypsin proteolysis of p33s, purified from chicken heterophils and liver, showed much the same pattern. Thus, it appears that ADP-ribosyltransferase and p33 present in heterophils are identical to those in the liver, respectively. p33 is considered to be an in situ substrate for ADP ribosyltransferase, since it was specifically mono(ADP-ribosyl)ated in permeabilized heterophils.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1769969 TI - Isolation and characterization of a monosialosylgangliopentaosyl ceramide from Xenopus laevis oocyte. AB - A monosialosylgangliopentaosyl ceramide was isolated from Xenopus laevis oocytes. It represented 5.8% of the total acidic glycosphingolipids. From the results of sugar-composition analysis, enzymatic hydrolysis, permethylation analysis, and negative ion fast atom bombardment mass spectrometry, the structure of the ganglioside was determined to be as follows: [sequence: see text] The predominant species of fatty acids were alpha-hydroxy fatty acids, h22:0, h24:0, and h24:1. The long chain bases of this ganglioside consisted mainly of d18:1 sphingosine and phytosphingosine. Other acidic glycolipids were also characterized. The most abundant component of acidic glycolipids was sulfatide, which represented 85.7% of the total acidic glycolipid mixture. GM3, GM2, GM1a, and GD1a were also detected. PMID- 1769970 TI - Purification and properties of growth inhibitor from normal rabbit serum. AB - It was previously found that rabbit serum contains a growth-inhibitory substance for a tumorigenic rat liver cell line RSV-BRL. In the present study, the growth inhibitor was purified from normal rabbit serum to show a homogeneous protein band with a molecular weight (Mr) of 56 k on SDS-polyacrylamide gel electrophoresis under non-reducing conditions. The purified growth inhibitor, tentatively named rabbit serum-derived growth inhibitor (RSGI), potently inhibited the growth of RSV-BRL and nine kinds of other cell lines including three human tumor cell lines at a concentration of 20 ng/ml or higher. The growth inhibitory effect of RSGI was reversible and appeared to be cytostatic rather than cytotoxic. RSGI was stable to heating at 56 degrees C for 30 min or treatment with 0.1 M 2-mercaptoethanol, but labile to heating at 100 degrees C for 3 min or treatment with 1 M acetic acid (pH 2.3), 6 M urea, 50% (v/v) 1 propanol, or 0.1% (w/v) trypsin. These properties of RSGI suggested that it was different from type beta transforming growth factors, tumor necrosis factor alpha, and other known growth-regulatory factors. PMID- 1769971 TI - Reconstitution of CMP-N-acetylneuraminic acid hydroxylation activity using a mouse liver cytosol fraction and soluble cytochrome b5 purified from horse erythrocytes. AB - The hydroxylation of CMP-N-acetylneuraminic acid (CMP-NeuAc) in the formation of CMP-N-glycolylneuraminic acid requires several components which comprise an electron transport system. A protein, which replaces one of the components, was purified to homogeneity from a horse erythrocyte lysate. Based on its partial amino acid sequence and immunological cross-reactivity, this protein was identified as soluble cytochrome b5 lacking the membrane domain of microsomal cytochrome b5. The electron transport system involved in CMP-NeuAc hydroxylation was reconstituted, and then characterized using the purified horse soluble cytochrome b5 and a fraction from mouse liver cytosol. The hydroxylation reaction requires a reducing reagent, DTT being the most effective. Either NADH or NADPH was used as an electron donor, but the activity with NADPH amounted to about 74% of that with NADH. The hydroxylation was inhibited by salts and azide due to interruption of the electron transport from NAD(P)H to cytochrome b5 and in the terminal enzyme reaction, respectively. PMID- 1769972 TI - Vesicle to micelle transitions of egg phosphatidylcholine liposomes induced by nonionic surfactants, poly(oxyethylene) cetyl ethers. AB - Vesicle to micelle transitions of sonicated liposomes of egg yolk phosphatidylcholine (EPC) induced by a homologous series of nonionic surfactants, poly(oxyethylene) cetyl ethers [POE(n) cetyl ether], were investigated by using the method of turbidity titrations. The turbidities of the mixed dispersions of sonicated vesicles and surfactant were systematically measured as a function of the surfactant added for a wide range of lipid concentrations (from 0.51 to 6.35 mM EPC). From the titration curves, two threshold points representing onset and complete solubilization of liposomal membranes were determined as a probe for the effect of the length of ethylene oxide (EO) moiety on the phase behavior of ternary system of POE(n) cetyl ethers-EPC-excess water. Patterns of turbidity curves and the surfactant concentrations at two threshold points as well as widths of region between two transitions, where lamellar sheets and mixed micelles may coexist, mainly depended on the length of EO head group. With changing the lengths, solubilization of liposomes and phase diagram showed optimal behavior. That is, in the middle range of EO numbers, it resulted in narrowest coexistence region between onset and complete solubilization. Assuming the equilibrium partitioning model, critical effective molar ratios of surfactant to lipid, Rsat, free surfactant concentrations, Dw, and the partition coefficient of surfactant between bilayer and aqueous phase, K, in surfactant-saturated liposomes were quantitatively determined as a function of EO number. Effective ratios, Rsol, and free surfactant concentration in mixed micelles were also determined. In addition, the effects of CMC and HLB of surfactants on the solubilization of liposome were discussed. PMID- 1769973 TI - Calcium ion regulates the release of lipase of Fusarium oxysporum. AB - The lipase production of a plant pathogenic fungus, Fusarium oxysporum f. sp. lini SUF 402, was induced by fat as the carbon source, and its release was stimulated by the infusion of intracellular free calcium ion with a calcium ionophore, A23187. N-(6-Aminohexyl)-5-chloro-1-naphthalenesulfonamide (W-7, a calmodulin inhibitor) and 1-[N,O-bis(5-isoquinolinesulfonyl)-N-methyl- L-tyrosyl] 4-phenylpiperazine (KN-62, a Ca2+/calmodulin dependent protein kinase II inhibitor) reduced the extracellular release of lipase in vivo. 1-(5 Isoquinolinylsulfonyl)-2-methylpiperazine (H-7, a protein kinase C inhibitor) did not have this ability. After K2H32PO4 had been incorporated into the cells, they were treated with W-7 or KN-62 and stimulated by Ca2+ ionophore. On SDS-PAGE of intracellular proteins followed by autoradiography, W-7- and KN-62-treated cells showed inhibition of the incorporation of 32Pi into the 20 kDa protein resulting from Ca2+ stimulation. F. oxysporum had calmodulin (CaM)-dependent protein kinase activity in the cytoplasmic fraction and had the ability to phosphorylate of syntide 2, a specific substrate of CaM kinase II. The partially purified CaM dependent protein kinase was inhibited by 10 microM KN-62 in vitro. Increase of the intracellular Ca2+ concentration of F. oxysporum activated CaM and CaM dependent protein kinase, resulting in the extracellular lipase release. These results suggest the existence of a Ca2+ signalling system in F. oxysporum like those observed in higher eucaryotes. PMID- 1769974 TI - Purification and properties of cloned Salmonella typhimurium LT2 sialidase with virus-typical kinetic preference for sialyl alpha 2----3 linkages. AB - Subclones containing the Salmonella typhimurium LT2 sialidase gene, nanH, were expressed in Escherichia coli from multicopy derivatives of pBR329. The cloned sialidase structural gene directed overproduction of sialidase polypeptide which was detected as the major soluble protein species in cell-free extracts. Overproduced enzyme was purified to near electrophoretic homogeneity after 65 fold enrichment using conventional preparative techniques. Unlike all previously investigated sialidases, S. typhimurium sialidase was positively charged (pI greater than or equal to 9.0). Km, Vmax, and turnover number of the purified sialidase, measured using 2'-(4-methylumbelliferyl)-alpha-D-N-acetylneuraminic acid (MUNeu5Ac), were 0.25 mM, 5,200 nmol min-1, and 2,700 s-1, respectively. These values are the highest yet reported for a sialidase. Sialidase was inhibited by 2-deoxy-2,3-didehydro-N-acetyl-neuraminic acid at unusually high concentrations (Ki = 0.38 mM), but not by 20 mM N-acetylneuraminic acid. Divalent cations were not required for activity. The pH optimum for hydrolysis of MUNeu5Ac was between 5.5 and 7.0 and depended on the assay buffer system. Substrate specificity measurements using natural sialoglycoconjugates showed a 260-fold kinetic preference for sialyl alpha 2----3 linkages when compared with alpha 2--- 6 bound sialic acids. The enzyme also efficiently cleaved residues from glycoproteins and gangliosides, but not from mucin or sialohomopolysaccharides. S. typhimurium sialidase is thus the first bacterial enzyme to be described with influenza A virus sialidase-like kinetic preference for sialyl alpha 2----3 linkages and to have a basic pI. PMID- 1769975 TI - Calculation of vertical ground reaction force estimates during running from positional data. AB - The purpose of this study was to calculate, as a function of time, segmental contributions to the vertical ground reaction force Fz from positional data for the landing phase in running. In order to evaluate the accuracy of the method, time histories of the sum of the segmental contributions were compared to Fz(t) measured directly by a force plate. The human body was modeled as a system of seven rigid segments. During running the positions of markers defining these segments were monitored using a video analysis system operating at 200 Hz. Special care was taken to minimize marker movement relative to the mass centers of segments, and low-pass cutoff frequencies of 50 Hz (markers defining leg segments) and 15-20 Hz (markers defining upper body) were used in filtering the position time histories so as to ensure that high signal frequencies were preserved. The magnitude of the high-frequency peak in Fz, also known as 'impact force peak', was estimated with errors less than 10%, while the time of occurrence of the peak was estimated with errors less than 5 ms. It would appear that the positional data were sufficiently accurate to be used for calculation of intersegmental forces and moments during the landing phase in running. Analysis of the segmental contributions to Fz(t) revealed that the first peak in Fz has its origin in the contribution of support leg segments, while its magnitude is determined primarily by the contribution of the rest of the body. These contributions could be varied independently by changing running style. It follows that if the possible relationship between 'impact force peaks' and injuries is to be investigated, or if the effects of running shoe and surface construction on these force peaks are to be evaluated, the calculation of segmental contributions to Fz(t) is a more suitable approach than measuring only Fz(t). PMID- 1769976 TI - Motion of the knee after condylar resurfacing--an in vivo study. AB - The purpose of this study was determine the amounts of rotation and displacement occurring in a relatively unconstrained condylar replacement knee, and to compare the motion with a matched group of normal knees. The motion was measured using an electromagnetic device, the 3-Space Tracker, for various common activities, for 25 normal volunteers and 25 total knee patients. The main variables studied were internal-external rotation of the tibia about its long axis and anterior posterior displacement of the femoral origin with respect to the tibia, as a function of flexion angle or per cent of gait cycle. The motion of the total knees was very similar to that of the normals. For sitting, standing and free swing, the knee rotated internally by 5-10 degrees and the femur displaced posteriorly by 9-14 mm, as the knee was flexed from 0 to 90 degrees. For walking and going upstairs and downstairs the absolute values of the rotations and displacements were similar to the above. However, the mean values of rotation were less due to greater variation in the rotation patterns, due probably to the increased laxity of the knee during the swing phases. From these data, taking the mean motions and one standard deviation (S.D.), it is suggested that a knee prosthesis should allow a rotation from minus to plus 12 degrees (a total range of 24 degrees) and an anterior-posterior displacement of 13 mm. It is suggested that these motions be subject to progressive restraint from the neutral position in the manner of the natural knee. PMID- 1769977 TI - Effects of asymmetric load carrying on the biomechanics of walking. AB - The purpose of the study was to investigate the effects of an asymmetric sidepack carrying system on frontal plane joint moments of force in both lower extremities and in the L5/S1 joint during level walking. Ground reaction force data and frontal plane film records were obtained from five males performing three walking conditions: 0, 10 and 20% bodyweight loads in a sidepack supported by the left shoulder. Inverse dynamics were used to calculate the lower extremity moments during stance and a static model of the pelvis was used to calculate the L5/S1 moments during single support for each limb. Normal walking was characterized by symmetric kinetics between left and right limbs and around the L5/S1 joint. The asymmetric loads produced unbalanced lateral trunk muscle dominance between left and right limb stance phases, increased right hip and knee moments and decreased left hip and knee moments. During normal walking, the L5/S1 moment was dominant on the contralateral trunk side for both limbs. The asymmetric loads applied to the left side caused a shift in L5/S1 moment dominance to the right side during left and right single support phases. PMID- 1769978 TI - Interstitial bone stress distributions accompanying ingrowth of a screen-like prosthesis anchorage layer. AB - Recent development of screen-like bonded weaves of titanium wire for orthopaedic implant anchorage affords a unique opportunity for analytic studies of porous ingrowth micromechanics. The regular geometry of individual wires and the periodicity of the mesh weave are exploited in a series of two-dimensional finite element models, mapping interstitial bone stress fields as a function of ingrowth depth and wire size, shape, and spacing. When the depth of bone ingrowth was less than one wire diameter, peak bone stresses always occurred at the leading (i.e. deepest) edge of bone ingrowth, immediately adjacent to the wire. As ingrowth depth approached a full wire diameter, peak local bone stresses were 2-9 times the nominal applied host bone stress, with greater stresses occurring for lower screen weave densities. Within multiple screen layers, the top layer consistently experienced the peak stress and transmitted most of the applied load, regardless of the number of underlying screen layers surrounded by bone. Neither wire size variations nor partial wire flattening substantially affected general trends in stress predictions. PMID- 1769979 TI - Tensile and compressive properties of cancellous bone. AB - The relationship between the mechanical properties of trabecular bone in tension and compression was investigated by non-destructive testing of the same specimens in tension and compression, followed by random allocation to a destructive test in either tension or compression. There was no difference between Young's modulus in tension and compression, and there was a strong positive correlation between the values (R = 0.97). Strength, ultimate strain and work to failure was significantly higher in tensile testing than in compressive testing. PMID- 1769980 TI - Modelling the mechanical effect of muscles with large attachment sites: application to the shoulder mechanism. AB - A general theory is described for deriving the mechanical effect of muscles with large attachment sites. In a cadaver experiment the complete attachment sites and bundle distribution of 16 muscles of the shoulder mechanism were recorded. These data were used to calculate the mechanical effect, i.e. the resulting force and moment vector, for a large number (200) and a reduced number (maximal 6) of muscle lines of action. The resulting error between both representations is small. The number of muscle lines of action in the reduced representation depends on the shape of the attachment site and muscle architecture. An important feature of this method is that the necessary number of muscle lines of action is determined afterwards. In the often used centroid line approach the number of muscle lines of action and partitioning of muscles is determined before recording the geometry, leading to unverifiable results. PMID- 1769981 TI - An improved biomechanical model for simulating the strain of the hand-arm system under vibration stress. AB - In order to define relationships between the vibration stress and the strain of the human hand-arm system a biomechanical model was developed. The four masses of the model representing the hand, the forearm and the upper arm were connected by dampers and springs in two perpendicular directions. Simulating muscle activity, damped torsion springs were included additionally. The motions of the model were described by a differential matrix equation which was solved by using a 'transfer matrix routine' as well as by numerical integration. Thus, functions with harmonic or transient time courses could be selected as an excitation. The simulated vibrations were compared with those of other hand-arm models. The forces and torques transmitted between the masses, and the energy dissipated by the dampers were computed for several combinations of exciter frequencies and accelerations. The dependence of torques upon excitation agreed fairly well with the behaviour of the arm muscles under vibration as described by various investigators. At frequencies above 100 Hz the energy was dissipated mainly by the dampers between the masses near to the exciter. Transferring this result to the hand-arm system it shows that at high frequencies energy is dissipated by the hand and its palmar tissues and this might be one cause for the incidence of vibration-induced white finger disease. PMID- 1769982 TI - Combining position and acceleration measurements for joint force estimation. AB - The calculation of joint forces in biomechanics is usually based on the measurements of the kinematics of a given body segment, the estimation of the inertial properties of that segment and the solution of the 'inverse dynamics problem'. Such a process results in estimates of the joint forces and moments needed to sustain the monitored motion. This paper presents a new approach that combines position and acceleration measurements for the purpose of deriving high quality joint force estimates. An experimental system that is based on an instrumented compound pendulum was designed and tested. The joint forces necessary to maintain a swinging motion of the pendulum were measured by an array of strain gauges, and were compared to the forces estimated by the integrated kinematic segment that measured the position and acceleration of the pendulum. The joint force measurements were also compared to the force estimates that were based on the calculated segmental acceleration generated by the differentiation of the segmental position alone. The results show a high degree of correlation between the forces estimated by the integrated segment and those measured by the strain gauges. The force estimates based on the position measurements alone were less accurate and noisier. The application of the integrated segment to the study of human kinetics is discussed and illustrated by the ankle and knee forces during slow walking. The results suggest that the use of accelerometers is necessary for the estimation of transients and high-frequency components of joint forces. PMID- 1769983 TI - A new method for assessing relative dynamic motion of vertebral bodies during cyclic loading in vitro. AB - A new experimental technique for measuring generalized three-dimensional motion of vertebral bodies during cyclic loading in vitro is presented. The system consists of an orthogonal array of three lasers mounted rigidly to one vertebra, and a set of three mutually orthogonal charge-coupled devices mounted rigidly to an adjacent vertebra. Each laser strikes a corresponding charge-coupled device screen. The mathematical model of the system is reduced to a linear set of equations with consequent matrix algebra allowing fast real-time data reduction during cyclic movements of the spine. The range and accuracy of the system is well suited for studying thoracolumbar motion segments. Distinct advantages of the system include miniaturization of the components, the elimination of the need for mechanical linkages between the bodies, and a high degree of accuracy which is not dependent on viewing volume as found in photogrammetric systems. More generally, the spectrum of potential applications of systems of this type to the real-time measurement of the relative motion of two bodies is extremely broad. PMID- 1769984 TI - Some medicolegal aspects of Dupuytren's contracture. AB - This article presents the medical and legal aspects of Dupuytren's contracture. It also presents a rational basis for the assessment of the relationship, if any, between a patient's occupation and the development of Dupuytren's contracture. PMID- 1769985 TI - Dupuytren's contracture. PMID- 1769986 TI - Diagnosis and indications for surgical treatment. AB - Dupuytren's disease is a common problem in most hand surgery practices. It is usually easily diagnosed by the presence of its primary palmar manifestations: the nodule, the cord, and the digital flexion contracture. The isolated nodule may occasionally require biopsy to rule out the possibility of malignancy, but this is unusual. The nodule is typically the first lesion to appear and is the site of active biologic activity. The cord is the pathologically thickened and shortened normal longitudinal fascial structure of the palm and digit. Its insertion distal to the MPJ or PIP accounts for the progressive flexion contracture of these joints. Secondary findings include knuckle pads, plantar fascial nodules, and penile fascial contracture, which may signal the presence of Dupuytren's diathesis, a particularly aggressive form of the disease. The need and advisability of surgical intervention should be determined in close consultation with the patient after becoming thoroughly familiar with functional deficits and specific functional goals. A flexion contracture of more than 30 degrees at the MPJ or any contracture at the PIP is generally thought to be an indication for palmar fasciectomy. Patients should be aware of potential complications, those in higher risk categories should be identified preoperatively. Details of the operative procedure and variations in technique are discussed in subsequent articles in this issue. PMID- 1769987 TI - Anatomy and pathogenesis of the digital cords and nodules. AB - Current theories on the origin of the diseased tissue in Dupuytren's contracture are reviewed, and previous descriptions of the pathologic anatomy are clarified. The pathogenesis of Dupuytren's contracture is cited, with emphasis on the development of the contracture at various sites. PMID- 1769988 TI - Pathologic anatomy. AB - The typical case shows one or more thickened bands overlying the flexor tendons in the palm that connect with one another via the transverse palmar fascia. Vertical septae fix the bands securely to the underlying fascia and transverse metacarpal ligaments. These septae pass deep between the tendon and neurovascular tunnel. Bands running into the fingers represent thickening and fibrosis of the natatory ligaments. Typically, a central band continues into the finger, forks, and dissipates just distal to the PIP joint. This dissipation occurs with bifurcation of the central band into two thickened bundles that pass deep to the neurovascular bundle and attach to the flexor sheath of the middle phalanx. There are also thickenings of Grayson's ligaments that run from the central cord laterally and dorsally. Understanding the anatomy of the palmar aponeurosis is essential to the effective treatment of Dupuytren's contracture. Because the cause is unknown, treatment is best directed at anatomic deformities. Although not systemic or lethal, poorly treated Dupuytren's contracture can lead to significant morbidity and long-term disability. The palmar aponeurosis and its substructures are more than just passive barriers. They integrate hand parts and when pathologically fibrosed can contract joints, deform skin, and deviate neurovascular structures. The best treatments are recognition of the contracture, meticulous dissection, and local radical fasciectomy. Special attention is directed toward protecting spiralling neurovascular bundles. Difficult releases are enhanced by judicious release of checkreins, tendon sheath attachments, and disease on the radial side of the hand. PMID- 1769989 TI - The role of the fibroblast in Dupuytren's contracture. AB - Ultrastructural, immunohistochemical, and biochemical studies to date show that the fibroblast in Dupuytren's contracture is identical to palmar fascia fibroblasts in patients unaffected by Dupuytren's contracture, and to all other fibroblasts. The major difference relating to fibroblasts is that in Dupuytren's contracture there are more of them, and they are clustered around narrowed microvessels. It is probable that these two phenomena are linked because recent studies indicate a greater potential for ischemia-induced oxygen free radical generation in Dupuytren's contracture, and because oxygen free radicals in these concentrations can stimulate fibroblast proliferation. The major source of oxygen free radicals is likely to be from microvascular endothelial xanthine oxidase catalyzed reactions. These observations also account for many of the epidemiologic associations of Dupuytren's contracture, because (1) age, race, and diabetes are associated with microvessel narrowing and (2) age, diabetes, alcohol consumption, HIV infection, cigarette smoking, and trauma are associated with increased free radical generation. Nonsteroidal anti-inflammatory drugs and allopurinol are two agents that decrease oxygen free radical release and may inhibit or prevent Dupuytren's contracture. PMID- 1769990 TI - The myofibroblast in Dupuytren's contracture. AB - Dupuytren's contracture nodules, but not cords, contain myofibroblasts. These cells, which combine many electron microscopic, physiologic, and immunohistochemical characteristics of fibroblasts and smooth muscle cells, are probably the active force of contraction. Prominent myofibroblasts and intracellular microtubules correlate with increased likelihood of clinical recurrence after surgery. Tissue culture of cells derived from Dupuytren's contracture myofibroblasts show consistently slower cell replication than from fibroblasts and show persistence of electron microscopic characteristics in early passages. Research in Dupuytren's contracture myofibroblasts has been done on human tissue and so has clinical correlation. Myofibroblast presence may help to predict recurrence of disease and suggests that palmar skin should be excised when adherent to disease nodules. The theory of myofibroblasts helps explain why the open technique often succeeds, and why full thickness skin grafts inhibit recurrent contracture. PMID- 1769991 TI - Anesthesia for Dupuytren's contracture. AB - Despite the potential complications of brachial plexus blockade, it remains a reliable and safe form of anesthesia for surgery of the upper extremity. The site of the surgery dictates which of the four approaches to the brachial plexus should be used. When the choice matches the site of surgery, the blocks should be successful in approximately 80% of cases. When supplemented with an additional peripheral block, the success rate is greater than 90% using the axillary and supraclavicular approaches. The duration of the blocks varies from 1 to 12 hours, depending on the choice of anesthetic agent. The addition of epinephrine to the anesthetic agent decreases the rate of tissue uptake of the drug, thereby both lengthening the duration of the block and decreasing the toxicity of the agent. Alkalinizing lidocaine with sodium bicarbonate decreases the latency time and increases the intensity and spread of the block. Surgeons should be aware of the advantages and capabilities of regional anesthesia and should discuss anesthesia options with patients and anesthesiologists. PMID- 1769992 TI - Dupuytren's contracture in women. AB - Dupuytren's contracture in women is similar to that in men. A limited fasciectomy is the operative procedure of choice for women with Dupuytren's contracture. The most significant difference between men and women is the higher incidence of a flare reaction in women following the operation. This must be considered when contemplating such procedures because the flare is associated with a greater risk of residual joint stiffness. PMID- 1769993 TI - Surgical alternatives in Dupuytren's contracture. AB - The treatment of Dupuytren's contracture is still controversial. The use of subcutaneous fasciotomy is useful in the medically unstable patient in whom long term results may be a moot point. Limited fasciectomy is preferred over radical excision as a simpler operation and because of fewer complications. Wound closure is still a major point of contention. A prospective, randomized study of open wounds versus skin grafts versus closed procedures is needed to give more information regarding the long-term results. Currently, at our institution, we perform limited fasciectomy and leave the palm open. Early and aggressive mobilization is thought to be the key to good results. PMID- 1769994 TI - The open palm technique. AB - Dupuytren's disease presents a difficult problem that should not be treated casually. It is a continuing, unpredictable condition in which surgery is the only treatment available when contracture occurs. Surgery itself may cause an acceleration of the disease. Patients should be made aware that this is a continuing problem, often unpredictable in its course, with and without treatment. It is a pervasive disease, and when surgery is unsuccessful, the hand that underwent surgery may worsen. The open palm technique is a useful technique for avoiding complications in the early postoperative period. It is particularly useful in those patients with significant metacarpophalangeal joint contractures at more than one finger. The open palm technique does not affect the long-term outcome in these patients. PMID- 1769995 TI - The use of the full thickness skin graft in Dupuytren's contracture. AB - For those hand surgeons who have experienced early complications associated with limited fasciectomies (those who have not, have not done enough limited fasciectomies) and are frustrated by a high rate of recurrence or extension of the disease, incision of the cord and interposition of a full thickness graft is a technique to seriously consider. The procedure is not difficult to perform, but patience and attention to detail are prerequisites for success. That success is measured by complete or near complete release of the contracture with a minimum of morbidity, a nil recurrence rate, and extension rate of less than 10%. This technique is indicated for patients who have one or more elements of the Dupuytren's diathesis. Usually people older than 65 who develop Dupuytren's contracture do not have the diathesis, and their disease can be managed by limited fasciectomy and Z plasty skin lengthening. Finally, Dupuytren's disease presenting with no contracture can be managed effectively and conservatively by a series of intralesional injections of triamcinolone into the nodules and cords, the treatment of choice for all plantar nodules and knuckle pads. PMID- 1769996 TI - Dystrophy, recurrence, and salvage procedures in Dupuytren's contracture. AB - Postoperative complications can jeopardize the results of surgery. These can be avoided by Y-V plasties that allow for efficient skin "lengthening" and wound healing. Proper dressing techniques can prevent hematoma formation. The patient must be started on early active motion to prevent stiffness, and the physician must monitor for reflex sympathetic dystrophy. If RSD should occur, the dystrophile program is the most effective means of treatment. Fasciectomy alone is not always successful in correcting Dupuytren's contracture, especially in longstanding cases. The surgeon should be prepared to correct other entities such as checkreins, sheath fibrosis, and tendon adhesions. Occasionally, a severely compromised finger is not amenable to correction. In this case, salvage procedures are available, such as the concentric arthrodesis that preserves the length of the volar structures. Only when all other attempts fail should one resort to amputation. PMID- 1769997 TI - Unsatisfactory results in Dupuytren's contracture. Philosophies of Dr. J. T. Hueston. AB - Unsatisfactory results from surgery for Dupuytren's contracture usually arise from complications. The author considers the complications and their subsequent unsatisfactory results that are attributable to the surgeon and those that are attributable to the patient. PMID- 1769998 TI - Z-DNA: a prodrome for the 1990s. PMID- 1769999 TI - Implantation, trophoblast differentiation and haemochorial placentation: mechanistic evidence in vivo and in vitro. PMID- 1770000 TI - The fission yeast gamma-tubulin is essential for mitosis and is localized at microtubule organizing centers. AB - gamma-Tubulin exists in fission yeast as the product of an essential gene, encoding a 446 amino acid protein that is 77.3% identical to Aspergillus nidulans gamma-tubulin. The gene disruption caused cell lethality, displaying condensed, undivided chromosomes with aberrant spindle structures. Anti-gamma-tubulin staining showed that gamma-tubulin is located, throughout the wild-type cell cycle, at the spindle pole bodies (SPBs), indicating that gamma-tubulin associates with interphase SPB in the absence of microtubules. In addition, anti gamma-tubulin immunofluorescence staining revealed cytoplasmic, cell-equatorial putative MTOCs (microtubule organizing centers), which appear only during mitotic telophase and cytokinesis, and are located at the centers for the new cytoplasmic microtubule arrays of the two daughter cells. In the multiple-SPB mutant cut1 cdc11, anti-gamma-tubulin antibodies revealed many dots on the periphery of the nucleus. These results confirm that gamma-tubulin is an important member of the tubulin superfamily, suggest that it may be a universal component of MTOCs, and are consistent with a role for gamma-tubulin in controlling microtubule formation in vivo. PMID- 1770001 TI - bimA encodes a member of the tetratricopeptide repeat family of proteins and is required for the completion of mitosis in Aspergillus nidulans. AB - The recessive, temperature-sensitive bimA1 mutation of Aspergillus nidulans blocks nuclei in metaphase at restrictive temperature. To determine whether the bimA product is essential, integrative transformation was used to create a mutation in the bimA gene. The mutation was maintained in a heterokaryon and the phenotype of spores produced by the heterokaryon was analyzed. Molecular disruption of the wild-type bimA gene is recessive in the heterokaryon and causes a metaphase block, demonstrating that bimA is an essential gene for mitosis. bimA was cloned by DNA-mediated complementation of its mutant phenotype at restrictive temperature, and the nucleotide sequence of a full-length cDNA was determined. A single large open reading frame was identified in the cDNA sequence, which predicts a protein containing 806 amino acid residues that is related (30.4% identity) to the Schizosaccharomyces pombe nuc2+ gene product, which also is required for completion of mitosis. The sequence of the bimA gene indicates that it is a member of a family of mostly nuclear proteins that contain a degenerate 34 amino acid repeat, the TPR (tetratricopeptide repeat) gene family. PMID- 1770002 TI - Effects of 6-dimethylaminopurine on microtubules and putative intermediate filaments in sea urchin embryos. AB - The effects of 6-dimethylaminopurine (6-DMAP) (a putative phosphorylation inhibitor) on the state of assembly of microtubules and intermediate filaments have been studied during the first cell cycle of the sea urchin Strongylocentrotus droebachiensis. Changes in the spatial organization of cytoskeletal structures were studied by indirect immunofluorescence with anti tubulin and anti-IFa antibodies. The rates and patterns of protein phosphorylation in control and treated eggs were also investigated. The transfer of fertilized eggs to 600 microM 6-DMAP within 4 min following insemination inhibits pronuclear migration and syngamy. This also prevents male pronuclear decondensation, while chromatin condensation and nuclear envelope breakdown do not occur in the female pronucleus. Immunolabeling with anti-tubulin antibodies reveals the presence of cortical microtubules as early as 15 min after fertilization in both control and treated eggs. However, no sperm astral microtubules could be detected in the treated eggs. At later stages, from syngamy (40 min) up to nuclear envelope breakdown (90 min), 6-DMAP affects neither cortical microtubule organization nor the state of chromatin condensation but it precludes nuclear envelope breakdown and entry into mitosis. Treatment of the fertilized eggs after nuclear envelope breakdown induces permanent chromosome decondensation and premature disappearance of the mitotic apparatus. This last event involves disruption of the spatial organization of both microtubules and putative intermediate filaments. Quantitative measurements of protein phosphorylation show that 6-DMAP efficiently and reversibly inhibits 32P incorporation into proteins. Qualitative analysis of the autoradiograms of 32P labeled proteins separated by SDS-PAGE reveals that a major protein band, migrating with an apparent molecular weight of 31 x 10(3)Mr, is specifically dephosphorylated in eggs treated with 6-DMAP. This study suggests that protein phosphorylation is required for sperm aster microtubule growth and migration, but not for cortical microtubule polymerization. It also strengthens the hypothesis that, in sea urchin eggs, putative intermediate filaments are tightly associated with spindle microtubules. Finally, it confirms that inhibiting protein phosphorylation before nuclear envelope breakdown reversibly prevents the entry into mitosis. PMID- 1770003 TI - Distinguishing the sites of pre-rRNA synthesis and accumulation in Ehrlich tumor cell nucleoli. AB - The precise location of transcribing rRNA genes within Ehrlich tumor cell nucleoli has been investigated using two approaches: high-resolution autoradiography of cells pulse-labelled with tritiated uridine, varying the exposure time, and in situ-in vitro transcription coupled with an immunogold labelling procedure. When autoradiographic preparations are exposed for a short time, silver grains are found associated almost exclusively with interphasic cell nucleoli. Labelling of extranucleolar areas requires longer exposure. Within the nucleolus, the first sites to be revealed are in the dense fibrillar component. Prolonging exposure increases labelling over the dense fibrillar component, with label becoming more and more apparent over the fibrillar centers. Under these conditions, however, labelling does not extend into the granular component, and no background is observed. Initiation of transcription on ultrathin cell sections occurs preferentially at the borders of condensed chromatin blocks and in their close vicinity. The condensed chromatin areas themselves remain unlabelled. Inside most nucleoli, gold-particle clusters are mainly detected in the fibrillar centers, especially at their periphery, whereas the dense fibrillar component and the granular component remain devoid of label. These results, together with previous observations made on the same cell type, clearly indicate that the fibrillar centers are the sites of rRNA gene transcription in Ehrlich tumor cell nucleoli, while the dense fibrillar component is the site of pre-rRNA accumulation. PMID- 1770004 TI - A new direct-viewing chemotaxis chamber. AB - A new form of chamber for studying chemotaxis, similar in principle to the Zigmond chamber, allows the behaviour of the cells in a linear concentration gradient to be observed directly. The chamber was developed mainly for studying chemotaxis in fibroblasts using interferometric microscopy and the main design criteria were that it should have better optical characteristics, a higher dimensional precision and better long-term stability than the Zigmond chamber. It is made entirely from glass by grinding a blind circular well centrally in the counting platform of a Helber bacteria counting chamber. This procedure leaves an annular 'bridge', approximately 1 mm wide, between the new inner circular well and the original outer annular well. This bridge fulfils the same function as the linear bridge of the Zigmond chamber but the precise construction of the counting chamber ensures that a gap of 20 microns between bridge and coverslip can be accurately and repeatedly achieved when the chamber is assembled. It is envisaged that the improved optical clarity, dimensional accuracy and long-term stability of the new chamber will be advantageous in other applications, particularly in studies requiring critical microscopy or a precise knowledge of the gradient and in studies of cells, such as fibroblasts, that move much more slowly than neutrophils. PMID- 1770005 TI - The response of endothelial cells to TGF beta-1 is dependent upon cell shape, proliferative state and the nature of the substratum. AB - Endothelial cells plated on two-dimensional (2-D) substrata proliferate until they form a tightly apposed confluent monolayer of quiescent cells that display a typical 'cobblestone' morphology. When added to proliferating cultures TGF beta-1 (transforming growth factor beta-1) inhibited cell growth and caused marked morphological changes, with the cells becoming enlarged and ragged. These effects were dose-dependent and reversible. TGF beta-1 also reduced the cloning efficiency and colony size of these cells, indicating that TGF beta-1 is cytotoxic and cytostatic for endothelial cells. By contrast, TGF beta-1 added to quiescent cobblestone cultures did not affect cell morphology or cell numbers. In the presence of 20% serum, the level of total protein synthesis per cell was significantly increased by TGF beta-1 in a dose-dependent manner when the cells were cultured on a 2-D substratum, regardless of whether the cells were proliferating or cobblestone quiescent. The level of plasminogen activator inhibitor type 1 was specifically increased in these cultures, as demonstrated by reverse fibrin zymography and immunoprecipitation. Endothelial cells embedded within a 3-D collagen gel display an elongated 'sprouting' morphology. Such cells self-associate to form three-dimensional cellular networks within the gel, but do not proliferate. The addition of TGF beta-1 to these quiescent sprouting cells initially induced rounding-up without altering protein synthesis, and cell death occurred later. The effects of TGF beta-1 on sprouting endothelial cells were also examined using two culture systems where both the cobblestone and the sprouting phenotypes were present. TGF beta-1 reduced the number of cells present and the extent of migration of sprouting cells embedded within a type I collagen gel, but had no effect upon sprouting cells embedded within a complex endothelial produced extracellular matrix. Large vessel (aortic) and microvessel (retinal) endothelial cells responded in a similar way to TGF beta-1; the only difference being that an increased synthesis of PAI-1 was not observed with sub-confluent BREC cultures. Our results suggest that the effects of TGF beta-1 upon endothelial cells depend on the shape (cobblestone or sprouting), on the proliferative state of the cells, and on the nature of the matrix surrounding the cells. The response of these cells to TGF beta-1 in vivo may be similarly modulated during angiogenesis by changes in the cell phenotype and the composition of the surrounding matrix. PMID- 1770006 TI - Binding of latent and high Mr active forms of stromelysin to collagen is mediated by the C-terminal domain. AB - A specific high-titre polyclonal antiserum to recombinant human prostromelysin was raised in a sheep and shown by immunoblotting to detect latent prostromelysin, high and low Mr active forms and the C-terminal domain. This antiserum was used to demonstrate by indirect immunofluorescence that latent and active high Mr prostromelysin bind to reconstituted collagen fibrils, and to other extracellular matrix components in tissues ex vivo but that active low Mr stromelysin does not. Isolation of the C-terminal domain was carried out to demonstrate that stromelysin binding was through this domain. By use of an antiserum to the tissue inhibitor of metalloproteinases (TIMP) it was shown that TIMP is unable to bind to reconstituted collagen fibrils. TIMP, however, will bind when active high Mr stromelysin is present but not if latent prostromelysin is bound. We conclude that stromelysin has different binding specificities from those previously documented for collagenase; only active collagenase binds to reconstituted collagen fibrils. However, TIMP binds to the active forms of both stromelysin and collagenase when these are bound to the collagen fibrils. These results have important implications for the interpretation of immunolocalization data in establishing the roles of metalloproteinases and their inhibitors in vivo. PMID- 1770007 TI - Isolation and ultrastructural analysis of microfibrillar structures from foetal bovine elastic tissues. Relative abundance and supramolecular architecture of type VI collagen assemblies and fibrillin. AB - Extensive intact assemblies of matrix macromolecules have been solubilized from foetal calf skin, nuchal ligament and aorta by a new procedure that includes bacterial collagenase digestion under non-reducing, non-denaturing conditions and gel filtration chromatography. Type VI collagen was identified as the major microfibrillar element of these tissues by SDS-PAGE analysis and Western blotting. Rotary shadowing electron microscopy of these preparations revealed by far the most abundant and extensive arrays of intact collagen VI microfibrils isolated to date. The distinct microfibrillar species, fibrillin, which was identified on the basis of its periodicity and morphology, was also solubilized in abundance by this protocol. Analysis of these complex polymers has generated new information on their supramolecular architecture and relative abundance in these tissues. The protocol also demonstrates that the release of intact collagen VI microfibrils from these tissues is largely dependent on the removal of the major collagen fibrils. PMID- 1770008 TI - Structural analysis and expression of human desmoglein: a cadherin-like component of the desmosome. AB - Desmosomes are adhesive cell junctions found in great abundance in tissues that experience mechanical stress. The transmembrane desmosomal glycoproteins have been proposed to play a role in cell adhesion; desmoglein I (DGI) is a major member of this class of desmosomal molecules. However, evidence supporting a role for DGI in cell adhesion or in the plaque is lacking. In order to begin to understand DGI function we have identified human cDNA clones encoding the entire mature polypeptide of 1000 amino acids. Our data suggest that like the bovine DGI molecule human DGI is highly related to the calcium-dependent class of cell adhesion molecules known as cadherins. Four related extracellular domains located in the amino-terminal domain of the molecule contain putative calcium binding sites originally identified in the cadherins. The highest degree of similarity between human N-cadherin and human DGI, and likewise between bovine DGI and human DGI, is greatest in the most amino-terminal extracellular domain. This suggests a conserved functional role for the extracellular domains, perhaps in calcium mediated cell adhesion. The cytoplasmic portion of the molecule contains a cadherin-like region and, like bovine DGI, a carboxy-terminal tail that is not present in the cadherins, comprising three additional domains. One of these contains a novel repeating motif of 29 +/- 1 residues, first identified in bovine DGI. Each of the highly homologous repeating units is likely to consist of two beta-strands and two turns with special characteristics. Five amino acids that are identical in bovine and human DGI lie in the second of the two predicted beta strands, and intriguingly contain putative target sites for protein kinase C. On the basis of structural analysis, a model predicting the disposition of human DGI domains in the desmosome is proposed. Northern analysis suggests that unlike bovine epidermis, which expresses a single mRNA of reported size approximately 7.6 kb, human foreskin and cultured keratinocytes display a complex pattern with bands of approximately 7.2, 4.0 and 3.0 kb. Each of these cross-hybridizing mRNAs is coordinately expressed in normal human keratinocytes in response to long-term culture and increased calcium. PMID- 1770009 TI - Expression in Escherichia coli of fragments of the coiled-coil rod domain of rabbit myosin: influence of different regions of the molecule on aggregation and paracrystal formation. AB - We have expressed in Escherichia coli a cDNA clone corresponding broadly to rabbit light meromyosin (LMM) together with a number of modified polypeptides and have used this material to investigate the role of different aspects of molecular structure on the solubility properties of LMM. The expressed material was characterized biochemically and structurally to ensure that it retained the coiled-coil conformation of the native molecule. Full-length recombinant LMM retained the general solubility properties of myosin and, although soluble at high ionic strength, precipitated when the ionic strength was reduced below 0.3 M. Constructs in which the 'skip' residues (that disrupt the coiled-coil heptad repeat) were deleted had solubility properties indistinguishable from the wild type, which indicated that the skip residues did not play a major role in determining the molecular interactions involved in assembly. Deletions from the N terminus of LMM did not alter the solubility properties of the expressed material, but deletion of 92 residues from the C terminus caused a large increase in solubility at low ionic strength, indicating that a determinant important for interaction between LMM molecules was located in this region. The failure of deletions from the molecule's N terminus to alter its solubility radically suggested that the periodic variation of charge along the myosin rod may not be as important as proposed for determining the strength of binding between molecules and thus the solubility of myosin. PMID- 1770010 TI - Renal metabolism of amino acids in early insulin-dependent diabetes mellitus. AB - Renal metabolism of amino acids (AAs) was evaluated in 5 patients with early IDDM, and in 7 controls (C) in the basal state for 80 minutes after the ingestion of an AA mixture simulating an animal protein meal. Insulin was withdrawn 20 hours before the study. Renal metabolism of AAs was evaluated by the arterial venous difference technique. In the basal state in IDDM, as in C, the kidney takes up large amounts of a few nonessential AAs (NEAAs): it releases many NEAAs and a few essential AAs (EAAs). After AA ingestion in C, renal extraction of most EAAs, mainly BCAAs, Lys, and Thr, occurs; Pro extraction also increases and a significant uptake of Gly, Glu, Asp, Orn, and Tyr takes place. EAA extraction accounts for 30-40% of total AA uptake. In IDDM, after AA ingestion, a) renal uptake of total AAs is significantly lower, owing mainly to a markedly lower uptake of BCAAs, Lys, and also of Pro, Orn, and Ala; b) renal EAA uptake accounts for less than 20% of total AA extraction. These results indicate that in IDDM postprandial renal N repletion is impaired and unbalanced. PMID- 1770011 TI - Mitochondrial derangement: possible initiator of microalbuminuria in NIDDM. AB - Morphometric analysis of 80 renal biopsy specimens from patients with non-insulin dependent diabetes mellitus, who had been classified into four groups by grade of proteinuria and renal function, revealed mitochondrial enlargement in the proximal tubules, with cellular hypertrophy as an initial morphologic change in the microalbuminuria. This was followed by a thickening of the proximal tubular basement membrane and an increased interstitial volume, causing persistent overt proteinuria. Glomerular nodular and sclerotic lesions and severe tubulointerstitial damage became evident in the advanced stages. As an initial cause of microalbuminuria, the mitochondrial abnormality disturbed adenosine triphosphate (ATP) metabolism in proximal tubules, reducing active transport and causing urinary excretion of low-molecular-weight protein. PMID- 1770012 TI - The etiology of microalbuminuria in early non-insulin-dependent diabetes mellitus. AB - Glomerular or tubular contribution for microalbuminuria was estimated by assessing albumin excretion rate (AER) in glomerular urine obtained by L-arginine infusion (AI) and glomerular filtration rate (GFR) in 20 non-insulin-dependent diabetes mellitus (NIDDM) patients before and after glycemic control, and in 19 age-matched controls. Glycemic control normalized AER during AI, while it decreased AER before AI, though it was still above normal. Glycemic control increased tubular reabsorption rate of albumin, but it was still less than normal. Tubular reabsorption rate of albumin declined in close relation with duration of diabetes mellitus, while AER in glomerular urine had no correlation with the duration. GFR had no correlation with AER before or during AI. In conclusion, impaired tubular reabsorption of albumin plays a key role for microalbuminuria in NIDDM. PMID- 1770013 TI - Renal metabolism of C peptide in type I (insulin-dependent) diabetic patients. PMID- 1770014 TI - Kinetic study of glomerular cells of diabetic rats in relation to the development of irreversible glomerular sclerosis. AB - In order to clarify the cellular kinetics involved in progression of diabetic glomerulosclerosis, the epithelial cells of spontaneously diabetic WBN/Kob rats were investigated by labeling with the DNA precursor bromodeoxyuridine, which was histochemically stained using monoclonal antibody. The labeling index (number of labeled cells/number of cells counted) of glomeruli was constantly low (approximately 0.15%) and no significant variation could be demonstrated in control rats of the Wistar strain. In both control and diabetic rats, podocytes showed no evidence of mitosis. In contrast to capillary podocytes, the Bowman epithelial cells of diabetic rats showed increased labeling, often surrounding sclerotic capillaries. These observations suggest a critical role of Bowman's epithelial cells in the development of irreversibly sclerotic glomeruli in diabetic nephropathy. PMID- 1770015 TI - High glucose concentration suppresses mesangial laminin B2 gene expression. AB - To study the role of laminin in the rat mesangial cell attachment, cell adhesion to laminin-coated dishes was assayed by adding various amounts of a pentapeptide (YIGSR). YIGSR (20-100 micrograms/mL) inhibited the cell attachment to laminin coated dishes. Mesangial laminin B2 messenger RNA (mRNA) levels were attenuated during exposure to 30 mM glucose or high osmolarity achieved by the addition of 25 mM choline chloride to 5 mM glucose (310 mOsm/kg H2O) for 3 hours. These results suggest that laminin, which may have a physiologic role in mesangial cell attachment, is produced in mesangial cells, and that the decrease of laminin B2 mRNA during hyperglycemia or exposure to high osmolarity may have some pathophysiologic significance in the development of diabetic nephropathy. PMID- 1770016 TI - The molecular biologic study of the expression of thrombospondin in vascular smooth muscle cells and mesangial cells. AB - Thrombospondin (TS) is a high-molecular-weight glycoprotein (MW 450,000) that is stored in alpha-granules of platelets and secreted by a wide variety of mesenchymal cells, including vascular smooth muscle cells (SMCs) and mesangial cells. TS binds to cell surfaces and to matrix macromolecules such as collagen, fibronectin, and heparin (heparan sulfate). We have isolated one of the complementary DNA (cDNA) clones of TS from human endothelial cell cDNA libraries. With the TS cDNA as a probe, we used Northern blot analysis to look at TS messenger RNA (mRNA) levels of rat aortic SMCs in a quiescent state and cultured under different stimuli. Treatment with platelet-derived growth factor (PDGF) caused a rapid increase of TS mRNA at 2 to 4 hours. This induction was enhanced by the addition of cycloheximide, suggesting that the induction of TS by PDGF does not require the synthesis of new protein species. Transforming growth factor beta (TGF-beta) also induced mRNA of TS at 8 hours after stimulation and the induction was blocked by cycloheximide, suggesting that TGF-beta requires the mediation of new protein synthesis to induce a TS gene. In mesangial cells, we observed the same type of gene expression of TS using an in-situ hybridization study. We conclude that during SMC and mesangial cell proliferation, the induction of TS mRNA is regulated in a specific manner by PDGF and TGF-beta. PMID- 1770017 TI - Three-dimensional architecture of glomerular extracellular matrices in diabetic glomerulosclerosis. AB - The three-dimensional ultrastructural changes of the glomerular extracellular matrices in diabetic glomerulosclerosis were studied in acellular rat and human diabetic glomeruli by scanning electron microscopy. The mesangial matrix appeared as fenestrated septa with oval stomata between the glomerular capillaries in normal control specimens. In diabetic glomerulosclerosis, both in humans and rats, expansion of mesangial matrix and narrowing of the mesangial fenestrae were observed. A thin layer of the mesangial matrix extended into the peripheral glomerular basement membrane (GBM) subendothelially. Thickening of the GBM in diabetic nephropathy might be due to expansion of the mesangial matrix into the peripheral GBM. PMID- 1770018 TI - Glomerular hyperfiltration in insulin-dependent diabetes mellitus: no evidence for enhanced activity of the renin-angiotensin-aldosterone system. AB - Glomerular hyperfiltration is a characteristic functional abnormality in insulin dependent diabetes mellitus (IDDM) patients, but the underlying mechanisms remain controversial. Supine and ambulant plasma renin activity (PRA) and aldosterone were measured in ten IDDM patients with normal glomerular filtration rate (GFR), in ten IDDM patients with elevated GFR and in ten nondiabetic controls. Basal and stimulated PRA or aldosterone did not differ significantly between the three groups. These results suggest that in insulin-dependent diabetes the glomerular hyperfiltration is not causally related to hyperactivity of the renin-angiotensin aldosterone system. PMID- 1770019 TI - Risk factors for development of proteinuria in NIDDM analyzed by Poisson regression. AB - To clarify the time dependency of risk factors for the development of diabetic nephropathy, we applied Poisson regression to the analysis of 7167 person-year data in 1447 patients with non-insulin-dependent diabetes mellitus (NIDDM) who were initially free of proteinuria. Significant predictors were found to be annual mean fasting blood glucose (FBG) level, male gender, duration, and age at diagnosis. Hyperglycemia was more influential, while duration was less in the previous year of development of proteinuria than at the initial visit. When more information during longer-year data was used as average, the contribution of FBG level was enhanced. Current age was less associated than was age at diagnosis. Thus, Poisson regression seems to be useful for the analysis of risk variables in chronic diseases. PMID- 1770020 TI - Risk factors for retardation of renal function in IDDM and NIDDM with nephropathy. AB - Risk factors for retardation of renal function in 22 patients with non-insulin dependent diabetes mellitus (NIDDM) were studied and compared with those in 16 patients with insulin-dependent diabetes mellitus (IDDM). The annual decline rate of reciprocal serum creatinine was calculated from the rise of creatinine to the commencement of dialysis. The annual decline rate was compared with levels of blood pressure, fasting blood glucose, HbA1, and lipids, and clinical findings in patients with or without nephrotic syndrome during the same period. There was no significant difference in the rate of decline in levels of fasting blood glucose and HbA1, in IDDM and NIDDM. In NIDDM, the major risk factor is hypertension, as in IDDM. Triglycerides and total cholesterol also play roles in the retardation of renal function. Nephrotic syndrome also influenced the retardation of renal function in both IDDM and NIDDM. PMID- 1770021 TI - Frequency of diabetic nephropathy in childhood diabetics in southern districts of Kyusyu. PMID- 1770022 TI - Glomerular charge selectivity in non-insulin-dependent diabetes mellitus. AB - To elucidate the stage of the charge selectivity defect in diabetic nephropathy, urinary excretions of IgG1 and IgG4 were measured in patients with non-insulin dependent diabetes mellitus (NIDDM) and healthy controls. The molecular weights of IgG1 and IgG4 were the same but their isoelectric points were different. Therefore, by measuring both urinary IgG1 and IgG4 excretions, the stage of charge selectivity impairment in the nephropathy of NIDDM may be elucidated. Results were expressed as urinary excretion rate (IgG1 ER, IgG4 ER) and compared between diabetic patients with different urinary excretion rates of albumin (AER). IgG4 ER increased to the stage in which AER was more than 10 micrograms/min, whereas IgG1 ER did not increase to the stage of AER between 10 and 100 micrograms/min. This finding suggests that the charge selectivity defect in the kidney of the NIDDM patient is present at the stage when AER is more than 10 micrograms/min. PMID- 1770023 TI - Changes in the glomerular pore size selectivity in patients with type II diabetes mellitus. AB - We measured the urinary excretion rate and clearance of three plasma proteins, albumin, transferrin, and IgG4, each of which has a similar isoelectric point, but a different molecular weight. This study consisted of 86 patients with type II diabetes mellitus and 15 healthy subjects. In the patients, the degree of the urinary excretion rate and clearance of both transferrin (TER and Ctrans) and IgG4 IgG4 ER and ClgG4) closely correlated with that of the urinary excretion rate of albumin (AER). Although significant increases in the medians of TER and Ctrans were found even in the patients with AER of less than 5 micrograms/min, significant increases in the medians of IgG4 ER and ClgG4 were observed only in the patients with AER of more than 10 micrograms/min, in comparison with age matched healthy subjects. Considering the biochemical properties of these proteins, our results indicate that an alteration in the glomerular size selectivity may appear even in patients with normoalbuminuria, and in patients with AER of more than 10 micrograms/min, more extensive damage in glomerular size selectivity may occur. PMID- 1770024 TI - Acute loading with proteins from different sources in healthy volunteers and diabetic patients. AB - To evaluate the effects of protein loading on glomerular filtration rate (GFR), urinary excretion rate of albumin (AER), and plasma concentration of amino acids, 10 healthy volunteers and six diabetics were studied before and after eating tuna fish, egg white, cheese, or tofu. Furthermore, to study the possible role of glucagon, growth hormone (GH), atrial natriuretic peptide (ANP), or kallikrein in the responses of GFR, these substances were measured before and after protein loading. GFR increased significantly (p less than .001) after ingestion of tuna fish. No significant differences were seen between the GFR before and that after ingestion of the other foods. AER was unchanged following protein loading. Plasma concentrations of alanine, glycine, and arginine increased to a greater degree after ingestion of tuna fish than after digestion of the other foods. This result suggests that the response of GFR after protein loading may differ from one protein to another, and that these responses may not be directly mediated by glucagon, GH, ANP, or kallikrein. PMID- 1770025 TI - Comparison of renal hemodynamics in early non-insulin-dependent and insulin dependent diabetes mellitus. AB - The differences in deranged renal hemodynamics in non-insulin-dependent diabetes mellitus (NIDDM) and insulin-dependent diabetes mellitus (IDDM) have never been fully investigated. Whether or not autoregulatory mechanism of renal hemodynamics in NIDDM and IDDM is preserved remains to be clarified. In the present study we directly compared renal hemodynamics and its autoregulatory function in the early stage of NIDDM and IDDM before and after short-term glycemic control. Before glycemic control, mildly exaggerated glomerular filtration rate (GFR), subnormal renal plasma flow (RPF), and elevated filtration fraction (FF) were found in NIDDM as well as in IDDM; but there were no differences in these parameters of renal hemodynamics between the two types of diabetics. Glycemic control decreased GFR, whereas it did not alter RPF, resulting in normalization of FF in NIDDM and in IDDM. Before glycemic control, mean blood pressure was significantly correlated with GFR, but was not correlated after glycemic control in either type of diabetes. In conclusion, hyperglycemia induced glomerular hyperfiltration evenly and disturbed autoregulation of renal hemodynamics in NIDDM and in IDDM. PMID- 1770026 TI - Nondiabetic renal disease complicating diabetic nephropathy. AB - The clinicopathological and laboratory findings for 35 diabetic patients who had undergone renal biopsy from 1982 to 1990 were reviewed. Ten of these patients (28.6%) were found to have nondiabetic renal diseases. Five of those patients (14.3%) suffered from nondiabetic renal disease complicated by diabetic nephropathy. Nondiabetic renal diseases included IgA nephropathy, idiopathic membranous nephropathy, membranoproliferative glomerulonephritis (types I and III), minimal change disease, and toxemia of pregnancy. The diagnosis of nondiabetic renal diseases complicated by diabetes is important for the treatment of renal disease. Urinary abnormalities and/or deterioration in renal function inconsistent with the natural history of diabetic nephropathy were suggestive of the presence of nondiabetic renal disease. PMID- 1770027 TI - Hypercalciuria and hematuria in non-insulin-dependent diabetes mellitus. AB - This study was undertaken to examine whether patients with non-insulin-dependent diabetes (NIDDM) are hypercalciuric and whether there is a pathophysiologic relationship between urinary calcium excretion (UCE) and the degree of diabetic nephropathy. Although UCE did not parallel the increase of urinary albumin excretion rate (AER) and the presence of hematuria was not corrected with the degree of UCE, we confirmed that 36% of diabetic patients have hypercalciuria and that the prevalence of hypercalciuria is more frequent in diabetic patients with normo- or microalbuminuria than in the controls. In 6 months, the AER of two hypercalciuric patients increased. However, the blood pressure and HbA1c of these two patients increased during the same 6 months. Therefore, it remains unclear whether hypercalciuria induced an increase in the AER of these patients. PMID- 1770028 TI - The range of urinary albumin index in normoalbuminuria. PMID- 1770029 TI - One-day survey of albuminuria in diabetic outpatients in Fukuoka Prefecture, Japan. Fukuoka Diabetic Clinic Group. AB - The prevalences and risk factors of micro- and macroalbuminuria were surveyed in all 927 patients with diabetes mellitus who visited outpatient clinics in 27 hospitals in the Fukuoka prefecture on a designated day. The urinary albumin creatinine ratio (UAI; mg/g Cr) of spot urine was determined in all patients except those with persistent macroproteinuria. The results were as follows: (1) The prevalences of microalbuminuria (UAI 30-299) and macroalbuminuria (UAI greater than or equal to 300) were 26% and 15%, respectively. (2) Hyperglycemia and high blood pressure synergistically increased the prevalences. (3) The independent risk factors of microalbuminuria were severities of retinopathy and neuropathy, duration of diabetes, blood pressure, and HbA1c, as determined by logistic regression analysis, although the explanation rate was low. PMID- 1770030 TI - Increased urinary excretion of kappa light chains in diabetic patients. PMID- 1770031 TI - Effects of angiotensin-converting enzyme inhibitor (alacepril) and calcium antagonist (nicardipine) in hypertensive non-insulin-dependent diabetic patients with microalbuminuria. AB - The influence of alacepril (50 mg/day) on arterial blood pressure and microproteinuria in 26 hypertensive non-insulin-dependent diabetic patients was studied for 16 weeks. Alacepril reduced blood pressure gradually from 175/88 (standard error of mean [SEM] 2.6/1.7) to 152/81 (3.3/2.0) mm Hg (P less than .005) and albuminuria from 160.6 (SEM 29.1) to 98.1 (14.1) mg/g Cr (P less than .05), while serum blood urea nitrogen, creatinine, HbA1c, and fructosamine (FRA) remained stable. No significant changes occurred in the urinary beta 2 microglobulin and N-acetyl-beta-D-glucosaminidase levels. As compared with the effects of a calcium antagonist (nicardipine, 60 mg/day) that reduced blood pressure from 170/92 (SEM 2.5/1.4) to 154/84 (2.5/1.5) mm Hg (P less than .001) and albuminuria from 162.2 (SEM 33.9) to 95.4 (25.0) mg/g Cr (not significant), it is suggested that the angiotensin-converting enzyme inhibitor (alacepril) may have an advantageous renal effect in spite of its mild antihypertensive effect. PMID- 1770032 TI - Beneficial effect of alacepril, a new angiotensin-converting enzyme inhibitor on albuminuria and glycemic state: an open multicenter trial. Alacepril Study Group. AB - Alacepril is a new angiotensin-converting enzyme (ACE) inhibitor that possesses sympatho-inhibitory action. We evaluated the effect of alacepril on blood pressure and progression of diabetic nephropathy in hypertensive type II diabetics in an open multicenter trial. Eighty-nine type II diabetics with mild hypertension were treated with 50 mg of alacepril daily and observed for 12 weeks. Blood pressure was reduced significantly at 4 weeks; this reduction continued throughout the study. Urinary excretion of albumin also was reduced significantly at 12 weeks. Glycosylated hemoglobin (HbA1c) and serum total cholesterol showed significant reduction with alacepril. We confirmed the beneficial effect of alacepril on blood pressure and diabetic nephropathy, and found that glucose and lipid metabolism improves in the diabetic state with this ACE inhibitor. PMID- 1770033 TI - Effect of proteinase inhibitor camostat mesilate on nephrotic syndrome with diabetic nephropathy. AB - The effect of serine protease inhibitor Camostat Mesilate on nephrotic syndrome with diabetic nephropathy was evaluated. Eight patients with nephrotic syndrome associated with diabetic nephropathy were orally administered 600 mg of Camostat Mesilate per day. Three patients showed a reduction of urinary protein excretion promptly at 4 weeks. Serum protein and degree of edema improved significantly at 4 weeks. Camostat Mesilate had no effect on renal function assessed by creatinine clearance. During the observation period there were no significant changes in blood pressure, level of blood sugar, or HbA1c. Camostat Mesilate would be beneficial for the treatment of diabetic nephropathy. PMID- 1770034 TI - Asymptomatic ischemic heart disease and diabetic nephropathy: relationship between prevalence of asymptomatic ischemic heart disease and urinary albumin excretion rate. AB - To examine whether prevalences of asymptomatic ischemic heart diseases in type II diabetic patients are correlated with the degree of diabetic nephropathy, 201TI scintigraphies with dipyridamole loading were performed in 28 type II diabetic patients without any chest discomforts. Positive findings of ischemic changes were found in 5 (28%) of 18 patients with normoalbuminuria (urinary albumin excretion rate, AER less than 20 micrograms/min) and 5 (50%) of 10 patients with micro- or macroalbuminuria (AER greater than 20 micrograms/min). Coronary angiography (CAG) was performed in 6 of 10 patients with positive findings of 201TI scintigraphy. No stenotic findings were found in any patients, but wall motion was decreased in some patients and pulmonary artery pressure was increased in one patient. As stenosis of arteries with diameter of more than 0.3 mm can be detected by CAG, it seems likely that microangiopathy may play some role in the pathogenesis of asymptomatic ischemic heart disease detected with 201TI scintigraphy. PMID- 1770035 TI - Analysis of the clinical course of 130 Japanese non-insulin-dependent diabetic patients undergoing dialysis. AB - To clarify the characteristics of diabetic nephropathy (DN) in Japanese patients with non-insulin-dependent diabetes (NIDDM), we analyzed the clinical course of 130 such patients who began dialysis treatment due to DN between 1978 and 1988 at the Diabetes Center of Tokyo Women's Medical College. Analysis of the clinical course prior to attending the Diabetes Center revealed that 64 (49.2%) of the patients neglected or discontinued their initial treatment for diabetes until the development of diabetic complications because of the lack of symptoms. The average duration of untreated diabetes in these patients was 10.7 +/- 4.6 years. The biggest problem for NIDDM patients was the absence of symptoms until the development of diabetic complications. PMID- 1770036 TI - Loss of sulfated carbohydrate from the glomerular podocyte as a cause of albuminuria in experimental diabetic rats: ultrastructural histochemical study. AB - Decrease of anionic sites and heparan sulfate proteoglycan has been demonstrated in diabetic glomerular basement membrane (GBM) and causally related to albuminuria. The HID-TCH-SP-PD technique is a sensitive histochemical method for negatively charged sulfated carbohydrates. In this study, we examined the localization of HID-TCH-SP-PD reaction in the glomeruli of diabetic and control rats. In both rats, the reaction was found in association with the surface of podocytes and with GBM. In diabetic rats, the former-associated reaction was markedly reduced. By contrast, the latter-associated reaction did not show any differences between both animal groups. Urinary albumin excretion (UAE) increased significantly in alloxanized rats. It is suggested that a decrease of podocyte associated sulfated carbohydrates, the primary observed change, gives rise to albuminuria in alloxan diabetic rats. PMID- 1770037 TI - Phosphate depletion with phosphate binder arrests the development of nephropathy in spontaneously hypertensive rats with non-insulin-dependent diabetes mellitus fed a high-protein diet. AB - The protective effect of phosphate binder (PB) on nephropathy was examined in spontaneously hypertensive rats with non-insulin-dependent diabetes mellitus (NIDDM) fed a high-protein diet. The rats were treated with vehicle or streptozocin neonatally. After 14 weeks, all rats were fed a high-protein diet (50% protein content), and in half of the diabetic rats the diets were supplemented with PB. At 24 weeks, the urinary excretion rate of albumin and kidney weight increased in diabetic rats, but decreased or tended to decrease in diabetic rats treated with PB. The elevation of urinary excretion rate of N acetyl-beta-D-glucosaminidase, probably due to protein load, was also abolished with PB. PMID- 1770038 TI - Effect of vanadate on renal function in rats with streptozotocin-induced diabetes. AB - The effects of vanadate on glycemic control (HbA1c) and renal function was assessed in streptozotocin-induced diabetic rats (STZ-D) with heminephrectomy. Vanadate-treated rats had a significantly lower HbA1c level compared with STZ-D rats without vanadate at 8 weeks after initiation of this study. In the STZ-D rats with vanadate, there were significant decreases in the urinary albumin and IgG excretion rates. The present findings suggest that glycemic control by oral administration of vanadate, which does not cause insulin release, improves diabetic renal function. PMID- 1770039 TI - Effect of a somatostatin analogue (SMS 201-995) on renal function and urinary protein excretion in diabetic rats. AB - We evaluated the effect of a somatostatin analogue (SMS 201-995) on diabetic nephropathy using urinary albumin excretion as a marker in a streptozocin-induced diabetic unilateral nephrectomized rat model. Nondiabetic rats were injected with either 0.9% sodium chloride (NaCl) (n = 10) or SMS (n = 10). Diabetic rats were also injected with either 0.9% NaCl (n = 10) or SMS (n = 10). The control saline and SMS groups showed significant increases in urinary albumin excretion (UAE) and albumin clearance. The diabetic saline-treated rats showed no significant changes in UAE or albumin clearance. The diabetic SMS-treated rats showed significant decreases in UAE (151 +/- 76 mg/day/kg to 98 +/- 46, P less than .005) and albumin clearance (5.85 +/- 3.34 mL/day/kg to 3.63 +/- 1.73, P less than .01). There was no significant difference in kidney weight between the two control groups, but a significant difference was found between the two diabetic groups (3.35 +/- 0.39 g vs. 2.68 +/- 0.26 g, P less than .001). The results suggest that in early diabetes with renal hyperfiltration and hypertrophy, the administration of SMS may prevent progression to late diabetic nephropathy. PMID- 1770040 TI - Insulin-like growth factor I (IGF-I) stimulates glucose and amino acid uptake in cultured glomerular mesangial cells. AB - Cultured mesangial cells possess a large number of receptors specific to IGF-I with a small number of insulin receptors. Physiological concentrations of IGF-I increased the uptakes of aminoisobutyric acid and 2-deoxyglucose in mesangial cells, while insulin exhibited similar effects only with unphysiologically high concentration. These findings suggest that, in cultured mesangial cells, IGF-I may regulate cellular metabolic functions such as glucose and amino acid uptakes through its own receptors rather than insulin receptors. PMID- 1770041 TI - Changes in glomerular extracellular matrices components in diabetic nephropathy. AB - The changes in glomerular extracellular matrices components in diabetic nephropathy were investigated. Indirect immunofluorescence staining, using polyclonal antibodies to heparan sulfate proteoglycan (HS-PG), laminin, type IV collagen, and fibronectin was carried out on renal specimens obtained by needle biopsy. Immunofluorescence intensity and distribution were observed. HS-PG and laminin decreased in the capillary walls; on the other hand, type IV collagen and fibronectin tended to increase in the mesangial area. HS-PG and laminin decreased in inverse proportion to sclerosis grades and proteinuria. These changes seemed to play an important role in progression of diabetic glomerulosclerosis. PMID- 1770042 TI - Serum concentrations of intact type IV collagen in diabetics. AB - We developed a sandwich enzyme immunoassay for intact type IV collagen (IV-C) using two monoclonal antibodies as a marker of basement membrane metabolism, and examined the relationship between serum IV-C and diabetic complications. Serum IV C was measured in 186 diabetics with or without clinical signs of retinopathy, neuropathy, and/or nephropathy, and 328 healthy subjects. Serum IV-C was significantly (P less than .01) higher in diabetics (mean +/- SE: 124.83 +/- 2.94 ng/ml) than in healthy subjects (73.32 +/- 1.42 ng/ml). In diabetics with microangiopathy, serum IV-C became higher as clinical signs worsened. Especially in diabetics with nephropathy, serum IV-C became higher with the elevation of blood urea nitrogen (BUN), serum creatinine, and beta 2-microglobulin. Serum IV-C level seems to be a useful marker for assessment of the activity or progression of diabetic microangiopathy, and for evaluation of therapeutic effects. PMID- 1770043 TI - Serum or urinary concentration of type IV collagen in diabetics. AB - Concentrations of serum or urinary type IV collagen, determined by sandwich enzyme immunoassay, were significantly elevated in diabetics compared to controls (P less than .01). Serum or urinary levels of type IV collagen were significantly increased in patients with microangiopathy compared to those without microvascular disease (P less than .05). Serum type IV collagen levels were also augmented in diabetics who showed an increased albumin index for 1 year. Serum levels of type IV collagen were not affected by any conditions of metabolic control. The measurement of serum or urinary type IV collagen may be a useful indicator for monitoring the development of diabetic microangiopathy, especially in early diabetic nephropathy. PMID- 1770044 TI - Clinical implications of serum levels of basement membrane components in diabetic patients with and without albuminuria. AB - Serum levels of type IV collagen (7S-IV) and laminin P1 in 185 non-insulin dependent diabetes mellitus patients were significantly higher than those in normal subjects. Furthermore, they were significantly elevated in relation to the excretion of urinary albumin, showing their increases even at the stage of microalbuminuria, although they were not correlated with HbA1c or age in diabetic patients. Thus, the determination of serum levels of basement membrane components, 7S-IV and laminin, could be beneficial as the early indices of diabetic microangiopathy, including diabetic nephropathy. PMID- 1770045 TI - Increased concentrations of the basement membrane component type IV collagen in sera and urine of diabetics. AB - We measured serum and urinary concentrations of type IV collagen by radioimmunoassay (RIA) and enzyme-linked immunosorbent assay (ELISA) in diabetics. Serum and urinary concentrations of type IV collagen measured by RIA and ELISA were increased compared to those of control subjects. In diabetics with macroproteinuria or with renal insufficiency, serum and urinary concentrations of type IV collagen were higher than in diabetics without nephropathy or with early renal damage as determined by the presence of microproteinuria. These results suggest that serum and urinary concentrations of type IV collagen are increased in patients with advanced diabetic nephropathy. These increases may indicate that alteration of basement membrane metabolism has occurred in diabetics. PMID- 1770046 TI - Clinical significance of urinary laminin P1 in diabetic patients. AB - The urinary concentrations of laminin fragment P1 (L-P1), a major component of laminin, were determined in diabetic patients without diabetic nephropathy and healthy controls. In the control subjects, urinary L-P1 increased with age, especially over 60 years of age. A significant increase of urinary L-P1 was observed in diabetics aged less than 50 years. Neither urinary albumin nor N acetyl-beta-D-glucosaminidase correlated to the urinary L-P1 level. We used immunohistochemistry to locate L-P1 in the cortex of human kidneys. In non diabetic kidneys, the glomerular and tubular basement membranes, mesangium, and Bowman's capsule were stained. In the diabetic kidney, more was stained, including the mesangial expansion and the thickened capillary basement membranes. PMID- 1770047 TI - Glucose-induced overproduction of type IV collagen in cultured glomerular mesangial cells. AB - Type IV collagen production by cultured rat glomerular mesangial cells was evaluated quantitatively by measuring type IV collagen secreted into culture media and associated with the cells using enzyme-linked immunosorbent assay (ELISA). The majority of type IV collagen was secreted into culture media; type IV collagen increased with cell growth in the early log phase and decreased in the late log phase and after cofluency. By exposing the cells to high concentrations of glucose (27.8 mM), both secreted and cell-associated type IV collagens increased significantly compared with the cells cultured under normal glucose concentrations (5.6 mM) or under equivalent concentrations of mannitol, resulting in a significant increase in total type IV collagen accumulation. PMID- 1770049 TI - Diabetes mellitus in Japan: past, present, and future. PMID- 1770048 TI - Glucose-induced production of type IV collagen and laminin P1 from cultured human umbilical vein endothelial cells. AB - To study the effect of high glucose on the production of type IV collagen and laminin P1 from the cultured human umbilical vein endothelial cells (HUVEC), we measured type N collagen and laminin P1 from HUVEC that were cultured under different conditions. The concentrations of type IV collagen in the cultured medium for high glucose (30 mM D-glucose) were significantly higher than those for low glucose (5.6 mM D-glucose), L-glucose (30 mM), or mannitol (30 mM). The increase of type IV collagen was dependent on the glucose concentration in the medium. The contents of type IV collagen in the cultured cells were also increased in high-glucose incubation compared with low glucose or L-glucose incubation. In contrast, the levels of laminin P1 in the medium cultured with high glucose were similar to those with low glucose or L-glucose. These results suggest that the increased production of type IV collagen may contribute to the thickening of basement membranes and may be linked to the development of diabetic nephropathy. PMID- 1770050 TI - Introductory notes on diabetic nephropathy: a diabetologist's view. PMID- 1770051 TI - Kidney disease of diabetes mellitus (diabetic nephropathy): perspectives in the United States. PMID- 1770052 TI - Glomerular hemodynamic function in early diabetes. PMID- 1770053 TI - Mesangial cell dysfunction. PMID- 1770054 TI - Renal hypertrophy in experimental diabetes. PMID- 1770055 TI - Diabetic nephropathy in insulin-dependent diabetes mellitus patients: how to measure progression of disease and effect of treatment. PMID- 1770056 TI - Structural-functional relationships in type I insulin-dependent diabetes mellitus in humans. AB - The major renal pathologic changes of diabetes include thickening of all renal extracellular basement membranes and mesangial matrix and, to a lesser extent, mesangial cell expansion. Two renal lesions appear critical in diabetic nephropathy. Mesangial expansion out of proportion to the size of the glomerulus is closely and inversely related to measures of peripheral capillary wall filtration surface and to clinical features of proteinuria, hypertension, and decreasing glomerular filtration rate (GFR). Arteriolar hyalinosis is related to global glomerulosclerosis, and both are correlated with the clinical features of nephropathy. These lesions are markedly advanced by the time renal dysfunction is clinically detectable. Relationships of structure and function early in the course of the diabetes have not been examined satisfactorily. PMID- 1770057 TI - Natural history and pathogenesis of diabetic nephropathy. PMID- 1770058 TI - Natural history of diabetic nephropathy in non-insulin-dependent diabetes mellitus. PMID- 1770059 TI - Morphologic study of the kidney in Japanese non-insulin-dependent patients. PMID- 1770060 TI - Pathogenesis of diabetic nephropathy in non-insulin-dependent diabetes mellitus. AB - To elucidate the characteristics of diabetic nodular lesions and the process of progression of diabetic glomerulosclerosis, kidney specimens obtained from 185 patients with non-insulin-dependent diabetes mellitus (NIDDM) were observed using light, electron, and immunofluorescence microscopes. The results suggest the following. First, there are two distinct subtypes of nodular lesions: One is formed by the progression and expansion of diffuse lesions; the other, showing a concentrically layered structure, is probably formed in the process of reconstruction of mesangiolysis. Second, there are three phases in the process of progression of diabetic glomerulosclerosis: In the first phase, arteriolosclerosis and diffuse lesions appear; in the second phase, mesangiolysis and nodular lesions develop in association with moderately advanced arteriolosclerosis; and in the third phase, exudative lesions and hyalinized glomeruli appear in association with advanced arteriolosclerosis together with advanced interstitial lesions. In the progression of the phases and in the development of mesangiolysis and layered nodular lesions, disturbed blood flow into glomeruli in consequence of diabetic arteriolosclerosis could be essential. PMID- 1770061 TI - Clinical significance of microalbuminuria in Japanese subjects with non-insulin dependent diabetes. AB - In order to elucidate the clinical significance of microalbuminuria in non insulin-dependent diabetes mellitus (NIDDM), 62 Japanese subjects with NIDDM and without proteinuria were followed for three years. After the three-year follow up, four (19%) of 21 microalbuminuric patients--albumin excretion rates (AER) greater than 15 micrograms/min--developed overt proteinuria, while none of the 42 normoalbuminuric patients did. Among these normoalbuminuric patients, eight patients (19.5%) developed microalbuminuria. The microalbuminuric patients who developed overt proteinuria had higher AER at the beginning of the study than the patients who stayed microalbuminuric. The patients who developed microalbuminuria showed a significantly higher systolic blood pressure in the final year than the patients who stayed normoalbuminuric. These results indicate that microalbuminuria precedes overt proteinuria in Japanese NIDDM, and progression of diabetic nephropathy is rapid and associated with a rise in blood pressure. PMID- 1770062 TI - Recent advance in the treatment of diabetic nephropathy: low-protein diet. PMID- 1770063 TI - Recent progress in the treatment of diabetic nephropathy: importance of strict glycemic control on the regression of diabetic nephropathy. PMID- 1770064 TI - Recent advance in the treatment of diabetic nephropathy: angiotensin I converting enzyme (ACE) inhibitors. PMID- 1770065 TI - Recent advance in the treatment of diabetic nephropathy: anticoagulant therapy. PMID- 1770066 TI - Effect of urokinase on preservation of renal function in patients with diabetic nephropathy. AB - Long-term effects of urokinase on the preservation of renal function in patients with diabetic nephropathy were evaluated. Twenty-nine adult patients with non insulin-dependent diabetes mellitus and overt proteinuria were randomly divided into two groups. One group was treated with daily oral administration of dipyridamole or dilazep dihydrochloride and weekly intravenous administration of urokinase; the other group was treated with dipyridamole alone. There was a significant decrease in the amount of proteinuria in the first group after 3 months of the treatment compared with the second group. There was also a significant preservation of renal function in the first group after three years of treatment compared with the second group. It was concluded that continuous administration of urokinase in addition to antiplatelet agents is useful in the treatment of patients with diabetic nephropathy. PMID- 1770067 TI - Exercise regimen for patients with diabetic nephropathy. AB - To elucidate the relationship between physical activity and the progress of diabetic nephropathy, patients were divided into two groups with physical activity maintained (G) or restricted (R). The period between the onset of 1+ and 3+ proteinuria was 56 +/- 25 months in G and 68 +/- 25 months in R. But the period between 3+ proteinuria and the serum creatinine exceeding 2.0 mg/dl was 29 +/- 19 and 23 +/- 22 months, respectively. Duration of the nephrotic stage before the entry to dialysis was about 27 months in each group. After initiation of hemodialysis or continuous ambulatory peritoneal dialysis (CAPD), postural hypotension tended to be less in G and Karnofsky score for fitness in daily physical activity was significantly better in G. Even after macroalbuminuria emerged, it was concluded that a strict restriction of exercise is of little benefit. PMID- 1770068 TI - Misoprostol--a logical therapeutic approach to gastroduodenal mucosal injury induced by non-steroidal anti-inflammatory drugs? AB - Misoprostol is a synthetic analogue of naturally occurring prostaglandin E1. The basis of the damaging actions of non-steroidal anti-inflammatory drugs (NSAIDs) on the gastrointestinal (GI) tract is believed to be a consequence of two events: a direct damaging action on mucosal integrity and depletion of endogenous mucosal prostaglandins (PGs). Due to the latter effect, and because current evidence indicates that PGs play an important role in maintaining the integrity of the GI tract, misoprostol has been developed as a logical therapy to prevent and heal gastric and duodenal damage caused by NSAIDs. The purpose of this review is to consider the need for such a therapy, to describe its pharmaceutical development, to review its pharmacology and to review its efficacy compared with other available agents. PMID- 1770069 TI - Advances in the management of cytotoxic drug-induced nausea and vomiting. PMID- 1770070 TI - Prescribing pattern in a Dutch university hospital. AB - In many countries, including The Netherlands, little is known about the overall prescribing patterns within hospitals. While individual hospitals have some data available, these are not pooled on a regional or national level. The available data consist of dispensing data that are neither patient-linked nor diagnosis linked. We report the results of a study in a Dutch university hospital which show that despite the limitations, such data can be used for a general evaluation of prescribing patterns. Using three categories of undesirable or irrational drug prescribing the dispensing data were screened. The categories were 'inferior or dubious' drugs, 'semi-innovative' drugs, and 'inappropriately used' drugs. The results show that most problems are seen with the use of new drugs. In the first instance, this involves the use of semi-innovative drugs whose adoption may be stimulated by clinical trials in the hospital concerned. Secondly, innovative drugs seem to be used on too large a scale, i.e., for indications for which their use is not warranted. Based on these findings, a follow-up study has been initiated to study some of these suboptimal drug choices in detail. PMID- 1770071 TI - Reactions of community pharmacists to questions by patients with a stigmatized disease. PMID- 1770072 TI - Application of the computerized compensation method and the orthogonal functions method to correct for irrelevant interference in spectrofluorometry. AB - The computerized compensation method and the orthogonal functions method were applied to correct for the presence of interferences in spectrofluorometric analysis. The methods were demonstrated by the determination of tetracycline (TC) and anhydrotetracycline (ATC) in combination. The calibration graphs were linear in the concentration range 0.02-0.12 mg/100 ml of either TC or ATC. PMID- 1770073 TI - Methicillin-resistant Staphylococcus aureus--an overview. AB - Methicillin-resistant strains of Staphylococcus aureus (MRSA) cause life threatening infections, but they are no more pathogenic than methicillin sensitive strains. Difficulties occur because of incorrect or missed identification of MRSA, and hence inappropriate or ineffective treatment of infections. Therapeutic options are severely limited and the increasing spectrum of resistance in MRSA is worrying. However, new methods of detection and new agents for treatment are being developed in response to the challenge of MRSA. Whilst the organism is a problem and control measures are necessary to contain its spread, the outlook is not bleak. In the medium term, the development of new, effective anti-MRSA agents should prevent the threat of MRSA becoming any greater in the field of hospital infection control. PMID- 1770074 TI - Onset of pruritogenicity of chloroquine and the implication for the timing of suppressive therapy. AB - The effectiveness of an antihistamine, chlorpheniramine, in suppressing chloroquine-related pruritus has been investigated in 38 patients, employing two modes of therapy. In the first treatment mode, chloroquine and chlorpheniramine were given concomitantly to the patient, and in the second treatment mode, chlorpheniramine was given 3 h after chloroquine ingestion. The extent of suppression of the pruritus with the first treatment mode was 40% but with the second mode it was 70%. The onset of itching was always delayed usually by 6-10 h. Bringing the time of antihistamine therapy closer to the onset for the reaction therefore, increased the extent to which pruritus was suppressed. PMID- 1770075 TI - Factors influencing the protein binding of bumetanide using an equilibrium dialysis technique. AB - Factors that influence the plasma protein binding of bumetanide were evaluated using equilibrium dialysis. It took approximately 12 h of incubation to reach an equilibrium between plasma and isotonic phosphate buffer of pH 7.4 containing 3% dextran using a Spectrapor 2 membrane (mol. wt cut-off = 12,000-14,000) in a water-bath shaker kept at 37 degrees C and at a rate of 50 oscillations per min. Bumetanide was fairly stable in both 4% human serum albumin (HSA) and in the isotonic phosphate buffer of pH 7.4 for up to 24 h. The binding of bumetanide to 4% HSA was constant (87.5 +/- 1.73%) at bumetanide concentrations ranging from 0.1 to 100 micrograms/ml. The extents of binding were 72.0, 83.3, 88.5, 90.2, 91.3 and 91.4% at albumin concentrations of 0.5, 1, 2, 3, 4 and 5 g/100 ml, respectively, and increased with a decrease in incubation temperature; the values bound were 94.6, 90.3 and 89.3% when incubated at 4, 22 and 37 degrees C, respectively. The binding of bumetanide was independent of the buffer composition used, the quantities of AAG (up to 0.32%), heparin (up to 40 units/ml), sodium azide (up to 0.5%) and anticoagulants (EDTA, heparin and citrate). The free fraction of bumetanide in rabbit plasma (2.91%) was significantly higher than in humans (1.98%) or rats (1.85%). PMID- 1770076 TI - Effect of change in vehicle composition on ophthalmic bioavailability of benzylpenicillin. AB - The stability and bioavailability of benzylpenicillin ophthalmic solutions were determined at pH 5, 6, 6.5, 7 and 8 in citrate buffer. The stability of benzylpenicillin solutions stored at room temperature was greatest at pH 6.6-7 while at 2-4 degrees C stability was greatest at pH 6.5. The uptake by corneal and aqueous humour of benzyl [14-C] penicillin into ovine eyes was greatest at a pH of 6.5, which indicates that for optimum stability and bioavailability benzylpenicillin ophthalmic solutions should be prepared in citrate buffer at pH 6.5. Under these conditions the stability of the refrigerated preparation is acceptable for a normal treatment period. PMID- 1770077 TI - Ovine luteinizing hormone. V. Significance of flow-through peaks observed during chromatofocusing as revealed by various methods of sample preparation and application. AB - In a previous study [Keel et al., Biol, Reprod., 36 (1987) 1102] the ovine luteinizing hormone (oLH) in pituitary extracts was chromatofocused on pH 10.5-7 gradients after equilibration in 25 mM triethylamine-HCl, pH 11.0, by gel permeation. Under these conditions, some immunoreactive oLH flowed through the columns unrestricted and this was interpreted to represent extremely basic isoforms. However, when selected flow-through peaks were re-chromatofocused, each was contaminated with other isoforms of oLH. In order to clarify this dilemma, various methods of sample preparation and application were systematically compared. Consistent with previous observations, variable amounts of the immunoreactive oLH in pituitary extracts equilibrated in triethylamine by gel permeation, dialysis, flow dialysis or ion-retardation chromatography eluted as flow-through peaks when chromatofocused. In contrast, when the ionic components in the pituitary homogenization buffer were removed by these methods as well as ultrafiltration and the proteins were applied to the resin in the elution buffer (1:45 Pharmalyte 8-10.5-HCl, pH 7.0), none of the immunoreactive oLH in pituitary extracts eluted as a flow-through peak. Thus, it appears that oLH eluting as a flow-through peak results from incomplete binding of the hormone to the chromatofocusing resin when applied in triethylamine. PMID- 1770078 TI - Ovine luteinizing hormone. VI. Analysis of the misclassification errors in the separation of intrapituitary isohormones by chromatofocusing. AB - Luteinizing hormone (LH) in extracts of the ovine (o) anterior pituitary gland elutes as eight or more distinct peaks when analyzed by chromatofocusing on pH 10.5-7 gradients [Keel et al., Biol. Reprod., 36 (1987) 1102]. In order to examine the efficacy of this approach to identify the distinct charge isomers of oLH, a pool of pituitary extracts was de-salted by flow dialysis and chromatofocused on a pH 10.5-7 gradient. The immunoreactive oLH eluted in nine distinct peaks which were coded with letters beginning with the most basic form. The fractions corresponding to each peak were pooled, dialyzed and lyophilized. Each peak was then re-chromatofocused on a pH 10.5-7 gradient except for the immunoreactive oLH eluting in peak A' because of the small amount present in this peak. Each peak, except for F and H, also consisted of a small percentage of immunoreactive oLH associated with adjacent peaks. This was plausible because chromatofocusing does not generally yield baseline resolution of peaks. Peak H eluted in a broad manner and was contaminated with significant amounts of isohormones F, G and Z. In contrast, peaks B, E, F, G and Z almost completely eluted in the anticipated regions. Thus, it appears that analysis of oLH charge isomers by chromatofocusing yields minimal misclassification errors and that the misclassification errors observed are associated with molecular forms which comprise a relatively small percentage of the oLH in pituitary extracts. PMID- 1770079 TI - Large-scale purification of the synthetic peptide fragment 163-171 of human interleukin-beta by multi-dimensional displacement chromatography. AB - Multi-dimensional chromatography has been used successfully in the displacement mode for the purification of the synthetic peptide H-Val-Gln-Gly-Glu-Glu-Ser-Asn Asp-Lys-OH, the fragment 163-171 of human interleukin-beta. This peptide can mimic several of the in vivo and in vitro immunostimulatory activities of the entire protein, except for the inflammatory effect. A large-scale procedure has been developed to purify the synthetic peptide by reversed-phase (RP) and ion exchange (IE) displacement chromatography (DC) in a single run without any pretreatment. Masses from 100 mg to about 35 g of the unpurified compounds synthesized by a solid-phase technique on a Merrifield-type resin and obtained by acidolytic cleavage from the solid support, can be purified in this way. In the RP-DC mode the carrier and the displacer were aqueous solutions of 0.1% trifluoroacetic acid and 50 mM benzyltributylammonium chloride, respectively, whereas in the IE-DC mode the carrier was water and the displacer 50 mM ammonium citrate solution. RP-DC and IE-DC were also performed in series by directing the effluent of the RP column onto the IE column. Peptide purities and recoveries greater than 96 and 90%, respectively, were obtained. PMID- 1770080 TI - Bioanalysis of the neuropeptide des-enkephalin-gamma-endorphin by high performance liquid chromatography with on-line sample pretreatment using gel permeation and solid-phase isolation. AB - A bioanalytical method is described that allows the determination of a number of beta-endorphin-related peptides. The method is based on the application of fluorescence detection after high-performance liquid chromatography followed by post-column derivatization with o-phthaldialdehyde. Concentrations exceeding 10 25 ng/ml could be determined by using conventional fluorescence detection, whereas lower concentrations demand the use of laser-induced fluorescence detection. The sample pretreatment includes the use of on-line gel permeation, on line solid-phase isolation and heart cutting of a peak from reversed-phase gradient elution. The sample pretreatment procedure does not discriminate between the dodecapeptide des-enkaphalin-gamma-endorphin (DE gamma E) and its metabolites in order to obtain similar recoveries for all components. The final chromatographic phase system is based on ion-pair formation, which permits the separation of DE gamma E from its metabolites and degradation products. The optimized procedure allows the determination of these peptides in plasma at concentration levels down to about 1 ng/ml, demanding a sample volume of 1 ml. PMID- 1770081 TI - Separation and simultaneous high-performance liquid chromatographic determination of benzocaine and benzyl benzoate in a pharmaceutical preparation. AB - A simple reversed-phase high-performance liquid chromatographic method suitable for the simultaneous determination of benzocaine and benzyl benzoate in dermatological preparations is described. An internal standard method was employed, using C18 "bonded phase" silica column and a mobile phase consisting of acetonitrile - water (40:60, v/v), with absorption of the column effluent monitored at 254 nm. No sources of interference were observed. The simultaneous determination of both compounds by the method described is rapid and accurate. PMID- 1770082 TI - Stability-indicating high-performance liquid chromatographic assay for alpha methyldopa in sustained-release capsules. AB - A stability-indicating high-performance liquid chromatographic assay has been developed for the analysis of alpha-methyldopa (MD) in sustained-release capsules and in the presence of MD decomposition products and an MD industrial impurity, 3 O-methyl-methyldopa (MMD). The method utilizes reversed-phase chromatography (cyano-bonded column), an acidic mobile phase containing sodium heptanesulphonate as ion-pairing reagent and UV detection. Detector responses were linear in the ranges 0.5-200 microgram/ml for MD and 0.2-100 microgram/ml for MMD. The mean recoveries of MD from authentic sample and sustained-release capsules were 100.09 +/- 0.38 and 100.38 +/- 0.46%, respectively. The recovery of MD added to degraded MD, were 99.69% by the proposed method and 153.13% by the US Pharmacopeial (USP) spectrophotometric method. The method is sensitive, accurate and rapid and can be used in routine analysis for MD. PMID- 1770083 TI - Quantitation of insulin injection by high-performance liquid chromatography and high-performance capillary electrophoresis. AB - High-performance capillary electrophoresis (HPCE) was evaluated as a potential technique for the regulatory analysis of commercial dosage forms of insulin. A comparison was made to a liquid chromatographic analysis presently being proposed as an official monograph in the United States Pharmacopeia. The salient points of this comparison were accuracy, precision and ease of use. Both authentic (i.e. single blind, spiked) samples and commercial pharmaceutical formulations (injections) were examined. Chromatographic analyses of both commercial formulations and authentic samples were characterized by good precision, with accuracy being supported by results from authentic (spiked) samples. Conventional HPCE (by which is meant a non-micellar electrolyte used with an uncoated, unmodified fused-silica capillary) achieved reasonable accuracy, but less than impressive precision, when applied to authentic samples. When used for commercial formulations, this type of HPCE did not produce a level of accuracy suitable for regulatory purposes, even with the use of an internal standard. PMID- 1770084 TI - High-performance liquid chromatographic method for the determination of cloxacillin in commercial preparations and for stability studies. PMID- 1770085 TI - Hydrogen-deuterium exchange in fused-silica capillary columns. AB - Ketones deuteriated alpha to the carbonyl have been observed to undergo significant isotope exchange on fused-silica capillary columns during gas chromatography-mass spectrometry. The residence time of the compounds on the column was found to influence the extent of isotope exchange. The degree of exchange was examined using a variety of columns and the isotope exchange was found to occur even with brand new columns. Conversion of the keto compounds into the methyloxime derivatives resulted in retention of the "correct" isotope content during gas chromatography-mass spectrometry. PMID- 1770086 TI - Application of a metal capillary column in gas chromatographic determination of catechol-o-methyltransferase activity. AB - The utility of a deactivated metal capillary column, Rascot, in the measurement of an enzymatic reaction, in this case measurement of rat catechol-O methyltransferase activity, was examined. 3,4-Dihydroxybenzaldehyde, 3,4 dihydroxybenzylalcohol and 3,4-dihydroxybenzoic acid were used as substrates and the m- and p-O-methylated products were separated by using Rascot after derivatization. The peaks on the chromatograms were symmetrical. The data obtained were compared with those reported in previously published papers. Good agreement with previous results proved that Rascot is able to withstand practical use in biological materials. PMID- 1770087 TI - Analysis of human blood plasma triacylglycerols using capillary gas chromatography, silver ion thin-layer chromatographic fractionation and desorption chemical ionization mass spectrometry. AB - The identification and quantitation from pooled human plasma of over 50 molecular species of triacylglycerols, including 22 not previously reported, are reported. The triacylglycerols were first resolved by silver ion thin-layer chromatography into seven fractions, which were independently analysed by polarizable capillary gas chromatography and desorption chemical ionization mass spectrometry in the presence of an internal standard. The two methods gave similar values for the estimates of oligoenoic species, but the former method underestimated the polyenes (due mainly to significant losses caused by thermal degradation), and the latter method overestimated the saturates. The results show that an effective analysis of molecular species of plasma triacylglycerols cannot be obtained by either technique alone. PMID- 1770088 TI - Quantitation of hypoxanthine in plasma from patients with ischemic heart disease: adaption of a high-performance liquid chromatographic method. AB - A high-performance liquid chromatographic method is described for the separation and quantitation of several purine compounds, including hypoxanthine. The isocratic separation of a standard mixture of nine compounds is achieved within 20 min on a reversed-phase Nucleosil 100-5C18 column, with a mobile phase of KH2PO4 (300 mM, pH 4.0)-methanol-acetonitrile-tetrahydrofuran (97.9:1:1:0.1, v/v). Uric acid, guanine, hypoxanthine, uridine, xanthine, allopurinol, inosine, guanosine and 7-methylxanthine were almost completely baseline-separated, with detection limits in the range 0.5-1.2 pmol per injection. The influence of the concentrations of buffer and tetrahydrofuran on the quality of separation are described. The within-day and the day-to-day precision were satisfactory (e.g. coefficients of variation of less than 1.5 and ca. 6.0%, respectively, for peak heights). The recovery of [3H]hypoxanthine added to samples was 86 +/- 1%. Hypoxanthine was quantified in human plasma samples obtained at various times during coronary artery bypass grafting. The hypoxanthine levels measured immediately after release of the aortic cross-clamp were significantly higher than those determined under control conditions (18.8 +/- 7.0 and 3.4 +/- 1.0 microM, respectively). PMID- 1770089 TI - High-performance liquid chromatography-thermospray mass spectrometry of prostaglandin and thromboxane acetyl derivatives. AB - A quantitative analysis of prostaglandin-related substances has been developed. Hydroxyl groups of prostaglandin and thromboxane were acetylated by acetic anhydride, the mixture was partially purified on a Sep-Pak C18 cartridge and analysed by high-performance liquid chromatography combined with thermospray mass spectrometry. Using this method, twenty kinds of prostaglandin derivative could be detected simultaneously within 11 min on a selected-ion monitoring detection chromatogram without a gradient system. Generally, the base ion, [M + H - n(60)]+, is produced through elimination of acetic acid (n = number of the hydroxyl group of prostaglandin or thromboxane). The detection limit for these derivatives was ca. 0.2 pmol at the levels of prostaglandin-related substances prior to derivatization. They could be analysed in the range 0.5-10 pmol. The assay was successfully applied to prostaglandin-related substances in human seminal fluid and rat brain. PMID- 1770090 TI - Determination of cytosine-beta-D-arabinoside in plasma using capillary electrophoresis. AB - An assay for the antileukaemic agent cytosine-beta-D-arabinoside (ara-C) has been developed using capillary zone electrophoresis. Solid-phase extraction and on capillary peak concentration are used to improve the detection limit. The electrophoretic separation time is less than 5 min. The limit of detection for ara-C in plasma is 0.5 microM (signal-to-noise ratio = 3). The assay has been validated for the determination of ara-C in human plasma over the concentration range 1-10 microM. The calibration curve was linear with a correlation coefficient r2 = 0.996. At an ara-C concentration of 8 microM the intra-day coefficient of variation was 9.1% and the inter-day coefficient of variation was 12.3%. At an ara-C concentration of 2 microM the coefficients of variation were 15.2 and 12.0%, respectively. PMID- 1770091 TI - Identification of the main metabolites of 2-ethylhexanoic acid in rat urine using gas chromatography-mass spectrometry. AB - The metabolites of 2-ethylhexanoic acid, an industrial chemical and the active ingredient in wood preservatives, were investigated in rat urine. Male Wistar rats were given 2-ethylhexanoic acid (2-EHA) in drinking water (600 mg/kg daily) for nine weeks, and then urine specimens were collected and analysed. The compounds were identified by gas chromatography-mass spectrometry in both electron-impact mode and chemical ionization mode. In addition to 2-EHA, ten different 2-EHA-related metabolites were found in the urine of 2-EHA-treated rats. The main metabolite was 2-ethyl-1,6-hexanedioic acid. Urine also contained 2-ethyl-6-hydroxyhexanoic acid and five other hydroxylated metabolites and two lactones, the detailed structures of which have not yet been elucidated. The unsaturated 5,6-dehydro-EHA was also identified; this is the metabolite corresponding to 2-n-propyl-4-pentenoic acid, the hepatotoxic metabolite of valproic acid. At least part of the 2-EHA is present in urine as a glucuronide conjugate. PMID- 1770092 TI - Determination of benzyl alcohol and its metabolite in plasma by reversed-phase high-performance liquid chromatography. AB - A study undertaken following recent reports of deaths in neonatal children associated with the use of benzyl alcohol resulted in the development of a stability-indicating high-performance liquid chromatographic assay of benzyl alcohol in plasma using benzocaine as internal standard. Thawed plasma samples were diluted and subjected to solid-phase extraction using Extrelut and eluted with ethyl acetate. The evaporated eluate was reconstituted with mobile phase and chromatographed on a C18 column with water-acetonitrile-glacial acetic acid as mobile phase and detection at 254 nm. Baseline separation was achieved within 12 min for benzyl alcohol, benzaldehyde, benzoic acid, hippuric acid and benzocaine. Peak-height ratios were linear over 80-640 ng of benzyl alcohol injected (r = 0.998) and over 10-80 ng of benzoic acid injected (r = 0.999). Benzaldehyde and hippuric acid were not quantitated because these compounds were not detectable in actual dog plasma. Validation studies by spiking dog plasma with benzyl alcohol and benzoic acid gave overall percent recoveries (+/- relative standard deviation, n = 4) of 98.3 +/- 3.0 and 101.4 +/- 7.6%, respectively. The method was applied to the assay of actual plasma samples. Since benzyl alcohol is very susceptible to oxidation to benzaldehyde and benzoic acid, its purity in bulk liquid samples can be determined by this method. PMID- 1770093 TI - High-performance liquid chromatographic method for direct separation of 5-(p hydroxyphenyl)-5-phenylhydantoin enantiomers using a chiral tris(4 methylbenzoate) column. AB - After simple purification of the incubation mixture of phenytoin in isolated rat hepatocytes, 5-(p-hydroxyphenyl)-5-phenylhydantoin (p-HPPH), which formed as a major metabolite, was readily resolved to each enantiomer by direct high performance liquid chromatography on a cellulose tris(4-methylbenzoate) column, with a mobile phase of ethanol-water. It was also observed that the formation of S-(-)-p-HPPH was dominant, and the S/R ratio was 11.5. PMID- 1770094 TI - Stereoselective high-performance liquid chromatographic determination of the enantiomers of ketamine and norketamine in plasma. AB - An enantioselective high-performance liquid chromatographic assay for the quantitation of the enantiomers of ketamine and its major metabolite norketamine in human plasma is described (assay I). The procedure involved extraction of the compounds from alkalized plasma into cyclohexane. Stereoselective separation was achieved with a prepacked alpha 1-acid glycoprotein column without any derivatization procedure. A second assay using a conventional reversed-phase column to determine total (racemic) ketamine and norketamine is also described. Because of interfering plasma peaks (assay II) the cyclohexane solution was reextracted into 1 M hydrochloric acid. The detection wavelength was 215 nm for all substances. The limit of quantification of the method was ca. 40 ng/ml in plasma. The assays were sensitive and reproducible. The method was demonstrated to be sensitive for stereoselective pharmacokinetic studies of ketamine after clinical doses. PMID- 1770095 TI - Determination of theophylline in serum and saliva in the presence of caffeine and its metabolites. AB - Because of marked variability in its metabolic clearance and its narrow therapeutic range (10-20 micrograms/ml) investigation of each patient's clearance of theophylline is desirable. The author reports here a rapid reversed-phase high performance liquid chromatographic (HPLC) method to determine, within 3 min, the theophylline in serum and saliva in the 0.1-50 micrograms/ml range. A fast HPLC column, 10 x 4.6 mm, packed with 3-microns spherical ODS packing is used with acetonitrile-methanol-buffer pH 4.7 (4:7:89) to achieve separation of theophylline from paraxanthine and matrix components. Since theophylline is a major pediatric bronchodilator, the feasibility of assay in saliva was investigated as an alternative route for determining the clearance is stressed asthmatic children. Using this method it was found that the ratio of theophylline in simultaneous serum and saliva samples is very consistent over time in the same person (+/- 3.99%), but inter-individually this consistency is reduced ten-fold. Simultaneous serum and saliva samples need be taken only once to obtain the ratio and the kinetics followed further with salivary samples only. PMID- 1770096 TI - Simultaneous determination of ketoprofen enantiomers and probenecid in plasma and urine by high-performance liquid chromatography. AB - A rapid, sensitive, stereospecific reversed-phase high-performance liquid chromatographic method was developed for simultaneous quantitation of ketoprofen enantiomers, probenecid and their conjugates in biological fluids. Following addition of the internal standard, indoprofen, the constituents were extracted into isooctane-isopropanol (95:5), water-washed, extracted with chloroform, then evaporated and the residue sequentially derivatized with ethyl chloroformate and L-leucinamide hydrochloride. The formed diastereomers were chromatographed on a reversed-phase column with a mobile phase of 0.06 M KH2PO4-acetonitrile triethylamine (65:35:0.1) at a flow-rate of 1 ml/min and a detection wavelength of 275 nm. The minimum quantifiable concentration was 0.5 micrograms/ml in 100 microliters of rat plasma and urine samples. The intra- and inter-day coefficients of variation for this method are less than 10%. The assay is successfully applied to a pharmacokinetic study. The simultaneous analysis of probenecid with several other non-steroidal anti-inflammatory drugs was also successful. PMID- 1770097 TI - Separation of o-phthalaldehyde-mercaptoethanol derivatives of amino acids from blood plasma on reversed-phase Nova-Pak C18 cartridges. AB - A separation of 25 o-phthalaldehyde-mercaptoethanol derivatives of primary amino acids in plasma prepared from human blood has been developed for Waters 10 cm x 0.8 cm I.D., 4-microns Nova-Pak C18 Radial-Pak cartridges. A binary gradient system with solvent-switching capability for the A pump is required. Computer methodologies have been utilized to develop mobile phase mixtures of phosphate buffer (pH 6.9), water, methanol and tetrahydrofuran. Advantages of the method include simple sample preparation, fast turnover time (67 min including the pre column Autotag derivatization procedure) and exceptional column durability (several hundred analyses). PMID- 1770098 TI - High-performance liquid chromatographic determination of taurine in biological fluids by post-column fluorescence reaction with thiamine. AB - A high-performance liquid chromatographic method is described for the selective determination of taurine in biological fluids by post-column fluorescence reaction. Taurine was separated on an adsorption-distribution type Shodex Ionpac KC-811 column. Then it was converted with hypochlorite into the corresponding N chloramine, which was allowed to react with thiamine to give fluorescent thiochrome. As little as 6 ng per injection of taurine could be determined. The average recoveries of spiked taurine in serum and urine were 99.5 +/- 2.7 and 101.8 +/- 2.9%, respectively. The method could be applied to the assay of taurine in human serum and urine with simple pretreatment. PMID- 1770099 TI - Fluorimetric determination of oxidised and reduced glutathione in cells and tissues by high-performance liquid chromatography following derivatization with dansyl chloride. AB - A high-performance liquid chromatographic method utilising fluorimetric detection of oxidised and reduced glutathione, following derivatization with dansyl chloride is described. Dansyl derivatives are separated on an aminopropyl silica column with a methanol-sodium acetate gradient system giving detection limits (signal-to-noise ratio = 2) of 1 pmol. This is in the order of 100-fold more sensitive than established methods based on the ultraviolet detection of dinitrophenylglutathione derivatives. The present procedures have been used to determine oxidised and reduced glutathione in rat lung tissues and in alveolar macrophages. PMID- 1770100 TI - Variation of hydrophobicity of human urinary epidermal growth factor. AB - Epidermal growth factor is present in human urine in large amounts, but its biological significance is not known. The results of this study indicate that the predominant 6000-dalton form of epidermal growth factor in human urine is divided by hydrophobic interaction chromatography into four fractions; only 3% of the total 6000-dalton epidermal growth factor coeluted with the biosynthetic epidermal growth factor and the rest was separated into three different peaks. These different forms may lack one or two amino or carboxy terminal amino acids from the 53 amino acids present in epidermal growth factor, or they may be products of deamidation or oxidation of amino acid(s). Further knowledge of these micromodifications of epidermal growth factor secreted in urine may reveal the origin and function of epidermal growth factor in humans. PMID- 1770101 TI - Determination of glycyrrhetinic acid in human plasma by high-performance liquid chromatography. AB - A high-performance liquid chromatographic (HPLC) method has been developed for measuring 18 beta-glycyrrhetinic acid (GRA) in human plasma in the range of 0.1-3 micrograms/ml. The acetate ester of GRA is added to the plasma as an internal standard, plasma proteins are denatured with urea to release GRA, and the GRA and the internal standard are extracted in an ion-pairing solid-phase extraction process. An isocratic, reversed-phase HPLC separation is used, followed by ultraviolet absorbance detection at 248 nm. The results from the analysis of five GRA-fortified plasma pools show a mean relative standard deviation of 7% and are accurate to within 10%. With evaporative concentration of the extract, the limit of detection for GRA in plasma is approximately 10 ng/ml. PMID- 1770102 TI - Reversed-phase high-performance liquid chromatographic analysis of atenolol enantiomers in plasma after chiral derivatization with (+)-1-(9-fluorenyl)ethyl chloroformate. AB - A sensitive high-performance liquid chromatographic method for the determination of the enantiomers of atenolol in rat plasma has been developed. Racemic atenolol and practolol (internal standard) were extracted from alkalinized plasma (pH 12) into dichloromethane containing 3% (v/v) heptafluoro-1-butanol, and the organic layer was evaporated. The samples were derivatized with (+)-1-(9-fluorenyl)ethyl chloroformate at pH 8.5 for 30 min. After removal of excess reagent, the diastereomers were extracted into dichloromethane. The diastereomers were separated on a Microspher C18 column (3 microns) with a mobile phase of acetonitrile-sodium acetate buffer (0.01 M, pH 7) (50:50, v/v) at a flow-rate of 0.8 ml/min. Fluorescence detection (lambda ex = 227 nm, lambda em = 310 nm) was used. When 100 microliters of plasma were used, the quantitation limit was 10 ng/ml for the atenolol enantiomers. The assay was applied to measure concentrations of atenolol enantiomers in plasma after intravenous administration of racemic atenolol to rats. PMID- 1770103 TI - Quantitation of the new hypoglycaemic agent AG-EE 388 ZW in human plasma by automated high-performance liquid chromatography with electrochemical detection. AB - A sensitive and selective high-performance liquid chromatographic assay has been developed for a new hypoglycaemic agent AG-EE 388 ZW (I) in human plasma. Plasma samples containing I were acidified with 0.2 M hydrochloric acid, directly injected into C2 reversed-phase pre-columns, and cleaned up on-line. After pre column switching, the substance was separated isocratically in 15 min on a C18 reversed-phase column. Quantitation was performed after amperometric detection by external standard calibration curves. The linearity of the assay was demonstrated over the therapeutic concentration range 5-200 ng/ml. between-day coefficient of variation was 9.2% at 30 ng/ml. The limit of detection was 5 ng/ml in plasma. Determination of human plasma samples after intravenous and oral administration of 1 mg of 14C-labelled I demonstrated the applicability of the assay for pharmacokinetic studies in humans. PMID- 1770104 TI - High-performance liquid chromatographic analysis of fatty acid compositions of platelet phospholipids as their 2-nitrophenylhydrazides. AB - A novel high-performance liquid chromatographic method for biologically important fatty acids incorporated into platelet phospholipids in esterified form has been developed. 2-Nitrophenylhydrazine hydrochloride was used as a pre-column labelling agent to convert the saponified platelet phospholipids directly into corresponding fatty acid hydrazides, without a complicated isolation procedure. Isocratic separation was achieved within only 36 min for twenty-five saturated and mono- and polyunsaturated fatty acids (C8:0-C22:6), including cis and trans isomers, on a YMC-FA column. The analytical results showed good quantitative accuracy. Fatty acid compositions were determined in platelet phospholipids obtained from normal subjects and patients with diabetes mellitus. The method is simple, rapid and adequate for labelling esterified fatty acids in biological materials, and has several advantages with regard to resolution, analysis time and sensitivity over previously published methods. PMID- 1770105 TI - New high-performance liquid chromatographic method for the determination of alprazolam and its metabolites in serum: instability of 4-hydroxyalprazolam. AB - A high-performance liquid chromatographic method was developed for the determination of alprazolam (ALP) and its active metabolites, alpha hydroxyalprazolam (AOH) and 4-hydroxyalprazolam (4OH) in human serum. During assay development, the instability of 4OH was revealed. Factors affecting stability of 4OH were then investigated. In this report, the assay methodology for the determination of ALP and AOH, the instability of 4OH, subsequent interference of 4OH breakdown products with AOH quantification, and factors affecting 4OH stability are described. The clinical significance of our findings are reported. PMID- 1770106 TI - Improved determination of the bisphosphonate pamidronate disodium in plasma and urine by pre-column derivatization with fluorescamine, high-performance liquid chromatography and fluorescence detection. AB - An improved method for the determination of 1-hydroxy-3-aminopropylidene-1,1 bisphosphonate (pamidronate) in human urine and plasma is described. The procedure is based on a co-precipitation of the bisphosphonates (pamidronate and 6-amino-1-hydroxypentilidene-bisphosphonate, used as internal standard) with calcium phosphate. After centrifugation the precipitate is redissolved in hydrochloric acid, followed by a second precipitation. Then the bisphosphonates are dissolved in ethylenediaminetetraacetic acid, derivatized with fluorescamine, and separated by high-performance liquid chromatography. Using fluorescence detection, the limit of quantitation for pamidronate was 0.8 mumol/l in plasma and 0.7 mumol/l in urine. PMID- 1770107 TI - Elimination of caffeine interference in high-performance liquid chromatographic determination of cotinine in human plasma. AB - A high-performance liquid chromatographic method with ultraviolet photometric detection for the determination of cotinine in human plasma was described. The use of a 30-cm reversed-phase column and of a mobile phase consisting of water methanol-0.1 M sodium acetate-acetonitrile (72:21:5.6:1.4, v/v), pH 4.1, eliminated caffeine interference. A simplified solid-phase extraction procedure was also performed for plasma samples. PMID- 1770108 TI - Automated direct high-performance liquid chromatographic assay for estetrol, estriol, cortisone and cortisol in serum and amniotic fluid. AB - An automated direct assay for the simultaneous determination of unconjugated estetrol, estriol, cortisone and cortisol in serum and amniotic fluid, using high performance liquid chromatography with electrochemical detection and ultraviolet detection, has been developed. The analysis time is ca. 1 h. This system offers good reproducibility with low coefficients of variation (estetrol, 2.3%; estriol, 2.3%; cortisone, 2.6%; cortisol, 1.9%). Detection limits are low enough for routine determinations (estetrol and estriol, 150 pg; cortisone and cortisol, 5 ng). Comparison of the values measured by the present method and by radioimmunoassay revealed significant correlations for estetrol (r = 0.787, p less than 0.01), estriol (r = 0.957, p less than 0.01), cortisone (r = 0.956, p less than 0.01) and cortisol (r = 0.865, p less than 0.01). This system proved to be valuable in monitoring feto-placental function. PMID- 1770109 TI - Method for measuring endogenous 3-O-methyldopa in urine and plasma. AB - The present report describes a method using column liquid chromatography with electrochemical detection for assaying concentrations of 3-O-methyldopa in urine and plasma. The technique combines a one-step sample preparation scheme with post column flow-through electrodes in series, allowing adequate chromatographic separation of 3-O-methyldopa from other endogenous substances in urine. The validity of the method was confirmed by markedly decreased urinary 3-O-methyldopa levels after administration of an inhibitor of catechol-O-methyltransferase to rats, radioactivity in chromatographic fractions corresponding to 3-O-methyldopa in urine of rats undergoing infusion of [3H]-L-DOPA, and correlations between excretion rates of 3-O-methyldopa and catechols in humans. In healthy humans, urinary excretion of 3-O-methyldopa averaged 974 +/- 707 (S.D.) nmol per day, and plasma levels of 3-O-methyldopa averaged 89 +/- 32 nmol/l. The method should be useful in studies about the metabolism of endogenous and exogenous DOPA. PMID- 1770110 TI - High-performance liquid chromatographic method for the simultaneous purification of cathepsins B, H and L from human liver. AB - A high-performance liquid chromatographic procedure for the isolation of the three cysteine proteinases, namely cathepsins B, H and L, is described. The method is based on the following four steps. (1) A classical AcA 44 gel permeation separation with a 30-70% ammonium sulphate fraction from the human liver homogenate is used to remove the non-enzymic high-molecular-mass components. (2) Preparative cation-exchange chromatography on a CM-SW TSK column can separate the three proteinases. (3) An anion-exchange step on a semi preparative DEAE-SW TSK column for the cathepsin H fraction is used to remove a small amount of cathepsins B and L activities. (4) The three separated enzymes are purified on an analytical TSK gel 2000 SW column. The purity of each enzyme is assessed by sodium dodecyl sulphate polyacrylamide gel electrophoresis and electrofocusing on polyacrylamide gels. To check the activities of the purified proteinases, the kinetic constants [Michaelis constant (KM) and catalytic constant (Kcat)] and the ratio Kcat/KM against the fluorigenic substrates Arg-NH Mec, Z-Arg-Arg-NH-Mec and Z-Phe-Arg-NH-Mec after active-site titration using E 64, were determined. Z-Phe-Phe-CNH2 was also used as a specific inhibitor of cathepsin L. This method requires only 6 g of human liver, and gives a high yield of the three lysosomal cysteine-proteinases: thus, about 150 micrograms of cathepsin B and 50 micrograms each of cathepsins L and H are obtained in a single run. PMID- 1770111 TI - Human plasma lecithin:cholesterol acyltransferase. Preparation and use of immobilized p-aminophenylarsenoxide as a catalytic site-directed covalent ligand in enzyme purification. AB - A method is described for the preparation of p-aminophenylarsenoxide-linked carboxymethyl (CM) Bio-Gel A and its use as a specific, catalytic site-directed affinity chromatography ligand in the final stages of the purification of human plasma lecithin:cholesterol acyltransferase (LCAT) (EC 2.3.1.43). Previous mechanistic studies by us demonstrated that phenylarsenoxide derivatives, which are highly specific for vicinal thiols, could inhibit LCAT via a covalent interaction with the sulphydryl groups of the two catalytic cysteine residues and that this inhibition could be rapidly and completely reversed upon addition of 2,3-dimercaptopropanesulphonic acid. The ligand was covalently linked to CM Bio Gel A activated through an N-hydroxysuccinyl ester formed by N-hydroxysuccinimide and dicyclohexylcarbodiimide in dry dimethyl sulphoxide; 87% of the added p aminophenylarsenoxide was coupled to the CM Bio-Gel A in 3 h at 25 degrees C giving 2.3 mg of p-aminophenylarsenoxide per ml of gel. Homogeneous LCAT free of apo A-I, apo E, apo D and albumin was obtained in an 11% yield and purified 15,013-fold overall. A 13-fold purification was obtained by chromatography upon p aminophenylarsenoxide-CM Bio-Gel A. This method is a useful final step in LCAT purification and will prove valuable in the purification of other proteins and compounds containing vicinal thiols. PMID- 1770112 TI - Purification of phospholipase C by hydrophobic interaction affinity chromatography. AB - A simple procedure is described for the purification of phosphatidylcholine hydrolyzing phospholipase C(PLC). Lecithin, the substrate for PLC, was ligated hydrophobically to octyl-Sepharose in 2 M (NH4)2SO4. The washed lecithin conjugated resin was then used to purify PLC from crude preparations by affinity chromatography. PLC binds to the lecithin moiety in the presence of Zn2+ and is eluted with an acidic buffer containing EDTA. PLC activity was recovered in the eluate. Both sodium dodecyl sulphate polyacrylamide gel electrophoresis and pI electrofocusing showed that the eluate contained a single monomeric protein with an apparent molecular mass of 66 kDa and a pI of 5.5. PMID- 1770113 TI - Separation of living red blood cells by gravitational field-flow fractionation. AB - The field-flow fractionation technique, using the earth's gravitational field, has been applied to peripheral blood cell populations. A more or less symmetrical, gaussian-like, elution peak is generally observed for the red cell population. The bimodal cell population obtained after a massive transfusion is shown to result in a shoulder on the red blood cell elution profile. In one case where a similar shouldering peak was obtained from a non-transfused donor, the existence of an immunological double population has been demonstrated. This suggests that field-flow fractionation has some potential for complementary biomedical diagnosis. PMID- 1770114 TI - [Progress in the treatment of acute myocardial infarction]. PMID- 1770115 TI - [An immunohistochemical study and its clinical application for endocrine disorders using monoclonal antibodies]. PMID- 1770116 TI - [A study of cerebral hemodynamics using transcranial Doppler ultrasonography with special reference to clinical evaluation of pulsatility index]. AB - Transcranial Doppler Ultrasonography (TCD) is now commonly used to evaluate the cerebral hemodynamics. However, the blood velocity measured with TCD is not always accurate, because as a rule the direction of the blood flow does not completely coincide with that of the ultrasonic beam. The error in the measurement could be as large as 15%. This could be eliminated by calculating pulsatility index (PI) from the Doppler ultrasonography. This study evaluates the reliability of the PI as an index of cerebral hemodynamics. In total, 164 measurements were made in patients with various cerebrovascular diseases (CVD), including 14 of brain death patients (group B) and 14 of inpending herniation patients (group I). Of CVD, 46 were persistent vegetative state patients (group V), and 43 were in relatively good conditions (group A). Other including 15 of hydrocephalus patients (group H) and 19 of cerebral vasospasm after subarachnoid hemorrhages (group S) were also investigated. Nineteen normal young volunteers (group N) were used as controls. The mean level of PI in group N shows 0.82. PI in group A was increased to 1.04, and in group V, 1.27. Furthermore in the brain death group, the mean level of PI was increased to 3.86, which was statistically significant. It was concluded that measurement of PI was very useful to evaluate the changes of cerebral hemodynamics, and the levels of PI was affected more with the changes in diastolic than in systolic flow velocity. PMID- 1770117 TI - [Gastric mucosa investigated by endoscopic biopsy and functional study]. AB - This study investigated the relationship between the gastric mucosa, gastric emptying and the peroral iron loading test in gastric ulcer and gastric cancer cases. The gastric mucosa in gastric ulcer cases was similar to that in gastric cancer cases. Gastric emptying in the M portion was delayed more than in the C and A portions as well as in the control group. In both early and advanced gastric cancer cases, gastric emptying was delayed slightly more than in the control group. The results of the peroral iron loading test showed that the serum iron level in the gastric ulcer cases in the active stage increased more remarkably than in the healing stage. In early gastric cancer cases the results of the peroral iron loading test were similar to those of the gastric ulcer cases. In advanced gastric cancer cases, the quantity of the serum iron did not increase significantly. In both gastric ulcer and gastric cancer cases, the quantity of serum iron in the cases with anemia was significantly increased. In both gastric ulcer and gastric cancer cases, negative correlation was recognized between serum ferritin and an increased quantity of serum iron. In gastric ulcer cases on the M portion, positive correlation was recognized between the increased quantity of serum iron and gastric emptying. In both gastric ulcer and gastric cancer cases, the increased quantity of serum iron in cases with severe atrophic gastric mucosa was more significant than in those with mild atrophic gastric mucosa. PMID- 1770118 TI - [Measurement of renal index on X-CT]. AB - Morphological measurements of the kidney were made using X-CT images. Anteroposterior width of the kidney as well as the renal sinus on both right and left sides and the transverse width of the first lumbar vertebral body were measured from CT images. Changes according to age in anteroposterior width of the kidney and the transverse width of the lumbar vertebral body were investigated. As to the ratio of the anteroposterior width of the kidney (both right and left) to the transverse width of the lumbar vertebral body, and the ratio of the anteroposterior width of the kidney to the anteroposterior width of the renal sinus, the changes due to aging and the differences between male and female were studied. 1) In actual CT measurements, the average anteroposterior width of the right kidney was 47 mm, while that of the left kidney was 49 mm. The left kidney was slightly larger than the right kidney with statistical significance. In subjects up to 19 years of age, both the anteroposterior width of the kidney and the transverse width of the lumbar vertebral body showed correlation with age, while after the age of 20, there was no age-related correlation. 2) The average ratio of the anteroposterior width of the kidney to the transverse width of the lumbar vertebral body was 1.13 for the right kidney and 1.19 for the left kidney. The difference between those two items was statistically significant and the changes due to aging were slight. During the age between 4 and 64 years, they were constant and no significant change was noticed. No difference between male and female was found. From the age of 65 years, a decreasing tendency was noticed. 3) The ratios of anteroposterior width of the kidney to the anteroposterior width of renal sinus for both right and left kidneys in males and females were found to be inversely correlated with age. They were similar to the changes due to aging in renal functions of the cortex system. As seen on CT image, the ratio of the anteroposterior width of the kidney to the transverse width of the lumbar vertebral body, and the ratio of the anteroposterior width of the kidney to the anteroposterior width of the renal sinus could be the index of both the size of the kidney and the thickness of the renal parenchyma respectively. PMID- 1770119 TI - [Relationships between noradrenaline kinetics and hemodynamic response under physical stressors]. AB - Noradrenaline (NA) levels in blood and urine were measured in 7 male adults before, during, and after a mild ergometer exercise. Blood pressure (BP) and heart rate (HR) were continuously recorded during all of their stages. Blood specimens were obtained with a catheter introduced into the antecubital vein and plasma NA (PNA) level was measured with high performance liquid chromatography (HPLC) with electrochemical detection. NA and vanillylmandelic acid (VMA) levels in urine were measured by HPLC. The sequential changes of BP, HR, PNA, UNA, and VMA were simulated in a mathematical models of multiexponential functions as expressed by: sigma Aiexp(-Bit)(t; time). The present study suggests that the sequential changes of HR and systolic blood pressure (SBP) reflected the amount of NA secreted at sympathetic nerve endings on the effectors subserving HR and SBP changes, and therefore they were related to overflow of NA into plasma and urine, and also that of VMA into urine. The net NA levels at the nerve endings, as a result of NA kinetics, could be estimated from SBP and HR and could determine the rate of overflow of NA into plasma and urine. It was also revealed that the levels of SBP, PNA, UNA and urine volume immediately before the exercise were closely related to the rate of the diffusion. The rate of diffusion of NA into urine decreased to some extent as that of NA into plasma increased, but the rate of diffusion turned to an increase, when the latter exceeded a critical level. PMID- 1770120 TI - [A study of idiopathic epilepsy of childhood with occipital electroencephalographic foci]. AB - Twenty five idiopathic epileptic children with occipital electroencephalographic (EEG) foci have been studied for more than 3 years clinically as well as electroencephalographically. They were categorized into two groups, i.e., those with (A group) and without (B group) visual symptoms. Not only visual symptoms, but also headache, nausea, vomiting or generalized tonic clonic convulsion (GTC) were observed in group A. GTC or tonic deviation of the eyes were observed in group B. Migrainous symptoms were present in 3 cases of group A. Interictal EEGs consisted of spikes or spike and wave complexes in the occipital area. In some cases epileptic foci existed not only in the occipital area, but also in other regions. The mean age of the onset of the clinical symptoms was 8 in group A and 5 in group B. Beyond the age of 15, the abnormal EEGs were observed in 80% of the cases in group A, and in 18% of the cases in group B. The symptoms disappeared by 9 years of age in 92% of the cases in group B, and by 15 years of age in 82% of the cases in group A. From these results the prognosis of idiopathic epilepsy of childhood with occipital EEG foci was considered as good. PMID- 1770121 TI - [Induction and analysis of viral specific cytotoxic T lymphocytes with modern biotechnology]. PMID- 1770122 TI - [Gene diagnosis and oncogenes of leukemia]. PMID- 1770123 TI - [The trend in the therapy of pediatric acute diarrhea]. PMID- 1770124 TI - Medium-associated luteinization expressed as progesterone release in granulosa luteal cells isolated from patients undergoing in-vitro fertilization. AB - The present study describes the effect of culture medium components on progesterone release from human granulosa-luteal cells isolated from patients undergoing in-vitro fertilization (IVF). Progesterone release was selectively measured as a central parameter of in-vitro luteinization, a process believed to decrease the success rate of IVF treatments. Ten different media of relevance to embryo culture were investigated for their effect on progesterone release in unstimulated granulosa cell cultures and in cultures stimulated with human chorionic gonadotrophin (HCG) (1 IU/ml) during 4 days in vitro. Culture media supplemented with human serum yielded the greatest secretion of progesterone. Supplementation with fetal calf serum caused an intermediate pattern of progesterone release. Substitution of serum with a synthetic replacement (Medi CultR SSR 1 and 2), lacking hormones, cholesterol and growth factors, led to a minimal output of progesterone from granulosa-luteal cells. Complex media (RPMI 1640 and Ham's F10) generally caused a greater progesterone release than simple salt solution (EBSS). No effect of insulin was detected when added to serum-free media. PMID- 1770125 TI - Immunohistochemical localization of superoxide dismutase in the human ovary. AB - To elucidate the physiological function of superoxide dismutase (SOD) in the ovary, we examined the immunohistochemical distribution of CuZn-SOD in the human ovary. We also measured the CuZn-SOD concentration in human follicular fluid by enzyme-linked immunosorbent assay (ELISA). The germinal epithelium and tunica albuginea showed no or weak immunoreactivity. No or weak staining activity was also observed in the non-antral follicle. Once the follicle began to form the antral cavity, theca interna cells began to show intensive immunostaining of SOD, as compared with no staining in the granulosa and theca externa cells. In the gestational corpus luteum, theca and granulosa lutein cells showed intensive and moderate staining activity, respectively. The concentration of CuZn-SOD was 0.222 +/- 0.186 ng/mg protein (mean +/- SD) in the preovulatory follicular fluid. In the present study, the immunohistochemical distribution of SOD was confirmed in the human ovary for the first time. Taking into consideration the fact that SOD catalyses the dismutation reaction of superoxide anion radicals, the present results suggest that theca interna cells play an important role in the protection of the developing oocyte from oxygen radicals by acting as a blood-follicular barrier during follicle maturation. PMID- 1770126 TI - A morphometric study of the uterine glandular epithelium in women with premature ovarian failure undergoing hormone replacement therapy. AB - In this study we examined the fine structure of the human glandular epithelium in women with idiopathic ovarian failure in artificial cycles produced by two different types of hormone replacement therapy (oestradiol valerate orally and either intramuscular injection of progesterone or progesterone via vaginal pessary), both of which had been claimed to be capable of supporting successful implantation. Biopsies were performed on day 19 of the artificial cycle. A variety of sterological probes were used to quantify the structural characteristics of these cells and the results obtained were compared with those from normal fertile subjects biopsied on days 2 and 5 after the luteinizing hormone (LH) surge. The glandular epithelial cells from the vaginal group had a less elaborate secretory apparatus when compared with the intramuscular group or with LH + 5 controls. Many of the features of the vaginal group suggested a continued oestrogenic influence, while the intramuscular group seemed to be more advanced than LH + 5. PMID- 1770127 TI - Evidence for direct regulation of epidermal growth factor receptors by steroid hormones in human endometrial cells. AB - Recent evidence suggests that epidermal growth factor (EGF) may serve as a paracrine and/or autocrine mediator of oestrogen action in uterine growth. In this study, the effects of various steroid hormones on EGF receptors in primary cultures of human endometrial cells were examined. Human endometrial cells exhibited a single class of high-affinity binding sites for EGF (Kd: 0.14 nM) with approximately 3600 receptors/cell. The addition of progesterone increased the EGF binding without affecting the Kd value. Cortisol also increased EGF binding and acted additively with a relatively low concentration of progesterone (10(-10) M). Oestradiol alone had no effect on EGF binding. However, oestradiol in combination with progesterone and cortisol further increased EGF binding. These results present evidence for the direct regulation of EGF receptors by steroid hormones in human endometrial cells, and raise the possibility that steroid hormones may act on these cells in part by modulating EGF receptors. PMID- 1770128 TI - The optimum dose and mode of administration of luteinizing hormone releasing hormone analogue in in-vitro fertilization: a comparison of three regimens. AB - Three regimens for administration of the luteinizing hormone releasing hormone analogue (LHRHa), buserelin, were compared in terms of pituitary down-regulation prior to ovarian stimulation for in-vitro fertilization (IVF). Thirty-three patients who had failed to conceive in previous IVF cycles were randomly divided into three groups. Patients in Group I (n = 11) received intranasal (i.n.) buserelin 200 micrograms four hourly for 21 days; patients in Group II (n = 11) received subcutaneous (s.c.) buserelin 500 micrograms twice a day for 7 days, followed by 500 micrograms daily for 14 days; patients in group III (n = 11) received (s.c.) buserelin 500 micrograms three times a day for 7 days. In all three groups administration of buserelin was continued until serum oestradiol levels were less than 100 pmol/l, at which time human menopausal gonadotrophin (HMG) was commenced. All the patients achieved pituitary down-regulation after seven days of treatment with buserelin, except for four patients who developed ovarian cysts and two with polycystic ovarian disease. The total dose of HMG used and the ongoing pregnancy rate were not significantly different between the three groups. A much higher proportion of patients in Group I developed side-effects and found their treatment disruptive to their life-style. Our results suggest that patient variables (e.g. polycystic ovaries, ovarian cysts) rather than the dose and mode of administration of buserelin, are the major determinant of the length of time needed for pituitary down-regulation. The s.c. route is preferable and the smallest dose of buserelin that will produce pituitary down-regulation should be used. PMID- 1770129 TI - Intrauterine release of oestriol in castrated rhesus monkeys induces local but not peripheral oestrogenic effects: a possible approach for the treatment and prevention of Asherman's syndrome. AB - Two types of oestrogen-medicated intrauterine devices (IUD) were studied in ovariectomized rhesus monkeys. An oestradiol (E2) fibre-wrapped IUD that released E2 at a rate of 3.57 micrograms/cm/day, or an oestriol (E3) fibre-wrapped IUD that releases E3 at a rate of 6.4 micrograms/cm/day, was inserted in eight animals and left in place for 4 weeks. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), E2 and E3 were determined by radioimmunoassay for 1 week before the IUD insertion, during the time the IUD was in place, and for 3 weeks after its removal. Uterine histology was performed at the time of IUD insertion and removal by light and transmission electron microscopy. Both E2 and E3 IUDs induced similar histological changes in the uterus, i.e. four- to five-fold increase in endometrial thickness, a shift of the gland/stroma ratio from 1:4 to 1:1, transformation to a marked pseudostratified epithelium with pronounced coiling of the glands, appearance of subnuclear and luminal secretion and, finally, change from spindle-dense stromal cells to plump eosinophilic cells. Oestradiol fibre-wrapped IUDs produced circulating E2 levels of 150-200 pg/ml during the entire 4 weeks. FSH and LH levels were decreased to an average of 55% and 65% from a castration baseline (P less than 0.001 and P less than 0.05, respectively). Oestriol fibre-wrapped IUDs produced circulating E3 levels of 100-250 pg/ml. However, FSH and LH levels were not altered in this group. The specific local oestrogenic effect of E3-IUDs without affecting the pituitary secretion of gonadotrophins, suggests their possible application in cases in which an exclusively oestrogenic effect at the uterine level, such as in Asherman's syndrome, is desired. PMID- 1770130 TI - Multiple follicular development in women with normal menstrual cycles treated with pulsatile gonadotrophin-releasing hormone. AB - In a prospective study, 15 patients with normal menstrual cycles were treated with pulsatile gonadotrophin-releasing hormone (GnRH) for one to four cycles. These cycles were compared to unstimulated cycles of 14 volunteers. There was a surprisingly stable number of large (greater than or equal to 14 mm diameter) follicles per patient. The number of large follicles in induction cycles was significantly greater than in controls (2.4 versus 1.07). This was due to significantly higher follicle stimulating hormone levels during the first days of treatment. Our data provide a rationale for the use of pulsatile GnRH for a safe and mild form of stimulation in assisted reproductive therapies. PMID- 1770131 TI - Increased frequency of complement C4 'null' alleles in recurrent spontaneous abortions. AB - Typings for major histocompatibility antigens HLA A, B, C and DR and for complement C4A, C4B and factor B were performed for 59 Finnish couples experiencing at least three consecutive recurrent spontaneous abortions (RSA). Forty-one of them were primary abortion (PA) couples with no children and 18 were secondary abortion (SA) couples who had one or two children before abortions. HLA sharing in A and B loci was slightly but significantly increased (15%, P less than 0.05) among RSA couples compared to the controls, as was DR sharing among SA couples compared to PA couples (50% versus 22%, P less than or equal to 0.05). The most interesting new finding, however, was the statistically significant increase of complement C4 functionally silent, i.e. C4 'null', alleles in RSA couples. C4 is a duplicated gene and its products differ in their functions in the complement cascade. C4A null alleles were equally increased in PA wives and in PA husbands (32%, P less than or equal to 0.05) compared to the controls (18%) and C4B null alleles in SA wives (56%, P less than or equal to 0.05) and in SA husbands (50%) compared to the controls (29%). Therefore, the offspring of RSA couples have a significantly increased risk of inheriting several null alleles. The majority, 95% (P less than 0.001) of PA couples and 83% of SA couples, had at least one C4A or C4B null in their phenotypes compared to 66% among Finnish controls. PMID- 1770132 TI - Infertility--epidemiology and referral practice. AB - A questionnaire-based study of infertility has been carried out in two age cohorts of women in a defined geographical region. Women were aged 36-40 years or 46-50 years at the time of the survey. The prevalence of infertility (no conception after 2 years of trying) was approximately 14% in both age cohorts. However, a significantly higher proportion of younger women had sought medical help. In both age cohorts there was a higher incidence of spontaneous abortion among infertile women. These findings suggest no significant increase in the prevalence of infertility over a decade but a considerable increase in the use of medical services. PMID- 1770133 TI - Severe ovarian hyperstimulation syndrome in assisted reproductive technology: definition of high risk groups. AB - In a retrospective analysis of 637 cycles of ovarian stimulation and transvaginal follicular aspiration for various assisted reproductive technologies, severe ovarian hyperstimulation syndrome (SOH) occurred in six (0.94%) cycles. The patients at a high risk of developing SOH in cycles of assisted reproduction were those who had excessive serum oestradiol levels on the day of human chorionic gonadotrophin (HCG) administration (oestradiol greater than 6000 pg/ml; 38% SOH) and a high number of oocytes obtained (greater than 30 oocytes; 23% SOH). In those patients with both oestradiol greater than 6000 pg/ml on the day of HCG administration and greater than 30 eggs retrieved, the chance of developing SOH was 80%. The higher the serum oestradiol levels and the more eggs retrieved, the higher the pregnancy rates observed. High oestradiol level did not appear to have a detrimental effect on pregnancy rates and outcome. Furthermore, our results are not consistent with suggestions that the addition of gonadotrophin-releasing hormone agonist to ovarian stimulation protocols, follicular aspiration and/or luteal support with progesterone may reduce the incidence of ovarian hyperstimulation syndrome. PMID- 1770134 TI - CA 125 in peritoneal fluid from patients with endometriosis. AB - This study was performed to evaluate CA 125 in peritoneal fluid as an indicator of endometriosis. Peritoneal fluid from patients with mostly minimal and mild endometriosis (n = 43) and normal controls (n = 17) was collected at laparoscopy or laparotomy. The median concentration of CA 125 in peritoneal fluid did not differ significantly between patients and controls (79 IU/ml versus 76 IU/ml). In patients with endometriosis, a significantly increasing concentration of CA 125 in peritoneal fluid was seen from the early follicular to the late luteal phase; a similar change was not observed in the controls. In 14 patients, peritoneal fluid was sampled again after treatment with danazol and a significant reduction in median CA 125 concentration (76.5 IU/ml versus 57 IU/ml), peritoneal fluid volume (17.5 ml versus 10.5 ml) as well as reduced endometriosis scores (4 versus 2) were found. In controls, the concentration of CA 125 was about 10 times higher in peritoneal fluid than in serum. As the peritoneal levels of CA 125 did not differ significantly between patients with endometriosis and controls and as the reduction seen after danazol treatment did not correlate with the decrease of endometriotic implants, it is concluded that the monitoring of CA 125 in peritoneal fluid will not be useful in the diagnosis or control of endometriosis. PMID- 1770135 TI - Is a long period without childbirth a risk factor for developing endometriosis? AB - Endometriosis was found in 42 (20%) of 206 symptom-free, parous Norwegian women with a mean age of 37 years at the time of sterilization. Case-control analysis between the 42 women with endometriosis and the 164 without endometriosis revealed an increased risk of endometriosis with increasing number of years since the last childbirth. After 10 years without a birth, the odds ratio for endometriosis was 4.5 compared with the first 5 years after the last delivery. An increased risk of endometriosis with increasing age of the women could not be detected. If these findings from women with voluntary infertility are transferred to women with endometriosis associated with involuntary infertility, endometriosis could be a consequence of a long period without childbirth. This might explain why endometriosis is often diagnosed in infertile women. PMID- 1770136 TI - Ultrasonic transvaginal aspiration of endometriotic cysts: an optional line of treatment in selected cases of endometriosis. AB - Transvaginal ultrasonically guided aspiration of pelvic endometriotic cysts was performed on 21 patients with recurrent endometriosis after previous surgical treatment. Their main complaint was pelvic pain and infertility. Further conservative surgery was considered a contraindication. The symptoms improved markedly following aspiration. During a 12 month follow-up, reaccumulation occurred in only six cases (28.5%) and the improvement in symptoms persisted in the majority of cases. The technique is simple, safe and effective in the treatment of selected cases of endometriosis. PMID- 1770137 TI - Expression of endometrial protein PP14 in pelvic and ovarian endometriotic implants. AB - Localization and immunohistochemical staining patterns of endometrial protein PP14 were studied in 55 patients providing 86 histologically confirmed pelvic and ovarian endometriotic implants. The cellular localization of PP14 in endometriotic implants is comparable with that in the endometrium: epithelial cells express PP14, whereas stromal cells are negative. Positive immunostaining is restricted to apical secretory-like granules of the epithelial cells. In endometriotic implants with positive staining, PP14 is expressed by some, but not all, glandular epithelial cells. Furthermore, positive staining for PP14 is observed most frequently in foci with in-situ secretory differentiation, whereas implants with proliferative or atrophic implants only rarely express PP14. Finally, PP14 can be localized in endometriotic foci at different depths of infiltration, although positive labelling is seen more often in superficial implants. These data demonstrate that PP14 can be expressed by endometriotic glandular epithelial cells with secretory cellular differentiation and that the histological appearance of ectopic implants sometimes only poorly reflects their function. PMID- 1770138 TI - The genetic control and germ cell kinetics of the female and male germ line in mammals including man. AB - The female germ line (germ cell lineage, Keimbahn) is provided with only one proliferation wave, the oogenic, whereas male gametogenesis involves two successive waves: prespermatogenic, which corresponds to the female proliferation wave, and spermatogenesis, which is responsible for the immense number of male gametes produced in mature testes. Both male proliferation systems are linked by the transitional or T prospermatogonia. Using the reverse percentage of labelled metaphases method, it has been shown that the first differences between female and male germ cells can be identified by the end of the first wave, when oogonia and multiplying or M prospermatogonia are proliferating. This prenatal first wave of proliferation of male germ cells was also demonstrated in man and ceases around the 22nd week of pregnancy. Spermatogenesis involves a stock of stem cells (stem spermatogonia), a flexibly reacting pool of undifferentiated spermatogonia and several generations of differentiating spermatogonia, which proliferate almost exponentially. Furthermore, it consists of spermatocytes and haploid spermatids transforming into spermatozoa. The oocytes pass through the preleptotene stage, synthesizing DNA, and thereafter traverse the meiotic prophase up to the diplotene stage. In mammals they act as 'pre-embryos' in a similar but to a lesser degree than oocytes of amphibia and insects. The maternal chromosomes are largely responsible for the development of the embryo, the paternal genome for the development of the extra-embryonic tissue. The synthesis of transgenic animals is a powerful weapon in the armoury of geneticists, as has recently been demonstrated: a 14 kb genomic DNA fragment (Sry) is sufficient to induce testis differentiation and subsequent male development when introduced into chromosomally female mouse embryos. PMID- 1770139 TI - Sites of antisperm antibody action. AB - Antisperm antibodies can affect sperm function in the cervical mucus, as they undergo capacitation, or during sperm-egg interaction. During capacitation, the sperm membrane destabilizes and antigens previously not available to antibodies may become exposed. Antibody attachment can reduce fertilization as measured by hamster egg preparation or the hemizona assay. A panel of monoclonal and polyclonal patient sera were tested for their ability to inhibit sperm-zona pellucida tight binding. We tested 25 monoclonals from a panel from the World Health Organization, but only nine were positive by indirect bead binding, indicating that the majority of the antibodies were not sperm surface antigens. The sera of 13 patients were used; three were negative and served as controls, nine had antibodies of the IgG isotype bound to 100% of the sperm heads examined, and seven also exhibited sperm specific IgA antibodies. Of the monoclonals tested, six inhibited zona binding by 60%. Sera of seven patients caused inhibition of greater than or equal to 50% zona binding; those from male patients caused the greatest inhibition. When further specific testing was conducted, one monoclonal caused the greatest inhibition of zona binding; sera of three patients inhibited zona binding by 70%. The antibodies, whether monoclonal or patient sera, were tested for their effect on capacitation. The ability to undergo hyperactivated motility after antibody exposure was assessed and no changes appeared due to antibody exposure. Serum from one of the patients appeared to affect sperm calcium influx to some extent. Sera from two patients appeared to reduce the number of spermatozoa capable of undergoing the acrosome reaction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770140 TI - Poor development of outer dense fibers as a major cause of tail abnormalities in the spermatozoa of asthenoteratozoospermic men. AB - For a reasonable analysis of sperm motility, consideration should be given to the morphology of the flagellum. Among various tail disturbances, the present paper describes a structural shaft defect that is characterized by variations in diameter, poor outline and/or lacking endpiece. Electron microscopical examinations, especially the negative staining technique, have shown that in addition to membrane alterations there is one essential cause for the limited extension of the outer dense fibres. This disturbance may be of genetic origin or due to toxic or inflammatory influences. Further molecular biological studies are required to detect the actual cause of this defect, for which there is so far no adequate therapy. PMID- 1770141 TI - Bilateral adnexal torsion after clomiphene citrate therapy. AB - A case of bilateral adnexal torsion after clomiphene citrate therapy is reported. Although this is rare, there is an increased risk after ovulation induction. Laparoscopic aspiration was successfully performed. PMID- 1770142 TI - Block to development in cultured rat 1-cell embryos is overcome using medium HECM 1. AB - Rat pronuclear embryos were cultured in hamster embryo culture medium-1 (HECM-1) or a modified Krebs-Ringer bicarbonate solution (mKRB). Embryo cultures in HECM-1 were also challenged with low oxygen concentrations. In HECM-1, 57.9% (70/121) of the pronuclear embryos developed into the 4-cell stage after 48 h of culture. The rates of 8-cell, morula and blastocyst formation were 32.2% (39/121), 17.4% (21/121) and 9.9% (12/121), respectively. On the other hand, in mKRB, rat pronuclear embryos showed developmental blockages at the 2-cell and 4-cell stages, and never developed beyond the 4-cell stage. The rate of blastocyst formation under a low oxygen concentration was 20.1% (43/214), showing a significant difference from the value of 5.5% (11/201) obtained under a standard oxygen concentration (P less than 0.005). This is the first report of successful culture of rat pronuclear embryos to the blastocyst stage. Furthermore, it is suggested that protection from oxidation stress is a prerequisite for rat embryo development in vitro. PMID- 1770143 TI - Induction of ovulation in rabbits with pure urinary luteinizing hormone and human chorionic gonadotrophin: comparison of oocyte and embryo quality. AB - Thirty-six 18-week-old nulliparous does were stimulated with a single dose of 25 IU pregnant mare serum gonadotrophin (PMSG). Ovulation was induced 48 h later with 50 IU luteinizing hormone (LH) (18 does) or 50 IU human chorionic gonadotrophin (HCG) (18 does) in order to determine the effects of pure urinary LH and HCG on the quality of oocytes and embryos. Nine does were mated in each group. The does were slaughtered 24 h after induction of ovulation to recover oocytes and 48 h after mating to recover embryos. The number of haemorrhagic, preovulatory and luteinizing follicles per ovary were recorded. The quality of oocytes and embryos recovered were evaluated. No significant differences in the number of haemorrhagic follicles (blood follicles without stigma), preovulatory and luteinizing follicles were observed between LH and HCG groups. LH has a selective action, which could permit the acquisition of better quality oocytes. Although the fertilization rate was similar in both groups (LH versus HCG), the percentage of degenerate embryos (grade 5) was lower for the LH (3%) than the HCG (13%) groups. PMID- 1770144 TI - Human trophectoderm biopsy and secretion of chorionic gonadotrophin. AB - We have previously developed a technique of trophectoderm biopsy to obtain cells from human blastocysts for preimplantation genetic diagnosis. To determine whether this technique affects the subsequent development of the blastocyst, 45 manipulated blastocysts were observed from days 3 to 14 in culture, the amount of human chorionic gonadotrophin (HCG) secreted by each embryo was measured and these results were compared with those of 26 non-manipulated controls documented in a previous study. A slit was made in the zona pellucida opposite the inner cell mass in 18 of the 45 blastocysts. This increased the rate of hatching but the other morphological changes up to day 14 were similar to those seen in the non-manipulated controls. There was no difference in the mean cumulative HCG secretion by these zona-slit controls (149.8 +/- 45.7 mIU/ml) compared to the non manipulated controls (146.2 +/- 23.7 mIU/ml). A slit was also made in the zona pellicida of the other 27 blastocysts. Approximately 12-18 h later, in 18 blastocysts a biopsy of the herniating trophectoderm cells (5-30) was performed. The rate of hatching and adherence to the culture dish was similar to the non manipulated controls. The mean cumulative HCG secretion decreased significantly (57.5 +/- 16.2 mIU/ml, P less than 0.01) after the biopsy procedure. However, if a small biopsy was performed (less than 10 cells removed) the decrease in HCG secretion (87.6 +/- 24.8 mIU/ml) was not significant, whereas when a large biopsy was performed (greater than 10 cells), HCG levels fell to 19.9 +/- 9.1 mIU/ml.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770145 TI - Fertilization and development of the human oocyte following exposure to cryoprotectants, low temperatures and cryopreservation: a comparison of two techniques. AB - Both glycerol and dimethyl sulphoxide (DMSO) equilibration prior to cryopreservation produced adequate rates of survival and development to the hatching blastocyst stage for mouse oocytes using the two chosen cooling and warming regimes. Successful fertilization of human oocytes and further development of the embryos produced, was achieved following equilibration with DMSO at 0 degrees C. Although fertilization of fresh human ova previously exposed to glycerol was recorded, all oocytes with two pronuclei failed to continue to undergo cell division by 48 h in culture. Following cryopreservation, human oocytes were successfully inseminated after equilibration with both glycerol and DMSO. However, cell division to the 2-cell stage was recorded in only one oocyte which had undergone exposure to DMSO, freezing and thawing. No cell divisions were recorded after glycerol cryopreservation, or even after simple exposure to glycerol. Therefore it appears that DMSO and slow cooling may be the best protocol, although further evaluation will be necessary. PMID- 1770146 TI - Fetal cells in the maternal circulation: isolation by multiparameter flow cytometry and confirmation by polymerase chain reaction. AB - During pregnancy, nucleated fetal erythrocytes enter the maternal circulation and can be isolated efficiently from the maternal cells by multiparameter flow cytometry. Male DNA, implying presence of a male fetus, can be identified in flow sorted maternal blood by polymerase chain reaction with oligonucleotide primers flanking single-copy Y-specific DNA sequences. Among flow-sorted samples, we correctly identified fetal sex in 17/18 (94%) pregnancies of 10-21 weeks gestation. Maternal blood thus provides a potential opportunity for prenatal diagnosis that could preclude the need for invasive procedures in current use. PMID- 1770147 TI - Return of reproductive performance after expectant management and local treatment for ectopic pregnancy. AB - The purpose of this study was to examine hysterosalpingographic findings and reproductive performance in patients previously managed non-surgically for ectopic pregnancy. Forty-nine patients with unruptured ectopic pregnancies were treated either by expectant management (n = 16) or medically (n = 33), using transvaginal methotrexate or sulprostone injection. The treatment was successful in 35 patients (71.5%), 12 out of 16 and 23 out of 33 in the two groups respectively. For all patients, follow-up currently varies from 3 to 52 months with a median follow-up of 16.6 +/- 11.2 months and 7.3 +/- 4.3 months in the two groups respectively. Hysterosalpingography was performed in 25 out of 26 patients who desired further pregnancy. We found evidence of tubal patency on the ectopic pregnancy treated side in 23 cases (92%). In this group, no recurrent ectopic pregnancy was observed. In the expectant management group, eight out of nine patients became pregnant, and the mean time to achieve pregnancy was 16.6 +/- 11.2 months. In the medical treatment group, eight out of 17 patients became pregnant and the mean time to achieve pregnancy was 8.6 +/- 4.2 months. In this last group, seven out of nine non-pregnant patients have had only a short follow up, 4.5 +/- 3.2 months since treatment completion. No recurrent ectopic pregnancy was observed in this successfully treated group of patients who desired further pregnancy. We conclude that the medical approach to unruptured ectopic pregnancy is associated with a high rate of tubal patency and a reproductive performance similar to conservative surgical methods. PMID- 1770148 TI - Quintuplet pregnancy and third degree ovarian hyperstimulation despite withholding human chorionic gonadotrophin. AB - A patient who suffered from polycystic ovarian disease and anovulation, was treated with pure follicle stimulating hormone for induction of ovulation. The treatment was stopped and human chorionic gonadotrophin was not administered because of high serum oestradiol levels and multiple follicular development. Ovulation occurred 11 days after pure follicle stimulating hormone was discontinued, the patient developed third-degree ovarian hyperstimulation syndrome and conceived with a quintuplet pregnancy. PMID- 1770149 TI - Intruders in the fallopian tube or a dream of perfect human reproduction. PMID- 1770150 TI - Psychological follow-up of women evaluated as oocyte donors. AB - Forty-five women were evaluated as candidates to donate oocytes to an infertile couple. Twenty-four women completed a cycle as oocyte donors. Follow-up data on donor satisfaction were obtained for 23 women. Ninety-one per cent were moderately to extremely satisfied with the experience and 74% would donate for another cycle if given the chance. Transient adverse psychological symptoms were reported by two donors but were resolved with medical or psychological treatment. Two women became pregnant soon after donation, one unintentionally. Psychological risk factors predicted donor candidates' decisions to participate and their compliance but were not predictive (within the group that completed a cycle) of donor satisfaction as follow-up or recipient pregnancy. PMID- 1770151 TI - Urinary 3-methoxy-4-hydroxyphenylglycol and the depression-type score as predictors of differential responses to antidepressants. AB - Pretreatment 24 hr urinary 3-methoxy-4-hydroxyphenylglycol (MHPG) levels and the Depression-type (D-type) scores (derived from a multivariate discriminant function equation based on levels of urinary catecholamines and metabolites) were examined as possible predictors of antidepressant responses to either imipramine or alprazolam. In the case of imipramine, the responders had significantly lower pretreatment urinary MHPG levels (p = 0.002) and D-type scores (p less than 0.001) than did nonresponders. In contrast, responders to the antidepressant effects of alprazolam had significantly higher pretreatment urinary MHPG levels (p less than 0.05) and D-type scores (p = 0.02) than did nonresponders. For each antidepressant treatment, D-type scores appeared to provide a better separation of responders from nonresponders than did urinary MHPG levels. For each drug, the effect size for the difference in mean log-transformed D-type scores between responders and nonresponders was greater than the effect size for the difference in mean log-transformed MHPG levels. The difference between the effect sizes was statistically significant for imipramine (p = 0.02) and tended toward significance for alprazolam using two-tailed tests. These results suggest that the D-type equation, which was initially derived to separate bipolar manic depressive depressions from other subgroups of depressive disorders, can also be used to predict differential responses to certain antidepressant drugs in patients with unipolar depressions. PMID- 1770152 TI - A controlled study of alprazolam and propranolol in panic-disordered and agoraphobic outpatients. AB - We studied the efficacy of propranolol (Inderal) compared to alprazolam (Xanax) in 29 patients with a diagnosis of agoraphobia with panic disorder or panic disorder with or without limited phobic avoidance in a 6-week double-blind controlled experiment. Alprazolam is effective in those syndromes, whereas to date only negative or ambiguous results had been reported for propranolol. Fourteen patients received a mean daily dose of 5.0 +/- 2.3 mg of alprazolam and 15 patients received 182.0 +/- 60.5 mg mean daily dose of propranolol. We found both drugs to be effective to suppress panic attacks and reduce avoidance behavior. The only significant between-drug difference was a more rapid onset of alprazolam's panicolytic effect. Propranolol merits further study. We suggest patients worthy of a clinical trial. PMID- 1770153 TI - A comparison of the single-dose effects of alprazolam, buspirone, and placebo upon memory function. AB - The effects of alprazolam and buspirone at varying dosages were compared with placebo in a battery of memory and cognitive tests in a sample of 125 young, healthy medical students by utilizing a single-dose, double-blind design. Although the dosages in this study did not impair visuomotor reaction time in any of the experimental groups, 1.0 mg of alprazolam did result in significantly impaired performance on selective aspects of memory function as assessed by the memory battery. PMID- 1770154 TI - Serum prolactin as a correlate of clinical response to haloperidol. AB - The rise in serum prolactin concentration in patients treated with neuroleptic drugs is well documented, but attempts to relate this rise to clinical response have yielded conflicting results. These conflicting results could be explained by design flaws in those studies attempting to relate prolactin to clinical response. Seventy-three newly (re)admitted drug-free schizophrenic men were randomly assigned to receive haloperidol either 5, 10, or 20 mg daily for 4 weeks. Prolactin levels post-treatment were significantly (p less than 0.02) related to global outcome by logistic regression. A serum prolactin level may be a useful guide to the lowest effective dose of haloperidol in newly treated schizophrenic men. Above a plasma prolactin level of approximately 30 ng/ml there was very little increase in response. Patients on the 5, 10, and 20 mg daily haloperidol doses had mean prolactin levels of 16, 32, and 34 ng/ml, respectively. PMID- 1770155 TI - Compliance during lithium treatment, intra-erythrocyte lithium variability, and relapse. AB - Differential lithium concentrations across the erythrocyte (RBC) membrane have been studied in the search for biological markers in the affective disorders. The methodologic problems of these studies are reviewed with particular reference to compliance effects. We assessed a triad of compliance parameters, including RBC lithium variability, in a group of 60 lithium clinic attenders, in relation to relapse data and diagnostic subgroups. It was found that RBC lithium variability, used in the present study for the first time, related to higher relapse rates on lithium, suggesting that it may be used as an objective medium term compliance parameter. The established patterns of compliance were compared for the diagnostic subgroups. PMID- 1770156 TI - Rebound insomnia: duration of use and individual differences. AB - This study assessed consistency, duration of use, and individual difference in rebound insomnia. Eleven healthy men, 20-30 years old, with normal sleep by both subjective and polysomnographic criteria, received each of four treatments in a double-blind Latin Square design (triazolam 0.50 mg for 1, 6, and 12 nights and placebo for 12 nights), followed by two placebo discontinuation nights. Triazolam increased sleep compared with placebo without differences in effects between the first and last nights of treatment. On discontinuation following active drug, sleep efficiency was reduced compared with placebo, but duration of administration did not alter the likelihood or intensity of rebound insomnia. Those subjects (5) showing poorer sleep on discontinuation from the 12-night treatment also had poorer sleep in the 1- and 6-night treatment. Subjects with rebound insomnia had poorer baseline sleep and a greater drug effect than did subjects without. PMID- 1770157 TI - A controlled trial of phenytoin in impulsive aggression. PMID- 1770158 TI - A potential drug interaction between fluoxetine and valproic acid. PMID- 1770159 TI - Fluoxetine-associated potentiation of calcium-channel blockers. PMID- 1770160 TI - Fluvoxamine-associated mania/hypomania in patients with obsessive-compulsive disorder. PMID- 1770161 TI - Amelioration of pseudobulbar affect by fluoxetine: possible alteration of dopamine-related pathophysiology by a selective serotonin reuptake inhibitor. PMID- 1770162 TI - Tricyclic-induced activation/jitteriness. PMID- 1770163 TI - The use of captopril in treatment-resistant depression: an open trial. PMID- 1770164 TI - Clozapine prophylaxis in rapid cycling bipolar disorder. PMID- 1770165 TI - Effects of long-acting propranolol on agonistic and stereotyped behaviors in a man with pervasive developmental disorder and fragile X syndrome: a double-blind, placebo-controlled study. PMID- 1770166 TI - Segmental differentiation in the leech central nervous system: proposed segmental homologs of the heart accessory neurons. AB - As part of an on-going study of segmental differentiation in the central nervous system (CNS) of the leech Hirudo medicinalis, a search was made for putative segmental homologs of the heart accessory (HA) neurons, which exist exclusively as a bilateral pair in the ganglia of the fifth and sixth body segments. As it is not yet feasible to obtain adequate cell lineage information in H. medicinalis, potential homologs of the HA neurons were determined using morphological, immunohistochemical, and electrophysiological criteria. Among cells in other body ganglia with somata in the same locations as HA neurons, a pair was found having extensive morphological and physiological similarities to HA neurons. These we have called HA-like (HAL) neurons. Adult HA and HAL neurons have closely related patterns of primary branching, in terms of shape, intraganglionic pathways taken, and extraganglionic projections. The number, location, and relative thickness of branches are also similar among these cells. In embryos 10 to 11 days old, HA and HAL neurons have virtually identical branching patterns, with primary and secondary branches of nearly uniform caliber. Differences in branch thickness develop gradually; by embryonic day 20, they resemble those found in adult neurons. Two features found to differ between HA and HAL neurons were the cell body diameter (larger for the HA cells) and the expression of antigens recognized by the monoclonal antibody Laz1-1 (absent at a detectable level in the HA neurons). At a physiological level, the HA and HAL neurons showed action potentials of similar size and shape, as well as inhibitory synaptic inputs from a common source, the heart interneurons (HN). The observations presented here suggest that there is a common developmental origin for the HA and HAL neurons, and hence that their fates are positionally determined by as yet unknown factors. PMID- 1770167 TI - Ontogeny of steroid accumulation in spinal lumbar motoneurons of the rat: implications for androgen's site of action during synapse elimination. AB - Androgens influence the postnatal development of motoneurons in the spinal nucleus of the bulbocavernosus (SNB) by regulating neuromuscular synapse elimination, the process through which multiple axonal inputs are retracted from each muscle fiber until single innervation is established. In the rat levator ani (LA), one of the target muscles for SNB motoneurons, much of this loss of multiple innervation can be prevented by prepubertal androgen treatment. We used steroid autoradiography to measure the ontogeny of steroid accumulation in the SNB and the retrodorsolateral nucleus (RDLN), two motoneuronal groups thought to differ in their sensitivity to androgens. Spinal cord tissue was analyzed from castrated male rats at 7, 14, 21, and 60 days of age after injection of radiolabelled testosterone. SNB and RDLN motoneurons differ in the ontogeny of androgen accumulation. Over 80% of SNB motoneurons develop the capacity to accumulate androgen during the second week after birth, during the period when androgen regulates synapse elimination in the LA. In contrast, androgen accumulation in RDLN motoneurons develops much later (after 21 days). These data suggest that androgen may act directly on SNB motoneurons to influence synapse elimination. PMID- 1770168 TI - Comparison of dorsal and ventral spinal root regeneration through semipermeable guidance channels. AB - Semipermeable guidance channels have been shown to support nerve regeneration in the peripheral nervous system (PNS) possibly through interactions with the wound healing environment. This study quantitatively assesses the ability of such channels to support regeneration in the PNS segment of the spinal roots across a 4 mm gap and compares the resultant dorsal and ventral root regeneration. Acrylic copolymer guidance channels with a molecular weight (Mw) cutoff of 50,000 Da were used in a transected rat spinal root model. Cohorts of 23 animals (11 ventral, 12 dorsal) were examined at four weeks; 6 animals (3 ventral, 3 dorsal) at ten weeks; and 10 animals (5 ventral, 5 dorsal) at twenty-four weeks post implantation. Both the dorsal and ventral roots were able to regenerate across the gap within the semipermeable channel. At all time periods, the regenerated dorsal roots contained fewer myelinated axons than found in the contralateral control root and consisted of an abundance of collagenous tissue. In contrast, by ten weeks the regenerated ventral roots contained twice the contralateral control number of myelinated axons and were composed predominantly of large, myelinated axons. At twenty-four weeks the number of unmyelinated axons was also quantified, with the regenerated dorsal root containing only one-fifth of the control number and the regenerated ventral root containing more than four times the control. Due to the proximity of the dorsal root lesion to the axonal cell bodies, the dorsal root ganglion (DRG) neuronal cell loss was investigated at four weeks post implantation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770169 TI - Tuberculoventral neurons project to the multipolar cell area but not to the octopus cell area of the posteroventral cochlear nucleus. AB - Tuberculoventral neurons in the deep layer of the dorsal cochlear nucleus (DCN) provide frequency-specific inhibition to neurons in the anteroventral cochlear nucleus (AVCN) of the mouse (Wickesberg and Oertel, '88, '90). The present experiments examine the projection from the deep DCN to the posteroventral cochlear nucleus (PVCN). Horseradish peroxidase (HRP) injections into the PVCN reveal that the multipolar cell area, but not the octopus cell area, is innervated by neurons in the deep layer of the DCN. Injections into the multipolar cell area, in the rostral and ventral PVCN, labeled neurons across the entire rostrocaudal extent of the deep DCN. The labeled tuberculoventral neurons generally lay within the band of labeled auditory nerve terminals in the DCN. Injections of HRP into the octopus cell area, in the dorsal caudal PVCN, labeled almost no cells within the band of auditory nerve fiber terminals that were labeled by the same injection. The inhibition from tuberculoventral neurons onto ventral cochlear nucleus (VCN) neurons is likely to be mediated by glycine (Wickesberg and Oertel, '90). Slices of the cochlear nuclear complex were immunolabeled by an antibody against glycine conjugated with glutaraldehyde to bovine serum albumin (Wenthold et al., '87). Glycine-like immunoreactivity was found throughout the DCN, the AVCN and the multipolar cell area, but there was little labeling in the octopus cell area. This finding provides independent evidence that tuberculoventral neurons do not innervate the octopus cell area and indicates that the octopus cell area is anatomically and functionally distinct. PMID- 1770170 TI - Generation and death of cells in the dorsal lateral geniculate nucleus and superior colliculus of the wallaby, Setonix brachyurus (quokka). AB - To study postnatal cell generation in primary visual centres of the quokka, tritiated thymidine was injected into pouch-young aged postnatal day (P)1-P85. Brains were examined at P100, just before eye-opening, when primary visual projections are essentially mature. Neurons in the dorsal lateral geniculate nucleus (dLGN) and superior colliculus (SC) were generated at P1-P10 and P1-P18 respectively. Peak numbers of labelled cells were seen at P3 and P5 in the dLGN and SC. Cell death was assessed in the dLGN and SC of young aged P10-P150. Low numbers of dying cells were seen in the dLGN throughout this period, with a small peak at P85. A more substantial peak of cell death was seen in the SC, also at P85. In the quokka, the time interval between the peaks of cell generation and of cell death in the dLGN and SC is 70-80 days, considerably longer than the interval of 40 days between birth and death of retinal cells. PMID- 1770171 TI - Adrenal steroids regulate postnatal development of the rat dentate gyrus: I. Effects of glucocorticoids on cell death. AB - The rat dentate gyrus undergoes a period of naturally occurring cell death during the first postnatal week. In the adult rat, removal of circulating adrenal steroids by adrenalectomy is followed by massive death in the granule cell layer, thus raising the possibility that developmental cell death results from low levels of these hormones. Interestingly, the first two postnatal weeks of life in the rat, termed the stress hyporesponsive period, are characterized by very low levels of adrenal steroids. In order to determine whether low levels of adrenal steroids enable developmental cell death to occur in the dentate gyrus, we examined the density of pyknotic and healthy cells in the dentate gyrus of rat pups which received one of the following treatments: (1) injections of the endogenous rat glucocorticoid corticosterone during the first postnatal week, or (2) adrenalectomy at the time when glucocorticoid levels normally rise. Quantitative analysis of the density of pyknotic cells in the granule cell layers revealed significant decreases with corticosterone treatment by the end of the first postnatal week. In these same brains, treatment with corticosterone resulted in a substantial increase in the density of pyknotic cells in the hilus. Adrenalectomy resulted in a significant increase in the density of pyknotic cells in the granule cell layer as well as in the hilus. Despite the dramatic alterations in the density of pyknotic cells with both increases and decreases in glucocorticoid levels, the density of healthy cells remained the same. These observations suggest that glucocorticoids regulate several processes, possibly including neurogenesis and migration, in addition to cell death. PMID- 1770172 TI - Adrenal steroids regulate postnatal development of the rat dentate gyrus: II. Effects of glucocorticoids and mineralocorticoids on cell birth. AB - Unlike the majority of mammalian brain regions, the rat dentate gyrus undergoes maximal cell birth and cell death during the same developmental time period. Granule cell birth and death peak at the end of the first postnatal week. We have found that manipulations of glucocorticoid levels during the stress hyporesponsive period profoundly influence the density of pyknotic cells in the dentate gyrus while apparently not affecting the density of healthy cells. This raises the possibility that glucocorticoids are regulating processes in addition to cell death, i.e., cell birth. In order to determine whether increases in circulating glucocorticoids or mineralocorticoids affect the birth of cells in the developing dentate gyrus, 3H-thymidine autoradiography was performed on brains of rat pups treated with either corticosterone or aldosterone during the first postnatal week. Quantitative analysis of 3H-thymidine-labelled cells revealed significant decreases in the density of labelled cells in the granule cell layers with both corticosterone and aldosterone treatment. In these same brains, significant decreases in the density of pyknotic cells were also observed in the granule cell layers. However, no changes in the numbers of 3H-thymidine labelled pyknotic cells were observed with any treatment. Increases in circulating corticosterone or aldosterone resulted in significant increases in the density of both 3H-thymidine-labelled and pyknotic cells in the hilus. These results suggest that dentate gyrus cell birth and cell death are related and that these processes are regulated by adrenal steroids. PMID- 1770173 TI - Relationships between neuronal birthdates and cytoarchitecture in the rat inferior olivary complex. AB - The correlation between birthdates of neurons and their ultimate location within the inferior olivary nucleus (ION) was investigated in the rat by the 5 bromodeoxyuridine (BrdU) method. We performed injections every 4 hours throughout the ION generation period, and were thus able to demonstrate that 1) neurons are distributed in the adult ION following characteristic gradients that define subdivisions identical to those established by hodological studies; and 2) ION neurons born at the same time tend to be arrayed in small clusters in the adult structure. Implications of these findings for the mechanisms of olivary neuron migration, selective aggregation, and elaboration of projectional topography are discussed. This study provides direct evidence that one of the factors governing the elaboration of the cytoarchitecture of a neuronal nucleus is the temporal sequence of generation of its neurons. PMID- 1770174 TI - Type I corticosteroid receptor-like immunoreactivity in the rat CNS: distribution and regulation by corticosteroids. AB - Previous maps of Type I corticosteroid receptor binding in the rat central nervous system (CNS) revealed a restricted distribution of the receptor in limbic regions, hypothalamus, and circumventricular organs. More recent studies have shown a more widespread expression of the receptor, with high levels of Type I receptor mRNA in limbic, motor, and sensory systems. We have used two antisera against peptide sequences derived from the cDNA of the human Type I corticosteroid receptor to map the regional distribution and corticosteroid regulation of the intracellular location of Type I corticosteroid receptor-like immunoreactivity (Type I-ir) in the rat CNS. Neurons showing Type I-ir were observed at all levels of the CNS. Highest densities of immunoreactive neurons were observed in limbic regions, isocortex, and some thalamic nuclei. Motor, sensory, and visceral systems often showed moderate densities of immunoreactive neurons. Type I-ir glia were observed in some fiber systems, e.g., corpus callosum, medial lemniscus, cerebral peduncles, spinal trigeminal tract, and funiculi of the spinal cord. In the majority of neurons and in glia, Type I-ir showed a diffusely nuclear and cytoplasmic location. Long-term adrenalectomy reduced immunoreactivity in most neurons and glia. Neuronal Type I-ir was localized mainly in the cytoplasm after long-term adrenalectomy. Nuclear immunoreactivity was retained in some neurons in the globus pallidus, motor trigeminal nucleus, and laminae 8 and 9 of the spinal cord. Acute treatment with corticosterone or aldosterone restored neuronal and glial Type I-ir to densities below that seen in intact rats. PMID- 1770175 TI - Relative lack of toxicity of transplatin compared with cisplatin in rodents. AB - The differential toxicity of the cis- and trans-isomers of diamminedichloroplatinum (II) (cisplatin and transplatin) was investigated in rats and guinea pigs. In both species, repeated daily administration of 1 to 2 mg per kg cisplatin produced severe histological and/or functional damage to renal and gastro-intestinal systems and resulted in death of the animals. Quantification of tissue platinum by atomic absorption spectroscopy demonstrated accumulation of large amounts of platinum in the kidney of the animals, with lesser amounts in the liver and gastro-intestinal tract. Transplatin, administered at total doses two- to four-fold that of cisplatin, was essentially non-toxic by histological and functional assessment. However, the amounts of tissue platinum measured in transplatin-treated animals were no smaller than those measured in cisplatin-treated animals; indeed, platinum concentrations in kidneys of transplatin-treated rats were more than 2.5 times those in cisplatin treated rats. Thus tissue platinum content did not correlate with organ damage. These data suggest that mechanism(s) involving steric interactions of platinum species, perhaps with cellular macromolecules such as DNA or RNA, may be important in the differential toxicity of these two compounds. PMID- 1770176 TI - The ultrastructural diversity of scrapie-associated fibrils isolated from experimental scrapie and Creutzfeldt-Jakob disease. AB - Several different samples of scrapie-associated fibrils (SAF) were extracted in identical fashion from the brains of golden Syrian hamsters infected with the 263K strain of scrapie agent and NIH Swiss mice infected with the Fujisaki strain of Creutzfeldt-Jakob disease (CJD) agent. Based on a total of over 500 measurements in individual fibrils in different extracts, hamster fibrils were more abundant, thicker and had better defined substructure than mouse fibrils. Hamster protofibrils were usually either twisted helically or in parallel arrays, whereas mouse protofibrils were often twisted, occasionally parallel, or could not be morphologically defined. Thus, SAF preparations from scrapie-affected hamsters can be ultrastructurally distinguished from those of CJD-affected mice, an observation that presumably reflects differences in their respective host encoded amyloid protein subunits. PMID- 1770177 TI - Coronary myointimal lesions in the dogfish shark Scyliorhinus canicula. AB - Proliferative lesions have been found in the coronary arteries of five specimens of dogfish shark (Scyliorhinus canicula). Three specimens lacked the internal elastic membrane and had a diffuse thickening of the intima obliterating most of the vascular lumen in several intramyocardial branches. Two specimens had intimal nodules in one of the main coronary conal trunks, where breaking and splitting of the internal elastic membrane and fibrosis of the tunica media were observed. These lesions appear similar to those described in salmonid fishes, but are less frequent. Although high concentrations of blood cholesterol and ApoB-containing lipoproteins have been related to the development of coronary lesions in these bony fishes, the dogfish sharks described in this paper showed low serum concentrations of both total cholesterol (0.33 to 1.64 mg per ml) and triglycerides (0.61 to 0.17 mg per ml). PMID- 1770178 TI - Chronic pancreatitis and biliary fibrosis associated with cryptosporidiosis in simian AIDS. AB - Two Rhesus monkeys infected with simian immunodeficiency virus for 15 and 24 months developed generalized oedema and one became jaundiced. At necropsy, the liver and pancreas were hard and irregular and the gall bladder was thickened. Histopathological examination showed extensive fibrosis of the pancreas, loss of exocrine acini and marked proliferation of ductules. Numerous cryptosporidia were present on the duct epithelium. The liver of both animals had widespread cirrhosis, bile duct proliferation and cholangitis. Cryptosporidia were found in many bile ducts and on the hyperplastic gall bladder epithelium. Lymph nodes and spleen of both animals showed depletion of cortical and paracortical elements characteristic of advanced immunodeficiency virus infection. PMID- 1770179 TI - Purification of Cytoecetes phagocytophila, the causative agent of tick-borne fever, from infected ovine blood. AB - Cytoecetes phagocytophila, the causative agent of tick-borne fever, was successfully separated by Percoll and Renografin density gradient centrifugation and by cellular affinity chromatography, from the peripheral blood leucocytes of experimentally infected sheep. After centrifugation on Renografin or Percoll density gradients, infectious particles of C. phagocytophila banded at buoyant densities which ranged between 1.063 to 1.140. Rickettsiae separated by wheat germ lectin cellular affinity chromatography retained their morphology but often lost their infectivity. Cell-free C. phagocytophila remained infective to susceptible sheep for 6 months when kept at -114 degrees C in sucrose phosphate buffer with 10 per cent dimethylsulphoxide as a cryopreservative. PMID- 1770180 TI - The experimental production of mastitis in sheep by intramammary inoculation of Pasteurella haemolytica. AB - Acute mastitis was consistently produced in primiparous ewes by inoculation of the mammary gland, via the teat canal, with an isolate of Pasteurella haemolytica, serotype A9, originating from a field case of ovine mastitis. Mastitis developed following the inoculation of as few as 10 colony forming units of this isolate, suggesting that only a small number of organisms would be required to initiate the disease under natural conditions provided they were already beyond the teat canal. Clinical signs and macroscopic lesions were well developed within 24 h of inoculation and were similar to those found in the naturally-occurring disease. The ability to reproduce mastitis consistently will facilitate studies of the pathogenesis of the disease and the comparison of different isolates of P. haemolytica with respect to virulence determinants. PMID- 1770181 TI - Pulmonary hamartoma in a calf. AB - A pulmonary hamartoma was found in a 5 weeks over term Jersey Holstein cross bull calf. A 36 x 22 x 22 cm, spongy, pale pink mass with a distinct lobulated pattern was continuous with the left caudal lung lobe and compromised other thoracic viscera. The mass was non-cystic and uniformly consisted of soft, pink tissue. Histologically, the mass consisted of a disproportionate number of bronchiolar and alveolar structures, arranged in a haphazard pattern. Ascites, localized subcutaneous oedema, and chronic passive congestion of the liver were additional findings. PMID- 1770182 TI - Assessment of children's social problem-solving skills in hypothetical and actual conflict situations. AB - This study compared the social problem-solving skills of 57 maladjusted and 57 well adjusted first and second graders in a series of hypothetical and actual provocations. All children were asked how they would react to four video-taped provocations involving same-age peers. They were also exposed to three provocations simulated by a peer-confederate; their verbal and nonverbal behaviors were videotaped. Multivariate analyses of variance indicated that, overall, maladjusted subjects displayed less assertiveness and more verbal and nonverbal aggressive responses to the actual provocations. Conversely, hypothetical situations yielded few between-group differences with respect to verbal strategies. The validity of hypothetical situations is questioned; the importance of actual situations for assessment and intervention purposes is stressed. PMID- 1770183 TI - Effects of methylphenidate on the persistence of ADHD boys following failure experiences. AB - We examined the effects of methylphenidate on the task persistence of 21 boys with attention-deficit hyperactivity disorder (ADHD), after they had been exposed to both solvable and insolvable problems. The boys attempted to solve 10 different find-a-word puzzles on each of 4 days, involving the crossing of medication (placebo vs. 0.3 mg/kg) and prior task difficulty (solvable vs. insolvable). The results revealed that medication prevented the decrement in performance following the insolvable problems that was evident with the placebo days. In addition, on medication compared with placebo, the boys were more likely to make external attributions for failure and internal attributions for success. The results are discussed in terms of the impact of medication on ADHD boys' performance as mediated by cognitive-motivational state mechanisms. PMID- 1770184 TI - Psychostimulant effects on academic and behavioral measures for ADHD junior high school students in a lecture format classroom. AB - This study evaluated the effects of two doses of psychostimulants on nine ADHD students' performance in a classroom designed to be analogous to a junior high school American history class conducted during a summer treatment program. Double blind, placebo-controlled assessment revealed significant and clinically important effects of psychostimulants on quiz and test performance, observations of attention and behavior during lectures, and teacher ratings, as well as accuracy on assignments completed during study hall. Analysis of individual differences revealed a 66% positive response rate. The implications for use of psychostimulants with ADHD young adolescents are discussed. PMID- 1770185 TI - The relationship of interparental conflict and global marital adjustment to aggression, anxiety, and immaturity in aggressive and nonclinic children. AB - Although there is agreement that marital problems are associated either directly or indirectly with particular child behavior problems, there is disagreement about the types of marital conflict associated with these problems and the differential effects on boys and girls in clinic and nonclinic samples. We examined the relationships among mothers' ratings of marital adjustment, parenting disagreements, and three child problem factors (aggression, anxiety, and immaturity) after the child's age and family socioeconomic status were controlled. These relationships were compared with samples of boys and girls (3 to 8 years of age) from clinic and nonclinic populations, revealing that parenting disagreement predicted aggression in all groups and that both marital adjustment and parenting disagreement predicted anxiety in boys. Neither marital variable predicted immaturity. Possible reasons for the results (including methodological limitations of the present data) are discussed. PMID- 1770186 TI - Prevalence and situational causes of stereotyped behaviors in blind infants and preschoolers. AB - Parents of 85 blind children aged from 10 months to the 6th year of life were asked regarding the frequency, duration and typical situations of the occurrence of various stereotypic behaviors in their children. The Bielefeld Parents' Questionnaire for Blind and Sighted Infants and Preschoolers was used as the instrument of measurement. All of the children displayed at least one stereotypic behavior; most displayed several stereotypic behaviors according to the parents' reports. Eye poking and body rocking dominated within the prevalence hierarchy. Four typical situations could be identified in which stereotypic behaviors were shown: monotony, arousal, demand, and during feeding or eating. The results suggested that repetitive hand and finger movements, stereotypic manipulation of objects, and making a face(s) mainly occur within arousal situations whereas eye poking, whimpering, and sucking thumbs or fingers especially are linked to monotony. PMID- 1770187 TI - Effects of a school-based cognitive-behavioral intervention for ADHD children. AB - Two variations of school-based cognitive-behavioral training (CBT) program were compared to each other and to a waiting-list control condition in the treatment of children with attention-deficit hyperactivity disorder (ADHD). The experimental interventions included a multicomponent condition that provided coordinated training programs for parents, teachers, and children and a teacher only condition that offered training for classroom teachers only. Evaluation of outcome occurred at pre-intervention, post-intervention and at 6-week followup periods. Depedent measures included classroom behavior observations, teacher ratings of child behavior, child self-report, and teacher ratings of adjustment. The multicomponent CBT condition was significantly better than the other conditions at improving observed off-task/disruptive behavior at post-test. This improvement was maintained at followup, although treatment condition differences were no longer significant. There were no treatment condition differences on any other measures at post-intervention or followup. It was concluded that the intervention had minimal short-term effects on the ADHD children. The results are discussed within the context of several methodological limitations of the study which serve as proposals for continued research in this area. PMID- 1770188 TI - An examination of learned helplessness among attention-deficit hyperactivity disordered boys. AB - We employed a learned helplessness paradigm to compare the performance of 23 boys with attention-deficit hyperactivity disorder (ADHD) and a comparable group of 22 nonreferred boys. The boys attempted to solve two different sets of 10 find-a word puzzles, one set following exposure to solvable puzzles, and one set following exposure to insolvable puzzles. Results revealed that the ADHD boys solved significantly fewer puzzles than did the control boys. In addition, the ADHD boys gave up on significantly more puzzles, and this was especially true following the insolvable condition when it occurred during the second set of puzzles. The ADHD boys also reported being more frustrated by the task than were the control boys. Finally, among the control boys, support was obtained for Diener and Dweck's (1978) distinction between mastery-oriented and helpless children. However, this distinction did not appear to operate in the same fashion for the ADHD boys. PMID- 1770189 TI - Tropical oil turmoil. PMID- 1770190 TI - Saturated and hydrogenated fats in food in relation to health. AB - The report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults published in 1988 evoked great interest from the medical profession, the public, and food manufacturers. The merits of different dietary interventions to lower plasma cholesterol are debated in advertising, popular publications, and research publications. The present paper is a review of the contributions of saturated and trans fatty acids (FA) to the US diet, their metabolism, and effects upon plasma cholesterol. Saturated (SFA) and trans FA are metabolized to yield energy. They are not dietary essentials; SFA can be biosynthesized, and trans FA are not naturally occurring in plants, with only very small amounts in animals. Trans FA are produced in hydrogenation of liquid vegetable oils and are estimated to contribute 3-7% of the fat consumed. Most of the SFA in the US diet (35% of total fat consumed) is obtained from meat, poultry, fish, and dairy products (approximately 60%). The fats and oils consumed directly or as components of food products, mostly baked goods, contribute approximately 20% of the SFA. More than 30 years of research led the NCEP to conclude that SFA was the most potent dietary component in increasing plasma cholesterol, and that no more than 10% of the energy (en%) of the diet should be SFA. Trans FA are metabolized similarly to SFA, but no recommendation has been made about their consumption. Reduction of consumption of SFA should be practiced in a prudent manner, by reducing consumption of foods high in SFA, and not by eliminating classes of foods. Some changes in formulations of foods or preparation practices (type of frying fat) can be made. These modifications may decrease the palatability of the food, thereby presenting a challenge to the food industry. Substitution of fats hydrogenated to contain trans FA for fats high in SFA may not be beneficial to health. Labeling of foods would improve the ability of the consumer to make appropriate choices. PMID- 1770191 TI - Nutritional and biochemical aspects of the hypolipidemic action of rice bran oil: a review. AB - In this paper, we review the effects of rice bran oil (RBO), an unconventional oil recently introduced onto the Indian market for human use. RBO contains oleic acid (38.4%), linoleic acid (34.4%), and linolenic acid (2.2%) as unsaturated fatty acids, and palmitic (21.5%) and stearic (2.9%) acids as saturated fatty acids. The unsaponifiable fraction (4.2%) has total tocopherols (81.3 mg%), gamma oryzanol (1.6%), and squalene (320 mg%). Oryzanol is a mixture of ferulic acid esters of triterpene alcohols such as cycloartenol (CA) (106 mg%) and 24 methylene cycloartanol (494 mg%). Studies on experimental rats demonstrated a hypolipidemic effect of RBO. The unsaponifiable fraction of RBO lowers cholesterol levels. Feeding phytosterols, CA, and 24-methylene cycloartanol in amounts present in RBO to hypercholesterolemic rats for 8 weeks indicates that CA alone reduces cholesterol and triglyceride levels significantly. Endogenous sterol excretion increases in animals given CA. The accumulation of CA in the liver inhibits cholesterol esterase activity, which in turn leads to reduction in circulating cholesterol levels. CA is structurally similar to cholesterol and may compete with the binding sites of cholesterol and sequestrate cholesterol, which is metabolized to its derivatives. RBO, which is rich in tocopherols and tocotrienols, may improve oxidative stability. Tocotrienols inhibit HMG CoA reductase, resulting in hypocholesterolemia. The hypolipidemic effect of RBO has also been established in human subjects. Thus, RBO could be a suitable edible oil for patients with hyperlipidemia. PMID- 1770192 TI - Alcohol, liver, and nutrition. AB - Until two decades ago, dietary deficiencies were considered to be the major reason why alcoholics developed liver disease. As the overall nutrition of the population improved, more emphasis was placed on secondary malnutrition. Direct hepatotoxic effects of ethanol were also established, some of which were linked to redox changes produced by reduced nicotinamide adenine dinucleotide (NADH) generated via the alcohol dehydrogenase (ADH) pathway. It was also determined that ethanol can be oxidized by a microsomal ethanol oxidizing system (MEOS) involving cytochrome P-450: the newly discovered ethanol-inducible cytochrome P 450 (P-450IIE1) contributes to ethanol metabolism, tolerance, energy wastage (with associated weight loss), and the selective hepatic perivenular toxicity of various xenobiotics. P-450 induction also explains depletion (and enhanced toxicity) of nutritional factors such as vitamin A. Even at the early fatty-liver stage, alcoholics commonly have a very low hepatic concentration of vitamin A. Ethanol administration in animals was found to depress hepatic levels of vitamin A, even when administered with diets containing large amounts of the vitamin, reflecting, in part, accelerated microsomal degradation through newly discovered microsomal pathways of retinol metabolism, inducible by either ethanol or drug administration. The hepatic depletion of vitamin A was strikingly exacerbated when ethanol and other drugs were given together, mimicking a common clinical occurrence. Hepatic retinoid depletion was found to be associated with lysosomal lesions and decreased detoxification of chemical carcinogens. To alleviate these adverse effects, as well as to correct problems of night blindness and sexual inadequacies, the alcoholic patient should be provided with vitamin A supplementation. Such therapy, however, is complicated by the fact that in excessive amounts vitamin A is hepatotoxic, an effect exacerbated by long-term ethanol consumption. This results in striking morphologic and functional alterations of the mitochondria with leakage of mitochondrial enzymes, hepatic necrosis, and fibrosis. Thus, treatment with vitamin A and other nutritional factors (such as proteins) is beneficial but must take into account a narrowed therapeutic window in alcoholics who have increased needs for such nutrients, but also display an enhanced susceptibility to their adverse effects. Massive doses of choline also exerted some toxic effects and failed to prevent the development of alcoholic cirrhosis. Acetaldehyde (the metabolite produced from ethanol by either ADH or MEOS) impairs hepatic oxygen utilization and forms protein adducts, resulting in antibody production, enzyme inactivation, and decreased DNA repair. It also enhances pyridoxine and perhaps folate degradation and stimulates collagen production by the vitamin A storing cells (lipocytes) and myofibroblasts.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1770193 TI - Immediate enteral nutrition following multisystem trauma: a decade perspective. AB - Metabolic support is an integral component of surgical critical care. Although prompt restoration of oxygen availability is clearly essential, the timing, composition, and route of nutritional support may also be decisive factors. The ensuing discussion will focus on: (a) timing of substrate delivery and (b) route of administration based on our clinical investigation over the past decade. The acutely injured patient was selected as a model of ICU hypermetabolism because of relative homogeneity with respect to age, comorbid factors, and stress level. Our first study hypothesis was that early nutritional support would improve outcome in the severely injured, but previously well-nourished patient. During an 18 month period, all patients undergoing laparotomy with a abdominal trauma index (ATI) greater than 15 were randomized to a control or total enteral nutrition (TEN) group. The control patients were given total parenteral nutrition (TPN) after POD 5, whereas the TEN cohort had a needle catheter jejunostomy (NCJ) inserted at laparotomy and received an elemental diet within 12 hours. The control (n = 31) and TEN (n = 32) groups were otherwise comparable with respect to risk stratification. The TEN patients, of course, shared improved nitrogen balance (p less than 0.001), but also had significantly (p less than 0.025) less septic morbidity. Nine (29%) of the controls developed major infections, contrasted to three (9%) of the TEN patients. Acknowledging the benefit of early nutrition, the next issue we addressed was the optimal route of substrate delivery; i.e., TEN vs TPN. The hypothesis was that TEN, compared to TPN, would reduce the injury stress response as reflected by the prioritization of hepatic protein synthesis. TEN given via NCJ and a nutritionally matched TPN solution were administered during the same postoperative period. Indeed, the TEN patients (n = 23) had significantly (p less than 0.05) higher constitutive proteins and lower acute-phase proteins, whereas the TPN patients manifested the opposite protein profile as measured by crossed immunoelectrophoresis. In view of these findings, we continued the study to ascertain clinical impact. Ultimately, 75 patients were randomized, providing groups with equivalent risk factors. Eleven (37%) of the TPN patients developed septic complications compared to five (17%) of the TEN group, and the incidence of major infection was six (20%) following TPN vs one (3%) with TEN. Thus, immediate TEN provided an additional clinical benefit compared to early TPN in these high-risk surgical patients. PMID- 1770195 TI - A comparison of fasting serum amino acid profiles of young and elderly subjects. AB - The fasting serum amino acid profile in 37 healthy young women and men (30-35 years) was compared with the fasting profile in 30 institutionalized elderly women and men (80-89 years), an ambulatory, self-fed senior-residence group. Levels of serum lysine, leucine, methionine, valine, and total essential amino acids were significantly lower in the older group than in the younger group; however, citrulline and hydroxyproline were significantly higher in the older group compared to the younger group. Histidine, threonine, tryptophan, and the ratio of tryptophan to large neutral amino acids (isoleucine, leucine, phenylalanine, tyrosine, and valine) were also generally lower in the older group than in the younger group, while the difference due to age was more pronounced in the females compared to males. The essential/nonessential amino acid ratio was lower in females compared to males. PMID- 1770194 TI - Hypocaloric diets and ketogenesis in the management of obese gestational diabetic women. AB - The extent to which given levels of caloric restriction will improve glycemic status but increase plasma ketone bodies in gestational diabetic women has received little attention. After reviewing the underlying physiology, we present data on two feeding studies investigating the question. In the first, a weight maintaining approximately 2400-kcal/day diet was fed on a metabolic ward to 12 gestational diabetic women for 1 week. In the second week, subjects were randomized to a continuation of the 2400-kcal/day diet or to a 1200-kcal/day diet. Twenty-four-hour mean glucose levels remained unchanged in the control group but declined in the calorie-restricted group (6.7 mM or 121 mg/dl in week 1 vs 5.4 mM or 97.3 mg/dl in week 2) (p less than 0.01). Nine-hour overnight fasting plasma insulin also declined but oral glucose tolerance did not improve with caloric restriction. Fasting plasma beta-hydroxybutyrate rose in the calorie restricted group, along with an increase in ketonuria, but not in the control group. A second study compared the impact of a 33% calorie-restricted diet or insulin to a full-calorie diet in a similar 2-week experimental design and measured hepatic glucose output and insulin sensitivity with dideuterated glucose before and during an insulin clamp. Diet in three subjects improved fasting and 24-hr mean glucose by 22 and 10%, respectively, whereas prophylactic insulin in three subjects produced 0 and 4% reductions, respectively. On average, ketonuria after a 9-hr fast declined to an equivalent degree with both treatments. Hepatic glucose output and insulin sensitivity were not statistically significantly altered by gestational diabetes or the therapeutic interventions compared to nondiabetic normal weight or obese pregnant controls. In conclusion, 50% caloric restriction improves glycemic status in obese women with gestational diabetes but is associated with an increase in ketonuria, which is of uncertain significance. An intermediate 33% level of caloric restriction (to 1600-1800 kcal daily) may be more appropriate in dietary management of obese woman with gestational diabetes mellitus and more effective than prophylactic insulin. Further studies are required to confirm these findings. PMID- 1770196 TI - Systeme International (SI) units to express the concentrations of triglycerides and cholesterol. PMID- 1770197 TI - Estimation of cellulase activity using a glucose-oxidase-Cu(II) reducing assay for glucose. AB - In the presence of the Cu(I)-chelating agent neocuproine (2,10-dimethyl-1,9 phenanthroline) hydrogen peroxide acts as a reductant of Cu(II). The reaction does not proceed in the absence of neocuproine and the addition of EDTA to the reaction mixture prior to addition of Cu(II) also inhibits the reduction. Colour development can be arrested and stabilized by addition of EDTA. The reaction can be used to estimate hydrogen peroxide concentrations in the range 0.68-6.8 micrograms/ml and glucose concentrations in the range 3.6-36 micrograms/ml (20 200 microM). Horseradish peroxidase is not required for the peroxide assay but glucose oxidase must be used for glucose estimations. Thermostable cellulase activity has been estimated at 60 degrees C against cellobiose, carboxymethylcellulose and cellulose substrates by estimation of the glucose released from the substrates. PMID- 1770198 TI - A simple polymerase chain reaction apparatus based on a computer printer. AB - We describe a very simple laboratory-made polymerase chain reaction (PCR) apparatus. The reaction tubes are placed in a holder fixed through a mechanical arm to the tape cartridge of a computer printer. A computer controls the horizontal movement of the tube carrier by sending the proper printing commands. The holder is raised or lowered by a frame fixed to the paper-advancing roller of the printer. The system allows the programmed movement of the test tubes within the holder, successively through three thermal baths placed in front of the printer. DNA from single lambda gtll lysis plaques was successfully amplified with this system in our laboratory. PMID- 1770199 TI - Cell growth experiments using a microcalorimetric vessel equipped with oxygen and pH electrodes. AB - A method is described for simultaneous measurements of heat production rate, oxygen activity and pH, using a 3-ml stirred microcalorimetric titration/perfusion vessel fitted with a polarographic oxygen sensor and a combination pH-electrode. Heat production rate (+/- 0.3 microW), pH (+/- 0.01) and oxygen concentration (+/- 4 mumol/l) could be measured without any cross interference between the three signals. Results from measurements on suspensions of T-lymphoma cells and E. coli are presented. PMID- 1770200 TI - Black substrate for spectrophotometric determination of cellulase activity in coloured solutions. AB - A simple procedure for spectrophotometric determination of cellulase activity in coloured solutions is described. CM-cellulose, cross-linked with epichlorhydrin in the presence of black drawing ink, is used as an insoluble chromolytic substrate. The absorbance of reaction mixture filtrates are read in the near infra-red region (at 800-900 nm) where the absorbances of contaminating coloured substances are substantially lowered; by contrast, black drawing ink released from the substrate during the action of cellulases absorbs strongly at these wavelengths. PMID- 1770201 TI - Quantification of apolipoprotein D in human urine by zone immunoelectrophoresis assay: a methodological and clinical study. AB - A zone immunoelectrophoresis assay (ZIA) has been developed for the quantification of apolipoprotein D (apo D) in unconcentrated native human urine. A standard curve, linear between 1 and 8 mg apo D/l was obtained with ZIA. The relative coefficients of variation for this method were 5-9% (n = 15 x 6) with a mean +/- SD of 7 +/- 1.4% and below 11% (n = 6 x 15) for within-run and between run reproducibility, respectively. Equal amounts of apo D in unconcentrated and diluted urines, in serum and of the purified protein produced the same zone migration distances indicating parallelism between the immunologic reactions of apo D in different sample matrixes. Storage experiments with normal urines demonstrated good stability of apo D in both acidic and alkalinized urine over at least 2 days at +5 degrees C and during several days at -20 degrees C to -40 degrees C. Using ZIA, urine samples from 50 normal healthy men aged 23-65 years were analyzed for apo D. Mean and SD were: 2.8 +/- 2.1 mg/l, 2.6 +/- 1.8 micrograms/min and 0.24 +/- 0.13 mg/mmol for concentration, rate of excretion and mass/creatinine concentration, respectively. PMID- 1770202 TI - The dorsal metatarsal cuneiform exostosis. PMID- 1770203 TI - Achilles tendon rupture in athletes: histochemistry of the triceps surae muscle. AB - Bilateral percutaneous muscle biopsies of the triceps surae were analyzed in 12 athletes who had sustained a one-sided subcutaneous rupture of the Achilles tendon while practicing their main sport. No necrosis, atrophy, or significant fiber grouping or regeneration was evident. The soleus muscle in these athletes was composed of approximately 70% of type I fibers in both the noninjured and injured sides, and no significant differences were detected in their histochemical composition. Fiber areas were within described values and not significantly different between the two sides. The noninjured side revealed an insignificant trend to greater average capillary density and average capillary/fiber ratio. Muscle abnormalities do not appear to be a significant factor in determining Achilles tendon rupture in healthy athletes. PMID- 1770204 TI - Distal ischemia with digital gangrene secondary to Buerger's disease. AB - Thromboangitis obliterans, or Buerger's disease, is a progressive vascular disorder that affects the distal extremities of young, otherwise healthy patients. The authors present two case histories of Buerger's disease with spontaneous digital ischemia and gangrene, leading ultimately to digital amputation. A review of the literature is also presented. The natural history of Buerger's disease, current diagnostic techniques, and management of these patients are discussed with emphasis on prevention of the acute attack and long term sequelae. PMID- 1770205 TI - The plantar approach to heel surgery: a retrospective study. AB - The authors' present a plantar surgical approach for the patient with painful heel syndrome that is refractory to conservative care. Patient selection, methods, and results are discussed and analyzed. Twenty-two patients with 25 painful heels underwent the procedure. Retrospective analysis of these patients clearly shows this procedure is a viable alternative for heel surgery. PMID- 1770206 TI - Hemi-metatarsal transposition: the use of autogenous bone grafting to treat brachymetatarsia--a unique approach. AB - Many surgical procedures have been developed for relieving symptoms and improving cosmesis for brachymetatarsia. The etiology, clinical consequences, various surgical alternatives, and a unique case report are discussed. Surgical correction, demonstrating the use of autogenous bone grafts in hemimetatarsal transpositions, was performed. The authors believe that this procedure is unique and efficient. It reestablishes the metatarsal parabola, restores function, relieves symptoms, and provides an excellent cosmetic result. PMID- 1770207 TI - Pes cavo-valgus foot. AB - Collapsing pes plano valgus deformity and pes cavus deformity have been identified and treated for many years. Recently, a combination of these deformities has been recognized occurring simultaneously. This multiplanar deformity is known as the cavo-valgus foot. Treatment of this foot type requires a firm understanding of planal dominance. The authors present a case report on this subject. PMID- 1770208 TI - Endoscopic plantar fasciotomy for chronic plantar fasciitis/heel spur syndrome: surgical technique--early clinical results. AB - A new, minimally traumatic endoscopic approach to plantar fasciotomy has been developed by the authors. This technique can be performed comfortably under a local anesthetic. Patients are immediately weightbearing and all returned to regular type shoes on the 3rd postoperative day. An earlier return to regular activity and work, with less pain and patient discomfort was found, as compared with traditional heel spur surgery techniques. PMID- 1770209 TI - A large lipoma involving the foot. AB - Lipomas are defined as benign tumors usually composed of mature fat cells. They are most commonly found in areas of abundant adipose tissue, which may explain why they are rarely found in the foot. Careful examination of any potential lipoma includes its anatomical location, consistency, clinical, and roentgenographic findings. The authors describe a large lipoma that was surgically excised from the dorsal aspect of the right foot. PMID- 1770210 TI - Wilson bunionectomy with internal fixation: a ten-year experience. AB - One hundred fifteen feet that underwent a Wilson (lateral, transpositional, shortening) osteotomy for the correction of hallux valgus between 1979 and 1989 were retrospectively reviewed. All osteotomies were stabilized either with a single cortical or cancellous screw, or with crossed Kirschner wires. The Wilson procedure is not technically difficult and can allow for tri-plane correction. Of the 115 feet on which this surgical procedure was performed, 92 (80%) were graded in long-term postoperative recovery as excellent or good. Only one complication of hallux varus occurred, which required additional surgery. Survey of the results of the 10-year experience in utilization of this operative procedure has shown a high patient satisfaction with minimum of postoperative complications and a low failure rate. PMID- 1770211 TI - Iatrogenic brachymetatarsia. AB - The authors present a case report of iatrogenic brachymetatarsia. The literature was reviewed and various surgical treatments discussed. The metatarsal was lengthened using a sagittally placed Z lengthening step-up osteotomy, with an autogenous bone graft and rigid internal fixation. PMID- 1770212 TI - Studies on chemiluminescence and protein kinase-C activity of cisplatin treated mouse peritoneal exudate cells. AB - A single i.p. injection of cisplatin (10 mg/kg body weight) into mice results in a significant increase in chemiluminescence and ATP contents of the peritoneal exudate cells (PEC) than that of PEC from untreated mice. It is also observed that in vitro treatment of macrophages with cisplatin, rIFN-gamma and LPS show increased activity of the protein kinase-C (PK-C). The activation of PK-C could result in stimulation of NADPH-oxidase resulting in increased levels of chemiluminescence. Increased contents of ATP in PEC after cisplatin treatment also suggests that this activation is energy dependent. PMID- 1770213 TI - Pharmacokinetic profile of the immunomodulating compound adamantylamide dipeptide (AdDP), a muramyl dipeptide derivative in mice. AB - A pharmacokinetic profile of 14C-AdDP with uniformly labelled alanine was investigated. It was shown that the distribution phase after an i.v. administration is very short with a half-life of 2.1 min. The half-life of elimination phase after the i.v. administration is about 2.85 hours, that is longer than those of MDP and its derivatives. The total body clearance (30 ml/min/kg) is caused predominantly by metabolism of the compound. All the radioactivity found in urine in a 48 hours interval after a s.c. administration represents only 3.1% of the administered dose. Only a smaller part of the excreted radioactivity is formed by unmetabolised AdDP. The concentration curve after a s.c. administration is characterized by a very fast absorption with a half-life shorter than 1 minute. The distribution and elimination phases are prolonged (20 min, 11 hours respectively) in comparison with an i.v. injection. The decreased absolute bioavailability after a s.c. administration (65%) is probably not biologically significant because of a slower release of the compound from the site of the s.c. administration. A relatively very high radioactivity was found in liver, kidney, thymus, spleen and brain very soon which suggest a very good penetration into tissues. It is an agreement with the high apparent distribution volume of peripheral compartment and higher lipophilicity of AdDP as compared to MDP. PMID- 1770214 TI - Immunologic effects of cocaine and related alkaloids. AB - Because of the national epidemic of cocaine abuse and the increasing prevalence of infectious diseases among drug abusers, we investigated the effects of cocaine and cocaine metabolites on human cellular immune functions. Mononuclear cells (MNC) were isolated from blood of healthy adult volunteers. MNC were stimulated in vitro with mitogens with and without various concentrations of cocaine. Because of cocaine's poor stability in vitro, we found it necessary to replenish cocaine daily to MNC cultures. Under these conditions, cocaine, in a dose response fashion, significantly inhibited MNC proliferation. Metabolites of cocaine did not alter MNC proliferative responses significantly from control cultures. Polymorphonuclear leukocyte chemotaxis was also significantly impaired by cocaine. Our data demonstrate that cocaine is immunosuppressive and that it acts on human MNC during early stages of cellular activation. These data further suggest that illicit cocaine use may compromise the integrity of the immune system. PMID- 1770215 TI - Induction of cytotoxic cell activities by a novel cyclic disulfide compound, SA3443 in vivo. AB - (4R)-Hexahydro-7,7-dimethyl-6-oxo-1,2,5-dithiazocine-4-carboxylic acid (SA3443) is a newly synthesized cyclic disulfide compound which offers potential hepatoprotective properties. The effect of SA3443 on the induction of natural killer (NK) and cytotoxic T lymphocyte (CTL) activities was investigated. NK activity in BALB/c mice splenic cells was investigated using YAC-1 cells as target cells. SA3443, at a dose range of 30-300 mg/kg/day, augmented NK activity significantly when administered orally once daily for 4 days before the assay. Alloantigen-specific CTL activity in splenic cells from BALB/c mice was detected 9 days after sensitization with C57BL/6 mice splenic detected 9 days after sensitization with C57BL/6 mice splenic cells. SA3443, at a dose of 100 mg/kg/day, augmented CTL activity significantly when administered orally, once daily for 4 days beginning after the sensitization and for 2 days before the assay, while a high dose of SA3443, at 300 mg/kg, suppressed CTL activity. From these results, it is thought that SA3443 may assist in the elimination of hepatitis viruses from the liver in patients with chronic active hepatitis, by the activation of NK and/or CTL activities. PMID- 1770216 TI - Effects of acetyl-L-carnitine oral administration on lymphocyte antibacterial activity and TNF-alpha levels in patients with active pulmonary tuberculosis. A randomized double blind versus placebo study. AB - Acetyl-L-carnitine (ALC), a drug for the treatment of ageing-related neuroendocrine dysfunctions, was orally administered--2 gm/day for 30 days--to 10 patients with active pulmonary tuberculosis (TBC). Lymphocyte-mediated antibacterial activity and serum levels of tumor necrosis factor (TNF)-alpha were evaluated before and after treatment, comparing the values with those of 10 TBC patients receiving placebo. Results show that by day 30, antibacterial activity remained unmodified or increased in ALC-treated subjects, while decreased in the placebo group. No influence of ALC on TNF-alpha levels was detectable. These data suggest that the host's immune responses to M. tuberculosis infection can be selectively modulated by drugs acting on the neuroendocrine axis. PMID- 1770217 TI - Kinetic analysis of human IL-2 activated cytotoxic cells. AB - Kinetic analysis was used to define lytic events in peripheral blood mononuclear cells (PBMC) activated in lymphokine conditioned medium (LCM) and recombinant interleukin-2 (rIL-2). This analysis provided quantitative information on the functional properties of these lymphokine-activated killer (LAK) cells against NK resistant and NK-sensitive tumor cell lines. The maximum rate of target cell lysis (Vmax) and Km (target cell number resulting in 1/2 Vmax) were determined. IL-2 activated effector cells that bound to target cells also lysed them (i.e., non-lytic bystander lymphocytes did not influence the determination of kinetic parameters) in contrast to lysis mediated by unactivated NK cells. The extent of LAK cell binding to tumor target cells was dependent upon the tumor type. LAK cell frequency determinations were calculated where Km approximated the concentration of LAK cells that were capable of killing a particular target. LAK cells generated in rIL-2 were lytically more efficient than those activated in LCM, and T-depletion resulted in a LAK population with the highest maximum rate of lysis. The use of kinetic analysis to evaluate LAK cell frequencies and quantitate lytic events will be useful in determining the effects of drugs, biological response modifiers and disease states on LAK cell function. PMID- 1770218 TI - Prostaglandin E2-induced inhibition of the in vitro immune response by SRBC stimulated human lymphocytes. AB - Exogenous PGE2 strongly inhibits the response of human lymphocyte cultures to SRBC. This effect is mediated through a T cell inhibition since non-T cells are not significantly affected. Indomethacin, which inhibits in this system lymphocyte endogenous PGE2 synthesis increases the in vitro immune response. The effect of indomethacin is overcame by exogenous PGE2. These data may be relevant for explaining the immunomodulatory role of PGE2 following antigen challenge. PMID- 1770219 TI - Effects of bromocriptine treatment on immune responses and 3-methylcholanthrene induced tumorigenesis in rats. AB - Seven-week-old male Sprague-Dawley rats were given a single injection of 1.5 mg of 3-methylcholanthrene (3MC) to induce in situ fibrosarcomas. The rats were also treated with the dopamine agonist bromocriptine (BCR) from two days prior to 14 days after 3MC treatment and again for 14 consecutive days beginning at week 5. Tumor incidence was markedly increased and latency decreased in BCR-3MC rats compared to 3MC controls. Natural killer (NK) cell cytotoxicity responses and production of interleukin 2 (IL2) was enhanced at two weeks in rats treated with only BCR. Natural killer cell activity was suppressed at two weeks in rats treated with only 3MC. This effect was reversed by BCR treatment. Rats treated with 3MC and BCR had suppressed NK cell responses and production of IL2 and interferon-gamma (IFN) at 12 weeks. In another study, rats injected with 1, 3 or 5 mg/kg BCR for 14 consecutive days had increased NK cell activity and IL2 production at all doses and increased IFN production at the two high doses. Antibody (IgG) responses to an injected antigen and delayed-type hypersensitivity reactions were not affected by BCR treatment. Animals treated with the two high doses of BCR had decreased serum prolactin (PRL) levels. Serum growth hormone (GH) concentrations were markedly increased in the group treated with 3 mg/kg BCR. These data suggest that BCR enhances 3MC-induced tumorigenesis. The mechanism of this effect is apparently not mediated by suppression of the immune system since BCR-treated rats had selectively enhanced immune function. Enhancement of immune responses by BCR has not been previously reported. PMID- 1770220 TI - Modulating effects on CD25 and CD71 antigen expression by lectin-stimulated T lymphocytes in the elderly. AB - During the last few years, several observations outline that the impaired T lymphocyte proliferative capacity in the elderly is due to a reduced interleukin 2 (IL-2) release. To further investigate the activation process during lectin stimulation, aged peripheral blood mononuclear cells (PBMC) were stimulated with phytohemagglutinin (PHA) and assessed for CD25 (IL-2 receptor) and CD71 (transferrin receptor) expression at different intervals of time. Our results provided evidence for a significant decline of both structure induction, above all in the later phase of culture. Indomethacin (INDO) treatment gave rise to an enhancement of CD71 antigen expression only, while prostaglandin E2 (PGE2) supplementation to culture media further decreased either CD25 or CD71 receptor induction. Interferon (IFN)-alpha and IFN-gamma treatment failed to modulate the frequency of CD25+ and/or CD71+ cells. Finally, the expression of CD71 receptor was increased by deferoxamine supplementation, this suggesting a partial involvement of iron overload in the depressed function. Although further studies are required to evaluate at a molecular level the decreased antigen expression, these findings indicate that several mechanism are involved in the elderly related decline of T lymphocyte activation structures during lectin stimulation. PMID- 1770221 TI - The effect of radon on human health. AB - Recently, physicians have had to come to grips with the issue of indoor radon. Patients and friends are asking whether there are risks to elevated levels in homes and commercial dwellings. This article summarizes current information and helps physicians respond to inquiries from patients. PMID- 1770222 TI - Endoscopic detection of a tiny cecal ulcer containing carcinoma in-situ. AB - A 3-mm cecal ulcer without any adjacent polypoid structure was detected in a 66 year-old asymptomatic man undergoing screening colonoscopy. Biopsies demonstrated carcinoma in-situ. The literature on tiny colonic carcinomas and carcinoma in situ in the absence of any polyp is reviewed in this article. PMID- 1770223 TI - Thyrotoxic periodic paralysis in a Caucasian man: recognition and diagnosis. AB - Periodic paralyses are uncommon disorders characterized by episodic muscle weakness, often with hypokalemia. Thyrotoxic periodic paralysis (TPP) is the most common and is rarely seen in the Caucasian population; the relative unfamiliarity of TPP among physicians in the United States may lead to initial errors in diagnosis. This article presents the case of a 25-year-old white man with frequent episodes of skeletal muscle weakness and cramping, associated with profound hypokalemia. Laboratory evaluation demonstrated primary hyperthyroidism, and a diagnosis of TPP was made. The disorder is found more commonly in men between the ages of 20 and 40. Hypokalemia is the most consistent laboratory abnormality, representing a transcellular shift rather than a total body deficit; the exact mechanism is unknown. The exercise test demonstrates distinct electromyographical abnormalities in those with periodic paralysis. The definitive treatment of TPP is establishing a euthyroid state. PMID- 1770224 TI - Scleroderma and its manifestations in the hand. PMID- 1770225 TI - Maternal mortality in Indiana: a report of maternal deaths in 1989. PMID- 1770226 TI - Journal of Immunological Methods: author and subject indexes (1991). Volumes 136 145. PMID- 1770227 TI - Clinical applications of human granulocyte-macrophage colony-stimulating factor. AB - Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a hematopoietic growth factor that stimulates myeloid cell proliferation and maturation and enhances the function of terminally differentiated effector cells. Phase I and II clinical trials have demonstrated mild to moderate toxicities at doses of less than 30 micrograms/kg/day. These studies suggest a potential role for this growth factor to stimulate myelopoiesis in patients with aplastic anemia, myelodysplastic syndromes, AIDS, chemotherapy-induced myelosuppression, chronic neutropenia, and following bone marrow transplantation. The potential clinical uses of GM-CSF will depend on results of studies designed to optimize its therapeutic efficacy. PMID- 1770228 TI - Hybrid cytokines as hematopoietic growth factors. AB - A large body of in vitro and in vivo data suggests that combinations of cytokines provide the most effective mechanism for stimulating multilineage acceleration of hematopoiesis. Creation of a granulocyte-macrophage colony-stimulating factor (GM CSF)/interleukin 3 (IL-3) fusion protein has yielded a single therapeutic which has enhanced biological activity in comparison to the individual cytokines from which it is composed. In vivo studies with this fusion protein (PIXY321) suggest that it may provide a means to accelerate both neutrophil and platelet recovery in clinical settings in which hematopoiesis is suppressed. The biology of PIXY321 and the potential for other fusion proteins is discussed. PMID- 1770229 TI - Lung cancer: from triumph to tragedy. PMID- 1770230 TI - A serum-free medium for the Courtenay-Mills soft agar assay. AB - A serum-free medium has been developed to support the clonogenic growth in soft agar of human cervical carcinoma cell lines xenografted into nude mice. Using the Courtenay-Mills assay, colony-forming efficiencies and colony sizes equivalent to those obtained using Ham's F12 plus 15% fetal calf serum can be obtained. Validation of the assay using the developed medium was obtained through establishing linearity between the number of cells plated and colonies formed, and by producing radiation survival curves. PMID- 1770231 TI - Canine BFU-e progenitors: adaptation of a reproducible assay and anatomical distribution. AB - In vitro cloning assays are used increasingly in investigative hematotoxicology and in screening candidate compounds for their hematotoxic potential. To expand these applications, a practical cloning assay for erythroid burst-forming units (BFU-e) that uses a microplasma clot (MPC) system was adapted to the dog, a species used extensively in experimental hematology and drug development. This system offers the advantage over the methylcellulose and soft agar culture systems of allowing specimen fixation and, therefore, morphological and cytochemical evaluation. The distribution of BFU-e among various anatomic sites was assessed using the MPC cloning system, which was modified to optimize the BFU e growth. BFU-e growth required only erythropoietin (Epo) in the culture medium and there was no need for an exogenous source of burst-promoting activity (BPA). The cloning efficiency was linearly proportional to the plating concentrations of Epo and marrow mononuclear cells (MMC) over a range of 0 to 3 U Epo and 1 x 10(5) to 3 x 10(5) MMC per ml of culture, respectively. Increases in concentrations of Epo and MMC beyond these levels were not associated with linear growth. The addition of transferrin and spleen-conditioned medium containing a mixture of growth factors (including BPA) reduced BFU-e growth. The relative concentration of BFU-e was comparable among samples collected from the iliac crest, femur, and humerus. Serial cultures performed on individual dogs were highly reproducible and there was little variation in BFU-e activity among dogs of comparable age. It was concluded that the MPC system is a practical and reproducible cloning system for early (BFU-e), as well as late erythroid colony-forming units (CFU-e) in the dog. The concentration of BFU-e appears comparable throughout the active marrow; therefore, various anatomic sites can be used interchangeably for serial quantitative analysis of this progenitor. PMID- 1770232 TI - Characterization of T lymphocyte clones isolated from BCNU-cured LSA mice. AB - 1,3-Bis(chloroethyl)-1-nitrosourea (BCNU) has been shown to "cure" over 90% of the mice bearing the syngeneic tumor LSA, and the cured mice acquire elevated levels of tumor-specific immunity. In the present study, we report for the first time the establishment and characterization of several tumor-specific CD8+ cytotoxic T cell (CTL) clones from splenic T cells of BCNU-cured LSA mice. Many of these clones were found to be strongly cytotoxic to LSA but not to a different H-2b tumor target such as EL-4, or the natural killer (NK)-susceptible target YAC 1, NK-resistant target P815, or con A or LPS blasts from H-2b mice. Some of the clones showed a moderate level of cytotoxicity to the NK-susceptible target YAC 1. The relative roles of interleukins such as IL-2, IL-4 or IL-6 in supporting the proliferative response of some LSA-activated CTL clones were analyzed. As expected, recombinant human (rh) IL-2 alone supported the proliferative response of activated CTL clones. Addition of recombinant murine (rm) IL-4 or rhIL-6 alone to the culture failed to influence the response. Also, in combination with rhIL 2, neither rmIL-4 nor rhIL-6 appreciably augmented rhIL-2-supported proliferative response of CTL clones. These studies may provide insights for the development of effective approaches to modulate function and activity of effector T cells. PMID- 1770233 TI - Epignathus. Case report of long-term survival with no surgery. AB - Clinical and radiological features of an epignathus of the soft palate and oropharynx are presented. The case was conservatively treated and followed for 8 years. PMID- 1770234 TI - Large cell, multilobated, B-cell lymphoma of the palate. A case report. AB - A case of B-large cell non-Hodgkin's lymphoma (NHL) with multilobated nuclei arising in the palatal mucosa is described. Immunologic typing of tumor cells was crucial to determine the exact cell of origin of this lesion. PMID- 1770235 TI - Developmental lingual bone defect of the mandible. Report of a case. AB - The case of a patient with a lingual bone defect of the mandible accompanied by spontaneous pain is described. This report presents the development of the lesion, and its disappearance 26 months after removal of the submandibular gland. Pain was relieved after the operation. We regard the development of this lesion related to the pressure exerted by the submandibular gland on the corical bone. PMID- 1770236 TI - Influence of age on the management of blow-out fractures of the orbital floor. AB - This study concerns 50 patients with blow-out fractures of the orbital floor, including 15 children, and was designed to evaluate the influence of age on clinical presentation and postoperative results. Fourteen of the 15 children were found to have a trap-door fracture. This type of fracture was not found in adults, who usually present with a large "open-door" fracture. In trap-door fractures, orbital tissues are liable to become trapped and even strangulated. It is therefore suggested that young patients with severely restricted eyeball motility, an unequivocal positive forced duction test, and findings indicating blow-out fracture of the orbital floor on CT, should undergo operative treatment as soon as possible after injury. A "wait and see" policy, keeping the patient under observation, seems to be appropriate for blow-out fractures in adults. Surgical treatment is recommended only in those adult patients who demonstrate impairment of vertical eyeball motility within the mainfield of view after the haemorrhage and oedema have resolved and in whom change in motility is no longer seen and Hertel measurements have stabilized. PMID- 1770237 TI - An analysis of 80 cases of mandibular fractures treated with miniplate osteosynthesis. AB - A study of 80 consecutive cases of mandibular fractures treated utilizing miniplate osteosynthesis is reported. Analysis of the data collected from 2 inner city hospitals revealed a high incidence of males (90%), alcohol abusers (44%), smokers (77%) and unemployed (36%). Assault was the aetiological factor in 72.5% of cases, with alcohol implicated in 58%. The injuries were predominantly non complex in nature, 94% having one or 2 mandibular fractures and only 11% having additional facial fractures. The results compared favourably with those found in previous studies with 8% having complications. The efficacy and advantages of miniplate osteosynthesis as a method of treatment of mandibular fractures is discussed. PMID- 1770238 TI - Anterior maxillary osteoplasty to broaden the narrow maxillary ridge. AB - The application of endosseous implants has extended the range of options and effectiveness of reconstructive preprosthetic surgery. Placement of endosseous implants in the edentulous maxilla is often restricted due to lack of available bone. Exposure of the underlying anterior maxillary bone frequently reveals a ridge form which is adequate in height but too narrow to accommodate endosseous implants. A horseshoe type osteotomy extending from the ridge crest into the floor of nose has been developed which allows advancement of the outer cortex to restore lost facial form and placement of an interpositional bone graft and endosseous implants to restore lost function. PMID- 1770239 TI - An assessment of the predictability of maxillary repositioning. AB - The purpose of this investigation was to compare our ability to perform the surgery that is planned in the prediction tracing and model surgery when using the mandible as a guide to maxillary repositioning, using internal and external reference points to establish the vertical dimension at the time of surgery. A total of 146 consecutive patients who underwent maxillary repositioning by means of Le Fort I osteotomy were selected. In all patients the unoperated mandible was used to provide anteroposterior and transverse maxillary position. In 100 patients, measurements made on the lateral wall of the maxilla (internal reference points--IRP) were used to determine the maxillary vertical dimension. In 46 patients, the vertical dimension was established by measuring between a Kirschner wire in the nasal bridge and a maxillary incisor (external reference points--ERP). Comparison between the predicted and actual change in the position of the incisor was calculated. Statistical analysis showed that there were significant differences between the predicted and actual change in vertical and horizontal position of the incisor (p less than 0.0001) for both experimental groups. However, there was a significant difference between the 2 experimental groups (p less than 0.001) for the accuracy of vertical repositioning. The use of an external reference point proved to be a more accurate method for vertical maxillary repositioning. The results of this investigation indicate that the ability to determine vertical repositioning of the maxilla with internal reference lines is limited. PMID- 1770240 TI - Feasibility of osteotomies in fibrous dysplasia of the jaws. AB - Two examples are presented of osteotomies performed simultaneously with surgical recontouring in cases of fibrous dysplasia of the jaws. Osteotomies are necessary when a coexistent discrepancy in jaw relationship is present. This provides a functional as well as aesthetic result. Rigid miniplate fixation was utilised, and dysplastic bone healing was uneventful, and found clinically not to differ from that of normal bone. Osteotomy is thus feasible in dysplastic bone, and may complement recontouring in achieving a better result. PMID- 1770241 TI - Temporomandibular joint eminence augmentation by down-fracture and inter positional cartilage graft. A new surgical technique. AB - A new surgical technique for the treatment of recurrent temporomandibular joint subluxation or dislocation is described. Following a horizontal osteotomy and down-fracture of the articular eminence an inter-positional bovine cartilage xenograft is inserted in order to augment the vertical height of the eminence. The procedure combines simplicity with minimal post-operative morbidity. The increase in eminence height is both predictable and stable. PMID- 1770242 TI - Intra-oral condylotomy for the treatment of temporomandibular joint derangement. AB - Open condylotomy using Moose's intra-oral approach was performed on 46 patients suffering from anterior disc displacement. The results show that condylotomy is useful in the treatment of this disorder, but the technique used is not recommended due to the risk of dislocation of the condylar fragment. PMID- 1770243 TI - Primary intraosseous squamous carcinoma. Report of two cases. AB - Two cases of primary intraosseous squamous carcinoma (PIOSC) are reported. One PIOSC is in the mandible of a 24-year-old man and appears to be a keratinizing PIOSC arising de novo. The other PIOSC presented in the edentulous maxilla of a 56-year-old man and was diagnosed as a PIOSC arising from an odontogenic cyst. The 2nd tumor subsequently metastasized to a cervical lymph node. Previous reports have noted a favorable prognosis for PIOC arising in odontogenic cysts, and only 3 other instances of metastases of a PIOSC in an odontogenic cyst have been documented. PMID- 1770244 TI - Primary intraosseous AIDS-associated Kaposi's sarcoma. Report of two cases with initial jaw involvement. AB - AIDS-associated Kaposi's sarcoma (KS), which in 80% of cases occurs in the oral cavity, usually presents with characteristic clinical features such as brown bluish pigmented macules or tumorous lesions. In later stages the tumor, most probably originating from the vascular endothelium, may secondarily induce erosion of the underlying bone. The primary, intraosseous occurrence of KS has prompted the present 2 case reports. The tumor presented as extensive, diffuse osteolysis within the mandible without causing clinical symptoms. Although rare, intraosseous KS must be included in the differential diagnosis of isolated bone defects in HIV-infected patients. PMID- 1770245 TI - Superselective embolization in an errosive haemorrhage of a carcinoma in the parotid gland. AB - Haemorrhage due to errosion of blood vessels in tumors of the head and neck are a dramatic event. Superselective embolization plays an important role in the treatment of these entities. A therapeutic approach and method of embolization is described. PMID- 1770246 TI - Some anatomical factors of the upper compartment of the temporomandibular joint related to the disc position. AB - Temporomandibular joint (TMJ) arthrograms of 20 joints with superior disc position (SDP), 20 joints with anterior disc displacement with reduction (ADDWR), and 20 joints with anterior disc displacement without reduction (ADDWOR) were compared. The distance from the insertion of the posterior disc attachment of the upper joint compartment to the top of the mandibular fossa in joints with ADDWR was significantly longer than in joints with SDP and ADDWOR (p = 0.003). The distance from the top of the mandibular fossa to the top of the articular eminence in joints with ADDWR was significantly shorter than in joints with ADDWOR (p = 0.006). The entire distance of the upper joint compartment in joints with ADDWR was significantly longer than in joints with SDP and ADDWOR (p = 0.02). PMID- 1770247 TI - [How does the DNA replication terminate?]. PMID- 1770248 TI - [JUN-family proteins as transcriptional regulators]. PMID- 1770249 TI - [Function of a G protein in yeast mating pheromone signal transduction]. PMID- 1770250 TI - [A new pituitary hormone, somatolactin]. PMID- 1770251 TI - [Two enzymes concerned in peptide hormone alpha-amidation are synthesized from a single mRNA]. PMID- 1770252 TI - [A simple and rapid method for site-directed mutagenesis by using the PCR]. PMID- 1770253 TI - [Chromato-scanning quantifications of nucleic acid, protein, lipid and carbohydrate molecules on the photograph]. PMID- 1770254 TI - [Long-term results of congenital dislocation of the hip treated with Pavlik harness]. AB - We have studied congenital dislocation and subluxation of the hip reduced by Pavlik harness with long-term roentgenographic results and prognostic factors. Eighty dislocations and thirty-five subluxations were assessed by X-ray. Average age at final follow-up was 17 years (14 to 23 years). Anatomical healing (Group I of Severin's classification) was 61.2% in dislocation and 71.5% in subluxation. Avascular necrosis of the femoral head was 7.0% (8 hips) and deformity was mild. Acetabular dysplasia appeared to be an important factor in determining the prognosis. In cases with both satisfactory and unsatisfactory results, the acetabular development differed from that of the normal cases from early childhood. After 11-12 year old the acetabular development normalized in cases with satisfactory results but did not in those with unsatisfactory results. Factors influencing the results were not clarified, there was the strong relationship between affected side and unaffected side in Center-Edge angle of Wiberg, Sharp's angle, AAQ (Approximate Acetabular Quotient) and Severin's classification respectively. This study concluded that long-term results of congenital dislocation and subluxation of the hip reduced by Pavlik harness were not always satisfactory and were strongly influenced by endogenous acetabular development in our cases. PMID- 1770255 TI - [Postoperative prognostic factors in patients with spinal cord tumors]. AB - This study is to analyse the prognostic factors of the patients with spinal cord tumors, consisted of intramedullary tumor (33 patients), multiple extramedullary tumor (15), solitary cauda equina tumor (22), and solitary extramedullary tumor (48). The significant prognosis of intramedullary tumors depends on the histopathological type, the tumor margin, and the extramedullary tumor extension. Multiple extramedullary tumors had a tendency to recur at the different spinal cord levels; poorer long-term clinical results than those with solitary spinal cord tumor. Solitary cauda equina tumor cases showed good clinical course except for the bladder disfunction. Prognostic factors for solitary extramedullary tumors were the preoperative neurological status, the duration of myelopathy prior to surgery, the age at surgery, the tumor size, tumor location along the spinal axis, and the site of tumor in relation to the spinal cord. PMID- 1770256 TI - Posterolateral approach to the atlas and the axis. AB - We have developed a new surgical approach to the atlas and the axis including the odontoid process, in which the vertebral artery is transposed and an access to their lateral aspects without exposing the anterior structures of the neck is achieved. A case of successful excision of a bone tumor of the lateral mass of the atlas and a hypertrophic odontoid process by this approach is described. PMID- 1770257 TI - [The extractable calcitonin value in normal individuals]. AB - Human calcitonin levels have been measured by many authors, however the limit of detectability of human calcitonin is as high as 10 pg/ml, and its normal value may range from 10 to 249 pg/ml. To avoid the limitations of present human calcitonin assays, Hunter Heath in 1983 developed a silica Sep-Pap extraction procedure. In this study, extractable calcitonin (Monomeric CT = CT-M) in 261 normal individuals was determined using Heath's method. The CT-M value ranged from 3.0 to 17.4 pg/ml with an average of 7.5 +/- 2.2 pg/ml. The limit of detectability of CT-M was 1.0 pg/ml. The CT-M value was higher in males than in females in all generations, and was highest in the third decade and slightly decreased in the seventh decade. CT-M seemed to accurately reflect human calcitonin in the pure form. The values of human calcitonin determined in this study may be useful in the clinical laboratory. PMID- 1770258 TI - [Static results of medial foot arch]. AB - The purpose of this study was to examine the factors which influence on the length of the medial arch of the foot. The length of the medial arch was measured by using the electric arch gauge in ten normal adults under various situation, such as, under vertical load from the knee to the foot, under weight-bearing on both-legs standing, on one-leg standing with and without support, at the dorsiflexion of first metatarsophalangeal joint, and during the inversion eversion and adduction-abduction of the foot. The medial arch lengthened by vertical load to the foot, and abduction of the foot. On the other hand, shortening was observed on one-leg standing without support on the dorsiflexion of the first metatarsophalangeal joint and on the adduction of the foot. These results indicate that the participation of these factors may be necessary for smooth walking. PMID- 1770259 TI - [The distribution of S-100 protein positive chondrocytes in the human articular cartilages under aging or diseased conditions]. AB - There have been few reports on the localization of S-100 protein positive chondrocytes in the human articular cartilages. We studied 59 articular cartilages of the aged subjects, 65 osteoarthritic (OA) and 39 rheumatoid arthritic (RA) articular cartilages, to detect the histological localization of S 100 protein using immunoperoxidase method (ABC). The results obtained from normal cartilages demonstrated strongly positive cells representing hypertrophic chondrocytes in the perivascular areas of the neonatal articular cartilage and in the deep zone of the infant articular cartilage. The moderately positive cells were found in the intermediate zone of infant and adult articular cartilages. In mild OA, there were many positive chondrocytes in the intermediate zone with erosion of the surface layer, while in moderate or severe OA many strongly positive cells were found in clusters. The hypertrophic cells in the metaplastic cartilage arising from bone marrow in subjects with severe OA, or from pannus after RA were also positive. It is therefore, suggested that S-100 protein may be correlated with the metabolic activity of the cartilage matrix such as collagen and proteoglycan, as reported in the literature. S-100 protein further, appears to be useful for evaluating histologically the activity of cartilage repair in the pathologic human articular cartilages. PMID- 1770260 TI - [Study on serum-sensitivity of Pseudomonas aeruginosa]. AB - Using a microtiter plate for cell culture one hundred strains of Pseudomonas aeruginosa isolated from various clinical materials were quantitatively investigated for sensitivity to the bactericidal activity of normal human serum. The sensitivity to the serum was widely distributed among these strains. In parallel, 100 strains of Pseudomonas aeruginosa were serotyped using a type specific anti-Pseudomonas antiserum kit. All type M strains were proven to be serum-sensitive, while types G, B, and A were generally serum-resistant. Using an experimental model of osteomyelitis in mice, osteomyelitis could not be caused by serum-sensitive strains of Pseudomonas aeruginosa. These results would indicate that serum-resistance is an important factor in pathogenicity of Pseudomonas aeruginosa. PMID- 1770261 TI - [Identification of cytokines produced by cells cultured from human giant cell tumors of bone]. AB - Morphological and biochemical studies were performed using tissue culture methods in 14 cases of giant cell tumor of bone. Primary cultures consisted of three types of cells, multinucleated giant cells, mononuclear round cells and spindle shaped cells. The round cells were considered to be infiltrating macrophages, not neoplastic cells, according to the results obtained by morphological and immunohistochemical studies. The spindle-shaped cells were apparently neoplastic since they extensively proliferated and showed chromosomal abnormalities. Western blotting analysis of the supernatant fluid from the culture of the spindle-shaped cells showed the presence of several cytokines; M-CSF, IFN-gamma, TNF-alpha, which were known to show chemotactic, differentiation-inducing and activating effects on macrophages. When the conditioned mediums of cultured spindle-shaped cells were added to the culture of U-937 macrophage cell line, U-937 cells were induced to differentiate and became multinucleated giant cells. The results indicate that the spindle-shaped cells which could be passaged are neoplastic elements and that the cytokines produced by these cells have a significant role in clinicopathological status of the giant cell tumor of bone. PMID- 1770262 TI - [Admittance plethysmographic study of the recovery of vasomotor function in replanted fingers]. AB - A new admittance plethysmograph, designed for the observation of finger vasomotor function, was employed to characterize circulation through replanted fingers and to clarify the relationship between the duration of ischemia and the postoperative recovery of finger sensory function. The study was carried out on 13 replanted fingers, 1 replanted arm and 12 contralateral normal fingers of 11 patients who underwent finger or arm replantation. To assess the reliability of this admittance plethysmograph, water-filled plethysmography was simultaneously performed, utilizing a newly devised electric volume sensor. Replanted fingers were divided into three groups based on vasomotor reactions; normal reaction group, vasodilation group and vasoconstriction group. This classification of vasomotor reactions had a high correlation ratio (0.86) with static two-point discrimination (2PD). Total ischemia time (time from amputation to reperfusion) did not correlate with static 2PD, while total warm ischemia time (obtained by subtracting the duration of cold storage of amputated finger from the total ischemia time) correlated well with static 2PD (gamma s = 0.766). The finding of various types of vasomotor reactions in replanted fingers suggests that normal vasomotor function cannot be restored by recovery of vasoconstrictor nerves alone, and that vasodilator nerves are also present in hands and fingers. PMID- 1770263 TI - [Immunotherapy of rheumatoid arthritis with and without immunosuppressive drugs]. PMID- 1770264 TI - [Rotational acetabular osteotomy--indications and operative procedures]. PMID- 1770265 TI - [Loose shoulder]. PMID- 1770266 TI - [20 years clinical results of Charnley-THR]. PMID- 1770267 TI - [Treatment of hallux valgus]. PMID- 1770268 TI - [Knowledge of lower extremity orthosis]. PMID- 1770269 TI - Synergy between tumor necrosis factor and endotoxin decreases early embryo development in vitro. AB - The purpose of the present study was to investigate the individual and combined effects of low levels of endotoxin and physiological levels of tumor necrosis factor on in vitro fertilization and preimplantation embryo development. B6D2F1 mice were superovulated by utilizing pregnant mare serum gonadotropin and human chorionic gonadotropin. Oocyte-cumulus complexes (3221 oocytes) were collected, pooled, and randomized into control and treatment groups. Sperm were collected from the caudae epididymides of mature male mice and allowed to capacitate. Treatments included culture media supplemented with increasing amounts of endotoxin (0.5, 1.0, and 2.0 ng/ml; sp act, 3000 IU/ng) and/or tumor necrosis factor (1, 10, and 50 pg/ml; sp act, 0.01 IU/pg) throughout the fertilization and preimplantation development process. Percentage cleavage and percentage expanded blastocyst formation were evaluated. No significant effects were observed for percentage cleavage or percentage expanded blastocyst formation in either the endotoxin (E) or the tumor necrosis factor (TNF) groups. The combination of endotoxin and tumor necrosis factor at any of the levels tested did not significantly decrease cleavage; however, percentage blastocyst formation was decreased with any combination of TNF and E (P less than 0.05-P less than 0.001). We conclude that TNF and E exert significant synergistic effects which are detrimental to in vitro preimplantation embryonic development. PMID- 1770270 TI - Effects of clomiphene citrate and leuprolide acetate on luteal-phase hyperprolactinemia during ovarian stimulation with menopausal gonadotropins. AB - Hyperprolactinemia, a known modulator of reproductive function, occurs commonly in women undergoing ovarian stimulation with human menopausal gonadotropins (hMG). Clomiphene citrate (CC) and gonadotropin releasing hormone analogues (GnRHa), when administered during the luteal phase, attenuate the hyperprolactinemic response to hMG. We asked whether follicular-phase administration of CC and GnRHa, as employed clinically in women undergoing ovarian stimulation for in vitro fertilization or gamete intrafallopian transfer, would alter the incidence and severity of hMG-induced luteal-phase hyperprolactinemia. Seventy-five percent of all patients had at least one luteal prolactin level greater than 25 ng/ml, and 40% had mean luteal-phase prolactin levels greater than 25 ng/ml. The incidence of hyperprolactinemia was similar in pregnant and nonpregnant cycles. The incidence of hyperprolactinemia was similar for both the GnRH agonist-treated group and those given clomiphene citrate. The increase in mean luteal prolactin levels over the follicular-phase baseline level was significantly greater in the CC-treated group (P = 0.03). This was due to the significant suppression of follicular-phase baseline prolactin levels in patients receiving CC. We conclude that neither CC nor GnRHa administration in the follicular phase prevents luteal-phase hyperprolactinemia in women undergoing ovarian stimulation with hMG. PMID- 1770271 TI - Atypical response to luteinizing hormone-releasing hormone (LH-RH) agonist (suprefact nasal) in induction of ovulation in in vitro fertilization (IVF). AB - Animal and human research has indicated the presence of receptors to luteinizing hormone-releasing hormone (LH-RH) in the ovaries. However, the role of these receptors is not yet clear. Forty-five patients were treated with Suprefact (D Serg-Des-Gly10-GnRGH), starting in the midluteal phase of a nonstimulatory menstrual cycle. The Suprefact (300 micrograms t.i.d.) was administered as a nasal spray until the administration of human chorionic gonadotropin (hCG). On the third to fifth day of the following menstrual cycle, the patients were treated with a high dose of human menopausal gonadotropin (hMG). hCG was administered when at least two follicles reached a mean diameter of 18 mm. Five of these patients who ovulated spontaneously and had normal menstrual cycles did not respond to the stimulation with hMG. Treatment was stopped after 12 days of hMG administration. During the following cycle of the five patients, levels of gonadotropins were found to be in the normal range, and all of them responded as expected to hMG administered for 3 days only (hMG test). These findings suggest that LH-RH agonist may interfere with ovarian steroidogenesis. PMID- 1770272 TI - Influence of the morphological aspect of embryos obtained by in vitro fertilization on their implantation rate. AB - In a series of 500 transfers of embryos obtained by in vitro fertilization, we examined the implantation rate of 1356 embryos transferred in utero. The average implantation rate per embryo was 15.1% and remained relatively constant, regardless of the number of transferred embryos per patient. The implantation rate per embryo, in relation to its morphology, was clearly lower when irregular blastomeres and fragments were present in the perivitelline area. Other embryos, regardless of their morphology, had an identical development potential. Analysis of the results of this series demonstrates the difficulty of determining the development potential of all the embryos on the basis of morphological criteria. PMID- 1770273 TI - Emotional experiences of in vitro fertilization participants. AB - Data were collected from self-administered questionnaires returned by 33 female participants and 18 of their partners in the University of British Columbia's in Vitro Fertilization/Gamete Intrafallopian Transfer (IVF/GIFT) Program during a 2 month period. Emotional reactions to each of the stages of IVF/GIFT by treatment phase were measured. Responses were then grouped into the following categories: anxiety, depression, loss of control, and positive feelings. For female participants, anxiety was reported most frequently throughout the treatment process and loss of control was highest following embryo replacement. Male and female participants reported high rates of depression at the completion of the treatment cycle. The findings from this pilot study outline the emotional experiences of male and female participants undergoing IVF/GIFT by treatment phase and indicate their desire for support services. PMID- 1770274 TI - Hysteroscopy in a program of in vitro fertilization. AB - Two hundred twenty-four women underwent hysteroscopic evaluation without anesthesia after at least two failed attempts of in vitro fertilization and embryo transfer. One hundred fifty-three (68%) women were diagnosed as having mechanical infertility, and abnormal hysteroscopic findings were observed in 32 (21%). Forty-one women were diagnosed as having unexplained infertility (18%) and six (15%) had abnormal findings with hysteroscopy. Of the 30 couples who entered the in vitro fertilization regimen program because of male infertility, 4 (13%) had abnormal findings. The overall rate of abnormal findings was 19%; cervical canal and intrauterine abnormalities were found in 10 and 32 patients, respectively. Ten patients were treated during hysteroscopic evaluation procedure, and four patients subsequently underwent operative hysteroscopy under general anesthesia. We suggest that diagnostic hysteroscopy should be a routine procedure before in vitro fertilization and embryo transfer therapy. PMID- 1770275 TI - A randomized prospective study on the effect of short and long buserelin treatment in women with repeated unsuccessful in vitro fertilization (IVF) cycles due to inadequate ovarian response. AB - Fifty four women with repeated unsuccessful in vitro fertilization (IVF) cycles due to inadequate ovarian response to stimulation with human menopausal gonadotropins (hMG) participated in this study. They were randomized to receive either gonadotropin releasing hormone agonist (GNRHa), Buserelin, prior to and during induction of ovulation by hMG (Group I--long protocol), or GnRHa starting on the first day of the cycle together with induction of ovulation by hMG (Group II--short protocol). Mean follicular phase serum luteinizing hormone (LH) and progesterone (P) levels were significantly lower in Group I than in Group II (P less than 0.01). Cancellation rate was significantly lower in Group I than in Group II (P less than 0.01). The long GNRHa protocol resulted in statistically significant lower cancellation rates, more oocytes per pickup (OPU), more embryos transferred per patient, and a higher pregnancy rate. Significantly more hMG ampoules and more treatments days were required in the long GNRHa protocol. Our data demonstrate that the use of GNRHa prior to and during ovarian stimulation with hMG offers a very good alternative for patients with repetitive unsuccessful IVF cycles due to inadequate response. PMID- 1770276 TI - Efficiency and cost effectiveness of three protocols for gamete transfer. PMID- 1770277 TI - The combined use of vibrostimulation and in vitro fertilization: successful pregnancy outcome from a retrograde specimen obtained from a spinal cord-injured male. AB - While pregnancies have been documented through the independent use of the vibrator method, from other methods of procuring ejaculate from spinal cord injured men, and from artificial insemination using a retrograde specimen, we believe that this is the first case report of a live birth resulting from a retrograde ejaculate obtained by vibration from a spinal cord-injured male whose partner underwent in vitro fertilization. Vibrostimulation may well be successful in the two-thirds of men whose spinal cord lesions are at the T10 neurological level and above, who have an intact bulbocavernosus reflex and anal tone but no pain or temperature sensation of the genitalia. Blood pressure monitoring, prevention of autonomic dysreflexia, alkalinization, dilution and infection control of urine, and retrograde specimen retrieval are all important techniques to ensure patient safety and optimal ejaculates. The timing of ovulation and insemination is the crucial factor for the partner of a SCI male whose sperm quality is poor. A complete gynecological workup, including studies of tubal patency, should be done before embarking on a series of artificial inseminations. Stimulation of ovulation and well-timed inseminations should optimize the chance of conception. Depending on semen analysis, female partner factors, and emotional and financial costs, IVF can appropriately be either an early or a final option. PMID- 1770278 TI - Water-escape time in adult mice derived from manipulated preimplantation embryos. PMID- 1770279 TI - Experience with intravaginal culture for in vitro fertilization (IVF). AB - It has been reported that intravaginal culture (IVC) yields results comparable to those obtained with classic IVF techniques; furthermore, it can simplify and reduce the costs of the procedure. In our experience with IVC however, only 8 of 78 mature oocytes inseminated (10.2%) fertilized. Possible causes of this low fertilization rate were analyzed. In our opinion this new and attractive technique needs further evaluation before being extended to common clinical practice. PMID- 1770280 TI - First birth in a new transport in vitro fertilization program. PMID- 1770281 TI - Anastomotic leaks in colorectal cancer surgery: a risk factor for recurrence? AB - This study examines anastomotic leaks as a potential influence on the long term outcome of patients with colorectal cancer. 167 patients were studied who had clinical and radiological assessment of anastomotic integrity in the post operative period, following potentially curative resections for left-sided colonic or rectal cancer. There was no evidence of a leak in 135 of these patients, while the remaining 32 developed a clinical and/or a radiological leak. At the end of a mean follow-up of 25 months, 15 patients with leaks (46.9%) developed tumour recurrence, compared with 25 of those without any leak (18.5%; p less than 0.001). Cancer specific mortality at 24 months was also significantly higher for patients with leaks (36.9% +/- 9.7% versus 12.6% +/- 3.3%; p less than 0.001). The influence of anastomotic leaks on the outcome was independent of tumour stage. These results suggest that in patients undergoing surgery for colorectal cancer development of an anastomotic leak is significantly associated with a poorer long-term outcome. PMID- 1770282 TI - Colorectal carcinoma over 30 years at one hospital: no evidence for a shift to the right. AB - Many recent reports in the North American literature have documented an increase in the ratio of proximal to distal colorectal cancers with an increase in right sided lesions. In order to assess trends in the distribution of large bowel carcinoma at our hospital we reviewed the files of 1553 patients who presented with primary colorectal carcinoma over a 30-year period. Thirty-nine percent of patients were over 70 years old and 51% were in the 50-69 year age group. Seventy five percent of the carcinomas were left-sided, 22% right-sided and caecal carcinomas accounted for 18%. This distribution varied only slightly over the study period. Left-sided lesions were more common in males (55%: p less than 0.005), and right-sided lesions were more common in females (57%: p less than 0.005). Caecal carcinoma was more common in patients over 69 years old than in younger patients (p less than 0.001). In elderly females (greater than 69 years) 30% of colorectal carcinomas occurred in the caecum. These findings may have important implications for the investigation of patients with suspected colorectal disease or for screening programmes. PMID- 1770283 TI - Disposable torch-lit anoscope. AB - A disposable torch-lit anoscope is described. Its bevelled end facilitates therapeutic procedures, while the fact that it does not need an external light source makes its use on the ward or in the patient's home more straight-forward. PMID- 1770284 TI - Early water-soluble contrast enema in the diagnosis of acute colonic diverticulitis. AB - Acute colonic diverticulitis is usually suspected by typical clinical findings supported by laboratory tests. Investigations of the colon are usually delayed 1 to 2 months until the acute situation is resolved. We studied 53 patients with an initial clinical diagnosis of acute diverticulitis by performing early water soluble contrast enema of the colon. The initial diagnosis proved to be uncertain, as 26 patients (49%) had acute colonic diverticulitis as their final diagnosis. There were ten patients who had diverticulosis of the colon, but without radiologic signs of acute diverticulitis. Four of these patients had some other disease responsible for their symptoms. Thirteen patients had normal findings at early water-soluble contrast enema. Three colonic carcinomas and one ischaemic colitis were diagnosed. There were no complications related to the radiologic studies. We conclude that early water-soluble contrast edema of the left colon is safe and useful in investigating patients with suspected acute colonic diverticulitis. If the finding is normal, investigations can be directed elsewhere without undue delay. PMID- 1770285 TI - Improved perineal wound healing with the omental pedicle graft after rectal excision. AB - The aim of this study was to determine whether significant improvement in perineal wound healing could be achieved by placing parts of greater omentum into the sacral cavity after rectal excision. 74 patients were evaluated, in 38, parts of the greater omentum were mobilised into the presacral cavity. The omentum flap increased primary healing from 41% to 61%. Sinus formation was reduced. Since using routine omentoplasty all wounds have healed by five months. Complications occurred only twice. In one patient the omentum became partially necrotic, while in another small bowel obstruction occurred due to herniation beneath the root of the flap. We conclude from our results that omentoplasty after rectal excision is a useful method to improve perineal wound healing and should be performed as routine procedure. PMID- 1770286 TI - Endoluminal prosthesis in protecting high-risk colonic anastomosis: an experimental study. AB - An experimental study was carried out to evaluate the protective role of an endoluminal prosthesis on high risk colo-colonic anastomoses. One hundred and fifty rats were divided into two groups: Group E with endoluminal latex prosthesis and Group C without. Bursting pressure and collagen concentration in the perianastomotic tissue were tested, respectively, on the 4th, 7th and 12th, and 4th, 7th, 12th, 18th and 38th postoperative days. Bursting pressure was significantly higher in Group E on the 4th postoperative day. There was no significant difference in the anastomotic collagen concentration between the two groups. The presence of the prosthesis did not produce any macroscopic or microscopic evidence of impaired healing or stricture at the suture line. Death due to anastomotic dehiscence occurred in 11/75 (15%) in Group C and in 1/75 (1.3%) in Group E (p less than 0.01). Endoluminal prosthesis appears to have a protective effect on anastomotic healing. The mechanism is probably due to mechanical protection and not to differences in collegen concentration. PMID- 1770287 TI - Biofeedback defaecation training for anismus. AB - Anismus, paradoxical external sphincter function, spastic pelvic floor syndrome, rectoanal dysnergia, abdomino-levator incoordination for abdominopelvic asychronism, are all due to paradoxical contraction of the striated sphincter apparatus during voiding and is characterised by prolonged and excessive straining at stool. Biofeedback is the treatment of choice and has to be introduced at an early stage. We present the results of an ambulatory approach based on the integration of simulated balloon defaecation with small (50 ml) as well as constant rectal sensation volume, defaecometry and anal manometry. The pathophysiology visualised by the patient's own anorectal pressure recordings on the screen of a personal computer is explained and corrected. Sixteen patients were treated and followed for at least 1 year. Manometric data were normal except for an increased minimum residual pressure and rectal compliance. Nine patients could not evacuate a 50 ml bolus initially. Simulated defaecation became possible in seven out of these nine patients when the bolus was increased up to the individual constant rectal sensation volume. Two patients could not evacuate this volume either, while defaecation was made much less laborious in the other seven patients. Paradoxical contraction was immediately corrected in 7/16 cases. Also, as an immediate, objective benefit of a single training session, improved defaecation of a 50 ml bolus was observed in 11 patients. This effect was preserved after 6 weeks in nine cases; symptomatic recurrence did not occur in these patients during follow-up. This method of defaecation training has many advantages as compared with sphincter training using EMG electrodes eventually performed in the absence of a desire to defaecate or in lying position.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770288 TI - Lactulose hydrogen and [14C]xylose breath tests in patients with ileoanal anastomosis. AB - To study the intestinal bacterial flora and mouth to pouch transit time after ileoanal anastomosis, lactulose hydrogen and [14C]xylose breath tests were performed on 19 patients with ileoanal anastomosis and J-pouch and 8 patients with conventional ileostomy. Evaluated by the [14C]xylose breath test, patients with ileoanal anastomosis and ileal pouch showed no difference in the bacterial flora of the proximal small bowel when compared with ileostomy patients. The lactulose hydrogen breath test showed a significant rise in breath hydrogen, indicating bacterial overgrowth, in 68% of patients with ileoanal anastomosis but in none with conventional ileostomy (p less than 0.01). It was concluded that this peak in breath hydrogen was produced by the bacteria in the pouch. Thus the lactulose hydrogen breath test can be used to measure mouth to pouch transit time in 2/3 of patients with ileoanal anastomosis. Mouth to pouch transit time was 63 +/- 9 min and it correlated inversely with stool frequency (p less than 0.05). PMID- 1770289 TI - Acute anal pain due to ingested bone. AB - Six cases of acute and anal pain due to impaction of ingested bone in the anal canal are reported. The clinical presentation mimicks common causes of acute anal pain such as perianal abscesses, fissures or thrombosed haemorrhoids. The diagnosis is readily made on simple digital rectal examination. Early removal of the bone results in immediate pain relief, whilst delayed diagnosis may result in deeper penetration of the bone and abscess formation. PMID- 1770290 TI - Strictureplasty for ileo-colic anastomotic strictures in Crohn's disease. AB - We report an audit of outcome on 24 patients (16 females) who had a strictureplasty to treat ileo-colic anastomotic strictures. All except one patient had their original resection for Crohn's disease, and required reoperation because of symptoms of recurrent intestinal obstruction for a mean 9.3 months (range 1-36); the remaining patient was discovered to have ileo-colic anastomotic stricture before he underwent laparotomy for closure of loop ileostomy. At operation, four patients needed additional small bowel strictureplasties, two of whom also underwent small bowel resection for separate areas of phlegmonous disease. There was no post-operative mortality, three patients developed wound infection and one had a pelvic abscess, which settled on antibiotic therapy. Two patients have since died of unrelated disease. Five patients have since needed reoperation for recurrence; only one had a stricture at the site of previous strictureplasty. Over a mean follow-up of 70.8 months (range 18-393) all 22 living patients now have complete relief of symptoms. PMID- 1770291 TI - Diathermy haemorrhoidectomy. PMID- 1770292 TI - Hyperlipoproteinemia in Nagase analbuminemic rats: effects of pravastatin on plasma (apo)lipoproteins and lecithin:cholesterol acyltransferase activity. AB - The present study demonstrates very high levels of plasma lipids and high density lipoprotein (HDL) apolipoproteins (apoA-I and apoE) in female Nagase analbuminemic rats (NAR) fed a semi-synthetic diet in order to further increase the hyperlipidemia present in this strain. Plasma apoB-containing lipoproteins (very low, intermediate, and low density lipoproteins) were also elevated in NAR. Plasma cholesterol was mainly present in lipoprotein particles with a density between 1.02 and 1.12 g/ml. Separation of lipoprotein classes by gel filtration showed that the major cholesterol-carrying lipoprotein fractions in NAR plasma are apoE-rich HDL and apoA-I-rich HDL. The high HDL levels in NAR are explained, at least partly, by the two- to threefold elevated activity of plasma lecithin:cholesterol acyltransferase (LCAT). The lysophosphatidylcholine generated in the LCAT reaction, as well as plasma free fatty acids, are bound to lipoproteins in NAR plasma. A study was carried out to determine whether the elevated LDL and aopoE-rich HDL levels could be corrected by administration of the HMG-CoA reductase inhibitor pravastatin (at a dose of 1 mg/kg per day). Pravastatin treatment results in a 43% decrease in plasma triglycerides in NAR, but not in Sprague-Dawley (SDR) rats, and had no significant effect on plasma total cholesterol, phospholipids apolipoproteins A-I, A-IV, B, or E, as well as on plasma LCAT activity levels in NAR or SDR. PMID- 1770293 TI - Chemical synthesis and hepatic biotransformation of 3 alpha,7 alpha-dihydroxy-7 beta-methyl-24-nor-5 beta-cholan-23-oic acid, a 7-methyl derivative of norchenodeoxycholic acid: studies in the hamster. AB - A new bile acid analogue, 3 alpha,7 alpha-dihydroxy-7 beta-methyl-24-nor-5 beta cholan-23-oic acid (7-Me-norCDCA) was synthesized from the methyl ester of norursodeoxycholic acid, and its hepatic biotransformation was defined in the hamster. To synthesize 7-Me-norCDCA, the 3 alpha-hydroxyl group of methyl norursodeoxycholate was protected as the hemisuccinate, and the 7 beta-hydroxyl group was oxidized with CrO3 to form the 7-ketone. A Grigard reaction with methyl magnesium iodide followed by alkaline hydrolysis gave 7-Me-norCDCA (greater than 70% yield). The structure of the new compound was confirmed by proton magnetic resonance and mass spectrometry. After intraduodenal administration of the 14C labeled compound into the anesthetized biliary fistula hamster, it was rapidly and efficiently secreted into the bile; 80% of radioactivity was recovered in 2 h. After intravenous infusion, the compound was efficiently extracted by the liver and secreted into the bile (greater than 75% in 3 h). Most (93%) of the biliary radioactivity was present in biotransformation products. The major biotransformation product (48.7 +/- 6.0%) was a new compound, assigned the structure of 3 alpha,5 beta,7 alpha- trihydroxy-7 beta-methyl-24-nor-5 beta cholan-23-oic acid (5 beta-hydroxy-7- Me-norCDCA). In addition, conjugates of 7 Me-norCDCA with taurine (13.7 +/- 5.0%), sulfate (10.3 +/- 3.0%), or glucuronide (5.1 +/- 1.7%) were formed. 7-Me-norCDCA was strongly choleretic in the hamster; during its intravenous infusion, bile flow increased 2 to 3 times above the basal level, and the calculated choleretic activity of the compound (and its metabolic products) was much greater than that of many natural bile acids, indicating that the compound induced hypercholeresis. It is concluded that the biotransformation and physiological properties of 7-Me-norCDCA closely resemble those of norCDCA. Based on previous studies, the major biological effect of the 7-methyl group in 7 Me-norCDCA is to prevent its bacterial 7-dehydroxylation in the distal intestine. PMID- 1770294 TI - Discrete subspecies of human low density lipoproteins are heterogeneous in their interaction with the cellular LDL receptor. AB - The low density lipoproteins (LDL) of human plasma consist of a series of discrete particle subspecies of distinct physicochemical, immunological, and hydrodynamic properties. Such structural differences are intimately linked to the metabolic heterogeneity of circulating LDL in vivo. The current studies were designed to evaluate and compare the interaction of discrete LDL subspecies from normolipidemic subjects with the LDL receptor. Plasma LDL of d 1.019-1.063 g/ml from healthy males were fractionated into 15 subspecies of defined physicochemical characteristics by isopycnic density gradient ultracentrifugation as described earlier (Chapman et al., J. Lipid Res. 1988. 29: 442-458). The major LDL subspecies, LDL-5 to LDL-10, exhibited an overall range in density from 1.0244 to 1.0435 g/ml; individual subspecies increased in density by increments of 0.027 (LDL-5), 0.026 (LDL-6), 0.030 (LDL-7), 0.031 (LDL-8), 0.035 (LDL-9), and 0.042 g/ml (LDL-10), respectively. Taken together, these subspecies accounted for approximately 70% of the total mass of LDL of d 1.019-1.063 g/ml; their cholesterol: protein ratios decreased from 1.70 to 1.12 and particle size from 275 to 260 A with increase in density. ApoB-100 was the unique protein component in subspecies 5-8, with trace amounts (less than 0.2% of apoLDL) of both apoA-I and apoE in subspecies 9 and 10. The interaction of individual LDL subspecies with the LDL receptor on cultured human U-937 monocyte-like cells was compared by determining receptor binding affinities at 4 degrees C. Scatchard analysis of specific binding curves demonstrated a single class of binding site for each subspecies. The lowest dissociation constants were displayed by LDL subspecies 6 (Kd 5.71 nM), 7 (Kd 5.24 nM) and 8 (Kd 4.67 nM), while subspecies 5, 9, and 10 displayed significantly higher Kd values (8.35, 7.20, and 6.87 nM, respectively). Competitive displacement studies at 4 degrees C, in which unlabeled subspecies from the same gradient series competed for binding with 125I-labeled LDL subspecies, confirmed the relative binding affinities of these subspecies. As the hydrophobic lipid core of LDL undergoes a thermotropic transition at approximately 37 degrees C, which may in turn influence the surface structure of the particle, internalization and degradation studies were performed at 37 degrees C. No effect of temperature was detectable; again, LDL subspecies at each extreme of the density distribution (LDL-5 and LDL-10) displayed significantly lower binding affinities for the LDL receptor than that from the peak region (LDL 7).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1770295 TI - Fluorescent derivatives of bile salts. I. Synthesis and properties of NBD-amino derivatives of bile salts. AB - In order to visualize bile salt transport, fluorescent bile salt derivatives were synthesized by introduction of the relatively small fluorescent 4-nitrobenzo-2 oxa-1,3-diazol (NBD)-amino group in either the 3-, 7-, or 12-position of the steroid structure, thus providing a complete set of diastereomeric derivatives, 3 alpha-NBD-amino-7 alpha,12 alpha-dihydroxy-5 beta-cholan-24-oic acid, 3 beta-NBD amino-7 alpha,12 alpha-dihydroxy-5 beta-cholan-24-oic acid, 7 alpha-NBD-amino-3 alpha,12 alpha-dihydroxy-5 beta-cholan-24-oic acid, 7 beta-NBD-amino-3 alpha,12 alpha-dihydroxy-5 beta-cholan-24-oic acid, 12 alpha-NBD-amino-3 alpha,7 alpha dihydroxy-5 beta-cholan-24-oic acid, 12 beta-NBD-amino-3 alpha,7 alpha-dihydroxy 5 beta-cholan-24-oic acid, as well as their taurine conjugates. Their optical properties with absorption maxima at about 490 nm and emission maxima at 550 nm make them suitable for fluorescent microscopic studies. Fluorescence of the NBD derivatives is strongly dependent on polarity of the solvent, on the concentration of the bile salt derivatives, and only slightly on temperature. PMID- 1770296 TI - Fluorescent derivatives of bile salts. II. Suitability of NBD-amino derivatives of bile salts for the study of biological transport. AB - Interaction of unconjugated and taurine-conjugated NBD-amino-dihydroxy-5 beta cholan-24-oic acids bearing the fluorophor in the 3 alpha, 3 beta, 7 alpha, 7 beta, 12 alpha, or 12 beta position with albumin results in a small hypsochromic shift of the emission maximum and an increase in quantum yield, suggesting binding by hydrophobic interactions. The different unconjugated fluorescent bile salt derivatives are metabolized by intact rat liver in different ways. The unconjugated 3 beta-NBD-amino derivative is completely transformed to its taurine conjugate and secreted as such, whereas the 3 alpha-NBD-amino derivative is completely transformed to a polar fluorescent compound not identical with its taurine conjugate. The unconjugated 7 alpha- and 7 beta-NBD-amino derivatives are only partially conjugated with taurine and mainly secreted in unmetabolized form. The unconjugated 12 alpha- and 12 beta-NBD-amino derivatives are not at all transformed to their taurine conjugates, but are partially metabolized to unidentified compounds. They are predominantly secreted as the unmetabolized compounds. In contrast to the unconjugated derivatives, all taurine-conjugated fluorescent bile salt derivatives are secreted into bile unmetabolized. With the exception of the 3 alpha-compound, all synthesized taurine-conjugated fluorescent derivatives interfere with the secretion of cholyltaurine. Differential photoaffinity labeling studies using (7,7-azo-3 alpha,12 alpha- dihydroxy-5 beta cholan-24-oyl)-2'-[2'-3H(N)]aminoethanesulfonate as a photolabile derivative revealed that in liver cells all fluorescent bile salt derivatives interact with the same polypeptides as the physiological bile salts. The hepatobiliary transport of taurine-conjugated NBD-amino bile salt derivatives is, due to hydrophobic interactions, accompanied by an increase in fluorescence intensity which is favorable for the study of biological bile salt transport by fluorescence microscopy. PMID- 1770297 TI - Lipophorin structure analyzed by in vitro treatment with lipases. AB - Adult Manduca sexta high density lipophorin (HDLp-A) is composed of three apolipoproteins (apoLp-I, -II, and -III) and 52% lipid. The flight-specific low density lipophorin (LDLp) contains 62% lipid and is associated with several additional molecules of apoLp-III. The amount of phospholipid remains constant in lipophorin (140 mol/mol of lipophorin), while the diacylglycerol content varies between different lipophorin species (310 mol/mol HDLp up to 1160 mol/mol LDLp). Both lipophorin particles were enzymatically depleted of phospholipid or diacylglycerol by in vitro incubation with either phospholipase A2 or triacylglycerol lipase. Albumin was used to remove free fatty acids generated during the reaction. Treatment with phospholipase A2 removed all phospholipids (except sphingomyelin) and the resulting particles were stable. Triacylglycerol lipase hydrolyzed large fractions of diacylglycerol. The resulting particles were smaller in size, higher in density, and devoid of apoLp-III. The particles retained apoLp-I and -II and the other lipid components, including a substantial amount of diacylglycerol. Structural integrity of diacylglycerol-depleted lipophorin was confirmed by electron microscopical analysis. When treated with both phospholipase A2 and triacylglycerol lipase, lipophorin precipitated. From these results we conclude that: 1) all phospholipid and apoLp-III are located at the surface of lipophorin, whereas diacylglycerol is partitioned between the sublayers and the surface of the particle; 2) both diacylglycerol and phospholipid play a role in stabilizing lipophorin in the aqueous medium; and 3) lipophorin can be extensively unloaded and still retain its basic structure, a necessary feature for its function as a reusable lipid shuttle. PMID- 1770298 TI - In vivo and in vitro loading of lipid by artificially lipid-depleted lipophorins: evidence for the role of lipophorin as a reusable lipid shuttle. AB - Lipid transport in the hemolymph of Manduca sexta is facilitated by a high density lipophorin in the resting adult insect (HDLp-A, d approximately 1.109 g/ml) and by a low density lipophorin during flight (LDLp, d approximately 1.060 g/ml). Lipophorin presumably shuttles different lipids between sites of uptake or storage, and sites of utilization. In order to shuttle lipid, a lipid-depleted lipophorin should be able to reload with lipid. To test this hypothesis, we used HDLp-A particles that were artificially depleted of either phospholipid (d approximately 1.118 g/ml) or diacylglycerol (d approximately 1.187 g/ml) and subsequently radiolabeled in their protein moiety. Upon injection into adult moths, both particles shifted their density to that of native HDLp-A, indicating lipid loading. Also, upon subsequent injection of adipokinetic hormone, both particles shifted to a lower density (d approximately 1.060 g/ml) indicating diacylglycerol loading and conversion to LDLp. Both phospholipid and diacylglycerol loading were also studied using an in vitro system. The lipid depleted particles were incubated with fat body that had been radiolabeled in either the phospholipid or the triacylglycerol fraction. Transfer of radiolabeled phospholipid and diacylglycerol from fat body to lipophorin was observed. During diacylglycerol loading, apoLp-III associated with lipophorin, whereas phospholipid loading occurred in the absence of apoLp-III. The results show the ability of lipid-depleted lipophorins to reload with lipid and therefore reaffirm the role of lipophorin as a reusable lipid shuttle. PMID- 1770299 TI - Production of platelet-activating factor in slugs. AB - The land slug, Incilaria bilineata, was shown to contain a large amount of 1-O alkyl-2-acyl (long chain)-sn-glycero-3-phosphocholine, which accounts for as much as 47% of the choline glycerophospholipid fraction. Since this unique either phospholipid has been regarded as a stored precursor form of platelet-activating factor (PAF) in mammalian inflammatory cells, we examined the possibility of the presence of PAF in this animal. We obtained the evidence for the occurrence of significant amounts of PAF in two species of slugs, Incilaria bilineta and Incilaria fruhstorferi. Gas chromatography-mass spectrometry analysis revealed that the alkyl fatty chain of PAF principally consists of 16:0. We confirmed the presence of both enzyme activities catalyzing the formation of PAF, one for the remodeling pathway and the other for the de novo pathway. We also found the occurrence of other enzyme activities involved in PAF metabolism: acetylhydrolase activity which inactivates PAF and phospholipase A2 activity toward alkylacylglycerophosphocholine. However, we failed to detect cofactor-independent transacylation activity in this animal. The amounts of PAF in slugs were markedly increased when slugs were administered several treatments which are considered to induce shock, such as the injection of dimethyl sulfoxide or injuries. These results suggest that PAF is produced and may have certain physiological and pathological roles in the land slug, as in the case of mammals. PMID- 1770300 TI - Rat apolipoprotein C-II lacks the conserved site for proteolytic cleavage of the pro-form. AB - Apolipoprotein C-II (apoC-II) plays a critical role in the metabolism of plasma lipoproteins as an activator for lipoprotein lipase. Human apoC-II consists of 79 amino acid residues (pro-apoC-II). A minor fraction is converted to a mature form by cleavage at the site QQDE releasing the 6 amino-terminal residues. We have cloned and sequenced the cDNA for rat apoC-II from a liver cDNA library using human apoC-II cDNA as a probe. The cDNA encodes a protein of 97 amino acid residues including a signal peptide of 22 amino acid residues. There is approximately 60% similarity between the deduced amino acid sequence of rat apoC II and other apoC-II sequences presently known (human, monkey, dog, cow, and guinea pig). Compared to these, rat apoC-II is one residue shorter at the carboxyl terminus. Furthermore, there is a deletion of 3 amino acid residues (PQQ) in the highly conserved cleavage site where processing from pro- to mature apoC-II occurs in other species. Accordingly, rat apoC-II isolated from plasma was mainly in the pro-form. Northern blot analyses indicated that rat apoC-II is expressed both in liver and in small intestine. PMID- 1770301 TI - Regulation of gene expression and synthesis and degradation of 3-hydroxy-3 methylglutaryl coenzyme A reductase by micellar cholesterolin CaCo-2 cells. AB - To investigate whether, and by what mechanisms, luminal (dietary) cholesterol regulates cholesterol synthesis in human intestinal cells, HMG-CoA reductase activity, gene expression, synthesis, and degradation were investigated in CaCo-2 cells exposed to taurocholate micelles containing cholesterol. In cells incubated with cholesterol solubilized in 5 mM taurocholate and 30 microM monoolein, HMG CoA reductase activity was decreased. 25-Hydroxycholesterol, delivered to the cells in the same manner as native cholesterol, was significantly more potent in inhibiting reductase activity and was used, therefore, to investigate mechanisms for sterol regulation. Cells incubated with taurocholate micelles without cholesterol lost cellular cholesterol into the medium causing an increase in HMG CoA reductase activity and enzyme mass. Although steady-state levels of HMG-CoA reductase mRNA were increased under conditions of cholesterol efflux, synthesis rates of reductase protein were not increased. An increase in activity and enzyme mass in cells incubated with micelles alone, however, was accompanied by a significant decrease in the rate of degradation of reductase protein. In contrast, sterol influx from taurocholate micelles was associated with a marked decrease in HMG-CoA reductase activity and mass without altering mRNA levels except at high concentrations of the polar sterol which did decrease reductase mRNA levels by 50%. The absorption of apical sterol resulted in a significant decrease in the translational efficiency of reductase mRNA and a modest increase in the rate of degradation of the enzyme. Thus, although the primary function of the enterocyte is to transport luminal (dietary) cholesterol to other tissues of the body, apically derived cholesterol enters metabolic pools within the cell which regulates its own cholesterol synthesis. Dietary cholesterol, therefore, will regulate the contribution to the total body cholesterol pool of endogenously derived cholesterol from the intestine. The mechanism for this regulation of intestinal HMG-CoA reductase by luminal cholesterol occurs primarily at the post transcriptional level. PMID- 1770302 TI - Metabolic pathways of apolipoprotein B in heterozygous familial hypercholesterolemia: studies with a [3H]leucine tracer. AB - The kinetics of apolipoprotein B (apoB) were measured in seven studies in heterozygous, familial hypercholesterolemic subjects (FH) and in five studies in normal subjects, using in vivo tracer kinetic methodology with a [3H]leucine tracer. Very low density (VLDL) and low density lipoproteins (LDL) were isolated ultracentrifugally and LDL was fractionated into high and low molecular weight subspecies. ApoB was isolated, its specific radioactivity was measured, and the kinetic data were analyzed by compartmental modeling using the SAAM computer program. The pathways of apoB metabolism differ in FH and normal subjects in two major respects. Normals secrete greater than 90% of apoB as VLDL, while one-third of apoB is secreted as intermediate density lipoprotein IDL/LDL in FH. Normals lose 40-50% of apoB from plasma as VLDL/IDL, while FH subjects lose none, metabolizing all of apoB to LDL. In FH, there is also the known prolongation of LDL residence time. The leucine tracer, biosynthetically incorporated into plasma apoB, permits distinguishing the separate pathways by which the metabolism of apoB is channeled. ApoB synthesis and secretion require 1.3 h. ApoB is secreted by three routes: 1) as large VLDL where it is metabolized by a delipidation chain; 2) as a rapidly metabolized VLDL fraction converted to LDL; and 3) as IDL or LDL. ApoB is metabolized along two pathways. The delipidation chain processes large VLDL to small VLDL, IDL, and LDL. The IDL pathway channels nascent, rapidly metabolized VLDL and IDL particles into LDL. It thus provides a fast pathway for the entrance of apoB tracer into LDL, while the delipidation pathway is a slower route for channeling apoB through VLDL into LDL. LDL apoB is derived in almost equal amounts from both pathways, which feed predominantly into large LDL. Small LDL is a product of large LDL, and the major loss of LDL-apoB is from small LDL. Two features of apoB metabolism in FH, the major secretory pathway through IDL and the absence of a catabolic loss of apoB from VLDL/IDL, greatly facilitate measuring the metabolic channeling of apoB into LDL. PMID- 1770303 TI - Nutritional regulation of cholesterol synthesis and apolipoprotein B kinetics: studies in patients with familial hypercholesterolemia and normal subjects treated with a high carbohydrate, low fat diet. AB - High carbohydrate, low fat diets decrease plasma low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apoB) mass in normal subjects and in patients with familial hypercholesterolemia (FH). To investigate the mechanisms for these effects, four normal, four FH heterozygous, and one FH homozygous subjects were studied on a basal (45% carbohydrate, 40% fat) diet and during continuous nasogastric infusion of Vivonex (90% carbohydrate, 1% fat). For the entire group, the mean changes in total cholesterol, LDL-C, high-density lipoprotein cholesterol (HDL-C) and triglycerides were -90, -95, -14 (all P less than 0.01) and +114 (P less than 0.02) mg/dl, respectively. Fecal sterol balance measurements demonstrated a 24% decrease in whole body cholesterol synthesis in normals, from 8.4 +/- 4.4 (mean +/- SD) to 6.4 +/- 1.3 mg/kg per day and in FH subjects, a 58% decrease, from 11.4 +/- 5.6 to 4.8 +/- 1.7 mg/kg per day (both P less than 0.05). ApoB kinetic studies were performed using a [3H]leucine tracer in two normals and three FH heterozygotes on both basal and Vivonex regimens, and the results were analyzed by compartmental modeling using the SAAM program. Total apoB production was not altered in a consistent manner by carbohydrate feeding. ApoB secretion, however, was shifted from the production of small VLDL/IDL-like particles to large VLDL by Vivonex, with an accompanying increase in intrahepatic assemblage time before secretion. In the two normal subjects, Vivonex induced an increase in apoB loss as VLDL/IDL; however, in the FH patients no such loss occurred. A decrease (P less than 0.05) in the residence time of LDL-apoB occurred for all subjects and was the primary determinant of the fall in plasma LDL concentration, since LDL-apoB transport did not change consistently. Thus, in FH patients, a high carbohydrate, low fat diet results in suppression of cholesterol synthesis and a fall in plasma LDL concentration due to an increased plasma clearance rate for LDL. PMID- 1770304 TI - In vivo metabolism of apolipoprotein A-I on high density lipoprotein particles LpA-I and LpA-I,A-II. AB - Apolipoprotein (apo) A-I is the major protein in high density lipoproteins (HDL) and is found in two major subclasses of lipoproteins, those containing apolipoprotein A-II (termed LpA-I,A-II) and those without apoA-II (termed LpA-I). The in vivo kinetics of apoA-I on LpA-I and LpA-I,A-II were investigated in normolipidemic human subjects. In the first series of studies, radiolabeled apoA I and apoA-II were reassociated with autologous plasma lipoproteins and injected into normal subjects. LpA-I and LpA-I,A-II were isolated from plasma at selected time points by immunoaffinity chromatography. By 24 h after injection, only 52.8 +/- 1.0% of the apoA-I in LpA-I remained, whereas 66.9 +/- 2.7% of apoA-I in LpA I,A-II remained (P less than 0.01). In the second series of studies, purified apoA-I was labeled with either 131I or 125I and reassociated with autologous plasma. Isolated LpA-I and LpA-I,A-II particles differentially labeled with 131I labeled apoA-I and 125I-labeled apoA-I, respectively, were simultaneously injected into study subjects. The plasma residence time of apoA-I injected on LpA I (mean 4.39 days) was substantially shorter than that of apoA-I injected on LpA I,A-II (mean 5.17 days), with a mean difference in residence times of 0.79 +/- 0.08 days (P less than 0.001). These data demonstrate that apoA-I injected on LpA I is catabolized more rapidly than apoA-I injected on LpA-I,A-II. The results are consistent with the concept that LpA-I and LpA-I,A-II have divergent metabolic pathways. PMID- 1770305 TI - A simplified micro-method for quantification of fecal excretion of neutral and acidic sterols for outpatient studies in humans. AB - A simple and precise micro-method for measurement of daily fecal excretion of neutral and acidic sterols has been developed which utilizes sitostanol (24-ethyl 5 alpha-cholestane-3 beta-ol) as fecal flow and recovery marker. Extractions of sterols were performed from 50 microliters of fecal homogenate (feces-water 1:1), and analyses of neutral and acidic sterols were carried out by gas-liquid chromatography. The method is sensitive, precise, and easy to perform; the intra assay variability yielded coefficients of variations of 1.9% and 3.5% (n = 6) for neutral and acidic sterols, respectively. The results from this method were compared with those obtained with the standard fecal flow marker chromic oxide. The correlation coefficients between the two markers were compared in 16 subjects and were 0.938 and 0.998 for excretion of neutral sterols and acidic sterols, respectively. Comparison of the fecal excretion of neutral and acidic sterols in 12 subjects determined from frozen samples and aliquots (approximately 1 g) sent by ordinary mail to the laboratory (transport time 1 to 5 days) gave identical results using sitostanol as fecal flow marker (818 +/- (SEM) 85 mg/day vs. 838 +/ 89 mg/day for neutral sterols and 417 +/- 59 mg/day vs. 414 +/- 60 mg/day for acidic sterols). The new micro-method is ideally suited for research laboratories in need of a simple, accurate, inexpensive, and high through-put method for measuring daily fecal excretion of neutral and acidic sterols, as well as total cholesterol synthesis, and can be performed on an outpatient basis. PMID- 1770306 TI - Stimulation and inhibition of the activity of rat liver cytosolic phosphatidate phosphohydrolase by various phospholipids. AB - The influence of phospholipids on the activity of the soluble phosphatidate phosphohydrolase from rat liver was studied. Phosphatidylethanolamine stimulated the enzyme activity whereas phosphatidylglycerol, phosphatidylserine, and phosphatidylinositol were inhibitory. At a phospholipid concentration of 0.7 mg/ml, phosphatidylglycerol inhibited phosphatidate phosphohydrolase activity by 75%, while the enzyme activity was stimulated twofold in the presence of phosphatidylethanolamine. Both lysophosphatidylglycerol and lysophosphatidylethanolamine inhibited phosphatidate phosphohydrolase activity as did octylglucoside, sodium cholate, and Tween 20. The finding that phospholipids influence hepatic phosphatidate phosphohydrolase activity indicates that changes in the lipid environment may modulate the enzyme activity. PMID- 1770307 TI - In vivo regulation of human leukocyte 3-hydroxy-3-methylglutaryl coenzyme A reductase: increased enzyme protein concentration and catalytic efficiency in human leukemia and lymphoma. AB - The activity of microsomal HMG-CoA reductase in freshly isolated leukocytes from patients with a variety of hematologic malignancies was significantly increased (up to 20-fold) when compared to enzyme activity in leukocytes from normal subjects (average 10.3 +/- 0.8 pmol/min per mg). Increased enzyme activity was not due to nonspecific leukocyte stimulation or to the presence of a malignancy, since normal enzyme activity was observed in subjects with either viral illnesses or solid tumors. Increased HMG-CoA reductase activity accompanying hematologic malignancy could also not be attributed to alterations in enzyme-substrate kinetic parameters (Km), or to alterations in the phosphorylation state or thiol disulfide status of the enzyme, nor was it correlated with differences in serum lipid or lipoprotein concentrations. The increase (3.6-fold) in HMG-CoA reductase activity in leukocytes from patients with preleukemia was due entirely to a rise in enzyme catalytic efficiency (specific activity), whereas the increase (4.3 fold) observed in leukocytes from patients with overt leukemia or non-Hodgkin's lymphoma was due to a concomitant increase in both enzyme catalytic efficiency (2.5-fold) and enzyme protein concentration (1.6-fold). Similar increases in HMG CoA reductase activity and catalytic efficiency were also noted for both transformed, nonmalignant, and malignant cultured leukocytes, suggesting that increased enzyme catalytic efficiency is not a nonspecific consequence of physiological changes occurring in response to the malignancy but may be an integral aspect of the malignant phenotype. HMG-CoA reductase protein concentrations, however, were not elevated in either transformed, nonmalignant, or malignant cultured leukocytes, suggesting that increases in enzyme protein levels may be secondary to other physiological changes that occur during the development of overt leukemia. Taken together, these observations suggest that an increase in the activity of HMG-CoA reductase, the rate-controlling enzyme in cholesterol synthesis, is a common occurrence in human hematologic malignancies and that a biphasic elevation of enzyme activity may exist in malignant leukocytes, such that changes in catalytic activity may occur early in tumorigenesis and may be followed by secondary changes in enzyme levels. PMID- 1770308 TI - Characterization of the discoidal complexes formed between apoA-I-CNBr fragments and phosphatidylcholine. AB - The structure, composition, and physico-chemical properties of lipid-protein complexes generated between dimyristoylphosphatidylcholine (DPMC) and the CNBr fragments of human apoA-I were studied. The fragments were separated by high performance liquid chromatography and purified on a reversed-phase column. The complexes with DMPC were isolated on a Superose column; their dimensions were obtained by gradient gel electrophoresis and by electron microscopy. The secondary structure of the protein in the complexes was studied both by circular dichroism and by attenuated total reflection infrared spectroscopy. The fragments 1 and 4 of apoA-I, containing, respectively, two and three amphipathic helices, recombined with the phospholipid to generate discoidal particles with sizes similar to that of apoA-I- and apoA-II-DMPC complexes. The infrared measurements indicated that in all complexes the apolipoprotein helical segments were oriented parallel to the phospholipid acyl chains and that the protein was located around the edges of the discs. Computer modelling of the complexes based on energy minimization techniques proposed a model for these particles in agreement with the dimensions measured experimentally. In conclusion, we propose that apoA-I and its longest CNBr fragments are able to generate discoidal particles with DMPC, with apolipoprotein helical segments oriented parallel to the acyl chains of the phospholipids. PMID- 1770309 TI - Alternate pathways in the desaturation and chain elongation of linolenic acid, 18:3(n-3), in cultured glioma cells. AB - Cultured C6 glioma cells rapidly incorporate and metabolize the essential fatty acids, 18:2(n-6) and 18:3(n-3), to 20- and 22-carbon polyunsaturated fatty acids. Using several deuterated fatty acid substrates we have obtained data that suggest alternate pathways, one possibly involving delta 8-desaturation, may exist in glioma cells for formation of 20:5(n-3) and 22:6(n-3) from 18:3(n-3). With 18:3(n 3)-6,6,7,7-d4 practically no 18:4(n-3)-6,7-d2 or 20:4(n-3)-8,9-d2 was detected whereas 20:3(n-3)-8,8,9,9-d4 accounted for 3.4% and delta 5,11,14,17-20:4-8,8,9,9 d4 for 21.1% of the total deuterated fatty acids recovered in phospholipids after a 16 h incubation; 20:5(n-3)-8,9-d2, 22:5(n-3)-10,11-d2, and 22:6(n-3)-10,11-d2 accounted for 42.4%, 13.2%, and 2.8% of deuterated acyl chains, respectively. When added exogneously, 20:3-8,8,9,9,-d4 was extensively converted to delta 5,11,14,17-20:4(n-3)-8,8,9,9-d4 (45%) and 20:5(n-3)-8,9-d2 (24%); a small amount (4%) of 18:3(n-3)-d4 also was detected. Both 20:4(n-3)-8,9-d2 and 18:4(n-3) 12,13,15,16-d4 were also converted to 20:5(n-3) and 22:6(n-3) with 8 and 0% of the respective original deuterated substrate remaining after 16 h. A possible pathway for 18:3(n-3) metabolism in glioma cells is described whereby an initial chain elongation step is followed by successive delta 5 and delta 8 desaturation reactions resulting in 20:5(n-3) formation and accounting for the ordered removal of deuterium atoms. Alternatively, extremely effective retroconversion may occur to chain shorten 20:3(n-3)-d4 to 18:3(n-3)-d4 followed by rapid conversion through the classical desaturation and chain elongation sequence.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770310 TI - Characterization of a new human apolipoprotein A-I Yame by direct sequencing of polymerase chain reaction-amplified DNA. AB - A new genetic variant apolipoprotein (apo), A-I Yame, was discovered during screening for apoA-I genetic variants with isoelectric focusing gel electrophoresis. To investigate the structural abnormality of apoA-I Yame, we amplified the apoA-I gene isolated from the proband's peripheral blood leukocytes with the polymerase chain reaction (PCR) method and directly sequenced these PCR fragments. ApoA-I Yame was found to have aspartic acid (GAC) substituted by tyrosine (TAC) at residue 13. We also identified this substitution by an automated DNA sequencer. This substitution was confirmed with amino acid sequencing of the isolated apoA-I Yame by Immobiline gel electrophoresis. This combined method, direct PCR from genomic DNA-derived individual peripheral blood leukocytes and subsequent direct sequencing, can be used to identify the entire sequence of apoA-I in a short period of time. Furthermore, with this method, it is possible to identify both alleles in heterozygous individuals. PMID- 1770311 TI - Acyl chain unsaturation modulates distribution of lecithin molecular species between mixed micelles and vesicles in model bile. Implications for particle structure and metastable cholesterol solubilities. AB - We determined the distribution of lecithin molecular species between vesicles and mixed micelles in cholesterol super-saturated model biles (molar taurocholate lecithin-cholesterol ratio 67:23:10, 3 g/dl, 0.15 M NaCl, pH approximately 6-7) that contained equimolar synthetic lecithin mixtures or egg yolk or soybean lecithins. After apparent equilibration (48 h), biles were fractionated by Superose 6 gel filtration chromatography at 20 degrees C, and lecithin molecular species in the vesicle and mixed micellar fractions were quantified as benzoyl diacylglycerides by high performance liquid chromatography. With binary lecithin mixtures, vesicles were enriched with lecithins containing the most saturated sn 1 or sn-2 chains by as much as 2.4-fold whereas mixed micelles were enriched in the more unsaturated lecithins. Vesicles isolated from model biles composed of egg yolk (primarily sn-1 16:0 and 18:0 acyl chains) or soy bean (mixed saturated and unsaturated sn-1 acyl chains) lecithins were selectively enriched (6.5-76%) in lecithins with saturated sn-1 acyl chains whereas mixed micelles were enriched with lecithins composed of either sn-1 18:1, 18:2, and 18:3 unsaturated or sn-2 20:4, 22:4, and 22:6 polyunsaturated chains. Gel filtration, lipid analysis, and quasielastic light scattering revealed that apparent micellar cholesterol solubilities and metastable vesicle cholesterol/lecithin molar ratios were as much as 60% and 100% higher, respectively, in biles composed of unsaturated lecithins. Acyl chain packing constraints imposed by distinctly different particle geometries most likely explain the asymmetric distribution of lecithin molecular species between vesicles and mixed micelles in model bile as well as the variations in apparent micellar cholesterol solubilities and vesicle cholesterol/lecithin molar ratios.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770312 TI - Developmental regulation of hormone-sensitive lipase mRNA in the rat: changes in steroidogenic tissues. AB - The hydrolysis of triglycerides and cholesteryl esters stored within cells is mediated by the enzyme, hormone-sensitive lipase. In adipose tissue and heart, hormone-sensitive lipase primarily hydrolyzes stored triglycerides to free fatty acids, while in steroidogenic tissues, it principally converts cholesteryl esters to free cholesterol for steroid hormone production. To determine whether hormone sensitive lipase is under tissue-specific, developmental regulation, the steady state levels of hormone-sensitive lipase mRNA were determined in normal rats from late fetal life through 2 years of age. Hormone-sensitive lipase mRNA levels did not appear to vary in adipose tissue from epididymal fat pads obtained from animals between 3 weeks and 2 years of age. In heart, hormone-sensitive lipase mRNA levels were lowest in the fetus increased rapidly within the first day postnatally, and then gradually increased to stable adult levels by 2 months that were 3-fold higher than observed in fetal rats. Steady state mRNA levels of hormone-sensitive lipase in the adrenals were lowest in fetal rats, increased 4 fold during the first day and peaked at levels that were 9-fold higher by the end of the first week. Thereafter, levels fell and remained 3- to 4-fold higher than at birth throughout adult life. Hormone-sensitive lipase mRNA was undetectable in testes before 4 weeks of age and increased 25-fold to stable adult levels between 4 and 12 weeks. Thus, hormone-sensitive lipase is differentially expressed and regulated in a tissue-specific fashion during development and aging. PMID- 1770313 TI - Determination of kinetic parameters of apolipoprotein B metabolism using amino acids labeled with stable isotopes. AB - The use of amino acids labeled with stable isotopes represents a relatively new approach for determining kinetic parameters of apolipoprotein metabolism; thus, several aspects of experimental protocols need to be defined. The aims of the present study were to determine whether a) different amino acid tracers or b) different methods of tracer administration affected apolipoprotein (apo) B kinetic parameters obtained by multicompartmental modeling, and c) to compare very low density lipoprotein (VLDL)-apoB metabolic parameters determined by multicompartmental modeling with those estimated by linear regression or by monoexponential analysis. [1-13C]leucine and [15N]glycine were given either as bolus injections or as primed constant infusions. A bolus of one amino acid was administered simultaneously with a primed constant infusion (8 h) of the other amino acid into four healthy normolipidemic subjects (age 23.0 +/- 1.4 yr; BMI 20.9 +/- 0.9 kg.m-2). VLDL-, intermediate density lipoprotein (IDL)-, and low density lipoprotein (LDL)-apoB enrichments were followed over 110 h. For subsequent analysis these values were converted to tracer/tracee ratios. Using the multicompartmental model, the fractional catabolic rate (FCR) for VLDL-apoB was estimated to be 0.36 +/- 0.09 h-1 after the administration of the tracer as a primed constant infusion and 0.35 +/- 0.07 h-1 when the tracer was administered as a bolus. The values for VLDL-apoB production were 14.6 +/- 6.5 mg.kg-1.d-1 and 14.1 +/- 5.4 mg.kg-1.d-1, respectively. The corresponding values for LDL-apoB were 0.027 +/- 0.016 h-1 (0.026 +/- 0.018 h-1) for the FCR and 10.5 +/- 3.7 mg.kg 1.d-1 (10.4 +/- 3.8 mg.kg-1.d-1) for the production following administration of the tracer as a primed constant infusion and a bolus, respectively. Approximately 47% of VLDL-apoB ultimately reached the LDL fraction via the VLDL-IDL-LDL pathway. Thirty-five percent of LDL-apoB did not originate from this cascade pathway, but was shunted from a rapidly turning over VLDL compartment directly into the LDL fraction. While there was some variation between individuals, VLDL apoB and LDL-apoB parameters derived from the bolus and the primed constant infusions showed no significant differences and were closely correlated. Metabolic parameters were also independent of the two amino acids tested. Although values for FCRs of VLDL-apoB obtained from linear regression (0.36 +/- 0.19 h-1) or monoexponential analysis (0.50 +/- 0.36 h-1) did not differ significantly from those obtained by the multicompartmental model, there was considerable variation and no significant correlation in a given individual.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1770314 TI - Effect of oral supplementation with D-alpha-tocopherol on the vitamin E content of human low density lipoproteins and resistance to oxidation. AB - Twelve clinically healthy subjects participated in a vitamin E supplementation study. Eight were given daily dosages of 150, 225, 800, or 1200 IU RRR-alpha tocopherol for 21 days (two persons per dose) and four received placebo. Prior, during, and after the supplementation period, alpha-tocopherol, gamma-tocopherol, and carotenoids were determined in plasma and low density lipoprotein (LDL). The maximum levels of alpha-tocopherol were 1.7- to 2.5-times the baseline values in plasma and 1.7- to 3.1-times in LDL. A high correlation existed between alpha tocopherol in plasma and LDL. gamma-Tocopherol significantly decreased in plasma and LDL during vitamin E supplementation. No significant influence on the lipoprotein and lipid status and carotenoid levels of the participants occurred throughout the supplementation. The resistance of LDL against copper-mediated oxidation was also measured. The oxidation resistance of LDL was significantly higher during vitamin E supplementation. However, the efficacy of vitamin E in protecting LDL varied from person to person. The statistical evaluation of all data gave a correlation of r2 = 0.51 between alpha-tocopherol in LDL and the oxidation resistance as measured by the length of the lag-phase preceding the oxidation of LDL. No association was seen between levels of carotenoids and vitamin E in plasma and LDL. The present study clearly shows that in humans the oxidation resistance of LDL can be increased by vitamin E supplementation. PMID- 1770315 TI - Rabbit hepatic lipase cDNA sequence: low activity is associated with low messenger RNA levels. AB - We have investigated a possible mechanism for the reported low activity of hepatic lipase (HL) in the rabbit by cloning and sequencing the cDNA for rabbit HL and using the clone to quantify mRNA levels. A 1.6 kb cDNA clone was sequenced and found to encode the mature protein of 477 amino acids and 20 amino acids of the hydrophobic leader peptide. A high degree of amino acid sequence identity was demonstrated with human (81%) and rat (79%) HL. The putative active site was well conserved, and mutations reported to reduce activity in HL or lipoprotein lipase were not present in the rabbit sequence. The activity and mRNA levels were compared with those of the rat, an animal possessing relatively high HL activity. In post-heparin plasma of the rat, HL activity was nine times greater than in that of the rabbit (24.9 +/- 1.6 units per ml plasma, n = 5 vs. 2.7 +/- 0.1, n = 5, P = 0.0001). Comparison of mRNA levels was made by dot blot analysis of liver poly (A+) RNA obtained from each species and probed with either rabbit or rat HL cDNA, labeled to the same specific radioactivity. Specific HL mRNA levels were found to be nine times greater in the rat than in the rabbit (8.90 +/- 0.11 units, n = 5 vs. 1.00 +/- 0.01, n = 5, P = 0.0001). Thus, low hepatic lipase activity in the rabbit is associated with low mRNA levels, suggesting that the observed species difference in activity is due to differences in the level of mRNA. PMID- 1770316 TI - ApoB gene nonsense and splicing mutations in a compound heterozygote for familial hypobetalipoproteinemia. AB - Two novel apoB gene mutations were identified in a patient (CM) with phenotypic homozygous hypobetalipoproteinemia. Haplotype analysis of the apoB alleles from this patient and his family members revealed him to be a genetic compound for the disease. In contrast to previous studies of other hypobetalipoproteinemic patients, no clues existed as to where in the apoB gene the molecular defects resided. Therefore, it was necessary to characterize the apoB genes of the patient by sequence analysis. The apoB gene contains 29 exons and is 43 kb in length. The gene encodes a 14.1 kb mRNA and a 4563 amino acid protein. Both apoB alleles from the patient were cloned via 26 sets of polymerase chain reactions (PCR). These clones contained a total of approximately 24 kb of apoB gene sequence, including regions 5' and 3' to the coding region, 29 exons, and the intron/exon junctions. Complete DNA sequence analysis of these clones showed that each apoB allele had a mutation. In the paternal apoB allele, there was a splicing mutation. The first base of the dinucleotide consensus sequence (GT) in the 5' splice donor site in intron 5 was replaced by a T. It is likely that this base substitution interferes with proper splicing and results in the observed absence of plasma apoB. In the maternal apoB allele, there was a nonsense mutation. The first base of the Arg codon (CGA) at residue 412 in exon 10 was replaced by a T, resulting in a termination codon (TGA). The nonsense mutation is likely to terminate translation after residue 411 resulting in a severely truncated protein only 9% of the length of B-100.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770317 TI - Effect of dietary lipid and vitamin E on mitochondrial lipid peroxidation and hepatic injury in the bile duct-ligated rat. AB - To assess whether lipid peroxidation of hepatic mitochondria is associated with cholestatic hepatic injury we examined the effect of bile duct ligation (BDL) versus sham surgery on mitochondrial lipids of rats maintained on one of seven diets. Diets included vitamin E-deficient (E-) and vitamin E-sufficient (E+) combined with normal lipid (11.9% calories as stripped corn oil), high lipid (35% calories as stripped corn oil), or n-3 fatty acid (fish oil) supplementation. Rats were killed 17 days after surgery, mitochondria were isolated by differential centrifugation, and lipid-conjugated dienes and thiobarbituric acid reacting substances (TBARS) were measured in mitochondrial lipids as indices of lipid peroxidation. BDL resulted in significant increases in lipid peroxidation in all dietary groups. The E- high lipid diets (with either corn oil or fish oil) were associated with higher lipid peroxide and serum bilirubin values in BDL rats compared to the normal lipid diets. Fish oil supplementation did not ameliorate cholestatic or oxidative injury. Serum alanine aminotransferase, bilirubin, alkaline phosphatase, and cholylglycine levels correlated significantly with levels of mitochondrial conjugated dienes and TBARS. These data suggest that free radical stress occurs during BDL in the rat and may result in mitochondrial lipid peroxidation, and that diets high in lipid may increase free radical damage to hepatic mitochondria. The role of free radicals in cholestatic hepatic injury requires further investigation. PMID- 1770318 TI - Fractionation of charge-modified low density lipoproteins by fast protein liquid chromatography. AB - We describe a methodology developed to separate different forms of charge modified low density lipoproteins (LDL) using the fast protein liquid chromatography (FPLC) system from Pharmacia. Lipoproteins were isolated by sequential ultracentrifugation and introduced onto an anion-exchange column (Mono Q HR 5/5). The multistep NaCl gradient elution was optimized and the analytical variables were determined on copper-oxidized LDL. After oxidation by copper for various times (up to 48 h), five forms were obtained (fractions A, B, C, D, and E). Within-run and day-to-day reproducibility were better than 8.6% and 10%, respectively. Protein and cholesterol recovery after the chromatographic separation was good (greater than 82%) and the detection limit was about 1 microgram. The more negative forms of collected LDL were mainly characterized by an increase in the lipid peroxidation product content, a depletion of vitamin E, an alteration of apoB and increased degradation by macrophages. The proposed methodology was applied to the study of LDL modifications generated by human umbilical endothelial cells and the protective effect of antioxidants (vitamin E and probucol). PMID- 1770319 TI - Inhibitors of sterol synthesis. Characterization of trimethylsilyl dienol ethers of 3 beta-hydroxy-5 alpha-cholest-8(14)-en-15-one. Applications in the analysis of mitochondrial metabolites of the 15-ketosterol by gas chromatography-mass spectrometry. AB - Derivatization of delta 8(14)-15-ketosterols as bis-TMS dienol ethers facilitates their analysis by gas chromatography-mass spectrometry (GC-MS). Conditions are presented for the preparation of each of the three possible bis-TMS dienol ethers of 3 beta-hydroxy-5 alpha-cholest-8(14)-en-15-one (1), a potent regulator of cholesterol metabolism. Treatment of 1 with N,O-bis(tri-methylsilyl) trifluoroacetamide (BSTFA) and pyridine for 20 h at 100 degrees C produced primarily 3 beta,15-bis(trimethylsilyloxy)-5 alpha-cholesta-7,14-diene. Treatment of 1 with BSTFA-pyridine in the presence of 0.1% perchloric acid for 20 h at 22 degrees C gave mainly the delta 8(14)15, dienol ether. Heating this reaction mixture at 100 degrees C for 4 days gave mainly the delta 8,14 ether. The structures of the three dienol ethers were established by GC-MS and 1H and 13C nuclear magnetic resonance spectroscopy. The three TMS dienol ethers of 1 were resolved by capillary GC and gave very simple mass spectra upon electron impact with fragmentation limited almost exclusively to the elimination of trimethylsilanol, methyl, and the side chain. The TMS dienol ethers showed reduced artefact formation, improved chromatographic resolution, and increased sensitivity relative to the delta 8(14)-15-ketosterols, properties that improve the detection and identification of minor components in analyses of complex biological mixtures. The utility of this derivatization is illustrated for the delta 7,14 TMS dienol ethers of the 3-deoxy, 3-keto, 3 alpha-hydroxy, and 3 beta methoxy analogs of 1 and for delta 8(14)-15-ketosterols in mixtures obtained from incubations of 1 with rat liver mitochondria in the presence of NADPH. PMID- 1770320 TI - Stereospecific synthesis and two-dimensional 1H-NMR investigation of isoursocholic acid. AB - This report describes the chemical synthesis of isoursocholic acid (3 beta, 7 beta, 12 alpha-trihydroxy-5 beta-cholanoic acid) from its corresponding 3 alpha analog. The method consists of refluxing a mixture of ursocholic acid, triphenylphosphine, and diethyl azodicarboxylate in benzene solution with an acid such as formic acid. The sterically pure ester (3 beta-formate) so formed after saponification with LiOH-aqueous methanol then allowed an easy access to the epimer of the starting acid. Large scale preparative separation and purification of the final product and synthetic intermediates were accomplished by flash column chromatography of their methyl ester derivatives. Structural assignment of the isourscholic acid molecule was confirmed by complete analysis of proton NMR spectra using 2-D NMR correlation experiments which rigorously established the (3 beta/3 alpha) and (7 beta/7 alpha) hydroxyl configurations in the isoursocholic and ursocholic acids. It is suggested that the isoursocholic acid will be useful as a reference compound and as a substrate in studies dealing with the hepatic inversion of the 3 beta-hydroxy group. PMID- 1770321 TI - An extremely elevated serum CA125 level in a Crohn's patient developing endometriosis and the establishment of a cell line (MD-E) from the endometrioma. AB - We report an extremely high serum CA125 value of 1243 units/mL in a 21-year-old patient with Crohn's disease who developed endometriosis. Such a high CA125 value has not been reported to date in endometriosis or other pathologies except ovarian carcinoma. The pelvic mass of unknown nature in the above patient was discovered by ultrasound during a sudden onset of severe abdominal pain which subsided within two days. The high CA125 value six days after the onset of pain and at the end of menses declined spontaneously to 100 units/mL in 15 to 30 days, and stabilized over the three months prior to colectomy and removal of the left ovarian endometrioma, after which it gradually declined to 7 to 11 units/mL as found a year earlier. Although primary cells from endometrioma produced 113 units/mL of CA125 in the culture medium, the cell line established from it gave a value of less than 7 units/mL even after treatment with interferons. The adherent cells were moderately positive for CA125, cytokeratin and non-specific esterase, were strongly positive for periodic acid Schiff's (PAS) and acid phosphatase, and had epithelioid morphology. In addition to the extremely high CA125 level in our endometriosis patient and the establishment of the cell line, the case illustrates the usefulness of CA125 estimation in helping to determine the nature of abdominal masses in female inflammatory bowel disease patients. PMID- 1770322 TI - Role of local and systemic factors in increasing serum glycoprotein markers of pancreatic cancer. AB - This study was performed in order to evaluate the role of various local and systemic alterations in influencing serum glycoproteic markers in patients with pancreatic cancer, and in healthy and diseased controls. Cancer antigen 19-9 (CA 19-9), carcinoembryonic antigen (CEA), and ferritin were determined in the sera of 23 control subjects, 30 patients with pancreatic cancer, 27 with chronic pancreatitis, and 27 with extra-pancreatic diseases mainly of gastrointestinal origin. A number of acute-phase proteins and indices of liver function and cholestasis were also assayed. The three antigens increased only in patients with pancreatic cancer. Higher CA 19-9 and CEA, but not ferritin, levels were found only in patients with hepatic metastases. Acute-phase proteins and synthetic functional indices were found to be higher and lower, respectively, in patients with pancreatic malignancy when compared with controls. Multiple regression analysis documented the dependence of circulating ferritin, but not of CA 19-9 and CEA, on the systemic indices. Canonical correlation showed a similar trend for CA 19-9 and CEA, which differed from that of ferritin. Ferritin was found to depend on the presence of systemic and hepatic alterations, especially of cholestasis. We can conclude that the variations of serum glycoprotein markers in patients with pancreatic cancer depend on various regional and systemic factors. CA 19-9 and CEA are related mainly to the extent of the neoplasia. The influence of a decreased liver function capacity associated or not to cholestasis and the interrelation with the acute-phase response may also be suggested. Ferritin, on the other hand, is related to a higher degree than CA 19-9 and CEA to hepatic dysfunction and also behaves similar to an acute-phase protein. PMID- 1770323 TI - Three cases of multiple myeloma developing into melphalan-related chronic myelomonocytic leukemia. AB - From 1980 to 1987, three cases of chronic myelomonocytic leukemia (CMML) were encountered among 68 cases of multiple myeloma who survived more than three years from the diagnosis. The incidence (4.8%) of secondary myelodysplastic syndrome (MDS) is almost identical to previous reports, but case reports of chronic myelomonocytic leukemia were rare. In Japan, there are few reports of multiple myeloma patients who later developed secondary MDS or acute myelogenous leukemia (AML). In our cases, none of the 31 patients treated with cyclophosphamide developed secondary MDS, while three of 37 patients treated with melphalan developed CMML. This difference is not statistically significant. PMID- 1770324 TI - Effect of buflomedil, dipyridamole and indobufene on hemorrheologic and blood coagulation parameters in patients who underwent vascular surgery for severe atherosclerosis. AB - We studied 30 patients (age range 58 to 64 years) who underwent vascular surgery for peripheral vascular disease (24 patients) and for carotid stenosis (6 patients). At the time of the study, all subjects have been taking antiplatelet agents for at least three months. They were divided into three groups of ten patients each: the first group received buflomedil (BUF), the second dipyridamole (DIP) and the third indobufene (IND), as treatment before vascular surgery. We investigated the influence of these drugs on hemorrheologic (hematocrit, whole blood and plasma viscosity) and blood coagulation (partial thromboplastin time, prothrombin time and bleeding time) parameters in all patients. In our experience, none of the three drugs influenced any tested parameters, which were within normal limits: among them we noted only a statistically significant difference in bleeding time between patients treated with BUF and IND. PMID- 1770325 TI - Histologic findings on the condylar process of the mandible in rats with reduced bone-mineral density. AB - We studied the histology of the condylar process in rats on a low calcium diet. Female rats aged 15 weeks were given a low Ca diet for 14 weeks, which reduced bone-mineral density, i.e., induced osteoporosis. Histologic observation revealed tylosis of the fibrous layer of the condyle, shrinkage of the cartilaginous layer, enlargement of the marrow cavity, reduction in the number of osteoblasts in the condylar neck, and cellular disarrangement and other morphologic changes of both the fibrocartilaginous and cartilaginous layers. PMID- 1770326 TI - Size of the pancreas in non-insulin-dependent diabetic patients. AB - We investigated the relationship between the size of the pancreas in non-insulin dependent diabetic patients (NIDDs) and normal subjects, and also the possible correlation between pancreatic size in diabetics and basal C-peptide concentrations. Eighty-four non-insulin-dependent diabetics and eighty control subjects matched for age, sex and body mass index (BMI) were studied, using a realtime sector system, with which we measured the head and body of the pancreas in cm2. Scans were performed twice in 50 subjects with no significant difference. Both the head and the body of the pancreas were significantly smaller in diabetics (4.60 +/- 1.10 cm2, 5.92 +/- 1.53 cm2, respectively) than in normal subjects (6.09 +/- 1.62 cm2, 7.43 +/- 2.14 cm2) (p less than 0.001). The mean total area of the pancreas for the diabetics was 10.53 +/- 2.45 cm2, and for the controls 13.53 +/- 3.60 cm2 (p less than 0.001). No correlation was found between the total area of the pancreas and the BMI in the two groups. In the diabetic group, there was a positive correlation between C-peptide and the total area of the pancreas (r = 0.30, p less than 0.01). We concluded that the size of the pancreas is smaller in NIDDs than in healthy controls, and there is a positive correlation with the basal C-peptide concentration. PMID- 1770327 TI - A patient with primary plasma cell leukemia accompanied by an extensive polypoid infiltration of the gastrointestinal tract. AB - A 37-year-old male presented with primary plasma cell leukemia (PCL) with kappa type Bence Jones proteinuria (BJP) and polyposis of the stomach and colon. His plasma cell leukemia was not preceded by a pre-existing multiple myeloma, and presented the complication of polyposis in both stomach and colon. Biopsy of mucosal lesions revealed marked accumulation of atypical plasma cells with positive cytoplasmic kappa-chain. No amyloidosis was present. His disease responded remarkably well to intermittent melphalan and prednisolone. This case represents an uncommon combination of primary plasma cell leukemia and polypoid gastrointestinal lesions with plasma cell infiltration. PMID- 1770328 TI - Altered hormonal status in a female deprived of food for 18 days. AB - From an endocrinological aspect, metabolic changes of humoral factors were examined in a female patient deprived of food for 18 days. On admission, serum acetoacetate (AcAc) and 3-hydroxybutyrate (3-OHB) levels markedly increased. The serum free triiodothyronine (T3) level decreased, whereas serum thyroxine (T4) concentrations were within normal range. Diurnal variations of serum cortisol levels were not observed. At day six after admission, the effects of intravenously administered thyrotropin releasing hormone (TRH) on pituitary thyroid stimulating hormone (TSH) was suppressed, whereas growth hormone (GH) was hyper-responsive. Re-feeding gradually normalized the decreased free T3 level following the reduction of serum ketone bodies. The diurnal rhythmicity of cortisol secretion was restored. At day 17, the TSH response to TRH was restored, while the GH hyperreaction was attenuated. The present case provided evidence that starvation elicits lowered TSH response and GH hypersecretion to intravenously administered TRH, and distorts diurnal rhythmicity of adrenal cortisol secretion in a healthy subject without any psychogenic disorders. PMID- 1770329 TI - Infants' coordination of auditory and visual depth information. AB - Using the preferential-looking procedure infants 5, 7, and 9 months of age were presented two videoimages side by side on separate monitors accompanied by a soundtrack that matched one of the images. Each infant was presented: (1) a stationary drum-beating toy paired with the same toy approaching and receding in depth, to assess infants' recognition both that changing sound amplitude is a property of an object that is moving in space and that constancy in amplitude is a property of a stationary object; (2) a drum-beating toy moving horizontally paired with one approaching and receding in depth, to assess infants' recognition that systematic increases and decreases in amplitude accompany object movement in a particular dimension, namely depth; and (3) two identical toys alternately approaching and receding in depth but out of phase (i.e., one approaching while the other is receding), to assess infants' recognition that increases and decreases in amplitude accompany a particular type of object movement in depth. Measures of mean duration of looking time indicated that the 5-month-olds looked reliably to the correct videoimage only for the stationary toy paired with the constant amplitude sound. The 7-month-olds recognized that changes in amplitude accompany object movement in depth but did not coordinate auditory with visual depth information as well as older infants. The 9-month-olds looked reliably to the correct videoimages in all conditions. Possible contributing factors to these developmental trends in performance are discussed. PMID- 1770330 TI - Developmental changes in memory source monitoring. AB - Previous research suggests that children are more likely than adults to confuse memories of actions they imagined themselves performing with memories of actions they actually performed (Realization Judgments), but are not more likely to confuse memories of actions they had imagined performing with memories of actions they saw another person perform (Reality Monitoring). We approach these findings in terms of a theory about the processes by which people identify the sources of their recollections (Source Monitoring). This approach suggests that children may be more likely than adults to confuse memories from different sources whenever the sources are highly similar to one another. Experiments 1 and 2 tested this hypothesis by manipulating the perceptual and semantic similarity of two sources of information and testing 4- and 6-year-old and adult subjects' recollection of the sources of particular pieces of information. Experiment 3 tested the hypothesis that children are more likely than adults to mistakenly identify memories of things they imagined another person doing as memories of things they witnessed that person doing. The findings indicate that (a) people are more likely to confuse memories from similar than dissimilar sources, (b) source monitoring improves during the preschool and childhood years, and (c) children may be especially vulnerable to the effects of source similarity. PMID- 1770331 TI - Sex differences in elaborative strategies: a developmental analysis. AB - The present study examined sex differences in the use of elaboration in paired associate learning in adolescence and young adulthood. In Experiment 1, 48 eighth grade and 48 tenth grade students were asked to recall 24 word pairs, half of which were high frequency pairs, and half low frequency pairs. After recall, students reported the type of strategy used for each word pair (reading the pairs carefully, rehearsing the words, using imagery or constructing a verbal connection). Females used elaborative strategies more often, were more likely to recall elaborated pairs, and recalled more word pairs than males at both ages. These effects were observed in both high and low frequency word pairs. There was also a main effect of frequency, with elaboration more common with high frequency word pairs. In Experiment 2, college students performed the same paired associates learning task, but with the added instruction to describe their elaborations in a sentence. At this age, there was a sex by materials interaction, with sex differences in strategy use only present with low frequency word pairs. These findings indicate that sex differences diminish under more favorable task conditions that encourage strategy use (high frequency word pairs) as males and females become more proficient strategy users, but remain under less favorable circumstances. An examination of the types of elaborations generated by college students indicated although males and females produced similar types of elaborations to the word pairs, sex differences in the recallability of low frequency words appeared with less interactive and more idiosyncratic elaborations. PMID- 1770332 TI - The height + width = area of a rectangle rule in five-year-olds: effects of stimulus distribution and graduation of the response scale. AB - This study attempts to account for disparities between the Anderson and Cuneo (1978), Leon (1982), and Lautrey, Mullet, and Paques (1989) studies in regard to children's area judgment. Two task variables were manipulated: stimulus distribution (biased/unbiased) and the type of response scale (graduated/ungraduated). Three age groups (5, 6, and 7 year olds) were tested. The mean integration pattern for 5-year-olds presented a negatively biased stimulus distribution, and an ungraduated response scale was highly convergent and suggested the use of a centration rule (replication of the Lautrey et al. results). When 5-year-olds were presented with an unbiased stimulus distribution and a graduated scale, the integration pattern was only slightly convergent (as in Leon). The effects of two factors (age and graduation) were significant and combined additively: The older the child, the more graduated the response scale and the more the integration pattern tended to form three ascending parallel lines (the Anderson & Cuneo results). PMID- 1770333 TI - Listening comprehension for sentences: the accessibility of referents for pronouns as a function of age, topic continuity, and pronoun emphasis. AB - An auditory comprehension task was employed to determine how subjects (20 first graders, 20 fifth graders, and 20 adults) use topic continuity and contrastive emphasis in the assignment of referents for pronouns in sentences. Significant differences in performance for emphasized and unemphasized pronouns were found suggesting that subjects used contrastive emphasis when assigning referents for pronouns. Fifth graders overused the cue of topic continuity in assigning referents for emphasized pronouns. This effect has not been shown previously in studies of children's understanding of pronomial reference. An interaction between age and pronoun emphasis was also significant. This interaction suggests that developmental changes continued to take place in the learning of cues for resolving pronouns by school age children. PMID- 1770334 TI - Text manipulations influence children's understanding of class inclusion hierarchies. AB - Second, fourth, and sixth grade children were presented with a passage which could be represented as a four-level class inclusion hierarchy. Top-down or bottom-up presentation of material and repetition or no repetition of category labels were manipulated in a 2 x 2 design. Children were requested to construct an external representation for the passage and to respond to questions requiring them to reason about its contents. Quality of representation and performance on the question task were related to grade level and to the text manipulations. Implications of the results, particularly as related to education, are discussed. PMID- 1770335 TI - Sensitivity to viewpoint in children's drawings of objects and relations between objects. AB - Previous literature suggests that young children are relatively insensitive to viewpoint, only showing their view when the task is manipulated to provoke it. In contrast, older children appear to become more sensitive to viewpoint and it has been claimed that there is a developmental progression toward use of linear perspective as a means of drawing a view-specific scene. This study investigates sensitivity to viewpoint by manipulating it directly. Children between the ages of 6 and 14 years were asked to draw an L-shaped array of three cubes from one of three views: frontal eye level, frontal looking down, and corner looking down. At every age children showed sensitivity to their view in the sense that there were consistent differences between the drawings produced in the three viewing conditions. In the case of younger children this did not lead to an accurate portrayal of either their view or the array relations. Older children portrayed their view and the array relations more accurately, and viewpoint had a strong effect on the choice of projection system both within and between objects. There was no evidence of a general progression toward use of linear perspective. PMID- 1770336 TI - A rapid method for the determination of cocaine in brain tissue. AB - A rapid procedure is described for the extraction and analysis of brain samples for cocaine and benzoylecgonine. Human brain tissue was sectioned at autopsy, and samples were subjected to a lipase digestion, subsequent to solid-phase extraction. The distribution of cocaine and benzoylecgonine throughout different regions of the brain was determined by high-performance liquid chromatography. PMID- 1770337 TI - Clinical and morphological findings on mustard gas [bis(2-chloroethyl)sulfide] poisoning. AB - In 1984 and 1985, a total of eleven Iranian patients were transferred to hospitals in Munich, Germany, after a reported gas attack in the Iran-Iraq war. The initial symptoms and pretreatment in Teheran, Iran, as well as the admittance examination data, the clinical courses of the patients, and the clinical laboratory data in Germany, are reported. The main injuries were to the skin, the eyes, and the respiratory tract. One patient stopped breathing suddenly on the third day of treatment (eight days after the exposure). A large piece of mucous membrane blocking a bronchus was removed during an immediate bronchoscopy, but attempts at resuscitation failed. The most important autopsy findings in this case were severe pseudomembranous inflammation of the trachea and the bronchial tubes. The histological findings are reported. Chemical proof of the poison (mustard gas) was established. A review of the history of chemical warfare, the physical and chemical properties of mustard gas, and a literature survey of clinical findings (including, especially, experiences from World Wars I and II) contribute to the understanding of the actual cases. PMID- 1770338 TI - Geriatric offenders examined at a forensic psychiatry clinic. AB - This descriptive research paper reports on 52 geriatric defendants accused of criminal offenses and referred for forensic psychiatric evaluation. It addresses demographic and clinical variables in that population. The authors hope that the data will assist in planning for forensic and therapeutic services for geriatric persons in the criminal justice system. PMID- 1770339 TI - Cocaine in decomposed human remains. AB - From March 1988 through March 1990, at the Philadelphia Medical Examiner's Office toxicology laboratory, samples from 77 decomposed human bodies were tested for the presence of cocaine, employing gas chromatography/mass spectrometry (GC-MS). The material analyzed included decomposed soft tissue, bloody decomposition fluid, mummified tissue, maggots, and beetle feces. Twenty-two cases (28.6%) were positive for cocaine, many of these cases in states of advanced decomposition. These findings indicate the usefulness of testing decomposed tissue for cocaine in all cases where its presence is suspected. This is contrary to what might be expected, since cocaine is generally labile and rapidly broken down by both enzymatic and nonenzymatic mechanisms. PMID- 1770340 TI - Matching bullets to bone impact signatures. AB - When bone is penetrated or perforated by a bullet, the bullet's impacting surface is often uniquely modeled by the fractured bone. Reconstructing bone with simple super-imposition of the bullet's contour lines allows matching of a particular bullet to its specific bone defect. PMID- 1770341 TI - Fetal death following maternal trauma: two case reports and a survey of the literature. AB - When a fetus dies after its mother has suffered trauma, questions often arise about whether the fetal death was linked to the maternal injury. Many state statutes make it a criminal act to cause the death of a fetus by injuring the mother. The authors present two cases in which fetal death resulted from maternal trauma. In addition, we review the pertinent literature on this subject and offer guidelines that may help forensic pathologists evaluate these difficult and often emotionally charged cases. PMID- 1770342 TI - Detection of bone and bone-plus-bullet particles in backspatter from close-range shots to heads. AB - A victim was shot in the head with a 9-mm Smith & Wesson pistol using Winchester Silvertip hollow-point ammunition. Of interest in this case was the distance from the muzzle of the weapon to the victim's head, since the wound characteristics were equivocal for firing distance. Two other handguns (revolvers) were involved in this shooting, in addition to a revolver owned by the victim. The handguns were sampled using tape lifts, and the casings were sampled by washing them in distilled water, followed by vacuum filtration of the washing water through 0.2 microns-pore Nuclepore filters. These materials were examined by scanning electron microscopy/energy-dispersive X-ray analysis. Calcium-phosphorous (bone) particles were detected on the 9-mm Smith & Wesson pistol, on two casings found at the scene, and on one of the revolvers. Two of the calcium-phosphorous particles on the casings had associated bullet fragments. Test shots on live pigs destined for slaughter showed that bone particles are a feature of backspatter from close-range shots to heads. Contamination of nearby surfaces by bone fragments and bone-plus-bullet fragments, as well as other organic debris, appears to be quite heavy. PMID- 1770343 TI - Autoerotic asphyxial death initially misinterpreted as suicide and a review of the literature. AB - Death during autoerotic activities is of special concern to law enforcement officials, medical examiners, the family of the decedent, and society in general. As in the probing of any violent demise, accurate identification, management, and preservation of all physical evidence; complete photographic documentation of the scene and the body; reconstruction of the scene; and interviews with the family and acquaintances (psychological autopsy) are mandatory for proper study, evaluation, and interpretation of the case. Because of a lack of knowledge on the part of many people, including professionals, about these activities and the fact that many autoerotic fatalities share common characteristics with suicide and homicide, these cases are often misinterpreted. The authors present a case of autoerotic accidental asphyxial death which was initially misinterpreted as suicide. PMID- 1770344 TI - Cardiac laceration and pericardial tamponade due to cardiopulmonary resuscitation after myocardial infarction. AB - Complications of cardiopulmonary resuscitation (CPR), such as rib fractures and pneumothorax, are not uncommon. The authors report the case of a 69-year-old woman who underwent surgery for a perforated duodenal ulcer. Eighteen hours postoperatively she sustained a cardiac arrest; vigorous resuscitation efforts, using advanced cardiac life-support procedures, failed. At autopsy, she had 350 mL of fresh blood in her pericardial sac, which had caused cardiac tamponade. Three ribs were fractured at the left sternal border. Directly underneath the fractured ribs were a 0.4-cm laceration of the pericardium and an accompanying 0.7-cm laceration of the left ventricle. There was an acute thrombus in the left anterior descending artery. Microscopic examination of the heart showed acute infarction of the left ventricle in the vicinity of the laceration. This case demonstrates that vigorous CPR performed on an acutely infarcted heart can result in lethal cardiac laceration and tamponade. PMID- 1770345 TI - Identification of human remains by comparison of frontal sinus radiographs: a series of four cases. AB - The value for identification purposes of the radiographic frontal sinus outline, which is unique to each individual and remains constant throughout that individual's lifetime, is discussed. A general discussion of identification using frontal sinus X-rays is presented, along with four cases. PMID- 1770346 TI - Purification and properties of an ethylene-forming enzyme from Pseudomonas syringae pv. phaseolicola PK2. AB - A novel ethylene-forming enzyme that catalyses the formation of ethylene from 2 oxoglutarate was purified from a cell-free extract of Pseudomonas syringae pv. phaseolicola PK2. It was purified about 2800-fold with an overall yield of 53% to a single band of protein after SDS-PAGE. The purified enzyme had a specific activity of 660 nmol ethylene min-1 (mg protein)-1. The molecular mass of the enzyme was approximately 36 kDa by gel filtration and 42 kDa by SDS-PAGE. The isoelectric point and optimum pH were 5.9 and ca. 7.0-7.5, respectively. There was no homology between the N-terminal amino acid sequence of the ethylene forming enzyme of Ps. syringae pv. phaseolicola PK2 and the sequence of the ethylene-forming enzyme of the fungus Penicillium digitatum IFO 9372. However, the two enzymes have the following properties in common. The presence of 2 oxoglutarate, L-arginine, Fe2+ and oxygen is essential for the enzymic reaction. The enzymes are highly specific for 2-oxoglutarate as substrate and L-arginine as cofactor. EDTA, Tiron, DTNB [5,5'-dithio-bis(2-nitrobenzoate)] and hydrogen peroxide are all effective inhibitors. PMID- 1770347 TI - Molecular cloning and nucleotide sequence of the gene encoding an endo-1,4-beta glucanase from Bacillus sp. KSM-330. AB - The gene encoding an acid endo-1,4-beta-glucanase from Bacillus sp. KSM-330 was cloned into the HindIII site of pBR322 and expressed in Escherichia coli HB101. The recombinant plasmid contained a 3.1 kb HindIII insert, 1.8 kb of which was sufficient for the expression of endoglucanase activity in E. coli HB101. Nucleotide sequencing of this region (1816 bp) revealed an open reading frame of 1389 bp. The protein deduced from this sequence was composed of 463 amino acids with an Mr of 51882. The deduced amino acid sequence from amino acids 56 through 75 coincided with the amino-terminal sequence of the endoglucanase, Endo-K, purified from culture of Bacillus sp. KSM-330. The deduced amino acid sequence of Endo-K had 30% homology with that of the celA enzyme from Clostridium thermocellum NCIB 10682 and 25% homology with that of the enzyme from Cellulomonas uda CB4. However, the Endo-K protein exhibited no homology with respect to either the nucleotide or the amino acid sequences of other endoglucanases from Bacillus that had been previously characterized. These results indicate that the gene for Endo-K in Bacillus sp. KSM-330 has evolved from an ancestral gene distinct from that of other Bacillus endoglucanases. PMID- 1770348 TI - Transcription of a stem/loop region of a tumour-amplified sequence induces bacterial aggregation. AB - A sequence of human DNA, amplified in a lung tumour, was shown to induce expression-dependent effects on Escherichia coli phenotype. Previous studies have demonstrated the induction of abnormal plasmid supercoiling and bacterial aggregation in host strains harbouring various constructs encoding this region. Subcloning identified a short stretch of 50 bp crucial for these effects. This study details further characterization of the active sequence. Computer analysis of the region predicted the formation of a stem/loop structure in transcribed RNA. Transcription, in the absence of translation, of a 22 bp sequence comprising this structure was sufficient to induce bacterial aggregation. Site-directed and random mutagenesis of the sub-region were carried out in order to identify critical factors in the induction of this phenotypic shift. It was found that changes in the loop sequence modulated activity, and mutations increasing predicted stem stability produced more active constructs. The wild-type sequence induced high level aggregation in only a limited number of strains but using the mutagenesis data, a sequence was synthesized that induced high level aggregation in most E. coli strains tested. PMID- 1770349 TI - Positive selection of antibiotic-producing soil isolates. AB - Stepwise discriminant analysis was used to identify the most powerful selective substrates which could be used to formulate media capable of enriching for antibiotic-producing soil isolates. This was achieved by characterizing a collection of 74 soil bacteria, including eubacteria and actinomycetes, according to their ability to produce antibacterial antibiotics and their growth responses to 43 physiological and nutritional tests. The characters which were selective for actinomycetes relative to eubacteria included growth on proline (1%, w/v) and humic acid (0.1%) as sole sources of both carbon and nitrogen, growth on nitrate as a nitrogen source, and growth at pH 7.7-8.0. Growth on proline (1%) and humic acid (0.1%) as sole carbon/nitrogen sources, growth on asparagine as a nitrogen source, and growth in the presence of vitamins were among the characteristics which allowed antibiotic-producing actinomycetes to be differentiated from non antibiotic-producing strains. Several simple isolation media which incorporated the selective substrates identified by discriminant analysis succeeded in increasing the proportion of actinomycetes isolated from soil samples. Furthermore, the percentage of isolates capable of antibiotic production was considerably increased. PMID- 1770350 TI - Plasmid effects on secondary metabolite production by a streptomycete synthesizing an anthelmintic macrolide. AB - Transformation of the thermotolerant streptomycete, soil isolate S541, with plasmid cloning vectors of varying size, copy number, and parent replicon (derived from pIJ101, SCP2* and SLP1.2) depressed the biosynthesis of nemadectins (polyketide-derived secondary metabolites possessing anthelmintic activity). However, production of the chemically distinct 21-hydroxyl-oligomycin A, also produced by S541, was either unaffected or increased in plasmid-containing strains. A causal relationship between plasmid carriage and the changes in secondary metabolite yield was confirmed since cured strains were restored to normal production levels and their subsequent retransformation by plasmid DNA was followed by the same effects on nemadectin and oligomycin biosynthesis as before. All the plasmids tested were highly unstable in S541 and it was generally necessary to include an appropriate selective antibiotic (usually thiostrepton) in the growth medium. Thiostrepton was not responsible for the depressive effect, since this was also observed in plasmid-containing strains (i) when grown in antibiotic-free media and (ii) when alternative selective antibiotics such as neomycin were used. In addition, the plasmid-free strain produced both nemadectins and 21-hydroxyl-oligomycin A in the presence of sub-inhibitory levels of thiostrepton. The thiostrepton resistance gene, which was present on many of the plasmids tested, did not mediate the effect since plasmids carrying other selectable markers (pIJ58, neomycin, and pIJ355, viomycin) also depressed nemadectin but not 21-hydroxyl-oligomycin A production. No obvious recombination or integration events between S541 chromosomal DNA and any of the plasmids tested were revealed by DNA-DNA Southern hybridization. PMID- 1770351 TI - Biological characterization of induced phages from Saccharopolyspora hirsuta 367 and comparison with phage JHJ-1. AB - Phages JHJ-2 and JHJ-3 were isolated from Saccharopolyspora hirsuta 367 UC 8106 following induction with mitomycin C and amplified on S. hirsuta NRRL B-5792. Their properties were compared with those of phage JHJ-1, isolated previously from S. hirsuta 367 NRRL 12045. The DNA restriction patterns appeared to be identical. One-step growth experiments showed no differences between the replication cycles. Burst sizes ranged from 100 to 110 p.f.u. per cell. However, the three phages showed some differences in their behaviour in different hosts. The host range of phage JHJ-1, on non-lysogenic strains, was emended to include all of the Saccharopolyspora strains tested; the host range of phage JHJ-2 was shown to be identical to JHJ-1. Phage JHJ-3 did not form detectable plaques on strains of S. rectivirgula or S. erythraea except S. erythraea NRRL 2359. Neither phage JHJ-2 nor JHJ-3 formed plaques on any lysogenic strains, while JHJ-1 formed plaques on all such strains except S. hirsuta 367 UC8106. Phage JHJ-3 was characterized as a temperate bacteriophage because it formed turbid, self limiting plaques and lysogenized S. hirsuta NRRL B-5792. It was spontaneously released from UC8106. Both JHJ-1 and JHJ-2 formed clear and invasive (Inv+ phenotype: the property to grow on old mycelium) plaques on some Saccharopolyspora strains but clear and self-limiting plaques on others. Thus, the expression of the Inv+ phenotype encoded by JHJ-1 and JHJ-2 appears to be modulated by the host cell. PMID- 1770352 TI - Molar growth yields and bioenergetic parameters of extremely alkaliphilic Bacillus species in batch cultures, and growth in a chemostat at pH 10.5. AB - Alkaliphilic Bacillus species that grow at pH 10.5 must cope with a low protonmotive force (-50 mV) due to a reversed transmembrane pH gradient at least 2 pH units more acid inside. Here we demonstrate that strictly alkaliphilic B. firmus RAB and two strains of B. alcalophilus (ATCC 27467 and DSM 485) grow exponentially in batch cultures with a doubling time of less than 1 h in 100 mM buffered medium, while the actual medium pH remains above 10.2. The ATCC strain continued to grow rapidly for at least 7 h, but the growth rate of the DSM strain declined dramatically after 3 h. However, both the B. alcalophilus strains, B. firmus RAB and facultatively alkaliphilic B. firmus OF4 were readily maintained for at least 24 h between pH 10.4 and 10.6 in a chemostat where nutrients were constantly replenished. A critical nutrient may be limiting in batch cultures of the DSM strain of B. alcalophilus. The facultative alkaliphile grew equally well in batch cultures at an initial pH of 7.5 or 10.5. Its molar growth yield (23 mg dry wt mmol-1) on malate (Ymal) was the same at the two pH values and was comparable to Ymal for B. subtilis grown at neutral pH. B. firmus RAB and B. alcalophilus ATCC 27467 grown at pH 10.5 also showed Ymal values at least as high as the neutralphile, indicating efficient use of the energy source even at low protonmotive force. Moreover, the phosphorylation potential of B. firmus OF4 grown at pH 7.5 (45.2 kJ mol-1) or pH 10.5 (46 kJ mol-1) was in a conventional range for bacteria. PMID- 1770353 TI - Modification of flavin adenine dinucleotide in alcohol oxidase of the yeast Hansenula polymorpha. AB - Alcohol oxidase, a major peroxisomal protein of methanol-utilizing yeasts, may possess two different forms of flavin adenine dinucleotide, classical FAD and so called modified FAD (mFAD). Conversion of FAD into mFAD was observed both in purified preparations of the enzyme and in cells grown in batch and continuous culture. The relative amount of mFAD in the enzyme varied from 5 to 95%, depending on the growth or storage conditions. The presence of mFAD led to a slight decrease in Vmax and a significant (about one order) decrease in the Km of alcohol oxidase with respect to methanol. The kinetics of modification measured in purified preparations of the enzyme obeyed first-order kinetics (k = 0.78 h 1). The modification process was strongly inhibited by methanol, formaldehyde or hydroxylamine. Modification observed in continuous culture under steady state conditions depended on the dilution rate and could also be described as a spontaneous first-order reaction (kapp = 0.27 h-1). FAD modification could only be detected in alcohol oxidase and not in other yeast peroxisomal flavoenzymes, such as D-amino acid oxidase from Candida boidinii. PMID- 1770354 TI - Antibodies to the N-terminal sequence of GVPa bind to the ends of gas vesicles. AB - Antibodies were raised against intact gas vesicles of Anabaena flos-aquae, and against a synthetic peptide (GVPaNT) whose sequence is identical to the N terminal region of the main gas vesicle protein, GVPa. A two-stage centrifugation procedure is described for separating gold-labelled antibodies bound to gas vesicles from unbound antibodies. The GVPaNT antibody bound to gas vesicles that had been previously rinsed with SDS to remove the outer gas vesicle protein, GVPc. Treatment with this antibody caused the gas vesicles to aggregate together end-to-end rather than side-by-side. The binding of the anti-GVPaNT-immunogold particles to the gas vesicle was restricted to the conical ends of the structure. These observations indicate that the sequence to which the GVPaNT antibodies were raised, residues 1 to 13 of the GVPa molecule, is exposed only at the outer surface of the cones and that it is normally obscured by GVPc. As GVPa forms both the conical ends and the cylindrical midsection of the gas vesicle, exposure of the N-terminal sequence only in the cones must be due to differences in the contact between adjacent GVPa molecules in the central cylinders and end-cones. PMID- 1770355 TI - Cloning and expression in Escherichia coli of a recA homologue from Mycobacterium tuberculosis. AB - A 3.8 kb PstI fragment of Mycobacterium tuberculosis was cloned in a recA-deleted Escherichia coli by selecting transformants with increased EMS resistance. The cloned fragment restored homologous recombination in Hfr crosses and conferred resistance to long wave (302 nm) but not short wave (254 nm) UV light. E. coli containing the 3.8 kb PstI fragment produced a 38-40 kDa protein which cross reacted with antibodies raised against the E. coli RecA protein. The cloned DNA thus probably encodes a RecA homologue. PMID- 1770356 TI - Plasmid-mediated NAD independence in Haemophilus parainfluenzae. AB - The location of the genes coding for NAD independence in four unusual clinical isolates of Haemophilus parainfluenzae was determined by transferring these genes to plasmid-free Haemophilus influenzae Rd by transformation and analysing transformants for the presence of plasmids by agarose gel electrophoresis. All NAD-independent transformants were found to carry a single plasmid species. The plasmids, originally harboured by the four H. parainfluenzae isolates recovered from unrelated sources, were of the same size (5.25 kb). Spontaneous reversion to NAD dependence occurred with a low frequency (0.1 to 0.2% of the progeny of a single clone) in both H. parainfluenzae and H. influenzae Rd. The revertants had lost this small plasmid. Mitomycin C exhibited a plasmid 'curing' effect with a frequency of 'curing' of between 1 and 6% of the surviving clones. It was concluded that the genes conferring NAD independence were located on the small 5.25 kb plasmid. PMID- 1770357 TI - Plasmid-encoded determinants for bacteriocin production and immunity in a Lactococcus lactis strain and purification of the inhibitory peptide. AB - Lactococcin, a bacteriocin produced by Lactococcus lactis subsp. lactis ADRIA 85LO30, was purified as a 2.3-2.4 kDa peptide. Six non-bacteriocin-producing (Bac ) and non-immune (Imm-) strains were isolated after curing experiments. These strains had in common the loss or modification of two plasmids: pOS4 (32 kb) and pOS5 (70 kb). By comparing pOS5 and several modified plasmids, a DNA region from pOS5 of about 10 kb, which was necessary for wild-type bacteriocin production and immunity, was identified. PMID- 1770359 TI - The thn mutation of Schizophyllum commune, which suppresses formation of aerial hyphae, affects expression of the Sc3 hydrophobin gene. AB - The spontaneous and recessive mutation thn in the basidiomycete Schizophyllum commune suppresses the formation of aerial hyphae in the monokaryon and, if present as a double dose, the formation of both aerial hyphae and fruit-bodies in the dikaryon. In the monokaryon, the mutation prevents accumulation of mRNA of the Sc3 gene, and in the dikaryon it also prevents the accumulation of fruiting specific mRNAs, including mRNAs of the Sc1 and Sc4 genes, which are homologous to the Sc3 gene. These three genes code for hydrophobins, a family of small hydrophobic cysteine-rich proteins. In the thn monokaryon, the only detectable change in synthesized proteins is the disappearance of an abundant protein of apparent Mr = 28 K from the culture medium and from the cell walls. Protein sequencing shows that this is the product of the Sc3 gene. The Sc3 hydrophobin is present in the walls of aerial hyphae as a hot-SDS-insoluble complex. Submerged hyphae excrete large amounts of the hydrophobin into the medium. PMID- 1770358 TI - Immunodominant carbohydrate determinants in the multicellular stages of Dictyostelium discoideum. AB - Two families of glycoprotein are defined in Dictyostelium discoideum by the presence of different glycoconjugates, both of which are highly immunogenic in mice. The previously described monoclonal antibodies MUD50 and MUD62 recognize the glycoconjugates and identify the respective glycoprotein families. Both types of glycosylation occur on vegetative and developmentally regulated glycoproteins. The immunodominant components of both families are reportedly O-linked sugars, but Western blots do not identify any glycoprotein that has both O-glycans, suggesting that there are two independently processed types of O-linked glycosylation in D. discoideum. The synthesis of the two O-glycan families is affected by glycosylation-defective mutations. Strains with a mutation at the modB locus lack one of these glycosylation types (that recognized by MUD50) and this mutation alters the size of two minor glycoproteins in the second family. Two new mutants, HU2470 (mod-352) and HU2471 (mod-353), lack the epitope recognized by MUD62. The two mutations map to different chromosomes. The mod-353 mutation also affects the size of PsA, a cell surface glycoprotein carrying the modB-dependent O-glycan. PMID- 1770360 TI - Vacuolar segregation to the bud of Saccharomyces cerevisiae: an analysis of morphology and timing in the cell cycle. AB - Vacuoles of Saccharomyces cerevisiae were visualized by phase-contrast microscopy. Visualization was enhanced by adding polyvinylpyrrolidone. Vacuolar segregation during the cell cycle was analysed in 42 individual cells of strain X2180 by time-lapse photomicrography. Within 15 min of bud emergence, more than 80% of the cells contained a vacuolar segregation structure in the form of either a tubule or an alignment of vesicles. The structure emerged from one point of the mother vacuole, then elongated and moved into the bud in a few minutes. The vacuolar segregation structure disappeared, usually within 20 min, before nuclear migration, leaving a separate vacuole in the bud. To test the generality of this observation several strains were grown in the presence of the vacuolar vital dye fluorescein isothiocyanate. The bud size was used to measure progress in the cell cycle. All strains formed vacuolar segregation structures in cells with small buds, although with variations in duration and timing in the cell cycle. In the presence of nocodazole vacuolar segregation occurred normally, thus, microtubules seem not to be essential in this process. PMID- 1770361 TI - A metabolic grid among versiconal hemiacetal acetate, versiconol acetate, versiconol and versiconal during aflatoxin biosynthesis. AB - Dichlorvos treatment of aflatoxigenic Aspergillus parasiticus SYS-4 (NRRL 2999) or a verscolorin A-accumulating mutant, NIAH-9, resulted in accumulation of versiconol acetate (VOAc) and versiconal hemiacetal acetate (VHA), whereas the production of aflatoxins, versicolorin A (VA), and versiconol (VOH) decreased. In feeding experiments using another non-aflatoxigenic mutant, NIAH-26, aflatoxins were newly produced from each of VHA, VOAc, VOH, versicolorin B (VB) and versicolorin C (VC). In these experiments, aflatoxin production from VHA or VOAc was inhibited by dichlorvos, whereas that from each of VOH, VB and VC was insensitive to dichlorvos. In cell-free experiments using the cytosol fraction of NIAH-26, VHA was converted to VC (or VB) and a substance tentatively identified as versiconal (VHOH). By further addition of NADH or NADPH to the same reaction mixture, VOAc and VOH were also formed together with VC (VB) and VHOH. VOH was produced from VOAc irrespective of nicotinamide adenine nucleotide. Also, the incubation of VOH in the presence of NAD or NADP led to the formation of VC (VB). The production of VC (VB) and VHOH from VHA, and that of VOH from VOAc was inhibited by dichlorvos, whereas the production of VOAc from VHA, and that of VC (VB) from VOH, was insensitive to dichlorvos. These results indicate that a metabolic grid catalysed by dehydrogenase and esterase among VHA, VOAc, VOH and VHOH, and a reaction from VHOH to VC (VB) are involved in aflatoxin biosynthesis. These enzyme activities were also detected when yeast extract peptone medium was used, or when A. oryzae SYS-2 was examined. PMID- 1770362 TI - Recovery of viable but non-culturable Campylobacter jejuni. AB - Suspensions of Campylobacter jejuni became non-culturable after storage in sterilized pond water at 4 degrees C for periods between 18 and 28 d, depending on the strain. Suspensions of four strains of C. jejuni that had been in water for 6 weeks, and shown to be non-culturable, were fed to suckling mice. Colonization of mice was established with two of the strains and failed with the other two strains. Examination of these suspensions under the electron microscope showed some cocci having the appearance of being viable, but most cocci and all remaining spiral forms showed extensive degeneration. The results indicate that non-culturable coccal forms of C. jejuni are capable of infecting mice but that this property may differ between strains. PMID- 1770363 TI - The type 4 pilin of Moraxella nonliquefaciens exhibits unique similarities with the pilins of Neisseria gonorrhoeae and Dichelobacter (Bacteroides) nodosus. AB - Moraxella nonliquefaciens is a bacterium which is part of the normal flora of the human upper respiratory tract and is an occasional cause of disease. Using a previously cloned type 4 pilin gene (tfpQ) from Moraxella bovis as a hybridization probe, we have cloned an 826 bp Sau3 AI fragment which contains an M. nonliquefaciens type 4 pilin gene (tfpA) from strain NCTC 7784. The pilin gene is expressed in Escherichia coli. We have examined NCTC 7784 and nine other M. nonliquefaciens strains by genomic Southern hybridization using tfpA as a probe, and they all appeared to have more than one pilin gene. While the predicted amino acid sequence of the M. nonliquefaciens tfpA pilin has conserved regions as compared to pilins of M. bovis and M. lacunata, it also shows similarities to both the type 4 pilin of Neisseria gonorrhoeae and the type 4 pilin of Dichelobacter nodosus (formerly Bacteroides nodosus). PMID- 1770364 TI - Autologous bone grafting for medial tibial defects in total knee arthroplasty. AB - Seventeen posterior stabilized Insall-Burstein knee arthroplasties were implanted in severely deformed varus knees with large medial tibial bony defects. The defect was filled with an autologous bone graft obtained from the same knee and fixed with one or two screws. The patients were reviewed during an average follow up period of 4 years (range, 2-8 years). The graft was completely united in 14 cases (82%), with bony trabeculae crossing the interface. Fibrous union occurred in three cases (18%). There was no evidence of graft necrosis or collapse. The results were classified as excellent in 10 knees (59%), good in 6 (35%), and poor in 1 (6%), which was revised for femoral loosening. The importance of meticulous technique and correct component positioning is emphasized. PMID- 1770365 TI - Mechanical stability of porous-coated acetabular components in total hip arthroplasty. AB - Five different porous-coated acetabular prosthetic configurations underwent in vitro testing to assess mechanical stability in embalmed cadaver hemipelves: Harris Galante II cup with three cancellous screws, Biomet Universal cup, Whiteside cup with peripheral pegs, Whiteside cup with two cancellous screws, and plain Whiteside cup. Following implantation in a neutral frame, cyclic load testing was done using 33 specimens at 100-kg load for 100,000 cycles using an MTS machine (MTS Systems Corp., Minneapolis, MN). Subsequently, static load-to failure testing was done in all specimens. Subsidence and micromovement were determined for each specimen using linear variable differential transformers. With cyclic testing, overall cup subsidence revealed a significant increase, from 500 to 100,000 cycles. Overall cup micromovement revealed a significant decrease, and all cup groups demonstrated less than 125 microns (.125 mm) of average mean micromotion at the completion of cyclic testing. The best cup configuration was a 1-mm, oversized, press-fit cup using two 6.5 cancellous screws for additional fixation, which revealed an average mean of 60 microns (.06 mm) of micromovement. Static load testing revealed unacceptable micromovement over 150 microns (.150 mm) in most cups with 300-kg loads. PMID- 1770366 TI - Screw-augmented fixation of acetabular components. A mechanical model to determine optimal screw placement. AB - Sixteen embalmed hemipelves were used to determine the optimal acetabular screw placement to provide maximal screw pull-out strength in unicortical and bicortical screw fixation. The anterior column, superior ilium, posterior column, ischium, and pubis regions of the pelvis were tested using 6.5-mm titanium alloy screws and a hydraulic servo-controlled 1321 Instron testing machine. Force vs displacement data were acquired. Bicortical fixation was stronger than unicortical fixation in the four zones compared. This difference was significant in the superior ilium, posterior column, and ischium. The anterior column could not accept unicortical screws due to inadequate bone depth, which ranged between only 6 mm and 10 mm. Bicortical fixation was significantly greater in the superior ilium, posterior column, and ischium than in the anterior column or pubis. Unicortical fixation was greatest in the superior ilium. This information may aid decisions concerning the positioning of screws to augment acetabular component fixation. PMID- 1770367 TI - Femoral instrumentation using the anterosuperior iliac spine as a landmark in total knee arthroplasty. An anatomic study. AB - Twenty-six adult cadavers were utilized in an anatomic study designed to measure intramedullary femoral alignment in relation to the anterosuperior iliac spine. Fifty femurs were measured to determine the reliability of the anterosuperior iliac spine as an accurate landmark for distal femoral resection in total knee arthroplasty (TKA). A precision machined stainless steel U-shaped parallel alignment guide was fabricated and inserted into the femoral canals of intact adult cadavers. The guide's relationship to the anterosuperior iliac spine was measured and recorded. All hips were maintained in neutral alignment. Independent variables recorded included gender, knee alignment, and side of lower extremity. The range for medial deviation was 1-28 mm for the right femur and 2-25 mm for the left femur (average, 8.5 mm). The range for lateral deviation was 3-14 mm for the right femur and 2-17 mm for the left femur (average, 10.3 mm). There was no statistical correlation between the independent variables of side measured, gender, and measured offset at the anterosuperior iliac spine. Based on this highly variable pattern of alignment, utilizing simulated intraoperative technique, use of the anterosuperior iliac spine does not provide a landmark accurate enough to repeatedly produce a distal femoral resection within 2 degrees 3 degrees of ideal. Use of the anterosuperior iliac spine may lead to less than ideal femoral resection and malpositioning of total knee components. PMID- 1770368 TI - Preoperative nutritional status of total joint patients. Relationship to postoperative wound complications. AB - The records of 217 consecutive patients who underwent a primary total hip or total knee arthroplasty were reviewed for preoperative and postoperative nutritional status. Fifty-seven patients had a lymphocyte count of less than 1,500 cells/mm3, four patients had an albumin level of less than 3.5 g/dL, and two patients had both, giving a 27% incidence of indices indicative of preoperative nutritional depletion. Patients without wound complications had an average preoperative lymphocyte count of 1,995 (+/- 631), compared to 1,638 (+/- 491) for those with persistent serous drainage from their wounds, and 1,553 (+/- 419) for those patients with a major wound complication (P = .002). The average albumin levels were 4.30 (+/- 0.33), 4.22 (+/- 0.31), and 4.13 (+/- 0.54), respectively. Patients with rheumatoid arthritis were compared to those with osteoarthritis and were found to have significantly lower preoperative albumin levels. They were three times as likely to develop a major wound complication. Patients on immunosuppressive medications had significantly lower preoperative lymphocyte counts, lower albumin levels, and higher complication rates (P = .04). After operation, lymphocyte counts of all patients dropped to an average of 57% of their preoperative values, and albumin levels dropped to 72% of their preoperative values. No nutritional parameters had returned to their preoperative levels by 10 postoperative days. For all patients, a preoperative lymphocyte count of less than 1,500 cells/mm was associated with a five times greater frequency of developing a major wound complication, and an albumin level of less than 3.5 g/dL had a seven times greater frequency.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770369 TI - Arthroscintography for detection of femoral component loosening. AB - Arthroscintography is a simple and effective means of detecting femoral component loosening. Fourteen patients with painful total hip arthroplasties were evaluated using arthroscintography for the detection of femoral component loosening. Using this method, a sensitivity of 100% and a specificity of 75% were achieved. It is therefore recommended that arthroscintography become a routine part of the evaluation of painful total joint arthroplasties of the hip. PMID- 1770370 TI - Evaluation of acetabular stability in uncemented prostheses. AB - The stability of two commonly used uncemented acetabular prostheses fixed with either pegs or screws has been established by evaluating the torque strengths in ten cadaveric acetabulae. The initial stability of implants to simulated frictional loads was satisfactory compared to previous estimations of the frictional torques in polyethylene-on-metal and metal-on-metal articulations. Testing of the torque required to produce 2 degrees of rotation at the bone implant interface showed that the peg fixation required significantly greater loads than did the screw fixation (P less than .03). Testing the prostheses to failure gave good results, although lower than previous cemented arthroplasty estimations. The margin of stability over the frictional torques that can be generated is such that it may affect the bony ingrowth into these prostheses. This may account for the common finding of fibrous ingrowth in these prostheses. PMID- 1770371 TI - Total knee arthroplasty using the total condylar III knee prosthesis. AB - Twenty-seven total knee arthroplasties (TKAs) were performed in 24 patients using the total condylar III knee prosthesis (TCP III) and were evaluated clinically and radiographically with a mean follow-up period of 4 years. Eighteen were revision TKAs, and nine were primary knee arthroplasties. Evaluations were made using the Hospital for Special Surgery (HSS) knee scale as well as the Knee Society radiographic evaluation method. Clinical results for all knees were 11% (3 of 27) excellent, 70% (19 of 27) good, 15% (4 of 27) fair, and 4% (1 of 27) poor. The one poor rating resulted from an intraoperative vascular injury. The results showed no statistical difference between revision and primary TKA. After operation, pain relief, range of motion, walking, function, and activity level improved in both the primary and revision patients. Radiolucencies 2 mm or greater in width were found in 6 of the 27 tibial components, in none of the 27 femoral components, and in 1 of the 19 patellar components. Only two tibial implants showed progressive radiolucencies. No correlation was found between the radiographic position of the implants and the clinical results. The authors conclude that the TCP III is a satisfactory choice for TKA in selected knees in which there is significant instability and in which intramedullary fixation is required. PMID- 1770372 TI - Revision total knee arthroplasty. A survival analysis. AB - The results of revision total knee arthroplasty (TKA) have been documented reasonably well in the literature. It is notable, however, that none of these reports have used the technique known as survival analysis to compare virgin and revision arthroplasties. This technique has an advantage over conventional analyses because it does not exclude patient data for inadequate follow-up study or patient death. In this study, survival analysis was applied to 37 revision TKAs performed exclusively by the senior author. With failure defined as removal of the prosthesis, revision surgeries experienced a 97.0% survival rate at 6 years. The secondary arthroplasty demonstrated a significantly lower survival rate than the index procedure over a period of approximately 6 years. PMID- 1770373 TI - Results of cementless total knee arthroplasty in an older rheumatoid arthritis population. AB - Fifty-five total knee arthroplasties (TKAs) in thirty-nine adult (mean age, 62 years) patients with rheumatoid arthritis were studied prospectively for a period of 1-7 years. All of the procedures were performed using cementless fixation of the tibial and femoral components. The Knee Society clinical rating system mean knee scores increased 56 points after operation (mean, 88 points), and the mean functional scores increased 28 points (mean, 64 points). Two revisions (4%) have been required, one for secondary late infection and one for failure of a cementless metal-backed patellar component. Good bone stock was retained in both, allowing for uneventful cementless revision. Forty-two arthroplasties (76%) were completely pain-free, twelve (22%) had mild, occasional discomfort with weight bearing, and one (2%) had moderate pain at last examination. In this older rheumatoid population, cementless TKA offers good or excellent early clinical results and excellent preservation of bone stock should revision become necessary. PMID- 1770374 TI - Surgical management of complex irreparable rotator cuff deficiency. AB - The authors surgically treated 23 shoulders in 23 patients with disabling pain associated with irreparable tears of the musculotendinous cuff. In a total of 12 shoulders with preserved passive motion, normal deltoid function, loss of glenohumeral joint surfaces, and sculpturing of the coracoacromial arch, a standard or oversized Neer II humeral prosthesis without glenoid replacement was selected. A total of 11 shoulders that failed to meet these prerequisites or demanded heavy use after operation underwent arthrodesis. Twenty-two patients (12 from the hemiarthroplasty group and 10 from the arthrodesis group) were available for evaluation at an average follow-up period of 37.5 months. Comfort level and overall function were improved in both groups. Active forward elevation improved an average of 44 degrees in the hemiarthroplasty group and an average of 15 degrees in the arthrodesis group. The success of hemiarthroplasty and the problems of glenoid loosening in the presence of cuff deficiency with upward head displacement have led to the conclusion that humeral hemiarthroplasty is the preferred method for managing complex irreparable tears of the rotator cuff in which the articular surface is destroyed, yet the deltoid muscle is functional. Shoulder arthrodesis is reserved for those patients who have both irreparable tears of the rotator cuff and irreparable deficiencies of the deltoid muscle, or the younger patient with demands for substantial strength at low angles of flexion. PMID- 1770375 TI - Fracture of the ceramic head in total hip arthroplasty. Report of two cases. AB - This article reports two cases of fracture of the ceramic head component in total cementless hip arthroplasty. There was no history of difficulty prior to the component fracture, neither during the operation nor during daily use, and in one of the patients, no history of trauma was observed. PMID- 1770376 TI - Recurrent disassembly of a modular humeral prosthesis. A case report. AB - A modular prosthesis for shoulder arthroplasty can be complicated by disassembly of the bearing surface from the humeral stem. Glenohumeral instability and increased humeral translation may be associated with this complication. PMID- 1770377 TI - Technique for access to the posterosuperior iliac spine for local bone graft during total hip arthroplasty. AB - A technique of local acquisition of large amounts of autogenous bone graft during revision total hip arthroplasty is described. Eleven such procedures in ten patients are described, with average total blood loss (intraoperative and postoperative) of 2,610 ml. No adverse wound or operative complications related to bone graft acquisition occurred. PMID- 1770379 TI - Similarity of molecular shape. AB - The similarity of one molecule to another has usually been defined in terms of electron densities or electrostatic potentials or fields. Here it is expressed as a function of the molecular shape. Formulations of similarity (S) reduce to very simple forms, thus rendering the computerised calculation straightforward and fast. 'Elements of similarity' are identified, in the same spirit as 'elements of chirality', except that the former are understood to be variable rather than present-or-absent. Methods are presented which bypass the time-consuming mathematical optimisation of the relative orientation of the molecules. Numerical results are presented and examined, with emphasis on the similarity of isomers. At the extreme, enantiomeric pairs are considered, where it is the dissimilarity (D = 1 - S) that is of consequence. We argue that chiral molecules can be graded by dissimilarity, and show that D is the shape-analog of the 'chirality coefficient', with the simple form of the former opening up numerical access to the latter. PMID- 1770378 TI - 3-D QSAR analysis of steroid/protein interactions: the use of difference maps. PMID- 1770380 TI - The structure-activity relationship of inhibitors of serotonin uptake and receptor binding. AB - An analysis of five different datasets of inhibitors of serotonin uptake has yielded quantitative structure/activity relationships (QSARs) which delineate the role of steric and hydrophobic properties essential for inhibition by phenylethylamine-type analogues. PMID- 1770381 TI - Techniques for the calculation of three-dimensional structural similarity using inter-atomic distances. AB - This paper reports a comparison of several methods for measuring the degree of similarity between pairs of 3-D chemical structures that are represented by inter atomic distance matrices. The methods that have been tested use the distance information in very different ways and have very different computational requirements. Experiments with 10 small datasets, for which both structural and biological activity data are available, suggest that the most cost-effective technique is based on a mapping procedure that tries to match pairs of atoms, one from each of the molecules that are being compared, that have neighbouring atoms at approximately the same distances. PMID- 1770383 TI - Yesterday, today and perhaps tomorrow. PMID- 1770382 TI - COSMIC(90): an improved molecular mechanics treatment of hydrocarbons and conjugated systems. AB - Four modifications to the COSMIC molecular mechanics force field are described, which greatly increase both its versatility and the accuracy of calculated conformational energies. The Hill non-bonded van der Waals potential function has been replaced by a two-parameter Morse curve and a new H-H potential, similar to that in MM3, incorporated. Hydrocarbon energies in particular are much improved. A simple iterative Huckel pi-electron molecular orbital calculation allows modelling of conjugated systems. Calculated bond lengths and rotational barriers for a series of conjugated hydrocarbons and nitrogen heterocycles are shown to be as accurate as those determined by the MM2 SCF method. Explicit hydrogen-bonding potentials for H-bond acceptor-donor atom pairs have been included to give better hydrogen bond energies and lengths. The van der Waals radii of protonic hydrogens are reduced to 0.5 A and the energy well depth is increased to 1.0 kcal mol-1. Two new general atom types, N+sp2 and O-sp3, have been introduced which allow a wide variety of charged conjugated systems to be studied. A minimum of parameterisation is required, as the new types are easily included in the Huckel scheme which automatically adjusts bond and torsional parameters according to the defined bond-order relationships. PMID- 1770384 TI - Nothing ventured, nothing gained. PMID- 1770385 TI - Incidence of bronchopulmonary dysplasia, growth failure, and pulmonary dysfunction assessed by clinical scoring. AB - A clinical scoring system was used to determine retrospectively whether the severity of bronchopulmonary dysplasia (BPD) in 67 preterm infants at 21 to 27 days of age would predict the need for home supplemental oxygen or growth retardation (weight less than 5th percentile at 12 months of age). The scoring system was composed of five variables, including fractional inspiratory oxygen, partial pressure of CO2, respiratory rate, chest retractions, and growth rate. The score did not predict the need for home supplemental oxygen or growth retardation (P = .87 and .79, respectively); in contrast, the number of hours of oxygen greater than 80% was significantly correlated with home O2 use (P = .0001) and growth retardation at 1 year of age (P = .013). Since there is no simple predictive score that can be used to determine the functional severity of BPD, each at-risk infant must be clinically evaluated for the degree of pulmonary dysfunction, the need for O2 supplementation, and other supportive pulmonary care prior to discharge. PMID- 1770386 TI - Improved oxygenation with prone positioning in neonates: stability of increased transcutaneous PO2. AB - To evaluate the effect of body position on oxygenation and ventilation in neonates over a prolonged period, infants with respiratory disease were followed by transcutaneous (tc) monitoring for alterations in tcPO2 and tcPCO2 with position changes. In 14 studies of seven patients, prone positioning was compared with supine positioning over a 6-hour interval. All patients were premature, were receiving supplemental oxygen, and had respiratory disease secondary to prematurity. The median gestational age was 29 weeks; all infants were 2 months old or less at the time of the study. Prone positioning resulted in a significantly higher tcPO2; mean (+/- SD) tcPO2 increased from 63 (+/- 11.6) mm Hg to 71 (+/- 14.6) mm Hg, and decreased to 65 (+/- 11.2) mm Hg when the infant was returned to supine (P less than .05). This increase in tcPO2 was stable throughout 2 hours in the prone position. No significant change in tcPCO2 was detected. Infants were also found to spend a greater proportion of time sleeping when prone (75% +/- 13% vs 33% +/- 14%; P less than .05). These finding suggest that improvement in oxygenation with the prone position is stable over an extended period in the sick preterm infant. PMID- 1770387 TI - Vibroacoustic stimulation and fetal hiccoughs. AB - Hiccoughs are a physiological phenomenon, beginning in the second trimester of pregnancy, increasing in frequency throughout gestation, and continuing into the neonatal period. There is concern about the safety of the use of vibroacoustic stimulation of the third-trimester fetus as part of the evaluation of fetal well being. This study was directed to determine whether the evoked fetal startle response would accentuate or decrease the incidence of hiccoughs. Of the 342 nonstress tests (NSTs) performed, fetal hiccoughs were heard during 39 (11.4%) tests. The incidence of hiccoughs was 10.6% (25/236) of patients stimulated with sound and 13.2% (14/106) of these without sound (P = NS). Hiccoughs were found to increase in frequency throughout the third trimester. In all nonreactive NSTs, hiccoughs were absent. This vibroacoustic stimulation did not affect the fetal physiologic response of hiccoughs, and the absence of hiccoughs in nonreactive NSTs may be another indicator of fetal compromise. PMID- 1770388 TI - Prevalence of illicit drug use among prenatal patients and predictive validity of nurses' judgments. AB - The purposes of this investigation were to: (1) estimate the prevalence of illicit drug use within the prenatal population of a midwestern suburban ambulatory care center; (2) explore the relationship between nurses' judgments of patient illicit drug use and urine toxicology results; and (3) determine if a difference exists between nurses' judgments of illicit drug use by private physicians' patients (PPP) and nurses' judgments of illicit drug use by resident physicians' patients (RPP). For a 16-week period, all new prenatal patients (N = 189) were included in this study; 78 (41%) were in the RPP group and 111 (59%) were in the PPP group. Urine remaining from routine urinalysis was assayed for seven drugs or drug classes. Fourteen (7.5%) subjects tested positive for illicit drugs, 8 (10.3%) in the RPP group, and 6 (5.4%) in the PPP group (chi 2, P greater than .33). Using a Likert-type scale, nurses rated the likelihood of a positive result of each patient's urine test. Nurses' judgments of patient illicit drug use and positive results were related, r = .28. Nurses were more likely (P less than .0001) to suspect residents' patients of illicit drug use than private physicians' patients. PMID- 1770389 TI - Manual ventilation of adult cats by neonatal respiratory therapists. AB - Manual ventilation of neonates suffering from respiratory distress is frequently performed in the hospital setting. The authors hypothesized that without manometer feedback present, experienced neonatal intensive care therapists cannot accurately estimate ventilating pressures. We also speculated that with rate feedback present, this same group could match a given ventilatory rate. Thirty respiratory therapists (RTs) were instructed to match the ventilating pressures and rates for two animal models receiving ventilatory support. Each animal was ventilated at high pressure settings: peak inspiratory pressure (PIP) 25 cm H2O, positive end-expiratory pressure (PEEP) 5 cm, and a rate of 60 breaths per minute; the low pressure settings were PIP 16 cm H2O, PEEP 3 cm, and a rate of 20 breaths per minute. There was essentially no replication of the desired PIP values. PEEP levels were constant in the study population, but there was no accuracy in relation to the targets. Rate accuracy was good with the higher rate, but there was some statistical deviation from the given lower rate for both models. We conclude that in the presence of a cycling ventilator set at the desired rate, this group of therapists could replicate the cycling rate. However, without a means for feedback of ventilating pressures, dictated pressures could not be matched. PMID- 1770390 TI - Anthropometry and bilirubin production. AB - Anthropometric measurements and total bilirubin formation (TBF) estimates were performed on infants born to normal and diabetic mothers. Although we do not exclude the theoretical possibility of a low-frequency occurrence of increased TBF in macrosomic infants of normal mothers, we can conclude that infants of mothers whose diabetes is well managed may have normal TBF. PMID- 1770391 TI - Relationship between neonatal excitability and respiratory habituation. AB - The Brazelton Neonatal Behavioral Assessment Scale was administered and analyzed in the cases of 25 full-term infants in order to assess the relationship between a behavioral measure of excitability and respiratory habituation. Sound and light stimuli were sequentially delivered, and prestimulus and poststimulus respiratory amplitude mean and standard deviation were analyzed. The stimulus with the least interperiod difference was considered as habituation. The correlation between arousal behavioral items and respiratory habituation ranged between 0.16 and 0.44. The two significant correlations were between peak of excitement and respiratory habituation to light (0.44) and between rapidity of buildup and respiratory habituation to sound (0.38). These results may indicate an interrelation in neonates between temperamental excitability attributes and respiratory regulation. PMID- 1770392 TI - Patient-triggered synchronized assisted ventilation of newborns. Report of a preliminary study and three years' experience. AB - The safety, efficacy, and outcome of long-term patient-triggered synchronized assisted ventilation in infants (SAVI) was studied in very low birthweight infants (450 to 1250 g) with uncomplicated respiratory failure. Synchronization was accomplished by modified thoracic impedance technology using standard neonatal cardiorespiratory monitors with the output of the ventilation synchronizer triggering the exhalation solenoid of a standard neonatal respirator. In this nonrandomized study, the technique was found to be safe and reliable without any episodes of technical failure or adverse effects. The results indicated that in comparison with infants receiving conventional ventilation, infants receiving SAVI required (1) shorter duration of ventilation, (2) decreased duration of oxygen therapy, and (3) decreased progression of intraventricular hemorrhage to greater than or equal to grade III. Decreased duration of ventilation was statistically significant in infants weighing less than 850 g (P less than .02). These beneficial trends were ratified during a 3 year period in a total of 110 cases. PMID- 1770393 TI - Neutropenia in donor (anemic) twins involved in the twin-twin transfusion syndrome. AB - Neutropenia is common in neonates with sepsis and in those born to women with pregnancy-induced hypertension. Neutropenia has not previously been described, however, as a result of the twin-twin transfusion syndrome. We observed neutropenia of 4 to 8 days' duration in each of five "donor" (anemic) twins affected with the twin-twin transfusion syndrome. No evidence of infection was observed. Like neutropenia of pregnancy-induced hypertension, no left shift was seen. Neutrophil kinetic studies were performed on one of the neutropenic patients. Assessment of the marginal, storage, proliferative, and progenitor cell pools indicated that neutropenia resulted from diminished neutrophil production. PMID- 1770394 TI - Low-dose doxapram for apnea unresponsive to aminophylline in very low birthweight infants. AB - This study was designed to test whether the addition of low-dose (less than or equal to 1.5 mg/kg/h) doxapram may help wean from positive airway pressure very low birthweight (less than or equal to 1250 g) infants with apnea unresponsive to aminophylline. Doxapram infusion was started at 0.1 to 0.5 mg/kg/h and increased as necessary up to a maximum of 1.5 mg/kg/h. Average birthweight (N = 12) was 1026 +/- 170 g (mean +/- SD, range 740 to 1250), gestational age 27.8 +/- 2.6 weeks (range 24 to 34), postnatal age 24.2 +/- 9.4 days (range 13 to 40), central spun hematocrit 44% +/- 4% (range 38% to 48%), and theophylline level 57.1 +/- 7.7 mumol/L. Doxapram therapy resulted in weaning to a head box in 11 of 12 patients; two required a subsequent course after stopping doxapram. Since the only observed toxicity was mild irritability in one patient, we conclude that very low birthweight infants with apnea unresponsive to aminophylline and older than 1 week of age often respond to the addition of low-dose doxapram with only minimal side effects. Since there was a negative correlation between theophylline level and the effective doxapram dose (r = -.64, N = 13, P less than .05), we recommend that treatment with doxapram be considered in the United States only in those infants with a theophylline level greater than or equal to 88.8 mumol/L, in order to limit the cumulative dose of benzyl alcohol administered. PMID- 1770395 TI - Narcotic sedation stabilizes arterial blood pressure fluctuations in sick premature infants. AB - Blood pressure (BP) fluctuations in infants with respiratory distress syndrome (RDS) are related to spontaneous respirations and have been associated with an increased incidence of intraventricular hemorrhage. Both initiation of mechanical ventilation in the nonventilated infant and muscle paralysis in the ventilated infant can help stabilize these fluctuations. We hypothesized that narcotic sedation would also be effective in decreasing BP fluctuations when pharmacologic intervention is deemed necessary. Twenty premature infants were paralyzed with pancuronium or sedated with morphine or fentanyl for clinical indications. Blood pressure and respiratory tracings before and after medication were analyzed for average peak systolic BP (SBP) and the percentage of spontaneous respirations (SResp). Fluctuations of SBP were quantitated using the coefficient of variation (CV). A marked reduction was found in both CV and SResp following administration of all three drugs. Peak inspiratory pressure and ventilator rate were increased in the pancuronium group. In 7 out of 14 patients in whom spontaneous respirations persisted following sedation, there was a strong association between the percentage of decrease in CV and SResp. Advantages of narcotic sedation over muscle paralysis are discussed. PMID- 1770396 TI - Withdrawal of nutrition and fluids from a neurologically devastated infant: the case of baby T. PMID- 1770397 TI - Comparison of two neonatal intravenous amino acid formulations in preterm infants: a multicenter study. AB - Two neonatal intravenous amino acid solutions (Aminosyn-PF and Troph-Amine) were compared in 44 preterm infants. The rate of weight gain, nitrogen balance, and changes in plasma aminograms were determined over 7 days to ascertain whether different outcomes could be identified for the two solutions. At study entry, the infants received a minimum infusion of 2 g amino acid/kg/d with 50 or more nonprotein kcal/kg/d. Group mean amino acid intake over the study period was approximately 2.6 g/kg/d for both groups; nonprotein caloric intake approximated 90 kcal/kg/d. Results showed no significant differences between solutions for the rate of weight gain, nitrogen balance, and nitrogen retention, which approximated intrauterine rates. The rate of weight gain averaged nearly 15 g/kg/d for both solutions. Differences between day 0 and day 7 plasma aminograms showed significant changes between solutions for histidine, lysine, methionine, phenylalanine, threonine, and glutamic acid. However, day 7 plasma aminograms for both solutions compared favorably with those from enterally fed preterm infants reported in the literature. Failure to identify significant differences for the rate of weight gain, nitrogen balance, or nitrogen retention between the two groups suggests that differences in plasma aminograms resulting from use of one solution or the other had no short-term clinical consequences in the premature infants studied. PMID- 1770398 TI - Abnormal fetal heart rate pattern and emergency cesarean section in an anomalous infant. PMID- 1770399 TI - Fetal monitoring casebook. The saltatory fetal heart rate pattern. PMID- 1770400 TI - Ventilatory casebook. Respiratory syncytial virus infection complicating bronchopulmonary dysplasia. PMID- 1770401 TI - Neonatal radiology casebook. Neonatal eventration of the diaphragm. PMID- 1770402 TI - Access to care, Part 4. PMID- 1770403 TI - Control of cab gene expression in synchronized Chlamydomonas reinhardtii cells. AB - In light-dark synchronized Chlamydomonas reinhardtii cultures transcripts of at least two members of the cab gene family coding for chlorophyll a/b binding proteins are highly abundant in the light, but almost undetectable in the dark. "Run-on" transcription assays in isolated nuclei were used to show that the rapid increase in cab mRNA levels during the light phase is primarily due to regulation at the transcriptional level. Functionally unrelated inhibitors such as dipyridyl and cycloheximide as well as anaerobic conditions block chlorophyll synthesis, presumably by interfering with the conversion of magnesium protoporphyrin monomethyl ester to protochlorophyllide. Under these conditions, cab mRNA does not accumulate and nuclei isolated from inhibitor-treated cells do not support cab gene transcription. Inhibitors such as dioxoheptanoic acid and diphenyl ether herbicides block earlier steps within the chlorophyll synthesis pathway without substantial effects on cab mRNA accumulation and transcription. A possible control of transcription by intermediates of the chlorophyll biosynthesis pathway is discussed. PMID- 1770404 TI - Different blue-light requirement for the accumulation of transcripts from nuclear genes for thylakoid proteins in Nicotiana tabacum and Lycopersicon esculentum. AB - We have isolated recombinant lambda gt11 phages which carry cDNA clones for the major light-harvesting chlorophyll a/b-binding proteins of photosystem I (LHCPI) and II (LHCPII), subunit II of photosystem I, a chlorophyll a/b-binding protein of photosystem II (CP24), the Rieske iron-sulphur protein of the cytochrome b6/f complex, and the 33, 23 and 16 kDa proteins of the water-oxidizing complex of photosystem II from Nicotiana tabacum. The nucleotide sequences of cDNA clones encoding the precursors for LHCPI and the FeS protein are presented. If tobacco or tomato seedlings, or seedlings of a phytochrome-deficient aurea mutant of tomato which lacks more than 95% of the phytochrome of the isogenic wild type, are kept in blue light, the transcript level of each of these genes is higher than in seedlings grown in red light suggesting the involvement of a blue-UVA light photoreceptor. In the case of LHCPI, a 1 min blue-light pulse applied to red-light-grown seedlings is sufficient to increase the transcript levels to those present in blue-light-grown seedlings, whereas almost no increase is observed for transcripts encoding the FeS and 33 kDa proteins. If dark-grown tomato seedlings receive a single far-red-light pulse, significant stimulation is detected for LHCPI transcripts, whereas transcripts encoding the FeS and 33 kDa proteins are not stimulated. It is concluded that the lower light requirement for the increase in the LHCPI transcript level is not specific for one of the light dependent signal transduction chains. PMID- 1770405 TI - Plastid DNA synthesis and nucleic acid-binding proteins in developing barley chloroplasts. AB - Activation of plastid DNA synthesis occurred early in barley leaf chloroplast development. High rates of DNA synthesis were observed in the leaf basal meristem of dark-grown plants where plastid transcription activity was low. DNA synthesis activity decreased in later stages of chloroplast development. Plastid nuclei acid-binding proteins were detected after lithium dodecylsulfate (LDS) polyacrylamide gel separation and renaturation. One set of nucleic acid-binding proteins was associated with plastid nucleoids. A second set of nucleic acid binding proteins co-sedimented with ribosomes and most probably corresponds to ribosomal proteins. Changes in the composition of the nucleic acid-binding proteins were characterized as a function of chloroplast development in dark grown and illuminated barley plants. PMID- 1770406 TI - Photocontrol and processing of LHCP II apoprotein in Euglena: possible role of Golgi and other cytoplasmic sites. AB - Like other green photosynthetic eukaryotes, cells of Euglena gracilis var. bacillaris and strain Z contain a light-harvesting chlorophyll a/b complex associated with photosystem II. In Euglena, the formation of the 26.5 kDa principal light-harvesting chlorophyll a/b binding protein of photosystem II (LHCP II) has a number of unusual features. The precursors to LHCP II are large polyproteins containing multiple copies of LHCP II, and photocontrol of their formation is largely translational. Under conditions favoring LHCP II accumulation in the thylakoids, a reaction with anti-LHCP II antibody can be observed in the Golgi by immunogold electron microscopy. The timing of the immunoreaction in the Golgi in synchronous cells and in cells undergoing normal light-induced chloroplast development suggests that the nascent LHCP II passes through the Golgi on the way to the thylakoids. The compartmentalized osmiophilic structure (COS) also shows an immunoreaction. These observations, and other discussed in this paper, suggest that light permits translation of polyprotein LHCP II precursors on cytoplasmic ribosomes of the rough endoplasmic reticulum (ER) and that these pass through the ER to the Golgi where, presumably, further modifications take place. Since an LHCP II immunoreaction is found in Golgi vesicles, these may transport the nascent LHCP II to the plastid and facilitate its uptake. PMID- 1770407 TI - Request that the USP Committee of Revision reevaluate its position relative to the inclusion of clean room air and microbial limits in the U.S. Pharmacopeia (USP) PMID- 1770408 TI - Proposed USP microbial limits. PMID- 1770409 TI - Metallurgical, manufacturing and surface finish requirements for high purity stainless steel system components. AB - The stainless steel piping systems that distribute water for injection (WFI) and other critical fluids in pharmaceutical and biotechnology plants will be the subject of this paper. We will confine our focus to the two major components of such systems--tubing and fittings. It should be noted that the discussions here can certainly be applied in the selection of other components such as valves, filter housings, pumps, and tanks used in these industries. The purpose of this paper will be to guide user choices with regard to raw material selection, surface preparation, and surface analysis within the context of system requirements. A suggested material specification for stainless steel tubing and fittings will also be presented. PMID- 1770410 TI - Some aspects on the use of the Biotest RCS Air Sampler in unidirectional air flow testing. AB - The Biotest Air Sampler RCS is often used for monitoring microbiological quality of air. Unidirectional air flow tests show that the dispersion region of contaminants around the RCS sampler is much larger than that of undisturbed parallel air flow. This must be taken into consideration when the RCS air sampler is used within pharmaceutical production, especially during aseptic operations. PMID- 1770411 TI - U.S. international standards strategies. PMID- 1770412 TI - The rate of endotoxin destruction during water treatment using a combination of ozone and ultraviolet radiation. AB - The rate of destruction of endotoxin in water samples by a combination of UV and ozone has been investigated. After an initial non-linear phase the rate of destruction followed 1st order kinetics with a calculated D value of between six and ten min on endotoxin levels as high as 100 EU/mL. Measuring endotoxin destruction rates has proved an effective way of validating the UV-ozone water treatment process. PMID- 1770413 TI - Airborne microbial challenges of Blow/Fill/Seal equipment: a case study. AB - Controlled microbial challenges, comprising air-dispersed spores of Bacillus subtilis var niger, have been generated within a containment room (around 54 m3 in volume) housing a Blow/Fill/Seal machine. 'Stirred-settling' conditions were created throughout the room and the airborne spore challenge was monitored to ensure homogeneity within the room for extended periods of time. The Blow/Fill/Seal machine was set to fill 2 cm3 ampoules with Tryptone Soya Broth at each of three airborne challenge levels of 10(4), 10(6) and 10(7) spores m-3 (about 10(2), 10(4) and 10(5) spores ft-3 respectively). A relationship has been established between the level of airborne micro-organisms in the machine operating environment and the extent of product contamination. This relationship allows prediction of operating conditions under which a level of sterility assurance, equal to that demanded of terminal sterilization, is attained. It is stressed that the findings apply only to the particular Blow/Fill/Seal machine and to the specific conditions of machine operation. PMID- 1770414 TI - Adsorption of hormones from serum by carbon embedded depth filters. AB - A composite filter pad formed by embedding activated carbon powder in fibrous matrix was applied for removal of hormones from human serum. Enhanced adsorption was demonstrated through direct comparison between the stacked filter pads and the powered carbon packed in a column both having an equal weight of carbon. In addition, the composite structure offers the advantage of eliminating the carbon fines mixed in the filtrant, avoiding the flow channeling, and providing favorable rate of adsorption. The adsorption of both thyroid hormones T3 (triiodothyronine) and T4 (thyroxine), and steroid hormone, cortisol, by the carbon filter were studied. The effect of pH on hormone adsorption by activated carbon was verified as an important environmental factor, minimum adsorption occurs at the neutral pH. It was found that T4 carrying one more iodine atom than T3 is less effectively adsorped by carbon adsorption from the serum under competitive condition due most likely to their size differences. The filter pad containing 70% activated carbon as adsorbent was fabricated in disk form and stacked in a column for processing bulk volume of biological fluid. Such a device provides an effective means for removal of hormones from biological solutions. PMID- 1770415 TI - Volatile hydrocarbons in pharmaceutical solutions. AB - Volatile pollutants such as hydrocarbons have, during many years, been analysed in small concentrations in air, water, food, pharmaceutical solutions, and human blood and tissues. It has also been shown that such substances have unexpected consequences for cell cultures and scientific experiments. These substances also accumulate in patients receiving haemodialysis and these patients are exposed to quite high concentrations. The knowledge of the toxicity of such compounds has led to the development of maximum limit concentrations with the aim to decrease the exposure of humans. This paper discusses the problems of human exposure in general and especially through pharmaceutical solutions, and the possibilities of eliminating such compounds with the aim of decreasing the exposure as a hygienic challenge. PMID- 1770416 TI - The outer limits of FDA inspections. PMID- 1770417 TI - A microbiological comparison of young adults based on relative amounts of subgingival calculus. AB - This study compared the relative amounts of Actinobacillus actinomycetemcomitans (Aa), Eikenella corrodens (Ec), and black-pigmented anaerobic rods, and the proportions of coccoid forms, nonmotile rods, motile rods, spirochetes, and total motile organisms in subgingival plaque samples from 2 groups of young adults with generalized moderate to severe periodontitis. Two groups of 12 untreated patients were selected based on the relative amounts of subgingival calculus detected. Subgingival plaque samples (2 sites/patient) were taken with a sterile curet, dispersed, and plated under anaerobic conditions on ETSA, ETSA-kanamycin, ETSA clindamycin, and TSBV agar. Appropriate biochemical tests were performed to confirm suspected microorganisms. Phase-contrast microscopy also was used to count the relative numbers of coccoid forms, nonmotile rods, motile rods, and spirochetes in each of the samples. Patients with no clinically detectable subgingival calculus harbored significantly greater proportions (%) of coccoid forms and Aa and greater amounts (CFU/mg) of Aa than did patients with obvious amounts of subgingival calculus. Subjects with clearly detectable subgingival calculus possessed greater proportions of motile rods, total motile organisms, and black-pigmented anaerobic rods than did subjects with little or no subgingival calculus. Young adult patients with generalized moderate to severe disease and little or no detectable subgingival calculus may possess a subgingival microbiota with relatively higher numbers of Aa and coccoid forms, and a lower percentage of BPB, motile rods, and total motile organisms as compared to similar patients with greater amounts of subgingival calculus. PMID- 1770418 TI - Heparan sulfate and fibronectin improve the capacity of collagen barriers to prevent apical migration of the junctional epithelium. AB - The objective of the present study was to assess the effect of bilayered/collagen barriers enriched with fibronectin and heparan sulfate on the prevention of apical migration of the epithelium during the initial stage of periodontal wound healing. Experimental osseous defects were produced on the labial aspect of maxillary canines in dogs. Experimental sites were treated with either bilayered enriched collagen barriers or with non-enriched bilayered collagen barriers, using the guided tissue regeneration technique. Control sites were treated with monolayered collagen barriers that were not enriched with fibronectin and heparan sulfate. Histologic and histomorphometric examinations performed on specimens obtained 20 days post-operative indicate the formation of a short junctional epithelium in the experimental sites treated with enriched collagen barriers. In this group, 95% of the occlusal-apical length of the defects was repopulated by connective tissue cells. In the other 2 groups, a long junctional epithelium developed with only 65% of the occlusal-apical length of the defects being repopulated by connective tissue cells. These findings suggest that the enrichment of collagen barriers with fibronectin and heparan sulfate may be important to enhance the repopulation of exposed root surfaces by connective tissue cells and prevent the apical migration of the epithelium during the initial stages of periodontal wound healing. PMID- 1770419 TI - Bacteremia following subgingival irrigation and scaling and root planing. AB - The purpose of this study was to determine the incidence of bacteremia after a single professional subgingival irrigation with a 0.12% chlorhexidine gluconate mouthrinse (CHX) as well as after a subsequent scaling and root planing (S/RP) during the same visit. Thirty subjects each with at least 1 site that probed 4 mm or more and bled on probing were randomly assigned to the following groups: 1) irrigation with 0.12% CHX; 2) irrigation with sterile water; and 3) non-irrigated controls. To begin the study blood was drawn just before and 2 minutes after irrigation. Thirty minutes later, blood was drawn again just before and 2 minutes after S/RP at the same site. Specimens were cultured for anaerobic and aerobic microorganisms using standard cultural techniques. Eighteen blood cultures from 15 subjects yielded positive cultures resulting in 23 isolates. Gram-positive rods comprised 34.8% of the total isolates; Gram-positive cocci 34.8%, Gram negative rods 21.7%, and Gram-negative cocci 8.7%. In the CHX group, bacteremia was detected in 5 subjects after irrigation and in 2 other subjects after S/RP. In the water group, bacteremia was detected in one subject after irrigation and in 4 subjects after S/RP. The control group had 3 bacteremias after S/RP. There was no significant difference between the incidence of bacteremia associated with irrigation by CHX or sterile water (P = 0.141). There was also no significant difference in the incidence of bacteremia after S/RP between the CHX and sterile water irrigation groups and in patients who did not receive irrigation (control group) (P = 0.88).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770420 TI - Early onset periodontitis in the United States of America. AB - A National Survey of the Oral Health of U.S. children aged 5 to 17 was conducted by the National Institute of Dental Research during the 1986-87 school year. Eleven thousand and seven adolescents aged 14 to 17 years received a periodontal assessment. Their patterns of loss of periodontal attachment as assessed by probing at mesial sites were used to classify adolescents as cases of early onset periodontitis. Approximately 0.53% of adolescents nation-wide were estimated to have localized juvenile periodontitis (LJP), 0.13% to have generalized juvenile periodontitis (GJP), and 1.61% to have incidental loss of attachment (LA) (greater than or equal to 3 mm on 1 or more teeth). The total number of adolescents affected were not trivial. Close to 70,000 adolescents in the U.S. were estimated to have LJP in 1986-87. More destructive GJP affected an estimated 17,000 adolescents. Another 212,000 adolescents were estimated to have incidental LA. Blacks were at much greater risk for all forms of early onset periodontitis than whites. Males were clearly more likely (4.3 to 1) to have GJP than females when other variables were statistically controlled. Gender associations were more complicated for LJP because gender interacted with race. Black males were 2.9 times as likely to have LJP as black females. In contrast, white females were more likely than white males to have the disease by about the same odds. When interactions among demographic variables exist, caution must be taken in comparing results from different studies. PMID- 1770421 TI - Clinical and microbiological effects of a sanguinaria-containing mouthrinse and dentifrice with and without fluoride during 6 months of use. AB - The purpose of this study was to test the efficacy and safety of sanguinaria containing regimens with and without fluoride using the American Dental Association guidelines for evaluating chemotherapeutic agents. The study was a 6 month, double-blind, 4-cell, placebo-controlled, parallel investigation involving 120 subjects. Following screening procedures, subjects were randomly assigned to 4 groups. Group 1 received a dentifrice containing 0.075% sanguinaria extract (SaE) and 2.0% zinc chloride (ZnCl2) in a dicalcium phosphate base, plus an oral rinse containing 0.03% SaE and 0.2% ZnCl2. Group 2 received identical products without SaE or ZnCl2. Group 3 received a dentifrice containing 0.8% sodium monofluorophosphate, 0.075% SaE, and 0.05% ZnCl2 in a silica base, plus an oral rinse containing 0.03% SaE and 0.2% ZnCl2. Group 4 products were identical to those of Group 3 but without SaE and ZnCl2. Supragingival plaque and gingival inflammation were scored at 0, 1, 2, 1.5, 3, 4.5, and 6 months; bleeding upon probing was measured at 1, 1.5, 3, and 6 months. Microbiological samples were taken from plaque, tongue, and cheek areas. The active products produced statistically significantly lower scores than the placebo agents for all indices (P less than .0001). Six-month plaque scores were 13.1% lower for Group 1 and 17.4% lower for Group 3 compared to placebo products. When the Plaque Severity Index was applied, the percentage reductions were 33% for Group 1 and 41% for Group 3 compared to placebos. Gingival inflammation scores were 16.7% lower for Group 1 and 18.1% lower for Group 3 at 6 months compared to placebo scores.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770422 TI - Periodontal status of HIV-seropositive and AIDS patients. AB - Few reported studies have evaluated the periodontal status of individuals infected by human immunodeficiency virus (HIV). The majority of these reports have evaluated the periodontal status of individuals presenting to dental care facilities due to oral problems. These reports suggest that severe gingival inflammation and attachment loss are often associated with HIV seropositive patients. The purpose of this study was to evaluate the periodontal status of HIV seropositive patients without biasing the data towards those presenting to dentists with oral problems. Sixty-three consenting male patients presenting to the infectious disease clinic at the Medical College of Virginia Hospitals were examined to determine the status of their periodontal health. Gingival index, plaque index, pocket depths, and attachment loss were determined using standard indices. Participants were first grouped according to the modified CDC Classification System for HIV infection and then categorized according to HIV risk factors for purposes of statistical analysis. No significant differences could be found in the gingival or periodontal status of subjects who were HIV seropositive versus those with AIDS. Periodontal status was also not significantly different for individuals based upon risk group. Periodontal health of the participants was similar to the general population (HIV status unknown). This would indicate that, although HIV gingivitis and HIV periodontitis have been documented in a number of HIV-infected patients, the frequency of affected individuals is less than previous reports would suggest. PMID- 1770423 TI - Resolution of early lesions of juvenile periodontitis with tetracycline therapy alone: long-term observations of 4 cases. AB - Our previous studies have demonstrated that early-identified lesions of localized juvenile periodontitis (LJP) can be treated by the use of systemically administered tetracycline alone (1 gm/day for 6 weeks). This therapy results in arrest of disease progression, decreased pocket depths, gains in clinical attachment, and significant repair of alveolar defects. This paper reports on the long-term clinical and radiographic improvement in 4 subjects followed for 1 to 4 years after the completion of tetracycline therapy. Four patients (mean age 14 years) were examined 1 to 4 years following the completion of a single 6 week course of tetracycline. Mean pocket depth was reduced from the initial level of 7.1 mm to 3.6 mm. Mean attachment loss was reduced from 3.8 mm to 0.9 mm and angular bone defects had filled by an average of 72%. Pocket depths and attachment loss continued to decrease during the entire study period, while alveolar bone repair continued to increase. The findings support those of our previous investigation and confirm that: 1) early identified lesions of LJP can be effectively treated with 6 weeks of tetracycline therapy alone; 2) decreases in pocket depth, gains in clinical attachment, and repair of alveolar defects remain stable up to 4 years following antibiotic therapy; 3) clinical and radiographic improvement continues over time and may lead to complete resolution of some lesions; and 4) the reparative/regenerative potential of the periodontium in early onset disease in young individuals may exceed that observed in chronic adult periodontitis. PMID- 1770424 TI - Angioedema as a complication in periodontal surgery: report of a case. AB - Angioedema is a diffuse swelling of the subcutaneous or submucosal tissues that occurs in both hereditary and non-hereditary forms. It can be a temporarily disfiguring condition, but not usually a serious one unless the airway is compromised. In the majority of cases, no underlying cause can be identified. In this report, a case of "idiopathic" angioedema that occurred while performing a periodontal surgical procedure is presented. This case is interesting because the patient was on long-term use of an angiotensin-converting enzyme [ACE] inhibitor for hypertension, and recent evidence has shown that ACE inhibitors suppress the breakdown of circulating bradykinins. With high plasma levels of bradykinins, a local anesthetic, periodontal surgical procedures, or even emotional stress may trigger an attack of angioedema. Practitioners should be aware of the pharmacologic side effects of ACE inhibitors and be prepared to handle an emergency if a patient's airway becomes compromised. PMID- 1770425 TI - Re: Antibiotic prophylaxis for medical-risk patients. PMID- 1770426 TI - Re: Guest editorial: Diabetes and periodontal disease. PMID- 1770427 TI - Re: Treatment of periodontal defects with an absorbable membrane (Polyglactin 910) with and without osseous grafting. PMID- 1770428 TI - Studies on egg zona pellucida-binding molecule (ligand) of mouse sperm. I. Sperm maturation and zona-binding ability. AB - The epididymis has three major regions; the caput, corpus and cauda. Sperm were obtained from each region, and their binding ability to egg zona pellucida was assayed. In the case of intact sperm: cauda sperm bound in high number, corpus sperm bound at an intermediate level (an average of 30% of cauda sperm binding level), and caput sperm bound rarely (1% of cauda sperm binding level). In the case of sperm immobilized by pretreatment with LaCl3, when eggs and sperm were shaken in order to allow them to come into collision with each other, the caput and corpus sperm were able to bind to zona pellucida as well as the caudal sperm could. These results suggest that the difference in binding efficiency of the native caput and corpus sperm to bind to the zona pellucida was not due to a defect in a ligand molecule on the plasma membrane but rather to their lack of motility. When a sperm-egg binding assay was done in the presence of a binding inhibitor of caudal sperm, the binding of caudal sperm was significantly inhibited by fetuin or N-acetylgalactosamine, but the binding of caput and corpus sperm was only slightly inhibited by them. We prepared a plasma membrane fraction from each epididymal sperm, and solubilized it with sodium dodecyl sulfate (SDS). Each SDS-solubilizable fraction inhibited the binding of corresponding epididymal sperm to egg zona pellucida but didn't inhibit the binding of sperm from different regions of epididymis. These results suggested that a ligand molecule of caudal sperm was different from that of caput and corpus sperm. PMID- 1770429 TI - Studies on mouse sperm lectin; the existence and the participation in sperm-egg binding. AB - Mouse sperm bound to egg zona pellucida and attached to unfixed rabbit erythrocytes specifically, but not to fixed-erythrocytes. When mouse sperm were treated with ionophore A23187, the sperm lost both the binding ability to the zona pellucida and the attachment ability to rabbit erythrocytes. The membrane vesicles released from A23187-treated sperm agglutinated rabbit unfixed erythrocytes. Sperm binding to egg zona pellucida was also inhibited by the membrane vesicles. The inhibition spectrum of a hemagglutination and of an inhibitory activity of sperm-egg binding by various carbohydrates was studied. The hemagglutination was inhibited by N-acetyl-glucosamine, N-acetylgalactosamine and glyco-proteins, such as fetuin and orosomucoid, but not by N-acetylneuraminic acid (NeuNAc) in saccharides and asialo-transferrin in glycoproteins. On the other hand, the sperm-egg binding was inhibited most effectively by NeuNAc and also by asialo-transferrin. The inhibition spectrum of hemagglutination and sperm egg binding didn't agree with each other. These results suggest that a lectin like molecule is expressed on mouse sperm surface but is not directly concerned in sperm-egg binding. PMID- 1770430 TI - Preparation and biological activities of sulfated derivatives of (1----3)-beta-D glucans. AB - Sulfated derivatives of (1----3)-beta-D-glucans with different degree of branching (DB) i.e., curdlan (linear, DB 0), grifolan (6-O-substituted by beta-D glucose at every third residue of the main chain, DB 1/3), and SSG (6-O substituted by beta-D-glucose at every second residue, DB 1/2) having DS value (degree of substitution) lower than 0.6 were prepared. Biological activities [clotting of plasma, alternative pathway of complement (APC), proliferative response of murine spleen cells (mitogenic activity), and activation of murine peritoneal macrophages in vitro] of these derivatives were examined. Clotting of plasma was inhibited by the derivatives having DS above 0.2 APC was inhibited by incubation with derivatives and was strongly dependent on substitution. Inhibition of APC was the most significant in sulfated SSG having DS 0.6 [SSG(3)]. Mitogenic activity was observed by most of the derivatives and the highest activity was shown by SSG(1) (DS 0.2). Macrophage was also activated but SSG(1) would lose the capability to recognize the receptor for (1----3)-beta-D glucans. From these results, it appears that the biological activities of (1--- 3)-beta-D-glucans were significantly modulated by sulfation and the effect was dependent on both DS and DB. PMID- 1770431 TI - A role of peripheral leukocytes in vascular permeability and edema formation in air pouch type allergic inflammation in rats. AB - Using an air pouch type allergic inflammation model in rats, a role of circulating leukocytes in allergic inflammation responses was investigated by comparing normal rats with peripheral leukocytopenia rats induced by cyclophosphamide treatment. In the leukocytopenia rats, vascular permeability, edema formation, leukocyte infiltration into the pouch fluid, neutrophil chemotactic activity in the pouch fluid occurred both at the early phase (4 h) and the late phase (8 h) after the antigen challenge were decreased. However, edema formation induced by intradermal injection of arachidonate metabolites, serotonin, or platelet activating factor was not suppressed at all in the leukocytopenia rats. A possible role of peripheral leukocytes in allergic and non allergic inflammation is discussed. PMID- 1770432 TI - Metabolism in vitro of 3,4,3',4'- and 2,5,2',5'-tetrachlorobiphenyl by rat liver microsomes and highly purified cytochrome P-450. AB - Metabolism of two polychlorinated biphenyls, 3,4,3',4'- and 2,5,2',5' tetrachlorobiphenyl (TCB), was studied using rat liver microsomes and the four forms of cytochrome P-450 (P-450), P-450b, P-450e, P-450c and P-450d. At first, effects of various inducers of P-450 such as phenobarbital (PB), 3 methylcholanthrene (MC), isosafrole (ISF) and pregnenolone 16 alpha-carbonitrile on the formation of metabolites of these TCBs by liver microsomes were compared. 3,4,3',4'-TCB was significantly metabolized by liver microsomes from MC-treated rats to form two previously reported metabolites, 4-hydroxy-3,5,3',4'-TCB and 5 hydroxy-3,4,3',4'-TCB with a relative ratio of 2.5:1. Incubation with microsomes from untreated or PB-treated rats produced none of the metabolites. On the other hand, 2,5,2',5'-TCB was metabolized to 3-hydroxy-2,5,2',5'-TCB most easily by liver microsomes from PB-treated rats and at a moderate rate by liver microsomes from ISF-treated rats. Activities of microsomes from untreated or MC-treated rats to hydroxylate 2,5,2',5'-TCB were low or undetectable. When these TCB hydroxylase activities were examined with a reconstituted system consisting of each P-450, reduced nicotinamide adenine dinucleotide phosphate (NADPH)-cytochrome P-450 reductase, dilauroylphosphatidylcholine and NADPH-generating system, only P-450c catalyzed both the 4- and 5-hydroxylations of 3,4,3',4'-TCB at a ratio of 2.2:1. On the contrary, the hydroxylation of 2,5,2',5'-TCB proceeded efficiently with P 450b and P-450e, being more efficient with the former. P-450d did not show any catalytic activity toward 3,4,3',4'-TCB and 2,5,2',5'-TCB.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770433 TI - Sensory integration in the spino-olivocerebellar pathways of the anaesthetized cat. AB - 1. The responses evoked by peripheral nerve stimulation in the c1 and c3 zones of the cerebellar cortex have been examined in barbiturate-anaesthetized cats. The responses evoked via the spino-olivocerebellar pathways (SOCPs), which terminate in the cortex as climbing fibres, were recorded as positive multiunit field potentials from the cerebellar surface of lobule V. 2. Low-strength conditioning stimulation of the superficial radial, ulnar or median nerve frequently modified the climbing fibre-mediated responses evoked by a subsequent test stimulus to one of the other nerves. In most cases this modification involved a depression of the evoked response. The depression was not dependent on the conditioning stimulus evoking climbing fibre-mediated responses in the cortex. 3. The depression of the evoked responses increased as the conditioning stimulus intensity was raised within the range of 1.1-1.5 x threshold (1.1-1.5T). 4. Topical application of bicuculline to the surface of the dorsal column nuclei reduced the depression evoked by conditioning stimulation and it is therefore concluded that GABAergic inhibition in the cuneate nucleus contributes to the depression. 5. The inhibition is discussed in relation to its possible contribution to movement related regulation of the excitability of SOCPs which occurs during locomotion in awake cats. PMID- 1770434 TI - Partial uncoupling of salt gland blood flow and secretion in the Pekin duck (Anas platyrhynchos). AB - 1. The aim of this study was to investigate the relationship between the blood flow through and the secretion by the salt glands of conscious, salt-water adapted Pekin ducks. 2. Intravenous loading with hypertonic saline induced a steady-state secretion from the salt glands with a concomitant increase in whole organ blood flow. The distribution of elevated local glandular blood flow was, however, uneven and in addition demonstrated vasomotor patterns that ranged from constant to rhythmic. 3. During on-going salt gland secretion, the infusion of three vasoactive agents, 5Val-angiotensin II (ANG II), 8Arg-vasotocin (AVT) and noradrenaline, via the carotid artery had differential effects on salt gland blood flow and secretion. 4. ANG II (80 pmol min-1 (kg body wt)-1) had no effect on mean arterial blood pressure (MABP), produced a transient 30% decrease in glandular blood flow and strongly diminished salt gland secretion (retention of 6.4 mosmol NaCl). 5. AVT (20 pmol min-1 (kg body wt)-1) had no effect on MABP and did not alter salt gland secretion despite a 35% reduction in blood flow. 6. Noradrenaline (20 nmol min-1 (kg body wt)-1) elevated MABP by 15 mmHg, reduced salt gland blood flow by more than 50%, but diminished salt gland secretion only slightly (retention of 2.7 mosmol NaCl). 7. Using ANG II, AVT and noradrenaline as hormonal tools, integrated changes in blood flow rate did not correspond with integrated changes in salt gland excretion. The partial dissociation between both parameters shows that control of secretion by the salt gland is more complex than simply being linearly dependent upon blood flow through it. PMID- 1770435 TI - The medullary projections of afferent bronchopulmonary C fibres in the cat as shown by antidromic mapping. AB - 1. The activity of eighty-seven bronchopulmonary vagal afferent neurones with unmyelinated axons (C fibres) was recorded extracellularly in the nodose ganglia of decerebrate, paralysed and artificially ventilated cats. On the basis of their response latencies following the right atrial injection of capsaicin or phenyldiguanide, the cells were classified as having their receptor endings within the reach of pulmonary (latency less than 3.5 s) or bronchial (latency above 3.5 s) circulation. 2. Pulmonary and bronchial receptor cells differed only slightly in their response characteristics (firing rate, burst duration) and the conduction velocity of their peripheral axons. Bronchial C fibres represented about 70% of the population studied. 3. The medullary distributions of the central branches of six pulmonary and six bronchial C fibres were determined by means of the antidromic mapping technique. The two receptor subtypes did not differ in their central projection patterns. 4. Rostral to the obex, the central branches of the bronchopulmonary C fibres were localized within the medial portions of the nucleus tractus solitarii (NTS) and area postrema, and were most densely distributed along the borders of the parvicellular subnucleus of the NTS. Caudal to the obex, the most dense branching was found in the dorsal portion of the commissural subnucleus. Projections to the contralateral NTS were found, but these were of a much lower density. 5. The central distribution of bronchopulmonary C fibres is compared to the projection patterns of vagal and glossopharyngeal afferents of other modalities that are involved in respiratory and cardiovascular control. This is discussed in relation to the concept of a modality-specific organization of the NTS. PMID- 1770436 TI - Noradrenaline-evoked cation conductance recorded with the nystatin whole-cell method in rabbit portal vein cells. AB - 1. Noradrenaline-evoked currents were studied with the perforated patch technique (nystatin in the patch pipette) in freshly dispersed rabbit portal vein cells. 2. With potassium-containing solutions noradrenaline produced an inward current at 50 mV and an outward current (IK(Ca] at 0 mV. In potassium-free conditions noradrenaline elicited two distinct membrane currents which could be differentiated according to their sensitivity to the presence of caffeine in the bathing solution. One current was blocked whereas the second response was unaffected by caffeine. 3. The reversal potential (Er = -2.0 mV) of the caffeine sensitive current was altered when external chloride was replaced with more permeant anions but Er was not changed when external sodium was replaced by Tris. Therefore the caffeine-sensitive current appears to be a calcium-activated chloride current (ICl(Ca]. 4. Er (+6.0 mV) of the caffeine-insensitive current was not altered by anion substitution but was changed when external sodium was replaced by Tris and barium ions. Thus the caffeine-insensitive conductance is a non-selective cation current (Icat). 5. When external NaCl was replaced by BaCl2, Er was shifted to more positive potentials which suggests that the cation conductance is more permeable to barium than to sodium. Icat was not affected by 10(-6) M-nifedipine. 6. The steady-state current-voltage relationship was linear between -50 and +50 mV for ICl(Ca) but the cation conductance mechanism displayed pronounced inward rectification and little outward current flowed across the membrane at positive potentials. 7. Caffeine (which releases calcium from internal stores) and the calcium ionophore ionomycin, which are expected to increase intracellular calcium concentration, evoked ICl(Ca) but not Icat. Thus ICl(Ca) but not Icat can be activated directly by an increase in intracellular calcium concentration. 8. When calcium was removed from the bathing solution the amplitude of Icat was not altered at early times in Ca(2+)-free conditions but was abolished after 10 min. Icat was readily activated by noradrenaline in the presence of ionomycin, which inactivated ICl(Ca). A permissive role for calcium in the generation of Icat is suggested. 9. The times between the application of noradrenaline and the onset of the chloride and cationic conductances were similar (0.75 and 0.9 s respectively). In contrast the rise time (3.9 s) and half decay time (11 s) of Icat were much longer than the corresponding values of ICl(Ca) (respectively 1.9 and 2 s). In high-barium solution noradrenaline sometimes evoked a response that lasted for up to 10 min.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1770437 TI - Unresponsive afferent nerve fibres in the sural nerve of the rat. AB - 1. The proportion of primary afferent nerve fibres in a skin nerve of the rat that responded or failed to respond to mechanical or thermal stimulation of the skin in the noxious and non-noxious range was analysed. 2. Activity of afferent nerve fibres was recorded from the dorsal roots. Units projecting into the sural nerve were selected using supramaximal electrical stimulation of the nerve stem. All other hindleg nerves were cut. 3. The receptive fields were searched by carefully examining the hindleg skin with noxious and innocuous mechanical, cooling and warming stimuli. Probing of the intrinsic foot muscles and manipulation of the ankle and toe joints was employed to recruit units projecting to deeper tissues. 4. In a first series of twenty-two experiments, eighty-nine rapidly conducting myelinated A beta units, thirty slowly conducting myelinated A delta units and 101 unmyelinated C units were investigated. Most units were identified as belonging to one of the established classes of cutaneous sensory units and this was also ascertained by a collision test. 5. Two A beta, eight A delta and forty-six C fibres did not respond to any one of the stimuli. Electrical thresholds and conduction velocities of the unresponsive C fibres were not significantly different from those of the units responding to natural stimulation of their receptive fields. In the A delta group unresponsive and high threshold mechanoreceptive units were preferentially found among the units with the slowest conduction velocities. 6. In a second series of seven experiments, one single nerve filament containing responsive and unresponsive C fibres was tested repetitively at 30 min intervals. Twenty unresponsive units and seven units responding to noxious mechanical and/or heat stimuli were studied. Ten of the twenty initially unresponsive units became activated by mechanical and/or heat stimuli after observation times of 30-150 min. Some of these units had mechanical thresholds as low as 64 mN (tested with calibrated von Frey hairs), or thermal thresholds down to 42 degrees C. 7. Two of the ten C units which became responsive in the course of an experiment later lost their responsiveness again. On the other hand, two of the C units which were initially responsive to noxious heat and/or noxious mechanical stimuli became completely unresponsive after repetitive stimulation, whereas one unit initially only responding to noxious heat became responsive to mechanical stimuli, suggesting that mechanical and heat responsiveness may be separately gained or lost by sensory C fibres.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1770438 TI - Differential connections by intracortical axon collaterals among pyramidal tract cells in the cat motor cortex. AB - 1. Recurrent EPSPs were produced in fast pyramidal tract (PT) cells in the cat motor cortex by stimulation of the medullary pyramid and/or by the glutamate induced activity of neighbouring PT cells using the spike-triggered averaging (spike-TA) method. 2. In fast PT cells located lateral to the end of the cruciate sulcus, predominantly the motor cortical representation area of the distal forelimb, two components (fast and slow) of recurrent EPSPs were produced by pyramid stimulation. 3. In response to pyramid stimulation, the appearance of the fast and slow components of recurrent EPSPs correlated with the appearance of N1 and N2 field potentials, respectively. 4. The monosynaptic nature of both the fast and slow components of recurrent EPSPs was demonstrated by a double shock test (interstimulus interval less than 5 ms) and high frequency repetitive stimulation (50-100 Hz). 5. The generation of the fast and slow components of recurrent EPSPs was attributed to the synaptic action of recurrent collaterals of fast and slow PT cells, respectively. 6. The amplitude of the slow component of recurrent EPSPs markedly increased with an increase in the stimulus frequency whereas that of the fast component did not, despite the change in stimulus frequency. 7. Selected spike-triggered averaging also revealed frequency facilitation of recurrent individual EPSPs produced in fast PT cells by the activity of single slow PT cells. 8. In fast PT cells located in the anterior and posterior lips of the cruciate sulcus, the motor cortical representation area of the proximal limb or trunk, only the slow component of recurrent EPSPs was produced by pyramid stimulation. 9. It is concluded that the pattern of recurrent connections between neighbouring PT cells differs depending on the motor cortical representation area, and that frequency facilitation of recurrent EPSPs is caused mainly by the input from axon collaterals of slow PT cells. PMID- 1770439 TI - Non-thermal vasodilatation by radio frequency burst-type electromagnetic field radiation in the frog. AB - 1. When the web of the anaesthetized Xenopus laevis was perfused with Ringer solution maintained at 20 degrees C, radio frequency (RF) burst-type electromagnetic (EM) field radiation not only dilated arterioles of the web which had been preconstricted with noradrenaline, but also dilated arterioles under non stimulated conditions. The EM field-induced vasodilatation increased slowly and reached a plateau 60 min after the onset of radiation. After the cessation of radiation, vasodilatation remained for 10-20 min, then slowly subsided. 2. When a 10 MHz, 1 V (peak to peak) generator voltage induced a 7.3 milliGauss, 2.19 V cm 1 EM field, the vasodilatory effect was optimum when bursts were applied 50% of the total time at 10 kHz burst rate. 3. The vasodilatory effect was not secondary to dielectric heat in the web, because the EM field was too weak to have produced enough heat to dilate the arterioles and heat would have been constantly conducted away by the perfusion solution. 4. During perfusion with Ringer solution warmed to 30 degrees C, no vasodilatation was found, but perfusion with Ringer solution warmed to 35 degrees C induced only 11% vasodilatation. Perfusion with Ringer solution warmed to 37 degrees C induced irreversible vasoconstriction. The pattern of vasodilatation induced by warm Ringer solution was different from the vasodilatory effect of weak EM field radiation. 5. The extent of the vasodilatory effect was influenced by Ca2+ concentration of the perfusion medium. Under normal Ca2+ conditions arterioles dilated to 126% of the control diameter, while under Ca(2+)-free conditions arterioles dilated to 131% of the control value and under high-Ca2+ conditions (twice the normal level) arterioles dilated to 111% of the control value. This suggests that the vasodilatory effect may be caused by facilitation of Ca2+ outflow, and the extent of this flow may settle down to the equilibrium level of countercurrent flux between Ca2+ influx and outflow. 6. The vasodilatory effect was not inhibited under perfusion with Na(+)-free Ringer solution, suggesting that Na(+)-Ca2+ exchange system may not be involved in the vasodilatory effect. The vasodilatory effect was inhibited by vanadate, an inhibitor of Ca(2+)-ATPase, and was abolished by Methylene Blue, an inhibitor of guanylate cyclase. The evidence suggests that the mechanism of the vasodilatory effect may depend on an increase in Ca2+ outflow through the plasma membrane of the smooth muscle and/or an increase in Ca2+ influx into the sarcoplasmic reticulum.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1770440 TI - Glucose stimulation of ouabain-resistant efflux of Na+ from rat pancreatic islets. AB - 1. Integrating flame photometry was employed for measuring the mobilization of sodium from rat pancreatic islets after substitution of extracellular Na+ by N methylglucamine. 2. Glucose accelerated the initial loss of sodium both in the absence and presence of ouabain (1 mM). In the latter case the effect was maximal at 5 mM of the sugar. 3. Amiloride (0.1 mM), an inhibitor of Na(+)-H+ exchange, prevented the effect of glucose on the ouabain-resistant Na+ efflux, increasing the rate of outward transport in the absence of the sugar. 4. Extracellular K+ and arginine (10 mM) mimicked the action of glucose in promoting a ouabain resistant mobilization of sodium. 5. Whereas the hypoglycaemic sulphonylurea tolbutamide (100 microM) did not modify the outward transport of Na+, the ouabain resistant component of this process was partially suppressed after bumetanide (100 microM) inhibition of the chloride-dependent co-transport of Na+ and K+. 6. It is suggested that the glucose-induced lowering of the steady-state content of islet sodium involves an increased outward transport mediated at least in part by mechanisms other than stimulation of the Na(+)-K+ pump. PMID- 1770441 TI - Total and free myoplasmic calcium during a contraction cycle: x-ray microanalysis in guinea-pig ventricular myocytes. AB - 1. At 36 degrees C and 2 mM [Ca2+]o single guinea-pig ventricular myocytes were voltage clamped with patch electrodes. With a paired-pulse protocol applied at 1 Hz, a first pulse to +5 mV was followed by a second pulse to +50 mV. When paired pulsing had potentiated the contraction to the maximum, the cells were shock frozen for electron-probe microanalysis (EPMA). Shock-freezing was timed at the end of diastole (-80 mV) or at different times during systole (+5 mV). 2. The same paired-pulse protocol was applied to another group of myocytes from which contraction and [Ca2+]i was estimated by microfluospectroscopy (50 microM-Na5 Indo-1). Potentiation moderately reduced diastolic sarcomere length from 1.85 to 1.82 microns and increased diastolic [Ca2+]i from about 95 to 180 nM. In potentiated cells, during the first pulse, contraction peaked within 128 +/- 25 ms after start of depolarization. [Ca2+]i peaked within 25 ms to 890 +/- 220 nM (mean +/- S.E.M.) and fell within 100 ms to about 450 nM. 3. Sigma Camyo, the total calcium concentration in the overlapping myofilaments (A-band), was measured by EPMA in seventeen potentiated myocytes. During diastole, sigma Camyo was 2.6 +/- 0.4 mmol (kg dry weight (DW]-1 which can be converted to 0.65 mM (mmoles per litre myofibrillar space). Since [Ca2+]i was 180 nM, we estimate that 99.97% of total calcium is bound. 4. A time course for systolic sigma Camyo was determined by shock-freezing thirteen cells at different times after start of depolarization to +5 mV. Sigma Camyo was 5.5 +/- 0.3 mmol (kg DW)-1 (1.4 mM) after 15-25 ms, 4.6 +/- 0.5 mmol (kg DW)-1 (1.1 mM) after 30-45 ms, and 3.1 mmol (kg DW)-1 (0.8 mM) after 60-120 ms. The fast time course of sigma Camyo suggests that calcium binds to and unbinds from troponin C at a fast rate. Hence, it is the slow kinetics of the cross-bridges that determines the 130 ms time-to-peak shortening. 5. Mitochondria of potentiated cells contained during diastole a total calcium concentration, sigma Camito, of 1.3 +/- 0.2 mmol (kg DW)-1 (0.4 mM). During the initial 15-25 ms of systole, sigma Camito did not change, however, during 30-45 ms sigma Camito rose to 3.7 +/- 0.5 mmol (kg DW)-1 (1.2 mM). The data suggest that sigma Camito can follow sigma Camyo with some delay, thereby participating in both slow diastolic and fast systolic changes in total calcium (sigma Ca), at least under the given conditions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1770442 TI - The transient K+ current in rat ventricular myocytes: evaluation of its Ca2+ and Na+ dependence. AB - 1. The transient outward K+ current (Ito) was studied in enzymatically isolated rat ventricular myocytes using the whole-cell patch clamp technique. 2. At holding potentials between -100 and -60 mV, depolarizing pulses activated outward current which was composed of transient and maintained components. These components differed from each other in their activation voltage range as well as in their kinetics of inactivation. 3. The transient component, in turn, appeared to be composed of rapidly and slowly inactivating components. Subtraction of ICa from the total current, or nifedipine pre-treatment, eliminated the slowly inactivating component of Ito indicating that the time course of inactivation of Ito may be contaminated by ICa. 4. Reduction of the holding potential from -100 mV to less negative holding potentials reduced all components of Ito, such that at holding potentials of -40 mV, very little or no Ito could be measured. 5. Elevation of [Ca2+]o activated Ito at holding potentials of -40 mV, and substitution of external Ca2+ by Sr2+ suppressed Ito, consistent with findings from other preparations and in support of a Ca(2+)-activated component of Ito. 6. Elevations of [Ca2+]o, however, also shifted the steady-state activation and inactivation parameters of the transient K+ current, such that a greater proportion of Ito channels were activated at the less negative holding potentials. 7. The shifts in the activation and inactivation parameters of the transient outward current were not mimicked by equivalent changes in external Mg2+. 8. Modulators of Ca2+ release from the sarcoplasmic reticulum (SR) such as caffeine and ryanodine suppressed Ito regardless of whether the myocytes were dialysed with low or high concentrations of Ca2+ buffers (EGTA or BAPTA, 0.5-14 mM) or whether nifedipine was used to block ICa. 9. 4-Aminopyridine (4-AP) blocked Ito in a dose-dependent manner, completely suppressing it at 10 mM. Similarly, tedisamil, a new K+ channel blocker, completely and reversibly blocked Ito at 5-20 microM concentrations. 10. TTX (10 microM) or removal of external Na+ decreased Ito, consistent with the idea that a component of Ito was Na+ activated. Both interventions, however, also shifted the voltage dependence of the activation and inactivation of Ito to more negative potentials, such that at 100 mV neither intervention had a significant effect on Ito. Alterations in [Na+]i had no effect on Ito.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1770443 TI - Soma neurofilament immunoreactivity is related to cell size and fibre conduction velocity in rat primary sensory neurons. AB - 1. Intracellular recordings were made in dorsal root ganglia in vitro at 37 degrees C. The L4, L5 and L6 ganglia from 46- to 51-day-old female Wistar rats were used. In each neuron conduction velocity (CV) was measured and fluorescent dye was injected. Later the intensity of the immunoreactivity to RT97 (a monoclonal antibody to the phosphorylated 200 kDa neurofilament subunit) as well as the cell size (cross-sectional area at the nuclear level) were measured in the dye-injected neurons. RT97 was used to distinguish between the L (light, neurofilament-rich) and the SD (small dark, neurofilament-poor) neuronal somata. 2. Neurons were classified as C neurons (CV less than 1.3 m/s), C/A delta neurons (1.3-2 m/s), A delta neurons (2-12 m/s) or A alpha/beta neurons (greater than 12 m/s). 3. All A-fibre somata were RT97 positive (L) and all C-fibre somata were RT97 negative (SD), although in the C/A delta group both positive and negative neurons were seen. Thus, RT97-negative somata had C (unmyelinated) or C/A delta fibres, while RT97-positive somata had A (myelinated) or C/A delta fibres. 4. The size distributions of A neurons and C neurons were consistent with their classification as L- and SD-cell neurons respectively. The size distribution of A delta cells was skewed with a peak of small cells and a tail of medium-sized cells. 5. There was a loose positive correlation between cell size and fibre CV. 6. RT97 intensity was positively correlated with CV if all neurons were considered together, but no correlation was seen within the C, A delta or A alpha/beta CV groups. 7. RT97 intensity was positively correlated with cell size when all neurons were considered together. Although no correlation was seen within the C or the A delta CV groups, a clear positive correlation was seen for A alpha/beta neurons. 8. The relationship of RT97 intensity to cell size was not demonstrably altered by axotomy, time in vitro or the presence of intracellular dye in control experiments. 9. RT97-negative and -positive neurons could be seen in neonatal rat ganglia. Their size distributions resembled, respectively, the SD and L-neuron populations at this age. RT97 immunoreactivity may therefore be a useful predictor of the cell type and myelinated state which a sensory cell is destined to reach in the adult rat. PMID- 1770444 TI - Depression of a sustained calcium current by kainate in rat hippocampal neurones in vitro. AB - 1. High-threshold, slow inactivating inward Ca2+ currents were studied in CA1 pyramidal neurones from rat hippocampal slices using the single-electrode voltage clamp technique. 2. Kainate (50-400 nM) induced a dose-dependent depression of the amplitude of the slow Ca2+ current. At a dose of 200 nM the current amplitude was reduced from -0.63 +/- -0.06 to -0.32 +/- 0.06 nA. Such an effect of kainate was associated with the development of a small inward current (-0.11 +/- 0.03 nA). Kynurenic acid (1 mM) or 6-cyano-7-nitroquinoxaline-2,3-dione (CNQX; 20 microM) fully prevented these actions of kainate. 3. The structurally related kainate analogue alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA; 200 nM) depressed the slow Ca2+ current by 30 +/- 7%, an effect also blocked by CNQX. 4. In low-Na+ medium slow Ca2+ currents were followed by sustained inward tail currents. Kainate reduced both the steady-state Ca2+ current (from -0.98 +/- 0.14 to -0.63 +/- 0.15 nA) and the tail current (from -0.40 +/- 0.04 to -0.14 +/- 0.03 nA). 5. The inactivation process of the slow Ca2+ current was tested by a double pulse protocol and was found to be enhanced by kainate. 6. Equimolar replacement of Ca2+ by Ba2+ produced larger inward currents followed by prolonged tails. Kainate reduced the Ba2+ steady-state current from -1.77 +/- 0.18 to -1.44 +/- 0.24 nA and the tail current from -0.47 +/- 0.15 to -0.17 +/- 0.05 nA. 7. In current clamp experiments Ca2+ action potentials were recorded from cells loaded with the Ca2+ chelator BAPTA. In these conditions kainate failed to reduce the Ca2+ action potential, while in the absence of BAPTA kainate shortened the Ca2+ action potentials by 30%. 8. It is suggested that low concentrations of kainate reduced the slow Ca2+ current by promoting its inactivation perhaps through a rise in free intracellular Ca2+. PMID- 1770445 TI - Secretagogue-evoked changes in intracellular free magnesium concentrations in rat pancreatic acinar cells. AB - 1. This study employs the fluorescent dye Mag-Fura-2 acetoxymethyl ester (AM) to measure intracellular free magnesium concentration [Mg2+]i in isolated rat pancreatic acinar cells. Initially a number of protocols were investigated to develop optimal loading conditions for the dye Mag-Fura-2 AM. The procedure yielding cells which showed minimal dye loss and no adverse compartmentalization was adopted for subsequent experiments. 2. The mean resting [Mg2+]i is 1.39 +/- 0.08 mM (n = 39). 3. Acetylcholine (ACh), cholescystokinin-octapeptide (CCK8), carbamylcholine chloride evoked marked reduction in [Mg2+]i in pancreatic acinar cells compared to resting values in the absence of secretagogues. The ACh-evoked decrease in [Mg2+]i was abolished by pre-treatment with atropine. In contrast, noradrenaline, adrenaline and histamine had no significant effect on [Mg2+]i. 4. In acinar cells loaded with the Ca(2+)-sensitive dye, Fura-2 acetoxymethyl ester (AM), ACh stimulation resulted in a marked elevation in intracellular free Ca2+ concentration [Ca2+]i. This response was blocked by pre-treatment with atropine. 5. Atomic absorption spectrophotometry was used to measure Mg2+ levels in effluent samples from pancreatic segments. Stimulation of pancreatic segments with ACh resulted in a marked elevation in Mg2+ concentrations (net efflux). On removal of ACh, Mg2+ concentration returned to resting level followed by a small net influx of Mg2+ into pancreatic tissue. 6. The results demonstrate that secretagogue-evoked alteration in [Mg2+]i may occur concurrently with Mg2+ release from pancreatic tissue. PMID- 1770446 TI - The voltage responses of hair cells in the basal turn of the guinea-pig cochlea. AB - 1. Intracellularly recorded voltage responses to tones and to current injection were measured from inner (IHC) and outer (OHC) hair cells in the basal turn of the guinea-pig cochlea. 2. The voltage responses of IHCs to tones are increased by negative current and decreased by positive current. For any given current strength, the decrease in the receptor potential amplitude caused by positive current is less than the increase caused by negative current. This was attributed to the voltage-dependent rectification of the membrane conductance. 3. Estimates of the reversal potential of the receptor current were based on extrapolation of the slopes of the current-voltage relations for potentials more negative than -60 mV. The estimated reversal potentials were close to the measured endolymphatic potential. 4. Negative current increased the IHC membrane time constant and increased the transducer driving voltage. When receptor potentials to low frequency tones were adjusted for constant driving voltage and for the membrane time constant, the positive DC component of the receptor potential was decreased relative to the AC component by current injection but the DC component in response to high-frequency tones near the best frequency of the IHC (16 kHz) was unchanged by negative current. 5. When compensated for constant driving voltage and low-pass filtering due to the basolateral membrane conductance, the proportion of the transducer conductance open in IHCs at rest is increased by negative current. 6. Negative current injection reduced the positive DC components of OHC voltage responses to low-frequency tones and may make them negative. In some cases negative current injection decreased the amplitude of the OHC receptor potential while positive current injection enhanced it. From these observations it is proposed that negative current injection shifts the operating point of the OHC transducer functions towards a positive, saturating region of the relationship and positive current decreases the proportion of the transducer conductance which is open at rest. PMID- 1770447 TI - Na(+)-activated K+ channels and voltage-evoked ionic currents in brain stem and parasympathetic neurones of the chick. AB - 1. Patch-clamp and computer-modelling techniques were used to study the activation of Na(+)-activated K+ channels (IK(Na] in dissociated neurones from the embryonic chick ciliary ganglion and the embryonic chick brain stem. 2. Numerical solutions of diffusion equations suggested that Na+ accumulation as a result of Na+ influx through voltage-sensitive Na+ channels (INa) is insufficient to allow for alteration in the gating of IK(Na) channels. 3. Whole-cell recordings using two independent micropipettes were made from chick ciliary ganglion neurones. These showed that transient outward currents were present only when there were clear indications of incomplete voltage clamp. 4. Single electrode whole-cell recordings from ciliary-ganglion neurones showed that transient tetrodotoxin (TTX)-sensitive outward currents were present, but only when partial TTX blockade produced significant alterations in the kinetics of INa. In cells that were properly voltage clamped, there was no effect of TTX on the kinetics of INa or on voltage-evoked outward currents. 5. Examination of the relationship between peak INa and the command potential showed that transient outward currents were only present in neurones that showed sharp deviations from the behaviour expected of a cell that is adequately voltage clamped. Transient outward currents were not present in cells that were adequately voltage clamped. 6. Application of TTX to isolated outside-out patches obtained from ciliary ganglion neurones eliminated voltage-evoked inward currents but had no effect on outward currents. 7. Isolated inside-out patches obtained from ciliary-ganglion neurones did not contain IK(Na) channels. These patches usually contained Ca(2+) activated K+ channels (IK(Ca] with a unitary conductance of around 200 pS when [K+]o = 150 mM and [K+]i = 75 mM. 8. Two-electrode whole-cell recordings from cultured brain stem neurones showed that transient outward currents were present only when there were clear indications of incomplete voltage clamp. 9. Application of TTX caused blockade of inward but not outward currents in brain stem neurones voltage clamped with a single whole-cell pipette. TTX had no effect on the kinetics of INa. Application of TTX to outside-out patches isolated from the same cells blocked only the inward currents. 10. Isolated inside-out patches obtained from brain stem neurones contained IK(Na) channels that could be activated by exposure of the cytoplasmic face of the patch membrane to 75 mM-Na+. These channels had a predominant conductance state of around 100 pS when [K+]o = 150 mM and [K+]i = 75 mM. The IK(Na) channels were not activated by 1 mM Ca2+.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1770448 TI - Characteristics of fluid secretion from isolated rat pancreatic ducts stimulated with secretin and bombesin. AB - 1. Micropuncture techniques were used to study the cellular mechanisms of fluid secretion by interlobular ducts isolated from the pancreas of copper-deficient rats. 2. Perifusing ducts with a calcium-free buffer containing 5 mM-EGTA reduced the volume of fluid secreted in the presence of 10 nM-bombesin by 62%, whereas fluid secretion measured in the presence of 10 nM-secretin was reduced by only 26%. 3. The anion selectivities of the fluid secretions evoked by secretin and bombesin were different. The anion sequence for secretin was: Br- = I- = NO3- = Cl- (1.0) much greater than thiocyanate = gluconate (0.3); whereas the sequence for bombesin was: Br- = Cl- (1.0) greater than I- = NO3- (0.6) greater than thiocyanate = gluconate (approximately 0.3). 4. SITS (4-acetamido-4' isothiocyanatostilbene-2,2'-disulphonic acid; mM), reduced fluid secretion measured in the presence of bombesin by 61%, but had no effect on the response to secretin. 5. The K+ channel blockers, barium (3 mM) and tetraethylammonium (TEA; 10 mM), inhibited fluid secretion measured in the presence of both secretin and bombesin by between 52 and 66%. 6. From these results, we conclude that secretin and bombesin may utilize different intracellular signalling pathways and, furthermore, may activate different anion secretory mechanisms within the pancreatic ductal epithelium. However, the effect of the potassium channel blockers is consistent with both peptides activating secretory mechanisms which are electrogenic, and which depend for their operation on potassium efflux across the basolateral membrane of the duct cell. PMID- 1770449 TI - Role of small diameter afferents in reflex inhibition during human muscle fatigue. AB - 1. Previous work has shown that the H reflex excitability of the human soleus motoneurones is reduced during fatigue and is accompanied by a corresponding decrease in electromyographic (EMG) activity during maximal voluntary contractions. These findings were consistent with the existence of a reflex whereby alpha-motoneurones are inhibited by sensory input from the fatigued muscle. 2. To elucidate the contribution of different-sized afferents in such reflex inhibition, compression of the sciatic nerve was used in an attempt to block large myelinated afferents prior to fatigue. 3. Fatigue of the soleus muscle was induced under ischaemic conditions by intermittent electrical stimulation at 15 Hz in ten healthy subjects. These subjects also participated in a control test in which the compression block was followed by ischaemia without fatigue. 4. Following nerve compression alone, both the mean maximal plantarflexion torque and the associated EMG for all ten subjects declined by 18.8 +/- 16.2% (S.D.) and 13.4 +/- 17.2%, respectively. 5. Following fatigue, there were five subjects in whom the large afferents remained blocked and the experimental findings were consistent with the existence of reflex inhibition during fatigue. The mean maximal plantarflexion torque decreased further by 36.2 +/- 7.6% from the value following the compression block compared to a decrease of 5.0 +/- 9.9% in the ischaemia control. The mean EMG associated with these contractions also decreased from post-block values by 56.8 +/- 19.6% following fatigue and by only 6.4 +/- 8.0% following ischaemia alone. 6. The peripheral excitability of the neuromuscular junction and muscle fibre membrane was adequate following fatigue as evidenced by only modest changes in the M wave (muscle compound action potential). The descending motor drive was deemed sufficient because of the absence of any large interpolated twitches superimposed upon the maximal voluntary contraction in all but two subjects. 7. The declines in maximal plantarflexion torque and the associated EMG activity were very similar to those found in a previous study in which the sensory input was unaltered. The findings demonstrated that any reflex inhibition of the alpha-motoneurone pool during fatigue was probably not mediated by large diameter afferents. Rather, it is suggested that the reflex is mediated by smaller diameter afferents originating from the fatigued muscle. PMID- 1770450 TI - Regulation of intracellular free magnesium concentration in the taenia of guinea pig caecum. AB - 1. In the taenia isolated from the guinea-pig caecum, changes in free intracellular magnesium concentration ([Mg2+]i) were measured based on the separation of the chemical shift of the alpha- and beta-peaks of ATP obtained with nuclear magnetic resonance (NMR). 2. When external Mg2+ was increased from 1.2 to 12 and 40 mM, [Mg2+]i increased from 0.34 +/- 0.05 to 0.39 +/- 0.07 and 0.61 +/- 0.18 mM (n = 3), respectively, in 125-150 min. In the absence of Ca2+, the increase was greater, i.e. [Mg2+]i reached 0.92 +/- 0.05 (n = 3) and 3.37 mM (n = 1), respectively. 3. In Ca(2+)- and Mg(2+)-free solution, [Mg2+]i decreased to about 10 microM in 100 min. This decrease was not affected by substitution of Na+ with K+, but the recovery of [Mg2+]i on Mg2+ readmission was slower in the absence of Na+. This recovery was prevented by Ca2+ (2.4 mM), but Na+ readmission produced full recovery of [Mg2+]i in the presence of Ca2+. 4. When Na+ was substituted with K+ in the absence of Ca2+, [Mg2+]i increased from 0.38 +/- 0.01 mM to 0.56 +/- 0.04 mM (n = 4) in 100 min. Substitution of Na+ with N-methyl-D glucamine produced a much greater increase (to 2.1 mM in 100 min). Removal of the external K+ in the absence of Ca2+ also increased [Mg2+]i to 0.66 +/- 0.11 mM (n = 4) in 150 min, but no clear change was observed in the presence of Ca2+. Full recovery of [Mg2+]i could be produced in normal solution even when the intracellular phosphocreatine and ATP concentrations were 70-80% of the control. 5. It is concluded that in the smooth muscle of the guinea-pig taenia caeci an Na(+)-Mg2+ exchange process and possibly also an ATP-driven Mg2+ pump are playing important roles in maintaining free [Mg2+]i at about 0.3 mM under the physiological condition. In addition to this, Ca2+ inhibits both Mg2+ efflux and influx, probably by reducing the membrane permeability to Mg2+ and by competing with Mg2+ in the Na(+)-Mg2+ exchange of the plasma membrane. PMID- 1770451 TI - Effect of muscle mass on the pressor response in man during isometric contractions. AB - 1. Changes in blood pressure and heart rate were measured in six healthy male subjects during voluntary isometric contractions of the forearm and quadriceps muscles. Arterial pressure was measured directly via a catheter inserted into the radial artery of the non-contracting arm. Each subject exerted two types of contractions: (a) sustained contractions at 70% of the maximum voluntary contraction (MVC) until fatigue occurred and (b) sustained contractions starting at maximum tension (100% MVC), held for a total duration of 1 min. 2. During fatiguing contractions at 70% MVC, there was a progressive increase in blood pressure, reaching a peak level at fatigue. The same level of mean arterial pressure was achieved during contractions of the same relative tension, regardless of the muscle mass. The same trend was observed for the changes in heart rate. 3. During contractions which started with the maximum tension, where tension fell continuously during the 60 s of maximal effort, mean arterial pressure rapidly increased to high levels within a few seconds, and then increased further by 20-30 mmHg during the sustained maximal effort. There was no difference in the initial rapid increases in mean arterial pressure, nor in the final mean arterial pressures reached between contractions of the forearm or quadriceps muscles. There were no differences in the heart rates achieved during these contractions either. 4. There was no significant difference between the mean arterial pressures observed at fatigue of a 70% MVC contraction or at the end of the 60 s maximum effort during handgrip contractions, or during contractions with the quadriceps muscles. 5. These results support the view that muscle mass is not a determinant of the magnitude of the cardiovascular reflexes during fatiguing isometric contractions in man. PMID- 1770452 TI - Slowly inactivating potassium current in cultured bull-frog primary afferent and sympathetic neurones. AB - 1. Cultured bull-frog dorsal root ganglion cells were voltage clamped in the whole-cell configuration. The cells were superfused with a nominally calcium-free Ringer solution containing tetrodotoxin (3 microM), magnesium (10 mM), cobalt (1 mM), barium (2 mM), 4-aminopyridine (3 mM) and caesium (2 mM). 2. Step depolarizations (10-40 mV, 100-300 ms) from a holding potential close to the rest (typically -70 mV) evoked an outward current (IK) followed by an outward tail current. The peak amplitude of the current was reduced to less than 10% by tetraethylammonium (30 mM). 3. IK developed to its peak in 200 ms at -30 mV. Tail currents reversed at potentials that changed according to the logarithm of the extracellular potassium concentrations. 4. Tail currents declined to the baseline according to an exponential function of time (tau congruent to 40 ms at -60 mV) and its reciprocal time constant increased e-fold with a 13 mV hyperpolarization. 5. The current inactivated during sustained (1-20 s) depolarizing pulses according to a single exponential function (tau congruent to 3 s). 6. The peak amplitude of IK at -30 mV was progressively increased as the holding potential was made more negative than -70 mV reaching the maximum with step depolarizations from -120 mV. Reversed phenomenon was observed as the holding potential was made less negative than -70 mV. 7. The removal of the steady-state inactivation occurred along with a single exponential function and the time constant was decreased from 70 ms at -70 mV to 10 ms at -120 mV. 8. It is suggested that a slowly inactivating potassium current which we called IK in amphibian sensory neurones could be a class of a 'delayed' rectifier potassium current. A potassium current with properties indistinguishable from those which have been described for the sensory IK also occurred in cultured bull-frog sympathetic neurones. 9. Forskolin (1-30 microM) and 1,9-dideoxy forskolin (10 microM) reduced the amplitude of IK by up to 85% but these actions were not mimicked by any of 8 bromo-cyclic AMP (1 mM), dibutyryl cyclic AMP (1 mM) and 3-isobutyl-1 methylxanthine (1 mM). A hydrophilic forskolin analogue, 7-O-hemisuccinyl-7 deacetyl forskolin (10 microM), was about one-tenth as potent as forskolin (10 microM). PMID- 1770453 TI - Flux of Ca2+ across the sarcoplasmic reticulum of guinea-pig cardiac cells during excitation-contraction coupling. AB - 1. A method has been developed for calculating the flux of Ca2+ across the sarcoplasmic reticulum (SR) during excitation-contraction coupling in mammalian heart cells. FSR will symbolize the net rate of movement of Ca2+, per litre of accessible cytoplasm, into or out of the sarcoplasmic reticulum. FSR has the units MS-1. 2. A theory of the cytoplasmic [Ca2+]i transient in mammalian heart cells is presented in which the [Ca2+]i transient results from the various cellular processes that tend to increase or decrease cytoplasmic [Ca2+]i. According to the theory, FSR can be calculated if all cellular processes that contribute to the [Ca2+]i transient (other than Ca2+ fluxes across the SR) are either eliminated or are known quantitatively. 3. To obtain the measurements required to apply this theory, [Ca2+]i transients and membrane currents were recorded in guinea-pig single ventricular myocytes subjected to whole-cell voltage clamp and internal perfusion. [Ca2+]i transients were recorded through the use of the Ca2+ indicator, Fura-2 (pentapotassium salt). 4. Ca2+ fluxes through the sodium-calcium exchanger were eliminated in all experiments, by perfusing the cells, internally and externally with Na(+)-free solutions. Ca2+ flux through the sarcolemmal L-type Ca2+ channel was measured as the verapamil sensitive current. Influx of Ca2+ through all other voltage-dependent pathways was found to be negligible for the calculation of FSR over the time course of a single [Ca2+]i transient. 5. In the combined absence of Ca2+ current, Na(+)-Ca2+ exchange and fluxes across the SR (10 mM-caffeine), the net rate of removal of Ca2+ from the cytoplasm, which includes presumed contributions from sarcolemmal Ca(2+)-ATPase and mitochondrial Ca2+ transport, was found to be a negligible quantity in the calculation of FSR, over the time course of a single [Ca2+]i transient. 6. Calculation of FSR requires that the Ca(2+)-binding capacity of cytoplasm be known. [Ca2+]i transients recorded during measurable total Ca2+ influx into the cytoplasm (verapamil-sensitive current in the absence of fluxes across the SR) were compared with theoretical Ca2+ transients computed on the assumption that the entering Ca2+ could bind only to intracellular ligands (values for ligands taken from literature) and to Fura-2 (30 microM). The slope of the regression line relating calculated total change in [Ca2+]i to the measured total Ca2+ influx was 0.99, not different from the perfect theoretical slope of 1.0 (correlation coefficient, 0.81; standard deviation of slope, 0.14; n = 7).4+ the SR and FSR had a similar time course to that on depolarization. 10. The unidirectional efflux of Ca2+ from the SR, symbolized FSR, rel was calculated utilizing assumed characteristics of the Ca2+ pump of the SR. The value of FSR, rel was not affected by repolarization from voltage-clamp pulses greater than 150 ms in duration.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1770454 TI - The medullary respiratory network in the rat. AB - 1. In urethane or Nembutal anaesthetized and artificially ventilated Wistar rats, respiratory neurones of the ventrolateral medulla oblongata were analysed in extracellular (n = 74) and intracellular (n = 43) recordings. 2. Some respiratory neurones were identified as bulbospinal by their antidromic response to spinal cord stimulation at the C4 level. The neurones examined were not antidromically excited by vagal nerve stimulation. 3. Based on their discharge pattern in relation to efferent phrenic and vagal nerve activity, six types of respiratory neurones were classified: early-inspiratory, throughout-inspiratory, late inspiratory, post-inspiratory, expiratory, and phase-spanning expiratory inspiratory neurones. 4. Analysis of postsynaptic activities and IPSP reversal following chloride injection revealed post-inspiratory and expiratory inhibition in inspiratory neurones a pronounced early-inspiratory and a relatively weak expiratory inhibition in post-inspiratory neurones, and an early-inspiratory and post-inspiratory inhibition in expiratory neurones. 5. In phase-spanning expiratory-inspiratory neurones the post-inspiratory inhibition was strong and effectively blocked action potential discharge. Expiratory-inspiratory neurones were quite similar to the group of inspiratory neurones, but seemed to receive tonic excitatory inputs not shunted by weak expiratory inhibition. This pre inspiratory discharge was readily blocked by weak negative DC injection. 6. Under conditions of experimental hypoxia, or long lasting lung inflation and non inflation, post-inspiratory neurones displayed a second burst of discharge at the end of the expiratory phase in addition to their longer lasting post-inspiratory discharge. 7. We conclude that in the rat the central respiratory rhythm is organized in three (inspiratory, post-inspiratory, expiratory) phases, and that synaptic interaction within the medullary respiratory network of the rat occurs similarly to that described for the cat. PMID- 1770455 TI - Effects of external and internal K+ ions on magnesium block of inwardly rectifying K+ channels in guinea-pig heart cells. AB - 1. Block of the inwardly rectifying K+ channel by intracellular Mg2+ was studied in guinea-pig ventricular cells at varying external or internal K+ concentrations. Sucrose or glucose was mainly used as a substitute for K+. 2. The current-voltage (I-V) relation for the single channel, in the absence of internal Mg2+, was almost linear in 30 mM-external K+ and 150 mM-internal K+ (30 mM [K+]o) and in 45 mM-internal K+ and 150 mM-external K+ (45 mM [K+]i) as well as in 150 mM-external and internal K+ (the control condition). The channel conductance was 31.7 +/- 1.7 pS (mean +/- S.D., n = 36) in the control, 23.1 +/- 1.2 pS (n = 8) in 30 mM [K+]o and 29.7 +/- 1.3 pS (n = 16) in 45 mM [K+]i, respectively. 3. Mg2+ on the cytoplasmic side blocked the outward currents without affecting the inward currents. Outward mean open-channel currents were measured at different Mg2+ concentrations (0-100 microM) and voltages. The current-voltage relation rectified inwardly in the presence of internal Mg2+ in a voltage- and concentration-dependent manner. 4. Outward mean open-channel currents were normalized to that measured in the absence of Mg2+. The normalized current voltage relation in 45 mM [K+]i was almost superimposable on that obtained in the control at the same Mg2+ concentration, while that in 30 mM [K+]o was shifted in the negative direction by some 30 mV. 5. The normalized current-Mg2+ concentration curve was fitted by a one-to-one binding curve at each K+ condition and voltage. In a semilogarithmic plot of dissociation constant versus membrane potential, data points for 45 mM [K+]i were located on the same line as the control, whereas data points for 30 mM [K+]o were shifted in the negative direction by about 30 mV. The dissociation constant at 0 mV is 37 microM in the control and 45 mM [K+]i and 8.8 microM in 30 mM [K+]o. The voltage dependence of dissociation constants gives a value for the fractional electrical distance of the Mg2+ binding site of 0.57. 6. Subconductance levels with one-third and two thirds of the unitary amplitude were seen with low internal Mg2+ at 45 mM [K+]i or 30 mM [K+]o as well as in the control condition. Blocking and unblocking rates were calculated on the assumption that the channel is composed of three identical conducting units and each unit is blocked by Mg2+ independently.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1770456 TI - [The stimulating effects of contralateral glossopharyngeal and hypoglossal afferent fibers on the glossopharyngeo-hypoglossal reflex activities in the frog]. AB - American Bullfrogs, Rana catesbiana, immobilized with suxamethonium chloride (20 mg/kg b. w., i. p.), were used. By stimulating the glossopharyngeal (IX) nerve, reflex activities, composed of early (10-20 ms in latency) and late (greater than 20 ms) components, were evoked in both protoractor branch (P. br.) and retractor branch (R. br.) of the ipsilateral hypoglossal (XII) nerve. Contralateral IXth nerve stimulation increased the reflex activities of both components in the P. br. elicited ipsilaterally by the homonymous nerve. Whereas, it increased the reflex activities of the early component in the R. br. but, decreased that of the late component. On the other hand, stimulation of P. br. in the contralateral XIIth nerve increased the activities of both components in the P. br. and those of the late component in the R. br., but did not affect the activities of the early component in the R. br. The time course of these effects was similar to that by contralateral IXth nerve stimulation. The present findings strongly suggest the existence of afferent fibers in the XIIth nerve. PMID- 1770457 TI - [An inexpensive and flexible personal-computer-based system for controlling the multiple stimulus events in classical conditioning]. AB - For the demand of biological discipline it is worth to develop a stimulus control system especially suitable for behavioral studies on learning and memory, in which the precise temporal control of the event sequence has been desired. We developed a flexible and inexpensive system based on IBM-PC for the classical conditioning of the marine mollusc. User can set a various temporal conditions with the data sheet on a display. It can be applicable in a wide range of conditions as well as in a lot of situations which require temporal control of multiple stimuli. PMID- 1770458 TI - [Impulse data processing system using personal computer]. PMID- 1770459 TI - [An on-line realtime cardiotachograph]. AB - A realtime cardiotachogram was devised to detect fluctuation of cardiac rhythm. The apparatus is composed of five parts; (1) a "preamplifier" for recording electrical and/or mechanical cardiac activities, (2) a "slicer" to obtain sampling pulses from cardiac activity at a certain trigger level, (3) a "trigger pulse generator" to monitor sampling pulse, (4) an "oscillator" whose output is fed to a pulse counter, and (5) a "pulse counter" which counts the outputs of the oscillator during the gating period determined by the sampling pulses. The count numbers are converted to analog output, thus we can get sawtooth wave whose amplitude is directly proportional to the cardiac interval. The cardiac intervals between 100 ms and 5 seconds can be recorded by this tachograph. PMID- 1770460 TI - Control orientation as a personality dimension among alcoholic and obese adult men undergoing addictions treatment. AB - Rotter's (1966) I-E Locus of Control Scale was administered to 18 men in residential treatment for alcoholism and 13 men in intensive outpatient treatment for obesity. The obese sample scored significantly higher in internal locus of control, whereas the alcoholic sample was comparatively external in control orientation. These findings contradict currently held assumptions on the directionality of control orientation among both alcoholic and obese adults and suggest that internally oriented obese adults may feel that they have little control over their weight and eating behavior but more control over other aspects of their lives. In contrast, externally oriented alcoholics appear to be aware of their inability to control their drinking and their limited control over many factors influencing their lives. Implications for treatment are also discussed. PMID- 1770461 TI - The viability of an abbreviated version of the Holtzman Inkblot Technique with older adults. AB - Multiple regression analyses of Holtzman Inkblot Technique (HIT; Holtzman, Thorpe, Swartz, & Herron, 1961) factor scores were conducted to empirically determine the viability of a short form of the HIT with older adults. Although R2 values were acceptable, the contribution of individual cards to total factor scores was dubious at best. These data suggest that the development of a short form of the HIT for use with older adults is premature and requires more systematic research to justify its viability. PMID- 1770462 TI - Intrafamilial sexual abuse: family-of-origin and family-of-procreation characteristics of female adult victims. AB - We examined connections between incest victims' family-of-origin and family-of procreation characteristics in a sample of 40 American women who were in treatment for childhood or adolescent experiences of victimization. Retrospective data on their families-of-origin were collected along with their perceptions of current relationships with family members in the three-generational system. Results showed a close association between family-of-origin and family-of procreation characteristics, especially in the areas of intergenerational intimacy, intergenerational fusion/individuation, and personal authority. A number of significant correlations were also found between subjects' past and present relationships with family-of-origin members and the dimensions of moral and religious orientation, achievement, and intellectual and cultural orientation, conflict, and control in their family-of-procreation. Some aspects of individual adjustment, including alienation, emotional discomfort, and defensiveness, were strongly related to various family-of-origin and family-of procreation characteristics. PMID- 1770463 TI - Screening for hypertension in fit children. PMID- 1770464 TI - Hypertension and insulin resistance: mechanisms an implications for treatment. PMID- 1770465 TI - Reference values for the ambulatory blood pressure and the blood pressure measured at home: a population study. AB - In order to determine reference values for the ambulatory blood pressure, a population sample of 328 subjects, aged 20-81 years, who reported themselves to be in good health, was investigated. The ambulatory blood pressure was recorded over 24 h, taking measurements at 20 min intervals from 8 am to 10 pm, and at 45 min intervals from 10 pm to 8 am. Blood pressure was also measured by trained observers on each of two separate home visits (5 readings per visit). The ambulatory blood pressure in the 328 subjects averaged 118/71 mmHg over 24 h, 124/76 mmHg during the day (10 am-8 pm), and 108/62 mmHg at night (0 am-6 am). Blood pressure measured by an observer at the occasion of the second home visit was 4/5 mmHg lower (P less than 0.001) than the daytime ambulatory blood pressure. The 95th centiles for the daytime ambulatory pressures were 144/95 mmHg in 85 men below age 50; 154/90 mmHg in 74 men aged greater than or equal to 50 years; 132/85 mmHg in 96 women below age 50; and 151/91 mmHg in 73 women aged greater than or equal to 50 years. The 95th centiles for the nighttime pressures in these four sex-age groups were 124/79, 140/83, 121/70, and 132/72 mmHg, respectively. PMID- 1770466 TI - Racial aspects of ambulatory blood pressure. AB - Ambulatory blood pressure measurements, recorded by a Del Mar Pressurometer IV, were performed in 71 patients (25 blacks and 46 whites) with documented essential hypertension (supine diastolic blood pressure 95-119 mmHg) after four weeks of placebo treatment. Each 24-hour ambulatory BP measurement was calibrated with manual measurements within 5 mmHg and was repeated according to the daily conditions (work status) of the original recording. Ambulatory BP measurements were recorded every 15 minutes over 24 hours on two separate occasions one week apart. The mean of two 24-hour measurements was the value for the individual patient. Analyses of variance indicated no significant difference in the mean age, height, weight, 24-hour ambulatory systolic or diastolic BP, 8 am to 12 noon systolic or diastolic ambulatory BP, or 12 midnight to 4 am ambulatory systolic or diastolic BP for blacks versus whites. Among the subset of females, the 20 blacks were older than the 23 whites. Despite this age difference, there was no significant difference in height, weight or 24-hour, 8 am to 12 noon, or 12 midnight to 4 am ambulatory BP measurements. Therefore, this study does not support a racial difference in the level of ambulatory blood pressure measurement in these hypertensive patients. PMID- 1770467 TI - Blood pressure and educational level among factory workers in Ibadan, Nigeria. AB - An epidemiological survey of blood pressure was carried out among men employed at a single factory in Ibadan, Nigeria. All available employees participated, with only four persons excluded at the time of analysis for missing data. Hypertension was uncommon (blood pressure greater than or equal to 160/95 = 8%) and little rise in mean blood pressure was observed with age. Obesity was likewise uncommon, although body mass index was related to blood pressure (r = 0.22; P less than 0.01). Contrary to reports from Western industrialised countries, education was found to have a significant positive association with blood pressure, and this finding was independent of age, body mass index, pulse, and alcohol consumption. The process of modernisation is associated with rising blood pressure in West Africa at the present time, but the absolute risk remains low. PMID- 1770468 TI - Cross-sectional and longitudinal relationship of sodium-lithium countertransport to insulin, obesity and blood pressure in healthy perimenopausal women. AB - The objectives of this study were to assess the possible role of insulin as a regulator of red blood cell sodium-lithium countertransport and to examine the relationship of countertransport activity to change over time in insulin, blood pressure, and other variables. At baseline, countertransport was measured, and at baseline and after 2-3 years of follow-up, blood pressure, body mass index (BMI), lipids, fasting and two-hour plasma insulin and glucose were measured in 144 white healthy, premenopausal women, age 42-50 years. At baseline, using high and low categories of fasting insulin, triglycerides and BMI, countertransport was independently related to fasting insulin (P = 0.017), and triglycerides (P = 0.001), but not to BMI by analysis of variance. In similar analyses with fasting insulin, BMI, and countertransport, diastolic blood pressure was independently related only to countertransport (P = 0.003). Among the 73 who remained premenopausal after 2-3 year follow-up, baseline countertransport was significantly correlated with increases in fasting and two-hour insulin (r = 0.37, 0.38, P = 0.003, respectively), and these relationships remained significant after adjustment for change in BMI. Among subjects with high baseline countertransport, systolic blood pressure increased 5.6 mmHg compared with -2.2 mmHg with low countertransport, P = 0.001 after adjusting for baseline and change in BMI, triglycerides, and fasting and two-hour insulin. The data are consistent with a role for insulin and lipids in the regulation of sodium transport which may, in turn, play a role in blood pressure regulation. A relatively short follow up in this healthy population suggests a relationship of baseline countertransport to changes in insulin metabolism, and blood pressure. PMID- 1770469 TI - Blood pressure and heart rate variability in elderly patients with isolated systolic hypertension. AB - To investigate the circadian profiles of BP and heart rate in elderly patients with isolated systolic hypertension (ISH), the variability of BP and heart rate during day time (daytime) and the amplitudes of nocturnal fall were evaluated in ISH (n = 19) comparing with those of essential hypertensive patients (EHT, n = 18) and normotensive subjects (NT, n = 16) in the same age range. ISH showed a significantly wider BP variability during the day time and a greater amplitude of nocturnal fall compared with EHT and NT. However, the heart rate variability during the daytime and the amplitude of nocturnal fall were similar among the three groups. ISH showed a stronger correlation between BP and heart rate during 24 hours compared with EHT and NT. Approximately 80% of ISH showed a significant positive correlation between BP and heart rate. These results suggest that the BP of ISH patients is susceptible to fluctuations in autonomic nerve activity. PMID- 1770470 TI - Arterial properties of early hypertension. AB - In addition to high blood pressure, hypertension is characterised by metabolic and cardiovascular abnormalities, including decreased arterial compliance. To evaluate arterial involvement in early hypertension, we have employed a technique that analyses the arterial pulse wave contour to separately quantify proximal compliance (aorta and large arteries) and distal compliance (small arteries and arterioles). Proximal compliance was 24% lower in patients with borderline (diastolic BP 90-99 mmHg, n = 22) and 33% lower in patients with established (n = 19) hypertension than in normals (n = 15); distal compliance was 58% and 61% lower. These differences were not age-dependent, for in 27 age-matched pairs, proximal and distal compliances were 22% (P less than 0.01) and 55% (P less than 0.01) lower in hypertensives (diastolic BP greater than or equal to 95 mmHg) than in normotensives. Moreover, independent of BP or age, both proximal (P less than 0.05) and distal (P less than 0.01) compliance values were significantly lower in subjects with a family history of hypertension than in those without. Proximal compliance correlated inversely with indices of BP variability and heart work measured by automated whole-day blood pressure monitoring. Thus, changes in the elastic properties of the distal arterial circulation, reflected by decreased compliance, occur at the initiation of hypertension and may be an early diagnostic marker. Low proximal compliance appears to be associated with established hypertension, and might be a determinant of cardiovascular prognosis. PMID- 1770471 TI - Use of cultured atherosclerotic cells for investigation of antiatherosclerotic effects of anipamil and other calcium antagonists. AB - Calcium antagonists have been shown to exhibit an antiatherosclerotic action in primary cultures of human aortic atherosclerotic cells by causing a reduction in intracellular lipid content, proliferative activity and synthesis of the extracellular matrix. Verapamil and nifedipine exhibited the highest efficacy in this respect. The new calcium antagonist, anipamil (racemate and enantiomers), has been tested in cell cultures. At 10(-6) M and higher concentrations, anipamil and its enantiomers produced considerable decrease in intracellular content of cholesteryl esters, triglycerides and free cholesterol, suppressed cell proliferation and inhibited synthesis of the extracellular matrix. The efficacy of anipamil (enantiomers and racemate) was similar to that of verapamil and greater than that of nifedipine. Plasma obtained from patients after administration of 80 mg verapamil or 20 mg nifedipine significantly lowered the cholesterol content of cultured cells. Blood plasma of most atherosclerotic patients possesses atherogenic properties, i.e., it is able to increase the cholesterol content in cultured cells. Plasma atherogenicity seen in cultures decreased considerably or even disappeared after both nifedipine and verapamil administration. After 28 days of nifedipine therapy, plasma atherogenicity was lower compared with the initial value at the beginning of the treatment. These observations suggest that control of plasma atherogenicity after drug administration may provide an additional tool for optimisation of direct antiatherogenic and antiatherosclerotic therapy. PMID- 1770472 TI - The impact of a patient education programme in the control of hypertension. AB - The value of patient education programmes in the control of hypertension is controversial. We have conducted a prospective study to investigate a patient education programme in our clinic. Every new patient was randomised into one of two different groups: a control group (CG, n = 149) and an intervention group (IG, n = 138); the latter group was invited to attend two educational talks and subsequently one tutorial meeting. Blood pressure, heart rate, Quetelet Index, attendance, knowledge level, analytical parameters and the prevalence of other risk factors were measured in both groups before and after 6 months follow-up. No significant differences were detected between the two groups initially. At 6 months, both groups significantly lowered their BP; the only differences observed between groups (IG vs. CG) were: the number of correct answers to the questionnaire (14.5 +/- 3.7 vs. 12.9 +/- 3.7, P less than 0.01), the rate of occasional therapeutic abandonment (10.3 vs. 25%, P less than 0.05), 24 h sodium excretion (97 +/- 45 vs. 127 +/- 68 mmol/l, P less than 0.01) and the number of withdrawals (39 vs. 25%, P less than 0.05). We conclude that in spite of increased knowledge, less frequent abandonment of drug treatment and better observance of a low salt diet, patients in the IG had an increase in the number of drop-outs. Our data suggest that education in hypertension clinics should play a supportive role rather than a primary one in the control of high blood pressure. PMID- 1770473 TI - Combined lipid-lowering and antihypertensive treatment as part of a strategy of multiple risk factor intervention. AB - Thirty-six patients with treated mild to moderate hypertension and hypercholesterolaemia (greater than 6.5 mmol/l) entered a 12 week study to evaluate the efficacy and patient tolerability of combined lipid-lowering and antihypertensive treatment as part of a strategy of multiple risk factor intervention. The principal effects on the plasma lipid profiles were significant reductions of 30-40% in total and LDL cholesterol. These reductions were achieved without loss of blood pressure control. There was no significant impact on HDL cholesterol or on lipoprotein Lp(a). These preliminary results suggest that substantial reductions in total and LDL cholesterol can be achieved without compromising blood pressure control which remained satisfactory at 144/82 supine and 143/80 mmHg standing. Furthermore, these changes were achieved without any problems of patient tolerability or interference with patient compliance with drug treatment. Overall, therefore, substantial reductions in CHD risk can be achieved with an acceptable combination of lipid lowering and antihypertensive treatments. PMID- 1770474 TI - The aetiology of essential hypertension. AB - Essential hypertension is primarily hereditary. The property inherited is present in all cells but because of adaptation and differentiation it is particularly prominent in systemic vascular smooth muscle. This inherited property is manifested functionally as increased reactivity to vasoactive substances, such as (-)noradrenaline and angiotensin II. This abnormal function is present before the onset of hypertension. Vascular hypertrophy and hyperplasia are not only caused by hyperactivity of the smooth muscle and by the hypertension itself but are also trophic effect of the agonists, especially noradrenaline. The only two proteins in vascular smooth muscle which can produce both contractile and trophic effects are the guanosine triphosphate binding protein (Gs) and phospholipase C. Phospholipase C has already been demonstrated to be abnormally active in response to agonists in the spontaneously hypertensive rat and in human essential hypertension. The Gs protein is less likely to be critically abnormal since it is active in the vascular smooth muscle relaxation cascade as well as in contraction. None of the other proteins involved in vascular smooth muscle contraction or relaxation affect both contractile reactivity and cellular growth. There are many secondary effects dependent upon the phospholipase C abnormality such as calcium (Ca2+) cellular content, Ca2+ Mg2+ ATPase pump effects and possibly Ca2+ Na+ exchange. There are also many secondary effects impinging on the phospholipase C abnormality including changes in noradrenaline and angiotensin II metabolism. Present antihypertensive therapy is directed largely at secondary factors dependent upon or influencing the primary phospholipase C cascade. The path is now open for a more direct and basic diagnostic and therapeutic attack. PMID- 1770475 TI - Prevalence and progression of hypertension in NIDDM and its relationship to IHD and diabetic complications. PMID- 1770476 TI - Giant saccular aneurysm of the renal artery presenting as malignant hypertension. PMID- 1770477 TI - Overberg research projects. X. The epidemiology of helminths in ewes and lambs in the southern Cape Province during autumn. AB - Nematode parasite burdens of ewes grazing on grass/lucerne pasture, increased 58 fold after the first autumn rains in the southern Cape Province. Lambs were infected before the age of 8 weeks and harboured large burdens of nematode parasites before the age of 14 weeks. Oestrus ovis infections were present in 96% of the ewes, while 92% of the lambs above the age of 3 weeks were infected. Anthelmintic treatments in autumn, winter and spring are recommended for controlling parasites of sheep in this region. PMID- 1770478 TI - The seasonal activity of adult ixodid ticks on Angora goats in the south western Orange Free State. AB - Adult ixodid ticks were collected at 2-weekly intervals for a period of 23 consecutive months from 15 to 20 Angora goats on a farm in the south western Orange Free State. A total of 6 ixodid tick species were recovered. Rhipicephalus punctatus was the most abundant and prevalent tick. It was present from spring to late summer. Ixodes rubicundus was the next most abundant tick and was present mainly from March or April to July with peak numbers present in April or May. The onset of this tick's activity appeared to be stimulated by low atmospheric temperatures. PMID- 1770479 TI - Arthritis in slaughter pigs. AB - Joints obtained from 192 pig carcases were examined by means of standard microbiological and macro- and histopathological procedures. Approximately 32% of the joints were considered normal; 35.5% showed lesions consistent with osteochondrosis and a non-specific synovitis was present in 24.4%. Only 6.1% of joints were arthritic and yielded either Staphylococcus aureus or Streptococcus spp. The remainder (2.3%) had periarticular lesions such as abscesses. The study emphasises that an accurate diagnosis and correct evaluation of pig carcases showing joint lesions, is absolutely essential if a high standard of meat inspection is to be obtained and unnecessary economic losses are to be avoided. PMID- 1770480 TI - The efficacy of ultrasonic pest controllers for fleas and ticks. AB - Two ultrasonic pest controllers, a pet-collar unit and a large unit for household use, were tested for their efficacy in repelling fleas and ticks in a choice chamber. Neither unit had any affect on the distribution of fleas or ticks in the choice chamber up to 24 h exposure, and activity of fleas, ticks and cockroaches was unimpaired. The study extends and supports previous findings that ultrasound is ineffective as a means of controlling common pests of households and pets. PMID- 1770481 TI - The effect of premedication on the induction dose of propofol in dogs and cats. AB - The effect of premedication on the induction dose of propofol was determined in 15 cats and 25 dogs undergoing elective surgical procedures. The induction dose of propofol in dogs younger than 8 years old was 6.9 +/- 0.9 mg kg-1 (n = 4) without premedication and 4.3 +/- 1.4 mg kg-1 (n = 12) with premedication with acetylpromazine maleate. The induction dose in cats younger than 3 years old was 7.8 +/- 1.1 mg kg-1 (n = 8) with atropine alone and 7.1 +/- 0.9 mg kg-1 (n = 7) with the inclusion of acetylpromazine maleate. The reduction in the induction dose of propofol was statistically significant in dogs, but not in cats. When atropine was used together with a fentanyl-droperidol combination or pethidine and acetylpromazine maleate in dogs, the mean induction dose of propofol was reduced to 2.1 +/- 0.1 mg kg-1 (n = 4) and 2.4 +/- 0.3 mg kg-1 (n = 5), respectively. Propofol was also evaluated as an induction agent in patients undergoing non-elective surgical procedures. PMID- 1770482 TI - The response of animals to suxamethonium (succinyldicholine) and succinylmonocholine. AB - The time which elapses before cessation of breathing, and blood pressure and blood gas changes after the intramuscular administration of suxamethonium, or a mixture of suxamethonium and hexamethonium, is compared in immobilised African elephants (Loxodonta africana) and buffaloes (Syncerus caffer). In addition, the respiratory responses of elephants and other animals to intravenous administration of suxamethonium and succinylmonocholine are reported on, as are the effects of darting animals with succinylmonocholine. The results show that respiration is affected in a similar fashion in all species investigated. However, the characteristic gradual decrease in respiratory rate seen in elephants during culling, using suxamethonium, resembles the effects observed when succinylmonocholine is administered. It is suggested that elephants are killed by this first breakdown product of suxamethonium during culling and/or that unique acetylcholine receptors may be involved. PMID- 1770483 TI - Encephalitozoon infection in a still-born foal. AB - A stud Clydesdale foal was still-born near full term. Macroscopic examination revealed a normal placenta, pulmonary atelectasis and faint white mottling of the kidneys. Microscopically there was severe lymphoplasmacytic interstitial nephritis. Numerous organisms resembling Encephalitozoon cuniculi were present in the affected kidneys. The organisms occurred in the areas of inflammation as well as in the renal glomeruli and intracellular cysts in the renal tubular epithelial cells and exhibited Gram positive staining. Ultrastructurally the organisms possessed a polar vacuole and a spiral filament typical of Microsporidia. The organisms were not detected in sections of the other organs examined. PMID- 1770484 TI - Erythema multiforme in two horses. AB - Erythema multiforme is reported for the first time in 2 South African horses. Both horses displayed a sudden, fulminant outbreak of raised, non-alopecic and non-pruritic plaques over the dorsolateral aspects of the neck and trunk. In both cases the distribution of the lesions was bilaterally symmetrical. Histopathological findings included hydropic degeneration of basal epidermal cells, eosinophilic necrosis of individual or groups of keratinocytes, intra epidermal and sub-epidermal cleft formation and mixed, dermal, perivascular infiltrates. An initiating cause could not be identified in either case. Both horses underwent gradual spontaneous remission within 3 months. PMID- 1770485 TI - Lithium toxicity in two dogs. AB - Two cases of lithium toxicity are reported on in dogs having had lithium hypochlorite chlorinated water as their sole source of drinking water. Clinical signs in one dog included polyuria, polydipsia, loss of body mass; dehydration, diarrhoea and general weakness and in the other case, polyuria, polydipsia, loss of body mass and seizures. Withdrawal of the water resulted in complete recovery. PMID- 1770486 TI - Laboratory animal bedding: a review of specifications and requirements. AB - The literature is reviewed regarding existing specifications and requirements for laboratory animal bedding. The lack of comprehensive specifications in the guidelines of laboratory animal governing bodies, and the introduction of external variables by unsuitable bedding into experimental design, are discussed on the basis of examples from the literature. PMID- 1770487 TI - Effect of monensin and its metabolites in broiler litter on sheep consuming the broiler litter. AB - Two trials were conducted to determine the effect of monensin in broiler litter on sheep receiving the broiler litter in their diets. Broiler litter from chickens fed monensin as a coccidiostat, and from chickens receiving no coccidiostat, was included at a level of 30% in 2 sheep diets. In a further 2 treatments, monensin (15 mg kg-1) was added to each of the 2 diets to give a 2x2 factorial experimental design. In the first trial, copper (20 mg kg-1 feed) was added to the diets. These lambs were fed individually at a slightly restricted level of intake. No differences between treatments were observed in feed intake, average daily gain or efficiency of feed utilisation or in the concentrations of zinc, iron and manganese in the liver, glutathione peroxidase in erythrocytes and creatine kinase concentrations in the plasma. Hepatic copper content and copper retention in the livers of the sheep receiving the added monensin were significantly higher (P less than 0.05 and less than 0.01 respectively) than in those not receiving added monensin. The aspartate transaminase and alkaline phosphatase concentrations in the plasma of these sheep were also higher (P less than 0.05) than in those not consuming added monensin. In the second trial, the lambs were group-fed according to treatment and received the diets on an ad lib basis. The mean intakes of the groups receiving the diets with the added monensin, were lower than the intakes by the other groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770489 TI - Disinfestation of irrigated sheep pastures by alternating grazing with cattle. PMID- 1770488 TI - The effect of endogenously produced carbon monoxide on the oxygen status of dogs infected with Babesia canis. AB - Carboxyhaemoglobin fractions were found to be significantly higher (P less than 0.05) in dogs (n = 5) with severe babesiosis than in control subjects (n = 5). The enzymatic conversion of haem to biliverdin by haem oxygenase is the only known source of endogenous carbon monoxide. We propose that the increased production of endogenous carbon monoxide following the haemolysis associated with babesiosis, results in the carboxyhaemoglobinaemia observed in this study. The superimposition of carboxyhaemoglobinaemia on severe anaemia results in further compromise of the oxygen status of dogs with severe babesiosis, and probably plays a role in the pathogenesis of the hypoxic tissue damage associated with this condition. PMID- 1770490 TI - A descriptive study of the canine population in a rural town in southern Africa. AB - The health status of a population of dogs (n = 220) from a rural southern African town is described. A cross sectional survey was done to collect the necessary information. All animals examined were mongrels with a mean condition score of 1.93. The oldest dog found in the population was 8 years old. Rhipicephalus sanguineus was the dominant tick species encountered on the dogs, Echidnophaga gallinacea the dominant flea species, while Cordylobia anthropophaga and Demodex canis also affected the health status of the population. Fourty five per cent of the population were found to have nematode eggs in the faeces. On clinical examination, 5% of the population were judged to be acutely ill and 27% to be chronically ill. Based on the clinical examination, bloodsmears and laboratory results, 51% of the population had one or more serious clinical conditions at the time of examination. The conditions with the highest point prevalence rate in the community were canine ehrlichiosis (17.2%), transmissible veneral tumour (6.8%), canine distemper (5%), Cordylobia infestation (5.5%), trauma (4.1%), and severe malnutrition (4.1%). It was concluded that a significant section of this population was in a chronic state of starvation and malnutrition. There was also a heavy infestation of internal and external parasites and the prevalence of serious diseases in this population was high. PMID- 1770491 TI - Mitral valve E point to ventricular septal separation in the dog. AB - Mitral valve E point to septal separation (EPSS) was measured (mean = 3.27 +/- 1.29 mm) in healthy non-anaesthetised Beagle and German Shepherd dogs (n = 50). The minimum and maximum values recorded were 1 and 6mm respectively. Breed, age, sex, mass and heart-rate had no significant effect on the EPSS value. PMID- 1770492 TI - [An analysis of informal veterinary consultations during radio programmes]. AB - A sample of informal consultations based on letters which were sent to a radio programme in which the theme was informal veterinary consultations were analysed. The animal-owner profile, the identification of animals involved and the need which motivated owners to seek such consultations were investigated. The results indicated that the most typical animal owner to participate in programmes of this nature was an adult woman living in the country and the most common animal involved was an intact male dog. The most common area of concern was ethological of nature. Behavioural problems were the most common ethological problem, followed by management and care. The significance of this study for the veterinarian is probably that it recognises the role and importance of informal consultations, that deficiencies in formal consultations are indicated and that it emphasises the need of readily available knowledge of ethology, that informal consultations are unsuitable for serious cases, and that informal consultations give further insight into human-animal interaction from a veterinary perspective. PMID- 1770493 TI - [The threat of wide dissemination of anthelmintic resistance by veld ram performance testing units]. AB - A veld ram performance testing unit consists of an association of stud or commercial ram breeders, who compare the performance of selected rams under field conditions on common pastures. The best performers are subsequently auctioned at public sales. To date, at least 10 Merino veld ram clubs have been established in various centres in South Africa. A strain of Haemonchus contortus, which was isolated from the pastures of one of these performance testing units, was found to be resistant to ivermectin, oxfendazole and rafoxanide. Closantel, levamisole and disophenol were more than 99% effective. The wide dispersal of the rams after testing, constitutes a potential danger for dissemination of helminths with resistant genes. Precautionary methods should include careful routine monitoring of drug susceptibility on the communal pastures, on the farms of individual members and thorough deworming of rams before they leave the testing unit. The prevention and control of resistance in such testing units are discussed, but it is emphasised that this is difficult, particularly if the worm strains on the communal grazing have become resistant to some of the anthelmintic groups. PMID- 1770494 TI - The role of the veterinarian in the education and health of pre-school children. AB - Two surveys conducted in pre-schools (n = 156) located in advantaged areas and disadvantaged areas in Pretoria, indicated that animals had social and psychological as well as educational value for pre-school children. All schools (n = 156) utilised animals in some way for the education of pre-school children. Nineteen of the pre-schools in advantaged areas kept animals permanently at the school. All of these schools utilised the zoo. Only 3 of the schools in disadvantaged areas (n = 106) were able to keep animals permanently on the premises although 69 would have liked to keep animals and 77 of the schools visited the zoo at least once a year. Limiting factors included lack of finances and facilities, lack of knowledge on animal management and anxiety about zoonoses. No cases of zoonotic disease in children were recorded. The species of animals utilised at the pre-schools differed from those found most commonly as household pets. Pre-schools favoured rodents, fish and birds rather than carnivores. The role of the veterinarian may include clinical treatment of the animals from the pre-school, advice on management and zoonosis prevention, pet care counselling, communication with children and their parents in the consulting room, public health aspects and promotion of environmental education. PMID- 1770495 TI - Overberg research projects. XIII. A comparison of the efficacy of albendazole drench and an albendazole slow-release capsule against nematode parasites in sheep. AB - The anthelmintic efficacy of albendazole intra-ruminal slow-release capsules (SRC) and albendazole drench against field strains of 5 genera of nematode parasites of sheep, where compared. The SRC reduced the number of L4 and adult Nematodirus by 64.1% and 58.3% and the albendazole drench by 98.1% and 99.1%, respectively. Neither formulation was more than 89.5% effective against either the L4 or adult stage of Teladorsagia. The efficacy of both formulations against the adult stages of Haemonchus, Trichostrongylus and Oesophagostomum ranged from 95.9 to 99.9%. PMID- 1770496 TI - Diagnosis of liver tapeworm, Stilesia hepatica, infection in sheep. AB - A practical method of diagnosing Stilesia hepatica in live sheep is described. Intestinal contents and faeces were sieved through a sieve with apertures of 1.0 mm onto a sieve with apertures of 100 microns to reduce volume and turbidity. The residue on the fine sieve was examined microscopically. Gravid proglottids passed through the intestine without being digested. Intact proglottids were recovered from the intestine and faeces of infected sheep. Used purely on faeces, the technique is simple and reliable as a diagnostic method. Its application could facilitate basic research into the biology and epidemiology of the parasite. PMID- 1770497 TI - Suspected avocado (Persea americana) poisoning in goats. AB - A herd of 15 Cameroon goats was suspected of having been poisoned by eating leaves of the Fuerte variety of avocado pear (Persea americana). Two of the affected goats were examined clinically, while necropsies were carried out on 3 of the 4 that had died. The most significant clinical findings were tachycardia, hyperpnoea and evidence of lung oedema. At necropsy severe lung oedema, hydrothorax and hydropericardium were present. Severe myocardial degeneration, necrosis and fibrosis were the major histopathological findings. PMID- 1770498 TI - Suspected cycad (Cycas revoluta) intoxication in dogs. AB - Three dogs which ingested part of the stem of a Japanese cycad (Cycas revoluta) vomited repeatedly within hours after ingestion, showed marked depression, severely congested mucous membranes, increased thirst and profuse salivation. Subsequent hematological and blood chemical investigation revealed elevated serum concentrations of alanine transaminase, an initial mild lymphocytopenia, thrombocytopenia and a leucocytosis. The dogs recovered uneventfully. PMID- 1770499 TI - The carbon dioxide laser scalpel. AB - The CO2-laser is currently used as a scalpel by a large number of medical surgeons, but in the field of veterinary surgery, relatively little has been published on the subject. A review of the origin of medical lasers, the basic physics of laser energy production and the characteristics of laser light was therefore considered necessary. This review includes a discussion on how the optical radiation generated by the different lasers is absorbed, the cutting power of the CO2-laser, and the effect on healing, tensile strength and haemostasis when used in the skin, linea alba and gastrointestinal tract. PMID- 1770500 TI - Cytochrome P-450-dependent metabolism of xenobiotics in human lung. PMID- 1770501 TI - Association of microcystin-LR and its biotransformation product with a hepatic cytosolic protein. AB - Microcystin-LR (MCYST-LR), a cyclic peptide hepatotoxin, associates with high molecular-weight, liver cytosolic components. Repetitive cycles of heat denaturation and pronase digestion released 80 +/- 6% of the bound radiolabel from these components, parent toxin (22%), and two biotransformation products, with high-performance liquid chromatography (HPLC) retention times of 6.7 (52%) and 5.6 (13%) min. Both parent and the biotransformed (6.7 min) toxin appeared to be covalently bound to a monomeric protein of molecular weight 40,000 (protein plus radiolabeled toxin). Binding and biotransformation reactions were time- and temperature-dependent and did not require endogenous molecules less than 6,000 daltons. The binding appeared to be saturable with a maximum of 20 pmol MCYST-LR bound per mg protein. The binding protein(s) and biotransformation activity were present in rat liver, brain, kidney, heart, lung, small intestine, large intestine, testes, skeletal muscle, and to a lesser extent, in fat. Okadaic acid, a specific protein phosphatase inhibitor, showed a concentration-dependent inhibition of [3H]MCYST-LR binding to hepatic cytosol. The molecular weight and organ distribution of the binding protein(s), and inhibition of binding by okadaic acid were consistent with one of the binding sites being the catalytic subunit of protein phosphatase type 2A. PMID- 1770502 TI - Fetotoxic alterations in the normal ontogenies of rat microsomal and lysosomal enzymes. AB - The activity patterns during development for acid phosphatase (Ac-P), alkaline phosphatase (A1-P), beta-glucuronidase (beta G), and UDP-glucuronyltransferase (UDPGT) have been determined in various tissues of the rat for corn oil and distilled water controls as well as in animals prenatally exposed to four fetotoxic chemicals. Postnatal assays were performed on both sexes separately. In control animals, tissue-specific differences between male and female activity levels were found for UDPGT. In the liver of mature offspring, enzyme activity was greater in males than in females. Although no sex difference was observed in the intestine, the kidneys of females exhibited higher values than those of males. An original computer-assisted methodology is presented, designed (a) to permit a mathematical description for the complex curves exhibited by these ontogeny profiles, and (b) to assess the statistical significance of chemical induced alterations in these complex developmental patterns, specifically, to target sensitive periods and subtle changes near the fetotoxic threshold. Oral administration (days 6-18 of gestation) of 3,3',4,4'-tetrachlorobiphenyl (4CB) to pregnant females resulted in an induction of liver UDPGT activity in offspring postnatally, and some alterations in the perinatal pattern of beta G in the same tissue. This treatment also produced differences in the intestinal patterns of Ac P and male UDPGT. No significant changes were observed in offspring exposed to diethylstilbestrol (DES). Treatment with zeranol (ZN) caused reductions in activity over the entire postnatal period for beta G in liver, brain, intestine, and kidney, for A1-P in brain, and for Ac-P in the intestine. Cadmium-treated dams gave birth to offspring that exhibited slightly altered ontogenies only in intestine for UDPGT and AcP. The alterations in these developmental profiles indicate periods of increased sensitivity, and may be useful in directing more specific studies into the fetotoxic mechanisms of these compounds. PMID- 1770503 TI - Anatoxin-a(s), a naturally occurring organophosphate, is an irreversible active site-directed inhibitor of acetylcholinesterase (EC 3.1.1.7). AB - Anatoxin-a(s) is a guanidine methyl phosphate ester (unprotonated molecular ion equals 252 daltons) isolated from the freshwater cyanobacterium (blue-green alga) Anabaena flos-aquae strain NRC 525-17. Previous work has shown anatoxin-a(s) to be a potent irreversible inhibitor of electric eel acetylcholinesterase (EC 3.1.1.7, AChE). In the present study the interaction of anatoxin-a(s) with AChE was investigated by protection studies and since similarities have been noted between anatoxin-a(s) and the synthetic organophosphate anticholinesterases, the ability of reactivators to reactivate the inhibited enzyme was investigated. Treatments directed toward eliminating poisoning symptoms and in vivo protection from anatoxin-a(s) poisonings were investigated using oxime reactivators and atropine or pretreatment with a carbamate and atropine. Anatoxin-a(s) was shown to be an active site-directed inhibitor of acetylcholinesterase which is resistant to oxime reactivation due to the structure of its enzyme adduct. In vivo pretreatment with physostigmine and high concentrations of 2-PAM were the only effective antagonists against a lethal dose of anatoxin-a(s). PMID- 1770504 TI - Role of cytochrome P-450 in ochratoxin A-stimulated lipid peroxidation. AB - The role of cytochrome P-450 in the stimulation of lipid peroxidation by the nephrotoxic mycotoxin ochratoxin A has been investigated. Ochratoxin A was previously shown to markedly stimulate lipid peroxidation in a reconstituted system consisting of phospholipid vesicles, NADPH-cytochrome P-450 reductase, Fe3+, ethylenediaminetetraacetic acid (EDTA), and reduced nicotinamide adenine dinucleotide phosphate (NADPH). We now show that purified cytochrome P-450IIB1 could effectively replace EDTA in stimulating lipid peroxidation suggesting that it could mediate the transfer of electrons from NADPH to Fe3+. Cobalt protoporphyrin is known to cause an extensive and long-lasting depletion of hepatic cytochrome P-450 in rats, and it has been used to evaluate the role of hepatic cytochrome P-450 in xenobiotic metabolism and toxicity. We have observed that microsomes isolated from livers of cobalt protoporphyrin-pretreated rats underwent ochratoxin A-dependent lipid peroxidation much more slowly than control microsomes. Also, the level of ethane exhaled (an index of in vivo lipid peroxidation) on ochratoxin A administration was much lower in cobalt protoporphyrin-pretreated rats than in control rats. Taken together, these results provide evidence for the stimulatory role of cytochrome P-450 in ochratoxin A-induced lipid peroxidation in a reconstituted system and strongly implicate its role in microsomal and in vivo ochratoxin A-induced lipid peroxidation. PMID- 1770505 TI - In vitro inhibition of rat platelet aggregation by ochratoxin A. AB - The mycotoxin ochratoxin A (OA) consists of 5-chloro-3-methyl-3,4-dihydro-8 hydroxyisocoumarin moiety linked by an amide bond to beta-L-phenylalanine. When added to washed rat platelets in vitro, OA caused a dose-dependent inhibition of aggregation induced by agonists such as adenosine diphosphate (ADP) or thrombin. The aggregatory response induced by prior addition of an agonist was also reversed in a dose-dependent manner by OA. Inhibition of aggregation appeared to be irreversible since exposure of platelets to OA followed by several washings removed most of the mycotoxin associated with the platelets but did not diminish the inhibitory response. Serotonin secretion from dense granules and arachidonic acid release from membrane phospholipid (especially phosphatidylcholine) as well as its further metabolism were also inhibited by OA. These results suggest that a disruption of the platelet plasma membrane structure by OA is probably responsible for inhibition of the primary and secondary phases of aggregation. PMID- 1770506 TI - Effects of inhibition of cystathionase activity on glutathione and metallothionein levels in the adult rat. AB - The effects of alterations in sulfur metabolism on hepatic and renal metallothionein and glutathione metabolism were studied in the adult rat using inhibition of two enzymes of these pathways, hepatic cystathionase and renal gamma-glutamyl transpeptidase. Rats were fed a diet containing both methionine (0.66%) and cystine (0.20%) for 1 week before receiving three consecutive daily intraperitoneal injections of propargylglycine, a selective cystathionase inhibitor, at various doses (2.5-375 mumol/kg). When hepatic cystathionase was inhibited greater than 90% (greater than or equal to 50 mumol propargylglycine/kg), renal and hepatic metallothionein and hepatic glutathione were unaltered except at the highest dose. On the other hand, renal glutathione was increased two-fold with a concomitant decrease in renal gamma-glutamyl transpeptidase activity (50% of control). In another experiment, when renal gamma glutamyl transpeptidase was inhibited greater than 90% with three consecutive daily injections of acivicin, a selective gamma-glutamyl transpeptidase inhibitor (10 mg/kg IP), renal glutathione content was unaltered while hepatic glutathione was decreased. Renal and hepatic metallothionein were not changed. Thus, the cysteine pools for metallothionein and glutathione appear unrelated under the present experimental conditions. In addition, following either proparglyglycine or acivicin injections, renal and hepatic glutathione pools appear to be altered differently. These results suggest that renal glutathione may be preferentially maintained even when hepatic glutathione is decreased. PMID- 1770507 TI - Calcium channel blocking agents protect against acetaminophen-induced cytotoxicity in rat hepatocytes. AB - The effect on acetaminophen-induced cytotoxicity of three calcium channel blocking agents--diltiazem, verapamil and gallopamil--was studied in primary cultures of rat hepatocytes and compared with the chelating agent EGTA. Using the measurement of cytosolic lactate dehydrogenase (LDH) as an index of cytotoxicity, it was demonstrated that a 1-hr pretreatment with calcium channel blocking agents protected cells against acetaminophen cytotoxicity, but were less effective than EGTA. These data suggest that influx of extracellular Ca2+ into the cells could have a role in the genesis of hepatocyte injury by acetaminophen. PMID- 1770508 TI - Seasonal population patterns of Spalangia endius Walker (Hymenoptera: Chalcidoidea) at a refuse dumping ground in Malaysia. AB - A study on population patterns of the parasitoid Spalangia endius Walker at a dumping ground near Kuala Lumpur city showed that the percentage of S. endius adult emergence varied seasonally. During the relatively heavy rainfall months of August and November 1988, and January, March, and April 1989, the population of S. endius adult emergence were low (0-14.2%) compared to the less rainy months of July, September, and December 1988, and May 1989 (29.3-39.6%). This information could be useful in formulating strategies to reduce house fly population at the refuse dumping ground through integrated pest management programs. PMID- 1770509 TI - Antigenic similarity between the mosquito vectors of malaria and filariasis. AB - Rabbit antisera were raised to the malaria vector Anopheles tessellatus, head thorax, abdomen, and midgut preparations. Reactivity of the antisera with An. tessellatus and the filariasis vector, Culex quinquefasciatus, were examined by enzyme-linked immunosorbent assay (ELISA) and Western blots. Although many antigens were shared between the two species of mosquitoes, tissue- and species specific antigens also were identified. PMID- 1770510 TI - Reduction in egg viability resulting from infestations on cattle of hybridized Boophilus ticks and B. microplus (Acari: Ixodidae) at various ratios. AB - The competitiveness of hybridized Boophilus males, which are 100% sterile, was compared to B. microplus (Canestrini). Hybrid larvae used in the study were the offspring derived by cross-mating B. annulatus (Say) males with B. microplus females. Cattle were infested with a total of 2,500 larvae at ratios of 5:1 and 10:1 (hybrid to pure strain). The reduction in egg hatch resulting from the hybrid males was 68 and 77.5% at the 5:1 and 10:1 ratios, respectively. Both treatment ratios produced egg sterility that were lower than expected, assuming purely random mating, suggesting that hybrid ticks were not as competitive as B. microplus males. At the 5:1 treatment level, genotypic determinations based on isoenzyme analysis indicated that mate pairings involving hybrid males occurred 20-40% less frequently than expected, whereas matings involving pure-strain B. microplus males occurred twice as frequently as expected. At the 10:1 treatment level, mate pairings involving hybrid males occurred 10-20% less frequently than expected, whereas pairings involving pure strain B. microplus occurred 2-4 times more frequently than expected. The results indicated that in a sterile hybrid male program, it would be necessary to increase the ratios of hybrids by approximately 2-fold over the 5:1 or 10:1 ratios to achieve the 80-90% sterility expected, because of the decreased competitiveness of hybrid males. PMID- 1770511 TI - Studies on the control of plague in the western United States: laboratory trials of six insecticide dust formulations applied to soil for the control of the plague vector Oropsylla montana (Siphonaptera: Ceratophyllidae). AB - In this study, six insecticide dust formulations were laboratory-tested in soil mixtures ranging in concentration from 40 to 1,280 parts per million (ppm) against a proven vector of bubonic plague, Oropsylla montana (Baker). Pulicidal effects of the six insecticides, which included three organophosphates, two carbamates, and a pyrethroid, were compared by LD(50) values at both ambient and 75% RH. Permethrin (Pyraperm 455 dust), a pyrethroid with a LD(50) less than 40 ppm, demonstrated the most effective pulicidal action for the 13-wk trial period, followed in order by chlorpyrifos, bendiocarb, propetamphos, diazinon, and carbaryl. PMID- 1770512 TI - Efficacy of three pyrethroids against Leptotrombidium fletcheri (Acari: Trombiculidae) infected and noninfected with scrub typhus. AB - Toxicities of three pyrethroids, d-phenothrin, decamethrin, and permethrin, were evaluated in the laboratory against Leptotrombidium fletcheri (Womersley & Heaslip). The susceptibilities between populations of the species infected and noninfected with scrub typhus were investigated. The three pesticides exhibited different toxicities to the chiggers. D- phenothrin was the most toxic, followed by decamethrin, then permethrin. There were no significant differences between susceptibilities of the infected and noninfected populations. Log-probit regression lines indicated that the species was most sensitive to increasing concentrations of d-phenothrin and least sensitive to permethrin. The results show that the three pesticides are potential candidates for chemical control of L. fletcheri. It may be possible in the future to conduct similar bioassays only with the noninfected population, thus reducing risk of infection to workers conducting the bioassays. Similarly, there may not be a need to separate field collected chiggers into the two populations before performing the bioassays. PMID- 1770513 TI - Concentrations of human erythrocytes by anopheline mosquitoes (Diptera: Culicidae) during feeding. AB - Erythrocyte densities in the blood meals of six Anopheles mosquito species were compared with those of human host erythrocyte densities. During engorgement, An. gambiae Giles and An. stephensi Liston concentrated erythrocytes by factors of 1.8 and 1.7, respectively; An. freeborni Aitken did not concentrate; and An. arabiensis Patton and An. dirus Peyton & Harrison demonstrated an intermediate level of erythrocyte concentration (1.4 and 1.2, respectively). An. albimanus concentrated host hemoglobin, but hemolysis during engorgement decreased bloodmeal erythrocyte density below that of host blood. The degree to which anopheline species concentrated erythrocytes was related to the frequency and time spent undergoing prediuresis (anal excretion of fluid during feeding), suggesting that prediuresis is responsible for erythrocyte concentration and that the fluid produced represents efflux from the filtration of ingested blood. Differences observed in erythrocyte concentration by different anopheline species are consistent with species-specific patterns of host selection. PMID- 1770514 TI - Origin of stable flies (Diptera: Muscidae) on west Florida beaches: electrophoretic analysis of dispersal. AB - Stable fly adults were collected from 16 locations within the state of Florida and from locations in six other states in an attempt to determine the source of stable fly populations along Florida beaches on the Gulf of Mexico. Electrophoretic analyses were made of a minimum of 10 enzymes in each of 37 separate populations. Extremely low heterozygosity resulted in an inability to use standard genetic identity and distance procedures for determining the divergence of allopatric populations to establish the source of flies captured from beach areas where reproduction was unlikely. Comparisons of rare alleles in populations grouped geographically, computations of number of possible migrants, and analysis of conditional average frequency of alleles led to the conclusion that flies captured on Florida beaches come from a variety of sites, with locations northwest of the beaches contributing the majority of flies in outbreaks. PMID- 1770515 TI - Visual assessment of sporozoite and bloodmeal ELISA samples in malaria field studies. AB - The accuracy of visually assessing positivity for samples of field-collected Anopheles tested by enzyme-linked immunosorbent assays (ELISA) for Plasmodium falciparum sporozoites and human bloodmeals was determined during malaria field studies in Kenya. Six observers familiar with ELISAs evaluated 5,344 sporozoite ELISA samples and four observers evaluated 360 bloodmeal samples as either positive or negative based on the presence and strength of green-colored peroxidase reactions relative to controls on each microtiter plate. Interobserver agreement ranged from 97.9 to 99.8% for sporozoite samples and from 90.3 to 96.1% for bloodmeal samples. For both assays, the mean sensitivity and specificity of visual readings, compared with spectrophotometric readings, exceeded 98% when absorbance values were greater than or equal to 0.4 (on a scale of 0.0 to 2.0). Most incorrect visual readings occurred for samples with absorbance values between 0.2 and 0.4. The total percentage of samples classified correctly by visual examination ranged from 97.7 to 99.5% for the sporozoite ELISA and from 95.0 to 96.7% for the bloodmeal ELISA. Thus, there was minimal error associated with visually determining positive reactions for the ELISA assays used in malaria field studies. PMID- 1770516 TI - Rectal infusion and aspiration of material through the guts of ixodid ticks (Acari: Ixodidae). AB - A technique for inoculating and removing substances via the anus of vector ticks was devised to define features of vector competence precisely. Calibrated inocula (greater than 5 nanoliter) containing aqueous dye and polystyrene beads as well as infectious agents were infused into the rectal sacs of ticks using glass microcapillary pipettes placed within the expanded anal orifice. The guts of preadult and adult ticks, Ixodes dammini Spielman, Clifford, Piesman & Corwin, Dermacentor variabilis (Say), Hyalomma impeltatum Schulze & Schlottke, and Amblyomma americanum (L.), were thereby infused with these inocula. Distribution of inocula was determined by examining hemolymph and sectioned ticks and confirmed that material placed in the rectal sac spread throughout the midgut diverticula. Ticks survived for greater than 6 mo after this procedure and were able to feed, molt to the next stage, or oviposit. In contrast, fewer ticks survived after intracelomic inoculation. The course of infection in ticks receiving anal infusions of Borrelia burgdorferi (the Lyme disease spirochete) was assessed. Such infections appear to differ from those established by feeding on infected hosts. Contents of the tick gut can be sampled nondestructively by anal perfusion to diagnose infection by this spirochete. PMID- 1770517 TI - Tabanus vaseyi Sherman, a new species of tabanid from Vietnam and a redescription of Tabanus flavioculatus Toumanoff (Diptera: Tabanidae). AB - A new species of Tabanidae, Tabanus vaseyi Sherman, n. sp., is described from Vietnam and differentiated from Tabanus cepuricus Surcouf. Tabanus flavioculatus Toumanoff is redescribed; anatomical features and variation not noted in the original description are given, along with a discussion of the taxon. It is recorded for only the second time and is newly recorded from Vietnam. Conflicting reports on the type data and type depository for the paratype of Tabanus sphinx Philip (= T. cepuricus) are clarified. Collection data of the only specimen of Tabanus soubiroui Surcouf known from Vietnam are recorded. Taxa from Southeast Asia related to T. vaseyi and T. flavioculatus are discussed briefly. PMID- 1770518 TI - Battery-powered, electrocuting trap for stable flies (Diptera: Muscidae). AB - A solar-charged, battery-powered, electrocuting grid was combined with a white plywood base to make a portable, pulsed-current, pest-electrocuting device that attracted and killed stable flies, Stomoxys calcitrans (L.), outdoors. The grid was powered once every 1-2 s by a 0.016-s pulse of 60-Hz alternating current of 4 mA and 9,500 V. Power was turned off at night by a photoresistor. The trap functioned continuously for 14 d with an unrecharged 12-V, 18A/h lawn-tractor battery and killed as many as 4,000 flies per day. Solar cells were used to charge a single 12-V battery continuously that operated 12 grids for a period of 90 d. The grid did not short circuit for any length of time even during heavy rainstorms or when large insects were killed. The incorporation of moire patterns and the utilization of the correct size, orientation, and placement of wires made the electrocuting grid itself attractive to stable flies. The traps were spaced at distances of up to 120 m from the battery and pulse circuit. The electrocuting traps were more effective than sticky traps and avoided the problems associated with chemicals. They are well suited for use around calf pens, dog kennels, or large animal shelters. PMID- 1770519 TI - Meteorological factors influencing host-seeking activity of female Simulium luggeri (Diptera: Simuliidae). AB - The influence of selected meteorological variables on host-seeking activity of parous and nulliparous female Simulium luggeri at cattle bait was studied in central Saskatchewan. Variability in the pattern of diurnal host-seeking probably was attributable to the secondary influence of meteorological parameters on endogenous rhythms that are primarily stimulated by illumination. Although some differences occurred, nulliparous and parous female S. luggeri activity was similarly influenced by the meteorological factors measured. The most important limiting factors were wind speeds greater than 15 km/h, followed by temperatures less than 20 degrees C. When values were outside of these thresholds, saturation deficit, cloud cover, barometric pressure, and illumination became influential. Parous S. luggeri appeared to be more tolerant of dry conditions than nulliparous individuals. Seasonal differences, site location (exposed versus protected), and varied interactions among environmental factors contributed to the inconsistent relationships among meteorological variables and black fly host-seeking activity. PMID- 1770520 TI - Environmental regulation of autogeny in Culex tarsalis (Diptera: Culicidae) from Manitoba, Canada. AB - Temperatures less than 21 degrees C suppressed the expression of autogeny in genetically autogenous females of Culex tarsalis Coquillett from Manitoba, even under a long day photoperiod of 16:8 (L:D). Under short day lengths (8:16), the percentage of autogenous females was suppressed at temperatures from 16 to 28 degrees C; but at 32 degrees C, maximum autogenous expression occurred. When genetically similar populations were maintained at 24 degrees C and exposed to photoperiods from 14:10 to 10:14 (L:D), autogeny was suppressed from a mean of 26% progressively to 1%. When all stages were maintained at 21 degrees C, pupae were photosensitive (i.e., the percentage of autogenous females was not affected by photoperiods at which larvae were maintained). The percentage of autogenous females in field populations followed the seasonal changes in temperature and photoperiod, demonstrating environmental regulation of facultative autogeny. Autogeny appeared to be genetically stable in Cx. tarsalis. Single families from a long standing laboratory colony (greater than 60 generations) had the same range (0-80%) in percentage of autogenous females per family as did recent field collected families from the same geographical location. PMID- 1770521 TI - Experimental transmission of African swine fever virus by the tick Ornithodoros (Alectorobius) puertoricensis (Acari: Argasidae). AB - The soft tick Ornithodoros puertoricensis Fox has been found on the Caribbean island of Hispaniola (Haiti and the Dominican Republic) where African swine fever (ASF) was endemic from 1978 to 1984. To evaluate the vector potential of O. puertoricensis for African swine fever virus (ASFV), second-instar nymphs were experimentally infected by feeding on a viremic pig that was infected with the Dominican Republic isolate (DR-II) of ASFV. Subsequent infection rates and mean virus titers for individually triturated ticks were: second-instar nymph (95.4%, 10(4.38 +/- 0.85)), third-instar nymph (48.9%, 10(4.59 +/- 0.61)), male (46.7%, 10(4.36 +/- 0.61)), and female (35.3%, 10(4.38 +/- 1.09)). Infected ticks transmitted ASFV to susceptible pigs by bite 23, 85, 126, 160, 182, and 239 d after the infective blood meal. These findings show that ASFV is passed transstadially among O. puertoricensis and that O. puertoricensis can be an efficient vector of African swine fever virus. PMID- 1770522 TI - Cuticular hydrocarbon geographic variation among seven North American populations of Aedes albopictus (Diptera: Culicidae). AB - Cuticular hydrocarbons were used to differentiate among the following North American populations of Aedes albopictus: Chicago, Ill.; Milford, Del.; Jacksonville, Fla.; San Antonio, Tex.; New Orleans, La.; Houston, Tex.; and Lexington, Ky. Forty cuticular hydrocarbon peaks were identified from each population using gas chromatography electron impact-mass spectrometry: 16 n alkanes, 21 monomethylalkanes, and 3 dimethylalkanes. Fourteen peaks occurred at equivalent chain lengths greater than 38.65 and consisted of complex mixtures of dimethyl- and trimethylalkanes. Quantitative analyses were performed on pooled samples of five females from each population using flame ionization gas chromatography. All populations contained the same cuticular hydrocarbons, but showed differences in percent composition. Five of seven populations were separable by discriminant analysis of hydrocarbon components. PMID- 1770523 TI - Blood digestion in the mosquito, Anopheles stephensi Liston (Diptera: Culicidae): activity and distribution of trypsin, aminopeptidase, and alpha-glucosidase in the midgut. AB - The activities of trypsin, aminopeptidase, and alpha-glucosidase were studied in the whole midgut, anterior and posterior midgut, and posterior midgut lumen and epithelium of the mosquito Anopheles stephensi Liston. Trypsin activity was restricted entirely to the posterior midgut lumen. No trypsin activity was found before the blood meal, but activity increased continuously up to 30 h after feeding, and subsequently returned to baseline levels by 60 h. Aminopeptidase was active in anterior and posterior midgut regions before and after feeding. In whole midguts, activity rose from a baseline of approximately 3 enzyme units (EU) per midgut to a maximum of 12 EU at 30 h after the blood meal, subsequently falling to baseline levels by 60 h. A similar cycle of activity was observed in the posterior midgut and posterior midgut lumen, whereas aminopeptidase in the posterior midgut epithelium decreased in activity during digestion. Aminopeptidase in the anterior midgut was maintained at a constant low level, showing no significant variation with time after feeding. alpha-glucosidase was active in anterior and posterior midguts before and at all times after feeding. In whole midgut homogenates, alpha-glucosidase activity increased slowly up to 18 h after the blood meal, then rose rapidly to a maximum at 30 h after the blood meal, whereas the subsequent decline in activity was less predictable. All posterior midgut activity was restricted to the posterior midgut lumen. Depending upon the time after feeding, greater than 25% of the total midgut activity of alpha-glucosidase was located in the anterior midgut. The enzyme distributions are consistent with described structural models for digestion in mosquitoes. After blood meal ingestion, proteases are active only in the posterior midgut. Trypsin is the major primary hydrolytic protease and is secreted into the posterior midgut lumen without activation in the posterior midgut epithelium. Aminopeptidase activity is also luminal in the posterior midgut, but cellular aminopeptidases are required for peptide processing in both anterior and posterior midguts. alpha-glucosidase activity is elevated in the posterior midgut after feeding in response to the blood meal, whereas activity in the anterior midgut is consistent with a nectar-processing role for this midgut region. PMID- 1770524 TI - Ixodes scapularis (Acari: Ixodidae) in Kansas: a new distribution record. AB - The blacklegged tick, Ixodes scapularis Say, previously known to occur only in the extreme southeastern corner of Kansas, has been collected in Douglas and Jefferson counties in the northeast. The new collections extend the northern range of this species in Kansas by approximately 240 km. The role of I. scapularis as a vector of the Lyme borreliosis spirochete, Borrelia burgdorferi, makes this a noteworthy extension of its known range. The proximity of these new collection sites to large centers of human population is of special significance to health-care providers in that region. PMID- 1770525 TI - Increasing horse fly (Diptera: Tabanidae) catch in canopy traps by reducing ultraviolet light reflectance. AB - Application of UV Killer, a commercially available product which reduced ultraviolet reflectance from cloth fabrics, increased the catch of tabanids in canopy traps by 24% and in CO2-baited traps by 30%. Catch decreased as ultraviolet reflectance increased during the experiment. PMID- 1770526 TI - Effect of temperature on late immature stages of Culicoides brevitarsis (Diptera: Ceratopogonidae). AB - Fourth-instar larvae of the biting midge, Culicoides brevitarsis Kieffer, were reared to adult in agar medium at temperatures of 20, 26, 30.5, 33, 35.5, 38 and 40 degrees C. Optimum (greater than 80%) survival to adult occurred from 26 to 33 degrees C. Temperatures outside this range disrupted development. Above 35.5 degrees C, all immatures died before completing development. Duration of development from fourth instar to adult was shortest at 30.5 degrees C (4.3 d). The estimated duration of development from egg to adult at 26-33 degrees C was 11 13 d. The increased mortality of immature stages at temperatures greater than 33 degrees C may be significant in the reduction of adult populations during summer in inland areas of the northern Australian tropics, where mean monthly maxima exceed 35 degrees C from October until February. PMID- 1770527 TI - A newly defined X linked mental retardation syndrome associated with alpha thalassaemia. PMID- 1770528 TI - Alpha thalassaemia/mental retardation syndrome (non-deletional type): report of a family supporting X linked inheritance. AB - In 1990 the existence of an X linked form of the alpha thalassaemia/mental retardation syndrome was postulated after the description of six isolated cases who were all cytogenetically male. The segregation pattern in the family described here supports X linked inheritance. The clinical details of our two patients are remarkably similar to the previously delineated phenotype. In addition, renal anomalies were identified in one patient, but their significance will remain uncertain until further cases have been assessed. Affected subjects could be identified by the presence of Hb H inclusions, and were also noted to have abnormalities of several haematological indices. Examination of blood from obligatory carriers in this family suggests that Hb H inclusions are not an invariable finding and that haematological indices appear to be unaffected by the condition in female heterozygotes. PMID- 1770529 TI - X linked alpha thalassaemia/mental retardation: spectrum of clinical features in three related males. AB - We describe three males (two brothers and a cousin) who have the X linked alpha thalassaemia/mental retardation (ATR-X) syndrome. The diagnosis, originally suspected in the brothers because of similarity in dysmorphic features to previous cases, was confirmed haematologically in the surviving brother. The cousin has less typical dysmorphism and a virtually normal routine blood count, but haemoglobin H inclusions were found in his red blood cells showing that he has the same condition. This report expands the clinical phenotype of the ATR-X syndrome and emphasises that a normal blood count does not exclude the diagnosis. PMID- 1770530 TI - The non-deletion alpha thalassaemia/mental retardation syndrome: further support for X linkage. AB - It has previously been suggested that the non-deletion form of the alpha thalassaemia/mental retardation syndrome may be an X linked disorder. We describe four brothers with this syndrome in whom the diagnosis was first suspected because of their characteristic clinical features, although these varied somewhat from one sib to another. The diagnosis was confirmed in each case by showing Hb H inclusions in a proportion of their red blood cells. The identification of four similarly affected boys in this pedigree is consistent with an X linked pattern of inheritance. In support of this, very rare Hb H inclusions could be found in the red blood cells of the mother and one sister who both share some facial features with the affected boys and are presumably carriers of this disorder. This pedigree thus provides further evidence that this is an X linked syndrome and indicates the clinical and haematological variability that may exist even within a single affected family. PMID- 1770531 TI - Watson syndrome: is it a subtype of type 1 neurofibromatosis? AB - Over 20 years ago, Watson described three families with a condition characterised by pulmonary valvular stenosis, cafe au lait patches, and dull intelligence. Short stature is an additional feature of this autosomal dominant condition. A fourth family with Watson syndrome has since been reported. We have had the opportunity to review members of three of these four families. The clinical phenotype of Watson syndrome has been expanded to include relative macrocephaly and Lisch nodules in the majority of affected subjects, and neurofibromas in one third of family members. Because the additional clinical findings enhance the similarity between Watson syndrome and neurofibromatosis 1, molecular linkage studies have been performed using probes flanking the NF1 gene on chromosome 17. Probe HHH202 showed the tightest linkage to Watson syndrome with a maximum lod score of 3.59 at phi = 0.0 (95% confidence limits of phi = 0.0-0.15). This suggests either that Watson syndrome and neurofibromatosis 1 are allelic, or that there is a series of contiguous genes for pulmonary stenosis, neurocutaneous anomalies, short stature, and mental retardation on 17q. PMID- 1770532 TI - Substitution of cysteine for glycine at residue 415 of one allele of the alpha 1(I) chain of type I procollagen in type III/IV osteogenesis imperfecta. AB - We have examined the type I collagen in a patient with type III/IV osteogenesis imperfecta. Two forms of alpha 1(I) chain were produced, one normal and the other containing a cysteine residue within the triple helical domain of the molecule. Cysteine is not normally present in this domain of type I collagen. Peptide mapping experiments localised the mutation to peptide alpha 1(I)CB3 which spans residues 403 to 551 of the triple helix. Subsequent PCR amplification of cDNA covering this region followed by sequencing showed a G to T single base change in the GGC codon for glycine 415 generating TGC, the codon for cysteine. The effect of the mutation on the protein is to delay secretion from the cell, reduce the thermal stability of the molecule by 2 degrees C, and cause excessive post translational modification of all chains in molecules containing one or more mutant alpha 1(I) chains. The clinical phenotype observed in this patient and the position of the mutation conform to the recent prediction of Starman et al that Gly----Cys mutations in the alpha 1(I) chain have a gradient of severity decreasing from the C-terminus to the N-terminus. PMID- 1770533 TI - Analysis of mitochondrial DNA in Leber's hereditary optic neuropathy. AB - Twenty-eight patients from 25 maternal lineages with Leber's hereditary optic neuropathy (LHON) were investigated by restriction enzyme analysis for the presence or absence of the point mutation described by Wallace et al. The mutation was identified in 18 of 25 (72%) families with LHON. This provides further evidence that this mutation is present in the majority of patients with LHON. In 19 of these families with LHON, additional analysis using sequencing, oligonucleotide probing, and competitive oligonucleotide priming of PCR products was performed. In 14 cases with the site loss the point mutation was present, and five without the site loss had the wild type sequence in this region. PMID- 1770534 TI - Mutation and linkage disequilibrium analysis in genetic counselling of Spanish cystic fibrosis families. AB - We have analysed haplotypes for four DNA polymorphisms, closely linked to the cystic fibrosis (CF) gene, in 82 Spanish families, in which the CF probands are either homozygous for non-delta F508 mutations or heterozygous for the delta F508 deletion and other CF mutations. The analysis provides genetic data for a new polymorphism for the closely linked marker pKM.19, which is very strongly associated with CF. Haplotypes generated with the four marker loci are also in strong disequilibrium with the non-delta F508 CF chromosomes. The data reported here are useful in 1 in 4 risk pregnancies of parents who have no living affected child, and when counselling close relatives of CF families who are negative for the major CF mutation. The data presented are useful in our population, in which the majority of CF mutations, apart from the delta F508 deletion, are uncommon. For other populations in which mutation heterogeneity is also very high, it still might be more feasible to use RFLPs for diagnostic purposes, when analysis for common mutations is negative and DNA is available from the index patient. The experience presented here provides a model for these population groups who in turn should obtain their own haplotype data. In addition, the model system for genetic counselling presented here might also be useful for other genetic disorders. PMID- 1770535 TI - Lymphocyte mRNA as a resource for detection of mutations and polymorphisms in the CF gene. PMID- 1770536 TI - Transmission of Proteus syndrome from father to son? AB - We present a male infant with cranial hemi-hypertrophy, a lymphangioma, a lipoma, and epidermal naevi. A diagnosis of Proteus syndrome was made. His father had had a large lymphangioma resected from the right side of the face as a child. We propose that Proteus syndrome has been transmitted from father to son. PMID- 1770537 TI - Microtia and short stature: a new syndrome. AB - Bilateral microtia, absent patellae, short stature, poor weight gain, and characteristic facial features are described in two female sibs. Other skeletal anomalies included complete habitual dislocation of the elbow, slender ribs and long bones, abnormal modelling of the glenoid fossae with hooked clavicles, and clinodactyly. Bone age was significantly delayed and there was flattening of the epiphyses. This unusual combination of features has many similarities to the syndrome described by Hurst et al. PMID- 1770538 TI - Ectopia lentis et pupillae: the genetic aspects and differential diagnosis. AB - Two sib pairs and a fifth child are described with autosomal recessive ectopia lentis et pupillae. Patients with this disorder need regular ophthalmic review, but do not have the skeletal and metabolic complications associated with other syndromes with ectopia lentis. PMID- 1770539 TI - Microcephalic osteodysplastic primordial dwarfism type I/III in sibs. AB - The clinical and radiological findings in a pair of sibs with microcephalic osteodysplastic primordial dwarfism (MOPD) are described, a boy who survived for 5 1/2 years and his more severely affected younger sister, who died at the age of 6 months. Neuropathological studies in this girl showed marked micrencephaly with severely hypoplastic, poorly gyrated frontal lobes and absent corpus callosum. Our observation supports the hypothesis that types I and III MOPD probably constitute a spectrum of one and the same entity and published data together with this report are consistent with autosomal recessive inheritance. The pathogenesis of this condition is as yet unknown, but its characteristics indicate a basic defect affecting cell proliferation and tissue differentiation. PMID- 1770540 TI - Severe manifestations of oculoauriculovertebral spectrum in a cocaine exposed infant. PMID- 1770541 TI - Kuwait type faciodigitogenital syndrome. PMID- 1770542 TI - Pericentromeric heterochromatin of chromosome 3. PMID- 1770543 TI - Cystic fibrosis in Bulgaria. PMID- 1770544 TI - Floating Harbor and the good ship Shprintzen. PMID- 1770545 TI - Helicobacter pylori infection: a novel risk factor in the etiology of gastric cancer. PMID- 1770546 TI - Cancer rates in Florida spark strong competition. PMID- 1770547 TI - Of pedigrees, probes, and p53: 20 years of family studies. PMID- 1770548 TI - Hematopoietic growth factors allowing aggressive treatment. PMID- 1770549 TI - Pediatric cancer forum examines chemotherapy variables. PMID- 1770550 TI - Rashomon and the procrustean bed: a tale of dysplastic nevi. PMID- 1770551 TI - Inheritance of nevus number and size in melanoma and dysplastic nevus syndrome kindreds. AB - Previous studies of the genetics of melanoma have focused on the dysplastic nevus syndrome (DNS). The variability in clinical and histopathological expression of affected individuals, however, has made definition and diagnosis of the syndrome difficult and subjective. Independent of the DNS, case-control studies have demonstrated the total number of nevi to be a significant risk factor for melanoma. In this article, we report results of genetic analyses of two quantitative nevus phenotypes that can be measured objectively in all subjects: the total number of nevi on an individual (TNN) and total nevus density (TND), a derived phenotype which incorporates both number and size of nevi. Ten kindreds ascertained for multiple cases of DNS-melanoma (multiplex ascertainment) and 16 kindreds and 19 solitary cases ascertained from a sequential list of melanoma cases without regard for family history (simplex ascertainment) were studied. Both phenotypes exhibited increased levels in relatives of probands compared with those in spouse controls. While neither TNN nor TND exhibited evidence for a major factor in the simplex pedigrees, a major factor was strongly indicated in the multiplex kindreds for TND. When both phenotypes were examined in more detail in the multiplex kindreds, the phenotype incorporating nevus size, TND, fit a mendelian pattern of inheritance better than the TNN. Significant residual familial correlations were found for both phenotypes. Parameter estimates from the best fitting genetic model indicated that a major gene may be responsible for 55% of the phenotypic variability of TND in the multiplex kindreds. PMID- 1770552 TI - Gastric adenocarcinoma and Helicobacter pylori infection. AB - Helicobacter pylori infection, thought to be causally related to chronic gastritis, may also be associated with an increased risk of gastric cancer. To determine whether an association with gastric cancer does exist, we retrospectively evaluated serum samples from 69 patients with histologically confirmed gastric adenocarcinoma (32 with cancer at the cardia and 37 with cancer at other sites) and from 218 patients with one of three categories of nongastric cancers, with other gastric cancers, or with benign gastric neoplasms. These samples were compared with samples from 252 cancer-free control subjects, a group comprising 76 asymptomatic volunteers and 176 persons with nonmalignant disorders. Serum samples collected from cancer patients prior to surgery and from cancer-free controls were tested for antibodies to H. pylori by using a highly sensitive and specific IgG enzyme-linked immunosorbent assay. The risk of H. pylori infection in the case patients relative to the control subjects was estimated with the use of multivariate logistic regression analysis to adjust for potential confounding variables. Antibodies to H. pylori were detected in 65% of the patients with noncardia gastric cancer but in only 38% of the patients with gastric cancer located at the cardia. A significant association was found between H. pylori infection and noncardia gastric cancer (odds ratio = 2.67; 99% confidence interval = 1.01-7.06). Within the subset of patients with noncardia gastric cancer, a statistically nonsignificant tendency existed for those with the intestinal versus the diffuse histologic type of noncardia gastric cancer to have a higher risk of H. pylori infection. Our results support the hypothesis of a relationship between H. pylori infection and the development of noncardia gastric adenocarcinoma. PMID- 1770553 TI - Lack of ranitidine effects on cyclophosphamide bone marrow toxicity or metabolism: a placebo-controlled clinical trial. AB - We previously reported that cimetidine but not ranitidine significantly enhances cyclophosphamide-induced bone marrow toxic effects and the appearance of cyclophosphamide alkylating species in a murine leukemia mouse model, and we advised caution in the use of cimetidine with microsomally metabolized anticancer drugs. Both drugs have been used for the treatment of gastric complications of chemotherapy. Using a randomized, double-blind, crossover study design, we have now evaluated the potential interaction of ranitidine with cyclophosphamide in seven cancer patients, who received two courses of cyclophosphamide, one with ranitidine and one with placebo. Four patients received ranitidine in the first course, and three received placebo. Ranitidine or placebo was started 3 days before a single dose of cyclophosphamide and given for 17 consecutive days. Ranitidine or placebo was given orally (300 mg/d), and cyclophosphamide (600 mg/m2) was given intravenously with [3H]cyclophosphamide (1000 muCi). Cyclophosphamide treatment was repeated at 4 weeks plus or minus 4 days. Blood samples were collected at intervals from 5 minutes to 24 hours after cyclophosphamide treatment and analyzed by thin-layer chromatography and radioassay for the drug and its metabolites. On days 0, 7, 14, and 21 after cyclophosphamide administration, complete blood cell counts, white blood cell differential counts, platelet counts, and SMA-17 were determined. The differences in mean nadir white blood cell counts, granulocyte counts, hemoglobin levels, and hematocrit values during ranitidine versus placebo treatment were not statistically significant. In a statistical but not a clinical sense, mean nadir platelet counts were significantly lower with ranitidine. There was a statistically significant increase in area under the curve for drug concentration in plasma x time (AUC) with ranitidine as well as a statistically significant decrease in the total-body clearance rate of the cyclophosphamide molecule. However, the effect on AUC for the major oncolytic metabolites 4 hydroxycyclophosphamide and phosphoramide mustard was not statistically significant. The lack of toxicologic or metabolic interaction between ranitidine and cyclophosphamide suggests that ranitidine can be used safely with cyclophosphamide. PMID- 1770554 TI - Two phase I studies of carboplatin dose escalation in chemotherapy-naive ovarian cancer patients supported with granulocyte-macrophage colony-stimulating factor. AB - Recombinant human granulocyte-macrophage colony-stimulating factor (rHuGM-CSF) may reduce myelosuppression and, thus, allow dose escalation of certain chemotherapeutic agents. We conducted two sequential phase I trials of escalating doses of carboplatin and a fixed dose and schedule of rHuGM-CSF in ovarian cancer patients who had not previously had chemotherapy, i.e., chemotherapy-naive patients. In the first trial, patients were assigned to regimens of increasing dose levels of carboplatin (starting at 400 mg/m2) and fixed doses and schedules of cyclophosphamide (600 mg/m2) and rHuGM-CSF (10 micrograms/kg given subcutaneously once daily on days 2-11). Chemotherapy was given every 3 weeks (regimen A). In the subsequent trial, the design was the same except that cyclophosphamide was omitted (regimen B). Fifteen patients received regimen A, and seven patients received regimen B. In regimen A, all three patients treated at the first dose level tolerated five cycles at full doses. Hematologic toxicity was dose limiting at the 600-mg/m2 dose level. When 500 mg/m2 carboplatin was given, six of eight patients tolerated three or four cycles at full doses before requiring dose reductions or treatment delays. In regimen B, doses could not be escalated above the first dose level (600 mg/m2) because of severe hematological toxicity. Nonhematological toxicity was tolerable and managed with acetaminophen, antihistamines, and/or nonsteroidal, anti-inflammatory medication. Compliance was excellent. We conclude that (a) rHuGM-CSF can be given safely and reliably to chemotherapy-naive ovarian cancer patients receiving these treatment regimens, (b) early and severe thrombocytopenia was a major problem with or without cyclophosphamide with doses of carboplatin at or above 600 mg/m2, and (c) 500 mg/m2 carboplatin administered every 3 weeks is the highest dose in regimen A that can be given safely in the outpatient setting. PMID- 1770555 TI - Pain and discomfort associated with film-screen mammography. PMID- 1770556 TI - Gonadotropin-releasing hormone agonist plus add-back sex steroids to reduce risk of breast cancer. PMID- 1770557 TI - Hypersensitivity reactions to carboplatin. PMID- 1770558 TI - Carbohydrate metabolism in liver cirrhosis. AB - Patients with cirrhosis of liver are more prone to have accompanying diabetes mellitus. The present study was conducted to investigate various biochemical parameters in patients with hepatic cirrhosis without diabetes. In these patients blood pyruvate, total bilirubin and globulin levels were elevated as compared to normal individuals. In contrast serum albumin level declined significantly whereas no significant change was observed in the concentrations of blood glucose, total proteins, total lipids, urea and serum cholesterol. These studies confirm the previous reports that carbohydrate metabolism is deranged in hepatic cirrhosis which may lead to diabetes mellitus. PMID- 1770559 TI - Supervised training of practical procedures in the internal medicine residency. AB - In order to get feedback whether the medical residents are getting adequate supervised training to perform practical procedures, a questionnaire was distributed among the residents asking their involvement in sixteen frequently performed procedures in the medical unit of the Aga Khan University Medical Centre. Though the residents were satisfied about their training in doing lumbar punctures, pleural and peritoneal aspirations, bone marrow aspiration and trephine and chest tubes placement, they showed their concern about training in putting central lines, venous cut downs, cardiac pacing and biopsies. A better schedule training programme, organized subspecialty rotation, continuous evaluation of resident's skill, credentialing procedures and willingness on the part of faculty to teach and residents to learn may improve the training. PMID- 1770560 TI - Toxoplasmic lymphadenitis--a clinicopathological study. AB - Forty-three cases of toxoplasmic lymphadenitis were studied. They constituted 0.5% of all lymph node biopsies and 4.2% of reactive lymphadenitis. The histological findings supporting a diagnosis of toxoplasmosis were correlated with serological studies. The condition primarily affects young men, causing cervical lymph node enlargement and varying degrees of fatigue, malaise, cough and fever. It is usually self-limited. This study emphasizes the need for clinicians to consider toxoplasmosis in the differential diagnosis of lymphadenopathies. PMID- 1770561 TI - Cardiocirculatory responses to upright tilt at sea level and high altitude. AB - A collaborative study was conducted to measure the cardiocirculatory responses to upright tilt in eight young men at sea level (SL); after 1h at 4300m simulated altitude (SA) and at 18h, 66h and 114h during residence at 4300m (HA). Heart rate (HR), stroke volume (SV), cardiac output (CO), calf blood flow (CBF), blood pressure (BP) and total peripheral resistance (TPR) were obtained during supine rest and after 13 min of 60 degrees head-up tilt using an impedance monitor and an electrosphygmomanometer. SL to HA changes in blood volume (BV) were calculated from hematocrit and hemoglobin values. Supine HR, TPR and BP were increased while SV, CO and CBP were reduced SL to HA (P less than .05). HR and BP in the upright position were increased SL to HA (P less than .05). The responses to tilt (delta supine to upright) were unaltered SL vs SA. With prolonged exposure, SV, CO, TPR and CBP responses to tilt were reduced (P less than .05). The reduced responses to tilt at HA were associated with a 10% decline in BV (P less than .01). It was concluded that the reduction in SV during tilt at SL and SA was compensated for by increases in HR and TPR in order to maintain BP. After 18h HA, BP in the upright position was maintained only by an increase in HR. PMID- 1770562 TI - Experience of erythropoietin in anemia of end stage renal disease. AB - Recombinant human erythropoietin 50 units/kg intravenous twice a week was given to 9 anemic patients and end stage renal disease (ESRD) who were undergoing dialysis at the Kidney Centre. Of the total, 8 required no transfusion since the initiation of therapy and their haematocrit increased to approximately 29% or more with the improvement in general condition, sense of well being and exercise tolerance. One patient showed an increase in serum creatinine and two iron deficiency during therapy. In all cases blood pressure remained adequately controlled. No organ dysfunction or any other complication was observed. PMID- 1770563 TI - Oesophageal changes in oral submucous fibrosis using fibreoptic endoscopy--a pilot study. AB - Thirty patients with oral submucous fibrosis (OSMF) underwent fibreoptic upper G.I. endoscopy and oesophageal biopsy from 20 cms to see if any correlation is found between visual and histological changes in OSMF and oesophageal mucosa. On endoscopy, the colour of oesophageal mucosa was normal in 28 and whitish pale in 2 cases. On endoscopy mucosa felt stiff and fibrotic in 19, leathery in 4, firm/gritty in 2 and normal in 5 cases. The biopsies were difficult to take in most cases yielding small tissue samples on repeated attempts. On histology most of the samples consisted of only a few layers of hyperplastic epithelium with lamina propria and submucosa being absent in all samples. Good correlation was found between the grade of OSMF and oesophageal changes seen on endoscopy. PMID- 1770564 TI - Exercise induced acute renal failure in 4 cases. PMID- 1770565 TI - Eosinophilic gastroenteritis. PMID- 1770566 TI - [Epidural anesthesia with high dose fentanyl for thoracic surgeries]. AB - Twenty-two elective thoracic surgeries were performed under epidural high dose fentanyl anesthesia. These included 11 mastectomies, 3 lung lobectomies, and 8 operations for esophageal carcinoma. Through an epidural catheter, 10 micrograms.kg-1 fentanyl with [E (+)] or without [E (-)] epinephrine (1: 100,000) was given. N2O (66%) and enflurane (0.2-0.8%) were also administered, and muscle relaxants were given as needed. The onset and duration of the action were approximately 20 minutes and 3 hours, respectively. Anesthesia was maintained with enflurane (up to 0.4%) in 17 patients (77.3%). There were no differences between the E (+) group and the E (-) group. Systolic pressure, diastolic pressure and heart rate during operations were about 30% lower than those observed before the operations. Patients recovered from anesthesia rapidly. Naloxone was administered intravenously in 6 patients after mastectomies or lung lobectomies (42.9%), whose respiratory rate was below 10.min-1. The patients with short operating time (shorter than 2 hours) needed more naloxone. Troubles did not occur either in the recovery room or in the ward with both naloxone and non naloxone groups. PMID- 1770567 TI - [Combined spinal and epidural anesthesia for orthopaedic surgery in the elderly]. AB - The pros and cons as to which anesthesia is more beneficial, either spinal or epidural, prompted us to perform combined spinal and epidural block in the elderly undergoing lower limb surgery. The selected epidural space was entered with a 17-gauge Tuohy needle and a longer 26-gauge spinal needle was passed through it and into the subarachnoid space. Following the injection of required dose of 2% preservative-free lidocaine (isobaric), spinal needle was withdrawn and an epidural catheter was inserted. We could use this combined technique on 17 patients older than 80 yr (mean age; 84.5 +/- 3.9 years) with satisfactory results and without any serious cardiovascular change, as with 17 middle-aged patients (57.5 +/- 5.2 years). This combination of techniques provides a rapid onset and reliability of spinal block with high quality analgesia by supplementation through the epidural catheter during and after surgery. In the orthopaedic procedures on the lower limbs, combined spinal and epidural block is more useful even for the elderly over the age of 80 yr than spinal or epidural anesthesia alone. PMID- 1770568 TI - [Continuous intravenous pethidine infusion for analgesia after upper abdominal surgery: a randomized, prospective double-blind comparison with continuous epidural infusion of pethidine]. AB - We conducted a randomized double-blind controlled study comparing patients receiving continuous intravenous pethidine infusion with those receiving continuous epidural infusion for postoperative analgesia after upper abdominal surgery. Twenty patients scheduled for upper abdominal surgery were randomized into 2 groups: IV Group (n = 10) received 100 mg.24 h-1 of pethidine intravenously and saline epidurally, Epi Group (n = 10) received 100 mg.24 h-1 of pethidine epidurally and saline intravenously. During 24-hour postoperatively, verbal descriptor pain scale, sedative scale, respiratory rate, pulse rate and blood pressure were evaluated at each 2 hours. During 72-hour postoperatively, visual analogue pain scale (added at 6-hour postoperatively), supplemental doses of pethidine, and side effects were evaluated at each period of 12 hours. There was no significant difference in the rating of analgesia in either group during 72-hour postoperatively. However in the first 12 hours postoperatively, VAS in Epi Group tended to be lower than that in IV Group. There was no respiratory depression in either group. We conclude that continuous intravenous infusion of 100 mg.24h-1 of pethidine was effective for postoperative analgesia after upper abdominal surgery without major side effects, and almost the same analgesic effect was obtained as compared with continuous epidural analgesia. PMID- 1770569 TI - [Effects of upper thoracic epidural anesthesia on hemodynamics and oxygen supply demand relationship in hypovolemic dogs]. AB - The purpose of the present study is to assess the influence of upper thoracic epidural anesthesia (TEA) on hemodynamics, the systemic oxygen supply-demand relationship, and several indications of stress in the presence of preexisting hypovolemia. Sixteen adult mongrel dogs were anesthetized with halothane and nitrous oxide, and blood was withdrawn at the rate of 3 ml.kg-1.min-1 for 10 min. The dogs were randomly assigned to two groups; one receiving TEA (TEA group, n = 8), and the other without (controls, n = 8). Mean arterial blood pressure, heart rate, arterial concentrations of epinephrine and norepinephrine remained significantly lower (P less than 0.05) in the TEA group than in the controls during the 100-min observation period following the start of TEA. Cardiac index, oxygen supply-demand ratio (O2 delivery/O2 consumption) and arterial lactate concentration showed no significant intergroup differences at any point during observation. By contrast, there was a significant difference in arterial pH between the TEA group (7.22 +/- 0.05, mean +/- SD) and the controls (7.15 +/- 0.08) after 100 min of TEA. These results indicate that in hypovolemic dogs anesthetized with halothane and nitrous oxide, TEA affects the acid-base balance favorably without significantly influencing the systemic oxygen supply-demand relationship. PMID- 1770570 TI - [The reduction in the local anesthetic dose required for a caudal epidural block in infants and children using a Teflon cannula]. AB - We investigated the spread of mepivacaine mixed with a radio-opaque substance in caudal epidural anesthesia for hernioplasty in 37 patients aged from 3 months to 5 years. All patients were placed in the left lateral position. Conventional caudal epidural anesthesia was performed on one group of patients (Group C) using a 23 gauge needle (25 mm in length). This new method was also performed on another group (Group N) using a 23 gauge Teflon cannula (63 mm in length), which was introduced as close to the S1 segment as possible. The volume for 9 segmental anesthesia (7.0 +/- 2.3 ml) was determined by following Takino's formula: Volume (ml.segmental-1) = 0.067 x [body weight (kg)] + 0.06. The amount was injected from the S1 in Group N patients, and the cephalad spread of the anesthetic reached Th12.8 +/- 0.8 on left side, and L1.1 +/- 0.7 on right side. When the volume for 13 segmental anesthesia (11.5 +/- 2.8 ml) was injected in Group C patients, the cephalad spread of the anesthetic reached Th12.6 +/- 1.2 on the left side, and Th12.5 +/- 1.1 on the right side. In conclusion, we detected no significant difference between Group C and Group N in the cephalad spread of the anesthetic. The required dose of local anesthetic for caudal epidural anesthesia using the Teflon cannula was about two-third the volume of that used for the conventional local anesthetic method. PMID- 1770571 TI - [Effect on cerebral blood flow of midazolam during modified neurolept anesthesia]. AB - Midazolam (0.2 mg.kg-1) was administered to ten patients undergoing neurosurgical operation and its influence on CBF was studied under modified NLA. Simultaneously, the plasma concentration of midazolam was measured. Heart rate and mean arterial blood pressure showed no significant changes after injection in comparison with the control. Cerebral blood flow (CBF) decreased for about 15-20% after 5 minutes, 10 minutes and 15 minutes in comparison with the control. However, 30 minutes later, CBF showed a trend to return to the control. This change in CBF is related to the changes of cerebro-vascular resistance. We applied cerebral oxygen extraction fraction (OEF) to evaluate cerebral metabolism. OEF was constant, showing no significant changes. It is concluded that cerebral oxygen consumption (CMRO2) has decreased together with the decrease in CBF. The plasma concentration of midazolam was 250-300 ng.ml-1 or greater after 5 minutes, 10 minutes and 15 minutes. We think that the sedative dose of midazolam can also sufficiently reduce CBF and CMRO2. The results suggest that midazolam is a safe and effective agent to use for anesthesia and provides adequate sedation for patients with intracranial hypertension. PMID- 1770572 TI - [Continuous infusion of ketamine and midazolam for prolonged sedation in the intensive care unit]. AB - The clinical effects and pharmacokinetics of ketamine and midazolam, administered continuously for prolonged sedation were studied in 7 critically ill patients under mechanical ventilation. Initially ketamine 1 mg.kg-1 and midazolam 0.1 mg.kg-1 were administered intravenously and these were followed by infusion at a rate of 1.0 mg.kg-1.hr-1 of ketamine and 0.05 mg.kg-1.hr-1 of midazolam. The infusion rate was changed every 30 minute with increments of 0.5 mg.kg-1.hr-1 of ketamine and 0.05 mg.kg-1.hr-1 of midazolam until the sedative score by Ramsy RAE reached rank 4 (i.e. slow response to loud verbal commands). The plasma concentrations of ketamine were analyzed using high performance liquid chromatography and those of midazolam using gas chromatography. The mean maintenance doses of ketamine and midazolam were 2.25 +/- 0.61 mg.kg-1.hr-1 and 0.11 +/- 0.05 mg.kg-1.hr-1 (mean +/- SD), respectively. There were no significant changes in blood pressure or heart rate before and after the injection of ketamine and midazolam in all the patients. The plasma concentrations of ketamine and midazolam were 2.98 +/- 0.20 micrograms.ml-1 and 494.1 +/- 66.7 ng.ml-1, respectively. The time to clear response to verbal commands after cessation of the continuous infusion was 168 +/- 109 min. The plasma concentrations of ketamine and midazolam decreased rapidly, and plasma half-life of ketamine was about 1 hour and for midazolam less than 2 hours. In conclusion, continuous infusion of ketamine and midazolam was very useful to sedate critically ill patients under mechanical ventilation, with minimal effect on the cardiovascular system and rapid recovery of consciousness. PMID- 1770573 TI - [Post-operative respiratory management of patients with ventricular septal defect with pulmonary hypertension (VSD+PH)]. AB - Post-operative respiratory management was evaluated in patients with VSD+PH. Comparison was made between Group I (6 patients under 6 months) and Group II (10 patients 6 months or above). Oxygenation after surgical operation in Gp I was poor and the patients needed longer period of mechanical ventilation (MV), while Gp II patients required shorter duration of MV. In Gp I, the duration of MV after the cardiac surgery correlated with the length of cardiopulmonary bypass. In conclusion, cardiopulmonary bypass may influence the post-operative pulmonary function and patients who require longer period of MV are younger infants or newborns whose pulmonary function is immature and PH is severe. PMID- 1770574 TI - [Changes in respiratory, circulatory, endocrine, and metabolic systems under induced total spinal block]. AB - Total spinal block was induced by 2% lidocaine in adult mongrel dogs, and its influence on the respiratory, circulatory, endocrine and metabolic systems was studied. HR, MAP, CI and LV dp/dt max during total spinal block decreased significantly compared with those during the control period. The blood gas, Qs/Qt and ETVI were hardly influenced by total spinal block. Regarding the endocrine and metabolic systems, plasma renin activity (PRA) was significantly elevated by total spinal block, while plasma epinephrine and norepinephrine levels showed no changes. Blood levels of lactic acid, pyruvic acid and blood sugar were not influenced by total spinal block. PMID- 1770575 TI - [The effect of dobutamine on hemodynamics, critical cooling, and myocardia excitability during simple deep hypothermia]. AB - The effects of dobutamine (DOB) on hemodynamics, critical cooling, and myocardial excitability were studied in dogs under simple deep hypothermia. Hypothermia was induced by surface cooling after the animals had been anesthetized with ether and triflupromazine (conventional method, group I). Continuous intravenous administration of DOB was combined with conventional method in group II, and surface cooling was performed with thiamylal in group III. The following results were obtained. The mean lowest temperature reached was 15.6 degrees C in group II. MAP, CO and V max of group II were maintained significantly higher than those of group I during cooling. Decrease in BE in group II was mild compared with group I. Catecholamine release during cooling was suppressed completely in group I and II, but increased markedly in group III. Myocardial threshold to artificial pacing in group II was elevated as the temperature fell, and restored during rewarming, while that of group III was unchanged during cooling. Ventricular fibrillation occurred by stimulation of pacemakers in some cases. Our results suggest that even in case of hypothermia, DOB retains a selective inotropic effect with no threat of arrhythmogenicity, and produces stable hemodynamics. These characteristics of DOB allow cooling down to 15 degrees C. PMID- 1770576 TI - [Clinical study on total intravenous anesthesia with droperidol, fentanyl and ketamine--12. Effects on plasma complement and immunoglobulin concentrations]. AB - Complements and immunoglobulins in the plasma are the important humoral factors to maintain immunity. As there is no study on immune response to total intravenous anesthesia with droperidol, fentanyl and ketamine (DFK), twelve patients who underwent abdominal, neck dissection, or plastic surgery were studied to determine plasma concentrations of complements and immunoglobulins. In five patients of isoflurane group, anesthesia was induced with intravenous thiopental 5 mg.kg-1 and succinylcholine 0.8-1 mg.kg-1 and maintained with 1-2% isoflurane in nitrous oxide (50%) and oxygen (50%). The remaining seven patients of the DFK group received intravenous droperidol 0.25 mg.kg-1, fentanyl 1-2 micrograms.kg-1, ketamine 1-1.5 mg.kg-1 and succinylcholine 0.8-1 mg.kg-1 for the induction of anesthesia, and then they were given a total dose of fentanyl 5-15 micrograms.kg-1, ketamine 2 mg.kg-1.hr-1 and oxygen (30%) for the maintenance of anesthesia. Vecuronium was given intravenously as needed. Lactated Ringer's solution was used for intraoperative fluid replacement. A total of 40 ml of arterial blood was drawn on four occasions, just before the induction of anesthesia, at the recovery from anesthesia, on the third and tenth post operative days. Plasma concentrations of complements (C3.C4) and immunoglobulins (IgG.IgA.IgM.IgD) were measured by immuno-turbidimetry. C3 concentrations in the plasma decreased significantly when the patients recovered from anesthesia, but they increased significantly on the third and tenth post-operative days in the isoflurane group. In the DFK group, they increased significantly on the tenth post-operative day only. No significant difference in the C3 concentrations was detected between two groups at any time of measurement.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770577 TI - [Clinical study on total intravenous anesthesia with droperidol, fentanyl and ketamine--13. Application for pediatric patients]. AB - Total intravenous anesthesia with droperidol, fentanyl, and ketamine (FK) was administered to 56 pediatric surgical patients ranging in ages from 5 to 15 years to evaluate their hemodynamics during anesthesia, post-operative hepatic as well as renal functions, and post-operative sedation as well as analgesia. These data were compared with those of the patients who underwent almost the same surgical procedures under enflurane-N2O anesthesia. The post-operative s-GOT, s-GPT, BUN, creatinine levels were not elevated significantly as compared with pre-operative levels in the FK group. As compared with those patients who received enflurane anesthesia, the blood pressure in the FK groups was higher by 15-30 mmHg, but it was stable during anesthesia without any complications. Their post-operative sedation and analgesia were better in the FK group than in the enflurane group and the complications such as nausea and vomiting were observed less frequently in the FK patients than in the patients who received anesthesia with ketamine alone reported in literatures. The data described above suggest that this method of anesthesia deserves further detailed clinical trials for pediatric patients. PMID- 1770578 TI - [Comparison between T-connecter and three-way stopcock as a portal for obtaining samples from indwelling catheter]. AB - The accuracy of measurements on a sample obtained via either T-connecter or three way stopcock connected directly with an indwelling catheter was comparatively evaluated. The sample was obtained through them after drawing glucose standard fluid (100 mg.dl-1) into a catheter which was primed with saline. The influence of sample volume and discarded volume on the glucose concentration in the sample was investigated, respectively. The results showed that both sample volume and discarded volume required smaller amount with a T-connecter than with a three-way stopcock to obtain more accurate measurements. The results also suggested that remaining discard aliquot in the connecting port of the three-way stopcock might influence the accuracy of the obtained sample when the sample volume was small. PMID- 1770579 TI - [Clinical observation of hemodynamic changes during anaphylactic reaction]. AB - Four cases of anaphylactic shock are reported. In two patients who underwent A-C bypass operation, we evaluated hemodynamic changes systemically when the anaphylactic reaction occurred. At that time it was observed that arterial pressure, central venus pressure, left atrial pressure and systemic vascular resistance decreased and that cardiac index increased. In other two patients it was not possible to evaluate hemodynamic changes during reaction. But one of these two patients developed coronary spasm accompanied with anaphylactic shock and the other patient who had depressed cardiac function and had developed cardiogenic shock, died of cardiac failure after 47 days. It is suggested that hemodynamic changes in anaphylactic reaction varies depending on different general conditions of the patient. PMID- 1770580 TI - [Subendocardial infarction on recovery from anesthesia]. AB - A 57-year-old man without any history of coronary artery disease underwent total hip replacement for which a continuous lumbar epidural analgesia combined with general anesthesia was used. During the recovery from anesthesia, the patient developed sudden hypotension and ventricular fibrillation (Vf), followed by ST elevation (I, II, III, aVF and V2-V6) on ECG. A coronary angiography, which was performed 30 min after the onset of Vf, revealed both the total occlusion of proximal left anterior descending artery (LAD) and 25% stenosis of proximal right coronary artery. It seemed that coronary artery spasm had occurred during the emergence from anesthesia, and then the coronary spasm ceased in a minute or two, while thrombus was produced in proximal LAD. The patient recovered from the episode of myocardial ischemia after percutaneous transluminal coronary recanalization and intraaortic balloon pumping. This patient was operated again on 4th and 8th postoperative days uneventfully under general anesthesia (enflurane and nitrous oxide in oxygen). PMID- 1770581 TI - [Neurological sequelae caused by surgical procedures during adenoidectomy under anesthesia]. AB - A five-year old boy with good risk was anesthetized with nitrous-oxide and halothane under orotracheal intubation for adenoidectomy and tubing of bilateral middle-ear cavities. Patient was on supine position with extension of neck. A mouth-gag was applied and the pharynx was packed with gauze. After long unskilled surgical procedures, severe neurological complications which were initiated with severe arrhythmias and followed by signs of paralysis of bilateral IX, X, XI, XII cranial nerves at their nuclei in medulla oblongata, were observed during the post-anesthetic period. The patient was saved with neurological sequelae of the cranial nerves and is alive after 6 years from the incident. The causes of this complications were discussed. PMID- 1770582 TI - [A case of severe near-drowning: the speech ability was regained on the 65th hospital day]. AB - A 3 y.o. boy suffered cardiac arrest after submersion in a winter pond for more than fifteen minutes. He was transferred to our hospital and was successfully resuscitated. Although his neurological condition was severely damaged at the beginning, he started searching objects with his eyes on the 18th hospital day, speaking on the 65th hospital day and walking by himself on the 76th hospital day. His consciousness fully recovered eventually. The treatments consisted of "HYPER" as suggested by Conn AW, et al. and active anti-hypertensive therapy. These treatments and the cold temperature of winter time might have contributed to the good neurological recovery of the patient. PMID- 1770583 TI - [Ectopic impulse formations of cardiac muscles]. PMID- 1770584 TI - [Arrhythmias--classification and definition]. PMID- 1770585 TI - [Points of view on mechanisms of cardiac arrhythmias]. PMID- 1770586 TI - [Exercise and arrhythmia]. PMID- 1770587 TI - [Electrophysiologic study of arrhythmia]. PMID- 1770588 TI - [Diagnosis of arrhythmia by esophageal electorocardiography]. PMID- 1770589 TI - [Diagnosis of arrhythmia by transesophageal pacing]. PMID- 1770590 TI - [Supraventricular tachycardia]. PMID- 1770591 TI - [Preexcitation syndrome]. PMID- 1770592 TI - [Atrial fibrillation, atrial flutter]. PMID- 1770593 TI - [Ventricular tachycardia]. PMID- 1770594 TI - [Ventricular fibrillation, cardiac arrest]. PMID- 1770595 TI - [Atrioventricular block, atrioventricular dissociation, and escape beats]. PMID- 1770596 TI - [Bundle branch block]. PMID- 1770597 TI - [Long RP' tachycardia; regular wide QRS tachycardia; endless loop tachycardia]. PMID- 1770598 TI - [Arrhythmia in ischemic heart disease]. PMID- 1770599 TI - [Arrhythmias in cardiomyopathy and specific myocardial diseases]. PMID- 1770600 TI - [Arrhythmogenic right ventricular dysplasia (ARVD)]. PMID- 1770601 TI - [Valvular heart disease]. PMID- 1770602 TI - [Idiopathic ventricular tachycardia]. PMID- 1770603 TI - [Cardiac arrhythmias caused by electrolytes abnormalities]. PMID- 1770604 TI - [Arrhythmias following cardiac surgery]. PMID- 1770605 TI - [Drug induced arrhythmias (digitalis, antiarrhythmic drugs and other drugs]. PMID- 1770606 TI - [Arrhythmia and sudden cardiac death]. PMID- 1770607 TI - [Cardiac pacing]. PMID- 1770608 TI - [Direct current therapy in tachyarrhythmias]. PMID- 1770609 TI - [Catheter ablation]. PMID- 1770610 TI - [Surgical treatment of arrhythmias]. PMID- 1770611 TI - [Interleukin 7 and its receptor]. PMID- 1770613 TI - [Proceedings of regional meetings of the Japanese Society of Gastroenterology. Abstracts]. PMID- 1770612 TI - [Living related liver transplantation]. PMID- 1770614 TI - [Toxicology of acetonitrile]. AB - Acetonitrile is a high-polarity organic solvent widely used in various chemical industries and laboratories. It was once used in consumer goods such as cosmetics. Acetonitrile is readily absorbed through the skin, by inhalation and by ingestion, and acute poisoning and even fatal effects are possible via these routes. The oral LD50 of acetonitrile in mice, which are one of the most susceptible animals to acetonitrile, is 170-520 mg/kg, and LC50 is about 2,700 ppm after one hour of inhalation. The toxic effects of acetonitrile are attributable to the metabolic release of cyanide, but the symptoms of poisoning may be delayed a few hours or more due to slow hepatic metabolism. No information is available yet about the toxicity of intact molecules of acetonitrile or formaldehyde which may be formed together with cyanide in the body. In subacute toxicity experiments in animals, slight changes in hemograms, histopathologic changes in the lung, increase in thyroid function, and other changes have been reported. No information is available about the accumulation of acetonitrile or its metabolites in tissues following repeated administrations, although formaldehyde is known to have high reactivity with macromolecules. No study has yet been done on the chronic toxicity or carcinogenicity of acetonitrile after prolonged administration. Acetonitrile is not mutagenic in the standard test using Salmonella typhimurium. Inhalation of acetonitrile by pregnant animals may produce malformations in the offspring such as axial skeletal disorders at maternally toxic levels. Education and information about the toxicity and regulations on the marketing of acetonitrile are of great importance for the safe use of this material. Further studies and information are needed on the chronic effects of acetonitrile, especially its carcinogenic potency, to human beings. PMID- 1770615 TI - [Evaluation of workload in middle-aged steel workers by measuring urinary excretion of catecholamines and cortisol]. AB - To evaluate physical and mental workload in middle-aged workers, urinary excretion of catecholamines and cortisol and self-reported scores of fatigue, stress and arousal in middle-aged steel workers were compared with those in young steel workers. Noradrenaline excretion in daytime of the day-off was higher in middle-aged workers than that in young workers. In the work days, noradrenaline excretion during working hours increased in both age groups when compared with that in the day-off. The work-related increase in noradrenaline excretion was more evident in the middle-aged group than in the young group. Adrenaline excretion during working hours was greater in the middle-aged group than that in the young group, whereas the adrenaline value in the day-off was almost the same in the two age-groups. Age-difference was hardly observed in dopamine and cortisol excretion. These findings suggest that the workload in middle-aged workers was greater than that in young workers. However, self-reported scores of fatigue and stress in middle-aged workers were less than those in young workers, suggesting inconsistency between subjective score of workload and urinary levels of catecholamines. These age-related differences in urinary levels of noradrenaline and adrenaline were not so obvious in workers engaged in automated and mechanized work (vigilance task) when compared to workers engaged in less automated and less mechanized work. It is considered that factory automation might reduce the workload in middle-aged workers. PMID- 1770616 TI - [Exposure of workers to electric and magnetic fields from radiofrequency dielectric heaters to process polyvinyl chloride material]. AB - Exposure of workers to electric and magnetic fields from radiofrequency dielectric heaters (RF heaters) to process polyvinyl chloride material was surveyed. Measurements of electric and magnetic field strengths were made in 10 workers operating 7 RF heaters at 3 plants in Japan. Six of the RF heaters are of the sewing machine type and the other is of the shuttle tray type. In all the RF heaters surveyed the nominal frequency of the radiofrequency generator was 40 MHz, and therefore electric and magnetic field from these are assumed to oscillate at the same frequency. The power output ranged from 0.83 W to 1.8 W for the sewing machine type and was 2.4 W for this shuttle tray type. Measurements were made at about 5 cm from the surface of the hand, eye, chest, waist, knee and foot of each worker. The meter readings were converted to equivalent plane wave power density and corrected for duty cycle (0.073 to 0.27). It was found that all the workers surveyed were exposed to electric and magnetic field strengths greater than the TLV recommended by ACGIH (1 mW/cm2). For the hand, eye, chest, waist, knee and foot of the worker, 95%, 63%, 32%, 47% and 36% and 27% of the measured field strengths exceeded the TLV, respectively. Especially for the sewing machine type RF heaters, electric fields at the hand and eye were extremely strong. Thus, for the hand, 100%, 75% and 38% of the measured electric field strengths exceeded the TLV, ten times the TLV, and one hundred times the TLV, respectively, and for the eye, 88% and 25% exceeded the TLV and ten times the TLV, respectively. No correlation was observed between power output of the RF heaters and measured electric and magnetic field strengths at any anatomical site of the worker. PMID- 1770617 TI - [Identification of urinary metabolites in a patient of acute poisoning by p chloroaniline]. AB - In order to clarify urinary metabolites of p-chloroaniline (p-CA), urine samples of a patient acutely poisoned with p-CA were analyzed by gas chromatography/mass spectrometry. Urinary metabolites were extracted with diethylether at pH 1.0 and pH 10 from urine samples hydrolyzed with acid and base and from intact urine samples. Aliquots of the ethereal extracts were injected into the gas chromatography, and p-CA and its metabolites were identified by comparing their mass spectra and retention times to those of standards. Six substances identified were as follows: p-CA, 2-amino-5-chlorophenol, 2,4-dichloroaniline, p chloroformanilide and traces of p-chloroacetanilide and 4-chloro-2 hydroxyacetanilide. Since p-CA was mainly detected in the hydrolyzed urine samples, p-CA was considered to form conjugates in the urine. N-Acetylation reactions of p-CA were suggested to be weak in human, because extremely minute amounts of p-chloroacetanilide and 4-chloro-2-hydroxyacetanilide were detected in the urine. PMID- 1770618 TI - In vitro evaluation on contact sensitivity from DNCB and DNBS using lymphocyte blastogenesis response test. AB - To assess the contact allergic potential of sensitizers, an in vitro predictive model was developed. First of all, guinea pigs were sensitized by 1-chloro-2 4,dinitrobenzene (DNCB), and lymph node cells from sensitized and control guinea pigs were cultured in the presence of DNCB, 2,4-dinitrobenzene sulfonic acid sodium salt (DNBS), DNCB plus epidermal cell (DNCB + EC), DNBS + EC and epidermal cell modified hapten (dinitrophenyl-EC, DNP-EC) at 3 x 10(5), 5 x 10(5) and 8 x 10(5) cells/well, respectively. Lymphocyte blastogenesis responses were assessed by uptake of 5H-thymidine. The results indicated that lymphocytes from sensitized guinea pigs responded to the foregoing antigens in vitro to a greater degree than those from control guinea pigs and the blastogenesis response by DNBS was the highest among the challenges of DNBS, DNCB, DNCB + EC, DNBS + EC and DNP-EC. When the number of lymphocytes was sufficient, the blastogenesis response of lymphocytes could be in vitro challenged successfully not only by DNBS, DNCB + EC, DNBS + EC and DNP-EC, but also DNCB alone. There was a cross sensitivity between DNCB and DNBS for in vivo and in vitro challenges. Moreover, significant relationships were observed between lymphocyte blastogenesis response and doses of DNBS used in vitro assay at 5 x 10(5) and 8 x 10(5) cells/well. The results indicate that this assay is an useful in vitro predictive model of contact sensitivity and cross sensitivity of sensitizers. PMID- 1770619 TI - [Changes in visual acuity observed in VDT workers in a printing company]. AB - A yearly ophthalmological examination was carried out in 2 VDT worker groups (A-1 and B-1 groups) and 2 control groups (A-2 and B-2 groups). The 4 groups were as follows; workers routinely engaged in both VDT work and key-punch work at a printing company (A-1 group), researchers or office workers handling VDT irregularly at a chemical company (B-1 group), typesetters at a printing company (A-2 group), and office workers at a chemical company (B-2 group). The examination was commenced in the same year in which the workers of A-1 or B-1 group were introduced to VDT work and was carried out for 3 years. Comparison between the first and the last examination on subjective refractive power showed that all the groups had lower refractive powers in the last examination than the first one. The decrease in A-2 group showed the greatest decrease in refractive power among the 4 groups. The decrease in A-2 group was more severe than in the other 2 groups. Before VDT introduction, the workers of A-1 group had been engaged only in key-punch work. Information on naked visual acuities of A-1 group 3 years before VDT introduction was also obtained and compared with those in the first and the last examination. The ratio of workers with a severe reduction in visual acuity evidently increased after VDT introduction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770620 TI - [Subjective symptoms and blood findings in painters exposed to organic solvents]. AB - Subjective symptoms and blood findings were studied in 16 construction workers and 30 vehicle repairmen using organic solvent and compared to 30 workers who were not exposed to organic solvents. A statistically significant increase was observed in the prevalence of subjective symptoms, serum phospholipid, lipoprotein fraction and IgE in construction workers and vehicle repairmen. A statistically significant decrease in neutrophils function was observed in construction workers. PMID- 1770621 TI - [The treatment of hypertensive patients with renal insufficiency--a comparison of the blood pressure management in patients with diabetic nephropathy and patients with hypertensive nephropathy]. AB - It is well known that hypertension (HT) is frequently accompanied with diabetic nephropathy (DN) and that HT contributes to progression of DN. Thus, proper anti hypertensive therapy is required in hypertensive patients with DN. However, there is so far no consensus of optimal blood pressure (BP) level to maintain the renal function in these patients. In order to evaluate the optimal BP level in the patients with renal insufficiency, we investigated the relation between BP and renal function in 15 DN patients with HT (aged 56.9 +/- 11.7 years at the first medical examination; 6 male and 9 female, total 117 patient-years) and 20 patients with hypertensive nephropathy (aged 44.3 +/- 13.0 years at the first medical examination; 17 male and 3 female, total 207.5 patient-years) as the control, who receive antihypertensive therapy for more than 4 years as outpatients at the second department of internal medicine of Tohoku University Hospital between 1974 and 1990. During this period 7 patients with DN came to receive hemodialysis therapy 2 to 6 (average 3.8 +/- 1.3) years after the first medical examination. As a result, in patients with hypertensive nephropathy, there was a tendency to show that the lower the mean BP was, the better the renal function. On the contrary, in DN patients there was an optimal mean BP (MBP) range; i.e, when MBP was controlled in this range, the deterioration rate of renal function was delayed, while deviation of MBP from this range made the renal function worse (p less than 0.01). However, this range varied with the serum creatinine (SCr) concentration level.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770622 TI - [A case of renovascular hypertension with nephrotic syndrome, accompanied by focal segmental glomerulosclerosis-like lesion in the contralateral kidney]. AB - A 66-year-old male patient of renovascular hypertension with nephrotic syndrome was described. Besides, focal segmental glomerulosclerosis like lesion was accompanied in the contralateral kidney. On admission, his blood-pressure amounted to 220/140 mmHg. Laboratory investigation included; urinary protein 10.5 g/day, serum creatinine 1.8 mg/dl, creatinine clearance 71.4/day, plasma renin activity 10.0 ng/ml/hr, angiotensin I 890 pg/ml and angiotensin II 40.0 pg/ml. Renogram and renal scintigram showed non-functioning pattern of left kidney. Arteriography disclosed approximately more than 95% stenosis of left main artery. Administration was discontinued because of poor control both in blood pressure and in proteinuria. After the left nephrectomy, the former normalized and the latter decreased. Microscopic examination of the right kidney revealed focal segmental glomerulosclerosis like lesion. So far as we know, this report is the first designed to elucidate renovascular hypertension with nephrotic syndrome accompanied by focal segmental glomerulosclerosis like lesion. The relationship between renovascular hypertension and nephrotic syndrome, and microscopic findings has been briefly discussed. It is suggested that the etiology of focal segmental glomerulosclerosis like lesion may be based on compensatory glomerular hyperfiltration caused by renovascular hypertension. PMID- 1770623 TI - [Clinical analysis of 35 patients with renal injury]. AB - Because of the increase of abdominal trauma owing to traffic accident, the number of renal injury is increasing. Between May 1, 1986 and December 31, 1989, thirty five cases with renal injury were treated in our hospital. The cases were classified as contusion, minor laceration, major laceration and vascular injury by the clinical findings and the radiographic evaluation. Contusion had 22 patients, who were treated conservatively except one with preexisting hydronephrosis. Four patients of minor laceration were all treated conservatively. In four cases of major laceration nephrectomy was performed, the other five cases were healed conservatively. There were two death cases caused by other organ injuries. The extent of associated injuries influenced the prognosis, rather than the degree of renal damage. Thirty-three cases except two survived with no complication. In cases of major injury same were managed conservatively, other required surgical treatment. Sometimes it is difficult to determine which treatment should be done. Indication for surgical treatment is discussed. PMID- 1770624 TI - [A study of serum and urinary immunoglobulins after forced lordosis]. AB - We described transient low or non selective proteinuria after forced lordosis was as a characteristic of orthostatic proteinuria and the decrease in the urinary IgA/IgG ratio after lordosis was useful in confirming the diagnosis of the disease. In this study we examined the urinary excretion of IgG, IgA and IgG4, an anionic immunoglobulin, after forced lordosis in 44 orthostatic proteinuria children (group OA) and 24 chronic glomerulonephritis patient in stable stage (group GN). Urinary IgG4/IgG after lordosis was not significantly different between groups OA and GN. It showed that urinary IgG4/IgG ratio was not so useful in the differential diagnosis of this disease. In group OA, urinary IgA/IgG correlated significantly with serum IgA/IgG (y = 0.35X + 7.0, r = 0.354, p less than 0.05), and urinary IgG4/IgG also correlated significantly with serum IgG4/IgG (y = 1.22x + 0.14, r = 0.813, p less than 0.001). From these results it is suggested that proteinuria after forced lordosis in children with orthostatic proteinuria is composed of a transient low or non selective proteinuria in terms of both size and charge of protein. It seems more likely that the so-called heteroporous theory and sieving function theory explain the mechanism of orthostatic proteinuria. PMID- 1770625 TI - [A study of urinary immunoglobulin excretion after forced lordosis]. AB - Changes in the urinary excretion of immunoglobulins (IgG and IgA) before and after forced lordosis were studied in 26 children with orthostatic proteinuria (group OA, where proteinuria disappeared within 120 min after lordosis was referred to as group OAA and where if disappeared after more than 120 min was group OAB) and 9 children with chronic glomerulonephritis in the clinically stable state (group GN). Urinary immunoglobulins were measured by ELISA (enzyme linked immunosorbent assay). In resting urine, the urinary excretion rates (total protein, IgG, and IgA) and the urinary protein ratio (IgG/protein, IgA/protein, and IgA/IgG) did not significantly differ between groups OA and GN. When forced lordosis was carried out, at maximum protein excretion, the urinary IgA/IgG ratio in groups OAA and OAB were significantly decreased (from 198 + 44% to 17.3 + 12.9% and from 147 + 88% to 18.7 + 16.9%, respectively). The ratio of IgA/IgG in groups OAA and OAB was significantly lower than that in group GN (88.9 + 53.9%, p less than 0.01). The urinary IgA/IgG ratio after lordosis in group OA was similar to the serum IgA/IgG ratio. These findings suggest that transient low or non selective proteinuria after lordosis is a characteristic of orthostatic proteinuria. Analysis of the urine after forced lordosis, especially using the urinary IgA/IgG ratio at maximum protein excretion, may be an useful examination for differentiating OA from other glomerulonephritides. PMID- 1770626 TI - [Immunohistochemical study on the extracellular matrix components in various renal diseases]. AB - In order to clarify considerable alterations of the extracellular matrix components in various renal diseases, monoclonal antibodies against type IV collagen (IV col), 200-KD laminin (200-KD Lam), 400-KD laminin (400-KD Lam) and heparan sulfate proteoglycan (HSPG) were applied to 142 renal biopsy specimens for the indirect immunofluorescence. These subjects included 5 cases with 1 hour specimen in the transplanted kidney, 32 minimal change nephrotic syndrome (MCNS), 30 mesangial proliferative glomerulonephritis (PGN), 2 focal segmental glomerulosclerosis (FGS), 21 membranous nephropathy (MN), 9 membranoproliferative glomerulonephritis (MPGN), 2 poststreptococcal acute glomerulonephritis (PSAGN), 13 diabetic nephropathy (DN), 16 lupus nephritis (LN), 9 diffuse sclerosing glomerulonephritis (DSGN), 2 amyloid kidney and 1 granulomatous nephropathy in sarcoidosis. In the transplanted kidney, the staining intensity of IV col was stronger than that of 200-KD Lam, 400-KD Lam and HSPG in general. IV col was predominantly distributed throughout the mesangium area and less along the glomerular basement membrane (GBM). The positive stainings with 200-KD Lam along the GBM and that with 400-KD Lam in the mesangium area were weakly recognized. HSPG was mainly detected along the GBM in the linear fashion. In MCNS, the distribution of the extracellular matrix components was mostly identical to that in the transplanted kidney. In the group of the glomerulonephritis showed the proliferations of mesangial cells, such as PGN and MPGN, the staining intensity of both IV col and 400-KD Lam, particularly in the latter, was remarkably increased in the sclerotic lesions. In MN, the thickened GBM was strongly stained with both IV col and 200-KD Lam, and the stainings of 200-KD Lam were more intensive. And still more, by the double labelling method performed for the couple of IV col and immunoglobulins, the correlation between glomerular capillary walls and/or mesangial areas and immunoglobulins deposits became more clear. These findings suggest as follows: (1) both IV col and 400-KD Lam, in particular 400-KD Lam, are possibly involved in the process of glomerulosclerosis: (2) both IV col and 200-KD Lam, in particular 200-KD Lam, are greatly involved in the process of new basement membrane-like materials formation in MN. PMID- 1770627 TI - [Study on the assay of proximal tubular antigen in urine and serum with an anti human renal monoclonal antibody]. AB - Monoclonal antibodies (Mabs) were produced by immunizing mice with human kidney microsomal antigen. Mab-B1 recognized brushborder (B1-Ag) in proximal tubules. Using Mab-B1, B1-Ag was assayed in the urine and serum of renal disease patients by sandwich ELISA. The subjects included normal control (Nor), minimal change nephrotic syndrome (MCNS), IgA nephropathy (IgA), membranous nephropathy (MN), membranoproliferative glomerulonephritis (MPGN), and chronic renal failure (CRF) (s-Cr greater than 2 mg/dl). Urinary B1-Ag demonstrated significant increases in the IgA (p less than 0.001), MN (p less than 0.001), MPGN (p less than 0.001) and CRF (p less than 0.01) groups as compared to the Nor group. There was no significant increase in the MCNS group. In the CRF group, B1-Ag in urine showed a significant increase in the progressive CRF group with delta s-Cr greater than 1.0 mg/dl/month as compared to the stationary CRF group with delta s-Cr less than 1.0 mg/dl/month. No correlation was observed between urinary B1-Ag and proteinuria, hematuria, s-Cr, s-BMG and u-NAG. The above findings suggested that the assay of urinary B1-Ag was useful as a new parameter in detecting the site and degree of proximal tubular damage. PMID- 1770628 TI - [Detection of glomerular deposits of various renal diseases on light microscopy using periodic acid thionin [PATS]-chromotrope staining]. AB - We devised a periodic acid thionine schiff (PATS)-chromotrope method to detect the glomerular deposits more distinctly than conventional staining methods. The PATS-chromotrope method was compared with other immunological staining methods, such as immunofluorescence method and avidin biotin complex method. Formalin fixed, and paraffin-embedded renal tissues were obtained from 26 patients with IgA nephropathy, 8 with lupus nephritis, 4 with minimal change nephrotic syndrome, 3 with membrano-proliferative glomerulonephritis, and 3 with hepatitis B associated nephropathy. Thionine Schiff reagent was used instead of fuchsin schiff reagent to stain the basement membrane blue. Subsequently, chromotrope 2R was used to stain the glomerular deposits. For immunofluorescence method, frozen renal tissues were stained with FITC-labelled anti-human IgG, IgA, C3 and fibrinogen. For avidin biotin complex method, the same sections as PATS chromotrope method were stained with anti-human IgG, IgA, and C3. In PATS chromotrope method, deposits were identified in 9 of 26 specimens with IgA nephropathy, 3 of 8 specimens with lupus nephritis, and one of 3 specimens with hepatitis-B associated nephropathy. Localization of deposits in PATS-chromotrope method was identified more distinctly than immunofluorescence method or avidin biotin complex method. PATS-chromotrope method is useful to detect the deposition of immune complex on routine light microscopy in human glomerular disease. PMID- 1770629 TI - [Oral challenge with cow's milk in patients with IgA nephropathy--estimation of serum antibodies to cow's milk protein]. AB - The author investigated the serum levels of antibodies against casein, beta lactoglobulin and lactalbumin before and after challenging with cow's milk in 35 patients with IgA nephropathy, 18 with primary glomerulonephritis except for IgA nephropathy (GN control) and 11 healthy volunteers (H control). Blood samples were obtained at fasting, and at 30, 60, 120 and 180 min after oral challenging with 400 ml of cow's milk. IgA and IgG anti-cow's milk proteins antibodies were analyzed by ELISA. The same challenge was tested after administration of the antiallergic agent, sodium cromoglycate (SCG), in 11 patients with IgA nephropathy and 4 H controls. Serum levels of IgA anti-casein, -beta lactoglobulin and lactalbumin antibodies in patients with IgA nephropathy were significantly higher than in control groups before challenging. However, those of IgG antibodies were not. The percent change of antibody titer after challenging with cow's milk did not elevate in any group, except for the level of IgA anti beta-lactoglobulin antibody at 60 min in IgA nephropathy. Cases in which challenging produced marked elevation above the M + 2SD of the levels found in H control were expressed as "positive". The number of "positive" cases was 16 (45.7%) with IgA nephropathy, but none with GN control. There was no significant correlations between "positive" and "negative" cases with IgA nephropathy in clinical manifestations. In 3 out of 4 "positive" patients with IgA nephropathy, the levels of IgA antibody were suppressed after administration of SCG. It is concluded that the serum levels of IgA antibodies against cow's milk proteins are significantly elevated in IgA nephropathy, and are inhibited in elevation after oral challenge with cow's milk by administration of an antiallergic agent in some patients with IgA nephropathy. PMID- 1770630 TI - [Serum beta 2-microglobulin as a index of the initiation of dialysis therapy for diabetic patients with chronic renal failure]. AB - This study was designed whether serum beta 2-microglobulin is good index for the initiation of dialysis therapy in diabetic patients with chronic renal failure. Serum creatinine (S. Cr), beta 2-microglobulin (S. beta 2-MG) and guanidinoacetic acid (S. GAA) were measured in dialyzed or undialyzed diabetic patients with chronic renal failure in comparison with non diabetic patients. 28.6% of diabetic patients showed S. Cr below 8.0 mg/dl at the initiation of dialysis therapy although all of non diabetic patients showed it over 8.0 mg/dl. On the other hand, there was no significant difference in S. beta 2-MG between diabetic and non diabetic patients, and all patients of the two groups showed S. beta 2-MG over 12.0 mg/l. In non diabetic patients whose S. Cr was below 8.0 mg/dl, undialyzed patients had a significant correlation between S. Cr and S. beta 2-MG (r = 0.840, P less than 0.01), and all non diabetic patients showed relatively high value of S. Cr as compared with that of beta 2-MG at the initiation of dialysis therapy. Undialyzed diabetic patients whose S. Cr was below 8.0 mg/dl also revealed a close correlation between serum creatinine and beta 2-MG (r = 0.864, P less than 0.01), but dialyzed diabetic patients showed different correlation between S. Cr and S. beta 2-MG from it of non diabetic patients and S. Cr was underestimated as compared with S. beta 2-MG. Undialyzed diabetic patients showed significant lower values of S. Cr and S. GAA of non diabetic patients whose S. beta 2-MG were almost same as diabetics.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770631 TI - [Circulating immune complexes and complement breakdown products in childhood IgA nephropathy]. AB - Circulating immune complexes (CIC), mainly IgA-CIC have been frequently detected in IgA nephropathy and recently increased levels of C3 fragments which indicate C3 activation have been reported. However, little is known about the relationship between CIC and complement activation. We determined CIC by the solid-phase anti C3 Facb enzyme immunoassay in 37 children with IgA nephropathy to investigate the relationship between CIC and clinical and/or histological findings, and also determined C3 fragments whether CIC correlate with complement activation. IgA-CIC were detected in 78% (27/37) with a mean level of 11.9 +/- 3.9 micrograms/ml, which was significantly higher than other glomerular diseases (P less than 0.05). IgA-CIC levels were also found significantly higher in 27 cases with proteinuria than in 10 cases without proteinuria (P less than 0.05). IgG-CIC were detected in 67% (12/18) with a mean level of 4.1 +/- 2.6 micrograms/ml, which was not significantly different from other glomerular diseases. No striking correlation was noted to exist between CIC levels at renal biopsy and the histological severity, because CIC are often present intermittently. C3d was quantitated by the rocket immunoelectrophoresis and C3 by the single radial immunodiffusion to determine the C3d/C3 ratio. The mean value of C3d/C3 was 0.63 +/- 0.19 which was significantly higher than a corresponding value for 15 healthy controls of 0.27 +/- 0.06 (P less than 0.05). Levels of IgA-CIC were found to have a significant positive correlation between C3d/C3 determined simultaneously in 33 cases (r = 0.43, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770632 TI - [Intraglomerular coagulation and fibrinolysis in human primary glomerular diseases]. AB - It is a well known fact that intraglomerular coagulation plays an important role in the development of human primary glomerular diseases. However, the precise mechanism of intraglomerular coagulation, and intraglomerular coagulability and/or fibrinolytic activity remains obscure. The present study was aimed to elucidate the role of the intraglomerular coagulation and fibrinolysis in human primary glomerular diseases. Subjects enrolled in this study were 27 patients with minimal change nephrotic syndrome (MCNS), 14 patients with focal glomerular sclerosis (FGS), 36 patients with membranous nephropathy (MN), 161 patients with mesangial proliferative glomerulonephritis (mesPGN), 9 patients with membranoproliferative glomerulonephritis (MPGN), and 40 healthy volunteers as controls. Normal human renal cortex as controls of isolated intraglomerular plasminogen activator activity (PAA) was obtained at the time of nephrectomy from the normal pole of kidneys removed because of an opposite pole tumor. Urinary urokinase (UK), fibrinopeptide A (FPA) and fibrinopeptide B beta 15-42 (B beta 15 42) antigens were measured by RIA. Urinary tissue plasminogen activator (t-PA) antigen was measured by ELISA. Urinary fibrin/fibrinogen degradation products (FDP) were measured by latex agglutination method. Moreover, PAA was measured by 125I-fibrin films. The following results were obtained: 1) In primary glomerular diseases, levels of urinary UK and t-PA were significantly lower than those in healthy volunteers, 2) Urinary UK and t-PA showed gradual decrease along with the development of mesangial proliferation, 3) Urinary UK and t-PA were significantly correlated with both the urinary FPA and B beta 15-42, 4) In mesPGN and FGS, PAA was significantly lower than that in normal controls, 5) PAA was significantly correlated with urinary UK, t-PA, FPA and B beta 15-42, 6) Urinary UK and t-PA in the patients with urinary FDP were significantly lower than those in patients without urinary FDP, 7) Urinary UK, t-PA and PAA were significantly lower in patients with intraglomerular fibrin deposition than those in patients without fibrin depositions. These findings suggest that the decrease of urinary UK and t PA levels and the diminution of isolated intraglomerular plasminogen activator activity contribute to the progression of primary glomerular diseases. PMID- 1770633 TI - [Pathological study on the effect of oral adsorbent AST-120 on chronic renal failure in rats]. AB - In order to evaluate the direct or indirect effect of AST-120 on chronic renal failure (CRF) in rats, histological and electron microscopical examinations were performed. A total of 30 Sprague-Dawley rats (aged 11 weeks and weighing 226 to 229 gm) with CRF induced by 5/6 nephrectomy were prepared. Rats were fed by a commercial diet (CE-2, Japan Kurea) and were divided into two groups: A (16 rats) and B (14 rats). AST-120 (5% content) was only administered to group B. After two months, kidneys were removed and prepared for the histological and electron microscopical examinations. On histological examination, group A kidneys showed severe glomerular hyalinization (more than 80%) and frequent crescents, as well as tubulo-interstitial fibrosis and many protein casts. In contrast, segmental glomerular lesions were identified in group B kidneys. Tubulo-interstitium were also well preserved. Furthermore, the ultrastructural findings of group B were milder than that of group A. The preservation of renal tissue in group B revealed the beneficial effect of AST-120 on CRF rats' kidneys. In conclusion, this beneficial effect is provided by the removal of the serum toxic metabolite (uremic toxin) and the precursor substance of the toxin by orally administered AST-120. PMID- 1770634 TI - [Effect of badoushuang on progressive glomerular sclerosis in rats with 7/8 nephrectomy]. AB - Effect of Badoushuang (Semen crotonis pulveratum) was studied in the 7/8 nephrectomied rats, which we could establish as progressive glomerulosclerosis model in rats (Jap J Nephrol 32: 127, 1990). Badoushuang was administered into rats orally 60 mg/kg/day every day after 7/8 nephrectomy. As controls 7/8 nephrectomied rats were used. No adverse effect of Badoushuang were noted during 8 weeks of observation periods. Administration of Badoushuang, in rats with a remnant kidney, decreases urinary protein and lowers blood pressure, keeps creatinine clearance and lowers serum creatinine level and BUN. Morphologically glomerular hypertrophy, crescent formation and sclerosis were less in experimental treated rats. These results suggest Badoushuang ameliorates the progressive kidney disease of rats with subtotal renal ablation. Further study is necessary to clarify the effect of Basoushuang on progressive glomerular sclerosis. PMID- 1770635 TI - [Effect of protease inhibitor on primary glomerulonephritis and the mechanism of the effect]. AB - Effect of serine protease inhibitor Camostat Mesilate (Foipan) on primary glomerulonephritis and it's mechanism were evaluated. Forty-two patients having primary glomerulonephritis (13 cases of IgA nephropathy, 11 cases of membranous nephropathy and others), aged 18 to 81 years were selected for this study. At the start of our study, twenty-one patients had received other drugs (13 cases of dipyridamole and 13 cases of prednisolone). A control period of four weeks was established to confirm that the levels of proteinuria and renal functions were stable. Patients were orally administered with 600 mg of Camostat Mesilate per day for four weeks. Effect of Camostat Mesilate was judged by urinary protein excretion, hematuria, serum total protein, albumin, Ccr, creatinine and BUN. In order to reveal the mechanism of the effect laboratory data such as granulocyte elastase, CH50, C3, C4, fibrinogen, platelate factor 4, beta-thromboglobulin, thromboxane B2 and prostaglandin F1 alpha were evaluated before and after the treatment. Parameters were analyzed by using paired t-test. Mean (+/- SEM) urinary protein excretion reduced from 4.31 +/- 0.91 to 2.80 +/- 0.43 g/day (p less than 0.05), and score of hematuria decreased from 1.8 +/- 0.16 to 1.5 +/- 0.15. A significant decrease in urinary protein excretion was seen in membranous nephropathy and a significant decrease in hematuria was seen in IgA nephropathy. In combination therapy (dipyridamole, prednisolone) urinary protein excretion markedly decreased (p less than 0.05) and in Camostat Mesilate therapy score of hematuria markedly decreased (p less than 0.05). Camostat Mesilate had no effects on renal function assessed by Ccr, creatinine and BUN.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770636 TI - [Effects of methylprednisolone pulse therapy on progressive IgA nephropathy]. AB - In order to estimate the effects of methylprednisolone pulse therapy on progressive IgA nephropathy, clinical parameters in eight patients with the disease were compared between before and after the therapy. In this study progressive IgA nephropathy was defined as follows; 24 hour urinary protein excretion was (++) or more and renal biopsy carried out just before the therapy revealed crescents, inevitably including cellular crescents, in 10% or more glomeruli observed. Methylprednisolone 1000 mg a day was intravenously administered for three consecutive days and the therapy was repeated with an interval of 4 days. The additional third course was given in two patients, in whom significant decrease in urinary protein had not been obtained after the original two courses of the therapy. Oral prednisolone 20 mg a day started simultaneously was tapered one month later to maintenance daily doses of 5-10 mg. After the pulse therapy urinary protein excretion was significantly decreased in every patient with a mean decrease from 2.3 +/- 0.5 (0.8-5.5)g to 1.1 +/- 0.3 (0 2.8)g (p less than 0.05). Glomerular filtration rate (GFR) was increased from 83 +/- 11 (31-115) ml/min to 96 +/- 10 (44-130) ml/min (p less than 0.05). In the initial biopsy crescents were observed in 25 +/- 7 (19-57)% of glomeruli observed and 20-100% of these were composed of cellular crescents. Complete loss of cellular crescents in 6 patients and a marked decrease from 73% to 33% in another were demonstrated by the second biopsies performed after the pulse therapy. These results suggested that the methylprednisolone pulse therapy significantly reduced urinary protein excretion and improved renal function through suppression of new crescent formation as well as transformation of cellular crescents to fibrocellular or fibrous crescents. PMID- 1770637 TI - [Protein binding of various cephems in healthy subjects and patients with chronic renal failure]. AB - This study was employed to investigate whether the serum protein binding of various cephems [cefpiramide (CPM), cefalotin (CET), latamoxef (LMOX)] differ among healthy subjects and patients with chronic renal failure (CRF) by means of in vitro equilibrium dialysis. The protein binding capacities of cephems in patients with CRF (hemodialysis, continuous ambulatory peritoneal dialysis, non dialysis) decreased significantly compared to those in healthy subjects. The binding capacities correlated directly with total protein, albumin concentration and correlated inversely with blood urea nitrogen and serum creatinine concentration. In the study of protein binding during and after hemodialysis, the binding capacities of CPM and LMOX decreased immediately after dialysis and then increased with the time. However, the binding capacities of CET increased immediately after dialysis and then decreased. The binding capacities of CPM and LMOX correlated inversely with non-esterified fatty acids (NEFA) and those of CET correlated directly with NEFA. In the study of protein binding in pooled sera from healthy subjects with or without palmitic acid (PA), the binding capacities of CPM and LMOX decreased by increasing the concentration of PA, while those of CET increased by increasing PA up to 3 mM. The changes in binding capacity of cephems during and after hemodialysis have been possibly caused by increase of NEFA due to activation of lipase in use of heparin as an anticoagulant. In conclusion, changes in protein binding capacity of cephems in sera from CRF, which should be taken into consideration to avoid possible side effects. PMID- 1770638 TI - [Renal osteodystrophy and growth in children undergoing CAPD]. AB - Renal osteodystrophy (ROD) and growth were assessed in 20 children undergoing CAPD. Serum calcium and inorganic phosphorus levels were maintained with normal limits in these patients. Elevated alkaline phosphatase and c-PTH levels and abnormal radiological bone changes of ROD were observed in patients with severe ROD, but they were not correlated each other in patients with mild ROD. Fifteen patients showed the radiological bone changes of ROD with deterioration and improvement in some patients, and administration of vitamin D seems to be necessary to prevent ROD during CAPD treatment. The growth of older children was poor during CAPD, but catch up growth was observed in young children under the age of 7 years. The growth was affected by rickets in young children, but the presence of mild secondary hyperparathyroidisms seemed to have little influence on growth in older children. PMID- 1770639 TI - [Influences of pregnancy on the natural course of chronic glomerulonephritis with impaired renal function]. AB - In an attempt to clarify the influence of pregnancy on the natural course of the chronic glomerulonephritis with impaired renal function (glomerular filtration rate: GFR less than or equal to 70 ml/min), the courses of 14 pregnancies occurring in 10 patients (seven with IgA nephropathy, one with membranoproliferative glomerulonephritis, one with membranous nephropathy and one with hereditary nephropathy) were studied. In 8 patients GFR measured before pregnancies ranged from 46 to 70 ml/min and in the other two creatinine clearance estimated in the first trimester of pregnancies was 62 and 49 ml/min, respectively. The pregnancies resulted in 10 live births, one spontaneous abortion, one artificial abortion and 2 neonatal deaths. In 2 out of 10 live births fetal weight was less than 2500 g. In 3 of 11 pregnancies there was neither increase in urinary protein nor elevation of blood pressure during pregnancies, while seven (64%) had increased proteinuria during the third trimester, and 4 of them were also complicated with hypertension. In 6 of 10 patients, there was no decrease in GFR during pregnancies. In three patients GFR was decreased from 70 to 36 ml/min, 70 to 58 ml/min and 62 to 48 ml/min, respectively. However, these reductions were considered to go with the natural course of respective patients because the reduction slopes were almost the same or rather mild in comparison with those estimated before or after pregnancies. The other patient also had a transient increase in serum creatinine level during two pregnancies, but the reciprocals of serum creatinine concentration before and after the pregnanciesdeclined linearly with time. These data suggest that pregnancy might have little influence on the natural course of the chronic glomerulonephritis even if complicated with renal functional impairment defined as GFR of 70 ml/min or less. PMID- 1770640 TI - [A case of lupus nephritis with hyporeninemic hypoaldosteronism]. AB - We report a case of 67-year-old woman with systemic lupus erythematosus presenting hyporeninemic hypoaldosteronism. She admitted because of anasarca in March, 1990. She manifested nephrotic syndrome, and hyperkalemia and hyperchloremic metabolic acidosis. The hyperkalemia was disproportionate to the degree of renal insufficiency. Basal levels of plasma renin activity and plasma aldosterone concentration were low. Renal tubular function studies revealed normal hydrogen ion secretion. Renal biopsy demonstrated diffuse proliferative lupus nephritis and prominent interstitial cell infiltration. There was no vasculitis of glomerular vascular poles. After treatment of lupus nephritis with prednisolone, levels of plasma renin activity and plasma aldosterone concentration were elevated. Hyperkalemia and metabolic acidosis were normalized and renal function improved. We conclude that the heperkalemia and metabolic acidosis could be attributed to hyporeninemic hypoaldosteronism. PMID- 1770641 TI - [Evaluation of 201Tl SPECT in patients with glioma: a comparative study with histological diagnosis, clinical feature and proliferative activity]. AB - The purpose of this study is to clarify the usefulness of 201Tl brain SPECT in the prediction of clinical degree of malignancy. Quantitative evaluation of 201Tl uptake in the tumor was expressed as count ratio of tumor site over contralateral normal region (D/C ratio) on 201Tl SPECT image. Fourteen patients with gliomas received an intravenous administration of bromodeoxyuridine (BUdR) at surgery to label tumor cells in the DNA synthesis phase. BUdR-positive cells in excised tumor specimen were stained with anti-BUdR monoclonal antibody by indirect immunoperoxidase staining. Percentage of labeled cells in relation to the total number of tumor cells in microscopic fields was defined as labeling index (BUdR LI). D/C ratio in patients with grade IV glioma (198.7 +/- 31.7) was higher than that in patients with grade III glioma (138.3 +/- 33.9) or more low-grade gliomas (94.2 +/- 11.9, p less than 0.001). BUdR-LI in patients with high-grade glioma was also higher than that in patients with low-grade glioma. D/C ratio correlated well (r = 0.753) with BUdR-LI, which is considered to represent proliferative activity of the tumor. D/C ratio does not only correlate well with histological grade of glioma, but with clinical course or prognosis of individual patient with glioma. In conclusion, degree of 201Tl uptake in the tumor may provide non invasive prediction of malignancy grade of gliomas and accurate estimation of efficacy of the therapy and early detection of recurrence or malignant transformation of the tumors, by delineating viable tumor tissue in patients with gliomas. PMID- 1770642 TI - [Quantitative evaluation of acute myocardial infarction by In-111 antimyosin Fab myocardial imaging]. AB - For quantitative evaluation of acute myocardial infarction, In-111 antimyosin Fab myocardial imaging (InAM) was performed in 17 patients with myocardial infarction who underwent Tl-201 (TL) and Tc-99m pyrophosphate (PYP) myocardial imaging in acute phase. For calculating the infarct size, voxel counter method was used for analysis in PYP and InAM, and extent and severity score were used on bull's-eye polar map in TL. The most appropriate cut-off level ranged from 65 to 80% by the fundamental experiment using cardiac phantom. The cut-off level of 0.70 (InAM) and 0.65 (PYP) were used for clinical application of voxel counter analysis. The infarct size calculated by InAM and PYP was compared with wall motion abnormality index by echocardiography (WMAI), TL extent score, TL severity score, peak CK and sigma CK. Infarct size by InAM showed the following correlations with other indices. PYP: r = 0.26 (ns), TL extent score: r = 0.72 (p less than 0.01), TL severity score: r = 0.65 (p less than 0.05), WMAI: r = 0.69 (p less than 0.05). The infarct size by PYP did not show any correlations with these indices. Therefore, the infarct size by InAM showed better correlations with TL and WMAI than that of PYP. So InAM was considered superior to PYP for quantitative evaluation of acute myocardial infarction. PMID- 1770643 TI - [67Ga imaging in the patients with infective endocarditis after surgery for congenital heart disease]. AB - 67Ga imaging was performed in sixteen patients (age: 8 m.-18 y.) who had persistent fever and positive acute phase reactants after surgery for congenital heart disease. Abnormal uptake of 67Ga over the heart and the lungs was evaluated with a computer. Abnormal uptake of 67Ga was observed in seven patients, three of them showed it in the area of peripheral pulmonary artery and another four showed it in the area of artificial vessels for pulmonary artery reconstruction. In six patients with positive blood cultures, five showed abnormal uptake of 67Ga and in ten patients with negative blood cultures, two showed it. Vegetation was detected with 2D-echocardiography in four patients and all of them showed abnormal uptake of 67Ga, while in 12 patients without vegetation three showed it. In conclusion, 67Ga imaging was useful to detect the foci of infective endoarteritis or pulmonary embolism caused by the vegetation in infective endocarditis in the patients after surgery for congenital heart disease, especially in the peripheral pulmonary arteries and artificial vessels which could not be detected with 2D echo. PMID- 1770644 TI - [Detection of human anti-mouse antibody in patients receiving 111In-antimyosin Fab: multicenter clinical study in Japan]. AB - In the multicenter clinical study of 111In-Antimyosin Fab (74 MBq, 0.5 mg), human anti-mouse antibody (HAMA) titers have been evaluated in serum from 456 patients using the sensitive enzyme-linked immunosorbent assay. Presence of HAMA was confirmed by the neutralization test or using the size exclusion high performance liquid chromatography (HPLC) analysis in 11 of 393 patients (2.8%). HAMA was still detectable in 2 patients even 40 weeks after injection. None of 7 patients judged as positive for the intradermal test, a patient with vascular pain or 3 patients with fever or flare and itching with fever, developed detectable levels HAMA in their serum. These results suggest that patients may develop HAMA response after infusion of 111In-Antimyosin Fab, but pathogenic role of HAMA in these patients remains to be studied. PMID- 1770645 TI - [The group study of diagnostic efficacy of cerebro-vascular disease by I-123 IMP SPECT images obtained with ring type SPECT scanner--the ROC analysis on the diagnosis of perfusion defect and redistribution]. AB - We performed two image reading experiments in order to investigate the diagnostic capability of I-123 IMP SPECT obtained by the ring type SPECT scanner in cerebro vascular disease. Fourteen physicians diagnosed SPECT images of 55 cases with reference to clinical neurological informations, first without brain XCT images and second with XCT images. Each physician detected perfusion defects and redistributions of I-123 IMP and assigned a confidence level of abnormality for these SPECT findings by means of five rating method. From results obtained by ROC analysis, we concluded as follows: (1) Generally, I-123 IMP SPECT is a stable diagnostic modality in the diagnosis of cerebro-vascular disease and the image reading of XCT had no effects on the diagnosis of SPECT on the whole of physician, (2) However, there were unnegligible differences among individuals in the detectability of findings and the effect of XCT image reading, (3) Detectability of redistribution of I-123 IMP was lower than that of perfusion defect and inter-observer variation in the diagnostic performance for redistribution was larger than that of perfusion defect. The results suggest that it is necessary to standardize diagnostic criteria among physicians for redistribution of I-123 IMP. PMID- 1770646 TI - [Cardiac response to exercise before and after coronary artery bypass grafting: evaluation by continuous ventricular function monitor]. AB - Cardiac response to exercise was evaluated with continuous ventricular function monitor (VEST) with cadmium telluride detector. Thirty-nine patients (30 male and 9 female, aged 57 +/- 8, 23 had old myocardial infarction) were monitored with VEST during and after supine ergometer exercise before and 4 weeks after coronary artery bypass grafting (CABG). Left ventricular ejection fraction (EF) responses were classified into 4 types; type A showed EF increase greater than 5% till end of exercise, type B demonstrated initial increase followed by decrease in EF, type C revealed no significant EF change, type D showed continuous EF decrease. Before CABG, each EF response type A, B, C, and D consisted of 4, 2, 12, 21 patients respectively and after CABG each type included 18, 10, 9, 2. The EF change from rest to peak exercise (delta EF-Ex) improved from -6.4 +/- 8.8% to 5.0 +/- 7.4% (p less than 0.001) after CABG. All patients showed rapid EF increase after exercise or "EF overshoot" (EF-OS). After CABG, the EF change from rest to EF-OS (delta EF-OS) and time to EF-OS (T-OS) were improved from 9.9 +/- 5.2% to 14.9 +/- 5.3% (p less than 0.001) and 162 +/- 86 sec to 80 +/- 48 sec (p less than 0.001) respectively. Type A, B patients showed higher delta EF-OS and shorter T-OS than type C, D patients, suggesting EF overshoot was contingent upon cardiac function during exercise. After CABG, in patients with myocardial infarction, T-OS shortened but delta EF-OS showed less improvement than patients without infarction, suggesting loss of myocardium hampered EF-OS. PMID- 1770647 TI - [Phase I clinical study on 99mTc-GSA, a new agent for functional imaging of the liver]. AB - Technetium-99m-DTPA-galactosyl human serum albumin (99mTc-GSA) is a new radiopharmaceutical which binds to the asialoglycoprotein receptors located specifically on the hepatocytes. Phase I study of 99mTc-GSA was performed on seven normal volunteers, who were intravenously injected with 185 MBq (5 mCi) and 1-10 mg of 99mTc-GSA. None of adverse reactions, abnormal findings of laboratory test and anti-99mTc-GSA antibody production was recognized. The livers were clearly visualized in all subjects. In the pharmacokinetic analyses on five subjects, 99mTc-GSA was rapidly taken up by the livers immediately after the injection and was slowly excreted through the biliary tracts and the urinary tracts. Dose-dependency which is a specific feature for the receptor-mediated agents was observed; the blood clearances of 99mTc-GSA were prolonged in proportion to the injected ligand doses. These results suggest that 99mTc-GSA may be a potential agent for evaluating hepatic functions based on the hepatic receptor quantities. PMID- 1770648 TI - [Evaluation of usefulness of Tc-99m-GSA liver scintigraphy in chronic liver diseases]. AB - Liver scintigraphy was performed using a newly developed radiopharmaceutical, Tc 99m-DTPA-Galactosyl-Human-Serum-Albumin (Tc-99m-GSA), which binds specifically to the receptors on the hepatic cell surface, in 15 patients with chronic liver diseases. The scintigraphy was evaluated qualitatively and quantitatively, and the results were compared with those obtained from the Tc-99m-PMT or Tc-99m-sn phytate scintigraphy, and the liver function tests. The Tc-99m-GSA scintigraphy showed clear liver images in chronic hepatitis. However, in liver cirrhosis, the liver images was not clear and the cardiac images still existed 40 minutes after administration of Tc-99m-GSA, suggesting that the image quality of the Tc-99m-GSA scintigrams may be inferior to that of Tc-99m-sn-phytate or Tc-99m-PMT in some cases of severe liver dysfunction. The time-activity curves of the heart and liver were analyzed by non-linear regression analysis. The clearance rate from plasma (Kd) were obtained from the time-activity curve of the heart, and the hepatic uptake rate (Ku), hepatic excretion rate (Ke) and peak time of hepatic uptake-excretion curve (PT) were obtained from the time-activity curve of the liver. Kd, Ku and PT values were more significantly decreased or prolonged in the patients with liver cirrhosis than those in the patients with chronic hepatitis. Kd, Ku and PT values had positive correlations with the result of the serum liver function tests, ICG-R15 and ICG-K. Ku and PT values had also correlations with the histological degrees of hepatic fibrosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770649 TI - [Intracranial accumulation of 99mTc-phosphorous compound on bone scintigraphy]. AB - Bone scintigrams of 99mTc-phosphorous compound in 4,579 cases were reviewed concerning the intracranial accumulation. Intracranial accumulations were demonstrated in 8 cases (0.17%). The lesions with intracranial accumulation were two cases of primary brain tumor (1 meningioma and 1 astrocytoma), five cases of metastatic brain tumor (1 rectal cancer, 1 gastric cancer, 1 uterine cervical cancer and 2 lung cancers) and one case of cerebral infarction. Calcification was detected in one of eight cases on CT scans. It is important to pay attention to the intracranial accumulation on routine bone scintigram because brain tumor or infarction may be detected. PMID- 1770650 TI - [Pulmonary alveolar proteinosis with reverse ventilation/perfusion mismatch; a case report]. AB - Generally, non-ventilated segments are not perfused on lung scans (V/Q match). Now we report a very rare case with pulmonary alveolar proteinosis whose scintigraphy shows the decreased ventilation, but well perfused (reverse V/Q mismatch). PMID- 1770651 TI - [Fundamental and clinical evaluation of equilibrium dialysis--radioimmunoassay system for measurement of serum free thyroxine]. PMID- 1770652 TI - [Clinical evaluation of bilateral diffuse lung uptake of 67Ga-citrate]. PMID- 1770653 TI - [A non-invasive quantitative measurement of cerebral blood flow using N-isopropyl [123I]p-iodoamphetamine and single photon emission CT]. AB - A non-invasive quantitative method using N-isopropyl-[123I]p-iodoamphetamine (IMP) was described for assessing regional cerebral blood flow (rCBF). Twenty four cases, composed of 11 patients with brain tumors, 9 patients having cerebrovascular disease and 4 other patients aged 15-73 years, all underwent the SPECT 133Xe inhalation method (Xe-SPECT) and IMP-SPECT using a Tomomatic 564. In the IMP-SPECT cases, 111-222 MBq (3-6 mCi) of IMP was injected intravenously and then sequential imaging was performed 9.5 +/- 1.2 (mean +/- SD) min (E1 image), 20.6 +/- 1.2 min (E2 image), 227.5 +/- 22.1 min (D1 image), and 236.6 +/- 22.4 min (D2 image) after the injection. The IMP-uptake value (counts/pixel/sampling time) in the region of interest (ROI), which was chosen in the non-affected cortex in the middle cerebral artery territory (MCAC), was counted on each image (E1 value, E2 value, D1 value and D2 value) and the E1/D1 ratios and E2/D2 ratios were consequently calculated. On the other hand, the absolute value of the ROIrCBF (Xe-rCBF) was obtained by Xe-SPECT. There were significant correlations noted between both the E1/D1 ratios and the E2/D2 ratios, and the Xe-rCBFs. Those correlation coefficients were found to be: r = 0.741 and 0.810 respectively. Based on this significant relationship, equations were deduced to involve the rCBF values by use of IMP-SPECT: y = Ax + B (y: rCBF, x: E1/D1 ratio (E2/D2 ratio), A = 52.8 (68.2), B = 6.3 (-14.9), where A and B indicate the slope and deviation of the regression line).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770654 TI - [The quantitative evaluation of myocardial blood flow and myocardial FDG uptake in the infarcted lesions with Q-wave and without Q-wave determined by O-15 water, FDG and PET]. AB - Cardiac PET elicits an accurate relationship between myocardial blood flow (MBF) and tissue viability, which is evaluated by myocardial FDG uptake (MFU). To differentiate reversible tissue from necrotic tissue after the ischemic event, we from necrotic tissue after the ischemic event, we measured absolute MBF and MFU in patients with myocardial infarction. The MBF obtained by O-15 water and dynamic PET was accurately corrected by employing a tissue fraction (a) for the partial volume effect, including wall-motion effect. MFU was also corrected by using the tissue fraction. The subjects consisted of 5 patients with non-Q-wave infarction and 7 patients with Q-wave infarction. The regions of interest were selected from the infarcted area, each corresponding to regions with Q-wave or non-Q-wave. The MBFs in regions with Q wave (0.36 +/- 0.14 ml/min/g) were lower than those without Q wave (0.74 +/- 0.29 ml/min/g) (p less than 0.005). MFUs in regions without Q-wave (0.061 +/- 0.028) were higher than those with Q-wave (0.038 +/- 0.017) (p less than 0.05). The highest threshold of MBF in regions where Q-wave was detected was 0.55 ml/min/g. It is concluded that we will able to find the threshold of electrophysiological dysfunction in the infarcted region with this method. PMID- 1770655 TI - [Utility of rest Tl-201 myocardial SPECT images for estimating myocardial viability]. AB - Rest Tl-201 myocardial SPECT images were underwent in 19 patients with anterior wall myocardial infarction under PTCR one month after the onset of acute myocardial infarction. The relationship between shortening rate (SR) of the left ventricle estimated by radial method and corresponding %Tl-201 uptake obtained by circumferential profile analysis was studied. For each patients 10 points on the anterior wall were taken into consideration. Seven patients showed depressive flat profile curve and 12 patients showed slant curve, in which %Tl-201 uptake continuously decreased from base to apex. Well correlation was obtained between SR and %Tl-201 uptake (SR = -41.2 +/- 1.03% Tl-201 uptake, r = 0.54, p less than 0.001). Average %Tl-201 uptake corresponding to SR = 0 was 46.3 + 6.8% (36-58). The sensitivity of %Tl-201 uptake greater than or equal to 60% for SR greater than or equal to 20% was 97% (87/90) and specificity was 69% (31/45). Tl-201 myocardial SPECT images were useful for estimating myocardial viability and %Tl 201 uptake was one of excellent parameters for quantitatively estimating myocardial viability. PMID- 1770656 TI - [Response analysis for an approximate 3-D image reconstruction in cone-beam SPECT]. AB - Cone-beam Single Photon Emission Computed Tomography (SPECT) offers the potential for a large increase in sensitivity as compared with parallel hole or fan-beam collimation. Three-dimensional image reconstruction was approximately accomplished by backprojecting filtered projections using a two-dimensional fan beam algorithm. The cone-beam projection data were formed from mathematical phantoms as analytically derived line integrals of the density. In order to reduce the processing time, the filtered projections were backprojected into each planes parallel to the circle on which the focal point moved. Discrepancy of source position and degradation of resolution were investigated by computer simulation in three-dimensional image space. The obtained results suggest that, the nearer to the central plane or the axis of rotation, the less image degradation is performed. By introducing a parameter of angular difference between the focal point and fixed point in the image space during rotation, degradation of the reconstructed image can be estimated for any cone-beam SPECT system. PMID- 1770657 TI - [The assessment of 99mTc-HMPAO tumor scintigraphy using VX-2 tumors in rabbits]. AB - Tumor scintigraphy using 99mTc-hexamethyl-propyleneamine oxime (99mTc-HMPAO) was performed in VX-2 tumors implanted in the muscles of the lower limbs of rabbits to evaluate the possibility that this agent could be used to estimate the blood perfusion of the tumor. The distribution of 99mTc-HMPAO in the tumor immediately after the intravenous injection of this radiopharmaceutical exhibited almost the same distribution on the static image 1 hour after administration. Tumor time activity curve for 99mTc-HMPAO revealed initial peak after the injection followed by fading of 99mTc-HMPAO activity and subsequent gradual decrease in activity over the next 1 hour. The ratio of 99mTc-HMPAO activity in the tumor to that in normal muscle tissue during this next 1 hour was high and independent of time. These findings indicate that static 99mTc-HMPAO scintigraphy can provide qualitative but not quantitative data useful in the estimation of tumor blood perfusion. Moreover, comparison of distribution of 99mTc-HMPAO on the static images and angiographic, histological findings also suggest that static 99mTc HMPAO images accurately reflect tumor blood perfusion. PMID- 1770658 TI - [Immunoscintigraphy of colorectal cancer with 111In labeled anti-CEA monoclonal antibody (ZCE-025)]. AB - Clinical trials with 111In labeled anti-CEA monoclonal antibody (ZCE-025) was initiated. Five patients with colorectal cancer suspected were given an intravenous injection of 1 mg of 111In labeled ZCE-025. Planar and SPECT images were obtained 24 and 72 hours after injection. Surgical operation was performed on all patients between 7 and 10 days post injection. Of 4 primary sites, all were clearly visualized. Intrahepatic metastasis was visualized as higher activity than normal liver in one of two patients. In one patient whose imaging was negative, no residual cancer was found at surgery. Persistent accumulation of 111In in the lymph nodes was also observed in one patient. Surgical exploration of these lymph nodes showed no gross or microscopic evidence of metastases of colon cancer. No side effects were encountered, although HAMA were detected in all 5 patients by 4 weeks after the administration of ZCE-025. Immunoscintigraphy appears useful in distinguishing recurrent tumor from postoperative granuloma. Further investigation directed to the causes of 111In accumulation in tumor-free lymph nodes is required. PMID- 1770659 TI - [A long-term follow-up study of late-onset hypothyroidism and prognosis of hyperthyroid patients treated with radioiodine]. AB - We performed a follow-up study of 7,325 cases of hyperthyroidism treated with radioiodine in Japan from 1953 to 1967. Of these cases, there were 1,892 which clearly had or had not received thyroid hormone substitution therapy. Based on this, the frequency, period of onset and background of patients of hypothyroidism were investigated. There was a high incidence of cases among women in their thirties who had received large doses of radioiodine. Also, consistent with previous reports, a continuous, long-term increase in hypothyroidism was recognized. There is a need to investigate the course of the disease more thoroughly. The outbreak of thyroid tumors was also investigated. No clear increase in the incidence of tumors was seen in cases that had received radioiodine therapy. An evaluation of prognosis was made to establish the anticipated mortality rate using the mortality rate of the population at large as a base for comparison. In the 2,379 cases in which there was an effective response, no significant increase in either mortality or cancer mortality was recognized in the group that received radioiodine therapy. Nor was there an increase in the mortality rate among the younger patients in the treated group. Although there was a tendency for the overall mortality to increase when large quantities of radioiodine were prescribed. There is, however, some uncertainty as to whether or not there is a direct relationship to hypothyroidism. From this standpoint, rigorous observation during the course of treatment is important as well as commencement of appropriate substitution therapy. PMID- 1770660 TI - [Prognostic significance of radionuclide-assessed right ventricular function in dilated cardiomyopathy]. AB - To assess the prognostic significance of right ventricular function in dilated cardiomyopathy (DCM), we studied consecutive 57 DCM patients. There were 41 men and 16 women, whose mean age was 48 ys. (range 3-68 ys.). The mean LVEF in all patients was 29 +/- 11%, and the mean interval from the onset of symptom of cardiac failure (CHF history) was 4 ys. (range 0-33 ys.). With follow-up of 3.8 ys., five patients had died until the first year, and 14 had died until the third year. By using multivariate regression analysis, there were no prognostic significance in clinical parameters such as age, CHF history, sex, atrial fibrillation, except for NYHA class, and medication at the third year. In survival curves according to Kaplan-Meier method, RVEF and mean PA had predictive value (p less than 0.05), while LVEF did not. The patients with RVEF less than 45% had poor survival rate compared to those with RVEF greater than or equal to 45%. The patients with RVEF less than 45% showed lower LVEF and LVESVI. RVEF may offer prognostic predictive value through the effect of not only mean PA but also left ventricular parameter. In conclusion, radionuclide assessment of right ventricular function should be valuable for the prognostic evaluation of DCM patients. PMID- 1770661 TI - [Value of fatty acid imaging using 123I-beta-methyl iodophenyl pentadecanoic acid (BMIPP) to assess viability of infarcted myocardium]. AB - To evaluate clinical value of a new fatty acid imaging tracer, 123I-beta-methyl iodophenyl pentadecanoic acid (BMIPP), 27 patients with myocardial infarction (MI) underwent BMIPP imaging at rest. The results were compared with those of thallium-201 imaging and contrast ventriculography. Of 100 hypoperfused segments on thallium-201 imaging, 34 segments (34%) showed lower BMIPP uptake than thallium-201, and remaining 66 segments showed similar distribution of those tracers. This discrepancy was more often observed in a patients with acute or subacute stages of MI (less than 4 weeks from onset) than those with chronic stage of MI (greater than 4 weeks) (75% vs. 47%; p less than 0.005). In addition, in the patients with chronic stage of MI, the regional wall motion abnormality was less severe in those showing discrepant BMIPP uptake than those showing concordant distribution (the wall motion score: 1.33 +/- 0.62 vs. 0.63 +/- 0.99; p less than 0.05). Furthermore, redistribution on stress thallium-201 imaging was more often observed in than those showing concordant distribution (12%) than those showing concordant distribution (12%) (p less than 0.005). These preliminary study indicates that discrepant distribution of BMIPP and thallium 201 may be often observed, particularly in recent MI and those showing less wall motion abnormality and redistribution on stress thallium-201 imaging. Thus, the combined study of BMIPP and thallium-201 has a potential for assessing tissue viability in patients with MI. PMID- 1770662 TI - [Bone scan "flare" in patients irradiated to formerly false negative bone metastasis]. AB - We discuss three cases irradiated to their bone metastases. 99mTc-MDP bone scan before irradiation showed normal uptake in the lesions. In all the cases, the irradiation therapy was effective, but focal increased uptake area corresponding to the site of bone metastasis was revealed by the follow-up bone scan one to three months after irradiation. We concluded that the change of tracer uptake was so-called flare in formerly false negative lesion. The cause of this phenomenon was considered either elevation of osteoblastic activity with control of tumor or progression of osteolysis until tumor got well-controlled. PMID- 1770663 TI - [Evaluation of non-circular orbit in thallium-201 myocardial SPECT]. PMID- 1770664 TI - Comparative histopathological study of free-running mode and continuous wave Nd:YAG laser photocoagulation of monkey retina and choroid. AB - The effects of free-running mode (FRM) or continuous wave (CW) Nd:YAG laser application on the retina and choroid of 12 monkeys were examined periodically up to 24 months by light and electron microscopes. FRM Nd:YAG laser produced severe choroidal hemorrhage even in mild burns, because of the extensive coagulation of melanocytes at the center of the burned lesion. The rupture of Bruch's membrane did not depend on the power of the laser. On the other hand, CW Nd:YAG laser rarely produced subretinal hemorrhage through the rupture of Bruch's membrane in the medium-grade and severe burns. However, choroidal hemorrhage was seen histologically even in mild CW burned lesions. In the healing stage of mild FRM burned lesions the retinal pigment epithelium (RPE) and choroidal fibroblasts showed different repair processes. FRM medium-grade burned lesions showed the proliferation of Muller cells, while CW burns showed the regeneration and proliferation of RPE, Muller cells and fibroblasts. Because of the difference in the repair processes evoked by these two modes of laser application, these findings suggest that CW Nd:YAG laser is preferable for the treatment of subretinal and choroidal disorders. PMID- 1770665 TI - Clinical correlation of mitochondrial DNA heteroplasmy and Leber's hereditary optic neuropathy. AB - Mitochondrial DNA (mtDNA) was studied in a Japanese family with two male siblings who were affected with Leber's hereditary optic neuropathy. The polymerase chain reaction (PCR) products of blood mtDNA from the affected siblings, the obligate carrier mother and a possible carrier sister showed abnormal restriction sites for endonucleases SfaNI and Mae III that were compatible with the Wallace mutation at nucleotide position 11,778 base pair of mtDNA, whereas PCR products from the father and controls had normal restriction sites. In addition to the mutant mtDNA, these family members had normal mtDNA that was revealed more obviously in Mae III-digested samples, indicating heteroplasmy consisting of a mixture of mutant and normal mtDNA. The affected siblings showed a marked difference in visual outcome during the 6-year follow-up, and the severity of optic nerve involvement appeared to be correlated with the relative proportion of mutant mtDNA. PMID- 1770666 TI - Changes in causes of visual handicaps in Tokyo. AB - Newly registered visually handicapped patients at the Tokyo Metropolitan Rehabilitation Center for the Physically and Mentally Handicapped were studied in 1968 (when the facility was opened), 1978, and 1988. Examinations were carried out by the same physicians and diagnoses were made by uniform criteria. Since approximately 10% of the total population of Japan lives in Tokyo, the statistics on the causes of visual handicaps in this area deserve to be reported. The changes observed over the past twenty years are as follows: There were few changes in the percentages of high myopia, retinal degeneration and senile cataract. The percentages of corneal opacity, retinopathy of prematurity, congenital cataract and optic atrophy decreased, while those of diabetic retinopathy, glaucoma and retinal macular degeneration increased. Advances in medical treatment and the shift into an aging society in Japan are responsible for these changes observed. PMID- 1770667 TI - Subjective detection of visual field defects using home TV set. AB - The usefulness of the noise-field spontaneously generated on a home television screen for subjective perception of visual field defects was studied in 196 eyes of ocular hypertensive or normal subjects, 166 eyes with primary open angle glaucoma and 124 eyes with low-tension glaucoma. All subjects had never perceived their field defects. In 290 glaucoma eyes, including 71 eyes of early glaucoma, 265 eyes (91.4%) could perceive abnormality of the noise-field which corresponded to visual field defects confirmed by static perimetry. In 6 normal eyes abnormality of the noise-field was perceived at the blind spot. The sensitivity and specificity of the test was 91% and 97%, respectively. The time required for testing one eye was 3-5 seconds. The results indicate that the Noise-Field Test using a home television set can be an excellent method for subjective perception of visual field defects, and can also be used for glaucoma screening. PMID- 1770668 TI - Effect of silicone oil on ocular tissues. AB - The effect of silicone oil on ocular tissues was investigated histopathologically in rabbit eyes by injecting silicone oil into the anterior chamber or the vitreous cavity after vitrectomy. The eyes were enucleated 3, 6, 9, 12 or 18 months after the injection and various tissues were observed by light and electron microscopy. Silicone oil was first observed in the retrocorneal membrane at 18 months after the injection. In the trabecular meshwork silicone oil was seen for the first time at 12 months after injection. Migrating cells engulfing silicone oil attached to the internal limiting membrane of the retina 3 months after the injection. Twelve and 18 months after the injection, silicone oil passed through the internal limiting membrane and was engulfed by Muller cells. These results indicate that attention should be paid to the effects of silicone oil on ocular tissues when it remains in the eye for a long time since, after a certain period, cells of the trabecular meshwork and retina may engulf silicone oil. PMID- 1770669 TI - Prognosis of orbital rhabdomyosarcoma in children in Japan. AB - Retrospective studies were made of patients with orbital rhabdomyosarcoma (RMS) who were registered in the Japan Children's Cancer Registry and the National Registry of Ocular Tumors in Japan during 1974-1989. Thirty-five children under 15 years of age were registered as orbital RMS patients. The median age of onset was 5 years and 2 months; lid swelling was the most frequent initial symptom and finding. Histologically, 79% were classified as the embryonal type. Orbital exenteration was the standard treatment until the mid-1970's, but all the 5 patients who had only surgical therapy experienced relapses. Since the mid 1970's, a combined regimen of surgery, radiation and chemotherapy has been used. Chemotherapy has recently been considered to play the most important role in this combined therapy. Among the 35 patients studied, three patients with only biopsy as the surgical procedure have had no relapses up to the present time. Recurrent tumors developed in 15 of the remaining 32 patients: 7 of those were local, 8 were distant. All relapses (10 of the 14 patients in the 1970's, and 5 of the 18 in the 1980's) occurred within 1 year and 11 months after initial treatment. The 3-year survival rate of these 32 patients, estimated by the Kaplan-Meier method, was 70% (52% in the 1970's, 86% in the 1980's). PMID- 1770670 TI - Presumed drusen of optic nerve head in siblings with Usher syndrome. AB - Two siblings with Usher syndrome had optic disc mulberry tumors that were photographically documented over a 5-year period. During this period, growth of these tumors was demonstrated. These lesions were reported histologically to be drusen. The existence of presumed optic disc drusen in siblings with Usher syndrome may be related to similar pathogenetic mechanisms rather than genetic implications. PMID- 1770671 TI - Correlation between progression of diabetic retinopathy and blood glucose control. AB - The relationship between the progression of diabetic retinopathy and consecutive blood glucose control evaluated by glycosylated hemoglobin (HbA1) values was statistically analyzed based on 422 eyes of 211 diabetic subjects who were followed up 2 years or more. The Cox regression model (proportional hazard model) with HbA1, as a time-dependent covariate was applied in the analysis. The cumulative effect and the relative risk of HbA1 affecting the progression of diabetic retinopathy was estimated. The effect of the moving average of HbA1 values for the previous 1-30 months on the progression of retinopathy was assessed to investigate the cumulative effect of HbA1. The cumulative effect of HbA1 on the progression of diabetic retinopathy was significant when the time span of the moving average was 6 months or more than 6 months. The moving average of HbA1 value for 7 months was most relevant to the retinopathy progression. The relative risk corresponding to the increase in the moving average of HbA1 values for 6 months by 1, 2 or 3% was 1.18, 1.39 or 1.63, respectively. When the HbA1 level was adjusted to its average value in the subjects (9.6%), the estimated cumulative retinopathy progression rate for 6, 12, 18 or 24 month follow-up was 3.6, 14.5, 22.5 or 30.5%, respectively. The differences in the cumulative retinopathy progression rate between a well-controlled group with a low moving average of HbA1 value (3% lower than the average) and a poorly-controlled group with a high moving average of HbA1 value (3% higher than the average) were estimated as 3% (6-month follow-up) and 23% (24 months). PMID- 1770672 TI - Inhibition in rat of development of in utero galactose-induced cataract by an aldose reductase inhibitor--a light microscopic study. AB - Aldose reductase inhibitors (ARIs) have been known to be effective in preventing galactose cataract by blocking the polyol pathway. Because the rat congenital galactose cataract is also induced by accumulated polyol, the effect of an ARI in the induction of congenital galactose cataract was investigated. Pregnant rats were placed on a 30% galactose diet. On fetal day 16, 17, 18 or 20, the fetal lenses were examined by light microscope. Lenses from newborn rats with mothers fed galactose diet until gestational day 16, 17, 18 or 20 and then given a galactose diet containing ARI were also examined. The fetal lenses obtained from galactose-fed mother rats on day 16 of gestation were morphologically similar to those of controls. On day 17, the experimental lenses displayed vacuolated areas. The lenses of newborn rats with mothers given an ARI diet after gestational day 16 showed no morphological changes, while a few small vacuoles were observed in the lens of rats with mothers given the ARI diet after day 17, 18 or 20 of gestation. ARI inhibited the rat congenital galactose cataract even when the drug was given to the mother rat during a late stage of pregnancy. PMID- 1770673 TI - Optic tract syndrome with relative afferent pupillary defect. AB - Two cases are reported of optic tract lesions with complete homonymous hemianopia, characteristic optic atrophy and retinal nerve fiber bundle defect, and relative afferent pupillary defect (RAPD). RAPD was 0.6 log units in both cases. Infrared pupillography revealed pupillary light response of the ipsilateral side to be 1.2 or 1.3 times higher than that of the contralateral side. We confirmed that the detection of RAPD is helpful in differentiating optic tract lesions from suprageniculate lesions in cases of complete homonymous hemianopia. PMID- 1770674 TI - Lysosomal acid hydrolases in vitreous fluid of patients with proliferative diabetic retinopathy. AB - Using a new method to collect vitreous fluid safely during vitrectomy, vitreous specimens were obtained from 18 eyes of diabetic patients with proliferative diabetic retinopathy (PDR) and from 14 eyes of nondiabetic patients. The activities of four lysosomal acid hydrolases in these samples were measured and compared with those in serum. Of these enzymes, only N-acetyl-beta glucosaminidase (NAG), a suspected retinal angiogenic factor, showed higher activity in the vitreous than in the serum in both diabetic (P less than 0.005) and nondiabetic eyes (P less than 0.05). However, no significant difference was found in any enzyme activity between diabetic and nondiabetic samples. These results suggested that this enzyme apparently does not have a significant effect, at least on the pathologic condition, during the late stage of PDR, and that NAG is usually present at higher activity in the vitreous than in the serum of diabetic as well as nondiabetic patients. PMID- 1770675 TI - Behcet's disease in Brazil--a review of 49 cases with emphasis on ophthalmic manifestations. AB - At the Uveitis Clinic of the Department of Ophthalmology of the Escola Paulista de Medicina, Sao Paulo, Brazil, Behcet's disease was diagnosed in 49 patients, representing 2.0% of the total uveitis cases attended during the 16-year period from February 1974 to June 1990. Of these, 71% were men. The age of onset of the disease was between 9 and 61 years, with a mean of 29.6 years. The ethnic distribution was the following: 76% Caucasian, 14% darkly pigmented, 8% Mongoloid and 2% Negroid. HLA-B5 was found in 45.5% of the 11 Caucasian patients typed. In 34.5% of the cases, the ocular attack was the initial manifestation, alone or associated with other symptoms. Oral aphthae were recorded in 98% of the patients, genital ulcers in 55.1%, and skin lesions in 51%. Joint involvement was present in 44.9%, neurologic symptoms were evidenced in 3 patients, and 2 patients had major vascular involvement. The mean interval between the first manifestation of the disease and the onset of ocular involvement was 3.1 years, with a range of 4 months to 14 years. The interval between affections of both eyes ranged from 0 to 2 years; in 38.4% of the cases it occurred within one month. Anterior and posterior segment involvement was seen in 85.7% of the patients. Hypopyon was observed in 34.7% of the cases. Seven patients did not present iridocyclitis at any time in the course of their disease. We did not see any cases with only anterior segment involvement.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770676 TI - Altered permeability of iris vessels following posterior chamber lens implantation: an electron microscopic study. AB - Altered permeability of the iris vessels of monkey eyes following extra-capsular cataract extraction and posterior chamber intraocular lens implantation was studied by transmission electron microscopy using horseradish peroxidase (HRP) as a tracer. In control animals, HRP-reaction products were confined to the vascular lumens and to a small number of vesicles on the luminal side of the endothelial cells. In experimental animals, however, the interendothelial junctions of the iris vessels were filled with HRP-reaction products, and the endothelial cells of the iris vessels contained a large number of HRP-labeled plasmalemmal vesicles that opened into the basal lamina. HRP-reaction products were also found in the surrounding iris stroma of these experimental animals. PMID- 1770677 TI - Ultrastructural study of adsorbed protein on extracted intraocular lenses. AB - A comparative study was made of 33 explanted intraocular lenses (IOL) by stereomicroscope, light microscope, phase-contrast microscope, scanning electron microscope and transmission electron microscope. The materials of the extracted lenses were polymethylmethacrylate (PMMA), silicone, polyhydroxyethylmethacrylate (PHEMA) and coated PMMA. The implanted period varied between 3 days and 88 months. An ultrathin membrane-like structure composed of fine, granular material, 0.01 to 0.08 microns thick, that covered the entire explanted IOL surface was observed regardless of the implant period and kind of IOL. The structure was determined to be a layer of adsorbed protein since it showed a positive reaction to protein stainings such as Ponceau 3R, nigrosine or ruthenium red. No membranous structure or cellular deposit could be seen on the surface of the unused PMMA IOL which served as a control. PMID- 1770678 TI - Floating cells in anterior chamber after IOL implantation. AB - Following planned extracapsular cataract extraction (PECCE) and posterior chamber lens implantation in rabbit eyes, aqueous humor samples were aspirated on the 3rd and 7th postoperative days and examined by transmission electron microscopy. The controls were cells from the aqueous humor of eyes which underwent only PECCE. Six different types of cells, namely, erythrocytes (including ghost erythrocytes), polymorphonuclear leukocytes, macrophages, lymphocytes, eosinocytes and plasmacytes, were observed in the aqueous samples, the following results were obtained. 1) In one control eye there was no significant difference in the ratio of macrophages between the 3rd and the 7th postoperative days. 2) On the 3rd postoperative day there was a significant increase in the macrophage ratio between one IOL implanted eye and one control eye (P less than 0.1). 3) On the 7th postoperative day there was a marked increase in one IOL implanted eye in the frequency of macrophages compared to the 3rd postoperative day of the same eye and the 7th postoperative day of one control eye. It was concluded that the macrophages had a close relationship with a specific cellular response to IOL implantation. PMID- 1770679 TI - [A clinicopathological study of thymomas, with special reference to evaluation of malignant grade by morphometric analysis]. AB - To determine the factors influencing the extent and recurrence of thymoma, 31 cases of thymoma who had undergone complete resection were analyzed clinicopathologically with special reference to the nuclear area of epithelial cells. The mean tumor size and incidence of recurrence of stage III thymomas were significantly larger and higher than those of stage I thymomas. The nuclear area of epithelial cells of stage III thymomas (72.9 +/- 29.2 micron 2) was significantly larger than that of stage I thymomas (48.4 +/- 13.2 micron 2) or stage II thymomas (49.4 +/- 11.6 micron 2). The nuclear area of thymomas with recurrence (70.2 +/- 21.5 micron 2) was significantly larger than that of those without recurrence (50.2 +/- 12.8 micron 2). In 16 cases who were followed up for 5 years or more, the nuclear areas were over 50 micron 2 in all thymomas with recurrence, while in 8 of 11 thymomas without recurrence it was under 50 microns 2. These results indicated that the tumor size and nuclear area increased step wisely in association with the advance of clinical stage and that the incidence of recurrence was related to not only clinical stage but also nuclear area. Thymomas with large nuclear area (over 50 microns 2) are considered to be a high risk group of recurrence and should be carefully followed up. PMID- 1770680 TI - [A study on interleukin 2 and soluble interleukin 2 receptor in serum and bronchoalveolar lavage fluid from patients with farmer's lung]. AB - Interleukin 2 (IL-2) and soluble Interleukin 2 receptor (IL-2R) were assayed in serum and bronchoalveolar lavage fluid (BALF) from patients with farmer's lung. Patients with farmer's lung had significantly higher levels of soluble IL-2R in serum and BALF than normal controls. The level of soluble IL-2R was correlated with the disease activity, and fell to within the normal range after successful treatment with corticosteroids. On the other hand, asymptomatic dairy farmers with precipitating antibodies against Micropolyspora faeni antigen or Thermoactinomyces vulgaris antigen had the same levels of soluble IL-2R in their serum and BALF as normal controls. IL-2 levels in serum and BALF were significantly higher in patients with farmer's lung than in normal controls; however, asymptomatic patients had low levels comparable to those of normal controls. These results indicate that soluble IL-2R could be a sensitive parameter for evaluation of the activity of this disease. It is also suggested that the IL-2/IL-2R system is important in the pathogenesis of hypersensitivity pneumonitis. PMID- 1770681 TI - [CT findings in panacinar emphysema]. AB - We analyzed the CT images (in vivo) of 5 lobes (right middle lobe, 1; left lower lobe, 1; right lower lobe, 3) with panacinar emphysema (PAE) obtained at autopsy or thoracotomy for solitary lung tumor. The lobes were inflation-fixed by the method of Heitzman and sliced axially for a CT-pathologic correlative study. One lobe with mild PAE had normal appearance on CT; however, the other four lobes with PAE demonstrated low-attenuation areas (LAAs) of various shapes and sizes on CT. LAAs were locally distributed on CT slices in one lobe, dominant in the inner zones in two lobes, and diffuse in one lobe. Relatively normal to diminished vasculature was observed within the LAAs of four lobes. These CT findings differed significantly from those of centriacinar emphysema (CAE) as reported in other studies. We conclude that CT is useful in the clinical diagnosis of PAE and its differentiation from CAE. PMID- 1770682 TI - [Characterization of childhood onset asthma in the adult asthmatic population]. AB - Adult asthma is composed of two groups; childhood type in which asthma begins in childhood, and adult type which starts in adult life. To characterize childhood onset asthma in the adult asthmatic population, we selected 171 patients with asthma who were treated at Hokkaido University Hospital and examined the time of onset, atopic factors (family history of asthma, skin tests, IgE (RIST, RAST], eosinophil counts, and clinical severity. We then compared these factors between childhood type and adult type. Thirty-three patients out of 171 (19.3%) developed asthma during childhood, mostly before the age of 5. The age of onset in the rest of the 138 patients was equally distributed from 20 to 60 years. Asthma rarely begun between 10 and 15 years. In childhood type, 15 of 33 patients (45%) had continuous symptoms from childhood, and 18 of 33 patients (55%) experienced remission of their asthma and recurrence at an adult age. The group with childhood-type asthma was younger than that with adult-type asthma (32.5 +/- 13.9 (SD) and 49.7 +/- 14.2 years (mean +/- SD), respectively, p less than 0.001). There were no significant differences in atopic factors except for a higher incidence of positive skin reaction and high IgE (RAST) score in childhood type than in adult type. Steroid dependent asthma was less frequent in childhood type than in adult type (10.5% and 37.7%, respectively, p less than 0.01). These results suggest that patients with childhood type are younger and have asthma of milder severity, and it is easier to determine specific antigens in childhood type than in adult type.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770683 TI - [Clinical study of respiratory infections complicating bronchial asthma]. AB - We conducted a clinical study on respiratory infections complicating bronchial asthma. Transtracheal aspiration (TTA) was performed 37 times in 22 patients. The most frequently isolated organism was H. influenzae. The patients in whom organisms were isolated on TTA had a high incidence of fever and evidence of inflammation. Antimicrobial therapy caused a decrease in indices of inflammation (white blood cell count and ESR), but was less effective against the asthmatic symptoms. Respiratory infection may play a complex role in the clinical picture of bronchial asthma. PMID- 1770684 TI - [Pulmonary epithelial permeability in normal subjects and patients with idiopathic interstitial pneumonia]. AB - 99mTc-DTPA is a low molecular weight substance which is believed to pass through the pulmonary epithelium when it is inhaled as an aerosol. We performed 99mTc DTPA inhalation studies in 10 nonsmoking normal subjects and 10 patients with biopsy proven idiopathic interstitial pneumonia prior to therapy. 99mTc-DTPA aerosol was inhaled for 3 min with the subject in the supine position and radioactivity was measured anteriorly with a gamma camera and recorded on a computer. Measurements were performed for 3 min with the subject inhaling aerosol and for the subsequent 30 min with the subject in the same position. Time activity curves from the five regions of interest (ROIs) including the entire left lung, the entire right lung, and the upper, middle and lower third of the right lung were separately fitted to a single exponential function for the initial 7 min following cessation of inhalation, and the respective clearance half life (t1/2) in min was calculated. Lung function data, arterial blood gas tensions and blood chemistry were also obtained for comparison with the t1/2 values. The t1/2 values were significantly smaller in all ROIs in patients with idiopathic interstitial pneumonia than in normal subjects, indicating a increased pulmonary epithelial permeability in these patients. There was no relationship between t1/2 and %DLco, %DLco/VA, PaO2, or LDH. Although the true pathophysiologic significance of t1/2 measured using 99mTc-DTPA aerosol is still not known, we consider that this measurement may be an important indicator of nonrespiratory lung function, in particular the degree of alveolar epithelial damage. PMID- 1770685 TI - [Clinical application of subtraction CT imaging for evaluation of pulmonary vascular permeability]. AB - In this clinical study, one normal subject, one patient with primary interstitial pneumonia, one patient with segmental pneumonia due to Staphylococcus aureus, one patient with post-operative esophageal carcinoma, and two patients with mitral stenosis were studied. Dynamic CT scan images under continuous injection of low osmotic contrast medium were analyzed in series, in an attempt to evaluate vascular permeability quantitatively. The following results were obtained: 1) Subtraction CT scan image 10 minutes after the start of contrast medium injection in two patients with pneumonia, showed a reduction of pulmonary vascular permeability following therapy. 2) Subtraction CT scan image of the patient with post-operative esophageal carcinoma treated with 25 Gy radiation showed a discrepancy between pulmonary vascular permeability and other findings. 3) In hemodynamically stable patients with mitral stenosis, subtraction CT images demonstrated that pulmonary vascular permeability was not affected by pulmonary congestion, irrespective of its severity. PMID- 1770686 TI - [A case of severe summer-type hypersensitivity pneumonitis treated with high-dose administration of steroid]. AB - A 40-year-old man who lived in a wooden house built 30 years ago presented with complaints of fever, dry cough and dyspnea. Chest X-ray findings showed interstitial shadows throughout bilateral lung fields. After admission, high-dose administration of 3000 mg of methylprednisolone was performed because of deterioration of chest X-ray shadows and symptoms. In a week, clinical data and symptoms improved. Findings of BAL fluid on admission revealed a relative increase of lymphocytes, neutrophils and mast cells, and pathological findings of transbronchial lung biopsy revealed non-caseous granulation and alveolitis. Precipitating antibodies and indirect fluorescent antibodies against Trichosporon cutaneum and Cryptococcus neoformans had positive reactions and T. cutaneum was isolated and identified from the patient's house. A diagnosis of summer-type hypersensitivity pneumonitis was made according to the criteria advocated by Ando et al. This seemed to be a rare case of summer-type hypersensitivity pneumonitis prolonged after isolation from his normal living environment, successfully treated by high-dose administration of steroid. PMID- 1770687 TI - [A case of leiomyoma of the trachea]. AB - An asymptomatic 59-year-old male in whom an abnormal shadow was detected on indirect chest X-ray film, was referred to our hospital for further examination. Further examinations revealed no problem at the previously checked site. However, bronchoscopy revealed a protruding hemispheric lesion on the membranous portion of the trachea 2 cm above the carina. The biopsy specimens revealed that the lesion was leiomyoma of the trachea. Transbronchoscopic biopsy was performed three times and the lesion disappeared. A few small fibrous nodules remained. The incidence of this primary tracheal tumor is rare, and benign lesions are much less common than malignant lesions. Furthermore, leiomyoma of the trachea is extremely rare. Only 20 cases have been reported in Japanese and English literature. The average age of the reported cases, including our case, was 49.3 years old. Among the male patients, most cases were around 50 years old but among female patients, there was no standard age for this disease. Clinical symptoms included coughing, dyspnea, wheezing and bloody sputum. There were several patients with severe dyspnea, two of which died. Ten patients (50%) had been misdiagnosed as having bronchial asthma. If a case is suspected to be bronchial asthma in which and where bronchodilators have little effect, we must always consider the possibility of this type of lesion, and perform further examinations and treatment. PMID- 1770688 TI - [A case of diphenylhydantoin-induced pneumonitis]. AB - A 60-year-old man had been administered diphenylhydantoin (DPH) for prevention of convulsive seizures following clipping of an aneurysm of the middle cerebral artery. About one month after the commencement of DPH administration, he developed cough and low grade fever. He was treated with various antibiotics, but his condition increasingly worsened. Chest X-ray film revealed bilateral interstitial processes throughout the entire lung fields. Transbronchial lung biopsy was performed and the obtained specimen showed histological findings compatible with drug-induced pneumonitis. Administration of DPH was stopped immediately and 50 mg/day of prednisolone was started. The patient's condition rapidly improved, and the abnormal shadows on chest X-ray film gradually diminished. The lymphocyte stimulation test by DPH was positive with a stimulation index of 282%. PMID- 1770689 TI - [A case of neurofibromatosis 2 combined with a vagal neurilemmoma in the mediastinum]. AB - A 39-year-old man was referred to our hospital for further evaluation of an abnormal mediastinal shadow on chest X-ray film. CT scan of the chest showed a cyst-like tumor in the mediastinum. CT scan of the brain to investigate the impairment of hearing revealed bilateral cerebropontine angle tumors. Histological examination of both tumors revealed neurilemmoma. Neurofibromatosis 2 combined with a vagal neurilemmoma in the mediastinum is very rare. PMID- 1770690 TI - [Case report of multiple myeloma associated with diffuse pulmonary calcinosis]. AB - A case of multiple myeloma with diffuse metastatic calcinosis of the lung is presented. The patient was a 60-year-old male with IgA-kappa-myeloma who developed renal failure and hypercalcemia. Multiple small nodular shadows were observed both in plain chest films and CT films. The patient died of progressive respiratory failure. Postmortem examinations showed pulmonary infiltrations and massive pulmonary calcifications. Small nodular shadows were due to diffuse calcium deposits which were observed in and around the alveolar basement membranes of both the bronchioles and the blood vessels. It is generally believed that pulmonary calcinosis may not be detected by routine chest films; however, the nodular shadows observed in our patient seem to be pathognomonic and may indicate the severity of calcinosis. PMID- 1770691 TI - [A case of rush dust (IGUSA-SENDO) pneumoconiosis with a large conglomerate mass shadow]. AB - A 61-year-old woman, who had engaged in "tatami" mat production for 20 years, showed a gradually increasing large conglomerate mass shadow associated with small irregular opacities on chest X-ray film. Transbronchial lung biopsy revealed findings consistent with pneumoconiosis, with no suggestion of pulmonary tuberculosis or lung cancer. After 6 years' observation, right upper lobectomy was performed because the mass shadow was still increasing in size. Histological examination revealed a well-defined large mass composed of numerous macrophages containing abundant silicate minerals and fibroblasts proliferating in storiform fashion. No evidence of tuberculosis or malignancy has ever been detected. These findings are compatible with the previously reported pathological findings of "IGUSA-SENDO" pneumoconiosis; however, PR4 type "IGUSA-SENDO" pneumoconiosis has never been previously reported. This is the first reported case of PR4 type "IGUSA-SENDO" pneumoconiosis. PMID- 1770692 TI - [A case of sustained-release theophylline (Theodur)-induced asthma]. AB - Theophylline is used as a prophylactic agent for controlling bronchospasm in patients with asthma. Sustained-release theophylline (Theodur) is widely used for this purpose. In this report, we describe a patient who developed asthma due to administration of Theodur. A 38-year-old man was referred to our hospital for assessment of the relationship between his respiratory symptoms and theophylline. He had been admitted to the hospital several times for dyspneic attacks. Theophylline ethylenediamine (Aminophylline) and hydrocortisone sodium succinate had been administered intravenously for the acute phase, followed by Theodur orally. Following administration of Theodur, he had developed dyspnea, chest tightness and dizziness. An inhalation challenge test with sulpyline showed a negative reaction. Although an oral challenge test with theophylline also showed a negative reaction, that with Theodur evoked an asthmatic response. We were unable to determined any possible cause or the mechanism for this reaction. We concluded that the vehicle or preservative (i.e., inactive ingredients) contained in Theodur were likely to be related to his asthmatic response. PMID- 1770693 TI - [A case of Legionnaires' disease cured with a combination of erythromycin and steroid therapy]. AB - A 53-year-old male was admitted to Keio University Hospital with a pneumonia shadow in the left lung field and respiratory failure. Because there was progression of respiratory failure, mechanical ventilation was required to maintain appropriate oxygenation. Although erythromycin administration was started at the time of admission, a steroid (prednisolone 60 mg/day) was added a few days later to temporarily inhibit the acute inflammatory response in the lung parenchyma. This intensive therapy resulted in resolution of the patient's pneumonia and improvement of his respiratory failure. No pathogens were detected in the clinical specimens. Indirect immunofluorescence examination demonstrated a marked increase in titers against Legionella pneumophila serogroup 1, which was sufficient to confirm a diagnosis of Legionnaires' disease. The causative organism of this disease, a gram-negative short rod, is rarely cultured on conventional culture media. Two clinical subtypes are known based on clinical manifestations: 1) the Pontiac fever-type in which the predominant symptom is fever alone; and 2) the pneumonia-type which was observed in the epidemic in Philadelphia when the disease was first reported in 1976. The present case of Legionnaires' disease was the severe pneumonia-type which was successfully treated with a combination of erythromycin and a steroid. PMID- 1770694 TI - [A case report of invasive thymoma presenting as a solitary metastatic lesion of the lung]. AB - A 66-year-old woman visited our hospital for further investigation of a coin shaped lesion in the right lower lung field. After admission, CT-scan revealed an anterior mediastinal tumor. Thymoma and lung metastasis from thymoma were suspected. At thoracotomy, an invasive thymoma involving the left phrenic nerve, the left upper lobe, and the pericardium was found, and the diagnosis of lung metastasis was made. Postoperative pathological findings showed a predominantly lymphocytic thymoma with round and oval-shaped epithelial cells, and the metastatic lung lesion revealed the same findings. Postoperative radiotherapy (4000 rads) and chemotherapy with a combination of CDDP, VDS, and CPA were administered. The metastasis of thymoma is not rare, but most often it is found after operation. In this case the diagnosis of metastatic thymoma was made pre operatively from a solitary lung lesion. PMID- 1770695 TI - [Ultrasonographic study on kidneys in patients with acute renal failure]. AB - Ultrasonotomograms of 22 kidneys were obtained in 11 patients with renal-acute renal failure (renal-ARF). The underlying diseases of renal-ARF were acute tubular necrosis in 8 patients and acute on-set chronic glomerulonephritis in 3 patients. They were treated by hemodialysis in 10 patients and intermittent peritoneal dialysis in 1 patient. Ultrasonic measurement of the size of kidneys revealed that the thickness (anterior-posterior diameter) and the ratio of thickness to length (T/L) were greater in patients with ARF than in those with chronic renal failure and normal renal function. The patients with a low value of T/L (under 0.60) had a significantly greater urine volume than those with high a value of T/L (0.60 or more). The sonographic features of renal-ARF kidneys were marked increase in parenchymal echogenicity and appearance of hypoechoic swollen renal pyramids with sharpness of the corticomedullary border. In the course of ARF, these sonographic changes gradually disappeared when the patients had recovered from ARF. However, the prognosis was poor in patients with severer sonographic findings. We believe that repeated ultrasonic examination of the kidneys in patients with renal-ARF is useful for not only differential diagnosis of post-renal urinary obstruction but evaluating the course of ARF. PMID- 1770696 TI - [Extracorporeal shock wave lithotripsy for renal and ureteral calculi with MPL 9000. Correlation between stone burden and shock wave energy]. AB - Clinical results of ESWL for renal and ureteral stone with MPL-9000 were presented. We also reviewed correlation between stone burden and shock wave energy. We studied 210 cases (295 sessions) of renal stone and 109 cases (154 sessions) of ureteral stone that were treated from November 1988 till January 1989 and from November 1989 till May 1990. Of those sessions, 76 sessions of renal stone cases and 53 of ureteral stone cases were carried out ambulatorily. Successful disintegration (within 4 mm) rate was 86% of renal stones, 84% of ureteral stones, and stone free rate after 6 months was 72% of renal stones and 84% of ureteral stones. As for the complications, brain infarction occurred in one case, subcapsular hematoma of the kidney in one, and arythmia in 5. No other severe side effects were observed. Between shock wave energy (the number of shock wave shots x voltage) and stone burden (long axis x short axis of the stone), a significant correlation was found in renal stone cases, but not in ureteral stone cases. E/B (shock wave energy/stone burden) was 33,100 (kv.shots/cm2) for the renal stone and 56,000 (kv.shots/cm2) for the ureteral stone. These results suggest that there is still another unknown factor, which is not related with renal stone, for successful disintegration of ureteral stone. We also confirmed that more energy is necessary for destruction of ureteral stone than for that of renal stone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770697 TI - [Intra-arterial cisplatin and concurrent radiation for invasive bladder cancer]. AB - Fifteen patients with invasive bladder cancer were treated with selective intra arterial cisplatin and external beam radiotherapy (30.6 Gy over 3 weeks) prior to a planned cystectomy. Cisplatin, in total 200 mg, was administered via bilateral internal iliac artery infusion during the course of radiotherapy. Seven patients were evaluated for local response. Partial response (PR) was revealed in 4, and minor response (MR) in 3. Ten patients received total cystectomy, and pathological effects by the criteria adipted by Japanese Urological Association and The Japanese Society of Pathology, were as follows: Ef. 3 in 1 case, Ef. 2 in 6. Ef. 1b in 1 and Ef. 1a in 2. Down staging was observed in 8 patients from the clinical to the pathological stage. Thirteen patients are alive for 21 months. Two patients have died (1 lung infarction, 1 pancreatic cancer). Though nausea and sciatica-like pain were observed in some cases, there was no severe systemic side effects such as bone marrow suppression and renal toxicity. From these results it is concluded that this therapeutic modality could be effective in the preoperative work-up of candidates for total cystectomy, and also that it could be useful in the treatment of patients in whom total cystectomy is contraindicated. PMID- 1770698 TI - [Serious complications of intravesical bacillus Calmette-Guerin therapy in patients with bladder cancer]. AB - Side effects and serious complications of intravesical bacillus Calmette-Guerin (BCG) therapy were reviewed in 120 patients with transitional cell carcinoma of the urinary bladder from October, 1983 to June, 1989 at Hirosaki University Hospital. As local side effects, 102 patients (85.0%) had bladder irritability with frequency and/or micturition pain, and 46 patients (38.3%) had hematopyuria. As systemic side effects, fever in 43 patients (35.8%), elevation of serum GOT, GPT in 9 patients (7.5%), and malaise in 3 patients (2.5%) were seen. Serious complications were observed in 7 patients. 4 patients had a severely contracted bladder with decreased compliance less than 50 ml, 2 patients had persistent arthritis and one patient had interstitial pneumonia. In all 4 patients with a contracted bladder partial cystectomy was performed before or after intravesical BCG therapy, and three of them received more than ten times instillation of BCG. It was suggested that contracted bladder most likely occurred after frequent BCG instillations in addition to decreased bladder compliance. Contracted bladder was irreversible in 2 patients. Histopathologically, there was marked fibrosis in the muscular layer of the bladder without tuberculous inflammatory changes. It might depend on the severity of fibrosis in the muscular layer whether contracted bladder was reversible or not. Persistent arthritis was nonspecific inflammation with negative culture results for mycobacteria in the joint fluid in 2 patients. In one patient with interstitial pneumonia, fiberoptic bronchoscopy with transbronchial lung biopsy demonstrated marked fibrosis of alveolar septums and increased lymphocyte count without tuberculous inflammatory changes. The pathogenesis of this complications is considered to be a hypersensitivity reaction to BCG. PMID- 1770699 TI - [Studies on in vitro anti-tumor activity of tumor necrosis factor alpha against human renal carcinoma cell line (KU-2)]. AB - We attempted to clarify the anti-tumor activity and its mechanism of human recombinant tumor necrosis factor alpha (rTNF alpha). The established cell line KU-2, derived from human renal cell carcinoma, was treated with rTNF alpha alone or in combination with the following anti-cancer agents in vitro: actinomycin D (ACD), vinblastine sulfate (VLB), nimustine hydrochloride (ACNU), and methotrexate (MTX). In vitro studies, including cytotoxic assay, colony forming assay and flow cytometric DNA analysis were performed. By cytotoxic assay, 21.4 +/- 4.0% and 34.8 +/- 4.7% of the cells were killed by 72 hour incubation with 100 ng/ml of rTNF alpha alone, and 1 ng/ml of ACD alone, respectively. An augmented cytotoxicity of 75.3 +/- 0.3% was observed by simultaneously adding 1 ng/ml of rTNF alpha and 1 ng/ml ACD. However, when KU-2 was treated with both 100 ng/ml of rTNF alpha and 3 micrograms/ml of ACNU or 2.5 ng/ml of MTX, no significant increase in cytotoxicity was noted. In the colony forming assay study, the colony forming efficiency (CE) of the control cultures was 31.8 +/- 8.1%. A 92.3 +/- 1.8% reduction in CE was demonstrated when 100 ng/ml of rTNF alpha was added to the cultures. No augmented effects were seen between rTNF alpha and chemotherapeutic agents in this study. In flow cytometric DNA analysis, no cell cycle specific effects of rTNF alpha were demonstrated, regardless of whether or not chemotherapeutic agents were added. These results indicate that the cytotoxic and cytostatic activities of rTNF alpha may be mediated by separate mechanisms of action and that rTNF alpha affects more markedly KU-2 cells having clonogenic potentials.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770700 TI - [Studies on anti-tumor activity of tumor necrosis factor alpha against human renal cell carcinoma cells heterotransplanted into nude mice]. AB - The anti-tumor activity of recombinant tumor necrosis factor alpha (rTNF alpha) against the renal cell carcinoma cell line KU-2 was studied in vivo, employing athymic nude mice. The nude mice were divided into six groups and each group was composed of six mice. Group I underwent no treatment, Groups II and III were injected with 5 and 10 micrograms of rTNF alpha intraperitoneally, respectively. Group IV received 5 micrograms of rTNF alpha intravenously and Groups V and VI were administered 2.5 and 5 micrograms of rTNF alpha six times, given intravenously every other day, respectively. Evaluation of the study was performed according to Battelle Colombus Laboratories Protocol. Tumor regression was defined as RW less than 1; inhibition of tumor proliferation was defined as TRW/CRW less than or equal to 42%. Other results were defined as no effect. No obvious anti-tumor activity was observed in group II and III. Though inhibition of tumor proliferation was noted in Group IV, death of two nude mice in this group was noted. When rTNF alpha was administered to the mice in Group V, complete disappearance of the heterotransplanted tumor in two nude mice and tumor regression in four were observed. No death of mice in this group occurred. When the dose of rTNF alpha was raised to 5 micrograms (Group VI), however, five mice died. The histopathological study revealed remarkable necrosis in the tumor tissue and congestion around the white pulps of the spleen 24 hours after intravenous administration of 5 micrograms of rTNF alpha, although no obvious changes were noted in the liver, kidney and digestive organs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770701 TI - [Methotrexate, vinblastine, adriamycin and cisplatin (M-VAC) in advanced urothelial cancer--analysis of efficacy and toxicity]. AB - Seventy-seven patients with advanced urothelial cancer were treated with methotrexate, vinblastine, adriamycin, and cisplatin (M-VAC). Of these 77 patients, 65 could be evaluated for response and 74 for toxicity. Response rates were 65% in the primary organs (62% in the renal pelvis and ureter, 67% in the bladder), 68% in the lymph nodes, 60% in the lung, 25% in the bone and 14% in the liver. Complete responses were noted in 11 patients (17%) and partial responses in 26 patients for an overall response rate of 57% (95% confidence limits 45 to 69%). The median durations of response were 11 months for complete response patients and 7 months for partial response patients. Of the 65 patients 20 (31%) are alive, and 1-, 2-, and 3-year survival rates were 65%, 37%, and 25%, respectively. While survival rates of responders were higher than those of nonresponders with a statistical significance until 15 months, no significant differences were observed in survival rates between these two groups in the subsequent period. The M-VAC regimen was used for 15 patients as a neoadjuvant chemotherapy. Of the 15 patients, 8 responded and primary organs were preserved in 6 of the 8 responders. Histological effects classified according to Oboshi Shimosato's criteria were G.I in 9, G.IIA in 3, G.IIB in 1, and G.IVC in 2. There were no significant differences in survival rates according to responses and histological effects. Factors related to response were analyzed with a multiple logistic regression model on 54 patients treated with intravenous administration of drugs and whose histological type was transitional cell carcinoma. The analysis results indicate that the presence of distant metastases is an important factor in predicting poor efficacy. Sixteen of 74 patients (22%) had white blood cell count of less than 1,000 cells per mm3 in the first cycle, while the decrease of platelet count was mild in degree compared with that of the white blood cell count. Patients with elevations of serum creatinine, GOT, and GPT were low in frequency, and toxic symptoms were controllable. Factors significantly related to the occurrence of side effects were sex, performance status, prior radiotherapy, prior chemotherapy, and the method of drug administration. Among these factors, prior radiotherapy was related to severe decrease of white blood cell count. While an excellent overall response rate was provided with the M-VAC regimen, disadvantages of the present regimen were low effectiveness in the bone and liver, and short duration of response.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1770702 TI - [Anatomic analysis of canine ureteral smooth muscle structure]. AB - We have investigated the structure of canine middle ureteral smooth muscle anatomically. In a transverse section inner fibers appeared to be longitudinal and outer fibers appeared to be circular. In the parallel sections with the wall of longitudinal ureteral muscle, inner and outer fibers appeared to be oblique in a mesh structure. In parallel sections with the wall of helical ureteral muscle, fibers appeared to be longitudinal. Anatomical analysis showed that canine ureteral smooth muscle is entirely composed of spinal fibers in a mesh structure and that the helical muscle strip have continuous fibers though the inner fibers have a tendency to run longitudinally and the outer fibers circularly. PMID- 1770703 TI - [Whole layer needle biopsy for evaluation of neoadjuvant therapy to invasive bladder cancer]. AB - The most important information for treatment of bladder cancer is to know its exact staging. A whole layer needle biopsy technique has been developed for this purpose. Recently, neoadjuvant therapy has been used for invasive bladder cancer. Although down staging of bladder cancer after neoadjuvant therapy are evaluated by CT or ultrasound, these imaging are not reliable. We examined 11 invasive bladder cancer patients by whole layer needle biopsy pre and post neoadjuvant therapy. All cases were pT3-4 by pretreatment biopsy. After neoadjuvant therapy 4 were changed to pT0 by needle biopsy, other cases were no change or minimal change. In 4 changed to pT0, 3 were done total or partial cyctectomy and the results of pathological diagnosis of cystectomized specimens were also pT0. Another one case changed to pT0 is selected as candidate for bladder sparing and the patient is now in close surveillance. All 4 cases changed to pT0 were done combined treatment by chemo (internal iliac artery infusion) and radiotherapy. In remaining 7 cases, pathological staging of surgical or autopsy specimen agreed with that of whole layer needle biopsy. Whole layer needle biopsy showed no severe complication, except minor bleeding from the bladder wall. Tumor seeding into the needle tract was not observed up to present time. In conclusion, this biopsy system is useful for evaluation of the change of stage with chemotherapy and/or radiation therapy. By using this technique we can select the cases for candidate of bladder sparing. PMID- 1770704 TI - [Radical surgery with pubectomy for primary male posterior urethral cancer--a case report]. AB - A 38-year-old male patient with the past history of polioencephalopathy was admitted with urinary retention and high grade fever. Although he was able to walk he had the intelligence of a 3-year-old child and his spine, thorax, fingers were deformed remarkably. Immediately after the admission, cystostomy was carried out and 600 ml of stinky and cloudy urine was noted. Although intensive antibiotic therapy was performed, high grade fever with leucocytosis (greater than 15,000/mm2) persisted for more than 10 days. Retrograde urethrogram showed stricture in the anterior urethra as well as irregular filling defect in the bulbomembranous urethra. After urethral dilation using urethral dilators, 18Fr nephrostomy balloon catheter was indwelled and the patient was discharged. However, the urethral irregular filling defect was unchanged and cytological examination of urine and urethral secretions revealed class V. After the readmission, endoscopic examination revealed papillary tumor lesions occupying the whole posterior urethra were found. With the diagnosis of invasive posterior urethral cancer, anterior exenteration by en bloc pubectomy, pelvic lymphadenectomy and ileal conduit urinary diversion were carried out. On the surgical specimen, the tumor occupied the bulbomembranous and prostatic urethra. Histopathological diagnosis was TCC G3 greater than SCC, stage B. Since the tumor invaded the serosa of the membranous urethra, we thought it could not be removed completely without the pubctomy. PMID- 1770705 TI - Clinical features of human immunodeficiency virus associated nephropathy. PMID- 1770706 TI - The nephropathology in human immunodeficiency virus (HIV-1) infection. AB - The nephropathology observed in patients with HIV infection is reviewed. A characteristic, though not specific, nephropathy associated with HIV infection can be encountered in HIV carriers, in patients with AIDS-related complex and in patients with AIDS. HIV-associated nephropathy typically exhibits the features of an aggressive form of focal and segmental glomerulosclerosis. Distinctive pathologic features include: 1) the "collapsing" and predominantly global pattern of glomerulosclerosis; 2) the severity of visceral epithelial cell hypertrophy and droplet formation; 3) the prominent tubular microcysts and cast formation; 4) the focal tubular degenerative features; and 5) the numerous tubuloreticular inclusions. PMID- 1770707 TI - Primary and secondary role of viruses in chronic renal failure. AB - Viruses may be the cause of renal disease. This effect may be direct, affecting the renal parenchyma, or may be indirect, usually through immune complex damage. The classification and potential role of viruses involved in renal damage is discussed. PMID- 1770708 TI - Worldwide perspective of hepatitis B-associated glomerulonephritis in the 80s. AB - Chronic HBsAg carriers may develop glomerulonephritis (GN). Besides membranous GN (MGN), which seems a well established association, membranoproliferative GN (MPGN) or proliferative GN are also encountered in these patients. It is clear that the variations in the incidence of hepatitis B virus (HBV) GN may be real or related to a more or less vigorous search for HBV in the different nephrologic centers. However, the frequency of HBV GN in a country correlates with the underlying prevalence of HBV infection in the general population. Geographic patterns of HBV prevalence vary greatly from areas of low endemicity where less than 1% of adults are chronic carriers to areas of intermediate and high endemicity where between 2 and 15% of adults are chronic carriers. The most important factor affecting prevalence is age of HBV infection. The probability of becoming a chronic carrier is greater following infection during infancy and early childhood. The rarity of HBV GN in the U.S. and in western Europe probably reflects the rarity of HBV infection, especially in children. The frequency of HBV GN is high in Asian or Black children. It is possible to hope that, with the extensive immunization in countries of high endemicity, the frequency of HBV GN will diminish. In the U.S. and in Europe, patients with HBV GN frequently belong to high risk groups for HBV infection. In these countries, the increase in the percentage of HBV infection due to sexual transmission or linked with drug abuse may lead to an increase in the percentage of adult patients with HBV GN. PMID- 1770709 TI - Clinical features and the natural course of hepatitis B virus-related glomerulopathy in adults. PMID- 1770710 TI - Clinical features and natural course of HBV-related glomerulopathy in children. AB - To evaluate the clinical features, immunopathology and the prognosis of hepatitis B virus-associated membranous nephropathy (HBVMN), 34 patients (25 boys and 9 girls) from April 1981 to November 1986 were studied. With Fab fragments of monoclonal antibodies, hepatitis B e antigen (HBeAg) was detected in the glomerular deposits from 30 cases (88.2%) and in the sera from 32 cases (94.1%). These results suggest that HBe Ag plays an important role in the development of HBVMN. In patients without corticosteroid treatment, HBV DNA was found as only episomal molecules with 3.2 kb in macrophage, T and B cells. The HBV cellular DNA disappeared within 12 months. In a HBVMN patient with corticosteroid treatment, even three years later, cellular HBV DNA was still detectable in T cells. They also had occasional proteinuria. From the in vitro study, we also demonstrated that corticosteroid stimulated endogenous HBsAg and HBeAg production from patient's mononuclear cells. Therefore, the use of corticosteroid could lead to a potential risk of enhancing viral replication. In addition, clinical trials of 32 cases demonstrate a relatively poor response to the steroid therapy with persistent heavy proteinuria (32.4%) or a high frequent relapse rate (38.2%); only one case (3.1%) had early response. Four cases received follow-up renal biopsy, progressive sclerosis with interstitial fibrosis being noted in each instance. The stage of membranous nephropathy in light microscope had progressed from stage I or II into III. One had impaired renal function. Therefore, HBVMN does not always take a benign course. Usage of corticosteroid in HBVMN patients should be avoided. PMID- 1770711 TI - [Injuries of the heart]. AB - The authors had 53 patients with heart injuries under observation; 52 patients were operated on for vital indications. The heart wound was sutured, the concomitant injuries to other organs were removed, and the pericardial and pleural cavities were drained. Air-tightness of the injured heart muscle was attained in all cases. Seven of the patients who were operated on died. One patient who did not undergo operation died suddenly in complete well-being from acute cardiac tamponade 2 days after injury to the chest inflicted with a pin like object. The authors emphasize the importance of organizational measures promoting earliest performance of the operation. PMID- 1770712 TI - [Catheterized balloon mitral valvuloplasty in pregnancy]. AB - Catheterized balloon mitral valvuloplasty was carried out in two females with rheumatic mitral stenosis on the 28th and 24th weeks of pregnancy. The operation on the first patient was performed at the beginning of the development of pulmonary edema. Treatment produced good results in both cases. The surface of the mitral orifice increased from 1.5 and 1.6 to 3.2 and 3.5 cm2, the pressure gradient between the left atrium and left ventricle reduced from 40 and 30 to 6 and 4 mm Hg. There was attended by disappearance of the diastolic murmur and the clinical manifestations of congestion in pulmonary circulation in both patients. Mitral regurgitation did not occur after the operation. Radioscopy lasted 20 and 33 minutes. Protective screens were used to protect the fetus from direct exposure to X-ray. Pregnancy terminated at full term by spontaneous delivery in both patients. The babies, both girls, are healthy. Catheterized balloon mitral valvuloplasty does not yield to closed mitral commissurotomy in efficacy. The mild character of injury inflicted during the operation and no need for general anesthesia make this intervention most preferable in female patients with mitral stenosis during pregnancy. PMID- 1770713 TI - [Treatment of spontaneous pneumothorax]. AB - The results of treatment of 418 patients with spontaneous pneumothorax are discussed. A total of 167 operations were carried out; they consisted in direct removal of the cause of the pneumothorax and operative pleurodesis. The complex of surgical measures included drainage of the pleural cavity, costal or apical pleurectomy, laser pleurodesis, and one-stage operation on both lungs by means of median sternotomy. Precise indications for applying each of the methods described were defined. Recurrent pneumothorax after the operative interventions was not encountered. PMID- 1770714 TI - [Direct infusion of drug mixture into the aorta in the treatment of necrotizing pancreatitis]. AB - The article analyses briefly the methods of modern treatment of destructive pancreatitis. The authors apply complex treatment the principal component of which is infusion of a drug mixture into the aorta after its direct puncture at the level of the 8th-9th thoracic vertebra. The mixture consists of procaine hydrochloride solution, heparin, morphocycline, ftorafur , diphenylhydramine hydrochloride, trimeperidine hydrochloride. Before the aorta is punctured, 100 150 ml of a procaine hydrochloride solution is injected into the paraaortic fat to block the celiac and vagus nerves and the solar plexus. In a period of 9 years 138 patients underwent such treatment. Comparative study showed that the method differed favourably from that in which intraaortic infusion of drugs and blockade of the mediastinal nerve elements were not applied. The mortality was 8.33 in the first and 27.8% in the second group. PMID- 1770715 TI - [Surgical tactics in combined lesions of the aortic arch and its thoraco abdominal segments in nonspecific aortoarteritis]. AB - Seventy-one patients with unspecific aortoarteritis and affections of the aortic arch and its thoracoabdominal segment were treated in the period between 1984 and 1989. All the examined patients had different variants of affection of the brachiocephalic arteries, in 57 (80.3%) of them there was a coexistent affection of the thoracoabdominal segment of the aorta, and in 14 (18.7%) coexistent affection of the abdominal aorta and the lower limb arteries. Operations were conducted on 56 (78.8%) patients. Reconstruction of the brachiocephalic arteries was carried out in 12 (21.4%), of the thoracoabdominal segment of the aorta and the renal arteries in 30 (53.6%), and of the abdominal aorta and lower limb arteries in 9 (16.1%) cases. Five (8.9%) patients underwent two-stage correction of the blood flow in the branches of the arch of the aorta and its thoracoabdominal segment. The clinical picture, the volume of the affection, the methods of examination, and techniques and the results of reconstructive operations are described in detail. The authors present their point of view on the performance of surgical treatment in stages in coexistent lesions differing in volume. PMID- 1770716 TI - [A surgeon's rating as objective criterion for professional competence]. AB - The authors suggest evaluation of the qualification of a general surgeon by means of an individual coefficient-rating which is determined from 2 tables: basic and working. Its value is expressed in scores and depends, on the main, on the number of operations carried out during the year. Comparison of the rating in dynamics for several years facilitates the control over the surgeon's professional background, optimal formation of the operating team, and reduction of the degree of operative risk. PMID- 1770717 TI - [Rupture of the posterior wall of the left ventricle after mitral valve prosthesis]. AB - Rupture of the posterior wall of the left ventricle after mitral valve prosthetics is a rare (0.6%) but a dangerous and death-threatening complication. Injury to the fibrous ring in the anatomically hazardous zone (at 4-5 o'clock of an imaginary clock-face) is the most frequent cause of the ruptures. Surgical correction of this complication will be successful only with the use of extracorporeal circulation and repeated cardioplegia. Preservation of the posterior cusp and subvalvular apparatus is a reliable measure preventing rupture of the posterior wall of the left ventricle. PMID- 1770718 TI - [Prevention of complications of endoscopic electric excision of benign tumors of the stomach]. AB - The authors suggest a method for endoscopic infiltration of glue under the base of a benign gastric tumor before its removal through an endoscope, for the prevention of bleeding from its seat and perforation of the organ. The method was used in removal of 116 benign tumors measuring from 0.5 to 5.0 cm in size. The results provide evidence of reliable prevention of these complications with the use of the suggested method. PMID- 1770719 TI - [Roentgenological endovascular prosthesis of the superficial femoral artery after rotor recanalization]. PMID- 1770720 TI - [Aneurysm of the vertebral artery]. PMID- 1770721 TI - [Abdominal ischemia after aorto-femoral bifurcation shunting]. PMID- 1770722 TI - [Aneurysm of the femoral vein simulating femoral hernia]. PMID- 1770723 TI - [Thoraco-abdominal injuries]. PMID- 1770724 TI - [A rare complication of intralobar pulmonary sequestration]. PMID- 1770725 TI - [Studies on gastric surgery. I. Paths in the development of gastric surgery. A short historical outline]. PMID- 1770726 TI - [Laser angioplasty]. PMID- 1770727 TI - [Methods of studying microcirculation in patients with occlusive vascular diseases of the lower extremities]. PMID- 1770728 TI - [Indications for the operation and selection of its method in bleeding gastroduodenal ulcers]. PMID- 1770729 TI - [Surgical techniques in combined operations on the coronary and brachiocephalic arteries]. AB - The author possesses some experience in surgical treatment of 34 patients with coexistent lesions of the coronary and brachiocephalic arteries. He discusses the results of one-stage operations in 11 patients with a severe clinical picture of ischemia of the heart and brain. The surgical techniques of one-stage operations is described in detail and clinical cases are reviewed. The flow of blood in the ++brachiocephalic arteries was restored before beginning extracorporeal circulation in all cases. One patient died on the 3rd postoperative day. PMID- 1770730 TI - [Simultaneous reconstructive operations in combined lesions of the coronary arteries, abdominal aorta and arteries of the lower extremities]. AB - The work deals with the results of one-stage reconstructive surgical interventions in 15 patients with affection of the coronary arteries, abdominal aorta, and lower limb arteries. All patients underwent operation for the creation of an aortocoronary shunt in combination with various types of vascular reconstructive operations, including the formation of an ascending aorta bifemoral shunt in 3 patients. The total hospital mortality was 26.7%. The authors discuss the indications and the surgical tactics of one-stage reconstructive interventions in combined affection of the coronary and peripheral arteries. PMID- 1770731 TI - [Characteristics of blood flow in the vertebral arteries in scalenus anticus syndrome]. AB - The authors studied hemodynamics in the vertebral arteries in 62 patients with the scalenus-anticus syndrome by means of radioconstrast angiography and ultrasonic angiography which produced a colour image of the vessels with calculation of the diameter and the linear and volume blood flow rate. The results of the study showed that in constriction of the subclavian artery to 60% of its diameter in the typical place, the volume blood flow rate in the vertebral arteries remained normal (184 +/- 6.9 ml/min) but reduced 1.5-2 times during the functional test. Adequate surgical correction restored normal hemodynamics, control ultrasonic angiography recorded increase of the volume blood flow rate in the vertebral values to normal values. Ultrasonic angiography provides authentic information on the character of affection of the subclavian artery in the scalenus-anticus syndrome and makes it possible to appraise the hemodynamic significance of affection of the vertebral arteries. Besides, the method allows objective evaluation of the efficacy of treatment and quantitative characteristics of hemodynamics. PMID- 1770732 TI - [Results of surgical treatment of chronic abdominal ischemia]. AB - The immediate results of surgical treatment for chronic abdominal ischemia were studied in 112 patients. The late-term results were studied in follow-up periods of 6 months to 20 years in 105 (95.5%) patients treated by operation and in 45 patients who were not operated on. In the immediate postoperative period, positive results were recorded in 104 (92.8%), no changes were found in 4 (3.6%) patients, and fatal outcomes occurred in 4 cases (3.6%). In the late-term postoperative period the results were positive in 79 (75.2%) patients, no changes were produced in 3 (2.9%), the disease recurred in 21 (20%) patients, and 2 (1.9%) patients died. Actuarial analysis showed the late-term results of surgical treatment to be higher by 40.8% in a 5-year follow-up period and by 27.7% in a 10 year follow-up period (69.93 +/- 5.8% in a 5-year period and 36.69 +/- 9.43% in a 10-year period) than in nonoperative treatment (29.16 +/- 6.75% and 8.97 +/- 4.27%, respectively) in P less than 0.01. PMID- 1770733 TI - [Cerebral blood flow after carotid-subclavian shunting]. AB - The radioisotope and rheography methods were used to study the cerebral blood flow in 12 patients in the late-term periods after formation of a carotid subclavian shunt in occlusion of the initial segments of subclavian arteries. It is shown that an intact donor common carotid artery ensures adequate supply of blood to the brain and upper extremity. PMID- 1770734 TI - [Raynaud's phenomenon]. AB - Raynaud's phenomenon is a pathological condition with a multicomponent pathogenesis characterizing the community of mechanisms of the reactivity of the terminal microvessels of the extremities in response to standard stimulation. Raynaud's phenomenon is not a nosological form. In discovering Raynaud's phenomenon, however, differential diagnosis must be conducted to recognize the disease which caused the phenomenon. The diagnosis of Raynaud's disease, which is a nosological form, can be established by the method of exclusion of all such diseases. Raynaud's syndrome in the existence of diseases which are the primary cause is merely a precise diagnostic formulation. PMID- 1770735 TI - [Computerized-tomographic arteriography--a method of diagnosis of primary and secondary tumors of the liver]. PMID- 1770736 TI - [A method of obtaining radial skin flap on a vascular-neural pedicle from the forearm]. AB - The authors examined 65 adult cadavers in which they studied vascularization of a radial skin flap of the forearm and conducted an anatomical experiment of its preparation. The vascularization boundaries were studied as well as the peculiarities of preparation of a radial skin flap of the forearm with a precise approach to a vascular-neural pedicle and maximal preservation of cutaneous branches arising from the radial artery. PMID- 1770737 TI - [Correction of insufficiency of communicating veins in varicose veins of the lower extremities]. AB - To simplify the techniques of the operation and attain a good cosmetic effect the authors suggest a new scalpel for excising the communicating veins. The method of the operation with the use of the scalpel and its results in 256 patients are described. Comparative analysis by means of modern complex diagnostic methods gives hope. The disease recurred in 3.6% of cases. The good cosmetic effect with simultaneous shortening of the hospitalization period allows the new method of epifascial communi- cant vein surgery to be recommended for application in practice. PMID- 1770738 TI - [Surgical treatment of varicose veins of the lower extremities in a polyclinic]. AB - The authors discuss the results of 40 operations carried out in the outpatient clinic for varicosity of the lower limb veins. The number of complications did not exceed that in operations performed in the inpatient clinic. The home conditions, the absence of a possible intrahospital infection, and the increased motor activity help in rapid rehabilitation of the patients. The period of working disability is significantly reduced. PMID- 1770739 TI - [Replacement of infected vascular prosthesis by the femoral vein]. AB - The article discusses restorative treatment of 12 patients with an infected prosthesis in the inguinal region after aortobifemoral, unilateral common iliofemoral, and submusculofemoral shunting. The infected segment of the prosthesis was removed 9 days to 5 weeks after the first operation by cutting it in tissues which were not involved in inflammation. The lacking segment of the shunt was replaced by the patient's femoral vein which was drawn through the infected wound. In 11 patients the wound in the inguinal region healed with maintained patency of the shunt. In 2 patients the extremity was amputated. Marked temporary venous insufficiency was encountered in one case. PMID- 1770740 TI - [Surgical treatment of chronic venous insufficiency of the lower extremities complicated by trophic ulcers]. AB - The article deals with the experience in surgical treatment of 157 patients with chronic venous insufficiency complicated by trophic ulcers of the leg. Purposeful study of the method of two-stage operative treatment of trophic ulcers of the lower extremities of venous origin was conducted. The expediency of dividing the operation into two stages is substantiated on basis of analysis of the results. One-stage operation was carried out in 77 and two-stage operation in 80 patients. In the group of patients treated by one-stage operation 7 (9.8%) had suppuration of the postoperative wounds. No suppuration of wounds was encountered in patients who were operated on in 2 stages. Among 51 patients who underwent one-stage operation 4, (7.8%) had a recurrence of the disease. A recurrence of the disease (trophic ulcer) was not revealed in 57 patients treated by two-stage operation. PMID- 1770741 TI - [Endolymphatic pressure in the evaluation of the status of peripheral lymph flow in the extremities]. AB - The functional capacity of the lymph vessels in their various pathological conditions was determined from 78 studies of the endolymphatic pressure in patients with lymphatic edema of the extremities. Four types of pressure curves were determined according to the maintenance of the contractility of the wall of the lymph vessels. It was found that marked hypertension develops in the lymphatic channel in obstruction of lymph drainage from the extremity. Endolymphatic pressure in hyperplasia of the lymph vessels and blocking of lymph drainage exceeds venous pressure several times, which confirms the competence of operation for the formation of direct lymph-vein anastomoses. PMID- 1770742 TI - [Plastic surgery of the valves of the major veins]. AB - Three variants of endovascular autovenous plasty of the valves are suggested for the treatment of patients with chronic venous insufficiency of the lower limbs due to primary or secondary incompetence of the valves of the major veins. All are based on the formation of a one-sided cusp with an inner elastic element. The author suggests criteria for appraising the efficacy of methods for plasty of venous valves. Seventy-six operations were carried out, 33 of them were combined with Linton's phlebectomy. The late-term follow-up periods are up to 10 years. The results are positive in 70 patients and no changes were found in 6 patients. No cases with thrombosis in the zone of plastic surgery were encountered. Complete or marked functioning of the valve was noted in half of the patients. Means for improving the methods of endovascular plasty of the venous valves are considered. PMID- 1770743 TI - [Evaluation of severity of ischemia after injuries of the major arteries of the extremity]. AB - Experiments were conducted in 32 dogs to study the results of rheography, ultrasonic Dopplerometry, electric excitability of muscles, and tissue pH measurement in various periods of ischemia and after restoration of blood flow in the extremities. Clinical follow-up of 226 patients with injuries to the major arteries of an ischemic extremity confirmed the importance of the results of instrumental methods of examination for appraising the severity of ischemia and predicting its outcomes. The author distinguished four degrees of ischemia in injury to the vessels. Combination of clinical findings and the results of special methods of treatment makes it possible to choose the rational surgical tactics in traumas of the arteries of the extremities. PMID- 1770744 TI - [Thrombosis and thrombophlebitis after catheterization of the subclavian vein]. AB - The authors analysed 685 catheterizations of the subclavian vein. Thrombophlebitic complications were diagnosed in 13 patients--phlebothrombosis in 9 of them and thrombophlebitis in 4. The complications developed mostly in cases with a severe general disease, in ++pyo-septic conditions. In 19 patients the catheter was displaced into the internal jugular vein during phlebography. Catheterization had to be repeated in 73 patients, thrombophlebitic complications occurred in 4 of them. A conclusion is drawn on the expediency of the principle of unilateral manipulations in catheterization repeated many times. PMID- 1770745 TI - [Re-evaluation of the opinions regarding vascular portacaval anastomosis in the surgical treatment of portal hypertension]. AB - Experience in the establishment of vascular portocaval anastomoses in 66 patients with cirrhosis of the liver and 52 patients with extrahepatic portal hypertension was studied. Selective portocaval anastomoses produced the best immediate and late-term results in cirrhosis of the liver, side-to-side or H-type splenorenal anastomoses were found to be optimal, they were marked by minimal trauma to the pancreas and adequate decompression of the gastroesophageal channel with maximal maintenance of the portohepatic blood flow. Maximal decompression of the portal system is expedient in extrahepatic portal hypertension; this is mostly accomplished by means of H-type mesentericocaval anastomosis with an autograft formed from the internal jugular vein. Introduction of selective anastomoses into practice and the use of an autovenous graft and precision techniques considerably widened the possibilities of vascular portocaval anastomosis in the treatment of gastroesophageal hemorrhages and made it possible to improve the results of these operations. PMID- 1770746 TI - [Surgical aspects of radical correction of tetralogy of Fallot]. AB - The article deals with the analysis of variant anatomy of Fallot's tetralogy due to hypoplasia of the pulmonary trunk on basis of morphometric and intraoperative examination of 141 patients 4 to 43 years of age (15.3 +/- 3.26) who underwent radical correction of the anomaly; 48 (34%) of these patients were operated on after various palliative operations. On grounds of detailed study of the variants of the relations of anomalies of the cardiac anatomical structures in Fallot's tetralogy the authors elaborated operative proceedings by means of which mortality after radical correction fell to 6.5%. PMID- 1770747 TI - [Transplantation of the heart-lung complex (the first clinical experience)]. AB - The article deals with experience in the first transplantation of a heart-lung complex in the USSR. The recipient was a 34-year-old male with dilation cardiomyopathy. It was decided to perform the transplantation because the terminal stage of cardiac failure and secondary pulmonary hypertension developed (cardiac index 1.3 l/m, pressure in pulmonary artery 80/50 mm Hg, resistance of pulmonary vessels 10.4 units after Wood). The heart and lung were transplanted from a 19-year-old male who died from a craniocerebral injury. Cyclosporine, metipred , imuran, dopamine in small doses, cardiotonics, and antibiotics were given in the postoperative period; the patient was kept on artificial respiration for 48 hours. For up to 10 days the patient's condition was relatively stable and his consciousness was clear. Bilateral pneumonia developed, however, from which he died on the 12th postoperative day. The article discusses organizational problems and some questions of immunosuppressive therapy, immunological monitoring, and the management of patients after transplantation of a heart-lung complex. PMID- 1770748 TI - [Effect of perioperative myocardial infarction on late results of the aortocoronary bypass]. AB - The article deals with the results of examination of 47 patients with a history of perioperative myocardial infarction after aortocoronary shunting and the findings in 358 persons of the control group who were operated on without this complication. The authors studied the dynamics of changes of the patients' functional condition after aortocoronary shunting, complicated by perioperative myocardial infarction in the late-term postoperative period. A comparative study was conducted of the dynamics of changes of the symptomatic status and the incidence of postoperative myocardial infarction among patients with and those without the complication. Its effect on the occurrence of the clinical picture of chronic circulatory insufficiency was also studied. A search was undertaken in this group for risk factors of the development of recurrent angina pectoris, myocardial infarction, and symptomatology of chronic circulatory insufficiency in the late-term postoperative period. The results of the study showed that perioperative myocardial infarction in the late-term postoperative period does not affect the patient's "character" of life. In the late-term postoperative period symptoms of chronic circulatory insufficiency are encountered in patients with perioperative myocardial infarction, as a rule, in a recurrence of angina pectoris and develop significantly more frequently in initial multiple affection of the coronary arteries. PMID- 1770749 TI - [Treatment of injuries of the heart and pericardium]. AB - The authors analyse the results of management of injuries to the heart and pericardium in 256 patients. From comparison of two periods during which treatment was applied, 1956-1971 and 1972-1984, they found that the results of surgical treatment were determined by a number of conditions among which organizational measures and active surgical tactics play an important role. For instance, in early thoracotomy the postoperative mortality was 13%, whereas in delayed thoracotomy it was 24.7%. The duration of the operative intervention also affected postoperative mortality. In thoracotomy lasting no longer than 90 minutes, the mortality was 13.9%, in operations lasting more than 150 minutes it reached 38.5%. The mortality was particularly high in cases of repeated thoracotomy (57.1%). PMID- 1770750 TI - Growth failure and insulin-like growth factor (IGF-I) in childhood celiac disease. AB - The prevalence of underweight, short stature, and abnormal laboratory tests was assessed in a retrospective study of 335 patients with biopsy-verified childhood celiac disease (CCD). Of the patients younger than 2 years old, 67.4% were underweight (body weight: less than - 2SD) and 33.9% were short (height: less than - 2SD). In children older than 2 years, underweight was present in 36.0% of patients; the prevalence of short stature was 50.0%. Therefore, diagnostic procedures related to CCD appear justified in all children with short stature of unknown etiology. However, because 50% of patients were neither short nor underweight, normal height and weight should not preclude workup of a patient with symptoms suggestive of CCD. Of the laboratory tests evaluated, antigliadin antibodies were the most sensitive for CCD. Insulin-like growth factor (IGF-I) serum levels were prospectively studied in 62 patients (32 CCD patients, 30 controls) referred for jejunal biopsy. IGF-I levels were significantly lower in female CCD patients than in control patients. There was a significant negative association between the duration of gluten exposure and IGF-I levels. Results indicate that significant reduction in IGF-I levels in CCD patients occurs only after prolonged gluten exposure but before growth failure. Reevaluation of IGF-I levels on a glutenfree diet showed rapid reversal of reduced IGF-I values. PMID- 1770751 TI - Differential patterns of PMN-elastase and type III procollagen peptide in knee joint effusions due to acute and chronic sports injuries. AB - In 38 traumatic knee joint effusions the proteolytic enzyme PMN-elastase (PMN-E) and the repair marker procollagen III aminoterminal peptide (PIIINP) were determined. According to the period between trauma and first aspiration of the effusion, the patients were divided into 3 groups. Group I (17 patients; period between trauma and first aspiration not longer than 72 hours) showed high concentrations of PMN-E (up to 5400 ng/ml) and low concentrations of PIIINP (less than 13 U/ml). Group II (11 patients; aspiration within 4 to 14 days) had mean PMN-E and PIIINP concentrations of 125.6 ng/ml and 52.1 U/ml, respectively. In group III (10 patients, aspiration after 14 days) mean PMN-E concentration was 123.8 ng/ml and mean PIIINP concentration was 63.4 U/ml. Graphic depiction of PMN E and PIIINP levels in each individual sample as a function of time between trauma and fluid collection revealed highly increasing PMN-E levels during the first 24 posttraumatic hours, followed by rapidly decreasing levels within 72 hours post trauma, and no change after the 4th posttraumatic day. In contrast, PIIINP increased continuously up to the first posttraumatic week and stayed at high levels up to 90 days (end of the observation period). The differential patterns of PMN-E and PIIINP concentration in knee joint effusions may be useful in estimating the period between trauma and first treatment (aspiration of effusion) and should, therefore, be helpful in detecting degenerative lesions, which seem to be characterized by low PMN-E concomitantly with high PIIINP levels. PMID- 1770752 TI - Increased collagen around deformed finger nailfold capillaries in type I diabetes mellitus. AB - Quantitative finger nailfold capillary microscopy was performed in 25 patients with type I diabetes and in 27 healthy control subjects. In the last consecutive 6 patients and 7 controls of these populations, finger nailfold biopsies were taken. Measurements of loop width as an in vivo parameter for deformities of the capillary loops showed significantly higher values in diabetic patients than in controls. Histopathological examination showed markedly and significantly increased deposition of collagen in nailfold dermal papillae of the diabetic patients. The deposition of collagen was positively correlated with the number of capillary endothelial cells in the nailfold dermal papillae and with the size of the papillae in diabetic patients. It is concluded that, in addition to deformity of nailfold capillaries, collagen deposition may also be a sign of metabolic disturbance and perhaps of proliferation of capillary endothelial cells in diabetic microangiopathy. PMID- 1770753 TI - Proteinuria after renal transplantation: diagnosis with highly sensitive silver stain in sodium dodecylsulphate-polyacrylamide gradient gel electrophoresis. AB - Sodium dodecylsulphate-polyacrylamide gel electrophoresis (SDS-PAGE) of urinary proteins is becoming increasingly significant in monitoring renal allograft recipients. After conventional Coomassie Blue staining, changes in renal proteinuric patterns during acute renal transplant rejection could not be seen in many cases. Discrimination between rejection and nephrotoxic side effects of cyclosporine overdosage was also not possible. We therefore examined the possible advantages of a highly sensitive silver staining technique in this study. A total of 734 urine samples obtained from 38 patients after allogenic kidney transplantation were examined by SDS-PAGE with consecutive Coomassie Blue and silver staining. Twenty-two histologically proven rejections and 20 cyclosporine overdosage episodes were diagnosed in these patients within a time period of up to 524 days after transplantation. No changes in proteinuric patterns were seen in 9 of 22 patients after Coomassie stain during rejection, and only 12 cases showed a rise of glomerular protein bands, whereas silver stain revealed an increase in 19 of 22 cases. Discrimination between cyclosporine overdosage and rejection was possible with a probability of p less than 0.001 after silver stain when using the changes in the number of glomerular protein bands as a criterion. These findings suggest that application of a highly sensitive silver stain instead of the conventional Coomassie stain after SDS-PAGE reflects considerable progress in monitoring renal allograft recipients. PMID- 1770754 TI - Gram-negative bacterial pneumonia with secondary aspergillosis in an AIDS patient. AB - A 40-year-old, HIV-infected female patient received antibiotic treatment for a urinary tract infection. After the initial success of therapy and a symptom-free period, she developed pneumonia with septic shock and adult respiratory distress syndrome (ARDS). In spite of intensive care and respirator therapy with positive end-expiratory pressure (PEEP), she died of infectious toxic shock. Autopsy findings showed relapsing, gram-negative, bacterial pneumonia (morphologically compatible with Klebsiella pneumonia) and secondary, invasive aspergillosis. The pathogenesis and epidemiology of these unusual complications of AIDS are discussed. PMID- 1770755 TI - GSH rescue by N-acetylcysteine. AB - Reduced glutathione (GSH) is the main intracellular low molecular weight thiol. GSH acts as a nucleophilic scavenger and as an enzyme-catalyzed antioxidant in the event of electrophilic/oxidative tissue injury. Therefore, GSH has a major role as a protector of biological structures and functions. GSH depletion has been recognized as a hazardous condition during paracetamol intoxication. Conversely, GSH rescue, meaning recovery of the protective potential of GSH by early administration of N-acetylcysteine (NAC), has been found to be life-saving. Lack of GSH and electrophilic/oxidative injury have been identified among the causes of the adult respiratory distress syndrome (ARDS), idiopathic pulmonary fibrosis (IPF), and the acquired immunodeficiency syndrome (AIDS). Experimental and early clinical data (in ARDS) point to the role of NAC in the treatment of these conditions. Recently, orally given NAC has been shown to enhance the levels of GSH in the liver, in plasma, and notably in the bronchoalveolar lavage fluid. Rescue of GSH through NAC needs to be appreciated as an independent treatment modality for an array of different disease, all of which have one feature in common: pathogenetically relevant loss of GSH. PMID- 1770756 TI - [Acid-base equilibrium, blood gases and glycolysis during modeling of the factors of extravehicular activities]. AB - The effect of factors simulating extravehicular activities (lower barometric pressure, 100% oxygen breathing, physical load on the upper body, head-down body position) on blood gas composition, acid-base equilibrium, and glycolysis end products was investigated in 17 test subjects. It was found that 5-hour exposure did not change physiological responses to test workloads, when compared to the baseline studies. In the simulation studies, changes in acid-base equilibrium of venous blood were more significant than those of mixed capillary blood. The variations of the parameters under study reflected primarily the effect of hyperoxia on metabolic processes. The head-down position affected the level of variations in gas composition and acid-base equilibrium of venous blood. These changes were transient and rapidly returned to the norm after termination of the exposure. PMID- 1770757 TI - [Changes in hematologic indicators in personnel testing during 370-day anti orthostatic hypokinesia]. AB - This paper presents the results of evaluating blood morphology (counts of red blood cells, hemoglobin, reticulocytes, platelets, leukocytes and their forms), hematocrit, mean corpuscular volume (MCV), mean corpuscular hemoglobin content and concentration, and erythrocyte sedimentation rate (ESR) in 9 test subjects during a 370-day head-down tilt study. It was demonstrated that blood morphology variations in 9 test subjects remained within normal variations throughout the entire period of observation, including the baseline, head-down tilt, and rehabilitation periods. There were the following exceptions. In the baseline period, a single episode of MCV increase and MCH decrease was recorded. In the course of head-down tilt, monocytosis, lymphocytosis, thrombocytopenia, basophilia, and lowered MCH were occasionally observed. MCV was slightly increased during several measurements. As compared to the norm, hematocrit increased or decreased. After exposure, there was a single episode of a decrease of erythrocyte count and hemoglobin, hematocrit, an increase of MCV and basophil count, and three episodes of monocytosis. These blood changes during 370-day head down tilt should be viewed as a result of a combined effect of adverse factors accompanying hypokinesia, particularly reduced infection resistance. PMID- 1770758 TI - [Effect of a passive orthostatic test on lymph circulation]. AB - Anesthesized dogs were exposed to a 30 minute tilt test at 30 degrees. Most significant changes were seen in venous and lymphatic vessels. During the first minutes of the tilt test lymph flow from the thoracic compartment diminished rapidly and later it partially recovered. Pressure in the thoracic lymphatic duct diminished in parallel with that in the jugular vein. Lymph flow from the neck vessel at first increased and then decreased. After the animals were returned to the recumbent position, their venous and lymphatic pressure reached the pretest level. Lymph flow from the thoracic duct increased drastically and then returned to the baseline level. During moderate orthostatic effects lymph circulation undergoes significant changes produced by gravitational shifts and morphofunctional specificities of lymphatic vessels. PMID- 1770759 TI - [Changes in blood lipids in humans during long-term ski crossing in the Extreme North]. AB - Serum lipids were measured in the men who made two ski crosses in the Far North during polar night. The first trip, which was to train the athletes, took 17 days and the second took 38 days. In both studies, lipid mobilization and utilization increased, which led to changes in the lipid spectrum: decrease of the concentration of LDL and, in the second trip, of VLDL and HDL3, and increase of the concentration of HDL2 and cholesterol HDL. In the second trip, lipids were most intensively utilized: lipolysis enhanced and free fatty acids declined. This was also indicated by an increase of the capillary-venous difference in terms of the total fraction of LDL and VLDL as well as free fatty acids. At the end of the second trip, the positive capillary-venous difference in terms of LDL and VLDL and, accordingly, the negative capillary-venous difference in terms of HDL2 and HDL3 increased. At the end of both trips the synthesis of transport lipids grew; in the most strenuous second trip, their active utilization in the working organs was stronger. PMID- 1770760 TI - [Informative value of the studies of beta 2-microglobulin in the plasma and urine of humans for evaluation of the resistance to static and bicycle ergometry tests]. AB - Changes of the beta 2-microglobulin concentration in blood and urine were measured in response to static and bicycle ergometry tests. In both cases, the concentration of beta 2-microglobulin in urine increased. A higher level of its renal excretion was seen in stable subjects before and after the tests. This relationship was also seen in patients with neurocirculatory dystonia of the hypertensive type. Possible mechanisms of these reactions are discussed. PMID- 1770761 TI - [Activation of respiratory sinus arrhythmia in monkeys during space flight]. AB - During the first day in space the rhesus monkey, called Vernyi, flown on Cosmos 1667 showed higher values of the daytime, night, and daily respiratory sinus arrhythmia (RSA) when compared to those observed before launch and before or the first day of a simulation study. During orbital flight, the mean daily value of RSA was in the range 13.08-16.00 beats/min. In the simulation study, this parameter increased from 4.68 beats/min during the first day to 15.16 beats/min on the 6th day. The mean RSA values during days 1 through 3 were significantly higher in real than in simulation flight. Analysis of rheopneumograms revealed a correlation between respiration parameters and RSA variations. In space, there was no correlation between RSA and HR, which was reported in the simulation study (r = -0.625). Assuming that RSA is a noninvasive indicator of parasympathetic control over cardiac rhythm, it can be postulated that the primate body adapted to microgravity via activation of parasympathetic mechanisms controlling the heart function. PMID- 1770762 TI - [Morphofunctional changes in the vascular system of the rabbit brain in rocking during anti-orthostatic position and administration of dimephosphon]. AB - It was demonstrated by experiment that exposure of non-anesthetized rabbits to rocking in the head-down position at -30 degrees led to acidosis, hypoxemia and hypercapnia, changes in impedance components that were suggestive of water imbalance in the cerebral tissue, paralytic dilation of microcirculation vessels, subarachnoidal hemorrhages, hyaline thrombi, stasis and sludge-syndrome, small perivascular extravasates in different brain compartments, marked perivascular and pericellular edema. Pretreatment with dimephosphone prevented or attenuated significantly acidosis, water imbalance, and pathomorphological disorders in the vascular system, nervous and glial elements of the brain of the rabbits examined. PMID- 1770763 TI - [Contractile function of the left ventricle of the heart in increased pressure of the gas medium]. AB - The hyperbaric effect on the contractile function of the left ventricle of the heart was examined in 16 test subjects by means of polycardiography. In a compressed air atmosphere (P = 0.5 MPa for 30 min), systolic time intervals varied. In a hyperbaric normoxic (N2 - O2) atmosphere, the changes were less expressed. In a medical oxygen atmosphere at a normal barometric pressure, the adverse effect on the left ventricle contractile function was least pronounced. It is concluded that hyperbaria, increased gas density, and hyperoxia produce a pathogenic effect on the heart; during short-term exposure increased gas density has the strongest effect. PMID- 1770764 TI - [Neutral peptide hydrolase activity in human blood in hypoxia]. AB - Athletes were taken to an altitude of 2100 m and allowed to get adapted to the highland environment for a month. Then blood serum neutral peptide-hydrolases were measured at rest and after exercise. Also, metabolic and respiratory parameters were investigated. In response to identical workloads some subjects showed a decrease (Group 1) while others showed an increase (Group 2) of proteolytic activity. Group 1 subjects exhibited high reactivity of the respiratory system whereas Group 2 subjects showed enhanced anaerobic glycolysis. PMID- 1770765 TI - [Problem od mental image in aviation psychology]. AB - This paper discusses theoretical aspects of aviation psychophysiology, specifically the problem of image control of objective actions of a pilot. The general concept representing a system of psychic control of pilot's actions is an image of the flight. Its structural components include: an image of spatial position, an image of an instrumental panel, and the feeling of an aircraft. It is shown that these three information-cognitive components are insufficient to use the flight image for controlling objective actions. It is important to supplement it with object-activity components. Using the flight image concept and experimental observations, a model of controlling objective actions of a pilot is discussed. Components of the model form a closed self-regulating system with direct and feedback control loops. It is underlined that the knowledge of functional patterns of mental images of a pilot is required not only to explain his actions at work but also to solve problems of designing his professional activities and to develop means and methods of his training. PMID- 1770766 TI - [Stimulating effect of long-term low-dose radiation on granulocytopoiesis]. AB - A mathematical model simulating variations in granulocytopoiesis of mammals exposed to chronic irradiation has been built. The model has been developed to take into account the chalone mechanism of hemopoiesis regulation. The model represents a system of 12 nonlinear differential equations. The modelling results have been found to be in agreement with experimental observations of variations in granulocytopoiesis of rats within a wide range of radiation dose rates. This model has been used for the first time to simulate a stimulating effect of prolonged irradiation with a low dose rate on granulocytopoiesis. Manifestations of this effect are explained. This model can be used to predict the effect of prolonged irradiation with different dose rates on variations of granulocytopoiesis in mammals. PMID- 1770767 TI - [Evaluation of biological effectiveness of high-energy accelerated particles based on the study of cytogenetic disorders in murine sex cells]. AB - The frequency of reciprocal translocations in spermatogonia of F1(CBAxC57Bl6) mice irradiated with 50 MeV protons, 4.2 GeV deuterons, 1.8 GeV/nucleon helium ions or 60Co gamma-rays was investigated. The relative biological effectiveness of these particles calculated by comparing the equieffective doses of reference and experimental radiations was less than 1.0 under the assumption of the linear dose-effect relationship. The RBE of the particles calculated by means of the nonparametric method largely depended on the doses applied. PMID- 1770768 TI - [Longitudinal study of health status of pilots: changes in body weight]. AB - On the basis of medical monitoring of the flying personnel, their body weight variations as a function of age and disease were studied (trauma complications, malformations, refraction, color perception, obesity without concomitant diseases were ignored). The subjects were subdivided into two groups with respect to the age when the first chronic disease was detected. It was demonstrated that the airmen who remained healthy for a long period of time had body weight values close to the group mean and age-related body weight gain within normal limits. The subjects who fell ill when younger than 28 years had a high body weight and those who fell ill at the age of 28-32 years had a low body weight which increased drastically at the age of 30-35 years. PMID- 1770769 TI - [Abramov-Fiedler myocarditis as a cause of sudden death of a helicopter MI-8 pilot]. PMID- 1770770 TI - [Effect of the Earth's decreased magnetic field on the blood coagulation system]. PMID- 1770771 TI - [Characteristics of the hemostatic potential of humans during vestibular stimulation]. PMID- 1770772 TI - [Functional carbohydrate test during 237-day space flight]. PMID- 1770773 TI - [Diagnostic value of the study of color discrimination function of the eyes in pilots' activities]. PMID- 1770774 TI - Arginine remains an essential amino acid after liver transplantation in urea cycle enzyme deficiencies. PMID- 1770775 TI - Liver transplantation in two children with tyrosinaemia type I: biochemical aspects. PMID- 1770776 TI - Fatal neonatal hepatocellular deficiency with lactic acidosis: a defect of the respiratory chain. PMID- 1770777 TI - NADH:Q1 oxidoreductase deficiency without lactic acidosis in a patient with Leigh syndrome: implications for the diagnosis of inborn errors of the respiratory chain. PMID- 1770778 TI - Pyruvate dehydrogenase deficiency due to a mutation of the E1 alpha subunit. PMID- 1770779 TI - Purification of alpha and beta subunits of phosphorylase-b-kinase in human liver and cardiac muscle by affinity chromatography and immunodetection. PMID- 1770780 TI - Hepatic glycogenosis with defects in the glycogen breakdown pathway: urinary oligosaccharide profile. PMID- 1770781 TI - Characterization of a disease-causing Lys329 to Glu mutation in 16 patients with medium-chain acyl-CoA dehydrogenase deficiency. PMID- 1770782 TI - Octanoate and palmitate beta-oxidation in human leukocytes: implications for the rapid diagnosis of fatty acid beta-oxidation disorders. PMID- 1770783 TI - The long-chain 3-hydroxyacyl-CoA dehydrogenase of human liver mitochondria. PMID- 1770784 TI - Long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency: different clinical expression in three unrelated patients. PMID- 1770785 TI - Macrocephaly: an important indication for organic acid analysis. PMID- 1770786 TI - Riboflavin responsive ethylmalonic-adipic aciduria in a 9-month-old boy with liver cirrhosis, myopathy and encephalopathy. PMID- 1770787 TI - Hexanol dehydrogenase activity shown by enzyme histochemistry on skin biopsies allows differentiation of Sjogren-Larsson syndrome from other ichthyoses. PMID- 1770788 TI - 5-Oxoprolinuria (glutathione synthetase deficiency): a case with neonatal presentation and rapid fatal outcome. PMID- 1770789 TI - Identification of pristanoyl-CoA oxidase and phytanic acid decarboxylation in peroxisomes and mitochondria from human liver: implications for Zellweger syndrome. PMID- 1770790 TI - Bile acids in amniotic fluid: promising metabolites for the prenatal diagnosis of peroxisomal disorders. PMID- 1770791 TI - Di- and trihydroxycholestanaemia in twin sisters. PMID- 1770792 TI - A new type of chondrodysplasia punctata associated with peroxisomal dysfunction. PMID- 1770793 TI - The effect of molybdenum cofactor deficiency on the purine pattern of cerebrospinal fluid. PMID- 1770794 TI - Dihydropyrimidinuria: a new inborn error of pyrimidine metabolism. PMID- 1770795 TI - Maternal PKU collaborative study: the effect of nutrient intake on pregnancy outcome. PMID- 1770796 TI - Alternative methionine degradation via the transamination pathway: an option for therapy for homocystinuria due to cystathionine synthase deficiency. PMID- 1770797 TI - A far advanced case of gyrate atrophy in a 12-year-old girl. PMID- 1770798 TI - Leukocytes as a diagnostic tool for classical galactosaemia. PMID- 1770799 TI - A new variant of the carbohydrate deficient glycoproteins syndrome. PMID- 1770800 TI - Inhibition of calcium-activated, phospholipid-dependent protein kinase (protein kinase C) activity in sphingolipidoses. PMID- 1770801 TI - Familial hypomagnesaemia with secondary hypocalcaemia--autosomal or X-linked inheritance? PMID- 1770802 TI - Seven-year experience of a reference laboratory for detection of inborn errors of metabolism in Brazil. PMID- 1770803 TI - Normal gait is differentially influenced by the otoliths. AB - Postural control depends on the integration of vestibular, somatosensory and visual orientation signals. The otolith contribution to postural control is achieved by the integration of otolith inputs and peripheral afferent inputs involved in crossed reflex pathways. This study shows that a functional linkage between otolith signals and activity in lower limb muscles is detectable in normal human gait. The otolith input appears to dominate particularly the neck proprioceptive and gaze motor influences during normal gait. This is demonstrated by an increase of tibialis anterior muscle activity during retroflexion of the head/neck, leading to an increased stability and counteracting possible perturbations. It is also shown by decrease of coordination during the movement caused by larger displacement of the centre of gravity demonstrated in vector diagrams. PMID- 1770804 TI - Relationship between hyperaemic response and viscoelastic properties in the coronary circulation of the dog. AB - A sudden reduction in perfusion pressure evokes a transient hyperaemic response in the coronary arteries of anaesthetized dogs; its characteristics depend on the vasomotor tone. A heuristic model, which mimics the vascular bed with a lumped second-order system on the lines of the well-known Windkessel model, but accounting for the blood inertia, is proposed to describe that response and to quantify the viscoelastic properties of the system. PMID- 1770805 TI - A real-time FFT analyser for monitoring muscle fatigue. AB - The TMS 32010 system for a real-time muscle fatigue monitor is described; it is based on mean frequency shift in the electromyographic signal (EMG). The mean frequency of the EMG is obtained, in real time, from its power spectrum, with a 2 Hz resolution. This is made possible by combining novel hardware and software. PMID- 1770806 TI - Dynamically variable electronic delays for ultrasound imaging. AB - A novel programmable delay line system (Patent 67595-A/89 from the Ministero dell'Universita e della Ricerca Scientifica e Tecnologica, Italy) for electronic control of delay profile in ultrasound real-time imaging systems is described. The line consists of a number of LC filters. The capacitance is obtained by using varicap diodes, so that electronic control over the desired depth is obtained by changing the diode inverse polarization voltage. This delay line exhibits a dramatic simplification and a broader time delay excursion than alternative techniques. Based on computer simulations, a delay line system was designed and integrated into an annular transducer-based echographic apparatus. PMID- 1770807 TI - Measuring fetal and maternal temperature differentials: a probe for clinical use during labour. AB - The healthy fetus maintains a higher temperature than that of its mother during gestation and labour. This results from the thermal balance between the heat generated by the fetus and the heat loss to its maternal surroundings. The heat loss can be by heat exchange via blood flowing in the umbilical cord and placenta, and via conduction through the fetal skin and amniotic fluid to the maternal wall. The temperature difference between the fetal and maternal tissue may reflect the metabolic state of the fetus and the magnitude and changing patterns of placental blood flow during labour. Physiological changes, such as those induced by epidural analgesia, and fetal infection have been shown to exhibit an increase in the absolute temperature. An intrauterine probe, previously used for non-invasive ECG detection, has been equipped with temperature sensors that measure fetal and maternal skin temperature in utero. Laboratory tests to characterize the performance of the probe reveal that absolute and differential temperatures can be resolved to around 0.01 degree C with a thermal time constant of approximately 9 s. Ideally the probe body should have infinite thermal insulation or thermal shunting across the probe will occur reducing the measured temperature difference. In this initial probe design, a high thermal isolation between sensors has been achieved but is not perfect, resulting in around 85% of the actual temperature difference across the probe being registered. Average feto-maternal differences of 0.2 degrees C have been measured in a clinical investigation. PMID- 1770808 TI - Trabecular bone densitometry using interactive image analysis. AB - Interactive image analysis is a novel application of digital image processing to the densitometry of trabecular bone. Briefly, the exposed surfaces of bleached slices of bone are illuminated so that the trabecular tips are bright in relation to the interstices. The image is then captured by a TV camera and digitized with an interactive image analysis system. A grey scale is then chosen that differentiates the bone at the surface from the background. Finally, a computer program calculates the area fraction of bone within a user-specified box which, by Delesse's principle, is an estimate of the volume fraction of bone. The reproducibility of the technique (expressed as an average SD) is +/- 1.5 vol. % and has surface-discriminating capabilities comparable to the traditional point counting method but is faster and more precise. Most importantly, the technique permits biomechanical testing of the sample after its density has been determined. PMID- 1770809 TI - Use of texture analysis to discriminate between normal livers and livers with steatosis. AB - We describe a technique for discriminating between livers that are normal and ones that have fatty infiltrate (livers with steatosis) based upon the application of a suitably defined texture measure to the corresponding digitized ultrasonographs. In brief, this texture measure sums, from some selected optimum spatial frequency to the upper limit set by the digitizing process, the frequency components of the normalized, radial power spectral density function. The analysis was run on six cases (two normal and four with steatosis) obtained from Dunedin Public Hospital, in New Zealand. Texture measure values for these six cases were compared with the corresponding biopsy scores. The results indicate the ability of the texture measure to discriminate between the two conditions; and furthermore, to quantitatively distinguish the severity of histological change. PMID- 1770810 TI - A comparative clinical study of fetal phono- and movement-sensors from Amsterdam, Cambridge and Edinburgh. AB - In a European collaboration, a joint project to conduct an experimental and clinical investigation of recently developed sensors from three centres (Amsterdam, Cambridge and Edinburgh) has been carried out. The Amsterdam sensor was based on an inductive principle whereas the Cambridge and Edinburgh transducers used a piezo-electric material (PVDF) as transducing element. Nine patients with varying gestational age (29-38 weeks) were measured in a clinical investigation. Recordings of fetal heart sounds (FHS) and fetal breathing movements (FBM) were made using three sensors; one from each centre. These recordings were digitized directly into a computer using a purpose-built data acquisition system. For each patient 3 min of FBM data, and 1 min of FHS data were recorded by each sensor. The FBM recordings were carried out simultaneously with ultrasound, so as to enable a correlation to be made between both recordings. The FHS recordings were carried out simultaneously with the maternal heart pulse, to discount any maternal heart influences on the resulting signals. Of the nine patients analysed, FHS were recorded in seven patients. On the other hand, it appeared difficult to identify fetal breathing movements in the FBM recordings due to the dominance of the maternal breathing component. The analysis of the FBM signals and its correlation with ultrasound could not be carried out due to the relatively poor quality of the signals detected by the sensors, given the present techniques of analysis. The evaluation of the FHS recordings showed that although there is relatively little difference between the sensors, the inductive sensor performed best. PMID- 1770811 TI - Time constant-related capnograph distortion: a theoretical analysis. AB - A theoretical analysis of time constant-related distortion in side-stream capnographs was carried out using two models of respiratory patterns. It is demonstrated that under circumstances likely to be encountered clinically, significant distortion may occur. This distortion may produce both spurious rebreathing and under estimation of the true end-tidal CO2 concentration. PMID- 1770812 TI - Passage time measurement of individual red blood cells through arrayed micropores on Si3N4 membrane. AB - A new system has been developed for determining the deformability of individual red blood cells (RBCs), simulating the passage of RBCs in capillaries. The kernel of this system was the micropore array filter with an accurately defined pattern made by semiconductor microprocessing techniques. Individual microscopic RBC images were processed in parallel through a microcomputer and its interfacing circuit. An experiment with a normal RBC from a human donor demonstrated that it could pass the circular pore filter with a diameter as small as 1.0 micron at 2 cm H2O pressure difference. Deformability of RBCs treated with diamide or acetylphenylhidralazine was also measured, showing that the system was sufficiently sensitive to detect the deformability loss due to membrane damage or to polymerization of the cytoplasma. PMID- 1770813 TI - Pulsatile non-Newtonian blood flow in three-dimensional carotid bifurcation models: a numerical study of flow phenomena under different bifurcation angles. AB - Flow and stress patterns in human carotid artery bifurcation models, which differ in the bifurcation angle, are analysed numerically under physiologically relevant flow conditions. The governing Navier-Stokes equations describing pulsatile, three-dimensional flow of an incompressible non-Newtonian fluid are approximated using a pressure correction finite element method, which has been developed recently. The non-Newtonian behaviour of blood is modelled using Casson's relation, based on measured dynamic viscosity. The study concentrates on flow and stress characteristics in the carotid sinus. The results show that the complex flow in the sinus is affected by the angle variation. The magnitude of reversed flow, the extension of the recirculation zone in the outer sinus region and the duration of flow separation during the pulse cycle as well as the resulting wall shear stress are clearly different in the small angle and in the large angle bifurcation. The haemodynamic phenomena, which are important in atherogenesis, are more pronounced in the large angle bifurcation. PMID- 1770814 TI - Device for quantifying tactile neglect in stroke patients. AB - Perceptual problems such as tactile neglect are important features of stroke and strong predictors of a poor outcome. Although new methods of treatment have been described, documentation of the effects of such treatment is inadequate, mainly because satisfactory methods of quantifying tactile neglect are unavailable. We describe a device for quantifying neglect based upon the principle of the Bender test which uses double or simultaneous bilateral stimulation to determine neglect. The device, which is computer driven to ensure uniformity of test protocols, determines the cutaneous perceptual threshold to controlled-current electrical stimulation using surface electrodes. The effect of rival contralateral stimulation on the perceptual thresholds on the affected side of the patient's body is a quantitative measure of tactile neglect. The device was evaluated in normal young and neurologically normal elderly subjects and in stroke patients with clinical evidence of tactile neglect. It was shown to distinguish reliably between normal subjects and those who had tactile neglect. The device will be suitable for use in trials of treatments for tactile neglect and in tracking the natural history of this symptom. PMID- 1770815 TI - Computer-controlled mechanical testing machine for small samples of biological viscoelastic materials. AB - Time dependency in the mechanical properties of viscoelastic materials means that a variety of tests is often required to fully characterize their properties. Computer control is the best way of controlling loads and displacements and the rate at which they are applied, as well as recording and analysing the data produced. This paper describes apparatus for measuring the viscoelastic properties of articular cartilage in compression which is readily adaptable to any small sample in which accurate strain measurements require small, carefully controlled displacements. An IBM-type microcomputer is used to control a stepper motor driving a ball screw with a positional accuracy of about 1 micron. PMID- 1770816 TI - Improving the pneumatic nebulizer by shaping the discharge of the capillary wick. AB - The theory and function of nebulizers is discussed and their performance parameters are reviewed. The possibility of adjusting the wick-draw and atomization by altering the geometry at the top of the capillary tube is considered. A visual experiment using film as the data collection medium was performed, and the results support the hypothesis that the nebulizer's performance can be improved by adjusting the tube's configuration. Further study is suggested that will complement this preliminary qualitative study. PMID- 1770817 TI - IBEES Prize Lecture: the future of biomedical engineering. PMID- 1770818 TI - [The treatment of anemia in patients on hemodialysis with recombinant human erythropoietin]. AB - BACKGROUND: Anaemia of chronic renal failure is primarily due to relative erythropoietin deficiency. This hormone has been recently cloned and it is now available for clinical use. METHODS: Sixteen patients maintained on haemodialysis with non-complicated anaemia and on stable clinical condition were selected for 12 months' treatment with r-HuEPO. Our aim was to analyse the factors influencing r-HuEPO response and the modifications on main haematological and biochemical parameters and adverse reactions occurrence. RESULTS: All patients responded with an increase of haemoglobin (from 78 +/- 9 to 103 +/- 18 g/dl at second month of therapy, p less than 0.001) and blood transfusions were eliminated. Time of response and doses were very different to one another. R-HuEPO requirements decreased slowly with time. Neither transfusion number, nor hyperparathyroidism, nor ferritin levels, nor diabetic condition influenced r-HuEPO response. Serum ferritin decreased significantly from 1,772 +/- 1,791 to 1,116 +/- 1,240 ng/ml (p less than 0.05), especially in patients without iron overload. Serum vitamin B12 levels did not decrease significantly. Both uric acid and phosporus increased significantly after the treatment period (5.25 +/- 1.18 to 6.29 +/- 0.99 mg/dl and 5.78 +/- 1.29 to 6.69 +/- 1.55 mg/dl respectively, p less than 0.01). Platelet counts did not modify. It was necessary to adjust antihypertensive therapy in a few patients because of a mild rise in blood pressure, although important adverse reactions did not occur. CONCLUSIONS: Anaemia of haemodialysis patients improves with r-HuEPO treatment and reduces blood transfusion requirement. Adverse effects are not very remarkable. PMID- 1770819 TI - [An epidemiological and clinical study of malignant cutaneous melanoma in the catchment area of Leon]. AB - BACKGROUND: During the last decade the incidence of cutaneous malignant melanoma (CMM) has increased in different geographic areas around the world. The aim of this study is to know the incidence and clinical characteristics of CMM in the area of Leon between 1980-1989. METHODS: One hundred nineteen cases corresponding to the total CMM cases diagnosed over the aforementioned period were reviewed. Clinical characteristics were studied and the annual and five-year incidence were calculated. Results were compared between two five year period (1980-1984 and 1985-1989). RESULTS: The mean annual incidence rose from 1.9 in the first five year period to 4.4 cases per one hundred thousand cases per year in the second period (p less than 0.01). Furthermore, in this period a diminution was observed in the diagnosis of CMM with an elevated Clark level (III-V), with an increase of the lowest levels (p less than 0.05). There was a high predominance of women (76%) which increased in the second five year period (p less than 0.05). The mean age was 61.7 years which was higher than that reported by other authors with the most frequent sites being: head-neck (40%) and trunk (25%) The predominant histology was melanoma of superficial spread (46%). These variables did not vary significantly throughout the period studied. PMID- 1770820 TI - [Interferon-alpha. A good treatment for some patients with chronic hepatitis B]. PMID- 1770821 TI - [The association of myasthenia gravis and hairy-cell leukemia]. AB - Myasthenia gravis (MG) and tricholeucemia (TL) produce an important immune alteration favoring the appearance of neoplastic and autoimmune disorders. The case of a 53 years old patient who developed type B TL 5 years after the diagnosis of MG is reported. Upon revision of the literature, 37 cases of association of MG and malignant hemopathies, fundamentally lymphoproliferative were found. In general, MG precedes the appearance of the neoplastic process. The autoimmunity and immunodeficiency characteristic of MG probably constitute the pathogenic mechanism leading to the appearance of the neoplastic process. PMID- 1770822 TI - [Gastrointestinal involvement and the response to dapsone in a case of the urticarial vasculitis syndrome]. AB - A case of urticarial vasculitis syndrome is described in which the gastrointestinal disease was the main clinical manifestation. The gastroduodenal barium meal demonstrated signs compatible with intestinal ischemia which reversed upon medical treatment. The colonoscopy with biopsy showed changes compatible with unspecific colitis. The role of reversible acute vasculitis as a pathogenic factor implicated in the gastrointestinal manifestations in this entity is discussed. Although the response to treatment with corticoids and cochicine was not constant, there was good response to dapsone in successive relapses of the disease. Despite some antibodies becoming positive during the third year of follow up, the patient did not fulfill the clinical criteria for the diagnosis of systemic lupus erythematosus. PMID- 1770823 TI - [Fever and diarrhea in a 68-year-old woman]. PMID- 1770824 TI - [The validity of the obligatory declaration of tuberculosis]. PMID- 1770825 TI - [A descriptive study of 105 patients with cerebral metastases]. PMID- 1770826 TI - [The design and preparation of slides with the aid of a computer]. PMID- 1770827 TI - [The circadian arterial pressure curve and kidney failure]. PMID- 1770828 TI - M1 and M3 muscarinic receptor subtypes in rat forebrain. AB - At least three pharmacologically different muscarinic receptor subtypes (M1, M2 and M3) have been identified in rat brain. While M1 and M2 subtypes can be directly labelled by selective ligands (3H-pirenzepine and 3H-AF-DX 116, respectively), there are no truly selective ligands for the M3 subtype. In the present study, we have investigated a possible method of studying the pharmacological M3 subtype in rat forebrain using the non-selective labelled antagonist 3H-N-methyl-scopolamine (3H-NMS) in the presence of unlabelled pirenzepine to protect the M1 subtype. The results obtained in kinetic experiments using 3H-NMS in presence of 30.10(-9) M unlabelled pirenzepine (Kon 1.2.10(-8) M-1 m-1, Koff 4.7.10(-2) m-1 and Kd 0.4.10(-9) M) are compatible with the studies carried out in rat pancreatic islets and submaxillary gland which contain predominantly the M3 subtype. We have also performed inhibition experiments with the selective antagonist AF-DX 116. Due to the small proportion of M2 receptors present in rat forebrain, this drug is able to discriminate between M1 and non M1 non M2 receptor subtypes in competition experiments with 3H NMS versus AF-DX 116 (Ki values 0.28.10(-6) M and 4.3.10(-6) M, respectively). When the competition experiments were performed using 3H-NMS in presence of 30.10(-9) M unlabelled pirenzepine, the Ki value obtained was 3.8.10(-6) M, very close to the value obtained for the non M1 non M2 receptor in competition experiments with 3H-NMS versus AF-DX 116 and in excellent agreement with the affinity of this drug for the glandular M3 subtype. All these data suggest that the approach using the non-selective antagonist 3H-N-methyl-scopolamine in presence of unlabelled pirenzepine allows the study of the pharmacological M3 subtype in rat forebrain. PMID- 1770829 TI - Response to noradrenaline and histamine in normal and sensitized guinea pig aorta and its relation to endothelium. AB - Pharmacological reactivity of sensitized blood vessels has been less studied than that of airways. Aorta rings were obtained from normal and actively sensitized guinea pigs and prepared for isometric recording of tension changes. Noradrenaline (10 nM-10 microM), histamine (0.1 microM-0.1 mM) and KCl (10-100 mM) produced concentration-related contractions of normal tissues. Removal of endothelium resulted in a marked left upward shift of the concentration-response curve to noradrenaline but it did not alter histamine- or KCl-induced responses. Pretreatment with ibuprofen (10 microM) or L-NG-nitroarginine (L-NOARG, 3.3 microM) enhanced noradrenaline-induced responses without affecting those to histamine or KCl. Removal of endothelium or pretreatment with ibuprofen or L NOARG did not alter agonist-induced responses in sensitized tissues. Neuronal uptake and release of [3H]-noradrenaline did not differ in normal and sensitized tissues. Loss of the modulatory role of endothelium and other mechanisms may be involved in the hyperreactivity of sensitized guinea pig aorta. PMID- 1770830 TI - Role of afterhyperpolarization in termination of early afterdepolarization in mouse atrial fibers. AB - Afterhyperpolarization (AHP) following triggered burst in early afterdepolarization (EAD) was investigated in mouse atrial fiber treated with aconitine or ryanodine. In both cases, a long second plateau (SP) with or without intermittent trains of bursts could be observed in certain conditions. Repolarization potentials were measured both in normal EAD (cycle lengths of 1-5 sec) and in EAD with a long SP. The values of repolarization potentials were almost constant, around -61 mV, in both situations. AHP could be recorded at the end of the intermittent bursts or after a burst elicited by an electrical stimulation on the long lasting SP. When the voltage of AHP attained the repolarization potential, rapid repolarization started instantly leading to complete repolarization of the EAD. It is suggested that AHP in EAD or following a burst elicited by stimulation enhances the termination of EAD. PMID- 1770831 TI - Increase of thiopental concentration in rat tissues due to anesthesia with isoflurane. AB - Thiopental distribution was studied in rats (30 mg/kg i.v.) anesthetized simultaneously with 1.25 "rat"-MAC isoflurane. The thiopental concentration in serum and several tissues was determined UV-photometrically at 305 nm after extraction and TLC. In the serum of rats anesthetized with isoflurane the thiopental concentration was significantly increased to +39----+74% in comparison to controls during 30 min following the barbiturate injection. Also in liver, brain, heart, kidney, lung and spleen of rats anesthetized with isoflurane the thiopental concentration was significantly increased at 3 and 10 min; at 30 min the difference vs. control had vanished in brain, heart, lung and spleen. Obviously, thiopental was transiently "trapped" during the early distribution phase to a considerable amount in these vessel-rich tissues when anesthesia with isoflurane was simultaneously performed; this pharmacokinetic interaction might be explained at least to some extent hemodynamically; in many tissues regional blood flow is reduced during anesthesia with isoflurane; thereby the "washout" of thiopental from the tissues and the redistribution are delayed. PMID- 1770832 TI - Effect of halothane anesthesia and trifluoroacetic acid on protein binding of benzodiazepines. AB - The in vitro effect of the halothane metabolite, trifluoroacetic acid, on the protein binding of three different benzodiazepines (diazepam, lorazepam and midazolam) has been investigated. Furthermore, protein binding of these drugs was studied in serum from patients under the effect of halothane anesthesia (1-2.5%; 2.5 h). Trifluoroacetic acid, 4 mmol/l, displaced diazepam and midazolam from serum and produced a marked increase in the free percentage, but did not influence lorazepam binding. Moreover, 48 h after the end of halothane anesthesia, there were changes in protein binding of diazepam (3.9 +/- 0.3% at 48 h vs. 3.3 +/- 0.3% before halothane anesthesia; p less than 0.05). It can be concluded that halothane anesthesia (1-2.5%; 2.5 h) may temporarily potentiate the pharmacological effect of diazepam in the postoperative period following anesthetic procedures. PMID- 1770833 TI - Interspecies scaling of the pharmacokinetic parameters of coumarin among six different mammalian species. AB - The pharmacokinetic parameters, total body clearance, apparent volume of distribution and the terminal elimination half-life of coumarin were correlated among six mammalian species. It was demonstrated that the total body clearance was highly related to the liver blood flow, liver weight and body weight. The apparent volume of distribution appeared to be related only to body weight. The elimination half-life, which is dependent upon both the apparent volume of distribution and total body clearance, was poorly correlated with all physiologic variables that were evaluated. Hence, it appears that only the primary pharmacokinetic parameters of coumarin display a definite interspecies relationship. PMID- 1770834 TI - Interleukin-1 in Alzheimer's disease and multi-infarct dementia: neuropsychological correlations. AB - It has been reported that patients with Alzheimer's disease (AD) exhibit an overproduction of interleukin-1 (IL-1) in the cerebrospinal fluid and brain tissue. Since IL-1 appears to promote the expression of the beta-amyloid precursor protein (APP) gene, we have investigated the concentrations of serum IL 1 alpha and IL-1 beta and AD and multi-infarct dementia (MID) in order to evaluate whether IL-1 acts as a peripheral activating factor on cerebrovascular endothelial cells stimulating APP production. Serum IL-1 alpha levels did not differ significantly between healthy elderly subjects (110.7 +/- 23.3 pg/ml), early-onset AD (EOAD; 112.5 +/- 23.3 pg/ml), late-onset AD (LOAD; 89.2 +/- 17.6 pg/ml) or MID (116.8 +/- 50.4 pg/ml) patients. Serum IL-1 beta levels were also similar in controls (223.7 +/- 55.7 pg/ml), EOAD (223.1 +/- 79.5 pg/ml), LOAD (212.5 +/- 58.9 pg/ml) and MID (199.4 +/- 29.0 pg/ml). In LOAD a negative correlation between mental performance (MMS score), IL-1 alpha (r = -0.7728; p less than 0.0715) and IL-1 beta (r = -0.9214; p less than 0.0011) was observed. These results indicate that serum IL-1 levels are not altered in AD and MID; therefore, it is unlikely that blood-borne IL-1 influences APP production in the central nervous system (CNS). In conclusion, the neuroimmune dysfunction present in AD seems to be mainly concentrated in the CNS, with only minor immune alterations at the peripheral level. PMID- 1770835 TI - Cardiac output and liver blood flow in humans: effect of the volatile anesthetic halothane. AB - In 40 men with normal circulatory and liver function, from whom 10 were undergoing general anesthesia with halothane for minor orthopedic surgery, the relationship between hemodynamic parameters and total hepatic blood flow (HBF) was investigated. Cardiac output (CO) was measured noninvasively by means of the thoracic electrical bioimpedance method, systemic arterial blood pressure (BPsys, BPdia, mean arterial pressure) by an automated oscillometric device and HBF by indocyanine green clearance. In the subjects without halothane anesthesia no relationship was found between BP and HBF, but a significant correlation could be seen between CO and HBF, whereby the fraction of HBF decreased with increasing CO. In contrast, in the presence of halothane the systemic arterial blood pressure correlated with the HBF, indicating a loss of autoregulation of the liver circulation. PMID- 1770836 TI - Dystrophin and disease. AB - Recent advances concerning the genetic and biochemical basis of Duchenne and Becker muscular dystrophies have resulted in a good understanding of the etiology of these common dystrophies. An important secondary consequence of the genetic and biochemical research has been the generation of gene-based and protein-based diagnostic tools which enable a 'molecular diagnosis' for patients and their families. This review summarizes our current understanding of the genetics, biochemistry, and pathophysiology of Duchenne dystrophy, and gives an overview of the molecular diagnostic tools and their applications. Recent correlations of clinical, genetic and biochemical data have indicated that dystrophinopathies can present with a wide range of neuromuscular symptoms, and that neither male sex nor proximal weakness are diagnostic prerequisites for consideration of an underlying dystrophin abnormality. PMID- 1770837 TI - Modern methods of promoting drug absorption through the skin. PMID- 1770838 TI - Toward representations for medical concepts. AB - The authors characterize the problems inherent to mapping across or combining terms from different vocabularies, focusing especially on MeSH and SNOMED. They also describe the exploration of the development of a frame-based representation of SNOMED. PMID- 1770839 TI - Automatic indexing of abstracts via natural-language processing using a simple thesaurus. AB - The authors describe CLARIT processing as an approach to automatic indexing. They also explore two elements of the indexing process, identifying concepts in text and selecting concepts to reflect the perspective of a domain. PMID- 1770840 TI - Using the UMLS to bring the library to the bedside. AB - This paper presents an algorithm that can be used to convert ICD9 terms to related MeSH terms. Preliminary evaluation indicates that together, the algorithm and the UMLS provide a reasonable resource for facilitating such conversions. PMID- 1770841 TI - Evaluation of Meta-1 for a concept-based approach to the automated indexing and retrieval of bibliographic and full-text databases. AB - SAPHIRE is a concept-based approach to information retrieval in the biomedical domain. Indexing and retrieval are based on a concept-matching algorithm that processes free text to identify concepts and map them to their canonical form. This process requires a large vocabulary containing a breadth of medical concepts and a diversity of synonym forms, which is provided by the Meta-1 vocabulary from the Unified Medical Language System Project of the National Library of Medicine. This paper describes the use of Meta-1 in SAPHIRE and an evaluation of both entities in the context of an information retrieval study. PMID- 1770842 TI - Symposium: Health outcomes research and its interfaces with medical decision making. 12th annual meeting of the Society for Medical Decision Making, November 13, 1990. PMID- 1770843 TI - Health outcomes research and its interfaces with medical decision making. Twelfth annual meeting of the Society of Medical Decision Making. November 13, 1990. PMID- 1770844 TI - Developing models to evaluate pregnancy outcomes. AB - The authors examined the proposition that the patient charge for a labor-and delivery admission can be used as a crude index of pregnancy outcomes. They are developing models of the relationships of certain complications of pregnancy to this outcome variable. These models could be used to estimate potential cost benefits associated with specific prenatal interventions and assist in identifying the areas that should be included in the authors' expert system. PMID- 1770845 TI - Predicting discharge diagnoses using a computerized preadmission screening tool. AB - The authors integrated into an existing hospital information system a preadmission screening system, intended to reduce payment denials and reimbursement shortfalls that result from improperly classifying the billing status of patients. They report the results of efforts to validate the expert system upon which the preadmission screening system is based. PMID- 1770846 TI - Automated severity classification of AIDS hospitalizations. AB - To validate an automated AIDS severity-of-illness prognostic algorithm, 2,113 discharge summaries of HIV-infected patients were merged with the Problem Oriented Medical Synopsis (POMS) and an HIV risk registry. The combination of a medically derived classification and staging algorithm with multivariate statistical techniques was used for automated severity-of-illness disease staging and prognostic assignment. The model correctly predicted the outcomes of 82% of all cases (death, survivorship) at discharge, and 66% of deaths. PMID- 1770847 TI - Injury severity: better data through direct physician entry of anatomic injuries? AB - The authors compared the injury diagnoses and Injury Severity Scores (ISSs) generated by three data-collection and -coding methods, and examined the times needed and costs associated with the methods. One method involved direct electronic entry of injury data by a physician in the admitting area. Codes, severity scores, and times and costs varied significantly with the different methods, thus suggesting a need for further study of the derivation of injury severity codes. PMID- 1770848 TI - A database coding system for vascular procedures. AB - A coding system was developed to overcome the difficulties encountered in data registry and retrieval from a national audit. In vascular surgery operations are frequently combined, and neither the OHIP fee schedule of codes (Ontario, Canada) nor the ICD-9 system provides sufficient detail for most vascular surgeons to retrieve information for long-term follow-up. However, some wish to record minimal data on their operative procedures. A numeric classification system was developed. A five-digit number is used, the first two digits classifying the operative procedure and anatomic details. Two decimal digits code the classification of operation (e.g., aortic aneurysm, tube graft, aortoiliac, or aortobifemoral) and the final digit may be used as a modifier. "Holes" in the numeric system allow for new operations to be added as they develop. Codes are stored in a database with the following fields: 1) codes; 2) description of operation; 3) translation. The translation field may be modified to permit translation of any existing databases into the system. This database has been distributed with a data registry program free of charge to vascular surgeons in Canada to allow nationwide registry of vascular surgery patients. A numeric code eliminates spelling and abbreviation errors, and can be sufficiently broad-based to allow all surgeons to participate in a nationwide audit. PMID- 1770849 TI - Exploitation of statistical tables: conceptual interaction with epidemiologic data. AB - Health-care applications need flexible data and interaction models capable of dealing with data of different natures coming from different sources. These applications are usually devoted to diverse user groups, often casual or novice. The user interface must help the user to understand the database information content in his or her querying process. The authors synthetically describe FLN, a system featuring an integrated interaction with epidemiologic data. In an integrated model the statistical aspects of data (macro data) are represented, together with the intensional and extensional views of the variables involved in statistical tables. PMID- 1770850 TI - Quality control in a medical information system. AB - Quality assurance techniques provide an opportunity to identify sources of error and to provide the feedback necessary to prevent their repetition. The authors outline an effort to define the steps required for effective quality management procedures in a computerized medical information system (MIS). The computerized management of medical information can be used not only to enhance current quality management activities but also to extend the realm of quality assurance to areas that have heretofore resisted management. Quality-management techniques have the potential for measuring and improving medical decision making processes central to patient care. PMID- 1770851 TI - Continuous quality improvement applied to medical care: experiences at LDS hospital. AB - At LDS Hospital the authors are implementing continuous quality improvement (CQI), a systems-analytic approach to quality management in industry, as an approach to quality management in medical domains. Their approach consists of 1) choosing a process to be improved, 2) assembling a team of expert clinicians that understands the process and the outcomes, 3) determining key steps in the process and expected outcomes, 4) collecting data that measure the key process steps and outcomes, and 5) feeding back the data to the practitioners. CQI theory states that the practitioners will use the information and their own best intentions to improve the manner in which they provide care. The authors have developed statistical tools that display the data and distinguish between random and assignable variation. PMID- 1770852 TI - The application of natural-language processing to healthcare quality assessment. AB - This paper describes the automatic extraction of information from hospital discharge letters. The computer analysis and extraction process, designed to eliminate much of the manual effort required to review patient documents, are presented. PMID- 1770853 TI - A database perspective of the transition from single-use (ancillary-based) systems to integrated models supporting clinical care and research in a MUMPS based system. AB - The Composite Health Care System (CHCS), a MUMPS-based hospital information system (HIS), has evolved from the Decentralized Hospital Computer Program (DHCP) installed within VA Hospitals. The authors explore the evolution of an ancillary based system toward an integrated model with a look at its current state and possible future. The history and relationships between orders of different types tie specific patient-related data into a logical and temporal model. Diagrams demonstrate how the database structure has evolved to support clinical needs for integration. It is suggested that a fully integrated model is capable of meeting traditional HIS needs. PMID- 1770854 TI - The lifespan personal health record. AB - A system for entry of health data in a computer-based patient record by lay individuals is described. The lay user is supported in data entry and data clarification, as well as by system-supported summarization of the data in context to show relationships, highlight sentinel events, and assist in evaluation of alternative decisions and actions as needed. PMID- 1770855 TI - Semantic standards for the representation of medical records. AB - Physicians developed their sublanguage (a system to represent medical concepts and their relations) to store and transmit general medical knowledge and patient related information. Adequate formalisms are needed to obtain a standard representation of semantics of medical expressions for computer use. Comparison of the semantic contents of two expressions is possible only if a unique canonical form is defined; the transmission of medical facts or patient-related information is really meaningful only by defining a set of primitives (semantic categories and links) and the domains of values (concepts). These primitives must be harmonized to yield a "common core subset" of semantic categories and links. This subset provides a common basis; a procedure to register extension sets of primitives must also be defined, to comply with specific representation needs of specialties and classes of application software. PMID- 1770856 TI - Hierarchical distribution analysis for computer-assisted classifications of patient records. AB - The many existing hierarchical classifications present opportunities for computer aided classification of medical data. The authors evaluate lexical term mapping followed by hierarchical node activation to determine the semantic locality of diagnoses in the American College of Radiology (ACR) classification. The activated hierarchy exposes conceptual structures behind lexically matched categories and markedly narrows the alternatives for human review. Several distribution analyses are evaluated for narrowing the candidate search space, to reduce ambiguity. The methods were tested on a prototype system, using a set of 78 samples of Mayo radiology diagnoses; their relative effectiveness is illustrated. PMID- 1770857 TI - Alternate approaches to a UMLS. AB - A scheme for the continuing development of Meta-1, a taxonomy of medical subjects based; on MeSH and other systems, is described. The objective is a single, structured classification for medical knowledge. PMID- 1770858 TI - Mary Margaret Riddle--Pennsylvania's gift to Massachusetts nursing. PMID- 1770859 TI - What is a grievance? PMID- 1770860 TI - A new technique for microvascular sleeve anastomosis. AB - This study describes our experience using an improved technique for microsurgical sleeve anastomosis of arteries. Modifications of previously described techniques include utilization of a sidecut and placement of the two stitches within separate vertical planes. In 40 arteries, we attained a patency rate of 97.5%. Histology, in vivo observation, and flow study using high-frequency pulsed ultrasound Doppler at 2 hr to 8 weeks demonstrate that the sidecut sleeve anastomosis shows patency and flow characteristics similar to those of standard end-to-end anastomosis, but with a dramatic decrease in operative time. PMID- 1770861 TI - Vascularized autogenous canine coccygeal bone transfer. AB - Based on cadaver studies in dogs, the 8th, 9th, or 10th canine coccygeal vertebra with overlying skin was designed for free vascularized bone transfer. In six dogs the coccygeal osteocutaneous flap was transferred to fill a defect of the tibia, anastomosing the median caudal artery and one of the two caudal veins to the tibial vessels. The overlying skin provided a reliable monitoring system for the transferred tissue. The behavior of the vascularized coccygeal vertebrae was then evaluated with radiographic and histologic examination and compared with control vertebrae transferred without reconnection of the blood vessels. The results revealed that the canine coccygeal bone graft is a reliable vascularized osteocutaneous flap, which can be applied either in clinical veterinary surgery or in orthopedic microsurgical research. PMID- 1770862 TI - Importance of fibrinolysis in limiting thrombus formation following severe microarterial trauma: an experimental study in the rabbit. AB - In a blind randomized study, two groups of six rabbits were treated with either the fibrinolytic inhibitor tranexamic acid, 14 mg/kg bw, or isotonic saline solution (control group) given intraaortically as single bolus injections 5 min prior to arteriotomy and intimectomy of central ear arteries. Arteriotomic bleeding times, accumulations of 32P-labeled platelets, patency, and sizes of thrombus deposits 2 hr after reperfusion were recorded. Fixed vessels were observed by scanning electron microscopy. Bleeding times were similar in the two groups. The patency rate in the tranexamic acid group was 2/12, i.e., a significant reduction (P less than 0.05) from 7/12 in the control group. Thrombus deposits in occluded vessels contained large amounts of fibrin and red cells. Platelet accumulations in occluded vessels were significantly lower in the tranexamic acid group than in the control group, which indicates that the ratio of fibrin to platelets was increased in thrombi formed during antifibrinolytic treatment. This study has demonstrated the importance of normal fibrinolytic capacity in limiting thrombus formation following microarterial trauma. It is suggested that the use of antifibrinolytic agents in microvascular surgery should be restricted. PMID- 1770863 TI - Volkmann's ischemic contracture in children: the results of free vascularized muscle transplantation. PMID- 1770864 TI - Free muscle transplantation combined with intercostal nerve crossing for reconstruction of elbow flexion and wrist extension in brachial plexus injuries. AB - Complete paralysis due to traumatic brachial plexus injury is extremely difficult to treat when the injury affects whole nerve roots and when motor function fails to show any signs of recovery. Seddon has suggested that arthrodesis of the shoulder and amputation at the humerus, combined with the use of a functional upper extremity prosthesis, was the most practical procedure available. Since 1965, in cases of irreparable lesions such as complete root avulsion type injuries, we have performed direct intercostal nerve crossing to the musculocutaneous nerve without free nerve graft to achieve elbow flexion. However, it is necessary to operate on the patient within 6 months following the injury to obtain good results. In the past there was no procedure for dealing with delayed cases of complete brachial plexus palsy. However, with the advent of microsurgical techniques, new approaches have become open to us. Since 1978, we have reconstructed the elbow flexor by the combined surgery of free muscle transplantation with intercostal nerve crossing in delayed cases of complete paralysis. This article introduces the operative technique and the results we have obtained. PMID- 1770865 TI - Monitoring free muscle transfer. PMID- 1770866 TI - MSMS should adopt a more adversarial relationship with the Blues. PMID- 1770867 TI - [Quantitative description of microbial growth in a batch culture depending on the physiologic state of inocula]. AB - The dynamics of biomass production and the respiration rate of five microorganisms grown as batch cultures were studied in detail. Cell suspensions with a known physiological state, i.e. chemostat cultures grown at a particular D value, as well as quasi steady-state populations cultivated with slow feeding and long energy-source starvation were used as inocula. The microorganisms were arbitrary subdivided into two groups. The biomass of Pseudomonas fluorescens, Bacillus subtilis and Debaryomyces formicarius accumulated smoothly with a monotonic rise of the specific growth rate to the upper level of microns. A distinct inverse correlation was established between the duration of the lag phase and the specific growth rate of the inoculum. Arthrobacter globiformis and Lipomyces tetrasporus were characterised by biphase growth referred to as false diauxia: glucose was accumulated without its oxidation during the first phase, and actual growth (just as in the first group of microorganism) occurred during the second phase. Most of the results are satisfactorily described by a simplified modification of the synthetic chemostat model. PMID- 1770868 TI - [Approximation of time-profiles of pH alteration by cells of Candida tropicalis by means of reactions of hypothetical linear object with negative feed-back]. AB - The autostabilization of the environment pH value in batch cultures of yeast Candida tropicalis was experimentally investigated. The pH alternation had unidirectional compensatory nature, which allowed to represent the reaction of the system as the reaction of hypothetical linear object with negative feed-back. The transmission functions of structural elements of this object were determined. It was shown that such a model describes experimental data quite well in a wide range of initial environment pH values. PMID- 1770869 TI - [Competition of isogenic haploid and diploid cells of the yeast Saccharomyces cerevisiae and Pichia pinus growing in mixed populations]. AB - During "quasi-continuous" cultivation in rich and minimal media diploid yeast cells of Saccharomyces cerevisiae completely displace isogenic haploid ones. When Pichia pinus are cultivated in the minimal medium, the diploids also have an advantage over isogenic haploids. The results are discussed within the framework of the hypothesis of fixation of diploid phase in the course of biological evolution. PMID- 1770870 TI - Study of lung reactions in six asymptomatic workers occupationally exposed to hard metal dusts. AB - The description of one case of pulmonary fibrosis in a group of workers occupationally exposed to hard metal dusts with high concentrations of cobalt (50 90%), followed for five years, prompted us to perform a cytological examination on the bronchoalveolar lavage fluid plus determination of the lymphocytic subpopulations in six asymptomatic workers with the longest exposure. Bronchoalveolar lavage performed 16 hours (3 cases) or 48 hours (3 cases) after the end of the workshift showed a lymphocytosis with inversion of the helper/suppressor ratio in 3 cases. This demonstrates an immune response at deep lung level. No difference was observed between a subject with ascertained interstitial fibrosis and the other subjects. Furthermore, bronchoscopy revealed marked inflammatory reaction of the tracheobronchial mucosa. PMID- 1770871 TI - [A case of methemoglobinemia due to 4-nitrobenzonitrile exposure]. AB - The paper describes a singular case of acute intoxication by 4-nitrobenzonitrile, a rare intermediate compound produced by pharmaceutical synthesis. The patients subsequently showed an increase in triglycerides and fatty alterations of the liver. PMID- 1770872 TI - [Acute exposure to vanadium-containing dusts: the health effects and biological monitoring in a group of workers employed in boiler maintenance]. AB - The authors describe an episode of acute intoxication due to inhalation of vanadium-containing dusts in a group of 10 workers during maintenance work inside a boiler of an oil-fired electricity power station. Historical, clinical and biological monitoring data concerning the acute exposure phase and subsequent checks are presented. The appearance of irritative symptoms of the upper airways, green tongue (in 6 out of 10 subjects) and the values of urinary excretion of vanadium (means = 92, D.S. = 47 micrograms/l: limits 20-270 micrograms/l) indicated acute vanadium exposure. With the use of appropriate individual protection devices and shorter shifts, 2 weeks after the episode there was a complete remission of the symptoms and a return of urinary vanadium concentrations to 38, D.S. = 26 micrograms/l. Checks made 6 months, 1 and 2 years later did not reveal any alterations in the general blood chemistry parameters and the urinary vanadium concentrations were below 1 microgram/l (reference value). As already often reported in the literature, this episode confirms the danger involved in working in the presence of fuel oil residues or ashes and the need to adopt appropriate prevention measures. PMID- 1770873 TI - [The biological levels of chloroform in the general population]. AB - The paper reports the results of determination, via gas chromatography and mass spectrometry, of chloroform in expired air, blood and urine of a group of non occupationally exposed blood donors. Chloroform concentrations were also measured for each subject in the air of the environment where samples were taken. PMID- 1770874 TI - [The prospects for the appearance of pleural mesothelioma in Italy]. AB - The mortality data of Italian males and females due to malignant tumour of the pleura, collected over a period of 7 years, from 1976 to 1985, showed a continuous, rectilinear type, increase. The increase in the quantity of asbestos that was processed from 1945 to 1979 was also rectilinear. On the basis of the well known relationship between asbestos and mortality due to mesothelioma, an extremely high correlation coefficient was obtained between quantity of asbestos processed per year and number of deaths due to malignant tumour of the pleura 25 years later. Extrapolating to the year 2000 on the basis of this relationship, it can be foreseen that at that time the deaths due to malignant tumour of the pleura in Italy will be about 1200 per year. It is recommended to apply a correction factor to this figure in order to obtain the number of true cases of mesothelioma, which are probably about 70% of the deaths attributed to tumour of the pleura. PMID- 1770875 TI - [Industrial noise and presbyacusia in the determination of hearing damage: studies in chemical industry workers]. AB - An audiometric investigation was carried out on 710 workers of a chemical plant in order to ascertain the role of industrial noise and presbysocio-acusia in causing hearing loss. The workers underwent an audiometric test both aerial and via bone, in a sound-proof chamber, after a 16-hour rest from noise. The subjects also answered a questionnaire on nonoccupational noise exposure and previous hearing and dysmetabolic disorders. Noise exposure was assessed on the basis of a cumulative exposure index obtained for each subject by multiplying the mean daily exposure level by seniority in the job. The results showed that in workers not exposed to high noise levels, industrial noise and presbysocio-acusia induce, via a direct mechanism, either separately or together, only slight damage to social hearing frequencies, i.e., those of normal conversation. At frequencies of 4 and 6 kHz, however, presbysocio-acusia seems to play a more important role than industrial noise in causing hearing loss. The practical implications arising from this study concern the frequencies that should be used for a medicolegal assessment of industrial noise induced hearing loss and the the threshold for these frequencies above which assessment of hearing loss should begin. As regards the first point, the results obtained in this study suggest the use of medicolegal methods based on normal conversation frequencies since presbysocio acusia should not in any case be taken from these frequencies as it affects them only marginally. As regards the second point, the results show that assessment of hearing loss should begin when the hearing threshold at the above frequencies exceeds 25 dB. The study also showed that in epidemiological investigations on subjects exposed to industrial noise, the cumulative exposure index is better correlated with the rise in hearing threshold at the various frequencies than with seniority. PMID- 1770876 TI - [An integrated course in occupational medicine. A proposed teaching program based on the new organization of the degree course in medicine and surgery]. AB - The curriculum of Italian Medical School of the Faculty of Medicine has been recently renewed at a national level. Considering the numerous innovations introduced, a new role has been attributed to the teaching of occupational health, particularly occupational medicine. Occupational Medicine is usually regarded as a part of community medicine and, despite the fact that occupational disease may be in decline in industrially developed countries, the increasing concern regarding environmental pollution related health effects, stress the relevance of the methodologies already formulated within the occupational health disciplines. Of all environmental factors, occupational medicine has contributed largely to the knowledge about the health effects of occupation and its role in the complex problem at work related to today's medical students as a way of introducing the appreciation of worldwide environmental effects and how to measure, monitor and modify them. In this article the content of the occupational health course is revised and according to the principles of modern medical pedagogy, the teaching is divided in primary and secondary objectives and organized to the resolution of real problems. The importance of the relevant evidences of clinical occupational medicine is discussed and their insertion into other clinical disciplines is proposed. The knowledge of distribution, recognition, management and prevention of the major occupational diseases is a final target of the teaching. The introduction of innovative teaching methods such as factory visits, case history discussion or role playing exercises is suggested as an integrated, multidisciplinary approach able to promote the preventive attitude of students. The efficacy of the teaching has to be evaluated with appropriate methods every time, to verify both informative and formative aspects. PMID- 1770877 TI - [Nonoccupational mercury poisoning in a woman worker of a fluorescent lamp factory]. PMID- 1770878 TI - [The erosion of asbestos cement roofs: an important source of environmental pollution]. AB - A microscopic investigation on samples of asbestos cement roofs weathered from 2 months to 15 years or more was carried out. Surface alterations begin as early as 2 months, are well visible after a few years and become very severe after 5-10 years. The deterioration of the cement structure, due mainly to the chemical attack of the acid rains produces a release of fibres that is more evident with increasing duration of the exposure. The surface of the "old" roofs must be considered as important source of environmental pollution, that increases the total carcinogenic potential of the polluted atmosphere in a non-negligible way, considering also the enormous extension of the surfaces. Instead of replacing the roofs, adequate primers and sealants can be applied after careful preparatory cleaning: gross contamination of water and/or surrounding areas must be avoided by appropriate work procedures. The deteriorated materials containing amphiboles must be considered with priority. PMID- 1770879 TI - [The optimization of a method for assessing the contagiosity and the degree of individual infectiousness of ticks with Borrelia]. AB - The results of dark-ground microscopy of 478 positive preparations from Ixodes persulcatus Sch. and I. ricinus L., gathered in the active natural foci of Lyme's disease in Leningrad Province, have been analysed. The preparation was prepared by cutting ticks placed into a drop of physiologic saline, with needles. It has been demonstrated that if all the standard conditions are fulfilled (magnification 600, drop volume 0.02 ml, covering glasses, 18 x 18 mm) it is practically impossible to overlook an infected tick during examination of 200-250 visual fields in such a preparation. The conditions described above ensure reliable results of Borrelia calculation and their concentration assessment. Differences in the degree of individual vector infestation may be expressed using a scale: low (up to 10), medium (10.1-50), high (50.1-250) and very high (above 250 Borrelia per 100 visual fields). PMID- 1770880 TI - [The determination of the species specificity of Leishmania antibodies in different groups of human sera]. AB - Species-specificity of two serological tests has been compared: Indirect immunofluorescence test and C-ELISA using antigens prepared of 7 Leishmania species of various groups of human sera, including sera from healthy donors; sera of patients with various tropical parasitoses; sera containing rheumatoid factor and antinuclear antibodies; sera of patients with visceral leishmaniasis (VL); sera of normal subjects arrived from regions endemic for VL; sera of students arrived in Czechoslovakia from various tropical countries endemic for leishmaniasis. It has been shown that C-ELISA (and EIA with corpuscular antigen), being highly sensitive techniques, are very promising for the identification of species-specific Leishmania antibodies. C-ELISA titres beginning from 1:800 and above may be considered as species-specific. With the titre 1:400, cross reactions with antigens of various Leishmania species are observed. PMID- 1770881 TI - [The trichinelliasis problem from the positions of general epidemiology, ecology and zoogeography. 1. The sources and routes of human infection]. PMID- 1770882 TI - [The computer processing of data from experimental research on malaria. 2. The quantitative characteristics of parasitemia dynamics]. AB - Models of simple and modified logistic function have been used for the quantitative characteristics of malaria infection development. The approach could be successfully used, which was demonstrated on experimental infection dynamics in rodents during parasitemia assessment both in absolute and logarithmic scales. Regression analysis of experimental data and choice of an optimal form of logistic equation are performed with the help of specially elaborated software. The calculated values of logistic parameters may be used for characterization of malaria parasite strains and isolates, their virulence and resistance, as well as the degree of their resistance to drugs. PMID- 1770883 TI - [The search for new antiparasitic agents. 4. The study of the antimalarial activity of N-(halogen naphthyloxy)-2-hydroxy-3,5-dihalogen benzamides]. AB - Antimalarial activity of 10 N-(haloidnaphthyloxy)-2-hydroxy-3,5-dihaloidbenzamide compounds earlier synthesized as potential anthelmintics has been studied. It has been shown that antimalarial activity is typical only of amides of 2-hydroxy-3,5 diiodinebenzoic acid. PMID- 1770884 TI - [The comparative characteristics of the clinico-immunological indices in different contingents of opisthorchiasis patients in a hyperendemic focus. 4. The transplacental transmission of Opisthorchis felineus antigens]. AB - 25 women in labour with chronic opisthorchiasis have been examined. They were representatives of native (7), local (8) and migrated population of the focus. Control group comprised 10 women from the local population free of invasion. Their immune status was assessed by the level of IgA, IgG, IgM, circulating immune complexes (CIC) and specific antibodies in the serum obtained from peripheral and funic veins, as determined by enzyme immunoassay (ELISA). To detect opisthorchis antigens in the serum modified radial immunodiffusion test was used. Antibody titres in ELISA, IgG and CIC levels were the highest in migrated women. Antibody titres in ELISA and IgG level in the newborn of migrated women were also considerably higher than in other newborn. Serum IgM level in all groups of newborn was considerably lower than in their mothers and IgA was altogether undetectable. In 3 native and 2 local women the results of immunodiffusion test were positive. It is suggested that transplacental migration of opisthorchis throughout the neonatal period may lead to tolerance formation. PMID- 1770885 TI - [The development of methods for the absolute count of the population of ixodid pasture ticks in open landscapes. 3. The count of hungry Dermacentor nuttalli Olen., 1919 larvae and nymphs in the steppe regions of the Transbaikal area]. AB - Methods for absolute registration of the number of hungry larvae and nymphs directly in the places of their natural habitation have been elaborated. Specific features of the activation of these phases in Transbaikal conditions have been studied. Peaks of their seasonal activity can be observed in July. It has been shown that the results of single (during seasonal peak in their number) capture of larvae and nymphs from all animal holes over a 100 m2 area can be used for characterization of density. Single capture accounts for 9-15% larvae and 12-16% nymphs of the total number of activized individuals. To assess reliably mean larval and nymph density, with the inadequacy of the results of absolute registration being 30%, not less than 100-130 areas should be examined. PMID- 1770886 TI - [The mathematical modelling of the processes in the natural multiplication of human lice (exemplified by the head louse population]. AB - Methods of mathematical modelling and prediction of louse propagation processes in the natural habitation medium are presented. Theoretical and experimental data on head louse ecology served the basis for the elaboration of a mathematical model predicting the population dynamics. The model structure corresponds to 3 stages of louse development cycle (eggs, larva, lice) and parameters corresponding to natural characteristics of louse propagation process: mean lifespan of each individual during each phase of the cycle, age, fertility and so forth. The model helped to study some properties of the population, assess maximum rate of head louse population growth, detect threshold effects, establish the effects of coefficients, limiting the number of louse per unit of the body surface. The model made it possible to formulate necessary data (distribution functions) for the creation of the mathematical model of Pediculosis. PMID- 1770887 TI - [Tick-borne encephalitis]. PMID- 1770888 TI - [The transmission of the tick-borne encephalitis virus via cow's milk]. AB - A case of group infection with tick-borne encephalitis (TBE) in Bikin, Khabarovsk Territory is reviewed. The disease developed as a result of drinking raw cow milk, bought from one owner, and eating sour-milk products made of that milk. 5 persons from 3 families were ill, in three cases the outcome was lethal. Data of clinical, epidemiological, viral and serological examinations confirm the diagnosis of TBE. Various antibodies to TBE virus have been determined in the blood of cows. The presence of complement-fixing antibodies may indicate fresh infection. The characteristics of TBE viral strain, isolated from the brain of dead Z. N. F. is presented on white mice. The data obtained confirm the previous suggestion on possible transmission of TBE virus with cow milk. PMID- 1770889 TI - [The modification of a medium for culturing and isolating the causative agent of Lyme disease]. AB - Possible use of three types of media (prepared on the basis of 199, RPMI and MEM, the rest of receipt being recommended for BSK-II) for cultivation of the agent of Lyme's disease is reviewed. The most satisfactory Borrelia burgdorferi growth has been noted on the medium with base 199. Using the same medium 5 spirochaete isolates have been obtained from 10 passages of the material from 41 ticks, Ixodes persulcatus Sch. and I. ricinus L. The results seem promising for further studies on the elaboration of Soviet medium with base 199 for the cultivation and isolation of the agent of Lyme's disease. PMID- 1770890 TI - [The ethyl acetate method of studying feces for Opisthorchis eggs]. AB - The ether-vinegar method used for the precipitation of helminths' oocysts is distinct from the ether-formalin one in progressive technology and lower toxicity of the reagents used. It can be applied for the diagnosis of opisthorchiasis with low invasion intensity. PMID- 1770891 TI - [Tridazol efficacy and tolerance in the treatment of lambliasis]. AB - The data on the clinical trials of the antiprotozoan agent tridazole-500 are presented. Drug parasitocidal activity and tolerance have been determined. The treatment was performed in 31 patients with lambliasis. A satisfactory drug tolerance and a 77.4% efficacy have been established. PMID- 1770892 TI - [Experience with enterobiasis control measures in the preschool institutions of Lithuania]. AB - The efficacy of treatment and hygienic antienterobiasis measures have been studied in organized groups of preschool children in the Trakay district of Lithuania. Daily washing of all the children and treatment of the invaded children with Vermox once a year proved effective for the prevention of enterobiasis transmission. PMID- 1770893 TI - [The epidemic manifestation of natural foci of tick-borne encephalitis on the territory of the Maritime Territory. 2. The spatial differences in the seasonality of tick-borne encephalitis]. AB - Using computer maps of the epidemic process season variations, tick-borne morbidity and lethality in the areas of the Maritime Territory [correction of Primorsky Region] have been analysed. According to season variations of the epidemic process the territory of Sikhote Alin has been divided into two separate parts--northern and southern, with morbidity peak in June and July, respectively. PMID- 1770894 TI - [Alcohol-induced hypoglycemia in type I diabetic patients]. AB - The hypoglycemic effect of alcohol, probably caused by inhibition of gluconeogenesis in the liver, is well known. However, accurate data on the effect of usual amounts of alcohol on the blood sugar in type 1 diabetics are not available. We therefore investigated the effect of an evening dose of alcohol on the blood sugar in 23 male type 1 diabetics (age 32.8 [20 to 64] years, duration of diabetes 11.5 [0.5 to 38] years, Broca index 0.98 [0.83 to 1.34] HbAlc 8.4 [5.8 to 12.2]%). On one day, the diabetics were given 0.56 g ethanol per kg body weight to drink in the evening, corresponding to about one liter of diabetic beer, on another day, the same volume of mineral water. In addition, eleven of the 23 patients received half the amount of alcohol on a third evening. Between 7 and 11 o'clock in the morning after alcohol consumption, blood glucose levels were significantly lower. The number of hypoglycemic episodes in the morning of the day following alcohol administration was appreciably greater. Usual amounts of alcohol consumed after the evening meal thus increase the risk of hypoglycemia the following morning. Diabetics should be instructed accordingly. PMID- 1770895 TI - [Acute adverse effects and complications of central venous digital subtraction angiography (DSA). Results of 2,600 studies]. AB - Side-effects and complications from 2,600 intravenous digital-subtraction angiographies (IV-DSA) are reported. All studies were performed in a standardized technique using a non-ionic contrast agent (Iopromid 370 mg J/ml). Side-effects or complications were noted in 2.5% of all IV-DSA. Most often nausea (0.92%), urticaria (0.5%), angina pectoris (0.5%) and symptomatic alterations of blood pressure (0.27%) were recorded. 8.4% of all reactions occurred with a delay of at least one hour. All side-effects and complications resolved, partly under symptomatic therapy. In one (0.04%) out of 2,600 studies a severe allergoid reaction occurred, affording intensive-care therapy. With proper patient selection and a suitable technique, IV-DSA may be regarded--within the angiographic methods--as a procedure of relatively low risk. PMID- 1770896 TI - [Surgical therapy of achalasia after prior pneumatic dilatation]. AB - Of 15 patients operated on for achalasia in the Department of General and Abdominal Surgery at the University of Mainz between September 1985 and April 1990, 14 were followed-up. All the patients had received an extramucous myotomy combined with Dor's semifundoplication; in twelve, one or more preoperative balloon dilatations had been performed. The results are reported in this study. The average age of the patients was 55.3 years (18 to 76 years), and the average follow-up period 21 months (six to 53 months). No postoperative complications were seen in any of the case. All patients reported appreciable improvements in their symptoms, six being completely symptom-free. Occasional dysphagia was reported in six cases, one patient had occasional, another frequent, nocturnal heartburn, which however had already presented preoperatively. In all seven cases submitted to postoperative radiological examination, the diameter of the esophagogastric junction was increased, and the diameter of the middle-third of the esophagus decreased. No gastroesophageal reflux or signs of inflammation were seen in any of the cases. The low complication rate and the high success rate despite prior balloon dilatation or bougienage support the use of Heller's operation combined with Dor's semifundoplication for the surgical treatment of achalasia after failed balloon dilatation. PMID- 1770897 TI - [Metabolic changes in patients with hereditary fructose intolerance. A contribution to the topic of fructose administration for parenteral feeding]. AB - The literature contains a number of reports of death following the intravenous administration of fructose in patients with hereditary fructose intolerance (HFI). The aim of the present study was, therefore, to investigate the metabolic changes occurring during intravenous administration of fructose to patients with HFI, with the aim of identifying metabolic parameters that would permit the early diagnosis of HFI. Also, the deaths reported in the literature were analyzed. In three of our own patients with fruit intolerance known since childhood, and in volunteers with normal metabolism, a one-hour intravenous fructose tolerance test (1.7 g fructose/min) was performed. An analysis was done using the usual enzymatic and chemical methods: blood glucose, fructose, lactic acid, serum uric acid, ammonia, free fatty acids, inorganic phosphate, and serum amino acids (ion exchange chromatography). During fructose infusion, the following metabolic changes were detected: hypoglycemia (20 to 60 mg/dl), increase in blood fructose levels (up to 350 mg/dl), hypophosphatemia (2 to 3 mg/dl), hyperlacticacidemia (up to 60 mg/dl), elevation of plasma ammonia levels (up to 120 mg/dl), increased serum glutamate, and a decrease in serum glutamine, as also hyperuricemia (up to 10 mg/dl). On termination of the fructose infusion, these changes were completely reversible. Analysis of the deaths reported in the literature revealed a known intolerance to fruit or sweets, and that no regular metabolic studies were apparently performed. Although HFI is rare, use should be made of the known advantages of sugar substitutes in post-aggression metabolism.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770898 TI - [84-year-old patient with intestinal hemorrhage of uncertain origin]. PMID- 1770899 TI - [Recurrent gallstones and possibilities for treatment after successful gallstone dissolution]. PMID- 1770900 TI - [Cyclosporin A in therapy of type I diabetes?]. PMID- 1770901 TI - [The challenge of the medical professional ethos by medical science]. PMID- 1770902 TI - [Bedside determination of clinical-chemical quantities using dry chemistry in an emergency admission]. AB - We evaluated the clinical relevance and reliability of a solid phase chemistry apparatus (Seralyzer) installed for near-patient testing of CK, GOT, glucose and potassium in the emergency admission of our hospital. Calibrations and quality controls were done by technologists of the central laboratory, the analyses were performed by the nursing staff after appropriate training. The rapid availability of the laboratory tests shortened the diagnostic process in only 8% of the patients. Clinical chemistry test results, therefore, appear to be of minor importance in making the diagnosis in an emergency room. The coefficients of variation of the inter-operator imprecision varied between 2.1 and 8.8% (means = 5.06%), when the measurements were performed by persons with no professional laboratory training, and between 2.7 and 8.5% (means = 3.98%) for skilled laboratory personal. In order to test the accuracy we correlated the dry chemistry values measured by the nurses in the daily routine with the results of a wet chemistry system. The Spearman rank correlation coefficients ranged between 0.916 and 0.950. Thus after appropriate training non-laboratory personal is able to perform dry chemistry testing with adequate precision and accuracy provided a competent supervision is guaranteed. PMID- 1770903 TI - [Clinical value of ultrasonography and computerized tomography prior to abdominal interventions]. AB - We studied the value of ultrasound and computed tomography in the preoperative diagnosis of abdominal diseases in 100 patients. Reference methods were the reports of surgery and pathology. A computed tomography or ultrasound diagnosis could be correct or false and was considered uncertain, if the main diagnosis was missed but computed tomography or ultrasound suspected pathology, which then could be clarified by other procedures. Overall, computed tomography was superior with 75 correct, 13 false and 12 uncertain diagnoses compared to ultrasound with 58 correct, 31 false and 11 uncertain diagnoses. Ultrasound often failed because obesity or gas impaired visibility. If only cases without technical problems of ultrasound were taken into account, diseases of liver, gallbladder, pancreas, kidney, the adrenal region and other abdominal masses were equally well diagnosed by ultrasound and computed tomography. As expected, the diagnostic value of both modalities was markedly reduced in diseases of the bile duct and the gastrointestinal tract. Because the study design required both, ultrasound and computed tomography, cases already clarified by ultrasound were not included. This fact might have further reduced the sensitivity of ultrasound in comparison to computed tomography. Furthermore, ultrasound was mostly one of the first diagnostic procedures performed right after the patient's admission with little information on anamnestic and clinical data. The information given prior to computed tomography was in general more detailed. PMID- 1770904 TI - [Transient polyuria in pregnancy in diabetes insipidus and gestational diabetes]. AB - Two pregnant women developed overt polyuria (up to 11 l/day) and polydipsia during their second and third trimesters of pregnancy. In one patient hydronephrosis was present. Both patients suffered from mild gestational diabetes mellitus. Plasma sodium was 145 and 162 mmol/l. Polyuria and urinary hypo osmolality responded well to desmopressin acetate. After delivery, polyuria and polydipsia disappeared in one patient and significantly improved in the other. Infusion of hypertonic saline one and two weeks respectively after delivery led to plasma hyper-osmolality (294 mosmol/kg and 305 mosmol/kg) without detectable stimulation of arginine vasopressin (AVP). Anterior pituitary function was normal. No stimulation of AVP occurred following insulin-induced hypoglycemia. AVP plasma disappearance after i.v. pulse injection of 1 microgram AVP as well as AVP plasma concentration after continuous infusion of 10 ng AVP/min was studied two weeks after delivery in one patient. The results suggested markedly elevated degradation of AVP compared to control subjects, probably due to an increased vasopressin activity. Eight months after delivery, hypertonic saline infusion in one patient led to a plasma-osmolality of 312 mosmol/kg without stimulation of AVP. In the second patient, AVP was not detectable (less than 0.2 pg/ml) six months after delivery when plasma osmolality was 290 mosmol/kg. Our studies demonstrate that a subclinical compensated diabetes insipidus was preexistent in both patients. Exacerbation occurred due to an increased AVP-clearance and presumably due to the hemodynamic and hormonal alterations during pregnancy, including a mild gestational diabetes mellitus. PMID- 1770905 TI - [Sclerosing mesenteritis with fatal course]. PMID- 1770906 TI - [Staged diagnosis in rheumatology]. PMID- 1770907 TI - [Endoscopic ultrasonography--possibilities and limitations in the gastrointestinal tract]. PMID- 1770908 TI - [HIV-associated non-hodgkin lymphoma. Prognosis and therapeutic options]. PMID- 1770909 TI - [Misdiagnosed osteomalacia in pancreatic insufficiency caused by chronic calcifying pancreatitis]. PMID- 1770910 TI - [Which anti-arrhythmia agent in continuous ventricular tachycardia?]. PMID- 1770911 TI - Behavior of calciotropic hormones in psoriasis. AB - This report was motivated by the finding that calciotropic hormones, except parathormone (PTH), do not show any response to 1a(OH)D3 therapy in psoriatic patients. These showed high basal whole PTH levels (127 +/- 38 pg/ml) which declined to 45 +/- 15 pg/ml after treatment (p less than 0.001) but did not correlate to calcemia values. Basal calcemia and calciuria were normal and rose with treatment (p less than 0.001 for both). Basal calcitonin and 25(OH)D3 were normal and did not change with treatment nor correlate to changes in calcemia. Due to the effect of 1-hydroxyvitamin D and calcemia on calcitonin and 25(OH)D, the lack of changes in the latter suggests a calciotropic hormone imbalance in psoriasis, which may be an etiologic factor in this entity. PMID- 1770912 TI - Renal denervation enhances the phosphaturic effect of parathyroid hormone. AB - Hyperventilation/hypocapnia increases renal phosphate reabsorption and decreases the phosphaturic effect of parathyroid hormone (PTH). Recent studies suggest that the blunted phosphaturic effect of PTH in hyperventilated/hypocapnic rats may be mediated by the stimulation of renal beta-adrenoreceptors. In the present study, no differences in plasma catecholamine levels were detected in hyperventilated/hypocapnic rats as compared to hyperventilated/normocapnic rats. Therefore, studies were performed to determine the role of the renal nerves in the blunted phosphaturic effect of PTH in hyperventilated/hypocapnic rats. In clearance experiments in acutely thyroparathyroidectomized male Sprague-Dawley rats, PTH infusion increased the fractional excretion of phosphate (FEPi) in the denervated left kidney of hyperventilated/hypocapnic rats (n = 8), from 2.4 +/- 1.1 to 18.6 +/- 2.7%, as compared to 1.0 +/- 0.3 to 9.1 +/- 2.1% in the contralateral innervated kidney. Denervation of the left kidney in hyperventilated/normocapnic rats (n = 8) also significantly increased the phosphaturic response to PTH by 2.5 +/- 1.5 to 26.9 +/- 3.0% as compared to 0.9 +/- 0.5 to 18.6 +/- 2.6% in the contralateral innervated kidney. The phosphaturic responses to PTH were similar when comparing the denervated kidney in hyperventilated/hypocapnic rats with the innervated kidney of hyperventilated/normocapnic rats. Thus, renal denervation enhanced the phosphaturic effect of PTH in both hyperventilated/hypocapnic and hyperventilated/normocapnic rats. These results suggest that renal nerves play a role in the modulation of the phosphaturic effect of PTH. PMID- 1770913 TI - Adaptation of renal tricarboxylic acid cycle metabolism to various acid-base states: study with [3-13C,5-15N]glutamine. AB - We studied mechanism(s) by which adaptations of renal TCA cycle metabolism abet ammoniagenesis from glutamine in altered acid-base states. Renal tubules from control, acidotic, or alkalotic rats were incubated at pH 7.4 with 1 mM [3-13C,5 15N]glutamine or 2 mM [3-13C]pyruvate. In acidosis there was a significantly higher flux through glutaminase and through glutamate, 2-oxoglutarate, succinate and malate dehydrogenases as well as markedly enhanced 13C-glucose formation. Alkalosis was associated with little change in 13C flux from glutamine to TCA cycle intermediates compared with control but production of 15NH3 and 13C glucose was significantly diminished. The current studies indicate that renal ammoniagenesis might be regulated at the sites of citrate synthetase (CS) and/or alpha-ketoglutarate dehydrogenase (KGDH). Thus, in chronic metabolic acidosis decreased flux through CS and increased flux through KGDH resulted in enhanced flux through glutamate dehydrogenase and glutaminase pathway. The opposite occurred in alkalosis. The data suggest that in various acid-base states the rate of renal gluconeogenesis is linearly correlated with malate efflux from the mitochondria. In renal tissue, inhibition occurs at one site of the TCA cycle there is an augmentation of fluxes through pathways beyond that site in order to maintain the respiratory process and the redox state in the mitochondria. PMID- 1770914 TI - Characterization of the renal and intestinal adaptations to dietary calcium deprivation in growing female rabbits. AB - To characterize the time courses and efficiencies of the renal and intestinal adaptations to dietary Ca deprivation, growing female albino rabbits were fed a low-Ca diet for up to 44 days while they were housed in metabolism cages. Urinary Ca excretion decreased markedly within 8 h of Ca restriction and became essentially undetectable after 14 days. This persisted as long as dietary Ca was low. The intestinal Ca absorption observed during the predeprivation control period was initially changed to net secretion with dietary Ca restriction. However, after 21 days of the low-Ca diet, intestinal Ca absorption was observed. Fecal Ca contents decreased appropriately with Ca deprivation, but never became undetectable. Hyperphosphaturia, which occurred within 8 h of Ca deprivation and persisted as long as dietary Ca was restricted, diminished positive P balance, despite increased intestinal P absorption. Intestinal hyperabsorption and renal conservation of Ca were observed after dietary Ca repletion, suggesting the presence of driving forces for the restitution of Ca deficits incurred by Ca deprivation during growth. We conclude that there are appropriate intestinal and renal homeostatic adaptations to dietary Ca deprivation in the growing female rabbit and that the latter are more rapidly induced and ultimately more efficient than the former. PMID- 1770915 TI - Role of parathyroid hormone in rat remnant kidney ammonium metabolism. AB - The role of parathyroid hormone (PTH) in ammonium metabolism in the rat remnant kidney was studied by examining the effects of parathyroidectomy (PTx) in rats with intact kidneys and with 5/6 nephrectomy (Nx). PTx in rats with intact kidneys caused a rise in urine pH and a decrease in urinary ammonium excretion without affecting in vitro ammonium production rate or the ammonium content in the cortex. Unexpectedly, the ammonium content in the medulla was markedly reduced by PTx so that the corticomedullary ammonium gradient was inverted. As compared to control rats, rats with 5/6 Nx had a lower urinary ammonium excretion rate, a higher in vitro ammonium production rate, and an increase in ammonium content in both cortex and medulla with reduced corticomedullary ammonium gradient. PTx in rats with 5/6 Nx led to a further decrease in urinary ammonium excretion, attenuated the increase in the in vitro ammonium production rate, and lowered the ammonium content in both cortex and medulla with inverted corticomedullary ammonium gradient. These effects of PTx in Nx rats were corrected by continuous PTH infusion with Alzet minipump. In summary, results from these studies indicate that PTH plays an important role in maintaining the urinary ammonium excretion. In rats with intact kidneys, PTH contributes to urinary ammonium excretion by increasing urinary acidification and medullary ammonium accumulation. In rats with reduced nephron mass, PTH enhances urinary ammonium excretion by stimulating ammonium production and retaining medullary ammonium in the remnant kidney. PMID- 1770916 TI - Dimethyl sulfoxide enhances hexose monophosphate shunt activity in cultured glomerular mesangial cells, leukocytes and erythrocytes. AB - The effect of dimethyl sulfoxide (DMSO) on the rate of glucose oxidation by cultured rat glomerular mesangial cells, human erythrocytes and peritoneal exudate cells was studied. Mesangial cells, erythrocytes and peritoneal exudate cells incubated with DMSO showed enhancement of 14CO2 production from D-[1-14C] glucose but not from D-[6-14C] glucose. The concentration of DMSO required to stimulate respiratory burst activity was lowest for erythrocytes and highest for peritoneal exudate cells. Studies utilizing tritiated deoxyglucose revealed that the increased glucose oxidation associated with DMSO exposure was not due to increased transmembrane glucose movement at low concentrations of DMSO, and only partially responsible at high concentrations of DMSO. This study documents the ability of DMSO to specifically enhance the activity of the hexose monophosphate shunt pathway in all cells studied. The precise mechanism whereby DMSO stimulates shunt activity remains unknown. PMID- 1770917 TI - [Postmenopausal and senile osteoporosis. Prevention or therapy?]. AB - Pharmacological treatments of osteoporosis can improve bone mineral content, but are not able to restore trabecular bone structure in presence of microfractures. It is therefore necessary to carry out at the right moment some preventive actions to increase peak bone mass in premenopausal age: adequate calcium intake, systematic physical activity and, if necessary, oestrogen administration before menopause are correct prophylactic measures against osteoporosis; moreover risk factors identification allows to perform a preliminary screening. Serial bone absorptiometry at lumbar level is able to identify fast losers women by means of integrating densitometric data and some metabolic results. Utilizing these methods it is possible to activate proper preventive or therapeutic measures and prevent osteoporotic complications. PMID- 1770918 TI - [The diagnosis of postmenopausal osteoporosis]. AB - Post-menopausal osteoporosis is a metabolic bone disease which is histologically characterised by a reduction of bone mass with normal mineral content of the remaining bone tissue. In clinical term, the symptoms of disease include pain in the bones, pathological fractures (of the vertebra, femur, wrist) and consequent deformations of the skeletons. X-ray is still the most efficient diagnostic tool, although it is only capable of revealing osteopenia when bone has lost more than 40% of its mineral content. Bone densitometry is an important stage in the diagnosis and study of osteoporosis. It is first performed at the distal extremity of the forearm, then at the lumbar vertebra and head of the femur. Bone mineralometry is also currently used to study the skeleton as a whole (total body absorptiometry). This method, which has a high level of precision and no positioning problems, is able to provide extremely reliable measurements of bone mineral content, in particular during monitoring. It is worth underlining, however, that other bone metabolic diseases, namely osteomalacia, are also characterised by reduced bone density: the level of bone density should therefore not be considered as an expression of bone mass. In biochemical terms, post menopausal osteoporosis leads to minimum modifications of the phospho-calcium metabolism: only during stages of accelerated bone turnover is it possible to observe a small increase in calciuria, hydroxyprolinuria and serum osteocalcin levels. A prime factor for the diagnosis of post-menopausal osteoporosis is the intestinal calcium absorption test: post-menopausal osteoporosis is characterized by insufficient intestinal calcium transport.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770919 TI - [Principles and theoretical basis for photon and x-ray mineral determination]. AB - The increasing spread of osteoporosis has made it necessary to develop improved diagnostic systems and to pay special attention to new techniques for the prediction of future risks. From a theoretical standpoint, it is known that by inserting between a radioactive source and a detector some higher density material, we obtain a decrease in the absorption counting rate. Through special mathematical models it is possible to determine the thickness of the absorbing material. This principle is at the basis of the first densitometer designed by Cameron and Sorenson. However such an absorption equation is valid only in case of constant density, while the human body is neither uniform nor linear. A first improvement is based on the use of radioactive sources characterized by two types of emission so as to be able to discriminate between various levels of tissue density. Improved densitometers include double photonic rays and use two variables mathematical models. The use of X rays instead of radioactive sources makes it possible to obtain clearer images, higher scanning speed, lower costs and total body examinations. Special attention is to be paid to machine calibration so to reach a perfect association between a well determined absorption counting rate and a well determined tissue thickness. PMID- 1770920 TI - [Applications and results of photon absorptiometry]. AB - Bone mineral content (CMO, mg/cm2) was measured at the distal radius by dual photon absorptiometry (DPA, I125, Am241) in 1.161 women (w), aged 20-87 years. Women were subdivided into different groups according to the presence and duration of menopause. For gross evaluation of spinal osteoporosis (OP), the results of spinal X-rays were graded as follows: score 0: no signs of OP; score 1: aspecific signs of OP; score 2: typical signs of OP; score 3: wedging or collapse of one or more vertebrae. Women in postmenopausal state showed significantly reduced CMO (p less than .0005) when compared to women in premenopausal state; a significant correlation was found between CMO and years since menopause (p less than .0001). Concerning the relationship between CMO and spinal score, a progressive decreases in CMO from score 0 to score 3 was present and the correlation was significant (p less than .0001). In addition, women with score 3 showed a mean CMO below the "fracture threshold", in spite of the large overlap in individual CMO values. Our data suggest that radial DPA should be maintained as a "screening" procedure for OP. PMID- 1770921 TI - [Ultrasound transmission velocity in the patella of normal subjects and in patients with postmenopausal osteoporosis]. AB - Recently, ultrasound transmission velocity (UTV) has been used to assess skeletal status. The basic principle of UTV measurement of bone is that the speed at which ultrasounds propagate in bone is determined by the mass density and by the index of elasticity, which is intimately correlated with bone strength. Theoretically UTV should provide more information about bone fragility than the absorptiometric techniques of measurement of bone mass. To test this hypothesis, UTV was measured using the SIGNET(TM) (Osteo Technology, Framingham, MA, USA) in the patella of 79 postmenopausal nonobese women. The subjects were divided into 2 groups: 29 postmenopausal normal women (NPM) and 50 patients with at least one vertebral crush fracture due to postmenopausal osteoporosis (PMO). Besides UTV measurements in all subjects lumbar spine bone mineral density (BMD) was measured by dual energy Rx (Hologic QDR 1000). UTV in NPM (mean age 57.9 +/- 8 SD years) averaged 1867 +/- 62 m/sec, and in PMO (mean age 63.5 +/- 7.8 SD years) averaged 1771 +/- 74 m/sec. It follows that the difference between the two groups was about 96 m/sec. UTV correlated significantly with BMD measured in the lumbar spine (r = 0.51; p less than 0.001), giving a discrimination power virtually identical to that obtained by using spine BMD values. This preliminary data are promising for the use of this new technique which offers a simple, noninvasive measure of bone quality without the limitation of radiation exposure. PMID- 1770922 TI - [X-ray bone densitometry. Study of in vitro and in vivo reproducibility]. AB - We studied the reproducibility in vitro and in vivo of a new bone densitometer (HOLOGIC QDR-1000, software version 4.03) which uses an x-ray source at two different levels of energy. Short and long term coefficient of variation (c.v.) in vitro is less than 0.5%. In vivo c.v. is less than 1% in normal body weight subjects and less than 3% in obese subjects. The ingestion of 500 mg of calcium element did not modify bone mineral density (BMD), while 1000 mg determined an increase of BMD equal to 2.6% and 1.5% in the two subjects examined. The increase of water thickness on a three femoral heads phantom caused a progressive reduction of bone mineral content (BMC) and BMD until 12.1% less than basal value and an increase of c.v. from 0.1% to 1%. The addition of oil to water at different percentages determined a slight increase of both BMC and BMD, till 3.5% with 66% of oil in water, if compared with the values obtained with water alone. The reduction of soft tissue around the bone determined a progressive decrease of BMD reaching 3.4% less than basal value when the reduction was 30%. PMID- 1770923 TI - [Computerized bone mineral measurement. Radiation protection and legal aspects]. AB - We begin by defining the standard units utilized in dosimetry and we illustrate the risks related to the interaction of ionizing radiation with living matter. Next we summarize the basic elements of radioprotection such as the physical and medical control of the employees and the inspection by the official authorities. Finally we consider the specific aspects of radioprotection in bone mineral measurement, in relation both with dosimetry and with the existing legislation on the matter. PMID- 1770924 TI - Waterborne-disease outbreaks, 1989-1990. AB - For the 2-year period 1989-1990, 16 states reported 26 outbreaks due to water intended for drinking; an estimated total of 4,288 persons became ill in these outbreaks. Giardia lamblia was implicated as the etiologic agent for seven of the 12 outbreaks in which an agent was identified. The outbreaks of giardiasis were all associated with ingestion of unfiltered surface water or surface-influenced groundwater. An outbreak with four deaths was attributed to Escherichia coli O157:H7, the only bacterial pathogen implicated in any of the outbreak investigations. An outbreak of remitting, relapsing diarrhea was associated with cyanobacteria (blue-green algae)-like bodies, whose role in causing diarrheal illness is being studied. Two outbreaks due to hepatitis A and one due to a Norwalk-like agent were associated with use of well water. Eighteen states reported a total of 30 outbreaks due to the use of recreational water, which resulted in illness for an estimated total of 1,062 persons. These 30 reports comprised 13 outbreaks of whirlpool- or hot tub-associated Pseudomonas folliculitis; 13 outbreaks of swimming-associated gastroenteritis, including five outbreaks of shigellosis; one outbreak of hepatitis A associated with a swimming pool; and three cases of primary amebic meningoencephalitis caused by Naegleria. The national surveillance of outbreaks of waterborne diseases, which has proceeded for 2 decades, continues to be a useful means for characterizing the epidemiology of waterborne diseases. PMID- 1770925 TI - Tuberculosis morbidity in the United States: final data, 1990. AB - The number of tuberculosis cases reported to CDC has been increasing since 1988, after a long historic decline. In 1990, 25,701 cases were reported, an increase of 9.4% over the 1989 figure and the largest annual increase since 1953. From 1985 to 1990, reported cases increased by 15.8%. Disproportionately greater increases in reported cases occurred among Hispanics, non-Hispanic blacks, and Asians/Pacific Islanders. In contrast, decreases were observed among non-Hispanic whites and American Indians/Alaskan Natives. By age, the largest increase in reported cases occurred in the 25- to 44-year age group; this increase may be largely attributable to rising numbers of tuberculosis cases among persons with human immunodeficiency virus infection or acquired immunodeficiency syndrome. Notable increases also occurred among children. The proportion of cases among foreign-born persons has risen steadily, from 21.6% in 1986 to 24.4% in 1990. PMID- 1770926 TI - Regional and temporal trends in the surveillance of syphilis, United States, 1986 1990. AB - During the latter half of the 1980s, an epidemic of syphilis occurred throughout the United States. A comparison of regional rates of primary and secondary syphilis in 1990 indicated that the rates were highest in the South, followed by the Northeast, the West, and the Midwest. Primary and secondary syphilis rates from 1986 through 1990 exhibited different regional patterns. Rates of primary and secondary syphilis in the West peaked in 1987 and declined from 1987 to 1990. Rates increased in the Northeast and the South from 1986 to 1990, but the increase reached a plateau in the Northeast in 1990. Rates did not begin to increase in the Midwest until 1988. More detailed analyses of the syphilis epidemics in specific communities in each region are needed to better understand the regional patterns. A comparison of these findings across regions could be helpful in evaluating which sexually transmitted disease intervention and control programs are most effective during epidemic periods. PMID- 1770927 TI - Trichinosis surveillance, United States, 1987-1990. AB - Since the Public Health Service began recording statistics on trichinosis in 1947, the number of cases reported by state health departments each year has declined. In the late 1940s, health departments reported an average of 400 cases and 10-15 deaths each year; from 1982 through 1986, the number declined to an average of 57 cases per year and a total of three deaths for the period. From 1987 through 1990, 206 cases of trichinosis from 22 states, including 14 multiple case outbreaks, were reported to CDC. In 1990, two large outbreaks associated with commercial pork accounted for 106 cases. In the 192 instances in which a suspect food item was identified, pork was implicated in 144 (75%) cases, walrus meat in 34 (18%), and bear meat in 14 (7%). Sausage, the most frequently implicated pork product, was associated with 128 of the 139 cases for which a form of ingested pork was specified. Before 1990, the proportion of cases of trichinosis attributable to consumption of commercial pork had declined steadily. This decline was probably due to a combination of factors, including laws prohibiting the feeding of garbage to hogs, the increased use of home freezers, and the practice of thoroughly cooking pork. Although the incidence of trichinosis has decreased substantially since national reporting was initiated in 1947, a dramatic increase in 1990, resulting from two large outbreaks, emphasizes the need for further education and control measures. PMID- 1770928 TI - [The effect of human growth hormone on protein metabolism in the surgically stressed state]. AB - The effects of human growth hormone (HGH) on protein metabolism were investigated. In the experimental study, thirty one male SD rats receiving TPN were divided into 2 groups (control group & HGH group). Cumulative nitrogen balance after burn in HGH group was significantly higher than in control group. (p less than 0.05) Rates of whole body protein turnover (Q), together with those of synthesis (S) and breakdown (B) were significantly higher in HGH group than in control group. (p less than 0.01) Nitrogen balance significantly correlated with urinary total catecholamine excretion in both groups. (p less than 0.01) The difference of correlations of nitrogen balance to urinary total catecholamine excretion between two groups was statistically significant (p less than 0.01) when compared by analysis of covariance. In the clinical study, 12 patients after sub-total esophagectomy receiving TPN were divided into 2 groups (control group & HGH group). Cumulative nitrogen balance after operation in HGH group was significantly higher than in control group. (p less than 0.01) Q,S, and B were higher in HGH group than in control group. Increase of S was statistically significant. (p less than 0.01). These results indicate that HGH may be greatly beneficial in improving protein metabolism in the surgically stressed state. PMID- 1770929 TI - [The effect of various compositions of TPN on nutritional and immunological assessment in patients with esophageal cancer]. AB - The purpose of this clinical study was to determine 1) whether high calorie diet gives any advantages for nutritional assessment and immunological functions after esophagectomy, 2) whether BCAA is useful to improve immunological parameters postoperatively and 3) which energy source is mainly utilized, fat or glucose, postoperatively. To accomplish the purpose of this study, three experiments were carried out. The subjects were 210 patients with esophageal cancer. Exp. 1: Either high (over 40kcal/kg/day) or low (under 35kcal/kg/day) calorie diet was administered postoperatively. Exp. 2: 30% BCAA versus 22.6% BCAA diet was compared under high calorie diet. Exp. 3: 24% fat versus 13% fat diet was compared, giving high calorie diet with 30% BCAA. Nutritional assessment was done by postoperative performance nutritional index, fatty acid analysis, energy expenditure, nitrogen balance and A-V difference of alanine and glutamine, and also immunological function by PHA, lymphocytes, NK activity of lymphocyte and leu 7 positive cells. Regardless of composition of TPN, high calorie diet improved nutritional assessment and immunological functions. A-V difference and fat combustion were improved with high fat diet in postoperative courses. It was concluded that high calorie diet with 30% BCAA and 24% fat was beneficial after esophagectomy. PMID- 1770930 TI - [Establishment and characterization of human esophageal carcinoma cell lines- especially the role of the serum-free culture]. AB - Three squamous cell carcinoma cell lines, YES-1, YES-2, and YES-3, were established from human esophageal carcinoma. Two cell lines, YES-1 and YES-2, were established from the surgically removed tumor and YES-3 was established from pleural effusion of the pleuritis carcinomatosa by esophageal carcinoma. These three cells not only resembled the original esophageal carcinoma tissue on microscopic examination, but also produced same tumor marker, such as SCC antigen, CEA, TPA, CA125 and CA19-9. However, the secretion patterns of tumor markers were different. The doubling times of YES-1 cells, YES-2 cells and YES-3 cells were 35.2 hours, 22.9 hours, and 61.0 hours, respectively. Chromosomal studies show that chromosomal number of YES-1 cells ranges 47 to 54 with a mode of 51, that of YES-2 cells ranges 53 to 62 with a mode of 60 and that of YES-3 cells ranges 48 to 52 with a mode of 50. These three cells grow both in serum containing medium and in serum free medium. When YES-1, YES-2, and YES-3 cells were injected into athymic nude mice subcutaneously, they introduced tumors which resembled the original esophageal carcinoma tissue histologically. These 3 cell lines may provide useful models for the study of human esophageal carcinoma. PMID- 1770931 TI - [Studies on operative method in intestinal hemodynamics of panperitonitis]. AB - Using a tissue spectrum analyser, intestinal hemodynamics were determined in 85 patients with panperitonitis. By the preoperative shock score(ss) the patients were classified into group I (ss less than or equal to 1: n = 30), group II (2 less than or equal to ss less than or equal to 4: n = 30), group III (5 less than or equal to ss: n = 25). The index of hemoglobin concentration (IHb) was increased in group II, while the index of oxygen saturation (ISO2) was decreased in groups I and II. There was an increase of the cardiac index and a decrease of total peripheral resistance in group III compared with other groups, indicating a hyperdynamic state. Oxygen delivery and consumption showed no marked changes in groups I and II, but they were impaired in group III. The incidence rate of anastomotic leakage was 0% in group I, 37.5% in group II, and 100% in group III. It was considered that in the group II patients, a decrease in tissue oxygenation caused by stagnation of blood flow becomes a cause of anastomotic leakage. In the group III patients, tissue damage caused by marked disturbances of oxygen delivery and consumption leads to a high incidence of anastomotic leakage. I concluded that the second look operation should be performed for the patients with the disturbance of oxygen delivery and consumption. PMID- 1770932 TI - [Cytofluorometric analysis of cell proliferation kinetics of the human colorectal cancer]. AB - In order to clarify cell proliferation kinetics of human colorectal cancer, 91 cases were investigated by cytofluorometry and clinicopathological findings. The results showed colorectal cancers could be divided into 3 groups according to the ploidy pattern. Group I was the diploid cell population, group II the polyploid cell populations and group II' the aneuploid cell populations. These ploidy patterns were found not to be related both to the histological types and the gross pathological classification. Most of the intramucosal cancers were found in group I, and the cancers of more advanced growth mainly in groups II and II'. The fraction of diploid cells in the groups I and II' did not show the remarkable change, but in the group II decreased with tumor progression. These results indicate the ploidy patterns appear to change with the submucosal invasion, and also that while the ploidy patterns in the groups I and II' are stable, those in the group II increase the extent of polyploidization with the tumor growth. Lymphatic metastases were found to be more frequent in the group II than in the groups I and II'. It is suggested that the mechanism of lymphatic metastasis would be related to the cell polyploidization. PMID- 1770933 TI - [Effects of sublethal endotoxemia to the hepatic reticuloendothelial system after massive hepatectomy]. AB - Sublethal doses (1mg/kg) of endotoxin (ET) were intravenously administered on the first, third and fifth days after 34%, 70%, and 84% hepatectomies in rats. The same hepatectomy groups of rats without ET administration were made. Survival rates, distribution of Kupffer cells (Kc), regeneration rate of the liver weight, carbon clearance test (K value) and PTAH staining were compared between ET treated and untreated groups. Survival rates of 84% hepatectomy rats with ET injection on the 3rd postoperative day (POD) was significantly lower than those of 70% hepatectomy rats with ET on the 1st or 3rd POD. ET activated reticuloendothelial function of the non-hepatectomized and 34% hepatectomy rats, but reduced the number of the Kc in the central zone, especially in 84% hepatectomized rats. K values and the number of Kc in the central zone showed a good correlationship (r = 0.9) after 70% and 84% hepatectomies. Patchy hepatic necrosis and fibrin clots were observed histologically in the liver, kidney and spleen of rats died after ET administration. In conclusion, sublethal endotoxemia reduces the function and number of Kupffer cells in the regenerating liver and causes postoperative death in the rats with massive hepatectomy. PMID- 1770934 TI - [Experimental studies on tissue injury by microwave tissue coagulator]. AB - The tissue injury caused by Microwave Tissue Coagulator (MTC) was assessed clinically and experimentally with dogs. Following hepatic transection using MTC on condition that the output was 60 watts and radiation lasted for 60 seconds at one time, GOT, GPT, lactic acid, FDP and endotoxin concentration increased and coagulation parameters such as hepaplastin test were deteriorated transiently. Of tissue injury, following results were obtained. 1) The mechanism of tissue injury by MTC consists of direct heat injury and infarct by circulatory disturbance. The extent of injury from the needle electrode is approximately 10 mm in the former mechanism and 20mm in the latter. 2) Injury of vessels in Glisson's sheath was confirmed up to 50mm apart from the needle electrode by labelling index of bromodeoxyuridine in bile duct epithelial cells. 3) The granulation formation at the site of necrosis was considerably retarded by wound infection. Accordingly, when MTC is utilized on hepatectomy, followings should be noted: 1) To prevent the large intrahepatic vessels from heat injury, MTC may be utilized at the surface of the liver and the needle electrode must be punctured more than 10mm apart from them. 2) Bile leakage at the resected stump should be eliminated to prevent infection at the stump. PMID- 1770935 TI - [Two different types of monoclonal antibodies against gallbladder carcinoma cell line]. AB - Monoclonal antibody FU-W-H6 whose immunoglobulin subclass was IgG2a kappa was produced against gallbladder carcinoma cell line FU-GBC-2. In normal tissue, this antibody has a strong reactivity specific to the mucosa of the gallbladder (14/15, 94%), bile duct (5/5, 100%), and pancreatic duct (4/5, 80%) in comparison with the lack of the gastric mucosa, and colorectal mucosa with statistically significant differences (p less than 0.01). In cancerous tissue, gallbladder cancer (11/12, 92%), bile duct cancer (5/5, 100%), and pancreatic cancer (2/2, 100%) reacted gastric cancer (4/12, 33%), and colorectal cancer (1/16, 6%) with statistically significant differences (p less than 0.05). On the other hand, another monoclonal antibody FU-W-E2 whose immunoglobulin was IgM has specificity to the gastrointestinal or gallbladder cancers. Eleven of 13 (85%) gastric cancers, 12 of 16 (75%) colorectal cancers, and 9 of 12 (75%) gallbladder cancers reacted positively with statistically significant differences with each normal epithelia (p less than 0.05). Immunoelectron microscopical study revealed that the antigen recognized by FU-W-H6 was localized by FU-W-H6 or E2 antigens were suggested to be a carbohydrates on the glycoprotein, and were thought to have relation to sialic acid by treatment of acid Sciff and enzymes. Western blot analysis demonstrated that their molecular weights were about 87000, and 92000. PMID- 1770936 TI - [Is the new WHO's histological typing clinically useful for the diagnosis of follicular cancer of the thyroid?]. AB - We tried to re-diagnose our 57 cases of thyroid follicular cancer between 1965 and 1988 in accordance with Histological Typing of Thyroid Tumours published by WHO in 1988. 1) The incidence of follicular cancer in differentiated cancers was decreased from 17.9% to 8.3% (26 cases). The number of widely invasive type and minimally invasive type was 13 cases equally. 2) Twenty four cases were diagnosed as papillary cancer. The reason was that 20 cases had a small focus of papillary structure, and other 4 cases had features of follicular variant type of papillary cancer. These 24 cases had good prognosis as our 262 cases of papillary cancer, in contrast to 26 cases of follicular cancer having worse prognosis. 3) The incidence of distant metastasis in follicular carcinoma was increased from 28.1% to 42.3%; 23.9% in minimally invasive type and 61.5% in widely invasive type, respectively. New WHO classification is acceptable according to this clinical study of our cases. We would have to treat more aggressively the patient diagnosed follicular cancer by WHO classification because of high incidence of distant metastasis. PMID- 1770937 TI - [Objective evaluation of nuclear grade in preoperative aspiration materials from breast cancers--special reference to the relationship of coefficiency variant of nuclear area with pathological prognostic features]. AB - The prognostic significance of cytomorphometry was investigated in 84 invasive ductal breast cancer patients. All patients were clinically followed for at least 5 years after radical mastectomy. The value of coefficiency variant of nuclear area (NA.CV) calculated from morphometor had good correlation with nuclear grade determined subjectively by cytologist on optical microscope. NA.CV in patients who had metachronous metastases (39.0 +/- 7.5%) was significantly higher than that in recurrence free cases (26.8 +/- 4.9%). The recurrence free period was also related to the value of NA.CV. In 39 cases (90.7%) out of 43 recurrence free survivors, the value of NA.CV was less than 30%, whereas it was over 40% in 11 (45.8%) out of 24 cases with short time (less than two years post operatively) metastases. NA.CV was the most variable, independent prognostic factor among several pathological prognostic features. The data assessed in this study showed that the value of NA.CV on cytological materials as the objective evaluation of nuclear grade may provide clinically relevant information with respect to the degree of malignancy and prognosis of patients with breast cancer at preoperative period. PMID- 1770938 TI - [An experimental study on supraventricular dysrhythmias after intracardiac surgery, with special reference to relationship between injury of the internodal tract and atrial flutter]. AB - Dysrhythmias after atrial reparative surgery for TGA or ASD can be lethal. Experiments were made to analyze their mechanism, and to search preventive methods. 1. Acute effects of atrial incisions were studied by epicardial mapping on the right atriums (RA) subjected to various incisions with or without internodal tract (INT) involvement 101 dogs. Atrial rapid pacing was used to induce sustained AF or af. 2. Chronic effects of atrial incisions were studied on longitudinal incisions with (8 dogs) or without (8 dogs) posterior INT (PINT) involvement. Few months later they were subjected to mapping, inducibility of AF, and histologic study of hearts. 3. Mechanism of induced AF was analyzed using reentrant circuit of AF in the longitudinal PINT incision group. At acute stage, conduction delay specific to each freewall incision was observed. AF or af was induced in 70.0% of the longitudinal incision with PINT involvement, but only in 1 dog without PINT. At chronic stage, AF was induced in 5 dogs (62.5%) which included 4 dogs not showed AF at acute stage. Marked chronic changes were histologically showed in injured atrial portion. Reentrant circuit of AF was demonstrated on RA near tricuspid orfice. The PINT kept intact is important to prevent AF. PMID- 1770939 TI - [Feasibility of estradiol and tamoxifen sensitivity test using contact-sensitive plates for clinical breast carcinoma: preliminary report]. PMID- 1770940 TI - [Serum CA125 in patients with gastric cancer or colon cancer was transiently increased after curative resection: preliminary report]. PMID- 1770941 TI - [Studies on combined therapy of topical administration of cisplatin and hyperthermia for VX2 tumor in rectum of rabbit: preliminary report]. PMID- 1770942 TI - [Effect of portal pooling on hepatic regeneration after partial hepatectomy: preliminary report]. PMID- 1770943 TI - Induction and turnover of catfish (Heteropneustes fossilis) metallothionein. AB - Induction of metallothionein by cadmium in catfish was a dose-dependent, transcriptionally-controlled process. Metallothionein mRNA was detected after Cd exposure. Chronic doses produced more metallothionein than a single acute dose. Zn and Cu induced metallothionein to a lower extent compared to Cd. A few other low molecular weight proteins were induced in cadmium-exposed catfish liver, besides metallothionein. Isoelectric point of catfish metallothionein was 3.9. The rate of depletion of Cd and metallothionein was very slow from liver and almost unchanged from kidney following its induction by cadmium. PMID- 1770944 TI - Effects of cholesterol oxidase on cultured vascular smooth muscle cells. AB - Cholesterol oxidase (3 beta-hydroxy-steroid oxidase) catalyzes the oxidation of cholesterol to 4-cholesten-3 one and other oxidized cholesterol derivatives. The purpose of the present study was to investigate its effects on cultured vascular smooth muscle cells. Cultured rabbit aortic smooth muscle cells were morphologically altered after exposure to cholesterol oxidase in the presence of culture medium containing 10% fetal calf serum. If fetal calf serum was absent, cells were unaffected by the treatment. The extent of morphological change of the smooth muscle cells was dependent upon the time of exposure to the enzyme and the concentration of cholesterol oxidase employed. After moderate treatment with cholesterol oxidase, cells excluded trypan blue. Further, a specific mitochondrial marker DASPMI (dimethyl aminostyryl-methyl-pyridiniumiodine) which was used as a fluorescent index of cell viability, revealed that cell viability was unchanged after moderate cholesterol oxidase treatment. Nile red, a hydrophobic probe which selectively stains intracellular lipid droplets, was applied to detect the cellular lipid content after treatment with cholesterol oxidase. Cellular nile red fluorescence intensity increased linearly with the time and concentration of cholesterol oxidase treatment. These results demonstrate that cholesterol oxidase alters lipid deposition in the cell and changes cell morphology. The primary site of action of cholesterol oxidase appears to be independent of the cell membrane itself and instead is dependent upon the lipid content in the surrounding culture media. These changes occur prior to the cytotoxic effects of extensive oxidation. Because oxidized cholesterol may play an important role in the pathogenesis of atherosclerosis, our results have implications for intracellular accumulation of lipids in smooth muscle cells during the atherosclerotic lesion. PMID- 1770945 TI - Effects of oxidative modification of cholesterol in isolated low density lipoproteins on cultured smooth muscle cells. AB - It has been proposed that low density lipoprotein (LDL) must undergo oxidative modification before it can participate in atherosclerosis. The present paper studied the effect of cholesterol oxidation in LDL on cultured vascular smooth muscle cells. LDL was oxidized by cholesterol oxidase (3-beta-hydroxy-steroid oxidase) which catalyzes the oxidation of cholesterol to 4-cholesten-3 one and other oxidized cholesterol derivatives. Cholesterol oxidase treatment of LDL did not result in lipid peroxidation. Cultured rabbit aortic smooth muscle cells were morphologically changed following exposure to cholesterol oxidized LDL. Nile red, a hydrophobic probe which can selectively stain intracellular lipid droplets, was applied to detect the cellular lipid content after treatment with oxidized or non oxidized LDL cholesterol. LDL which did not undergo oxidation of its cholesterol had no effect on the cells. However, cellular nile red fluorescence intensity was increased as the pre-incubation time of cholesterol oxidase with LDL increased. This was supported by HPLC analysis which revealed that the oxidized cholesterol content of treated cells increased. These findings suggest that cholesterol oxidation of LDL can alter lipid deposition in the cells and change cell morphology. The oxidation of cholesterol in vivo may play an important role in the modification of LDL which could contribute to the generation of the lipid laden foam cells. PMID- 1770946 TI - Insulin induces changes in the subcellular distribution of actin and 5' nucleotidase. AB - An increase in the amount of actin associated with the plasma membrane was visualized by immunocytochemistry 5 min after the addition of insulin to Krebs II ascites tumour cells maintained in serum-free medium. At 1 h of incubation the rim of fluorescence at the plasma membrane as measured by image analysis, was about 30% more intense than in control cells indicating that the initial accumulation of actin at the plasma membrane was not of a transient nature. Since an increase in the total cellular actin content in ascites cells did not occur until after a lag period of about 15 min then the increased amount of actin at the plasma membrane seen at 5 min was attributed to a stimulation of the polymerization of actin. An increase in the association of actin at the plasma membrane was also observed in 3T3 fibroblasts in areas of membrane ruffling, while in some cells there was also increased actin accumulation in the perinuclear area. The putative plasma membrane-microfilament linking protein 5' nucleotidase was shown to be present in association with actin in the cytoskeletal fraction. Incubation of cells with insulin resulted in a shift of the enzyme toward the bottom of gradients indicating association with actin filaments of a greater length. The results demonstrate that insulin causes a stimulation of actin polymerization and that the hormone can be therefore assigned a role in the regulation of the cytoskeleton. PMID- 1770947 TI - Isolation and partial sequence of goat spleen prothymosin alpha. AB - Goat prothymosin alpha, a highly acidic polypeptide of pI3.5, 109 amino acid residues, has been isolated from lymphoid and non-lymphoid tissues of young female goats. Unlike rat, murine and porcine prothymosins alpha, goat prothymosin alpha appears at a higher concentration in the spleen compared with the thymus. The sequence of segments of the polypeptide involving known mutations has been determined, by automatic sequencing of its tryptic peptide fragments. The acidic amino acid-rich segment in the middle of the molecule, including residues 49-83, has not been sequenced. Goat prothymosin alpha closely resembles bovine prothymosin alpha, with only one substitution, proline for alanine at position 85. It also resembles human prothymosin alpha, with only three substitutions. It differs more significantly from rat and murine prothymosins alpha, by two deletions and three substitutions. The results show the highly conserved nature of the molecule, with substitutions at given positions only. PMID- 1770948 TI - Impaired calcium uptake by cardiac sarcoplasmic reticulum and its underlying mechanism in endotoxin shock. AB - Effects of endotoxin administration on the ATP-dependent Ca2+ uptake by canine cardiac sarcoplasmic reticulum (SR) were investigated. Results obtained 4 h after endotoxin administration show that ATP-dependent Ca2+ uptake by cardiac SR was decreased by 27-43% (p less than 0.05). Kinetic analysis indicates that the Vmax values for Ca2+ and for ATP were significantly decreased while the S0.5 and the Hill coefficient values were not affected during endotoxin shock. Magnesium (1-5 mM) stimulated while vanadate (25-250 microM) inhibited the ATP-dependent Ca2+ uptake, but the Mg(2+)-stimulated and the vanadate-inhibited activities remained significantly lower in the endotoxin-treated animals. Phosphorylation of SR by the exogenously added catalytic subunit of the cAMP-dependent protein kinase or by the addition of calmodulin stimulated the ATP-dependent Ca2+ uptake activities both in the control and endotoxin-injected dogs. However, the phosphorylation stimulated activities remained significantly lower in the endotoxin-injected dogs. Dephosphorylation of SR decreased the ATP-dependent Ca2+ uptake, but the half-time required for the maximal dephosphorylation was reduced by 31% (p less than 0.05) 4 h post-endotoxin. These data indicate that endotoxin administration impairs the ATP-dependent Ca2+ uptake in canine cardiac SR and the endotoxin induced impairment in the SR calcium transport is associated with a mechanism involving a defective phosphorylation and an accelerated dephosphorylation of SR membrane protein. Since ATP-dependent Ca2+ uptake by cardiac SR plays an important role in the regulation of the homeostatic levels of the contractile calcium, our findings may provide a biochemical explanation for myocardial dysfunction that occurs during endotoxin shock. PMID- 1770949 TI - Adrenocortical pregnenolone-binding protein activity requires a small heat-stable factor: evidence that regulation by phosphorylation/dephosphorylation occurs at the level of the factor, not the protein. AB - The steroid-binding capacity of the adrenocortical pregnenolone-binding protein (PBP) is effectively destroyed by extreme temperature (boiling water for 2-5 min); however, the boiled preparation contains a factor that potentiates ligand binding when readded to native PBP. Treatment of the boiled fraction with calf intestinal alkaline phosphatase at pH 9 reverses the stimulatory effect on PBP activity. Additionally, if native PBP is first incubated with alkaline phosphatase, which converts it to a nonbinding form, activity can be fully restored in a dose-dependent manner by the addition of the boiled preparation. The factor (itself devoid of binding capacity) can also be generated by exposing native PBP to acidic conditions (pH 4). The molecule is small (mol wt, less than 2000), as judged by Sephadex G-25 gel filtration and equilibrium dialysis. It is not retained on Concanavalin-A-Sepharose and is not extractable with a variety of organic solvents. The factor remains active after lyophilization and has a net negative charge at pH 7.4 (determined by DEAE-cellulose chromatography). While the binding capacity of native PBP is destroyed by a variety of proteases, the heat-stable factor is unaffected by similar treatment. Additionally, factor activity is not susceptible to RNase, DNase, or lipase digestion. Thus, the protein moiety of the PBP has an absolute requirement for a distinct phosphorylated heat-stable factor for expression of ligand-binding activity, and it may be through this factor that binding activity is regulated. It is not yet known whether the factor is acting allosterically or actually functions as part of the steroid-binding site. PMID- 1770950 TI - The tissue-specific mammalian transcription factor, Pit-1, activates transcription in Saccharomyces cerevisiae. AB - Pit-1 is a tissue-specific transcription factor which binds to specific DNA sequences within 5' flanking regions of the PRL and GH genes and activates the transcription of these genes. Previous studies have shown that expression of Pit 1 is necessary to activate transcription from the PRL or GH promoters in heterologous mammalian cells. In the present study the ability of Pit-1 expression vectors to activate expression of reporter genes in Saccharomyces cerevisiae was examined. The test system used Pit-1 expression vectors and an indicator plasmid containing multiple copies of a Pit1-binding site as a replacement for the upstream activator sequence of the CYC1 promoter. Significant activation of indicator plasmid expression was detected only in the presence of functional Pit-1 expression vectors. In both mammalian and yeast cells, amino terminal deletions of the Pit-1 coding sequence produced similar and gradual loss of transcriptional activation. This finding indicates that similar or identical regions of Pit-1 are required for transcriptional activation in mammalian and yeast cells. Although synthetic DNA elements containing multiple copies of a single Pit-1-binding site were sufficient to permit Pit-1-mediated transcriptional activation in both yeast and mammalian cells, DNA fragments representing the proximal region or distal enhancer region of the PRL gene were transcriptionally active only in mammalian cells. These studies establish the ability of Pit-1 to stimulate transcription in the absence of other tissue specific factors and provide a system for further genetic studies of Pit-1 structure/function relationships as well as evaluation of target sequences necessary for Pit-1 action. PMID- 1770951 TI - Inhibition of protein kinase-A by overexpression of the cloned human protein kinase inhibitor. AB - Human cDNA clones for a heat-stable protein kinase inhibitor (PKI) protein of the cAMP-dependent protein kinase (PKA) were isolated using a mouse PKI cDNA fragment. Two human cDNA clones of 1.7 and 2.0 kb were sequenced and shown to encode the entire open reading frame of 228 nucleotides. Together these clones comprised 2147 nucleotides of the mRNA. The deduced amino acid sequence of the human clones showed 100% identity to the rabbit skeletal muscle PKI protein and 97% identity to the mouse brain PKI. The mouse and human PKI cDNAs shared nucleotide homology in their 3' untranslated regions as well as in the 32 nucleotides immediately 5' of the translation initiation site. Northern blot analysis of human skeletal muscle RNA with a human cRNA probe detected a major mRNA of approximately 4.0 kb. Transient overexpression in COS cells verified that a heat-stable inhibitor of protein kinase was produced by he human PKI cDNA, and protein extracts from the transfected COS cells inhibited both the C alpha and C beta isoforms of the PKA catalytic subunit with equal efficacy. Functional expression of the human PKI protein was further studied by assaying the ability of PKI expression vectors to inhibit PKA catalytic subunit stimulation of transcription from the human enkephalin promoter. In these studies, elimination of a conserved alternative translation start site in the 5' untranslated region of PKI was shown to potentiate the inhibitory activity of the PKI expression vector. PMID- 1770952 TI - Structural characterization of the rat carboxypeptidase-E gene. AB - Several genomic clones encoding carboxypeptidase-E (CPE) have been isolated and partially sequenced. Southern blot analysis indicates that a single copy of this gene is present in the rat genome. The entire gene spans approximately 50 kilobases and consists of nine exons, each of which contains protein-coding regions. Only one of the exon/intron junctions of the rat CPE gene is present in a comparable position within the genes for carboxypeptidase-A and -B, both of which are only 17-21% homologous to CPE at the amino acid level. Nuclease protection analysis shows that alternative splicing of exons 7, 8, and 9 does not occur, indicating that the heterogeneity of the C-terminal region of CPE is due to posttranslational processing. Primer extension and nuclease protection analyses have identified the 5' end of CPE mRNA to be 105 nucleotides up-stream from the ATG used for protein translation. The 5' flanking region does not contain TATA and/or CCAAT boxes in the near vicinity of the transcription initiation site. The 5' flanking region is GC rich, containing 70% GC residues over nucleotides -1 to -150 (relative to the transcription initiation site). Putative consensus sites for the enhancer elements SP-1, NF-1, Pan-1, and AP-2 are present in the region from -60 to -330. Since this report describes the first neuropeptide-processing enzyme gene to be partially sequenced, it is not possible to compare the sequence with those of other processing enzymes that show similar tissue-specific expression. However, comparison of the CPE sequence with 5' flanking regions of other neuroendocrine genes has revealed a short region (12-18 nucleotides) that is highly conserved among CPE, neuropeptide-Y, oxytocin, insulin, and tyrosine hydroxylase genes. PMID- 1770953 TI - A role for protein kinases in the growth hormone regulation of cytochrome P4502C12 and insulin-like growth factor-I messenger RNA expression in primary adult rat hepatocytes. AB - GH is a major determinant of cytochrome P4502C12 and insulin-like growth factor-I (IGF-I) mRNA expression in rat liver. In the present study, a possible role for protein kinase C (PKC) in the GH-mediated regulation of these two genes was investigated. Addition of bovine GH (bGH) to cultured primary adult rat hepatocytes lead to the formation of diacylglycerol and subsequent induction of P4502C12 and IGF-I mRNA, indicating a PKC-dependent signal transduction. However, stimulation of PKC by phorbol 12-myristate 13-acetate (PMA) or sn-1,2 dioctanoylglycerol treatment, in dose and time-course experiments in the presence or absence of ionomycin, failed to induce either P4502C12 or IGF-I mRNA. On the other hand, down-regulation of PKC by PMA treatment, i.e. 24 h pretreatment, attenuated the bGH induction of both P4502C12 and IGF-I mRNA. One hundred nanomolar PMA reduced the bGH-stimulated expression of both IGF-I mRNA and P4502C12 mRNA (approximately 50%). Treatment with the potent kinase inhibitor staurosporine in combination with bGH caused a dose-dependent decrease of the bGH response with different sensitivities toward the inhibitor for the different mRNA species, IGF-I being less sensitive. These data indicate a permissive role for PKC in the GH-mediated induction of P4502C12 and IGF-I mRNA. When activators of protein kinase A, such as forskolin and 8-Br-cAMP were added to the culture medium opposite effects were observed on the mRNA levels of P4502C12 and IGF I.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770954 TI - [Pediatric audiological diagnosis and therapy of hearing disorders in childhood]. AB - Practical suggestions concerning screening hearing tests, clinical paedoaudiological diagnosis, adjustment of hearing aids and the use of cochlear implants during infancy are briefly reviewed. PMID- 1770955 TI - [Rehabilitative measures in hearing-impaired children]. AB - On the basis of certain fundamental data on the maturation processes of the central auditory pathways in early childhood the importance of early intervention with hearing aids is discussed and emphasized. Pathological hearing, that is acoustical deprivation in early childhood will influence the maturation process. Very often speech development is delayed if diagnosis and therapy or rehabilitation are not early enough. Anamnesis, early diagnosis and clinical differential diagnosis are required before a hearing aid can be fitted. Selection criteria and adjustment parameters are discussed, showing that the hearing aid fitting procedure must be embedded in a complex matrix of requirements related to the development of speech as well as to the cognitive, emotional and social development of the child. As a rule, finding and preparing the "best" hearing aids (binaural fitting is obligatory) for a child is a long and often difficult process, which can only be performed by specialists who are pedo-audiologists. After the binaural fitting of hearing aids an intensive hearing and speech education in close cooperation between parents, pedo-audiologist and teacher must support the whole development of the child. PMID- 1770956 TI - [250 central venous silastic catheters in premature infants less than 1.500 g. A clinical study of technique and complications]. AB - 250 central venous catheters were inserted percutaneously in premature infants weighing less than 1,500 g in a prospective study over a period of five years. The mean catheter life was 25 days. We noted 47 complications (= 1/134 days). The most common complication was phlebitis (9.2%). The risk of phlebitis was highest after inserting catheters through the saphenous vein (60%) and lowest after inserting them through the basilic vein (3.9%). Septicaemia was diagnosed in 15 infants (6%). The incidence of thrombosis was 1.2%. Two infants had cardiac perforation with a resultant pericardial effusion. There were no deaths related to any catheter complication. In 116 catheterizations the position of the catheter was checked by recording the intravascular ECG via catheter. The ECG method proved to be very reliable. PMID- 1770957 TI - [Presystolic increasing maximal flow velocity in the intracranial vessels in 3 children with heart failure]. AB - The doppler-sonographic examination of flow velocities in intracerebral arteries is of central importance in the diagnostic evaluation of potential neurologic complications in intensive care patients. Furthermore pulsed Doppler-sonography can assess the hemodynamic consequences of several congenital heart defects (e.g. the ductus arteriosus Botalli). Characteristics of the normal flow profile in the intracranial arteries are the systolic and diastolic forward flow caused by the "Windkessel" function of the aorta. Well known pathologic flow profiles (systolically and diastolically increased flow velocities, diastolically decreased flow velocities and diastolic retrograde flow) occur in neurologic and cardiovascular diseases. We have investigated three children after cardiac surgery, who showed a presystolic increase in the flow velocities, which is clearly different from the flow profiles mentioned above. In our opinion, this abnormal flow pattern is due to a decreased ventricular output in combination with an elevated central venous pressure in these patients. PMID- 1770958 TI - [Thrombocyte function in children with Type I diabetes mellitus. Cross-sectional study]. AB - Platelet count, spontaneous platelet aggregation, ADP- and collagen-induced platelet aggregation platelet adhesion, platelet volume, shape change, beta thromboglobulin and von-Willebrand-factor have been investigated in 51 insulin dependent diabetic children without clinical signs of diabetic angiopathy. Compared to an age matched healthy control group diabetic children showed a significant enhancement of spontaneous platelet aggregation, elevated plasma levels of von-Willebrand-factor, increased platelet shape change and adhesion. No alterations could be found in ADP--and collagen--induced platelet aggregation and in beta-thromboglobulin levels. Significant correlations could be found between the total glycosylated haemoglobin concentrations (Hb A1) and spontaneous platelet aggregation, as well as between duration of diabetes Hb A1, and platelet volume. In this study we could demonstrate changes in platelet function in diabetic children without clinical signs of diabetic angiopathy. However these changes could be due to metabolic adjustment and may precede diabetic vasculopathy. PMID- 1770959 TI - [Ultrasonographically determined thyroid gland volume in children]. AB - The size of the thyroid was evaluated by sonography in 199 boys and 237 girls age one month to 17 years. The volume is 1.2/1.06 ml in boys/girls during the first month, 1.2/1.6 ml at the end of the first year of life, 1.7/2.4 ml at age four, 3.2/3.4 ml with eight years and up to the age of 12 years 5.7/5.7 ml. In juveniles older than 12 years the average volume is 8 ml, sex independently. However, the range appears to be rather wide (1.5-14.5 ml). The right lobe is usually larger than the left one. The rates of the length of the right lobe and the body length, of the total volume and the body weight, and of the total volume and the body surface area are almost independent of age for schoolchildren. There is no significant difference of the thyroid volume between the sexes. PMID- 1770960 TI - [Neonatal focal seizures and transitory inappropriate ADH secretion syndrome due to an infarction in the region of the middle cerebral artery]. AB - Cerebral arterial infarction is a very rare condition during the neonatal period. In recent times, cerebral infarctions with an atypical bland course are reported in healthy, unsuspected newborns. For the first time, we saw focal seizures and a transient syndrome of inappropriate ADH secretion in a full-term, male newborn with an infarction of the middle cerebral artery as the first sign of this disorder. On the basis of these rare clinical manifestations, the literature about neonatal cerebral infarction is reviewed. The diagnostic possibilities and prognostic expectations are discussed. It is the aim of this case report to call attention to this rare disease in order to avoid a delay in diagnosis and therapy, even if the initial manifestations are atypical. PMID- 1770961 TI - [Partial trisomy of the short arm of chromosome 3. Case report and phenotype expression]. AB - A female infant with partial trisomy 3p, facial dysmorphism, cleft palate and severe psychomotor retardation is described. Cytogenetic evaluation revealed a paternal balanced translocation which could also be detected in three relatives of the father. The observed clinical features of the patient are discussed by comparison with 47 previously reported cases. PMID- 1770962 TI - [Cohen syndrome. Personal case report and literature review]. AB - We report the case of a fourteen years six months old girl with features of the Cohen-syndrome. The patient shows all main symptoms of this entity: characteristic craniofacial appearance, truncal obesity, mental retardation, microcephaly, short stature and limb anomalies. PMID- 1770963 TI - [Guidelines for the chemoprophylaxis of meningitis caused by Haemophilus influenzae type B]. PMID- 1770964 TI - National survey of problems and competencies among four- to sixteen-year-olds: parents' reports for normative and clinical samples. AB - We compared parent-reported problems and competencies for national samples of 2,600 4-16-year-olds assessed at intake into mental health services and 2,600 demographically matched nonreferred children assessed in a home interview survey. Parents responded to the ACQ Behavior Checklist, which includes 23 competence items, three competence scales, 216 problem items, eight syndrome scales, Internalizing, Externalizing, and total competence and problem scores. Most items and scales discriminated significantly (p less than .01) between referred and nonreferred samples. There were important sex and age differences in problem patterns, but regional and ethnic differences were minimal. Somewhat more problems and fewer competencies were reported for lower- than upper-socioeconomic status children. Referral rates were similar in the most urban and rural areas, but they were significantly higher in areas of intermediate urbanization. Correlations of problem scores with those obtained 10 years earlier in a regional survey and with surveys in other countries showed considerable consistency in the rank order of prevalence rates among specific problems. Apparently owing to its more differentiated response scales, the ACQ was susceptible to respondent characteristics that reduced its discriminative power below that of the Child Behavior Checklist. Comparisons of procedures for discriminating between the normal and the clinical range supported the value of a borderline category for children who are neither clearly normal nor clearly deviant. Interview data from the survey sample yielded significantly higher ACQ problem scores for children who had fewer related adults in their homes, those who had more unrelated adults in their homes, those whose biological parents were unmarried, separated, or divorced, those whose families received public assistance, and those whose household or family members had received mental health services. Children who scored higher on Externalizing than Internalizing problems tended to have unmarried, separated, or divorced parents and to come from families receiving public assistance. However, among children whose household or family members had received mental health services, there were greater proportions of both Externalizing and Internalizing patterns than among other children. PMID- 1770965 TI - [Therapy resistance to antidepressive drugs: risk factors and treatment possibilities]. AB - Resistance to antidepressants is a relevant clinical problem, especially under inpatient treatment conditions. Based on an extensive review of the literature, risk factors and treatment strategies are described. Beside an adequate dose regimen with the control of serum levels several other strategies are quite well empirically proven: change of the mode of action of the antidepressant, co medication of an antidepressant with lithium, thyroid hormone (T3) or an MAO inhibitor, respectively. In case of delusional depressions the combination of an antidepressant with a neuroleptic, starting with the beginning of the treatment, can be recommended. Under certain conditions special psychotherapeutic activities should be started early enough. The treatment strategy of patients resistant to the usual antidepressive treatment should follow a systematic regimen and each step of this scheme should follow the other in intervals as short as possible. With respect to this regimen the ECT should not be considered too late. PMID- 1770966 TI - [Slot machine and roulette gamblers. Psychiatric and criminologic differences]. AB - In an unselected group of 48 excessive gamblers who came for psychiatric help or for an expert opinion on legal responsibility, childhood developmental limitations were frequent, as well as disorders in the ability to form and maintain partner relationships in later life. However, the childhood conditions and biographies of this group were diverse, and the spectrum of their observed mental and personality disorders rather wide. Differences in age, social class and psychiatric spectrum were found between gamblers at electronic game machines (german style slot-machines) and roulette gamblers. Delinquent behaviour was relatively frequent and had usually started before the onset of excessive gambling. PMID- 1770967 TI - [Phenomenologic constellations of persistent alterations in idiopathic psychoses. An empirical comparative study]. AB - The long-term outcome of 355 patients with affective, schizoaffective and schizophrenic disorders was evaluated after long duration of the illness (mean more than 25 years). All patients were personally interviewed using operational instruments (PSE, WHO/DAS, WHO/PIRS, GAS, Huber's Psychopathological Criteria). By application of descriptive methods, integrating operationally estimated findings with clinically-impressively estimated "interactional atmosphere", we defined eight types of phenomenological constellations of persistent alterations ("residual-types") of functional disorders: "depletion syndrome", "apathetic paranoid syndrome (resp. apathetic-hallucinatory syndrome)", "adynamic-deficient syndrome", "chronic psychosis", "structural deformation", "asthenic insufficiency syndrome", "chronic subdepressive syndrome", and "chronic hyperthymic syndrome". It was found a different distribution of persistent alterations in affective and schizophrenic disorders while schizoaffective disorders occupied a position in between. The differences in the phenomenology of persistent alterations are interpreted as the result of differing biological and psychological processes. It was also found that the phenomenology of persistent alterations is related to the degree of disability. PMID- 1770968 TI - [Personality profile in bipolar schizoaffective psychoses. A comparison with bipolar affective psychoses]. AB - The aim of this study was to investigate personality profiles in patients with bipolar affective and schizoaffective disorder, classified according to ICD-9 criteria using objective psychological tests (Personal Research Form, Objective Analytical Test Battery, IPC-Query Form). The bipolar schizoaffective patients were further subtyped according to Research Diagnostic Criteria (RDC) into schizoaffective-affective and schizoaffective-schizophrenic patients. 81 patients took part in the study (29 bipolar affective and 52 bipolar schizoaffective patients; the latter were subtyped into 23 schizoaffective-schizophrenic and 29 schizoaffective-affective patients). We showed that the personality profiles are quite similar in schizoaffective-affective and schizoaffective-schizophrenic patients if compared to purely affective patients. But indeed there are pronounced differences between the schizoaffective-affective and the schizoaffective-schizophrenic subtypes, so that subtyping schizoaffective disorder like done in Research Diagnostic Criteria (RDC) seems to show that schizoaffective disorders are not a homogenous group. PMID- 1770969 TI - [The Beck Depression Inventory in clinical practice]. AB - The German version of the Beck Depression Inventory (BDI) was administered to 477 depressed in- and out-patients, 180 patients with chronic pain and 86 matched healthy control subjects. Earlier studies have applied the German BDI successfully, but only on students and other non-clinical samples. The clinical use of the BDI was found to have good internal consistency and validity. Cronbach's alpha reached 0.88, the average item-total correlation was 0.47. With one exception (weight loss), all items showed significant item-total correlation with the overall severity of depression. Correlations with other self-rating scales were 0.72 and 0.74 and with the Hamilton rating scale 0.34 and 0.37. A factor analysis showed a general factor as the most appropriate solution. Age, sex, and diagnostic subgroups (e.g. endogenous depression) had no significant influence on these results. A score of 18 and higher indicates depressive symptoms severe enough to require further clinical consideration. The BDI is also sensitive to changes in symptomatology over one week or one month, and can be used for pre-post comparisons in psychological and/or pharmacological interventions. Altogether, the German BDI proved to be a useful psychometric instrument for measuring the intensity of depressive symptoms in clinical samples. PMID- 1770970 TI - [Validity of the Beck Depression Inventory for cross-cultural comparisons. A study of German and Egyptian patients]. AB - The present study compares self-rated depressive symptoms of 95 inpatients with depressive syndromes: 45 in Germany and 50 in Egypt. In each country, 50 patients suffering from acute internal diseases served as controls. Psychiatric patients were selected according to DSM-III criteria for major depressive disorder (MDD). Depressive symptoms and depth of depression were scored by the Beck Depression Inventory (BDI). The self-rating of depressive symptoms proved sufficient for transcultural comparison, provided controls are used, and was more practicable than observer rating scales. The results indicate higher BDI total scores for Egyptian than for German inpatients. This appear to be due to cultural differences, presumably mostly in language performance ("tendency to hyperbole"). Moreover, Egyptians complained more about somatic symptoms, as has already been frequently suggested on the basis of clinical observations. PMID- 1770971 TI - [Comments on the contribution by H. Sass and C. Wiegand. Excessive gambling as a disease? Critical comments on inflation of addictions]. PMID- 1770972 TI - [Comments on the contribution of H. Sass and C. Weigand. Gambling as a disease? Critical remarks on inflation of addictions]. PMID- 1770973 TI - Intracellular membranes are more fluid in platelets of Alzheimer's disease patients. AB - We studied 12 patients with probable Alzheimer's disease versus age- and sex matched healthy control subjects. Platelets were subfractionated into intracellular membranes and plasma membranes, and steady-state anisotropy of diphenylhexatriene was measured on the preparations as an index of membrane fluidity. Fluidity was higher in intracellular membranes from platelets of Alzheimer's patients compared to controls (P = 0.016). However, no difference was observed in purified plasma membrane's fluidity from the same patients versus controls. Neither the platelet counts, platelet volumes, percent of larger platelets, nor the amount of internal membrane protein per platelet were different between groups. There was no correlation between intracellular membrane anisotropy and severity of dementia as measured on the Mini-Mental State Exam. The results extend previous studies suggesting that there is an intracellular membrane alteration in platelets in Alzheimer's disease. PMID- 1770974 TI - Ferritin: the role of aluminum in ferritin function. AB - We previously showed that human brain ferritin (HBF) binds aluminum (Al) in vivo and in vitro and HBF isolated from Alzheimer's brain had more Al bound compared to aged matched controls (7). To further understand the role ferritin may play in Al neurotoxicity, we have studied in vitro the effect of Al on the function of human ferritin isolated from Alzheimer's (AD) and normal brain tissue, and compared the results with other mammalian ferritins. Al causes a concentration dependent decrease in the initial rate of iron loading into apo-horse spleen and human brain ferritin and the rates were similar for ferritin isolated from both AD and normal brains. The rates of iron release of mammalian ferritins from different tissues were determined: horse spleen much greater than human liver greater than rat brain greater than human brain = rat liver ferritin. The rates of iron release of AD and normal human brain ferritin were similar and were unaffected by preloading with Al. Several mammalian ferritins were compared for their total iron uptake: horse spleen = human liver greater than human brain (normal) = human brain (AD) ferritin. In 20 mM HEPES (pH 6.0) buffer holoferritin is more resistant to precipitation by Al than apoferritin suggesting that holoferritin is a better chelator for nonferrous metal ions. PMID- 1770975 TI - Age-related decline of vasopressin mRNA in the bed nucleus of the stria terminalis. AB - To determine whether aging influences arginine vasopressin (AVP) biosynthesis in the extrahypothalamic neurons of the bed nucleus of the stria terminalis (BNST), we used in situ hybridization and quantitative autoradiography to compare AVP mRNA in 3-month-old, 14-month-old, and 24-month-old male Fischer 344 rats. As AVP synthesis in the BNST has previously been shown to be steroid-dependent, plasma testosterone (T) was measured by radioimmunoassay. The 24-month-old animals had significantly fewer AVP-labelled cells than either the 3-month-old (p less than 0.01) or 14-month-old (p less than 0.05) animals. The cells that were present in the 24-month animals were less intensely labelled than in the other groups, as indicated by a significantly reduced number of grains per cell (p less than 0.01). Plasma T was also significantly lower in 24-month-old animals when compared with 3-month (p less than 0.01) or 14-month (p less than 0.05) groups. The results indicate that there is a marked age-related decline in vasopressin biosynthetic activity in neurons of the BNST. PMID- 1770976 TI - Quantitative analysis of the Purkinje cell population during extreme ageing in the cerebellum of the Wistar/Louvain rat. AB - The loss of neurons is viewed as one of several causes of the deterioration of neural function during ageing. However, the existing experimental evidence for an age-related decrease in the neuronal number may be misinterpreted due to the way the cells are counted and to the interference of unsuspected degenerative pathology of the animals studied. To reinvestigate this question we have quantified an easily identifiable population of neurons, the cerebellar Purkinje cells, in very old but healthy rats. The number of Purkinje cells in the cerebellum was assessed in two populations of rats: control (10 months) and old (42 months) rats from the Wistar/Louvain strain. In both groups, paraffin embedded brains were cut serially in the sagittal plane. Purkinje cells were counted every 15 or 22 sections under the light microscope at a magnification of 1250 x. The raw value of cell counts were corrected according to the method of Hendry (21) in order to avoid the overestimation due to splitting of the nucleus during sectioning. The latero-lateral extent of the cerebellar cortex, obtained by multiplying the thickness of the section by the number of sections in which Purkinje cells were counted, was not statistically different (mean +/- standard deviation): 12.8 +/- 1.16 mm (n = 6) for the control rats and 12.0 +/- 1.02 mm for the old animals (n = 8) (Student's t-test, p = 0.18). The corrected number of the Purkinje cells (mean +/- standard deviation) was 330,350 +/- 35,448 cells (n = 6) for the control animals and 299,019 +/- 50,223 (n = 8) cells for the old rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770977 TI - Protective action of phosphatidylserine on stress-induced behavioral and autonomic changes in aged rats. AB - Phosphatidylserine (PS) was administered in aged rats subjected to various stressor stimuli in order to evaluate its effect on grooming behavior, core temperature and gastric ulcers. Novelty-induced grooming appeared to be increased in aged rats as compared to young controls. The subchronic intraperitoneal treatment with PS (20 mg/kg/day for 20 days) decreased grooming activity in aged rats, whereas it did not affect that of young animals. Restraint stress induced hyperthermia in both aged and young rats. However, 90 min after the beginning of restraint, PS-treated old rats showed a normalization of core temperature. Furthermore, restraint-plus-cold stress induced gastric ulcers in both aged and young rats. The treatment with PS was followed by a decreased incidence of gastric lesions in aged, but not in young rats. The mechanism of PS protective action against stress-induced behavioral and autonomic changes is unknown, but it may involve the brain level as this drug exerts a noteworthy influence on behavior and autonomic functions. PMID- 1770978 TI - Increase in perforant path quantal size in aged F-344 rats. AB - The data presented here confirm and extend the evidence for fewer, but stronger, perforant path synaptic connections onto the granule cells of the hippocampus in old F-344 rats. The old animals used in the present report were drawn from a population that showed deficits in the retention of a spatial problem in the Morris water task. Using the method of minimal-stimulation of perforant path afferents, unitary granule cell EPSPs were found to be larger in the 25-month than in the 6- and 9-month age groups. Furthermore, applying statistical methods for quantal analysis, data are presented that suggest that the larger synaptic responses of the old rats come about through an increase in quantal size. These experiments therefore suggest that individual synapses become more powerful in the perforant pathway of old rats, and that this strengthening occurs through an increase in quantal size. The implications of these findings for hippocampal information processing are discussed. PMID- 1770979 TI - Hippocampal NGF levels are not reduced in the aged Fischer 344 rat. AB - The sympathetic sprouting response that occurs in the rat hippocampal formation following septal denervation is reduced in aged rats. Since considerable evidence implicates NGF-like activity in eliciting the sprouting, the simplest explanation for the age-related decline in sympathetic sprouting is a reduction in hippocampal NGF levels. In the present study, hippocampal NGF levels were measured using a 2-site ELISA in four different age groups of Fischer 344 rats. There was no decline in NGF levels with age, nor did we find any differences between male and female rats. This contradicts an earlier report in which a 40% reduction in hippocampal NGF protein levels was found in aged rats. Possible reasons for this discrepancy are discussed. The present results do not support the hypothesis that the age-related decline in sympathetic sprouting is due to a reduction in total hippocampal NGF levels. PMID- 1770980 TI - Dietary restriction does not alter retinal aging in the Fischer 344 rat. AB - In the present study, the effects of long-term dietary restriction (60% of the calories in the ad lib diet, beginning at 16 weeks of age) on quantitative morphometric measures and histopathologic indications of aging have been investigated in the retina of Fischer 344 male rats. The animals were maintained by the NIA Biomarkers Program, National Center for Toxicological Research. Group size ranged from 8 to 15 rats. A gradual thinning of the outer nuclear layer (ONL) of photoreceptor nuclei occurred with aging in control ad lib groups. The restricted diet did not affect retinal aging in 18-, 21-, 26-, or 27-month-old rats, as judged by photoreceptor cell death, ONL thickness, and pattern of cell loss. Retinal thickness (RT) was unaffected by restricted diet, except in the 21 month-old group; in that group, the RT was reduced significantly in thickness as compared to ad lib animals. These results are in contrast to studies of dietary restriction on most nonneuronal markers of aging and suggest that a different mechanism may modulate at least some aspects of brain aging. PMID- 1770981 TI - MSLT-defined sleepiness and neuropsychological test performance do not correlate in the elderly. AB - This study investigated whether a sensitive, physiological measure of alertness/sleepiness, the Multiple Sleep Latency Test (MSLT), was related to neuropsychological test performance in elderly individuals. We hypothesized that the greater likelihood of falling asleep during the daytime on the MSLT would be related to relatively poorer performances on a variety of neuropsychological tests. Results from a homogeneous sample of 35 relatively well-educated, high functioning, elderly community volunteers confirmed the presence of characteristic levels of daytime alertness which were stable within individuals (r = .70 to .73) and showed large variation across individuals (coefficients of variation: 54-84%). Despite this wide intersubject variability, MSLT-defined alertness/sleepiness was unrelated to neuropsychological test results. We discuss these results in terms of the performance deficits known to accompany sleepiness in experimental studies of sleep deprivation and in terms of the behavioral slowing known to occur in normal aging. PMID- 1770982 TI - Inositol phosphates and intracellular calcium after bradykinin stimulation in fibroblasts from young, normal aged and Alzheimer donors. AB - Several studies suggest that alterations in the receptor-mediated phosphoinositide cascade and cytosolic free calcium concentration ([Ca2+]i) are involved in the pathophysiology of aging and Alzheimer's disease. Therefore, the phosphoinositide cascade and [Ca2+]i were determined under resting conditions and after stimulation with bradykinin (100 nM) in cultured human skin fibroblasts from young (21 +/- 3 years), normal aged (59 +/- 6 years) and Alzheimer subjects (58 +/- 6 years). The inositol polyphosphates (IP3, IP2 and IP) were monitored after prelabeling the cells with [3H]inositol in serum free medium. [Ca2+]i was determined with the fluorescent probe, fura-2AM, under exactly analogous conditions. The bradykinin-induced formation of IP3 and IP2 increased significantly in fibroblasts from normal aged and Alzheimer donors compared to young subjects, but did not differ from each other. Bradykinin-induced IP3 formation was 63-117% above the young group at time points between 10-60 s in normal aged or Alzheimer donors. Bradykinin-induced IP2 formation was 49-59% above the young group at time points between 10-60 s in normal aged or Alzheimer subjects. Neither the basal [Ca2+]i, nor the bradykinin-stimulated [Ca2+]i, differed among fibroblasts from young, normal aged and Alzheimer donors. The precise molecular basis and pathophysiological significance of the enhanced bradykinin-induced phosphoinositide cascade in fibroblasts from aged donors remains to be determined. PMID- 1770983 TI - Age-related changes in glucocorticoid receptor binding and mRNA levels in the rat brain and pituitary. AB - Hypothalamic-pituitary-adrenal (HPA) activity under both basal and poststress conditions is often increased in the aged rat. This change has been associated with the loss of corticosteroid receptors in specific regions that mediate glucocorticoid negative feedback. In order to study the cellular basis for the loss of receptors, we measured glucocorticoid (type II corticosteroid) receptor binding and mRNA levels in pituitary and selected brain regions in rats at 6, 12, and 24 months of age. Receptor binding, measured using [3H]RU 28362, was stable in all regions (pituitary, hypothalamus, amygdala, and frontal cortex) except the hippocampus, where there was about a 40% decrease in binding capacity, with no change in the affinity of the receptor for RU 28362. The loss of receptors in the hippocampus was apparent in animals at 12 months of age, and binding was further decreased at 24 months. Glucocorticoid receptor mRNA levels were significantly higher in all regions at 12 months of age than at 6 months. By 24 months, however, receptor mRNA levels in most regions had returned to levels that were similar to those at 6 months of age. In contrast, glucocorticoid receptor mRNA levels in the hippocampus were significantly decreased at 24 months of age compared to levels at both 6 and 12 months of age. Thus, in general, variations in receptor mRNA levels parallel those in receptor binding in animals 6 and 24 months of age, with the hippocampus as the only region showing a significant loss of receptors and a decrease in mRNA levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1770984 TI - Recognition memory deficits in a subpopulation of aged monkeys resemble the effects of medial temporal lobe damage. AB - The present study examined individual differences in recognition memory function in a group of Old World monkeys (Macaca mulatta). Four young (9-11 years) and 10 aged (22-33 years) monkeys were tested in the same delayed-nonmatching-to-sample (DNMS) recognition memory procedure that has been widely used to study the effects of experimental hippocampal lesions in young subjects. Animals were first trained to a 90% correct learning criterion in the DNMS task using a 10-second delay between the sample and recognition phase of each trial. The memory demands of the task were then increased by gradually extending the retention interval from 15 seconds to 10 minutes. Three of the aged monkeys performed as accurately as young subjects at all delays. The remaining aged monkeys performed well at the shortest delays (15 and 30 seconds), but progressively greater impairments emerged across delays of 60 seconds, 2 minutes, and 10 minutes. These results suggest that recognition memory is only compromised in a subpopulation of aged monkeys. Moreover, aged monkeys that are impaired in the DNMS task exhibit the same delay-dependent pattern of deficits that is the hallmark of memory dysfunction resulting from medial temporal lobe damage. PMID- 1770985 TI - Cortical cerebral blood flow governed by the basal forebrain: age-related impairments. AB - This study sought to compare resting and evoked increases in cortical microvascular perfusion elicited by electrical microstimulation of the basal forebrain (BF) in young (4-6 months) and aged (22-26 months) Sprague-Dawley rats. Regional cerebral blood flow (rCBF) was measured in chloralose-anesthetized rats for twelve bilateral regions using 14C-iodoantipyrine with regional brain dissection, while second-to-second changes in tissue perfusion were concurrently assessed using laser-doppler flowmetry (LDF). In young animals, BF stimulation elicited significant ipsilateral increases in CBF in parietal (+123%) and frontal (+107%) cortices, caudate nucleus (+63%) and thalamus (+59%) (p less than 0.05). The BF-elicited increases were preserved in frontal cortex and thalamus, but not in parietal cortex or caudate nucleus of aged animals. No frequency- or current specific attenuations were observed in the spared frontal cortex of aged animals. However, there was a significant (+70%) age-related increase in the latency to reach maximal blood flow increases (p less than 0.05), without any change in the total time of increased blood flow. These findings support the hypothesis that cortical CBF is in part governed by BF neurons, and suggest that regionally selective, age-related impairments of cortical coupling of neuronal to dynamic vascular responses exist. It remains to be determined whether the mechanism of this impairment relates to an age-related impairment in coupling of blood flow and metabolism. PMID- 1770986 TI - Oxytocin cell number in the human paraventricular nucleus remains constant with aging and in Alzheimer's disease. AB - Total cell numbers in the paraventricular nucleus (PVN) were previously shown to remain unaltered with aging and in AD. The aim of the present study was to determine the aging pattern of the oxytocin (OXT) cell population in the PVN. For this purpose, the number of immunocytochemically identified oxytocin cells was determined in the PVN of the human hypothalamus in 20 control subjects ranging in age from 15 to 90 years and in 10 Alzheimer's disease (AD) patients aged 46 to 97 years. The results show that the number of OXT cells in the PVN is similar in males and females and remains unaltered in senescence and AD. It is concluded that the remarkable stability of the PVN in these conditions also applies for the subpopulation of OXT cells in this nucleus and that reports in the literature on diminished OXT secretion in AD do not seem to be based on a decrease in the number of OXT expressing neurons from the PVN. PMID- 1770987 TI - Synapse formation occurs in association with the induction of long-term potentiation in two-year-old rat hippocampus in vitro. AB - Following induction of long-term potentiation in subfield CA1 of the hippocampal slice from 26-month-old rats, shaft synapse numbers increased by 44% and sessile spine synapses (synapses on stubby, headless spines) by 72%, with the more common mushroom-shaped spine synapses statistically unaltered. These effects are smaller than in prior work with young adults, whereas population spike amplitude changes were comparable to young adults. Reasons for the discrepancy are unclear, but the results confirm continuing capacity for induction of LTP in aged rats and indicate that substantial synaptogenic capacity also persists, but may be impaired, at these ages. PMID- 1770988 TI - 5'-Nucleotidase activity increases in aging rat brain. AB - The enzyme 5'-nucleotidase is present in glial and neuronal membranes, and catalyzes the formation of adenosine, which in turn can act as a neuromodulator or neurotransmitter. The present study found marked increases in histochemically demonstrated 5'-nucleotidase activity in most regions of rat brain from young adulthood (3-4 months) to middle age (12-18 months), with smaller or no changes between middle and old age (24-32 months). The aging adult cerebellum showed alterations in the histochemical pattern, with declines in the molecular layer and increases in the Purkinje layer. Both myelin and synaptic plasma membrane fractions from forebrain showed increases in enzyme activity. Assays of various other body tissues suggested that the increases are fairly specific to brain, and thus apparently do not represent a ubiquitous cellular mechanism of aging. Changes in brain 5'-nucleotidase activity during aging probably reflect the increasing number and size of glial cells, and perhaps also affect synaptic transmission through regulation of adenosine. PMID- 1770989 TI - Net dendritic stability of layer II pyramidal neurons in F344 rat entorhinal cortex from 12 to 37 months. AB - Dendritic extent of Golgi-Cox stained layer II entorhinal cortex pyramidal neurons was quantified in five groups of male F344 rats aged 12, 20, 27, 30 and 37 months. Over the age range studied, neither the apical nor the basal dendritic trees showed any statistically significant change in total dendritic length, numbers of segments or average segment length. This finding of average stability of the dendritic tree does not imply absence of remodelling of connections, but does require that if remodeling does occur, retraction and proliferation of dendrites must, on average, be equal. We hypothesized that in groups of animals with similar genetic and environmental histories neighbor neuron death provides the major stimulus for dendritic proliferation. Since we found dendritic stability in the cells reported here, we would predict that there should be no age-related loss of layer II pyramidal neurons in the entorhinal cortex of the normally aging F344 male rat between 12 and 37 months. This hypothesis may be tested by counting neurons within this region. PMID- 1770990 TI - Spatial relationships between astrocytes and classical plaque components. AB - Four biopsies of the brain cortex of patients with Alzheimer's disease were used for ultrastructural studies. Three-dimensional reconstruction and morphometric studies of three classical plaques were carried out to determine the distribution of the astrocytes and their processes, and spatial relationships between astrocytes and plaque components. Morphologic and morphometric studies showed marked ultrastructural changes in the astrocytes located in the vicinity of the plaque. Proliferating processes of the two or three astrocytes nearest to the plaque become part of the plaque. Processes of hypertrophic astrocytes touch neighboring vessels, neurons, and amyloid deposits. The volume of the peripheral amyloid deposits in the classical plaques examined exceeds the volume of the amyloid star by about 26%. Amyloid of the classical plaque periphery appears as amyloid wisps. Most amyloid wisps are isolated between astrocytic processes proliferating and penetrating into the plaque. Proliferation and penetration of astrocytic processes into the plaque lead to fragmentation of amyloid deposits and their dispersion. Reduction in the size of amyloid wisps isolated between astrocytic processes toward the plaque periphery and changes in the morphology of amyloid fibers in this plaque region suggest that astrocytes participate in gradual degradation of at least part of the amyloid fibers. PMID- 1770991 TI - Rapid adaptation of central pathways explains the suppressed baroreflex with aging. AB - Aging is associated with suppressed baroreflex function. Renal sympathetic nerve activity was recorded from young (1 year) and old beagles (11 years) during a step rise in isolated carotid sinus pressure. An abrupt increase in pressure resulted in a significant and similar inhibition of efferent nerve activity in both groups, but the inhibition was not sustained in the old as compared with the young animals. The escape from sympathetic inhibition in the old could not be explained by a decline of input from sensory baroreceptor neurons. Thus the defect in the aged animals is caused by a rapid adaptation of central baroreflex neurons to the baroreceptor input instead of a lack of responsiveness of these neurons, suggesting a functional rather than a structural impairment. PMID- 1770992 TI - Spatial learning and memory in the radial maze: a longitudinal study in rats from 4 to 25 months of age. AB - This longitudinal study was designed to investigate whether previous experience may influence performances and strategies of rats tested in the radial maze without external cues when aged 4, 13, and 25 months. Their performances and strategies were compared with those of another group of rats tested only when aged 25 months. Expert old animals showed a good retention of previous experiences, whereas age-matched nonexpert animals exhibited some acquisition deficits. On the contrary, in the course of aging, the animals kept modifying their strategies independently of experience. In summary, we can conclude that previous experience is likely to influence performances of the aged rat but not the strategies adopted which are strictly age-dependent and independent of acquired experience. PMID- 1770993 TI - Impairment of radial-arm maze performance in rats following lesions involving the cholinergic medial pathway: reversal by arecoline and differential effects of muscarinic and nicotinic antagonists. AB - Pharmacologic studies have indicated that accurate performance on the radial-arm maze depends upon the integrity of both nicotinic and muscarinic cholinergic neurotransmitter systems and that these systems interact in a complex fashion. Although numerous studies have suggested that pathways deriving from the basal nuclear complex of the forebrain are critical for the cholinergic modulation of learning and memory, most have focussed on the septohippocampal projection, and none have specifically targeted the medial or lateral systems. In Experiment 1, cortical knife cuts interrupting the medial cholinergic pathway were made at the level of the caudate-putamen nucleus. Such transections produced a robust but temporary disruption of choice accuracy performance in the radial-arm maze. Recovery of this behavior occurred within 10 days and before cholinergic fiber regeneration, suggesting that compensatory changes could have taken place in non ablated neuronal circuits. In Experiment 2, daily postsurgical administration of arecoline, an agonist with predominantly muscarinic actions, was found to virtually eliminate the adverse behavioral effects of medial pathway transections, indicating that the deficit could be attributable, in part, to disruption of cholinergic projections. In Experiment 3, the effects of scopolamine, a muscarinic antagonist, and mecamylamine, a nicotinic antagonist, were examined in rats with medial cholinergic pathway transections after behavior had returned postsurgically to control levels. Although both drugs attenuated radial-arm maze performance before knife cuts, only scopolamine reduced choice accuracy following surgery. We conclude that the medial cholinergic pathway, particularly its nicotinic actions, plays an important role in cognitive function, at least as exemplified by radial-arm maze performance. Muscarinic mechanisms associated with other telencephalically projecting cholinergic networks, as well as possibly with the medial pathway itself, appear to operate interactively with nicotinic influences. PMID- 1770994 TI - Distribution of the calcium-binding proteins parvalbumin and calbindin-D28k in the sensorimotor cortex of the rat. AB - This study examined and compared the immunocytochemical distribution of the two calcium-binding proteins parvalbumin and calbindin-D28k in the primary motor and somatosensory areas of the rat neocortex. Parvalbumin-immunoreactive cells were found in all layers of the cortex except layer 1 and reached their peak density in the middle layers. The two cortical areas differed markedly in the number, cell size and morphology of immunoreactive cells. Parvalbumin-positive cells were more than twice as numerous in the somatosensory cortex compared to the motor cortex. In addition, the average size of their cell bodies was 25-30% larger in the somatosensory area. Parvalbumin cells in the motor area represented several classes of nonpyramidal cells, while the somatosensory cortex contained in addition many large cells with thick vertically oriented primary dendrites. Some of these cells resembled regular or inverted pyramidal neurons. Punctate neuropil labeling was much heavier in the upper layers of the somatosensory than in the motor cortex and was especially heavy in layer 4. Dense parvalbumin-positive perisomatic puncta surrounded large, unstained pyramidal cells in layer 5B of the motor cortex. Calbindin-D28k neuronal staining in both areas was confined to two populations. The most prominent was darkly labeled, small nonpyramidal cells confined to two bands in layers 2/3 and 5/6. There was also a lighter stained population composed of many pyramidal cells distributed throughout layers 2 and 3. In addition, the motor area contained a band of lightly stained, large pyramidal cells in layer 5B. Calbindin-D28k neuropil labeling was heaviest in layers 1 to 3. In contrast to parvalbumin, we found only minor differences in distribution, size and morphology of calbindin-D28k cell body or neuropil staining in the two cortical areas. Double-labeling immunocytochemistry showed that the large majority of immunoreactive cells contained only calbindin-D28k or parvalbumin, but a distinct population of multipolar cells in the upper layers of the somatosensory cortex contained both. The clear parcellation of parvalbumin immunoreactivity in the rat neocortex suggests that parvalbumin is preferentially associated with specific neuronal populations and terminals in the somatosensory cortex. The more general and homogeneous labeling of the upper layers of the cortex indicates that calbindin-D28k could be related to the relatively high density of calcium channels or N-methyl-D-aspartate receptors in the superficial layers of the rat cortex. PMID- 1770995 TI - Immunoautoradiographic localization of interleukin 2-like immunoreactivity and interleukin 2 receptors (Tac antigen-like immunoreactivity) in the rat brain. AB - Immunoautoradiographic techniques were used to determine the topographical distribution of interleukin 2-like immunoreactivity and interleukin 2 receptor like immunoreactivity (Tac antigen-like immunoreactivity) in rat brain. Interleukin 2 receptors were also visualized by film autoradiography using 125I recombinant human interleukin 2. Endogenous interleukin 2-like immunoreactive material was present in a limited number of brain regions. The highest densities were localized to the median eminence-arcuate nucleus complex, hippocampal formation, lamina IV of the cerebral cortex, lateral septum, neostriatum and cerebellum. Lower levels of interleukin 2-like immunoreactive material were present in the thalamus, medial septum and granule cell layer of the cerebellar cortex. Tac antigen-like immunoreactivity was observed in virtually the same brain regions, and within these brain regions showed the same distribution as interleukin 2-like immunoreactivity. In contrast, [125I]interleukin 2 binding sites were only detected in the hippocampal formation and the molecular layer of the cerebellar cortex. Quantitative analyses confirmed that there was a positive correlation between the densities of interleukin 2-like immunoreactivity and interleukin 2 receptor immunoreactivity (Tac antigen-like immunoreactivity) in various brain regions, suggesting that interleukin 2 is synthesized and/or stored in the vicinity of the site of interaction with the Tac antigen of its receptor. Overall, the presence of endogenous interleukin 2-like immunoreactive material and interleukin 2 receptor-like immunoreactive material in selective regions of the rat brain suggests that this neurokine may normally act to regulate a variety of brain functions in the adult rat. PMID- 1770996 TI - Distribution of type B monoamine oxidase immunoreactivity in the cat brain with reference to enzyme histochemistry. AB - We studied the detailed distributions and morphology of structures immunoreactive to type B monoamine oxidase, and compared them with those stained by monoamine oxidase enzyme histochemistry in the brain of cats treated with or without colchicine. By means of the indirect immunohistochemical method in conjunction with type B monoamine oxidase monoclonal antibody, we demonstrated type B monoamine oxidase immunoreactivity in neuronal cell bodies, fibers and astroglial cells in the cat brain. As expected, the distribution of type B monoamine oxidase immunoreactive cell bodies overlapped that of serotonin-containing ones in the lower brainstem and midbrain, as well as that of histaminergic ones in the posterior hypothalamus. We found novel cell groups containing type B monoamine oxidase in the areas described below. Intense type B monoamine oxidase immunopositive and enzymatically active neurons, corresponding to liquor-contact ones, were discovered in the wall of the central canal of the spinomedullary junction. Weak immunoreactivity was identified in neurons of the dorsal motor nucleus of the vagus, parvocellular reticular formation and locus coeruleus complex, which have been reported to contain type A monoamine oxidase enzymatic activity. Type B monoamine oxidase-immunostaining in these structures was enhanced by treatment with colchicine. In addition, lightly immunostained cells were distinguished in the caudal portion of the hypothalamic arcuate nucleus, area of tuber cinereum, retrochiasmatic area, and rostral portion of the paraventricular thalamic nucleus after colchicine treatment. These cells also displayed monoamine oxidase activity; however, it was difficult to enzymatically characterize their nature due to its weak activity and sensitivity to inhibitors of both A and B. Distinct type B monoamine oxidase-immunoreactive fibers and terminal-like dots were abundant in the whole brain, particularly in the central gray, dorsal pontine tegmentum, interpeduncular and pontine nuclei, nucleus of the solitary tract and dorsal motor nucleus of vagus, where dense innervations of serotonergic fibers have been reported. Their immunoreactive density increased after colchicine treatment, but monoamine oxidase enzymatic reaction did not. An intense immunoreactivity could be seen in many glial cells in parts of the brain including myelinated axon pathways. The densest accumulation of such labeled glial cells was found in the central gray, inferior olive, medial geniculate body, substantia nigra, ventral tegmental area of Tsai, retrorubral area, hypothalamus, thalamus and bed nucleus of the stria terminalis. In contrast, the striatum contained less numerous type B monoamine oxidase-immunoreactive and enzymatically active astroglial cells in comparison with the other structures.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1770997 TI - Limited distribution of pertussis toxin in rat brain after injection into the lateral cerebral ventricles. AB - In vivo administration of pertussis toxin is often used to study the involvement of guanine nucleotide binding proteins in signal transduction. Especially when it is administered in the brain the effect is often poor. This could be due to the fact that pertussis toxin does not reach the area of interest. To evaluate the extent to which pertussis toxin is distributed in rat brain after intraventricular injection, different techniques were used. Immunohistochemical studies with an antibody against pertussis toxin showed that immunoreactivity was limited to periventricular brain structures less than 0.5 mm from the lumen. The highest immunoreactivity was seen 16-24 h after injection. After 96 h the labeling was very weak. The proportion of guanine nucleotide binding proteins that were ADP-ribosylated by in vivo injection of pertussis toxin into the ventricles as assessed by in vitro [32P]-back-ADP-ribosylation was very low 48 h after the injection, in all regions studied. Direct injection of pertussis toxin into the brain caused a marked ADP-ribosylation localized to the region injected that was maximal at 72 h after injection. At 96 h there were also effects after control injections, indicating non-specific effects. Synaptosomal membranes and other membranes were equally affected by pertussis toxin. The results suggest that in studies regarding the effect of pertussis toxin treatment on signal transduction, the toxin must be injected very close to the brain region of interest and, furthermore, that the rats should be killed 48-72 h after injection. In case of lack of effect on the response of interest one should examine whether the ADP-ribosylation of pertussis toxin-sensitive guanine nucleotide binding proteins in the area of concern has been affected. PMID- 1770998 TI - Membrane peptidases in the peripheral nervous system of the pig: their localization by immunohistochemistry at light and electron microscopic levels. AB - The presence and cellular localization of five membrane peptidases has been investigated in peripheral nerves, including those of the autonomic nervous system, in the pig. Endopeptidase-24.11 ("enkephalinase") peptidyl dipeptidase A, aminopeptidase N, aminopeptidase W and dipeptidyl peptidase IV were studied by both enzymic assays of membranes prepared from samples of nerve and by immunoperoxidase histochemistry at light and in two cases, endopeptidase-24.11 and aminopeptidase W, at electron microscopic levels. All five peptidases could be quantified by enzymic assay, though the activities were about 1% of those in renal microvilli and less than those of choroid plexus membranes. Endopeptidase 24.11 was associated with Schwann cell membranes in all types of nerve examined, including major nerves containing predominantly myelinated fibres as well as autonomic nerves, such as the vagus and splenic nerves and the sympathetic chain, staining being observed in membranes associated with myelinated and unmyelinated fibres. The Schwann cell location of endopeptidase-24.11 was confirmed by correlation with immunostaining for glial fibrillary acidic protein and by electron microscopy. This peptidase is known to have a wide repertoire of susceptible substrates among neuropeptides which was here shown to include vasoactive intestinal polypeptide (Km 268 microM, kcat 568 min-1), one of a number of neuropeptides present in peripheral nerve fibres. Three of the peptidases, peptidyl dipeptidase A, aminopeptidase N and dipeptidyl peptidase IV, were associated with microvessels of peripheral nerves. Aminopeptidase N was also observed in connective tissue elements, including the perineurium. Aminopeptidase W was unique among the five peptidases in having a neuronal localization. This was observed in unmyelinated and myelinated nerves and was supported by comparison with the pattern of staining observed for neurofilament protein and by electron microscopic immunoperoxidase staining. This observation was unexpected since aminopeptidase W has not been detected as a neuronal marker in the brain. Some possible roles for the membrane peptidases in peripheral nerves are discussed. PMID- 1770999 TI - Decrease of behavioral and biochemical denervation supersensitivity of rat striatum by nigral transplants. AB - The effect of fetal mesencephalic transplants on dopamine receptor supersensitivity has been studied behaviorally and biochemically in rats with a unilateral lesion of the nigrostriatal pathway. Female rats were lesioned with 6 hydroxydopamine in the left substantia nigra. At least one month later they were tested with apomorphine (0.25 mg/kg, s.c.), amphetamine (5 mg/kg, s.c.), LY 171555 (D2 agonist) (0.5 mg/kg, i.p.) and CY 208243 (D1 agonist) (0.5 mg/kg, s.c.). A suspension containing approximately 1.5 x 10(6) cells from the ventral mesencephalon of rat embryos was distributed in three sites in a triangular fashion in the center of the denervated striatum. Six months later, grafted dopamine neurons reinnervated the medial part of the dorsal striatum, increased the dopamine level and reversed the rotational asymmetry evoked by amphetamine. Apomorphine given four months post-transplant still elicited contraversive circling but the number of turns was reduced. Circling evoked six months post transplant by CY 208243 or LY 171555 was significantly less in grafted rats than in lesioned non-grafted rats. The density of dopaminergic receptors in the striatum of grafted and lesioned rats was examined by autoradiography by means of in vitro binding with [3H]SCH 23390 for D1 receptors and [3H] spiperone for D2 receptors. The results show that intrastriatal nigral transplants decrease the supersensitivity of the D2 receptors and to a lesser extent of the D1 receptors. Normalization of D2 receptors may explain the decrease of behavioral supersensitivity following administration of apomorphine and D2 agonist in grafted rats. D1 receptors were less affected by the lesion and also less normalized than D2 receptors by the transplants.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771000 TI - Trigeminal sensory fiber stimulation induces morphological changes reflecting secretion in rat dura mater mast cells. AB - Mast cells are involved in allergic reactions, but may also participate in neurogenic inflammation. The morphology of mast cells in rat dura mater and tongue was evaluated by histochemistry, as well as by scanning and transmission electron microscopy following unilateral trigeminal ganglion stimulation (5 min, 5 Hz, 5 ms, and 0.02, 0.1 or 1.0 mA). Mast cells in dura and tongue of normal animals were numerous, perivascular and often in close proximity to nerve fibers. After 5 min of electrical stimulation, mast cells contralateral to the stimulation showed histochemical characteristics of normal peripheral tissue mast cells (Safranin-positive), and by electron microscopy appeared homogeneous with numerous intact electron-dense granules. On the stimulated side, however, the staining characteristics of mast cells showed changes indicating progressive intracellular loss of their granular content. In addition, the total number of stainable mast cells decreased at all three stimulus intensities, but reached significance only at 0.1 and 0.02 mA. Ultrastructural evidence of granule changes consistent with secretion were observed although degranulation was not observed until 20 min after stimulation. There were no mast cell changes after electrical trigeminal stimulation in adult rats treated as neonates with capsaicin to destroy small caliber sensory afferent axons. These results suggest that mast cells may secrete in response to electrical stimulation of trigeminal axons, possibly mediated by antidromic release of neuropeptides, and may participate in the development of neurogenic inflammation. PMID- 1771001 TI - CS gas: an antidote and decontaminant. PMID- 1771002 TI - Traumatic asphyxia secondary to ejection from military aircraft during Operation Desert Storm. PMID- 1771003 TI - Early discharge of mothers and infants following vaginal childbirth. AB - With the construction and implementation of the first birthing center in the Air Force, it became necessary to deviate from the traditional 3-day postpartum hospitalization. The purpose of this study is to evaluate that decision. Three hundred seventy-one vaginal deliveries were examined. The average postpartum stay was 1.6 days. There were two maternal readmissions; both had the onset of symptoms at greater than 3 days postpartum. There were no infant readmissions. In patient questionnaires revealed only satisfaction from the puerperae. It is the authors' opinion that early discharge is safe, cost-effective, and should be considered for implementation where feasible. PMID- 1771004 TI - Guidelines for conducting a hospital-based smoker's consult service. AB - Thirty percent of all hospital admissions are smokers. Hospitals are quickly becoming smoke-free facilities. Individuals hospitalized for medical ailments associated with smoking might have increased motivation to quit in a smoke-free hospital. This article outlines a method to conduct a smoker's consult service. There are four treatment intervention phases: (1) consultation; (2) detoxification; (3) cessation; and (4) recovery-follow-up. The entire consultation and intervention will take approximately 2 hours. The organized smoker's consult service is a necessary component to a successful hospital-based intervention. Eliminating tobacco addiction with hospitalized patients is a movement toward the goal of a smoke-free society. PMID- 1771005 TI - Live fire testing: assessing blunt impact and acceleration injury vulnerabilities. AB - The joint services live fire testing program is a vulnerability and lethality assessment program in which realistic munitions are fired at combat-loaded U.S. systems. The program provides direct visual observation of potential damage caused by weapons effects on targets and crew under combat conditions and provides data assisting subjective engineering judgments on system vulnerabilities with the rapid advance in munitions technologies. Congress and the Department of Defense recognize the need to improve the scientific capability to estimate the effects of weapon systems on humans and the need to produce precise estimates of potential casualties in combat situations. This study evaluates the current U.S. capability to make credible crew casualty assessments of blunt impact and acceleration injury in live fire tests. It summarizes the results of a 2-day workshop hosted by the Department of Defense to identify potential live fire threats, mechanisms of injury and performance criteria, available data bases, requirements for instrumentation and analysis, use of crew casualty information in weapon system evaluations and risk assessments, and to prioritize future efforts. It also develops a strategy for improving the U.S. capability to assess injury risks. PMID- 1771006 TI - Development and current status of USAF mental health screening. AB - Early detection and appropriate disposition of non-adaptable military recruits has been a concern of the military for many years. In the 1950s and 1960s, various branches of the military conducted large studies searching for accurate, cost-effective ways to predict which recruits could and could not adapt to military training. In the 1970s, research in this area spawned the development of the Air Force Medical Evaluation Test (AFMET), the three-phase mental health screening process used by the Air Force today. This article briefly reviews the development of AFMET, and presents current data supporting its utility and effectiveness. PMID- 1771007 TI - A model program: stress management unit--a clinic run by army nurses. AB - People suffering from stress and stress-related disorders are a great challenge to our already depleted military health care system. Early identification and separation of soldiers not able to adjust, immediate intervention for temporarily stressed soldiers, and stress management for dependents and retirees help decrease visits to military hospitals and clinics. Immediate intervention for salvageable soldiers also helps improve work performance and productivity. A Stress Management Unit has been open for two years at Brooke Army Medical Center (BAMC), Texas. This article identifies the need for stress management clinics in the military and briefly describes the nurse-run program at BAMC. PMID- 1771008 TI - The Air Force's central reference laboratory: maximizing service while minimizing cost. AB - The Laboratory Services Branch (Epi Lab) of the Epidemiology Division, Brooks AFB, Texas, is designated by regulation to serve as the Air Force's central reference laboratory, providing clinical laboratory testing support to all Air Force medical treatment facilities (MTFs). Epi Lab recognized that it was not offering the MTFs a service comparable to civilian reference laboratories and that, as a result, the Air Force medical system was spending hundreds of thousands of dollars yearly for commercial laboratory support. An in-house laboratory upgrade program was proposed to and approved by the USAF Surgeon General, as a Congressional Efficiencies Add project, to launch a two-phase initiative consisting of a 1-year field trial of 30 MTFs, followed by expansion to another 60 MTFs. Major components of the program include overnight air courier service to deliver patient samples to Epi Lab, a mainframe computer laboratory information system and electronic reporting of results to the MTFs throughout the CONUS. Application of medical marketing concepts and the Total Quality Management (TQM) philosophy allowed Epi to provide dramatically enhanced reference service at a cost savings of about $1 million to the medical system. The Epi Lab upgrade program represents an innovative problem-solving approach, combining technical and managerial improvements, resulting in substantial patient care service and financial dividends. It serves as an example of successful application of TQM and marketing within the military medical system. PMID- 1771009 TI - Oxygen and acceleration. AB - Significant numbers of high performance fighter aircraft continue to be lost due to acceleration (Gz)-induced loss of consciousness. This is due to the rapid onset of high sustained Gz which results in the sudden loss of blood flow to the brain. Present research efforts to extend Gz tolerance are directed toward the maintenance of cerebral blood flow, i.e. straining maneuvers, anti-G suits, tilt seats. The purpose of this paper is to review the present situation and discuss the potential benefit of breathing 100% oxygen at high pressure. Basic science evidence and experience with hyperbaric oxygen in the clinical setting suggest that if the oxygen concentration in the brain tissue is increased, prior to the onset of Gz, additional time of useful consciousness may be realized. The advanced tactical fighter, now in the design stage, will have a sustained Gz capability of 12-14 Gz. This is above human tolerance at the present time and provides an impetus for future acceleration research. Continued aircraft loss due to Gz loss of consciousness will remain an operational problem in aerospace pathology in the 1990s and beyond. PMID- 1771010 TI - Emergency department duty: a training model for the future. AB - Air National Guard (ANG) medical units perform 2 weeks of active duty training each year to develop and maintain essential medical skills. Providing meaningful training is, however, a great challenge to both the Guard unit and its active duty counterpart. Too often, annual training is not a relevant learning experience and so the ability of some Guard medical units to respond to actual medical taskings is compromised. The 135th Tactical Clinic, an ANG medical unit, devised and implemented a unique plan--a plan particularly relevant to the medical support requirements of Operation Desert Shield. PMID- 1771011 TI - The history of the Navy Medical Corps Insignia: a case for diagnosis. PMID- 1771012 TI - Use of lightweight X-ray machine and processor during Riverine medical readiness training exercise on the Amazon River. AB - A small lightweight X-ray machine and processor are needed for use in military medicine for humanitarian service missions, training exercises, and even tactical situations. Size and weight have frequently been a limiting factor for the use of X-ray equipment in military medicine. The large size and great weight of X-ray equipment often limit its use and make this diagnostic modality unsuitable. I believe that a smaller X-ray machine, combined with the new improved lightweight Polaroid processor and film, can provide adequate X-ray exams in a high percentage of patients. PMID- 1771013 TI - Anuria following reduction of a giant omphalocoele in a neonate: an unusual complication. AB - Giant omphalocoele in the neonate is a challenging surgical emergency and requires individualized approaches to operative repair. Post-operative complications and associated congenital anomalies still continue to exert a high morbidity and mortality in spite of intensive and improved post-operative care. This case report describes an unusual mechanism which produced anuria in a neonate immediately after operative reduction of a giant omphalocoele. In retrospect, this complication was related to the unique anatomy of the neonate and the type of closure utilized. PMID- 1771014 TI - Femoral hernia in children: an infrequent problem revisited. AB - Femoral hernias are of very rare occurrence at any age, but are exceedingly rare in the pediatric population. A 10-year survey, 1979-1989, of our experience with pediatric hernias produced a total of 1,134 inguinal hernias and 6 femoral hernias, supporting an incidence of 0.5% for femoral hernias in our population. The correct diagnosis was made in only two cases preoperatively. These two patients had undergone inguinal herniorrhaphies less than 6 months prior to presenting with recurrent groin masses. Femoral hernias were most frequently misdiagnosed as inguinal hernias. Inclusion of this entity in the differential diagnosis of groin masses, an accurate preoperative physical exam, and a careful surgical exploration will allow one to make the correct diagnosis and prevent unnecessary reoperations. In addition, early recurrence of a groin mass after inguinal exploration and herniorrhaphy should make one suspicious of a femoral hernia. At surgery, our recommendations include a simple infra-inguinal exploration medial to the femoral vessels when an inguinal hernia is unexpectedly not found at groin exploration and a Cooper's ligament repair when a femoral hernia is encountered. All six cases in our review were repaired with Cooper's ligament repair without complication. PMID- 1771015 TI - An unusual occurrence of endometriosis in the right groin: a case report and review of the literature. AB - A case of endometriosis involving the superficial femoral lymphatic chain is presented. We feel that it is significant due to the rare location and the implications for diagnosis and therapy. It is our opinion that endometriosis should be included in the differential diagnosis of groin masses in menstruating women. A brief review of pertinent literature is also presented. PMID- 1771016 TI - Transhiatal esophagectomy in the management of perforated esophageal cancer. AB - Instrumental perforation of esophageal malignancy is best managed by immediate esophagectomy. Transthoracic esophagectomy has been the technique most described in the management of patients with this injury. A recent series reported the successful use of transhiatal esophagectomy with primary cervical esophagogastrostomy in four patients with perforated esophageal cancers. We have also used this technique to treat a patient with instrumental perforation of a distal esophageal cancer. This case is presented to add to the published experience using transhiatal esophagectomy in the management of perforated esophageal malignancy. The merits of transhiatal esophagectomy warrant consideration of this approach as a useful alternative to transthoracic resection in the management of selected patients with perforated esophageal cancer. PMID- 1771017 TI - Delayed diagnosis of post-traumatic arteriovenous fistula from trip wire detonated booby trap in Vietnam. AB - Traumatic arteriovenous fistulas are very common, especially with penetrating injuries. Undiagnosed traumatic arteriovenous fistulas for long periods, as in this case, however, are less frequent because the patient often experiences clinical manifestations associated with arteriovenous shunting. This patient denied any history of problems that might be associated with this arteriovenous shunting. He was operated on for the arteriovenous fistula and had an uneventful postoperative course. PMID- 1771018 TI - Preparation for overseas movement: lessons learned. AB - Preparation for overseas movement (POM) screening was conducted in Aschaffenburg, Germany prior to deployment of 3,574 soldiers to Operation Desert Shield. Despite being a well equipped, highly trained brigade, numerous problems were encountered in conducting medical screening of deploying personnel. These problems were to a great extent avoidable, and involved both medical and administrative deficiencies. The POM guidelines themselves also caused some confusion. Attention to these problems should lead to a more fit and mobile force. PMID- 1771019 TI - Probable vitamin deficiency states among future U.S. POWs in the Middle East. PMID- 1771020 TI - [The surgical prevention of pulmonary embolism. Comments on 100 patients treated by different methods]. AB - A series of 100 patients suffering from deep venous thrombosis with prior episodes of pulmonary embolism or ilio-caval floating thrombi, submitted to surgery for the prevention of new embolic episodes, is analysed. Indications are discussed together with the various prevention techniques adopted over the past 5 years. Special attention is paid to the analysis of 11 patients operated on in the last 2 years by thrombectomy of the infra- and suprarenal vena cava. PMID- 1771021 TI - [Pulmonary metastases. Their diagnosis and surgical therapy]. AB - The Authors on the basis of their own experience and scientific literature, study the indications to the surgical treatment of pulmonary metastasis. Surgical treatment usually produces a palliative result, bettering the quality of life. For some other Authors, surgical treatment if there are no local recurrences and metastasis, could produce complete healing. PMID- 1771022 TI - [Hamartochondroma of the lung. Apropos 11 cases]. AB - The authors take the opportunity of 11 cases of pulmonary hamartomas observed during the last 10 years, to specify the clinical and diagnostic problems and the therapeutic possibilities of this rare pulmonary neoplasm. The hamartochondroma is found mainly in the male sex, between the age of the fifth and sixth decades of life; the size of the neoplasm varies from 2 to 4 cm, rarely exceeding 10 cm. In 8 cases the operation was the simple enucleation of the hamartochondroma or its removal by atypical resection: in only one case, become of the conspicuous dimensions of the neoplasm, was it necessary to perform a typical lobectomy. The follow-up did not demonstrate any relapse, or the appearance of carcinoma of the lung in any of the cases under observation and surgically treated. PMID- 1771023 TI - [Criteria for a rational choice of treatment in biliary ileus. The authors' personal experience]. AB - Treatment of biliary ileus is still controversial in respect of surgical strategy. While some surgeons have agreed enterolithotomy as a simple and safe operation, others prefer to perform enterolithotomy, cholecystectomy and repair bilio-enteric fistula at the same time. The authors examine their experience and discuss various modalities of treatment to identify the rational method of therapy in these patients. PMID- 1771024 TI - [Acute cholecystitis associated with calculosis of the biliary tract in a high risk patient. Combined emergency surgical and peroperative endoscopic treatment]. AB - Patient age (over 65), and lithiasis of the common bile duct are two factors which increase the morbidity and mortality rate in emergency surgery for biliary lithiasis. Normally, calculi in the CBD can be cleared by means of supraduodenal or transduodenal access. In both cases, however, complications are frequent in high risk patients. Treatment of gallstones can be modified to achieve a reduction in the morbidity and mortality rate. This study presents an initial survey of 4 elderly patients, presenting with acute gallbladder disease and CBD stones, treated with surgical cholecystectomy and contemporary perioperative endoscopic papillotomy and CBD clearance. The underlying rationale and the good initial results support this combined surgical and endoscopic approach. PMID- 1771025 TI - [Postgastric resection cholelithiasis]. PMID- 1771026 TI - [An analysis of 100 consecutive mediastinoscopies for the diagnosis and/or staging of pulmonary carcinoma]. AB - The authors analyze data of 100 consecutive mediastinoscopies, performed for diagnostic and/or staging purposes in suspected or known bronchogenic carcinomas. They confirm once again how mediastinoscopy is, in many cases, the only diagnostic procedure that can give, at the same time, a preoperative histological diagnosis and a quite accurate staging, thus avoiding useless exploratory thoracotomies. PMID- 1771027 TI - [The surgical treatment of inguinal hernia by Shouldice's plastic repair under local anesthesia: our path towards day-hospital surgery. The results and prospects]. PMID- 1771028 TI - [Our experience of parenteral nutrition (PN) in general surgery]. AB - The problems caused by malnutrition in postoperative complications are well know as is the importance of parenteral nutrition (NP). Thanks to the improvement in instruments and methods, NP can be used not only in intensive therapy departments, but also in less well equipped ones. The Authors report their experience of the use of NP in 77 patients from January 1978 to December 1989 treated in the Surgical Department of the Civil Hospital of Susa (TO), USSL 36, Regione Piemonte. PMID- 1771029 TI - [Aneurysms of the superficial femoral artery at the rupture stage. Apropos 2 personal cases]. AB - The paper reports two case of aneurysms of the surface femoral artery during the rupturing stage. Preoperative clinical data are described together with intraoperative angiographic examinations. These led to the choice of different surgical techniques in the two patients, thus enabling their limbs to be saved. In addition, it is extremely important to carry out an echographic control of all areas which are most likely to be affected by aneurysmatic degeneration in subjects with both obstructive and dilatative arteriopathies in order to avoid emergency surgery. PMID- 1771030 TI - [AIDS in Italy]. PMID- 1771031 TI - [AIDS in the world]. PMID- 1771032 TI - Development of the health claims regulations: the case of omega-3 fatty acids and heart disease. PMID- 1771033 TI - Nutritional support in treatment of oral carcinomas. AB - Two young adults, one lean and one obese, with squamous cell carcinomas of the oral cavity received aggressive antitumor therapies with comprehensive nutritional support in an effort to minimize the secondary malnutrition that often accompanies cancer treatments. PMID- 1771034 TI - Postgraduate Medical Journal, Volume 47, 1971: The peripheral uptake of glucose and endogenous insulin. PMID- 1771035 TI - Is malabsorption an important cause of growth failure in HIV-infected children? AB - Sixty percent of HIV-infected children malabsorbed carbohydrate (lactose or D xylose). Surprisingly, however, carbohydrate malabsorption was not predictive of growth failure. Although HIV infection, in the absence of detectable enteric infection, may result in small intestinal injury, additional factors may also be responsible for growth failure in HIV-infected children. PMID- 1771036 TI - A new function for transferrin receptor in cellular iron uptake. AB - Transferrin receptors may facilitate the release of iron from transferrin at mildly acidic pH, possibly a key reaction in making iron available to cells and allowing transferrin to be recycled back to the cell surface for release from the cell. PMID- 1771038 TI - What do elderly people really eat? AB - Nutrient intakes of elderly women living in a retirement home were estimated from 24-hour dietary recalls and using a novel videotape method. Results of the two approaches differed significantly; correlation coefficients for nutrient intakes estimated by the two methods ranged from 0.09 to 0.82. PMID- 1771037 TI - Transferrin receptor regulation coordinates placental iron uptake with maternal stores. AB - Transferrin receptor expression in the placenta may be regulated by the level of transferrin iron in maternal serum. This control mechanism assures a safe yet sufficient supply of iron to the developing fetus. PMID- 1771039 TI - The vindication of a medical examiner points to the need for reform. PMID- 1771040 TI - Neonatal hyperbilirubinemia. PMID- 1771041 TI - Observations on neonatal hyperbilirubinemia. PMID- 1771042 TI - HIV infection among members of the Army Reserve components residing in New York City. AB - A total of 10,722 members of the US Army Reserve and Army National Guard residing within the five boroughs of New York City (NYC) were tested for antibody to human immunodeficiency virus (HIV). The crude prevalence in NYC was found to be 10.6 per 1,000, compared with a national prevalence of 1.6 per 1,000. The highest prevalences were found among Blacks and Hispanics, males, and among those aged 30 39 years. Patterns of infection were found to be similar to those found among heterosexual and drug abusing populations. Prevalence was highest in the Bronx and varied by less than twofold over all boroughs. Comparisons with reported cases of acquired immunodeficiency syndrome (AIDS) in New York City indicated differences in the demographic and geographic characteristics of the current epidemic of AIDS and HIV infection among members of the Army Reserve components. PMID- 1771043 TI - Hyperbilirubinemia in the term infant: when to worry, when to treat. PMID- 1771044 TI - Bilirubin toxicity: pathophysiology and assessment of risk factors. PMID- 1771045 TI - Historical perspective and a proposal for forensic medical services in New York State. PMID- 1771046 TI - A community-based hospice program. PMID- 1771047 TI - Pelvic fracture following karate kick. PMID- 1771048 TI - Constrictive pericarditis presenting as bilateral pleural effusions--a diagnostic challenge. PMID- 1771049 TI - The human tail. PMID- 1771050 TI - Symptomatic duodenal web in the elderly. PMID- 1771051 TI - Imaging of parietal thinning. PMID- 1771052 TI - Triplicate prescription: issues and answers. Introduction. PMID- 1771053 TI - The effect of drug regulation on the management of cancer pain. PMID- 1771054 TI - Drug use and abuse in five US communities. AB - Data from the five-site Epidemiologic Catchment Area study (ECA), a probability sample of 18,571 adults, were used to describe the prevalence of drug abuse in the United States and to evaluate the hypothesis that multiple prescription regulations are effective in reducing drug abuse and drug diversion. The five sites surveyed were New Haven, Connecticut; Baltimore, Maryland; St. Louis, Missouri; Durham, North Carolina; and Los Angeles, California. The California triplicate prescription law was established in 1939 and is the longest continuously running triplicate prescription program in the country (Schedule II drugs). None of the other ECA sites had multiple prescription regulations in effect at the time the study was conducted. In general, the rates of drug use, abuse, and dependence were significantly higher in Los Angeles as compared with the other sites, both before and after controlling for sociodemographic differences. The proportion of users who go on to become abusers was consistent across sites (about 20%). The vast majority of those with a DSM-III diagnosis of abuse of prescription drugs reported that they obtained the drugs from a source other than their physician, suggesting that "diversion" of prescriptions from legal channels occurred at all sites. Limitations of the study design with respect to conclusions are discussed. PMID- 1771055 TI - The impact of the New York triplicate prescription program on the Hispanic community. PMID- 1771056 TI - Multiple copy prescription programs and alternative monitoring programs: cost issues. PMID- 1771057 TI - The patient's perspective. PMID- 1771058 TI - Filling the knowledge gap: a continuing medical education course on prescribing drugs with abuse potential. AB - Learning the components of the task of writing a prescription is not the same as learning when to prescribe what drug, in which quantity, dose, and frequency; how to counsel the patient about taking the drug; what to look for while monitoring the patient; and particularly, in the case of controlled drugs, what to do if a patient abuses a medication. Education about prescribing drugs with abuse potential is very limited in medical school, and little exists in the way of continuing medical education. We have designed a two-day continuing medical education course for primary care practitioners that blends a variety of learning experiences and incorporates innovative approaches. This program emphasizes active participation, even within a traditional large group format. Computerized clinical case simulation activities call on participants to draw on their own medical practice experience, and to apply newly acquired knowledge to solve clinical problems before they leave the classroom. The pilot test of the program reinforced how powerful teaching can be when it is led by credible, skillful experts interacting with individuals face-to-face and when it is complemented by small group discussion. Plans for dissemination of this program are under way. PMID- 1771059 TI - Panic disorder: clinical features, neurobiology, and pharmacotherapy. AB - Anxiety disorders are common, debilitating illnesses. Panic disorder is an anxiety disorder with a characteristic clinical presentation. A growing body of neuroanatomical and neurochemical data is beginning to elucidate its pathophysiology. There are currently three types of effective pharmacotherapies for panic disorder: tricyclic antidepressants, monoamine oxidase inhibitors, and highpotency benzodiazepines. The choice of a pharmacologic approach may be guided by considerations of potential side effects and other clinical/pharmacologic concerns. PMID- 1771060 TI - Triplicate prescription in New York: history and review. PMID- 1771062 TI - Face to face with AIDS. PMID- 1771061 TI - Negative clinical consequences of triplicate prescription regulation of benzodiazepines. PMID- 1771064 TI - In service to others. PMID- 1771063 TI - Would I choose dentistry again? AB - Despite having backed into dentistry nearly 50 years ago, the author expresses few regrets. However, it's doubtful he would choose to repeat his experience today. PMID- 1771065 TI - Distance and near readings of associated heterophoria taken on 500 patients. AB - Distance and near readings of associated heterophoria were taken, using standard Mallett units, on 500 patients passing consecutively through an optometric practice and any symptoms, connected with distance and near vision, were noted. Complete sets of results were obtained on 383 people. Distance readings, either in size or direction, did not appear related to symptoms and such readings did not appear helpful in patient management. For near vision a fair degree of association existed between readings of associated phoria and symptoms and it was possible in the under 40 years and 40-59 years age groups to express clinically useful rules regarding the relationship. Over 60 years of age such a relationship was complicated by the fact that high degrees of exophoria readings existed in both symptomatic and asymptomatic patients and it is suggested that this may be related to the quality of binocular vision. PMID- 1771066 TI - The refractive status of Hong Kong Chinese infants. AB - One hundred and fifty-eight full-term Hong Kong Chinese infants were examined, at the age of approximately 10 weeks, using retinoscopy. Fifty of the subjects were re-examined at the ages of 20, 30 and 40 weeks. Cyclopentolate 1% was used to produce cycloplegia. Photographic methods were used to assess the straightness of the eyes of 122 infants. While the mean spherical equivalent of the refractive error at 10 weeks was within the limits reported in studies of Caucasian infants, a rapid decrease, not previously reported, occurred between the ages of 10 and 40 weeks. The amounts of astigmatism found were in line with results from Caucasian eyes but the direction was overwhelmingly with-the-rule. The prevalence of anisometropia decreased with age and anisometropia was not prevalent at the age of 37 weeks. Two exotropes (1.6%) and no esotropes were identified although this may have been confounded by the use of cyclopentolate. PMID- 1771067 TI - The amelioration of myopia using biofeedback of accommodation: a review. AB - The purpose of this review is to give an account of the issues raised by reports that myopia can be treated by operant conditioning or biological feedback. Devices are available that provide auditory feedback of accommodative state such that variation in tone frequency provides a means by which the patient can monitor his or her ability to induce changes in accommodation response, the task thus being to change the pitch of the tone in a direction corresponding to a more distant far point. The aim of a training programme is to reinforce and establish control over the accommodative response by a process akin to operant conditioning and subsequently to transfer the skill to normal visual environments such that a manifest reduction in myopia becomes apparent. Although there are reports that the technique can induce a reduction in myopia by up to 3 D the findings are of limited value owing to the lack of objective data, for example pre- and post training cycloplegic refraction. The pre- and post-training measures of subjective letter acuity used by many studies are, with repeated trials, particularly vulnerable to individual differences in the ability to learn how to discriminate and interpret blurred images. The review concludes that more comprehensive clinical trials are needed before accommodation biofeedback can qualify as an established method of clinical treatment of myopia. The trials should be designed to encompass the following issues: the characteristics of a feasible physiological model linking accommodation and myopia development; the rationale with regard to patient selection; the technical performance of the optometer employed; the characteristics of the control group used; the criteria for assessment of myopic change; the transfer of training to performance in normal visual environments; the economic viability of the programme of training and equipment; and the skill, training and knowledge of the clinician implementing the training programme. PMID- 1771068 TI - Colour-mediated grouping effects in good and disabled readers. AB - Specific deficits in the processing of transient visual stimuli have been identified in reading disabled children. It has, separately, been suggested that suitably chosen coloured lenses can be used to assist reading disabled children but this is controversial. To assess an hypothesis as to how coloured lenses might remediate visual processing, this study compared the visual perceptual grouping effects of eighteen disabled readers with those made by eighteen good readers of the same age. Perceptual grouping effects were obtained for each child under a normal condition and wearing blue, yellow, grey, red and green optical framed lenses. The results replicated previous work in demonstrating a larger grouping effect for the disabled readers, and it was suggested that this finding was consistent with the presence of a transient deficit in these children. Comparison of the grouping effects obtained using the coloured lenses showed that although there was no significant impact on the performances of the disabled readers, the blue lens significantly increased the size of the grouping effect for the good readers. The presence of the blue lens decreased the activity initiated by stimulation of the red and green cones relative to the level of activity initiated by blue cone stimulation. As blue cone initiated activity appears to play little part in the transfer of acuity information, the presence of the blue lens could depress performance in a normal visual system by decreasing the level of acuity information transfer (i.e., the information required for efficient selective attention sorting and minimizing the grouping effect).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771069 TI - On proximal effects in objective and subjective testing of dark accommodation. AB - This study investigated to what extent objective and subjective measurements of accommodation in darkness are affected by instrumentation or by flashed light stimuli that are arranged close to the subject's eye, and by the instructions given to the subjects. Subjects differed markedly in their susceptibility to these factors. Dark accommodation measured with an infra-red autorefractometer tended to be more distant by 0.2 D on the average if the autorefractometer allowed a free view into a large, but dark, room compared with a closed apparatus. When subjects were instructed to look into far or near distances during objective measurements, mean dark accommodation was more distant by 0.15 D and closer by 1.4 D, respectively, relative to the condition of 'relaxed eyes'. To find a simple screening test of dark accommodation, a 'number test' was investigated: subjects had to report which was the most sharply visible among a series of numbers that were simultaneously flashed at different optical distances in a Badal optometer. Objective measurements revealed that this test induced near shifts of 0.37 D on the average, relative to accommodation in a dark surround. Therefore, the results of the number test were only moderately correlated to objective measurements. PMID- 1771070 TI - The effect of mental effort on open- and closed-loop accommodation. AB - The accommodative response to stimuli in normal visual environments is determined by a complex and subtle integration of optical and non-optical factors. Mental effort associated with the visual task can modify significantly the steady-state accommodative level, but, owing to the diversity of experimental designs, there is no clear consensus on the mechanisms involved. Changes in the accommodation response of ten emmetropic subjects (mean (+/- SD) age = 20.4 +/- 4.5 years) under open- and closed-loop conditions were investigated for three levels of mental activity. (1) A passive task whereby subjects simply read letters to themselves. (2) A stimulus-dependent task (SDT) whereby subjects are instructed to respond only when the letter 'e' appears in one of a series of presentations. (3) A stimulus-independent task (SIT) whereby subjects count backwards in sevens to themselves while viewing the target. An objective infra-red (IR) optometer was used in its static mode of operation to make monocular measurements of accommodation under monocular viewing conditions. Open-loop conditions were achieved by placing a pinhole (0.5 mm diameter), drilled into an IR filter, 12 mm in front of the eye. Under closed-loop conditions the mean accommodation response for passive viewing of the near target was +3.08 D. A significant (F = 5.45 d.f. 9,18 P less than 0.005) accommodative shift induced by mental effort in the mean response of +0.17 D occurred for the SDT. The SIT induced a mean shift of -0.05 D which was not significantly different to the passive viewing response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771071 TI - Errors in distance appreciation and binocular night vision. AB - Studying binocular vergence in relation to luminance levels, we isolated two types of behaviour which may explain differences in distance appreciation: 1. Underestimation of distances in subjects with overconvergence in darkness. 2. Overestimation of distances in subjects with underconvergence in darkness. Progression towards the limiting value of convergence varies from one individual to another for each mesopic and scotopic luminance level and for different experimental conditions: variable discrepancy between the observation distance and the tonic vergence distance; accommodative or fusional stimuli at varying degrees of eccentricity; mobile stimuli in the observer's peripheral field. The study of bipartition in depth of a given interval for different observation distances confirms the existence of two major categories of individuals. Over- or underestimation of the nearer subjective half correlates to the binocular dark convergence capacity of each individual. These findings may explain errors in distance appreciation for road users in night vision. PMID- 1771072 TI - The suppression effect of simulated anisometropia. AB - Although there is evidence that differential interocular image clarity degrades binocular performance (for example, reducing stereo sensitivity) little is known about how this sensitivity reduction occurs. As there is evidence that suppression scotomas are induced in the more defocused eye, the presence and approximate size of suppression scotomas induced with uni-ocular defocus was investigated in five binocularly normal subjects. The targets comprised a fusional lock and a suppression check for each eye and the task of each subject was to report the presence of the suppression check with varying amount of defocus. There was a range of simulated anisometropia over which suppression did not occur (approximately +/- 0.50 DS). Thereafter the probability of suppressing a small foveal target increased approximately linearly until the target was always suppressed. Greater amounts of simulated anisometropia produced larger suppression scotomas. However, less anisometropia was required to produce an equivalent sized suppression scotoma if greater amounts of fusional detail were provided. These results suggest that the decrement in binocular performance which accompanies simulated anisometropia may occur because of localized inhibition in the more defocused eye and is not solely due to loss of resolution in that eye. PMID- 1771073 TI - The optical modelling of the human lens. AB - The effect of varying lens shape factors and refractive index distribution on two lens performance characteristics (equivalent power and spherical aberration) are considered, using a mathematical model of the human lens which is based upon ellipsoidal iso-indical contours. Values of radii of curvature based on the work of various authors are used to determine asphericity and these inferred values compared with previous measurements. Discrepancies are found and although asphericity has no effect on equivalent power, it does affect the spherical aberration. Based on preliminary findings of the refractive index distribution in the equatorial plane of human lenses, the index distribution is described by a polynomial in the Y (the distance from the optical axis in the equatorial plane), the coefficients of which are polynomials in Z (the distance along the optical axis). The shape of the index profile was found to have a significant effect on the equivalent power and spherical aberration of the lens. The results indicate that more information on surface asphericity and accurate measurement of the index profile in the sagittal plane are required for more accurate modelling of the human lens. PMID- 1771074 TI - Influence of transiently altered retinal vascular perfusion pressure on rod/cone contributions to scotopic oscillatory potentials. AB - The oscillatory potentials (OPs) are sensitive to vascular disturbances in the retina. Rods in man are more susceptible than cones to ischaemia. The findings in a recent study showed that the white flash OP-5 had a heightened sensitivity to altered retinal vascular perfusion pressure (RVPP), compared with earlier OPs and the b-wave. In the present study, a comparison was made of the sensitivity of scotopically matched blue and red flash OPs to dim white flash OPs, to transient stepwise changes in the RVPP, in 10 healthy young adults. After 30 minutes of dark adaptation, two consecutive 0.3 Hz flash groups (n = 20) were filtered and averaged to obtain 100 ms flash ERGs and OPs simultaneously via DTL fibre electrodes for white, blue, and red flashes. To minimize any carry-over effects across flash colour, or repeated testing, the retinal responses to each of these stimuli were measured in separate test sessions several hours to days apart. The RVPP was increased or decreased by 20% and 40% non-invasively by body inversion and scleral suction respectively. For the flash intensities used, blue and red flash OPs appeared more variable than white flash OPs. The OP index increased or decreased across all flash colours when the RVPP was increased, with blue OPs showing the greatest spread of data. Retesting in five subjects using white and red flashes against a blue background disclosed the input of both rods and cones to the white flash scotopic OPs. The provocative test conditions described here offer a potentially profitable approach for studies attempting to differentiate the effects of vascular disorders on rod versus cone function. PMID- 1771075 TI - The distribution of dioptric power: ellipsoids of constant probability density. AB - A sample from a population of dioptric powers may be used to estimate the distribution of dioptric powers in the population itself. This paper describes the method and shows further how one can obtain a graphical representation of the distribution. The graphical representation takes the form of ellipsoids of constant probability density. The centroid of each ellipsoid estimates the mean of the population while the size, shape and orientation show the extent and nature of the spread of the population. For illustrative purposes the theory is applied to measurements of refractive status before and after radial keratotomy. The ellipsoids are presented as stereo-pairs. They are useful for comparative and predictive purposes. Thus the ellipsoid that contains 95% of the population after surgery defines the set of refractive errors within which the refractive error of a particular eye can be expected to fall with a probability of 95%. PMID- 1771076 TI - Ocular chromatic aberration and age. AB - The amount of longitudinal chromatic aberration in groups of younger and older subjects is compared in three separate studies, using a laser speckle optometer, Badal optometers with monochromatic illumination, and monochromatic retinoscopy. No evidence is found for any systematic change in chromatic aberration with age. PMID- 1771077 TI - Ocular adverse effects to the therapeutic administration of digoxin. AB - Disturbances in colour vision are a well-reported adverse ocular effect to toxic levels of digoxin. We present a case history of a patient with both colour vision changes and transient visual field defects to therapeutic serum levels of digoxin. PMID- 1771078 TI - [Child and adolescent gynecology: perspectives of sexual behavior of adolescents, gynecologic problems of violence against children]. PMID- 1771079 TI - [Development of neonatology in Tyrol 1979-1988. An epidemiologic analysis of the Innsbruck University Pediatric Clinic (in comparison with the years 1968-1978)]. AB - From 1979-1988 5863 term and preterm infants were admitted to the Pediatric University Clinic of Innsbruck during their neonatal period. Compared to 1968 1978 the percentage of preterm infants increased from 44.8% to 47.9%. The mortality during this hospital admission decreased from 11.8% (preterms: 18.2%) to 7.8% (preterms: 10.5%). The number of patients transferred from the Gynecological University Clinic of Innsbruck and from other provinces including South-Tyrol increased, whereas the number of patients transferred from other hospitals of Tyrol decreased. Generally there was a constant trend towards an earlier point of referral (e.g. first-day-admission from the Gynecological University Clinic increased from 74.8% (1968-1978) to 92.1% (1979-1988), first day-admission from other hospitals of Tyrol increased from 57% to 70.6%). Small for-date-infants constituted 21.6% of hospital admissions (1979-1988) resp. 18.3% (1968-1978). Mortality of these infants was reduced from 9.2% to 5.3%. In a decade of continuously decreasing over-all-neonatal mortality especially several risk groups for perinatal complications (e.g. preterms, small-for-date-infants, twins) substantially profited from the progress of comprehensive peri- and neonatal care. PMID- 1771080 TI - Correct placement of endotracheal tube by single strand fiberoptic light in prematures. Initial clinical experience. AB - In order to reduce non radiographically improper placement of the endotracheal tube, we manufactured a single fiberoptic strand, connected to a high-intensity illuminator, to be introduced by reference marks up to the tip of conventional endotracheal tube. This system showed, in our initial clinical experience, confirmed by radiograms, to be non invasive and safe. Use of this method could be useful when the intubated premature is moved for necessary procedures, and a chest-X-ray film is not allowed. Infact, it permits the visualization of the tip of the endotracheal tube by a circle of light on the neck at the suprasternal notch. Furthermore, it results useful for all conventional tubes, without constant reduction in cross-sectional area or modification of mechanic characteristics of the tube wall. PMID- 1771081 TI - [Clinical evaluation of a test strip for measuring creatinine in capillary blood of children]. AB - Basing on an enzymatic method for determining creatinine, the new reagent strip "Reflotron Creatinin" of the Reflotron system recently was presented. In this study, it will be compared with another enzymatic test (Creatinin-PAP) and with a Jaffe-based assay (Creatinin-Jaffe for Hitachi 737). The quality control (within days and within-series) yielded a sufficient accuracy and precision (CV = 4%) for the charge of used test strips. The recovery of double measured values was very good (r greater than 0.94). As regards the method comparison, differences in both charges were seen. The values of the former charge lay 7% on an average below the Jaffe-values, those of the latter 28% below. The slope of the latter regression line was considerably steeper. Comparing both enzymatic tests, the regression analysis gave poor results (y = -0.33 + 1.35 x). Bilirubin had not remarkable influences, whereas an evelated hematocrit slightly depressed the values. It seems necessary to start further studies to clear up the difference in test strip charges and to check more capillary blood samples of newborn and children with a pathologic creatinine level. PMID- 1771082 TI - [Multiple liver abscesses in chronic granulomatosis]. AB - We report on a case of a three year old boy, suffering from chronic granulomatosis disease, which led to repeated bacterial infections and finally to multiple liver abscesses. Diagnosis was based on the nitroblue-tetrazolium-test and histology. Antibiotic therapy over many weeks was not successful in spite of an adequate choice of medication against staphylococcal microorganisms and of good intracellular penetration, applicated parenterally. Only treatment by chloramphenicol after previous surgical drainage of the abscesses led to a dramatic clinical improvement and regression of the liver abscesses. The subsequent chemoprophylaxis with trimethoprim/sulfamethoxazole for at lest two years left the patient without clinical symptoms. PMID- 1771083 TI - [You make the diagnosis. Heterozygote factor XI deficiency]. PMID- 1771084 TI - A call for more science, not more rhetoric, regarding opioids and neuropathic pain. PMID- 1771085 TI - Genuine resistance to opioids--fact or fiction? PMID- 1771086 TI - Re-experienced sexual abuse as 'side effect' or cure following intravenous 2 chloroprocaine: comments on Phero et al., Pain, 43 (1990) 349-352. PMID- 1771087 TI - Comment on 'Simultaneous interview technique for patients with persistent pain' by L. Jacobson, A.J. Mariano, C. Chabal and E.F. Chaney in Pain, 45 (1991) 105 106. PMID- 1771088 TI - Plasma morphine and morphine-6-glucuronide during chronic morphine therapy for cancer pain: plasma profiles, steady-state concentrations and the consequences of renal failure. AB - Morphine-6-glucuronide (M-6-G) is an active metabolite of morphine that may contribute to drug effects. To understand better the relationship between morphine and M-6-G in cancer patients receiving chronic therapy, we employed high performance liquid chromatography with electrochemical detection to measure: (1) morphine and M-6-G plasma concentrations following discontinuation of dosing in 2 patients, one receiving oral therapy and the other an intravenous infusion; (2) morphine and M-6-G concentrations in random blood samples taken at apparent steady state from 8 patients, 7 with normal renal function and 1 with mild renal insufficiency, who were receiving continuous morphine infusions; and (3) morphine and M-6-G concentrations in random blood samples taken over a period of weeks from 4 patients, 2 with stable and 2 with declining renal function. Results demonstrated a slightly slower decline in plasma M-6-G than morphine concentrations following drug discontinuation, as would be expected for metabolite and parent relationship; roughly similar M-6-G: morphine ratios (mean molar ratio = 1.22) across a broad range of morphine doses in patients with normal renal function; and an increase in this ratio over time in patients with progressive renal dysfunction. These data illustrate the kinetics of M-6-G in cancer patients receiving chronic morphine therapy and confirm the importance of renal function in determining the concentration of the metabolite. PMID- 1771089 TI - Lack of effect of ephedrine on opiate analgesia. AB - Opiate-adrenomimetic interaction was investigated by studying the effect of the adrenomimetic agent, ephedrine, on the analgesia produced by intravenous placebo and that produced by the predominantly kappa opiate agonist, pentazocine, in patients with dental postoperative pain. Ephedrine did not significantly affect the analgesia of intravenous placebo or of pentazocine. These results contrast with earlier studies demonstrating enhancement of opiate analgesia by other adrenomimetics. Further clinical studies are needed to delineate the specificity of opiate-adrenomimetic interaction. PMID- 1771090 TI - Does addition of low-dose flupentixol enhance the analgetic effects of low-dose amitriptyline in somatoform pain disorder? AB - In a double-blind, crossover study, the effects of 75 mg amitriptyline alone during 5 weeks on pain intensity were compared with the effects of a combination of 75 mg amitriptyline and 3 mg flupentixol during 5 weeks in 34 patients with somatoform pain disorder. Both treatments resulted in a statistically significant reduction in pain. However, pain reduction in the combined treatment did not differ from that in the treatment with amitriptyline as a single drug. Neither tardive dyskinesias nor other serious side effects were observed. The results do not support the clinical practice of adding low-dose neuroleptics to low-dose antidepressants in the treatment of somatoform pain disorder. PMID- 1771091 TI - A comparison of cryoprobe and crush lesions in the rat sciatic nerve. AB - This study examines the behavioral, sensory, motor and structural recovery during the first 2 months following a freeze (cryoprobe) lesion compared to a nerve crush (forceps). There is a complete loss of sensory and motor function following either type of lesion during the first 2 weeks of recovery. The toe spreading reflex and the sciatic functional index of locomotion behavior returned to normal without significant group differences. Latency times for the pain withdrawal reflex were slightly shorter in the cryoprobe group, but both groups returned to baseline during the second month. An improved regenerative pattern was suggested for the motor recovery in the cryoprobe group as expressed by the amplitude of the digital twitch tension curves. However, the respective curve areas were not different. Morphometric analysis indicated a significant reduction in the distal nerve cross-sectional area, an increase in the mean myelinated fiber density and an increase in the estimated total number of myelinated nerve fibers in both experimental groups. Mean fiber diameter and myelin sheath thickness had not fully returned to normal in either experimental group. Both the fiber size and myelin sheath thickness were significantly reduced in the cryoprobe group. In conclusion, the two lesion types have remarkably similar patterns of recovery. Functional data suggest that motor recovery precedes sensory recovery following a cryoprobe lesion. PMID- 1771092 TI - Pain during burn dressing change in children: relationship to burn area, depth and analgesic regimens. AB - To determine the level of pain that acutely burned children experience, we obtained pain scores before, during and after burn dressing change (BDC). Pain scores were higher during the BDC, consistent with severe pain during this procedure. A positive correlation between pain scores and the body surface area (BSA) burned suggests that pain increases with the size of the burn. Contrary to widely held beliefs, comparison of mean pain scores and the percent of 3rd degree burn revealed that the larger the area of full-thickness injury, the greater the pain. Regardless of wide variations in patient characteristics, fixed doses of oral narcotics were usually prescribed for pain. Patients with BSA greater than 70% experienced severe pain during BDC despite the type, dose or route of opioids. These findings suggest the need for (a) education to correct the myth that 'third-degree burns don't hurt'; (b) revision of analgesic prescribing patterns in the burned child; and (c) research to determine the mechanisms (e.g., tolerance or deafferentation) underlying the opioid-resistant nature of pain after large burns. PMID- 1771093 TI - Selective encoding and retrieval of affective words during exposure to aversive stimulation. AB - It has been demonstrated that memory for pain plays an important role in medical practice. Since affect is an integral component of the pain experience, it is possible that pain may produce effects on memory that parallel those engendered by emotion. This investigation examined whether acute pain selectively influenced the encoding and retrieval of affective words. The results indicated that the experience of pain significantly decreased the encoding of positive words and significantly increased the retrieval of negative words previously seen, regardless of whether they were accompanied by a painful experience. Thus, pain interferes with memory of positive events by disrupting their encoding and facilitates the memory of negative events through selective retrieval of those events. PMID- 1771094 TI - Acupuncture-like stimulation induces a heterosegmental release of Met-enkephalin like material in the rat spinal cord. AB - In order to investigate the effects induced by acupuncture on the activity of enkephalinergic neurons in the spinal cord, either the lumbar or the cervico trigeminal area was perfused with artificial cerebrospinal fluid (CSF) (0.1 ml/min) in halothane-anaesthetized rats, and Met-enkephalin-like material (MELM) was measured in 0.5 ml fractions of the perfusates. The effects of manual acupuncture performed by a traditional Chinese acupuncturist at the 'Zusanli' point on the right hind limb were compared to the effects induced by acupuncture applied at a non-acupoint next to 'Zusanli.' The manipulation of needles either at the 'Zusanli' point or at the non-acupoint had no effect on the release of MELM from the lumbar area but significantly increased the release from the cervico-trigeminal zone. It is concluded that manual acupuncture triggers a heterosegmental activation of enkephalinergic neurones within the spinal cord and that this effect is non-specific in terms of the location of the stimulated point. PMID- 1771095 TI - Systemic capsaicin and olvanil reduce the acute algogenic and the late inflammatory phase following formalin injection into rodent paw. AB - Systemic capsaicin and an analogue, olvanil (NE-19550, 4-hydroxy-3-methoxyphenyl methyl-9Z-octadecenamide), were tested for antinociceptive activity in a model of persistent pain produced by the subcutaneous injection of formalin into the rodent hind paw. Formalin induced a biphasic nociceptive response in mice and rats which was measured (a) by the time spent licking the injected paw in mice and (b) by making electrophysiological recordings of single nociceptive neurone discharges in L1-L3 of the spinal dorsal horn of halothane-anaesthetised rats. In mice the initial phase of the response was reduced by systemic administration of morphine, capsaicin and olvanil but not by indomethacin. The second, more prolonged, inflammatory phase of the response was reduced by each agent. In rats, similar concentrations of capsaicin and olvanil reduced both the first and second components of the formalin response. These data show that capsaicin and a non pungent analogue, olvanil, are efficacious antinociceptive agents in a model of prolonged chemical nociception induced by formalin. Their activity compares favourably with that of morphine and appears superior to that of indomethacin. PMID- 1771096 TI - Cancer of the esophagus: ten years' experience. AB - The paper reports the authors' ten-year experience of the surgical treatment of cancer of the esophagus. A total of 625 patients with esophageal carcinoma were observed during the period 1980-89 of whom 490 were admitted to hospital and, of the latter, 172 (35.1%) were operated with a sectile rate of 86% (148 patients). Data from this period were analysed both retrospectively and prospectively using a computerised system. There were 105 radical operations (70.9%) and 43 palliative operations (29.1%). The 3-year actuarial survival rate was 21.7% and the difference between radical and palliative resections was at the limit of significance (p less than 0.1). PMID- 1771097 TI - Surgical treatment of abdominal aortic aneurysm. A ten-year experience (1980 1989) referred to 1725 patients operated on. AB - The authors' experience of surgical management of abdominal aortic aneurysms (AAA), in 1725 consecutive patients, operated on in a ten years period (1980 1989) is presented. Surgical indications, operative technique, and outcome of elective and emergency procedures are analyzed. A ten years follow-up period is also presented. This shows a significantly better survival rate in surgically treated patients than in nonoperated cases. PMID- 1771098 TI - Correlation between angiographic success and functional improvement assessed by exercise test following percutaneous transluminal coronary angioplasty. AB - Sixty-one consecutive patients with stable effort angina and single vessel disease underwent successful (reduction of coronary stenoses by greater than or equal to 20%) percutaneous transluminal coronary angioplasty (PTCA). Anatomical results were analysed on the basis of functional evaluation obtained by exercise test (ET) 1 week before (pre-PTCA) and within 1 month after (post-PTCA) PTCA. Total exercise duration and maximal double product significantly increased after PTCA (4.5 +/- 1 min vs 6.9 +/- 1.5 min, p less than 0.001 and 14.1 +/- 3.6 x 1000 mmHg x bpm vs 18 +/- 4.2 x 1000 mmHg x bpm, p less than 0.001). Pre-PTCA ET was positive in 43 patients (70%) and post-PTCA ET in 15 (24%). In patients with post PTCA positive ET, mean stenosis diameter reduction was significantly lower than that obtained in patients with negative post-PTCA ET (29.6 +/- 8.9% vs 61.1 +/- 18.8%, p less than 0.001). In conclusion, PTCA improved exercise tolerance in the majority of patients with myocardial ischemia, however the definition of anatomical success used in this study appears to be poorly correlated with functional improvement as assessed by ET. PMID- 1771099 TI - Pulmonary embolism secondary to puerperal ovarian vein thrombophlebitis. AB - Four cases of pulmonary embolism (PE) secondary to puerperal ovarian vein thrombophlebitis (POVT) were treated surgically during the first semester 1990. Clinical features are described in detail. The diagnosis was made by echotomography in three cases, but the crucial examination was contrast phlebocavography in all the subjects. Ovarian vein ligation, caval thrombectomy and inferior vena cava interruption by DeWeese clip positioning was the operation performed in any cases. Postoperative courses were always uneventful and three to six months follow-up was available. The extensive practice of echotomography during the first week of puerperium could demonstrate that POVT is more frequent than previously thought. PMID- 1771100 TI - Acute antihypertensive, diuretic and metabolic effects of etozolin and chlorthalidone. AB - Etozolin, a new diuretic agent, has shown a dose-dependent diuretic and saluretic effect in both experimental and clinical studies. Etoxolin, when compared to furosemide or thiazides, exerts a similar effect on urinary excretion of water and Na+, but induces a lower urinary K+ and Cl- excretion and a smaller activation of the renin-angiotensin-aldosterone system. Furthermore, the E series of the prostaglandin system seems to play a role in the mechanism of action of the drug. Seven uncomplicated hypertensive patients were included in this double blind, placebo controlled study, according to a latin square design. Each patient received three single oral doses of etozolin (200 mg, 400 mg, 600 mg), of chlorthalidone (25 mg, 50 mg, 75 mg) and one dose of placebo. Etozolin and chlorthalidone caused a similar, dose-dependent antihypertensive and diuretic effect. However, several haemodynamic and metabolic differences were observed between the two drugs. Etozolin, unlike chlorthalidone, caused no increase of heart rate, no decrease of serum K+ levels and a marked rise plasma PGE2. Moreover, etozolin caused a significantly smaller decrease of serum Na levels compared to chlorthalidone, and a significantly lower increase of supine and standing PRA, of plasma aldosterone and of the urinary excretion of Na and K. These results confirm that the acute antihypertensive and diuretic activity of etozolin occur with little involvement of the RAA system and with a significant but still unclear activation of the prostaglandin system. PMID- 1771101 TI - Psychological status and immunological parameters of institutionalized aged. AB - In the elderly, an impairment of the immune system could lead to increased incidence of infectious, neoplastic and autoimmune diseases; on the other hand, depression, which is the most common psychiatric problem in aged people, seems to be linked with alterations in immunological function. Thirteen institutionalized elderly subjects were studied to investigate the relationship between depression and immunological parameters. These subjects were selected as "healthy" according to the SENIEUR-EURAGE protocol and they belonged to a population already evaluated by our group--one year before--for psychological, endocrinological and immunological parameters. The lymphocyte mitotic response to PHA was greatly diminished in aged subjects, when compared to the adult controls. Depressed elderly showed impaired immunological function as compared with nondepressed ones, either "in vitro" or "in vivo". Lymphocyte stimulation with phytohemagglutinin (PHA), T cell growth factor (TCGF) production (induced by stimulation with PHA) and cutaneous delayed hypersensitivity (CDH) were reduced in depressed aged subjects. As far as lymphocyte proliferation with PHA in the whole group were concerned, no differences were found comparing the present results with those obtained in a former study. Although it is difficult to understand the significance of the immune imbalance associated with depression in the elderly, our results suggest that psychological status could influence the immunological functions in old people. PMID- 1771102 TI - Some thoughts on thinking. PMID- 1771103 TI - Limited open-tendon-sheath irrigation in the treatment of pyogenic flexor tenosynovitis. AB - A retrospective review of 27 patients (28 fingers) with pyogenic flexor tenosynovitis, who were treated by a limited, open-tendon-sheath, intermittent irrigation method that utilized a small pediatric feeding catheter, was conducted. The cases were subcategorized into three stages, based on the intraoperative appearance of the wound. Our results were 100% excellent in stage I; and 88.4% excellent, 5.8% good, and 5.8% fair in stage II. This method proved effective for the surgical management of pyogenic flexor tenosynovitis. PMID- 1771104 TI - Patellofemoral arthritis resulting from malalignment. A long-term evaluation of treatment options. AB - This study examines and compares three treatment options for patellofemoral arthritis resulting from patellofemoral malalignment: longitudinal semipatellectomy, total patellectomy, and a modified Trillat procedure. Patients returned for examination in a 3- to 12-year follow-up period. Results from longitudinal semipatellectomy were unsatisfactory, with a reoperation and failure rate of 70%. Good long-term effects were found with total patellectomy (87% good or excellent). The modified Trillat procedure was effective in preventing recurrent dislocation (94%); however, the procedure was less effective in relieving anterior knee pain (65% good or excellent). A satisfactory solution remains to be found. PMID- 1771105 TI - The semitendinosus: anatomic considerations in tendon harvesting. AB - The length and course of the semitendinosus tendon was studied in cadaveric specimens. The average length of the tendinous portion was 23 cm. The tendon separates from the other pes anserinus tendons as it passes beneath the semimembranosus muscle, where the deep fascia forms a sling for the tendon; the surgeon should be aware of this anatomy when using tendon strippers. PMID- 1771106 TI - Works in progress #7. Age-dependent fibrin clot invasion by human meniscal fibrochondrocytes. A preliminary report. AB - This study was performed to determine whether human fibrochondrocytes possess the same biologic potential for initiating a reparative response in a meniscal defect as that found in lower vertebrates. Small, circular defects were created in meniscal fragments obtained from nine men aged 14 to 72 years. The defects were filled with purified fibrin and placed in a culture medium. By 4 weeks, there was excellent cellular penetration into all clots. This study suggests that human meniscal fibrochondrocytes are also capable of initiating a reparative response, and the rapidity of this response appears to be age dependent. The 14- and 16 year-old menisci mounted a more rapid healing response in vitro than did those obtained from skeletally mature individuals. PMID- 1771107 TI - Imaging rounds #110. Osteopetrosis. AB - The following case is presented to illustrate the roentgenographic and clinical findings of a condition of interest to the orthopaedic surgeon. Initial history, physical findings, and roentgenographic examinations are found on this page. The next page presents the final clinical and roentgenographic differential diagnosis. PMID- 1771108 TI - Dysmyelinating leukodystrophies: "LACK Proper Myelin". AB - A mnemonic has been developed, "LACK Proper Myelin", which can serve as a spring board in developing a differential diagnosis in a child with a dysmyelinating leukodystrophy. Certain distinguishing features of the diseases can be used including laboratory evaluation, head size and sex of the child. The important common ground that all the dysmyelinating leukodystrophies share, they all are inherited disorders that have a enzymatic or biochemical abnormality resulting in the development of abnormal myelin. PMID- 1771109 TI - Parotid haemangioma in infants: MR imaging at 1.5T. AB - Parotid gland neoplasms are uncommon and account for less than 2% of human tumours. Haemangiomas account for about 50% of parotid tumours in infants and children compared to only 2% in adults. As the clinical course of infantile haemangiomas may be self limiting and the initial treatment is expectant, early and accurate diagnosis is essential. We report 3 cases of paediatric parotid haemangioma and discuss the Magnetic Resonance (MR) characteristics of these tumours. In two cases the diagnosis was proven histologically and in one case Computed Tomography (CT) was also performed. PMID- 1771110 TI - Sonographic evaluation of suspected pediatric vascular diseases. AB - Sonographic studies on 52 children with suspected peripheral vascular disease examined between January 1988 and December 1989 were retrospectively reviewed. A technique for examining the jugular, subclavian veins, and superior vena cava (SVC) was developed and is described. The technique for examining the extremities in the child is similar to the adult except higher frequency transducers are used. Twenty-six patients had normal examinations. Twenty-six examinations were abnormal with arterial or venous thrombosis in patients with central lines [10 patients], deep venous thrombosis in patients with painful swollen extremities [9], arterial pseudoaneurysm as a complication of vascular punctures [1], arteriovenous fistula in a renal dialysis patient [1], dilated vessel presenting as a mass [1], compression of a vessel by a mass resulting in extremity swelling [2]. Two patients had other etiologies causing their symptoms and diagnosed on sonography including an infected hematoma and a hip effusion. The advantages of sonography include no contrast material necessary, nonionizing radiation, qualitative and quantitative characterization of vascular flow is possible with Doppler, and the examination can be performed portably. Color Doppler aided in localizing the vessel, visualizing the thrombus, as well as decreasing exam time. Doppler sonography usually answered the clinical question and made further invasive procedures such as venograms and arteriograms unnecessary. PMID- 1771111 TI - The question of parallax-effect on radiographic assessment of short trachea in infants and children. AB - Disproportionately short trachea, can be recognized in AP chest radiographs of infants and older children taken during quiet respiration and showing an evaluable air tracheobronchogram, by the thoracic vertebral level of the carina (normally at T4 in neonates and infants, and at T5 in children two years of age or older). To establish the extent to which a parallax-effect of differing angles of X-ray beam relative to the patient can influence the radiologic assessment of carinal level, we measured the tracheal-vertebral distance at the carina in 29 lateral radiographs of neonates, infants and children, prepared diagrams of the loci of carinal beam intercept of the vertebral column for different angles of beam to body, from tracings of lateral radiographs of two 2-week-old infants, one with trachea of normal length and one with short trachea; of a nine-year-old child with short trachea, and of a ten-year-old with normal trachea, and made radiographs of a postmortem tracheobronchogram of a two-day-old infant at different beam angles. We conclude that tube-body angles of the order of 10-15 degrees from vertical at 27 inches (68.6 cm) or at 40 inches (101.6 cm) FFD do not significantly affect the apparent thoracic vertebral level of the carina in AP chest radiographs, and that a beam angle of 20 degrees or more from vertical is necessary to change the apparent level of tracheal bifurcation by one vertebral body, depending on the patient's age and on whether the patient's position relative to the X-ray beam is lordotic or anti-lordotic.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771112 TI - Tubular communicating duplications of esophagus and stomach. AB - A child with vertebral anomalies and tubular communicating duplications of the esophagus and stomach had a post-natal ultrasound interpreted as normal. This complex anomaly was delineated by barium studies and surgically confirmed. PMID- 1771113 TI - Liver candidiasis. The various sonographic patterns in the immunocompromised child. AB - Liver candidiasis is characterised by small abscesses spread throughout the organ at random. These lesions may be identified sonographically. In the active phase of the disease, hepatomegaly is seen together with the "wheel in wheel" phenomenon, the "wagon wheel" appearance and/or the "bull's eye" lesion. Later on, hypoechoic defects develop. When the echogenic foci are revealed, the healing phase is initiated. These manifestations are demonstrated in 4 pediatric oncology patients. The sonographic patterns as well as its differential diagnosis from primary liver tumors, metastatic infiltrations or other abscess formations are discussed. PMID- 1771114 TI - Cystic dysplasia of the testis. Sonographic features with pathologic correlation. AB - Testicular cysts are an uncommon in the pediatric population unlike adults where they occur frequently. We describe a case of cystic dysplasia of the testis in a prepubertal boy. The known literature is reviewed and the sonographic appearance of the lesion is correlated with pathologic findings. PMID- 1771115 TI - Traumatic atlanto-occipital disruption in children. AB - Ten cases of traumatic atlanto-occipital disruption in pediatric patients are reported. All injuries resulted from motor vehicle accidents, the majority of which were pedestrian/automobile. Three patients survived their injury for a period greater than one year. The importance of recognizing atlanto-occipital disruption is stressed because of its relative frequency in severely traumatized pediatric patients, particularly pedestrian/vehicle incidents, and because of the potential for survival. Diagnosis, in most instances, is based on the lateral cervical spine radiograph. The most applicable diagnostic features in children, as demonstrated on the lateral cervical spine radiograph, are reviewed. PMID- 1771116 TI - Radio-ulnar synostosis in Williams syndrome. A frequently associated anomaly. AB - Limitation of supination and pronation of the forearm has been occasionally described in individuals with Williams syndrome. It was found in 26% of 23 subjects examined, and was associated with a spectrum of severity of radio-ulnar synostosis on radiography. The occurrence of this functional motor impairment in a substantial subset of persons with Williams syndrome is relevant, because its evaluation is important in habilitation planning. PMID- 1771117 TI - Unilateral congenital nasolacrimal mucocele. AB - A case of a congenital nasolacrimal mucocele is reported. This very uncommon finding presents usually with a diagnostic triad on CT: an intranasal cystic mass, a dilated nasolacrimal duct and lacrimal sac. PMID- 1771118 TI - Lissencephaly in two brothers detected by US. A "pseudo-liver" pattern. AB - We report on two cases of lissencephaly in two brothers studied by high frequency ultrasound and subsequently confirmed by CT and, in one case, by post-mortem study. In addition to well known sonographic and CT signs described in the literature, a typical structural change of the brain (named "pseudo-liver") was detected using high-frequency sonography. PMID- 1771119 TI - Diagnosis of anterior cervical spinal epidural abscess by US and MRI in a newborn. AB - A 10-day-old girl who initially presented with fever developed over five days a complete paresis of both upper arms and swallowing difficulty. After emergency drainage of a retropharyngeal abscess, cervical US demonstrated a cervical anterior epidural mass compressing the cord. MRI confirmed the diagnosis of spinal epidural abscess secondary to C4-C5 spondylodiscitis. Surgical removal of the abscess was followed by complete disappearance of the neurologic symptoms after six months of follow-up. This is the first case of spinal epidural abscess in a newborn to be diagnosed by US and MRI preoperatively. The advantages of these non-invasive imaging modalities are discussed, and compared to myelography. PMID- 1771120 TI - Single arterial trunk arising from the aortic arch. Evidence that the fifth branchial arch can persist as the definitive aortic arch. AB - A seven month old female having a single arterial trunk arising from the aortic arch is presented. The baby also had severe coarctation of the aorta and a patent ductus arteriosus. This anomaly cannot be explained by Edwards' embryonic double aortic arch model. However, it can be explained by persistence of the fifth branchial arch as the definitive aortic arch. PMID- 1771121 TI - Air embolism and pulmonary interstitial emphysema in a preterm infant with hyaline membrane disease. AB - A preterm infant with severe hyaline membrane disease requiring extreme mechanical ventilation developed pulmonary air leaks with consecutive shock. The chest roentgenogram showed bilateral pulmonary interstitial emphysema and gas within the heart silhouette as well as in the hepatic veins, inferior v. cava, portal vein, and many abdominal vessels. The respiratory and circulatory failure by massive systemic gas embolism resulted in death. PMID- 1771122 TI - Concurrent bronchopulmonary foregut malformations. A rare occurrence. AB - The incidence of multiple or bilateral bronchopulmonary foregut malformations is unusual, and has rarely been reported in the literature. The presence of symptomatic concurrent, different malformations in the same patient, as described here, has not been previously reported. The spectrum of these congenital lesions is wide, and each form may present with its own set of symptoms. This may lead to a complex clinical picture requiring extensive and varied imaging evaluation. PMID- 1771123 TI - Omphalocele associated with intrapericardial diaphragmatic hernia. PMID- 1771124 TI - CT diagnosis of strangulated diaphragmatic hernia. AB - Strangulated diaphragmatic hernia is a surgical emergency which on occasions can be a diagnostic dilemma. We report of a 2-year-old-male child with strangulated diaphragmatic hernia in whom a correct preoperative diagnosis was made with progression of illness. CT depicted a curvilinear fat stripe in a fluid filled hemithorax. PMID- 1771125 TI - Ultrasound diagnosis of congenital intrahepatic portosystemic venous shunt. AB - There are few radiologic descriptions of intrahepatic portosystemic venous shunts and all in adults. A case is reported of a newborn where the diagnosis of shunt was made with color Doppler and where the shunt resolved spontaneously at one year of age. Proposed etiologies for intrahepatic portovenous shunts are discussed. PMID- 1771126 TI - Utero-vaginal hypoplasia. Sonographic, embryologic and clinical considerations. AB - Congenital absence of hypoplasia of the uterus is a cause of primary amenorrhea in approximately 15% of cases. Ultrasound is often employed as an early imaging modality in the evaluation of patients with primary amenorrhea. Demonstration of total absence or marked hypoplasia of the uterus in the presence of normal ovaries during pelvic ultrasound examination, suggests the diagnosis of congenital uterine aplasia or hypoplasia. Sonography may obviate the need for laparoscopy and for other imaging modalities. A case report of uterovaginal hypoplasia in association with anal atresia and recto-vaginal fistula is presented, and the value of ultrasound in the diagnosis of this entity is discussed. The embryology and clinical features of this anomaly are also reviewed. PMID- 1771127 TI - Sonographic aspects of pseudoxanthoma elasticum. AB - We describe a case of pseudo-xanthoma elasticum (PE) in a child with distinctive skin lesions without other symptoms. Renal ultrasonography showed a characteristic pattern of dotted increased echogenicity in the corticomedullary junction. Pancreas and spleen had similar echographic findings. We point out the importance of ultrasonography in the diagnosis of this rare disorder. PMID- 1771128 TI - Combining binocular and monocular curvature features. AB - A study is reported of the perception of visual surfaces in wire-frame stimuli generated by combinations of monocular surface contours and binocular disparity that provide differing information about 3-D relief. Observers vary considerably in the relative contribution made by the binocular and monocular cues to the perception of overall 3-D form. Without training, many observers may entirely fail to perceive surface curvature from the binocular disparity patterns, interpreting the form of the surface only according to the monocular information. For other observers, both cues contribute to the end percept, with the monocular interpretation dominating where the disparity information indicates planarity and with disparity dominating where disparity information suggests curvature and the monocular interpretation suggests planarity. Where stereo and monocular interpretations indicate inconsistent surface curvature features at a common location, more complex resolution strategies are suggested. PMID- 1771129 TI - Orientation disparity, deformation, and stereoscopic slant perception. AB - Koenderink and van Doorn's theory, that the basis of stereoscopic slant perception is the deformation component of the disparity, field, was tested for slant around a horizontal axis, which produces images with a vertical ramp of horizontal disparity (horizontal shear) characterised by a global orientation disparity at the vertical meridian. The disparity field in this case can be parsed into two components, deformation and curl, which each contribute half of the orientation disparity. This case was compared with similar random-dot stimuli in which the deformation component was doubled and the curl component eliminated or vice versa. All three types of stimuli had identical orientation disparity at the vertical meridian. A condition in which there was no such orientation disparity, but deformation was present, was also included. It was found that perceived slant was not related to the deformation present, as Koenderink and van Doorn's theory would predict, but was predictable from the orientation disparity at the vertical meridian per se. PMID- 1771130 TI - The influence of dimensionality on eye fixations. AB - Eye fixation patterns were explored for sixty adult subjects, each of whom viewed one of three stimuli, either in a three-dimensional model format or in a two dimensional photographic format. The stimuli consisted of one symmetrical and two asymmetrical color representational drawings displayed in the form of a photograph or of a model. Total fixation times (in ms) were computed for seven portions of each stimulus: top, bottom, left, right, foreground, middle ground, and background. Results indicated that for all stimuli, subjects viewing the 3-D model spent significantly more time fixating the foreground and significantly less time fixating the background than subjects viewing the 2-D photograph. For the two asymmetrical stimuli subjects in the two groups differed significantly in their fixation patterns for the left/right variables. It was concluded that eye fixation patterns vary as a function of dimensionality. PMID- 1771131 TI - Evidence for a common motion mechanism of luminance-modulated and contrast modulated patterns: selective adaptation. AB - Selective adaptation effects were measured with contrast-modulated patterns and sine-wave gratings in order to determine the extent to which the two patterns are processed by common mechanisms. Direction-specific adaptation effects were measured for a contrast-modulated adapting pattern and a test pattern. The contrast-modulated adapting pattern was composed of a sine-wave grating of 8 cycles deg-1 whose contrast was spatially modulated by a sinusoid of 1 cycle deg 1 at one of four levels: 100%, 60%, 30%, or 0%. The results showed that contrast modulation thresholds for contrast-modulated gratings were raised by 0.3 to 0.5 log units following adaptation to a contrast-modulated grating moving in the same direction as the test pattern, relative to thresholds obtained following adaptation to a contrast-modulated grafting moving in the opposite direction. Cross-adaptation effects were also measured with a sine-wave adapting pattern and a contrast-modulated test pattern. The sine-wave adapting pattern was a sine-wave grating of 1 cycle deg-1 whose contrast was set to one of three levels: 16.4%, 1.25%, or 0%. The contrast-modulated test pattern was a sine-wave grating of 8 cycles deg-1 whose contrast was modulated by a sinusoid of 1 cycle deg-1. The results revealed that contrast-modulation thresholds for contrast-modulated gratings were raised by approximately 0.25 log units following adaptation to moving sine-wave gratings, relative to thresholds obtained following adaptation to a uniform field. Cross-adaptation effects were also obtained with a contrast modulated adapting pattern and a sine-wave test pattern. The results support the view that signals generated from luminance-domain stimuli and from contrast domain stimuli are processed by a common motion mechanism. PMID- 1771132 TI - Rapid discrimination of McCollough effects. AB - The McCollough effect is a colour aftereffect that is contingent on pattern orientation. Three experiments were conducted to establish whether such aftereffect colours could serve as a basis for discrimination in several rapid discrimination tasks. In the first experiment it was investigated whether aftereffect colours could act like a simple 'feature' in a visual search task involving a difficult orientation discrimination. Without McCollough adaptation, the time taken to detect a 'target' among 'distractors' increased substantially as the number of distractors increased. With adaptation, detection time was essentially independent of the number of distractors, indicating that the nature of the task changed from a difficult orientation discrimination to a simple discrimination based on differences in aftereffect colours. The second and third experiments employed a difficult four-alternative forced-choice procedure in which subjects were required to discriminate a monochromatic patch of square-wave grating oriented at 45 degrees from three others oriented at 135 degrees (and vice versa). The gratings were presented very briefly (67-333 ms) followed by a 500 ms mask. Subjects performed the task with and without McCollough adaptation. Performance was strikingly better after adaptation: colour aftereffects could be used to make the discrimination even at exposure durations as short as 67 ms. The third experiment demonstrated that this enhanced performance was indeed due to perceived colour differences (rather than a possible contrast difference). The results of the three experiments are discussed in relation to proposals about the locus of the McCollough effect. PMID- 1771133 TI - Texture-based tasks are little affected by second tasks requiring peripheral or central attentive fixation. AB - Experiments are described in which observers attempted to perform concurrently two separate visual tasks. Two types of tasks were used: the identification of a T-shaped or L-shaped letter target, and the detection or localization of a texture element of unique orientation (texture target) within a dense texture. Combining these tasks to form various task pairs, performance as a function of stimulus onset asynchrony (SOA) was established separately for each task in a pair. In addition, performance was measured when each task was carried out by itself. When paired, two identification tasks (T or L) on (two) letter targets required a significantly larger SOA than either identification task by itself. This outcome suggests the involvement of serial performance and competition for a limited resource, confirming that letter identification requires attentive fixation. However, when the identification of a central letter target was paired with the localization (upper or lower hemifield) of an eccentric texture target, performance in the pair was comparable to performance of each task by itself. This suggests parallel performance and a lack of conflict over resources. The outcome was similar when the identification of an eccentric letter target was paired with the detection (present or absent) of an eccentric texture target. These results are consistent with the possibility that localization and detection of a textural singularity do not require attentive fixation. PMID- 1771134 TI - A microgenetic study of the Muller-Lyer illusion. AB - In two experiments a decomposed Muller-Lyer pattern was used to measure the time course of the illusion. A partial report procedure was used to prevent the subjects from focusing only on parts of the pattern and to maximize visual processing. The Muller-Lyer figure was decomposed into two parts, its angles and its line. A configuration of three pairs of angles, each corresponding to a row in the usual partial report arrangement, was used. A line that did or did not fit the gap was shown with a variable delay (interstimulus interval, ISI). By this procedure the relevant row (line gap) was cued. The subject had to decide whether the line fitted or was too short/long. Two exposure times for the angles were used, 50 or 200 ms in one experiment and 50 or 500 ms in the other. The result of the first experiment, with outward-pointing fins, was a stable illusion for all values of ISI (25-400 ms) and all exposure times, with one significant exception: exposure for 50 ms with an ISI of 50 ms yielded an illusion peak. It was shown that this was not caused by a reduction in length-discrimination performance. In the second experiment, with inward-pointing fins, no such peak occurred. There was only a tendency for the illusion to vanish with zero ISI. The results are discussed with respect to 'global to local' theories of visual processing. PMID- 1771135 TI - The detectability of geometric structure in rapidly changing optical patterns. AB - Human vision is sensitive to the coherent structure and motion of simple dot patterns undergoing rapid random transformations, even when the component dots are widely separated spatially. A study is reported in which visual sensitivity to translations, rotations, expansions, pure shear, and additive combinations of these transformations was investigated. Observers discriminated between coherent (correlated) movements, in which all the component dots moved simultaneously in corresponding directions and distances, and incoherent (uncorrelated) movements, in which the movements of individual dots were statistically independent. In experiment 1 the accuracy of coherence discrimination was found to be similar for all four of the basic transformations and to increase linearly with the distance of the movements. The discriminability of coherent versus incoherent motion was also found to be similar to the detectability of any motion, suggesting that concurrent movements of individual dots are visually interrelated. In experiments 2 and 3 the visual independence of these four groups of transformations was tested by comparing the accuracy of coherence discrimination of each of the transformations presented alone with that when added to background motions produced by each of the four transformations. Coherence discriminations were less accurate when the target transformation was added to another background transformation, indicating that these transformations are not visually independent. Rotations and expansions, however, were visually independent. In experiment 3 qualitatively similar effects for patterns of several different sizes and dot densities were found. In general, an impressive visual sensitivity to globally coherent structure and motion under several different geometric transformations was observed in these experiments. A basic theoretical issue concerns the local visual mechanisms underlying this sensitivity. PMID- 1771136 TI - Looking for a structural network: effects of changing size and style on letter recognition. AB - The accuracy of identifying backward-masked strings of unrelated letters was measured to test a prediction of a structural network model in which information about the absolute size of letters in a font is factored out from other types of information and is represented by a single size parameter. In this model, variation from block to block in the font size should be handled relatively easily by changing this parameter. In contrast, variation in several aspects of the font style would require changing multiple parameters and should be more difficult. In three experiments, the font was alternated in style, size, size and style, or not at all, at the end of each block of eight trials. The accuracy was lower overall when the font was varied, but contrary to the predictions of the model, variation in size reduced the accuracy of performance as much as did variation in style and variation in size and style. PMID- 1771137 TI - Auditory localization in teleoperator and virtual environment systems: ideas, issues, and problems. AB - The increasing availability and use of advanced high-tech human-machine interfaces raise many interesting questions about what information should be presented to each sensory modality and how the information should be coded for a given modality. In this paper, attention is confined to the auditory component of the interface and, more specifically, to auditory localization. Both teleoperator systems and virtual-environment systems are considered, and attention is focused upon the opportunities and difficulties associated with the use of unnatural perceptual cues in these systems. Of central interest in this discussion is the use of such cues to improve resolution and thereby obtain systems with superlocalization capabilities. PMID- 1771138 TI - Current topics in immunotherapy and the role of the pharmacist on a solid organ transplant service. AB - Solid organ transplantation has become a well-accepted therapy for the treatment of end-stage disease of the liver, heart, kidney, and pancreas. The development of highly effective immunosuppressant drugs has led to major improvements in graft and patient survival over the last decade. In spite of this success the perfect immunosuppressive drug has yet to be discovered. Currently available agents have numerous short-term and, more disturbingly, long-term toxicities. This has led to the use of triple- and quadruple-drug regimens in an attempt to maintain good graft and patient survival rates with less toxicity. Multiple-drug combinations have questionable benefits compared to double-drug regimens containing cyclosporine and prednisone. With the advent of new immunosuppressant drugs, it will be important to perform randomized, controlled trials to assess their efficacy and toxicities in comparison with current regimens. Pharmacists who work with solid organ transplant teams can function as pharmacotherapists and provide skills such as pharmacokinetic and pharmacodynamic drug monitoring. In addition, they can become involved with clinical and laboratory-based research to assess the properties of conventional and newly developed immunosuppressive agents. PMID- 1771139 TI - Structural and functional features of the peptidyl prolyl cis-trans isomerase, cyclophilin. PMID- 1771140 TI - Dosage forms of cyclosporine. AB - Cyclosporine can be given intravenously or orally, as a solution or soft gelatin capsule. Because of the drug's poor water solubility, ethoxylated plant fats and ethanol are added to the commercially available dosage forms. PMID- 1771141 TI - The use of immunosuppressive drugs in kidney transplantation. AB - The proper management of immunosuppression in transplantation requires a working knowledge of immunology and pharmacology. In practice we employ two to four agents in one of several complicated protocols. If we consider the variability of individual patients, the potential for drug interactions, and significant compliance problems inherent in any long-term multidrug regimen, the dimensions of the challenge of immunosuppression to the practicing clinician become apparent. PMID- 1771142 TI - Laboratory analysis of cyclosporine. PMID- 1771143 TI - Noncompliance in organ transplant recipients. AB - The frequency of noncompliance with postoperative medical therapy ranges from 2% to 43% in organ transplant recipients and causes more graft loss than uncontrolled rejection in compliant patients. Retrospective and prospective studies undertaken at our center showed no difference in the rate of noncompliance between males and females or between recipients of cadaveric kidneys and those from living, related donors. Patients less than 20 years of age were statistically the most noncompliant (p = 0.0001) compared with those over 40 years. A significant difference in compliance was seen among blacks, Hispanics, and non-Hispanic whites, with the greatest frequency in blacks. This was not due to race, but to socioeconomic status, with those in the low socioeconomic group the most noncompliant. Problems of noncompliance may be reduced if they are identified early in the treatment course. PMID- 1771144 TI - Antidepressant effects of flupenthixol. AB - Strong evidence exists that flupenthixol, not presently distributed in the United States, is an effective antidepressant. Its advantages over available antidepressants include its safety with respect to overdose and in combination with other medications, low dependency risk, rapid onset of action, and availability in depot preparation. Flupenthixol also may be useful as a mood elevator for schizophrenics, an alternative mood stabilizer for patients with bipolar disease, and a facilitator for cocaine withdrawal. PMID- 1771145 TI - Comparison of pharmacokinetic and safety profiles of amantadine 50- and 100-mg daily doses in elderly nursing home residents. AB - Pharmacokinetic and adverse event profiles of 50- and 100-mg amantadine doses administered daily for up to 21 days for influenza prophylaxis were compared in 82 elderly nursing home residents (mean age 85 yrs, 68% female). We sought to determine if a standard daily dose of 50 mg would achieve mean steady-state trough serum concentrations (CPSSt) of 300 ng/ml and be associated with a lower frequency of adverse events than 100-mg doses. Statistically significant relationships were found between CPSSt and dosage (in mg/kg/day) and serum creatinine. Adverse events were more common with the 100-mg dose (24% vs 14%); 94% occurred in women. Amantadine CPSSt and apparent clearance were not significantly different between sexes. Thirty-nine residents (89%) receiving 50 mg daily achieved CPSSt below 300 ng/ml compared to 42% receiving 100 mg. Standard daily amantadine doses of 50 mg may not achieve adequate CPSSt in elderly nursing home residents, but 100 mg may lead to excessive CPSSt and adverse events, especially in the presence of renal impairment. PMID- 1771146 TI - Renal parenchymal disease related to over-the-counter analgesic use. AB - The occurrence of parenchymal renal disease has been attributed in many case reports to heavy use of over-the-counter (OTC) analgesics. To quantify this putative relationship, we carried out a comprehensive case history review of newly diagnosed parenchymal renal disease requiring hospitalization among patients who ever used acetaminophen, aspirin, or ibuprofen, at Group Health Cooperative of Puget Sound. During the 6-year period 1984-1989, 17 cases of newly diagnosed, unexplained renal disease were identified among the 378,769 users of OTC analgesics, among whom 26,931 filled at least 20 prescriptions for the analgesics studied. Six of the 17 were possibly attributable to outpatient drug use. Of these, OTC analgesics were suspected clinically as a possible causal factor in two, but in both patients other causes seemed equally likely. We did not find any patients with anatomic or pathologic findings associated with analgesic nephropathy. We conclude that parenchymal renal disease attributable to OTC analgesic use and requiring hospitalization is a rare occurrence. PMID- 1771147 TI - Legal and ethical issues in electroconvulsive therapy. AB - The use of electroconvulsive therapy (ECT) today has become mired in legal regulations. Obtaining a valid informed consent prior to administering ECT is the duty of the treating psychiatrist; failure to obtain such consent is the most common area of professional liability. The trend of increased judicial scrutiny of ECT has generated both clinical and ethical dilemmas, especially in the context of the emerging concept of the right to effective treatment. PMID- 1771148 TI - Electroconvulsive therapy. PMID- 1771149 TI - Impact of the antipsychiatry movement on the revival of electroconvulsive therapy in the United States. AB - In spite of its acknowledged efficacy and safety in the treatment of affective and psychotic illnesses, electroconvulsive therapy (ECT) remains a controversial treatment, with limited use mainly in academic and private hospitals. The controversy results from attack by the antipsychiatry movement, and from a lack of support by mental health professionals who have not come to terms with their ambivalence and lack of understanding of the ECT process. The history of the past 20 years is reviewed. PMID- 1771150 TI - Stimulus intensity, seizure threshold, and seizure duration: impact on the efficacy and safety of electroconvulsive therapy. AB - There has been considerable uncertainty in the clinical community on how stimulus dose, seizure threshold, and seizure duration relate to the efficacy and side effects of electroconvulsive therapy (ECT). This article reviews the evidence bearing on these issues. Recent evidence contradicts a number of long-standing views about how to optimize ECT administration. Among these recent observations are findings that (1) generalized seizures that are "adequate" by conventional duration criteria may be produced reliably, yet lack therapeutic properties; (2) the degree to which stimulus intensity exceeds seizure threshold is critical in determining the efficacy of unilateral ECT and also the speed of response with both unilateral and bilateral ECT; (3) the degree to which electrical dose exceeds seizure threshold, not the absolute dose administered, determines dosing effects on clinical outcome and on the magnitude of cognitive deficits; (4) there is marked variability among patients in their seizure thresholds that is related reliably to patient characteristics (sex, age) and treatment factors (electrode placement); and (5) seizure duration alone should not serve as a marker of the adequacy of treatment--there are complex relations between stimulus dosing and seizure duration, with the likelihood that substantially suprathreshold stimulation may result in shorter durations particularly early in the treatment course. PMID- 1771151 TI - The monitoring and management of electrically induced seizures. AB - Because induced seizures have such a fundamental influence on both beneficial and adverse effects associated with ECT, it is crucial that they be monitored as effectively as possible. In practice this process involves a combination of both motor and EEG monitoring. The technology for such monitoring, although not overly sophisticated, is also not trivial, and a certain amount of training is required before a practitioner can meaningfully interpret this type of information. Efforts to standardize monitoring practices, at least within a particular ECT program, are also indicated. Our knowledge of what constitutes an adequate seizure is limited, with duration still the primary focus. Future studies of ictal electrophysiology may well provide better answers in this regard. One area where already accomplished work has proved productive involves the delineation of many of the factors which influence seizure threshold and duration. On the basis of these data, practitioners now can exert considerably greater control over such measures, and thereby make more optimal use of this treatment modality. PMID- 1771152 TI - Electroconvulsive therapy in the medically compromised patient. AB - A review of the physiologic effects and potential risks--and how to reduce and manage them--of administering electroconvulsive therapy to patients with cardiovascular and cerebral disorders is presented. PMID- 1771153 TI - Electroconvulsive therapy in the treatment-resistant patient. AB - In medication-resistant patients with major depressive disorder, the response rate with bilateral electroconvulsive therapy (ECT) drops to 50% from the expected range of 80% to 90%. Relapse rates following ECT are high in medication resistant depressed patients and are clustered in the first 4 months following clinical response. Medication resistance during the index episode predicts a high rate of relapse, whereas those patients who have not received an adequate medication trial prior to ECT are less likely to relapse. If a patient who fails an antidepressant trial then responds to a course of ECT, alternative pharmacologic strategies or maintenance ECT should be considered to decrease the likelihood of relapse. Patients who do not respond to a traditional course of bilateral ECT may respond subsequently to longer courses of bilateral ECT at markedly suprathreshold stimulus intensity, or may respond to a different class of antidepressant medication from that which they failed previously. PMID- 1771154 TI - Treatment of Parkinson's disease with electroconvulsive therapy. AB - There is substantial evidence that electroconvulsive therapy (ECT) can ameliorate the symptoms of Parkinson's disease independent of any antidepressant activity. ECT thus presents a treatment alternative for the severely impaired, medication resistant Parkinson's patient. In this article, we review the literature on this subject and present our recommendations for current clinical practice. PMID- 1771155 TI - Optimal use of electroconvulsive therapy: choosing a treatment schedule. AB - Choice of treatment schedule is an important component of the ongoing efforts to optimize electroconvulsive therapy (ECT) administration and thereby maximize therapeutic benefit while reducing cognitive adverse effects. Frequency of ECT administration (that is, the spacing between treatments) and the total number of treatments in a series are the two factors that define the ECT schedule. Available evidence supports the view that a schedule of twice weekly ECT with a total of six to eight treatments is an effective therapeutic regiment that potentially reduces cognitive morbidity associated with more frequent administration and a larger number of treatments. More frequent administration, however, may accelerate antidepressant response and may be indicated in cases in which rapidity of therapeutic effect is a significant clinical consideration. This consideration may be at the cost of greater cognitive impairment, which could be reduced by limiting the number of treatments administered. Aside from their clinical relevance, these issues have important implications for understanding the mechanisms of action of ECT. PMID- 1771156 TI - Maintenance electroconvulsive therapy. AB - Maintenance electroconvulsive therapy remains an infrequently used and insufficiently researched treatment for the prevention of relapse and recurrence of affective illnesses. The foundation for this treatment is examined by reviewing the relevant scientific literature, with particular attention to identifying those patients who may benefit most from this form of therapy, as well as establishing standard techniques of application. A critical assessment of current research is made, and areas for future investigation are proposed. PMID- 1771157 TI - Neuroendocrine testing in electroconvulsive therapy. AB - Dysregulation of specific neuroendocrine axes is seen frequently in patients with depressive disorder. Electroconvulsive therapy (ECT) causes both acute and chronic changes in numerous neuroendocrine parameters. The measurement of serum and cerebrospinal levels of hormones as well as the development of specific challenge tests have allowed the identification of potential state-specific markers for depression. These markers offer the potential for predicting both outcomes of treatment with ECT and long-term prognosis. PMID- 1771158 TI - Nursing care in electroconvulsive therapy. AB - Psychiatric nursing care for the electroconvulsive therapy (ECT) patient has evolved from a traditional supportive and adjunctive practice to the current practice of independent and collaborative nursing actions. The nurse's multifaceted role is enacted by providing education and support, performing pretreatment assessments, monitoring the procedure, and observing and interpreting posttreatment patient responses. Areas of future nursing education and research should include the expansion of nursing practice with the ECT patient in the provision of quality nursing care. PMID- 1771159 TI - Choosing an electroconvulsive therapy device. AB - The selection of an electroconvulsive therapy (ECT) device from the more than 10 American-made models can be a difficult endeavor. This article is meant to be a single source of basic descriptions of these ECT devices. The information provided will allow the ECT clinician to be aware of the important issues involved in the selection of an ECT device and to become familiar with the basic features of each model. PMID- 1771160 TI - 6-OHDA lesion to the entorhinal cortex does not abolish angiotensin II improvement of recall in rats. AB - Our recent studies have shown that facilitating effect of angiotensin II (AII) on recall is mediated by dopaminergic systems. In this study the influence of bilateral destruction of dopaminergic endings in the entorhinal cortex on improving recall intracerebroventricular injection of AII was tested. Since this lesion did not abolish the facilitating influence of AII, it may be suggested that the dopaminergic projection to the entorhinal cortex is not responsible for the facilitating effect of AII on recall in a passive avoidance situation. PMID- 1771161 TI - The effect of some microsomal enzyme inducers on amitriptyline distribution in rats. AB - The influence of different types of enzyme inducers: phenobarbital, Aroclor 1254 and benzo(a)pyrene, on distribution of amitriptyline and its metabolite nortriptyline in rats was investigated. The level of amitriptyline and nortriptyline in serum, brain, heart and liver was determined by gas chromatography. The maximum concentration values of amitriptyline and nortriptyline as well as areas under concentration-time curves (AUC0-6) in serum and organs were statistically compared using Student t test and AUCCOMP computer program. The results suggest that studied xenobiotics significantly influence the distribution of amitriptyline and nortriptyline in rats. The changes of these drugs concentration in target organs may be very important from the toxicological point of view. PMID- 1771162 TI - Effect of monosodium glutamate on cell-mediated immunity. AB - Cell-mediated immunity was investigated in adult mice and rats treated with monosodium glutamate in their suckling period. Delayed-type hypersensitivity to xenogeneic cells and host-versus-graft reactivity to allogeneic cells were depressed in these mice. Their splenocytes showed reduced mitogen-induced blastogenesis in vitro which was restored by removal of nonadherent to glass spleen cells. Xenogeneic local graft-versus-host reaction induced by spleen cells taken from Wistar rats treated with monosodium glutamate was significantly decreased. Treatment with monosodium glutamate of neonatal mice and rats (possibly producing hypothalamic lesions) significantly reduced their cell mediated immunity. PMID- 1771163 TI - Synthesis and pharmacological screening of some new N-[4-(N,N-disubstituted aminocarbonyl)phenyl]-3,5-dinitrobenzoic acid hydrazides. AB - Ten title compounds were synthesized by the action of N-[4-carboxyphenyl]-3,5 dinitrobenzoic acid hydrazide with thionyl chloride, followed by condensation with different secondary amines. The synthesized compounds were screened for toxicity, gross central nervous system, cardiovascular and anti-inflammatory activities. Most of the compounds were found to be moderately toxic and to depress the central nervous system. Some of them showed anti-inflammatory activity against carrageenin-induced oedema. Certain compounds displayed mild cardiovascular activity. PMID- 1771164 TI - Synthesis and preliminary pharmacological assessment of novel 9-substituted pyrimidino-[2,1-f]-purines. AB - Synthesis, chemical properties and results of preliminary pharmacological evaluation of several new 9-substituted pyrimidino-[2,1-f]-purines are described. The most interesting was 1,3-dimethyl-2,4,8-trioxo-9-[gamma-N1-(N4-C6H5) piperazynopropy l]-1,3,6,7-tetrahydro-9H-pyrimidino-[2,1-f]-purine (compound 4a), which exerted strong sedative, hypothermizing and cataleptogenic action and possessed some anti-amphetamine and anti-apomorphine properties. PMID- 1771165 TI - Central pharmacological effects of long-term application of piracetam in rats. AB - Effect of the 14-day administration of piracetam in a dose of 5 g/kg ip upon the behavior of rats and on the content of biogenic amines and their metabolites in different brain areas was studied. It was shown that the treatment by PI for 14 days produced changes in the rat behavior manifested mainly by inhibition of exploratory activity. Long-term PI administration modified the content of NA, DA and 5-HT and their metabolites in different parts of the brain. PMID- 1771166 TI - A quantitative structure-activity relationship (QSAR) analysis of the effects of aromatic substitution on the anticonvulsant activity and toxicity of arylsuccinimides. AB - Anticonvulsant activity and toxicity of 20 arylsuccinimides were quantitatively correlated with the hydrophobic, electronic and steric parameters of the substituents in the benzene ring and at the nitrogen atom. The activity was highest when the benzene ring substituents X were characterized by hydrophobic fragmental constants fx lying in the 1.0-1.7 range, though toxicity increased with fx. PMID- 1771167 TI - Paradoxical effect of naloxone on the hemorrhagic hypotension in normotensive and spontaneously hypertensive Wistar-Kyoto rats. AB - The influence of naloxone on recovery from hemorrhagic hypotension was investigated in conscious normotensive and spontaneously hypertensive (SHR) Wistar-Kyoto rats. In both groups arterial blood pressure (MBP) was reduced to 50% of the resting level by arterial bleeding. Administration of naloxone (0.02 mg/kg iv) significantly impaired restitution of MBP in WKY and SHR in comparison to control experiments on WKY and SHR receiving no naloxone. The magnitude of this effect was similar in both strains, however in SHR, it appeared with a significant delay. The results indicate that small doses of naloxone may suppress recovery from hemorrhagic hypovolemia. PMID- 1771168 TI - [Bacteriology of tuberculosis]. PMID- 1771169 TI - Sphingomyelin and derivatives as cellular signals. AB - This comprehensive review was necessitated by recent observations suggesting that sphingomyelin and derivatives may serve second messenger functions. It has attempted to remain true to the theme of cellular signalling. Hence, it has focussed on the lipids involved primarily with respect to their metabolism and properties in mammalian systems. The enzymology involved has been emphasized. An attempt was made to define directions in which signals may be flowing. However, the evidence presented to date is insufficient to conclusively designate the mechanisms of stimulated lipid metabolism. Hence, the proposed pathways must be viewed as preliminary. Further, the biologic functions of these lipids is for the most part uncertain. Thus, it is difficult to presently integrate this sphingomyelin pathway into the greater realm of cell biology. Nevertheless, the present evidence appears to suggest that a sphingomyelin pathway is likely to possess important bioregulatory functions. Hopefully, interest in this novel pathway will grow and allow a more complete understanding of the roles of these sphingolipids in physiology and pathology. PMID- 1771170 TI - Essential fatty acids in growth and development. PMID- 1771171 TI - Effect of chronic treatment with clonidine and spironolactone on cold-induced elevation of blood pressure. AB - The present study was designed to determine whether antihypertensive agents known to affect the renin-angiotensin-aldosterone (RAA) system might affect the elevation of blood pressure induced by chronic exposure to cold. Spironolactone, a mineralocorticoid receptor blocker, was added to the food and administered to rats chronically exposed to cold. In addition, clonidine, and alpha 2-adrenergic agonist and inhibitor of renin secretion, was administered to another group of cold-exposed rats by daily intraperitoneal injection. A warm-adapted and a cold treated control group were also used. Chronic administration of spironolactone prevented the development of hypertension but failed to prevent other adaptive physiological changes characteristically occurring during exposure to cold and seen in the cold-treated control rats. Thus, increased weight of the heart, kidneys, adrenals and brown adipose tissue, increased dipsogenic responsiveness to angiotensin II, increased urinary outputs of norepinephrine and epinephrine, and increased food and water consumption were observed in all rats, treated and untreated, during exposure to cold. Similarly, daily injection of clonidine attenuated the elevation of blood pressure but also failed to prevent the other adaptive physiological changes characteristic of cold. These results are consistent with the hypothesis that the RAA system plays a role in the development of the cold-induced elevation of blood pressure. PMID- 1771172 TI - Acute blood pressure effects of selected serine proteases in normotensive rats and dogs. AB - The effects of bolus intravenous injections of various serine proteases (thrombin, trypsin, plasmin, neutrophil elastase and chymotrypsin) on arterial blood pressure were evaluated in anesthetized, normotensive rats. The activity to intravenous trypsin was also studied in anesthetized, normotensive dogs. In the rat, both thrombin (0.33-10 nmol/kg) and trypsin (4.2-420 nmol/kg) produced pronounced vasodepressor responses. The activity on blood pressure was observed immediately following injection of either protease, and both the magnitude and duration of the responses were dose dependent. Plasmin (37-350 nmol/kg) and neutrophil elastase (91-910 nmol/kg) also induced dose-dependent hypotension but at much higher dose levels. In addition, the magnitude of the blood pressure responses after plasmin and neutrophil elastase was less than those produced by thrombin and trypsin. Chymotrypsin, on the other hand, had a more diverse blood pressure profile. The protease induced a modest decrease in pressure at doses of 40 and 120 nmol/kg, a pressor response after 400 and 1,200 nmol/kg and at the highest dose tested (4,000 nmol/kg) profound hypotension. In the dog, trypsin produced a dose-dependent vasodepressor response similar to that observed in the rat. The doses of proteases producing alterations of blood pressure in the rat correlated inversely with the ability of rat serum or plasma to completely inhibit those proteases. The pharmacology of the trypsin or thrombin blood pressure response suggests the requirement of specific active enzymes to mediate the vasodepression induced by both proteases. PMID- 1771173 TI - Aspartame and sucrose produce a similar increase in the plasma phenylalanine to large neutral amino acid ratio in healthy subjects. AB - Aspartame (L-aspartyl-L-phenylalanine methyl ester) consumption has been postulated to increase brain phenylalanine levels by increasing the molar ratio of the plasma phenylalanine concentration to the sum of the plasma concentrations of the other large neutral amino acids (Phe/LNAA). Dietary manipulations with carbohydrate or protein can also produce changes in the Phe/LNAA value. To compare the effects of aspartame and carbohydrate on Phe/LNAA, beverages sweetened with aspartame, sucrose, and aspartame plus sucrose, and unsweetened beverage were ingested by 8 healthy, fasted subjects in a randomized, four-way crossover design. The beverages were sweetened with an amount of aspartame (500 mg) and/or sucrose (100 g) approximately equivalent to that used to sweeten 1 liter of soft drink. The baseline-corrected plasma Phe/LNAA values did not differ significantly following ingestion of aspartame or sucrose. Following aspartame alone, the high mean ratio increased 26% over baseline 1 h after ingestion. Following sucrose alone, the high mean ratio increased 19% at 2.5 h. Sucrose increased the Phe/LNAA value due to an insulin-mediated decrease in the plasma LNAA, while aspartame increased the ratio by increasing the plasma Phe concentration. These findings indicate that similar increases in plasma Phe/LNAA occur when healthy, fasting subjects ingest amounts of equivalent sweetness of sucrose or aspartame. PMID- 1771174 TI - Gastroprotective effect of nitrendipine on stress-induced gastric lesions in rats. AB - The effects of nitrendipine on stress-induced acute gastric lesions were investigated in rats. Intraperitoneally injected nitrendipine (8, 16, or 32 mg/kg) given 30 min before stress, dose-dependently prevented gastric glandular ulceration. The anti-ulcer effects of nitrendipine were not reversible by indometacin or dexamethasone. These results suggest that calcium is important in gastric pathophysiology and that the proof of gastroprotective effects of calcium channel blockers is of great value in the development of new and improved therapies for treatment and prevention of gastric ulcers in humans. PMID- 1771175 TI - Effect of beta-alanyl-L-histidinato zinc on osteoblastic MC3T3-E1 cells: increases in alkaline phosphatase and proliferation. AB - The effect of beta-alanyl-L-histidinato zinc (AHZ) on bone metabolism was investigated in osteoblastic MC3T3-E1 cells. Cells were cultured for 3 days at 37 degrees C in a CO2 incubator in plastic dishes containing alpha-modified minimum essential medium supplemented with 10% fetal bovine serum. After the cultures, the medium was exchanged for that containing 0.1% bovine serum albumin plus various concentrations of AHZ or zinc sulfate, and the cells were cultured further for appropriate periods of time. The presence of AHZ (10(-6)-10(-4) mol/l) stimulated proliferation of cells. AHZ increased alkaline phosphatase activity in a dose-related manner up to 10(-5) mol/l; the increase was about 2 fold over the control value. Studies on the effect of actinomycin D or cycloheximide treatment indicated that AHZ may enhance de novo synthesis of the enzyme. AHZ also increased deoxyribonucleic acid (DNA) content dose dependently (10(-6)-10(-4) mol/l). This increase was completely blocked by treatment with cycloheximide. The AHZ (10(-5) mol/l)-induced increases in alkaline phosphatase activity and DNA content were entirely abolished by the presence of dipicolinate (10(-4) mol/l), a chelator of zinc, indicating that the effect of AHZ needs zinc. However, AHZ had a potent effect, more than that of zinc sulfate, on alkaline phosphatase activity and DNA content. The present results indicate that AHZ has a direct specific anabolic effect on osteoblastic cells in vitro and that this effect is related to protein synthesis. PMID- 1771176 TI - The inhibition of glutathione S-transferases: mechanisms, toxic consequences and therapeutic benefits. AB - Inhibition of the enzymes belonging to the family of glutathione S-transferases is important from several points of view. These involve applications in studies of the catalytic mechanism, e.g. studying the topology and binding characteristics of the active site. Also, from a therapeutic standpoint, inhibition of glutathione S-transferases steadily becomes more interesting, since these enzymes appear to be involved in drug resistance, and in the biosynthesis of a number of important arachidonic acid metabolites such as prostaglandins and leukotrienes. Modulation of the glutathione S-transferase activity could be used to regulate the concentrations of these compounds, Thirdly, unwanted inhibition by xenobiotics makes a cell more vulnerable for alkylating agents and can thus have toxic consequences. This review describes the state of the art, dealing with the various types of inhibiton employed (reversible, irreversible or nonsubstrate ligands). Furthermore, isoenzyme selectivity, organ distribution and interindividual differences are discussed. PMID- 1771177 TI - Gene expression of nonsegmented negative strand RNA viruses. AB - Nonsegmented negative strand RNA viruses comprise major human and animal pathogens in nature. This class of viruses is ubiquitous and infects vertebrates, invertebrates, and plants. Our laboratory has been working on the gene expression of two prototype nonsegmented negative strand RNA viruses, vesicular stomatitis virus (a rhabdovirus) and human parainfluenza virus 3 (a paramyxovirus). An RNA dependent RNA polymerase (L and P protein) is packaged within the virion which faithfully copies the genome RNA in vitro and in vivo; this enzyme complex, in association with the nucleocapsid protein (N), is also involved in the replication process. In this review, we have presented up-to-date information of the structure and function of the RNA polymerases of these two viruses, the mechanisms of transcription and replication, and the role of host proteins in the life-cycle of the viruses. These detailed studies have led us to a better understanding of the roles of viral and cellular proteins in the viral gene expression. PMID- 1771178 TI - Protein kinase C. AB - Based on the molecular structure of the individual members of the protein kinase C family, general properties and the mode of activation of this enzyme family are discussed. Examples are presented of how the investigation of protein kinase C function in vivo has been approached at the molecular level. PMID- 1771179 TI - Phantoms for hyperthermia and impedance tomography. PMID- 1771180 TI - New materials for dielectric simulation of tissues. AB - Two novel materials have been developed to simulate the dielectric properties of human muscle and fat at 1000 MHz. These materials, which are based on ethanediol set with gelatine, are easily made and have good mechanical properties. The complex permittivity, epsilon *, of each material was measured with an open-ended coaxial sensor in conjunction with an automatic network analyser. Values of epsilon * at 1000 MHz and room temperature (49.4-24.4j for the muscle-equivalent material, 8.2-3.6j for the fat-equivalent) compared well with literature values for tissue at body temperature. Thermal properties were also considered. Specific heat capacities of the materials at room temperature were measured by differential scanning calorimetry and found to be very close to values predicted by theory. Densities were also measured and the thermal conductivities estimated. For comparison, new measurements were made of the specific heat and density of human muscle and fat at body temperature. PMID- 1771181 TI - Perfect-mixer retention function by analytical deconvolution of tracer histograms: application to evaluation of left-ventricular contractility and competence. AB - The analytical solution for the perfect-mixer retention function, r(t), was developed from tracer histograms sampled at the system input, i(t), and its output, y(t), linked by the convolution integral y = i * r. Theories were developed for both continuous-output mixer and pulsatile, discrete mixer. The latter method was applied in first-pass radioangiography (FPRA) to calculate the forward ejection fraction of the left ventricle (LVFEF). Curves generated over the lungs and the ventricle provided system input and output respectively. LVFEF correlated strongly with the reference values obtained with simultaneously acquired gated FPRA(LVGEF) in 32 non-regurgitant patients: LVGEF = 0.90LVFEF + 5.93, r = 0.96, SEE = 3.98, p less than 0.001. In 14 patients with left-side valvular incompetence LVFEF values (0.41 +/- 0.13) were consistently lower than the corresponding LVGEF values (0.63 +/- 0.11). The method is free from instability inherent in numerical deconvolution. Applied in FPRA it yielded accurate estimates of LV contractility and competence. The continuous-mixer theory may apply to arbitrary compartmental models studied via tracer kinetics. PMID- 1771182 TI - A convenient method of measuring the thermal conductivity of biological tissue. AB - The basic principle of the thermal conductivity probe is described. Thin probes were developed based on this principle, with a reproducibility of 5.3% and relative error less than 6.0%. Each measurement can be completed in 90 s and the temperature increase can be controlled within 2 degrees C. Using the probes, the thermal conductivities of pig fat, meat, liver, kidney and live and dead snake head were measured and it was found that water content plays an important role in influencing the magnitude of the thermal conductivity of biological tissues. The probe can be used over a temperature range from -40 to 150 degrees C. PMID- 1771183 TI - The influence of model parameter values on the prediction of skin surface temperature: II. Contact problems. AB - A model of heat transfer and temperature distribution in the skin and superficial tissues which is based on a finite difference numerical solution of the one dimensional multilayer coupled bioheat equation is presented. The model is used to investigate the influence of the values chosen to represent the physiological and thermal properties of the tissues on the skin surface temperature after contact with an external medium. It was found that the skin blood flow and dermal conductivity were the main cutaneous parameters which influence the contact response, but in terms of normalized temperature the response was little influenced by cutaneous metabolic heat generation and deep dermal temperature. For contact with a good conductor, the transient behaviour was sensitive to the heat transfer coefficient on the outer surface and the thickness of the contact material, but insensitive to the conductivity of the material. PMID- 1771184 TI - Fast evaluation of patient set-up during radiotherapy by aligning features in portal and simulator images. AB - A new fast method is presented for the quantification of patient set-up errors during radiotherapy with external photon beams. The set-up errors are described as deviations in relative position and orientation of specified anatomical structures relative to specified field shaping devices. These deviations are determined from parameters of the image transformations that make their features in a portal image align with the corresponding features in a simulator image. Knowledge of some set-up parameters during treatment simulation is required. The method does not require accurate knowledge about the position of the portal imaging device as long as the positions of some of the field shaping devices are verified independently during treatment. By applying this method, deviations in a pelvic phantom set-up can be measured with a precision of 2 mm within 1 minute. Theoretical considerations and experiments have shown that the method is not applicable when there are out-of-plane rotations larger than 2 degrees or translations larger than 1 cm. Inter-observer variability proved to be a source of large systematic errors, which could be reduced by offering a precise protocol for the feature alignment. PMID- 1771185 TI - A correction for total body hydrogen used as an internal standard in the measurement of total body protein by prompt gamma in vivo neutron activation analysis. PMID- 1771186 TI - Time evolution of bone/soft-tissue ratio with dynamic SPET. PMID- 1771187 TI - A simple method for the correction of photon attenuation caused by patient couches in SPECT. PMID- 1771188 TI - Radiation field edge detection in portal images. PMID- 1771190 TI - [Ordinary and technical terms in psychiatry]. PMID- 1771189 TI - [Present status and future aspect of psychiatric drug therapy]. PMID- 1771191 TI - [Practical family therapy of mental disease]. PMID- 1771192 TI - [New therapy of epilepsy]. PMID- 1771193 TI - PRN psychotropic drug use on a psychiatric unit. AB - PRN psychotropic drug use is a frequent practice on psychiatric units. This study examined medical records for patient demographics and prescribing patterns of drugs. The omission of the indication and frequency of dosing for the drug were common prescribing errors. There was no significant association between diagnosis and whether a patient received PRN drugs. Anxious patients were significantly more likely to receive PRN anxiolytics whereas psychotic patients were as likely to receive PRN anxiolytics as antipsychotics. Anxiolytics also were significantly more likely to be judged effective by the nursing staff than antipsychotics. A perplexing finding was that manic and schizophrenic patients were significantly less likely to receive PRN hypnotics than were patients with Major Depression. The clinical implications of the findings are discussed and recommendations are made to improve standards of practice for this commonplace treatment. PMID- 1771194 TI - A comparison of demographic, behavioral, and ego function data in borderline and eating disorder patients. AB - Seven borderline personality and ten eating disorder patients were compared using demographic, descriptive/behavioral, and ego function measures on admission to an inpatient unit. Demographic and descriptive data analysis revealed areas of overlap, consistent with other reports of co-morbidity between the two groups. Ratings of intrapsychic function were made using Bellak's Ego Function Assessment profiles, and showed that the two groups shared deficits in the areas of impulse/affect control and sense of identity, but had otherwise easily distinguishable profiles. The authors feel that studying ego functioning is a useful way of assessing co-morbidity in borderline personality and eating disorder patients. PMID- 1771195 TI - Quality of life in alternative residential settings. AB - Central to policy revisions over the past forty years toward persons with psychiatric disabilities has been a change in where they live. Whereas forty years ago those patients needing assistance were generally housed in large public mental hospitals, today a myriad of alternative community housing settings are offered. A major impetus for this shift in housing, at least as currently articulated in most public forums, has been to improve their quality of life. Here we examine the quality of life experiences of psychiatrically disabled persons living in alternative settings: a state hospital, large residential care facilities, small group homes, and supervised apartments. Our central hypothesis, only partly supported, is that a quality of life gradient exists across these living settings. The results lend support to the value of quality of life assessments and point to the importance of more focused notions about how our various interventions may affect the persons whom we serve. PMID- 1771196 TI - Not guilty of murder by reason of paroxysmal insanity: the "mad" doctor vs. "common-sense" doctors in an 1865 trial. AB - In July 1865, the Harris/Burroughs trial marked the first time in a U.S. courtroom that expert medical testimony supported a plea of paroxysmal [temporary] insanity in a murder defense. Furthermore, the "medical expert" ["mad doctor"] was pitted against "common-sense" physicians. Forensic rationales and societal reactions of the 1860s appear to be remarkably similar to what happens in the 1990s. By merely changing the antebellum language, the arguments and ripostes could readily be recycled into current temporary insanity confrontations. Sociocultural aspects of the Harris/Burroughs murder case may yield clues as to the persistence of the forensic and attitudinal stances toward temporary insanity pleas by the mass media, the physicians, the legal profession and the public. PMID- 1771197 TI - Chronic patients' power games and the proper setting of limits. AB - The author found that the chronic mental patients at a state hospital aftercare clinic brought for consultation because of lack of therapeutic progress were all engaged in manipulative power games with the staff. The most common games involved medication, attendance and punctuality, and misbehavior. Defiance was the major motive: the patients' ability to frustrate and triumph over the staff created subtle "high" for them in otherwise bleak lives. The staffs were usually unaware of the games. When they recognized them, stopped them effectively, and focused therapeutically on helping the patients examine and change their maladaptive ways of acting and thinking, improvement began to occur. Power games are important in other aspects of psychiatric practice; examples are given. PMID- 1771198 TI - A comprehensive alternative to residential treatment for adolescents and young adults. AB - This paper describes a treatment modality for adolescents and young adults who do not respond successfully to treatment within the family context. A comprehensive therapeutic program is implemented in the open community, providing benefits of residential care while avoiding many of the drawbacks. Five key components are discussed: creating individualized programs using community resources; effecting a complete separation from parents; maximizing autonomy and self-reliance; facilitating a corrective family experience; and capitalizing on transference in intensive individual psychotherapy, which is enhanced when a married couple functions as the treatment team. Suggestions for implementing this model are discussed and advantages and limitations are cited. PMID- 1771199 TI - [Development of a therapeutic partnership understanding of schizophrenia as a sequela of recent concepts of etiology and changes in psychiatric contemporary theory]. AB - Ideas and concepts of the essence and nature of mental diseases have always been rooted in the current zeitgeist that usually regarded the psychotic patient as a helpless victim of demoniacal influences, degenerative processes, organic (endogenous) diseases or the dynamics of familial determinants, all of which seemingly destroyed or paralysed the autonomy of the person who became a schizophrenic. In consequence of these concepts the doctor-patient relationship (active expert-passive object of treatment) has largely been asymetrical, whereas at the same time the doctors' attitude towards the relatives was either indifferent or in the manner of a defence reaction, or of a corrective nature. Recent theories such as the concept of vulnerability and stress-coping stimulated new and fruitful forms of cooperation between doctor, patient and relatives. The schizophrenic patient is now being credited with a greater measure of possibilities to influence the prodromata, the course and the consequences of his psychosis. His relatives can help him in doing so, and in fact they should. Clearly formulated and easily appreciated information on this concept, as well as common attention to and assistance of self-protective and compensatory efforts to cope with psychological basic deficiencies, managing of stressors, early symptoms and handicaps. could promote a "treatment partnership" that is also effective as a preventive measure. The idea of a partnership therapy, too, is linked to current trends in research theory and practice that are characterised by the systemic paradigm while aiming at partially restoring the mental patients' capacity and right to act. PMID- 1771200 TI - [The dynamics of outcome predictors in the early phase of schizophrenic psychoses -an empirical study]. AB - The interrelationship and predictive validity of certain outcome predictors were studied on 54 young schizophrenic patients. In the first year after outburst the illness shows a great variability and the course seems to be open. Neither the premorbid social adjustment nor the amount of negative symptoms seem to predict the course in the first year. But as in earlier studies the expectations of patient, relatives and staff show to have a certain predictive significance. PMID- 1771201 TI - [Clinic discharge of schizophrenic patients: treatment termination or transition? A catamnestic study of community psychiatric management]. AB - In order to evaluate which single or combined factors can lead to best acceptance of continuing out-patient psychiatric care, a random sample of 73 patients diagnosed as schizophrenic were entered into a follow-up study on leaving a psychiatric hospital. In a given region with only one public mental health center it was found that early and comprehensive planning of hospital dismissal, cooperation of family and--where possible--no change of the responsible therapist led to a 84% rate of patients remaining in the regional psychiatric care system, with a rehospitalisation rate of 33% within a year. Literature on the subject is reviewed in perspective of the rather high acceptance of psychiatric aftercare and the rather low rate of rehospitalisation. PMID- 1771202 TI - [The function of the round table in social psychiatric ambulatory care]. AB - The round table is the center of the activities in the outpatient service of the Sociopsychiatric University Clinic Bern. First the life at the round table is shortly described. Then the different functions of the round table in the care of psychiatric longterm patients are discussed in detail. So the patients, who are partly considerably handicapped, out of their social isolation. The so arising relationships can be helpful for the patients in different areas. Furthermore it can be shown, that the round table fullfills all the functions of an informal, open, sociotherapeutic group. We emphasize on the great importance of the open and tolerant atmosphere at the round table for the therapeutic effect of it. PMID- 1771203 TI - [Music therapy evaluated by schizophrenic patients]. AB - Music therapy is presented as an integral part of the therapeutic program of an open reception ward at a state-funded psychiatric hospital. The target group for music therapy comprises schizophrenic patients whose primary psychopathological symptoms are characterized by basic disorders, autistic withdrawal, anergia and limited means of verbal communication. A sample of 30 schizophrenic patients selected for music therapy is described. The subjective evaluation and rating of the music therapy was registered using a specially developed questionnaire. The primary results are: 1. Music therapy has a high level of subjective acceptance among patients. 2. No negative effects are recorded despite the therapy being introduced in the post-acute phase. 3. The positive therapeutic effects quoted are relaxation, activation, reduced anxiety, easier contact-making, and improved opportunities for emotional expression. The duration of the effects is limited. 4. The training-related concept and the clearly structuring behavior of the group leader are given a positive rating by the patients. PMID- 1771204 TI - Low dopamine-beta-hydroxylase: a biological sequela of abuse and neglect? AB - Twenty-one psychiatrically hospitalized boys were studied while off psychoactive medication to determine if conduct disorder, solitary type, and abuse or neglect experiences correlated with low levels of dopamine-beta-hydroxylase (DBH) activity. Preliminary results supported earlier findings that undersocialized types of conduct disorder in boys were correlated with low DBH activity. Possible or definite neglect or abuse before 36 months of age was correlated with low DBH activity. Abuse or neglect was not correlated with low DBH activity when time of occurrence was not specified. Low serum DBH may be a biological sequela of seriously disrupted attachment. PMID- 1771205 TI - Ventilatory response to CO2 in panic disorder. AB - The Read rebreathing technique was used to measure the ventilatory response to inhalation of carbon dioxide in 15 panic disorder patients, 15 obsessive compulsive disorder patients, and 15 healthy control subjects. No significant differences in ventilatory response were found among the three groups. The tidal volume and frequency components of the ventilatory response also did not differ among the groups. The hypothetical pCO2 value corresponding with zero ventilation was significantly lower in the panic disorder patients than in normal control subjects. PMID- 1771206 TI - Lack of seasonal variation in the births of patients with dementia of the Alzheimer type. AB - Seasonal variation in the birth rates of patients suffering from dementia of the Alzheimer type (DAT) was investigated in 150 patients, aged 42-88 years, and in 132 normal control subjects of comparable age and gender. No seasonal variation or cyclic trend could be demonstrated in the DAT patients compared with control subjects. The exclusion from the analysis of the patients with a positive family history did not change the results of the study, which further suggests that a seasonality in DAT birth rates is unlikely. PMID- 1771207 TI - Cross-national reliability, concurrent validity, and stability of a brief method for assessing expressed emotion. AB - The Five-Minute Speech Sample (FMSS; Magana et al., 1986) is a brief method designed to assess the "expressed emotion" (EE) status of a respondent. The FMSS EE rating is derived from statements made by a patient's key relative during a 5 minute monologue, with codes similar to those used in the original EE rating system (e.g., criticism and emotional overinvolvement). Rating is done from the audiotape and takes about 15-30 minutes. The article reports on the results of a cross-national study carried out in Germany using the FMSS with a sample of 60 relatives of schizophrenic patients. Results indicated that (1) German investigators could readily learn the system and could achieve a high degree of interrater reliability; (2) the association with the original index of EE, the Camberwell Family Interview, was comparable to that found by Magana et al.; and (3) the method yields very stable data over a 4-5 week retest period. PMID- 1771208 TI - Hard neurologic signs and psychopathology in relatives of schizophrenic patients. AB - Previous research found more hard neurologic signs (i.e., signs that have localizing significance and exclude likely artifacts) in the nonschizophrenic relatives of schizophrenic patients than in control subjects, and in the psychiatrically normal relatives of schizophrenic patients compared with their ill relatives. Using interview-based DSM-III-R diagnoses and standard clinical neurological examinations on new samples, we found a trend to more hard signs in the 52 nonschizophrenic relatives of schizophrenic patients than in 20 control subjects, and significantly more signs in psychiatrically normal relatives than in ill ones. When pooled with previous data, signs were significantly higher in (1) relatives vs. controls and (2) normal vs. ill relatives, suggesting neurologic signs reflect an etiologic factor that often runs in families of schizophrenic patients. PMID- 1771209 TI - Interrater reliability of the Structured Clinical Interview for DSM-III-R, Axis II: schizophrenia spectrum and affective spectrum disorders. AB - Three interviewers (second raters) blindly rated 15 audiotapes each of the Structured Clinical Interview for DSM-III-R, Axis II (SCID-II) administered to the first degree relatives of probands with either DSM-III-R schizophrenia, schizoaffective disorder, or bipolar disorder, for a total of 45 second ratings. Interrater reliability was determined using the intraclass correlation coefficient and ranged from 0.60 to 0.84. The previous studies of the reliability of structured interviews for diagnosing personality disorders are summarized and compared to the present findings. We conclude that the SCID-II can be reliably used to diagnose schizophrenia-spectrum and affective spectrum disorders in the first degree family members of probands with schizophrenic or bipolar affective disorders. PMID- 1771210 TI - Uncovering psychiatric test information with graphical techniques of Exploratory Data Analysis. AB - This article illustrates how Exploratory Data Analysis (EDA) can complement conventional statistical methods in evaluating psychiatric tests. Using one recent EDA computer program, we evaluated the ability of repeated psychiatric screening tests (the General Health Questionnaire [GHQ]) to predict medical and psychiatric service use in a Health Maintenance Organization (HMO), the Harvard Community Health Plan (HCHP). Using a stratified random sample of 244 new HCHP enrollees and viewing three-dimensional graphs of their data from multiple perspectives, we found two subpopulations: low GHQ scorers, for whom the tests did not predict service use; and high scorers, for whom they did. Surprisingly, improving scores forecast increased use and chronically high scores predicted diminished use. Using another stratified random sample of 213 new HCHP enrollees, and with scatterplot matrices from another interactive computer program, we found that high and unchanging GHQ scores forecast HMO dropout. We examine possible interpretations--for example, that chronically distressed patients may become immobilized, diminish service use, and ultimately leave the HMO. We also explain how EDA methods may help uncover elusive results in other data (e.g., mental health outcomes). PMID- 1771211 TI - Patterns of illness in parent-child pairs both hospitalized for either schizophrenia or a major mood disorder. AB - Results are reported of a blind rediagnosis of a consecutive series of parent child pairs hospitalized with a diagnosis of schizophrenia or mood disorder. Patterns of illness in pairs meeting DSM-III-R criteria for either disorder were examined by contrasting the two generations on their respective distributions of diagnoses, and means of age at onset and severity of illness. While no case of mood disorder was found in the children of schizophrenic parents, 50% of the children of parents with psychotic mood disorders presented with schizophrenia. The offspring also had an earlier age at onset of illness than did their parents. PMID- 1771212 TI - Avoidant and dependent personality traits in relatives of patients with panic disorder, patients with dependent personality disorder, and normal controls. AB - Psychiatric researchers have long wondered whether personality traits might predispose toward or be integral to Axis I illnesses. The question is difficult to address because acute illness can either create personality traits or distort their measurement. The present study bypassed that problem by examining personality traits in relatives of patients. Panic disorder, dependent personality disorder, and control subjects were the proband groups. A cluster of traits that appeared to reflect low social self-confidence combined with a desire for social interaction occurred significantly more often in relatives of patients in both groups. PMID- 1771213 TI - Comparison of the effects of mianserin and its enantiomers and metabolites on a behavioral screen for antidepressant activity. AB - The behavioral effects of racemic mianserin, its (+) and (-) enantiomers, and its metabolites desmethylmianserin and 8-hydroxymianserin were evaluated on the differential-reinforcement-of-low-rate 72-s (DRL 72-s) schedule, a screen known to be sensitive to and specific for the antidepressant properties of drugs. Racemic mianserin produced the antidepressant-like effect (increased reinforcement rate, decreased response rate) at 5 and 10 mg/kg. The mianserin enantiomers showed the antidepressant-like effect beginning at lower doses [(+) mianserin; 0.6 mg/kg; (-) mianserin: 2.5 mg/kg]. The mianserin metabolites showed no clear dose-related effect at doses up to 10 mg/kg. It is concluded that the antidepressant-like effects of mianserin are due to the activity of the parent compound rather than to its metabolites, and that they may be primarily attributable to the (+) enantiomer. The greater potency of (+)-mianserin may be related to its higher affinity for the 5-HT2 receptor. PMID- 1771214 TI - Effect of hypothalamic and peripheral fluoxetine injection on natural patterns of macronutrient intake in the rat. AB - The effect of the serotonin (5-HT) reuptake inhibitor, fluoxetine (FLU), on nutrient intake was examined in rats given free access to three pure macronutrient diets (protein, carbohydrate and fat). Fluoxetine was administered either peripherally or directly into the hypothalamic paraventricular nucleus (PVN) at three different times of the rats' nocturnal cycle. Using a range of doses for IP (0.6-10 mg/kg) and PVN injection (3.2-100 nmol), FLU exerted a selective, dose-dependent suppression (-20% to -60%) of carbohydrate intake only during the first hour of the dark. No change in the consumption of protein or fat was observed. This suppressive effect in the early dark period was not observed during the late dark phase, after either IP or PVN administration. In animals with brain cannulae aimed at different hypothalamic nuclei, the nutrient suppressive effect of FLU was found to be localized to the medial hypothalamic nuclei, namely, the ventromedial, dorsomedial and suprachiasmatic nuclei, in addition to the PVN. These results, along with other published work, support a role for hypothalamic 5-HT systems in the control of nutrient intake in a circadian-related manner and in mediating the central action of the anorectic compound FLU. PMID- 1771215 TI - Effects of MK-801 stereoisomers on schedule-controlled behavior in rats. AB - Behavioral effects of (+)MK-801 (0.03-0.32 mg/kg) and (-)MK-801 (0.32-3.20 mg/kg) were evaluated in rats using a multiple fixed-ratio, fixed-interval (FR20, FI2) schedule of food presentation. Both enantiomers produced dose-dependent decreases in response rate under the FR20 and in this respect (+)MK-801 was approximately ten times as potent as (-)MK-801. Under the FI2 schedule component, the (+) enantiomer produced substantial increases as well as decreases in response rate whereas the (-) enantiomer produced only decreases. When 0.178 mg/kg (+)MK-801 and 1.78 mg/kg (-)MK-801 were administered for 11 consecutive days, tolerance developed to the decrease in response rate under the FR20 schedule component. Tolerance to the effects of the (+) enantiomer under the FI2 schedule component was indicated by progressively larger increases in response rate than those observed during acute administration. These results support potential therapeutic applications of MK-801. PMID- 1771216 TI - Impaired sensitivity of the hypothalamo-pituitary-thyroid axis to the suppressant effect of dexamethasone in elderly subjects. AB - It has been shown that glucocorticoids have a suppressant effect on the thyrotropin (TSH) response to thyrotropin-releasing hormone (TRH) in young men. To assess whether this effect of corticosteroids is also present in aged individuals, six young subjects (aged 26-32 years) and six elderly men (aged 68 75 years) underwent, in random order, at 1 week intervals, three TRH stimulation tests 30 min after IV administration of placebo and 2 mg and 4 mg dexamethasone phosphate. Elderly men showed higher basal plasma levels of TSH (P less than 0.02) and lower plasma levels of FT3 (P less than 0.03) and FT4 (P less than 0.01). The TSH response to TRH was significantly lower in aged subjects than in young ones (P less than 0.009). Moreover, 2 mg dexamethasone significantly blunted the TSH response to TRH in young men (P less than 0.0001), but not in the elders. The inhibitory effect of the glucocorticoid on the TRH-induced TSH secretion, in aged subjects, was evident only after 4 mg dexamethasone administration (P less than 0.0001). These data confirm that glucocorticoids have an inhibitory role on the thyrotropic axis and show, for the first time, that normal elderly men are hyporesponsive to this suppressant effect of corticosteroids. PMID- 1771217 TI - Effect of extended depot fluphenazine treatment and withdrawal on social and other behaviors of Cebus apella monkeys. AB - To examine whether or not prolonged exposure to a depot neuroleptic has either residual or "tardive pathological" effects on normal behavior, 38 Cebus apella monkeys were observed daily for 108 weeks. The issue of stress influencing such effects was also addressed. During weeks 25-48 half of the monkeys received 0.22 mg/kg fluphenazine decanoate, IM, every 3 weeks, with the dose increased to 0.33 mg/kg during weeks 49-72. Behavioral measures were combined to form composite behavioral variables which quantify four major aspects of behavior: self- and environment-directed behavior, affiliation, aggression, and normal locomotor activity. Mean plasma fluphenazine levels at 48 h post-injection were 0.13 (+/- 0.03) ng/ml for injections 3-8 and 0.24 (+/- 0.07) ng/ml for injections 11-16. The pre-study null hypothesis that the four major aspects of behavior would not be adversely affected by this treatment during the drug-discontinuation phase of the study (weeks 73-108) was not statistically negated. There were highly significant decreases in self- and environment-directed behaviors and affiliation during the treatment periods, implying that treatment may contribute to the negative symptoms of treated schizophrenics. Stress reduced the above effects. Aggression showed some increase during early drug discontinuation, accentuated by stress. Recovery of normal (baseline) behavioral scores began by week 7 after the last treatment. Mild (bucco-lingual) tardive dyskinesias persisted in 30% of the animals for a prolonged time. PMID- 1771218 TI - Excitatory amino acids and morphine withdrawal: differential effects of central and peripheral kynurenic acid administration. AB - The non-selective excitatory amino acid antagonist kynurenic acid, which does not readily cross the blood-brain barrier, dose-dependently attenuated the behavioral signs of naltrexone-precipitated withdrawal in morphine-dependent rats following both intraventricular and subcutaneous administration. However, intraventricular and subcutaneous administration of kynurenic acid had different effects on individual withdrawal behaviors. Moreover, single unit recordings in anesthetized animals showed that intraventricular, but not subcutaneous, kynurenic acid administration attenuated the withdrawal-induced increased firing of locus coeruleus neurons. These studies indicate that: (1) both central and peripheral excitatory amino acid receptors may play an important role in opiate withdrawal; and (2) excitatory amino acid antagonist treatments might be developed to reduce opiate abstinence symptoms in man. PMID- 1771219 TI - Serotonergic modulation of the rat pup ultrasonic isolation call: studies with 5HT1 and 5HT2 subtype-selective agonists and antagonists. AB - A modulatory role for serotonin has been described for the development and expression of the ultrasonic call of infant rat pups during brief maternal separations. In previous studies, serotonin reuptake inhibitors selectively reduced the rate of calling following acute administration to 9-11-day-old pups and a serotonin neurotoxin (MDMA) systematically disrupted the development of ultrasonic vocalizations but not other measures of motor development. In the current studies, we extended our investigations to include drugs with purported receptor subtype selectivities. Consistent with previous reports, acute administration of 5HT1A agonists buspirone and 8-OH-DPAT [+/-)-8-hydroxy-2-(di-N propylamino)tetralin) reduced the rate of calling at doses which did not affect motor activity or core body temperature. The rate reducing effects of buspirone persisted up to 1 but not 2 h after injection. Administration of purported 5HT1B receptor agonists, CGS12066B (7-trifluoromethyl-4(4-methyl-1-piperazinyl) pyrrolo[1,2-a] quinoxaline) and TFMPP (1-[3-fluoromethyl)phenyl]-piperazine) increased the rate of calling depending on the specificity of the drug for the 5HT1B receptor. d,l-Propranolol, a 5HT1 receptor antagonist, blocked the effects of both 8-OH-DPAT and TFMPP. m-CPP (1-(3-chlorophenyl)piperazine) and DOI [+/-)-1 (2,5-dimethoxy-4-iodophenyl)-2-aminopropane), drugs with putative actions at 5HT1C and 5HT2 receptor sites both decreased calling but differed according to their effects on motor activity. Ritanserin, a 5HT2 and 5HT1C antagonist, produced a dose-related increase in call rate. A dose of ritanserin with no apparent intrinsic effects effectively antagonized DOI rate reducing effects but potentiated the rate reducing effects of m-CPP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771220 TI - Effects of glucose on memory processes in young adults. AB - Recent studies suggest that glucose enhances memory in rodents and humans. The present experiment investigated the effects of glucose on memory performance and blood glucose changes in young adults (19-25 years). Subjects ingested (300 ml beverage) three doses of glucose (0, 30, 100 g) in a random, double-blind, triple crossover design. Thirty minutes post-glucose, subjects were shown nouns on a computer monitor and then administered recall and recognition memory tests. Blood samples were drawn at regular intervals. There was no effect of glucose on memory performance, and plasma glucose measures did not correlate with memory test scores. Statistical power was adequate to detect a medium effect. The results contradict the hypothesis that glucose enhances memory performance in young, healthy normal adults. PMID- 1771221 TI - Chronic alcohol consumption in alcohol-preferring P rats attenuates subsequent conditioned taste aversion produced by ethanol injections. AB - Rats of the P line were tested for the development of tolerance to the aversive effects of ethanol during 33 days of continuous availability of food, water and a 10% (v/v) ethanol solution. Beginning on the day following the removal of ethanol, five daily conditioned taste aversion (CTA) trials were administered to the ethanol-drinking P rats and an ethanol-naive control group. The CTA trials consisted of a 20-min access to a Polycose solution, followed by IP injection of saline, 0.5, 1.0, or 1.5 g ethanol/kg. The ethanol-drinking rats developed a preference for the Polycose solution when it was paired with 0.5 g ethanol injections, but the control rats did not. Both control and ethanol groups had similar CTAs at the 1.5 g dose. However, at the 1.0 g dose, the ethanol group had an attenuated CTA compared with the water control group. The results suggest that P rats develop tolerance to aversive effects of ethanol during chronic drinking. This tolerance could contribute to the high ethanol intake in these selectively bred rats. PMID- 1771222 TI - Distribution of diazepam, nordiazepam, and oxazepam between brain extraneuronal space, brain tissue, plasma, and cerebrospinal fluid in diazepam and nordiazepam dependent dogs. AB - The compartmental distribution of diazepam (DZ) and nordiazepam (ND) and their metabolites was studied in DZ and ND dependent dogs. The levels of DZ, and ND and their metabolites were determined during the last week of stabilization in the extraneuronal brain space, in brain tissue, in plasma and in CSF. In these studies dependent dogs were anesthetized with pentobarbital and microdialysis probes were inserted bilaterally into the parietal cortex and perfused with artificial cerebrospinal fluid. Microdialysis probes were also used to determine the unbound parent drugs and their metabolites in plasma. The brain-plasma distribution of total ND and oxazepam (OX) is about equal in ND dependent dogs but in DZ dependent dogs total ND and OX are about 2-fold higher in brain than in plasma. The levels of DZ, ND, and OX in the extraneuronal brain space are similar to their unbound levels in plasma. These data suggest that the concentration of free benzodiazepines in plasma is a good approximation of the concentration in the vicinity of the membrane receptors in the dependent dogs. PMID- 1771223 TI - Kinetics of piribedil and effects on dopamine metabolism: hepatic biotransformation is not a determinant of its dopaminergic action in rats. AB - The importance of hepatic metabolism in relation to the central (dopaminergic) effects of piribedil (PD) is still not really known. Plasma and brain kinetics and the effects on striatal dopamine (DA) metabolism of the parent drug and its known metabolites were therefore evaluated in rats, a species widely used in neurochemical studies of this drug. PD injected intraperitoneally (IP, 15-60 mg/kg) and centrally (ICV, 100-200 micrograms/rat) lowered striatal 3,4 dihydroxyphenylacetic acid (DOPAC) and 3-methoxy-4-hydroxyphenylacetic acid (HVA) content and the intensity and time-course of the neurochemical effects were route and dose-relatedly dependent on brain PD kinetics. The catechol (M1), p hydroxylated (M2) and N-oxide (M3) metabolites of the drug were detectable only in trace amounts in rat brain and only at the highest IP dose tested; when administered ICV at doses equimolar to PD they caused no decrease in striatal DA metabolites, although striatal concentrations were higher than after IP PD, being comparable to or higher than those of the ICV parent drug. These data suggest that metabolites do not contribute to the dopaminergic effects of PD in rats. PMID- 1771224 TI - Effect of two beta-blockers on stress during mental arithmetic. AB - Heart rate, blood pressure, and subjective stress ratings were recorded from 36 healthy normotensive students at three points in time: during a drug-free baseline, during a baseline 2 h after ingesting single oral doses of atenolol (75 mg), metoprolol (150 mg), or lactate placebo, and during a subsequently administered mental arithmetic test. Both beta-blockers equally reduced baseline heart rate and heart rate response to arithmetic, but subjective stress rating increases to arithmetic were greater for atenolol than for placebo and metoprolol. These results are contrary to peripheral theories of anxiety regulation. While the hydrophilic atenolol barely penetrates the blood-brain barrier, the lipophilic metoprolol can exert direct CNS effects in addition to its peripheral actions. Central stress-dampening effects of lipophilic beta blockers may override peripheral baroreceptor-mediated stress-promoting effects. PMID- 1771225 TI - Low but not high doses of buspirone reduce the anxiogenic effects of diazepam withdrawal. AB - After 21 days of treatment with diazepam (2 mg/kg/day IP) rats were tested 24 h after the last injection in the social interaction and elevated plus-maze tests of anxiety. Compared with control-treated rats, they showed significant decreases in social interaction, in the % numbers of entries onto open arms of the plus maze and in the % of time spent on the open arms, indicating an anxiogenic response on withdrawal from diazepam. Buspirone (200 micrograms/kg SC) significantly increased social interaction in diazepam withdrawn rats and in the plus-maze also this dose significantly reversed the anxiogenic effects of diazepam withdrawal. Buspirone (400 micrograms/kg SC) was without effect in the plus-maze, but buspirone (800 micrograms/kg SC) significantly decreased the % of time spent on open arms in control-treated rats, indicating an anxiogenic effect. In the social interaction test buspirone (800 micrograms/kg SC) was without significant effect. The contrasting effects of the 200 and 800 micrograms/kg doses are discussed in terms of the pre- and post-synaptic actions of buspirone. The findings are consistent with earlier proposals that the increased anxiety during benzodiazepine withdrawal is at least partly caused by an increased release of hippocampal 5-HT. PMID- 1771226 TI - [Personality markers of phobic patients and their change in psychotherapy. Descriptive results of a catamnestic project of the effectiveness of 6-9 week inpatient treatment]. AB - The present paper is part on an extensive follow-up study aimed at the investigation of the effects of in-patient psychotherapy and at the durability of those effects. Using a psychoanalytic oriented personality-inventory (PSKB, Rudolf 1981) 85 phobic patients were examined at the beginning, at the end, and one year after a 6-8 week in-patient psychotherapy. Our results confirmed some of the generally described personality-characteristics in patients with phobia: the phobic symptoms are often accompanied by physical symptoms (sensation of dizziness, weakness sensation, palpitation, sleep disturbance, heavy sweating and breathlessness) and psychic symptoms (anxiousness, depression, restlessness, reduced self-awareness, pedantry, inhibition of aggressive impulses) which could be influenced by psychotherapy. Furthermore we depicted results which have not yet been published in literature. PMID- 1771227 TI - ["You need a new heart". The problem of diagnostic disclosure from the viewpoint of the affected cardiologic patient]. AB - Heart transplantation has become a reasonable therapeutic option in treatment of patients with terminal heart diseases. Though it offers increased quantity as well as improved quality of life, information about needing a donor heart is a turning point in the patient's life. The aim of the study was to evaluate through postoperative interviews how that information was given by the doctors and how the patients had coped with it. It could be shown that 19 of the 49 interviewed patients took the information about needing a new heart as an expected event and chance, while for the remaining 30 it absolutely meant an unexpected information and a shock. Furthermore, only 3 persons reported about having had a helpful and empathic talk to their doctors. 26 about nothing but a short, cool information, and 10 held the shock about the way of information given by the doctors responsible for their bad preoperative psychical condition. Statements of patients are given to elucidate the results, which were discussed from the point of psychosomatics as well as from the communication sciences. At last, summarizing, rules for a helpful pretransplant-information to the patients were given. PMID- 1771228 TI - [Cardiovascular factors of cardiac phobia--a field study]. AB - The interaction between psychological and physiological factors was studied with a field approach in 28 patients with cardiac phobia and 20 healthy controls. A 24 hour ambulatory ECG was recorded, and the subjects were instructed to report their activities and any cardiac perception during this period. Additionally, psychological tests assessing well-being (Bf-S), bodily complaints (B-L), and state and trait anxiety (Stai-S and Stai-T) were administered. The groups did not differ in the mean cardiovascular parameters, however patients with cardiac phobia and healthy controls showed clear differences in the strength and direction of correlations between psychological and physiological variables. The incidence of cardiac perceptions was about the same in both groups, but only patients with cardiac phobia attributed the perceptions to an internal stimulus and associated the perceptions with anxiety. Depending on the anxiety elicited by the cardiac perceptions, the patients with cardiac phobia showed heart rate accelerations, which did not occur in healthy controls. This study confirms a psychosomatic process between psychological and physiological variables, which seems to be able to explain the development and maintenance of cardiac phobia. PMID- 1771229 TI - [Help, I can work again. Analysis of the rehabilitation process into work life of a chronically ill patient after survival of myocardial infarct]. AB - The prime objective of the pension insurances' rehabilitation measures is to successfully reintegrate clients into their working environment. The high number of early retired clients indicates that Germany's health system cannot reach this objective satisfactorily. Empirical studies as to the various causes and factors leading to illness and--as a consequence--to early retirement provided only a few results. The client's personal and psycho-social situation in particular, as well as her/his biographical data and the available scope of action are hardly ever considered appropriately. With this in mind, we set out to reconstruct the rehabilitation process from a client's view using the method of structural hermeneutics. Against the background of biographical development, we describe the origin of illness, rehabilitation results and the opinion of social medicine experts preceding reintegration. The hermeneutic analysis shows that--in spite of the intentions of the persons concerned--an unconscious agreement arises between the client and the therapeutic system manifesting itself in the application of rehabilitation measures reproducing premorbid behaviour. On the basis of the reconstructed client-related situation a critical aspect of the general structure of Germany's health system becomes apparent: the fragmentation of the client into responsibilities of experts giving the opinion and those responsible for treatment. PMID- 1771230 TI - [Problem solving, or: what is my real contribution as a helper?]. AB - A helper's most important task is helping a client find his own solution although it often seems strange how it comes about. In doing this he enters the client's internal and external conversational field and with that into a stochastic process decisive for human life and development. There are however some well defined steps which he can do to reach his goal as the author tries to demonstrate by means of a longer therapy-example. PMID- 1771231 TI - Regulation of methionine biosynthesis in the Enterobacteriaceae. PMID- 1771232 TI - Three-dimensional fluorescence microscopy. PMID- 1771233 TI - Molecular biological databases: the challenge of the genome era. PMID- 1771234 TI - Lectin binding to glycoconjugates of the human gastric fundus. PMID- 1771235 TI - Direct airway injury results in elevated levels of sulfidopeptide leukotrienes, detectable in airway secretions. AB - Sulfidopeptide leukotrienes (LTC4/D4/E4) are suspected to be important lipid mediators in inflammatory responses in the lung. Previous investigations have provided evidence to support enhanced synthesis and secretion of these eicosanoids into bronchoalveolar lavage fluid in patients with Adult Respiratory Distress Syndrome (ARDS). We have prospectively examined the relationship between sulfidopeptide leukotriene levels in tracheal aspirates of 14 intubated and mechanically ventilated patients. When compared with the aspirate from one patient who required ventilation because of respiratory muscle weakness, the tracheal aspirates from eight ARDS patients had elevated leukotriene levels (range 2020-2052 pg/aspirate). However, the aspirates from four of the five patients with direct airway injury [inhalational burn (n = 3) and massive aspiration of gastric contents (n = 2)] contained significantly higher amounts of sulfidopeptide leukotrienes (range 10309-52244 pg/aspirate). Three of the five patients with direct airway injury did not develop ARDS. We conclude that simple aspiration of tracheal secretions can be used to monitor airway leukotriene biosynthesis in patients with lung injury and that elevated airway leukotriene levels may reflect airway epithelial damage, but may not predict the development of ARDS. PMID- 1771236 TI - Physiologic role for enhanced renal thromboxane production in murine lupus nephritis. AB - To investigate the physiologic significance of enhanced renal thromboxane production in murine lupus nephritis, we measured renal hemodynamics and eicosanoid production in MRL-lpr/lpr mice from 8 to 20 weeks of age. Over this age range, MRL-lpr/lpr mice develop an autoimmune disease with nephritis similar to human systemic lupus erythematosus (SLE). In these studies, glomerular filtration rate (GFR) and PAH clearance (CPAH) decreased progressively with age in MRL-lpr/lpr mice, but not in controls. This impairment of renal hemodynamics was associated with increased renal thromboxane production, as well as increased excretion of both thromboxane B2 (TxB2) and 2,3-dinor TxB2 in urine. There was an inverse correlation between renal thromboxane production in MRL-lpr/lpr mice and both GFR and CPAH. Furthermore, there were positive correlations between thromboxane production by the kidney and both the severity of renal histopathology and serum anti-DNA antibody levels measured in individual animals. Enhanced urinary excretion of TxB2 and the development of renal dysfunction also coincided temporally with the appearance of increased levels of interleukin 1 beta (IL-1 beta) mRNA in renal cortex. Acute administration of the specific thromboxane receptor antagonist GR32191 to MRL-lpr/lpr mice restored GFR to normal in early stages of the autoimmune disease. However, in animals with more advanced nephritis, the effect of acute thromboxane receptor blockade on renal hemodynamics was less marked. We conclude that thromboxane A2 is an important mediator of reversible renal hemodynamic impairment in murine lupus, especially in the early phase of disease. PMID- 1771237 TI - Lack of effect of focally administered prostaglandins on electrically kindled seizure activity. AB - Several previous studies have demonstrated increased synthesis of cerebral prostaglandins (PGs) following convulsive activity. In addition, it has been proposed that endogenous prostanoids have anticonvulsive properties and may act to attenuate or limit seizure activity in vivo. In this study we have used focal injections of prostaglandins (PGs) to examine their potential modulatory effects on electrically kindled seizure activity. We report that the intra-amygdaloid administration of PGD2, PGE2 or PGF2a, (1-10 micrograms) showed no significant effects on any of the kindled seizure parameters studied. The highest dose of PGF2a was ineffective at all pretreatment times between 2-30 mins. Our data is inconsistent with the view that PGs exert protective effects against seizure activity, at least within the amygdala against electrically kindled seizures. PMID- 1771238 TI - Distribution of tritium labeled 12(S) hydroxy-eicosatetraenoic acid (12-HETE) in the rat. AB - The in vivo metabolism of 12-(S)-Hydroxy-eicosatetraenoic acid (12-HETE), the end lipoxygenase product of arachidonic acid in platelets, has been investigated in the rat. Fifty microcuries of 5,6-[3H]-12-HETE (50 Ci/mmol) were injected to anesthetized rats and the radioactivity was followed in plasma. At the end of the experiment, various organs of the animal were removed and the radioactivity attached to them was determined. The label of the plasma plateaued to approximately one third of the initial radioactivity ten minutes after the injection. Among the various organs tested (brain, heart, intestine, kidney, liver, lungs, spleen, testis/uterus) the kidney was far the most active to accumulate 12-HETE and/or its labeled metabolites, and no radioactivity could be detected in urine during the course of the experiment. The analysis of lipid extracts from the various tissues revealed that 12-HETE was not accumulating in its unesterified form but was likely bound to phospholipids. We conclude that, although the label providing from the initial 12-HETE did not completely disappear from plasma, circulating 12-HETE cannot be considered as a circulating marker of cell activation. PMID- 1771239 TI - Urinary excretion of diols derived from eicosapentaenoic acid during n-3 fatty acid ingestion by man. AB - Epoxides and fatty acid diols derived from arachidonate by the action of cytochrome P-450 appear in human urine and have biological activities. Dietary eicosapentaenoic acid gives rise to prostaglandins in vivo, but vascular effects of n-3 supplements do not all correlate with altered types or amounts of in vivo cyclooxygenase products. We investigated whether dietary eicosapentaenoic acid could also be metabolized by cytochrome P-450, by assessing the excretion of its vicinal diols. Utilizing gas chromatography/negative chemical ionization mass spectrometry, we have found that humans ingesting n-3 fatty acids excrete vicinal diols of eicosapentaenoic acid in substantial quantities. PMID- 1771240 TI - A chemiluminescent immunoassay for urinary thromboxane B2. AB - Because of the vasoactive properties of thromboxane A2 and other related prostaglandins, much research has been conducted on drugs which alter their levels. Urinary levels of thromboxane B2 and 2,3-dinor thromboxane B2 (major urinary metabolite of thromboxane B2) are used as an indication of thromboxane production in-vivo. In order to accurately measure urinary TXB2 levels of subjects on investigative drugs which lower TXA2 and subsequently TXB2, a simple and sensitive analytical tool becomes necessary. We have thus developed a non radioisotopic (chemiluminescent) assay for urinary TXB2. Sensitivity has been demonstrated to 5 pg/ml. The method correlates well with gas chromatography/mass spectrometry (the accepted reference method) even without column chromatographic purification prior to the conduct of the chemiluminescent assay (r = 0.96). In addition, we have demonstrated feasibility for a chemiluminescent assay to measure urinary 2,3-dinor TXB2. PMID- 1771241 TI - Intravenous prostacyclin (PGI2) infusion to 108 patients with ischaemic peripheral vascular disease: phase II-open study. AB - We recently reported the results of a double-blind trial of PGI2 in 108 patients with ischaemic peripheral vascular disease Stage II according to Fontaine. They were randomly allocated to receive an intravenous infusion of either PGI2 (6 ng/kg/min over 8 hours daily for 5 consecutive days) or placebo and classified as treatment responders or non-responders on the basis of changes in absolute and relative walking times. Patients treated with placebo and those who did not improve in this double blind trial entered an open trial in which they all received infusion of PGI2 (6 ng/kg/min over 8 hours daily for 5 consecutive days). The results of this open trial are reported here. Patients who had been allocated to PGI2 in the blind trial had significantly (p less than 0.01) longer walking times as compared to placebo-treated patients prior to receiving the second (PGI2) infusion. PGI2-infusion caused significant (p less than 0.01) prolongation of walking times in both groups up to the 2nd follow-up month. One month after infusion 52% (23 patients) of the initially placebo-treated patients and 31% (14 patients) of the initially PGI2-treated patients were scored as positive treatment responders (p less than 0.01). PMID- 1771242 TI - Emergent simple discrimination in children: transfer of stimulus control under non-reinforced conditions. AB - Previous research on humans suggests that simple discriminations may emerge if both stimuli, B1 and B2, are compounded with the stimuli of a previously trained discrimination, A1 (S+) and A2 (S-), and responding to the compounds, B1A1 and B2A2, is reinforced. Two questions were addressed. First, do simple discriminations also emerge if (a) only one stimulus, B1, is compounded with a training stimulus, A1 (S+) or A2 (S-); or with both training stimuli, A1 (S+) and A2 (S-); and (b) neither B1 nor B2 is compounded with the training stimuli? Second, do simple discriminations emerge if reinforcement in the presence of the AB compounds is withheld? Normal preschool children served as subjects. The study consisted of six experiments. Transfer occurred in all experiments regardless of whether both test stimuli, one test stimulus, or none of the test stimuli were compounded with the training stimuli under non-reinforced conditions. The results can be described by the following rules: Respond to any stimulus that includes a component of a "correct" stimulus of a previous discrimination. Otherwise, respond away from the stimulus that incorporates a component from an "incorrect" stimulus of a previous discrimination. The implications of data for sensory pre conditioning and language-based accounts are discussed. PMID- 1771243 TI - Perceptual learning in maze discriminations. AB - In Experiment 1, rats were trained on a discrimination between rubber- and sandpaper-covered arms of a maze after one group had been pre-exposed to these intra-maze cues. Pre-exposure facilitated subsequent discrimination learning, unless the discrimination was made easier by adding further discriminative stimuli, when it now significantly retarded learning. In Experiment 2, rats were trained on an extra-maze spatial discrimination, again after one group, but not another, had been pre-exposed to the extra-maze landmarks. Here too, pre-exposure facilitated subsequent discrimination learning, unless the discrimination was made substantially easier by arranging that the two arms between which rats had to choose were always separated by 135 degrees. The results of both experiments can be explained by supposing that perceptual learning depends on the presence of features common to S+ and S-. PMID- 1771244 TI - Maternal discrimination and the development of sex differences in exploratory behaviour in infant spiny mice (Acomys cahirinus). AB - The present paper reports sex differences in exploratory behaviour by infant Spiny Mice, Acomys cahirinus, that may, in part, be related to differences in maternal behaviour towards pups; like some other rodents, mother Acomys differentiate behaviourally between male and female pups. In Experiment 1 infant Acomys were allowed to explore a novel arena. This experiment showed that even by Day 3 (the day of birth = Day 1) female Acomys explored a novel environment more than males; they entered the arena sooner than males and spent more time in contact with a novel object. Experiment 2 showed that infant females were more active than males when observed in the home cage in the presence of their parents and made more approaches to the mother. Mothers, on the other hand, directed more licking behaviour towards males. Experiment 3 focused on the exploratory behaviour of individual pups in the presence of the mother. Given access to a large, complex arena, female pups explored more than males. The results also showed that mothers direct more of their social interactions towards sons than daughters, particularly when pups are about a week old. Some mothers appear to "direct" the movement of their offspring, by blocking their forward movement; this was done more often to male than to female pups. The data suggest that the previously observed changes in exploratory behaviour at this time, and the emergence of sex differences in exploration, may in part depend upon the mothers' reactions to pups by sex. PMID- 1771245 TI - Metastatic pancreas cancer from the thyroid; clinical imaging mimicking non functioning islet cell tumor. AB - A case of pancreatic metastasis from thyroid cancer resected seven years previously is presented. Pancreatic metastases of thyroid cancer are rare. The radiological features of the tumor are described and the diagnostic implications of pancreatic metastases are discussed. PMID- 1771246 TI - A huge gastric leiomyosarcoma diagnosed preoperatively through diagnostic imaging. AB - The authors were able to diagnose a huge gastric leiomyosarcoma prior to surgery using various diagnostic imaging techniques. The patient was a 68-year-old woman who presented with a large gas-filled mass the size of a child's head in the center of her abdomen. Based on characteristic findings from a gastric barium study, CT, MRI, and angiography, the patient was diagnosed as having a gastric leiomyosarcoma displaying extramural growth. Upon operation an extramural tumor (20 x 19 x 12 cm) originating from the gastric antrum was confirmed. PMID- 1771247 TI - Ultrasonographic evaluation of pancreatic cancers: size, contour, echo texture, and ductal configuration. AB - To improve the detection rate of small pancreatic tumors, it is important to know the characteristic differences in echographic patterns that distinguish small tumors from larger ones. We have studied the echographic patterns of histologically confirmed pancreatic cancers, with special reference to tumor size. The tumor size in 243 cases of adenocarcinoma determined by measurement of the pathological specimen correlated with that determined by ultrasonography. The ultrasonographic pancreatic configurations, tumor echo patterns, and pancreatic duct size and configurations were reviewed in accordance with the size of the tumor. Many pancreatic cancers showed localized swelling of the pancreas, however, more than half of all T1 cases had normal pancreatic contour, suggesting that we cannot rely on abnormal findings in configuration for the early diagnosis of pancreatic cancer. The very low echo pattern of tumor was seen only in T1 tumors. In cases in which the tumors were not detected by ultrasonography, the detection of a dilated pancreatic duct and common bile duct were very important clues to diagnosing a small tumor in the pancreas. PMID- 1771248 TI - Osteosarcoma following radiotherapy: a case report. AB - The case of a patient with postirradiation osteosarcoma is presented. The 20-year old female was diagnosed as having osteosarcoma by histological examination of an open biopsy specimen. She underwent surgery for pure dysgerminoma and received adjuvant postoperative radiotherapy, 40 Gy to the pelvis and 30 Gy to the para aortic region, 11 years ago. This case satisfied the criteria for radiation induced osteosarcoma proposed by Cahan et al. Radiation-induced osteosarcoma is rare, but the possibility of that must be borne in mind. PMID- 1771249 TI - Leiomyosarcoma after retinoblastoma radiotherapy. AB - The CT and MR appearance of leiomyosarcoma in the left orbit in a 15-year-old girl is presented. This tumor developed after successful radiation therapy for bilateral retinoblastoma. PMID- 1771250 TI - Single photon emission computed tomography in children with idiopathic seizures. AB - Single photon emission computed tomography (SPECT) with N-isopropyl-p[123I] iodoamphetamine (IMP), X-ray computed tomography (X-CT), and magnetic resonance imaging (MRI) were performed in 20 children with idiopathic seizures. In children with idiopathic seizures, SPECT could detect the abnormal sites at the highest rate (45%) compared with CT (10%) and MRI (12%), but the abnormal sites on SPECT correlated poorly with the foci on electroencephalograph (EEG). Idiopathic epilepsy with hypoperfusion on SPECT was refractory to treatment and was frequently associated with mental and/or developmental retardation. Perfusion defects on SPECT scans probably affect the development and maturation of the brain in children. PMID- 1771251 TI - SPECT evaluation of simulated white matter lesions: experimental study using a brain phantom. AB - An experimental study using a brain phantom was performed to evaluate the detectability of simulated white matter lesions on two types of single photon emission computed tomography (SPECT) systems. A ring-type SPECT system with high spatial resolution was able to demonstrate these lesions in the white matter, while a widely used general-purpose single-head rotating gamma camera failed to show them. The detectability of white matter lesions was decreased by photons scattered from the highly radioactive gray matter and the poor spatial resolution of the SPECT system. In order to improve the detectability of white matter lesions it is important to apply scatter correction and improve the spatial resolution of the SPECT system. Brain phantom studies made it easier to interpret white matter lesions that were difficult to interpret on the basis of clinical images alone, and the knowledge acquired from the brain phantom study will contribute to the interpretation of clinical images. PMID- 1771252 TI - Minor changes in regional cerebral blood flow revealed by the early distribution of I-123 IMP in brain. AB - To evaluate the early distribution of I-123 IMP in the brain, 10 dynamic images were obtained in the first 10 minutes after injection using a ring-type SPECT system with a high-sensitivity collimator. In cases of chronic carotid occlusion without brain CT abnormalities, areas of low perfusion were more clearly demonstrated in dynamic images than in static images obtained beginning 20 minutes after injection and continuing for 15 minutes using a high-resolution collimator. In cases of hyperperfusion following infarct or surgery, there was a difference between dynamic and static images in the visualization of hyperemic lesions. The distribution of I-123 IMP in the brain changes gradually, even in the early period after injection, and evaluation of early accumulation is useful for the detection of minor changes in regional cerebral blood flow. PMID- 1771253 TI - The European core curriculum on radiotherapy. PMID- 1771254 TI - Rapid repopulation in radiotherapy: a debate on mechanism. The phantom of tumor treatment--continually rapid proliferation unmasked. PMID- 1771255 TI - Rapid repopulation in radiotherapy: a debate on mechanism. Accelerated repopulation in tumours and normal tissues. AB - Accelerated repopulation is a well established response pattern of normal epithelial to fractionated irradiation. It is delayed until the tissue recognises functional injury. It is well regulated to maintain a steady state and continues until integrity of the tissue is restored. We assume that some of these features of the parental normal tissue are preserved and still operate in squamous cell carcinoma, although probably in a less well controlled and organised manner. PMID- 1771256 TI - Clinical evidence for tumor clonogen regeneration: interpretations of the data. AB - A therapeutic gain is expected from accelerated fractionation in radiotherapy because of reduced times for proliferation of tumor clonogens and the likelihood that the late effects of radiation are unaffected by changes in overall time. While there can be no dispute over the existence of the phenomenon, there are questions about the ways clinical data have been interpreted to adduce the influence of proliferation. Moreover, recent clinical and experimental evidence throw some doubt on the assumption that late effects are independent of overall treatment time. It is concluded that some of the issues remain in doubt, and that rather large-sized phase-III trials may be required to show any benefit from reductions in the overall time, especially if this is accompanied by substantial reductions in the total dose. PMID- 1771257 TI - Time-dose factors in positive neck nodes treated with irradiation only. AB - This article describes an analysis of time-dose and clinical factors which affect the 2 year rate of control of cervical node metastases from squamous cell carcinoma of the head and neck following external beam radiotherapy in a series of 140 patients. We find that node diameter and normalized total dose are the most important factors, and that overall treatment time is not statistically significant. PMID- 1771258 TI - Radical surgery and postoperative split-course radiotherapy in squamous cell carcinoma of the mobile tongue: factors influencing local control and the time to recurrence. AB - During 1981-1988 63 patients with squamous cell carcinoma of the oral tongue (27 females and 36 males) were treated with radical surgery and postoperative split course radiotherapy. The 3-week rest period was compensated with a 10% increase in the total radiation dose to 66 Gy. The local control rate was 76% in stage I, 71% in stage II, 45% in stage III and 0% in stage IV. Failures were observed in 25 (40%) patients, and 8 patients died of intercurrent diseases. For further analysis the material was stratified in three groups according to the time interval between surgery and postoperative radiotherapy: less than 6 weeks, 6-8 weeks and greater than 8 weeks. The local control rate in the three strata were 75, 57 and 44%, and the 5-year actuarial survival 61, 46 and 30%, respectively. In the logistic regression analysis and the proportional hazard's regression analysis the histologic grade of the primary tumour and the time interval between surgery and the start of radiotherapy were the most important factors influencing respectively local control and time to recurrence. However, it appeared that the lengthening of the time interval was often caused by factors or events which directly can influence the prognosis, such as surgical complications, infections and poor general condition. When cases with such special causes for lengthening of the interval were excluded, the effect of the time interval nearly completely disappeared. It would seem that a final evaluation of the effect of the time interval requires a prospective randomized trial. The same may well hold true for reliable evaluation of the influence of overall treatment time. PMID- 1771259 TI - Application of the LQ model to the interpretation of absorbed dose distribution in the daily practice of radiotherapy. AB - In 1991, the vast majority of radiotherapy centers are implemented with computer treatment planning systems (TPS), and it has become routine practice to compute full absorbed dose distribution (ADD) in almost all treatment situations. Usually the target is covered by the 100% isodose and the surrounding normal tissues receive a lesser dose than the tumor. It implies, that, as the dose per fraction of, say, 2 Gy is prescribed at the 100%, normal tissues receive a daily dose different than 2 Gy. The absorbed doses delivered at different organs have therefore not the same biological effectiveness and must be corrected according to the actual dose per fraction for a proper interpretation of the treatment planning. This is of great importance since most of the "tolerance levels" used in the practice have been determined for doses per fraction around 1.8-2 Gy. The linear-quadratic (LQ) model provides a simple method for establishing biological equivalencies and has been used throughout this article to establish the difference between the absorbed dose computed by the TPS and its biological equivalent. It is shown that normal tissues receiving less than 100% of the daily dose are relatively more protected than suggested by the ADD, and, inversely, that normal structures overdosed and thus receiving more than the 100% daily dose are relatively more at risk for complications than suggested from the ADD. PMID- 1771260 TI - Suprahyoid Hodgkin's disease stage IA. AB - From 1973 to 1987, 71 patients (age greater than or equal to 16 years) with stage IA supradiaphragmatic Hodgkin's disease were treated with radiotherapy alone. 23 patients (20, clinical stage; 3, pathological stage) had disease localised to the suprahyoid region of the neck (upper deep cervical, 11; submandibular, 6; submandibular and upper deep cervical, 5; submental, 1). The age range was 17 to 64 (median 33). The male to female ratio was 2.8:1. The histological types were: lymphocyte predominant, 11; nodular sclerosis grade I, 8; mixed cellularity, 4. The 5 and 10 year cause-specific survival was 100% with a disease-free survival of 90% at 5 and 10 years. The proportion of patients with suprahyoid Hodgkin's disease IA was constant over the 15-year period. This only became apparent when the histology of patients with suprahyoid non-Hodgkin's lymphoma stage IA was reviewed. PMID- 1771261 TI - Is the dose-response relationship for local control of Hodgkin's disease obscured by lung inhomogeneity corrections? AB - Absence of a dose-response relationship has been reported for local control of Hodgkin's disease between 30 and 42 Gy delivered to the mantle field in definitive irradiation. These dose ranges were determined at the central ray using irregular field (IF) calculations without benefit of dosimetric correction for lung inhomogeneity. Detailed analysis was performed of dose delivered to hilar and mediastinal regions with mantle field irradiation incorporating lung inhomogeneity corrections for the indicated dose ranges using 60Co and 6 MV linear accelerator. Inclusion of lung inhomogeneity (LI) corrections revealed dose heterogeneity within the treatment volume, delivering higher total doses to hilar and lateral mediastinal regions. For a prescribed dose of 40 Gy to midline with 6 MV photons, the hila and mediastinum would receive 45 Gy with IF and LI corrections. Similar increases are observed with 60Co. Mantle field calculations should be performed with CT planning including lung inhomogeneity corrections to account for anatomic irregularity of the mediastinal contour and interposed lung. As lung inhomogeneity dosimetric data become available, conclusions drawn from clinical experience should be re-evaluated based upon location and extent of mediastinal disease involvement. Implications for treatment associated late toxicity using dose-volume histogram analysis should be considered. PMID- 1771262 TI - Inherent radiosensitivity testing of tumor biopsies obtained from patients with carcinoma of the cervix or endometrium. AB - The inherent radiosensitivity of tumor biopsies obtained from a series of patients with carcinoma of the uterine cervix or endometrium has been characterized. Early passage cell lines were irradiated and assayed for cell survival using a clonogenic assay system. Survival curves were generated using the alpha/beta model and the surviving fraction at 2 Gy (SF2) was estimated. A wide range of SF2 values was observed among histologically similar tumors. The mean (+/- SD) SF2 value was 0.29 +/- 0.12 (range = 0.11-0.59) for the cervical biopsies and 0.30 +/- 0.13 (range = 0.11-0.67) for the endometrial biopsies. No correlation between inherent radiosensitivity and tumor DNA index or histopathology was observed. Patient accrual continues with the expectation that these results may help to determine whether SF2 values are of clinical value in predicting the response of individual patients to treatment with radiotherapy. PMID- 1771263 TI - Malignant pineal teratomas: a report on three patients and the case for craniospinal irradiation following chemotherapy. AB - Malignant pineal teratomas carry a poor prognosis. We describe a long-term survivor after chemotherapy and craniospinal irradiation, and another who achieved only transient disease control with chemotherapy and cranial irradiation. Spinal cord spread occurred in first patient and long-term survivors have been reported following surgery and craniospinal irradiation alone, suggesting a role for craniospinal irradiation following chemotherapy. PMID- 1771264 TI - The carrot and the stick: regulation versus education and motivation. PMID- 1771265 TI - Major issues raised by the OMB report from the perspective of the regulatory agencies. PMID- 1771266 TI - Quantitative assessment of a human carcinogenic potency for propylene oxide. AB - The potential for causing carcinogenic and mutagenic effects is the main concern when assessing the risks associated with low-level exposures of humans to the industrially important epoxide, propylene oxide (PO). The available basic information used in estimation of carcinogenic risk has been reviewed. It is concluded that the published data from gavage studies in rodents are less appropriate and that observed cancer incidences from long-term inhalation should preferably be utilized for quantitative risk assessment. Furthermore, PO and ethylene oxide (EO) are directly acting alkylating agents which exhibit several similarities. Although data are less comprehensive for PO than for EO, PO appears to yield a rather uniform alkylation pattern in various tissues. Also, similarly to EO, PO is probably detoxified at a rate which does not vary widely in various mammalian species, including man. For these reasons, the surface-based extrapolation model for estimation of the human equivalent dose may not be appropriate, and the previously derived carcinogenic potency factors should be revised downward. Alternative risk estimates are provided. From the most relevant available studies, we propose a carcinogenic potency factor of 0.001 (mg/kg/day) 1 for PO in humans by inhalation. PMID- 1771267 TI - Screening radon risks: a methodology for policymakers. AB - This paper provides an easy-to-use screening methodology to estimate potential excess lifetime lung cancer risk resulting from indoor radon exposure. The methodology was developed under U.S. EPA Office of Policy, Planning, and Evaluation sponsorship of the agency's Integrated Environmental Management Projects (IEMP) and State/Regional Comparative Risk Projects. These projects help policymakers understand and use scientific data to develop environmental problem solving strategies. This research presents the risk assessment methodology, discusses its basis, and identifies appropriate applications. The paper also identifies assumptions built into the methodology and qualitatively addresses methodological uncertainties, the direction in which these uncertainties could bias analyses, and their relative importance. The methodology draws from several sources, including risk assessment formulations developed by the U.S. EPA's Office of Radiation Programs, the EPA's Integrated Environmental Management Project (Denver), the International Commission on Radiological Protection, and the National Institute for Occupational Safety and Health. When constructed as a spreadsheet program, the methodology easily facilitates analyses and sensitivity studies (the paper includes several sensitivity study options). The methodology will be most helpful to those who need to make decisions concerning radon testing, public education, and exposure prevention and mitigation programs. PMID- 1771268 TI - Dietary exposure to furocoumarins. AB - Natural furocoumarins, some of which are carcinogenic, are widespread components of the diet which are frequently consumed. Because of the paucity of samples, the wide scatter of analytical values, and other limitations in the data, only broad conclusions can be drawn. Most of the exposure is from limes, with smaller amounts coming from other citrus and umbelliferous food plants. The per capita exposure is estimated to be 1.3 mg per day. Exposure can be reduced through controlling stress in growing plants and stored food products. Because furocoumarins are one class of a large group of chemicals in a defensive system essential to plant survival, their total eradication is not possible. Further research is needed to assess their health risk. PMID- 1771269 TI - Utilization of quantitative structure-activity relationships (QSARs) in risk assessment: alkylphenols. AB - Alkylphenols are a class of environmentally pervasive compounds, found both in natural (e.g., crude oils) and in anthropogenic (e.g., wood tar, coal gasification waste) materials. Despite the frequent environmental occurrence of these chemicals, there is a limited toxicity database on alkylphenols. We have therefore developed a "toxicity equivalence approach" for alkylphenols which is based on their ability to inhibit, in a specific manner, the enzyme cyclooxygenase. Enzyme-inhibiting ability for individual alkylphenols can be estimated based on the quantitative structure-activity relationship developed by Dewhirst (1980) and is a function of the free hydroxyl group, electron-donating ring substituents, and hydrophobic aromatic ring substituents. We evaluated the toxicological significance of cyclooxygenase inhibition by comparison of the inhibitory capacity of alkylphenols with the inhibitory capacity of acetylsalicylic acid, or aspirin, a compound whose low-level effects are due to cyclooxygenase inhibition. Since nearly complete absorption for alkylphenols and aspirin is predicted, based on estimates of hydrophobicity and fraction of charged molecules at gastrointestinal pHs, risks from alkylphenols can be expressed directly in terms of "milligram aspirin equivalence," without correction for absorption differences. We recommend this method for assessing risks of mixtures of alkylphenols, especially for those compounds with no chronic toxicity data. PMID- 1771270 TI - Decision model for biomarkers of exposure. AB - The quantitation of exposure is one of the most critical elements of the risk assessment process. Contemporary risk assessment models rely on monitoring the target chemical in various environmental media and incorporate a variety of assumptions to estimate this. Recently, biomarkers have been advanced to improve estimates of the delivered dose of a given chemical or mixture of chemicals. A biomarker of exposure may be defined as an indicator of exposure to an environmental pollutant within the exposed organism, which becomes manifest before any adverse effects are evident. Measurement of such a biomarker within a biological system may potentially be used to identify and quantitate directly exposure to hazardous substances. This paper describes a decision model for the selection, evaluation, and validation of a biomarker of exposure. PMID- 1771271 TI - Trihalomethanes and maximum contaminant levels: the significance of inhalation and dermal exposures to chloroform in household water. AB - Our review of the literature on the importance of inhalation and dermal exposures to volatile organic compounds in household water relative to ingestion exposures sought to answer two questions. First, how well do the inhalation and dermal doses predicted by simple models, complex simulations, and measurements agree with one another? And second, what are the implications for the cancer risk from chloroform in household water? The literature yields a coherent and credible range of dose estimates: the ratio of lifetime inhalation dose to lifetime ingestion dose is probably in the range of approximately 0.6 to approximately 1.5, but may be as high as approximately 5.7; and the ratio of lifetime dermal dose to lifetime ingestion dose is probably about approximately 0.3, but may be as high as approximately 1.8. However, because the U.S. Environmental Protection Agency's (EPA's) Cancer Potency Factor (CPF) for inhalation of chloroform is much higher than the CPF for ingestion, the ratios of incremental lifetime cancer risk from inhalation of chloroform to risk from ingestion are much larger than the corresponding ratios for dose. The incremental lifetime cancer risk from chloroform by all three pathways is probably approximately 9 to approximately 21 times the ingestion risk and may be as much as approximately 79 times the ingestion risk. As the EPA reviews the drinking water standard for total trihalomethanes, it is essential that the Agency take account of all exposure pathways in estimating cancer risk. PMID- 1771272 TI - Pyridine derivatives: structure-activity relationships causing parkinsonism-like symptoms. AB - In recent years, sufficient evidence has surfaced to implicate low-molecular weight organic compounds in certain known neurological disorders. At this time, 1 methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) is considered the compound capable of inducing conditions most similar to idiopathic parkinsonism in clinical, biochemical, and histopathological characteristics. Substances containing MPTP-like fragments are used as herbicides, drugs and intermediates in the synthesis of many heterocyclic compounds. The mechanistic study of toxic MPTP action has enabled development of criteria for appraising potential parkinsonogenic properties of similar chemical structures. Key features of MPTP action include the following: 1. Ability to pass through the blood-brain barrier (BBB). 2. Enzymatic biotransformation to the neuroactive form (pyridine metabolites). 3. Transfer to neurons via a neuromediator reuptake system. 4. Action on intracellular targets. This review discusses data concerning the effects of metabolite structure on the major steps in the neurotropic action mechanism of MPTP-like compounds. Special attention is focused on the key steps defining the selectivity of MPTP's neuronal action, i.e., the activation step caused by monoamine oxidase (MAO) and interaction with the dopamine (DA) reuptake system. Most structural MPTP analogs (including certain pesticide preparations) used in our experiments and described in the literature exhibit no degenerative MPTP-like properties. This is probably related to the fact that each consecutive stage in the MPTP neurotoxicity mechanism makes rather stringent demands on metabolite structure. The number of structures which concurrently meet the requirements of all the processes is finite. This, however, does not invalidate the hypotheses concerning the ecotoxic nature of idiopathic parkinsonism. Possible ecotoxins may have only a partial, presymptomatic effect which, however, promotes age-related neurodegenerative processes and accelerates development of parkinsonism. This concept necessitates designing special tests of the possible neurotoxic properties of compounds found in the environment which may be functional MPTP analogs. PMID- 1771273 TI - Degradation of xenobiotics by white rot fungi. AB - White rot fungi such as P. chrysosporium degrade the nonrepeating, nonstereoselective, insoluble polymer lignin under conditions of nutrient limitation. The attack on lignin principally involves extracellular peroxidases (ligninases) and hydrogen peroxide. Hydroxyl radicals may also make a significant contribution. The ligninolytic system lends itself to the degradation of xenobiotics, since these often have limited solubility in water and are not readily available in soil to intracellular metabolism. A nonspecific attack should proceed at a rate independent of the target's concentration and the fungal system would be expected to remediate soil contaminated with a mixture of compounds. This contrasts with the need for induction and problems with simultaneous metabolism encountered with bacterial inoculation. The P. chrysosporium system has been found active against such diverse substrates as DDT, lindane, PCBs, TNT and crystal violet, with substantial mineralization in many cases. Some like biphenyl and triphenylmethane dyes are structurally related to lignin substructures while others bear groups such as nitro (TNT) or halogen (PCP) that are absent from the natural polymer. The fate of transformed targets varies: pentachlorophenol is incorporated into soil organic matter as a result of fungal ligninase action, whereas highly lipophilic Aroclor PCBs are converted to water-soluble metabolites. Normally less toxic intermediates are generated: for example, with benzo[a]pyrene, mutagenic arene oxides do not appear in the white rot fungal system. In certain cases, purified ligninases were also active in degrading pollutants such as PCP, benzo[a]pyrene or triphenylmethane dyes. Methods of optimizing ligninase activity in fungal reactors have been described, such as the addition of surfactants and veratryl alcohol to the medium. It remains to be seen how molecular biology can provide further advances in maximizing the bioremediating activity of white rot fungi applied to contaminated soil. PMID- 1771274 TI - Freshwater molluscs as indicators of bioavailability and toxicity of metals in surface-water systems. AB - Freshwater molluscs--snails and bivalves--have been used frequently as bioindicator organisms. With increasing needs for research on contaminant effects in freshwater ecosystems, this kind of biomonitoring is likely to develop further in the future. Molluscs can be used effectively for studies of both organic and inorganic contaminants; this review focuses on studies involving bioaccumulation and toxicity of metals. Two important advantages of snails and bivalves over most other freshwater organisms for biomonitoring research are their large size and limited mobility. In addition, they are abundant in many types of freshwater environments and are relatively easy to collect and identify. At metal concentrations that are within ranges common to natural waters, they are generally effective bioaccumulators of metals. Biomonitoring studies with freshwater molluscs have covered a wide diversity of species, metals, and environments. The principal generalization that can be drawn from this research is that bioaccumulation and toxicity are extremely situation dependent; hence, it is difficult to extrapolate results from any particular study to other situations where the biological species or environmental conditions are different. Even within one species, individual characteristics such as size, life stage, sex, and genotype can have significant effects on responses to contaminants. The bioavailability of the metal is highly variable and depends on pH, presence of organic ligands, water hardness, and numerous other controlling factors. Despite this variability, past studies provide some general principles that can facilitate planning of research with freshwater snails and bivalves as metal bioindicators. These principles may also be useful in understanding and managing freshwater ecosystems. Bioaccumulation of metals in biota is a function of both uptake and depuration. Uptake in molluscs may be through either of two vectors- ingestion of food and other metal-containing substances or through direct adsorption of dissolved constituents. Under some conditions, the bioconcentration factors can be in the range of 10(3) to 10(6), relative to water. Most studies that provide comparisons among taxonomic groups indicate that bioaccumulation in molluscs is greater than that is fish. However, such comparisons should be interpreted with caution because metals tend to be nonuniformly distributed among different organs in both molluscs and fish. Bioaccumulation and acute and chronic toxicity are highly dependent on metal speciation. Mainly because of this influence of metal speciation, toxicity and bioaccumulation do not have a consistent relation to each other. Sensitivity to toxic effects of a metal is likely to be considerably greater in juvenile or larval stages than in adults. PMID- 1771275 TI - Pesticide personal protective clothing. AB - A fairly large established data base provides information on clothing worn by U.S. and Canadian farmers to work with pesticides, their attitudes and beliefs about pesticide risk, and clothing as a dermal barrier. Very limited similar data are available for farmers in less developed countries. Clearly, farmers perceive the benefits of pesticides to far exceed any risks. While few report poisoning symptoms, most believe that their usual work clothing offers a sufficient pesticide barrier, and few wear special-purpose protective clothing. Gloves of various materials, including cotton and leather, appear to be the major protective clothing item. Although farmers feel that their usual work clothing provides excellent protection, fabric penetration research does not support this. Shirting-weight fabrics offer some limited protection against light spray of field-strenght pesticides. Heavier-weight fabrics, such as denim and twill, are better barriers. With a heavier spray or a spill, usual work clothing does not give sufficient protection. Greater protection can usually be achieved with the use of a fluorocarbon finished fabric, such as Scotchgard or Zepel. Scotchgard can readily be applied at home. A durable-press finish does not appear to improve fabric's pesticide-barrier resistance and some data suggest that it may decrease barrier properties. A second alternative for increased protection is the use of a special-purpose fabric, such as a coated nonwoven or possibly Gore-Tex. Numerous other new "waterproof breathable" fabrics have recently come to the market. Many of these are finished or coated fabrics and one would expect them to be at least somewhat resistant to pesticides. However, they have not been tested. Wearing an additional layer also appears to be another clothing strategy to minimize exposure. Fabric penetration research also shows that pesticide formulation, volume or spray regime, concentration, and active ingredients influence the barrier properties of fabrics. Clothing evaluation studies have shown that protective clothing and coveralls of various materials and designs were effective in reducing exposure. Results of some of these studies suggested that the farmer's typical work clothing was more effective than fabric penetration results suggested. This apparent conflict is not surprising, given the methods used in both types of research. The field studies use pads placed in various areas under the clothing. This method assumes that exposure is uniform over entire body regions. But fluorescent tracer research has shown that this is not a valid assumption (DeJonge et al. 1985; Fenske 1988). Also, the way in which the pads are attached may make a difference, although no research has examined this issue.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1771276 TI - Alcohol, cognitive function and psychomotor performance. PMID- 1771277 TI - Coffee, cardiovascular and behavioral effects current research trends. AB - This review attempts to summarize cardiovascular and behavioral research on coffee over the last five years. Interest in these areas has increased relative to earlier periods, and new aspects have been considered. Acute cardiovascular effects induced by giving average total daily doses as a single dose to non-users or abstaining users have been compared between normotensives and hypertensives, between habitual users and non-users, and with and without additional mental stress. Implications for daily use were studied semichronically. Great interest has also been devoted to the putative atherogenic effects and to epidemiological associations with cardiovascular disease. Behavioral research has continued, in part, the tradition of assessing effects on performance and mood in random samples, in users and non-users, and in different personality types. Objective measures of sleepiness were increasingly used to assess the maintenance of wakefulness and the antagonism of physiologically or pharmacologically induced sleepiness. A recent topic involves the search for reasons underlying and maintaining the coffee drinking habit. PMID- 1771278 TI - A psychopharmacological and psychophysiological evaluation of smoking motives. AB - Compared to alcohol or opiate dependence, the physical withdrawal symptoms which occur with the cessation of the tobacco smoking habit are relatively weak, although they can produce discomfort. Long-term abstinence rates, however, remain similarly low. This raises the question about the nature of the strength of this habit. When evaluating the complex mechanisms of cigarette smoking behavior and its determinants, a surprisingly large variety of pharmacological and nonpharmacological motives emerges. These appear to outweigh the health-related arguments for abstinence in the majority of smokers. An attempt has been made to categorize classes of motives according to their positive or negative reinforcing impacts on the habit. The acute tobacco withdrawal syndrome, problems with weight gain after cessation and the phenomenon of craving are classified as primarily negative reinforcers. Effects of smoking on cognitive functions and on "pleasure" are seen as primarily positive reinforcers. In conjunction with stress, the tranquillizing effects of smoking seem to have negative reinforcing properties in situations involving passive coping and anxiety, whereas smoking may have positive reinforcing effects in situations involving active coping. It is suggested that the memory of these reinforcing effects of smoking can contribute to the phenomenon of craving. Although substantially reduced after discontinuation of the smoking habit, craving may exacerbate and contribute significantly to late relapse. PMID- 1771279 TI - [Clinical consequences of the auto-PEEP phenomenon]. PMID- 1771280 TI - [Induction and maintenance of anesthesia with propofol and with thiopental isoflurane. Comparative study]. AB - Thirty one patients of both sexes, ASA I-II, aged 18-65 years have undergone a randomized trial in order to compare two anesthetic techniques. Patients in group I (n = 15) received a 2.5 mg/kg induction dose of propofol followed by a continuous infusion of the same drug at 3.6-9 mg/kg/h. Patients in group II (n = 16) were induced with 4 mg/kg thiopentone and maintained with 0.5-1.5% isoflurane. Both groups were evaluated for time and quality of induction, collateral effects, quality and hemodynamic stability during maintenance and time and quality of recovery. Induction time for patients in group I (49.6 +/- 15 seg) was significantly longer than for group II patients (23 +/- 3 seg) (p less than 0.01). Respiratory depression (apnea period longer than 20 seconds) was also commoner and longer in group I (p less than 0.01) although no problems were observed with manual ventilation. One patient in group I required an extra dose for induction. Both groups had similar hemodynamic changes along the procedure. Awakening time for patients in group I (24.2 +/- 7.3 min) was significantly longer than for patients in group II (14.3 +/- 4.4 min) (p less than 0.001). Although surgery times were longer in group I, a possible cumulative effect of propofol for infusions over 90 min cannot be discarded. PMID- 1771281 TI - [Comparative study between propofol and thiopental for anesthesia induction in surgery of short duration]. AB - To compare anesthetic characteristics of thiopental and propofol in short duration surgical interventions, we have studied 40 patients undergoing gynecologic and proctologic surgery. Patients were randomly assigned to two groups receiving 2.5 mg/kg of propofol or 5 mg/kg of thiopental. In both groups, arterial hypotension of comparable intensity occurred. Heart rate was significantly higher in thiopental anesthesia. Postanesthesia recovery was significantly more rapid with propofol. Some of these results can be influenced by the different immediate premedication (atropine and diazepam in thiopental group) and duration of anesthesia. PMID- 1771282 TI - [Application of continuous positive pressure to the uppermost lung in patients ventilated through a single lung]. AB - We have studied the oxygenation process in a series of 20 patients who underwent thoracic surgery and were ventilated through a single lung. There were 19 men and one woman with a mean age (+/- SD) of 63 +/- 10.5 years, a mean height of 166 +/- 37.9 cm and a mean weight of 67 +/- 14.1 kg. Premedication and anesthesia were comparable among all patients. Endotracheal intubation was performed with a double lumen Robersthaw cannula. After anesthetic induction the radial and pulmonary arteries were catheterized to obtain samples for gasometric investigation in arterial and venous mixed blood before and after exclusion of one lung with continuous positive pressure (CPAP). Gasometric analysis was also performed during the immediate postoperative period. All patients were ventilated with 100% oxygen concentration 20 min before blood sampling in order to remove the alveolar nitrogen. During single lung ventilation and during application of CPAP (5 cm H20) to the upright sided lung we observed a 50% increase in arterial p02 (Pa02) (p less than 0.001) without any change in mean alveolar p02 (PA02). There was also a 17% decrease in alveolo-arterial oxygen difference (D[A-a]02) (p less than 0.001) and a 16.6% reduction in the intrapulmonary shunt (Qs/Qt) (p less than 0.001). Improvement of oxygenation was attributed to a beneficial effect of CPAP applied to the upright sided lung while intermittent positive pressure was maintained in the recumbent lung. PMID- 1771283 TI - [Antalgic activity of adrenal medulla transplantation into the lumbar subarachnoid space. Experimental study]. AB - The possible antalgic effect of autografting the medulla adrenal into the subarachnoid lumbar space has been assessed in an experimental model in rats. There were three experimental groups: normal, sham operated, and transplanted. The electrical stimulation of the tail was used as a test for measuring the analgesic effect. The test was performed two days before the surgery and is was repeated 3, 7, 14, 21, and 28 days thereafter. Beta-endorphin levels in the spinal fluid were measured 30 days after surgery using radioimmunoassay techniques. Graft survival was assessed by pathologic examination. The results show that even though the grafts survived, there were only transient changes in pain threshold and the levels of beta-endorphin in the spinal fluid did not change significantly. PMID- 1771285 TI - [Thermal effects of epidural anesthetic block]. AB - In a sample of 20 healthy men (ASA I) we studied the thermal effects induced after epidural anesthetic blockade with bupivacaine (0.625%) and their relationship with the level of sensitive blockade to puncture or to cold. After 30 min of epidural injection of bupivacaine the level of cephalic analgesia was D IX (D IX +/- 2 segments) and that of cold discrimination D VII (D VII +/- 2 segments) being the thermo-algesic differential blockade of 2 to 3 segments. During epidural anesthesia there was a significant increase in foot skin temperature (4.1 +/- 1 centigrade degrees, p less than 0.001) without any appreciable skin temperature change at the thorax, abdomen, thigh, and calves. It is concluded that epidural anesthesia with bupivacaine (0.625%) at a sensitive analgesic level D IX produces significant increases in skin temperature only at the foot. This indicates that the extension level of sympathetic blockade is lower that of the analgesia. PMID- 1771284 TI - [Effect of an intravenous nitroglycerin bolus on the hemodynamic impact of laryngoscopy and intubation]. AB - The aim of this study was to evaluate the effectiveness of intravenous administration of a single dose of nitroglycerin in lessening the hemodynamic effects induced during laryngoscopy and tracheal intubation. In an initial subset of 8 patients we verified that the hemodynamic changes after an intravenous dose of 2, 5, or 10 micrograms/kg of nitroglycerin were comparable. The study included 30 patients with a good clinical condition who were anesthetized with fentanyl, thiopental sodium and succinylcholine. They were allocated into two groups of 15 patients according to the intravenous administration or not of 2 micrograms/kg of nitroglycerin after induction of anesthesia. Increase in systolic blood pressure (SBP) and double product (SBP x heart rate) during laryngoscopy and 15, 30, and 45 seconds thereafter was significantly lower in nitroglycerin treated patients than in controls. Increase in diastolic blood pressure was also lower in nitroglycerin treated patients but this difference was only present during laryngoscopy. There were no significant heart rate differences among the two groups of patients. It is concluded that a single intravenous dose of 2 micrograms/kg of nitroglycerin was able to lessen the increase in blood pressure induced by laryngoscopy and tracheal intubation without deleterious effects. PMID- 1771286 TI - [Monitoring of mechanical ventilation during IPPV: implications due to the intrapulmonary entrapment of gas. Study on a physical model of the lung]. AB - This work was undertaken to determine the possible influence of gas trapping on the values of total respiratory system compliance and on the air flow resistance at the air ways obtained by conventional effects of positive telespiratory alveolar pressure (auto-PEEP) typical of gas trapping on ventilatory dynamics. This study has been carried out in a physical model of the lung. The results support the contention that in the above situation: 1) the total compliance of the respiratory system measured as the quotient between the current volume and the plateau pressure (C.DIN) shows lower values than those of the static compliance (C.EST), and 2) flow resistance at the air ways must be measured as the quotient between the time constant and the plateau pressure. It should not be measured as the quotient between the time constant and the static compliance since in that case the values would be lower than the real ones. PMID- 1771287 TI - [Nitrous oxide in dental anesthesia: facts about its introduction in Spain]. AB - After a free period of twenty years the interest for using nitrous oxide in suppressing pain related to dental surgery has increased since the end of the sixties of the last century. In this work we present the result of our investigations on the person who must be considered the introducer of this technique in Spain: Jose Meifren Alfares, odontologist at Barcelona. PMID- 1771288 TI - [Intrinsic PEEP as a ventilation complication after pneumonectomy]. AB - We report the case of a female patient who developed a clinical picture characterized by hemodynamic deterioration, bradycardia and asystole due to pulmonary hyperinsufflation (documented by X-ray examination) during the immediate postoperative phase of a right pneumonectomy. Occlusion of the respiratory limb of the respirator was followed by a positive pressure at the end of the respiration (PEEP) suggesting the presence of an intrinsic PEEP independent of the respirator. Application of a PEEP to the respirator induced a radiologic improvement. The mechanisms by which an intrinsic PEEP may develop are discussed. PMID- 1771289 TI - [Intracardiac knotting of a Swan-Ganz catheter. Detection using intraoperative trans-esophageal echocardiography]. AB - Transoesophageal echocardiography is a new technique that allows continuous and noninvasive assessment of cardiac function during surgery. More recently this technique is being used to detect the presence of external objects into the cardiac cavities. We report a case of Swan-Ganz catheter knotting confirmed by this echocardiography technique. He was a 57 year old male with previous history of arterial hypertension and ischemic heart disease who was scheduled for surgery because poor response to medical therapy. After anesthetic induction a thermodilution catheter was introduced percutaneously into the right internal jugular vein under continuous pressure monitoring from the distal catheter hole. In view of the difficulties in introducing the catheter into the pulmonary artery an intravascular catheter knotting was suspected and a bidimensional transesophageal echocardiogram confirmed the diagnosis. During extracorporeal circulation the catheter was withdrawn through a right auriculotomy. Monitoring with a Swan-Ganz catheter, as other invasive monitoring techniques, is followed by a certain degree of complications which should be avoided by a careful manipulation. Echocardiography is a valuable diagnostic procedure to identify the position of monitoring catheters into the cardiac cavities. PMID- 1771290 TI - [Comparative study of radial and cubital arterial catheterization]. AB - In this prospective study we evaluated catheterization of the cubital artery as an alternative to cannulation of the radial artery. Seventy six surgical patients were randomly allocated into two groups of 38 patients according to the intention to catheterize the cubital or the radial artery. The incidence of failure and the technical difficulties were significantly higher in cubital than in radial arterial catheterization (p less than 0.001 and p less than 0.05, respectively) and they were related to the cubital pulse palpation. There were no significant differences in the time elapsed to achieve the catheterization, time of stability of the catheter, nor in the incidence of complications. The qualification of the technician, the arterial blood pressure and the anatomic characteristics of the forearm did not influence the results. We conclude that whenever the cubital arterial pulse is appropriately perceived, catheterization of this artery is a good alternative to radial catheterization. PMID- 1771291 TI - [Continuous intraoperative arteriovenous hemodiafiltration in liver transplantation]. AB - This study reports two cases of urgent hepatic retransplantation due to graft failure developing 37 and 10 days after the first transplant in which intraoperative continuous arteriovenous hemodiafiltration (CAH) was performed. They were female patients aged 33 and 58 years respectively who presented oliguric renal insufficiency before surgery (plasmatic creatinine 2.6 and 2.8 mg/dl and urea 77 and 278 mg/dl) and severe electrolytic imbalance (sodium 128 and 135 mmol/l; potassium 8.5 and 3.8 mmol/l; bicarbonate 8.8 and 12.7 mmol/l; pH 7.18 and 7.16). In both cases CAH was used from the beginning of anesthetic induction (Hemofilter Biospal SCU/CAHH- Kit A2-U with reversed infusion of glucose Dianeal 1.5%). An intraoperative ultrafiltered volume of 2200 and 2400 ml was respectively obtained in each patient. The use of intraoperative CAH favoured the correction of the electrolyte imbalance, contributed to maintain the hemodynamic stability, and rendered the administration of fluids more appropriate during the surgical process. PMID- 1771292 TI - [Water-salt equilibrium. Regulation and modifications in the intraoperative period]. PMID- 1771293 TI - Advantage of PCR for detecting low amounts of HBV DNA in patients' sera. AB - Serum hepatitis B virus DNA (HBV DNA) is now the most important and reliable marker for monitoring viral replication. Quantitative detection of HBV DNA in serum is based on a commercial standardized solution hybridization assay (Genostics). In this work, we studied the sensitivity and specificity of this method, in comparison with the polymerase chain reaction (PCR) technique, for low value HBV DNA serum samples. Fifty-four patients with or without HBV serological markers were divided into 4 groups according to their HBV DNA values. Genomic amplification was found to affect 2 conserved regions of the viral genome, the S and C regions. Samples with an HBV DNA concentration equal to or greater than 1.5 pg/ml were considered positive in the "Genostics" test. A total of 38% of patients considered negative in the quantitative assay (less than 1.5 pg/ml) were found to be positive for HBV DNA in serum after PCR. Only 26% of patients with an HBV DNA concentration of between 1.5 and 10 pg/ml in the Genostics test had PCR detectable viral DNA in serum. Some 56% of patients with HBV DNA values between 10 and 20 pg/ml were found to be positive after amplification. All patients whose HBV DNA values were above 20 pg/ml had PCR-detectable viral DNA in serum. Our PCR results suggest that the positive limit level of the Genostics test has to be re evaluated. Indeed, for low values of HBV DNA (under 20 pg/ml and especially under 10 pg/ml), it is not possible to conclude about the positivity from the quantitative assay, and results have to be estimated according to the clinical and serological status of the patients. Moreover, PCR can be falsely negative because of methodological problems. Nevertheless, this study confirms that PCR does enable detection of the viral genome in HBV-seronegative patients and in "old" and "cured" HBV-infection marker carriers. PMID- 1771294 TI - Transmission of Crimean-Congo haemorrhagic fever virus from experimentally infected sheep to Hyalomma truncatum ticks. AB - Crimean-Congo haemorrhagic fever (CCHF) virus was inoculated into West African sheep that were simultaneously infested with adult Hyalomma truncatum ticks. Certain sheep developed a viraemia and antibodies, indicating virus infection and replication; however, the length and magnitude of the viraemia and serological responses corresponded to the animals' immunological status. Tick attachment and feeding was not influenced by sheep infection. CCHF virus infection was acquired by 11-33% of female and 0-60% of male ticks. Infection in the ticks did not influence their feeding success, as judged by weight at drop-off, and the weight of eggs produced by infected and non-infected ticks was similar. Transovarial transmission of CCHF virus was demonstrated in 2 of 12 (17%) egg batches from infected female ticks, but in none of 19 egg batches from ticks that tested negative for CCHF virus. Our results suggest that under certain ecological conditions, sheep may serve to amplify CCHF virus in nature through horizontal transmission and that the maintenance cycle also may be influenced by transovarial transmission to the next generation of ticks. PMID- 1771295 TI - Molecular variation between ordinary and Andean strains of potato virus S. PMID- 1771296 TI - Overcoming murine tumor cell resistance to vinblastine by presentation of the drug in multilamellar liposomes consisting of phosphatidylcholine and phosphatidylserine. AB - We determined whether vinblastine (VLB) encapsulated within multilamellar vesicle liposomes (MLV) would reverse target cell resistance to the drug exhibited by the UV-2237M murine fibrosarcoma and its Adriamycin (ADR)-selected multidrug resistant (MDR) variants. Resistant fibrosarcoma cells were grown in medium containing 1 and 10 micrograms/ml ADR to yield the MDR lines UV-2237M/ADRR (ADR 1) and UV-2237M/ADRRR (ADR-10), respectively. VLB encapsulated in MLV composed of phosphatidylcholine (PC) and phosphatidylserine (PS) (7:3 molar ratio) was hydrophobic, occupied an internal space equivalent of 6.13 microliters/mumol, and was stable in medium at 37 degrees C for up to 6 days. The 50% inhibitory concentrations (IC50) of VLB were 2, 25, and 70 ng/ml for the parent, ADR-1, and ADR-10 cell lines, respectively. VLB in MLV significantly enhanced sensitivity of tumor cells to VLB. The respective IC50 of liposomal VLB were 0.5, 5.7, and 12 ng/ml for the parent, ADR-1, and ADR-10 lines. MLV containing saline were not toxic to the cells. These data indicate that presentation of VLB entrapped in PC:PS MLV provides a method to overcome tumor cell resistance to this drug. PMID- 1771297 TI - Decreased oral toxicity with the local use of allopurinol in patients who received high dose 5-fluorouracil. AB - 5-Fluorouracil (5FU) is the most effective drug in gastrointestinal cancer. Mucositis and bone marrow toxicity are the two major limiting side effects. In our effort to reduce mucositis we administered Allopurinol mouthwash in 42 patients who had experienced oral mucositis during prior treatment with 5FU. In all patients significant reduction of oral toxicity was noticed as well as prolonged pain relief. PMID- 1771298 TI - Amelioration of doxorubicin resistance by pentoxifylline in human chronic myeloid leukemia cells in vitro. AB - Doxorubicin (DOX) is a potent anticancer agent, the use of which is limited by its cumulative dose-dependent cardiotoxicity. Pentoxifylline (PTX) is a non-toxic methylxanthine used clinically for the treatment of intermittent claudication. It is an active haemorheological agent, used for the treatment of defective microcirculation. In the present study, we employed PTX as a drug response modulator in combination with DOX to achieve increased cytotoxicity in human chronic myeloid leukemia (CML) cells. Inhibition of 3H-TdR incorporation was used as a measure of cytotoxicity. PTX at 100 microM concentration significantly (P less than 0.001) potentiated DOX-mediated DNA biosynthesis inhibition in CML cells in vitro. Significant synergistic inhibition was seen in 13 out of 22 CML samples. Decreased DOX accumulation is a characteristic feature of DOX resistant tumor cell lines. Drug accumulation studies demonstrated that PTX significantly (P less than 0.02) increased the intracellular accumulation of DOX in the CML cells. The enhanced DOX accumulation can be a mechanism of increased cytotoxicity by DOX-PTX combination. PMID- 1771299 TI - Single and combination treatment with vitamin K3 and adriamycin: in vitro effects on cell survival and DNA damage in human chronic myeloid leukemia cells. AB - Utility of drug response modulators to increase therapeutic:toxic ratio of anticancer drugs in the treatment of refractory malignancies is becoming desirable. In this study, we have attempted to potentiate the tumor cell killing ability of Adriamycin (ADR) against chronic myeloid leukemia cells (CML), in the presence of vitamin K3. Cell growth was evaluated by the MTT assay and the 3H thymidine incorporation inhibition assay. A highly significant (p less than 0.001) inhibition of cell survival and 3H-thymidine incorporation was effected in CML cells exposed to the combination of ADR and vitamin K3. When the CML cells were treated with ADR and vitamin K3 simultaneously, a greater fragmentation of the intact DNA was revealed as observed by the enhanced formation of DNA single strand breaks. Results demonstrate the therapeutic significance of employing vitamin K3 as an adjuvant in CML chemotherapy with ADR. PMID- 1771300 TI - Reduction by norepinephrine of the side effects induced by combined hepatic arterial administration of degradable strach microspheres and adriamycin in rats with a liver adenocarcinoma. AB - In previous studies we found degradable starch microspheres (DSM) to increase the antitumor effect of adriamycin injected by the hepatic artery in rats with a liver adenocarcinoma. Increased side effects also appeared, namely body weight loss and liver necroses. In the present paper, norepinephrine in four different protocols was added to the injection of adriamycin + DSM to decrease the drug flow to normal tissues. In two protocols norepinephrine decreased the body weight loss. There was also a non-significant decrease in liver necroses but also in antitumor effect. In these experiments we also observed that some rats given adriamycin + DSM got gastric necroses. This was not found when norepinephrine was added. Addition of propranolol to norepinephrine did not decrease side effects. Vasoactive drugs may therefore be of value to diminish adverse side effects of the combination cytostatic agent + DSM, probably decreasing overspill into normal tissues. PMID- 1771301 TI - Antibiotics in lung abscess. AB - Anaerobic bacteria are relatively common and important pathogens in the lower airways, but are rarely detected due to problems in obtaining adequate specimens for anaerobic bacterial culture. As a consequence, therapeutic decisions are generally empiric and made on the basis of suspected involvement of these organisms according to various clinical clues. With respect to antibiotic options, there is probably a multitude of drugs that would be effective, but there are only three that have a sufficient experience according to published reports: clindamycin, penicillin, and metronidazole combined with penicillin. Recent studies suggest that many of the bacteria involved in these infections produce beta-lactamase, consequently favoring drugs other than penicillins for these infections. Nevertheless, the in vivo experience continues to be relatively good for penicillin when given for orodental or pulmonary infections involving anaerobes derived from the upper airways. For a serious anaerobic infection, such as putrid abscesses associated with large cavities or severe toxicity, the usual drug recommendation is clindamycin. For less serious infections, regimens with established merit are noted above. It is likely that almost any beta-lactam (other than antistaphylococcal penicillins, ceftazidime, or azthreonam) would be adequate; metronidazole should not be used as a single agent. PMID- 1771302 TI - Antimicrobial penetration into polymorphonuclear leukocytes and alveolar macrophages. AB - Infections caused by intracellular organisms often involve the lung and may be implicated in chronic disease. These intracellular bacteria may be protected from otherwise lethal concentrations of extracellular antimicrobials. Knowledge of the intracellular concentration of usual antimicrobials used to treat pneumonia may allow physicians to refine their initial choice of therapy. Lipid-insoluble antimicrobials, such as penicillin, cephalosporins, aminoglycosides, trimethoprim, and imipenem penetrate poorly into cells, if they penetrate at all. Isoniazid, tetracycline, and lincomycin have intermediate intracellular penetration, and chloramphenicol, rifampin, ethambutol, quinolones, and lincosamides, plus macrolides, are avidly concentrated. Nonetheless, to date it has been difficult to correlate intracellular concentrations of antimicrobials with cellular killing or clinical outcome. Information derived from a more standardized approach to the evaluation of antimicrobial agent intracellular penetration will be useful in improving the direct application of in vitro study results to the clinical care of patients with pneumonia. PMID- 1771303 TI - Sputum antimicrobial levels and clinical outcome in bronchitis. AB - The role of antimicrobials in the treatment of bronchitis remains controversial. Antimicrobials are rarely indicated in acute bronchitis. Antimicrobials are indicated in a subset of patients with acute exacerbations of chronic bronchitis. The efficacy of an antimicrobial agent in bronchitis can be estimated by the ratio of the sputum concentration of the antimicrobial to its in vitro activity against common respiratory pathogens (S/M90). These S/M90 rates are presented in tabular form. However, given the lack of solid data to support antimicrobial treatment for most episodes of bronchitis, use of the S/M90 to select antimicrobial therapy remains theoretical rather than of proven clinical benefit. PMID- 1771304 TI - Introduction: antimicrobial penetration into respiratory secretions. PMID- 1771305 TI - Antibiotic treatment of pharyngitis. AB - Pharyngitis is one of the most common medical problems and ranges in severity from minor to fatal. The treatment regimens presented have been standardized for the various pathogens on the basis of clinical response and pathogen eradication. The current major challenge is the rapid recognition and diagnosis of streptococcal infection and clarification of the etiologic role of several nonstreptococcal pathogens. PMID- 1771306 TI - Antimicrobial treatment of sinusitis. AB - Sinusitis is a common disease. Most cases of acute sinusitis involve the maxillary sinus and occur after viral infections of the upper respiratory tract. The usual pathogens are Streptococcus pneumoniae and Haemophilus influenzae. Moraxella (Branhamella) catarrhalis is also an important pathogen in children. Anaerobic infections are more common in chronic sinusitis. Fungi are frequently observed in granulocytopenic cancer patients but also can occur in apparently normal hosts. Many strains of H influenzae and M catarrhalis observed in patients with sinusitis produce beta-lactamases. Many antimicrobial regimens have proven successful in the treatment of sinusitis, including ampicillin, amoxicillin, trimethoprim-sulfamethoxazole, the tetracyclines, and cefuroxime axetil, but only the latter three drugs are active against most beta-lactamase-producing strains. Nosocomial sinusitis usually occurs in intensive care unit settings and is frequently associated with nasopharyngeal instrumentation. The pathogens observed in nosocomial sinusitis are gram-negative bacilli or staphylococci and frequently require therapy with broad-spectrum penicillins or cephalosporins, an aminoglycoside, or vancomycin. PMID- 1771307 TI - Antimicrobial treatment of otitis media. AB - The major pathogens causing acute otitis media (AOM) are Streptococcus pneumoniae and Haemophilus influenzae, with Moraxella catarrhalis, Streptococcus pyogenes, and Staphylococcus aureus less frequently isolated. The same organisms and Staphylococcus epidermidis are found in chronic otitis media with effusion. In chronic suppurative otitis media, Pseudomonas aeruginosa and S aureus are most frequently found. Antimicrobial agents found to be most effective in treating AOM are amoxicillin, trimethoprimsulfamethoxazole, erythromycin-sulfisoxazole, amoxicillin-clavulanate, and cefaclor. Cefuroxime axetil and cefixime are alternatives for which there are less data. Currently, about 20% of AOM cases are caused by beta-lactamase-producing strains (usually H influenzae or M catarrhalis) that are resistant to amoxicillin, thus favoring the use of the other agents listed. Concentrations of antibiotics in middle ear infections range from 10% to 76% of peak serum levels for the listed agents and are higher in AOM than in chronic otitis media with effusion, emphasizing the importance of adequate dosing for successful treatment. PMID- 1771308 TI - Antibiotic therapy of pleural empyema. AB - Most empyemas occur as a complication of pneumonia or lung abscess, but 15% to 30% occur after thoracic surgery and 10% occur in association with an intraabdominal infection. The bacteriology of empyemas that occur in association with lung infections is often polymicrobial and mixed, containing multiple species of both aerobic and anaerobic bacteria, the latter found in up to 75% of cases. In contrast, empyema following thoracic surgery is more likely to be monomicrobial and caused by common nosocomial pathogens such as Staphylococcus aureus and aerobic gram-negative bacilli. Diffusion of antibiotics into both infected and uninfected pleural fluid is good, but certain agents (aminoglycosides and some beta-lactams) may be inactivated in the presence of pus, low pH, and beta-lactamase enzymes. Single antibiotic agents that are likely to be active against the wide spectrum of potential pathogens include imipenem cilastatin and ticarcillin-clavulanic acid. Combinations of antibiotics should include an effective agent against anaerobic bacteria (clindamycin, metronidazole) coupled with an agent active against aerobic gram-positive cocci and gram-negative bacilli. PMID- 1771309 TI - [Systemic scleroderma and cancer]. PMID- 1771310 TI - [Microcirculation, from ancient history to recent congresses]. PMID- 1771311 TI - [Anti-thyroid peroxidase in non-neoplastic thyroid pathology]. AB - Anti-thyroid peroxidase antibodies were prospectively assayed and compared with anti-microsome and anti-thyroglobulin antibodies in 203 patients (188 women, 15 men; mean age 42 +/- 14 years). These patients consulted for hyperthyroidism (n = 42, including 18 with Graves' disease), fumary hypothyroidism (n = 50, including 20 at the diagnosis stage), euthyroid diffuse or nodular goitre (n = 81) or benign euthyroid nodule (n = 14). Sixteen patients examined for fatigue, gynecomastia, menstrual disorders or overweight had normal thyroid function. Anti thyroid peroxidase, anti-microsome and anti-thyroglobulin antibodies were assayed by radioimmunology or indirect immunofluorescence. Anti-thyroid peroxidase antibodies were most frequently present in patients with autoimmune thyroid diseases, such as Graves' disease (72%) or primary hypothyroidism (70%), and correlated with anti-microsome antibody levels (r = 0.87; p less than 0.001). Anti-thyroid peroxidase antibodies were absent in patients with benign euthyroid nodule; they were present in 22% of patients with euthyroid goitre and in 12% of control patients; their level decreased during replacement therapy for hypothyroidism. It is concluded that radioimmunological assays of anti-thyroid peroxidase antibodies should replace anti-microsome and anti-thyroglobulin antibodies in thyroid evaluation. PMID- 1771312 TI - [Desensitization by autologous saliva and Behcet's disease]. AB - Among 240 patients with Behcet's disease seen in the Internal Medicine Department of the Ibnou Rochd University Hospital, Casablanca, between January 1981 and April 1988, 44 were selected to study the effects of desensitization by autologous saliva on oral and genital aphthae and on articular manifestations. Thirty of these 44 patients received gradually decreasing dilutions of their own saliva, and 14 control patients received physiological saline. Injections were administered intradermally twice a week during 15 weeks, then once a week during one year, so that the study lasted one and a half year, from October 1986 to April 1988. No improvement of the arthritis was observed, whereas the oral aphthae were improved in 50% of the patients desensitized by their own saliva. This percentage would have raised some hopes for the treatment of these sometimes disabling lesions were it not for the fact that 50% of the controls were similarly improved. This suggests that desensitization by saliva has a placebo effect. PMID- 1771313 TI - [Systemic mastocytosis and malignant hemopathies. Review of the literature apropos of a case]. AB - The authors report the case of a 68-year old woman with systemic mastocytosis revealed by spleen enlargement and portal hypertension, and associated with chronic myelomonocytic leukaemia. Based on their review of the literature, they describe the general characteristics of systemic mastocytosis and underline the frequent association of this disease with malignant haematological disorders, notably in the myeloid series. PMID- 1771314 TI - [Systemic scleroderma and malignant diseases. A review of the literature]. AB - Whether or not the association of systemic scleroderma and carcinoma is fortuitous is a much debated subject. Since 1886, approximately 320 cases of this association have been published. The most frequent malignancy involved is lung cancer (102 cases), followed by breast cancer (52 cases), malignant blood diseases (46 cases), cancer of the oesophagus (20 cases) and other gynaecological or gastrointestinal malignant tumours. A recent epidemiological study has shown that lung cancer is significantly more frequent than other malignancies, but statistical data on the latter are lacking. However, it would be wise to recommend that patients with systemic scleroderma should be regularly examined for gynaecological, haematological and gastrointestinal malignant diseases. PMID- 1771315 TI - [Pleuropulmonary manifestations of systemic lupus erythematosus]. AB - Pleuro-pulmonary manifestations are frequent in systemic lupus erythematosus (SLE), being found in 40 to 70% of patients with this disease. However, these manifestations can be attributed to SLE only when other pathologies, and notably infections, have been excluded. The truly SLE-related pleuro-pulmonary manifestations can be divided into five types: pleurisy, interstitial pneumonia, lupus pneumonia and two new entities: diffuse pulmonary haemorrhage and pulmonary arterial hypertension. The most frequent manifestation, pleurisy, only requires symptomatic treatment combined with non-steroidal anti-inflammatory agents. Corticosteroids are seldom necessary, but they must be used in lupus pneumonia or in diffuse interstitial pneumonia, owing to the severity and potentially poor prognosis of these two manifestations. Pulmonary haemorrhage is a serious and probably underestimated manifestation; it is diagnosed by bronchoalveolar lavage which also enables other causes, in particular infections, to be excluded. As soon as the aetiological diagnosis is made, high-dose corticosteroid therapy, usually combined with immunosuppressants, is mandatory. Pulmonary arterial hypertension is a classical, but hitherto unrecognized manifestation of SLE which benefits from new exploratory techniques, such as doppler-ultrasonography. At present, its diagnosis rests on data supplied by cardiac catheterization which is generally performed too late, making it irreversible and resistant to all treatments. Some of these pleuro-pulmonary manifestations are probably underestimated and they require new methods of investigation, such as bronchoalveolar lavage or doppler-ultrasonography, resulting in earlier diagnosis and treatment at an accessible stage. PMID- 1771316 TI - [Guillain-Barre syndrome. Recent clinical and therapeutic aspects]. AB - Guillain-Barre syndrome is an acute primary polyradiculoneuritis. A prototype of demyelinating disease, its essential characteristic is that it spontaneously evolves towards recovery from paralysis. Yet the vital and functional prognosis may be compromised in severe cases. Death and motor sequelae are particularly to be feared when the maximum deficit is severe and the maximum paralysis phase is prolonged. Cardiovascular vegetative disorders are also more frequent in these extended types. Symptomatic treatment rests on close supervision of the patients during the paralysis extension phase. Transferring the patient to an intensive care unit is mandatory as soon as disorders of deglutition and/or a significant decrease of vital capacity appear. Plasma exchange is the only treatment proven to be effective. It must be carried out early on in patients whose deficit is severe enough to interfere with walking and for whom this treatment is not contra indicated. Fresh frozen plasma must not be used as replacement solution: it creates more incidents and complications than diluted albumin and has no additional beneficial effect on the course of the neurological disease. PMID- 1771317 TI - [Renal complications of anti-cancer treatments]. AB - Life prolongation in cancer patients is attended by a greater frequency of renal lesions associated with chemotherapy, and in the last few years cancer patients cured or in lasting remission have begun to haunt dialysis centres. Before blaming the renal toxicity of cytotoxic drugs, it is necessary to exclude all other causes of renal dysfunction (pre-renal, obstructive, iatrogenic or cancer related). The renal toxicity of certain drugs, such as cisplatin, cyclophosphamide, ifosfamide, streptozocin, nitrosoureas, methotrexate, mitomycin C and recombinant IL2, is of importance as it is frequent and limits their use. The dangers of anticancerous drugs combinations, concomitant administration of other nephrotoxic drugs (antibiotics, non-steroidal anti-inflammatory agents) and extracellular dehydration created by gastrointestinal disorders must be borne in mind. Careful evaluation of renal function prior to chemotherapy, application of preventive measures with proven efficacy and repeated laboratory tests in short mid- and long-term should reduce the frequency of renal complications while preserving or even improving therapeutic effectiveness. PMID- 1771318 TI - [Systemic scleroderma and primary bronchopulmonary adenocarcinoma. A new case]. AB - The authors report a case of systemic sclerosis associated with primary lung adenocarcinoma. This association has previously been reported in patients with old scleroderma complicated by extensive fibrosis of the lungs allegedly regarded as a precancerous lesion. The case reported here is of interest owing to the absence of pulmonary fibrosis. PMID- 1771319 TI - [Nailbed capillaroscopy in Crohn's disease]. AB - It has recently been suggested that chronic mesenteric vasculitis was a pathogenetic mechanism in Crohn's disease. We have performed a prospective nailfold capillaroscopy study in seven patients with acute Crohn's disease. Minor nailbed abnormalities were frequently observed and three patients presented with major capillary dystrophy. These features are similar to those observed in some systemic vasculitis. PMID- 1771320 TI - [Wegener's granulomatosis disclosed by clinical symptoms of Horton's disease]. AB - In a series of 60 patients with Wegener's granulomatosis, 2 had initially presented with clinical signs suggestive of temporal arteritis. One of these two patients was a 69-year old woman suffering from inflammatory pain in the shoulders, wrists and knees, myalgias in the lower limbs and intermittent jaw claudication. The other patient was a 60-year old man with febrile polyarthritis predominantly affecting the knees and shoulders, and hyperaesthesia of the scalp. In both cases biopsy of the temporal artery gave negative results. Corticosteroids provided a dramatic improvement, but a relapse corrected the diagnosis. Three similar cases have been reported, but only one had a histological lesion of the temporal artery. Cases of temporal arteritis associated with pulmonary granulomatosis raise the problem of classification with localized Wegener's disease. An initial presentation suggestive of temporal arteritis may hide other systemic diseases, notably rheumatoid arthritis, periarteritis nodosa or Chug and Strauss angitis; Wegener's granulomatosis must be added to this list. PMID- 1771321 TI - [Angioimmunoblastic lymphadenopathy: a pathogenetic intersection between dysimmune, viral and lymphomatous diseases]. AB - Angioimmunoblastic lymphadenopathy (AIL) still is a clinico-pathological syndrome with little known physiopathology. The advent of molecular biology has improved our understanding of this syndrome by characterization of the clonal cell. With this technique, combined with cytogenetics and immunohistochemistry, three pathological states have been individualized: 1) true AIL without evidence of monoclonal proliferation; 2) transformed AIL, and 3) AIL-like T-cell lymphoma. This clinical complex can be integrated in an evolutive continuum, starting with simple lymphoid hyperplasia and ending with frank malignant T-cell lymphoma. PMID- 1771322 TI - [New developments of antiplatelet drugs]. AB - A better knowledge of platelet activation mechanisms has made it possible to develop antiplatelet agents that are capable of inhibiting primary haemostasis at very precise levels. Many of these agents block the synthesis or receptor of an hemostasis I agonist. Thus, the thromboxane A2 receptor can be blocked, or its synthesis can be interrupted, by thromboxane synthetase inhibitors, by cyclooxygenase inhibitors, or by omega 3 fatty acids which are competitive inhibitors. Inhibitors of thrombin (hirudin), PAF acether and serotonin (ketanserin) also are available. Other antiplatelet agents secreted by endothelial cells act as haemostasis I antagonists by elevating platelet cAMP or cGMP levels (prostacyclins and analogues, nitrate derivatives). Monoclonal antibodies and RGD peptides directly inhibit the glycoproteins that are responsible for platelet adhesion or aggregation, but their users are faced with problems of cost and route of administration. Of all these new antiplatelet agents, only ticlopidine, which has an imperfectly known mode of action, has proved effective in multiple situations, but its use is limited by its side effects. PMID- 1771323 TI - [Peritonitis caused by perforation of jejunal adenocarcinoma disclosing celiac disease in adults]. PMID- 1771324 TI - [Recurrence after 12 years of De Quervain-Crile subacute thyroiditis]. PMID- 1771325 TI - [Alain Piquet: "I count on the stress of nurses". Interview by Agnes Montloin]. PMID- 1771326 TI - [Toulouse, capital of health cities]. PMID- 1771327 TI - [Nurses without landmarks. Interview by Claire Manicot]. PMID- 1771328 TI - [From the streets of Paris to the streets of the north]. PMID- 1771329 TI - [An experience in inservice training in urology]. PMID- 1771330 TI - [Two close disorders: anorexia and bulimia]. PMID- 1771331 TI - [Severe eating disorders. Predispositions and risk factors]. PMID- 1771332 TI - [Severe eating disorders. Therapeutic approaches]. PMID- 1771333 TI - [Influenza]. PMID- 1771334 TI - [Insurance and AIDS]. PMID- 1771335 TI - [Rediscovering basic care]. PMID- 1771336 TI - [Rehabilitation of the coronary patient]. PMID- 1771337 TI - [Surgical gloves]. PMID- 1771338 TI - [The conflict is gone, the difficulties persist]. PMID- 1771339 TI - [Jean de Kervasdoue: "Nurses are no longer acknowledged by society". Interview by Anne Bergogne]. PMID- 1771340 TI - [Laurence of Australia. Interview by Claire Manicot]. PMID- 1771341 TI - [At the theater ... drugs]. PMID- 1771342 TI - [Current data on immunotherapy]. PMID- 1771343 TI - [Interleukin 2]. PMID- 1771344 TI - [Growth factors]. PMID- 1771345 TI - [The day of an independently practicing nurse]. PMID- 1771346 TI - [75% of seropositives are heterosexual]. PMID- 1771347 TI - [Neuropsychiatric complications of AIDS]. PMID- 1771348 TI - [Turner's syndrome]. PMID- 1771349 TI - [Ambulatory coronary angiography]. PMID- 1771351 TI - [Don't touch my old people!]. PMID- 1771350 TI - [Technical note No. 107. Pentamidine aerosol]. PMID- 1771352 TI - [AIDS, hepatitis: waiting for a decree]. PMID- 1771353 TI - [Settlement: when the signatures?]. PMID- 1771354 TI - [Specialty diploma: the students give their opinion]. PMID- 1771355 TI - [Constructing the education of tomorrow]. PMID- 1771356 TI - [Nurse in a center of transit]. PMID- 1771357 TI - [Gilles Baulieu: "being a nurse anesthetist, a plus". Interview by Agnes Montloin]. PMID- 1771359 TI - [The demands of the nurse anesthetists. National Syndicate of Nurses Specializing in Anesthesia-Resuscitation and the National Coordination of Nurse Anesthetists]. PMID- 1771358 TI - [What place for the nurse anesthetists in the hospital?]. PMID- 1771360 TI - [Soothing the pain of a child. Interview by Corinne de Buhan]. PMID- 1771361 TI - [Extracorporeal circulation: a nice toy for the pump assistant]. PMID- 1771363 TI - [The story of a mastectomy patient]. PMID- 1771362 TI - [Chemotherapy of HIV]. PMID- 1771364 TI - Endrin-induced histopathological changes and lipid peroxidation in livers and kidneys of rats, mice, guinea pigs and hamsters. AB - Endrin toxicity may be due to an oxidative stress associated with increased lipid peroxidation, decreased glutathione content, and inhibition of glutathione peroxidase activity. Extensive interspecies variability exists in sensitivity towards endrin. Therefore, histopathological changes and lipid peroxidation in the livers and kidneys of rats, mice, hamsters, and guinea pigs were examined 24 hr after the administration of 4 mg endrin/kg body weight orally in corn oil. Degeneration and necrotic changes with inflammatory cell infiltration were observed in livers and kidneys, and interspecies variability occurred. Fatty changes in the form of hepatic foam cells with cytoplasmic vacuolation were present. Lipofuscin pigments, associated with lipid peroxidation, were observed in hepatocytes and Kupffer cells. These histopathological conditions were prevented in rats which had been pretreated with butylated hydroxyanisole, vitamins E and C, or cysteine, antioxidants and free radical scavengers which have previously been shown to inhibit lipid peroxidation. The extent of endrin induced lipid peroxidation correlated well with the degree of histopathological changes. Thus, histological changes consistent with the induction of an oxidative stress were observed following the administration of endrin to various animal species. PMID- 1771365 TI - Incidence, distribution, and morphology of amyloidosis in Charles Rivers CD-1 mice. AB - The incidence, morphology, and distribution of amyloidosis were reviewed in a 2 year toxicity-oncogenicity study in Charles Rivers CD-1 mice. Amyloid was present in the duodenum, jejunum, mesenteric lymph node, and ovary in animals sacrificed at 8 months. In animals sacrificed at 12 months, amyloid was also present in the adrenal gland, gall bladder, heart, ileum, kidney, pancreas, parathyroid, spleen, glandular stomach, testis, and thyroid. In the animals sacrificed at 24 months, the gland was also involved. The organs most frequently involved at 24 months included the adrenal gland, duodenum, jejunum, ileum, heart, kidney, liver, mesenteric lymph node, ovary, spleen, and thyroid. PMID- 1771366 TI - Oxidative injury induces influx-dependent changes in intracellular calcium homeostasis. AB - Understanding of the mechanisms of cell injury and cell death is fundamental to the understanding of both protection against and initiation of cell injury and cell death. We subjected primary cultures of proximal tubular epithelium (PTE) from adult rats to an exogenous oxidative stress, generated by xanthine/xanthine oxidase (X/XOD), and studied its effect on the concentration of cytosolic ionized calcium ([Ca2+]i) by means of digital imaging fluorescence microscopy (DIFM) using a cytosolic calcium probe, fura-2. Exposure to 25 mU/ml X/XOD caused notable increases in [Ca2+]i detectable within 15 sec and increasing to micromolar levels with time. Experiments with Ca(2+)-free medium containing ethylene glycol-bis(beta-aminoethyl ether)N,N,N',N'-tetraacetic acid (EGTA) showed that the increase of [Ca2+]i was due to influx from the extracellular space. Smaller and slower increases in [Ca2+]i were seen after exposure to lower concentrations of X/XOD (5 and 10 mU/ml). PTE injury and killing were assessed by measuring the release of cytosolic lactate dehydrogenase (LDH), exclusion of trypan blue, and observation of morphologic changes. Exposures to the 25 mU/ml concentration of X/XOD caused significant LDH release after 2 hr and correlated with trypan blue staining of exposed cells. Again, lesser concentrations of X/XOD resulted in a slower release of smaller amounts of LDH, and thus delayed trypan blue staining. Cytoplasmic bleb formation was seen by phase microscopy within minutes of exposure to 25 mU/ml, followed by cell rounding, retraction, and disintegration. Transmission electron microscopy revealed a progression of changes characteristic of lethal cell injury, beginning with dilatation of the endoplasmic reticulum, detachment of ribosomes, condensation of mitochondria, and chromatin clumping and terminating with mitochondrial swelling and formation of intramitochondrial flocculent densities. These studies clearly show that notable increases of [Ca2+]i precede both sub-lethal and lethal changes in rat PTE. These results indicate that interventions designed to minimize or to accelerate calcium entry could be of importance in cell preservation or cell killing, respectively, and therefore to therapeutic strategies for myocardial infarction, stroke, or shock in the former instance and for cancers in the latter. PMID- 1771367 TI - Pathological study on beagles after long-term oral administration of cadmium. AB - Histopathological, histochemical, and electron microscopic examinations were performed on beagles after a long-term oral cadmium (Cd) administration of greater than 8 years. Although renal atrophy was remarkable in groups receiving doses of 50 and 100 mg/kg body weight/day, bone lesions could not be demonstrated by roentgenological and histopathologic examination. It was noticed that concomitant regeneration or recovery and cell death of the epithelium occurred in the proximal convoluted tubules. The cell death was consistent with apoptosis, a special feature of cell death, which was shown to play a major part in the tubular damage of cadmium by electron microscopic examination. Fatty degeneration of the pars recta tubules was seen to show dose-dependence. The intrarenal cadmium was localized predominantly in the cytoplasm of the proximal tubular epithelium by histochemical and ultracentrifugal cell fractionation examinations. Although no remarkable changes were found in the other organs, aggregates of siderophages in the liver and focal hemorrhage in the spleen, known as spontaneous lesions, might be related to Cd intoxication. In conclusion, the present study revealed that no bone lesions occur with Cd administration in adult beagles in spite of long-term administration. An excessive cell death to regeneration or recovery in the proximal tubules might result in the renal cortical atrophy. No remarkable changes were seen in the glomeruli and distal nephrons, which were in good agreement with Cd distribution. PMID- 1771368 TI - Spontaneously occurring leiomyosarcomas of the mouse urinary bladder. AB - Spontaneous leiomyosarcomas of the mouse urinary bladder have not been reported. Data from 8 chronic toxicity/oncogenicity studies that included 400 male and 400 female mice were reviewed and evaluated to gather information on spontaneously occurring urinary bladder leiomyosarcomas. Three control mice from 3 different studies had leiomyosarcomas in the submucosa of the trigone area of the urinary bladder. These tumors were not connected to the surface epithelium; however, they were connected to and destroyed the smooth muscle layer of the urinary bladder. This communication describes the incidence and histopathological features of these neoplasms. PMID- 1771369 TI - Strain A/J mouse lung adenoma growth patterns vary when induced by different carcinogens. AB - The histogenesis of mouse lung adenomas is currently being investigated in several laboratories. Based upon studies of a limited number of carcinogens in different mouse strains, some investigators suggest that all lung adenomas in mice are derived from alveolar type II cells, whereas others suggest a Clara cell origin for a majority of the tumors. This report differs from previous investigations in that 12 different carcinogens were evaluated for the types of lung tumor growth patterns they induced in a single mouse strain (strain A mice). The carcinogens aflatoxin B1 (AFB1), benzo(a)pyrene (BP), 1,2-dimethylhydrazine (DMH), 3-methylcholanthrene (MCA), 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), and N-nitrosomethylurea (MNU) induced tumors with a predominantly solid/alveolar growth pattern, whereas N-nitrosodiethylamine (NDEA) induced predominantly papillary tumors. Most of the other carcinogens induced a higher proportion of lung tumors with the solid/alveolar growth pattern than with the papillary growth pattern; however, ratios between the 2 growth patterns varied. If, as suggested by others, solid tumors are derived from alveolar type II cells and papillary tumors from Clara cells, then carcinogens may differ with respect to their ability to transform one cell type or the other. PMID- 1771370 TI - A 90-day continuous vapor inhalation toxicity study of JP-8 jet fuel followed by 20 or 21 months of recovery in Fischer 344 rats and C57BL/6 mice. AB - The kerosene-type jet fuel, JP-8, consists of a complex mixture of aliphatic and aromatic hydrocarbons. Because of the utility of JP-8, studies have been conducted to identify the potential long-term consequence of occupational inhalation exposure. Fischer 344 rats and C57BL/6 mice of both sexes were exposed to JP-8 vapors at 0, 500, and 1,000 mg/m3 on a continuous basis for 90 days, then followed by recovery until approximately 24 months of age. Occurrence of necrotizing dermatitis associated with fighting resulted in an increase in mortality in mice (male greater than female) during the 2 week to 9 month post exposure recovery period. The male rat kidney developed a reversible ultrastructural increase in size and propensity for crystalloid changes of phagolysosomal proteinic reabsorption droplets in the proximal convoluted tubular epithelium. A specific triad of persisting light microscopic renal lesions occurred but functional change was limited to a decrease in urine concentration compared to controls that persisted throughout the recovery period. The response is comparable to the chronic effect of lifetime exposure of the male rat to unleaded gasoline, d-limonene, and p-dichlorobenzene, except for the absence of tubular tumorigenesis. The active toxicologic response presumably must occur over a greater proportion of the male rat's life span for the tumor component of this male rat hydrocarbon nephropathy syndrome. The predictiveness for humans must be questioned, since the pathologic response to JP-8 involved only one tissue in one sex of one species, and since the male rat response appears to be linked to an inherent renal protein peculiarity. PMID- 1771371 TI - Acute cardiovascular toxicity induced by an adenosine agonist-antihypertensive in beagles. AB - An adenosine agonist, designated chemically as (R)-N-(2,3-dihydro-1H-inden- 1-yl) adenosine, or CI-947, was administered to 3 male and 3 female beagles in oral doses of 5 mg/kg body weight. Multiple episodes of arrhythmia were recorded electrocardiographically with Holter monitors in 2 males and 2 females monitored up to 48 hr. One male and 1 female were necropsied at 24 hr and the remaining dogs were necropsied at 48 hr post-dosing. At 48 hr, multifocal perivascular epicardial and myocardial hemorrhage was noted grossly in 1 female. Microscopic coronary arterial alterations were present in all treated dogs irrespective of the occurrence of arrhythmias. At 24 hr, proteinic material and red cells were present in the media accompanied by minimal adventitial accumulation of neutrophils. At 48 hr, coronary arterial lesions progressed to media vacuolation, transmural necrosis, and perivascular accumulation of neutrophils. Ultrastructural alterations included: endothelial retraction, subendothelial accumulation of fibrin and platelets, necrosis of smooth muscle cells, and mural infiltration of granulocytes and monocytes. Coronary vascular injury may be due to altered hemodynamics associated with the coronary vasodilator properties of adenosine agonist compounds. PMID- 1771372 TI - Organic content in occlusal groove-fossa-system in unerupted 3rd mandibular molars: a light and electron microscopic study. AB - A method is described by means of which organic content in fissure areas of 12 unerupted 3rd mandibular molars can be prepared for studies in the light microscope (LM) and in the transmission electron microscope (TEM). Thus, LM and TEM examinations revealed that the organic content throughout the fissure in bone covered and in mucosa-covered 3rd molars with uncompleted root formation consists of cells belonging to the enamel organ in late or in postmaturative stages. In mucosa-covered teeth with completed root formation it was only possible to identify enamel organ cells at the entrance of the fissure. Deeper parts were occupied by degenerative cells, polymorphonuclear cells and unidentified material. The results indicate that ameloblasts in fissures do not transform to stratified squamous epithelium but gradually degenerate towards terminal stages and remain as such, as the tooth emerges into the oral cavity. PMID- 1771373 TI - Age estimation based on tooth development: a test of reliability and validity. AB - The precision and accuracy of three commonly used methods for age determination by teeth were studied in 541 children aged 5.5-14.5 yr. These methods rely on estimation of tooth development as seen in radiographs compared with compiled dental charts. It was found that charts made from Scandinavian populations gave a rather good precision, while one from a Canadian population gave a consistent overestimate. Dependent on the method used, sex, and age, the 95% confidence interval for an individual prediction could be more than +/- 2 yr. PMID- 1771374 TI - Effect of fluoride amalgams on artificial recurrent enamel and root caries. AB - The present study examined the effect of F-containing amalgams on recurrent caries in vitro. Four amalgams were tested: A - Conventional amalgam; B - Amalgam A with 1% SnF2; C - Non-gamma-2 amalgam; D - Amalgam C with 1% SnF2. Twenty fillings from each amalgam were placed at the cementoenamel junction in sound extracted human teeth. The teeth were covered with varnish except for a 2-mm-wide zone around the fillings and immersed in separate vials containing dialyzed 15% gelatin gel, pH 4.2, for 17 days. Longitudinal sections through the created enamel and root lesions were examined using polarized light microscopy with distilled water as imbibition medium. Lesion depth was measured adjacent to the fillings and at the midpoint of the lesions. In the amalgam D group, 14 enamel lesions and 15 root lesions showed no demineralization in the area closest to the fillings, and mean lesion depth was significantly smaller than adjacent to the F free amalgams in enamel as well as in root surfaces. In the root lesions, protection was most evident in amalgam D. At the midpoint of the lesions, depths were not statistically different between groups A-D. This study suggests that fluoride amalgams have anticaries properties sufficient to inhibit recurrent caries. PMID- 1771375 TI - Caries incidence after topical application of varnishes containing different concentrations of sodium fluoride: 3-year results. AB - Previous studies have shown that topical application of the fluoride varnish Duraphat reduces caries incidence. The aim of the present study was to compare the caries inhibiting effect of a new fluoride varnish (Carex) containing 1.8% fluoride (F) with that of Duraphat (2.26% F). Informed consent was obtained from the guardians of 495 children 10-12 yr old in Voss Dental Health District (low F area). The children were randomly allocated to two groups. One group of subjects received 6-monthly application of Duraphat (n = 185), the other Carex (n = 165). Ethical considerations precluded the use of a placebo varnish. All participants received dental examinations including one pair of posterior bitewing radiographs and necessary dental care annually. One trained examiner interpreted bitewing radiographs blindly. Total 3-yr net DFS increment for 24 posterior approximal surfaces was 2.63 (SD = 3.81) in the Duraphat group and 2.12 (SD = 3.50) in the Carex group. DMFS increments based on 40 posterior occlusal and approximal surfaces were 5.21 (SD = 5.79) and 4.04 (SD = 4.92), respectively. Thus the results indicate a comparable efficacy for Carex and Duraphat at the caries activity level exhibited by these study participants. PMID- 1771376 TI - Combined effects of Zn(2+)-chlorhexidine and Zn(2+)-cetylpyridinium chloride on caries incidence in partially desalivated rats. AB - The effects of Zn2+ combined with either chlorhexidine or cetylpyridinium chloride (CPC) on caries incidence in partially desalivated rats were investigated. Seven groups of 12 animals each received topical applications for 20 s with a saturated swab (0.2 ml) of the following aqueous solutions twice daily on weekdays (10 a.m. and 3 p.m.) and once daily during weekends (12 a.m.) for 5 wk: deionized water (placebo); 40 mM zinc acetate; 2.2 mM chlorhexidine diacetate; 4.4 mM CPC; 40 mM zinc acetate and 2.2 mM chlorhexidine diacetate; 40 mM zinc acetate and 4.4 mM CPC; and 20 mM NaF (positive control). Coronal caries was scored by the method of Keyes. All treatments except CPC alone resulted in significantly (P less than 0.05, ANOVA) less smooth-surface caries than did the placebo. NaF treatment resulted in significantly less smooth-surface caries than did Zn2+, chlorhexidine, CPC, and Zn(2+)-CPC. The inclusion of zinc ions did not significantly increase the caries-inhibitory efficacy of chlorhexidine (CH). The combination of Zn(2+)-CPC decreased smooth-surface scores significantly more than did CPC alone. Significant differences in sulcal-surface caries were not observed among the groups. Zn(2+)-CPC suppressed the Streptococcus sobrinus counts significantly more than did the separate agents. Animals treated with Zn(2+)-CH harbored the lowest populations of S. sobrinus. PMID- 1771377 TI - Influence of phenytoin on cytoplasmic free Ca2+ level in human gingival fibroblasts. AB - Influence of 5,5-diphenylhydantoin (phenytoin; PHT) on the cytoplasmic free Ca2+ concentration, [Ca2+]i, was studied in fura 2 loaded adherent monolayers of human gingival fibroblasts derived from three patients before and after 9 months of PHT therapy. In the patient where gingival overgrowth developed during PHT medication (responder), addition of PHT to gingival fibroblasts derived before PHT medication induced a transient extracellular Ca2+ dependent increase in [Ca2+]i. In a non-responder patient, where gingival overgrowth did not develop during the same period of PHT therapy, addition of PHT to gingival fibroblasts derived before the start of medication did not significantly affect [Ca2+]i. Under extracellular Ca2+ deficient conditions, addition of PHT to serum-starved fibroblasts derived from the two categories of patients before the medication resulted in an increase in [Ca2+]i. In fibroblasts derived from the responder patient during PHT medication, in contrast to those from the non-responders (n = 2), the basal level of [Ca2+]i was significantly decreased. The results indicate that, in the cases studied, there is a relationship between PHT induced alterations in [Ca2+]i in gingival fibroblasts and the clinical development of gingival overgrowth. PMID- 1771378 TI - Objective and subjective efficacy of saliva substitutes containing mucin and carboxymethylcellulose. AB - The lubrication properties of mucin and carboxymethylcellulose (CMC)-containing saliva substitutes and water were evaluated in a double-blind trial. After mouthrinsing with the substitutes, the patients answered a questionnaire (subjective effect) and the change of oral mucosal friction was measured with a probe (objective effect). Mucin and CMC-containing saliva substitutes showed almost the same objective effects, with changed friction values of about 15 min, which was more than twice as long as for water. Both water and the two saliva substitutes relieved the symptoms of dry mouth to some extent but they did not have a sufficiently long-lasting effect. PMID- 1771379 TI - Hypersensitivity reactions to dental materials in patients with lichenoid oral mucosal lesions and in patients with burning mouth syndrome. AB - Epicutaneous patch testing of a battery of 35 dental test substances was carried out in 24 patients with visible lichenoid oral mucosal lesions and in 24 patients with burning mouth syndrome (BMS) without any visible lesions. Reactions to mercury ammonium chloride were found in 33% (8/24) of the patients with visible lesions compared to 0% (0/24) of the patients with BMS. The difference was statistically significant. In 7 of the 8 patients who reacted to mercury, total or partial regression of the lesions was observed after removal of dental amalgam. Reactions to nickel sulfate were found in 21% (5/24) of the patients with BMS compared to 3% (1/24) of the patients with lichenoid lesions. This difference was also statistically significant. Nickel is a rare component in dental restorations, but the oral mucosa is daily exposed to nickel through food and water intake. Removal of nickel from the environment of the patient can therefore be hard to accomplish. PMID- 1771380 TI - A new device for measuring oral mucosal surface friction--reference values. AB - Sialometry and dryness measurements performed with a sliding friction instrument were carried out in healthy subjects and patients with oral dryness due to salivary gland diseases. The salivary flow rates were within normal reference values. The mean friction value in the healthy population was 1.73 +/- 0.37 in the lip mucosa and 1.25 +/- 0.31 in the buccal mucosa and did not show any age or sex differences. In the group of patients with salivary gland diseases, none produced measurable amounts of resting saliva but a few of them did produce small amounts of paraffin wax chewing-stimulated saliva. The friction instrument proved to register lubrication produced even by these very small amounts of saliva. PMID- 1771381 TI - Oral sugar clearance in elderly people with prosthodontic reconstructions. AB - The aim was to study oral sugar clearance in elderly individuals, around 70 yr of age, with various types of prosthodontic reconstructions. Salivary glucose concentration was measured under the tongue after chewing a glucose tablet in four groups of individuals with: 1) complete dentures (CD) (n = 19), 2) removable partial dentures (RPD) (n = 22), 3) fixed partial dentures (FPD) (n = 24), and 4) no dentures (controls) (n = 23). Salivary glucose clearance was also studied after a mouthrinse with 10% glucose in 18 of the 19 individuals with CD and in 13 of the 22 with RPD both with and without the dentures. Saliva samples for glucose analysis were taken, in this part of the experiment, at two separate locations: under the tongue and in the labial vestibule near the mandibular right first molar. After the tablet intake, the group with CD showed the highest initial salivary glucose concentration, the longest oral sugar clearance time and the largest area under the curve, followed by the group with RPD. FPD did not seem to influence the oral sugar clearance. After the glucose rinse, higher values for the various clearance variables were obtained in the vestibule than under the tongue and, to some extent, when the experiments were carried out with than without the dentures. Thus, the results from this study indicate that removable dentures, especially CD, contribute to less effective oral sugar clearance in elderly people and that the oral clearance seems to be more dependent on the site than on the presence or absence of removable dentures in the oral cavity. PMID- 1771382 TI - Distortion of impression materials used in the double-mix technique. AB - According to the so-called double-mix technique for impression taking, a material of high and one of low viscosity set against each other. We found that a distortion of the joined materials occurred which may compromise the precision of the impression. The distortion of such combinations of materials of high and low viscosity was measured on beam-like specimens. Significant differences between materials were observed. The phenomenon may be explained by a swelling of the material of low viscosity. The swelling may be associated with a diffusion of unreacted compounds from the material of high viscosity into the material of low viscosity. Measurements of the swelling of specimens immersed in the catalyst component of unset material showed an increase in length of 2-5%. PMID- 1771383 TI - NSAIDs and the gastrointestinal tract--case closed? PMID- 1771384 TI - Causes of death amongst a population of gastric ulcer patients in New South Wales, Australia. AB - The purpose of this study was to investigate whether any specific causes of death were more frequent than expected in an Australian group of 305 gastric ulcer patients (131 men, 174 women) who had died in New South Wales between 1 January 1974 and 31 December 1983. The distribution of causes of death among the ulcer population deaths was compared with that among the New South Wales population deaths, after adjusting for sex, 5-year age group, and time period of death (1974 1978, 1979-1983). Causes of death were ascertained from death certificates. Deaths due to peptic ulcer, liver cirrhosis, and diffuse pulmonary disease were more frequent than expected (p less than 0.05). The associations found with these other diseases accord with those found in previous surveys on causes of death in gastric ulcer patients and in studies of living gastric ulcer populations. Overall, the combined evidence suggests that liver cirrhosis and diffuse pulmonary disease are associated with gastric ulcer. PMID- 1771385 TI - Serum carcinoembryonic antigen and DNA ploidy in colorectal carcinoma. A prospective study. AB - We have analysed the relationship between carcinoembryonic antigen (CEA) and DNA ploidy prospectively in 130 colorectal carcinoma patients. CEA was elevated preoperatively significantly more often in patients with DNA-aneuploid tumours than in DNA-diploid or DNA-tetraploid tumours--that is, in 48% (36 of 75) of patients with aneuploid tumours, in 34% (14 of 41) of patients with diploid tumours, but only in 14% (2 of 14) of patients with tetraploid tumours (p less than 0.05). Aneuploid tumours had an elevated CEA level in 38% of stage A-B disease and in 61% of stage C-D disease. The elevated CEA values (greater than or equal to 5.0 micrograms/l) correlated with tumour stage in patients with aneuploid tumours but not in patients with diploid tumours. Whereas CEA is a suitable marker for aneuploid carcinomas, other more sensitive tumour markers should be sought for diploid and also for tetraploid tumours. If such markers are found, flow cytometry could provide the most important information in selecting individual follow-up programmes for colorectal cancer patients. PMID- 1771386 TI - Prophylaxis of gastrointestinal tract bleeding with magaldrate in patients admitted to a general hospital ward. AB - A randomized, placebo-controlled trial was performed to assess the effect of magaldrate (800 mg every 4 h) in reducing the rate of upper gastrointestinal tract bleeding among 100 consecutive patients with severe diseases admitted to a general hospital ward. Upper gastrointestinal tract bleeding occurred in 11 of 48 placebo-treated patients and in only 1 of 52 magaldrate-treated patients (p less than 0.01). Endoscopic examination of these patients showed gastric ulcer (two cases), multiple gastric mucosa ulcerations (nine), and no lesions (one). In three patients who received placebo the hemorrhage was clinically relevant and required transfusion of two or more blood units. Patients with two or more risk factors showed a higher rate of gastrointestinal hemorrhage (p less than 0.05). Respiratory failure and treatment with a high dose of corticosteroids were associated with the highest incidence of bleeding (p less than 0.05 for both). The only adverse reaction associated with magaldrate was a mild and self-limiting diarrhea in two cases. We conclude that patients seriously ill admitted to a general hospital ward should be treated with a prophylactic agent against stress induced ulcer bleeding. Magaldrate is an effective and safe antacid to prevent gastrointestinal tract bleeding in such patients. PMID- 1771387 TI - The role of the antrum and the vagus nerve in the metabolism of histamine in the human gastric mucosa. AB - The effects of antrectomy and proximal gastric vagotomy on the metabolism of histamine in the human gastric mucosa were studied in the basal state and during pentagastrin stimulation in patients with duodenal or gastric ulcer disease. Mucosal biopsy specimens were taken from the antral and oxyntic gland areas, whereafter histamine content, histidine decarboxylase activity, and histamine methyltransferase activity were simultaneously assayed. Vagotomy was followed by a decrease in the acid secretory capacity and an increase in basal serum gastrin levels. Histamine content of the oxyntic mucosa increased after vagotomy, but the ability of pentagastrin to form new amounts of the amine was impaired. Antrectomy caused a decrease in acid secretion and a fall in gastrin concentrations. Basal histamine content and rate of amine formation in the remaining oxyntic mucosa were unaffected by antrectomy. Antrectomy impaired the ability of pentagastrin to release histamine. Histamine methyltransferase was not affected by pentagastrin, vagotomy, or antrectomy. In conclusion, both antral gastrin and the vagus nerve seem to exert a regulatory influence on the metabolism of histamine in the human oxyntic mucosa. The withdrawal of these factors either causes impaired ability of pentagastrin to release histamine from its storage site or counteracts the ability of pentagastrin to accelerate histamine synthesis. PMID- 1771388 TI - Repletion and depletion of vitamin E in gastroduodenal mucosa. AB - Male rats were used to assess the effect of fasting and depletion and repletion rates on the levels of vitamin E in the liver and in mucosa from the fundus, antrum, and duodenum. Fasting for 24 h did not produce a significant decrease in vitamin E content in gastroduodenal mucosa. Feeding rats a diet low in vitamin E content for 10 weeks produced very low levels of the vitamin in all the tissues studied (below 2.4 micrograms/g tissue). Feeding rats a diet high in vitamin E content for 10 weeks produced high levels of vitamin E in the liver (64.5 micrograms/g) and in fundic (47.5), antral (36.9), and duodenal (24.5) mucosa. Calculated rates of depletion (microgram/g tissue/day) were very low in fundic and antral mucosa (0.2-0.7); duodenal mucosa (4.2) and liver (12.2) were the highest. Rates of repletion (microgram/g tissue/day) were lower in the antrum (1.2) and fundus (2.6); duodenal (4.2) and liver (7.6) were the highest. The findings of this study indicate that fasting or short-term dietary manipulation did not substantially change the vitamin E content of the gastroduodenal mucosa. PMID- 1771389 TI - Radial analysis of duodenal motility recordings in humans. AB - To analyze radial variations in pressure recordings from the human duodenum, we used a catheter with six radially placed side holes with identical dynamic characteristics. Twenty-one hours of fasting pressure recordings were obtained in six volunteers. Computer-based cross-correlation analysis, event detection and counting, amplitude analysis, and concordance analysis were used for comparing the signals of the individual channels. Both the cross-correlation analysis and the counting of events showed radial asymmetry of contractile activity. This asymmetry was not related to any individual channel. The maximum difference between the individual channels was constantly between diametrically opposite spaced channels. The asymmetry was most pronounced during phase-I-like and phase II-like activity of the migrating motility complex, whereas a much higher degree of cross-correlation and concordance was shown during phase-III-like activity. The results indicate that a greater in-depth analysis of pressure recordings from the small intestine--such as identification of individual events and differentiation between contractions and artefacts--requires that the recordings as a minimum comprise two diametrically placed side holes at each measurement level. PMID- 1771390 TI - Pancreatic lipolytic enzymes in human duodenal contents. Radioimmunoassay compared with enzyme activity. AB - The total pancreatic lipolytic capacity was determined in duodenal contents in healthy humans 10-120 min after a liquid test meal, by estimating the amount of pancreatic lipase, colipase, carboxyl ester lipase, and phospholipase A2 by means of radioimmunoassays and enzymatic assays. The molar concentrations of the different proteins were of the same order of magnitude. The relative specific activity (enzyme activity/milligram immunoreactive protein expressed as a percentage of the specific activity of the respective pure protein) amounted to 75-120% for lipase, 45-80% for colipase, 30-70% for carboxyl ester lipase, and 45 120% for phospholipase A2. These varied, and sometimes low values can be explained by the fact that the enzymes are inhibited or partly inactivated in the duodenal contents by surface denaturation, in which cases the products are still immunoreactive. Also, the proforms of colipase and phospholipase A2 may not always be completely activated. Furthermore, the specific activities of the pure enzymes (and thus the relative specific activities) are related to the methods used, which are not specific enough to distinguish completely the three enzymes and the cofactor in duodenal contents. PMID- 1771391 TI - A radiologic method for the study of postoperative colonic motility in humans. AB - Propulsive colonic motility in the postoperative period was studied, in 49 patients undergoing cholecystectomy, by means of radiopaque markers, water soluble contrast, and serial abdominal radiographs. The colon was divided into four segments, and the propagation of the markers and contrast to the segments was registered. Marker propagation correlated significantly with the propagation of the contrast to all segments of the colon (p less than 0.001). The first postoperative passage of gas did not correlate significantly with the propagation of the markers or the contrast to the various colonic segments. The first passage of faeces postoperatively did not correlate significantly with the return of propulsive motility in the right colon; however, there was a significant correlation with the propulsion of markers to the descending colon (p less than 0.05) and the rectosigmoid colon (p less than 0.05). The duration of postoperative paralytic ileus, as measured by the start of propagation of the markers from the caecum, correlated directly with the consumption of opiate analgesics in the postoperative period (p less than 0.01) but inversely with age (p less than 0.05). The duration of surgery did not correlate significantly with the duration of paralytic ileus in the colon. In conclusion, a limited number of radiopaque markers can be used to study the return of postoperative propulsive motility in the colon. The first postoperative passage of gas is not an indicator of the duration of postoperative paralytic ileus, whereas the first passage of faeces is primarily representative of the return of propagative motility in the left colon. PMID- 1771392 TI - The problems of using NSAIDs in the elderly. AB - It has been estimated that, in the United Kingdom, at least, women over the age of 65 years are more likely than not to have taken a nonsteroidal anti inflammatory drug (NSAID). It is against this enormous use that reports of toxicity must be balanced. There has been a tendency during the past decade to deprecate the use of NSAIDs, especially in the elderly. Yet, despite the well known problems associated with these agents in older patients, such as reduced glomerular filtration rate, this group of drugs is tolerated surprisingly well. Nevertheless, some NSAIDs do have a greater propensity to cause gastrointestinal bleeding, especially in older female patients. Ketoprofen, metabolized by the liver, may have advantages over other NSAIDs in the elderly. This paper reviews the problems associated with the use of NSAIDs in older patients. In general, NSAIDs have proved to be an advance in the management of rheumatic diseases in the elderly, displacing the far more toxic aspirin. PMID- 1771393 TI - Long-term safety of ketoprofen in an elderly population of arthritic patients. AB - A total of 823 patients (620 women and 203 men) aged greater than or equal to 65 years (mean age: 72 years) with osteoarthritis (n = 642) or rheumatoid arthritis (n = 181) were enrolled in an international prospective study designed to assess the safety profile of ketoprofen, a propionic acid derivative, over a 12-month treatment period. The patients received a 200-mg, sustained-release tablet of ketoprofen once daily. At the end of the study, 521 patients (63.3%) remained on the drug regimen, whereas 302 patients (36.7%) had withdrawn from treatment for various reasons, including adverse reactions, inefficacy and improvement, or had been lost to follow-up. A total of 314 patients (38.2%) experienced at least one adverse event during the study. Most side effects involved the digestive system (232 patients [28.2%]), the central nervous system (33 patients [4.0%]) or the cardiovascular system (26 patients [3.2%]). Fourteen patients (1.7%) experienced gastrointestinal adverse events (e.g., ulceration and bleeding). Most of these events occurred during the first 3 months of the study. Thus, it may be concluded that sustained-release ketoprofen, 200 mg once daily, is safe for the long-term treatment of elderly arthritic patients. PMID- 1771394 TI - Improving the risk-benefit ratio of NSAID therapy in the elderly. AB - Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely prescribed to elderly patients. This population may have a decreased capacity to metabolize and excrete NSAIDs and other agents. Furthermore, older patients frequently use NSAIDs concomitantly with other commonly prescribed drugs, thereby increasing the potential for drug interactions. A major challenge in rheumatology is to improve the risk-benefit ratio of NSAID therapy in older patients. Clinicians first must identify which patients are at increased risk. Several studies have shown that compromised cardiovascular and renal functions in older individuals may be important factors in increasing their vulnerability to the adverse effects of NSAIDs. Epidemiologic studies have provided valuable information concerning risk factors for adverse drug reactions in the elderly. Older patients with rheumatic diseases, osteoporosis, degenerative changes and certain autoimmune diseases and neoplasms should be treated less aggressively than younger patients. Statistical analyses of data bases correlating specific adverse events with NSAID use in the elderly may help clinicians in their therapeutic decisions. These data bases are now available in several readily accessible forms. PMID- 1771395 TI - Maintenance of blood pressure control in elderly hypertensives on ketoprofen. AB - In elderly patients, nonsteroidal anti-inflammatory drugs (NSAIDs) are often used concomitantly with antihypertensive agents. It is therefore important to assess the potential for interactions between NSAIDs and these agents. In a double blind, placebo-controlled study, 40 elderly hypertensive patients treated with acebutolol or atenolol, together with frusemide, were randomized to receive either ketoprofen, 200 mg/day (50 mg q.i.d.), or matching placebo for 7 days. Arterial blood pressure and heart rate were monitored for a 24-hour period at baseline and at the end of treatment. Standard sphygmomanometric measurements of blood pressure and heart rate were conducted twice a day during the study. No clinically significant side effects or blood pressure or heart rate alterations were observed during the trial. The results indicate that ketoprofen does not interfere with blood pressure control in elderly hypertensive patients being treated with a combination of beta-blockers and diuretics. PMID- 1771396 TI - Nonsteroidal anti-inflammatory drug toxicity: increased risk in the elderly. AB - Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used in the therapy of rheumatic diseases, especially in older patients. The toxicity profile of NSAIDs includes gastrointestinal (GI) toxicity, renal dysfunction and hepatic disease. Altered drug pharmacology in older patients may be a factor in their increased risk for drug toxicity. Elderly patients appear to be at greatest risk for symptomatic GI toxicity, including ulceration and even major GI bleeding. Central nervous system toxicity, characterized by dizziness, headaches, mood alteration and confusion, and renal dysfunction have also been reported to occur more commonly among elderly patients. Hepatic dysfunction is a rare NSAID-induced toxicity, but older patients are often at greatest risk for serious hepatic disease. Understanding the patient's underlying physiologic condition, concomitant drug therapy and the kinetics of the NSAID being used is critical to the safe administration of these agents to elderly individuals. PMID- 1771397 TI - Plasma hyaluronan levels in rabbit immobilization osteoarthritis: effect of remobilization. AB - The right knee joint of 11 rabbits was immobilized in full extension with a splint for a period of three days. The effect of the immobilization and subsequent remobilization on plasma hyaluronan (HA) level was measured, using a sensitive radiometric HA binding protein (125I-HABP) assay. No significant effect of the immobilization on plasma HA level (54 +/- 4 micrograms/l) was noted, but shortly (45 minutes) after splint removal, plasma hyaluronate was at its highest (91 +/- 20 micrograms/l). One day after removal of the splint a return to baseline (53 +/- 6 micrograms/l) was observed. It is suggested that HA may accumulate in the joint during immobilization. Shortly after removing the splint, the level of HA shows a rise in many of the rabbits, even if this is not a consistent finding, probably due to variation in the extent and kinetics of the HA mobilization. Such an accumulation of HA could be deleterious for joint tissues, since HA is an-effective stimulator of interleukin-1 (also called catabolin) synthesis and secretion, and since immobilization osteoarthritis ensues in the splinted rabbit joints. PMID- 1771398 TI - Clinical features of patients with mild systemic lupus erythematosus. AB - Clinical features of 16 patients with mild systemic lupus erythematosus (SLE) were compared with those of 21 control patients with moderate or severe disease. Age at the time of diagnosis of SLE was higher in mild disease group. The incidence of the coexistence of Sjogren's syndrome (SS) at the time of diagnosis of SLE was higher in patients who later developed mild disease. Anti-Sm antibody and decreased levels of C3, C4, and CH50 occurred less frequently in patients with mild disease. SLE patients with the coexistence of SS at the time of diagnosis of SLE may represent a subset with a benign prognosis. PMID- 1771399 TI - The effect of olive oil and fish consumption on rheumatoid arthritis--a case control study. AB - In an interview based, case control study of Rheumatoid Arthritis (RA) 168 cases and 137 controls were included. Patients and controls were interviewed with regard to a variety of socioeconomic, medical and dietary factors. During univariate analysis it was found that RA cases consumed significantly less olive oil and fish and adhered more rarely to the dietary restrictions traditional in Orthodox lent than controls. Applying multiple logistic analysis though (by which several variables were controlled for), only the association with olive oil consumption and lent adherence remained significant. More specifically; an increase in olive oil consumption by two times per week, resulted in a Relative Risk (RR) for development of RA of 0.49, whereas adherence to lent during the 27 weeks per year prescribed by the Orthodox Church, resulted in a RR of 0.33. We conclude that olive oil consumption and adherence to Orthodox lent may have a protective effect on the development and/or the severity of RA. This is a hypothesis generated by the present study that needs verification. PMID- 1771400 TI - Oral contraceptives in systemic lupus erythematosus: side-effects and influence on the activity of SLE. AB - The risk of a disease flare-up and the side-effects experienced during the use of oral contraceptives (OCs) were studied in 85 female SLE patients, 18-44 years old, regularly attending two specialist rheumatological clinics. Thirty-one patients had used combined oral contraceptives (cOCs) during or after the onset of SLE. Initial manifestations or exacerbations of SLE were noted in 4 (13%) of these patients during the first six months after starting cOCs and three of these four patients had major renal involvement. The incidence of disease flare-ups was the same as in patients not using cOCs. Two patients developed deep venous thrombosis during cOCs, and they both had antiphospholipid antibodies. Thirty-two patients had used progestagen-only contraceptives (PCs) and they were discontinued in 25 (78%) of the patients because of minor side-effects, mainly reflecting poor gynaecological tolerance. Albeit there is no definitive proof that cOCs actually precipitate or exacerbate SLE some patients may be more likely to have adverse effects while taking cOCs. It appears best to avoid cOCs in SLE patients with high levels of antiphospholipid antibodies and in patients with active nephritis. PCs cause many side-effects in SLE patients, but do not seem to activate the disease. PMID- 1771401 TI - Rheumajecta and vasolastine in the treatment of rheumatoid arthritis--the results of a placebo-controlled, double-blind trial of a complementary treatment. AB - The so called "enzymatic preparations" Rheumajecta and Vasolastine (R & V) belong to the complementary treatments. The preparations have been used for many years in the treatment of patients with rheumatic conditions such as rheumatoid arthritis (RA) in the Netherlands and other countries of Europe, although a proper study showing efficacy was never performed. Therefore a double-blind, placebo-controlled, modified cross-over trial during two periods of 3 months was performed in 34 patients with RA. They were allocated at random to R & V or to placebo injections, all intramuscular. After 3 months of therapy each patient could opt for cross-over in the event of lack of subjective improvement. Clinical assessments including Ritchie's articular index, grip strength, the DUTCH-AIMS questionnaire, ESR and CRP were performed. R & V did not prove to be more effective than placebo. No serious side-effects were seen. PMID- 1771402 TI - Platelet function and plasma factors in connective tissue disorders. PMID- 1771403 TI - Pleural effusions in Wegener's granulomatosis: report of five patients and a brief review of the literature. AB - Wegener's granulomatosis (WG) is an uncommon disease of unknown aetiology which is characterised histologically by a necrotising granulomatous angiitis. The airway, lungs and the kidneys are predominantly involved, but the disease has been documented to affect virtually every organ system. The clinical course is variable and ranges from a short, rapidly fatal illness at one end of the spectrum to indolent involvement compatible with several years of survival at the other. A majority of patients have pulmonary disease evidenced clinically by cough, sputum production and haemoptysis and radiologically by infiltrates, nodules and cavitation. Pleural effusions, however, are rare. No detailed information regarding the nature and clinical behaviour of these effusions is available and only a recent French study has listed the nature of the fluid in passing. We have observed pleural effusions in five patients with WG who are the basis of this report. PMID- 1771404 TI - [The epidemiology of gasterophilosis of horses in Switzerland]. AB - Between March 1988 and December 1989, 198 gastrointestinal tracts from slaughtered horses from different areas of Switzerland have been analysed for the presence and the frequency of Gasterophilus spp. During the same period--always between July and November--200 horses from selected areas of Western Switzerland have been checked for the presence of eggs and their subsequent developmental stages in order to investigate further clinical and biological aspects of this infection. The evaluation has been performed according to origin, age, sex, colour of the horse and seasonal pattern of the cases and the various larval stages, respectively. The prevalence of Gasterophilus spp. amounts to 64.6%, showing a marked seasonal distribution. Only Gasterophilus intestinalis has been detected and the Western part of Switzerland appears to be considerably more contaminated than the other areas of the country. The reasons are discussed. It is possible that an intensive horse-traffic at the border is partly responsible. Horses with a dark coat are more often parasitized whereas no difference occurs with regard to age and sex. The observed high prevalence of this parasite infection in the Swiss horse population confirms that gasterophilosis has to be taken into serious consideration and prophylactic measures might be indicated. PMID- 1771405 TI - [The occurrence of the parasite Collyriclum faba (Bremser in Schmalz, 1831) in wild birds in Switzerland]. AB - The infection of our indigenous wild birds by the parasite Collyriclum faba represents a rare event. The adult trematodes reside in the subcutaneous tissue of the host, where prominent cysts can be found. In summer 1988, two cases were diagnosed, in a house sparrow (Passer domesticus) and in a goldcrest (Regulus regulus), which led us to a description of this unusual parasitic disease, whose cycle still remains unknown, and to a review of the prior known appearances in Switzerland. In the time between 1960 and 1989, a total of 2070 wild birds were examined in our Institute. In only four cases could an infection with C. faba be demonstrated. All of the affected birds belonged to the order of the Passeriformes. The occurrence rate of infestation among all wild birds was of 0.2%, and of 0.6% within the order of the Passeriformes. On the basis of this infection rate in our samples, we conclude that the rate of C. faba infections in wild birds of Switzerland is extremely low. PMID- 1771406 TI - [Intestinal cellular reaction of cattle after infection by Fasciola hepatica]. AB - Defence reactions of cattle against Fasciola hepatica take place not only in the liver but also on a prehepatic level. The aim of the present experiments is to identify and quantify the cellular response in the small intestine. Five groups of two bulls (Simmental x Red Holstein, 6 months old) were infected by oesophageal probe with metacercariae of F. hepatica (MC) according to two experimental procedures. Two groups of bulls served as controls. In the first experiment both infected groups received 1000 MC once or twice at an interval of five weeks. The intestinal tissue was taken before infection and 5, 10 and 19 weeks p.i., respectively 5 and 14 weeks p. reinf. (p.ri.). In the second experiment, three infected groups received 400, 2 x 400 MC (at an interval of five weeks) and 800 MC respectively. Biopsies were taken one week ante infectionem, 6, 11 and 19 weeks p.i., respectively 1, 6 and 14 weeks post reinfectionem (p. ri.). The biopsies of the small intestine were prepared for histology and the tissue sections stained as follows: Astra blue for mucosal mast cells (MMC), Lendrum for eosinophils (EOS) and Periodic Acid Schiff (PAS) for goblet cells (GC). The density of the three cell populations in the mucosa was determined microscopically and quantified. In both experiments the density of the MMC and EOS increased with each reinfection and depended on the infectious dose. There was no significant variation of the GC-numbers. The described intestinal cellular reactions suggest a participation of the small intestinal wall in the immunity against the common liver fluke. PMID- 1771407 TI - [Fish diseases in Switzerland. A statistical evaluation of the diagnostic materials of the fish research laboratory from 1979-1988. I. General aspects]. AB - The entire diagnostic material of the Fish Disease Laboratory at the University of Berne from 1979 to 1988, a total of more than 3800 cases, is presented. Not included is material of import controls and material from experimental work. The following criteria were evaluated: fish species, origin and length of fish, season, infectious and noninfectious diseases. Furthermore, the results were investigated for changes of the composition of fish species and number of diseases within the ten-year period and for a seasonal influence on the outbreak of diseases. More than 40% of all fish investigated were rainbow trout, followed by brown trout, omamental fish and cyprinids. Over 40% of fish originated from private fishfarms whereas 20% were of governmental origin (governmental fishfarms, rivers, lakes) and 20% from aquaria. Parasites were present in more than 40% of all cases. Bacterial infections were diagnosed in nearly 30%, viral infections in 6% and fungal diseases in 5% of all cases. 20% of all cases concerning noninfectious diseases were caused by unfavourable environmental conditions whereas the incidence of diseases related to nutrition was less than 10%. The occurrence of the different diseases was waxing and waning over the period of ten years but no definite tendencies could be emphasized. However, most of the diseases investigated demonstrated a significant seasonal influence. PMID- 1771408 TI - Comparative studies on various assays for the laboratory evaluation of r-hirudin. AB - Several laboratory methods are available to measure r-hirudin, including clot based, amidolytic, immunologic, and physicochemical techniques. The global tests, such as the PT, APTT, and Heptest, did not show an adequate response to r-hirudin in the range of 0.5 to 10.0 micrograms/ml, where full anticoagulation is achieved, as determined by animal models of thrombosis. The 10 U/ml thrombin time assay was very sensitive to r-hirudin, whereas the 10 U/ml calcium thrombin time gave a dose-dependent response from 0.15 to 10.0 micrograms/ml. Whole blood clotting assays (ACT, TEG) effectively measured r-hirudin levels up to 25 micrograms/ml. The amidolytic anti-Factor IIa assay, specific for evaluating direct thrombin inhibition, was very effective, particularly when modified to decrease the sample: thrombin ratio for higher r-hirudin concentrations. This assay may be useful in quality control, since it is biochemically defined and reagents are easily standardized. Thrombin generation assays based on synthetic substrates showed limited effect of r-hirudin; however, assays based on TAT complex and prothrombin fragment F1+2 generation showed a dose-dependent response. Immunologic methods (ELISA) are under development. Since these assays measure both complexed and noncomplexed hirudin, and since they are only sensitive to submicrogram levels, they may only be useful for the direct quantitation of absolute levels of r-hirudin but not for monitoring clinical anticoagulation. Thus, thrombin-based clotting, amidolytic, and immunologic assays can be used to evaluate and measure r-hirudin. However, optimization of each assay to respond to high and low concentrations of r-hirudin and their application to clinical monitoring, batch control, and standardization needs to be determined. PMID- 1771409 TI - Hirudin and platelets. PMID- 1771410 TI - Toxicology of hirudin. PMID- 1771411 TI - Neutralization of recombinant hirudin: some practical considerations. PMID- 1771412 TI - Pharmacokinetics of hirudin. PMID- 1771413 TI - Report on a discussion forum: "Medical and surgical application of recombinant hirudin". PMID- 1771414 TI - Hirudin. PMID- 1771415 TI - The comeback of hirudin as an antithrombotic agent. PMID- 1771416 TI - Isolation and characterization of hirudin from Hirudo medicinalis. PMID- 1771418 TI - Structure-activity relationships of recombinant hirudins. AB - The complex formation between thrombin and hirudin is unique among other serine proteinase-inhibitor complexes. The serpines occupy the specificity pocket of the active site of the target enzyme with an amino acid residue corresponding to the specificity of the enzyme at the P1 site of the substrate. In contrast, the Thr2 residue of hirudin approaches only the entrance of the pocket. The peptide chain of the inhibitors D-Phe-Pro-ArgCH2Cl and NAPAP is antiparallel to the enzyme backbone, whereas the N-terminal amino acids of hirudin run parallel. These unexpected interactions seem to contribute to a greater extent to the tight binding than the ionic interactions of the hirudin tail with the fibrinogen binding site of thrombin. Obviously, these interactions account for the unique selectivity of hirudin for thrombin. PMID- 1771417 TI - Recombinant hirudin: genetic engineering and structure analysis. PMID- 1771419 TI - Methods for determination of hirudin. PMID- 1771420 TI - [Technical measuring procedures for 3-dimensional movement analysis of experimentally-induced fractures of the thoracolumbar spine and initial results]. AB - Biomechanics and motion following fractures of the thoracolumbar spine have not yet been clarified. The motion acts in 6 degrees of freedom: three rotations and three translations parallel to the system of coordinates. The problem is to measure each rotation and each translation individually. This requires a method allowing precise three-dimensional evaluation of the motion that takes place in the genesis of a spine fracture. This technique should not influence the experiment, should give exact data over a wide range of measurement and, finally, should require as little equipment as possible. To fulfil these conditions we have developed a "double cube" model. Cadaver spine units from T11 to L3 were used. T11 was blocked with T12 and L2 with L3. These blocks were used to fix the spine in a testing machine so that a wedge-compression fracture could be produced in L1. Dorsal to each of the blocks one cube was mounted, the caudal one fixed while the cranial one could be moved by the machine. In the caudal cube a right handed cartesian system of coordinates was defined, in which the vertebrate above would move and break. This technique can be used to describe either physiological or fracture experiments or, for example, to compare stability tests for different fixation devices. It is demonstrated that precise three-dimensional description of the biomechanics of vertebral fractures is possible with little and simple equipment. The cubes in this model are easily to integrate in the experiment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771421 TI - [Dorsal fixation of the thoracic and lumbar spine with grooved plates in combination with the Universal Spine Instrumentation System. A short stretch, angle-stable alternative]. AB - In the Department of Surgery in the University Hospital "Bergmannsheil" in Bochum, 67 patients with unstable injuries of the thoracic and lumbar spine were analyzed in a retrospective study. The sagittal correction loss was greatest about 6 months after dorsal stabilization--6 degrees on the average--after stabilization with a plate alone. The correction loss after stabilization with plates combined with the Universal Spine Instrumentation System (USIS), which was developed for ventral derotational spondylodesis or after implantation of an internal fixation device, however, amounted to 3 degrees on the average. The clinical results show that by combining the plate and USIS the injuries can be stabilized for short stretches and without correction loss. The main advantage of this combination over internal fixation is the smaller amount of metal used, which means the soft tissue in loss compromised and there is a possibility of fitting the implant more directly. In 10 patients (15%) the implants broke at the place of maximum shear stress between 4 and 8 months postoperatively after consolidation of the fracture and without spoiling the result. This occurred equally often with all types of implants. Efficient use of the three systems is discussed with regard to the different pathomechanical modes of injury. A causative scheme of treatment is presented. PMID- 1771422 TI - [Reposition of dislocated dorsal vertebral wall fragments in fractures of the thoracolumbar transition and the lumbar spine. Experience with 35 cases]. AB - Pre- and postoperative CT scans of 35 patients with fractures of the thoracolumbar and lumbar spine (20 men and 15 women, with a mean age of 35 years), were evaluated with reference to the extent and shape of spinal stenosis. There were 24 patients with wedge-shaped fragments compressing the canal, the wedge being intact in 14 and broken in 10; 3 had fragmented wedges; and in 5, pedicular or arch fragmentation was combined with the dorsal vertebral fractures mentioned. Spinal stenosis was due to flexion-distraction injuries with angulation 3 patients, 1 of whom showed signs of dislocation and compaction. Fixation was done with the fixateur interne (F.I.) in 28 patients (combined with remodeling in 2), while 7 patients underwent plating with Teinturier plates and screws from the USI program. Burst fractures were most commonly encountered (25 patients) followed by flexion-distraction injuries of different types (10 patients). Instrumented reduction of the vertebral fragments was done in 24 patients. The effects of ligamentotaxis alone were relied upon in only 2 patients. Mean spinal canal narrowing amounted to slightly more than 50% (0.56) preoperatively. Residual narrowing postoperatively was just over 25% (0.26). In the patients followed up there was no evidence of secondary dislocation since the postoperative findings had been recorded. (ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771423 TI - [Knee joint hemarthrosis. An absolute indication for operation?]. AB - The degree of severity of an injury of the knee joint is estimated mainly on the basis of the history given by the patient, stability testing and hemarthrosis. Once these are known the surgeon usually decides whether an arthroscopy should be done or not. In a group of 365 patients who had undergone arthroscopy after acute knee injury, we made a retrospective check of the indications. The purpose of the study was to evaluate the sensitivity of hemarthrosis as an indicator of severe injury of the knee joint necessitating operative treatment. For stability testing we used the varus and valgus stress test, the Lachman test, the Anterior drawer test, the pivot shift test and the anterior drawer test with medial and lateral rotation. The Lachman test was repeated under general anesthesia in the majority of patients just before the arthroscopy. The results were evaluated retrospectively with the aid of electronic data processing. In nearly 70% of cases the arthroscopy was indicated because of positive signs of instability together with a typical history provided by the patient or hemarthrosis. In another 27%, the hemarthrosis was the sole reason for the surgeon's decision to perform an arthroscopic investigation of the injured knee joint. In 80.5% of all cases the clinical diagnosis of lesion of the anterior cruciate ligament (ACL) or combined injury to ligaments and menisci was confirmed by the arthroscopy. In addition to this group, in another 10.8% we found other severe lesions necessitating by operation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771424 TI - [Value of sonography of the anterior cruciate ligament in post-traumatic hemarthrosis]. AB - Periosteal avulsions of the femoral insertion of the anterior cruciate ligament (ACL) should be treated by reinsertion within 2 weeks of the injury. Due to painful muscular hypertension, the clinical examination of ligament stability incorrectly revealed negative results in 12-62% posttraumatically. The only sufficiently sensitive indication of ACL rupture is posttraumatic hemarthrosis. Therefore, early arthroscopy of any posttraumatic hemarthrotic knee joint is required to exclude or confirm ACL rupture. Up to 30% of such procedures are carried out with no clinical consequences. We therefore set out to test the value of sonography of the ACL in hemarthrosis of the injured knee joint. A total of 117 posttraumatic hemarthrotic knee joints were subjected to ultrasound examination prior to arthroscopic evaluation. With a 5 MHz linear scanner, the femoral insertion of the ACL at the femoral condyle is represented in the same projection of injured and noninjured knee joints. In noninjured knee joints the hypoechoic insertion of the ACL lies directly on the S-shaped line of the lateral femoral condyle. The space between the condyles is hyperechoic. In case of a femoral ACL avulsion the insertion of the ACL and the hyperechoic structures between the condyles are forced aside by a hypoechoic area. Of 51 arthroscopically demonstrated complete ruptures of the ACL, 49 were detected by sonography. In 16 cases sonography suggested ACL rupture, but this could not be confirmed by arthroscopy, though 8 of these cases showed evidence of ACL strain without any lost of stability of the knee joint. For sonography we found a sensitivity of 96.1% and a fairly good specificity of 75.2%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771425 TI - [Axis-related spontaneous correction after tibial fractures in childhood]. AB - In the Department of Surgery at the Bergmannsheil University Hospital, a total of 50 children with measurable post-traumatic deformity of the axis after fracture of the lower limb were examined. Clinical and radiological monitoring was carried out 6 years after their accidents, which they had sustained at the age of 3-15 years. The real degree of axis deformity remaining was determined mathematically, and the correction tendency was analysed in three dimensions and projected graphically using sum vectors. This showed better results in the correction of axis deformations of the lower limb visualized on a-p X-ray photographs as varus or valgus than of deformations seen as ante- and recurvation of lateral X-ray photographs. The excentric arrangement of muscles in the dorsal part of the lower limb could be one reason for this. All 50 patients experienced a reliable spontaneous correction of the axis deformity with no complications of stimulatory growth disturbance with showing good functional results. Shaft fractures of the lower limb in children are generally treated conservatively, operative treatment being indicated only in the case of severe lesions of the soft tissue and in adolescent patients. PMID- 1771426 TI - [Unreamed tibial nail in tibial shaft fractures with severe soft tissue damage. Initial clinical experiences]. AB - In a prospective study, since March 1989, 55 tibial shaft fractures have been treated with a new, unreamed solid tibial nail (UTN). This nail was initially designed as a temporary implant. The first 33 cases with second or third degree soft tissue damage were reviewed 6 months or more after the operation. Fractures were classified according to Muller: 6 type A (18.2%), 15 type B (45.5%), and 12 type C (36.7%). In 9 cases (27.3%), there was GII (n = 4) or GIII (n = 5) closed soft tissue damage according to Tscherne's classification. The 24 open fractures (72.7%) comprised 11 OII, 3 OIIIA and 10 OIIIB fractures (Gustilo classification). 24 patients (72.7%) were polytraumatized, the mean PTS (Hannover Polytrauma Score) was 18 points (range: 8-65 points). All fractures were stabilized without reaming. The implant diameter was 8mm (n = 14) or 9 mm (n = 19). Static locking was performed in 31 cases. Dermatofasciotomy was necessary because of compartment syndrome in 14 cases. In 1 grade IIIB open fracture soft tissue coverage was performed with a latissimus dorsi myocutaneous free flap 4 days after nailing. In 32 of the 33 cases the use of an additional cast or brace was not necessary during the follow-up treatment; 1 patient had a cast for 8 weeks for the treatment of accompanying injuries. Full weight-bearing was achieved in 5 cases within 3 weeks, in 16 cases within 12 weeks, and in 30 cases within 26 weeks. In 16 cases (48.5%) the interlocking screws were removed after 5 26 weeks (mean: 10 weeks).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771427 TI - Four years of essential drugs' list in Nigeria. AB - A survey using questionnaires was carried out to determine the extent of awareness and acceptability of the Nigerian Essential Drugs' List and its effect on drug procurement and prescription pattern in some health institutions. Analysis of the responses showed that there was a 100% awareness on the part of the health professionals involved in the survey. Acceptability of the list was low: 96% of the sample group were of the opinion that the essential drugs' list should be abrogated. Medical doctors prescribe drugs without due consideration for the list while pharmacists stock and dispense drugs on a similar basis. The concept of the essential drugs' list has not been included in the curricula of the universities and other teaching institutions studied. It was also found that essential drug supply by manufacturers in Nigeria is inadequate. PMID- 1771428 TI - Self care: Japan and the U.S. compared. AB - Experience of common symptoms and subsequent self care behaviors among older adults are compared between Japan and the United States, two industrial countries with different cultural backgrounds and health insurance systems. Based on a modification of the Health Belief Model, perceived susceptibility to illness and belief in the efficacy of physician care were selected as major explanatory concepts for the decision to use self care for a complaint. Among 900 respondents in Japan and 728 in the United States, in three communities of varying size, self evaluations of good health, an indicator of low susceptibility, were very similar. Although Japanese respondents claimed fewer experiences of physician error, they still expressed lower preference for physician care than did those in the U.S. In addition, the Japanese reported far fewer symptoms than their U.S. counterparts during a three month period, and were more likely to use self care, even for symptoms they considered more serious. Disparate effects of such variables as good health behaviors, presence of a chronic condition and desire for autonomy are discussed in terms of cultural differences in the two countries. PMID- 1771429 TI - Core-periphery differences in children's health and use of general practitioner services in Finland from 1964 to 1987. AB - Finland is a modern welfare state in Northern Europe especially proud of its development of programs for children's health. The aim of this study was to investigate the development of core-periphery differences in children's health and use of health services. The study material was obtained from the national health and social security interview survey carried out in 1964, 1968, 1976 and 1987. Age standardized prevalence of chronic diseases, number of restricted activity days and physician contacts were presented for two age groups: 0-6-year olds and 7-14-year-olds. The prevalence of chronic diseases was quite similar in the core and periphery in 1976 and 1987, but the number of restricted-activity days throughout the study period (1964-1987) was significantly higher in the core than in the periphery. The consistently higher frequency of physician contacts in the core in comparison with the periphery was spectacular; the welfare policy of the last decades seems to have had very little or no effect on this difference. The core-periphery division thus continues to have relevance with respect to the health of Finnish children. PMID- 1771430 TI - Daily hassles and chronic strains: a hierarchy of stressors? AB - Among 105 poor, male heads of household in an urban center of India, common daily hassles were similar to those experienced by individuals from economically advantaged, western countries. However, we did not replicate the correlation between hassle frequency and mental health problems that has been previously found in a middle-class, western sample. In contrast to daily hassles, which include low-intensity, relatively discrete stressors (e.g. disagreement with spouse, missing a bus), chronic strains include ongoing social and environmental conditions that represent high-intensity stressors (e.g. substandard housing, inadequate access to water) that threaten survival. We found that chronic strains were associated with greater levels of psychosomatic symptomatology, as well as lower perceived social support. Furthermore, the correlation between chronic strains and psychosomatic symptoms increased when the effects of income were statistically controlled, suggesting that income attenuates the effects of chronic strains and that chronic strains affect symptoms independent of income. In sum, chronic strains may be a more valid and potent stressor than daily hassles in poor, urban populations in developing countries. PMID- 1771431 TI - A model of willingness to become a potential organ donor. AB - This article presents two models of the decision to become a potential organ donor. In the first model the act of carrying or requesting an organ donor card is related to values and factual knowledge regarding organ donation, through intervening attitude and willingness constructs. A sample of 286 students is used to test this model via the LISREL computer program for modeling latent variables. All hypothesized relationships had the predicted sign and were significant. This model is extended by adding the variables attitude towards death, prior blood donation, and age of subject to the model. A second sample of 365 adults from the local community is used to test the second model via LISREL. With two exceptions in the adult sample, all hypothesized relationships had the predicted sign and were significant. Where the two models overlap the results are generally similar. Implications of the models for marketing the act of becoming a potential organ donor are discussed. PMID- 1771432 TI - Doctors' willingness to intervene in patients' drug and alcohol problems. AB - A telephone survey of 103 Sydney general practitioners (GPs) was conducted to assess the extent of agreement or disagreement with 15 statements originating from an earlier, focus groups study, concerning patients' drug and alcohol problems. Another aim of the present study was to determine whether the results provided evidence for a typology of general practitioners. A cluster analysis indicated the presence of three groups: Interactive Problem Solvers; Traditionalist Healers and; Distant Technologists. However, a subsequent principal components analysis and re-examination of the distributions of scores lead to the preferred explanation that the survey was measuring a continuous dimension--"Willingness To Intervene" (WTI). Overall, the GPs' responses suggested high levels of willingness to intervene, although older doctors showed less willingness to intervene than younger doctors. Implications of these findings for medical educators are discussed in relation to evidence that, in practice, doctors often fail to intervene in patients' drug and alcohol problems. Willingness to intervene is viewed as one of several necessary factors, such as knowledge, clinical skills and self efficacy, none of which are sufficient alone to guarantee intervention. Arising from consideration of the willingness to intervene dimension, a general model of probability of medical intervention is outlined. PMID- 1771433 TI - The effect of widowhood on health: a prospective analysis from the Massachusetts Women's Health Study. AB - Previous research has consistently demonstrated adverse physical and psychological effects following the death of a spouse. Conclusions regarding the effects of widowhood have been hampered, however, by such methodological limitations as lack of adequate comparison groups, non-random samples of the widowed, and lack of data on pre-widowhood status. This paper examined the physical and psychological effects of widowhood in a randomly sampled cohort of women, aged 45-55 years at baseline, who were followed prospectively for five years. Analyses employed a design in which women whose spouses died during the course of the study (N = 76) were compared to age-matched married controls (N = 1625). The following two questions were addressed: (1) What are the physical and psychological effects of widowhood? and (2) What is the effect of widowhood on socioeconomic factors, social support and health behavior? Following the death of a spouse, the percentage of widows reporting psychological symptoms increased. The widows did not report higher rates of physical symptoms or a decrease in health. Widows had higher rates of health care utilization, in particular, taking prescribed medication, which were in part for mental health reasons. There was no evidence of changes in health behaviors among the widows, but social support increased following widowhood and more widows reported a decrease in income. The results highlight the importance of controlling for pre-widowhood status when studying the consequences of widowhood and provide additional evidence that widowhood may not adversely affect physical health for women. PMID- 1771434 TI - Psychological sequelae of infertility treatment: the role of gender and sex-role identification. AB - Infertility has traditionally been viewed as a female problem and women have been expected to suffer greater psychological distress due to infertility. This paper investigates the nature of gender differences and sex-role identification in the psychological sequelae associated with infertility treatment. The expectation that infertile women experience higher distress levels than men was not supported by these data. No gender differences were observed in either the level of emotional strain, marital adjustment, or sexual satisfaction for the 104 couples studied. However, gender differences were apparent in factors associated with psychological distress, suggesting that while the level of strain might be comparable, the experience of infertility is different for men and women. Sex role identification was found to have a greater relationship to the indices of distress than gender. Masculinity was associated with lower emotional strain and greater marital satisfaction for both genders and enhanced sexual satisfaction for men. Femininity was related to enhanced marital and sexual satisfaction for both genders. Gender differences and sex-role identification are discussed in the context of the unique experience of infertility. PMID- 1771435 TI - Professional home care for the elderly: an application of the Andersen-Newman model in The Netherlands. AB - The Andersen-Newman model, which relates the use of services to predisposing, enabling and need-for-care variables, has not often been applied to the utilization of professional home care by elderly people, especially not in Europe. In this study, the variables of this model were used to predict the amount of professional home care used by new users of this type of care. From the data it appeared that the 'predisposing' and 'enabling characteristics' of the elderly have relatively smaller effects on the amount of professional home care used than do the 'need characteristics'. This is consistent with previous research. However, in this study the amount of variance explained by the model as a whole is considerably higher than was reported elsewhere. This discrepancy, which can partly be attributed to the utility of variables and other methodological issues, is discussed. It can be concluded that, provided several aspects are taken into account, the Andersen-Newman model seems to be an adequate framework for selecting and sequencing relevant variables in the research on professional home care utilization by the elderly. PMID- 1771436 TI - Many people seek the opinion of a doctor when ill. PMID- 1771437 TI - The prevention of HIV infection from injecting drug use--a review of health promotion approaches. AB - This review examines the prevention of HIV infection among injecting drug users through the framework provided by the Ottawa Charter on Health Promotion. Among the key issues considered are the problems of achieving the changes in policy and service direction needed to prevent HIV infection. The role of the media in influencing public opinion is examined, together with the potential for traditional educational approaches to achieve safer practices among injecting drug users. The authors conclude that a better integrated and more comprehensive approach to HIV prevention may be needed for substantial progress to occur. A proactive response utilising outreach work is recommended for drug services, and health workers together with drug service professionals are encouraged to act as advocates in gaining public and political support for change. PMID- 1771438 TI - From development to sustained crisis: structural adjustment, equity and health. AB - We argue that the nature of the economic crises in sub-Saharan Africa cannot be understood outside the context of the legacy of colonialism and class formation. Structural adjustment programmes serve to exacerbate inequalities and threaten to reverse the social gains of the majority achieved through the struggle for independence, in the interest of the indigenous capitalist class. Under such circumstances social scientists have a social responsibility to take a stand against the current policies that have led to an unprecedented decline of the health status of the poor; their skills must be put at the disposal of the oppressed with a view to giving voice to the experiences and needs of the majority. PMID- 1771439 TI - Contradictions in the development of new hospices: a case study. AB - Despite a decade of concern about the 'mushrooming' of new hospice developments within the British Isles, we remain remarkably ignorant about the processes which lead to the initiation of new hospice projects and the factors which affect their progress. Three inter-related issues appear important: (1) policy and resource implications; (2) changing models of hospice care; (3) 'community' factors. This paper explores the interconnections between these, using a case study approach and describes in detail the efforts of a single local voluntary group to establish a programme of community care for dying people. It shows that: (1) local 'communities' are likely to make continued demands for hospice type care, despite official scepticism about proliferation; but also that these communities should not be seen as homogeneous in their aspirations and demands; (2) new models of community care will interact with wider policy changes in the NHS and Social Services to raise questions about how terminal care services can be further developed; (3) shifts away from traditional in-patient models of care are likely to high-light divisions between 'lay' and 'professional' groups in their perceptions of how services can be delivered. PMID- 1771441 TI - [Prediction of dangerous behavior]. PMID- 1771440 TI - [Give me a stimulant]. PMID- 1771443 TI - [Masked auto-aggression and pathomimia]. PMID- 1771442 TI - [Emergency psychiatry. Dangerous behavior in the rural milieu]. PMID- 1771444 TI - [Alcohol and dangerous behavior]. PMID- 1771445 TI - [Dangerous behavior. The difficulties for an expert]. PMID- 1771446 TI - [Psychiatric emergencies and dangerous behavior]. PMID- 1771447 TI - [Psychiatric emergencies]. PMID- 1771448 TI - [Emergency therapies in psychiatry. Indications, precautions and contra indications]. PMID- 1771449 TI - [Transitional workshops]. PMID- 1771450 TI - [Psychodynamic approach to violence]. PMID- 1771451 TI - [A severe coma in a drug abuser]. PMID- 1771452 TI - [Behavioral and cognitive therapies for depression]. PMID- 1771453 TI - [The management of stress]. PMID- 1771454 TI - [Day hospital. Training group in social communication]. PMID- 1771455 TI - [Children and adolescents. Cognitive and behavioral approach]. PMID- 1771456 TI - [The mobilization of nursing. A question of sense]. PMID- 1771457 TI - [Behavioral and cognitive therapies]. PMID- 1771458 TI - [Female prison]. PMID- 1771459 TI - [From doing nothing to not doing nothing]. PMID- 1771460 TI - [Treatment of panic attacks. Hyperventilation, respiratory control, behavioral cognitive therapy]. PMID- 1771461 TI - [Why the resignations?]. PMID- 1771462 TI - [The obsessive-compulsive patient. Cognitive and behavioral management]. PMID- 1771463 TI - Early diagnosis of cervical spondylotic myelopathy. A useful clinical sign. AB - This is a retrospective study of 67 patients, seen during a 4-year period, with cervical pathology requiring surgical correction. The purpose of this study was to evaluate the usefulness of a new physical finding (dynamic Hoffmann's sign) in diagnosing early cervical myelopathy or in suggesting a narrow cervical canal clinically. Hoffman's sign was checked with the head in neutral (static) and during multiple active full flexion to extension as tolerated by the patient (dynamic). Forty patients had negative Hoffman's signs, 20 had positive static Hoffman's signs, and 7 had positive dynamic Hoffman's signs. Canal measurements were made on eight randomly selected negative patients on both plain films and myelographic studies, and on the seven positive patients. A positive dynamic Hoffmann's sign was consistent with a narrow sagittal diameter of the cervical canal, and aided clinically in making the diagnosis of early cervical spondylotic myelopathy or congenital cervical narrowing. PMID- 1771464 TI - Iohexol cervical myelography in adult outpatients. AB - The incidence of adverse reactions following standard film or screen cervical myelography with iohexol in 32 adult outpatients was reported. Iohexol at a dose of 1,080-3,000 mg of iodine was administered via a lateral C1-C2 approach in 26 patients and via a lumbar route in 6 patients. All 32 patients underwent postmyelographic cervical spine computed tomography and were discharged after the procedure was completed. No adverse reactions occurred in 53.1% of patients. The most common adverse reaction was headache (31.3%); other minor adverse reactions included exacerbation of pre-existing pain (12.5%), neck stiffness (9.4%), and vomiting (6.3%). Good to excellent technical quality was seen on all myelograms and computed tomographic scans. Outpatient cervical myelography with iohexol appears to be a safe and cost-effective alternative to inpatient examination. PMID- 1771465 TI - Spinal cord monitoring in patients with nonidiopathic spinal deformities using somatosensory evoked potentials. AB - Seventy-nine somatosensory evoked potentials were intraoperatively recorded in 52 patients undergoing spinal surgery for nonidiopathic spinal deformities. There were 37 true-negative, 28 true-positive (a significant change in the somatosensory evoked potential related to the surgical process), and 14 false positive (a significant change in the somatosensory evoked potential not related to a surgical event) readings. There were, however, no postoperative neurologic deficits with any of the true-positive readings and no false negatives. Spinal and subcortical somatosensory evoked potentials gave few false-positive readings. True-positive somatosensory evoked potentials occurred in 44% of the patients with neuromuscular deformities, 17% with congenital deformities, 45% with Luque instrumentation, 22% with Harrington instrumentation, and none with fusion in situ. Fifty percent of the true positives occurred while the sublaminar wires were tightened. The predictive accuracy of intraoperative spinal cord monitoring in this patient population is not high, but the sensitivity to potentially harmful surgical events is high. PMID- 1771466 TI - Symptomatic spinal epidural lipomatosis induced by a long-term steroid treatment. Review of the literature and report of two additional cases. AB - Spinal epidural lipomatosis associated with Cushing's syndrome is an uncommon complication (11 reported cases). Two additional symptomatic cases with neurologic deficit are described. Steroid treatment was systemic in the first case and local with epidural injections in the second. The second case is unique because no similar observations have yet been reported. In most cases, a preoperative computed tomographic scan establishes the diagnosis by demonstrating dural compression by an adipose mass. Myelography is far less specific. In some cases, the exact diagnosis is made at the time of surgery. The treatment is primarily surgical, with laminectomy over the length of the compression and the removal of the compressing fat. Neurologic recovery is dependent on two factors: the level of the compression and the adequacy of decompression. PMID- 1771467 TI - Clear fluid from a spinal fracture-dislocation does not always mean dural tear. A case report. PMID- 1771468 TI - The use of the operating microscope for cervical foraminotomy. PMID- 1771469 TI - Cruciate paralysis secondary to C1 on C2 fracture-dislocation. PMID- 1771470 TI - Use of the lateral scout image as an adjunct to computed tomography-guided spinal biopsy. PMID- 1771471 TI - Foraminotomy rongeur. PMID- 1771472 TI - Distribution of the 3.05-Mdal "Toronto" beta-lactamase plasmid among penicillinase-producing isolates of Neisseria gonorrhoeae in the Far East. AB - One hundred and fifty-two beta-lactamase-producing Neisseria gonorrhoeae isolates from Japan (n = 25; 1983, 1985, 1986), Taiwan (n = 14; 1983, 1984), and the Republics of Singapore (n = 58; 1986, 1987) and the Philippines (n = 55; 1989) isolated from 1983 through 1989 were characterized by auxotype, serovar, and plasmid content to determine the distribution and diversity of penicillinase producing N. gonorrhoeae (PPNG) strains possessing the 3.05-Mdal "Toronto" beta lactamase plasmid. PPNG isolates possessing a 3.05-Mdal beta-lactamase plasmid were isolated in Japan (1/25: 4%), Taiwan (4/14: 29%), and the Republic of the Philippines (3/55: 5%); no PPNG isolates with the 3.05-Mdal plasmid were isolated in the Republic of Singapore. All isolates possessing the 3.05-Mdal plasmid also possessed a 24.5-Mdal conjugative plasmid and belonged to the auxotype/serovar class, Proto/IB-1. Studies with five isolates possessing the 3.05-Mdal plasmid, and representing isolates from each country in which they were found, confirmed that the beta-lactamase plasmid in these strains could not be transferred to another gonococcal isolate by conjugation. PPNG isolates possessing the "Toronto" plasmid are widespread in the Far East; spread of these isolates may, however, be limited to the physical spread of a single strain. PMID- 1771473 TI - Epidemiologic characteristics of two different populations of women with Chlamydia trachomatis infection and their male partners. AB - Two groups of women under the age of 26 with chlamydial infection (A-asymptomatic women from a screening program, B-traditional STD clinic patients) and their partners were compared with respect to history of STD, sexual behavior, contraception, and indices for income and social welfare expense. The mean number of partners was 1.3 in group A and 1.8 in group B. Women in group B, in spite of more frequent condom use, demonstrated greater risk behavior both with respect to STD and to unwanted pregnancy and also had higher indices for social welfare expense. More group A partners than group B partners were asymptomatic and chlamydia negative. Group B partners also more often had low income as well as high social welfare expense indices. In both groups, complicated chains of transmission were found, and the need for expert contact tracing in both types of patient groups is stressed. PMID- 1771474 TI - Notification of the sex and needle-sharing partners of individuals with human immunodeficiency virus in rural South Carolina: 30-month experience. AB - The authors conducted a confidential and voluntary partner notification program to identify and educate the sex and needle-sharing partners of individuals with the human immunodeficiency virus (HIV) in a rural health district in South Carolina. During the first 30 months, of 485 named contacts, 290 (60%) were residents of the health district and were contacted and offered testing. Of the 290 contacted, 280 (97%)--53 women and 227 men; age range 14-74 years--accepted counseling and testing and 49 (18%) were HIV-antibody positive. Only 3 of the 49 (6%) had been previously tested. All HIV-infected individuals received appropriate physician, laboratory, and public health referrals. During the study, the mean number of sex partners per 6-month period decreased from 5.6 to 1.1 (80% reduction) for HIV-antibody positive persons and from 4.0 to 2.0 (50% reduction) for HIV-antibody negative persons. The authors conclude that in a rural setting, partner notification of HIV exposure can accurately target education and testing and can produce positive behavior change. PMID- 1771476 TI - Neisseria meningitidis in specimens from urogenital sites. Is increased awareness necessary? AB - Neisseria meningitidis serogroups B type 2 and Y were isolated from urogenital specimens from three heterosexual patients. The first patient was a young man with the clinical signs and microscopic findings of a typical gonococcal urethritis. The second was a middle-aged woman with cervicitis, in whom neither Neisseria gonorrhoeae nor Chlamydia trachomatis were demonstrated by culture. In the third patient, a young woman, N. meningitidis was associated with cervicitis, acute salpingitis, and peritonitis. The patients' clinical symptoms responded quickly to antibiotic treatment. Meningococci of the same serogroup/serotype as the index cases were demonstrated in two of the sexual consorts in pharyngeal specimens but not in genitourinary specimens. Orogenital sexual practice seemed to be the most likely route of transmission. During the period of this study (August 1989-March 1990), the three meningococcal strains observed at the authors' laboratory represented 20% of the total number of urogenital isolates of pathogenic Neisseria. A greater awareness of this problem from medical, diagnostic, epidemiologic, and legal viewpoints is therefore needed. PMID- 1771477 TI - A retrospective study of efforts to diagnose infections by Chlamydia trachomatis in a Swedish county. AB - Diagnostic work on the detection of Chlamydia trachomatis infections in Uppsala county, Sweden, during the period from April 1985 to March 1991 was studied. The number of patients examined for C. trachomatis in this area increased annually by 6% to 15% during the study period, reaching 17,224 test occasions by the last 12 month period. A 40% decrease (from 1,412 to 852; or from 565 to 326 cases per 100,000 inhabitants) in diagnosed C. trachomatis infections was noted between the first and the last 12-month period. No significant tendencies were evident in either age distribution or sex ratio in the detected cases during the study period. Intensified sampling work was noted at youth clinics and maternal health care centers, while the dominant role of the venereal disease clinic as case detector declined steadily. The results have been interpreted in the context of available national figures for Sweden. PMID- 1771475 TI - A voluntary serosurvey and behavioral risk assessment for human immunodeficiency virus infection among college students. AB - The authors conducted a voluntary serosurvey and educational campaign among 3394 undergraduate students attending the University of Maryland at College Park to determine the prevalence of and risk factors for human immunodeficiency virus type 1 (HIV-1) infection. Two students were seropositive (0.06%, 95% confidence interval 0-0.15%). Both were homosexual men with multiple sexual partners. Despite the low prevalence of infection, potential risk factors for transmission of HIV-1 were common, as assessed by a self-administered anonymous questionnaire. These included a previous sexually transmitted disease (12.6%), male homosexual intercourse (4.8% of men), heterosexual anal intercourse (25.3%), heterosexual intercourse with a person at risk (an HIV-1 infected person, a bisexual man, a parenteral drug user, a female prostitute, or a hemophiliac) (5.2%), multiple sexual partners (21% reported 10 or more lifetime partners), and intravenous drug use (1.3%). Assessment of the efficacy of our program by comparing responses on pre- and post-test questionnaires showed gains in knowledge about heterosexual transmission of HIV-1 and an increase in the reported frequency of condom use 1-2 months after participating in the survey. The authors conclude that HIV-1 infections are occurring among college students but in our study group remain confined to persons with known high-risk behavior; however, practices that may support transmission are common, and programs designed to diminish these behaviors among college students are needed. PMID- 1771478 TI - Neisseria gonorrhoeae in Athens, Greece. Epidemiologic classification and antimicrobial susceptibility patterns of strains isolated between 1986 and 1989. AB - The incidence of gonorrhoea cases diagnosed in a major venereal hospital of Athens, Greece, was markedly reduced between 1986 and 1989. All 182 gonococcal isolates found during this period were epidemiologically classified into Sero /Auxo-/Plasmid content (S/A/Pc) types. Susceptibility to six antimicrobials was also determined. Penicillinase-producing Neisseria gonorrhoeae (PPNG) strains were isolated in an increased frequency of 7.7% and a striking shift in their distribution into S/A/Pc types was noted from previous years. The isolates exhibited wide heterogeneity of type: none of the 14 PPNG strains was identical, while the 168 non-PPNG strains were distributed into 64 S/A/Pc types. Fifty-seven percent (57%) of the PPNG and 86% of the non-PPNG isolates were of the WII/III serogroup. Chromosomally mediated resistance to penicillin, ampicillin, or both was exhibited by 14% of the non-PPNG isolates. Greater frequency of reduced susceptibility to cefotaxime, tetracycline, and chloramphenicol was also found among PPNG and non-PPNG strains, mostly of the WII/III serogroup. Twelve percent (12%) of the non-PPNG and 57% of the PPNG strains had multiple patterns of resistance, involving 2 to 4 antimicrobials of different class lines. PMID- 1771479 TI - [Progress of ultrasound diagnosis of veins]. PMID- 1771480 TI - [Intraluminal ultrasound diagnosis in assessment of arteriosclerotic vascular changes]. PMID- 1771481 TI - [FLuid dynamic aspects of atherogenesis and thrombogenesis]. PMID- 1771482 TI - [Color-coded duplex sonography of arteries of the extremities--possibilities for diagnosis and therapy follow-up]. PMID- 1771483 TI - [Role of fluid dynamic factors in the development and progression of atherosclerosis, thrombosis and aneurysms]. PMID- 1771484 TI - [Shockwave angioplasty using a tissue differentiating color laser]. PMID- 1771485 TI - [Quantifying the degree of stenosis with duplex sonography in patients with arterial occlusive disease of the lower extremities]. PMID- 1771486 TI - [Conventional and color-coded duplex sonography of the carotid arteries following thrombendarterectomy]. PMID- 1771487 TI - [Ultrasound diagnosis of the carotid arteries; what are the advantages of color coded duplex sonography?]. PMID- 1771488 TI - [Value of duplex sonography in diagnosis of renal artery stenosis]. PMID- 1771489 TI - [Duplex sonographic measurement of maximal and intermediate blood flow velocity in an interapparative and interindividual comparison modeled by the popliteal artery]. PMID- 1771490 TI - [Value of the systolic delay time index and height-width index in comparison with pulsatility index]. PMID- 1771491 TI - [Doppler ultrasound detection of extracranial and peripheral macroangiopathy in diabetes mellitus]. PMID- 1771492 TI - [Duplex sonography of vertebral arteries]. PMID- 1771493 TI - [Interaction of geometric hemorheologic parameters in the development of secondary flow in elastic vascular models]. PMID- 1771494 TI - [Duplex sonography of the vertebral arteries. Concurrence or supplement to DSA?]. PMID- 1771495 TI - [Color-coded duplex sonography in primary diagnosis, monitoring and prognostic evaluation of fibrinolytic and conservative therapy of thrombophlebitis]. PMID- 1771496 TI - [Continuous wave Doppler spectral analysis, method and critical evaluation--a new Doppler concept for spectral analysis]. PMID- 1771497 TI - [Long-term Doppler sonographic study of patients with asymptomatic carotid stenoses]. PMID- 1771498 TI - [Correlation of arteriosclerosis of the carotid arteries and coronary sclerosis]. PMID- 1771499 TI - [Intraoperative, mechanical flow monitoring using 20-MHz microvascular Doppler- contribution to optimizing the reconstruction of the vascular anastomosis of the carotid artery]. PMID- 1771500 TI - Pathological aspects of carotid plaques: surgical and clinical significance. PMID- 1771501 TI - [Tumors of the glomus caroticum--diagnostic and therapeutic aspects]. PMID- 1771502 TI - [Video capillary microscopy studies of probands without and with occlusions of the finger arteries before and following hyper- and isovolemic hemodilution]. PMID- 1771503 TI - [Relation between capillary microscopy parameters and clinico-serologic data in patients with systemic lupus erythematosus]. PMID- 1771504 TI - [Fluorescence perfusographic hyperemia reaction of the foot sole in patients with intermittent claudication]. PMID- 1771505 TI - [Dermofluorography--bindings in scleroderma patients]. PMID- 1771506 TI - [Effect of hydrostatic pressure, environmental temperature and age, sex and smoking history on transcutaneous oxygen partial pressure measurement]. PMID- 1771507 TI - [Behavior of tissue oxygen pressure in skeletal muscle of patients with peripheral arterial occlusive disease in simulated altitude stress]. PMID- 1771508 TI - [Therapy follow-up of vascular surgery interventions by measuring tissue oxygen in arterial occlusive disease of the thigh]. PMID- 1771509 TI - [Effect of diabetic neuropathy on tcPO2 measurements for detection of reactive hyperemia and orthostatic vasoconstrictor reflex]. PMID- 1771510 TI - [Increase in skin microcirculation and oxygen tension and improved venous function in patients with combined arterial and venous circulatory disorders of the leg during and following lower leg immersion in water containing carbon dioxide]. PMID- 1771511 TI - [Aspects of transcutaneous measurement of oxygen partial pressure in patients with critical ischemia]. PMID- 1771512 TI - [2-channel measurement of the laser Doppler signal: an ultimate technique or technical play?]. PMID- 1771513 TI - [Livedo racemosa generalisata--studies in 12 patients]. PMID- 1771514 TI - [Incidence, risk profile and mortality rate of a sample of type II diabetic patients with albuminuria in general practice. A 3-year prospective follow-up study]. PMID- 1771515 TI - [Gunther vena cava filter. Results of long-term follow-up]. PMID- 1771516 TI - [Incidence of pulmonary embolism in relation to the site of thrombophlebitis]. PMID- 1771517 TI - [Echogenicity, a reliable parameter for determining the age of venous thrombosis?]. PMID- 1771518 TI - [Thrombocyte function as an indicator of thrombophilia in a cross-sectional study of patients with angiographically confirmed coronary sclerosis]. PMID- 1771519 TI - [Thrombophilia in patients with arterial occlusive diseases and its therapeutic modification]. PMID- 1771520 TI - [Thrombocytes, blood coagulation factors and fibrinolysis following aortocoronary venous bypass operation]. PMID- 1771521 TI - [Peripheral local lysis in deep leg and pelvic vein thrombosis. A new, additional treatment possibility--results of 29 patients]. PMID- 1771522 TI - [Possibilities of mathematical models of flow anomalies in arterial blood vessels]. PMID- 1771523 TI - [Can systemic changes in the blood coagulation system be detected in low-dose local thrombolysis with r-tPA?]. PMID- 1771524 TI - [Inhibition of induced thrombocyte aggregation in the presence of endothelial cells by dipyridamole]. AB - Dipyridamole is widely used as a platelet function inhibitory drug. Its effect on platelet aggregation was investigated in a newly developed system, in which platelet aggregation was carried out in the presence of a human endothelial cell monolayer (EC). After iv. injection of 20 mg Dipyridamole platelet aggregation (inducer ADP 5 microM, Collagen 5 micrograms) was totally inhibited. The EC dependent antiaggregatory effect of Dipyridamol could be abolished if EC's were pretreated with 1 mmol ASA for 30 min. Our results, carried out in PRP demonstrate that Dipyridamole inhibits platelet aggregation even in the absence of red blood cells which were supposed to enhance the antiplatelet effect by their reduced adenosine uptake. Anenhanced PGI2 production in the EC's may explain the aggregation inhibiting effect of Dipyridamole in this test system. PMID- 1771525 TI - [Fibrinolytic therapy of deep venous thrombosis]. PMID- 1771526 TI - [Hemorheologic risk profile in peripheral arterial occlusive disease, diabetic angiopathy and essential arterial hypertension]. PMID- 1771527 TI - [Follow-up studies of plasma viscosity and erythrocyte filterability in coronary bypass operations]. PMID- 1771528 TI - [Experiences with the clinical use of iso- and hypervolemic hemodilution in conservative therapy of vascular diseases]. PMID- 1771529 TI - [Effect of prostaglandin E1 on neutrophilic granulocytes of patients with intermittent claudication]. PMID- 1771530 TI - [Hemorheology in patients with Raynaud's phenomenon--diagnosis and therapy with plasmapheresis]. PMID- 1771531 TI - [Motility of cultivated vessel wall myocytes from percutaneous atherectomized primary and re-stenosis plaque]. PMID- 1771532 TI - [Cell cultivation of human plaque tissue following percutaneous and intra operative coronary atherectomy]. PMID- 1771533 TI - [Effects of the non-ionic angiography contrast medium iopromide on contact phase activation and the blood coagulation system]. PMID- 1771534 TI - [Noradrenaline liberates an "endothelium-derived constricting factor" from endothelium of isolated blood vessels]. PMID- 1771535 TI - [Claforan concentration in wound secretion following intravenous, intra-arterial, and regional intravenous infusion in patients with stage IV arterial occlusive diseases of the lower extremities]. PMID- 1771536 TI - [Mechanism of action of ultraviolet irradiation of blood: on the possible role of the anti-oxidative enzyme system]. PMID- 1771537 TI - [The compliance of arteriosclerotic blood vessels]. PMID- 1771538 TI - [Phantom studies of duplex sonographic quantification of arterial stenoses]. PMID- 1771539 TI - [Prostaglandin E1 in treatment of incomplete ischemia syndromes of the lower extremity]. PMID- 1771540 TI - [The temporal course of hemodynamic changes following intermittent intra-arterial infusion therapy: follow-up based on duplex sonographic parameters]. PMID- 1771541 TI - [A new oral prostaglandin E1 derivative (OP 1206) compared with intravenous PGE1: assessment of the effect on macro- and microcirculation]. PMID- 1771542 TI - [Testing phyto-drug effects on spontaneous and chemically modified deformation of erythrocyte membranes: demonstrated with Ginkgo-Biloba extracts]. PMID- 1771543 TI - [Effect of nitroglycerin on finger artery blood pressure]. PMID- 1771544 TI - [Epidural electrostimulation of the spinal cord for therapy of Fontaine stage III peripheral arterial occlusive disease]. PMID- 1771545 TI - [Epidural spinal cord stimulation in treatment of refractory Fontaine stages III and IV arterial occlusive disease: indications, use and clinical results]. PMID- 1771546 TI - [Effectiveness of temperature biofeedback in therapy of Raynaud's disease]. PMID- 1771547 TI - [An epidemiologic study of the use of vascular sports in arterial occlusive disease]. PMID- 1771548 TI - [Retrograde venous perfusion in treatment of diabetic gangrene]. PMID- 1771549 TI - [Methodologic aspects of retrograde venous perfusion]. PMID- 1771550 TI - [Effect of increased arterial flow on the measured venous filling time parameter in diagnosis of phlebologic function]. PMID- 1771551 TI - [Diagnosis of deep leg vein thrombosis with Doppler sonography, duplex sonography and phlebography. A prospective study of 66 patients]. PMID- 1771552 TI - [Arterial thrombosis as a sequela of flow anomalies--activation of the hemostatic system and endothelial damage]. PMID- 1771553 TI - [More safety in therapy of chronic venous insufficiency by follow-up control of therapy]. PMID- 1771554 TI - [Functional long-term results following conservative and surgical therapy of pelvic-upper leg thrombosis]. PMID- 1771555 TI - [Venous capacity and venous outflow in healthy patients and patients with chronic venous insufficiency before and following swimming in 34 degree C warm water]. PMID- 1771556 TI - [Mechanical prevention of thrombosis in immobile and mobile patients]. PMID- 1771557 TI - [Are anti-thrombosis stockings effective?]. PMID- 1771558 TI - [Compression class comparison of compression knee stockings by various manufacturers]. PMID- 1771559 TI - [Venous occlusion plethysmography: current status of the development and new equipment-related possibilities]. PMID- 1771560 TI - Paratibial fasciotomy. AB - Paratibial fasciotomy is a new surgical approach to conservatively therapy resistant venous leg ulcers. Its technique and preliminary results are reported. It is concluded hypothetically that the fasciotomy splitting itself plays the main role for its therapeutical success. PMID- 1771561 TI - [Conservative and esthetic surgical techniques in varicose vein surgery]. PMID- 1771562 TI - [Non-iatrogenic injury of the popliteal artery]. PMID- 1771563 TI - [Incidence of entrapment of the popliteal artery in high performance athletes and a control sample]. PMID- 1771564 TI - [Spontaneous aortic rupture]. PMID- 1771565 TI - [Surgical indications in risk patients with asymptomatic rupture of abdominal aortic aneurysms]. PMID- 1771566 TI - [Desobliteration of the external carotid artery within the scope of surgical reconstruction of internal carotid artery stenoses--open versus endoluminal TEA]. PMID- 1771567 TI - [Iliaco-femoral crossover bypass--ultima ratio or rational alternative]. PMID- 1771568 TI - [Combined arterial bypass operation and coumarin therapy--a concept for long-term management and its conditions]. AB - Antithrombotics of cumarin type or with antiplatelet effect are preferred to obtain results from vascular surgical interventions in arterial occlusion disease. In our experience the combination with cumarin long term therapy seems to be the better method, especially if the following conditions can be achieved: very good compliance of patients respectively strict consideration of absolute and relative contraindications, a sufficient number of patients who are treated and a long enough experience of therapeutists followed by using the recommendations of the WHO expert committee for the worldwide application of standardization in measuring the anticoagulation effect, using reagents and calibration materials, and the expression of results in INR. Further in our anticoagulation behaviour we are used influencing risk factors, having a good cooperation between patients and doctors during secondary diseases and new drug intake. For dental surgery we prefer a Quick test between 30 and 35% activity or 1, 9 and 2, 1 INR. With Phenprocoumon (Falithrom, Markumar) we use the long term anticoagulation effect without several daily applications. Since September 1987 there has been the possibility of a computer assisted programme for dose prediction. PMID- 1771569 TI - [Angioscintigraphy with krypton 81 m, a semiquantitative method for measuring tissue perfusion in patients with arterial occlusive disorders]. PMID- 1771570 TI - [Use of reflection oximetry for localizing the site of severe peripheral arterial occlusive disorders]. PMID- 1771571 TI - [Thermography in angiology]. PMID- 1771572 TI - [Comparative study between walking test, ankle-arm quotient and proportion of ankle pressure increase in the first minute following stress, for evaluation of arterial occlusive disorders of the leg]. PMID- 1771573 TI - [Noninvasive phlebodynamometry: principle and initial results]. PMID- 1771574 TI - [A new opto-electronic screening system for long-term diagnosis of peripheral arterial occlusive diseases]. PMID- 1771575 TI - [Computer-assisted evaluation of optically recorded biosignals from peripheral circulation]. PMID- 1771576 TI - [Thrombotic reactions of vascular anastomoses: comparison of model studies with experimental findings]. AB - The areas of predilection for atherosclerosis and thrombosis in the vascular system are characterized by curvature, branching, bifurcation or embankment. We have investigated induced thrombus formation at arteriolar bifurcations with migrating stagnation points and local vortex flow. Thrombogenic endothelial lesions were produced in rat mesenteric arterioles by argon laser injury or by photochemical reactions (using FITC-dextran 70). The following items have been evaluated: local red blood cell velocity, geometry of the vessel, localization of the first thrombus growth. The first appearance of thrombus formation at presumably (re-) attachment points at bifurcations in the microcirculation could be directly demonstrated by intravital microscopy. PMID- 1771577 TI - [Electronic data processing-assisted documentation in vascular surgery]. PMID- 1771578 TI - [Diagnostic staged program in acute cerebrovascular infarct]. PMID- 1771579 TI - [Pathomechanisms of intermittent claudication as a sign of tissue decompensation in arterial occlusive disease]. PMID- 1771580 TI - [Criteria for the practical angiologist for early detection of claudication as a stress insufficiency in progressive atheromatosis]. PMID- 1771581 TI - [Electrophysiology of muscular nociception in ischemia and oxygen deficiency]. PMID- 1771582 TI - [Biochemical modifications in stress ischemia of the calf muscles]. PMID- 1771583 TI - [Possibilities and limits of physical training therapy of intermittent claudication patients with simultaneous drug therapy]. PMID- 1771584 TI - [Possible correlation between venous complaints and psychological status]. PMID- 1771585 TI - [Intermittent claudication as chronic illness]. PMID- 1771586 TI - [Flow changes at the carotid bifurcation--an ultrasound study in the human]. PMID- 1771587 TI - Technical limitations of the present color coded US-Doppler systems in analyzing flow anomalies in arteries. AB - The pulsatile nature of blood flow, compliance and tapering of arteries, and arterial bifurcations and curves affect the flow distribution within an artery as function of time. Temporarily and spatially secondary flow phenomena may occur. The presence of secondary flow phenomena causes the flow velocity vector to deviate from the axial direction. In general ultrasound Doppler systems only register the velocity component along the line of observation. For color coded Doppler systems the accuracy to assess this velocity component highly depends on the number of subsequent pulses issued along the same line. A high number of repetitive pulses will improve the accuracy, but only at the expense of a reduced frame rate in the Doppler mode, a reduced width of the region of interest, or both. To appreciate properly the time dependent nature of the velocity distribution quite a high frame rate is required. This paper discusses the flow phenomena of interest and the basic factors affecting the accuracy in velocity assessment that can be obtained. Computer generated Doppler signals are analyzed to obtain quantitative information about the standard deviation of the estimate for the velocity in a given sample volume. PMID- 1771588 TI - [The value of Doppler spectral analysis for practical diagnosis]. PMID- 1771589 TI - [19th annual meeting of the German Society for Angiology. Aachen, 12 September 1990]. PMID- 1771590 TI - Comments on "Unique anomalies in cephalothoracopagus janiceps conjoined twins with implications for multiple mechanisms in the abnormal embryogenesis". PMID- 1771591 TI - ACE inhibitor fetopathy and hypocalvaria: the kidney-skull connection. AB - Two cases of angiotensin converting enzyme inhibitor fetopathy with renal tubular dysgenesis and severely underdeveloped calvarial bone are described. Six additional, unexposed cases of hypocalvaria are described, and possible links between calvarial development and fetal hypotension and/or chronic hypoxia are explored. PMID- 1771592 TI - Phenytoin teratogenicity and midgestational pharmacokinetics in mice. AB - Mice of the A/J and C57BL/6J (C57) strains were dosed with phenytoin (PHT) every 48 hr throughout pregnancy by gastric intubation to test the hypothesis that maternal plasma PHT concentration may be the significant factor in determining PHT reproductive and developmental toxicity. Serial serum samples were obtained from each mouse from gestation day (GD) 10-GD 12 for determination of individual dam PHT pharmacokinetics. Maximum PHT concentration and PHT AUC (area under-the time-concentration curve) were regressed to laparotomy and fetal evaluation endpoints to determine whether significant association existed. Although serum PHT concentrations exceeded levels associated with teratogenicity (greater than 10 micrograms/ml), few major malformations were induced in either strain. However, in the A/J strain, there was a significant increased incidence of hydrocephaly and open eyelid. Regression of pharmacokinetic parameters with embryo and maternal endpoints indicated significant associations between gestational weight gain and maximum concentration measured (Cmax) or AUC in both strains. This association was also found for fetal weight in the C57 strain. In the A/J strain, the induction of decreased ossification of the sternebrae was also associated with maternal PHT concentration; however, linear regression of hydrocephaly and open eyelid to PHT concentration was not statistically significant. These results suggest that maternal plasma PHT concentration may be a quantifiable determinant of certain aspects of PHT developmental toxicity in the mouse. PMID- 1771593 TI - Reversible effects of triamcinolone and lack of effects with aspirin or L-656,224 on external genitalia of male Sprague-Dawley rats exposed in utero. AB - Inhibitors of the arachidonic acid cascade were given to pregnant rats during the critical period for morphogenesis of the external genitalia. Groups treated subcutaneously (s.c.) with 0.1 or 0.25 mg/kg/day of triamcinolone acetonide (TA) on gestational days (GD) 14-19 had male fetuses on GD 20 with moderate decreases in absolute anogenital distance (AGD), but gross and histological examinations revealed no alterations to the genital tubercle (i.e., no hypospadias). The s.c. coadministration of arachidonic acid at 100 mg/kg/day had minimal to no effect on AGD in the TA-exposed groups. No effect on AGD was observed in male fetuses from groups administered aspirin orally at 150 mg/kg/day, and only a 6% decrease was observed in the 300-mg/kg/day group. Neither TA nor aspirin adversely affected AGD of female fetuses. In another study, TA was administered on GD 11-19 at dose levels of 0.05 and 0.1 mg/kg/day, and dams were allowed to deliver. High-dose male offspring examined on postcoitum day (PCD) 23, had moderate decreases in AGD. In both studies with TA, there were also significant decreases in offspring weights. The contribution of the decreased weight to the decrease in absolute AGD was examined by a variety of methods (ratio of AGD to cube root of weight or biparietal distance, comparison to weight-matched controls, and covariance analysis). We conclude that TA caused a specific decrease in AGD on GD 20 that was largely reversed by PCD 23. When examined as adults (8 weeks old), the external genitalia of TA-exposed offspring were normal. Thus, the TA-induced decreases in AGD on GD 20 did not predict irreversible malformation. TA also caused other effects, which included a somewhat flattened genital tubercle and apparently thinned and glossy skin between the tubercle and the anus in both sexes on GD 20 and PCD 23, but not as adults. In addition, there were high pup mortality and high incidences of micrognathia and omphalocele (in the 0.25 mg/kg/day group only). Aspirin at 75 or 150 mg/kg/day and a specific lipoxygenase inhibitor (L-656,224) at 1,000 or 2,000 mg/kg/day were also administered from GD 14 to 19, and no offspring effects were observed. Thus, of the three agents that potentially inhibit the arachidonic acid cascade, only triamcinolone produced moderate effects on rat external genitalia that were largely reversible.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1771594 TI - Aspirin dose-dependently reduces alcohol-induced birth defects and prostaglandin E levels in mice. AB - The purpose of the present study was threefold. The first purpose was to determine if aspirin (ASA) decreases alcohol-induced birth defects in mice in a dose-dependent fashion. The second purpose was to see if the antagonism of alcohol-induced birth defects afforded by ASA pretreatment was related to dose dependent decreases in prostaglandin E (PGE) levels in uterine/embryo tissue. The third purpose was to determine if ASA pretreatment altered maternal blood alcohol level. In experiments 1 and 2, pregnant C57BL/6J mice were administered ASA (0, 18.75, 37.5, 75, 150, or 300 mg/kg) on gestation day 10. One hour following the subcutaneous injection of ASA, mice received alcohol (5.8 g/kg) or an isocaloric sucrose solution intragastrically. In experiment 1 the incidence of birth defects was assessed in fetuses delivered by caesarean section on gestation day 19. In experiment 2 uterine/embryo tissue samples were collected on gestation day 10 1 hr following alcohol intubation for subsequent PGE analysis. In experiment 3 blood samples were taken at five time points following alcohol intubation from separate groups of alcohol-treated pregnant mice pretreated with 150 mg/kg ASA or vehicle. The results from the three experiments indicated that 1) ASA dose dependently reduced the frequency of alcohol-induced birth defects in fetuses examined at gestation day 19, (2) ASA decreased the levels of PGE in gestation day 10 uterine/embryo tissue in a similar dose-dependent fashion, and 3) ASA pretreatment did not significantly influence maternal blood alcohol levels. These results provide additional support for the hypothesis that PGs may play an important role in mediating the teratogenic actions of alcohol. PMID- 1771595 TI - Additive incidence of developmental malformation for Xenopus embryos exposed to a mixture of ten aliphatic carboxylic acids. AB - A modified FETAX (Frog Embryo Teratogenesis Assay: Xenopus) protocol was used to assess the joint action of ten aliphatic carboxylic acids on Xenopus embryo development. Stock solutions of each acid alone, made up at twice the EC50 of the individual acids, were prepared for testing alone and in a mixture with an equal volume of each acid stock solution. For each treatment, five concentrations and a control dish, each with 25 embryos, were tested for 96 h, with solution renewal every 24 h. The embryos were then fixed and evaluated for gross malformations. For each dish, the number and types of malformations were recorded. An EC50 was calculated for each acid alone and this value was defined as 1.0 toxic unit (TU) for malformation induced by the acid. An EC50 was also calculated for the mixture. The concentration of each acid at the mixture EC50 and the TU values corresponding to these concentrations were then determined. A TU value of 0.990 (0.923-1.060) was obtained for the mixture by adding the TU values for each acid in the mixture. This represents a concentration additive rate of malformation. Microcephaly, TU = 1.09 (1.01-1.18), was the primary malformation, but did not completely account for the response. The concentration additive rate of malformation indicates that all ten acids are likely to induce malformation in Xenopus embryos in a similar manner. Quantitative structure-activity relationship (QSAR) analysis revealed developmental malformation induced by the acids was highly correlated (r2 = 0.979) with hydrophobicity and molar refractivity (r2 = 0.949). The approach has potential application in determining compounds that induce developmental malformations in a similar manner, when metabolism and pharmacokinetic factors are considered. PMID- 1771596 TI - Heterogeneity of neural tube defects in Europe: the significance of site of defect and presence of other major anomalies in relation to geographic differences in prevalence. AB - In the period 1980-1987, neural tube defects were two to three times more prevalent in populations covered by EUROCAT registries in the United Kingdom and Ireland (UKI) than in Continental Europe and Malta (CEM). 1864 NTD cases in a total population of 580,000 births in UKI and 455 cases in a population of 380,000 births in CEM were analysed to find if there were differences in the ratio of prevalence rates between UKI and CEM according to site of the defect and association with non-central nervous system (CNS) anomalies. The prevalence rate ratio was high for anencephaly with accompanying spina bifida, iniencephaly, and upper spina bifida, and low for encephalocele, lower spina bifida, and anencephaly without other neural tube defects. There was a greater female excess for anencephaly with accompanying spina bifida, iniencephaly, and upper spina bifida than for other defects in both geographic areas. There was a female excess for encephalocele in UKI but a male excess in CEM. Certain sites (anencephaly with accompanying spina bifida, iniencephaly, and encephalocele) were more likely to have accompanying non-CNS anomalies. The prevalence rate ratio of multiply malformed NTD was in general lower than for isolated NTD but showed the same pattern by site. The prevalence rate ratio was high for multiply malformed anencephaly with accompanying spina bifida, iniencephaly, and upper spina bifida. The sex ratio was similar between isolated and multiply malformed cases when site of the defect is taken into account. It is concluded that the geographic prevalence pattern and sex ratio differ according to site of NTD but do not differ substantially according to whether NTD is isolated or associated with non CNS anomalies. PMID- 1771597 TI - Toxicity of sera from individuals with Chagas' disease to cultured rat embryos: role of antibodies to laminin. AB - In previous studies antilaminin antibodies in the sera of immunized monkeys and rats were found to be toxic to cultured rat embryos. In order to extend these studies to humans, head-fold stage rat embryos were cultured for 48 hours on ten different serum samples from individuals with Chagas' disease. All embryos (n = 20) cultured on these sera were found to be abnormal. Using ELISA, Western immunoblot, and indirect immunofluorescence it could be shown that antibodies in these sera reacted with laminin. That these antilaminin antibodies were, at least in part, responsible for the toxicity was indicated 1) by reduced cultured embryo toxicity for six of seven serum samples after pre-absorption with purified laminin, 2) by demonstrating a relationship between the amount of affinity purified antilaminin IgG added to control serum for culture and the severity of embryo abnormalities seen at the end of culture, and 3) by the sera's failing to react with other basement membrane proteins, including type IV collagen, fibronectin, osteonectin, and heparan sulfate proteoglycan. PMID- 1771598 TI - Immunohistochemical localization of chondroitin and heparan sulfate proteoglycans in pre-spina bifida splotch mouse embryos. AB - The splotch (Sp) mutation on mouse chromosome I is a genetic model for the neural tube defects spina bifida and exencephaly. Embryos carrying Sp or its allele splotch-delayed (Spd), have been shown to have delays in neural tube closure, and neural crest cell emigration, as well as a reduction in extracellular space around the neural tube. Pre-spina bifida Sp and Spd embryos have abnormalities of notochord, mesoderm and neuroepithelial development. Chondroitin sulphate proteoglycans (CSPG) and heparan sulfate proteoglycans (HSPG) have been shown to play essential roles during neural tube closure and neural crest cell emigration and migration and thus might well be affected by the splotch mutation. Therefore, the effects of Sp and Spd on the temporal and spatial distributions of CSPG and HSPG were studied in pre-spina bifida embryos cytogenetically identified as Sp/Sp (Spd/Spd), Sp/ + (Spd/ +) or +/+. Immunohistochemical localization of CSPG by means of the CS-56 monoclonal antibody showed that in Sp/Sp head sections, the neuroepithelial basement membranes stained more intensely at 5-, 10-, and 15 somite stages, whereas similar staining was observed at 16- and 19-somite stages compared with matched +/+ sections. In caudal sections Sp/Sp again showed a more intense stain for CSPG in the neuroepithelial basement membranes in all sections (except one comparison, in which staining was similar) from embryos of 14-, 15-, 16-, and 19-somite stages, compared to matched +/+ sections. Heterozygotes did not differ consistently from the mutant or the normal (+/+) embryos in CS-56 stain intensity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771599 TI - Cadherin mRNAs during rat embryo development in vivo and in vitro. AB - Whole rat embryo cultures are being used in increasing numbers of laboratories to study the mechanisms by which teratogens disturb development. The development of early somite stage embryos in vitro is very similar morphologically to that in vivo, yet few biochemical comparisons have been made. The purpose of this study was to determine the steady-state mRNA concentrations of a family of Ca(2+) dependent cell adhesion molecules, the cadherins, during rat embryonic development in vivo and in vitro. Embryos and yolk sacs were collected on days 10, 11, and 12 of gestation (in vivo); they were also obtained from day 10 embryos after growth in culture for 24 hr (day 11 in vitro) or 45 hr (day 12 in vitro). Total RNAs isolated from embryos and yolk sacs were studied by Northern blot analysis using specific cDNA probes for three cadherins, E-cadherin, N cadherin, and P-cadherin. Although E-cadherin mRNA was detected in embryos, it was present at much higher concentrations in yolk sacs. In addition, multiple species of E-cadherin mRNA ranging from 3.0 to 13 kb were detected. Interestingly, the concentration of the major 4.5-kb E-cadherin mRNA species in yolk sac after 45 hr in culture was increased 2.8-fold over that on day 12 of gestation in vivo. Second, two species (4.3 and 3.5 kb) of N-cadherin mRNA were detected, almost exclusively in embryos. In yolk sac, N-cadherin mRNA was detected only after 45 hr in culture. Third, P-cadherin mRNA was detected as a single 3.5-kb species, mainly in embryos. P-cadherin mRNA concentrations in yolk sac after 45 hr in culture were 5.6-fold higher than in vivo. Thus, these results demonstrate that there is a differential distribution of cadherin mRNAs in rat embryos and yolk sacs. Further, there appear to be multiple species of mRNAs for E-cadherin and N-cadherin. Finally, while whole embryo culture in vitro did not significantly alter the steady-state concentrations of cadherin mRNAs in the embryo, these concentrations were dramatically increased in the yolk sac. PMID- 1771600 TI - Alternative and complementary medicine for asthma. PMID- 1771601 TI - Acupuncture and asthma: a review of controlled trials. AB - BACKGROUND: Published controlled trials of acupuncture in asthma have often contained a small number of subjects and the results are contradictory. Controlled trials have been reviewed to determine whether clearer conclusions could be obtained by assessing as many studies as possible according to methodological criteria. METHODS: A literature search produced 13 trials on the efficacy of acupuncture in the treatment of patients with asthma. These studies were reviewed on the basis of 18 predefined methodological criteria. A maximum of 100 points for study design could be earned in three main categories: (a) adequate study population, (b) adequate intervention, and (c) adequate measurement of effects. RESULTS: The quality of even the eight better studies (more than 50% of the maximum score) proved to be mediocre. No study earned more than 72% of the maximum score. The results from the better studies are highly contradictory. CONCLUSIONS: Claims that acupuncture is effective in the treatment of asthma are not based on the results of well performed clinical trials. PMID- 1771602 TI - Vertebral fractures in steroid dependent asthma and involutional osteoporosis: a comparative study. AB - BACKGROUND: Reduced bone mass predisposes patients to the development of vertebral fractures. Measurement of bone mass by non-invasive methods is used to detect patients with involutional osteoporosis at risk from fractures. These methods have not been assessed in patients with steroid dependent osteoporosis. The objective of this study was to assess the value of a predictive fracture threshold value of bone density in patients with steroid dependent asthma. METHODS: Three groups of patients were studied. Group 1 (67 patients) had steroid dependent asthma (mean daily dose of prednisone 11.7 mg) and no vertebral fractures, group 2 (32 patients) had steroid dependent asthma (mean daily dose of prednisone 12 mg) and vertebral fractures, and group 3 (55 patients) were not taking steroids but had involutional osteoporosis and a recent non-traumatic vertebral fracture. Bone mineral density was measured by dual photon absorptiometry and vertebral fractures by radiography of the lumbar spine. A fracture threshold was determined in the two groups with fractures as the 90th percentile of the mean bone mineral density measured in the lumbar spine. RESULTS: Bone mineral density was significantly higher in the steroid dependent group with fractures (group 2) than in group 3 patients, who had involutional osteoporosis and fractures (0.946 (0.18) g/cm2 v 0.830 (0.16) g/cm2). The fracture threshold value was therefore higher for patients with steroid related vertebral fractures (group 2, 1.173 g/cm2) than for those with involutional osteoporosis (group 3, 0.979 g/cm2). Vertebral fractures were more likely to occur in steroid dependent asthmatic patients with bone density above the fracture threshold value (obtained from subjects with involutional osteoporosis) than in subjects in group 3 (34% v 9%). CONCLUSION: Vertebral fractures occur in patients treated with steroids in the presence of higher bone mineral density than is the case with patients with involutional osteoporosis. The findings suggests that the assessment of the efficacy of preventive treatment requires measurement of bone mineral density and radiology. PMID- 1771603 TI - Self reported snoring and daytime sleepiness in men aged 35-65 years. AB - BACKGROUND: It has been suggested that snoring alone, without conventional sleep apnoea or hypopnoea, may disrupt sleep and produce substantial daytime hypersomnolence. This study addresses this potential relationship. METHOD: Eight hundred and fifty men, aged 35-65 years, drawn from one general practice were visited at home and asked a range of questions potentially related to sleepiness, snoring, and sleep apnoea; these included inquiries about alcohol and cigarette consumption, nasal stuffiness, shift work, hypnotic or other drug use, and medical diagnoses. In addition, measurements of height, weight, and overnight arterial oxygen saturation were made. The relation between snoring and sleepiness, with allowance made for potentially confounding variables, including sleep apnoea, was assessed by multiple logistic regression. RESULTS: Positive answers to all questions about sleepiness were correlated significantly with self reported snoring. After potentially confounding variables and any sleep apnoea had been controlled for, positive answers to four questions about inappropriate drowsiness or sleepiness were independently related to snoring. For example, the odds ratio of admitting to "having almost had two or more car accidents while driving due to sleepiness" was 5.8 (95% confidence intervals: 2.7-12.5) in an "often" snorer. CONCLUSIONS: Although epidemiological associations such as this do not prove a causal relation, the study suggests that snoring (without classical sleep apnoea) may sometimes reduce sleep quality sufficiently to produce substantial daytime drowsiness. PMID- 1771604 TI - Effect of inhaled budesonide on bronchial reactivity to histamine, exercise, and eucapnic dry air hyperventilation in patients with asthma. AB - BACKGROUND: It has been suggested that inhaled corticosteroids may provide greater protection against constrictor stimuli that act indirectly such as exercise than those that act directly such as histamine. METHODS: The effects of six weeks treatment with inhaled budesonide (800 micrograms twice daily) on bronchial reactivity to histamine, exercise, and eucapnic voluntary hyperventilation of dry air were compared in a double blind, placebo controlled, non-crossover study in 40 subjects with asthma. Change in bronchial reactivity to histamine and eucapnic hyperventilation over the six weeks was measured as change in the provocative dose of histamine or dry air causing a 20% fall in FEV1 (PD20 histamine and PV20 eucapnic hyperventilation (EVH) of dry air); this was not possible for exercise because of the development of refractoriness. To enable the change in response to all three stimuli to be compared, the response (percent fall in FEV1) to a fixed dose was measured for all three challenge tests. RESULTS: After budesonide there was an increase in PD20 histamine from 0.48 to 2.81 mumol and in PV20 EVH from 364 to 639 litres, and a significant correlation between the changes in PD20 histamine and PV20 EVH (r = 0.63). The median percentage fall in FEV1 in response to eucapnic hyperventilation, exercise, and histamine was similar before budesonide (25.5%, 26.6%, and 24.5%); the reduction in the percentage fall in FEV1 with budesonide was also similar for the three challenges (18.9%, 17.5%, and 16.6%), and all differed significantly from the changes following placebo. There was a significant correlation between change in percentage fall in FEV1 after budesonide with the three stimuli (histamine v exercise: r = 0.48; histamine v eucapnic hyperventilation: r = 0.46; exercise v eucapnic hyperventilation: r = 0.63). CONCLUSION: The similar magnitude of change in bronchial reactivity to all three stimuli after budesonide and the within subject correlation obtained between these changes suggest that corticosteroids act by a common mechanism to protect against eucapnic hyperventilation, exercise, and histamine. PMID- 1771605 TI - Effect of terbutaline on mucociliary clearance in asthmatic and healthy subjects after inhalation from a pressurised inhaler and a dry powder inhaler. AB - BACKGROUND: beta Agonists have been shown to increase mucociliary clearance in some studies but not all. Whether the formulation of beta agonists affects mucociliary clearance is not known but may be important as the use of dry powder inhalers increases. METHODS: The effect of different methods of administration of inhaled terbutaline on mucociliary clearance and forced expiratory volume in one second (FEV1) was assessed in 10 patients with asthma and 10 healthy subjects. Terbutaline (1 mg) was administered through a metered dose inhaler with a spacer (Nebuhaler) or a dry powder inhaler (Turbuhaler), or both treatments were given, in a four way double blind, double dummy trial. Mucociliary clearance was measured by bronchoscintigraphy. RESULTS: Clearance of radioactivity from the lobar bronchi increased in the asthmatic patients by a median of 32% after terbutaline was given by metered dose inhaler and 55% after a combined dose of 2 mg from both inhalers (1 mg from each) compared with placebo but by only 9% after 1 mg of terbutaline was given by a dry powder inhaler. In the healthy subjects mucociliary clearance increased by 51% when terbutaline was given by a dry powder inhaler, by 66% when given by a metered dose inhaler, and by 66% when given by both inhalers combined. The effect of terbutaline on FEV1 was the same with each of the inhalers. CONCLUSION: Despite similar changes in FEV1 with the two formulations terbutaline increased mucociliary clearance significantly in asthmatic and healthy subjects when inhaled from a metered dose inhaler whereas when it was inhaled from a dry powder inhaler its effect was significant only in healthy subjects. The reason for the difference in asthmatic subjects is unclear, but may be associated with differences in the deposition of terbutaline. PMID- 1771606 TI - Increased expression of growth factor genes for macrophages and fibroblasts in bronchoalveolar lavage cells of a patient with pulmonary histiocytosis X. AB - Pulmonary histiocytosis X is the local manifestation of a systemic disorder of unknown cause characterised by infiltration of Langerhans cell like histiocytes and parenchymal fibrosis. In a male smoker with histologically proved histiocytosis X and functional impairment bronchoalveolar lavage showed an increase in CD-1/OKT-6 antigen positive histiocytes to 8%. Northern blot analysis of RNA from bronchoalveolar lavage cells showed an exaggerated expression of the M-CSF gene and of the c-fms gene encoding for the corresponding receptor. An increased level of c-sis RNA, which encodes the B chain of platelet derived growth factor, was also found. Diffuse reticulonodular infiltrates on the chest radiograph resolved with glucocorticoid treatment and CD-1/OKT-6 antigen positive histiocytes fell to 3%. Macrophage colony stimulating factor, c-fms and c-sis gene expression were reduced almost to normal after treatment. The results suggest that macrophage colony stimulating factor and platelet derived growth factor may have a role in the initiation or maintenance of pathological reactions in pulmonary histiocytosis X. PMID- 1771607 TI - Diffuse pulmonary angiomatosis. AB - A six year old girl with diffuse pulmonary angiomatosis presented with haemoptysis and diffuse interstitial changes with bilateral pleural effusions on the chest radiograph. The lung lesion as seen on biopsy specimens (and confirmed at necropsy) consisted of bloodless, thin walled, endothelium lined channels, affecting the interstitial septae, pleura, bronchi, and adventitia of large vessels. There was no response to oral corticosteroids or a trial of cyclosphamide. This lesion may be an example of an angiogenic disease. PMID- 1771608 TI - Achilles tendon rupture: an underrated complication of corticosteroid treatment. AB - Ten patients attending outpatient clinics who were taking oral corticosteroids ruptured their Achilles tendon in the course of 12 years. It is suggested that Achilles tendon rupture is a complication of corticosteroid treatment. PMID- 1771609 TI - Bronchial compression as a result of lung herniation after pneumonectomy. AB - A patient developed severe exertional dyspnoea and stridor eight months after a right pneumonectomy for a carcinoid tumour, with a progressive loss of lung function. These events were the result of compression of the left main bronchus against the vertebral column by the mediastinal contents, which had shifted into the right hemithorax with the herniated lung. PMID- 1771610 TI - Synchronous double primary lung cancers of squamous and neuroendocrine type associated with cryptogenic fibrosing alveolitis. AB - A 72 year old man with simultaneously occurring squamous cell and neuroendocrine carcinomas in association with cryptogenic fibrosing alveolitis is reported. The tumours were separate and both were in the fibrotic area of the right lower lobe. PMID- 1771611 TI - Unintentional percutaneous aspiration of a pleural hydatid cyst. AB - A Saudi man underwent repeated percutaneous aspiration of a pleural effusion before a pleural biopsy showed hydatid disease. Subsequent investigations confirmed hydatid disease in the pleura and liver. The patient underwent surgical evacuation and irrigation of the pleural cavity followed by medical treatment for the liver cyst with albendazole, with complete recovery and disappearance of the liver cyst. PMID- 1771612 TI - Influence of a concentrated ethylester compound of n-3 fatty acids on lipids, platelets and coagulation in patients undergoing coronary bypass surgery. AB - Twenty patients accepted for coronary bypass surgery were randomized to receive either a concentrated ethylester compound of n-3 fatty acids, with a daily dose of 3.15 g of eicosapentaenoic acid (EPA) and 1.89 g of docosahexaenoic acid (DHA), or corn oil (controls) in a double blind study, to evaluate the effect on lipids, platelets and coagulation during the pre- and postoperative phase. Only patients with fasting triglyceride (TG) levels greater than or equal to 1.6 mmol/l at recruitment were eligible. The study was continued for 5 to 6 months. Surgery was usually performed at mid-intervention. Blood samples were collected during morning hours in fasting subjects, just prior to intervention, preoperatively and at final postoperative follow-up. Moreover, blood loss was accurately accounted for postoperatively. A threefold increase (p = 0.0001) of EPA was noted at pre- and postoperative follow-up. TG-levels were reduced 20 and 39%, respectively, in patients on n-3 fatty acids, reaching statistical significance at end of intervention (p = 0.034). TG-levels in controls remained largely unchanged. In patients on n-3 fatty acids, there was a statistically significant increase in serum total cholesterol preoperatively, but this change was no longer present at completion of the study. No significant changes were noted in platelet function, as judged by bleeding time, collagen induced platelet aggregation and release of TxB2 during aggregation. Parameters of extrinsic coagulation, including phospholipase C-sensitive factor VII (PLC-VII) and extrinsic pathway inhibitor (EPI), also remained essentially unchanged in both groups of patients. However, fibrinogen was significantly reduced in controls (p less than 0.05) at end of intervention.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771613 TI - Comparison of the effects of heparin and hirudin on thrombin binding to the normal and the de-endothelialized rabbit aorta in vitro. AB - The properties of heparin and hirudin to inhibit thrombin from binding to the freshly-excised rabbit aorta wall were compared in vitro. When aorta segments were incubated with 125I-thrombin (4.4 +/- 0.4 nM) in the presence of heparin or hirudin, both anticoagulants inhibited 125I-thrombin binding to the endothelium in a concentration-dependent manner (IC50: 0.1 USP U heparin/ml; 0.1 ATU hirudin/ml). Endothelium-bound 125I-thrombin was displaced by either heparin (50% liberated at 4.1 U/ml) or hirudin (0.4 U/ml). Using de-endothelialized aortas, heparin inhibited thrombin binding by the exposed subendothelium (IC50: 1.8 U/ml) whereas hirudin was without effect. Neither heparin nor hirudin was able to significantly liberate thrombin bound to the exposed subendothelium. These observations suggest that both heparin and hirudin mask the binding site on thrombin to the endothelial cell membrane. A separate site on thrombin must bind to the subendothelium because only heparin inhibits binding. Thrombin, although bound reversibly to the endothelium, is bound irreversibly to the exposed subendothelium due, probably, to reaction with endogenous extracellular antithrombin activities (e.g. antithrombin-III, protease nexin-1). PMID- 1771614 TI - The effect of lysed platelets on neutralization of heparin in vitro with protamine as measured by the activated coagulation time (ACT) AB - The effect of lysed platelets on the activated coagulation time (ACT) was studied in heparinized whole blood during titration with protamine. Frozen-thawed washed platelet suspension, or a chromatography fraction thereof, or autologous frozen thawed platelet-rich plasma was added in various dilutions to freshly drawn blood anticoagulated with 3,000 USP units/l heparin. After a 10 min incubation, the amount of protamine needed to restore the ACT to baseline ("protamine titration dose") was determined. We found that the protamine titration dose decreased in proportion to the amount of lysed platelet material added; expressed as a percentage of the total number of platelets present, each unit increase in lysed platelets produced a 1.7% +/- 0.8 (SD) reduction in the protamine dose needed to normalize the ACT. A heparin activity assay showed that this effect was not due to anti-heparin activity of lysed platelets such as platelet factor 4 (PF4). Our data indicate that the procoagulant activity of platelet membranes reduced the sensitivity of the ACT to heparin. These findings suggest that membranous platelet microparticles may cause an inaccurate calculation, based on the ACT, of a protamine dose to reverse heparin anticoagulation in cardiopulmonary bypass procedures. PMID- 1771615 TI - Variable effects of radiological contrast media on thrombus growth in a rabbit jugular vein thrombosis model. AB - We studied the effect of an ionic high osmolar contrast medium (Ioxitalamate), an ionic low osmolar contrast medium (Ioxaglate) and various nonionic low osmolar contrast media (Iopamidol, Iopromide and Iohexol) on thrombus growth in a rabbit jugular vein thrombosis model. Thrombus growth was determined by the accretion of 125I-labeled fibrinogen onto autologous preformed thrombi in rabbit jugular veins at various time-intervals from 15 min up to 10 h after infusion of the study solution. The ionic low osmolar contrast medium markedly inhibited thrombus growth whereas all nonionic low osmolar contrast media promoted thrombus growth. The ionic high osmolar, contrast medium inhibited thrombus growth, but less than the ionic low osmolar contrast medium. Within the group of nonionic contrast media, the Iopamidol associated promotion of thrombus growth was significantly higher than the Iopromide or Iohexol associated effects. The simultaneous administration of the apparently most potent thrombus growth promoting contrast medium (i.e. Iopamidol) and heparin resulted in complete abolishment of the increase in thrombus growth. These results support the claims of prothrombotic properties of nonionic as compared to ionic contrast media and could explain the clinically encountered thromboembolic complications after the use of nonionic low osmolar contrast media. PMID- 1771616 TI - The Erythrina protease inhibitor: interactions with tissue plasminogen activator. AB - The Kunitz-type trypsin and tissue plasminogen activator (t-PA)-inhibitor from Erythrina caffra seeds was cleaved by trypsin at low pH to yield a disulphide linked two-chain molecule with reduced hydrophobicity. This change was used to separate cleaved from native inhibitor by phenyl-Sepharose chromatography. The inhibitor was not cleaved by t-PA. Trypsin, but not t-PA, catalysed resynthesis of the cleaved bond. Although the cleaved protein retained inhibitory activity for both trypsin and t-PA, 6-10 times higher concentrations were required for equivalent inhibition. Removal of the active site arginine (Arg63) from the cleaved inhibitor by digestion with carboxypeptidase B resulted in a further loss of inhibitory activity towards both proteases. The activity of the inhibitor could also be decreased by modification of one susceptible arginine residue with peptidyl arginine deiminase. These results suggest that the trypsin-reactive site of the Erythrina inhibitor is also involved in the interaction between the inhibitor and t-PA. PMID- 1771617 TI - Dexamethasone and phorbol ester, but not cytokines, increase the production of plasminogen activator inhibitor type-2 in the PL-21 human promyelocytic leukemia cell line. AB - PL-21 is a promyelocytic leukemia cell line that produces plasminogen activator inhibitor 2 (PAI-2). Differentiation-linked expression of PAI-2 was investigated by adding cell-differentiation promoting agents [such as phorbol myristate acetate (PMA), retinoic acid (RA), dexamethasone (Dex), and recombinant cytokines, including tumor necrosis factor-alpha (TNF-alpha), transforming growth factor-beta (TGF-beta), granulocyte-colony stimulating factor (G-CSF), and interleukin-6 (IL-6)] into the culture medium of PL-21 cells. PAI-1 and PAI-2 antigens were measured by an enzyme-linked immunoassay. The PAI-1 antigen, however, became detectable only after stimulation. The presence of PAI-2 antigen was further verified by immunoblotting using a monoclonal antibody against PAI-2 purified from a PL-21 culture medium. PAI activity both in the culture medium and in the cell lysate increased approximately 70-fold after exposure to PMA. Both PAI-1 and PAI-2 antigens increased, but the amount of the latter in the culture medium and in the cell lysate was approximately 10 times and 2,500 times, as much, respectively, as that of the former. Dex also increased the intracellular PAI activity approximately 6-fold, parallel with PAI-2 antigen. PAI-1 antigen increased only slightly in the culture medium but not in the cell lysate after Dex-stimulation. As with the case of PMA, TNF-alpha and IL-6 induced PL-21 cells to macrophage-like cells, but did not affect the PAI activity. Thus, the increase of the PAI-2 production by PMA may not necessarily depend on differentiation into macrophages. Other cytokines examined did not increase the PAI activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771618 TI - Normal ADP-induced aggregation and absence of dissociation of the membrane GP IIb IIIa complex of intact rat platelets pretreated with EDTA. AB - ADP-induced platelet aggregation requires the presence of external calcium and fibrinogen. When human platelets are incubated for 30 min at 37 degrees C with 5 mM EDTA and then resuspended in a calcium containing medium, they lose their ability to bind fibrinogen and to aggregate in response to ADP stimulation. Under these conditions, the effect of EDTA is irreversible and accompanied by dissociation of the glycoprotein (GP) IIb-IIIa complex into its free subunits, GP IIb and GP IIIa. We studied the effect of incubation of intact rat platelets with 5 mM EDTA at 37 degrees C from 30 to 120 min. EDTA treated rat platelets showed normal aggregation in response to 5 microM ADP in the presence of added purified rat fibrinogen and bound 125I-labeled rat fibrinogen at the same rate and magnitude after stimulation with 5 microM ADP as untreated platelets. Control and EDTA treated rat platelets, labeled or not with 125I and solubilized in Triton X 100, had a similar pattern of immunoprecipitates after crossed immunoelectrophoresis (CIE) analysis. The rat GP IIb-IIIa arc was located by incorporation of an 125I-labeled polyclonal anti-human GP IIb-IIIa antibody. In contrast, in experiments using rat platelet lysates, we demonstrated that the rat GP IIb-IIIa is a Ca(2+)-dependent heterodimer as it was dissociated by EDTA. Using SDS-PAGE and two-dimensional SDS-PAGE, the rat GP IIb-IIIa complex was found to have characteristics similar to the human complex with the exception that the light chain of the rat GP IIb was undetectable after 125I surface labeling.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771619 TI - Platelet 5-hydroxytryptamine increases with platelet age in dogs. AB - Thrombocytopenia was induced in mongrel dogs by two mechanisms: immunologically, by intravenous injection of heterologous antiplatelet antibody, and non immunologically, by circulating the blood through glass beads in anesthetized animals. The platelet content of 5-HT was monitored before and during the recovery of the blood platelet counts. This period is associated with the normalization of the mean platelet survival time and with a progressive increase in the mean age of the circulating platelet population. A continuous increment in platelet 5-HT closely followed the increase in platelet counts in both models of thrombocytopenia, and a strong correlation was found between the platelet age and 5-HT content. These findings support the concept that platelets accumulate 5-HT during their physiological aging process, contradicting the notion that a negative balance in 5-HT content results at the end of their physiological lifespan in circulation. These results are not in conflict with the concept that circulating platelets release and re-uptake 5-HT. PMID- 1771620 TI - Inventory of exogenous platelet-aggregating agent derived from venoms. PMID- 1771621 TI - Nomenclature of exogenous hemostatic factors. PMID- 1771622 TI - Comparison of standard curve for heparin calibration prepared in whole blood or plasma. PMID- 1771623 TI - Paroxysmal finger haematoma: a neglected syndrome. PMID- 1771624 TI - The behaviour of protein C in diabetes is still an open question. PMID- 1771625 TI - Antithrombotic activity of a novel C-terminal hirudin analog in experimental animals. PMID- 1771626 TI - Release of a small two-chain form of antithrombin III from a conformationally changed antithrombin III-thrombin complex. AB - Reaction of antithrombin III (AT) with thrombin results in the formation of stable antithrombin III-thrombin (AT-T) complex with a Mr of 92.5-kDa, accompanied by the appearance of a proteolytically modified form of the inhibitor (ATM). Under these conditions AT-T is also transformed to a smaller complex (AT TS). This smaller complex (81-kDa), a product of a conformational change at the AT moiety of the AT-T complex, is further transformed to a very small complex (AT TVS) with a Mr of 71-kDa. Along with this process, AT-TS slowly dissociates to a free enzyme and a small, presumably two-chain product of AT (ATMS) with a Mr of 49-kDa. The newly described component, ATMS, naturally occurs in plasma and serum and accumulates significantly in plasma of patients suffering from cardiovascular disease. PMID- 1771627 TI - igh sialic acid content slows prourokinase turnover in rabbits. AB - The clearance of natural and recombinant prourokinase (proUK) from the blood of rabbits was studied by means of a double-isotope method which allowed the differential removal of two distinct proUK species to be monitored when simultaneously administered to an individual animal. In initial experiments, proUK expressed in different cell lines contained between 0 and 2.5 molecules of sialic acid per molecule of protein. A slight trend toward slower clearance of proUK with higher sialic acid content was observed but rate differences were not statistically significant. Recombinant proUK produced in CHO cells grown in flow reactors, contained unusually high levels of sialic acid in excess of 3 moles/mole protein. Controlled exposure to immobilized neuraminidase was used to remove sialic acid from this protein in defined amounts. The clearance of the parent material was biphasic with average alpha and beta half-lives of 1.7 min and 16.7 min respectively. The AUC of the parent material was only slightly lowered upon removal of 30% of the original sialic acid. Species with 60% or 90% removal of sialate were much more rapidly cleared from the circulation respectively yielding AUCs equal to 56% and 41% of that observed with the parent material. Thus proUK containing 2.5-3.5 sialic acid molecules per molecule of protein turned over significantly more slowly in rabbits than did less sialylated proUK. The clearance rate was relatively insensitive to sialic acid content between 0 and 1.5 sialic acid residues per proUK molecule. PMID- 1771628 TI - Factor XIII of blood coagulation inhibits the oxidative phagocyte metabolism and suppresses the immune response in vivo. AB - Factor XIII of blood coagulation (F XIII) belongs to the family of transglutaminases and is a major cell product of certain subsets of macrophages. The gene for F XIIIA is coupled to the immune response genes of the HLA-region on chromosome 6. F XIII dose- dependently inhibits the in vitro chemiluminescence response of human phagocytes. About 0.1 units of F XIII/ml (final) decreased the chemiluminescence response to about 50%. In addition, about 0.6 units of F XIII/ml inhibits 50% of the release of the lysosomal hydrolase N-acetyl-beta glucosaminidase in both immune complex stimulated and unstimulated monocytes. Intraperitoneal application of F XIII reduced the activity of phagocytes in a F XIII dose dependent manner. 0.25 units of F XIII reduced the chemiluminescence reaction of murine peritoneal M phi to about 50% of the activity of PBS treated animals after 2 or 24 hours of in vivo incubation. In the Fisher/Lewis rats skin transplantation model, injections of 5 units of F XIII/animal on days 1-7 or on days 10-17 increased the survival times of the transplants from the control value of 17.0 +/- 1.4 to 26.0 +/- 2.0 and 23.0 +/- 2.4 days, respectively. F XIII may represent a novel and physiological immune suppressive agent for a broad range of human diseases of autoimmune character. PMID- 1771629 TI - A new hereditary abnormal protein C (protein C Yonago) with a dysfunctional Gla domain. AB - A familial abnormal protein C most probably with the dysfunctional Gla domain was found in a 60-year-old man with recurrent thrombosis. Namely, the anticoagulant activity as measured by the APTT method and the antigen level by an ELISA utilizing a calcium-dependent antibody were reduced to nearly half of normal, 43.5% and 2.1 micrograms/ml (normal range: 2.8-5.0 micrograms/ml), respectively. On the other hand, the amidolytic activity determined on a synthetic chromogenic substrate, S-2366, and the total antigen measured by an ELISA utilizing a polyclonal antibody were both in the normal range, 74.1% and 83% of normal, respectively. Crossed immunoelectrophoresis showed more anodal migration than the normal control in the presence of calcium ions, and adsorption of protein C to barium citrate was insufficient. These data altogether indicated that a half population of protein C in the patient's plasma was dysfunctional in the Gla domain or its related structures. Four other members of his immediate family were found to have the same abnormality of protein C, although they had been all asymptomatic. We thus conclude that the dysfunctional protein C is hereditary, and that the abnormalities noted in several tests are most likely due to a structural defect residing in the Gla or its related regions. We hereby designate this abnormal protein C as protein C Yonago. PMID- 1771630 TI - Probabilistic assessment of the HLA sharing of recurrent spontaneous abortion couples in the Japanese population. AB - In spite of a number of investigations, the concept of human leukocyte antigen (HLA) sharing in recurrent spontaneous abortion (RSA) couples remains controversial. We introduced the basal antigen sharing rate (BSR) by the original mathematical approach using the gene frequency of all HLA specificities derived from our regional control population and applied this parameter for the comparison with RSA couples. RSA couples were classified into three subgroups; primary (3 or more consecutive abortions), secondary (3 or more consecutive abortions after 1 live birth), and potential (2 consecutive abortions) aborters. No significant differences between the HLA class I sharing rates (one or more antigens shared on a single locus) of the all RSA subgroups and the calculated BSRs were observed. In the HLA-DR and DQ loci, on the other hand, the antigen sharing rates of primary aborters were significantly higher than BSRs (p less than 0.01/DR, p less than 0.05/DQ). While potential aborters showed a result similar to that of the primary aborters, no significant antigen sharing of HLA class II was observed in secondary aborters. Our data suggest that BSR is a useful parameter for detection of significant HLA sharing in regional populations and the consecutive abortions that occurred primarily are certainly relevant to HLA class II sharing. PMID- 1771631 TI - A possible association between HLA and HTLV-I-associated myelopathy (HAM) in Japanese. PMID- 1771632 TI - The third subset of HLA-A9. PMID- 1771633 TI - A comparison of the reactivity of HLA-Aw33.1 and Aw33.2 with the 10th and 11th Workshop reagents. PMID- 1771634 TI - Further findings on the mechanism of cadmium uptake by intestinal mucosal cells (step 1 of Cd absorption). AB - This work confirms and extends earlier studies on the mechanism of Cd uptake (step 1 of absorption) by the jejunal mucosa of the rat. The Q10 for step 1A, the binding of Cd to the membrane, approximates 1.0. Internalization of bound Cd (step 1B) exhibits a constant Q10 of 1.4 between 0 and 37 degrees C, providing no evidence for a phase shift in the membrane in that range. Chelators which compete for Cd with the membranes thereby inhibit step 1. Membrane-bound Cd behaves kinetically as a single pool, even though only 1/3 participates in step 1B. Binding does not involve reactive -SH groups. Fractional uptake of 5 microM 109Cd is equally depressed by 250 microM Cd or Zn; the non-specific apparent saturation of Cd uptake can be explained by charge neutralization on the membrane, and does not require postulation of Cd carriers. These findings support the proposed model of jejunal Cd uptake. PMID- 1771635 TI - Human lymphocyte reactivity after in vitro exposure to technical and analytical grade pentachlorophenol. AB - To investigate the potential effects of technical pentachlorophenol (PCP-T, contaminated with polychlorinated dioxins and furans) and of analytical grade pentachlorophenol (PCP-A) on the human immune system, in vitro assays with freshly prepared human peripheral blood lymphocytes were used as an alternative to experimental animals. Both cell-mediated and humoral immune functions were examined after direct lymphocyte exposure to PCP-T or PCP-A at concentrations ranging from 0-200 microM. In each case the viability of the treated cells remained within the control value range. T lymphocyte blastogenesis after 3 days incubation with PCP was measured using both optimal and suboptimal mitogen (PHA) concentration. Interleukin-2 activity of 24.5-h supernatants of lymphocytes in response to PHA, pretreated with PCP for 20-24 h, was examined in a bioassay using the mouse IL-2-dependent CTLL-6 cell line. The synthesis of immunoglobulins was determined after stimulation with T-dependent (PWM) and T-independent (KlebsM) polyclonal B cell activators. In the proliferation assay the effects of PCP-T became more evident after suboptimal mitogen stimulation. Whereas after optimal mitogen stimulation blastogenesis was affected only at the highest concentration of 200 microM PCP-T, cell reactivity after suboptimal PHA stimulation was altered by all PCP-T doses. In the lower concentration range PCP T caused enhanced proliferative responses, but at the two highest PCP-T concentrations cell reactivity was significantly suppressed as compared to the medium controls. Significant differences between the effects of PCP-T and PCP-A could be demonstrated only after optimal mitogen stimulation at the highest PCP concentration (200 microM). In contrast, lymphokine production as well as Ig secretion showed severe dose-dependent suppression after exposure to both PCP-T and PCP-A. The humoral immune response appeared to be more suppressed when cultures were stimulated with T-dependent rather than T-independent mitogens. The two different PCP preparations caused immunosuppression of both lymphocyte functions to the same extent. To summarize, the results of our studies indicate that PCP itself is directly immunotoxic to human immunocompetent cells and the T helper cell subset appears to be especially sensitive to PCP exposure. Furthermore, the observation of a direct effect on humoral immunity is similar to previous results showing considerable alterations of antigen specific antibody production in experimental animals after in vivo exposure. PMID- 1771636 TI - The effect of the insecticide heptachlor on ras proto-oncogene expression in human myeloblastic leukemia (ML-1) cells. AB - Expression of the ras proto-oncogene mRNA in human myeloblastic leukemia (ML-1) cells was analyzed as a function of cDNA amplification by polymerase chain reaction (PCR). By using a pair of oligonucleotides that flank exon-2 from opposite strands (5' and 3') of H-ras cDNA for PCR amplification, ML-1 cells were found to express a 112 bp segment of the ras transcript. A rapid decline in the expression of this transcript was seen in cells treated with heptachlor, a chlorinated hydrocarbon insecticide. Expression of the same ras segment was not affected by treatment of ML-1 with the tumor promoter 12-O-tetradecanoylphorbol 13-acetate (TPA). Furthermore, addition of serum to quiescent, heptachlor-treated cultures of ML-1 cells inhibited the effect of heptachlor and restored the expression of the ras protooncogene mRNA. PMID- 1771637 TI - Intracellular glutathione in human hepatocytes incubated with S-adenosyl-L methionine and GSH-depleting drugs. AB - The present study was undertaken to investigate (a) whether S-adenosyl-L methionine (SAMe) added to culture medium can increase intracellular glutathione (GSH) levels in human hepatocytes and (b) whether SAMe can prevent the GSH depletion found in human hepatocytes incubated with GSH-depleting drugs (paracetamol, opiates, ethanol). Incubation of hepatocytes with increasing concentrations of SAMe resulted in a dose-dependent elevation of intracellular GSH content, which reached its maximum (35% increase) at 30 microM after 20 h. SAMe, as the only sulfur source in the medium, was efficient in repleting GSH depleted hepatocytes following treatment with diethyl maleate. Incubation of human hepatocytes with SAMe attenuated the GSH depletion of cells incubated with toxic concentrations of paracetamol (2 mM), heroin (0.5 mM) and methadone (0.2 mM). A decrease in GSH due to exposure of hepatocytes to 50 mM ethanol was prevented when SAMe was simultaneously added to ethanol, and human hepatocytes maintained their GSH levels like non ethanol-treated cells. The experimental results of our work give the first direct evidence of the ability of exogenously administered SAMe to increase intracellular GSH levels in human hepatocytes and to prevent the GSH depletion caused by paracetamol, opiates and ethanol. PMID- 1771638 TI - Ethanol-induced fatty acid ethyl ester formation in vivo and in vitro in rat lung. AB - Fatty acid ethyl esters (FAEE) are the end products of a non-oxidative pathway for ethanol metabolism in a variety of human, rabbit, rat and murine tissues. Our objective was to determine the significance of this pathway in the metabolism of ethanol by the rat lung. In vitro, 14C-labeled ethyl oleate formation was assayed in the lung and compared with the pancreas, liver, heart and brain. Lipids were extracted with acetone, and 14C-labeled ethyl oleate was isolated and quantified by thin layer chromatography (TLC) and scintillation spectrometry. FAEE synthetic activity in the lungs (in vitro) was found to be intermediate among the organs examined. In vivo, male rats received 10% ethanol in their drinking water with or without daily i.p. injections of 4-methylpyrazole (1 mmol/kg body wt) for 15 days. Another group of male rats received 4 g/kg body wt ethanol as a 50% (v/v) solution by gavage every 12 h for 2 days. FAEE from the three organs with the highest in vitro activity for FAEE synthesis (pancreas, liver and lung) were extracted with acetone, isolated from normal lipids by TLC and separated by gas chromatography. The lung had lower FAEE-forming activity than the pancreas or the liver in the 15-day studies. However, in the 2-day study, the lung had higher activity than the liver but lower activity than the pancreas. Ethyl oleate, ethyl stearate and ethyl palmitate were the predominant FAEE formed in the intact organism. Ethanol-induced FAEE may play a role in the development of alcohol related injuries to the lung. PMID- 1771639 TI - Tier-2 studies on monocrotaline immunotoxicity in C57BL/6 mice. AB - Monocrotaline (MCT) is a member of a class of naturally occurring phytotoxins known as pyrrolizidine alkaloids, and is a toxicological concern to both man and his livestock. The purpose of these studies was to evaluate the effect of a 14 day oral MCT (0-100 mg/kg per day) exposure on the functional integrity of various immunocyte effector systems in C57BL/6 mice, as well as to investigate potential mechanisms for its immunotoxicity. Decreases in lymphoid organ weights and cellularity, and resident peritoneal exudate cell (PEC) number were only observed after exposure to the highest dose of 100 mg/kg MCT. This dose also inhibited NK cell cytotoxicity, while the total number of NK lytic units per spleen was decreased (-53%) after exposure to 50 mg/kg MCT. Following i.p. injection of SRBC, the percentage of PEC macrophages containing engulfed SRBC was significantly increased in MCT-exposed mice, while the percentage of large vacuolated (activated) macrophages was decreased in a dose-dependent manner. Exposure to MCT significantly decreased the total number of Ig+ cells without altering the number of CD4+ and CD8+ cells. The antibody responses (PFC/10(6) spleen cells) to two T cell-independent antigens, TNP-LPS and DNP-Ficoll, were significantly decreased at all MCT doses, and the degree of suppression of both responses was identical at coincident doses. MCT exposure (25 mg/kg) significantly suppressed the blastogenic response to the T cell mitogen concanavalin A (-38%), and to the B cell mitogen lipopolysaccharide (-58%). These results indicate that exposure to MCT can alter the functional integrity of various immune effector responses in a dose-dependent manner, and suggest that the B cell may be a relatively more sensitive target of MCT immunotoxicity compared to T cells, macrophages and NK cells. PMID- 1771641 TI - Persistence of 5-bromo-2'-deoxyuridine in tissues of rats after exposure in early life. AB - Outbred L10 rats received 4 subcutaneous injections of 3.2 mg per rat 5-bromo-2' deoxyuridine (BrdUrd) at 1, 3, 7 and 21 days of age. Groups of rats were sacrificed 1 h, 1 month or 49 weeks after the final injection. Tissues were fixed in 70% ethanol, embedded in paraffin and unstained sections were prepared for immunohistochemical demonstration of BrdUrd. A monoclonal antibody to BrdUrd was used with the avidin biotin peroxidase-complex (ABC) technique. The numbers of immunoreactive nuclei were tissue, cell and time-related. The labeling indices declined from 1 day to 49 weeks for all tissues studied. At 49 weeks after the last exposure to BrdUrd, many cells were still reactive, especially in tissues with normal low cell turnover (brain, uterine stroma). For cells with high turnover, including lymphocytes and ovarian germinative epithelium, few or no labeled cells remained at 49 weeks. This study provides clear evidence for the persistence of BrdUrd in normal tissues, some of which may be targets for the carcinogenic effect of the chemical and others which are not targets. PMID- 1771640 TI - Effect of autacoid modulation on N-(3,5-dichlorophenyl)succinimide (NDPS) and NDPS metabolite nephrotoxicity. AB - N-(3,5-Dichlorophenyl)succinimide (NDPS) is an agricultural fungicide which has been shown to induce acute tubular necrosis. The purpose of the present study was to determine if creatinine clearance was altered early in the development of NDPS nephrotoxicity. This study also examined the effect of autacoid modulation on the renal effects induced by NDPS and two metabolites of NDPS, N-(3,5-dichlorophenyl) 2-hydroxysuccinimide (NDHS) and N-(3,5-dichlorophenyl)-2-hydroxysuccinamic acid (NDHSA). In one set of experiments, male Fischer 344 rats (4 rats/group) were administered a single intraperitoneal (i.p.) injection of NDPS (1.0 mmol/kg) or vehicle and creatinine clearance was determined at 3 and 6 h post-treatment. NDPS administration resulted in a marked decrease in creatinine clearance at both time points. In a second set of experiments, rats (4-8 rats/group) were pretreated with the cyclooxygenase inhibitor indomethacin (3.0 or 5.0 mg/kg, i.p.) or the thromboxane synthase inhibitor dazmegrel (20 mg/kg, i.p.) 1 h before the i.p. administration of NDPS (0.2 or 0.4 mmol/kg), NDHS (0.05 or 0.1 mmol/kg), NDHSA (0.05 or 0.1 mmol/kg) or vehicle. Indomethacin pretreatment potentiated the nephrotoxic potential of NDPS and its two metabolites, while dazmegrel pretreatment attenuated NDPS nephrotoxicity without marked effects on NDHS or NDHSA nephropathy. These results indicate that renal hemodynamic changes occur early in the development of NDPS nephrotoxicity and that autacoids are important modulators of NDPS- and NDPS metabolite-induced renal effects. PMID- 1771642 TI - The effect of guanidine on the accumulation of amikacin in guinea pig renal cortical slices. AB - The role of a recently identified organic ion transport system in the accumulation of the aminoglycoside (AG), amikacin (AK) in the kidney was investigated in the present study. Because this transport system has been characterized as being a carrier for the organic cation, guanidine, the effect of guanidine on the uptake of AK into renal slices from guinea pig was examined. Renal slices incubated in medium containing AK concentrated the drug against a concentration gradient (i.e. slice:medium ratio (S/M) greater than 1.0). This uptake was significantly reduced when an equimolar concentration (1 x 10(-5) M) of another AG, gentamicin was added to the incubation medium. In contrast, AK uptake was relatively insensitive to the presence of the cation, tetraethylammonium (TEA) in the medium. Guanidine was also ineffective at inhibiting AK uptake into slices and reduced AK uptake by only 22% at guanidine concentrations of 1 x 10(-2) M. In comparison, TEA was slightly more sensitive to the presence of guanidine in the incubation media since TEA uptake was reduced by 22% at guanidine concentrations of 1 x 10(-3) M and reduced by approximately 70% at guanidine concentrations of 1 x 10(-2) M. Thus, the results of the present study suggest that the guanidine transport system does not play a role in the renal accumulation of AK since the presence of guanidine in the incubation medium had little effect on the accumulation of AK into renal cortical slices. PMID- 1771643 TI - Factors influencing the pharmacokinetics of cyclosporine in man. AB - The clinical use of cyclosporine A (CsA) is complicated by large intra- and interindividual variabilities in its pharmacokinetics. Several factors contribute to these variabilities. This review aims at describing these factors and their relative contribution in the clinical situation. Cyclosporine A has a highly variable absorption. The absorption is dependent on the liver function, bile flow, and gastrointestinal status. A large fatty meal may increase the absorption of CsA. Impaired absorption is observed postoperatively. The vehicle or dosage form is of no importance for the absorption. The distribution of CsA is mainly influenced by the lipoprotein concentration in plasma and to a lesser extent by the haematocrit. However, age, gender, and obesity are of no clinical importance for the distribution. The metabolism is presumably genetically determined and the rate of metabolism varies greatly between individuals. Furthermore, the rate of metabolism is age-related and may be affected by concomitant medication. Factors of limited importance for the metabolism include sex, lipoprotein pattern, and drug concentration. Factors such as time after transplantation, haemodialysis, haematocrit, obesity, and uremia are not associated with altered metabolism. Thus, the major factor for the intraindividual variability in CsA kinetics is the variable absorption, whereas the major cause for the interindividual variability supposedly is the inherited capacity to metabolize the drug. The factors mentioned above and other factors, found to be of minor or no importance for the kinetics of CsA, are discussed in detail. PMID- 1771644 TI - Naproxen free plasma concentrations and unbound fractions in patients with osteoarthritis: relation to age, sex, efficacy, and adverse events. AB - Plasma samples from 237 patients with osteoarthritis treated with 750 mg naproxen daily were obtained after four weeks of active therapy. The samples were subjected to equilibrium dialysis, analyzed by high-performance liquid chromatography, and free concentrations and unbound fractions were determined. Within the free plasma concentration range in this large patient group, we could detect no association between free naproxen concentration and efficacy score or between free concentrations and adverse events. Free concentrations were 0.295 +/ 0.260 microgram/ml (mean +/- SD) and unbound fractions were 0.33 +/- 0.24%. Females had 65% higher free concentration compared to males (p less than 0.001). For females, but not for males, there was a statistically significant correlation (p less than 0.005) between age and free concentration. The free concentration was estimated to be 88% higher in an 80-year-old female compared to a 50-year old. Females had a 41% higher unbound fraction than males (p less than 0.005). For females, but not for males, a statistically significant relationship between age and unbound fraction was found. The unbound fraction was estimated to be 62% higher in an 80-year-old female than in a 50-year-old. PMID- 1771645 TI - Disposition of dothiepin after overdose: effects of repeated-dose activated charcoal. AB - Although the tricyclic antidepressant dothiepin is often encountered in deliberate self-poisonings, there are no published studies of its disposition in overdose. In the present study, we have documented the plasma disposition of dothiepin and its major metabolites in eight overdose patients. All had high initial levels of dothiepin (819-3,851 micrograms/L), dothiepin-S-oxide (655 2,162 micrograms/L), nordothiepin (88-422 micrograms/L), and nordothiepin-S-oxide (176-530 micrograms/L) that were considerably above steady-state therapeutic concentrations. In three patients who received treatment with repeated-dose activated charcoal, dothiepin half-lives were 10.6, 12.5, and 13.1 h compared with the literature range of 18.5-24 h. All patients survived and none experienced any significant cardiovascular event despite exhibiting clinical signs of tricyclic antidepressant overdose. We suggest that repeated-dose activated charcoal treatment may decrease the dothiepin half-life after overdose. PMID- 1771646 TI - Pharmacokinetics of quinine and doxycycline in patients with acute falciparum malaria: a study in Africa. AB - The pharmacokinetics of quinine was investigated in patients with acute falciparum malaria treated with quinine alone or in the presence of doxycycline. Twenty-six patients divided into two groups of equal number were enrolled in the study. In the absence of doxycycline, the volume of distribution of quinine (mean +/- SD) was estimated to be 1.32 +/- 0.32 L/kg, and its clearance was 0.125 +/- 0.47 L/h/kg, which was only in partial agreement with previously published data. No effect of doxycycline on the pharmacokinetics of quinine was observed. PMID- 1771647 TI - Individualizing amikacin regimens: accurate method to achieve therapeutic concentrations. AB - Amikacin's pharmacokinetics and dosage requirements were studied in 98 patients receiving treatment for gram-negative infections. A wide interpatient variation in the kinetic parameters of the drug occurred in all patients and in patients who had normal serum creatinine levels or normal creatinine clearance. The half life ranged from 0.7 to 14.4 h in 74 patients who had normal serum creatinine levels and from 0.7 to 7.2 h in 37 patients who had normal creatinine clearance. The necessary daily dose to obtain therapeutic serum concentrations ranged from 1.25 to 57 mg/kg in patients with normal serum creatinine levels and from 10 to 57 mg/kg in patients with normal creatinine clearance. In four patients (4%), a significant change in baseline serum creatinine level (greater than 0.5 mg/dl) occurred during or after treatment, which may have been amikacin-associated toxicity. Overt ototoxicity occurred in one patient. The method of individualizing dosage regimens provided a clinically useful means of rapidly attaining therapeutic peak and trough serum concentrations. PMID- 1771648 TI - Graphic estimation of phenytoin dose in adults and children. AB - Two simple nomograms for individualizing the phenytoin dose in adults and children based on two or more steady-state plasma or serum levels (Css) at different daily doses are described. The nomograms allow one to plot, detect, and exclude abnormal points due to noncompliance, interactions, or laboratory errors, to draw the best line for the remaining points, and to estimate the dose necessary to reach a desired Css without calculations but with the same accuracy as more complex computer-dependent methods based on calculation of Vmax and Km. Our nomograms may be a practical aid in adult or pediatric practice. PMID- 1771649 TI - Performance of fluorescence polarisation immunoassay reagents for carbamazepine, phenytoin, phenobarbitone, primidone, and valproic acid on a Cobas Fara II analyser. AB - Reagents are now available for the measurement of a range of antiepileptic drugs by fluorescence polarisation immunoassay using the Roche Cobas Fara II analyser. Evaluation data are presented that demonstrate that these assays represent a convenient, cost-effective, and analytically reliable alternative to other commercially available systems for the measurement of drugs during therapeutic drug monitoring. The use of a general-purpose analyser, the opportunity to perform different drug assays simultaneously, and long calibration stability confer significant benefits on these methods. These are especially applicable for the laboratory that undertakes only small or moderate numbers of such investigations during therapeutic drug monitoring. PMID- 1771650 TI - Interference of digoxin-like immunoreactive substances with TDx digoxin II assay in different patients. AB - The TDx digoxin II immunoassay was used in controls and in patients not taking digoxin or any other cardiac glycoside. We report the frequency of interference thought to be caused by digoxin-like factors (DLFs). We found a high incidence of false-positive results in 15 patients with severe hepatic disease (60% false positive results). In newborn infants we found false-positive results both when their blood was drawn from a peripheral vein (89% false-positive results) and, more strikingly (100% false-positive results), when it was obtained from an umbilical cord vein (p less than 0.001). Compared to a control group, no statistically significant false-positive results were found in patients with mild to moderate chronic renal failure (n = 21) or in pregnant women (n = 15). In patients with chronic renal failure undergoing hemodialysis six of 25 had false positive results. These results suggest that digoxin levels must be interpreted carefully in patients with chronic liver disease and chronic renal failure and in newborns until new methods that eliminate the interference caused by DLFs become readily available. PMID- 1771651 TI - Trace analysis of methotrexate and 7-hydroxymethotrexate in human plasma and urine by a novel high-performance liquid chromatographic method. AB - A new high-performance liquid chromatographic method for the quantitative determination of methotrexate (MTX) and its metabolite 7-hydroxymethotrexate (7 OHMTX) in blood plasma and urine was developed. The method utilized a solid-phase extraction procedure (Certify II cartridges) for the simultaneous isolation of MTX and 7-OHMTX. Chromatographic separation was achieved using a C18 reversed phase column with isocratic elution. The eluent was irradiated with UV light of 254 nm, which converted MTX and 7-OHMTX by photolytic oxidation to fluorescent products. The limits of detection of MTX and 7-OHMTX in plasma were approximately 0.2 and 1 nmol/L, respectively. The intraday variability in the quantitation of MTX and 7-OHMTX was less than 8% down to 1 nmol/L and 4.6 nmol/L, respectively. Both MTX and 7-OHMTX could be detected in plasma from a patient being treated for rheumatoid arthritis 1 week after the last dose (10 mg orally). PMID- 1771652 TI - Extremely long plasma half-life of amitriptyline in a woman with the cytochrome P450IID6 29/29-kilobase wild-type allele--a slowly reversible interaction with fluoxetine. AB - A 61-year-old woman, a nonsmoker, was admitted to the hospital because of endogenous depression. No concomitant disease, especially kidney or liver dysfunction, was diagnosed. After 9 days of treatment with 125 mg of amitriptyline (AMI) daily, she developed signs of a severe anticholinergic syndrome. Plasma concentrations of AMI (510 ng/ml) and nortriptyline (NOR; 320 ng/ml) were very high and the half-life of AMI was about 120 h. The debrisoquine metabolic ratio was 0.55 and 0.79 on two occasions, which shows that she had no deficiency of cytochrome P450IID6. This result was confirmed with a dextromethorphan test, analysis of restriction fragment length polymorphisms (29/29-kb fragments), and genotyping with allele-specific polymerase chain reaction (homozygous 29 kb wild-type alleles). Patients with high plasma levels of tricyclic antidepressants are usually poor metabolizers of debrisoquine. Before the administration of AMI, our patient was pretreated with fluoxetine. A slowly reversible interaction with fluoxetine or an extremely long-lasting metabolite may be responsible for the long plasma half-life of AMI. PMID- 1771653 TI - Clofibrate metabolite interference in screening test for sulphonylureas. PMID- 1771654 TI - Negligence in the operating room: understanding the law. AB - 1. Negligence has two broad meanings: it is the name for a cause of action, ie, a lawsuit for negligence or the theory of negligence; and it is a certain kind of conduct, ie, negligent conduct where one has breached a certain duty owed to another. 2. Four elements must be met to establish a negligence lawsuit: duty, breach of duty, causation, and damages. 3. The OR nurse must act as a reasonable OR nurse would under the same conditions or similar circumstances to protect the patient from harm. This professional is held to the standards of the reasonable nurse and must act in accordance with community and national standards. PMID- 1771655 TI - The first assistant's role in the management of complications during phacoemulsification. AB - 1. Every surgeon who performs phacoemulsification will encounter complications. Successful management of complications is enhanced by a combination of surgical skill, good judgment, and a well-trained, highly motivated first assistant. 2. The first assistant must have already mastered the names and uses of all instruments and equipment, and will have practiced the eye/hand coordination necessary to work comfortably with microscopes and loupes. A positive attitude and total concentration on the procedure and the surgeon is imperative. 3. A complete understanding of the management of the most common complications will enable the assistant to begin setting the stage to manage a complication during the anticipatory phase. PMID- 1771657 TI - Nursing diagnosis in the O.R. Knowledge deficit. PMID- 1771656 TI - The fine art of giving encouragement. AB - 1. Support and encouragement can significantly influence emotional well-being and profoundly affect quality of life. Encouragement is a powerful nursing strategy, increasing both nursing effectiveness and feelings of job satisfaction. 2. A variety of encouragement techniques are available, including focusing on the positive, communicating respect, showing appreciation, picking up the phone, avoiding a superior attitude, sharing personal experiences, providing motivation, and cheerleading. 3. To be most meaningful, words of encouragement should relate to a specific behavior. If encouragement is not consistent with an individual's personal wishes, goals, or feelings, encouragement may receive a negative response or be denied. PMID- 1771658 TI - AIDS protection is patients' right. PMID- 1771659 TI - Is professionalism dead? PMID- 1771660 TI - Mechanisms behind heterosexual HIV transmission explored. PMID- 1771661 TI - Hemostatic agents. Adjuncts to control bleeding. AB - 1. Allergic reactions can occur with the use of topical hemostatic agents. 2. Some hemostatic agents may be used in combination to provide more effective hemostasis (eg, thrombin and Gelfoam). 3. Documentation should be made of any hemostatic agent left in situ at the time of closure. 4. Use of topical hemostatic agents is generally contraindicated in contaminated wounds. PMID- 1771662 TI - OR nursing 100 years ago: nursing care of President McKinley. PMID- 1771663 TI - A tornado by the tail: the importance of initial assessment. PMID- 1771664 TI - A shift in the "right to die" focus. PMID- 1771665 TI - Understanding people in groups. AB - The leader is the key to a successful group. A leader must communicate acceptance, warmth, and concern for others, because these human qualities are also related to effective group work. In addition to positive facilitation, however, the leader must be able to handle behaviors that disrupt accomplishment of the group's goals. By controlling the group, the leader can maintain a sense of security, which contributes to positive group functioning. PMID- 1771666 TI - Toxin targets AIDS-infected cells. PMID- 1771667 TI - A donation to life: organ procurement. AB - 1. Only 15% of brain dead patients become organ donors. This is due to a lack of public education regarding the benefits of organ donation, lack of recognition of potential donors, poor donor management, and unfortunately, even the reluctance of health-care workers to approach families with the choice to donate. 2. Once the patient has been officially accepted as an organ donor and the consents have been signed, the donor goes through a thorough evaluation involving physician consultations and lab work, and the medical history is reviewed for possible complications. 3. As many as four surgical teams may be involved in organ procurement, and good communication between nurses, physicians, and coordinators is vital to promote successful recovery of donor organs. PMID- 1771668 TI - Pressure-proof your life: creative ways to reduce stress. AB - 1. Stress causes a person to feel anxious and exhausted, and it may cause mood swings. A person under stress is unable to experience much pleasure or joy in life. 2. Effective ways to deal with stress include talking about pressure, taking time off, using music to alter your mood, looking at a negative experience in a positive light, exercising, and reciting affirmations. 3. Stress can build if you allow your life to center on work and production. Remember to take time to play and to experience the lighter side of life. PMID- 1771669 TI - A fragile understanding. PMID- 1771670 TI - Translation, oncogenesis and myopathies. PMID- 1771671 TI - Improved resolution of radiolabelled proteins by blotting before autoradiography. PMID- 1771672 TI - Competent Saccharomyces cerevisiae cells can be frozen and used for transformation with high frequency. PMID- 1771673 TI - Genetically identified protein kinases in yeast. I: Transcription, translation, transport and mating. AB - Studies from a wide array of different fields using Saccharomyces cerevisiae as an experimental organism have uncovered protein phosphorylation as a recurrent theme in the regulation of diverse cellular activities. Protein kinases in yeast regulate a variety of processes; this article discusses several genetically identified protein kinases and the roles that these kinases play in cell growth and development. PMID- 1771674 TI - Diversity of coding strategies in influenza viruses. AB - Influenza viruses have exploited a variety of strategies to increase their genome coding capacities. These include unspliced, spliced, alternatively spliced and bicistronic mRNAs, translation from overlapping reading frames and a coupled stop start translation of tandem cistrons. PMID- 1771675 TI - An immunogenetic view of delayed type hypersensitivity. AB - This review, the third in the series on cellular immune reactivity to tubercle bacilli in the centenary year of Koch's classical paper describing this phenomenon and its possible implications, represents an immunogenetic point of view. In fact this will be quite a broad point of view by an immunogeneticist who is not hampered by specific knowledge on therapy or prevention of tuberculosis. In this respect I probably do not differ very much from Robert Koch 100 years ago! An important difference, however, is that we think we now understand a great deal of the cellular and molecular basis of the immunological phenomena observed by Koch. Immunogenetics has contributed considerably to our current understanding and I will try to review that contribution here. Because thus far my main research interest has been in another mycobacterium, namely Mycobacterium leprae, I will use M. leprae and leprosy as an example to illustrate some ideas. The message of this review is that there is a reason for optimism: the knowledge recently gained by cellular and molecular immunologists as well as immunogeneticists has straightforward implications for the rational development of subunit vaccines and immunotherapeutic strategies. PMID- 1771676 TI - Comparative in vitro and in vivo activity of fleroxacin and ofloxacin against various mycobacteria. AB - In vitro antimicrobial activity of fleroxacin (6,8- difluoro-1-(2-fluoroethyl)-1, 4-dihydro-7-(4-methyl-1-piperazinyl)-4-oxo-3-quinolinecarboxylic acid) and ofloxacin against representative pathogenic mycobacteria was evaluated by the agar dilution method, using 7H11 agar medium. Fleroxacin showed appreciable antimicrobial activity against Mycobacterium tuberculosis (MIC90 = 6.25 mg/l), M. kansasii (MIC90 = 3.13 mg/l), and M. fortuitum (MIC90 = 6.25 mg/l), whereas M. marinum, M. scrofulaceum, M. avium, M. intracellulare, and M. chelonae were highly resistant to the agent. The activity of fleroxacin was comparable to that of ofloxacin. Fleroxacin showed antimicrobial activity against M. intracellulare phagocytosed in murine peritoneal macrophages at a concentration of 10 mg/l in the culture medium, but its activity was considerably lower than that of ofloxacin. On the other hand, the therapeutic activity of fleroxacin against M. fortuitum infection induced in mice was higher than that of ofloxacin. Neither fleroxacin nor ofloxacin was efficacious against M. intracellulare infection. Fleroxacin significantly depressed the growth of M. leprae in the mouse footpad. PMID- 1771677 TI - Sensitivity to sensitins and tuberculin in Swedish children. III. Sequential versus simultaneous skin testing. AB - The aim of this study was to determine whether simultaneous and sequential skin testing with tuberculin and sensitins give consistent results. A total of 475 8- or 9-year-old schoolchildren were skin tested sequentially, at an interval of 3 days, with PPD tuberculin and with either Mycobacterium scrofulaceum or M. avium sensitin. The results were compared with those of 470 simultaneously tested children chosen from the same living area. There were no statistically significant differences between the frequencies of the reactions of sequentially and simultaneously tested children. When the sequential testing procedure was employed, 3.1% reacted to tuberculin, 19% to M. avium sensitin and 30% to M. scrofulaceum sensitin, taking a 6 mm cut-off. The corresponding figures for the simultaneously tested children were 4.7, 21 and 36%, respectively. Thus, there was no indication that the simultaneous testing procedure in itself influenced the results, neither was there any sign of a booster effect when testing in sequence with an interval of 3 days in non-BCG-vaccinated children. PMID- 1771678 TI - Adenosine deaminase levels in cerebrospinal fluid in tuberculosis and bacterial meningitis. AB - Adenosine deaminase activity was measured in cerebrospinal fluid of patients with confirmed tuberculous and bacterial meningitis. The values were compared with those of control subjects without meningitis. A statistically significant increase in the level of this enzyme was noted in the two types of meningitis, but no definite demarcation in the levels was observed between the two types. Therefore increases in adenosine deaminase activity may not be of such diagnostic significance as reported elsewhere. PMID- 1771679 TI - Diagnostic value of ascites gamma interferon levels in tuberculous peritonitis. Comparison with adenosine deaminase activity. AB - The value of ascites gamma interferon concentration and ascites adenosine deaminase activity in distinguishing tuberculosis from other causes of ascites was examined in a prospective study of 86 patients with ascites, including 16 with tuberculous peritonitis. Gamma interferon concentration was higher in tuberculous peritonitis than in the other causes of ascites (p less than 0.0001), and a cut-off between 3 and 9 u/ml reached a sensitivity and a specificity of 100%. The mean (+/- SD) gamma interferon level in tuberculous ascites was 39.3 +/ 18.3 u/ml in patients seronegative for HIV and 14.2 +/- 4.7 u/ml in patients with AIDS (p = 0.01). Adenosine deaminase activity in tuberculous ascites was also higher than in the other causes of ascites (p less than 0.0001), and a cut off of 40 u/l reached a sensitivity of 100% and a specificity of 97%. The two false positives for adenosine deaminase test were true negatives for the gamma interferon test. There was no significant correlation between gamma interferon concentration and adenosine deaminase activity either in tuberculous ascitis or in any other group. This study suggests that ascites gamma interferon determination may be very useful in the screening of tuberculous peritonitis, but its cost makes it advisable to use adenosine deaminase activity as a routine test, at least in areas where tuberculosis is endemic. PMID- 1771680 TI - Differentiation between mycobacteria of the Mycobacterium tuberculosis complex by pyrolysis mass spectrometry. AB - 32 isolates belonging to the Mycobacterium tuberculosis complex were examined by pyrolysis mass spectrometry (PyMS). This technique demonstrated that recent clinical isolates of M. africanum were indistinguishable from those of M. bovis and together formed a homogeneous group distinct from M. tuberculosis. Isolates of BCG were heterogeneous and more closely related to laboratory-adapted strains of M. tuberculosis than to recent isolates of either M. tuberculosis or M. bovis. PyMS is a simple and inexpensive technique which gives interesting information on the relationships between members of the M. tuberculosis complex and can make the clinically important distinction between strains of M. bovis and M. tuberculosis accurately and much more rapidly than conventional techniques. PMID- 1771681 TI - Diagnosis of sputum smear-negative forms of pulmonary tuberculosis by transthoracic fine-needle aspiration. AB - We reviewed 25 patients submitted to transthoracic fine-needle aspiration (TFNA) who had a final diagnosis of pulmonary tuberculosis. In all cases, bacteriological stains and cultures of sputum and bronchial washing had been performed before admission and were negative. According to the material obtained from the procedure, the aspirates were divided in three groups: diagnostic (Ziehl Neelsen and/or culture positive, n = 8, 32%), suggestive (granulomatous inflammatory changes, n = 10, 40%) and inconclusive (nonspecific inflammatory changes, isolated giant cells and/or blood, n = 7, 28%). On chest X-ray, 12 patients had opacities with the greatest diameter not exceeding 4 cm. All aspirates in the diagnostic group were from patients with this type of lesion, while all the inconclusive aspirates belonged to patients with larger lesions. As complications, 1 patient needed thoracic drainage for pneumothorax and 3 patients had haemoptyses. Thus TFNA has a place in the diagnosis of suspected pulmonary tuberculosis when more simple methods have failed, and its effectiveness seems to be increased when the lesions do not exceed 4 cm in diameter. PMID- 1771682 TI - Comparison of three methods for decontamination of faeces for isolation of Mycobacterium tuberculosis. AB - Sputum and faeces were obtained from 276 patients on admission to a study of drug resistance in Hong Kong. Acid-fast bacilli were detected microscopically in 103 (37%) sputum specimens and 135 (49%) yielded Mycobacterium tuberculosis on culture. Three methods were used to decontaminate faeces prior to dilution and culture in selective liquid Kirchner medium. A total of 61 faecal specimens were positive for M. tuberculosis on culture and, of these, pretreatment with sodium hydroxide yielded 60 (98%), Portaels modification of Wolinsky and Rynearsons's method 28 (46%) and the combined use of benzalkonium chloride and 1 hexdecylpyridinium chloride yielded 32 (52%). It is recommended that faeces should be treated with sodium hydroxide followed by dilution and culture in selective media, although it may be necessary to formulate new selective media for mycobacterial species other than M. tuberculosis. PMID- 1771684 TI - A guinea pig model of experimental airborne tuberculosis for evaluation of the response to chemotherapy: the effect on bacilli in the initial phase of treatment. AB - The purpose of this study was to develop and evaluate a guinea pig model of experimental airborne tuberculosis for its ability to assess chemotherapeutic regimens for their efficacy against virulent tubercle bacilli in vivo during the initial phase of treatment. The tissues examined included primary lung lesions and the metastatic foci in lung and spleen which result from the naturally occurring bacillaemia. The treatments examined, INH + RIF, INH + EMB, EMB + RIF, were initiated 4 weeks after infection and were continued for 8 weeks. Although minor differences were observed in the time of onset of a significant bactericidal effect or in the rate of decline in the microbial population, all three treatment combinations resulted in a significant reduction in the number of M. tuberculosis H37Rv recovered from primary lung lesions, primary lesion-free lung lobes and spleen. X-rays taken of excised inflated lung lobes showed a relationship between the degree of calcification of primary lung lesions and the number of surviving bacilli. PMID- 1771683 TI - Pulmonary disease caused by Mycobacterium malmoense. Comments on the possible origin of infection and methods for laboratory diagnosis. AB - Mycobacterium malmoense was isolated from sputum and gastric lavage from a 68 year-old man with gastric adenocarcinoma. The patient meets the criteria for diagnosis of pulmonary mycobacteriosis. The cultural, physiological and biochemical properties of the isolates were compared with other slowly growing mycobacterial species. Fatty and mycolic acid analyses revealed the presence of 2 methyleicosanoic and 2,4,6-trimethyltetracosanoic acids and alpha-, alpha'-and ketomycolates, all regarded as typical for M. malmoense. The possible origin of M. malmoense infections and methods for laboratory diagnosis are discussed. This is the first case of documented infection due to this organism in Belgium. PMID- 1771686 TI - [Ugeskrift for Laeger: 1991 index]. PMID- 1771685 TI - Disturbance of the psychological balance during isoniazid preventive chemotherapy. PMID- 1771687 TI - [Calcium antagonists: comparison of the "ancient" drugs with the modern ones and importance of the cost factor]. PMID- 1771688 TI - [The periodical medical examination update 1991: 1. Screening for cognitive deficiencies in elderly persons. Canadian study group on the periodical medical examination]. PMID- 1771689 TI - [Evaluation of clinical variables leading to involuntary admission in psychiatry]. AB - This study attempted to describe the main clinical criteria used to determine involuntary admissions. The mental status of 140 involuntary-admitted patients and 177 voluntary-admitted patients was examined using an objective questionnaire. An analysis of proportions was conducted on 18 observed signs and symptoms and yielded significant differences (p less than 0.0028) on several variables such as lack of awareness of their psychopathology (autocritique), impulsivity, lack of collaboration, impaired judgement, threatening attitudes, recent history of public mischief, verbal aggressivity, active violent ideation and psychomotor agitation (Phi. Co: 0.31-0.56). There was no significant difference between the two groups for hallucinations and suicidal ideation. These results confirmed the impression that involuntary admission is still necessary for some patients to provide treatment, but in terms of dangerousness toward self or others the clinical prediction shows doubtful value. PMID- 1771690 TI - [Pneumonology in Quebec 1991. A specialty with big challenges]. AB - A brief review of the history of pneumology in Quebec is presented. The present situation is however such that while the incidence of respiratory diseases is steadily increasing, it seems that there will soon be a shortage of manpower in respiratory diseases specialists during the 90's. The Quebec Pneumologist Association faces quite a challenge for the coming years. It will have to solve this problem as soon as possible, with the collaboration of our universities, of the Federation of Quebec Medical Specialists, and with the Quebec Government. This is a must if the Quebec population is to receive the respiratory cares which it expects. PMID- 1771691 TI - [Asthma, an inflammatory disease: the resulting diagnostic and clinical methods]. AB - Asthma is a common disease and its morbidity and mortality seem to increase despite a broader choice of satisfactory medication. Asthma is now identified as a chronic inflammatory bronchial condition and not only as "bronchospasm". Because asthma is a chronic condition associated with an increased mortality, a closer follow-up of asthmatic subjects with objective assessments has been suggested. An international consensus on an adequate treatment action plan has been reached. This scheme suggests the early use of antiinflammatory preparations instead of simple broncho-dilators. PMID- 1771692 TI - [Pulmonary transplantation in Quebec]. AB - Quebec performed the first lung transplantation in 1963 which was unsuccessful in term of survival rate at that time. Since 1985, as the advancement of knowledge of pulmonary pathologies and of surgical techniques, 18 heart lung transplantations and 30 lung transplantations have been performed. PMID- 1771694 TI - [Depression: undertreated or overtreated?]. PMID- 1771693 TI - [Obstructive sleep apnea syndromes]. AB - Obstructive sleep apnea syndrome was first described 200 years ago but the definition of the syndrome was only developed during the last ten years (snoring, apneas during the night, somnolence, high blood pressure, changes of personality). The frequency of the syndrome is not known exactly but the pathophysiology, the morbidity and the mortality associated with the syndrome is facilitating by application of a positive airway pressure (CPAP) at the nose. Good compliance and rapid improvement of the symptomatology with practically no complications make that CPAP is the first choice for the physician in 1991. PMID- 1771695 TI - [Depression. The first meeting with the patient: key to the diagnostic and therapeutic process]. PMID- 1771696 TI - [Choice of antidepressants: the profile of secondary effects is of prime importance]. PMID- 1771697 TI - [Thanks to a plan of action, the general practitioner can better follow the evolution of asthma, a fluctuating disease, and the unforeseen recrudescences]. PMID- 1771698 TI - Metabolism of pyridoxine in mild metabolic hyperoxaluria and primary hyperoxaluria (type 1). AB - Plasma pyridoxine metabolites in plasma and 4-pyridoxic acid excretions in urine were measured in normal subjects, in 7 patients with type-1 hyperoxaluria and in 8 patients with mild metabolic hyperoxaluria, while receiving various doses of pyridoxine. Compliance with ingestion of pyridoxine was verified by measuring urinary 4-pyridoxic acid. In the normal subjects the maximum level of pyridoxal phosphate was obtained after only 10 mg/day of pyridoxine. The patients were divided into nonresponders, good responders and poor responders to pyridoxine according to the fall in urinary oxalate and glycollate excretions. In patients taking pyridoxine, the plasma pyridoxal phosphate levels were as for normal subjects in primary hyperoxaluria, lower than for normal subjects in mild metabolic hyperoxaluria (p less than 0.01), and in the latter group lower in partial responders than in good responders (p = 0.04). Hence in mild metabolic hyperoxaluria there may be difficulty in converting pyridoxine to pyridoxal phosphate. PMID- 1771699 TI - Partial ureteric obstruction in the pubescent rat. II. Long-term effects on the renal morphology. AB - Partial obstruction of one ureter was created in pubescent rats (6 weeks of age) and its effects were studied after 1-15 weeks. Within 1 week, a considerable hydronephrosis and a moderate decrease in the number of glomeruli had developed. These changes did not progress with time. The renal parenchymal weight never became affected and the microstructure was only slightly influenced. Thus, the effects of a partial ureteric obstruction on renal morphology seem to be comparatively mild in this age group, and even less prominent than the modest changes previously observed in rats obstructed since the neonatal period. The reasons for this age difference and for the reduction in glomerular number are discussed. PMID- 1771700 TI - Characteristics and usage of different ureteral stent catheters. AB - Presuming that complications associated with ureteral stenting vary in type and occurrence depending on the material and cross-section of the stent, six types of stents immersed in 48 different preparations of artificial urine for 1 month to observe surface changes with a scanning electron microscope. As a result, there was less encrustation on the silicone material compared with other material types, probably due to the smoothness of the surface. This may be related with higher frequency of spontaneous removal or migration to the bladder of this catheter type. Because silicone catheters have softer and thicker walls with a narrow lumen, they may be appropriate for long-term stenting, but not for urinary drainage. In alkaline bacteriuria, struvite encrustation was observed on all stents. This reaction was especially intense with Towers peripheral stents, which had most irregular and uneven surfaces. In aseptic alkaline urine, calcium phosphate crystals partly covered with proteinaceous debris were noted on catheter surfaces. Although in some patients encrustation of uric acid occurred in the bladder portion of the stents, there was no uric acid encrustation in this experimental study. PMID- 1771701 TI - Effect of trospium chloride on urodynamic parameters in patients with detrusor hyperreflexia due to spinal cord injuries. A multicentre placebo-controlled double-blind trial. AB - In a multicentre placebo-controlled double-blind study 61 patients with spinal cord injuries and detrusor hyperreflexia were treated: 20 mg trospium chloride was given twice daily over a period of 3 weeks. Pre- and posttreatment urodynamic measurements demonstrated large improvements in maximum cystometric capacity (mean = 138.1 ml), decreased maximum detrusor pressure (mean = -37.8 cm H2O) and an increase in compliance (mean = 12.1 ml/cm H2O) in the treatment group. Urodynamic parameters in the placebo group remained substantially unchanged. Comparisons between the two groups revealed highly significant differences for these parameters (all, p less than 0.001). No effect on maximum flow rate and residual urine was detected in either group. The incidence of spontaneously reported side-effects was extremely low and comparable for both groups. PMID- 1771702 TI - Penile venous surgery in impotence: results in highly selected cases. AB - Currently, indications for penile venous surgery are dynamic pharmacocavernosographic findings in impotent patients who fail to respond to intracorporeal application of vasoactive substances and who demonstrate unimpaired arterial perfusion. We used pharmacocavernosometry to measure penile intracorporeal maintenance flow rate in 48 impotent men: 20 had maintenance flow rates higher than 30 ml/min, 12 of the 20 had leakage mainly via Santorini's plexus. In 7 of this 12, venous ligation procedures were initially successful, and in 6 of them erectile function returned. After a mean follow-up, seven of the 12 eventually had to be treated with penile implants. Another 4 used self injection of prostaglandin E1; only 1 patient reported spontaneous erections sufficient for intercourse. Poor long-term results of surgery and recent data on active mechanisms in venous outflow restriction raise doubts as to whether penile venous surgery can ever cure so-called venous incompetence. PMID- 1771703 TI - Clinical experience and successful impregnation using an artificial spermatocele. AB - We have to date installed artificial spermatoceles made of silicone in a total of 33 patients. Artificial insemination of husband (AIH) was performed in 1-9 times using semen collected from 11 of the 33 patients in whom spermatocele was installed, and pregnancy was achieved in 2 cases. Reported cases of pregnancy achieved using semen collected from artificial spermatoceles are few in number; indeed, our successful cases were the fifth and sixth reported so far. The key point for success in achieving pregnancy by means of the artificial spermatocele is considered to be attempting AIH as soon as possible after collecting the sperm, because collection of sperm soon becomes impossible, due to early obstruction of the incised region at the epididymis by degeneration of fibrous tissue. 3% HSA-TMPA medium was found to be useful for sperm collection. PMID- 1771704 TI - Evoked potentials in urology: a method to make an exact diagnosis? AB - Due to the complex innervation of the lower urinary tract, many neurological diseases will lead to disturbances in the function of the lower urinary tract. The usual urodynamic procedures leave a group of patients where definitive diagnosis is impossible. Fifty-three patients were evaluated with evoked potentials of the bulbocavernosus reflex at the Urological Laboratory, Herlev Hospital. In 5 cases (2 with operative sequelae after prolapsed intervertebral discs, 1 with tethered cord syndrome and 2 with early multiple sclerosis) the examination gave a definitive diagnosis. The cases are reported. PMID- 1771705 TI - Diagnosis of renal artery occlusion by duplex sonography and successful lysis therapy. AB - A case of partial renal artery occlusion in a 44-year-old man is reported. Diagnosis was established by Duplex sonography and confirmed by digital subtraction angiography. Subsequently performed local lysis therapy with recombinant tissue plasminogen activator achieved partial revascularization. Doppler evaluation of renal blood flow is useful to detect renal infarction. PMID- 1771706 TI - Coincidental renal cell carcinoma and renal angiomyolipomas in tuberous sclerosis. AB - We report a case of bilateral renal multiple angiomyolipomas associated with renal cell carcinoma on one side in a patient with tuberous sclerosis. The difficulties in diagnosis and management of such a condition are discussed. PMID- 1771707 TI - Primary localized amyloidosis of the ureter associated with osseous metaplasia. AB - A case of primary localized amyloidosis of the ureter associated with osseous metaplasia, presenting as a calcification on computerized tomography, is reported. We believe this is the second such case to be reported in the world literature. The previous 34 cases of primary amyloidosis of the ureter are reviewed and the clinical presentations and treatments discussed. The difficulties of distinguishing the condition from transitional cell carcinoma of the ureter is emphasized. Surgical treatment should be conservative, if possible. PMID- 1771708 TI - Spontaneous perforation of augmented bladder after exstrophy repair. AB - A patient with spontaneous perforation of an augmented bladder following exstrophy repair is presented. Apart from the clinical presentation the various causes for augmented bladder perforation are discussed and the literature reviewed. PMID- 1771709 TI - Sigmoid colon conduit urinary diversion in a renal transplant recipient. AB - Renal allotransplantation is the treatment of choice for patients with end-stage renal disease (ESRD). With increasing technical expertise, it has been realised that presence of a normal lower urinary tract is not a necessity for transplantation. Advanced genito-urinary tuberculosis frequently leads to a small capacity bladder. Herein, we present a case of ESRD due to urinary tuberculosis in whom sigmoid colon conduit urinary diversion was carried out. The immunosuppressed status did not increase the complications of a sigmoid colon conduit urinary diversion. PMID- 1771710 TI - Malignant lymphoma of the prostate. Report of a case. AB - A 63-year-old man with primary malignant lymphoma of the prostate is presented. The patient underwent total cystoprostatectomy and ileal conduit construction. The specimen revealed malignant lymphoma, diffuse small cleaved cell of the gland. Three months after the operation, local recurrence and enlarged lymph node development were demonstrated by computed tomography. The patient tolerated well a combination chemotherapy of VP-16, doxorubicin, cyclophosphamide and prednisolone for 5 cycles. Tumor recurrence and lymph node spread could never be recognized following this drug treatment. The patient has been asymptomatic after this chemotherapy for over 3 years. PMID- 1771711 TI - Primary malignant melanoma of the male urethra. AB - We report a case of primary malignant melanoma of the male urethra, increasing the total number of reported cases to 31. The experience with our case suggests that urinary cytology is a diagnostic method for malignant melanoma and essential in the preoperative diagnosis of this disease. PMID- 1771712 TI - [Pathology of benign and malignant renal cell tumors]. PMID- 1771713 TI - [Localized prostate cancer]. PMID- 1771714 TI - [Localized prostate cancer]. PMID- 1771715 TI - [Prostatic cancer--clinical and morphometric principles]. PMID- 1771716 TI - [Morphologic principles for radical prostatectomy]. AB - As a result of studies by P. Walsh, better anatomical knowledge of the prostate and the periprostatic tissue has considerably improved the surgical technique of radical prostatectomy over the last 10 years. The improvement is reflected by markedly lower morbidity and mortality rates after radical prostatectomy, which has led to a wider use of this operation for the treatment of localized prostate cancer in nearly all centers. Additional information has been obtained since Walsh performed his studies. The present state of the art is presented in this paper. A survey of the literature reveals that many of the new insights into the anatomical structure were already known at the beginning of the last century, some even in 1776. PMID- 1771717 TI - [Intra- and postoperative morbidity of radical prostatectomy]. AB - Operation-related morbidity was analyzed in 147 patients, who had undergone radical prostatectomy during the last 3 years. Six major complications (4.1%) had occurred requiring surgical revision. One single postoperative death (0.7%) was caused by a pulmonary embolus. In 51 patients (34.7%) minor complications were noted. Urinary incontinence was severe in 4 patients (3.9%), which was treated by an artificial sphincter in one man during the follow-up period. Twelve patients (11.8%) complained of stress incontinence, grade I-II. Postoperative determinations of serum PSA were below the detectable range in 81% of the patients, including those with a locally advanced tumor stage and adjuvant antiandrogen therapy. Based on our data, it is concluded that radical prostatectomy is today a safe and standardized operative procedure. PMID- 1771718 TI - [Selection criteria for radical prostatectomy with reference to long-term results]. AB - Between July 1969 and May 1991 radical prostatectomies were performed in 410 consecutive patients with prostate cancer at the Department of Urology, University of Wurzburg. The calculated survival rates for these 410 patients up to 15 years after surgery are very similar to the life expectancy of the normal male age-matched population. In 127 of the 410 cases radical prostatectomy was carried out more than 10 years ago, so that the data relating to these cases have been definitely observed, not merely statistically evaluated. In order to permit a comparison of our results with those reported in the literature, the TNM classification of 1979 was utilized in this study. This means that only tumors penetrating through the capsule of the prostate were classified as stage pT3. Those tumors that are only infiltrating the apex or the prostatic capsule, are classified as stage pT2. For patients with stage pT1pN0M0 and pT2pN0M0-tumors, 10 year survival rates (90.5% and 70% respectively) were recorded which are even slightly better than those of the normal male age-matched population. For patients with tumors extending through the capsule, the 10-year survival rate was found to be 60%. Forty percent ot these patients with stage pT3pN0M0 disease are alive tumor-free after more than 10 years and can thus be regarded as cured. When lymph node metastases were present (stage pT2-3pN1-2M0), some of the patients appeared to benefit from radical prostatectomy, since 4 out of 11 patients with this stage disease survived for more than 10 years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771719 TI - [Autologous blood transfusion and hemodilution in planned large interventions exemplified by 132 radical prostatectomies]. AB - The hospital records of 132 consecutive patients between May 1988 and August 1991 with biopsy-proven local prostate carcinoma, who were scheduled for radical prostatectomy were reviewed. Seventeen patients had positive lymph nodes at pelvic lymphadenectomy and were subsequently given hormone therapy. The mean blood loss in 115 patients undergoing pelvic lymphadenectomy and radical prostatectomy was 1379 ml. Since September 1988 we have operated a program for predeposit autologous blood donation in all patients prior to radical prostatectomy. Sixty patients were entered into this program and 59 received their autologous blood back during operation. Seventy-eight percent of our patients received only autologous blood. The basis of an efficient autologous blood donation program is a simple logistic schedule for all patients (risk and non-risk), who can choose their dates for autologous blood donation. We hope with this study to encourage other centers to introduce autologous blood donation. PMID- 1771720 TI - [The role of radiotherapy in locally limited prostate cancer]. AB - Radiation therapy is a legitimate option of treatment for patients with clinically localized prostate carcinoma. Local control of the primary neoplasm can be improved, since clinical and biopsy evidence of prostate cancer after radiation remains high. Improved megavoltage and interstitial radiation methods are being tested to improve local cure rates, preserve bladder and sexual function, and reduce morbidity. Not all patients respond to radiation therapy, and current investigation may help to distinguish those tumors that will respond versus those better treated by alternative means. PMID- 1771721 TI - [Acceptance of corpus cavernosum auto-injection therapy in long-term treatment of erectile dysfunction]. AB - A total of 121 patients suffering from erectile dysfunction were evaluated by means of a questionnaire. In all these cases corpus cavernosum autoinjection therapy had been recommended. The aim of the study was to determine the acceptance and complications of the therapy, general level of satisfaction with it, and reasons for refusal. Completed questionnaire were received from 89 patients (75.5%), 56.2% of whom had applied the therapy continuously, while 18% had broken it off and 25.8% had never started on therapy (cumulative dropout rate 43.8%). The complications encountered were temporary hematomas (25.8) and deviations of the penis (10.1%). In 6.1% indurations of the penis were found. The frequency of prolonged erection needing an antidote was 0.07% in the continuous treatment group. The relatively high drop-out rate in the autoinjection therapy group shows the necessity for intensive patient care and the need for alternative therapy options and a more critical view of reports already published of success with autoinjection therapy. PMID- 1771722 TI - [Chemical contamination of the cervical mucus in cows in relation to pregnancy and age factors]. AB - Applying the method of absorption atom spectrometry (AAS), the contamination of cervical mucus by chemical elements (Cd, Pb, Hg, Cr, Cu, Zn) was demonstrated in the oestrus period of cows in different ecological agricultural regions of the North Moravian region. The results of observation revealed only a statistically significant difference (P less than 0.05) in Cd contents in the test groups; test group mean = 0.015 micrograms.g-1 Cd, control group mean = 0.006 micrograms.g-1. Cr findings in cervical mucus are of priority importance, the same applies to Cu findings. Zinc was found to be an element influencing negatively the conception of cows. The Zn values in cervical mucus of nonpregnant cows were demonstrated to be significantly higher (P less than 0.01) (conception--group = 0.841 micrograms.g-1, conception + group = 0.219 micrograms.g-1 Zn. So called sum of chemical elements: Cd + Pb + Hg + Cr + Cu + Zn was proposed and evaluated as a picture of the total contamination of cervical mucus. This characteristic was also influenced by the Zn findings in the group of pregnant and nonpregnant cows. Zn: Cd antagonism in cervical secretions of barren and pregnant cows was statistically highly significant (P less than 0.01). Chemical elements in cervical mucus were determined for the first time in a digested sample of cervical secretion. The correlation coefficients used for the cows (n = 99) from a contaminated region showed that the content of chemical elements in cervical secretion was not influenced by the age of cows. The content of chemical elements in cervical secretion was not increasing with the age. PMID- 1771723 TI - [Detection of residues of foreign substances in the tissues of cows and bulls and in bull sperm]. AB - The presence of residues of some chemical foreign substances in the tissues of cow and bull genitals and in sire sperm was investigated due to frequently occurring reproductive disorders in some large cow herds, mainly with the large scale rearing system. Negative effects of these substances on the reproductive process of cows and bulls were supposed to be exerted. In keeping with the opinions and data mentioned by some authors in the literature there is a fact that the sperm and tissues of genitals belong to those biological materials which are the first to respond to the toxic effects of different chemicals by disorders of their physiological functions. These disorders, mainly in sperm cells, can be evaluated objectively from the recorded changes in physical and biological characteristics. The chemicals under investigation were residues of hexachlorobenzene (HCB), alpha, beta, gamma hexachlorocyclohexane isomers, sigma DDT and its metabolites and of polychlorinated biphenyls (PCB). The concentrations of the residues of these substances in the examined biological materials were very low, in some cases they were not detected at all. It is therefore supposed that these residues could not exert and significant effects on the physiological functions of examined cows and bulls with respect to their reproductive organs. These examinations should become more extensive and thorough, mainly in the herds and regions exposed to potential contamination; the residues of foreign substances should be investigated in view of ecological conditions. These postulates are very urgent, as illustrated by the literature data: in some cases negative effects of certain foreign substances (PCB) were found out and demonstrated on the reproductive functions of people and farm animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771724 TI - [The effect of selected antibiotics on microorganisms contaminating boar ejaculate]. AB - The occurrence of microorganisms, including their total counts in boar native ejaculates, was investigated in two stages; the objective of this investigation also was to determine contamination after the sperms were treated with diluents containing the antibiotics ampicillin, gentamycin, apramycin, cefoxitin, or antibiotic combinations penicillin + streptomycin, ampicillin + cefoxitin, gentamycin + cefoxitin and ampicillin + gentamycin. The representation of bacterial species and total counts of microbes in 1 ml diluted sperm stored at a temperature of about 18 degrees C were determined in 24, 48 and 72 h after dilution. The microorganisms were cultivated from all native ejaculates. Proteus sp. (63.3%) and Pseudomonas aeruginosa (51.5% of the total number of examined samples) were the most frequent species. The number of contaminated diluted ejaculates ranged from 12.5 to 95.8% in 24 h after dilution, from 12.5 to 98.5% in 48 h and from 16.8 to 95.8% of the total number of examined ejaculates in 72 h. The occurrence of microorganisms correlated mostly with the efficiency spectrum of the antibiotics or their combinations. The average counts of microorganisms in 1 ml of native ejaculate made 2,363,000 in stage I and 1,472,108 in stage II. The highest average counts in 1 ml of diluted sperm were found in ejaculates containing cefoxitin and apramycin. Gentamycin was the most effective antibiotic used as a sole component (average counts of microorganisms CPM in 1 ml were 416 in 24 h, 955 in 48 h and 2260 in 72 h after dilution); ampicillin and gentamycin were the most efficient combination (14--20--21). This combination exerted very good effects also on Proteus sp. and Pseudomonas aeruginosa. PMID- 1771725 TI - [beta-D-glucosidase in the microvillous zone of small intestine enterocytes in experimental coccidiosis in suckling piglets]. AB - In the small intestine mucosa of 24 gnotobiotic farrows experimentally infected with the oocysts of coccidiosis of Isospora suis (infection administration- 100,000 oocysts) on the first day after the delivery, we carried out the microdensitometric evaluation of the activity of beta-D-glucosidase (phlorizin hydrolase; hetero-beta-galactosidase; lactase-beta-glucosidase complex; EC. 3.2.1.21). Great attention was paid to the topochemistry of enzyme, deposited in a microvillous zone of enterocytes. We studied likewise the activity of beta-D glucosidase in the striped fringe of enterocytes of the four control gnotobiotic farrows, in the age from 2 to 5 days. We found out that in healthy farrows the reaction product of studied disaccharidase is located in high concentrations in the microvillous zone of absorptive cells of the whole small intestine. We proved a topographic gradient at which the beta-D-glucosidase activity decreases in control farrows the duodenum mucosa in the aboral direction. When using the choice substrate for beta-D-glucosidase (5-Br-4-Cl-beta-indolyl-3-D-glucoside) we did not prove the enzyme deposition in the small intestine wall. The negative enteral effect of coccidiosis I. suis was provable in the farrows experimentally infected already on the first day after the infection (DPI) when the beta-D glucosidase activity decreased within the whole small intestine by 15% (ileum) and even by 23% (middle jejunum). The activity reduction had been deepening since the first after the infection and it reached its maximum on the 9th day after the infection when the enzyme concentration in the microvillous zone of absorptive cells reached only 11% of the activity level found in control farrows. On the 10th and 11th day after the infection we registered the increase of the density of beta-D-glucosidase reaction product, however the microvillous zone was even in that final stage of experimental infection significantly deficient (31% of intestine mucosa activity of control farrows). PMID- 1771727 TI - [Immunoenzyme detection of the mycotoxin, ochratoxin A]. AB - Indirect, enzymoimmunological assays of the mycotoxin ochratoxin A were developed. In this technique a polyclonal (rabbit) antibody to ochratoxin A was used, along with the other, peroxidase-labelled (pig anti rabbit) antibody. The sensitivity of this method ranged around 75 pg of ochratoxin A per pit. The range of calibration curve was from 10 to 1000 pg per pit. The cross reactions with other ochratoxins made 1.4% (ochratoxin C). The ELISA test of ochratoxin A can be used as an expeditious screening method for a preliminary examination of the greater number of samples. PMID- 1771726 TI - [Sarcocystosis in lambs]. AB - We studied the problems of sarcocystosis of lambs in regard to the transfer of antibodies over ewes to lambs. Antibodies in the blood serum of 26 ewes found out by help of indirect immunofluorescent reaction (NFR) varied within the range from 640 to 5120 titres, while in six cases their level was higher than in blood. In none of new-born lambs there were proved antibodies to the sarcocystosis before the drinking of colostrum but three days later we already detected antibodies in the dilution 1:4 to 1:128. Then we studied the titre dynamics of antibodies in weaned lambs. In the age of 10-18 weeks we proved only low titres of antibodies, from the 20th to the 24th weeks the titres gradually increased and from the 26th to the 30th weeks the level of antibodies increased significantly (5120 titres) with its maximum on about the 28th week. Animals had no clinic symptoms of disease. In the other part of the work we examined the muscular substance of 342 lambs, killed in the slaughter house, by a digestive method and we carried out the blood serologic examination (NFR). Microcysts were found out in 35.67% of lambs while macrocysts were so in none of them. Specific antibodies of sarcocystosis were detected in 94.44% of young animals. A high discrepancy of the both methods (61.69%) in young animals is a result of a significant antibody reaction at still undeveloped muscular cysts. PMID- 1771728 TI - [A screening method for simultaneous immunochemical detection of aflatoxins and ochratoxin A in cereals and feed]. AB - An immunochemical method was proposed for simultaneous determination of aflatoxin and ochratoxin A with the use of mixed solutions of the following reagents: standards of both mycotoxins, antiserums against the mycotoxins, and radioligands of 125I-aflatoxin B1 and 125I-ochratoxin A. The result of the analytical procedure is the value of concentration of the aflatoxin + ochratoxin A sum in the sample. The procedure needs half the amount of reagents as separate determination of each of the two mycotoxin, and is far less laborious. The proposed simultaneous immunoanalysis is suitable for large-are inspection of grain and feed safety from the viewpoint of aflatoxin and ochratoxin A levels. PMID- 1771729 TI - [Microscopic changes in intercaruncular endometrium and ovarian follicles in cows 35 days after parturition]. AB - Surface epithelium of intercaruncular endometrium in pluriparous cows, crossbreds of Bohemian Pied cattle with Holstein-Friesian cattle, was not coherent until day 15 after parturition, with a variable height of cells (16-64 microns). Oedematous nature of lamina propria was subsiding gradually. From day 15 to day 20 after parturition the cell height of coherent surface epithelium and uterine glands became equable and stabilized (16-32 microns), and the lamina propria assumed its cellular nature with marked infiltration of polymorphonuclears and lymphocytes. Noticeable symptoms of atresia were demonstrated to occur more frequently in ovaries in the follicular population until day 15 after parturition. From day 10 to day 25 after parturition an increasing occurrence of luteinized follicles with diameters of maximally 3 mm was demonstrated. PMID- 1771730 TI - [The effect of clover silage treated with acrylic acid on selected indicators of metabolism in cows around the time of parturition and the status of their calves]. AB - A trial was conducted with 16 cows divided into control and test group (eight cows in either); since day 57.6 +/- 21.1 before parturition, test cows were given feed rations for 107 days which contained 16.0 kg clover-grass silage a day, treated with 3 l acrylic acid per t ensiled matter. Control group of cows was administered feed rations containing silage treated with 4 l formic acid per 1 t ensiled matter from day 55.5 +/- 21.9. In the blood (plasma) of test cows the alkaline phosphatase activity was increasing gradually, in the time after parturition a tendency of lower glucose (P 0.05 to 0.01), thyroxine and triiodothyronine concentrations was observed, and the phagocytal activity of leucocytes and its index decreased. The levels of ketone bodies and aspartate aminotransferase activity were found to be higher. In this period in urine the pH value and net acid-base output were lower, while the inorganic phosphorus concentration was higher. No difference were observed in colostrum density, liveweight of born calves and in the target metabolic parameters in the blood (plasma) of calves. In the 30-day period of investigation the cows of test group gave an average daily milk yield lower by 1.5 l (in comparison with control cows). The residues of acrylic acid (method sensitivity of 1.0 mg acrylic acid in 1 l sample) were not detected in their colostrum and milk. PMID- 1771731 TI - [The effect of temperature and relative humidity on survival of eggs of the cestode, Monieza expansa (Rudolphi, 1810)]. AB - The survival of Moniezia expansa eggs in the droppings of lambs was investigated at various temperatures in laboratory conditions and on test plots outdoors. The optimum temperature of the livability of M. expansa eggs in laboratory conditions is 5 degrees C; at this temperature 10% of oncospheres survived after 161 days. At the temperatures of 10, 25, 35 degrees C the oncospheres survived 105, 28, 46 days respectively, at -12 degrees C it was 28 days. It was for 21 and 35 days that on the test grassy plots the eggs of M. expansa survived in the droppings of lambs in the summer months of July and August at the average air temperatures of 15.7-18.2 degrees C and relative humidity of 67.7-74.3%. In autumn in September and October, at the average temperatures of 5.8-14.6 degrees C and relative humidity of 65.3-76.7% the oncospheres survived for 49 to 91 days. The M. expansa eggs in the droppings of lambs were able to survive on the test plot. The living oncospheres were demonstrated for 119 days from November 1987 to March 1988, and for 175 days till May by means of experimental infection of intermediate hosts. PMID- 1771732 TI - [Cholinergic innervation of the oviduct in rabbits]. AB - Distribution of cholinergic nerves in the oviduct wall in rabbits was investigated by a neurohistochemical method after El Badawi and Schenk (1967). Higher density of cholinergic nerve fibres was confirmed to occur mainly in the isthmic part, but in contrast with literary data it was also found in the ampullar part of oviducts. In the basal parts of oviduct mucosa there were only few cholinergic nerve fibres unlike their density in woman's oviduct. A major part of cholinergic nerves are concentrated in a thick muscular tissue; this is probable to be related with its influence on oviduct motility. In the course of pregnancy, progesterone reduces the number of cholinergic nerves in rabbit oviducts, the number is largely reduced in all layers. These results are considered as preliminary with respect to the number of test rabbits; they indicate that the rabbit oviduct is not any ideal model to study the development of cholinergic innervation in dependence on oestrous cycle phase and pregnancy duration and that they should not be applied to changes in the functional neuromorphology of tuba uterina in woman. PMID- 1771733 TI - [Evaluation of Elevent, a ventilator manufactured in Czechoslovakia for controlled ventilation during inhalation anesthesia in dogs]. AB - Controlled breathing during halothane inhalation anesthesia was tested experimentally in fifty clinically healthy test dogs. In the first group the breathing regime was evaluated when a new Czechoslovak electronic ventilator Elvent was used in the course of 120-minute anaesthesia in 10 dogs. In the second group controlled ventilation was used in 40 dogs in the course of 180-minute anaesthesia with an administration of pipecurium as muscle relaxant. In the course of these experiments a total of 28 parameters was investigated to evaluate the effects of the given breathing regimes on the dog organism. An evaluation of the dynamics of changes in the target parameters indicated that the following model of ventilation programme with these parameters was the best: breathing rate 15-20 breaths per min., per-minute breathing capacity 1.5-3.5 l per min., breathing capacity from 0.15 to 0.25 l, inspiration length 0.8 to 1.2 s and twofold expiration length. PMID- 1771734 TI - [Changes in clinical, hematologic and biochemical indicators in controlled respiration during anesthesia in dogs]. AB - Some clinico-biochemical parameters were investigated in fifty clinically healthy dogs in the course of controlled breathing in halothane inhalation anaesthesia to evaluate in a complex manner the dynamics of metabolic processes in the dog organism. The test dogs were divided into three groups. In the first test group, ECG and values of acid-base balance parameters in venous blood were followed in ten dogs. In the second test group, the values of blood gases were followed in addition to the above-mentioned parameters in twenty anesthetized dogs. In the third test group comprising twenty animals, acid-base parameters in arterial blood and blood gas tension were evaluated. Greatest divergences were recorded in pH values, blood gas tension and acid-base balance values. Partly compensated respiration acidosis was observed already in 30 minutes from the start of anaesthesia, as shown by complex evaluation. The results indicate that also in optimum ventilation programme it is necessary to apply infusion solutions to the internal environment of organism which will secure metabolic rebalancing in the course of artificial pulmonary ventilation. PMID- 1771735 TI - [Pathologic changes in the lungs of deer spontaneously infected with nematodes from the Protostrongylidae family]. AB - Lungs of 30 animals of the red deer (Cervus elaphus hippelaphus) attacked by parasitic helminths were submitted to a histological examination, and the changes which were caused by the nematodes of Protostrongylidae family were estimated. The lungworm Varestrongylus sagittatus (Mueller, 1891) creates hatching tubercles of a dark-red or yellow-green and even ochre colour. The lobular catarrhal bronchopneumonia is a histological correlate. In hatching tubercles there are located adult nematodes, ova of 46 x 27 microns and larvae of the 1st stage. For the infection of the Elaphostrongylus cervi nematodes (Cameron, 1931), the typical changes are those of the character of disseminated interstitial pneumonia. In the pulmonary tissue affected in such a way, there are numerous haemorrhages often visible microscopically. In the capillaries of interalveolar septa there are ova of E. cervi that reach up to 83 microns in dependence on the degree of their development and in alveoli there are larvae of the 1st stage. Adults do not occur in lungs. PMID- 1771736 TI - Intraocular and orbital malignant schwannomas in F344 rats. AB - Intraocular and orbital malignant Schwannomas in two F344 rats are presented. The two Schwannomas were identified among approximately 60,000 male and 60,000 female F344 rats. The intraocular malignant Schwannoma occurred in the iris, invading the corneal stroma through the destroyed Descemet membrane. The malignant orbital Schwannoma occurred in the left orbit, invading the contralateral orbit along the optic nerve. Histologically, the intraocular Schwannoma consisted predominantly of a perivascular fascicular pattern of plump spindle cells associated with marked cytoplasmic vacuolization. The orbital Schwannoma consisted of Antoni type A and B pattern, but Antoni B tissues predominated. Antoni A tissues consisted of closely packed, elongated spindle cells arranged in interlacing fascicles, while Antoni B tissues were highly cellular and consisted of anaplastic, small cells associated with marked cyst formation. Immunohistochemically, the intraocular Schwannoma had a positive immunoreactivity for S-100 protein, while the orbital Schwannoma had a negative immunoreactivity. Ultrastructurally, the cells of both intraocular and orbital Schwannomas had long, thin cell processes and pericytoplasmic basal laminae. Particularly, the plump spindle cells of the intraocular Schwannoma were most strikingly characterized by the well developed, extremely attenuated cell processes arranged in a lamellar or spiral pattern. These cell processes and cell bodies were associated with numerous desmosomes. Intracytoplasmic filamentous granules and bodies, consisting of intermediate filaments approximately 7 nm in width, were additional characteristics of the plump spindle cells. PMID- 1771737 TI - Pathology of enzootic intranasal tumor in thirty-eight goats. AB - Intranasal tumors were studied in 38 goats ranging from 7 months to 8 years of age of both Murciana-Granadina and crossed breeds. Tumors were diagnosed in eight herds. Clinically, the affected goats showed a copious seromucous nasal discharge, ocular protrusion, and skull deformations. The tumors originated from the ethmoid region. They involved one or both nasal cavities, although most were bilateral (26/38). The tumors were generally accompanied by inflammatory polyps. The histologic patterns were very similar in all cases, and the tumors were classified as low grade adenocarcinomas of the nasal glands. Histochemical, immunohistochemical, and ultrastructural studies suggested that the serous glands of nasal mucosa were the probable origin of the neoplastic cells. Budding and extracellular retrovirus-like particles were observed ultrastructurally in 6/8 tumors. The similarities between these caprine tumors and nasal tumors in sheep and the etiologic role of the retrovirus are discussed. PMID- 1771738 TI - T and B lymphocyte subsets in spermatic granulomas in five rams. AB - Epididymal spermatic granulomas from five adult (greater than 4 years old) rams from a commercial flock were evaluated by quantitative histologic methods. Sections were stained for isotype specific immunoglobulin (Ig)-containing cells or specific lymphocyte subsets, as indicated by plasma membrane staining with monoclonal antibodies (MoAb). For the purpose of analysis, individual spermatic granulomas were allocated to one of three groups (early, resolving, or intermediate) on the basis of histologic examination. Ig-containing cells were most prevalent in early spermatic granulomas, and IgG-containing cells predominated in all spermatic granulomas regardless of their presumed age. IgM immunoglobulin-containing cells were the next in prevalence, and IgA-containing cells were infrequent. Assessment of lymphocyte subsets confirmed that lymphocytes present were of both T- and B-cell lineage and were well represented in all spermatic granulomas. CD4+ (MHC Class II-restricted "helper") T-cells were more prevalent in early spermatic granulomas than in intermediate or resolving types, while CD8+ (MHC Class I-restricted, "cytotoxic/suppressor") T-cells were more prevalent in spermatic granulomas of the intermediate type. These results suggest that in addition to an essentially foreign body reaction to extravasated spermatozoa, both local production of antibody and accumulation of a variety of B and T-lymphocytes are present in ovine spermatic granulomas. PMID- 1771739 TI - Brucella abortus-associated meningitis in aborted bovine fetuses. AB - Granulomatous meningitis was present in 6/33 bovine fetuses from which Brucella abortus (B. abortus) had been isolated. Meningitis was severe in three fetuses, moderate in one fetus, and mild in the remaining two fetuses. The meningitis was characterized by the infiltration of a mixed population of lymphocytes, plasma cells, and macrophages in the leptomeninges. Vasculitis characterized by the infiltration of lymphocytes and plasma cells in the vascular wall was observed in the vessels of the cerebral cortices of 4/6 fetuses. Gram negative coccobacilli were present in the cytoplasm of the leptomeningeal macrophages and extracellularly. Brucellar antigens labeled by the avidin-biotin-peroxidase complex method were present in massive amounts in leptomeningeal macrophages and in small foci of stained cells in the choroid plexus and ependyma. The findings indicate that B. abortus is one of pathogens capable of inducing meningitis in bovine fetuses. PMID- 1771740 TI - Lentivirus-induced pulmonary lesions in rhesus monkeys (Macaca mulatta) infected with simian immunodeficiency virus. AB - Necropsy reports from 28 rhesus monkeys that had been experimentally infected with simian immunodeficiency virus (SIV) and that were free of cytomegalovirus were reviewed. Lung sections from 24 of these monkeys that had no etiologic agent other than SIV detected in the lung were studied in detail by histopathologic, immunohistochemical, and electron microscopic examination and by in situ hybridization. Fourteen of the monkeys were part of a serial euthanasia study, while others were euthanatized after they became moribund. The following lesions were detected: perivascular inflammation, vasculitis, interstitial pneumonia, syncytial cells, hemorrhage, fibrin exudation, and pleural fibrosis. Perivascular inflammation was the most frequent lesion and occurred as early as 2 weeks after inoculation. Severe pneumonia and numerous syncytial cells were seen only in animals euthanatized because they had become moribund. The lesions appeared to be directly due to SIV infection. SIV antigens, RNA, and virions were detected in syncytial cells and macrophages by immunohistochemical examination, in situ hybridization, and transmission electron microscopic examination, respectively. The amount of virus present was correlated with the severity of the lesions. The SIV-induced lesions were different from those of the lymphocytic interstitial pneumonia, which occurs in human immunodeficiency virus-infected children and in ovine lentivirus-infected sheep and goats. PMID- 1771741 TI - Enterovirulence of enterotoxigenic Bacteroides fragilis in gnotobiotic pigs. AB - A porcine isolate of enterotoxigenic Bacteroides fragilis colonized the intestinal tract and caused watery, nonhemorrhagic diarrhea when given orally to 12, 1- to 2-day-old gnotobiotic pigs. Diarrhea occurred 2 to 3 days post inoculation and continued throughout the 4 to 6 day post-inoculation period. Diarrheic pigs became mildly anorexic and dehydrated. They developed intestinal lesions characterized by swelling, vacuolation, and exfoliation of enterocytes, and crypt hyperplasia throughout the large intestine and, to a lesser extent, in the distal small intestine. Bacterial adherence to, or invasion of, the intestinal mucosa was not detected. A porcine isolate of nonenterotoxigenic B. fragilis was administered orally to six control pigs. The isolate colonized the intestinal tract, but the pigs did not develop clinical disease or intestinal lesions. The pathogenetic mechanism of the disease may involve mediation by a soluble enterotoxin (or toxins) elaborated by B. fragilis. PMID- 1771742 TI - The effects of Escherichia coli and its endotoxin on amyloidogenesis in ducks. AB - To compare the effects of two inocula on the induction of amyloidosis in normal and thymectomized ducks, 180 normal and 50 thymectomized ducks were injected intravenously weekly for up to 16 weeks with either crude endotoxin or crude whole cell extract of a virulent strain of Escherichia coli (O78), and another 60 ducks were injected with normal saline as study control. During the first 5 weekly injections, the initial doses of inducing agents were the smallest and then adjusted upward to the maximum study doses (1 or 2 mg/bird of crude endotoxin and 15-18 x 10(8) bacteria/bird of crude whole cell extract), which were then maintained over the course of the study. The incidence of amyloid deposition were: 50.00% (25/50) for thymectomized ducks that received 1 mg/bird/week of crude endotoxin, 61.67% (37/60) for intact ducks that received 15 x 10(8)-18 x 10(8) bacteria (crude whole cell extract)/bird/week, 53.33% (32/60) for intact ducks received 2 mg/bird/week of crude endotoxin, and 63.33% (38/60) for intact ducks received 1 mg/bird/week of crude endotoxin. The results suggest that crude whole cell extract and crude endotoxin induced amyloidosis in ducks at similar rates and that, in ducks, thymectomy has no appreciable effect on the occurrence of amyloidosis. PMID- 1771743 TI - Myeloencephalopathy with Rosenthal fiber formation in a miniature poodle. PMID- 1771744 TI - Giant cell glioblastoma in a Syrian hamster. PMID- 1771745 TI - Neuronal loss and gliosis in limbic system in an epileptic dog. PMID- 1771746 TI - Chronic eosinophilic enteritis attributed to Pythium sp. in a horse. PMID- 1771747 TI - Spontaneous leprosy in a chimpanzee (Pan troglodytes). PMID- 1771748 TI - Bovine herpesvirus 4 isolates: a comparison of three major glycoproteins. AB - Twenty-four Belgian field isolates of bovine herpesvirus 4 (BHV-4), together with four reference strains were compared by radio-immunoprecipitation and western blotting using a polyvalent antiserum and monoclonal antibodies raised against major glycoproteins. Most of these strains showed the same protein profile as the European reference strain Movar 33/63. For two strains the molecular weight of gp 6, p (gp 10/gp 17) and gp 10 were the same as those of the American reference strain DN 599. No relationship could be established between the protein profiles and origin of the isolates or with the restriction patterns. This study provides a view of the molecular weight variations of the major BHV-4 glycoproteins among field isolates. PMID- 1771749 TI - Abortion in Japanese cows caused by Chlamydia psittaci. AB - An outbreak of abortion in cows occurring in Niigata Prefecture was shown to be caused by Chlamydia psittaci. Elementary bodies characteristic of Chlamydia were found in the liver of aborted fetuses and C. psittaci antigen was demonstrated by indirect immunofluorescence. Chlamydia was isolated from the liver of aborted fetuses by the yolk sac inoculation of developing chick embryos and by the intraperitoneal inoculation of guinea pigs. Abortion occurred mostly in middle or late pregnancy. Aborted fetuses showed subcutaneous edema and gelatinous infiltration, enlarged liver and spleen, and dark red pleural and ascitic fluid. Focal necrosis was shown in the liver, spleen and lymph nodes. Serological findings and isolation of Chlamydia from fecal specimens indicated a wide dissemination of C. psittaci among cows in the area. PMID- 1771750 TI - Characterization of the immunogenicity of formaldehyde detoxified Pasteurella multocida toxin. AB - The immunogenicity of the Pasteurella multocida toxin (PMT) was studied in murine model systems. Mice were vaccinated with either formaldehyde treated pure PMT (pure toxoid) or formaldehyde treated crude extract of toxigenic P. multocida (crude toxoid). The corresponding mean anti-PMT titres, sero-conversion rates and survival rates after challenge with affinity purified PMT were compared. When assessed both by anti-PMT titres and seroconversion and challenge, pure toxoid was a more potent immunogen than crude toxoid. This greater immunogenic potency was unaffected by the addition of killed cell preparations of Bordetella bronchiseptica, non-toxigenic P. multocida and B. pertussis. Increasing anti-PMT titres and seroconversion rates were induced by increasing doses of formaldehyde treated PMT (fPMT) in the pure toxoid vaccines, but not in the vaccines containing crude toxoid. However, improved survival rates were observed for both types of vaccine, when the fPMT content was raised. Immunization of pregnant mice with vaccines containing fPMT induced protection of the offspring against challenge with PMT; the protection of the offspring corresponded to that of the mother. PMID- 1771751 TI - Preliminary observations of interaction between bacteriophages and Streptococcus bovis bacteria on ruminal epithelium primoculture. AB - Five Streptococcus bovis strains (47/3, 59/2, 4/1, 46/2 and 44/9) isolated from calf ruminal fluid samples were examined for the adherence to cultured ruminal epithelium cells. Four strains (47/3, 59/2, 4/1 and 46/2) were able to attach to the cultured epithelial cells. However, S. bovis 47/3 strain attached to the target cells in significantly greater numbers than the other strains. Strain 44/9 did not adhere to cells of ruminal epithelium. The adherent bacteria were observed on the surface of differentiated (mainly keratinized) cells of ruminal epithelium primoculture only. The different effect of F4, F5 and F6 bacteriophages was ascertained on S. bovis bacteria adhering to rumen epithelial primoculture. A significant decrease in the number of adherent bacteria was shown after cultivation of strains 47/3 and 4/1 with F6 bacteriophage and of 47/3 strain with F4 phage. The F5 bacteriophage had no significant effect on these bacteria. PMID- 1771752 TI - Virulence and serum-resistance in different clonal groups and serotypes of Yersinia ruckeri. AB - The virulence in rainbow trout (Oncorhynchus mykiss) of 32 isolates of Yersinia ruckeri, representing a range of biotypes, serotypes, and OMP-types, was examined. Virulence was assayed in fish of average weight 7.7 g by bath challenge for 1 h with approximately 5 x 10(7) cells per ml. Two of the six serotype O1 clonal groups of Y. ruckeri, clones 2 and 5, were virulent, whereas the other four clonal groups, clones 1, 3, 4 and 6, as well as all serotype O2, O5, O6 and O7 isolates examined, were avirulent. Analysis of susceptibility to the bactericidal effect of non-immune rainbow trout serum demonstrated an association between virulence and serum resistance. The virulent serotype O1 clonal groups were serum resistant, whereas the avirulent serotype O1 clonal groups and other serotypes were, with some exceptions, serum sensitive. The fact that some serum resistant isolates were avirulent suggested that other factors may be required for the full expression of virulence. The study also demonstrated that rainbow trout and brook trout (Salvelinus fontinalis) differ in their susceptibility to Y. ruckeri. PMID- 1771753 TI - Determination of K88 antigens and enterotoxins of Escherichia coli strains isolated from Polish piglets with diarrhea by the use of enzyme-linked immunosorbent assays. AB - We studied 103 Escherichia coli strains isolated from suckling and weaned piglets with diarrhea using different ELISA tests. K88 fimbrial antigen was determined by the slide agglutination test and the ELISA inhibition method. LT and STa enterotoxins were tested directly in the microtiter plates using monoclonal antibodies. It was found that 56.3% strains possessed K88 antigen, all of which were of the K88ac type. There was 100% correlation between the slide agglutination and ELISA tests. Of the 103 strains tested 68.9% produced LT or STa or both toxins. LT-positive strains were the most common ones in both groups of piglets. All K88-positive strains were enterotoxigenic and elaborated LT (56 strains) or LT and STa (2 strains); STb production was not determined in this study. Our ELISA tests were easy to perform, specific and can be used for determination of K88 and enterotoxins in E. coli strains isolated from piglets. PMID- 1771754 TI - Comparison of Mycoplasma gallisepticum strains and identification of immunogenic integral membrane proteins with Triton X-114 by immunoblotting. AB - Pooled chicken antisera from 33 and 77 days post Mycoplasma gallisepticum strain R contact-exposure reacted with cell proteins of 19 M. gallisepticum strains. These pooled antisera reacted with more proteins and with greater intensity to reference strains (R, PG31, S6, and A5969) and nine field strains than they did with six other field strains including three (703, 503, and 730) that have been described as serological variants. Following extraction with Triton X-114 the majority of immunogenic M. gallisepticum proteins partitioned exclusively or primarily into the detergent phase indicating that they are integral membrane proteins. This included three immunogenic species-specific proteins (p64, p56 and p26). M. gallisepticum p56 was detected, by immunoblotting, in 18 of 19 strains suggesting that it could serve as an antigen for serological tests. P26 was evident in 13 of 19 strains. Hyperimmune antiserum to p64 reacted with a 64 kDa protein in 19 M. gallisepticum strains, but did not react with seven other avian Mycoplasma spp. There was no evidence found supporting the view that p64 is the hemagglutinin of M. gallisepticum. PMID- 1771755 TI - Identification of ruminant mycoplasmas by dot immunobinding on membrane filtration (MF dot). AB - A simple method of species identification of ruminant mycoplasmas by dot immunobinding (MF dot) is described. Mycoplasmas from broth cultures were directly trapped onto the surface of low protein-binding affinity membranes by vacuum filtration. Specific polyclonal anti-mycoplasma sera were then applied. Mycoplasma-antibody complexes were then revealed by an enzyme conjugated anti immunoglobulin. A positive reaction was indicated by the development of a color reaction when substrate was added. The method was tested on 22 type-strains representative of species, subspecies, types or yet unnamed serogroups of mycoplasmas isolated from ruminants. MF dot presented a specificity close to that which could be expected from the reference serological tests. The advantages of the MF dot over the other tests are utility, rapidity, ready standardization and it allows many samples to be treated simultaneously. PMID- 1771756 TI - A study of the heterogeneity of isolates of Mycoplasma ovipneumoniae from sheep in New Zealand. AB - To investigate the heterogeneity of Mycoplasma ovipneumoniae, sixty isolates from three sheep on each of twenty farms were examined by restriction endonuclease analysis (REA) and SDS-PAGE. All were found to be different except for three isolates obtained from one farm. The protein and REA patterns of individual isolates were both highly reproducible and remained unchanged following long term passage (approximately 400 generations) in vitro. No plasmids were detected in the twelve strains which were examined and when two isolates were co-cultured in vitro, no genetic interchange, as judged by changes in REA patterns were detected. Since the heterogeneity of M. ovipneumoniae when examined by SDS-PAGE is too great to allow groups to be recognised, it could be advantageous for this purpose if only surface proteins were compared. As a preliminary step to this end we have identified several surface proteins of M. ovipneumoniae and found that some are common to all strains, one surface protein was shared by five of the eight strains examined and another was unique to one strain. This approach has the potential to allow the recognition of grouping of M. ovipneumoniae isolates. PMID- 1771757 TI - The isolation of multiple strains of Mycoplasma ovipneumoniae from individual pneumonic sheep lungs. AB - The heterogeneity of Mycoplasma ovipneumoniae isolates from the lungs of sheep with chronic non-progressive pneumonia (CNP) from the same flock raised the possibility that multiple isolates derived from one lung were not all identical. To test this hypothesis, thirty isolates were obtained from each of six pneumonic sheep lungs at slaughter. Four lungs had relatively severe lesions and from each of these, three or four strains of M. ovipneumonia, distinguishable by REA and in most cases by SDS-PAGE, were detected. From the lungs of each of two sheep with mild lesions, two strains of M. ovipneumoniae were detected. Four isolates from one lung were further examined by restriction endonuclease analysis (REA) using many restriction endonucleases. Those which differed with EcoRI also differed when other restriction endonucleases were used. However, partial digests occurred mainly with those restriction endonucleases which recognise cytosine-rich sequences. The presence of multiple strains of one species of microorganism in individual lesions is an unusual concept which may not be limited to one disease or to one host. PMID- 1771759 TI - Biochemical changes in the peritoneal fluid following rumenotomy in goats. PMID- 1771760 TI - The role of traditionally harvested hay in the transmission of ovine fasciolosis in the Ethiopian highlands. PMID- 1771758 TI - Bacteraemia in man and animals: an overview. AB - Bacteraemia signifies invasion of the bloodstream by bacteria. In most systemic infections in man and animals, bacteria enter the blood at some stage during the infection and are rapidly distributed throughout the body. A wide variety of organisms have been associated with bacteraemia. Prompt detection of the aetiological agents of bacteraemia is of prime importance in clinical microbiology. There are no defined recommendations for blood cultures in animals but both conventional and improved methods are available for detection of bacteraemia in man. The consequences of bacteraemia are as diverse as the potential aetiological agents. Monoclonal antibodies to the core glycolipid (lipid A) seems very promising for the treatment of bacteraemia and septic shock caused by Gram-negative bacteria in man and animals. PMID- 1771761 TI - The reticulocyte response to the anaemia in goats caused by experimental Trypanosoma brucei infection. PMID- 1771762 TI - Gossypol pharmacokinetics in mid-lactation Brown Swiss dairy cows. AB - A bolus equivalent to 450 ppm (dosage based on average feed intake for lactating dairy cows of similar mass) of gossypol was administered orally to three Brown Swiss dairy cows in mid lactation daily for a 7-day treatment period. Blood samples were taken during a 2-day pretreatment period, the 7-day treatment period and a 6-day recovery period. The serum recovered from the cows was stored at -20 degrees C until analysis for extractable gossypol content. The highest concentration of gossypol (a mean of 0.53 microgram/ml serum) was attained in all the cows on day 6 of the treatment period, indicating that a steady-state condition had been reached before the end of the treatment period. The gossypol concentrations then gradually declined during the 6-day recovery period but never fell to the zero baseline. The cows exhibited terminal elimination half-lives of 67, 67.5 and 40 h. Gossypol elimination was best described by a bi-exponential decay curve in two cows and a mono-exponential decay curve in the remaining cow. PMID- 1771763 TI - Arterial blood sample collection from the newborn calf. AB - Measurements of arterial blood gas tensions and acid-base status provide a means of assessing how well the respiratory system is functioning. This information is essential for thorough evaluation of a compromised neonatal calf but arterial blood sampling is difficult immediately after birth. A technique for collecting blood from the brachial artery of the newborn calf is described. This technique, which uses an easily located site, has been successfully used in field studies to determine arterial blood gas values in such calves. PMID- 1771764 TI - The nature of naturally occurring mutations in the hemagglutinin gene of vaccinia virus and the sequence of immediately adjacent genes. AB - The expression of the vaccinia IHD-J hemagglutinin (HA) gene is regulated by two promoters, an early/late and a second distinct late promoter. The first promoter results in transcripts that begin early and are synthesized throughout the infection. All transcripts from this promoter initiate at the same 5' site. A second promoter is only active late in infection and initiates transcription some distance upstream of the first promoter. We have previously shown that the transcriptional start site controlled by this second, "late only" promoter lies within the coding sequence of an upstream reading frame (p16-ORF), whereas the termination of early transcription of the HA gene utilizes a transcription termination signal (TTTTTNT) located just beyond the coding region of an immediately downstream reading frame (p17-ORF). In order to assist our understanding of HA gene expression, we report here the sequence of these two ORFs adjacent to the HA gene. The HA-ORF itself consists of 945 bp, whereas the upstream p16-ORF consists of 429 bp and the downstream p17-ORF of 453 bp, sufficient to encode polypeptides of 16 and 17 kD, respectively. While many strains of vaccinia are HA+, rabbitpox virus and the variant of vaccinia IHD-J, designated IHD-W, are HA-. We report and compare here the HA gene sequences of wild-type rabbit poxvirus, two spontaneous HA+ revertants of rabbit poxvirus, and the HA- vaccinia strain IHD-W to that of the previously sequenced (1) prototype HA+ IHD-J strain of vaccinia. All differences were found to occur within the HA open reading frame.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771765 TI - Nucleotide sequence of cDNA encoding the coat protein of beet yellows virus. AB - A cDNA clone of beet yellows viral RNA expressed the viral coat protein gene in E. coli. The sequence of the 2724 nucleotide insert revealed three open reading frames, the 3' of which was shown to be the coat protein cistron. This cistron is expressed in E. coli, in spite of there being no obvious ribosome binding site upstream. PMID- 1771766 TI - Genome replication/expression strategies of positive-strand RNA viruses: a simple version of a combinatorial classification and prediction of new strategies. AB - A combinatorial approach to the classification of replication/expression strategies of positive-strand RNA virus genomes is suggested. Eighteen genome strategies defined as combinations of distinct modes of expression and replication are briefly characterized, 10 of which have been actually found in diverse virus groups. The chances for realization of the remaining eight strategies are evaluated. It is demonstrated that positive-strand RNA virus genome strategies are not necessarily monophyletic characters and could, in some cases, evolve convergently. PMID- 1771767 TI - Is dopamine involved in the generation of the light peak in the intact chicken eye? AB - The implication for dopamine (DA) in the modulation of the standing potential (SP) and the light peak (LP) was tested in intact chickens using an indirect EOG method. After an intravenous or intravitreal injection of DA, a transient, dose dependent increase in the SP was observed. The LP, recorded after an intravenous injection, was preserved. But after an intravitreal injection, the LP was strongly reduced or even abolished depending on the dose of DA, whereas the photoreceptor response was unchanged. The data supports the hypothesis that the light peak, which is generated by a neural retina-pigment epithelium interaction, could be triggered by dopamine released at light onset from the inner retinal layers. PMID- 1771768 TI - The effect of a slow flicker on the human photopic oscillatory potentials. AB - Flicker-induced modifications of the human photopic oscillatory potentials (OPs) were investigated with the use of flash stimuli of 0.89 and 8.9 cd m-2 sec in strength. When the dimmest stimulus is used, increasing the rate of presentation from 0.5 to 20 Hz augments the amplitude and peak time of OP2. For a brighter stimulus, the 10 Hz flicker significantly reduces the amplitude of OP2 and OP3, increases the peak time of OP2 and reduces that of OP4. The 20 Hz flicker increases the peak time and reduces the amplitude of OP2 and completely abolishes OP3, while it has no significant impact on the amplitude and timing of OP4. The data presented support the claim that each OP making the photopic response represent independent electrophysiological entities. PMID- 1771769 TI - Visual evoked magnetic fields to flash and pattern in 100 normal subjects. AB - The practicality of recording visual evoked magnetic fields in 100 subjects 15-87 yr of age using a single channel d.c. SQUID second order gradiometer in an unshielded environment was investigated. The pattern reversal response showed a major positive component between 90 and 120 msec (P100M) while the response to flash produced a major positive component between 90 and 140 msec (P2M). Latency norms of the P100M were more variable than the corresponding P100 and P2 visual evoked potentials. The latency of the P100M may show a steep increase with age in most subjects after about 55 yr whereas only a small trend of latency with age was detected for the flash P2M. PMID- 1771770 TI - Time-till-breakdown and VEP measures of short-range apparent motion. AB - Varying short-range apparent motion (AM) stimulus displacements from 2.7 to 21.6 min it was found that VEP amplitudes varied as a function of the limits for short range AM described using time-till-breakdown as a behavioural measure of AM strength. This VEP amplitude difference was, however, in the reverse direction to that predicted as the "motion" condition elicited lower VEP amplitude responses than the "non-motion" conditions (which did not significantly differ from each other). This direction of VEP amplitude difference was supported by an intensive study of a single subject. The "breakdown effect" enabled VEPs to be gathered during periods in which the subjective experience was of either coherent lateral motion, or breakdown (incoherent motion) without changing any stimulus parameter. The VEP component identified in expt 2, as predicted, was of lower amplitude during motion with respect to periods of breakdown. The results of these experiments are discussed in terms of describing motion and breakdown in short range AM displays as "coherent" and "incoherent" motion, rather than as "motion" and "non-motion". PMID- 1771771 TI - Critical flicker frequency to red targets as a function of luminance and flux across the human visual field. AB - When the number of cells (cones at eccentricities 0-10 deg and ganglion cells above 10 deg) stimulated at various retinal locations was kept constant by enlarging the stimulus area with increasing eccentricity in the temporal visual field (M-scaling), CFF to red stimuli with dark surround increased as a single function of photopic luminous flux, collected by ganglion-cell receptive-field centres and calculated by multiplying Ricco's area with retinal illuminance at each eccentricity studied. The increase of CFF with the logarithm of photopic flux could be best explained by the Collins logarithmic law, the Kelly square root law was almost equally good and the Ferry-Porter law was poorest. Adopting the general formulation of Corwin and Dunlap (Vision Research, 27, 2119-2123, 1987) the exponent of CFF is 0, 0.5, and 1 for the Collins, Kelly and Ferry Porter laws, respectively. The exponent that best explained our results was found to be 0-0.3. PMID- 1771772 TI - Two carriers for motion perception: color and luminance. AB - Starting with the experiments of Ramachandran and Gregory (Nature, 275, 55-56, 1978), several psychophysical studies in apparent motion (AM) have established that the perception of motion is significantly impaired at equiluminance. Still debated, however, is whether color alone can resolve ambiguities in AM. We report here on several psychophysical experiments, the quantitative results of which indicate that color does play a substantial role in AM. These findings seem to support recently proposed neurophysiological frameworks according to which there exist significant interactions among the neuronal pathways mediating the perception of basic visual attributes such as color, motion, form and depth. PMID- 1771773 TI - Judging object motion during smooth pursuit eye movements: the role of optic flow. AB - We tend to following moving objects with our eyes. To estimate their velocities, therefore, we must take account of our eye movements. During smooth pursuit, velocity judgements can be led astray by moving the background. Do we misjudge an object's velocity when the background moves because the additional shift of the background's image on the retina is interpreted as the result of additional motion of the observer rather than as motion of the background? In the present experiment, the traditional configuration of target and background was supplemented with a "floor of tiles" drawn in perspective directly under the "background". The motion of this new simulated plane was used to specify whether the additional retinal shift represents actual motion in the background, rotation of the observer's eyes, or observer locomotion parallel to the target. Moving the background clearly influenced the perceived velocity of the target. However, "specifying" whether the observer or the background had moved did not affect the outcome. For observer locomotion parallel to the target, the change in target velocity that is predicted by the optic flow depends on the perceived distance of the target. Nevertheless, presenting the target at different distances (by presenting different images of the two eyes) did not affect the subjects' settings. The results show that our judgement of objects' velocities does not depend on an assessment of our own movements on the basis of a global analysis of the optic flow. PMID- 1771774 TI - Ocular proprioception and efference copy in registering visual direction. AB - We measured the roles of eye muscle proprioception ("inflow") and efference copy ("outflow") in registering eye position. During monocular fixation, pressing on the side of an occluded eye results in a passive rotation, changing the proprioception without affecting oculomotor efference. As we have shown previously, a constant press on the side of the viewing eye induces active resistance to rotation, changing efference because oculomotor innervation compensates for the eyepress; the viewing eye's fixation remains constant. Using these two types of eyepress, both perceived target deviations and pointing biases in an unstructured visual field were measured in 8 subjects under efference copy, proprioception and control (no eyepress) conditions. Eye deviation was measured photoelectrically. Physiological gains of efference copy and proprioception was about 5/8 and 1/4 respectively. There was no statistically significant difference between perceptual judgement and open-loop pointing. The sum of gains of efference copy and proprioception, about 7/8, indicates incomplete registration of eye eccentricity in an unstructured field, and quantitatively accounts for several previously unexplained results in the literature. PMID- 1771775 TI - The time courses of visual mislocalization and of extraretinal eye position signals at the time of vertical saccades. AB - The time course of perceptual mislocalization at the time of vertical saccades was compared with that reported previously for horizontal saccades. Despite the difference in the oculomotor system involved in generating these saccades with different directions, the time course of the perceptual mislocalization and that of the extraretinal eye position signal estimated on the basis of visual mislocalization were the same between vertical and horizontal saccades. The results are discussed in relation to the outflow theory of subtraction, and it is argued that there is a common neural center for producing extraretinal eye position signals for both vertical and horizontal saccades. PMID- 1771776 TI - The role of colour as a monocular depth cue. AB - Does colour information play a role in the perception of depth? Its input to stereopsis is weak, and it has been suggested that depth from monocular cues, such as texture gradients, is also abolished at isoluminance (colour contrast with no luminance contrast). We first investigated whether depth from texture gradients disappears at isoluminance. The percept remained unaltered. Further experiments revealed that certain colour gradients (at isoluminance) markedly affected the perceived depth. A gradient in saturation (e.g. red-to-grey) was particularly effective, whereas a red-green hue gradient had no effect on perceived slant. We concluded that colour information can be used by the visual system to encode depth, especially in situations where the visual environments is rich in cues which could be used to signal depth in this way. PMID- 1771777 TI - Spatial-interval discrimination in two-dimensions. AB - This study is concerned with the precision of spatial-interval discrimination when the stimulus is varied in two-dimensions rather than one-dimension. For the two-dimensional task, observers were required to judge the centrality of a dot within a circle. Similar measurements were made in a one-dimensional task, i.e. the test dot was displaced only along one meridian, and the results were compared. This study shows that thresholds for the two-dimensional task are approx. square root of 2 times the threshold of the one-dimensional task when the observer's task is to simply detect an offset in both one- and two-dimensional conditions. However, thresholds are about a factor of two higher for the two dimensional task if the observer is required to label the direction of offset. PMID- 1771778 TI - Long-term nonconjugate adaptation of human saccades to anisometropic spectacles. AB - It is generally believed that saccades follow Hering's law in the sense that they are equally large in the two eyes. We demonstrated that saccades are different in size in the two eyes in 8 habitual wearers of anisometropic spectacles, which have lenses of different refractive powers, and therefore supply each eye with a differently sized visual image. The eye provided with the larger visual image made larger saccades than its fellow eye. This nonconjugate adaptation was almost complete for both horizontal and vertical saccades. Post-saccadic drift was also asymmetrically adapted: it reduced any fixation-disparity present at saccadic offset. The nonconjugate adaptation was also expressed in smooth-pursuit eye movements. In addition, these nonconjugate adaptations were present during monocular viewing, which shows that they were hard-programmed. PMID- 1771779 TI - Short-term nonconjugate adaptation of human saccades to anisometropic spectacles. AB - It has been demonstrated before that the long-term wearing of anisometropic spectacles may induce nonconjugate adaptations of saccades. Saccades then become different in size in the two eyes. We examined the time-course and the limits of such adaptations of horizontal and vertical saccades during the short-term (1-6 hr) wearing of anisometropic spectacles. After only 1 hr of conditioning to 2 D of anisometropia, the nonconjugate size-adaptations were almost complete along the horizontal meridian. For progressively larger anisometropias (up to 8 D) the adaptative nonconjugacies after 1 hr became also systematically larger. An anisometropia larger than 6 D did not further increase the rate of adaptation during the first 6 hr of conditioning, which suggests that about 6 D of difference in spectacle correction, causing size differences of about 12%, may be the upper limit of the nonconjugate adaptive range of the saccadic subsystem. Post-saccadic drift of horizontal saccades was also adequately changed. In addition, nonconjugate adaptations had developed in smooth-pursuit eye movements. All of these plastic changes persisted during monocular viewing, indicating that the basic programming of these eye movements was changed. PMID- 1771780 TI - Occlusion and the perception of coherent motion. AB - Recent work (Shimojo, Silverman & Nakayama, 1989; Vision Research, 29, 619-626) suggests that the visual system must discriminate between extrinsic boundaries (boundaries created by front occluding surfaces) and intrinsic boundaries (real object boundaries) in order to recognize objects and that this would importantly affect the way it solves the so-called "aperture problem" in motion. With the aid of a series of demonstrations (plus two formal experiments) we (1) propose a new explanation for the fact that edge line terminators in a "barber pole" display are perceived as intrinsic; (2) show that inner line terminators in a plaid pattern (i.e. those resulting from the intersection of the two sets of bars) specify coherent or incoherent motion depending on the availability of occlusion related depth information; and (3) suggest a unitary scheme integrating the two current alternative solutions to the aperture problem, the one based on line terminators and the one based on a velocity space combination of orthogonal components. PMID- 1771781 TI - Induced rotary motion and ocular torsion. AB - When a large patterned annulus rotates around a stationary sectored disc the latter appears to rotate in the opposite direction. Such induced rotary motion was examined with central discs subtending 5, 20 and 40 deg at the eye, with the surround filling the remainder of the visual field. The annular surround or the central disc could be oscillated sinusoidally around the fixation point through 20 deg at 0.2 Hz. In each case, subjects estimated the angles through which the moving and stationary parts of the display appeared to rotate on one half-cycle. Subjects also estimated the angle of rotation of an oscillating display that filled the visual field. Induced rotation of the centre was around 100% of the inducing amplitude for all disc sizes, but there was no induced motion of the surround when the centre rotated. Ocular torsion was measured under the same conditions, using the scleral search-coil technique. The amplitude of ocular torsion was a function of the size of the stationary or rotating field. Thus, variations in stimulus conditions affected induced rotary motion and ocular torsion in different ways. The implications of the results for theories of induced motion in terms of underregistered eye movements are discussed. PMID- 1771782 TI - Spatial interactions in apparent contrast: inhibitory effects among grating patterns of different spatial frequencies, spatial positions and orientations. AB - Suppression of the apparent contrast of a small 4 cycle wide suprathreshold sine wave grating patch by a high contrast sine wave grating surround pattern was studied as a function of the spatial frequency, orientation and spatial extent of the surround. The data are consistent with the existence of a complex network of inhibitory interconnections among mechanisms that mediate contrast perception. These connections must extend over spatial distances equivalent to more than 12 cycles of the central grating patch. PMID- 1771784 TI - Against the existence of a range effect during reading. AB - Some experiments have shown that saccades towards isolated targets which are presented at variable eccentricities in one block of trials, overshoot the near targets and undershoot the far targets. This phenomenon, called the "range effect" was claimed by McConkie, Kerr, Reddix and Zola (Vision Research, 28, 1107 1118, 1988) to be the explanation for the fact that in normal reading the eye lands closer to the beginning of a word when it is launched far from the word than when it is launched near to the word. The present experiment tested this hypothesis by presenting isolated words at variable eccentricities from the fixation point, in one block of trials. Results were against the existence of a range effect during reading, since they showed that the eye's initial landing position in the word did not differ as a function of its eccentricity. PMID- 1771783 TI - The local border mechanism in grating induction. AB - Both White's effect and the grating induction effect are examples of brightness contrast phenomena. Models to account for these effects have either explicitly rejected local border mechanisms (such as retinal ganglion cells) in favour of cortical mechanisms, or explicitly rejected elongated cortical filters in favour of local mechanisms. We have argued that any viable model must include both classes of mechanism. In this paper we present some novel versions of induction effects, and describe the explanatory power of a model couched solely in terms of the operation of local spatial filters. The model employs filters at different spatial scales whose outputs are then averaged. Using this approach it is possible to give a good account not only for the novel demonstrations we present, but also for the pattern of results reported by others concerning various manipulations of the spatial parameters of induction displays. PMID- 1771785 TI - Metacontrast with masks varying in spatial frequency and wavelength. AB - In a metacontrast masking paradigm, adult subjects were required to detect briefly presented target lines followed at various delays by a flanking mask varying in spatial frequency and wavelength. Detection accuracy, the dependent measure, was recorded as a function of the delay of the mask. The results showed that long wavelength masks produced maximum masking at a relatively short delay, while short wavelength masks produced maximum masking at a relatively long delay. Results are discussed within the framework of transient/sustained (magnocellular/parvocellular) theory of visual processing, and suggest that low spatial frequency channels respond with shorter latency and/or faster rise time to short wavelength stimuli, and high spatial frequency channels respond with greater sensitivity to long wavelength stimuli. PMID- 1771786 TI - Short- and long-range processes in structure-from-motion. AB - Human ability to detect 3-D structure in an array of 2-D moving dots was tested. Under limited exposure time, we found high detection rates only when the 2-D motion was restricted to the spatio-temporal region of short-range motion. Long range moving dots failed to produce a strong impression of 3-D structure and yielded only weak detection rates. This result is consistent with the view that the processing of long-range motion is more serial than that of short-range motion. PMID- 1771788 TI - Temporal relationship between the ERG and geniculate unit activity in rabbit: influence of background luminance. AB - The comparative analysis of the retinal and lateral geniculate nucleus (LGN) intensity-response function revealed that the timing of the LGN unit response was highly correlated to that of one oscillatory potential (OP2). To examine if this OP2-LGN intensity-response function was retained irrespective of the state of retinal adaptation, we performed simultaneous recordings to the ERG and single cell unit activity at the geniculate level evoked to a flash of constant energy while the level of background luminence was varied. For a stimulus of 6.7 cd m-2 sec, the shifts in latency induced by increasing the background luminance from 0 to 125 cd m-2 are of 1.17 +/- 0.61 msec for OP2, a value almost identical (P greater than 0.10; n = 36) to the one obtained at the geniculate level (1.11 +/- 0.88 msec). However, when a dimmer flash is used, the latency shifts are not so well correlated. The latter could be partly explained by the threshold nature of the resulting stimulus (i.e. high photopic background combined with a dim flash). PMID- 1771787 TI - Natural coordinates for specification of eye movements. AB - Tweed and Vilis (Journal of Neurophysiology, 58, 832-849, 1987) have argued that quaternion algebra provides the most appropriate description of the rotations of the eye, and have derived a three-dimensional model of gaze control based on quaternion operations. Euler angles give a simpler description of the rotations of the eye, and can also be used to formulate an alternative version of the three dimensional gaze control model. Comparison of the two versions of the model highlights the distinction between the functional predictions of the model, and the predictions which depend only on the choice of mathematical descriptions. PMID- 1771789 TI - Image segmentation and VEP topography. AB - VEP scalp fields were measured for four pattern onset-offset stimuli identical except for the single contrast attribute that allowed a square-wave grating to be seen. The contrast attribute used for each stimulus was either texture, binocular disparity, luminance, or color. All stimuli were presented as dynamic random dot displays. Scalp potentials were sampled at 1.5 cm intervals by 66 electrodes over the posterior scalp. Customized rigid helmets were constructed for each subject to ensure reproducible electrode placement. The scalp fields due to the four stimuli were significantly different in all cross-comparisons. This implies that in the human visual cortex there exists regional selectivity for the processing of the four different contrast attributes. PMID- 1771790 TI - Spectral characteristics of photoreceptors and horizontal cells in the retina of the Siberian sturgeon Acipenser baeri Brandt. AB - In the retina of Siberian sturgeon, three spectral classes of photoreceptors were identified by microspectrophotometry. These were rods, oil drop-containing and oil drop-free cones possessing P549, and oil drop-containing cones possessing P613 and P465. With intracellular recordings, rod-driven, cone-driven, and mixed horizontal cells of luminosity type were found, as well as color-opponent horizontal cells of, at least, 6 kinds. Biphasic R/G cells received hyperpolarizing input either from rods or from green cones; in R/B cells, it was from blue cones. Other three types comprised biphasic G/B (or Y/B), RG/B, and triphasic G/BR cells. So the Chondrostean retina has the color-processing circuitry common for all ray-finned fishes. PMID- 1771791 TI - Flicker distorts visual space constancy. AB - Effects of flicker on space perception were measured by displacing a flickering target during saccadic eye movements. A small target was flickered at 33, 66, 130 or 260 Hz. Using a 2-interval forced-choice design, sensitivity to the displacement was about twice as great when the target was moved in the direction opposite the eye movement as when it was moved in the same direction. This would be expected from a partial breakdown of space constancy--the world should seem to jump in the direction opposite an eye movement. Even if a suppression of displacement detection during saccades prevents this jump from being perceived; it should be easier to detect a target displacement in the direction opposite the eye movement than in the same direction: when movement is opposite, the imposed displacement adds to the illusory displacement, making detection easier. Displacements were more easily detected at lower flicker rates. Results imply that both masking and extraretinal signals are important in suppressing the detectability of target displacements during saccades, and that flicker on video display terminals may distort space perception. PMID- 1771792 TI - Interaction of visually guided saccades with saccades induced by electrical stimulation of the posterior parietal cortex in the monkey. AB - The properties of the neural code specifying the parameters of trained, visually guided saccades were examined by applying micro-stimulation of area PG in monkeys while they generated saccades to receive reward. It was hypothesized that electrical stimulation would alter the spatial pattern of cells being activated, and thereby predictably alter the characteristics of the resultant saccade. Instead, the two mechanisms of saccade generation, one initiated by electrical stimulation, the other initiated internally, were mutually exclusive, and resulted in either the cancellation of saccades, or the delay (up to 640 msec) of the visually guided saccade. Visually guided saccades accurately fixated visual targets (no longer visible at the start of saccades) whether or not the eyes were previously perturbated by the electrical stimulation. Unlike stimulation applied to the frontal eye fields or the superior colliculus, the end position of visually guided saccades cannot be modified by altering activity in area PG during saccade generation. PMID- 1771793 TI - Efficiency of locating centres of dot-clusters by human observers. AB - A spatial interval acuity task was used to determine the efficiency with which observers located the centroids of circular clusters of individually-small elements. A cluster was defined by its radius and by the number of elements within it. The observer's task was to compare the horizontal distance between the centres of two such clusters to a standard distance, and to decide whether it was greater or smaller. The standard distance was made explicit by two markers on the display screen. As expected on statistical grounds, thresholds increased with the radius of the clusters, and decreased as a function of the number of elements. There were considerable individual differences in efficiency between observers, but the best observers achieved efficiencies close to 100% in many of the conditions. One anomalous observer showed virtually no decrease in thresholds as the number of elements increased, and thus her efficiencies declined to as little as 10%. The ability to combine positional information over spatially-separated elements to obtain an estimate of their central tendency appears in general to be high, and may underlie the perceptual biases revealed in certain geometric illusions, such as the Muller-Lyer. PMID- 1771794 TI - The cyclopean ternus display and the perception of element versus group movement. AB - This study investigated the perception of bistable stroboscopic motion (Ternus display) with cyclopean stimuli created from retinal disparity embedded in dynamic random-element stereograms, the responses to which arise at binocular integration levels of the visual system. To provide comparison data, observers were also tested with luminance-domain stimuli matched as closely as possible to their cyclopean counterparts. The results showed that the perception of element vs group movement was similar for both stimulus domains: element movement predominated at short interstimulus intervals (ISIs) while group movement predominated at long ISIs, and there was a tendency for a greater percentage of group movement to occur with a longer frame duration. These results cast suspicion on the interpretation of bistable motion that assumes element movement is a signature of a lower-level, short-range motion system whereas group movement is a signature of a higher-level, long-range system; both percepts are engendered at binocular-integration levels of vision. PMID- 1771795 TI - Stereo-thresholds: simultaneity, target proximity and eye movements. AB - Stereo-thresholds are much higher when adjacent targets are presented without temporal overlap than when they are shown simultaneously. Sequentially presented adjacent targets also evoke small involuntary eye movements toward the newly presented target. Neither of these phenomena is evident with widely separated targets; for sequential presentation of targets 10 degrees apart, stereo thresholds are only slightly higher (a factor of about 1.5) than for simultaneous presentation; and stable fixation can be maintained. If the differing influence of simultaneity on stereoacuity for adjacent and for widely separated targets arises because adjacent alternating targets evoke eye movements, that effect is apparently not mediated exclusively by displacement of retinal images due to the measured eye movements. It could, however, be due to a general long-term instability of fixation associated with repetitive small involuntary eye movements. PMID- 1771796 TI - The contribution of color to motion in normal and color-deficient observers. AB - By opposing drifting luminance and color gratings, we have measured the "equivalent luminance contrast" of color, the contribution that color makes to motion. We found that this equivalent contrast was highest (greater than 10%) for low spatial and temporal frequencies and was higher for red/green than for blue/yellow stimuli. Equivalent luminance contrast was about 4% for a green/purple stimulus that fell along the tritan confusion line, indicating a modest input to the motion pathway from the short wavelength-sensitive cones (B cones). Contrast thresholds for the discrimination of the direction of motion showed that the contribution of color to motion was about the same (within a factor of 2) as that for luminance in terms of multiples of threshold contrast. These responses to moving, chromatic gratings could be mediated by any of several factors that can create a residual response in a luminance pathway: temporal phase lag between the responses to the colors of the stimuli, second harmonic distortion in the response and variability in equiluminance points across units. Each of these factors was evaluated experimentally and their combined effect could account for only a small portion of the contribution of color to motion. As a result, we attribute the perception of the motion of equiluminous stimuli to an opponent-color input to directionally selective cortical units. Chromatic stimuli had little or no equivalent contrast for color-deficient observers, whether the stimulus was red/green, which they discriminate less well than normals, or blue/yellow, which they discriminate almost as well as normals. The equivalent contrast measure provided an excellent basis for classifying normal, protan and deutan observers. PMID- 1771797 TI - Parallel perception of vernier offsets, curvature, and chevrons in humans. AB - A vernier offset is detected at once among straight lines, and reaction times are almost independent of the number of simultaneously presented stimuli (distractors), even if absolute orientation cues are masked by varied orientation of the verniers. This result implies that the human visual system processes vernier offsets in parallel. Reaction times for identifying one straight target among offset verniers, on the other hand, increase with the number of stimuli. The same is true for the identification of a vernier offset to one side among verniers offset to the opposite side, if absolute orientation cues are masked. These tasks require serial or semi-parallel processing. Chevrons and curved targets show the same pattern of results. Even deviations below a photoreceptor diameter can be detected at once. The visual system thus attains positional accuracy below the photoreceptor diameter simultaneously at different positions. I conclude that deviation from straightness, or change of orientation, is detected in parallel over the visual field. Discontinuities or gradients in orientation may represent an elementary feature of vision. PMID- 1771798 TI - The invariance of unique white; a possible implication for normalizing cone action spectra. AB - The locus of unique white was measured for two observers over a wide range of stimulus intensities, using both direct matching and absolute judgements. Chromaticity coordinates of each observer's unique white were found to be invariant over a range of about 4 log units. This result is discussed in the context of the class of models that explain the intensity-evoked change in perceived color (Bezold-Brucke effect) on the basis of response compression in color channels. Invariance of unique white may be interpreted, then, as evidence for its non-polarizing effect on color channels, including the three classes of cones. On the basis of that assumption we have used unique white as criterion for normalizing cone action spectra. Assuming an equal-energy spectrum for the standard observer's unique-white stimulus, as we found to be consistent with literature data, we calculated the associated coefficients of the conversion formulae between CIE space and cone space (both for XYZ to LMS and LMS to XYZ) of the Vos-Walraven (1971 Vision Research, 11, 799-818) and Smith-Pokorny (1975 Vision Research, 15, 161-171) receptor fundamentals. The action spectra that thus result, intersect at the spectral neutral (achromatic) points of the three classes of dichromats. PMID- 1771799 TI - Interocular correlation, luminance contrast and cyclopean processing. AB - We have investigated the nature and viability of interocular correlation as a measure of signal strength in the cyclopean domain. Thresholds for the detection of interocular correlation in dynamic random element stereograms were measured as a function of luminance contrast, a more traditional measure of stimulus strength. At high contrasts, correlation thresholds were independent of contrast. At low contrasts, correlation thresholds were inversely proportional to the square of contrast. Stereothresholds were also measured as a function of both contrast and interocular correlation. At low contrasts, stereoacuity was inversely proportional to both interocular correlation and the square of contrast. These results are consistent with an inherently multiplicative mechanism of binocular combination, such as a cross-correlation of the two eye's inputs. PMID- 1771800 TI - Saccade control without a fovea. AB - Prior research has suggested that two types of fast eye movements (FEMs) can be distinguished behaviorally. Foveating saccades respond to salient peripheral targets by directing the target image to the fovea. Non-foveating saccades include other FEMs such as nystagmus quick phase, saccades without visual stimuli and visually-directed saccades that direct target images to eccentric retina. Foveating saccades have a shorter initiation latency and are faster than non foveating saccades. Following adaptation to central scotoma, patients tend to use preferred retinal loci for fixation (PRL). If PRL acquire the foveal characteristic of a retino-motor center then visually guided saccades would acquire the properties of foveating saccades. Using an objectively-calibrated 2 dimensional search coil, we measured saccades in response to salient, unpredictable targets. The saccades of normal observers were compared to the saccades of patients with long-standing macular scotomas. Although the saccades of patients consistently directed images to PRL, the saccades still had the latency and dynamic characteristics of non-foveating saccades. Moreover, the non foveating saccades of patients were found to be less accurate than foveating saccades, showing a range effect (larger saccades undershoot with greater error than do smaller saccades). Apparently, patients with macular scotoma suppress rather than adapt a foveating saccade mechanism. PMID- 1771801 TI - The effects of simultaneous central and peripheral field motion on the optokinetic response. AB - The effects of central and peripheral retinal stimulation on the optokinetic response were examined using full-field, central field only, peripheral field only and simultaneous central and peripheral field motion. Stimulation of the central field in isolation produced similar responses to those obtained for full field motion whereas peripheral field stimulation resulted in greatly reduced responses. Central field dominance was also evident during central and peripheral field motion in opposing directions. However with unidirectional, simultaneous central and peripheral stimulation the optokinetic response was determined not by the central stimulus but by whichever stimulus moved the slower. PMID- 1771802 TI - Detection of chromatic deviations from white across the human visual field. AB - We studied how much blue, green, or red light had to be added to or subtracted from white to obtain veridical hue perception (blue, green, red, or their complementary colours) at various locations in the temporal visual field. The CIE 1931 (x, y) chromaticity coordinates corresponding to a veridical hue perception were subtracted from the chromaticity coordinates of the white (0.35, 0.35) in order to obtain the threshold differences (dx, dy) in chromaticity coordinates. When stimulus size was constant at all visual field locations, dx and dy changed with eccentricity. However, when the stimulus was M-scaled by magnifying its size with increasing eccentricity in inverse proportion to the lowest local sampling density across the human retina (cones and ganglion cells at eccentricities 0-10 and above 10 deg, respectively), dx and dy remained constant at all eccentricities. PMID- 1771803 TI - A constant latency difference determines directional anisotropy in visual motion perception. PMID- 1771804 TI - [Transesophageal and transthoracic echocardiography--their diagnostic contributions]. AB - Of 815 patients referred for echocardiographic examination 77 were examined also by the transoesophageal route. The most frequent reason were pathological processes where standard echocardiography provides relatively limited information as well as technically inadequate transthoracic examinations, if the echogenicity of the patient is low. The reasons for examination were complications of myocardial infarctions, a cardiac source of embolization bacterial endocarditis, congenital heart defects, cardiac formations, aortal disease and comatose conditions. Transthoracic echocardiography was positive in 25 cases (32.4%), transoesophageal echocardiography in 44 cases (57.1%). In 15 patients the transthoracic approach was not conclusive from the diagnostic aspect (19.5%). From the results ensues that transesophageal echocardiography has a ca 30% higher sensitivity than transthoracic echocardiography, the specificity being equal. The authors emphasize that the transoesophageal approach is the method of choice in the diagnosis of sources of embolization (auricular appendage), in evaluation of the mitral apparatus, in affections of the thoracic aorta, in the diagnosis of intracardiac formations and defects of the atrial septum. It is very useful in the critically ill, in particular in patients with poor echogenicity. It helps in a significant way to rule out falsely positive transthoracic findings. The examination is safe, relatively well tolerated by out- and in-patients. Transoesophageal echocardiography supplements in an effective way the transthoracic approach but does not replace it. PMID- 1771805 TI - [Testing the effectiveness of drug therapy in supraventricular dysrhythmias using diagnostic esophageal cardiac stimulation]. AB - The authors examined 33 patients aged 59.9 years with a new atrial fibrillation and 18 patients aged 45.6 years with attacks of supraventricular tachycardia. After medicamentous change to a sinus rhythm (in fibrillation after digoxin and verapamil i.v. and in supraventricular tachycardia after verapamil i.v.) the patients were changed to oral antiarrhythmic drugs. The method of diagnostic oesophageal stimulation was used after saturation with the oral form to test the effectiveness of long-term treatment. In the author's opinion the basic drug in atrial fibrillation is digoxin, possibly combined with verapamil or quinidine. In supraventricular tachycardia the basic drug is verapamil, in particular in case of a double AV node pathway. In the majority of patients combined treatment is indicated, selected individually by means of diagnostic oesophageal stimulation. The authors consider the described method due to its innocuous and repeatable character as the method of choice for optimization of antiarrhythmic treatment of supraventricular dysrhythmias. PMID- 1771806 TI - [Functional cardiovascular disorders in patients with neuroses at rest and during physical loading]. AB - The authors examined using selected non-invasive cardiological examination methods 33 patients with neurosis. Four were eliminated on account of organic heart disease. From the group of 29 patients 12 had ECG changes (41%)--of those 5 (17%) had an incomplete right bundle branch block and 1 (3%) had a left anterior fascicular block; 2 (7%) had the syndrome of early repolarization and 4 (14%) had changes of the T wave. The polycardiogram did not reveal a statistically significant difference in the investigated indicators (PEPc, LVETc, WI, PVR) between the group of sick and healthy patients at rest. Ambulatory 24-hour monitoring of the ECG was done in 21 patients--in 2 (10%) it revealed a sinoatrial block, in 10 (50%) episodic sinus tachycardia, in 6 (30%) occasional supraventricular extrasystoles, in 5 (25%) rare ventricular extrasystoles. The echocardiographic examination confirmed the statistically significantly increased systolic function of the left ventricle (P less than 0.05) in all investigated parameters (%D, Vcf, MNSER, EF), as compared with healthy subjects. After a loading ECG test of 28 patients 2 (7%) had ST-T changes. Statistical comparison with the group of healthy subjects revealed in the patients with neurosis a significantly reduced value of systolic (P less than 0.005) and median blood pressure (P less than 0.01), as well as of the inner cardiac work at the peak of the submaximum load (P less than 0.05) and an increase of the diastolic blood pressure (P less than 0.05) during the 10th minute of recovery. The orthostatic test in 20 patients with neurosis revealed a significantly higher heart rate at rest and during the 30th and 60th second after rising (P less than 0.05) and a significantly lower orthostatic index (P less than 0.001) on statistical comparison with healthy subjects. PMID- 1771807 TI - [Blood pressure and insulin resistance in type 2 diabetics]. AB - The authors analyzed in 145 patients with Type 2, diabetes, persisting on average for 10 years, influences affecting the blood pressure reading. 1. In patients treated on account of hypertension (40%) the increase of systolic and diastolic pressure persisted and the fasting concentrations of C peptide were elevated. 2. In patients with elevated levels of diastolic blood pressure and C peptide the rate of cerebrovascular attacks in direct relatives was higher. 3. Higher blood pressure readings were associated with a higher C peptide concentration, signs of ischaemia on the ECG tracing and left ventricular hypertrophy respectively. 4. The higher blood pressure levels were associated also with other manifestations of insulin resistance, i.e. elevated triacylglycerols, low HDL cholesterol levels, raised uric acid levels. 5. Also in stepwise regression analysis the fasting concentration of C peptide held one of the important places among variables which contribute towards variations of systolic blood pressure. 6. These findings support the idea on common pathogenic influences of raised insulin concentrations on metabolism, blood pressure and the development of complications of atherosclerosis. PMID- 1771808 TI - [Multicenter study with gliquidone in type 2 diabetes mellitus]. AB - The effectiveness and tolerance of the new sulphonyl urea antidiabetic gliquidone (commercial name Glurenorm) was tested by three-month administration of this preparation in a group of 39 type 2 diabetics. Gliquidone proved a medium strength beta-cytotropic antidiabetic preparation. As to side-effects, the authors noted only dyspepsia in one patient (2.5%). Symptomatic hypoglycaemia did not develop in any of the patients. In the subgroup of six patients with diabetic nephropathy the indicators of renal functions did not deteriorate. In a sub-group of 6 patients with concurrent hepatopathy the originally elevated gamma-glutamyl transpeptidase activity receded. The authors confirmed thus the good tolerance of gliquidone in diabetes associated with nephropathy and diabetes with hepatopathy. PMID- 1771810 TI - [Helicobacter pylori after proximal selective vagotomy]. AB - The authors examined histologically in 40 patients after proximal selective vagotomy on account of duodenal ulceration specimens of the antral mucosa for the presence of Helicobacter pylori. The latter was detected in 38 (95%) patients. The intensity of colonization evaluated semiquantitatively was not directly related to the dyspeptic complaints. No relapses of ulcers were observed and the author's experience does not confirm the theory of a direct part played by Helicobacter in the manifestation of duodenal ulceration in patients after proximal selective vagotomy. PMID- 1771809 TI - [Chronic active surface-positive Campylobacter antrum gastritis-- morphological changes 1 year after treatment with bismuth]. AB - The works is based on a previous investigation published in the journal Vnitrni Lekarstvi, 36, 1990, 8, pp. 759-762. The authors investigated morphological changes of the gastric mucosa and the presence of Campylobacter pylori (CP) in probands with chronic active surface CP positive antrum gastritis one year after treatment with a bismuth preparation (Bismuth citrate 120 mg per capsule made on prescription) for a one-month period 4 capsules per day. This concerned probands with functional dyspepsia without a history of alcohol intake. After a one-year interval eradication of CP persisted in 8 probands (53.3%); in 7 patients (46.7%) there was a relapse of CP positivity. The authors confirmed that CP and active chronic gastritis are associated. Chronic non-specific inflammatory cellulitis persisted after one year with the same intensity in 17 probands (74%), in 6 it increased by one grade (26%). Improvement or complete recovery of the histological finding was not recorded in any of the patients. In the corpus of the stomach the unaltered finding persisted. Morphological changes were always directly proportional to the presence of CP. Its eradication appears to be causal treatment of chronic active surface CP positive antrum gastritis, one of the groups in the wide spectrum of chronic gastritis. PMID- 1771811 TI - [HLA-B27 in the families of probands with arthritis after acute respiratory tract disease]. AB - HLA B27 antigen was found in 10/25 patients with arthritis after acute respiratory disease (ARD) and in 21/75 direct relatives of 23 of these probands, where a genealogical investigation could be made. With regard to the 9.5% incidence of HLA B27 in the Czech population this implies a positive association in patients (RR = 6.35) and direct relatives (R = 3.70). In the sub-group of HLA B27 positive probands HLA B27 positivity was found in 19/27 (70.4%) of direct relatives (RR = 22.6). In one female relative a recurrent monoarthritis of the talo-crural joint was found, the remainder did not suffer from inflammatory changes of the joints. The revealed positive associations indicate the probability of arthritis after ARD in HLA B27 positive subjects and their families. They indicate also that in arthritis after ARD reactive arthritis is involved with a less common organ manifestation of the initial infection. PMID- 1771812 TI - [Relation of HLA antigens to prognosis in Hodgkin's disease]. AB - The prognostic value of HLA antigens in Hodgkin's disease was assessed by multivariate regression analyses. A significantly adverse prognostic impact for achieving complete remission by primary treatment and for its persistence was proved in four antigens locus B (B18, B5, B27 and B15). Five-year survival without signs of the disease, i.e. survival without relapse is significantly lower in subjects with antigen B5, as compared with the group of patients where the antigen was not detected (42% vs. 58%, p = 0.05). An independent prognostic impact of the selected HLA antigens was confirmed in models incl. also formerly tested risk factors for the relapse of Hodgkin's disease. PMID- 1771813 TI - [The effect of ethanol on increased expression of HLA-A,-B antigens on lymphocytes]. AB - Ethanol in a concentration of 0.001% to 2% increases the expressivity of HLA-A, B antigens on lymphocytes. In 26.13% of the examinations HLA antigens were proved only on lymphocytes processed with ethanol. The expressivity is maximally enhanced already by short-term incubation of lymphocytes with ethanol; if prolonged to 120 mins at 20 degrees C ethanol does not produce an unspecific positivity of results. There is no difference between processing of lymphocytes at 20 degrees C and 37 degrees C. 1% and 2% ethanol facilitates detection of HLA A, B antigens after addition to serum and lymphocytes in the first stage of the microlymphocytotoxic test. PMID- 1771815 TI - [Perispondylitis psoriatica]. AB - In their brief paper the authors draw attention to the rapid development of morphological changes on the axial skeleton in a patient with psoriasis vulgaris. They give a brief account of the classification of spinal and paraspinal ossifications in seronegative spondarthritis, spondyloses and other spondylopathies. The described case-history pertains to a paraspinal ossification and the authors try to explain why they assume that the term "Perispondylitis psoriatica" is quite justified. PMID- 1771814 TI - [Candida myocarditis and polymyositis in acute lymphoblastic leukemia]. AB - Candida sepsis in 18-year-old man with acute lymphoblastic leukemia was associated with multisystem alteration accentuated in cardiac and skeletal muscles. Candida tropicalis identified in the post-mortem blood culture was resistant to azole-chemotherapeutics and semi-sensitive to polyene-antibiotics. Unusual myocardial involvement and a role of Candida spp. during opportune infections in immunosuppressed patients are discussed. PMID- 1771816 TI - [Biological aspects of paraneoplastic syndromes]. AB - The author discusses some aspects of indirect manifestations of tumourous diseases, i.e. paraneoplastic syndromes. The already known paraendocrine hormone secretion by tumours is supplemented by recent knowledge from the biology of tumourous diseases incl. indirect manifestations where an important part is played by autocrine secretion of regulatory, mainly growth factors. PMID- 1771817 TI - [How shall we treat ventricular arrhythmias?]. PMID- 1771818 TI - [The indomethacin treatment of glomerulonephritis patients with the urinary syndrome]. AB - Immediate results are analyzed of the treatment of 57 glomerulonephritis patients with the urinary syndrome using indomethacin. The treatment proved effective in 65% of patients. It was established that indomethacin had no immunotropic effects in urinary syndrome. Absence of arterial hypertension is not a prognosis-positive factor for treatment of the urinary syndrome with indomethacin. PMID- 1771819 TI - [Ventricular tachycardia in secondary amyloidosis]. PMID- 1771820 TI - [HIV infection in children]. PMID- 1771821 TI - [The characteristics of the biological action of ionizing radiation at low doses]. PMID- 1771822 TI - [A quality assessment study of the document information flow in the differential diagnosis of lung diseases]. PMID- 1771823 TI - [The interrelationship of arterial hypertension and social hygiene risk factors for the development of circulatory system diseases in rural inhabitants]. PMID- 1771824 TI - [The 150th anniversary of the Department of Normal Anatomy of the Kiev Medical Institute]. PMID- 1771825 TI - [The treatment of Lesia Ukrainka by the folk healer P. N. Bogush in Sumy Guberniya (on the 120th anniversary of her birth)]. PMID- 1771826 TI - [Antioxidants in experimental and clinical hepatology]. PMID- 1771827 TI - [Pseudomonas aeruginosa preparations for active immunization]. PMID- 1771828 TI - [The concept of the development of higher medical education in the Ukraine]. PMID- 1771829 TI - [Plasmapheresis combined with hemosorption in the treatment of hypertension patients]. AB - It was established that use of plasmapheresis in association with hemosorption in 36 patients suffering of hypertensive disease improved the clinical course of the disease, reduced the resistance to drug treatment, increased the treatment efficacy, decreased the risk of complications. Simultaneously there was an improvement of the hemodynamics and hemorheological properties of the blood. PMID- 1771830 TI - [The use of laser puncture for managing hypertensive crises]. AB - The authors report efficacy of using laser puncture and pointed massage in controlling hypertensive crises in patients suffering of hypertensive disease. The arterial pressure was reduced mainly due to decrease of the peripheral resistance. This method of treatment was more effective in patients with moderate and significant hypertrophy of the left ventricle as compared with patients showing marked hypertrophy of the left ventricle. PMID- 1771831 TI - [The characteristics of treating hypertension with clofelin in pregnant women]. AB - Long-term effective use of clophelin was observed only in 1/3 of pregnant suffering of hypertensive disease. The efficacy of treatment with this drug is determined not so much by its hypotensive action as by its influence on the state of the central hemodynamics. Clophelin may often reduce the minute cardiac volume and thus, deteriorate the uterine-placental blood flow and that is why its use be carried out under meticulous control of the central circulation. The authors designed a mathematical model for the prognosis of the efficiency of long-term clophelin treatment in pregnant women with hypertensive disease. PMID- 1771832 TI - [Biorhythms and the seasonality of myocardial infarct]. AB - An analysis of 881 case histories of patients with acute myocardial infarction revealed circatrigentane rhythms of general acute myocardial infarction morbidity and its complications (disorders of rhythm and conduction, circulatory insufficiency) as well as a seasonal character of rise and decline depending on the sex, location and spread of myocardium necrosis. The authors determined the correlation of general acute myocardial infarction with fluctuations of the frequency of the main death causes indicating their close pathogenetic relationship. The obtained data may be of value in the chronotherapy and chronoprophylaxis of acute myocardial infarction and its complications. PMID- 1771833 TI - [Benzofurocaine analgesia in acute myocardial infarct]. AB - A native non-narcotic analgetic agent benzofurcaine was used in 51 patients. It was shown that the analgetic activity of benzofurocaine had a dose-dependent character. Most effective was its use in doses of 2.1-2.7 mg/kg of body weight. It was established that the character of hemodynamic reactions due to benzofurocaine depended on the initial state of circulation. Benzofurocaine did not depress breathing. It is concluded that benzofuricaine is an effective means in moderate pain syndrome due to residual pain as well as in pain of pericardial genesis. PMID- 1771834 TI - [The binding capacity of serum immunoglobulins with amino acids in systemic lupus erythematosus]. AB - The content of G, M, A, serum immunoglobulins and binding capacity with amino acids prolin, oxyprolin, alanin and serin was examined in 40 patients with systemic lupus erythematosus (grade I and II activity). It was established that the degree of increase of the binding capacity of Ig with amino acids was higher than that of corresponding Ig and depended on the activity of the process. PMID- 1771835 TI - [Sarcoidosis of the respiratory organs: the current concepts]. PMID- 1771836 TI - [Acupuncture and pharmacological repair agents in the combined treatment of peptic ulcer patients]. PMID- 1771837 TI - [The use of sound waves, drug preparations and electrostimulation in the combined treatment of patients with chronic functional duodenal obstruction]. AB - An analysis was carried out of the efficiency of using sound waves, drugs and electrostimulation on the motor activity of the duodenum in 45 patients with chronic duodenal obstruction of functional genesis. Excellent and good results were obtained in 80% of patients treated with sound waves complexly with other methods, in 40% when only drugs were used and 53% when only electric stimulation was used. The advantages of sound in the treatment are emphasized as concerns early effect, long-term results, absence of side-effects, low incidence of recurrences of the disease. PMID- 1771838 TI - [The characteristics of the development of bradycardia in digestive canal diseases]. PMID- 1771839 TI - [The tolerance of diabetic patients for physical loading before and after enterosorption treatment]. AB - Use of enterosorption in 58 patients with diabetes mellitus of different severity grades allowed to establish that a course of treatment with SKN sorbents resulted in an increase of the tolerance to physical load, improvement of myocardial hemodynamics after veloergometric loads. This was evidenced by an increased volume of work performed on the veloergometer, reduction of the index of energy expenditures of the heart coefficient of expenditures of the myocardial reserves. The used enterosorbents produced a hypotensive effect. Enterosorption furthers increase of tolerance to physical load in a relatively short time period--10 days. During this time traditional treatment including sugar-reducing agents, angio- and hematoprotectors did not result in essential changes of hemodynamic indices. PMID- 1771840 TI - [Changes in thrombocytic hemostasis in patients with diabetic glomerulosclerosis]. AB - Indices of thrombocytic hemostasis were determined in 40 patients with diabetic glomerulosclerosis. It was found that patients suffering of diabetic glomerulosclerosis with chronic renal insufficiency showed signs of hypercoagulemia while changes of the thrombocytic hemostasis become of diverse values. There was a high correlation of hemostasis changes and clinical manifestations of diabetes mellitus and diabetic glomerulosclerosis. Three tests are recommended for treatment choice: hemolysate-aggregation test, determination of soluble complexes of monomer fibrin and fibrin-splitting product. PMID- 1771841 TI - [The indices of free-radical oxidation in persons in contact with synthetic pyrethroids]. AB - The authors revealed regularities in the change of free-radical oxidation depending on the intensity of contact with synthetic pyrethroids. The results are related to immunological reactivity and health state of the workers. Results indicate the expediency of using antidote antioxidant therapy in persons contacting in the process of work with pyrethroids. Further immunological studies are necessary. PMID- 1771843 TI - [Hemosorption in the combined treatment of patients with acute exogenous poisonings]. AB - The authors analyze their experience with 247 hemosorptions in 163 patients with acute exogenous poisonings. Indications and contraindications to hemosorption in these patients are described. Methodical aspects of hemosorption are described: vascular approaches, apparatus, prehemosorption care, regimens of hemosorption. Hemosorption may be associated with hemodialysis, hemofiltration, ultraviolet irradiation of the blood. PMID- 1771842 TI - [The lysozyme content of phagocytosing peripheral blood cells in sarcoidosis patients]. AB - The content of lysozyme in the phagocytosing peripheral blood cells was carried out in 50 patients with active pulmonary sarcoidosis depending on the clinical form, extension and duration of the pathological processes. The function of these cells showed essential changes in patients with widely spread old processes and those of long duration. The changes of lysozyme secretion by neutrophil granulocytes and monocytes were diverse that may be explained by different mechanisms of this process in the cells. PMID- 1771844 TI - [The efficacy of the mildronate treatment of patients with ischemic stroke]. AB - A study is presented of the clinico-hemodynamic efficacy of mildronate in 38 patients with ischemic stroke. The drug produces a positive inotropic effect on the myocardium, improves the cerebral hemodynamics in patients with stroke and postischemic hypo- and hyperperfusion of the brain tissue. It is concluded that mildronate may be recommended for the complex treatment of ischemic disorders of the cerebral circulation. PMID- 1771845 TI - [Emergency care at the prehospital and early hospital stages for patients with acute cerebrovascular diseases]. AB - Many-year observations, literary data were analyzed to work out indications for hospitalization and methods of transportation of patients with acute cerebrovascular disease to intensive care departments, neurosurgical or neurological department. The problem of non-differentiated and differentiated treatment at the prehospital and early hospital stage is discussed. PMID- 1771846 TI - [Complications in patients during ascending epidurography with verografin]. PMID- 1771847 TI - [The correction of microcirculatory disorders in patients with circulatory encephalopathy]. AB - The state of microcirculation was studied by bulbar biomicroscopy in 18 healthy persons and 53 patients with dyscirculatory encephalopathy before and after treatment with vasoactive drugs (xanthinol nicotinate, Cavinton, Sermion). It was found that the microcirculation changes depended on the stage of the disease. It was found that the above drugs produced a positive effect on the microcirculation, the values of which normalized by the end of the course of treatment, especially after their direct administration. PMID- 1771848 TI - ["Pseudosemantic" aphasia]. AB - It was established that in left hemispheric involvement, the basis of speech disorders are non-understanding the primary speech logical connections in semantic constructions. In right-sided involvement it is caused by disorders of orientation in space, reduction of critical attitude, anosognosia and is according the authors opinion "pseudosemantic" aphasia. PMID- 1771849 TI - [The treatment of patients with chronic gastritis]. PMID- 1771850 TI - [The peripheral hemodynamics in the inter-relapse period in erysipelatous inflammation of the lower extremities]. AB - A study is presented of 89 patients with primary and recurrent erysipelas of the lower extremities. Ultrasound sonography, dopplerography and tetrapolar rheography were used in the examination. It was found that disorders of the peripheral circulation remain stable in the inter-recurrence period, are manifested by lymphovenous insufficiency, continuous state of pre-edema, trophic disorders of the lower extremities. PMID- 1771851 TI - [The motivational structure of alcohol consumption in men with venereal lesions of the urogenital system]. PMID- 1771852 TI - [The efficacy of the allopurinol treatment of patients with gouty nephropathy]. AB - The efficacy was studied of using allopurinol in 68 patients with primary podagra. The obtained results were compared with the treatment of 118 other patients who received similar treatment but without allopurinol (zanthinoxidase inhibitor). Allopurinol increased essentially the efficacy of therapeutic measures though positive dynamics concerning the renal process was achieved in 1/3 of patients. PMID- 1771853 TI - [The role of sodium and the kidney in the pathogenesis of essential hypertension]. PMID- 1771854 TI - [The role of the inadequate expression of HLA class-II molecules on pancreatic beta cells in the pathogenesis of type-1 diabetes mellitus]. PMID- 1771855 TI - [The use of immunoglobulin preparations in clinical practice]. PMID- 1771856 TI - [The metastasis of malignant tumors--the therapeutic problem]. PMID- 1771857 TI - [The evolution and prognosis of ulcerative colitis]. PMID- 1771858 TI - [The characteristics of repeated myocardial infarcts in men and women]. AB - 117 patients, 89 men and 28 women, with repeated myocardial infarction were followed up for a two year period. The following were taken into consideration: risk factors, number and localization of previous infarctions, interinfarction period, clinical onset of the new infarction, complications, electrocardiographic changes, time of death, causes of death, pathologicoanatomical localization of the new and old infarctions in comparison with the electrocardiographic localization. Statistically significant differences between the two sexes were found for the death of cardiogenic shock--48.9% for men and 13.3 for women (p less than 0.01) and for chronic cardiac failure as a complication of the second myocardial infarction--50.0% for women and 16.1% for men (p less than 0.001). For all other indices the differences were not statistically significant. PMID- 1771859 TI - [Changes in the clinico-functional and immunological indices of patients with chronic obstructive lung disease, the allergic form, following combined climatotherapy at Sandanski health resort]. AB - 20 patients with chronic obstructive pulmonary disease who were treated in the resort of Sandanski, Bulgaria, during the autumn of 1988 were investigated for changes of some clinical, functional and immunologic indices--secretory immunoglobulins, lysozyme, serum bactericidal activity. The results revealed an improvement of the clinical indices mean in 50% of the patients, of the expiratory spirometric indices in mean 47% of the patients. Other findings were a distinct tendency towards a decrease of IgG and albumin in the saliva and an increase of the secretory IgA together with a statistically significant increase of the indices characterizing the nonspecific defence mechanisms of the lung. PMID- 1771860 TI - [A clinico-therapeutic study of the Bulgarian preparation fupiram]. AB - The study includes 30 patients: 21 patients with various cardiac diseases which had led to chronic cardiac failure with well expressed edemas, 7 patients with liver cirrhosis and ascites, 2 patients with chronic glomerulonephritis and nephrotic syndrome. For 7 consecutive days the patients received fupyram or furanthril. In the morning, before breakfast, they received either 1 capsule fupyram (which is composed of amyloride hydrochloride 0.005 g and furezemide 0.04 g) or 1 tablet furanthril. In case of insufficient diuresis the daily dose was increased to 2 capsules fupyram (or 2 tablets furanthril respectively). In the patients with satisfactory diuretic effect the dose was reduced to 1 capsule (tablet) every other day or 2 capsules 2 times weekly after the second week. At the end of the 4-th week the general condition of the patients improved considerably. The diuresis increased, the body mass and the arterial pressure decreased. The potassium serum level increased from 4.4 +/- 0.3 mmol/l at the beginning of the treatment to 5.3 +/- 0.7 mmol/l. In 11 patients the potassium level reached values about 5.5 mmol/l. The drug fupyram exerts a pronounced diuretic efficacy. In the patients with preserved renal function fupyram does not change significantly the potassium serum level, but in patients with impaired renal function it can lead to hyperkalemia even after an unprolonged treatment. PMID- 1771861 TI - [Endocrine changes in males with anorexia nervosa: 2 of the authors' own cases]. AB - Two men with nervous anorexia were fully investigated and the results were compared with those of 15 healthy men and 19 women with the same disease. A similarity of the hormonal changes in both sexes concerning the somatotropic hormone, thyroid and cortico-suprarenal axis was established. A difference was found between the women and the two men concerning the gonadotropic hormones which in the men showed a well expressed reaction to gonadoliberin with an early maximum. PMID- 1771862 TI - [The characteristics of glucose tolerance in obesity]. AB - In 151 obese patients an oral glucose tolerance test was carried out. In 118 patients (mean relative body mass 161.5 +/- 39%) the test was normal. In 33 patients (mean relative body mass 167 +/- 32.1%) the glucose tolerance was decreased. In these patients the mean duration of the pathologic overmass was 15.2 +/- 4.8 years. 4 basic types of curves of pathologic tolerance are described. Obesity in men is significantly more frequently complicated with pathologic glucose tolerance than in women (42.2% vs 15.5%). The great variety of glucose tolerance curves in the obese patient is probably related to various types of response of the insulin secretion and the contrainsular mechanisms. PMID- 1771863 TI - [Tobacco smoking and beta-cell secretion]. AB - The beta-cell secretion was studied in 7 healthy volunteers (women) by a venous glucagon (1 mg) test. First the test was carried out without smoking and then repeated one week later on the background of continuous smoking (4 cigarettes at intervals of 15 min). The C-peptide was examined at the 0, 10, and 60, min. The mean age of the volunteers was 44.5 +/- 5.1 years and the mean body mass index was 24.22 +/- 1.9 kg/m2. The area of the stimulated insulin secretion under the C peptide curve in the test on the background of smoking was significantly smaller than in the test without smoking (F = 5.09, p less than 0.05). The conclusion is that smoking exerts an unfavourable influence on the beta-cell secretion. PMID- 1771864 TI - [Autoimmune changes in thyroid diseases]. PMID- 1771865 TI - [Urinary electrolyte excretion in autosomal dominant polycystic kidney]. AB - In 33 patients with autosomal dominant renal polycystosis the urine excretion of the electrolytes sodium and potassium was examined and analyzed in relation to the renal function and the arterial pressure. The clearances, the urine ratio and the excreted fractions of both electrolytes were calculated. It was established that by normal renal function and without arterial hypertension there were no significant differences in the parameters studied between the patients and the healthy controls. In the patients with arterial hypertension and preserved renal function the sodium clearance and urine excretion were lower, but the differences with the normotensive patients were not statistically significant. In the patients with chronic renal failure (when diuretic was applied) higher mean values of the excreted fractions of sodium and potassium were established. The results support the thesis that hypertension in renal polycystosis is of volumetric character. PMID- 1771866 TI - [The treatment of primary biliary liver cirrhosis with ursodeoxycholic acid (preliminary report)]. AB - Seven women, mean age 47.7 years, with primary biliary cirrhosis (6 patients in the II-III stage and I patient in IV stage of the disease) were treated in the course of 16 months with ursodeoxycholic acid (Ursofalk) 500 mg daily. At the end of the 3-d month of treatment the itching had passed in 3 of the patients and in the remaining 4 patients it had substantially decreased. In all patients the subjective complaints, dyspeptic syndrome, appetite and sleep improved. The serum concentrations of bilirubin, copper and cholesterol started to decrease and the serum activity of the enzymes alkaline phosphatase, ALAT and ASAT also decreased. In one patient the treatment was discontinued in the 6-th month because of allergic reaction. After 16 month treatment in the 6 patients who completed the treatment the itching passed and the working capacity improved. The serum concentrations of bilirubin, cholesterol, copper and IgG significantly fell (p less than 0.01), the serum activity of alkaline phosphatase, gamma glutamyl transpeptidase, ALAT and ASAT fell near the upper normal range. The hepatomegaly, splenomegaly, McLagan's flocculation test, serum concentration of IgM and the titer of the specific antimitochondrial antibodies (M2) did not change in spite of the treatment. The results show the ursodeoxycholic acid as a perspective therapeutic means for primary biliary cirrhosis which lowers or overcomes the syndrome of intrahepatic cholestasis and limits the activity of the cirrhotic process in the liver. Ursodeoxycholic acid is well tolerated. PMID- 1771867 TI - [Changes in the gastric mucosa of ulcer patients with a reflux syndrome]. AB - To 254 patients with active peptic ulcer 302 esophageal and 438 gastric endoscopic biopsies were performed and studied histologically. The patients were classified into 2 groups with and without (control group) reflux syndrome. The histological examination established atrophic changes in the antral mucosa in 58.2 +/- 6.0% of the patients with active peptic ulcer and reflux syndrome and in 40.0 +/- 4.6% of the patients of the control group and reflux esophagitis in 46.8 +/- 5.6% of the patients with reflux vs 17.6 +/- 10.8% of the control patients. The significantly greater frequency of structural changes in the esophageal mucosa in the patients with active ulcer and reflux syndrome is related to the greater frequency of the atrophic changes in the antrum and the greater frequency of duodenogastric reflux in these patients. The role of the altered endogenous gastrin secretion and the disturbed antrum motility in the physiological function of the gastroesophageal segment is discussed. PMID- 1771868 TI - [Multiple gastric aspiration biopsies combined with endoscopic and histomorphological studies]. AB - The study includes 50 patients with duodenal peptic ulcer who are classified into 2 groups: 1 gr. of 30 patients to whom biopsy was performed twice at a 14 day interval in order to study the reproducibility of the method in relation to the histological diagnosis; II group of 20 patients served for determination of the percentage of full value biopsies suitable for diagnosis. The results showed that the histological diagnosis based on the second examination coincided with the diagnosis from the first examination in 78% of the cases and by the single examination 33% of the biopsies showed gastritis of different severity from the rest. Most of the biopsies were of full value--84%, and the material of 19 mg obtained from mean 10 biopsies to a patient was sufficient. The endoscopic control following the biopsies revealed artificial erosions of incomplete type localized in the corpus and rarely single erosions in the antrum. The difference in the percentage of antral biopsies found by gastroscopy--6% and that found by histological examination--0.6% is a proof for the fundalization of the antral glands. The proposed method for multiple aspiration biopsy is informative, noninvasive and technically easy to perform. PMID- 1771869 TI - [Acute kidney failure as a "mask" of a dissecting aortic aneurysm]. AB - Two cases--of a 52-year-old man and a 59-year-old woman--are presented. The onset of the disease was acute with diarrheal syndrome and the patients were hospitalized in the Infectious Disease Clinic. The diagnosis of acute infectious enterocolitis was rejected. In the first days after the hospitalization the patients became oligoanuric and increased levels of urea and creatinine were established. A diagnosis of acute renal failure after acute enterocolitis was made and the patients were transferred to the Nephrologic Clinic. In spite of the rapid restoration of the diuresis after i.v. infusions, the patients died suddenly. The postmortem examination revealed an aortic dissecting aneurysm. PMID- 1771870 TI - [Drug disease related to the use of nonsteroidal anti-inflammatory agents]. AB - A case is presented of a woman with drug disease related to the use of non steroid antiinflammatory drugs. The disease was manifested by combined impairment of several organs and systems: arthralgia, febrility, anorexia, fibroscopic data for superficial gastritis, iron deficiency anemia, angiospastic syndrome, impairement of the liver and the kidneys. The renal lesions differed from the usual for such cases tubulointerstitial changes and a mild mesangioproliferative glomerulonephritis without manifested clinical symptoms was found. Discontinuance of the treatment with the non-steroid antiinflammatory drugs lead to the disappearance of the complaints and normalization of all laboratory indices. PMID- 1771871 TI - [Shock and acute kidney failure because of not taking fluids]. AB - A case is presented of shock and acute renal failure due to dehydration in a woman with a psychic disease who had not taken food and fluids for a long time. The post mortem examination revealed the pathomorphologic pattern of shock with microthrombi in the inner organs, brain and leptomeninges. PMID- 1771872 TI - [Prof. Vasil Mollov--an eminent Bulgarian internist (on the 115th anniversary of his birth)]. PMID- 1771873 TI - Helmet use improves outcomes after motorcycle accidents. AB - To determine the effects of motorcycle helmet use on the outcome of patients admitted to a Level I trauma center, we studied patient outcomes and demographic and epidemiologic variables of 474 patients injured in motorcycle collisions and treated at such a center over a 45-month period. Of those involved in a motorcycle collision, 50% were not wearing a helmet, 23% were wearing a helmet, and in 27% helmet use was unknown. Those who were wearing a helmet had fewer and less severe head and facial injuries, required fewer days on a ventilator, and sustained no serious neck injuries; fewer patients who wore helmets were discharged with disability, and hospital charges were lower. These data support the need for both increased public education regarding helmet use and mandatory helmet use legislation. PMID- 1771874 TI - Cardiac dysfunction in patients seropositive for the human immunodeficiency virus. AB - To confirm the presence of cardiac dysfunction in a group of patients seropositive for the human immunodeficiency virus with either dyspnea on exertion or a reduced anaerobic threshold, 9 patients with no history of opportunistic infection underwent exercise right-sided heart catheterization. When compared with 13 control patients previously exercised in the same manner, the patients showed elevated exercise pulmonary capillary wedge pressure (14.6 +/- 3.3 mm of mercury versus 9.9 +/- 3.3 mm of mercury; P less than .005) and right atrial pressure (10.1 +/- 2.1 mm of mercury versus 4.7 +/- 3.2 mm of mercury; P less than .001) at a similar exercise oxygen consumption and cardiac index. Of the 9 patients, 8 had at least 1 catheterization value outside the 95% confidence limits for the control group and 4 patients had multiple abnormalities. Values for blood CD4 lymphocytes were 0.2 x 10(9) per liter or more for 7 of the 9. One patient underwent endomyocardial biopsy with findings consistent with a cardiomyopathy. We conclude that cardiac disease may occur at any immunologic stage of human immunodeficiency virus infection. These observations suggest an effect of this disease on the heart. PMID- 1771875 TI - Patterns of primary care of patients infected with human immunodeficiency virus. AB - To determine the patterns of care of patients infected with the human immunodeficiency virus (HIV), data from 2 sources were analyzed. Initial data obtained from the Washington State HIV/Acquired Immunodeficiency Syndrome (AIDS) Epidemiology Unit indicate that 46% of patients with class IV AIDS were seen by physicians who reported fewer than 5 patients with AIDS, and 68% of all Washington physicians who reported treating patients with AIDS have reported only 1 patient. Subsequent data obtained from a questionnaire distributed in 4 Northwest states suggest that 74% of primary care internists and 73% of family practitioners have some experience in caring for patients with HIV infection, but most of these physicians report fewer than 6 patients in the past 2 years. Although most providers seeing large numbers of HIV-infected patients in their practices were based in the region's major metropolitan area, 59% of the internists and 55% of the family practitioners surveyed outside of the metropolitan area had seen at least 1 HIV-infected patient in their practices. These results suggest that primary care physicians with relatively little experience treating HIV infection are providing care for a large number of HIV infected persons. Further study is needed to determine the extent and quality of care provided. PMID- 1771876 TI - Evaluating cancer patients for rehabilitation potential. AB - The Karnofsky performance scale is the most widely used method of quantifying cancer patients' ability to function. It has also been used to measure patients' function before and after treatment. Because identifying problems with function is the cornerstone of rehabilitating patients with cancer, we developed a table that relates the functional independence measure with the Karnofsky scale. This approach encourages oncologists to consider inpatient or outpatient rehabilitation services for a broader range of cancer patients. We assessed 70 cancer patients undergoing rehabilitation to identify similarities between the functional independence measure used at our facility and the Karnofsky scale. In activities we considered vital, only 14% of patients were independent with ambulation on admission and, at discharge, 80% were independent or supervised with ambulation. Toilet transfers and bowel and bladder continence improved by the time of discharge. Three months after they were discharged, 28 of the 37 patients had maintained their discharge function level or had improved. Of the original group, 19 had died. PMID- 1771878 TI - Vibrio vulnificus. Hazard on the half shell. AB - Vibrio vulnificus is an extremely invasive gram-negative bacillus that causes bacteremia and shock. It should be suspected in any patient who is immunocompromised or has liver disease or hemochromatosis. Reduced gastric acidity may also increase the risk of infection if a patient presents with a history of ingesting raw shellfish (especially oysters) or trauma in brackish waters and skin lesions. Patients most commonly present with one of three clinical syndromes: primary septicemia, wound infection, or gastroenteritis. Treatment includes aggressive wound debridement, antibiotic therapy, and supportive care. Rapidly diagnosing and promptly initiating therapy are critical because V vulnificus infection is rapidly progressive and mortality approaches 100% if septic shock occurs. PMID- 1771880 TI - Use and abuse of parenteral nutrition. PMID- 1771879 TI - Advances in the management of hemorrhagic shock. AB - The Scientific Board of the California Medical Association presents the following inventory of items of progress in general surgery. 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 general surgery 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 General Surgery of the California Medical Association, and the summaries were prepared under its direction. PMID- 1771877 TI - Molecular genetics of retinitis pigmentosa. AB - Retinitis pigmentosa is a model for the study of genetic diseases. Its genetic heterogeneity is reflected in the different forms of inheritance (autosomal dominant, autosomal recessive, or X-linked) and, in a few families, in the presence of mutations in the visual pigment rhodopsin. Clinical and molecular genetic studies of these disorders are discussed. Animal models of retinal degeneration have been investigated for many years with the hope of gaining insight into the cause of photoreceptor cell death. Recently, the genes responsible for two of these animal disorders, the rds and rd mouse genes, have been isolated and characterized. The retinal degeneration of the rd mouse is presented in detail. The possible involvement of human analogues of these mouse genes in human retinal diseases is being investigated. PMID- 1771881 TI - Procuring donor organs for transplantation. PMID- 1771882 TI - Surgical treatment of chronic ulcerative colitis. PMID- 1771883 TI - Efficacy of carotid endarterectomy in randomized trials. PMID- 1771884 TI - Surgical treatment of hemoptysis. PMID- 1771885 TI - Fulminant hepatic failure following low-dose sustained-release niacin therapy in hospital. PMID- 1771887 TI - Mouse joint--another manifestation of an occupational epidemic? PMID- 1771886 TI - Gastric tuberculosis presenting as fever of unknown origin. PMID- 1771888 TI - Cisplatin therapy-associated recurrent toxic shock syndrome. PMID- 1771889 TI - Acute mediastinal widening following endotracheal intubation and gastric lavage. Esophageal perforation, with mediastinal abscess. PMID- 1771890 TI - A lethal leviathan--Vibrio vulnificus. PMID- 1771891 TI - Molecular advances in retinitis pigmentosa. PMID- 1771892 TI - Niacin--the long and the short of it. PMID- 1771893 TI - Preceptorships in the 21st century, The return of the apprentice. PMID- 1771894 TI - Public interest in human growth hormone therapy. PMID- 1771895 TI - Tort reform works. PMID- 1771896 TI - Medical tourists. PMID- 1771897 TI - The menace of alcohol. PMID- 1771898 TI - Dopamine receptor classification, neuroanatomical distribution and in vivo imaging. AB - The classification of dopamine receptors and their neuroanatomical distribution is reviewed, including the newly discovered D3, D4 and D5 subtypes. In vivo imaging techniques and methods for quantification are briefly described and PET and SPECT studies of D2 receptors in schizophrenia, under neuroleptic treatment, in aging, Parkinson's disease, Huntington's disease, tardive dyskinesia and multisystem atrophies are reviewed and compared with our own results. A short description is given of imaging studies of D1 receptors. PMID- 1771899 TI - Lymphoscintigraphy using epidermal growth factor as tumour-seeking agent in uterine cervical cancer. AB - Fourteen patients suffering from advanced inoperable cervical cancer were investigated by planar scintigraphy after subcutaneous administration of a radiolabelled (I-123) epidermal growth factor (EGF). The objective of the study was to test whether labelled EGF concentrates in lymph node metastases of squamous cell cancer of the cervix uteri. Scintigraphic results were correlated with the gynecological findings, computed tomography (CT), ultrasound (US) and in two patients with histology. A series of scintigrams were performed up to 24 hours post injection. Slight activity in liver and kidneys was found already 30 min after s.c. injection of EGF. Optimal imaging quality for the lymphatics was obtained at 6-8 hours post injection. Accumulation in the pelvic lymph nodes was documented by the region of interest technique (ROI). Lymph nodes of the inguinal and iliac communis region were marked in all cases. Due to this, accumulation of EGF could not be called selective. In 11/14 patients hot spots were correlated to other pelvic lymph nodes. In 4/11 patients with positive EGF-scanning metastatic disease was confirmed by CT scan and/or US examination. 2/11 patients underwent a Probatoria operation. The respective histological reports confirmed our scintigraphic results. In conclusion, labelled EGF did not fulfil our theoretical expectations of excellent accumulation in lymph node metastases and cannot at present be recommended for routine clinical use. PMID- 1771900 TI - 123I-tyrosine-(A14)-insulin: preparation and preliminary clinical studies. AB - Insulin was radioiodinated with 123I (123I-tyrosine-(A14)-insulin) to a specific activity of 1 micrograms/mCi, corresponding to 0.025 I.U. of insulin/mCi. This preparation was used for in vitro binding experiments with adipose tissue, showing active binding to the two subunits of the known insulin receptor. In a preliminary clinical investigation, 5 adipose patients with (n = 2) and without (n = 3) diabetes mellitus Type II, were subject to in vivo injection of the same radiolabeled product using 3 mCi/patient. During the first minutes of dynamic imaging, the liver was the major organ of tracer uptake in all patients. Furthermore, the pancreas, and in one patient the kidneys, were visualised. Further studies on insulin in vivo kinetics and quantification are under way. PMID- 1771901 TI - [Inflammatory demyelinating diseases if the peripheral nervous system: immunological concepts and experimental models]. AB - Some inflammatory diseases of the peripheral nervous system, most prominently the Guillain-Barre syndrome, are currently regarded to be of autoimmune origin. Experimental models show clearly that the balance between cellular and humoral autoimmune reaction against peripheral myelin components significantly determines the appearance of the disease. Yet, important questions, such as target antigens of the antimyelin reaction are still unresolved. PMID- 1771902 TI - The place of high dose immunoglobulins in the treatment of Guillain-Barre patients based upon the dutch trial. AB - The preliminary results of a multicenter trial in the Netherlands comparing plasma exchange (PE) with high-dose intravenous immunoglobulin (IgIV) (dose 0.4 g/kg during 5 consecutive days, total dose of 2.0 g/kg) are reported. The trial was performed on 150 patients. After 4 weeks, 34.2% of the PE patients and 52.7% of the IgIV patients showed improvement. While in 11 patients plasma exchange had to be discontinued for medical reasons, no serious side effects were seen in the high-dose immunoglobulin treatment group. In 30% of the patients antibodies to GM1 ganglioside were found. The presence of such antibodies was correlated with a more severe clinical course and delayed recovery. Since improvement in the IgIV group occurred almost twice as often in GM1 negative patients, the effect appears to be limited in GM1-positive patients, who obviously need additional treatment. A current multicenter trial uses IgIV combined with high-dose methylprednisolone. PMID- 1771903 TI - [Clinical symptoms and diagnostic criteria in polyradiculitis--Landry Guillain Barre]. AB - Acute polyradiculitis ("acute inflammatory demyelinating polyradiculitis--AIDP" or the Landry-Guillain-Barre syndrome--GBS) is an acute inflammatory disease of the peripheral nervous system. Despite extremely severe courses and complications, the prognosis is favourable for the majority of patients. The typical clinical course is featured by non-characteristic sensory symptoms following an infection, with ensuing ascending motor signs and symptoms which, in 80% of the patients, reach a maximum within two weeks. The legs are usually involved before the arms. About 50% of the patients show involvement of cranial nerves. In the acute phase, respiratory insufficiency and autonomous dysfunctions may occur. For diagnosis, predominantly clinical criteria are used according to the criteria summarized by Asbury. PMID- 1771904 TI - [Electrophysiological studies in acute Guillain-Barre syndrome]. AB - Based on a synopsis of the literature and our own investigations we discuss the electrophysiological changes in acute Guillain-Barre syndrome. These changes must be viewed in relation to the clinical course of the illness. The SPA evoked by distal stimulation decreases by 50% during the first week of illness, continues decreasing in the second and third weeks and then shows a tendency to normalization. In a similar way, the motor NCV reaches a minimum in the third week and then shows a slow increase again. The motor NCV findings return to normal earlier than SPA. At an early stage we find changes in F-wave and distal latency as well. In connection with the clinical picture, the incidence of changes pointing to a primary demyelinating polyneuropathy can be seen as an electrophysiological sign for the Guillain-Barre syndrome. The relevant criteria are discussed. There are various views concerning the validity of the electrophysiological findings in terms of prognosis of acute Guillain Barre syndrome. Since prognosis is dependent, at first, on the amount of the denervation, the decrease of SPA is of importance. To be able to give a prognosis it is necessary to examine large number of motor nerves electrophysiologically. However, it is very often not possible to make a reliable electrophysiological prognosis in the individual case. The pathophysiological basis for electrophysiological changes in demyelinating PNP's is discussed. PMID- 1771905 TI - [Short definitions of medical ethics concepts. Part 14]. PMID- 1771906 TI - [Utilitarianism and medical ethics]. PMID- 1771907 TI - [Medical ethics, patient ethics and pluralistic society]. PMID- 1771908 TI - [Medical documentation exemplified by neurology. 20 years' experience--current challenges--future prospects]. PMID- 1771909 TI - [Synergetics--a possible hypothetical approach to better understanding of pathologic processes]. AB - Modern understanding of the human disease cannot be reduced only on the disturbed biological processes of the living organism. Disease as the consequence of the disorders of a complex system needs in the same sense a complex view. It is necessary to take in consideration the theory of systems, the concept of layers and the idea of the deterministic chaos. A helpful clamp to coordinate these different views seems to be the synergetics, the teaching of the cooperation in complex systems. Synergetics investigate the mechanisms of the self-organization, too. The self-organization is of great significance in the phylogenetic and ontogenetic morphogenesis. Especially all diseases which are characterized by the disorders in the differentiation the processes forming "Gestalten" are to understand as processes of the disturbed self-organization. These refers the malformations, the malignant tumours and the chronic diseases. Self-organization being a system-internal mechanism is to understand as a process which determines the behaviour of complex organized living systems in confrontation with their environment. PMID- 1771910 TI - [Development of a psychological superstructure in phobic patients]. AB - Firstly the importance of a (behavioristically interpreted) psychic superstructure, that is formed by hypostatizing avoidance behavior and more direct reflex-mechanisms like rituals is emphasized. Phobic syndromes (in a larger sense) as well as their therapy should be understood in a better way. Just for this reason that superstructure should complement Freuds unconscious psychic life. Lastly possibilities of multidimensional work are commented. PMID- 1771911 TI - [Comment on F. Berghold, W. Schaffert and K. Pallasmann: Prerequisites and guidelines for acclimatization to great and extreme altitude in prevention of altitude sickness]. PMID- 1771912 TI - [Short definitions of concepts in medical ethics. Part 15. Autonomy]. PMID- 1771913 TI - [Ethics committees: medical treatment counseling or prescribing?]. AB - Ethics committees react to the crisis of justification of both research and treatment in modern medicine. Their composition, functioning, task, and identity depend on the question if they consider themselves as instruments of controller consultation. The more moral thinking in medicine is oriented towards support for reasoning, towards consultation for solving conflicts of motivation, and in elucidation interests the more ethics committees will succeed in becoming institutions of consultation by ethical reasoning in medicine. PMID- 1771914 TI - [AIDS and the law. Does the state neglect its protective function?]. AB - Criminal law and labor legislation concerning with AIDS and the problems of data protection in both countries are shown. PMID- 1771915 TI - [Fibrinogen: a "new" cardiovascular risk factor]. AB - There can be little doubt today that fibrinogen is a major cardiovascular risk factor. In spite of this clear message, many fundamental problems are as yet unsolved. We know too little at present about the determinants of the "normal" fibrinogen level, about the biochemical control of its synthesis, and about the mechanisms involved in harming the circulatory system. From a practical point of view we can use today's knowledge 1) to identify individuals at risk, 2) to normalize (within limits) their plasma fibrinogen levels. A precondition for the latter strategy would be that fibrinogen and the cardiovascular risk are causally related. Even though the published data does support this view, it has to be established more firmly in the future. PMID- 1771916 TI - [Comparative clinical, roentgenologic, scintigraphic and nuclear magnetic resonance tomography studies in sympathetic reflex dystrophy]. AB - The results of clinical, radiological, three phase bone scan and magnetic resonance imaging (MRI) examinations in 17 patients with reflex sympathetic dystrophy (RSD) are reported. Characteristic clinical symptoms, positive radiographic and scintigraphic findings were compared with the MRI. Soft tissue and bone signal intensity changes in MRI as well as bone scan demonstrated significant correlation to the duration of RSD. In conjunction with scintigraphy soft tissue diagnostic sensitivity and specificity are 1, 0.67 or 0.71 respectively. Bone signal diagnostic sensitivity and specificity are 0.5 or 0.67 respectively and 0.93 or 0.87 respectively. According to the results MRI appears to be of much value in establishing the diagnosis of RSD. In consequence a diagnostic schedule is evaluated. PMID- 1771917 TI - [Headache: interdisciplinary cooperation]. AB - Tendency towards subspecialization in medicine, especially in medical literature, endangers the patient who does not fit in one of the specialities. Hence he may be treated badly or not at all. Headache forms an interdisciplinary meeting point and shows this in high grade. Four following reviews of books on headache will demonstrate it. Each of it claims a good deal of competence and authority. In itself however the four books are widely contradictory. Our concept of multidimensional classification in headache builds up a planned polypragmasy using target symptoms. This is an attempt to evade such dilemma. Further seems to be needed: better knowledge of the marginal territories in our specialization, closer interdisciplinary cooperation and maybe a new organisation of medical system. PMID- 1771918 TI - Evaluation of patients with atypical results of a Papanicolaou smear. AB - One hundred women with atypical Papanicolaou smear results were examined in a protocol of colposcopy, cervicography, cervical cultures, and wet preparations of vaginal secretions. Infections of the vagina and cervix were rare and often found in patients with coexistent cervical dysplasia. Cervicography identified many of the patients who ultimately were found to have cervical dysplasia but had high false positive and false negative rates. Forty-seven percent of the patients had cervical dysplasia or cervical condyloma. Based on this high rate of dysplasia, treatment of vaginitis and repeated cervical cytology cannot be recommended. Colposcopy represents the most appropriate approach to the patient with atypical cytology. PMID- 1771919 TI - Hyperkalemia from blackstrap molasses. PMID- 1771920 TI - High total dose 5-fluorouracil treatment during pregnancy. AB - Experience with systemic chemotherapy in the treatment of the pregnant patient with metastatic breast cancer is limited. Most available reports review the use of single agents and those of combination chemotherapy deal predominantly with hematologic malignancies. While 5-fluorouracil (5-FU) is a commonly used antineoplastic agent in the treatment of metastatic breast cancer, there is minimal reported experience with this drug in the therapy of pregnant patients. We report here the birth of a normal infant in a woman with metastatic breast cancer treated with cyclophosphamide, adriamycin and high total dose 5-FU. PMID- 1771921 TI - The problem of recurrent stenosis following carotid endarterectomy. AB - From 1977 to 1985, 306 consecutive patients underwent carotid endarterectomy by a single surgeon. The post-operative stroke and death rates were 1.3% and 2.6%. Of the 184 patients with follow-up duplex scanning, 24 (13%) had a recurrent stenosis of 50% or greater. Of 15 possible risk factors studied to assess a possible relationship with recurrent stenosis, four were definitely associated and a fifth probably implicated. The four definitely associated risk factors for recurrent stenosis were an age of 70 years or older (p = 0.0025), female gender (p = 0.0001), ulcerated lesions (p = 0.013), and asymptomatic lesions (p = 0.041). The fifth risk factor that may play a role (though not reaching statistical significance) was combined carotid endarterectomy and myocardial revascularization (p = 0.066). In these patients, we recommend using vein patch angioplasty to reduce the recurrence rate. PMID- 1771922 TI - Identifying women who have never had a mammogram. PMID- 1771923 TI - The children are our future. PMID- 1771924 TI - [The laser in gastroenterology]. AB - The use of lasers in gastroenterology is an enrichment of the non-invasive therapeutic methods. Prerequisite is their critical use which, in order to be successful, needs a minimum frequency and thus experience. In form of a strictly constructed survey the paper deals with the potential possibilities of laser application and with the alternative approaches being today at our disposal. PMID- 1771925 TI - [Molecular mechanisms in atherogenesis]. AB - Disturbances of the lipid metabolism play a key role in atherogenesis, cholesterol, however, is not stored passively in the arterial wall, but on the basis of complex, partly still unknown humoral and cellular processes. The proliferative lesion of the arteriosclerotic vascular wall is characterized by injured endothelial cells, differentiating macrophages, immunocompetent T lymphocytes and proliferating smooth muscle cells. Molecular biological investigations on cells of arteriosclerotic plaques among others clarified growth factors, cytokines, factors of angiogenesis and growth inhibitors in form and significance. Risk factors damage the endothelium and thus cause the production of these mediators. The adhesion proteins and the proto-oncogene c-sis play a further role. The latter might produce a connection between arteriosclerosis and cancer research. PMID- 1771926 TI - [Diabetes mellitus and arterial hypertension. In search of the connecting link]. AB - Late diabetic effects are the sequelae of for a long time super elevated blood sugar levels. The diabetic nephropathy is the cause of the secondary arterial hypertension. The investigation seeks for the connections between the diabetes mellitus and the essential, that is primary hypertension. The two diseases frequently appear and clearly increase in the second half of life. Moreover, they are above average frequently associated with each other. Among brothers and sisters of diabetic hypertensives in comparison to normal cohorts clearly increased high blood pressure prevalences were found. The insulin resistance which could be proved in a great number of hypertensive and which has been known since more than two decades might be the connecting link between hypertension and diabetes mellitus. Like the obesity the essential hypertension can be associated with all degrees of an insulin hyposensitiveness. The sodium-retaining effect of the insulin might explain the increased sodium content of the body in hypertensives. The differential diagnostics of the essential hypertension should therefore seek for conditions of an insulin resistance. The type II diabetic lacks a release of bradykinin during muscle work. Thus the glucose uptake into the cell is unfavourable influenced and demands an increased insulin excretion. This genetically (?) fixed defect is found also in essential hypertensives. It could be the connecting link between the two diseases. ACE-inhibitors have via a kininase II inhibition an effect also on the bradykinin decomposition and can favourable influence the glucose uptake into the muscle. An improved insulin effect among the ACE-inhibitors was described. Therefore, they should be preferred in the treatment of hypertensive diabetics. PMID- 1771927 TI - [Treatment of type 2 (non-insulin dependent) diabetes and the metabolic syndrome with diet]. AB - Insulin resistance appears as the pathophysiological basis of metabolic syndrome and NIDDM. In type 2 diabetics additionally we observe a delayed and prolonged postprandial insulin response. These both processes represent a pathophysiological and pathogenetic unity of disturbances. The prevention and therapy of insulin resistance, metabolic syndrome and type 2-diabetes with diet involves 3 main issues: reduction of energy uptake and of body weight in obese; Composition of meals concerning the principles of fat reduced lactovegetabile nutrition; guaranteeing of longer postabsorptive phases (between meals), to avoid a permanent postprandial hyperinsulinemia and development of insulin resistance. Anti-insulin resistance diet is therefore a carbohydrate enriched, fat-reduced (lactovegetabile) nutrition with not too frequent meals (longer meal-free phases) and mainly reduced energy intake in overweight. PMID- 1771928 TI - [Incidence of hyperthyroidism in the Halle area before and after introduction of general preventive iodine treatment]. AB - With an average frequency of more than 10% the former GDR is an endemic area of struma with an iodine insufficiency of second to third degree. After an effort for many years we succeeded in introducing the gradual prophylaxis with iodine preparations with the help of the action of an interdisciplinary iodine commission. After an initial addition of 25 mg of potassium iodide to the kilogram kitchen salt beginning with 1986 an iodination with 32 mg KJO3/kg was established for circa 85% of the so-called packet articles. At the same time an iodination of the mineral mixtures for the animal feed was performed. From the supplementation altogether resulted a daily iodine uptake of about 135 microgram. Apart from a reduction of strumata of newborn to lower than 1% further provable effects of the supplementation of iodine developed. Among others the losses of animals could be diminished and the production of meat and milk could be improved. In the animal production the annual losses in a value of more than 180 million GDR mark were eliminated. As the only side-effect foreseen an increase of the hyperthyroidisms by a factor between 2 and 3 appeared. It concerned both immunogenic and autonomy-caused overfunctions and is to be compared to the success of iodination known from other countries, egg. Tasmania. The cases of hyperthyroidism are transitory, in the course moderate and concern only already preformed, so-called latent form.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771929 TI - [Portal hypertensive gastropathy--a rare cause of upper gastrointestinal hemorrhage]. AB - There is evidence that the portal-hypertensive gastropathy is a clinical complication of portal hypertension and a distinct clinical entity being different from various types of gastritis. According to endoscopical findings one can differentiate 4 stages: I = superficial reddening on the surface of the gastric rugae, II = white reticular pattern separating areas of prominent pink oedematous mucosa (snake-skin or mosaic pattern), III = cherry red spots, IV = diffuse bleeding. These alterations occurring more prominently in the gastric fundus are caused by venous and capillary ectasia and by arteriovenous shunts. The potential of diffuse mucosal bleeding distinct from variceal haemorrhage is of clinical importance. Additionally, congestive mucosa seems to be more vulnerable to noxious agents in the gastric lumen. For therapy propranolol has been recommended. PMID- 1771930 TI - [Diagnosis and therapy of deep phlebothrombosis of the extremities]. AB - The typical symptoms of the deep phlebothrombosis are not always given, often we have to do with a quiescent or atypical form of the course. For this reason not only the classical symptoms but also the differential-diagnostic considerations were mentioned. Apart from the clinical examination the ultrasound Doppler sound and above all the phlebography will help us for finding the diagnosis. As to the therapy in particular the thrombolytic treatment is discussed. Hereby nowadays the so-called ultrahigh streptokinase treatment seems to preponderatell, since it also develops a shortening of the time of therapy, the conventional lysis with urokinase is reserved to the risk patients. Not only the immediate results as well as the long-term results concerning the formation of a postthrombotic syndrome are mentioned. PMID- 1771931 TI - [Electromyographic and manometric studies of stomach motility after vagotomy]. AB - Vagotomy coincides not only with a reduction of the cephalic phase of secretion but also with a significant reduction of the motor activity of the stomach. Electrical and mechanical activity of the gastric wall after truncal vagotomy were verified in animal experiments (dog n = 5) by means of implanted electrodes and pressure transducers. Longlasting motility disturbances expressed as a disorganisation of the basic electrical rhythm occurred in the gastric wall. According to the pattern periods of tachygastria and tachyarrhythmia were identified. Those periods interrupted the regular fasted motility and persisted in the postprandial period. Simultaneous registration of the mechanical activity of the gastric wall during disorders of the electrical rhythm revealed a complete absence of contractility which probably is the pathophysiological correlate for the frequently described delayed gastric emptying after vagotomy. PMID- 1771932 TI - [Helicobacter pylori colonization of the gastric mucosa in rheumatic patients]. AB - This study examines whether infections with Helicobacter pylori are more frequent in patients suffering from rheumatoid arthritis than in patients with non inflammatory rheumatic diseases. The study furthermore examines whether the colonisation by H. pylori is favoured by antiphlogistic-antirheumatic treatment. For this purpose gastric biopsies obtained by endoscopy from 123 patients were histologically evaluated for the presence of H. pylori. 85 patients with rheumatoid arthritis were compared with 38 patients with non-inflammatory rheumatic diseases. Although an increased susceptibility for infections can be expected in persons with rheumatoid arthritis undergoing long-term antirheumatic treatment, this could not be confirmed by our results for the colonisation of the stomach by H. pylori. It is therefore statistically confirmed that rheumatoid arthritis itself and treatment with short-term effective antirheumatic drugs has no significant influence on the colonisation rate. Still it is doubtful whether any lesion associated with NSAR and H. pylori must necessarily be considered an NSAR-"induced". Future studies will have to elaborate whether NSAR in H. pylori infected mucosa will lead to higher incidence of damage. PMID- 1771933 TI - The simplified 13C-urea breath test--one point analysis for detection of Helicobacter pylori infection. AB - A 13C-urea breath test for detection of Helicobacter pylori infection was validated in 306 patients. Breath samples (four, two or one) were taken at various time points within 30 minutes after a motility inhibiting liquid test meal with citric acid followed by 75 mg of 13C-urea. The 13CO2/12 CO2-ratio (delta-value) was measured using isotope ratio mass spectrometry and the recovery of tracer in the exhaled breath was calculated (UBT-value). In 172 patients a comparison of established reference methods (culture, CLO test, and Fuchsin staining) with the 4 point breath analysis for detection of Helicobacter pylori showed high values of quality parameters (greater than 80% for sensitivity, specificity, positive and negative predictive value), independent of expression of the results as delta-value or as UBT-value. In 134 patients a reduction of samples to one single breath sample taken 30 minutes after ingestion of the tracer showed no significant differences in the quality parameters when compared with the standard 4 point breath analysis. This indicates that the analysis of a single breath sample is suitable for detection of Helicobacter pylori status in man. PMID- 1771934 TI - The role of omeprazole (40 mg) in the treatment of gastric Helicobacter pylori infection. AB - The efficacy of omeprazole in the elimination of Helicobacter pylori was investigated in a prospective randomized-controlled trial. 50 patients with upper gastrointestinal symptoms and chronic active H. pylori-associated gastritis were allocated to one of the following four therapeutic schedules: 1) omeprazole 40 mg/d for 4 weeks (n = 13); 2) bismuth subsalicylate (BSS) 3 x 600 mg for 4 weeks (n = 12); 3) omeprazole plus BSS for 4 weeks (n = 13); 4) triple therapy (BSS for 4 weeks, amoxicillin 3 x 750 mg and metronidazole 3 x 400 mg for 10 days) (n = 12). Clinical symptoms, endoscopic and histologic findings, and H. pylori status were reassessed immediately after therapy, and 1 and 6 months later. After cessation of therapy bacterial clearance rates were: 1) omeprazole 2/13 (15%); 2) BSS 6/12 (50%); 3) omeprazole plus BSS 5/13 (38%); 4) triple therapy 10/12 (83%). The degree of density of gastric mucosal infestation with H. pylori and the degree of activity of gastritis was reduced in all treatment groups but was most prominent after triple therapy. Clinical symptoms improved in all treatment groups. One and six months after completion of therapy H. pylori eradication rates were: 1) omeprazole 0/13 (0%); 2) BSS 1/12 (8%); 3) omeprazole plus BSS 1/13 (8%); 4) triple therapy 10/12 (83%). Our study shows that 40 mg/d omeprazole is ineffective in eradicating H. pylori. Dual therapy with omeprazole and bismuth subsalicylate does not improve bacterial elimination. Only triple therapy effectively eradicates H. pylori. PMID- 1771935 TI - [75 mg roxatidine nocte protects human gastric mucosa against 300 mg acetylsalicylic acid nocte]. AB - In a randomized double-blind parallel study the gastroduodenal tolerability of 300 mg ASS nocte (8 p.m.) has been evaluated in the presence of 75 mg roxatidine nocte (8 p.m.) or placebo in 20 healthy volunteers using upper GI-endoscopy. The treatment periods lasted 14 days. Endoscopic controls were performed at entry, and repeated at day 7 and day 14. At entry the mean endoscopic score averaged 0.9 +/- 0.1 in the ASS/placebo-group and 0.9 +/- 0.1 in the ASS/roxatidine-group. The median values were 1.0 and 1.0. 300 mg ASS nocte induced in the placebo experiments marked gastroduodenal lesions both at day 7 and day 14 (6.5 +/- 1.2 and 7.9 +/- 0.7, respectively). The median values were 8.0 and 9.0, respectively. Concomitant administration of 75 mg roxatidine nocte afforded significant protection against 300 mg ASS nocte both on day 7 and day 14 (3.3 +/- 1.0 and 3.1 +/- 0.9, respectively) (p less than 0.05). The corresponding median values were 1.0 and 1.0. Our data suggest that coadministration of roxatidine nocte reduces significantly gastroduodenal lesions evoked by acetylsalicylic acid 300 mg nocte. PMID- 1771936 TI - Manifestation of acute intermittent porphyria in patients with chronic inflammatory bowel disease. AB - In a retrospective study covering 411 acute intermittent porphyria patients, four cases of a coincidence with Crohn's disease or ulcerative colitis were found. Their courses of disease confirmed that patients with chronic inflammatory bowel disease have a higher risk for acute porphyria manifestation. Both malnutrition (glycopenic induction) and sulphasalazine (drug-induced exacerbation) are known as triggering factors for acute porphyric states. Furthermore, diagnosis of acute intermittent porphyria tends to be much more difficult in such cases, as the acute phases of abdominal pain are likely to be associated with the enteral disease process. A delay of diagnosis and therapy of acute hepatic porphyria, however, may endanger the patient by pareses, which could be irreversible or even lethal. Therefore, whenever there is suspicion of a coinciding acute porphyria, urinary screening tests for porphyria should immediately be performed and, if a coinciding acute hepatic porphyria is diagnosed, porphyrogenic drugs like sulphasalazine should be avoided in treatment of chronic inflammatory bowel disease. PMID- 1771937 TI - Cryptosporidiosis of the appendix vermiformis: a case report. AB - The present case report describes a 30-year-old man with AIDS who developed cryptosporidiosis of the appendix vermiformis. The patient had been admitted to hospital with all the symptoms of appendicitis, and an appendectomy was performed. The histological work-up of the surgical specimen revealed an acute phlegmonous appendicitis, and also a welldeveloped cryptosporidiosis, which was confirmed by electron-microscopic examination. Two years later, the patient died of pneumonia contracted during a generalised CMV infection. The postmortem examination revealed cryptosporidial organisms in the biliary tract. As far as we know, this is the first ever report of cryptosporidiosis of the appendix vermiformis. PMID- 1771938 TI - [Ileocecal tuberculosis. A rare disease picture]. AB - Gastrointestinal tuberculosis is a rare disease in industrial countries. The most frequent localisation is the ileocaecal region. We report about two cases of stenotic ileocaecal tuberculosis, treated by surgical resection. The main clinical symptoms are abdominal pain, weight loss and low-grade fever. Uncomplicated cases responses successfully to antituberculous drugs, just complications require surgery. PMID- 1771939 TI - [Microbiologic findings in protracted and chronic enterocolitis]. AB - Novel diagnostic methods (immunoblotting, immunofluorescence test) have been proved to be very sensitive and specific for detecting enteropathogenic bacilli. 28 patients with chronic enterocolitis were investigated. In 50% (14/28) of these patients Yersinia enterocolitica could be visualized in biopsies by immunofluorescence. The serum of 8 patients also contained IgA-antibodies against plasmid encoded released proteins of Y. enterocolitica. This paper reports evidence for persistence of Yersinia bacilli in a group of patients with chronic enterocolitis. Further studies must show, if these results may have therapeutic implications. PMID- 1771940 TI - [Value of tissue iron index in differential diagnosis between primary hemochromatosis and alcohol-induced liver disease]. PMID- 1771941 TI - [Five years experience with extracorporeal shockwave lithotripsy of gallstones]. PMID- 1771942 TI - Reply to the "Commentated report" by Schepp, W and Schusdziarra, V., Z Gastroenterol, 1990; 28: 644-645, Does omeprazole damage the gene? PMID- 1771943 TI - [Gallbladder carcinoma as an incidental finding]. AB - Between March 1982 and December 1990, 903 patients underwent elective cholecystectomy. In 40 patients cholecystectomy was performed for gallbladder carcinoma. 15 malignomas (1.7%) were found incidentally. Preoperatively no anamnestic or diagnostic tumor signs were found in this group of patients. An en bloc-resection of the gallbladder with resection of the bordering liver segments was performed when gallbladder carcinoma was diagnosed intraoperatively. When the diagnosis was established by postoperative histology, a relaparotomy with liver resection and lymphnode-dissection was done, except in one case (T-1a stage). Histology showed adenocarcinoma in 11 out of 15 cases. No significant difference in the course of the disease was observed in patients with gallbladder carcinoma of different types. The hospital mortality rate was 0% after curative and palliative surgical treatment of gallbladder carcinoma. Patients with T-1 and T-2 stage have survived without tumor-recurrence up to now. The median survival time after surgery for gallbladder carcinoma in T-3 stage was 17 months, and 8 months in T-4 stage. The morbidity rate after elective cholecystectomy is low and hospital mortality is 0%. According to the short survival times in advanced stages of gallbladder carcinoma, a prompt cholecystectomy in symptomatic gallbladder lithiasis or chronic cholecystitis is advocated. PMID- 1771944 TI - Effect of intraduodenal or intragastric nutrient infusion on food intake in man. AB - In man, only little is known about the site of origin of satiety signals within the gastrointestinal tract. Therefore, it was the aim of this study to examine the role of the stomach and the small intestine as a source of satiety signals. 8 overnight fasted healthy volunteers received intraduodenal (100 or 200 ml/h) or intragastric (100 ml/h) infusions of a mixed liquid diet (Biosorb) or iso-osmolar saline, respectively. 20 minutes after start of the infusion, standardized mini sandwiches and water were presented and food intake was recorded for the ensuing 90 minutes. During both rates of intraduodenal nutrient infusion, cumulative food intake was identical to that during saline infusion. However, during intragastric nutrient infusion, cumulative food intake was significantly reduced compared to saline infusion (30 +/- 1 vs. 36 +/- 2 sandwiches; p less than 0.05). These data indicate that food consumption in man is reduced, if initiation of eating is preceded by nutrient administration into the stomach, but not into the duodenum. This effect does not appear to be mediated by gastrin, since plasma gastrin levels were not different during gastric and duodenal nutrient administration. In conclusion, the results of this study suggest that the generation of satiety signals in man is dependent on the presence of food in the stomach. Food only in the duodenum has no effect, although synergistic gastric and intestinal mechanisms can as yet not be excluded. PMID- 1771945 TI - Effects of acarbose on carbohydrate metabolism, electrolytes, minerals and vitamins in fairly well-controlled non-insulin-dependent diabetes mellitus. AB - The alpha-glucosidase inhibitor acarbose induces a reversible delay of carbohydrate digestion. This action represents a new therapeutic option for the treatment of diabetes mellitus. The current investigation is a prospective, randomized double-blind crossover trial in 24 non-insulin dependent diabetics, fairly well controlled on diet alone or diet plus sulphonylurea. In periods of 10 weeks, the patients received successive treatment with acarbose and placebo in random order. A significantly lower HbA1 level and urinary glucose excretion were shown during acarbose as compared to placebo. The other parameters of diabetic control remained unchanged. Acarbose induced no significant alterations in the concentrations of important electrolytes, iron, vitamin B12 and folic acid. Although no major side effects occurred, meteorism and flatulence were frequent complaints. These data suggest that acarbose, in a dosage of 3 x 100 mg/day, is a safe drug, with slight beneficial effect on diabetic metabolic control. PMID- 1771946 TI - [Assessment of biotransformation capacity following oral administration of various model substances as cocktail]. AB - A cocktail of four model substances orally administered to humans is used for simultaneous characterization of phenobarbital and 3-methylcholanthrene inducible forms of cytochrome-P450 and two genetic polymorphisms, the debrisoquine hydroxylation and N-acetylation. The investigations offer the possibility to assess four main processes of hepatic drug metabolism as well as the judgement of alterations in drug elimination. Both acetylation and hydroxylation phenotypes are not influenced after administration of the cocktail compared to the administration of the substances alone. A statistically significant 30.4% increase of mean body residence time could be found only for monomethylaminoantipyrine. The other pharmacokinetic parameters of monomethylaminoantipyrine and caffeine were unchanged. A one-point-determination for the 9 hour serum concentrations of monomethylaminoantipyrine, caffeine and sulfamethazine/acetylsulfamethazine as well as the 0-9 hours urine concentrations of debrisoquin/4-hydroxydebrisoquin will be conceivable by using "normal ranges". PMID- 1771947 TI - [Initial clinical experiences with a simplified analytic method for fecal alpha-1 antitrypsin]. AB - A new assay for the determination of faecal alpha-1-antitrypsin including a simplified extraction of native stool and nephelometric measurement was studied. Its validity was established by a comparison with standardized methods and with well-known activity parameters. Excellent correlations were found, comparing this method with radial immuno-diffusion carried out on lyophilized (R = 0.96; p less than 0.05) and native (R = 0.97; p less than 0.05) stool samples. Faecal alpha-1 antitrypsin concentrations as measured with this method were significantly (p less than 0.001) higher in patients with inflammatory bowel diseases (Crohn's disease = 40, ulcerative colitis = 15) than in 25 normal controls (0.51 +/- 0.06 mg/g vs. 0.13 +/- 0.02 mg/g; x +/- SEM). There was a significant correlation of faecal alpha-1-antitrypsin with CDAI, activity index van Hees, and with various laboratory parameters (ESR, CRP, serum alpha-1-antitrypsin, orosomucoid, albumin, iron, haematocrit, haemoglobin, leucocytes, and thrombocytes). The presented method is equivalent to standard techniques in measuring faecal alpha-1 antitrypsin concentrations. It is highly useful for clinical routine and for follow-up studies in patients with inflammatory bowel disease. PMID- 1771948 TI - [Tube dislocation following percutaneous, endoscopically-controlled gastrostomy- a case report]. AB - Percutaneous endoscopic gastrostomy (PEG) is an accepted and increasingly utilized means of obtaining access to the gastrointestinal tract for alimentation. The Memosond (Pfrimmer-Viggo Co.) as a new system presents advantages in comparison to the commonly used thread-guided tubes rendering a simplified technique of setting the tube and giving the possibility of later changing without repeated endoscopy. We present a case of a 65 yr female patient with advanced carcinoma of throat. A PEG using a Memosond system was performed. Two days later the distal part of the tube dislocated into the abdominal cavity. The patient died four days later of her malignant disease. PMID- 1771949 TI - [Placebo-controlled double-blind study of cyclosporin A in primary biliary cirrhosis]. PMID- 1771950 TI - [Antimitochondrial antibodies as a sensitive parameter in the prognosis of primary biliary cirrhosis]. PMID- 1771951 TI - [Letter to the Zeitschrift fur Gastroenterologie concerning the paper by Ljubicic et al., 1991; 29: 286-8]. PMID- 1771952 TI - [Gestational age and birth weight. Part 2. The placenta and maternal cofactors]. AB - A comparison of median values of intrauterine fetal growth curves (UFK Tubingen) with those contained in all-German and international literature reveals that these data are in close agreement with the results achieved at UFK Heidelberg and by Kyank et al. and Voigt et al. The analysis of 16,740 placental weights indicates that intra-uterine weight development is primarily dependent upon the weight of this organ: Rank correlations were calculated between placental weights and birth weights for various gestational times and parities, the length of gestation remaining constant. As would be expected, the associations encountered were highly significant. After studying the distribution structure of the placental weights in the different weeks of gestation, a table of placenta percentiles (from weeks 24 to 42 of gestation) was drawn up. The dynamics of intra-uterine placental development was compared to the dynamics of fetal weight development. It has been demonstrated that this parameter is dependent on the maternal weight prior to conception as well as on the mother's height and age (only primiparae) (alpha less than 0.001). However, the "extragenital" weight gain of the mother, which increases with rising parity, seems to have no effect on intra-uterine growth. The authors conclude that constitutional, i.e. genetically governed maternal factors exert a greater influence on intra-uterine growth than would have been anticipated. No data were available about the fathers. PMID- 1771953 TI - [Prevention of late abortion and high risk premature labor--measures suited for routine practice]. AB - Ascending infection is likely to be the main cause of late abortion and early delivery. In a retrospective evaluation performed at our hospital, evidence of infection was encountered in 76% of 195 pregnancies with premature infants having birth weights less than 2000 g. It may be assumed that the processes responsible for this development take place at the lower pole. It was against this background that we developed a programme designed to contribute to an effective prevention of late abortion and early delivery. The essential requirement is that measurements of vaginal pH enter into routine use during prenatal care. This simple procedure allows for the identification of many (not all) vaginal disorders that might occur in patients at risk. In the presence of other serious anamnestic or diagnostic evidence of imminent late abortion or early delivery, specific bacteriologic examinations including a check-up for chlamydia, vaginal ultrasonography of the cervix and testing for CRP should be carried out. Lower pole lavage, a procedure recently developed by the authors, facilitates the identification of pathogens in the upper part of the infected area, as compared to conventional vaginal and cervical smear. Following are the most important therapeutic measures: An early total blockage of the os uteri is desirable in patients with a clinical history of late abortion or premature infants with little chance of surviving. Acidifying local treatment with Lactobacillus acidophilus is recommended in the presence of abnormally high vaginal pH values (over 4.2). If pathogenic or potentially pathogenic micro-organisms are identified in the upper part of the infected area, local antibiotic therapy should be resorted to, if useful; otherwise systemic antibiotics should be given. If the patient shows definite symptoms of imminent late abortion or early delivery (e.g. critical cervical findings and/or premature labour and/or positive CRP values), systemic wide-spectrum antibiotics should be administered, even if no pathogens have been encountered. The first assessments of the effectiveness of this programme have shown that since its institution in 1989 and 1990, the incidence of underweight infants (birth weight below 1500 g) was significantly reduced at this hospital (by 30%) as compared to the years 1987 and 1988. On the other hand, the incidence of larger underweight infants having a birth weight of 1500 g and more was shown to rise slightly by 9%, while the total number of underweight infants remained unchanged (8.7%).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1771954 TI - [Neurosonography and creatine kinase BB level in premature infants with perinatal risk factors]. AB - High-resolution real time ultrasound scan is used for early diagnosis of PIVH in neonates. Furthermore, in term infants an increase of serum Creatine-Kinase BB (CK-BB) values has been found to be clinically useful for diagnosis and prognosis of several perinatal cerebrovascular injuries. Eighty-eight preterm infants with different grades of PIVH (I-IV) were studied by serial measurements of CK-BB levels in serum. No statistical correlation was found between enzymatic levels, severity of PIVH and perinatal risk factors (p greater than 0.5). PMID- 1771955 TI - [Computer-assisted cardiotocography analysis within the scope of continuous electronic labor monitoring with simultaneous use of noninvasive and invasive methods of registration]. AB - In frame of a simultaneously study with noninvasive and invasive registration technic by application of 2 fetal monitors with following computer aided CTG analysis at 22 patients we found in relation to the quantitative CTG-parameters DF (fetal condition), D (dip area), BI (bradycardia index) as well as BR (bradycardia residuelle) in part distinct differences for the range of distribution in spite of missing statistical significance (p less than 0.05) which point to insecurity in trigger signals for the noninvasive method. As exceptionally dangerous turned out to be false trigger signals in range of medium term heart rate changes in attendance to auto-correlation US-DOPPLER-technic. The noninvasive registration of labour pains impressed forcibly for some time about longer CTG-phases to be unsuitable for the exactly judgment of uterine activity (Montevideo-unit). In conclusion the noninvasive method in supervision of labour should be considered more critical than earlier particular under forensic points of view. PMID- 1771956 TI - [Parametrial hematoma after forceps delivery]. AB - We report on a large intraligamentous haematoma developed after low forceps delivery. The diagnosis was made from symptoms and signs, rectal examination, and sonographic findings. The haematoma was incised and clots were evacuated by laparotomy. The bleeding vessel could be ligated. The 31-year-old woman left our hospital on the 12th postoperative day. PMID- 1771957 TI - [Quantitative coronary angiography: progression and regression of coronary stenoses--an intervention study with fenofibrate]. AB - In order to examine the effect of fenofibrate on coronary narrowings, within the framework of a prospective intervention study, we treated a total of 44 hypercholesterolemic patients (who were in our clinic to undergo PTCA) with diet and fenofibrate (200-400 mg/day) over a period of 3 years. After a mean interval of 21 months, control angiographies were performed in nearly identical projections for 21 patients on clinical grounds. The minor and medium-grade narrowings of the reangiographed patients at the beginning and at the end of the intervention interval were measured by means of digital image processing and automatic contour detection. The measuring parameters were percent diameter reduction (% DR) and percent plaque area (%PA). With regard to their angiographic progression, the 21 reangiographed patients of the intervention group were compared to a comparison group consisting likewise of 21 patients of similar age and sex distribution and persistently high lipid and lipoprotein levels. During the intervention period, the reangiographed patients of the intervention group showed the following changes of the lipid and lipoprotein levels in contrast to the outset values: cholesterol -19 +/- 8%, LDL -20 +/- 14%, HDL +19 +/- 44%, triglycerides -30 +/- 31%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771958 TI - [Experimental evaluation of the accuracy and safety of intraluminal ultrasound]. AB - In this in vitro investigation, we studied the feasibility and accuracy as well as the safety of intravascular ultrasound imaging. Plastic cylinders were used in order to validate measurements of luminal area, perimeter, diameter, and wall thickness. Fifty-nine segments of human arteries were also examined by intravascular ultrasound; then the results regarding the luminal area, perimeter, and wall thickness were compared with the corresponding histopathologic section. Close correlations were found in plastic cylinder studies (r = 0.999, 0.999, 0.998, and 0.994 for area, perimeter, diameter, and wall thickness, respectively). There was also an excellent correlation between intravascular ultrasound imaging and pathologic measurements (r = 0.993, 0.994, and 0.915 for luminal area, perimeter, and wall thickness). Five different cylinders, with a volume of 2, 5, 10, 20, and 50 mls, were employed to evaluate the effect of ultrasound on temperature. Ten blood samples anticoagulated with EDTA were used to detect the effects of ultrasound on blood elements. In the course of time, the ultrasound caused a slight increase of solution temperature (from 23.9 degrees C to 24.6 degrees C after 1-h examination in a 2-ml cylinder) and the temperature change became less obvious as the solution volume increased (the temperature raised 0.3 degrees C in the 2-ml cylinder, 0.1 degrees C in the 20-ml cylinder, but no change was detectable in the 50-ml cylinder after 10 min). No significant differences about WBC, RBC, and platelet counts were found between test and control group (p greater than 0.1) before and 5, 10, 15, 30, and 60 min after ultrasound examination.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771959 TI - [Improvement of chronic regionally impaired myocardial function immediately after coronary angioplasty]. AB - The effect of PTCA on chronically impaired, regional wall motion was studied in 40 patients with stable angina and stenoses in the left anterior descending artery. Left-ventricular angiograms were obtained before, 15 min after PTCA and, additionally, in eight patients 15 +/- 5 weeks after PTCA. Left-ventricular ejection fraction and regional myocardial function were assessed by the centerline method. Patients with no (n = 18) or non-Q-wave (n = 12) infarction were compared to patients with Q-wave infarction (n = 10). After PTCA, ejection fraction increased from 54 +/- 8% to 59 +/- 8% (p less than 0.05) and regional function improved significantly (maximal standard deviation before PTCA: 2.8 +/- 0.8; after PTCA: 1.9 +/- 0.9- segments below the first standard deviation before PTCA: 31 +/- 16; after PTCA: 19 +/- 17). The improvements were found in patients with no or non-Q-wave infarction. The benefit on regional function was unchanged at follow-up. CONCLUSIONS: PTCA reduced chronic regional myocardial dysfunction in 78% of the patients with stable angina within 15 min. Reversible myocardial dysfunction is most likely related to hibernating myocardium. PMID- 1771960 TI - [Effect of bypass operation and balloon angioplasty on heart function at rest]. AB - Improvement of exercise left-ventricular ejection fraction after successful aortocoronary bypass operation and transluminal coronary angioplasty has been demonstrated. The purpose of this study was to investigate in which patients improvement of left-ventricular function at rest can be observed. Radionuclide ventriculography and exercise stress test was carried out in 34 patients before and after successful aortocoronary bypass operation (Group 1), and in 69 patients before and after successful transluminal coronary angioplasty (Group 2). After bypass surgery, mean ejection fraction at rest increased from 42 +/- 11 to 49 +/- 13% (p less than 0.001). Marked improvement (greater than or equal to 5%) was observed in 19 patients (56%) in whom severe myocardial ischemia could be documented during exercise ECG (Group 1.1: Increase of ejection fraction from 40 +/- 14 to 54 +/- 12%, p less than 0.001; ischemia score during exercise test 8.8 +/- 10). In the remaining 15 patients no significant improvement occurred (Group 1.2: 43 +/- 16 vs. 43 +/- 16%, p = n.s.; ischemia score during exercise test 3.2 +/- 2.4, p = 0.02 vs. Group 1.1). After angioplasty, resting left-ventricular ejection fraction increased, on average, from 50 +/- 11 to 52 +/- 12% (p less than 0.001). Comparable to the results observed in patients after surgery, improvement was most pronounced in patients with severe exercise-induced ST depression (Group 2.1: Increase of ejection fraction from 49 +/- 10 to 58 +/- 10%, p less than 0.001; ischemia score during exercise 2.5 +/- 2.3).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771961 TI - Transient myocardial perfusion abnormalities during cold provocation test in patients with arterial hyperreactivity. AB - The effect of peripheral cold provocation on myocardial perfusion was evaluated utilizing thallium-201 perfusion imaging in 13 selected patients with arterial hyperreactivity (Raynaud's phenomenon: n = 8; migraine: n = 6) and angiographically documented coronary artery spasm. Eleven out of 13 subjects with coronary arterial spasm--but none of a group of patients with obstructive coronary artery disease--had transient myocardial perfusion defects during cold provocation. The localization of transient perfusion abnormalities during myocardial scintigraphy correlated with the myocardial areas distal to the spontaneous or ergonovine-induced coronary arterial spasm detected by angiography. Transient reduction of tracer uptake during cold provocation and normalization of myocardial perfusion by redistribution imaging was paralleled by areas of hypokinesia observed during the test by contrast ventriculography (n = 8). The described findings in the coronary system during peripheral cold pressor test occurred independently of the presence of Raynaud's phenomenon, and without achieving the ischemic threshold. PMID- 1771962 TI - [Echocardiography findings in isolated anomalous origin of the right pulmonary artery from the ascending aorta]. AB - Origin of the right pulmonary artery from the ascending aorta is extremely rare. We describe the echocardiographic findings of this lesion in a single case. The absence of an image of the right pulmonary artery in the echocardiographic short axis view at the level of the great arteries, is highly suggestive of this lesion. Differentiation from truncus arteriosus, aorto-pulmonary window and transposition of the great arteries must, and can be made by a comprehensive echocardiographic study. PMID- 1771963 TI - [Left ventricular inflow behavior in dual chamber stimulation with differential atrioventricular conduction: an echocardiography study]. AB - The influence of the AV interval on early passive (E) and late active diastolic filling (A) during transmitral flow was analyzed in patients with AV sequential pacing. In 16 patients with dual-chamber pacemakers at the age of 25 to 76 years CW- and color Doppler echocardiography was used to determine inflow time (t), flow velocity (Vmax), the E/A ratio, the time-velocity integral (TVI), and the inflow jet at constant AV sequential pacing (80 bpm) with various AV interval settings (50-100-150-200-250 ms). The inflow pattern was compared to findings in 16 normals (age 26 +/- 7 years). The prolongation of the AV interval from 50 to 250 ms resulted in the following changes: 1) Decrease of tE: 220 +/- 30 ms to 170 +/- 40 ms (p less than 0.05), of VmaxE: 78 +/- 12 to 68 +/- 14 cm/s) (ns) and of TVI-E: 8.5 +/- 2.1 to 5.6 +/- 1.7 cm (p less than 0.001); 2) Increase of tA: 140 +/- 30 to 270 +/- 60 ms (p less than 0.001), of VmaxA: 48 +/- 18 to 73 +/- 24 cm/s (p less than 0.001) and of TVI-A: 2.4 +/- 1.1 to 6.1 +/- 2.9 cm (p less than 0.001); 3) Decrease of the E/A ratio from 1.6 +/- 05 to 0.85 +/- 02. Longer AV intervals shortened the total diastolic filling period and produced more diastolic aliasing without change of the relative diastolic inflow jet. The AV interval of 150 ms was associated with an abnormal high atrial component of transmitral inflow, as found with abnormal diastolic LV function.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1771964 TI - [Transluminal angioplasty. Report of the professional workshop of the 57th annual congress of the German Society of Cardiovascular Research, Mannheim, 4 April 1991]. PMID- 1771965 TI - Perspective on the development of vaccines against Lyme disease. AB - Lyme disease, the multisystem illness caused by the tick-borne spirochaete, Borrelia burgdorferi, has emerged as a threat to public health worldwide. It is a particularly vexing problem in the United States where it is growing in range and intensity. In fact, in some hyperendemic regions of New York and New England, Lyme disease is now such a threat that it interferes with all sorts of outdoor activities, and has even led to depreciation of real estate values. Family dogs in these areas seem to have been particularly hard hit by a near epidemic of lameness caused by Lyme arthritis. Persons at high risk for infection, such as outdoor workers, campers and hikers, suburbanites with lawns to cut, and pregnant women exposed to potentially infected Ixodes ticks, are clamouring for some means of protection beyond simple behaviour modification and tick avoidance which are known not always to work. Hence, the interest in human and veterinary vaccines against Lyme disease is growing. PMID- 1771966 TI - Anthrax vaccines: past, present and future. AB - Most livestock vaccines in use throughout the world today for immunization against anthrax are derivatives of the live spore vaccine formulated by Sterne in 1937 and still use descendants of his strain 34F2. Credit belongs to this formulation for effective control in many countries with considerable reduction, sometimes complete elimination, of the disease in animals and, since man generally acquires it from livestock, in man also. However, there are some contraindications of its use and situations in which it cannot be easily administered, and room for development of a successor is discussed. The human vaccines, formulated for at-risk occupations and situations, date from the 1950s (UK vaccine) and 1960s (US vaccine). The rather greater need for improvement of these as compared with the veterinary vaccine stimulated valuable research during the 1980s which has led to a number of promising candidate alternatives for the future. PMID- 1771967 TI - Pneumococcal vaccination of elderly individuals. AB - Pneumococcal infections are still a cause of high morbidity and mortality in elderly populations. Since antibiotics are not wholly effective, vaccination should be performed. The response to pneumococcal vaccination of a limited group of elderly persons aged 60 to 90 years was studied. The sera of most individuals were found to contain antipneumococcal antibodies prior to vaccination. Vaccination resulted in antibody level increases in sera of all subjects except two. On the basis of antibody levels, 19 out of 20 vaccinees proved to be protected after vaccination. Combination of vaccination with a non-specific immunostimulation enhanced the antibody response. PMID- 1771968 TI - Rabies-specific production of interleukin-2 by peripheral blood lymphocytes from human rabies vaccinees. AB - Cell-mediated immunity induced by rabies vaccination was studied in humans by the determination of specific interleukin-2 (IL-2) production in a large number of donors (postexposure immunized patients and pre-exposure immunized laboratory workers). Peripheral blood lymphocytes (PBL) from 35 donors were tested for IL-2 production after in vitro stimulation by different rabies and rabies-related viruses. IL-2 responses were compared to antibody recognition of these different virus serotypes by sera from the same individuals. IL-2 was produced by PBL from more than 85% of donors after stimulation with inactivated and purified rabies viruses (IPRV) prepared from either Pittman Moore (PM) or Pasteur Virus (PV) strains. IL-2 was also produced by 65 and 45% of donor PBL stimulated with IPRV from the European Bat Lyssavirus (EBL) and Mokola (Mok) rabies-related virus strains respectively. No correlation was found between the production of IL-2 by PBL and the levels of virus neutralizing antibody (VNAb). Moreover, 50, 25 and 35% of donors produced IL-2 after stimulation of their PBL with ribonucleoprotein (RNP) from PV-, EBL- and Mok-viruses, respectively. These results obtained with a large number of human rabies vaccinees and using an assay specific to T-cell activation confirm the significant cross-reactivity of T-cell responses directed against rabies and rabies-related viruses. This study shows that IL-2 production could be used for the study of cell-mediated immunity and T-cell memory induced in humans by rabies vaccination. PMID- 1771969 TI - Escherichia hermannii (ATCC 33651) polysaccharide-protein conjugates: comparison of two conjugation methods for the induction of humoral responses in mice. AB - Escherichia hermannii (ATCC 33651) LPS O-polysaccharide was covalently linked to a carrier (bovine serum albumin) to form conjugates either directly or with a spacer arm (adipic acid dihydrazide). The immunogenicity of both conjugates at three different doses was tested in mice. Antibodies to the conjugate were produced and were shown to react with free lipopolysaccharide. The directly coupled conjugate was found to be more immunogenic than the indirect one (i.e. lower dose necessary for a similar response). The antibody response elicited by the directly coupled conjugate (1 microgram/animal) began at 21 days and was sustained for at least 4 months. The mouse model described here may be applicable to the testing of other conjugates composed of bacterial cell wall polysaccharides and LPS O-chains. PMID- 1771970 TI - One-year study of the 2-1-1 intramuscular postexposure rabies vaccine regimen in 100 severely exposed Thai patients using rabies immune globulin and Vero cell rabies vaccine. AB - The 2-1-1 rabies postexposure treatment schedule is an abbreviated regimen in which a tissue culture rabies vaccine is administered intramuscularly at two sites on day 0, and at one site on days 7 and 21. Compared to the standard five dose intramuscular regimen, the 2-1-1 schedule reduces the number of clinic visits from five to three and the amount of vaccine used by 20%. One hundred Thai patients, who were severely exposed to rabies, were treated with rabies immune globulin and the 2-1-1 regimen using purified Vero cell rabies vaccine. They were followed for 1 year. Rabies antibody titres were measured in 10% of this group. All patients survived and adverse reactions were mild. A satisfactory antibody response (a titre greater than 0.5 IU ml-1) occurred in all ten patients studied at day 14, but persisted for 90 days in 80% and for 360 days in only 50%. The authors therefore do not recommend use of the 2-1-1 schedule in severely exposed patients who also need to receive rabies immune globulin. PMID- 1771971 TI - Rabies control in the Republic of the Philippines: benefits and costs of elimination. AB - We compared the benefits and costs of eliminating animal and human rabies in the Philippines. If rabies had been eliminated in 1988, economic benefits would total P52.8 (US$2.5) million in 1989. These benefits would largely arise from the abolition of expenses associated with rabies prevention: P29.7 (US$1.4) million for animal vaccination, P21.6 (US$1.0) million for human postexposure prophylaxis, and P0.3 (US$0.02) million for animal rabies examinations. Benefits also included P1.2 (US$0.06) million in additional earnings of humans whose death due to rabies would be prevented. Nationwide elimination was estimated to cost between P88.1 (US$4.2) million and P317.2 (US$15.0) million, assuming a canine-to human ratio of 1:10, vaccine coverage of 60%, and a cost per vaccination of no less than P25 (US$1.19) and no more than P90 (US$4.27). These costs would be recouped 4.1-11.0 years after the initiation of a one-year elimination campaign. A sensitivity analysis showed that an elimination programme would be economically beneficial in all but the most extreme cases. PMID- 1771972 TI - Amino-terminal domain of the El Tor haemolysin of Vibrio cholerae O1 is expressed in classical strains and is cytotoxic. AB - Previous studies have shown that the classical isolates of Vibrio cholerae possess an 11 bp deletion in the structural gene for the El Tor haemolysin leading to the production of a 27 kDa non-haemolytic truncated product HlyA* compared to the 82 kDa haemolysin, HlyA. These studies were designed to assess whether this truncated product had any biological activity. A KmR cartridge was introduced into the hlyA gene effectively eliminating the haemolysin. This was recombined into the chromosome of a variety of strains and isogenic pairs were examined in a number of systems. These studies suggest that the haemolytic (cytolytic) domain of HlyA resides at the C-terminus and that the N-terminus, which is conserved as HlyA* in classical strains, possesses enterotoxic (cytotoxic) activity. Experiments with the cholera-toxinless vaccine candidate JBK70 and its hlyA::KmR mutant suggest that HlyA* may be responsible for the residual diarrhoea observed in cholera-toxinless vaccine strains. PMID- 1771973 TI - A simple and quick gas chromatographic method for the determination of propham and chlorpropham in potatoes. AB - This study describes a gas chromatographic method for the quantitative determination of residual propham and chlorpropham in potatoes. Both herbicides are extracted from the foodstuff with methylene chloride. After centrifugation and concentration, propham and chlorpropham are quantitatively determined by gas chromatography thermionic detection using a fused silica capillary column CP Sil 5CB. 2-Chloraniline is used as internal standard. Recoveries of 100 +/- 15% and 99 +/- 10% have been obtained for propham and chlorpropham in blank samples spiked at the level of 0.5, 1.0 and 5.0 mg/kg. The absolute detection limit for both compounds is 1 ng corresponding to 0.1 mg/kg. Of the 161 samples of fresh potatoes analysed using this method, 136 contained residues of these herbicides and 18 of them (11%) exceeded the maximum tolerated value of 5 mg/kg. PMID- 1771974 TI - [Image processing devices for measurement of intracellular calcium concentration]. AB - Recent development of fluorescence calcium indicators and image processing devices made it possible to measure temporal and spatial change in intracellular calcium concentration in neuronal cells in culture and also in brain slice preparation. In this technical note the characteristics, applicability and problems of the method are described. PMID- 1771975 TI - [Modification of stereotypy-producing and ambulation-increasing effects following repeated administration of methamphetamine in rats]. AB - Effects of repeated administration of methamphetamine (MAP: 1.25, 2.5 and 5 mg/kg, sc) at an interval of 4 days for 10 times on stereotyped behaviors as well as ambulatory activity in adult male rats of Wistar strain were investigated. In the first administration of MAP 1.25 mg/kg, marked ambulation-increasing effect was observed mixing with simple stereotyped behaviors such as sniffing and head bobbing. The stereotypy-producing effect of MAP was apparently observed in a dose dependent manner, and complicated stereotyped behaviors such as head-weaving and licking simultaneously with sniffing and head-bobbing were frequently demonstrated when 5 mg/kg of MAP was first administered. Furthermore, the ambulation-increasing effect after the drug showed biphasic pattern, i.e. pre stereotypic and post-stereotypic increases in ambulatory activity, because the activity was interfered by the stereotyped behaviors. When MAP was administered repeatedly, the sniffing- and head-bobbing-producing effects were selectively enhanced at any dose, showing sensitization phenomenon (reverse tolerance), and the pre-stereotypic increase in ambulatory activity was inhibited, while the post stereotypic increase was progressively enhanced. Although the sensitized stereotypy-producing effect was observed more markedly in the 10th administration of MAP 2.5 mg/kg than that in the first administration of MAP 5 mg/kg, the complicated stereotyped behaviors were hardly seen. It is suggested that the sensitization effects are not always identical qualitatively with the effects observed after increase in MAP-dose. PMID- 1771976 TI - A kampo prescription, shimotsu-to, improves scopolamine-induced spatial cognitive deficits in rats. AB - The effect of a Kampo (traditional Chinese medicine) prescription, Shimotsu-to, on spatial cognitive deficits produced by scopolamine was examined using an eight arm radial maze and a T-maze. Scopolamine (SCOP; 0.075-0.3 mg/kg, ip) dose dependently disrupted the radial maze performance. Single doses of Shimotsu-to (0.5 and 1.0 g/kg, po) as well as physostigmine (0.15 and 0.3 mg/kg, ip) improved the SCOP (0.3 mg/kg)-induced performance deficits in a dose-dependent manner. Shimotsu-to administered for 1 week in drinking water (0.5 and 1.0 g/kg/day) also exhibited dose-dependent reversal of SCOP-induced impairments in the radial maze performance. The same treatment improved SCOP (0.2 mg/kg)-induced impairments in T-maze delayed alternation performance. These data clearly demonstrated the beneficial effects of Shimotsu-to on spatial cognition. PMID- 1771977 TI - [Cu deficiency in growing dogs]. AB - It was the aim of the investigation to evaluate the influence of marginal (60-30 micrograms/kg BW/d) or adequate (680-360 micrograms/kg BW/d) Cu-intake on the development of growing beagles (n = 10) and the incidence of skeletal diseases. Low Cu-intake (6 dogs) reduced Cu-concentrations in plasma (1.4 vs. 9.7 mumol/l), hair (3.3-4.5 vs. 12.6-14.5 mg/kg DM), liver (19 vs. 246 mg/kg fat free DM), bile (0.28 vs. 7.04 mg/l), and other samples significantly. Hemoglobin and packed cell volume decreased after 4 months of depletion (normochromic anemia). First clinical signs of Cu-deficiency were depigmentation and greying of hair, followed by hyperextensions in the distal forelegs. After necropsy deformations of the long bones were seen more frequently in the depleted animals, without distinct alterations of the microstructure or chemical composition of bones or tendons. PMID- 1771978 TI - Profile of some plasma enzyme activities in growing dwarf and landrace kids. AB - Plasma alanine aminotransferase, aspartate aminotransferase, creatine kinase and alkaline phosphatase activities were studied in clinically healthy Danish landrace and dwarf kids in seven herds from birth to 12 months of age. The purpose was to evaluate the influence of age, breed and herd on reference values. The mean enzyme levels +/- standard deviation (s) in neonatal dwarf kids were 0.09 +/- 0.04, 1.23 +/- 0.24, 2.79 +/- 1.50 and 18.3 +/- 11.0 mu kat/l respectively. The respective values in landrace kids were 0.13 +/- 0.06, 1.06 +/- 0.22, 2.44 +/- 1.60 and 37.6 +/- 23.6 mu kat/l. In 8-12 months old dwarf kids they were 0.30 +/- 0.11, 1.49 +/- 0.13, 3.28 +/- 0.44 and 11.1 +/- 2.4 mu kat/l respectively and 0.23 +/- 0.05, 1.12 +/- 0.34, 3.68 +/- 1.63 and 14.1 +/- 8.40 mu kat/l respectively in landrace kids of the same age. The 5th to 95th percentile intervals of the enzyme activities were within mean +/- 2s for most age groups in both breeds except alkaline phosphatase. The means and medians were close to each other for the values of alanine aminotransferase, aspartate aminotransferase and creatine kinase but not for alkaline phosphatase. Alanine aminotransferase, aspartate aminotransferase and creatine kinase levels were low at birth and increased with age, whereas for alkaline phosphatase it was vice versa. Significant differences were observed in mean enzyme activities between kids of different ages (within breeds), breeds (in same age kids) and herds (within same breed and age kids). Sex variations (within the breeds) were not observed. It was concluded that plasma enzyme activities are dependent on age, breed and environment. PMID- 1771979 TI - Evaluation of triflupromazine as a sedative in camels (Camelus dromedarius). AB - Effects of administration of triflupromazine were evaluated in 11 adult domesticated camels (Camelus dromedarius) weighing 403 +/- 29.5 kg (Mean +/- SE). Six camels were used to evaluate sedative properties of the drug and its effects on haematological and blood biochemical parameters. In the remaining 5 camels, effects on haemodynamics, acid base status and blood gases were studied. In all the animals triflupromazine was administered intramuscularly in the gluteal region at the rate of 2 mg/kg. Camels voluntarily sat down 48.9 +/- 5.4 min after administration of the drug but stood up again if disturbed. Drowsiness, drooping of lower lip and salivation were evident. The animals stood on their own and started walking with ataxia after 159 +/- 7 min and recovered completely from the effect of drug within 259 +/- 23 min. The drug caused a significant tachycardia and a moderate hypotension. The decrease in central venous pressure was also significant. Rectal temperature, respiratory rate, acid base status, blood gases, haemoglobin concentration, packed cell volume, total erythrocyte count, total leucocyte count, differential leukocyte count, blood urea nitrogen, plasma alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, alkaline phosphatase, blood glucose and plasma concentrations of sodium, potassium, chloride and inorganic phosphate were not significantly affected by triflupromazine. PMID- 1771980 TI - Influence of digoxin followed by dopamine on the cardiovascular depression during a standard halothane anaesthesia in dorsally recumbent, ventilated ponies. AB - The influence of digoxin (0.01 mg/kg) given as an intravenous bolus followed by dopamine at different infusion rates (1.25, 2.5 and 5.0 micrograms/kg/min) on the cardiovascular depression during a standard halothane anaesthesia was studied in dorsally recumbent ventilated ponies. Preanaesthetic digitalization induced no clear positive cardiovascular effects over 30 minutes, except for non-significant increases in mean pulmonary artery pressure and total pulmonary resistance. These changes were probably time-related. No specific side-effects related to the fast intravenous digitalization were noticed. Dopamine at lower infusion rates (1.25 and 2.5 micrograms/kg/min) given minimally 30 minutes after the digitalization did not induce further changes (only minor non-significant increases in cardiac output and systemic blood pressure). Dopamine infusions at a higher infusion rate (5.0 micrograms/kg/min) improved the cardiovascular depression (significant increases in cardiac output and systemic blood pressure while total peripheral resistance tended to decrease). Heart rate, blood gases and total pulmonary resistance remained constant. The combination of a fast acting inotropic agent, dopamine, and a slow acting inotropic drug, digoxin, induced positive effects in reversing the cardiovascular depression and might therefore be useful during clinical anaesthesia in the horse. PMID- 1771981 TI - Embryonic development of the porcine indifferent gonad and testis. AB - The early gonadal development in the pig from day 18 to day 36 post conception, when distinct testes were present in male embryos, has been studied. The development of the porcine gonad followed the general mammalian pattern. During testicular differentiation, the germ cells and the relevant somatic cells, the Sertoli cells, became enclosed in testicular cords, thus creating an intracordal germ cell compartment and an extracordal compartment. The development of conspicuous cell junctions and the production of a basal lamina were evident in the Sertoli cells during the early testis development. Their origin in this species remains unclear. PMID- 1771982 TI - The relationships between the fertility of dairy cows and clinical and biochemical measurements, with special reference to plasma glucose and milk acetone. AB - Blood and milk samples were taken at first insemination in 352 dairy cows from 18 herds for charting the relation between clinico-chemical parameters and fertility rate. Neither total protein, albumin, globulin, AST, bilirubin, bile acids, calcium, magnesium and phosphorus in blood nor urea in milk was significantly related to the rate of pregnancy. On the other hand, there was a significant difference for plasma glucose between cows that became pregnant and those that did not. Cows with low plasma glucose concentrations at first insemination also had low values four and seven weeks after calving, indicating that it is primarily cows with chronically low blood glucose which are likely to have reduced fertility. At first insemination there was no increase in the concentration of acetone in milk of cows with reduced fertility. However, they had had increased milk acetone concentrations three to five weeks after calving. It therefore seems possible to evaluate the risk of reduced fertility by measuring either blood glucose or milk acetone some weeks after calving. Owing to the difficulties associated with the sampling and laboratory techniques for glucose, analyses of milk acetone are more suitable under field conditions. PMID- 1771983 TI - Near triploidy in a feline fibrosarcoma. AB - A seven-year-old male cat developed a subcutaneous fibrosarcoma. The numerical cytogenetic evaluation of the tumour revealed the presence of 69.2% of cells in the near-triploid chromosome range between 51 and 64. The copy numbers of the different chromosomes were widely distributed from monosomies up to heptasomies. Two giant chromosomes were regularly present. PMID- 1771984 TI - Effect of recombinant bovine somatotropin (BST) on physiological parameters and on milk production in German Fleckvieh cows. AB - The efficacy of injecting primiparous cows of a dual purpose breed (Deutsches Fleckvieh) with a BST prolonged release formulation (500 mg Sometribove s.c.) was tested in a cross-over design. Seven cows were given 500 mg BST in the 10th through 19th week of lactation and a placebo in the 24th through 33rd week. A second group of seven cows received a placebo in the 10th through 19th week and BST in the 24th through 33rd week. Blood samples were taken from the jugular vein (via a permanent cannula) in the 13th, 17th, 23rd, 27th and 31st week of lactation over a period of 24 hrs at 30 min intervals. During the periods of BST treatment the amount of FCM (amount of milk corrected to 4% fat content) was higher in treated than in non-treated animals by 3.6 kg (19.8%) and 3.2 kg (22.5%) respectively. Milk fat levels were elevated significantly during both treatment periods. Milk protein concentration showed a significant rise during the second half of lactation only. There was no influence on lactose content. Blood concentration of somatotropin and IGF-I rose during treatment by a factor of 3-4. Insulin, T3, T4 and FTI as well as glucose, urea and GOT showed no changes or changes within physiological ranges. Free fatty acids and beta hydroxybutyrate rose during treatment. PMID- 1771985 TI - [The ionized calcium fraction of the blood: dependence on different methodical factors]. AB - In the present study the influence of different methodical factors (analyzer with ion-selective electrodes used, anticoagulation of blood samples with heparin, storing of samples at different temperatures) on the concentration of ionized calcium in blood was investigated. It could be shown that nowadays' systems for analysis of ionized calcium (ORION SS-20, AVL 980, NOVA 2 and 8, ICA 1) yield reproducible values for human as well as canine blood. System-related differences point to a varying degree of interferences on the ion-selective electrodes used. The concentration of ionized calcium is strongly dependent on different preanalytic factors. Heparin leads to a concentration-related reduction of calcium ions in blood. This negative impact of heparin can be overcome by substitution of the solvent for CaCl2 (2.5 mmol.l-1) without meaningful falsification of the measured values. At 4 degrees C blood samples can be stored without detectable changes in Ca++ concentration for 8 hours. PMID- 1771986 TI - Bovine endometritis: current and future alternative therapy. AB - Abnormal parturition can be followed by a persistent endometritis which can have deleterious effects on the cow's subsequent reproductive performance. Normal and active uterine defense mechanisms have been reported to be very important for the exclusion of bacterial infection from the uterus and recovery from endometritis developing after parturition. Despite the widespread use of local or systemic antibiotics, antiseptics, sulfonamides and hormones, rates of recovery from endometritis and the cow's subsequent fertility have not increased appreciably. Furthermore, the cost of any treatment, the frequency of its administration and the milk disposal after treatment make their use uneconomic. Alternative therapies which stimulate the natural uterine defense mechanisms have been suggested as treatments of bovine endometritis. These include: (I) Endotoxins such as lipopolysaccharide of E. coli, (II) serum, plasma or hyperimmune serum, (III) polymorphonuclear leucocyte (PMN) extracts and components and (IV) granulocyte-macrophage colony stimulating factors (G-M CSF). PMID- 1771987 TI - [Adenoma of the pigmented epithelium of the iris with endothelialization and descemetization in the horse]. AB - The authors describe peculiar tumors with brown-white piebald anterior surface, which had grown bilaterally from the corpora nigra (C.N.) of an adult horse and occluded the pupils. The surgical procedure for removing the larger tumor and the postoperative treatment are described. The findings by light and electron microscopy suggest that the tumor represent a so-called adenoma of the iris pigment epithelium. The white patches on its surface consist of newly formed Descemet-like material produced by displaced corneal endothelial cells, which have probably grown on the tumor after contact with the posterior face of the cornea. PMID- 1771988 TI - Concurrent conjunctivitis and placentitis in aborted bovine fetuses. AB - Consistent histopathological lesions were found in 10 out of 136 aborted fetuses examined during a three year period, using a multi-disciplinary diagnostic investigation technique. Fetuses exhibited a generalized mononuclear inflammatory cell infiltration, accompanied by distinctive lesions of conjunctival hyperplasia and goblet cell formation, alveolitis, and necrotic placentitis. In two cases where amnion was also examined, a chronic amnionitis was present. No consistent laboratory findings could be related to these cases. The fetal and placental lesions described were similar to those associated with experimental inoculation of Ureaplasma diversum in pregnant cows, and with field isolations of the same organism in aborting cattle. PMID- 1771989 TI - [Effect of an oral sedative on the behavior and the zootechnologic performance of fattening bulls of the white-blue Belgian breed]. AB - This trial was conducted with 22 Belgian White and Blue double-muscled cattle (body weight: 241.5 +/- 6.2 kg; age: 7 months). Two similar groups were constituted: a group of bulls which were treated with potassium bromide (BT; n = 11) and another one which remained untreated (UT; n = 11). The treatment (736 mg potassium bromide/kg feed dry matter) was stopped 60 days before the slaughtering day. The treatment with potassium bromide induced a significant reduction in the rear engagements during the whole trial period (221 days), in direct attacks during the period A (from day 0 to day 53) and in side-on attacks during the period B (from day 54 to day 167). The daily weight gains, calculated for the whole trial period, were not significantly different between the two groups. Feed utilization was lower in treated bulls. During the period C (from day 168 to day 221), the sedative potency of potassium bromide seemed to be weaker than during the periods A and B. This might be due to the habituation to potassium bromide. On the basis of these results, we can conclude that the frequency of rear engagements and, during a restricted period of fattening, the frequencies of side and direct attacks are significantly reduced when potassium bromide (736 mg/kg feed dry matter) is used. The time spent for hay intake, the frequency of water intake (even if the time consumed at the drinking trough was the same) was reduced and the time during which the bulls were standing was prolonged by bromide. PMID- 1771990 TI - Profiles of some clinical chemical parameters in growing dwarf and landrace kids. AB - Plasma creatinine, urea, bilirubin, glucose, cholesterol, calcium, magnesium, sodium, potassium, inorganic phosphorus and total serum proteins were analyzed in kids of Dwarf and Danish Landrace breeds from birth to 12 months of age. The purpose was to determine the reference ranges, age profiles and the influence of other factors. Comparisons between parametric (mean +/- standard deviation) and the corresponding nonparametric (5th and 95th percentile, median) values were calculated for each parameter, the results of which indicated no apparent differences. The levels were very much dependent on age. Creatinine, urea and total serum protein levels increased gradually with age. Glucose and cholesterol levels were high at birth and then decreased with age. The electrolyte concentrations were maintained within narrow limits. Significant differences were observed between kids of different ages (within the breeds), breeds (within similar age) and herds (within the same age and breed). Differences between female and male Landrace kids of the same ages were observed in plasma urea, creatinine, glucose and total serum proteins. It is concluded that age has a major influence on the clinical chemical reference values in young goats, followed by herd and breed, but the influence of sex was small and is negligible in most parameters. PMID- 1771991 TI - [Development of fused vertebrae in swine]. AB - Radiographical findings are reported on the vertebral column of healthy weanling pigs and of two pigs with connatal formation of block vertebrae and clinically visible kyphosis in the lumbar region. The diagnosis of congenital malformations of the vertebral column in two patients is based on the anamnesis, the lack of locomotor disorders and radiographic-morphologic examinations showing fusions of vertebral bodies, arches and spinous processes as well as additional dorsal hemivertebrae but no inflammatory reactions. PMID- 1771992 TI - [Indirect detection of ovulation and fertilization in the dog by progesterone level testing]. AB - In addition to already published data (Arbeiter et al., 1990) we could achieve important facts concerning the estimation of mating time of the bitch by measuring the progesterone (P4) level continuously and observing the clinical signs on a collective of 106 ambulant patients. We found that a P4-concentration of 5 ng/ml plasma and above is signaling ovulation or ova fertilisation; a sudden rise of the progesterone over 10 ng (Ovucheck), reflecting 19.2 ng/ml (Serozyme Progesterone), turned out to be a diagnostic mark for determination of mating time. Copulation took place between the 9th and 19th day of heat. 89% of the controllable bitches (n = 79) conceive and birth occurred 61.4 days (mean) later. The litter size and the loss of dead born puppies (4.7%) was normal with regard to the pertinent races. Because of their easy handling the P4-test kits (Ovucheck; Serozyme-Progesterone) are of good use for the practitioner. PMID- 1771993 TI - Evaluation of a haematological analyser for its use in canine clinical pathology. AB - A semiautomatic electronic system for counting blood cells in veterinary haematology (Sysmex F-800) was evaluated. A total of 100 samples of canine blood were analysed. The results for leucocyte (WBC), erythrocyte (RBC), and platelet (PLT) counts, the haemoglobin concentration (Hb), and haematocrit value (Hct) obtained using the autoanalyser were compared with those obtained using a manual method as a reference. The results show very high levels of correlation for WBC (r = 0.96), Hb (r = 0.97) and Hct (r = 0.95) and high levels for RBC (r = 0.85) and PLT (r = 0.72). The precision is satisfactory in all the parameters studied with the exception of the platelet count (CV = 10.2%) where it is unsatisfactory. Taking into consideration the margin of error associated with manual cell counting methods, we conclude that this haematological analyser is sufficiently accurate for work with blood samples from dogs. PMID- 1771994 TI - [Effect of the action of stimulants and blockers of adrenergic receptors on the electrical activity of the uterus in pregnant cows]. AB - The effects of stimulants and inhibitors of adrenergic receptors on the myoelectric activity were studied in pregnant cows at different points of the last trimester of pregnancy. The results showed that noradrenaline produced an increase of the myoelectric activity of the uterus specially at the 6th week before parturition. Furthermore i.v. infusion of propranolol potentiated and of phentolamine diminished the stimulating activity of noradrenaline. PMID- 1771995 TI - Plasma histamine levels in laminitic horses and in horses treated with a corticosteroid. AB - In seven sound horses histamine plasma levels were evaluated by means of a radioenzymatic method using the enzyme histamine-N-methyltransferase (mean = 4.46 nmol/l, SD = 1.55 nmol/l). Histamine levels of laminitic horses were significantly higher (n = 11; mean = 12.46 nmol/l, SD = 3.24 nmol/l). In three sound horses plasma histamine levels were determined over a two week period following a double administration of 10 mg dexamethasone-21-isonicotinate/100 kg body weight. Histamine levels remained within the range of sound control horses. PMID- 1771996 TI - Collagen biosynthesis in lichen sclerosus et atrophicus studied by biochemical and in situ hybridization techniques. AB - Collagen was studied by biochemical and immunohistochemical techniques and by in situ hybridization in four patients with lichen sclerosus et atrophicus (LSA). The solubility of collagen in acetic acid and pepsin was increased in the lesional skin of the LSA patients when compared with their non-affected skin or samples from control subjects, indicating that a marked proportion of the collagen was newly synthesized. Collagen synthesis was slightly increased in fibroblasts derived from the lesional skin of the LSA patients. In situ hybridization with human sequence-specific cDNAs to type I procollagen demonstrated active fibroblasts in lesional skin of LSA patients, further confirming a high level of collagen synthesis in LSA. Remarkably, active fibroblasts were not associated with inflammatory cell infiltrates noted in LSA skin nor did they express transforming growth factor beta(TGF beta 1). Our results indicate that despite the degeneration of connective tissue, there is an active regeneration process in LSA with significant collagen synthesis. PMID- 1771997 TI - Protective gloves of polymeric materials. Experimental permeation testing and clinical study of side effects. AB - In the occupational use and handling of hazardous chemicals and infectious materials, exposure must be minimized. To diminish the risk of direct skin contact and percutaneous toxicity, the use of protective gloves is one of the most important measures to consider. For effective protection, the selection process must include evaluation of permeation test data as well as the risk of side effects possibly caused by the glove materials. In permeation testing (in vitro), breakthrough time and permeation rate are key values measured. Test conditions such as size and design of the permeation test cell, flow rate of the collecting medium through the test cell, measurement systems, testing procedures and analytical equipment can vary and can have crucial influence on the test results. In the present investigation, five permeation test cells of different sizes and design were used, the collecting gas flow rate was varied between 60 and 120 ml/min and 120 to 500 ml/min, the ASTM F 739 and ISO/DIS standard test procedures were performed using two different measurement systems, and in vitro versus in vivo testing techniques were studied. Gloves and glove materials of neoprene were exposed to four organic solvents. The breakthrough times (in vitro) for the test chemicals were slightly influenced by variations in cell size and design, flow rate and test procedure. The only significant influence on the breakthrough time values was between the two measurement systems, direct flow and automatic sampling. On the other hand, the permeation rate values were affected to a much greater extent, in most cases significantly. The test conditions in the in vitro and in vivo procedures differed in many ways and the test results were therefore compared on a relative basis. The breakthrough time values for the solvents through gloves of vinyl, natural rubber and butyl rubber were in the same rank order in both in vitro and in vivo testing. There was no evident correlation between the relative permeation rate values (in vitro) and the relative absorption rate values (in vivo). Disposable gloves of latex or plastic materials are also commonly used in health care as protection against microorganisms. Therefore contact with disinfectants is frequent. The resistance of gloves made of natural rubber latex, vinyl (PVC) and polyethylene to permeation by ethanol, isopropanol, m-chlorocresol and glutaraldehyde-based disinfectant was studied mainly according to the ISO/DIS permeation test procedure. In addition, glove pieces exposed to isopropanol and ethanol were studied with the scanning electron microscope (SEM).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1771998 TI - T-wave response in cervical root lesions. AB - T-wave responses of biceps and triceps brachii muscles were recorded electrophysiologically from 31 normal subjects and 15 patients with unilateral lesions of the cervical C6 or C7 roots. Pathological T-wave responses were found in 11 (73%) patients. Patients with radiological correlate showed electromyographic (EMG) pathology in 60% but a pathological T-wave response in 90%. All patients with radiological correlate also showed pathological electrophysiological tests (EMG or T-wave responses). Electrophysiological measurement of the T-wave response appears to be a potentially useful tool in the diagnosis of cervical radiculopathies. PMID- 1771999 TI - Warning signs in subarachnoid hemorrhage: a cooperative study. AB - The present study is part of a survey of subarachnoid hemorrhage cases observed in 16 neurosurgical and 8 neurological departments in Italy between June 1985 and June 1986. Warning signs preceding major hemorrhage were analyzed in 364 patients with intracranial aneurysms confirmed by angiography and reliable clinical history. Seventy-four (20.3%) had warning signs. Clinical features of premonitory warning signs were compared with symptoms of 78 patients without a history of minor leak and clinical grade 1 (according to the criteria of Hunt & Hess) at admission. Symptoms of warning signs are generally clear enough to be considered a misdiagnosis of intracranial aneurysm. Thunderclap headache described as severe, unusual and sudden was the main symptom in every case though the higher frequency of focal of diffuse signs in groups with a correct diagnosis attracted more careful attention in referral and diagnostic-therapeutic management. Improving the identification of minor leak and defining diagnostic strategy are discussed. PMID- 1772000 TI - Serum soluble interleukin-2 receptor levels in chronic progressive, stable and steroid-treated multiple sclerosis. AB - Serum levels of the soluble interleukin-2 receptor (sIL-2R), an indicator of T cell activation, were significantly elevated in chronic progressive MS (CPMS) patients, clinically stable MS patients and in patients with other neurological diseases (OND) as compared to healthy controls. Levels of sIL-2R in steroid treated CPMS patients were markedly lower than in untreated CPMS patients and were comparable to healthy controls. Thus, systemic T cell activation occurs in MS during clinically stable and progressive disease stages and in other neurological disorders. The ability of oral corticosteroids to depress serum sIL 2R levels in vivo may be one mechanism by which they exert their therapeutic effect. PMID- 1772001 TI - Antiplatelet therapy is effective in the prevention of stroke or death in women: subgroup analysis of the European Stroke Prevention Study (ESPS). AB - Previous stroke prevention studies have suggested that the efficacy of antiplatelet therapy may be less in women than in men. This however, could be due to the small number of women in these trials and the low incidence of cases among female subjects. The European Stroke Prevention Study was a multicenter trial comparing the effect of a combination of dipyridamole 75 mg t.i.d and acetylsalicylic acid 330 mg t.i.d. to placebo in the secondary prevention of stroke or death after one or more recent attacks of TIA (transient ischemic attack), RIND (reversible ischemic neurological deficit) or stroke of atherothrombotic origin. From the 2500 patients recruited, 1307 patients were from a single center, Kuopio, East Finland. Forty-five percent of the patients were women. The number of end-point events (stroke or death from any cause) in women was one-third lower than that in men. End-point reduction in the treatment group was about 50% in women and about 40% in men, significantly lower than in the placebo group in both sexes. Thus, in the relatively randomly selected patient population from one Finnish center, a combination of dipyridamole and acetylsalicylic acid is as effective in women as in men in the prevention of stroke or death. It is unclear, however, whether this beneficial effect in both sexes is due to aspirin only or to the combination therapy of aspirin and dipyridamole. PMID- 1772002 TI - Evaluation of how age modifies the risk for Parkinson's disease, based on stratified comparisons of descriptive data. AB - This is a study of selected information on incidence and prevalence of Parkinson's disease (PD), mortality from Parkinsonism, and levodopa use (LDU). The concept of effect modification (EM) by age (EMA), a variation across age of incidence or odds ratios, was here extended to comparisons of prevalences, mortalities and drug use, and mathematically defined following a reported model. Age-specific EM from comparisons of empirical data was measured and combined with figures for calendar time and the annual infant mortality rates (IMRs) in the population of each observation, using linear regression analysis. Statistically significant associations of EM at ages 70-79 and 80+ were found: with IMR from prevalence comparisons; and with IMR and calendar time in comparisons of proportionate mortalities in longitudinal observations. A similar age-specific pattern of associations was observed with time from incidence in Rochester. The observations for LDU and PD incidence in Iceland and Turku, Finland, fitted well the age-specific regression lines of the IMRs with the age-specific EM components from prevalence data. We concluded that there is a universal age-specific pattern of variation of epidemiological characteristics of PD related to calendar time, and to local factors represented by the IMR. Moreover, this change can be perceived from different parameters under certain conditions. Comparisons of survey, death-records, and LDU data when used for generation of causal hypotheses for PD require that EMA be taken into account. PMID- 1772003 TI - Utilization of health care resources after stroke. A population-based study of 258 hospitalized cases followed during the first year. AB - In a prospective population-based study the cumulative utilization of health care resources (and the rehabilitation outcome) was followed in consecutive stroke patients 3, 6 and 12 months after the onset of the disease. The study group comprised 258 patients diseased during the period February 1st 1986-January 31th 1987. The pattern of various forms of hospital beds and non-hospital facilities in open care utilized during the first post-stroke year was analysed at 1986 year's cost level. The mean utilization of acute hospital beds during the initial phase was 15 days; at an expenditure cost of 26,670 SEK ($3,683). The mean utilization of acute hospital and of geriatric beds during the first year was 19 and 59 days respectively. Thus the total hospital bed days amounted to a mean of 78 days; at a mean expenditure of 87,0000 SEK ($12,000); 70% of the patients were discharged from hospital care to independent living after 36 days. The acute care hospital provided 36% and geriatric care 64% of the beds needed before discharge. The expenditure of non-hospital facilities was mean 19,000 SEK ($2600); thus total expenditure for health care amounted to 106,000 SEK ($14,600). The relation between non-hospital and hospital care was approximately 1 to 5. Severity of the stroke influenced markedly the pattern and the total utilization of both hospital and non-hospital care. Patients with major stroke utilized health care resources at an expenditure 3.5 times that used by patients with minor stroke. Age of the patient also influenced health care utilization.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772004 TI - Stretch reflex variation in the relaxed and the pre-activated quadriceps muscle of normal humans. AB - The stretch reflex to patellar tendon taps was quantified by force measurements at the ankle in 7 normal subjects. In each experiment the stretch reflex was elicited from 14 consecutive stretches by two types of hammers (an ordinary hand held hammer and a motorized hammer) in the relaxed and the pre-activated quadriceps muscle. The coefficient of variation for the 14 stretch reflexes fell from 54% in the relaxed muscle to 39% in the contracting muscle (p less than 0.05). The stretch reflex varied less between the different levels of active contraction than between the relaxed state and the contracted level (p less than 0.05). The experiment was repeated in all subjects and at all contraction levels. The coefficient of variation of the mean for the two experiments fell non significantly from a mean value of 27% in the relaxed muscle to 14% in the contracting muscle. The coefficients of variation for the two hammers were almost identical. It is concluded that quantification of the stretch reflex can be made more precisely in the contracting muscle. PMID- 1772005 TI - Etiopathogenesis and prognosis of cerebral ischemia in young adults. A survey of 155 treated patients. AB - Etiology and long-term prognosis were prospectively investigated in 155 consecutive patients (96 men and 59 women), aged 16 to 45 years, referred to our Neurosurgical Unit with cerebral transient ischemic attacks or infarction during the period 1978-1988. All patients underwent neurological and medical cardiological evaluation, cerebral computerized tomography scanning, electrocardiogram, and laboratory tests. Two-dimensional echocardiography was performed in 123 cases (79%), cerebral angiography in 147 (95%). Atherosclerosis was the leading etiology occurring in 48 patients (31%). A cardioembolic disorder was considered the probable cause of ischemia in 8 cases (5.1%). Further possible etiologies were contraceptive pill assumption (5.8% of the total, but 15.3% within the female group), spontaneous arterial dissection (4.5%), migraine (4%), puerperium (2.6%), cervical trauma (2.6%), and other, more uncommon conditions. Despite extensive evaluation, the cause of cerebral ischemia remained unknown in 40% of cases. All patients received antiplatelet medication and 16 underwent surgery. The long-term outcome at a mean follow-up of 5.8 years was favorable: 91% of subjects resumed their work on a full or part-time basis. PMID- 1772006 TI - Vibratory and thermal thresholds in diabetics with and without clinical neuropathy. AB - Vibration and thermal detection threshold and heat pain threshold were determined in 34 diabetics scrutinized for clinical neuropathy using a standardized questionnaire and examination form. On the basis of the clinical grading patients were classified as having either no neuropathy or a neuropathy of increasing severity. As expected thermal and vibratory detection threshold increased with increasing severity of neuropathy. Comparison between diabetics without symptoms and signs of neuropathy and a corresponding non-diabetic control group showed that a warm sensibility index (WSI = the range in which non-noxious heat is perceived) was significantly lower on feet in diabetics than in their matched non diabetic controls. The findings show that quantitative assessment of thermal sensitivity may be of value to detect early small nerve fiber dysfunction even in patients without symptoms or signs of a clinical neuropathy. PMID- 1772007 TI - Moyamoya disease: computed tomographic and angiographic correlation in 10 caucasoid patients. AB - The computed tomographic (CT) features in 10 patients with moyamoya disease have been analysed. The scan findings were correlated with the corresponding angiographic profile and the stage of the vascular disease. Multiple infarcts (82%), abnormal enhancement patterns (50%) and cerebral atrophy (60%) were the frequent abnormalities detected. Though the abnormalities on scan did not correlate entirely with the angiographic and the clinical profiles, the CT Scans were most frequently abnormal in later stages of the disease (Stages-4 and 5). No scan abnormalities were detected in the territory of the posterior circulation. PMID- 1772008 TI - Delayed neuropsychiatric sequelae after acute hydrogen sulfide poisoning: affection of motor function, memory, vision and hearing. AB - A shipyard worker was poisoned by hydrogen sulfide (H2S), and rescued after 15-20 min. He regained consciousness after 2 days. Three days later his condition deteriorated, and he was more or less comatose for a month. When he woke up, he was amnesic, nearly blind, had reduced hearing, and had a moderate spastic tetraparesis and ataxia. Two months after the accident, he had greatly improved. Audiograms showed hearing loss with maximum at 2000 Hz and significantly poorer speech discrimination. EEG showed generalized dysrhythmia. At follow-up 5 years later he had not been able to resume his work, and had slight motor, memory and visual symptoms. CT and MRI showed slight cerebral atrophy. EEG and evoked responses were normal. PMID- 1772009 TI - Post-ischemic and kainic acid-induced c-fos protein expression in the rat hippocampus. AB - The c-fos protein is a gene regulatory third messenger involved in long-term responses of cells to various stimuli. It can be used as a marker of neuronal activity. In the present immunohistochemical study the presence of c-fos protein (FP) in the rat brain from 1 h to 14 days after 10 min of cerebral ischemia was compared with that 3 h after an intraventricular injection of kainic acid. The kainic acid injection resulted in staining of dentate hilar cells, granule cells and hippocampal interneurones. The postischemic changes at Day 1 were sporadic CA1 pyramidal cells expressing the FP. At Day 2 FP was expressed with variable intensity in many pyramidal cells in the CA1. At Day 3 many necrotic CA1 pyramidal cells were seen. They did not express the FP, and the expression was less intense and found in fewer cells than at Day 2. At Days 3, 7 and 14 there was increasing gliosis without c-fos expression in the CA1. The study demonstrates a delayed postischemic synthesis of the gene regulatory protein c fos preceding the necrosis in the selectively vulnerable CA1 region. PMID- 1772010 TI - Leber's optic atrophy: VEP and BAEP changes in 16 asymptomatic subjects. PMID- 1772011 TI - [Tibiotarsal and subtalar instability of the ankle. Importance of an original dynamic test in the treatment choice. Experimental study and clinical application]. AB - Various ligamentoplasties are available allowing formation of new proprioceptive chains in cases of failure of physiotherapy. Most of these plasties sacrifice half or all of the fibulolateral tendon, causing stiffness of the subtalar joint. This is a too serious complication to accept for simple tibiotarsal instability: hence the importance of preoperative assessment to determine the type of plasty most appropriate for each type of instability. We have designed an adjustable boot, linked to a dynamometer by means of a metal rod, with a radiological marker attached to the boot, to measure subtalar mobility preoperatively. We studied this boot with the ankles of 15 cadavers, on which we sectioned the ligaments of the tibiotarsal and subtalar joints to measure the degree of laxity. Accurate assessment is possible if the mobility of the tibiotarsal and subtalar joints is measured in cases of acute sprain, in particular in isolated lesions of the anterior talofibular ligament and lesions of the calcaneofibular ligament; or in chronic instability, including: purely tibiotarsal, purely subtalar, and mixed types. This method allows optimal therapeutic choice. PMID- 1772012 TI - External fixation for comminuted intra-articular wrist fractures. AB - We treated 101 consecutive patients with Frykman type III, IV, VII and VIII fractures of the distal radius and ulna with the small Hoffman external fixator between 1986 and 1989. All patients were reviewed after a mean follow-up period of 22 months (range: 12 to 45 months). At follow-up, 88 wrists (87%) were rated good or excellent, according to the demerit point system, and 13 wrists (13%) were rated fair or poor according to the same system. A highly significant correlation (p less than 0.01) was found between the overall scores at follow-up and the grade of postoperative articular incongruity, between the overall scores and the grade of osteoarthritis at follow-up, between the grade of postoperative articular incongruity and the grade of osteoarthritis at the follow-up, as well as between the overall scores and the grip strength at follow-up. A significant correlation (p less than 0.05) was found between the length of follow-up and the grade of osteoarthritis at follow-up. Although the complication rate was rather high (40%), most of these problems were minor, transient and pin-related. PMID- 1772013 TI - [The external fixator in unstable fractures of the distal end of the radius. Current literature review]. AB - A recent review of the literature concerns instability of distal radius fractures and their treatment by external fixation. Redisplacement of distal radius fractures most often occurs chronically, and the severity can be predicted by initial deformity, axial shortening and dorsal comminution of the radius. The need for an anatomical reduction of these fractures is emphasized by different clinical and biomechanical studies. For many authors, external fixation provides good to excellent results in more than 75% of cases, both clinically and anatomically. Most of the complications are benign and do not affect long-term results. This study also discusses the different techniques and the best indications for external fixation. PMID- 1772014 TI - Conservative treatment of displaced supracondylar humerus fractures of the extension type in children. AB - Numerous methods for the treatment of displaced supracondylar humerus fractures of the extension type are described in the literature. From 1974 until 1988, we treated conservatively 33 children with such fractures with Dunlop traction. Twenty-nine patients (88%) were re-examined. Four patients (12%) were interviewed by telephone. Good or excellent results were obtained in 31 patients. The Dunlop method is a simple, well-tolerated and safe method that permits surveillance for possible complications. In comparison with other methods, it yields good and reproducible results. PMID- 1772015 TI - [Development in conservatively treated scoliosis in patients with myelomeningocele (patients of the years 1964-1977)]. AB - The advances in urological and neurosurgical management in myelomeningocoele patients have led to an increased survival rate. The extremely complex spinal deformity presents a major treatment challenge. Clinical and radiological evolution of scoliosis treated conservatively for at least 10 years was studied. Eighty-nine myelomeningocoele patients born between 1964 and 1977 were reviewed. Thirty-one (35%) were noted to have scoliosis (10 congenital type, 21 developmental type). All congenital forms showed rapid progression despite brace treatment, often to curvatures in excess of 100 degrees. Among the developmental type, curves detected prior to 10 years (10 cases before 5 years, 6 cases between 6 and 10 years) were rapidly progressive beyond 70 degrees. Curves detected after 10 years (5 patients) never exceeded 30 degrees. Because of this natural history, conservative treatment should be limited to developmental forms less than 50 degrees. Spinal stabilization is indicated in all curvatures over 50 degrees without awaiting adulthood. PMID- 1772016 TI - Transcutaneous electrical stimulation (TCES) for the treatment of adolescent idiopathic scoliosis: preliminary results. AB - The authors report on the results of a preliminary study on the treatment of progressive idiopathic scoliosis by electrical surface stimulation. The study, involving 30 spinal curvatures, showed stabilization of the median primary curvature (30 degrees) in the course of treatment, the median duration of which was 12 months. Overall, 73.2% of the curvatures treated, responded favorably (stabilization or regression of the curve); however, 26.8% of the curvatures progressed in spite of the transcutaneous electrical stimulation treatment. The only complication noted was contact eczema in 20% of the cases. The authors feel that surface electrical stimulation treatment can be regarded as an acceptable alternative to a brace in the treatment of idiopathic scoliosis, and at this stage it deserves a place in the conservative therapeutic approach to idiopathic scoliosis. PMID- 1772017 TI - [Application and electric insulation of strain gauges used on fresh bone. Preliminary study]. AB - This report describes the optimal use of strain gauges placed on fresh wet bones. Two principal stages in gauge installation were studied: surface preparation and gauge insulation. Different surface preparation procedures were tested on bovine bone specimens loaded in traction. The preparation efficiency was evaluated by comparing strains measured from gauges and from an extensometer with sharp edges. Results show the necessity of sufficient rubbing: a minimum of 5 rubbing cycles with n. 320 emery paper. Scanning electron microscopy was used to examine the effect of the preparation procedures. Different coatings were also tested with special attention given to the influence of these coatings on the measured strains. An optimal polyurethane coating is proposed. PMID- 1772018 TI - The syndrome of Parsonage and Turner. Discussion of clinical features with a review of 8 cases. AB - A clinical analysis of 8 patients with brachial plexus neuropathy is presented. The disease may involve the upper, the lower, or the entire plexus. There is a higher incidence in men than in women. The syndrome is not uncommon but is frequently diagnosed incorrectly. The fairly typical pattern of symptoms and signs includes sudden onset with severe pain along one side of the shoulder girdle, followed in a few hours or days by atrophic paralysis of muscles over the affected shoulder. The disorder is occasionally bilateral. The paresis persists for months or even years. The overall prognosis is excellent despite the severity and extent of the lesion. The etiology is unknown, but decreased physical resistance is a predisposing factor. PMID- 1772019 TI - [Combination auto-heteroplasty in ligament repair in chronic anterior laxity of the knee]. AB - From September 85 to September 88, 130 patients were treated by our own technique for chronic laxity of the knee. All the patients were examined at regular intervals (6, 12 and 24 months) both clinically and by arthroscopy. Neuromorphological studies, an experimental approach with the "Pivot" and evaluation of the results, show that surgery is indicated, especially in young patients, before intraarticular lesions appear. PMID- 1772020 TI - Fracture of the humeral diaphysis with extreme rotation. AB - We report a spiral fracture of the humeral diaphysis with marked rotational deformity complicated by radial nerve neuropraxia in a young girl. Conservative management resulted in fracture healing and full recovery of the radial nerve palsy. PMID- 1772021 TI - Meniscal bearing dislocation in the Oxford knee. AB - The Oxford knee is a unicompartmental knee prosthesis with a polyethylene meniscal bearing. Anterior dislocation or medial subluxation has been described in lateral compartment arthroplasties. The authors present the case of a medial dislocation of the lateral meniscal bearing and a review of the literature concerning meniscal bearing instability in the Oxford Knee. PMID- 1772022 TI - Vertebral osteomyelitis. A case with massive osteolysis and compression of the dural sac. AB - We present a case of a 59-year-old male with 6 bilateral sensory and motor involvement of spinal roots L5 through S4 due to compression of the dural sac caused by a staphylococcus infection. We also discuss the treatment and favorable progress with major recuperation of the motor, sensory and sphincter functions. PMID- 1772023 TI - Osteosarcoma appearing as a pathologic fracture. AB - Osteosarcoma is the most frequent primary malignant bone tumor. It usually occurs in the second decade of life. Pathologic fracture as the primary manifestation of an osteosarcoma is rather unusual, especially under the age of 10. The authors present the case of a 9-year-old boy with a diaphyso-metaphyseal femoral fracture, in whom the radiological features of an osteosarcoma were not recognized at the time of the fracture as they were not clearly visible, and at follow-up initially were considered as proliferative callus formation. PMID- 1772024 TI - Dorsal dislocation of the distal end of the ulna in a judo player. AB - A 32-year-old policeman injured his left wrist while engaged in judo training. A distal radio-ulnar dislocation, ulna dorsal, was reduced under general anesthesia, but, as the distal radio-ulnar joint was unstable, a Liebolt's ligamentous reconstruction procedure and a partial excision of the triangular fibrocartilage complex were carried out. The patient could resume his job eight weeks after the operation, and light training after a further six months. The need for proper physical examination and accurate radiographic positioning is stressed. PMID- 1772025 TI - Giant solitary osteochondroma of the proximal humerus treated by resection and fibular autograft reconstruction. AB - A giant solitary osteochondroma of the proximal humerus in a 9-year-old boy was widely resected. Reconstruction of the bone defect was achieved with two nonvascularized fibula segments which gave sufficient stability to the proximal humerus and yielded rapid bone remodeling into an almost normal cortical bone after six months. PMID- 1772026 TI - [Chondrosarcoma of the foot. Apropos of a case--literature review]. AB - Primitive chondrosarcoma of the foot is rare. About 50 cases have been reported. It often poses diagnostic problems, and the confirmation of malignancy necessitates a broad resection. The tumor is radioresistant and chemotherapy is minimally effective, as illustrated by the present report. PMID- 1772027 TI - Flexor pollicis longus rupture with scaphoid nonunion. A case report and literature study. AB - A case of flexor pollicis longus rupture which resulted from a pseudarthrosis of the scaphoid in a non-rheumatoid patient is described. Treatment consisted of an interphalangeal joint arthrodesis. PMID- 1772028 TI - Comminuted fracture of the scapula following electric shock. A case report. AB - A case of a comminuted fracture of the scapula, following electric shock, is reported. Recovery was uneventful, and normal function returned after conservative treatment. PMID- 1772029 TI - Segmental aortic wall stiffness from intravascular ultrasound at normal and subnormal aortic pressure in pigs. AB - Segmental aortic wall stiffness was calculated from intravascular ultrasound images and intravascular pressures in six pigs at normal and subnormal aortic pressures (21 sequences of pressures and areas before and after boli of intravenous nitroglycerin). The wall stiffness was expressed as the pressure strain elastic modulus (Ep). The Ep was calculated from the formula: Ep = delta PR delta R-1 (P, pressure; R, radius) in two different ways. First from maximal and minimal values of pressure and area. Second as the slope of linear regression line of delta PR as a function of delta R from 29 simultaneous recorded pressures and images. The average Ep value for all sequences in the different segments was 0.58 +/- 0.55 10(5) Pa (Method 1) and 0.50 +/- 0.40 10(5) Pa (Method 2). Ep increased with the distance from the heart at normal aortic pressures. At subnormal aortic pressures after intravenous nitroglycerin this relationship was not so evident. At subnormal aortic pressures the calculated Ep values were significantly reduced in the lower half of the abdominal aorta. The phase lag, i.e. hysteresis, between pressure and diameter was demonstrated. Our study shows the applicability of intravascular ultrasound as a tool to evaluate arterial wall stiffness. PMID- 1772030 TI - A note on the errors of using venous congestion in intact rats for determinations of microvascular permeability. AB - The established ideas of transcapillary exchange have recently been challenged based on studies in intact rats. In vivo measurements of net fluid flux and albumin clearance in muscle (and skin) have given estimates of the reflection coefficient (sigma) for albumin of 0.98-0.99 compared to the sigma value of 0.90 obtained by most other techniques. This discrepancy has vast consequences for the understanding of the transcapillary passage of macromolecules. A sigma for albumin near unity implies that there is virtually no coupling between protein and fluid transfer as induced by, for example, increases in vascular hydrostatic pressures. However, there are several assumptions inherent in the seemingly straight-forward experiments on intact rats, and in the present study we tested the hypothesis that occlusion of the femoral vein by ligation induces only moderate and transient increments of venous pressure (PV). During control conditions PV was 6.3 mmHg and pressure increased to 12.8 mmHg immediately following venous occlusion. However, PV declined with time and after 30 minutes of occlusion the capillary hydrostatic pressure was only increased by 3.0 mmHg. Calculations of the capillary filtration coefficient gave completely unrealistic values, close to those of maximally vasodilated skeletal muscle. The findings suggest that data obtained from intact rats, albeit important and interesting, should be evaluated with great care due to possible experimental errors in the in vivo approaches. In particular, the technique of estimating sigma for albumin in intact rats must be subjected to modifications before allowing any reliable conclusions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772031 TI - Upper and lower bounds on capillary permeability ratios of Cr-EDTA to cyanocobalamin in rat hindquarters. AB - The single injection indicator dilution technique, often used for assessing capillary permeability, was employed for estimations of the equivalent pore radius of skeletal muscle microvessels according to the theory of restricted diffusion. There are, however, certain important sources of error that must be considered in order to allow conclusions regarding the degree of restricted diffusion. In this study, we have recalculated previously published data in order to minimize the effect of heterogeneity of the second kind, i.e. a transit-time dependence of the fractional extraction values. The method used makes it possible to calculate reliable intervals of confidence for the permeability surface area products, and hence for the permeability surface area product-ratios (and equivalent pore radius), taking into account the maximal theoretical impact of back diffusion on measured extraction data. After correction for transit-time dependent effects of heterogeneity, the permeability surface area product-ratio of Cr-EDTA to cyanocobalamin (vit. B12) from 48 measurements in eight rats was found to have a theoretical 'upper bound' of 2.63 +/- 0.06 and a lower bound of 2.10 +/- 0.07, corresponding to an equivalent pore radius of 60 to 109 A. This minimum pore radius estimate was even further reduced by corrections for plasma flow dependent reductions in overall extraction fraction (heterogeneity of the first kind) to 45 A, whereas the upper bound on pore radius was reduced to 60 A. These data strongly support the presence of marked restricted diffusion of small solutes in the maximally vasodilated rat hindquarter microvasculature. PMID- 1772032 TI - Dyssynchrony of segment shortening in the anterior wall of the feline left ventricle. AB - Non-uniformity of regional contraction may be both spatial and temporal. This study was undertaken to deal with the temporal aspects of shortening and to quantify non-uniformity with regard to timing. Nine cats were anaesthetized and artificially ventilated. Two pairs of ultrasonic crystals were situated in the anterior midwall of the left ventricle to measure regional shortening. One pair, longitudinal segment, was oriented to align with midwall fibres. The other pair, transverse segment, was placed perpendicular to the first one. Registrations in control state, during caval occlusion, and during aortic constriction were carried out with and without isoprenaline infusion. Cyclic events were analysed in terms of phase angle, 0-2 pi representing one heart cycle. Transverse segments showed marked shift of duration of shortening, from 1.19 pi +/- 0.06 pi (mean +/- SEM) in the control state to 0.40 pi +/- 0.14 pi during caval occlusion with isoprenaline infusion. Duration of shortening of longitudinal segments showed less prominent shift with mean values between 1.38 pi and 1.11 pi. Regional uniformity of timing, expressed as synchronization index, varied markedly with interventions (P less than 0.0005). Dyssynchrony was most prominent during caval occlusion with mean values less than 0.6. A simple model of force generation for the two segments visualizes that segment shortening of the transverse segment is of shorter duration than the longitudinal segment and a common mechanism for temporal and spatial non-uniformity within a region could be elaborated. This study quantifies both the time course of shortening and temporal non-uniformity of two cross-oriented segments within the same myocardial region. PMID- 1772033 TI - Evaluation of the impression technique by measuring interstitial oedema in rat testis. AB - The impression method for assessment of subcutaneous oedema was evaluated in a rat testis model where the testicular interstitial fluid volume was changed both artificially by infusion of rat plasma and pharmacologically by administration of human chorionic gonadotrophin. Both the integral value and the impression force value, as measured with the impression method, changed with infused volume, and changes as small as 16 microliters (approximately 7% of the total interstitial fluid volume in a testis) could be detected. Rats were treated with a single injection of 100 i.u. human chorionic gonadotrophin in order to induce changes in the volume of interstitial fluid in the testis. Both the integral value and the impression force value seemed to reveal information on testicular interstitial fluid volume in rats treated with human chorionic gonadotrophin that was similar to data revealed by measuring the actual fluid content in the testis. Interstitial fluid volume measured morphometrically in the contralateral testis in human chorionic gonadotrophin-treated rats was significantly correlated to the impression force value (r = 0.75) and the integral value (r = 0.52). This rat testis model proved to be an interesting experimental set-up for evaluation of the impression technique. PMID- 1772034 TI - Acute volaemic changes modify the gastroduodenal resistance to the flow of saline in anaesthetized dogs. AB - The effect of acute and sequential volaemic changes on the gastroduodenal flow of saline was assessed in 23 anaesthetized dogs following two different experimental protocols. Hypervolaemia, by i.v. infusion of saline, induced a gradual decrease on gastroduodenal flow which amounted to 76% below control values (P less than 0.001) when volaemic expansion attained 5% of body weight. This effect was volume dependent (17% increase on gastroduodenal flow per volume of infused saline equivalent to 0.5% of body weight, P less than 0.001), lasted for at least 90 minutes after infusion was completed and was also obtained by expanding previously bled animals. Hypovolaemia due to bleeding was followed by an increase on gastroduodenal flow of about 88% above control values (P less than 0.05) when haemorrhage was equal to 3% of body weight. This effect was also volume dependent (23% increase on gastroduodenal flow per volume of blood shed equivalent to a 0.5% of body weight, P less than 0.01) and was reversed after blood volume was restored. These modifications in the resistance of the gastroduodenal segment to the flow of liquid due to acute volaemic changes suggest that the extracellular fluid volume modulates the contractile activity of the gastroduodenal portion of the gut possibly to set a gastroduodenal handling of liquid adequate to cope with volaemic imbalances. PMID- 1772035 TI - Tissue osmolality in intestinal villi of four mammals in vivo and in vitro. AB - Using a freezing point depression method osmolality in the intestinal tissue of four mammals (gerbils, guinea-pigs, rabbits and rats) was estimated in vivo, during fluid transport from an isotonic electrolyte-glucose solution. Net fluid transport was also measured. In gerbils, guinea-pigs and rabbits tissue osmolality was also estimated during in vitro conditions. A marked hyperosmolality was observed in vivo in the upper parts of the villi of all four mammals studied. The tissue osmolality was significantly higher than that seen in the same species during in vitro conditions. A villus hyperosmolality was observed also in species which exhibited a net fluid secretion (guinea-pig, rabbit ileum), indicating that the fluid secretion emanated from the intestinal crypts. Based on the results of the present experiments and on observations made in earlier experiments performed on the cat, it is proposed that the villus hyperosmolality is created by a countercurrent multiplier present in the intestinal villus. The hyperosmolar compartment in the villus tissue creates the force that drives fluid from lumen to tissue. PMID- 1772036 TI - Interstitial lactate, inosine and hypoxanthine in rat kidney during normothermic ischaemia and recirculation. AB - The aim of this study was to determine the potential value of extracellular fluid (ECF) lactate, inosine and hypoxanthine for monitoring the disturbance in energy metabolism associated with kidney ischaemia and recirculation, using intrarenal microdialysis as sampling technique. Normothermic ischaemia was produced in rats by clamping of the left renal pedicle. Microdialysis probes were implanted into the renal cortex and the medulla, respectively. Dialysates were collected in 10 minute fractions before, during 20 (Group A) or 40 minutes (Group B) ischaemia and 2 hours of recirculation. Samples were analysed by HPLC for lactate, inosine and hypoxanthine. Ischaemia caused a dramatic increase of extracellular fluid lactate, inosine and hypoxanthine in both groups, reflecting the disturbance of energy metabolism. The basal extracellular fluid level of lactate as well as that during ischaemia was markedly higher in the medulla compared to cortex, whereas the relative change in lactate concentration was similar (i.e. about 4-fold). In group A all three metabolites returned to the pre-ischaemic level within 20 minutes after reperfusion. However, while inosine and hypoxanthine returned promptly to base line in Group B, recovery of lactate varied dramatically between animals suggesting a persistent metabolic disturbance in some rats. Our results indicate that extracellular fluid lactate, inosine and hypoxanthine, measured by intrarenal microdialysis, may be useful for monitoring of the energy state of the kidney during normothermic ischaemia and that extracellular fluid lactate may be a sensitive indicator of post-ischaemic disturbances in energy metabolism. PMID- 1772037 TI - A study on the renal synthesis of dopamine in aged rats. AB - The present study has examined the synthesis of dopamine from L-DOPA in kidney slices and in kidney homogenates of 3- and 24-month-old rats. The deamination of newly-formed dopamine into 3,4-dihydroxyphenylacetic acid (DOPAC) was also studied. The assay of L-DOPA, dopamine, noradrenaline and DOPAC was performed by high pressure liquid chromatography with electrochemical detection. Incubation of renal slices and homogenates of whole kidney with exogenous L-DOPA (0.1-100 microM) resulted in a concentration-dependent formation of both dopamine and DOPAC. At 50 and 100 microM L-DOPA, but not at lower concentrations (10 and 25 microM), the total amounts of dopamine and DOPAC formed were significantly greater in kidney slices obtained from 3-month-old rats. By contrast, the total amount of dopamine and DOPAC formed was greater in homogenates of renal tissues from aged rats than from young animals; this was particularly evident at 5.0 and 10.0 microM L-DOPA in the incubation medium. However, the DOPAC/dopamine ratios, both in kidney slices and kidney homogenates, were found to be higher in young rats than in old rats. The present results suggest an impairment in the formation of dopamine and of its deamination into DOPAC in renal tissues of aged rats; however, the reduced synthesis of dopamine does not appear to be the result of a decreased activity of the enzyme aromatic L-amino acid decarboxylase. PMID- 1772038 TI - Acute but not chronic gastric sodium administration regulates vasoactive intestinal peptide metabolism by the liver. AB - We have shown previously that gastric sodium loading releases vasoactive intestinal peptide from the intestine and in rabbits on a low sodium diet it appears to decrease vasoactive intestinal peptide metabolism by the liver. To determine the contributions of the low sodium diet and the acute sodium load to changes in vasoactive intestinal peptide metabolism, metabolic clearance studies of vasoactive intestinal peptide infused intraportally were performed. These studies were performed in male New Zealand white rabbits equilibrated on normal and low sodium diets before and after an acute gastric sodium load of 1.5 mmol kg 1. No difference was detectable in metabolic clearance rates between normal and low salt diets, however, decreases in metabolic clearance rates were observed in response to the sodium load (normal diet P less than 0.005, low salt P less than 0.0005). Secretion rates also decreased following the gastric sodium load (normal P less than 0.005, low salt P less than 0.05). We conclude that hepatic VIP metabolism is decreased by acute gastric sodium loading but it is not affected by chronic sodium intake. PMID- 1772039 TI - Regional distributions of blood flow and tissue uptake rates of vitamin B12 and albumin within single rabbit skeletal muscles. AB - The mechanism underlying the marked regional variations in blood flow within single skeletal muscles has not been identified. The present investigation was prompted by previous data pointing to a regional distribution of the number of perfused vessels as one possible determinant for the heterogeneous perfusion pattern. We examined this possibility by assessing the regional tissue uptake rates of vitamin B12 and albumin assuming that these are related to the number of perfused vessels. This is the first study that has included simultaneous measurements of regional blood flow and of regional tissue uptake rates of vitamin B12 and albumin within single skeletal muscles in the intact animal. The microsphere method was adopted to measure regional blood flow in 0.25 g muscle regions in awake and in anaesthetized rabbits. Various tracers were used to assess the regional distributions of tissue uptake rates and of vascular and interstitial volumes. Albeit displaying a marked regional heterogeneity, neither the tissue uptake rate of vitamin B12 nor that of albumin were correlated to regional blood flow (P less than 0.05) at rest (awake or anaesthetized rabbits) or during exercise hyperaemia (anaesthetized). At rest, but not during exercise, the distributions of regional tissue uptake rates of the two tracers showed a striking bimodal pattern. Vascular and interstitial volumes showed minimal interregional variations. The lack of correlation between regional blood flow and tissue uptake rates and the minute interregional variation in vascular volume, argue against variations in the number of perfused vessels as the explanation for the regional heterogeneity in blood flow. PMID- 1772040 TI - The initiation of non-micturating contractions in the feline bladder. AB - The extrinsic nervous system of the bladder may not be involved in the initiation of non-micturating contractions in the cat, because neither the sympathetic or parasympathetic motor drives appear to change their level of activity before the first contraction. This stability of the motor drives may only reflect the absence of afferent drive from the relatively empty bladder. This assumption was examined by recording from the pelvic nerve during bladder filling at a natural rate in pentobarbitone anaesthetized cats. Afferent multifibre nerve activity was always increasing before the onset of non-micturating contractions. Six out of nine nerve fibres innervating localized bladder wall mechanoreceptors were discharging before the onset of non-mictating contractions, whereas all had been silent with the bladder empty. Because mechanoreceptor activity preceded the onset of non-micturating contractions, reflex changes in autonomic motor activity, which have not yet been observed, may have a role in initiating non micturating contractions. PMID- 1772041 TI - Spatial distribution of motor unit fibres in fast- and slow-twitch rat muscles with special reference to age. AB - The spatial arrangement and morphometrical properties of the muscle fibres within single motor units (motor unit fibres) were studied in fast-twitch units of the tibialis anterior (TA) and in slow-twitch units of the soleus, using a computer assisted model. The motor unit fibres were identified by the glycogen-depletion technique and the position of each fibre was defined by (x, y)-coordinates. The distance between each fibre and the nearest motor unit fibre (nearest-neighbour distance), and the distance between each fibre and each of the other fibres in the unit (interfibre distance), was calculated and plotted. Comparisons were made between young adult (3-6 months) and old (20-25 months) rats. In old animals, the motor units of TA and the soleus were larger (P less than 0.05 and P less than 0.01), contained an increased number of muscle fibres (P less than 0.01) and covered a larger portion of the muscle cross-section (P less than 0.01 and P less than 0.1). These changes indicate the presence of an age-related denervation reinnervation process in both types of muscles. In the young adult group, the fast-twitch motor unit fibres of TA were non-randomly arranged (P less than 0.05 0.01) whereas the fibre arrangement within the slow-twitch motor units of the soleus was not significantly different from random. In old animals, the fibre arrangement was non-random in both fast- and slow-twitch motor units. In TA, the distribution of nearest-neighbour distances showed an increased (P less than 0.05) proportion of short distances in old age, whereas the distribution of interfibre distances was unchanged. In the soleus, the distribution of interfibre distances showed an age-related displacement to the left at short distances (P less than 0.05) and to the right at long distances (P less than 0.01), but the distribution of nearest-neighbour distances was not significantly altered. It is concluded that motor unit fibres are non-randomly arranged in the fast-twitch motor units studied and that a non-random rearrangement of motor unit fibres takes place in both fast- and slow-twitch units during the ageing process. This age-related rearrangement is secondary to a denervation-reinnervation process and it appears as if different types of reinnervation predominate in fast- and slow twitch units. PMID- 1772042 TI - Ethanol may be used with the microdialysis technique to monitor blood flow changes in skeletal muscle: dialysate glucose concentration is blood-flow dependent. PMID- 1772043 TI - Reserpine treatment increases PEC-60-like immunoreactivity in the substantia nigra of the male rat as determined by radioimmunoassay. PMID- 1772044 TI - Sympathetic control of vascular resistance in skeletal muscle and skin of man. PMID- 1772045 TI - [Statistical study of outpatient urologic care]. AB - Attendance generated in an urology outpatients office, reaching up to 6564 visits, was studied for a complete year. Considering only the initial visits handled during that period (1968), we evaluated the following parameters: age, sex, mode of remission, data presented, type of consultation, most common type of urological pathology. No particular period of life has come out as showing greater incidence of urological pathology. Males represented twice as many visits as women. 84.29% patients had been correctly referred to the office. Sixty percent of visits happened without appropriate clinical data to support the case. Emergencies represented 13.31%, but 90% of those actually lacked such condition. Renal-ureteral lithiasis (25.57%) was the most frequently present pathology in our office, followed by benign hypertrophy of the prostate (16.07%). Urinary lower tract infections (15.59%) and inflammatory and/or congenital prepuce pathologies (14.09%) were the second most frequent ones. In this paper, we emphasize the increasing prevalence of male-related sterility visits in the outpatients environment, as well as nephrological. PMID- 1772046 TI - [Infiltrating transitional carcinoma of the bladder. 3. Effect of regional lymph node dissemination on the prognosis]. AB - The evolution of 168 patients, 136 of which underwent bilateral lymphadenectomy is analyzed in this paper. In 126 cases it was possible to obtain all the data in order to define N within the T.N.M. rating. With regard to the remaining patients 10, of which we lack the anatomopathological report, and 32 which did not undergo lymphadenectomy, are included under item Nx. During follow-up, metastasis was diagnosed in 60% node-positive patients. We believe it to have been already present at the time of undergoing surgery. Survival was significantly higher in the group without node dissemination than in both negative-nodes and Nx groups. When assessing the nodular dissemination group, patients treated with 2000 rad prior to cystectomy showed higher survival rates: 36% vs 22% and 11% for groups treated with 4500 rad and no radiotherapy. respectively. Metastatic percentage, however, was lower for the group managed with surgery alone (50%) than those treated with pre-operative radiotherapy (73% and 67% with 2000 and 4500 rad, respectively), on the other side, it would seem a contradiction that a 2000 rad dosage should be more effective than a 4500 rad dosage for this group of patients, since theoretically, the latter is closer to the ideal dosage to eradicate the nodular disease. Since 3 of 5 patients have micrometastasis, which we are yet unprepared to detect, all positive-node patients should receive chemotherapy immediately after recovery from surgery. PMID- 1772047 TI - [Complications during and after extracorporeal lithotripsy in elderly patients]. AB - Report of our experience of complications arisen from treatment of urinary lithiasis with extracorporeal shock-wave lithotripsy, using a Dornier HM3 lithotripter in 218 elderly patients (over 65 years). No complications arose during lithotripsy in 160 patients (73.39%). Most frequent complications (when they happened) were skin disorders, which occurred in 33 patients (15.13%). One hundred and thirty-six (62.38%) patients had no post-lithotripsy non-obstructive urological complications, but when these occurred, renal colic, evident in 52 patients (23.85%), was the most frequent one. During the post-lithotripsy period, 88.53% patients (193) had no obstructive urological complications. When they emerged, they usually developed asymptomatically (13 patients, 5.95%). With regard to the approach used to treat the obstructive cases, the most common one was medical, representing 56%. Surgery was used only in 2 occasions. A total of 175 patients (80.27%) presented no post-lithotripsy complication, fever of up to + 38 degrees C being the most prevalent condition (9.65%). PMID- 1772048 TI - [Determination of Fe, Mg, Cu, and Zn in normal and pathological prostatic tissue]. AB - Using Atomic Absorption Spectrophotometry (AAS), Fe, Cu, Mg and Zn tissue concentrations were determined in 100 prostates with anatomopathological diagnosis of benign hyperplasia (25 cases), hyperplasia-associated prostatitis (25 cases), adenocarcinoma (25 cases) and normal gland (25 cases). Also at the same time, serum concentrations of the same elements were determined in order to correlate both results and see whether there was a relationship between them. A subsequent statistical study of the results was made looking for significant differences between the anatomopathological groups considered. Also a correlation study of these ions was conducted using Pearson's correlation coefficient(r). This report describes in detail the methodology used to conduct the present study, from tissue obtention through AAS determinations. According to the results obtained, prostatic adenocarcinoma shows in this study a Zn tissue concentration sensibly lower than that seen in hyperplasia, prostatitis and normal tissue. Also, Mg concentration is lower than in the other groups. In eutrophic prostatic tissue, Mg tissue concentrations were higher than in hyperplastic tissue and prostatitis, while Cu and Fe concentrations were lower as compared with the mentioned pathologies. These results have been compared to other series, and the biochemical assessment of the findings disclosed for discussion. PMID- 1772049 TI - [Urologic complications in 237 recipients of cadaveric kidney transplantation]. AB - We describe the urological complications occurred in 237 patients undergoing cadaveric renal transplant in 13 years. Two techniques of extravesical ureterocystoneostomy were used. Thirty patients (13%) presented 35 (15%) urological complications: 23 (9.7%) urinary fistula and 12 (5.1%) ureteral stenosis. The vast majority (80%) were early complications (before 90 days): 82% fistulas and 18% stenosis. All early complications were identified as technical deficiencies; all late complications were obstructive in nature. A new ureteral reimplant was performed in 15 patients, with successful results in 14. Six patients underwent nephrectomy and pyelostomy, 2 of these required a second operation. Seven patients underwent endo-urological procedures with good results. Three patients undergoing conservative treatment for urinary fistula required surgical drainage of an infected urinoma. No statistical difference was observed in the survival rates of both the grafts and the patients presenting or not urinary complications. PMID- 1772050 TI - [Melanoma in urology: our experience and review of the literature]. AB - Melanomas make up 2% of all body tumours, but the figure is increasing mainly in countries with longer sun hours daily. Genitourinary location is even more infrequent. That explains our clinical report when we discovered the three cases seen in our unit, one in a female urethra, one suprarenal and the third one in the bladder. PMID- 1772051 TI - [Spleno-gonadal fusion: a clinical case]. AB - The presence of splenic tissue in the scrotum, creating a spleno-gonadal fusion, is a very rare condition within benign intra-scrotal tumours. Accidental discovery in a 68 year-old male following histopathological study allows us to make a few considerations and review the literature. PMID- 1772052 TI - [Foreign bodies in the bladder and urethra]. AB - Many cases have been published in the urological literature of foreign bodies apparent in the bladder and urethra. Based on the five cases we are now presenting, we review this chapter of urology. We discuss the clinico pathological aspects of this pathology and provide diagnostic and therapeutical guidance. We recall the role urologists have to play in preventing such events in the course of their diagnostic and therapeutic activity. PMID- 1772053 TI - [Bladder carcinosarcoma with osteosarcomatous differentiation]. AB - Osteoid tissue can eventually be identified outside the bone skeleton adopting the form of metastasis, osteoid metaplasia or primitive osteosarcoma. This latter presentation is most frequently located in soft tissues and exceptionally at the visceral level. The term used for any of these forms is extra-bone osteogenic sarcoma. This paper reports the case of a 62 year-old female patient diagnosed with vesical urothelial carcinosarcoma treated with external radiotherapy. After a disease-free period of 20 years the patient developed osteosarcomatous differentiated vesical carcinosarcoma. A literature review is made to analyze, from a clinical and histopathological perspective, several items of interest presented by this pathology. The role of sarcomatous radio-induction is also highlighted. Finally, we emphasize the relevance of using radical treatments from the start, so as to restrain the highly malignant potential of this condition. PMID- 1772054 TI - [Malignant hemangiopericytoma: a rare primary retroperitoneal tumor]. AB - A case of malignant retroperitoneal hemangiopericytoma is described. The infrequency of the retroperitoneal mesenchymatous origin, specific anatomopathological criteria of malignity, constant hypervascularization as well as clinico-radiological, surgical and prognostic characteristics found in the literature are highlighted. PMID- 1772055 TI - [Cyst of the prostatic utricle]. AB - Presentation of a case of prostatic utriculus cyst which due to its size and the patient's history suggested a differential diagnosis with a urethral or vesical diverticulum. Awareness of frequent association to urethral malformations and azoospermia would be very useful when choosing a treatment strategy in such cases. PMID- 1772056 TI - [Sarcoma of the bladder. Report of 2 cases]. AB - Discussion of a retrospective study in our unit of two cases of vesical tumours of mesenchymal origin, in adult patients and with different maturation behaviour. The first patient started with haematuria and after an extensive follow-up period is now free from the disease. The second patient was an accidental finding causing death in the course of the immediate postoperative. PMID- 1772057 TI - [Abscess of the seminal vesicle. Clinico-therapeutic review apropos of a case]. AB - Reporting the case of a patient diagnosed with an abscess of the seminal vesicle, treated successfully through parasacral transgluteal percutaneous aspiration lead by computerized axial tomography (CAT). This represents the first case in the literature of percutaneous access to the seminal vesicles through this route. CAT is an effective diagnostic test which makes non-surgical treatment for this type of abscess simpler. A review is made of the literature with regard to the etiology, diagnosis and therapy of seminal vesicle abscesses. PMID- 1772059 TI - [Primary lymphoma of the prostate]. PMID- 1772058 TI - [Diagnosis and treatment of coital penile injury]. AB - Two cases are presented of non-penetrating coital trauma of erect penis. This is a rare pathology. No prospective studies are therefore available, but instead there is much controversy. We review the existing literature as well as the various diagnostic and therapeutic attitudes and we propose an algorithm to systematize its management. PMID- 1772060 TI - Autoradiographic studies of 5HT2 receptors. PMID- 1772061 TI - Ambivalence on the multiplicity of mammalian aromatic L-amino acid decarboxylase. PMID- 1772062 TI - Interrelationships of DNA cycles and melatonin synthesis. PMID- 1772064 TI - Tryptophan and related alkaloids. PMID- 1772063 TI - Regulation of melatonin synthesis in the ovine pineal gland. AB - The results presented here show clearly that the rapid nocturnal increase in circulating melatonin in sheep is associated with an equally rapid increase in melatonin production in the pineal gland. Pineal NAT activity and NAS concentration also increased under this condition, indicating that NAT activity is an important factor in this process. According to the current model for the regulation of pineal melatonin production in the rat, the large nocturnal increase in NAT activity is the major factor responsible for the daily rhythm in melatonin, as well as for the opposite rhythm in serotonin and its oxidation products in the pineal gland. Increased NAT activity in the pineal gland at night channels serotonin toward melatonin production at an enhanced rate, thereby causing pineal serotonin levels to drop. This, in turn, leads to decreased production of oxidative metabolites due to reduced substrate availability for MAO. Thus, the large increase in NAT activity acts as the key factor, directly or indirectly, for the generation of all rhythms in serotonin metabolites in the pineal gland, and possibly in the circulation. Such an exclusive role for NAT is doubtful in the sheep pineal gland for the following reasons: First, the nocturnal increase in NAT activity is relatively small (3-5-fold) compared to the rat (50-100-fold). Second, in at least two instances--a 30 min light pulse and prazosin treatment--there was a clear dissociation between melatonin production and NAT activity. This lack of correlation between NAT activity and melatonin production does not seem to be due to serotonin availability since serotonin levels did not change under the above conditions. Further, serotonin levels were found to decrease rather than increase when melatonin levels increased at night. Finally, our observation that melatonin production can be increased during the day by increasing serotonin levels in the pineal gland may reflect only the incompletely saturated nature of pineal NAT and may have little relevance for the physiological regulation of pineal melatonin production. Even though NAT activity may not be the only factor responsible for the rhythmic production of serotonin metabolites in sheep pineal gland, activation of the serotonin----melatonin pathway seems to be the primary metabolic response involved in this regulation, since the rhythms in the serotonin metabolites are similar in both rat and sheep. In the rat, the activation of the serotonin----melatonin pathway is brought about exclusively by the increase in NAT activity.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1772065 TI - The role of tryptophan and kynurenine transport in the catabolism of tryptophan through indoleamine 2,3-dioxygenase. PMID- 1772066 TI - Kynureninase and kynurenine 3-hydroxylase in mammalian tissues. PMID- 1772067 TI - Relationships between pteridine synthesis and tryptophan degradation. PMID- 1772068 TI - Serotonin: its role and receptors in enteric neurotransmission. AB - Enteric neural 5-HT receptors were analyzed and related to possible physiological actions of 5-HT. Receptors were identified electrophysiologically with intracellular microelectrodes and by studies of the binding of radioligands. Radioligand binding was assessed by rapid filtration and by radioautography. Three subtypes of 5-HT receptor, 5-HT1P, 5-HT3, and 5-HT1A, were identified. 5 HT1P receptors were found to mediate slow depolarizations of myenteric neurons that were associated with a decrease in membrane conductance. These responses were inhibited by 5-HTP-DP and by BRL 24924 and mimicked by 5- and 6 hydroxyindalpine. 5-HT1P receptors were labeled with high affinity by 3H-5-HT and were located on both submucosal and myenteric neurons and on processes of intrinsic neurons in the lamina propria. Serotonergic EPSPs were found to be mediated by 5-HT1P receptors; it is postulated that 5-HT1P receptors may be involved in initiation of the peristaltic reflex and in the regulation of gastic emptying. 5-HT3 receptors have been shown to be responsible for fast depolarizations of myenteric and submucosal neurons associated with a rise in membrane conductance. These responses are antagonized by ICS 205-930 and mimicked by 2-methyl-5-HT. 5-HT1A receptors have been reported by others to mediate hyperpolarizing responses of myenteric neurons associated with a rise in membrane conductance. Hyperpolarizing responses are also elicited by the 5-HT1A agonist, 8 OH-DPAT. No physiological role has yet been identified for 5-HT3 or 5-HT1A receptors in the ENS. PMID- 1772069 TI - Bidirectional relationships between tryptophan and social behavior in vervet monkeys. PMID- 1772070 TI - Stability of tryptophan in peptides against oxidation and irradiation. PMID- 1772071 TI - Physiological role of 3-hydroxykynurenine and xanthurenic acid upon crustacean molting. AB - Studies with crabs (Charybdis japonica) and crayfish (Procambarus clarkii) revealed that the tryptophan metabolites, 3-hydroxy-L-kynurenine (3-OH-K) and xanthurenic acid (XA), common secretory products of the X-organ-sinus gland complex of eyestalks from several decapods, regulated the molting of crustaceans in species-nonspecific fashion. Injection of 3-OH-K to the eyestalk-ablated crayfish delayed the onset of the first molt and lengthened the interval between the first and second molts. These lines of evidence were in accord with previous accounts of the so-called "molt inhibiting hormone" (MIH) effect. Removal of eyestalks caused a change in the conversion capacity of exogenous 3-OH-K to XA in the hemolymph. The peak in transformation capacity was followed by a peak in the titer of 20-hydroxyecdysone or molting hormone. Moreover, the seasonal profiles of the XA and ecdysone titers in Charybdis japonica exhibited a staggered relationship in the tissues tested. The ratio of XA to 3-OH-K, which is expected to indicate the apparent 3-OH-Kase activity, fluctuated seasonally and locally. When the Y-organ with the adhering tissues (Y-organ complex or YOC) was incubated during the period of high XA titer, the YOC produced 100 times more ecdysone than before incubation. It is suggested that ecdysteroidogenesis in situ was suppressed during this period by XA, but incubation of the YOC lead to a dramatic acceleration in ecdysone synthesis by overriding this inhibitory effect. XA profoundly repressed ecdysteroidogenesis in the YOC culture. Thus, XA is the ecdysone biosynthesis inhibitor (EBI) and 3-OH-K the precursor in crustaceans. An interfering effect of XA to a biocatalyst cytochrome P-450 system was postulated for the inhibition mechanism of ecdysteroidogenesis. PMID- 1772073 TI - Tryptophan nutrition and metabolism: an overview. PMID- 1772072 TI - Kynurenines in the regulation of behavior in insects. PMID- 1772074 TI - Comparison of tryptophan metabolism in vivo and in isolated hepatocytes from vitamin B6 deficient mice. PMID- 1772076 TI - Induction of indoleamine 2,3-dioxygenase in tumor cells transplanted into allogeneic mouse: interferon-gamma is the inducer. AB - Tryptophan depletion observed during induction of indoleamine 2,3-dioxygenase (IDO) in cultured cells has been suggested to involve a mechanism identical to that employed in self-defense against inhaled microorganisms and tumor growth. We recently reported that a dramatic induction of IDO occurred in i.p. transplanted tumor (Meth-A) cells undergoing rejection from allogeneic mice (C57BL/6), and that soluble factor(s) released from infiltrated host cells was responsible for the IDO induction. Here we report on the characterization of the soluble factor. To assay the factor, we used a 35 mm special culture dish (Transwell), which consisted of two wells divided vertically with a membrane (0.4 micron pore). Host cells (mainly lymphocytes) that infiltrated into the transplantation loci were cultured in the upper well, and untreated Meth-A cells in the lower well. With this in vitro system, the membrane-permeable factor, released by the host cells (upper well), induced IDO in the tumor cells (lower well). The culture superna tants, obtained by centrifuging the culture media from the upper and lower wells, contained the IDO inducer. The inducer activity was completely neutralized by the addition of antibody against interferon-gamma (IFN-gamma) but not by antibody against IFN-alpha/beta. The concentration of IFN-gamma in the medium after 1-day culture with a Transwell culture dish was found to be 2-3 U/ml based on the neutralization curve with the antibody. At this concentration, recombinant IFN gamma induced IDO in Meth-A cells to the same extent as the inducer in the culture medium. These observations indicate that the in vivo factor for IDO induction in the allografted tumor cells is IFN-gamma. PMID- 1772075 TI - Effects of the diet and other metabolic phenomena on brain tryptophan uptake and serotonin synthesis. PMID- 1772077 TI - Tryptophan metabolism in senile cataract patients assessed by high-performance liquid chromatography. PMID- 1772078 TI - Kynurenine and lipid metabolism. PMID- 1772079 TI - Content of tryptophan in human hair. PMID- 1772080 TI - Detection of a new intermediate product of indolealkylamine metabolism in the brain. PMID- 1772081 TI - Evidence for the preferential production of 3-hydroxyanthranilic acid from anthranilic acid in the rat brain. PMID- 1772082 TI - Circadian patterns of salivary melatonin and urinary 6-sulfatoxymelatonin before and after a 9 hour time-shift. PMID- 1772083 TI - Signal-to-noise optimization of HPLC-fluorometric systems and their application to the analysis of indoles. AB - The signal-to-noise optimization of high performance liquid chromatographic (HPLC) flow-cell fluorometric systems is described and the possibilities for further improving limits of detection for indoles is discussed. Application of HPLC-fluorometry to analyses in rat cerebrospinal fluid (CSF), human lumbar CSF, and human blood is presented. Finally, the intriguing clinical finding of hyperserotonemia in autism is discussed. PMID- 1772084 TI - Differential effects of estradiol and hydrocortisone on liver tryptophan pyrrolase in rats of various ages. PMID- 1772085 TI - Indole-3-pyruvic acid as a direct precursor of kynurenic acid. PMID- 1772086 TI - On kynureninase activity. AB - 1) In Mg-deficient rats, kynureninase activity is decreased. 2) p Hydroxyphenylpyruvate inhibits kynureninase activity. 3) -SH groups in the apoenzyme of kynureninase play a very important role in the enzymatic reaction. 4) 3-Hydroxykynurenine may be a very important regulative metabolite in the 3 hydroxykynurenine----xanthurenic acid pathway. PMID- 1772087 TI - Rat skin tryptophan 2,3-dioxygenase. PMID- 1772088 TI - Kynurenine 3-monooxygenase activity of rat brain mitochondria determined by high performance liquid chromatography with electrochemical detection. PMID- 1772089 TI - Interferon type I and II antagonism: a novel regulatory mechanism of indoleamine dioxygenase induction in human peripheral blood monocytes and peritoneal macrophages. PMID- 1772090 TI - Non-competitive inhibition of 3-hydroxyanthranilate-3,4-dioxygenase by 4-chloro-3 hydroxyanthranilic acid in whole brain of rat. PMID- 1772091 TI - Kynurenine-pyruvate aminotransferase in rat kidney and brain. PMID- 1772092 TI - Enzymatic synthesis of Papiliochrome II. PMID- 1772093 TI - Endocrine response of prolactin, cortisol, and growth hormone to low dose intravenous L-tryptophan in healthy subjects during day and night. PMID- 1772094 TI - Specific binding of L-tryptophan to serum albumin and its function in vivo. PMID- 1772095 TI - Effects of L-tryptophan on the brainstem indole and catecholamine metabolites in spontaneously hypertensive rats. PMID- 1772096 TI - Cytotoxicity of 3-hydroxykynurenine: implications for CNS damage in neonatal vitamin B-6 deficiency. PMID- 1772097 TI - Pellagra, mycotoxins and tryptophan-niacin metabolism. PMID- 1772098 TI - Levels of non-proteic tryptophan in milk and soybean formulas. PMID- 1772099 TI - Characterization of L-tryptophan transport into liver in suckling rats. PMID- 1772100 TI - Why does a difference in growth rate between rats of the Wistar and Sprague Dawley strains occur when a niacin-free and tryptophan-limiting diet is fed? PMID- 1772101 TI - Kynurenine and mesangial-proliferative glomerulonephritis. PMID- 1772102 TI - Impairment of kynurenine metabolism in cardiovascular disease. PMID- 1772103 TI - Autoradiographic measurement of the rate of serotonin synthesis in the rat brain. PMID- 1772104 TI - Primary immunodeficiencies in Italy. Data revised from the Italian Register of Immunodeficiencies--IRID (1977-88). AB - Data revised from the Italian Register of Immunodeficiencies (IRID) are reported in this paper. As previous reports on the matter, the registered cases are described according to the more recent WHO classification of primary immunodeficiencies (PIDs). Distribution of associated tumors and autoimmune diseases are showed in comparison with data from other published registers. From selected patients the evaluation of non infectious diseases is reported and their association with PIDs. PMID- 1772105 TI - Immunostimulation of neutrophil phagocytic function by RU41740 (Biostim) in elderly subjects. AB - On this randomized, double-blind trial we investigated the effect of RU41740, a glycoprotein extracted from Klebsiella pneumoniae, on human neutrophil function after oral administration to elderly subjects with a previously demonstrated phagocytic defect. Six subjects were given RU41740 orally at a daily dose of 2 mg for one week the first month and of 1 mg for one week the second month, while six subjects received placebo. Already after the first week of treatment with RU41740 (T1) and more evidently 3 weeks after the last administration of the first course of therapy (T2), a significant improvement of the neutrophil phagocytic capacity was observed; at the time T2, as well as at the end of the second course of therapy (T3), the phagocytic capacity was completely restored with no differences between control and aged subjects. Similar results were obtained in the chemiluminescence assays. As expected, placebo had no significant effect on neutrophil functions. No significant differences were observed between the two group of elderly subjects for total or differential leukocyte number. These results suggest that RU41740 exerts, almost in part, its clinical effect, i.e. the prevention of recurrent infections, by stimulating blood neutrophil phagocytic function. PMID- 1772106 TI - Antibodies to hepatocyte derived antigens and liver damage in patients after bone marrow transplantation. AB - The follow-up sera from 33 patients who received allogenic bone marrow transplantation (BMT) were tested by ELISA for antibodies to liver derived antigens present in a macromolecular, lipid associated, protein complex (LSP). Anti-LSP were found in 20% of patients with graft-vs-host disease (1 with acute GVHD, 3 with chronic GVHD), but in none of the 13 patients without GVHD. Lymphocytotoxic antibodies (LCTA) were frequently detected with similar prevalence in patients with and without GVHD. In the 4 anti-LSP +ve cases, LCTA serum levels did not follow the trend of anti-LSP antibody levels. Liver biopsy was performed in 10 patients with clinical and biochemical sign of GVHD and showed features of hepatic GVHD in six cases; although piecemeal necrosis was present in 3 cases, anti-LSP were detected only in one patient. An anti-LSP response can be elicited in patients after BMT only during GVHD, with no relationship to LCTA and without a close association with signs of periportal hepatocyte damage. PMID- 1772107 TI - Immunological studies of renal allograft recipients treated with total lymphoid irradiation. AB - It is well known that highly sensitized patients and/or high responders, even under CsA therapy, constitute a risk category for transplantation. Based on this evidence, in 1982, our group initiates a pilot study using total lymphoid irradiation (TLI) as a pre-transplant modulator of patient's immuno-response. TLI has been employed in 30 uremic, non diabetic, patients. During this experience the first protocol, characterized by pre-transplant TLI greater than 2,000 rads (13 pts.) and post-transplant conventional therapy, was abandoned because of the severe TLI side effects. In the second protocol TLI dose never exceeded 2,000 rads and CsA was given, at initial dose of 7-12 mg/Kg/day according to CsA blood through levels. The immunological monitoring was performed during TLI treatment and in the postoperative clinical course by cell markers profile determination and functional assays. The data obtained have demonstrated that TLI treatment causes a prolonged depression in CD4 positive cells, a predominant recovery of T suppressor population, a pronounced impairment of T functions and a development of specific unresponsiveness to donor antigens. Furthermore the TLI plus CsA protocol, showing an additive effect which steadily decreases patient immunoreactivity, a lack of side effects and a stable long term graft function seems to be a more useful method for transplantation in high-risk or in strongly immunoreactive patients. PMID- 1772108 TI - Angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) in a patient with food allergy. PMID- 1772109 TI - Comparative specificity and sensitivity evaluation of a rapid test for the detection of anti HIV antibodies (Test Pack). PMID- 1772110 TI - Drug delivery systems. AB - New and emerging drug delivery systems for traditional drugs and the products of biotechnology are discussed, and the role of the pharmacist in ensuring the appropriate use of these systems is outlined. Advantages of advanced drug delivery systems over traditional systems are the ability to deliver a drug more selectively to a specific site; easier, more accurate, less frequent dosing; decreased variability in systemic drug concentrations; absorption that is more consistent with the site and mechanism of action; and reductions in toxic metabolites. Four basic strategies govern the mechanisms of advanced drug delivery: physical, chemical, biological, and mechanical. Oral drug delivery systems use natural and synthetic polymers to deliver the product to a specific region in the gastrointestinal tract in a timely manner that minimizes adverse effects and increases drug efficacy. Innovations in injectable and implantable delivery systems include emulsions, particulate delivery systems, micromolecular products and macromolecular drug adducts, and enzymatic-controlled delivery. Options for noninvasive drug delivery include the transdermal, respiratory, intranasal, ophthalmic, lymphatic, rectal, intravaginal, and intrauterine routes as well as topical application. Rapid growth is projected in the drug delivery systems market worldwide in the next five years. Genetic engineering has mandated the development of new strategies to deliver biotechnologically derived protein and peptide drugs and chemoimmunoconjugates. The role of the pharmacist in the era of advanced drug delivery systems will be broad based, including administering drugs, compounding, calculating dosages based on pharmacokinetic and pharmacodynamic monitoring, counseling, and research. The advent of advanced drug delivery systems offers pharmacists a new opportunity to assume an active role in patient care. PMID- 1772111 TI - Drug product distribution systems and departmental operations. AB - Technologies affecting institutional pharmacy practice and the operation of pharmacy departments are reviewed, future developments are outlined, and implications of these developments for pharmacy education are proposed. Computer technology, especially as applied to areas such as artificial intelligence, online information databases, electronic bulletin boards, hospital information systems, and point-of-care systems, will have a strong impact on pharmacy practice and management in the 1990s. Other areas in which growth is likely to be active include bar-code technology, robotics, and automated drug dispensing. The applications of these technologies are described, with particular attention placed on the effects of increased automation on the drug-dispensing function. Technological advances may effect marked reductions in dispensing and medication errors; questions concerning the cost-effectiveness of these new systems remain to be answered. These advances also create new opportunities for clinical involvement by pharmacists; however, a fundamental understanding of computer systems is essential. Current practitioners can benefit from attending seminars, participating in users' groups, and keeping current with the computer literature. Many students now acquire the needed skills in computer laboratories and in the classroom. Technological advances will offer the opportunity for pharmacists to expand their clinical role. PMID- 1772112 TI - High-technology i.v. infusion devices. AB - Some of the newer high-technology infusion devices commercially available or under development are described. The range of infusion devices includes both controllers and pumps; pumps can be classified by mechanism of operation (peristaltic, syringe, cassette, elastomeric reservoir), frequency or type of drug delivery (continuous or intermittent infusion, bolus dosing, single- or multiple-solution delivery), or therapeutic application (such as the patient controlled analgesia, or PCA, pump). Advances in infusion technology and computer technology have led to the development of devices with extremely sophisticated drug-delivery capabilities (multiple-rate or multiple-solution programming, operation as pump or controller, or both, and interchangeable applications and settings). Current research in infusion-device technology is focusing on implantable pumps, pumps with chronobiological applications, osmotic-pressure devices, and open- and closed-loop systems. Pharmacists need to keep abreast of the rapidly changing intravenous device marketplace to provide clinical expertise and leadership in the review and evaluation of high-technology drug delivery systems. PMID- 1772113 TI - Research and development of drugs and biologic entities. AB - Uses of and problems associated with the products of biotechnology are described, and implications of the new technology for pharmacy practice and education are outlined. Biotechnology is the application of biological processes to the generation of new therapeutic and diagnostic drug products and vaccines. More than 100 biotechnology products are under development in the United States. Sixteen products, including 13 therapeutic agents and three vaccines, have been marketed. The largest category of biotechnology products now in development is monoclonal antibodies; nearly half of these are targeted for cancer therapy. The second largest group of agents undergoing clinical trials is vaccines. Showing particular promise are products such as colony-stimulating factors and growth factors, which may offer therapy for conditions that are currently untreatable. Problems intrinsic to the products of biotechnology include their short half lives, difficulties associated with delivering the product in a timely fashion to a specific site, and, in the case of vaccines, the ability of the target organisms to change their structure. Ethical and economic considerations complicate decisions facing those concerned with the rational use of these products. Preparing pharmacy students and practitioners to take a lead role in the use of the products of biotechnology will require substantial modifications in pharmacy education and training at all levels. While some schools of pharmacy have instituted major curriculum revisions to accommodate such needs, others have yet to respond to the challenge of biotechnology. Biotechnology offers increasing opportunities for pharmacists to take an active role in therapeutic decision making, drug delivery, and the education of their health-care colleagues and of patients. PMID- 1772114 TI - Pharmacists' knowledge of infusion devices. AB - Results of a mail survey of pharmacists' knowledge of infusion-device technology are presented. In order to develop recommendations on how to prepare pharmacists to take responsible roles in the use of infusion devices, a survey was mailed to 576 directors of pharmacy in hospitals and home health-care companies, deans of pharmacy schools, and executives of state pharmaceutical associations. A total of 237 responses (41.2%) was received. Directors in both hospital and home health care settings predicted increases in the use of infusion devices in their respective settings within the coming five years. Practitioners and deans concurred that pharmacy schools are not providing adequate instruction in the use of these devices. All four groups of respondents believed that the competencies most essential in the use of these devices are knowledge of therapeutic applications and the ability to select the most appropriate pump to meet clinical needs. Use of drug-infusion technology will increase in the coming five years, and undergraduate, postgraduate, and inservice pharmacy curricula must prepare pharmacists to use it appropriately. PMID- 1772115 TI - Mas oncogene receptor coupling and peptide specificity in Balb 3T3 and vascular smooth muscle cells. AB - The mas oncogene receptor has been reported to confer angiotensin (Ang) responsiveness in NG115-401L neuronal cell line. To test if mas oncogene encodes an Ang receptor in peripheral tissue, Balb 3T3 and rat aortic vascular smooth muscle cells (VSMC) were cotransfected with a plasmid containing the mas oncogene (pSM422) and a plasmid expressing a selectable marker (pRSV-Neo). Transfected cells (Balb/mas and VSMC/mas) expressed the appropriate 2.4 Kb mas transcript, which was not present in parental cells. Both Balb/mas and VSMC/mas cells acquired Ang II and Ang III responsiveness as documented by Ang-stimulated increased [Ca2+]i. The ED50 for these peptides were relatively high (4 - 6 x 10( 5) M). Ang III was approximately two times more potent than Ang II in stimulating 45Ca efflux from Balb/mas cells, and its effect was not blocked by Sar1, Ile8-Ang II. In contrast, substance P and a substance P analogue ([D-Arg1, D-Pro2, D Trp7,9, Leu11] substance P) behaved as agonists, resulting in the stimulation of 45Ca efflux and [Ca2+]i in Balb/mas cells without affecting control cells. The rank order potency for stimulating 45Ca efflux in Balb/mas cells was substance P analogue much greater than Ang III, substance P greater than Ang II. In summary, the authors show that although Ang III can stimulate biochemical events in mas transfected cells, which are known to be essential for Ang receptor signal transduction in other cell types, ie, [Ca2+]i and pHi transients, as well as inositol triphosphate formation, it did that at supraphysiological concentrations of the peptide. PMID- 1772116 TI - In vitro and in vivo characteristics of a heme oxygenase inhibitor: ZnBG. AB - The authors evaluated the in vitro and in vivo efficacy and photosensitizing effects of zinc deuteroporphyrin 2,4-bis glycol (ZnBG) as an inhibitor of adult Wistar rat tissue heme oxygenase (HO) activity and bilirubin production. Concentrations of 0.02-0.05 microM ZnBG inhibited the HO activity in postmitochondrial supernatants of liver, spleen, brain, and kidney by at least 50%. Administration of 4 mumole ZnBG/kg body weight to adult rats significantly reduced the total body carbon monoxide (CO) excretion, an index of bilirubin formation, from 1 to 6 hours posttreatment. At 6 hours posttreatment, the HO activity in postmitochondrial supernatants of the liver and spleen, but not of the brain, was significantly lowered. ZnBG also behaved as an in vitro photooxidizer by degrading, in the presence of cool white light, the reduced form of nicotinamide adenine dinucleotide phosphate and histidine to CO and other nonidentified products. ZnBG also enhanced the natural photodegradation of bilirubin. Furthermore, administration of ZnBG to 1-day-old neonatal rats caused mortality within 12 hours in light-exposed animals, with a lethal dose 50 of 23 microM/kg body weight. PMID- 1772117 TI - Measurement of plasma total renin by the anti-human renin monoclonal antibodies. AB - The authors evaluated the assay performances and clinical usefulness of a newly developed solid phase radioimmunoassay (RIA) for total renin concentration (TRC) in human plasma. The direct total renin RIA was performed by a sandwich technique with a pair of anti-human renin monoclonal antibodies. Renin activation with trypsin did not change TRC. The RIA showed satisfactory assay performances and demonstrated full compatibility with a direct RIA-kit for active renin concentration (ARC) in human plasma. The values of TRC were 105.3 +/- 8.6 pg/mL in normal subjects and 136.5 +/- 14.6 pg/mL in patients with essential hypertension. The values of TRC and the ratios of ARC to TRC were high in patients with renovascular hypertension and were low in patients with primary aldosteronism. Although the TRC value in diabetic patients was 134.4 +/- 14.8 pg/mL, the ratio of ARC to TRC was low. The RIA procedure was simple since prior purification or activation of renin was not required. These results suggest that the total renin RIA and its combined use with the active renin RIA may be helpful in understanding the renin-angiotensin system in human plasma. PMID- 1772118 TI - Short courses of antibiotics in selected febrile neutropenic patients. AB - To evaluate their policy of discontinuing broad spectrum antibiotics in patients with negative cultures who become afebrile but remain neutropenic, the authors retrospectively reviewed the charts of all pediatric patients diagnosed with cancer between 1980 and 1986. Two hundred seventy-one children had 385 admissions for infectious complications during the study period. In 39 of those episodes (9%), the patients had negative cultures, became afebrile, and were discharged with absolute neutrophil counts of less than 1000 cells/mm3 (mean 390 cells/mm3). They received relatively short courses of antibiotics with a median duration of 4 days. Only four of these patients became febrile during the followup period and there were no fatalities. Given the benign course of these patients, recommendations for prolonged antibiotic courses should be reconsidered. PMID- 1772119 TI - Improving handwashing habits in the newborn nurseries. AB - In five separate sessions over a 13-month period, the authors monitored the handwashing habits of doctors, nurses, and other healthcare professionals in the nursery. Compliance rates regarding three specific items related to handwashing prophylaxis were noted by a group of observers without the knowledge of the subjects involved. Good handwashing prophylaxis was carried out by the doctors only 37.5% prior to handling infants, and 29.2% after contact with inanimate objects, whereas for these items the nurses complied 53.9% and 29.2%, respectively. Wrist ornaments were removed prior to handwashing in 72.7% and 75.3% of contacts. The data for other healthcare professionals were generally similar. The information from this study was used for educational purposes, which seemed to have had an impact on handwashing habits. The compliance rates during the later part of the study for the first two items combined improved from 28.4% to 62.6% (p less than 0.001). The authors conclude that in the newborn units, the compliance with handwashing is generally poor. They believe that with continued monitoring and educational efforts, it may be possible to improve habits regarding handwashing prophylaxis. PMID- 1772120 TI - The interrelationship between salivary epidermal growth factor and the functional integrity of the esophageal mucosal barrier in the rat. AB - The role of salivary epidermal growth factor (sEGF) in the maintenance of the esophageal mucosal mucus coat and its permselective properties was investigated for this study. Eighteen Sprague-Dawley male rats underwent sialoadenectomy (SAD), while 18 others with sham operation served as a control. Nine SAD rats in each group received EGF in a dose of 15 micrograms/kg/d for five consecutive days prior to sacrifice. Esophageal mucosa dissected from the muscle layer was placed in the central port of a specially designed permeability chamber filled on both sides with equimolar solutions of NaCl or HCl (0.155 M). The rate of hydrogen ion diffusion from the mucosal to the serosal side was estimated by continuous recording of pH in the NaCl compartment. In addition, the mucosal mucus coat was evaluated by Alcian blue uptake methodology. SAD led to a 108% increase in the rate of permeability of the esophageal mucosa to hydrogen ion. Simultaneously, an 83% decrease in the mucus content on the surface of the esophageal mucosa was observed. A five-day supplementation of EGF substantially improved the permeability of esophageal mucosa (67%) and the mucous layer of esophagus (41%). sEGF seems to play an important physiological role in the maintenance of the functional integrity of the esophageal mucosa. PMID- 1772121 TI - Case report: heterogeneity of aldolase B in hereditary fructose intolerance. AB - Hereditary fructose intolerance (HFI) is a recessive genetic disorder with an estimated disease frequency of 1 in 20,000 and a carrier frequency of 1 in 70. Affected individuals are unable to assimilate fructose from fruit sugars and may develop severe hypoglycemia, metabolic problems, and death if misdiagnosed. Those who survive childhood learn to avoid sweets, effectively preventing further symptoms and complications. The disease is caused by a genetically defective hepatic enzyme, aldolase B. Traditionally, diagnosis has been made by intravenous fructose challenge or by liver biopsy, both difficult and risky invasive tests. Identification of mutations of the aldolase B gene by analysis of DNA from blood leukocytes is now possible, allowing for potential noninvasive diagnosis of subjects at risk in the future. The authors demonstrate heterozygosity for an aldolase B gene mutation in a patient with HFI. PMID- 1772122 TI - Case report: isoimmune inhibition of erythropoiesis following ABO-incompatible bone marrow transplantation. AB - A 26-year-old ABO-O positive patient with aplastic anemia received a bone marrow transplant from his genotypically HLA identical, but ABO-A positive, brother. Engraftment of myeloid and megakaryocytic lineages occurred within 4 weeks but pure red cell aplasia and transfusion dependent anemia persisted for 160 days. The authors postulated that the failure of erythropoiesis was due to a high titer of anti-A isohemagglutinins. They tested this hypothesis with clonal cell cultures and flow cytometric analysis of ABO antigen expression by colony forming cells in vitro. During the period of prolonged red cell aplasia, the patient had normal numbers (85 +/- 12 per 10(6) cells) of circulating donor derived, burst forming units-erythroid (BFU-E). Immunophenotypic analysis of erythroid burst colonies derived from culture of the patient's bone marrow cells showed that 91 +/- 5% of 274 nucleated red cells were A-antigen positive, confirming full donor engraftment. Autologous plasma and complement added on day 1 of culture did not affect the colony growth (82.5 +/- 15 per 10(6) cells). However, when the addition of complement was delayed until day 7 of culture, there was 90% inhibition of BFU-E (7.5 +/- 5 per 10(6) cells) compared to controls (p less than 0.0004). Based on this, the authors propose a model for expression of ABO antigens during erythropoiesis, in which BFU-E do not express ABO antigens but their progeny do. The data support the hypothesis that the mechanism of prolonged pure red cell aplasia after ABO-incompatible bone marrow transplantation is complement mediated immune destruction of erythroid progenitors past the stage of BFU-E in differentiation. PMID- 1772124 TI - Case report: intermittent, positive pressure ventilation-dependent right bundle branch block. AB - A 73-year-old man with severe chronic obstructive pulmonary disease and cor pulmonale developed an intermittent right bundle branch block (RBBB) during mechanical ventilation. The appearance and disappearance of his RBBB was temporally associated with each positive pressure breath. Intermittent RBBB is a previously undescribed complication of positive pressure ventilation. PMID- 1772123 TI - Case report: splenic infarction and acute splenic sequestration in adults with hemoglobin SC disease. AB - While acute splenic sequestration and splenic infarction are commonly observed in infants and young children with sickle cell anemia, they are rarely experienced by adult hemoglobin S homozygotes because the recurrent splenic infarction that takes place during childhood is typically followed by scarring, atrophy, and splenic fibrosis. Both acute splenic sequestration and splenic infarction do remain relatively common in adults with the other sickle hemoglobinopathies. These episodes are almost certainly a consequence of the persistently enlarged and distensible spleens that often remain present in these conditions. In this report, the authors describe two adult patients with hemoglobin SC disease: one who developed acute splenic sequestration and one with splenic infarction. In neither case was there a history of recent air travel or exposure to altitude. The clinical course of these two syndromes is presented, and the hematologic, radiologic, and pathologic manifestations are discussed. Because they can sometimes be difficult to distinguish from one another, and because a failure to identify acute splenic sequestration can be catastrophic, these two entities must be included in the differential diagnosis for any hemoglobin SC patient who present with an unexplained fall in hemoglobin, left upper quadrant pain, unexplained fever, or symptomatic splenomegaly. PMID- 1772125 TI - Case report: disseminated Mycobacterium gordonae infection in a nonimmunocompromised host. AB - Mycobacterium gordonae is considered the least pathogenic of the Runyon Group II mycobacteria, although there are now well-documented reports of infection varying from localized soft tissue infection to disseminated life threatening diseases. We report a 40-year-old Pakistani housewife, treated in childhood for tuberculosis, who presented with severe systemic illness, fever, ascites, hepatomegaly, persistent dysuria with sterile pyuria, pulmonary disease, and anorexia with weight loss. Liver biopsy histology showed multiple granulomata and multiple isolation of M. gordonae from sputum and urine, in keeping with disseminated mycobacterial infection. She had dramatic response to antituberculosis therapy with streptomycin, isoniazid, rifampicin, and pyrazinamide. No evidence existed for disturbed humoral or cellular immunity and HIV infection. This represents the fifth reported case of disseminated M. gordonae infection, the first from the Arabian Gulf. It was treated successfully with standard antituberculosis regimen. PMID- 1772126 TI - Initial treatment of pulmonary edema: a physiological approach. AB - An understanding of the physiological principles involved in lung fluid balance is useful in the initial treatment of pulmonary edema. Normally, a very small volume of fluid is filtered from the pulmonary vasculature into the interstitial space. This interstitial fluid enters the pulmonary lymphatics and is transferred to mediastinal lymphatics at an estimated rate of 20 ml/hr. Under abnormal circumstances, fluid filtration may occur at such a rapid rate that it overwhelms the lymphatics and interstitial space and results in alveolar flooding. This may occur as a result of increased pulmonary vascular pressure or increased vascular permeability. The two general goals of initial therapy are (1) to relieve hypoxemia and (2) to reduce pulmonary capillary pressure. Relieving hypoxemia may require the use of supplemental oxygen by nasal prongs or mask, continuous positive airway pressure (CPAP) mask, or even endotracheal intubation and mechanical ventilation. Measures to decrease preload and thereby reduce pulmonary capillary pressure include sitting the patient up, administering a loop diuretic or morphine intravenously, and in some circumstances using sublingual nitroglycerin. After initial treatment is underway, a search for and specific management of the underlying cause of pulmonary edema can proceed. PMID- 1772127 TI - Selegiline in the treatment of Parkinson's disease. PMID- 1772128 TI - Hepatitis B--molecular variants with clinical significance? AB - Mutations in the DNA of the hepatitis B virus have been discovered and they may have clinical significance. A single nucleotide substitution resulting in a premature stop codon in the pre-core region of the hepatitis B genome is the most common change. The premature stop codon prevents the synthesis of hepatitis B e antigen (HBeAg), a virally encoded protein normally secreted by hepatocytes. The mutant hepatitis B virus was initially discovered in patients who lacked HBeAg in the serum yet had high levels of hepatitis B viral DNA, a marker of active viral replication usually found in association with the continued presence of HBeAg. Other studies demonstrated that the mutant forms were observed with increasing frequency during the successful conversion from HBeAg positivity to anti hepatitis B e antibody (anti-HBe) positivity. The mutant form of hepatitis B virus was not identified in patients with stable chronic hepatitis B who were positive for HBeAg or in any patients with uncomplicated acute hepatitis B, regardless of the presence of HBeAg or anti-HBe. However, mutant hepatitis B virus was detected in patients with fulminant hepatitis B who lacked both HBeAg and anti-HBe. The lack of HBeAg in the serum therefore may result in a more severe form of acute disease. Together with experimental animal studies of the normal role of HBeAg, these data suggest that serum HBeAg may be associated with immunologic tolerance, whereas clearance of or lack of HBeAg may be associated with an active immunologic response. Future studies are expected to clarify the role of mutant forms of hepatitis B virus in the natural history of hepatitis B infection. PMID- 1772129 TI - [Quantitative histologic studies of the gonads of sand rats (Psammomys obesus) during the development of diabetes mellitus]. AB - Quantitative-histological investigations (point counting method) are pointed out in 27 male and 15 female sand rats. The animals are divided in the IGT (impaired glucose tolerance), the diabetic and the control group. The LEYDIG cells are in the IGT-group increased, and in the diabetic group decreased. The female sand rats are characterized by the tendency of increase of size and number of follicles in the IGT-group. Corpora lutea are reduced but atretic follicles are increased in the diabetic group. The ovaries are greater in diabetic sand rats. PMID- 1772130 TI - Distribution of the cells of primary afferent fibers to the cat auricle in relation to the innervated region. AB - The origin and peripheral distribution of the primary afferent fibers to the cat auricle were studied by the horseradish peroxidase (HRP) method. Following HRP injection into the whole region of the auricle, HRP-labeled cells were found ipsilaterally in the trigeminal ganglion, geniculate ganglion, superior ganglion of the vagus nerve and in the C1 to C4 spinal ganglia. In addition to the ganglia of cranial and spinal nerves, labeled cells were also observed in the facial nerve trunk and in the dorso-lateral portion of the superior cervical ganglion. In the case of HRP injection into the central region of the auricle, labeled cells were principally observed in the ganglia of cranial nerves and to a lesser degree in the spinal ganglia. On the contrary, in the case of HRP injection into the peripheral region of the auricle, labeled cells were principally observed in the spinal ganglia, although some were seen in the ganglia of cranial nerves. This study suggests that the cutaneous innervation of the auricle is supplied by both the cranial and spinal nerves, and that the central region of the auricle is strongly innervated by the cranial nerves and the peripheral region of the auricle is strongly innervated by the spinal nerves. PMID- 1772131 TI - Stability of motor neuron and interneuron number in the hypoglossal nucleus of the ageing mouse brain. AB - The number of motor neurons and interneurons in the hypoglossal nucleus was estimated in mice aged 6, 15, 25, 28 and 31 months. The number of motor neurons (overall mean 974) and interneurons (overall mean 125) did not vary significantly with age. Possible reasons for neuron number remaining stable with age were discussed. PMID- 1772132 TI - Immunohistochemical localization of serotonin in the pineal gland of the chicken during post-hatching development in relation to light-dark cycle. AB - In the present immunohistochemical study using an antiserum against serotonin, the localization of serotonin was demonstrated in the pineal gland of the chickens from 1 day to 3 years of age. Serotonin-like immunoreactivity was located in the supranuclear region of the follicular cells and in the perikaryon of the parafollicular cells in the pineal gland, exhibiting distinct changes during post-hatching development. The reactivity reached its peak in 1-year-old chicken. Moreover, diurnal changes in immunoreactivity also existed after 1 day of age, being high in the light period and low in the dark period. Occasionally in 1-3-year-old chickens, a part of granular-shaped reactive products observed in the light period appear to be diffused in the cytoplasm in the dark period. In addition, a number of immunoreactive fibers were shown in the pineal parenchyma, exhibiting a slight increase in number and in reactivity at 40 days of age. PMID- 1772133 TI - Light- and electron-microscopic studies on isolated bovine islets of Langerhans. AB - While several recent studies have focussed on the critical assessment of yield, purity and function of isolated islets, fine-structural investigations of isolated islets have been the subject of only a few studies. After intraductal injection of collagenase solution, the distended bovine pancreata were processed in a continuous digestion-filtration device, after which the purification of the islet suspension was accomplished by density gradient centrifugation. Purified islets were then prepared for light- and transmission electron-microscopic analysis. In semithin sections, no evidence of either connective tissue or exocrine tissue surrounding isolated islets was found. Endocrine cells exhibiting cytoplasmic granules were packed in clusters varying in size. In ultrathin sections, A-cells containing numerous secretory granules were distinctive; their cytoplasm contained conspicuous formations of rough endoplasmatic reticulum and juxtanuclear Golgi complexes. In the B-cells, the Golgi complexes were also prominent; these elements, however, were poor in endoplasmic reticulum and displayed characteristic B-cell granules surrounded by a halo. A few ultrastructurally heterogeneous cells were scattered among the identified cellular elements. PMID- 1772134 TI - Annulated gap junctions in the rat neural tube. AB - Annulated gap junctions have been studied electron microscopically in normal rat embryo neural tube on day 12 of gestation. Localization, size and content of annulated gap junctions were characterized. Like in other tissues annulated gap junctions are thought to be involved in a degradation cycle of gap junctions. PMID- 1772135 TI - A study of lectin bindings to the fetal membranes. AB - Human tissues contain carbohydrates for a main component, functioning as a source and reservoir of energy, connective and supporting element, recognition site and related tasks. Our main interest is to reveal the synthesis and distribution of carbohydrate elements in human fetal membranes. The aim of our work was to clarify, which kinds of elements containing carbohydrates, existed in the fetal membranes. Therefore we applied a lectin-binding study using the following FITC labelled lectins: ConA, WGA, PNA, LCA, RCA. This lead to the result, that ConA, LCA, WGA and RCA produced a positive reaction in the amnion epithelium, which was negative when using PNA. The basement membrane I showed an intense fluorescence when we used ConA, LCA and WGA, using RCA it was weaker and using PNA fluorescence was nearly missing. The examination of the amniotic fibroblast and intercellular substance showed a positive reaction with all lectins, but the intercellular substance lead to weaker fluorescence. The chorionic fibroblasts, intercellular substance and basement membrane II produced fluorescence using ConA, LCA, WGA and PNA, but no reaction could be examined, when using RCA. The trophoblastic cells did not react with LCA and RCA. The intercellular substance reacted positively with all lectins. PMID- 1772136 TI - [The surgical approach to the cochlear nucleus area]. AB - The stimulation of the proximal auditory nerve or the Cochlear Nuclear Complex (CNC) situated in the lateral recess of the fourth ventricle is a possibility of hearing rehabilitation for patients suffering from bilateral deafness by bilateral cerebellopontine-angle tumors or by transsections of cochlear nerves on both sides. Using such anatomical landmarks as proximal cochlear nerve, flocculus, choroid plexus and taenia the surgeon can locate exactly the CNC for this stimulation. We investigated location, diameter and surrounding structures of the CNC on 10 human brains fixed in 10% formalin-solution and on 9 histological series of these subjects. PMID- 1772137 TI - Comparison between swim-up and glass bead column techniques for the separation of human spermatozoa. AB - The glass bead column filtration method was compared with the swim-up technique regarding spermatozoa recovery in normal and pathological human semen. The general characteristics of the semen and the spermatic ATP concentration were measured in 67 patients. Samples processed with glass bead columns provided a good amount of motile forms which however, showed less velocity and linearity than in the case of using the swim-up technique. Additionally, the ATP determination in spermatozoa was included. PMID- 1772138 TI - Influence of cryopreservation on the microelectrophoretic motility (EPM) of human spermatozoa. AB - The net surface charge of spermatozoa represents a characteristic of the plasmamembrane. It can be evaluated indirectly, by the measurement of the sperm electrophoretic motility (EPM). The EPM of washed human spermatozoa was determined in the microelectrophoresis to investigate three problems: (a) intra- and interindividual variation coefficients of EPM of cryopreserved spermatozoa, (b) effects of cryopreservation medium, temperature shock and cryoprotection on the EPM, (c) relationship between the EPM and the cryotolerance of the spermatozoa. The inter- and intrain-dividual variation coefficients of the sperm EPM of 24 cryopreserved semen samples of 6 fertile semen donors amounted to 7% and to 6%, respectively. The cryopreservation did not cause a significant change of sperm EPM in contrast to the temperature shock in liquid nitrogen. Temporary incubation of spermatozoa with egg yolk decreased their EPM. A significant correlation between EPM and the cryotolerance ascertained by the alteration of sperm motile efficiency could be found. After contact with egg yolk spermatozoa achieved a behaviour that corresponded to a better cryotolerance. PMID- 1772139 TI - Antifertility effects of sulfapyridine on male hamsters. AB - Sulfapyridine was administered to mature male golden hamsters either by impregnation in feed pellets, or by subcutaneous injection as a solution in dimethylsulfoxide. The average litter size for control males was 8.3 +/- 3.3 (n = 13) vs. 4.2 +/- 2.7 (n = 11) for sulfapyridine-fed treated animals. Histology of the testis and epididymis was normal and sperm were normal in morphology and motility. Subcutaneous injection of sulfapyridine caused much more dramatic inhibition of male fertility than was achieved by feeding the drug. Sulfapyridine (750 mg/kg body weight in 0.2 ml DMSO) injected subcutaneously for 60 days was effective in reducing testis size and sperm quality. Histology of testes showed spermatogenic arrest at young spermatids. Two classes of animals were found in both sulfapyridine-fed and -injected treatment groups. One class was relatively resistant to the antifertility effects of the drugs. This difference may reflect differing abilities of the animals to convert sulfapyridine to an active form or to excrete its metabolites. PMID- 1772140 TI - Increased plasminogen activator activity and plasminogen activator inhibition in spermatozoa and seminal plasma of the ram after serum gonadotrophin (PMSG) administration. Correlation with the increased level of testosterone in the blood. AB - After a single injection of serum gonadotrophin (PMSG) at the dose of 15 IU/kg, i.m. into rams testosterone in the plasma of blood showed a significant rise between 4th and 7th day post-injection. At the same time (4th-7th day) the plasminogen activator activity (PAA) in seminal plasma was found to be increased, but the plasminogen activator inhibition (PAI) expressed against t-PA (anti-t-PA) showed an increase between 32nd and 46th day. In spermatozoa a marked increase of PAA was revealed between 32nd and 46th day post-injection, while an increase of PAI (anti-t-PA) was exhibited on the 74th day. Plasmin inhibition (PI) in seminal plasma and spermatozoa showed no change compared to controls. A positive correlation has been found between increased concentrations of testosterone and PAA or PAI (anti-t-PA) in spermatozoa and seminal plasma. The induced increase of PAA in spermatozoa under the effect of testosterone might be of physiological importance, since PAA is localized to sperm membranes and might participate in the whole process of fertilization. PMID- 1772141 TI - Neuron-specific enolase-like immunoreactivity in human Leydig cells. AB - Using the peroxidase anti-peroxidase immunocytochemical technique, neuron specific enolase (NSE)-like immunoreactivity (NSE-LI) was revealed in Leydig cells of adult human testes at the light microscopic level. Differences in the NSE staining intensity were observed between the individual Leydig cells, separate cell groups within a testis and between the testes of individual patients. Together with the already established substance P-like immunoreactivity (SP-LI), the results obtained provided further evidence for the possible neuroectodermal origin of human Leydig cells and their presumable relation to the APUD- or the Diffuse Neuroendocrine System (DNES). PMID- 1772142 TI - Achievement of spermatogenesis and genital tract maturation in hypogonadotropic hypogonadic subjects during long term treatment with gonadotropins or LHRH. AB - 15 subjects with Hypogonadotropic Hypogonadism (HH) were treated with either gonadotropins (13 cases) or pulsatile subcutaneous Luteinizing Hormone Releasing Hormone (LHRH) (2 cases) for up to 42 months, to study the effects of therapy step by step. The following results were obtained: (A) In postpubertal HH (5 cases = Group A), therapy brought about onset of spermatogenesis within 3 months and its normalization within 6 months. In HH of prepubertal onset (10 cases = Group B), spermatogenesis started within 9 to 21 months and became normal in only 3 cases after at least 18 months. The best sperm counts were obtained in Group A in the third month of treatment (41.75 +/- 43.68 mil./ml) and in Group B in the 36th month (14.87 +/- 17.06 mil./ml). Sperm motility was normal in the majority of the cases in Group A from the beginning but did not become normal in Group B. (B) Seminal fructose and zinc were normal from the beginning of therapy in 66% of the cases in both groups. Zinc became normal in 100% within 3 months in Group A, in Group B within 18. Carnitine was normal in 50% of cases in both groups, contemporaneous with sperm appearance. Transferrin was normal in Group A after appearance of spermatozoa, but in Group B never became normal. (C) We hypothesize that the recovery of fertility passes through the following stages: (1) Functional recovery of Leydig cells, followed by seminal vesicles and prostate. (2) Recovery of epididymal function, which probably implies beginning of the tubular function. Recovery of Sertoli cell function occurs with more difficulty. PMID- 1772143 TI - Assisted reproductive technologies may obviate apparent immunologic infertility. AB - Spermatozoal autoantibodies have been associated with reduced fertilization by natural coital methods. Nine subfertile men were evaluated who repeatedly tested positive for spermatozoal autoantibodies as characterized by direct immunobead test. Using the hemizona assay, we determined whether tight binding of spermatozoa to the zona pellucida was reduced in these test males as compared to a fertile male whose semen had been cryopreserved and thawed immediately prior to testing. The average number of spermatozoa tightly bound to the zona pellucida from the subfertile male was significantly reduced compared to the fertile male (mean +/- SD, P less than or equal to 0.01) 19.5 +/- 8 versus 77.1 +/- 49. Seven of the nine couples eventually had successful fertilization using intrauterine insemination or gamete intrafallopian tube transfer and one couple conceived with natural coital insemination. Our findings, albeit limited, suggest that greater caution should be used in implicating associations of spermatozoal autoantibodies with absolute infertility, because novel assisted reproductive technologies often may obviate conventional encumbrances on opportunities for pregnancy. PMID- 1772144 TI - Testicular suspension: effect on testicular function. AB - The present communication studies the testicular function during suspension of the testicle to the scrotal neck. The material consisted of 28 dogs: 20 test dogs and 8 controls. In the 20 test dogs, the 2 testicles were suspended to the skin at the scrotal neck by 2-3 silk stitches. After one year, the testiculo-scrotal suspension was released. During testicular suspension, there was significant drop in the scrotal-rectal temperature difference. Semen quality showed gradual deterioration so that by the 12th month, 80% of the test dogs were azoospermic. There was a significant drop of serum testosterone and elevation of serum prolactin. 8 of the 20 test dogs which produced pregnancy when mated before testicular suspension, failed after suspension. After release of testicular suspension by 3 months, scrotal-rectal temperature difference, sperm count and morphology and hormonal assay showed normal levels. Mating of the same 8 dogs produced pregnancy. In conclusion, testicular suspension leads to spermatogenic depression and infertility which are reversible. PMID- 1772145 TI - Germ cell DNA quantification shortly after IR laser radiation. AB - The immediate effect of IR laser radiation on rat germ cells was studied by cytophotometric quantification of the nuclear DNA content in testicular sections. Two different levels of radiation were studied: one according to clinical application (28.05 J/cm2) and another known to increase the germ cell number (46.80 J/cm2). The laser beam induced changes in the germ cell DNA content depending on the cell type, the cell cycle phase and the doses of radiation energy applied. Following irradiation at both doses the percentage of spermatogonia showing a 4c DNA content was increased, while the percentage of these with a 2c DNA content was decreased. Likewise, the percentages of primary spermatocytes with a DNA content equal to 4c (at 28.05 J/cm2), between 2c and 4c (at 46.80 J/cm2) and higher than 4c (at both doses) were increased. No change in the mean spermatid DNA content was observed. Nevertheless, at 46.80 J/cm2 the percentages of elongated spermatids with a c or 2c DNA content differed from the controls. Data show that, even at laser radiation doses used in therapy, the germ cell DNA content is increased shortly after IR laser radiation. PMID- 1772146 TI - Penile fracture: emergency surgery for preservation of penile functions. AB - Traumatic rupture of the corpus cavernosum is a rare injury and occurs following a blunt trauma on erected penis. We herewith present 16 cases which underwent a uniform emergency operation. With this strategy we observed no complications, and all penile functions including erection were preserved. PMID- 1772147 TI - Gonads and genital ducts in a case of male pseudohermaphroditism. AB - We describe a patient with a 46,XY karyotype, ambiguous external genitalia and partial 17a-hydroxylase deficiency in whom we performed a light microscopic study of the gonads and genital ducts. The right and left testes and epididymides were hypoplastic whereas the right vas deferens was normal, the left one was atretic and a left infundibular remnant was also present, which could be due to a concomitant deficiency in testicular secretions in the early stages of embryonic development or to the possibility of receptor insensitivity for testicular hormones or to a concomitant gonadal dysgenesis. PMID- 1772148 TI - Homelessness. PMID- 1772149 TI - The epidemiology of alcohol, drug, and mental disorders among homeless persons. AB - This article describes recent research on the prevalence of alcohol, drug, and mental (ADM) disorders and the characteristics of homeless substance abusers and persons with mental illness. Methodological problems in homelessness research are reviewed, particularly in relation to definitions of homelessness and sampling- and case-ascertainment methods. Prevalence rates of ADM disorders are much higher in homeless groups than in the general population. As is true of homeless people in general, homeless substance abusers and mentally ill persons are characterized by extreme poverty; underutilization of public entitlements; isolation from family, friends, and other support networks; frequent contact with correctional agencies; and poor general health. Knowledge of these disadvantages should be used to advocate for better services to prevent homelessness and support homeless people. PMID- 1772150 TI - A decade of research and services for homeless mentally ill persons. Where do we stand? AB - Over the past decade, researchers have documented the range of needs and devised new methods for increasing our understanding of the homeless severely mentally ill population. Clinicians have developed an appreciation of the difficulty and complexity of effectively treating this population, and policymakers have become increasingly aware of the barriers to developing services and housing. In this article, the progress-to-date in research, the evolution of new service approaches, and the development of federal, state, and local policies to meet the needs of homeless mentally ill individuals are assessed. The many challenges that remain are also considered. PMID- 1772151 TI - Alcoholism, drug abuse, and the homeless. AB - Credible estimates of the prevalence of alcohol and drug abuse suggest that alcohol abuse affects 30% to 40% and drug abuse 10% to 15% of homeless persons. A review of policies that address substance abuse among the homeless finds that interventions alternate between control and rehabilitation. However, the unique needs of a changing homeless population require an integration of alcoholism and drug abuse recovery services with programs for women, adolescents, and the mentally ill. Alcohol- and drug-free housing is essential to support and maintain recovery. Psychology can contribute in the development of effective programs for homeless individuals struggling with addiction and alcoholism. PMID- 1772152 TI - Homelessness and dual diagnosis. AB - People who are dually diagnosed with severe mental illness and substance use disorders constitute 10%-20% of homeless persons. They are a heterogeneous and extremely vulnerable subgroup with complex, poorly understood needs. In this article recent research on the epidemiology, subject characteristics, and service needs of the dually diagnosed homeless population is reviewed. Also, the range of evolving approaches to providing social services, housing, and mental health and substance-abuse treatments; the relevant system issues and legal issues; and problems with current research, as well as future research directions, are discussed. The importance of the distinction between providing appropriate living environments and mental health treatments emerges throughout. PMID- 1772153 TI - Homeless women. Moving toward a comprehensive model. AB - This article uses a theoretical perspective on stress to review and organize the largely descriptive empirical literature on homeless women. From this perspective, homelessness is considered as a highly stressful circumstance, and the sources and mediators of homelessness are examined. The article suggests that more is known about the risk factors for homelessness among women than about the mediating factors that may lessen the impact of their stressful circumstances. PMID- 1772154 TI - The impact of homelessness on children. AB - This article reviews and critiques community-based research on the effects of homelessness on children. Homeless children confront serious threats to their ability to succeed and their future well-being. Of particular concern are health problems, hunger, poor nutrition, developmental delays, anxiety, depression, behavioral problems, and educational underachievement. Factors that may mediate the observed outcomes include inadequate shelter conditions, instability in residences and shelters, inadequate services, and barriers to accessing services that are available. Public policy initiatives are needed to meet the needs of homeless children. PMID- 1772155 TI - Social relationships and vulnerability to becoming homeless among poor families. AB - This study compares social relationships of 677 mothers in families requesting shelter with those of 495 mothers in housed families, randomly selected from the public assistance caseload in New York City. As hypothesized, women seeking shelter had experienced higher levels of a variety of childhood and adult events indicative of disruptions in social relationships. Contrary to our hypothesis, they were more likely than were housed mothers to have had recent contact with parents, other relatives, and friends, although they felt less able to draw on these resources for help with their current housing needs. More than three fourths of families seeking shelter had already stayed with members of their social network in the past year. The data suggest that they had used up potential sources of support before turning to public shelter. PMID- 1772156 TI - Homeless youths and HIV infection. AB - Risk of human immunodeficiency virus (HIV) infection exacerbates the already difficult lives of 1.5 million homeless adolescents in the United States. Homeless youths engage in sexual and substance-abuse behaviors that place them at increased risk of contracting HIV, and they demonstrate other problem behaviors that reduce their coping responses. Model HIV prevention programs and interventions for HIV-positive youths, implemented for homeless adolescents, need to be disseminated on a national level. Social policies must recognize adolescents' rights to satisfaction of basic survival needs; comprehensively address the needs of dysfunctional, disenfranchised, and single-parent families; and provide continuity of care for adolescents to facilitate independent living. Special provisions must be made when designing programs for gay, sexually abused, and substance-abusing youths. PMID- 1772157 TI - Homeless women with children. The role of alcohol and other drug abuse. AB - For some women with children, alcohol and other drug use may be an important risk factor for homelessness because it may interfere with a woman's capacity to compete for scarce resources such as housing, employment, or services. The impact of various policy decisions on homeless women, their dependent children, and the family unit is considered, including women's right to privacy, criminalization of drug use, and scarcity of appropriate treatment programs for homeless women. PMID- 1772158 TI - Homelessness in the United States. An ecological perspective. AB - This article presents an ecological perspective on homelessness that emphasizes the context in which homeless people live and the complex interactions between personal, social, economic, and service system resources that affect their well being. The ecological perspective encourages researchers and program developers to assess the problems of homelessness at multiple levels of analysis, to view homelessness as a result of contextual factors that interact with individual and family vulnerabilities, and to assess carefully the social contexts in which researchers and program developers operate. Four ecological principles are described as a heuristic for research, intervention, and policy development. The implications of an ecological perspective for psychologists who wish to get involved in dealing with homelessness are discussed. PMID- 1772159 TI - Homelessness as psychological trauma. Broadening perspectives. AB - Most mental health literature on homelessness has focused on characteristics that may be risk factors for homelessness. The authors of this article argue that homelessness itself is a risk factor for emotional disorder and use the construct of psychological trauma--focusing on social disaffiliation and learned helplessness--to understand the potential effects of homelessness. Psychological trauma is likely among homeless individuals and families for three reasons. (a) The sudden or gradual loss of one's home can be a stressor of sufficient severity to produce symptoms of psychological trauma. (b) The conditions of shelter life may produce trauma symptoms. (c) Many homeless people--particularly women--become homeless after experiencing physical and sexual abuse and consequent psychological trauma. Research suggests that negative psychological responses to traumatic events can be prevented or mitigated by a supportive and empowering posttrauma environment. The implications of trauma theory for improving the psychosocial conditions of homeless people are discussed. PMID- 1772160 TI - Ending homelessness. Policy challenges. AB - The extent and nature of homelessness is discussed. Only after understanding these parameters was the federal government able to develop an appropriate homelessness policy, including an explicit goal to help end, rather than simply address, the problem. The article describes how, with increased information, federal programs for the homeless have evolved, beginning with emergency remedies and shifting to more permanent solutions. Significantly increased cooperation at federal, state, and local levels is called for to effectively address this multifaceted problem. In the long term, we must wage a broad attack on poverty if we are to eradicate the root problems that force people into homelessness. PMID- 1772161 TI - The politics of homelessness. A call to action. AB - This article reviews the problem of homelessness from the perspective of an advocate who has been working to change national policy. The Stewart B. McKinney Homeless Assistance Act, an important initial step supported by advocates and (now) political leaders, is described as providing too few resources and limited programs. An agenda for policy change is proposed to deal with the dual problems of rapidly dwindling low-cost housing and inadequate income among the poor and homeless. It is hoped that psychologists and other professionals will get actively involved in creating such policy change. PMID- 1772162 TI - Psychology and homelessness. A public policy and advocacy agenda. AB - This article describes a public policy agenda developed for the American Psychological Association (APA) by the APA Ad Hoc Advisory Panel on Homelessness, which met May 31-June 1, 1991. The agenda is intended to inform APA staff in their legislative and policy work with Congress and Executive Branch agencies on issues relevant to homelessness. PMID- 1772164 TI - [Infant nutrition: pathological conditions and recommendations to be followed]. PMID- 1772163 TI - Homelessness and public policy priorities. AB - Public policy issues related to homelessness and their priorities are reviewed. It is argued that the three most important policy issues are housing, income, and health. Cutting across these priority areas are the special problems of homeless children and youth, both in families and alone. Alcohol, drug abuse, and mental health services, although needed and effective, will neither stop nor slow the rate of increase in homelessness experienced in recent years. Psychologists, in emphasizing aspects of homelessness that they are expert in, are deflected from variables determining the prevalence and incidence of homelessness. The latter variables must be regarded as the priority policy issues in homelessness. PMID- 1772165 TI - [Urolithiasis in childhood]. AB - We report a retrospective study of 51 children who presented urolithiasis between 1980 and 1989 in our Hospital. Mean age was 7 years and the male:female ratio was 2. 1:1. A positive family history was found in 60% of cases. It was done metabolic evaluation in every case: hypercalciuria was found in 34% of cases. In 6% of cases there were hyperuricosuria. None of our patients presented hyperoxaluria, cystinuria or hypocitraturia. Abdominal echography was the most sensible an specific imaging technique of diagnosis. In 16 cases it was necessary a surgical procedure although most cases received only medical management. Four patients were treated with extracorporeal shock-wave lithotripsy. We emphasize the importance of metabolic evaluation. We report our own protocol of study and results. PMID- 1772166 TI - [Joint hypermobility in Palma school children]. AB - Joint mobility was examined on 1.136 schoolchildren of both sexes at the ages of 11 and 14 years. At the same time, they were asked if they had a history of bone fractures and about their weekly consumption of liver. The results were that 13% of the boys and 21% of the girls had hypermobility of their joints. A description is made of a short test to detect hypermobility. It was found that liver consumption and hypermobility are related, also that only in boys hypermobility is contrarily related with the history of fractures. PMID- 1772167 TI - [Hemodynamic study in meningococcal septic shock]. AB - We analyzed 8 cases of meningococcal septic shock diagnosed in a three year period. The age varied from 20 months to 10 years (mean: 4.8 years). Two patients died. Every child was monitored with a Swan-Ganz catheter 5 F or 7F, placed on by puncture of internal jugular or subclavicular veins. Of this hemodynamic study, we can conclude that in septic shock, there is a myocardial depression, that persist for several days, and improves with dopamine and dobutamine. In addition to this, in sepsis exists a pulmonary hypertension that makes worse the prognosis. PMID- 1772168 TI - [Tuberculosis: epidemiologic and clinical study of 268 pediatric patients]. AB - TBC begins to be a big health problem at this moment. It was achieved a retrospective study with 238 cases in infant age, entered at Infections Section of Children's Hospital "Miguel Servet" of Zaragoza, during 18 years (1972-1989) studying epidemiologic and clinic factors. We divided in two groups: the first, latent disease (TBC turn) and the second, patent disease. The found incidence was 0.17%. The most affected group were among 0-5 years old (39.075%) of whom 53.76% were male. It was a little prevalence during winter and spring months. The middle drop social class were the most affected. The epidemiologic ambient was positive in 31.4%. Only were vaccinated 33.6% of children. We observed more clinic forms among nonvaccinated. The lung-form (59.6%) and pleurisy (14.2%) were the most frequent found forms. The less frequent form was miliary TBC (0.96%). The parenquimatosa infiltration was the most frequent found form (42.5%). PMID- 1772169 TI - [Epidemiology of mental deficiency. The Safor study (II): age at detection, person making the diagnosis, medical studies]. AB - As part of an epidemiological study on Mental Deficiency which was carried out in an area of the region of Valencia, a study has been made of the age when Mental Deficiency can be detected, who made this discovery, and which children have been the object of a medical study. 12% of the cases were detected at birth, 16% before the age of 3, 7% at 3, and 64% after the age of 4. In 16% of the cases the deficiency was detected by the family, in 20% of the cases a doctor and a psychologist in 62% of the cases. A medical study to discovered the causes of the Mental Deficiency was only carried out in 44% of the cases. PMID- 1772170 TI - [Pathogenic factors in bronchopulmonary dysplasia]. AB - This paper analyses the main pathogenic and prognostic factors of BPD. A study was made of 60 premature babies who were ventilated for a period of more than 72 hours. The control group consisted of the 37 premature babies who did not develop BPD and the study group of the remaining 23 who, 28 days after birth, showed respiratory difficulties, a compatible radiography of the thorax and FiO2 requirements above 0.21. The severity of the BDP in the neonatal period was quantified by means of the clinical and radiological criteria of Toce and a special scale was applied to its evolutive aspects. PMID- 1772171 TI - [Evaluation of the school health program in the Murcia region. School year 1989/90]. PMID- 1772172 TI - [Self-induced dermatosis. Pathomimia]. PMID- 1772173 TI - [Bilateral infantile striatal necrosis]. PMID- 1772174 TI - [Toxic epidermal necrolysis. Severe multiorgan involvement]. PMID- 1772175 TI - [Ring chromosome 22. Description of a new case (1)]. PMID- 1772176 TI - [Infantile fibromyalgia. Review and case report]. PMID- 1772177 TI - [Epidural hematoma in a newborn infant: spontaneous resolution]. PMID- 1772178 TI - [Depressed skull fracture in the newborn infant. To operate or not?]. AB - In recent literature the question of the convenience of neurosurgical treatment of cranial depressed fracture of the newborn has been a subject of discussion. The authors review their experience with 4 cases of this condition, that stress the necessity of the operation. Most reported series have dealt with the short term results of the different ways of treatment. In this article the outcome is evaluated at least 10 years after surgery. PMID- 1772179 TI - [Familial hypercholesterolemia in a homozygote and LDL kinetics]. PMID- 1772180 TI - [The use of hypertonic sodium phosphate enema in pediatric patients]. PMID- 1772181 TI - Atrophie blanche. Clinical diagnosis and treatment. AB - In this report, we describe 11 Greek patients with atrophie blanche (AB). All patients had characteristic skin lesions: petechial or purpuric papules or hemorrhagic bullae, that became necrotic and formed ulcers which in turn, became atrophic scars with hyperpigmentation of the surrounding skin. The majority of patients presented these skin lesions on the lower limbs. Two had idiopathic AB, 3 in association with venous insufficiency of the lower extremities and 6 with livedo reticularis (LR) and/or Raynaud's phenomenon (RP). Prior to our evaluation, most of these patients were diagnosed as having skin vasculitis and were treated with prednisone and/or cyclophosphamide. We conclude that AB is a distinct clinical entity with characteristic skin lesions affecting the legs. The disease is associated mainly with LR and RP. Very careful clinical assessment is needed to avoid incorrect diagnosis and unnecessary and potentially harmful therapeutic intervention. PMID- 1772182 TI - [Anti-hypertensive drugs prescribed to the elderly. Multicenter study at the hospital admission of 631 patients aged 70 plus years]. AB - The anti-hypertensive treatment of 631 patients 70 years old and over was evaluated at the time of their hospitalization in 12 Internal Medicine departments in the western Paris suburbs, in May and June 1990. 49.6 +/- 3.9% received no such therapy; 30.3 +/- 3.6% were being treated for hypertension (group 1); 8.7 +/- 2.2% were taking anti-hypertensive drugs for poorly specified reasons (group 2); 11.4 +/- 2.5% were under such treatment for another reason. In groups 1 or 1 + 2, the most frequently prescribed medications were, in decreasing order: diuretics, calcium channel blockers, converting enzyme inhibitors, beta blockers or central inhibitors. In the oldest patients, the beta-blockers were prescribed less and converting enzyme inhibitors more. More than half of the patients in groups 1 + 2 were taking a single drug. The most frequently prescribed combined therapy was diuretic + converting enzyme inhibitor. Our results seem to indicate that the prescription modalities depended, for the most part, upon an associated or suspected pathology, notably cardiac insufficiency. PMID- 1772183 TI - [Muscle metastases of cancers]. AB - In a retrospective study of cancer patients seen between 1980 and 1990, 7 cases of metastases to skeletal muscles were found: 2 primary bronchial carcinomas, 1 spindle cell sarcoma, 1 malignant melanoma, 1 ovarian adenocarcinoma, 1 squamous cell laryngeal carcinoma and 1 malignant neuroendocrine tumor from an unknown primary site. Despite their rich blood supply, skeletal muscles are rarely secondary metastatic sites (less than 1% of all malignant metastases of hematogenous origin); only 242 cases have previously been reported in 82 publications. Primary cancers of the lung, blood, gastrointestinal tract and genitourinary tract were the most frequently involved. Although skeletal muscle metastatic sites were rarely observed, the possibility of such a colonization should be known to physicians, as their detection requires specific tests. Furthermore, the localization of such sites clearly illustrates the recent progress made in the biology of metastases, especially the organ--or tissue- specificity of the site. PMID- 1772184 TI - New vaccines for the prevention and treatment of disease. PMID- 1772185 TI - [Good clinical practices in internal medicine]. PMID- 1772186 TI - [Zidovudine (AZT). Current state of the development]. PMID- 1772187 TI - [Abdominal aortic aneurysm caused by Salmonella enteridis in a patient with human immunodeficiency virus]. PMID- 1772188 TI - [A case of nocardiosis revealing acquired immunodeficiency syndrome]. PMID- 1772189 TI - [Kaposi's disease and HIV negative acquired immunodeficiency syndrome (AIDS)]. PMID- 1772190 TI - [Cardiac complications of pentamidine isethionate. Report of a case]. PMID- 1772191 TI - [Pyridoxine-sensitive hereditary sideroblastic anemia]. PMID- 1772192 TI - [Chronic lymphoid leukemia and pneumocystosis: 3 cases]. PMID- 1772193 TI - [Vertebrobasilar ischemic accident revealing syphilitic meningo-arteritis]. PMID- 1772194 TI - [Listeria monocytogenes liver abscesses revealing pancreatic cancer]. PMID- 1772195 TI - [Survival]. AB - In a shared silence, the demented patients suddenly name or designate an accurate reality: they attest to the quality of a thing or its place in space. These proposals appear to be simply precarious certainties doomed to the resorption of forgetfulness. Ever since then the thoughts never face the named thing as in front of a previous objectivity, but present to the movement from which they proceed. What is conquered with naming is not the knowledge that acknowledges something: what exists is confounded with what seems to be; knowledge and creation are identical. The patient creates the object; he asserts, and what is asserted is therefore created. Likewise we have underlined this same thought which has the value of an action in onirism. This form of creation sets problems which involve a conception of the life of spirit that enables us to perceive its richness. Some precisions are brought on the creative hallucination of the mother by the baby and the maternal consent to this creation. These remarks confirm our reticence about any binary algorithm and explain that we cannot commit ourselves to some formalizations such as Freud's (the negative hallucination, and Lacan's Name-of-the-Father). PMID- 1772196 TI - [Prayer, an intermediary world]. AB - Prayer, considered under its theological aspect as a love relation between the orant and God becomes, under a psychopathological point of view, deviated as it is from its original aim, a space of potential cure for narcissistic wounds. In this sense, prayer is a kind of intermediary world between normality and madness, which according to the religious ideas of the individual and the importance of his mental disorders, tends towards one or the other of these extremes, and makes his defences operative. It happens therefore that Faith, as materialized in prayer, can be a mean to save oneself of mental morbidity. Prayer is an intricate phenomenon which originates in the multiple dimensions of the human being, where religion, psychology, morals, pathology and metaphysics confront each other. PMID- 1772197 TI - [Factors and situations related to the onset of psychosomatic disorders in northern African patients in France]. AB - A clinical study of 60 people in two groups (patients and controls), using clinical interviews and a questionnaire, brought to light three series of obvious factors, directly related to the onset of psychosomatic disorders: 1) the disruption generated by transplantation; 2) the cultural make-up of personality; 3) a structural predisposition. Finally, we point out that this study is the partial transcription of a research topic treated in detail elsewhere. PMID- 1772198 TI - [Who are the surrogate mothers? Psychological problems]. PMID- 1772199 TI - [The ambiguity of the term depression]. PMID- 1772200 TI - [Knight Yvain's melancholia]. AB - The first, or maybe, occurrence of the word "melancholia" is found in a French mediaeval book "Knight Yvain" (12th century). A clinical and mythological analysis is propounded. PMID- 1772201 TI - [The alcoholic patient, his work and the subjectivity of the period]. AB - In the western contemporary society, employment is above all the premise for social integration. Thus, the alcoholic will play on the professional scene the complex question of that which associates him with the community of mankind and that which distinguishes him. The role of the "model worker" allows him to conform to the mass opinion and at the same time to mark his difference. Nevertheless, the excesses that characterizes his game and the lack of faith, that he places on his principal partners will lead to his secretly sought after exclusion. It remains for the physician to receive his commentaries, his work often being the last point in which he can still speak of himself. PMID- 1772202 TI - [The French classification of mental disorders in children and adolescents (CFTMEA), DSM-III-R et CIM-10: application to 40 hospitalized adolescents (aged 16-19 years )]. PMID- 1772203 TI - [Molecular genetics and prenatal diagnosis. Status and perspectives]. PMID- 1772205 TI - [The nutritional balance of young children. Progression to a diversified diet]. PMID- 1772204 TI - [Diabetes and cystic fibrosis. Survey of glucose intolerance factors]. PMID- 1772206 TI - [Severe acute hepatitis in children. The Pediatric Liver Transplantation Group at the Bicetre-Cochin Hospitals]. PMID- 1772207 TI - [Liver transplantation in children]. PMID- 1772208 TI - [Misleading forms of algoneurodystrophy in children and adolescents. Apropos of 19 cases]. PMID- 1772209 TI - [Juvenile spondylo-arthropathies]. PMID- 1772210 TI - [Siblings of sudden infant death infants. What are the risks of recurrence? Management]. PMID- 1772211 TI - [Sleep obstructive apnea syndrome in children]. PMID- 1772212 TI - [Abdominal pain and lactose intolerance in older children]. PMID- 1772213 TI - [The prevention of sickle cell crisis]. PMID- 1772214 TI - [Simple delayed puberty in boys]. PMID- 1772215 TI - [Passive smoking in children]. PMID- 1772216 TI - [Childhood otorhinolaryngologic disease and swimming pools]. PMID- 1772217 TI - [Cervicofacial cysts and fistulas in children]. PMID- 1772218 TI - [Lengthening of the leg in children. Evaluation and perspectives]. PMID- 1772219 TI - AIDS, wound healing, and the surgeon's well-being. PMID- 1772220 TI - Logos--vanity or venality? PMID- 1772221 TI - Methods for providing vascularized tissue protection of microanastomoses. AB - Perianastomotic thrombosis following free tissue transfer must be systematically prevented if even routine successes are to be expected. One possible culprit that must be considered is the method of soft tissue closure around the recipient site pedicle that frequently poses a challenge to avoid tension and the resultant compression that may then predispose to such thrombosis. One hundred sixteen consecutive free tissue transfers from 1982 to 1990 were analyzed; simple local soft tissue manipulations to provide adequate coverage were satisfactory in 67% of cases. Local flaps (5%) or extensions of the free flap itself (28%) as a source of vascularized tissues were necessary specifically to avoid this risk for the remainder. Ninety-seven percent of these latter flap alterations were required for the extremities where a paucity of local tissues (as would be expected) most frequently precluded local techniques. An appreciation of this seldom discussed but ubiquitous concern for coverage of the zone of microanastomoses to decrease the risk of thrombosis by intentional inclusion of vascularized tissues should serve to eliminate morbidity further in these complex procedures. PMID- 1772222 TI - Lidocaine diffusion in five tissue expanders: an in vitro and in vivo study. AB - Previous work in our laboratory has demonstrated that tissue expanders are permeable to lidocaine. In this two-part study, we assessed the in vitro lidocaine diffusion in the following five common tissue expanders: Dow Corning, McGhan, Cox-Uphoff, Hyer-Schulte (Mentor), and Surgitek. In part 1, we demonstrated that wall thickness appeared to be the major determinant for diffusion. Part 2 reports an in vivo study of lidocaine diffusion from tissue expanders used for breast reconstruction. We initially determined that there is incomplete mixing between the valve and connecting tubing and the contents of the expanders, over the period of 1 week. We subsequently examined the lidocaine diffusion from seven tissue expanders placed in a submuscular position for breast reconstruction. The rate of lidocaine diffusion was highly variable, but on average was about 3% per day. PMID- 1772223 TI - Monodelphis domesticus: a model for early developmental wound healing. AB - Fetuses heal significantly differently than adults; amniotic fluid and the fetal environment have profound effects on the fetus' response to excisional wounding. The Brazilian gray short-tailed opossum (Monodelphis domesticus) is presented as a new model for early developmental wound healing. This is a small, docile, pouchless marsupial whose young, at birth, are equivalent to an 8-week gestational age human, which allows investigations of early developmental wound healing exclusive of the amniotic environment. Incisional and excisional wounds were made on the dorsum of pups 1 or 15 days after birth. The pups were killed 1, 3, or 6 days after wounding and were fixed for histology. All incisional wounds were bridged by keratinocytes within 24 hours. Day 1 excisional wounds healed 6 days after wounding with a hypertrophic layer of keratinocytes and no inflammation. Day 15 excisional wounds exhibited inflammation, focal necrosis, and healing by epithelial migration 6 days after wounding. This model allows for investigations into early developmental wound healing and exhibits responses dependent on age similar to prepartum and postpartum young of higher mammals. PMID- 1772224 TI - A new flap model in the rat. AB - Standardized skin flap models in the rat, such as the McFarlane and Finseth flaps, have suggested placement on the rat of only a single flap. The single flap, because of variations in skin vasculature among rats, may be problematic and require prohibitively large numbers of rats to obtain statistically significant results. In this study of 60 Sprague-Dawley rats, we have developed a flap model designed to be paired in a single rat and standardized to serve as the experimental flap and the control. At the level of the symphysis pubis, symmetrical, three-sided, caudally based, bilateral skin flaps, 2 cm in width, were extended to different bony landmarks. Only the length of the flaps was varied. The inferior epigastric pedicle was then divided. The flap length, which optimally produced predictable and persistent necrosis, was found midway between the xiphoid and the sternal notch. The model was pharmacologically manipulated with the injection of superoxide dismutase through the epigastric vein before division of the inferior epigastric pedicle; this scavenger did not effect the survival of the random pattern flaps. PMID- 1772225 TI - A new compound-curved needle for microvascular surgery. AB - A new compound-curved needle has been designed and developed for microvascular surgery from a unique stainless steel alloy, American Society for Testing Materials 45500. This needle has two distinct radii of curvature and a short tapered point, followed by a curved distal section. Despite its geometry, it exhibits similar resistance to bending and breakage as a curved needle with a single radius of curvature manufactured from the same alloy. The design of this new needle enables plastic surgeons to pass it through vessel walls with greater accuracy to a controlled depth and length of bite than a curved needle with a single radius of curvature. PMID- 1772226 TI - Use of a vertical island flap for correction of epispadias. AB - An 18-year-old man presented with epispadias. His main complaints were dorsal curvature of the penis and difficulties during erection and micturition. Primary urethroplasty at another hospital had been only minimally successful. The public bones were normal and he was continent. He was treated by complete excision of the chordee and urethroplasty. Local flaps were used to reconstruct the glandular urethra, and a vertical penile island flap was used to replace the missing portion of the penile urethra. Good straightening of the penis and a new urethra with a well-closed meatus at the tip of the glans were achieved in a single-stage operation. No complication occurred, and the result was satisfactory from both the aesthetic and functional points of view. PMID- 1772227 TI - Synchronous eruption of cotton-induced granulomas 45 years after exposure: report of an unusual case. AB - A 58-year-old woman developed multiple, recurrent abscesses and subcutaneous nodules over both buttocks during a 12-year period. Microbiological studies of surgical biopsy specimens were inconclusive for a specific infectious cause, but histochemical preparations on several separate occasions revealed an exuberant foreign body reaction to raw cotton fibers. Interestingly, the patient gave a detailed history of sliding down piles of cotton hulls during her childhood, some 45 years earlier. With a probable cause-and-effect relationship established, we postulate a dramatically delayed foreign body granulomatous reaction to cotton fibers. PMID- 1772228 TI - Immediate muscle flap coverage for repair of cardiac rupture associated with mediastinitis. AB - Sternal wound infection with mediastinitis is a dreaded complication of cardiac surgery. Even more devastating is perforation of the heart or great vessels secondary to advanced mediastinitis. The exsanguinating hemorrhage and presence of extensive infection usually lead to a poor salvage rate in these patients. Citations in the English literature of successful management of cardiac rupture associated with mediastinitis are, as expected, scare. Recently, the capability for immediate muscle flap coverage in the repair of associated rupture of the heart secondary to active mediastinal infection has been discussed in two reports. This article presents another report, in which bilateral pectoralis major muscle flaps were used successfully in salvage of a patient who sustained rupture of the right ventricle after debridement of an extensively purulent sternal wound and mediastinum. PMID- 1772229 TI - Amputation stump salvage using a "banked" free-tissue transfer. AB - A free radical forearm flap was salvaged from a nonreplantable amputated extremity and banked on the ipsilateral chest wall. Later, the flap was simply rotated to provide coverage of the proximal humeral stump, eliminating the need for a second microvascular procedure. PMID- 1772230 TI - Complications of laser therapy in the gynecological patient: a review of four patients. AB - Complications of gynecological laser treatment for perineal disease have been seen with increasing frequency. This may be the result of more women undergoing therapy with this method. Four women presenting with unstable perineal scarring are discussed. PMID- 1772231 TI - Binder's syndrome: peculiarities in Japanese patients. AB - We have seen 4 Japanese patients with Binder's syndrome or maxillonasal dysostosis. The diagnosis of Binder's syndrome was very difficult, based on facial appearances alone. Although the flattened nasal tip was quite unusual in Japanese individuals, the midface retrusion and flattened nasal bridge would be considered within normal limits. Consequently, the diagnosis of Binder's syndrome is only rarely made in Japanese persons. The peculiarities of this syndrome in Japanese patients are discussed and our surgical methods are shown. PMID- 1772232 TI - Acquired nostril stenosis. AB - Acquired nostril stenosis is an uncommon but challenging problem. Etiology, pathophysiology, presentation, and treatment options are presented, together with two patient reports. A classification is offered that allows for appropriate selection of the surgical procedure. PMID- 1772233 TI - Use of immediate postoperative mastectomy prostheses. AB - From materials readily available in the operating room, a temporary breast prosthesis can be fashioned for use in the immediate postoperative period. These materials yield a prosthesis with good shape and form, filling a brassiere cup and providing the general pressure needed on skin flaps in the immediate postoperative period. Psychologically, filling the absent breast cup helps patients adjust to their new body image and eliminates the shock of gross asymmetry. PMID- 1772234 TI - [Local surgical treatment of anal-perineal lesions in Crohn's disease. Retrospective study of 68 cases]. AB - Sixty eight cases of ano-perineal lesions (APL) were studied. Lesions were classified into primary (19) and secondary (49) after Hughes. The course of primary APL was favourable (15 cases, 78 p. cent) when proximal CD was controlled, with 4 proctectomies being required when the latter was not the case. Suppurative secondary APL (48) were treated surgically either for an acute abscess (22) or for a chronic fistula (low: 14; high: 12). The treatment of fistulas involved: opening in 10 cases (4 recurrences, 5 failures) or slow fistulotomy with elastic in 17 cases (9 recurrences, 4 failures). Genital fistulas (9 cases) were studied separately: 3 recto-vaginal fistulas resulted in a permanent bypass and 6 ano-vulval fistulas healed or were tolerated. When proximal CD was controlled medically, proctological treatment alone resulted in the healing or quiescence of APL in 17/24 cases. In the group of patients undergoing intestinal resection with restoration of continuity, 10/25 recurred, with the appearance of worsening of an APL in 9 of them. Fifteen had no recurrence, with the appearance or worsening of an APL in 3 of them. In total, 13 patients (19 p. cent) underwent proctectomy, including 6 from the outset. Five had a stroma which was left open and 46 (72 p. cent) a functional anus. Local surgical treatment improved the comfort of patients without any increased risk regarding sphincter function, but the long term benefits of the active treatment of chronic fistulas remain to be proven. PMID- 1772235 TI - [Anal-perineal lesions in Crohn's disease]. AB - Radical surgery preserving the sphincter was performed in 190 patients with anal Crohn's disease and achieved good results in 163 cases. 28 patients had a restorative sphincteroplasty. Anal Crohn's disease should be treated according to the same surgical criteria than the other localizations of the disease. PMID- 1772236 TI - [Epidemiologic profile of colorectal cancers in a medical service at Rabat]. AB - The authors report their clinical experience concerning carcinomas of the colon and rectum based upon 212 patients hospitalised in a Department of Medicine. The group consisted of 109 men and 101 women. The mean age was 46.4. Almost 50 per cent of the patients had first presented only 6 months after the onset of symptoms. The recto-sigmoid was the commonest site (81.6 per cent). From a histological standpoint, adenocarcinomas were commonest (93.86 per cent of carcinomas). PMID- 1772237 TI - [The contribution of endoscopy in the diagnosis of esophago-gastro-duodenal disorders in a tropical milieu. Experience in Benin with 930 examinations]. AB - The authors analyse the results of esophago-gastro-duodenal fibroscopy in 930 symptomatic patients. Ninety one per cent of them had lesions. Inflammatory pathology was predominant: esophagitis, gastritis and duodenitis were seen in 21.5%, 47% and 29.08% respectively of the patients investigated. Gastritis accompanied 75.13% of cases of esophagitis and 76.4% of duodenitis, and was associated with the demonstration of the presence of Helicobater pylori in gastric biopsies in 56.41% of patients with that lesion. The relatively high incidence of carcinoma of the esophagus (2.7%) is a particular feature of this study, while that of carcinoma of the stomach (1%) was in accordance with classical data. Duodenal ulcer was found in 18% of patients as compared with 5.16% for gastric ulcer. From a pathophysiological standpoint, mention is made of traditional diet (hot, highly spiced), self-medication and intestinal parasite infestation in causing inflammatory lesions. Finally, emphasis is placed upon the role of Helicobacter infection in the development of chronic gastritis. The high rate of infection with this organism and its involvement in the mechanisms of duodenal ulcerogenesis could explain the high incidence of duodenal ulcers in our group and in studies emanating from developing countries. PMID- 1772238 TI - [Severe ischemic hepatitis after taking cibenzoline]. AB - The authors report the case of a 77 year old man suffering from chronic congestive heart failure, who presented a severe hepatic failure. Since 9 days the patient was treated by cibenzoline for serious ventricular arythmias. Hepatic failure was not due to drug hepatotoxicity but to an indirect effect of cibenzoline diminishing cardiac output. Arguments for ischaemic hepatitis and also two mechanisms of hepatic involvement in cardiac diseases are developed. In most cases association of two mechanisms, vascular stasis and low cardiac output is necessary to create hypoxic hepatitis. PMID- 1772239 TI - [Acute severe steatosis following an acute necrotic, hemorrhagic pancreatitis after treatment with asparaginase]. PMID- 1772240 TI - [Management of a focal hepatic lesion]. PMID- 1772241 TI - [Seroepidemiologic data on anisakiasis. Prophylactic consequences for fish products]. AB - The Western blotting method allowed us to confirm the diagnosis in 7 cases of acute anisakiasis, to assess it in 5 cases of chronic anisakiasis, and to follow up the evolution. These chronic frames according to the question of their long term evolution, and the part played by Anisakis simplex in fish nutritional allergy increase the negative score of that parasite. This situation should lead to discuss preventive rules. PMID- 1772242 TI - [Hepatitis B virus and hepatocellular carcinoma]. AB - Hepatocellular carcinoma in woodchuck were characterized for woodchuck hepatitis virus integration nea c-myc oncogene. In one tumor, viral integration resulted in overexpression of a c-myc viral cotranscript. In a second tumor, viral insertion, 600 bp upstream of c-myc exon 1, was associated with increased levels of normal c myc mRNA. These results demonstrate that integration of woodchuck hepatitis virus near a proto-oncogene can contribute to the genesis of liver tumors. From a comparison of a single hepatitis B virus (HBV) integration site in a human hepatoma with the corresponding unoccupied site have shown HBV DNA insertion in a putative cellular exon. This exon presented striking similarity to the DNA binding domain of the thyroid/steriod hormones receptors. The corresponding cDNA has been isolated (hap gene) as shown to encode the retinoic acid receptor. It is most probable that consequent to HBV insertion, hap gene became inappropriately expressed as an altered chimaeric gene retinoic acid receptor, thus contributing to the cell transformation. As for woodchuck these results strongly support the possibility that HBV, may play a direct role in liver carcinogenesis by insertional mutagenesis. PMID- 1772243 TI - [Evaluation of the "squamous cell carcinoma antigen" as marker of epidermoid cancer of the anal canal]. AB - The authors studied the value of Squamous Cell Carcinoma Antigen (SCC) in squamous carcinoma of the anal canal in 66 patients. Assays were made at the time of diagnosis, before any treatment and during follow-up. A total of 353 assays were made. The positive threshold was selected at 2 ng/ml. At the time of diagnosis, sensitivity of the marker was 44 per cent and its specificity 92 per cent. In our series, pre-treatment SCC levels were not correlated with T by the Papillon classification, but were correlated with lymph node involvement (p less than 0.05). They had no prognostic value at the time of the initial diagnosis. During follow-up, at the time of recurrence, SCC levels were 20.3 +/- 43 ng/ml. This rise was significant (p less than 0.01), the sensitivity of the marker being 77 per cent. In patients who had a recurrence, the outcome was correlated with SCC levels and the latter were of prognostic value (p less than 0.01). In conclusion, SCC levels should form part of the clinical monitoring of patients with a squamous carcinoma of the anal canal. PMID- 1772244 TI - Little science. PMID- 1772245 TI - The effect of repeated endotracheal suctioning on arterial blood pressure. AB - The purpose of this study was to examine the effects of three lung hyperinflation/suction sequences on mean arterial pressure (MAP). The results indicate both lung hyperinflation (LHS) and suction sequences (SS) significantly increased MAP (p = .05) from baseline. There was a mean increase in MAP of 13.72 mm Hg over the three lung hyperinflation/suction sequences. The results showed a significant increase in MAP from baseline between SS1 to LHS2 (3.62 mm Hg), from LHS2 to SS2 (4.36 mm Hg), and from LHS3 to SS3 (2.84 mm Hg) at p = .05. The increase in MAP was cumulative with each successive lung hyperinflation/suction sequence. Consequently, the number of repeated lung hyperinflation/suction episodes should be limited to only those necessary to maintain airway patency. PMID- 1772246 TI - The family's experience of living with a child with Duchenne muscular dystrophy. AB - An ethnographic inquiry was conducted to better understand the experience of families living with a child with Duchenne muscular dystrophy. Participant observation and in-depth interviews were used to collect data. Six themes emerged as primary descriptors of the experience: (a) Disillusionment: The Erosion of the Hope for Normalcy; (b) Society Confirms the Impossibility of Normalcy; (c) Dynamics of the Family: Who's Disabled Anyway?; (d) A Smaller World; (e) Letting Go or Hanging On; and (f) Things Must Change. Implications of these themes are discussed in terms of need for counseling and support services for families, in service education for health professionals, and activities for children diagnosed with Duchenne muscular dystrophy. PMID- 1772247 TI - Progressive relaxation and the sleep of older noninstitutionalized women. AB - Fifty-five randomly selected women over the age of 65 years participated in this study to determine the effect of progressive relaxation on their sleep patterns. Using a Pretest-Posttest Same Subject design, subjects spent 8 nights participating in the study. Progressive relaxation was introduced on days 4 and 5. Data were collected with polysomnography and the Sleep Pattern Questionnaire. It was found that progressive relaxation significantly improved certain sleep parameters. Nurses should encourage its use with older women who report disturbed sleep patterns and sleep dissatisfaction. PMID- 1772248 TI - Post-traumatic stress disorder in an urban trauma population. AB - This descriptive study examined the incidence of post-traumatic stress disorder (PTSD) in individuals who experienced physical traumas within the past 6 months and the relationship between severity of physical injury and PTSD. The sample consisted of 92 subjects who were treated at a Level 1 trauma center in an urban hospital. Scores on the Impact of Event Scale indicated that over half of the sample had medium or high levels of PTSD. However, the severity of physical injury from trauma was not related to PTSD development. PMID- 1772249 TI - The influence of preference for information on preoperative stress and coping in surgical outpatients. AB - The purpose of this study was to examine how differences in preference for information may influence stress and coping in patients undergoing outpatient surgery. Data were collected from a convenience sample of 69 subjects undergoing outpatient surgery for the first time. Subjects who had a high preference for information were found to have significantly lower levels of preoperative stress than subjects who had low preference for information; however, preference for information did not have an influence on the percentage of problem-focused coping strategies used by these subjects. PMID- 1772250 TI - Characterization of intravenous infiltrates. PMID- 1772251 TI - Apathy: development of a nursing diagnosis. PMID- 1772252 TI - Effect of individualized prompted toileting on incontinence in nursing home residents. PMID- 1772253 TI - A practical approach to content validation. AB - Often researchers are unable to find instruments to estimate variables they want to investigate. Once the variable of interest has been defined and operationalized, demonstrating content validity is the next step in the instrument development process. It requires that experts confirm that the operational definitions created are congruent with the universe of the theoretical definition of the concept. Grounded in appropriate standards and psychometric theory, the process of content validation is explored. Helpful suggestions are provided for the development of a form, the selection of experts, and the collection and analysis of data. The guidelines and examples presented offer a set of blueprints to assist the nurse researcher with a practical approach to the content validation process. PMID- 1772254 TI - Phenomenology as a method for conducting clinical research. PMID- 1772255 TI - Elements, perceptions, and issues of informed consent. PMID- 1772256 TI - Visual dysfunction among former microelectronics assembly workers. AB - Although known neurotoxins with potential ophthalmotoxic properties are commonly used in microelectronics assembly, there has been no systematic study of visual disturbances among past or present workers in this industry. The objective of the present study was to compare visual functions, using a matched-pair design, between former workers from a microelectronics plant and a local reference population. From an initial population of 180 former workers and 157 potential referents, 54 pairs were matched for age (+/- 3 y), education (+/- 2 y), sex, ethnic origin, and number of children. Near and far visual acuity, chromatic discrimination, and near contrast sensitivity were assessed monocularly. Paired comparisons (Signed-rank Wilcoxon test) revealed that the former microelectronics workers had significantly lower contrast sensitivity, particularly in the intermediate frequencies, independently of near visual acuity loss. There were no differences for far visual acuity in both eyes. Even though near visual acuity and color vision were compromised among the former workers, the differences were only significant for one eye, as was the prevalence of acquired dyschromatopsia (chi-square for matched pairs, p less than .001). These findings suggest a pattern of contrast sensitivity deficits consistent with impairment to foveal and/or neuro-optic pathways among these former microelectronics workers. Exposure to ophthalmotoxic chemicals is proposed as the most probable risk factor. PMID- 1772257 TI - Increased frequency of chromosomal aberrations in railroad car painters. AB - The purpose of this study was to determine if exposure to paints and solvents contributes to chromosomal alterations in occupationally exposed individuals. A total of 25 male railroad and underground railroad car painters were studied. This group had a mean age of 32.7 y and a mean exposure time of 5.2 y. The results were compared with those obtained for 25 healthy (unexposed) males. The scoring of structural chromosome aberrations clearly revealed an increase in the number of all types of aberrations considered in the population of painters. This suggests that exposure to a combination of chemicals may increase genotoxicity in industrial workers. PMID- 1772258 TI - Heptachlor, heptachlor epoxide, and other chlordane compounds in Finnish plywood workers. AB - Residue levels of heptachlor, heptachlor epoxide, and other chlordane compounds were determined in sera from 74 Finnish plywood workers and 52 controls. Concentrations of heptachlor epoxide in plywood workers varied from below the detection limit of 0.1 ng/g to 19.2 ng/g serum (conversion factor for SI units = 975 [1 ng/g = 0.98 microgram/l]); the mean and standard deviation were 3.2 and 3.9 ng/g, respectively. Heptachlor expoxide values in controls varied from below the detection limit to 1.2 ng/g serum. The exposure time, i.e., number of years spent working with sizings that contained heptachlor, correlated with the residue levels of heptachlor epoxide that were measured in serum samples taken from employees at two companies (p = .03). The most common chlordane compound (contaminant of heptachlor) found in the sera of plywood workers was trans nonachlor; also found were high concentrations of heptachlor epoxide. Headache, dizziness, and eye irritation were not related to serum levels of heptachlor or chlordane compounds. PMID- 1772259 TI - Depressed serum erythropoietin in pregnant women with elevated blood lead. AB - During the course of a prospective study of lead exposure and pregnancy outcome in 1,502 women, we tested the hypothesis that environmental lead exposure is associated with depressed serum erythropoietin concentration. At mid-pregnancy and at delivery, blood samples were stratified by hemoglobin concentration; within each hemoglobin stratum, sera of women with the lowest and highest whole blood lead concentrations were selected for serum erythropoietin analysis. Analysis of variance revealed that women with higher blood lead levels had inappropriately low serum erythropoietin at both mid-pregnancy and at delivery. Thus, depressed serum erythropoietin appears to indicate lead nephrotoxicity, and it may also be responsible for the anemia associated with lead poisoning. PMID- 1772260 TI - Dentine lead and child intelligence in Taiwan. AB - It is well known that lead is a developmental neurotoxin, but, because many factors influence a child's development, a safe level of lead for children is still not clear. In this study, personal lead exposure was assessed. A total of 940 deciduous teeth--mostly incisors--was collected from 764 children in grades 1 3 who attended 7 primary schools. Two of the primary schools were near smelters, 4 were in Taipei City, and 1 was located in a coastal village. Teachers were provided with a questionnaire about classroom performance, and 97% completed and returned the questionnaire to the laboratory. Parents were given a questionnaire about family background, pregnancy, and health history (92% returned). Dentine lead levels of shed incisors for children in Taipei City were higher than levels reported in Boston, i.e., mean (standard deviation) of 4.4 (3.5) versus 3.3 (2.5) micrograms/g, respectively (p less than .001). The lead values were significantly higher in children who attended school near a smelter than in children who attended school in Taipei City: 6.3 (3.3) (p less than .001). The mean lead levels in children who attended school in a coastal village was 5.1 (2.8). The ranges for all schools overlapped, which indicated that there were multiple lead sources. Intelligence scores from Raven's Colored Progressive Matrices Test were negatively correlated with lead levels, especially among girls and among children whose parents had less education. We adjusted for other risk factors--most notably parental education, which correlates inversely with lead levels--and found that the role of the lead term was lowered but not eliminated. PMID- 1772261 TI - Height and lung function in preadolescent children of Kuwaitis and European origin: a pilot survey on health effects of gas cooking in the Middle East. AB - Spirometric testing, including forced vital capacity (FVC), forced expiratory volume in .5 s (FEV0.5), FEF25-75%, and peak expiratory flow resistance (PEFR), was conducted among 130 10-y-old children (67 Kuwaitis, 63 Europeans) who lived with their parents in the same area in Kuwait city. Lung function of children who lived in houses with gas stoves were compared with those who lived in homes supplied with electric cookers. The FEV0.5 for children who lived in households with gas stoves was significantly lower (average difference, 94 ml; p = .05; corrected to height and sex). Other lung function indices, i.e., FVC, FEF25-75%, and PEFR, were also lower but, after accounting for confounders, were not statistically significant. Children from households that were equipped with gas cookers were approximately 3 cm shorter than children who lived in homes with electric cookers. These findings suggest that children who live in a very hot and dry climate--even with efficient air conditioning systems--are susceptible to the same environmental hazards to which children from other climatic zones are exposed. This susceptibility may be more pronounced before or at the onset of puberty. PMID- 1772262 TI - Incidence and causes of carbon monoxide intoxication: results of an epidemiologic survey in a French department. AB - The purpose of this study was to estimate the incidence, mortality, and causes of carbon monoxide intoxications in France. A survey was conducted in the department of the Hauts-de-Seine, which is representative of the French population. Data were collected through a headquarters that had direct contact with all department emergency organizations and to a technical laboratory. During the 3-y study, 735 cases that were related to 291 events were reported. Thirty-six patients died. The average incidence of carbon monoxide intoxications was 17.5 per 100,000 inhabitants. Poisoning was caused by fires in 36 events and by car exhausts in 12. For the remaining events, causes were determined as follows for 196: water heaters (57%), boiler (20.5%), coal stove (9%), brazier (4%), cooker (2%), heating device (1.5%), and miscellaneous (6%). The main mechanisms of intoxication were a defective device, poor ventilation, or poor evacuation of combustion gases. Carbon monoxide intoxication occurs frequently in France, and preventive actions are warranted. PMID- 1772263 TI - Immunochemically detected placental proteins and their biological functions. AB - During the last 20 years a systematic search for proteins occurring in human term placenta (afterbirth) has been performed in our laboratory. As a result more than 30 soluble placental proteins and at least 20 different solubilized antigens apparently derived from the placental membranes have been identified by immunochemical methods in extracts from human term placentas. Most of these proteins have already been isolated to purity and characterized by their physicochemical parameters. Specific antisera to these proteins were obtained by immunizing animals with the corresponding purified proteins. They were used detect and localize these antigens by immunochemical methods in the placenta and in other human tissues. Sensitive immunochemical assays have been developed to exactly quantitate the new proteins in body fluids and to find out the diagnostic significance of measurement of these proteins in pregnant women and in patients with tumors and other diseases. Another aim was to elucidate the biological functions of our immunochemically detected proteins. The results obtained thus far are reported. PMID- 1772264 TI - The effects of high parity and socioeconomic status on obstetric and neonatal outcome. AB - We studied the interaction of social status and high parity in 15,102 consecutive births in one inner-city hospital, of which 1874 (12.4%) occurred in mothers who had given birth to seven or more infants (Grand multiparae). Group 1 consisted of 1258 grand multiparae from a socioeconomically stable and homogeneous ultra orthodox Jewish community in Jerusalem, and group 2, included all other grand multiparae of relatively greater age and lower socioeconomic status. A significantly higher rate of small for gestational age, low birth weight and preterm infants was found in group 2 compared with group 1. The results suggest that grand multiparity is not of itself a risk factor, but reflects the confounding effect of environmental conditions. PMID- 1772265 TI - Sex steroids enhance endotoxin-stimulated phospholipase A2 activity in hum endometrial cells. AB - Growing evidence suggests an association between intra-amniotic infection and preterm labor. We recently demonstrated that some factor(s) including endotoxin produced by the organism stimulated endogenous phospholipase A2 resulting in liberation of arachidonic acid and prostaglandin formation (Takahashi et al. 1988). The studies presented in this report were designed to evaluate whether ovarian steroids alter activity of the phospholipase A2 responsive to endotoxin. Exposure of human endometrial proliferative- or secretory-phases epithelium to endotoxin from Escherichia coli increased the level of lysophosphatidylcholine (lyso-PC) by 15- and 25-fold, respectively. When the endometrial cells were preincubated with progesterone alone or progesterone and estradiol-17 beta for 16 h, the increase of lyso-PC by endotoxin was enhanced by approximately 1.5-fold. Progesterone showed a stimulatory effect on the response of phospholipase A2 to bacterial endotoxin in endometrial cells. These observations may explain the mechanism(s) by which preterm or term labor associated with intra-amniotic infection is initiated. PMID- 1772266 TI - Placental morphometry using a computer assisted measuring programme: reference values for normal pregnancies at term. AB - Using the principle that the human placenta is anatomically composed of fetomaternal flow units, we developed a computer-assisted measurement programme capable of recording complex histometric data about the characteristics of the maturation and structural differentiation of resorption villi, as well as subjecting the results to simultaneous statistical processing. Using 42 placentas obtained after normal pregnancies, reference values were derived for the five primary geometrical and six further arithmetical parameters. From these findings, we also calculated the total resorption villi surface area, the proportion of this surface area occupied by epithelial plates, and the resorption-villi surface are relative to the birth weight of the child. Our findings are compared with other available results, and the reasons for discrepancies between previously published measurements are discussed. PMID- 1772267 TI - First-trimester legally induced abortions. The amount of aspirated tissue in relation to gestational age. AB - A possible method for reducing complications after legally induced first trimester abortions was sought. One hundred-seventeen patients participated in the study and had the gestational age determined by ultrasound before evacuation. The aspirated amount of tissue was measured and a definite correlation was made to the seventh to twelfth week of gestation respectively. It is concluded that at least 15 ml tissue should be evacuated in the seventh to eight week, 25 ml in the ninth to tenth week, and 35 ml in the eleventh to twelfth respectively. PMID- 1772268 TI - Malignant endometrioid cystadenofibroma of the ovary. AB - Malignant endometrioid cystadenofibroma is recognized as a distinct category of epithelial ovarian cancer and yet is rarely reported. Three patients from the University of North Carolina experience are described to emphasize similarities between this unusual tumor and common epithelial ovarian cancer with respect to clinical behavior, surgical staging, and treatment. PMID- 1772269 TI - [ACE-inhibitors in the diagnosis of arterial hypertension of renovascular origin]. PMID- 1772270 TI - [Echography, a diagnostic method in testicular abscess]. AB - We report on 10 patients who presented with a scrotal mass. The diagnosis of testicular abscess was made on ultrasonographic examination of the scrotal mass. The sensitivity and specificity rates of the foregoing imaging technique were 100%. Furthermore, it permitted determining with precision the extent and degree of involvement of the following structures: testes, epididymis, spermatic cord and scrotal layers. PMID- 1772271 TI - [Renal biopsy of nephrologic origin. Report of 283 biopsies]. AB - Two techniques are utilized for renal biopsy (RB): open renal biopsy (ORB) and percutaneous renal biopsy (PRB). We reviewed 283 renal biopsies: 140 ORBs and 143 PRBs. The number of glomeruli obtained were 34.6 and 13.4, respectively. Sufficient biopsy material for the pathological analyses was obtained in 100% of the ORBs and 91% of the PRBs. These were diagnostic in 98.5% and 91%, respectively. The two groups were significantly different. Patients submitted to ORB had a worse general condition (analytically more uremic and anemic). The creatinine and urea values prior to RB were higher for the complicated ORB group versus the overall ORB group. Statistically, the complicated ORB group is related with hyperpotassemia and hypernatremia. The sodium values were higher and the urea values were lower for the complicated ORB group, although we believe the foregoing findings to have no clinical value. The remaining analytical studies were not different for the groups or subgroups of the present study. PMID- 1772272 TI - [Diagnostic and therapeutic considerations in bilateral renal carcinoma. Report of a case and review of the literature]. AB - Conservative surgery is considered to be the treatment of choice in patients with bilateral renal tumors or tumor in the solitary kidney owing to the need to preserve renal function. A case of a 63-year-old patient with bilateral renal carcinoma is described. The presenting symptoms were pain and paraneoplastic signs. The patient did not present hematuria throughout the course of the disease. The urographic, ultrasound and tomodensitometric work up correctly determined tumor size, characteristics and anatomic relationship. Arteriography permitted mapping of the vascular structures of both kidneys. Fine needle aspiration biopsy permitted histologic classification preoperatively. The approach was via a Chevron incision. An extended nephrectomy was performed on the left kidney and surgical enucleation of the tumor in the right kidney in a one stage procedure. The diagnostic aspects are discussed and the therapeutic options are reviewed with special reference to the conservative procedures. PMID- 1772273 TI - [Clinical and pathological characteristics of carcinoma of the kidney: computerized analysis]. AB - To evaluate the significance of the clinical and pathological features and survivorship data, we analyzed 203 cases of renal carcinoma who underwent surgery at our department from 1974 to 1988. Tumor stages P2 and P3 and grades G2 and G3 were the most frequent. The series is large enough to permit classification according to tumor stage and grade and most of the possible associations. The diagnostic procedure and the surgical technique were consistent. Radical nephrectomy via the transperitoneal approach was performed in 153 patients. Transpleural thoracophrenolaparotomy was performed in 22 patients with a very large tumor mass in the upper pole. Extended classical nephrectomy via the lumbar approach was performed in 27 patients. Computer-assisted analysis of the clinical and pathological data showed tumor stage to be an important prognostic factor. Given a similar situation for tumor stage, the histologic grade has been shown to influence prognosis significantly. Other clinical or pathological parameters such as pseudocapsule, histological type and paraneoplastic biological and humoral changes often correlated with tumor stage or grade. Clinical staging is a point of reference for surgery. However, detection of microfoci of tumor metastasis that might be responsible for late reactivation of the disease is as yet not possible. PMID- 1772274 TI - [Solitary contralateral, asynchronous adrenal metastasis of renal adenocarcinoma. Review of the literature]. AB - A case of solitary, contralateral, asynchronous adrenal metastasis that appeared 5 years following nephrectomy is described herein. To our knowledge, ours is the fifth case reported in the world literature. PMID- 1772275 TI - [Diagnostic yield of the urodynamic study of the upper urinary tract in the orthotopic and transplanted kidney]. AB - Urodynamic pressure-flow studies (Whitaker test) of 28 kidneys (21 orthotopic and 7 transplanted) with equivocal obstruction of the upper urinary tract (UUT) yielded a sensitivity rate of 77.7% and a specificity rate of 75% in the orthotopic kidney, and sensitivity and specificity rates of 75% in the transplanted kidney. Trauma to the transplanted kidney (denervation, ischemia and surgery) does not modify the urodynamic of the pyelocaliceal system, thus conferring on the test the same diagnostic reliability as in the orthotopic kidney. PMID- 1772276 TI - [Conservative treatment of bladder and prostatic rhabdomyosarcoma in childhood: possibilities for non-radical surgery]. AB - Treatment of rhabdomyosarcoma (RMS) of the bladder and prostate has always been difficult. Despite the significant advancements that have permitted cure, there is no agreement in the choice and order of the different therapeutic options. We reviewed the available literature evaluating the role of non-radical surgery and attempts at bladder preservation especially in children. Partial resection with sufficient margin of safety is only possible in 20% of the primary bladder tumors and the 3-year survival rate is 80%, similar to the overall survival rate for tumors localized to this site. The excellent results achieved in the case described herein underscores the possibilities of a conservative treatment modality in well-selected cases. The patient, who was submitted to partial cystectomy and received VAC polychemotherapy for a period of one year, is alive, tumor free and has preserved bladder function 50 months post-operatively. PMID- 1772278 TI - [Sub-albugineous castration. A passed-over operation?]. AB - Surgical castration continues to be the most reliable method in the treatment of advanced prostatic carcinoma. PMID- 1772277 TI - [Current role of the Zeiss extractor catheter. Comparative study with other methods. Presentation of 80 personal cases and a comprehensive review]. AB - The present study compared the Zeiss and Dormia type extractors for ureteral calculi with the new methods of treatment (shock waves and laser) to determine the place of these extractors in our urological armamentarium today. The results and the complications in our series comprised of 80 cases are presented and the literature available on this subject reviewed. We discuss briefly the methods commonly used today, i. e., shock waves and laser, with special reference to the good results and scant complications. We can conclude from this study that these catheters continue to be useful in current urological practice. PMID- 1772279 TI - [Liposarcoma of the spermatic cord. Presentation of a new case]. AB - We report on a 52-year-old patient who presented with a right-sided tumor mass of the spermatic cord. We describe the operative and biopsy procedures and present our conclusions. PMID- 1772280 TI - [Primary abscess of the psoas muscle]. AB - An additional case of primary psoas abscess is described. The literature is reviewed and its etiopathogenesis, clinical features, diagnosis and treatment are discussed. PMID- 1772281 TI - [Duplication of the inferior vena cava associated with renal carcinoma]. AB - Although uncommon, vascular anomalies of the inferior vena cava can have important consequences in urological oncologic surgery. A case of duplicated vena cava associated with clear cell renal adenocarcinoma is described. This type of tumor of the genitourinary system had been detected intraoperatively. PMID- 1772282 TI - [Iliac-ureteral fistula as a complication of multimodal treatment of bladder carcinoma]. AB - We report on a patient who developed a fistula between the primitive left iliac artery and left ureter following combined treatment with systemic chemotherapy, local radiotherapy and surgery with ureteric diversion and ileal bladder. The role of each of the factors involved in this uncommon complication is discussed. PMID- 1772283 TI - [Calcification of a double-J ureteral catheter]. AB - Two cases of stone formation on double J ureteral catheter are described. Resolution was achieved by ESWL in one and by simple endoscopic removal in the other case with calcification in the distal J. The appearance of calcareous encrustation is frequent and depends on various factors especially the length of time the catheter is left indwelling, urinary stasis and infection. The efficacy of extracorporeal lithotripsy in resolving this complication is discussed. PMID- 1772284 TI - Anatomo-functional considerations on venogenic impotence. AB - The authors report their clinical experience with cavernosography and cavernosometry on impotent patients. The indications of method and its correct place in the diagnostic workup are underscored. The methods of evaluation are described, highlighting the advantages of a diagnostic pharmacological approach in respect to a near as possible physiological haemodynamic evaluation. Finally they propose a future development for the method, such as the use of PGE1 instead of the commonly employed drugs, and a new classification for the veno-occlusive disease with stage and grade. PMID- 1772285 TI - Percutaneous endoureterotomy of uretero-ileal stenosis in the Camey-Le Duc substitution bladder. Our experience in two cases. AB - Two patients with a Camey-Le Duc substitution bladder who presented monolateral uretero-ileal stenosis were treated by percutaneous endoureteral incision using electrocautery and moulding stents. The results were encouraging in one patient after 12 months follow-up. In the other case, however, endourological manipulation had solely symptomatic purpose since the stenosis was caused by local recurrence of primitive neoplasm. PMID- 1772286 TI - Urticarial vasculitis and syndromes in association with connective tissue diseases. PMID- 1772287 TI - Essential fatty acids and inflammation. PMID- 1772288 TI - Human heart sarcolemmal sheath antibodies in children with non-suppurative sequelae of group A streptococcal infections: a follow up study. AB - The kinetics of the human heart sarcolemmal sheath antibody were studied in children with acute rheumatic fever who had no carditis, children with acute rheumatic fever who had carditis and developed rheumatic heart disease, and in children with acute poststreptococcal glomerulonephritis. The children with rheumatic fever and those who developed valvular heart disease were given continuous secondary antistreptococcal prophylaxis. The titre of antibody at onset was significantly higher than that of the controls in children with acute rheumatic fever and carditis and in children with acute poststreptococcal nephritis. The difference in the antibody titre between children with rheumatic fever who had no carditis and controls was not statistically significant. After a mean follow up of three years, however, a high titre was only maintained in children with rheumatic fever who developed valvular heart disease. PMID- 1772289 TI - Localisation of xanthine oxidase to synovial endothelium. AB - The presence of the xanthine oxidase enzyme system has been demonstrated in the rheumatoid synovium. This supplies a reactive oxygen species generating system to synovium that is subjected to hypoxic-reperfusion cycles (cf inflamed rheumatoid synovium). An antibody to bovine milk xanthine oxidase has been used to localise the enzyme by immunohistochemistry to synovial endothelium. This implicates the endothelial cell as playing a major part in exacerbations of synovitis, induced by radicals. PMID- 1772290 TI - Absence of an association between HLA typing in cystic fibrosis arthritis and hypertrophic osteoarthropathy. AB - Fourteen patients with cystic fibrosis arthritis and eight patients with cystic fibrosis and hypertrophic osteoarthropathy were typed for HLA-A, B, C, DR, and DQ antigens and were compared with age and sex matched controls with cystic fibrosis. The diagnosis of cystic fibrosis arthritis and hypertrophic osteoarthropathy was confirmed by radiography and bone scanning. The prevalence of HLA-A, B, C, D, antigens in the cystic fibrosis group (44 patients) did not differ from that in the control group. A comparison between patients with cystic fibrosis arthritis or hypertrophic osteoarthropathy and their respective controls did not show any significant differences in HLA prevalence. It is concluded that HLA antigens may not be a factor in the susceptibility of patients with cystic fibrosis to cystic fibrosis arthritis or hypertrophic osteoarthropathy. PMID- 1772291 TI - Absence of autoimmunity to type II collagen in generalised nodal osteoarthritis. AB - A cardinal feature of generalised nodal osteoarthritis is the loss of articular cartilage. To determine if autoimmunity to these cartilage collagens occurred, serum antibodies to native and denatured type II collagen were measured by enzyme linked immunosorbent assay (ELISA) in 96 patients (90 women, six men, aged 47-91 years) with generalised nodal osteoarthritis. Generalised nodal osteoarthritis was diagnosed by typical clinical and radiological features. Serum samples from 42 blood donors were assayed as controls. No significant difference was found between the patients with generalised nodal osteoarthritis and the controls. Furthermore, the 20 patients who were HLA-A1, B8 positive had similar antibody levels to the group as a whole. One woman patient with generalised nodal osteoarthritis (HLA-A1, B8 negative) had markedly increased antibody levels to native and denatured type II collagen in a pattern similar to that seen in patients with rheumatoid arthritis. This patient did not develop super added rheumatoid arthritis during a three year follow up period. Autoimmunity to type II collagen is therefore rare in generalised nodal osteoarthritis. A lack of collagen antibodies in a condition characterised by hyaline cartilage loss suggests that the presence of such antibodies in rheumatoid arthritis is more than a secondary event to joint damage. PMID- 1772292 TI - Ankylosing spondylitis: an autoimmune disease? AB - Identification of several autoantibodies in serum samples from patients with ankylosing spondylitis or suspected ankylosing spondylitis is reported. Five antibodies associated with ankylosing spondylitis were identified by applying cytoimmunofluorescence and immunoblotting techniques to antigen pools from insect tissue. At least one of these antibodies was found in 82% of serum samples from patients with ankylosing spondylitis. A 36 kD drosophila antigen, which showed the most common and most dominant reaction, was further purified and isolated. Thirty two (34%) of the serum samples from 95 patients with definite ankylosing spondylitis and 12 (28%) of the serum samples from 43 patients with suspected ankylosing spondylitis reacted with this antigen. Antibodies purified from the 36 kD antigen reacted specifically with a 69 kD antigen present in separations of total protein preparations from human lymphocytes and HeLa cells. The 36 kD antibody was not found in 29 patients with rheumatoid arthritis nor in 38 apparently healthy controls. The prevalence of the 36 kD antibody was comparable in HLA-B27 positive and negative patients. In addition, the same immunoreaction was found in patients with so called 'seronegative' spondylarthropathies, particularly of the ankylosing spondylitis-type, suggesting that this antibody is specific for ankylosing spondylitis or other 'seronegative' spondylarthropathies with the typical clinical and radiological changes of ankylosing spondylitis. PMID- 1772293 TI - Determination of oxygen radical production in spondyloarthropathies by whole blood chemiluminescence. AB - Oxygen derived free radicals are considered to play an important part in the development of inflammation. A whole blood chemiluminescence assay was used to study N-formyl-methionyl-leucyl-phenylalanine induced oxygen radical production in subjects with ankylosing spondylitis or previous yersinia arthritis. In luminol enhanced chemiluminescence, the subjects with previous yersinia arthritis showed significantly increased initial activation (at one minute), whereas the subjects with ankylosing spondylitis showed decreased responses at both the initial activation and at peak activation (at two to three minutes). This finding gives credence to the view that, in terms of oxygen radical production, the pathogenesis of yersinia arthritis is different from that of ankylosing spondylitis. PMID- 1772294 TI - Immunolocalisation of type VI collagen in the intervertebral disc. AB - Type VI collagen has been isolated from many connective tissues, including the intervertebral disc. Distribution of this collagen, however, varies considerably within different tissues. In adult mammalian nasal and articular cartilage it is localised preferentially in the matrix immediately surrounding the cell. Intervertebral discs from various species and of various ages were studied and a similar pericellular localisation was found. When antisera to type VI collagen were used staining was seen around the cells of all sections of intervertebral disc, being particularly prominent in the nucleus pulposus. Staining on or around the cells was also seen in the adjacent cartilaginous end plate and bone. PMID- 1772295 TI - Morphometric analysis of blood vessels in synovial membranes obtained from clinically affected and unaffected knee joints of patients with rheumatoid arthritis. AB - Synovial tissues from inflamed and noninflamed knee joints of 13 patients with untreated rheumatoid arthritis were examined for vascular proliferation and morphological alteration of endothelial cells. Perivascular mononuclear cell infiltration and increased thickness of the synovial lining layer were noted in tissues from inflamed and noninflamed joints of patients with rheumatoid arthritis; vascular proliferation and morphological alteration of endothelial cells to resemble high endothelial venules were seen only in tissues from inflamed joints of patients with rheumatoid arthritis. These observations suggest that the migration of mononuclear cells from the peripheral blood to the perivascular areas and lining layer occurs before vascular proliferation and morphological alteration of endothelial cells. PMID- 1772296 TI - Effect of misoprostol on concentrations of prostaglandins in synovial fluid. AB - The effect of misoprostol, a synthetic analogue of prostaglandin E, on prostaglandin concentrations in synovial fluids was investigated in a randomised placebo controlled, double blind study. The synovial fluid concentrations of prostaglandin E1, 6-keto-prostaglandin F1 alpha, and thromboxane B2 were measured at the beginning and end of a 24 hour period in 25 patients with effusions of the knee joint. During this period the patients were treated with diclofenac (50 mg every eight hours) and either misoprostol (400 micrograms) or placebo every 12 hours. The concentrations of prostaglandin E and 6-keto-prostaglandin F1 alpha were not significantly altered during treatment. There was an unexpected significant reduction in thromboxane B2 concentrations in the group treated with misoprostol (within group analysis). Although the mean concentration with misoprostol was about half the mean concentration with placebo, this difference was not statistically significant in the between group analysis. These results indicate that misoprostol is unlikely to exert a proinflammatory effect or to interfere with the prostaglandin mediated effects of non-steroidal anti inflammatory drugs. The significant decrease in thromboxane B2 concentrations in the misoprostol treated group suggests that misoprostol may exert an anti inflammatory effect. PMID- 1772297 TI - Antiphospholipid syndrome: five year follow up. AB - Nineteen patients out of 250 subjects with antiphospholipid antibodies, who had initially presented to the lupus clinic at St Thomas's Hospital, London five or more years ago with a history of venous/arterial occlusions, were entered into the study. The patients were divided into two main groups: I those who remained well without any further thromboembolic complications (n = 10); II those who developed recurrent thrombotic events in the five year period (n = 9). The patients were followed up to determine the relation between the level or the isotype of the anticardiolipin antibodies, or both, to the recurrent thromboembolic events, and the effect of a variety of treatments (corticosteroids, immunosuppression, anticoagulation) in the prevention of further vascular occlusions. Lupus activity over the five year period varied considerably between the two groups--those in group I tending to be relatively inactive compared with those in group II. For some patients in group II thromboembolic events seemed to occur at the time of lupus activity. Antiphospholipid antibodies remained positive in all patients, the levels remaining fairly constant. Levels fell in only one patient in group I and in two in group II. Patients in group II had more systemic lupus erythematosus related disease than those in group I; most were receiving concomitant steroid and immunosuppressive therapy, but this did not seem to protect against the development of further occlusions. All patients were given anticoagulation treatment (warfarin/heparin) or salicylates (low dose aspirin 75 mg daily), or both. Patients with deep vein thromboses developed more complications during anticoagulation therapy than those with cerebrovascular symptoms. Problems in anticoagulation control and recurrent thromboses consequent on warfarin withdrawal despite the administration of subcutaneous heparin were responsible for complications in most patients in group II. PMID- 1772298 TI - Calcitonin treatment for intersternocostoclavicular ossification: clinical experience in two cases. AB - Intersternocostoclavicular ossification is a benign arthro-osteitis of the upper anterior chest of unknown cause. Two patients with acute exacerbation of this disorder were successfully treated with intramuscular injections of an eel calcitonin analogue (40 units three times a week). Besides symptomatic relief of local pain and swelling, serial scintigrams showed quantitative improvement in radiophosphonate uptake. The rapid alleviation of pain implies that the hormone has a central analgesic effect, in addition to its direct influence on bone cells and antiinflammatory action. In one patient the disease was associated with palmoplantar pustulosis, which was cured with oral colchicine, whereas the other patient did not have such skin lesions. Despite a hypothetical link between palmoplantar pustulosis and intersternocostoclavicular ossification, colchicine had no beneficial impact on the bone pain. Salmon calcitonin delivered by nasal spray was tried for the second patient but failed, probably because of insufficient drug delivery. The initial favourable results described here warrant future use of calcitonin injection on a larger number of patients with intersternocostoclavicular ossification. PMID- 1772299 TI - Detection of antineutrophil cytoplasmic antibody in a patient with L-tryptophan induced eosinophilia-myalgia syndrome. AB - The Center for Disease Control has received numerous reports of an eosinophilia myalgia syndrome related to products containing L-tryptophan. The case is reported of eosinophilia-myalgia syndrome and polyneuropathy associated with myeloperoxidase specific antineutrophil cytoplasmic antibody. PMID- 1772300 TI - Haemarthrosis due to fracture through amyloid deposits in bone in Portuguese familial amyloidosis. AB - A patient with Portuguese familial amyloid polyneuropathy who developed haemarthroses secondary to pathological fractures is described. Amyloid material was demonstrated on bone biopsy and confirmed immunohistochemically to be transthyretin (prealbumin). Although amyloid deposits in bone have been described in other types of amyloid, this is believed to be the first proved case of amyloid deposition resulting in pathological fracture in familial amyloidosis. PMID- 1772301 TI - Ranges of movement at the shoulder complex using an electromagnetic movement sensor. AB - There are few published data on the ranges of available motion at the shoulder and no clinical technique for the assessment of three dimensional movement. An electromagnetic movement sensor (Isotrak), which makes three dimensional measurements of shoulder movement and measures the ranges of flexion, extension, abduction in the neutral position, abduction preceded by external rotation, and internal rotation achieved by placing the hand as far up the back as possible, was used to study 16 normal subjects. Intraobserver repeatability was good, and a study of five subjects by two observers showed no significant difference between single measurements made by each. The measured ranges were in broad agreement with published data, though they tended to be smaller. This was attributed to either the bulk of the mounting for the movement sensor or to the immobilisation of the elbow and hence the biceps muscle. Women had greater ranges, except for externally rotated abduction. PMID- 1772302 TI - Vascular endothelium, cytokines, and the pathogenesis of inflammatory synovitis. PMID- 1772303 TI - Feedback regulation of antibody production: a role in rheumatoid arthritis? PMID- 1772304 TI - Epidermal growth factor receptors (EGFR) localization in human testis. AB - An indirect immunofluorescence technique was used to detect and localize epidermal growth factor receptors (EGFR) in human testicular biopsies in different testicular diseases. Monolateral biopsies from twelve infertile subjects were studied from qualitative/quantitative points of view and were examined by immunofluorescence study with anti-EGFR monoclonal antibody. Two different patterns of EGFR expression were observed: a very weak presence of EGFR was detectable on Sertoli cells, peritubular basal structures, and interstitial compartment in testicular biopsies showing a normal spermatogenic status; and an important increase in EGFR expression was observed on the cytoplasm of Sertoli cells and on peritubular basal structures in biopsies exhibiting various degrees of hypospermatogenesis and in a case of Sertoli cells only syndrome. Germ cells did not show EGFR immunolocalization. EGFR seems to be present on different testicular target cells. EGFR expression increases on peritubular and Sertoli cells in the presence of significant tubular damage. PMID- 1772305 TI - GnRH antagonist treatment affects nuclear size and membrane associated indentations in rat Leydig cells. AB - In semi-thin preparations of rat testis treated with GnRH antagonist (Ac-D2Nal 1, D4ClPhe 2, DTrp 3, DArg 6, DAla 10; GnRH code- 103-289-10, National Institutes of Health, USA) for a period of 5 weeks, Leydig cells showed a reduction of 18% in the mean nuclear area as compared to the controls. The number of cells with nuclear membrane indentations increased by more than 40% as compared to the controls. Nuclear condensation was evident in the form of dark, electron-dense patches of heterochromatin present all along the rough, uneven boundary of the nuclear wall. In some cells, indentations in the nucleus appeared in the form of deep grooves extending into the core of the nucleus. Shrinkage in the cytoplasm of the cells was very much apparent. Circulating levels of LH and testosterone were very low. LH decreased from 29.6 +/- 2.9 ng/ml to 0.55 +/- 0.018 ng/ml and testosterone from 7.8 +/- .29 ng/ml to 0.5 +/- .02 ng/ml. The mean nuclear area of Leydig cells from other groups of rats treated with estradiol 17-beta (1 microgram/rat per day), testosterone (60 micrograms/rat per day) or combinations of testosterone and estradiol or GnRH antagonist and testosterone in the same regime and for the same period remained unaltered. On the other hand, cells appeared normal when testosterone was supplemented (60 micrograms/rat/day) in rats treated with GnRH antagonist. The mean nuclear area of the Leydig cells recovered significantly (p less than 0.001), but was not completely restored. PMID- 1772306 TI - Influence of incubation time/temperature on acrosome reaction/sperm penetration assay. AB - The acrosomal status of human spermatozoa was studied in relation to the score of the sperm penetration assay (SPA) at low-temperature (4 degrees C) incubation for induction and synchronization of the acrosome reaction (AR) and the incubation time of spermatozoa in conventional SPA. Spermatozoa were collected from 18 patients, selected by the "swim-up" method and treated in three different ways: (1) short-term incubation group (SIG): 3 h incubation at 37 degrees C, and (2) long-term incubation group (LIG): 20 h incubation at 37 degrees C, and (3) low temperature group (LTG): 24 h incubation at 4 degrees C followed by additional incubation at 37 degrees C for 3 h. The conventional methods of incubation, i.e. SIG (3 h) and LIG (20 h) did not show any significant differences as evaluated by the sperm penetration rate and the number of decondensing sperm heads per oocyte. In contrast, in the LTG all parameters were significantly increased, especially those of penetration rate (p less than 0.0005) and decondensing sperm heads per oocyte (p less than 0.0005). The percentage of AR significantly increased (p less than 0.0005) in the LTG (14.7%) compared with SIG (6.1%) and LIG (10.6%). A significant correlation was demonstrated between AR and the parameters used for evaluation of the SPA. The penetration rate (Spearman test, r = 0.462, n = 54, p less than 0.003) was the most significant parameter correlated with AR. It would appear that only human spermatozoa having completed AR are capable of fusing with the zona-free hamster ova.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772307 TI - In vitro decondensation of nuclear chromatin of human spermatozoa: assessing fertilizing potential. AB - Spermatozoan nuclear chromatin is in a highly condensed state prior to fertilization. In vivo decondensation occurs in the ooplasm and is essential for successful fertilization and the formation of male pronucleus and the zygote to occur. The chromatin of spermatozoa and nucleus can undergo in vitro decondensation with sodium dodecyl sulfate (SDS) and 6 mM ethylene diamine tetraacetic acid (EDTA). The ability of sperm to decondense in vitro was compared with their ability to fertilize human oocytes in vitro. Spermatozoa from normal samples were studied for their decondensation ability as regards their fertilizing performance in an in vitro fertilization (IVF) program. Fertilization occurred when the decondensation percentage of sperm nuclear chromatin was more than 70%. The effective sperm count was significantly (p less than 0.05) lower in the unfertilized group. This is a new diagnostic technique to assess sperm fertilizing potential at the initial evaluation of the male. PMID- 1772308 TI - Effect of smoking on concentration, motility and zona-free hamster test on human sperm. AB - The effect of smoking on sperm concentration, motility, and zona-free hamster egg sperm penetration assay (SPA) was evaluated in 293 smokers of more than 10 cigarettes/day and 382 nonsmokers. Prerequisites for inclusion in the study were sperm concentration of greater than 10 x 10(6)/ml, sperm motility of greater than 30%, and normal morphology of greater than 60%. Although a lower sperm concentration was found in smokers, no significant difference was observed in sperm motility and SPA. PMID- 1772309 TI - A simplified technique for freezing human sperm for AIH: cryosyringe/floating platform of liquid nitrogen vapor. AB - A cryosyringe and floating platform were developed to simplify the procedures for human sperm cryopreservation without sacrificing post-thaw sperm quality. The cryosyringe was developed as a vessel for cryopreservation and as a device for post-thaw insemination. A platform-like polystyrene foam board 3-cm in height was floated on the surface of liquid nitrogen in a polystyrene foam freezing container. The cryosyringe containing sperm/KS-II medium mixture was placed on it for 5 min, then it was dropped into the liquid nitrogen. Freezing velocity was 27 degrees C/min. Poor quality semen specimens (40 +/- 14 x 10(6)/ml, 18 +/- 2.6% motility, n = 9) were concentrated (87 +/- 46 x 10(6)/nl, 29 +/- 9.1%) previously and then cryopreserved in the cryosyringe or in a commercial tuberculin syringe under the conditions established in the present study. The post-thaw sperm motility of the specimens in the cryosyringe (18 +/- 7.4%) was significantly superior (p less than 0.05) to that in the commercial tuberculin syringe (13 +/- 5.3% motility). PMID- 1772310 TI - Effect of antisperm antibodies on computerized semen analysis. AB - The effect of antisperm antibodies (ASA) in males was determined in 239 men by the use of a computerized semen analyzer (CASA). ASA was assessed using the direct immunobead test (IBT). Sperm variables for men with positive ASA were significantly lower than those with negative results in percentages of motility, velocity, and linearity. PMID- 1772311 TI - Human acrosin: purification and some properties. AB - Human sperm with normal morphology and good viability were obtained by centrifugation using a discontinuous Percoll density gradient with an inner column. Acrosin (E.C.3.4.21.10) was rapidly purified from sperm by ion exchange adsorption and elution and was purified by affinity adsorption on a lima bean trypsin inhibitor (LBTI) Cellulofine column. The final preparation was found to be homogeneous on polyacrylamide gel electrophoresis and to have a molecular weight of about 4 x 10(4) daltons. The enzyme had an esterolytic activity of 3.5 mumol/min/A280 with N-alpha-tosyl-L-arginine methyl ester as the substrate. Human acrosin showed a broad substrate specificity for arginine and lysine derivatives and it seemed to have a somewhat different specificity from trypsin. The optimal pH of this enzyme with amidolytic activity was 9.0. Enzyme activity was stimulated by a high concentration of calcium chloride. LBTI and aprotinin strongly suppressed the amidolytic activity with the D-valyl-L-leucyl-L-arginine p-nitroanilide (Val-Leu-Arg-pNA) as the substrate, but alpha 1-antitrypsin and soybean trypsin inhibitor were less effective. PMID- 1772312 TI - [About "sudden death"]. PMID- 1772313 TI - [Pulmonary thromboendarterectomy as a treatment of chronic pulmonary arterial hypertension secondary to unresolved pulmonary thromboembolism. A preliminary report]. AB - This is a preliminary report of our initial experience with thromboendarterectomy in the treatment of four patients with chronic major-vessel thromboembolic pulmonary hypertension. Before surgery, these patients all had severe pulmonary hypertension and cor pulmonale as well as significant abnormalities in lung function (mechanics and gas exchange). They were in class III-IV (NYHA). One of our patients died immediately after the procedure as a result of major bleeding. The remaining three surviving patients have shown a remarkable improvement in both, pulmonary hemodynamics and lung function which has been translated in an also significant improvement in their clinical condition. Although there is still a significant risk involved with this procedure, the thromboendarterectomy represents a reasonable and useful therapeutic approach for selected patients with this deadly form of chronic pulmonary hypertension in which other forms of treatment have proved to be unsuccessful. PMID- 1772314 TI - [Percutaneous transvenous mitral commissurotomy with the Inoue catheter: the initial experience in Mexico]. AB - Percutaneous transvenous mitral commissurotomy (PTMC) with the Inoue balloon catheter (IBC) was performed in 11 adult, symptomatic patients with moderately severe, pure of predominant mitral stenosis (MS). The transseptal approach and a valvuloplasty technique of progressive and controlled valvular dilatation were utilized. The procedure failed in one patient due to an inadequate transseptal puncture, and it was successful in the other 10. The mitral valve area increased from 1.00 +/- 0.27 to 2.19 +/- 0.31 cm2 (p less than 0.001); the diastolic mitral gradient decreased from 20.9 +/- 4.6 to 5.9 +/- 3.3 mmHg (p less than 0.001); similar reduction was obtained in the mean atrial pressure from 22.3 +/- 5.8 to 11.6 +/- 4.2 mmHg (p less than 0.001), and the mean pulmonary arterial pressure from 41.3 +/- 16.1 to 26.4 +/- 10.5 mmHg (p less than 0.05). There were no complications. Left to right shunting at the atrial level, due to the transseptal approach, was moderately significant in only 2 patients (QP/QS = 1.4 and 1.3 respectively). Grade I, and grade I-II mitral insufficiency occurred in 2 patients, one of them with previous mitral regurgitation, and it was not demonstrated or disappeared (if preexistent) in the rest. Patients were discharged in 48 hs at the most. They all referred improvement in their functional class, and at 4.3 months of average follow-up they are asymptomatic. In conclusion, PTMC with the IBC is a safe, simple and successful technique to separate the fused commissures, increase the mitral valve area and improve the functional class in selected cases of rheumatic MS. A long term follow-up is required for evaluation of late results. PMID- 1772315 TI - [Left ventricular mechanics in Chagas' disease and primary dilated myocardiopathies. A hemodynamic study]. AB - The evolution of several mechanical parameters of left ventricular function was studied in 32 control subjects, 171 chronic chagasic and 60 primary dilated cardiomyopathy patients, which were submitted to an extensive invasive and non invasive protocol. Preload and afterload (end-diastolic and end-systolic stress), contractile status (ejection fraction), the magnitude (mass/index) and adequacy of hypertrophy (mass/volume ratio) and afterload (systolic stress/volume ratio) were derived from the invasive explorations. There was an increased afterload in 25% of chronic chagasic patients without other evidence of early myocardial damage, which was accompanied by signs of inadequate hypertrophy. Both findings increased further with the progression of the disease. Systolic performance was initially preserved, but showed a progressive depression paralleling the clinical evolution. Patients with dilated cardiomyopathy showed a mechanical profile similar to chagasic patients with advanced degree of myocardial damage. The hemodynamic determination of mass index, mass/volume ratio, end-systolic and end diastolic stress seem to be the best parameters for detection of early abnormalities in loading conditions of the heart in chronic Chagas, disease, and for indication and evaluation of the results of vasodilator therapy in both groups of patients. PMID- 1772316 TI - [The mortality determinants in 93 cases operated on for aortic stenosis]. AB - We report 93 cases of severe aortic stenosis. We discuss their clinical data, hemodynamic parameters, and surgical outcome. The surgical mortality and variables determining this event evaluated in groups: A (deaths) and B (survivors). Functional class (mean = 2.5 vs 2.0 p less than 0.05) was statistically as determinant for mortality as were also: transaortic gradient (group A mean = 110 +/- 37 mmHg vs group B mean = 82 +/- 31 p less than 0.005), and ejection fraction (group A mean = 55 +/- 13.7 vs group B mean = 64 +/- 14.8 p less than 0.005). Neither time of cardiopulmonary bypass nor aortic clamping were determinants for mortality. Our results are similar to those reported in other groups. Mortality rates, are determined basically by deterioration of left ventricular function, and by the severity of transaortic gradient. PMID- 1772318 TI - [Basic considerations of the treatment of cardiac arrhythmias]. PMID- 1772317 TI - [Pulmonary thromboembolism in children]. AB - We report our experience with five children with pulmonary embolism and infarction. Two with congenital heart disease, one with rheumatic cardiopathy and two with a previously healthy cardiopulmonary system. The risk factors, clinical behavior and ECG were similar to those in adults. In chest roentgenogram we found pulmonary infarction with cavitations in three patients because of a delayed diagnosis. All patients had hypoxemia and hypocapnia, and diagnosis was made on the basis of segmentary or larger defects in perfusion gammagraphy. In just one case we obtained V/Q gammagraphy and pulmonary angiography. In one case we confirmed the clinical diagnosis by autopsy. We conclude that it is very important to keep this diagnosis in mind in all children with respiratory failure. PMID- 1772319 TI - [Arrhythmias of ectopic origin: the physiopathological bases for their treatment]. PMID- 1772320 TI - [The reentry concept as the basis for clinical arrhythmias]. PMID- 1772321 TI - [The treatment of arrhythmias in today's cardiology clinic]. PMID- 1772322 TI - [Programmed electrical stimulation of the heart in the treatment of tachyarrhythmias]. PMID- 1772323 TI - Effects of the enantiomers of flecainide on action potential characteristics in the guinea-pig papillary muscle. AB - The enantiomers of flecainide, a Class Ic antiarrhythmic agent, were tested in the guinea-pig papillary muscle using the standard microelectrode technique. In 5.4 mM external K+ and at a stimulation frequency of 1 Hz, significant differences were observed in the effect of the enantiomers on maximal rate of depolarization, action potential amplitude and action potential duration. Maximal rate of depolarization and action potential amplitude were more suppressed in the presence of (+)flecainide. Maximal rate of depolarization was reduced to 54.4 +/- 1.4% (n = 23) (mean +/- S.E.M.) of maximum in the presence of 7.2 microM (+)flecainide and to 60.5 +/- 1.1% (n = 24) in the presence of the same concentration of (-)flecainide. The stimulation interval used had a pronounced influence on maximal rate of depolarization for both enantiomers. At almost all stimulation intervals tested, block was larger for (+)flecainide than for ( )flecainide. When the stimulation interval was shortened from 10 sec to 0.25 sec, the maximal rate of depolarization was reduced from 89.8 +/- 0.8% (n = 13) to 37.4 +/- 2.3% (n = 10) of the control in the presence of 7.2 microM of (+)flecainide and from 91.7 +/- 0.8% (n = 14) to 44.9 +/- 1.6% (n = 12) when the same concentration of (-)flecainide was used. The effect on maximal rate of depolarization was also voltage-dependent. For both enantiomers, inactivation curves, recorded at a frequency of 0.6/min, were shifted to more negative potentials. There was no significant difference in magnitude of shift between the two enantiomers. PMID- 1772324 TI - Pharmacological effects of berberine on the longitudinal muscle of the guinea-pig isolated ileum. AB - The effects of berberine on the contractions of the longitudinal muscle of the guinea-pig isolated ileum were investigated. Lower concentrations of berberine (less than or equal to 5 x 10(-5) M) induced a parallel rightward shift of the dose-response curve of acetylcholine, suggesting that berberine is antagonizing the actions of acetylcholine at the receptors competitively. At higher concentration, berberine (1 x 10(-4) M) facilitated a rightward shift of the dose response curve of acetylcholine with a reduction of maximum response, indicating that the interactions of the two agents changed from competitive to noncompetitive antagonism. The competitive antagonism is due to the actions of acetylcholine at the muscarinic receptors, while the noncompetitive antagonism is probably due to the action of berberine at other sites in addition to the muscarinic receptor sites. Berberine dose-dependently antagonized the effects of muscarine, a specific muscarinic receptor agonist, in a fashion similar to the antagonism of acetylcholine, providing evidence that the site of action of berberine is at the muscarinic receptors. Hexamethonium (7.5 x 10(-4) M) did not influence the effect of berberine on the concentration-response curve of acetylcholine and berberine had no effects on the contractions of the preparation elicited by histamine, suggesting its specificity for muscarinic receptors. Berberine also concentration-dependently reduced electrically induced cholinergic contractions, corresponding with its effects at the muscarinic receptor sites. Berberine had no effects on the contractions elicited by KCl, which acts at postreceptor sites. The action of berberine was reversible and dependent on the duration of incubation with the preparation; the longer the time of incubation with the tissues, the slower the recovery. The results of this series of experiments support the hypothesis that berberine blocks muscarinic receptors and this might be part of the explanation of its efficacy in the reduction of intestinal motility and in the treatment of diarrhea. PMID- 1772325 TI - Relationship between nasal absorption and physicochemical properties of quaternary ammonium compounds. AB - The present study was undertaken to investigate the in situ nasal absorption of a series of tetraethylammonium chloride-related aliphatic quaternary ammonium compounds in rats and its relationship with their physicochemical properties (molecular weight and partition coefficient). All of the ten quaternary ammonium compounds examined were found to be absorbed through the nasal mucosa of rats. The nasal absorption rates of ethyltrimethyl-ammonium iodide and tetraethylammonium chloride, with the lowest molecular weight, were the highest, and those of tetra-n-butylammonium chloride and tetra-n-propylammonium bromide, with high molecular weight, were much lower. Thus, there was a tendency that the nasal absorption rates of quaternary ammonium compounds in rats decreased with an increase in their molecular weight. A physicochemical study has shown that there was a linear relationship between the molecular weight of the ten quaternary ammonium compounds and their partition coefficient, thereby suggesting an increase in lipophilicity with the molecular weight. In addition, there was a good correlation between the extent of the nasal absorption of the quaternary ammonium compounds studied and their molecular weight or partition coefficient. These data suggest that there is a reciprocal relationship between the membrane transport of quaternary ammonium compounds in the nasal mucosa and their lipophilic character. In conclusion, it seems likely that quaternary ammonium compounds are predominantly absorbed from the nasal mucosa of the rat through waterfilled channels or pores rather than through the lipid membrane. PMID- 1772326 TI - Action of tioxamast on various models of anaphylactic shock, hyperreactivity and bronchial inflammation in guinea-pigs. AB - Tioxamast, an anti-allergic compound inhibiting the release and synthesis of certain mediators of allergy and having no major antagonist effect towards such mediators, was experimented on various models of anaphylactic shock, hyperreactivity and bronchial inflammation in guinea-pigs. Tioxamast does not reduce passive pulmonary anaphylactic shocks induced in anaesthetized or conscious guinea-pigs by i.v. challenge of antigen. Likewise, the compound has no effect on systemic hyperreactivity towards i.v. histamine induced in anaesthetized guinea-pigs after a passive anaphylactic shock caused by i.v. challenge of antigen. On the other hand, tioxamast inhibits passive pulmonary anaphylactic shock induced in guinea-pigs by antigen aerosol in conscious guinea pigs. Likewise, tioxamast decreases hyperreactivity to inhalation of histamine or carbamylcholine obtained after an active or passive anaphylactic shock by aerosol in conscious guinea-pigs. The oxamate derivative attenuates the increase in number of eosinophils and mononuclear cells obtained in the bronchoalveolar lavage fluid 24 hr after an active anaphylactic shock induced by aerosol. The anti-allergic activity of tioxamast on the various models carried out in guinea pigs thus appears when these models are induced by a challenge of antigen or mediator by inhalation. PMID- 1772327 TI - Compound M & B 39890A [N-(3-imidazol-1-ylpropyl)- 2-(3 trifluoromethylbenezensulphonamido)-benzamide hydrochloride], a glucagon and insulin secretion inhibitor, improves insulin sensitivity in viable yellow obese diabetic mice. AB - Compound M & B 39890A [N-(3-imidazol-1-ylpropyl)-2- (3 trifluoromethylbenzenesulphonamido)benzamide hydrochloride] had no effect on cellular cAMP and cGMP levels but significantly inhibited insulin and glucagon secretion from freshly isolated normal rat islets stimulated with 10 mM glucose and 20 mM arginine. Daily gavage of the compound for three days lowered the elevated blood glucose and plasma insulin levels in fed, male viable yellow obese diabetic mice; the minimum effective dose was 25 mg/kg. However, M & B 39890A did not affect the blood glucose level of fasted diabetic mice. In addition, it had no effect on blood glucose levels of normal mice and streptozotocin-diabetic rats. M & B 39890A, fed in the diet at the concentration of 1 mg/g for 42 days, reversed the hyperglycemia of the fed diabetic mice without causing tachyphylaxis and improved the sensitivity to exogenous insulin as demonstrated by the lowering of blood glucose. When M & B 39890A was fed to young male mice destined to become diabetic, the development of hyperglycemia was prevented. Thus, M & B 39890A represents a new class of pharmacological agents that may prove to be effective for the chronic treatment of type II diabetics without the risk of hypoglycemia. PMID- 1772328 TI - Early toxicity of recombinant interleukin-2 in cats. AB - Studies were conducted in cats to determine whether this species could serve as an animal model for the therapeutic toxicity of recombinant interleukin-2 in humans, and to establish the role of the area postrema in the causation of recombinant interleukin-2-induced vomiting. Injections of recombinant interleukin 2 (3.6 x 10(6) IU/kg, i.m.), given once every 24 hr for one to three days, evoked repeated vomiting in 4 out of 6 area postrema intact cats and in 3 out of 3 area postrema-ablated cats. These results suggest that the area postrema is not essential for the emetic action of recombinant interleukin-2. In anesthetized intact cats, no remarkable changes in ventilation, blood pressure, heart rate or blood pH were observed over 4.5 to 54 hr of continuous physiological recording after i.v. injections of recombinant interleukin-2 to a total dose as high as 27 x 10(6) IU/kg. Cat lymphocytes responded appropriately to the cytokinetic action of human recombinant interleukin-2. PMID- 1772329 TI - Relaxation of coronary artery smooth muscle cells. AB - The effect of adenosine and nitroglycerine on single smooth muscle cells isolated from the right coronary artery of the pig is reported. Trypan Blue exclusion and electron microscopy revealed that the cells used in this study were structurally intact. These cells were 79.2 +/- 1.6 microns long. Within 1 min of exposure to solutions containing norepinephrine, carbachol and high KCl, the cells contracted by 20-30%. The concentrations required for half maximal contraction for norepinephrine, carbachol and KCl were 0.1 to 1 nM, 0.01 to 0.1 nM and 15 to 25 mM, respectively. Adenosine and nitroglycerine inhibited the contractions caused by high (30 mM) K+ and also relaxed the cells previously contracted by high K+. Thus adenosine and nitroglycerine relax by acting directly on the smooth muscle cells. PMID- 1772330 TI - 5-HT2 receptor-stimulated calcium influx in ovine uterine artery in late pregnancy. AB - The effects of 5-hydroxytryptamine (5-HT) and 2,5-dimethoxy-4-methyl-amphetamine (DOM) on the Ca2+ influx in the ovine uterine artery in late pregnancy have been studied by measuring 45Ca2+ uptake. Both 5-HT and DOM (2.5 x 10(-8) M to 2.5 x 10(-5) M) induced concentration-dependent rises in 45Ca2+ uptake in the ovine uterine artery, from a basal level of 30.5 +/- 3.5 muMoles/kg wet tissue to peak levels of 91.1 +/- 9.2 and 84.2 +/- 8.1 muMoles/kg wet tissue, respectively. The Ca2+ influx evoked by 5-HT and DOM was inhibited by ketanserin in a concentration dependent manner. Methiothepin (2.5 x 10(-7) M) also inhibited 5-HT-induced (2.5 x 10(-6) M) Ca2+ influx by 86%. No antagonism was found with 2.5 x 10(-6) M of 3 tropanyl-3,5-dichlorobenzoate (MDL 72222). The contraction elicited to 5-HT (10( 6) M) and DOM (10(-6) M) was blocked by D600 (10(-6) M) which also blocked the contraction produced to KCl (9 x 10(-2) M). Amrinone (10(-5) M) had no inhibitory effect on these contractions. In accord with the results of the contraction study, D600 (2.5 x 10(-6) M) blocked the Ca2+ influx stimulated by 5-HT (2.5 x 10(-6) M) and amrinone (2.5 x 10(-5) M) failed to inhibit 5-HT-induced Ca2+ influx. Nifedipine (2.5 x 10(-6) M) did not antagonize the influx of Ca2+ induced by 5-HT. Sodium nitroprusside inhibited the 5-HT-induced Ca2+ influx, indicating that at least part of its inhibitory effect on the vasoconstriction evolved by 5 HT is due to the inhibition of the influx of Ca2+. PMID- 1772331 TI - Salicylate binding by human albumin in the presence of a perfluorochemical emulsion. AB - The binding of 43 and 216 micrograms/ml sodium salicylate by a perfluorochemical emulsion, by human albumin, and by their mixtures, has been examined at ambient room temperature. Sodium salicylate was chosen as a model drug since it is bound by both sites I and II on human albumin. The concentration of free salicylate was determined through standard centrifugation followed by supernatant ultrafiltration. Sodium salicylate was weakly bound by the perfluorochemical emulsion droplets through an interaction with the emulsifiers. This binding was independent of salicylate concentration. Sodium salicylate was also bound by human albumin and the per cent free salicylate was dependent on both drug and albumin concentration. Relative to salicylate binding by 4% human albumin, addition of the emulsion to 4% human albumin resulted in an increase in the per cent free salicylate in all mixtures examined. The addition of equal or greater volumes of the emulsion to 4% human albumin resulted in the direct and/or indirect displacement of albumin bound salicylate in addition to the protein dilution effect. This displacement of albumin bound salicylate was due to the oleic acid component of the emulsion. PMID- 1772332 TI - Carbachol differs from classical muscarinic agonists in producing long-term desensitization in smooth muscle. AB - In the rat and guinea-pig antrum and in the guinea-pig trachea, carbachol (10(-3) M) desensitized the smooth muscle to the contracting action of other muscarinic drugs and BaCl2. In spite of extensive washing, the smooth muscle was completely unresponsive 30 min after the exposure to carbachol and still partially unresponsive after 75 min. None of the classical muscarinic agonists, i.e., acetylcholine, methacholine or bethanechol, showed such a long-term desensitizing effect when tested in identical conditions. Bethanechol (10(-3) M) desensitized the rat antrum heterologously but this desensitization ceased already after 5 min. Carbachol desensitized the rat antral smooth muscle also in a calcium-free incubating medium. It is concluded that the carbachol-induced heterologous long term desensitization is not related to persisting contraction, changes in receptors or blockade of calcium influx. PMID- 1772333 TI - Haloperidol on rat phrenic hemidiaphragm. AB - The butyrophenone neuroleptic haloperidol (10.65-85.2 microM) blocked the indirectly elicited twitch response of rat phrenic nerve diaphragm preparation. The depression was poorly reversible and was not mediated through dopamine receptors since neither dopamine nor apomorphine could alter the haloperidol blockade. Experiments on the isolated phrenic nerve indicated that the excitability of the nerve was blocked by haloperidol (42.6 microM) and that this blocking effect was minimized in presence of a high concentration of Ca2+ (5 mM) in the bathing fluid. Haloperidol (10.65-85.2 microM) also concentration dependently inhibited acetylcholine (2.7 microM) contracture, without affecting the potassium chloride (0.5 M) and caffeine (15 mM) contracture. We conclude that haloperidol acts as a local anaesthetic on the motor nerve, probably by affecting calcium channels. PMID- 1772334 TI - Muscarinic receptor subtypes of guinea-pig common bile duct. AB - The antagonism of carbachol-induced contractions of guinea-pig common bile duct smooth muscle strips by various antagonists has been investigated in order to find out the muscarinic receptor subtype(s) of common bile duct smooth muscle. Atropine, pirenzepine, 4-DAMP and AF-DX 116 were used as nonselective, M1 selective, M1- and M3-selective and M2-selective muscarinic antagonists, respectively. All muscarinic antagonists examined displaced the concentration response curves to the right, parallelly and in a concentration-dependent manner, without affecting maximum response. Schild analysis of data was consistent with competitive antagonism. pA2 values of the antagonists were as follows: atropine, 9.59; pirenzepine, 7.32; 4-DAMP, 8.99; AF-DX 116, 6.85. When these pA2 values are compared with those obtained in the ileum, it may be concluded that the muscarinic receptors of the guinea-pig common bile duct mediating cholinomimetic induced contractions, are of the M3 subtype, but not of the M1 and M2 subtypes. PMID- 1772335 TI - Guanabenz action on renal excretory function in New Zealand genetically hypertensive rats. AB - The renal action of guanabenz, a centrally acting antihypertensive drug, was evaluated in anesthetized New Zealand genetically hypertensive rats and in normotensive Sprague-Dawley rats using clearance techniques. In high doses (1 mg/kg/hr), the drug lowered systemic blood pressure in the hypertensive rats without reducing glomerular filtration rate. Mean urine flow increased from 2.42 +/- 0.34 to 36.52 +/- 4.52 microliters/min per 100 g b.wt. while fractional water excretion increased from 0.34 +/- 0.05 to 4.36 +/- 0.50%. The renal and hemodynamic actions of the drug were sustained throughout the experiment. In a lower dose (10 micrograms/kg/hr), guanabenz reduced blood pressure in the hypertensive rats to an extent similar to that of the higher dose but had only a moderate effect on kidney function. Renal elimination of water, sodium and potassium increased slightly and glomerular filtration rate remained unchanged. Infusion of the vehicle alone did not cause significant changes in the hemodynamic and renal excretory functions. In the normotensive rats, receiving the high dose of the drug, mean urine osmolarity declined nearly 10-fold from 2466 +/- 136 to 290 +/- 37 mOsl while total solute excretion doubled. Infusion of the vehicle alone did not cause significant changes in the hemodynamic and renal excretory functions. The drug appears to have a primary action on the renal tubular handling of water and sodium. It may inhibit the secretion of antidiuretic hormone or block the antidiuretic hormone-stimulated cAMP-dependent increase in water permeability of the collecting tubules through its alpha 2 adrenoceptor agonistic effect. Natriuresis may have resulted in part from a lowered sympathetic tone to the kidneys. PMID- 1772336 TI - Effects of mefloquine on the isolated chick biventer cervicis and rat phrenic nerve hemidiaphragm preparations. AB - The effects of the antimalarial agent mefloquine on skeletal muscle and its neurotransmission were investigated on the isolated chick biventer cervicis and rat phrenic nerve hemidiaphragm. At concentrations of 64, 128 and 257 microM, mefloquine reduced twitch contraction responses to nerve stimulation, and inhibited carbachol- and KCl-induced contractures of avian muscle. Qualitatively similar responses were observed for chloroquine (257 microM) and quinine (512 microM) but the inhibitory effects of mefloquine were more pronounced and less readily reversible. On the rat phrenic nerve hemidiaphragm, mefloquine (50, 75 and 100 microM) inhibited twitch contractions stimulated indirectly via the nerve. When nerve transmission has been blocked with alpha-bungarotoxin, mefloquine inhibited twitch responses obtained by direct stimulation of the hemidiaphragm. The present findings indicate that its prime action seems to be on muscle contractility, possibly by inhibiting excitation-contraction coupling. PMID- 1772337 TI - Influence of clomipramine and embolization on the characterization of serotonin uptake in rabbit lung using a new mathematical model. AB - The kinetic parameters Vmax and Km of the carrier-mediated uptake of serotonin by the lung can be used as an index of endothelial distress. To this purpose we have recently developed a new mathematical model which estimates the kinetic parameters of the double uptake mechanism of serotonin by the rabbit lung (MODEL3, Peeters et al., 1989). The aim of the present study was to evaluate the behavior of this new model after inhibition of the uptake by clomipramine and after reduction of the perfused lung surface with glass bead embolization. Clomipramine administration did not cause distinct hemodynamic alterations, but decreased the serotonin extraction and Vmax/Km (the sum of all first order rate constants). After clomipramine, Vmax1, i.e., the maximal velocity for the first uptake pathway, was significantly decreased, while Km1 tended to increase without reaching significance. The virtual inhibition constant of clomipramine was about 1 microM. Glass bead embolization resulted in large hemodynamic responses, decreased extraction of serotonin and decreased values for Vmax/Km and Vmax1. This is consistent with a diminished vascular surface available for serotonin extraction. We conclude that MODEL3 was able to detect changes in intrinsic uptake capacity and vascular surface area, which were especially reflected in a decrease of Vmax/Km and Vmax1. PMID- 1772338 TI - Effect of an antiarrhythmic agent, carocainide, on action potentials of ventricular papillary muscle of the guinea-pig heart in vitro. AB - The effect of carocainide, a new benzofuran derivative showing an antiarrhythmic action in animal models, on transmembrane potentials was examined in isolated ventricular papillary muscles of guinea-pig, using a conventional microelectrode technique in vitro. Carocainide, at concentrations above 5 x 10(-6) M, induced a dose-dependent decrease of the maximum upstroke velocity at a stimulation frequency of 0.1 Hz, while the resting membrane potential, the amplitude and duration of action potential were not affected even at 5 x 10(-5) M. In the presence of carocainide, trains of stimuli higher than 1 Hz led to an exponential decline in maximum upstroke velocity to a new steady state level. This use dependent block was augmented at the higher stimulation frequency as carocainide (5 x 10(-5) M) decreased the maximum upstroke velocity to 50-60% and to 40-50% of the initial level at 2 Hz and at 3 Hz, respectively. Carocainide (5 x 10(-5) M) at 1 Hz caused an appreciable shift (6-7 mV) of the curve at 50% of the maximum upstroke velocity (mid-point), bringing the membrane potential and the maximum upstroke velocity along the voltage axis in the hyperpolarizing direction. Our results indicate that carocainide has similar electrophysiological effects to those of other Class Ib antiarrhythmic drugs and that it can be characterized as a potent use-dependent sodium channel blocker. PMID- 1772340 TI - Systemic study of the hemodynamic effects of sublingual nitroglycerin in unanesthetized dogs. AB - The cardiovascular effects of nitroglycerin, given sublingually and intravenously in a clinical dose range, were studied in unanesthetized and unrestrained normal dogs. The parameters examined included coronary blood flow, coronary conductance arterial diameter, internal diameter of the left ventricle, blood flow in the aorta and vena cava, diameters of the aorta, carotid, mesenteric, iliac, internal thoracic and pulmonary arteries and vena cava, pressures in the left ventricle, abdominal aorta and pulmonary arteries, organ thickness of the spleen, liver and sartorius muscle, and rate of rise in arterial pressure pulses. It was suggested that nitroglycerin does not dilate the veins in the splanchnic area and hind limb, but efficiently dilates conductance arteries. It was concluded that the therapeutically important effects of nitroglycerin involve the dilatation of conductance arteries, including both coronary and general systemic arteries. The effect of the former would be directly on stenotic lesions in the epicardial large coronary artery, improving blood flow to the ischemic part of the myocardium, whereas the latter might be beneficial for reducing cardiac work and lowering systolic pressure by increasing the Windkessel volume. Therefore, the heart regains its ventricular function and pumps stagnant blood from heart, lungs and veins to the arterial side, resulting in a reduction of the elevated preload to normal levels in anginal patients. PMID- 1772339 TI - Effect of antiarrhythmic drugs on the postischaemic metabolic recovery of isolated rat hearts. AB - In isolated perfused rat hearts, global ischaemia for 20 or 40 min led to a substantial decrease of myocardial ATP, creatine phosphate and glycogen, and to an increase in lactate and glucose-6-phosphate. Subsequent coronary reperfusion was associated with severe tachyarrhythmias (ventricular fibrillation occurring in 40% of the hearts after 20 min of ischaemia, and in 100% after 40 min of ischaemia) and the release of great activities of creatine kinase. Metabolic recovery was obtained only in hearts in which reperfusion-induced fibrillation was lacking. Significant improvement of the metabolic recovery during reperfusion was obtained with corynanthine, a stereoisomer of yohimbine, given in concentrations which prevented reperfusion-induced fibrillation. Moreover, a highly significant decrease of the enzyme release was observed. Similar results were obtained with quinidine. Lidocaine (30 mumol/l) failed to prevent ventricular fibrillation and had no beneficial effect on myocardial metabolism. The effects of these antiarrhythmic drugs are discussed in view of the importance of ventricular fibrillation on postischaemic metabolic recovery. PMID- 1772341 TI - Synergism between UK 38485 and ICI 185282 against digoxin-induced arrhythmias in guinea-pigs. AB - In this study, the combination of a thromboxane synthetase inhibitor (UK 38485) and a thromboxane receptor antagonist (ICI 185282) was tested for an interaction of potential therapeutic importance and the effect of acetylsalicylic acid pretreatment on this combination was evaluated in digoxin-induced arrhythmias in guinea-pigs. Drug treatments at the dose combinations used (ICI 185282: 0.2 mg/kg + 0.2 mg/kg/hr + UK 38485 0.1 mg/kg/hr and ICI 185282: 2 mg/kg + 2 mg/kg/hr + UK 38485 1 mg/kg/hr) markedly reduced the incidence of ventricular fibrillation, mortality rate and arrhythmia score. Pretreatment with acetylsalicylic acid plus drug combination resulted in a dose-dependent increase in mortality rate and arrhythmia score. The increase in mean arterial blood pressure, observed after digoxin administration, was inhibited by the combination therapy. Although heart rate values were increased, the computed pressure-rate index remained unchanged when compared with the control group. These data suggest that the combined treatment with a thromboxane synthetase inhibitor and a thromboxane receptor antagonist provides a better protection against digoxin intoxication than with either agent alone. Furthermore, the results illustrate that formation of cyclooxygenase metabolites of arachidonic acid plays an important role in this action. PMID- 1772342 TI - 5-Hydroxytryptamine-induced contraction of human isolated umbilical artery and its dependence on cellular and extracellular Ca++. AB - The contribution of intra- and extracellular Ca++ during KCl- and 5 hydroxytryptamine-induced contractions was investigated in human isolated umbilical arteries obtained from cords of normal full-term deliveries. In normal solution, nifedipine caused dose-dependent relaxations of the arteries contracted by high K+ (80 mM) and 5-hydroxytryptamine. The IC50 value of nifedipine on KCl induced contractions was about 9 times lower than that on 5-hydroxytryptamine induced contractions. In Ca(++)-free medium, KCl failed to induce contractions of the artery. However, 5-hydroxytryptamine caused contractions amounting to 52% of the maximum response obtained by re-addition of Ca++, and this response was abolished by 10(-6) M of nifedipine. In the presence of either KCl or 5 hydroxytryptamine, subsequent addition of Ca++ caused reproducible contractions which were also inhibited by nifedipine. These results indicate that the KCl induced contraction of human isolated umbilical artery is mainly dependent on extracellular Ca++, whereas that induced by 5-hydroxytryptamine involves both intra- and extracellular Ca++. It is also suggested that nifedipine does not only inhibit the influx of extracellular Ca++ during the contraction by 5 hydroxytryptamine but that it may also have intracellular effects. PMID- 1772343 TI - Methanol metabolism in a peroxisome-deficient mutant of Hansenula polymorpha: a physiological study. AB - We have studied methanol-utilization in a peroxisome-deficient (PER) mutant of Hansenula polymorpha. In spite of the fact that in carbon-limited chemostat cultures under induced conditions the enzymes involved in methanol metabolism were present at wild-type (WT) levels, this mutant is unable to grow on methanol as a sole carbon and energy source. Addition of methanol to glucose-limited (SR = 12.5 mM) chemostat cultures of the PER mutant only resulted in an increase in yield when small amounts were used (up to 22.5 mM). At increasing amounts however, a gradual decrease in cell density was observed which, at 80 mM methanol in the feed, had dropped below the original value of the glucose-limited culture. This reduction in yield was not observed when increasing amounts of formate instead of methanol were used as supplements for the glucose-limited mutant culture and also not in WT cells, used as control in these experiments. The effect of addition of methanol to a glucose-limited PER culture was also studied in the transient state during adaptation of the cells to methanol. The enzyme patterns obtained suggested that the ultimate decrease in yield observed at enhanced methanol concentrations was due to an inefficient methanol-metabolism as a consequence of the absence of peroxisomes. The absence of intact peroxisomes results in two major problems namely i) in H2O2-metabolism, which most probably is no longer mediated by catalase and ii) the inability of the cell to control the fluxes of formaldehyde, generated from methanol. The energetic consequences of this metabolism, compared to the WT situation with intact peroxisomes, are discussed. PMID- 1772344 TI - Metabolic changes induced during adaptation of Saccharomyces cerevisiae to a water stress. AB - When exponentially growing Saccharomyces cerevisiae was transferred from a normal high water activity growth medium (aw 0.997) to a medium containing 8% NaCl low water activity growth medium (aw 0.955), glycerol accumulation during the first eight hours of the adaptation was both retarded and greatly diminished in magnitude. Investigation of the underlying reasons for the slow onset of glycerol accumulation revealed that not only was overall glycerol production reduced by salt transfer, but also the rates of ethanol production and glucose consumption were reduced. Measurement of glycolytic intermediates revealed an accumulation of glucose-6-phosphate, fructose-6-phosphate, fructose 1,6 bisphosphate and phosphoenolpyruvate in S. cerevisiae 3 to 4 h after transfer to salt, suggesting that one or more glycolytic enzymes were inhibited. Potassium ions accumulated in S. cerevisiae after salt transfer and reached a maximum about 6 h after transfer, whereas the sodium ion content increased progressively during the adaptation period. The trehalose content also increased in adapting cells. It is suggested that inhibition of glycerol production during the initial period of adaptation could be due to either the inhibition of glycerol-3-phosphate dehydrogenase by increased cation content or the inhibition of glycolysis, glycerol being produced glycolytically in S. cerevisiae. The increased accumulation of glycerol towards the end of the 8-h period suggests that the osmoregulatory response of S. cerevisiae involves complex sets of adjustments in which inhibition of glycerol-3 phosphate dehydrogenase must be relieved before glycerol functions as a major osmoregulator. PMID- 1772345 TI - N5, N10-methylenetetrahydromethanopterin dehydrogenase (H2-forming) from the extreme thermophile Methanopyrus kandleri. AB - Methanopyrus kandleri is a novel abyssal methanogenic archaebacterium growing at 110 degrees C on H2 and CO2. The N5, N10-methylenetetrahydromethanopterin dehydrogenase, an enzyme involved in methanogenesis from CO2 and H2, was purified from this hyperthermophile and characterized. The dehydrogenase was found to be composed of only one polypeptide of apparent molecular mass 44 kDa. The UV/Vis spectrum was similar to that of albumin. The protein catalyzed the reversible dehydrogenation of N5, N10-methylenetetrahydromethanopterin (CH2 = H4MPT) to N5, N10-methenyltetrahydromethanopterin (CH identical to H4MPT+) and molecular hydrogen: CH2 = H4MPT H+ in equilibrium CH identical to H4MPT+ +H2. The rate of CH2 = H4MPT dehydrogenation (apparent Vmax) at 65 degrees C and pH 5.8 was 1500 U/mg, the apparent Km for CH2 = H4MPT was 50 microM, the Arrhenius activation energy was 52 kJ/mol, and the Q10 between 30 degrees C and 70 degrees C was 2.0. The specific activity increased hyperbolically with the proton concentration between pH 7 and pH 4.5. The purified dehydrogenase did not catalyze the reduction of viologen dyes, of coenzyme F420, and of pyridine nucleotides with either CH2 = H4MPT or H2. For activity the CH2 = H4MPT dehydrogenase required the presence of salts. Fifty percent of maximal activity was reached at salt concentrations of 100 mM, potassium phosphate, potassium chloride, and sodium chloride being almost equally effective in stimulating the enzyme activity. Cell extracts of M. kandleri did not loose CH2 = H4MPT dehydrogenase activity when incubated at 90 degrees C for 60 min. The purified enzyme, however, proved very thermolabile. The purified enzyme, however, proved very thermolabile.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772346 TI - Methyl-coenzyme M reductase and other enzymes involved in methanogenesis from CO2 and H2 in the extreme thermophile Methanopyrus kandleri. AB - Methanopyrus kandleri belongs to a novel group of abyssal methanogenic archaebacteria that can grow at 110 degrees C on H2 and CO2 and that shows no close phylogenetic relationship to any methanogen known so far. Methyl-coenzyme M reductase, the enzyme catalyzing the methane forming step in the energy metabolism of methanogens, was purified from this hyperthermophile. The yellow protein with an absorption maximum at 425 nm was found to be similar to the methyl-coenzyme M reductase from other methanogenic bacteria in that it was composed each of two alpha-, beta- and gamma-subunits and that it contained the nickel porphinoid coenzyme F430 as prosthetic group. The purified reductase was inactive. The N-terminal amino acid sequence of the gamma-subunit was determined. A comparison with the N-terminal sequences of the gamma-subunit of methyl coenzyme M reductases from other methanogenic bacteria revealed a high degree of similarity. Besides methyl-coenzyme M reductase cell extracts of M. kandleri were shown to contain the following enzyme activities involved in methanogenesis from CO2 (apparent Vmax at 65 degrees C): formylmethanofuran dehydrogenase, 0.3 U/mg protein; formyl-methanofuran:tetrahydro-methanopterin formyltransferase, 13 U/mg; N5,N10-methylenetetrahydromethanopterin cyclohydrolase, 14U/mg; N5,N10 methenyltetrahydromethanopterin dehydrogenase (H2-forming), 33 U/mg; N5,N10 methylenetetrahydromethanopterin reductase (coenzyme F420 dependent), 4 U/mg; heterodisulfide reductase, 2 U/mg; coenzyme F420-reducing hydrogenase, 0.01 U/mg; and methylviologen-reducing hydrogenase, 2.5 U/mg. Apparent Km values for these enzymes and the effect of salts on their activities were determined. The coenzyme F420 present in M. kandleri was identified as coenzyme F420-2 with 2-gamma glutamyl residues. PMID- 1772347 TI - The production and utilization of nitric oxide by a new, denitrifying strain of Pseudomonas aeruginosa. AB - When a new strain of Pseudomonas aeruginosa was grown aerobically and then transferred to anaerobic conditions, cells reduced NO3- quantitatively to NO2- in NO3(-)-respiration. In the absence of nitrate, NO2- was immediately reduced to NO or N2O but not to N2 indicating that NO2(-)-reductase but not N2O-reductase was active. The formation of the products NO or N2O depended on the pH in the medium and the concentration of NO2- present. When P. aeruginosa was grown anaerobically for at least three days N2O-reductase was also active. Such cells reduced NO to N2 via N2O. The new strain generated at H(+)-gradient and grew by reducing N2O to N2 but not by converting NO to N2O. For comparison, Azospirillum brasilense Sp7 showed the same pattern of NO-reduction. In contrast, Paracoccus denitrificans formed 3.5 H+/NO during the reduction of NO to N2O in oxidant pulse experiments but could not grow in the presence of NO. Thus the NO-reduction pattern in P. denitrificans on one side and P. aeruginosa and A. brasilense on the other was very different. The mechanistic implications of such differences are discussed. PMID- 1772348 TI - [An immunohistochemical study on cellular infiltration of bronchial walls in bronchial asthma]. AB - Inflammatory cell reactions in bronchial asthma have been considered to contribute directly to asthmatic attacks. Therefore, attention has been focused on the role of inflammatory cells in the airway wall. In this study, we investigated inflammatory cells in the airway wall of bronchial asthma histologically and immunohistologically using 20 autopsy cases who died of the asthma attacks (Group A) and 11 autopsy cases who died of other causes (Group B). Six autopsy cases were treated as controls (Group C). A significantly larger number of eosinophils in the bronchi and bronchioles were found in Group A. The majority of eosinophils were found to be stained with EG2. Parts of the bronchial epithelium with marked infiltration of EG2 positive eosinophils were detached from the basal layer. Immunoelectron microscopically, the matrix of EG2 positive areas within the eosinophils corresponded to that of eosinophil granules. A significantly larger number of lymphocytes in the bronchi and bronchioles was observed in Groups A and B. Almost all of these lymphocytes were determined to be activated T lymphocytes. There were significantly more IgE positive cells in cases with bronchial asthma, especially in Group A. The majority of IgE positive cells were determined to be mast cells. These results suggest that eosinophils, lymphocytes and mast cells play an important role in the pathogenesis of bronchial asthma. PMID- 1772349 TI - [Eosinophil activation in acute asthma attacks evaluated by electronmicroscopic findings of eosinophils and the concentration of eosinophil cationic protein in sputum]. AB - We evaluated the activation of eosinophils in the airways of patients with acute asthma attacks by measuring the concentration of sputum eosinophil cationic protein (ECP) and changes in the electron densities of the eosinophil specific granules in sputum. In six hospitalized patients with asthmatic attacks, sputum samples were collected for seven consecutive days after admission and were used for the evaluation of eosinophil activation. The concentration of sputum ECP, the incidence of changes in the electron densities of eosinophil specific granules and the severity of asthma attacks were highest on the day of admission and decreased in association with each other after treatment. A significant correlation was found between the concentration of sputum ECP and the incidence of changes in the electron densities of eosinophil specific granules. These findings suggest that the eosinophils in the airways are markedly activated and degranulated in asthma attacks. PMID- 1772350 TI - [Complement fragments in patients with bronchial asthma]. AB - In this study, we investigated the pharmacological reactions induced by ibudilast to the complement system with the aim of clarifying the functional relation of the complement system to allergic reactions and pathology in patients with bronchial asthma. Complement hemolytic activities (CH50 and ACH50), complement profile, anaphylatoxins (C3a and C5a) and complement fragments (Bb, iC3b and C4d) were measured in 20 patients with bronchial asthma. One of antiasthmatic activities induced by ibudilast was concluded to be brought about though inactivation of the alternative complement pathway working on type III allergic reaction. Ibudilast increased the complement fragment Bb in the patients' plasma with the fairly controlled bronchial asthma. This increase in circulating Bb was suspected to be a result of inactivation of intermediate complement complexes, for example C3b.Bb.P, because the amounts in plasma of C3 and C5 showed no changes, while those of factor, B, P, H and I were decreased by ibudilast administration in patients with fairly controlled bronchial asthma. This antiasthmatic ability of ibudilast was restrained in those patients whose peripheral leukocytopenia was advanced before ibudilast administration, and in those whom ibudilast did not provoke an increase in the plasma level of iC3b, or did not prevent the serum level of C5 from increasing. In those unfairly controlled cases, enough anaphylatoxins, especially C5a might be produced to make the margination of peripheral neutrophils to the lung and increase CR3 on neutrophils binding with iC3b. PMID- 1772351 TI - [A basic study on the plasma and serum levels of eosinophil cationic protein (ECP) in bronchial asthma]. AB - A basic study on the blood eosinophil cationic protein (ECP) as an index for eosinophil activation in bronchial asthma was performed. 1) ECP concentration in the serum collected 2 hours after blood sampling and the peripheral eosinophil count were significantly higher in asthmatic patients than in normal individuals. A correlation between these two parameters was observed in normal controls but not in asthmatic patients. These findings suggest that the degree of eosinophil activation, which is reflected by the blood ECP concentration, varies with the clinical condition in asthmatic patients. 2) The plasma and serum ECP levels were compared. The serum ECP was higher than the plasma ECP in both normal controls and asthmatic patients. In asthmatic patients, however, plasma ECP levels poorly correlated with serum levels: the serum levels were markedly elevated in some cases, and only the plasma levels were significantly elevated during symptomatic periods compared with stable periods. Therefore, attention must be paid not only to the serum ECP concentration, but also to the plasma ECP concentration and the plasma-serum difference. 3) This plasma-serum difference in ECP concentration may be due to the in vitro release of ECP during coagulation after blood sampling rather than the effect of alpha 1-macroglobulin concentration, because supernatants from stimulated platelets elicited ECP release from eosinophils. PMID- 1772352 TI - [A statistical investigation of the influence of allergic factors on intractable asthma by multiple factor analysis]. AB - The relationships of the development of intractability in bronchial asthma with 11 factors, namely 1) sex, 2) age of onset, 3) duration of the disease, 4) severity of the disease, 5) disease type, 6) family history within the third degree of consanguinity, 7) history of smoking, 8) history of atopic dermatitis, 9) history of allergic rhinitis, 10) history of chronic sinusitis and 11) history of nasal polyp were studied by multiple factor analysis in 95 patients. The severity of the disease was shown to be the most important factor in whether the disease becomes intractable or not, followed by the age of onset. The history of atopic dermatitis had the least influence, and the influences of the other factors were not markedly different from one another. Evaluation of each factor according to the category score suggested that severe or moderate non-atopic bronchial asthma in males with a positive family history and positive histories of smoking, chronic sinusitis, nasal polyp and atopic dermatitis within a short period after the onset in the second decade or fifth decade or later tend to become intractable. PMID- 1772353 TI - [IgE.IgG4 antibody in eczema in infants between 5-7 months of age. I. Relationship to the degree of eczema involvement]. AB - Assessments have been made of serum IgE and IgA value, specific IgE and IgG4 antibody titers to foods, house dust, mite and percent peripheral++ eosinophil count in 191 infants with and without eczema between 5-7 months of age. Eczema patients were divided into 4 groups according to the degree of eczema involvement and laboratory data were compared between these and not eczematous group. The results were as follows; 1) IgE antibody titers were higher as the degree of eczema involvement increased. 2) RAST positive rates to foods increased with the degree of eczema involvement. Positive rate was highest to egg white followed by milk, soybean, wheat and rice. 3) Only 9 cases were RAST-positive to rice or wheat and all of them had IgE antibodies to other allergens tested. 4) A value of 10 IU/ml, which is the lowest measurable value of IgE in infants was considered to be a little too high to speculate allergy to some foods. 5) Specific IgG4 antibodies were positive only to milk. 6) All the 18 cases with positive milk specific IgG4 antibody were all negative in milk-specific IgE antibody, and conversely all the 14 cases with positive milk-specific IgE antibody were negative in milk-specific IgG4 antibody. From these results, it was concluded that food allergy is related to the degree of eczema involvement in infants between 5-7 months of age. PMID- 1772354 TI - [Allergenic relationships between Aspergillus restrictus and Aspergillus fumigatus determined by radioallergosorbent test inhibition]. AB - Recently Aspergillus restrictus, a species of osmophilic fungi, has been found to be widely distributed in our inhabited environment. The authors reported previously that the prevalence of hypersensitivity to this fungal species determined by skin prick test and radioallergosorbent test (RAST) was comparable with that to Aspergillus fumigatus. In this study, the allergenic relationships between the two fungi were examined by RAST and RAST inhibition tests in which A. restrictus extracts prepared from mycelial mats of two different strains cultured in M40Y liquid medium and A. fumigatus, one made from a mycelial mat cultured in YNB liquid medium containing 3% sucrose, were used. In the RAST inhibition tests using a serum pool obtained from five patients with highly positive RAST to these species, the two extracts of A. restrictus inhibited RAST to A. fumigatus by over 80%, and A. fumigatus extract inhibited RAST to the two strains of A. restrictus by approximately 75%. In A. fumigatus RAST inhibition tests using individual sera with positive A. fumigatus RAST, a strong inhibition (greater than 60%) elicited by each extract of A. restrictus was observed in 5 of 8 sera tested. In RAST, nine of 11 serum samples with positive RAST to A. fumigatus showed positive RAST to both strains of A. restrictus. There was a significant correlation between the RAST values of the two fungal species. These results give evidence of the presence of shared allergenic components between the two fungi, and indicate that these components may contain part of major allergens of A. fumigatus. PMID- 1772355 TI - [The bronchodilating effect of pirenzepine]. AB - The purpose of this study was to clarify the bronchodilating effect of pirenzepine (PZ) and to verify its mechanism. Ten asthmatic patients (6 men, 4 women: aged 20 to 65, 5 atopic 5 non-atopic) and ten non-asthmatic volunteers (8 men, 2 women: aged 25 to 60) were studied. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1.0) and peak expiratory flow rate (PEFR) were measured after intravenous administration of 20 mg PZ. PZ increased FVC, FEV1.0 and PEFR significantly by 15%, 29% and 37% respectively in asthmatic patients (p less than 0.01). We also studied the effects of PZ on the contractile responses of tracheal smooth muscle to intra-arterially administered acetylcholine (ACh) and the electrical stimulation of the vagus nerves (VNS) using isometric technique in situ in 5 mongrel dogs. PZ significantly inhibited the contractile responses elicited with ACh at doses larger than 1000 micrograms/kg (p less than 0.01). PZ also significantly inhibited the contractile responses elicited by VNS at doses larger than 100 micrograms/kg (p less than 0.01). These data demonstrate that intravenously administered PZ dilates the airway in asthmatic patients and also suggest that the bronchodilating effect of PZ related to inhibition of the M1 and M3 muscarinic receptors. PMID- 1772356 TI - [Current aspects of pathogenesis of atherosclerosis]. AB - The development of atherosclerotic plaques is assessed as a result of interaction between modified apoprotein-B-containing lipoproteins and the cells of a vascular wall. The immune inflammation in atherosclerosis is considered, on the one hand, as a result of sensibilization to the modified lipoproteins, and, on the other, as a protective-adaptive reaction directed at the elimination of atherogenic lipoproteins from the vascular wall. The author's approaches to the treatment of atherosclerosis are based on the pathogenesis taking into consideration the role of macrophages in the lipid elimination from the plaques. PMID- 1772357 TI - [Klebsiella pneumonia today]. AB - Analysis of incidence and morphology of Klebsiella pneumonia nowadays in the adults (10 observations), children (5 observations) and newborns (23 observations) is presented. The pneumonias account for 11.3% of total number of lobar pneumonias in the adults dying in 1979-1989. Klebsiella infection represent 16.1% of total number of autopsies a year according to the pediatric infection pathology department. Etiological role of Klebsiella is established in 21.5% of total number of autopsies of newborns for 1985-1988, pneumonia being 61% of total Klebsiella infections. Klebsiella pneumonias in the adults correspond in principle to the Friedlander's pneumonia studied in detail by V.D. Zinserling (1891-1960) and his students. Generalized forms of, as a rule, hospital Klebsiellosis with most grave lung damage, unknown up to now, are frequently observed in children. Klebsiellosis was combined practically in all cases both in the adults and children with other bacterial, viral and fungal infections. The degree of clinico-morphological manifestations may considerably vary. PMID- 1772358 TI - [Manifestations of Streptococcus infection resulting from various serologic groups of streptococcus]. AB - 44 autopsy cases (from 1985 to 1990) are studied out of which in 38 cases the diseases were produced by streptococcus of group A. In 18 cases there was a pharyngeal or extra-pharyngeal generalized streptococcus infection (scarlet fever). Moderately pronounced local damage, mainly pneumonia, were found in 20 cases. In 3 other cases the disease was produced by group B streptococcus, in 2 cases by streptococcus D and in 1 case by streptococcus of G group. Group A streptococcus was encountered mainly in children older than 6 months (31 cases), B and D at an earlier age (particularly B streptococcus). Morphologically, there were no essential differences connected with different streptococcus groups. The infection in most cases was correlated with a respiratory diseases, more frequently with influenza or respiratory-syncytial infection this favouring more grave course of streptococcus infection. PMID- 1772359 TI - [V. D. Tsinzerling]. PMID- 1772360 TI - [Infectious complications of congenital immunodeficient conditions]. AB - 12 autopsy cases of congenital immunodeficiency in children who died from various infectious complications at the age of from 2 months to 4 years 1 month are studied. Infection was in all cases combined (viral-bacterial, sometimes even viral-mycoplasmic-bacterial-mycotic). Morphological changes of the thymus, spleen, tonsilla, lymph nodes and lungs are described. PMID- 1772361 TI - [Diagnostic value of the endomyocardial biopsy in the cardiologic therapeutic clinic]. AB - Literature and authors' own data on the diagnostic value of endomyocardial biopsy in cases with clinical diagnosis of dilatation cardiomyopathy are analysed. It is shown that due to this biopsy the diagnosis of more than 20 heart diseases becomes possible. Myocarditis, the diagnosis of which is particularly difficult, is most frequently masked under dilatation cardiomyopathy. Ultrastructural studies are of great importance allowing to diagnose a number of heart diseases including alcoholic cardiomyopathy and viral myocardial lesions. The authors advocate wider use of endomyocardial biopsy which is sufficiently safe and informative. PMID- 1772362 TI - [Alterations of the aortic endothelium ultrastructure after the administration of cholesterol oxidation products to rabbits]. AB - Intravenous administration of 7 alpha-hydroxycholesterol and cholestane-triol at the dose of 2.5 mg/kg produces, one day later, ultrastructural alteration of aortic endothelial cells such as cytoplasmic vacuolation, protruding and crateriform surface defects, subendothelial oedema with a subsequent exfoliation of endotheliocytes. The endothelial damage was more pronounced after the administration of equal doses of cholestane-triol as compared to 7 alpha hydroxycholesterol. Ultrastructural changes 10 days after oral administration of 500 mg/kg cholesterol mixed with its auto-oxidation products were similar to those developing after cholestane-triol and 7 alpha-hydroxycholesterol. Cholesterol free of the oxidation products at the same doses did not produce alterations in the rabbit aortic endothelium. PMID- 1772363 TI - [Radiation-induced human osteogenic sarcoma]. AB - The authors studied clinically, roentgenologically and morphologically 8 patients with radiation osteogenic bone sarcomas which the patients developed 9 to 24 years (15 years, on the average) after distant gamma therapy at total local doses from 35 to 111 Gy (average 63 Gy) for primary skeletogenic and non-skeletogenic tumors when the bone was in the zone of irradiation. Radiation osteogenic sarcomas developed when the women or patients at early age were irradiated. Osteosclerotic (3), osteoblastic (2), osteoid (1), chondroblastic (2) forms of osteogenic sarcoma were identified. Necrotic and regeneratory bone changes preceding tumour growth may be found that alter the roentgenomorphological correlations. PMID- 1772364 TI - [Aplasia of the inferior vena cava]. AB - A rare case of congenital aplasia of the vena cava inferior in a girl is presented. This condition arose in the presence of marked dilatation of subcutaneous veins of the anterior and lateral surface of the abdomen and restructuring of venous system with formation of cava-caval anastomoses which completely compensated the return of the venous blood from the lower part of the body to the heart. PMID- 1772365 TI - [Scientific activity of V. D. Tsinzerling during World War II 1941-1945]. PMID- 1772366 TI - [Fibromyxomatous hyperplasia of the heart valves as a manifestation of intrauterine carditis]. AB - A rare case of the combination of fibromyxomatous hyperplasia of the valves and postmyocarditis elastofibrosis is described in a child who died at the age of 1 month and 26 days. The genesis of the heart pathology may be attributed to the carditis at the early fetal period. A possible source of the carditis could be a focus of chronic inflammation in the maternal internal genitalia. PMID- 1772368 TI - [Diagnosis (discussion of the paper by D. S. Sarkisova]. PMID- 1772367 TI - [Angiosarcoma of the testicular tunica]. AB - One autopsy case of angiosarcoma of the testis tunica in a male of 60 is described. Histologically, the tumour corresponded to malignant haemangioendothelioma while electron microscopically areas having the structure of malignant haemangiopericytoma were also found. PMID- 1772369 TI - [Place of medicinal shock in the structure of diagnosis]. AB - Medicinal shock (MS) in this disputable paper is considered as a part of a combined main disease together with a condition treated with a drug-allergen. MS may be regarded either as a concurrent or a parallel disease depending on the gravity of the above condition. In cases when the treatment with a drug was a mistake MS should be regarded as a main disease and a preceding condition as a parallel condition. PMID- 1772370 TI - [Results of testing the automatic device At-4M in comparison with AT-4]. AB - A flow line of the histological material treatment with the use of improved automatic device AT-4M is described, 2-hour treatment of the endoscopic material is proposed. PMID- 1772371 TI - [Neutrophilic granulocytes and host defense systems]. AB - The review shows that neutrophil granulocytes play a key role in the host defence against infection diseases. An important role belongs to the antibacterial cation proteins. Their study allows to create new methods of rapid diagnosis of the host resistance. The use of one of such tests (lysosome-cationic one) showed its high efficiency in the assessment of the disease gravity and the prognosis of complications. PMID- 1772372 TI - [Combined and mixed infections in human pathology]. AB - The author' and his colleagues publications dealing with combined and/or mixed infections are summarized. It is pointed out that these pathological studies of current autopsy, surgical, biopsy and experimental materials were performed according to principles formulated by V. D. Zinserling (1892-1960) as early as in 1920-1930. The results obtained are compared to the facts revealed by V. D. Zinserling and his students 30 to 70 years ago. Rather high incidence of combined and mixed infections is outlined, various localizations of main lesions are described (lungs, brain, gastro-intestinal tract, tonsilla and other organs and tissues). Considerable influence that combined infections exert on each other is shown; it is brought about mainly by the change of the host. Some mechanisms are discussed: damage of local protective mechanisms, suppression or stimulation of immune mechanism, including interferonogenesis, and others. PMID- 1772373 TI - [Cognitive dysfunctions of alcohol dependence using event related potentials]. AB - Event-related potentials (ERPs) have been used to investigate cognitive dysfunction in alcoholics. Previous findings are not concordant. Thirty alcoholics, and sex and age matched healthy controls (N = 30) were tested. The average age of alcoholics and the controls were 43.8 +/- 10.3 years and 44.7 +/- 11.5 years, respectively. All subjects were right handed and free from medication. Alcoholics met the criteria of DSM-III-R for alcohol dependence. ERPs were recorded during presentation of auditory stimuli. The stimuli consisted of 1kHz tone bursts referred to as 'frequent (non-target) stimuli' and 2kHz tone bursts referred to as 'rare (target) stimuli'. The probability of frequent stimuli and rare stimuli were 0.8 and 0.2, respectively. The amplitudes of N100 and P300 were smaller in alcoholics than the controls. However, the latencies of these components were not different between the groups. The amplitudes and latencies of both N200 and P200 were not different between two subject groups. Although in the controls the maxima of P300 were seen only at parietal region, in alcoholics P300 maxima were seen at parietal region (16 out of 30, 53.3%), at frontal region (11 out of 30, 36.7%) and at occipital region (3 out of 30, 10.0%). Correlations between the distributions of P300 maxima and brain CT findings were examined in alcoholics. While CT abnormalities were been in 2 out of 19 (10.5%) subjects having P300 maxima at pareital region, in subjects having P300 maxima at frontal region the abnormalities were seen in 10 out of 11 subjects (90.9%). Correlations between values of CT measurements and the amplitudes (Pz) of P300 were examined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772374 TI - [Clinical and epidemiological studies of alcoholic dementia]. AB - Alcoholic dementia is hard to classify as a distinct disorder. The purpose of this study is to clarify the clinical characteristics of alcoholic dementia. Twenty four cases out of the 215 inpatients with alcoholism had been treated under the diagnosis of alcoholic dementia in the 12 mental hospitals. These 24 cases with alcoholic dementia were examined with the results as follows. 1) The mean ages at the time of admission to a mental hospital, and of examination in this study were 58 years and 63 years respectively. 2) Almost all of them had a long history of heavy drinking of alcohol. 3) At the time of admission to a hospital, they had already showed the symptoms of dementia such as amnesia, disorientation, poor understanding, disinhibition and impulsive acts, wandering a careless handling of fire, and so on. 4) Eighty percent of them showed severe or moderate dementia. 5) Cerebellar ataxia was observed most frequently as a neurological complication. 6) Diffuse atrophy of the cerebral cortex and cerebellum were the main findings on the brain CT. PMID- 1772375 TI - Interactive effect of ethanol administration on blood propranolol levels in rats. AB - Effect of ethanol administration on blood propranolol concentration (BPC) was investigated with rats. By oral administration of 20 mg/kg propranolol hydrochloride together with 1.5 g/kg of ethanol, it was suggested that there might be an increase in blood 4-hydroxypropranolol concentration (BHPC) though BPC did not increase. By oral administration of propranolol 3 hours after oral administration of 1.0 g/kg ethanol, it was suggested that both BPC and BHPC might increase. It was considered that the main mechanisms of increases in BPC and BHPC by ethanol were a rise of intestinal permeability to propranolol and an inhibition of 4-hydroxypropranolol metabolism in hepatic microsomes, respectively. PMID- 1772376 TI - [A case of neuroleptic malignant syndrome developed in liver cirrhosis patient addicted to alcohol]. AB - A 55-year-old man with addiction of alcohol was admitted to our hospital with hematoemesis. After admission, the rupture of esophageal varices was observed and it was treated with endoscopic injection sclerotherapy. On the 3rd hospital day, the patient showed alcohol withdrawal syndrome and therefore haloperidol was administered intramuscularly and intravenously. After a half day of this treatment, high fever, diaphoresis, hypotension, tachycardia, muscular rigidity and tremor developed. With the laboratory data including high serum levels of CK, LDH, GOT and GPT, neuroleptic malignant syndrome (NMS) was suspected. Regardless of intensive care, hepatic failure, DIC and acute renal failure promptly developed, and he died on the 11th hospital day. Neuroleptics may cause serious side effects, such as NMS, when the physical status of patients was deteriorated. Especially in exhausted patient such as our case, even the small dose of neuroleptics caused NMS within short term. Thus, it seemed to be important for clinicians to pay attention to choice of neuroleptics. PMID- 1772377 TI - Unusual productions of endogenous alcohol: report of two autopsy cases. AB - We experienced two autopsy cases in which endogenous alcohol productions by saprogens had been unusual. Case 1 is a victim found in a mountain stream 3 to 4 weeks after his death. Since ethanol and n-propanol concentrations in the right intrathoracic bloody fluid, pericardial sac fluid, and blood in the right side of the heart were 0.41 mg/g and 0.052 mg/g, 0.42 mg/g and 0.032 mg/g, and 0.45 mg/g and 0.025 mg/g, respectively. The ethanol detected in those specimens appeared to have been produced postmortem. The femoral muscle and urine, however, contained very little n-propanol though the ethanol levels were 0.21 mg/g and 0.05 mg/g, respectively. Thus, we judged the victim might have died soon after drinking a little alcohol. Case 2 is a victim who was stabbed in the abdomen (liver) with a knife and died due to hemorrhagic shock after 26.5 hours in spite of a peritoneotomy. It was probable that metabolic activities of the liver had decreased significantly after getting a wound. Almost 1 mg/g of ethanol and little n-propanol were detected in the heart blood. In the intraabdominal bloody fluid, however, 2.45 mg/g of ethanol and 0.079 mg/g of n-propanol were detected. n-Propanol level in the bloody fluid is equal to that in severely decomposed body and indicates that a large amount of ethanol was endogenously produced. It may be considered that the unusual ethanol production was caused by the severe peritonitis after the operation. PMID- 1772378 TI - [A case of traveller who showed heroin withdrawal after returning from abroad]. AB - A 28-year old Japanese man with heroin abuse was reported. He is an ex-beautician and has abused a variety of substances such as toluene, marihuana, methamphetamine, LSD, and so on since he was in a junior high school in Japan. He experienced an intravenous injection of heroin for five days on his first trip to Thailand in 1989. Soon after he returned home, he went back there to use heroin again. He also experienced tearing and running nose as withdrawal at the end of his ten-day trip. During his third stay there he got a job as a wholesale dealer of heroin under a illegal drug organization in the northern part of Thailand. Before he returned home in Japan, he managed to withdraw from heroin by reducing the dose and replacing it with opium smoking. On his fourth trip he failed to withdraw from heroin and injected the drug intravenously at Chiang Mai Airport before leaving Thailand. He began to show acute heroin withdrawal just after he arrived in Osaka, Japan and sought treatment without telling heroin abuse. He was hospitalized next day and soon showed more severe withdrawal and delirium for next ten days. The delirium was thought to be due to not only heroin but the other drugs which he used. Recently heroin abuse, once prevalent during the latter half of 1950s in Japan, has been hardly seen owing to changing the law to severe punishment in 1963. To avoid strict regulations in home some of young Japanese seem to travel abroad and abuse drugs in Asian countries where the drugs are easily available.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772379 TI - [Modeling and simulation on the appearance of peak value of breath alcohol concentration after various drinking methods]. AB - In this paper, we try to estimate directly the time variations and the peak values of the breath alcohol concentration (BrAC) after drinking. First, the time variations of the BrAC is applied to the impulse response models of the 2nd order lag + time delay and the 3rd order lag. The Dirac's Delta functions are used to investigate the difference between drinking directly and out of a cup in many times. The relationship between the appearance of the peak value as time increases and the various drinking methods (i.e., quantity or interval) is discussed by using these models, and the results is confirmed experimentally. According to the simulation results, the appearance of the peak value of the BrAC depends on the various drinking methods considerably. Provided the parameters of these models are known in advance, time variations of the BrAC can be predicted immediately. Lastly, these results might be use in practice to reduce the risk of traffic accidents and maintenance of health. PMID- 1772380 TI - Glutathione S-transferase in alcoholic fatty liver. AB - Hepatic glutathione (GSH) S-transferase (GST) activity and the tissue distribution of a cationic GST were investigated in biopsy liver samples obtained from patients with alcoholic liver diseases. GST activities in alcoholic fatty liver were significantly high, whereas those in cirrhosis were significantly low compared with normal liver. In fatty liver, immunohistochemically, the staining of the enzyme was strongly positive in hepatocytes around intensive fatty metamorphosis. Then, using experimental chronic alcohol-fed rats, the changes in hepatic GST and GSH peroxidase (GPx) activities and lipid peroxide (LPO) and GSH contents in alcoholic fatty liver were evaluated. Hepatic GST isoenzymes were analyzed and tissue distribution of cationic and neutral GSTs was also investigated. Liver GSH content decreased at two weeks and increased at six weeks. Liver LPO content was elevated at four and six weeks and cytosolic GPx activity was enhanced at four weeks. Cytosolic GST activity was enhanced at six weeks. The cationic and neutral GST isoenzyme pattern was unchanged compared with normal liver. Immunohistochemically, the distribution and intensity of the staining of GSTs were essentially unchanged. There was no evidence of an increase in the GST isoenzyme with selen-independent GPx activity. However, GSTs were strongly stained in the hepatocytes with fatty droplets. Thus, in alcoholic fatty liver, hepatic GST and GPx activities are thought to be enhanced by different mechanisms. The elevated GPx activity may relate to the production of LPO. However, the enhancement of GST activity may result from some other causes which include the enzyme induction. PMID- 1772381 TI - Development of a rehabilitation program for people affected with occupational hearing loss. 1. A new paradigm. AB - The highly insidious character of the development of occupational hearing loss (OHL) bears several implications in terms of the nature of the resulting handicap. It calls for rehabilitative services that are adapted to the specific needs of those suffering from OHL. A paradigm for a rehabilitation program was defined using a public health model bringing about social changes. The health problem is defined in terms of reduced listening and communication abilities. Its consequences are examined for the workplace, leisure activities, social involvement, family relationship and individual well-being and self-esteem. The precursors of the problem are hierarchically determined according to their potential influences, and appropriate interventions are identified accordingly to act upon each of them. These interventions include: (a) psychosocial support to the affected workers and their families through group intervention; (b) information to the victims of OHL, their families, to workplaces, public services and the general population, and (c) skill development to facilitate listening and communication for and with the hearing-impaired person. This paradigm was used in the development of a rehabilitation program. PMID- 1772382 TI - Development of a rehabilitation program for people affected with occupational hearing loss. 2. Results from group intervention with 48 workers and their spouses. AB - A group intervention program was designed to initiate an active search for solutions to listening and communication problems among hearing-impaired workers. Six groups of 8 workers were recruited from different areas of the Province of Quebec. The workers were males; they had hearing threshold levels equal to or higher than 30 dB averaged over 0.5, 1, 2 and 4 kHz in at least one ear. The recruitment was conducted by occupational health nurses of local community health centers. The workers were invited to a group meeting with their spouses by means of a home interview. Three groups met during 2-hour weekly evening sessions, and three groups during a 1.5-day weekend session. A follow-up was conducted over a period of 3 months ending with an evaluation meeting. Results based on responses to a handicap questionnaire showed that the workers judged their hearing problem as being significantly less severe after their participation in the session. Group interviews showed that, although they were more conscious of their hearing difficulties, they agreed on being much more confident in dealing with them. Different steps were taken towards improving their situation, including disclosure of their hearing impairment to others, making requests to conversational partners to facilitate communication, and acquiring instrumental aids. PMID- 1772383 TI - Advantages of directional hearing aid microphones related to room acoustics. AB - In this study, two types of hearing aids were used. Both aids had the same frequency characteristics for frontal sound, but one employed an omnidirectional microphone and the other a directional microphone. The frequency characteristics of both hearing aids were measured for five azimuths on KEMAR and in situ in 12 normal-hearing subjects. For these subjects we also determined the speech reception threshold (SRT) with background noise in two rooms with different reverberation times. The direction of the speech stimuli was always frontal; the direction of the noise was varied. Additionally, directional hearing was measured with short noise bursts from eight loudspeakers surrounding the subject. In the less reverberant room, sounds coming from behind were less amplified by the hearing aid with the directional microphone than by the one with the omnidirectional microphone. In this room the monaural SRT values were largely determined by the level of the background noise. For the directional hearing aids there was an extra binaural advantage which depended on the direction of the background noise. Only for low-frequency noise bursts was directional hearing better with directional hearing aids. In the more reverberant room, no distinct differences between the frequency characteristics of the two hearing aid types were measured. However, a systematic difference between monaural SRT values measured through the two hearing aids was found. This difference was independent of noise azimuth. In conclusion, hearing aid(s) with a directional microphone showed no disadvantages and clear advantages under specific conditions. PMID- 1772384 TI - Delayed temporary threshold shift induced by impulse noises (weapon noises) in men. AB - Most of the available information on the effects of impulse noise on hearing is derived from temporary threshold shift (TTS2) measurements performed 2 min after a single exposure to small-weapon noises. TTS is known to recover as a linear function of the logarithm of time when it is induced by a continuous noise of moderate intensity. Following the exposure to impulse noise, several investigators have reported individual exceptions to the log-time relation, e.g. increases in TTS during the first hour of recovery. These authors observed a 'rebound recovery function' for most of the exposed men, and they conclude that this phenomenon '... has implications for the use of TTS in the construction of damage risk criteria for hazardous noise exposure ..., a single measure, such as the widely used TTS2 may not be an adequate index of the magnitude of the TTS'. In order to thoroughly investigate in man the existence of 'delayed' TTS following the exposure to actual weapon noises, the 'French Committee on Weapon Noises' carried out the following study. Three groups of soldiers (28 subjects) wearing no hearing protection were exposed in the free field over 2 days to impulse noises produced by a rifle. Bekesy audiograms were obtained from each subject just before the exposure, and at 5 min, 1 h and 4 h after exposure. All audiometric tests were carried out even when no TTS was observable in the first postexposure audiogram. A significant number of subjects showed a 'delayed TTS' and/or 'rebound recovery'. The maximum TTS was observed at 1 h after exposure, but the observation of a delayed recovery and a rebound recovery indicate that audiometric tests should be performed in all cases at least up to 4 h after the exposure. More detailed work is necessary to establish what changes may be necessary in the present damage risk criteria for impulse noises of a very high level. PMID- 1772385 TI - The relationship between regional blood flow and contractile function in normal, ischemic, and reperfused myocardium. AB - The prevailing paradigm of coronary physiology and pathophysiology is that a balance between blood flow (i.e., supply) and function (i.e., demand) exists under normal conditions and that an imbalance between supply and demand occurs during ischemia. However, this paradigm is derived largely from studies relating changes in total coronary inflow to global ventricular function. The present article examines the relationship between myocardial blood flow and function on a regional level and proposes that a change may be needed in the current paradigm of coronary pathophysiology. In normal myocardium, considerable heterogeneity of regional blood flow exists, indicating either similar heterogeneity of metabolic demand and function or questioning the precision of metabolic coupling between flow and function. After the onset of ischemia, a transient imbalance between the reduced blood flow and function may exist. However, myocardial function rapidly declines and during early steady-state ischemia regional myocardial blood flow and function are once again evenly matched. Such supply-demand balance may persist over prolonged periods of ischemia enabling the myocardium to remain viable through reduction of energy expenditure for contractile function, i.e., to "hibernate". Whereas in "hibernating" ischemic myocardium, regional myocardial blood flow and function are both reduced but appropriately matched to one another, flow and function appear to be largely uncoupled in reperfused "stunned" myocardium. The clinical identification of viable but ischemic (hibernating) and postischemic (stunned) myocardium is of utmost importance in patients undergoing reperfusion procedures. A new paradigm of coronary and myocardial pathophysiology, encompassing a regional as well as a global view of perfusion and function, will have to include explanations for phenomena such as myocardial hibernation and myocardial stunning. PMID- 1772386 TI - Chronic administration of allopurinol fails to exert any cardioprotective effect in rats submitted to permanent coronary artery ligation. AB - It has been shown that allopurinol, an inhibitor of xanthine oxidase, may limit the extent of myocardial infarction in dogs. In the present work, we studied the effect of a chronic administration of allopurinol on myocardial infarct size measured histochemically 48 h after in situ left coronary artery ligation in the rat. Our results indicate that allopurinol pretreatment does not produce any limitation of the extent of necrosis, but induces a significant increase in the volume of the non-ischemic portion of the myocardium, accompanied by an increase in protein content. This phenomenon, which could be due to the development of an edema in the non-ischemic portion of the myocardium, may well explain some discrepancies reported in previous experimental studies in which the infarct size was conventionally expressed as a percentage of the total volume of ventricular tissue. We have also shown that allopurinol pretreatment failed to improve the residual cardiac function in rats after left coronary artery ligation. We conclude that the enzyme xanthine oxidase is probably not involved in the pathophysiology of myocardial infarction in the rat because of the absence of collateral vasculature in this species which prevents any oxygen supply to the ischemic zone. In most other mammals such as the dog, the existence of a collateral system maintains a residual blood flow and oxygen supply to the ischemic portion of ligated hearts, allowing the xanthine oxidase-induced production of superoxide anions to be activated, thereby initiating peroxidative lesions in membrane lipids. PMID- 1772387 TI - Superoxide dismutase and catalase do not improve recovery of regional myocardial contractile function when given at the time of reperfusion after reversible regional ischemia in anesthetized dogs. AB - Earlier studies have demonstrated an improvement in the recovery of the regional myocardial function after reversible myocardial ischemia when dogs were treated with superoxide dismutase (SOD) + catalase (CAT). In all these studies, drug administration was started prior to the ischemic period. The aim of this study was to investigate the effects of SOD and CAT on the recovery of the regional contractile function in anesthetized beagle dogs when the drugs were administered at the time of reperfusion. The animals were subjected to 20 min of left coronary artery occlusion followed by 3 h reperfusion. The regional myocardial contractile function, measured as subendocardial segment shortening (SS, sonomicrometry) decreased to below zero and the regional blood flow in the ischemic subendocardium was reduced to about 5% of pre-ischemic values during the coronary artery occlusion period. The size of the occluded bed was similar in the two groups. Saline (n = 8) or SOD (10 mg/kg) + CAT (3.4 mg/kg) (n = 8) were infused into the left atrium from 2.5 min prior to until 20 min after the start of reperfusion. The peak plasma level of SOD was 102 +/- 15 mg/l at 20 min reperfusion. There were no significant differences in the arterial blood pressure, cardiac contractile function and regional blood flow between the two groups at any time during the experiment. During reperfusion in the dogs given vehicle, SS recovered to 48 +/- 7% (mean +/- SEM) after the first hour of reperfusion, and to 51 +/- 6% of pre-ischemic values after 3 h of reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772388 TI - Is malondialdehyde a marker of the effect of oxygen free radicals in rat heart tissue? AB - We tested the effect of exogenous purine derived free radicals and H2O2 vs ischemia and reperfusion on the thiobarbituric-acid (TBA)-reactive material and malondialdehyde (MDA) formation in isolated rat hearts using the thiobarbituric acid test and high performance lipid chromatography (HPLC). We could not detect increased thiobarbituric-acid-reactive material or MDA production during 6 mM H2O2 infusion, during free radical generation by purine-derived free radicals, or using ischemia and reperfusion. Increased thiobarbituric-acid-reactive material and MDA tissue levels were detected only during infusion of 12 mM H2O2 (p less than 0.001). We conclude that the generally used thiobarbituric acid assay for MDA is susceptible to artifacts and unsuited as an indirect measure for low-to medium-levels of oxygen free radicals. Using HPLC assay, which accurately measures MDA, no evidence was found that MDA is a primary and direct lipid peroxidation product of exogenous or endogenous reactive oxygen species. PMID- 1772389 TI - Influence of phorbol esters on stimulation-induced noradrenaline release and contractile force of isolated guinea-pig atria. AB - Phorbol-12,13-dibutyrate (PDB) and phorbol-12-myristate-13-acetate (PMA) increased the field-stimulation-induced efflux of radioactivity from guinea-pig atria preloaded with 7-[3H]-noradrenaline. The efflux was more than doubled by 10(-7) mol/l of either compound. Phorbol-12-myristate-13-acetate-4-O-methylether (PME), which has no effect on the protein kinase C (PKC), did not modify the stimulation-induced efflux of radioactivity, while a slight reduction was seen with 70 microM of the PKC inhibitor polymyxin B. In the presence of polymyxin B, the effects of PMA and PDB were greatly attenuated. In addition, PDB had a concentration-dependent negative inotropic effect (EC50 7.0 x 10(-10) mol/l). Pretreatment with polymyxin B shifted the concentration-response curve for PDB to the right (EC50 4.6 x 10(-9) mol/l). No negative inotropic effect was seen with PMA or PME. The results suggest that all effects of the phorbol esters were mediated by a stimulation of PKC. The different lipophilicity of PMA and PDB or a different influence on the various isozymes of PKC may account for the diverging postjunctional effects of the two compounds. PMID- 1772390 TI - [Significance of pharmacokinetic parameters for effective drug therapy in house and domestic animals]. AB - Aspects of pharmacokinetics (absorption, distribution, metabolism and excretion) and pharmacokinetic parameters (half-life time, elimination time, volume of distribution and bioavailability) are discussed. Treatment with food or drinking water demands additionally considerations to obtain a suitable drug level in the organism. Age- and sickness-dependent variations cause important changes of pharmacokinetic parameters. For an efficacious therapy, pharmacokinetic considerations are essential. PMID- 1772391 TI - [Hematology and cytodiagnosis of leukosis of the horse (review)]. AB - In a review supplementary to prior evaluations further hematological or cytodiagnostic aspects respectively of equine leucosis are discussed. Leukemic nature of the disease is characterized by increased count of normal blood cells or by the presence of morphologically non-differentiated cells in circulating blood or by disorder or loss of function of blood cells respectively. Thrombocytopenia in the most cases is accompanied by anemia, leukemia and tumor cell infiltration in bone marrow. Tumor cells in circulating blood indicate their presence in bone marrow too. In cases of equine leucosis with effusions in thoracic and/or in abdominal cavities tumor cells seem to be present more frequently in hydrothorax than in ascites. PMID- 1772392 TI - [Epidemiologic and genetic analysis of veterinary data of German Brown cattle]. AB - In totally 3740 cows of the breed German Brown Swiss distributed over 115 herds risk factors for the occurrence of diseases were analysed using a threshold model. Disease data were recorded by ten practitioners in southern Bavaria. The most frequent diseases were fertility disorders, followed by metabolic, udder and calving disorders. The influence of the herds could demonstrated clearly for all diseases analysed. The effect of the lactation number contributed significantly to the frequency of milk fever, mastitis, retained placenta, endometritis/metritis and ovary cysts. Heritability estimates vary between h2 = 0.5% and h2 = 4.2% with exception of anestrus/acyclia (h2 = 8.8%). With higher milk yield of cows the disease frequencies increase, especially fertility diseases. However, increasing herd milk yield is associated with decreasing disease frequencies. A depression of A.I.-parameters and an increase of culling rate caused by diseases could be observed. In the case of the occurrence of uterus- and ovary disorders days open are elongated by 58 days in comparison to cows without diseases. Recording of disease data for use in electronic data processing seems necessary, in order to diminish production diseases by breeding and herd control programmes. An important prerequisite in organization of disease data recording is an efficient cooperation between the veterinary practitioner, farmer, inseminator and the official milk recording organisation. PMID- 1772393 TI - [Incidence of antibodies to Borrelia burgdorferi in dogs in small animal practice in North Bavaria]. AB - With help of indirect immunofluorescent assay antibodies were detected to Borrelia burgdorferi, agent of Lyme borreliosis in 46 (35.5%) serum samples of 130 randomly selected dogs of a small animal practice in Northern Bavaria. A positive reaction of the indirect immunofluorescent assay was demonstrated in 15 cases in a serum dilution of 1:64, in 9 cases in a serum dilution of 1:128, in 5 cases in a serum dilution of 1:256, in 2 cases in a serum dilution of 1:512, in 3 cases in a serum dilution of 1:1024, in 2 cases in a serum dilution of 1:2048 and in 10 cases in a serum dilution of 1:4096 and higher. There was significant correlation between the symptoms pain of segments or muscles in dorsal region, between painful arthritis, between paralysis of hind legs or between chronic erythema ("hot spot") and the positive reaction of the immunofluorescent assay in the serum dilution of 1:256 ("borderline titre") and higher. PMID- 1772394 TI - [Content of beta-carotene, vitamin E and ascorbic acid in blood plasma of female calves, cattle, bulls, castrates and ox throughout the course of the year]. AB - The concentration of beta-carotin, of vitamin E and of ascorbic acid in the plasma of female calves (beginning with an age of 4 weeks), of cows in the 2nd and 5th lactation, of bulls, of short scrotum bulls and of oxes in the course of the year was analysed. The concentration of beta-carotin in the plasma of calves after driving up to pasture increased slower than that of cows. After transition to stable feeding there was a significant decrease in the concentration after 4 weeks. During the period of suckling the concentration of vitamin E in the plasma of calves was low. After transition to pasture the concentration of vitamin E in the plasma of calves increased slower than in that of the cows. The concentration of ascorbic acid in the plasma during the winter was higher than during the summer. There was no influence of experimental cryptorchism or castration on the mentioned values. PMID- 1772395 TI - Genetic control and expression of the major ejaculatory bulb protein (PEB-me) in Drosophila melanogaster. AB - PEB-me is a predominant protein of mature Drosophila melanogaster ejaculatory bulbs. It is resolved into four or five closely spaced subfractions (apparent molecular weight 35-39 kD) by sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Four electrophoretic variants of PEB-me differing in apparent molecular weight by 200-800 daltons were found. These appear to be controlled by four alleles of a gene (peb) located by recombination and deletion mapping to the 60F1-2 region of chromosome 2. A minor ejaculatory bulb protein of ca. 80 kD (hPEB) was found to be immunochemically related to PEB and possibly encoded by peb. PEB is not detected by immunoblotting techniques in virgin females, in male tissues other than the ejaculatory bulb, or during developmental stages preceding the formation of this organ. The results of transplantations of genital imaginal discs and of immature ejaculatory bulbs between two strains having different PEB alleles suggest that the ejaculatory bulb is the site of PEB synthesis. In flies mutant for tra, tra-2, dsx, or ix, tissue specificity of PEB localization is retained and the protein is found whenever the ejaculatory bulb is formed, regardless of the chromosomal sex of the fly. The protein is transferred into the female genital duct during mating, where it can be detected for up to 12 hr. Possible functions of PEB in Drosophila reproduction are discussed. PMID- 1772396 TI - Glycerol-3-phosphate dehydrogenase (G-3-PDH; EC 1.1.1.8) variation in Brazilian stingless bees and in wasp species. AB - In only 1 bee species (Tetragona clavipes) of 24 sampled in 145 colonies (0.69%) did we detect the presence of more than one allele for glycerol-3-phosphate dehydrogenase (EC 1.1.1.8), an enzyme that is involved in flight. In 34 colonies containing 9 wasp species, 5 colonies of only 2 species (Polybia paulista and P. sericea) showed variation in larval G-3-PDH (14.7%). The small amount of variation observed for the G-3-PDH-1 locus in the bee and wasp species analyzed in the present study agrees with that reported for the G-3-PDH system in other insects. PMID- 1772397 TI - Specificity of the sex-influenced esterase (ES-SI) isozyme in rat liver. AB - A carboxylesterase which shares common antigenicity with sex-influenced esterase (ES-SI) was found in both the male and the female liver of the rat but not in the following tissues: erythrocyte, heart, kidney, lung, spleen, small intestine, testis, thymus, and lymph node. Subcellular fractionation showed the esterase localizes in the microsome-rich fraction. The strain distribution of the presence or absence of the esterase in inbred rats was identical to that of ES-SI, although in adult males a considerable amount of the esterase exists, unlike ES SI. The esterase had a higher isoelectric point than ES-SI but after neuraminidase treatment the difference disappeared, suggesting that the esterase has a sialic acid moiety. Because this esterase has different properties from those previously reported, it is proposed that it is designated liver-ES-SI. The common antigenicity and similar strain distribution between ES-SI and liver-ES-SI suggest that liver-ES-SI is a precursor molecule of ES-SI and therefore the two esterases are products of a single gene. PMID- 1772398 TI - Genetic deficiency of complement component C8 in the rabbit: evidence of a translational defect in expression of the alpha-gamma subunit. AB - We examined the molecular basis for rabbit C8 alpha-gamma deficiency (C8D) using human C8 cDNA probes. Sequential probing of normal rabbit poly(A)+RNA revealed messages of 2.1, 1.9, and 0.8 kb for alpha, beta, and gamma, respectively. Corresponding analysis of C8D rabbit poly(A)+RNA identified messages for alpha and gamma of the same size and amounts as normal rabbits. Thus, C8 alpha-gamma deficiency in the rabbit appears to be the result of a translational rather than a transcriptional defect. PMID- 1772399 TI - Electrophoretic and chromatographic evidence for allelic polymorphisms in the river buffalo alpha-globin gene complex. AB - Isoelectric focusing in the ultranarrow immobilized (7.1-7.5) pH gradient (IPG) of hemoglobin and high-performances liquid chromatography (HPLC) of globin chains were used to investigate Hb polymorphism in Italian river buffalo. Six different phenotypes, each characterized by two or four different Hbs, were detected by IPG, whereas two different II alpha-globin chains were separated from two different I alpha-chains by HPLC. Two alpha-chains (I alpha 1 and II alpha 3), and Hbs with similar mobilities (Hb1 and Hb3), were associated with the AA Hb phenotype: two alpha-chains (I alpha 2 and II alpha 4), and Hbs with different mobilities (Hb2 and Hb4), were associated with the BB phenotype: two sets of doublet Hbs were associated with the AB phenotype, thus suggesting allelic polymorphisms at the two alpha loci. An allele at the beta locus is responsible for increasing to as many as eight the number of different Hbs, thus further complicating the notable Hb polymorphism of the river buffalo. PMID- 1772400 TI - Genetic polymorphism of erythrocyte histone H1 in Japanese quail. AB - Histone H1 from erythrocytes of Japanese quail was resolved in a sodium dodecyl sulfate (SDS)-polyacrylamide gel into five fractions differing in apparent molecular weights. A polymorphism of histone H1.1, H1.2, and H1.3 bands was detected among quail individuals. While some birds possessed either a high (phenotype .3+) or a low (phenotype .3+/.3-) level of H1.3, at least half of the quail population lacked this H1 band (phenotype .3-). Appropriate genetic crosses demonstrated that H1.3 behaved as though it was coded by a gene with two codominant alleles at an autosomal locus. Using two-dimensional polyacrylamide gel electrophoresis (acid-urea followed by SDS gels), it was found that birds .3+ contained polypeptides H1.b1 and H1.b'1; birds .3-, polypeptides H1.b2 and H1.b'2 with lower apparent molecular weights; and birds .3+/.3-, both types of polypeptides in equal proportions. The H1.b2 + H1.b'2 complement was not discernible in SDS gels, for it migrated together with H1.c' within band H1.4. It was found that a small number of birds lacking the H1.2 band in SDS gels failed to express histone H1.a. Since birds with phenotype .2- with a defective allele of the gene H1.a were simultaneously lacking the H1.3 band, it seems that the imperfect allele of the H1.a gene might be closely linked to the alleles producing H1.b2 + H1.b'2. PMID- 1772401 TI - High-mobility group and other nonhistone substrates for nuclear histone N acetyltransferase. AB - A variety of nonhistone proteins and polyamines has been studied for their substrate activity for nuclear histone N-acetyltransferase. Nonhistone chromatin high-mobility group (HMG) proteins are found to be as good a substrate for the enzyme as histones. The enzyme also acetylates spermidine and spermine. However, protamine, bovine serum albumin, and ubiquitin are not substrates. Chymotryptic peptides of histone and HMGs retained about 64% of the substrate activity, but trypsin treatment reduced the substrate activity by more than 85%. Both N acetyltransferase activities for HMGs and histones are copurified through salt extraction, polyethylene glycol fractionation, and chromatography on DEAE cellulose, phosphocellulose columns, and a HPLC anionic-exchange column. The highly purified nuclear histone acetyltransferase shows similar optimal pH and ping-pong kinetics for both HMGs and histones. The Km for HMG is 0.25 mg/ml. HMGs are able to accept the acetyl group from isolated acetyl-enzyme intermediate. Denatured gel analysis shows that HMG 1 and HMG 2 are the major proteins acetylated. High salt concentrations, mononucleotides, and DNA, which inhibit histone substrate activity of the enzyme, also inhibit HMG substrate activity. These observations suggest that there is a major nuclear N-acetyltransferase which is responsible for the acetylation of both histones and HMGs and perhaps also of spermine and spermidine. Thus the regulation of the structure and function of chromatin through postsynthetic acetylation can be achieved by a single nuclear N-acetyltransferase. PMID- 1772402 TI - The equine major plasma serpin multigene family: partial characterization including sequence of the reactive-site regions. AB - The equine Pi system, which is highly polymorphic and was considered to be controlled by a single locus, has been shown to be controlled by four loci (named Spi 1-4). This system is the equine equivalent of the major human plasma serpin (serine protease inhibitor), human alpha 1 PI. Twenty-two haplotypes of the equine Pi system have been characterized by two-dimensional electrophoresis, resulting in the assignment of pI, Mr, and bovine trypsin and chymotrypsin inhibition characteristics to 109 proteins. These proteins have been analyzed further to determine their relatedness to each other as well as to human alpha 1 PI using immunochemical, structural, and functional criteria. The amino acid sequences of the N termini and reactive-site regions have been determined on proteins from each of the four equine Spi loci. This allowed the designation of the proteins from the Spi 1 locus as being METserpins and the functional equivalents of human alpha 1 PI. The Spi 4 proteins are ARGserpins, and by alignment the Spi 2 proteins are ILEserpins, the first so far described. The P1 residue for the Spi 3 proteins was unable to be determined. The limited peptide and immunopeptide mapping revealed that proteins from all four loci were closely related, but within the four there were two pairs (Spi 1 and 2 and Spi 3 and 4) which were more related. All were probably derived from the same gene that gave rise to human alpha 1 PI. PMID- 1772403 TI - Genetic diversity in the Chinese pangolin (Manis pentadactyla): inferred from restriction enzyme analysis of mitochondrial DNAs. AB - Two different forms of Chinese pangolins can be recognized according to the color of their scales, i.e., brown and dusky. We analyzed mitochondrial DNA (mtDNA) purified from the livers of seven dusky and six brown Chinese pangolins from the same locality, using cleavage patterns from 19 restriction enzymes. From the 19 6 bp recognition enzymes used, 51-56 sites were observed. By combining the cleavage patterns for each enzyme, the 13 samples were classified into four restriction types: two in dusky and two in brown Chinese pangolins. The estimated number of nucleotide substitutions per site in dusky and brown types is 0.002, and that between dusky and brown types is 0.012. Divergence between brown and dusky forms began 0.6 Myr ago, provided the mean rate of sequence divergence is 0.02 per Myr in mtDNA. Our results suggest that there is considerable divergence in Chinese pangolins, and brown and dusky Chinese pangolins may be quite different forms or, at least, belong to different maternal groups. PMID- 1772404 TI - Structure-function relationships in eukaryotic nuclei. AB - It may be that eukaryotic nuclei contain a collection of operationally independent units (genes), each controlled through its interactions with soluble protein factors which diffuse at random throughout the nucleoplasmic space. Alternatively, nuclei might be organized in such a sophisticated fashion that specific genes occupy distinct sites and that spatially ordered RNA synthesis, processing and transport delivers mature RNAs to predestined sites in the cytoplasm. Different fields of research support each of these extreme views. Molecular biologists inspecting the precise details of specific interactions, usually in vitro, inevitably favour the former, while cell biologists working with far more complicated systems generally assume that more elaborate arrangements exist. In considering the importance of nuclear architecture, I have attempted to relate a collection of experiments each of which intimates some close relationship between structural aspects of chromatin organization and the precise mechanisms underlying nuclear function. I will argue that higher-order structures are crucial for achieving the observed efficiency and coordination of many nuclear processes. PMID- 1772405 TI - Growth cone inhibition--an important mechanism in neural development? AB - Since the growth cone was first described a century ago by Cajal, considerable effort has been directed towards understanding the mechanisms responsible for its guidance. Traditionally, attention has focussed on the role of adhesive molecules in determining neural development. Recently, it has become apparent that inhibitory interactions may play a crucial part in axonal navigation. A common feature of inhibition seen in three model systems (peripheral nerve segmentation, retinotectal mapping and CNS/PNS segregation) is a collapse of the motile structures of the growth cone. It is increasingly clear that the identification of molecular mechanisms of inhibition, as well as those of adhesion, will be of fundamental importance to understanding neural development. PMID- 1772406 TI - Cells and cell-interactions that guide motor axons in the developing chick embryo. AB - A considerable challenge confronts any developing neuron. Before it can establish a functional and specific connection, it must extend an axon over tens and sometimes hundreds of microns through a complex and mutable environment to reach one out of many possible destinations. The field of axonal guidance concerns the control of this navigation process. To satisfactorily identify the cell interactions and molecular mechanisms that mediate axonal guidance, it is essential to first identify the pertinent cell populations. Embryonic surgeries have provided solid information on which tissues are critical and which are irrelevant to the navigation of motor axons within the chick embryo. The gross anatomical nerve pattern is established as axons respond to both positive (path) and negative (barrier) tissue environments. Analysis of the interactions of motoneurons with these tissues reveals that several cellular interactions- chemotaxis, substratum preference, and perhaps contact paralysis--are important to the common patterns of motor axon advance. Axons simultaneously interact with population-specific cues that have begun to be identified on the tissue level. PMID- 1772407 TI - Swimming against the tide: chemotaxis in Agrobacterium. AB - Chemotaxis in bacteria is an excellent model for signal transduction processes. In Agrobacterium tumefaciens, the causative agent of crown gall tumour on wounded plants, it is a vital part of the organism's biology. A chromosomally-determined chemotaxis system causes the bacterium to be attracted into the rhizosphere by chemoattractants in plant exudates. By interfacing with this system, the multifunctional products of two Ti-plasmid encoded genes, virA and virG, allow the sensing of specific wound phenolics such as acetosyringone. This attracts Ti plasmid harbouring A. tumefaciens to wound sites, where the higher acetosyringone concentrations lead to virA and virG-mediated induction of the vir-genes. The products of the induced genes, act in concert to effect transfer of the T-DNA to the plant cell. PMID- 1772408 TI - Three-stranded DNA helices as intermediates in genetic recombination. PMID- 1772409 TI - Combinatoric strategies for genome mapping. PMID- 1772410 TI - Lethal chromosomal deletions in the mouse, a model system for the study of development and regulation of postnatal gene expression. AB - Mechanisms involved in the regulation of development and its genetic control are receiving ever-increasing attention in studies of mammalian developmental genetics. The potential success of such studies is strongly enhanced by the availability of suitable systems of analysis. Such a system was identified in a series of radiation-induced chromosomal deletions at and around the albino (c) locus of the mouse associated with cell type-specific effects on liver differentiation. Their detailed study has aided the analysis of possible mechanisms of cell type-specific gene expression. As summarized in this review, the experimental results strongly suggest that specific trans-acting developmental regulatory genes are concerned with the differentiation of hormone inducible expression of a cluster of hepatocyte specific structural genes mapping in different parts of the genome. PMID- 1772411 TI - Mitosis-specific phosphorylation of caldesmon: possible molecular mechanism of cell rounding during mitosis. AB - One of the profound changes in cellular morphology during mitosis is a massive alteration in the organization of microfilament cytoskeleton. It has been recently discovered that nonmuscle caldesmon, an actin and calmodulin binding microfilament-associated protein of relative molecular mass Mr = 83,000, is dissociated from microfilaments during mitosis, apparently as a consequence of mitosis-specific phosphorylation. cdc2 kinase, which is a catalytic subunit of MPF (maturation or mitosis promoting factor), is found to be responsible for the mitosis-specific phosphorylation of caldesmon. Because caldesmon is implicated in the regulation of actin myosin interactions and/or microfilament organization, these results suggest that cdc2 kinase directly affects microfilament re organization during mitosis. PMID- 1772412 TI - Intercommunication between mammalian oocytes and companion somatic cells. AB - Cellular interactions in the mammalian ovarian follicle between its germ-line and somatic cell components are crucial for its development and function. These interactions are mediated by both membrane gap junctions and paracrine factors. Somatic cell-to-oocyte communication is essential for oocyte growth and the regulation of meiotic maturation. In particular, granulosa cells provide nutrients and molecular signals that regulate oocyte development. Oocytes, on the other hand, promote the organization of the follicle, the proliferation of granulosa cells, and the differentiation and function of cumulus cells, a subset of granulosa cells. Determining the nature of the oocyte-to-granulosa cell signals remains a key challenge for future work. PMID- 1772413 TI - Transduction of plant signal molecules by the Rhizobium NodD proteins. AB - The regulatory NodD proteins of Rhizobium bacteria mediate the activation of a gene set responsible for symbiotic nodule formation by plant signal molecules. Here we discuss the signal recognition and gene activation properties of NodD and present a model summarizing the current knowledge on NodD action. PMID- 1772414 TI - Biological activities of oxygenated sterols: physiological and pathological implications. AB - Oxygenated derivatives of cholesterol (oxysterols) are widely distributed in nature, being found in the blood and tissues of animals and man as well as in foodstuff. They exhibit many biological activities which are of potential physiological, pathological or pharmacological importance. Many oxysterols have been found to be potent inhibitors of cholesterol biosynthesis and one or more oxysterols may play a role as the physiologic feedback regulator of cholesterol synthesis. Oxysterols also inhibit cell replication and have cytotoxic properties, effects which suggest that these sterols may participate in the regulation of cell proliferation and may be potentially useful as therapeutic agents for cancer. Furthermore, there is considerable evidence that oxysterols may be involved in the pathogenesis of atherosclerosis. Although the mechanism of action of oxysterols in all these instances is not well understood, the existence of cytosolic and microsomal proteins which bind oxysterols with high affinity and specificity suggests that this group of compounds may represent a family of intracellular regulatory molecules. PMID- 1772415 TI - Molecular interactions in intermediate filaments. PMID- 1772416 TI - XIST and the mapping of the X chromosome inactivation centre. PMID- 1772418 TI - Biochemical and Biophysical Research Communications: 1991 index issue. Cumulative indexes for volumes 174-181. PMID- 1772417 TI - Control of eukaryotic DNA replication at the chromosomal level. AB - A hypothesis for the control of eukaryotic DNA replication at the chromosomal level is proposed. The specific regulatory problem arises from the subdivision of the genome into thousands of individually replicating units, each of which must be duplicated a single time during S-phase. The hypothesis is based on the finding of direct repeats at replication origins. Such repeats can adopt, beyond the full-length double helical structure, another configuration exposing two single-stranded loops that provide suitable templates for the initiation of DNA replication. Any further initiation at the same origin is excluded as the single strandedness is eliminated by the replication process. Restoration of the initiable loop structure is proposed to occur by DNA-protein rearrangements involved in chromosome condensation and duplication of the chromosomal protein backbone during mitosis. A possible role of the maturation promoting factor (MPF) is suggested. PMID- 1772419 TI - In vivo labeling studies on the biosynthesis and degradation of collagen in experimental myocardial infarction. AB - The biosynthesis and degradation of myocardial collagen was studied in myocardium infarcted rats after a single intraperitoneal injection of 3H-proline. The incorporation of tritiated proline into collagen as 3H-hydroxyproline was regarded as a measure of collagen synthesis. The total content as well as total activity of hydroxyproline were measured in the whole homogenate, neutral salt soluble fraction, insoluble fraction and in urine collected at different time intervals and specific activities were calculated. Both collagen anabolism and catabolism were found to be affected in infarcted rat hearts. Degradation of existing collagen at the earlier stages of myocardial infarction and a simultaneous new collagen synthesis and deposition as insoluble form later took place. PMID- 1772420 TI - Isolation and characterization of a cytotoxin P4 from the venom of Naja nigricollis nigricollis preferentially active on tumor cells. AB - Cytotoxin P4 was isolated from the venom of Naja nigricollis nigricollis in three steps and contained 55% of the crude cytotoxic activity. It had a molecular weight of 8 KD, was stable over a pH range of 1-11 and in boiling water for at least 15 min. It had no measurable enzymatic activities, but was destroyed by proteases. Concentrations of 0.8, 1, 1.2, 25. 20 and 45 ug/ml, were needed to destroy murine melanoma B16 and WEHI 3B leukemia, rat chondrosarcoma, mouse erythrocytes and spleen cells, and human erythrocytes, respectively, thereby showing preferential cytotoxicity to the examined tumor cells. It also prevented the development of the melanoma, leukemia and chondrosarcoma tumors in vivo when mixed with the cells prior to the injection into the animal. PMID- 1772421 TI - Isolation of HnRNP particles from Drosophila melanogaster embryos. AB - HnRNP from nitrogen frozen Drosophila melanogaster embryos were isolated in the presence of EDTA and EGTA cosedimenting in sucrose and density gradients like hnRNP from vertebrates. Four "core" proteins of 23.000, 28.000, 32.000 and 45.000 Da are strongly enriched in these complexes. One could conclude that the basic structural organization of Drosophila melanogaster hnRNP is similar to that described for vertebrates. PMID- 1772422 TI - Ca2+ and pH dependence of hydrophobicity of alpha-lactalbumin: affinity partitioning of proteins in aqueous two-phase systems containing poly(ethylene glycol) esters of fatty acids. AB - Hydrophobic affinity partitioning in an aqueous two-phase system, composed of dextran and poly(ethylene glycol), has been used to study the hydrophobic binding capacity of bovine alpha-lactalbumin. The hydrophobicity of the poly(ethylene glycol)-containing phase was adjusted by including varying amounts of fatty acids bound to the polymer via an ester linkage. The change in the logarithmic partition coefficient of the protein in such systems was used as a measure of the hydrophobic binding. This value was strongly influenced by the amount of Ca2+ present as well as the pH value. The results are discussed in terms of the exposure of hydrophobic binding sites on alpha-lactalbumin and their relation to the conformational change in this protein due to Ca(2+)-binding, chelation of Ca2+ and pH dependence. PMID- 1772423 TI - Examination of subunit interaction in human ADH: carboxymethylation of the heterodimer beta 2 gamma 1. AB - Conflicting results have been obtained on whether the subunits of the human dimeric enzyme alcohol dehydrogenase interact kinetically. To examine this question, chemical modification by iodoacetate was used to selectively inactivate the beta 2 subunit of the heterodimeric isozyme beta 2 gamma 1. Subsequent studies of the modified beta 2 gamma 1 which, presumably, has only one functional active site per dimeric molecule, indicate that it is still active. Moreover, the properties of this hybrid are similar to those of the unmodified subunit. From these results, it is fair to conclude that the individual subunits of alcohol dehydrogenase contribute to the activity of the dimeric isozymes in an independent manner. PMID- 1772424 TI - Vanadate stimulates ornithine decarboxylase activity in C3H/10T1/2 cells. AB - Ornithine decarboxylase (ODC) activity of C3H/10T1/2 cells reflects their response to conflicting actions of many tumor promoters and tumor suppressors. In cultured C3H/10T1/2 cells, addition of vanadate (50 nM) increased ODC activity. Over the range 0.05-5 microM, vanadate increased ODC levels in a dose dependent manner to 11 times control levels. The presence of retinoic acid (5 microM) or the absence of fetal calf serum blocked the stimulation by vanadate. PMID- 1772425 TI - Induction of heat shock protein and thermal sensitivity of mammalian cells maintained at low culture temperature. AB - Effects of low culture temperature on the induction of heat shock proteins in FM3A cells by a heat shock and on the thermal sensitivity of the cells were examined. FM3A cells maintained at 33 degrees C could not induce hsp70 during continuous heating or after a short heat shock at either 39, 42, or 45 degrees C, although FM3A cells maintained at a normal culture temperature of 37 degrees C can induce the synthesis of hsp70. Furthermore, the cells maintained at 33 degrees C were more sensitive to the subsequent heat shock than the cells maintained at 37 degrees C. Thus, the culture temperature of the mammalian cells may be an important factor for the induction of hsp70, and hsp70 may play an important role to protect or repair the thermal damage of cells. PMID- 1772426 TI - Control of initiation of eukaryotic protein synthesis by guanine nucleotides and methionyl-tRNAi. AB - The influence of changing concentrations of GDP, methionyl-tRNAi, eIF-2 and eIF 2B on possible rates of initiation of protein synthesis have been explored in calculations based on previously derived rate constants for interaction of the components involved in formation of ternary or quaternary complexes of eIF-2B, eIF-2, GTP and Met-tRNAi. When allowance is made for the limitation of diffusional coefficients imposed on macromolecules by the intracellular milieu it is apparent that recent estimates by Rowlands et al. (Eur. J. Biochem. 175, 93:1988) of higher concentrations of eIF-2 and eIF-2B in cells than hitherto proposed become necessary to support known rates of initiation. Under these conditions changing concentrations of met-tRNAi as proposed by Cooper and Braverman (J. Biol. Chem. 256, 7461:1981) are likely to have an important regulating influence. PMID- 1772427 TI - A spectrophotometric modification of a sensitive densitometric Safranin O assay for glycosaminoglycans. AB - Recently, an assay for quantification of glycosaminoglycans has been reported based on precipitation with Safranin O (Lammi, M. and Tammi, M. (1988) Anal. Biochem. 168, 352-357). In this procedure, the precipitate which forms when the glycosaminoglycan or proteoglycan is mixed with the Safranin O is collected with a dot-blot apparatus onto a membrane filter. The intensity of the color in the dots is measured densitometrically and is proportional to the amount of glycosaminoglycan or proteoglycan in the sample. This report describes a modification of the densitometric Safranin O assay which allows its use as a spectrophotometric assay. For this, the precipitates are solubilized in cetylpyridinium chloride and the absorbance determined for the resulting solutions. As with the densitometric method, guanidinium chloride diminishes the color intensity. However, the color is stable, even after solubilization, for at least one week. The precipitates collected from as much as 10 micrograms of material can be solubilized in as little as 100 microliters of cetylpyridinium chloride, so that increased sensitivity may be obtained if the solubilized precipitate is measured in a microcuvet. Thus, solubilization with cetylpyridinium chloride allows use of the Safranin O assay for glycosaminoglycans and proteoglycans even when a densitometer is unavailable. PMID- 1772428 TI - Cu(II) and Cd(II) inhibition of rat liver glutathione S-transferase. A steady state kinetic study. AB - The true Michaelis constant for GSH and CDNB was 0.287 mM and 0.180 mM, respectively. Regarding the quantitative effect of Cu(II) and Cd(II) inhibition on the GST system, the I50 value for Cu(II) was 0.250 mM; in contrast, Cd(II) GST inhibition did not reach the I50 value. When the varied substrate was GSH and CDNB was fixed at saturant concentration, the Cu(II)-inhibition was consistent with a pure competitive pattern. However a mixed pattern was found when CDNB was the varied substrate and GSSH was fixed at saturant concentration. The Cd(II) inhibition effect was consistent with an uncompetitive pattern when GSH was the varied substrate and CDNB was kept at saturant level. When CDNB changed over an extensive range of concentration, the inhibition effect shows a mixed inhibition pattern with a competitive character. In addition the inhibition constants of Cu(II) were one order of magnitude lower than those of Cd(II). PMID- 1772429 TI - Low molecular weight GTP-binding proteins in hepatocytes and an assessment of the role of p21ras proteins in the activation of phospholipase D. AB - A GTP-binding protein with an apparent molecular weight of 25 kDa was detected in hepatocyte extracts using SDS-PAGE and [alpha-32P]GTP. p21ras proteins could only be detected by immunological analysis. The amounts of p21ras proteins present in isolated hepatocytes and in a highly purified preparation of liver plasma membrane vesicles were 0.3 and 4 ng p21ras protein/micrograms membrane protein, respectively. In comparison with the total cell extract, the degree of enrichment of plasma membrane vesicles with p21ras was similar to that of 5'-nucleotidase. The p21ras proteins were tightly associated with the membrane. Treatment of [3H]choline-labelled plasma membranes with an excess concentration of the anti p21ras antibody Y13-259 failed to inhibit either basal or guanosine 5'-[gamma thio]triphosphate (GTP[S])-stimulated [3H]choline release. It is concluded that in hepatocytes (a) the majority of p21ras is bound to the plasma membrane and (b) p21ras is not directly involved in the activation by GTP[S] of phospholipase D. PMID- 1772430 TI - Thermostability of Bacillus subtilis neutral protease. AB - The thermostability of the B. subtilis neutral protease was studied under various conditions. At elevated temperatures the enzyme was inactivated as a result of autolysis. The rate of inactivation did not depend on the enzyme concentration and the enzyme was most stable near its pH optimum. The rate of inactivation was unaffected by the presence of a second protease during the incubation at high temperatures. The results indicate that the rate of thermal inactivation of the neutral protease is determined by the kinetics of local unfolding processes that precede autolysis rather than by the catalytic rate of the autodigestion reaction or an irreversible unfolding step. PMID- 1772431 TI - Effect of perfluorodecalin on activities of hepatic phase II xenobiotic biotransformation enzymes. AB - The activity of the hepatic phase II enzymes of xenobiotic biotransformation after intravenous administration of perfluorodecalin emulsion to rats was measured. Perfluorodecalin was found to increase the microsomal glutathione S transferase and UDP-glucuronosyltransferase activities 1.4- and 2.3-fold, respectively. The activity of sulphotransferase was decreased 2-fold. These results show that perfluorodecalin is an inducer of both the enzymes of cytochrome P-450-dependent monooxygenase system [Mishin V. et al (1989) Chem. Biol. Interactions, 72, 143-155.] and those catalyzing conjugation reactions: microsomal glutathione S-transferase and UDP-glucuronosyltransferase. PMID- 1772432 TI - Transient down-regulation of c-myc protooncogene expression by the alkaloid nicotine in human promyelocytic HL-60 cells. AB - Human promyelocytic leukemia cells (HL-60) acquire monocytic biochemical characteristics when exposed to the alkaloid nicotine. We report herein that the nicotine-induced phenotype change is accompanied by the transient reduced expression of mRNA for the protooncogene c-myc. The suppressive effect of nicotine on c-myc mRNA levels is not reversed by the addition of ADP-ribosyl transferase inhibitor, 3-aminobenzamide. PMID- 1772433 TI - Construction of a chloroplast DNA library from rye (Secale cereale), a cereal plant of temperature-inducible chloroplast ribosome deficiency. AB - The chloroplast genomes of flowering plants are circular DNA molecules, 120 to 160 kilobase pairs long, encoding the rRNA, all tRNAs, and 21 r-proteins of the chloroplast translational apparatus as well as key protein components of the photosynthetic and carbon reduction cycle reactions. In this paper we describe some characteristics of the rye chloroplast (plastid) genome and the construction and characterization of a clone library of 93% of its DNA in a plasmid and a cosmid vector. The size of rye chloroplast DNA is estimated at 135 kbp, similar to that for wheat and rice but slightly smaller than the estimate for maize (139 kbp). Chloroplast ribosome deficiency is induced in rye seedlings by germination and growth at 32 degrees-34 degrees C; therefore these clones would be useful for analyzing the regulation of chloroplast ribosome synthesis in higher plants, a process that requires coordinate expression of genes located in the nucleus and the chloroplast. PMID- 1772434 TI - Structural analysis of the decanucleotide duplex d(GGTAATTACC)2 using 1H NMR spectroscopy. AB - The conformation of the decanucleotide duplex d(GGTAATTACC)2 has been investigated in solution by one- and two-dimensional proton NMR spectroscopy. Intra- and inter-nucleotide two-dimensional nuclear Overhauser enhancement data, recorded at mixing times between 15 and 250 ms, reveal a right-handed B-DNA structure. The data also show that the A-T basepairs of the TAATTA tract are highly propeller twisted and the minor groove is particularly narrow. PMID- 1772435 TI - Characterization of a 67-kDa S6 protein kinase from rat liver. AB - Fractionation of rat liver cytosol on DEAE-cellulose resolved two S6 kinases eluting at 25 mM KCl (peak I) and 100 mM KCl (peak II). The apparent molecular weights of the peak I and peak II kinases are 26,300 and 67,000, respectively. The peak II kinase was further purified and characterized. Incubation of the kinase with [gamma-32P] ATP and Mg2+ resulted in the incorporation of 32P predominantly into a 67-kDa band. Optimal activity of the kinase was observed in the presence of 5 mM Mg2+ and in the pH range of 8.0-8.5. The Km for ATP and 40S subunit were 7.3 microM and 1.5 microM, respectively. The Mg(2+)-stimulated kinase activity was inhibited by various divalent metals, NaF, and polyamines. The properties of the peak II S6 kinase are very similar or identical to the previously described mitogen-activated S6 protein kinase and may represent the nonactivated form of this enzyme. PMID- 1772436 TI - Changes in polypeptide expression following Trypanosoma cruzi differentiation from trypomastigotes to amastigotes. AB - Changes in the dynamic of expression of polypeptides following the differentiation from infective trypomastigotes to multiplicative amastigote forms of Trypanosoma cruzi were mapped by two-dimensional gel electrophoresis and quantitatively analyzed by laser densitometry. Following the differentiation from trypomastigotes to amastigotes the expression of the polypeptides 212, 183, 176, 149, 50-55, 43, 39, 34 and 28 kDa is turned off in multiplicative amastigotes, whereas the expression of the polypeptides 80, 66 (p.Is. 6.75-7.50), 42 and 38 kDa is turned on. After complete differentiation from trypomastigotes to amastigotes the expression of the polypeptides 43, 42, 33, 32, 29 and 23 kDa is up-regulated in amastigotes, whereas the expression of the acidic polypeptides 66 (p.Is. 6.27-6.64), 45-48 and 41-43 kDa is down-regulated. PMID- 1772437 TI - Purification and characterization of the apically secreted 80 KDa glycoprotein from Madin-Darby canine kidney (MDCK) cells. AB - An 80 KDa glycoprotein (gp 80), known to be released predominantly from the apical surface by filter-grown Madin-Darby canine kidney cells, was purified to electrophoretic homogeneity. Purified gp 80 was found to have a disulfide-bonded dimeric structure, and appeared to exist in two molecular forms, a major (high molecular weight) form consisting of a 46 KDa subunit and a 39 KDa subunit and a minor (low-molecular weight) form consisting of a 46 KDa subunit and a 33 KDa subunit. Upon de-glycosylation by N-glycanase treatment, the 46 KDa subunit was converted to a 25.6 KDa form, whereas both the 39 KDa and the 33 KDa subunit gave rise to a 21.1 KDa form. V8 protease mapping of deglycosylated polypeptides revealed the 39 KDa and the 33 KDa subunit to have nearly identical band patterns, which also exhibited a high degree of homology to that derived from the 46 KDa subunit. Radioimmunoassays revealed that the binding of the purified gp 80 to fibrinogen (or heparin) was dependent on both pH and divalent cations. Furthermore, binding of gp 80 to immobilized fibrinogen (or heparin) was inhibited in the presence of free fibrinogen (or heparin) added in the assay mixture. PMID- 1772438 TI - Branched-chain 2-oxoacid dehydrogenase kinase activity is regulated by alteration of protein thiol groups. AB - Effects of sulfhydryl reagents (5,5'-dithiobis(2-nitrobenzoic acid) and N ethylmaleimide) and potassium ferricyanide on the activities of branched-chain 2 oxoacid dehydrogenase complex and its kinase were studied. The dehydrogenase activity was inhibited by the sulfhydryl reagents, but not by potassium ferricyanide. The kinase activity of branched-chain 2-oxoacid dehydrogenase kinase complex was inhibited with an increase in concentration of all three compounds. However, direct treatment of the purified kinase with N-ethylmaleimide prior to reconstitution with kinase-depleted branched-chain 2-oxoacid dehydrogenase resulted in no loss of kinase activity. These results suggest that protein thiol groups of the E2 component of the dehydrogenase complex are involved in the interaction between the dehydrogenase and its kinase. PMID- 1772439 TI - Photocleavage of muscle glycogen phosphorylase by vanadate. AB - Glycogen phosphorylase is progressively degraded during irradiation with near UV light in the presence of vanadate. The pattern of protein cleavage by monovanadate is characterised by fewer peptides than that by decavanadate, which leads to fragmentation in a ligand dependent way. In both instances, the initial cleavage releases a peptide of 82,000 daltons which accounts for the N-terminal portion of the subunit, including the regulatory phosphorylation site. PMID- 1772440 TI - Molecular analysis of cell cycle-related gene expression in anti-HLA class I monoclonal antibody (01.65) treated PHA-activated human T-lymphocytes. AB - HLA class I antigens seem to be involved in the proliferative response of PHA activated human T-lymphocytes. We have previously reported that the treatment of PHA-activated peripheral blood mononuclear cells (PBMC) with an anti-HLA class I monoclonal antibody, 01.65, (i) inhibits the tritiated thymidine incorporation, (ii) inactivates cytosolic protein kinase C (PKC) and (iii) causes an increase in the duration of the cell cycle. Northern Blot kinetic analysis of c-fos, c-myc, cdc2, IL-2R, c-myb, ODC, TK and H3, from 10 minutes to 120 hours, was performed in MAb 01.65 treated cultures. We found that the expression of four genes (c-myc, IL-2R, cdc2 and TK) was depressed 24 hours after PHA stimulation. PMID- 1772441 TI - Primary structure of ovine apolipoprotein C-II and the production of antibodies directed towards a synthetic fragment (residues 46-59). AB - Two distinct activator proteins for lipoprotein lipase were isolated from ovine plasma and purified to homogeneity by reverse phase HPLC. The two proteins were partially sequenced (up to residue 59) and the results show that they are identical except that 6 residues were missing from the N-terminal of the smaller protein. The complete sequence of the proteins has been deduced from amino acid composition studies and by comparison with the sequence information available from other species. Antibodies were produced in BALB/c mice to a synthetic peptide corresponding to a highly hydrophilic region (residues 46-59) of the activator protein. The antibodies cross-reacted with the two forms of activator and with ovine lipoproteins. This work with a synthetic fragment of ovine activator protein confirms that the technique is useful for investigating antibody production and specificity directed against native lipoproteins. PMID- 1772442 TI - 4-(4-R-phenylamino)-5-methoxy-1,2-benzoquinones are new selective inhibitors of carbon tetrachloride-initiated free radical reactions in liver. AB - The action of several 1,2-benzoquinone derivatives on free radical processes initiated by carbon tetrachloride was studied. Among them a substance that effectively inhibited lipid peroxidation without substantial influence on covalent binding of radical products of metabolic cleavage of carbon tetrachloride as well a substance that equally inhibited both processes were found. It was shown that 1,2-benzoquinones can be useful tool for investigation of free radical mechanisms of carbon tetrachloride-initiated liver cell damage in vivo. PMID- 1772443 TI - Novel oligomannose-type sugar chains derived from glucose oxidase of Aspergillus niger. AB - The primary structure of the N-linked sugar chains of glucose oxidase from Aspergillus niger was investigated. These sugar chains were released from the polypeptide backbone by hydrazinolysis, and the reducing ends of the sugar chains were pyridylaminated. HPLC of the pyridylamino sugar chains with an amide-silica column showed at least seven sugar chain peaks. Chemical and exoglycosidase digestion and 400 lMHz H-NMR studies of the sugar chains of lower molecular weight showed that these were novel oligomannose-type sugar chains, (Man)5-7 (GlcNAc)2, with the structure: +/- Man alpha 1----3Man alpha 1----3(Man alpha 1-- -6)Man alpha 1----6(+/- Man alpha 1----3Man alpha 1---3)Man )Man beta 1--- 4GlcNAc beta 1----4GlcNAc. PMID- 1772444 TI - DNA polymerase action blocked by adenine adducts induced by 5 hydroxymethylchrysene sulfate. AB - Modification of M13mp10 single-stranded DNA with 5-hydroxymethylchrysene (5HCR) sulfate, the ultimate carcinogenic metabolite of 5-methylchrysene, resulted in formation of N6[(chrysen-5-yl)methyl]adenine and N2[(chrysen-5-yl)methyl]-guanine at the ratio of 2.7:1. Measurement of DNA synthesis using this modified template and E.coli DNA polymerase I (Klenow fragment) demonstrated that increasing levels of adducts caused a progressive decline in replication. Analysis of reaction products on DNA-sequence gels revealed DNA elongation to be arrested exclusively at adenine adducts in -AAAGGA- and -AACA- sequences. PMID- 1772445 TI - Avian tandem repeats: nuclear protein binding sites and the origins of short tandem repetitive DNAS. AB - A 14 bp repeat isolated from the genome of a Mallard duck (Anas platyrhynchos) and a 13 bp repeat isolated from the genome of a Muscovy duck (Cairina moschata) were both tandem and genus-specific. There were 2.1 x 10(6) copies of the 14 bp repeat in the Mallard duck genome and 1.3 x 10(6) copies of the 13 bp repeat in the Muscovy duck genome. These two repeats were not obviously homologous but each contains different transcription protein binding sites. Experimentally, the two repeats were also observed to bind nuclear proteins specifically. A sequence selective mechanism for the expansion of short tandem repeats from single ancestral sequences containing nuclear protein binding sites is presented. PMID- 1772446 TI - Development of sensitive enzyme immunoassay for human nerve growth factor. AB - We prepared anti-recombinant human nerve growth factor (hNGF) antibody IgG and characterized its property immunologically. This antibody IgG reacted with some animal NGFs, especially with bovine NGF, on immunodiffusion analysis. Using this antibody IgG, we developed a sensitive two-site enzyme immunoassay (EIA) system for human NGF, based on the biotin-streptoavidin system. NGF at a concentration as low as 0.02 pg/well (corresponding to 8 x 10(-19) mol) could be measured with high reproducibility. The sensitivity of this EIA was equal to that of our EIA for mouse NGF. With this EIA, the detection limit of other mammalian NGFs was reduced in parallel with the degree of decrease in amino acid sequence homology between them and hNGF. PMID- 1772447 TI - Purification and kinetic properties of pyruvate kinase from Brochothrix thermosphacta. AB - Pyravate kinase (ATP: pyruvate 2-0 phosphotransferase E.C.2.7.1.40) was purified from Brochothrix thermosphacta. The enzyme is a homotetramer of monomer Mr 58,000. Fructose-1,6-bisphosphate stimulates activity and promotes hyperbolic kinetics although it is not essential for enzyme activity. The positive effect of fructose-1,6-bisphosphate on activity is repressed by inorganic phosphate which enhances cooperative kinetics. Unlike pyruvate kinases from other sources, the Brochothrix enzyme is uncompetitively inhibited by glucose-6-phosphate, although at high concentration. ATP is a strong inhibitor of pyruvate kinase and shifts the residual activity/pH profile towards more alkaline values. PMID- 1772448 TI - Deleted mitochondrial DNA in the skeletal muscle of aged individuals. AB - Human mitochondrial DNA deletions occur mainly in the major region between the origins of replication of the heavy and light strands both in mitochondrial myopathy and in the ageing process. To determine whether deletions in the minor region also contribute to the ageing process, we analyzed a 3,610-basepair deletion (nucleotide position 1,837-5,447, from the 16S rRNA gene to the ND2 gene) in the skeletal muscle from individuals of various ages. The direct repeated sequence at each boundary of the deletion was identified as 5'-CCCC-3'. This minor-region deletion was detected in one of five individuals of the sixth decade, two of five in the seventh decade, and all of five in the eighth decade, but not in individuals below age 60. These results indicate that age-related accumulation of mtDNA deletions occurs not only in the major region but also in the minor region. PMID- 1772449 TI - The effect of nicotine on cell proliferation and synthesis of secreted proteins in BALB/C 3T3 cells. AB - The alkaloid nicotine induces a dose-dependent inhibition of cell proliferation and morphological change when added to BALB/C 3T3 cells. Significant differences were observed between control and nicotine-treated cells with respect to the newly synthesized secreted proteins by using heparin-agarose column chromatography. Both the anticellular and protein synthesis modulating activities of nicotine were affected by the degree of confluence of cells, suggesting a complex mode of action of nicotine in mammalian cells. PMID- 1772450 TI - Molecular cloning and nucleotide sequence of cDNA encoding the human liver S adenosylmethionine synthetase. AB - cDNA clone for human liver S-adenosylmethionine synthetase (liver-specific isoenzyme) was isolated from a cDNA library of human liver poly(A)+ RNA. The cDNA sequence encoded a polypeptide consisting of 395 amino acid residues with a calculated molecular mass of 43675 Da. Alignment of the predicted amino acid sequence of this protein with that of rat liver S-adenosylmethionine synthetase showed a high degree of similarity. The coding region of the human liver S adenosylmethionine synthetase cDNA sequence was 89% identical at the nucleotide level and 95% identical at the amino acid level to the sequence for rat liver S adenosylmethionine synthetase. PMID- 1772451 TI - Re-evaluation of rate constants involved in the action of the initiation and elongation factors eIF-2B and EF-Ts. AB - Rate constants calculated previously by the author (Biochem. Int. 22, 523 533:1990) for the reactions catalysed by eIF-2B (GEF) in which free GDP exchanges with GDP bound to eIF-2 have been re-evaluated using the computational procedures developed by Chau et al. (J. Biol. Chem. 256, 5591-5596:1981) for the analogous reactions catalysed by EF-Ts. Modification of the equations used by Chau et al. emphasises the interrelationships of the rate constants for the binding of GDP and of EF-Ts (eIF-2B) to the ternary complex EF-Ts.EF-Tu.GDP (eIF-2B.eIF-2.GDP). The modification leads to some revision of the previously published values for the rate constants involved in the action of EF-Ts as put forward by Chau et al. as well as for those involved in the action of eIF-2B. PMID- 1772452 TI - [The action profile of D,L-kavain. Cerebral sites and sleep-wakefulness-rhythm in animals]. AB - To investigate neurophysiological effects of D,L-kavain, two studies were conducted on unrestrained cats with chronically implanted electrodes. In group A animals (n = 26) we recorded the blood pressure, the EEG of cortical and subcortical areas, the electromyogram, EEG arousal reactions, and subcortical evoked potentials elicited by central stimulation. This was done before and after injection of D,L-kavain (10-50 mg/kg i.p.) or--for comparison--of a kava extract in Ol. arachidis (50-100 mg pyrones/kg i.p.). Group B cats (n = 9) served for polygraphic, 10-h analyses of the sleep-wakefulness rhythm; they received--in a random sequence--0.9% NaCl (3 ml i.p.), D,L-kavain (28 mg/kg p.o.), pentobarbital (1 mg/kg i.m.), or the combination D,L-kavain plus pentobarbital. With both D,L kavain and the extract, muscle tone was seen to be diminished in about 50% of the experiments. It was only the extract which exerted marked effects on the EEG; it induced high amplitude delta waves, spindle-like formations, and a continuous alpha- or beta-synchronization in the amygdalar recordings (p less than 0.001). Neither D,L-kavain nor the kava extract changed the threshold of the EEG arousal reaction. As to the evoked potentials, the hippocampal response following stimulation of the amygdalar nucleus showed an increase in amplitude in the animals given D,L-kavain (50 mg/kg; p less than 0.05) and in those given the extract (100 mg pyrones/kg; p less than 0.01). In addition, after injection of the extract, further projections arising from the amygdala as well as the connection from the caudate nucleus to the amygdala proved to be activated. The percentage duration of active wakefulness was significantly shortened by both D,L kavain and pentobarbital, as compared to placebo. There was a likewise significant prolongation of synchronized sleep with D,L-kavain, pentobarbital, and the combination of both these agents. However, a potentiation of drug effects failed to occur. It is concluded from the findings that limbic structures and, in particular, the amygdalar complex represent the preferential site of action for both D,L-kavain and the kava extract. The participation of these structures in modulating emotional processes may explain the promotion of sleep, even in the absence of sedation. There is no congruity of D,L-kavain with either the tricyclic thymoleptics or the benzodiazepines regarding the profile of neurophysiological effects. PMID- 1772453 TI - Effect of oxiracetam on cerebrovascular impairment in rats. AB - The effect of oxiracetam (CGP 21690E, CAS 62613-82-5) on cerebrovascular impairment was investigated in rats. 1. After injection of tranylcypromine (a MAO inhibitor), spontaneously hypertensive rats (SHR) which had been previously infused with norepinephrine (NE) for 14 days displayed stroke-related behaviour including kangaroo-like posture, seizures and death. Administration of oxiracetam at doses of 400 and 800 mg/kg/d p.o. for 14 days before tranylcypromine injection inhibited the stroke-related behaviour. 2. Bilateral common carotid and vertebral artery occlusion induced electroencephalogram (EEG) flattening, the EEG recovering gradually after re-perfusion of cerebral blood flow. Oxiracetam administered after the re-perfusion at a dose of 100 mg/kg, i.v. accelerated the recovery. This facilitatory effect was not seen when either piracetam (50 and 100 mg/kg i.v.) or idebenone (50 and 100 mg/kg i.v.) were administered. 3. Occlusion of middle cerebral artery produced cerebral infarction and disturbed the circadian rhythm of spontaneous motor activity with an relative increase of activity in the light period. Treatment with oxiracetam (400 mg/kg/d p.o.) for 14 days after the occlusion showed a tendency to an improvement in the disturbed circadian rhythm but did not influence the size of brain infarction. From these results, oxiracetam is thought to have a protective effect in cerebrovascular impairment. PMID- 1772454 TI - Pharmacokinetics of alpha-dihydroergocryptine in rats after intravenous and oral administration. AB - The pharmacokinetic properties of alpha-dihydroergocryptine methanesulphonate (alpha-DHEK, CAS 19467-62-0) were investigated in rat using a radioimmunoassay technique for nonmetabolized drug. alpha-DHEK, intravenously administered at the dose of 6 mg/kg, showed a plasma profile according to an open 3-compartment pharmacokinetic model with a long half-life (about 7.56 h). The kinetics of alpha DHEK after oral administration (6 mg/kg) showed two peaks; the second peak at 8 h was probably due to an enterohepatic cycle. The disposition of alpha-DHEK consisted in a fast absorption and a slow elimination (t1/2el about 6.78 h). The alpha-DHEK was largely metabolized as results from the complex metabolite profile in body fluids and from very low urinary elimination of unchanged drug. PMID- 1772455 TI - Effects of raclopride and haloperidol on spontaneous motor activity and on conditioned avoidance behavior in rats. A comparison of potency, efficacy and time-course of action. AB - The spontaneous locomotor activity of rats was used as an index of centrally mediated effects of raclopride (CAS 84225-95-6). The results indicate a duration of less than 2 h after s.c. administration of 2 mumol kg-1. In support of a rapid first-pass metabolism in the rat, the effect was considerably weaker after i.p. administration. This difference was further supported by comparing the dose effect curves after s.c. and i.p. raclopride administration. Haloperidol (CAS 52 86-8) appears to be slightly more potent than raclopride, the estimated ED50 values being 0.15 and 0.24 mumol kg-1 s.c., respectively. Both compounds (s.c. administration) produced a complete suppression of the conditioned avoidance behavior with approximately the same potency. As assessed in the latter situation, the duration of the effects of raclopride is considerably shorter than that of haloperidol. PMID- 1772456 TI - Increased binding of thiopental in tissue homogenates of the rat in the presence of a volatile anesthetic. AB - Thiopental (CAS 76-75-5) binding (0.4 mmol.l-1) in tissue homogenate of rats (liver, brain, heart, kidney, lung, spleen and skeletal muscle) was studied by equilibrium dialysis. Percentage of thiopental bound was relatively low in homogenate of brain, lung, spleen and skeletal muscle (14-19%); it was much higher in that of liver, heart and kidney (24-27%). Simultaneously present halothane (11.8 mmol.l-1) increased the percentage of thiopental bound in the homogenate of all tissues investigated at least to a factor of 1.4 (spleen) and maximally of 2.4 (brain). The same phenomenon of an increased thiopental binding in tissue homogenate was found in the presence of 10.3 mmol.l-1 enflurane (except skeletal muscle) and 10.2 mmol.l-1 isoflurane (except kidney, spleen and skeletal muscle), yet to a significantly lower extent in the presence of these halogenated ethers as compared with halothane. PMID- 1772457 TI - Study to evaluate the encephalotropic potency of a hemodialysate. Controlled study using electro-retinography and visual evoked potentials under hypoxic conditions in human volunteers (preliminary communication). AB - Twelve healthy young males volunteered in this pilot-study to test the encephalotropic potency of a deproteinized hemodialysate of calf blood (Actovegin). This compound contains peptides, oligosaccharides and nucleinic acid derivatives, which are supposed to improve transport of glucose and oxygen into cells. The study is based on a placebo-controlled, partially double-blind, 3-way crossover design. The subjects received single administrations of the hemodialysate as injection (10 ml, 400 mg), as infusion (500 ml, 4 g) and a placebo injection (saline) in randomized sequence. Drug effects on visual evoked potentials (VEP) and electro-retinography (ERG) were tested--in the context of a hypoxia based model of dementia (10.5% O2 inspiratory)--1, 2, and 4 h post administration. The main target variables were the amplitudes of the VEP-P2 component and of the ERG-b-wave. The hemodialysate--as an encephalotropic drug- was expected to counteract the hypoxia-induced reduction of both amplitudes. On a descriptive/exploratory level the restitution of the (hypoxia-suppressed) target variables was found. The combined application of visual evoked potentials (VEP) and of electroretinography (ERG) was able to consistently reveal central and peripheral sites of hypoxia-antagonistic action of the drug in study, which might not be restricted solely to neuronal structures, but seems to be extended to glial structures too. The predominant effects form a pattern of clinically relevant changes, which should be confirmed in a larger number of subjects. The preferable form of administration--featuring positive effects in hypoxia antagonism--seems to be the infusion with its higher dosage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772458 TI - 4-heterotricyclic substituted 1,4-dihydropyridines with a potent selective bradycardic effect. AB - A series of 4-heterotricyclic substituted 1,4-dihydropyridines were prepared. The compounds were evaluated for inotropic, chronotropic and calcium antagonist properties. The tested compounds are fairly good as calcium antagonists, but exert potent selective bradycardic effects. PMID- 1772459 TI - Effects of felodipine on vascular smooth muscle in comparison with nifedipine. AB - Felodipine (ethylmethyl 4-(2,3-dichlorophenyl)-1,4-dihydro-2,6-dimethyl- 3,5 pyridine dicarboxylate, CAS 72509-76-3), a vasoselective calcium antagonist, has a slow onset inhibitory effect on high K(+)-induced contractions in vascular smooth muscle and a longer duration than that of nifedipine. In addition it non competitively inhibits Ca(++)-induced contraction in the depolarized aorta or femoral artery in the rat. Felodipine's inhibitory effect on caffeine or norepinephrine-induced contraction was observed at a micromolar range. This result suggests that felodipine may inhibity Ca++ release from intracellular Ca++ stores through a mechanism of Ca++ or inositol 1,4,5-triphosphate induced Ca++ release in addition to a blockade of Ca++ influx through the sarcolemma. PMID- 1772460 TI - [Biologic availability and hemodynamic actions following administration of sublingual glycerol trinitrate. A new delivery system]. AB - Bioavailability and Hemodynamic Properties of Sublingually Applied Glyceryl Trinitrate/A new delivery system Bioavailability of glyceryl trinitrate (GTN, CAS 55-63-0) was investigated in 16 healthy subjects after sublingual application of 0.8 mg GTN from either a reference product (B) where GTN release is effected by fluorochlorohydrocarbon (FCH) or a test product (A) (Corangin Nitrospay) where GTN release is effected FCH-independently by a pumping system. Plasma concentrations of GTN and hemodynamic effects (digital plethysmography) were measured until 30 min after application. There was no significant difference (Wilcoxon's matched pairs signed rank test) in AUCo-t (A: 8.9 +/- 7.3 ng x h/ml; B: 8.3 +/- 7.6 ng x h/ml) and Cmax (A: 1.43 +/- 1.26 ng/ml; B: 1.13 +/- 1.06 ng/ml), but tmax was significantly shorter after application of the test product (A: 4.6 +/- 1.0 min; B: 6.7 +/- 2.7 min, p less than 0.01). Nonparametric confidence limits (90%) were 0.80-1.89 for AUCo-t (point estimator of the median 1.14), 0.92-2.78 for Cmax (point estimator 1.06) and 0.61-0.90 for tmax (point estimator 0.75). EC50-values obtained from the individual concentration/effect curves were linked with the concentration/time-curves to establish the time of reaching EC50 (tEC50). GTN response did not differ for both preparations (EC50A: 0.25 +/- 0.24 ng/ml; EC50 B: 0.34 +/- 0.36 ng/ml), coincident with tmax, tEC50 was significantly shorter after administration of (A) (A: 1.8 +/- 0.3 min, B: 2.7 +/- 1.0 min). With respect to the variability of GTN pharmacokinetics, the test preparation shows superior bioavailability and a faster onset of hemodynamic action. PMID- 1772461 TI - [Comparative studies on the bioavailability of nicergoline from two different steady-state preparations]. AB - Comparative Studies on the Bioavailability of Nicergoline from Two Different Preparations in Steady State The bioavailability of nicergoline (CAS 27848-84-6) in a new 30 mg tablet and a 10 mg dragee formulation (Sermion) was evaluated under steady state conditions in 18 healthy male volunteers between the age of 21 and 37 years. During the run-in phase, the volunteers received on 7 consecutive days 30 mg nicergoline either 1 x 30 mg/d tablet (test substance) or 3 x 10 mg dragees (reference). On day 8, after intake of 1 x 30 mg in a 24 h interval or 1 x 10 mg in a 8 h interval respectively, the plasma concentrations of the nicergoline metabolite 10-methoxy-6-methyl-ergoline-8 beta-methanol (MDL) were measured. The area under the plasma concentrations in the 24 h interval after administering the 30 mg tablet was not 3 times greater as to be expected; it was by a factor of 4 significantly greater than the area under the curve of the 10 mg dragee in the 8 h interval. Therefore, nicergoline has a higher availability in the 30 mg tablet than in the 10 mg dragee form. Both formulations were equally well tolerated. PMID- 1772462 TI - Influence of food on the bioavailability of theophylline from a sustained released theophylline preparation. AB - In a single-dose cross-over study with 12 healthy male volunteers the relative bioavailability of theophylline (CAS 58-55-9) in a dosage of 700 mg (sustained release preparation) under fasting- and non-fasting conditions was investigated. The areas under the plasma concentration-time curves AUC amounted to 184.2 +/- 42.7 micrograms.h/ml (fasting) and 157.9 +/- 32.9 micrograms.h/ml (non-fasting, p = 0.031). The bioavailability was reduced by approx. 15% by concomitant food intake. The 95% confidence intervals for AUC and Cmax were 76-99% and 78-105%, respectively, and therefore narrowly outside the usual 80-120% limits. There were no therapeutically relevant changes with regard to the parameters Cmax, tmax and MRT. The MRT values of 13.4 and 13.9 h respectively showed furthermore that theophylline represents a twice-daily formulation. No "dose-dumping effect" was observed. PMID- 1772463 TI - Beneficial effects on serum lipids in noninsulin dependent diabetics by acarbose treatment. AB - Acarbose (Bay g 5421, Glucobay; CAS 56180-94-0) inhibits alpha-glucosidases of the small intestine and thus delays glucose release from complex carbohydrates. It is therefore efficient as a first-line drug in the treatment of noninsulin dependent diabetics (NIDDM) insufficiently treated with diet alone. Information is scarce whether under acarbose treatment the lipid metabolism can also be improved. Therefore the changes of triglycerides, cholesterol and HDL-cholesterol were analyzed in a randomized double-blind placebo-controlled trial. In brief, 94 NIDDM aged 43 to 70, after a pretreatment period of at least 3 months, were treated with 100 mg acarbose t.i.d. or placebo for 24 weeks. The patients were recruited after a 4-week screening phase with reinforcement of diet. The most impressive results of acarbose treatment were lowering of blood glucose and insulin, especially in the postprandial state, and of HbA1 (glycosylated hemoglobin). Results on lipids: The initial serum cholesterol levels showed a broad spectrum. Low concentrations remained unchanged under acarbose, while high concentrations (the upper tercile) decreased from 273 to 251 mg/dl. This effect was statistically significant compared to placebo. HDL-cholesterol levels increased continuously under acarbose and placebo as well thus indicating some study effect. Similarly, fasting triglycerides leveled down under acarbose and placebo. However, drastic differences appeared in postprandial triglycerides which were checked 1 and 5 h after a test meal given at entry and at finish of the study. The lowering by acarbose compared to placebo was highly significant for the 1 h postprandial concentrations. It is concluded that acarbose treatment can reduce elevated cholesterol concentrations and postprandial triglyceride concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772464 TI - [Acidity profile in humans after multiple oral administration of hydrotalcite]. AB - Acid Suppression Profile of Hydrotalcite in Man. In this randomized, double blind, placebo-controlled cross-over study, the effect of hydrotalcite (CAS 12304 65-3, Talcid), 2 tablets qid (neutralizing capacity 122 mmol) on intragastric 24 h acidity was investigated. 12 healthy male and female volunteers were administered hydrotalcite, 2 tablets qid, or placebo on 2 study days, in each case at 10, 15, 20 and 23 h. Daytime (8-22 h) and nighttime (23-7 h) intragastric H+ concentrations (mmol/l) were significantly reduced by hydrotalcite compared with placebo. The following inhibiton rates were obtained: daytime 37.4%, nighttime 31.5% (p less than 0.05). During the 2-h periods immediately after oral application of hydrotalcite or placebo inhibition rates of up to 65% were observed. These results suggest that hydrotalcite may have also antiulcer activity like other antacids which are used in the treatment of peptic ulcer disease in low daily neutralizing capacities (120-280 mmol/die). PMID- 1772465 TI - Pharmacological study in vivo of the new topical anti-inflammatory steroid 21 thiol-9 alpha-fluoro-11 beta,17 alpha-dihydroxy-16 alpha-methyl-3,20-dione-21 acetylamino cysteine. AB - The pharmacological evaluation, using animal models, of 21-thiol-9 alpha-fluoro 11 beta, 17 alpha-dihydroxy-16 alpha-methyl-3,20-dione- 21-acetylamino cysteine (CMJ), a new steroidal anti-inflammatory compound, is reported. The results obtained show a significant anti-inflammatory activity for CMJ. Comparison with dexamethasone indicates that CMJ is about 9 to 10 times less active in vivo. Of particular interest, however, is the dissociation of local and systemic activities of CMJ, since this compound was shown to be practically devoid of systemic activity (about 970 times less active than dexamethasone) after subcutaneous administration in rats. It is therefore expected that the topical use of CMJ in therapy may not cause the side effects provoked by many of the corticosteroids currently used. PMID- 1772466 TI - In vitro effects of 2-tert-butyl-benzothiazole derivatives on microfilariae of Litomosoides carinii, Brugia malayi and Acanthocheilonema viteae. AB - Six 2-tert-butyl-benzothiazole derivatives (2-tert-butyl-6-iso-thiocyanato-5 methyl-benzothiazole CGP 21306); 3-[(2-tert-butyl-5-methyl-benzothiazole-6-yl) aminothiocarbonylthiol] propionic acid (CGP 21835); 2-tert-butyl-5-methyl-6-(N methyl-piperazinyl-thiocarbonylamino)-b enzothiazole (CGP 21833); 2-tert-butyl-5 methyl-6-(4-dimethylamino-piperid-1-yl-thiocarbo nylamino)- benzothiazole (CGP 26702); CGP 20376, the 5-methoxy analogue to CGP 21835 and CGP 20309, the 5 methoxy analogue to CGP 21833) with known, high filaricidal activity in vivo were tested for in vitro efficacy against microfilariae of L. carinii (Lc), B. malayi (Bm) and A. viteae (Av) in order to study intrinsic antifilarial activities. All drugs affected the motility of the microfilariae of the three species in a species, dose and time dependent fashion. Lc was the most sensitive, Av the most resistant species. CGP 20376 and 21835 were the most effective compounds followed by CGP 21306. Complete immobilization of microfilariae was observed after 20 h in protein-free medium RPMI 1640 at drug concentrations of 0.1 to 10 nmol/ml. Effects were still marked 2 when graded on a 4 (full motility) to 0 (immobile) scale at concentrations of 0.01-0.1 nmol/ml. In the case of the thiourea derivatives CGP 21833, 26702 and 20309 concentrations had to be increased 10-100 fold to obtain similar effects. When proteins were present in the incubation medium (10% foetal calf serum, 100% normal serum) the efficacy of the compounds was reduced, i.e. drug concentrations had to be increased up to 100 fold to produce similar effects as in protein-free medium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772467 TI - Metabolic fate of exogenous chondroitin sulfate in man. AB - Chondroitin sulfate is administered as a drug to man by intravenous, intramuscular or oral route. However, few data are available on the metabolic fate of exogenous chondroitin sulfate in man. After intravenous administration of 0.5 g of chondroitin sulfate to healthy volunteers, the plasma level decreases according to a two-compartmental open model. The half-lives of distribution and elimination are 25.5 +/- 6.6 and 281 +/- 32 min, respectively. The volumes of central and tissue compartments are 6.0 +/- 1.0 and 22.9 +/- 7.7 l, respectively. More than 50% of the administered chondroitin sulfate is excreted with urine during the first 24 h as high and low molecular weight derivatives. After oral administration of 3 g of chondroitin sulfate to 12 healthy volunteers, a main peak (11.4 +/- 3.7 micrograms/ml) preceded by a lower peak is observed after 190 +/- 21 min. The elimination half-life is 363 +/- 109 min. The absolute bioavailability following oral administration calculated from AUC of plasma concentration is 13.2%. A peak of oligo- and polysaccharides with a molecular weight lower than 5000 Daltons derived from partial digestion of exogenous chondroitin sulfate is also present in plasma. These observations indicate that the metabolic fate of exogenous chondroitin sulfate is similar in man and in experimental animals. PMID- 1772468 TI - Regression of atherosclerosis in humans by lowering serum cholesterol. PMID- 1772469 TI - Aging and atherosclerosis in the rabbit. 1. Distribution, prevalence and morphology of atherosclerotic lesions. AB - Aging is considered a risk factor in the pathogenesis of atherosclerosis. It is not clear, however, whether the relationship between aging and atherosclerosis is the result of increased susceptibility of the arterial wall related to intrinsic alterations or the expression of the increase in intensity or duration of exposure to risk factors. In this study, we used aged (median age 46 months) and young (4 months old) New Zealand white rabbits. Nine aged and 11 young rabbits received a hyperlipemic diet enriched with a low dose of cholesterol for 18 months. Eleven aged and 8 young rabbits, fed standard chow for the same period, were used as controls. Using morphologic and morphometric methods, we detected in aged hyperlipemic rabbits (a) a marked prevalence of fibroatheromatous plaques (as opposed to fatty streaks in young hyperlipemic rabbits); (b) aortic lesions more extensive and of greater dimensions than in young hyperlipemic rabbits; (c) fibroatheromatous plaques in carotids and raised fatty streaks in the large subepicardial coronary branches. Our results show an increased susceptibility of the aged arterial wall to hypercholesterolemia. PMID- 1772470 TI - An investigation of the role of lecithin:cholesterol acyltransferase and triglyceride-rich lipoproteins in the metabolism of pre-beta high density lipoproteins. AB - Small high density lipoproteins (HDL) with pre-beta electrophoretic mobility (pre beta HDL) have recently been shown to be the primary acceptor of cholesterol from cultured cells. We studied the metabolism of these particles by incubating serum at 37 degrees C in the presence and absence of active lecithin: cholesterol acyltransferase (LCAT). We found that the serum pre-beta HDL concentration decreased in the presence of LCAT, but when LCAT was inhibited the concentration remained constant, or increased, depending on the method of inhibition. This suggests that pre-beta HDL are a substrate for LCAT. We also found a significant negative correlation between levels of LCAT activity and pre-beta HDL in 28 fasting healthy subjects, this provides evidence that the activity of LCAT regulates, at least in part the concentration of these particles in vivo. During the early phase of incubation there was a more rapid decrease in pre-beta HDL concentration which was greater in the post-prandial than fasting state. When we infused a triglyceride emulsion into 6 subjects or added this to serum in vitro we observed an immediate fall in pre-beta HDL concentration. These findings suggest that pre-beta HDL interact with triglyceride rich particles. We investigated the origin of pre-beta HDL from blood lipoproteins during their lipolysis, in vivo and in vitro and found that they were produced from both triglyceride-rich and high-density lipoproteins. Formation from triglyceride-rich lipoproteins was evident by the rise in pre-beta HDL concentration during heparin induced lipolysis when fasting and post-prandially. The rise was greater post prandially and particularly marked in 4 hypertriglyceridaemic patients following a fat load. Generation from alpha-HDL was evident when we prolonged the action of the heparin-released lipases by incubation of post-heparin sera at 37 degrees C. Continued formation of pre-beta HDL occurred at an equal rate in the fasting and post-prandial samples suggesting release by lipolysis of alpha-HDL. This was supported by the action of lipases on serum and isolated HDL in vitro, where triglyceride lipase rather than phospholipase activity appeared more effective at releasing pre-beta HDL. These findings suggest binding and release of pre-beta HDL by triglyceride-rich lipoproteins depending on the prandial state and production from alpha-HDL through the action of lipases. PMID- 1772471 TI - Influence of early diabetic nephropathy on very low density lipoprotein (VLDL), intermediate density lipoprotein (IDL), and low density lipoprotein (LDL) composition. AB - The procedure of discontinuous gradient ultracentrifugation (DGU) was used to characterize the influence of early diabetic nephropathy on the composition of very low density lipoprotein (VLDL, flotation density 60-400 Svedberg (Sf) units), low density lipoprotein (LDL, flotation density 0-12 Sf) and subfractions of intermediate density lipoprotein (IDL1 and IDL2, 20-60 and 12-20 Sf, respectively). Forty-six subjects with type 1 (insulin-dependent) diabetes and serum creatinine, less than 140 mumol/l were studied, of whom 23 consistently had normal rates of albumin excretion (AER less than 15 micrograms/min), and 23 had persistent albuminuria (AER 20.0-960.6 micrograms/min). The two groups were similar with respect to total serum lipids, glycaemic control, age and body mass. The composition (lipid, protein and phospholipid) and mass of VLDL, LDL and IDL2 was not appreciably altered by early nephropathy, but free and total cholesterol concentration in IDL1 (Sf 20-60) was increased (total cholesterol 0.68 (0.09) (mean (SE)) vs. 0.47 (0.07) mmol/l, and free cholesterol 0.27 (0.04) vs. 0.17 (0.03) mmol/l, both P less than 0.05). The explanation of these findings was probably an accumulation in the circulation of the remnants of chylomicron metabolism and/or intermediates in the conversion from VLDL to IDL1. In addition, there was a decrease in serum high density lipoprotein (HDL) cholesterol in early nephropathy (1.27 (0.06) vs. 1.38 (0.10) mmol/l, P less than 0.05), due to a decrease in the HDL2 cholesterol subfraction (P less than 0.05). These findings may in part explain the increased risk of premature atherosclerosis associated with the development of albuminuria. PMID- 1772472 TI - Hypervascularity of nontoxic goiter as shown by color-coded Doppler sonography. PMID- 1772473 TI - Thallium-201-chloride for the detection of viable myocardium. PMID- 1772474 TI - Thiazide diuretics and polydipsia in schizophrenic patients. PMID- 1772475 TI - Electrocution injuries. A case report. AB - A case study of a high-voltage injury was presented. The short period that the patient was in contact with the electrical source prevented further systemic injury and may have saved her life. The patient's present neuritis is indicative of long-term sequelae of electrocution injury, in which ischemic necrosis of the surrounding nerves can occur near or at the site of the exit wound. PMID- 1772476 TI - Chiropractic in the United States and the changing health care environment: a view from outside the profession. AB - This paper is divided into three main parts. The first part describes chiropractic in the 1960s, 1970s and 1980s. While harassment by the medical profession largely characterized the 1960s, the health care environment of the 1970s was more favorable. However, during the 1980s, the spread of prospective payment schemes and the intensification of competition have largely hurt the development of chiropractic. All three possibilities: co-optation, subordination and nationalization are problematic as far as chiropractic is concerned. In light of these prospects, this paper makes four policy recommendations: research, education, alliance-building and politics (or REAP). The paper concludes with a brief discussion of each one. PMID- 1772477 TI - The wounded bull and the skin man: a clinical encounter. PMID- 1772478 TI - Pericardial effusion in alcoholic cirrhosis. PMID- 1772479 TI - Planned homebirths in Western Australia 1981-1987: a descriptive study. PMID- 1772480 TI - If 'A-B' does not predict heart disease, why bother with it? A comment on Ivancevich & Matteson. AB - A recent article by Ivancevich & Matteson notes many problems with research into the 'A-B' personality but recommends continued research into the construct. It is pointed out that these authors omit consideration of much of the relevant literature and that, when the omitted work is included, the 'A-B' construct must be viewed as a false trail which should now be abandoned. PMID- 1772481 TI - Can cytology proficiency testing programs discriminate between competent and incompetent practitioners? PMID- 1772482 TI - Isolation and characterization of biologically active murine interleukin-6 produced in Escherichia coli. AB - Interleukin-6 (IL-6) is a multi-functional cytokine produced and secreted by several different cell types, including those of the immune system. A cDNA coding for the mature murine IL-6 (mIL-6), which extends from amino acid (aa) 25 through 211, was cloned into a prokaryotic vector and then expressed in Escherichia coli. The recombinant mIL-6 (remIL-6) was isolated from bacterial inclusion bodies by solubilization in 4 M guanidine hydrochloride followed by gel-filtration chromatography. The protein was refolded to an active conformation by dialysis against 25 mM Na. acetate pH 5.5. A final step of purification and concentration on a cation exchange resin yielded pure and biologically active remIL-6. The purified preparation had the expected aa composition, as confirmed by aa analysis and pI of 7.0-7.1. The biological activity of the recombinant protein was measured in two systems; a proliferation assay employing 7TD1 cells, and a fibrinogen biosynthesis assay employing primary rat hepatocytes. Both assay systems demonstrated that the remIL-6 was active in the range of 10(8) units/mg, which is similar to that estimated for native cytokine. Antibodies raised in rabbits against remIL-6 neutralized the biological activity of both recombinant and native IL-6. PMID- 1772483 TI - Outpatient dacryocystorhinostomy. AB - We report 105 dacryocystorhinostomy procedures in 87 patients performed on an outpatient basis. Seventy-six patients received local, and 29 received general, anesthesia. The patients left the hospital an average of 2.6 hours after surgery, but 14 were admitted after surgery--9 immediately, and 5 after some delay, primarily for epistaxis. There were no serious complications related to the outpatient nature of the surgery. The success rate was 94%. We conclude that outpatient dacryocystorhinostomy is successful, well accepted by patients, and safe, provided that inpatient care facilities are readily available should they be needed. PMID- 1772484 TI - Depo-Medrol and myelographic arachnoiditis. AB - OBJECTIVE: This study was undertaken to see if patients who had a radiological diagnosis of arachnoiditis attributed to methylprednisolone acetate (Depo-Medrol, Upjohn Pty Limited) had the clinical syndrome of arachnoiditis. DESIGN: An attempt was made to review all patients, reported by Roche in 1984 with a radiological diagnosis of corticosteroid-induced arachnoiditis, by taking a detailed history and performing a physical examination. SETTING: The Department of Orthopaedics and Traumatic Surgery, The University of Sydney, The Royal North Shore Hospital, Sydney. RESULTS: Of the 18 patients reported by Roche 15 were located and participated in this study. The clinical syndrome of arachnoiditis was defined as a constant burning pain in the back and legs, impotence, marked limitation of spinal motion, alteration of sensation and power in the legs, and a need for regular analgesia. Three of the 15 patients had the clinical syndrome of arachnoiditis. The grade of radiological change was unrelated to the severity of symptoms. The details of doses and precise sites of administration were unavailable for the severely affected individuals. CONCLUSIONS: The absence of any other apparent cause for their symptoms implies that Depo-Medrol should not be used in or about the thecal sac. PMID- 1772485 TI - Hypernatraemic dehydration after Lucozade. AB - OBJECTIVE: To emphasise the dangers of inappropriate rehydration fluids in the treatment of gastroenteritis. CLINICAL FEATURES: A two-year-old girl was admitted to hospital in shock and unconscious. She had a 36-hour history of diarrhoeal illness and had received Lucozade. Therapy with this hypertonic fluid resulted in worsening diarrhoea and seizures. On examination she had hypernatraemic dehydration and decorticate posturing. INTERVENTION AND OUTCOME: An intravenous line was inserted, stable plasma protein solution was given, and she was admitted to the intensive care unit. Anticonvulsant and antibiotic therapy were begun. Significant neurological impairment was still evident after 14 days, at which time shw was discharged from hospital. Six months later she had made a good recovery, with no persisting neurological deficit. CONCLUSION: The inappropriate use of hypertonic fluids in gastroenteritis may be associated with significant electrolyte imbalances and neurological sequelae. PMID- 1772486 TI - The need for revaccination 10 years after primary pneumococcal vaccination in splenectomized adults. PMID- 1772487 TI - Locked seclusion for children. PMID- 1772488 TI - Comparisons of tertiary versus satellite in vitro fertilization programs. PMID- 1772489 TI - Astrocytic changes in white matter of ALS brain. PMID- 1772490 TI - Clozapine concentrations and clinical response in schizophrenic patients. PMID- 1772491 TI - Research on alcohol abuse. PMID- 1772492 TI - Deja vu phenomena. PMID- 1772493 TI - Hydrostatic dilation of arterial conduits. PMID- 1772494 TI - The future obstetrician/gynecologist. Commentary. PMID- 1772495 TI - New deal for old hearts. PMID- 1772496 TI - Computer aided teaching packages. PMID- 1772497 TI - Randomisation. PMID- 1772498 TI - Assessing protective effect of sunscreen products. PMID- 1772499 TI - General practitioners' attendance at case conferences. PMID- 1772500 TI - Intra-arterial thrombolytic therapy in the management of acute and chronic limb ischaemia. PMID- 1772501 TI - Strongyloidiasis and the acquired immune deficiency syndrome. PMID- 1772502 TI - Hemodynamic stress in hypertrophic cardiomyopathy, blood pressure changes: the age factor/the law of Laplace. PMID- 1772503 TI - Treatment of elderly-onset rheumatoid arthritis. PMID- 1772504 TI - Chiropractic in the United States and the changing health care environment: a view from outside the profession. PMID- 1772505 TI - Detection of myocardial viability [correction of validity]. PMID- 1772506 TI - Transcutaneous carbon dioxide pressure for monitoring patients with acute upper airway obstruction. PMID- 1772507 TI - Clinicians and information technology. PMID- 1772508 TI - Medical aspects of euthanasia. PMID- 1772509 TI - Obstetrics--way back when! (a sequel) PMID- 1772510 TI - Hazards of certain types of visual training. PMID- 1772511 TI - On alleged gains in power from lower P-values. PMID- 1772512 TI - Obstetric forceps after a failed ventouse application. PMID- 1772513 TI - Duodenal ulcer in Africa. PMID- 1772514 TI - Primary health care: delivery or participation. PMID- 1772515 TI - Juvenile xanthogranuloma. PMID- 1772516 TI - Substituted judgment and the decision to withhold life support. PMID- 1772517 TI - Gastro-oesophageal reflux and the lung. PMID- 1772518 TI - Noncalibration as a source of precision in cholesterol testing? PMID- 1772519 TI - Infantile acropustulosis. PMID- 1772520 TI - [Current treatment of osteoporosis]. PMID- 1772521 TI - [Anti-HBc in blood donors. Distribution by sex and age classes]. AB - Among the 21,341 blood donors who gave their blood in 1990, 638 were anti-HBc positive. There is a significant difference between men and women who are 18 to 22 years old and those who are more than 50 years old. In the first case, this difference can be referred to the heterogeneity of the male population and in the second case, to the aftermath of military campaigns. PMID- 1772522 TI - [HLA class II DP antigens and bone marrow transplantation]. AB - The biochemical structure of the HLA class II DP antigens is close to that of the remainder DR and DQ isotypes. Nevertheless, they may play a peculiar functional role. Their importance in bone marrow transplantation, where a complete HLA class II identity between graft donor and recipient is requested, is not yet known. The detection of a DP mismatch by using the mixed lymphocyte reaction is quite difficult. The role of such a mismatch in the incidence of graft versus host disease (GVHD) or graft rejection has to be defined. Studies on large series of recombinant families, using oligotyping, are necessary. PMID- 1772523 TI - [Bacteriologic monitoring of 1,000 units of human packed red blood cells for Yersinia enterocolitica]. AB - Several reports of Yersinia enterocolitica (Ye) post-transfusion septicaemia have been recently published. In order to study the prevalence of Ye contamination of packed red blood cells (PRBC) we performed a post-transfusion control on 1,000 PRBC units. We did not find any Ye contamination. This is in accordance with the rarity of the reported cases. However as they are very serious, a prevention is necessary. As classical bacteriological techniques are not feasible, the only possibility is to decrease the PRBC conservation time and to select blood donors by a careful questioning about recent GI tract disturbances. PMID- 1772524 TI - [Characterization and validation of a human anti-C monoclonal antibody]. AB - Peripheral lymphocytes were obtained from an immunized woman against C and Ce antigens. Punction was realized 14 days after childbirth. After hetero hybridization, a unique cell line continued secreting a monoclonal IgM antibody. Serological characterization of this antibody was determined by direct agglutination tests against 150 native and enzyme treated red blood cells including some rare phenotypes. This antibody was specific of C determinant of the Rh system. It showed strong reactions by saline and enzymatic technics, against C positive cells from Ce positive and Ce negative patients. The validation was performed by a manual direct agglutination test in saline (tube) and by an automated-hemagglutination test (in microplate) against 2,500 patients samples. No discrepancy was observed. This monoclonal IgM anti-C could be used as a potent reagent and since one year, about 30,000 patients and pregnant women have been phenotyped in our laboratory successfully. PMID- 1772525 TI - [Allo-immunization against 5 erythrocyte antigens after transfusion exclusively of packed platelets]. PMID- 1772526 TI - [A rare cause of early post-transfusional jaundice]. PMID- 1772527 TI - [Non-cardiogenic pulmonary edema after transfusion of plasma containing an anti HLA-B21 antibody]. AB - A patient with a von Willebrand factor deficiency received three units of fresh frozen plasma during a postoperative period. During the last unit transfusion she developed a severe respiratory distress and non cardiac pulmonary edema was diagnosed based upon the clinical, radiological and hemodynamic findings. Reintubation and mechanical ventilation with end-expiratory pressure were instituted leading to a complete and rapid recovery within 48 h. The serum from the last plasma donor contains an anti-HLA-B21 lymphocytotoxic antibody that did agglutinate neutrophils from HLA-B21 positive individuals. The patient's HLA type was B21. The concerned donor was a IVpar Igeste female. Two problems are evoked by this observation with regard to transfusion: first, fresh-frozen plasma was used as an inappropriate treatment for a coagulating factor deficiency, second, exclusion of this donor from a classical blood donation is needed. PMID- 1772528 TI - [Liver transplantation and the major histocompatibility complex]. AB - We have carried out a retrospective study over 308 liver transplant patients (31 of them have had a retransplantation) in Professor Bismuth's Department at Paul Brousse Hospital. The purpose of the study was a search for the possible effect of donor/recipient major histocompatibility complex on the evolution of the transplantation. We chose to study four parameters: early acute rejection; chronic rejection; retransplantation cases and death frequency; graft survival. We observed the following: for HLA A locus: in cases of total or partial compatibility there are more moderate early acute rejections than in the case of incompatibility (p less than 0.02); for HLA B locus: in the case of total compatibility there are more chronic rejections than in cases of partial or total incompatibility (p less than 0.03); for joint A and B locus: the results are similar to those of A locus (p less than 0.03); for HLA class I: we observed no effect either on graft survival or on retransplantation cases or on death frequency; for HLA DR: we did not find any effect on the studied parameters. Considering the low statistical significance of these results and in order to confirm our analysis, we have started a prospective study in collaboration with two other European Transplantation Centers. PMID- 1772529 TI - [Evaluation of the quality of the principal kits to identify HBs antigen used in French blood transfusion centers. "Viral hepatitis" group of the SNTS]. AB - The aim of this study is the evaluation of the main kits used for the HBs Ag screening in French blood donors. Eight ELISA or RIA kits were evaluated. The specificity was assessed by testing samples from unselected blood donors. Repeatedly reactive sera were confirmed by a neutralisation test using an anti HBs polyclonal antibody. The specificity expressed by the false positive reactions was lower than 0.1% for the ELISA and RIA kits. Sensitivity was assessed by the study of a panel of 16 HBs Ag specimens (ad and ay subtypes) with titres ranging from 0.05 to 1.80 ng/ml; all were tested in duplicate. Differences in sensitivity were observed according to the kits and procedures used. Some kits have a better sensitivity than RIA which is no longer the most sensitive technique. Such a study and a permanent control of each lot of HBs Ag commercial kit allow an improvement of reagents quality. PMID- 1772530 TI - The influence of one hyperbaric oxygen-induced seizure on brain eicosanoid content. AB - The levels of prostaglandin F1 (6-keto-PGF1 alpha), thromboxane B2 (11-dehydro TxB2), and peptidoleukotriene C4 (LTC4) were measured (acetylcholinesterase immunoassay) in the frontal cortex (FC) and the striatum (SA) of the rat brain to study the possible role of eicosanoids in seizures induced by hyperbaric oxygen (HBO). The rats were exposed to (1) hyperbaric oxygen (HBO, 6 ATA O2) up to the first seizure (2) compressed air (6 ATA air, i.e., approximately equal to 1.25 ATA O2) or (3) atmospheric pressure (1 ATA air, i.e., 0.21 ATA O2); there was no seizure in groups 2 and 3. Transition from 6 ATA to atmospheric pressure was obtained in 15 min; the rats were then decapitated and their heads frozen in liquid nitrogen before extraction and analysis of prostanoids. Whatever the conditions, cortical levels of 6-keto-PGF1 alpha and 11-dehydro-Tx B2 are higher than striatal levels; considering the same area, 11-dehydro-Tx B2 and LTC4 concentrations were not significantly different whatever the condition, but there is a trend for lower 6-keto-PGF1 alpha levels in FC after HBO seizure. Biochemical mechanisms are discussed. Eicosanoids do not seem to play a major role in HBO seizures, although some modifications of their metabolism may take place. PMID- 1772531 TI - Monoaminergic dysfunction in Sjogren-Larsson syndrome. AB - The anteroposterior distribution of monoamine and monoamine metabolite concentrations was determined in subcortical brain nuclei of two cases of Sjogren Larsson syndrome (SLS) and was compared to two control cases. The brains were divided into halves and sectioned coronally. For biochemical analyses, caudate nucleus, putamen, globus pallidus, substantia nigra, nucleus accumbens, amygdala, and hippocampus were dissected macroscopically. Monoamine and its metabolites were determined by reverse-phase liquid chromatography with electrochemical detection. The other hemisphere was studied neuropathologically. The SLS cases revealed cell loss in substantia nigra and putamen and a widespread white-matter destruction. Biochemically, most pronounced alterations were seen in the dopamine system in putamen with severely reduced concentrations of dopamine (DA; 14% of control values) and the catabolic metabolites 3-methoxytyramine (3-MT; 9% of control values) and homovanillic acid (HVA; 20% of control values). In substantia nigra and the other striatal regions studied, a general decrease of 3-MT and HVA concentrations was observed in the SLS subjects compared to the controls, although the decrease was less pronounced than in putamen. Generally, somewhat reduced noradrenaline and 3-methoxy-4-hydroxyphenylglycol (MHPG) concentrations were seen in the SLS cases, whereas serotonin and 5-hydroxyindoleacetic acid (5 HIAA) concentrations were increased compared to the controls in most regions studied. These data suggest a specific monoaminergic dysfunction in patients with SLS. The severe decline in the dopaminergic system in putamen suggests that supplementation of dopamine agonists may ameliorate the symptoms of SLS patients. PMID- 1772532 TI - Energy depletion in culture. Adenine nucleotides are altered as in vivo. AB - Modeling of ischemic phenomena in vitro has been hindered by the inability to create specific alterations in the variables of interest over a defined time frame. In particular, changes in the adenine nucleotide pool have been quite difficult to mimic because of the putative low metabolic rate in culture and the long times necessary to achieve even partial chemical energy depletion. Here we present evidence for a rapid method of producing a profound chemical energy depletion with the combination of a NADH dehydrogenase inhibitor (amytal) and a mitochondrial proton ionophore (CCCP). Treatment with our protocol in enriched spinal cultures results in a 40% decrease in ATP within 2 min and a fall to one third of control values by 15 min. The overall pool size of the total adenine nucleotides is decreased 46% by 15 min and does not completely recover after 5 min of reenergization. The ATP/ADP ratio declines to one-third of control values during deenergization and returns to control values after 5 min in control buffer. Such a loss of the total adenylate pool closely mimics that seen in vivo during ischemia and provides an in vitro model system in which the effects of the combination of this means of cellular injury with others (e.g., excitotoxins) may be examined. PMID- 1772533 TI - Simultaneous delivery of valproic acid and glycine to the brain. Deamination of 2 propylpentylglycinamide by monoamine oxidase B. AB - 2-Propylpentylglycinamide (2-PPG), a branched aliphatic amine derivative, was found to be readily deaminated by rat liver monoamine oxidase B in vitro and in vivo. The deamination leads to production of 2-propyl-1-pentaldehyde, which can be subsequently converted to valproic acid (VPA), and glycinamide, which is then subsequently converted to glycine. Absorption and biotransformation of a single ip dose of 2-PPG into blood as well as transfer of the drug and its metabolite into the brain were rapid processes. Although VPA (an anticonvulsant) and glycine (an inhibitory neurotransmitter) can be detected in the brain following administration of 2-PPG, its anticonvulsant action cannot be determined. 2-PPG at relatively low doses exhibited distinct tremor effects. Furthermore, 2-PPG appeared to potentiate the convulsant effect induced by pentylenetetrazol. PMID- 1772535 TI - Spinal fractures associated with ejection from jet aircraft: two case reports and a review. AB - Virtually any A&E department in the UK may see aircrew who have ejected. The case histories of two pilots who ejected and sustained spinal fractures are presented. Both had minimal back symptoms and walked from the site of landing. All ejectees should be considered to have a spinal fracture until proven otherwise radiographically. Other injuries that these patients may sustain during ejection are also discussed. PMID- 1772534 TI - Fat embolism--a review. AB - The subject of fat embolism is of recurring interest to those managing trauma. This article covers the topic of fat embolism in general, and presents a case of fulminant fat embolism syndrome which highlights the importance of clinical expertise, and whatever technological aids are available to diagnose and appropriately treat this relatively rare, but highly significant form of the syndrome. Fulminant fat embolism syndrome has a very high mortality and should be watched for in patients who have experienced major trauma. PMID- 1772536 TI - Injuries sustained by falls. AB - During a recent 4-year period, 381 patients were admitted with injuries sustained from falls. Equal numbers of patients were less than and greater than 50 years of age and included 53 children (less than or equal to 16 years) and 214 elderly (greater than or equal to 55 years). Falls from heights occurred predominantly in young males (mean age 34.2 years), were most commonly job or recreation related and resulted in higher injury severity scores (ISS). Falls in the elderly occurred more commonly in women, typically on a flat surface, and were less severe. Despite lower mean ISS, fall victims over 55 years of age had longer hospitalizations (11.4 vs. 4.5 days) and incurred higher hospital charges compared to younger patients. There were 35 deaths (9.2%). In patients under 55 years, deaths resulted from fall-related central nervous system (CNS) injury and/or multisystem trauma. In patients over 55 years, fatalities were most commonly related to pre-existent medical conditions. Based on a review of this experience, we conclude that: (1) unlike other causes of blunt and penetrating trauma, both sexes are equally at risk from fall-related injuries but sex incidence is age related; (2) falls from heights are more common in men; (3) advanced age and pre-existing medical conditions account for the increased morbidity and mortality following falls and; (4) cost containment measures for fall-related trauma must consider not only injury severity, but the age and pre existent medical conditions of the patient. PMID- 1772537 TI - Inability to fully extend the injured elbow: an indicator of significant injury. AB - Elbow injuries are commonly seen in accident departments. Patients with possible bony injuries to the elbow were assessed to see if inability to fully extend the elbow was a good indicator of bony injury and hence the need for X-ray. The sensitivity of this test was 90.7% (95% confidence limits 80.7-100.7) and the specificity 69.5% (95% confidence limits 60.3-78.7). Use of this simple test would reduce both radiography costs and unnecessary exposure to radiation. PMID- 1772538 TI - Injuries due to falls as a result of uneven pavements. AB - At least one person per day attending the A&E department at King's College Hospital has sustained injuries from uneven pavements. The injuries have a significant morbidity as well as mortality of 1%. A&E records can be a source of useful information to aid local authorities in identifying areas associated with these injuries in order to reduce their frequency and subsequent claims for compensation. PMID- 1772539 TI - X-ray reporting in accident and emergency departments--an area for improvements in efficiency. AB - All Accident and Emergency departments in England seeing more than 20,000 new patients each year were surveyed for the extent and mechanism of their radiological reporting service. A total of 190 of the 210 departments replied, 39% of these departments were not satisfied with the service available to them. A 'hot' reporting service was available in 2.6% of departments and 49% did not have films reported in under 48 h. The methods used to detect radiological abnormalities missed by the A&E doctor were investigated further. A total of 60% of departments had a traditional reporting system but 29% had introduced systems that required the A&E doctor to include his or her radiological diagnosis with the films prior to their being returned to the X-ray department for reporting. This allowed rapid audit of radiological assessment. Its introduction to all A&E departments is recommended. PMID- 1772540 TI - Pleuritic chest pain in a postpartum woman. PMID- 1772541 TI - Eye irrigating lenses. PMID- 1772542 TI - Are cyclists protecting their heads? PMID- 1772543 TI - A fellowship a year abroad: the 'pros' and 'cons'. PMID- 1772544 TI - The case against trauma centres. PMID- 1772545 TI - Attitudes towards assault patients. PMID- 1772546 TI - A simple to use audit for accident and emergency departments. PMID- 1772547 TI - Serious eye injuries caused by darts. PMID- 1772548 TI - Ketamine in severe acute asthma. PMID- 1772549 TI - Migration of a Kirschner Wire from the clavicle into the abdominal aorta. PMID- 1772550 TI - Characteristics of belted and unbelted drivers. AB - Drivers who had been observed wearing or not wearing shoulder belts were compared using vehicle registration data, driver records, and telephone interviews. The observations were made on the New York Thruway during a special seat belt publicity and enforcement program, which achieved a 75% overall belt use. The results showed that those drivers who still did not wear a shoulder belt despite New York law and the special Thruway program were more likely to be male, to be driving older vehicles, to have more prior traffic convictions, to have more prior injury crash involvements, and to say they are more likely to take risks than others. Although drivers reported that assessing points against the drivers license for belt law violations could increase belt use, citations for belt use law violations were very rare, and enforcement would probably have to increase before any new penalty could be effective. PMID- 1772551 TI - Sentence severity and the drinking driver: relationships with traffic safety outcome. AB - While a major response to the drinking-driving problem has been to increase penalties for drinking-driving offences, the impact of sentence severity on the driving behaviour of offenders (specific deterrence) remains unclear. In this research, relationships between aspects of sentence severity (license suspension, fine, jail term, assignment to probation, or temporary absence programmes) and postconviction accidents and drinking-driving convictions were examined, while controlling statistically for demographic and previous driving record factors. License suspensions were consistently associated with traffic safety benefits. However, increasing severity of other aspects of punishment seemed unrelated to outcome or was associated with increased traffic safety problems. As well, important differences between first, second, and multiple offenders were observed, which may be related to the impact of different aspects of sentence severity on driving behaviour. PMID- 1772552 TI - Comparing one's driving with others': assessment of abilities and frequency of offences. Evidence for a superior conformity of self-bias? AB - Research into self-evaluation of driving abilities has shown that drivers in North America and Europe consider that their driving abilities to be superior to those of the average driver. This survey (N = 454), carried out using a questionnaire, has confirmed this phenomenon in France where about 60% of the subjects rated themselves superior to other drivers in general. If this result is interpreted as a bias towards superior conformity of self, the study appears to show a bias with regard to conformity to driving regulations (assessed in terms of the frequency of driving offences committed). This interpretation would thus confirm the hypothesis that all subjects, whether they consider themselves superior or not to other drivers in general, believe they commit fewer offences than other drivers in general. The consequences of such a bias for the effectiveness of road safety campaigns and for drivers' risk-taking are discussed. PMID- 1772553 TI - Epidemiology of traffic accidents in a Swedish municipality. AB - Total population injury surveillance was done in an area with a population of over 41,000. All traffic accidents (N = 632) occurring within a 12-month period and requiring medical care were noted, giving a ratio of 15.3 per 1,000. They involved cyclists (38.3%), pillion passengers on cycles (1.9%), pedestrians (29.3%), motorcar drivers (7.8%), motorcar passengers (3.6%), passengers entering or leaving a vehicle (7.3%), mopedists (6.8%), motorcyclists (3.5%), and "others" (1.6%). Children and teenagers predominated in the cycle group; 55% of the males were aged 0-15 years compared with 41% of the females. Women were involved in 65% of the pedestrian accidents; 69% were aged 50 years or more. Of the accidents involving women aged over 50 years, 61% occurred in icy or snowy conditions. The police statistics were incomplete and accounted for only 23% of the total number of people reported injured by the health authorities. In some respects, the accident pattern in the present study differed from that in other comparable studies. The difference is especially great concerning the incidence of traffic accidents, the proportion of young persons involved in cycle accidents, and the number of accidents caused by motorcar drivers who developed sudden illness whilst driving. PMID- 1772554 TI - Usage patterns and misuse rates of automatic seat belts by system type. AB - This study examined seat belt usage in North Carolina by drivers of 4,151 late model cars equipped with a variety of restraint system types. We measured usage by restraint type (automatic belt, air bag, manual belt), by make/model and by driver characteristics (age, sex, and race). Usage ranged from a high of 94.2% for motorized shoulder belts (but with only 28.6% lap belt usage in these cars) to 73.9% usage of manual lap/shoulder belts in cars equipped with air bags. Various types of misuse of the shoulder belt (e.g. excessive slack, detachment from the door, placement under the arm) were observed in nearly 6% of the sample. PMID- 1772555 TI - Airbag effectiveness in preventing fatalities predicted according to type of crash, driver age, and blood alcohol concentration. AB - The effectiveness of airbags was estimated in a recent paper by assuming that they do not affect ejection probability and protect only in frontal and near frontal crashes; the impact-reducing effectiveness in such crashes was assumed equal to that of lap/shoulder belts. The effectiveness, estimated as 18%, thus depends on the distribution of crashes by direction of impact and the incidence of ejection. Ejection rates and impact directions are markedly different for single-car as compared to two-car crashes and as a function of driver age and alcohol use. This raises the possibility that the overall effectiveness estimates might reflect an average of higher effectiveness for drivers more likely to be responsible for crashes (youths, drunks, those involved in single-car crashes) and a lower effectiveness for those less likely to be responsible (non-youths, the sober, and those involved in two-car crashes). By using FARS data for 1975 1986 to distribute fatal crashes by impact direction under various conditions, airbag effectiveness was calculated under these same conditions. Although substantial dependencies on impact direction were found, the fraction of all fatalities that were frontals remained surprisingly constant. It is concluded that effectiveness does not depend much on driver age or alcohol consumption, but is greater for two-car crashes than for single-car crashes (21% compared to 16%). PMID- 1772556 TI - The effects of combining sanctions and rehabilitation for driving under the influence: an evaluation of the New Jersey Alcohol Countermeasures Program. AB - In contrast to many other state Driving under the Influence (DUI) programs developed in the United States in the 1970s as alternatives to traditional sanctions, the New Jersey Alcohol Countermeasures Program combined sanctions with mandatory education/rehabilitation for offenders. Three components were evaluated: DUI education, "treatment," and Alcoholics Anonymous. For 2,734 first and repeat offenders participating in this program between 1979 and 1982, the program was effective in reducing DUI recidivism for program completers (66% while licensed and 51% while suspended) compared with noncompleters, but it was less effective in reducing subsequent moving violations while licensed (20% compared with noncompleters) and accidents while licensed (18% compared with noncompleters). Completers had higher rates of violations and accidents while suspended (9% compared with noncompleters). A small group of repeat offenders, missassigned to DUI education, had higher post conviction rates of negative driving events than those of comparable offenders assigned to "treatment" or Alcoholics Anonymous, indicating that for these offenders the latter interventions were more effective. PMID- 1772557 TI - Characteristics of motor vehicle accidents resulting in spinal cord injury. AB - The majority of cases of spinal cord injury (SCI) occur during car crashes. Yet, relatively little is known about the precise accident factors involved. The present study investigated 30 cases of SCI in automobile drivers that occurred in a series of 91 spinal cord injuries. A matched control group was also studied. SCI drivers were not different from controls in terms of mortality, number of rollover crashes, alcohol use, citations for contributing human factors, nighttime accidents, or unfavorable weather and road conditions. However, SCI drivers less frequently used restraints. Results are discussed in terms of preventive measures, specifically, those concerning restraint use, alcohol use, and driving behavior. PMID- 1772558 TI - Unenlightened: an unsuccessful attempt to promote the use of cycle lights at night. AB - The risks of bicycle riding are greatly increased at night, especially if the cyclist does not have lights. Over 13 winter weeks a community behavioural intervention promoting cycle light use was implemented in the city of Christchurch, New Zealand, at two tertiary educational institutions. A third location served as a control. Baseline data from inspection of parked cycles and street observation of cycle riders showed that about 60% of cycles were not fitted with lights and between 40% and 60% of cyclists rode without legal lights, with the percentages varying as functions of sunset time, weather, and time of night. At neither experimental location did prompting, an incentive competition, nor performance feedback increase the number of parked cycles with lights or increase the number of cyclists observed riding with lights. PMID- 1772559 TI - Drinking locations of drink-drivers: a comparative analysis of accident and nonaccident cases. AB - This study utilizes data collected by the Perth (Australia) Traffic Police on the last drinking location of persons arrested for drink-driving either as a consequence of their being involved in a road traffic accident or as a result of failing a roadside breath test. A comparison of these data has found that significantly more persons involved in traffic accidents had been drinking at unlicensed locations, that is at private residences or in public places such as parks, than at licensed premises. It was also found that accident cases were more likely to involve males under 25 years; for those involved to have, on average, significantly higher blood alcohol levels than was the case for nonaccident drink driving cases; and for most accidents to occur late at night and early morning. The significance of these findings were confirmed by logistic regression. A surprise incidental finding was that considerably more women had been arrested for drink-driving than had been previously reported in other studies, both in Australia and overseas. PMID- 1772560 TI - Nonfatal farm injuries in eastern Ontario: a retrospective survey. AB - A one-year retrospective survey was conducted to study the incidence of, and potential risk factors for farm-related injuries. One hundred thirteen dairy and beef farms in Eastern Ontario were surveyed using a personal interview. Information was collected on demographic characteristics of the farm owner, workers, and family; characteristics of the farm operation; and information on behaviours potentially affecting injury risk. The crude rate of injury was 9.6 per 100 person years. Significantly higher rates of injury were found for: owner operators of farms (RR = 2.9; p less than 0.001); male sex (RR = 3.8; p less than 0.001); living/working on a beef as opposed to dairy farm (RR = 2.3; p = 0.01); farm owners in the age groups of less than 30 and greater than 70 years (p = 0.05), full-time as opposed to part-time beef farm owners (RR = 4.2; p = 0.02); and full-time owners of beef as opposed to dairy farms (RR 2.4; p = 0.03). Common patterns of injury included accidental falls (E880-8); lacerations, bruises, and crush injuries from working with cattle (E906) or from agricultural machinery (E919.0); and foreign body injuries to the eye (E914). Few injuries were associated with the use of tractors or power take-offs. 82% of injuries, for which medical treatment was sought, were treated in a hospital-based emergency department. This information would support efforts to establish an emergency department-based surveillance system for farming injuries in our setting. PMID- 1772561 TI - Prediction in road safety studies: an empirical inquiry. AB - Studies about the road safety effect of interventions are usually retrospective quasi-experiments. In these, one key task is to predict what would have been the safety of the treated group without the intervention. Such predictions can be made by several methods, one of which is to use a "comparison group." We use 26 yearly counts of reported injury accidents for the Canadian provinces to examine which of several simple methods of prediction would have historically predicted best. We find that the use of more data does not always improve prediction. How well one predicts depends not only on the amount of data used but also on the extent to which the prediction method is in accord with the unknown time trend behind the accident counts. We also find that the use of a comparison group to predict is not always better than predicting that this year's count will be the same as last year's. In addition, the intuitive notion that a good comparison group is that which is thought similar to the treated group is too simple. Both similarity and size (as measured by the number of accidents) are important. Moreover, whatever preconceived notions of similarity we had, were contradicted by the data. If the history of accident counts on the treatment group and on several possible comparison groups is available, a simple method to select the most suitable comparison group is suggested. PMID- 1772562 TI - Comparison groups in road safety studies: an analysis. AB - When the safety effect of some treatment is to be estimated, one has to answer the question: "what would have been the ratio of the expected number of accidents 'before' and 'after' had the treated group been left without treatment?" In retrospective observational studies, the count of accidents on a "comparison group" is often used to provide an answer. In consequence, the estimate of the safety effect depends on which of several comparison groups is chosen. It is therefore important to have guidance for this choice. The empirical inquiry in the companion paper led to several conclusions. The explanation of what has been noted by the examination of data requires analysis and is taken up in this paper. PMID- 1772563 TI - Preparation and pharmacological activity of some 1-lupinylbenzimidazoles and 1 lupinylbenzotriazoles. AB - Twelve new 1-lupinyl-benzimidazole and 1-lupinyl-benzotriazole derivatives were prepared and, together with some previously described analogues, were tested for analgesic (hot plate test), antiinflammatory (against carrageenan edema), diuretic and antihypertensive (in spontaneously hypertensive rats) activities. Several compounds exhibited a good degree of activity in one or in more than one areas. PMID- 1772564 TI - 5-substituted 4-isoxazolecarboxamides with platelet antiaggregating and other activities. AB - The synthesis of a series of 5-substituted 4-isoxazolecarboxamides by reaction of eight 5-substituted 4-isoxazolecarbonyl chlorides with pyrrolidine, piperidine, morpholine and 4-trifluoromethylaniline is described. Some of these amides showed platelet antiaggregating activity in vitro slightly inferior to that of acetylsalicylic acid, as well weak antiinflammatory, analgesic and antipyretic activities in rats and mice. PMID- 1772565 TI - HPLC analysis of oleuropein and some flavonoids in leaf and bud of Olea europaea L. AB - Reversed phase high-performance liquid chromatography was applied for qualitative and quantitative analysis of secoiridoid oleuropein and some flavonoids in leaf and bud extracts of Olea europaea L. The RP-HPLC procedure is rapid and reproducible. The results of quantitative analysis, correlated with pharmacological activity, are reported here. PMID- 1772566 TI - Preparation and antiproliferative activity of 1H-pyrrolo [2,3-f]quinolinium and isoquinolinium iodides. AB - 2-Carbomethoxy-N-methyl-1H-pyrrolo[2,3-f]quinolinium and isoquinolinium iodides were prepared. Their in vitro ability to form complexes with DNA is enhanced in respect to parent compounds. This, however, does not appear to be agreement with their ability to inhibit cellular DNA sunthesis. PMID- 1772567 TI - Alpha-oligonucleotides: a unique class of modified chimeric nucleic acids. AB - alpha-Anomeric oligonucleotides are resistant to nucleases and display parallel hybridization with complementary DNA and RNA sequences. Although alpha-DNA/beta RNA duplexes are not substrates for RNases H, alpha-oligos are able to inhibit translation through a RNase H independent mechanism. alpha-Oligos and their alpha phosphorothioate analogs (12 mer) targeted against the splice acceptor site of the HIV-TAT gene were potent inhibitors of de novo HIV infection. Furthermore alpha-phosphorothioate and dithioate homo-oligomers exhibit an in vitro, nonsequence-specific, inhibitory effect on HIV reverse transcriptase. PMID- 1772568 TI - In vivo studies with phosphorothioate oligonucleotides: pharmacokinetics prologue. AB - Phosphorothioate oligonucleotides which contain 35S at each internucleoside linkage have been prepared and employed to evaluate the in vivo pharmacokinetics in mice, rats and rabbits. A single administration of a 27-mer complementary to the rev gene of HIV into adult male rats by either the intravenous or intraperitoneal route reveals a biphasic plasma elimination. An initial half-life of 15-25 min represents distribution out of the plasma compartment and a second half-life of 20-40 h represents elimination from the body. The second half-life is significantly longer than a variety of nucleic acids such as poly-IC and Ampligen and suggests therapy with phosphorothioate oligonucleotides should be possible and practical. Repeated daily injections of the 27-mer provides steady state concentrations in 6-9 days, confirming the estimated long half-life from single injection studies. Finally, chronic treatment studies indicate that the phosphorothioate oligonucleotides are relatively non-toxic. Hence, pharmacokinetic considerations are not likely to be limiting factors in anti cancer drug design with phosphorothioate oligonucleotides. PMID- 1772569 TI - Phosphorothioate oligonucleotides: chemistry, purification, analysis, scale-up and future directions. AB - There is widespread and growing interest in the use of phosphorothioate-modified oligonucleotides as sequence-specific agents to control transcription, splicing, translation and other regulated processes in vitro and in vivo, as pharmaceuticals. These exciting applications are predicated on the resistance of phosphorothioate oligonucleotides to degradation by nucleases, a property that results simply from incorporation of sulfur into the phosphate backbone. The popularity of phosphorothioate oligonucleotide analogs derives from several of their features: relatively easy automated synthesis, uncomplicated purification and handling, plus high solubility in water. Presented here are current preparative and analytical methods, together with a comprehensive comparative analysis of solid-phase and solution processes for manufacturing phosphorothioate oligonucleotides as bulk pharmaceutical compounds for clinical evaluation. A prospective view of the future is offered with the hope of directing attention to important areas of needed research dealing with phosphorothioate oligonucleotide technology in particular, and manufacturing of nucleic acid pharmaceuticals in general. PMID- 1772570 TI - The anti-gene strategy: control of gene expression by triplex-forming oligonucleotides. AB - Oligonucleotides are being developed to selectively inhibit gene expression at the translational level (antisense oligonucleotides) and at the transcriptional level (anti-gene oligonucleotides). This review deals with the anti-gene strategy whereby an oligonucleotide binds to the major groove of double helical DNA where it forms a local triple helix. The molecular mechanisms for DNA recognition by triple helix formation are discussed together with some of the rules presently available to design the sequence and orientation of the triple helix forming oligonucleotide. Triplex stability can be enhanced by covalent attachment of an intercalating agent to the terminal nucleotide of the oligonucleotide. The intercalating agent can be used to induce irreversible reactions in the target sequence: double strand cleavage by a phenanthroline-Cu chelate in the presence of a reducing agent, photo-induced cleavage by ellipticine derivatives, photo induced cross-linking of the two DNA strands by psoralen... Triple helix-forming oligonucleotides can be used to control gene expression at the transcriptional level. Inhibition of binding of transcription activating factors by triplex formation modulates the level of transcription of the target gene. Binding of a triplex-forming oligonucleotide immediately downstream of the RNA polymerase binding site can inhibit transcription initiation as shown with the E. coli beta lactamase gene. Studies with cells in culture show that triple helix formation may occur in the intracellular environment and consequently leads to transcription inhibition. This inhibitory effect can be made irreversible by using, e.g., psoralen-substituted oligonucleotides. Oligonucleotides synthesized with the alpha-anomers of nucleotide units are resistant to nucleases and still form triple helices with double-stranded DNA. Oligo-[alpha]-deoxynucleotides can be derived by stabilizing (intercalating) agents or reactive groups (cleaving reagents, cross-linkers ...). The results presently available provide a rational basis for the development of new tools for cellular biology and of new therapeutical approaches to selectively control gene expression at the transcriptional level. PMID- 1772571 TI - Medicinal chemistry of antisense oligonucleotides--future opportunities. AB - The emerging future of antisense oligonucleotides depends on rational modifications of its nucleotide repeating units. Currently the most prevalent design features that are crucial for continued antisense development are nuclease resistance, cellular uptake, hybridization properties, and disruption of RNA functions through terminating events. Very few structure-activity relationship (SAR) studies have been directed to these problems and these have typically used binding affinities and nuclease sensitivities as activity end points rather than in vitro or in vivo biological activities. Further SAR studies may be approached by sequence selection SARs which hold a certain uniform modification type constant (e.g. phosphorothioates) while varying the sequence of the oligonucleotide. The more traditional approach is to modify the oligonucleotide while keeping the sequence constant. This review is concerned with the latter approach and summarizes modifications of the phosphorus atom, pentofuranosyl (sugar) linker, pentofuranosyl ring and its 2'-substituents, and the heterocycles. The review covers the 1989-91 literature of various modified oligonucleotides designed and synthesized to enhance pharmacokinetic and pharmacodynamic properties of antisense oligonucleotides. PMID- 1772572 TI - In vitro toxicology and pharmacokinetics of antisense oligonucleotides. AB - The ability to rationally design antisense drugs and the theoretical selectivity of these compounds for specific genomic and viral mRNA targets make their use as therapeutic agents extremely attractive. Pharmacologic data emerging from our and other laboratories indicate that some unmodified and backbone modified oligonucleotides may be cytotoxic. In general, cytotoxicity was usually seen at concentrations higher than those required for specific antisense effects. Factors that may modulate the toxicity of phosphorothioates include cell type, various media components including serum, length and method of preparation. Pharmacokinetic experiments using phosphodiester, phosphorothioate and methylphosphonate oligonucleotides suggest that these compounds may be taken up and distributed within some cells. Uptake was generally time, temperature, concentration dependent, and required cellular energy. The mechanism of uptake varied according to oligonucleotide type. The in vitro data as well as preliminary in vivo studies demonstrating the safety, antiviral activity and bioavailability of a number of oligonucleotides suggest that these compounds represent a novel therapeutic modality. PMID- 1772573 TI - Asthma trough to Parietaria in pediatrics. AB - We selected 183 patients with asthma, rhinitis and/or conjunctivitis. They responded positively to Parietaria Judaica skin prick-tests. In the first test 91 were positive. Of those 11 were monosensitive and 80 polysensitive. In the follow up tests 92 were positive, of which 5 were monosensitive and 87 polysensitive. There were 54 cases of rhinitis, of which 23 developed asthma. Of 129 asthma cases, 90 developed asthma with rhinitis. The main seasons are Spring and Autumn and activity declines during winter. 18.57% are perennial. IgE was greater in the re-examination of the polysensitive cases. The monosensative cases confirmed the clinical symptoms most characteristic of rhinitis syndrome, 16.893% and asthma with rhinitis, 49.18%. PMID- 1772574 TI - Food allergy and the respiratory tract. AB - The role of food allergy in the respiratory tract is often underestimated. A wide variety of food-induced respiratory symptoms has been described. In some patients, a food additive rather than a food protein is the offending agent. This presentation focuses on food-induced asthma and milk-induced chronic pulmonary disease in infants. PMID- 1772575 TI - Prevention of atopic disease in at risk newborns. AB - At least 15% of children have at least one atopic disease and genetic factors play an important role in the development. Screening of family history and high serum cord IgE permits introduction of dietary and environmental measures to prevent atopy. Environmental, prenatal, perinatal factors, exposure to household allergens, infections, cigarette smoking, dietary factors, including those during pregnancy, duration of breast feeding, dietary measures during lactation, all have effects in modifying the atopic response. PMID- 1772576 TI - In memoriam Richard Heikkila. The MPTP story: irony creeps back in. AB - Progress in Parkinson's disease research has been rapid in recent years from both a scientific and clinical point of view. The MPTP discovery represented a milestone in the knowledge of the biochemical mechanism underlying degeneration of dopaminergic neurons of the nigrostriatal pathway. Recent life and scientific events have initiated, even ironically, new trends in the mechanism of MPTP toxicity. The role of excitatory amino acids, particularly of NMDA receptors, in this toxicant-induced degenerative process, seems to be crucial. If this new finding is further confirmed by studies on primates, the animal species most sensitive to the neurotoxin, research into Parkinson's disease might move in other directions, useful in both treatment and prevention. PMID- 1772577 TI - Metals and trace elements in plasma and cerebrospinal fluid in normal aging and Alzheimer's disease. AB - Cerebro-spinal fluid (CSF) and blood levels of aluminium, cadmium, calcium, copper, lead, magnesium, and mercury were studied in 24 subjects with dementia of the Alzheimer type (DAT) and in 28 healthy volunteers. Furthermore, arsenic, bromine, chrome, iron, manganese, nickel, rubidium, selenium, strontium, and zinc were measured only in blood. There were significant changes in the DAT group when compared to the controls. The plasma levels of aluminium, cadmium, mercury and selenium were increased and the contents of iron and manganese were lower in the DAT group as compared to control subjects. In CSF there were low levels of cadmium and calcium and increased content of copper in DAT cases. Iron and zinc levels in blood and calcium in both blood and CSF of DAT patients correlated with memory and cognitive functions. Iron, manganese and strontium levels of DAT sufferers in blood and aluminium in CSF were related with changes in behaviour. PMID- 1772578 TI - Failure of the gamma-aminobutyric acid (GABA) derivative, baclofen, to stimulate growth hormone secretion in Parkinson's disease. AB - In order to evaluate whether the stimulating effect of GABA on growth hormone (GH) secretion changes in patients affected by Parkinson's disease, ten male parkinsonian patients and ten age matched normal controls were tested with the GABA derivative and GABAergic agent Baclofen (10 mg in a single oral administration at 09.00 h) (experimental test). In a different occasion, normal men and parkinsonian patients were tested with a placebo (control test). Basal GH levels were similar in normal controls and parkinsonian patients and remained unmodified during the control test. Plasma GH levels rose three times within 120 min after the administration of baclofen in the normal subjects. In contrast, plasma GH concentrations remained unmodified after baclofen treatment in the parkinsonian patients. In agreement with previous reports in the literature showing alterations of GABAergic neurotransmission in the parkinsonian brain, these data show a reduced GABAergic control of GH secretion in patients with Parkinson's disease. PMID- 1772579 TI - A study of brain dopamine sulfate levels in relation to free dopamine and homovanillic acid in Parkinson's disease. AB - High performance liquid chromatography with electrochemical detection was used for determining dopamine sulfate in human brain tissues. Dopamine sulfate was examined in the striatum and frontal cortex of human brain. The concentrations of dopamine sulfate in these regions are extremely low in comparison to free dopamine, and to dopamine sulfoconjugates in the cerebrospinal fluid, plasma and urine. Data obtained with this technique in human post mortem brain specimens indicate that the analysis of tissues and body fluids for dopamine conjugates is useful for profiling metabolic dopamine activity in controls and neurodegenerative disorders like Parkinson's disease. PMID- 1772580 TI - Can we differentiate symptomatic and neuroprotective effects in parkinsonism? The dopamine agonist lisuride delays the need for levodopa therapy to a similar extent as reported for deprenyl. AB - Delaying levodopa therapy by a drug currently is being perceived by patients and doctors as an indication for a beneficial effect on the progression of Parkinson's disease. We discuss this view critically and present results from a retrospective analysis of data of 185 consecutive patients treated with lisuride monotherapy which show a significant degree in postponing levodopa therapy. These clinical observations have indicated that the initiation of levodopa administration could be postponed in some 60% of patients for 1 year or more, whilst after several years most patients required levodopa as an addition or alternative treatment. Some patients (approximately 10%, 5 out of 66 at one center at Turku, and 12 out of 119 in an Italian multicenter study) did well on lisuride alone for greater than or equal to 5 years. Thus, the results for long term lisuride monotherapy in the controlled prospective study by U.K. Rinne could be confirmed by the data from the various Italian centers with similar long-term experiences, with even more favourable results. Comparable results as obtained with deprenyl in the DATATOP study could be found with lisuride monotherapy patients. This demonstrates that symptomatic therapy with the dopamine agonists lisuride is able to postpone levodopa therapy to a similar extent as has been reported in the case of deprenyl. In the latter case, a favourable effect on the progression of the disease had been postulated. We compare published data on both drugs and conclude that the delay in levodopa therapy observed with both drugs is compatible with the assumption of a symptomatic or general activating effect, and that other criteria need to be used for studying the progression of a neurodegenerative disease. PMID- 1772582 TI - Judging the clinical relevancy of nursing research. PMID- 1772581 TI - Holding death at bay: the experience of the spouses of patients undergoing cardiovascular surgery. AB - This study utilized a grounded theory design to investigate the experiences related to being the spouse of a cardiovascular surgical patient during five subject-identified phases: a) finding out the surgery was necessary, b) waiting for surgery, c) waiting during surgery, d) the intensive care unit (ICU) experience, and e) the recovery period before hospital discharge. Data were collected from each of eight subjects via three unstructured, tape-recorded interviews conducted a) on the day of the patients' hospital admission, b) during the first 48 hours of the patients' ICU stay and c) just before the patients' hospital discharge. Holding Death at Bay was identified as the core category. Three main categories: uncertainty, helping commitment and reorganization emerged from the data and were apparent in each of the five subject-identified phases of the spouses' experience. Main categories and subcategories of the core category emerging from the data are described. Implications of this research for nursing practice and further nursing research are discussed. PMID- 1772583 TI - Lifestyle profiles of hypertensives. AB - Healthy lifestyles and quality of life are key elements in the health of individuals and the community as a whole. This study examines the relationship of specific lifestyle behaviours to blood pressure in subjects being treated for hypertension. Data were collected over a two-year period and analysis was completed in June, 1989. Discriminant analysis identified that, of the lifestyles selected, predictors of uncontrolled hypertension were a high calcium intake, a high perceived level of stress, and a 'normal' body mass index. Profiles of lifestyle behaviours identified by discriminant analysis found to be important to various age and sex groupings of the subjects are illustrated. PMID- 1772584 TI - Weight change in cardiac transplant patients. AB - The perception exists that excessive weight gain commonly occurs after cardiac transplantation. To examine this perception, 91 transplant patients from one to eight years post-transplant responded to a questionnaire eliciting data on premorbid and post-transplant weights, exercise frequency, and fat intake. Only 37% of subjects weighed more post-transplant than premorbidly. More than half of the subjects were over their ideal weights premorbidly and post-transplant. On t test there was no significant difference (p less than .05) between weight gainers and weight losers in exercise frequency (t = .63; p = .53), or fat intake (t = .80; p = .43). Findings of the study dispute the perception of excessive weight gain post-transplantation. This perception may be due to the comparison of cachectic pre-transplant weight with well weight post-transplant. Since more than half of the subjects were over their ideal weight post-transplantation, teaching regarding weight control remains important. Future research on effective methods of weight control is needed. PMID- 1772585 TI - Amebiasis: clinical and laboratory perspectives. AB - Entamoeba histolytica, the premier intestinal protozoan, has traversed time in its relentless quest for survival in its dichotomous role of parasite and pathogen. Enigmatic in its transition from human intestinal commensal to invader of human tissue, diverse in its pathogenicity for the human host, and intricate in its bacterial interrelationship in the bowel, E. histolytica has become the focal point of intensive investigation in its basic biology underscoring human pathogenicity. This review will focus on facets of cell biology, pathophysiology, clinical, therapeutic, and epidemiologic, correlates, along with diagnostic modalities and future research trends. PMID- 1772586 TI - Leukocyte-poor blood components: issues and indications. AB - Leukocyte-poor blood components (LPBC) have now become part of the armamentarium of available transfusable blood components. Indications for the use of LPBC vary in accordance with the underlying clinical condition, as well as the intended objectives of the transfusion therapy. Technological advances have made it possible to prepare LPBC using rather simple procedures. However, any manipulation of blood components and the additional use of filters, washing, rinsing solutions, etc. inevitably result in additional costs to the patient, the health-care institution, or third-party payers. Requests for LPBC involve the preparation of RBC or platelets, leuko-depleted by at least one log. Transfusion of LPBC must be done in a logical fashion that meets the needs of the patient. Currently, LPBC is indicated for patients with a history of nonhemolytic febrile transfusion reactions to delay alloimmunization to HLA antigens and avoidance of cytomegalovirus (CMV) infection. PMID- 1772587 TI - Chemosensitivity testing: a critical review. PMID- 1772588 TI - The measurement of bilirubin fractions in serum. AB - Bilirubin fractions are measured by (1) the direct diazo reaction, (2) high performance liquid chromatography (HPLC), (3) direct spectrophotometry, and (4) enzymatic methods. HPLC, which effects separation and quantitation of the four bilirubin fractions, is the method of choice, but impractical for routine use. A special application of direct spectrophotometry allows the measurement of unconjugated bilirubin and the sum of bilirubin conjugates. This approach, which provides essentially the same information as HPLC, unfortunately is available only in one clinical analyzer. The direct diazo reaction measures bilirubin conjugates plus delta-bilirubin, albeit not very accurately. Direct diazo methods that measure unconjugated bilirubin as direct could obscure the clinical diagnosis. At acid pH, enzymatic methods measure all direct reacting bilirubins, while at pH 10 only conjugated bilirubins are measured. Because the measurement of conjugated bilirubins is clearly more helpful than that of direct bilirubin in the differential diagnosis of jaundice, direct diazo methods should be replaced by methods specific for bilirubin conjugates. PMID- 1772589 TI - Transmission of parasitic and bacterial infections through blood transfusion within the U.S. AB - The American public has become aware that viral infections can be transmitted by blood transfusions; however, less attention has been paid to nonviral agents that are similarly transmitted. Although donors are tested routinely for serologic evidence of Treponema pallidum infection (syphilis), there are no other bacterial infections for which donors are routinely tested, and no testing is done routinely to detect parasitic infections. Although current preventive strategies appear effective in preventing the transmission of nonviral agents by transfusion, changing population demographics, increased travel and immigration, and increased occurrence of certain asymptomatic bacterial infections in blood donors may require new policies to maintain the safety of the U.S. blood supply. This review focuses on the parasitic and bacterial infections that might pose a risk to transfusion recipients in the U.S. PMID- 1772590 TI - Purification and characterization of 2-halocarboxylic acid dehalogenase II from Pseudomonas spec. CBS 3. AB - 2-Halocarboxylic acid dehalogenase II from Pseudomonas spec. CBS 3 (EC 3.8.1.2), which had been cloned in E. coli Hb 101 was purified to electrophoretic homogeneity from crude extracts of E. coli Hb 101 clone 1164. Ammonium sulfate fractionation and three subsequent chromatographic purification steps yielded a pure enzyme in a 230-fold enrichment. The relative molecular masses as determined by gelfiltration on Superose 12 and SDS-polyacrylamide gel electrophoresis were 64,000 Da for the holoenzyme and 29,000 Da for the subunit. The isoelectric point, determined by isoelectric focusing, was at pH 6.2. Substrate specificity towards chlorinated and brominated substrates was limited to short chain monosubstituted 2-halocarboxylic acids. Fluorocompounds were not converted. The reaction proceeded best at a pH above 9.5 and at a reaction temperature of 40-45 degrees C. PMID- 1772591 TI - On the inhibition mechanism of the sialidase activity from Newcastle disease virus. AB - N-Acetylneuraminic, 2-deoxy-2,3-didehydro-N-acetylneuraminic acid and the beta anomer of methoxyneuraminic acid (Neu5Ac, Neu5Ac2en, MeONeu) have been used as probes for the catalytic mechanism of the activities of the outer membrane-bound haemagglutinin-neuraminidase (HN) from newcastle disease virus (NDV). Neu5Ac and Neu5Ac2en produced a competitive inhibition of the sialidase (= neuraminidase) activity, whereas MeONeu had no effect on this activity. This lack of inhibition can be explained by the free amino-acid group lacking the acetyl substituent in the MeONeu. Neu5Ac2en produced the highest inhibition. Based on the effect of the inhibitors, a reaction mechanism is suggested. On the other hand, the above mentioned inhibitors of the sialidase activity had no effect on haemagglutinating activity, suggesting different active sites for the both activities. PMID- 1772592 TI - The amino-acid sequences of the Bacillus stearothermophilus ribosomal proteins S17 and S21 and their comparison to homologous proteins of other ribosomes. AB - Ribosomal proteins S17 and S21 from the moderate thermophile Bacillus stearothermophilus were purified by one-step high-performance liquid chromatography from the 30S-subunit protein mixture employing a semi-preparative reversed-phase C4 column. The complete amino-acid sequences of these proteins were determined by a combination of N-terminal sequencing in picomole quantities of the protein and of appropriate peptide fragments. Proteins S17 and S21 consist of 86 and 55 amino-acid residues, corresponding to molecular masses of 10074 and 6593 Da, respectively. They are homologous to proteins S17 and S21 from the Escherichia coli ribosome, showing 50 and 55% identities in the corresponding regions, respectively. The C-terminal region of protein S21 from B. stearothermophilus has a deletion of 15 residues as compared to the E. coli S21 protein. The evolutionary relationships of the Bacillus proteins to various other members of the S17 and S21 ribosomal protein families are discussed. PMID- 1772593 TI - The complete amino-acid sequence of the heavy chain of the human myeloma protein WIE, an immunoglobulin D. AB - The human myeloma protein WIE is a lambda-type immunoglobulin D; the amino-acid sequence of its Fc part and aminoethylated heavy chain was completely determined. The VH-part (subgroup III) begins N-terminally with 5-oxoproline, and it contains a long, unique CDR3 region. Since the constant part differs from known delta chains by one amino-acid substitution in the hinge region, IgD WIE probably represents an allotypic variant. As in other protein delta chains, O glycosylations are confined to the hinge region. Furthermore, the ratios of N glycosylations at the three positions are identical in IgD WAH [Takahashi, N. et al. (1984) J. Chromatogr. 317, 11-26.] and IgD WIE (100%, 50%, 100%). From the most conserved constant domain, C delta 3, a three-dimensional model was constructed to clarify the role of its delta-specific substitutions and glycosylation. PMID- 1772594 TI - Inhibition of wheat embryo calcium-dependent protein kinase and avian myosin light chain kinase by flavonoids and related compounds. AB - Avian myosin light chain kinase (MLCK) is inhibited by a range of plant-derived flavonoids. Maximal inhibition requires 2,3-unsaturation and polyhydroxylation of two of the three flavonoid rings. Phosphorylation of a synthetic myosin light chain-related peptide by wheat embryo Ca(2+)-dependent protein kinase (CDPK) is also inhibited by a range of flavonoids but phosphorylation of histone preparation III-S by wheat CDPK is not inhibited by flavonoids. The structural requirements for inhibition of wheat CDPK by flavonoids are more stringent than for inhibition of avian MLCK. Potent flavonoid inhibitors of wheat CDPK are unsaturated in 2,3 position, have hydroxyl groups in positions 3' and 4' and an additional hydroxyl in the chromone ring. Flavonoid glycosylation or methylation can abolish inhibition. A number of other naturally occurring plant phenolics including chalcones and gossypol also inhibit avian MLCK and wheat CDPK. Gossypol binds to calmodulin, abolishing Ca(2+)-dependent enhancement of dansyl-calmodulin fluorescence. PMID- 1772595 TI - Signal transduction in endotoxin-stimulated synthesis of TNF-alpha and prostaglandin E2 by rat Kupffer cells. Role of extracellular calcium ions and protein kinase C. AB - Endotoxin is a well established elicitor of cytokine production in mononuclear cells. Nevertheless, the path of signal transduction between the crucial contact of the cells with endotoxin (lipopolysaccharide) and the synthesis and release of the mediators is yet poorly understood. In particular, the involvement of Ca2+ and protein kinase C in this process is still a matter of controversy. Here, it will be demonstrated that removal of extracellular Ca2+ by EGTA does not have a significant effect on the endotoxin-stimulated production of tumor necrosis factor-alpha (TNF-alpha) and on total protein synthesis in rat Kupffer cells. However, the release of prostaglandin E2 could not be raised above the basal level under these conditions. Treatment with inhibitors of protein kinase C such as the isoquinoline derivative, H-7, or staurosporin is without influence on TNF alpha synthesis. The depletion of protein kinase C through preincubation of rat Kupffer cells with phorbol 12-myristate 13-acetate for 24 h was also without effect on TNF-alpha production. The effectiveness of these inhibitors under the conditions used was ascertained by measurement of the O2- release from the same cell batches. Superoxide production known as protein kinase C-dependent in Kupffer cells (Dieter et al. (1986) Eur. J. Biochem. 86, 451-457) was suppressed in a dose-dependent manner by staurosporin or after prolonged pretreatment with the phorbol ester. H-7 decreased superoxide production only slightly in high doses that severely harm the Kupffer cells. Prostaglandin E2 release, although clearly protein-kinase C-dependent in phagocytosing rat Kupffer cells, is not decreased following exposure to lipopolysaccharide in the presence of protein kinase C inhibitors. PMID- 1772596 TI - Equine cutaneous amyloidosis derived from an immunoglobulin lambda-light chain. Immunohistochemical, immunochemical and chemical results. AB - Amyloid deposits from equine cutaneous nodular amyloidosis associated with extramedullary plasmacytoma were classified immunohistochemically as equine immunoglobulin lambda-light chain-derived and designated eA lambda (HIP). For chemical identification, the amyloid fibril proteins were separated on Sephadex G 100 in 6M guanidine.HCl. Polypeptides of predominantly 24 kDa and 50 kDa were found by polyacrylamide gel electrophoresis. They have preponderance of immunoglobulin lambda-antigenic determinants as detected by immunodiffusion and immunoblotting. Since the N-terminus of the major proteins was blocked, peptides were generated with trypsin and endoproteinase Asp-N and then isolated using reversed-phase high-performance liquid chromatography. Automatic amino-acid sequence determination of seven peptides showed novel sequences. Data bank comparison indicated that these peptides were derived from a monoclonal immunoglobulin lambda-light and a gamma-heavy chain. The light chain was considered to be the leading amyloidogenic polypeptide, since it was the predominant component in a virtually pure amyloid fibril preparation. Thus, immunoglobulin lambda-light chain-derived amyloidosis, so far established only in man and cat, has now also been identified in the horse. PMID- 1772597 TI - Preparation of rabbit antibodies to 4,4'-dimethoxytriphenylmethyl, the protective group in oligonucleotide synthesis. AB - Antibodies were raised in 2 rabbits by immunization with carrier proteins covalently bound to deoxyguanosine bearing a 4,4'-dimethoxytriphenylmethyl group protecting the 5'-hydroxy terminus of deoxyribose. After several injections with such complexes, immune sera were tested with an immuno-enzymatic method using as antigens several compounds containing the hapten, as well as synthetic oligonucleotides bearing, or not, this protective group at the 5' terminus. One of the two antisera appeared to recognize the dimethoxytrityl group bound to carrier molecules, and thus might find a useful application for the detection, quantitation, and control of oligonucleotides obtained by automatic synthesis. PMID- 1772598 TI - [Fragments from albumin and beta 2-microglobulin--constituents of the middle molecule fraction in hemofiltration]. AB - Peptides were isolated from the middle molecule fraction of hemofiltrate obtained from uremic patients by adsorption of the organic compounds on RP 18. By stepwise elution an enriched peptide fraction was obtained. This procedure was followed by a combination of ion-exchange-chromatography, gel-chromatography and HPLC. The pure peptides obtained in this way were investigated by liquid secondary ion mass spectrometry (LSIMS)-if necessary after enzymatic digestion. The identified peptides turned out to be fragments of the human serum albumin and beta 2 microglobulin. PMID- 1772599 TI - Substrate and inhibitor specificity of 3-hydroxy-3-methylglutaryl-CoA reductase determined with substrate-analogue CoA-thioesters and CoA-thioethers. AB - 1) Analogues of 3-hydroxy-3-methylglutaryl-CoA were prepared in which the substituents at C-3 of the acyl residue were altered. The same analogues were additionally modified by replacement of the thioester oxygen by hydrogen to yield reduction-resistant CoA-thioethers. The interaction of both types of CoA derivatives with a 58-kDa catalytic fragment of human 3-hydroxy-3-methylglutaryl CoA reductase was studied. 2) This enzyme reduces glutaryl-CoA at a very low rate whereas 3-hydroxyglutaryl-CoA is well reduced, the maximal rate of reduction being 7% that of the physiological substrate. Only half of total 3 hydroxyglutaryl-CoA was attacked, thus reflecting the stereo-specificity of the enzyme for (3S)-3-hydroxy-3-methylglutaryl-CoA. The results invalidate the hitherto assumed absolute substrate specificity of the enzyme. 3) The affinity of both 3-hydroxyglutaryl-CoA and its thioether variant S-(4-carboxy-3 hydroxybutyl)CoA to the reductase, Ki = 0.3 microM and Ki = 0.4 microM, respectively, is higher than that of the physiological substrate, Km = 1.5 microM (data related to (S)-diastereomer). The results show for the first time that the methyl-group effect observed with the inhibitor lovastatin is an intrinsic property of the enzyme. 4) All of the prepared CoA derivatives are purely competitive inhibitors of the reductase, the affinities varying within a range of two powers of ten (Ki = 0.3-32 microM). On variation of the substituents at C-3 of the acyl residue of the physiological substrate the affinity of both CoA thioesters and CoA-thioethers increases in the sequence CH2, C(CH3)2, CH(CH3), C(OH)CH3, CH(OH). PMID- 1772600 TI - Radical excision of craniopharyngioma by the temporal route: a review of 50 patients. AB - Attempts at radical excision of craniopharyngioma have been made increasingly possible by progress in neuroradiological imaging and the use of microscopic technique. Between 1977 and 1990, 50 patients of The National Hospital for Neurology and Neurosurgery, London, have undergone radical surgical excision of craniopharyngioma by the temporal route, with a small anterior temporal resection. Surgical mortality was 4%. Thirty-eight (76%) patients remain well at average follow-up of 30 months; 15% had major complications (hypothalamic damage, subdural haematoma, scalp collections requiring shunt drainage). There were three recurrences in those patients where the initial operations were considered as complete microscopic excision. It is concluded that maximal control of tumour recurrence by removal of all tumour accessible and visible to the surgical microscope is best achieved by a radical excision at the first operation. PMID- 1772601 TI - Type III collagen mutations cause fragile cerebral arteries. AB - Premature vascular aneurysms and fragility of cerebral arteries are commonly associated with type III collagen mutations and physical signs suggesting a generalized abnormality of connective tissue. Sometimes these traits are clearly genetically transmitted. Here we present seven examples of early cerebrovascular aneurysms or fragility including five examples of carotid cavernous sinus aneurysms. With one exception in which we suspect the mutation is too small to be detected, all of them had easily visible abnormalities of their type III collagen proteins. Further work in progress will eventually allow the characterization of their mutations at gene sequence level and will be followed by the ability to prevent transmission of the mutant genes in these families. PMID- 1772602 TI - Aetiology of intracranial saccular aneurysms in childhood. AB - Intracranial saccular aneurysms in childhood are rare neurosurgical lesions, occurring in 1-3% of large epidemiological aneurysm series. Analysis of previous reports indicates several distinct characteristics of this entity. First, there is a predominant male:female ratio approaching 2:1. Second, a disproportionately high number of these aneurysms arise at peripheral locations on the arterial tree. Third, approximately half of them are large or even giant aneurysms. These identifiable characteristics suggest that aneurysms in the younger age group may be a distinct pathophysiological entity from aneurysm in the adult population. In adults, epidemiological evidence indicates that 'acquired' factors such as hypertension, cigarette smoking, alcohol consumption, and oral contraceptive use together with 'intrinsic' or 'vascular' factors are causally related to the formation and rupture of cerebral aneurysms. Inherently, some of the 'acquired' factors must be of minor importance in aneurysm formation and rupture in childhood, whereas the 'intrinsic' factors may have a greater importance. PMID- 1772603 TI - A modified technique for placement of the peritoneal end of a shunt system: technical note. AB - Infection and extrusion of the peritoneal catheter can complicate shunt surgery. We present a modification in the technique of peritoneal catheter placement which can help reduce the incidence of these complications, as it places the peritoneal catheter away from the abdominal wound. The subcutaneous passer is first introduced into the peritoneal cavity through the abdominal incision. It is then thrust superficially and manipulated into the subcutaneous plane, from where the procedure follows the conventional steps. We have followed this technique for 6 years without any additional hazard attributed to this procedure. PMID- 1772604 TI - Stereotactic biopsy of cerebral lesions in patients with AIDS. AB - Central nervous system involvement with AIDS is not uncommon. The indications and timing of brain biopsy remains controversial. Stereotactic CT-guided biopsy offers a safe and effective means of establishing a diagnosis in any patient with a cerebral mass lesion and has less morbidity and mortality than freehand biopsy or exploratory craniotomy. Eleven patients with AIDS have undergone CT-directed stereotactic biopsy between May 1987 and November 1990 with one death from intracerebral haemorrhage. Histological diagnosis of the biopsy specimens showed multifocal leucoencephalopathy, toxoplasmosis, lymphoma and non-specific changes. Biopsy is recommended for patients with an atypical presentation, negative serology, progressive clinical deterioration and differential response of lesions to empirical therapy. PMID- 1772605 TI - Factors affecting outcome after surgery for intracranial aneurysm in Glasgow. AB - Two-hundred and ninety-five patients with angiographically demonstrated intracranial aneurysms presented to the Institute of Neurological Sciences, Glasgow over a 3-year period (1986-88). We have reviewed this group to assess the effect of changing patterns of management upon outcome. The overall mortality rate was 9.4%, and the surgical mortality rate was 4% in this selected series. Factors significantly associated with a poor outcome were: WFNS grades III-V on admission, presence of a haematoma on the first CT scan, delayed ischaemic deficit, and development of a post-operative haematoma. Seventy-six per cent of the patients who developed a delayed ischaemic deficit (nearly a third of those with recent subarachnoid haemorrhage) made a good recovery, in contrast to previous studies, and over two-thirds of those accepted in grades IV and V (28 patients) made a good recovery after surgery. Active management of patients in grades IV and V, and those with delayed ischaemia, together with prophylactic Nimodipine therapy and selective early surgery, offers the best prospect for further improvement in outcome after aneurysmal subarachnoid haemorrhage. PMID- 1772606 TI - Can early admission reduce aneurysmal rebleeds? A prospective study on aneurysmal incidence, aneurysmal rebleeds, admission and treatment delays in a defined region. AB - One-hundred and eighty-five patients sustaining an aneurysmal subarachnoid bleed were detected in a well-defined urban region in Stockholm, during a 3-year period. Of all detected patients, 21% died before coming to neurosurgical attention. In this prospective series 54 of the admitted patients had more than one bleed. In 29 of them rebleed was subsequently verified. There were 25 patients with a clinical history of a minor bleed or a warning leak preceding the major bleed. Of all rebleeds--minor bleeds included--35% occurred in the first 24 h, 5% between days 1 and 3, 19% between days 4 and 7 and 41% after the first week. Although the greatest distance to the hospital was 65 km, not more than 53% of the patients were admitted within the first 12 h post bleed. This delayed admission was attributed almost equally to a patient delay or a referral delay by doctors. The outcome of the patients was more gloomy if referral delay was apparent. A substantial number of rebleeds could have been avoided had the patient not disregarded the first bleed or the first doctor on line had not misunderstood the symptoms. Thus, 35 of the 54 rebleeds were regarded as avoidable, if admitted in time. Hypothetically a better outcome was expected in 20 of these 35 avoidable rebleeds. Substantiated by this study, aiming at early admission and treatment in the first 72 h post bleed, almost 65% of the late (after 72 h) rebleeds could be avoided. PMID- 1772607 TI - The diagnosis of dural spinal vascular malformations. AB - Dural spinal arteriovenous malformations are increasingly recognized as a rare but treatable cause of progressive paraplegia, but the clinical picture, especially in early cases, is not easy to recognize and operation may therefore be delayed until considerable loss of function has occurred. We present a series of seven cases which illustrate the characteristics and diagnostic difficulties of this condition. PMID- 1772608 TI - The association between skull fracture, intracranial pathology and outcome in pediatric head injury. AB - We prospectively studied 653 consecutive head-injured children (less than or equal to 14 years old) treated over a 54-month period (1984-88) at the Department of Neurosurgery of the Rambam Medical Center (Haifa, Israel). Demographic and clinical data were collected, the patients were divided into five age groups (birth to 2 years, 169; 3-5 years, 194; 6-9 years, 164; 10-12 years, 77; and 13 14 years, 49), and the information relative to each was then compared. All patients (except three who died on the operating table) underwent computed tomography (CT) scans; 225 (34.6%) had intracranial pathology, e.g. focal mass lesions, diffuse axonal injury, and subarachnoid haemorrhage. The rate of detected pathology increased with age. Skull fracture was documented in 468 (72%) patients. Craniotomies were done on 114 (17.5%) patients. After 3 months, the patients were classified as having good recovery (84.8%), moderate disability (5.5%), or severe disability (2.3%); 0.9% were in a vegetative state. The mortality was 6.6% (43 patients); of these, 39 (90.7%) had admission Glasgow Coma Scale scores below 8. In our area the annual incidence of neurosurgical hospitalization due to head injury in the pediatric group was 37.6 per 100,000 inhabitants per year. This study substantiates the findings of other series on the effects of prognosis of factors such as associated trauma, admission Glasgow Coma Score, mass lesions with persistent intracranial pressure elevation, or diffuse axonal injury.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772609 TI - Large cavernous haemangioma of the pituitary fossa: a case report. AB - A large pituitary fossa cavernous haemangioma in a 48-year-old male is presented. The rarity of this lesion is stressed. The relevant literature is reviewed. PMID- 1772610 TI - Multicentric malignant glioma. AB - Multicentre gliomas are a well recognized entity but the occurrence of such tumours both above and below the tentorium remains uncommon. We report the case of an 11-year-old boy who underwent stereotactic biopsy of a brain stem ring enhancing tumour with histology of an anaplastic astrocytoma (Grade 3). Nine months following his radiotherapy a large left frontal mass was biopsied and found to be a malignant glioma (Grade 4). Advances in neuroradiological imaging will readily show multiple cerebral lesions and multicentre glioma should be considered in the differential diagnosis of such lesions and biopsy is indicated. PMID- 1772611 TI - Arachnoid cyst presenting as an extradural haematoma. AB - A case of extradural haematoma as the presenting feature of an arachnoid cyst is described. Haemorrhagic complications of arachnoid cysts are well known, but extradural haematoma is rare. A possible pathogenetic mechanism is proposed and the treatment of asymptomatic arachnoid cysts is discussed. PMID- 1772612 TI - Lymphocytic hypophysitis: can open exploration of the sella be avoided? AB - A case of lymphocytic hypophysitis (LYHY) in a menopausal woman is presented. A review of the literature suggests that conservative treatment may be tried in suspected cases of LYHY, if the vision of the patient is not threatened. A transphenoidal stereotactic biopsy of the mass may be performed if the patient fails to improve or deteriorates, thus avoiding open exploration of the sella in selected cases. PMID- 1772613 TI - Brain tumours and the occurrence of severe invasive basal cell carcinoma in first degree relatives with Gorlin syndrome. AB - We describe the occurrence of a medulloblastoma and an astrocytoma in successive generations of a family with the Gorlin syndrome. The appearance of thousands of invasive basal cell carcinomata after craniospinal irradiation led to the death of one patient from intracranial involvement. PMID- 1772614 TI - Cavernous angioma involving the 7th nerve. PMID- 1772615 TI - Nursing development units. Ten years at Tameside. PMID- 1772616 TI - The age of enlightenment. PMID- 1772617 TI - Health screening. A flexible contract to care. PMID- 1772618 TI - At the crossroads. PMID- 1772619 TI - Team spirit. PMID- 1772620 TI - Sitting pretty. PMID- 1772621 TI - Continuing care in the Highlands. PMID- 1772622 TI - Preparing for change. PMID- 1772623 TI - A pioneering nurse. PMID- 1772624 TI - As I was saying.... PMID- 1772625 TI - Voluntary organisations. A sense of belonging. PMID- 1772626 TI - Nursing homes. Shabby treatment. PMID- 1772627 TI - Devilish developments. PMID- 1772628 TI - Protein engineering of Rubisco. AB - Modification of the kinetic parameters of enzymes by protein engineering requires extensive knowledge of the structural details of the enzyme and its complexes with different reaction intermediate analogues. Such structural studies are described here for Rubisco, ribulose-1,5-bisphosphate carboxylase/oxygenase, which catalyzes the initial reactions of two important but competing physiological events in green plants; carbon dioxide fixation and photorespiration. Observed functional changes in mutants of Rubisco are correlated with structural details as well as with the defined conformational changes that occur during catalysis. A possible functional role of the small subunit of Rubisco is described based on a comparison of the active-site geometry of a bacterial L2 molecule with that of higher plant L8S8 molecules. The ultimate aim of these studies is to engineer Rubisco mutants that are more efficient than the wild-type enzyme by decreasing the oxygenase/carboxylase ratio. PMID- 1772629 TI - Structure solution and molecular dynamics refinement of the yeast Cu,Zn enzyme superoxide dismutase. AB - Cu,Zn yeast superoxide dismutase was crystallized from polyethylene glycol solutions. The crystals belong to the P2(1)2(1)2 space group, with cell dimensions a = 105.3, b = 143.0, c = 62.1 A; two dimers of Mr = 32,000 each are contained in the asymmetric unit. Diffraction data at 2.5 A resolution were collected with the image-plate system at the EMBL synchrotron radiation facility in Hamburg. The structure was determined by molecular replacement using as a search model the 'blue-green' dimer of the bovine Cu,Zn superoxide dismutase. The crystallographic refinement of the molecular replacement solution was performed by means of molecular dynamics techniques and resulted in an R factor of 0.268 for the data between 6.0 and 2.5 A. The model was subsequently subjected to conventional restrained crystallographic refinement of the coordinates and temperature factors. The current R value for the data between 6.0 and 2.5 A is 0.220. Owing to the large radius of convergence of the molecular dynamics crystallographic refinement, the convergence of the refinement process was reached after 18.1 ps of simulation time. The geometry of the active site of the enzyme appears essentially preserved compared with the bovine superoxide dismutase. The beta-barrel structure in the yeast enzyme is closed at the upper part by an efficient hydrogen-bonding scheme. PMID- 1772630 TI - X-ray studies on crystalline complexes involving amino acids and peptides. XXIII. Variability in ionization state, conformation and molecular aggregation in the complexes of succinic acid with DL- and L-lysine. AB - Crystalline complexes of succinic acid with DL- and L-lysine have been prepared and analysed by X-ray diffraction. DL-Lysine complex: C6H15N2O2+.-1/2C4H4O4(2 ).1/2C4H6O4, Mr = 264.2, P1, a = 5.506 (4), b = 8.070 (2), c = 14.089 (2) A, alpha = 92.02 (1), beta = 100.69 (3), gamma = 95.85 (3) degrees, Z = 2, Dx = 1.44 g cm-3, R = 0.059 for 2546 observed reflections. Form I of the L-lysine complex: C6H15N2O2+.C4H5O4-, Mr = 264.2, P1, a = 5.125 (2), b = 8.087 (1), c = 8.689 (1) A, alpha = 112.06 (1), beta = 99.08 (2), gamma = 93.77 (2) degrees, Z = 1, Dm = 1.34 (3), Dx = 1.34 g cm-3, R = 0.033 for 1475 observed reflections. Form II of the L-lysine complex: C6H15N2O2+.1/4C4H4O4(2-).-1/4C4H6O4.1/4(C4H5O4.. .H...C4H4O4)2-, Mr = 264.2, P1, a = 10.143 (4), b = 10.256 (2), c = 12.916 (3) A, alpha = 105.00 (2), beta = 99.09 (3), gamma = 92.78 (3) degrees, Z = 4, Dm = 1.37 (4), Dx = 1.38 g cm-3, R = 0.067 for 2809 observed reflections. The succinic acid molecules in the structures exhibit a variety of ionization states. Two of the lysine conformations found in the complexes have been observed for the first time in crystals containing lysine. Form II of the L-lysine complex is highly pseudosymmetric. In all the complexes, unlike molecules aggregate into separate alternating layers. The basic element of aggregation in the lysine layer in the complexes is an S2-type head-to-tail sequence.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772631 TI - Structure determination of the bacteriophage MS2. AB - The structure of the bacterial virus MS2 has been solved at 3.3 A resolution. Initial phases to 13 A resolution were obtained from a model based on the known coordinates of the plant virus southern bean mosaic virus. These phases were extended in small steps to a resolution of 3.4 A. The phases obtained represented essentially the Babinet opposite of the true structure and were not of a sufficiently good quality to allow an interpretation of the electron density contoured at negative levels. Difference Fourier maps of two heavy-atom derivatives based on these phases were interpretable, and these derivatives were used to calculate isomorphous replacement phases at 8.8 A resolution. Phase extension to 3.3 A resolution led to maps which could be easily interpreted. PMID- 1772632 TI - Disordered fatty-acid chains in piperazinium myristate and palmitate. AB - (I) Piperazinium n-tetradecanoate (myristate), C4H12N2(2+).2C14H27O2-, Mr = 542.85, m.p. = 368.9 K, triclinic, P1, a = 5.681 (1), b = 7.454 (1), c = 20.676 (3) A, alpha = 84.59 (1), beta = 86.37 (1), gamma = 81.73 (1) degrees, V = 861.5 A3, Z = 1, T = 296 K, Dm = 1.05, Dx = 1.05 g cm-3, F(000) = 304, Mo K alpha, lambda = 0.7107 A, mu = 0.723 cm-1, R = 0.062 for 2198 independent reflections with I greater than sigma (I). (II) Piperazinium n-hexadecanoate (palmitate), C4H12N2(2+).2C16H31O2-, Mr = 598.95, m.p. = 370.2 K, triclinic, P1, a = 5.678 (1), b = 7.472 (1), c = 22.916 (3) A, alpha = 84.64 (1), beta = 89.82 (1), gamma = 81.32 (1) degrees, V = 956.8 A3, Z = 1, T = 296 K, Dm = 1.04, Dx = 1.04 g cm-3, F(000) = 336, Mo K alpha, lambda = 0.7107 A, mu = 0.708 cm-1, R = 0.052 for 1931 independent reflections with I greater than sigma (I). These crystal structures, together with the previously reported n-decanoate and n-dodecanoate (laurate) salts, form an isostructural series. The piperazinium cations, which have a crystallographic centre of symmetry, are in the chair conformation. Each cation forms a salt bridge to four different anions with N ... O distances ranging from 2.67 to 2.70 A. The alkanoate chains are bent with torsion angles of 78.6 degrees (I) and 79.7 degrees (II) at the C3-C4 bond. The longer sections of the alkanoate chains are close-packed together in an antiparallel array.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772633 TI - Structure of porcine insulin cocrystallized with clupeine Z. AB - The crystal structure of NPH-insulin, pig insulin cocrystallized with zinc, m cresol and protamine, has been solved by molecular replacement and refined using restrained least-squares refinement methods. The final crystallographic R factor for all reflections between 2 and 10 A is 19.4%. The insulin molecules are arranged as hexamers with two tetrahedrally coordinated Zn atoms in the central channel and one m-cresol bound to each monomer near His B5. One protamine binding site has been unequivocally identified near a dimer-dimer interface, although most of the polypeptide is crystallographically disordered. The conformation of the insulin moiety and the structural differences between the three unique monomers have been analysed. The zinc and m-cresol environments are described and the nature of the protamine binding site is outlined. PMID- 1772634 TI - Structure of oligomeric beta B2-crystallin: an application of the T2 translation function to an asymmetric unit containing two dimers. AB - The molecular structure of the main subunit of the beta-crystallins, components of the vertebrate eye lens, has recently been solved by molecular replacement at 2.1 A resolution [Bax, Lapatto, Nalini, Driessen, Lindley, Mahadevan, Blundell & Slingsby (1990). Nature (London), 347, 776-780]. The protein, beta B2, is a dimer in solution, but a tetramer in the crystal with one subunit in the asymmetric unit of space group I222. Using the crystallographic dimer from this I-centred form the structure of a C222 crystal form of the beta B2 protein with four subunits in the asymmetric unit has now been solved by molecular replacement at 3.3 A. The solution involved the use of a new translation function for non crystallographic symmetry, based on the T2 function of Crowther & Blow [Acta Cryst. (1967), 23, 544-548]. PMID- 1772635 TI - Molecular replacement solution of the structure of apolactoferrin, a protein displaying large-scale conformational change. AB - The crystal structure of an orthorhombic form of human apolactoferrin (ApoLf) has been determined from 2.8 A diffractometer data by molecular replacement methods. A variety of search models derived from the diferric lactoferrin structure (Fe2Lf) were used to obtain a consistent solution to the rotation function. An R factor search gave the correct translational solution and the model was refined by rigid-body least-squares refinement (program CORELS). Only three of the four domains were located correctly by this procedure, however; the fourth was finally placed correctly by rotating it manually onto three strands of electron density which were recognized as part of its central beta-sheet. The final model, refined by restrained least-squares methods to an R factor of 0.214 for data in the resolution range 10.0 to 2.8 A, shows a large domain movement in the N-terminal half of the molecule (a 54 degree rotation of domain N2) and smaller domain movements elsewhere, when compared with Fe2Lf. A feature of the crystal structure is that although the ApoLf and Fe2Lf unit cells appear very similar, their crystal packing and molecular structures are quite different. PMID- 1772636 TI - Coupling of m1 muscarinic receptors to G protein in Alzheimer disease. AB - The potential usefulness of cholinergic replacement therapy for Alzheimer disease (AD) is dependent upon retention of postsynaptic muscarinic receptors and their transduction mechanisms long after the degeneration of cholinergic nerves. The receptors most clearly associated with cholinergic cerebral excitation are m1 muscarinic receptors, which work via a G protein to activate phospholipase C. The ability of these receptors to couple to their associated G protein was assessed in the middle temporal gyrus of postmortem brains from persons with and without AD. A low concentration of [3H]-pirenzepine (1 nM) was used to label m1 receptors preferentially. The affinity of the agonist, oxotremorine-M, for labeled receptors and the ability of these receptors to couple with G protein were assessed by competition between the agonist and 1 nM [3H]-pirenzepine in the presence and absence of guanine nucleotide. Brain tissue from 7 patients with AD and five age-matched controls showed very similar levels of labeled receptors, agonist affinities for the high- and low-affinity states of m1 receptors, and guanine nucleotide-sensitive high-affinity binding. It is concluded that the coupling of m1 receptors to G protein is adequate to permit responses to exogenous muscarinic drugs in AD. PMID- 1772637 TI - Nutritional intake in patients with senile dementia of the Alzheimer type. AB - The dietary intake of 29 healthy controls was compared with that of 35 community dwelling patients with probable or definite senile dementia of the Alzheimer type (SDAT), based on NINCDS-ADRDA criteria. The control subject or the caregiver of the SDAT patient completed a 3-day estimated-dietary-intake record. Foods offered to patients were chosen, for the most part, by caregivers, but SDAT patients were allowed to eat ad libitum from those choices, and food consumed was recorded. Dietary intake was evaluated against the 1989 Recommended Dietary Allowances (RDA). Dietary intakes did not differ significantly between control and SDAT patients for any of the 32 nutrients analyzed. The controls and SDAT patients met the RDA guidelines for intake of total energy, protein, and micronutrients, with the exception of female SDAT patients, who did not consume a minimum of two thirds of the RDA for vitamin D. All biochemical indices of nutritional status were within normal limits for the SDAT patients. In addition, cognitive function did not correlate with intake of any nutrient studied. We conclude that moderately impaired, community-dwelling patients with SDAT do not differ from healthy controls in nutritional status or nutrient intake. Neither general nor nutrient-specific malnutrition was present in this population. Based on this cross-sectional study, malnutrition does not appear to be a major contributor to the pathogenesis of Alzheimer disease. However, this investigation examined only a single point in time, when patients were being fed by caregivers, so that the role of malnutrition at the beginning of the disease was not addressed. PMID- 1772638 TI - Relatives' recall of a psychiatric interview. AB - One hundred seventeen patients from the Burke Rehabilitation Center (White Plains, NY) with clinically diagnosed dementia of the Alzheimer type (DAT) were identified for a case-control study (CCS) designed to assess risk factors for DAT. A psychiatric evaluation was part of the Burke dementia workup. The study sample was composed of 96 relatives who (a) were present with the patient at the psychiatric evaluation and (b) were interviewed for the CCS. The data for this study were the relatives' responses to the question "Did your relative (patient with DAT) ever see a psychiatrist?" The recall of relatives, regardless of relationship category (spouse, adult children, and others) did not exceed the 50% recall predicted by chance. When the age of the relative and length of time between the two interviews were considered, they did not modify these results. PMID- 1772639 TI - Survey of U.S. Alzheimer Brain Banks: a 1990 directory. PMID- 1772640 TI - Neuropathologic examination of rabbit brain after long-term immunization with Alzheimer paired helical filaments. PMID- 1772641 TI - Experimental immunization with Pseudomonas aeruginosa alginate induces IgA and IgG antibody responses. AB - We tried experimentally to induce a specific antibody response against Pseudomonas aeruginosa locally in the airways and systemically in rats by three different routes of immunization; intragastric feeding, intratracheal inoculation or subcutaneous vaccination. Three groups of rats were immunized with live mucoid P. aeruginosa PAO 579 by intragastric feeding or with killed PAO 579 intratracheally or subcutaneously. Three other groups were immunized with purified P. aeruginosa alginate either by intragastric feeding, intratracheally or subcutaneously. At weekly intervals for four weeks animals were sacrificed and serum and bronchial fluid were obtained. The specific IgA and IgG antibody response in lavage fluid and serum was measured. Only traces of antibodies could be detected in the bronchial lavage fluids. Anti-alginate IgA and IgG antibodies developed in all rats immunized with alginate but no antibodies against other P. aeruginosa antigens were detected. The highest IgA and IgG titer against alginate was induced by the subcutaneous immunization. IgA and IgG antibodies against other P. aeruginosa antigens developed in rats immunized with liver and sonicated bacteria. The highest IgA and IgG titers were obtained after intratracheal and subcutaneous immunization with sonicated bacteria. The present work has shown that IgA and IgG antibodies develop with high specificity after immunization. The different titers obtained do not necessarily reflect different degrees of protection. PMID- 1772642 TI - Fixation of the macula densa with fixatives of different osmolarities in normal and diabetic rats. AB - The influence of different fixative osmolarities on the ultrastructure of the macula densa region has been studied in normal and in streptozotocin diabetic rats after 50 days' duration of diabetes. In vivo perfusion fixation of the kidneys was performed retrogradely through the aorta in five groups of controls and diabetic animals with a 1% glutaraldehyde fixative in a Tyrode solution. Between groups, the osmolarity of the fixative solution varied from 216 to 476 mosm/l. This was accomplished by variation of the NaCl concentration of the fixative vehicle. The tissue was embedded in Epon and midcortical tissue was prepared for electron microscopy. The volume density of the lateral intercellular spaces between the macula densa cells was measured applying a morphometric technique. The results confirmed that the lateral intercellular spaces are narrowed in diabetes and also showed that for all fixative osmolarities the difference is persistent between diabetic and non-diabetic animals, except at very low osmolarities. The abnormal macula densa ultrastructure has been suggested to be connected with the functional abnormalities in diabetes, i.e. the resetting of the tubuloglomerular feedback and subsequent increases in GFR. It is therefore of interest to further understand the mechanisms underlying the narrowing of the lateral intercellular spaces in diabetes. The present study has shown that the size difference in lateral intercellular spaces between diabetic and normal animals is reproducible over a wide range of fixative osmolarities, further indicating that it is an in vivo phenomenon. The diminution of the LIS in diabetes could perhaps indicate a decrease in signal function, previously reported at the MD level in diabetic animals, contributing to the increased GFR in diabetes. PMID- 1772643 TI - Should aerobic blood cultures be shaken intermittently or continuously? AB - Stationary incubation of aerobic blood cultures was compared with intermittent shaking in aerobic Vacutainer 2630 bottles with agar slants during the first 24 h, and was simultaneously compared with the continuously shaken aerobic Bactec 6A bottles as a reference system. Intermittent shaking did not significantly increase or decrease the seven days yield of the Vacutainer bottles as compared with the continuously agitated Bactec 6A bottles. When one of 604 paired Vacutainer bottles was agitated for eight h and the other incubated stationary, the speed of growth detection was significantly greater in the agitated bottle (p less than 0.001), but significantly less than with continuously agitated Bactec 6A bottles (p less than 0.001). Agitation for 14 h showed the same pattern of detection speed. These results suggest that it is desirable initially to agitate aerobic blood cultures either intermittently or continuously. PMID- 1772644 TI - Darkening of haemoglobin in simulated, continuously agitated aerobic blood cultures: an early indicator of bacterial growth. AB - The change of purple oxyhaemoglobin to the darker reduced haemoglobin and methaemoglobin was used as an initial visual growth indicator in continuously agitated, aerobic Colorbact bottles after inoculation with a broad assortment of aerobic and facultatively anaerobic bacteria previously isolated from blood cultures. Growth of all the faster growing strains could be detected by darkening of the blood cultures within a 24 h period of agitation, after they had stood unshaken for eight h. The darkening was accompanied by consumption of O2 and acidification of the fluid media. The slower growing bacteria were detected by turbidity. This growth detection method is easy, quick, inexpensive and reliable, and is especially promising for application in clinical microbiological departments which daily receive blood cultures from peripheral hospitals. PMID- 1772645 TI - Colorbact, a visually read blood culture system using darkening of haemoglobin in aerobic blood cultures as an early growth indicator, compared with Bactec 6A and 7A. AB - Colorbact-A (aerobic), a blood culture system using darkening due to oxygen reduction and acidification of haemoglobin as an initial growth indicator during the first day of incubation of continuously agitated, aerobic blood cultures, was compared with the 24 h agitated aerobic Bactec 6A in 1767 consecutive paired cultures. Both systems were examined simultaneously twice daily during the first two days and once daily the next five days of incubation. In addition, during the agitation period Colorbact-A was observed for darkening four to five times during day duty between 8 a.m. and 4 p.m. The final seven days detection rate found by Colorbact-A using observation for darkening during initial agitation was similar to the rate found by Bactec 6A for both clinically significant strains and "contaminants", but Colorbact-A was significantly faster (p less than 0.001) in finding clinically significant strains. Colorbact-AN (anaerobic) was more rapid (p less than 0.01) and yielded more positive cultures than the anaerobic Bactec 7A. The Colorbact system was flexible, inexpensive, reliable and especially promising for laboratories which receive blood cultures from other hospitals once daily, as many positive cultures can be found immediately on arrival undisturbed by agitation during transport. PMID- 1772646 TI - Parathyroid cell number and size in hypocalcemic young rats. AB - Weanling rats were fed diets with normal (1%) or low (0.08% or 0.02%, respectively) Ca content for 28 days prior to sacrifice. The total volume of the parathyroids was estimated from serial sections. Volume density of secretory cells was calculated according to conventional stereological techniques, whereas cell number and cell size were estimated by the dissector method. Compared with controls the animals of the experimental groups developed moderate and severe hypocalcemia and their parathyroids were enlarged with a proportional growth of parenchyma and interstitium. Related to the body weight, secretory cell volume was highest in animals with severe hypocalcemia. In the enlarged glands the size of parathyroid secretory cells was increased by 30-40%, whereas total cell number was unaltered. Thus, the increased parathyroid size was due to cell hypertrophy rather than hyperplasia. PMID- 1772647 TI - Prevalence of antibiotic-resistant Escherichia coli in Danish pigs and cattle. AB - The present paper reports on the antibiotic resistance of E. coli isolated from Danish piglets and calves in 1987-1988, and compares the results with similar investigations performed during the periods 1971-1972 and 1977-1978. Rectal swabs from 52 piglets and from 78 calves were examined. All the animals studied harboured resistant E. coli. This is a significant increase compared to the previously conducted investigations. The number of strains having three or more resistance markers did not differ significantly from the previous findings. The spectrum of resistance markers among Danish piglets and calves had increased through all three investigations and resistance to chloramphenicol was still found to be considerable 10 years after the withdrawal of chloramphenicol as a therapeutic drug for farm animals in Denmark in 1978. Certain resistance patterns (sulfonamide + streptomycin, sulfonamide + streptomycin + tetracycline, sulfonamide + streptomycin + tetracycline + ampicillin) were found to be shared by numerous strains, suggesting a genetic linkage of the resistance markers. PMID- 1772648 TI - Tumors developing in nude mice express unusually large amounts of MHC class I antigens. AB - Tumors were induced in athymic, T-cell-deficient nude mice and in syngeneic normal haired mice by treatment with low doses of 3-methylcholantrene (MCA). The tumors were studied for tumor cell expression of MHC class I molecules and for immunogenicity by transplantation to syngeneic haired recipients. Ten tumors were obtained by the MCA treatment, six from nude and four from haired mice. They were all fibrosarcomas as judged from their microscopic appearance. Five of the "nude" tumors expressed measurable amounts of MHC class I molecules and two of them expressed high amounts. Both were immunogenic in the sense that they evoked a cytotoxic T-cell response in transplanted haired recipients. Only one of the four "haired" tumors expressed measurable amounts of MHC class I, and none of them were immunogenic. These findings support the concept that some tumors are immunoselected at an early point of time in their existence in a host with a normal immune system and that this results in an elimination of tumor cell variants which are highly immunogenic for the T-cell system, leaving the low or non-immunogenic variants. These take over and grow and kill their host. The results suggest that tumor cell variants expressing high amounts of MHC class I are important targets in the immunoselection in hosts with a normal immune system. PMID- 1772649 TI - Normal human serum depleted of C1q, factor D and properdin: its use in studies of complement activation. AB - Normal human sera were depleted of C1q, factor D (D) and properdin (P) by a simple and reproducible procedure providing reagents for analysis of complement dependent functions. Classical pathway activity was restored with purified C1q, and alternative pathway activity with purified D and P. Since both activation pathways were abolished, antibodies and other components could be removed without loss of complement activity during immunoabsorption procedures. Synergism between the two pathways during haemolysis of rabbit erythrocytes was clearly demonstrated, and was also found on analysis of C3 cleavage in serum incubated with other alternative pathway activators such as zymosan and inulin. Experiments with a Neisseria meningitidis serogroup W-135 strain isolated from a patient with inherited P deficiency showed that both pathways were capable of supporting antibody-dependent killing of the bacteria in serum. The alternative pathway was possibly more efficient than the classical pathway in the assay system. In C1q,D,P-depleted serum with high concentrations of anticapsular IgG antibodies, the addition of D alone resulted in efficient alternative pathway-mediated killing. The alternative pathway was equally efficient in a C1q,D,P-depleted serum with low concentrations of anticapsular antibody, but in this case the reaction required both D and P. PMID- 1772650 TI - Three-dimensional reconstruction of juxtaglomerular apparatus (JGA) in five-sixth nephrectomized rats. AB - In Wistar male rats, hypertension was induced by five-sixth nephrectomy (5/6N). Body weight, systolic blood pressure (SBP) and plasma renin concentration (PRC) were followed for 12 weeks after 5/6N. Three-dimensional reconstruction and morphometry of the JGA were carried out using a computer program "GLOM". Immunohistochemistry and electron microscopy of the JGA were also investigated. A statistically significant increase in SBP was shown after 5/6N. However, PRC showed no increase and was not correlated with SBP. Renin-containing cells were demonstrated in the afferent and efferent arterioles and the interlobular arteries. Electron microscopy revealed granules of various shapes, sizes and electron densities within the JG cell. The frequency of granulated cells in the efferent arteriole was less than that in the afferent arteriole. The afferent arteriole wall volume of 5/6N rats was significantly increased and positively correlated with SBP. The lack of relationship between PRC and SBP in this model suggests that mechanisms other than the renin-angiotensin system may be involved in the pathogenesis of hypertension. PMID- 1772651 TI - Specific binding of lactoferrin to Escherichia coli isolated from human intestinal infections. AB - The degrees of human lactoferrin (HLf) and bovine lactoferrin (BLf) binding in 169 Escherichia coli strains isolated from human intestinal infections, and in an additional 68 strains isolated from healthy individuals, were examined in a 125I labelled protein binding assay. The binding was expressed as a percentage calculated from the total labelled ligand added to bacteria. The HLf and BLf binding to E. coli was in the range 3.7 to 73.4% and 4.8 to 61.6%, respectively. Enterotoxigenic strains demonstrated a significantly higher HLf binding (median = 19%) than enteropathogenic, enteroinvasive, enterohaemorrhagic strains or normal intestinal E. coli isolates (medians 6 to 9). Enteropathogenic strains belonging to serotypes O44 and O127 demonstrated significantly higher HLf binding compared to O26, O55, O111, O119 and O126. No significant differences in the degree of HLf or BLf binding were found between aerobactin-producing and non-producing strains. The interaction was further characterized in a high Lf-binding EPEC strain, E34663 (serotype O127). The binding was stable in the pH range 4.0 to 7.5, did not dissociate in the presence of 2M NaCl or 2M urea, and reached saturation within two h. Unlabelled HLf and BLf displaced the 125I-HLf binding to E34663 in a dose-dependent manner. Apo- and iron-saturated forms of Lf demonstrated similar binding to E34663. Among various unlabelled subepithelial matrix proteins and carbohydrates tested (in 10(4)-fold excess) only fibronectin and fibrinogen caused a moderate inhibition of 125I-HLf binding. According to Scatchard plot analysis, 5,400 HLf-binding sites/cell, with an affinity constant (Ka) of 1.4 x 10(-7) M, were estimated in strain E34663. These data establish the presence of a specific Lf-binding mechanism in E. coli. PMID- 1772652 TI - Membranes. PMID- 1772653 TI - The protein translocation apparatus of the rough endoplasmic reticulum, its associated proteins, and the mechanism of translocation. AB - The demonstration that the yeast Sec61, Sec62, and Sec63 proteins are assembled into a multisubunit complex in the yeast endoplasmic reticulum was of particular significance in a year when protein, and nucleic-sequence analyses revealed interesting homologies between pathways of protein transport in mammals and yeast, and possibly in Escherichia coli. PMID- 1772654 TI - Degradation of proteins within the endoplasmic reticulum. AB - Certain newly synthesized proteins within the endoplasmic reticulum undergo rapid turnover by a non-lysosomal proteolytic pathway. Biochemical and morphological evidence has suggested that these proteins never leave the endoplasmic reticulum before they are degraded. The mechanism(s) for the selective targeting of proteins for degradation within the endoplasmic reticulum is still not understood, but appears to rely on specific structural determinants on the protein substrates. Important cellular functions are likely to be served by this endoplasmic reticulum degradative system, including disposal of abnormal proteins and the selective turnover of metabolically regulated proteins. PMID- 1772655 TI - Proteins involved in vesicular transport and membrane fusion. AB - In the past year, new information about proteins involved in vesicular transport has been plentiful. Particularly noteworthy are the complementary findings that Sec17p is required for vesicle consumption in endoplasmic reticulum-to-Golgi transport in yeast and that an analogous activity in mammalian cells, termed SNAP, is required for transport from the cis to the medial cisternae of the Golgi apparatus. PMID- 1772656 TI - Phospholipid-transfer proteins. PMID- 1772657 TI - Sorting of plasma membrane proteins in epithelial cells. AB - Proteins follow two routes to reach the correct surface (apical or basolateral) of a polarized epithelial cell: direct sorting from the trans-Golgi network and transcytosis from early endosomes. Several signals have been identified recently that control these sorting events, namely a glycosyl-phosphatidylinositol anchor for apical targeting, a 14-residue cytoplasmic segment of the polymeric immunoglobulin receptor for basolateral targeting, and phosphorylation of a Ser residue for transcytosis of this receptor. The machinery involved is still poorly understood. PMID- 1772658 TI - The molecular biology of K+ channels. AB - It is now clear that voltage-gated K+ channels are encoded by a set of multigene subfamilies. Expression of different members of these subfamilies, coupled with mutational analysis, has advanced our knowledge of the structure and function of voltage-dependent K+ channels. PMID- 1772659 TI - Membranes. PMID- 1772660 TI - Structure, evolution, expression and regulation of insulin-like growth factors I and II. AB - Insulin-like growth factors (IGF) I and II are chemically-related single-chain peptides with diverse actions on cellular growth and metabolism. This review will focus on recent information pertinent to the biochemical and molecular biological aspects of these peptides. Three areas will be examined: The structure of the two IGF molecules and their precursors will be analyzed; the complicated anatomy of the IGF genes and their mRNAs will be described; and the multiple ways in which the expression of IGF-I and IGF-II can be regulated will be discussed. Gaps in our understanding of these peptides will be highlighted in the context of opportunities for further investigation in this field. PMID- 1772661 TI - Ligand induced internalization of epidermal growth factor receptors by A431 cells decreases at high cell densities in culture. AB - Internalization of epidermal growth factor (EGF) receptors by human A431 epidermoid carcinoma cells was studied at various culture densities. The extent of EGF receptor internalization was measured by quantitation of internalized 125I EGF during incubation at 37 degrees C for 30 min. When cell culture density was below 1 x 10(5) cells/cm2 receptor internalization was active; 30-40% excess moles of ligand over the moles of surface EGF receptors were internalized during this period. However, when culture density increased to above 1.5 x 10(5) cells/cm2 receptor internalization became less extensive, as only 30-50% of ligand bound to the cell surface underwent internalization during 30 min incubation. In parallel with this reduction in receptor internalization, the degradation rate of 35S-methionine labeled EGF receptors was reduced at a high culture density. In contrast with this regulation of receptor internalization, the affinity of EGF receptors for the ligand increased as culture density increased. The extent of EGF-dependent receptor phosphorylation was found to be constant at all culture densities tested. Thus, the observed low level of receptor internalization at high culture densities was not attributable to lower responsiveness of receptors to EGF. These data suggest the presence of an as yet unidentified cell density-dependent mechanism for regulating receptor internalization in cultured A431 cells. PMID- 1772662 TI - Differences in the biological activities of transforming growth factor-beta and platelet-derived growth factor in vivo. AB - Transforming growth factor-beta 1 (TGF-beta 1 and recombinant platelet-derived growth factor-BB (rPDGF-BB) promoted an extensive, dose-dependent development of fibrous connective tissue when continuously delivered for 8 days by mini-osmotic pumps implanted subcutaneously in adult guinea pigs. Biochemical analyses demonstrated that TGF-beta 1 and rPDGF-BB stimulated dose-dependent increases in the dry weight, and protein, DNA, collagen, and glycosaminoglycan (GAG) contents of the fibrous connective tissue capsule that enveloped the pumps. The GAG/DNA mass ratio was markedly elevated by TGF-beta 1, but the collagen/DNA, protein/DNA, and collagen/protein ratios were not significantly increased. In contrast, rPDGF-BB generally decreased these mass ratios. Histological analyses suggested that this was due to the fact that rPDGF-BB induced a very cellular response with a marked influx of neutrophils and fibroblasts. TGF-beta 1 induced significantly less cellular response, which consisted primarily fibroblasts and macrophages. These results indicated that rPDGF-BB and TGF-beta 1 induced connective tissue deposition in vivo in a dose-dependent fashion, although the cellular nature of the responses as well as the structural composition of the extracellular matrices were clearly distinguishable between the two growth factors. PMID- 1772663 TI - The in situ expression of granulocyte-macrophage colony-stimulating factor (GM CSF) mRNA at the maternal-fetal interface. AB - Granulocyte-macrophage colony-stimulating factor (GM-CSF) is produced by cells in the placenta, is known to be a growth factor for trophoblast cells in vitro and when injected into pregnant mice at risk for mid-gestation fetal resorption, dramatically lowers the fetal death rate while stimulating placental and fetal growth. We describe here the localization of GM-CSF mRNA expression in murine placenta by in situ hybridization. It is found in small round cells (lymphoid like) and endothelial cells in the maternal decidua. In addition, GM-CSF transcripts are located in cells of the spongiotrophoblast zone (trophoblast-like cells), but not in the labyrinthine zone. These results indicate that GM-CSF may be influencing the growth and function of the fetal placenta in a paracrine autocrine manner. These results support earlier observations that link GM-CSF production during pregnancy to decidual T-lymphocytes and further suggest a placental source within the invasive trophoblast. PMID- 1772664 TI - Bronchial circulation after experimental lung transplantation: the effect of direct revascularization of a bronchial artery. AB - Direct revascularization of a bronchial artery has been proposed as a measure to alleviate the problem of bronchial ischemia after lung transplantation. To assess the effect of restoration of arterial blood flow to the transplanted bronchus, bronchial mucosal blood flow was measured in a model of modified unilateral lung transplantation in pigs. Laser Doppler velocimetry (LDV) and radioisotope studies using radio-labeled erythrocytes (RI) were used to measure blood flow at the donor main carina (DC) and upper lobe carina (DUC) after 3 h of reperfusion. The recipient carina was used as a reference point; values obtained by LDV and RI were expressed as percentage of blood flow at the recipient carina. Two groups of animals were studied. In group 1 (n = 6) standard unilateral transplantation was performed; in group 2 (n = 6) a left bronchial artery was reimplanted into the descending thoracic aorta of the recipient. No differences were observed between the two groups with respect to preoperative or postoperative gas exchange or hemodynamics. In group 1, bronchial blood flow at the DC was 37.6 +/- 2.2% (LDV) and 44.1 +/- 14.8% (RI) of reference blood flow. At the DUC, blood flow was 54.9 +/- 7.7% (LDV) and 61.6 +/- 25.7% (RI) of normal flow. In group 2, blood flow was increased at the DC as measured by LDV (55.3 +/- 17.1%; p less than 0.05) and by RI (60.8 +/- 25.3%; p less than 0.2). A similar increase was found at the DUC (LDV: 81.8 +/- 19.3%; p less than 0.05; RI: 88.6 +/- 31.0%; p less than 0.2). It is concluded that there is a significant gradient of blood flow from intra- to extrapulmonary airways after lung transplantation. Reimplantation of a bronchial artery results in significant improvement of graft bronchial blood flow. Restoration of bronchial perfusion to normal levels, however, cannot be achieved, suggesting a possible defect in the microcirculation of the donor airways. PMID- 1772665 TI - Aneurysm of the ductus arteriosus. A review of the literature and the surgical implications. AB - One hundred and forty-four cases of aneurysms of the ductus arteriosus (DAA) have been reported in the literature of which 106 appeared spontaneously and 38 followed surgical treatment of a patent ductus arteriosus (PDA). Within the last few years there has been an increasing number of reported spontaneous DAA. However, the real incidence is presumably still underestimated. Aortography is a well established diagnostic method. In neonates, transthoracic echocardiography has shown convincing potential, whereas in older children and adults, transoesophageal echocardiography has yielded very promising results. Serious complications following spontaneous DAA are rupture, erosion, infection and thromboembolism. In infants younger than 2 months of age, the complication rate is 31%, in children between 2 months and 15 years, 66%, in adults, 47%. The rate of complications following postoperative DAA is even higher: 91% of the unoperated cases died due to rupture or infection. The operative mortality in children older than 2 months and adults is low. In the neonate group, 2 of 8 died during operation. The operative mortality in patients with postoperative DAA was 26%. Based on information from the literature, we suggest prompt surgical treatment of all spontaneous DAA in patients older than 2 months of age, and in all patients with postoperative DAA. In infants, a DAA should be closely followed with echocardiography, as spontaneous regression has been reported in this age group. If no regression is seen within a few days, it should be surgically corrected. PMID- 1772666 TI - Primary repair of complete atrioventricular septal defect in infancy. AB - Forty infants with complete atrioventricular septal defect have undergone primary repair within their 1st year of life. The mean age at time of surgery was 4 months (range 1-12 months) and the mean weight 4.2 kg (range 2.9-7.0 kg). Either the one- or the two-patch method was used. Four patients died (10%). There were no late deaths. Three patients needed reoperation due to mitral valve insufficiency. Postoperative complications were: 1 total atrioventricular block in an infant with an absent ventricular septum 3 weeks after surgery, 9 complete right bundle branch blocks, 3 small residual ventricular septal defects. Mean follow-up of the 36 survivors is 22 months (3-46 months). Thirty (83%) are in NYHA functional class I, 4 (11%) in NYHA class II and 2 (6%) in NYHA class III. No atrioventricular valve regurgitation is detectable by the color Doppler technique in 19 (53%) patients. Mitral incompetence is mild in 13 cases (36%) and moderate in 4 (11%). In ten recatheterized patients the average systolic pulmonary to systemic artery pressure ratio dropped from 1.0 to 0.42 and the average pulmonary arteriolar resistance was reduced from 5.5 to 3.9 U/m2. All but one patient gained weight and underwent adequate statomotoric development. Primary repair should be performed at the age of 5-6 months or even earlier, if pulmonary arteriolar resistance exceeds 5 U/m2. PMID- 1772667 TI - Reconstruction of the superior vena cava in patients with mediastinal malignancies. AB - We performed reconstruction of the superior vena cava (SVC) and left brachiocephalic vein following extensive resection of malignant thymic tumours in eight patients, five of whom had invasive thymoma. The other patients each had a thymic Hodgkin's lymphoma, thymic carcinoma and thymic germ cell tumour. Teflon grafts were used in the first two cases and expanded polytetrafluoroethylene (EPTFE) grafts in the subsequent six cases. Occlusion occurred only in one SVC graft and two left brachiocephalic vein grafts. The mean survival after this operation was 35 months, with the longest survivor showing no occlusive symptoms for 8 years. This operation not only alleviates the symptoms of the SVC syndrome but may also improve the prognosis of such patients. PMID- 1772668 TI - Esophagocutaneous drainage to treat late and complicated esophageal perforation. AB - Five patients with complicated esophageal perforation--three with spontaneous rupture, one with dehiscence after resection of a diverticulum, and one with an iatrogenic lesion--were successfully treated by esophagocutaneous drainage of the esophageal perforation. At thoracotomy, after careful debridement and cleaning of the mediastinum and pleura, a T-tube drain was placed in the esophagus through the perforation in addition to pleural drains. A feeding jejunostomy and a gastrostomy was carried out via a separate laparatomy in 4 cases. Postoperatively the patients were managed according to a protocol with subsequent removal of pleural drains, esophageal T-tube and, after esophageal healing, gastrostomy and feeding jejunostomy. Broad-spectrum antibiotics were given initially. Healing was slow but progressive and without major problems. The healing process was followed by repeated contrast swallows. In all cases the esophagus healed without residual stenosis within 8-12 weeks. This method seems to be a way to save the life and the esophagus of patients with esophageal perforations complicated by late discovery or failure of primary repair. PMID- 1772669 TI - Results of resection for bronchogenic carcinoma with mediastinal lymph node metastases in selected patients. AB - Between 1982 and 1988, 254 consecutive patients underwent resection for bronchogenic carcinoma with mediastinal lymph node metastases at Marie Lannelongue Hospital. Selection of cases for surgery was carried out using CT and mediastinoscopy. The surgical procedure performed were pneumonectomy (169), lobectomy (65), or bilobectomy (20) associated with resection of ipsilateral mediastinal lymph nodes. Almost all diseased nodes appeared grossly enlarged at surgery and only a few were of normal size. Postoperative mortality was 5.6%. Resection was potentially curative in 191 cases (75%) and palliative in 63 cases (25%). Almost all patients received adjuvant treatment (mainly radiotherapy). Actuarial 5-year survival was 18% for the entire group, and 23% for those who underwent curative resection. No patient with palliative resection survived 5 years. The following factors proved to be significantly associated with a better prognosis: complete resection, independent lymph node metastases, involvement of only one level, lower paratracheal involvement. On the other hand, there was no difference between pathological types (squamous cell carcinomas, adenocarcinomas, oat cell carcinomas) with regard to prognosis. We advocate an aggressive approach in selected cases of N2 bronchogenic carcinoma. Neoadjuvant chemotherapy should be tested in these specific patients with a view to the possibility of improving results. PMID- 1772670 TI - Thromboembolism in patients with pericardial valves in the absence of chronic anticoagulation: 12 years' experience. AB - Between January 1977 and January 1989, 465 pericardial bioprostheses were implanted in 424 patients. The mean age of patients was 59.1 years (range 16-81 y.) At the time of surgery, 68% of the patients suffered from chronic atrial fibrillation. Mitral valve replacement was performed in 167 patients, aortic valve replacement in 216, multiple replacement in 40 (36 mitral and aortic, 3 mitral and tricuspid, and 1 mitral, aortic and tricuspid), and 1 pulmonary valve replacement. The different types of pericardial valve used were: Ionescu-Shiley 408, Mitral Medical 23, Bioflo 30, and Hancock 4. Hospital mortality was 10.1% with an attrition rate of 1.8 episodes per 100 patients/year. The 12-year actuarial survival rate was 65.1%. No patient underwent long-term anticoagulant treatment. The first 144 patients undergoing mitral and multiple valve replacements received temporary anticoagulation for the first 8 weeks after surgery. There was no valve thrombosis observed. Altogether 19 thromboembolic events (6 early and 13 late) were clinically documented. One patient died after an embolic event. The linearized rates of thromboembolism were 1.64 episodes per 100 patients/year for mitral and multiple valve replacements and 0.33 episodes per 100 patients/year for aortic valve replacement, with an overall rate of 1.0 episodes per 100 patients/year. Excluding early thromboembolism, the linearized rate was 1.02 episodes per 100 patients/year overall. The actuarial freedom from embolism was 92.4% overall, 88.2% for the mitral and multiple valve replacement group, and 97.6% for the aortic valve replacement group at a maximum follow-up of 12 years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772671 TI - Global and regional ventricular function following intracoronary application of papaverine. AB - Intracoronary injection of papaverine is used to determine coronary flow reserve in patients. The present study was to investigate the effect of papaverine on the performance of myocardium with reduced flow reserve. In nine anaesthetized open chest dogs a bypass from the aorta to the left circumflex coronary artery (LCX) was established. Left ventricular end-diastolic and aortic pressure, dP/dt, stroke volume, LCX blood flow, and ECG were monitored. The performance of a segment of subendocardial wall supplied by the LCX was assessed by sonomicrometry. Peak reactive hyperaemia after 15s bypass occlusion was 1.44 +/- 0.09 times the baseline flow (41 ml/min), indicating reduced coronary flow reserve. Papaverine was injected into the bypass (0.3, 0.6, 1.2, 2.5, 5.0 mg/ml, 1 ml in 15s). The maximum LCX flow following PAPA 0.3 mg was comparable to peak reactive hyperaemia, but 10-15% higher after injection of 0.6-5.0 mg papaverine. Systolic shortening of the myocardium (control: 17.5% of end-diastolic length) became reduced in a dose-dependent fashion (5-25%) for about 1 min following papaverine injection. Stroke volume (control: 0.94 +/- 0.12 ml/kg) was reduced by about 8%, left ventricular end-diastolic pressure (control: 6.2 +/- 0.8 mmHg) increased by 15%, and dP/dtmin (control: 1850 +/- 150 mmHg/s) was curtailed by 15 25%. The ECG showed a transient T inversion and S-T depression following papaverine administration and in one experiment ventricular fibrillation occurred after the injection of 2.5 mg papaverine. The observed effects of intracoronary papaverine are consistent with the theory of transient subendocardial ischaemia arising from a redistribution of blood flow from the subendocardial to the subepicardial layers, because of greater vasodilatory capacity in the latter than in the former. PMID- 1772672 TI - Resection of central primary pulmonary artery sarcoma. AB - Primary sarcomas of the pulmonary arteries are rare, and the diagnosis is in the majority of the reported cases established postmortem. Surgical resection of these centrally located tumors has been performed either by pneumonectomy and/or local tumor resection. We report on two patients with sarcomas of the central pulmonary arteries who underwent successful resection of the tumor and prosthetic replacement of the arteries under cardiopulmonary bypass. One patient required additional thromboendarterectomy of the right pulmonary artery branches because of secondary thrombus formation. As primary pulmonary artery sarcomas are refractory to both chemotherapy and radiation, surgical resection remains the only means of treatment. The prognosis depends entirely upon resectability, which, if necessary, should be performed with the aid of cardiopulmonary bypass. In this way, lung resection may be avoided. PMID- 1772673 TI - Congenital aortic regurgitation caused by absence of the right coronary cusp. AB - We describe a patient with congenital aortic regurgitation, well documented from the age of 1 month. Surgery was performed at the age of 7 years, when echocardiography showed progressive dilatation of the left ventricle with decreasing shortening fraction. Inspection of the valve during the operation showed a basically tricuspid valve, but with a rudimentary right coronary cusp. At histological examination, myxoid dysplasia was found in all the cusps. An aortic homograft was inserted and the left ventricular internal dimensions returned to normal within 3 months after the operation. PMID- 1772674 TI - Combined subclavian artery rupture and delayed bronchial stenosis from blunt chest trauma. AB - A 23-year-old man suffered crush injury to the thorax resulting in rupture of the left subclavian artery and left main bronchus. The arterial injury was diagnosed immediately and successfully repaired. Despite the presence of bilateral pneumothoraces and mediastinal and chest wall emphysema the bronchial injury was not initially diagnosed because both lungs re-expanded with tube thoracostomies. The patient re-presented 5 weeks later with complete atelectasis of the left lung. Bronchoscopy revealed a fibrotic stenosis of the left main bronchus. The stenosed segment was completely excised and the cut ends anastomosed with full re inflation of the lung. PMID- 1772675 TI - Gerbode ventricular septal defect following endocarditis. AB - A Gerbode defect is a ventricular septal defect communicating directly between the left ventricle and right atrium. There has been some debate about the existence of such an entity. We present the case of a previously healthy 15-year old boy who developed bacterial endocarditis following ear piercing and was subsequently found to have a defect between the left ventricle and right atrium, which was successfully repaired surgically. PMID- 1772676 TI - Silent left ventricular dysfunction during exercise after coronary artery bypass surgery. AB - Serial changes in left ventricular function during exercise were assessed by radionuclide continuous ventricular function monitoring in 80 patients undergoing coronary artery bypass surgery before and after operation. This monitor records serial beat by beat radionuclide and electrocardiographic data and calculates the left ventricular ejection fraction every 20s. The profiles of ejection fractions during graded bicycle exercise were divided into 4 types. In type A, the ejection fraction continued to increase. In type B, the ejection fraction initially increased but decreased in late exercise. In type C, the ejection fraction did not change. In type D, the ejection fraction continued to decrease. Type A is considered to be the normal response to exercise and types B, C and, D are considered to be abnormal responses. Before operation, 8 patients showed type A, 21 type B, 13 type C, and 38 type D. After operation, 53 patients showed type A, 16 type B, 8 type C, and 3 type D. The mean ejection fraction decreased with exercise from 53% +/- 11% to 47% +/- 11% before surgery, but increased with exercise from 55% +/- 10% to 64% +/- 14% after surgery. During postoperative exercise, no patient developed chest pain but 19 patients showed a decrease in the ejection fraction in early or late exercise. A decrease in the ejection fraction is an earlier indicator of myocardial ischaemia than angina or electrocardiographic changes. Silent left ventricular dysfunction during postoperative exercise was considered to reflect myocardial ischaemia resulting from occluded grafts, ungrafted coronary arteries, or inadequate perfusion by arterial grafts. The radionuclide continuous ventricular function monitor can detect silent left ventricular dysfunction after coronary artery bypass surgery. PMID- 1772677 TI - Decision-making aspects in the timing of surgical intervention in aortic rupture. AB - Twenty-one consecutive patients with traumatic rupture of the thoracic aorta were treated at the University Hospital of Basel, Switzerland. The patients were divided into two groups according to their clinical status at the time of surgery. Six patients with unstable vital functions underwent immediate surgery (group 1), while 15 patients were operated upon semi-urgently because of delayed diagnosis or electively (group 2). Five of 6 patients undergoing immediate repair in group 1 died intraoperatively, 3 of 15 patients with deferred surgery expired postoperatively after a period of 6 weeks to 3 months. All 13 survivors underwent follow-up for 10 months to 20 years. NMR imaging of the aorta in 12 patients revealed neither pseudoaneurysms nor stenosis at the anastomoses. The results indicate that the timing of the surgical intervention in stable contained aortic rupture with serious associated injuries should preferably be deferred until after stabilization of the clinical status. PMID- 1772678 TI - Pulmonary hypertensive crises following surgery for congenital heart defects in young children. AB - In this clinical study, 20 high risk infants and neonates were monitored to identify and characterize pulmonary hypertensive crises following surgery for congenital cardiac defects. Monitoring included right ventricular or pulmonary artery pressure catheters and transcutaneous oximetry. Eleven patients also had continuous analog recording of hemodynamic data so that antecedents of crises and the sequence of events following treatment could be reconstructed. Eleven of the 20 patients had one or more crises. Six of these ultimately died whereas 5 patients survived with aggressive vasodilator therapy. Four patients without crises but with episodic pulmonary hypertension benefitted from pulmonary vasodilator therapy to ease weaning from ventilatory support. Typically, each crisis was associated with a stress event. Crises were difficult to ablate if not rapidly treated and multiple crises would often cluster following an initial event. High dose narcotic (fentanyl) analgesia was found to be important in the postoperative management. Tolazoline and oxygen were the most consistently useful vasodilators, but isoproterenol and nitrates also played a role. Five of the children who died were examined post mortem: histologically, there was increased pulmonary arterial muscularization in 2, in none were there changes of fixed pulmonary vascular disease. The postoperative management must be individualized on the basis of monitored responses of pulmonary circulation. PMID- 1772679 TI - The influence of age on the durability of Carpentier-Edwards biological valves. Thirteen years follow-up. AB - Two hundred and ninety-nine patients received 325 Carpentier-Edwards biological valves from April 1976 to April 1982. Valves were placed in the following positions: 150 aortic (AVR), 120 mitral (MVR), 26 multiple (MR), 2 pulmonary (PR) and 1 tricuspid (TR). The mean age was 54.7 years. The total follow-up time was 2545 patient-years. Patients were divided into different age groups: less than 40, 40-49, 50-59, 60-69 and greater than 70 years and were followed-up for reoperations and tissue failure. Ninety-three operations were performed in 91 patients (30.5%) for valve related dysfunctions. The main cause of reoperation was primary tissue failure (85%). The respective incidence and risk of reoperation in the different age groups were 51.5% and 5%, 41.5% and 4%, 32% and 3%, 18% and 2.5%, and 0% for greater than 70 years of age. The risk of reoperation decreased significantly with increasing age (P less than 0.05). The respective incidence and risk of tissue failure in the age groups were 43.8% and 4.1%, 35% and 4%, 27.3% and 3.2%, and 17.2%, 2.4% and 0%. The freedom from reoperation and tissue failure was significantly higher in the older patient (greater than 60 years) compared to the younger patients (less than 60 years). The commonest cause of failure in young patients was calcification, while in older patients it was cusp rupture. Comparing aortic and mitral bioprostheses in the different age groups showed no difference between these valves in patients less than 50 years of age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772680 TI - Risk factors for total and cause-specific mortality in human cardiac transplantation. Prolonged extracorporeal bypass time: a high risk factor for rejection and infection. AB - Data from the first 103 human heart transplantations in 100 recipients performed at a single centre from November 1983 to January 1990 were analysed to detect risk factors for overall and cause-specific mortality. Twenty-two patients died. Cumulative 1 year graft survival was 82% and 5 year, 68%. Acute and chronic rejection was the cause of death in 9 patients, disseminated infection in 8 and cancer in 3. One patient died from cerebral haemorrhage and 1 from acute cardiac failure. The mean observation time was 803 days (range: 1-2 308 days). Total follow-up was 226.6 graft years. Risk factors were analysed by univariate and multivariate methods. The type of immunosuppression regimen and recipient age above 50 years were independent risk factors for mortality. Histocompatibility mismatching (HLA-DR) and type of immunosuppression were independent risk factors for lethal rejection and a female recipient was an independent risk factor for lethal infection. Prolonged time on extracorporeal bypass was an independent risk factor for both lethal rejection and infection, and also for overall mortality. The impact of extracorporeal bypass time on rejection and infection is discussed, and the importance of prospective HLA matching in heart transplantation is stressed. The association between recipient female sex and infection remains uncertain. PMID- 1772681 TI - Gianturco self-expanding metallic stents in treatment of tracheobronchial stenosis after single lung and heart and lung transplantation. AB - Three patients with recurrent bronchial stenosis following single lung transplant (SLTx), and one patient with tracheal stenosis following heart-lung transplantation (HLTx), not responding to repeated dilatations (3 patients) and prolonged use of silastic stents (patient with tracheal stenosis), have been treated by the endoscopic insertion of Gianturco self-expanding metallic stents under fluoroscopic control. The stent resulted in immediate improvement in respiratory function in all four patients. One patient (SLTx) had early bronchial re-stenosis due to growth of granulation tissue within the stent which was successfully treated by cryotherapy. In one patient (HLTx), a left lower lobe bronchial stenosis developed 14 months after tracheal stenting. The metallic stent appears to be a promising device in the management of recurrent or resistant bronchial stenosis following SLTx or tracheal stenosis after HLTx. PMID- 1772682 TI - Tumor-related obstruction of the inferior vena cava extending into the right heart--a plea for surgery in deep hypothermic circulatory arrest. AB - This study reviews eight patients, 39-63 years old, with tumor-related obstruction of the inferior vena cava (IVC) extending into the right atrium (n = 5) and ventricle (n = 3). Five patients suffered from renal cell carcinoma, 3 from sarcomatous disease. The general approach was a median sternotomy and laparotomy with hypothermic circulatory arrest (17.0-20.5 degrees C; 23-46 min) in six patients, while in two patients, the IVC was clamped sequentially under moderate hypothermia and extracorporeal circulation. Four patients had tumor infiltration of the IVC necessitating partial caval resection. In three, the IVC was reconstructed by fabric patches or tubular prothesis. In one patient, the continuity of the IVC was interrupted permanently. Three patients underwent nephrectomy during the same procedure, two before and one after IVC disobliteration. In one patient each, pulmonary embolectomy and intrahepatic IVC stenting were performed. Two patients died early, one due to uncontrollable hemorrhage the other due to non-cardiogenic pulmonary edema. Six patients were discharged in good physical condition and are still alive at a mean follow-up of 24 months. Five patients have since remained free of recurrence, one patient underwent three further surgical interventions for bone metastases. We feel that IVC desobliteration is feasible in selected cases with extended tumor-related obstruction with an acceptable early risk and late outcome. PMID- 1772683 TI - Spontaneous rupture of the ascending aorta. AB - A case of spontaneous non-traumatic rupture of the thoracic aorta in a hypertensive patient is presented. The clinical findings suggested acute aortic dissection, and a large pericardial effusion was detected by echocardiography. The typical angiographic features of aortic dissection were not found. Autopsy revealed a longitudinal intimal tear and a rupture in the postero-lateral aspect of the ascending aorta. No false lumen was seen in the ascending aorta. When acute intrapericardial or intrapleural bleeding develops with no evidence of aortic aneurysm or dissection, spontaneous aortic rupture should be suspected. PMID- 1772684 TI - Early rupture of a saphenous vein graft. AB - Early rupture of a saphenous vein graft used for coronary artery surgery has not been previously reported. In a 69-year-old man having a third coronary by-pass procedure, one of the saphenous vein grafts ruptured on the 8th postoperative day. The other vein graft showed marked aneurysm formation at two sites. Histological examination of the ruptured graft revealed that this was due to a bacterial infection within the wall of the vein. Although he survived an emergency operation to control the haemorrhage and replace the ruptured graft, he died some days later of mediastinitis. It appeared that both the rupture of the graft and the ensuing mediastinitis were due to a primary infective process within the saphenous vein used for the graft. PMID- 1772685 TI - Hypertensive disorders in pregnancy. The role of eicosanoids. AB - Pregnancies complicated by hypertensive disorders are always extremely hazardous for mother and child. In up to 30% of pregnant women this disease is characterized by feto-maternal dysfunction, looking like a kind of "chronic anaphylactoid reaction". As a result of defective genetic control, immunologic events seem to be the central etiologic aspect. Arteriolar vasospasm, pathology of platelets, disseminated intravascular coagulation and finally, elevation of maternal blood pressure, all these symptoms can be regarded as a reaction to immunologic processes. The central role of eicosanoids in the pathogenesis of pregnancy induced hypertension/preeclampsia-eclampsia is generally accepted. We can explain almost all known pathophysiologic abnormalities to be the consequence of disturbed eicosanoid production in a multitude of organs or organ systems. Defective placentation provokes poorly perfused placental tissue. This is correlated with endothelial cell disorder, endothelial damage and denudation. The resulting platelet activation, dysfunction of coagulation and vasoconstriction are due to an increased ratio between vasoconstricting and vasodilating eicosanoids. The suppression of prostacyclin (and PGE) formation in the fetal placental-maternal unit even before the clinical manifestation of the disease seems to be the conditio sine qua non. So, the homeostatic response to the effects of vasoconstrictors (such as angiotensin, serotonin etc.) in the general and in the placental circulation is impaired. The depressed prostacyclin (and PGE) biosynthesis can be measured in urine. Altered urinary metabolite excretion appears to be a very early index for patients at risk to develop pregnancy induced hypertension. PMID- 1772686 TI - Increased concentrations of eicosanoids and platelet-activating factor in menstrual blood from women with primary dysmenorrhea. AB - Prostanoids, leukotrienes and platelet-activating factor were measured by radioimmunoassay in menstrual blood of seven women with primary dysmenorrhea and five healthy controls. The eicosanoids and PAF concentrations in dysmenorrheic patients were significantly higher than those found in healthy women (P less than 0.005 for PGF2 alpha, 11-dehydro-TXB2, 2,3-dinor-TXB2 and LTC4/D4; P less than 0.001 for PAE; P less than 0.05 for PGE2 and 2,3-dinor-6-keto-PGF1 alpha). Whereas no relationship could be found between the concentrations of PGF2 alpha, PGE2, 11-dehydro- and 2,3-dinor-TXB2 and severity of primary dysmenorrhea, a close correlation between LTC4/D4 and PAF and severity of the disease was observed, particularly in patients who responded poorly to therapy with prostaglandin synthetase inhibitors. We conclude that the hyperstimulation of myometrial activity is not caused by selective stimulation of one metabolic pathway of arachidonic acid, but rather by an overall stimulation of phospholipid metabolism. The assessment of prostanoids, leukotrienes and PAF in menstrual blood many be useful as a direct index of primary dysmenorrhea, and the development of their antagonists may have therapeutic implications in improved treatment of the disease. PMID- 1772687 TI - Differential metabolism of intracellular and extracellular arachidonic acid by decidual stromal cells and macrophages. AB - Term decidual stromal cells metabolized extracellular arachidonic acid to cyclo oxygenase, lipoxygenase and epoxygenase products. Prostaglandins were the major metabolites from extracellular arachidonic acid. In contrast, intracellular arachidonic acid was metabolized mainly to an epoxygenase product, together with some lipoxygenase products. Decidual macrophages showed similar results, though these cells had higher production rates per cell of most metabolites. The calcium ionophore A23187 increased the levels of arachidonic acid released from the intracellular stores of decidual stromal cells and had variable effects on the production of cyclo-oxygenase, lipoxygenase and epoxygenase metabolites. Less than 15% of the total metabolites released from A23187-stimulated cells were cyclo-oxygenase products, which suggested that the cyclo-oxygenase products released by decidual stromal cells or macrophages may be mainly derived from extracellular arachidonic acid. This implies that the regulation of decidual cyclo-oxygenase may have a major role in determining prostaglandin output from this tissue. PMID- 1772688 TI - NADPH-dependent formation of 15- and 12-hydroxyeicosatrienoic acid from arachidonic acid by rat epidermal microsomes. AB - Rat epidermal microsomes were incubated with [1-14C]-arachidonic acid for 30 min at 37 degrees C in the absence and presence of NADPH. The arachidonate metabolites that eluted in the "monohydroxy acid fraction" on reverse-phase high performance liquid chromatography (HPLC) were methylated, purified by straight phase HPLC and analyzed by chromatography with standard compounds, UV spectroscopy and/or gas chromatography-mass spectrometry (GC-MS). In the absence of NADPH, epidermal microsomes converted arachidonic acid to two major products identified as 15(S)-hydroxy-5,8,11,13-eicosatetraenoic acid (15(S)-HETE) and 12(S)-hydroxy-5,8,10,14-eicosatetraenoic acid (12(S)-HETE). In the presence of NADPH, the microsomal reaction produced, besides 15(S)- and 12(S)-HETE, two less polar metabolites which were characterized as 15-hydroxy-5,8,11,-eicosatrienoic acid (15-HETrE) and 12-hydroxy-5,8,14-eicosatrienoic acid (12-HETrE). Stereochemical analysis by chiral-phase HPLC showed that the biosynthesized 12 HETrE consisted of a mixture of optical isomers in a S/R ratio of 65:35. Formation of 15- and 12-HETrE was blocked by the mixed cyclooxygenase lipoxygenase inhibitors quercetin and phenidone but was not affected by the cyclooxygenase inhibitor indomethacin or the cytochrome P-450 monooxygenase inhibitor metyrapone. These data indicate that rat epidermal microsomes, supplemented with NADPH, are capable of metabolizing arachidonic acid to 15- and 12-HETrE. The production of these compounds may be initiated by lipoxygenase mediated hydroperoxidation of arachidonic acid. PMID- 1772689 TI - Increased prostacyclin biosynthesis in patients with osteoid osteoma. AB - Osteoid osteoma is a benign osteoid-forming tumor of the bone characterized by pain which is relieved by nonsteroidal anti-inflammatory drugs. Very high levels of prostaglandins have been found in the lesion. In nine patients with osteoid osteoma, prostaglandin E2 (PGE2) and prostacyclin (PGI2) synthesis in explants from the nidus incubated in vitro yielded 947.3 +/- 482.6 (mean +/- SD) and 340.2 +/- 178.1 pg/mg of wet tissue respectively, values 32 and 49 times higher than in fragments of normal bone. In eight patients the excretion rate of the major urinary metabolite of PGI2, i.e. 2,3-dinor-6-keto-PGF1 alpha, was nearly double the control value (499 +/- 93 vs 257 +/- 117 pg/mg of creatinine; mean +/- SD). In six of them, from whom urine was collected 1 month after surgery, urinary 2,3 dinor-6-keto-PGF1 alpha decreased significantly (P less than 0.01) from 487 +/- 100 to 229 +/- 52 pg/mg creatinine. Urinary 6-keto-PGF1 alpha, largely a reflection of intrarenal PGI2 synthesis, was comparable to the control group (4.6 +/- 0.9 vs 4.5 +/- 1.0 ng/h, respectively) and remained unchanged after operation. These results suggest an enhanced PGI2 biosynthesis in vivo in patients with osteoid osteoma. This abnormality of arachidonate metabolism is consistent with enhanced biosynthetic capacity of the tumor in vitro, and is reversible upon its removal. PMID- 1772690 TI - The diagnostic value of immediate post-exercise left ventricular ejection fraction (LVEF). AB - The diagnostic value of immediate post-exercise left ventricular ejection fraction (LVEF) was assessed in 161 patients at rest, during maximal exercise, and immediately post-exercise by radionuclide angiography. Fifteen patients had a second examination, giving a total of 176 radionuclide examinations. Additionally, the correlation between post-exercise LVEF and physical validity was investigated. Sixty-one patients (35%) with a recent myocardial infarction (less than 4 weeks), 66 patients (37%) with an old myocardial infarction (greater than 4 weeks), and 21 patients (12%) with valvular lesions were studied. Twenty eight patients (16%) with an abdominal aneurysm were considered as controls based on history and a normal resting and exercise electrocardiogram (ECG). LVEF and a cumulative regional wall motion (RWM) score for three regions were obtained. LVEF post-exercise was significantly increased compared to LVEF at maximal exercise in all four diagnostic groups. Absolute LVEF values were significantly dependent on the level of exercise. We conclude that immediate post-exercise LVEF should not be used for separating patients with and without coronary artery disease. PMID- 1772691 TI - Measurements of the effect of dipyridamole on regional myocardial blood flow with positron emission tomography and the first-pass flow model. AB - We assessed percent changes of regional myocardial blood flow (RMBF) after infusion of dipyridamole (0.56 mg/kg) with dynamic N-13 ammonia PET and the first pass flow model. Positron emission tomography (PET) was performed at rest and after infusion of dipyridamole in 17 participants [five normal subjects, five patients with hypertrophic cardiomyopathy (HCM), and seven patients with coronary artery disease]. Dipyridamole increased RMBF 126 +/- 69% (mean +/- SD) in normal subjects and 55 +/- 43% in the patients with HCM. In the cases of coronary artery disease, the percent changes of RMBF were +19 +/- 19% in ischemic areas and +76 +/- 23% in nonischemic areas. These results demonstrate that N-13 ammonia dynamic PET study is useful in assessing the percent changes of RMBF induced by dipyridamole infusion. PMID- 1772692 TI - Aortic root dimension measurement by first-pass radionuclide angiography. AB - A method for measuring the ascending aortic cross-sectional dimension is reported. First-pass radionuclide angiocardiography was performed in 53 patients with various cardiac diseases. The number of pixels from superior vena cava/right atrium junction to the main pulmonary artery were counted horizontally and converted to distance in centimeters. Aortic root size was also measured in these patients by M-mode echocardiography performed within 6 months of the radionuclide study. The two methods were compared by regression analysis. The correlation coefficient between the methods was 0.76, and the standard deviation of the regression was 0.23 cm. This radionuclide method has an accuracy which can be clinically useful for size assessment of the ascending aorta. PMID- 1772693 TI - The value of parenchymal transit time index of Tc-99m DTPA diuretic renography in the evaluation of surgery in chronic bilharzial obstructive uropathy. AB - Selection of patients with chronic bilharzial uropathy (CBU) for surgery is a difficult problem due to the presence of grossly dilated urinary tracts without a significant obstruction in most of the cases. In this prospective study of 40 patients with CBU, the time-activity curve (TAC) patterns of the pre- and postoperative Tc-99m DTPA diuretic renography (RDR) studies were compared with the corresponding parenchymal transit time indices (PTTI). The aims were to find out which of these renographic parameters was more accurate in identifying obstruction and which was better in predicting the outcome of surgery. PTTI was more sensitive than TAC in identifying obstruction (96% and 92%, respectively) but it was less specific (78% and 98%). The detection accuracy of RDR for obstruction using TAC patterns was 96% compared to 84% using PTTI. Being independent of renal uptake function, PTTI could not predict the outcome of surgery as TAC could. In contrast to PTTI, TAC patterns could differentiate obstructed kidneys from severely nephropathic kidneys. However, PTTI was useful in identifying kidneys with residual nephropathy. PMID- 1772694 TI - Prostaglandin E1 and papaverine: a comparative study on the ability to increase the penile bloodpool as measured by the 99mTc-penogram in the baboon model. AB - The evaluation of arterial blood supply and venous drainage of the penis is essential in assessing the impotent male. The vaso-active drugs prostaglandin E1 and papaverine, as intracavernous injections, cause penile erections in humans by influencing the arterial blood supply and venous drainage. These drugs were used in the normal baboon and in vascular compromised baboons using a 99mTc-penogram to quantify the vascular status of the penis. Ligation of the A. Iliaca Interna was performed to change the penile blood supply, thus compromising the vascular supply. It was observed that pre- and post-operatively, the increase in the penile bloodpool was more dramatic although not significantly so (P less than 0.05), but more variable after papaverine than with prostaglandin E1. The effect was even more enhanced (P less than 0.05) in the vascular compromised baboons so that the occurrence of priapism after papaverine can speculatively not be excluded. Also the more consistent vasoactive response after prostaglandin E1 seems to establish it as the superior intracavernous injectable agent. PMID- 1772695 TI - Animal tumor models for the evaluation of in-vivo diagnostic radiotracers. PMID- 1772696 TI - Physiological considerations in imaging liver metastases from colorectal carcinoma. AB - Approximately 150,000 new cases of colorectal cancer are discovered annually in the United States; 20,000 of these, or 15%, are potentially resectable for cure by current surgical criteria. Knowledge of the presence or absence of hepatic metastases from colorectal cancer is critical to the application of these criteria. This knowledge is also important during the follow-up period. We discuss the pathophysiology of these lesions and current diagnostic approaches. PMID- 1772697 TI - mRNA quantitation by a simple and sensitive RNAse protection assay. AB - An RNAse protection assay is described that increases substantially the degree of precision with which one can measure the mRNA levels in cells and tissues through the use of the internal standard. The assay can be used to measure any mRNA for which the corresponding cDNA is available. We describe here the use of the assay to measure the apolipoprotein (apo)-A-I, apo-B, and apo-E mRNA levels in tissues from the cynomolgus monkey. cDNA fragments derived from each mRNA were subcloned into pGEM-9Zf(-), a vector containing a polylinker that is flanked by the SP6 and T7 RNA polymerase promoters. That series of plasmids, called RNA quantitation vectors (pRQV-AI, B, or E), permitted the synthesis of a sense RNA strand and an antisense RNA strand for the gene of interest. The sense stand was used as the internal standard and added to the RNA to be analyzed just prior to initiation of the assay. The radiolabeled antisense strand served as the probe. By including some nucleotides derived from the vector, we were able to design both the internal standard and the probe such that, after solution hybridization and RNAse digestion, the size of the protected internal standard-probe fragments was different from that of the authentic mRNA-probe fragments. Those fragments were then separated by gel electrophoresis, and the radioactivity in the authentic mRNA band was compared to that in the internal standard band. The mass of the authentic mRNA could then be calculated from the ratio of the radioactivity in each band and the mass of the internal standard. PMID- 1772698 TI - The future of laboratory automation. AB - Among the many factors that will define the laboratory of the future are the development of advanced computer communications systems, artificial intelligence, robotic systems, and material storage and retrieval systems. This article examines some of these factors and challenges current automation justification procedures in light of the greater competitive environment of today. PMID- 1772699 TI - Human patterning and chronic pain. PMID- 1772700 TI - A philosophical study of the art of nursing explored within a meta-theoretical framework of philosophy of art and aesthetics. PMID- 1772701 TI - Transcultural exploration of measurement scales for the study of Rogers' science of unitary human beings. PMID- 1772702 TI - "The chamber of light". PMID- 1772703 TI - The art of nursing is the imaginative and creative use of nursing knowledge. PMID- 1772704 TI - Nursing: science of irreducible human and environmental energy fields. Glossary. PMID- 1772705 TI - Antihypertensive drugs and plasma lipids. PMID- 1772706 TI - Assessment of anomalous systemic and pulmonary venous connections by transoesophageal echocardiography in infants and children. AB - OBJECTIVE: To assess the value of transoesophageal echocardiography in the preoperative definition of systemic and pulmonary venous connections. DESIGN: Transoesophageal echocardiographic studies were performed prospectively under general anaesthesia in 76 consecutive unoperated children. Results were compared with those obtained by earlier transthoracic ultrasound studies (n = 76), cardiac catheterisation (n = 62), and subsequent surgical inspection (n = 58). SETTING: Two tertiary referral centres. PATIENTS: 76 unoperated infants and children (age 0.2-14.8 years, mean age 4.1 years) with congenital heart disease. MAIN OUTCOME MEASURE: Identification of anomalous systemic and pulmonary venous connections. RESULTS: Transoesophageal studies showed anomalous venous connections in 14 patients. Two had both anomalous systemic and pulmonary venous connections. Transoesophageal studies showed 12 anomalous systemic venous connections in nine patients. In eight patients these were confirmed at operation or catheterisation: one patient is awaiting operation. Six anomalous systemic venous connections were missed during earlier transthoracic studies. Anomalous pulmonary venous connections (one mixed total, six partial) were shown in seven patients. These were confirmed at operation in six and by cardiac catheterisation in one. Four of these patients were missed during earlier transthoracic ultrasound studies. No patient defined as having normal venous connections by the transoesophageal study was subsequently shown to have anomalous venous connections at operation or angiography. CONCLUSIONS: Transoesophageal echocardiography is a highly sensitive tool for the preoperative definition of systemic and pulmonary venous connections. In this series it was better than transthoracic ultrasound and complemented cardiac catheterisation and angiocardiography. PMID- 1772707 TI - Increased plasma viscosity and erythrocyte aggregation: indicators of an unfavourable clinical outcome in patients with unstable angina pectoris. AB - OBJECTIVE: To determine the prognostic significance of altered plasma viscosity and erythrocyte aggregation in unstable angina. DESIGN: A prospective study of 96 consecutive patients with unstable angina allocated to one of two groups according to predefined threshold values for plasma viscosity and erythrocyte aggregation at study entry. The patients received a standardised treatment and were followed up for six months or until angioplasty or bypass surgery. MAIN OUTCOME MEASURE: Frequency of myocardial infarction. RESULTS: Myocardial infarctions occurred in 7/26 patients with a plasma viscosity greater than or equal to 1.38 mPa s and in 8/35 with a rate constant of erythrocyte aggregate formation greater than or equal to 0.5 mPa (corrected for plasma viscosity) but in only 4/70 with a plasma viscosity less than 1.38 mPa s and in 3/61 with an erythrocyte aggregation less than 0.5 mPa (odds ratios: 6.1 (95% confidence interval 1.3 to 31), p = 0.008, and 5.7 (95% CI 1.2 to 35), p = 0.016). Plasma viscosity and erythrocyte aggregation were more predictive of myocardial infarction than age, male gender, fibrinogen concentration, ST segment abnormalities, or coronary score. Furthermore, Holter monitoring with ST segment analysis showed that ischaemic episodes were more common in patients in whom the rate constant of erythrocyte aggregate formation was greater than 0.5 mPa (15/27 v 17/50, p = 0.029). Cardiac troponin T release was increased in patients with a plasma viscosity of greater than 1.38 mPa s (10/26 v 9/70, p = 0.010). CONCLUSIONS: In patients with unstable angina a considerable increase in plasma viscosity and erythrocyte aggregation identified a subgroup of patients at a high risk of acute myocardial infarction in whom medical treatment was likely to be unsuccessful. PMID- 1772708 TI - Effect of single lung transplantation on pulmonary hypertension in patients with end stage fibrosing lung disease. AB - OBJECTIVE: To investigate the effect of successful single lung transplantation on pulmonary haemodynamic variables and right ventricular function. DESIGN: Pulmonary haemodynamic variables and right ventricular function were measured at right heart catheterisation after single lung transplantation. The results were compared with the preoperative pulmonary haemodynamic variables measured at the time of assessment for transplantation. SETTING: A tertiary referral centre. PATIENTS: Five survivors of single lung transplantation performed for end stage lung disease. INTERVENTIONS: Cardiac catheterisation in all five patients at a mean of 18 months postoperatively. Preoperative catheter data were available for comparison in four. Right heart pressures and cardiac output were measured and right ventricular angiography was performed. Perfusion scans performed for clinical reasons were used to assess the percentage of cardiac output passing through each lung. MAIN OUTCOME MEASURES: Right heart pressures, cardiac output, right ventricular function, percentage perfusion to lungs. RESULTS: After operation mean peak right ventricular pressure fell from 53 mm Hg to 33 mm Hg, mean pulmonary artery pressure from 33 mm Hg to 18 mm Hg, total pulmonary resistance from 11.2 U x m2 to 5.8 U x m2, and pulmonary arteriolar resistance from 8.9 U x m2 to 3.6 U x m2. Pulmonary artery wedge pressure and cardiac index were unchanged. Right ventricular function improved in all patients. The transplanted lung received most of the cardiac output. CONCLUSION: In patients with moderate pulmonary hypertension and right ventricular dysfunction secondary to end stage fibrosing lung disease single lung transplantation was followed by an improvement in pulmonary haemodynamic variables and right ventricular function. PMID- 1772709 TI - Abnormal right heart filling after cardiac surgery: time course and mechanisms. AB - OBJECTIVE: To study the time course and underlying mechanisms of right heart filling after cardiac surgery. DESIGN: A prospective observational study of adult patients undergoing cardiac surgery. SETTING: Echocardiography laboratory of the Stanford University Medical Center. PATIENTS: Twenty six patients (mean age 54.9) undergoing cardiac surgery were studied before and two days, one week, six weeks, and six months after cardiac surgery. MAIN OUTCOME MEASURES: Flow in the hepatic veins and superior vena cava, tricuspid and mitral annulus motion, signs of tricuspid regurgitation, and right ventricular size were assessed by echocardiography. RESULTS: Right heart filling, expressed as the ratio of systolic to diastolic forward flow Doppler velocity integrals in the superior vena cava and by tricuspid annulus motion, decreased in parallel from before surgery baseline values of 3.5 (SD 3.1) and 21.9 (3.4) mm, respectively to 0.2 (0.1) and 8.1 (2.3) mm two days after operation. A gradual increase towards baseline values was noted after six months, to 1.4 (1.3) and 15.1 (2.3) mm respectively; however, these values were still significantly less than those before operation. Similar changes were seen in the hepatic venous flow pattern. The decrease in total tricuspid annulus motion was most pronounced in its lateral segment and the atrial component of the tricuspid annulus motion showed similar changes. CONCLUSIONS: The pronounced decrease in tricuspid annulus motion during the early postoperative period suggests right atrial and right ventricular dysfunction as mechanisms responsible for the early changes seen. The progressive return to a normal venous filling pattern and the partial recovery of annular motion six months after operation further support the influence of the above mechanisms, as well as their resolution with time. The persistent flow abnormalities and compromised motion of the free aspects of the tricuspid annulus, however, suggest long term tethering of the right heart wall. PMID- 1772710 TI - Effect of left bundle branch block on diastolic function in dilated cardiomyopathy. AB - OBJECTIVE: To assess the diastolic effect of left bundle branch block in patients with dilated cardiomyopathy. DESIGN: Retrospective study of M mode and Doppler echocardiograms along with electrocardiogram and phonocardiogram. SETTING: Tertiary referral cardiac centre. PATIENT PARTICIPANTS: Fifty two patients with dilated cardiomyopathy, all with functional mitral regurgitation. Twelve with left bundle branch block (group 1) were compared with 40 without (group 2). RESULTS: Mean (SD) age 60 (15) v 55 (18) years, left ventricular end diastolic dimension 72 (9) v 70 (7) mm, and heart rate 88 (15) v 84 (15) beats/min were similar in both groups. In patients with left bundle branch block the electromechanical delay, 50 (20) v 70 (20) ms, was shorter (p less than 0.05) whereas the preejection contraction time, measured from the onset of mitral regurgitation to that of aortic ejection, 130 (40) v 70 (20) ms (p less than 0.01), and left ventricular relaxation time, A2 to the end of mitral regurgitation, 130 (30) v 80 (30) ms (p less than 0.01), were both prolonged. Ejection time itself was similar, 230 (40) v 235 (40) ms. Thus the overall duration of mitral regurgitation was increased (495 (90) v 390 (60) ms (p less than 0.01], which made filling time shorter (190 (45) v 325 (90) ms (p less than 0.01]. In patients with left bundle branch block, unlike those without, contraction and relaxation times both shortened as RR interval fell; this made the duration of mitral regurgitation more sensitive to heart rate. Filling time was less than 200 ms in eight out of 12 patients with left bundle branch block and four out of 40 patients without (p less than 0.001). CONCLUSION: Left bundle branch block prolongs rather than delays mitral regurgitation by increasing pre ejection and relaxation times. This directly impairs diastolic function by shortening the time available for the left ventricule to fill to an extent likely to limit stroke volume. PMID- 1772711 TI - A new cross sectional echocardiographic method for estimating the volume of large pericardial effusions. AB - OBJECTIVE: To evaluate a new cross sectional echocardiographic method for estimating the volume of pericardial effusions. DESIGN: The volume of pericardial fluid removed by surgical drainage or paracentesis was compared with the volume estimated by the echocardiographic method. The pericardial sac volume and cardiac volume were calculated by applying the formula for the volume of a prolate ellipse (pi x 4/3 x L/2 x D1/2 x D2/2) where L is the major axis and D1 and D2 are the minor axes. The pericardial fluid volume was calculated as the pericardial sac volume minus the cardiac volume. PATIENTS: 13 patients with 14 large pericardial effusions (one recurrence) all of whom had tamponade and cross sectional echocardiography just before therapeutic full drainage of the effusion. RESULTS: The volumes of pericardial fluid drained ranged from 0.5 to 2.11. The correlation between these actual volumes and the volumes estimated by echocardiography was excellent (r = 0.97); the correlation was good in four patients with intrapericardial adhesions. CONCLUSIONS: Because of certain approximations in measuring quantity of pericardial fluid drained, the echocardiographic estimations cannot be claimed to be definite. The data, however, indicate that the echocardiographic method is sufficiently reliable to provide useful estimates for practical clinical purposes. PMID- 1772712 TI - Echocardiographic evaluation of fibrous replacement in the myocardium of patients with Duchenne muscular dystrophy. AB - OBJECTIVES: To study myocardial echo amplitude in Duchenne muscular dystrophy and to examine the implications of increased echo amplitude. DESIGN: Regional echo amplitude, wall motion, and uptake of thallium-201 were examined in the left ventricular wall and the relation between these variables was investigated. SETTING: Hara National Sanatorium, Japan. PATIENTS: Seven healthy controls aged 10-28 years and 14 patients with Duchenne muscular dystrophy aged 12 to 30 years. INTERVENTIONS: Echocardiography with a sector scanner (Hitachi EUB-150, Japan) and a 3.5 MHz transducer (Hitachi EUP-S21, Japan); thallium-201 myocardial single photon emission computed tomography at rest with a rotating gamma camera system (Hitachi RC-135DT, Japan). MAIN OUTCOME MEASURES: Echo amplitude of the myocardium, thickness and wall motion of the posterior wall and ventricular septum, and myocardial uptake of thallium-201. RESULTS: Areas of increased echo amplitude were detected along the outer half of or throughout the posterior wall of left ventricle in nine of the 14 patients. Their posterior walls showed significantly decreased maximal systolic and diastolic endocardial velocities (mean (SE) 31.4 (16.0) and 55.6 (53.5) mm/s) compared with normal subjects (57.7(19.4) and 113.0 (27.5) mm/s), and decreased uptake of thallium-201. Their ventricular septa, however, showed normal echo amplitude and wall motion and normal uptake of thallium-201. CONCLUSION: Areas of increased echo amplitude were detected in the posterior walls of left ventricles of patients with Duchenne muscular dystrophy. These areas were suspected to be the sites of myocardial fibrosis. PMID- 1772713 TI - Angiographic demonstration of incoordinate motion of the ventricular wall after the Fontan operation. AB - OBJECTIVE: To study regional wall motion of the systemic ventricle in patients after the Fontan operation. DESIGN AND PATIENTS: Systemic ventricular angiograms of 15 patients after the Fontan operation and of 11 unoperated patients with a univentricular atrioventricular connection were digitised frame by frame. Strict criteria for abnormal wall motion were used so that minor abnormalities were not considered. RESULTS: Incoordinate contraction of the ventricular wall was found in five of the 11 patients before and in four of the 15 patients after the Fontan operation (NS). Only three of the 11 patients before the Fontan operation, showed incoordination of ventricular relaxation, but incoordinate relaxation was seen in 12 of the 15 patients after operation (p less than 0.01). CONCLUSIONS: Whereas incoordination of ventricular contraction was common in patients with a univentricular atrioventricular connection, before or after the Fontan operation, incoordinate relaxation of the ventricular wall was a common consequence of the Fontan operation and was rare in patients before operation. PMID- 1772714 TI - Surgical treatment of pulmonary hypertension in protein C deficiency. AB - Two patients with protein C deficiency developed symptomatic pulmonary hypertension secondary to chronic pulmonary embolism. They were successfully treated by thromboendarterectomy. PMID- 1772715 TI - Successful stenting of a life threatening pulmonary arterial stenosis. AB - A 35 year old woman with multiple pulmonary arterial stenoses and occlusions was admitted with increasingly severe breathlessness. Balloon angioplasty of a life threatening stenosis in a remaining pulmonary artery branch was attempted on two occasions but without success. When a self-expanding stainless steel stent was inserted at the site of stenosis after a further angioplasty acute localised pulmonary oedema developed as blood flow distal to the lesion increased considerably. This was followed by a slow and dramatic improvement in the patient's condition. She no longer required an urgent transplant and resumed an active life. PMID- 1772716 TI - Stenting of superior vena cava and inferior vena cava for symptomatic narrowing after repeated atrial surgery for D-transposition of the great vessels. AB - Double venous stenting of the superior vena cava and inferior vena cava was successfully performed after failed balloon angioplasty in a young woman who had venoatrial narrowing and kinking after repeated Mustard procedure for D transposition of great vessels. Self-expanding metallic stents were used. Angiography showed that the first stent was fully patient after six months when a second stent was implanted. This operation was followed by sustained clinical improvement. The present report shows the feasibility and success of stenting of the great veins when postoperative narrowing or kinking is unresponsive to balloon angioplasty alone. PMID- 1772717 TI - Cardiac interventional procedures in the United Kingdom in 1989. PMID- 1772719 TI - Short humerus: results of 11 prolongations in 10 children and adolescents. AB - The author evaluates the results of extension of 11 humeri in 10 children and adolescents with an average age of 12.5 years. The most frequent cause of the abbreviation was neonatal osteomyelitis. A Wagner apparatus was used with success and is considered highly suitable for this purpose. The maximum extension was 95 mm; one bone was extended twice with an interval of 2 years in between. The most serious complication was temporary paralysis of the nerves of the forearm and hand. Correction of the length of the upper extremities has a positive effect on the patient's psyche and on the aesthetic appearance and the functioning of the limb. PMID- 1772718 TI - Locking screw-plate fixation of cervical spine fractures with and without ancillary posterior plating. AB - Forty consecutive patients with 19 fractures and 21 fracture-dislocations in the lower cervical spine were treated prospectively with open reduction and interbody fusion, using the AO titanium locking screw-plate system. There were 30 men and 10 women with a mean age of 36 years (range 16-90 years). Eight were admitted tetraplegic, 12 tetraparetic, and 6 had nerve root injuries. Eleven of the fractures and 18 of the fracture-dislocations were also plated posteriorly. Complications included two cardiac arrests, two transient neurological impairments, two severe gastrointestinal bleedings, and one esophageal fistula. At 2-year follow-up, three patients had died and one had emigrated. Three out of ten patients who had complete motor loss initially had regained useful muscle function, while incomplete motor loss usually returned to normal. All fusions had healed in a good or acceptable position. Twenty-four of the 60 posterior plates impinged on facet joints and five were loose. Six screws transgressed facet joints below the fusion. Ten posterior fusions extended to adjacent mobile segments by exuberant bony overgrowth. Ancillary posterior plating significantly reduced the range of neck mobility and also caused significantly more pain than anterior plate fixation alone. PMID- 1772720 TI - Circumferential fusion of the lumbar and lumbosacral spine. AB - Seventy-four patients with circumferential fusion of the lumbosacral spine have been assessed after a mean follow up of 49.8 months. For the ventral procedure, an anterior interbody fusion with tricortical iliac bone graft was performed. The additional dorsal fusion was according to various techniques with mainly transpedicular internal fixation. Forty-six patients underwent a one-stage operation while 28 underwent the ventral and dorsal procedure in different sittings. The results favour the technique of a combined anterior/posterior approach for fusion of the lumbosacral spine in patients with instability and deformity of all three columns, such as fractures and spondylolisthesis of more than 50%. Optimal stability with satisfactory reduction of the deformity may be achieved. The one-stage operation proved to be superior, with less complications and a shorter hospital stay. PMID- 1772721 TI - The function of the Thomas splint. An experimental study. AB - A Thomas splint of traditional design was fitted with measuring devices and examined for its hip-relieving effect during varying activities. It was shown that there is no complete weight relief of the hip joint with this orthosis. In the most favourable case, 50% of the weight can be conducted via the ischial tuberosity and therefore transferred to the ground surface bypassing the hip joint. In regard to the hip joint, the Thomas splint is a device that reduces weight but does not entirely remove it. The results proved to be practically independent of the fitting of the orthosis and of the kind of activity. PMID- 1772722 TI - An analysis of the results of transferring the musculocutaneous nerve onto the median nerve in tetraplegics. AB - Following injuries of the cervical spinal cord at the common level with C6 neurological level sparing, abduction of the shoulder and elbow flexion remain active. The flexors of the elbow are controlled by the musculocutaneous nerve formed mainly from C5 and C6 fibers, the motor cells of which are usually located above the level of the spinal lesion. The encouraging report of anastomosis of the musculocutaneous nerve to the median nerve, described by Benassy and Robart, induced us to perform similar operations in 42 patients with traumatic tetraplegia. In 32 patients this has restored simple grasping function of the hand, increasing the patients' independence. The operation is particularly indicated in cases of complete lesion of the spinal cord at the C6-C7 level in young people, and for best results should be performed with in the first few months after trauma. PMID- 1772723 TI - Blood loss in total hip replacement. A retrospective study. AB - Two hundred and twelve total hip replacements performed in one clinic over 1 year were reviewed. The mean operative time was 89 min and mean total blood loss 1090 ml. Homologous blood was administered to 74% of the patients. Blood loss was dependent on sex, body weight and height, but these correlations were eliminated when blood loss was related to estimated blood volume. There was no correlation to age. There was a positive correlation between operative time and intraoperative blood loss, but not between any of these factors and postoperative blood loss. Operative time varied significantly between surgeons, but there was no correlation between surgeon's experience and operative time or blood loss. Despite a mean of only 12 total hip replacements per surgeon, both operative time and blood loss were small compared to what was found in other studies. The use of a posterior approach is believed to contribute to a shorter operative time as well as to moderate blood loss. Intraoperative blood loss was less under epidural than under general anaesthesia, but in contrast to others we found higher postoperative blood loss after epidural anaesthesia. PMID- 1772724 TI - Usefulness of a new technique for hind limb immobilization in rats for the study of tendon healing. AB - To study wound repair in rat Achilles tendon, we utilized a novel surgical method for immobilizing only one hind limb. In this technique, the femoral vessels were preserved while the skin, muscles, nerves and the shaft for the femur were transected. The limb was then rotated and sutured to lie on the posterolateral flank of the animal. The recovery was prompt and the procedure affected the routine growth and metabolism of the animal minimally throughout the period of experimentation. In the immobilized limb, healing of the Achilles tendon was studied after subtotal severance in the midsection. The rats were killed at intervals of 1, 2, and 4 weeks postoperatively. After 1 week, the surface of the wound was covered by a thin layer of cells. A gap persisted underneath and showed fibrovascular proliferation at the margins. In 2 weeks, the gap was completely occupied by fibrovascular tissue that was beginning to align along the long axis of the tendon. By the 4th week, remodeling had occurred and the site of the wound had almost blended with the rest of the tendon. We conclude that this new technique of hind limb immobilization causes little stress on the animal, and it can be useful for the study of tendon healing. PMID- 1772725 TI - Proliferative cell response to loosening of total hip replacements: a cytofluorographic cell cycle analysis. AB - Monocyte/macrophages and fibroblasts are the major reactive cells in the periprosthetic connective tissue in a loose totally replaced hip. Monocyte/macrophages are bone-marrow-derived, hematogenous cells, whereas mesenchymal fibroblasts replenish by local proliferation. The cell-cycle-phase frequency distribution therefore reflects the local mitotic fibroblast response to the loose total hip replacement (THR) implant. In 13 patients who underwent revision of a loose THR implant, most of the local cells were in the resting G0/G1 phase (88.1 +/- 6.3%, mean +/- SD), whereas 8.6 +/- 3.7% were in the S phase of the cycle, and 3.4 +/- 2.9% had already reached the G2/M phase. The highest DNA values were recorded in an osteoarthritic patient undergoing revision 4 years after the primary uncemented THR, while the lowest values were observed in a rheumatoid arthritis patient with a loose cemented prosthesis 15 years after the primary operation. The results suggest that the local proliferative fibroblast response in general is uniform and does not seem to depend on the type of prosthesis or the use of cement. The responses in aggressive granulomatous type loosening and the common type of loosening were similar. PMID- 1772726 TI - Decalcified and undecalcified cancellous bone block implants do not heal diaphyseal defects in dogs. AB - In a previous study it has been shown that granulae of decalcified bone matrix do not induce bony healing of 8-week-old mid-diaphyseal defects in dogs. The aim of this study was to test whether osteoinduction combined with the osteoconductive mechanisms provided by the natural structure of cancellous bone blocks would yield better results. A 30-mm-long diaphyseal defect of the left ulna was created in eight adult mongrel dogs and the bone was stabilized with a plate. A Silastic spacer was inserted in the defect for 8 weeks, followed by implantation of frozen undecalcified or decalcified allogeneic cancellous bone blocks for 16 weeks. Healing was analyzed using morphologic methods. At 16 weeks after implantation all grafts had been resorbed. In the decalcified group one defect healed, while none in the other group did so. The implant material was bioassayed in nude rats for osteoinductivity, which was found to be low in decalcified matrix and not detectable in undecalcified bone. CONCLUSION: Allogeneic cancellous bone blocks, demineralized or not, have no osteoinductive capacity and no osteoconductive function that promotes healing of mid-diaphyseal bone defects in dogs. PMID- 1772727 TI - Hematomas and subcutaneous suture techniques in total hip replacement. An ultrasound study. AB - Thirty-five patients undergoing total hip replacement due to primary arthrosis were randomized into two groups. In one group each subcutaneous suture included a stitch in the fascia; in the other group the fascia was not included in the suture. Ultrasonography examination showed no significant difference in the number of subcutaneous hematomas in each group. Nine subcutaneous and nine deep hematomas were diagnosed by ultrasound in 15 patients. Three patients had a clinical diagnosis of hematoma and in only one of these did ultrasonography support the diagnosis. It appears that the clinical diagnosis of hematomas, even subcutaneous hematomas, is unreliable. Careful hemostasis is recommended. PMID- 1772728 TI - Orthopaedic treatment in tibial diaphyseal fractures. Risk factors affecting union. AB - A retrospective of 216 tibial fractures treated orthopedically was carried out. The aim was to analyze a set of clinicobiological parameters that owing to their assumed action on the physiological model of consolidation can be considered as risk factors to be taken into account in all kinds of orthopedic treatment, because they may lead to a lengthening of the normal consolidation time of the fracture. The variables analyzed were the following: type of immobilization, causative agent of the fracture, location of the focus of the fibular fracture, initial displacement, degree of conminution, type of wound, type of fracture, appearance of radiologically observable callus, commencement of weight-bearing, post-fracture hematoma, secondary displacement, and infection of soft tissues. In the particular case of immobilization by an ischiopedic plaster cast, the following parameters showed a greater degree of prognostic significance: initial displacement, secondary displacement, and age. PMID- 1772729 TI - Transition into midlife. AB - During the midlife years, ages 35 through 65 years, women experience a series of transitions. How the transitions affect the midlife woman depends, in part, on her vision of those transitions and her strategy for dealing with them. This chapter provides a framework for understanding the transition process. In addition, it provides strategies for attenuating the psychological, physiologic, and social changes that often result with the transition into midlife. PMID- 1772730 TI - Management of perimenopausal symptoms. AB - The perimenopausal period brings about many changes. The significance of many of the signs and symptoms associated with menses also may change. Premenstrual syndrome (PMS) and uterine bleeding need close follow-up during the perimenopausal period. Urinary incontinence appears to worsen because of hormonal changes occurring during the climacteric. All three of these conditions present a special challenge to the health care practitioner. PMID- 1772731 TI - Menopause and cardiovascular disease. AB - As the life expectancy of women increases, a greater percentage of women's lives will be spent in the menopause. The greatest cause of morbidity and mortality during that period is cardiovascular disease. The associated risks that predispose to the development of cardiovascular disease are multifactoral and include hypertension, diabetes mellitus, smoking, obesity, family history, and elevated cholesterol levels. The menopause, per se, is associated with an increased risk because of the unfavorable changes in cholesterol metabolism secondary to estrogen deprivation. The replacement of estrogen to menopausal women is believed to improve the lipid profile and reduce the atherogenic changes that increase the risk of cardiovascular disease. However, this form of preventative therapy is futile unless other factors that promote cardiovascular disease also are modified. Such modification may be achieved by following a well balanced diet, combined with an exercise program, cessation of smoking, weight control, and the monitoring of blood pressure and diabetes in high-risk patients. PMID- 1772732 TI - New perspectives on the relationship of hormone changes to affective disorders in the perimenopause. AB - Menopause and the preceding climacteric years are normal aspects of the reproductive life cycle in women. However, the fluctuations and declines in hormone levels are physiologic changes that may have a significant impact on perimenopausal mood changes. These observations are based on both clinical experience with perimenopausal women and recent neuroendocrine research that describes hormone effects on central nervous system neurotransmitters regulating mood, sleep, and behavior. In particular, both estrogen and progesterone have profound effects on the serotonin, norepinephrine, dopamine, and endorphin receptor systems that are involved in mood regulation. This chapter discusses these correlations, describes pharmacologic and nonpharmacologic treatment approaches, and recommends directions for needed research. PMID- 1772733 TI - Midlife women's health. AB - The purpose of developing midlife women's health programs is to enhance the overall physical and mental health of the woman and to promote health habits necessary to ensure a healthy and active older woman. To design these programs, the demographic characteristics and health habits of women must first be examined. Innovative approaches are greatly needed as factors such as accessibility and cost are considered. PMID- 1772734 TI - Physiology of menopause and update on hormonal replacement therapy. AB - Menopause is the period during which ovarian function declines. It is a time that may last for years, during which changes in many organ systems occur as a consequence of estrogen deficiency. For some women, estrogen replacement therapy can alleviate some of these changes and prevent others. The physiologic basis, principles of therapy, contraindications, and side effects for this approach are discussed. PMID- 1772735 TI - Osteoporosis. AB - Osteoporosis is a serious condition affecting millions of American women after the age of 45 years. Emphasis in women's health care must be directed toward identification of risk factors and preventive measures. Therapeutic intervention for patients with osteoporosis is based on three goals: halting bone loss, remineralizing bone, and minimizing the danger of falling and fractures. PMID- 1772736 TI - Nutrition and health patterns in midlife women. AB - The middle years for women present many challenges and opportunities. The changes of life--physical, psychosocial, developmental, and environmental--can be rewarding, positive experiences. At the same time, as women enter the middle years, they may face a number of health problems. Preparation for health maintenance, illness prevention, and coping with problems as they occur can prevent many of the potential health alterations through life style changes. Even when these health problems are unpreventable, modification of behaviors and habits may ameliorate some of their consequences. The nurse is the logical person to educate and counsel women on how to lower their risks for midlife health problems. An overview of the health status of women at midlife is presented, including current life expectancy, mortality, and morbidity data. Risk factors and risk assessment specific to diseases prevalent in midlife and older women are reviewed, with emphasis on nutrition and obesity. Nursing strategies for reducing the risk factors (obesity, hypercholesterolemia, and sedentary life style) related to many of the health concerns of midlife women are presented. PMID- 1772737 TI - A menopause center: bridging the midlife gap. AB - As women 40-60 years of age become the fastest growing segment of the population, it is time for women's health care providers to identify the health care needs of these women and provide the appropriate services. In 1985, Northwestern Memorial Hospital developed the Menopause Center to address these concerns. The objectives of the Menopause Center are to inform women of the natural bodily changes menopause creates, dispel common myths about the menopause, identify risk factors for osteoporosis and heart disease, provide information regarding hormone replacement therapy, and provide a forum for women experiencing the menopause to share information. PMID- 1772738 TI - Cerebral blood flow and metabolism during sleep. AB - A review of the current literature regarding sleep-induced changes in cerebral blood flow (CBF) and cerebral metabolic rate (CMR) is presented. Early investigations have led to the notion that dreamless sleep was characterized by global values of CBF and CMR practically at the level of wakefulness, while rapid eye movement (REM) sleep (dream sleep) was a state characterized by a dramatically increased level of CBF and possibly also of CMR. However, recent investigations firmly contradict this notion. Investigations on CBF and CMR performed during non-REM sleep, taking the effect of different levels of sleep into consideration, show that light sleep (stage II) is characterized by global levels of CBF and CMR only slightly reduced by 3-10% below the level associated with wakefulness, whereas CBF and CMR during deep sleep (stage III-IV) is dramatically reduced by 25-44%. Furthermore, recent data indicate that global levels of CBF and CMR are about the same during REM sleep as in wakefulness. On the regional level, deep sleep seems to be associated with a uniform decrease in regional CBF and CMR. Investigations concerning regional CBF and CMR during REM sleep are few but data from recent investigations seem to identify site-specific changes in regional CBF and CMR during REM sleep. CBF and CMR are reflections of cerebral synaptic activity and the magnitude of reduction in these variables associated with deep sleep indicates that overall cerebral synaptic activity is reduced to approximately one-half the level associated with wakefulness, while cerebral synaptic activity levels during REM sleep are similar to wakefulness. However, even though the new understanding of CBF and CMR during sleep provides significant and important information of the brain's mode of working during sleep, it does not at its current state identify the physiological processes involved in sleep or the physiological role of sleep. PMID- 1772739 TI - Positron emission tomography in Alzheimer's disease in relation to disease pathogenesis: a critical review. AB - PET studies of brain metabolism and blood flow in Alzheimer's disease (AD) patients lead to the following conclusions: (a) Reductions in "resting state" regional brain metabolism are roughly proportional to dementia severity. (b) These reductions are greater in association than in primary sensory and motor neocortical regions, and correlate with the distribution of neuropathology and cell loss postmortem. (c) Demented but not nondemented Down syndrome adults also have worse metabolic reductions in the association than primary neocortices, suggesting an equivalent pathological process in demented Down syndrome and AD patients. (d) Brain metabolic patterns in AD patients are heterogeneous, belonging to at least four distinct metabolic groups that correspond to different patterns of cognitive and behavioral abnormalities; the metabolic patterns have not been shown to be related to disease etiology. (e) Abnormal right-left metabolic asymmetries in mildly demented AD patients can retain their initial directions for as long as 48 months; these asymmetries precede and predict the cognitive "discrepancies" that later appear, such that moderately demented patients with disproportionate visuospatial compared with language deficits, or disproportionate visual recall compared with verbal recall, have a greater metabolic reduction in the right than left hemisphere, and vice versa. (f) Parietal association/frontal association metabolic ratios also retain their direction over time; in moderately demented patients, relative hypometabolism in the prefrontal association cortex is related to deficits in verbal fluency and attention to simple sets, whereas relative hypometabolism in the parietal association cortex correlates with failure in arithmetic, verbal comprehension, drawing, and immediate memory for visuospatial location. (g) Although metabolically spared compared with the association cortices, the primary sensory cortices, basal ganglia, thalamus, and cerebellar hemispheres show metabolic declines in AD using high-resolution PET scanners, possibly due to their connections with more pathologically affected regions. (h) Early metabolic deficits in AD are hypothesized to arise from synaptic failure in association cortical areas; such failure in the occipitotemporal visual cortex can be reversed in mildly to moderately demented AD patients who are capable of performing a face-matching task. PMID- 1772740 TI - Current concepts of pathophysiology and management of cerebral vasospasm following aneurysmal subarachnoid hemorrhage. AB - Approximately 10 in 100,000 persons suffer rupture of a saccular intracranial aneurysm annually, and roughly 60% of these will survive the initial catastrophe in reasonable neurological condition. Of the many ensuing complications of aneurysmal subarachnoid hemorrhage, the most frustrating continues to be a form of delayed-onset cerebral arterial narrowing known as vasospasm. Because it is caused by thick subarachnoid blood clots coating the adventitial surface of cerebral arteries, the distribution and severity of vasospasm correlates closely with location and volume of subarachnoid hematoma as visualized on computed tomography (CT). Critical vasospasm causes cerebral ischemia and infarction: the "second stroke." It is now know that vasospasm represents sustained arterial contraction rather than structural thickening of the vessel wall with lumen encroachment. A large body of evidence points to oxyhemoglobin, released from lysing erythrocytes, as the principal component of blood clot responsible for this contraction. The precise mechanism by which oxyhemoglobin causes prolonged vascular smooth muscle cell constriction has not yet been established, but possibilities include secondary generation of vasoactive free radicals, lipid peroxides, eicosanoids, bilirubin, and endothelin. Vasospasm treatments are directed at preventing or reversing arterial narrowing, or at preventing or reversing cerebral ischemia. Several treatments from the latter category, namely, hypertensive, hypervolemic hemodilutional therapy and the calcium channel blocker nimodipine, have proven moderately effective and are in widespread clinical use. It has also been possible to mechanically dilate vasospastic vessels with transluminal angioplasty improving cerebral blood flow to ischemic brain. However we are still in need of an effective agent to prevent arterial narrowing, and several hopeful candidates in this category of treatment are clot lytic agent tissue plasminogen activator (rt-PA) and an inhibitor of iron-dependent peroxidation, 21-aminosteroid U74006F (tirilazad mesylate). PMID- 1772741 TI - Myositis and myopathies. PMID- 1772742 TI - Raynaud's phenomenon, scleroderma, overlap syndromes, and other fibrosing syndromes. PMID- 1772743 TI - Humoral immunity and immunogenetics in the idiopathic inflammatory myopathies. AB - The idiopathic inflammatory myopathies (IIMs) are a heterogeneous group of rare but increasingly recognized syndromes characterized by chronic muscle inflammation of unknown cause. The finding of other autoimmune diseases in association with IIM, the inflammatory pathology, the response to immunosuppressive therapy, and the frequent occurrence of autoantibodies all support the notion that the IIMs are autoimmune diseases. IIM patients are unique in their immune targeting of a group of autoantigens involved in protein synthesis. Recent studies of the autoantibodies that bind these autoantigens (the myositis-specific autoantibodies) suggest that they arise by mechanisms that closely resemble standard immune responses. There is increasing interest in and efforts directed toward dividing the rheumatic diseases into more uniform groups for purposes of better defining etiology and pathogenesis. This approach has been useful in the analysis of the IIMs in which new approaches, subsetting patients by autoantibodies, have produced more homogeneous groupings. Recent data on predisposing immunogenetic factors in different clinical and serologic subsets of IIM patients also suggest that these disorders result from environmental agents acting on groups of genetically restricted individuals to induce immunologic activation and subsequent tissue pathology. This review summarizes these findings about the origins of the myositis-specific autoantibodies and their epidemiologic, clinical, prognostic, and immunogenetic associations. PMID- 1772744 TI - The role of cell-mediated immunity in polymyositis. AB - Although the etiologic stimulus has not been identified, there is considerable evidence that cell-mediated immune mechanisms play an important role in the pathogenesis of polymyositis-dermatomyositis: 1) a discrete chronic mononuclear cell infiltrate is almost always present in the affected muscles of patients with polymyositis-dermatomyositis; 2) the predominant cell of this chronic mononuclear cell infiltrate is the T lymphocyte; 3) the infiltrating T cells appear to be activated because they express activation antigens, such as major histocompatibility complex class II molecules; 4) peripheral blood lymphocytes express activation markers, they are sensitized to muscle, and they seem to be cytotoxic to muscle in vitro; and 5) pathologic similarities reminiscent of polymyositis are found in animal models of experimental myositis. Recent observations on cell-mediated immunity in polymyositis-dermatomyositis, discussed in this review, provide new insights into the pathogenesis of the inflammatory myopathies. PMID- 1772745 TI - Therapy for myositis. AB - The mainstay of therapy for polymyositis-dermatomyositis continues to be corticosteroids either alone or in combination with other immunosuppressive agents. Intravenous cyclophosphamide may be beneficial in some patients, and success with cyclosporine has been reported in children with dermatomyositis. Intravenous gamma-globulin has resulted in short-term benefit for both children and adults. Other seldom-used therapies for the refractory patient with myositis include plasmapheresis, total body irradiation, and thymectomy. PMID- 1772746 TI - Metabolic myopathies. AB - The term metabolic myopathy refers to a heterogeneous group of conditions that have in common abnormalities of muscle energy metabolism that result in skeletal muscle dysfunction. Most recognized metabolic myopathies are considered primary, represent inborn errors of metabolism, and are associated with known or postulated defects that affect the ability of muscle fibers to maintain adequate ATP concentrations. Traditionally, these diseases are grouped into abnormalities of glycogen, lipid, purine, and mitochondrial biochemistry. This discussion reviews the basic metabolic pathways that regulate normal muscle function; recent observations involving glycogen storage diseases, carnitine deficiency states, and myoadenylate deaminase deficiencies; and lastly, newer techniques available to assess patients with myopathic disorders. PMID- 1772747 TI - Animal models of myopathy. AB - Animal models have proven very useful in furthering insight into a number of muscle diseases. Studies of ethanol-fed rats are being used to understand the pathogenetic mechanisms underlying acute and chronic myopathy induced by ethanol. Several animal species, including mice, dogs, and cats, develop X-linked muscular dystrophies, which have genetic defects identical to those of Duchenne muscular dystrophy. As in the human disease, these animals lack dystrophin. They are being used to investigate the mechanisms by which lack of dystrophin results in weakness and to examine myoblast transfer as a treatment modality. A model of eosinophilia-myalgia syndrome has recently been induced in Lewis rats by the feeding of L-tryptophan samples that were implicated in the clinical syndrome in humans, making possible studies of the pathogenesis of this interesting new entity. A dermatomyositis-like syndrome occurs spontaneously in dogs, and polymyositis-like illnesses can be induced in mice by immunization with muscle or following infection with selected viruses, especially enteroviruses. Study of the latter is helping us understand mechanisms in the etiology and pathogenesis of inflammatory myositis and virus-induced autoimmunity. PMID- 1772748 TI - Genetic and environmental factors in scleroderma. AB - This review discusses possible markers of scleroderma, including fibronectin gene mutations, major histocompatibility complex class II antigens, anti-Scl-70, and the Fc receptor. The association between genetic and environmental factors is also reviewed, as is a mouse model of human disease. PMID- 1772749 TI - Immunologic aspects of scleroderma. AB - Evidence continues to accumulate supporting in vivo activation of T cells in scleroderma. The studies reviewed reported finding circulating cytokines in scleroderma serum or soluble T-cell membrane molecules, especially soluble interleukin-2 receptor and CD8. The antigens to which T-cell reactivity is directed, if indeed such antigens exist, remain to be identified. Specific humoral immune responses in the form of autoantibodies to nuclear-associated antigens appear to be polyclonal and antigen driven. Although autoantibodies cannot as yet be implicated in disease pathogenesis, patterns of autoantibodies are associated with, but do not reliably define, disease subsets. In patients with Raynaud's phenomenon alone, the absence of autoantibodies is predictive of not developing systemic connective tissue disease, while the presence of autoantibodies indicates an increased risk. PMID- 1772750 TI - Connective tissue metabolism including cytokines in scleroderma. AB - Fibroblasts within the skin of scleroderma patients constitute a phenotypically heterogeneous population with regard to expression of collagens, cytokines, and cytokine receptors. By in situ hybridization techniques, scleroderma skin is shown to contain a subpopulation of fibroblasts that are stimulated for expression of type VI collagen; the size of this subpopulation is larger than that found in normal skin. The heterogeneity in collagen production among scleroderma fibroblasts can also be demonstrated in vitro following sorting by flow cytometric analysis. An isoform of a cytokine known to be a potent modulator of collagen expression, transforming growth factor-beta 2, is overexpressed in and around inflammatory infiltrates in biopsies of skin from scleroderma patients. Scleroderma fibroblasts grown in culture express slightly elevated levels of transcripts for transforming growth factor-beta 1, demonstrated by Northern analysis. Osteonectin, or SPARC (secreted protein, acidic and rich in cysteine), messenger RNA is also clearly elevated in fibroblasts cultured from the affected skin of scleroderma patients. The affinity of epidermal growth factor receptors on fibroblasts derived from the skin of scleroderma patients is decreased compared with that of receptors on normal fibroblasts. Platelet-derived growth factor-beta receptors were detectable by immunohistochemical staining in dermal vessels and surrounding fibroblasts in 13 of 14 biopsies of skin of scleroderma patients, whereas they were absent in sections of normal skin. These studies completed within the past year allow recognition of the importance of interactions between cell types, and the possible consequences of alterations in cytokine secretory patterns and cell responsiveness. PMID- 1772751 TI - Raynaud's phenomenon. AB - Raynaud's phenomenon is episodic digital ischemia provoked by cold and emotion; it is associated with other disorders, such as Raynaud's syndrome, especially the connective tissue diseases. Recent information suggests links with Sjogren's syndrome, malignancy, and obstructive vascular disease. The vasospasm can affect areas outside the periphery such as the inner ear in vibration white finger syndrome and the placental vessels in pregnancy. The initial presence of autoantibodies increases the chance by 63-fold of developing connective tissue diseases, and such immunologic testing can be usefully combined with nailfold vessel microscopy. Several factors are considered to be of etiologic importance in Raynaud's phenomenon, such as the augmenting effect of cold on the responsiveness of alpha 2-adrenoceptors to agonists. Deficiency in the vasodilator neuropeptide calcitonin gene-related peptide has been detected, as have excess amounts of the vasoconstrictor endothelin. Treatment of vasospasm remains symptomatic, and directed towards the vasospasm and altered blood constituents. PMID- 1772752 TI - Epidemiology of scleroderma. AB - The rarity of scleroderma makes it a difficult disorder to study epidemiologically. Recent studies have highlighted some of the environmental exposures associated with the disease. Among occupational exposures silica remains the most important, whereas appetite suppressants might be an important drug cause. The disease also appears to cluster in space, with one report suggesting that proximity to airports might be important. There has been considerable recent attention given to a scleroderma-like syndrome developing after ingestion of L-tryptophan; the link seems definite and the latter's subsequent withdrawal indicates that this might become of historic interest only. The relevance for "sporadic" scleroderma is unclear. Interest has also focused on survival and its predictors. It is clear that scleroderma is associated with a substantially reduced survival and that the extent of skin involvement and the development of internal organ involvement, particularly renal and pulmonary, are the worst prognostic features. PMID- 1772753 TI - Clinical aspects of localized and systemic scleroderma. AB - A number of reports of potential etiologic agents of localized and systemic scleroderma appeared in the past year, including alterations in tryptophan metabolism, use of appetite suppressants, and exposure to silicone. An infectious agent, Borrelia burgdorferi, was found not to be implicated in localized scleroderma. The improvement in outcome of systemic scleroderma complicated by renovascular hypertension was highlighted in several papers, as was the emerging importance of cardiac and pulmonary involvement. Recent advances in the early detection and evaluation of cardiac and pulmonary complications of scleroderma are discussed. PMID- 1772754 TI - The eosinophilia-myalgia syndrome and eosinophilic fasciitis. AB - The scientific excitement that follows the recognition of a new disease has been reflected in the numerous publications describing the clinical, histopathologic, and pathogenetic aspects of the eosinophilia-myalgia syndrome (EMS) during the period covered by this review. The clinical picture that has emerged during the past 2 years indicates that EMS is a multisystemic disease with prominent cutaneous, hematologic, and visceral manifestations that frequently evolves into a chronic course and can occasionally be fatal. Considerable progress has been made toward understanding the etiology and pathogenesis of EMS. The demonstration of an association with the ingestion of L-tryptophan-containing products originating from a single source has led to the identification and characterization of a putative etiologic agent present as a contaminant in these preparations. Although the accumulation of eosinophils, lymphocytes, macrophages, and fibroblasts in the affected tissues suggests that these cells play important roles in the pathogenesis of EMS, the precise mechanisms of their involvement have not been established. Several studies have demonstrated the activation of eosinophils and the deposition of eosinophil-derived toxic proteins in affected tissues. Fibroblast activation and increased expression of genes coding for various connective tissue macromolecules have been demonstrated employing in situ hybridizations with complementary DNAs. Furthermore, interleukin-5 and transforming growth factor-beta have been implicated as potential mediators in the pathogenesis of EMS. The explosive epidemic of EMS has emphasized the importance of chemical and environmental factors in the development of systemic disorders characterized by chronic inflammation and fibrosis. It is expected that further study of the pathogenesis of EMS will provide valuable information regarding the mechanisms responsible for these obscure disorders. PMID- 1772755 TI - Overlap syndromes and mixed connective tissue disease. AB - While the etiology of connective tissue diseases remains unknown, the classification of individual cases will continue to depend on identifying certain patterns of clinical and laboratory features. As many as 25% of connective tissue disease patients present with an overlap syndrome with features of systemic lupus erythematosus, systemic sclerosis, polymyositis, or dermatomyositis, with rheumatoid arthritis and Sjogren's syndrome evolving concurrently or consecutively during the course of the disease. The term overlap syndrome is applied to what appears to be a heterogeneous group of disorders, but in recent years there have been attempts to identify antibody markers within this population to identify subsets with particular patterns of disease expression. Thus, anti-U1-ribonucleoprotein is associated with overlap syndromes in which features of systemic lupus erythematosus are accompanied by features of systemic sclerosis or myositis; antibodies to polymyositis-scleroderma, Ku, and U2 ribonucleoprotein are associated with overlaps of systemic sclerosis and polymyositis, and anti-Jo-1 is associated with polymyositis and pulmonary fibrosis. A practical reason for subdividing cases in this way relates to prognosis and treatment, but at a more fundamental level it is hoped that the study of the origin of these antibodies and their antigen targets will provide clues to pathogenesis and even etiology. PMID- 1772756 TI - Mechanisms of ceftriaxone prophylaxis against late bacteremic vascular graft infection caused by Staphylococcus aureus in a dog model. AB - Possible mechanisms of the prophylactic effect of ceftriaxone against late bacteremic vascular graft infection in dogs were investigated. Dogs bearing an expanded polytetrafluoroethylene graft implanted as thoracoabdominal aortic bypass for one month were exposed to transient bacteremia produced by intravenous injection of 2.6 +/- 1.8 x 10(8) colony forming units Staphylococcus aureus 209P R. To assess the effect of the antibiotic on bacteria already adherent onto the grafts, we compared the results from six untreated dogs used as controls and six dogs receiving ceftriaxone (0.5 g, intramuscularly) 90 minutes after the bacteremic challenge. The grafts were removed one week after the bacteremic challenge and cut into 10 to 15 fragments, each submitted to viable bacterial counts. The number of grafts and the number of fragments yielding bacterial growth were the same in the two groups. However, the median density of bacteria was lower (p less than 0.01) in the dogs given ceftriaxone, 64 colony forming units/cm (range: 3-8,700), than in the control dogs, 585 colony forming units/cm (range: 12-64,000), suggesting that ceftriaxone had an effect on the postadherence phase of the development of infection. To assess the effect of ceftriaxone on the adherence phase we compared the results from seven untreated dogs and seven dogs receiving ceftriaxone (0.5 g intramuscularly) 90 minutes before the bacteremic challenge. The grafts were removed two hours after the bacteremic challenge. Though all the seven grafts were colonized in each group, the number of fragments yielding bacterial growth was lower (p less than 0.05) in the dogs given ceftriaxone (59/70) than in the control dogs (90/91).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772757 TI - Infrainguinal polytetrafluoroethylene grafts: saved limbs or wasted effort? A report on ten years' experience. AB - Two-hundred and twenty-four infrainguinal polytetrafluoroethylene reconstructions were performed for critical ischemia over a 10 year period: 48 to the above-knee popliteal artery, 113 to the below-knee popliteal artery, and 63 to the tibial vessels. The cumulative patency rates were 84 +/- 6% and 63 +/- 9% for above-knee popliteal, 53 +/- 5% and 35 +/- 7% for below-knee popliteal, 45 +/- 6% and 30 +/- 9% for tibial vessels at one and five years respectively. Limb salvage rates were 81 +/- 6% and 73 +/- 9% (above-knee popliteal), 69 +/- 5% and 57 +/- 9% (below knee popliteal), 64 +/- 7% and 32 +/- 10% (tibial vessels) at one and five years respectively. Graft occlusion did not result in limb loss in 32 cases. Preoperatively, 54% of the patients had limited mobility while 43% were regarded as severely restricted. At follow-up, 57% of the patients were considered to be independent, 26% had limited mobility, and 17% were still severely restricted. Polytetrafluoroethylene provides good short-term limb salvage and improved mobility in patients with critical ischemia and poor life expectancy. Its use is well worth the effort. PMID- 1772758 TI - Remote arteriovenous fistula with infrapopliteal polytetrafluoroethylene bypass for critical ischemia. AB - Between January 1985 and January 1989, 13 patients underwent femorotibial bypass using a polytetrafluoroethylene graft with a remote distal arteriovenous fistula. Indications for operation were gangrene in six patients, rest pain in five patients, and nonhealing ulcer in two patients. No patient had a usable autogenous saphenous vein. Eight patients had a previous failed femorodistal bypass. Standard femorotibial bypass was performed using a 6 mm thin-walled polytetrafluoroethylene graft. The distal remote arteriovenous fistula was done on the same artery. Warfarin was given postoperatively. Graft patency was assessed by duplex scan and digital arteriography. There was no postoperative mortality. All grafts and fistulas remained patent initially with improvement in symptoms and limb salvage. In the follow-up period there was continued graft patency in all but two patients who had a below-knee amputation. Three patients died with a patent graft. In two additional patients the graft remained patent but the fistula closed. We believe that in selected situations, the remote distal arteriovenous fistula is a potentially valuable adjunct for obligatory polytetrafluoroethylene femorotibial bypass. PMID- 1772759 TI - Mycotic aneurysm of the suprarenal aorta secondary to Streptococcus pneumoniae: an unusual pathogen. AB - Mycotic aneurysms of the suprarenal aorta are rare lesions, accounting for less than 1% of aortic reconstructions for aneurysmal disease. The bacteriology of these lesions differs from the infrarenal aneurysms and primarily consists of Gram-negative organisms. We report an unusual case of an 87-year-old man successfully treated for a ruptured mycotic suprarenal aortic aneurysm caused by Streptococcus pneumoniae. We have not seen a previously reported case where this pathogen has been associated with a suprarenal mycotic aneurysm. The unique bacteriology of these aneurysms is reviewed along with theories of etiology and their classification. The current management of these aneurysms is summarized. PMID- 1772760 TI - Hepatic artery aneurysm in corticosteroid-treated, adult Kawasaki's disease. AB - We describe a single case of Kawasaki's disease (mucocutaneous lymph node syndrome) with the rare complication of a hepatic artery aneurysm which was surgically repaired. Unusual features include arterial aneurysmal formation in the hepatic arteries rather than in coronary arteries, the unusual morphology of the hepatic artery aneurysm, and the expansion of the aneurysm after corticosteroid therapy. PMID- 1772761 TI - Replacement of the abdominal aorta with an aortic homograft in a patient with an aortic dissection. AB - The use of aortic and femoral homografts in early vascular surgery has been abandoned for the more successful and abundant synthetic substitutes. With the recent introduction of cryopreservation, homograft use has again met with improved success. A 40-year-old man who had a DeBakey Type I aortic dissection initially underwent replacement of the aortic root with a pulmonary homograft. Subsequently, in the presence of an intraabdominal infectious process, progressive mesenteric and lower limb ischemia was treated by replacing the abdominal aorta with an aortic homograft. Thirty-six months postoperative the patient has a functioning gastrointestinal tract and no vascular insufficiency of the lower extremities and no evidence of degeneration of the homograft. Further laboratory studies should be undertaken using the newer and improved cyropreserved homograft in the presence of, or potential for, an intraabdominal infectious process. PMID- 1772762 TI - Blowout of carotid venous patch angioplasty. AB - Two cases of vein patch blowout were observed five and seven days after carotid bifurcation endarterectomy with patch angioplasty. Both patients died in spite of emergency reoperation. One patient developed respiratory failure with subsequent fatal cardiac arrest seven days after reoperation; the other died of extensive hemispheric infarction on the fifth postoperative day. At reoperation both ruptures were found to be located in the middle of the patch whereas the suture lines were intact. Both patients were hypertensive. In the first case, an accessory saphenous vein retrieved from the calf had been the only venous material available for the patch, while the other patient had varicose veins in the contralateral leg. Pathology revealed central transmural tissue necrosis in one of the disrupted patches. A review of the literature regarding morphologic alterations of free vein grafts placed within the arterial circulation as well as hemodynamics in patched arterial segments may provide additional insight as to the inherent benefits and risks of vein patch angioplasty after carotid endarterectomy. When considering vein patch angioplasty, particular attention should be directed to the gross aspect of the vein to be used as well as to any antecedent history of phlebitis. PMID- 1772763 TI - Subclavian artery revascularization for myocardial ischemia. AB - A 54-year-old woman had a secondary occlusion of the subclavian artery proximal to the internal mammary artery, which had been used for an anterior interventricular artery bypass, and was the source of recurrent angina. A left carotid-to-subclavian bypass was performed with success. This rare complication underscores the need for careful selection and surveillance of candidates for myocardial revascularization using the internal mammary artery. PMID- 1772764 TI - Spontaneous dissecting aneurysm of the common iliac artery. AB - A 52-year-old man sought medical advice for sudden onset of intermittent claudication of the left lower limb after 50 meters walking. Aortography documented a dissecting aneurysm limited to the left common iliac artery. After resection, a prosthetic graft was inserted. Pathology showed that the cause of the dissection was atheroma. Spontaneous dissecting aneurysm of the common iliac artery is rare. Rupture represents the principal hazard. A high index of suspicion should lead to diagnosis as soon as signs of lower limb ischemia, occasionally transient, appear. PMID- 1772765 TI - Monobloc resection of the upper extremity of the leg for bone tumor with distal vascular reconstruction. AB - A patient with juxtacortical osteosarcoma of the upper extremity of the left tibia which encased the popliteal neurovascular bundle was treated by monobloc resection of the superior extremity of the tibia and the tibial nerve. The knee joint was replaced by a Guepar prosthetic knee. Arterial and venous continuity was reestablished by a double bypass using the contralateral greater saphenous vein. One year later the patient had good lower limb function and was free of local or general disease. This observation confirms that preservation of lower limb function is possible using reconstruction techniques of bone, nerves, and vessels in sarcoma of the musculoskeletal system. PMID- 1772766 TI - Surgical management of major varicose veins of the lower limb using a pneumatic tourniquet. AB - A technique to facilitate ablation of varicose veins is described. We have tested this technique in 25 patients. A pneumatic tourniquet is place on the lower limb during operation for a maximum of 90 minutes. This technique allows the operative field to remain dry and clean, and the resulting bloodless field makes the operation easier and faster. Because the veins are empty, they are removed more easily and completely, even in cases of severe dermatitis or adhesion. PMID- 1772767 TI - Valve disruption for in situ vein bypass: use of a new technique. AB - Following its introduction in 1960, the in situ bypass technique has gradually gained acceptance among vascular surgeons. This can be explained, in part, by the lack of a reliable method for rendering vein valves incompetent. Several instruments developed by Skagseth and Hall, Leather and Karmody, and others have been used. Although most are relatively easy to use, one common drawback is the difficulty in controlling rotation of the cutting blade. This is due to insufficient torsional rigidity of the shaft and the lack of a blade plane indicator. Edwards, in 1936, described the consistent orientation of vein valves, whose margins are always parallel to the overlying skin surface. This knowledge facilitates complete midline incision of the valve cusps, provided that the surgeon is able to control the cutting blade. With this fact in mind, we have developed a new set of instruments. They feature satisfactory torsional rigidity, as well as blade plane indicators at the handle. For the endoscopist, the blade plane is made visible by a mark at the tip of each instrument. Precision manufactured of stainless steel and welded with laser technology, the instruments are suitable for multiple use, which we consider an advantage from an economic, as well as an ecological viewpoint. PMID- 1772768 TI - Reconstructive internal carotid artery surgery over forty years (October 20, 1951 1991). AB - The background and history of internal carotid reconstruction are presented. High lights in the early development of this technique include the research of John Ramsay Hunt, Moniz, and Leriche, and the surgical techniques of Carrel and Guthrie. Miller Fisher published his extensive studies on cerebrovascular disease and carotid occlusion in 1951. Pioneering operations by Carrea and Molins in Argentina, Strully, Hurwitt, and Blankenberg in New York and DeBakey in Houston soon followed. DeBakey's technique became the standard technique for the surgical treatment of occlusive carotid lesions. Eastcott, Pickering and Rob published the first paper describing a carotid reconstruction in The Lancet in 1954. Recently two large multicenter trials have reinforced the benefit of carotid surgery under proper indications and in experienced hands. PMID- 1772769 TI - Buerger's disease (thromboangiitis obliterans). PMID- 1772770 TI - Traumatic aortic disruption. PMID- 1772771 TI - PVD: nurse--patient interventions. AB - The intervention program described began with teaching patients in simple terms about PVD, associated risk factors, and why change is important. Teaching aids such as posters and booklets were used to supplement discussion. Positive reinforcement was emphasized. Phone calls, follow-up visits, encouragement and praise were frequent. Newsletters focusing on different aspects of the various risk factors were developed and mailed monthly. Patients were encouraged and helped to develop an individualized program of change based on discussions and practicality. They were encouraged to start slowly and increase gradually. Emphasis was placed on reinforcement, self-help, and praise for efforts. Patients were encouraged to keep a brief daily log of progress and thoughts. Regularly scheduled physical assessments provided a tool to assess change and provide tangible evidence of their ability to set a goal, follow through, and make life style change. PMID- 1772772 TI - Foot care and footwear to prevent amputation. PMID- 1772773 TI - Donation of used diagnostic equipment. PMID- 1772774 TI - Symptomatic subclavian artery occlusion: a case study. AB - Although symptomatic upper extremity ischemia due to subclavian artery occlusion is uncommon, it is a recognized syndrome in the vascular literature. When it does occur, significant functional disabilities can result. Carotid-subclavian bypass is one approach to revascularization of the ischemic upper extremity. Nurses should be aware of the signs and symptoms of subclavian artery occlusion, the appropriate assessments, pre-op and post-op interventions, and educational needs of these patients. PMID- 1772775 TI - Prevention of infection during neutropenia. PMID- 1772776 TI - Shift in the megakaryocyte ploidy in MDS patients: microcytofluorometry with DAPI staining after destaining of Wright-Giemsa stain. AB - We applied DAPI (4',6-diamidino-2-phenylindole) staining to the determination of nuclear DNA content in single megakaryocytes in 12 normal subjects and 12 patients with myelodysplastic syndrome (MDS). After the megakaryocytes had been identified on Wright-Giemsa stained smear and classified according to modified Feinendegen's classification, they were photographed. Then Wright-Giemsa stain was removed by immersion in 50% ethanol at 37 degrees C for 1 h and 100% methanol at 37 degrees C for 1 h. The specimens were then stained with DAPI solution (DAPI 0.01 mg/ml, pH 7.4 Tris-EDTA-2Na buffer solution and 0.01 M 2-mercaptoethylamine hydrochloride mixed at the ratio of 0.5:98.5:1.0) for more than 30 min. The amount of nuclear DNA in the previously identified megakaryocytes was measured by microcytofluorometry. The maximum population of megakaryocytes ploidy was in 16N in normal subjects, 8N in 10/12 MDS patients, and 4N in the remaining two patients. These findings suggest impairment of the development of the megakaryocytes nucleus in the MDS patients. PMID- 1772777 TI - Antiproliferative activity of quercetin on normal bone marrow and leukaemic progenitors. AB - We used an in vitro clonogenic assay in semi-solid medium to test the sensitivity of normal bone marrow and acute myeloid and lymphoid leukaemia progenitors to the flavonol quercetin. We have studied 14 acute myeloid (AML) and four acute lymphoid (ALL) leukaemias. All ALL and the vast majority of AML (12/14) had a high sensitivity to quercetin with more than 50% growth inhibition at 2 x 10(-6) M quercetin. One M3-AML was partially quercetin-sensitive displaying 60% surviving AML-colony forming units (CFU-AML) at a quercetin concentration of 10( 5) M. One M1-AML was resistant to the growth inhibitory effect of quercetin at a concentration of 2 x 10(-5) M. The clonogenic efficiency of both AML and ALL positively correlated with leukaemic colony-forming unit (CFU-L) sensitivity to quercetin suggesting that this parameter can be useful in predicting quercetin responsiveness of leukaemic cells. We have also studied the effect of various quercetin concentrations on colony formation by normal bone marrow cells. At a quercetin concentration of 10(-5) M, we observed (in five different experiments) a mean recovery of 53% and 65% of erythroid blast-forming units (BFU-E) and granulocyte-macrophage colony-forming units (CFU-GM), respectively. Thus, normal bone marrow appeared partially resistant to quercetin, being inhibited less than 50% by quercetin concentration higher than 2 x 10(-5). When normal bone marrow were deprived in CD34+ haematopoietic progenitors the resultant population became highly sensitive to quercetin, with a mean recovery of BFU-E and CFU-GM of 5% and 12% of controls respectively in the presence of 2 x 10(-5) M quercetin. Furthermore, CD34 progenitors, positively selected, appeared fully resistant to quercetin concentrations as high as 2 x 10(-5) M. Thus, CD34+ progenitors are a quercetin-resistant component in normal bone marrow. In conclusion, our results further provide a biological basis for the therapeutic use of quercetin, considering that this compound could inhibit leukaemic cell growth without suppressing normal haematopoiesis. PMID- 1772778 TI - Second transplants for leukaemic relapse after bone marrow transplantation: high early mortality but favourable effect of chronic GVHD on continued remission. A report by the EBMT Leukaemia Working Party. AB - Ninety second bone marrow transplants (BMT) for relapsed leukaemia were carried out in 30 European BMT centres. At second BMT, after further treatment in 64 cases, 43 patients were in complete remission or in chronic phase of CML, and 47 were in continuing relapse, accelerated phase or blast crisis of CML. Seventy patients died, 37 from early transplant-related toxicity and relapse or failure to eradicate leukaemia which occurred in 23. There were 20 survivors. The actuarial disease-free survival was 11% with a relapse probability of 69% at 3 years. Associated with reduced graft-versus-host disease (GVHD) prophylaxis during second BMT, the incidence and severity of acute and chronic GVHD, was increased when compared with the first BMT (P = 0.02, and 0.002 respectively for acute and chronic GVHD). In multivariate analysis survival was shown to be favoured by a prolonged interval between first and second BMT (relative risk 1.3/year, P = 0.02), and no or mild chronic GVHD following first BMT (relative risk 2.3, P = 0.02). Continuing remission was favoured by chronic GVHD occurring after second BMT (relative risk 8.1, P = 0.004). These results confirm the high treatment-related mortality following second BMT, but identify superior survival in selected patients. Improved results might be achieved by further reduction in preparative regimen intensity, and increasing graft-versus-leukaemia reactivity. PMID- 1772779 TI - Chromosome 17- and p53 changes in lymphoma. AB - The clinical course of lymphoma patients in whom rearrangements or deletions of the short arm of chromosome 17 (17p) were evident by cytogenetics was rapidly progressive with a short survival. The gene for the protein designated p53 resides in 17p. We studied four lymphoma cell lines derived from human tumours, and 25 tumour samples of patients with lymphomas, for any evidence of p53 genomic changes by Southern blot technique. The four cell lines and four of the 25 tumour samples showed numerical changes of chromosome 17 or structural abnormalities of 17p (translocations or deletions). Allelic loss of the p53 gene was found in two of the four cell lines, and one of these in addition showed a rearrangement of the 3' end of the gene. Of the four tumours known to have chromosome 17 abnormality, one specimen showed allelic loss of the p53 gene. None of the remaining tumour samples showed any significant change. These studies suggest that acquisition of changes in the short arm of chromosome 17, which may be interrelated with the p53 gene, may carry a poor prognosis in patients with non Hodgkin's lymphoma. PMID- 1772780 TI - In vitro Ig-synthesis and proliferative activity in multiple myeloma are stimulated by different growth factors. AB - Plasma cells isolated from bone marrow (BM) aspirates of 15 patients with active multiple myeloma (MM) were cultured and analysed for in vitro proliferative response and Ig-synthesis upon stimulation with interleukin-3 (IL-3), interleukin 4 (IL-4) and interleukin-6 (IL-6). The proliferative response, determined as Ki 67 positivity in concentrated plasma cells, was increased by IL-6 (Stimulation Index, SI = 1.77 +/- 0.21 (M +/- SEM] but not by IL-3 or IL-4. This proliferation could be blocked by anti-IL-6. In vitro Ig-synthesis was stimulated by IL-4 (SI = 1.62 +/- 0.12 (M +/- SEM) P less than 0.05) but not by IL-6 or IL-3. This effect was not antagonized by anti-IL-6. An inverse correlation was found in this group of patients between the IL-6 induced stimulation of plasma cell proliferative activity and the IL-4 induced increase of Ig-synthesis (P = 0.027). These data indicate in MM that Ig-synthesis and the in vitro proliferative activity may be stimulated by different haematopoietic growth factors, which may reflect the involvement of different responding cells. PMID- 1772781 TI - Detection of endothelial cell-reactive immunoglobulin in patients with anti phospholipid antibodies. AB - Individuals with anti-phospholipid antibodies are at increased risk for the development of thrombosis and fetal loss. The pathogenesis of these syndromes is unknown, but may involve antibody-mediated alterations in endothelial cell coagulant activity. To address this possibility, we determined the incidence of endothelial cell-reactive antibodies in 76 patients whose plasma contained anti phospholipid antibodies, but who had no clinically-evident immune disorder. Plasma from 47 patients deposited significantly more immunoglobulin on cultured endothelial cells than control plasma. Positive tests were more frequent in patients with a history of thrombosis than in those without (17/19 v 23/48; P = 0.004). However, we observed no correlation between immunoglobulin deposition on cardiolipin and endothelial cells by individual plasmas. Furthermore, endothelial cell reactivity was not diminished by adsorption of anti-cardiolipin antibodies from patient sera using liposomes. Immunoglobulin fractions prepared from 5/6 patient sera immunoprecipitated a approximately 70 kDa endothelial cell surface protein; 4/5 of these fractions also induced the release of von Willebrand factor from endothelial cells. These results demonstrate that plasma from many patients with anti-phospholipid antibodies, but no clinically-evident autoimmune disease, also contains endothelial cell-reactive antibodies. Detection of such antibodies might help identify individuals in this patient population at greatest risk for thrombosis. PMID- 1772782 TI - No activation of the common pathway of the coagulation cascade after a highly purified factor IX concentrate. AB - Purer factor IX concentrates, containing very little or no factor II or X, have been developed in an attempt to avoid the thromboembolic complications that occur with prothrombin complex concentrates (PCC), which also contain factors II and X and variable amounts of factor VII. To evaluate ex vivo the thrombogenic potential of one of these purer concentrates, we studied whether large single doses produced signs of activation of the coagulation cascade in patients with haemophilia B, and compared the results with those obtained after infusion of a PCC. Seven patients were infused with 50 IU/kg of factor IX concentrate and seven additional patients were subsequently infused with 100 IU/kg of the same concentrate. After the infusions, factor IX levels rose in proportion to the administered dose while the concentrations of factor II and factor X did not rise at all. At both doses of concentrate, we did not observe significant post infusion increments in the levels of the factor X activation peptide (a measure of the activity of the factor VIIa-tissue factor complex and/or the factor IXa VIIIa-activated surface complex), prothrombin fragment 1 + 2 (a measure of factor Xa activity), and fibrinopeptide A (a measure of thrombin activity). We also infused 10 patients with a PCC (50 IU/kg). After the infusions, significant rises in the concentrations of the factor X activation peptide and prothrombin fragment were observed. Therefore, it appears that the infusion of a PCC to patients with haemophilia B can augment factor X activation and subsequently thrombin generation in vivo and that this process can be abrogated by the administration of more pure factor IX concentrate. PMID- 1772783 TI - Recurring mutations at CpG dinucleotides in the region of the von Willebrand factor gene encoding the glycoprotein Ib binding domain, in patients with type IIB von Willebrand's disease. AB - The mutant von Willebrand factor (vWf) molecule in type IIB von Willebrand's disease (vWd) has an increased binding affinity for the platelet receptor glycoprotein Ib (GpIb). In previous studies we have confirmed genetic linkage of this phenotype to the vWf gene and in this report we document three recurring missense mutations in the region of the gene that encodes the GpIb binding domain. Two families with type IIB vWd were found to have an arginine to tryptophan substitution at residue 543, three families had a valine to methionine substitution at residue 553, and one kindred had an arginine to glutamine change at amino acid 578. None of these sequence changes were found in 200 normal vWf genes and within each of the six families the mutations were only found in affected subjects. This is strong circumstantial evidence in support of these substitutions representing the disease causing mutations in these families. All three of these substitutions have occurred at CpG dinucleotide sequences, and their polymorphic associations indicate that they represent recurring new mutations. Missense mutations at these sites may represent the underlying genetic pathology in a large number of type IIB vWd families. PMID- 1772784 TI - An in-vitro direct chemiluminescence assay for assessment of platelet-bound antibody in thrombocytopenic patients. AB - A direct chemiluminescence test (CLT) employing autologous monocytes and granulocytes was used to assay platelet-bound antibody in comparison to the direct platelet suspension immunofluorescence test (PSIFT) in 50 patients. Twenty six of the 30 immune thrombocytopenic purpura (ITP) patients, including all 21 chronic ITP patients with platelet counts below 100 x 10(9)/l, showed positive results with at least one type of phagocytic cell; so did seven of the eight patients with other presumed autoimmune thrombocytopenias, and three out of 12 patients with thrombocytopenia associated with non-immune disorders. This test appears potentially valuable in the clinical diagnosis of immune thrombocytopenias. PMID- 1772785 TI - Iron metabolism in patients with the anaemia of end-stage renal disease during treatment with recombinant human erythropoietin. AB - Iron metabolism was studied in 21 patients with the anaemia of end-stage renal disease during 40 weeks of treatment with recombinant human erythropoietin (rhEPO). Oral iron was prescribed to all patients. Initial serum iron concentrations and transferrin saturation levels were subnormal, decreased during the correction period of treatment, and increased thereafter. In 81% of patients in whom pretreatment transferrin saturation was below 0.25, transferrin saturation decreased below 0.16, despite sufficiently high serum ferritin levels. Serum ferritin concentrations decreased significantly. There was no correlation between serum ferritin levels and serum iron or transferrin saturation. Ferrokinetic studies, performed before and during treatment, showed an increase in plasma iron turnover, in erythron transferrin uptake, and in the flux of iron binding sites through the plasma. The rhEPO dose needed to keep the haematocrit at the target level during the maintenance period of treatment was significantly correlated with transferrin saturation, and iron binding capacity, but not with serum ferritin concentrations. This suggests that the functional availability of iron in plasma, rather than the size of body iron stores, is a major factor in the determination of the response to rhEPO treatment in end-stage renal disease. PMID- 1772786 TI - Rare beta-thalassaemia mutations in Asian indians. AB - Five beta-thalassaemia mutations hitherto undescribed in Asian Indians were identified in beta-thalassaemia carriers originating from the Indian subcontinent by direct sequencing of their beta-globin genes which were amplified by the polymerase chain reaction (PCR). A T-G substitution at IVS 2 position 837, which probably creates an alternative acceptor splice site and a T insertion in codon 88, resulting in a shift in the reading frame with a premature stop codon, are new beta-thalassaemia mutations. The others were framshift codon 5 (-CT), IVS 1 position 110 (G-A) and IVS-1 minus 1 (G-A) which have been described previously in other populations. These results complete the characterization of the beta thalassaemia mutations in 708 carriers of Asian Indian origin and will enable a comprehensive programme of carrier screening and prenatal diagnosis of beta thalassaemia in this population. PMID- 1772787 TI - Multiprimer-PCR for screening of genetic abnormalities in acute lymphoblastic leukaemia. PMID- 1772788 TI - Acute lymphoblastic leukaemia in butchers and abattoir workers. PMID- 1772789 TI - Proposed classification for the myelodysplasia/myelofibrosis syndromes. PMID- 1772790 TI - Hyperfibrotic myelodysplasia. PMID- 1772791 TI - Treatment of plasma cell leukaemia and resistant/relapsed multiple myeloma with vincristine, mitoxantrone and dexamethasone (VMD protocol) PMID- 1772792 TI - Detection of abnormal haemoglobins by the Sysmex NE-8000 automated cell counter. PMID- 1772793 TI - Increased percentage of activated T lymphocytes in B cell lymphocytic leukaemia (B-CLL) patients. PMID- 1772794 TI - Abstracts of papers presented at a Combined Meeting of the Dutch Society of Haematology and the British Society for Haematology, Lunteren, 17-20 September 1991. PMID- 1772795 TI - Exposure to cement dust at a Portland cement factory and the risk of cancer. AB - The relation between exposure to cement dust and cancer was examined in a population of 546 cement workers and a reference population of 858 randomly sampled men of similar age and area of residence. In 1974 all men gave lifelong occupational and smoking histories; information on incidence of cancer in the period 1974-85 was obtained from the Danish Cancer Registry. No increased risk of overall cancer was found among cement workers. Among men with more than 20 years exposure to cement dust, 14 cases of respiratory cancer were observed (observed/expected (O/E) 1.52, 95% confidence interval (95% CI) 0.90-2.57) when compared with all Danish men. Men with 1-20 years exposure had O/E 1.14 (95% CI 0.59-2.19) based on nine cases of cancer. After excluding all men with documented exposure to asbestos during employment in an asbestos cement factory no increased risk of overall cancer or respiratory cancer was found among cement workers compared with white collar workers from the local reference population, using a Cox regression model controlling for age and smoking habits. Relative risks were 0.5 (95% CI 0.1-1.5) and 1.0 (95% CI 0.4-2.6) for men with 1-20 and more than 20 years of exposure to cement dust respectively compared with white collar workers. PMID- 1772796 TI - A case-control study of lung cancer in a cohort of workers potentially exposed to slag wool fibres. AB - A cohort of 4841 men were identified as having worked for more than a year at nine slag wool plants. Some of these men were potentially exposed to man made vitreous fibres (MMVF). The vital status of the entire cohort was ascertained to the end of 1989. Of the 504 deaths that occurred between 1970 and 1989, 61 were attributed to lung cancer (cases). Individually matched controls were randomly selected from the remaining deaths. Attempts were made to locate and interview the surviving families of the cases and controls. The families of three lung cancer cases could not be located and no matched controls were found for another three cases. Included in the final analysis were 55 cases and 98 controls. Estimates of individual exposure to MMVF were based on employment records and industrial hygiene surveys. Data on smoking and histories of employment outside the MMVF industry were obtained from telephone interviews and employment records. Relative risks were calculated for cigarette smoking and exposure to MMVF. No increased risk of lung cancer was found associated with exposure to MMVF, and analysis by cumulative fibre exposure did not indicate any trend. As expected, cigarette smoking was found to be responsible for the observed increase in mortality from lung cancer in this group of MMVF workers, and the risk increased with increasing pack-years of cigarette smoking. PMID- 1772797 TI - Quantitative skin prick and bronchial provocation tests with platinum salt. AB - Occupational asthma due to platinum salts is a frequent disease in platinum refineries. The diagnosis is based upon a history of work related symptoms and a positive skin prick test with platinum salts. Bronchial provocation tests have not been performed in epidemiological studies because the skin test is believed to be highly specific and sensitive. As no reliable data about this issue currently exist, this study assesses the use of skin prick and bronchial provocation tests with methacholine and platinum salt in platinum refinery workers. Twenty seven of 35 workers, who were referred to our clinic with work related symptoms and nine control subjects with bronchial hyperreactivity underwent a skin prick test and bronchial provocation with methacholine and platinum salt. For skin prick and bronchial provocation tests with platinum salt a 10(-2)-10(-8) mol/l hexachloroplatinic acid solution, in 10-fold dilutions was used. Four of the 27 subjects and all controls showed neither a bronchial reaction nor a skin reaction. Twenty three subjects were considered allergic to platinum salt; 22 of these showed a fall of 50% or more in specific airway conductance after inhalation of the platinum salt solution. Four workers experienced a positive bronchial reaction despite a negative skin prick test. No correlation of responsiveness to methacholine with responsiveness to platinum salt was found, but the skin prick test correlated with the bronchial reaction to platinum salt (rs = 0.50, p less than 0.023, n = 22). One dual reaction was seen in bronchial provocation tests. Side effects of both skin tests and bronchial provocation tests with platinum salt were rare and were not encountered in workers without a skin reaction to platinum salt. It is concluded that bronchial provocation tests with platinum salts should be performed on workers with work related symptoms but negative skin tests with platinum salts. PMID- 1772798 TI - The protective role of zinc in the toxic action of coal dust upon mouse macrophages. AB - Macrophages from mice were cultured at 37 degrees C with 1640 medium containing 10% bovine serum. The macrophage suspension was made from 50 Swiss mice and was cultured in the following groups: control group; coal dust group (with added coal dust particles (10 micrograms/ml) smaller than 4 microns diameter); subdivided zinc-coal dust group (as coal dust group with zinc added in three different concentrations--namely, 10 ppm, 30 ppm, and 60 ppm). Cells were examined by light microscopy. Obvious differences were found in the rate of cell deaths between the coal dust group and the zinc-coal dust group after culture for 48 hours. The cell membranes were ruptured after culturing with coal dust, and the presence of zinc appeared in some degree to protect cell membranes from damage caused by the dust. Staining the cells with Gomori's modified method, showed that acid phosphatase particles in the zinc-coal dust group were more numerous than in the coal dust group. The results indicate that the trace element zinc may play an important part in protecting against the cytotoxic action of coal dust. PMID- 1772799 TI - Cigarette smoking and small irregular opacities. AB - A survey of chemical workers by chest roentgenograms was designed to determine whether exposure to acrylic dust and/or cigarette smoking was associated with diffuse abnormalities suggestive of pneumoconiosis. The films were examined without knowledge of dust exposure or smoking habits. The International Labour Office (ILO) classification and standard films were used. Workers with exposure to asbestos were excluded. There was no relation between prevalence of abnormalities and exposure to dust. Among 181 workers 28 had s and/or t small irregular opacities with profusion of 0/1 (23), 1/0 (three), or 1/1 (two). These findings were present in 20% of smokers compared with 2.2% of non-smokers. The prevalence increased with increasing age to 31.6% among smokers aged 50-64. Prevalence was 10% among ex-smokers of cigarettes. Among current cigarette smokers, prevalence was 5.3% in those who smoked less than one pack per day, 31.3% in heavier cigarette smokers, and 52.9% in 17 heavy cigarette smokers aged 50-64. Profusions of 0/1 and 1/0 are classified as "suspect" pneumoconiosis according to the ILO guidelines. The data in this study indicate that such abnormalities are directly related to age and smoking habits among workers not exposed to hazardous dust. PMID- 1772800 TI - Toxicity of mercury compounds as a possible risk factor for cardiovascular diseases. PMID- 1772801 TI - Resolving mixtures of strategies in spatial visualization tasks. AB - The models of standard test theory, having evolved under a trait-oriented psychology, do not reflect the knowledge structures and the problem-solving strategies now seen as central to understanding performance and learning. In some applications, however, key qualitative distinctions among persons as to structures and strategies can be expressed through mixtures of test theory models, drawing on substantive theory to delineate the components of the mixture. This approach is illustrated with response latencies to spatial visualization tasks that can be solved by mental rotation or by a non-rotational rule-based strategy. It is assumed that a subject employs the same strategy on all tasks, but the possibility of extending the approach to strategy-switching is discussed. PMID- 1772802 TI - Scaled test statistics and robust standard errors for non-normal data in covariance structure analysis: a Monte Carlo study. AB - Research studying robustness of maximum likelihood (ML) statistics in covariance structure analysis has concluded that test statistics and standard errors are biased under severe non-normality. An estimation procedure known as asymptotic distribution free (ADF), making no distributional assumption, has been suggested to avoid these biases. Corrections to the normal theory statistics to yield more adequate performance have also been proposed. This study compares the performance of a scaled test statistic and robust standard errors for two models under several non-normal conditions and also compares these with the results from ML and ADF methods. Both ML and ADF test statistics performed rather well in one model and considerably worse in the other. In general, the scaled test statistic seemed to behave better than the ML test statistic and the ADF statistic performed the worst. The robust and ADF standard errors yielded more appropriate estimates of sampling variability than the ML standard errors, which were usually downward biased, in both models under most of the non-normal conditions. ML test statistics and standard errors were found to be quite robust to the violation of the normality assumption when data had either symmetric and platykurtic distributions, or non-symmetric and zero kurtotic distributions. PMID- 1772803 TI - Early dendritic outgrowth of primate retinal ganglion cells. AB - The pattern of dendritic stratification of retinal ganglion cells in the fetal monkey (Macaca mulatta) was examined using horseradish peroxidase and retinal explants. Ganglion cells in the rhesus monkey are born between embryonic day (E) 30-70 (LaVail et al., 1983). At E60, E67, and E68, approximately 50% of all ganglion cells within the central 3.0 mm of the retina had dendritic arbors that were unistratified within the inner plexiform layer (IPL), while the remaining 50% had bistratified arbors. Unistratified cells had relatively flat arbors that ramified within a restricted portion of the IPL. In contrast, bistratified cells had one portion of the arbor that branched in the inner half of the IPL and a second portion that branched in the outer half of the IPL. Relatively few bistratified cells were encountered in the central 1.0 mm of the retina but were more numerous with increasing eccentricity. At E81, E90, and E110, the dendritic arbors of ganglion cells increased in both area and complexity, but occupied a relatively small percentage of the total depth of the IPL. The bistratified cells encountered at these fetal ages were typically located in the far retinal periphery. Between E125-E140, the dendritic arbors of individual ganglion cells increased in area and depth to occupy a greater proportion of the total IPL than at earlier fetal ages. These observations suggest that ganglion cells in the macaque undergo at least three stages of dendritic stratification: (1) an initial period of dendritic growth during which the cells have either unistratified or bistratified dendritic arbors; (2) a loss of the majority of bistratified cells through cell death or remodeling of the arbor; and (3) growth or expansion of the arbor to occupy a greater percentage of the total depth of the IPL. The first two stages are similar to recent observations in the fetal cat (Maslim & Stone, 1988) with the exception that dendritic development in the primate lacks an initial diffuse ingrowth to the IPL. Additionally, primate ganglion cells undergo a third stage of dendritic growth in late fetal development during which the arbor occupies a greater proportion of the depth of the IPL. PMID- 1772804 TI - Motion selectivity and the contrast-response function of simple cells in the visual cortex. AB - The responses of simple cells were recorded from the visual cortex of cats, as a function of the position and contrast of counterphase and drifting grating patterns, to assess whether direction selectivity can be accounted for on the basis of linear summation. The expected responses to a counterphase grating, given a strictly linear model, would be the sum of the responses to the two drifting components. The measured responses were not consistent with the linear prediction. For example, nearly all cells showed two positions where the responses approached zero (i.e. two "null phase positions"); this was true, even for the most direction selective cells. However, the measured responses were consistent with the hypothesis that direction selectivity is a consequence of the linear spatiotemporal receptive-field structure, coupled with the nonlinearities revealed by the contrast-response function: contrast gain control, halfwave rectification, and expansive exponent. When arranged in a particular sequence, each of these linear and nonlinear mechanisms performs a useful function in a general model of simple cells. The linear spatiotemporal receptive field initiates stimulus selectivity (for direction, orientation, spatial frequency, etc.). The expansive response exponent enhances selectivity. The contrast-set gain control maintains selectivity (over a wide range of contrasts, in spite of the limited dynamic response range and steep slope of the contrast-response function). Rectification conserves metabolic energy. PMID- 1772805 TI - Complicated substructure from simple circularly symmetric Gaussian processes within the centers of goldfish ganglion cell receptive fields. AB - The center of the receptive field of some retinal ganglion cells exhibits an interesting fine structure: the relative amplitudes of responses to onset and responses to offset of a small spot of light varies systematically as the spot is positioned at various places within the center. Although this pattern may appear complicated, a simple model can account for it in detail. The model postulates that the ganglion cell receives input from separate ON and OFF processes within the center of its receptive field. These processes have the form of Gaussian functions and are laterally displaced from each other. These central ON and OFF input processes are not associated with the additional antagonistic surround of the receptive field. The model is examined for various parameters of the input processes. The observed systematic variation in the ratio of offset to onset responses is predicted when the two processes are of nearly equal width (standard deviation of the Gaussians). Receptive fields made of more than two Gaussians produce various patterns, depending on the relative standard deviations of the Gaussians. Oblong fields, reminiscent of those found in visual cortex, may be generated from a relatively small number of circularly symmetric Gaussian processes. PMID- 1772806 TI - Extraretinal representations in area V4 in the macaque monkey. AB - Several neurophysiological studies have shown that the visual cerebral cortex of macaque monkeys performing delayed match-to-sample tasks contains individual neurons whose levels of activity depend on the sample the animal is required to remember. Haenny et al. (1988) reported that the activity of neurons in area V4 of monkeys performing an orientation matching task depends on the orientation for which the animal is searching. It was proposed that these neurons contribute to a representation of the orientation being sought. We have further characterized these neurons by recording visual responses from individual neurons during multiple behavioral tasks. Animals were trained to perform an orientation match to-sample task using either a visual or a tactile orientation sample. In a set of 89 neurons examined using both types of sample, 25% showed statistically significant effects of sample orientation regardless of whether the sample was visual or tactile. Most of these preferred the same sample orientation in both conditions. These results allow us to specify the nature of the information signaled by these neurons more precisely than has previously been possible. For 193 units tested using one of the matching tasks, responses were also recorded while the animal performed a simple fixation task. In this task the animal was not required to attend to the visual stimuli that were presented. A few neurons that were responsive during the matching task were silent during fixation, but a comparable number was much more responsive during fixation. Across the whole population there was no systematic change in either responsivity or selectivity for orientation under the two conditions. PMID- 1772807 TI - Light-induced GTPase activity and GTP[gamma S] binding in squid retinal photoreceptors. AB - Illumination greatly increases the GTPase activity in homogenates of squid (Loligo) whole retinas or rhabdomeric membranes. Adenylylimidodiphosphate inhibits the light-insensitive (but not the light-sensitive) GTPase activity in these homogenates. Illumination also greatly increases the binding of GTP[gamma S] to the rhabdomeric membranes. This binding at saturating illuminations indicates that there are approximately 10-100 times more rhodopsin molecules than G-protein molecules in squid photoreceptors. Each light-activated rhodopsin molecule activates about 10 G-protein molecules which might provide amplification for the first stage of the phototransduction cascade. PMID- 1772808 TI - Refractive state, contrast sensitivity, and resolution in the freshwater turtle, Pseudemys scripta elegans, determined by tectal visual-evoked potentials. AB - Visual-evoked potentials (VEPs) were recorded from the surface of the optic tectum of the freshwater turtle, Pseudemys scripta elegans, in response to phase reversal of square-wave gratings of different spatial frequency and contrast. The refractive state of a group of 12 turtles in air was assessed from VEPs by placing trial lenses in front of the eye. The group mean refraction did not differ significantly from emmetropia, as compared to 4.8 diopters of hyperopia when refracted retinoscopically. The difference was explained by the retinoscopic reflex originating from the interface between vitreous humor and retina. Peak VEP amplitude was approximately linear with log grating contrast; extrapolation to zero VEP amplitude yielded contrast thresholds as low as 1%. High spatial frequency cutoffs ranged from 4.4-9.9 cycle/deg in different animals, the highest values corresponding to the intercone spacing in the area centralis and to behavioral measures of acuity in a related species. PMID- 1772809 TI - Ocular dimensions and schematic eyes of freshwater and sea turtles. AB - Measurements were made of the ocular dimensions from living and frozen eyes of one species of freshwater turtle, Pseudemys scripta elegans, and of three species of marine turtles, Chelonia mydas, Dermochelys cariacea, and Eretmochelys imbricata. Estimates of refractive error by retinoscopy were also obtained with eyes in air and under water. The results suggest that unaccommodated eyes of all four species are approximately emmetropic in air but strongly hyperopic in water. Schematic eyes were calculated for each species in both air and water. PMID- 1772810 TI - Reduction of ocular blood flow results in glial fibrillary acidic protein (GFAP) expression in rat retinal Muller cells. AB - Reduction of blood flow to the rat retina was achieved by either clamping both carotid arteries briefly (24 min) or combining clamping of the carotid arteries with permanent occlusion of the vertebral arteries. Analysis of retinas 6 days after operations showed that GFAP immunoreactivity is expressed throughout the retinal Muller cells, although this was variable in retinas from animals where only the carotid arteries were clamped. GFAP immunoreactivity was not associated with retinal Muller cells from control animals and no obvious neuronal damage was observed in retinas from operated animals. These data suggest that Muller-cell GFAP expression may be used as an index to follow possible processes leading to an ischemic insult. PMID- 1772811 TI - The effects of epinephrine on the anesthetic and hemodynamic properties of ropivacaine and bupivacaine after epidural administration in the dog. AB - Ropivacaine is a new local anesthetic that is chemically related to mepivacaine and bupivacaine. Previous laboratory studies have demonstrated that ropivacaine possesses an anesthetic profile similar to that of bupivacaine and has less arrhythmogenic potential. The current study was initiated to compare the hemodynamic and anesthetic effects of epidurally administered 0.75% bupivacaine and 1% ropivacaine, with and without epinephrine (1:200,000), in the dog. Two groups of six dogs were randomly assigned to the ropivacaine or bupivacaine treatment groups. Administration of 0.75% bupivacaine and 1% ropivacaine with and without epinephrine was randomized. Volumes of 3 ml of each solution were injected in a blinded manner via an indwelling lumbar epidural catheter with 48 hours between injections. No statistically significant difference existed between the four treatment groups with regard to onset and duration of sensory or motor block. Hemodynamic changes were, for the most part, not different between drugs. Significant decreases were seen in mean arterial blood pressure and cardiac output in all test groups. No difference in the degree of cardiovascular depression was observed. The addition of epinephrine did not alter onset or duration of sensory or motor block in this animal model. Epinephrine reduced the average anesthetic blood concentration observed in both treatment groups at the various time intervals, but not the time to achieve the mean maximum blood level. No residual adverse effects were observed in any animal. PMID- 1772812 TI - Efficacy of subarachnoid meperidine for labor analgesia. AB - Meperidine is an opioid agonist with known weak local anesthetic properties. To determine the efficacy of subarachnoid meperidine as a labor and delivery analgesic, 20 term parturients were given 10 mg meperidine via continuous spinal catheter. Visual analog pain scores on a ten-point scale and patient satisfaction scores on a four-point scale were measured before and after establishment of the block and one hour after maximum block was achieved. Time to pain relief and return of pain was recorded. Additional doses of 7 mg meperidine were given subarachnoid via the catheter when patients requested additional analgesia. Follow-up assessment 24 hours postpartum was used to determine overall patient satisfaction. Visual analog pain scale scores (mean +/- SD) were 8.57 +/- 1.43 before block, 0.62 +/- 0.89 immediately after block, and 0.33 +/- 0.57 at one hour after block (p less than 0.0001). Patient satisfaction scale scores (mean +/ SD) were 0.83 +/- 0.88 before block, 3.90 +/- 0.37 immediately after block, and 3.85 +/- 0.31 at one hour after block (p less than 0.0001). At follow-up, 14 of 18 patients rated satisfaction as excellent, with the remaining 4 rating it as good. Expulsive efforts were excellent in 14, good in 3, and fair in 1; 2 patients had cesarean sections. Mean time to onset of pain relief was 3.9 minutes (range, 2-12), with analgesia lasting a mean of 83 minutes (range, 38-180). Two patients developed slight motor block. Side effects appeared insidiously and are similar to those observed with other neuraxial opioids. PMID- 1772814 TI - Low-dose thoracic epidural anesthesia induces discrete thoracic anesthesia without reduction in cardiac output. AB - The sensory spread and hemodynamic effects of low-dose thoracic epidural anesthesia were closely studied in 13 elective preoperative patients undergoing thoracotomy. An epidural catheter was inserted at the T4-5 or T5-6 intervertebral space and 5 ml 0.5% plain bupivacaine was injected. Cardiac output was measured by suprasternal Doppler method in all patients and also by thermodilution method with a Swan-Ganz catheter in six subjects. The cardiac outputs measured by suprasternal Doppler (Y) and thermodilution (X) methods showed a high correlation (Y = 0.74X + 0.99, r = 0.90, n = 24). Cephalad and caudad levels of hypesthesia at 15 minutes after bupivacaine injection were C8.4 +/- 2.1 (mean +/- SD) and T7.8 +/- 2.6, and those of anesthesia, T1.9 +/- 2.4 and T5.7 +/- 2.6, respectively. After epidural injection of 0.5% plain bupivacaine, a mean decrease in heart rate of 12 was observed in 15 minutes, which while clinically insignificant, was statistically significant (p less than 0.001). The decreased heart rate returned to control level after endotracheal intubation. Mean arterial blood pressure decreased slightly and only a slight elevation was seen after endotracheal intubation. Cardiac index and pulmonary capillary wedge pressure were essentially unchanged during the study period. Central venous pressure increased gradually and significantly, but within the normal range. Pulmonary vascular resistance slightly decreased in 15 minutes and returned to the control level after endotracheal intubation. Thus, low-dose thoracic epidural anesthesia was associated with minimal cardiovascular changes. PMID- 1772813 TI - Tourniquet pain: the response to the maintenance of tourniquet inflation on the upper extremity of volunteers. AB - This investigation examined the effect of three factors--tourniquet width, tourniquet inflation pressure, and application of the tourniquet to the left or right extremity--on the intensity of tourniquet pain and duration of tourniquet inflation, as well as the circulatory effects associated with maintenance of inflation of a pneumatic tourniquet on an upper extremity of 12 healthy, unmedicated volunteers. All subjects manifested a time-dependent circulatory response to maintenance of tourniquet inflation, characterized by increases in heart rate and systolic and diastolic blood pressure. The mean duration of tourniquet inflation was 34 +/- 13 minutes (mean +/- SD). No difference was demonstrated with respect to the width of the tourniquet, the tourniquet inflation pressure, or the application of the tourniquet to the left or right extremity on the intensity of pain or the duration of tourniquet inflation. PMID- 1772815 TI - Temperature monitoring during epidural anesthesia for cesarean delivery. AB - Tympanic, rectal, and axillary temperatures were measured and compared in 12 ASA Physical Status I and II parturients during epidural anesthesia for cesarean delivery. Measurements were performed before (T0) and at 15 (T1), 30 (T2), 45 (T3), and 60 (T4) minutes after epidural anesthesia. At birth, rectal neonatal and maternal temperatures were measured. Before anesthesia, maternal tympanic and rectal temperatures were statistically not different but higher than axillary temperature (difference, 0.5 degrees C). During anesthesia, all three maternal temperatures decreased. There was no difference for the first 45 minutes between rectal and tympanic membrane temperatures and no difference between tympanic and axillary temperatures after 30 minutes. The difference between rectal and tympanic temperatures became significant at T4. During the same period, the difference between axillary and tympanic temperatures became nonsignificant at T3 and T4. At birth, both maternal and newborn rectal temperatures were similar at 36.0 +/- 0.2 degrees C. The relative hypothermia observed in the newborns at birth after regional anesthesia was well correlated with the decrease in maternal temperature. A decrease in tympanic temperature of 1.4 degrees C developed during the course of epidural anesthesia for cesarean delivery. This decrease was underestimated by the measurement of rectal and axillary temperatures. PMID- 1772816 TI - The hypothermic action of epidural and subarachnoid morphine in parturients. AB - Sublingual body temperatures were measured before and at 0.5, 1, 2, 3, 4, 8, 12, and 24 hours after administration of epidural or subarachnoid morphine in four groups of patients (n = 15 in each group) undergoing cesarean delivery with regional anesthesia. All patients were acutely hydrated with 1200 ml warmed lactated Ringer's solution. Group 1 received 5 mg epidural morphine; Group 2, 5 ml epidural saline; Group 3, 0.5 mg subarachnoid morphine, and Group 4, 0.5 ml subarachnoid saline. The results were expressed as means +/- SEM and analyzed using analysis of variance at p less than 0.05. Body temperature decreased significantly in all the four groups after anesthesia. The maximum decreases in Groups 1, 2, 3, and 4, respectively, were 0.95 +/- 0.1, 0.9 +/- 0.1, 1.4 +/- 0.2, and 0.8 +/- 0.13 degrees C and occurred at 0.5, 1, 2, and 1 hour, respectively. The decrease was greater in the subarachnoid morphine group than in the other groups (p less than 0.03). At any of the measurement periods, the temperatures in the two epidural groups did not differ from each other. However, the temperature in the subarachnoid morphine group remained significantly lower than the corresponding temperature in the control group for up to 24 hours. It is concluded that subarachnoid morphine intensifies the hypothermic action of spinal anesthesia in parturients. PMID- 1772817 TI - Subarachnoid midazolam: histologic study in rats and report of its effect on chronic pain in humans. AB - Subarachnoid administration via a catheter of a water-soluble benzodiazepine, midazolam, was tested in the control of cancer pain. First, the lack of its toxicity during constant subarachnoid administration (50 micrograms per day) was assessed in the rat. After 15 days of treatment, a histologic examination of the spinal cord revealed the same amount of fibrosis, infiltration, and deformation in the control group (n = 14), which had received only saline, as in the test group (n = 18), treated with subarachnoid midazolam. Therefore, the histologic changes observed in the spinal cord probably are related to the presence of the catheter. After these results, a mixture of 2 mg midazolam and a variable dose of subarachnoid morphine was injected in two patients presenting chronic neoplastic pain resistant to high doses of morphine. In these two cases, the addition of midazolam appeared to be effective in controlling intractable neoplastic pain. PMID- 1772819 TI - Epidural anesthesia: modified method to identify the epidural space. PMID- 1772818 TI - Continuous subarachnoid analgesia in two adolescents with severe scoliosis and impaired pulmonary function. AB - We report postoperative pain management of two adolescents after upper abdominal procedures, one with Hurler-Scheie syndrome and a second with Duchenne muscular dystrophy, and both had progressive spinal scoliosis with poor pulmonary function. A combined technique of subarachnoid and general anesthesia was used during surgery. Postoperative administration of small intermittent doses of subarachnoid morphine produced profound analgesia, which eliminated the need for systemic opioids, restored preoperative arterial oxygenation within 48 hours after the operation, and expedited postoperative recovery. PMID- 1772820 TI - Combined spinal-epidural anesthesia with a specialized needle. PMID- 1772821 TI - An alternative to pinprick testing. PMID- 1772822 TI - Differential scanning calorimetric studies on bovine serum albumin: II. Effects of neutral salts and urea. AB - Using defatted and SH-blocked bovine serum albumin (BSA), measurements of differential scanning calorimetry (d.s.c.) have been made mainly in NaSCN solution. BSA undergoes a heat-induced conformational transition in a particular range of pH and ionic strength and is separated into two thermally independent units, each of which has different thermostability in acidic and alkaline pH regions. Comparisons were made of the pH dependencies of the enthalpy of thermal denaturation (delta H) and the temperature of thermal denaturation (Td) in 0.01 M NaSCN with those in 0.01 M NaCl. It has been found that the stabilizing effect of NaSCN on BSA is larger than that of NaCl at pH 3.5-8, and that the heat-induced transition occurs by the electrostatic repulsive forces among the positively charged amino acid residues in a segment Arg 184-Arg 216 containing Trp 212 and the primary binding sites of anions. At ionic strength 0.01, the relative effectiveness of anions in suppressing the heat-induced transition and increasing the thermostability of BSA follows the order ClO4- - greater than or equal to SCN greater than I- greater than SO4(2-) greater than Br- greater than Cl-. At ionic strength 0.1, the heat-induced transition is suppressing in all the salt solutions, and a Td increase follows the order ClO4- greater than or equal to SCN greater than I- greater than Br- greater than Cl- greater than or equal to SO4(2 ). Thus, the highly chaotropic ions thermostabilize BSA more markedly than kosmotropic ions in the low and moderate salt concentrations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772823 TI - Destabilization of the duplex and the high-salt Z-form of poly(dG-methyl5dC) by substitution of ethyl for the 5-methyl group. AB - The B-to-Z conformational transition of poly(dG-dC) is highly promoted by 5 methyl substitution of the dC moiety, i.e. in poly(dG-methyl5dC). By the synthesis of a new poly(dG-dC) analogue, poly(dG-ethyl5dC), the effect of a longer alkyl-chain substituent of dC on structure and conformation has been studied with ultraviolet absorption melting profiles and circular dichroism spectroscopy. The 5-ethyl substituent in poly(dG-ethyl5dC) destabilizes the duplex structure against thermal denaturation compared with both poly(dG methyl5dC) and poly(dG-dC). C.d. studies also reveal that for the high-salt B-Z transition of poly(dG-ethyl5dC) a higher NaCl concentration is required than for that of poly(dG-methyl5dC), although much lower than for poly(dG-dC). However low salt Z-DNA in poly(dG-ethyl5dC) shows unique features, e.g. it needs no divalent cations to be stable. The low-salt B-Z transition of poly(dG-ethyl5dC) can also be observed by the absorption-temperature melting profile, in contrast to both poly(dG-methyl5dC) and poly(dG-dC). The effects of MgCl2 concentration, temperature, acid pH and trifluorethanol on the conformation of poly(dG-ethyl5dC) have also been determined. PMID- 1772824 TI - Room temperature, low-field 13C-n.m.r. spectra of degraded carrageenans. Part II. On the specificity of the autohydrolysis reaction in kappa/iota and mu/nu structures. AB - A kappa/iota carrageenan from Gigartina skottsbergii and a partially cyclized mu/nu carrageenan from Iridaea undulosa were submitted to autohydrolysis. The 13C n.m.r. spectra of the degraded products give structural information on the polysaccharides and show clearly that besides the known splitting of 3,6 anhydrogalactosidic linkages, the linkage between alpha-D-galactose 2,6 disulphate and beta-D-galactose 4-sulphate is cleaved with similar specific reaction rate. PMID- 1772825 TI - Kinetics of the reaction between 5,5'-dithiobis[2-nitrobenzoic acid] and the sulphydryl group in Zn(2+)-dependent beta-lactamase II. AB - The kinetics of the reaction of the thiol residue in Zn(2+)-dependent beta lactamase II with 5,5'-dithiobis[2-nitrobenzoic acid], and the concomitant inactivation revealed that both events take place at the same rate. The inactivation could not be reverted by incubation with Zn2+ or by using a substrate concentration about eight times the Km of the enzyme. EDTA incubation also produced inactivation of the enzyme, although it was reverted by increasing the substrate concentration in the assay. A dual role is proposed for Zn2+ in beta-lactamase. The kinetic analysis of the thiol modification and the concomitant inactivation is in agreement with previous reports on the implication of the metal ion in catalysis. A role in stabilizing the native structure of the enzyme is also suggested. PMID- 1772826 TI - Changes in the c.d. spectra of calf thymus DNA induced by sequential polypeptides in aqueous solutions. Part I. AB - Interactions of calf thymus DNA with sequential polypeptides were studied using c.d. spectroscopy in aqueous solutions. It was found that DNA structural alterations induced by sequential polypeptides (L-Arg-X-Gly)n (where X = L-Val, Leu, Ile, Nva, Nle) are modulated by the nature of the X residue. Thus, the polypeptide (L-Arg-L-Nva-Gly)n induced the 10.2B-DNA form, whereas the polypeptides (L-Arg-L-Ile-Gly)n having one methyl group less on the X residue side chain, did not provide any significant modification to the structure of DNA. The effect of ionic strength from 0.14 M NaCl (physiological value) to zero was also analysed on the basis of the observed c.d. changes and the degree of complexation in the DNA-polypeptides was estimated. PMID- 1772827 TI - Changes in the c.d. spectra of calf thymus DNA induced by sequential polypeptides in trifluoroethanol solutions. Part II. AB - Interactions between calf thymus DNA and (L-Arg-X-Gly)n sequential polypeptides (where X = L-Ala, Val, Leu, Ile, Nva, Nle) in trifluoroethanol: water (40:60) solutions in the salt range of 0.12-0.5 M NaCl, were studied using c.d. spectroscopy. It was found that DNA tertiary structure (psi form) is modulated by the nature of the polypeptides (variation of X residue). The effect of the secondary structure of polypeptides on the formation of psi-DNA was also analysed. Unordered polypeptides destabilized psi aggregates, while helical polypeptides favoured DNA tertiary structure. A loss of tertiary structure was observed in the presence of the (L-Arg-L-Val-Gly)n, which can be attributed to the ability of valine to suppress psi-type DNA. PMID- 1772828 TI - Short and long range order in basement membrane type IV collagen revealed by enzymic and chemical extraction. AB - Oriented bovine lens capsules give X-ray diffraction patterns suggesting a considerable degree of order in the collagenous components, predominantly type IV collagen. Here we report the effects of preliminary treatment of lens capsules before orientation. Extraction with 4 M guanidinium hydrochloride or with heparinase/hyaluronidase reveals the same collagenous diffraction patterns previously seen after extraction with 1 M NaCl. There is a four-point pattern of d-spacing 3.9 nm, indicating liquid crystal cybotactic nematic organization, along with sharp streaked meridional reflections which index as orders of 21 nm. This suggests that the removal of basement membrane proteoglycans results in a reduction in diffuse scatter and clarification of the pattern. Extraction of the lens capsules with trypsin or dithiothreitol greatly reduces the intensity of the four-point pattern while leaving the meridional pattern unaffected. This strengthens the evidence that the 21 nm period has its origins in the collagen IV helix. Reduction in the four-point pattern could arise if disruption of non helical NC1 domains or 7S overlap regions allows slippage of the collagen molecules on orientation, weakening the proposed 1 nm intermolecular stagger. Ultra-low angle diffraction patterns of extracted lens capsules show meridional reflections which index as a long-range axial repeat of approximately 95 nm. This is consistent with a model of microfibrils of type IV collagen in which the NC1 domains bind to the collagen helix at approximately 100 nm intervals, as has been previously suggested. PMID- 1772829 TI - Non-specificity of a colorimetric method for the estimation of N-acetyl-D glucosamine. AB - The colorimetric method of Reissig et al. for the estimation of N-acetylamino sugars, is often used as a specific method for the quantification of the N-acetyl D-glucosamine. Although this assay is more sensitive to the monomer, it recognizes all soluble N-acetyl-D-glucosamine oligomers. This result is very important because this method is extensively used in biology for the estimation of chitinolytic activity. PMID- 1772830 TI - Secretory IgA adsorption and oral streptococcal adhesion to human enamel and artificial solid substrata with various surface free energies. AB - In this paper, secretory IgA adsorption from a single component sIgA solution and from human whole saliva onto human enamel and artificial solid substrata with various surface free energies was studied as a function of time. ELISA indicated that screening or displacement of adsorbed sIgA by other salivary proteins occurred only on low surface free energy substrata, not on high surface free energy substrata such as enamel. In addition, the adhesion of three oral streptococcal strains (Streptococcus mitis BMS, S. sanguis 12, and S. mutans NS), also having widely different surface free energies, to sIgA-coated surfaces was studied. The adhesion of all three streptococcal strains was significantly reduced in the presence of a sIgA coating. However, ranking the adhesion data with respect to the various substrata revealed a similar order to that in the case of uncoated substrata, indicating that substratum properties were at least partly transferred by the adsorbed protein film to the interface with adhering micro-organisms. For S. sanguis 12 and S. mitis BMS, adhesion decreased proportionally with the amounts of sIgA detected by ELISA, but for S. mutans NS such relations with the amounts of sIgA detected on the protein-coated substrata were not found. Thus, for S. mutans NS a specific antibody effect seems to exist in addition to a non-specific protein effect like that observed for S. sanguis 12 and S. mitis BMS. PMID- 1772831 TI - New quaternary ammonium polymers as antimicrobial agents. Part II. Alkylation products of linear aliphatic poly (aminodisulphides). AB - Two new polymeric disulphides containing t-amino groups in their main chain, namely poly[1,8-(3,6-dimethyl-3,6-diaza) octaine diyl disulphide] (5) and poly[1,8-(1,12-(3-10-dimethyl-3,10-diaza) dodecane diyl disulphide] (6) were prepared by the polyoxidation of 3,6-dimethyl-3,6-diazaoctane-1,8-dithiol (3) and 3,10-dimethyl-3,10-diazadodecane-1,12-dithiol (4), respectively. They were quaternized with methyl iodide and benzyl bromide, and the resulting quaternary ammonium polymers were preliminarily tested for antimicrobial activity against Escherichia coli K12, Pseudomonas aeruginosa, and Staphylococcus aureus. All the quaternized products showed interesting killing potency against P. aeruginosa. The benzylated products, besides being more active against P. aeruginosa, showed fair activity also against the other bacterial strains tested. PMID- 1772832 TI - Analysis of proteins eluted from hemodialysis membranes. AB - To further investigate the types of interactions occurring between blood and hemodialysis membranes, proteins were sequentially eluted from used dialysers. Four different membranes (cuprophan, hemophan, cellulose acetate and polyacrylonitrile) were successively treated with a hydrogen bond cleaving agent (10 M urea), an ionic detergent destabilizing the hydrophobic interactions between apolar groups (SDS solution), and a hydroxylamine solution at alkaline pH to release postulated covalently bound C3 fragments. The eluted proteins were analyzed by SDS-PAGE and immunological techniques. Total protein determinations demonstrate different behaviour of the membranes as regards the 'protein cake'. Electrophoretic analysis suggests that qualitative and quantitative differences in the binding of the blood proteins are related to the membrane material. Complement fragment studies indicate that the complement activating potential of the dialysis membrane may not be determined by the availability of potential binding sites for activated C3b. An attempt is made to correlate these results with the biocompatibility concept. PMID- 1772833 TI - Kinetic aspects of human placental alkaline phosphatase enzyme membrane. AB - The crosslinking of alkaline phosphatase of human placenta with human serum albumin has been optimized. During the physico-chemical characterization of this immobilized biocatalyst, special attention was paid to attributes such as the irreversibility of the enzyme support bonding, the stability of the catalytic activity, and the effects of pH and temperature on this activity. Regarding stability, patterns of denaturation are proposed, to account for inactivation curves over time and under storage/operation conditions. These patterns, in some cases, indicate the existence of different populations of immobilized enzyme molecules, with a different degree of sensitivity to denaturation. The activity vs pH profiles are clearly modified by the immobilization process. This is because the pH of the free homogeneous solution, measurable with a pH-meter, differs from the real pH of the immediate microenvironment of the immobilized enzyme molecules due to the effects of proton accumulation in the microenvironment (in the reaction catalysed by alkaline phosphatase, protons are produced), to limitations to the free diffusion of H+ and to the possible partition effects of H+ due to polar interactions with residues or molecules of the enzyme membrane. In the experimental working conditions, the apparent optimum temperatures are centered at 40 degrees C, inactivation (thermal denaturation) occurring above this temperature. In the temperature range 10-40 degrees C, the kinetic control over the overall activity of the immobilized enzyme was observed, causing the Arrhenius profiles to be linear. PMID- 1772834 TI - Poly(amidoamine)s with potential as drug carriers: degradation and cellular toxicity. AB - Poly(amidoamine)s were synthesized by polyaddition reaction: to bis acryloylpiperazine of piperazine (1), or N,N'-bis(2-hydroxyethyl)ethylenediamine (2), and to 2,2-bis(acrylamido)acetic acid of piperazine (3). Compound 2 was also end-capped with 4-hydroxythiophenol, thus introducing a terminal moiety suitable for radio-iodination using the chloramine T method (4). Such polymers behave as bases in aqueous solution, and their net average charge alters considerably as the pH changes from 7.4 to 5.5. This results in a change in polymer conformation which may prove useful in the design of polymeric drug delivery systems. However, their suitability for use in the organism will depend on polymer toxicity and also on their rate of biodegradation. Here we studied the biological properties of the above poly(amidoamine)s with a view to optimizing the synthesis of novel drug carriers. The general cytotoxicity of compounds 1, 2, 3, and 4 was examined in vitro using two human cell lines, hepatoma (HepG2) and a lymphoblastoid leukaemia (CCRF). Several different methods [the tetrazolium (MTT) test, [3H]leucine or [3H]thymidine incorporation, or counting cell numbers] were used to measure cell viability. Compounds 1, 2, and 4 were much less toxic to both cell lines than equivalent concentrations of the polycationic poly-L-lysine, and in no case did viability fall below 50% (concentrations up to 2 mg/ml). Although compound 2 was not markedly toxic to HepG2 cells, concentration-dependent toxicity was observed against CCRF cells. In this case, the polymer concentration decreasing viability by 59% (ID50) was approximately 50 micrograms/ml for compound 2 compared with an ID50 of approximately 10 micrograms/ml for poly-L lysine. The rate of hydrolytic degradation of compound 2 was examined using viscometric measurements and gel permeation chromatography (GPC). After incubation at pH 7.5 and 8.0 for 24 h, polymer intrinsic viscosity was decreased by approximately 50% and GPC elution profiles showed a simultaneous increase in polymer retention time, indicating a fall in molecular weight. Hydrolytic degradation progressed much more slowly at pH 5.5. Compound 4 was also incubated with a mixture of isolated rat liver lysosomal enzymes (tritosomes) at pH 5.5, but no increase in the rate of degradation was observed. PMID- 1772835 TI - Comments on protein adsorption on polymer surfaces: calculation of adsorption energies. PMID- 1772836 TI - Fast space-filling molecular graphics using dynamic partitioning among parallel processors. AB - We present a novel algorithm for the efficient generation of high-quality space filling molecular graphics that is particularly appropriate for the creation of the large number of images needed in the animation of molecular dynamics. Each atom of the molecule is represented by a sphere of an appropriate radius, and the image of the sphere is constructed pixel-by-pixel using a generalization of the lighting model proposed by Porter (Comp. Graphics 1978, 12, 282). The edges of the spheres are antialiased, and intersections between spheres are handled through a simple blending algorithm that provides very smooth edges. We have implemented this algorithm on a multiprocessor computer using a procedure that dynamically repartitions the effort among the processors based on the CPU time used by each processor to create the previous image. This dynamic reallocation among processors automatically maximizes efficiency in the face of both the changing nature of the image from frame to frame and the shifting demands of the other programs running simultaneously on the same processors. We present data showing the efficiency of this multiprocessing algorithm as the number of processors is increased. The combination of the graphics and multiprocessor algorithms allows the fast generation of many high-quality images. PMID- 1772837 TI - Implementing knot-theoretical characterization methods to analyze the backbone structure of proteins: application to CTF L7/L12 and carboxypeptidase A inhibitor proteins. AB - In this work we apply a recently developed method for characterizing the shape of the tertiary structure of proteins. The approach is based on a combination of graph- and knot-theoretical characterizations of Cartesian projections of the space curve describing the protein backbone. The proposed technique reduces the essential shape features to a topologically based code formed by a sequence of knot symbols and polynomials. These polynomials are topological invariants that describe the overcrossing and knotting patterns of curves derived from the molecular space curve. These descriptors are algorithmically computed. The procedure is applied to describe the structure of the carboxy terminal fragment of the L7/L12 chloroplast ribosomal protein (CTF L7/L12) and the potato carboxypeptidase A inhibitor protein (PCI), which has a set of three disulfide bridges. In the former case, we describe the protein's shape features in terms of its alpha-helices, and a backbone simplified by considering helices without internal structure. An extension of the methodology to describe disulfide bridges is discussed and applied to PCI. Changes in the knot-theoretical characterization due to possible uncertainties in the resolution of the X-ray structure, as well as the inclusion of low-frequency motions of the backbone, are also discussed. PMID- 1772838 TI - Pharmacophoric pattern matching in files of three-dimensional chemical structures: use of smoothed bounded distances for incompletely specified query patterns. AB - This paper describes a technique for increasing the screen-out of pharmacophoric pattern searches in the databases of three-dimensional chemical structures when only some of the interatomic distances in the query pattern are specified. The technique involves the application of a distance bounds-smoothing procedure to the query distances; this smoothing allows the calculation of upper and lower bounds for the unspecified distances. The bounded distances can then be used to set screens additional to those that are set to describe the distances that have been specified by the searcher. Evidence is presented to suggest that use of the technique can lead to increases in the efficiency of substructure searches for partially specified query patterns. PMID- 1772839 TI - Visualization of structural similarity in proteins. AB - Two new methods for the visualization of structural similarity in proteins with known three-dimensional structures are presented. They are based on the degree of equivalence of alpha-carbon pairs in two proteins. The quantitative measure for residue equivalence is the comparison score generated using the sequence and structure alignment method of Taylor and Orengo, which is based on the comparison of interatomic distances (and other properties that can be defined on a residue basis). The first method uses information on corresponding alpha-carbon positions to display vectors joining these structurally equivalent residues. These vectors can be defined as target constraints, and their minimization "bends" the two proteins toward a common average structure. In the average structure the corresponding residues virtually superpose, while insertions and deletions become clearly visible. The second method uses the comparison scores to perform a weighted least-squares fit of the two structures. It is further used to color code the two structures according to the score value, i.e., their similarity, on a continuous scale from red to blue. Examples of the methods for the comparison of flavodoxin, chemotaxis Y protein and L-arabinose-binding protein are given. PMID- 1772840 TI - FORME: an interactive package for protein backbone deformation. AB - The FORME package presented herein is designed for modeling purposes: It allows interactive deformation of the protein backbone. General formalism on transformations is introduced and the operators of stretching inside an "acceptance area" and stretching with end-block invariance (i.e., governed by a translational moving) are described. A discussion is presented on the choice of strategy to achieve an interactive deformation tool. Perspectives about complex transformations are presented. PMID- 1772841 TI - Calculation and display of electrostatic potentials. AB - A general methodology is developed for incorporating accurate electrostatic information from ab initio molecular orbital calculations into molecular mechanics calculations. Examples are given of the method applied to simple aromatic organic molecules. A program has been developed for displaying the results of the ab initio calculations on a Silicon Graphics workstation. The technique developed here provides an alternative method for including electrostatic interactions in molecular mechanics calculations and is compared with other methods for determining atomic charges. PMID- 1772842 TI - ANTHEPROT: an interactive graphics software for analyzing protein structures from sequences. AB - ANTHEPROT is a fully interactive program devoted to the analysis of protein structures using a graphics workstation. It presents four options: The first option can predict secondary structures using five methods, and hydrophobicity, solvent accessibility, flexibility and antigenicity profiles using eighteen scales. The user may introduce his own scales. The results displayed on the screen can be easily analyzed. The second option is for representing results concerning up to eight proteins by one method. To compare these proteins, it is possible to align the profiles or the predicted secondary structure according to various motifs. The secondary structure deduced from crystallographic data may also be introduced. The third option is designed to compare the primary structure of two proteins and to visualize on the screen regions that exhibit similarity. Six different comparison matrices may be used, but the user can also introduce his own matrices. The last option is for studying the proteolytic peptides resulting from a chemical or enzymatic digestion of a given protein. It is possible to analyze the protein cleavage using eleven chemical reagents or enzymes. The results are displayed on the screen as RP-HPLC chromatogram. PMID- 1772843 TI - Exact visibility calculation for space-filling molecular models. AB - The visible portion of two intersecting atoms is exactly calculated to be bounded by a circular arc and an elliptic arc. The elliptic arc can be approximated either by a circular arc or by a cubic Bezier curve. Using one shaded template for each atom type and stamping the templates in a mask bitmap delineated by these curves, images are generated rapidly. PMID- 1772844 TI - Displaying inter-main chain hydrogen bond patterns in proteins. AB - Two computer graphics techniques for displaying hydrogen bonds between the main chains of different proteins are described, and illustrated for two thiol proteases. (The X-ray crystallography was performed by Kamphuis et al. in 1984, and by Baker and Dodson in 1980.) One is a three-dimensional model that can be manipulated in space; the hydrogen bonds are represented with the smoothed alpha carbon plot of the polypeptide chain. In the other type of display, hydrogen bonds are viewed in relation to the one-dimensional sequence. Both types of picture facilitate visualization of hydrogen bond patterns, such that loop motifs, as well as alpha-helices and beta-sheets, can be examined easily. We suggest that such displays are useful as a general means of displaying whole proteins and whole domains because they reveal more information than do conventional simplified pictures of proteins, which focus exclusively on alpha helices and beta-sheets. These techniques can be implemented on a UNIX-based computer graphics workstation. (UNIX is a trademark of Bell Telephone laboratories.) PMID- 1772845 TI - Pharmacophoric pattern matching in files of three-dimensional chemical structures: characterization and use of generalized valence angle screens. AB - This paper describes the use of generalized valence angles for the screening of pharmacophoric pattern searches in databases of three-dimensional chemical structures. A generalized valence angle is defined as the angle between two vectors, AB and BC, which have a common vertex B, and in which both vectors correspond to formal chemical bonds; one vector corresponds to a bond and the other to a non-bonded interaction; or both vectors correspond to non-bonded interactions. The screens are identified by a statistical analysis of the frequencies of occurrence of these angle-based features in the Cambridge Structural Database. The occurrence frequencies are discussed and shown to be explicable in terms of small, commonly occurring structural features. The effectiveness of the screens is demonstrated by an extensive series of searches for representative pharmacophoric patterns. The results are compared with those obtained from a similar series of searches using distance-based screens: The latter are found to give a better level of performance, and evidence is presented to suggest that this is due to a high degree of association between the assignments of the angle-based screens. PMID- 1772846 TI - VESICA: computer graphics modeling of lipid vesicles. AB - A vesicle simulation and computer analysis program, VESICA, is described which employs spherical projections of triangularly tessellated icosahedra to produce molecular graphics models of the three-dimensional structures of lipid vesicles. The program is used to analyze the molecular architecture of small unilamellar vesicles of dipalmitoyl-phosphatidylcholine and is demonstrated as a worthwhile investigative tool for determining the factors that govern the minimum vesicle size. PMID- 1772847 TI - On the use of a general-purpose CAD program for molecular graphics. AB - It is suggested that general-purpose computer-aided design software can be of good use in producing high-quality molecular graphics. Such software is often widely available. Besides being an alternative to existing programs, hard copy creation is facilitated by this approach. PMID- 1772848 TI - Conic: a fast renderer for space-filling molecules with shadows. AB - We present an algorithm for generating images of molecules represented as a set of intersecting opaque spheres. Both perspective and shadows are computed to provide realistic visual cues. Compared to existing programs for generating similar images, our algorithm is both more accurate and several times faster. We present in detail the mathematics used in picture generation, along with examples of the computed images. PMID- 1772849 TI - Molecular mechanics of the formation of cholic acid micelles. AB - The molecular mechanics of cholic acid micelle formation were simulated using the Sybyl energy minimization program (MAXIMIN2), developed by Tripos Associates, interfaced with micro-Vax. Before energy minimization, the molecular dimensions of the cholic acid dodecamer C24H40O6, in terms of the unit cell axes a, b, and c in the cubic crystal class, had values of 13, 18, and 6.7 A, respectively. After energy minimization, at 9370 kcals/dodecamer, these values had increased to 21.6, 42.8 and 20.9 A. At an energy minimization level of 21,626 kcals/dodecamer, the micelle structure is stabilized by hydrophobic interaction, forming distinct horizontal channels along the b-axis, directing the carboxyl and hydroxyl groups toward the surface. These structural changes remain relatively constant as the process of energy minimization continues, down to the lowest energy level we considered, 9370 kcals/dodecamer. The cholic acid layers are highly dissimilar, forming channels of irregular size and shape in a somewhat helical structure. The carboxyl groups and phenanthrene rings are in a puckered orientation, which permits compact packing of the sandwiched multilayers. From the dimension of the channels, it is apparent that guest molecules, such as phospholipid, cholesterol, or inorganic calcium, can be incorporated into the micelle through more than one channel, forming inclusion complexes, such as gallstones. PMID- 1772850 TI - The application of fractal clustering to efficient molecular ray tracing on low cost computers. AB - Ray tracing is a powerful, and highly computer intensive means for generating high-quality molecular displays. A variety of simple, yet effective optimization strategies are described that allow large molecular models to be ray traced on microcomputers and low-cost desktop workstations. In particular, the method of fractal clustering provides a time and space-efficient means for spatially subdividing the molecular scene into a hierarchy of spherical bounding volumes, permitting ray-atom intersections to be determined by a form of binary search. An implementation of the algorithms, MolRay, is described which demonstrates that large structures may be ray traced in a reasonable time on a PC or small Unix workstation. Images generated by PC and Unix versions of MolRay are shown. PMID- 1772851 TI - Improved AMYR program: an algorithm for the theoretical simulation of molecular associations, including geometrical and topological characterization of the dimers. AB - Program AMYR, originally written by S. Fraga (University of Alberta, Canada), allows for the calculation of molecular associations using a pair-wise atom-atom potential. The interaction energy is evaluated through a 1/R expansion. Our improved version includes a dispersion energy term in the potential corrected by damping functions, the possibility of carrying out energy minimizations through variable metric methods, as well as the optional calculation of geometrical and topological indices. Program AMYR has been adapted also for high-performance computing and vectorization. An interactive version of the program carries out real-time molecular graphics showing simultaneously the energy profile of the calculations. PMID- 1772852 TI - Improved ribbon-drawing programs. AB - We describe significant improvements to RIBBON (a program system that produces schematic pictures of proteins) that extend its capabilities and simplify its use. Enhanced features include the drawing of ligands as an integral part of the picture and in a variety of styles, greater control of the displayed image, and a much improved user-interface. PMID- 1772853 TI - Midfacial fractures and the eye: the development of a system for detecting patients at risk of eye injury. AB - Maxillofacial trauma is often complicated by injury to the eye. Such injuries may be difficult to detect and may therefore be missed. Detailed ophthalmic examinations were carried out prospectively on 363 patients who had sustained midfacial fractures. Fifty four parameters comprising maxillofacial, radiological and ophthalmic data were recorded and coded for each patient. All encoded data were divided into predictors (the data potentially available to the maxillofacial surgeon) and outcome (the data potentially available to the ophthalmologist). Statistical methods of regression, and the analysis of contingency tables, led to the identification of the principal predictors indicative of underlying ophthalmic injury and thence to a scoring system which predicts the severity of such injuries. Impaired visual acuity is the principal predictor and when employed alone gives a sensitivity value of 80%. Pure blow-out fracture or comminuted facial fracture, double vision and amnesia emerged as additional factors which yielded an efficient scoring system with a sensitivity of 89% and specificity of 90% for the population upon which it was based. A score sheet is provided in the paper. These predictors can be remembered from the acronym Blow out fracture, Acuity, Diplopia, Amnesia, Comminuted Trauma. As many such injuries result from a BAD ACT, it is easily remembered. This scoring system requires to be tested upon a new population of individuals in order to determine its efficacy. PMID- 1772854 TI - Midfacial fractures and the eye: the development of a system for detecting patients at risk of eye injury--a prospective evaluation. AB - Midfacial trauma is often complicated by ocular disorder. A scoring system has been devised to help the maxillofacial surgeon identify patients who warrant referral to an ophthalmologist. A prospective pilot study was carried out on 100 patients with midfacial fractures to evaluate the effectiveness of this system in clinical practice. The sensitivity value was 94.4% and the specificity value was 89%. Only 1 patient, who clinically warranted referral to an ophthalmologist, was missed by the system whilst 9 others were incorrectly classified as warranting referral. The results of this evaluation demonstrate the competence of the system. PMID- 1772855 TI - Maxillofacial trauma in severely injured patients. AB - A study was made of maxillofacial trauma in seriously injured patients to determine the likely role of oral and maxillofacial surgeons working in the regional trauma centres proposed by the Royal College of Surgeons of England. There were 153 patients, aged 70 years or less, who sustained major trauma (injury severity score 16 or more) and were admitted directly to the accident departments of the Bristol Royal Infirmary or Derriford Hospital, Plymouth during 1989. Maxillofacial injuries occurred in 50 (33%) of these patients with lacerations present in 39, burns in 1 and facial bone fractures in 28 (18%); soft tissue abrasions and contusions were excluded. The aetiology, patterns of injury, surgical treatment and outcome were reviewed. The implications for the provision of maxillofacial surgical services in regional trauma centres is discussed. PMID- 1772856 TI - An upper cervical spine injury producing paraesthesia in the distribution of the mandibular division of the trigeminal nerve. AB - A case is reported of a 37-year-old man who developed paraesthesia in the distribution of the mandibular division of the trigeminal nerve following an injury to the upper cervical spine during a game of rugby. The central pathways of the trigeminal nerve are discussed and it is proposed that mandibular fibres descended beyond their expected level in the spinal trigeminal nucleus, and that it was these fibres which were compressed in the unstable dislocation at the atlanto-axial joint producing the paraesthesia described. Other remote anatomical explanations for the paraesthesia are considered. PMID- 1772857 TI - Internal derangement of the temporomandibular joint: an audit of clinical findings, arthrography and surgical treatment. AB - Forty seven patients who underwent double contrast video-arthrography followed by surgery for internal derangement of the temporomandibular joint were reviewed retrospectively. Of the 50 joints assessed, arthrography demonstrated 39 (78%) with irreducible meniscal displacement and 11 (22%) with reducible displacement. Clinical findings were found to be unreliable in demonstrating the degree of internal derangement: 49% of irreducible meniscal displacements presented with clicking and only 20% with loss of click. The importance of video-arthrography is emphasised. Surgery for internal derangement proved successful. It is proposed that patients who have clinical evidence suggestive of irreducible meniscal displacement and have disabling symptoms should undergo early video-arthrography and be offered surgical correction. PMID- 1772858 TI - Viruses in the aetiology of oral carcinoma? Examination of the evidence. AB - This paper examines the evidence for an aetiological role for viruses in the development of oral carcinoma. Several viruses have been sought in oral cancer and evidence found for some, particularly herpes simplex and human papillomavirus. However, the evidence also suggests that these viruses are ubiquitous agents and a number of criteria must be met before these potentially oncogenic agents can reliably be implicated in human carcinogenesis. In contrast, there is no evidence that viruses such as adenovirus, Epstein-Barr virus, and retroviruses play any role in oral carcinogenesis. PMID- 1772859 TI - A central venous catheter complicating head and neck surgery. AB - A case is reported of a central venous catheter that was placed inadvertently into the internal jugular vein during the anaesthetic preparation for surgery. The catheter tip was sectioned during surgery and was feared to have embolised into the central circulation but it was subsequently identified in the pathological specimen. A summary of the complications associated with central venous catheterisation is reported and a simple protocol is proposed to avoid a similar complication. PMID- 1772860 TI - Intra-osseous squamous cell carcinoma of the maxilla: probably arisen from non odontogenic epithelium. AB - This paper reports a case of intra-osseous squamous cell carcinoma (IOSC) of the maxilla. The patient was a 52-year-old male with a chief complaint of swelling of his hard palate. The lesion was initially diagnosed as an incisive canal cyst from the clinical and radiographic findings, but histological examination revealed the lesion to be a poorly differentiated squamous cell carcinoma. The review of the literature yielded only a few previous cases of IOSC of the maxilla, which were probably of odontogenic origin. The present maxillary IOSC is thought to be non-odontogenic in origin. PMID- 1772861 TI - Three main arteries of the face and their tortuosity. AB - The anatomy of the facial, transverse facial and infraorbital arteries and their tortuosity was studied in 69 human cadavers (age range 18-95 years). The types of facial vascularisation were divided into four categories according to the gradually diminishing relative dominance of the facial artery. Type A, in which the facial artery was dominant, comprised 22% of the cases; type B 49%; type C 20%; and the variant of the hypoplastic facial artery, type D, 9% of the cases. The type of vascularisation was not dependent on age or sex. The tortuosity of all three arteries showed a statistically significant increase with age. A weak correlation was found between the relative dominance and the tortuosity of the facial artery. PMID- 1772862 TI - John Herbert Hovell: the man. PMID- 1772863 TI - Orthognathic surgery: perspectively and prospectively. PMID- 1772864 TI - The transfacial approach to the postnasal space and retromaxillary structures. PMID- 1772865 TI - Anthropometric and dietary survey of elderly Chinese. AB - The study was conducted to provide reference values of anthropometry and dietary intakes of elderly Chinese aged greater than or equal to 70 years and to investigate differences between urban and rural groups. A total of 441 subjects comprising 260 urban elderly (126 men and 134 women) and 181 rural elderly (83 men and 98 women) participated in the anthropometric study. One hundred subjects (50 men and 50 women) from both urban and rural locations were selected randomly from the anthropometric cohort for dietary survey using the method of diet recall. For both men and women, the urban elderly had significantly higher intakes of protein, fat, calcium, iron, retinol, thiamin, riboflavin and nicotinic acid than did the rural elderly. Significant sexual differences were also observed: men had higher intakes of total energy and three macronutrients than women. Both regional and sexual differences in anthropometry (but not blood pressure) seemed to be consistent with the results of the dietary survey. Positive correlations were found between systolic blood pressure and the ratio waist:hip circumference for both men and women. As a marker of adipose tissue distribution, it seemed that this ratio was more predictive of high blood pressure than body-weight. PMID- 1772866 TI - Rumen fill and digesta kinetics in lactating Friesian cows given two levels of concentrates with two types of grass silage ad lib. AB - Four lactating Friesian cows with permanent cannulas in the rumen and proximal duodenum were given early (EC)- or late (LC)-cut grass silage ad lib., each with either 3 or 9 kg concentrate dry matter (DM)/d in a 4 x 4 Latin square design starting about 10 weeks after calving. Feed was offered twice daily at 08.30 hours and 15.30 hours. Periods lasted 5 weeks and measurements were made in the last 15 d. The higher amount of concentrates increased total DM intake but reduced silage DM intake and the fractional rate of degradation of silage-fibre DM. Later cutting date of silage had no effect on DM intake or the fractional rate of degradation of silage-fibre DM but reduced potential degradability of silage fibre. Dilution rate of CoEDTA in rumen fluid was greater during the day (eating period) than during the night (resting period). Dilution rates measured at the duodenum were lower than those measured in the rumen, but neither was affected by diet. Silage-particle passage rates were measured by use of ytterbium labelled silage fibre (Yb-fibre) and chromium-mordanted faecal particles (Cr faeces) and samples were taken at the duodenum and in the faeces. Values for slower rate constant (k1) and transit time were higher and for faster rate constant (k2) were lower for Yb-fibre than for Cr-faeces, but differences in total mean retention time were inconsistent. Values for k1 for both markers and k2 for Yb-fibre only were similar at both sampling sites, but values for k2 for Cr-faeces were lower in the faeces. No diet effects were established with Yb fibre but, with Cr-faeces, k1 was reduced by more concentrates and EC-silage. Daily mean weights of wet digesta, liquid, neutral-detergent fibre (NDF) and indigestible NDF in the rumen were greater with LC-silage but were unaffected by the amount of concentrates whereas weight of rumen DM was increased by the amount of concentrates only. Maximum rumen fill occurred at 18.00 hours with all diets. Particle-size distribution of rumen contents did not vary markedly during the day. Mean particle size was generally greater with LC-silage than EC-silage. Very small particles, passing through the 0.3 mm screen, constituted about half the rumen DM. It is concluded that rumen fill could have limited intake of LC-silage but not EC-silage.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1772867 TI - Passage and digestibility of lucerne (Medicago sativa) hay in Japanese sika deer (Cervus nippon) and sheep under restricted feeding. AB - The mean retention time (MRT) of stained hay through the whole digestive tract and its digestibility were measured in Japanese sika deer (Cervus nippon) and were compared with those in sheep when lucerne (Medicago sativa) hay was fed at 10, 20 and 30 g/kg body-weight. The recoveries in faeces of plastic particles with five specific gravities were also measured in deer. MRT for deer was significantly shorter than that for sheep at 10 and 20 g/kg feeding levels. The digestibilities of dry matter, organic matter, and neutral-detergent fibre were significantly lower for deer than for sheep at 30, 30 and 10 g/kg feeding levels respectively. The recovery rates of plastic particles were increased, but the ruminated rates were decreased, with increasing specific gravity in deer. These results suggest that the lower digestibility of lucerne hay in Japanese deer may be due to a shorter MRT compared with sheep. PMID- 1772868 TI - A new approach to the quantitative estimation of nitrogen metabolic pathways in the rumen. AB - Rumen nitrogen metabolism values were estimated by the use of a single injection of 15(NH4)2SO4 into the rumen of sheep and consecutive 15N enrichment measurements in the rumen ammonia pool, rumen non-NH3-N (NAN) pool, rumen purine pool and blood urea-N (BUN) pool for a period of 24 h. Synthesis and degradation of N compounds in the rumen and passage of N to and from the rumen were evaluated on a chemical rather than a microbial basis; microbial fractions were not separated. This model was examined in two experiments. In Expt 1 a ram (55 kg) was given a semi-synthetic diet (1067 g dry matter (DM), 22.8 g N) in which soya bean meal provided over 90% of the N. In Expt 2, two rams (45 kg) were given in three consecutive periods a semi-synthetic basal diet containing: (1) roasted soya-bean meal (SBM, 725 g DM, 14.8 g N/d); or (2) fishmeal (FM, 728 g DM, 15.5 g N/d); or (3) raw soya-bean meal (RSBM, 724 g DM, 13.8 g N/d). In all these rations, the main protein source provided over 90% of the N. In Expt 1, 68.3% of N intake was degraded directly to NH3 in the rumen, 21.2% escaped rumen degradation and 10.5% was incorporated into stable N compounds in the rumen. Net NH3 transfer to the blood was 30.4%, NH3 flow from the rumen was 6.6% and rumen NAN output was 63% of N intake. In Expt 2, rumen NAN output was larger (7.67, 14.36 and 8.89 g N/d for diets containing SBM, FM and RSBM respectively; P less than 0.05) and net NH3 loss to the blood was smaller (6.1, 0.39 and 4.17 g N/d for diets SBM, FM and RSBM respectively; P less than 0.05) for diet FM as compared with the soya-bean diets. The percentage of rumen NAN that was synthesized from NH3 was larger for diet RSBM (36.4, 40.3 and 49.1 for diets SBM, FM and RSBM respectively; P less than 0.05) than for the other two rations. NH3 pool sizes (g N) were 0.463, 0.385 and 0.301 for diets SBM, FM and RSBM respectively (P less than 0.05), while their hourly turnover rates were 15.8, 26.1 and 5.12 for diets SBM, FM and RSBM respectively (P less than 0.01), indicating no correlation between pool size and its turnover rate.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1772869 TI - Effects of mesenteric vein L-alanine infusion on liver metabolism in beef heifers fed on diets differing in forage:concentrate ratio. AB - Effects of 24 h mesenteric vein infusion of L-alanine (75 mmol/h) and diet forage:concentrate ratio on net nutrient metabolism by portal-drained viscera (PDV) and liver were measured in four Hereford-Angus heifers. Heifers were fed on diets containing approximately 750 g lucerne (Medicago sativa) or 750 g concentrate/kg every 2 h at similar metabolizable energy intakes in a balanced single reversal design with 6 weeks for diet adaptation. Measurements of blood flow and net metabolism of nutrients were obtained at 30 min intervals starting immediately before (four measurements) and after (five measurements) beginning, immediately before ending (four measurements) and 1.5 h after ending (three measurements) alanine infusion. Only values obtained immediately before beginning and ending alanine infusion were compared statistically. Net total splanchnic (PDV plus liver) release of glucose was greater when heifers were fed on the 750 g concentrate/kg v. 750 g lucerne/kg diet due to greater net PDV absorption. Net PDV absorption of ammonia-nitrogen, beta-hydroxybutyrate (BOHB) and lactate, and net liver and total splanchnic release of urea-N (UN) were greater when heifers were fed on the 750 g lucerne/kg v. 750 g concentrate/kg diet. Infusion of alanine increased net liver removal of alanine and alpha-amino-N, net liver release of UN and net total splanchnic release of alanine, UN and lactate. Infusion of alanine decreased net liver release of BOHB and removal of lactate. Mesenteric vein infusion of alanine altered the net availability of precursors for liver glucose synthesis, but did not affect net glucose release by liver in these beef heifers. PMID- 1772870 TI - Tissue protein synthesis in lactating and dry goats. AB - Intravenous infusion of L-[3H]phenylalanine (Phe) was carried out for 8 h in dry, non-pregnant and lactating dairy goats. Nitrogen balance was positive in the dry group and negative in the lactating group. Whole-body Phe flux was 50% greater in lactating goats (P less than 0.01). Fractional synthesis rates (Ks) of tissue proteins were estimated from plasma- (Ksp) and tissue- (Ksh) specific radioactivities of Phe. In lactating goats, Ksp for mammary gland, duodenum and diaphragm was increased (P less than 0.05). Ksp also tended to increase in liver, kidney and rumen (P less than 0.08) of lactating goats, but was not different in uterus, spleen, caecum or heart. Values of Ksh were higher than Ksp; however, these measures agreed qualitatively. When absolute rates of protein synthesis were calculated, an increased contribution of mammary and visceral organs was seen in lactating goats. Ks and absolute rates of protein synthesis of hind-limb skin were less in lactating goats (P less than 0.05). A decreased proportion of skeletal muscle (P less than 0.05). Decreased rates of muscle and skin protein synthesis would appear to participate in alterations of protein metabolism, permitting lactation to occur at the expense of body reserves. PMID- 1772871 TI - Intestinal absorption of linoleic acid in experimental renal failure. AB - Linoleic acid (LA) transport in rats with experimental short-term and long-term renal failure (RF) was compared with that of sham-operated normal animals on liberal food intake and pair-fed animals. The perfusions in vivo and incubations in vitro were conducted using a micellar solution containing a wide range of LA concentrations. Both absorption in vivo and uptake in vitro of LA were significantly reduced in animals with short-term RF. Lipid extraction and separation by thin-layer chromatography revealed a marked LA trapping as trilinolein (TL) in the perfused intestinal tissue in the short-term RF group. The esterification process, as defined by the rate of LA incorporation into TL, was moderately reduced in short-term RF animals. The thickness of the unstirred water layer showed no significant difference among the groups studied. In contrast, animals with long-term RF exhibited normal absorption of LA in vivo at all concentrations tested. In conclusion, LA absorption is reduced in short-term RF and restored in long-term RF. Several steps including LA transport into and TL transport out of the enterocyte and the esterification process were impaired in short-term RF. These changes are not due to alteration in the unstirred water layer, anorexia, weight loss or a rapid effect of uraemic chemical environment or circulatory factors. PMID- 1772872 TI - Biodynamics of cholesterol and bile acids in the lithiasic hamster. AB - By using the isotopic equilibrium method in the young male Syrian hamster, the rates of cholesterol turnover processes, i.e. dietary cholesterol absorption, cholesterol synthesis, cholesterol excretion in the faeces and urine and cholesterol transformation into bile acids, were determined in the hamster receiving a control (C) or a lithogenic diet (L) for 7 weeks. At the end of this period the gall bladder of all animals in group L contained cholesterol gallstones. The coefficient of dietary cholesterol absorption was reduced by 26%, cholesterol synthesis and cholesterol faecal excretion were twofold higher in group L than in group C. Bile acid content in the small intestine was diminished in group L, but bile acid composition was similar in the two groups. The increase in cholesterogenesis in lithiasic animals essentially took place in the liver. Bile acid biosynthesis did not significantly differ in the two groups, but represented only 35% of total cholesterol input (dietary absorption + internal secretion) in group L v. 52% in group C. Thus, in the lithiasic hamster, hepatic synthesis of cholesterol and bile acids are not coupled. The molar percentage of cholesterol in bile was twofold higher in group L than in group C but those of bile acids and of phospholipids were not modified. In the lithiasic hamster the specific activity of biliary cholesterol was similar to that in plasma and liver. Consequently, biliary cholesterol does not derive directly from cholesterol newly synthesized in the liver but from hepatic cholesterol rapidly exchangeable with plasma cholesterol. PMID- 1772873 TI - Effects of magnesium and zinc deficiencies on growth and protein synthesis in skeletal muscle and the heart. AB - The effects of magnesium or zinc deficiency on growth, tissue contents of Mg or Zn and protein synthesis have been compared in 4-13-week-old rats. When maintained on Mg-deficient fodder (1.6 mmol/kg) or Zn-deficient fodder (27 mumol/kg) rats showed a reduced weight gain, whereas repletion caused increased growth rates. Pair-feeding experiments showed that this could not be attributed to reduced energy intake only. In rats maintained on Mg-deficient fodder for 14 d [3H] leucine incorporation into skeletal muscle and the heart was reduced by 24 38% compared with pair-fed controls (P less than 0.001-0.002). The incorporation of [3H]phenylalanine was reduced by 19-31%. Tissue Mg contents, however, were only reduced by 6-7% (not significant). The pair-fed rats showed no reduction in the [3H]leucine incorporation compared with ad lib.-fed animals. In rats maintained on Zn-deficient fodder for 15 d [3H]leucine incorporation into skeletal and heart muscle was reduced by 57-64% compared with pair-fed controls. The pair-fed rats showed no reduction in the [3H]leucine incorporation compared with ad lib. fed animals. In the Zn-deficient animals the content of Zn was not reduced in the skeletal muscles, whereas there was a small (15%) but significant loss of Zn in the heart. In another experiment, Zn depletion for 17 d caused a reduction in [3H]leucine incorporation of 35-41%. After 5 d of Zn repletion this defect was restored, and the [3H]leucine incorporation was above control level in the skeletal muscles. It is concluded that the intact organism is very sensitive to dietary Mg or Zn deficiency, and that the reduced growth and protein synthesis cannot easily be attributed to the reduction of tissue Mg or Zn content per se. This points to the existence of other control mechanisms mediating down regulation of growth and protein synthesis in response to reduced dietary supplies and the ensuing drop in the plasma concentrations of Mg and Zn. PMID- 1772874 TI - Role of insulin-like growth factor-1 and growth hormone in growth inhibition induced by magnesium and zinc deficiencies. AB - Nutritional deficiencies of magnesium or zinc lead to a progressive and often marked growth retardation. We have evaluated the effect of Mg and Zn deficiency on growth, serum insulin-like growth factor-1 (s-IGF-1), growth hormone (s-GH) and insulin (s-insulin) in young rats. In 3-week-old rats maintained on Mg deficient fodder for 12 d the weight gain was reduced by about 34%, compared with pair-fed controls. This was accompanied by a 44% reduction in s-IGF-1, while s insulin showed no decrease. After 3 weeks on Mg-deficient fodder, growth had ceased while serum Mg (s-Mg) and s-IGF-1 were reduced by 76 and 60% respectively. Following repletion with Mg, s-Mg was completely normalized in 1 week, and s-IGF 1 reached control level after 2 weeks. Growth rate increased, but the rats had failed to catch up fully in weight after 3.5 weeks. Absolute and relative pair feeding were compared during a Mg repletion experiment. Absolute pair-fed animals were given the same absolute amount of fodder as the Mg-deficient rats had consumed the day before. Relative pair-fed animals were given the same amount of fodder, on a body-weight basis, consumed in the Mg-deficient group the day before. In a repletion experiment the two methods did not differ significantly from each other with respect to body-weight, muscle weight, tibia length and s IGF-1, although there was a tendency towards higher levels in the relative pair fed group. The peak in s-GH after growth hormone-releasing factor 40 (GRF 40) was 336 (SE 63) micrograms/l in 5-week-old rats that had been Mg depleted for 14 d, whereas age-matched control animals showed a peak of 363 (SE 54) micrograms/l (not significant). In 3-week-old rats maintained on Zn-deficient fodder for 14 d weight gain was reduced by 83% compared with pair-fed controls. Serum Zn (s-Zn) and s-IGF-1 were reduced by 80 and 69% respectively, while s-insulin was reduced by 66%. The Zn-deficient animals showed a more pronounced growth inhibition than that seen during Mg deficiency and after 17 d on Zn-deficient fodder s-IGF-1 was reduced by 83%. Following repletion with Zn, s-Zn was normalized and s-IGF-1 had increased by 194% (P less than 0.05) after 3 d. s-IGF-1, however, was not normalized until after 2.5 weeks of repletion.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1772875 TI - Nutritional response of growing rats to faba beans (Vicia faba L., minor) and faba bean fractions. AB - The effects of raw faba bean (Vicia faba L., minor) meal (VFM) and its fractions on the growth and nitrogen utilization of rats have been determined in two experiments. Two commercial varieties of VFM were tested, local VFM (409-439 g/kg diet) and Troy VFM (439 g/kg diet). The bean fractions tested were V. faba lectin depleted protein (VFDP), V. faba lectin (VFL) and V. faba cotyledon residue (VFCR). All diets were supplemented with amino acids to target requirements. Body weight, body N and lipid contents of rats fed on VFM were reduced significantly in comparison with control rats fed on lactalbumin. This was due, in part, to the lower digestibility of the protein, lipid and dry matter (DM) of VFM diets. As a result, net protein utilization (NPU) and biological value (BV) of faba bean proteins were less than expected. Urine and urea-N outputs of the VFM-fed rats were also elevated in both experiments. Increasing the energy content of local VFM diets led to significantly higher dry body-weight, body N and lipid contents, with the result that the NPU and BV values of the protein also increased. However, the NPU values for VFM-fed rats were still significantly lower than those for the controls in both experiments. In contrast, true N, lipid and DM digestibilities in rats given local VFM were not significantly affected by the difference in the energy content of the diets. The replacement of two-thirds of the lactalbumin in the diet with VFDP (65 g/kg) reduced dry body-weight, N and lipid contents, NPU and BV compared with the control rats, even though N, lipid and DM digestibilities were not significantly different. The nutritional performance of rats fed on lactalbumin-based diets containing 7 g VFL/kg was similar to that of the controls. Similarly, the inclusion of the cotyledon residue (237 g VFCR/kg diet) had no appreciable effect on any of the variables studied. As VFL and VFCR had no antinutritional effects in these rats, it appears that the low nutritional value of VFM for rats (NPU 0.66) results not only from the low digestibility of the bean proteins, but also from disturbances in N metabolism. PMID- 1772876 TI - Expression of a MHC non-classical class I gene, Q4, is similar to a classical class I gene, Dp. AB - We have investigated the effects of the cell cycle on expression of Q4 mRNA. Q4, the gene encoding the Qb-1 antigen, is transcribed in a wide variety of tissues, unlike many other non-classical class I genes. We have compared the pattern of Q4 transcription in the cell cycle to classical class I, beta-2-microglobulin and actin. We found that the pattern of Q4 RNA levels resembles that of the classical class I genes, consistent with the similarity of the 5' sequences of Q4 and K/D. Thus, Q4 mRNA accumulates during the cell cycle along with the total RNA, but does not show specific transcriptional enhancement. This is consistent with a function for Q4 similar to the classical K/D gene products. PMID- 1772877 TI - Non-radioactive oligotyping for HLA-DR1-DRw10 using polymerase chain reaction, digoxigenin-labelled oligonucleotides and chemiluminescence detection. AB - We describe a rapid non-radioactive DNA typing of the serological types DR1-DRw10 using polymerase chain reaction (PCR)-amplified DNA and 15 sequence-specific oligonucleotides (SSO) which are labelled enzymatically at their 3' end with one digoxigenin (DIG). The hybridized SSOs were detected using anti-DIG alkaline phosphatase and Fab fragments and visualization was obtained with the chemiluminescent substate 3-(2'-spiroadamantan)-4-(3''-phosphoryloxy)-phenyl-1,2 di o xetan (AMPPD). The results were identical with those of the previously used 5-bromo-4-chloro-3-indolyl-phosphate (BCIP)/4-nitrobluetetrazolium chloride (NBT) system. The use of AMPPD is more rapid and allows the repeated rehybridization of the membrane-bound DNA. PMID- 1772878 TI - Expression of rabbit Ig allotypes in litters of mothers immunized against a paternal allotype. AB - Sera of successive littermates of mothers producing anti-allotype antibodies (Ab) were analysed for altered a locus or b locus allotype expression. We measured the allotype concentration in sera of 66 individuals (17 litters) of seven mothers producing anti-a1 Ab, and 63 individuals (15 litters) of seven mothers producing anti-b4 Ab, in an enzyme-linked immunosorbent assay (ELISA). We confirmed that the ability to induce allotype suppression in utero increases with the number of antigen boosts applied to the mother, even though the Ab titre in the maternal serum may be decreased. All individuals of a litter expressed the allotype in about equal concentration. This contrasts the results we obtained when newborn rabbits were injected with anti-allotype antiserum. Injection of the same amount of anti-allotype antiserum into nine offspring of two mothers caused allotype suppression in only five individuals, showing no effect in the others. No suppression was observed when IgG-depleted antiserum was injected into newborn rabbits. As expected, maternal antibodies to a paternal allotype do not affect the Mendelian distribution of the progeny phenotypes. PMID- 1772879 TI - Analysis of HLA specificity of human monoclonal antibodies by cytofluorimetry and cell ELISA. AB - In this study we report on the characterization of cytotoxic human monoclonal antibodies (HmAb) detecting polymorphic HLA class II specificities using cytofluorimetric analysis in combination with micro cell ELISA. In both techniques, five anti-HLA HmAb were tested against HLA-transfected murine L cells as target cells and the bound antibody was detected, either by cytofluorimetry or by cell ELISA reader, after addition of fluoresceinated or peroxidase-conjugated anti-human IgG+IgM antibodies, respectively. The results demonstrate that HmAb directed against HLA-DR, -DQ and -DP molecules can be efficiently discriminated by cytofluorimetry and cell ELISA, which appear to be highly sensitive and perfectly comparable to the standard cytotoxicity assay. PMID- 1772880 TI - Imbalance of MHC class I expression in 3LL tumour cells. AB - Cell lines and a clone established from the C57BL/6 (H-2b) Lewis lung (3LL) tumour were previously characterized with respect to tumour growth and metastatic spread in vivo, and to the expression of a 3LL tumour-specific antigen (3LL TA) using a monoclonal antibody raised in syngeneic mice immunized with 3LL cells. No correlation was observed between the presence of 3LL TA and the prevention of metastatic spread which suggests that the immune recognition of this tumour antigen requires the presence of a self H-2 molecule absent from these tumour cells. Indeed, radioimmunoassay (RIA) and cytofluorometric analysis using specific monoclonal antibodies have shown that the H-2Kb molecule was not expressed at the cell surface of all 3LL cell lines and clones, while the H-2Db molecule was present at normal levels. This defect, which was not the consequence of a lack of beta 2m expression, was accompanied by an absence or a marked reduction of the H-2K mRNA level (which has been reversed in the M4 cell line by in vitro gamma interferon treatment), while the H-2D class I gene was normally transcribed. Another defective transcription was also observed for a gene in the Tla region (gene 37). This low '37' phenotype was corrected by in vitro treatment of the M4 cell line with gamma interferon, which indicates that this class I gene of the Qa/Tla region has an interferon response sequence in the promoter. PMID- 1772881 TI - H-2 influence on the production of real but not of apparent H-2-specific antibodies induced by the association of syngeneic class I heavy chains with bovine beta 2-microglobulin. AB - Immunogenic properties of class I molecules resulting from the association of mouse class I heavy chains with a xenogeneic beta 2-microglobulin (beta 2-m) were investigated by studying the antibody response of mice of injections to syngeneic Con A lymphoblasts, induced in conditions allowing the replacement of endogenous beta 2-m by exogenously added bovine beta 2-m provided by fetal calf serum (FCS Con A blasts). Lymphocytotoxic antibodies were regularly produced and according to their specificities they could be divided into two types: antibodies whose reactivity was (1) dependent on and (2) independent of the presence of bovine beta 2-m on target cells. Although both types displayed an H-2 dependent polymorphic reaction pattern, only antibodies recognizing class I molecules without bovine beta 2-m can be considered as real H-2-specific antibodies. The others are only apparent H-2-specific antibodies: their polymorphic reaction pattern is dependent both on the presence of bovine beta 2-m on the surface of target cells and on their H-2 haplotype. A comparison of the antibody response of mice with various H-2 haplotypes to injections of syngeneic FCS-Con A blasts showed no significant difference in the induction of bovine beta 2-m-dependent antibodies (apparent H-2-specific) among the mice from all strains tested (H-2b, H-2p, H-2q, and H-2s). Unexpectedly, for most strains more than 60% of the immunized mice produced also beta 2-m-independent antibodies (real H-2-specific), with the exception of H-2q mice, in which only 30% of sera were positive. The real H-2-specific antibody response is of two types: some mice (H-2p and H-2s) produced antibodies only reactive with allogeneic target cells whereas others (H 2b and H-2q) produced in addition antibodies that were reactive with syngeneic cells. Thus H-2 appears to play an important role in the induction and specificity of the lymphocytotoxic H-2-specific antibodies induced upon immunization with cells expressing syngeneic class I heavy chains associated with bovine beta 2-m. PMID- 1772882 TI - An additional family of VH sequences in the channel catfish. AB - A heavy chain variable region cDNA sequence of the channel catfish (Ictalurus punctatus) prototypical for a new VH family (approximately 20 or more members) is presented. The nucleotide and inferred amino acid sequences differ by 32-52% and 41-68%, respectively, from those for the already described catfish VH families. PMID- 1772883 TI - Proceedings of the West Coast Scientific Symposium on Health Care of Runaway and Street Youth. PMID- 1772884 TI - West Coast Scientific Symposium on Health Care of Runaway and Street Youth. Introduction. PMID- 1772885 TI - The medical care of street youth. AB - Our clinical contacts with street youth support the view that their numbers are growing and that their medical needs are largely neglected. We describe our experience in providing medical care to street youth in Seattle, with attention to their medical presentations and patterns of health care utilization. We address aspects of adolescent street life that are unique to that particular mode of living or importantly formative in the lives of persons drawn to it. PMID- 1772886 TI - Runaway and street youth at risk for HIV infection: legal and ethical issues in access to care. AB - Significant numbers of runaway and street youth are at risk for human immunodeficiency virus (HIV) infection. These youth are physically, socially, and psychologically vulnerable and need access to health care and related services. Legal and ethical concerns of consent and confidentiality may limit their access, although in many states the law allows some minors to consent to HIV testing and treatment and protects confidentiality of HIV-related information. Appropriate pretest and posttest counseling and follow-up for youth at risk of infection are essential. Limited access to HIV treatment for youth testing positive raises serious ethical concerns. Access to comprehensive treatment is currently limited by lack of adequate financing, despite a patchwork of numerous public funding sources providing some coverage for treatment of HIV and acquired immunodeficiency syndrome (AIDS). Research studies and clinical trials are critical elements in the planning and delivery of HIV-related services to adolescents, but require consideration of special ethical and legal concerns. PMID- 1772887 TI - Street youth: adaptation and survival in the AIDS decade. AB - This article discusses adaptational and survival strategies of homeless youth and describes how pilot research, begun in 1982 on these strategies in the western United States, led to additional research and activity focused upon the related international street youth problem. The results of this research suggest that a critical relationship exists between survival strategies and the AIDS pandemic. The impact of this pandemic on street youth can be mitigated only by immediate and comprehensive preventive actions at both national and international levels. PMID- 1772888 TI - Gay and lesbian homeless/street youth: special issues and concerns. AB - Data on homeless and runaway youth were collected through a consortium of agencies, including one that provides services to a high percentage of gay- lesbian-, and bisexual-identified youth. Gay and bisexual male youth appear to be at increased risk for both homelessness and suicide. Gay male street youth may have been forced out of their homes because of their sexual orientation, and are more likely to engage in survival sex (prostitution) than their nongay male counterparts. In one sample, 53% of gay-identified street youths had attempted suicide, compared with 32% of a cohort of street youths that included both gay and nongay youths. Prejudice, discrimination, and homophobia are still rampant in society today; these factors contribute to a multiplicity of problems that face the young person who is gay. PMID- 1772889 TI - Homeless youth in Seattle. Planning and policy-making at the local government level. AB - Young people leave home for many reasons--a push away from problems, a pull toward the independence and seeming excitement of the street. Once on the street they face serious risks to their health and well-being. Homelessness among youths is a concern in Seattle, with as many as 2,000 on the street in a year's time. The service system is overburdened and poorly coordinated. The City of Seattle examined the problem, inadequacies of the service system, and issues affecting its ability to address the needs of homeless youths and their families. This article presents data on the problem, policies proposed to shape the city's response, and progress made in the last 2 years. PMID- 1772890 TI - Birth outcomes of prostituting adolescents. AB - In 1989, researchers at the University of Washington, Division of Adolescent Medicine, described the multifactorial risks of pregnancy for adolescents engaged in prostitution activities. Factors identified as placing this population at particular risk were transience, substance abuse, violence, sexually transmitted diseases, inadequate (or no) medical care, and poor nutrition. The relationship between such risks in the pregnant adolescent and poor birth outcome has been widely demonstrated. In this follow-up study, we describe the birth outcomes of 54 of the original sample of 61 prostituting adolescents who delivered infants between November 1987 and November 1989 in Seattle, Washington. The data were collected by retrospective chart review. Maternal factors evaluated were 1) age 2) ethnic group 3) substance abuse history 4) number of prenatal visits 5) maternal complications and 6) parity. The infant inpatient charts were reviewed for the following characteristics: 1) birth weight 2) occipitofrontal head circumference 3) length 4) Apgar scores and 5) neonatal complications. Results indicated high rates of maternal and infant complications with respect to: preterm birth (22%), precipitous delivery (15%), pregnancy-induced hypertension (16%), positive toxicology screens (28%), meconium staining (30%), infant hypertonicity (30%), and small for gestational age infants (14.5%). PMID- 1772891 TI - Risk profile of homeless pregnant adolescents and youth. AB - Pregnant homeless young women have special service needs. This article examine those needs by comparing the risk profiles of 55 pregnant homeless youths and 85 pregnant youths who live with their families. These young women were seen in a primary health care clinic and underwent extensive lifestyle interviews during their physical examinations. Clinical social workers provided social services and follow-up. The homeless pregnant youths were younger, primarily white, and from outside Los Angeles County. They were more likely to be diagnosed as depressed, to have previously attempted suicide, to have histories of sexual and physical abuse, and to be diagnosed as drug abusing. Review of pregnancy outcomes showed the difficulty of serving homeless pregnant youth and the lack of services for them. Following this study, the clinic instituted new monitoring procedures and established a team case management approach to serving homeless pregnant teens and youths. PMID- 1772892 TI - HEADSS, a psychosocial risk assessment instrument: implications for designing effective intervention programs for runaway youth. AB - In this article, we present data obtained with the psychosocial interview instrument, HEADSS (Home, Education, Activities, Drug use and abuse, Sexual behavior, Suicidality and depression) that was administered to High Risk Youth Clinic clients at their initial visits during a 1-year period. Of the 1,015 new patients, 63% were homeless/runaway youths and 37% were living with their families. Utilizing the HEADSS interview instrument, we compared homeless/runaway youths to nonhomeless youths in a number of areas, including risks for human immunodeficiency virus (HIV) infection. Our results showed that homeless teens tended to be younger, female, and white compared to their nonhomeless counterparts. They were more likely to have dropped out of school and were far more likely to be depressed and actively suicidal. They demonstrated all forms of drug abuse. They engaged in first sexual intercourse at an earlier age, and experienced a higher incidence of sexual abuse and prostitution. They were 6 times more likely to be at risk for HIV infection. PMID- 1772893 TI - A risk profile comparison of homeless youth involved in prostitution and homeless youth not involved. AB - All initial visits (n = 620) of runaway/homeless youths to an outpatient medical clinic over a 12-month period (July 1988-June 1989) were analyzed. Of these visits, 467 made by youth not involved in prostitution were compared with 153 visits by youth who were involved. According to the data from an adolescent risk profile interview, homeless youth involved in prostitution are at greater risk for a wide variety of medical problems and health-compromising behaviors, including drug abuse, suicide, and depression. The implications for public health and social policy are discussed. PMID- 1772894 TI - Effects of alternative street school on youth involved in prostitution. AB - Prostitution-involved adolescents self assigned into one of three groups: school attenders (of alternative street school), unable to attend, and school refusers. Data were collected at intake and 50 days after intake for the following measures: Reynolds Adolescent Depression Scale, Rosenberg Self-Esteem Scale, Quality of School Life Scale, and self-reported weekly prostitution events. School attenders improved significantly on all measures, showing less depression, improved school sentiment, improved self-esteem, and reduced prostitution activity after less than 2 months of street school. Except for self-esteem, no significant changes on these dependent variables were observed for either of the other school groups. PMID- 1772895 TI - The Los Angeles system of care for runaway/homeless youth. AB - Runaway and homeless young people generally do not seek help unless they are in a severe personal crisis. For the past 7 years, the Division of Adolescent Medicine, Childrens Hospital of Los Angeles, has learned a good deal about how to intervene effectively with these youths and divert them from high-risk behaviors such as prostitution and drug abuse. The program model we have developed has five major components: 1) networking and consolidation, 2) outreach, 3) short-term crisis shelter, 4) comprehensive medical and psychosocial care, and 5) long-term shelter and case management. Our approach has been collaborative; we subcontract a substantial portion of the work to other youth agencies in the community in order to build and strengthen the network of existing services. In the process, we have moved steadily closer to developing a comprehensive system of care for homeless street youth throughout Los Angeles County. Where programs previously operated in relative isolation, representatives from 40 private and public agencies now meet regularly at Childrens Hospital of Los Angeles to discuss ways to improve services. Systematized data collection has helped agencies understand how they can work together and has prompted additional funding for needed services. PMID- 1772896 TI - Outreach health services for street youth. AB - A voluntary health agency operated a clinic at a drop-in center for street youth. Six hundred nine youths were seen, with an average age of 16 years, 9 months. There were 2,086 diagnoses made during 1,895 visits. Respiratory, dermatologic, and gynecologic problems represented 56% of all diagnoses. Pregnancy tests accounted for 38% of all procedures, 50% of all medications dispensed were either oral antibiotics or decongestants, and 17% of the visits resulted in referrals. This chart review revealed that street youth seen at a drop-in center sought care for common medical problems. Problems related to substance abuse and sexually transmitted diseases were seen much less frequently than anticipated. Elements critical to the success of this clinic included its on-site location, hours of operation when teenagers were using other services, close working relationships between clinic and center staffs, the capability to perform a few simple laboratory procedures, and an on-site pharmacy. PMID- 1772897 TI - Evaluation of Threshold: an independent living program for homeless adolescents. AB - The Threshold Project, a residential treatment program, was designed to work with homeless and alienated young women who were approaching 18 years of age but lacked the skills, values, and attitudes necessary to care for themselves and assume the responsibilities of adulthood. Project services were designed to prepare these young women for independent living and to break the intergenerational cycle of abuse and neglect experienced by this population. Threshold offered a series of progressively more independent living experiences to young homeless women ages 16-18 years, who had been sexually/physically/emotionally abused or neglected, and who had been involved in or at high risk for prostitution. A majority of the clients responded well to the requirements of the program, including the expectation that they maintain employment and participate in educational programs during the semi-independent living phase of the project. A follow-up assessment undertaken after clients left the project found that 42% of the young women met all "success" criteria, that is, they lived independently (or in stable situations), attended school and/or were employed, had not engaged in prostitution or other offense behavior, and did not abuse alcohol or other substances. PMID- 1772898 TI - An AIDS prevention program for homeless youth. AB - Larkin Street Youth Center (LSYC) is a multidisciplinary service center for homeless youth in San Francisco. This article describes the strategies developed by the medical clinic at LSYC for the prevention of human immunodeficiency virus infection. PMID- 1772899 TI - Homeless and runaway youth mental health issues: no access to the system. AB - Data from a center for homeless and runaway youth are presented in order to summarize the major mental health problems faced by these youth. This article also identifies indicators related to behavioral and environmental variables that may help in the development of intervention and prevention strategies for this population. PMID- 1772900 TI - Development of sensitive radioiodinated anti-sense oligonucleotide probes by conjugation technique. AB - Radioactive and nonradioactive oligonucleotide (ON) probes have been used in a variety of studies of in vitro hybridization for locations of specific genes and determination of the level of mRNA transcription in activated and proliferative cells. Nuclease-resistant phosphorothioate derivatives of oligonucleotides are also finding potential therapeutic applications in intact cells and animal models. In this study, we have developed new techniques of radioiodination by the conjugation of oligonucleotides with p-methoxyphenyl isothiocyanate (PMPITC) and optimized the conditions of the radioiodination, e.g. concentration of reactants, oxidants, pH, time, and temperature. We have used a 25-mer actin mRNA probe as a model substrate for radioiodination. The ON probe was modified by conjugation with the addition of aminohexyl (AH) group at the 5'-terminal. Both the techniques of preiodination of PMPITC followed by conjugation and radioiodination of PMPITC-conjugated AHON were evaluated; the latter was found to be more convenient. The optimum pH of radioiodination of PMPITC with 125I was 6.5; on the other hand, the optimum pH for PMPITC-conjugated AHON was 8.5. The conditions of conjugation were optimized with 125I-labeled PMPITC. The techniques of paper chromatography and HPLC with a Spherogel column were developed for the purification and characterization of these oligonucleotide probes. Without PMPITC conjugation, the yield of direct radioiodination of the same oligonucleotide was very low (4-6%); the yield in our optimized technique is 50-60%. Radioiodination of conjugated oligonucleotides is a simple and efficient route to radiolabeled probes for hybridization studies. PMID- 1772901 TI - Oxidative degradation of cationic metalloporphyrins in the presence of nucleic acids: a way to binding constants? AB - Mn(III) and Fe(III) complexes of meso-tetrakis(N-methylpyridinium-4-yl)porphyrin (M-TMePyP) and related hybrid molecules ("metalloporphyrin-ellipticine") were activated by potassium monopersulfate in the presence of variable calf thymus (CT) DNA and NaCl concentrations. Monitored by visible spectroscopy (Soret band), fast degradation of the free metalloprophyrin was observed while the DNA-bound form appeared protected. This direct quantitation of free versus bound metalloporphyrin ratios allowed determination of binding constants: Mn- and Fe TMePyP respectively bind to CT DNA (5 mM phosphate buffer, 0.1 M NaCl, pH 7) with K = 3 X 10(4) and 1.2 X 10(4) M-1. Mn-TMePyP showed a greater affinity for poly[d(A-T)] (K = 1.2 X 10(5) M-1) than for poly[d(G-C)] (K = 0.2 X 10(4) M-1). This method allowed us access to the intrinsic DNA affinity of the metalloporphyrin moiety of the hybrid molecules "metalloporphyrin-ellipticine". PMID- 1772902 TI - Introduction of unnatural amino acids into chalcone isomerase. AB - The active site cysteine residue of chalcone isomerase was rapidly and selectively modified under denaturing conditions with a variety of electrophilic reagents. These denatured and modified enzyme were renatured to produce enzyme derivatives containing a series of unnatural amino acids in the active site. Addition of methyl, ethyl, butyl, heptyl, and benzyl groups to the cysteine sulfur does not abolish catalytic activity, although the activity decreases as the steric bulk of the amino acid side-chain increases. Modification of the cysteine to introduce a charged homoglutamate or a neutral homoglutamine analogue results in retention of 22% of the catalytic activity. Addition of a methylthio group (SMe) to the cysteine residue of native chalcone isomerase preserves 85% of the catalytic activity measured with 2',4',4-trihydroxychalcone, 2',4',6',4 tetrahydroxychalcone, or 2'-hydroxy-4-methoxychalcone as substrates. The competitive inhibition constant for 4',4-dihydroxychalcone, the substrate inhibition constant for 2',4',4-trihydroxychalcone, and other steady-state kinetic parameters for the methanethiolated enzyme are very similar to those of the native enzyme. The strong binding of 4',4-dihydroxychalcone to the methanethiolated enzyme shows that there is no steric repulsion between this modified amino acid residue and the substrate analogue. This structure-activity study clearly demonstrates that the active site cysteine residue does not function as an acid-base or nucleophilic group in producing the catalysis or substrate inhibition observed with chalcone isomerase. The method presented in this paper allows for the rapid introduction of a series of unnatural amino acids into the active site as a means of probing the structure-function relationship. PMID- 1772903 TI - Acridine- and cholesterol-derivatized solid supports for improved synthesis of 3' modified oligonucleotides. AB - New solid supports are described which allow the direct synthesis of oligonucleotides bearing either cholesterol or acridine at the 3'-terminus. A stereochemically defined amino diol was prepared by reduction of N-Cbz-hydroxy-L proline. This linker molecule was first acylated with the desired conjugate molecule, then protected as the dimethoxytrityl ether. The remaining secondary hydroxyl group was succinylated and immobilized on a controlled-pore glass support. 3'-Modified oligodeoxynucleotides (ODNs) were prepared from these supports by using standard phosphoramidite coupling and deprotection conditions. A cholesterol-modified support was prepared from cholesterol chloroformate and the amino diol linker. Two types of acridine-modified solid supports were prepared from acridine tetrafluorophenyl esters with linker arms of different length. In an alternative synthesis of 3'-derivatized ODNs, these active esters were also utilized for acylation of a 3'-amine-modified ODN. A thermal denaturation study was done to determine the effect of the different linker arms on hybridization to a complementary ODN target. Facile synthesis and purification of the 3'-modified ODNs makes these functionalized solid supports especially useful for preparation of oligonucleotides bearing these and other modifications. PMID- 1772904 TI - DNA-binding transferrin conjugates as functional gene-delivery agents: synthesis by linkage of polylysine or ethidium homodimer to the transferrin carbohydrate moiety. AB - We have previously demonstrated that transferrin-polycation conjugates are efficient carrier molecules for the introduction of genes into eukaryotic cells. We describe here a more specific method for conjugation of transferrin with DNA binding compounds involving attachment at the transferrin carbohydrate moiety. We used the polycation poly(L-lysine) or the DNA intercalator, ethidium homodimer as DNA-binding domains. Successful transferrin-receptor-mediated delivery and expression of the Photinus pyralis luciferase gene in K562 cells has been shown with these new transferrin conjugates. The activity of the transferrin-ethidium homodimer (TfEtD) conjugates is low relative to transferrin-polylysine conjugates; probably because of incomplete condensation of the DNA. However, DNA delivery with TfEtD is drastically improved when ternary complexes of the DNA with TfEtD and the DNA condensing agent polylysine are prepared. The gene delivery with the carbohydrate-linked transferrin-polylysine conjugates is equal or superior to described conjugates containing disulfide linkage. The new ligation method facilitates the synthesis of large quantities (greater than 100 mg) of conjugates. PMID- 1772905 TI - Chemical modification of hyaluronic acid by carbodiimides. AB - Hyaluronic acid (HA) is a linear polysaccharide with repeating disaccharide units of glucuronic acid and N-acetylglucosamine and is found in the extracellular matrix of connective tissues. Reaction of high molecular weight sodium hyaluronate (NaHA, MW approximately 2 x 10(6] with EDC at pH 4.75, either in the presence or absence of a primary diamine, gave the N-acylurea and O-acylisourea as NaHA-carbodiimide adducts. None of the expected intermolecular coupling with the amine component was observed. On the basis of this new observation, this method for chemical modification of HA was used in conjunction with new synthetic carbodiimides to prepare HA derivatives bearing lipophilic, aromatic, cross linked, and tethered functional groups. The degree of conversion to NaHA-acylurea products appears to depend upon both the characteristics of various carbodiimides and the conformational structure of NaHA. PMID- 1772906 TI - Novel carboranyl amino acids and peptides: reagents for antibody modification and subsequent neutron-capture studies. AB - A new alpha-amino acid derivative incorporating the 1,2-dicarba-closo- dodecarborane(12) cage, namely 5-(2-methyl-1,2-dicarba-closo-dodecarborane(12)-1 yl)- 2-aminopentanoic acid (2), was synthesized by the alkylation of the benzophenone Schiff's base of glycine methyl ester with 3-(2-methyl-1,2-dicarba closo-dodecaborane(12)-1-yl)pr opyl iodide (8). This amino acid was employed in the synthesis of peptide derivatives such as 19-21 using solid-phase Merrifield methods. Dipeptide 19 was converted to a water-soluble ionic derivative by the pyrrolidine-mediated carborane cage degradation reaction followed by cation exchange to afford sodium salt 22. Dansylation of 22 with dansyl chloride yielded fluorescence-labeled dipeptide 23. Undecapeptide 21 was dansylated while still anchored to the Merrifield resin. Following its cleavage from the resin with hydrogen fluoride, product 25 was acetylated to block the free amino group on the lysine residue and then converted to water-soluble derivative 27. Trial conjugations of dipeptide 23 and undecapeptide 27 to T84.66, an anti-CEA antibody, were carried out by means of carboxyl activation with N hydroxysulfosuccinimide and N,N-diisopropylcarbodiimide. Studies of the chemical syntheses of these and other peptide derivatives and the conjugation of 23 and 27 to the antibody are described. PMID- 1772907 TI - Synthesis and evaluation of radioiodinated cholesteryl ethers as lipoprotein probes. AB - Two novel cholesteryl ether derivatives were synthesized and radioiodinated: (1) [125I]cholesteryl m-iodobenzyl ether (125I-CIBE) and (2) [125I]cholesteryl 12-(m iodophenyl)dodecyl ether (125I-CIDE). These radioiodinated ethers were incorporated into low-density lipoprotein (LDL) by incubating the compounds (solubilized in saline with Tween-20) with isolated LDL or with whole plasma. Such LDL preparations were taken up by cultured fibroblasts in a receptor dependent manner similar to that of radioiodinated LDL. Upon injection into guinea pigs, 125I-CIBE-labeled guinea pig LDL cleared from the plasma similarly to radioiodinated guinea pig LDL. The primary sites of 125I-CIBE uptake were the adrenal and the liver, and the compound was stable to both hydrolysis and deiodination over 24 h. In summary, 125I-CIBE and 125I-CIDE, like previously described tritiated cholesteryl ethers, appear to be potentially useful tracers of cholesteryl ester uptake. Moreover, these radioiodinated probes have the advantage of being more easily quantitated in tissue samples as well as being detectable by noninvasive scintigraphic imaging. PMID- 1772908 TI - Properties of mitomycin C-albumin conjugates in vitro and in vivo. AB - Mitomycin C, an antineoplastic agent, was covalently attached to bovine serum albumin through a spacer of the glutaryl group. Two different synthetic methods were adopted; one was by the prior glutarylation of albumin followed by binding to mitomycin C, and the other was by the synthesis of glutarylated mitomycin C followed by binding to albumin. Physicochemical properties of the conjugates, such as Stokes radius, molecular weight, and helical content, were comparatively examined. The glutarylation of albumin resulted in an increase in Stokes radius of the protein due to the conformational change. The conjugates significantly stabilized mitomycin C and liberated it gradually under the physiological condition (t1/2 = 66-84 h). Both conjugates accumulated effectively in the tumor tissues. However, the distribution behavior of the conjugates depended on physicochemical properties such as molecular size. Treatment with the conjugates suppressed the tumor growth and increased the survival rate in the tumor-bearing mice. PMID- 1772909 TI - Ca(2+)-responsive extensible monolayer membrane of calmodulin-albumin conjugate. AB - A Ca(2+)-responsive monolayer protein membrane was prepared by developing calmodulin and bovine serum albumin at the air-water interface and by conjugating them with a bifunctional agent. In the case of the BSA monolayer, complex formation with Mg2+ generated a larger change in surface pressure than that with Ca2+. On the other hand, a drastic change in surface pressure was observed for the conjugated thin membrane associated with Ca2+ than that associated with Mg2+. Due to a drastic change in the conformation of calmodulin, the conjugated protein film changes its morphology (STM image), depending on Ca2+ concentration: the extended structure in the presence of Ca2+ transforms to a shrinked structure in the absence of Ca2+. The largest surface pressure change was detected when calmodulin was mixed with an equimolar amount of bovine serum albumin. PMID- 1772910 TI - Specific interchain cross-linking of antibodies using bismaleimides. Repression of ligand leakage in immunoaffinity chromatography. AB - The extensive use of antibody-containing affinity columns in the purification of biologically active compounds (e.g., genetically engineered proteins) is severely hampered by the leaching of antibody (or portions thereof) from the immunoaffinity resin during elution of the target antigen. One of the major problems in this context is the combined use of reducing (i.e., thiols) and chaotropic (e.g., detergents and denaturants) agents in the elution step, which causes the disassociation of heavy and/or light chains from the immobilized antibody, thereby contaminating the resultant product. In order to overcome this problem, we have cross-linked the four antibody chains at their sites of disulfide interlinkage, thus producing a single antibody chain. To accomplish this, interchain disulfide bonds were reduced, and the resultant thiol groups were cross-linked by using bifunctional SH-specific reagents (particularly bismaleimides). Cross-linking of up to 95% of the available SH groups produced was achieved with concomitant retention of antigen-binding activity. The cross linked antibody was immobilized onto CNBr-activated Sepharose, and the resultant column was found to be substantially more stable to harsh elution conditions than similar columns which contain the un-cross-linked antibody. PMID- 1772911 TI - The power of knowledge in radiologic education and decision making. PMID- 1772912 TI - A high-resolution networked computer system for radiologic instruction of medical students. AB - A network of 18 Macintosh II-based workstations (Apple Computer Corp, Cupertino, CA) having high-resolution 1,024-line monitors is used for the radiologic instruction of medical students in our institution. Although this is an expensive system, it is time-shared with the Departments of Pathology, Physiology, Neuroscience, Biochemistry, Parasitology, and Microanatomy. The number of workstations available allows the entire class to access the system simultaneously by working in small groups. Because of its high resolution, medical imaging studies and text may be displayed on the same monitor side by side. We have chosen a question-and-answer format (Carousel). Forty-one radiologists in our affiliated medical institutions contributed cases. These cases in question-and-answer form supplement the lectures and film-based tutorials given as part of our mandatory third year radiology clerkship. PMID- 1772913 TI - A radiology hypertext system for education and clinical decision making. AB - Hypertext is a computer-based means of organizing information that allows one to explore the connections among related subjects. FACT/FILE is a hypertext computer system that provides access to a wide variety of information of interest to radiologists and radiology residents. Information is presented as notecards, or frames, which can contain textual information about relevant anatomy, physiology and pathology, as well as differential diagnosis "gamut" listings. More than 800 frames are available. Users can choose frames from an alphabetical index produced automatically from key words in each frame's title, or from a hierarchically organized subject index. Links between frames allow users to explore related frames and then return to the original frame. Physicians can add new frames to the system, so that specialized knowledge can be shared. This system has been implemented as a module of the radiology information system at the University of Chicago Medical Center. PMID- 1772914 TI - A "building block" approach to application development for education and decision support in radiology: implications for integrated clinical information systems environments. AB - Education and decision-support resources useful to radiologists are proliferating for the personal computer/workstation user or are potentially accessible via high speed networks. These resources are typically made available through a set of application programs that tend to be developed in isolation and operate independently. Nonetheless, there is a growing need for an integrated environment for access to these resources in the context of professional work, during clinical problem-solving and decision-making activities, and for use in conjunction with other information resources. New application development environments are required to provide these capabilities. One such architecture for applications, which we have implemented in a prototype environment called DeSyGNER, is based on separately delineating the component information resources required for an application, termed entities, and the user interface and organizational paradigms, or composition methods, by which the entities are used to provide particular kinds of capability. Examples include composition methods to support query, book browsing, hyperlinking, tutorials, simulations, or question/answer testing. Future steps must address true integration of such applications with existing clinical information systems. We believe that the most viable approach for evolving this capability is based on the use of new software engineering methodologies, open systems, client-server communication, and delineation of standard message protocols. PMID- 1772915 TI - Application of an artificial neural network in radiographic diagnosis. AB - The description of 44 cases of bone tumors was used by an artificial neural network to rank the likelihood of 55 possible pathologic diagnoses. The performance of the artificial neural network was compared with the performance of experienced (3 or more years of radiology training) residents and inexperienced (less than 1 year of radiology training) residents. The artificial neural network was trained using descriptions of 110 radiographs of bone tumors with known diagnoses. The descriptions of a separate set of 44 cases were used to test the neural network. The neural network ranked 55 possible pathologic diagnoses on a scale from 1 to 55. Experienced and inexperienced residents also ranked the possible diagnoses in the same 44 cases. Inexperienced residents had a significantly lower mean proportion of diagnoses ranked first or second than did the neural network. Experienced residents had a significantly higher proportion of correct diagnoses ranked first than did the network. Otherwise, a significant difference between the performance of the network and experienced or inexperienced residents was not identified. These results demonstrate that artificial neural networks can be trained to classify bone tumors. Whether neural network performance in classification of bone tumors can be made accurate enough to assist radiologists in clinical practice remains an open question. These preliminary results indicate that further investigation of this technology for interpretation assistance is warranted. PMID- 1772916 TI - The prospect of expert system-based cognitive support as a by-product of image acquisition and reporting. AB - In order for computer-based decision-support tools to find routine use in the everyday practice of clinical radiology, further development of user interface and knowledge content are required. In an ideal interface, the interaction between the radiologist and the computer would be minimized and painlessly integrated into existing work patterns. In this article, we explore some of the ways that pre-existing computer interactions in the processes of image acquisition and reporting can be used to feed case information into an expert system and thereby allow users to acquire advice from it in an automatic fashion. We describe interface models that we have developed in the domains of mammography and obstetric ultrasound, and discuss interface and content-related questions that have arisen from informal evaluations of these systems. In particular, the need for clinical outcome-relevant decision support and training level appropriate decision support are discussed in detail. PMID- 1772917 TI - An improved phantom for quality control of laser scanner digitizers in picture archival and communications systems. AB - Various quality control (QC) procedures may be used to evaluate image quality for picture archival and communications (PACS) systems. A standard PACS QC protocol applied on a regular basis is desirable to ensure optimal diagnostic performance. We describe a QC phantom designed especially to test PACS systems that acquire images by digitizing x-ray films. The phantom is a sheet of x-ray film upon which a digital test pattern is printed. Multiple parameters of image quality are tested, including resolution, contrast, gray scale, geometric distortion, and noise. Individual test patterns are incorporated to detect specific artifacts of laser scanner digitizers. As part of a regular QC protocol, the phantom provides an objective measurement of change in digital image quality over time, as well as an objective means for comparison with other systems. PMID- 1772918 TI - Quality assurance of picture archiving communication systems with laser film digitizers. AB - A comprehensive quality assurance (QA) program should be implemented for all teleradiology and picture archival and communications (PACS) systems. In this report, we summarize our QA experience with a teleradiology system that includes a laser digitizer for x-ray film. A key component required for the evaluation of laser film scanners is an appropriate test pattern; digitizers should be evaluated with enhanced test patterns specifically designed for this purpose. The phantom pattern should measure high-contrast resolution, low-contrast discrimination, gray scale linearity, geometric distortion, and noise. In addition, a uniformly exposed sheet of film (approximately 0.3 optical density) serves as a good phantom for testing screen nonuniformities of viewing station monitors. It is also suggested that clinical images should be included in a QA program. Finally, it is recommended that any discrepancies in the interpretation of teleradiology images should be monitored and investigated. PMID- 1772919 TI - High-resolution digital teleradiology: a perspective. AB - Teleradiology has come a long way, from analog transmission systems using slow scan television over standard telephone lines, to present-day, commercially available, microcomputer-based, low-resolution teleradiology systems. However, there exists a need to address the high-resolution end of the medical imaging categories, namely chest radiographs and mammograms, to firmly establish teleradiology. The availability of high-resolution image digitizers, display units, and digital hard copiers has made high-resolution digital teleradiology a feasible concept. Although the use of satellite channels can speed up the transmission of radiographic image data, with widespread acceptance of high resolution teleradiology systems in the foreseeable future, the sheer amount of data involved in this field will give rise to problems of data transmission and storage. Data compression schemes can bring down the amount of data handled and can have a great economic impact on future teleradiology systems. We have developed a number of compression techniques for reversible compression of medical images. Our experiments have shown that lossless compression of the order of 4:1 is possible for a class of high-resolution medical images. Use of pattern recognition techniques offers the potential to bring down these data rates even further. We plan to use these techniques in a prototype high-resolution teleradiology system being developed. In this paper, we trace some of the developments in teleradiology and image data compression, and present a perspective for teleradiology in the 1990s. PMID- 1772920 TI - Image terminal series of Hokkaido University picture archiving communication system. AB - In Hokkaido University Hospital, the large-scale PACS has been in clinical use since 1989. We developed various kinds of imaging terminals such as the image input terminal and the image display terminal for this system. This article presents detailed description of these terminals. PMID- 1772921 TI - FCR system in Hokkaido University Hospital. AB - The complete digital x-ray system using FCR is now being used in daily diagnosis as a part of the picture archiving and communications system (PACS) in Hokkaido University (HU) Hospital. This project is based on a 3-year plan started in 1988. In the first year (1988), six Fuji Computed Radiography (FCR) units (two FCR501, one FCR502, three FCR7000), PACS interfaces, and an optical disk system were installed. In the first year, about 60% of x-ray filming changed from the conventional technique to the FCR, and 60% of FCR images were transferred to PACS. In the second year, we began to use FCR in gastrointestinal (GI) study with two additional FCR7000s and three x-ray TV units. Then the percentage of plain films made by FCR increased to 80%. In the third year, angiographic studies will be converted to FCR. A specially designed built-in type FCR is under development to examine the entire spine. When this project is complete, almost all conventional radiography except chest tomography will be performed by FCR. The tomography x-ray computed radiography (CR) unit with automatic-imaging plate (IP) changer is expected to be developed soon. PMID- 1772922 TI - The practical use and evaluation of picture archiving and communication system in the Department of Orthopaedic Surgery. AB - A picture archiving and communication system (PACS) was started in June 1989 in the outpatient clinic of the Department of Orthopaedic Surgery, Hokkaido University, Sapporo, Japan. The PACS system has several advantages: space savings for storage of images, safe custody and quick access to image data, simultaneous access to image data, the possibility of obtaining good quality data on utilization of images, and applications for medical education and resident training. However, this system has just begun, and several problems must still be solved. In this article, we describe our experiences with the PACS system in the outpatient clinic of the department of orthopaedic surgery. PMID- 1772923 TI - Picture archiving and communication system in Hokkaido University Hospital: advantage and disadvantage of HU-PACS chest roentgenogram images in the outpatient clinic. AB - A new Hokkaido University picture archiving and communication system (HU-PACS) has been in clinical use in the outpatient clinic at HU Hospital. To evaluate the quality of the cathode-ray tube (CRT) monitor images, we compared the detectability of line shadows in the chest roentgenogram images on the CRT monitor with those on the computed radiography (CR) film. We randomized chest roentgenograms from 20 patients who were admitted to the outpatient clinic with pulmonary disease. Two physicians, whose speciality is chest roentgenogram diagnosis, checked whether they could recognize a horizontal fissure line (hairline) on the posteroanterior view and a minor fissure line and major fissure lines on the lateral view. Only 30% of hairlines were recognized on CRT monitor as compared with 65% on CR film. On the lateral view, only 68% of major fissures and 53% of minor fissures on CRT monitor were recognized as compared with 89% and 79%, respective on CR film. Furthermore, it was somewhat difficult to follow entire lines on some of the CRT monitor images. Clinically, the greatest advantage of the PACS is immediate availability of images, including chest roentgenogram, chest computed tomography (CT) and magnetic resonance imaging (MRI). PACS is also convenient for consulting colleagues in other departments. Unfortunately, the quality of the image on the CRT monitor is not yet good enough to visualize line shadows and small solitary lesions on the chest roentgenogram image. Recent advances in high technology have been so rapid, however, that higher resolution CRT monitors will be available soon. PMID- 1772924 TI - Concept of Hokkaido University picture archiving communication system. AB - The basic concept of Hokkaido University picture archiving communication system (HU-PACS) for its design in hardware architecture and in its characteristic functions is reported. After almost 10 years, the concept was solidified as the opinion of most of the doctors of HU Hospital. Discussions with vendors were very helpful in providing technical or industrial expertise and equipment to effect this concept with the limited funds available. PMID- 1772925 TI - Management and clinical utilization of computed tomography, magnetic resonance imaging, and angiography in Hokkaido University Hospital picture archiving and communication system. AB - We made a preliminary assessment of the Hokkaido University picture archiving and communication system (HU-PACS). Data access time from either imaging machines or data base to workstations was 1.5 minutes, which is great benefit for data communication in routine examinations. Image quality of the work station was estimated in terms of brain computed tomography (CT) and digitized cerebral angiograms. Cerebral infarction was definitely observed on the cathode-ray tube (CRT) monitor of the work station. Although the picture quality of CRT was acceptable, we had to manipulate window level and width for CRT diagnosis of cerebral angiography. Data compression was routinely used without significant degradation of those image quality. Nevertheless, further improvement of maneuverability of the workstation should be considered. PMID- 1772926 TI - Evolution of picture archiving and communication systems--1989. AB - Several areas of partial picture archiving and communication systems (PACS) applications such as teleradiology, nuclear medicine, archiving modules, and systems for handling computed tomography and magnetic resonance digital data are mentioned prior to the discussion of a fully functional PACS system. Some of the present and future social implications of PACS are reviewed. Experience to date with a pilot system called MicroRSTAR at the Massachusetts General Hospital is described. PMID- 1772927 TI - Picture archiving and communication in radiology: an American perspective. AB - A comprehensive image management and communication (IMAC) network has been installed at Georgetown University Hospital (GUH) for an extensive clinical evaluation. The network is based on the AT&T CommView system and includes interfaces to 12 imaging devices, 15 workstations (inside and outside the radiology department), a teleradiology link to an imaging center, an optical jukebox, and a number of advanced image display and processing systems. Two years of clinical experience with the network enable us to develop a plan for future activities from an American perspective. The IMAC project is not just a technical challenge, but also a professional, organizational, and administrative one. Several obstacles remain, but they are gradually being overcome as more cost effective and streamlined technologies become available and as users and developers gain more operational experience in managing diagnostic images in an electronic environment. PMID- 1772928 TI - Implementation aspects of image management, archiving, and communication systems in routine clinical use. AB - Implementation of a digital imaging network in routine clinical use is a difficult task. Not only the high technical requirements, but especially the complexity of the organization of the diagnostic information flow in a hospital makes commitment essential in PACS implementation. The application of project management with a dedicated project team is a good approach to establish this complex endeavor. The different phases of a project for implementation are initiative, definition, design, preparation, realization, and evaluation and are exemplified by what we learned from the Dutch PACS project. PMID- 1772929 TI - Network system: the integrated picture archiving and communication system with the hospital information system. AB - We describe the outline of Hokkaido University picture archiving and communication system (HU-PACS) and its network functions. HU-PACS processes 0.5 Gbytes of images daily through 10 acquisition devices. Functional integration of hospital information system (HIS) and PACS has been implemented. The HU-PACS can access common data base with HIS. Multi-image data-base systems provide fast throughput of image retrieval. The system is composed of 4 modules: (1) 2 image data-base systems (IDS), (2) 1 image management system (IMS), (3) image display terminals (IDT), and (4) 8 image acquisition nodes interfaced to 10 modalities and 1 film scanner. These 4 modules are connected by branch and loop type local area networks (LAN). HU-PACS has functions other than basic PACS functions. Images in optical disk library (ODL) are loaded onto magnetic disks (MD) in advance according to patient booking information, the images expected to be viewed are transferred to the local storage automatically, and the desired images can be pre-downloaded into local storage by instruction through HIS terminals. PMID- 1772930 TI - The impact of networking on image acquisition system design. AB - Widespread integration of networking technology will change the hospital imaging environment, making computational, archiving, and film production services available to network-connected modalities. This change will be reflected in the designs of the image acquisition modalities themselves. A view of the future is presented in which the modalities depend on network-provided services, simplifying the modalities' designs and making them more cost-effective. Achieving this view will require cooperative efforts by standards groups, PACS and modality manufacturers, and hospital organizations. PMID- 1772931 TI - Justifying the picture archiving and communication system: general considerations based on the Trieste experience. PMID- 1772932 TI - Economic model of a whole hospital picture archiving and communication system installation. PMID- 1772933 TI - [More anesthetic safety by EEG monitoring?]. PMID- 1772934 TI - [Cerebral monitoring]. AB - Several studies have shown that most anaesthesia-related critical incidents are due to human error. There is evidence that cerebral monitoring procedures may be of value for an early detection of cerebral hypoxia or ischaemia. Monitoring of central nervous physiology includes both evaluation of systemic parameters like arterial blood pressure, arterial PO2, PCO2, and temperature, and more specific parameters for the assessment of central nervous system function and intracranial haemodynamics. It has been suggested that parameters from the processed EEG may be used as an indicator for depth of anaesthesia. Even though anaesthetic-induced EEG alterations are unspecific, depth of anaesthesia may be assessed quantitatively by combined monitoring of general parameters and processed EEG. Interpretation of the EEG signals has to take into account that critical events like hypoxia or cerebral ischaemia results in EEG patterns similar to those seen under deep anaesthesia. Sensory evoked potentials are frequently used to monitor specific neural pathways that are at risk during surgery. Different pathways may be tested using different trigger modalities (somatosensory, auditory, visual). Changes in latencies and amplitudes of primary components may indicate impaired conduction in the pathway monitored. For operations in which monitoring of evoked responses is indicated, the anaesthetic technique should have minimal impact on latencies and amplitudes. In patients, cerebral blood flow can be monitored only at discrete time intervals. In contrast, non-invasive transcranial Doppler sonography may provide continuous information on intracranial haemodynamics. Relative changes in cerebral blood flow velocity have been shown to correlate closely to changes in cerebral blood flow. Cerebral perfusion pressure can be calculated by monitoring of intracranial pressure in patients with compromised intracranial compliance. PMID- 1772935 TI - [The effect of thiopental on mid-latency auditory evoked potentials and their frequency analysis]. AB - The effect of Thiopentone on mid-latency auditory evoked potentials has not yet been examined sufficiently. Therefore, mid-latency auditory evoked potentials during induction of general anaesthesia with thiopentone were studied. Following informed consent in 10 patients scheduled for elective surgery, anaesthesia was induced with thiopentone (5 mg/kg b.w. i.v.). Assisted ventilation via face mask with 100% O2 was performed until the first purposeful movement of the limbs appeared. Then a second bolus of thiopentone (2 mg/kg b.w. i.v.) was given and general anaesthesia was maintained according to anaesthesiological and operative necessities. Auditory evoked potentials were recorded in the awake and on-line when thiopentone was injected up to 9 min after the onset of general anaesthesia. Latencies of the peaks V, Na, Pa were measured. Using Fast-Fourier-Transform Analysis, corresponding power spectra were calculated to analyse energy portions of the AEP frequency components. In the awake state peak latencies were in the normal range. Corresponding power spectra indicated energy maxima in the 30-40 Hz frequency range. After induction of general anaesthesia an increase in latencies of the peaks Na, Pa could be observed. The energy in the 30-40 Hz range became suppressed, the AEP energy maxima shifted to the low frequency range. These effects were observable until 3 min after injection. When the first purposeful movement of a limb occurred, Na, Pa latencies returned to normal values and most part of the AEP-energy was in the 30-40 Hz range as in the awake.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772936 TI - [The effects of halothane and nitrous oxide on transcranial magnetic evoked potentials]. AB - The influence of volatile anaesthetic agents on transcranial magnetic motor evoked potentials (TMEP) is not known. The effect of halothane and nitrous oxide on TMEP as recorded from hand was studied in 10 patients undergoing lumbar spinal surgery. In no case were the TMEP documented when halothane and nitrous oxide were administered. After withdrawal of both agents it took up to 29 minutes until the TMEP reappeared. It is concluded that intraoperative monitoring of TMEP is not possible if halothane and nitrous oxide are administered. PMID- 1772937 TI - [EEG power spectra and evoked potentials during alfentanil/midazolam analgesia sedation in intensive care patients]. AB - In a prospective study, 10 patients (ASA II-IV) with different ailments received varying amounts of an alfentanil/midazolam mixture (consisting of 15 mg of alfentanil and 37.5 mg of midazolam) for analgesia and sedation in a typical ICU setting over a period of 3-14 days. Special interest focussed on potential residual activity of both drugs after termination of the treatment. Since both compounds interact with receptor sites in the CNS, neurophysiological measurements were performed before, during and after the sedation. Thus, EEG power spectra were used to evaluate the central effects of midazolam, while the late peak (greater than 50 ms) of the somatosensory-evoked potential (SEP) was used to determine the inhibitory effect of alfentanil on the propagation of efferent nerve volleys along the sensory tract. A residual activity of midazolam after long-term administration seems likely as the return in the fast beta-domain was slow, and the high power in the slow EEG frequency bands delta and theta still persisted 24 hours after treatment. However, rapid recovery of the amplitude of the late N100-peak in the evoked potential suggests no potential "overhang" of alfentanil even if administered for several days together with a benzodiazepine. Among the variables most suitable for the determination of a sufficient sedation, the spectral edge activity (the highest frequency component in the EEG incorporating 95% of the entire power spectrum) showed a close relationship to the applied dose. All patients except one, a former alcoholic with CT-verified widening of the cerebral ventricles, could be sufficiently sedated with alfentanil/midazolam.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772938 TI - [The value of criteria for pneumonia in the diagnosis of a ventilated pneumonia]. AB - Reliable diagnosis of pneumonia in ventilated patients is frequently difficult, since there is no single specific criterion. In the present study, the following diagnostic criteria for pneumonia were checked in 25 ventilated patients: 1. temperature over 38.5 degrees C, 2. leukocytosis over 12,000/mm3, infiltration in the x-ray, 4. positive auscultatory findings, 5. purulent tracheal secretion (TS), 6. positive bacteriological findings (TS). Diagnosis of bacterial pneumonia was assumed if in the bronchoalveolar lavage (BAL) the concentration of a plausible causative organism was greater than or equal to 10(4)/ml and the "Bacterial Index" (BI) was greater than or equal to 6 (16). 15 patients fulfilled more than four criteria for pneumonia. In all patients the concentration of bacteria in the BAL was greater than or equal to 10(4)/ml (median 10(6)/ml, BI: 10). 10 patients fulfilled less than or equal to 4 criteria of pneumonia. In three of the patients, BAL was sterile, in four cases organisms less than 10(4) were isolated; none of these patients received antibiotics and diagnosis of pneumonia was not confirmed in the further course of illness. In three patients, bacteria greater than or equal to 10(4)/ml were isolated (BI 9, 10, 13); they improved under adequate antibiotic therapy. We conclude from these results that "as a rule" more than four of the criteria of pneumonia specified above should be present for diagnosis of pneumonia in ventilated patients in a surgical intensive care ward. If there is any doubt, BAL should be performed to confirm the diagnosis. PMID- 1772939 TI - [Candida infections in intensive care patients]. AB - In 31 of 60 long-term ventilated intensive-care patients, a significant Candida antigen titer in serum was found that correlated with positive Candida cultures. In some cases the detection of the antigen was the first indication of Candida infection, while the isolation of the infectious agent required a culture period of 24-48 hours. In addition to routinely performed controls of Candida colonisation, determination of Candida antigen in the serum appears to be a valuable tool in the early diagnosis of candida infections. PMID- 1772940 TI - [Coronary circulation and myocardial oxygen balance in anesthesia]. AB - It is generally believed that in patients with impaired coronary reserve an imbalance between myocardial O2-demand and O2-supply is the main cause of myocardial ischaemia. However, clinical experience as well as recent experimental results indicate that this global view may not always explain the occurrence of regional myocardial ischaemia. It was therefore investigated whether in patients before and after induction of anaesthesia as well as during sternotomy metabolic indices of ischaemia, i.e. lactate and/or hypoxanthine release into the coronary sinus, are related to global indices of myocardial O2-balance. It was found that neither myocardial O2-demand or O2-supply nor O2-balance correlated with myocardial ischaemic events. Conversely it was observed that in contrast to expectations lactate and/or hypoxanthine release occurred more often in conjunction with high values of coronary venous oxygen saturation than with low values. Since coronary venous oxygen saturation can be considered as a physiological index of global myocardial O2-balance, the data of the present investigation suggest that during anaesthesia a global imbalance between myocardial oxygen supply and demand is not the main cause of myocardial ischaemia. Thus, regional factors seem to be more important for initiation of myocardial ischaemic events than global O2-balance. PMID- 1772941 TI - [Determination of oxygen content: a comparison between the new Oxystat-Photometer and the Lex-O2-Con]. AB - The Oxystat-photometer (Fa. Andos) is a new instrument for measuring of oxygen content and haemoglobin of blood. Using specific agents oxygen and haemoglobin can be registered in small cuvettes. The principle of measurement is photometry. Additionally O2-saturation can be calculated. In 139 experiments we checked the reliability of the Oxystat-photometer in comparison to the Lex-O2-Con (Lexington Instruments Corporation). High significance could be demonstrated (r = 0.96). There was a range from the control value below 5%. Following investigations using calculation, results could be confirmed. PMID- 1772942 TI - [Gas embolism with cardiac arrest during hysteroscopy. A case report on 3 patients]. AB - Hysteroscopy and laparoscopy are relatively non-invasive methods routinely employed in the investigation of infertility. The danger of air embolism during these procedures was recognized early, and carbon dioxide was substituted for air since it is more readily soluble in blood. In this report we describe 3 cases of circulatory collapse and cardiac arrest in healthy young women during routine hysteroscopy (out of a total of 62 patients during the period 1989-1990) which were most probably caused by massive carbon dioxide embolism. Premedication was with oral diazepam 10 mg. Anesthesia was induced with 0.1 mg fentanyl, 2.5 mg droperidol and 100 mg methohexital (100 mg propofol in one case). Intubation was facilitated with 2 mg pancuronium and 50-100mg succinylcholine. Anesthesia was maintained with nitrous oxide 66% and halothane. Ventilation was controlled with a tidal volume of 10 ml per kilogram body weight at a rate of 10 per minute. Monitoring included ECG, automated non-invasive blood pressure, capnometry, pulse oximetry and body temperature. Anesthesia was uneventful prior to insufflation. In each case the signs and symptoms began approximately 5-8 minutes after the start of insufflation and consisted of an initial tachycardia rapidly followed by ventricular dysrhythmias, bradycardia and cardiac arrest. The end-tidal CO2 decreased during the tachycardic phase and prior to asystole. The patients were cyanotic with engorged jugular veins. Resuscitation with closed chest heart massage and intravenous epinephrine or orciprenaline was successful in every case. The typical "mill wheel phenomenon" of gas embolism was audible on auscultation after heart activity had returned, but disappeared after about 5 minutes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772943 TI - [Franz Kuhn (1866-1929) on the 125th anniversary of his birthday]. AB - At the beginning of the 20th century, the German surgeon Franz Kuhn (1866-1929) was the leading protagonist of various endotracheal intubation technics. In the period between 1900 and 1912, he wrote several papers on this topic including a remarkable monograph on intubation, which was not widely appreciated for decades. In this, he discussed--among others--the advantages and possible risks of the endotracheal intubation, for patients during surgical procedures as well as in situations of cardiopulmonary resuscitation. Kuhn recommended the use of flexible metal tubes which were generally introduced into the trachea under digital control. Kuhn suggested the advantageous use of Kirstein's autoscope, too, a forerunner of modern laryngoscopes. To overcome the "pneumothorax problem" in thoracic surgery, he emphasized the positive pressure ventilation via endotracheal tubes. As an alternative, he suggested the insufflation technique for this purpose. He was the first to incorporate a carbon-dioxide absorption system within the anaesthesia apparatus. Later, he developed technical devices for the perioperative intravenous administration of fluids or the injection of local anaesthetic drugs under high pressure. In honour of Kuhn's 125th birthday, the various contributions to anaesthesia and emergency medicine are outlined. PMID- 1772944 TI - Race, genetics, and scientific integrity. PMID- 1772945 TI - Undetected breast cancer in black women. PMID- 1772946 TI - Patient-Centered Patient-Valued Care. PMID- 1772947 TI - Decreasing the field strength of the National Health Service Corps: will access to care suffer? AB - To study the effect that the decline in physicians in the National Health Service Corps (NHSC) pipeline will have on access to care for patients at sites to which NHSC physicians are assigned, a survey was sent to all NHSC physicians completing their obligated service in 1989. Seventy-four (74) percent of the respondents believed that the decreased number of NHSC doctors in the pipeline would threaten the existence of their site and 52 percent reported that no doctors or clinic sites would be able to provide free or subsidized care if their NHSC site were forced to close. Of the physicians who stated that their NHSC patients would be able to find an alternative source of care, the most commonly cited (33 percent) alternative was the local hospital emergency room. We conclude that access to care for patients at NHSC sites will be seriously impaired by the decline in physicians in the NHSC pipeline. PMID- 1772948 TI - Preventing violence in at-risk African-American youth. AB - Homicide and nonfatal injuries resulting from interpersonal violence are significant contributors to the excess early mortality and morbidity of African American youth. Although there is growing recognition of the need for prevention programs specifically directed to these youth, culturally relevant programs to reduce aggression and victimization in high-risk racial and ethnic groups are virtually nonexistent. This article reports preliminary findings of a program to train African-American adolescents in social skills, an approach which shows promise as a means of preventing violence. The pilot study suggests a need for continued research on this and other prevention approaches to reduce the disproportionate--and preventable--risk of injury or death for this vulnerable population. PMID- 1772949 TI - Health habits of school-age children. AB - While health habits such as eating breakfast, maintaining desirable weight, sleeping regularly, and wearing seat belts are related to the longevity of adults, very little is known about the health habits of disadvantaged school-age children. Using data from the 1987 National Medical Expenditure Survey (NMES), this paper examines selected health habits of children between the ages of five and 17 (n = 6,722) by sociodemographic characteristics. Descriptive analyses indicate that while the majority of these school children had good health habits, many did not. Over 17 million school-age children did not regularly wear a seat belt. More than eight million of these children did not regularly eat breakfast, while close to three million were overweight. Multivariate analyses revealed that after controlling for gender, age, race, income, residence, and the education level of the highest wage earner in the family, only income and education were significantly related to the number of good health habits. PMID- 1772950 TI - Residual monomer in acrylic polymers. AB - Three proprietary dental resins were found to include acrylates (as distinct from methacrylates). As acrylates are well known to have adverse skin reactions, the nature and content of the acrylates were obtained. One resin contained methyl acrylate, and the other two ethyl acrylate. Also, the extractable free monomer from one proprietary and one experimental bone cement was determined as a function of time. This was carried out: (a) on unpolymerized material as soon as it formed a coherent dough; and (b) on already polymerized material. The extraction of n-butyl methacrylate from the experimental bone cement was very much less than that of methyl methacrylate from the proprietary bone cement. In both cases, whilst the kinetics of loss for short times appeared to conform to diffusion theory, subsequent loss did not; this was attributable to both continued polymerization of the monomer and to the concentration dependence of the diffusion coefficient. PMID- 1772951 TI - Biological activity of urokinase immobilized to cross-linked poly(2-hydroxyethyl methacrylate). AB - The fibrinolytic enzyme urokinase was immobilized by encapsulation or cross linking to poly(2-hydroxyethyl methacrylate) networks. The immobilized urokinase was more thermally stable, more stable against pH change and more resistant to inactivation by plasma protease inhibitors. These stabilities were improved with increasing degree of cross-linking. On the other hand, the enzymatic activity of immobilized urokinase decreased with increasing degree of cross-linking. A suitable degree of cross-linking is needed for the maintenance of high biological activity of immobilized urokinase over a long period. PMID- 1772952 TI - Pulsed oscillation technique for assessing the mechanical state of the dental implant-bone interface. AB - The sensitivity of a vibrational test for in vivo assessing the interfacial rigidity of a biocompatible dental root implant was studied using models. Aluminium alloy rods of 4 mm diameter and 7 mm long were root implant models. Cyanoacrylate and epoxy adhesives were hard interface models. Soft interfaces were modelled in a soft silicone adhesive, a gel, adhesive tapes and direct loose contact. Blocks of bovine and canine jaw-bones chemically treated and dried were models of a human alveolar bone. It was found that the minimum average thickness of a soft interface layer distinguishable from a hard interface depends on load directions and positions and ranges from 0 to 160 microns. The sensitivity was rather low in the direction for which a normal load was applied to the bone, reflecting a mechanical difference of the surrounding bone and/or the interface. Therefore, it is desirable that the assessment by the vibrational test is done in the direction, too, for which a shearing load is applied to the interface. PMID- 1772953 TI - Phosphate glass cement bone graft. AB - The objective of this study was to prepare cement-forming substances from phosphate glasses for use as a bone graft. The glass-forming system of CaO-SrO Na2O-P2O5 was explored and ten phosphate glasses were prepared of varying compositions. Cements were made by reducing the glass to powders and reacting them with a water solution of calcium hydroxide or phosphoric acid. The cements were evaluated by X-ray diffraction, electron microscopy, density and porosity measurements, pH change during reaction and solubility in water. Because of the water solubilities of these cement materials, they may be useful as bone grafts containing drugs such as antibiotics which would be slowly released as the graft material degrades. PMID- 1772954 TI - Biocompatibility and osteogenetic characteristics of new biocompatible glasses. AB - A fibre-shaped glass with qualities of biocompatibility and biodegradation could be promising for reconstructive bone surgery in orthopaedics and neurosurgery. New highly biocompatible glasses, originally made by the Italian Group of Study on Biocompatible Glass, are obtained both in cylinder and fibre shapes due to their original chemical composition (Glassfiber). This is the only glass which is also available as a continuous filament. Hydrolytic in vitro and in vivo tests demonstrate that these glasses present both good biocompatibility and adjustable biodegradation in relation to their chemical composition. The advantages of bioactive glass also being available as a continuous filament are suggested. PMID- 1772955 TI - Macroporous calcium phosphate ceramics for bone substitution: a tracer study on biodegradation with 45Ca tracer. AB - The value of artificial materials in bone replacement depends highly on their biocompatibility and biostability. Porous calcium phosphate ceramics have a good compatibility with natural bone. To study the biodegradation process of calcium phosphate bioceramics, labelled [45Ca]-beta-whitlockite and [45Ca]-hydroxyapatite were implanted in the femurs of dogs. The effects accompanying the ingrowth of new bone into the pores of these bioceramics and its replacement by natural bone were investigated. In vivo degradation of the implant material by biochemical dissolution processes was observed. The beta-whitlockite implants showed a conspicuous decrease in radioactive calcium, in contrast to the hydroxyapatite implants. 45Ca was absent in adjacent bones and locally newly formed bone in both beta-whitlockite and hydroxyapatite suggesting a restricted availability of the 45Ca liberated in these processes. Indications of minor mechanical degradation of the materials were also found; in the lymph nodes a very small amount of 45Ca with a high specific activity was detectable. Urine, blood or faeces contained no detectable amounts of 45Ca activity. PMID- 1772956 TI - Treated xenografts as gliding tendon prostheses in an ovine model. AB - A model for testing the properties of gliding tendon grafts has been developed that allows anastomoses to be evaluated separately from the mid-portion of the graft. In addition, two different graft materials may be implanted in one sheep foreleg whilst maintaining control (not operated) tendons in both the operated leg and contralateral foreleg. The model has been used to evaluate the response of xenografts made from chemically treated kangaroo tail tendon (KTT) compared with autografts. At 3 month the mid-sections of the glutaraldehyde-fixed xenografts maintained between 57 and 82% of their initial ultimate tensile strength whereas lyophilized KTT dropped to 10% and autografts retained 91% of initial strength. Sterilization by gamma-radiation of wet xenografts did not affect the material and implant properties significantly. Longer term studies are necessary to determine the resorption behaviour of the xenografts. Anastomosis strengths were found to be about the same for all grafts, at about 25% of the strength of the original tendon. Alternatives need to be investigated to improve this strength. PMID- 1772957 TI - Hydrogels for site-specific oral drug delivery: synthesis and characterization. AB - Novel types of hydrogels based on hydrophilic N-substituted (meth)acrylamides, N tert-butylacrylamide and acrylic acid cross-linked with 4,4' di(methacryloylamino)azobenzene were synthesized. The gels were characterized by the equilibrium degree of swelling as a function of pH, modulus of elasticity in compression at pH 2 and 7.4 and permeability of insulin at pH 2 and 7.4. It was found that the structure of the polymer backbone influenced the pH-dependent swelling. In all cases, the degree of swelling was lower at pH 2 than at 7.4. As the degree of swelling decreased, the modulus of elasticity was found to increase and the permeability of insulin decreased. These gels are enzymatically degradable by microbial azoreductases present in the colon and have a potential use in site-specific drug delivery to the colon. PMID- 1772958 TI - Platelets process adsorbed protein: a morphological study. AB - The nature of the adsorbed protein on a non-biological biomaterial surface is known to influence cell adhesion. This work deals with the contribution of adherent platelets towards the redistribution of preadsorbed proteins. A redistribution was only observed with spread platelets on adsorbed fibrinogen and fibronectin, but not with adsorbed beta-lactoglobulin. The labelled protein images showed a dark outer ring with an inner region having fluorescent areas, with greater intensity than regions not covered by platelets. The fluorescent patterns observed may be a result of the binding of adsorbed fluorescent protein to the glycoprotein IIb/IIIa receptors of platelets, followed by their redistribution within the plasma membrane. PMID- 1772959 TI - Reduced thrombogenicity of artificial materials by coating with ADPase. AB - A novel coating solution for the improvement of biocompatibility of polyurethane based vascular prostheses was tested in rabbits and rats in vivo. Segments of coated and uncoated vascular prostheses were implanted into the peritoneal cavity of rats, followed by induction of experimental haemorrhage; otherwise whole vascular prostheses were implanted in the carotid artery of rabbits using microsurgical procedures. While in both rats and rabbits, the uncoated material showed abundant formation of fibrinoid thrombi, clear reduction of thrombus formation was seen in all ADPase coated materials following implantation in vivo. PMID- 1772960 TI - Neutrophil polarization and immunoelectrophoresis assays in the study of complement activation by biomaterials. AB - The neutrophil polarization assay, a technique used to measure chemotaxis, was adapted to examine complement activation. Complement activation in serum which had been incubated with metallic and polymeric biomaterials was examined using the neutrophil polarization assay and immunoelectrophoresis assay. In agreement with previous publications, nylon activated the complement cascade, but PTFE did not. The neutrophil polarization assay was found to be the most sensitive technique for examining complement activation by endotoxin but the immunoelectrophoresis assay is the technique most sensitive for detecting complement activation by cobalt powder. In both assays, complement activation was not detected in serum incubated with chromium powder. However, serum incubated with silver and nickel powder stimulated neutrophils to polarize indicating that these powders may activate complement. PMID- 1772961 TI - Biocompatible orthopaedic polymer. PMID- 1772962 TI - Heart muscle antibodies in myasthenia gravis. AB - Myasthenia gravis (MG) may in some patients, especially in those with a thymoma, involve the heart. Using an ELISA, we measured heart muscle antibodies in sera from 75 MG patients and in 173 control sera. Heart muscle antibodies were detected in 29/30 thymoma MG patients, in none of 30 young onset MG patients with thymic hyperplasia and in 7/15 late onset MG patients with thymic atrophy. Among the controls, four sera had a very low concentration of heart muscle antibodies. Absorption studies showed that the heart muscle antibodies cross-react with skeletal muscle, but are unrelated to acetylcholine receptor antibodies. PMID- 1772963 TI - On the localization of effector cells in cyclosporin-induced autoimmunity. AB - Lethally irradiated rats, reconstituted with syngeneic bone marrow and given Cyclosporin A (CyA) for 6 weeks, developed disease resembling allogeneic graft versus-host disease 2 weeks after withdrawal of CyA. Other studies have demonstrated the pivotal role of the thymus in the etiology of this CyA-induced autoimmune disease (CyA-AI). In this study the question was addressed whether inducer/effector cells of CyA-AI are generated in the thymus during or after CyA administration; whether these cells stay in the thymus, or, if they don't, whether they home to the secondary lymphoid organs. Adoptive transfer of thymocytes from donors treated for induction of CyA-AI obtained one and 14 days after cessation of CyA administration did not elicit CyA-AI in irradiated secondary recipients. Furthermore, adult thymectomy of rats immediately after the course of CyA did not influence the kinetics of development of skin pathology, although weight loss commenced later in thymectomized than in sham-thymectomized rats. Lymph node and spleen cells obtained from donors treated for induction of CyA-AI one and 14 days after withdrawal of CyA-AI caused CyA-AI upon adoptive transfer to secondary recipients, but the symptoms of acute disease (dermatitis, alopecia and weight loss) were strikingly less severe upon transfer of lymphoid cells obtained one day after stopping CyA than 14 days thereafter. Therefore, this study demonstrates that CyA-AI inducer/effector cells are generated in the thymus during the administration of CyA. These cells exit from the thymus during CyA administration; either they home predominantly peripherally (i.e. in the skin) rather than in the secondary lymphoid organs, or they leave the thymus as inducer cells which home in the lymphoid organs where they subsequently may trigger potentially autoreactive lymphocytes as probably also present in normal individuals, or both pathways may be operative. PMID- 1772964 TI - Genes for interleukin-1, interleukin-6, and tumor necrosis factor are expressed at markedly reduced levels in the livers of patients with severe liver disease. AB - The genes for interferon (IFN) alpha, IFN gamma, IL-1 beta, IL-6, and TNF alpha were transcribed at readily detectable levels both in liver biopsies from individuals with normal liver function and in samples of normal viable liver taken for transplantation. These results provided evidence for the concept that such multifunctional cytokines play a role in homeostasis in normal human tissues. In normal human liver, in situ hybridization studies showed that, in the absence of a detectable inflammatory response, both hepatocytes and mononuclear cells exhibited a similar degree of expression of IL-6 mRNA in keeping with the finding that IL-6 is produced by cells of different lineages. The levels of IL-1, IL-6, and TNF mRNA were found to be markedly reduced in extracts of the livers of patients with primary biliary cirrhosis and other forms of autoimmune liver disease at a time when extensive liver lesions were apparent, compared to the levels of expression of these cytokines in the livers of normal individuals. The reduced expression of IL-1, IL-6, and TNF mRNAs appeared to be a specific effect and not due to a general reduction in RNA synthesis as the IFN alpha, IFN gamma and actin mRNAs were expressed at similar levels in both normal and diseased livers. The levels of IL-1 beta, IL-6, and TNF mRNAs were also reduced in samples of liver from a patient with a drug induced fulminant hepatitis suggesting that this specific pattern of altered cytokine gene expression was characteristic of the advanced stage of severe liver disease. PMID- 1772965 TI - Repetitive exposure of pancreatic islets to interleukin-1 beta. An in vitro model of pre-diabetes? AB - The slowly progressing loss of glucose tolerance over years before clinical onset of Type 1 (insulin-dependent) diabetes mellitus may be due to repetitive immunological attacks on the pancreatic beta-cell mass. Accordingly, we studied the effects of repetitive exposure of isolated rat pancreatic islets to the beta cytotoxic immune-mediator interleukin-1 beta. Islets were exposed thrice to 60 U/ml of recombinant interleukin-1 beta for 24 hr. The islets were allowed to recover for 6 d between the interleukin-1 beta exposure periods. After each of the three interleukin-1 beta exposure periods, islet capacity to release insulin was decreased to 12, 6 and 3% of control, respectively, and islet insulin content decreased to 75, 56 and 21%, respectively. After the two recovery culture periods, the capacity for insulin release reversed to 75 and 30% of control, respectively. An increase in islet insulin content was only seen after the first recovery culture. During repetitive as well as long-term (6 d) interleukin-1 beta exposure of islets, medium accumulation of glucagon was either increased or unaffected. In analogy, beta-cells exposed to interleukin-1 beta for 6 d showed ultrastructural signs of degeneration and cytolysis, whereas alpha-cells were intact. In conclusion, interleukin-1 beta injury to beta-cells was partially reversible, but successive episodes of islet interleukin-1 beta exposure were increasingly detrimental; alpha-cell function and structure did not show susceptibility to damage by interleukin-1 beta. These findings may contribute to our understanding of islet cell behaviour before and during onset of Type 1 diabetes. PMID- 1772966 TI - The possible role of interleukin-6 in acute sarcoidosis with arthropathy, Lofgren's syndrome. PMID- 1772967 TI - Factors within the body determining the glycogen reserves in the tissues of rats with transplantable tumours. AB - Attempts have been made to determine the reason for the depletion of glycogen reserves in tumour-bearing rats. The possible roles of anorexia, competition for glucose by the tumour, and lack of hormonal control of glycogen biosynthesis have been investigated. The glycogen content of the liver, skeletal muscle, and brain, and the levels of glucose and the hormones corticosterone, insulin, and glucagon were determined in healthy rats which had been starved for various periods and in tumour-bearing rats carrying the fast-growing Zajdela ascites hepatoma or the slow-growing solid hepatoma 27. It was found that towards the terminal stages of tumour development there was an increase in the content of corticosterone and glucagon in the blood serum and also an increase in the glycogen reserves in skeletal muscle and brain despite the presence of hypoglycaemia and hypo insulinaemia. There was at this time a sharp fall in the level of liver glycogen. It is shown that neither anorexia nor excessive competition for glucose by the tumour were the main reasons for liver glycogen depletion and hypoglycaemia. A strong correlation was observed, however, between the occurrence of anaemia and the loss of liver glycogen, which suggests that the former may be an important factor in the changes in host tissue observed in response to tumour growth. PMID- 1772968 TI - Mossbauer spectroscopy of oxygenated haemoglobins. AB - Murine tetrameric oxyhaemoglobin and insect monomeric erythrocruorin were studied. A doublet with the Lorentz form of lines (delta EQ = 2.22 mm s-1; delta alpha-Fe = 0.27 mm s-1; gamma 1/2 = 0.29 mm s-1) was observed in the oxyhaemoglobin spectrum at 4.2 K. In the 80-170 K interval the doublet components are distorted, but at T greater than 175 K, the lines again become symmetrical. In the 175-210 K region the value of gamma 1/2 is approximately 0.42 mm s-1. The profiles of the oxyhaemoglobin spectra are not dependent on the nature of the samples (blood; whole, or in aqueous or water-glycerol solutions at different pH values), or on the rate at which the latter are frozen. The oxyerythrocruorin spectra in aqueous solution and in a water-glycerol solution at 80 K and 170 K were doublets with Lorentz lines (the delta EQ values are equal to 2.20 mm s-1 and 2.12 mm s-1, respectively). It is concluded that the characteristics of the oxyhaemoglobin spectra reflect the specific electronic and structural properties of the oxy-complex in this protein. It was found that the oxyhaemoglobin spectra are very adequately described by two doublets with equal delta and gamma 1/2 values, but with different delta EQ values and relative intensities. A model is described in which these doublets correspond to two types of hydrogen bond associated with the distal histidine (E7), involving the terminal atom of molecular oxygen and the oxygen atom bound with the haem iron, respectively. PMID- 1772969 TI - Amino acid sequence determination of vaccinia virus immunodominant protein p35 and identification of the gene. AB - A major immunodominant envelope protein of vaccinia virus (protein p35) was purified by extraction from virions with the nonionic detergent Nonidet P-40. The protein was cleaved with cyanogen bromide. Four homogeneous peptides were isolated and their N-terminal amino acid sequences determined. A computer search of a protein-sequence data bank revealed complete identity of the determined sequences with sequences 44-63, 144-149, 154-165, and 224-238 of ORF H3 of the HindIII-H fragment of the vaccinia virus genome (Rosel et al 1986). It has therefore been established that the immunodominant protein p35 of vaccinia virus is encoded by the gene in the HindIII-H fragment of the vaccinia virus genome. PMID- 1772970 TI - Polymerase chain reaction polymorphisms in HLA-DQ alpha and IL6 from Mongoloid and Caucasoid populations. AB - Polymerase chain reaction polymorphisms have been used to study European, Chinese, Russian and Buryat populations at the HLA-DQ alpha and IL6 loci. DNA from individuals in these populations was specifically amplified at these loci, and analyzed either with allele-specific oligonucleotides for HLA-DQ alpha or directly on agarose gels for IL6. Allelic frequencies were calculated for each of the loci in each population. Comparisons between the population frequencies show that the Russian population is more closely related to Europeans, and that the Buryat population is more closely related to Chinese. This finding is in agreement with conclusions based on the phenotypic frequencies of classical blood group and other protein markers in these populations. PMID- 1772971 TI - Effects of Pluronic F-68 on 2-deoxyglucose uptake and amino acid incorporation into chick embryonic fibroblasts in vitro. AB - The effects of the nonionic surfactant Pluronic F-68 on 2-deoxyglucose uptake and amino acid incorporation in vitro into chick embryonic fibroblasts prepared from day 7 embryos have been studied. During early culture growth (3-10 days), Pluronic supplementation at 0.05% (w/v), but not at 0.1%, stimulated 2 deoxyglucose uptake by 20%-30% above control levels. Pluronic also markedly increased amino acid incorporation, maximally at 3 days of culture (200%-300% above control levels with 0.1% and 0.05% Pluronic, respectively), but to a lesser extent thereafter. These effects of Pluronic were seen only when freshly-prepared solutions were used; 'aged' solutions produced no comparable stimulation of 2 deoxy-glucose uptake or amino acid incorporation. PMID- 1772972 TI - Identification of RNA replicase subunits responsible for initiation of RNA synthesis of tick-borne encephalitis virus by affinity labelling. AB - Porcine embryo kidney cells infected by tick-borne encephalitis virus (TBEV) were fractionated into nuclear, membrane, and cytoplasmic fractions. To identify proteins involved in the initiation of RNA replication at different stages of infection a highly specific affinity labelling technique was used. In samples of the nuclear fraction taken from cells 45 h after infection (late stage), affinity labelling with aldehyde-containing derivatives of ATP and elongation of this label with [alpha-32P]GTP identified a polypeptide with a molecular mass of about 69 kDa. By means of affinity labelling with aldehyde-containing analogues of GMP, GDP, and GTP as initiation substrates and [alpha-32P]ATP as the elongation substrate, a polypeptide of 100 kDa was selectively modified in the nuclear fraction of cells at the early stages of infection (8 h). These proteins were immunostained with TBEV-specific antibodies, and were identified as the nonstructural TBEV proteins NS3 and NS5, respectively. It was concluded that NS3 and NS5 take part in the initiation of TBEV genome replication at the late and early stages of infection, respectively. PMID- 1772973 TI - Target cells for immunomodulatory action of muramyl dipeptide. AB - Identification of the target cells for the immunomodulatory action of muramyl dipeptide (MDP) was addressed by investigation of various B-cell and T-cell lines. The lines used were: IM-9, a human lymphoblastoid B-cell line that spontaneously produces IgG; EL-4, a murine T-cell line that produces interleukin 2 (IL-2) on stimulation with phorbol myristate acetate; and CTLL-2, an IL-2 dependent murine T-cell line. MDP was shown to modulate such T-cell and B-cell functions as cell proliferation and secretion of IL-2 and IgG, respectively, in vitro. The effect of MDP in vitro was determined by both MDP dose and the control level of cell activity. The evidence obtained supports the possibility of the direct action of MDP on T and B lymphocytes. PMID- 1772974 TI - In vitro activation of protein kinase C by prolactin in guinea pig adrenal cortex. PMID- 1772975 TI - Affinity-purified secretory immunoglobulin A possesses the ability to phosphorylate human milk casein. PMID- 1772976 TI - Use of recombinant hirudin to increase the patency rate of microanastomosis in a rabbit model. AB - Microvascular surgical techniques now play an extremely important role in reconstructive surgery. Failures still persist and are most commonly due to thrombotic occlusion of the microvascular anastomosis. Five to 20% of all free tissue transfers and replants are affected. A logical step in the effort to resolve this problem would be the infusion of the newly available recombinant hirudin (r-hirudin). The value of r-hirudin in microvascular surgery has not been investigated. An animal model mimicking the thrombotic mechanisms similar to those in the clinical situation has been described in which a length of rabbit femoral artery is excised, turned inside out and reinserted into the vessel with two standard microvascular anastomoses. The major factors in clinical anastomosis failure are represented in this animal model by medial disruption, imperfect vessel wall alignment, needle holes, trauma, foreign suture material and changes in flow. The type III adventitial collagen turned inward reproduces the clinical problem of adventitial strands becoming caught in the anastomosis. A predictable rate of thrombosis results depending on inversion graft length: a 2 mm segment has an occlusion rate at one week of about 30%. Using this model heparin infusions significantly decrease thrombosis rates compared to saline. Using an almost identical model we have begun a study the effect of r-hirudin on microvascular patency. New Zealand White male rabbits were anaesthetized with ketamine and xylazine. Through a groin incision the femoral vein was catheterized and tubing connected to an infusion pump. The femoral artery was exposed, and the adventitia aggressively removed since it is difficult to minimally debride adventitia in a reproducible fashion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772977 TI - Comparison of recombinant hirudin and heparin as an anticoagulant in a cardiopulmonary bypass model. AB - Recombinant (r) hirudin is a potent thrombin-specific inhibitor originally derived from the natural hirudin of the leech (Hirudo medicinalis). We have studied the efficacy of r-hirudin compared to heparin in a dog model of cardiopulmonary bypass (CPB) surgery. Two administration regimens were used for r hirudin: Group I received 1.0 mg/kg intracardiac (i.c.) bolus then intravenous (i.v.) bolus at 30 min (n = 10); Group II received 1.0 mg/kg (i.c.) bolus with 1.25 +/- 0.04 mg/kg/h (i.v.) infusion (n = 8). Group III was given heparin 1.66 mg/kg (i.c.) bolus (n = 9). Aspiration of blood from the chest cavity revealed no significant difference between the three groups. Measurement of fibrin deposits in the pump line filter revealed higher amounts in the r-hirudin groups (P = 0.02). Decreases in platelets, fibrinogen and haematocrit due primarily to haemodilution were the same in each group. The bleeding time was less prolonged for r-hirudin than for heparin (p less than 0.001). No antagonist for r-hirudin was used; however, due to its short half-life, all coagulation parameters returned to baseline within 30 min after CPB. Since r-hirudin has no effect on platelets, is a poor immunogen, does not require a plasma cofactor, and may not require an antagonist, it may provide an alternative anticoagulant to heparin in CPB. Additional studies are, however, needed to optimize the dose and to evaluate other clinical aspects of r-hirudin. PMID- 1772978 TI - Production of the HV1 variant of hirudin by recombinant DNA methodology. AB - Recombinant DNA technologies now allow the preparation of virtually any polypeptide sequence. Very efficient expression systems for prokaryotic and eukaryotic cells have been developed which may yield large quantities of the desired protein. Bacterial systems are still the most widely used while alternative organisms are often considered when post-translational modifications could influence the biological behaviour of the product. For hirudin or its analogues, two important molecular characteristics should be taken into account. First, it is necessary that no extra amino acid residue, such as the initial methionine, is present on the NH2 end of the recombinant polypeptide. It is known that a free N-terminal sequence is crucial for the thrombin inhibitory activity. Second, a sulphate group on tyrosine at position 63 is found in natural hirudin extracted from leeches. Such post-translational modification has never been observed for all the recombinant hirudin preparations reported to date even though the importance of the sulphate group on the in vitro and in vivo activity of hirudin has not yet been clarified. Finally, the recombinant DNA methodology of choice for the commercial development of hirudin must also take into consideration yield and cost factors which ultimately will affect the widespread use of this product particularly if it has to compete with heparin. We will review our work on the preparation of recombinant hirudin describing bacterial and insect cell expression systems and addressing some of the questions mentioned above. PMID- 1772979 TI - Development of a chromogenic substrate assay for the determination of hirudin in plasma. AB - Hirudin is a potent and specific thrombin inhibitor. Since recombinant hirudin is being considered for anticoagulant and antithrombotic therapy we developed a fast and sensitive chromogenic substrate assay for its determination in plasma. The plasma samples (20 microliters) were incubated with 1 ml reagent mixture (0.2 M Tris buffer, 0.025 M NaCl, pH 8.1, containing 0.833 M urea, 0.7 trypsin inhibitor U/ml aprotinin, 100 ng/ml Polybrene and 0.31 NIH U/ml bovine thrombin) for 1 min. Thereafter 100 microliters Chromozym TH (Tos-Gly-Pro-Arg-pNA, 1.9 mM) was added. The change in absorbance/min (delta A/min) was recorded at 405 nm. delta A/min was linear for at least 3 min. The calibration curve was linear at least up to 800 ng hirudin/ml plasma. Intra-assay and inter-assay coefficients of variation were 2.8-3.1% and 5.3-5.8% respectively. The influence of progressive thrombin inhibitors can be neglected because of the short incubation time. Plasma samples can be assayed directly if aprotinin, polybrene and urea are added to the reagent mixture. PMID- 1772980 TI - Determination of thrombin-hirudin complex in plasma with an enzyme-linked immunosorbent assay. AB - An enzyme-linked immunosorbent assay (ELISA) was developed for the determination of the thrombin-hirudin complex (TH) in plasma. The test is based on the sandwich principle and uses appropriate antibodies which selectively bind the corresponding moieties of the complex. The assay was calibrated by adding performed TH to normal human citrated plasma. The detection limit of the assay was 1.2 ng/ml. Mean coefficients of variation of 6.0% (intra-assay) and 6.4% (inter-assay) were found. The presence of TH was demonstrated in normal human plasma that was spiked with hirudin and subsequently activated in vitro by calcium-thromboplastin to generate thrombin. This complex was also found in plasma samples from pigs which had been treated with hirudin during experimentally induced septicaemia. PMID- 1772981 TI - An objective perspective on recombinant hirudin: a new anticoagulant and antithrombotic agent. AB - Leeches have been in medical use for many years. Hirudin, the anticoagulant obtained from the medicinal leech has been purified, characterized and can now be produced by recombinant (r) technology. R-hirudin is a potent inhibitor of thrombin and is therefore a potentially valuable anticoagulant and antithrombotic drug. This article reviews the current status of r-hirudin in this role and compares the pharmacokinetics, mechanism of action and clinical efficacy of this agent with heparin. The methods available for laboratory assessment and clinical monitoring of r-hirudin and the possible ways of antagonizing its effects are also discussed. Finally, the potential clinical applications of r-hirudin are outlined, although further laboratory and clinical studies, together with a fall in the cost of this compound are required before r-hirudin can be more widely accepted as an anticoagulant and antithrombotic agent. PMID- 1772982 TI - Interaction of hementin with fibrinogen and fibrin. AB - The giant Amazon leech Haementeria ghilianii manufactures blood anticoagulant which is present in the posterior and anterior salivary glands. The mechanism of blood anticoagulation by Haementeria ghilianii is completely different from that used by Hirudo medicinalis. The anticoagulant is mostly associated with a fibrinogen-degrading proteinase, hementin. However, other inhibitors of blood coagulation are also present in the salivary glands. The salivary gland extract inhibits platelet aggregation that is mostly attributable to the degradation of fibrinogen. Hementin purified by various methods has a molecular weight in the range of 80,000-120,000 and appears to be a metalloproteinase that is regulated by calcium ions. The enzyme degrades both fibrinogen and fibrin. The Michaelis constant for human fibrinogen is 1 microM. The cleavage of the isolated chains of fibrinogen is inefficient implying that the native conformation of the substrate may play a role in the recognition mechanism. The pattern of fibrinogen degradation by hementin resembles that caused by plasmin since products analogous to fragments Y, D and E are generated. However, the unique action of hementin on fibrinogen is in the initial proteolytic attack in the coiled-coil connector region while proteolysis of the alpha-chain is very slow. In consequence, unique fibrinogen fragments are formed that contain the entire COOH-terminus of the alpha-chain. The mechanism of blood anticoagulation by hementin is very efficient since the cleavage of only three peptide bonds in the fibrinogen molecule disassembles its bivalent structure and renders it non-functional. PMID- 1772983 TI - The biological function of hementin in the proboscis of the leech Haementeria ghilianii. AB - The giant Amazon leech Haementeria ghilianii feeds by inserting an exceedingly long tubular proboscis (up to 10 cm) deep into its mammalian host. The wound from its bite is not associated with prolonged bleeding because all antihaemostatic factors, including the fibrinogenolytic enzyme hementin, appear to be secreted exclusively into the lumen of the proboscis. It is in this narrow lumen that blood first comes into contact with hementin, the secretion of which is under neuronal control from the brain. During feeding, about 15 ml of blood are sucked through the proboscis at the rate of approximately 0.14 ml/min. A complete passage of blood takes less than 1 min, much faster than the approximately 6 min needed for coagulation (fibrin formation). Therefore, it is unlikely that hementin functions in the proboscis simply to prevent fibrin formation. Of greater risk is platelet aggregation which can occur within 1-2 min. The formation of a platelet-rich clot within the proboscis could make the proboscis non-functional. Hementin's unique ability to dissolve platelet-rich clots offers a way of restoring blood flow through the proboscis. Hementin is able to disaggregate platelets by breaking the fibrinogen crosslink between platelets. Hementin's unique cleavage site in the connector region of platelet-bound fibrinogen is thought to be a most effective mechanism for eliminating the crosslinking. PMID- 1772984 TI - Studies on the anticoagulant, antimetastatic and heparin-binding properties of ghilanten-related inhibitors. AB - The purpose of this study was to investigate the structure-activity relationships of ghilanten, an anticoagulant-antimetastatic protein of the South American leech Haementeria ghilianii. Five sequence-related variants of ghilanten, termed P1-P5, were purified and were shown to potently block the active-site hydrolysis of methoxycarbonyl-D-cyclohexylglycyl-glycyl-arginine-p-nitroanilide acetate by the human blood coagulation enzyme factor Xa; inhibition was rapid and stoichiometric. The amino acid sequence of P5 revealed a consensus sequence for heparin-binding at the carboxy-terminus. A synthetic peptide homologous to this region (93P-N-G-L-K-R-D-K-L-G-C-E-Y-C-E-C-R-P-K-R-K-L-I-P-R-L-S119) bound 125I labelled heparin maximally at physiological pH and salt concentration. When administered intravenously to mice, the peptide suppressed lung metastases although less potentially than whole ghilanten. These findings suggest that the carboxy-terminal heparin-binding region may play a role in the antimetastatic action of the inhibitor. PMID- 1772985 TI - Destabilase, the novel epsilon-(gamma-Glu)-Lys isopeptidase with thrombolytic activity. AB - The salivary gland secretion of the leech Hirudo medicinalis contains the enzyme destabilase which hydrolyses epsilon-(gamma-Glu)-Lys cross-links in stabilized fibrin. Accumulation of Glu residues instead of the original Gln residues leads to spontaneous depolymerization of destabilized fibrin. L-gamma-Glu-p nitroanilide; L-gamma-Glu-dansylcadaverine and isopeptide epsilon-(gamma-Glu)-Lys are low-molecular-weight substrates of destabilase. Destabilase probably exists in molecular forms of molecular weight 50,000, 25,000 and 12,300. The protein part of destabilase is covalently bound to a lipid component of molecular weight 390, which has little cross-reactivity to 6-keto-prostaglandin F1 alpha antiserum. The lipid component ensures the hydrophobic properties of destabilase, inhibition of platelet aggregation, protection from proteolysis and absorption from the intestine into blood during oral administration to experimental animals. It also ensures the protective antithrombotic effect. Almost total (80-100%) thrombolysis of preformed thrombus in the rat was achieved by destabilase 70-100 h after i.v. injection or oral administration. PMID- 1772986 TI - 5-Hydroxytryptamine (5-HT)-induced shape change in human platelets determined by computerized data acquisition: correlation with [125I]-iodoLSD binding at 5-HT2 receptors. AB - The 5-HT-induced shape change and subsequent aggregation of platelets provides a functional assay for 5-HT2 receptors. In the present study we describe a method to increase aggregometer sensitivity by digital conversion of the voltage produced by changes in light transmittance through a platelet suspension, thereby allowing accurate analyses of the primary shape-change response. The pharmacology of 5-HT-induced shape change was then compared with that of [125I]-iodoLSD binding in human platelets. 5-HT caused a dose-dependent change in platelet shape (maximum response 5 x 10(-6) M, EC50 10(-6) M). Furthermore, there was a significant correlation across a selection of drugs between IC50 values for inhibition of 5-HT-induced shape change and for inhibition of platelet binding of the 5-HT2 receptor ligand [125I]-iodoLSD. These results support the hypothesis that 5-HT-induced shape change and [125I]-iodoLSD binding in human platelets are mediated through the same receptor, and validate the methods of data acquisition described. PMID- 1772987 TI - Matrix engineering. AB - Matrix engineering is a technology that utilizes hyaluronan (HA, hyaluronic acid) based matrices to control, direct or augment tissue regenerative processes. Hyaluronan and the concept of matrix engineering have become established tools in ophthalmic and orthopaedic medicine. The clinical indications for HA are limited by the physical properties and short residence time of the natural HA molecule. To expand and improve upon its current medical applications, a family of HA derivatives was prepared by chemical modification and cross-linking. Relative to the non-modified HA molecule, the hylan family of polymers provides more versatile physical forms, improved mechanical properties and an extended residence time. Hylan can also be used as a surface coating to improve blood compatibility. The chemical, physical and biological properties of hylans will be reviewed, focusing on the specific therapeutic indications they enable. PMID- 1772988 TI - Calin--a platelet adhesion inhibitor from the saliva of the medicinal leech. AB - The saliva of the medicinal leech, Hirudo medicinalis, contains a potent, hitherto unsuspected, inhibitor of collagen-mediated platelet adhesion/aggregation. Calin, of molecular size approximately 65,000 (reduced), has a rapid (1-10 min) effect on collagen which is reflected in its ability to suppress collagen-induced platelet aggregation, as well as adhesion of platelets to collagen-coated microcarrier beads. It also causes flocculation of Type I collagen fibril suspensions. Calin is differentiated from leech collagenase in two ways: (1) by demonstrating, by SDS-PAGE analysis of the products of incubations of Calin with Type I collagen at 37 degrees C, that Calin binds to but does not cleave collagen; and (2) by showing that Calin cannot be purified using the methods used to isolate leech collagenase. Calin's rapid and unusual interaction with collagen makes it a prime candidate for one of the agents that are the causative factors of the prolonged bleeding phenomenon seen after leech bites. PMID- 1772989 TI - The use of medicinal leeches in microsurgery. AB - Medicinal leeches have been used to treat a variety of ailments for thousands of years. During the past decade the leech has become valuable for salvaging surgically uncorrectable venous insufficiency which is occasionally encountered after microsurgical free flap and replantation procedures. Leech anatomy and physiology are reviewed. Indications and the technique for application of medicinal leeches is discussed, as well as potential complications of leeching. PMID- 1772990 TI - Clinical leech use in a microsurgical unit: the San Francisco experience. AB - One microsurgical unit's experience with leech application to 67 patients is surveyed. Five illustrative cases are presented to explain strategies of leech use, and plans for future research are discussed. PMID- 1772991 TI - The use of leeches in distal digital replantation. AB - Over the past 18 years we have operated on 50 patients who had sustained distal amputation of fingers. Their average age was 30 years (range 2-72 years). Replantation of radial digits on the right hand was most common and the thumb was involved in nearly half the cases in our series. Out of the 50 cases we were able to repair both arteries in 35 patients and only one artery in the other 15. Regarding veins, two were anastomosed in 12, only one in 23 and none in 15 because of the severity of the contusion or the very distal site of replantation. Although early arterial thrombosis usually leaves no solution other than reoperation, venous complications can be relieved by ancillary methods such as leeches which we first used in 1976. We encountered a venous problem in 16 (32%) out of the 50 cases. In three cases a venous anastomosis had been performed, but in 13 others it proved impossible. If congestion was mild, paraungeal or pulpar incision provided some relief because of repeated topical application of heparin and systemic heparinization. If congestion was severe, leeches were used on average for 6 days at a frequency of four to six leeches a day. All cases where leeches were used could be salvaged. One can assess through this sequence that the use of leeches in distal digital replantation has improved the survival rate by 26%. PMID- 1772992 TI - Leech therapy: when once is not enough. AB - Venous congestion is a constant threat in the survival of free flaps, pedicled flaps, tissue replantations and traumatized tissue. Leech therapy has proved effective in salvaging much of these compromised tissues. To be effective, leeches must be both readily available and hungry, requirements not always easily met. Our investigation seeks to establish a means to return sated leeches to their previous unfed, hungry state for reuse. Sated leeches were purged of their blood meals by placement in 3% hypertonic saline or by gentle finger pressure, then exposed to serotonin 0 microM (control), 10 microM, 30 microM or 90 microM for 20 min. Subsequent rebiting/refeeding was observed and analysed. Leeches bathed in serotonin rebit or reattached at nearly four times the rate of unexposed leeches; 30% vs 8% respectively. Biting, however, is not refeeding. Overall, 41 leeches were treated with serotonin with four (10%) refeeding. Those that refed consumed a significantly smaller blood meal than the initial feeding; 50% +/- 47% SD vs 348% +/- 143% SD of original body weight. None of the control group refed. As a method for routinely reusing leeches, serotonin bathing cannot be recommended. In the immediate postoperative period with the sudden emergence of venous congestion requiring leech therapy, but with an inadequate number available, this 20% [corrected] refeed rate after 10 microM serotonin exposure could potentially determine the success or failure of the flap/replantation until fresh leeches are made available. PMID- 1772993 TI - Aeromonas hydrophila infections following clinical use of medicinal leeches: a review of published cases. AB - Ten Aeromonas hydrophila infections following postsurgical leech applications have been reported. These cases indicate that postsurgical wounds and damaged tissue can provide entry for either acute or delayed A. hydrophila infection. These infections can range from localized cellulitis to progressive myonecrosis and sepsis. These infections may occur with measurable frequency in groups of patients exposed to leeches. Based on this review, it is recommended that leeches be applied only to tissue with a reasonably certain arterial supply; that patients receive antibiotics against A. hydrophila prior to leech administration; and that consideration be given to prolonged antibiotic administration to patients discharged home with open wounds or questionably viable tissue after leech administration. PMID- 1772994 TI - Use of a radioimmunoassay for 5-hydroxytryptamine (5-HT) in thrombocytosis. AB - A decrease in intra-platelet 5-hydroxytryptamine (5-HT) may be a possible marker for primary thrombocytosis and there are several different methods for the measurement of platelet 5-HT content (e.g. fluorimetry, high-performance liquid chromatography and radioimmunoassay). The present study has shown that, in laboratories with radioprotected areas, radioimmunoassay of 5-HT is a simple method which correlates well with a standard fluorimetric technique and yields satisfactory results in patients with thrombocytosis. PMID- 1772995 TI - Coagulation disorder during liver transplantation. AB - Detailed haemostatic changes were investigated during eight liver transplantations. The patients were divided into two groups; group 1 had minor operative bleeding (four cases) and group 2 had major bleeding (four cases). Group 2 had lower levels of platelets, fibrinogen, factor V (FV), and alpha 2 antiplasmin than group 1, and the thromboelastography showed fibrinolysis. In both groups, plasma tissue-plasminogen activator levels rose slightly. After revascularization of the graft liver, reductions in the values of PT, fibrinogen, FV and FVII were noted, along with a prolongation of the PTT and an increase in thrombin-antithrombin III complex levels. Plasma levels of protein C, protein S, antithrombin III, and plasminogen remained relatively stable throughout the operation. These results show that the preceding fibrinolysis and subsequent superimposed activation of the clotting system are the main causes of coagulopathy during liver transplantation, which correlate with the amount of operative haemorrhage and the abnormalities found in haemostatic tests. PMID- 1772996 TI - Pregnancy-induced worsening of thrombocytopenia in a patient with type IIB von Willebrand's disease. AB - Thrombocytopenia has been reported in patients with type IIB von Willebrand's disease (vWd) during pregnancy. In the present work we report the behaviour of platelet count and von Willebrand factor (vWf) multimers in a pregnant type IIB vWd patient who presented with mild thrombocytopenia in the steady state. The evolution of pregnancy was associated with a progressive decrease of platelet count which showed its lowest value two days before delivery (20 x 10(9)/l). The tendency of the platelet count to decrease was suddenly reversed a few days later (77 x 10(9)/l). At the same time, the vWf multimeric pattern showed a strict but inverse correlation with the platelet count. In fact, a progressive increase in low and intermediate sized vWf multimers, which proceeded until platelets reached their minimum level, was noted. A few days after delivery, concomitant with the prompt platelet increase, low and intermediate multimers became decreased. During pregnancy, the patient's platelet showed additional increased responsiveness to ristocetin but did not demonstrate spontaneous platelet aggregation (SPA). On the contrary, the patient's plasma, collected both during and after pregnancy, caused normal platelets to aggregate spontaneously. SPA appeared completely blocked by an anti-GPIIb-IIIa monoclonal antibody (MAb), which recognized the binding site for fibrinogen, vWf and fibronectin. In contrast, a MAb against ristocetin induced vWf binding site on GPIb did not affect SPA. These findings suggest that the common stimulus or stimuli, responsible for the pregnancy-induced decrease of platelet count and improvement of vWf multimeric pattern in type IIB vWd is strictly related to pregnancy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1772997 TI - Increased plasminogen activator inhibitor antigen levels in diabetic patients with stable angina. AB - PAI-1 antigen, tPA antigen and thrombin - antithrombin III complexes (TAT) levels were measured in 10 males with stable angina and type-II diabetes mellitus and in 16 males with stable angina without diabetes or other risk factors (hyperfibrinogenaemia, hyperlipidaemia, diabetes, hypertension, smoking and obesity) known to increase PAI levels. Ten healthy men of equivalent age served as controls. Because only diabetics with coronary artery disease (CAD) showed a decreased fibrinolytic capacity, a second study was performed on the 16 non diabetic CAD patients to determine whether submaximal workload induces significant changes of tPA and PAI levels. TAT levels were increased in CAD, and significantly so in the diabetic group. tPA levels were increased only in the CAD patients without diabetes. PAI levels were significantly increased in diabetic CAD patients (5.26 +/- 1.96 ng/ml) but not in the stable angina patients without diabetes (2.97 +/- 1.44 ng/ml). Immunologically-reactive tPA released after exercise was higher in the 16 CAD patients without diabetes than in controls. Our data could indicate that in stable angina without diabetes there is no chronic latent activation of the clotting system, with no impairment of fibrinolytic activity. On the other hand, the presence of diabetes mellitus seems to influence the fibrinolytic capacity in CAD, particularly increasing PAI levels. PMID- 1772998 TI - Urokinase-plasminogen activator in breast cancer: assay by both catalytic and immunoassay. AB - Urokinase plasminogen activator (uPA) is a serine protease implicated in cancer spread and is thus a potential prognostic marker for human cancers. The aim of this investigation was therefore to compare uPA activity and uPA antigen as prognostic markers in breast cancer. Patients with tumours containing high levels of either uPA activity or antigen, had a significantly worse disease-free interval and survival pattern than patients with low levels. However, uPA antigen was a stronger prognostic marker than uPA activity. It is concluded that uPA should be assayed by immunoassay when using this protease as a prognostic marker in breast cancer. PMID- 1772999 TI - Thrombin structure and function: why thrombin is the primary target for antithrombotics. AB - Thrombin has both beneficial and harmful effects. In order of importance, at very low concentrations, alpha-thrombin firstly amplifies its own generation through the activation of factors V and VIII, which are the primary targets of antithrombotic agents. It secondly functions at the cellular level where, at low concentrations it activates platelets, and at higher concentrations, induces endothelial cell changes (e.g., shape changes, albumin transport release of plasminogen activators and other substances). It thirdly converts fibrinogen into clottable fibrin and becomes actively incorporated into the forming thrombus. In addition, it activates protein C, which in turn degrades factors V and VIII (and/or their activated forms) and causes the shutdown of thrombin generation. When compared to other serine proteinases of the blood coagulation and fibrinolytic systems, alpha-thrombin is unique in that it loses most of its proenzyme activation fragment and has developed multisite short-ranged bridge binding interactions, which appear to explain thrombin specificity. To understand thrombin is to understand haemostasis. PMID- 1773000 TI - Production of thromboxane and prostaglandins in human blood in the presence of thromboxane synthase inhibitors: a comparison of RIA and GC/MS determinations. AB - The radioimmunological determination (RIA) of primary prostaglandins (PGs) in serum and plasma was evaluated with gas chromatography/mass spectrometry (GC/MS). Human blood was stimulated in vitro in the presence or absence of the specific thromboxane synthase inhibitor ridogrel. TxB2, 6-keto-PGF1 alpha, PGE2, PGD2 and PGF2 alpha were determined with RIA and GC/MS on the same samples. For GC/MS analysis, prostanoids were extracted and derivatized to their methoximepentafluorobenzyl-esters-trimethylsilyl-ethers. An excellent correlation was observed between levels of all eicosanoids determined by RIA or GC/MS (r = 0.996-0.999) when plasma was spiked with known amounts of PGs and TxB2 (2-500 ng/ml). In stimulated blood, with or without inhibition of thromboxane synthase, the correlation between RIA and GC/MS values remained good, except for 6-keto PGF1 alpha. RIA largely overestimated the levels of 6-keto-PGF1 alpha and no significant correlation was found with levels detected by GC/MS. The results demonstrate the importance of corroborating the reliability of RIA with GC/MS. PMID- 1773001 TI - Thrombin inhibition by covalently bound hirudin. AB - Hirudin is the most potent known natural inhibitor of thrombin and is presently gaining popularity as an anticoagulant since recombinant and synthesized forms have become available. We have made use of recombinant hirudin (rHir) by covalently binding it to both biomolecules and prosthetic biomaterials. Heterobifunctional crosslinking reagents were used to derivatize rHir and form covalent crosslinks between rHir and albumin producing active conjugates. Both derivatized rHir and conjugates inhibited human alpha-thrombin similarly, however, both showed a ten-fold decrease of alpha-thrombin inhibition when compared to rHir alone using the tripeptide substrate, S-2238. Immobilization of 2.75 +/- 0.45 micrograms rHir on 1.0 cm2 Dacron prosthetic graft patches resulted in inhibition of 1.88 +/- 0.03 micrograms alpha-thrombin in solution (mean +/- SD, n = 3), which is a 8:1 molar ratio, respectively. rHir ED50 inhibition of 0.1 NIH U alpha thrombin stimulated whole blood platelet aggregation was 0.12 x 10( 6) microM. The conjugate ED50 inhibition was 1.37 x 10(-6) microM showing an eleven-fold loss of activity. We conclude that there is only a ten-fold loss of inhibitory activity when rHir is covalently immobilized and that this technique has a benefit of localizing antithrombin activity to surfaces or soluble carrier molecules. PMID- 1773002 TI - Isolation of thrombin inhibitor from the leech Hirudinaria manillensis. AB - The leech Hirudinaria manillensis belongs to the same family as the medicinal leech Hirudo medicinalis, which has been widely used for the study of hirudin, a specific thrombin inhibitor. A similar inhibitor has now been isolated from the heads of the Hirudinaria leech by acetone/acid extraction and further purified to near homogeneity by ion exchange chromatography followed by affinity chromatography on thrombin-agarose and reverse phase HPLC. The purified material was recovered at about 10-15% yield and had a specific activity of about 12,000 14,000 ATU/mg, similar to other hirudin variants. The inhibitor was shown to be homogenous by sodium dodecyl sulphate/polyacrylamide gel electrophoresis in the presence of 8 M urea with an apparent molecular mass of about 7000 daltons under reducing conditions. Comparison of the anticoagulant effect on human plasma by partial thromboplastin time assay have shown that the inhibitor from Hirudinaria has similar potency as hirudin variant 1 at equivalent dosage. However, it does not cross-react with monoclonal antibodies towards recombinant hirudin variant 1. Comparison of the N-terminal amino acid sequence up to residue 25 also indicates differences at positions 2, 13, 17 and 24 between the two thrombin inhibitors. These findings indicate that the primary anticoagulant present in the leech Hirudinaria is a potent thrombin inhibitor (Bufrudin) with biological activity similar to hirudin, but differs in its structural and immunological properties. PMID- 1773003 TI - Structure-function relationships of the C-terminal functional domain of hirudin and its variants. AB - The C-terminal functional domain of hirudin, hirudin variant 1 (residues 55-65), binds to a non-catalytic site on thrombin. In doing so, it is capable of inhibiting the procoagulant actions of thrombin. In terms of free energy of binding, this domain, which comprises 17% of the total sequence of the protein, contributes approximately half of the binding energy of the whole protein to thrombin. This situation also appears to hold true for the known variants of hirudin, some of which differ in the functional nature of their C-terminal regions. Extensive structure-function studies on this domain yield insights into the differences and similarities in the modes of thrombin interaction of hirudin and its variants. In particular, hirudin and hirudin PA have a similar and somewhat interchangeable structure-activity relationships (SAR) profile that indicates that they interact with thrombin in a similar manner. Hirullin P18, a 62 amino acid member of the hirudin family and isolated from Hirudinaria manillensis, is substantially different in sequence and its SAR, which shows that, although it seems to utilize the same non-catalytic binding domain as hirudin, it must utilize a different mode of interaction with thrombin. PMID- 1773004 TI - Reocclusion after thrombolysis: a problem solved by hirudin? AB - The effect of recombinant hirudin (r-hir), unfractionated heparin (UFH) and acetylsalicylic acid (ASA) on the incidence of reocclusion after thrombolysis with plasminogen activator (rt-PA) was evaluated in anaesthetized rabbits. Formation of a platelet rich thrombus was achieved by implantation of a copper coil into the iliac artery. The occluded artery was recanalized in six of ten animals by intravenous administration of rt-PA given as a bolus injection of 0.1 mg/kg followed by infusion of 0.5 mg/kg/h. Within 1 h after termination of rt-PA infusion rethrombosis was observed in 100% of recanalized vessels. The incidence of reocclusion was diminished by r-hir in a dose-dependent manner to 50% after infusion of 0.05 mg/kg/h and to 25% after 0.1 mg/kg/h. No effect on APTT was detectable in this dosage after 3 h infusion. UFH in a dosage increasing APTT two fold (35 U/kg/h) did not reduce the reocclusion rate. 100 U/kg/h UFH increased APTT to greater than 3 min and reduced reocclusion rates to 50%. ASA showed a minor effect on the incidence of restenosis whereas the combination of 0.1 mg/kg/h r-hir plus bolus injection of 10 mg/kg ASA led to a further reduction in reocclusion rates to only 11% and an increase in reperfusion rates from 60 to 90%. Our experiments indicate that the combination of plasminogen activator with r-hir may be a useful approach for the prophylaxis of early reocclusion. PMID- 1773005 TI - Sodium-23 and lithium-7 NMR spin-lattice relaxation measurements in the study intercalation in DNA. AB - Sodium-23 spin-lattice relaxation rate (the reciprocal relaxation time) measurements have been used to study the intercalation of 9-aminoacridine in calf thymus DNA. The results are analyzed by a two state model based on the counterion condensation theory and a theory for the quadrupolar relaxation of counterions in polyelectrolyte solutions. It is shown that change of the solvent from H2O to D2O has a negligible effect on the intercalation process. Furthermore, an attempt is made to analyze the dependence of the 7Li spin-lattice relation rate on intercalation of 9-aminoacridine in LiDNA. It is shown that both quadrupolar and dipolar mechanisms contribute to the bound 7Li relation rate, and that both these contributions are reduced upon intercalation of 9-aminoacridine. PMID- 1773006 TI - A simple model describing the kinetics of the xanthophyll cycle. AB - A new kinetic model of the xanthophyll cycle is proposed. The model is based on the assumption that the light-dependent interconversion of the so-called available and unavailable violaxanthin constitutes the rate-limiting process of the cycle at intermediate, non-saturating light intensities. This assumption, together with the known properties of violaxanthin de-epoxidase, explains all specific features of the experimental facts. PMID- 1773007 TI - Computer simulation of surface-induced aggregation of ferritin. AB - Models are presented describing the transient mass-transport limited adsorption and cluster growth of ferritin at a solid surface. Computer simulations are carried out on a hexagonal lattice using a computer model that can be characterized as a two-dimensional stochastic cellular automaton allowing different rules regarding association, lateral interaction and dissociation to be incorporated in the model. The fractal dimensions of individual clusters were extracted from simulated aggregates and for similar rules found to be consistent with literature values on reversible diffusion-limited aggregation in two dimensions. The distribution of clusters versus free surface were shown to be affected by neighbor-dependent association probability. Low fractal dimension clusters were generated by a combination of strong lateral cohesion and neighbor dependent dissociation to the bulk. By comparing computer simulated aggregation to experimental electron micrographs of adsorbed ferritin layers it is suggested that neighbor-dependent association, neighbor-dependent dissociation and lateral interactions are important factors in the complex dynamics of adsorbed protein layers. PMID- 1773008 TI - Electrical characteristics in an excitable element of lipid membrane. AB - Electrical characteristics in a membrane constructed from a porous filter adsorbed with a lipid analogue, dioleoyl phosphate (DOPH), were investigated in a situation interposed between 100 mM NaCl + 3 mM CaCl2 and 100 mM KCl. Calcium ions affected significantly the membrane characteristics. The membrane potential was negative on the KCl side, which implies the higher permeability to K+ than Na+; this tendency was increased by a tiny amount of Ca2+. While the membrane showed a low electrical resistance of several k omega . cm2 under K+/Na+ gradient, it showed several M omega . cm2 by Ca2+. The surface structure of the membrane exhibited many voids in the low-resistance state, but the surface was covered by oil droplets in the high-resistance state. Oscillations of the membrane potential appeared spontaneously with application of the electrical current from the KCl side to the NaCl + CaCl2 side. The frequency was increased with the electrical current. All these results were explained comprehensively using an electrochemical kinetic model taking account of the Ca2+ binding effect, where DOPH assemblies make a phase transition between oil droplets due to Ca2+ and multi-bilayers with excess K+. The oscillation arises from coupling of the phase transition to accumulation and release of K+ or Ca2+. This membrane can be used as an excitable element regulated by Ca2+ in neuro-computer devices. PMID- 1773009 TI - Effects of volatile anesthetics on bacteriorhodopsin in purple membrane, Halobacterium halobium cells and reconstituted vesicles. AB - In this study, we have investigated effects of volatile anesthetics on absorption spectra, proton pumping activity and decay of photointermediate M of bacteriorhodopsin (bR) in differently aggregated states. Anesthetics used in this study are ether-type general anesthetics; enflurane and sevoflurane. The observed effects on bR depend not only on variety or concentration of anesthetics but also strongly on the aggregation state of bR molecules in the membrane. In purple membrane (PM), bR having maximum light absorption at 567 nm (bR567) is formed in the presence of sevoflurane or a small amount of enflurane, while a species absorbing maximally at 480 nm (bR480) is formed upon the addition of large amounts of enflurane. X-ray diffraction studies show that the former species maintains crystallinity of PM, but the latter does not. In reconstituted vesicles where bR molecules exist as monomer, even sevoflurane forms bR480. Flash photolysis experiments show that bR567 contains a shorter-lived M intermediate absorbing maximally at 412 nm in the photoreaction cycle than bR does and that bR480 contains at least two long-lived M intermediates which seem to absorb maximally near and at lower than 380 nm. The measurements of light-induced pH changes of the whole cells and of the reconstituted vesicles in the presence of the anesthetics indicate that bR567 has a enhanced proton pumping efficiency, while bR480 has a quite low or no activity. No significant difference was observed in the anesthetic action between two inversely pumping vesicles. These observations suggest that on the formation of bR480, anesthetics enter into the membrane and affect the protein-lipid interaction. PMID- 1773010 TI - Temperature- and ionic strength-induced conformational changes in the lipid head group region of liposomes as suggested by zeta potential data. AB - Neutral liposomes composed of DMPC (dimyristoylphosphatidylcholine), DPPC (dipalmitoylphosphatidylcholine) or DSPC (distearoylphosphatidylcholine) are found to exhibit non-zero zeta potentials in an electric field even when they are dispersed in solution at pH 7.4. A model for the orientation of lipid head groups is proposed to explain the observed non-zero zeta potentials. The dependence of the zeta potential on temperature and ionic strength is analyzed via this model to obtain the information on the direction of the lipid head group in the liposome surface region. The direction of the lipid head group is found to be sensitive to the temperature and the ionic strength of the medium. At low ionic strengths, the phosphatidyl groups are located at the outer portion of the head group region. At constant temperature, as the ionic strength increases, the choline group approaches the outer region of the bilayer surface while the phosphatidyl group hides behind the surface. At the phase transition temperature of the lipid, the phosphatidyl group lies in the outer-most region of the surface and the choline group is in the inner-most region. PMID- 1773011 TI - Stability of equine lysozyme. I. Thermal unfolding behaviour. AB - The thermal denaturation of Ca(2+)- and apo-forms of equine lysozyme was followed by using far and near UV circular dichroism and intrinsic fluorescence methods. The difference found between the temperature dependence of the ellipticity at 222 nm and 287 nm, which show two stages in the thermal transition, and those at 228 nm and 294 nm, which indicate only one stage over a wide range of temperatures reflects that different subdivisions of the protein molecule are characterized by a different stability, cooperativity and pathway of denaturation. The first transition, reflected in the increase of the ellipticity at 222 nm and 287 nm, coincides with the transition detected by fluorescence and occurs at 30-50 degrees C for the apo-form and at 50-60 degrees C for the Ca(2+)-form of lysozyme. It seems to correlate with the transfer of some tryptophan residues to a more hydrophobic environment and with a local rearrangement of the tertiary and secondary structures. The unfolding transition detected by the decrease of the ellipticity at all wavelengths occurs nearly in the same temperature region for the apo- and Ca(2+)-forms, i.e. 50-80 degrees C and 55-80 degrees C, respectively. The presence of a Ca(2+)-binding loop in equine lysozyme may be partly responsible for the drastic destabilization of its structure as a whole both in the presence but especially in the absence of Ca2+ in comparison with hen and human lysozymes. PMID- 1773012 TI - Conformation and aggregation of M13 coat protein studied by molecular dynamics. AB - Molecular dynamics (MD) simulations are performed on M13 coat protein, a small membrane protein for which both alpha- and beta-structures have been suggested. The simulations are started from initial conformations that are either monomers or dimers of alpha-helices or U-shaped beta-sheets. The lipid bilayer is represented by a hydrophobic potential. The results are analyzed in terms of stability, energy and secondary structure. The U-shaped beta-structure changes from a planar to a twisted form with larger twist for the monomer than the dimer. The beta-sheet is much more flexible than the alpha-helix as monitored by the root mean square (rms) fluctuations of the C alpha atoms. A comparison of the energies after 100 ps MD simulation shows that of the monomers, the alpha-helix has the lowest energy. The energy difference between alpha- and beta-structures decreases from 266 kJ/mol to 148 kJ/mol, when going from monomers to dimers. It is expected that this difference will decrease with higher aggregation numbers. PMID- 1773013 TI - Biological functions of recombinant human interleukin-2. AB - Recombinant interleukin-2 (rIL-2) is able to maintain the growth and multiplication of T-lymphocytes and IL-2 dependent CTLL-2 cells up to 28 days with the multiplication of T-lymphocytes as high as about 1000 fold. When rIL-2 and its monoclonal antibody were added together, the above functions of rIL-2 were specially blocked, showing that these biological functions were exerted specifically by rIL-2. The rIL-2 is also able to increase the natural killer (NK) activity up to 46-96%, while higher concentrations of rIL-2 might exhibit inhibitory effect. The cytotoxicity of lymphokine activated killer (LAK) cells induced by rIL-2 for killing HL-60 cell line and solid tumour (human lung carcinoma) reached 54.84% and 37.96%, respectively. All these results indicate that the biological functions of rIL-2 were quite similar to that of the natural one. PMID- 1773014 TI - Coloning and expression of spiramycin polyketide synthase genes and resistance genes from S. spiramyceticus U-1941. AB - The plasmid containing the spiramycin polyketide synthase genes, pCN3H8, was obtained from the genomic library of spiramycin producing strain, S. spiramyceticus U-1941, using homologous DNA to actI and actIII genes as hybridization probes. Restriction analysis of the plasmid pCN3H8 showed that the molecular weight was 44kb. The regions homologous to the actI & actIII genes were localized by Southern hybridization, and corresponding DNA fragments were subcloned onto E. coli-Streptomyces shuttle vector pWHM3. A recombinant plasmid pCG4 was obtained. Transformation of the pCN3H8 DNA into the polyketide synthase deficient mutant of midecamycin producing strain, S. mycarofaciens subsp. No. 68, resulted in the production of midecamycin A by UV analysis. Transformation of the pCN3H8 DNA into the polyketide synthase deficient mutant of actinorhodin producing strain, S. coelicolor TK17, resulted in the production of an antibacterial compound which was neither similar to actinorhodin in color nor to spiramycin by paper chromatographic analysis. Transformant of S. lividans with pCN3H8 DNA produced an antibacterial compound as well. Resistance to spiramycin was expressed in transformants of spiramycin sensitive strain, S. griseofuscus, with pCN3H8 DNA. A plasmid pSG3 DNA with molecular weight of 7.0kb, isolated from the transformant, might be a result of in vivo deletion of pCN3H8 in S. griseofuscus. Retransformation of pSG3 DNA into S. griseofuscus confirmed that the gene of resistance to spiramycin was on the plasmid pSG3 DNA. Transformation of spiramycin producing strain, S. ambofaciens, with pCG4 or pSG3 DNA increased spiramycin production in fermentation broth. PMID- 1773015 TI - Cloning and expression of propionyl acylase gene of Streptomyces mycarofaciens mutant. AB - The midecamycin producer, S. mycarofaciens mutant, which has propionyl acylase activity, can convert spiramycin into propionyl spiramycin. Plasmid pIJ702 was used as a vector for the cloning of propionyl acylase gene. After shot-gun cloning, the DNA fragments of the mutant were cloned in S. lividans TK54. The results of TLC and HPLC showed that No.9 transformant can convert spiramycin into propionyl spiramycin. It demonstrated that the propionyl acylase gene was cloned and expressed in S. lividans TK54. The insert fragment of No.9 recombinant plasmid is about 4.16 kb. Southern hybridization showed that the fragment originated from S. mycarofaciens mutant. The restriction endonuclease map of No.9 recombinant plasmid was constructed. PMID- 1773016 TI - Expression of hepatitis B virus surface antigen gene in insect baculovirus vector systems. AB - The gene coding for the hepatitis B virus surface antigen (HBsAg) under the control of Autographa californicanuclear polyhedrosis virus polyhedrin promoter was successfully inserted into the genome of the Trichoplusia ni nuclear polyhdrosis virus. Infection of Spodoptera frugiperda cells with this recombinant virus produced a significant amount of HBsAg protein and secreted 22 nm particles containing the HBsAg. The expression of HBsAg gene was also obtained both in Trichoplusia ni larvae and in Philosamia cynthia ricini prepupae when infected with the recombinant virus. The HBsAg proteins expressed by baculovirus vector systems have morphological and antigenic properties identical to the 22 nm particles secreted by human cells. PMID- 1773017 TI - Cloning and expression of penicillin G acylase gene in Bacillus megaterium. AB - Bacillus megaterium BM1, which produces penicillin G acylase (PGA), has been isolated. Gene encoding for PGA was cloned into E. coli MC1061 using pBR322 as the vector, obtaining a recombinant plasmid pBmPA4 containing 9.9 kb inserted DNA. Restriction map of the plasmid was analyzed. A pBmPA5 containing 4.9 kb was gained by deletion in vitro. Both pBmPA4 and pBmPA5 clones can be expressed in E.coli MC1061, and their expressions were induced by phenylacetic acid. PMID- 1773018 TI - Study on rat-rat hybridoma technique and production of rat monoclonal antibodies against HIV and HBsAg. AB - The rat-rat hybridoma technique has some definite advantages in the three systems (mouse, rat or human system) currently utilized for monoclonal antibody production. The study on rat-rat hybridoma technique and its application to the productions of monoclonal antibodies against human immunodeficiency virus (HIV) and hepatitis B virus surface antigen (HBsAg) are described as examples in this paper. PMID- 1773019 TI - Crystallization and chemical modification of disulfide bond of calf chymosin. AB - In order to carry out protein engineering of chymosin, purification, crystallization and chemical modification of calf chymosin were undertaken. The resolution of iso-enzymes A,B and the degraded product, fraction C was improved and the period of purification was shortened by using fast protein liquid chromatograph (FPLC). Crystal of approximately cubic shape was obtained from 10 mg/ml purified chymosin B at 4 degrees C after successive dialysis against 1.4, 1.8 and 2.0 M NaCl in 0.1 M sodium phosphate buffer. One disulfide bond located on the surface of chymosin molecule was reduced by 0.72 mM dithiothreitol (DTT) at pH 6.3. The reduced disulfide bond was identified as Cys250-Cys283 by using the method of cyanogen bromide cleavage and peptide separation. The reduction of one disulfide bond resulted in the loss of about 25% activity. Carboxymethylated and mercurated derivatives exhibit the similar activity to that of the reduced enzyme suggesting that Cys250-Cys283 plays some role in keeping the conformation with full activity. PMID- 1773020 TI - Clinical utility and prognostic value of ambulatory blood pressure monitoring. AB - Ambulatory blood pressure monitoring is a useful procedure in the diagnosis and management of hypertension, in the assessment of anti-hypertensive drugs and as a means of predicting outcome in hypertension. With ambulatory blood pressure monitoring is possible to detect usual variability of blood pressure, circadian rhythms and the response to environmental influences in both normotensive and hypertensive subjects. A number of clinical conditions are better evaluated with this procedure than with conventional measurements, eg white-coat hypertension (the rise of blood pressure in the physician's office), borderline hypertension, episodic hypertension and secondary hypertension. Multiple readings improve the precision of the estimate of blood pressure profile of the patient and allow a precise evaluation of blood pressure load to which a patient is exposed throughout 24 h. Ambulatory blood pressure monitoring is closely related to the incidence of cardio- and cerebrovascular events and to the prevalence and the degree of target-organ damage. Casual and ambulatory blood pressure readings are not alternative but complementary tools for clinical management of hypertension and for assessment of the prognostic risk of hypertension. PMID- 1773021 TI - The hypolipidemic activity of heterocyclic amine boranes in rodents. AB - Heterocyclic amine boranes were observed to be potent hypolipidemic agents in rodents at 8 mg/kg per day lowering both serum cholesterol and triglyceride levels. These agents were also effective in lowering tissue lipids. Rat serum lipoprotein cholesterol levels were reduced in the low density lipoprotein (LDL) and very low density lipoprotein (VLDL) fractions and elevated in the high density lipoprotein (HDL) fraction after 14 days. The modes of action of the agents appear to accelerate excretion of lipids in the bile and the suppression of the activities of key hepatic regulatory enzymes of lipids synthesis. PMID- 1773022 TI - Ultrastructural alterations of normal blood cells and leukemic lymphoblasts incubated with vindesine. AB - The effect of one of the vinca alkaloids derivatives, vindesine (VDS), on the ultrastructure of normal peripheral blood cells and leukemic lymphoblasts was examined in vitro. The drug caused an increase in the size of polymorphonuclear specific granules, but exerted no effect on the internal ultrastructure of control lymphocytes platelets, or leukemic lymphoblasts. However, the surface ultrastructure of all cell types examined showed alterations which were dose dependent. The question whether the lack of internal impairment in the presence of membral alterations may be due to the relatively short exposure time to the drug is discussed. PMID- 1773023 TI - Effects of the recombinant human erythropoietin (rHuEPO) administration on hematologic parameters, red cell creatine and 2,3-diphosphoglycerate contents, in patients affected by end-stage renal disease. AB - Twenty patients with renal failure and severe anemia (hemoglobin range 6.6-8.7 g/dl) on thrice-weekly maintenance hemodialysis were treated with recombinant human erythropoietin (rHuEPO). After three months of intravenous (iv) therapy the hemoglobin increase averaged 2 g/dl, and was steadily maintained even after two months of subcutaneous (sc) therapy. The significant increase of macrocyte counts, determined by an automated red blood cell counter after both steps of therapy, suggested the release of young red cells (large cells) into blood circulation. This assumption may be supported by the significant increase of the red cell creatine contents. 2,3-diphosphoglycerate (2,3-DPG) levels of the erythrocytes did not significantly change after rHuEPO administration. PMID- 1773024 TI - Is there a link between debrisoquine oxidation phenotype and lung cancer susceptibility? AB - A link between debrisoquine oxidation phenotype and lung cancer susceptibility has been evoked by some authors but not confirmed by others. For this reason, we compared the frequency of debrisoquine poor metabolizer phenotype in 91 Belgian patients with lung cancer to that studied in 167 healthy Belgian subjects. No significant difference was observed in our study. These results do not support the existence of this link. PMID- 1773025 TI - Effects of metformin on haemorheology, lipid parameters and insulin resistance in insulin-dependent diabetic patients (IDDM). AB - We have evaluated the effect of metformin on haemorheology, lipid levels and insulin resistance in insulin-dependent diabetic patients over a 6-week period. Rheological parameters remained unaltered except for the whole blood clogging rate which decreased significantly. No effect on lipid levels was seen. The main effect of metformin was limited to daily insulin requirement and insulin units/kg bw. Bearing in mind the negative effects of high insulin levels, metformin could be useful in the prevention of atherogenesis in insulin-dependent diabetic patients. PMID- 1773026 TI - Effect of calcitriol on peripheral blood lymphocyte cytotoxicity. AB - To clarify the biochemical mechanism responsible for the inhibition by calcitriol (1,25-dihydroxyvitamin D3) of cytotoxicity in peripheral blood lymphocytes (PBL), the human NK sensitive K562 cell line and the human tumor necrosis factor sensitive murine L929 cell line were used as targets and subsequently compared. The cytotoxicity of PBLs for K562 cells was not changed by preincubation for 4 h with 10 ng/ml phorbol myristate acetate (PMA), but was reduced after an overnight preincubation with 10(-9) or 10(-8) M calcitriol. Using L929 cells, preincubation of PBLs with 10 ng/ml PMA for 4 h increased their cytotoxicity. Overnight incubation with calcitriol significantly reduced PBL cytotoxicity for L929 cells in a dose related manner and suppressed the enhancement of this cytotoxicity by PMA. Pretreatment of PBLs with cycloheximide reduced their cytolysis for L929 cells but did not change their cytotoxicity towards K562 cells. Consequently, the natural cytotoxicity of PBLs for K562 cells does not involve the same mechanism as their cytotoxicity for L929 cells and is therefore subject to different forms of regulation. However, calcitriol reduced PBL cytotoxicity towards both target cells. PMID- 1773027 TI - Measurement of platelet-activating factor in biological specimens. PMID- 1773028 TI - A competitive receptor binding assay for platelet-activating factor (PAF): quantification of PAF in rat brain. AB - A radioreceptor assay (RRA) was developed using rabbit platelet membrane preparations to quantify platelet-activating factor (PAF) and lyso-PAF, the deacylated derivative of PAF, in a variety of tissues and biological fluids. We examined PAF and lyso-PAF levels in different rat brain areas with regard to the many proven and postulated actions of PAF in brain functions. Human saliva was selected to check the validity of this RRA. The samples were extracted with methanol/chloroform/water and purified by high-performance liquid chromatography on a 5-microns Nucleosil Si column (overall recovery: 78%). Sample extracts were acetylated before chromatography to assay lyso-PAF. PAF itself was assayed in non aceylated samples. A competitive binding assay was performed using aliquots of platelet membrane preparation and tritiated PAF. The minimum detectable amount of PAF was 144 pg per tube and the receptor was highly specific for PAF. In human saliva, we confirm the presence of PAF and lyso-PAF within the range expected. Moreover there was a good correlation between the RRA and the aggregation assay (r = 0.976). A defined cocktail of protease inhibitors allowed storage of platelet membrane preparations for at least 3 months at -20 degrees C with no change in binding properties. In the brain we observed the prevalent presence of lyso-PAF and large variations in PAF and lyso-PAF concentrations between the different brain areas analyzed. PAF was undetectable in the hypothalamus but the lyso-PAF concentration was 2.5 micrograms/g wet tissue. The PAF concentration in the cortex varied from 0 to 16 ng/g wet tissue while that of lyso-PAF was 0.7 micrograms/g wet tissue. Moreover the amount of lyso-PAF varied between the different brain areas analyzed. The hippocampus contained the highest amount (7 micrograms/g wet tissue), and relatively high levels were found in the hypothalamus, medulla oblongata and corpus striatum. The cerebellum and cortex contained the lowest levels of lyso-PAF. These findings show that PAF is present in the central nervous system mainly in its inactive form, lyso-PAF, and suggest that its effects as a modulator of brain function may be dependent on deacetylation, rather than synthesis. PMID- 1773029 TI - Effect of BAY U 3405, a new thromboxane antagonist, on sudden death in rabbits. AB - We studied the effects of BAY U 3405 in experimental models of arachidonic acid- and collagen-induced sudden death. BAY U 3405 was effective in dose-dependently inhibiting death from both arachidonic acid and collagen at doses of 1, 3 and 10 mg/kg orally. The survival rate, usually amounting to less than 10% in vehicle treated animals, was dramatically increased to 100% at the highest dose. The data obtained emphasize the role of thromboxane A2 as a mediator in this model, and the potential usefulness of BAY U 3405 for thromboembolic disorders. PMID- 1773030 TI - Structure-activity relationships in platelet-activating factor (PAF). 5. Synthesis and in vitro antagonistic activities of ketophosphonates. AB - The synthesis of new ketophosphonate isosteres of biosynthetic precursors of ether glycerophospholipids resistant to phospholipase C is described following two routes depending on whether the alkoxy chain is introduced before or after the phosphonic moiety. The common intermediates are ketophosphonic acids: better yields were obtained by attaching the n-octadecyl chain to epichlorohydrin, opening and oxidation, blockage of the resulting ketone as the chlorohydrazone, followed by an Arbuzov reaction or by azoene formation and Michael addition. These ketophosphonates differing in chain length in position 3 exhibit potent agonistic activities on rabbit platelets which increase with the number of methylene groups between the phosphonate and the ammonium moieties. PMID- 1773031 TI - Involvement of platelet-activating factor in the hypotensive response to zymosan in rats. AB - In anaesthetised rats, intravenous injection of zymosan induced a reduction of serum complement haemolytic activity, leukopenia, thrombocytopenia, a decrease in blood pressure, an increase in haematocrit and paw oedema. Stimulation of platelets resulted in their accumulation in lungs and liver as shown by the distribution of 51Cr-labelled platelets. The hypotensive response to zymosan was largely inhibited by WEB 2086, a PAF antagonist. Plasma extravasation was reduced by WEB 2086, by the association of mepyramine and methysergide with ketoprofen or BW 755C. Paw oedema was increased by ketoprofen and abolished by the association of WEB 2086, BW 755C, methysergide and mepyramine. This treatment did not modify the leukopenia. Lipopolysaccharide produced a decrease in blood pressure and, at higher doses, a reduction of serum complement haemolytic activity. It is concluded that the vascular responses to intravascular complement activation by zymosan in rats depend mainly on the release of PAF. They are also mediated, for a small part, by eicosanoids and mast cell amines. Though zymosan and endotoxin induced similar PAF-dependent effects, the complement system is not involved in endotoxin shock in rats. PMID- 1773032 TI - Acrylyl-PAF, a synthetic platelet-activating factor analogue. AB - Acrylyl-PAF, a novel platelet-activating factor analogue with substantial agonist properties, was synthesized from lyso-PAF and acrylyl chloride. Incubation of acrylyl-PAF with partially purified human serum acetylhydrolase inhibited the action of acetylhydrolase on PAF. Kinetic studies using several concentrations of PAF as well as acrylyl-PAF suggested that acrylyl-PAF was a competitive inhibitor of the acetylhydrolase. Reciprocal Lineweaver-Burk plots and Dixon plots showed that acrylyl-PAF has an apparent Ki of 2.6 microM. Radiolabeled 18: 0-acrylyl-PAF was also synthesized. Studies comparing the effectiveness of acrylyl-PAF as a substrate for the acetylhydrolase versus PAF show that approximately 60% more PAF is metabolized by acetylhydrolase than acrylyl-PAF under identical conditions. Acrylyl-PAF was shown to aggregate washed rabbit platelets and to stimulate the release of glucose in the perfused rat liver. Dose-response curves illustrate that acrylyl-PAF was about half an order of magnitude less potent than PAF as an agonist. Tissue extracts of freeze-clamped livers that were perfused with radiolabeled acrylyl-APF indicated that approximately 26% of the label associated with acrylyl-PAF washed through the liver into the perfusate, while 48% of the acrylyl-PAF remained intact in the liver. Only 9% of the acrylyl-PAF was converted to k lyso-PAF with the ramainder metabolized to other lipids. This observations stands in contrast with livers perfused with radiolabeled PAF where less than 1% of the activity associated with PAF washed through the liver while about 70% remained as intact PAF and 30% was converted to lyso-PAF. Repeated bolus infusions of acrylyl-PAF exhibited desensitization of the glycogenolytic response of the perfused rat liver. The present study describes teh synthesis and characterization of acrylyl-PAF, which was shown to be: (a) poorly hydrolyzed by the human serum acetylhydrolase; (b) a competitive inhibitor of the acetylhydrolase; and (c) an agonist with potent activity in both platelet aggregation and hepatic glycogenolytic responses. PMID- 1773033 TI - Capsaicin desensitization selectively inhibits lipoxin A4-induced contraction in guinea pig bronchus. AB - The pharmacological ablation of capsaicin-sensitive afferents by means of capsaicin desensitization is usually utilized as a first functional criterion to identify substances whose biological effects might involve activation of this type of nerves. We have studied, in guinea pig epithelium-denuded bronchial rings (in the presence of the neutral endopeptidase inhibitor thiorphan), the effect of in vitro capsaicin desensitization (10 microM for 15 min) on bronchomotor responses elicited by leukotriene D4 (10-100 nM), 15-HETE (3-6 microM) and lipoxin A4 (3-6 microM). While all these three lipid mediators contract bronchial preparations, only lipoxin A4 effects were markedly depressed by previous capsaicin challenge. As expected, capsaicin desensitization abolished subsequent motor responses to capsaicin itself or stimulation of non-adrenergic non cholinergic nerves, while it left unaffected cholinergic responses. It is proposed that endogenously-generated lipoxin A4 acts, at least partially, through the activation of capsaicin-sensitive sensory nerve fibers. PMID- 1773034 TI - Straight talk about EIS and DSS. AB - The introduction of Executive Information Systems (EIS) to the health-care industry has brought confusion over the relationship between EIS and Decision Support Systems (DSS). This article describes how EIS is distinguished from DSS by its technical origins, the ways decision-makers use both systems, and the process of building and using EIS and DSS. As hospitals become more adept at using the features which EIS technology offers, the inherent differences between EIS and DSS will become even more apparent. PMID- 1773035 TI - Decision support systems and the healthcare strategic planning process: a case study. AB - The repertoire of applications that comprises health-care decision support systems (DSS) includes analyses of clinical, financial, and operational activities. As a whole, these applications facilitate developing comprehensive and interrelated business and medical models that support the complex decisions required to successfully manage today's health-care organizations. Kennestone Regional Health Care System's use of DSS to facilitate strategic planning has precipitated marked changes in the organization's method of determining capital allocations. This case study discusses Kennestone's use of DSS in the strategic planning process, including profiles of key DSS modeling components. PMID- 1773036 TI - Realizing the benefits of executive information systems. AB - Over the last several years, the literature on EISs (executive information systems) in all business sectors--including health care--has been focused on the design and implementation of these new systems. However, little attention has been given to identifying the wide range of direct and indirect benefits that occur after an EIS is successfully installed. This paper discusses in qualitative terms these tangible and intangible benefits and the factors that impact their realization and maximization. The paper is based on findings the authors have gained as a result of installing EISs in the past two years. PMID- 1773037 TI - DSS/EIS systems review. PMID- 1773038 TI - The future of decision support systems in hospital management. AB - This article discusses the evolution of decision support systems (DSS) within the hospital management environment. It begins with an outline of the historical factors leading to the need for this technology, then goes on to review the unique data-processing attributes a DSS offers and the requisite changes hospital management must make to maximize the benefits of these systems. The purpose is to provide hospital managers and other interested individuals with an overview of DSS functionality. Increasingly restrictive hospital reimbursement systems have created an economic incentive to install DSS technology and refine management structures to take advantage of the enhanced data-processing capabilities. A DSS enables a hospital to organize data captured by its information system on a product-line basis. This capability affords management with an entirely new way of analyzing a hospital's financial performance. Hospitals, traditionally organized on a departmental basis, must change their management structures in order to effectively use the data provided by a DSS. PMID- 1773039 TI - Facilitating discharge summary preparation in small hospitals. AB - This paper presents the result of a project to facilitate discharge summary preparation in small hospitals at low cost. Using an eye diseases hospital with twelve beds as an example, an integrated system for discharge summary preparation on a microcomputer platform was developed. The integrated system eliminated redundant data entry by a pull-type approach that automatically retrieved pertinent information from pre-existing records for inclusion in the discharge summary. Abbreviated and full versions of the discharge summary were generated with very little interactive time required of the physician or record clerk. The microcomputer implementation is described in this paper to illustrate the functionality and ease of this integrated system. PMID- 1773040 TI - Transient behavior of a stochastic process for screening progressive diseases. AB - This paper extends a mathematical model developed by the authors for describing the stochastic process underlying the etiology of non-contagious progressive diseases. For a population with no prior history of scheduled screening, the number of undetected and detected diseased individuals in the population under an established screening policy is used to calculate the expected total screening cost at any given time during the transient period of the associated stochastic process. A graphical representation of our model shows the status of different subgroups of a particular age group at any time T, and provides a clear summary of the expected number of individuals whose disease remains undetected. PMID- 1773041 TI - HBNF and MK, members of a novel gene family of heparin-binding proteins with potential roles in embryogenesis and brain function. AB - HBNF (heparin-binding neurite-promoting factor) is a heparin-binding protein which is found primarily in the brain and stimulates neurite outgrowth in cultured perinatal neurons. It was also reported to be mitogenic for fibroblasts and endothelial cells but this activity is still controversial. The sequence of HBNF is highly conserved in diverse species suggesting important function. Expression of the HBNF gene in brain tissue appears to be developmentally regulated, increasing during gestation to highest levels around the time of birth. The HBNF gene shows high sequence homology to another gene, MK (midkine). Like HBNF, the MK gene is developmentally regulated, however, high expression occurs in most fetal tissues during mid-gestation. The biological properties of the MK protein are remarkably similar to those of HBNF. The available evidence suggests that HBNF and MK are members of a new family of genes with potential roles in fetal development and in brain function or maintenance. PMID- 1773042 TI - Interleukin 5 and its receptor. AB - IL-5 is a cytokine mainly produced by T lymphocytes, especially when they are sensitized with microorganisms, which induce eosinophils and Ly-1 positive B lineage cells, both of which are probably engaged in the primary protection against micro-organisms. These possibilities are discussed by analyzing IL-5 transgenic mice. We also discuss the possibility of using these mice as animal models for the diseases which may be caused by increased levels of eosinophils. Although IL-5 is not produced by bone marrow stromal cells, it is involved in the early development of eosinophils and Ly-1 positive B-lineage cells that can differentiate into macrophages. The clue to the role of IL-5 may exist in the constitution of IL-5 receptor. The IL-5 receptor consists of alpha and beta chains. The alpha chain is a 60 kDa glycosylated protein which binds IL-5, by itself, with low affinity. On the other hand, the 130 kDa beta chain does not bind IL-5 by itself, but forms high affinity IL-5 receptors together with the alpha chain. Surprisingly, this beta chain is probably shared with the GM-CSF receptor and is very homologous to the IL-3 receptor. It seems that the beta chain is expressed in the very early stage of hematopoiesis. The alpha chain may be directly related to the cell lineage commitment. PMID- 1773043 TI - The role of MHC class I and II antigen expression in immune surveillance against tumors. II. Experimental systems. PMID- 1773044 TI - The structure and function of MHC molecules. Possible implications for the control of tumor growth by MHC-restricted T cells. AB - We briefly survey recent basic progress on the structure and function of MHC molecules. We call attention on a number of remaining unanswered questions, and focus on a few points which we think might be of importance in immune surveillance against tumors mediated by MHC restricted T cells. In particular, we discuss the possible peptidic nature of certain tumor antigens. Following these lines, we mention a recent approach for the in vivo activation of specific CTL. PMID- 1773045 TI - Molecular mediators and events associated with attenuated MHC class I gene expression. AB - Numerous examples of altered expression of MHC class I antigens by cells with a malignant phenotype have been described. Of particular interest in this regard has been the description of neoplastic cells with attenuated class I antigen expression. The model system used in this laboratory for understanding the molecular mediators and events associated with attenuation in MHC class I gene expression enlists the use of Abelson virus transformed leukemia cells from which H-2 surface null variants have been immunoselected. For these variants, interdiction in MHC antigen expression occurs at many levels of eukaryotic gene regulation. The regulated expression of H-2 antigens from these somatic cell variants is discussed in relationship to the mechanisms of attenuated MHC class I gene expression described for other leukemias. PMID- 1773046 TI - MHC gene control of the natural killer system at the level of the target and the host. AB - Natural killer (NK) cells represent an important complementary and alternative effector mechanism in cell-mediated immunity since they can recognize alterations that cannot be detected by the peptide/MHC specific T cells. NK cells can probably utilize several parallel recognition mechanisms to distinguish and eliminate aberrant cells. This article reviews studies starting from the idea that one of the NK recognition strategies is based on the ability to identify missing self MHC class I products on potential target cells. In the murine RBL-5 lymphoma system, this is supported by the NK mediated rejection, observed either after loss of MHC products in the target cell, or after introduction of a novel class I transgene in the host. 'Missing self' recognition by NK cells may be an important factor when analysing tumor MHC expression in relation to prognosis, immunoselection, cytokine-activated effector cells and immunotherapy. PMID- 1773047 TI - Influence of major histocompatibility complex class I, class II and TLA genes on tumor rejection. AB - T lymphocytes recognize antigen associated with MHC class I and/or class II gene products. Recognition of malignant cells is therefore dependent on presentation of tumor associated antigen(s) by MHC molecules. We have studied immunity to tumors that have down-regulated class I expression. These studies demonstrate a requirement for class I antigens, but suggest that additional factors may also be required for tumor-specific immunity. The MHC also encodes TLA class I antigens, whose function is unknown. Our studies suggest that these molecules function is unknown. Our studies suggest that T lymphocytes, specifically in tumor cells that do not express H-2K or H-2D moieties. Other studies are aimed at improving tumor specific Th cell generation by producing class II+ tumor cells. The success of these experiments indicates that this approach may be a potentially useful immunotherapy. PMID- 1773048 TI - Resistance to NK and metastatic potential of fibrosarcoma cells is associated with products encoded by the H-2D region. AB - We have used the murine 3-methylcholanthrene induced T10 fibrosarcoma tumor cell system originating in (C3II/en x C57BL/6)F1 mice (H-2b x H-2k) to elucidate the possible correlation between metastatic potential, expression of individual H-2 antigens and susceptibility to NK cells. Transfection of the non metastatic and NK sensitive IC9 cells (Db+, Kk, Kb, Kk-) with the H-2Dk gene, altered the metastatic phenotype of the parental cells, yet had no effect on the susceptibility of these tumor cells to lysis by NK and did not elicit a specific CTL response in syngeneic hosts. Variants of the metastatic and NK resistant IE7 clone (Db+, Kk-, Kb-, Kk-), lacking H-2Dk, were selected by treatment with monoclonal anti H-2Dk antibodies and complement. These variants were sensitive to NK and poorly or non metastatic. Transfection of Dk negative variants with the H 2Dk gene, resulted in the isolation of several clones which expressed a wide range of metastatic phenotypes but maintained sensitivity to NK. In addition, by cloning the cDNA of the H-2Dk gene of the metastatic T10-IE7 variant cells and analyzing its nucleotide sequence, we found four single nucleotide changes. Two of them are not expected to alter the encoded amino acids, whereas the others should result in two amino acid substitutions in the alpha-2 domain of the class I H-2Kd protein product. These changes might account, at least partially, for the failure of the transfection of H-2Dk to restore resistance to NK.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1773049 TI - MHC class I genes controlling the metastatic phenotype of tumor cells. AB - Metastatic clones of murine tumors that manifest impaired expression of class I MHC antigens do not induce an antitumor CTL activity. Transfection of H-2Kb genes into D122 carcinoma and B16 melanoma clones converted these cells to low metastatic immunogenic clones that can be used to protect in vivo against metastases of parental clones. Amplification of the protective effect can be achieved by combination of syngeneic and allogeneic MHC class I genes. Studying the mechanisms involved in MHC class I suppression in tumor cells, we found that changes in H-2 promoter activity were the cause of low expression. Proteins that might be involved were demonstrated by migration retardation methods. The involvement of the fos-jun complex in regulation of MHC expression is discussed. PMID- 1773050 TI - Cytotoxic T lymphocyte therapy of cancer and tumor escape mechanisms. AB - In animal models complete and permanent eradication of tumors can be achieved by adoptive transfer of tumor specific T cells, combined with interleukin 2. The most active cells are CD8+ cytotoxic T lymphocytes (CTL), which recognize peptides of 8-10 amino acids in length, bound to the antigen presenting groove of MHC class I molecules. In the case of virus-induced tumors these peptides are processed from viral proteins. Potentially immunogenic human tumors include melanoma and renal cell carcinoma in addition to the virus-associated cancers Burkitt's lymphoma and cervical carcinoma. The potential of CTL therapy of human cancer needs to be tested with cloned tumor cells. Remedies to over-come poor immunogenicity and evasion by tumor cells of CTL mediated-destruction are discussed. PMID- 1773051 TI - Power and health care. PMID- 1773052 TI - Measuring adolescent satisfaction with nursing care in an ambulatory setting. AB - This descriptive study addresses the topic of patient satisfaction with nursing care. A convenience sample of adolescent females who attended health department family planning clinics in a southeastern city was surveyed to determine the level of satisfaction with care provided by clinic nurses. Data were collected using the Risser Patient Satisfaction with Nursing Care instrument (Risser, 1975) which had been used exclusively with adults. A primary purpose, therefore, was to test the instrument with a teenage population. Data analysis yielded descriptive statistics, frequency distributions, correlations and alpha reliability coefficients. Findings indicated that the teenagers were most satisfied with the technical-professional aspect of nursing care and least satisfied with the interpersonal-educational aspect. The Risser instrument was found to be highly reliable with this adolescent cohort. PMID- 1773053 TI - A health education program for inner city high school youths: promoting positive health behaviors through intervention. AB - This descriptive study examined the influence of a 7-week Health Education Program (HEP) on the reported health behaviors of inner city high school youths. A convenience sample of 83 youths between the ages of 14 and 17 years was selected from a moderate size, metropolitan, midwestern high school. A 32-item Health Behaviors Survey (HBS), developed by the researcher, was administered to the youths before and after the completion of the HEP. Participants were classified by their health behaviors into high-, moderate-, or low-risk categories. In addition, the subjects completed a health diary that was discussed before the weekly presentations. Findings of the study revealed a positive shift in several reported health behaviors from high-risk to low-risk following completion of the HEP. The professional nurse is in an excellent position to develop nursing interventions and creative innovations including preventive measures to positively influence the health behaviors of young people. PMID- 1773054 TI - Minority student nurses' perceptions of their educational program. PMID- 1773055 TI - Occurrence of oligopurine.oligopyrimidine tracts in eukaryotic and prokaryotic genes. AB - A program to analyse the length and frequency distribution of specific base tracts in genomic sequences is described. The frequency of oligopurine.oligopyrimidine tracts (R.Y. tracts) in a data base of 163 transcribed genes is analysed and compared. The complete genomes of SV40 virus, N. tobacum chloroplast, yeast 2 micron plasmid, bacteriophage lambda, plasmid pBR322 and the E. coli lac operon are also analyzed. A highly significant overrepresentation of oligopurine and oligopyrimidine tracts is observed in all eukaryotic genes examined, as well as in the chloroplast genome. The overrepresentation is evident in all gene subregions of the chloroplast, in the following order: intergenic regions, 3' downstream and 5' upstream (promoter), 5' and 3' untranslated, introns and coding regions. In genes coding for basic proteins, oligopurine rather than oligopyrimidine tracts are found on the coding stand. In prokaryotic genes only the longest R.Y. tracts (greater than or equal to 12) are found in excess, and are concentrated near regulatory regions. While a structural role for R.Y. tracts is most likely in intergenic regions, a functional role, as initiation sites for strand separation, is proposed for regulatory gene regions. PMID- 1773056 TI - Sequencing with the large fragment of DNA polymerase I from Bacillus stearothermophilus. AB - The large fragment of DNA polymerase I, isolated from Bacillus stearothermophilus, was used for dideoxy sequencing. This heat-stable enzyme permits performing sequencing reactions at high temperature to melt secondary structure and results in uniform band intensities and low background on the autoradiogram. The enzyme can be used in the standard Sanger one-step protocol or in a two-step protocol which separates the labeling reaction from the elongation termination reaction. The enzyme can be used in double-stranded sequencing. 35S labeled nucleotides may be used instead of 32P-labeled nucleotides. Both 7-deaza dGTP and dITP can be used during the reaction in order to minimize band compression on the gel. Results presented here indicate that this enzyme should be a useful tool for sequence determination. PMID- 1773057 TI - Bovine and feline gastrin cDNA sequences and the amino acid and nucleotide sequence homologies among mammalian species. AB - The complete nucleotide sequences of cDNAs encoding bovine and feline preprogastrins have been cloned from the antral mucosa mRNA. The gastrin mRNA of each animal encodes a preprogastrin of 104 amino acids consisting of a signal peptide, a prosegment of 37 amino acids, and a gastrin 34 sequence, followed by a glycine (the amide donor). The cleavage following a pair of lysine residues yields gastrin 17. We found that pairs of arginine residues flanking gastrin 34, the typical processing site sequence of all other preprogastrins and many peptide hormones, were arginines in the bovine preprogastrin, but the first basic amino acid pair had changed to Arg-Trp (57-58 residues) instead of Arg-Arg in the feline preprogastrin. Comparison of these amino acid and nucleotide sequences with published mammalian sequences showed extensive homology in the coding (63 to 73% amino acid identity) and in the untranslated regions (67 to 89% identity). Prosequence, the most variable region, shows greater amino acid difference between bovine and human preprogastrin (54% identity), and between bovine and rat preprogastrin (54% identity) than between other species (62 to 82% identity). PMID- 1773058 TI - Sequence and features of the tryptophan operon of Vibrio parahemolyticus. AB - The nucleotide sequence of the trp operon of the marine enteric bacterium Vibrio parahemolyticus is presented. The gene order E, G, D, C(F), B, A is identical to that of other enterics. The structural genes of the operon are preceded by a long leader region encoding a 41-residue peptide containing five tryptophan residues. The organization of the leader region suggests that transcription of the operon is subject to attenuation control. The promoter-operator region of the V. parahemolyticus trp operon is almost identical to the corresponding promoter operator of E. coli. The similarities suggest that promoter strength and operator function are identical in the two species, and that transcription initiation is regulated by repression. The operon appears to lack the internal promoter within trpD that is common in terrestrial enteric species. PMID- 1773059 TI - Analysis of the gene for phenylalanine ammonia-lyase from Rhodosporidium toruloides. AB - We have cloned and sequenced the pal gene encoding phenylalanine ammonia-lyase (PAL) from Rhodosporidium toruloides strain CBS14. Our data imply a different start codon and thus a different amino acid sequence for the N-terminus of PAL as compared to the previously published sequence for pal from R. toruloides strain IF00559. Primer extension analysis shows three transcription initiation sites with non-translated leaders of 24-35 nucleotides. Upstream of these initiation sites is a long stretch rich in pyrimidines. PAL from R. toruloides is 78% and 37% homologous to PAL from Rhodotorula rubra and Petroselinum crispum, respectively. Alignment of the PAL sequences is related to data of enzyme function. PMID- 1773060 TI - Rop/helix-loop-helix similarity. PMID- 1773061 TI - Yeast U3 localization and correct sequence (snR17a) and promotor activity (snR17b) identified by homology search. PMID- 1773062 TI - A yeast homologue of a proteasome subunit. PMID- 1773063 TI - [Solid waste management for conservation of global environment]. PMID- 1773064 TI - [An evaluation of the attitudes and productivity of public health nurses in mental health service programs for the elderly]. AB - The relationship between productivity of public health nurses (PHN) employed in mental health programs including home visit service for elderly people with dementia, and their attitudes toward mental health services was studied by surveying PHN at 31 health centers (HC) in Osaka Prefecture. A review of the services provided for 382 clients with dementia visited during a one-year period showed that PHN had provided the following services: home health care education: family education to promote understanding of the disease; management of interpersonal relations in the family; intervention to reduce the burden placed on the family members; medical facility referral; social service resource referral. For each of these PHN-provided services, the service had been provided to more than 60% of the clients. The percentage of clients who had been visited by a PHN accompanying a psychiatrist or a social worker was significantly higher at the 13 HC where PHN attach importance to counseling programs for the elderly, the 8 HC which provide group work services, and the 13 HC which hold case conferences more than six times a year than at other HC. In addition, the service provision rates for many PHN-provided services were significantly higher for these HC than for other HC. Analysis on the basis of whether PHN did or did not attach importance to the counseling program, showed that in either group, clients who had been visited by a PHN accompanying a psychiatrist or a social worker were more likely to have received PHN-provided services than other clients. Furthermore, at HC where PHN actively participated in mental health programs, PHN attitudes toward mental health care were more enthusiastic than at other HC. These results indicate that increased productivity of PHN employed in mental health programs and promotion of a multidisciplinary approach in client services are correlated with each other, and that both factors contribute to improving the quality of home visit services provided by PHN. PMID- 1773065 TI - [Relation of baseline examination results to death from ischemic heart disease, cerebro-vascular disease and sudden death]. AB - The relation of variables obtained from a baseline examination to death from ischemic heart disease (IHD), cerebro-vascular disease (CVD) and sudden death (SUD) was analyzed in a case-control study. From questionnaire survey of approximately 180,000 subjects who underwent baseline health examinations in 1971 1986 at Aichi prefectural center of health care, 148 deaths were selected for this study. The number of cases on IHD, CVD and SUD was 36, 60, and 52, respectively. Mean age of cases was 54.8 years old and the mean follow up interval between baseline examination and death was 3.7 years. Four controls matched according to year of baseline examination, age and sex were chosen arbitrarily for each case, and odds ratios for the three diseases were estimated. In some of the matched sets, odds ratios at a follow up examination were compared with that at the first examination. The results were as follows: 1) Variables showing positive relationships to death from each of the three diseases were hypertension, high fasting blood sugar, abnormality of cardio-thoracic ratio, ST T abnormality in ECG, left ventricular hypertrophy in ECG. The odds ratio for ST T abnormality in ECG was significant for all three causes of death. 2) High total cholesterol showed a significant positive relation only to death from IHD. As to death from CVD and SUD, albuminuria and sclerotic changes in fundus oculi were positively and significantly related. Risk factors differed for deaths from the three diseases. 3) In death from IHD and CVD, odds ratio at the second examination was apt to be higher than that at baseline examination. In death from SUD, however, odds ratios at the first and the second examination showed no significant difference. PMID- 1773066 TI - [A five-year follow-up study on blood pressure and serum cholesterol in junior high school children]. AB - Blood pressure and serum cholesterol changes over a five-year period were studied in 299 junior high school children (127 males and 172 females) examined during 1980-1984 in Akita Prefecture, Japan. The six factors studied were height, weight, body mass index (by Minowa's method), systolic blood pressure, diastolic blood pressure and serum cholesterol. Mean values for systolic and diastolic blood pressure increased more than 10 mmHg during the five years in both sexes. Significant positive correlations between initial and follow-up blood pressure ('tracking') were observed. The correlation coefficients for systolic blood pressure in males and in females were 0.33 and 0.28 respectively, and those for diastolic blood pressure were 0.36 in males and 0.19 in females. While there were no significant differences in serum cholesterol levels between the two periods in either sex, the correlation coefficients, which were higher than those for blood pressure, were 0.55 in males and 0.45 in females. Among the six factors at each period, significant positive correlations were observed between height and systolic blood pressure at the initial period, and between obesity and systolic blood pressure at both periods in males and females. A significant positive relationship between obesity and serum cholesterol was seen at the follow-up period in both sexes. These data suggest that a moderate degree of 'tracking' occurs in blood pressure and serum cholesterol during childhood, and that obesity is an important factor related to blood pressure and serum cholesterol. PMID- 1773067 TI - [An analysis of participation rates for health and cancer screenings in Wakabayashi ward of Sendai]. AB - Persons who were non-employed as determined from the 1985 census were assumed to be the target population for health and cancer screenings, comprising 54.8% and 55.5% of both the male and female population over 40 years of age in Sendai and in Wakabayashi ward respectively. Similar mean participation rates were obtained for health screening from 1986 to 1989 of 24.0% in Sendai and 23.3% in Wakabayashi ward. However, mean participation rates differed for gastric cancer screening, being 18.2% in Sendai and 15.8% in Wakabayashi ward. Both screening rates increased from 1986 to 1989 in Sendai as well as in Wakabayashi ward. Rates for both screenings were high in the suburbs and low in metropolitan Wakabayashi ward. The target population for uterine and breast cancer screenings were 69.8% and 70.1% of women over 30 years of age in Sendai and in Wakabayashi ward respectively. Mean participation rates for uterine cancer screening from 1986 to 1989 were 33.8% in Sendai and 35.1% in Wakabayashi ward, and showed an overall decrease from 1987 to 1989 in both Sendai and Wakabayashi ward. The rate was high in the suburbs and low in metropolitan Wakabayashi ward. Mean participation rates for breast cancer screening from 1988 to 1989 were 13.9% in Sendai and 13.6% in Wakabayashi ward, with rates being low in both the suburbs as well as metropolitan. Wakabayashi ward in 1988 (the beginning year of the screening), but increasing significantly in the suburbs during the following year. PMID- 1773068 TI - [Effects of sodium chloride on destruction of microorganisms by microwave heating in potatoes]. AB - To assess the destructive effect of different sodium chloride concentrations (0, 0.3, 1.5, and 3%) on microorganisms with microwave heating, strains of Vibrio parahaemolyticus, Staphylococcus aureus, Salmonella enteritidis, Escherichia coli and Bacillus cereus were used to inoculate a mashed potato preparation. After microwave heating for 1 min at 800 W, resulted in temperatures and rate of destruction of bacteria significantly higher (p less than 0.05) in the core than on the surface of mashed potato when no salt was added. Except for B. cereus, microorganisms inoculated into mashed potato, with no added salt, could be completely destroyed by 2 min of microwave heating. Core temperatures and rate of destruction of microorganisms in the mashed potato decreased significantly (p less than 0.05) with increase in concentration of added salt. The results also indicate that bacterial species differ in their susceptibility to microwave inactivation. In particular, S. aureus, which exhibited a level of survival that was greater than that of any other species tested here, seemed notably resistant to microwave treatment for 2 min while V. parahaemolyticus was highly susceptible. PMID- 1773069 TI - [Present situation of salt restriction guidance by health nurses and dietitians in Japan and some problems]. PMID- 1773070 TI - [Evaluation of eating pattern of the aged]. PMID- 1773071 TI - Early detection of hearing loss. PMID- 1773072 TI - Modeling the cost and performance of early identification protocols. AB - This is the first in a series of three papers concerned with the early identification of hearing loss. In this paper, a simple model is presented that permits the calculation of the performance and cost of early identification protocols. In the second paper (Turner, in press), this model is used to compare four early identification protocols that differ in hearing screening strategies. The third paper (Turner, in press) examines the factors that influence the early identification protocol. The model described in this paper is sufficiently general to accommodate most early identification strategies including those that meet the goal of identification and habilitation by 6 months. The model measures protocol performance using hit rate, false alarm rate, and selected posterior probabilities. The model also calculates two measures of the financial cost. One measure reflects the cost of implementing the protocol; the other reflects the cost-effectiveness of the protocol. The parameters required by the model are also specified and are based on published clinical data. The model is provided to help audiologists design and select early identification protocols that are optimum for their particular clinical situation. PMID- 1773073 TI - Intrasubject variability in the absolute latency of the auditory brainstem response. AB - For many applications, the latency of obtained ABR peaks is compared to clinical norms. Using this approach, one presupposes that basic assumptions regarding inter- and intrasubject variability of latency are met. Although much is known about intersubject variability, virtually nothing has been reported about intrasubject variability. The purpose of this investigation was to describe intrasubject variability of ABR latency as observed in a clinical setting. Nine male subjects, 10 to 12 years old, participated in the study. At each of four sessions, five ABRs were obtained for each of three stimulus conditions. Stimuli were 100 microseconds condensation clicks presented at 80 dB nHL. For each ABR peak, the intrasubject distribution of latencies was analyzed. For every subject, variability of latency was observed. Typically, the latencies were normally distributed, and the magnitude of variability was less than is commonly reported for groups of subjects. We conclude that by establishing a baseline, the sensitivity of the ABR might be increased for certain monitoring applications. PMID- 1773074 TI - Stimulus presentation level and speech perception through a single-channel cochlear implant. AB - This study evaluated the effects of stimulus presentation level on 12 adult 3M/House single-channel cochlear implant users' speech perception performance. Dynamic ranges and loudness growth functions were measured for meaningful speech, and performance-intensity functions were plotted for VCV and CVC nonsense stimuli to determine the presentation level(s) that produced maximum speech perception performance for each subject. Considerable variability was found in the subjects' dynamic ranges. Generally, loudness growth functions were steep for subjects having restricted dynamic ranges and more gradual for those having wide dynamic ranges. No single optimal presentation level was determined; instead, a range of levels produced maximum performance for each subject. Mean levels producing peak scores in equivalent dB SPL were 80 for VCVs and 72 for CVCs. Presentation levels producing optimal performance varied with type of speech stimulus. PMID- 1773075 TI - Effect of speech distinctions and age differences on auditory event-related potentials. AB - P3 event-related potentials were recorded from 37 subjects in two age groups (19 25 and 61-75 years) listening to tones, stop + vowel (CV) monosyllables, and isolated vowels. P3 latencies were found to be significantly longer for older subjects in all stimulus conditions. CV latencies were also significantly longer than simple tone latencies with the increase being approximately 1.30 msec/year. Latencies to the vowel stimuli were somewhat more variable but also tended to be greater than the tone latencies. P3 amplitudes were greater for the tone stimuli than for the speech stimuli, but no significant age effects were found. PMID- 1773076 TI - Effects of stimulus duration on air caloric slow phase velocity. AB - This study was designed (1) to assess the test-retest reliability of the slow phase velocity (SPV) in response to air calorics, (2) to compare four procedures for calculating the SPV (average of 3 beats, average of 10 beats, average of all beats in a 10 second period, and the single largest beat), and (3) to investigate the effects of the duration of air irrigation (45, 60, and 75 seconds) on the SPV. Three groups of 10 subjects each were administered test and retest air irrigations (8 L/min) in each ear at 24 degrees C and 50 degrees C. Reliability was assessed with the standard error of measurement, which was approximately 4 degrees/second for all SPV calculations. This value is consistent with previous research. The 1-beat and 3-beat measurements revealed larger SPVs (approximately 24 degrees/sec) than the 10-beat and 10-sec measurements (approximately 20 degrees/sec). Considering time efficiency, and to avoid the effects of an artifact on the single largest beat, the 3-beat average may be preferred for calculating the SPV. Finally, our data do not allow recommendation of a preferred stimulus duration from among those evaluated (45, 60, 75 seconds). PMID- 1773077 TI - Psychological status of patients undergoing electronystagmography. AB - Dizzy patients undergoing electronystagmography (ENG) often express stressful life situations, anxiety, and other adverse psychological states. Many past studies have dealt with the interrelations among actual vertigo (or less specific dizziness) and various psychological factors. The present study compares results of a psychological screening questionnaire, the State-Trait Anxiety Index, between vertiginous patients undergoing ENG, and nonvertiginous patients undergoing another diagnostic test, auditory brainstem response (ABR), for complaints other than dizziness. A second age-matched control group consisted of subjects without medical complaints. Results showed that the ENG group have a significantly greater degree and prevalence of adverse psychological state than either control group. These results, while not indicating whether vertigo is the cause or effect of such states, do indicate the high prevalence of psychological morbidity among the comparatively mildly dizzy patients typically encountered in ENG testing. Greater attention to the psychological aspects of the dizzy patient is indicated. PMID- 1773078 TI - The visual input stage of the mammalian circadian pacemaking system: II. The effect of light and drugs on retinal function. AB - Acute light pulses as well as long-term light exposure may not only modulate photoreceptive properties, but also induce reversible or irreversible damage to the retina, depending on exposure conditions. Illuminance levels in laboratory animal colonies and manipulations of lighting regimens in circadian rhythm research can threaten retinal structure and physiology, and may therefore modify zeitgeber input to the central circadian system. Given the opportunity to escape light at any time, the nocturnal rat self-selects a seasonally varying "naturalistic skeleton photoperiod" that protects the eyes from potential damage by nonphysiological light exposures. Both rod rod-segment disk shedding and behavioral circadian phase shifts are elicited by low levels of twilight stimulation. From this vantage point, we hypothesize that certain basic properties of circadian rhythms (e.g., Aschoff's rule and splitting) may reflect modulation of retinal physiology by light. Pharmacological manipulations with or without the addition of lighting strategies have been used to analyze the neurochemistry of circadian timekeeping. Drug modulation of light input at the level of the retina may add to or interact with direct drug modulation of the central circadian pacemaking system. PMID- 1773079 TI - Circannual rhythms of gonadal maturation in female rainbow trout (Oncorhynchus mykiss). AB - Individually identified, 2-year-old female rainbow trout were maintained for up to 51 months on a constant schedule of 6 hr light and 18 hr darkness (LD 6:18), constant temperature (8.5-9.0 degrees C), and constant feeding rate. The fish exhibited free-running circannual rhythms of gonadal maturation and ovulation, which were self-sustaining for up to three cycles. The periodicity of the rhythm showed variation between fish and in successive cycles for the same fish, ranging from approximately 11 to 15 months. PMID- 1773080 TI - The visual input stage of the mammalian circadian pacemaking system: I. Is there a clock in the mammalian eye? AB - Threads of evidence from recent experimentation in retinal morphology, neurochemistry, electrophysiology, and visual perception point toward rhythmic ocular processes that may be integral components of circadian entrainment in mammals. Components of retinal cell biology (rod outer-segment disk shedding, inner-segment degradation, melatonin and dopamine synthesis, electrophysiological responses) show self-sustaining circadian oscillations whose phase can be controlled by light-dark cycles. A complete phase response curve in visual sensitivity can be generated from light-pulse-induced phase shifting. Following lesions of the suprachiasmatic nuclei, circadian rhythms of visual detectability and rod outer-segment disk shedding persist, even though behavioral activity becomes arrhythmic. We discuss the converging evidence for an ocular circadian timing system in terms of interactions between rhythmic retinal processes and the central suprachiasmatic pacemaker, and propose that retinal phase shifts to light provide a critical input signal. PMID- 1773081 TI - Circadian inputs influence the performance of a spiking, movement-sensitive neuron in the visual system of the blowfly. AB - Long-term extracellular recordings from a spiking, movement-sensitive giant neuron (H1) in the third optic ganglion of the blowfly Calliphora vicina (L.) revealed periodic endogenous sensitivity fluctuations. The sensitivity changes showed properties typical of an endogenous circadian rhythm. This was true for the responses in reaction to intensity changes of visual patterns as well as for the responses elicited by pattern movement. For these two types of stimuli, the circadian fluctuations were comparable, but the envelope in the case of responses to movement was more robust. A circadian fluctuation in responses to movement is, therefore, present at the level of single elementary movement detectors. The tonic activity of the neuron was also shown to be under circadian control. In constant darkness (DD) the fluctuation was circadian, whereas in constant light it was not. The subjective light-dark (LD) transitions in the tonic activity in DD closely followed the LD transitions in the holding cages initially; that is, there was low activity at night and high activity during the daytime. The sensitivity fluctuations in response to visual stimuli led the tonic spike activity fluctuations by several hours. PMID- 1773082 TI - Effects of daily schedules of forced activity on free-running rhythms in the rat. AB - Circadian rhythms of hamsters can be phase-shifted or entrained by single or daily sessions of induced wheel running. In contrast, observations of rats under restricted-feeding schedules suggest that their free-running rhythms are not readily entrainable by a daily bout of intense activity. A formal test of this idea was made by subjecting rats to daily 2-hr or 3-hr sessions of forced treadmill activity. None of 18 rats entrained to a daily treadmill schedule when tested in constant dim light, but 1 of 16 did entrain when tested after blinding, when the period of its free-running activity rhythm was very close to the period of the treadmill schedule and when the onset of its daily active phase overlapped with the treadmill sessions. These conditions were recreated in a final group of eight rats; the rats were trained in a light-dark cycle, blinded, and subjected to a treadmill schedule with a period of 23.91 hr that was initiated at the onset of the rats' active phase on day 1. Six of these rats entrained. The mechanism for entrainment by activity schedules clearly exists in rats, but the conditions under which this occurs are highly constrained, suggesting that activity is a very weak zeitgeber in this species. It is argued that the evolution of functionally separable food- and light-entrainable oscillators in the rat demands a very low sensitivity to feedback effects of activity. PMID- 1773083 TI - "Demasking" the temperature rhythm after simulated time zone transitions. AB - Simulated time zone transitions were performed in an isolation unit upon groups of one to four human subjects. In the first series of experiments, the adjustment of the circadian rhythm of body temperature, measured in the presence of sleep and other masking factors, was assessed by cosinor analysis and by cross correlation methods. These methods modeled the circadian timing system either as a single component or as the sum of two components, those due to exogenous and endogenous influences. The one-component models described a more rapid adjustment of the temperature rhythm to the time zone transition than did the two-component models; we attribute this difference to the masking effects of the exogenous component. In a second series of experiments, we showed that the shift of the endogenous component, as assessed by the two-component models, was not significantly different from that measured during constant routines. The results also showed that, if the zeitgebers were phased in advance of the endogenous component, then advances of the endogenous component were produced only if this mismatch was less than about 10 hr. Mismatches greater than this, and cases where the zeitgebers were delayed with respect to the endogenous component, both produced delays of the endogenous component. We conclude that the two-component cross-correlation methods can be used to estimate shifts of the endogenous component of a circadian rhythm in the presence of masking factors. They are therefore an alternative to constant routines when these latter are impracticable to carry out. PMID- 1773084 TI - Technical comment: in quest of data. PMID- 1773085 TI - Damped oscillation of the lateral hypothalamic multineuronal activity synchronized to daily feeding schedules in rats with suprachiasmatic nucleus lesions. AB - In male Wistar rats with chronically implanted electrodes, multiple-unit activity (MUA) was recorded from the lateral hypothalamus (LH) and ventromedial hypothalamus (VMH). Blinded rats with bilateral suprachiasmatic nucleus (SCN) lesions showed no circadian rhythm in MUA or motor activity when food was available ad libitum. However, under a restricted-feeding schedule (food was available from 1400 to 1600 hr; water was always available) lasting for 10 days, a gradual increase of MUA of the LH developed, starting 3-4 hr prior to the feeding time. The elevated MUA lasted up to 6-7 hr after feeding and subsequently returned to the baseline level. This circadian rhythm of MUA of the LH persisted up to 4 days under total food deprivation, with quickly decreasing amplitude after termination of the schedule. MUA rhythm in VMH was less obvious than that in LH. Also, general motor activity showed a rhythm comparable to that of MUA, but it was less prominent. The elevated MUA in the LH prior to the feeding time may have been neural substrate of anticipatory activity appearing under the restricted-feeding schedule. These findings may suggest the existence of a quickly damping oscillator mechanism in the brain, presumably in the LH, which can be induced by daily feeding cues in the absence of the SCN. PMID- 1773086 TI - A re-examination of the role of the nucleus in generating the circadian rhythm in Acetabularia. AB - The role of the nucleus in the generation of the circadian rhythm in Acetabularia has been nuclear. Early experiments showed that the plant could exhibit a circadian rhythm in the absence of a nucleus. However, other experiments appeared to show that the nucleus could impart phase information to the rhythm, and so therefore must be a part of the system that generates the rhythm. We have conducted experiments similar to these--in particular, one in which the nuclear end of the plant was entrained on a light-dark cycle that was opposite that of the rest of the plant. The phase of the free-running rhythm of this type of plant is not consistent with the conclusion that the nucleus is part of the circadian oscillator. We have also tried entraining opposite ends of plants with no nuclei on opposite light-dark cycles. The ultimate phases of these plants appear to be nearly random. A possible interpretation of these experiments is discussed. PMID- 1773087 TI - Light and norepinephrine similarly prevent damping of the melatonin rhythm in cultured chick pineal cells: regulation of coupling between the pacemaker and overt rhythms? AB - The circadian rhythm of melatonin output displayed by chick pineal cells in static culture damps rapidly in constant red light (RR). This can be seen in the first cycle following a switch from a cycle of 12 hr white light (L) and 12 hr red light (R) to RR. Melatonin output is higher during the "day" in R than it is in L, but higher that next night (in R) after daytime L than after daytime R. This effect might be due entirely to the entraining effect of L. Alternatively, the higher nocturnal output after daytime L could be related to the acute suppression caused by L; it might be a "rebound" phenomenon. These alternative hypotheses differ in their predictions for the effects of norepinephrine (NE) and pertussis toxin (PT). Previous results dissociated the acute and entraining effects of L: PT blocks the acute effect but not the entraining effect of L. NE mimics the acute effect of L (and is blocked by PT), but not the entraining effect. If L prevents damping entirely by entrainment, then NE should not mimic and PT should not block this same-cycle effect of daytime L on nocturnal melatonin output. However, the present research found that NE did mimic and PT did block this effect, indicating that the ability of L to prevent damping is mediated by a same-cycle "rebound" following L's acute inhibition of melatonin production. Furthermore, NE enhanced the "rebound" effect of daytime L, and cycles substituting NE for L were effective in driving the melatonin rhythm. Lowering extracellular potassium did not induce a "rebound," and adding exogenous melatonin did not prevent one. The difference between nocturnal melatonin synthesis after daytime R and that after daytime L or NE implies regulation of coupling between the output of the circadian pacemaker and melatonin production. These results also suggest a role for NE in regulating and maintaining the expression of the melatonin rhythm. PMID- 1773088 TI - Evidence for independence of circadian characters and extent of photoresponsiveness in the Djungarian hamster, Phodopus sungorus. AB - Djungarian hamsters (Phodopus sungorus) exposed to a short-day photoperiod generally respond with a syndrome of physiological and behavioral changes, such as body weight loss and molt to a white pelage. The extent of the short-day induced responses differs among individuals. Furthermore, some hamsters show no photoresponse. In this study, we sought to determine whether variation in the photoresponse would be associated with circadian function: whether phase angle or free-running period (tau) would differ between responsive and nonresponsive hamsters; and whether changes in these circadian characters would correlate with the extent of weight loss and molt (and the timing of molt onset) in photoresponsive hamsters. Adult hamsters were kept in a short-day photoperiod (9 hr light, 15 hr dark) for 14 weeks, during which time body weight and molt were measured biweekly. Hamsters were then transferred to cages equipped with running wheels; we measured the phase angle of activity onset under a short-day photoperiod and tau in constant dark. Hamsters exhibiting a short-day-induced molt had a significantly shorter tau and a less negative phase angle than nonmolting animals. Hamsters that exhibited weight loss also had a significantly less negative phase angle, but no difference in tau. No significant Pearson's or Spearman's correlation coefficients were found between extent (or timing) of the photoresponse and the circadian characters in responsive hamsters. Although these results indicate that threshold for photoresponsiveness is related to circadian function, the extent (and timing) of the photoresponse may not be. PMID- 1773089 TI - Double-pulse experiments with nonphotic and photic phase-shifting stimuli. AB - Three-hour pulses of novelty-induced wheel running in the early to middle subjective day of golden hamsters produced phase advances of 2-3 hr. This phase shifting could be almost totally abolished by a light pulse following within 3 hr of the exercise pulse. When light pulses occurred about 8 hr after the exercise pulses, the phase-advancing effects of the latter were enhanced. Consideration of the amplitude of the phase response curve (PRC) for light pulses alone, in the test paradigms used here, showed that nonphotic and photic phase shifts did not combine additively. Antagonistic and synergistic interactions between photic and nonphotic shifts may have to be taken into account if it transpires that exercise in people can be used to assist adjustment to new schedules after crossing time zones, or in shiftwork. PMID- 1773090 TI - Circadian locomotor rhythms, but not photoperiodic responses, survive surgical isolation of the SCN in hamsters. AB - Surgical isolation of the suprachiasmatic nuclei (SCN) within a hypothalamic island is reported to produce loss of circadian rhythmicity. The results have been interpreted to indicate that SCN efferents are necessary for the expression of circadian rhythms. It is not clear, however, whether the loss of circadian rhythms in behavioral responses following SCN isolation is attributable to transection of efferents, to loss of cells within the island, or to gliosis produced by the knife cut. To explore this issue, we examined locomotor activity and gonadal state of male golden hamsters housed in constant darkness (DD, with a dim red light for maintenance) for at least 10 weeks following isolation of the SCN from the rest of the brain by cuts by means of a Halasz wire microknife. Brain sections were immunocytochemically stained for the peptides vasoactive intestinal polypeptide (VIP), vasopressin (VP) or neurophysin II (NP II), and neuropeptide Y (NPY) to localize the SCN and to assess its viability, and for glial fibrillary acidic protein (GFAP) to delimit the border of the knife cut. Experimental animals with VIP and VP/NP II immunoreactivity in the SCN within the island retained free-running locomotor rhythms following transection of SCN efferents. Animals with cuts that failed to sever SCN efferents, and sham operated animals (in which the Halasz knife was lowered but not rotated), also maintained circadian rhythmicity. Hamsters sustaining severe damage to the SCN showed disrupted locomotor activity. In those hamsters that retained circadian locomotor rhythmicity following SCN isolation, gonads failed to regress in DD, demonstrating the absence of an appropriate photoperiodic response. The results suggest a multiplicity of SCN coupling mechanisms in the control of circadian rhythms. PMID- 1773091 TI - Activity feedback to the mammalian circadian pacemaker: influence on observed measures of rhythm period length. AB - In the mouse, activity is precisely timed by the circadian clock and is normally most intense in the early subjective night. Since vigorous activity (e.g., wheel running) is thought to induce phase shifts in rodents, the temporal placement of daily exercise/activity could be a determinant of observed circadian rhythm period. The relationship between spontaneous running-wheel activity and the circadian period of free-running rhythms was studied to assess this possibility. With ad libitum access to a running wheel, mice exhibited a free-running period (tau) of 23.43 +/- 0.08 hr (mean +/- SEM). When running wheels were locked, tau increased (23.88 +/- 0.04 hr, p less than 0.03), and restoration of ad libitum wheel running again produced a shorter period (tau = 23.56 +/- 0.06 hr, p less than 0.05). A survey of free-running activity patterns in a population of 100 mice revealed a significant correlation between the observed circadian period and the time of day in which spontaneous wheel running occurred (r = 0.7314, p less than 0.0001). Significantly shorter periods were observed when running was concentrated at the beginning of the subjective night (tau = 23.23 +/- 0.04), and longer periods were observed if mice ran late in the subjective night (tau = 23.89 +/- 0.04), F (1, 99) = 34.96, p less than 0.0001. It was previously believed that the period of the circadian clock was primarily responsive to externally imposed tonic or phasic events. Systematic influences of spontaneous exercise on tau demonstrate that physiological and/or behavioral determinants of circadian timekeeping exist as well. PMID- 1773092 TI - Cold entrainment of the annual cycle of ovarian activity in the lizard Lacerta vivipara: thermoperiodic rhythm versus hibernation. AB - A constant warm thermoperiod maintains ovarian quiescence in the lizard Lacerta vivipara, whereas a 4-month artificial hibernation rapidly induces synchronized vitellogenesis after transfer to warmth. The present study examined the possibility of a thermoperiodic regulation of the ovarian cycle and the formal properties of an internal temporal program. These questions were addressed using 24-hr thermoperiodic conditions that combined a long or a short thermophase (6 or 2 hr of basking) with a warm (19-21 degrees C), a cool (5-15 degrees C), or a cold (3-7 degrees C) cryophase. Lizards were exposed to the natural photocycle or to LD 12:12. Occurrence and timing of vitellogenesis completion were monitored using immunodetection of plasma vitellogenin and laparotomies. Cold remained stimulatory when given intermittently with a 24-hr periodicity. However, under long-thermophase conditions, lizards responded poorly to cool cryophases but fully to cold ones (72.7-100% vitellogenesis). Thus a certain amount of cold must be provided during each 24-hr cycle in order to be effective through the succession of thermocycles. Reduction of the daily heat input from 6 to 2 hr modulated the stimulating effects of cold cryophases: The median date for the beginning of vitellogenesis occurred 1 month earlier, but the number of responding females decreased from 100% to 40%. The thermoperiodic regulation of the ovarian cycle also relies upon a precise heat-cold balance per nycthemeral unit. This ensures the entrainment of an internal rhythm, since the timing of reproductive responses varies with the date of transfer from the inhibitory warm thermoperiod to the inducing thermoperiod (long thermophase, cold cryophase). At least half the females started vitellogenesis within 1-2 months after a late transfer (winter solstice) instead of 6 months after an early one (autumn equinox), and the median date for onset differed by 1 month between the two groups. However, autumn transfer was the only one to induce a group response in close agreement with the natural timing. PMID- 1773093 TI - Adult locomotor rhythmicity as "hands" of the maternal photoperiodic clock regulating larval diapause in the blowfly, Calliphora vicina. AB - Some basic properties of the adult locomotor activity rhythm and of the maternal induction of larval diapause in Calliphora vicina are described. Diapause responses in Nanda-Hamner experiments indicate that circadian rhythmicity is involved in photoperiodic time measurement (PPTM). However, although the locomotor rhythm shows long-lasting changes in free-running period (aftereffects of photoperiod and constant light) and occasional "splitting," thereby indicating a structural complexity to the circadian system, the overt rhythm may be used as an indicator of phase relationships (or "hands") of the covert system involved in PPTM, within the framework of a simple external-coincidence model for the diapause clock. Thus, in light-dark (LD) cycles close to "resonance" with the circadian pacemaker(s) (T 24, LD 12:12; T 48, LD 12:36; and T 72, LD 12:60), light is restricted to the subjective day and diapause incidence is high. In T 36 (LD 12:24) and T 60 (LD 12:48), light falls into the subjective night and illuminates the postulated light-sensitive phase (phi i), and diapause incidence is low. Within the primary range of entrainment, light invades the late subjective night in T 20 (LD 12:8), illuminates phi i, and causes low incidence of diapause; however, it invades the early subjective night in T 30 (LD 12:18) and diapause remains high. PMID- 1773094 TI - Influence of melatonin treatment on human circadian rhythmicity before and after a simulated 9-hr time shift. AB - The hormone melatonin is currently proposed by some investigators to be an efficient means for decreasing the impairing effects of jet lag. Eight healthy male subjects, aged 20 to 32, underwent a 9-hr advance shift in the isolation facility of our institute during two periods each of 15 days' duration. In a double-blind, crossover design, subjects took either melatonin or placebo at 1800 hr local time for 3 days before the time shift and at 1400 hr for 4 days afterwards. The time shift was simulated on days 7 and 8 by shortening the sleep period by 6 hr and the following wake period by 3 hr. Body temperature was recorded every 90 min, and urine was collected at 3-hr intervals all day and night. Melatonin treatment enhanced the resynchronization speed of some, but not all, hormone and electrolyte excretion rates for several days after the time shift. The adaptation speed of the temperature rhythm significantly increased during one postshift day. In addition, the circadian temperature rhythm had a significantly higher amplitude under melatonin treatment than under placebo after the time displacement. For the placebo group, the rhythm of 6 hydroxymelatoninsulfate excretion exhibited an advance shift in five subjects, whereas the other three showed a delay shift, and adjustment did not achieve more than one-half of the expected value within 8 days. A significantly different adjustment could be observed in the melatonin-treated group: Seven subjects underwent an advance shift of the expected 9 hr within an average of 8 days. The results suggest that melatonin treatment can accelerate resynchronization of the melatonin excretion rhythm after eastward time zone transitions. The improvement is not, however, sufficiently great that we can recommend melatonin for the alleviation of jet lag. PMID- 1773095 TI - Melatonin administration to blind people: phase advances and entrainment. AB - The purpose of this study was to test the phase-shifting and entraining effects of melatonin in human subjects. Five totally blind men were found in a previous study to have free-running endogenous melatonin rhythms. Their rhythms were remarkably stable, so that any deviation from the predicted phase was readily detectable. After determination of their free-running period and phase, they were given exogenous melatonin (5 mg) at bedtime (2200 hr) for 3 weeks, in a double blind, placebo-controlled trial. The effects on the endogenous melatonin rhythm were assessed at intervals ranging from several days to 2 weeks. Exogenous administration of melatonin phase-advanced their endogenous melatonin rhythms. In three of the subjects, cortisol was shown to be phase-shifted in tandem with the melatonin rhythm. A sixth subject [one of the coauthors (JS)] was previously found to have free-running cortisol and temperature rhythms and was plagued by recurrent insomnia and daytime sleepiness. He had tried unsuccessfully to entrain his rhythms for over 10 years. After he took melatonin (7 mg at 2100 hr), his insomnia and sleepiness resolved. Determination of his endogenous melatonin rhythm after about a year of treatment demonstrated endogenous rhythms that appeared normally entrained. The treatment of blind people with free-running rhythms has many advantages for demonstrating chronobiological effects of hormones or drugs. PMID- 1773096 TI - Feedback in the rabbit's central circadian system, revealed by the changes in its free-running food intake pattern induced by blinding, cervical sympathectomy, pinealectomy, and melatonin administration. AB - Long-term records of the number of food approaches per 30 min were obtained from 16 rabbits in constant light and after blinding. Optic nerve sectioning usually resulted in a shortening of the free-running period (tau; mean reduction = -0.26 hr) of the oscillator governing the rabbit's food intake pattern. Subsequent resection of both superior cervical ganglia always reduced this tau (mean = -0.41 hr), and it could be further shortened (mean = -0.24 hr) by chronic administration of melatonin. These observations led to experiments in which the food intake of 15 blinded rabbits was recorded before and after pinealectomy. This always resulted in a lengthening of tau (mean = +0.27 hr), which was never seen after subtotal or sham pinealectomy in 10 other blinded animals (mean = 0.05 hr). Sympathectomy also reduced tau (mean = -0.50 hr) in the pinealectomized rabbits, whereas it induced a smaller reduction (mean = -0.29 hr) after sham pinealectomy. These results, together with previous observations on the effect of sympathectomy on the retinal "dark" discharge and on the influence of the latter upon the food intake pattern, indicate that the cervical sympathetic nerves may form part of three feedback loops for the rabbit's central circadian system. These have separate postganglionic pathways; there are also differences in the circadian phasing of their activities and in their effects on tau. PMID- 1773097 TI - The amplitude of circadian oscillations: temperature dependence, latitudinal clines, and the photoperiodic time measurement. AB - This paper develops several propositions concerning the lability of the amplitude of Drosophila circadian pacemakers. The first is that the amplitude of the pacemaker's motion, unlike its period, is markedly temperature-dependent. The second is that latitudinal variation in pacemaker amplitude (higher in the north) is responsible for two very different sets of observations on Drosophila circadian systems at successively higher latitudes. One of these is a cline in D. auraria's phase-shifting response to light, which steadily weakens in a succession of more northerly strains. The other, concerning D. littoralis in the very far north, is a cline in the rate at which eclosion activity becomes arrhythmic (the circadian rhythm damps out) in constant darkness; damping is faster in the north. The third proposition concerns a plausible selection pressure for the cline in pacemaker amplitude that we propose underlies the two directly observed clines. Two points are emphasized: (1) The amplitude of the pacemaker's daily oscillation declines as the duration of the entraining light pulse (photoperiod) is increased; and (2) the duration of the daily photoperiods throughout the breeding season is steadily increased as one moves toward the poles. Selection for conservation of pacemaker amplitude (during the breeding season) would produce the latitudinal cline we propose. The fourth, and final proposition is that since the amplitude of the pacemaker's daily motion responds systematically to change in photoperiod, amplitude is clearly one way--and a temperature-dependent way--in which insect circadian systems may sense seasonal change. These propositions concerning the temperature and latitude dependence of pacemaker amplitude may be relevant to a wider array of circadian pacemakers than Drosophila. PMID- 1773098 TI - Suprachiasmatic nucleus and photic entrainment of circannual rhythms in ground squirrels. AB - The efficacy of photoperiod as a zeitgeber for entrainment of circannual body weight and estrous rhythms was tested in female golden-mantled ground squirrels maintained for 3 or more years in either a simulated natural photoperiod (SNP) or a fixed LD 14:10 photoperiod (FP). The role of the retinohypothalamic tract- suprachiasmatic nucleus (RHT-SCN) projection in photic entrainment was assessed in animals that sustained destruction of the SCN (SCNX). Circannual rhythms were lengthened by the SNP as compared to the FP. Mean periods (tau's) for neurologically intact animals in the third year of testing were 49.6 +/- 0.3 weeks and 43.1 +/- 1.2 weeks (p less than 0.001) for the SNP and FP groups, respectively; furthermore, 56% and 7% of animals in these groups had tau's not significantly different from 365 days (p less than 0.005), and within-group variability was lower for SNP than for FP squirrels (p less than 0.01). SCNX squirrels differed from animals with the SCN intact (SCNC), as evidenced by higher within-group variability (p less than 0.001); only 29% of SCNX squirrels had tau's not different from 365 days (p less than 0.03 compared to the SCNC group). The coupling between estrous and body weight rhythms that was evident in SCN-intact SNP and FP squirrels was disrupted in SCNX animals. The RHT-SCN pathway is implicated in entrainment and in maintenance of normal phase relations among the several circannual rhythms. In a second experiment, female squirrels were maintained for 2.5 years in an accelerated SNP that compressed two normal annual photocycles into each calendar year. Of 12 squirrels, 3 had tau's that did not differ significantly from 6 months; 6 had tau's equivalent to 12 months; and 3 had tau's significantly different from both 6 months and 12 months. The data suggest that photoperiod is a major zeitgeber for entrainment of golden-mantled ground squirrels circannual rhythms. PMID- 1773099 TI - Photoperiodic induction in quail as a function of the period of the light-dark cycle: implications for models of time measurement. AB - The earliest detectable event in the photoperiodic response of quail is a rise in luteinizing hormone (LH) secretion beginning at about hour 20 on the first long day. The timing of this rise was measured in castrated quail after entrainment to short daylengths which cause significant phase angle differences in the circadian system: (1) LD 2:22 and LD 10:14, and (2) LD 3:21 (T = 24 hr) and LD 3:24 (T = 27 hr). The quail were then exposed to 24 hr of light (by delaying lights-off), and the time of the first LH rise was measured; it was similar in all schedules. Quail were also entrained to LD 3:21 or LD 3:24 and then given a single 6-hr nightbreak 6-12, 7-13, or 13-19 hr after dawn. The earlier pulse was marginally more inductive in the 27-hr cycle. Thus the entrainment characteristics of the photoinducible rhythm (phi i) in quail appear very different from those of the locomotor circadian rhythm, and raise doubts as to whether phi i is a primary circadian oscillator. PMID- 1773100 TI - Control of annual endocrine rhythms in the edible dormouse: nonprimary effect of photoperiod. AB - We investigated the extent to which photoperiodic fluctuations synchronize annual thyroid and gonadal rhythmicity in edible dormice. The effects of different daylength manipulations (LD 4:20, LD 6:18, LD 18:6, LD 20:4) were examined during the two critical ascending and regressive phases of the annual plasma testosterone and thyroxine cycles that correspond to naturally increasing or decreasing photoperiod variations. The data failed to demonstrate any essential photoperiodic contribution to control systems that generate these two annual biological rhythms in dormice. PMID- 1773101 TI - The effect of constant light and phase shifts on a learned time-place association in garden warblers (Sylvia borin): hourglass or circadian clock? AB - Garden warblers are able to learn an association between time of day and feeding place. In constant dim light and constant food availability, the learned feeding pattern (successive visits to four feeding rooms for approximately 3 hr each) persisted for at least 1 day in three birds and for at least 6 days in one bird. The free-running feeding rhythm had a period of slightly greater than 23 hr. In response to a 6-hr phase advance of the light-dark cycle, the birds advanced their learned feeding pattern by 2.6 hr on the first day, whereas a 6-hr phase delay had no significant effect. These results are consistent with the hypothesis that the birds use a circadian clock rather than an hourglass mechanism of timing. This conclusion is further supported by the response of birds to forced interruptions of the daily feeding pattern (Krebs and Biebach, 1989). PMID- 1773102 TI - Type 2 resetting of the Euglena gracilis circadian rhythm? PMID- 1773103 TI - Autonomy and beneficence in the family: describing the family covenant. PMID- 1773104 TI - Chronic illness: a problem of passive injustice. PMID- 1773105 TI - Ethics education for psychiatry. PMID- 1773106 TI - Competence as accountability. PMID- 1773107 TI - Family refusal to accept brain death and termination of life support: to whom is the physician responsible? PMID- 1773108 TI - Hopes for the PSDA. PMID- 1773109 TI - The PSDA: a logical next step. PMID- 1773110 TI - Getting ready for the PSDA: what are hospitals and nursing homes doing? PMID- 1773111 TI - Approximating informed consent and fostering communication: the anatomy of an advance directive. PMID- 1773112 TI - The PSDA: a long-term care view. PMID- 1773113 TI - Implementing the PSDA for psychiatric patients: a common-sense approach. PMID- 1773114 TI - The PSDA of 1991: what does it mean for health-care organizations. PMID- 1773115 TI - "Dealing with real Jewish patients". PMID- 1773116 TI - Reproductive and developmental biology of the oriental cockroach Blatta orientalis (Dictyoptera). AB - At 27 degrees C and 45% r.h. in the laboratory, the oriental cockroach Blatta orientalis (L.) developed to adulthood in seven to nine instars for males (66% had eight instars) and eight to ten instars for females (67% had nine instars) in mixed groups, with up to twelve instars for isolated females. Nymphal development lasted 185 +/- 2 days for males, 216 +/- 4 days for females, with 89% survival to adulthood. Adult longevity was significantly more for males than females in mixed groups. Virgin females lived for 135 +/- 6 days compared with 87 +/- 9 days for females kept with males. After an initial maturation time of 12.2-13.5 +/- 0.4 days for mated and unmated females, oothecae were produced, on average, every 6-7 (range 2-29) days. Ootheca viability was 68% from females kept with males, 32% from females kept apart from males. Numbers of nymphs emerging were 14.1 +/- 0.26 after 45 days from mated female oothecae 8.2 +/- 0.3 after 49 days from unmated females. With sexual reproduction the sex ratio of progeny reaching adulthood was 1.1 males per female (n = 443), whereas unmated females produced only female progency, which is consistent with parthenogenetic reproduction. Drawings of the ventral aspect of the terminalia are given to show features useful for instar determination and for distinguishing between male and female nymphs and adults of B. orientalis. PMID- 1773117 TI - Distribution of Oriental and German cockroaches, Blatta orientalis and Blattella germanica (Dictyoptera), in the United Kingdom. AB - Results are presented of a survey carried out by Rentokil Ltd on the distribution of the Oriental cockroach Blatta orientalis L. and the German cockroach Blattella germanica L. in the United Kingdom. The known ranges of both species are increased considerably by the findings of the survey, with several new vice county records for Scotland (including the Western Isles), England and Wales. The frequency at which Blatta orientalis was observed in outdoor habitats may indicate that this species sometimes spreads to new areas without human assistance. PMID- 1773118 TI - Sandfly distribution and abundance in a tropical rain forest. AB - 1. The distribution patterns of sandflies (Diptera: Psychodidae) upon tree buttresses were studied in tropical rain forest at Finca la Selva in the Caribbean lowlands of Costa Rica. 2. Four species of sandfly, Lutzomyia shannoni Dyar, L. trapidoi F. & H., L. ylephiletor F. & H. and L. vespertilionis F. & H. comprising 97% of those caught, used tree buttresses as diurnal resting sites. Their distribution on the buttresses was aggregated. 3. During the dry season tree species had no significant effect upon the distribution of the sandflies. However, during the wet season the distributions of two of the species, L. trapidoi and L. ylephiletor, were significantly affected by the species of tree; it is suggested that some species of tree may provide greater protection from rainfall than others. 4. L. vespertilionis was restricted to a single buttress on each positive tree. Distribution of this species is evidently determined by the distribution of its host animal, the bat (Emballonuridae). Female flies feed upon the bat's blood and male flies may be attracted to the bat as it provides a source of female sandflies. It is suggested, therefore, that tree buttresses serve as sandfly swarming sites. 5. Within a large buttress the sandflies are not randomly distributed but are aggregated in particular areas. Within these aggregations, the sandflies are vertically zoned upon the buttress with a shift in species composition with height. Two hypothesis were suggested to account for this distribution pattern: a response to an environmental gradient or an interaction between the four species of fly. PMID- 1773119 TI - Chrysops silacea and C.dimidiata seasonality and loiasis prevalence in the Chaillu mountains, Congo. AB - Seasonal activity of the loiasis vectors Chrysops dimidiata Wulp and Chrysops silacea Austen (Diptera: Tabanidae) was studied during 1987-89 in villages and surrounding forest of the Chaillu Mountains, Congo. Chrysops were captured mainly in the hot rainy season (November-May) and densities of both species were higher in the forest than in villages. C.silacea predominated at all sites and C.dimidiata was rarely found in villages. In the rain forest, between 07.00 and 18.00 hours, 12 times more C.silacea and 3 times more C.dimidiata were collected with hand-nets (range 15-81 per man-day) than were caught in landing/biting collections on human bait. Chrysops man-biting rates were higher in villages closer to the forest, but variations in loiasis prevalence among villagers (microfilaraemia rates 16-37%) were not proportional to the intensity of contact between people and vectors in the villages, indicating that the majority of loiasis transmission probably occurs when people go into the forest. PMID- 1773120 TI - Studies on the possible role of cattle nuisance flies, especially Hydrotaea irritans, in the transmission of summer mastitis in Denmark. AB - The summer mastitis pathogens Actinomyces pyogenes, Peptococcus indolicus, Bacteroides melaninogenicus ss. levii, Fusobacterium necrophorum and Streptococcus dysgalactiae were isolated from the polyphagous symbovine dipterans Hydrotaea irritans (Fallen) and Morellia sp. caught around dairy heifers on pasture, but not from the haematophagous species Haematobia irritans (L.), Haematobosca stimulans (Meigen), Culicoides sp. and Simulium sp. Secretions from clinical cases of summer mastitis proved to be sources of summer mastitis bacteria for more than 3 weeks despite antibiotic treatment and teat amputation. Taking into account the seasonal activity pattern of Hydrotaea irritans and its topographical distribution on grazing cattle, it appears evident that this fly may play a central role in the establishment and maintenance of the bacterial contamination with summer mastitis pathogens on the teats of healthy cattle. In the present study the survival of A.pyogenes and P.indolicus for 7 days in experimentally infected Hydrotaea irritans, as demonstrated by the recovery of these microorganisms from agar plates exposed to live infected flies, is described. However, experimental transmission of summer mastitis from sick to healthy heifers by Hydrotaea irritans proved unsuccessful. PMID- 1773121 TI - Ixodes (Pholeoixodes) hexagonus, an efficient vector of Borrelia burgdorferi in the laboratory. AB - Borrelia burgdorferi Johnson et al. was first isolated from the midgut of Ixodes dammini Spielman et al. in the U.S.A. and from the midgut of I.ricinus (L.) in Europe. I.ricinus was considered to be the only tick vector of this borrelia, in Europe, until I.hexagonus Leach, the hedgehog tick, was found to harbour spirochaetes. This paper reports an evaluation of the vector competence of I.hexagonus for the spirochaete B.burgdorferi. Transovarial and trans-stadial survival were demonstrated and the spirochaete was transmitted to laboratory mice via the bites of trans-stadially infected I.hexagonus females. PMID- 1773122 TI - Comparative micromorphology of third instar larvae and the breeding biology of some Afrotropical Sarcophaga (Diptera: Sarcophagidae). AB - Four sympatric species of Sarcophaga, viz S. cruentata Meigen, S. exuberans Pandelle, S. nodosa Engel and S. tibialis Macquart, which occur in the Transvaal, South Africa, showed oviparity under optimum laboratory breeding conditions. Details of the life cycle duration under these conditions are discussed. Rearing and colonizing methods were developed. Scanning electron microscopy of third instar larvae provided useful data in distinguishing between the four species. The characters which were examined were the spinulation of the body segments and the rim surrounding the spiracular atrium of the posterior spiracles, the anterior spiracles and the spiracular hairs of the posterior spiracles. PMID- 1773123 TI - DNA probes to identify members of the Anopheles farauti complex. AB - DNA probes have been constructed to distinguish between the members of the Anopheles farauti complex of mosquitoes known as species numbers 1, 2 and 3. Partial genomic libraries of the three known species were exposed to labelled total genomic DNA from each species. Colonies showing differential hybridization were selected for further testing. These probes were found which allow identification of the three known species: probe pAf1 (160 bp fragment) hybridizes to DNA from An. farauti nos. 1 and 2; probe pAf2 (95 bp fragment) hybridizes to DNA from An. farauti no. 2 only; and probe pAf3 (1.3 kb fragment) hybridizes strongly to DNA from An. farauti no. 3, less to no. 1 and faintly to no. 2. Increasing the stringency of hybridization reduced the cross-hybridization of probes pAf1 and pAf3. Only radioactively labelled probes were tested. Males and females and individuals from diverse habitats and localities showed the same species/probe hybridization characteristics. This technique allows faster identification of the sibling species than previous methods, and has the added advantage that it allows air-dried and alcohol stored specimens to be identified. PMID- 1773124 TI - Synthetic DNA probes for the identification of sibling species in the Anopheles gambiae complex. AB - The cloned DNA sequences pAna1, pAnq1 and pAnm14, which may be used to distinguish between at least five of the six species in the Anopheles gambiae Giles complex of Afrotropical malaria vector mosquitoes, have been sequenced. Each clone was found to possess a series of repeated sequences of 41, 30 and 163 bases respectively. In pAnq1 and pAnm14 the repeats were in direct tandem array, whilst in pAna1 the repetitive sequence was found to be interspersed by 15-17 variable bases. A comparison of a number of copies of each of the repetitive sequences within the three clones enabled the definition of the consensus sequence for each repetitive element. Based on these consensus sequences, three oligonucleotides of 21, 23 and 26 bases were derived from pAna1, pAnq1 and pAnm14 respectively. When tested as probes against DNA dot-blots and squash-blots of mosquito specimens, each oligonucleotide retained the same species-specificity as the original clones from which they were derived. The radioactively labelled oligonucleotides were able to detect as little as 5 ng of target genomic DNA in an overnight autoradiographic exposure. The synthetic DNA probes will form the basis of a simplified system for the field identification of Anopheles gambiae sibling species specimens. PMID- 1773125 TI - Pyrethroid-treated bednet effects on mosquitoes of the Anopheles gambiae complex in The Gambia. AB - The response of Anopheles gambiae complex mosquitoes to men sleeping under insecticide-impregnated or untreated bednets in six verandah trap huts was studied during the dry season in The Gambia. With this type of hut it was possible to collect live and dead indoor-resting mosquitoes and estimate the number of wild mosquitoes which entered, bloodfed on man, and exited each night. Bednets were treated with emulsions targetted to leave deposits of 25 mg/m2 lambda-cyhalothrin, or 5, 50 or 500 mg/m2 permethrin, diluted from emulsifiable concentrates (EC), or a blank formulation similar to the EC except that the permethrin was omitted; the sixth net was left untreated. Nets and sleepers were rotated between huts on different nights, the design being based on a series of Latin squares and conducted double-blind. Permethrin-impregnated bednets deterred mosquitoes from entering the huts. The degree of deterrency was proportional to the dosage of permethrin. This effect was also caused by the blank formulation and therefore attributed to other components of the formulation, rather than to the permethrin itself. The net impregnated with 500 mg permethrin per square metre gave the best individual protection, reducing mosquito bloodfeeding by 91% compared with untreated nets. However, lambda-cyhalothrin was proportionately more insecticidal than permethrin at doses of equivalent deterrency. At this stage of research, it remains conjectural whether chemical deterrency or killing of malaria vectors is better for community protection. PMID- 1773126 TI - Effect of N-acetyl-D-glucosamine on the migration of Brugia pahangi microfilariae into the haemocoel of Aedes aegypti. AB - Two strains of Aedes aegypti (L.), differing in their susceptibility to Brugia pahangi (Buckley & Edeson), were examined with regard to the effect on the proportion of microfilariae migrating from the mid-gut, of specific carbohydrate supplements in the infecting bloodmeal. N-Acetyl-D-glucosamine (GlcNAc), a sugar also present on the microfilarial sheath, significantly increased the migration rate. This enhancement is greater for the refractory strain of Ae.aegypti. The use of sucrose as a control sugar results in no enhancement of microfilariae migration. It is postulated that the GlcNAc is acting by blocking endogenous gut/peritrophic membrane carbohydrate binding proteins, which would normally inhibit microfilariae migration. Furthermore, there is a significant correlation whereby increasing loads of microfilariae ingested result in decreasing proportions migrating across the mid-gut. PMID- 1773127 TI - Lectin and peritrophic membrane development in the gut of Glossina m.morsitans and a discussion of their role in protecting the fly against trypanosome infection. AB - Newly emerged Glossina m.morsitans Westwood tsetse flies lack a peritrophic membrane which develops to fully line the midgut after c. 80-90 h. Midgut lectins are mainly associated with the peritrophic membrane. Lectin levels in the blood free gut of adult flies rise slowly up to 8 days and then rapidly to at least 14 days post-eclosion (when the last of our recordings was made). Despite starving flies for 4 days prior to the agglutination assay, gut lectin levels in older flies are 100-200 times more than those in newly ecloded flies. This is inconsistent with the idea that there is a simple relationship between lectins and the protection of tsetse flies against trypanosome infection. Various theories put forward to account for age-dependent variation in the ability of tsetse to become infected with trypanosomes are discussed in the light of these findings. PMID- 1773128 TI - Bedbug reinfestation rates in rural Africa. PMID- 1773129 TI - Balta notulata (Stal) is a domiciliary cockroach in Papua New Guinea. PMID- 1773130 TI - The cliff swallow bug Oeciacus vicarius (Hemiptera: Cimicidae) in Florida: ectoparasite implications for hole-nesting birds. AB - In May 1988, ten juvenile birds, not yet ready to fledge, jumped to their death from a colony of the purple martin, Progne subis near Okeechobee City, Florida. The martin house and nestlings were found to be infested with ectoparasitic Oeciacus vicarius Horvath, the cliff swallow bug, not previously reported from Florida. This ectoparasite infestation apparently led to early abandonment of two houses by the adult martins. Oeciacus vicarius therefore represents a possible threat to all hole-nesting birds. PMID- 1773131 TI - The ovariectomized rat model of postmenopausal bone loss. AB - An animal model of postmenopausal bone loss can be defined as a living animal in which spontaneous or induced bone loss due to ovarian hormone deficiency can be studied, and in which the characteristics of the bone loss and its sequalae resemble those found in postmenopausal women in one or more respects. Although in comparison to humans, the skeletal mass of rats remains stable for a protracted period during their lifespan, rats can be ovariectomized to make them sex-hormone deficient, and to stimulate the accelerated loss of bone that occurs in women following menopause. Ovariectomy induced bone loss in the rat and postmenopausal bone loss share many similar characteristics. These include: increased rate of bone turnover with resorption exceeding formation; and initial rapid phase of bone loss followed by a much slower phase; greater loss of cancellous than cortical bone; decreased intestinal absorption of calcium; some protection against bone loss by obesity; and similar skeletal response to therapy with estrogen, tamoxifen, bisphosphonates, parathyroid hormone, calcitonin and exercise. These wide-ranging similarities are strong evidence that the ovariectomized rat bone loss model is suitable for studying problems that are relevant to postmenopausal bone loss. PMID- 1773133 TI - Morphometric traits and femoral histomorphometry in mice selected for body conformation. AB - Skeleton characteristics and femoral histomorphometry were investigated in two lines of mice divergently selected for antagonistic conformations (CBi/C: high body weight-short tail; CBi/L: low body weight-long tail). An unselected control line (CBi) was used. Genotypes were a significant source of variation for almost all traits studied (body size, skeletal measurements, histomorphometry of the femur, number of caudal vertebrae) indicating that eighteen generations of artificial selection were successful in modifying phenotypes. Antagonistic selection revealed an association between the mechanisms that regulate skeleton growth and body conformation. Trunk length seemed to be dependent of the biomass a mouse would attain. Femur length and its morphometric characteristics were conditioned by other factors than body weight. The observed response in caudal vertebrae number could be explained if this character is considered as a threshold one. The selective procedure applied in this research was also useful to study other biological characters such as fat deposition, immune reactions and bone biomechanics. PMID- 1773132 TI - c-fos oncogene expression in dexamethasone stimulated osteogenic cells in chick embryo periosteal cultures. AB - Although the complex effects of glucocorticoids on bone cells have been studied extensively in vitro, little is known about the molecular mechanisms of glucocorticoid responses in osteogenic cells. As c-fos and its protein product are believed to play a key role in intracellular signal transduction, and since their role in regulation of bone formation is well-recognized, we studied the effect of the glucocorticoid analogue dexamethasone (DEX) on the expression of c fos oncogene in the chick periosteal osteogenesis (CPO) model. C-fos mRNA expression was determined by in situ hybridization at various time points after 10(-7) M DEX treatment. Prior to DEX treatment, the cultures had been synchronized with 2 mM thymidine. The mean area of positively hybridized cells in experimental (DEX-treated) and control (DEX-free) cultures was quantitated by computer assisted morphometry. In DEX-treated cultures c-fos mRNA could be detected transiently and mainly in the osteogenic layer at 30, 45 and 60 min after treatment whereas no c-fos expression could be detected above background level in the control groups. Differences between experimental and control groups were significant (P less than 0.01) as determined by a general linear model (GLM) analysis of variance. These data indicate that in the CPO culture system, DEX (10(-7) M) induces c-fos expression. The findings are compatible with the hypothesis which states that glucocorticoid-induced phenotypic changes in osteogenic cells may be mediated by c-fos. PMID- 1773134 TI - 24,25(OH)2D3 affects the calcemic effects of 1,25(OH)2D3 by mechanisms independent of intestinal calcium absorption. AB - To better define the interaction between 1,25(OH)2D3 and 24,25(OH)2D3 in different states of renal function, the fractional absorption of Ca45 (FCa45) and plasma calcium (PCa) were determined in rats with intact kidneys and in rats with reduced renal mass after 5/6 nephrectomy. The two series of experiments were performed in control animals, and in rats treated with: 1) 1,25(OH)2D3, 54 ng/rat/day, 2) 24,25(OH)2D3 in the same dose, and 3) 1,25 and 24,25(OH)2D3 in the same (and equal) doses. In all animals 1,25(OH)2D3 administration was associated with a significant increase in PCa and in FCa45. In rats with normal renal function, however, 24,25(OH)2D3 enhanced and in rats with reduced renal mass it suppressed the hypercalcemic effect of 1,25(OH)2D3. These variations in PCa were not associated with further alteration in FCa45 which was similar after 1,25(OH)2D3 and after combined 1,25 and 24,25(OH)2D3 in normal rats and in rats with chronic renal failure. FCa45 was found to be of the same magnitude in rats with normal renal function and in rats with reduced renal mass. These results confirm previous findings of normal intestinal absorption of Ca in mild to moderate renal failure. The above data suggest that 24,25(OH)2D3 used in an equivalent dose does not influence the intestinal effects of 1,25(OH)2D3. Therefore, the interaction of 1,25 with 24,25(OH)2D3 in rats with intact kidneys or with reduced renal mass occurs at extra-intestinal sites. PMID- 1773135 TI - Age-related changes in bone mass among Japanese-American men. AB - Bone mass and appendicular bone loss rates were examined in a cohort of Japanese American men. Across their age range (ages 61 to 82 years) bone mass steadily declined at the proximal and distal radius, and at the calcaneus. The cross sectional reduction in bone mass was 3.5-6.3% per decade at the various sites. Longitudinal measurements of the same cohort indicated greater losses than suggested by the cross-sectional data, yet still less than 10% per decade. Linear trends of increasing loss rates with aging were significant at the calcaneus, and marginally significant at the radius sites. However, the oldest men in the cohort strongly influenced these trends. Men under age 75 had essentially constant annual rates of bone loss. The most elderly men had both the lowest bone mass and the greatest bone loss rates. PMID- 1773136 TI - Intermittent treatment with intravenous 4-amino-1-hydroxybutylidene-1,1 bisphosphonate (AHBuBP) in the therapy of postmenopausal osteoporosis. AB - Since data on the efficacy of 4-amino-2-hydroxybutylidene-1,1-bisphosphonate (AHBuBP) in the therapy of osteoporosis are not yet available, we have examined in an open, randomized study, the effects of an intravenous intermittent treatment with this drug on the vertebral and radial bone mass in postmenopausal osteoporosis. Forty postmenopausal osteoporotic women were randomly assigned to one of two groups, one treated with AHBuBP (5 mg/day on two consecutive days every 3 months for one year; n = 20), the other with oral calcium (n = 20). The bone mineral density (BMD) of the spine increased significantly in women receiving AHBuBP, whereas it tended to decrease in patients given calcium. The differences in the vertebral BMD changes between groups was highly significant (P less than 0.01). Radial BMD tended to increase in patients treated with AHBuBP, and to decrease in patients receiving calcium. The difference in the linear trends was statistically significant (P less than 0.05). The side effects of AHBuBP (a transient acute phase reaction in 3 out of 20 subjects) were slight and well-tolerated. A good effect of AHBuBP was observed also on back pain (P less than 0.05). We conclude that intermittent treatment with AHBuBP is capable of increasing spinal BMD and conserving radial BMD in postmenopausal osteoporosis and may represent a convenient therapeutic choice in this condition. PMID- 1773137 TI - A comparison of low versus high dose pamidronate in cancer-associated hypercalcaemia. AB - Pamidronate has been demonstrated to be an effective agent in the treatment of cancer-associated hypercalcaemia. The dose regime, however, remains controversial. In this study 16 patients with cancer-associated hypercalcaemia were given 30 mg pamidronate by intravenous infusion and 16 were given 90 mg also by infusion. Groups were well-matched in terms of tumour types, bone metastases, pre-treatment serum calcium and creatinine, fasting urinary calcium/creatinine ratio, nephrogenous cAMP and the renal tubular threshold for phosphate reabsorption (TmPO4). The calcium lowering effect was similar in both treatment groups with nadir at day 6 of mean (+/- SEM) 2.48 mmol/l (+/- 0.06) in the 30 mg group and at day 9 in the 90 mg group of 2.51 mmol/l (+/- 0.03) (P less than 0.01). 10 patients in the 30 mg group and 8 in the 90 mg group were normocalcaemic at this point. Similarly when those patients with more severe hypercalcaemia (greater than 3.30 mmol/l, n = 7 in each group) were analysed separately, no significant difference was evident between the two groups. Urinary calcium/creatinine ratios fell to a nadir at day 6 in both groups of 0.33 (+/- 0.05) (30 mg group) and 0.37 (+/- 0.10) (90 mg group) (P less than 0.01). Follow up results after the initial 9 days showed the mean time to relapse to be 38 days (range 18-90) in the 30 mg group and 34 days (11-105) in the 90 mg group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1773138 TI - Efficacy and safety of the bisphosphonate tiludronate for the treatment of tumor associated hypercalcemia. AB - Tiludronate is a new bisphosphonate whose efficacy has already been reported for the prevention of postmenopausal bone loss. We have evaluated its efficacy and tolerance by a dose-finding study in 19 hypercalcemic cancer patients after adequate intravenous (iv) rehydration. Treatment consisted of 3 days of iv tiludronate given at doses of 3.0 mg/kg/day (n = 3), 4.5 mg/kg/day (n = 3), or 6.0 mg/kg/day (n = 13); this iv therapy was followed by 17 days of oral tiludronate, 400 mg (n = 13) or 800 mg (n = 6) daily. Treatment had to be discontinued in 9 patients, including 3 because of evident treatment failure and 1 because of severe toxicity. After iv tiludronate, 13/18 patients had a normal Ca level, including 10/12 who had received 6.0 mg/kg/day, but Ca2+ levels were fully normalized in only 4/18 and 3/12 patients, respectively. After 6.0 mg/kg/day, Ca levels had fallen from 12.1 +/- 0.3 to 10.0 +/- 0.4 mg/dl (P less than 0.0005), whereas fasting urinary calcium excretion went from 0.639 +/- 0.099 to 0.272 +/- 0.054 mg Ca/mg creatinine on d4 (P less than 0.001). On the other hand, oral tiludronate was unable to normalize Ca in patients who were still hypercalcemic after the iv course, although the daily administration of 800 mg appeared to be more efficient than the 400 mg daily dosage. The administration of tiludronate caused an increase in serum phosphate levels, from 2.9 +/- 0.2 to 3.7 +/- 0.2 mg/dl after the iv course, probably through an increase in the TmP/GFR index, which went from 2.3 +/- 0.2 to 3.6 +/- 0.4 mg/dl (P less than 0.05). Three patients had an increase in serum creatinine levels after the iv course, one obese patient developing an acute renal insufficiency; during oral tiludronate therapy, 5 other patients also presented an increase in serum creatinine levels. Oral tiludronate administration was also associated with occasional nausea and vomiting. In summary, compared with aminobisphosphonates, tiludronate is not indicated for the treatment of tumor-associated hypercalcemia because of the need for high iv doses which are potentially nephrotoxic. PMID- 1773139 TI - Treating Wolff-Parkinson-White syndrome. PMID- 1773140 TI - How well do we manage families with genetic problems? PMID- 1773141 TI - Adults with congenital heart disease. PMID- 1773142 TI - Understanding Marfan's syndrome. PMID- 1773143 TI - Doctors in the making. PMID- 1773144 TI - Training in obstetrics. PMID- 1773145 TI - French payout for HIV victims. PMID- 1773146 TI - Aids education in schools. PMID- 1773147 TI - Elective total hip replacement: incidence, emergency readmission rate, and postoperative mortality. AB - OBJECTIVES: To report the incidence of elective total hip replacement and postoperative mortality, emergency readmission rates, and the demographic factors associated with these rates in a large defined population. DESIGN: Analysis of linked, routine abstracts of hospital inpatient records and death certificates. SETTING: 10 hospitals in six districts in Oxford Regional Health Authority covered by the Oxford record linkage study. SUBJECTS: Records for 11,607 total hip replacements performed electively in 1976-85. MAIN OUTCOME MEASURES: Incidence of operation, postoperative mortality, relative mortality ratios, and incidence of emergency readmission. RESULTS: NHS operation rates increased over time from 43 to 58 operations/100,000 population. Variation in operation rates between districts reduced over time. Operation rates were on average 25% higher in women than men. There were 93 deaths (11/1000 operations) within 90 days of the operation and 208 emergency readmissions (28/1000 operations) within 28 days of discharge. Postoperative mortality and emergency readmission rates increased with age. No significant trend with time was found. Mortality in the 90 days after the operation was 2.5-fold higher (1.9 to 3.0) than in the rest of the first postoperative year. This represented an estimated excess of 6.5 (4.2 to 8.8) early postoperative deaths/1000 operations. Most deaths were ascribed to cardiovascular events. Thromboembolic disease was the commonest reason for emergency readmission. CONCLUSIONS: The pronounced increase in operations in districts with initially low rates suggests a trend towards greater equity in the local provision of NHS hip arthroplasty. The early postoperative clusters of deaths attributed to cardiovascular disease and of readmissions for thromboembolic disease suggest that there is scope for investigating ways of reducing the incidence of major adverse postoperative events. PMID- 1773149 TI - Training and supervision of obstetric senior house officers. PMID- 1773148 TI - Intensified conventional insulin treatment and neuropsychological impairment. AB - OBJECTIVE: To assess whether intensified insulin treatment, with an increased frequency of hypoglycaemic episodes, leads to cognitive deterioration. DESIGN: Prospective randomised trial of intensified conventional treatment and standard treatment. SETTING: Outpatient clinic for patients with insulin dependent diabetes. SUBJECTS: 96 patients with insulin dependent diabetes, high blood glucose concentrations, and non-proliferative retinopathy were randomised to intensified conventional treatment (n = 44) or standard treatment (n = 52). MAIN OUTCOME MEASURES: Glycated haemoglobin concentration (metabolic control); the number of hypoglycaemic episodes reported by patients at each visit; results of computerised neuropsychological tests performed at entry and after five years. RESULTS: Mean glycated haemoglobin concentration during the study was 7.2% (SE 0.1%) with intensified conventional treatment and 8.7 (0.1%) with standard treatment (p less than 0.001). During five years 34 (77%, 95% confidence interval 53% to 100%) of the patients given intensified treatment and 29 (56%, 36% to 75%) of the others had at least one episode of serious hypoglycaemia (p less than 0.05). The intensified conventional treatment group had a mean of 1.1 episodes of serious hypoglycaemia per patient per year compared with 0.4 episodes in the standard treatment group. Results of the neuropsychological tests were similar in the two groups after five years. CONCLUSIONS: Intensified conventional insulin treatment led to lower blood glucose concentrations and a higher frequency of hypoglycaemic episodes, but patients showed no signs of cognitive deterioration. PMID- 1773150 TI - Roles of midwives and general practitioners in hospital intrapartum care, England and Wales, 1988. PMID- 1773151 TI - Health risks associated with bathing in sea water. PMID- 1773152 TI - Effect of high dose steroid bolus on occlusion of ocular central artery: angiographic study. PMID- 1773153 TI - GP trainees' views on hospital obstetric vocational training. AB - OBJECTIVES: To examine the content of hospital obstetric vocational training for general practice, the beliefs of general practitioner trainees about this training, and their perceived competence at practical obstetric procedures and the effect of training. DESIGN: Confidential postal questionnaire. SUBJECTS: A 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: Trainees' competence and beliefs on Likert scale, numbers of procedures witnessed and performed, type of maternity care trainees intended to provide. RESULTS: Of 1019 trainees sent questionnaires, 765 (75.1%) replied; 517 had done some hospital obstetric training. After six months as a senior house officer 232/367 (63%) believed they were competent to perform a normal delivery unaided, 228 (62%) to manage a severe postpartum haemorrhage, and 227 (62%) to resuscitate a newborn infant. 272 (35.6%) trainees intended to provide intrapartum care and 56 (7.5%) to book home deliveries in the future. Hospital training increased confidence in performing most obstetric procedures in all trainees. However, a greater proportion of trainees who intended to provide full care than shared care felt competent at performing a normal vaginal delivery (63% (170/272) full v 45% (215/473) shared), low forceps delivery (38% (103) v 17% (79)), manual removal of placenta (24% (65) v 17% (82)), and intubating a neonate (42% (114) v 34% (161)). Trainees who had done any obstetric training were less likely to think that training encouraged future provision of intrapartum care (113/509 (22%) training v 65/213 (31%) no training). CONCLUSION: Hospital vocational obstetric training increases the perceived competence of trainees but fails to encourage them to use obstetric skills. PMID- 1773155 TI - Urinary incontinence in women: have we anything new to offer? PMID- 1773156 TI - European health care systems. PMID- 1773154 TI - Co-amoxiclav in recurrent acute otitis media: placebo controlled study. AB - OBJECTIVE: To determine the efficacy of coamoxiclav in children aged 6 months to 12 years with recurrent acute otitis media. DESIGN: A randomised double blind placebo controlled clinical trial. SETTING: General practice in the Netherlands. PATIENTS: 121 children with recurrent acute otitis media, defined by onset of otalgia and otoscopic signs of middle ear infection within four to 52 weeks after the previous attack. Confirmation of diagnosis and randomisation was done by otolaryngologists. INTERVENTION: Oral co-amoxiclav or placebo in weight related doses for seven days. MAIN OUTCOME MEASURE: An irregular clinical course defined as the presence of otalgia or a body temperature greater than or equal to 38 degrees C, or both, after three days. RESULTS: Eleven (16%; 95% confidence interval 9% to 28%) children had an irregular course in the co-amoxiclav group and 10 (19%; 9% to 31%) in the placebo group (difference not significant). Age, dichotomised at 2 years, was the only significant prognostic factor for irregular course of the disease (odds ratio 5.9; 1.8 to 19.1). Among children aged below 2 years, 28% (4/14) in the co-amoxiclav group and 58% (7/12) in the placebo group had irregular courses. For children 2 years and older these percentages were 13% (7/52) and 7% (3/41). CONCLUSION: Children with recurrent acute otitis media are at greater risk of an irregular clinical course of the disease than children with a first episode of acute otitis media. Co-amoxiclav has no significant benefit over placebo in treating children over 2 years with acute otitis media. PMID- 1773157 TI - Air pollution: I--From pea souper to photochemical smog. PMID- 1773158 TI - ABC of vascular diseases. The swollen leg. PMID- 1773159 TI - Adipsic hypothalamic diabetes insipidus after clipping of anterior communicating artery aneurysm. PMID- 1773160 TI - Science and medicine down under. PMID- 1773161 TI - Fetal and infant growth and impaired glucose tolerance. PMID- 1773162 TI - Laparotomy in the acute abdomen. PMID- 1773163 TI - Postoperative feeding. PMID- 1773164 TI - How to pay for expensive drugs. PMID- 1773165 TI - Counselling patients before an HIV test. PMID- 1773166 TI - Strategy for asthma. PMID- 1773167 TI - Camelford revisited. PMID- 1773168 TI - Off the rails. PMID- 1773169 TI - The "Q" in QALYs. PMID- 1773170 TI - Physicians for Human Rights (UK) PMID- 1773171 TI - On lightning. PMID- 1773172 TI - Aboriginal skeletons in the closet. PMID- 1773173 TI - Chaos--predicting the unpredictable. PMID- 1773174 TI - Discovery in medicine. PMID- 1773175 TI - Economics, health, and the economics of health. PMID- 1773176 TI - Hugh Owen Thomas: the cripple's champion. PMID- 1773177 TI - First among women. PMID- 1773178 TI - Death of a heart surgeon: reflections on press accounts of the murder of Victor Chang. PMID- 1773179 TI - Changing the hideous face of war. PMID- 1773180 TI - Vincent van Gogh's illness: acute intermittent porphyria? PMID- 1773181 TI - Medecins Sans Frontieres: 20 years old. PMID- 1773182 TI - Garcia da Orta in Goa: pioneering tropical medicine. PMID- 1773183 TI - The Keppel Club (1952-74): lessons from the past for the future. PMID- 1773184 TI - Seeing for themselves. PMID- 1773185 TI - In defence of eponyms. PMID- 1773186 TI - Microbial flora on doctors' white coats. AB - OBJECTIVE: To determine the level and type of microbial contamination present on the white coats of doctors in order to assess the risk of transmission of pathogenic micro-organisms by this route in a hospital setting. DESIGN: Cross sectional survey of the bacterial contamination of white coats in a general hospital. SETTING: East Birmingham Hospital, an urban general hospital with 800 beds. SUBJECTS: 100 doctors of different grades and specialties. RESULTS: The cuffs and pockets of the coats were the most highly contaminated areas. The level of bacterial contamination did not vary with the length of time a coat had been in use, but it increased with the degree of usage by the individual doctor. Staphylococcus aureus was isolated from a quarter of the coats examined, more commonly from those belonging to doctors in surgical specialties than medical specialties. Pathogenic Gram negative bacilli and other pathogenic bacteria were not isolated. CONCLUSIONS: White coats are a potential source of cross infection, especially in surgical areas. Scrupulous hand washing should be observed before and after attending patients and it may be advisable to remove the white coat and put on a plastic apron before examining wounds. There is little microbiological reason for recommending a more frequent change of white coat than once a week, nor for excluding the wearing of white coats in non-clinical areas. PMID- 1773187 TI - Do pathologists have extrasensory perception? PMID- 1773188 TI - How to have a fever of unknown origin. PMID- 1773189 TI - Give a drug a bad name. PMID- 1773190 TI - How heavy the patient? PMID- 1773192 TI - Keeping the cat out of the bag: a hazard in continuous ambulatory peritoneal dialysis. PMID- 1773191 TI - Haemodynamic response in soccer spectators: is Scottish football exciting? AB - OBJECTIVE: To determine the effect of watching a game of Scottish football on heart rate and blood pressure. DESIGN: Prospective study. SETTING: Two Scottish Premier League football grounds. SUBJECTS: 10 healthy men, each a supporter of one of two clubs. MAIN OUTCOME MEASURES: Systolic and diastolic blood pressure and heart rate at home, while walking, and during the match. RESULTS: Systolic blood pressure and heart rate were significantly higher when the men were watching the match than when they were at home. While they were watching the match, heart rate was maximal immediately after a goal had been scored by the supported team. CONCLUSION: The emotional stress invoked by Scottish football is associated with significant increases in heart rate and systolic blood pressure. PMID- 1773193 TI - A potpourri of parasites in poetry and proverb. PMID- 1773195 TI - Countdown to the BMJ. PMID- 1773194 TI - Modifying chickenpox. PMID- 1773196 TI - Text telecommunication for people who are deaf: assessing the use of a text-relay service. AB - This study investigated the pattern and frequency of telephone use by people with a profound or severe hearing impairment. The main purpose was to assess the benefits of text telecommunication for making calls by typing rather than speaking and listening. Data on 169 adults were obtained by personal interview. The sample was stratified between subscribers to an experimental text-relay service and non-subscribers: a minority of respondents in both groups used a text telephone for direct telecommunication. Access to the relay service increased independent use of the telephone significantly above that of other respondents, whether for social contact, conducting personal business, or in paid work. The text-relay service was less than satisfactory for urgent calls and apparently did not encourage reciprocal contact. Nearly all respondents, subscribers and non subscribers alike, relied on other people making or receiving calls on their behalf via an ordinary telephone. Direct text telecommunication was as important as the text-relay service for social contact, especially with friends. The costs of telephone text equipment were substantially more than those normally incurred by hearing people. The implications for improving deaf people's access to the telephone are discussed. PMID- 1773197 TI - Comparative speech recognition results in eight subjects using two different coding strategies with the Nucleus 22 channel cochlear implant. AB - This study was designed to compare the results of several speech tests administered to eight subjects who used two types of speech-coding strategies with the Nucleus 22 channel cochlear implant. The subjects had an average experience of 40 months with the F0F1F2 coding strategy implemented in their previous wearable speech processor. Three subjects were good performers (showing significant open-set understanding without lip-reading) and five were moderate performers (not able to do speech-tracking by auditory means alone). All subjects were evaluated again after 1 month and 6 months of experience with the MULTIPEAK coding strategy of the miniature speech processor. The test materials included vowel and consonant identification, monosyllabic words, everyday sentences and numbers in noise. All eight subjects showed an improvement on more than three of five measures. The group of moderate performers showed a larger improvement in vowel (+16%) and consonant (+17%) identification scores than the group of good performers. For the open-set sentence test, the better patients were able to increase their score from 52% to 80% correct; two of the moderate performers did not improve. Six subjects achieved significantly higher scores at moderate signal to-noise ratios (up to 10 dB S/N) in the (Freiburger) number test. Results of information transmission analysis are also discussed. PMID- 1773198 TI - Interaction between sound and gentamicin: immediate threshold and stereociliary changes. AB - Our aim was to determine whether the immediate effects of a just-damaging sound exposure (8 kHz at 116 dB SPL for 1 h) might be potentiated by a single sub ototoxic dose of gentamicin (50 mg kg-1). Auditory brainstem responses in pigmented guinea pigs were measured before and after treatment and used to calculate threshold shift (TS). Histological disturbances to sensory hair cells were assessed by scanning electron microscopy. All experimental ears excepting the gentamicin only group showed TS and histological changes. The largest TSs occurred at half an octave above the exposure frequency, and were greatest in the gentamicin + sound (G + S) group. First row outer hair cells showed most histological disturbances, followed by inner hair cells. The severest histological damage occurred at the exposure frequency and basally from it, the G + S group being most affected. Generally, there was good correlation between the severity of TS and histological damage. Results from both analyses indicated greater changes with gentamicin present. PMID- 1773199 TI - The influence of contralateral acoustic stimulation on click-evoked otoacoustic emissions in humans. AB - Contralateral acoustic stimulation has the effect of reducing the amplitude and shifting the phase of click-evoked OAEs. This effect is thought to be mediated via the medial efferent system and, therefore, the presence of this effect could be used to test the integrity of the neural pathway from one cochlea to the other. With a clinical application in mind, a technique for demonstrating the influence of contralateral acoustic stimulation on click-evoked OAEs was designed to overcome fluctuations in patient and environmental noise. The results of this test on three normal subjects and a patient with a posterior fossa lesion are described. PMID- 1773200 TI - Assistive devices for hard-of-hearing persons--distribution system and costs. AB - A system to provide hearing-impaired persons with adequate assistive devices is described. Investigation of 100 persons' recommended devices in 1985 shows that the system functions reasonably well. To secure provision of adequate devices, a system must be established to take care of all practical tasks. The mean expense to supply a hearing-impaired person with the assistive devices needed was found to be 764 pounds. Supplying elderly hearing-impaired persons with assistive devices may enable them to stay at home longer. The cost of the required assistive devices for a hearing-impaired person is on average approximately the same as for 8 days' stay in a nursing home. PMID- 1773201 TI - Orientation perception, motion sickness and vertigo: beyond the sensory conflict approach. AB - Current theoretical issues central to the understanding of pathological disorientation (vertigo) are addressed through a critical review of research into perceptual disorientation in healthy subjects (motion sickness). Investigations inspired by the 'sensory conflict' model of orientation perception typically paid insufficient attention to higher-order meaningful properties of the environment, purposive activity, and individual differences in sensorimotor experience and skill. These factors are incorporated into an alternative 'active perception' approach, which characterizes perception of orientation as arising from interactions between intra-individual variables and the perceptual properties and sensorimotor demands of the environments encountered. It follows that vertigo is a form of disability which can only be properly assessed in the broader context of a range of relevant attributes of the patient, and his or her activities and environment. Analysis of the principles governing responses to disorienting conditions identifies several factors relevant to the assessment and rehabilitation of vertiginous patients. PMID- 1773202 TI - A controlled trial of azapropazone in tinnitus. AB - A single-blind placebo-controlled trial of azapropazone, a non-steroidal anti inflammatory drug, is presented in 10 patients with tinnitus. Seventeen variables were assessed by questionnaire and six by a daily diary. In none of these was there a significant difference between placebo and drug. A larger trial is probably therefore not justified. PMID- 1773203 TI - The performance and calibration of TDH39 earphones fitted with Model 51 and MX41/AR cushions. AB - Coupler measurements were made to compare the performances of new-style Model 51 cushions and old-style MX41/AR cushions fitted to TDH39 earphones. In addition, the calibration, using an artificial ear, of TDH39 earphones fitted with Model 51 cushions was compared with the calibration, using a reference coupler, of the same earphones fitted with MX41/AR cushions. It is concluded that the two cushion types can be taken as identical when fitted to TDH39 earphones, except at 6 kHz where differences in earphone sensitivity of up to 2.8 dB were observed. Likewise, output hearing levels of TDH39 earphones measured using a reference coupler and an artificial ear were found to be similar, except at 6 kHz where differences of up to 6.4 dB were observed. The data support the decision by ISO to declare the Model 51 equivalent to the MX41/AR cushion, thereby requiring TDH39 earphones to be calibrated using a reference coupler whichever cushion is fitted. However, they also highlight once again the ill-defined performance of TDH39 earphones at 6 kHz. PMID- 1773204 TI - Mechanical thermostatic mixer valve for caloric irrigation. PMID- 1773205 TI - A microbiological hazard in caloric testing. AB - The use of caloric testing is widespread in hospital audiology departments. This paper describes contamination of the caloric water tanks with the organism Acinetobacter anitratus and the changes in practice instituted to eliminate this risk to patients. PMID- 1773206 TI - An initial investigation into the equivalence of the metal and plastic-cased TDH39 earphones. AB - Since the adoption of the Telephonics TDH39 pattern of earphone as the main audiometric earphone in use in Britain and elsewhere, there have been a number of superficial changes in its design. The most significant change was around 1980 when the metal-cased design was replaced by a plastic-cased version: the TDH39P. At that time it was assumed that the new earphone was equivalent to the metal cased version since both types of earphone exhibited similar frequency responses as measured on the IEC 303 acoustic coupler. However, it has been found, through measurements taken during the course of routine audiometer calibration, that the two types of earphone appear to exhibit a significant difference in the measured SPL at 6 kHz when they are compared using an IEC 318 wide-band artificial ear. PMID- 1773207 TI - The future of psychotherapy. AB - Psychotherapy, once the dominant vehicle of psychiatric care, and still the most distinctive aspect of the psychiatric therapeutic armamentarium, is rapidly becoming an endangered species within psychiatry. The author reviews the decline in psychotherapy training since World War II. In the immediate decades following the war, as many as 3,000 hours (50%) of the 3-year residency training program were devoted to the learning and practice of psychoanalytic psychotherapy, under close supervision. The current situation is totally transformed from that earlier period, as psychiatry has grown and diversified with the explosive rise of neurobiology (especially in the areas of molecular biology and molecular genetics), clinical psychopharmacology, competing psychological paradigms (behavioral, family, and social systems) and their therapeutic applications, and community psychiatry, with its preventive, crisis-oriented, and epidemiological approaches. Today, various authoritative bodies recommend as little as 200 hours (2 1/2%) of psychotherapy training out of the 8,000 hours of the current 4-year residency program. The author explores the implications of this significant reduction in psychotherapy training. PMID- 1773208 TI - Effects of extended hospitalization: a one-year follow-up study. AB - The C. F. Menninger Memorial Hospital is conducting an ongoing follow-up study of the effects of extended hospitalization. The authors report key indicators of outcome at one year postdischarge for 110 patients hospitalized on extended care units for at least 180 days. Outcome is determined by postdischarge rates of rehospitalization, postdischarge suicide attempts, and occupational functioning at the time of the one-year follow-up interview. After comparing these areas with preadmission levels of symptomatology and functioning, the authors report significant improvement in each category at the time of follow-up. PMID- 1773209 TI - Mothers' mental representations and their relationship to mother-infant attachment. AB - The association between the constructs of mental representation posited by object relations theory and attachment theory was studied through an assessment of adolescent mothers' mental representations and their infants' security of attachment. Forty-two pregnant adolescents were given the Adult Attachment Interview (George, Kaplan, & Main, 1985) to assess their modes of attachment, and the Krohn Object Representation Scale for Dreams (Krohn & Mayman, 1974) to assess object-representations. When the 42 infants were 15 months old, they were videotaped in the Strange Situation (Ainsworth, Blehar, Waters, & Wall, 1978) with their mothers. Subjects were primarily low-income African-American and Hispanic mothers and infants. As measured by the significant association between classifications on the Adult Attachment Interview and the Krohn scale (p less than .001), the adolescents' attachment and object-representations were highly related. Both attachment and object relations were also significantly related to infant attachment (p less than .001 and p less than .01, respectively). Results suggest that the concepts of mental representation proposed by object relations theory and attachment theory overlap and that mothers' mental representations have heuristic value in predicting mother-infant attachment. PMID- 1773210 TI - The transformation of affect in posttraumatic nightmares. AB - The author questions the classical psychoanalytic assumptions that anxiety in posttraumatic nightmares arises from the same conflict represented in the manifest content of the nightmare, that such nightmares have no latent content, and that the day residue is insignificant. Such assumptions obscure the function of these nightmares, in which the dreamwork transforms shame into fear. Case material from two patients highlights the instigating role of posttraumatic dissociative states and shame in the day residue of posttraumatic nightmare sufferers. The author also emphasizes that conflict in the latent dream thoughts differs from that represented in the manifest content. PMID- 1773211 TI - Elective mutism: origins in stranger anxiety and selective attention. AB - Through a focus on the events of early infancy, the author interprets elective mutism on the basis of the infant's responses to discrepancies from expected stimuli. Initially, the child's silence derives from a "freezing" of action when exposed to perceived danger. Subsequently, aberrant or fearful stimuli are minimized by the child's apparent unresponsiveness. Through identification with the parent, the child imbues elective mutism with information value as a pause to signal impending communication. Mutism later represents an identification that is displaced from the parent to "stranger" adults. PMID- 1773212 TI - Developmental aspects of the primary process. AB - The structural-developmental view of primary process initially proposed by Holt (1967) defines primary process as a special system of processing information in the service of "synthetic necessity." Rather than being an archaic, chaotic mode of ideation, primary process follows an independent line of development with specific organizational and synthesizing properties. Vignettes from three phases of the treatment of a severely disturbed child provide clinical evidence to support this viewpoint. PMID- 1773213 TI - Transactions of the Topeka Psychoanalytic Society. PMID- 1773214 TI - An orthodontic evaluation of 16-year-old males with an original complete unilateral cleft lip and palate problem repaired during the neonatal period. AB - A cephalometric analysis is presented of a group of 21 16-year-old males born with complete unilateral clefts of lip and palate with surgical repair carried out in the neonatal period. Comparisons are made with the multicentre study reported by Ross (1987). The study demonstrates that the effect of early surgery on facial growth is similar to that of the average of the multicentre study. PMID- 1773215 TI - Nasal symmetry: a 10-year comparison between the Pigott and McComb nasal correction. AB - The objective assessment of the symmetry of the cleft lip nose has not been properly evaluated. A simple technique using enlarged photographs and area assessment is described. Two different techniques were assessed, the Pigott "alar leapfrog" technique and the McComb alar lift technique. The children were assessed at 10 years of age. The results show no differences in the linear measurements or when the symmetry is assessed in the frontal view. In the worm's eye view, the Pigott correction was shown to produce a more asymmetric nose when compared with the McComb technique. Both corrections produce significant asymmetry when compared with a control group. PMID- 1773216 TI - Reconstruction of short nose deformity using nasolabial flaps pedicled on the infraorbital vessels. AB - Bilateral nasolabial flaps pedicled on the infraorbital vessels, and costal cartilage grafts were used to reconstruct a severe nasal deformity caused by Wegener's granuloma. We believe this flap is another useful method for nasal reconstruction, when nasolabial flaps pedicled on the angular vessels cannot be used. PMID- 1773217 TI - Reconstruction of a completely burned nose by a free dorsalis pedis flap. AB - A 25-year-old female with a scarred and contracted nose following burns, because the upper limbs could not be used as donor areas, had a free dorsalis pedis flap used to reconstruct the nose 18 months post-burn. The case is reported and the literature reviewed. PMID- 1773218 TI - A new approach for the refinement of the very broad nasal tip. AB - Refining the very broad nasal tip has been difficult to achieve with a single technique. Operations described often violate the domes and may result in visible irregularities and collapse of the ala. Adequate narrowing can be obtained by decreasing the angle between medial and lateral crura of the ala cartilage at the dome and decreasing the overall length of the ala cartilage. This narrowing is achieved predictably by removing a small segment at the lateral most part of the ala cartilage. Scoring of the dome can also be done. We describe the technique in a large series of patients, all of whom have retained their results without undesirable problems. PMID- 1773219 TI - Repair of "coup de sabre" with tissue expander. AB - Two cases of coup de sabre, a linear form of scleroderma, treated by means of tissue expansion, are discussed. Expanded skin flaps on the scalp and forehead provided sufficient skin and tissue for closure of the defect after resection of the defect, and good results were obtained. PMID- 1773220 TI - Hyaluronan and wound healing: a new perspective. AB - Hyaluronan has long been associated with the remodelling extracellular matrix. Such remodelling occurs in development, growth and wound healing. This role has been thought to be related to the physical structure and chemical composition of the pure glycosaminoglycan chain. We question this proposition and present evidence which suggests that proteins associated with hyaluronan may be more critical determinants of tissue remodelling. PMID- 1773221 TI - Cause of closed suction drainage tube obstruction and its prevention using a tube coated on the inside with a silicone gel drug delivery system. AB - In experimental and clinical studies we showed that obstruction of closed suction drainage tubes is often caused by clots. To prevent this we describe a tube coated on the inside with a silicone gel drug delivery system, which releases anticoagulant drugs. It prevents coagulation and liquefies blood clots present in the tube. This device should thus find application as a tube for continuous suction drainage systems. PMID- 1773222 TI - The very long posterior tibial artery island flap. AB - Limb salvage procedures utilising tissue which would otherwise be discarded have become a well established practice in the management of trauma. These principles may also be utilised in the treatment of the burn injury. Two patients are presented with severe burns to the lower limbs involving muscle and bone where above knee amputation seemed inevitable. Salvage of the knee joint and conversion to a below knee amputation has been made possible by utilising the remaining skin of the sole of the foot based on a very long posterior tibial neurovascular pedicle ("Fillet of Sole" flap). This has provided full thickness sensate skin over the knee joint and below knee stump and has led to improved functional performance of the patient. PMID- 1773223 TI - Two unusual cases of distal interphalangeal joint Dupuytren's contracture. AB - Following trauma, two Caucasian males presented with Dupuytren's contracture affecting the distal interphalangeal joint of the little finger and extending onto the dorsum of the digit to insert into the nail bed. Complete excision of the cords and appropriate physiotherapy helped the patients achieve excellent postoperative results. PMID- 1773224 TI - Computed tomography in the preoperative assessment of Poland's syndrome. AB - Four cases of Poland's syndrome were investigated with thoracic computed tomography (CT) to determine the precise extent of the upper limb girdle abnormalities. CT confirmed in all cases the absence of the sternocostal head of pectoralis major and clearly showed associated abnormalities of pectoralis minor, serratus anterior and latissimus dorsi as well as bony structures. In view of the importance of latissimus dorsi in reconstructive surgery, we believe that a limited thoracic CT scan provides useful information in patients with Poland's syndrome requesting anterior axillary reconstruction and breast mound formation. PMID- 1773225 TI - The use of intermingled autograft and parental allograft skin in the treatment of major burns in children. AB - Large burns continue to pose the problem of providing sufficient autologous skin cover. The experience of this unit using cultured keratinocytes as a substitute for split-skin grafts has been disappointing; at the same time, we have been obliged to abandon human allograft skin from cadavers and other patients because of the possibility of infection with HIV. Our favoured method for resurfacing large-area burns in children is to use widely meshed autologous skin overlaid with meshed allograft from a parent (to minimise the risk of HIV transmission). We report our experience using this technique in 10 children. The fate of the intermingled grafts has been followed clinically, and in some cases histologically and by Y-chromosome identification. There has generally been long term persistence of the parental skin without rejection, and allograft dermis appears to contribute to the final cover. Evidence suggests, however, that cellular elements of the parental skin do not survive. PMID- 1773226 TI - A comparison of the use of polythene sheet and Jelonet as temporary dressings for excised wounds. AB - This paper reports our experience of the use of polythene sheet as a temporary dressing for excised wounds. A prospective randomised double-blind trial was conducted to see whether or not polythene dressing was less painful to remove than our traditional dressing of Jelonet. Polythene was found to be less painful (p less than 0.01). Other advantages of the use of polythene are presented. PMID- 1773227 TI - Carbon fibre pad insertion as a method of achieving soft tissue augmentation in order to reduce the liability to pressure sore development in the spinal injury patient. AB - Twenty patients at the Northern Regional Spinal Injury Unit received carbon fibre implants inserted into the sites of previously closed pressure sores or threatened pressure sores. The most common site was over the ischium, but some have also been inserted at the trochanteric area, the sacral area and also over bony protuberances of the leg. Seven implants from four patients had to be removed because of damage or infection. Sixteen patients with 18 implants have proceeded with no recurrence for a period of 4-8 years. PMID- 1773228 TI - Metastatic squamous cell carcinoma presenting as cellulitis. AB - A metachronous skeletal muscle secondary from a primary squamous cell carcinoma on the back of the hand manifested as an area of cellulitis of the forearm. Such clinical behaviour does not appear to have been previously described. PMID- 1773229 TI - Uvulopalatorrhaphy in a case of obstructive sleep apnoea. AB - A reversible uvulopalatorrhaphy is reported in a case of obstructive sleep apnoea. The patient had an abnormally long uvula but no skeletal abnormality. PMID- 1773230 TI - A new technique for harvesting calvarial bone. PMID- 1773231 TI - Ptosis of the ear. PMID- 1773232 TI - Breast hypoplasia. PMID- 1773233 TI - Infant psychiatry: its relevance for the general psychiatrist. AB - The study of infancy can provide us with new models for the genesis and treatment of psychiatric disorders. It allows us to observe development and can elucidate the contribution the internal and external world make to mental health and disorder. It can also help to define and describe developmental pathways which may be instrumental in creating a resilient or vulnerable adult. PMID- 1773234 TI - The construction and selection of predictive scales, with special reference to parasuicide. AB - Issues concerning the use of predictive and screening instruments include the difficulties posed by temporal changes in the base rates for the behaviour of interest, the possible advantages of using three rather than the customary two risk categories, and the desirability of specifying in advance the proportional sizes of the risk subgroups. A method is proposed for constructing and assessing tripartite risk scales, and a new scale for predicting the repetition of parasuicide, with the results of a prospective validation study, is reported. PMID- 1773235 TI - The diagnosis of dementia in the elderly. A comparison of CAMCOG (the cognitive section of CAMDEX), the AGECAT program, DSM-III, the Mini-Mental State Examination and some short rating scales. AB - The performance of CAMCOG, the cognitive section of the CAMDEX, is compared in a non-random sample of 222 elderly people with diagnoses based on AGECAT and on DSM III criteria, and with the MMSE and some short rating scales. With a cut-off point of 69/70 and AGECAT organic syndrome as the criterion, the sensitivity of CAMCOG was 97% and the specificity 91%. However, 21% of DSM-III diagnoses of dementia scored above this cut-off; these were mostly mild cases. The correlation between CAMCOG and MMSE scores was 0.87, and the advantage of CAMCOG may be more apparent in longitudinal studies. Multivariate analyses showed that CAMCOG scores are affected by age, sociocultural factors and hearing and visual deficits in addition to dementia, but not by depression. There was a suggestion that individual subsections are differentially affected. PMID- 1773236 TI - Heavy drinking as a risk factor for depression and dementia in elderly men. Findings from the Liverpool longitudinal community study. AB - A random community sample of subjects aged 65 and over was re-interviewed after three years by psychiatrists using the GMS and HAS. The relationship between drinking history and current psychiatric morbidity was examined. Men with a history of heavy drinking for five years or more at some time in their lives were found to have a greater than fivefold risk of suffering from a psychiatric disorder at the time of the interview. Among this group past alcohol consumption was significantly higher for those with a current psychiatric diagnosis compared with those who were well. This association between heavy alcohol consumption in earlier years and psychiatric morbidity in later life is not explained by current drinking habits. PMID- 1773237 TI - Effects of substance abuse on ventricular and sulcal measures assessed by computerised tomography. AB - Computerised tomography (CT) was used to assess the possible effects of substance abuse on brain morphology. Polydrug abusers had significantly wider third ventricles than normal controls, with a positive correlation between age and ventricle:brain ratio (VBR). Assuming no effect of age, estimated quantity of substance abuse was not significantly related to ventricular and sulcal measures, except that alcohol consumption correlated positively with VBR and severity of cocaine use correlated negatively with sulcal width. When age of the subjects was partialled out, alcohol use showed a tendency for association with VBR; however, severity of cocaine use did not remain a significant predictor of cortical sulcal width. The findings suggest that chronic use of alcohol, but not necessarily of other commonly abused substances, produces brain atrophy. PMID- 1773238 TI - Psychosis in migrants from the Indian subcontinent and English-born controls. A preliminary study on the use of psychiatric services. AB - A cohort of first-generation Asian immigrants who received a diagnosis of a functional psychosis at the Bethlem Royal and Maudsley Hospitals were compared with an English-born control group. The Asians were found to have spent a lower total percentage of time in the two hospitals, had fewer in-patient admissions per year, and had a shorter average duration of stay in hospital than the matched controls. PMID- 1773239 TI - Suicidal ideation as a presenting complaint. Associated diagnoses and characteristics in a casualty population. AB - A prospective study was conducted of all referrals to the emergency psychiatric service of an inner-London hospital over one year. There were 53 individuals who presented with the specific and spontaneous complaint of suicidal ideation without any accompanying act of self-harm. The main diagnoses in this group were personality disorders (40%) and alcohol dependence (15%); only 13% were suffering from depressive illness. Members of the group differed from the other 369 presenters to the service in that they were less likely to be accorded a diagnosis of a defined mental illness, twice as likely to have a criminal record, and more likely to have a previous history of deliberate self-harm. A quarter of the suicidal complainants were admitted to hospital following assessment. PMID- 1773240 TI - Social adjustment of remitted bipolar and unipolar out-patients. A comparison with age- and sex-matched controls. AB - Various areas of social adjustment were compared using the Social Adjustment Scale in 27 remitted bipolars, 24 remitted unipolars and 25 normal controls matched for age and sex. Scores for global adjustment and for social and leisure activities were significantly worse in patients than in controls. The maladjustment in social and leisure activities appeared only in 'contact with friends' for bipolar patients and 'diminished social interactions' for unipolar patients. Unipolar patients differed significantly from controls on the items investigating sexual adjustment. In unipolars, social maladjustment seemed to be independent of the course of the disease; in bipolars, it was partly related to the mean number of lifetime episodes and current residual symptoms. PMID- 1773241 TI - The COSTAR programme. 1: Improving social networks of the long-term mentally ill. AB - The present study examined the socio-demographic, clinical, cognitive, social behaviour and social network characteristics of the 97 patients in contact with the COSTAR programme--a mobile treatment and case management service for the long term mentally ill in inner-city Baltimore. Compared with shorter-contact patients, those in contact for more than one year showed no change in symptoms, or in cognitive or global function. They did manifest improved social function, especially for slowness, personal hygiene and posturing. The long-contact group showed improvements in the quality and quantity of their social networks. Our results suggest that a home-based treatment system can help patients to reverse a vicious cycle of social isolation and to establish supportive social contacts. PMID- 1773242 TI - A comparison of nutritional management with stress management in the treatment of bulimia nervosa. AB - In a comparison of nutritional management (NM) and stress management (SM) for treatment of bulimia nervosa, 55 female patients were randomly assigned to either treatment. Therapy consisted of 15 sessions in a group over three months, by the end of which, patients under both treatment conditions showed a significant reduction in the frequency of binge eating and vomiting and a significant improvement in various psychopathological features such as body dissatisfaction and depression. All improvements were maintained over 12-month follow-up NM produced a more rapid improvement in general eating behaviour, a faster reduction in binge frequency and a higher abstinence rate from binge eating. SM led to greater positive changes in certain psychopathological features such as feelings of ineffectiveness, interpersonal distrust and anxiety. NM should be regarded as a necessary first intervention in all bulimic patients. Further psychological therapy, such as SM, is indicated as well for some patients, depending on their specific psychological difficulties. PMID- 1773243 TI - Neuroendocrine challenge studies in puerperal psychoses. Dexamethasone suppression and TRH stimulation. AB - Subjects admitted to hospital with post-partum psychoses were compared with matched normal post-partum controls using two neuroendocrine challenge tests: dexamethasone suppression of cortisol and TRH stimulation of TSH. Post dexamethasone cortisol levels were significantly elevated. There were less-clear hints of blunting of TSH response. In the small samples there was no obvious association of abnormalities with any particular diagnoses within the range of mania, psychotic depression and schizoaffective disorders. PMID- 1773244 TI - Schizophrenia and affective disorder: are they genetically linked? AB - The relationship between schizophrenic 'spectrum' disorders and affective illness was studied in the nuclear families of 90 chronic schizophrenic probands. An increased risk of schizophrenia and related disorders was demonstrated among the first-degree relatives of probands with a family history of major affective disorders. Conversely, relatives of probands with a family history of schizophrenic 'spectrum' disorders were at a greater risk of affective illness (major depression) than relatives of probands with no family history. These results lend support to the notion that a subset of affective disorders is associated with the liability to schizophrenia. PMID- 1773245 TI - Enhancement of recovery from psychiatric illness by methylfolate. AB - "41 (33%) of 123 patients with acute psychiatric disorders (DSM III diagnosis of major depression or schizophrenia) had borderline or definite folate deficiency (red-cell folate below 200 micrograms/l) and took part in a double-blind, placebo controlled trial of methylfolate, 15 mg daily, for 6 months in addition to standard psychotropic treatment. Among both depressed and schizophrenic patients methylfolate significantly improved clinical and social recovery. The differences in outcome scores between methylfolate and placebo groups became greater with time. These findings add to the evidence implicating disturbances of methylation in the nervous system in the biology of some forms of mental illness." PMID- 1773246 TI - Obsessive slowness revisited. AB - Of 665 patients referred between 1969 and 1984 for behavioural treatment of obsessive-compulsive disorder, 22 had marked slowness not due to washing, which was secondary to mental or overt rituals or ruminations. Over 90% of the slowness cases were male, and over a quarter had pre-natal or delivery problems. PMID- 1773248 TI - Secondary mania after open-heart surgery. PMID- 1773247 TI - Rapid-cycling manic-depressive illness following subarachnoid haemorrhage. AB - The case of a young man who developed a remarkably regular and rapid cyclical affective illness following a subarachnoid haemorrhage is reported. A CT scan showed damage restricted to the brain-stem. The illness proved resistant to a variety of agents; carbamazepine and lithium combined proved effective. PMID- 1773249 TI - An unusual monosymptomatic hypochondriacal delusion presenting as self-insertion of a foreign body into the urethra. AB - The case of a middle-aged man who inserted a knitting needle into his urethra is described. This behaviour was associated with a monosymptomatic hypochondriacal delusion. The causes of such behaviour are discussed, together with the nosological status of monosymptomatic hypochondriacal psychosis. PMID- 1773250 TI - Delusion of pregnancy in schizophrenia. PMID- 1773251 TI - Spousal allegations of incest during transient psychotic episodes. AB - Two patients with transient psychotic episodes made false allegations of sexual abuse concerning their spouses. In both cases, these charges were withdrawn by the individuals upon resolution of the psychosis. PMID- 1773252 TI - New genetic model of schizophrenia. PMID- 1773254 TI - Transmissible dementias. PMID- 1773253 TI - Sibling sex and bulimia nervosa. PMID- 1773255 TI - The Yates' correction factor in chi-squared analyses. PMID- 1773256 TI - The strength of association. PMID- 1773257 TI - Reading about transcultural psychiatry. PMID- 1773258 TI - Early cortical tactile-evoked potentials, laterality and schizophrenia. PMID- 1773259 TI - Clozapine in patients with NMS. PMID- 1773260 TI - Outcome indicators in mental handicap. PMID- 1773261 TI - Census-derived measures and planning. PMID- 1773262 TI - Screening of admissions to accident and emergency. PMID- 1773263 TI - Anorexia nervosa in the elderly. PMID- 1773265 TI - Advances in basic science: have they benefited patients with cancer? PMID- 1773264 TI - Buspirone-induced mania: possible interaction with disulfiram. PMID- 1773266 TI - Sonographic evaluation of the parotid ducts: its use in tumour localization. AB - The previously unreported sonographic anatomy of the intraglandular parotid ducts is described, and how this aids tumour localization is illustrated. Forty patients underwent ultrasonography and computed tomography (CT) sialography for the evaluation of parotid tumours. Ultrasound identified two extra unsuspected 5 mm tumours in the superficial lobe, which could not be seen at CT. Both techniques produced similar results for deep and mixed lobe lesions. Ultrasound had one false positive mixed lesion, which surgery subsequently found to be confined to the deep lobe. The full extent of invasion in three deep lobe tumours was revealed only by CT to be parotid invasion by nasopharyngeal carcinomas. We conclude that parotid sonography with reference to the intraglandular ducts is highly accurate in localizing parotid tumours and should probably be the first line imaging technique. Computed tomography should only be necessary for visualization of deep lobe tumour extent and in those cases where the complete tumour boundary cannot be seen by ultrasound alone. PMID- 1773267 TI - The radiological (CT) and clinical sequelae of primary intracerebral haemorrhage. AB - To determine the radiological and clinical outcome of primary intracerebral haemorrhage, a prospective study was carried out involving computed tomography (CT) of 388 consecutive Chinese patients admitted with acute stroke to a large public hospital in Hong Kong. Further CT and functional assessment were performed 3 months later in 71% of survivors. The patients were admitted over a 6 month period. 120 (31%) were found to have had presumed primary intracerebral haemorrhage. Of these, 64 patients (53%) died within 3 months. From 40 of the 56 survivors who returned for a follow-up study at 3 months, 30 were functionally independent and five mildly disabled; only five were significantly disabled. Follow-up CT showed no residual lesion in 27%, low attenuation areas in 37%, slit like lesions in 25% and calcification in 10% of patients. The size of residual lesions correlated statistically with the degree of residual disability, although the association was not close. It is concluded that primary intracerebral haemorrhage accounts for a high percentage of strokes among Hong Kong Chinese with more than half of the patients dying within 3 months. Many survivors, in whom follow-up CT appearances are variable, show good functional recovery. PMID- 1773268 TI - The chest X ray in Q-fever: a report on 69 cases from the 1989 West Midlands outbreak. AB - Acute and serial chest radiographic appearances of Q-fever in a large UK outbreak in the West Midlands are described. In 69 acute films (taken within 20 days of onset of illness), 10% of films were normal. Appearances in 62 abnormal films were varied and, in contrast to some previous reports, showed no features that might distinguish Q-fever pneumonia from pneumonias of other origins. Analysis of serial films in 47 cases showed that complete radiographic resolution frequently took up to 6 months, longer than has been described previously. Initial appearances deteriorated over the first 2 weeks of radiographic surveillance in 20% of cases. No relationship was found between the extent of radiographic change and the age of the patient or the presence or absence of respiratory symptoms. Age did not affect time to resolution. PMID- 1773269 TI - The value of repeated chest radiographs in the follow-up of patients with germ cell testicular tumours. AB - Patients with germ cell testicular tumours customarily have repeated follow-up chest radiographs after treatment. This study assesses the contribution of chest radiography to the detection of recurrent disease in 162 patients. Six patients developed an intrathoracic recurrence, but in only one case was the chest radiography the only indication of recurrence. Five had other evidence to suggest recurrence, such as raised serum markers or palpable masses. The yield from follow-up chest radiographs in patients with germ cell testicular tumours is very low and their use must be balanced against both the harmful effects of radiation and the financial cost. PMID- 1773270 TI - Chronic stress injuries of the elbow in young gymnasts. AB - The radiological changes of chronic stress injuries of the elbow in 19 adolescent elite gymnasts are reported. The principal abnormalities were avascular necrosis of the capitellar epiphysis (Panner's disease) (one patient), post-traumatic subarticular necrosis (osteochondritis dissecans) of the capitellum (six patients) and the medial articular eminence of the distal humerus (one patient). Flattening and anterior depression of the radial head epiphysis with an underlying metaphyseal notch associated with an epiphyseal cleft (three patients), which, in one patient who continued training, developed into a chronic Salter Type IV stress fracture. A further patient, post-epiphyseal fusion, showed osteochondritis dissecans of the anterior aspect of the radial head. Seven patients exhibited a spectrum of olecranon changes from fragmentation of the epiphysis to chronic Salter Type I stress fractures of the growth plate. A follow up survey found that, of those who responded to a questionnaire, nearly all the patients with articular surface damage failed to continue with competitive gymnastics whereas those with olecranon abnormalities were able to continue gymnastics at the same level. The mechanism of injury and the pathological changes are discussed. PMID- 1773271 TI - Quantitative lymphoscintigraphy using 99Tcm human serum albumin in patients with previously treated uterine cancer. AB - To evaluate the clinical usefulness of lymphoscintigraphy using 99Tcm human serum albumin (99Tc-HSA) in assessing lymphoedema in the lower extremities, lymphoscintigraphy was performed by subcutaneous injection of 7.4 MBq of 99Tcm HSA in 26 patients with uterine cancer, previously treated by operation (OP) and/or radiation therapy (RT), and in five controls. Radioactivity at the injection site in the lower extremities was counted for 3 min at 10 min (A) and at 3 h (B) after injection, and clearance of 99Tcm-HSA was defined as (1-(B)/(A)) x 100(%). Clearance in controls was 46.8 +/- 3.9%, which was significantly more than those in the other treatment groups. Clearances in patients treated with both OP and RT were less than those in patients treated with either OP or RT alone (30.1 +/- 11.4 vs. 41.9 +/- 8.9, 43.7 +/- 9.6%, respectively; p less than 0.01). The clearance in legs with lymphoedema was less than those without lymphoedema in patients treated with both OP and RT (16.6 +/- 7.7 vs. 34.9 +/- 9.3%; p less than 0.01) and in patients treated with RT (33.1 +/- 7.4 vs. 48.0 +/ 5.6%; p less than 0.01). There was a significant difference between clearance in controls and clearance in non-oedematous patients' legs treated with OP and RT (p less than 0.01). In patients treated with RT alone, radiation dose was closely correlated with 99Tcm-HSA clearance and with the development of lymphoedema. These data suggest that lymphoscintigraphy using 99Tcm-HSA is useful in evaluating lymphoedema and that radiation dose is one of the factors in the development of lymphoedema. PMID- 1773272 TI - Normal tissue reactions in the British Institute of Radiology Study of 3 fractions per week versus 5 fractions per week in the treatment of carcinoma of the laryngo-pharynx by radiotherapy. AB - The radiobiological data obtained from a multicentre clinical trial of the British Institute of Radiology, which compared the treatment of carcinoma of the laryngo-pharynx by 3 fractions per week (3F/wk) with 5 fractions per week (5F/wk) radiotherapy, have been studied. The trial involved an intake of 734 patients between 1966 and 1975. The number of fractions, overall treatment time and total doses used by different treatment centres ranges from 9 to 40 fractions, 18 to 70 days and 3880 to 7800 cGy, respectively. An 11-13% reduction in the total radiation dose was applied for treatments with 3F/wk as compared with 5F/wk in centres treating over 6 weeks and 3 weeks, respectively. All patients were followed for 10 years from the start of treatment. Different types of early and late normal-tissue reactions were investigated, ranging from a low percentage incidence of perichondritis to 95% for slight early reactions. Greater than 80% of the late normal-tissue reactions seen were observed within the first year after the start of treatment, and 96% were observed within the first 5 years. There was no statistically significant difference in the normal-tissue event-free rates between the 3F/wk and 5F/wk treatment groups. This finding did not differ when different major treatment centres were studied separately. For a number of end-points, alpha/beta ratios and N- and T-exponents of a modified nominal standard dose (NSD) formula have been calculated. PMID- 1773274 TI - Radical radiotherapy for 28 cases of mucosal melanoma in the nasal cavity and sinuses. AB - Mucosal melanoma is rare and is traditionally treated by radical surgery. A retrospective survey was made of 28 cases of malignant mucosal melanoma of the nasal cavity and paranasal sinuses treated by definitive radiotherapy. Initial complete regression was observed in 22 out of 28 cases (79%). Absolute local control by radiotherapy alone was achieved in 17 out of 28 cases (61%) but follow up was limited in many cases by early death due to metastatic disease; actuarial local disease-free survival was 49% at 3 years. The approach of radical radiotherapy for melanoma of this site can be justified on the basis of the local control achieved, low treatment morbidity in patients who are typically elderly and the propensity to disseminated disease. Doses of radiotherapy required to achieve local control need to be radical; the influence of dose per fraction is uncertain. PMID- 1773273 TI - Time-related changes in lymphatic clearance in pig skin after a single dose of 18 Gy of X rays. AB - The early and late effects of X rays on lymphatic microcirculatory function have been investigated in pig skin. Paired estimates of lymph clearance were performed in irradiated and unirradiated sites on the flank skin of anaesthetized Large White pigs at 3, 6, 9, 12, 26, 39, 52, 64 and 78 weeks after a single dose of 18 Gy of X rays. The dermal clearance of 99Tcm-colloid was used to assess lymph flow. The results demonstrated two waves of impaired lymphatic clearance which correlated well with the gross morphological changes observed. The first wave occurred between 6 and 12 weeks after irradiation and corresponded to a period of ischaemia and oedema. The second wave, at 52 weeks, corresponded with dermal thinning and subcutaneous atrophy. X irradiation resulted in an impairment of lymph drainage both within and outside the field of irradiation. Impaired lymphatic drainage probably contributes to the gross and histological changes observed in the skin after X irradiation. PMID- 1773275 TI - Attempting to increase the sensitivity of the plain film for ureteric calculi; use of the full bladder. PMID- 1773276 TI - Spontaneous fracture of the wire tip during breast localization. PMID- 1773277 TI - Afferent loop obstruction diagnosed by sonography and computed tomography. PMID- 1773278 TI - Scintigraphic detection of abdominal hernias associated with continuous ambulatory peritoneal dialysis. PMID- 1773279 TI - Spontaneous disappearance of a staghorn calculus. PMID- 1773280 TI - Mistaken identity of a neck mass. PMID- 1773281 TI - Fractionated high dose rate versus low dose rate cervix cancer regimens. PMID- 1773282 TI - Informed consent--issues for the 1990s. PMID- 1773284 TI - Idiopathic kidney stone formation--where and why? AB - An attempt was made to analyse where and why stone formation in the kidney starts. For this purpose specific electrical conductivity (SEC) of the serum and urine of the same individual in 50 cases of stone formers (Group I) and 50 controls (Group II) was measured. The mean serum value of SEC at 37 degrees C and 50 Hz in mu mho/cm of Group I was 1.23 x 10(4), while that of Group II was 1.20 x 10(4). This was not statistically significant. However, urinary SEC values did differ significantly between the 2 groups. An analysis of observations reveals that in the case of stone formers there is a fault in the solute transfer system in the kidney at the membrane level (urothelium). PMID- 1773283 TI - Does further extracorporeal lithotripsy promote clearance of small residual fragments? AB - Small persistent fragments (less than or equal to 4 mm) following extracorporeal shock wave lithotripsy have been termed clinically insignificant residual fragments (CIRF), but their presence may be associated with an increased rate of development of recurrent symptomatic renal calculi. We have adopted a policy of further extracorporeal piezoelectric shock wave lithotripsy (EPL) for patients with CIRF in an attempt to promote complete clearance. A series of 22 patients with a mean initial stone burden of 16 mm (range 7-48) developed CIRF after a median of 2 EPL treatment sessions (range 1-9). CIRF were in the lower calices (n = 20), middle calices (n = 1) and upper calices (n = 1). These calices were normal (n = 6), slightly dilated (n = 9), moderately dilated (n = 2) or grossly dilated (n = 5). After 6 to 14 months, patients underwent a further session of EPL. One month later, 3 patients with normal calices showed a considerable reduction in CIRF, but all other patients showed no change. When CIRF form in normal calices a further session of EPL may promote clearance. However, when calices containing CIRF are significantly dilated, further EPL is of no value. PMID- 1773285 TI - Magnetic resonance imaging of renal carcinoma with extension into the vena cava: staging accuracy and recent advances. AB - In 16 patients with surgical confirmation of inferior vena cava thrombi from renal carcinoma, magnetic resonance imaging (MRI) and computed tomography (CT) were compared to assess the ability of non-invasive, cross-sectional imaging techniques to detect tumour thrombus, the level of its extension, and vessel wall invasion. MRI accurately detected tumour thrombus in the inferior vena cava in all 16 cases (CT in 14) and demonstrated the cephalad extent of tumour thrombi in 15 of 16 (CT in 11). The level of extension was more easily seen on MRI, as was the presence of extension into the hepatic veins--a finding not detected by CT. Tumour invasion of the wall of the inferior vena cava was correctly demonstrated in 7 cases on MRI and in 1 case on CT. In 8 of 16 patients, gradient recall acquisition in steady state (GRASS imaging) was performed in addition to conventional spin echo sequences and it correctly identified the composition of thrombus in all: tumour in 6 patients, blood clot in 1 and both tumour and blood clot in the remaining patient. MRI and CT are excellent for detection of tumour but MRI is superior in the evaluation of vascular extension. In addition, the use of GRASS imaging allows differentiation of tumour from blood thrombus. PMID- 1773286 TI - 15-Hydroxyprostaglandin dehydrogenase activity in the lower genitourinary tract. A preliminary report. AB - In the pathway of prostaglandin inactivation, 15-hydroxyprostaglandin dehydrogenase (15-OHPGDH) has been proven to be the catalyst of the primary catabolic step in the oxidation of the 15-hydroxyl group into a 15-keto moiety in most derivatives of prostaglandins. In this study, we analysed 15-OHPGDH activity in the lower genitourinary tract. The specimens were obtained with permission from patients who underwent surgery. These specimens were then sent for quantitative determination using a tritium release assay specific for 15-OHPGDH. The highest enzyme activity was found in the ureter with a mean +/- SE (pmol/min/mg) of 94.99 +/- 51.00; the lowest activity was in the vas deferens, with a value of 0.18 +/- 0.21. This preliminary study indicated that the activity of 15-OHPGDH in the lower genitourinary tract was significant and that prostaglandin levels in the genitourinary tract may be regulated by this enzyme. PMID- 1773287 TI - Bilharzial vesicoureteric reflux and bladder neck stenosis: fact or fiction? AB - A group of 47 patients with histologically confirmed chronic urinary bilharziasis underwent micturating cystourethrography to look for vesicoureteric reflux (VUR) and bladder neck stenosis (BNS); 13 patients were found to have VUR of varying grades (8 unilateral and 5 bilateral). None had evidence of BNS. Urinary tract infection (UTI), loin pain, hydroureter and renal failure were compared in patients with and without VUR. Of the 13 patients with reflux, 3 had UTI, loin pain was present in 8, 11 had an ipsilateral hydroureter and 2 presented with renal failure. In the 34 patients without reflux, 8 had UTI, loin pain was present in 22, 30 had hydroureter and 3 presented with renal failure. It was concluded that the incidence of UTI, loin pain, hydroureter and renal deterioration associated with bilharzial VUR was not significantly different from that found in bilharzial patients without VUR. Thus the clinical significance and the need for surgical correction of isolated VUR in bilharziasis are questionable. PMID- 1773288 TI - Para-urethral collagen implantation for female stress incontinence. AB - A series of 25 women with genuine stress incontinence were treated by para urethral injection of glutaraldehyde cross-linked collagen. The technique was simple and associated with few complications. Follow-up at 3 months revealed 20 patients (80%) to have been symptomatically improved or cured. An increase in urethral closure pressure together with a decrease in urine flow rate and increase in detrusor pressure was found post-operatively. The success rate was significantly higher (90%) in patients who had undergone previous surgery for urinary incontinence when compared with those who had had no previous surgery (73%). PMID- 1773290 TI - The neurourology of tropical spastic paraparesis. AB - We report the clinical features, urodynamic results and neurophysiological findings in 6 patients with urinary symptoms related to tropical spastic paraplegia. The widespread nature of the pathological changes within the nervous system result in a complex variety of urodynamic and neurophysiological features. PMID- 1773289 TI - Bladder augmentation and replacement. Urodynamic and clinical review of 25 patients. AB - Bladder augmentation has a role in the management of patients with neuropathic bladder dysfunction and in urinary undiversion. Several reports attest to its clinical value, but there have been few detailed urodynamic studies of its effects. We have carried out a prospective review over a 4-year period of 25 patients undergoing bladder augmentation or substitution assessed by conventional and ambulatory urodynamic studies. All patients had a detubularised reservoir made of ileum in 6, and of the ileocaecal segment in the remainder. Six patients also had an artificial sphincter fitted and 2 underwent colposuspension. There was no mortality. After operation, bladder capacity increased from 122 +/- 91 ml to 659 +/- 431 ml and there were significant decreases in the pressure rise during filling and increases in bladder compliance. Hyper-reflexia was present in 74% before operation and 23% after operation. Regular phasic activity was observed in 77% of patients at the end of filling after operation, probably due to bowel activity despite detubularisation. Four patients described urge incontinence associated with this activity. After operation, one man had persistent major stress incontinence. He has since undergone insertion of an artificial urinary sphincter (AUS) and is now completely dry. Of the remainder, 10 patients had minor, infrequent defects in continence, 9 patients with leakage when the bladder was full and 4 with occasional leakage at night. With the exception of the patient with major stress incontinence, all but one felt the operation had been worthwhile--40% reporting complete success and 52% excellent improvement. Reconstruction of the neuropathic lower urinary tract is a major surgical procedure, but the final clinical outcome is very satisfactory. PMID- 1773291 TI - Peri-operative blood transfusion in relation to tumour recurrence and death after surgery for prostatic cancer. AB - Several reports have suggested that peri-operative blood transfusion promotes tumour recurrence and death after surgery for cancer. We have studied the effect of transfusion in 156 patients operated on for prostatic cancer. A retrospective review was made of the clinical, histopathological and transfusion data in their hospital records. Sixty patients received blood transfusions and 96 did not. The 5-year prostatic cancer specific survival rate was 0.56 in the transfused patients and 0.69 in the non-transfused group. The transfused patients had a higher prevalence of risk factors than did the non-transfused. When the differences in risk factors were accounted for by Cox regression analysis, peri operative blood transfusion reduced the prostatic cancer death intensity by 36%. The study does not support the hypothesis that blood transfusion promotes recurrence following surgery for prostatic cancer. PMID- 1773292 TI - Effect of catheter material on the incidence of urethral strictures. AB - The aetiology of urethral strictures in patients catheterised for short periods at the time of surgery is the subject of some debate. The occurrence of epidemics of strictures associated with certain batches of latex catheters, and the demonstrable in vitro cytotoxicity of latex in general, have supported the suggestion that catheter material (and in particular latex) has an important role. We have looked retrospectively at 299 patients undergoing transurethral resection of the prostate gland by 1 urologist, 135 of whom had a latex catheter and 164 a plastic one; 19 patients developed strictures over the next 12 months with no proven difference attributable to the catheter material. The study provides no evidence that the short-term use of latex catheters is associated with stricture formation. PMID- 1773294 TI - Management of fracture of the penis in Qatar. AB - We present 21 patients with fracture of the penis treated between July 1982 and July 1990. Eighteen patients were treated surgically, with good functional and morphological recovery; 3 refused surgery, 1 of whom had penile deformity and pain on erection. The literature is reviewed with respect to the necessity of different diagnostic and therapeutic options. PMID- 1773293 TI - Penile strangulation. AB - Penile strangulation is a rare injury that requires urgent management. Non metallic, thin objects are easy to remove but can cause severe injury. Metallic objects are difficult to remove but the injuries are usually less severe. Penile ulceration and oedema in children may well indicate the presence of a strangulation object. We describe a new hammer and chisel method for removing such objects. PMID- 1773295 TI - Traumatic rupture of the corpus cavernosum. AB - Twelve patients with fracture of the penis have been treated in this department during the last 18 years. Their mean age was 41.5 years (range 25-55) and two thirds of the injuries resulted from coitus. Eleven patients underwent immediate exploration and repair of the tunica albuginea and only 1 still has sexual dysfunction. One patient was treated conservatively and remains impotent. Immediate surgical treatment is recommended, since it avoids the formation of penile plaque, penile fibrosis and angulation and accelerates restoration of normal penile function. PMID- 1773297 TI - Urethral calculi caused by cholestyramine. PMID- 1773296 TI - Erectile response to visual erotic stimuli before and after intracavernosal papaverine, and its relationship to nocturnal penile tumescence and psychometric assessment. AB - Three methods of assessing erectile capacity--nocturnal penile tumescence (NPT), response to visual erotic stimuli (VES) and to intracavernosal papaverine (ICI)- have been assessed in 42 men presenting with erectile dysfunction. There was some overlap but also important differences between the 3 measures. Subjects were divided into "high" and "low" NPT groups. The "high" group produced greater erectile responses to both VES and ICI. The combination of VES and ICI was the best discriminator of the two NPT groups, and may be of diagnostic value, particularly in younger men, reducing the need for repeated injections and higher doses of papaverine. In the "low" NPT group, presumed predominantly organic, the ICI response correlated better than the VES response with NPT. In the "high" NPT group, the opposite applied, suggesting that in "psychogenic" cases, response to ICI may be modified by psychological mechanisms which could be of aetiological importance and which deserve further study. These three methods should be regarded as measuring different aspects of erectile function and not as alternative diagnostic procedures. More research is required before their respective diagnostic values are established. PMID- 1773298 TI - Spontaneous perforation of an augmented bladder. PMID- 1773299 TI - Congenital ureteric valves. PMID- 1773300 TI - Kidney rupture and psoas abscess after ESWL. PMID- 1773301 TI - Oxybutynin and incontinence during grand mal seizures. PMID- 1773302 TI - Metastatic carcinoma of the kidney presenting to the oral surgeon. PMID- 1773303 TI - Leiomyosarcoma of kidney. PMID- 1773304 TI - Bilateral synchronous seminoma. PMID- 1773305 TI - Catheterisation of the tortuous neo-urethra. PMID- 1773306 TI - Raising the cervix by finger for closure of vesicovaginal fistulae. PMID- 1773307 TI - Re: BAUS UROLINK. PMID- 1773308 TI - Re: Gamma-seminoprotein--a new tumor marker in prostatic cancer? PMID- 1773310 TI - Re: Carcinoma of the prostate masquerading as rectal carcinoma. PMID- 1773309 TI - Re: Carcinoma of the bronchus and metastases from an occult testicular tumor. PMID- 1773311 TI - Animal experimentation. PMID- 1773312 TI - Iatrogenic injury to the bile duct. PMID- 1773313 TI - Popliteal artery entrapment syndrome. AB - Popliteal artery entrapment syndrome is an uncommon cause of peripheral vascular disease in young fit individuals, presenting as progressive claudication or sudden limb ischaemia. It can also present later in life with insidious symptoms relating to popliteal thrombosis or aneurysm. As a local cause of atherosclerosis in the popliteal artery it is probably under-diagnosed, as clinical and radiological features are subtle and varied. Early diagnosis and surgical division of aberrant muscular relations result in an excellent clinical result. Late surgical treatment with vein grafting is less durable. The disease incidence, clinical features, pathology, investigations, treatment and prognosis are reviewed. PMID- 1773314 TI - Relationship between blood transfusion and tumour behaviour. AB - Blood transfusion results in significant alterations in some parameters of immune function. Because some human cancers appear to stimulate immune responses and may be influenced by host immunity, the possibility arises that transfusion could alter the behaviour of tumours. Experimental studies indicate that allogeneic transfusion can directly alter tumour growth in some circumstances, but at present studies of human cancers do not provide evidence of a causal association between transfusion and tumour growth. PMID- 1773315 TI - Sphincter injury after anal dilatation demonstrated by anal endosonography. AB - Anal dilatation is still used in the treatment of anal fissure and haemorrhoids. Using anorectal physiology and anal endosonography we have studied 12 men presenting with faecal incontinence following anal dilatation. Resting anal pressures were low, pudendal nerve latencies were normal; 11 men had a disrupted internal anal sphincter and in ten this was extensively fragmented. Three also had defects of the external anal sphincter. These findings demonstrate for the first time the nature of the structural injury which may be caused by anal dilatation. PMID- 1773316 TI - Lateral ligament division during rectopexy causes constipation but prevents recurrence: results of a prospective randomized study. AB - Denervation of the rectum during rectopexy has been suggested as a reason for postoperative constipation. Bowel symptoms and anorectal function have been examined in a prospective randomized study of rectopexy with (n = 14) or without (n = 12) division of the lateral ligaments. Incontinence improved in both groups of patients. Division of the lateral ligaments increased the number of patients with constipation (three before operation, ten after operation, P less than 0.01). Mean and canal pressures were higher after operation in all patients. Rectal electrical sensory threshold increased significantly in those in whom the ligaments had been divided (preoperative 27.6 mA versus postoperative 56.7 mA; P less than 0.01) but not in those in whom they were preserved (39.0 versus 34.9 mA; P greater than 0.05). Prolapse recurred in six patients who did not undergo division of the lateral ligaments, but in none of the group in whom the ligaments were divided. PMID- 1773317 TI - Function after anoabdominal rectal resection and colonic J pouch--anal anastomosis. AB - Twenty-eight patients undergoing anoabdominal resection of the rectum with construction of a colonic J reservoir and eight patients without a reservoir were studied 2 years after surgery. Frequency of defaecation and daytime soiling were inversely correlated with the maximum tolerable volume of the colonic J pouch. The distensibility and threshold volume of those with a pouch were significantly greater than in those without a pouch 6 months or more after stoma closure. Anal resting pressure, squeeze pressure, anal canal length and a positive inhibitory reflex were similar in both groups. Anal resting pressure, squeeze pressure and pouch distensibility correlated with frequency of defaecation in the stable phase. Pouch construction may improve the patient's quality of life in the adaptation phase. PMID- 1773318 TI - Prospective audit of an extramucosal technique for intestinal anastomosis. AB - A computerized prospective audit was conducted of 500 intestinal anastomoses constructed in 470 operations on 461 consecutive patients between 1 January 1986 and 16 November 1990. All anastomoses were constructed by an open extramucosal method, emphasizing the avoidance of sutures through mucosa and avoiding the use of intestinal clamps. There were 214 men and 247 women, with a median age of 66 years. Clinical anastomotic leakage was detected from 11 (2.2 per cent) of 500 anastomoses. There were 18 (3.8 per cent) deaths resulting from the 470 operations, but only two (0.4 per cent) were associated with anastomotic leakage, which was not the direct cause of death in either. Peritonitis occurred as a consequence of leakage in two (8 per cent) of 26 resections for Crohn's disease, but the patients survived after reoperation. The single-layer extramucosal technique is probably the safest method available for intestinal suture. PMID- 1773319 TI - Traumatic transection of the second part of the duodenum managed by primary repair. PMID- 1773320 TI - Combined inguinal herniorrhaphy and transurethral prostatectomy. AB - Between January 1979 and June 1988, 41 men underwent combined inguinal herniorrhaphy and transurethral prostatectomy at the Instituto Nacional de la Nutricion in Mexico. These cases (group 1) were compared retrospectively with 100 consecutive cases of inguinal herniorrhaphy alone (group 2) and 100 consecutive cases of transurethral prostatectomy alone (group 3) during the same period. Group 1 had the highest incidence of preoperative risk factors because of age and associated medical problems. However, there were no significant differences in the rate of operative or postoperative complications between groups. No recurrences of inguinal hernia were recorded in group 1 after a follow-up period of 47.1 months. The length of hospitalization was similar between groups, and no patient died. Our observations suggest that when an inguinal hernia and symptomatic prostatism occur together, combined inguinal herniorrhaphy and transurethral prostatectomy is a practical, safe and effective operative procedure. The advantages of this combined procedure include one anaesthetic period, one operative procedure, one hospital stay and one convalescence with morbidity and mortality rates that are comparable to those of inguinal herniorrhaphy or transurethral prostatectomy alone. PMID- 1773321 TI - External intestinal strangulation with a recurrent inguinoscrotal hernia. PMID- 1773322 TI - Mechanical lithotripsy of large common bile duct stones using a basket. AB - Experience with the Olympus basket mechanical lithotriptor (BML-1Q) in crushing large common bile duct stones before their endoscopic removal is reported. From January 1988 to January 1990, 68 patients with common duct stones too large to be extracted by Dormia baskets or balloon catheters after sphincterotomy were treated with the BML system. The largest stones in each patient ranged from 1.0 to 4.9 cm in diameter. Fifty-seven patients required one session of lithotripsy, ten patients two sessions and one patient three sessions; 26 patients required further endoscopic extraction of stone fragments after successful lithotripsy. The stones were successfully crushed by the BML system and the ducts cleared in 55 patients (81 per cent). In 13 patients mechanical lithotripsy failed because the stones could not be engaged in the lithotriptor basket. In one patient the stone was crushed with the Soehendra lithotriptor, six patients were successfully managed by electrohydraulic lithotripsy through a 'mother and baby' endoscope, indwelling stents were inserted in four patients and two patients underwent surgery. PMID- 1773323 TI - Bleeding duodenal varices. PMID- 1773324 TI - Rapid-bolus contrast-enhanced dynamic computed tomography in acute pancreatitis: a prospective study. AB - The purpose of this prospective study was to determine the clinicopathological significance of necrotic areas demonstrated by rapid-bolus contrast-enhanced computed tomography (CT) in patients with biochemically predicted severe pancreatitis. Although CT necrosis occurred significantly more frequently in patients with clinically severe (ten of 12) compared with mild (seven of 20) pancreatitis (P less than 0.025), seven of 17 (41 per cent) patients with CT necrosis developed clinically mild pancreatitis and six of ten (60 per cent) patients with clinically severe pancreatitis and CT necrosis recovered with conservative management. The site and extent of CT necrosis did not correlate with disease severity. Fine-needle aspiration cytology, operative and post-mortem findings and endoscopic retrograde cholangiopancreatography examinations all strongly suggested that CT necrosis represents true pancreatic necrosis. We conclude that the finding of CT necrosis is not in itself an indication for operative intervention, but that rapid-bolus contrast-enhanced dynamic CT greatly facilitates the planning and execution of surgical therapy. PMID- 1773325 TI - Influence of epidural analgesia upon postoperative fatigue. AB - This study examined the effect of epidural analgesia on the development of postoperative fatigue and the ability to ambulate after surgery. Seventeen patients admitted for elective abdominal surgery were randomized to receive postoperative analgesia with a continuous infusion of epidural fentanyl (epidural group) or intermittent intramuscular morphine (non-epidural group). Fatigue was assessed on an analogue scale of 1 (fit) to 10 (fatigued). Steady state measurements of respiratory gas exchange, respiratory rate, tidal volume and heart rate were made before operation and repeated on the third postoperative day. Energy expenditure was calculated from Weir's formula. Ambulatory measurements were made during treadmill walking at a work rate of 20 kpm min-1 (3.3 W). At rest, patients in both groups had a similar cardiorespiratory response to surgery irrespective of the method of analgesia. Subjective feelings of fatigue were significantly greater in those patients who had received epidural analgesia (P less than 0.01) and patients in this group expended significantly more energy in performing the postoperative exercise test than did those in the non-epidural group (P less than 0.05). The use of epidural opiate analgesia does not limit postoperative fatigue in patients undergoing upper abdominal surgery. PMID- 1773326 TI - Role of salivary epidermal growth factor in the pathogenesis of Barrett's columnar lined oesophagus. AB - Epidermal growth factor (EGF) is implicated in the regeneration of epithelial cells at the site of inflammation or ulceration in the gastrointestinal tract. Single parotid EGF concentration and production was studied in 64 patients with Barrett's columnar lined oesophagus (CLO), in 22 patients with severe reflux oesophagitis without columnar metaplasia and in 51 normal controls. In control patients, mean salivary EGF concentration was 2790 pg/ml (median 1450 pg/ml; range 450-16,500 pg/ml) and mean single parotid EGF production was 2550 pg/min (median 1750 pg/min; range 790-18,000 pg/min). Patients with severe reflux oesophagitis had a similar EGF concentration (mean 3112 pg/ml; median 1500 pg/ml; range 300-16,000 pg/ml) and production (mean 3100 pg/min; median 2200 pg/min; range 790-17,950 pg/min) to controls. Patients with CLO had a 62 per cent lower mean EGF concentration (mean 1197 pg/ml; median 640 pg/ml; range 233-4500 pg/ml) (P less than 0.001, Mann-Whitney U test) and a 60 per cent lower EGF production (mean 1254 pg/min; median 800 pg/min; range 170-3125 pg/min) (P less than 0.001, Mann-Whitney U test) than patients with severe reflux oesophagitis. A subpopulation with malignant change in CLO (n = 16) had a similar EGF concentration and production to the CLO group as a whole (mean 1240 and 1300 pg/min, respectively). Low salivary EGF levels are associated with Barrett's CLO but not with severe oesophagitis without columnar metaplasia. EGF levels do not identify those patients who will subsequently develop malignant change. PMID- 1773327 TI - Skin cancer: a late complication of skin tube oesophagus. PMID- 1773328 TI - Oesophageal and severe gut involvement in the haemolytic uraemic syndrome. AB - Between 1982 and 1989, 78 children with diarrhoea-associated haemolytic uraemic syndrome (HUS) were referred to this hospital. Most presented with abdominal pain, bloody diarrhoea and vomiting. Seven had severe gastrointestinal involvement, four of whom required resection for bowel perforation or necrosis. One also developed an oesophageal stricture, a previously unreported complication of HUS. These seven children had a high incidence of other complications including hypertension, and cerebral and pancreatic involvement. One died from severe cerebral involvement, one has a residual neurological deficit and one has residual renal impairment. Severe gastrointestinal involvement did not significantly affect the long-term outcome. Simple haematological indices helped predict severe gut involvement. Four of the 78 children had undergone appendicectomy before the diagnosis of HUS was made. The operative findings were in no case typical of primary acute appendicitis, although histological examination did confirm inflammation of the appendix in two patients. Diagnosis is difficult in early disease, but increased awareness may help prevent unnecessary appendicectomy. PMID- 1773329 TI - 24-hour survival of autotransfused red cells in elective aortic surgery: a comparison of two intraoperative autotransfusion systems. AB - Twelve patients undergoing elective aortic surgery had intraoperative autotransfusion using either the Haemonetics Cell Saver or the Solcotrans device. The 24-h post-transfusion survival of the patients' preoperative red cells, labelled with indium-111, was compared with the survival of salvaged red cells labelled with chromium-51. A correction coefficient for the instability of the indium-111 label was calculated from the study of red cell survival in six healthy volunteers. There was no significant difference in the volume of circulating red cells measured using each isotope, indicating that extensive early destruction of the autotransfused red cells does not occur. The percentage survival of autotransfused red cells at 24 h was similar to that of the red cells that had not undergone salvage. Both devices were comparable with respect to the effects of cell salvage on the 24-h survival rate of autotransfused red cells. PMID- 1773330 TI - Aggressive arterial reconstruction for critical lower limb ischaemia. AB - A consecutive series of 315 patients underwent arterial reconstruction for 329 critically ischaemic lower limbs over a 5-year period. Patients were not excluded from limb salvage surgery on the basis of poor run-off on preoperative angiography. Femorocrural bypass to a single calf vessel was required in 239 limbs (73 per cent); the 30-day cumulative mortality rate was 7 per cent, rising to 41 per cent at 5 years. Cumulative graft patency at 30 days, 1 year, 2 years and 5 years was 96, 85, 84 and 82 per cent respectively and was independent of the level of reconstruction. In situ long saphenous vein was the conduit of choice for distal bypass but, when this was absent, satisfactory results were obtained with arm vein or composite vein grafts. Acceptable results can be obtained for reconstructive surgery without preoperative angiographic selection of patients. An aggressive approach to limb salvage is therefore justified. PMID- 1773331 TI - Failed femorocrural reconstruction does not prejudice amputation level. AB - From January 1985 to December 1989, 500 consecutive patients presented to a single vascular unit with limb-threatening acute or critical ischaemia. Vascular reconstruction was attempted unless the patient had insufficient viable tissue to permit weight bearing or complete absence of run-off vessels in the calf. Fifty patients underwent a primary amputation and 450 patients underwent vascular reconstruction, of whom 265 had a femorocrural bypass. Sixty secondary amputations were performed following femorocrural bypass failure. The below-knee amputation to above-knee amputation ratio (BKA:AKA) was 2.0 in the primary amputation group and 1.1 in the secondary amputation group. Direct comparison between the two groups is not valid as they are clinically different. The combined BKA:AKA ratio was 1.4. This compares favourably with the BKA:AKA ratio of recent published series and figures from the National Amputation and Limb Fitting Services. It suggests that an unselective policy of vascular reconstruction for critical ischaemia does not lead to a higher proportion of above-knee amputations. PMID- 1773332 TI - Risk factors for early lower limb loss after embolectomy for acute arterial occlusion: a population-based case-control study. AB - To identify risk factors for lower limb loss after arterial embolectomy a cohort of 1189 patients was studied. Detailed data were obtained for 165 patients who underwent a major amputation within 30 days of embolectomy and for 165 matched controls. The amputation risk was increased in patients with two or more myocardial infarctions (odds ratio (OR) 3.1, 95 per cent confidence interval (CI) 0.8-11.2), chronic ischaemia (OR 2.1, CI 0.9-4.9), long duration of symptoms (OR 4.3, CI 1.9-9.6, for greater than or equal to 25 h versus less than or equal to 6 h) or postoperative heart failure (OR 3.4, CI 1.8-6.5). Reduced risks were found in association with acute myocardial infarction (OR 0.3, CI 0.1-0.9) and postoperative anticoagulation treatment with warfarin (OR 0.3, CI 0.1-0.9). The independent prognostic value of chronic ischaemia and symptom duration, and the beneficial effect of postoperative anticoagulation gained additional support in multivariate analysis. We conclude that the risk of early amputation after arterial embolectomy or thrombectomy can be predicted by several clinical characteristics. PMID- 1773333 TI - Importance of the unilateral absence of the vas. PMID- 1773334 TI - Rebound tenderness test. PMID- 1773335 TI - Vasodilatory capacity of the skin. PMID- 1773336 TI - Zinc containing projections to the bed nucleus of the stria terminalis. AB - A retrograde tracing method that selectively labels the perikarya of zinc containing neurons was used to identify the neurons that supply zinc-containing fibers to the bed nucleus of the stria terminalis in the rat. In agreement with prior lesion studies, retrograde tracing indicates that neurons in amygdalar and periamygdalar regions are the major sources of the zinc-containing innervation of the bed nucleus complex. Zinc-containing neurons in the presubiculum and prosubiculum were also retrogradely labeled from the BNST, whereas cells of the subiculum proper did not label. Light and occasional retrograde labeling of some CA1 and CA2 neurons and limbic cortical neurons was also observed, but the possibility of transport from regions bordering BNST injections (septum, caudate putamen) could not be excluded in the latter cases. PMID- 1773337 TI - Muscarinic receptor localization and function in rabbit carotid body. AB - Acetylcholine and muscarinic agonists inhibit chemosensory activity in the rabbit carotid sinus nerve (CSN). Because the mechanism of this inhibition is poorly understood, we have investigated the kinetics and distribution of muscarinic receptors in the rabbit carotid body with the specific muscarinic antagonist [3H]quinuclidinylbenzilate ([3H]QNB). Equilibrium binding experiments identified displaceable binding sites (1 microM atropine) with a Kd = 71.46 pM and a Bmax = 9.23 pmol/g tissue. These binding parameters and the pharmacology of the displaceable [3H]QNB binding sites are similar to specific muscarinic receptors identified in numerous other nervous, muscular and glandular tissues. Comparisons of specific binding in normal and chronic CSN-denervated carotid bodies suggest that muscarinic receptors are absent on afferent terminals in the carotid body; however, nearly 50% of the specific [3H]QNB binding is lost following chronic sympathectomy, suggesting the presence of presynaptic muscarinic receptors on the sympathetic innervation supplying the carotid body vasculature. Autoradiographic studies have localized the remainder of [3H]QNB binding sites to lobules of type I and type II parenchymal cells. In separate experiments, the muscarinic agonists, oxotremorine (100 microM) stimulation of the in vitro carotid body. Our data suggest that muscarinic inhibition in the rabbit carotid body is mediated by receptors located on type I cells which are able to modulate the excitatory actions of acetylcholine at nicotinic sites. PMID- 1773339 TI - Auditory projections from the cochlear nucleus to pontine and mesencephalic reticular nuclei in the rat. AB - We investigated projections from the cochlear nucleus in the rat using the anterograde tracer Phaseolus vulgaris-leucoagglutinin. We focused on nuclei in the brainstem which are not considered to be part of the classical auditory pathway. In addition to labeling in auditory nuclei, we found presumed terminal fibers in 4 pontine and mesencephalic areas: (1) the pontine nucleus (PN), which receives bilateral projections from the antero- and posteroventral cochlear nuclei; (2) the ventrolateral tegmental nucleus (VLTg), which receives a contralateral projection from the rostral portion of the anteroventral cochlear nucleus; (3) the caudal pontine reticular nucleus (PnC), which receives bilateral input originating predominantly in the dorsal cochlear nucleus; and (4) the lateral paragigantocellular nucleus (LPGi), which receives projections from all subdivisions of the cochlear nuclei. In the VLTg and PnC, anterogradely labeled varicose axons were often found in close apposition to the primary dendrites and somata of large reticular neurons. Injections of the retrograde fluorescent tracer Fluoro-Gold into the VLTg demonstrated that the neurons of origin are mainly located contralaterally in the rostral anteroventral cochlear nucleus and in the cochlear root nucleus. The relevance of these auditory projections for short-latency audio-motor behaviors and acoustically elicited autonomic responses is discussed. PMID- 1773338 TI - Interleukin-6 as an endogenous pyrogen: induction of prostaglandin E2 in brain but not in peripheral blood mononuclear cells. AB - Fever induced by endogenous as well as exogenous pyrogens is often prevented by cyclooxygenase inhibitors; endogenous pyrogens stimulate prostaglandin E2 (PGE2) in or near the thermoregulatory centers of the brain. The cytokines, interleukin 1 (IL-1) and tumor necrosis factor (TNF), are two pyrogens which stimulate brain PGE2 formation during fever and also increase PGE2 synthesis in human mononuclear cells in vitro. In the present study, we examined whether interleukin-6 (IL-6) stimulates PGE2 formation in a manner similar to IL-1 and TNF. Both glycosylated and non-glycosylated forms of recombinant human IL-6 were tested. Following intravenous injection into rabbits, the glycosylated IL-6 was more pyrogenic than the non-glycosylated form and there was no evidence of synergy in the production of fever when IL-6 and IL-1 were given simultaneously. IL-6 fever was blocked by prior administration of the cyclooxygenase inhibitor ibuprofen. IL-6 was also pyrogenic in the cat by either the systemic or the intraventricular route. However, in both species, IL-6 was less effective than IL-1 beta. When given intraventricularly to cats, IL-6 produced an increase in PGE2 levels of the cerebrospinal fluid in parallel with the rise in body temperature. In the latter respect, IL-6 imitated IL-1 beta; however, IL-6 from 0.15-15 micrograms/ml did not increase mononuclear cell PGE2 production in vitro whereas IL-1 beta induced 20-30-fold increases in PGE2 at 100 ng/ml.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1773340 TI - A pharmacogenetic evaluation of the role of local anesthetic actions in the cocaine kindling process. AB - Repeated administration of subconvulsant doses of lidocaine or cocaine results in the development of an increased susceptibility to seizures induced by the two drugs (pharmacological kindling). It has been hypothesized that the local anesthetic properties of cocaine are responsible for its convulsant and epileptogenic actions. As genetic factors appear to mediate acute sensitivity to the convulsant properties of cocaine and the development of cocaine-kindled seizures, the present studies used a pharmacogenetic approach to address this question further. The convulsant effects of lidocaine were evaluated in BALB, C57, DBA and SJL mice and compared with previous studies evaluating cocaine induced seizures. We have also evaluated the development of lidocaine- versus cocaine-kindled seizures and the effects of repeated treatment with cocaine or lidocaine on subsequent lidocaine seizure susceptibility in three of these inbred mouse strains. As observed for cocaine, genetic factors influence the convulsant properties of lidocaine; however, the differences between the strains of mice in susceptibility to lidocaine-induced seizures (SJL greater than DBA = BALB = C57) did not parallel those seen for cocaine-induced seizures (C57 greater than DBA = BALB greater than SJL). Similarly, the time course for the expression of kindled seizures and the differences between the various inbred strains were not the same for lidocaine kindling and cocaine kindling. However, depending on the genetic background of the subject, the repeated administration of lidocaine, or cocaine, resulted in the development of sensitization or tolerance to the convulsant effects of lidocaine in an identical manner.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1773341 TI - Dynamics of neurotensin stores in the stellate ganglion of the cat. AB - Neurotensin (NT) within the stellate ganglion (SG) of the cat is present in axon terminals of extrinsic, presumably preganglionic, neurons and may play a role in ganglionic transmission. NT content of the SG, and of the preganglionic axons which innervate it, was determined by radioimmunoassay in the anesthetized cat under various experimental conditions in order to understand the factors determining the size of the ganglionic NT stores. The immunoreactive NT (iNT) from extracts of SG and its preganglionic inputs (white rami T2 and T3, sympathetic trunk between SG and T4 white ramus) coeluted with synthetic NT(1-13) on RP-HPLC. NT accumulated proximal to ligatures on the preganglionic inputs of the SG. The daily rate of axonal transport of NT, estimated from the accumulation, represents 28.7% of the ganglionic stores of NT. Preganglionic stimulation at 2 Hz for 100 min did not change ganglionic NT content. Preganglionic stimulation at 40 Hz reduced the NT content to 70.4 +/- 1.8% of control in 10 min and to 34.7 +/- 4.2% of control in 20 min. Additional 100 min of 40 Hz stimulation produced no further depletion. The residual iNT, which coeluted with NT1-13, presumably represents a pool of unreleasable NT. Post depletion recovery was complete in 7 days and showed an initial rapid phase over the first 24 h followed by a slower phase over the remaining 6 days. Pepsin treatment, which has previously been shown to generate iNT from NT precursor in liver and other tissues, provided no evidence of the NT precursor in extracts of SG and its preganglionic input.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1773342 TI - Chloride efflux from isolated choroid plexus. AB - Chloride efflux was analyzed in adult rat lateral ventricle choroid plexus (LVCP) incubated in artificial CSF (aCSF) at 37 degrees C. Following steady-state loading of 36Cl in LVCP, the tracer release from plexus to aCSF was quantified by the efflux coefficient (k, s-1), equal to ln 2/t/2. Cl efflux could be described by a 2-component model, with a t/2 for the 'fast' component matching well that for [3H]sucrose (extracellular marker) and a slower, drug-inhibitable component of 36Cl release thought to reflect cellular washout. The cellular Cl efflux was more than twice as fast as 37 degrees C than at 15 degrees C. There was progressively more rapid efflux (k) of 36Cl from cells as the aCSF was altered over a range of several pH values from 6.7 (k = 0.026 s-1) to 8.2 (0.070 s-1). CSF medium anion replacement (isethionate and HEPES for Cl and HCO3, respectively) reduced the k for 36Cl by 57%. Acetazolamide (0.1 mM) and other Cl transport inhibitors (disulfonic stilbenes and loop diuretic) reduced Cl efflux by 35-55%. Acetazolamide inhibited Cl release from LVCP into aCSF whether the latter contained Cl and HCO3, or not. Overall, the findings suggest that Cl extrusion from choroid plexus is by way of an anion exchanger and via channels. PMID- 1773343 TI - Activation of a specific vestibulo-olivary pathway by centripetal acceleration in rat. AB - Unanesthetized Long-Evans (pigmented) rats were subjected to 2.0 G centripetal acceleration for 90 min. Immunohistochemical analysis, using a polyclonal antibody for Fos, revealed a distinct pattern of neuronal activation in the off axis animals in the dorsomedial cell column (DMCC) of the inferior olivary nucleus. These results are consistent with previous anatomical evidence and indicate that the DMCC is an important component in an otolith-olivocerebellar circuit which may help to define an internal spatial reference. PMID- 1773344 TI - Human recombinant tumor necrosis factor and interferon affect the activity of neurons in the organum vasculosum laminae terminalis. AB - It is generally thought that fever is induced by blood-borne cytokines via an action on hypothalamic thermosensitive neurons. Recent studies suggest that the organum vasculosum laminae terminalis (OVLT), which lacks the blood-brain barrier, may be necessary for fever induction by systemic pyrogens. We have examined the responses of neurons in the OVLT to the pyrogenic cytokines, human recombinant tumor necrosis factor alpha (TNF) and interferon alpha 2 (IFN), by recording extracellular single-units in brain slice preparations from guinea pigs. Of all the OVLT neurons tested with TNF (900-5000 ng/ml perfusate/min) and IFN (1200-8500 units/ml perfusate/min), administered for 2.5 min, 44% increased their firing rates (FR) for 30.6-57.5 min (average, 47.4 min) with onset latencies of 6.1-9.8 min (average, 7.9 min). The remaining 56% of the neurons did not change their FR after TNF or IFN. Carrier vehicles for these cytokines produced no FR change. The results suggest the possibility that the OVLT may be a site where chemical signals of blood-borne cytokines are transduced into neuronal signals. PMID- 1773345 TI - Inhibition of an N-methyl-D-aspartate induced short-term potentiation in the rat hippocampal slice. AB - The effects of the phorbol ester 4 beta-phorbol-12,13 dibutyrate (PDBu) and the protein kinase (PK) inhibitors H-7 and sphingosine were investigated on the short term potentiation (STP) of the population excitatory postsynaptic potential (EPSP) induced by perfusion of N-methyl-D-aspartate (NMDA) in the stratum radiatum of CA1 of the rat hippocampal slice. Bath perfusion of 130 microM NMDA for 10 s caused an initial depression of the population EPSP followed by a STP, which averaged 46% and lasted 16 min. PDBu (100 nM) perfused for 2 h completely inhibited the NMDA induced STP, suggesting that the stimulation of PKC inhibited an NMDA receptor activated process which induced the STP. The protein kinase inhibitors H-7 and sphingosine did not alter the NMDA induced STP. PMID- 1773346 TI - Chronic continuous nicotine treatment causes decreased burst firing of nigral dopamine neurons in rats partially hemitransected at the meso-diencephalic junction. AB - Chronic continuous administration of nicotine (0.125 mg/kg/h, 14 days) to male Sprague-Dawley rats with a partial hemitransection at the meso-diencephalic junction caused a significant reduction in burst firing of remaining dopamine (DA) neurons in the zona compacta, substantia nigra, whereas neither the firing rate nor the number of spontaneously active DA cells per track were altered in comparison with saline-treated, hemitransected controls. The reduced functional activity of the remaining DA cells subjected to nicotine treatment provides a physiological correlate to the previously observed, reduced DA utilization in these neurons. It may also help to explain the increased nigral DA cell survival found after chronic nicotine treatment in similar lesion experiments. PMID- 1773347 TI - Temporal pattern of survival and dendritic growth of fetal hippocampal cells transplanted into ischemic lesions of the adult rat hippocampus. AB - Cell suspensions obtained from the fetal hippocampus were transplanted into the adult rat hippocampus at 1 or 4 weeks after transient forebrain ischemia. Only when the ischemia induced death of most of the CA1 pyramidal cells of the host hippocampus and transplantation was performed at 1 week after the ischemia, did a large number of transplanted cells survive and the most extensive dendritic growth was demonstrated by microtubule-associated protein 2 immunohistochemistry. The dendrites of the cells located in the ventral part were oriented ventrally, lining up similarly to the parallel arrangements of apical dendrites of normal CA1 pyramidal cells. These findings suggest that certain forms of trophic factors, which appear to occur in association with the presence of free terminals of afferent fibers during the earlier period after ischemic insult, are involved in the survival of and dendritic growth from transplanted hippocampal cells. PMID- 1773348 TI - The functional anatomy of middle latency auditory evoked potentials. AB - The neural origins of middle latency auditory evoked potentials (MAEP) were studied in rat cortex. MAEP were mapped from the cortical surface with a high spatial resolution electrode array. Spatiotemporal analysis, based on multivariate statistical methods, was then used to relate putative neural generators of the MAEP complex to established cytoarchitectural anatomy. These data indicate that the MAEP waveform reflects systematic asynchronous activation of both primary and secondary auditory cortex during the processing of simple click stimuli. PMID- 1773349 TI - Effects of ketamine on outcome from temporary middle cerebral artery occlusion in the spontaneously hypertensive rat. AB - This experiment evaluated the potential for ketamine HCl, a non-competitive glutamate antagonist, to minimize injury resulting from temporary focal cerebral ischemia. Male spontaneously hypertensive rats were randomly assigned to receive either ketamine (n = 13) or halothane anesthesia (n = 12) during 2 h of reversible middle cerebral artery occlusion (MCAO). Ketamine was administered as a 50 mg/kg i.v. loading dose followed by a continuous 1.25 mg/kg/min i.v. infusion beginning 25 min prior to ischemia and continued until 30 min after reperfusion. An additional group of rats (ketamine-shams, n = 8) underwent craniectomy and ketamine administration (as above) but the middle cerebral artery was not ligated. Physiologic values were similar between groups with the exception of plasma glucose which was elevated in the halothane-MCAO group. After 4 days recovery, rats in all groups were neurologically evaluated. There were no differences between the two groups undergoing MCAO for neurologic grading or open field behavior, although both groups performed worse than did ketamine-shams (P less than 0.05). In contrast, motor performance revealed more severe deficits in the ketamine-MCAO rats vs either the halothane-MCAO or ketamine-sham groups (P less than 0.05). Cerebral infarct volume was then planimetrically measured after triphenyl tetrazolium chloride (TTC) staining of fresh brain sections. Mean +/- S.D. infarct volume was not different between the halothane-MCAO (134 +/- 51 mm3) and ketamine-MCAO (131 +/- 64 mm3) groups. Seven of 8 sham rats were free of TTC demarcated injury and in the remaining rat injury was minimal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1773351 TI - The role of midline ventral medullary structures in generation of respiratory motor high frequency oscillations. AB - Lesions 1-2 mm deep in the midline of the ventral medulla (VM) abolished high frequency oscillations (HFO) in the respiratory motor output in cat and rabbit. Raising arterial pCO2 increased phrenic nerve activity to its prelesion level but did not restore HFO. We conclude that the neuronal pathways crossing the midline of the VM are crucial for reinforcement of respiratory activity and HFO generation. PMID- 1773350 TI - Activation of tuberoinfundibular and tuberohypophysial dopamine neurons following intracerebroventricular administration of bombesin. AB - The effect of bombesin on the activity of dopamine (DA) neurons comprising the nigrostriatal, mesolimbic, tuberoinfundibular and tuberohypophysial systems in the male rat was determined by measuring: (1) the accumulation of 3,4 dihydroxyphenylalanine (DOPA) after administration of a decarboxylase inhibitor, and (2) the concentration of the DA metabolite 3,4-dihydroxyphenylacetic acid (DOPAC) in brain (striatum, nucleus accumbens, median eminence) and pituitary regions (intermediate and neural lobes) containing terminals of these neurons. Intracerebroventricular (i.c.v.) injection of bombesin caused a dose- and time related increase in the activity of DA neurons projecting to the median eminence and intermediate lobe of the pituitary, and a corresponding decrease in the concentrations of prolactin and alpha-melanocyte-stimulating hormone (alpha MSH) in the plasma. In contrast, doses of bombesin up to 10 ng i.c.v. failed to alter the activity of DA neurons terminating in the striatum, nucleus accumbens or neural lobe of the pituitary gland. Equimolar doses of bombesin and gastrin releasing peptide (GRP), a bombesin-like peptide, increased the concentrations of DOPAC in the median eminence and intermediate lobe of the pituitary, suggesting that GRP-preferring receptors may be responsible for the stimulatory effects of bombesin on DA neuronal activity in these regions. The results of these studies suggest that bombesin increases the activity of tuberoinfundibular and tuberohypophysial DA neurons projecting to the median eminence and intermediate lobe of the pituitary, respectively, and thereby inhibits the secretion of prolactin and alpha MSH. PMID- 1773352 TI - Melatonin directly resets the rat suprachiasmatic circadian clock in vitro. AB - The environmental photoperiod regulates the synthesis of melatonin by the pineal gland, which in turn induces daily and seasonal adjustments in behavioral and physiological state. The mechanisms by which melatonin mediates these effects are not known, but accumulating data suggest that melatonin modulates a circadian biological clock, either directly or indirectly via neural inputs. The hypothesis that melatonin acts directly at the level of the suprachiasmatic nucleus (SCN), a central mammalian circadian pacemaker, was tested in a rat brain slice preparation maintained in vitro for 2-3 days. Exposure of the SCN to melatonin for 1 h late in the subjective day or early subjective night induced a significant advance in the SCN electrical activity rhythm; at other times melatonin was without apparent effect. These results demonstrate that melatonin can directly reset this circadian clock during the period surrounding the day night transition. PMID- 1773353 TI - Reciprocal connections between rostral ventrolateral medulla and inspiration related medullary areas in the cat. AB - We investigated connections between the rostral ventrolateral medulla (rVLM) and the two main inspiration-related medullary areas, i.e., the dorsal respiratory group (DRG) and the rostral ventral respiratory group (rVRG) in the cat. Non respiration-related tonically firing units encountered in the rVLM displayed either antidromic or orthodromic responses to DRG or rVRG microstimulation. Some units responded to the stimulation of both regions. We suggest that at least part of rVLM neurons are components of medullary loops operating in the control of breathing. PMID- 1773354 TI - Interaction between afferent neurones in a crab muscle receptor organ. AB - Two of the three mechanoreceptor neurones which innervate the crab thoracic-coxal muscle receptor organ are non-spiking. The third, the small diameter P neurone, employs graded amplitude receptor potentials with either spikes or graded amplitude active membrane responses superimposed. An excitatory synaptic connection between one of the larger non-spiking afferents and the P neurone has now been detected within the thoracic ganglion. This novel connection between two afferents innervating the same receptor strand effectively extends the dynamic sensitivity range of the P neurone. PMID- 1773355 TI - GM1 ganglioside treatment reduces visual deficits after graded crush of the rat optic nerve. AB - Despite numerous reports of beneficial effects of GM1 ganglioside treatment following brain lesions in animals, the underlying neurobiological mechanism of ganglioside-induced functional restoration is still unclear. In order to obtain a better insight into this question, we have made use of a newly developed animal model of brain injury that would potentially permit us to determine the causal relationship(s) among behavioral and neuroanatomical/neurochemical parameters of restoration of function. Following graded crush of the adult rat optic nerve, we have treated the rats with intraperitoneally injected gangliosides and studied the functional outcome with electrophysiological and behavioral parameters. The electrophysiological recording of the compound action potential (CAP) from excised rat optic nerve revealed a significant loss of CAP throughout the first 2 weeks after the injury. However, when rats were treated daily for 7 days with GM1 gangliosides, the CAP measured 10 days after the crush was significantly larger compared to operated controls without treatment. Thus, GM1 appeared to be capable of delaying or partially preventing retinal ganglion cells or their axons from secondary degeneration. Loss of visual function was also evident on the behavioral level of analysis: when rats with unilateral optic nerve crush were evaluated in a visual orienting paradigm, the rats revealed deficits in their ability to orient towards small, moving visual stimuli. However, within about 2 weeks, the animals recovered spontaneously to near normal performance. Daily treatment with GM1-gangliosides was found to significantly improve outcome, largely due to a reduction of the immediate post-lesion deficit. In a second behavioral experiment we also created graded crush in rats bilaterally and evaluated the animals visual capacities in a two-choice brightness discrimination task. In this task, an initial loss of function was followed by recovery within about 2 weeks, but GM1 treatment was without beneficial effects in this paradigm. It is concluded that GM1 improves outcome after graded crush of the adult rat optic nerve, although it appears that improved function needs to be documented with sufficiently sensitive behavioral assays. PMID- 1773356 TI - Experimental nerve ischemia and injury produced by cocaine and procaine. AB - The effects of ethanol, glycerol, procaine, and cocaine were tested on rat sciatic nerve blood flow. Blood flow measurements were made using a laser Doppler blood perfusion monitor with a 1 mm diameter probe. The local anesthetics procaine and cocaine produced a dose-dependent and time-dependent decrease in nerve blood flow, but 80% ethanol, 80% glycerol, and 0.9% saline did not significantly alter nerve blood flow either acutely (10 min) or for up to 4 h. For histopathologic studies, the same nerves were removed at 2 days after blood flow tests. Evidence of nerve injury (edema and nerve fiber pathology) was observed for the neurolytic agents ethanol and glycerol and for both local anesthetics. No relationship between nerve blood flow and injury was seen for either ethanol or glycerol; however, both local anesthetics exhibited a highly significant negative correlation (P less than 0.01) between blood flow at 4 h and injury at 2 days. These data provide additional evidence that local anesthetics can decrease nerve blood flow; and these results are consistent with an ischemic mechanism for local anesthetic-induced nerve injury. PMID- 1773357 TI - Potassium channel-dependent changes in the volume of developing mouse Schwann cells. AB - Physiological roles of voltage-gated K+ channels in developing mouse Schwann cells were investigated using whole-cell variation of the patch-clamp technique. In neonatal myelin-associated Schwann cells, local cytoplasmic swellings were induced when membrane potential (MP) was kept more negative than zero-current potential (membrane hyperpolarization) and they decreased in sizes when MP was kept positive. A lack of changes of cytoplasmic volume in Schwann cells of 17- to 18-day-old embryos or in neonatal myelin-associated cells in a solution containing Ba2+ suggested that activation of Ba(2+)-sensitive K+ channels caused cytoplasmic volume changes. Significant increase in magnitudes of Ba(2+) sensitive K+ currents in neonatal myelin-associated cells after membrane hyperpolarization suggested that these K+ channels locate in adaxonal Schwann cell membrane and probably determine the sites of Schmidt-Lanterman incisures. PMID- 1773358 TI - Muscle differentiation in Xenopus laevis is characterized by particular states of vinculin phosphorylation. AB - Vinculin is a 130 kD cytoskeletal protein which is involved in the anchorage of actin microfilaments to the plasma membranes at sites of cell-cell and cell matrix contacts. In this paper we prove that smooth and cardiac muscles of Xenopus laevis contain a specific isoform of vinculin not present in any other tissue including skeletal muscle and epithelia and we demonstrate that this form of the molecule is characterized by a specific state of phosphorylation. These data are discussed in view of the importance of posttranslational modifications of structural proteins, such as vinculin, in the determination of cellular behaviour during differentiation and development. PMID- 1773359 TI - [Demonstration of viral proteins and RNA in hypothalamus of mice infected by canine distemper virus]. AB - There are a number of reports suggesting that neurological disorders may be due to infectious agents, such as viruses. In order to study the role of viruses on cellular plasticity in the central nervous system, we established a model of virus infection in the mouse. Inoculation of mouse with canine distemper virus (CDV) led to an acute encephalitis, late neurological disorders and an obesity syndrome. To analyse the role of viral replication on the development of this syndrome we studied the cerebral distribution of viral products during the course of infection. Viral proteins and RNA accumulated in mouse brain from the 9th day to the 6th week post-inoculation, particularly in hypothalamus, a cerebral structure implicated in obesity. Such selective viral tropism may explain some of the unexpected features of viral-induced disorders. PMID- 1773360 TI - In vivo inhibition of megakaryocyte and platelet production by platelet factor 4 in mice. AB - The in vivo effect of human platelet factor 4 (PF4) on murine megakaryocytopoiesis and thrombopoiesis was studied. Administration of PF4 induced a dose-dependent decrease in the numbers of megakaryocytes and their progenitor cells (CFU-MK), continuing for 1 week after the injection. However, the size of megakaryocytes and their colonies was not changed following PF4 injection. Platelet levels were significantly decreased at days 3-4. The number of CFU-GM was decreased at days 1-2. White blood cells and hemoglobin were unaffected by PF4. These data indicate that PF4 inhibits megakaryocyte and platelet production in vivo by acting on the early stage of megakaryocyte development. PMID- 1773362 TI - [Anesthesia for operations having no therapeutic benefit]. PMID- 1773361 TI - [Comparison of synaptic vesicles of neuromuscular and nerve electroplaque junctions in Torpedo marmorata]. AB - A morphological comparison of neuromuscular and nerve-electroplaque synapses of torpedo was performed. Synaptic vesicles are much smaller at the neuromuscular synapse. The question of the respective role of these populations is raised. PMID- 1773363 TI - [Anesthesia in a medical unit for treatment of trophic disorders of vascular origin]. AB - The authors report here a first experiment of anaesthesia in a medicine unit. 29 anaesthesias were performed for 22 patients classed ASA II and III. The indications were nurses dressing for trophic troubles related to extremely painful vascular diseases. The whole treatment was realised in the medicine ward. Anaesthesia consists first in morphine injection as a premedication then several injections of propofol and alfentanil combined. The heart beat frequency was still and the blood pressure never lowered more than 10% of the preoperative level. No incident occurred. The awaking was of good value and without discomfort. The usual autonomy is regain in 2 hours after anaesthesia. This type of anaesthesia offers a new approach of painful cares and through a better dressing should lower the hospital stay. PMID- 1773364 TI - [The effect of alfentanil on pain caused by the injection of propofol during anesthesia induction in children]. AB - Three modes of administration of alfentanil were assessed in order to reduce pain on injection with propofol. Forty healthy children scheduled for ENT surgery were included in this double-blind randomized study. All patients received intrarectal premedication with midazolam and atropine. Pain was scored with a behavioral scale. The children experience pain when alfentanil was administered a few seconds before or just after propofol. An bolus injection reduced significantly discomfort in patients. Dosages of alfentanil in plasma might determine the right moment of propofol injection to obtain analgesia. PMID- 1773365 TI - [The reduction of anesthetic risk by high frequency jet ventilation during endobronchial cryotherapy]. AB - Endotracheal cryotherapy was performed in 22 ASA III or IV patients with inoperable carcinoma. All patients received propofol by continuous infusion and fentanyl by bolus. In 11 patients (SV group) ventilation remained spontaneous. In 11 patients (HFJV group) high frequency jet ventilation was used with air-CO2 (1:1). Respiratory and haemodynamic parameters were studied and compared in the two groups. Systolic blood pressure was slightly and transiently lower in the HFJV group. In this group PaCO2 remained excellent during the whole procedure, in SV group hypoxemia was constant. PaCO2 increased in both groups but very shortly in the HFJV group. Several arrhythmias and other transient adverse effects occurred in the SV group, none in the HFJV group. Thus clinical and haemodynamic tolerance of HFJV seem excellent. HFJV appears to be a very secure method for difficult endoscopic procedures. PMID- 1773366 TI - [A comparison of propofol, ethrane, neuroleptanalgesia in maxillofacial surgery]. PMID- 1773367 TI - [Propofol and etomidate: a comparative study in emergency anesthesia in ASA I and II patients]. AB - The use of propofol and etomidate in emergency anaesthesia is studied in 39 patients ASA I and 11 patients ASA II. After premedication, the narcosis is induced and maintained either by iterative injections or by continued infusion. Concerning haemodynamic changes, the diastolic blood pressure decreases in propofol group without any deleterious effect for these patients. Recovering time is the same in the two groups. The time for recovering memorization is significantly shorter in the propofol group. The use of these two drugs is fully justified in an emergency situation with preference for propofol in case of preoperative haemodynamic stability. PMID- 1773368 TI - [A comparison of the hemodynamic effects of midazolam and propofol during anesthetic induction in patients at vascular risk]. AB - The haemodynamic effects of midazolam or propofol, with a low dose of fentanyl, were studied during induction of anaesthesia and tracheal intubation in 20 patients undergoing aortic reconstructive surgery. This study demonstrates that both drugs induce important modifications of haemodynamic parameters undesirable in elderly, high-risk patients. PMID- 1773369 TI - [Continuous-flow propofol in pediatric oncologic surgery]. PMID- 1773370 TI - [Propofol in pediatric anesthesia]. AB - Administration of propofol in paediatric anaesthesia is relatively recent. Cardiovascular effects are minimal. Respiratory depression observed is in part in relation with the decrease of CO2 response. EEG tracing does not show spikes or "burst suppression" for usual doses. Pharmacokinetics are similar to those reported for young adults with the exception of a larger central compartment volume. Dosage depends particularly on age, injection speed and premedication. Propofol is often used for induction, halogenated agents taking over with a narcotic and a myorelaxant. Main disadvantages is pain on injection which are reduced by addition of lignocaine. Spontaneous movements during induction appeared chiefly with low doses. The most important advantage of propofol is the rapidity and the quality of recovery. Propofol has its place in paediatric anaesthesia and in addition sedation in intensive care unit is an new unexplored field. PMID- 1773371 TI - [Prekallikrein deficiency: a rare cause of a significant prolongation of the activated partial thromboplastin time. Apropos of a case]. PMID- 1773372 TI - [A rare and serious complication of spinal anesthesia: bacterial meningitis]. AB - Bacterial meningitis following spinal anaesthesia is a rare but serious complication. We describe a case in which an old woman received spinal anaesthesia for hip replacement. Diagnosing the aetiologic agent is a major medical challenge. The possible aetiological causes of this complication are discussed and the difficulty in differentiation between aseptic and bacterial meningitis noted. PMID- 1773373 TI - [Is it possible to avoid a penal offence in carrying out ambulatory anesthesia?]. AB - French jurisprudence about outpatient anaesthesia is resolutely unfavorable. It is principally based on the June 22nd 1972 decision of the cessation court, the highest court of justice in France. Preoperative non hospitalisation has been considered as a fault by negligence/carelessness of the practitioners. It resulted in their penal condemnation for involuntary injuries and compensation for the harm. This decision is linked with the evolution of the fault and the responsibility share between surgeon and anaesthetist. The post-operative phase seems to involve "theory of missing luck" (causality linkage or the detriment in itself), excluding a penal condemnation but not a partial compensation. Though some new legal considerations could be put forward, a written contract between physicians and patients is necessary in outpatient surgery, whereas the medical files and the organisation of the unit can prove the quality of medical care. PMID- 1773374 TI - [The resuscitation of the dead from suffocation, chloroform poisoning or electrocution. 1900]. PMID- 1773375 TI - [Reflections on tracheal intubations]. PMID- 1773376 TI - [The demographic future of the pharmacy profession (1990-2020)]. AB - Training of pharmacists in France is regulated by a numerous clausus system. However, forecasting the number of active pharmacists in the future is not an easy task for various reasons: (i) after graduation, certain pharmacists do not become occupationally active; (ii) there are many types of pharmaceutical occupations, a pharmacist may leave an occupation for an other or enter an occupation long time after graduation; (iii) for the time being, the dynamics governing retirement, mortality and other occupation leaving processes have not been observed and analyzed. Based on certain sets of reasonable assumptions, the Centre de Sociologie et de Demographie Medicales has attempted to design scenarios for future development of French pharmaceutical manpower. If the student annual intake is kept at its current level (2,250), the number of active pharmacists registered with the Ordre des Pharmaciens would rose to 60,400-63,000 in the year 2000, and to 65,400-71,300 in the year 2010, from less than 53,000 in 1990. If the numerous clausus is immediately reduced to 1,500 (i.e. a cut of one third from the current level), the number of registered pharmacists would be 57,000-58,300 in 2000 and 57,500-61,000 ten years later. All these calculations are carried out with techniques of demographic projection. It remains to know what set of figures would be the most suitable to the future need of the nation regarding pharmaceutical manpower. PMID- 1773377 TI - [Venous island flap anastomosed with a vein of recipient area at its distal end]. PMID- 1773378 TI - [Causes of failure of skin transplantation (an analysis of 649 cases)]. PMID- 1773379 TI - [Treatment of 151 deeply burned hands in the early stage]. AB - The paper presents the treatment of 151 deeply burned hands out of 294 burned hands of 210 cases. During 44 months, 907 burned patients were treated in our department. It is learned that the first three weeks after burn is the key opportunity for preserving hand functions. In this period, active treatment can reduce the deformity of the hand and shorten the time of treatment. For wound with infection or not, skin burn only or complicated by injury of tendon, nerve, muscle, or with exposed bones should be covered with various ways and treated actively in the first three weeks. PMID- 1773380 TI - [Common pathogens in burn infection and changes in their drug sensitivity]. AB - This paper reports common pathogens in burn infection and changes in their drug sensitivity from 1985 to 1988. Gram negative rods constituted 55.7% of all pathogens, while 40.5% were gram positive cocci. The former group consisted of 173 strains of Pseudomonas aeruginosa (28.5%), 55 Proteus (9.1%), 33 Serratia (5.4%), 23 Klebsiella (3.8%) 19, Acinetobacter (3.1%), 18 Enterobacter (3.0%) and 17 E. coli (2.8%). Among gram-positive cocci, Staphylococcus aureus accounted for 32.8%, Staphylococcus epidermidis accounted for 5.6%, and Streptococcus faecalis accounted for 2.1%. All the gram-negative rods and gram-positive cocci showed more resistance against various antibiotics. Ps. aeruginosa were resistant to 24 commonly used antibiotics. However, ciprofloxacin, ceftaztdime and piperacillin were comparatively effective, the sensitivity rates were 92.9%, 91.5% and 78.3%, respectively. Ps. aeruginosa showed a sensitivity rate of 92.5% and 86.1% to amikacin and polymyxin-B, respectively, from 1980 to 1984, but the rates were lowered to 65.9% and 17.3%, respectively, from 1985 to 1988. Staphylococcus aureus showed a sensitivity rate of 88.9% to ciprofloxacin, 76.1% to ceftazidime, 71.4% to amikacin, 48.5% to piperacillin, 63.1% to cefuroxime. This organism showed a sensitivity rate of 87.3%, 83.9%, 81.7% and 82.8% to amikacin, cefoperozone, leucomycin and lincomycin, respectively, from 1980 to 1984, but the sensitivity rates declined to 71.4%, 56.8%, 60.8% and 43.7%, respectively, from 1985 to 1988. PMID- 1773381 TI - [Detection of Candida albicans infection by indirect immunofluorescence]. AB - It has been a serious problem that candida sepsis is increasing followed thermal injury, which related to the increasing use of antibiotics in part. This paper showed that indirect immunofluorescence assay (IFA) is a more sensitive, efficiency, rapidly and specific method by staining urine sample in early diagnosis or monitoring the candida infection from gut after burn injury. It seems that IFA is more useful to make early diagnosis of candidal infection for the clinical purpose. PMID- 1773382 TI - [Re-evaluation of vascular anatomy of dorsal lateral digital island flap and its clinical significance]. PMID- 1773383 TI - [Pathological changes in allogenic skin in combined radiation-burn injury in rats]. AB - Skin allografts were transplanted to rats inflicted with third degree burns of 15% of BSA alone or combined with 5 Gy gamma ray radiation. Histopathological, histochemical and ultrastructural changes of the allografts were examined at different postoperative periods. In burned rats, allografts began to be rejected on the 8th postoperative day, showing degeneration and necrosis of its epithelial cells. Only in one rat it survived on the 14th day (10%), and all allografts were rejected before the 19th day. In contrast to this, most allografts (60-80%) on the rats with combined injury survived well for a period of 29 days. Epithelial cells and collagen fibers of the allografts degenerated in 1 to 4 days postoperation, and recovered to near normal during 9 to 14 days. During 24 to 29 days postoperation, the epithelial cells and appendices appeared almost normal in texture except an infiltration of a few lymphocytes and monocytes. The restoration of degenerated collagen, however, was slower than that of degenerated epithelium. The result shows that the survival time of skin allografts in severe combined radiation burn injury is prolonged than that in burns. PMID- 1773384 TI - [Growth of transplanted auricular cartilage in young rabbits]. AB - Three months after isotopic and heterotopic autotransplantation of 100 pieces of auricular cartilage grafts (10 x 10 mm each) in 25 seven-week-old rabbits, growth was observed in 93% of the grafts. The length increased 24.0% to 26.0%, the width 12.0% to 17.0%, the area 40.0% to 47.4%. A synchronous growth of the transplant and the ear was observed with the growth of the rabbits. Histologic study showed that the growth of transplanted auricular cartilage is achieved jointly by two mechanisms, namely interstitial growth and appositional growth. The results of this experiment offer a positive and encouraging outlook for autotransplantation of cartilage in young patients. PMID- 1773385 TI - [Experimental electric injuries: repair and histology]. AB - 66 rats were submitted to bilateral hindlimb high-voltage electric injuries. When palliative debridement, followed by flap transplantation, was done within 48 hours after the injury, both the external appearance and functions were restored satisfactorily. On the contrary, when radical debridement or skin grafting with split thickness skin was done, all the limbs lost their functions. The results suggest that early palliative debridement and good coverage with skin flap are feasible in the treatment of electric burns. PMID- 1773386 TI - [Protective effect of lyophilized skin on early deep second degree burn wound]. PMID- 1773387 TI - [Experimental studies on the effect of various cleaning fluids in phosphorus burns]. AB - Male Wistar rats were divided into three groups. Group 1 consisted of uninjured normal rats. Animals in groups 2 and 3 were inflicted with 20-30% third degree phosphorus burn. Group 2 served as control without cleansing, and group 3 animals were washed with various fluids postburn. There were five subgroups in group 3: Subgroup I, the wound was washed with water (fluid I); Subgroup II. 1% detergent solution was used (fluid II); Subgroup III, 5% NaHCO3 was applied after being washed with 2% CuSO4 (fluid III); Subgroup IV, 2% CuSO4 was used only (fluid IV); Subgroup V, water was used after the application of 2% CuSO4. The results showed: 1. The tissue phosphorus and serum BuN values were decreased markedly immediately and 6 h postburn when fluid II was used. It was demonstrated that the detergent was more effective than fluids I and III. Therefore we proposed that a detergent should be used to wash off phosphorus from the wound. 2. The serum copper value increased immediately after the application of 2% CuSO4. However, the serum copper value decreased significantly after the use of NaHCO3. The results suggest that copper poisoning can possibly occur when CuSO4 is used alone, and NaHCO3 solution is effective to wash off CuSO4. PMID- 1773388 TI - [Changes in glucose metabolism after burn injury]. PMID- 1773389 TI - [One stage reconstruction of auricle with partial defect after trauma]. AB - An improved method for one stage reconstruction of partial defect of the ear lobe is reported. A postauricular mastoid skin flap is constructed with the pedicle on the margin of the defect of the ear. If necessary, the distal part of the flap may carry a piece of subcutaneous tissue of the scalp to cover the framework. The operation has been done in 19 patients with satisfactory results. PMID- 1773390 TI - [Diagnosis and treatment of inhalation injury (a report of 62 cases)]. AB - 62 cases with inhalation injury are included in this paper. 19 patients died, constituting a mortality of 30.7%. Among the symptoms, there is a characteristic high-pitched laryngotracheal respiratory sound, which is produced by narrowing of the laryngo-tracheal tract due to edema after the injury. It can be heard in the middle of the neck with a stethoscope. It can be regarded both as a diagnostic sign of inhalation injury and an indication for tracheotomy. The pressure exerted by the eschar in the neck can be released by incising the eschar. Tracheotomy can be avoided in some patients after the releasing incisions. Other problems such as artificial ventilation, liquid resuscitation etc. are also discussed. PMID- 1773391 TI - [Treatment of post-irradiation ulcers with island myocutaneous and axial flaps]. PMID- 1773392 TI - [Use of irradiated porcine skin in the treatment of deep burn wound]. PMID- 1773393 TI - [Gluteus maximus myocutaneous flap in the repair of sacral and gluteal decubitus ulcers]. AB - 16 cases of decubitus ulcers in the sacral, ischiadic and great trochanter regions were treated with rotating myocutaneous flap of the caudal portion of the gluteus maximus from 1983 to 1989. They were followed up for 3 to 68 months, with the exception of 4 patients. The results were excellent. 30 gluteus regions were studied in 15 cadavers. It was found that the caudal 3/4 of the gluteus maximus muscle was supplied by the inferior gluteal artery, and a flap measuring 12.9 x 9.7 cm could be formed therein with easy dissection. The flap tolerates pressure well. Unilateral flap is adequate to cover a decubitus ulcer within a diameter of 10cm, while bilateral flaps are necessary for a larger ulcer. PMID- 1773394 TI - [Simple frontal muscle flap suspension in the treatment of ptosis of the upper eyelid]. PMID- 1773395 TI - [One stage reconstruction of penis with composite ilio-abdominal island flap]. PMID- 1773396 TI - [Augmentation mammaplasty using indigenous silicone gel]. PMID- 1773397 TI - Geropsychiatry--a challenge for the '90s. PMID- 1773398 TI - Electroconvulsive therapy: electric stimulus variables and the convulsive response. AB - The ability of an electrical stimulus to induce a grand mal convulsion during electroconvulsive therapy (ECT) was investigated using four clinical treatment protocols during which the stimulus waveform, the electrical energy and/or the electrode placement were varied. The statistically significant results support the view that a pulsatile square wave stimulus is effective in inducing convulsions, provided that the d'Elia and not the Muller unilateral electrode placement is used. Higher stimulus energy may be required for older patients. The results illustrate successive attempts to remedy a previously reported problem with the effectiveness of the pulsatile waveform as a convulsive stimulus. The benefit of maintaining a database of treatment variables in order to monitor the effect of changes in the protocol under conditions of routine clinical practice is also demonstrated. PMID- 1773399 TI - Electric stimulus energy and the clinical response to electroconvulsive therapy. AB - The relationship between electric stimulus energy and clinical response was examined in depressed patients receiving electroconvulsive therapy (ECT) under routine clinical conditions with a protocol which dichotomized the stimulus energy by patient age. There was no significant difference in the number of treatments and cumulative seizure duration between groups. The results support the observation that the stimulus energy may contribute to the therapeutic effect of ECT. Reduction of that energy in order to minimize side-effects may compromise the therapeutic effectiveness. The implications for dosage strategies in routine clinical practice are discussed. PMID- 1773400 TI - Validation of the crisis triage rating scale for psychiatric emergencies. AB - Using a sample of 500 emergency psychiatric patients at Victoria Hospital in London, Ontario, this study replicated part of the research on the Crisis Triage Rating Scale (CTRS) conducted by Bengelsdorf, Levy, Emerson and Barile in 1984. The relationship between the suggested CTRS cut-off score and the decision whether or not to hospitalize the patient was studied, independently of these scores. The relative contribution of each of the subscales (Dangerousness, Support System and Ability to Cooperate) to this decision was also determined. The results of this study suggest that using a cut-off score of 9, the easily administered Crisis Triage Rating Scale could be an additional assessment aid in determining whether patients require emergency hospital admission to a psychiatric unit. PMID- 1773401 TI - The relationship of suicide rates to sociodemographic factors in Canadian census divisions. AB - The correlates of suicide rates were determined by conducting a multivariate study of sociodemographic indicators and suicide rates of 261 Canadian census divisions. Twenty-one sociodemographic variables were entered into a stepwise multiple linear regression to develop a model for suicide rates. The important variables were mortality rate for all causes of death, the age of the population, average family income, population density, proportion with no religious affiliation, proportion of Francophones, unemployment, immigration, proportion of Native people, a regional effect for British Columbia and the north, and growth by mobility, explaining 62% of the observed variation. This spatial ecologic analysis highlights the importance of cultural differences in explaining the variation of suicide rates. The analysis supports the previously found negative relationship between income and suicide while contrasting from previous studies in determining a inverse relationship with unemployment and an inverse relationship with the age distribution. PMID- 1773402 TI - A plea for paraphrenia. AB - Clinicians who deal with psychotic patients see individuals whose illness is similar to schizophrenia, but whose symptoms are less florid, and deterioration less severe, than in schizophrenia. The diagnosis of atypical psychosis or psychotic disorder NOS is not satisfactory since it lumps disparate conditions together, whereas the term "paraphrenia" can include such illnesses. Paraphrenia is a well-established concept that was ignored in the DSM-III and the DSM-III-R and may be excluded from the ICD-10. There is a need to re-establish the diagnosis, for accurate diagnostic purposes and for future research of the paranoid/delusional disorders. PMID- 1773403 TI - Therapy begins at home: the psychiatric house call. AB - The house call is a valuable but underused component of community psychiatric care. A review of home visits conducted by the staff of a community mental health service over a 12 month period identified four situations in which a home visit is useful: getting reluctant patients to enter therapy, conducting a comprehensive assessment, strengthening a support network, and maintaining patients in the community when their condition has deteriorated. Making psychiatric house calls requires some additional skills on the part of therapists and offers residents valuable training experience. PMID- 1773404 TI - Photophilic and photophobic behaviour in patients with schizophrenia and depression. AB - The authors interviewed 32 patients (25 with an RDC diagnosis of schizophrenia and seven with schizoaffective disorder) consecutively admitted to a psychiatric outpatient clinic. Ten patients had a history of photophilic behaviour with sun gazing, while 20 patients showed no unusual behaviour related to light. Two patients who had depressive symptoms at the time of interview had a history of photophobic behaviour. Sixteen patients and 12 controls were tested for their threshold for discomfort of high intensity light; the thresholds were significantly higher in the patients with schizophrenia (especially in those with history of sun gazing). The implications of these findings for clinical practice and research are discussed. PMID- 1773405 TI - Seasonal affective disorder presenting as chronic fatigue syndrome. AB - Although operational criteria have been recently proposed to better define chronic fatigue syndrome (CFS), it remains a controversial diagnosis. There are many overlapping symptoms between CFS and major depression. The author presents two patients with seasonal affective disorder, who responded to phototherapy and had previously been diagnosed as CFS. Because of the consequences of treatment, seasonal and non seasonal depression need to be ruled out in patients with chronic fatigue symptoms. PMID- 1773406 TI - Penile self-mutilation presenting as rational attempted suicide. AB - Genital self-multilation is rare, and reports suggest that it is usually associated with psychotic illness. We report a case in which penile self multilation was an attempt to commit suicide and justified as a rational action. The literature on genital self-mutilation is reviewed. It is argued that the strong association between genital self-mutilation and psychosis may be the result of selective reporting. PMID- 1773407 TI - Autism: its primary psychological and neurological deficit. AB - Autism is a perplexing condition because of its unique presenting signs and high degree of variability. Evidence is presented that the basic underlying information processing disorder is a dysfunction of the appreciation of the emotional significance of incoming stimuli and attaching motivational value to the stimuli. It is proposed that this dysfunction occurs when the amygdaloid nucleus and/or its connections are disrupted, resulting in the variability of the presentation of this syndrome among individuals. Herpes simplex encephalitis sometimes results in signs of autism. The virus has a predilection to attack specific areas of the brain, which provides information on the probable underlying neurological dysfunction in autism. PMID- 1773408 TI - Intramuscular clonazepam for the treatment of psychotic agitation. PMID- 1773409 TI - Manic-like response to phototherapy. PMID- 1773411 TI - Functional circulation time images in the diagnosis of cerebral lesions by angio CT. AB - An application of angio CT as an adjunct to contrast enhancement evaluation of cerebral lesions is presented. We performed rapid sequential scanning following intravenous bolus injection of an iodinated contrast medium, analyzed the time contrast curves and generated a functional circulation time image. This was accomplished by calculating on a pixel-by-pixel basis the first mathematical moment of the monitored time-density curves about injection time which corresponds to regional arm brain circulation time (rABCT). This method increased the rate of detection of cerebral lesions by contrast enhancement from 30 to 90%. PMID- 1773410 TI - Computed tomography in spinal tuberculosis. AB - Exhaustive clinicoradiologic and computed tomographic (CT) analysis of 114 cases of spinal tuberculosis seen between January 1983 and January 1989 is presented. The mechanisms of the spinal involvement are reviewed. CT helped to diagnose cases of spinal tuberculosis in their initial stages. Inaccessible fixed areas of spine were seen with ease on axial sections of CT. The extent and anatomic depiction of soft-tissue involvement as depicted on CT helps surgeons choose the appropriate surgical approach, which may affect future spinal stability. PMID- 1773412 TI - Low-osmolality contrast media: dosage comparison of ioversol and iohexol for cranial computed tomography. AB - One hundred patients undergoing cranial computed tomography were evaluated in this prospective, randomized, double-blind comparative study. Patients received 50 mL of ioversol 320 (16 g iodine), 75 mL of ioversol 320 (24 g iodine), 100 mL of iohexol 240 (24 g iodine), 100 mL of iohexol 300 (30 g iodine) or 150 mL of iohexol 240 (36 g iodine). Twenty patients were enrolled in each treatment group. No patient in any treatment group experienced any contrast-media-related adverse reaction. Results of this study coupled with our prior work suggests that the lowest dose and optimal concentration of low-osmolality contrast media necessary to produce diagnostic cranial computed tomography is 32 g of iodine administered in a concentration of 320 mg/100 mL iodine. PMID- 1773413 TI - Thymic carcinoma arising from long standing thymoma and presenting with pituitary metastases. AB - Primary thymic squamous cell carcinoma is uncommon and has only rarely been linked to a pre-existing thymoma. We are reporting a case of primary thymic squamous cell carcinoma with pituitary metastases, in a patient with a long standing thymoma. PMID- 1773414 TI - MRI findings of hypothalamic hamartoma: report of five cases and review of the literature. AB - Hypothalamic hamartoma is a relatively rare congenital malformation, associated with the clinical presentation of precocious puberty of central type. Five cases with hypothalamic hamartoma are reported here, with an emphasis on MR appearance. The most common presentation of hypothalamic hamartoma was a small and well defined mass in the inferior aspect of the hypothalamus, showing isointensity on T1 weighted images and hyperintensity on T2 weighted images compared with the gray matter. The previous reports with MRI description are reviewed and compared with the present results. PMID- 1773415 TI - MRI differentiation of recurrent nasopharyngeal carcinoma from postradiation fibrosis. AB - A prospective study was performed to determine the usefulness of magnetic imaging (MRI) in differentiating local recurrence versus post-irradiation fibrosis in 72 patients after radiotherapy of nasopharyngeal carcinoma (NPC). All patients had a soft-tissue mass in the nasopharynx demonstrated by computed tomography. A total of 29 patients had tumor recurrence; 40 patients had only radiation fibrosis; 1 patient had postradiation edema and 2 patients had inflammatory changes. Based on the differences in signal intensity on T2-weighted images, MRI may be promising as a noninvasive method for differentiating radiation fibrosis from local recurrent NPC. However, the signal intensity pattern of the tumor is not specific and may be seen in radiation edema and infection. PMID- 1773416 TI - Pitfalls in diagnosis of aortic dissection by angiography: algorithmic approach utilizing CT and MRI. AB - Dissection of the thoracic aorta is a life-threatening event requiring imaging studies to define the level of the tear and the intimal flap. The "gold standard" has been angiography. This method may fail to demonstrate the dissection, however, due to overlap of the true and false lumens or a very thin flap that is imaged en face rather than tangentially. Computed tomography has a diagnostic accuracy of 95%, but can fail to image the dissection due to technical factors or a thrombosed false lumen. Magnetic resonance imaging requires a hemodynamically stable and cooperative patient. A diagnostic algorithm is proposed for diagnosis of aortic dissection based on renal function and the surgeon's imaging modality preference. PMID- 1773417 TI - Inferior vena cava interruption with renal vein collar continuation: CT and MRI appearance. AB - The CT and MRI appearance of an inferior vena cava (IVC) interruption with renal venous collar continuation is presented. CT and MRI identify and define venous anomalies without the need for invasive angiography. Knowledge of an anomalous IVC is important to the vascular and transplant surgeon as well as to the interventional radiologist. PMID- 1773418 TI - MR imaging of orbital mass lesions with contrast agent: a preliminary report. AB - To investigate the advantage and limit of contrast enhancement in the examination of orbital mass lesions, precontrast T1- and T2-weighted, and postcontrast T1 weighted spin-echo images were retrospectively compared by two experienced observers. Using contrast material, intraocular tumors were well detected and characterized, and several orbital tumors were characterized as to whether cystic or necrotic and intracranial involvement was better evaluated. On the other hand, tumor-fat interface lost conspicuity when tumors showed enhancement. We conclude that gadopentetate-dimeglumine-administered T1-weighted images were helpful in detecting, differentiating and characterizing tumors of the orbit. However, the loss of contrast with fatty tissue is a disadvantage to be considered. PMID- 1773419 TI - Peripheral findings in MR using surface coil. AB - Incidental peripheral lesions found during neuroradiological MR examinations with surface coils are reviewed. These include intracranial metastases during orbital examinations, cerebellar and thyroid lesions during cervical spine examinations, and dissecting and saccular abdominal aneurysms, as well as renal and intrapelvic abnormalities during lumbar spine examinations. Because of the reduced field-of view and rapid signal drop-off in deeper portions of the body when examinations are performed with surface coils, peripheral and deep regions also need careful attention during routine evaluation. PMID- 1773420 TI - Parkinson's disease: an epidemiologic method for distinguishing between symptomatic and neuroprotective treatments. AB - Recent studies have suggested that deprenyl may exert a neuroprotective influence and thus retard progression of Parkinson's disease (PD). On the other hand, the data do not disprove that deprenyl is primarily another form of symptomatic therapy like levodopa. Longitudinal Gompertzian analysis demonstrates the absence of beneficial alteration of intrinsic or environmental influences on the epidemiology of PD mortality after the introduction of levodopa. Moreover, this method demonstrates the basis for the enhanced survival in PD that resulted from the efficacy of levodopa as symptomatic therapy. If deprenyl becomes standard therapy in PD and exerts a beneficial (neuroprotective) influence on intrinsic and environmental pathogenic mechanisms, this will become evident by a decrease in the PD mortality rate in the United States in men at age 73.4 years and in women at age 79.1 years. The ability to accurately assess the overall impact of new therapies on the general population is increasingly important in an era of upward spiraling health care costs. Longitudinal Gompertzian analysis is a simple method of detecting and distinguishing between symptomatic (competitive) and protective (intrinsic and environmental) influences on disease mortality at the population level after the introduction of new therapies. PMID- 1773421 TI - A computational model of levodopa pharmacodynamics in Parkinson's disease. AB - A series of computational models were developed to better understand basal ganglia functions and the effects of levodopa pharmacodynamics in Parkinson's disease. The models employed a relatively new computational approach known as a neural network, which is a small number of simple processing units interconnected with designated constraints. A key difference from traditional computational modeling is that the networks are "trained" rather than programmed with experimental input and output data. After training, only a limited number of these models, could explain the pharmacodynamic data observed by Mouradian et al. in different groups of Parkinsonian patients. These successful models strongly argue for at least two pharmacologic mechanisms to explain the antiparkinsonian effect and dyskinesia tendency for the different classes of Parkinson's patients: never-treated, stable, wearing-off, and on-off. They suggest different roles for the striatal units by examining predictions of motor and dyskinesia tendency through theoretical blockade of each kind of unit. The models show that the antiparkinsonian effect in Parkinson's disease cannot be explained by the action of dopaminergic neurons on striatal neurons alone. Although the models necessarily oversimplify basal ganglia function, they provide a useful quantitative insight into how motor and dyskinesia behaviors may develop in different Parkinsonian subgroups. PMID- 1773422 TI - The influence of bromocriptine on the pharmacokinetics of levodopa in Parkinson's disease. AB - Several hypotheses have explained the beneficial effect of adding bromocriptine (BR) to levodopa (LD) in Parkinson's disease (PD) by interaction at the striatal level. In the present study we show the influence of BR on plasma LD values in an acute loading experiment (125 mg LD + 12.5 mg carbidopa [DCI] given alone and together with 2.5 mg BR at 0 time; 4 h observation). On the basis of this influence we have been able to differentiate between three groups of patients: (a) in six patients (five of them with frequent off episodes) LD values were significantly lower (p less than 0.05) when both drugs were given together (area under the curve [AUC] +/- SE 2.10 +/- 0.42 micrograms/ml/h vs. 4.96 +/- 1.10 micrograms/ml/h); (b) in eight patients (one with frequent akinesia) LD levels were significantly higher (p less than 0.003) when both drugs were given together (AUC +/- SE 4.05 +/- 0.51 micrograms/ml/h vs. 1.94 +/- 0.19 micrograms/ml/h); (c) in six patients (without motor fluctuations) no difference in LD levels was noted (AUC +/- SE 3.91 + 0.62 micrograms/ml/h vs. 3.81 +/- 0.70 micrograms/ml/h). The clinical evaluation (Webster scale) did not show substantial differences, except for increased dyskinesia, which correlated with higher LD levels. In summary, we suggest that the diminution of motor fluctuations and the occurrence of dyskinesias when BR is added to LD may stem from changes in LD plasma levels. These findings would be taken into consideration in the interpretation of therapeutic response fluctuations under combined treatment. PMID- 1773423 TI - L-deprenyl therapy improves verbal memory in amnesic Alzheimer patients. AB - Altered monoaminergic neurotransmission could play an important role in the cognitive dysfunctions typical of dementia of the Alzheimer type (DAT). DAT is not, however, a homogenous phenomenon inasmuch as two forms are distinguishable: early onset (EO) and late onset (LO). Moreover, focal patterns of neuropsychological deterioration fall into various subgroups. According to our hypothesis, DAT patients, who at the onset of the disease mainly manifest memory disorders, also represent a specific subgroup characterized by impaired cortically projecting catecholaminergic pathways. In a 6-month randomized, double blind, cross-over study versus placebo we analysed the influence of L-deprenyl on the verbal memory of 19 amnesic EO-DAT patients. Verbal memory was assessed by means of the Rey Auditory Verbal Learning Test. The results obtained show significantly better performances for L-deprenyl treated patients in learning and long-term memory skills. We suggest that L-deprenyl, through selective inhibition of MAO-B and by increasing the activity of the catecholaminergic systems, positively influences cognitive functions and behaviour founded on memory efficiency. PMID- 1773424 TI - Sublingual apomorphine in the treatment of Parkinson's disease complicated by motor fluctuations. AB - Subcutaneous apomorphine is a useful treatment for refractory motor fluctuations in Parkinson's disease. We have now clinically evaluated a formulation of sublingual apomorphine (57 mg) and performed preliminary pharmacokinetic studies. In acute studies, all 10 patients switched "on" after a mean latency of 25 min with a mean duration of motor benefit of 118 min. In three patients followed for a mean of 4.7 months, we have shown that chronic sublingual use can be effective, safe, and convenient in controlling motor fluctuations. The pattern of clinical response followed closely the plasma profile of apomorphine with a mean Cmax of 76 pmol/ml (50-106 pmol/ml) and a mean Tmax of 60 min (45-80 min), with moderate interpatient variability in bioavailability. Sublingual apomorphine is a practical alternative to subcutaneous use in selected patients with severe motor fluctuations. PMID- 1773426 TI - 3-Amino-5-C-phenyl-D-altrofuranose and 3-amino-5-C-[3-carboxy-4-(carboxymethyl)-2 oxo-3-cyclohexen-1-yl] -D-altrofuranose, possible intermediates for synthesis of of the anthracycline antibiotic decilorubicin. PMID- 1773425 TI - Glucuronoxylomannan of Cryptococcus neoformans serotype B: structural analysis by gas-liquid chromatography-mass spectrometry and 13C-nuclear magnetic resonance spectroscopy. AB - The major extracellular polysaccharide (glucuronoxylomannan, GXM) from six strains of Cryptococcus neoformans serotype B was characterized by gas-liquid chromatography (g.l.c.), g.l.c.-mass spectrometry (g.l.c.-m.s.), and nuclear magnetic resonance (n.m.r.) spectroscopy. Ultrasonic irradiation (u.i.) was used to reduce the mol.wt. of native GXM from 9.75 x 10(5) to 1.15 x 10(5) without apparent change in its composition (GXM-S). The Xylp:Manp:GlcpA molar ratio of the GXM and GXM-S from the six strains of C. neoformans serotype B is approximately 3.5:3.0:0.6. GXM-S was O-deacetylated (GXM-D) by treatment with NH4OH. The 13C-n.m.r. analysis of GXM-D gave spectra that served as characteristic fingerprints of the structure and also facilitated the assignment of the anomeric carbon resonances to specific structural moieties present in GXM D. The GXM-D from each serotype B strain was found to be similar by 13C-n.m.r. spectroscopy. The structure contains a linear (1----3)-alpha-D-Manp backbone substituted with 2-O-beta-GlcpA and 2-O-beta-Xylp. beta-Xylp is also O-4 linked to the Manp substituted with GlcpA. In addition, a model for the disposition of the Xylp and GlcpA side chain substituents along the mannopyranan backbone is proposed, based upon results from the combination of g.l.c.-m.s. and 13C-n.m.r. spectroscopy. PMID- 1773427 TI - Synthesis of pseudo-laminarabiose, -cellobiose, and -maltose (D-glucopyranosyl 5a carba-D- and L-glucopyranoses). PMID- 1773428 TI - Determination of the degree of N-acetylation and the distribution of N-acetyl groups in partially N-deacetylated chitins (chitosans) by high-field n.m.r. spectroscopy. AB - The composition and sequence of 2-acetamido-2-deoxy-beta-D-glucose (GlcNAc) and 2 amino-2-deoxy-beta-D-glucose (GlcN) residues in partially N-deacetylated chitosans, prepared under homogeneous and heterogeneous conditions, have been determined by 1H-n.m.r. spectroscopy. It was necessary to depolymerise the chitosan slightly by treatment with nitrous acid before spectroscopy. A sequence dependent deshielding of H-1 of the GlcNAc residues made it possible to determine the proportions of the four possible diads. Chitosan prepared by N-deacetylation under homogeneous conditions gave values for the diad frequencies that were roughly consistent with a random distribution of the N-acetyl groups. Samples prepared under heterogeneous conditions have a frequency of the GlcNAc-GlcNAc diad slightly higher than for a random (Bernoullian) distribution. The chitosans, prepared under both homogeneous and heterogeneous conditions, with a degree of acetylation of 50% were soluble at neutral pH. PMID- 1773429 TI - Structural studies of the Escherichia coli O1A O-polysaccharide, using the computer program CASPER. PMID- 1773430 TI - Synthesis of two phosphate-containing "heptasaccharide" fragments of the capsular polysaccharides of Streptococcus pneumoniae types 6A and 6B. AB - The "heptasaccharides" O-alpha-D-galactopyranosyl-(1----3)- O-alpha-D glucopyranosyl-(1----3)-alpha, beta-L-rhamnopyranose 2''-[O-alpha-D galactopyranosyl-(1----3)-O-alpha-D-glucopyranosyl- (1----3)-O-alpha-L rhamnopyranosyl-(1----3)-D-ribit-5-yl sodium phosphate] (25) and O-alpha-D galactopyranosyl- (1----3)-O-alpha-D-glucopyranosyl-(1----3)-alpha, beta-L rhamnopyranose 2''-[O-alpha-D-galactopyranosyl-(1----3)-O-alpha-D-glucopyranosyl- (1----3)-O-alpha-L-rhamnopyranosyl-(1----4)-D-ribit-5-yl sodium phosphate] (27), which are structural elements of the capsular polysaccharides of Streptococcus pneumoniae types 6A and 6B ([----2)- -alpha-D-Galp-(1----3)-alpha-D-Glcp-(1----3) alpha-L-Rhap- (1----X)-D-RibOH-(5-P----]n; 6A X = 3, 6B X = 4), respectively, have been synthesized. 2,4-Di-O-acetyl- 3-O-[2,4,6-tri-O-acetyl-3-O-(2,3,4,6 tetra-O-acetyl-alpha-D- galactopyranosyl)-alpha-D-glucopyranosyl]-alpha-L rhamnopyranosyl trichloroacetimidate (13) was coupled with 5-O-allyloxycarbonyl 1,2,4-tri-O- benzyl-D-ribitol (10), using trimethylsilyl triflate as a promotor ( ---14), and deallyloxycarbonylation (----15) and conversion into the corresponding triethylammonium phosphonate then gave 16. Condensation of 16 with 4-methoxybenzyl 2,4-di-O-benzyl-3-O-[2,4,6-tri-O-benzyl-3-O-(3,4,6-tri-O-benzyl alpha-D- galactopyranosyl)-alpha-D-glucopyranosyl]- alpha-L-rhamnopyranoside (22) followed by oxidation and deprotection afforded 25. 5-O-Allyl-1-O allyloxycarbonyl-2,3-di-O-benzyl-D-ribitol (12) was coupled with 13, using trimethylsilyl triflate as a promoter, the resulting tetrasaccharide-alditol derivative 17 was deallyloxycarbonylated (----18), acetylated (----19), and deallylated (----20), and the product was converted into the triethylammonium phosphonate derivative 21. Condensation of 21 with 22 followed by oxidation and deprotection afforded 27. PMID- 1773431 TI - Analysis of positions of substitution of O-carboxymethyl groups in partially O carboxymethylated cellulose by the reductive-cleavage method. AB - A method is described for the analysis of positions of substitution of O carboxylated groups in commercial samples of O-carboxymethylcellulose. Sequential permethylation of the polymer and reductive cleavage gives eight products, which are analyzed as their O-acetyl derivatives by gas-liquid chromatography. PMID- 1773432 TI - The design and synthesis of antibody binding site probes: three pentasaccharide analogues of the Brucella A antigen prepared by activation in situ of thioglycosides with bromine. AB - Three pentasaccharide analogues of the Brucella A antigen [----2)-alpha-D Rhap4NFo-(1----], each with one formamido group replaced by a hydroxyl group, have been prepared as their methyl glycosides. Mono- and di-saccharide thioglycosides of D-rhamnose and 4-azido-4,6-dideoxy-D-mannose were used as glycosyl donors for the preparation of protected pentasaccharide derivatives with trisaccharides as intermediates. Glycosylations were performed by activation in situ of the thioglycosides with bromine in the presence of a glycosyl acceptor and silver triflate as promoter. Reduction of the azido groups with hydrogen sulfide. N-formylation with ethyl formate, and hydrogenolysis then gave the target pentasaccharides. PMID- 1773433 TI - Structural characterization of a new anticoagulant fucan sulfate from the brown seaweed Ecklonia kurome. AB - Methylation analysis of a fucose-containing, sulfated polysaccharide (C-II), which was isolated from the brown seaweed Ecklonia kurome and has a potent anticoagulant activity, showed the presence of 3-O- and 3,4-O-disubstituted fucopyranosyl residues in addition to small proportions of nonreducing, terminal fucofuranosyl and fucopyranosyl groups, and 2,3-di-O- and 2,3,4-tri-O-substituted fucopyranosyl and galactopyranosyl residues with various glycosidic linkages. Methanolysis of C-II gave several neutral oligosaccharide fractions in small proportions and two high-molecular-weight acidic fractions in large proportions. Methylation analysis of the low-sulfated acidic fraction showed that the proportion of 3-O-linked fucosyl residues increases and that of 3,4-O disubstituted decreased as compared to C-II. Methylation and g.l.c.-m.s. analysis of the neutral oligosaccharide fractions showed the presence of Fuc-(1----3)-Fuc and a fucosyl trisaccharide, in addition to small proportions of Gal-(1----4) Fuc, Fuc-(1----2)-Fuc, Fuc-(1----4)-Fuc, Fuc-(1----2)-Gal, and Fuc----Gal----Fuc. Methylated C-II was also desulfated by methanolysis, followed by remethylation with (2H3)methyl iodide, and most of (2H3)methyl groups were linked to O-4 of the 3-O-linked fucosyl residues. These results suggested a highly branched, new type of fucan sulfate containing a backbone of (1----3)-linked L-fucosyl residues having sulfate groups mainly attached to C-4. PMID- 1773434 TI - L-guluronan-specific alginate lyase from a marine bacterium associated with Sargassum. AB - The major extracellular alginate lyase activities secreted by a Gram-negative, facultative bacterium associated with actively growing Sargassum fluitans have been resolved an examined for substrate specificity. A fraction excluded from Sephadex G-75 was equally active toward (1----4)-beta-D-mannuronan, (1----4) alpha-L-guluronan, and alginate with the formation of di- and tri-saccharides as apparent limit products and oligo-saccharides indicative of an endolytic mechanism. A second fraction which was included during G-75 filtration was inactive toward D-mannuronan and 4 times more active toward L-guluronan than native alginate. Proton magnetic resonance spectrometry identified the primary product of this enzyme as O-(4-deoxy-alpha-L-erythro-hex-4-enopyranosyluronic acid)-(1----4)-O-(alpha-L-gulopyranosyluronic acid)-(1----4)-O-alpha-L gulopyranuronic acid. The L-guluronan-specific enzyme requires 0.5 M NaCl for maximal activity and has been purified as a monomeric protein having an apparent molecular mass of 38 kD and an approximate pI of 4.5. The predominant formation of trisaccharide over the course of a reaction showed a primarily exolytic mechanism, indicating an enzyme activity unique from any previously reported. PMID- 1773435 TI - Influence of the sympathetic nervous system as well as trigeminal sensory fibres on rat dural mast cells. AB - The dura mater has attracted considerable attention as an exquisitely sensitive tissue implicated as playing a role in various cephalalgias including vascular headache. Because of the potential clinical impact of the relationship/interaction of neural elements and mast cells the influence of sensory and autonomic nerve fibres on mast cells of the rat dura mater was studied. The trigeminal or superior cervical ganglion was electrically stimulated and the mast cells were examined. Wholemount supratentorial dural preparations were stained using berberine sulphate and the number of mast cells with intact vs dispersed granules counted. Unilateral stimulation of either ganglia resulted in a statistically significant increase in the percentage of mast cells with dispersed granules ipsilateral to the side of stimulation. These results support our idea that in addition to the trigeminal system the sympathetic nervous system must be considered as playing a role in the oedema pathophysiology of vascular headache. PMID- 1773436 TI - Some clinical comparisons between common and classical migraine: a questionnaire based study. AB - In a questionnaire-based study we compared the clinical features of migraine with aura (classical migraine) and migraine without aura (common migraine) in 354 and 397 patients, respectively, attending The Princess Margaret Migraine Clinic. Other than those related to the aura, no significant differences were seen in any clinical features of the attack (e.g. frequency or duration of attacks, time of day at onset, location of headache at onset, severity of headache, or nausea and vomiting). Common migraine attacks were significantly more likely to occur at weekends (p = 0.002). Dietary triggers tended to be more troublesome in classical migraineurs while pregnancy and the menstrual cycle affected both migraine types equally. Classical migraine patients were twice as likely to have a history of hypertension (p less than 0.05) and showed a slightly but not significantly greater tendency to depression. Family histories of migraine were similar in each migraine type. We conclude that classical and common migraine are fundamentally similar in their clinical characteristics and that the occurrence of focal neurological symptoms during a migraine attack has little influence on the rest of the attack. PMID- 1773437 TI - Migraine postdromes: symptoms after attacks. AB - To determine the nature and duration of symptoms after the headache phase of migraine, 40 migraineurs (11 with and 29 without an aura) were given a questionnaire to complete on the day after a migraine attack. The most common symptoms that remained were physical and mental tiredness, subdued or depressed mood, impaired concentration, reduced physical activities and yawning; weak or clumsy limbs, head tenderness, neck ache or stiffness, impaired sight and altered fluid balance were less frequent. The number of symptoms ranged from 2 to 11 (average 6) per patient lasting for a mean of 18 h, usually the whole of the next day. Symptoms after the main migraine attack can help to diagnose migraine particularly when there is no aura before the onset of headache. Eliciting postdromes aids patient-doctor rapport and confidence. The range of symptoms lends support to the notion that the whole of the brain is involved in the aftermath of migraine attacks. PMID- 1773438 TI - Overlap of migraine and tension-type headache in the International Headache Society classification. AB - Using questionnaire data from two recent surveys, headache sufferers were classified as having either migraine, episodic, or chronic tension-type headache using the International Headache Society criteria. Of 410 subjects with a headache history of 2 years or more, 147 or 35.9% were assigned Code 1.7 (migrainous disorder not fulfilling the above criteria) or Code 2.3 (headache of the tension-type not fulfilling above criteria). In 79 of these 147 subjects (53.7%), either of the above codes would have been equally valid. Separate scores for "migraine" and "tension" symptoms may provide a way to handle this overlap and aid in choosing optimal therapy. PMID- 1773439 TI - Prevalence of headache at preschool age in an unselected child population. AB - In a representative study of 5356 five-year-old children, 4405 (82.2%) could be traced for follow-up. Headache occurred in 861 (19.5%) of them; highly frequently in 0.2%, fairly frequently in 0.5%, less frequently in 4.3% and infrequently in 14.5%. Type of dwelling was the only predictor of housing standard, the risk of headache being about 1.5-fold in children living in other than one-family houses. Low economic status of the family, nursery day care and an increasing number of leisure activities were additional risk factors. Compared with infrequent or no headache, those with highly frequent or fairly frequent headache were at a 1.4 fold risk of temper tantrums. The risk of stomach ache was 8.9-fold in children with infrequent headache and 13.7-fold in those with fairly frequent or frequent headache compared with children with no headache. PMID- 1773440 TI - Transcranial Doppler study. PMID- 1773441 TI - Characterization of extracellular binding sites for [3H]-staurosporine on capillary endothelial cells. AB - [3H]-staurosporine, a non-specific protein kinase inhibitor, bound with high affinity and in a reversible manner to specific and saturable binding sites in cultured bovine cerebral cortex capillary endothelial cells. Scatchard analysis revealed the presence of one class of non-interacting binding sites with an equilibrium dissociation constant (KD) of 9.2 nM and Bmax of 19.3 fmol/10(5) cells. The binding of [3H]-staurosporine was fully displaced by unlabelled staurosporine, H-7 and ATP with IC50 values of 6.9 nM, 3 microM and 0.4 microM respectively. Mild trypsinization of cells after [3H]-staurosporine binding revealed the presence of membrane-associated, extracellular binding sites which could be an ecto-protein kinase. PMID- 1773442 TI - Indefinite growth of mammalian cell autotrophs on amino acids, vitamins, and glucose. AB - Established mammalian cells segregate variants, named autotrophs, able to proliferate in the absence of hormones and proteins of any kind. We provided complete formulas for autotrophic media composed of amino acids, vitamins, glucose, and inorganic salts only and showed that such media are sufficient to sustain continuous propagation of Chinese hamster fibroblasts and human keratinocytes. The cells grew on bare polystyrene and divided every 32 to 44 hours reaching approximately 8 x 10(5) cells/cm2. The results showed that the autotrophs may replace conventional cultures in most experimental and industrial cell production systems. PMID- 1773443 TI - Effects of cholinergic muscarinic agents on protein kinase C activity in rat pineal gland. AB - The role of protein kinase C (PKC) on muscarinic regulation of serotonin release in the pineal gland was investigated by measuring the pineal-PKC activity and serotonin secretion in response to muscarinic agents. Pineal slices, short-term incubated (0-15 min) without additions produced a low serotonin release and 20 to 24 percent PKC activity was found associated with membrane fractions. Prolonged exposure of pineal slices (30-180 min) produced further translocation of PKC activity to the membranes and a significant increase of serotonin release. Short term treatment with pilocarpine and carbachol, stimulated PKC activity of both cytosolic and particulate fractions and the release of pineal serotonin. The pilocarpine effect was blocked by atropine indicating that it was mediated by muscarinic receptors. The present data support that PKC activation correlates with the increase of serotonin release by muscarinic agonist in pineal gland. PMID- 1773444 TI - Myosin light chain kinase inhibitors ML-7 and ML-9 inhibit mouse lung carcinoma cell attachment to the fibronectin substratum. AB - We studied the effects of various protein kinase inhibitors on the attachment of mouse lung carcinoma 3LL cells to the fibronectin (FN) substratum. Calmodulin antagonists (W-7 and W-13) and myosin light chain kinase inhibitors (ML-7 and ML 9) exhibited the inhibitory effect for the attachment, while inhibitors of protein kinases A and C were ineffective. Since Arg-Gly-Asp-containing hexapeptide blocked the attachment, cell surface FN receptor appeared to be involved in this mechanism. These results support the hypothesis that the cell attachment requires the rearrangement of the cytoskeleton in association with the phosphorylation of myosin light chain which would lead to the clustering of the cell surface FN receptors. PMID- 1773445 TI - Evidence for the existence of cytoskeleton-bound polysomes in plants. AB - When conventional, high ionic strength buffers were used for the isolation of polysomes from pea plants, less than 20% were retained in the detergent-insoluble pellet. Reducing Tris, K+ and Mg++ to 10 mM increased retention to 70%, and when a new, microfilament-stabilizing buffer was used, retention increased to 80%. Conditions which favoured polysome pelleting at lower g forces permitted the retention of actin in the pellet. The data are consistent with the hypothesis that higher plants, like animals, contain cytoskeleton-(actin)-bound polysomes. PMID- 1773446 TI - Alpha-, beta-, and gamma-tubulins: sequence comparisons and structural constraints. AB - Comparison of congruent to 160 alpha-, beta-, and gamma-tubulins, and excluding the highly divergent C-terminal peptide, indicates that the three subclasses have similar tertiary structures. Conserved sequences within or between the subclasses have been identified, together with the locations of known epitopes, chemical modifications, and mutations. Evidence is also reviewed concerning the identity of the GTP-binding sites, about which residues are exposed in the assembled microtubule and at subunit:subunit interfaces. These characteristics constrain the possible tertiary structure of the tubulin subunit. PMID- 1773447 TI - Vinculin in relation to stress fibers in spread platelets. AB - To investigate the function of vinculin in blood platelets, we studied its localization in relation to other cytoskeletal proteins as well as its state of phosphorylation in platelets allowed to spread on fibrinogen-coated surfaces. By 5 minutes after loading the platelets onto the surfaces the 47 and 20 kDa polypeptides became phosphorylated, indicating activation. By 30 minutes, platelets formed small, typical bundles of fibers which stained brilliantly with rhodamine phalloidin. Myosin and tropomyosin, detected with specific antibodies, were localized in periodic arrays along these bundles. By indirect immunofluorescence, a discrete patch of vinculin was observed at each end of every actin-containing bundle. Vinculin phosphorylation was not detected in immunoprecipitates protected against phosphatases. Interference reflection images showed that regions of close binding to the substratum (adhesion plaques) closely matched the vinculin staining sites. Talin appeared diffusely localized. It could be shown to be present in the plaques when platelets were stabilized with ZnCl2 by the method of Geiger and then sonicated to remove some of the surface membrane. Localizations of vinculin and myosin were unaltered by this treatment. Talin phosphorylation or proteolysis could not account for vinculin translocation. We conclude that platelets, in response to an appropriate physiological surface, form typical actin bundles with vinculin at the termination of each bundle, in close relation to adhesion plaques. The signal for this translocation does not appear to depend on phosphorylation of vinculin or on phosphorylation or proteolysis of talin. Our findings support the conclusion that in platelets, as in nucleated cells, vinculin serves as at least part of the connection between bundled actin fibers and the extracellular matrix. Such a connection seems required for platelets' known ability to exert tension on surfaces. PMID- 1773448 TI - Dynamic morphology of metastatic mouse T-lymphoma cells invading through monolayers of 10T1/2 cells. AB - We have used an in vitro model system to analyze cytomechanical aspects of tissue infiltration by T-lymphocytes. The interaction of metastatic T-lymphoma cells with a precultured monolayer of 10T1/2 fibroblast-like cells was recorded in time lapse video with alternating phase contrast and reflection interference contrast microscopy. Sectioning of embedded specimens as well as cytoskeletal stainings have been performed on matching cocultures. The lymphoma cells did not strongly attach or spread on the dorsal surface of the monolayer cells. Invasion started with the protrusion of a pseudopodium through a narrow gap, and conspicuous constriction of the invading cell's body and nucleus was a consistent feature during the later steps. Overt retraction of the target cells was not seen, but the invading lymphoma cells elevated the fibroblasts over relatively large areas, thereby creating dome-shaped open spaces, allowing for further migration under the monolayer with minimal resistance. Invasion was not unidirectional but was readily reversible at any stage. Due to this wavering character, an invasion event could take more than 1 hour, although the shape alterations involved were fast. Even after the invasion process had been completed, the lymphoma cells could come out from below the monolayer again. Therefore we propose that invasion in this model should be considered as a dynamic equilibrium. Invading T-lymphoma cells displayed diffuse F-actin staining and a well-organized microtubular complex with the centrosomes behind the nucleus in the uropod, which also contained most vesicular organelles. PMID- 1773449 TI - Centripetal flow and directed reassembly of the major sperm protein (MSP) cytoskeleton in the amoeboid sperm of the nematode, Ascaris suum. AB - The cytoskeleton of the amoeboid spermatozoa of Ascaris suum consists of major sperm protein (MSP) filaments arranged into long, branched fiber complexes that span the length of the pseudopod and treadmill rearward continuously due to assembly and disassembly at opposite ends of the complexes (Sepsenwol et al., Journal of Cell Biology 108:55-66, (1989)). Examination by video-enhanced microscopy showed that this cytoskeletal flow is tightly coupled to sperm locomotion. The fiber complexes treadmilled rearward at the same rate (10-50 microns/min) as the cell crawled forward. Only fiber complexes with their plasmalemmal ends within a limited sector along the leading edge of the pseudopod underwent continuous assembly. Thus, the location of this sector, which occupies about 50% of the pseudopod perimeter, determined the direction of sperm locomotion. Treatment of sperm with agents that lower intracellular pH, such as weak acids and protonophores, caused the fiber complexes to disassemble completely in 4-5 sec. Removal of these compounds resulted in reassembly of the cytoskeleton in a pattern that mimicked treadmilling in intact sperm. The fiber complexes were reconstructed by assembly at their plasmalemmal ends so that within 30-60 sec the entire filament system reformed and the cell resumed locomotion. Both cytoskeletal reassembly and treadmilling required exogenous HCO3 . These results suggest that variation in intracellular pH may help regulate cytoskeletal treadmilling and thereby play a significant role in sperm locomotion. PMID- 1773450 TI - Properties of the spectrin-like structural element of smooth-muscle alpha actinin. AB - The fragment of smooth muscle alpha-actinin, comprising the four spectrin-like structural repeating units, has a high alpha-helix content, similar to that of spectrin, and a hydrodynamic frictional coefficient, indicative of an elongated, probably bent or kinked rod-like structure, as found for spectrin dimer and tetramer. The fragment exists in solution as an extremely stable dimer, which is dissociated only under denaturing conditions and is much more resistant to dissociation by urea than is the spectrin heterodimer. High-resolution proton magnetic resonance spectra reveal that a part of the polypeptide chain gives rise to sharp resonances; this is also true of spectrin and it implies that the individual structural repeating units contain segmentally mobile elements, which may be required to generate the elastic properties of the spectrin family of proteins. Again like spectrin, the alpha-actinin fragment contains multiple binding sites for long-chain fatty acids, as revealed by quenching of tryptophan fluorescence by 2-bromostearate (though not by 9(10)-bromostearate). The results point to extensive structural and functional similarities between the repeating units of all the proteins of the spectrin family. PMID- 1773451 TI - Selective vulnerability in brain hypoxia. AB - In the adult human brain, acute hypoxic episodes result in a certain pattern of nerve cell damage from which a hierarchy of neuronal vulnerability can be formed. Among the most sensitive regions are the "older" brain structures like hippocampus and cerebellum. In these structures, the typical picture is loss of pyramidal and Purkinje cells. Also, the neocortex is among the vulnerable structures, and often a characteristic laminar neuron loss is found. In the neonatal brain, the pattern of damage is somewhat different after hypoxia ischemia, where damage to the periventricular white matter is frequent in addition to the above-mentioned cortical damage. This review deals with a number of pathogenetic factors, including excessive formation of lactate, arachidonic acid, and free radicals, as well as an increased release of excitatory neurotransmitters. Experimental studies on the effect of calcium and glutamate receptor blockers in hypoxia-ischemia and their possibilities for treatment of ischemic-hypoxic damage in humans are critically evaluated. PMID- 1773452 TI - Scope and contribution of genetic models to an understanding of the epilepsies. AB - Studies of the genetic models of the epilepsies emphasize that some seizure disorders result from an aberrant "wiring diagram" coupled with abnormal activity of individual neurons. These defects cause the unique seizer-triggering mechanisms operative within the epileptic nervous system but which are inactive or do not exist in normal subjects. Moreover, causes of epilepsy reside not only within the brain area, wherein initial appearance of epileptic EEG discharge occurs, but also outside that region. Etiologically significant neurochemical dysfunctions may be common features of the epileptic condition in genetic models across species. Accordingly, genetically determined convulsive epileptogenesis in rats, baboons, and humans may result partially from noradrenergic and GABAergic deficits. In contrast, genetically derived absence seizures in the rat and perhaps also humans may occur in response to GABAergic excess. The unique features of the genetically epileptic animals emphasize their usefulness in developing novel drugs that selectively ameliorate seizure predisposition. PMID- 1773453 TI - [Paeonia Lactiflora injection in treating chronic cor pulmonale with pulmonary hypertension]. AB - The changes of clinical features of blood stasis, hemorheology, arterial blood gas and hemodynamics which was determined by impedance cardiogram and pheopneumogram, hemorheologic examination, blood gaseous analysis and right heart catheterization were observed in 42 patients (male 35, female 7; age 64 +/- 16.5 years), 32 patients with decompensative chronic cor pulmonale (CCP), served as noninvasive methods group (NMG) treated by intravenous injecting 100% Paeonia lactifiora injection 5 ml per day, 10 patients with CCP as well as pulmonary hypertension, which was proved through right heart catheterization were considered as invasive methods group (IMG) treated by pulmonary artery injecting 100% Paeonia lactiflora 5 ml (one-time). After the treatment, the clinical features of blood stasis were improved significantly in NMG (P less than 0.05). Also the results of impedance cardiogram and pheopneumogram (such as: Q-B, B-Y interval and Q-B/B-Y ratio, cardiac output), the hemorheologic parameters (such as: blood viscosity, plasma viscosity, hematocrit and erythrocyte electrophoresis) and oxygen consumption of myocardium were improved significantly in NMG and IMG. In IMG, PAP was reduced by 0.71 +/- 0.27 kPa; PaO2 was promoted significantly in NMG. All of these have statistical significance (P less than 0.05 or 0.01). There are no statistical significance about the change of PaCO2, SaO2, blood pH and Bp (P less than 0.05). PMID- 1773454 TI - [Clinical and experimental research on chronic bronchitis treated with ke chuan ping decoction]. AB - This paper presents the results of clinical observation and experimental research of ke chuan ping (KCP) in treating 31 cases of chronic bronchitis compared with that of traditional prescription qing jin hua tan decoction (QJHT) in other 31 patients with the same conditions randomized as control. The total effective rate of KCP group was 93.55% including 67.74% of basically cured and markedly effective cases. The total effective rate of QJHT group was 74.19% including 41.94% basically cured and markedly effective cases. There were significant differences between them (P less than 0.05). According to laboratory observation KCP had the ability to dilute sputum viscosity, promote pulmonary ventilation function, decrease WBC and raise PO2. Animal experimental research suggested that KCP had the effects on reducing sputum, relieving cough, modifying stridor and inhibiting bacteria. It was proved that KCP is a highly effective recipe for patients with chronic bronchitis. It was also shown that clearing away heat and dispersing phlegm therapy is an important measure for chronic bronchitis with Biao Zheng. PMID- 1773456 TI - [301 cases with bronchial asthma treated by kahusu]. AB - 301 cases of bronchial asthma (BA) in observation group were treated by kahusu [each tablet contained 50 mg heat-killed BCG and 50 mg huercaosu] with the oral administration 1 tablet each time, 3 times each week and 30 cases of BA in control group were treated by heat-killed BCG (each tablet contained 100mg) with the oral administration 1 tablet 3 times each week. Each treatment course was 3 months in both groups. After 1 year's treatment the effective rates of these 2 groups were 81.40% and 80% respectively, and during 2 years follow-up the effective rates of both groups were 44.83% and 42.31% respectively. It was not statistically significant between both groups. The therapeutic effects were associate with the type and the condition of BA. Laboratory examination showed that IgG, IgA value increased, PHA and OT test strengthened and C3 lowered clearly. It indicated that both cellular and humoral immunity had been strengthened and inflammation had been resolved. In the course of treatment no side effect had been found. PMID- 1773457 TI - [Immunological study of inefficiency schizophrenics with deficiency syndrome treated with xin shen ling]. AB - This paper reports 30 cases of chronic schizophrenics with deficiency syndrome who had chronically taken many sorts of neuroleptic medications and other therapies to be ineffective. The 7 immunological functioning markers were detected: phytohemagglutinin (PHA) intradermic test; circulating immune complex (CIC); T, B lymphocytes, null (N), double (D) cell; and large granular lymphocyte (LGL) and to be compared with a control group of 30 healthy individual. The result showed that 6 immunological markers (PHA, CIC and T, B, N and D cell) were significantly different as compared with the control group (P less than 0.01). In order to regulate proportion and function to immune cell, the 30 patients were given to take immuno-modulating herbs (xin shen ling, XSL) during 6 weeks, while their 7 immunological markers were detected before treatment (BT) and after treatment (AT). The results showed that 5 immunological markers (PHA, CIC, T, N, and D cell) of BT were significantly different as compared with that of AT (P less than 0.01). However, the 5 immunological markers (PHA, CIC, and T, N and D cell) of AT were not significantly different as compared with that of the control group (P less than 0.05). The brief psychosis rating scale (BPRS) and nurses observation scale for inpatient evaluation (NOSIE) were used as evaluating changes of clinical symptoms BT and AT. The results showed that BPRS and NOSIE of BT were significantly different as compared with that of AT (P less than 0.05). The clinical efficacious rate was 67%. We have followed up the results for near 3 years which had a relapse of 5 cases of 20 cases be discharged. It seemed that XSL may be one of the preventive relapse agent for these patients. PMID- 1773455 TI - [Clinical and experimental research on prevention and treatment of child reversal respiratory tract infection by feibao]. AB - This article reports the child reversal respiratory tract infection treated with Feibao syrup which produced in accordance with the TCM theory of "the evil factor can't attack the body with vital-Qi" and "the evil factor will attack the body which vital-Qi is weak". Feibao syrup consisted of Radix Astragali, Herba Hedyotis diffusae, etc. The clinical research proved that after taking the medicine, the general condition, appetite and anemia were improved, the profuse sweating disappeared, the tolerance against cold was improved, the frequency of occurrence of the disease was decreased or ceased. Even if the disease occurred, the symptoms were mild, the disease course was short. The efficacy of the medicine was 95.2%. It was better than that of levamisole (78.6%), P less than 0.05. This medicine can obviously improve the level of serum IgA and the cellular immunity (P less than 0.01). The experiment on mice manifested that it could obviously enhance the macrophage phagocytic rate, lymphocyte transformation rate, EAC rosette forming rate, and hemolysin generating rate. PMID- 1773458 TI - [Sheng xue tang on immunological functions of cancer patients with spleen deficiency syndrome]. AB - 242 cases of cancer patients with spleen-deficiency syndrome have been studied. It has been found that some immune indexes such as phagocytic activities of macrophages, lymphocytic transformation rate, E-rosette forming rate, Th-cell in T cell subgroup, the NK cell cytotoxicity and combining ability, of cancer patients with spleen-deficiency syndrome were lower than those of normal donor (P less than 0.001 or 0.002). After the patients were treated with sheng xue tang (SXT), the immune indexes above mentioned have been increased significantly. These results suggest that SXT can improve the cell-mediated immune function, therefore, it can strengthen the anticancer ability of the patient, prolong the survival period of some patients. PMID- 1773459 TI - [Effect of Polyporus umbellatus polysaccharide on function of macrophages in the peritoneal cavities of mice with liver lesions]. AB - The cells in peritoneal cavities of mice were taken out and cultured in vitro. The amount to release H2O2 of the macrophages was assayed by fluorimetry. Polyporus umbellatus polysaccharide (PUP) could not only increase the number of macrophages and the amount of H2O2 release in the peritoneal cavities of normal mice, but also raise the lowered number of macrophages and the ability to release H2O2 in the peritoneal cavities of the mice with liver lesions caused by CCl4 significantly. So PUP could improve the cellular immunity of normal mice and the mice with liver lesions. PMID- 1773460 TI - [Effect of promoting biliation mixture on E. coli lipopolysaccharide under electron microscopy]. AB - With electron microscopy this article observed the effect of promoting biliation mixture (PBM) and polymyxin B on E. coli lipopolysaccharide (LPS). The result showed that PBM could breakdown the typical structure of E. coli LPS with only short sections or partially disaggregate it. The morphology changes were similar to the effect of polymyxin B. It would appear that the loss of endotoxicity caused by PBM may be due to the loss of structural integrity of the E. coli LPS. The result may also give some evidence for the clinical effects of PBM theoretically. PMID- 1773461 TI - [Study on hypoimmunity in the patients with obstructive lung disease based on the theory of insufficiency of spleen-yang]. PMID- 1773462 TI - [Use of Chinese herbal medicines in the field of dermatology]. PMID- 1773463 TI - [Changes in leucocytic estrogen receptor levels in patients with climacteric syndrome and therapeutic effect of liuwei dihuang pills]. AB - The numbers of estrogen receptor (ER) in human peripheral leucocytes in 22 women with climacteric syndrome were measured by radioligand method. The results were compared with those of 12 normal child-bearing-age women. It wat found that the contents of leucocytic ER in climacteric syndrome patients were significantly lower than normal child-bearing-age women. The authors used a Chinese prescription--Liuwei Dihuang Pills (LDP) to treat the patients for 2 months. The numbers of leucocytic ER were significantly increased after treatment. The data indicate that decrease of ER levels in cell may involve in the pathogenesis of climacteric syndrome. LDP not only increases plasma estradiol levels, but also increases the leucocytic ER levels. This may be the basis of the therapeutic effect on the disease. PMID- 1773464 TI - [Treatment of endometriosis with removing blood stasis and purgation method]. AB - According to the method of differentiation of symptom complexes of traditional Chinese medicine (TCM), endometriosis is a disease of blood stasis and mass in the lower portion of abdomen. 76 cases were treated by TCM prescription named endometriotic pill No 1 with rhubarb as the main ingredient. The chief functions of the rhubarb were removing blood stasis, disintegrating mass and purgation. The total effective rate was 80.26%. Among them, the effective rate of dysmenorrhea was 88.89%, that of pelvic pain was 66.72%, that of intercourse pain 72.12%, and diminishing in size of mass or nodule 22.15%; 3 cases of 22 infertility got pregnant (13.63%). The results revealed that the endometriotic pill No 1 yielded distinct improvement in the treatment of endometriosis, including clinical symptoms and signs, laboratory assay of blood rheology, serum Ig, subgroup of T lymphocyte (OKT system) and PG. PMID- 1773465 TI - [Effects of gossypol and GnRHa on the prostaglandins contents of endometriotic cell and in situ]. AB - In order to study a direct effect of some traditional and western medicine on the prostaglandins (PGs) of endometriosis, endometriotic cell and endometrial cell in situ were cultured in vitro. 6-keto-PGF1 alpha and thromboxane (TXB2) were measured in the above cells using the RIA from the superfusates. These PGs changes after gossypol acetate, progesterone, danazol and gonadotrophin releasing hormone agonist (GnRHa) treatment were studied. High PGs levels were observed in endometriotic cell, and higher in endometrial cell in situ of patients than in endometrial cell of healthy persons (P less than 0.01). After treatment with drug (but not GnRHa), the prostacyclin (PGI2) and TXB2 content were reduced in endometriotic cell, and the TXB2 contents were reduced in endometrial cell in situ (P less than 0.01). These results indicate that endometriotic cell and endometrial cell in situ can produce more PGI2 and TXB2--at least in vitro, which perhaps may provide an explanation for the puzzling clinical phenomenon of endometriosis. Gossypol acetate, progesterone and danazol inhibit PGI2 and TXB2 content in endometrial cell of patients with endometriosis. It is pertinent to ask whether these drugs can be used to improve endometriosis-associated infertility or dysmenorrhea as well. PMID- 1773466 TI - [Prediction and prevention of hypertension syndrome of pregnancy]. AB - Analysis of mean artery pressure (MAP-2) according to the differentiation of symptom complex of TCM can predict the occurrence of hypertension syndrome of pregnancy (HSP) at patients' first visit to hospital during their middle gestational period (less than 24 pregnant weeks). 424 pregnant women (MAP-2 greater than or equal to 12kPa) were divided into 4 groups and given preventive treatment as follows: (1) The control group, 122 women, no drugs were given; (2) the Theragan group, 102 women; (3) the TCM (A) group, 100 women, those with Liver Kidney deficiency of Yin or no apparent signs were given Qiju Dihuang Wan, and those with Spleen-Kidney deficiency of Yang were given Shenqiwan; (4) the TCM(B) group, 100 women, were given Salvia miltiorrhiza plus (A) group's drugs. The results of prediction: (1) The occurrence rate of HSP in the MAP-2 less than 12kPa group was 10. 5%; in the MAP-2 greater than or equal to 12kPa group, 49.2%. The difference was significant. (2) The rate of deficiency of Yin in the MAP-2 greater than or equal to 12kPa was significantly higher than in the MAP-2 less than 12kPa. The rate of HSP in the deficiency of Yin was higher than in the nondeficiency of Yin. The rate of HSP increased to 70. 7% in the MAP-2 greater than or equal to 12kPa with deficiency of Yin. The results of prevention: (1) The occurrence rates of HSP in 4 groups were 49.2%, 30.4%, 15% and 14% respectively. (2) There was no side effect for mother and infant after preventive treatment. No eclampsia occurred. PMID- 1773467 TI - [Treatment of hypertension syndrome of pregnancy with ligustrazine]. AB - 75 patients with hypertension syndrome of pregnancy (HSP) were randomly designed to 2 groups: the control group treated with magnesium sulfate (20-25g/d) and the Ligustrazine (120-160mg/d) group. The results of Ligustrazine group compared with the control group were as follows: (1) Mean arterial pressure was significantly decreased (P less than 0.01). (2) Edema and proteinuria was lowered (P less than 0.05). (3) The condition of rheology was improved, especially, hematocrit was significantly decreased (P less than 0.001). (4) The positive rate of NST and Apgar's score were not different between the 2 groups. Clinical monitoring showed Ligustrazine without side effects in the group. Mechanisms of Ligustrazine in HSP were (1) dilating blood vessel; (2) improving kidney function; (3) improving microcirculatory and rheology. PMID- 1773469 TI - [Comparative study of menstruation in 240 healthy women at various altitudes]. AB - To assess the relation of menstrual physiologic functions and altitudes, the authors made a comparative study of 240 healthy women with four diagnostic methods on traditional Chinese medicine and obtained their menstrual changes, picture of tongue and type of pulse in Xining (2260m) and Yushu Zhaduo (4300m). The results suggested that the menarche which occurred before 15 years old (P less than 0.005), the menstruation cycle of 16-25 days (P less than 0.05), and moderate quantity menstruation (P less than 0.005) are found more in the Xining group than in the Zhaduo group; the menstrual phase in the Xining group lasted 4 7 days and 1-3 in the Zhaduo group. The incidence of abdominal pain, cold, and lumbago increased significantly in the Zhaduo group and the symptoms were serious. The age of menostasia after 46 was 100% in the Xining group, whereas 27.3% of the Zhaduo group had menostasia at the age of 36-45. The colour of tongue varied from darker red to pink with increasing altitudes (P less than 0.005). Meanwhile, cases of rapid pulse increased (P less than 0.005). It is concluded that the physiology of menstruation for healthy women has obviously changed under high altitude hypoxic environment. The mechanism of pathology could be explained by dysfunction of Zang and Fu, deficiency of Qi, stagnation of blood and Qi stasis due to cold. Treatment and prevention of menstrual disorders of women at high altitudes could be carried out by invigorating Qi, regulating blood, promoting the flow of Qi, by warming the channel and regulating Zang and Fu, etc. PMID- 1773468 TI - [Treatment of climacteric syndrome with new gengnian prescriptions]. AB - It was found by the observations of clinical treatment that the three indexes of epinephrine(E), norepinephrine(NE) and dopamine(D) of urinary catecholamine(CA) increased (P less than 0.001, P less than 0.05 and P less than 0.001) for the climacteric patients who suffered from the deficiency of Yin leading to the hyperactivity of the internal heat of the heart, and the urinary 17 hydroxycorticosteroid (17-OHCS) increased (P less than 0.001) for the patients who suffered from the deficiency of Yin leading to the hyperactivity of the internal heat of the liver. Both the three indexes and urinary 17-OHCS increased for the two groups (P less than 0.01). However, for all the above groups who suffered from the deficiency of Yin leading to the hyperactivity of the internal heat, the NE/E ratio was larger than the normal ratio, which stands for the level of central catecholamine. After the treatment with new Gengnian prescriptions, the clinical symptoms of the patients were improved, and in the meantime urinary CA. 17-OHCS and NE/E were decreased. The total efficiency was 89.2%. The principle of treatment with this prescription may be due to the fact that the level of central catecholamine decreased so that the excessive excitation of sympathetics-adrenocortical system and sympathetics-adrenocortical system was restrained. PMID- 1773470 TI - [Reflux gastritis treated by traditional Chinese medicine combined with Western medicine]. PMID- 1773471 TI - [Prevention and treatment of isoproterenol induced ventricular fibrillation in rats by aqueous extract of Salvia miltiorrhiza]. AB - Acute fatal ventricular fibrillation (VF) in male Sprague-Dawley rats was induced by subcutaneous injection of isoproterenol (1 mg or 5 mg/kg body weight) to two groups of rats of different body weights (525 +/- 21 g or 387 +/- 11 g) respectively. VF occurred in all control rats resulting in 96% death with only 4% spontaneously reverted and survived. Pretreatment of animals, with or without pentobarbital anaesthesia, with an aqueous extract of Salvia miltiorrhiza (SM-H, i.p., 5 g herb/kg body weight) significantly reduced J-point displacement and VF induced by isoproterenol. Survival rate was significantly raised compared with the control (P less than 0.05). Immediate intravenous injection of SM-H (5 g herb/kg body weight) to poisoned rats which developed VF caused 71% of them to recover temporarily their sinus rhythm and significantly prolonged their survival time (P less than 0.05). PMID- 1773472 TI - [Effects of Cordyceps sinensis, rhubarb and serum renotropin on tubular epithelial cell growth]. AB - Primary cultured rat tubular epithelium was utilized to investigate the effect of Cordyceps sinensis (CS) on cellular proliferation and metabolism. Judging from incorporation rate of 3H-TdR, it was found that the addition of serum containing CS metabolites into the culture media could promote the DNA synthesis of tubular cells profoundly (P less than 0.001). In association with its beneficial effects on gentamycin nephrotoxity in vivo study, it is indicated that CS could enhance the regeneration of injured tubular cells. In addition, sera obtained from 5/6 nephrectomized rats (5/6 NT) and rhubarb treated rats were studied to see their effects on tubular cells growth. The results showed that the serum of 5/6 NT rats could promote the DNA synthesis of tubular epithelium, while the presence of experimental serum of rhubarb in culture median markedly inhibited the DNA synthesis of cells. PMID- 1773473 TI - [Experimental study of the heat and cold constitutional types (II). A comparative observation on the heat and cold constitutional type rats on the DNA replication capacity after ultraviolet damage]. AB - The cold-constitutional and the heat-constitutional type had selected in Wistar rats as the object of study. Using peripheral blood and spleen as materials by means of ultraviolet injury, isotope incorporation, cells incubation in vitro and liquid scintillation counting, the capacity of peripheral lymphocytes DNA replication after damage with ultraviolet radiation and the capacity of the spleen lymphocytes proliferation in vitro was observed. The results showed that the both capacities mentioned above were higher in the heat constitutional type rat than that in the cold type. It is suggested that the following conclusion in the Lingshu Jing is correct: "the capacity of tissue repair is higher in the heat constitutional type than in the cold." PMID- 1773474 TI - [Evaluation of the side effects of liu shen wan]. PMID- 1773475 TI - [Clinical use of interventional ultrasound]. PMID- 1773476 TI - [Current states of viral myocarditis treated with traditional Chinese medicine combined with Western medicine]. PMID- 1773477 TI - [Clinical application and prospect of bulbus Allii for relieving asthma]. PMID- 1773478 TI - Plasma kallikrein generation in endotoxemia is abolished by ultra high doses of methyl-prednisolone: in vivo studies in a pig model. AB - Thirty-one healthy young pigs were studied to evaluate the effects of methylprednisolone sodium succinate (MP) on cellular, proteolytic, and hemodynamic parameters in normal and endotoxin-exposed animals. Fourteen animals served as controls, whereas 17 test animals received a continuous infusion of endotoxin, 0.01 mg/kg/3hr. Seven of the test animals and seven of the control group received a total of 200 mg/kg body weight over 5 hr of MP, 100 mg/kg as pretreatment before the endotoxin infusion was started. The administration of MP to control animals did not cause changes in the plasma kallikrein-kinin system, as determined with chromogenic peptide substrate assays. Only temporary effects, which normalized during the observation period, were seen in hemodynamic parameters. The pretreatment with MP significantly counteracted the increases in plasma kallikrein activity (KK) and the decreases in functional kallikrein inhibition capacity (KKI) seen after endotoxin infusion in untreated animals. Marked reductions in the number of circulating leukocytes and platelets were observed in untreated endotoxemia, together with increases in hematocrit. Furthermore, increases in pulmonary vascular resistance (PVR) and decreases in cardiac output (CO), left ventricular stroke work (LVSW), and mixed venous oxygen saturation (SvO2) ensued. The changes in circulating cells, PVR, and SvO2 were significantly counteracted by MP treatment, whereas changes in hematocrit, CO, and LVSW were only moderately improved. PMID- 1773479 TI - Relationship between the lung and systemic response to endotoxin: comparison of physiologic change and the degree of lipid peroxidation. AB - The lung and systemic response to Escherichia coli endotoxin either 2 or 5 micrograms/kg was measured in 16 sheep with chronic lung and soft tissue lymph fistulae. Oxidant-induced lung and liver lipid peroxidation was measured as tissue malondialdehyde (MDA). Conjugated dienes were also monitored. Both doses produced a comparable pulmonary hypertension and hypoxia as well as a comparable increase in protein-rich lymph flow, QL. However, lung MDA was significantly greater with the 5 micrograms/kg than with the 2 micrograms/kg dose, both being more than twofold greater than controls. The systemic physiologic responses between the two doses were quite different. The 5 microgram/kg dose resulted in a significant increase in oxygen delivery (DO2), oxygen consumption (VO2), and decrease in arterial O2 extraction in the 3-5 hr postendotoxin period compared with the 2 microgram/kg dose. A twofold increase in protein-rich soft tissue QL was also seen after the 5 micrograms/kg dose, whereas QL was not changed after 2 micrograms/kg. Liver MDA was only increased by 30% over controls with both doses. We conclude that the relationship between oxidant change and physiologic response varies considerably between lung and systemic tissues after endotoxemia with the degree of lung lipid peroxidation corresponding with the degree of impairment in systemic tissue O2 extraction and the onset of delivery-dependent O2 consumption. PMID- 1773480 TI - Effect of cerebral ischemia on hypotension-induced increase in plasma vasopressin and hepatic glycogen concentration in the rat. AB - The effect of cerebral ischemia on the vasopressin response to hemorrhagic hypotension and on the hepatic and muscular glycogen mobilization was studied in rats. The addition of cerebral ischemia to the hemorrhage required withdrawal of significantly more blood to lower mean arterial pressure (MAP) to 50 mmHg but not if combined with ganglionic blockade. The increase in plasma vasopressin concentration during hypotension was not significantly different in rats with and without concurrent cerebral ischemia. Ganglionic blockade blunted the vasopressin response. Thus cerebral ischemia in fact attenuated the vasopressin response to hemorrhage. One hour after the insult, the hormone concentration in rats exposed to combined cerebral ischemia and hemorrhagic hypotension without ganglionic blockade was still above control levels and higher than in all other groups. Concomitantly the hepatic but not the muscular glycogen concentration in these rats was significantly lower than in the other groups. PMID- 1773481 TI - Vagotomy alters the hemodynamic response of dogs in hemorrhagic shock. AB - We examined the hemodynamic response of severely hemorrhaged dogs to vagotomy to further define the role of vagal innervation in circulatory control during severe hemorrhage. When the cervical vagi were severed in severely hemorrhaged, pentobarbital-anesthetized dogs, MAP decreased immediately after vagotomy and remained lower than in vagal-intact dogs. Cardiac output (CO) and heart rate (HR) also remained lower in the vagotomized dogs. When 45 ml/kg of 0.9% NaCl was administered to vagal-intact or vagotomized, severely hemorrhaged dogs, the MAP and CO increases were attenuated by vagotomy. Blood flow increases in the renal and splanchnic, but not femoral, vascular beds were inhibited by vagotomy. Vagotomy attenuates the hemodynamic response of severely hemorrhaged dogs, limits the effectiveness of isotonic fluid therapy, and exerts a differential effect on blood flow distribution. PMID- 1773482 TI - Absence of the Staub-Traugott effect in endotoxicosis. AB - Intravenous glucose tolerance tests (IVGTTs) using 1.2 g/kg of D-glucose in fasted, male rats were repeated twice, with an interval of 75 min, during early (2.5 hr) and late (26.5 hr) nonlethal endotoxicosis induced by Salmonella enteritidis endotoxin (ETX) at 10 micrograms/kg i.v. In comparison with saline controls, glucose tolerance was dramatically increased in early endotoxicosis; however, it was restored to near normal in late endotoxicosis. Augmentation of tolerance by repeated IVGTTs i.e. the Staub-Traugott effect, occurred in the saline control groups; however, it was absent in both early and late endotoxicosis. The elevations of plasma insulin (IRI) in response to the glucose loads were exaggerated vs. controls in both early and late endotoxicosis; however, the hyperinsulinemias were not significantly diminished by repeated IVGTTs in any group. These results indicate loss of the Staub-Traugott effect in endotoxicosis that is 1) independent of augmented insulin secretory responses to a repeated glucose challenge and 2) dependent on some adaptive cellular mechanisms to repeated glucose loads which were impaired in nonlethal endotoxicosis. PMID- 1773483 TI - Oxygen-free radicals (OFR) and circulatory shock. AB - During the past decade a large body of information has been collected showing that formation of short-lived highly reactive metabolites (i.e., radicals) constitutes an important principle of tissue injury. There are several sources of information which suggest that radicals are formed in connection with tissue ischemia and shock, and they may then cause damage to cells and contribute to the pathophysiology of ischemia and shock. In the present review we attempt to discuss how radicals damage tissue as well as the data which suggest that radicals are causing tissue injury in shock. PMID- 1773484 TI - Proinsulin: biosynthesis, conversion, assay methods and clinical studies. AB - Insulin, like other secretory peptides, is synthesized via a larger and less active precursor, proinsulin, converted in the beta cell by sequential limited proteolysis to insulin and C-peptide which are stored in secretory granules. Since this process is incomplete, some intact and partially processed proinsulins with variable biological and immunological activities remain trapped in the granules and enter the circulation with insulin, resulting in the heterogeneity of plasma immunoreactive insulin (IRI). Whereas methods measuring proinsulin from corrected IRI in sera fractionated by gel chromatography were not sufficiently sensitive and specific, immunoradiometric assays (IRMA) now allow reliable determinations of proinsulin, split proinsulins and true insulin and thereby the monitoring of the dynamics of conversion in various diabetic states. The recent finding of increased 32,33-split proinsulin associated with absolute true insulin deficiency, correlated with cardiovascular risk factors in Type II diabetics, sheds new light on the molecular pathology of noninsulin-dependent diabetes. PMID- 1773485 TI - Determination of bupivacaine in plasma by high-performance liquid chromatography. Levels after scalp infiltration in children. AB - The local anaesthetic bupivacaine could be very useful for analgesia in pediatric neurosurgery. Since systemic toxic reactions to bupivacaine are correlated with high plasma levels it was important, as an adjunct to clinical evaluation, to measure plasma bupivacaine. This report describes a high-performance liquid chromatography (HPLC) method for the quantitation of plasma bupivacaine. Sample preparation involves extraction into ether followed by back-extraction into HCl. After evaporation, the acid extract is redissolved and separated by reversed phase chromatography. The assay is linear to 5 mg bupivacaine/L and shows excellent recovery and precision. With samples from children undergoing brain surgery following scalp infiltration with either 0.125% or 0.25% bupivacaine, plasma levels peak within 10 min, then fall rapidly to a plateau by 30 min. This plateau is maintained for at least 120 min. In no case did we find supposed toxic levels of bupivacaine. PMID- 1773486 TI - Synthesis and structural characterization of a cardioactive biotinylated digoxin analogue. AB - We have biotinylated the terminal glycose of digoxin by reaction of the periodate oxidized steroid with biotin hydrazide. A biotinylated product (BD-1) was formed which retained significant digoxin receptor (Na+/K+ ATPase) binding activity. Sustained reaction resulted in a second biotinylated product (BD-2) which showed reduced receptor binding activity. The products were characterized by FAB mass spectroscopy and shown to be the mono- and di-biotinylated digoxin conjugates of the oxidized glycose moiety. These analogues may prove useful in determining the subcellular site of digoxin binding. PMID- 1773487 TI - Digoxin-like immunoreactivity in cord blood plasma extracts is not only due to endogenous corticosteroids. AB - Methods for quantitative extraction and enrichment of digoxin-like immunoreactive substances (DLIS) from human cord blood plasma (CBP) using organic solvents combined with a solid state absorbent are presented. Sephadex LH-20 column chromatography is more suitable than sephadex G-25 for DLIS separation and purification from CBP extract. The elution pattern of sephadex LH-20 chromatography of deproteinized and desalted CBP shows two distinct DLIS peaks. The first peak coelutes with the steroids aldosterone, cortisol, progesterone, 17 OH-progesterone, testosterone and estradiol, while the second DLIS peak coelutes with dehydroepiandrosterone sulfate (DHEA-S). The Na+,K(+)-ATPase inhibitory activity peak partially overlaps with the first DLIS peak. Coeluted steroids could account only partially for digoxin-like immunoreactivity in the first DLIS peak; however, they did not contribute to the Na+,K(+)-ATPase inhibitory activity, whereas the second DLIS peak could be ascribed to endogenous DHEA-S. PMID- 1773488 TI - A highly sensitive chemiluminescent assay for glycerylphosphorylcholine in human seminal plasma. AB - Glycerylphosphorylcholine (GPC), one of the major phosphorus-containing-choline compounds of seminal plasma, is secreted mainly by the epididymal epithelium under androgenic control. This study reports a new method that uses chemiluminescence to determine seminal GPC content, comparing it with a spectrophotometric technique. The results, obtained with both techniques studying 20 fertile patients (as control), 35 infertile patients with normospermia, 23 infertile patients with oligozoospermia and impaired motility and 9 patients with excretory azoospermia, demonstrate that the GPC chemiluminescent assay is more sensitive, simple and rapid than the spectrophotometric assay. Our data confirm that GPC may be used as a marker of vas deferens and ejaculatory duct perviousness, suggesting a possible role of this glycerophosphodiester in sperm motility. PMID- 1773489 TI - Urinary composition in men and women and the risk of urolithiasis. AB - Urinary concentrations of certain biochemical constituents that play an active role in stone formation were determined in 2 h urine collections in healthy men and women (at four phases of the estrous cycle) to elucidate the sex difference in the incidence of urolithiasis. The excretion of the lithogenic substance, calcium, was higher in men than in women during phase I (p less than 0.01) and phase II (p less than 0.05) of the estrous cycle. Oxalate excretion was marginally elevated in men compared to women during each phase. Urinary citrate was lower in men compared to women during each phase (p less than 0.05). Uric acid excretion was lower (p less than 0.05) in men compared with phase I and phase III in women. Estrous phase-related alterations were also observed in the excretion of calcium and citrate in women. The data suggest that low concentrations of calcium and oxalate with an elevated citrate excretion might be responsible for the reduced risk of stone disease in women compared to men. PMID- 1773490 TI - Diagnostic value of four assays for lipase determination in serum: a comparative reevaluation. AB - We assessed the diagnostic value of four commercially available methods for determining pancreatic lipase (LPS) in serum (the turbidimetric procedure from Boehringer, two enzymatic approaches from Kodak and Poli, and an immunochemical assay) in a population of 46 hospitalized patients with acute abdominal pain. In 31 cases (67.4%), the final diagnosis was acute pancreatitis. When evaluated by means of receiver-operating characteristic (ROC) curves, no significant differences were found among the procedures. Concerning clinical efficiency, all the assays had values equal to or greater than 90%. Using the calculation of the overlap index (OI) as a statistical approach to quantify the clinical utility of various LPS assays, the test having the greatest potential for differentiating between patients with and without acute pancreatitis was the turbidimetric assay (OI = 0.14). PMID- 1773491 TI - Serum 17 alpha-hydroxyprogesterone in infants and children as measured by a direct radioimmunoassay kit. AB - A direct 17 alpha-hydroxyprogesterone (17-OHP) radioimmunoassay kit was used for the assay of samples from 219 infants and children. The kit was used according to the manufacturer's protocol on unextracted serum or plasma and also on reconstituted material extracted from the serum with propanol-heptane. The extraction protocol recovers approximately 88% of 17-OHP. Patients were grouped as infants 3-90 days (96 subjects) or older children, adolescents and young adults 91 days-20 years (123 subjects). 17-OHP results by the direct and extraction protocols correlated but the slopes of the regression lines (0.43 and 0.63) differed in the two groups, indicating that only about 49% of the immunoreactive material measured by the kit in the infants was 17-OHP whereas the corresponding percentage was 72% in the older children. Despite this nonspecificity, the present antibody is much more specific for 17-OHP in the presence of neonatal plasma steroids than that used previously. Reference values were obtained for the two groups using the method with and without an extraction step. 17-OHP values on four untreated patients with CAH were clearly elevated at the time of diagnosis. It is recommended that when the kit is used with neonatal and infant samples, an extraction step should be incorporated to enhance specificity. PMID- 1773492 TI - Cholesterol ester deposition is reduced in rats with hypercholesterolemia and hypertension. AB - High K diets prevent hypertensive endothelial injury and intimal thickening. Cholesterol esters often deposit during hypercholesterolemia. We investigated whether a high K diet would influence cholesterol ester deposits in stroke prone SHR rats. Stroke prone SHR rats were fed for 3 months a basic diet containing 4% cholesterol, 14% coconut oil and 7% NaCl. One group of 13 rats had normal (.5%) K in the diet. Another group of 10 rats ate high (2.1%) K. Mean intra-arterial BPs averaged 165 mmHg in the normal K group and 161 mmHg in the high K group (NS). The serum cholesterol averaged 229 mg/dl in the normal K group and 214 in the high K group (NS). Total aortic cholesterol esters per rat averaged 187 micrograms in normal K vs 68 micrograms in high K, measured by gas chromatography. Thus high K reduced cholesterol ester deposits by 64% (p less than .0003), even though BPs and cholesterol levels were quite similar in the two groups. Both high cholesterol and high BP injure endothelial cells and increase invasion of monocytes and vascular smooth muscle cells into the intima and increase endothelial permeability to proteins. With high plasma cholesterol, these processes lead to atherosclerosis with cholesterol ester deposition. The high K diet, by protecting endothelial cells, can greatly decrease this cholesterol ester deposition. This effect could possibly be useful for preventing heart attacks in human hypertension. PMID- 1773493 TI - Alterations in vasopressin mechanisms in captopril-treated spontaneously hypertensive rats. AB - The effects of lifetime captopril treatment on vasopressin (VP) were assessed in spontaneously hypertensive rats (SHR). Pregnant and nursing dams were treated with oral Captopril (100 mg/kg/day). After weaning, the pups were maintained on Captopril (50/kg/day) for 19-20 wks. Blood pressures of Captopril-treated SHR were in the normotensive range and significantly lower (p less than .001) than SHR control rats. Control and Captopril-treated SHR were perfused and brains were sectioned for immunohistochemical staining with a polyclonal antibody directed against vasopressin (VP). Compared to control SHR, Captopril-treated rats displayed decreased VP-like immunoreactivity in the paraventricular (PVN) and supraoptic (SON) nuclei of the hypothalamus. Captopril treatment also selectively decreased the number of brightly labeled cell bodies in the SON and PVN and reduced VP-like labeling in the axons of the neurons in these nuclei. Concurrent with a decrease in VP-like immunoreactivity, Captopril treatment reduced plasma VP levels (RIA) (p less than 0.01, Captopril, 5.6 +/- 0.5 pg/ml; control, 11.8 +/ 2.2 pg/ml). Scatchard analysis of 3H-VP binding indicated that Captopril treatment increased the number but not the affinity of VP receptors in the hypothalamus and brain stem of SHR. These results suggest that in SHR oral Captopril treatment attenuates the synthesis and release of VP, an effect that may contribute to the blood pressure lowering effect of converting enzyme inhibitors. PMID- 1773494 TI - Therapy and prevention of hypertension of M-SHRSP. AB - M-SHRSP rats appear to be a useful animal model for studying juvenile human malignant hypertension. Using M-SHRSP, the present study was conducted. Drugs selected for use were captopril, SQ 29,852 and hydralazine hydrochloride. The rats were also fed a 33% fish meal diet. When given separately, all three drugs were shown to be anti-hypertensive. However, using the fish meal diet combined with hydralazine was more effective than were any of the drugs given separately, while the effect of hydralazine combined with captopril or SQ 29,852 was even greater than that of the combined fish meal diet and hydralazine treatment. Some rats treated with captopril or SQ 29,852 separately were resistant to treatment, however even for these rats life spans were significantly prolonged and hypertensive vascular lesion incidence rates were drastically lowered. It was also found that even such vascular lesions as angionecrosis seemed to disappear with captopril or SQ 29,852 treatment. PMID- 1773495 TI - Effects of long-term cerebral ischemia caused by bilateral carotid artery ligation on the acceleration or the development of hypertension in spontaneously hypertensive rats (SHR) or Wistar-Kyoto rats (WKY). AB - Bilateral carotid artery ligation (BCL) was performed with one week interval between the each operation in male spontaneously hypertensive rats (SHR) and Wistar-Kyoto rats (WKY) aged 4 months. BP rose immediately after unilateral carotid artery ligation (UCL) and BCL in both WKY and SHR due to carotid sinus reflex. Once returning to preoperative levels after both UCL and BCL, BP of SHR and WKY increased again gradually one and 4 months after BCL and thereafter, respectively. BP was significantly higher than that in the controls of each strain, and the BP increment was significantly greater in SHR than in WKY. A significant regional cerebral blood flow (rCBF) increase on the contralateral side of carotid ligation was observed in SHR in contrast to a little change in that of WKY and a reduction of rCBF after BCL was significantly greater in SHR than in WKY. Behavioral activities in SHR were also reduced after BCL. Cerebral edema with nerve cells damage was recognized in SHR. In contrast, little change was found in WKY. On the other hand, upper cervical sympathectomy attenuated convulsive seizures after BCL more markedly in SHR, which survived longer than non-denervated SHR. These results suggest that chronic mild cerebral ischemia caused by BCL with one week interval accelerates the development of severe hypertension in SHR and developed mild hypertension in WKY. Sympathetic innervation might play much more important role in collateral circulation through the vertebrobasilar system in SHR. PMID- 1773496 TI - Decreased cerebral metabolism in stroke-prone spontaneously hypertensive rats (SHRSP) with stroke and its possible improvement by Solcoseryl. AB - Local cerebral glucose utilization (LCGU) was decreased in SHRSP with stroke compared with normotensive Wistar rats. The decrement of LCGU was less in Solcoseryl-treated SHRSP with stroke than that in saline-treated SHRSP with stroke and these brain areas where LCGU was less damaged, in Solcoseryl-treated SHRSP were consistent with the important functioning sites of emotion, motor movement and memory. The result suggests that Solcoseryl may be useful for metabolic improvement of the brain damage after stroke. PMID- 1773497 TI - Detailed disease processes of cerebral pericytes and astrocytes in stroke-prone SHR. AB - We examined ultrastructurally cerebral pericytes and astrocytes in 20 normotensive Wistar Kyoto rats and 60 asymptomatic stroke-prone spontaneously hypertensive rats, which were sequentially killed at 4-52 weeks of age. Another 30 SHRSP were killed soon after they showed symptoms of stroke. We found two kinds of pericytes around the capillaries; granular pericytes and filamentous pericytes. Granular pericytes possibly serve as scavenger cells in the central nervous system and became active and grew in size with time. In contrast, filamentous pericytes degenerated during the development of hypertension. Degeneration of the filamentous pericytes was involved in an increase of endothelial permeability. Increased permeability caused focal and then circumferential swelling of the astrocytes around the capillaries. Swelling of the astrocytes seemed to accelerate the production of attachment plaques. Following this increase in the number of attachment plaques, numerous astrocytic filaments were produced within the cytoplasm. As a result, fibrous astrocytes were fully developed. Adjacent to the fibrous astrocytes we detected opening of the interendothelial junctions as well as dead neurons. From these observations we propose that astrocytes perform the main function in trophic interactions among cerebral endothelial cells, astrocytes, and neurons and that dysfunction of astrocytes disturbs the neural environment, resulting in neuronal death. PMID- 1773498 TI - The anti-tachycardic mechanism of a direct-acting vasodilator, budralazine, in rats. AB - The present study was undertaken to elucidate the anti-tachycardic effect of a direct-acting vasodilator, budralazine, using an electrophysiological technique. Normotensive male Wistar rats were used. Rats were anesthetized intraperitoneally with urethane and alpha-chloralose. Intravenous administration of budralazine (0.5-5.0 mg/kg) produced a dose-dependent reduction of mean arterial pressure in anesthetized rats. At doses of 0.5 and 1.0 mg/kg, budralazine induced bradycardia accompanied with a decrease in cardiac sympathetic nerve activity (ICNA). Preganglionic adrenal sympathetic nerve activity (ASNA) was also reduced by budralazine (1.0 mg/kg). A 0.5 mg/kg of budralazine neither influenced carotid sinus nerve activity nor augmented aortic depressor nerve activity (ADNA). On the contrary, at dose of 5.0 mg/kg, budralazine produced a tachycardia accompanied with increases in both ICNA and ASNA. The ADNA was decreased by budralazine (5.0 mg/kg) significantly. These findings suggest that the central sympathoinhibitory action of budralazine may be responsible for the anti-tachycardic effect of budralazine and baroreceptor-mediated tachycardia occurred after high dose of budralazine. PMID- 1773499 TI - Overview: studies on spontaneous hypertension-development from animal models toward man. AB - The development of genetic rat models for research on hypertension, stroke and other cardiovascular diseases (CVD) such as spontaneously hypertensive rats (SHR) and stroke-prone SHR (SHRSP) have contributed not only to the elucidation of the pathogenesis of hypertension-related CVD but also to their prediction and prevention. Since both genetic and environmental factors are involved in the pathogenesis of CVD as extensively studied so far on these models, the detection of the early pathogenic mechanisms related to the genetic factors and the control of environmental factors such as dietary improvement are useful as predictive and preventive measures against CVD. Sympathetic overresponsiveness, early development of cardiovascular hypertrophy, increased salt sensitivity and membrane or transport abnormalities in vascular smooth muscle cells (VSMC) from SHR and SHRSP, possibly related to the pathogenesis of hypertension, are so far regarded as predictors for hypertension partly applicable to human hypertension. Genetic pathogenic mechanisms of stroke in SHRSP which have been proven to be greatly influenced also by dietary factors are hypertension-induced VSMC degeneration and necrosis of intracerebral arteries due to local nutritional disturbance. One of predictors of stroke related to the pathogenic mechanisms is reduction of regional cerebral blood flow. On the other hand, the control of environmental factors, especially nutrition and diets such as intakes of animal and vegetable proteins, some amino acids and fatty acids, potassium, calcium, magnesium, dietary fibers, etc., have been experimentally demonstrated to be effective for the prevention of CVD in these genetic models, and the applicability of these experimental findings to the CVD prevention in man is now supported from our world-wide epidemiological studies (WHO CARDIAC Study). PMID- 1773500 TI - Central hypotensive effects of nicardipine in conscious freely moving spontaneously hypertensive rat. AB - The central cardiovascular effects of the calcium channel blocker nicardipine was studied in conscious freely moving normotensive Wistar Kyoto rats (WKY) and spontaneously hypertensive rats (SHR). Nicardipine was administered in a 1.5 microliters volume into the lateral ventricle of the brain (i.c.v.) or intravenously (i.v.). The injection of vehicle alone did not significantly change mean arterial pressure (MAP) or heart rate (HR). Nicardipine (10, 30, 100 and 300 micrograms/kg) intravenously administered, dose-dependently decreased MAP and increased HR in WKY and SHR. However, when administered i.c.v., nicardipine (10 micrograms/kg) increased MAP and HR in WKY and decreased MAP without any significant change in HR in SHR. These results are consistent with previous work reporting an exaggerated hypotensive response to i.c.v. administration of dihydropyridine calcium channel blockers in anesthetized SHR as compared to WKY. They suggest that a 1,4-dihydropyridine-sensitive pressor system is present in the SHR but not in the WKY. PMID- 1773501 TI - In SHR rats, dietary potassium determines NaCl sensitivity in NaCl-induced rises of blood pressure. AB - The current study tested whether the spontaneously hypertensive rats (SHR) from Charles River Laboratories are resistant or not to NaCl-induced rises of blood pressure and deaths. These rats are fairly NaCl-resistant on a 2.1% high K diet, whereas they are quite susceptible to NaCl-induced hypertension and deaths on a 0.5% normal K diet. Thus, a high K diet strongly protects against a NaCl-induced rise of blood pressure as well as deaths in these SHR rats. Hence the level of dietary K determines the degree of NaCl sensitivity in these SHR rats. PMID- 1773502 TI - The effect of a high salt diet and gender on blood pressure, urinary protein excretion and renal pathology in SHR rats. AB - A high salt diet produced increases in SBP, urinary protein excretion (UPE) and renal vascular lesions (RVL) across groups of male and female SHR rats which were allowed to develop moderate or excessive increases in SBP. A highly significant linear relationship between SBP and log-transformed UPE was found when the data from all groups were analyzed together. Males developed high blood-pressure more rapidly, and exhibited more severe RVL and greater UPE than females. Two results prevent the conclusion that the elevated UPE was simply due to the adverse effects of high BP on the kidney. First, the relationship between SBP and UPE across groups could not be demonstrated when regression analyses were performed within individual dietary sub-groups. Secondly, gender differences in UPE were highly significant by analysis of covariance adjusting for individual differences in SBP. The increases in SBP and UPE may be independent consequences of ingestion of a high salt diet. PMID- 1773504 TI - Contrasting hemodynamic effects of high oral calcium in genetic models of salt sensitive hypertension. AB - Interest in effects of oral calcium (Ca) on blood pressure is now generally focused on salt-induced hypertension. In this study hemodynamic effects of long term high oral Ca were examined in two different genetic models of salt-sensitive hypertension, stroke-prone spontaneously hypertensive rats (spSHR) and Dahl salt sensitive (DS) hypertensive rats. High vs low oral Ca (2.0 vs 0.4% Ca, 8-13 rats/diet) significantly (p less than 0.05) attenuated salt-induced hypertension (7% NaCl intake) in female spSHR (mean arterial pressure = 137 vs 175 mmHg) but aggravated such hypertension in female DS rats (141 vs 124 mmHg). Pressor responsiveness to norepinephrine (NE) and angiotensin (A) II were examined in the same rats. High oral Ca decreased pressor responses to graded intravenous injections of NE and AII in spSHR and increased such responses in DS rats. In spSHR, the decreased pressor responsiveness preceded the antihypertensive effect of high oral Ca. In summary, 2.0 vs 0.4% oral Ca produces contrasting effects on blood pressure in two genetic models of salt-sensitive hypertension (stroke-prone SHR and Dahl salt-sensitive rats). These contrasting effects on blood pressure may be related to differential effects of oral Ca on vascular responsiveness to endogenous vasoconstrictors in these two genetic models of salt-sensitive hypertension. PMID- 1773503 TI - Effects of dietary sodium and calcium on blood pressure reactivity in the SHR and WKY. AB - Salt-sensitive spontaneously hypertensive rats (SHR) and their normotensive control strain, Wistar-Kyoto rats (WKY) were fed four diets varying in sodium chloride and calcium content in order to assess the effects of diet on learned blood pressure responses. The animals were exposed to a classical conditioning paradigm in which one tone was always followed by a brief electric shock and a second tone was never followed by shock. Sodium chloride loading raised baseline blood pressure in both strains, while supplemental calcium attenuated blood pressure. Sodium chloride potentiated blood pressure orienting responses to initial presentations of the tones among calcium deficient, but not calcium replete SHR. Increased sodium chloride intake also potentiated the learned pressor responses to the tone paired with shock in the SHR, but not the WKY. Calcium intake had no apparent effect on the learned blood pressure responses to the two tones. PMID- 1773505 TI - Changes in free calcium concentrations in platelets of SHRSP and WKY: its relationship to ATP releasing potencies and platelet aggregation activities upon stimulation of several reagents. AB - To clarify the relationships between free calcium levels, ATP release and aggregation potencies of SHRSP platelets, we examined the platelets from 9-month old SHRSP and WKY using fura-2AM and luciferine-luciferase. In the absence of extracellular Ca2+, each reagent elevated the free calcium level to the same extent in the samples of both SHRSP and WKY. With regard to ATP release, thrombin and collagen less potentiated the platelet action in SHRSP than WKY, and ATP release was not affected by extracellular Ca2+. Collagen and ADP induced aggregations showed lower activities in SHRSP than WKY. TPA caused higher Ca2+ influx and aggregation activity in SHRSP than WKY in the presence of extracellular Ca2+. These results indicate that Ca2+ release must be followed by ATP release, and ATP release may be less potentiated, while thrombin and TPA induced aggregation is likely to be stimulated in SHRSP platelets, because protein kinase C activity in SHRSP platelets appears to be high. PMID- 1773506 TI - Age-related changes in calcitonin gene-related peptide (CGRP)-mediated neurogenic vasodilation of the mesenteric resistance vessel in SHR. AB - Age-related changes in CGRP-containing vasodilator nerve activity in hypertension were studied in perfused mesenteric vascular beds isolated from SHR and normotensive rats (WKY). Perivascular nerve stimulation (PNS; 0.5-8 Hz) of both SHR and WKY preparations with active tone produced a frequency-dependent vasodilator response, which was abolished by 100 nM tetrodotoxin, 500 nM capsaicin or cold storage denervation. This response in SHR greatly decreased with age, whereas the response in WKY slightly decreased with age. The neurogenic vasodilation in 15- and 30-week-old SHR but not 8-week-old SHR was significantly smaller than that in age-matched WKY. Vasodilator responses to exogenous CGRP (0.1-30 nM) in SHR increased with age, whereas an age-related decrease in the vasodilation was found in WKY. Immunohistochemical studies showed an age-related decrease in CGRP-containing fibers in SHR. These results suggest that CGRP containing vasodilator innervation is greatly decreased when SHR develop and maintain hypertension. PMID- 1773507 TI - Stroke-prone SHR (SHRSP) as a model for osteoporosis. AB - Since previous studies on SHRSP showed various abnormalities in Ca metabolism, aged SHRSP together with age-matched Wistar-Kyoto (WKY) were examined for bone mineral density and contents as well as bone histomorphometry and mechanical properties. SHRSP and WKY, 10 rats of each group at the age of 7 to 8 months were sacrificed with or without tetracycline and calcein labellings for the estimation of mineral appositional rate. Both femurs, tibia and the 1st lumbar vertebra were extirpated from each rat; one femur was used for mineral density and content analyses and the other was used for analyzing mechanical properties by three point-bending and torque methods (Maruto, MZ500D). Mineral density and cortical thickness index were decreased significantly in SHRSP compared with WKY, and Ca contents were decreased as well. Correspondingly femurs from SHRSP were proven to be fragile in the maximum bending stress. Undecalcified histological sections of tibial proximal epiphysis histomorphometrically indicated bone volume and trabecular thickness were significantly decreased in SHRSP. These findings together with others indicate SHRSP can be a good model for spontaneous osteoporosis in man. PMID- 1773508 TI - Platelet-derived growth factor A-chain homodimer stimulated growth of cultured smooth muscle cells from spontaneously hypertensive rats. AB - Vascular smooth muscle cells from spontaneously hypertensive rats (SHR) were growth stimulated when cocultured with bovine aortic endothelial cells whereas myocytes from normotensive, Wistar Kyoto rats (WKY) were growth inhibited. The responsiveness of cells from the two rat sources to the two homodimeric forms of platelet-derived growth factor (PDGF-AA or -BB) was different; SHR-derived cells responding equally well to both PDGF forms whereas cells from WKY responded to the B-chain homodimer only. The responses measured included S6 kinase activation, phospholipase C mediated phosphoinositide catabolism and cell growth. Saturation binding experiments using [125I]-labelled PDGF homodimers (AA or BB) indicated that smooth muscle cells from hypertensive rats possess similar numbers of cell surface A-chain receptors (alpha subunits) as Swiss 3T3 cells which have been used to characterize the mitogenic effects of the two PDGF homodimeric forms. The differences in responsiveness of SHR vs WKY cells to PDGF-AA and to the influence of endothelial cells may reside in their differential expression of PDGF receptors. PMID- 1773509 TI - Myosin and actin from aortae of spontaneously hypertensive and normotensive rats. AB - Contractile proteins were extracted from thoracic aortae of 9-month-old spontaneously hypertensive stroke-prone (SHRSP) and normotensive Wistar Kyoto rats (WKY). The average wet weight of the aortae from SHRSP was approximately 1.6 fold heavier than that of WKY. On polyacrylamide gel electrophoresis of the myofibrillar extracts prepared from normalized, equal weights of aortae of SHRSP and WKY, both the compositions and concentrations of major polypeptides including myosin heavy chains and actin were nearly identical in these extracts. The myosins purified from these extracts contained identical light chains of about 20 and 17 kDa. Proteolytic peptide maps of the heavy chains of myosin from SHRSP were also indistinguishable from those of WKY, suggesting that the same isoforms of myosin are expressed in both aortae. From these results it is suggested that the qualitative differences may be small, if any, between the major contractile proteins in the aortae of SHRSP and those of WKY. PMID- 1773510 TI - Differences in response between SHRSP and WKY vascular smooth muscle cells to inhibition of cell proliferation by sodium nitroprusside. AB - The effects of sodium nitroprusside on the proliferation of cultured vascular smooth muscle cells (SMC) from stroke-prone spontaneously hypertensive rats (SHRSP) and Wistar-Kyoto rats (WKY) were examined. Sodium-nitroprusside (SNP, 1mM) inhibited DNA synthesis by SMC from SHRSP and WKY by 90% and 95%, respectively. SNP also decreased cell proliferation. However, SNP was inactive when SMC were pretreated 6 and 12 hrs before growth stimulation by FCS. On the other hand, the inhibitory action of SNP decreased with time (posttreatment) in SHRSP SMC (42% inhibition at 12 hr post addition). However, in WKY SMC, the decrease of inhibitory action was very slight and SNP still inhibited 73% of DNA synthesis at 12 hr post treatment. SNP inhibited RNA synthesis for 3-6 hr and 6-9 hr after FCS stimulation, however no difference was noted between SHRSP and WKY. Protein synthesis was inhibited more strongly by SNP (9-12 hr after FCS stimulation) in WKY SMC than SHRSP SMC. It is probable that the specific protein(S) whose synthesis is inhibited by SNP is/are responsible for the differences in cell proliferation rate between SHRSP and WKY SMC. PMID- 1773511 TI - Epidermal growth factor stimulation of DNA synthesis and its inhibition by tyrosine kinase inhibitor in aortic smooth muscle cells from SHR. PMID- 1773512 TI - Influence of sex on the reactivity to endothelin-1 and noradrenaline in spontaneously hypertensive rats. AB - The response to endothelin-1 and noradrenaline in isolated aortas in vitro and mesenteric arterioles in situ was studied in male and female spontaneously hypertensive rats (SHR). Greater sensitivity to endothelin-1 and noradrenaline and decreased reactivity to endothelin-1 but not to noradrenaline were found in aortas of male SHR. Mesenteric arterioles of male SHR were more sensitive to endothelin-1 and noradrenaline. Aortas and mesenteric arterioles of female SHR exhibited similar sensitivity to endothelin-1 as compared to controls, whereas a greater reactivity to this agent was only observed in microvessels. It is suggested that sex-linked alterations of vascular reactivity exist in SHR. These alterations seemed not to affect all vascular territories and were not due to differences in blood pressure levels of male and female SHR. PMID- 1773513 TI - Paracrine role of prostanoids in activation of arterial baroreceptors: an overview. AB - Baroreceptors located in carotid sinuses and aortic arch are activated with increases in arterial pressure. The increased afferent nerve activity triggers reflex adjustments that buffer the rise in pressure. Mechanical deformation of baroreceptor nerve endings is considered the primary mechanism of receptor activation. Recent studies in our laboratory have demonstrated that prostanoids, most likely released from endothelial cells during stretch, contribute--as paracrine factors--to the activation of baroreceptors. Exposure of the isolated carotid sinus in anesthetized rabbits to prostacyclin (PGI2) or arachidonic acid increases baroreceptor sensitivity whereas inhibition of endogenous formation of prostanoids with indomethacin or aspirin decreases sensitivity. Baroreceptor sensitivity is also decreased after endothelial denudation and restored after adding PGI2 back to the denuded sinus suggesting that endothelium is the source of prostanoids that sensitize baroreceptors. Pathologic states such as chronic hypertension and atherosclerosis are associated with both endothelial cell dysfunction and decreased baroreceptor sensitivity. The endothelial cell dysfunction and impairment of prostanoid formation contribute to the decreased baroreceptor sensitivity in these diseases. PMID- 1773514 TI - Role of baroreceptor resetting in the tachycardia observed during the onset of one-kidney, one clip hypertension. AB - A previous study from our laboratory demonstrated the occurrence of transient tachycardia during the onset of one-kidney, one clip (1K1C) hypertension in conscious rats. In the present study, using electroneurographic recordings in anesthetized rats, we investigated the time course of baroreceptor resetting at the onset (3, 7, 14 and 21 days) of 1K-1C hypertension. No significant difference between the diastolic pressure and the systolic threshold pressure for baroreceptor activation was detected in normotensive control rats and hypertensive rats 3, 7, 14 and 21 days after clipping. These data indicate that the baroreceptors were completely reset to the hypertensive levels during the periods studied. The data also suggest that baroreceptor resetting may play a facilitating role in the onset of tachycardia and the development of 1K1C hypertension in the conscious animal model. PMID- 1773515 TI - Cardiovascular responses produced by the systemic injection of kainic acid in conscious WKY and SH rats. AB - This study examined the cardiovascular effects of systemic injections of the excitatory amino acid analogue (EAA) kainic acid (KA) in conscious normotensive Wistar-Kyoto (WKY) and spontaneously hypertensive (SH) rats. The injection of KA (100-1000 micrograms/kg, i.v.) produced dose-dependent but transient pressor and tachycardic responses followed by a prolonged period of bradycardia in both strains. Higher doses of KA also produced a secondary prolonged depressor response in WKY but not SH rats. Pharmacological studies demonstrated that the pressor and tachycardic responses are due mainly to increased sympathetic drive to the vasculature and heart. The KA-induced depressor response in the WKY is due principally to cardiovagal activation. After ganglionic blockade, KA produced a prolonged pressor response which was due to the release of vasopressin. These results indicate that the systemic administration of EAAs may produce their cardiovascular effects by activation of the autonomic nervous and endocrine systems and that the absence of the KA-induced hypotension in the SH rats may be related to an abnormality of cardiovagal function in this strain. PMID- 1773516 TI - Exaggerated response to electrical nerve stimulation of angiotensin II release in isolated perfused hind legs of spontaneously hypertensive rats. AB - Previously we reported that a large amount of immunoreactive angiotensin II (Ang II) was released from isolated perfused rat hind legs at steady rates for several hours. In view of a recent intriguing hypothesis that the vascular renin angiotensin system plays an important role in the maintenance of high blood pressure in certain forms of experimental hypertensive models, the release of immunoreactive Ang II from isolated hind legs of spontaneously hypertensive rats (SHR) was examined in comparison with normotensive rats of Wistar-Kyoto strain (WKY) by using a Sep-Pak C18 cartridge directly connected to the perfusion system. We also examined effect of electrically-induced nerve stimulation on the release of immunoreactive Ang II in the two strains. High performance liquid chromatography demonstrated the presence of Ang II in the perfusate. The spontaneous release of immunoreactive Ang II was as high as about 300 to 500 pg/30 min, tended to be higher in SHR rats (435.0 +/- 68.2 pg/30 min) than in WKY rats (342.1 +/- 65.1 pg/30 min), and stable up to 3 hours of perfusion for both strains. Periarterial nerve stimulation elicited a significant increment in the release of immunoreactive Ang II in either SHR (p less than 0.02) or WKY rats (p less than 0.05); however, the amount of released immunoreactive Ang II evoked by nerve stimulation was significantly greater in SHR than in WKY rats (781.3 +/- 89.6 vs 498.8 +/- 54.6 pg/30 min, p less than 0.05). These results further provide evidence for local generation and release of Ang II in peripheral vascular tissues, and are consistent with the hypothesis that the vascular renin angiotensin system is one of important factors responsible for the maintenance of blood pressure. PMID- 1773517 TI - Reduced nociceptive effects of intravenous serotonin (5-HT) in the spontaneously hypertensive rat. AB - This study compared the cutaneous (baseline tail-flick (TF) latencies) and visceral nociceptive responses (5-HT-induced inhibition of the TF reflex and pseudaffective responses) in lightly pentobarbital-anesthetized 16 week old Wistar-Kyoto (WKY) and spontaneously hypertensive rats (SHR). SHR were significantly less sensitive to the nociceptive effect of i.v. 5-HT compared to WKY rats. That is, SHR had a greater quantal ED50 for inhibition of the TF reflex than WKY rats (50.0 and 15.1 micrograms/kg, respectively). SHR also showed the presence of distinct pseudaffective responses (flattening of the ears, closure of the eyes to slits and contraction of the facial musculature) at much greater doses than in WKY rats, thereby paralleling the same changes in sensitivity observed the 5-HT-induced inhibition of the TF reflex. 5-HT-induced similar cardiovascular responses in WKY and SHR except that the SHR showed a significantly greater pressor response compared to WKY rats. These results demonstrate that the SHR show a marked reduction in sensitivity to the nociceptive, but not the cardiovascular, responses to i.v. 5-HT. PMID- 1773518 TI - Aggravating effects of isolated caging on the development of hypertension and its complications in stroke-prone spontaneously hypertensive rats (SHRSP) and Wistar Kyoto rats (WKY). AB - Stroke-prone spontaneously hypertensive rats (SHRSP) and normotensive Wistar Kyoto rats (WKY) were maintained in isolation or in group to analyze the effect of isolation, one type of emotional stress, on the development of hypertension and its complications. SHRSP kept isolated during the whole or a half of the experimental period developed severer hypertension within a shorter period than those kept together with other animals throughout the experiment, and showed significantly higher incidences of cerebral stroke (40 or 33%) than the latter (8.3%). Histological and pathophysiological studies revealed pituitary-adrenal and cardiac hypertrophy accompanying more accelerated urinary epinephrine (E) excretion which indicated emotional stress caused by isolation might aggravate pathological lesions in hypertension. Neither WKY in isolation nor in groups developed hypertension, although isolated WKY had significantly heavier pituitary and adrenal glands accompanied with more accelerated urinary E and calcium excretions than WKY kept in groups. PMID- 1773519 TI - The effects of exercise training on salt-induced hypertension in the borderline hypertensive rat. AB - The borderline hypertensive rat (BHR) develops severe hypertension when chronically subjected to either a high salt diet or behavioral stress. Previous research has shown that daily exercise can attenuate the development of stress induced hypertension in the BHR. The current study sought to determine whether exercise might also exert a similar protective effect on salt-induced hypertension. Two groups of BHR were placed on a high salt diet for 20 weeks; one of the groups also engaged in daily swim training for the entire 20 week period. A third group of BHR served as maturation controls. At the end of the experimental period, direct measurement of heart rate in conscious subjects revealed a significant resting bradycardia in the trained group on a high salt diet but no significant group differences with respect to blood pressure level. Cardiovascular responses to an episode of acute stress revealed that BHR are capable of elevating pressure in response to a novel stressor after swim training. These observations suggest that exercise may be an environmental intervention capable of increasing cardiovascular responses to acute stressors. PMID- 1773520 TI - Cardiovascular responsiveness to stress in relation to behavior and hypertension. PMID- 1773521 TI - Effects of restraint by tether jackets on behavior in spontaneously hypertensive rats. AB - Spontaneously hypertensive rats (SHRs) were compared to Wistar-Kyoto (WKY) and Wistar (WIS) rats on 18 behaviors to determine strain differences while undisturbed and when being restrained by a jacket and tether system often used for monitoring blood pressure chronically. Male SHRs unrestrained in the home cage initially exhibited greater magnitudes of body grooming, quadrant changes, turning, sniffing and rearing than WKYs, whose behavioral levels remained low throughout the entire session. SHRs and WISs gradually declined in behavioral levels within the sessions. The effects of restraint significantly decreased the exploratory/activity behaviors of nose poking, rearing and quadrant changes, with SHRs showing a greater decrement as a result of the restraint. Because of this differential effect of restraint on behaviors distinguishing SHRs and WKYs, studies simultaneously measuring behavior and blood pressure should be interpreted with caution, especially when comparing strains. The hypoactivity of the WKY would suggest the use of an additional control strain in behavioral studies. PMID- 1773522 TI - A new method for continuous chronic measurement and recording of blood pressure, heart rate and activity in the rat via radio-telemetry. AB - Accurate continuous chronic measurements of blood pressure from conscious laboratory rats are critical to many experimental protocols but have been difficult or impossible to acquire. A system consisting of an implantable radio telemetry device, receiver, and computer-based data acquisition system that allows such measurements to be easily obtained has been developed. This system is capable of monitoring and recording arterial pressure (waveform, systolic, diastolic, and mean), heart rate, and activity from rats weighing greater than 175 gm for periods in excess of 6 months. Chronic patency has been achieved through a patented design which includes an antithrombogenic film and a gel membrane located at the catheter tip. Validation of telemetered measurements via carotid catheter has demonstrated the accuracy to be better than +/- 5 mmHg in 85% (N = 20) tested at 3 weeks post implantation, 86% (N = 15) tested at 8 weeks, and 78% (N = 9) at 12 weeks. Incidence of loss of patency was 2.3% (N = 44). This system has a demonstrated ability to obtain accurate continuous chronic measurements of arterial pressure free of the stressors associated with conventional systems. PMID- 1773523 TI - Effects of canrenone on RRM-sucrose hypertension in WKY. AB - Ingestion of a diet high in sucrose content by WKY rats having reduced renal mass (RRM) via a unilateral nephrectomy causes a significant elevation of BP--greater than might be expected from either condition alone. The same findings occur whether the added sucrose calories replace protein or fat. The elevated BP differential remained throughout the 6 months of the study. In some ways, these results resemble a well recognized model of hypertension produced by the removal of 70-80% of renal mass plus excess salt consumption (RRM-salt). When the RRM sucrose WKY were given canrenone, an agent which is a digoxin antagonist, the BP decreased significantly simulating previous findings in RRM-salt. Therefore, like the RRM-salt model, evidence suggests that the RRM-sucrose model is also caused, at least in part, by a digoxin-like factor (DLF). PMID- 1773525 TI - The role of dominance and epistasis in the genetic control of blood pressure in rodent models of hypertension. AB - Genetic analyses of crosses between hypertensive rodent models and their normotensive controls were performed on 43 sets of data published between 1970 1989. In each case, the cross involved F1, F2, and both backcross generations for a "complete genetic cross." Biometrical analysis estimated genetic parameters and their standard errors associated with dominance and epistasis (interaction of alleles that are not at the same locus). The statistical significance of these parameters was determined by comparing the parameter to its standard error. A purely additive inheritance pattern was seldom found. Additive/dominance inheritance was apparent in only two models. The prevailing pattern of inheritance was one with partial dominance for alleles for normal blood pressures and epistatic interactions. Finding epistasis in so many models will have implications for the application of cosegregation and linkage analyses in hypertension research. PMID- 1773524 TI - Genetic variability in SHR (SHRSR), SHRSP and WKY strains. AB - Genetic background for SHR (SHRSR) and SHRSP and WKY lines were screened by using biochemical genetic markers and class I major histocompatibility complex (RT1) typing. There were many kinds of SHR (SHRSR), SHRSP and WKY inbred lines. The genetic variabilities within SHR (SHRSR) or SHRSP strains were small, but those within WKY strains were not so small. When SHR lines were compared with WKY lines, the allele distribution in SHR lines was different from that in WKY lines at 3-13 loci. Three genetic markers, the Es-3b, Es-4a and PT1k, were identified as specific markers of SHR (SHRSR) and SHRSP. WKY/Izm, WKY/Hos, and WKY/Jim also carried the PT1k as well as SHR lines, but WKY/N and WKY/NCrj had the RT1l haplotype. PMID- 1773526 TI - Chimeric rats from the fusion of genetically hypertensive and normotensive rat embryos. AB - Structural changes in the cardiovascular musculature of the SHR during the development of hypertension appears to involve both prehypertensive hyperplastic cellular growth and hypertension induced cellular hypertrophy. The genetic factors determining these changes are not fully known, but may involve altered growth control. The role of genetic determination on the development of hypertension in the SHR was investigated by producing chimeric rats composed of a mixture of genetically homozygous SHR and normotensive cells. Preimplantation 8 cell embryos isolated from SHR and the normotensive NBR (NIH Black Wistar) rat strains were aggregated in vitro and cultured to the blastocyst stage before implantation into surrogate mothers. Chimeric rats born to the surrogate females were raised to 36-40 wks of age and the development of hypertension monitored by tail cuff pressure (BP). BP in the chimeras varied from 115 to 205 mm Hg (146 +/- 25). Heart weights were positively correlated with BP, r = 0.76, p less than 0.05, while only a marginal and non-significant correlation of aortic weight was found (r = 0.53). The renin-angiotensin system was normal in the chimeras. This model may prove useful in determining the extent of genetically mediated cellular events in the development of hypertrophy and hypertension in the SHR. PMID- 1773527 TI - Reciprocal embryo transfer between SHR and WKY. II. Effect on cardiovascular development. AB - In order to study the in vivo effect of putative hypertensinogenic factors on early development of the cardiovascular system, embryos were reciprocally transferred between WKY and SHR to allow embryonic and fetal development of WKY in a hypertensive intrauterine environment and SHR in a non-hypertensive uterine environment. In one day-old neonates blood vessel dimensions and blood pressures were assessed. Pressures were also measured in animals which matured to the adult stage to determine whether there were any long-term effects on pressure of having developed in an in utero environment different from the one they would have naturally experienced. The data indicate that there are no consistent effects of intrauterine environment on vascular development, as indicated by the fact that normalized wall/lumen ratios were not different between normal and transferred animals, and immediate and long-term pressures were also similar in normal and transferred groups. PMID- 1773528 TI - Effects of tryptophane on SHRSP offspring growth. AB - The effects of tryptophane on growth and hypertension of offspring obtained from mothers given L-tryptophane prior to mating: In the tryptophane group, body weights were heavier and blood pressures were higher than in the control group. Stroke lesion incidence rates were also much higher in the tryptophane group. At 20 weeks of age, brain enzyme activities were lower and serotonin content was higher in the tryptophane group in comparison with the control. These results suggest that dietary tryptophane may affect precocious maturation and as well as affect elevation in blood pressures due to brain serotonin turnover. PMID- 1773529 TI - Changes in TSH and 11-deoxycorticosterone (DOC) in hypertension. AB - In order to elucidate the role of thyroid hormones in hypertension, several plasma hormones were chronologically examined using M-SHRSP (malignant SHRSP). In this study, M-SHRSP blood pressure went above 160 mmHg at 6 weeks of age. At the same time, both free T3 and free T4 were already higher in M-SHRSP than in WKY. At 8 weeks of age, M-SHRSP blood pressure reached 220 mmHg, and their TSH and DOC were higher than in WKY. On the other hand, M-SHRSP corticosterone was lower than in WKY. M-SHRSP free T3 and free T4 also decreased momentarily. At 10 weeks of age, M-SHRSP blood pressure reached 250 mmHg, TSH and DOC were higher than in WKY, and their corticosterone was nearly equal to that of WKY. At 12 weeks of age, M-SHRSP blood pressure went above 250 mmHg. At the same time, their free T3 and free T4 increased and was again higher than in WKY. Therefore, it is quite possible that free T3, free T4, and DOC are closely related to the development and/or maintenance of hypertension in M-SHRSP. PMID- 1773530 TI - Effect of cholesterol feeding on the compositions of plasma lipoproteins and plasma lipolytic activities in SHRSP. AB - By cholesterol feeding, atherogenic VLDL, beta-VLDL (IDL) and LDL increased more remarkably in SHRSP than in normotensive WKY, suggesting that hypertension may promote the productions of atherogenic lipoproteins. On the other hand, HDL significantly decreased in SHRSP, which was associated with the decrease in apoA I and E in the HDL fraction. This indicates the decreases of two HDL subfractions, apoE HDL and apoA-I HDL, in SHRSP. These decreases of HDL subfractions in SHRSP may be closely related to the higher h-TGL activity in SHRSP than in WKY, and could be a trigger of the excess production of atherogenic lipoproteins. PMID- 1773531 TI - Association of a genetic polymorphism in human apolipoprotein B-100 with intermediate density lipoprotein concentrations. AB - Immunochemical techniques have been used to identify five antigenic (Ag) sites on apolipoprotein B-100 (apoB), the major protein constituent of very low density (VLDL), intermediate density (IDL), and low density lipoproteins (LDL). Each Ag site results from allelic variation at a specific locus of the apoB gene. In the present study, we assessed whether variations in the five Ag loci were associated with concentrations of plasma lipids or lipoprotein fractions measured by analytical ultracentrifugation in a group of 44 healthy men. Pair-wise analyses of the Ag markers revealed that Ag(a1/d), in association with either Ag(x/y) or Ag(t/z), is significantly related to plasma IDL-mass concentrations. In this cohort we detected no significant associations of the Ag alleles (singly or in combination) with plasma total cholesterol, triglycerides, LDL-cholesterol, HDL cholesterol, or mass of total VLDL or LDL. These results suggest that genetic variations in the apoB molecule may predispose to variations in concentrations of IDL that could have consequences for atherosclerotic risk. PMID- 1773532 TI - Trembling chin--a report of this inheritable dominant character in a four generation Canadian family. AB - Trembling chin is an unusual, benign, dominant trait. We describe the condition in a four-generation Canadian family. Investigations, which included E.E.G., electromyograph and facial nerve conductance studies on affected and unaffected individuals, were normal. Premature hearing loss, present in all affected members of this family over age 50, strongly suggests an association of trembling chin with otosclerosis. The merits of early diagnosis and preventive treatment for otosclerosis in persons affected by trembling chin are discussed. PMID- 1773533 TI - Enhancement of amniotic fluid cell growth for genetic amniocentesis. AB - The last two decades have witnessed a logarithmic growth in demand for prenatal diagnosis of human disease through amniocentesis. Consequently, culture turn around-time has become the major concern of all those who are primary care providers for patients seeking help. We report a rapid method for obtaining cytogenetic results from amniocytes as early as 5 days. Early tapping and reducing the turn-around-time during cytogenetic analysis may provide an alternative to chorionic villi sampling. PMID- 1773534 TI - Absence of predictable phenotypic expression in proximal 15q duplications. AB - We describe ten individuals with an insertional duplication 15q12----q13. Phenotypic analysis of these individuals and 15 previously reported cases of proximal 15q duplications fails to show any consistent clinical manifestations. It appears that a duplication of this region is phenotypically silent. PMID- 1773535 TI - EEC syndrome (ectrodactyly, ectodermal dysplasia and cleft lip/palate) with a balanced reciprocal translocation between 7q11.21 and 9p12 (or 7p11.2 and 9q12) in three generations. AB - Familial cases (a grandfather, a father and a daughter) of the EEC syndrome (ectrodactyly, ectodermal dysplasia and cleft lip/palate) are reported. All of them have a balanced reciprocal translocation (46,XY or XX, t(7;9) (q11.21;p12) or (46,XY or XX, t(7;9) (p11.2;q12)), but no other members of the family have either the EEC syndrome or chromosome abnormalities. This indicates that one of the chromosome sites 7q11.21, 9p12, 7p11.2 and 9q12 is a candidate for gene locus of the EEC syndrome. PMID- 1773536 TI - Patients with deletions of 9q22q34 do not define a syndrome: three case reports and a literature review. AB - Three children with deletions involving the 9q22q34 region are described. A review of clinical features of these three new patients and seven previously reported ones did not demonstrate a recognizable dysmorphic pattern. Our cases illustrate the need for repeat karyotyping at higher levels of resolution when there is a suspicion of a chromosome anomaly, since each deletion was missed on initial analysis. PMID- 1773537 TI - Extra small marker chromosome associated with normal phenotype due to 3:1 disjunction of t(14;22) in a parent. Implications for the origin of marker chromosomes. AB - A family with segregation of a translocation t(14;22) (q31;q11) is is reported. The proband was ascertained by chromosome analysis after repeated spontaneous abortions in his wife. His normal sister was found to have the karyotype 47,XX,+ der (22). The small size and banding pattern of chromosome 22 make it difficult to determine the breakpoint with certainty, but it was judged to be at q11. This small marker chromosome could thus be similar to the one found in the cat eye syndrome, and further studies may cast light on gene(s) involved in this syndrome. PMID- 1773538 TI - Poland-Moebius syndrome in a boy and Poland syndrome in his mother. AB - A 4 4/12-year-old boy with the Poland-Moebius syndrome, whose mother had the POland syndrome, is presented. This is the first report of the occurrence of both syndromes in the same family, suggesting that they are expressions of the same autosomal dominant gene. PMID- 1773539 TI - Smith-Lemli-Opitz syndrome in female, monozygotic twins. AB - A pair of monozygotic female twins with SLO syndrome is presented. We have found only one paper in the literature that referred to twins with this rare syndrome. The multiple congenital defects in these cases, consist of limb and genital abnormalities, retardation of growth, mental deficiency, craniofacial defects and abnormal neurological status. PMID- 1773540 TI - Cell line segregation in a 45,X/46,XY mosaic child with asymmetric leg growth. AB - Clinical evaluation of a 13 1/2-year-old male revealed a 4.4-cm leg length discrepancy and a small penis with a normal endocrine evaluation. Cytogenetic analysis of peripheral blood lymphocytes and skin fibroblasts derived from the back showed 45,X/46,XY mosaicism with similar percentages of 45,X cells, 36% and 30% respectively. However, two separate skin fibroblast cultures derived from the thigh and calf of the short (right) leg showed significant lack of Y-bearing cells with 100% and 80% 45,X, respectively. In contrast, skin biopsies of the thigh and calf of the normal (left) leg both showed 100% 46,XY. Similar evidence for differences in the percentages of Y-bearing cells in the left versus right leg fibroblast cultures was obtained using densitometric scanning of dot blots following DNA hybridization with a Y-specific probe at the DYZ4 locus. Asymmetric limb growth in cases of X/XY lymphocyte mosaicism warrants further cytogenetic investigation to substantiate possible genotype-phenotype correlations which may help uncover the fundamental growth deficiency in Turner syndrome. PMID- 1773541 TI - Balanced pericentric inversion 8(p23q13) in a child with rhizomelic chondrodysplasia punctata and his mother. PMID- 1773542 TI - Hypoplasia of the corpus callosum and growth hormone deficiency in a boy with the XXXXY syndrome. PMID- 1773543 TI - Insulin-dependent diabetes developed in a young man with Bloom's syndrome. PMID- 1773544 TI - Acrodysgenital dwarfism or Smith-Lemli-Opitz type II syndrome. PMID- 1773545 TI - First treatment of family with hereditary adductor cord paralysis. PMID- 1773546 TI - Mosaic trisomy 8 associated with jejunal duplication. PMID- 1773547 TI - Controlled release metoprolol. Clinical pharmacokinetic and therapeutic implications. AB - Metoprolol is a relatively beta 1-selective beta-blocker used extensively to treat hypertension and angina and as a prophylaxis after myocardial infarction. Conventional formulations are usually administered twice daily and the drug has a tendency to lose its selectivity of action at higher plasma concentrations. Two controlled release formulations, metoprolol CR and metoprolol 'Oros', have made it possible to achieve sustained beta 1-blockade over an entire 24h period and to minimise the loss of selectivity associated with higher plasma concentrations. The CR formulation has been extensively investigated and is the major subject of this review. The 'Oros' formulation is pharmaceutically different from the CR, yet both produce similar plasma concentration profiles and comparable beta 1 blocking effects. The availability of these preparations occurs at a time when increasingly persuasive data are becoming available on the cardioprotective or coronary preventive action of metoprolol. PMID- 1773549 TI - Pharmacokinetic interactions with calcium channel antagonists (Part I). AB - Calcium channel antagonists are a diverse class of drugs widely used in combination with other therapeutic agents. The potential exists for many clinically significant pharmacokinetic interactions between these and other concurrently administered drugs. The mechanisms of calcium channel antagonist induced changes in drug metabolism include altered hepatic blood flow and impaired hepatic enzyme metabolising activity. Increases in serum concentrations and/or reductions in clearance have been reported for several drugs used with a number of calcium channel antagonists. A number of reports and studies of calcium channel antagonist interactions have yielded contradictory results and the clinical significance of pharmacokinetic changes seen with these agents is ill defined. The first part of this article deals with interactions between calcium antagonists and marker compounds, theophylline, midazolam, lithium, doxorubicin, oral hypoglycaemics and cardiac drugs. PMID- 1773548 TI - Metabolites of antihypertensive drugs. An updated review of their clinical pharmacokinetic and therapeutic implications. AB - Many antihypertensive drugs are extensively metabolised in humans. Since some metabolites are active and may therefore contribute to the pharmacological activity of the parent drugs, knowledge of the pharmacokinetic properties of active metabolites is important for understanding the overall effects of drugs. Four categories of antihypertensive drugs with active metabolites are dealt with, with selected examples described in some detail. First, drugs with effects relying totally on active metabolites include agents such as methyldopa, cadralazine and many angiotensin converting enzyme (ACE) inhibitors. Secondly, those with effects primarily due to active metabolites include drugs such as triamterene and spironolactone. Thirdly, agents with effects primarily due to the parent drug, but with active metabolites providing significant contributions to the overall pharmacological effect, include drugs such as indoramin, alprenolol, acebutolol, diltiazem and verapamil. Lastly, agents with pharmacological effects with only minor (if any) contributions from active metabolites include drugs such as propranolol, metoprolol, carteolol and others. PMID- 1773550 TI - Ofloxacin pharmacokinetics in chronic renal failure and dialysis. AB - Data on the pharmacokinetics of ofloxacin in chronic renal failure, in patients who were not dialysed or were receiving haemodialysis or continuous ambulatory peritoneal dialysis (CAPD), are reviewed. In addition, a large pool of data obtained in patients with a wide range of renal dysfunction is provided. The good absorption of ofloxacin after oral administration is not influenced by renal failure. Total plasma clearance (CL) is largely dependent on renal elimination of the drug, and renal clearance (CLR) and urinary recovery are reduced in parallel with reductions in renal function. Consequently, the serum half-life progressively increases when creatinine clearance decreases. Although there is wide variation in the published absolute values for the CL and CLR of ofloxacin, all studies show a similar pattern in the pharmacokinetic behaviour of the drug in chronic renal failure. A proposed protocol for ofloxacin dosage adjustment in chronic renal failure is reported which differs slightly but significantly from that recommended by the manufacturer. This new dosage regimen was derived from the pharmacokinetic results after single and multiple oral administration of the drug to patients with chronic renal failure. Since no clinically relevant losses of ofloxacin occur during haemodialysis or continuous ambulatory peritoneal dialysis (CAPD), the same protocol should be followed in these patients as in undialysed patients with terminal chronic renal failure. PMID- 1773551 TI - Bioinequivalence of four 100 mg oral aspirin formulations in healthy volunteers. AB - The single dose pharmacokinetics of 4 commercially available 100 mg oral aspirin formulations were studied in 6 healthy men and 6 healthy women. Two of the formulations were rapid release ('Cardiprin' 100, 'Platelin') and the other 2 were enteric coated formulations ('Astrix' 100, 'Cartia'). There were marked differences in the plasma concentration-time profiles between the rapid release and the enteric coated formulations. There were no significant differences (p greater than 0.05) in the mean time to achieve maximum aspirin concentrations between 'Cardiprin' 100 (0.48 h) and 'Platelin' (0.35 h), but this was significantly prolonged (p less than 0.001) for 'Astrix' 100 (3.73 h) and even more prolonged for 'Cartia' (6.84 h). Similar between-formulation differences were seen in the areas under the plasma concentration-time curves, for which the rank order was 'Cardiprin' 100 (1.60 mg/L.h) = 'Platelin' (1.54 mg/L.h) greater than 'Astrix' 100 (0.73 mg/L.h) greater than 'Cartia' (0.56 mg/L.h). For 'Cardiprin' 100, 'Platelin' and 'Astrix' 100 plasma aspirin concentrations were below 5 micrograms/L by 7 h after ingestion, whereas for 'Cartia' aspirin was detectable for up to 16 h, giving the appearance of sustained release. The enteric coated formulations produced the greatest variability in the plasma aspirin concentration vs time profiles. The urinary recovery of salicylate was greater than 80% of the administered dose for all 4 formulations. The clinical significance of the marked pharmacokinetic differences observed with these 4 low dose aspirin formulations is not known. PMID- 1773552 TI - Pharmacokinetics of theophylline and its metabolites during acute renal failure. A case report. AB - After unsuccessful therapy with salbutamol syrup and inhaled terbutaline a 3-year old boy with an acute exacerbation of asthma was treated with nebulised salbutamol (albuterol), intravenous aminophylline and hydrocortisone. His condition continued to deteriorate and he required artificial ventilation. Subsequently, he became anuric, with liver dysfunction, nonspecific encephalopathy and limb tremor. Peritoneal dialysis was started. Plasma theophylline concentrations were monitored and maintained in the therapeutic or subtherapeutic range. Despite this, he was hyper-reflexic with limb tremor. Excessively high plasma concentrations of the principal theophylline metabolite, 1,3-dimethyluric acid, were found [maximum 92 mg/L (470 mumol/L)], which cleared only with the return of normal renal function. Plasma concentration monitoring of drugs other than theophylline was not performed. After the patient recovered, a pharmacokinetic study demonstrated that normal methylxanthine metabolism was re established. Pharmacokinetic analysis indicated that the undue accumulation of the metabolites was a result of an inability to clear these compounds. Thus, pharmacologically and toxicologically active metabolites of theophylline may accumulate in anuric patients on peritoneal dialysis, producing clinical symptoms of toxicity. However, in the present case the possible role of metabolites of other drugs cannot be definitely excluded. PMID- 1773553 TI - The current role of computed tomographic arthrography of the shoulder. PMID- 1773554 TI - Renal artery stenosis in children. AB - In a large paediatric renal unit over the last 14 years, 19 children (10 male and 9 female, aged 1 week to 16 years, mean 7 years) with renal artery stenosis (RAS) were evaluated. Transplant RAS cases were not included. All 19 children were hypertensive. In 10 this was an incidental finding. Based on clinical findings and arteriography, the causes of RAS included a middle aortic syndrome (MAS) (n = 5), neurofibromatosis (n = 3), William's syndrome (n = 3), fibromuscular hyperplasia (FMH) (n = 4), idiopathic RAS (n = 2) and isolated branch artery stenosis (n = 2). Previous studies have suggested FMH is the commonest cause of RAS in the paediatric population. In our study the largest subgroup are MAS/William's syndrome children, in whom the angiographic appearances were indistinguishable. Where possible, management, both surgical and radiological, and eventual outcomes have been described. PMID- 1773555 TI - Retroperitoneal fibrosis in Marfan's syndrome. AB - To our knowledge, an association between Marfan's syndrome and retroperitoneal fibrosis (RPF) has never been described. We describe two cases who presented acutely with aortic disease and were later found to have changes of undiagnosed retroperitoneal fibrosis causing hydronephrosis on computed tomography (CT). An association is readily understandable based on the current hypotheses for the aortic disease in Marfan's syndrome and the etiology of RPF. We suggest why this has not been noted previously. CT has an established role in the diagnosis and follow up of RPF as well as in the assessment of the aortic complications of Marfan's syndrome. Awareness of the possibility of RPF and it's demonstration on CT may allow early diagnosis and help prevent significant renal impairment. PMID- 1773556 TI - Non-Hodgkin's lymphoma of the bladder--CT and MRI appearances. AB - Computed tomography (CT) appearances of two patients with primary bladder non Hodgkin's lymphoma are presented with magnetic resonance imaging (MRI) correlation in one. The differences between primary and secondary bladder lymphoma with respect to their clinical presentation, course and prognosis are described. Bladder lymphoma is a rare tumour which often presents as a large multilobular submucosal mass, and such an appearance may suggest the diagnosis. Bladder lymphoma, however, cannot be differentiated from the more common transitional cell carcinoma on the basis of CT attenuation values or enhancement patterns, or MRI signal characteristics. The diagnosis must, therefore, be made by histology. Other differential diagnoses and the role of various imaging techniques in the diagnosis and management of bladder lymphoma are considered. PMID- 1773557 TI - Magnetic resonance imaging: when is one sequence sufficient? AB - We have studied 100 patients undergoing magnetic resonance imaging (MRI) in eight well-defined clinical problems. The relative values of the clinical details and the initial imaging sequence in reaching the final MR diagnoses were assessed. For each patient, two radiologists independently predicted the likely radiological findings from the clinical details. They then assessed the radiological appearances shown by the initial imaging sequence (which was chosen according to the clinical problem). Lastly, they made a final interpretation using all the available information. Prediction of likely radiological abnormalities from the clinical details proved unreliable. However, the radiological assessment of the initial imaging sequence was reliable for clinical problems related to the pituitary fossa, posterior fossa, internal auditory meatus and for suspected multiple sclerosis. In these patient groups additional sequences might be reserved for those with equivocal findings. Conversely, assessment of the initial imaging sequence proved unreliable compared with the full radiological assessment for clinical problems in the lumbar spine, the axilla and the knee. This study has led us to reduce the number of sequences performed for some clinical problems, with a commensurate increase in the throughput of patients. PMID- 1773558 TI - The appearances of lumbar intraspinal synovial cysts. AB - Intraspinal synovial cysts most commonly occur in the lower lumbar spine and may cause radicular symptoms. Eight symptomatic patients are described, each of whom had a single synovial cyst with associated facet joint degeneration. Four were at the L4-5 level and two each at L3-4 and L5-S1. Myelography in four patients revealed a posterolateral indentation on the contrast column in each case. Computed tomography (CT) revealed a structure of similar or greater density than the thecal sac in six cases and of gas density in one case. Two of the former cases also contained gaseous elements, three cases had a mildly dense rim and in the eighth case calcification was demonstrated within the cyst. One cyst resolved after facet joint injection with local anaesthetic and steroid. PMID- 1773559 TI - Digital subtraction angiography (DSA) of the extracranial cerebral vessels: a direct comparison between intravenous and intra-arterial DSA. AB - Fifty patients being investigated for ischaemic cerebrovascular disease underwent both intravenous digital subtraction angiography (IV-DSA) and intra-arterial arch digital subtraction angiography (arch-DSA) to enable a direct comparison to be made between the two techniques. The overall quality of the images obtained by arch-DSA was better than that obtained by IV-DSA, but there was no significant difference between the number and gradation of stenoses detected by the two techniques. No significant stenosis was missed by IV-DSA and the technique was found to be sufficiently accurate for it to be used as a screening procedure for carotid bifurcation stenoses suitable for carotid endarterectomy. The advantages and limitations of both techniques are discussed. PMID- 1773560 TI - Calvarial thinning in low grade intracerebral gliomas presenting with epilepsy. AB - Intracranial gliomas can erode or thin the skull. These changes are detectable on conventional radiographs but they appear to be rare. Only a few examples of the appearances on computed tomography (CT) are recorded in the literature. This paper describes the CT appearances of 11 cases. All of the patients presented with epilepsy. In most the tumours were small and indolent. Some went undetected or misdiagnosed for several years because of a lack of familiarity with the appearances. PMID- 1773561 TI - The significance of pulmonary nodules detected by CT but not by chest radiography in tumour staging. AB - Computed tomography (CT) is more sensitive than the chest radiograph in the detection of pulmonary metastases, but specificity is lower because CT detects more small benign nodules. This study assessed the significance of pulmonary nodules demonstrated on CT when the chest radiograph was normal. Staging CT scans of 146 patients with extrathoracic primary tumours were reviewed. Thirteen per cent of CT scans showed pulmonary nodules despite a normal chest radiograph. In over 80% of these cases the nodules were benign. This has implications for accurate staging. When such nodules are demonstrated on CT, comparison with a repeat scan at a suitable interval will increase diagnostic confidence. PMID- 1773562 TI - The ultrasound appearance of asbestos-related pleural plaques. AB - Twenty-five patients with a history of asbestos exposure and radiological evidence of pleural plaques were examined by ultrasound (US). Non-calcified pleural plaque appeared as a regular area of echo-poor tissue which was well defined adjacent to the diaphragm or lateral chest wall, and varied in thickness from 5 mm to 12 mm. Calcified plaques had echogenic and irregular anterior margins with acoustic shadowing beyond. They were associated with characteristic comet tail and straight line artefact. PMID- 1773563 TI - 'Sabre sheath' trachea with mediastinal lipomatosis mimicking a mediastinal tumour. AB - Two cases of 'sabre sheath' trachea in combination with mediastinal lipomatosis are reported. The initial chest radiographs in both cases were interpreted as showing a mediastinal tumour causing tracheal compression. The correct diagnosis was subsequently made using computed tomography (CT). It is important to be aware of these benign conditions when interpreting chest radiographs, particularly in cases of suspected mediastinal pathology. PMID- 1773564 TI - Coronary cameral fistulae following heart transplantation. AB - Coronary cameral fistulae in 208 orthotopic heart transplants performed at Papworth Hospital were examined. Sixteen fistulae in 208 heart transplants were identified (7.7%). This compares with a reported incidence of 0.2% or less in native hearts. Seven (3.4%) were similar to previously described fistulae to the right ventricle and were secondary to endomyocardial biopsy. Four (1.9%) arose from right or left coronary artery atrial branches and drained into the right atrium. We have called these 'suture line fistulae'. Five (2.4%) arose from left coronary branches at the apex; four of these drained into the left ventricle and one into the right ventricle. We believe these to be secondary to cutting needle biopsy of the apex of the donor heart before transplant and have designated them 'harvest biopsy fistulae'. One patient with a large fistula angiographically had no oximetric evidence of shunt at cardiac catheterization. Coronary cameral fistulae are an uncommon complication of heart transplantation and follow-up biopsy, and appear to be of no haemodynamic significance. PMID- 1773565 TI - Case report: percutaneous drainage of periappendiceal actinomycosis. AB - Abdominal actinomycosis is a disorder which often complicates a chronic perforation of the gastrointestinal (GI) tract, such as at the appendix (Wyngaarden and Smith, 1988). Delayed diagnosis characterizes abdominal actinomycosis. Multiple abscesses and draining sinuses are frequently present. Treatment has consisted of long-term oral antibiotic therapy coupled with surgery, including incision and drainage of abscesses with removal of persistent sinuses (Berardi, 1979). We present a patient with abdominal actinomycosis complicating a chronically ruptured appendix who was managed by percutaneous catheter drainage and antibiotic therapy. PMID- 1773566 TI - Case report: frontal aspergilloma--a complication of paranasal aspergillosis. AB - Aspergillosis is a rare cause of intracranial disease in the non immunocompromised patient. We report a case of invasive paranasal aspergillosis with extensive frontal lobe involvement, and discuss the role of computed tomography (CT) and magnetic resonance imaging (MRI) in diagnosis. PMID- 1773567 TI - Case report: transient thymic calcification--association with rebound enlargement. AB - Thymic calcification is usually associated with a thymic neoplasm. A case is reported in which transient calcification preceded rebound thymic enlargement related to chemotherapy, in an otherwise normal thymus. PMID- 1773568 TI - Case report: spontaneous radiographic 'resolution' of retrosternal goitre. PMID- 1773569 TI - Case report: isolated right coronary artery obstruction presenting as acute anterior myocardial infarction. AB - A patient presented with chest pain and S-T segment elevation in the anterior chest leads diagnostic of acute anterior myocardial infarction (MI). The non invasive imaging studies showed no evidence of left ventricular anterior MI but showed a right ventricular MI. Coronary angiography showed an isolated right coronary artery obstruction. Occasionally, the ECG in acute right ventricular myocardial infarction may resemble an anterior MI. The differentiation is important from a therapeutic viewpoint. PMID- 1773570 TI - Case report: systemic lupus erythematosus (SLE) serositis mimicking acute cholecystitis. AB - Systemic lupus erythematosus (SLE) is a well recognized cause of an acute abdomen. What is less well recognized is that the underlying pathology can be varied. The computed tomography (CT) and ultrasound appearances of the gall bladder in a case of SLE serositis are shown. The imaging findings were strongly suggestive of primary gall-bladder disease although at laparotomy the gall bladder showed serosal inflammation only. PMID- 1773571 TI - Delayed presentation of traumatic diaphragmatic hernia. PMID- 1773572 TI - Bright or not-so-bright livers. PMID- 1773573 TI - Anti-thrombotic drugs following angioplasty. PMID- 1773574 TI - Injury to the major airways. PMID- 1773575 TI - Severe reaction to oral iohexol. PMID- 1773576 TI - Consensus panel stresses need for greater awareness of panic disorder and its treatment. PMID- 1773577 TI - Comparing surfactant products. PMID- 1773578 TI - Inverse relationship between desmopressin dosage and antidiuresis. PMID- 1773579 TI - Nomogram for dosing warfarin at steady state. AB - The predictive performance of a nomogram for dosing warfarin was compared with that of a computer program. The nomogram and the computer program were developed from the log-linear model describing warfarin pharmacodynamics at steady state. The nomogram's dose-response curves were generated by using previously reported pharmacodynamic and pharmacokinetic values for an outpatient population receiving warfarin. The series of dose-response curves were plotted by altering the pharmacodynamic values over a range of 3 standard deviations. The ability of the nomogram to predict the steady-state prothrombin time ratio (PTR) after an adjustment in the dosage of warfarin was evaluated, and the results were compared with those of a commercially available program involving Bayesian regression. Data for 65 outpatients were evaluated. The mean +/- S.D. nomogram-predicted, computer-predicted, and measured PTRs were 1.63 +/- 0.27, 1.64 +/- 0.24, and 1.66 +/- 0.23, respectively. The mean prediction errors for the nomogram and the computer program were -0.037 and -0.026, respectively, and the mean percent absolute prediction errors were 11.6% and 11.0%, respectively. Neither method was biased, and differences between the results for the two methods were not significant. The predictive performance of the warfarin dosing nomogram was comparable to that of the computer program. PMID- 1773580 TI - Estimating phenytoin dosages in black African and Indian children. PMID- 1773581 TI - Use of gentamicin clearance in estimating renal function. PMID- 1773583 TI - Effect of use of generic thioridazine products on clinical outcome and quality of life. PMID- 1773582 TI - Effect of flurbiprofen and aspirin on platelet aggregation. PMID- 1773584 TI - Which lipid-lowering agent should be used first? PMID- 1773585 TI - Criteria for use of sargramostim (granulocyte-macrophage colony-stimulating factor). PMID- 1773586 TI - Neonatal screening for haemoglobin variants using filter paper-dried blood specimens. AB - Neonatal screening for haemoglobinopathies utilizing cord blood samples is well established, although it has a high miss rate and has the inherent problem of possible misdiagnosis from maternal contamination of the sample. The use of dried Guthrie card samples which are taken at six days of age avoids these problems and has the advantage of using an established system of sample collection. Controversy exists as to the method of choice for analysis of dried samples, this study of 2406 samples found that Iso-electric focusing (IEF) analysis of dried specimens gives excellent correlation when compared with cellulose acetate/citrate agar electrophoresis of liquid cord blood samples. The IEF results were clear and relatively simple to interpret even when the samples had been stored at room temperature for 4 weeks. The commercial enzyme linked immunosorbent assay (ELISA) screening test JOSHUA reliably determines the presence or absence of haemoglobin S in dried specimens. It could therefore be used as a relatively cheap and simple method for the confirmation of sickle cell trait in neonatal screening programmes based on dried specimens. PMID- 1773587 TI - Bone marrow hypervascularity in patients with myelofibrosis identified by infra red thermography. AB - Infra-red thermography was used to assess bone marrow vascularity in six patients with myelofibrosis secondary to myeloproliferative disorders (four primary myelofibrosis and two primary proliferative polycythaemia). The technique was evaluated with conventional static and dynamic radio-isotopic imaging and with immunohistochemical staining of bone marrow biopsies. Infra-red thermography identified increased bone marrow blood flow in patients with established myelofibrosis and correlated with dynamic radio-isotopic studies of blood flow and hypervascularity identified by immunohistochemistry. Increased bone marrow blood flow and vascular proliferation was not confined to the central bone marrow but also extended into the peripheral marrow of the long bones. Endothelial cell proliferation may be an initiating event in the pathogenesis of myelofibrosis but evaluation of bone marrow vascularity and blood flow has hitherto relied on invasive and complicated techniques. This study has identified bone marrow hypervascularity in patients with myelofibrosis and shown infra-red thermography to be a simple non-invasive method of assessing vascularity. This non-invasive technique may be used to study disease progression and response to therapeutic regimens in patients with myelofibrosis and to study bone marrow blood flow in other bone marrow disorders. PMID- 1773588 TI - Reversible infertility and Castleman's disease. AB - Castleman's disease may cause systemic symptoms with biochemical and haematological disturbances (Featherstone et al. 1990). These usually resolve completely soon after surgical removal of the abnormal mass. We report two cases of infertility associated with the systemic disturbances of abdominal Castleman's disease. Both women conceived less than one year after removal of the 'tumour' and delivered normal infants. PMID- 1773589 TI - Discriminant analysis of iron deficiency anaemia and heterozygous thalassaemia traits: a 3-dimensional selection of red cell indices. AB - The two main causes of microcytic and hypochromic anaemia are iron deficiency and thalassaemia traits. Discriminant analysis based on a simple combination of classical red cell indices have been used to differentiate between iron deficiency anaemia and thalassaemia with varying degree of accuracy. Two new indices are now available from modern cell counters: red cell distribution width (RDW) and haemoglobin concentration distribution (HDW). Our discriminant analysis suggests that RBC, MCHC and RDW contribute significantly to the differentiation between iron deficiency anaemia and thalassaemia in both healthy donors and hospital-patient groups. In the discriminating process, previous workers have overlooked the heterogeneity of anaemia between anaemic groups as well as biological differences in MCV and MCH among the alpha and beta thalassaemia subjects. This study took into account of these biases and proved, for the first time, that differentiation between iron deficiency and thalassaemia by discriminant analysis was clinically reliable and not significantly biased by the severity of anaemia. The diagnostic accuracy of discriminant analysis was confirmed retrospectively by the reallocation algorithm using the jack-knife principle and prospectively by testing the discriminant functions on independent new samples. Selection of the red cell indices contributing to the discrimination of microcytic hypochromic anaemia was based on biological and statistical considerations. The clear separation of red cell index data of iron deficiency anaemia and thalassaemia traits was shown 3-dimensionally by surface plots. PMID- 1773590 TI - The effect of blood transfusion on 51Cr-red blood cells surface-counting data in homozygous beta-thalassaemia. AB - The effect of blood transfusion on 51Cr-red blood cells surface-counting patterns was studied in 22 patients with homozygous beta-thalassaemia being transfused during erythrocyte survival study. Surface-counting patterns of 15 thalassaemics who had not been submitted to blood transfusion during the erythrocyte survival study were served as controls. In 17 of the transfused patients (group A), spleen excess counts (SEC) appeared decreasing after blood transfusion, reaching a minimum (about 50% of the initial value) 3-4 days later, and increasing thereafter to reach again their initial value on 8th to 10th posttransfusion day. The SEC pattern of the remaining 5 transfused patients (group B) presented a continuously ascending curve. Corresponding changes were observed in excess liver counts and heart counts patterns. As a result of these changes spleen/liver ratio (S/L) was found significantly affected by blood transfusion in the majority of thalassaemic patients which were transfused during the erythrocyte survival study. Furthermore, the mean age of group A patients (12.1 +/- 5.5 years) has been found to be significantly lower than that of group B (21.8 +/- 3.3 years). On the contrary, in the control group the SEC pattern appeared permanently increasing and the S/L was found unaltered during the whole duration of the erythrocyte survival study. In conclusion, as far as the surface-counting data represent indexes for splenectomy in thalassaemic patients, the results of this study signify that the influence of blood transfusion on these has to be taken into account. PMID- 1773591 TI - Parallel line bioassay in a coagulation laboratory. A program for personal computer use and an example application to Ristocetin Cofactor assay. AB - The authors review the statistical principles of parallel line bioassay and describe a computer program written to facilitate a correct approach to most coagulation assays. This program should be especially useful for those assays in which linearization of dose-response curves may prove difficult, or in which careful analysis of assay validity is required. How the knowledge of bioassay theory can be applied to von Willebrand factor Ristocetin Cofactor activity measurement is shown as a general example. PMID- 1773592 TI - Acute epiglottitis in immunocompromised patients--a report of two cases. PMID- 1773593 TI - Erythroleukaemia-associated haemophagocytic syndrome. PMID- 1773594 TI - Myelodysplasia as the initial presentation of Fanconi's anaemia in a phenotypically normal child. PMID- 1773595 TI - Spontaneous complete remission of acute myeloid leukaemia with interstitial deletion of chromosome 5. PMID- 1773596 TI - Case report. Spurious thrombocytosis in a patient with severe burn. PMID- 1773597 TI - Testing the myelotoxic potential of new anti-HIV drugs in vitro. PMID- 1773598 TI - Addressing the public mental health personnel crisis through systemic reform and public-academic linkages. AB - This article examines the personnel crisis in public mental health and proposes that improved public academic linkages combined with substantive changes at national, state, local, and university levels can provide a collective solution to this crisis. First, an overview of the problem is presented. For each of these four levels critical issues affecting the training of mental health professionals and suggested changes that would enhance the development of strong public academic linkages are presented. Finally, Ohio is used as a case example of a state that developed a number of successful PAL initiatives in response to this human resource development crisis. PMID- 1773599 TI - Public-academic linkages in western States. AB - The role of the Western Interstate Commission for Higher Education (WICHE) in facilitating collaboration between higher education and state mental health agencies in the western states is presented in this paper. Unique service and training problems posed by sparsely populated states with limited numbers of professionally trained personnel and few clinical training programs make collaboration an important human resource issue in the West. WICHE's efforts over the past ten years to strengthen collaboration and the recent development of a regional coalition of educators, providers, and consumers to solve chronic treatment and research problems in the western states are described. PMID- 1773600 TI - State-university collaboration in psychiatry: the Pew Memorial Trust Program. AB - This contribution summarizes the background leading up to the goals of and the experience gained from a major national initiative to expand and improve collaborative activities between state departments of mental health and university departments of psychiatry through regional conferences, national workshops, ongoing consultations, and awards. It details the problems of the public system and how successful collaborative efforts have improved the situation, cites the role of one such a program (in Maryland), recounts the process of holding a national invitational conference and the subsequent "Call to Action," and summarizes what the Pew Project is intended to do and how the project is progressing. PMID- 1773601 TI - University-state hospital collaboration in an inpatient psychiatric rehabilitation program. AB - From 1981 until present the Department of Psychology of the University of Nebraska-Lincoln has collaborated with the Lincoln Regional Center, a state hospital, on an inpatient psychiatric rehabilitation project. The University provides clinical psychology services under contract, including direct clinical services and consultation on program development. The project includes a 40-bed inpatient treatment unit, which represents a clinical training and research site for University faculty and graduate students. Program evaluation data indicate the collaboration has produced a cost-effective state-of-the-art treatment program, now considered a model for psychiatric rehabilitation services across the state. The collaboration played a key role in securing two major grants, one for specialty training for clinical psychologists in schizophrenia and psychiatric rehabilitation, one for a treatment outcome study. Facilitating factors in the project include convergence of the collaborators' professional and research interests with national and state mental health policy. Obstacles include hospital administrative policies which fail to recognize or appreciate requirements for program management and accountability, and unwillingness to recognize program leadership from nonmedical professionals. PMID- 1773602 TI - The Galt Visiting Scholar in Public Mental Health: a review of a model of state university collaboration. AB - The Galt Visiting Scholar in Public Mental Health program was developed in Virginia to strengthen the relationships between the Virginia Department of Mental Health, Mental Retardation, and Substance Abuse Services and the Commonwealth's three medical schools. We describe the development and evolution of this program and its accomplishments to date. Despite significant accomplishments, many of the key recommendations of previous Galt Scholars have not been enacted. The Galt Scholar approach of a consultant model is discussed and analyzed structurally using consultation theory. This analysis demonstrates both the potentials and limits of consultant models of state-university collaboration. PMID- 1773603 TI - Public-academic linkages: a "linchpin" model. AB - The "linchpin" model of collaboration between state mental health agencies and university training programs has been developed in two states. This paper describes the model, pointing out both strengths and weaknesses. Recommendations for institutions seeking this type of collaboration and persons who are in the collaborative role are provided. PMID- 1773604 TI - Using LabVIEW to facilitate calibration and verification for respiratory impedance plethysmography. AB - A system for calibrating the Respitrace impedance plethysmograph was developed with the capacity to quantitatively verify the accuracy of calibration. LabVIEW software was used on a Macintosh II computer to create a user-friendly environment, with the added benefit of reducing development time. The system developed enabled a research assistant to calibrate the Respitrace within 15 min while achieving an accuracy within the normally accepted 10% deviation when the Respitrace output is compared to a water spirometer standard. The system and methods described were successfully used in a study of 10 subjects smoking cigarettes containing marijuana or cocaine under four conditions, calibrating all subjects to 10% accuracy within 15 min. PMID- 1773605 TI - A software for the elaboration of job histories. AB - This article presents a software designed to help the occupational physician elaborate, print and automatically interrogate the job histories of workers. The need for the surveillance of professional risks throughout careers is the basic assumption on which this software is based and it runs on a PC. PMID- 1773606 TI - Density profiles of biological specimens from Tiff files. AB - A program for achieving density profiles of Tiff images is described. Densitometric analysis is performed applying a cross-lateral averaging and longitudinal interpolation along the image axis. These procedures may be adapted to a variable axis curvature, length, width and morphological resolution. Since the Tiff format is supported by all desktop scanners and a large number of frame grabbing devices, the range of applications includes the analysis of light and electron micrographs, autoradiograms, chromatograms, and data from any kind of bidimensional medium or flat surface. A special feature is the possibility of retrieving data from published pictures taken from literature. PMID- 1773607 TI - Resampling algorithms for diagnostic radiology. AB - The use of digital image resampling can be highly suitable for diagnostic radiology. It can be applied not only to obtain zoom effects but also to solve various problems related to the comparison of images of different origin (NMR, CT, NM). The mathematical approach to this kind of algorithm, based on rational assumptions, can be very wide and diversified. In this work the principles of the stochastic and of the analytical methods have been analyzed. In particular, a complete mathematical treatment of the integral analytical methods, which are both the most theoretically interesting and analytically complex, has been performed. The practice of these techniques has to be determined each time from the analysis of the specific problem to which they are to be applied in the routine, and after a retrospective analysis of the results obtained. PMID- 1773608 TI - A distributed image-processing system for measurements of intracellular calcium in living cells. AB - During the last decade, image-processing techniques have been introduced as a valuable tool in biologically oriented research. In combination with novel fluorescent probes, these techniques permit assessment of subcellular distributions of several intracellularly important cations, such as free calcium ions and protons. Typically, systems used for image processing are located centrally around the experimental setup. This configuration has drawbacks, mainly because the laborious extraction and processing of data that generally follow an experimental session limits the access to the system for other investigators. We describe here the principles of a distributed image processing system, based on IBM-compatible personal computers (PCs), that without extra hardware can cope with all the necessary image processing involved in imaging of intracellular cations. The potential of the PC as an image processor, however, reaches beyond this specific application and many image processing tasks can be carried out successfully on a standard PC. Thus, the centrally located dedicated image processor is used only for image acquisition in the experimental situation. This in turn optimizes the utilization of expensive resources and increases efficiency. The mouse-operated software is described in detail, so that interested investigators can extract useful parts for integration into their own applications and experimental environment. PMID- 1773609 TI - A compiled computer program for assisting the diagnosis of gastrointestinal helminths of humans and animals. AB - A compiled computer program for assisting the diagnosis of gastrointestinal helminths in fecal examinations of humans and animals is described. The characteristics of this program which distinguish it from previous similar programs are that it does not require specific software, it does not need a lot of computer memory, and it covers both humans and animals, making it easier to use. PMID- 1773610 TI - Object-oriented design and programming in medical decision support. AB - The concept of object-oriented design and programming has recently received a great deal of attention from the software engineering community. This paper highlights the realisable benefits of using the object-oriented approach in the design and development of clinical decision support systems. These systems seek to build a computational model of some problem domain and therefore tend to be exploratory in nature. Conventional procedural design techniques do not support either the process of model building or rapid prototyping. The central concepts of the object-oriented paradigm are introduced, namely encapsulation, inheritance and polymorphism, and their use illustrated in a case study, taken from the domain of breast histopathology. In particular, the dual roles of inheritance in object-oriented programming are examined, i.e., inheritance as a conceptual modelling tool and inheritance as a code reuse mechanism. It is argued that the use of the former is not entirely intuitive and may be difficult to incorporate into the design process. However, inheritance as a means of optimising code reuse offers substantial technical benefits. PMID- 1773611 TI - Quantification of vertical-fiber defect in cattle hide by small-angle light scattering. AB - Vertical-fiber defect (VFD), an abnormal arrangement of collagen fibers in hides of certain cattle breeds, is still not fully understood. Prior work has been limited to subjective histological examinations from hide biopsies. A device using small angle light scattering (SALS) was used to quantify the collagen fiber orientation of sections taken from hide biopsies. Sections were chosen from the Hereford cattle breed and classified by conventional observation as belonging to either the normal, intermediate, or vertical phenotypes. The vertical fibers occur only in the upper reticular dermis, with the fibers in the lower reticular dermis lying parallel to the plane of the hide in all phenotypes. By SALS the vertical phenotype was found to be significantly different from the normal phenotype, whilst the intermediate phenotype was found to be structurally indistinguishable from the vertical one. No evidence was found for the existence of other phenotypes. PMID- 1773612 TI - Three-dimensional structures of uterine elastic fibers: scanning electron microscopic studies. AB - We report findings that demonstrate for the first time that the structure of the elastic fibers of the uterus and cervix are characteristic to these tissues. Elastic fibers of the uterine corpus and cervix were studied by scanning electron microscopy (SEM). Elastic tissues were prepared from non-pregnant human uteri and pregnant rat uteri by three different methods: extraction from the tissue homogenates, in situ digestion by autoclaving of sliced tissue, and in situ formic acid digestion of sliced tissue. In addition, in situ formic acid digestion of the glutaraldehyde-fixed uterine wall of pregnant rats was done. Under SEM, the uterine elastic fibers revealed two distinct structures--fibrils and thin sheets of elastic membranes. Isolated fibers and membranes ranged in thickness from 0.1 to 0.4 micron which is thinner than aortic elastic lamellae (1 2.5 microns in thickness). These thin sheets of elastic membranes and elastic fibrils probably allow the uterus to maintain its elasticity without exerting excess pressure on the growing fetus. Formic acid digestion of fixed uterine walls of pregnant rats preserved the structural organization of elastic tissues near in vivo conditions. In these tissues, the fibers were arranged in a honeycomb structure made up largely of membranes, although sparse fibrils were present. These elastic, membranous sheets were arranged parallel to the plane of the uterine surface and interconnected with the threads of the membranes or fibrils. In the rat uterine wall, at least 12 parallel layers of elastic sheets were present. In contrast, at low magnification, the elastic tissues in the non pregnant human uterus had no specific architectural arrangement and exhibited a sponge-like structure. Elastic fibers of the cervix were also made up of membranes and fibrils, and these fibers were organized into fishnet-like structures. These cervical membranes had fenestrations and pits with a diameter of 3-5 microns. In these studies, the concentrations of insoluble elastin in human uteri were found to be 1.38 and 1.32-1.41% of dry-defatted tissues for uterine body and cervix, respectively. The concentrations of total collagen were 38.8 and 64.3-72.4% of dry-defatted tissues for uterine body and cervix, respectively. PMID- 1773613 TI - The "epiligament" of the rabbit medial collateral ligament: a quantitative morphological study. AB - The thin layer of connective tissue covering ligaments--the epiligament--has not been well described. The aim of the present study was to define, describe, and quantify the structure of the epiligament of the rabbit medial collateral ligament (MCL) using polarized light, scanning-electron, transmission-electron microscopy, and computerized histomorphometry. Epiligament was composed of woven bundles of collagen fibers, 3 morphologically-distinct cell types (spinous-shaped cells, cuboidal-shaped cells, and fat cells), and a neurovascular network that periodically arborized into the MCL. The areal fraction of vessels was significantly greater in the epiligament than in the MCL. The epiligament was significantly thicker on the superficial surface of the MCL than the deep surface, and the thickness of epiligament changed significantly during skeletal growth. Based on these structural features we speculate that the epiligament serves several important functions including: (1) protecting the MCL against abrasion, (2) supporting the neurovasculature, (3) controlling water and metabolite flux into the epiligament and possibly the MCL, and (4) being a source of extracellular matrix, cells, and vasculature during ligament growth and during ligament healing. PMID- 1773614 TI - Some effects of gamma irradiation on patellar tendon allografts. AB - The purpose of this study was to investigate possible causes for altered mechanical properties of patellar tendon allografts, used for reconstructive surgery, after sterilization with 2.0 Mrads gamma irradiation. The tissues were analyzed using a Hydrothermal Isometric Tension (HIT) device in conjunction with biochemical assays of soluble collagen and electron microscopy to understand the action of this processing. Gamma irradiation was found to significantly lower the shrinkage temperature and tended to increase the rate of isometric tension development. While no significant alteration in the acetic acid solubility was noted, the processing doubled the solubility of collagen to pepsin. This could mean that the predominant effect of the gamma irradiation at this dose level is polypeptide chain scission. The stiffening of the HIT curve may suggest some minor cross linking also occurred. The damaging effect of gamma irradiation, however, was not significant enough to cause any major disruption of the normal banding pattern in collagen. These data support earlier biomechanical data showing that using current processing methods, 2.0 Mrads of gamma irradiation sterilization significantly decreases the tensile strength and modulus of human patellar tendon graft tissues. PMID- 1773615 TI - An evaluation of the levonorgestrel-releasing IUD: its advantages and disadvantages when compared to the copper-releasing IUDs. AB - The levonorgestrel-releasing IUD (LNG-IUD-20), providing a daily dose of 20 ug, has recently been approved for marketing in Finland. The IUD's high efficacy in preventing accidental pregnancy and other numerous positive features make it a promising contraceptive device for worldwide use, just like the currently available T-shaped copper-releasing (TCu) IUDs. This paper reviews published reports comparing the LNG-IUD-20 and the currently used TCu IUDs. The merits and disadvantages of the steroid-releasing IUD are evaluated in terms of its performance and other special features relative to the TCu IUDs. Also, a number of future studies with medical and programmatic importance are proposed. A broader understanding about these two IUD families will facilitate their use in a complementary way for family planning programs. PMID- 1773616 TI - A multicentred, two-year, phase III clinical trial of norethisterone enanthate 50 mg plus estradiol valerate 5 mg as a monthly injectable contraceptive. AB - Norethisterone enanthate (NET-EN) 50 mg combined with estradiol valerate (EV) 5 mg was studied as a once-a-month injectable contraceptive with regard to effectiveness, cycle control, adverse events and acceptability. In eight Family Planning Centres from 5 Latin American countries, 652 fertile women were followed up for a period of 24 months, providing a total of 10,689 woman-months of experience. Only 1 pregnancy occurred, in the first treated month a few days before the second injection (failure rate 0.11 per 100 woman-years). Under treatment, the first cycle was drastically shortened in most cases, but thereafter cycles tended to recover to pre-treatment patterns. There was a significant decrease of hypermenorrhea and dysmenorrheic cycles. Intracyclic bleeding and spotting appeared in 1.2% and 2.4%, respectively, and amenorrhea in 2.5% of cycles. Incidence of other adverse events was very low with the exception of weight gain of 2 Kg (28%). Continuation rate at 12 months was 64.7%. The cumulative discontinuation rate due to bleeding problems was 7.4% and 10.7% due to adverse events at 24 months. PMID- 1773617 TI - Effects of nomegestrol acetate (5 mg/d) on hormonal, metabolic and hemostatic parameters in premenopausal women. AB - The effects of nomegestrol acetate on circulating hormone levels, metabolic and hemostatic parameters and blood pressure were studied in 36 premenopausal women. The progestogen was administered from day 7 to 25 of the cycle during six cycles at a dosage (5 mg/d) known to inhibit ovulation. Analysis were performed before and in the third and sixth cycles. Estradiol and progesterone levels decreased significantly (p less than 0.001) during treatment. Body weight, fasting blood glucose and insulin, total HDL and LDL cholesterol, apolipoprotein B, fibrinogen and plasminogen did not change significantly. Triglycerides in the third cycle (p less than 0.05) and apolipoprotein A1 levels (p less than 0.01) in both periods of sampling decreased significantly. There was a significant increase in antithrombin III (p less than 0.01). These results indicate that nomegestrol acetate has no deleterious effect on blood glucose and lipids. The decrease in apolipoprotein A1 and increase in antithrombin III may be related either to the decrease in estradiol levels induced by the treatment or to the effect of the progestogen itself. PMID- 1773618 TI - A diaphragm tampon applied to an ovulation method in a birth control system. AB - Gynaeseal is a re-usable diaphragm tampon made from latex which forms a unique cervico-vaginal seal and isolates menstrual loss. In a prospective study involving 80 women, Gynaeseal was offered in combination with the Billings Ovulation Method in an advised birth control system. This system included: use of the diaphragm tampon during the menstruation-fertile phase interphase; periodic abstinence during the overtly fertile phase of the cycle; and if extreme reliability was required, for a further 2 days after the Billings method 'rules' allow resumption of intercourse. The diaphragm tampon successfully complemented the Billings Ovulation Method with 44 women (60.4%) assessing the GOM System as being as good, or better than, currently available reversible methods. It functioned effectively as a tampon with 50% (31 women) stating that they used the product as a contraceptive. One woman claimed an unplanned pregnancy. No significant medical complications were recorded. The product has major advantages as a tampon: it is easily and accurately inserted because of the efficient applicator; it isolated menstrual loss within a collection chamber; it protects the cervix; and it facilitates sexual activity. Based on a minimum effective diameter (62mm), the diaphragm tampon does not interfere with the normal physiology of the vagina. There appeared to be no significant distortion of normal adult pelvic anatomy, and properly placed, no sensation of the diaphragm tampon's presence. Regarding insertion of the diaphragm tampon using the spiral curved applicator: 31 women (42.5%) had little or no difficulty; 29 (39.7%) moderate difficulty; 13 (17.8%) experienced serious difficulty; and 7 (8.7%) were unable to use the product. PMID- 1773619 TI - Sterilization acceptance and regret in Thailand. AB - The prevalence of sterilization increased steadily in Thailand from 1969/70 to 1984, but remained unchanged over the period 1984-87. This paper uses data from the 1987 Thai DHS to examine sterilization acceptance and regret. The prevalence of sterilization increases with both the number of children and with the age of the woman. Among women with two or more children, there is a positive association between education and wealth, and tubal ligation, but there is no correlation between education and wealth and the percentage of husbands with a vasectomy. Women whose last delivery was in hospital were more likely to have been sterilized than were women with a home delivery, and among women with a hospital delivery, those who had a cesarean section were more likely to have been sterilized than were women with a vaginal delivery. Both accessibility to medical facilities and medical problems apparently play a role in affecting who gets sterilized. The percentage of women who reported that they regretted that either they had gotten sterilized or that their spouses had gotten sterilized was 11% but regret was higher in cases in which the wife had had surgery (12%) than in cases in which the spouse had had a vasectomy (8%). This difference persisted even when other variables were introduced to examine the correlates of regret (number of children at time of sterilization, subsequent death of a child, whether sterilization was done at time of CS, residence of the respondent) using multiple classification analysis. Perhaps when women themselves are sterilized, they attribute subsequent problems in health to the operation, whereas such changes cannot be attributed to the vasectomy of their husband. PMID- 1773620 TI - Long-term use of depot-norethisterone enanthate: effect on blood coagulation factors and menstrual bleeding patterns. AB - Fifty-six women using depot-norethisterone enanthate injections for contraception for 2 years or more were compared with a control group of 48 women not using hormonal contraception. No significant difference was found between the study group and controls for Factors VIIc and Antithrombin III. Factor Xc was reduced in women who had used the injections for over two but less than five years [controls: mean 90.3% SD31.2 vs users for 2-5 yr: 78.7% SD17.1, 95%CI difference in means -0.3, -22.9]. In the group using Net-En for five years or more, Factor Xc was significantly higher than in the control group, but only by 14% of the mean control value [users for over 5 yr: 103.2% SD15.2, 95%CI difference in means 3.1, 22.7]. Haemoglobin levels, red cell count and packed cell volume were higher in those using the injections than in the control group. Changes in the platelet count were not statistically significant. Twenty-three women using the injection agreed to keep menstrual diaries. Of these, 20 experienced amenorrhoea for more than two consecutive injection intervals (112 days). It is concluded that long term use of norethisterone enanthate is not associated with any markedly deleterious effects on Factor VIIc, Xc, or antithrombin III or haemoglobin levels. Amenorrhoea of 4 months or more can be expected after two years of continuous use. PMID- 1773621 TI - The male antifertility activity of 6-chloro-6-deoxyglucose. AB - 6-Chloro-6-deoxy[U-14C]glucose is not metabolised by mature boar spermatozoa nor has it any specific inhibitory action on their metabolic activity in vitro. The compound is metabolised by the male rat and the identification of two urinary metabolites as alpha-chlorohydrin and 3-chlorolactate confirmed that (S)-3 chlorolactaldehyde is produced by this species in vivo. A tissue distribution study revealed that radioactivity from 6-chloro-6-deoxy[U-14C]glucose was more concentrated in rat caudal spermatozoa than in any other of the major tissues. PMID- 1773623 TI - Effect of late follicular phase administration of antide on ovulation and inhibin secretion in macaques. AB - In previous studies, the LHRH antagonist detirelix, administered to stumptailed macaques during the menstrual cycle, was only partially effective in blocking pituitary-ovarian function when given during the late follicular phase. Since the antagonist was suppressive when administered during the early luteal phase, we investigated the ability of antide, a putative long-acting LHRH antagonist, to cause inhibition of the LH surge or luteal function when administered during the late follicular phase. Six animals with regular ovulatory cycles were treated on day 10 of the follicular phase with 1mg/kg antide s.c. All animals demonstrated a continued rise in serum concentrations of estradiol which were followed by an LH surge beginning 2-5 days after antide injection and serum progesterone and inhibin secretion which indicated normal luteal function. In a second experiment, six animals were treated on day 10 of the follicular phase with 3mg/kg antide s.c. In three animals, this caused a fall in serum concentrations of estradiol and the expected LH surge and rises in progesterone and inhibin secretion indicating ovulation failed to occur. In 2 animals, the LH surge was not prevented but the consequential rise in progesterone and inhibin was attenuated. In the remaining animal the cycle appeared unaffected. Pharmacokinetics of antide revealed an initial high release rate during the first 4 days (1mg/kg) or 6 days (3mg/kg) followed by a period of sustained release at a relatively low level. These results show that antide is partially effective in blocking ovulation at a high dose in the macaque and may result in an inadequate luteal phase, presumably as a result of its extended action. PMID- 1773624 TI - Noninvasive and invasive testing after myocardial infarction. AB - Recurrent myocardial ischemia, moderate to marked depression of left ventricular systolic function, and late-occurring or recurrent cardiac arrhythmia indicate increased risk for patients with acute myocardial infarction. Some patients, on the basis of high risk and/or unsuccessful response, will be early candidates for early aggressive diagnostic and therapeutic procedures. Others will have clinical indicators of increased risk during hospitalization that warrant diagnostic coronary arteriographic assessment before discharge. Still other patients with low risk clinical characteristics can be further stratified by predischarge or early postdischarge stress testing for myocardial ischemia, left ventricular functional reserve, and/or likely occurrence of arrhythmias. Some stratified to low risk patients will be treated only with secondary prevention measures. Others at higher risk will undergo more aggressive evaluation and subsequent medical or surgical therapy. PMID- 1773622 TI - Fucoidin inhibits the zona pellucida-induced acrosome reaction in human spermatozoa. AB - We recently reported that fucoidin (a polymer of predominantly sulfated L-fucose) significantly inhibits tight binding of human sperm to the human zona pellucida in vitro and that several oligosaccharides obtained after acid hydrolysis possess sperm-zona pellucida binding inhibitory activity equal to the original fucoidin. This inhibition may be specific to sperm-zona interactions or may be the consequence of the interruption of capacitation, a series of biochemical and physiological events leading to final sperm maturation, that must occur for successful fertilization. Completion of capacitation is most often determined by assessing two end-points of the process: acquisition of hyperactivated motility and ability to complete the acrosome reaction. Here, we examined the effects of fucoidin on these two end-points of capacitation in vitro. Fucoidin did not affect the proportion of sperm with hyperstimulated motility. Neither did fucoidin cause an increase in sperm that had spontaneously acrosome-reacted at 4.5 hours compared to controls as evaluated by indirect immunofluorescence using the acrosomal marker, monoclonal antibody, T-6. Comparable percentages of sperm had completed the acrosome reaction when exogenously stimulated by calcium ionophore A23187 with and without the addition of fucoidin. However, in the presence of fucoidin, stimulation of the acrosome reaction by acid solubilized human zonae pellucidae was significantly inhibited. These data indicate that fucoidin does not impede the normal progression of capacitation. These results provide strong evidence to support the hypothesis is that the inhibitory effect of fucoidin is at the level of the sperm membrane since inhibition can be bypassed by increasing intracellular calcium directly with a calcium ionophore. PMID- 1773625 TI - ["Defensive thinking in medicine"--the wrong way or necessity? On the subject as jurist with special reference to criminal law]. PMID- 1773626 TI - [Legal consequences as a result of medical science]. PMID- 1773627 TI - [Prevention of infection in accident surgery from the viewpoint of hospital hygiene]. PMID- 1773628 TI - [The change in accident surgery in the last 10 years--a contribution to infection prevention]. PMID- 1773629 TI - [Plastic reconstructive microsurgery in post-traumatic infection control and therapy]. PMID- 1773630 TI - [Antibiotic prophylaxis in accident surgery]. PMID- 1773631 TI - [C-reactive protein in the early diagnosis of postoperative infection following bone surgery]. AB - Of a prospective 101 patient study group after different operative osteosynthetic procedures 94 patients without postoperative infection showed a uniform acute phase response which was characterized by determination of C-reactive protein levels, ESR, WBC and body temperature. 7 patients suffering from infection in the postoperative period but no patient with non-inflammatory complications showed distinct CRP value patterns. In 4 wound infections CRP increased from day 2 to 4 and thus was the earliest sign of developing infection. Latency to the clinical diagnosis based on clinical signs, ultrasound, WBC in blood and wound drainage was up to 14 days. There was no patient with CRP increasing after day 2 but no infection. CRP is a very sensitive, non-expensive tool for early diagnosis of bacterial infection. It is superior to ESR, WBC in blood and drainage, ultrasound and diagnosis based on clinical signs. PMID- 1773632 TI - [The effect of Federal Public Health Service guidelines on air, surface and floor germ count in a general surgery and an orthopedic operating room]. AB - In a prospective study the environmental contamination in an old and a new operating theatre was investigated. The old operating rooms were constructed in 1936 whereas the new rooms were built in 1986. The study was conducted in surgical and orthopedic surgical operating rooms. There was a slight increase in floor as well as in surface contamination in the new operating rooms. On the other hand there was a slight decrease in the airborne microorganisms in the orthopedic surgery and nearly identical colony counts in the general surgery operating rooms. All the differences were statistically not significant. The spectrum of microorganisms and the occurrence of Staphylococcus aureus in the old and the new operating rooms showed no difference. PMID- 1773633 TI - [Hygiene rituals in surgery. A guest commentary]. PMID- 1773634 TI - [Principles of radicality in stomach carcinoma--a critical evaluation]. AB - The healing rate in patients with gastric cancer did not change during the last three decades despite major changes in therapeutic strategies. The internationally accepted classification allows an exact comparison between different stages of disease. The postoperative mortality has been decreased by improvement in surgical techniques and postoperative intensive care; postoperative morbidity, however, still is high depending on the extent of the surgical procedure. The type of gastric resection is determined by the localisation of the tumour. If systematic lymphadenectomy is of any benefit for the patient, is still unknown. First controlled studies do not allow any definite answer. PMID- 1773635 TI - [Lymphadenectomy in stomach carcinoma? Observations on the previous publication by H.D. Becker]. PMID- 1773636 TI - [The value of computerized tomography and of the surgical assessment for lymph node staging in bronchial carcinoma. A prospective study]. AB - We evaluated the accuracy of computed tomography (CT) and of surgical assessment for lymph node staging prospectively in 108 patients with bronchogenic carcinoma. For CT/surgical assessment a sensitivity of 29/90%, a specificity of 93/63%, a positive predictive value of 49/39% and a negative predictive value of 85/96% were calculated on a node-by-node basis. Sensitivity and specificity of CT were highly influenced by the lymph node region studied and by typing of the tumor. Adenocarcinomas showed a high proportion of normal-sized metastatic lymph nodes whereas squamous cell carcinomas exhibited a high proportion of enlarged tumor free lymph nodes. The diagnostic accuracy in predicting the correct N-stage by CT was determined with 54% for squamous cell carcinoma and 56% for adenocarcinoma. The surgeon predicted the N-stage correctly in 39% of squamous cell carcinoma and 69% of adenocarcinoma. In conclusion, accuracy of CT-scan is too low to renounce mediastinoscopy for routine use in preoperative staging of bronchogenic carcinoma. PMID- 1773637 TI - [The mucosal sliding flap in the treatment of supra and high trans-sphincteric anal fistula]. AB - Since 1989 we have operated upon 28 patients for trans- or suprasphincteric fistula, using the mucosal sliding flap: After injection of a vasoconstrictory agent into the submucosal tissue we sparingly excise the inner opening of the fistula just beyond the dentate line. A mucosal flap is then meticulously dissected and used to cover the lesion in the rectum. The flap prevents fecal bacteria from invading the intrasphincteric portion of the fistula. This portion remains intact, and so does the sphincter apparatus. Then we excise the fistulous tract, proceeding from its external opening towards the sphincter muscle. After a mean follow-up of 8.1 months all 28 patients are free of symptoms. Proctoscopy did not reveal persistent or recurrent fistula in any of them. PMID- 1773638 TI - [Life-threatening lower gastrointestinal bleeding caused by erosion of the cystic artery in gallbladder-transverse colon fistula]. PMID- 1773639 TI - [Recurrent digital herpes simplex]. PMID- 1773640 TI - [Opinion on the publication by K. Koch et al.: pancreatic penetration of antibiotics]. PMID- 1773641 TI - [Extracorporeal lithotripsy. Results with Sonolith 3000]. PMID- 1773642 TI - [Short hospital stay, a step towards ambulatory surgery for hernia repair in 1990?]. AB - In the first part the authors report their experience in Hernia surgery from 1980 to 1989. The comparison between 4 personal series shows that local anesthesia favoured short hospital stay, that the length of hospital stay decreased from 95% of more than 7 days hospitalization to 49% of less than 2 days; local anesthesia has almost suppressed post-anesthetic functional, respiratory and urinary troubles; no patient operated under local died; lastly the recurrence rate has not been related to hospital stay duration. Comments follow on Ambulatory surgery in general, technical and deontological principles. Ambulatory and short stay hospitalization in Hernia Surgery, and on advantages and pitfalls of these type of Surgery. The authors conclude on the feasibility, acceptability, benefits and usefulness of to day ambulatory surgery in hernia repair in the frame of a Universitary Hospital Center. PMID- 1773643 TI - [Results of extracorporeal lithotripsy by electromagnetic shock waves (Siemens Lithostar)]. PMID- 1773644 TI - [Mucinous cystadenocarcinoma of the appendix. Apropos of a case]. AB - A case of mucinous cystadenocarcinoma discovered into a voluminous benign mucocele of the appendix, is presented. The clinical feature is a tumor of the right iliac fossa. The identification of a limited area of epithelial degenerescence in the cyst wall--by peroperative microscopic examination--permits immediate enlargement of the cystectomy by a right hemicolectomy. The prognosis of the tumor is generally excellent as soon as the diagnosis is early and the removal large enough. PMID- 1773645 TI - [Mobile extracorporeal lithotripsy]. PMID- 1773646 TI - [Percutaneous surgery of nephrolithiasis]]. PMID- 1773647 TI - [Role of conventional surgery in the treatment of renal lithiasis]. PMID- 1773648 TI - [Massive small bowel resection. Apropos of 27 cases]. AB - 27 patients were admitted in the Digestive intensive care unit of Croix-Rousse Hospital after a massive bowel resection (residual bowel 120 cm). The etiology was of vascular origin in 15 cases. The length of intestine was nil in 4 cases, between 20 and 50 cm in 12 cases, and between 50 and 120 cm in 11 cases. A colon resection was performed in 20 cases. For 5 patients, a "double temporary intestinal stoma" for ischemic bowel was made. A "second look laparotomy" was performed in 11 cases. The definitive intestinal continuity restauration was made in 23 cases (7 immediately, 16 later) with 3 duodenocolic anastomoses. 8 patients were able to find back a oral alimentation. 19 patients (with 4 total bowel resections) received a home parenteral nutrition. Actually, 11 are alive. PMID- 1773649 TI - [Total thyroidectomy to prevent recurrence of benign thyroid goiter]. AB - Surgical approach of benign nodules and goiters in euthyroid patients is not yet well definite concerning the latent of the resection: has it to be large (for avoiding recurrence) of thrifty (in the aim of decreasing the necessity of postoperative thyroid replacement therapy)? We reviewed the results of 338 surgical thyroidectomies in patients followed at least 7 years. 87.36% of them had diffuse pathological abnormalities. Recurrence level was 1.68% in this group, occurring in an average delay of 10 years after the first thyroidectomy. Another study group concerned 47 patients operated for a recurrence in an average of 13.9 years after the first thyroidectomy (mean age at the first thyroidectomy: 35 years). Post operative sequellae after one thyroidectomy or after a second for recurrence seemed not statistically different. Recurrence rate is not important, but it is probably underevaluated by the frequent absence of long-term follow-up. Total thyroidectomy avoids it, and its sequellae are comparable with those observed after reoperation for recurrence. The surgical choice is between the acceptation of a possible recurrence and the necessity of an indefinite thyroid replacement therapy. PMID- 1773650 TI - [Substernal goiter]. AB - In a series of 363 patients operated for goiter, 60 were retrosternal (16.5%). The female incidence although less than in cervical goiters remains predominant (2.5:1). Most patients are in older age group, 68% being above 40 years. The majority of goiters are multinodular and of long duration. Bilateral (37%) and left sided location (43%) were common. The incidence of cancer was 7%, thyrotoxicosis was noted in 5 patients (8%). Most patients were symptomatic (97%). Diagnosis is easily done by physical examination, chest X-ray and thyroid scintigraphy. Computed tomography might be helpful. Retrosternal goiter is an indication to surgery except in high risk patients. The cervical approach has been used in 98% of cases. There were no post-operative death and no major complications (compressive hematoma, laryngeal nerve paralysis, hypocalcemia). PMID- 1773651 TI - [Piezo-electric extracorporeal lithotripsy]. PMID- 1773653 TI - [Extracorporeal lithotripsy. Principle and equipment]. PMID- 1773652 TI - [Old traumatic lesions of the dorsal and lumbar spine]. AB - The authors present 71 cases of malunion or old traumatic lesions. They result from an unadapted initial surgical or functional treatment. The pain symptoms are in the form of vertebral pain or nerve root pain, often associated with signs of neurological deficit. The authors emphasize the stability or instability of the lesion in order to assess its reducibility. The radiographic exploration (dynamic views, MRI, CT, medullary arteriography) would serve as a guide for the treatment strategy. The authors do not report any case of permanent postoperative neurological aggravation. Three surgical options are analyzed (anterior approach, posterior approach and "three-stage" surgery). An enlarged posterior approach enables treatment and reduction of all malunions, except if a medullary feeder artery is present on the site of the lesion. The pain symptoms improve in 87% of all cases. The authors do not report any permanent postoperative neurological aggravation. PMID- 1773654 TI - [Combined kidney-pancreas transplantation. Experience at the Urologic Clinic of the La Pitie Hospital]. AB - The first attempts of pancreas transplantation were made in the middle of the 1960s and were further developed in the early 1980s with the coming of Cyclosporine. Various surgical techniques were used to carry out pancreas grafts; a total pancreatic transplantation with duodenovesical anastomosis was selected for 7 combined kidney-pancreas transplantations carried out during the past 18 months in our group. After a time lapse ranging from 18 months to 30 days, all patients were alive with functional kidney grafts. One patient only, who had lost his pancreatic graft, showed biological and histological signe of chronic rejection of his kidney graft. Five pancreas grafts are functioning, as is proved by the normal blood glucose and the normality of the markers. An immunosuppressant treatment was used in all similar cases, comprising, after an initial bolus of one gram of Methyl-Prednisolone, an initial four-drug treatment on 1/3 mg/kg/day of Prednisone, 7 mg/kg/day of Cyclosporine, 1 mg/kg/day of Imurel and, during the first fifteen days, the use of rabbit antithymocytic globulins. Ana analysis of the postoperative period revealed frequent local infectious complications, probably due to pancreatitis of the graft; however, in our experience so far, no pancreas graft was lost. The credit for this specific feature of our short series may be due to an exclusively subperitoneal approach for both the pancreas and the kidney transplantation, thus limiting the seriousness of postoperative infectious complications to a large extent. PMID- 1773655 TI - [Anterior cutaneous nephrostomy using ringed Gore-Tex. An initial study]. AB - With a view to improve the living comfort of patients having undergone a permanent, palliative per-cutaneous derivation, we have carried out a preliminary study of a new kind of urinary drainage. This new system is a nephrostomy that consists of a ringed tube made up of expanded polytetrafluorethylene (Gore-Tex). The improved living comfort of the patients must be based, on the one hand, on a low risk of calcification during a long-lasting contact between the Gore-Tex and urine, this also preventing repeated changes of tubes, and on the other hand, the possibility of a single, anterior apparatus even in case of bilateral derivation, owing to a subcutaneous tunnelling of the tubes as soon as they exit the lumbar region. The risk of displacement is eliminated because of the spontaneous anchoring of the tubes by their rings in the kidney and throughout their subcutaneous course. This preliminary study was carried out in 5 pigs and enabled us to ascertain both the simplicity of setting up this derivation and the efficiency of parenchymal anchoring of the tubes. However, no conclusions may be drawn about the risk of calcification of Gore-Tex in urine because of secondary infections inherent in and associated with the experimental model used. PMID- 1773656 TI - [Surgical treatment of aneurysms of the celiac trunk. Apropos of a case]. AB - On the basis of one personal case and 63 cases reported in the literature for patients operated from 1958 onwards, the authors assess the surgical treatment of aneurysms of the celiac trunk. These are rare (4% of all visceral aneurysms), often latent (41.3% of cases) or without any specific symptoms (36.2% of cases), and have an atheromatous (51.8% of cases) or dysplasic (38.8% of cases) origin in most cases. They mainly affect men (68.4% of cases) after 40 years of age (72.2% of cases). They are rarely identified during the clinical examination, but are detected by ultrasound and confirmed by computed tomography and/or angiography (51.8% of cases). They are often small, less than 50 mn, and their size is a criterion for the approach, which usually remains abdominal. Resection is a routine operation (84.3% of cases), but the continuity of the artery is restored in 78.3% of cases only, due to the good-quality replacement provided by the superior mesenteric artery. The operative mortality rate is 7.8%. There are 96.2% good results (2 recurrences), but the average lapse in time is only 15.75 months. PMID- 1773657 TI - [A cooperative study of extracorporeal lithotripsy (non modified HM-3 Dornier equipment)]. PMID- 1773658 TI - [Treatment of neuralgia after surgical repair of inguinal hernia. Apropos of 47 cases]. AB - A semiologic study is performed and therapeutic proposals are made on the basis of the anatomical and physiopathological data relating to residual neuralgia after the cure of a hernia. A series of 47 patients, 41 of whom were treated at the Multidisciplinary Pain Treatment Center of Avicenne Hospital (Bobigny) is analysed. The results are the following: 16 cures, 22 improvements, 6 failures, 3 patients lost to follow-up. The authors emphasize the difficulties of treatment, the poor effectiveness of second surgery as a rule, and the necessity of a general management. PMID- 1773659 TI - Across the nuclear pores with the help of nucleoporins. AB - Proteins targeted to specific intracellular organelles such as mitochondria or the endoplasmic reticulum are able to cross membranes. Yet, to enter or exit the nucleus, proteins and RNA must pass through nonmembranous "gates" of the nuclear envelope, the nuclear pore complexes. Recently, the primary amino acid sequence of a few nuclear pore proteins (the nucleoporins) became available. Nucleoporins from mammals, amphibians and yeast are structurally homologous indicating that nuclear pore structures are evolutionarily conserved in the eukaryotic cell. The role of nucleoporins in nucleocytoplasmic transport is still unclear: are nucleoporins involved in decoding nuclear targeting signals or are they mere transporters? Although definite answers are not yet available, data are rapidly accumulating from several laboratories using a variety of approaches. PMID- 1773660 TI - Structure of the fission yeast centromere cen3: direct analysis of the reiterated inverted region. AB - We determined the structure of the Schizosaccharomyces pombe centromere cen3 using direct genomic mapping and cosmid walking. The repetitive region of cen3 is approximately 110 kb, much longer than that of the previously determined cen1 and cen2 regions. The approximately 30 kb long left and approximately 60 kb right repetitive sequences are arranged with an inverted symmetry and flank the 15 approximately 20 kb central domain. The repeat motifs in cen3, although they consist of the common centromeric repeat elements, are slightly different from those in cen1 and cen2. The cen3 repeat motifs appear to be reiterated four times in the left and nine times in the right side repetitive regions. We found that the central domain consists of the common approximately 5 kb core sequence associated with the pair of innermost inverted sequences, most of which are reiterated only twice in the genome. Although their sizes differ significantly, the general features of cen1, cen2 and cen3 are similar, and a prototype, consensus structure for the fission yeast centromere may be deduced. PMID- 1773661 TI - Faithful in vivo transcription termination of Xenopus laevis rDNA. Correlation of electron microscopic spread preparations with S1 transcript analysis. AB - DNA sequencing and subsequent functional in vitro analysis of the Xenopus laevis rDNA transcription termination has led to the identification of three transcription termination sequence elements: T1, located at the 3' end of the 28S rDNA; T2, a putative processing site 235 bp downstream of T1; T3, the principal terminator positioned 215 bp upstream of the gene promoter. As demonstrated for nuclear run-off assays, T3 was found to be the main terminator for Xenopus rDNA transcription. These in vitro data are in obvious contradiction to results obtained by electron microscopic (EM) spread preparations from rapidly isolated amplified oocyte nucleoli, i.e., an rDNA chromatin probe thought to represent the in vivo situation, indicative of transcription termination at sites T1-2. However, most interestingly, T3 had--again by the EM method--been identified as the exclusive terminator for NTS spacer transcription units. In order to answer the question of whether read-through transcription of the complete rDNA spacer sequence is obligatory for 40S pre-rRNA in vivo transcription, we analyzed several hundreds of spread rRNA genes from Xenopus oocyte nucleoli in great detail, applying two different spreading procedures, e.g., dispersal of amplified oocyte nucleoli shortly in detergent-free or detergent containing low-salt media prior to the EM spreading technique. Quantitation of EM spreads resulted in the finding that read-through rDNA spacer transcription beyond T1-2 termination sites (i.e., indicative of T3 transcription termination) can be visualized for the in vivo situation at a frequency of less than 3% of rRNA genes analyzed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1773662 TI - Histone genes are located at the sphere loci of Xenopus lampbrush chromosomes. AB - In the anuran Xenopus, as has been demonstrated previously in several species of urodele Amphibia, histone genes lie at the sphere organizer loci of the lampbrush chromosomes. They were located by in situ hybridization of a 3H-labelled histone H4 anti-sense cRNA probe applied to lampbrush preparations in which transcript RNA had been retained, and likewise to preparations in which transcripts were absent but whose DNA had been denatured prior to hybridization. In Xenopus the histone genes lie in intimate association with the spheres that are attached to the lampbrush chromosomes, but they are absent from spheres that lie free in the germinal vesicle. The Anura separated from the Urodela several hundred million years ago, so the sphere organizer/histone gene association is of great antiquity. This suggests that the association has a functional significance, though it is one that has yet to be discovered. PMID- 1773663 TI - Chromosome pairing and recombination in mice heterozygous for different translocations in chromosomes 16 and 17. AB - In order to clarify the relationship between meiotic pairing and recombination, an electron microscopic (EM) study of synaptonemal complexes (SC) and an analysis of chiasma frequency and distribution were made in male mice singly and doubly heterozygous for Robertsonian [Rb(16.17)7Bnr] and reciprocal [T(16:17)43H] translocations and also in tertiary trisomics for the proximal region of chromosome 17. In all these genotypes an extensive zone of asynapsis/desynapsis around the breakpoints was revealed. At the same time a high frequency of non homologous pairing was observed in precentromeric regions of acrocentric chromosomes. The presence in the proximal region of chromosome 17 of the t haplotype did not affect the synaptic behaviour of this region. Chiasma frequency in the proximal region of chromosome 17 in the T(16:17)43H heterozygotes and trisomics was increased when compared with that in Robertsonian heterozygotes. PMID- 1773664 TI - [The effects of noise in wind tunnel on cardiovascular system in workers]. AB - Systolic time interval (STI), the estimated value of Oxygen expenditure in heart muscle, blood pressure, total peripheral resistance (TPR) were estimated in 24 workers of the air wind tunnel. The results showed increased PEP/LVET, elevated systolic blood pressure and TPR under high intensive noise [87-119 dB(A)]. PMID- 1773665 TI - [Excretion of trichloroacetic acid (TCA) in urine of workers exposed to trichloroethylene]. AB - The excretion pattern of TCA in urine of workers exposed to trichloroethylene and the correlation between concentration of TCA in urine and uptake amount of trichloroethylene were investigated by applying Head Space Gas Chromatography. We examined 33 unexposed subjects (control group) and 48 workers (exposure group). The results showed that the concentration of TCA in urine rose obviously after exposure to trichloroethylene. The concentration of TCA in urine and trichloroethylene exposure was positively correlated (X = 2.916Y + 4.619, r = 0.956 8). Based on the observation of 6 volunteers, we found that the concentration of TCA in urine reached its peak about 48 hours after exposure has ceased. It then slowly declined and did not recover completely up to 96 hours. PMID- 1773666 TI - [Alveolar air analysis for benzene as a biomonitoring index]. AB - To establish a well validated biological monitoring procedure for benzene exposure, the concentration of benzene in alveolar air and phenol in urine was studied in conjunction with personal monitoring data both in workers and volunteers. There existed good correlation between benzene concentration in alveolar air, phenol concentration in urine by the end of workshift and the benzene concentration in workplace when the exposure level was above 5 mg/m3. When the exposure level was below 5 mg/m3, the urinary phenol was no longer a valid indicator of uptake/exposure in volunteers. The determination of benzene concentration in expired air collected after the workshift was a potentially useful index. The relationship between benzene concentration in alveolar air collected after shift and environmental air declined when the exposure level was very high (TWA greater than 200mg/m3). In general, the alveolar air analysis was valid as a biomonitoring index of benzene exposure under the exposure concentration ranged 3-120 mg/m3. The lest sampling time of alveolar air appears to be 30 minutes after the cessation of exposure and before the next shift. PMID- 1773667 TI - [The clinical features of 160 cases of acute sodium silicon fluoride poisoning]. AB - 160 cases of acute sodium silicon fluoride poisoning due to accidental intake are reported in this paper. Owing to the great amount of the chemical taken, the onset was abrupt and the digestive symptoms were prominent and severe. Twelve cases had acute gastritis or acute ulceration as shown by gastroscopy. The cardiovascular findings were notable. Ninety-six cases had abnormal electro cardiographic findings. Abnormal heart rhythm and S-T segment changes were the main findings. These changes were positively correlated with the toxin amount of fluoride. Two cases died from sudden arrest of heart beat. Lung, kidney, liver, and brain functions were also impaired. The authors suggested diagnostic criteria and control procedures. PMID- 1773668 TI - [Observations of neurobehavior in lead exposed workers]. AB - A neurobehavioral test of lead-exposed workers and the correlations between test scores and certain biochemical indices was made. The results showed that the scores of digit span, mental arithmetic, block design, digit symbol, Santa-Ana dexterity, Benton visual retention and pursuit aiming of lead-exposed workers tests were significantly lower than those of control groups. The scores of Santa Ana dexterity, block design and digit span tests of lead-exposed workers were highly negatively correlated with levels of ZPP in blood. PMID- 1773669 TI - [Lead placental transfer and metals content in biosamples from occupationally lead exposed female workers]. AB - This paper presents a study of five metals content in biosamples of placenta, maternal venous blood, cord blood from 32 occupationally lead exposed female workers and 32 controls. The results showed that lead levels in biosamples of lead exposed individuals were significantly greater than those from controls. Results also showed that there existed very close relationships between placental lead and maternal blood lead, placental lead and cord blood lead, maternal blood lead and cord blood lead, showing that there was a lead transfer from the mother to the child via the placenta. The relationships between metals in the biosamples were also discussed in the paper. PMID- 1773670 TI - [Five years' epidemiologic study of intoxication of pesticide use in a county]. AB - The Intoxication of Pesticide Use (IPU) in a county since 1984-1988 was studied 1,345 cases of intoxication were found and two of them died among 732,128 persons investigated during those five years. The incidence rates of IPU were 0.410 8%, 0.166 7%, 0.052 1%, 0.205 7% and 0.090 5% respectively. Analysis on the relationship between the IPU and air temperature showed that they had a positive correlation (r = 0.886, P less than 0.01), indication that air temperature was one of important factors that affected the occurrence of IPU. Suggestions were made for the prevention of IPU. PMID- 1773671 TI - [Study on risk factors involving train traffic accidents--effects of human factors on accidents]. AB - This article analysed human factors involving train traffic accidents by using log-linear model. The results showed that lower degree of culture (OR = 2.571) and weak nervous type (OR = 2.099) were risk factors involving train traffic accidents. Interactions were shown to exist between nervous type and degree of culture, average sleeping time everyday, and visuomotor reaction time. PMID- 1773672 TI - [Evaluation of risk factors of the daughters of breast cancer patients]. AB - The determination of salivary hormones on 41 daughters of breast cancer patients and 41 controls and nutritional survey and measurement of the height and weight were carried out. The result was that salivary estradiol (E2) was significantly higher in the daughters than in the controls. This suggest that the free E2 in the body fluid might be the direct factor for the daughters' high susceptibility to breast cancer. It was also found that the mean value of daily intake of fat per capta was significantly higher in the daughters' group than the controls, which indicated that the daily intake of fat might be an indirect factor of the daughters' susceptibility to breast cancer. The preventive measures are early diagnosis and decrease of the daily intake of fat for daughters of breast cancer patients. PMID- 1773673 TI - [The co-mutagenic effect of metabolic extracts of fungi grown on the main grain in high incidence liver cancer areas--Fusui County]. AB - Twenty strains of the common fungi were isolated from the staple grains in the high incidence liver cancer areas--Fusui county, and their metabolic extracts were prepared. Possible co-mutagenic effects of these metabolic extracts on Salmonella typhimurium TA98 and TA100 mutants were tested. The results showed that in vitro these metabolic extracts had different degrees of co-mutagenic effects. It is considered that these co-mutagenic effects may play an important role in the incidence of liver cancer in Fusui county. PMID- 1773674 TI - [Plasmid pSK1002-mediated mutator effect and SOS response in Salmonella typhimurium and its use for detection of mutagens]. AB - The plasmid pSK1002 carrying the fused gene umuC'-'lacZ could increase the number of revertants induced by methyl methanesulfonate (MMS) and 4-nitroquinoline-1 oxide (4NQO) in S. typhimurium LT2 TA 1535(his-). Maximum revertants were 4.35 and 3.96 times that of the controls without the plasmid. The values induced by N methyl-N'-nitrosoquanidine (MN-NG) were about the same with or without plasmid. However, the plasmid pKM101-mediated mutagenesis-enhancing effect was much greater than that through the mediation of pSK1002 as induced by the three mutagens mentioned above. Moreover, the plasmid pSK1002 could induce umu-mediated SOS response in the presence, of either mutagen stated above and mitomycin C(MMC). Maximum levels of beta-galactosidase (beta-gal) activity induced by four mutagens respectively were 4.56, 7.14, 4.94, and 3.42 times that of the controls, and a dose-response relationship was evident. The sensitivity of SOS response was superior to mutagenesis-enhancing effect. It showed that pSK1002 (umuC'-'lacZ) had a dual biological effect, namely, mutator effect and the effect of inducing SOS response. Besides, this study has proved SOS mutagenesis of 2,5 dichloronitrobenzol (2,5-DCNB). Because of the dual indicator nature of pSK1002, it is probable that pSK1002 would be further developed and applied in studying the relation between SOS response and mutagenesis, and monitoring environmental SOS mutagens. PMID- 1773675 TI - [Investigation of the effect of polluted water in Song-hua River on the chromosome aberrations and SCE of inhabitants]. AB - This investigation indicated that the chromosome aberration of lymphocytes in inhabitants influenced by mercury- or methylmercury-polluted water was higher than that in control persons although the difference was not significant; but the SCE of them was significantly higher than the control. Both endpoints had a tendency of decreasing with the distance away from the polluted river water. Smoking and age did not have any effect. It was suggested that the polluted river water by mercury or methylmercury compounds could have some cytogenetic effects, although other factors cannot be excluded. PMID- 1773676 TI - Predation of free-living engorged female Rhipicephalus appendiculatus. AB - In experiments done over a period of 1 1/2 years using engorged female Rhipicephalus appendiculatus tethered in a grass plot, 42% predation was observed in long grass (40-60 cm), and 36% in short grass (6-10 cm). Deaths due to environmental factors were 4.8% and 6.8% in long and short grass, respectively. Six groups of animals were confirmed to be predators of the ticks, namely: ants, spiders, rodents, birds, lizards and shrews. The implications of these results in making tick population models, and the possibility of using predators in integrated tick-control packages are discussed. PMID- 1773677 TI - Predators of the tick Amblyomma variegatum (Acari: Ixodidae) in Guadeloupe, French West Indies. AB - Some vertebrate species in Guadeloupe are predators of free or parasitic stages of Amblyomma variegatum (Fabricius). Among birds, 1.9% of the 421 identified animals found in the stomachs of grackles (Quiscalus lugubris), 1.6% of the 364 animals found in the stomachs of free-ranging chickens, and 0.3% of the 4642 animals found in the stomach of cattle egrets (Bubulcus ibis) were A. variegatum ticks. The most efficient predator of ticks was the tropical fire ant, Solenopsis geminata, which was observed to only attack engorged stages of ticks. An average of 8% of the 564 individual ticks or batch of ticks released on the ground, mainly in a grass environment, were attacked by this ant species. Mice (Mus musculus) and mongooses (Herpestes auropunctatus) feed on engorged nymphs and female ticks. None of the 15 strains of entomophagous nematodes, genera Steinernema and Heterorhabditis, experimentally put in contact with engorged larvae and nymphs were able to parasitize them. In the laboratory, the insects Megaselia scalaris (Diptera) and Tineola sp. (Lepidoptera) were occasionally found to feed on engorged and unfed ticks, respectively. PMID- 1773678 TI - Acaricide susceptibility of Amblyomma variegatum (Acari:Ixodidae) from Puerto Rico and Guadeloupe. AB - Base-line data on acaricide susceptibility of larvae and of larvae and nymphs of the tropical bont tick, Amblyomma variegatum (Fabricius), from Puerto Rico and Guadeloupe were collected on 14 and six compounds, respectively. Nymphs 7-8 weeks old from Puerto Rico and Guadeloupe, and larvae 3-4 weeks old from Guadeloupe, were exposed for 24 or 48 h to residues of acetone dilutions of technical-grade or commercial formulations of acaricides on disposable glass pipettes. Effectiveness of the acaricides in killing nymphs (LC50) from Guadeloupe and Puerto Rico ranged from 0.0001% for deltamethrin2 to 0.269% for malathion. For Puerto Rico, the susceptibility to toxaphene and amitraz, but not to dioxathion, increased with increasing age of nymphs. Nymphs from Guadeloupe were 9.5 times more susceptible to chlorpyrifos than nymphs from Puerto Rico. The susceptibility of larvae from Guadeloupe to acaricides tested ranged from LC50 0.000012% for deltamethrin to 0.0141% for ethion. There was no evidence of development of acaricide resistance in ticks from Guadeloupe or Puerto Rico. PMID- 1773679 TI - Towards the selection of cattle for tick resistance in Africa. AB - Half-body tick collections and visual assessment of tick burdens were performed monthly over six months on 100 bulls at the Kenya National Boran Stud, Mutara Ranch, Kenya. Boophilus decoloratus predominated among several tick species infesting the animals. Burdens of B. decoloratus and total tick burdens were highly correlated. Rankings of relative tick resistance among bulls were consistent from month to month. Rankings based on visual assessment were very close to those based on actual tick burdens. Animals with thin skins appeared to carry fewer ticks, but tick burden bore no relationship to coat colour. The results suggest that simple visual inspection of total tick burdens may be a suitable basis for the selection of tick resistance in cattle. PMID- 1773680 TI - Resistance of indigenous African cattle to the tick Amblyomma hebraeum. AB - Field collections of Amblyomma hebraeum Koch adults from six breeds of cattle were conducted on two farms in the Northern Transvaal. The density of A. hebraeum adults was highest on Simmentaler cows, followed by Santa gertrudis, Africaner, Bonsmara, Brahman and Nguni. Indigenous breeds, namely Nguni, Bonsmara and Africaner, have the highest level of resistance to A. hebraeum. The relationship between tick abundance and the high level of resistance found in the indigenous breeds is discussed. PMID- 1773681 TI - Sites of attachment and intraspecific infestation densities of the brown paralysis tick (Rhipicephalus punctatus) on Angora goats. AB - Significant differences in the distribution of brown paralysis ticks on various age classes of Angora goats were recorded. In kids, most (greater than 98%) of the ticks attached to the head and ears, whereas in older groups, in addition to the ears, a high proportion (greater than 20%) of ticks also attached to the ventral side of the neck. There were significant differences in the mean infestation densities of both male and female R. punctatus in kids and older animals. These differences were, however, only significant for the first two sample dates involving kids, and are probably related to behavioural attributes of the kids which enhance tick/host contact. Newly born Angora goat kids are considered a high-risk group with regard to paralysis caused by the brown paralysis tick. Methods of avoiding mortality amongst kids are suggested. PMID- 1773682 TI - Host associations and seasonal abundance of immature Ixodes persulcatus (Acari: Ixodidae) in a Lyme-disease-endemic area in China. AB - Ticks of nine small mammal species were studied in an area of endemic Lyme disease in Hailin County, Heilongjiang Province, from 1 May to 10 October 1986. The bulk (93%) total small mammal captures were Apodemus speciosus (45%), Clethrionomys rufocanus (31%), A. agrarius (11%) and Eutamias sibiricus; (5%): these host species accounted for 97% of the 162 ticks collected. Ixodes persulcatus Schulze were most abundant on E. sibiricus (0.64 larvae and 0.08 nymphs/squirrel), and less abundant on A. agrarius (1.16 larvae/mouse), A. speciosus (0.38 larvae/mouse) and C. rufocanus (0.37 larvae and nymphs/vole). The seasonal abundance pattern of larval I. persulcatus on four small mammal species appears as a bimodal peak (June and September), but nymphal I. persulcatus has a monomodal peak during spring. The prevalence of immature I. persulcatus on four small mammal species may play an important role in the epidemiology of Lyme disease in Hailin County. PMID- 1773683 TI - Effects of cyclosporin A and low dosages of steroid on posttransplantation diabetes in kidney transplant recipients. AB - OBJECTIVE: To investigate the adverse effects of cyclosporin A (CsA) on pancreatic beta-cell function in kidney transplant recipients. RESEARCH DESIGN AND METHODS: The study consisted of 73 patients without a history of diabetes mellitus who had undergone kidney transplantation in our clinic. RESULTS: We experienced a higher incidence of posttransplantation diabetes mellitus (PTDM) in patients receiving CsA and low dosages of methylprednisolone (6/20, 30%, P less than 0.05) than in patients receiving conventional therapy of azathioprine methylprednisolone (4/53, 7.5%) since the introduction of CsA. In all 6 patients in the CsA-treated group, PTDM occurred within 3 mo after transplantation. The CsA level during the initial 3 mo posttransplant was significantly higher in diabetic than nondiabetic subjects, and the highest CsA level was observed shortly (1 mo) before the development of PTDM. After an average of 71 days of insulin therapy, there was complete remission of PTDM in 5 of 6 diabetic patients, with a corresponding decrease in CsA level. For the patients who were in remission for greater than 1 yr, a significant improvement of glucose intolerance was observed in association with a significantly higher insulin response to oral glucose load; however, their glycemic profile still showed a significantly higher plasma glucose concentration and a prolonged continuous elevation without initial peak of the insulin-response curve in contrast to the normal pattern found in nondiabetic subjects in the CsA-treated group. CONCLUSIONS: This study suggests that CsA in combination with low dosages of steroid may have adverse effects on glucose metabolism, which may lead to effects similar to those in non-insulin-dependent diabetes mellitus. PMID- 1773684 TI - Smoking and diabetes mellitus. Findings from 1988 Behavioral Risk Factor Surveillance System. AB - OBJECTIVE: To examine the association between smoking and self-reported diabetes mellitus. RESEARCH DESIGN AND METHODS: The study was comprised of 3006 people greater than or equal to 18 yr of age with diabetes and 52,750 without diabetes. RESULTS: Twenty-six percent (SE 1.8) of the diabetic population were current smokers, 25.9% (SE 1.4) were former smokers, and 48.1% (SE 2) had never smoked. Similar percentages were found among the nondiabetic population. Compared to respondents without diabetes, the prevalence of current smoking was notably higher among respondents with diabetes who were between the ages of 18 and 34 yr (36.1%, SE 4.1), who had not graduated from high school (44.9%, SE 3.7), and who were men of African-American origin (54.8%, SE 5.8). CONCLUSIONS: Despite the excess risks, the overall prevalence of smoking in the diabetic population is comparable to that of the general population. Our finding of a higher prevalence of smoking among young people, people who had not graduated from high school, and African-American men with diabetes suggests that additional educational efforts should be targeted at these groups. PMID- 1773685 TI - Clinical evaluation of decision support system for insulin-dose adjustment in IDDM. AB - OBJECTIVE: We developed a wallet-sized learning memory decision support system that helps patients with insulin-dependent diabetes mellitus adjust their insulin dosages. RESEARCH DESIGN AND METHODS: To determine the efficacy of the support system, we designed a randomized clinical trial with patients participating in a program in a diabetes education center. Patients were assigned to two groups of 21 patients each. All patients performed self-monitoring of blood glucose (SMBG) and were treated with multiple daily injections of insulin. Each of the patients was examined over a 32-day period. The basic educational program, i.e., practical advice in SMBG, diet, and exercise under homelike conditions, was identical in both groups. The only difference was that the first group used the computer for adjusting the insulin dose, whereas the second group received recommendations from the education team. RESULTS: The baseline HbA1 levels (9.8 +/- 1.6 vs. 9.9 +/- 1.6%) of both groups did not differ significantly. Mean blood glucose over the last 2 wk of the study was higher (P less than 0.01) in the second group (8.4 +/- 1.4 vs. 9.2 +/- 2.0 mM); the frequencies of hypoglycemic episodes were not different (1.7 vs. 2.3%). CONCLUSIONS: Metabolic control and safety were comparable in both groups. Thus, patients may benefit from such a system at home where no support by diabetes educators is available. PMID- 1773686 TI - Change in metabolic control and functional status after hospitalization. Impact of patient activation intervention in diabetic patients. AB - OBJECTIVE: To determine whether a short intervention to enhance patient information seeking and decision making during hospitalization results in improved metabolic control and functional status in patients with diabetes mellitus. RESEARCH DESIGN AND METHODS: A randomized clinical trial was conducted in which control patients received a comprehensive 3-day evaluation and educational program, whereas experimental patients received a 45-min patient activation intervention and a 1-h self-administered booster in addition to the program. Metabolic control and functional status were measured at baseline and 4 mo postdischarge. RESULTS: During their discharge discussions, experimental patients asked significantly more questions than control patients (7.4 vs. 3.0, P less than .001) and 4 mo later reported significantly fewer physical limitations in activities of daily living than the control group (P = 0.02). Improvement in metabolic control was statistically significant only for experimental patients (P = 0.02), although their glycosylated hemoglobin levels were not significantly lower than control patients' at follow-up. The intervention did not diminish physician satisfaction with patient interactions, although it may have increased physician frustration with responsibilities that competed with patient care. CONCLUSIONS: These results suggest that the addition of a patient activation intervention to a comprehensive diabetes management program may substantially enhance physical functioning among adults with diabetes mellitus. PMID- 1773687 TI - Insulin sensitivity, glucose effectiveness, and body fat distribution pattern in nondiabetic offspring of patients with NIDDM. AB - OBJECTIVE: To determine the relationship of insulin sensitivity (SI), glucose effectiveness (glucose-dependent glucose transport [SG]), and body fat distribution patterns in glucose-tolerant offspring of patients with non-insulin dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS: Ten glucose tolerant offspring of patients with NIDDM and 10 age-, sex-, and weight-matched healthy control subjects without family history of diabetes were studied with the minimal model method of Bergman et al. Body fat composition and distribution pattern were assessed by the bioelectrical impedance analyzer and waist-hip circumference ratios (WHR), respectively, in each subject. RESULTS: Mean fasting serum glucose (4.39 +/- 0.17 vs. 3.94 +/- 0.17 mM) and postglucose peak (18.50 +/ 1.50 vs. 13.20 +/- 1.06 mM) levels were significantly greater (P less than 0.05) in the offspring than in the control subjects. Mean fasting serum insulin levels were slightly greater but not significantly different in the offspring versus control subjects (64 +/- 14 vs. 29 +/- 7 pM). After intravenous stimulation with glucose and tolbutamide, the mean serum insulin rose to significantly greater (P less than 0.05) levels at t = 5 and 25 min in the offspring compared with the control subjects. Mean SI was significantly reduced by 45% in the offspring compared with the control subjects (4.77 +/- 0.67 vs. 8.37 +/- 1.24 x 10(-4) min 1.mU-1.L-1). However, SG was not different in the offspring versus control subjects (1.92 +/- 0.12 vs. 2.10 +/- 0.17 x 10(-2) min-1). SI correlated significantly and inversely with the percentage of body fat mass (r = -0.580, P less than 0.05) but not with the WHR (r = -0.019) in the offspring. We found a negative association between SI and basal serum insulin (r = -0.798, P less than 0.01) but not with the poststimulation incremental insulin responses in the offspring. Family history of diabetes independently accounted for at least 27% of variance in the SI in our subjects. CONCLUSIONS: Our study confirmed that insulin insensitivity but not a reduced glucose effectiveness exists in young glucose tolerant offspring of patients with NIDDM. The reduced S1 appears to be causally related to the total body fat content and may be a familial and/or genetic trait in the offspring. PMID- 1773688 TI - Hand skin blood flow in diabetic patients with autonomic neuropathy and microangiopathy. AB - OBJECTIVE: To determine whether changes in hand skin blood flow in diabetic men could be demonstrated with liquid crystal contact thermography and to assess the relative effects of autonomic neuropathy and microangiopathy on these changes. RESEARCH DESIGN AND METHODS: Thirty-four diabetic and 12 age-matched nondiabetic men comprised the study. The diabetic men were categorized according to standard cardiovascular autonomic function tests and the presence or absence of background or proliferative retinopathy and/or proteinuria. Bilateral hand thermograms were measured at rest and after immersion of the right hand in ice-cold water. RESULTS: Diabetic men with definite or severe autonomic neuropathy (n = 13) had a high frequency of anisothermal baseline thermograms (77 vs. 25% in nondiabetic subjects, P less than 0.05). After ice-cold water immersion, right-hand recovery was abnormally slow (514 +/- 157 arbitrary U, area under the curve) compared with nondiabetic men (685 +/- 135 arbitrary U, P less than 0.01). Diabetic men with proliferative retinopathy (n = 8) all had definite or severe autonomic neuropathy and showed the same abnormalities. Diabetic men with nor or early autonomic changes showed normal thermographic patterns. CONCLUSIONS: These results are consistent with increased palmar arteriovenous shunt blood flow or capillary closure in the hands of diabetic patients with definite or severe autonomic neuropathy. They indicate that thermoregulatory reflex changes in hand skin blood flow are controlled by the autonomic nervous system. It is possible, however, that diabetic microangiopathy, associated with the presence of proliferative retinopathy, also independently affects hand skin blood flow. PMID- 1773689 TI - Age-related differences in case-fatality rates among diabetic patients with myocardial infarction. Findings from National Hospital Discharge Survey, 1979 1987. AB - OBJECTIVE: To determine age-related differences in case-fatality rates among diabetic patients with myocardial infarction (MI). Published studies have demonstrated 60% higher case-fatality rates during acute MI among diabetic patients compared with those without diabetes. However, many previous reports have been of insufficient size to examine the effect of age on mortality and have not been drawn from a representative sample of hospitals. The National Hospital Discharge Survey provides data on discharge diagnosis and vital status from a random sample of approximately 500 short-stay American hospitals. RESEARCH DESIGN AND METHODS: In this analysis, people with acute MI listed as the first diagnosis on the discharge sheet were studied. Any mention of diabetes mellitus on the discharge sheet was used to stratify the patients into those with and without diabetes. RESULTS: Age-adjusted case-fatality rates were identical in patients with and without diabetes for both sexes: 16.1 vs. 16.3 in men and 18 vs. 18.2 in women, respectively. Mortality rates were, however, higher among the younger patients with diabetes. Ratios of the case-fatality percentage by 10-yr age groups (age 35-75 yr) and greater than or equal to 75 yr old for diabetes versus no diabetes were 1.7, 1.8, 1.2, 0.9, and 0.9 for men and 2.4, 1.2, 1.1, 1, and 0.9 for women. CONCLUSIONS: Diabetes thus appears to increase the in-hospital mortality risk with acute MI disproportionately in the younger age-groups, particularly among men, and does not appear to be a marker of increased risk among the elderly. PMID- 1773690 TI - Topical phenytoin in diabetic foot ulcers. AB - OBJECTIVE: The efficacy of topical phenytoin in the treatment of diabetic foot ulcers was evaluated in a controlled inpatient study. RESEARCH DESIGN AND METHODS: Fifty patients were treated with topical phenytoin, and 50 patients matched for age, sex, and ulcer areas, depth, chronicity, and infection were dressed with dry sterile occlusive dressing. RESULTS: Both groups improved, but the ulcers treated with topical phenytoin healed more rapidly. Mean time to complete healing was 21 days with phenytoin and 45 days with control. The differences seen were statistically significant (P less than 0.05) via the chi 2 test. CONCLUSIONS: Phenytoin appears to be useful as a topical agent in promoting the healing of diabetic foot ulcers. PMID- 1773691 TI - Antihypertensive therapy with Ca2+. Antagonist verapamil and/or ACE inhibitor enalapril in NIDDM patients. AB - OBJECTIVE: To assess the efficacy and tolerance of a diuretic-free antihypertensive therapy with a Ca2+ antagonist and an angiotensin-converting enzyme (ACE) inhibitor in patients with non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS: After a 2-wk washout and a 4-wk placebo phase, 47 hypertensive patients with NIDDM randomly received verapamil or enalapril alone and, if blood pressure remained elevated, both agents combined over 30 wk. RESULTS: Verapamil or enalapril alone normalized blood pressure to less than 90 mmHg diastolic in 30 patients; verapamil decreased mean +/- SE blood pressure from 159/98 +/- 3/1 to 146/87 +/- 3/2 mmHg (n = 18, P less than 0.001) and enalapril from 166/99 +/- 5/2 to 146/86 +/- 3/1 mmHg (n = 12, P less than 0.001). In 17 patients who were still hypertensive after 10 wk of monotherapy, combination of both drugs decreased blood pressure from 170/104 +/- 4/2 to 152/90 +/- 4/2 mmHg (P less than 0.001). Fasting plasma glucose, glycosylated hemoglobin, serum fructosamine, total lipids, high-density and low-density lipoprotein cholesterol, apolipoproteins A-I and B, creatinine, and urinary albumin-creatinine ratio were not significantly modified. CONCLUSIONS: In hypertensive patients with NIDDM, a diuretic-free therapy based on the Ca2+ antagonist verapamil and/or the ACE inhibitor enalapril can effectively decrease blood pressure without adversely affecting carbohydrate and lipid metabolism. PMID- 1773692 TI - Visual impairment and retinopathy in people with normal glucose tolerance, impaired glucose tolerance, and newly diagnosed NIDDM. AB - OBJECTIVE: Prevalence rates of visual impairment and retinopathy were compared in 1992 people with normal glucose tolerance, impaired glucose tolerance (IGT), or newly diagnosed non-insulin-dependent diabetes mellitus (NIDDM). RESEARCH DESIGN AND METHODS: Glucose tolerance status was based on an oral glucose tolerance test after exclusion of those with a history of diabetes and/or diabetes medication use in an upper middle-class community of older white adults in southern California between 1984 and 1987. RESULTS: Although many sex-specific comparisons were made between glucose tolerance groups, only a few emerged as statistically significant. Among those, women with IGT had significantly higher age-adjusted rates of visual impairment (10.8%) than women with normal glucose tolerance (4.4%). Among men, those with IGT had significantly higher age-adjusted rates of visual impairment (7.9%) than men with newly diagnosed NIDDM (4.0%). CONCLUSIONS: Low frequencies of retinopathy were found in all three glucose tolerance groups. PMID- 1773693 TI - Contact thermography of painful diabetic neuropathic foot. AB - OBJECTIVE: To investigate regional differences in skin blood flow (measured by contact thermography) in the diabetic neuropathic foot and to examine the effect of foot temperature on the severity of neuropathic pain. RESEARCH DESIGN AND METHODS: Thirty-five diabetic patients with painful polyneuropathy (PPN) and 33 healthy age- and sex-matched control subjects comprised the study. Mean foot temperature (MFT) in PPN (mean +/- SE 28.3 +/- 0.3 degrees C) was significantly higher (P less than 0.001) than in the control subjects (25.9 +/- 0.5 degrees C), with the highest temperatures over the metatarsal areas and heel. Visual analogue scale pain score (mean +/- SD 5.3 +/- 1.9 cm) did not correlate with MFT (r = 0.14, P = 0.52). In 10 patients with PPN followed for 2-8 mo (mean 4.6), MFT fell by 1.6 degrees C (P = 0.05), but pain scores did not alter. CONCLUSIONS: Neuropathic pain is unaffected by alterations in skin temperature. Elevated skin temperatures at recognized sites of weight bearing (metatarsal heads and heels) are common in the diabetic neuropathic foot and may indicate tissue injury or inflammation induced by pressure trauma or increased arteriovenous shunting. Follow-up studies will determine whether thermographic hot spots are more susceptible to ulceration. PMID- 1773694 TI - Severe amnesia after hypoglycemia. Clinical, psychometric, and magnetic resonance imaging correlations. AB - OBJECTIVE: To determine the correlation between clinical, psychometric, and magnetic resonance imaging (MRI) findings after an episode of hypoglycemic coma resulting in amnesia. RESEARCH DESIGN AND METHODS: Detailed psychometric assessment, especially memory testing, performed with MRI in a man with severe amnesia after hypoglycemic coma. RESULTS: Psychometric testing confirmed impaired immediate recall. MRI findings were consistent with a lesion in the left temporal lobe. CONCLUSIONS: This is the first description of MRI in determining the neurological damage in hypoglycemic coma. PMID- 1773695 TI - Intra-arterial urokinase infusion in diabetic patients with rapidly progressive ischemic foot lesions. AB - OBJECTIVE: The effectiveness of local intra-arterial thrombolysis by urokinase was evaluated in eight non-insulin-dependent diabetic patients with angiographic evidence of infrapopliteal occlusive disease and rapidly progressive foot lesions. RESEARCH DESIGN AND METHODS: With an electric peristaltic pump, urokinase was infused for 96 h by a 5-6 F catheter introduced into the femoral artery and placed immediately above the occluded infrapopliteal arteries. After baseline, angiography was repeated at 24- to 48-h intervals and at conclusion of the treatment. RESULTS: Six patients showed immediate improvement of clinical symptoms. Angiography revealed the reestablishment of blood flow in collateral vessels of the leg and foot in the dorsal pedal artery in three patients and in the plantar arch in two. Recanalization of the major arteries of the trifurcation was not achieved. After 12 mo of follow-up, all limbs were salvaged, although four patients required vascular reconstruction to further improve foot perfusion and complete healing. CONCLUSIONS: Intra-arterial urokinase, which opens collateral and smaller vessels of the leg and foot in patients with diabetes, may be effective in improving blood flow in lower extremities and in making the patient a better candidate for vascular surgery. PMID- 1773696 TI - Munchausen's syndrome by proxy mistaken for IDDM. PMID- 1773697 TI - Screening for idiopathic hemochromatosis among diabetic patients. PMID- 1773698 TI - Insulin syringe disposal patterns at a VA hospital. PMID- 1773699 TI - Adrenal myelolipoma, Rathke's cyst, and diabetes mellitus. PMID- 1773700 TI - Metabolic implications of body fat distribution. AB - Insulin resistance is the cornerstone for the development of non-insulin dependent diabetes mellitus (NIDDM). Free fatty acids (FFAs) cause insulin resistance in muscle and liver and increase hepatic gluconeogenesis and lipoprotein production and perhaps decrease hepatic clearance of insulin. It is suggested that the depressing effect of insulin on circulating FFA concentration is dependent on the fraction derived from visceral adipocytes, which have a low responsiveness to the antilipolytic effect of insulin. Elevated secretion of cortisol and/or testosterone induces insulin resistance in muscle. This also seems to be the case for low testosterone concentrations in men. In addition, cortisol increases hepatic gluconeogenesis. Cortisol and testosterone have "permissive" effect on adipose lipolysis and therefore amplify lipolytic stimulation; FFA, cortisol, and testosterone thus have powerful combined effects, resulting in insulin resistance and increased hepatic gluconeogenesis. All these factors promoting insulin resistance are active in abdominal visceral obesity, which is closely associated with insulin resistance, NIDDM, and the "metabolic syndrome." In addition, the endocrine aberrations may provide a cause for visceral fat accumulation, probably due to regional differences in steroid hormone-receptor density. In addition to the increased activity along the adrenocorticosteroid axis, there also seem to be signs of increased activity from the central sympathetic nervous system. These are the established endocrine consequences of hypothalamic arousal in the defeat and defense reactions. There is some evidence that suggests an increased prevalence of psychosocial stress factors is associated with visceral distribution of body fat. Therefore, it is hypothesized that such factors might provide a background not only to a defense reaction and primary hypertension, suggested previously, but also to a defeat reaction, which contributes to an endocrine aberration leading to metabolic aberrations and visceral fat accumulation, which in turn leads to disease. PMID- 1773701 TI - Dyslipidemia in type II diabetes. Implications for therapeutic intervention. AB - Cardiovascular disease, and in particular ischemic heart disease, is the principal cause of morbidity, functional disability, and mortality in patients with non-insulin-dependent (type II) diabetes. The main risk factors for the macrovascular complications of diabetes are dyslipidemia, hypertension, and cigarette smoking. Although degree of hyperglycemia is a risk factor for microvascular complications, it is not a prominent risk factor for macrovascular complications. Nevertheless, there are theoretical reasons for believing that glycemic control could lower cardiovascular risk. For example, glycemic control may both improve clearance and suppress hepatic overproduction of very-low density lipoprotein. Moreover, there is direct empirical evidence that improved glycemic control can favorably alter lipid profiles in type II diabetic patients. Despite this, the only clinical trial that has assessed cardiovascular mortality as an end point in diabetic subjects (i.e., the University Group Diabetes Program) failed to demonstrate a benefit of glycemic control. In this study, the insulin-variable group, which achieved sustained glycemic control relative to the placebo group, had essentially the same cardiovascular mortality as the latter group. All of the conventional lipid-lowering agents have been shown to produce favorable changes in lipid profiles in diabetic subjects. However, the optimum regimen remains to be defined. Metabolic differences between diabetic and nondiabetic subjects mean that the optimum lipid-lowering regimens for the two categories of patients may differ. For example, nicotinic acid, which is a powerful lipid-altering drug, may worsen glucose intolerance. The characteristic lipid abnormalities in type II diabetic subjects are hypertriglyceridemia and low high-density lipoprotein cholesterol, not hypercholesterolemia. Although the role of hypertriglyceridemia as a cardiovascular risk factor in the general population has been questioned, there is evidence that this lipid abnormality may play a stronger role in diabetic subjects. For all of the above reasons, there is an urgent need for large-scale clinical trials assessing cardiovascular end points and testing various strategies of improving lipid profiles in diabetic subjects, particularly given the fact that all of the current generation of lipid-lowering trials have systematically excluded diabetic patients. PMID- 1773702 TI - Biological effects of omega-3 fatty acids in diabetes mellitus. AB - Fish oils exert important biological effects on several pathways predisposing to atherosclerosis. Epidemiological studies provided the initial evidence that omega 3 fatty acids may be the principal factor in fish oils responsible for these effects and have led to several short-term clinical trials in which fish-oil concentrates have been administered to various populations at risk for coronary heart disease, including patients with diabetes mellitus. omega-3 Fatty acids reduce serum lipids and lipoproteins, impair platelet aggregation, increase cell membrane fluidity, and lower blood pressure in humans. In this review, we highlight these and other potentially antiatherogenic properties of marine lipids in diabetic subjects. PMID- 1773703 TI - Energy and substrate metabolism in obesity and postobese state. AB - The total energy expenditure (EE) of human beings is represented by basal metabolic rate (which corresponds to 60-70% of EE), dietary-induced thermogenesis (10% of EE), and the energy expended in physical activity (20-30% of EE). Obese individuals have an increased total EE compared with lean subjects; this increase is essentially due to an increased lean body mass concomitant with obesity, and is completely reverted after weight loss. Glucose-induced thermogenesis (GIT), measured during an oral glucose tolerance test (OGTT) or hyperinsulinemic euglycemic clamps, has been found to be decreased in obese individuals, although some discrepancy exists between studies. The observed decreases in GIT show a gradation, increasing progressively from obese patients with normal glucose tolerance to obese patients with impaired glucose tolerance (IGT) to obese patients with non-insulin-dependent diabetes mellitus (NIDDM) and an increased insulin response after OGTT to obese patients with NIDDM and a hypoinsulinemic response after OGTT. The defect in GIT appears to be related to impairment in nonoxidative glucose storage and with the degree of insulin resistance. Obese patients after weight loss show a further decrease in GIT after OGTT or during a euglycemic clamp, which remains unclear. Obese patients have an increased basal lipid oxidation and a decreased suppression of lipid oxidation after OGTT or during a euglycemic clamp. Glucose oxidation and storage are both markedly decreased during a euglycemic clamp. In contrast, the defect in glucose storage is less apparent after OGTT, due to the compensatory effect of hyperglycemia and hyperinsulinemia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1773704 TI - Influence of dietary protein intake on whole-body protein turnover in humans. AB - Methods for measuring rates of protein synthesis and degradation in the whole body of humans with isotopes of carbon and nitrogen are described and attention is drawn to their relative merits and drawbacks for studying the nutritional control of protein metabolism. A review of published work on dietary protein and protein metabolism leads to the conclusion that protein is the major dietary determinant of whole-body protein turnover rates, and that energy intake is comparatively unimportant. Dietary protein affects protein turnover at two levels: an immediate response to the intake of protein in meals and a longer-term adaptation after a change in protein intake. An increase in the level of dietary protein enhances the response to meals, which mainly consists of a decrease in the rate of protein degradation. The adaptation to higher protein intakes involves an increase in the basal (postabsorptive) rates of both synthesis and degradation. Suggestions for future investigation include more detailed studies of the acute and adaptive responses, to facilitate understanding of dietary protein requirements, and the effects of very-high-protein intakes with continued development of techniques for studying protein turnover in individual tissues in humans. PMID- 1773705 TI - Stereoscopic acuity in ocular pursuit of moving objects. Dynamic stereoscopy and movement parallax: relevance to road safety and occupational medicine. PMID- 1773706 TI - Misclassification of diabetic subjects may account for the increased vascular risk of impaired glucose tolerance: the Islington Diabetes Survey. AB - We have studied the associations of macrovascular disease and hypertension with impaired glucose tolerance in a recall sample of 223 subjects selected from a population aged greater than or equal to 40 years who had been screened for diabetes using two separate glucose tolerance tests. Blood pressure was higher in subjects with diabetes, but not in those with impaired glucose tolerance, than in normals. Coronary heart disease, based on ECG criteria and history, was more frequent both in subjects with impaired glucose tolerance (odds ratio 1.94, 95% CI 1.02-3.69) and those with diabetes (odds ratio 3.88, 95% CI 1.33-11.97) than in normals, but the excess in the impaired glucose tolerance group was reduced, and was no longer significant, when adjusted for other variables (odds ratio 1.29, 95% CI 0.62-2.66). Peripheral vascular disease was more frequent in subjects with diabetes, but not in those with impaired glucose tolerance. When the subjects with impaired glucose tolerance on a single test were reclassified according to the results of a separate glucose tolerance test, the prevalence of coronary heart disease increased significantly with increasing degrees of glucose intolerance. Subjects with impaired glucose tolerance on both tests had an adjusted odds ratio of coronary heart disease of 0.90 (95% CI 0.42-1.94) compared with normal subjects. The excess of macrovascular disease in subjects with impaired glucose tolerance may result, at least in part, from the admixture of 'false negative diabetics' in that class. PMID- 1773707 TI - Evaluation of a new automated affinity-chromatographic method for the measurement of glycated hemoglobin. AB - A new automated affinity-chromatographic method for the rapid determination of glycated hemoglobin is described. It has a four min cycle time, does not measure the labile fraction of glycosylated hemoglobin and is not interfered with by abnormal hemoglobins. PMID- 1773708 TI - A comparison of the pharmacokinetics and metabolic effects of human regular and NPH insulin mixtures. AB - The effects of three human premixes (Mixtard, Actraphane, Humulin M3), syringe mixed 30% regular and 70% NPH insulin, regular insulin alone and NPH insulin alone, on intermediary metabolism, plasma free insulin levels and action profiles were compared using the euglycemic clamp technique. Seven normal volunteers received 20 IU of each insulin subcutaneously in a randomized fashion on separate days. The first and last 60 min of the 6 h clamp were chosen as summary measures of clinical importance. Significantly elevated plasma free insulin levels were found with all treatments compared to NPH insulin alone during the first hour, although by the final hour only Mixtard produced significantly higher levels compared to NPH (19.4 +/- 1.2, 10.5 +/- 0.3 mU/l P less than 0.01, respectively). Analysis of area under the incremental insulin absorption curve demonstrated that Mixtard produced significantly increased levels compared to syringe-mixed regular: NPH (7.6 +/- 0.8), Actraphane (9.6 +/- 1.0) and Humulin M3 (9.0 +/- 0.8 mU/l all P less than 0.05). Mixtard also resulted in significantly higher glucose infusion rates compared to the other premixes. No difference in action was found between regular and pre- or syringe-mixed human insulins during the first hour of the studies. The effects on intermediary carbohydrate and lipid metabolism were similar for syringe and premixed insulins. We conclude that: (1) fixed human insulin mixtures with NPH cause no blunting of the action of the soluble component. (2) Actraphane and Humulin M3 are similar but Mixtard may have a greater effect on some aspects of insulin action. (3) In clinical practice, fixed human insulin mixtures will be as efficacious as syringe-mixed preparations but may be easier and more convenient to use. PMID- 1773709 TI - Glucose intolerance and diabetic complications among Japanese-American women. AB - The prevalence of glucose intolerance and diabetic complications was determined in second-generation Japanese-American (Nisei) women and compared to previously obtained results in Nisei men. A volunteer study sample of 191 Nisei women 45-74 years old was enrolled from a study population of 1489 Nisei women born 1913 1942, raised and educated in the U.S., and residing in King County, Washington. The enrolled sample included 72 with normal glucose tolerance, 67 with impaired glucose tolerance (IGT), and 52 with non-insulin-dependent diabetes. A random sample was also drawn from the study population to form a reference sample of 157 women. Based upon observations in the reference and enrolled samples, an estimated 16% of Nisei women in the study population have diabetes and 40% IGT. These rates compare to 20% diabetes and 36% IGT previously estimated for Nisei men 45-74 years old. The prevalence of cardiovascular disease (hypertension, peripheral vascular disease, and/or coronary heart disease) was highest among diabetic women, lowest in those with normal glucose tolerance, and intermediate in women with IGT. In comparison to diabetic men, there was a significantly lower frequency of neuropathy, peripheral vascular disease, and coronary heart disease in diabetic women. However, hypertension occurred equally often in both. Thus Japanese-American men and women 45-74 yr old have a similar prevalence of glucose intolerance, although less severe in women, and complications, except for hypertension, are reduced in women. PMID- 1773710 TI - Glycosuria and diabetes mellitus in children and adolescents in south India. AB - In Madras city (India) 10,513 school students between 3 and 20 yr of age were investigated for glycosuria and its causes. While no previously known cases of diabetes mellitus of any type were encountered, four students (0.038%) in the survey population were found to have glycosuria. One (0.009%) had renal glycosuria, two (0.019%) were possibly NIDDY (MODY) and one (0.009%) had transient glycosuria while receiving anti-tuberculous chemotherapy. It is therefore concluded that neither diabetes mellitus nor glycosuria of non-diabetic causes is a crucial health problem in Indian children and adolescents. While the reasons for this are not known, further research in this field could be of global interest. PMID- 1773711 TI - Different awareness of hypoglycaemia induced by human or purified pork insulin in type I diabetic patients. AB - Recently, there have been reports on a diminished awareness of hypoglycaemia after a switch from purified pork insulin (PPI) to human insulin (HI) in insulin dependent diabetes mellitus (IDDM). To clarify this phenomenon we investigated nine IDDM patients without signs of autonomic neuropathy. After an overnight euglycaemic clamp, blood glucose was lowered to hypoglycaemic levels by means of an artificial pancreas (Biostator) on 2 days. Insulin was used in a double-blind, randomized, cross-over fashion, either PPI or HI. The symptomatology and the hormonal counterregulation of developing hypoglycaemia was recorded. Venous concentrations of free insulin, cortisol, glucagon, growth hormone and the prevailing blood glucose were similar under both insulins. Eight out of nine IDDM patients felt more symptoms and at a higher blood glucose concentration under PPI than under HI. The first symptom of developing hypoglycaemia appeared at a mean blood glucose concentration of 61.1 +/- 5.4 mg.dl-1 under PPI and 44.4 +/- 5.3 mg.dl-1 under HI respectively (P less than 0.05). We conclude that HI may cause symptoms of hypoglycaemia to appear later and with a lesser number in comparison to PPI. PMID- 1773712 TI - Correction of fructosamine value for serum albumin and globulin concentrations. AB - Using the data of 131 patients with non-insulin dependent diabetes mellitus (NIDDM), the correction formulas of fructosamine value ([FRA]) were devised to standardize the uncorrected [FRA] to serum albumin concentrations ([ALB]) of 4 g/dl, globulin concentrations ([GLB]) of 3 g/dl, and total protein concentrations ([TP]) of 7 g/dl. The following formula was derived for its maximum correlation coefficient (r) between corrected [FRA] ([FRAc]) and fasting blood glucose concentration ([G]); [FRAc] = [FRA]x33.3/(7.6 [ALB]+[GLB]). In these 131 diabetic patients, r between uncorrected [FRA] and [G] at 2 weeks ago was 0.562. When corrected by [FRA]x33.3/(7.6 [ALB]+[GLB]), [FRA]x4/[ALB], [FRA]+30 (4-[ALB]), [FRA]+23 (4-[ALB]), [FRA]+30 (7-[TP]), [FRA]x7/[TP], and [FRA]x3/[GLB], r was, respectively, 0.616, 0.612, 0.595, 0.589, 0.582, 0.581 and 0.478. In 24 patients with NIDDM whose [ALB] is either above 4.5 g/dl or below 3.5 g/dl, r between uncorrected [FRA] and [G] was as low as 0.389 without positive correlation. By using our correction formulas of [FRA]x33.3/(7.6 [ALB]+[GLB]) or [FRA] x 4/[ALB], r was statistically increased, respectively, to 0.769 or 0.788 (P less than 0.05 in both cases) in contrast to no significant increase of r by other formulas being at 0.598, 0.556, 0.540, 0.562 and 0.121. Based on these analyses, it is concluded that our correction formula of [FRA] by [FRAc]=[FRA]x33.3/(7.6 [ALB]+[GLB]) accurately reflects [G] in NIDDM even with hypo- or hyper albuminemia, and [FRAc]=[FRA]x4/[ALB] is useful for practical application for its simplicity. PMID- 1773713 TI - High incidence of sleep apnea syndrome in a male diabetic population. AB - In order to study the possible relationship between sleep apnea syndrome (SAS) and diabetes mellitus, we first examined the prevalence of SAS among 12,787 general patients (6554 males and 6233 females) who visited Katsumata Hospital at Nagoya, Japan. Among them, thirty-five males and five females were diagnosed as having SAS. The male patients were statistically analysed by the corrected Mantel Haenszel chi-square test taking the body type into account, and it was found that the prevalence of SAS was significantly high both in a diabetic population and in a hypertensive one. Among 40 SAS patients of both sexes, 34 were given a glucose tolerance test (GTT) with oral administration of 75 g glucose. Thirteen showed a diabetic pattern, 12 a borderline pattern and only 9 had a normal pattern. All 13 diabetic patients had non-insulin-dependent type diabetes (NIDDM). The present results showed that SAS has a close relationship not only to hypertension but also to NIDDM. PMID- 1773714 TI - Background, quality of life and metabolic control in patients with insulin dependent diabetes mellitus. AB - The interference of background characteristics with quality of life and metabolic control in patients with insulin-dependent diabetes mellitus (IDDM) were examined. Seventy-three consecutive outpatients who switched from syringe injections to multiple pen-injection treatment comprised the study group. Perceived status as well as retrospective changes in quality of life, attributed to the new treatment modality, were assessed at follow-up after 9-13 months. Data on metabolic control (HbA1C) were collected at base-line and follow-up. Sub-group comparisons in life quality and metabolic control were performed with regard to differences in sex, age, cohabitation, onset and duration of IDDM. Most of the background characteristics had no or just minor significance for status and change in the life quality and metabolic control of the patients. Cohabitation, however, was linked to a better life quality status pertaining to different domains and a tendency to better metabolic control. In addition, females reported a slightly better health status and a more healthy life style (i.e. eating, drinking and smoking habits) than did males. Extra treatment attention may therefore be justified for non-cohabiting males. PMID- 1773715 TI - Semmes-Weinstein monofilaments: a simple, effective and inexpensive screening device for identifying diabetic patients at risk of foot ulceration. AB - Both vibration perception threshold (VPT) by biothesiometry and pressure perception using Semmes-Weinstein monofilaments (filaments) have been proposed to identify diabetic patients at risk of foot ulceration. The two methods were compared in 182 subjects attending a national patients conference. Both measures were made over the great toe. Filaments of three calibres were used: 4.17, 5.07 and 6.10 bending with 1, 10 and 75 g force, respectively. Pressure perception was normal (4.17) in 122 patients (group 1) whereas in 45 patients it was grade 5.07 (group 2) and 6.10 or greater in 15 (group 3). The corresponding mean VPT (+/- SD) for the three groups were 10.6 (+/- 6.7), 22.8 (+/- 12.7) and 32 (+/- 14.3), respectively. The mean VPT for the 3 groups were significantly different (P less than 0.001). The filaments were more sensitive (100%) but less specific (77.7%) in identifying patients who had foot ulcers compared to biothesiometry which was less sensitive (78.6%) but more specific (93.4%). The filaments are therefore reliable and may be superior to biothesiometry in screening for patients at risk of foot ulceration since sensitivity is the more important parameter. In addition, they are inexpensive (12 pounds) compared to the biothesiometer (400 pounds) and are simple and easy to use. PMID- 1773716 TI - Could intranasal insulin be useful in the treatment of non-insulin-dependent diabetes mellitus? AB - To evaluate whether intranasal insulin might be useful as a meal-adjunct in the treatment of NIDDM we compared plasma glucose and insulin responses to a mixed breakfast (9 kcal/kg, 50% carbohydrate) following either intranasal insulin (INI) or placebo in eleven patients with NIDDM. Five patients treated with subcutaneous insulin and in good to moderate glycemic control and six patients who were 'failing' on oral agents and in poor glycemic control were studied. In the patients usually on sc insulin, INI inhibited postprandial hyperglycemia. Lower doses (1 U/kg vs 1.5 U/kg b.w.) were needed to accomplish this in 2 patients with low fasting glucose (less than or equal to 7.8 mmol/l) than in three patients with higher fasting glucose (10.5 +/- 0.5 mmol/l). In the patients on oral agents who had marked fasting hyperglycemia (14.8 +/- 0.8 mmol/l) an only transient reduction (for 90 to 120 min) of postprandial hyperglycemia was achieved when INI (1 U/kg) was given in addition to po glyburide (10 mg) prior to the meal. Following placebo in the group previously treated with sc insulin, plasma free insulin levels increased maximally by 23 mU/l, 75 min after the meal. The group on oral agents had a comparable but later peak increment (at 180 min) indicative of an even greater impairment of endogenous insulin secretion in response to hyperglycemia. Following INI, the peak increment in plasma insulin occurred earlier (30 min after the meal) and was greater in all patients (55 +/- 18, 139 +/- 68, 86 +/- 24 mU/l respectively for the prior sc insulin therapy group at doses of 1.0 and 1.5 U/kg and for the oral agent group at 1.0 U/kg).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1773717 TI - Elevation of serum CA 19-9 in parallel with HbA1c in a diabetic female with the Lewis(a+b-) blood group. AB - We report a 66-yr-old diabetic female with her serum CA 19-9 levels elevated in parallel with her hemoglobin A1c (HbA1c) levels. She was initially suspected of having pancreatic cancer, but this was later proved to be false. Her serum CA 19 9 levels varied between 58 and 235 U/ml over a 3-yr period, and correlated significantly (r = 0.68, P less than 0.01) with her HbA1c levels (7.2-13.3%). She belonged to the Lewis (a+b-) blood group. Serum CA 19-9 levels were also assessed in 73 diabetic patients (36 males and 37 females) in relation to sex and Lewis blood group. The mean level of serum CA 19-9 was higher in females than in males in each Lewis blood group, and it was the highest in patients with Le(a+b-) and the lowest in Le(a-b-). Patients with a higher level of HbA1c showed a higher level of serum CA 19-9 in Le(a+b-), but patients with Le(a-b-) showed a low level of serum CA 19-9 irrespective of HbA1c level. Patients with Le(a-b+) appeared to intermediate between the patients with Le(a+b-) Le(a-b-). Thus, the elevation of serum CA 19-9 level due to hyperglycemia was indicated to be affected by sex as well as Lewis blood group. The biosynthesis of CA 19-9 seemed to be accelerated in hyperglycemic diabetic patients, especially in females. Consequently, it was considered that the present case was a diabetic female with the Le(a + b -) blood group, which led to showing a relatively high level of serum CA 19-9 correlated with HbA1c level. PMID- 1773718 TI - Diabetic ketoacidosis precipitated by genital herpes infection. AB - Diabetic ketoacidosis is frequently precipitated by infections. We report three cases in which ketoacidosis was induced by genital herpes infection. There is good evidence that early treatment with systemic Acyclovir is effective in patients with a first attack of genital herpes. Therefore genital examination should be considered in patients with diabetic ketoacidosis particularly when there are symptoms of genital herpes. During episodes of recurrence, diabetic patients need to monitor their blood sugars more frequently and adjust insulin requirements accordingly. We believe that this is the first description of ketoacidosis being associated with this increasingly common and recurrent infection. PMID- 1773719 TI - Prevention of low dose streptozotocin-induced diabetes by acetyl-homocysteine thiolactone. AB - We used acetyl-homocysteine-thiolactone (citiolone) as an enhancer of superoxide dismutase (SOD), a free radical scavenger, in order to assay any possible prevention of the insulitis and subsequent B cell damage caused by streptozotocin (STZ) when given in multiple low doses. Mice were given citiolone (50 mg/kg b.wt.) as a long pretreatment or concomitantly with STZ for a shorter period. Ten days after the last STZ injection, pancreases were processed for SOD assay and morphological observations. Results demonstrate that citiolone increases SOD values, but to a variable degree, after the STZ administration. The highest SOD levels were found in animals treated for the longer period (P less than 0.001 vs saline-treated controls; P less than 0.0001 vs STZ-treated controls) but we did not observe a direct correspondence between high SOD values and morphological integrity of islet beta cells and/or low blood glucose levels. In conclusion, we hypothesize that the onset of type 1 diabetes in mice involves free radical generation but in addition some other factor may be responsible for the beta cell damage. PMID- 1773720 TI - [Unilateral effect of intracerebral microinjections of thymosin on the instrumental behavior of monkeys]. PMID- 1773721 TI - [Vector-endocrine regulation of secretory function of organs in the gastroduodenal region]. PMID- 1773722 TI - [Structure of two myelopeptides affecting pain sensitivity]. PMID- 1773723 TI - [A chemically synthesized gene assures the biosynthesis of a polypeptide in Escherichia coli cells, the structure of which corresponds to human leukocytic interferon alpha 2]. PMID- 1773724 TI - [Effect of heterologous and homologous exogenous alcohol dehydrogenase on alcohol consumption by white rates]. PMID- 1773725 TI - [Effect of stomach endogenous factors of fed and hungry rats on the ultrastructure of oxyntic cells]. PMID- 1773727 TI - [Grieving processes at the loss of a partner by separation or death]. PMID- 1773726 TI - [Autoooscilation of vaginal mucosal components during ovulation in mammalian species]. PMID- 1773728 TI - [Grieving in the hospital. Thoughts on the culture of dealing with dying and death]. PMID- 1773729 TI - [Dying in the hospital]. PMID- 1773730 TI - [People die in homes for the aged and in nursing homes]. PMID- 1773731 TI - [Truth at the sick-bed. Dealing with truth in life-threatening disease from the jurist's viewpoint]. PMID- 1773732 TI - [Dealing with truth in life-threatening diseases from the chaplain's viewpoint]. PMID- 1773733 TI - [Shared grief is half the grief. A report on the work in circles of grieving dialog]. PMID- 1773735 TI - [Dealing with death in a secular society]. PMID- 1773734 TI - [Work of mourning and psychological resistance mechanisms]. PMID- 1773736 TI - [Islamic burial rites and graveyard culture]. PMID- 1773737 TI - [Approach to dying children in the hospital]. PMID- 1773738 TI - [Bernd has cancer. The loss of light-heartedness]. PMID- 1773739 TI - [Miscarriage, stillbirth, genetic interruption. How does the hospital personnel cope with the contact with parents after the loss of a child?]. PMID- 1773740 TI - [Promotion of nursing science]. PMID- 1773741 TI - [Nurses shortage and educational system--communicating vessels of one development]. PMID- 1773742 TI - Embryology of the hair follicle. AB - A study of hair follicle development has enabled us to differentiate four stages by relating them to corresponding gestation ages. Stage I of the hair bud is characterized by an epiblastic proliferation penetrating the subjacent mesenchyma at the extremity of which mesenchymal cells accumulate. This appears, at the level of the lower lip, before the 11th week of intrauterine life. Stage II of the hair bulb is reached on the 12th-13th week of intrauterine life, as soon as the distal extremity of the hair bud, which has extended, becomes depressed at the mesenchymal papilla level. Stage III is defined by the observation of hair cone and rough sebaceous glands on the 15th week of intrauterine life. Finally, stage IV shows a differentiated sebaceous gland with a hair which comes through the skin surface on the 18th week of intrauterine life. PMID- 1773743 TI - Critical appraisal and further development of the methodology for open circuit calorimetry in neonates. AB - A non-invasive technique for open circuit calorimetry based on a Vickers 79 incubator as the gas collection chamber was developed and evaluated. The technique, which involved drawing air from the incubator hood at 11 1/min for gas analysis, did not have a significant cooling effect on the infant and the noise levels within the incubator did not exceed current safety standards. A new technique for checking the calibration of the whole system was developed as the traditional alcohol burn method proved unsatisfactory. Either pure oxygen or carbon dioxide were fed into the incubator hood at controlled physiological rates using a calibrated throttling valve. Over a number of calibration checks the mean error of the system proved to be +/- 4.3% for oxygen and +/- 4.45% for carbon dioxide. Less than a fifth of this error was attributable to the pump and flow meter. When oxygen is introduced to the system at a constant physiological rate it takes 30 min for a plateau to be reached. Therefore it is recommended that this system is used when readings are to be taken in a steady state situation or data is to be cumulated over a long period of time such as in an energy balance study. A run in period of 30 min before collecting data is essential. It is recommended that a calibration check is performed before each study. PMID- 1773744 TI - Comparison of different rates of artificial ventilation for preterm infants ventilated beyond the first week of life. AB - The effect on blood gases of different ventilator rates in preterm infants ventilated beyond the first week of life was assessed. Seventeen infants, median gestational age 25 weeks, were studied at median postnatal age of 11 days. The infants were ventilated through a set sequence of rates: 30, 60, 30, 100 and 30 breaths per min (bpm), each rate being maintained for 20 min. Peak and positive end expiratory pressure and I:E ratio (1:1) were unchanged at each rate and mean airway pressure was kept constant by altering flow as necessary. No significant change in oxygenation was demonstrated at either rates of 60 or 100 bpm compared to 30 bpm. PaCO2 levels were, however, significantly reduced at 60 bpm (P less than 0.001) compared to 30 bpm; but this improvement in PaCO2 was not seen at 100 bpm. These results suggest that increasing ventilator rate higher than 60 bpm in the majority of infants ventilated after the first week of life is not advantageous. PMID- 1773745 TI - Relationship between fetal cardiac and extra-cardiac Doppler flow velocity waveforms and neonatal outcome in intrauterine growth retardation. AB - In a total of 42 consecutive pregnancies with intrauterine growth retardation (IUGR), Doppler velocimetry was related to neonatal outcome as determined by Apgar score at 1 min, umbilical artery acid-base status and PO2, number of nucleated red blood cells (NRBC), duration of ventilatory support, and sonographic appearance of cerebral leukomalacia. Doppler flow velocity waveforms were obtained from the ascending aorta (AO), pulmonary artery (PA), internal carotid artery (ICA) and umbilical artery (UA) at 2-3 day intervals until delivery. At cardiac level the peak systolic velocity (PSV) and time-averaged velocity (AV), and at peripheral level the pulsatility index (PI) was determined. As all Doppler parameters were significantly related to gestational age at birth, gestational age was taken into account in the analysis. There was no relationship between Apgar score, acid-base status and Doppler parameters. Low AVAO was related to a low umbilical artery PO2. Significant correlations were established between PSVPA, AVPA and PIUA, and the duration of neonatal ventilatory support. Infants who died within 22 days after admission to the neonatal intensive care unit (n = 7) displayed a significantly higher PIUA than those who remained alive. The PIUA was also related to the absolute and relative number of NRBCs. No relationship existed between the Doppler parameters and degree of leukomalacia. The present study demonstrates that from all Doppler parameters, the PIUA is most clearly related to neonatal outcome in IUGR. PMID- 1773746 TI - A ten-year temporal analysis of primary congenital hypothyroidism in Israel. AB - It was previously shown that some congenital malformations present seasonal variations, suggesting a seasonal etiology such as viral infections. Some earlier studies have shown a certain degree of variation in the incidence rates of congenital hypothyroidism. As from April 1978 all infants born in Israel were screened for congenital hypothyroidism (CH) in one central laboratory at the Sheba Medical Center Tel-Hashomer. During the 10-year screening period (April 1978 to March 1988) 303 infants were found to have primary CH, which constitutes an overall incidence of 1/3192 live births. The annual and monthly birth incidence was calculated for the 120 months of the screening period. The annual CH incidence was significantly low in 1978 and 1979 and significantly high in 1985. There were wide and significant variations in the individual monthly incidences of CH. The average monthly incidence showed a low peak in August; however the autocorrelation analysis of the monthly incidences of CH showed no significant periodicity. This was supported by the Fourier analysis which showed no distinctive frequency peak. The last menstrual period was calculated for 138 of the infants' mothers and an autocorrelation analysis of these dates showed no significant periodicity. These results support a non-periodic etiology for sporadic primary CH in Israel. PMID- 1773747 TI - Arm and leg blood pressures--are they really so different in newborns? AB - Controversy still exists over differences between upper and lower limb blood pressures (BP) in neonates. We measured upper arm and calf systolic (S) and diastolic (D) BP and heart rate (HR) using 2 Dinamap 847 instruments simultaneously every half minute for several measurement periods of 5-10 min. Nine healthy term newborns were studied in active (AS) and quite (QS) sleep on post-natal days 1 and 5. The results were examined using unbalanced analyses of variance. Arm SBP was 62.3 +/- 1.6 mmHg and DBP 35.5 +/- 1.0 mmHg on day 1 in AS and QS. Calf values were not significantly different but were slightly higher (by 2-3 mmHg) in AS. Arm SBP and DBP rose by 8.5 and 5 mmHg, respectively, between days 1 and 5 but calf pressures rose less. Calf SBP and DBP were significantly lower (by 4.6 and 3.4 mmHg, respectively) than the arm values in QS on day 5. Arm SBP and DBP were dependent on post-natal age but not on sleep state while calf SBP and DBP and HR were dependent on both. Mean HR rose with age from 114 to 117.6 bpm in QS and from 118.6 to 122.4 bpm in AS. Our non-invasive BP measurements were similar to available invasive data. We postulate that differences in arm and calf vasoreactivity account for the different dependence on sleep state and for the unequal changes in arm and calf BE from days 1 to 5. PMID- 1773748 TI - Cardiovascular responses to tilting in healthy newborn babies. AB - It has been suggested that newborn infants have immature baroreceptor responses and they are unable to maintain their blood pressure (BP) by appropriate reflex peripheral vasoactivity and heart rate (HR) changes in response to tilting. We have measured simultaneously upper arm and calf systolic and diastolic BP and HR every 30 s using an oscillometric method (Dinamap 847) in quiet and active sleep in 9 term babies. Measurements were performed continuously with 5-min periods in each of three positions; horizontal, 30 degrees head up and 30 degrees head down tilt. The results were analysed using unbalanced analyses of variance and multivariate regression. All responses were proportional to the angle of the tilt. The observed values were very close to those predicted from the model. HR increased and decreased by 3.25 beats/min (bpm) on 30 degrees up and down tilting respectively and by twice this amount when tilting through 60 degrees. Arm systolic and diastolic BP both decreased by 1.3 mmHg when tilting through 60 degrees from down to up and increased correspondingly with down-tilting. Calf systolic BP changed appropriately for the change in hydrostatic pressure (+7.37 mmHg with 30 degrees up tilting), but diastolic BP rose only by 60% of this value. The results showed no individual variation, were independent of day, sleep state, the number of tilts, the starting value of the BP and the direction of the previous tilt. This study shows that the healthy newborn has a well developed baroreceptor reflex. PMID- 1773749 TI - Plasma manganese, selenium and glutathione peroxidase levels in the mother and newborn infant. AB - Manganese (Mn), selenium (Se) and glutathione peroxidase (GPX) levels were determined in 56 paired samples of maternal and cord blood plasma at birth in both term and preterm pregnancies. Correlations existed between maternal and newborn plasma levels for Se, but not for Mn or GPX. Values of Mn, Se and GPX were all greater in the term than the preterm infant. Levels of Mn were greater in the pregnant than the non-pregnant woman, but levels of Se and GPX were lower during pregnancy. PMID- 1773750 TI - The firing probability of single motor units following transcranial magnetic stimulation in healthy subjects and patients with neurological disease. AB - Magnetic stimuli applied to the scalp can cause single motor units (MUs) to discharge in intrinsic hand or more proximal arm muscles. MUs are much more likely to be fired by stimuli if they are being activated voluntarily at the same time. The changes in firing probability induced by magnetic stimuli in such tonically active MUs have been studied in healthy subjects and patients using peri-stimulus time histograms (PeSTHs). The mean firing level in the 250 msec before the stimulus, was used to define 2 peaks of increased firing after the stimulus. The first, termed the primary peak (PP), was always present, had an onset latency in first dorsal interosseous (FDI) muscle of 20-31 msec and was short in duration (mean 4.9 msec). A second increase in firing probability, the secondary peak (SP), was present in about half the FDI MUs studied, had a mean peak latency of 81.5 msec and had a duration up to about 40 msec. PP often consisted of a number of sub-peaks with intermodal intervals of around 1.5 msec. It is believed that PP is the result of activation of corticospinal (CS) fibres making monosynaptic connections and that sub-peaks within PP are due to the arrival at the motoneuron of successive CS impulses produced by the stimulus. SP is probably due to operation of other excitatory inputs to the motoneuron. In patients, a number of different abnormalities have been identified. PP has been found to be normal, absent, delayed and dispersed or having abnormally separated sub-peaks. Clearly the technique is a powerful tool for dissecting abnormalities in CS projections at the synaptic level. PMID- 1773751 TI - Magnetic coil stimulation of human visual cortex: studies of perception. AB - The effects of magnetic coil (MC) stimulation of human visual cortex on the foveal perception of briefly presented letter trigrams include: (1) letters were nearly always reported correctly at visual stimulus-MC pulse intervals less than 60-80 msec or greater than 120-140 msec. Thus, by 120-140 msec, information related to letter recognition is relayed from calcarine cortex. (2) Presentation of equiluminant chromatic stimuli (specifically green letters against a red background) results in suppression curves which commence at longer latencies than those obtained with achromatic stimuli. (3) At a stimulus-MC pulse interval of 100 msec, shifting the MC laterally or rostrally resulted in suppression of the contralateral or caudal-most letter respectively. This implies a focal, topographical effect on visual cortex. (4) Two trigram stimuli separated in time (e.g. 100 msec) resulted in classical backward masking in which S1 (the target) was suppressed by S2 (the mask), using an S2/S1 luminance-contrast ratio of 4:1. When the MC was subsequently discharged 80-100 msec after S2, and S2 was suppressed, the response to S1 was easily retrieved (unmasked). Presumably, by 160 msec, S1 has been transmitted to the next processing, extrastriate level. (5) The unmasking phenomenon has been used to track information flow from visual cortex to higher cortical centers (e.g. Wernicke's, Broca's, and related areas). (6) Using a prototype repetitive stimulator, a consecutive train of single MC pulses given 70, 143 and 216 msec following a brief alphabetic trigram stimulus elicited a significant reduction in letter perception. This notably contrasts with the absence of suppression when a single MC pulse was given 70 or 143 msec following presentation of the alphabetic trigram. The results with 3 pulses suggest that the first MC pulse (at 70 msec) delays but requires repetition to prevent processing and/or transmission of information from visual cortex. PMID- 1773752 TI - Magnetic stimuli applied over motor and visual cortex: influence of coil position and field polarity on motor responses, phosphenes, and eye movements. AB - Transcranial magnetic stimulation was performed over the motor and visual cortex with the Novametrix 12-cm diameter stimulation coil. The influence of coil position on the size of electromyographic responses and on the intensity and position of phosphenes in the binocular visual field was studied. Furthermore, it was investigated whether stimulation over the visual cortex or over the frontal eye field evoked or disturbed eye movements. Coil position was recorded by constructing grids on the skull surface using extracranial bony landmarks, and was then related individually to underlying cerebral sulci by analysis of magnetic resonance images of the brain. Motor responses. Excitatory effects were maximal when the coil windings in the middle of the coil ring lay over the particular motor representation field of area 4. The response size depended on the direction of the coil currents passing over the motor cortex. For example, coil currents passing over the lateral part of the precentral gyrus from the front and transversely to the central sulcus elicited maximal responses in hand muscles. With the currents passing over the same area in the opposite direction, response amplitudes were much smaller, suggesting activation of different inputs to cortical motoneurons. Phosphenes. Fields of fixed, white and unstructured phosphens occurred in the lower half of the visual field when the coil center was placed about 7 cm anterior to the inion on the inion-nasion line. Counterclockwise or clockwise coil currents elicited phosphenes within the left or right lower quadrant of the binocular visual field, respectively, which could be attributed to an activation of the right or left primary visual cortex (area 17). The 'cortical' phosphenes moved with voluntary eye movements, but not during caloric and optokinetic nystagmus. Phosphenes resulting from an excitation of the optic nerve rather than the retina could be evoked by stimulation over frontal parts of the skull. Eye movements. The application of single magnetic field pulses over the frontal eye field or over the visual cortex did not elicit eye movements except for small vertical eye movements as part of a magnetically elicited blink. PMID- 1773753 TI - Cerebellar evoked potentials and motor evoked potentials in the spinal cord of rats. AB - In rats, the cerebellar evoked potentials (CEPs) were monitored along the spinal cord following the electrical stimulation of cerebellar cortex. The CEPs monitored at thoracic and lumbar cord consisted of from 1 to 3 waves with conduction velocities of 16-20.28 m/sec. The amplitudes of these waves declined dramatically as the frequency of the stimulation increased above 50 Hz, indicating that the CEPs were either evoked or conducted polysynaptically. The pathway conducting CEPs were studied using acute spinal cord lesioning and intracord recording methods. The pathways conducting CEP and MEP were also compared in the same preparation in controlled spinal-cord-lesioned animals. The CEPs were mainly conducted along the ventral and lateral funiculi where the reticulospinal tracts and the vestibulospinal tracts are located. Simultaneous disappearance of both MEP and CEP after controlled spinal cord section seems to suggest the 2 different evoked potentials are conducted along the same pathways in the spinal cord of rats. Species difference in conduction pathways of MEP and CEP were compared and discussed. PMID- 1773754 TI - Corticospinal potentials after electrical and magnetic stimulation in man. AB - The present report deals with our study of the descending volley evoked by both electrical and magnetic transcranial stimulation in man. We discuss the differences of these two techniques specifically as regards the latency and amplitude of evoked potentials. In both cases, electrodes were placed either in the epidural space or directly on the spinal cord. Following electrical stimulation, the descending volley consisted of an early wave which appeared at low stimulation intensity and increased in amplitude and decreased in latency when the strength of the stimulus was increased. At high stimulation intensities the early wave was followed by later waves which travel at the same speed as the initial wave. By delivering paired cortical stimuli, the early wave evoked by the test stimuli is present at 1-msec interval and progressively recovered with longer intervals. The recovery cycle of the later waves is also extremely short. Following magnetic stimulation, the descending volley also consisted of an initial wave followed by later waves. The initial wave has a slightly longer latency, a higher threshold and a smaller amplitude than the early wave evoked by electrical stimulation. The results are discussed with reference to the D and I waves recorded from the pyramidal tract in animals. PMID- 1773755 TI - CNS activation patterns underlying motor evoked potentials as demonstrated by c fos immunoreactivity. AB - Monopolar (n = 5) and bipolar (n = 4) electrical stimulation of the motor cortex associated with spinal motor evoked potentials (MEPs) in rats resulted in central nervous system (CNS) staining for c-fos protein. Staining was demonstrated in the cortex, hippocampus, and caudate-putamen, irrespective of the type of stimulation. C-fos protein was demonstrated in the ventral horn cells in 3 animals and in the superficial layer of the posterior horn in 8 animals. Brainstem staining was more frequent and intense in rats stimulated with monopolar electrodes. In contrast to the diffuse and bilateral cortical staining observed with electrical stimulation, motor cortex stimulation by the local application of bicuculline resulted in c-fos protein staining restricted to the stimulated motor cortex. The cerebellum failed to demonstrate c-fos protein following motor cortex stimulation or direct electrical cerebellum stimulation. The present study demonstrates that c-fos protein can be used as a marker of direct or synaptically activated neurons during electrical and chemical stimulation of the motor cortex. Activation of neural structures outside the motor pathway may reflect physiologic activation or stimulus spread. Increased c fos protein staining of the brainstem with monopolar stimulation supports previous studies that suggest that components of the MEP following monopolar motor cortex stimulation in the rat may arise from brainstem structures. PMID- 1773756 TI - Repetitive high magnetic field stimulation: the effect upon rat brain. AB - The effect on rat brain of a large number of stimulations with a high strength pulsed magnetic field was investigated in 31 rats: 10 naive controls, 10 anesthetized controls, and 11 stimulated and anesthetized rats. An investigational magnetic stimulating device with a circular 5.5 inch diameter stimulating head was used. The stimulating coil was energized by 1000 V, 8000A, 200 microseconds half sine pulses at a rate of 8 Hz. The peak field strength was 3.4 T, and the peak field flux was approximately 53,000 T/sec. Stimulation was performed for 20 min at a rate of 8/stimuli per second, for a total of at least 10,000 stimulations. The rats were sacrificed after 8 days, and their brains were examined using light microscopy with hematoxylin and eosin staining, or electron microscopy. Histological samples were taken from the neocortex, the hippocampus, the basal ganglia, and the cerebellum. No significant changes were seen. PMID- 1773757 TI - Magnetic stimulation of the human motor cortex: ipsilateral and contralateral facilitation effects. AB - Voluntary contraction of a muscle greatly increases the amplitude and decreases the latency of the motor potentials evoked by electromagnetic coil brain stimulation (facilitation). Facilitation has also been observed with contraction of a nearby ipsilateral and a contralateral homologous muscle. We studied these facilitatory relationships in 5 normal subjects in small hand, forearm and upper arm muscles using surface-recorded compound motor action potentials, single motor unit recordings, and post-stimulus time histograms. There was no evidence for spread of facilitation between any pair of muscles if the muscle from which motor evoked potentials (MEPs) were recorded was completely at rest during brain stimulation, although this sometimes required training to accomplish or could not be achieved. Thus, although spread of facilitation has been observed by others under these conditions, we did not find this effect. There may be significant interindividual variations in the degree of facilitatory spread. PMID- 1773758 TI - Motor evoked potentials facilitated by an additional peripheral nerve stimulation. AB - In order to explore the use of intraoperative monitoring of motor systems under general anesthesia, the effect of transcutaneous electric brain stimulation was examined by non-invasive muscle activity recording. The mechanisms of anesthetic suppression of myogenic responses as well as different concepts to circumvent this suppression are reviewed. Facilitation of cortical stimulation effect at the spinal level was attempted by adding a well-timed peripheral nerve stimulation to it, similar to that for H-reflex from M. flexor carpi radialis. Eight comatose patients from the intensive care unit and 17 patients under general anesthesia were examined. Spinal motoneuron excitability changes caused by cortical stimulation in anesthetized patients showed a monophasic facilitation pattern with lower facilitation degree and shorter duration, compared to non-anesthetized patients. The latter showed a long-lasting, three-phase pattern of excitability change. Before there can be any clinical application of this facilitation technique, however, two problems remain to be solved: achieving a stable motoneuron conditioning level throughout anesthesia, and making the application of a compatible technique in more muscles possible. PMID- 1773759 TI - Influence of peripheral nerve stimulation on the responses in small hand muscles to transcranial magnetic cortex stimulation. AB - The influence of afferent median nerve stimulation on the responses of small hand muscles (CMAPs) to cortical stimulation (CortStim) was investigated by applying short stimulus trains to the median nerve at the wrist and slightly suprathreshold magnetic stimuli to the scalp. Train stimulus frequency (TSF), train stimulus intensity (TSI), and train onset (TO) in relation to the CortStim were varied. Amplitudes and latencies of CMAPs were compared with those obtained by CortStim alone. When applying short trains of 10 msec duration, of 300/sec 400/sec TSF, and of threshold or supramaximal intensity for motor fibers, both facilitatory and inhibitory effects on the responses to CortStim were achieved depending on the timing of the train onset. With a TO of 8-10 msec before CortStim, mean amplitudes of CMAPs were enhanced 3-10 times; mean amplitudes reached up to 20 times the baseline values when the TO was greater than 45 msec before CortStim. With a TO of 15-35 msec before CortStim, amplitudes were diminished below control values. No systematic changes in latency were noted with TO of 8-10 msec, but when the TO was 45-60 msec before CortStim the latencies of CMAPs were 1.5-3 msec shorter than baseline latencies. With afferent stimuli that were subthreshold for motor fibers facilitation only occurred when the TO was about 45 msec before CortStim. The differences were statistically significant (Wilcoxon-Mann-Whitney Test). This biphasic pattern of facilitation and inhibition probably reflects spinal and supraspinal reflex phenomena mediated by spindle receptor and various cutaneous afferents. PMID- 1773760 TI - Magnetic nerve stimulation: the effect of waveform on efficiency, determination of neural membrane time constants and the measurement of stimulator output. AB - We describe the first investigation into the effect on stimulation efficiency of varying the output of a commercial magnetic stimulator based on our original clinical design. Over the range of magnetic field waveforms considered, it is shown that the stored energy required to achieve stimulation, both cortically and in the periphery, varies by approximately 2:1. Greater efficiency is obtained by using shorter risetime magnetic fields. This results in more effective stimuli for the same stored energy, or, for the same stimulus, a decrease in energy storage, power dissipation and peak currents, thus simplifying hardware design. A novel method of processing the data obtained from different waveforms is presented which enables neural membrane time constant to be calculated. Data from normal subjects is presented showing both peripheral and neural time constants to be of order 150 microseconds. The cortical measurements represent the first non invasive determination of cortical membrane time constant in man. Time constant measurements using magnetic stimulation may be clinically useful because they give information concerning the electrical properties of the nervous system not available from present techniques. Finally a method of quantifying the output of magnetic stimulators and coils is described which enables laboratory comparisons to be made, and takes into account magnetic field waveforms and coil geometry. The proposed symbol for this new measurement is Et150 with units volt seconds/meter. PMID- 1773761 TI - Optimizing magnetic stimulator design. AB - Optimal magnetic stimulation depends on application and design. The best design generates the desired depolarization current in the desired area with acceptable current speed. Power and cooling requirements, electrical and mechanical safety, stimulus rate, reliability, and ease of use are additional considerations. By understanding the interactions among these requirements, suitable choices are made. Magnetic stimulation requires moving enough charge through an electrically sensitive tissue to depolarize it reliably. Usually there is a need to depolarize a delimited volume of tissue and to repeat the depolarization at convenient intervals. A good design achieves the focality and speed needed for the application. Since the applications for magnetic stimulation are varied, however, the designs for the stimulators also will be different, and defining the application (or applications) is, therefore, a requirement for optimization. PMID- 1773762 TI - Magnetic stimulation: technical aspects. AB - When the voltage induced in a measuring coil by different magnetic stimulators was assessed, the strongest stimulus was generated by Cadwell followed by Novametrix, Dantec and then Digitimer. The Cadwell produced a polyphasic pulse, while the other stimulators generated monophasic stimuli. This is the reason that reversing coil polarity does not influence the site of nerve excitation with the Cadwell equipment, but does with the other stimulators. The magnetic method has proved to be most useful for transcranial excitation of the motor cortex. Magnetic stimuli at C7 excite cervical roots submaximally. Electrical stimuli excite cervical roots supermaximally. No advantage was found in the use of small coils for cervical transcutaneous root stimulation. Electrical stimulation (60 85% output) excited lumbar motor roots supramaximally in each healthy subject. However, magnetic stimulation at T12/L1 (100% output) evoked responses in only 8 (Novametrix) and 12 (Cadwell) out of 18 trials without any difference between right and left. The most reliable method for transcutaneous non-invasive excitation of motor roots is electrical stimulation. PMID- 1773763 TI - Guidelines for energy-efficient coils: coils designed for magnetic stimulation of the heart. AB - Magnetic stimulation of the heart requires high magnetic field energy and results in considerable Joulean dissipation. Energetically efficient and mechanically robust coils were designed for magnetic stimulation of the canine heart. Circular coils with rectangular cross section oriented either parallel or perpendicular to the skin were employed. A reasonable compromise between coil size and energy efficiency is achieved when the outer radius is twice the target depth. Nearly optimal efficiency is obtained by coils with annular width and height of 60% and 20% of the radius, respectively. A coplanar pair of coils parallel to the skin surface requires less energy and provides a more localized stimulus than a single coil. Placing a single coil perpendicular to the skin provides stimulus localization comparable to that of a coplanar pair; however, a single coil requires approximately 4 times the energy. The large coil currents required for cardiac stimulation exert Lorentz forces on the conductors that may exceed their tensile strength, emphasizing the need for an adequate support structure. Coils fabricated along the preceding guidelines were used to stimulate dog hearts repeatedly, requiring magnetic fields with energy greater than 12,000 J, without coil failure. Although the principles for coil design described herein were applied to a cardiac stimulator, they can also be applied to coils for other tissues, resulting in less coil heating, better stimulus localization and less power consumption. PMID- 1773764 TI - The electric field induced during magnetic stimulation. AB - The electric field induced in tissue during magnetic stimulation is calculated. There are two sources of the electric field: charge and a time-dependent magnetic field: both sources are important in magnetic stimulation. Charge accumulation on the tissue surface tends to shield the nerve from the stimulus. The induced electric field is generally parallel to the tissue surface. Simulations of both peripheral and central nervous system stimulation are presented. PMID- 1773765 TI - Theoretical and practical performance of magnetic stimulators and coils. AB - The diagnostic use of magnetic brain stimulation has not been extensive because of several technical drawbacks. These include the relatively low field strength and low repetition rate of available stimulators, design problems which can be resolved with the construction of stronger and faster magnetic stimulators. The present study details the design of a magnetic stimulator in two phases: energy storage and switching current; and the head or 'probe' design. The theoretical and practical implications of these design factors are discussed, and design effects on safety limits and stimulation parameters are also considered. PMID- 1773766 TI - The electrophysiological assessment of the pyramidal and non-pyramidal tracts of the spinal cord of rats. AB - The present paper summarizes our experience with the use of motor evoked potentials (MEP) and cerebellar evoked potentials (CEP) to assess the physiological integrity of the motor tracts of the spinal cord in a rat model. The MEP elicited by intracortical microstimulation of motor cortex reflected activity only in the pyramidal tracts; in contrast the MEP obtained by extradural cortical stimulation with a macroelectrode also reflected activity in a number of non-pyramidal pathways including the lateral vestibulospinal and rubrospinal tracts. The CEP was principally conducted in ventral spinal cord tracts and may reflect direct activation of brainstem nuclei. Data are presented which correlate the relationship between the MEP and axonal integrity after cord injury. PMID- 1773767 TI - Physiological studies of electric and magnetic stimulation of the human brain. AB - It is suggested that transcranial electric stimulation can activate pyramidal tract projections both directly and indirectly in a manner similar to that described after direct stimulation of the exposed cortex in the monkey. This produces both D- and I-waves in the pyramidal tract. At high intensities of stimulation, the stimulus can spread into the brain and activate pyramidal tract axons several centimeters below the cortical surface. Magnetic stimulation at moderate intensities produces electromyographic (EMG) responses with latencies 1 2 msec longer than those after electric stimulation. Two possible explanations have been put forward to account for this effect: (1) because of the difference in the direction of electric current flow induced in the brain by the 2 forms of stimulation, magnetic stimulation preferentially excites pyramidal tract cells indirectly, and hence evokes only I-waves in the pyramidal tract. (2) Electric stimulation (even at threshold) activates pyramidal axons deep in the white matter, whereas magnetic stimulation activates the pyramidal cells in the gray matter, probably at their initial segment. There is one interesting consequence common to both explanations. Whether magnetic stimulation activates the pyramidal neurons transsynaptically or at their initial segment, the size of the descending volley evoked will depend on the level of excitability of the motor cortex. In contrast, the response to electric stimulation will be less affected, since a proportion of the descending volley is initiated directly at the axon of the pyramidal cell. This differential effect of cortical excitability on the responses to electrical and magnetic stimulation can be useful in describing excitatory or inhibitory influences on motor cortex from other structures. PMID- 1773768 TI - Assessment of functional recovery after spinal cord injury in rats by reticulospinal-mediated motor evoked responses. AB - Auditory startle reflexes (ASR) and cortico-myoelectric evoked potentials (CMyEP) were investigated as possible tests of descending motor function in a rat spinal cord injury model. ASR, which consist of stereotyped myoelectric responses recorded in limb and axial muscles to brief loud tones, were found to provide a simple, objective, and reliable measure of motor recovery after spinal cord injury (SCI). While ASR are easily recorded in awake rats, they are blocked by anesthetics, and thus cannot be recorded during the acute injury period. ASR were compared with CMyEP, which can be recorded while the animal is anesthetized. CMyEP were found to produce large myoelectric responses in the vastus lateralis and tibialis anterior hindlimb muscles of the rat similar to ASR except that latencies were approximately 3 msec earlier. Both ASR and CMyEP tended to be bilaterally symmetric regardless of the stimulus configuration, and threshold for responses were the same for both muscles in both hindlimbs. The results suggest that CMyEP may be related to ASR and thus mediated partly by reticulospinal pathways. Evidence supporting this hypothesis is reviewed. PMID- 1773770 TI - Magnetic motor stimulation. A symposium. Chicago, 1989. PMID- 1773769 TI - Matching focal and non-focal magnetic coil stimulation to properties of human nervous system: mapping motor unit fields in motor cortex contrasted with altering sequential digit movements by premotor-SMA stimulation. AB - Possible classifications of effects of magnetic coil (MC) stimulation are discussed, with the conclusion that the most useful is focal versus non-focal excitation. The mode of excitation of peripheral motor axons by the longitudinal orthogonally orientated round MC is deduced from the insignificant latency shift in motor unit response when the current direction is reversed either by rotating the coil or by a switching device. A hypothesis is advanced of how peak membrane current entry and exit could occur only 1-3 nodes apart. The mode of excitation of cerebral cortex is more complex. Related to the orientation of the round MC, corticospinal neurons are: (1) directly excited and; or (2) indirectly excited through stimulation of corticocortical and other presynaptic inputs. Although the round MC can directly excite monkey corticospinal neurons at two sites, i.e. the initial segment and the node, the node is believed to be the main target in humans. The meaning of 'focality' of excitation is discussed as applied to MC stimulation of peripheral nerve and cerebral cortex. A potential conflict exists between focality and magnitude of response to MC excitation. However, by appropriately orientating the round MC, activation of all motor axons in one nerve (e.g., the median nerve at the wrist) can be achieved without coactivation of another (e.g., the ulnar nerve). By contrast, no orientation of the round MC, or use of a specially designed MC (e.g., double coil) over motor cortex permits all members of a defined set to be activated in isolation. Nevertheless, some members of the set can be activated in isolation with the MC over motor cortex. Response properties of individual motor units in the extensors of the digits when focally stimulating motor cortex with the figure '8' MC include: (1) Responses are variable to a given stimulus a little above threshold. Comparing responses by individual motor units with that of the population, or with other simultaneously recorded units revealed both coherent and independent sources of variability. (2) The scalp field from which the motor units could be driven by suprathreshold stimulation was of the order of 4-6 cm2. The fields were elongated in the antero posterior axis, possibly related to the similar orientation of the junction region of the figure '8' MC. (3) Motor units initially excited by threshold MC stimulation were typically recruited early during voluntary contraction (confirming Hess et al. 1987).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1773771 TI - Reinforcement of motor evoked potentials in patients with spinal cord injury. AB - Transcranial magnetic stimulation of the motor cortex has been used to investigate the putative existence of spared motor pathways in spinal cord injured patients with clinically complete paralysis. Particular consideration was given to methods of neurological reinforcement likely to minimize the risk of false negative interpretation of absent motor evoked potentials (MEPs). The principal methods of reinforcement included target and remote muscle contractions and conditioning of MEPs with a brief (20 msec) train of cutaneous stimulation (500 Hz: duration 0.1 msec) delivered 20-150 msec prior to cortical stimulation. Twelve control subjects and 26 patients with severe traumatic spinal cord injury underwent cortical stimulation delivered from a Cadwell MES-10 (70-100% intensity) through a 9-cm focal-point coil. Electromyographic responses were recorded from surface electrodes in bipolar configuration and amplified (3 dB down at 10 Hz-1 kHz) prior to storage. MEPs were recorded, following reinforcement, in muscles with clinically complete paralysis in 4/26 patients. In each case, MEPs were of low amplitude (less than 0.5 mV), polyphasic, and with variable and prolonged latencies. MEPs were evoked in severely paretic (clinically incomplete paralysis) muscles in 6/8 patients only when neurological reinforcement was employed. Conditioning of MEPs in tibialis anterior with preceding cutaneous stimulation to the plantar surface (subthreshold for evoking a flexion reflex) yielded a well-defined modulation of MEP amplitude in control subjects. An early (Conditioning-Test (C-T) intervals 20-45 msec) period of inhibition of MEPs (mean = 60% of control) was followed by a period (C-T intervals 50-90 msec) of facilitation (mean = 345%) and a subsequent (C-T intervals 90-150 msec) period of inhibition (mean = 0%). In spinal cord injured patients the same conditioning paradigm failed to reveal MEPs, but did result in the appearance of suprathreshold flexion reflexes in 2 patients at 20-55 msec C-T intervals. This summation of convergent but subliminal cortical and cutaneous inputs to the target motoneuron pool provided additional evidence of preserved cortical influence on segmental structures that was not detectable by other means. These results extend previous reports of electrophysiological evidence of spared motor pathways in spinal cord injured patients with complete paralysis, and affirm the need for neurological reinforcement as a routine procedure in cortical stimulation studies of spinal cord injuries. PMID- 1773772 TI - Magnetic stimulation of corticonuclear systems and of cranial nerves in man: physiological basis and clinical application. AB - After transcranial magnetic brain stimulation, two types of responses in muscles supplied by cranial nerves (trigeminal, facial, accessory, and hypoglosseal nerves) can be observed. With a placement of the coil center approximately 6 cm lateral of the vertex on the interaural line, purely ipsilateral responses can be evoked in the cranial muscles which are induced by excitation of the nerves at or near their intracisternal course ('short-latency' responses). With the coil center 4 cm lateral of the vertex bilaterally 'long-latency' responses can be evoked which are the result of an excitation of that part of the motor cortex which mediates impulses to the motoneurons of cranial nerves via the corticonuclear tract. Evaluations of latencies and amplitudes of the responses in cranial muscles, and of the excitability of their supplying nerves at a proximal site considerably improve the electrophysiological assessment of the site, severity, and prognosis of cranial motor disturbances, especially in facial nerve palsies. PMID- 1773773 TI - Mechanisms of peripheral nervous system stimulation using the magnetic coil. AB - We measured the distribution of the electric fields induced within isotropic and anisotropic volume conductors by figure '8' and round magnetic coils (MCs). For various MC orientations maximal electric fields were induced parallel to the inner surface of the volume conductor. Predictions from physical models roughly approximating human forearm and vertebral column were then tested by MC stimulation of distal median nerve at the wrist and nerve roots at the cervical spine, respectively. Predictions that were confirmed included: (1) Peripheral nerve is most easily excited by a tangential-edge round MC in which current is induced parallel to the long axis of the nerve. As a corollary, peripheral nerve is least excited when the round MC is geometrically bisected by the long axis of the nerve. (2) Peripheral nerve excitation most likely occurs at locations corresponding to the first spatial derivative of the electric field; i.e. where the electrical field is changing most rapidly over distance. For the figure '8' MC, this occurs distally when the anterior divergence of the junction is directed distally. (3) Nerve roots are excited at a relatively constant latency, low threshold location. This site most likely corresponds to the vicinity of the neuroforamina where the induced electric field is most intense and the first spatial derivatives peak. By contrast, the low value of the first derivative in the longitudinal axis of the vertebral canal implies that long tracts in the spinal cord are not likely to be excited using commercially available MCs. Our study also indicates that intracranial stimulation of facial nerve occurs at a selected low threshold location, probably reflecting focusing of induced current. PMID- 1773774 TI - Topographic maps of human motor cortex in normal and pathological conditions: mirror movements, amputations and spinal cord injuries. AB - We studied motor evoked potentials to transcranial magnetic stimulation in patients with unilateral upper limb amputations, complete T10-T12 spinal cord transection, and congenital mirror movements and in controls. Different muscles in the trunk and upper and lower extremities were evaluated at rest. In controls, muscles could be activated with stimulation of regions several centimeters wide. These areas overlapped extensively when muscles studied were from the same limb and shifted positions abruptly when muscles were from different limbs. Distal muscles were easier to activate than proximal muscles and normally evidenced exclusively a contralateral representation. Congenital defects in motor control in patients with mirror movements resulted in marked derangement of the map of outputs of distal hand muscles with enlarged and ipsilateral representations. Peripheral lesions, either acquired (amputations) or congenital (congenital absence of a limb), resulted in plastic reorganization of motor outputs targeting muscles immediately proximal to the stump. Central nervous system lesions (i.e., spinal cord injury producing paraplegia) also resulted in enlargement of the map of outputs targeting muscles proximal to the lesion. These results indicate that magnetic stimulation is a useful non-invasive tool for exploring plastic changes in human motor pathways following different types of injury. PMID- 1773775 TI - Transcranial magnetic stimulation of the facial nerve: where is the actual excitation site? AB - The site where excitation on the facial nerve to transcranial magnetic stimulation occurs was studied by recording the muscle responses of 13 patients who had facial nerve lesions at different locations, and by comparing the latencies of muscle responses to transcranial magnetic and direct electrical stimulation of the facial nerve recorded in another 5 patients undergoing posterior fossa surgery. The results of both approaches of this study led independently to the conclusion that magnetic stimulation acts within the proximal part of the facial canal. It is suggested that the cerebrospinal fluid (CSF) conducts the magnetically induced stimulation currents into the labyrinthine segment of the facial canal, where the facial nerve is still surrounded by CSF for about 10 mm. PMID- 1773776 TI - Transcutaneous magnetic and electrical stimulation over the cervical spine: excitation of plexus roots-rather than spinal roots. AB - Percutaneous magnetic stimulation (MagStim) and electrical stimulation (ElStim) over the cervical spine were performed in 65 subjects. Compound muscle action potentials (CMAPs) from the abductor digiti minimi (ADM) and the biceps muscles (BICEPS) could be recorded in all subjects tested with both, ElStim and MagStim. Maximal stimulation as determined from the amplitudes of CMAPs was possible in most cases with ElStim but not with MagStim. Latencies after MagStim (centered over C7) and ElStim (cathode over C7/T1, anode positioned 6 cm cephalad in the midline) were not statistically significantly different (P = 0.3). However, in the individual case, it was difficult to predict the precise site at which the motor roots would be activated, since latencies of CMAPs to ElStim and MagStim could differ by up to 1.2 msec. In addition, the excitation site migrated distally when the stimulation intensity was increased with the aim to obtain CMAPs of nearly maximal amplitudes. The results of studying brachial plexus stimulation as well in 22 of the subjects led us to the conclusion that excitation of the motor roots occurs on the average 7 cm (range: 1.4-8.2 cm) proximally to Erb's point. This was confirmed by the finding that when the C7 motor root was stimulated directly intraoperatively within the intervertebral foramen, the excitation site was calculated to be 7.7 cm distal to the foramen and 8.4 cm proximal to Erb's point. PMID- 1773777 TI - Mapping of motor cortex gyral sites non-invasively by transcranial magnetic stimulation in normal subjects and patients. AB - Transcranial stimulation offers the opportunity to replace a standard clinical method of invasive brain cortical mapping. A figure '8' magnetic coil with a 1-3 cm area of stimulation is combined with a new method of creating magnetic resonance imaging (MRI) scans which represent the cortical surface (mapping cuts) and thus establishing common landmarks between the MRI and the scalp for cortical mapping. This assigns gyral sights to scalp sites of transcranial stimulation. We report the development and evaluation of these techniques in 6 normals and 10 patients. Cortical maps were shown to enlarge during voluntary contraction. They were variable between individuals, as reported for direct cortical mapping. Maps showed a degree of short and longer term consistency within an individual. The maps were influenced by lesions. They also provided clinical information of the relation of functioning cortex to brain tumors that could influence clinical management including surgical decisions. A consideration of safety of the method in comparison to direct brain stimulation indicates that it falls within existing parameters for electrical stimulation of the brain, and could reduce the risks of the present standard by lowering charge density and the need for invasive methods. Broader application could lead to development of functional imaging methods, which would be a useful preoperative planning tool and investigative method. PMID- 1773778 TI - Studies of sensory and motor cortex physiology: with observations on akinesia in Parkinson's disease. AB - Magnetic stimulation of the brain can be used to investigate sensory and motor physiology and pathophysiology in intact humans. Although uncommon, it is possible for magnetic stimulation over sensorimotor cortex to produce paresthesis. With magnetic stimulation, it is also possible to block the conscious sensation of an electrical shock delivered to the index finger. The magnetic stimulus must be delivered in the interval from 300 msec before to 200 msec after the cutaneous shock and must be delivered over the contralateral hand region of the sensorimotor cortex. In a reaction time situation, the expected voluntary response may be delayed by a magnetic stimulus delivered over the sensorimotor cortex just before the movement. With the use of a relatively weak magnetic stimulus that does not produce a motor evoked potential (MEP) when the body part is at rest, but that will produce a response when the body part is activated, the reaction time can be divided into two periods. In the first period, there is no MEP and the motor cortex remains 'inexcitable'. In the second period, there is a gradual increase in MEP amplitude even though the voluntary electromyographic activity has not yet appeared. This 'excitable' period indicates the activation of motor cortex before the motor command is delivered. Application of this technique to the analysis of prolonged reaction time (akinesia) in patients with Parkinson's disease shows that the excitable period is prolonged. This describes the mechanism underlying the difficulty in the generation of a motor command in these patients. PMID- 1773779 TI - Responses of the epileptic focus to transcranial magnetic stimulation. AB - 48 patients with medically intractable epilepsy were submitted to a total of 60 series of transcranial magnetic stimulation. Effects of transcranial magnetic stimulation were monitored via subdural electrodes. The aim of the study was to investigate the use and reliability of the method for the localization and delineation of the epileptic focus in the process of presurgical evaluation of epilepsy. The following effects of transcranial magnetic stimulation could be observed: (i) Induction of complex partial seizures or auras during (n = 3) or within 5 min after (n = 3) serial stimulation. (ii) Necessity of the presence of additional provocative circumstances for the induction of seizures. (iii) Induction of short-lived epileptiform afterdischarge potentials selectively in the epileptogenic area (or areas) (n = 22). (iv) Enhancement as well as suppression of epileptiform potentials in patients with continuously spiking epileptic foci (n = 7). (v) Temporary interruption of epileptiform paroxysms for 1-3 sec (n = 9). (vi) Persistent suppression of spontaneous spikes (n = 1). (vii) Induction of focal theta or delta activity (n = 26). (viii) No clear-cut response of the epileptic focus (n = 18). (ix) Action of anticonvulsant medication against epileptiform afterdischarge or seizure induction. In conclusion, transcranial magnetic stimulation provides complementary information about the location of the epileptic focus in the process of presurgical evaluation. However, its practical use is limited mainly by its low capability to induce seizures. PMID- 1773781 TI - International Conference on Critical Target Genes in Chemical Carcinogenesis. September 10-14, 1989, North Carolina. PMID- 1773780 TI - Clinical pharmacology of lamotrigine. AB - The pharmacokinetics and pharmacodynamics of lamotrigine (LTG), a new antiepileptic drug (AED), were studied in healthy volunteers. In an open dose escalating study, LTG 240 mg produced peak plasma concentrations of around 3 micrograms/mg with no significant adverse events. Subsequent pharmacokinetic studies revealed complete oral absorption, first-order kinetics with a mean half life of approximately 1 day, and elimination mainly as a glucuronide in the urine. Early studies in patients with epilepsy revealed more rapid metabolism when given with enzyme-inducing AEDs and delayed metabolism by valproate. A placebo-controlled, double-blind study compared LTG 120 and 240 mg with phenytoin (PHT) 500 and 1,000 mg, and diazepam (DZP) 10 mg. Visual analogue scales showed sedation after PHT 1,000 mg and DZP 10 mg, but not after LTG. Smooth pursuit eye movements and adaptive tracking were impaired by DZP and PHT 1,000 mg. LTG did not affect these variables. A comparison of LTG 150 and 300 mg and carbamazepine (CBZ) 200, 400, and 600 mg demonstrated impairment of smooth pursuit and saccadic eye movements by CBZ 600 and 400 mg, but not by LTG. Additionally, CBZ 600 mg impaired adaptive tracking and increased body sway and heart rate. These studies have shown LTG to have desirable and predictable pharmacokinetic properties for an AED. Pharmacodynamic effects were absent, suggesting a high therapeutic index. PMID- 1773782 TI - Identification of genes associated with tumor suppression in Syrian hamster embryo cells. AB - Loss of a tumor-suppressor gene function appears to play a critical role in the multistep process of neoplastic transformation of Syrian hamster embryo (SHE) cells in vitro. Clonal variants of two independent, preneoplastic cell lines have been isolated that have either retained (termed supB+) or lost (termed supB-) the ability to suppress the tumorigenicity of a highly malignant benzo[alpha]pyrene transformed SHE cell line (BP6T) in cell hybrids. We have pursued several approaches in an attempt to identify genes that are responsible for tumor suppression in these cells. The only consistent differences detected in two dimensional gel analyses of supB+ and supB- cellular proteins were decreases in the levels of two high molecular weight isoforms of tropomyosin in supB- cells. Differential screening of a supB+ cDNA library for genes that are preferentially expressed in supB+ cells yielded cDNA clones for four genes, i.e., collagen type II, collagen type IX, H19, and a previously unidentified gene (clone 5). Nuclear run-on assays suggested that higher transcription rates were responsible for the increased steady-state levels of some of these transcripts in supB+ cells. DNA sequence comparisons showed that two copies of a 9 bp element, previously identified in each of the mouse H19 enhancers, were also present in the 5' flanking region of the rat type II collagen gene. A transcription factor that controls expression of the collagen and H19 genes through binding to this conserved motif would be an attractive candidate for the supB+ gene or at least a mediator of the supB+ phenotype. PMID- 1773783 TI - Three-dimensional structure of p21 in the active conformation and analysis of an oncogenic mutant. AB - The three-dimensional structure of the active guanosine triphosphate (GTP) analogue-containing complex of the H-ras-encoded p21 has been determined. It was necessary to correct the topology of p21 as published earlier. The structure analysis shows all of the interactions between protein and GTP and how the important cofactor Mg2+ is bound. From the oncogenic mutants of p21 crystallized, a Gly12 to Arg mutation has been analyzed in detail. It shows that the overall structure of the mutant is not perturbed and that the side chain of Arg12 is coming close to the gamma-phosphate for an interaction. PMID- 1773784 TI - Gene regulation and genetic susceptibility to neoplastic transformation: AP-1 and p80 expression in JB6 cells. AB - The mouse epidermal JB6 cell system consists of clonal genetic variants that are sensitive (P+) or resistant (P-) to the promotion of neoplastic transformation by phorbol esters and other tumor-promoting agents. P+ cells display AP-1-dependent phorbol-ester-inducible transactivation of gene expression, whereas P- cells have a defect in transactivation. Transfection of promotion sensitivity gene pro-1 into P- cells reconstituted both P+ phenotype and AP-1-dependent phorbol-ester inducible transactivation. P- and P+ cells exhibited induction of c-jun and c-fos messenger RNA levels by phorbol ester, but P- cells had significantly lower basal and induced levels of jun mRNA than P+ cells. Basal and induced levels of c-jun protein were significantly lower in P- cells as well. Differences in levels the 80-kDa pI 4.5 protein p80 were also observed in JB6 cells as a function of preneoplastic progression; high levels of p80 protein and mRNA were observed in P cells, intermediate levels in P+ cells, and negligible levels were observed in transformed derivatives of JB6 cells. Phorbol ester treatment induced phosphorylation but not synthesis of p80. These data are consistent with the hypotheses that AP-1 is required in the signal transduction pathway for promotion of neoplastic transformation by tumor promoter, that pro genes may control AP-1 activity, that threshold levels of Jun mRNA and protein may play a role in transactivation and promotion sensitivity, and that the p80 protein in JB6 cells may behave in vivo as a suppressor of cellular transformation. PMID- 1773785 TI - Activation of proto-oncogenes in human and mouse lung tumors. AB - Lung cancer is a leading cause of cancer-related deaths in several nations. Epidemiological studies have indicated that 85% of all lung cancer deaths and 30% of all cancer deaths in the U.S. are associated with tobacco smoking. Various chemicals in tobacco smoke are thought to react with DNA and to ultimately yield heritable mutations. In an effort to understand the molecular mechanisms involved in lung tumorigenesis, we have analyzed proto-oncogene activation in a series of human lung tumors from smokers and spontaneously occurring and chemically induced lung tumors in mice. Approximately 86% of the human lung tumors and greater than 90% of the mouse lung tumors were found to contain activated oncogenes. ras Oncogenes activated by point mutations were detected in many of the human lung adenocarcinomas and virtually all of the mouse lung adenomas and adenocarcinomas. The mutation profiles of the activated K-ras genes detected in the chemically induced mouse lung tumors suggest that the observed mutations result from genotoxic effects of the chemicals. Comparison of the K-ras mutations observed in the human lung adenocarcinomas with mutation profiles observed in the mouse lung tumors suggest that bulky hydrophobic DNA adducts may be responsible for the majority of the mutations observed in the activated human K-ras genes. Other data indicate that approximately 20% of human lung tumors contain potentially novel transforming genes that may also be targets for mutagens in cigarette smoke. PMID- 1773787 TI - Genetic regulation of mammary carcinogenesis in the rat by susceptibility and suppressor genes. AB - Rat strains differ in their susceptibilities to mammary carcinogenesis. Strains such as Wistar-Furth are very susceptible to chemically induced carcinogenesis. This phenotype is controlled by autosomally dominant susceptibility genes. Strains such as the Copenhagen are resistant to spontaneous and induced mammary carcinogenesis. This phenotype is controlled by an autosomal dominant gene termed the mammary carcinoma suppressor (MCS). Strains with intermediate susceptibility such as the F344 carry neither the MCS nor susceptibility genes. Both the MCS and susceptibility genes are chiefly active within the mammary parenchyma. Both genes act at carcinogenesis stages beyond carcinogen metabolism and DNA adduction. The MCS gene completely inhibits both palpable and microcarcinomas. It does not inhibit focal alveolar hyperplasias. Its gene product acts solely within the mammary epithelial cell in which it is produced. We are currently investigating the interactions of various oncogenes and the MCS gene. In addition, efforts are underway to identify and clone this gene. PMID- 1773788 TI - Loss of amplified genes by poly(ADP-ribose) polymerase inhibitors. AB - A poly(ADP-ribose) polymerase inhibitor, benzamide (BA), was found to induce flat revertants of NIH 3T3 cells that had been transformed by human Ha-ras, rat Ki ras, rat c-raf, and human ret-II. These genes had been amplified in original transformants, but they were completely eliminated by BA. Contrary to this, endogenous activated Ha-ras in a human bladder carcinoma cell line, T24, was not eliminated by BA. The gene loss seemed to be restricted to exogenous and/or amplified sequences. BA also eliminated the amplified c-myc gene in HL-60 cells, concomitant with differentiation into granulocytes. We demonstrated that the amplified c-myc gene was not present as episomes. It is probably present as double minutes or a homogeneously staining region. Dimethylsulfoxide also induced differentiation at a concentration that did not inhibit poly(ADP-ribose) polymerase. The cell lost the c-myc gene in association with this differentiation. The amplified c-myc gene in a colon adenocarcinoma cell line, COLO 320HSR, and the amplified mdr-1 gene in an adriamycin-resistant myelogenous leukemia cell line, K562/ADM, were not eliminated by BA. Various poly(ADP-ribose) polymerase inhibitors also eliminated human Ha-ras in the NIH 3T3 transformant and the c-myc gene in HL-60 cells. PMID- 1773786 TI - Genetic studies on lung tumor susceptibility and histogenesis in mice. AB - The probability that a mouse develops a pulmonary tumor, as well as the structure of that tumor, are dependent on several genes. Three pulmonary adenoma susceptibility (pas) genes predispose some inbred strains to develop lung tumors, even in the absence of carcinogen exposure, and cause others to be resistant. One pas gene is K-ras, which may also be overexpressed in these tumors in a mutated form capable of transforming cells. Mice with activated Ha-ras transgenes override the resistant pas alleles and are born with lung cancer. Susceptible strains have a higher turnover rate of alveolar type II and bronchiolar Clara cells, those cells from which lung tumors arise, than more resistant strains. A high precursor cell turnover rate correlates with a propensity to neoplasia in other animal models as well, possibly due to low concentrations of endogenous growth regulatory molecules such as corticosterone and protein kinase C (PKC). Neoplastic lung epithelial cells are relatively resistant to glucocorticoids and have low PKC levels. A set of genes other than the pas genes governs the response to tumor modulation by butylated hydroxytoluene (BHT). The genes that determine whether lung tumor multiplicity is enhanced by chronic BHT exposure may regulate the ability to hydroxylate BHT at a tert-butyl position to form BHT-OH, a metabolite with greater tumor-promoting potency than BHT. Inbred and recombinant inbred strain variations in adenoma growth patterns indicate that another set of genes, which we have designated pah for pulmonary adenoma histogenesis, may determine which cell type becomes neoplastic and whether adenomas will undergo malignant conversion. PMID- 1773789 TI - GTP-binding proteins as oncogenes in human tumors. PMID- 1773790 TI - Nonmutagenic mechanisms in carcinogenesis: role of protein kinase C in signal transduction and growth control. AB - There is accumulating evidence that the multistage carcinogenic process is associated with the progressive acquisition of mutations in cellular proto oncogenes and in growth-suppressor genes. At the same time, several types of evidence indicate that nongenotoxic agents and epigenetic events also play an important role in the evolution of tumors. One of the most intensively studied nongenotoxic agents is the phorbol ester tumor promoter 12-O-tetradecanoyl phorbol-13-acetate (TPA) and related compounds. Since TPA appears to exert its biologic effects through protein kinase C (PKC), a key enzyme in signal transduction, we have studied this enzyme in considerable detail. Our strategy has been to perturb signal transduction by developing cell lines that overexpress the beta 1 isoform of PKC. Such derivatives of rat fibroblasts display alterations in morphology and growth factors, altered expression of c-myc, ornithine decarboxylase, and phorbin, and increased susceptibility to transformation by certain oncogenes, H-ras, myc, and fos. These findings provide direct genetic evidence that PKC plays a critical role in growth control and the action of certain growth factors, tumor promoters, and oncogenes. In related studies, we have characterized the beta 1 isoform that is overproduced in the above cell systems in terms of its biochemical, kinetic, and immunologic properties. The enzyme has several properties characteristic of native PKCs. A surprising finding is that c-H-ras-transformed derivatives of the cells that overexpress PKC beta 1 display a several-fold increase in the expression of the endogenous alpha 1 isoform of PKC and a decrease in the expression of the endogenous epsilon isoform.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1773791 TI - ras activation in human tumors and in animal model systems. AB - Environmental agents such as radiation and chemicals are known to cause genetic damage. Alterations in a limited set of cellular genes called proto-oncogenes lead to unregulated proliferation and differentiation. We have studied the role of the ras gene family in carcinogenesis using two different animal models. In one case, thymic lymphomas were induced in mice by either gamma or neutron radiation, and in the other, keratoacanthomas were induced in rabbit skin with dimethylbezanthracene. Human keratoacanthomas similar to the ones induced in rabbits were also analyzed. We found that different types of radiation such as gamma rays and neutrons, induced different point mutations in ras genes. A novel K-ras mutation in codon 146 has been found in thymic lymphomas induced by neutrons. Keratoacanthomas induced in rabbit skin by dimethylbenzanthracene show a high frequency of H-ras-activated genes carrying a mutation in codon 61. The same is observed in human keratoacanthomas, although mutations are in both the 12th and the 61st codons of the H-ras gene. H-ras activation is less frequent in human squamous cell carcinomas than in keratoacanthomas, suggesting that ras genes could play a role in vivo in differentiation as well as in proliferation. PMID- 1773792 TI - Is there a critical target gene for the first step in carcinogenesis? AB - Our work has suggested that a high-frequency event is involved in the initiation phase of malignant transformation in vitro; a later, mutationlike event appears to be involved in the later stages of transformation. There may be no specific "target gene" which directly interacts with carcinogens. It is hypothesized that nonspecific types of DNA damage are involved in the induction of an ongoing process we know as carcinogenesis. Several genes could be involved in maintaining this process. Our recent results suggest that c-myc and c-fos could be involved in the early stages of carcinogenesis, as they are affected by anticarcinogenic protease inhibitors in a manner that corresponds to the way in which protease inhibitors suppress malignant transformation. PMID- 1773793 TI - Skeletal concentrations of lead, cadmium, zinc, and silver in ancient North American Pecos Indians. AB - Bone samples of 14 prehistoric North American Pecos Indians from circa 1400 A.D. were analyzed for lead, cadmium, zinc, and silver by graphite furnace atomic absorption spectrometry to establish the baseline levels of these elements in an ancient North American population. Measurements of outer and inner bone fractions indicate the former were contaminated postmortem for lead, zinc, and cadmium. The contamination-adjusted average (mean +/- SD) level of lead (expressed as the ratio of atomic lead to atomic calcium) in bones of the Indians was 8.4 +/- 4.4 x 10(-7)), which was similar to ratios in bones of ancient Peruvians (0.9 to 7.7 x 10(-7)) and significantly lower than ratios in bones of modern adults in England and the United States (210 to 350 x 10(-7]. The adjusted average concentrations (microgram per gram dry weight) of biologic cadmium, silver, and zinc in the Pecos Indian bones were 0.032 +/- 0.013, 0.094 +/- 0.044, and 130 +/- 66, as compared to concentrations of 1.8, 0.01 to 0.44, and 75 to 170 in the bones of modern people, respectively. Therefore, cadmium concentrations in Pecos Indian bones are also approximately 50-fold lower than those of contemporary humans. These data support earlier findings that most previously reported natural concentrations of lead in human tissues are erroneously high and indicate that natural concentrations of cadmium are also between one and two orders of magnitude lower than contemporary concentrations. PMID- 1773794 TI - Ultrastructural immunohistochemical localization of Clara cell secretory protein in pulmonary epithelium of rabbits. AB - Highly purified Clara cells (93 +/- 3%) isolated from the lungs of rabbits were used to produce an antiserum against Clara cell secretory proteins. This antiserum was used to identify and study the biosynthesis and secretion of [35S]methionine-labeled proteins from isolated Clara cells. The antiserum recognized one major secretory protein with apparent molecular weight of 6 kDa and reacted weakly with a higher molecular weight protein of about 180 kDa. Biosynthesis and secretion of these proteins was not detected in preparations of isolated alveolar type II cells or alveolar macrophages. Immunocytochemical localization of the antigen with colloidal gold indicated a dual localization in bronchiolar Clara cells. Gold labeling was found over the osmiophilic secretory granules of Clara cells and smooth endoplasmic reticulum. In tracheal Clara cells, labeling was found mostly in association with secretory granules and relatively little in association with the smooth endoplasmic reticulum. Labeling was also found over the lamellar bodies of type II cells, although the reaction was weak. Labeling of ciliated cells, alveolar type I cells, capillary endothelial cells, and alveolar macrophages was not distinguishable from background. These data indicate that Clara cells of both the bronchioles and trachea of rabbits synthesize and secrete the low molecular weight protein previously called Clara cell secretory protein (CCSP). This antigen does not belong to that group of surfactant proteins whose molecular weights range from 26 to 40 kDa. PMID- 1773795 TI - Target organs in chronic bioassays of 533 chemical carcinogens. AB - A compendium of carcinogenesis bioassay results organized by target organ is presented for 533 chemicals that are carcinogenic in at least one species. This compendium is based primarily on experiments in rats or mice; results in hamsters, nonhuman primates, and dogs are also reported. The compendium can be used to identify chemicals that induce tumors at particular sites, and to determine whether target sites are the same for chemicals positive in more than one species. The Carcinogenic Potency Database (CPDB), which includes results of 3969 experiments, is used in the analysis. The published CPDB includes details on each test, and literature references. Chemical carcinogens are reported for 35 different target organs in rats or mice. More than 80% of the carcinogens in each of these species are positive in at least one of the 8 most frequent target sites: liver, lung, mammary gland, stomach, vascular system, kidney, hematopoietic system, and urinary bladder. An analysis is presented of how well one can predict the carcinogenic response in mice from results in rats, or vice versa. Among chemicals tested in both species, 76% of rat carcinogens are positive in mice, and 71% of mouse carcinogens are positive in rats. Prediction is less accurate to the same target site: 52% of rat carcinogens are positive in the same site in mice, and 48% of mouse carcinogens are positive in the same site in rats. The liver is the most frequent site in common between rats and mice. PMID- 1773796 TI - Chemicals associated with site-specific neoplasia in 1394 long-term carcinogenesis experiments in laboratory rodents. AB - The carcinogenicity data base used for this paper originated in the late 1960s by the National Cancer Institute and since 1978 has been continued and made more comprehensive by the National Toxicology Program. The extensive files contain among other sets of information detailed pathology data on more than 400 long term (most often 24 month) chemical carcinogenesis studies, comprised of nearly 1600 individual experiments having at least 10 million tissue sections that have been evaluated for toxicity and carcinogenicity. Using the current data set of 379 studies made up of 1394 experiments, we have compiled listings of chemicals having like carcinogenic target sites for each of the 34 organs or systems for which histopathology diagnoses have been recorded routinely. The most common tumor site is the liver (15% of all experiments), followed in rank order by: lung, hematopoietic system and kidneys, mammary glands, forestomach, thyroid glands, Zymbal glands, urinary bladder, skin and uterus/cervix, and circulatory system and adrenal glands. These compilations are most useful for maintaining a historic perspective when evaluating the carcinogenicity of contemporary experiments. Equally important, the chemical-tumor-organ connection permits an evaluation of how well chemically induced cancers in a particular organ in one sex or species will predict or correlate with the other sex or species. Using liver cancers as an example, the overall interspecies concordance is 80%. Likewise target site predictions can be made for chemicals selected for study that may be similar to those already evaluated; thereby experimental protocols could be adjusted to allow, for example, more extensive pathology on preselected target organs (i.e., serial sections of the kidney). Further from these observations, one could decide to use two strains of mice to evaluate a short chain chlorinated aliphatic compound or to study a human carcinogen in a sex species known to develop chemically induced tumors in the same site observed in humans. Structural classes of chemicals having a propensity for certain organs can be easily identified from these data. Sex-species responders to particular induced cancers become clearly evident, such as in the ovary of female mice or in the kidney of male rats. PMID- 1773797 TI - Frequency and spectrum of c-Ki-ras mutations in human sporadic colon carcinoma, carcinomas arising in ulcerative colitis, and pancreatic adenocarcinoma. AB - Sporadic colon carcinomas, carcinomas arising in chronic ulcerative colitis, and pancreatic adenocarcinomas have been analyzed for the presence of c-Ki-ras mutations by a combination of histological enrichment, cell sorting, polymerase chain reaction, and direct sequencing. Although 60% (37/61) of sporadic colon carcinomas contained mutations in codon 12, only 1 of 17 specimens of dysplasia or carcinoma from ulcerative colitis patients contained c-Ki-ras mutations, despite a high frequency of aneuploid tumors. In contrast, a higher percentage (16/20 = 80%) of pancreatic adenocarcinomas contained mutations in c-Ki-ras 2, despite a lower frequency of DNA aneuploidy in these neoplasms. Moreover, the spectrum of mutations differed between sporadic colon carcinoma, where the predominant mutation was a G to A transition, and pancreatic carcinomas, which predominantly contained G to C or T transversions. These results suggest that the etiology of ras mutations is different in these three human neoplasms. PMID- 1773798 TI - Sequential measurements of bone lead content by L X-ray fluorescence in CaNa2EDTA treated lead-toxic children. AB - With the development of L X-ray fluorescence (LXRF) to measure cortical bone lead directly, safely, rapidly, and noninvasively, the present study was undertaken to a) evaluate LXRF as a possible replacement for the CaNa2EDTA test; b) quantify lead in tibial cortical bones of mildly to moderately lead-toxic children before treatment; and c) quantify lead in tibial cortical bones of lead-toxic children sequentially following one to two courses of chelation therapy. The clinical research design was based upon a longitudinal assessment of 59 untreated lead toxic children. At enrollment, if the blood lead (PbB) was 25 to 55 micrograms/dL and the erythrocyte protoporphyrin (EP) concentration was greater than or equal to 35 micrograms/dL, LXRF measurement of tibial bone lead was carried out. One day later, each child underwent a CaNa2EDTA provocative test. If this test was positive, lead-toxic children were admitted to the hospital for 5 days of CaNa2EDTA therapy. These tests were repeated 6 weeks and 6 months after enrollment. Abatement of lead paint hazards was achieved in most apartments by the time of initial hospital discharge. The LXRF instrument consists of a low energy X-ray generator with a silver anode, a lithium-doped silicon detector, a polarizer of incident photons, and a multichannel X-ray analyzer. Partially polarized photons are directed at the subcutaneous, medial mid-tibial cortical bone. The LXRF spectrum, measured 90 degrees from the incident beam, reveals a peak in the 10.5 KeV region, which represents the lead L alpha line.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1773799 TI - Alterations in epidermal biochemistry as a consequence of stage-specific genetic changes in skin carcinogenesis. AB - The induction of cancer on mouse skin by initiation-promotion protocols occurs through stages in which a benign squamous papilloma is an obligate precursor of squamous cell carcinoma. Activation of the Ha-ras gene is sufficient to produce the papilloma phenotype, while additional genetic changes are required for malignant conversion. The introduction of Ha-ras into normal keratinocytes suppresses the expression of differentiation markers, keratin K1 and K10, and loricrin (a cornified envelope precursor) and, to a lesser extent, filaggrin, at the level of transcription. However, cells initiated by Ha-ras express a nonepidermal keratin, K8. The transcription of K8 in these cells is sensitive to the level of medium Ca2+, being abundant in 0.5 mM Ca2+ and not detected in 0.05 mM Ca2+. Epidermal differentiation is regulated by signalling, which involves changes in phosphatidylinositol turnover and intracellular Ca2+. Cells initiated by Ha-ras do not differ from normal keratinocytes in their intracellular Ca2+ response patterns, at least in response to changes in extracellular Ca2+ and serum factors. However, c-Ha-ra keratinocytes have a high basal level of phosphatidylinositol (PI) turnover, which is additive with several other inducers of this pathway, including Ca2+ and aluminum fluoride. Additional studies suggest that high turnover of the PI pathway is incompatible with differentiation specific gene expression in keratinocytes. We suggest this negative relationship is mediated through elevated diacylglycerol production and chronic down modulation of protein kinase C. Protein kinase C is known to be essential for expression of differentiation-related genes in keratinocytes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1773801 TI - Differential gene expression during multistage carcinogenesis. AB - The use of the mouse skin multistage model of carcinogenesis has aided our understanding of critical target genes in chemical carcinogenesis. The mutagenic activation of the Harvey-ras proto-oncogene has been found to be an early event associated with the initiation of mouse skin tumors by the polycyclic aromatic hydrocarbon 7,12 dimethylbenz[alpha]anthracene and the pure initiator ethyl carbamate (urethane). In contrast to chemical initiation of mouse skin tumors, ionizing radiation-initiated malignant skin tumors have been shown to possess distinct non-ras transforming gene(s). Differential screening of cDNA libraries made from chemically initiated malignant skin tumors has been used to identify a number of cellular gene transcripts that are overexpressed during mouse skin tumor progression. These differentially expressed genes include beta-actin, ubiquitin, a hyperproliferative keratin (K6), a gene whose product is a member of a fatty acid or lipid-binding protein family, and a gene called transin or stromelysin. The overexpression of the stromelysin gene, which encodes a metalloproteinase that degrades proteins in the basement membrane, is hypothesized to play a functional role in malignant tumor cell invasion and metastasis. We believe that the cloning, identification, and characterization of gene sequences that are differentially expressed during tumor progression could lead to the discovery of gene products that either play functional roles in skin tumor progression or in the maintenance of various progressive tumor phenotypes. PMID- 1773800 TI - Oncogenes and radiation carcinogenesis. AB - Current research indicates a role for several oncogenes in radiation-induced carcinogenesis in vivo and cell transformation in vitro. Certain oncogenes are probably also involved in some cases of human cancer caused by exposure to nonionizing radiation and may play a mechanistic role in the phenomenon of radioresistance seen in later stages of tumor progression. The mechanisms of oncogene activation seen in radiation-induced tumors include point mutations, gene amplification, and changes in gene expression. Genetic factors associated with target species, strain, and tissue type play an important role in determining the specific nature of oncogene activation by radiation exposure. Using the rat skin as a model for cancer induction by ionizing radiation, we found concurrent activation of K-ras and c-myc oncogenes in end-stage tumors. Amplification of the myc gene proved to occur during a late stage of tumor progression and is not an early initiating event resulting from the direct action of radiation on target cells. The importance of tissue specificity, tumor cell heterogeneity, and physical characteristics of the radiation exposure are discussed. PMID- 1773802 TI - Lessons learned from studies on tumor suppression by microcell-mediated chromosome transfer. PMID- 1773803 TI - Drosophila as a model system for molecular analysis of tumorigenesis. AB - In Drosophila, homozygous mutations in a series of genes can cause the appearance of tissue-specific tumors. These tumors occur either during embryonic or larval development. The majority of the identified genes give rise to larval tumors that affect either the presumptive adult optic centers of the brain, the imaginal discs, the hematopoietic organs, or the germ cells. These genes act as recessive determinants of neoplasia and have been designated as tumor-suppressor genes. They are normally required for the regulation of cell proliferation and cell differentiation during development. Among these genes, the lethal(2)giant larvae (l(2)gl) has been best studied. Homozygous mutations in l(2)gl produce malignant tumors in the brain hemispheres and the imaginal discs. The l(2)gl gene has been cloned, introduced back into the genome of l(2)gl-deficient animals, and shown to restore normal development. The nucleotide sequence of the l(2)gl gene has been determined, as well as the sequence of its transcripts. Anti-l(2)gl antibodies recognize a protein of about 130 kDa that corresponds to the major product of l(2)gl transcripts. Analysis of the spatial distribution of l(2)gl transcripts and proteins revealed a first phase of intensive expression during embryogenesis and a second weaker phase during the larval to pupal transition period. As revealed by mosaic experiments, the critical period of l(2)gl expression for preventing tumorigenesis takes place during early embryogenesis. During this period, the l(2)gl protein is ubiquitously expressed in all cells and tissues, while during late embryogenesis expression becomes gradually restricted to the midgut epithelium and the axon projections of the ventral nervous system that show no phenotypic alteration in the mutant animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1773804 TI - Genetic analysis of the K-rev-1 transformation-suppressor gene. AB - Flat revertants with reduced malignancy in vivo can be isolated from Kirsten sarcoma virus-transformed NIH 3T3 cells (DT line) following transfection with a normal human fibroblast cDNA expression library. We have recovered from one such revertant a 1.8-kb cDNA clone, K-rev-1, that exhibits an activity of inducing flat revertants at certain frequencies (2-5% of total transfectants) when transfected into DT cells. The K-rev-1 cDNA has the capacity to encode a protein with a calculated molecular weight of 21,000, having strong structural similarity to ras proteins (approximately 50% homology), especially in their guanosine triphosphate/guanosine diphosphate-binding, effector-binding, and membrane attachment domains. Toward understanding the mechanism of action of K-rev-1 protein, we constructed a series of point mutants of K-rev-1 cDNA and tested their biological activities. Substitutions of the amino acid residues in the putative guanine nucleotide-binding regions (Asp17 and Asn116), in the putative effector-binding domain (residue 38), at the putative acylation site (Cys181), and at the unique Thr61 all decreased the transformation-suppressor activity. On the other hand, substitutions including Gly12 to Val12, Ala59 to Thr59, and Gln63 to Glu63 were found to significantly increase the transformation-suppressor activity of K-rev-1. These findings are consistent with the idea that K-rev-1 protein is regulated like many other G-proteins by guanine triphosphate/guanine diphosphate-exchange mechanism probably in response to certain negative growth regulatory signals. PMID- 1773805 TI - Molecular and functional analysis of tumor-suppressor genes by transfection. AB - The transformed and tumorigenic phenotype of H-ras transfected rat FE-8 cells can be suppressed by cell fusion with normal rat embryo fibroblasts. Transfection into FE-8 cells of DNA prepared from normal human placenta followed by selective elimination of tumorigenic transfected cell clones resulted in the isolation of phenotypically normal revertants. These cells exhibited a fibroblastlike, normal morphology; were anchorage-dependent; and were unable to proliferate in medium with reduced serum concentrations. Their tumorigenicity was also reduced. The suppressed phenotype has been transferred in a second transfection cycle. Human repetitive DNA sequences were detected in secondary transfectant DNA. A putative human suppressor gene, designated NTS-1, has been molecularly cloned. Reintroduction of cloned NTS-1 sequences into FE-8 cells resulted in suppression of the neoplastic phenotype in spite of a high ras expression. PMID- 1773806 TI - Molecular determinants of metastatic transformation. AB - In recent years, experimental systems have developed to analyze genetic and epigenetic regulation of the metastatic phenotype. Numerous studies have uncovered a potent role for transforming oncogenes in metastatic conversion. In addition, it has been shown that oncoprotein products operate in a dose-dependent fashion. The continued expression of oncoproteins is required to induce and regulate metastatic dissemination of tumor cells and, consequently, many of the signal transduction pathways that are controlled by the oncogene products can regulate metastasis. Exogenous growth factors that act through these same pathways also alter metastatic potential. Some primary and immortalized cells can be transformed by oncogenes but remain completely benign and nonmetastatic. Malignant transformation can be achieved in these cells through the cooperative interaction of specific oncogenes or loss of active suppression regulated by recessive genetic determinants. Therefore, it is likely that tumor cells acquire the metastatic phenotype through the cooperative interaction of dominant and recessive genetic alterations. This model is consistent with the correlative data accumulating in studies of human tumor specimens where more malignant carcinomas often contain both activating mutations in oncogenes and either inactivating mutations or loss of tumor-suppressor genes. PMID- 1773807 TI - Eccentric and posteccentric contractile behaviour of skeletal muscle: a comparative study in frog single fibres and in humans. AB - Eccentric and posteccentric force behaviour in human skeletal muscle and in isolated frog muscle fibres was studied by imposing stretch-and-hold loading conditions during contractions with maximal voluntary effort or under tetanic stimulation in the isolated preparations. The investigations on human muscle were made on the forearm flexors of a group of kayak racers (n = 16; age: 17-22 years) and of schoolgirls (n = 15; age: 17-18 years) with both groups participating in a strength-training programme over 4 (kayak racers) or 3 (girls) months. Half of the training regime consisted of eccentric elements. In the isolated muscle fibres, it could be shown that in the posteccentric hold phase the enhanced force decayed exponentially to the original isometric value with a mean time-constant of 0.35 s (10 degrees C) and of 0.23 (20 degrees C). In the forearm flexor of human subjects similar results were obtained not only qualitatively but even quantitatively (time constant of posteccentric force decay: 0.25-0.37 s). Strength training in both groups did not lead to an enhancement in maximal isometric force alone [mean increase in force 17 (SD 10)%], a well-known and generally accepted fact, but also to a parallel shift in eccentric [21 (SD 10)%] and posteccentric force level. The close similarity between the findings in isolated muscle fibres and in human muscle in situ suggests that the eccentric and posteccentric behaviour must be primarily ascribed to the contractile properties of the muscle fibres themselves. A three-element muscle model with variable visco-elastic properties would appear to be most suitable for simulating the experimental findings. PMID- 1773808 TI - Cardiovascular responses and electroencephalogram disturbances to intermittent noises: effects of nocturnal heat and daytime exposure. AB - During sleep, in thermoneutral conditions, the noise of a passing vehicle induces a biphasic cardiac response, a transient peripheral vasoconstriction and sleep disturbances. The present study was performed to determine whether or not the physiological responses were modified in a hot environment or after daytime exposure to both heat and noise. Eight young men were exposed to a nocturnal thermoneutral (20 degrees C) or hot (35 degrees C) environment disturbed by traffic noise. During the night, the peak intensities were of 71 dB(A) for trucks, 67 dB(A) for motorbikes and 64 dB(A) for cars. The background noise level (pink noise) was set at 30 dB(A). The noises were randomly distributed at a rate of 9.h-1. Nights were equally preceded by daytime exposure to combined heat and noise or to no disturbance. During the day, the noises as well as the background noise levels were increased by 15 dB(A) and the rate was 48.h-1. Electroencephalogram (EEG) measures of sleep, electrocardiograms and finger pulse amplitudes were continuously recorded. Regardless of the day condition, when compared with undisturbed nights, the nocturnal increase in the level of heart rate induced by heat exposure disappeared when noise was added. Percentages, delays, magnitudes and costs of cardiac and vascular responses as well as EEG events such as transient activation phases (TAP) due to noise were not affected by nocturnal thermal load or by the preceding daytime exposure to disturbances.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1773809 TI - The influence of dietary manipulation on plasma ammonia accumulation during incremental exercise in man. AB - The influence of a pattern of exercise and dietary manipulation, intended to alter carbohydrate (CHO) availability, on pre-exercise acid-base status and plasma ammonia and blood lactate accumulation during incremental exercise was investigated. On three separate occasions, five healthy male subjects underwent a pre-determined incremental exercise test (IET) on an electrically braked cycle ergometer. Each IET involved subjects exercising for 5 min at 30%, 50%, 70% and 95% of their maximal oxygen uptake (VO2max) and workloads were separated by 5 min rest. The first IET took place after 3 days of normal dietary CHO intake. The second and third tests followed 3 days of low or high CHO intake, which was preceded by prolonged exercise to exhaustion in an attempt to deplete muscle and liver glycogen stores. Acid-base status and plasma ammonia and blood lactate levels were measured on arterialised venous blood samples immediately prior to and during the final 15 s of exercise at each workload and for 40 min following the completion of each IET. Three days of low CHO intake resulted in the development of a mild metabolic acidosis in all subjects. Plasma ammonia (NH3) accumulation on the low-CHO diet tended to be greater than normal at each exercise workload. Values returned towards resting levels during each recovery period. After the normal and high-CHO diets plasma NH3 levels did not markedly increase above resting values until after exercise at 95% VO2max. Plasma NH3 levels after the high-CHO diet were similar to those after the normal CHO diet.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1773810 TI - Significance of skin temperature changes in surface electromyography. AB - Differing results have been reported concerning the direction and quantity of the electromyogram (EMG) amplitude response to changes in tissue temperature. The EMG signals from the soleus muscle of six healthy human subjects were therefore recorded during dynamic exercise (concentric contractions) at ambient temperatures of 30 degrees C and 14 degrees C. The mean skin temperature (Tsk) above the muscle investigated was 32.9 degrees C and 21.7 degrees C, respectively. The core temperature, estimated by rectal temperature, was unchanged. The cooling of the superficial tissues caused approximately a doubling of the EMG amplitude. For the probability level 0.9 in the amplitude probability distribution function, the average signal level increased from 73 microV to 135 microV (P = 0.02). The average mean power frequency of the EMG signal was reduced from 142 Hz to 83 Hz (P = 0.004). The amplitude increase was not due to shivering but other possible explanations are presented. As the changes in Tsk investigated were within the range which may occur normally during the working hours, it was concluded that Tsk should be carefully controlled in vocational EMG studies. PMID- 1773811 TI - Effect of work rate increment on peak oxygen uptake during wheelchair ergometry in men with quadriplegia. AB - The purpose of this study was to determine the effect of work rate increment on peak oxygen uptake (VO2 peak) during wheelchair ergometry (WCE) in men with quadriplegia due to cervical spinal cord injuries (CSCI). Twenty-two non ambulatory subjects (aged 20-38 years) with CSCI were divided into two groups based on wheelchair sports classification (n = 12 for IA group and n = 10 for IB/IC group). Subjects underwent three different, continuous graded exercise tests (spaced at least 1 week apart) on an electronically braked wheelchair ergometer. Following a 3-min warmup, the work rate was increased 2, 4, or 6 W.min 1 for the IA group and 4, 6, or 8 W.min-1 for the IB/IC group. Ventilation and gas exchange were measured breath-by-breath with a computerized system. Repeated measures ANOVA showed no significant difference among the three protocols for VO2 peak in the IA group (P greater than 0.05). The mean (SD) VO2 peak values (ml.kg 1.min-1) were 9.3 (2.4), 9.4 (3.2), and 8.4 (2.6) for the 2, 4, and 6 W.min-1 protocols, respectively. In contrast, the IB/IC group showed a significant difference among the protocols for VO2 peak (P less than 0.05). The mean (SD) VO2 peak values (ml.kg-1,min-1) were 15.1 (4.0), 14.1 (4.4), and 12.7 (4.0) for the 4, 6, and 8 W.min-1 protocols, respectively. Post hoc analysis revealed a difference between the 4 and 8 W.min-1 protocols. Our results suggest that graded exercise testing of men with quadriplegia due to CSCI, using WCE, should employ work rate increments between 2 and 6 W.min-1 and that work rate increments of 8 W.min-1 or greater will result in an underestimate of VO2 peak. PMID- 1773812 TI - Muscle metabolism during 30, 60 and 90 s of maximal cycling on an air-braked ergometer. AB - This study examined the anaerobic and aerobic contributions to muscle metabolism during high intensity short duration exercise. Six males [mean (SD): age 25.0 (6.0) years, height 179.0 (8.2) cm, mass 70.01 (7.42) kg, VO2max 4.63 (0.53) l.min-1, body fat 12.7 (2.3)%] performed three counterbalanced treatments of 30, 60 and 90 s of maximal cycling on an air-braked ergometer. All treatments were also performed on days when biopsies were not taken from the vastus lateralis muscle and cannulae not inserted into a forearm vein to ascertain whether these procedures adversely affected performance. The mean results can be summarised as follows: (Table: see text). The muscle lactate and O2 deficit data suggested that 60 and 90 s were more appropriate durations than 30 s for assessing the anaerobic capacity on an air-braked cycle ergometer. The mean power outputs also indicated that the invasive procedures did not adversely affect performance [corrected]. PMID- 1773813 TI - The influence of stationary auditory fields on postural sway behaviour in man. AB - Postural sway behaviour was investigated in 30 young subjects (15 male and 15 female) during 60 s of erect standing, under various combinations of auditory and visual input. Sway was assessed using a standard biomechanical measuring platform, the output of which led directly to an online computer from which the following parameters were determined: mean lateral and antero-posterior sway, velocity and radius of sway, length of the sway path and area within the sway profile. A marked difference in sway behaviour between the sexes was observed, with women showing increased magnitudes of some sway parameters. Postural sway was significantly increased in conditions without visual feedback. The presence of an auditory field tends to have a destabilising influence on sway behaviour, with both the direction of the sound source and the type of auditory input being important variables. Nevertheless there appears to be no interaction between the visual and the auditory environment in the control of posture. PMID- 1773814 TI - Quantification of T- and H-responses before and after a period of endurance training. AB - Tendon (T-) and Hoffmann (H-) responses in the soleus muscle were quantified either separately or in association to compare the mononeurons activated and to study their changes after a period of endurance training. In a first experiment T and H-responses of the same amplitude were compared: the electrical stimulus (inducing the H-response) and the Achilles tendon tap (inducing the T-response) were associated so that the T-response firstly was concomitant with the H response, and secondly shifted 10 ms forward or back compared to the H-response. From the study of these combined reflexes we would suggest that the same motoneurons are involved in T- or H-responses of the same amplitude. In a second experiment the maximal H-responses, the T-responses and maximal aerobic power (Waer,max) were measured on 20 subjects before and after a period of endurance training. For 75% of the subjects the Waer,max and the reflex parameters (T or H) varied in the same direction: most of them exhibited higher values of both Waer,max and reflex amplitudes while the others had Waer,max and reflex values hardly modified or decreased. The different effects of the training period could reflect the heterogeneity of the subject's status and involvement in sport. In most cases the T:Hmax ratios were also influenced, reflecting the fact that T- and H-responses were not identically affected by training. Thus it is suggested that an endurance training programme can influence not only the excitability of the motoneurons but also the response of the muscle receptors to stretch. An interpretation in terms of a change of spindle receptivity and/or a change in their recruitment due to a greater stiffness of the trained muscles is suggested. PMID- 1773815 TI - Effects on energy expenditure of facial cooling during exercise. AB - Estimated energy expenditures for men during Arctic manhauling expeditions were 29-33 MJ day-1, higher than those documented for other hard-working groups and exceeding predicted energy costs for such activities. Although physiological effects from generalised cooling were unlikely, cold exposure of the face could have influenced exercise metabolism via autonomic stimulation. This hypothesis was examined by measuring oxygen consumption, energy expenditure, respiratory exchange ratio (R) and cardiovascular changes during rest and exercise, with and without exposure of the face to air at--20 degrees C. Measurements were made in five subjects during 15 min of rest followed by continuous exercise on a cycle ergometer consisting of 15-min periods at 75, 100, 125 and 150 W external work. The cold air caused a profound fall in facial temperatures and small falls in mean skin and rectal temperatures (P less than 0.001). These changes were associated with a small increase in the mean oxygen consumption over all levels of rest and exercise (0.86 l min-1 vs 0.82 l min-1, P less than 0.001) and a corresponding increase in mean energy expenditure (294 W vs 283 W, P less than 0.05). Cold air also caused an increase in mean resting R values (1.00 vs 0.88, P less than 0.01) but a decrease in the mean R value for all levels of exercise (0.85 vs 0.91, P less than 0.05). Pulse rates were unchanged but systolic and diastolic blood pressures were relatively elevated throughout the cold face experiments (P less than 0.001). PMID- 1773816 TI - Transition from slow to ballistic movement: development of triphasic electromyogram patterns. AB - The purpose of this investigation was to determine how the triphasic electromyogram (EMG) pattern of muscle activation developed from the agonist muscle only pattern as movement time (tmov) decreased. Six adult women produced a series of 30 degrees elbow extension movements in the horizontal plane at speeds ranging from ballistic (less than 400-ms tmov) to very slow (greater than 800-ms tmov). Surface EMG from triceps brachii (agonist) and biceps brachii (antagonist) muscles were recorded, together with elbow angle, on a microcomputer. The results showed that triphasic EMG patterns developed systematically as tmov decreased from 1000 ms to less than 200 ms. In trials with very long tmov, many elbow extension movements were produced by a single continuous activation of the agonist triceps brachii muscle. As tmov decreased however, agonist activation became predominantly burst-like and other components of the triphasic EMG pattern [activation of the antagonist (Ant) and second agonist activation (Ag2)] began to appear. At the fastest movement speeds, triphasic EMG patterns (Ag1-Ant-Ag2, Ag1 being first activation of agonist muscle) were always present. This data indicated that the triphasic pattern of muscle activation was not switched on when a particular tmov was achieved. Rather, each component systematically developed until all were present, as distinctive bursts of activity, in most trials with tmov less than 400 ms. PMID- 1773817 TI - Effect of lowered muscle temperature on the physiological response to exercise in men. AB - The effect of low muscle temperature on the response to dynamic exercise was studied in six healthy men who performed 42 min of exercise on a cycle ergometer at an intensity of 70% of their maximal O2 uptake. Experiments were performed under control conditions, i.e. from rest at room temperature, and following 45 min standing with legs immersed in a water bath at 12 degrees C. The water bath reduced quadriceps muscle temperature (at 3 cm depth) from 36.4 (SD 0.5) degrees C to 30.5 (SD 1.7) degrees C. Following cooling, exercise heart rate was initially lower, the mean difference ranged from 13 (SD 4) beats.min-1 after 6 min of exercise, to 4 (SD 2) beats.min-1 after 24 min of exercise. Steady-state oxygen uptake was consistently higher (0.2 l.min-1). However, no difference could be discerned in the kinetics of oxygen uptake at the onset of exercise. During exercise after cooling a significantly higher peak value was found for the blood lactate concentration compared to that under control conditions. The peak values were both reached after approximately 9 min of exercise. After 42 min of exercise the blood lactate concentrations did not differ significantly, indicating a faster rate of removal during exercise after cooling. We interpreted these observations as reflecting a relatively higher level of muscle hypoxia at the onset of exercise as a consequence of a cold-induced vasoconstriction. The elevated steady-state oxygen uptake may in part have been accounted for by the energetic costs of removal of the extra lactate released into the blood consequent upon initial tissue hypoxia. PMID- 1773818 TI - Fish diet and physical fitness in relation to membrane and serum lipids, prostanoid metabolism and platelet aggregation in female students. AB - The effects of a 14-week fish diet and exercise programme on lipid metabolism and platelet aggregation in healthy female students (n = 99) were studied. The subjects were divided into four groups: a control group, a fish diet group (3.5 meals containing fish per week, 0.9 g n-3 fatty acids per day), an exercise group (at least three training sessions per week) and a combined fish diet and exercise group. The proportion of n-3 fatty acids increased at the expense of n-6 fatty acids in platelets and erythrocyte ghosts in the fish diet groups. Serum triglyceride concentrations tended to decrease in the fish diet and exercise groups and a significant decrease was found in the combined fish diet and exercise group (13%, P less than 0.05). No significant changes took place in the other serum lipid and apolipoprotein concentrations. Platelet production of thromboxane B2, plasma 6-keto-PGF1 alpha concentrations and adenosine 5' diphosphate (ADP)-induced platelet aggregation also remained unchanged in all groups during the study. However, an inverse correlation was found between physical fitness (maximal oxygen uptake and maximal exercise intensity) and serum triglycerides, total cholesterol, low density lipoprotein cholesterol and platelet aggregation. This suggests that improved physical fitness is related to beneficial changes in serum lipid concentrations and to a decreased aggregation tendency of platelets. The responses of the female subjects to a fish diet were smaller when compared to earlier studies on male subjects. This suggests that there are sex differences in the efficiency of n-3 fatty acids in modifying lipid metabolism. PMID- 1773819 TI - Muscle strength in male athletes aged 70-81 years and a population sample. AB - Muscle strength characteristics of different muscle groups were studied in active male strength-trained (ST, n = 14), speed-trained (SP, n = 16), and endurance trained (EN, n = 67) athletes aged between 70 and 81 years. A population sample of similar age (n = 42) served as a control group. The isometric forces for hand grip, arm flexion, knee extension, trunk extension, and trunk flexion were higher for the athletes than the controls and higher for the ST than EN group. The SP athletes showed higher values in knee extension and trunk flexion than the EN group. When the isometric muscle forces were related to lean body mass, significant differences still existed between the athletes and controls. However, the differences between the ST and EN groups disappeared. The elevation of the body's centre of gravity in the vertical jump was also higher for the athletes than the controls. The SP group performed better in the vertical jump than either the ST or EN group. The results showed that the athletes who trained not only for strength and speed but also for endurance had superior muscle function compared to the average male population of the same age. Although the strength and speed athletes generally showed the highest muscle strength in absolute terms, the endurance athletes also preserved excellent strength characteristics related to body mass. PMID- 1773820 TI - Pharmacological characteristics of NP-252, a new dihydropyridine slow Ca2+ channel blocker, in isolated rabbit vascular smooth muscle and guinea pig myocardium: vascular selectivity. AB - NP-252, a new dihydropyridine derivative, and nifedipine non-competitively inhibited contractile responses to KCl and responses to Ca2+ in Ca(2+)-free medium containing KCl in rabbit aorta and renal, mesenteric, coronary and basilar arteries, mesenteric veins and vena cava. The effects of NP-252 in these smaller arteries and veins were much greater than those in aorta. However, a similar differential selectivity was not seen with nifedipine. In aorta, only NP-252 reduced total La3+ resistant 45Ca binding. However, the increases in bound 45Ca at La3+ resistant sites and 45Ca unidirectional influx due to KCl were inhibited by both NP-252 and nifedipine. The displacement of [3H]nitrendipine binding to rabbit aorta was monophasic for both NP-252 and nifedipine. In guinea-pig papillary muscles, NP-252 (greater than 10(-7) M) slightly decreased action potential duration, developed tension and slow action potentials. The cardiac effects of NP-252 were much less prominent than those of nifedipine. These results indicate that NP-252 inhibits voltage-operated Ca2+ channels in small arteries and veins much more effectively than those in aorta, and this tissue selectivity is more apparent for NP-252 than nifedipine. PMID- 1773821 TI - The myocardial depressant effect of volatile anesthetics does not involve arachidonic acid metabolites or pertussis toxin-sensitive G proteins. AB - The involvement of the phospholipid-arachidonic acid pathway and of a pertussis toxin-sensitive G protein in the myocardial depressant effect of volatile anesthetics was examined in the rat heart left papillary muscle and atria. Neither phospholipase A2, cyclooxygenase or lipoxygenase antagonists altered the potency or the efficacy of clinically used concentrations of halothane and isoflurane in decreasing the contractile force of the muscles. Pretreatment of rats with pertussis toxin (50 micrograms/kg i.v., 72 h before sacrifice), which abolished the myocardial depressant effect of muscarinic agonists, did not prevent the decrease in contractile force induced by the anesthetics. The results of this study indicate that the cellular mechanism of the myocardial depressant effect of volatile anesthetics does not involve a metabolite of the phospholipid arachidonic acid pathway, does not require a functional pertussis toxin-sensitive G protein, and differs from that of muscarinic agonists. PMID- 1773822 TI - Evidence that imipramine activates 5-HT1C receptor function. AB - The anti-immobility effect of imipramine (15 mg/kg) in the forced swimming test in mice was antagonized by the non-selective 5-hydroxytryptamine (5-HT) antagonist, metitepine (0.5 mg/kg), by the 5-HT1C/5-HT2 antagonist, mesulergine (15 mg/kg), and by the dopamine D2 antagonist, d,l-sulpiride (50 mg/kg). These three antagonists did not alter the behaviour of imipramine-treated mice in an open-field and did not reduce imipramine brain levels. The 5-HT2 antagonist, ritanserin (0.06 mg/kg), the 5-HT1A/5-HTB antagonist, l-propranolol (20 mg/kg), and the 5-HT3 antagonists, endo-2,3-dihydro-N-(8-methyl-8-azabicyclo[3.2.1]oct-3 yl)-2-oxo-1H- benzimidazole-1-carboxamide hydrochloride (DAU 6215; 0.1 mg/kg) and 1,2,3,9-tetrahydro-9-methyl-3[(2-methyl-1H-imidazol-1-yl)methyl]-4H- carbazol-4 one, HCl.2H2O) (GR 38032F; 0.1 mg/kg), failed to reduce imipramine-induced anti immobility. Subthreshold doses of 8-hydroxy-2-(di-n-propylamino)tetralin hydrochloride (8-OH-DPAT; 0.5 mg/kg) and imipramine (7.5 mg/kg) did not synergize in reducing immobility. d,l-Sulpiride, but not mesulergine, antagonized the effect of desipramine (15 mg/kg) in the forced swimming test. All compounds were administered i.p. 6 min before imipramine or desipramine, given i.p. 30 min before the testing. Imipramine produced 50% inhibition of [3H]mesulergine binding to 5-HT1C receptors at 10 microM, a concentration below that obtained following i.p. imipramine administration. The results suggest a contribution of 5-HT1C receptors in the mechanism of the imipramine effect in the forced swimming test. PMID- 1773823 TI - The physical dependence liability of butorphanol: a comparative study with morphine. AB - In these studies, the physical dependence liability of butorphanol, a mixed 'agonist/antagonist' opioid analgesic, was compared to that of morphine. Male, Sprague-Dawley rats received i.c.v. infusions of saline (1 microliter/h), or an equimolar dose of butorphanol or morphine (52.3 nmol/h) for 3 days. The physical dependence liabilities of these two compounds were then compared by assessing both behavioral withdrawal signs and weight loss following naloxone-precipitated withdrawal. Body weight loss was also evaluated following abrupt (cessation of infusion) withdrawal from butorphanol or morphine. In animals receiving i.c.v. infusions of butorphanol or morphine, naloxone administration (5 mg/kg s.c.) induced an equivalent degree of body weight loss compared to saline-treated animals. In addition, the ED50 of naloxone to produce wet shakes, escape behavior, teeth chattering, urination and defecation was equivalent in rats receiving butorphanol or morphine. Infusions of butorphanol or morphine also produced an equivalent degree of weight loss in animals undergoing abrupt withdrawal. These results demonstrate then that a substantial degree of physical dependence had developed in rats which received a large dose of butorphanol. PMID- 1773824 TI - Anti-sedative and anti-cataleptic properties of NCS-382, a gamma-hydroxybutyrate receptor antagonist. AB - NCS-382 possesses antagonistic properties at gamma-hydroxybutyrate receptor sites. Its effect on the sedative/cataleptic behaviour observed in rats after gamma-hydroxybutyrate administration was investigated. NCS-382 diminished, in a dose-dependent manner, the sedative and/or cataleptic effects of gamma hydroxybutyrate, as revealed by a variety of sensorimotor tests. These results indicate that the well-known sedative/anaesthetic effects induced by gamma hydroxybutyrate administration are provoked via stimulation of a specific class(es) of gamma-hydroxybutyrate receptors which exist in the rat brain and which could mediate a local stimulation of opiate synthesis and release. PMID- 1773825 TI - Cardiovascular effects of E4080, a novel bradycardiac agent with coronary vasodilating properties, in anesthetized dogs. AB - The cardiohemodynamic effects of E4080, a novel bradycardiac agent with a coronary vasodilating feature, were studied in anesthetized open-chest dogs. E4080 (0.3 and 1 mg/kg i.v.) decreased heart rate (HR), mean aortic pressure (MAP) and total peripheral resistance, and increased coronary blood flow (CBF) without affecting cardiac output and the electrocardiogram. The maximum rate of rise in left ventricular pressure decreased at 1 mg/kg. In addition, E4080 (0.3 and 1 mg/kg i.v.) decreased myocardial oxygen consumption. On administration in sinus node artery, E4080 (10 and 30 micrograms) selectively decreased HR. Glibenclamide, an ATP-sensitive K+ channel blocker (5 mg/kg i.v.), inhibited both the increase in CBF and the decrease in MAP caused by E4080 (1 mg/kg i.v.) but did not inhibit the bradycardia. These results suggested that E4080 has both bradycardiac and coronary vasodilating effects, and that activation of ATP sensitive K+ channel contributes to the vasodilating action of E4080 but not to the bradycardiac action. PMID- 1773826 TI - Potential sources of artefact in the co-axial bioassay. AB - The apparent release of relaxant activity from airway epithelium (epithelium derived relaxing factor, EpDRF) has been examined in a co-axial bioassay system. The endothelium-denuded rat aorta, placed inside either the epithelium-intact guinea-pig trachea or rabbit bronchus relaxed in response to acetylcholine. In a modification of the standard preparation, the airway was slit longitudinally and immobilised inside a silicone rubber tube. Under these conditions, the acetylcholine-induced relaxation was abolished. Under the conditions of the co axial bioassay, the oxygen tension in the lumen of either airway tube was lower than that of the bathing fluid. Upon addition of acetylcholine at concentrations which caused relaxation in the co-axial bioassay, the oxygen tension inside the epithelium-intact, but not the epithelium-denuded guinea-pig trachea was depressed to levels which would have affected the contractile response of a rat aorta. We suggest that the assay of relaxant activity from airways using co-axial preparations may be complicated by changes in volume and oxygen tension in the lumen of the donor airway and discuss how such problems might be avoided. PMID- 1773827 TI - Muscarinic subtype selectivity of tetrahydroaminoacridine: possible relationship to its capricious efficacy. AB - Tetrahydroaminoacridine discriminated slightly in its potency to displace [3H]N methylscopolamine ([3H]NMS) binding from different muscarinic receptor subtypes (M2 greater than M1 greater than M3) and to allosterically decelerate ligand binding (M2 greater than or equal to M1 greater than M3). The steep displacement curves suggest that marked changes in receptor occupancy may occur within a relatively narrow dose range. Thus, individual inter-patient variability and inconsistent results in clinical studies may be related to blockade of muscarinic receptors, which would oppose the beneficial effects resulting from acetylcholinesterase inhibition. PMID- 1773828 TI - Pre- and postjunctional muscarinic receptor subtypes in dog airways. AB - To examine muscarinic receptor subtypes involved in cholinergically mediated contractions of the airway, we studied the effects of the M1-selective antagonist, pirenzepine, the M2-selective antagonist, AF-DX 116, the M3-selective antagonist, 4-diphenyl-acetoxy-N-methylpiperidine (4-DAMP) methiodide, and the non-selective antagonist, atropine, on acetylcholine (ACh)- and electrically induced contractions in dog bronchi and bronchioles. The relative potencies of the antagonists based on IC50 values of each antagonist for contractions induced by the two concentrations of ACh that produced 50% of the maximum (ED50) and the maximum (EDmax) contractions and the pA2 values were atropine greater than or equal to 4-DAMP methiodide greater than pirenzepine = AF-DX 116 in both the bronchi and bronchioles. The IC50 and pA2 values of each antagonist did not differ significantly between the bronchi and bronchioles. 4-DAMP methiodide significantly inhibited the contractile response to electrical field stimulation (EFS) at 5 Hz at concentrations that did not alter the contractile responses to exogenous ACh in both the bronchi and bronchioles, whereas pirenzepine, AF-DX 116 and atropine inhibited the EFS-induced contraction only at the concentrations that reduced the contraction induced by exogenous ACh. The present results suggest that the cholinergic contraction is mediated via the postsynaptic receptor M3, based on functional potencies of muscarinic antagonists and presynaptic receptor auto-facilitatory M3, based on the suppression of the contractile response to EFS by 4-DAMP methiodide in central and peripheral airways. PMID- 1773829 TI - Amphetamine exerts anomalous effects on dopaminergic neurons in neonatal rats in vivo. AB - The effects of amphetamine, apomorphine and haloperidol on the spontaneous activity of electrophysiologically identified nigral dopaminergic neurons were examined with extracellular recordings in vivo in neonatal rats ranging in age from postnatal day 1 to postnatal day 28, and in adult rats. In postnatal day 1-6 pups amphetamine (5 mg/kg i.p.) produced a paradoxical increase in neuronal firing in 45% and had no effect on 30% of the 20 neurons examined. During the second week half of the neurons recorded were unresponsive to amphetamine. Typical amphetamine-induced inhibition was observed in only 25% of the neurons from postnatal day 1-6 and 50% of those from postnatal day 7-15 rats compared to 81.8% in postnatal day 16-28 pups and 100% in adults. Apomorphine (50-200 micrograms/kg i.p.; 5-20 micrograms/kg i.v.), significantly inhibited the spontaneous activity of dopaminergic neurons, including cells that previously failed to be inhibited by amphetamine, independent of age. The apomorphine induced inhibition was consistently reversed by administration of haloperidol (0.5-2.0 mg/kg, i.p.; 50-200 micrograms/kg i.v.). The anomalous responses to amphetamine in early neonatal rats may be related to its paradoxical behavioral effects in human children afflicted with attention deficit disorder. PMID- 1773830 TI - D-myo-inositol-1,2,6-trisphosphate is a selective antagonist of neuropeptide Y induced pressor responses in the pithed rat. AB - The antagonistic effects of a new inositol phosphate derivative, D-myoinositol 1,2,6-trisphosphate (PP56), on pressor responses to preganglionic sympathetic nerve stimulation and exogenously administered phenylephrine or neuropeptide Y (NPY) were investigated in vivo in the pithed rat. In this model an intravenous (i.v.) bolus administration of PP56 (1-50 mg/kg) dose dependently inhibited the increase in mean arterial blood pressure (MAP) induced by a continuous infusion of NPY (2 micrograms/kg per min for 10 min). PP56 in a dose of 5 mg/kg i.v. bolus reduced the entire NPY dose-response curve (0.4-8 microgram/kg per min 10 min infusion) without any shift to the right indicating a non-competitive interaction. Furthermore, PP56 (10-50 mg/kg i.v.) was found to inhibit the pressor response to preganglionic sympathetic nerve stimulation and i.v. bolus injection of the alpha 1-adrenoceptor agonist, phenylephrine. The dose-response curves for increasing doses of phenylephrine and incremental preganglionic sympathetic nerve stimulation were not significantly altered by a lower dose of PP56 (5 mg/kg i.v. bolus). We conclude that PP56, representing a new class of synthetic drugs, can antagonize the actions of exogenous and endogenous NPY in vivo, an action which is specific for NPY within a limited dose range. PMID- 1773832 TI - Nitric oxide mediates neuronal death after focal cerebral ischemia in the mouse. PMID- 1773831 TI - Antioxidant effect of calcium antagonists on microsomal membranes isolated from different brain areas. AB - The antioxidant effect of Ca2+ antagonists on sheep brain microsomal membranes and on liposomes prepared with total lipids extracted from the membranes was studied. Microsomal membranes were isolated from three brain areas: frontal cortex, hippocampus and caudate nucleus. Lipid peroxidation was induced by ascorbic acid and measured by malondialdehyde formation. Seven Ca2+ antagonists representative of the major chemical classes (dihydropyridines, benzothiazepines, phenylalkylamines, alkylamines, diphenylpiperazines) were tested for their antioxidant activity over a wide range of concentrations (0-500 microM). The order of antioxidant activity on frontal cortex membrane phospholipids, expressed as 50% inhibition of peroxidation (antioxidant IC50), was: nifedipine (IC50 = 4 microM) greater than flunarizine (IC50 = 48 microM) greater than bepridil (IC50 = 50 microM) greater than verapamil (IC50 = 74 microM). The dihydropyridines, nitrendipine and nimodipine, and the benzothiazepine, diltiazem, did not affect peroxidation even at a concentration of 500 microM. Membrane phospholipids are the substrate for free radical-induced damage since the extent of peroxidation in brain microsomal membranes was equal to that produced in liposomes prepared from membrane lipids. Although the lipophilicity of certain Ca2+ channel antagonists can enhance their antioxidant activity, our data suggest that Ca2+ antagonists inhibit peroxidation of the membrane lipid bilayer by a free radical scavenger effect that may be related to their chemical structure. PMID- 1773833 TI - [Prognosis in the surgical correction of progenia and prognathism]. AB - The soft tissue profile changes entailed by the operation were examined on teleroentgen image taken before and after operation in case of fifty patients with progenia and prognatism. The connection between the moving of the body and soft tissue of oral parts was determined and on basis thereof, the operational prognostics of the soft tissue was elaborated. The operational prognostics based on observations is shown on the photographical and x-ray documentation of one of the author's patients. PMID- 1773834 TI - [Relationship between the caries status and metabolic imbalance in diabetics]. AB - The dental clinical examination of 1600 (815 insulin dependent of type 1 and 761 non-insulin dependent of type 2 respectively) patients cared of because of diabetes mellitus was carried out and an answer to the question was sought for whether the condition of the teeth does change according to he type of the metabolic disturbance of the diabetic, the time of its manifestation, its setting, the manner of therapy, the family occurrence of the illness and the mouth hygiene, respectively. According to examination results, greater edentulousness with diabetes over 30 years showed a positive interdependence according to the confirmance time of diabetes. On the other hand, with diabetic of better setting there were less teeth with caries or removed ones and the DMF-T average was lower than with patients with worse diabetes setting. No independence was found in the development of the DMF-T average and the caries conditions, respectively, if diabetes occurred in the family history and according to the type of diabetes. PMID- 1773835 TI - [Comparative study on wound healing in the oral cavity following experimental surgery using a scalpel, electrocauterization and CO2 laser beam]. AB - In the mouth cavity of white rats lesion was created by means of surgical scalpel and electrokauter the course of the wound healing was observed on basis operations of various types (coagulation, vaporization, excision) as well as scalpel and electrokauter the course of the wound healing was observed on basis of histological examination of biopsies taken on the second, fifth, tenth, twentieth and fortieth day. It was verified that the wound healing is excellent after all three types of laser surgical intervention and is significantly more favourable than in case of electrokauter. The course of healing is finished during 3 weeks after coagulation and vaporaziation, and during 4 weeks after excision. The new epithelium layer became thinner than the original while the submucosa became twice as thick. The laser treated surfaces are protected by coagulation proteins, the wound edges are sharp, the amount of the cicatrice tissue formed after the wound healing is less than after the employment of the scalpel and the electrokauter. PMID- 1773836 TI - [Possibilities of reducing the sensitivity of the neck of the tooth]. AB - Authors overview the etiology and pathomechanism of the root hypersensitivity. The most commonly used therapeutical aids and devices are discussed. They discuss the theory of action of the drugs used for controlling root hypersensitivity. In details the dental literature of devices used on the individual bases--included different fluoride compounds, stronciumchloride, and potassium nitrate--are reviewed. In the end the authors's own clinical experience and findings with the Sensodyne toothpaste (kindly donated by the Block Drug Co.) are presented. PMID- 1773837 TI - [Dental enamel hardness tests in diabetics]. AB - The authors studied by in vivo methods (Fosse et al. 1986) the microhardness of dental enamel in diabetic patients compared to healthy persons. No differences of enamel microhardness values between diabetics and healthy persons, neither by longer diabetes duration nor by worse diabetes attitude have been found. PMID- 1773838 TI - [The focus of dental infection]. AB - The authors taking into consideration the ways of therapy divide dental centers into two groups: 1. The active center, the patient has a center-originated or an illness possibly dependent of a center. The treatment is the elimination of the center, medical preparation, in close cooperation with the physicians curing the second illness. 2. The passive center. The patient has no other illness in connection with the center. From the therapeutical point of view the center must be treated as separate disease. PMID- 1773839 TI - [Radiation moulage therapy of gingival tumors]. AB - An irradiation treatment technique, long ago known yet seldom employed, is reported on. With a patient, because of an inoperable gingiva-tumor, after percutan irradiation for complementary purpose radium-moulage treatment was employed. Due to the irradiation treatment the patient became symptomless. PMID- 1773840 TI - Osteoarthritis: with emphasis on primary osteoarthritis of the shoulder. AB - Fifty-three shoulders in 35 patients were found to have osteoarthritis (OA) of the shoulder using radiographic criteria to establish the diagnosis. Thirty of these shoulders did not exhibit any predetermined signs of secondary OA and were labeled primary OA. The average age of the patients was 79 years. This article discusses OA, with special emphasis on primary OA of the shoulder. Primary OA of the shoulder appears to occur in older individuals and may not be as rare as many observers have stated. PMID- 1773841 TI - Osteoporosis--estrogen replacement therapy: risk/benefit ratio for treatment. PMID- 1773842 TI - Are your retirement plan assets safe from malpractice judgments? AB - In conclusion, there is a reasonable chance that retirement plan assets in Delaware qualified plans are insulated from judgment creditors, but the best course is to maintain adequate insurance protection and follow an aggressive prejudgment strategy in serious cases so you don't have to resolve the issue in a bankruptcy proceeding. PMID- 1773843 TI - Mortgaging the medical profession. PMID- 1773844 TI - Asthma: important considerations for better management. PMID- 1773845 TI - Access to care. PMID- 1773846 TI - Characterization of a naturally occurring protease inhibitor in the hemolymph of the scorpion, Heterometrus bengalensis. AB - A protease inhibitor has been purified by ultracentrifugation, affinity chromatography on trypsin-sepharose 4B, and chromatofocusing on PBE-94 from hemolymph of the scorpion Heterometrus bengalensis. Homogeneity of the protease inhibitor was demonstrated by high performance liquid chromatography (HPLC). The protease inhibitor is a monomeric glycoprotein with a molecular weight of 120,000 dalton, which is stable between pH 4 and pH 8. The molecule inhibits serine proteases like trypsin and alpha-chymotrypsin and shows a noncompetitive mode of inhibition towards trypsin, with a Ki value of 6.1 x 10(-6) mM. Amino acid analysis shows a preponderance of aspartic acid, glutamic acid, serine, and glycine. The protease inhibitor is efficient in inhibiting phenoloxidase activity in both the hemolymph and the isolated phenoloxidase. Melanin synthesis by phenoloxidase may be influenced by this protease inhibitor. PMID- 1773847 TI - In vitro release of lectins by Phallusia mamillata hemocytes. AB - alpha-Lactose specific lectins are released from Phallusia mamillata hemocytes during short-term cultures. The molecular weight of the subunits, the immunological cross-reaction and the sugar specificity suggest that the released lectins are similar to those isolated from the sonicated hemocytes. Because lectin release appears to take place independently of active protein synthesis, the possibility exists that lectins are pre-formed, stored in hemocytes and released when in vitro conditions stimulate the cells. PMID- 1773848 TI - Isolation of a phosphoryl choline-binding protein from the hemolymph of the snail, Achatina fulica. AB - A phosphorylcholine-binding protein from the hemolymph of the snail Achatina fulica was purified to near homogeneity using a Sepharose phenylphosphorylcholine affinity column. The protein bound to the affinity column was eluted with 5 mM phosphorylcholine as a single symmetrical peak. The purified protein (400 Kda) contained 35-40% carbohydrate. On SDS-PAGE the protein separated into two bands of 20 and 24 Kda, and had a pI of 5.9. On immunodiffusion, antiserum to the snail phosphorylcholine binding protein did not cross-react against other phosphorylcholine binding proteins, like rat serum phosphorylcholine-binding protein (PCBP), limulus C-reactive protein (CRP), or human CRP. On pretreatment of the snail hemolymph with this antiserum, the hemagglutination titer of the hemolymph was markedly decreased. The purified snail phosphorylcholine binding protein agglutinated rabbit erythrocytes in the absence of divalent cation (Ca+2) but trace amount of Ca+2 increased its binding. The strongest inhibitor of the agglutination reaction was lactose, followed by melibiose and 2-deoxygalactose. The relationships of the snail phosphorylcholine binding protein to other hemolymph agglutinins and to CRPs are discussed in light of common phylogeny. PMID- 1773849 TI - Induction of immunity by latex beads and by hemolymph transfer in Galleria mellonella. AB - Injection of sterile latex beads into the hemocoel of last instar larvae of Galleria mellonella provoked a strong defense reaction. Cellular defense by hemocytes was followed by enhanced antibacterial activity in hemolymph. Latex injected insects showed increased survival rates after a challenge injection with high doses of bacteria. Factors which stimulate the production of antibacterial activity could be demonstrated soon after injection by transfer of hemolymph from preinjected to untreated larvae. A large induction capacity in donor hemolymph was accompanied by a strong decrease in the total hemocyte count of free floating hemocytes, resulting from a decrease in number of plasmatocytes and granular cells, the cell types involved in the cellular defense against the injected latex beads. The results presented support the hypothesis that during cellular defense reactions, factors are released from the hemocytes which stimulate the production of antibacterial substances. PMID- 1773850 TI - A comparison of phenoloxidase activity in the blood of marine invertebrates. AB - A range of marine invertebrates were screened for prophenoloxidase (a marker protein of the prophenoloxidase activating system) in the coelomic fluid or hemolymph. The crustaceans and the ascidian, Ciona intestinalis, displayed strongest activity, with low levels found in the starfish, Asterias rubens, the sea urchin, D. antillarum, and the brachiopod, Liothyrella uva. The enzyme appeared to be absent from the isopod, Glyptonotus antarcticus. Further analyses of the blood cells of selected species revealed that prophenoloxidase tends to reside in the granular-type cells or their equivalent, and in the crustaceans and C. intestinalis is activated by lipopolysaccharides. In arthropods, prophenoloxidase is known to represent the terminal component of a complex cascade of enzymes that functions in non-self-recognition and host defence. The present study establishes that the enzyme is present in the blood cells of most, but not all, crustaceans and occurs in certain other invertebrate species, notably the urochordate, C. intestinalis. PMID- 1773851 TI - Characterization of antigen-binding protein in earthworms Lumbricus terrestris and Eisenia foetida. AB - Injection of antigen into the annelid worms Lumbricus terrestris (LT) and Eisenia foetida (EF) results in a marked increase of coelomic fluid protein concentration and the formation of a protein which binds the stimulating antigen (3). In this report we show that the increases in total protein concentration after first and second doses of antigen were higher and were achieved earlier in LT than in EF, while the accumulation of antigen-binding protein in coelomic fluid was similar in both species. Antigen-binding protein isolated by affinity chromatography retained its original binding activity. Its molecular weight in coelomic fluid as well as after isolation was 56 kD when analyzed by SDS-PAGE and immunoblotting. Under reducing conditions, two bands with mol./wt. 31 and 33 kD appeared which did not reveal detectable binding activity. This suggests that the 56 kD binding protein of annelids is composed of two disulphide-linked polypeptide chains both of which participate in antigen-binding site formation. PMID- 1773852 TI - The interaction of a protein from the coelomic fluid of earthworms with staphylococcal protein A. AB - A Staphylococcal protein A (SpA)-binding protein was isolated from coelomic fluids of the annelids, Lumbricus terrestris (LT) and Eisenia foetida (EF), by affinity chromatography on SpA-Sepharose. Analyses by polyacrylamide gel electrophoresis in sodium dodecyl sulfate (SDS-PAGE) under reducing and nonreducing conditions showed that SpA-binding activity is associated with a single chain protein, with a mol wt of 62 kD. The carbohydrate moiety of this protein consists of 21.4 g/100 g of O-linked and N-linked oligosaccharides. The amino acid composition of SpA-binding protein did not show structural homology with that of human IgG1 heavy chain (Daw), which also binds SpA. PMID- 1773853 TI - Development of immunological memory in rainbow trout (Oncorhynchus mykiss). I. An immunochemical and cellular analysis of the B cell response. AB - In vivo and in vitro analyses of the antibody responses of rainbow trout (Oncorhynchus mykiss) confirmed the existence of immunological memory in this species. An enhanced in vitro secondary antibody response was found to be due strictly to an expansion of the antigen-sensitive precursor pool without a concomitant increase in clone size. In contrast to the development of immunological memory in mammalian species, there was no evidence for affinity maturation during the primary or secondary response. A distinct shift in the fine specificity profiles of the antibodies, however, did occur during the generation of the secondary response. Additionally, more than a single injection of the priming antigen, TNP-KLH was required to produce an enhanced in vitro response to this T-dependent antigen. However, a second priming injection was not required to produce an enhanced secondary response to the T-independent form of antigen, TNP LPS. These results indicate that memory in trout may be due to a simple expansion of the antigen-specific precursor pool without many of the qualitative changes in antibody or B cell function associated with the expression of memory in mammals. PMID- 1773854 TI - Leucocyte migration in rainbow trout (Oncorhynchus mykiss [Walbaum]): optimization of migration conditions and responses to host and pathogen (Diphyllobothrium dendriticum [Nitzsch]) derived chemoattractants. AB - A rainbow trout leucocyte-derived chemoattractant(s) was prepared and tested as a stimulant of leucocyte migration. It was used to optimize an in vitro leucocyte migration assay using a 48-well micro chemotaxis chamber. This assay has subsequently been used to test the chemoattractant activity of antigen extracts from the tegument of Diphyllobothrium dendriticum plerocercoids and conditioned medium obtained after in vitro maintenance of live plerocercoids. Leucocytes were found to have an increased directional motility (chemotactic response) to the host-derived chemoattractant(s) but a random increased motility (chemokinetic response) following stimulation/contact with parasite-derived antigens. PMID- 1773855 TI - Lack of expression of the T-cell marker XTLA-1 in Xenopus tropicalis: exploitation in thymus restoration studies. AB - Flow cytometric studies employing the monoclonal antibody XT-1 reveal that, in contrast to other strains and species of Xenopus examined, thymocytes and splenocytes from X. tropicalis do not express the T lineage-specific antigen XTLA 1. Thymus dependence of XTLA-1 expression in splenocytes is confirmed in X. laevis by early thymectomy experiments. When X. tropicalis larval thymus is implanted to thymectomized X. borealis larvae, histological studies reveal extensive colonisation by host-derived (quinacrine-positive) cells following metamorphosis. Flow cytometry of propidium iodide-stained nuclei shows that within 3 months of xenothymus implantation, 90% of cells within the implant originate from the recipient; donor cells were undetectable in recipient spleens at this time. The emergence of near normal levels and distribution of XTLA-1 positive cells within xenogeneic thymus implants within 3 months of implantation is illustrated by flow cytometric observations and through immunofluorescence analysis of cryostat sections. These kinetic studies indicate that immigrant host cells require sojourn within the foreign thymus environment before they express the T-cell marker. PMID- 1773856 TI - Splenocyte response to T cell-derived cytokines in thymectomized Xenopus. AB - A miniaturized, "hanging-drop" bioassay reveals that splenocytes from early thymectomized (Tx) Xenopus can respond (by enhanced thymidine incorporation) to thymic-dependent "cytokines" generated in PHA- or alloantigen-stimulated cultures. Preliminary evidence, using fluorescence activated cell sorting, indicates that surface IgM- splenocytes, rather than sIgM+ cells, from Tx toads are sensitive to the crude, splenocyte-derived, active supernatants. Although these responsive cells display residual, but low, reactivity to PHA, their thymus independence is suggested by flow cytometric observations using the anti-T cell monoclonal antibody XT-1. The development of "T-like" cells in Tx Xenopus is discussed. PMID- 1773857 TI - Characterization of a receptor on activated chicken T cells. AB - Chicken lymphoblasts were generated from spleen cells which had been incubated with concanavalin A (Con A) for 48 h. Monoclonal antibodies were produced by immunizing mice with 48-h Con A lymphoblasts. The cellular ELISA, with lymphoblasts and spleen cells as the target cells, was used to select for specific monoclonal antibodies. A monoclonal antibody was found to have strong response against the lymphoblasts but not resting spleen cells. By immunofluorescence staining, this monoclonal antibody reacted strongly with lymphoblasts and did not react with resting spleen cells. This monoclonal antibody was also shown to inhibit the lymphokine activity present in conditioned medium (CM) which was collected from 24-h cultures of Con-A-activated spleen cells. In immunoprecipitation, this monoclonal antibody precipitated a lymphoblast surface antigen with a molecular weight of about 45 kDa. PMID- 1773858 TI - Serial transfer of GVH-R splenomegaly in chicken embryos. AB - Using histocompatible chicken strains B14 and B19, we demonstrate that the capacity to induce a GVH-R in an embryo could be induced precociously by the reaction itself. While naive chickens display this capacity around 3 to 4 weeks posthatching, embryos engrafted with adult allogeneic cells at E13 or E8 became endowed with this capacity at E20 and E15, respectively. Furthermore, this acceleration could be obtained by serial transfer of splenic cells through a sequence of three embryos undergoing the GVH-R. The highest efficiency in transfer was realized by regularly alternating the MHC haplotype at each transfer. It is concluded that the original cells from the adult donor may be partially responsible for the transfer, but that cells from the successive embryos are also certainly involved. Thus, maturation of the embryonic immune system appears accelerated by a GVH-R. PMID- 1773859 TI - Changes in lymphoid organs and blood lymphocytes induced by vitamin A deficiency and Newcastle disease virus infection in chickens. AB - The effect of vitamin A deficiency in the presence or absence of Newcastle disease virus infection (NDV, La Sota strain) on weight of lymphoid organs and on the number and type of circulating white blood cells (WBC) was investigated in chickens. Day-old chickens with limited vitamin A reserves were fed purified diets containing either marginal (ad libitum) or adequate (pair-fed) levels of vitamin A and at 21-28 days of age; half the chickens in each group were infected with NDV. Vitamin A deficiency resulted only in significantly lower absolute and relative weights of bursa of Fabricius and after infection both weights of bursa and thymus were significantly lower. Relative weight of spleen was significantly higher after infection irrespective of vitamin A status. Liver weights were not affected by vitamin A status and/or NDV infection. Both vitamin A deficiency and NDV infection resulted in lymphopenia, while the lowest number of WBC were observed in vitamin A-deficient chickens during the acute phase of NDV (5 days after infection). Subsequent to lymphopenia due to NDV infection, a marked lymphocytosis was observed in controls and to a lesser extent in vitamin A deficient birds. These results indicate that vitamin A deficiency, which is aggravated by concomitant NDV infection, affects lymphoid cell systems. PMID- 1773860 TI - Duck lymphocytes. IV. Collective effects of mitogens. AB - Duck (Anas platyrhynchos) blood lymphocytes were cultured in the presence of phytohaemagglutinin (PHA), concanavalin A (Con A), pokeweed mitogen (PWM), lentil lectin (LL), Roman snail lectin (HP), wheat germ agglutinin (WGA), Bandeiraea simplicifolia seed lectin (BSS), peanut agglutinin (PNA), horseshoe crab lectin (HSC) and bacterial lipopolysaccharide (LPS). Mitogens were used individually, in pairs, and in multiple combinations. Some pairs resulted in synergism; transformation, assessed by uptake of [3H]thymidine, was much greater than a direct addition of the effects of the two mitogens used separately. Best results were obtained when PHA or LL were paired with a second mitogen. In general, combinations of lectins at slightly suboptimal concentrations gave highest transformation, and all strongly synergistic combinations elicited a similar pattern of dose response through different concentrations of PHA. If a third mitogen was included, some combinations gave some further synergism, in other combinations the synergism of two mitogens was reduced by including a third, and if a pair of mitogens did not demonstrate synergism then none was generated when a third mitogen was included. Inclusion of more mitogens to successfully synergistic trios reduced transformation. The system could provide a useful model for in vitro enhancement of responses among lymphocytes from a species with a weak immune system. PMID- 1773861 TI - Genetic selection for aflatoxin B1 resistance influences chicken T-cell and thymocyte proliferation. AB - Studies were conducted with two lines of chickens that were selected for high and low plasma protein concentrations in response to aflatoxin B1 (AFB1) exposure. The experiments were designed to determine genetic differences in the responses of T cells and thymocytes to the toxin. Chicks were orally administered AFB1 at a rate of 0, 100, or 500 micrograms/kg body weight up to 21 days of age. At 4 weeks of age, concanavalin A (Con A, 2.5 micrograms/mL) stimulated T-cell proliferation was similar for untreated chicks from the low line (LL) and the high line (HL). However, AFB1 reduced the responses of T cells with HL cells being more sensitive. In a second experiment, immature chickens were bled and peripheral blood lymphocytes were cultured with Con A and either 0, 3.125, 6.25, 12.5, or 25 micrograms/mL AFB1. T cells from LL had greater responses to Con A than those from HL, and LL T-cells were also more resistant to in vitro AFB1 exposure. Furthermore, thymocyte proliferation was greater for LL chicks; but when thymocytes were cultured with 25 micrograms/mL AFB1, 3H-thymidine incorporation was similarly reduced in both lines. Cell cycle analysis indicated that there were more LL thymocytes in S phase, and the percentages for both lines decreased with AFB1 treatment. Although there were no differences between the lines for percent G2/M cells, AFB1 treatment increased the percentages of thymocytes in G2/M. These studies showed that selection for plasma protein response also changed T-cell and thymocyte proliferative activity. PMID- 1773862 TI - Characterization and distribution of lymphocyte subsets in sheep hemal nodes. AB - Marked differences were found in the percentage and distribution of lymphocyte subsets (CD5, CD4, CD8, T19, CD45, and CD45R cells) in hemal nodes compared to those in mesenteric lymph nodes and blood. There were a greater number of T19 (gamma/delta)+ lymphocytes and fewer CD8+ lymphocytes in hemal nodes than in mesenteric nodes and a higher percentage of CD4+ in hemal and mesenteric lymph nodes than in blood. T19 (gamma/delta)+ lymphocytes were found throughout hemal nodes but were absent from the follicles. Of special interest was the finding that 20% of hemal node lymphocytes appeared not to express CD45 (leucocyte common antigen). According to these results, because of the unique distribution of lymphocyte subsets and the presence of germinal centers, hemal nodes may have a specialized role in the immune system. PMID- 1773863 TI - Production of interleukin-1 in a South American opossum (Monodelphis domestica). AB - A homologous thymocyte costimulatory assay using thymocytes from a South American opossum (Monodelphis domestica) detected and measured interleukin-1 (IL-1). Opossum IL-1 was obtained from lipopolysaccharide-stimulated macrophage and skin cultures and its molecular weight was determined to be 15,000 to 17,000. Opossum IL-1 did not stimulate proliferation of murine thymocytes; conversely, neither human nor murine IL-1 stimulated opossum thymocytes. Anti-human IL-1 antibodies were also not reactive with opossum IL-1. These observations indicate that there is no serological and functional crossreactivity between the opossum (marsupial mammals) and human and mouse (eutherian mammals) in an IL-1/thymocyte system. This is unusual because such crossreactivity occurs between rodents and distant, nonmammalian species. M. domestica has been used in our laboratory as a model for photobiological research; studies on IL-1 may provide insight into the relationship of immunosuppression and tumorigenesis induced by ultraviolet radiation. PMID- 1773864 TI - Ontogeny, distribution and structure of aggregated lymphoid follicles in the large intestine of sheep. AB - Aggregates of lymphocytes were demonstrated from 70 days gestation (term 150 days in sheep) in the proximal colon and rectum. Immunoperoxidase staining for 5' bromo-2'-deoxyuridine incorporation and IgM, indicated that the lymphocyte population of lymphoid follicles in fetal sheep colon was actively dividing and surface IgM positive. Enzyme histochemistry for 5'-nucleotidase showed that the lymphocytes developed in a meshwork of positive reticular cells, suggestive of developing follicles. Follicle aggregates were distributed in a characteristic pattern in lambs, with major accumulations in the ascending colon and in the rectum. In adult sheep a partial atrophy of follicle aggregates was observed. The microscopic structure of large intestinal aggregates showed similarities to the jejunal Peyer's patch (PP), with broad follicles containing a prominent corona and wide interfollicular areas in older lambs. The apparent deep penetration of crypts into the lymphoid tissue proper, which is a frequently reported phenomenon for colon follicles, was dependent on the contractile state of the mucosa, as judged from its absence in specimens where the intestinal wall had been stretched before fixation. PMID- 1773865 TI - Analysis of immunocompetent cells in the bat, Pteropus giganteus: isolation and scanning electron microscopic characterization. AB - Immunocompetent cells of the Indian fruit bat (P. giganteus) were characterized by differential surface adhesiveness and surface topography. We observed three cell types: (1) plastic adherent with pseudopodia; (2) nylon wool adherent with small microvilli and pits; and (3) a nylon wool nonadherent with comparatively smooth surfaces. These cell types resemble, respectively, macrophages, B cells and T cells of other mammals, including mice and humans. The disposition of microvilli on the B-type cell surface changes significantly after immunization, which suggests modulation of the molecular organization of the cell membrane and its fluidity. The proportions of these three cell types are not much different from those found in mice. Follicular dendritic cells, capable of retaining antigen for long periods in mice, have also been detected in bats. Further characterization of immunocompetent cells wil help in understanding the mechanism of immune responses in bats. PMID- 1773866 TI - Absorption of carbon from the yolk into gut-associated lymphoid tissues of chickens. PMID- 1773867 TI - Expression of antigens on rat thymic epithelial cells during ontogenesis. PMID- 1773868 TI - Lupus anticoagulant in pre-eclampsia and intra-uterine growth retardation. AB - In a prospective study we proposed to identify the relationship between the level of lupus anticoagulant activity in pre-eclampsia and in growth retardation among 88 pregnant women. In 23 women suffering from severe pre-eclampsia (PET), and 22 women with fetal growth retardation, the mean anticardiolipin binding index was significantly higher than 43 controls (P less than 0.01 and P less than 0.005, respectively). The mean kaolin cephalin clotting time (KCCT) was significantly higher in patients with severe PET than in the control group (P less than 0.05). In intra-uterine growth retardation (IUGR), patients with 610-2452 g infants had significantly higher anticardiolipin binding index than those with 2500-3200 g infants (P less than 0.05). The Caesarean section rate was 46% in the patients with intra-uterine growth retardation (IUGR), 43% in the PET patients, and 2% in the control group. PMID- 1773869 TI - Changes in platelet function in pregnancies complicated by fetal growth retardation. AB - Platelet function was investigated in three patients with severely decreased fetal growth rates detected by ultrasound scanning. Only one patient had hypertension, which was mild and developed after decreased fetal growth and altered platelet responses had been detected. Much higher concentrations of platelet-activating factor (PAF) (20-500 nM) were required to stimulate maximal platelet aggregation in all three patients compared with the concentrations of PAF (5-10 nM) required in control pregnancies of similar gestational age. In a fourth patient, platelet desensitisation was observed 5 weeks before the detection of decreased fetal growth. These results are similar to those observed in women with hypertensive disorders of pregnancy, and indicate that there may be a similar change in platelet function in gestational hypertension and in fetal growth retardation, although the clinical manifestations are different. PMID- 1773870 TI - Influence of vehicle form on efficiency of prostaglandin E2 gel for cervical ripening. AB - A double-blind randomized controlled trial compared the efficiency of prostaglandin E2 (PGE2) gel in two different vehicle forms, one solid and the other more liquid, with respect to inducing labour in women with highly unfavourable cervical states. 43 received 0.5 mg PGE2 in a solid gel (Cerviprost) and 37 received 0.5 mg PGE2 in a more liquid cellulose-gel. After one application 18 (42%) and 9 (24%), respectively, went into labour (OR 2.8; 95% confidence interval: 0.8-6.0). After two applications of the gel 91 and 76%, respectively, were in active labour or had amniotomy performed as the cervical state had improved (OR 2.9; 95% confidence interval: 0.8-10.3). It is concluded that the solid gel was more efficient and safe than the more liquid gel. PMID- 1773871 TI - Cerebral pathology in the very low birthweight infant: predictive value of peripartum metabolic acidosis. AB - One-hundred-and-three infants with a birthweight of less than 1500 g and delivering at a gestation of less than 32 weeks were examined by serial cranial ultrasound scans. A capillary blood sample was drawn for blood gas analysis within 1 h of birth in all cases. The subsequent development of intracranial pathology was found to be significantly associated with gestation at delivery (P less than 0.01), birthweight (P less than 0.01) and base deficit within 1 h of birth (P less than 0.001). For infants with a base deficit of greater than 5.0 mmol/l within the first hour of life, the sensitivity for predicting the subsequent development of cerebral pathology was 51.5% with a specificity of 97.3%, and a positive predictive value of 97.1%. This relationship between a metabolic acidosis within 1 h of birth and the subsequent development of cerebral pathology held for both major and minor degrees of pathology, but was stronger in those infants developing major cerebral pathology. The study suggests that improved surveillance of the very preterm infant during labour and at birth with the aim of reducing the incidence of metabolic acidosis at birth, may help to reduce subsequent intracranial pathology, and thereby perinatal and long-term morbidity. PMID- 1773872 TI - The fetal maturity and mode of delivery of a woman's first baby influences the characteristics of her next labour. AB - There are well documented differences between the characteristics of labour in primigravidae and multigravidae. The present study was undertaken to determine whether the gestational age and mode of delivery of a woman's first baby influences the characteristics of labour in her next pregnancy. Information regarding previous obstetric history and subsequent obstetric performance was derived from a database of 75,974 consecutive singleton births. As a group, women with a history of one preterm vaginal delivery had labour characteristics similar to those women whose one previous pregnancy had resulted in a vaginal delivery at term. When this group were analysed by the gestation at which the previous birth had occurred, a gestation-dependent effect was seen. Women whose first birth had been at less than 28 weeks gestation behaved in a similar manner to primiparous women. On the other hand, the characteristics of labour in women whose first birth had occurred between 33 and 36 weeks gestation were similar to those of women who had had a previous vaginal delivery at term. Women whose first delivery had been by caesarean section behaved in a similar manner to primiparae. The typical differences between the characteristics of first and second labours are the result of a gradual change which appears to be related to the gestation at which the first birth occurred. PMID- 1773873 TI - Follicular fluid steroid and epidermal growth factor content, and in vitro estrogen release by granulosa-luteal cells from patients with polycystic ovaries in an IVF/ET program. AB - The follicular fluid (FF) content of androgens, estrogens and epidermal growth factor (EGF) has been evaluated in a group of patients with policystic ovary disease (PCO) and in one of normally-ovulating infertile women (NOW) in an IVF/ET program. The in vitro response to follicle-stimulating hormone (FSH) has been also evaluated in granulosa luteal cells from the same patients. PCO patients showed significantly higher FF androstenedione (delta 4) and testosterone (T) and similar FF estrone (E1) and 17 beta-estradiol (E2) levels compared to controls. In vitro production of E1 and E2 by granulosa luteal cells from PCO patients and from controls were overlapping and their response to FSH was similar. These data indicate a normal intrinsic potential aromatase activity in ovaries from PCO patients stimulated with gonadotropins and suggest that PCOs do not derive from inherent ovarian aromatase deficiency. Increased FF androgen content following gonadotropin stimulation may result from theca cell hyperactivity and androgen accumulation in the follicular antrum of rescued hyperandrogenic follicles as well as from inhibitory factors that may inhibit aromatase activation in vivo, partially counteracting the effect of gonadotropins. FF EGF levels were significantly higher in the group of PCO patients compared to those of NOW. EGF may play a role in blunting the in vivo response of granulosa cells to gonadotropins. PMID- 1773874 TI - Infertility treatment: implications for perinatology. AB - From 1975 to 1989 multiple birth rate in The Netherlands increased with almost 40%. Only a quarter of the increase can be related to births after in vitro fertilization. Evidence is presented that ovulation induction as an independent therapy or in combination with other forms of assisted reproduction is highly responsible for the rising number of multiplets. As a consequence, a heavy burden is placed on the units for specialized neonatological care as well as on the obstetrical wards in the tertiary centres for neonatology. Doctors should become aware of the facts and should inform the public properly about the risks of multiple pregnancy. An international approach is needed to get insight in the problems and to develop effective policies for the future. PMID- 1773875 TI - Empty gestational sacs diagnosed by abdominal real-time ultrasonography. AB - 310 patients with threatened abortion were examined by ultrasound. 86 cases showed empty gestational sacs of which 14 (16%) completed their pregnancy. All sacs were evaluated (and scored) with respect to size, shape, wall definition, trophoblastic reaction and position inside the uterus. Prediction of a non-viable pregnancy from a single ultrasound examination was achieved in some cases. However, this prediction could not be made in other cases before a follow-up ultrasound examination was performed. The proposed scoring system proved to be very helpful in identifying empty gestational sacs in which serial ultrasound examinations are highly required before termination of pregnancy. PMID- 1773876 TI - Vasoconstrictive effect of bile acids on isolated human placental chorionic veins. AB - Intrahepatic cholestasis of pregnancy (ICP) is a rare complication of late pregnancy associated with a high rate of premature delivery, antepartum fetal death and fetal hypoxia. Since the principal biochemical feature of ICP is a marked elevation of maternal serum bile acid levels, a role of these substances in the pathophysiology of fetal complications has been suggested. In this study, the effect of bile acids on isolated human placental chorionic veins is described. High concentrations of bile acids, especially cholic acid, have a dose dependent vasoconstrictive effect, which suggests that these substances could exert a detrimental effect on the fetus by increasing the resistance in chorionic veins through a vasospasm of the placental chorionic surface. An abrupt reduction of the oxygenated blood flow at the level of the placental chorionic plate may cause an acute impairment of the fetal perfusion and oxygenation, leading to fetal asphyxia. This is the first report that provides experimental evidence of the possible role of bile acids in those mechanisms that trigger fetal asphyxia in pregnancies complicated by ICP. PMID- 1773877 TI - Bacterial vaginosis and the vaginal leucocyte/epithelial cell ratio in women attending an outpatient gynaecology clinic. AB - In order to investigate the usefulness of vaginal leucocytosis as a sign of genital infection, vaginal wet smears were obtained from 230 consecutive non pregnant women attending an outpatient gynaecology clinic. Although 52 (22.6%) of the women were diagnosed as having bacterial vaginosis, none had symptoms of cervicitis or genital infection. Of the patients with bacterial vaginosis 19 (36.5%) had vaginal leucocytosis compared to 37.1% of the women without bacterial vaginosis. In a further study, bacterial vaginosis was also diagnosed in 104 of 384 women (33.3%) attending for first trimester legal abortions. Of the women with bacterial vaginosis 37.5% had vaginal leucocytosis compared to 31.8% for those without bacterial vaginosis (P greater than 0.05). There was no correlation between vaginal leucocytosis and the presence of cervical Chlamydia trachomatis; however, the presence of C. trachomatis did correlate with bacterial vaginosis. Vaginal leucocytes varies with factors unrelated to genital infection. This fact must be taken into consideration when wet smears from patients with suspected genital tract infection are evaluated. PMID- 1773878 TI - Geographical variations in the sampling quality of cervical smears. AB - It is generally accepted that cervical smears are adequately sampled when they contain endocervical and/or metaplastic cells. An extensive literature search via MEDLINE and FAMLI for papers on cervical smears yielded 33 articles providing explicit information both on the country where the study was executed and on the relationship between the adequate sampling of smears and the sampling method used. The correlation between the geographic origin of cervical smears and the proportion of those smears that were adequately sampled was examined. The results were controlled for the sampling method. It was found that the proportion of adequately sampled smears reported in studies in the U.K. is exceedingly low, in contrast with the proportion reported from The Netherlands. The differences between the various countries studied are stable over different sampling methods. It is suggested that, in order to ameliorate the sampling quality of cervical smears, factors associated with the working conditions in particular regions also need be considered. PMID- 1773879 TI - Chlamydia trachomatis infection among Hungarian teenage girls. AB - The presence of Chlamydia trachomatis antigen was examined in 20 sexually active teenage girls by enzyme immunoassay to prove chlamydial infection. Seven of the study group showed evidence of C. trachomatis infection. The infection was more frequent in girls who used a non-barrier method for contraception and had more than four sexual partners previously. Screening for and treatment of C. trachomatis infection in high-risk teenage girls is recommended. PMID- 1773880 TI - Prolonged, pregnancy-related pure red cell aplasia; a case report. AB - We describe the clinical course of a patient with pregnancy-related, acquired, pure red cell aplasia (PRCA). The course of PRCA was prolonged and ultimately responded only to corticosteroids. It did not recurr over 4 years of observation despite another gestation, and no other cause for PRCA could be detected during this long period. PMID- 1773881 TI - Ovarian chocolate cyst with markedly elevated serum CA19-9 level: a case report. AB - We report a patient with ovarian chocolate cyst with an abnormally high serum CA19-9 level (2380 U/ml) in whom MRI (Magnetic Resonance Imaging) was especially useful for the diagnosis. CA19-9 was detected in the epithelium of the chocolate cyst by the immunohistochemical technique, but it was not detected in the endometrium and adenomyotic tissue of the uterus. Twelve weeks were needed for normalization of the serum level of CA19-9 after operation. PMID- 1773882 TI - Knobs, knob proteins and cytoadherence in falciparum malaria. AB - 1. The sequestration of trophozoite and schizont infected erythrocytes (IRBC) in post-capillary venules of host internal organs causes most of the morbidity and mortality in falciparum malaria. It is a knob mediated cytoadherence phenomenon where knobs act as the focal junction between IRBC and host endothelial cell. Knobless (K-) parasites, isolated from cultures (not yet isolated from in vivo), do not cause virulent infections. Knobs thus play an important role in pathophysiology of falciparum malaria. 2. The chemical composition of knobs is partly explored, several proteins (Known as knob proteins) have been identified. According to their function they can be classified as (a) knob-inducing protein, "KAHRP" (b) knob-associated cytoadherent proteins, e.g. PFEMP-1, modified band 3 and an antigen recognized by monoclonal 33G2 and (c) knob-associated structural protein, e.g. PFEMP-2/MESA/PP-300. Most of them show size polymorphism among different isolates. Only KAHRP and MESA/PFEMP-2 have been studied at molecular level. Their chromosomal locations have been identified such as KAHRP on chromosome 2 and MESA/PFEMP-2 on chromosomes 5 and 6. 3. The receptor molecules on endothelial cells for knob ligands have been identified and partially characterized. 4. Knob ligands and their receptor molecules can play an important role in developing the immunotherapeutic reagents. 5. Based on the available data a tentative hypothesis has been proposed about the loss of knobs in vitro. Nevertheless, this needs further support from other experimental evidence. 6. Future work should be directed towards the structure and function of knob proteins and their interactions with each other as well as with host proteins. Regulation of expression of knobs and knob protein(s), evaluation of knob antigens for immunotherapy of severe falciparum malaria and for a malaria vaccine also require further investigations. PMID- 1773883 TI - The uncoupling protein UCP: a membraneous mitochondrial ion carrier exclusively expressed in brown adipose tissue. PMID- 1773884 TI - Production of delta-aminolevulinic acid: characterization of murine liver 4,5 dioxovaleric acid: L-alanine aminotransferase. AB - 1. We report on the kinetic properties of murine liver 4,5-dioxovaleric acid:L alanine aminotransferase (DOVA transaminase). 2. The transamination of 4,5 dioxovaleric acid (DOVA) led to the production of delta-aminolevulinic acid. 3. L Alanine was the preferred amino group donor among the common 20 amino acids. 4. The optimum pH of the reaction was 7-8. 5. A Km of 220 microM for DOVA and a Km of 970 microM for L-alanine were obtained. 6. The reaction was inhibited by each of the following: glyoxylate, beta-chloroalanine, methylglyoxal, delta aminolevulinate, pyruvate, heme, and gabaculine. 7. None of several xenobiotic inducers of microsomal mixed function oxidases tested had a significant effect on DOVA transaminase activity in studies performed with murine primary hepatocyte cultures. PMID- 1773885 TI - Fatty acid composition of phospholipids of myelin and synaptosomal proteolipid complexes from vertebrate brain. AB - 1. Fatty acid composition of five main phospholipids of vertebrate brain myelin and synaptosomal proteolipids and membranes was studied. 2. Higher content of monoenoic and lower content of saturated and polyenoic fatty acids was found to be characteristic of phospholipids from myelin and myelin proteolipids as compared to phospholipids from synaptosomal proteolipids and membranes of vertebrates (from fishes to mammalians). Fatty acid composition of phospholipids of proteolipid complexes and of the membranes, from which they were isolated, were found to be similar in various species studied. 3. Microviscosity was found to be higher in myelin as compared to synaptosomal membranes of frog Rana temporaria and in rabbit Lepus cuniculus. It appears to be due to the difference in proteolipid content and in lipid composition of myelin and synaptosomal membranes. PMID- 1773886 TI - Role of a calf thymus preparation in the degradation of native and reductively methylated low density lipoprotein. AB - 1. The clearance of low density lipoprotein (LDL) is mediated by a specific LDL receptor pathway and by an alternative metabolic pathway that is responsible for the receptor-independent LDL catabolism. 2. This alternative catabolism can be studied in vivo using a preparation of chemically modified LDL that are reductively methylated. 3. Recently we showed that a calf thymus protein extract affects the cholesterol metabolism via activation of LDL catabolism. 4. The aim of this study was to investigate whether in vivo the specific LDL receptor pathway and the independent LDL receptor pathway are affected by thymus treatment. 5. The results obtained injecting in rats native and chemically modified 125I-LDL to probe the receptor independent pathway, show that the thymus gland decreases serum cholesterol by activation of the specific LDL receptor pathway. 6. This effect is mainly evident in liver and kidney that represent organs in which the specific LDL receptors are widely present. PMID- 1773887 TI - Effect of B- and T-cell mitogens on the maximum activities of hexokinase, lactate dehydrogenase, citrate synthase and glutaminase in bone marrow cells and thymocytes of the rat during four hours of culture. AB - 1. Cells from the bone marrow and cells from the thymus of the rat were incubated in the presence of glucose and glutamine and phytohaemagglutinin, concanavalin-A or lipopolysaccharide. Cells were harvested at times up to 4 hr, extracted and maximum activities of hexokinase, lactate dehydrogenase, citrate synthase or glutaminase measured. 2. In bone marrow cells, there were little changes in enzyme activities except for an increase in the activity of citrate synthase which was prevented by concanavalin-A. This mitogen also caused a decrease in the activity of hexokinase. 3. In contrast, in thymocytes, the activities of hexokinase and glutaminase were decreased in the control condition but addition of lipopolysaccharide, a B-cell mitogen prevented these decreases in activity and concanavalin-A maintained the activity of glutaminase. Concanavalin-A caused a decrease in hexokinase activity but a marked increase in that of glutaminase. 4. It is suggested that changes in the maximum activities of hexokinase and glutaminase over this 4 hr period may represent the effect of removal of thymus produced growth factors, whose effects can be replaced, at least in part, by two mitogens. PMID- 1773888 TI - Effect of aflatoxin B1 on human platelet protein kinase C. AB - 1. Aflatoxin B1 serves as an activator for protein kinase C (PKC). 2. Following activation, the enzyme translocates from the cytosol to the particulate fraction. 3. Aflatoxin B1 leads to rapid and extensive phosphorylation of the known substrate of the enzyme. 4. Aflatoxin B1 causes rapid hydrolysis of phosphatidylinositol-4,5-biphosphate to diacylglycerol and inositol-1,4,5 triphosphate. PMID- 1773889 TI - A comparison of the histone H1 complements of avian erythrocytes. AB - 1. Histone H1 from chicken, turkey, duck and goose erythrocytes was resolved into six bands and that from quail into seven bands in an acetic acid-urea polyacrylamide gel. 2. A fast migrating minor subtype H1.e was detected in avian erythrocytes using two-dimensional polyacrylamide gel electrophoresis. 3. Although histone subtype H1.z from quail, turkey and duck was well separated in acid-urea gel, a similar protein in goose was found only in two-dimensional gel. This spot was absent in chicken. 4. Histone H1 spots .c, .c' and .d migrate in two-dimensional gel in a relatively constant manner forming a triangle-shaped pattern that facilitates comparison of H1 subtypes among various avian species. PMID- 1773890 TI - Effects of insulin on glucose uptake in cultured cells from the central nervous system of rodent. AB - 1. Incubation of C6 glioma cultures with insulin resulted in a time and dose dependent stimulation of 2-deoxy-D-glucose uptake. The maximal stimulation (160% of the control) was observed with 1 nM insulin and 0.05 nM caused half-maximum effect. 2. Incubation of NG 108-15 (neuroblastoma x glioma hybrid) and N2 neuroblastoma cells with 160 nM insulin did not result in a significant stimulation of this glucose uptake. 3. The basal level and stimulatory effect by insulin on this glucose uptake observed in C6 glioma cells were dependent on the presence of calcium in the medium. 4. Such an increase in glucose uptake in C6 glioma cells was also observed in the presence of diacylglycerol (DG) generating agents, such as carbachol (1 mM) and phospholipase C (0.05 unit/ml) or of DG analogs, such as sn-1,2-dioctanoyl glycerol (250 microM) and phorbol myristate acetate (1 microM). 5. Our results indicated that both calcium ion and DG levels play important roles in the regulation of glucose uptake in the glial cells, but not in neuronal cells from the brain. PMID- 1773891 TI - The fate of human polymorphonuclear leukocyte aminopeptidases upon cell stimulation with phagocytic and chemical stimuli. AB - 1. After being treated with nonopsonized zymosan A or phorbol-12-myristate-13 acetate, human polymorphonuclear leukocytes release aminopeptidases together with granules marker-enzymes and vitamin B12-binding protein. 2. Chemotactic peptide, fMet-Leu-Phe and its analogs, fMet-Phe, fMet-Ala and fMet-Leu-Phe-Lys have a similar effect. 3. By their isoelectric point determinations the released aminopeptidases correspond to the enzymes from granules. Among aminopeptidases released the highest activities were those toward methionine- and alanine-2 naphthylamide and the lowest one toward arginine-2-naphthylamide. PMID- 1773892 TI - Kinetic properties of bilirubin UDP-glucuronyltransferase in squirrel monkeys exhibiting fasting hyperbilirubinemia. AB - 1. Bolivian squirrel monkeys (BoSM), unlike Brazilian squirrel monkeys (BrSM), exhibit a marked fasting hyperbilirubinemia (FH) and serve as animal models for Gilbert's syndrome type I. 2. Compared to BrSM, BoSM possess a higher apparent UDPGAKm (0.51 vs 0.29 mM) and lower Vm (0.36 vs 0.48 nmol BR conjugated/min per mg microsomal protein) for hepatic bilirubin (BR) UDP-glucuronyl-transferase (BR UDPG-T). 3. Lineweaver-Burk plots are linear and obey Michaelis-Menten kinetics when UDP-acetylglucosamine is used as activator and UDPGA substrate concentrations are within the physiologic range present in the liver during the fed and fasted state (0.10-0.71 mM); above these concentrations, there is a discontinuity of kinetic plots as noted in other species. 4. There is no effect of fasting on the Km of BR conjugation (i.e. sum of mono- and diglucuronides) in either monkey; however, fasting is associated with lower Vm values (15-20%) in each subspecies. 5. By calculating the potential BR flux (nmol BR conjugated/min per kg) using known hepatic UDPGA concentrations, liver weights and in vitro Km and Vm, a markedly lower BR flux is observed in BoSM (58.4 nmol/min per kg) than in BrSM (91.6 nmol/min per kg). 6. Significantly higher apparent UDPGAKm and lower Vm of BR UDPG-T for conjugation of BR to BR monoglucuronide appears responsible in part for the four- to five-fold elevations in unconjugated BR in the liver and plasma in the fasted BoSM. PMID- 1773893 TI - Interstrain differences in organization of metabolic processes in the rat liver- I. The dynamics of changes in the contents of adenine nucleotides, glycogen and fatty acyl-CoAs in the course of short-term starvation in the livers of rats of Wistar, August and WAG strains. AB - 1. The metabolic patterns in the livers of rats of the Wistar, August and Wag strains were evaluated 4, 8, 12 and 24 hr after food withdrawal. 2. In the fed state (4 hr) there were large differences in the liver's contents of ATP, phosphate potential values, glycogen contents and blood FFA. These distinctions disappeared in the fasted state (12 hr). 3. There are large differences between the strains in the dynamics of transition of the liver metabolic patterns from the fed to the starved states. 4. The results obtained show that the three strains of the laboratory animals strongly differ in the organization of the liver energy metabolism. PMID- 1773895 TI - Purification and comparative characterization of cytochrome P-450scc from porcine adrenocortical mitochondria. AB - Cytochrome P-450scc (cholesterol side-chain cleavage enzyme) was purified from porcine adrenocortical mitochondria. 2. The purified cytochrome P-450scc was found to be homogeneous on SDS-polyacrylamide gel electrophoresis. 3. The heme content of the purified enzyme was 20.6 nmol/mg protein. 4. The enzymatic activity of the reconstituted cytochrome P-450scc-linked monooxygenase system amounted to 7.8 nmol of pregnenolone formed per nmole of P-450 per minute, with cholesterol as a substrate. 5. The amino acid sequence of the amino-terminal region of the cytochrome P-450scc and the amino acid residue at the carboxyl terminal were determined and compared with those of other mammalian cytochromes P 450scc. PMID- 1773894 TI - Inhibition of the veratridine-induced increase in cytosolic Ca2+ and respiration by Ca2+ antagonists in isolated cardiac myocytes. AB - 1. We studied the effect of verapamil, nitrendipine, 3',4'-dichlorobenzamil (DCB) and Cd2+ on the increase in cytosolic free Ca2+ ([Ca2+]c) and the rate of O2 uptake induced by depolarization of isolated rat cardiac myocytes with veratridine. 2. The degree of inhibition by the several drugs tested on the increase in [Ca2+]c and respiration was dependent on extracellular Ca2+, pH and Na+. 3. Low verapamil and nitrendipine concentrations (2.5 microM) were fully effective in Ca2+ channel blockade, as indicated from experiments with isoproterenol and in a low-Na+ medium. 4. A complete inhibition of veratridine induced increase in [Ca2+]c and O2-uptake was attained with higher Ca2+ blocker concentrations (25-30 microM), implying that these processes depend to a major extent on some other Ca2+ transport system, probably Na+/Ca2+ exchange. PMID- 1773896 TI - Studies on low molecular weight nuclear protein of tumour and normal cells. AB - 1. Preliminary results of comparative electrophoretical and immunological analyses of the components of two classes of non-histone proteins, i.e. NHP1 and NHP2 eluted from hydroxyapatite allowed to suppose that protein of Mw 18,000 is specific for animal tumour cells. 2. However, the studies on cellular distribution of this polypeptide indicated that it is exclusively located in nuclei of hepatoma and normal liver as well. 3. The former observation seems to be the result of changes of the affinity of this protein to DNA during neoplastic transformation. PMID- 1773897 TI - Harderian gland porphyrin, lysosomal and type II 5'-deiodinase rhythms in Sprague Dawley and Fischer-344 rats kept under chronic long- or short-photoperiod conditions. AB - 1. Harderian gland porphyrin concentrations were 1.5-fold higher in Fischer-344 male rats than in Sprague-Dawley male rats and there were no differences due to exposure to LD 14:10 (LP) or LD 10:14 (SP) lighting conditions for 8 weeks in either strain. 2. 24-hr periodic regression analyses of porphyrin concentration detected a significant rhythm in both lighting conditions in both strains, with no differences in acrophase due to lighting conditions. 3. In both strains, porphyrin levels were highest in the late phase-early dark period and fell during the early part of the dark period. 4. Acid phosphatase activity did not vary with time (circadian rhythm), strain or photoperiodic lighting condition. 5. Circadian rhythms in beta-glucuronidase, alpha-mannosidase and hexosaminidase activity were present in some instances, but, probably due to the low amplitude to these rhythms, a consistent effect of strain or housing condition was not found. When 24-hr rhythms were observed in either strain, the acrophase occurred during the afternoon-early evening daylight period. 6. A significant effect of strain on mean values of type II 5'-deiodinase activity was noted in Fischer-344 rats. 7. Significant rhythms in type II 5'-deiodinase activity were found in both strains exposed to LD 10:14. PMID- 1773898 TI - Evidence for the induction of fatty acid desaturation in proliferating hepatic endoplasmic reticulum in response to treatment with polychlorinated biphenyls. Are fatty acid desaturases cytochrome P-450-dependent monooxygenases? AB - 1. Polychlorinated biphenyls (PCBs) are abundant and persistent pollutants in the ecosystem which accumulate in biological systems. 2. We have shown previously (Borlakoglu et al., 1990; Eur. J. Biochem. 118, 327-332) that 120 hr after treating pigeons and rats with 1.5 mmol Aroclor 1254/kg body weight, hepatic microsomal membranes showed significant increases in the proportion of arachidonate (20:4,5, 8,11,14), in the concentration of cytochrome P-450 and in the activities of a wide range of cytochrome P-450-dependent enzymes involved in the metabolism of drugs and other xenobiotics. 3. After treating pigeons and rats in vivo with Aroclor 1254, linoleate desaturases activity increased significantly 3.35-, 4.35-, 5.83- and 8.61-fold 24, 48, 68 and 120 hr for pigeons and 2- and 7 fold for rats respectively 48 and 120 hr post treatment. The total activity of linoleate desaturases in the whole liver of pigeons and rats increased 40- and 10 fold respectively. 4. There were excellent correlations between the concentrations of cytochrome b5 and cytochrome P-450 and the activity of pigeon linoleate desaturases. Extrapolation of the concentration of cytochrome P-450 to zero is coincident with zero linoleate desaturase activity. 5. Evidence is presented to suggest the novel concept that linoleate desaturation is dependent upon the catalytic cycle of these monooxygenases. PMID- 1773899 TI - The effect of tumour bearing on skeletal muscle glutamine metabolism. AB - 1. The effects of tumour bearing on glutamine metabolism in rat skeletal muscle were examined using the Walker 256 carcinosarcoma. 2. There was a rapid and marked decrease in skeletal muscle glutamine content, which was correlated with the size of the tumour, and a decrease in plasma glutamine concentration. 3. The rate of release of glutamine from EDL muscle in vitro was increased in cachectic, tumour bearing animals, but was unaffected from the soleus muscle of the same animals. 4. It is hypothesized that the increase in the rate of muscle glutamine release during cachexia represents a response of this tissue in order to satisfy the demand for glutamine by the tumour or by cells of the immune system. PMID- 1773900 TI - Human placental protein methylase--I. Purification and characterization. AB - 1. Protein methylase I (S-adenosylmethionine[:]protein-arginine N methyltransferase; EC 2.1.1.23) which methylates protein-bound arginine residues has been purified from human term placenta 400-fold with an approximate yield of 6%. 2. When histone was used as in vitro substrate, the methylation products were found to be NG-mono-, NG, NG-di- and NG, N'G-dimethylarginine. The enzyme was found to be sensitive toward Cu2+ with Ki value of 8 x 10(-5) M. The Km value for S-adenosyl-L-methionine was 5 x 10(-6) M. 3. When this partially purified protein methylase I was incubated with isolated human placental nuclei and S-adenosyl-L [methyl-3H]methionine, the major endogenous [methyl-3H]-labeled proteins were protein species of 23, 38, 45 and 68 kDa, the 23 kDa species being the most predominant. 4. The endogenous enzyme activity during the pregnancy increased significantly, reaching more than 4 times the initial activity at the end of term. PMID- 1773901 TI - Hexose metabolism in pancreatic islets. Regulation of aerobic glycolysis and pyruvate decarboxylation. AB - 1. D-Glucose (0.5-16.7 mM) preferentially stimulates aerobic glycolysis and D [3,4-14C]glucose oxidation, relative to D-[5-3H]glucose utilization in rat pancreatic islets, the concentration dependency of such a preferential effect displaying a sigmoidal pattern. 2. Inorganic and organic calcium antagonists, as well as Ca2+ deprivation, only cause a minor decrease in the ratio between D-[3,4 14C]glucose oxidation and D-[5-3H]glucose utilization in islets exposed to a high concentration of the hexose (16.7 mM). 3. Non-glucidic nutrient secretagogues such as 2-aminobicyclo[2,2,1]heptane-2-carboxylate (BCH), 2-ketoisocaproate and 3 phenylpyruvate fail to stimulate aerobic glycolysis and D-[3,4-14C]glucose oxidation in islets exposed to 6.0 mM D-glucose. Nevertheless, BCH augments [1 14C]pyruvate and [2-14C]pyruvate oxidation. 4. The glucose-induced increment in the paired ratio between D-[3,4-14C]glucose oxidation and D-[5-3H]glucose utilization is impaired in the presence of either cycloheximide or ouabain. 5. These findings suggest that the preferential effect of D-glucose upon aerobic glycolysis and pyruvate decarboxylation is not attributable solely to a Ca(2+) induced activation of FAD-linked glycerophosphate dehydrogenase and/or pyruvate dehydrogenase, but may also involve an ATP-modulated regulatory process. PMID- 1773902 TI - Peroxisomal oxidases and catalase in liver and kidney homogenates of normal and di(ethylhexyl)phthalate-fed rats. AB - 1. Activities of peroxisomal oxidases and catalase were assayed at neutral and alkaline pH in liver and kidney homogenates from male rats fed a diet with or without 2% di(2-ethylhexyl)phthalate (DEHP) for 12 days. 2. All enzyme activities were higher at alkaline than at neutral pH in both groups. 3. The effect of the DEHP-diet on the peroxisomal enzymes was different in kidney and liver. Acyl-CoA oxidase activity was raised three- and sixfold in kidney and liver homogenates, respectively. The activity of D-amino acid oxidase decrease in liver, but increased in kidney homogenates. In liver homogenates, urate oxidase activity was not affected by the DEHP diet. The catalase activity was twofold induced in liver, but not in kidney. 4. The differences suggest that the changes of peroxisomal enzyme activities by DEHP treatment are not directly related to peroxisome proliferation. 5. DEHP treatment caused a marked increase of total and peroxisomal fatty acid oxidation in rat liver homogenates. 6. In the control group the rate of peroxisomal fatty acid oxidation was higher at alkaline pH than at neutral pH. 7. This rate was equal at both pH values in the DEHP-fed group, in contrast to the acyl-CoA oxidase activity. These results indicate that after DEHP treatment other parameters than acyl-CoA oxidase activity become limiting for peroxisomal beta-oxidation. PMID- 1773904 TI - Lipoproteins in the elderly. AB - Changes in lipid metabolism with age result in lower total serum cholesterol and low-density lipoprotein concentrations. There is no evidence that longevity and lipid profiles are influenced by genetic make-up. It is difficult to establish an optimum total serum cholesterol in the elderly but values established in younger subjects give a guide. High-density lipoprotein may be even more protective in the elderly and could turn out to be a better predictor of coronary disease. Screening for the treatment of hypercholesterolaemia should be carried out in the elderly. Although death is an inevitable fact, intervention in, for example, recently retired, apparently disease-free subjects is important. The first approach should be the introduction of changes in life style (increased exercise, stopping smoking, improved diet). Drugs may also be introduced if these interventions fail. Although drug therapy in the elderly may pose immediate problems due to poor renal and hepatic function, the adverse effects of long-term use have less relevance in the elderly. PMID- 1773903 TI - Paying for family planning. PMID- 1773905 TI - Effect of oral administration of bacterial extracts on the bactericidal capacity of polymorphonuclear leucocytes in children with recurrent respiratory infections. AB - The effect of orally administered bacterial extracts given intermittently over 16 weeks on the bactericidal capacity of polymorphonuclear leucocytes (PMNs) in children with recurrent respiratory infections was investigated using a luminol amplified chemiluminescence assay. Chemiluminescence of PMNs stimulated with zymosan or N-formyl-methionyl-leucyl-phenylalanine (fMLP) before and after treatment with bacterial extracts or intramuscular benzanthine penicillin was evaluated. Chemiluminescence induced by opsonized zymosan increased significantly (P less than 0.05) after treatment with bacterial extracts, whereas no significant changes were observed in the fMLP-stimulated PMNs. Long-acting penicillin treatment did not significantly affect zymosan- or fMLP-stimulated chemiluminescence. The data suggest that orally administered bacterial extracts can increase the opsonic capacity of serum and thus the bactericidal capacity of PMNs in subjects with recurrent respiratory infections. PMID- 1773906 TI - Prostaglandin E1 and tracheal intubation: relationship between the cardiovascular responses and plasma catecholamine concentrations. AB - A study was carried out on 30 normotensive patients (American Society of Anesthesiologists physical status 1) to investigate whether or not a suppressive effect of 0.3 or 0.6 microgram/kg prostaglandin E1 on the hypertensive response to tracheal intubation was due to inhibition of the increase in plasma catecholamine concentrations following the stressful stimulation. A total of 30 patients in three groups underwent elective surgery. Anaesthesia was induced with 5 mg/kg sodium thiopentone given intravenously and tracheal intubation was facilitated by 0.2 mg/kg vecuronium. Either saline (group A) or 0.3 (group B) or 0.6 micrograms/kg (group C) prostaglandin E1 was administered intravenously 15 s before direct laryngoscopy (lasting 30 s) which was attempted 2 min after administering thiopentone and vecuronium. All groups exhibited significant (P less than 0.05) increases in mean arterial pressure, heart rate, rate-pressure product and plasma noradrenaline concentrations following tracheal intubation, but the increases in mean arterial blood pressure and rate - pressure product were significantly (P less than 0.05) less in groups B and C than in group A. Prostaglandin E1, however, enhanced the increase in plasma noradrenaline concentrations following intubation. Data suggest that attenuation of the pressor response to intubation by prostaglandin E1 may not be due to inhibition of the noradrenaline release stimulated by intubation but to inhibition of noradrenaline induced vasoconstriction. PMID- 1773907 TI - Changes in serum lipid and lipoprotein measures after maximal exercise in men. AB - Normolipidaemic, healthy male volunteers (age range 20-23 years) were studied after a session of three maximal exercises and serum lipid and lipoprotein concentrations were measured. The exercise programmes, one of which was performed each week, consisted of a triangular progressive test (TPT), a rectangular sustained test (RST) and an interval endurance test (IET). There was a significant (P less than 0.05) increase of 14% in serum total cholesterol concentrations after TPT, 9.6% after RST and 14% after IET. Serum triglyceride concentrations increased by 17% after TPT, 5.7% after RST and 8.2% after IET, but increases were not significant. High-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C), and apolipoprotein (A-I, A-II) concentrations rose significantly (P less than 0.05) after TPT. There were also insignificant increases in AI, AII and LDL-C after RST and IET, whereas HDL-C rose significantly (P less than 0.05) after IET. It is concluded that the three maximal exercises had similar metabolic effects which were independent of the exercise duration. PMID- 1773908 TI - Comparative effect of dimethindene maleate and chlorpheniramine maleate on histamine-induced weal and flare. AB - Antihistaminic activity of 3 or 6 mg dimethindene maleate was compared with that of placebo and 12 mg chlorpheniramine maleate in 60 healthy volunteers in a randomized, crossover study. Activity of each drug was assessed by measuring 2 micrograms histamine-induced weal and flare areas. Compared with placebo, both doses of dimethindene and chlorpheniramine significantly (P less than 0.001) reduced weal area. Both doses of dimethindene (P less than 0.001) and chlorpheniramine (P less than 0.05) also significantly reduced flare area. Dimethindene (6 mg) brought about the maximum reduction in weal area (28.8%) and flare area (39.1%). Dimethindene (6 mg) also reduced weal area significantly (P less than 0.01) compared with chlorpheniramine and reduced flare area significantly (P less than 0.05) compared with 3 mg dimethindene. Using a 100 mm visual analogue scale for assessment of weal and flare intensities, 6 mg dimethindene again produced the maximum response. The study confirmed that the antihistamine activity of dimethindene was better than that of chlorpheniramine. PMID- 1773909 TI - A long-term follow-up of five patients with hepatitis delta virus in Japan. AB - From 1973 to 1989 five patients with hepatitis delta virus having anti-hepatitis delta antibodies continuously in the serum for more than 5 years were identified among 1019 hepatitis B virus carriers who were being followed-up for more than 3 years (mean 8.9 years). Of the five patients with antibodies, three had a history of blood transfusion, in two cases the transfusion was massive, and one patient had been addicted to narcotics given intravenously 35 years before. In the remaining patient, the route of superinfection could not be determined. Hepatitis delta antigen was detected in hepatocyte nuclei of one of the three patients in whom liver biopsies were performed and there was chronic persistent hepatitis detected by an indirect immunoperoxidase technique. During the follow-up, hepatocellular carcinoma developed in one case but the clinical prognosis was favourable in the remaining four cases. PMID- 1773910 TI - Decreased creatinine clearance which may be observed during prostaglandin E1 therapy: is it reversible with discontinuation of therapy? AB - A study was carried out in four patients with nephrotic diabetic nephropathy in order to determine if decreased creatinine clearance observed during prostaglandin E1 therapy was reversible on discontinuation of therapy. The patients received 40 micrograms prostaglandin E1 intravenously twice daily for 4 weeks and creatinine clearance and daily excretion of urinary protein were measured immediately before, during and 2 weeks after therapy. Total serum protein and serum albumin were also determined. There was a significant decrease in creatinine clearance during therapy and after therapy clearance increased but not significantly. It is concluded that decreased creatinine clearance during prostaglandin E1 therapy has a partial reversibility on discontinuation of the treatment. PMID- 1773911 TI - Effect of prostaglandin E1 on renal haemodynamics in a patient with diabetic nephropathy. AB - A 66-year old male with severe hyperglycaemia due to previously uncontrolled diabetes mellitus was also suffering from arteriosclerosis obliterans and diabetic nephropathy. The patient was treated with 16 IU/day insulin zinc suspension. In addition, an intravenous infusion of 80 micrograms/day prostaglandin E1 was given for 28 days in an attempt to improve the arteriosclerosis obliterans and diabetic nephropathy. Treatment resulted in a reduction in fasting blood glucose but no decline in urinary protein. Prostaglandin E1 treatment, however, produced an improvement in renal haemodynamics assessed by renography. PMID- 1773912 TI - Unconfounded evidence of sex-biased, postnatal maternal effort by Mongolian gerbil dams. AB - In previous studies of effects of offspring sex on postnatal maternal effort there has often been unintentional confounding of the sex ratio of the pups that a dam reared with the sex ratio of the litter that she gestated. By controlling the sex ratio of litters that female subjects gestated, we showed that (1) the probability of dams retrieving pups was influenced by the sex ratio of the litters dams gestated, not by the sex of litters that dams reared and (2) both frequency of nursing and duration of vaginal closure were influenced by the sex of litters that dams reared, not by the sex ratios of litters that dams gestated. PMID- 1773913 TI - Time course of the effect of maternal deprivation on the hypothalamic-pituitary adrenal axis in the infant rat. AB - Prolonged (i.e., 24-hr) maternal deprivation leads to a marked disinhibition of the infant rat's adrenocortical response to stress and/or ACTH. In the following study we examined the time course over which these effects develop. Pups were maternally deprived for varying lengths of time (i.e., 0, 2, 4, 8, & 24 hr); at the end of this period, corticosterone (CORT) secretion in response to stress (novelty or novelty plus saline injection) and ACTH injection was measured. Basal levels of CORT increased progressively over time in 7- and 11- (but not 3-) day old pups. CORT release in response to stress followed a similar pattern. In contrast, ACTH injection resulted in marked increases in CORT levels regardless of the length of maternal deprivation in 3-day-old animals; at older ages, however, 24 hr of deprivation led to a much larger increase. These findings support the hypothesis that the hypothalamic-pituitary-adrenal axis of the neonatal rat is subject to maternal regulation. PMID- 1773914 TI - Sex steroids at birth: genetic and environmental variation and covariation. AB - Three sex-steroids (estradiol, progesterone, & testosterone) were assayed from the umbilical cord blood of 58 same-sex twin pairs in an investigation of the effects of sex, as well as genetic and environmental factors, on neonatal hormone levels. Although significant mean differences were found between boys and girls for both testosterone and progesterone, sex appeared to account for very little of the total variation for any of the hormones. Results showed that genetic influences significantly affected within-sex variation in both estradiol and progesterone levels, while variations in the intrauterine (shared twin) environment accounted primarily for differences in levels of testosterone. Moderate correlations were also found among the three hormones. Multivariate biometrical analyses revealed these relationships to be explained by an underlying general factor of nonshared environmental influences affecting all three hormones. Genetic factors appeared to be specific to each hormone rather than correlated across hormones. These results suggest not only that genes are operating at this early age, but also that maternal and other prenatal factors (e.g., placental effects, uterine position) have a significant role in variations of sex-steroids and possibly on later behaviors. PMID- 1773915 TI - Anxiety in rhesus monkey infants in relation to interactions with their mother and other social companions. AB - In this study the anxiety-related components of rhesus monkey infant behavior at an early stage of social development were examined. Eight rhesus infants (age 30 40 weeks) belonging to 3 captive groups were administered with an anxiogenic drug (beta-CCE; 0.2 mg/kg) and an anxiolytic drug (midazolam; 0.2 mg/kg). Saline solution was used as placebo. All infants were tested twice with each drug (four times with placebo) and their behavioral interactions with their mother and other social companions were recorded in 1-hr observation sessions. No convulsant or sedative effects of the drugs were observed. beta-CCE was associated with an increase in time spent by the infant with its mother and a concomitant reduction in proximity with other individuals and in social play. Midazolam did not affect the mother-infant interaction but increased the infant's locomotor activity away from the mother and its proximity and social play with juveniles and subadults when compared to peers. These results suggest that, although infant anxiety can be experimentally induced, it is not a major component of the mother-infant relationship. Infant anxiety, however, might affect the formation of other social bonds and play a part in the development of avoidance responses toward other individuals. PMID- 1773916 TI - Growth and branching morphogenesis of rat collecting duct anlagen in the absence of metanephrogenic mesenchyme. AB - The growth and differentiation of the epithelium in many tissues is mediated by interactions with the adjacent mesenchyme, but the mechanisms responsible remain undefined. To identify the factors involved in the growth and branching morphogenesis of ureteric bud, which is the collecting duct anlagen, buds from 13 gestation-day rat embryos were separated from the metanephrogenic mesenchyme and explanted to culture dishes coated with gelled type I collagen in a defined medium. Under these conditions buds attached to the substrate and grew out without indication of cell senescence. When buds were instead suspended in gelled type I collagen, branching morphogenesis was observed despite the absence of mesenchyme although it was not as extensive as in vivo. Since growth occurred much more slowly in culture than expected, culture conditions were varied in attempts to accelerate the process. Despite extensive screening of matrices and growth factors, only epidermal and endothelial cell growth factors stimulated growth to a significant extent. Transforming growth factor-beta, on the other hand, was a potent inhibitor of growth. Homogenates from tumors that caricature metanephrogenic mesenchyme were highly mitogenic for bud cells and, thus, will be a source of material for characterizing regulatory factors involved in renal growth. These studies show that growth and branching morphogenesis of the ureteric bud can occur without direct cell-cell interactions with the metanephrogenic mesenchyme and that matrices and factors secreted by the mesenchyme may mediated these activities in vivo. PMID- 1773917 TI - Isolation and characterization of PC-3 human prostatic tumor sublines which preferentially metastasize to select organs in S.C.I.D. mice. AB - We have developed and partially characterized a mouse model system for studying human prostate tumor cell metastases in vivo. To develop this model we have selected highly invasive (3 x I.) and non-invasive (3 x N.I.) PC-3 human prostatic tumor sublines based on enhanced and diminished capacities to migrate across a reconstituted basement membrane barrier (Matrigel) in Boyden chamber chemotactic assays. When the 3 x I. cells were injected intravenously (i.v.) in the tail vein of severe combined immune deficient (scid) mice, the cells initially metastasized to a wide variety of tissues as demonstrated by using [125I] IUdR labeled cells and histology. Four distinct sublines were eventually isolated which preferentially metastasized at approximately 80% efficiency to the lumbar vertebrae (PC-3 ML), the mandibular region of the right cheek (PC-3 MC), the rib cartilage (PC-3 MR), and the right front knee bone (PC-3 MK), respectively. Implantation experiments at different sites indicated that organ metastases may somehow be conferred on the tumor subclones by the host tissue. PMID- 1773918 TI - Immunohistochemical localization of the carbohydrate antigen 4C9 in the mouse embryo: a reliable marker of mouse primordial germ cells. AB - Expression of 4C9, a Lex[Gal beta 1----4(Fuc alpha 1----3)GlcNAc] antigen, during mouse embryogenesis was studied by immunohistochemical methods. Distribution of 4C9 was similar to, but not identical with that of SSEA-1 (stage-specific embryonic antigen-1). Notably, 4C9 was detected in some of the inner cell mass cells of late blastocysts, ectoderm cells migrating from the primitive streak to the mesoderm space and primordial germ cells just formed from the migrating cells. Thus, 4C9 was considered to be continuously expressed in the cell lineage starting at the totipotent 8 cell stage and leading to primordial germ cells. While 4C9 gradually decreased from the surface of primordial germ cells after they have settled in the gonad, the antigen remained in cytoplasmic granules for some period in a sex determined manner. In male gonads, cytoplasmic granules positive for 4C9 tended to be polarized to one side of cytoplasm. The 4C9 reactive material completely disappeared from male germ cells by day 16 of gestation. In female gonads, granules scattered throughout the cytoplasm and cell surface were positive for 4C9. On day 16 of gestation the cell surface antigenicity was lost, but some cytoplasmic antigenicity still remained. As above, 4C9 is a reliable marker to study the origin, migration and differentiation of primordial germ cells, and to distinguish male and female germ cells. By immunoelectron microscopy, 4C9 was detected at the plasma membrane, the Golgi apparatus, and dense-cored vesicles in primordial germ cells on 10-11 days of gestation. PMID- 1773919 TI - The response of female urogenital tract epithelia to mesenchymal inductors is restricted by the germ layer origin of the epithelium: prostatic inductions. AB - The epithelium of the mammalian vagina arises from two distinct germ layers, endoderm from the urogenital sinus and mesoderm from the Mullerian ducts. While neonatal vaginal epithelium can be induced to form prostate which is normally an endodermal derivative, it has not been determined whether this ability to form prostate is shared by both mesoderm- and endoderm-derived vaginal epithelia. To test the competence of vaginal epithelia we have isolated sinus-derived and Mullerian-derived vaginal epithelia from newborn mice, combined them with rat urogenital sinus mesenchyme, and grown the tissue recombinants for 4 weeks in male athymic nude mice. Endoderm-derived sinus vaginal epithelium was induced to form prostatic tissue which expressed prostate-specific secretory proteins in 21 of 23 tissue recombinants. Mullerian-derived vaginal epithelium formed small ducts and cysts lined by a simple epithelium. These latter tissue recombinants lacked any evidence of prostatic secretory proteins. Similarly, endoderm-derived urethral epithelium was induced to form prostate (17 of 17 cases), while mesoderm derived uterine epithelium was not (0 of 13 cases). Therefore, the ability to form prostatic epithelium was limited to endodermal derivatives of the urogenital tract. PMID- 1773920 TI - [Fetal behavior in multiple pregnancy: methodologic, clinical and scientific aspects]. AB - In multiple pregnancy, an intense supervision of the fetal condition is indicated during pregnancy and delivery. With the aid of a recently developed actocardiograph originally described by Maeda, it is possible to monitor the fetal heart rate (FHR) and fetal movements (FM) of twins simultaneously on one tracing by 2 external Doppler transducers. Additional methods (stimulation, real time and Doppler ultrasound) were tested in combination with the equipment. In addition, FHR tracings of triplets were registered during delivery simultaneously with FM and contractions. First patterns of "twin behaviour" are described. It may be concluded that this way of recording is of definite practical and potential scientific value. PMID- 1773921 TI - [Prognostic significance of intrauterine hematomas in the 1st and 2d trimester for the course of pregnancy and labor]. AB - The courses of 66 pregnancies with sonographic evidence of an intrauterine haematoma within the egg-membranes during threatened abortion, between 7th and 24th week of gestation, were compared to the courses of 55 patients at the same gestational age admitted to our hospital, during the same period, with vaginal bleeding only. The aim of our study was to determine the prognostic significance of intrauterine haematomata in the I. and II. trimester for the course of pregnancy and delivery. The abortion-rate after intrauterine haematomata was significantly increased to 17.5%, a high percentage of them taking a febrile or septic course. The rate of preterm labour in haematoma patients was significantly higher (34.5 compared to 12.7%, respectively), than that in patients, who were only bleeding; this, furthermore, was reflected by a strong trend of preterm delivery (21.9 compared to 12.9% resp.). The caesarean section rate of 55.8% in the haematoma group was found to be significantly higher than in the control group (16.7%), mainly due to a significantly increased proportion (23.1%) of abnormal foetal presentations. Abnormal placental stages had to be treated significantly more often after intrauterine haematomata (32.6%) than in the control group (9.3%); however, no differences could be found between the two groups in respect of metabolic or respiratory placental dysfunction. The parameters examined in this study were not influenced by the volume of the haematoma, although the spectrum of complications seemed to be correlated to the gestational age at the time of diagnosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1773922 TI - [Development of symptoms and perinatal complications in HELLP syndrome]. AB - At the Kiel University Department of Gynaecology, 21 patients between the 21th and 39th week of gestation were treated in 1987 and 1988 following diagnosis of HELLP syndrome. At the time of diagnosis all patients presented an advanced gestosis/eclampsia. 9 patients developed the classical signs and symptoms, while hospitalised. The typical signs of gestosis, hypertension, proteinurea, oedema and hypoproteinaemia preceded the changes in laboratory values caused by the HELLP syndrome. Upper abdominal pain and increase in transaminase values occurred on the average 3.4 or 2.7 days prior to the decrease of, thrombocyte count. In 19 of the 21 cases, pregnancy was terminated by caesarean section. Severe peripartal complications occurred in 7 cases e.g. foetal death in utero (n = 3), eclampsia (n = 5), renal failure (n = 2), cerebral oedema (n = 1), intracerebral haemorrhage (n = 1), disseminated intravascular coagulation (n = 1), abdominal wall haematoma (n = 1). 6 of these patients were admitted after complications had occurred prior to admittance. All 18 infants born alive survived the neonatal period. The average birth weight was 1,571 g. 11 infants were discharged clinically normal. The remaining infants included 5 cases pointing to retinopathy and 3 cases of cerebral palsy. One infant developed post-haemorrhagic hydrocephalus. PMID- 1773923 TI - [The diagnostic potential of amniocentesis in the first 12 weeks of pregnancy]. AB - Prenatal diagnosis of chromosomal and biochemical defects is accepted as a routine in high-risk patients. To eliminate the disadvantages of traditional amniocentesis (late diagnosis) and of chorion villus sampling (placentar mosaics, higher fetal loss rate) we evaluated the facts on amniocentesis during the first 12 weeks of pregnancy. 42 samples were analysed. 21 amniotic fluid samples were from pregnancies before the 13th week of gestation, 21 further punctures were performed between the 13th to 15th week and served as comparative figures. Of 21 samples, diagnosis was possible in 16 cases. Four cultures did not show any growth of cells; in one case, amniotic fluid could not be aspirated. In the comparison group chromosomal diagnosis could be done in every case. An average of 12.3 ml of amniotic fluid were taken. Chromosomal disorders found, included a translocation in chromosome 13/14 as well as a trisomy of chromosome 18. Biochemical defects such as Gaucher's disease and Niemann-Pick disease were excluded. 30 pregnancies without pathological symptoms were seen (mean birth weight 3200 g, mean duration of pregnancy 39 weeks). One case of abortion following amniocentesis was found in the 16th week of gestation. One case of premature delivery occurred in the 34th week and the pregnancy of a 40-year old women was complicated by EPH gestosis while 9 pregnancies were terminated by interruption following the patients' wish. Because chromosomal diagnosis could not be performed in five of 21 cases, amniocentesis during the 13th week of gestation cannot be recommended as a routine method. Early amniocentesis, however, is an alternative to the traditional amniocentesis at the 16th week of gestation. PMID- 1773924 TI - [Opiate analgesia in labor--use of nalbuphine in comparison with administration of the combination Dolantin/Atosil/Haldol]. AB - Since July 1, 1990, Nalbuphine has been used as an obstetric analgesia at the Municipal Women's Hospital in Cologne-Holweide. The following differences were found between 2 groups of 122 patients each, one of which received Nalbuphine and the other a socalled cocktail, a combination of dolantin, haldol, and atosil. The number of spontaneous births in the Nalbuphine group was higher and the number of Caesarean sections and vagino-operative births were lower in comparison to the cocktail group. The pH-level of the arterial umbilical cord was higher in the Nalbuphine group, which can be explained by less stress on the child during birth. Overall, the post partum irregularities were less in the Nalbuphine group, whereas 6 children in the cocktail group had respiratory adaptation disturbances. PMID- 1773925 TI - [Drainage of large breast abscesses with reference to esthetic and functional aspects]. AB - In 11 puerperal women, a breast abscess was treated by drainage from the inframammary fold. Eight patients wished to continue breast feeding. During the healing period, the babies were not breast fed on the operated side. In 3 patients, the skin over the abscess necrotised, resulting in a defect of 1 to 2 cm. In 2 patients, a small seroma had to be punctured after removing the drainage tube. Aesthetic results were judged by the patients as good. Resumation of suckling on the operated side revealed only 15 to 20% milk yield compared to that of the other breast. This treatment meets aesthetic and function-preserving criteria. PMID- 1773926 TI - [Effect of surgical procedure and adjuvant therapy on cosmetic results after breast conserving therapy in breast cancer]. AB - A total of 207 patients undergoing breast conserving therapy (BCT, excision of tumour with clear margins, radiotherapy, sequential chemotherapy for node positive patients) were clinically evaluated after a median follow-up of 11 months (min 2/max 22). The aim of the study was to analyse the impact of various individual factors, surgical techniques and adjuvant therapies on the cosmetic result. In 85.7% of all cases the objective outcome was satisfactory (very good: 48.8%, good: 36.9%) and in 14.3% unsatisfactory (fair: 13%, poor: 1.3%). Objective cosmetic results were rated significantly better by the patients (p = 0.01), in cases with biopsy weights of greater than 100 grms. (large/hyperplastic breast, p = 0.01), non-reconstructed mammary glands (simply closure of subcutis and skin, p = 0.01), non suction drainage of the breast (p - 0.04) and normal healing of the wound (p = 0.01). There was a trend towards better cosmetic results in the premenopause in patients with a tumour localised in the upper outer quadrant, in cases of a curvilinear as compared to a radial incision (upper/outer quadrant) and in small or average-sized breasts with biopsy weights of less than 50 grms. Cosmetic results were unaffected by a "two-step" procedure, standardised postoperative radiotherapy (45-55 Gy) and by sequential chemotherapy (3x CHT/radiotherapy/3x CHT). Unsatisfactory cosmetic short-term results should primarily be regarded as a surgical complication of BCT. Results can be improved by taking into consideration the importance of the relation of breast/biopsy weight as well as standardising the operative procedure (curvilinear incision, closure of subcutis and skin, drainage without suction, perioperative antibiotic prophylaxis). PMID- 1773927 TI - [Effectiveness of Burch colposuspension in females with recurrent stress incontinence--a urodynamic and ultrasound study]. AB - A collective of 31 women with recurrent stress urinary incontinence was subject to Burch colposuspension. The average time interval between the primary treatment (anterior colporrhaphy) and surgical colposuspension was 5.5 years. All patients underwent clinical, urodynamic and sonographic assessment of incontinence prior to and after surgery. The follow-up examination was performed at an average of 14.5 months after colposuspension according to the method reported by Burch. In 87% of patients, continence was achieved. 90% of patients were able to void without any formation of residual urine in the bladder. In the attempt to optimise the diagnostic and therapeutic procedures pertaining to female incontinence, introitus sonography and urodynamic assessment have proved to be valid adjuvant tools. PMID- 1773928 TI - [Visceral peritonealization after abdominal hysterectomy--a retrospective pilot study]. AB - A closure of the parietal and visceral peritoneum has always been thought to be a necessary measure in gynaecological surgery to avoid postoperative ascending infections or adhesion formation with the risk of a consequent ileus. Based on good experience in radical gynaecological surgery and the opinion of many authors, who consider the closure by means of sutures as the real cause for adhesion formation, we omitted the closure of the visceral peritoneum in abdominal hysterectomies. We performed 80 such procedures and analyzed them with regard to their postoperative course. We found a strikingly low rate of postoperative fever, no signs of infection of the wound and not a single case of postoperative ileus. We therefore believe, that omitting the closure of the visceral peritoneum entails notable advantages, that should be confirmed by follow-up studies. PMID- 1773929 TI - [The advantage of preventive vaginal antisepsis with hexetidine in obstetrics and gynecology]. AB - In five studies, the advantage of repeated vaginal prophylaxis by a new preparation of hexetidine vaginal suppositories (10 mg) was investigated prospectively, randomised and method-controlled (n = 2 x 50). After a five-day application, the hexetidine group achieved bacterial reductions of five log CFU/ml in the vagina and nearly three log CFU/ml in the cervix uteri, whilst no reduction was found in the controls at any time (p less than 0.01). The reduction of individual bacterial species was investigated in 224 pregnant and also gynaecological patients. In cases of impending preterm childbirth, a five-day application of 20 mg hexetidine/day could reduce all bacteria sufficiently with the exception of lactobacilli; especially beta Streptococci were reduced. The same was achieved by a three-day application of 10 mg hexetidine/day pre operatively. A long-term study in 11,724 deliveries showed, that neonatal infectious mortality and morbidity after 36 gestational weeks could be reduced significantly by hexetidine. The new hexetidine preparation appeared to be efficient in vaginal antisepsis, especially in pregnancy. A favourable lactobacilli-selective effect was demonstrated. Since the importance of lactobacilli in vaginal ecology is known, hexetidine prophylaxis must be considered as advantageous in Obstetrics and Gynecology. From a practical and economic point of view, the application of hexetidine as vaginal suppositories appears favourable compared to antiseptic solutions. PMID- 1773930 TI - [Acute infantile cerebral form of Gaucher disease]. AB - A foetus causing attention by disharmonic growth retardation and suspected CTG, died within the 34th week of gestation. The infantile cerebral form (type II) of Gaucher's disease was detected by histological examination. In another pregnancy a second afflicted child was discovered by decreased cerebroside-beta-glucosidase activity in amniotic fluid cells. Abortion was therefore induced. PMID- 1773931 TI - [Intravenous leiomyomatosis of the uterus]. AB - Intravenous leiomyomatosis imitates an invasive malignant tumour both clinically and pathologically although it represents a perfectly benign disease with a favourable outcome. The knowledge of this very rare disease is necessary not to omit the indicated operation on the patient, because of an erroneous assumption of incurability. Therefore, we present the clinical and pathological appearance of this disease from two typical cases of our own. PMID- 1773932 TI - [Patient education--informed consent--extended operation]. PMID- 1773933 TI - [Characterization of novel partial t-haplotypes tM1, tM2, tM3, tM4]. AB - The results of genetic analysis of the effects of four novel partial mouse TM haplotypes are presented in this work. Fertility and viability of tM/tM homozygotes and tM/t6 compounds, transmission ratio distortion (trd) in males heterozygous for tM, suppression of recombination and taillessness effects were studied. Three novel t-haplotypes tM1,2,4 are viable and heterozygous for these haplotypes males T/tM show low trd (20-30%). Comparison of these data and the t6 haplotype structure suggests that the tM1,2,4-haplotypes were derived as a result of recombination events in the non-inverted T-complex fragment located between two inversions. The tM3-haplotype is semilethal and heterozygous T/tM3 males show the trd equal to that of t6-heterozygotes. Homozygous tM3/tM3 and tM3/t6 male compounds are fertile or subfertile. Potential recombination ways of derivation of tM3 are discussed. PMID- 1773934 TI - [Morphology and behavior of the sex chromosomes in meiosis in four vole species of the genus Microtus]. AB - Morphology and behaviour of the X and Y chromosomes of four species of genus Microtus were studied at pachytene, metaphase I and meiotic metaphase. The X chromosomes of the species varied with respect to their size and location of heterochromatic blocks. The axes of X and Y chromosomes of these species as well as Microtus agrestis never formed true synaptonemal complexes at any sub-stage of the pachytene. They approached each other at the start of the pachytene throughout to metaphase I, getting situated closely. At the end of the pachytene, they formed sex vesicle. The X and Y chromosomes kept their proximity during metaphase I, but never formed true bivalents. It is suggested that lack of synapsis of the X and Y chromosomes in the genus Microtus is the final step of evolutionary trend to reduction of the size of the pseudo-autosomal region. The abolition of restrictions on homology between the X and Y chromosomes is supposed to be a cause for the fast divergence in morphology of sex chromosomes in the genus. PMID- 1773935 TI - [Study of the breed-forming process in sheep using multivariate methods of analysis of genetic and morphologic distances]. AB - Comparison of biochemical genetic variation and morphological variation during formation of a new breed of sheep by means of multi-breed mating has been carried out. Genetic distances calculated by biochemical markers using various methods (by M. Nei, J.S. Rogers, I.I. Cavalli-Sforza and A.W.F. Edvards) have been discovered to significantly correlate with Manhattan and average taxonomic distances calculated on the basis of six morphological traits (r = 0.841-0.889, t = 2.98-2.99, P = 0.999). Nevertheless, it appeared that relationships between crossbred animals revealed with the help of methods for multidimensional analysis (principle component analysis and multidimensional scaling) on the basis of genetic distances matrix more precisely correspond to the real scheme and direction of breeding work than relationships described while using the given methods on the basis of morphological distances matrix. Greater correspondence of data on biochemical genetic variations of the animal groups studied to real processes of breeding, as compared with the data on morphological traits, is supposed to be connected with direct involvement of non-accounted phenotypic characters into the breeding work. PMID- 1773936 TI - [Comparative analysis of chromosomal nucleolar organizing region activity in spontaneous and medical abortuses]. AB - Comparative analysis of functional activity of silver stained nucleolar organizing regions (NOR) activity was carried out in human fibroblasts of 70 spontaneous and 50 medical abortuses. The NOR activity was significantly higher in spontaneous abortuses compared with medical ones. This phenomenon which was observed in female, but not in male abortuses, did not depend upon the tissue origin of fibroblasts (embryonic or extraembryonic) and was due to increase of the NOR activity of the all acrocentric chromosomes to the level at which individual differences in the NOR activities among some acrocentrics were smoothed. It has been suggested that the ribosomal genes activity in different sex is likely to be differently involved in polygenic systems determining vitally important features of organism that may lead to different selection intensity in different sex resulted in deviation of the ribosomal gene copy number from the optimum. The possible role of changes in DNA methylation at the genome level in activation of ribosomal genes in spontaneous abortuses is discussed. PMID- 1773937 TI - [Species-specific features of the distribution of restriction sites in Bsp repeats of Canidae genome]. AB - Differences and similarities of the Bsp-repeats' organization in fox, dog, polar fox and raccoon dog genomes were studied. Specificity of Bsp-repeats to the Canidae family was demonstrated. The repeats are mainly organized in large clusters in all species studied. The species-specific features in restriction patterns were revealed for all five genomes, in spite of high intragenomic polymorphism exhibited in each case. This suggests that certain unique sets of structural versions of Bsp-repeats were fixed in canid genomes by amplification during the process of speciation. Fox and polar fox exhibited the highest similarity in restriction patterns of Bsp-repeats. Raccoon dog pattern is most unusual among others: its distinguishable character is the absence of large multimeric series. The EcoRI hydrolysate of raccoon dog Bsp-repeats consists mainly of one band corresponding to 1600 bp. These are in accordance with phylogenetic relations between canids. PMID- 1773938 TI - [Heterogeneity of the Canidae Bsp-repeats family: discovery of the EcoRI subfamily]. AB - A 1600 bp EcoRI fragment was cloned from genome of raccoon dog. The structure obtained is homologous to the Canidae Bsp-repeats family. Comparative blot hybridization of the EcoRI fragment and BamHI repeat from fox genome with restricted hydrolysates of the total of raccoon dog and fox DNAs revealed differences both in structure and genomic organization between these two Bsp repeats versions. Evidently, the EcoRI fragment contains a sequence lacking from the BamHI fragment of the fox Bsp-repeats. Quantitative differences in contents of two Bsp versions in various canid genomes were revealed as well. The EcoRI version is most abundant in raccoon dog genome, while the BamHI fox version is most representative in polar fox genome. With other species studied, quantitative differences in version contents are not so dramatic, and the EcoRI fragment is always present in lower copy numbers. The discovery of the EcoRI subfamily of the Bsp-repeats is in accordance with the "library hypothesis" advanced by Salser in 1976. Connection of the Bsp-repeats' evolution with centric fusions and breaks characteristic of karyotype evolution of canids is being discussed. Comparative study of cloned EcoRI and BamHI fragments of Bsp-repeats in cytogenetical and molecular aspects may be useful, when investigating the role of tandem repeats in large chromosome rearrangements. PMID- 1773939 TI - [A new pleiotropic mutation affecting purine metabolism, sporulation and biosynthesis of exoenzymes in Bacillus subtilis]. AB - A pleiotropic mutation (cpm) which is localised in the vicinity of the spoA gene of Bacillus subtilis chromosome has been described. The mutation inhibits spore formation, renders bacteria auxotrophic for adenine and tyrosine, increases sensitivity to antibiotics, decreases cell motility and the ability to grow on D ribose and D-xylose, inhibits growth of bacteriophages PBS1 and AR9 as well as enhances activity of alkaline proteinase and alpha-amylase. At the same time, the cpm mutants acquire the ability to produce inosine. Inosine excretion is connected with more than 50- and 5-fold increase in activity of 5'-nucleotidase in respect to IMP and AMP, accordingly, and 10-fold decrease in activity of purine nucleoside phosphorylase. Biosynthesis of inosine and Ade- phenotype of the cpm mutant are not mediated by the change in activity of sAMP synthetase. The nature and mechanism of action of the cpm mutation are under discussion. PMID- 1773940 TI - Electrochemistry of Cu(I) bipyridyl complexes with alkene, alkyne, and nitrile ligands. Implications for plant hormone action of ethylene. AB - The redox behavior was evaluated for several (BIPY)Cu(I) complexes (BIPY = 2,2' bipyridyl) with unsaturated ligands by means of cyclic voltammetry in CH2Cl2 at reduced temperatures (-78 degrees, -23 degrees, 0 degree C). The complexes studied are [Cu(I)(BIPY)(C2H4)]PF6, [Cu(I)(BIPY)(3-hexyne)] PF6, [Cu(I)(BIPY)(DEAD)]PF6, ([Cu(I)(BIPY)]2 DEAD)[PF6]2 (DEAD = diethyl acetylene dicarboxylate) and [Cu(I)(BIPY)(CH3CN)]PF6. The oxidations are quasi-reversible at -78 degrees C for scan rates of 20 to 200 mV/sec. The reductions were irreversible on the CV time scale. Evidence is presented in support of a role for an electron transfer mechanism in the case of the plant hormone ethylene. Related literature data are also discussed. PMID- 1773941 TI - Effect of various mixtures of diethylether, halothane, nitrous oxide and oxygen on low molecular weight iron content and mitochondrial function of the rat myocardium. AB - Anaesthetic drugs can induce reversible as well as irreversible changes in cell membranes and intracellular proteins as well as lipid peroxidation in the liver. Low molecular weight iron species (LMWI) can by their catalytic activity contribute to the generation of free radicals (hydroxyl radicals). Free radicals are a recognisable cause of intracellular damage. Impaired mitochondrial function is also a sign of intracellular damage, which is usually irreversible. Thus, an agent may be cytotoxic when it causes a significant increase in intracellular LMWI. Whether the LMWI arise from ferritin or is released from iron containing proteins, the same reaction occurs. As long as LMWI can undergo redox cycling, hydroxyl radicals can be formed. We investigated the effect of various mixtures of diethylether, halothane, nitrous oxide and oxygen on the intracellular LMWI content and mitochondrial function of the rat myocardium. Hearts isolated from rats anaesthetised with diethylether showed an increase in the cytosolic LMWI compared to the control group. No increase in mitochondrial LMWI was demonstrated. Subsequent perfusion of the isolated hearts showed a further increase in the LMWI. On perfusion the mitochondrial LMWI increased in comparison with controls. Mitochondrial function was significantly impaired as measured by the QO2 (state 3), ADP/O ratio and oxidative phosphorylation rate (OPR). Exposure of rats to 50% nitrous oxide for 15 minutes increased the myocardial LMWI, but had no effect on mitochondrial function. Exposure to room air for 30 minutes before isolating the hearts, still showed a significant increase in LMWI with no detectable change in mitochondrial function.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1773942 TI - Inhibition of lipid peroxidation of lecithin liposomes kept in a pH-stat system near neutral pH. AB - During 5 days of autoxidation of egg lecithin liposomes in nonbuffered saline pH dropped from an initial value of 7.4 to 4.5. A linear relationship between oxidation index and pH was obtained. Lipid peroxidation, monitored as conjugated diene and TBA-reactive products, was inhibited significantly by keeping the samples under pH-controlled conditions (7.4 +/- 0.5), compared to controls. Obtained results indicate that the buffering capacity of Tris and Hepes buffers may play a role in their recently reported (D. Fiorentini et al. (1989) Free Radical Res. Commun., 6, 243) inhibitory action against lipid peroxidation of lecithin liposomes. PMID- 1773943 TI - The free radical trapping agent N-tert.-butyl-alpha-phenylnitrone (PBN) attenuates cerebral ischaemic injury in gerbils. AB - Several studies have suggested that oxygen-derived free radicals play an important role in the genesis of ischaemia-induced neuronal damage. We report here that the spin trap agent, N-tert.-butyl-alpha-phenylnitrone (PBN) reduced neuronal damage in gerbils subjected to forebrain ischaemia. PBN (100 mg/kg) administered either 30 min. prior to, or 30 min. after a 5 min. period of bilateral carotid occlusion prevented the increase in locomotor activity observed in saline-injected ischaemic animals and significantly reduced the damage to the hippocampal CAI pyramidal cell layer observed 5 days post-ischaemia. Telemetry measurements of body temperature revealed that administration of PBN and the induction of cerebral ischaemia were associated with small reductions in body temperature, but these changes were not significant. PBN (100 mg/kg) administered 2 hr post-ischaemia failed to protect against cerebral ischaemia. These findings support the hypothesis of an involvement of free radicals in ischaemia reperfusion induced cerebral damage and suggest that spin trap agents may be useful for the prevention of cerebral ischaemic damage. PMID- 1773944 TI - Aetiology and natural history of primary sclerosing cholangitis--a decade of progress? PMID- 1773945 TI - Relations among autonomic nerve dysfunction, oesophageal motility, and gastric emptying in gastro-oesophageal reflux disease. AB - Recent studies suggest that vagal nerve dysfunction may be important in the aetiology of gastro-oesophageal reflux disease. Delayed oesophageal transit and slowed gastric emptying occur frequently and may also be of pathogenic importance. In 48 patients with gastro-oesophageal reflux disease we studied the prevalence of and relations between autonomic nerve dysfunction (as assessed by cardiovascular reflex tests) and oesophageal transit, oesophageal motility, gastric emptying, and endoscopic grade of oesophagitis. Of the 48 patients, 21 (44%) had abnormal autonomic nerve function, which was predominantly parasympathetic. Oesophageal transit was delayed in 28% of the patients and gastric emptying of the solid component of the meal was delayed in 46%. Oesophageal transit was significantly (p less than 0.007) slower in patients with abnormal autonomic nerve function. The percentage of synchronous oesophageal contractions was related to the score for autonomic nerve dysfunction (r = 0.40, p less than 0.05). There was no significant relation of autonomic nerve dysfunction to either delayed gastric emptying or endoscopic grade of oesophagitis. We conclude that in gastro-oesophageal reflux disease there is a high prevalence of parasympathetic nerve dysfunction which relates to delayed oesophageal transit and abnormal peristalsis and may therefore be of pathogenic importance. PMID- 1773946 TI - Only patients with dysplasia progress to adenocarcinoma in Barrett's oesophagus. AB - Columnar lined oesophagus (Barrett's oesophagus) carries a risk for the development of adenocarcinoma. Epithelial dysplasia appears to be a precursor but the utility of this marker for predicting subsequent adenocarcinoma is unsettled. We therefore prospectively studied 81 patients with histologically proven columnar epithelium of at least the distal 3 cm of the tubular oesophagus with regular endoscopic biopsies for a total of 289.2 patient years (mean 3.6 years, range 0.5-8). Twenty three patients (28%) had epithelial dysplasia detected during follow up. Both patients with persistent high grade dysplasia present on initial biopsies developed adenocarcinoma after 2.6-4.5 years, despite the absence of gross macroscopic change. The initial single layer pleomorphic high grade dysplasia in one patient regressed to low grade dysplasia which has persisted for 1.5 years. Of 10 patients with initial low grade dysplasia, one progressed to adenocarcinoma in 4.3 years. The low grade dysplasia persisted unchanged in seven patients for 1.5-7 years and appears to have regressed in two patients after three to five years. Ten patients developed low grade dysplasia during the surveillance period. This has persisted unchanged in six patients from 0.5-5 years, regressed in three for 0.5-5 years and has appeared after the first yearly biopsy in one patient. No patient without dysplasia has developed adenocarcinoma. The incidence of adenocarcinoma in Barrett's oesophagus in this study is one case per 96 patient years. This is 61 times (95% confidence limits 12-176) the age adjusted incidence of oesophageal cancer in Australia. Persistent high grade dysplasia appears to be a sensitive indicator for the development of subsequent adenocarcinoma. PMID- 1773947 TI - Gastric carcinogenesis in the rat induced by duodenogastric reflux without carcinogens: morphology, mucin histochemistry, polyamine metabolism, and labelling index. AB - Chronic duodenogastric reflux induces gastric adenocarcinomas in the rat without the use of carcinogens. Altogether, 186 male Wistar rats were randomised to undergo either a simple gastrojejunostomy or a gastrotomy and sacrificed at eight weekly intervals for 56 weeks. No control animals developed dysplasia or carcinoma. All rats subjected to a gastrojejunostomy showed hyperplasia of the proliferative neck zone, with increased sulphomucin production adjacent to the scar. Low grade dysplasia was found at 16 weeks, and carcinoma was first seen at 32 weeks. Most carcinomas were well differentiated mucin secreting adenocarcinomas of the expanding type, which secreted a mixture of sialomucins and sulphomucins. Duodenogastric reflux was associated with a 100% increase in labelling index (assessed autoradiographically with tritiated thymidine) in the gastric mucosa when compared with corresponding tissue adjacent to a gastrotomy scar. This increase was significant at eight weeks and persisted for 56 weeks after surgery. This study supports the theory that, in this model, hyperplasia precedes the development of carcinoma. PMID- 1773948 TI - Simplified single sample 13Carbon urea breath test for Helicobacter pylori: comparison with histology, culture, and ELISA serology. AB - There is no ideal method for detecting Helicobacter pylori. The 'standard' 13Carbon urea breath test (13C-UBT), which involves collecting eight to 15 breath samples and subsequent costly analysis, was modified by pooling 21 samples of expired breath taken at five minute intervals for 40 minutes into a collecting bag, from which a single 20 ml aliquot was taken and analysed by mass spectrometry. This test was evaluated on 50 patients after routine upper gastrointestinal endoscopy, and results were compared with those from the standard 13C-UBT, bacteriology, ELISA serology, and histology--the latter being taken as the gold standard. H pylori were seen in 34 of 50 (68%) patients (in three it was detected in biopsy specimens from the corpus alone). The modified 13C-UBT was positive (pooled excretion delta 13CO2 greater than 5 per mil) in 31 patients and negative in 19 (three false negative results), specificity was 100% (standard 13C-UBT 94%) and sensitivity 92% (standard 13C-UBT 93%). The modified 13C-UBT had a coefficient of variation within subjects of 3.7%. For the ELISA serology and culture the specificities were both 100%, but the sensitivities were 82% and 68% respectively. The 13C-UBT results correlated with the grade of histological gastritis. The modified 13C-UBT is simpler, cheaper, more reproducible, and provides an easy non-invasive method for the detection of H pylori. PMID- 1773949 TI - Gastric cancer associated structure in mucus glycoproteins shown as a clinically useful marker. AB - A new monoclonal antibody has been developed which is capable of detecting structures in gastric mucus glycoproteins expressed in the fetus and in adult gastric mucosa in conditions such as gastric carcinoma. Cancer associated monoclonal antibodies were selected by testing them against various mucous glycoprotein samples from the alimentary tract, including salivary glycoproteins from both secretory and non-secretory subjects, and cancerous and normal gastric juice glycoproteins. They were tested against 1000 samples of gastric juice from an unselected population. Immunochemical characterisation suggested that the glycoproteins picked up by P4 and i11 include one of the compounds reacting with rabbit anti-fetal sulphoglycoprotein antigen serum. On the basis of a clinical trial and immunohistological evaluation further evidence was obtained of P4 as the most promising antibody for further experimentation. A total of 302 gastric juice specimens from patients with various gastric symptoms were analysed using the enzyme linked immunosorbent assay technique and P4 antibody. Of 10 gastric cancers, nine had P4 in the gastric juice. A positive correlation was found between gastric ulcer and the appearance of P4. Duodenal ulcers were not correlated to P4. Atrophic gastritis and P4 coincided less frequently. Raised P4 values were found in between 3% and 9% of subjects, depending on the population. Cancer cases showed high P4 values, which allows adjustment of the lower limit of a positive result to high level whereby a considerable number of non-cancerous P4 positives are omitted. PMID- 1773950 TI - Increased intestinal permeability in ankylosing spondylitis--primary lesion or drug effect? AB - We have found increased small intestinal permeability to 51Cr ethylenediaminetetra acetate in patients with ankylosing spondylitis compared with controls. There is no significant difference between patients with ankylosing spondylitis and patients with rheumatoid arthritis taking non steroidal anti-inflammatory drugs (NSAID). The increased intestinal permeability in ankylosing spondylitis is independent of disease activity. These findings suggest that the increased permeability is caused by NSAID treatment and is probably not a primary lesion of small bowel mucosa. PMID- 1773951 TI - Mucosal tumour necrosis factor alpha and interleukin-6 in patients with Helicobacter pylori associated gastritis. AB - The production of tumour necrosis factor alpha (TNF alpha) and interleukin-6 by human antral mucosa during short term culture in vitro has been measured by enzyme linked immunosorbent assay. TNF alpha and interleukin-6 concentrations in culture supernatants were significantly greater (p less than 0.001) in patients infected with Helicobacter pylori, all of whom had chronic gastritis, than in patients who were H pylori negative with histologically normal gastric mucosa. Among H pylori colonised patients, TNF alpha concentrations were significantly higher in those with active gastritis and neutrophil infiltration into the epithelium than in those with inactive gastritis. In contrast, interleukin-6 concentrations were raised in both active and inactive gastritis. This study shows that H pylori gastritis is associated with increased gastric mucosal production of TNF alpha and interleukin-6 and that the nature of the mucosal cytokine response varies with the immunohistology of the disease. Inflammatory cytokines generated locally within the gastric mucosa could be relevant to the gastric physiology of H pylori infection. PMID- 1773952 TI - Plasma precursor amino acids of central nervous system monoamines in children with coeliac disease. AB - Some children with coeliac disease show behavioural disorders such as depression and other signs which have been correlated with reduced central monoamine metabolism. We have therefore investigated the brain availability of the monoamine precursors tryptophan and tyrosine in 15 untreated children with coeliac disease and 12 treated children with coeliac disease as well as in 12 control children. Significantly decreased plasma concentrations of tryptophan were found in untreated children (mean (SD) 13 (4) mumols/l, p less than 0.001) compared with treated children (31 (13) mumols/l), and in both groups of coeliac children when compared with control children (81 (22) mumols/l). A significantly lower ratio of plasma tryptophan to large neutral amino acids (tyrosine, valine, isoleucine, leucine, and phenylalanine) was also observed, which could indicate impaired brain availability of tryptophan in coeliac children and was more pronounced in untreated children. The impaired availability of tryptophan could produce decreased central serotonin synthesis and in turn behaviour disorders in children with coeliac disease. PMID- 1773953 TI - Postoperative changes in collagen synthesis in intestinal anastomoses of the rat: differences between small and large bowel. AB - Collagen synthesis is an essential feature of anastomotic healing in the intestine. Postoperative collagen synthesis, measured in vitro in intestinal anastomoses was studied from three hours to 28 days after operation. For this purpose, an ileal and a colonic anastomosis were constructed within the same animal and the results in both intestinal segments were compared. In the ileum, collagen synthesis was significantly increased, with respect to unoperated controls, three hours after operation. It remained raised during the period of study, with a maximal 10-fold stimulation four days after operation, and had nearly returned to the preoperative level after four weeks. The general pattern was the same in the colon, although quantitatively different: the increase in synthetic activity was delayed in comparison with the ileum. Maximal stimulation was approximately six-fold. In addition, we calculated the ratio for each rat between anastomotic collagen synthesis and the average value found in non operated control animals. Postoperative stimulation in the ileum was higher than in the colon in almost every animal examined. The results show that the ileum responds more quickly and strongly to wounding than the colon, at least as far as the production of new collagen is concerned. Possibly, this phenomenon contributes to the lower failure rate apparent for anastomoses in the small bowel. PMID- 1773954 TI - Effects of ileal resection on biliary lipids and bile acid composition in patients with Crohn's disease. AB - Biliary lipid composition, cholesterol saturation, and bile acid pattern were determined in fasting duodenal bile of 10 patients (four men and six women, mean age 41 years) with Crohn's disease and a history of ileal resection (mean 64 cm). The data were compared with corresponding values in a group of healthy subjects. None of the patients with Crohn's disease had supersaturated bile. Cholesterol saturation was significantly lower in the patients with Crohn's disease than in the healthy subjects. The molar percentage of cholesterol was also lower among the patients but there was no significant difference. The molar percentages of phospholipids and bile acids were normal. Bile acid composition in the patients with ileal resection was characterised by a significant decrease in the deoxycholic acid fraction and a pronounced increase in the ursodeoxycholic acid fraction compared with the healthy subjects. The surprisingly high percentage of ursodeoxycholic acid may contribute to the low degree of cholesterol saturation in bile. Based on these results patients with Crohn's disease should not have an increased risk of cholesterol gall stone formation. PMID- 1773955 TI - Controlled trial comparing two types of enteral nutrition in treatment of active Crohn's disease: elemental versus polymeric diet. AB - To determine whether an elemental diet or a polymeric defined formula diet would be more effective for treating active Crohn's disease, we conducted a prospective randomised clinical trial in 30 patients with active Crohn's disease unresponsive to steroids and/or complicated by malnutrition. They received a four to six week enteral nutrition course with either an elemental diet or a polymeric diet. Clinical remission occurred in 10 of the 15 patients on elemental diet compared with 11 of the 15 patients assigned to polymeric diet. Both groups showed similar improvements in nutritional status, biological inflammation, alpha 1 antitrypsin clearance, and colonoscopic lesions (diminished in 17 out of 24 patients). Most patients relapsed during the year after discharge. We conclude that enteral nutrition, whatever the diet, is an efficient primary therapy for active Crohn's disease but does not influence the long term outcome. PMID- 1773956 TI - Competition for hydrogen by human faecal bacteria: evidence for the predominance of methane producing bacteria. AB - Studies of sludge have shown that some species of sulphate reducing bacteria outcompete methane producing bacteria for the common substrate H2. A similar competition may exist in human faeces where the methane (CH4) producing status of an individual depends on the faecal concentration of sulphate reducing bacteria. To determine if non-methanogenic faeces outcompete CH4 producing faeces for H2, aliquots of each type of faeces were incubated alone or mixed together, with or without addition of 10% H2 and/or 20 mmol/l sulphate. Methane producing faeces consumed H2 significantly more rapidly and reduced faecal H2 tension to a lower value compared with non-methanogenic faeces. The mixture of the two types of faeces yielded significantly more CH4 than CH4 producing faeces alone (mean (SD) 8.5 (1.3) v 2.9 (0.45) mmol/l of homogenate per 24 hours, p less than 0.01). Faecal sulphide concentrations were similar in CH4 producing and non-producing homogenates both before and after 24 hours of incubation. The addition of sulphate to the homogenates did not significantly influence CH4 production or sulphide formation. Our results suggest that in human faeces methane producing bacteria outcompete other H2 consuming bacteria for H2. PMID- 1773957 TI - Value of positive technetium-99m leucocyte scans in predicting intestinal inflammation. AB - The value of positive scans of autologous 99mTc-labelled leucocytes in the detection of intestinal inflammation was assessed in 29 patients with known inflammatory bowel disease and a high probability of intestinal inflammation and 58 with a low probability of intestinal inflammation comprising 37 with intestinal symptoms and 21 with suspected abscess. Autologous leucocytes were labelled with 99mTc using either of the established methods. In patients with inflammatory bowel disease, 3/13 with ileocaecal and 1/11 with colonic accumulation of 99mTc were incorrectly diagnosed in that there was no histological evidence of inflammation in those regions. In the low probability patients, all 26 positive images were false positives: there were 19 in the ileocaecal and 7 in colonic regions and no differences between the two subgroups. False positives were more common in low probability than high probability patients (p = 0.011). The results were independent of the 99mTc cell labelling technique used. Three false positive patients also had normal scans for 111In labelled granulocytes. The time of first detection of 99mTc in the bowel was earlier in true than in false positive patients (92% v 33% within 1 h, p = 0.008), the false positive rates in the first hour of imaging being 5% in high and 15% in low probability patients. In 99mTc scintigraphy, the appearance of the isotope in the intestine occurs commonly in the absence of inflammation irrespective of the cell labelling technique used. In high probability patients, imaging at 1 h can more reliably discriminate true from false positives and retain clinical usefulness. In low probability patients specificity remains unacceptable and 99mTc-labelled leucocyte scanning in these patients is of little value as a positive predictor of intestinal inflammation. PMID- 1773958 TI - Histopathological evaluation of colonic mucosal biopsy specimens in chronic inflammatory bowel disease: diagnostic implications. AB - In a prospective blind evaluation of multiple colonic mucosal biopsy specimens, 45 clinically well defined patients with chronic inflammatory bowel disease (21 Crohn's disease and 24 ulcerative colitis) and 16 control subjects (seven normal subjects and nine patients with diverticular disease) were studied to identify reproducible histopathological features which could distinguish chronic inflammatory bowel disease (CIBD) from non-CIBD and Crohn's disease from ulcerative colitis. Using kappa statistics 16 of 41 histological features were sufficiently reproducible for further stepwise discriminant analysis to differentiate between CIBD and non-CIBD, and between Crohn's disease and ulcerative colitis. Using the combination of three features (an increase of lymphocytes and plasma cells in the lamina propria, the presence of branching of crypts, and neutrophils in the crypt epithelium) we were able to distinguish CIBD from non-CIBD in 89% of the cases with high probability (p greater than 0.85). To separate Crohn's disease from ulcerative colitis three features (an excess of histiocytes in combination with a villous or irregular aspect of the mucosal surface and granulomas) had a high predictive value. Using these features 70% of Crohn's disease patients and 75% of ulcerative colitis patients were correctly classified with a high probability (p greater than 0.85). These findings indicate that the pathologist is dependent on the presence of only a few histological features for a reliable classification of Crohn's disease and ulcerative colitis. PMID- 1773959 TI - Dysplasia and carcinoma in longstanding ulcerative colitis: an endoscopic and histological surveillance programme. AB - From 1976 to 1989 a total of 66 patients with longstanding ulcerative colitis were entered in a colonoscopic surveillance programme in order to detect dysplasia. Thirty patients had extensive or total ulcerative colitis and 36 left sided colitis. The median duration of the disease at the end of the follow up was 15.0 years. Altogether 182 colonoscopies (2.8 per patient), each involving approximately 20 biopsies from different sites of the colon, were performed. In the total or extensive colitis group, five patients had low grade and one patient had high grade dysplasia. In the left sided colitis group, three patients had low grade dysplasia. In three patients low grade dysplasia was detected in a macroscopic lesion or mass of colonic mucosa. Sixty per cent of the dysplasia specimens were from the right colon. The incidence of dysplasia was higher in patients with extensive colitis and increased with the duration of the disease. None of the patients have so far developed colorectal carcinoma. Our results indicate that a colonoscopic surveillance programme is a safe alternative to prophylactic colectomy in longstanding ulcerative colitis. PMID- 1773960 TI - Risk factors for extensive ulcerative colitis and ulcerative proctitis: a population based case-control study. AB - To examine socioeconomic factors, dietary and other personal habits, and medical history as risk factors for ulcerative colitis, we studied 167 (98%) of all prevalent cases of ulcerative colitis diagnosed in Uppsala county from 1945 to 1964 and 167 age and sex matched population controls. Ulcerative colitis patients were less likely than controls to be current cigarette, pipe, or cigar smokers (odds ratio (OR) = 0.44; 95% confidence limits (CL) = 0.25-0.78), but more likely to have symptoms induced by drinking milk (OR = 4.63; 95% CL = 2.15-9.93). Patients with ulcerative colitis do not differ in most of the socioeconomic, dietary and personal habits compared with the background population. PMID- 1773961 TI - High circulating concentrations of interleukin-6 in active Crohn's disease but not ulcerative colitis. AB - Peripheral venous plasma concentrations of interleukin-6 were studied in 21 patients with active Crohn's disease, 20 patients with ulcerative colitis, and 16 control subjects. Interleukin-6 was detected in the plasma of 18 of 21 patients with Crohn's disease (median 47 (range less than 20-250) pg/ml) but in only two with ulcerative colitis and two control subjects. In the patients with Crohn's disease there was a significant negative correlation between the plasma interleukin-6 and the serum albumin concentrations. In eight patients with Crohn's disease and five patients with ulcerative colitis undergoing resection plasma from peripheral circulation and mesenteric vein draining diseased intestine was studied. Interleukin-6 was detected in seven of eight peripheral and mesenteric samples from the patients with Crohn's disease but was not detected in any of the samples from the patients with ulcerative colitis. There was no significant difference between mesenteric and peripheral samples in the concentrations of interleukin-6. PMID- 1773962 TI - Small bowel gas in severe ulcerative colitis. AB - The prognostic significance of excess small bowel gas on a plain abdominal radiograph has been assessed in 75 patients with severe attacks of ulcerative colitis requiring intravenous hydrocortisone. The radiographs were reviewed without knowledge of the subsequent outcome. Small bowel distension was defined as the presence of three or more loops of gas filled small bowel. Forty two patients responded to medical treatment and 33 underwent colectomy. The two groups were comparable for age, sex, and length of history. The surgical group had more extensive disease. Of those who did well on medical therapy, 18 (42.9%) had small bowel distension compared with 24 of 33 (72.7%) who failed medical therapy. The difference was significant (p less than 0.05, odds ratio = 3.55, 95% confidence interval of 2.27-5.87). Of the 24 patients with small bowel distension who came to surgery, five had more than four loops of gas filled small bowel. This degree of distension was not seen in any of the patients settling on medical therapy. Thus the presence of small bowel distension on a plain abdominal radiograph in a patient with severe ulcerative colitis may predict a poor response to medical therapy. PMID- 1773963 TI - Colectomy for idiopathic megarectum and megacolon. AB - The outcome in 40 patients who underwent colectomy for idiopathic megacolon and megarectum over an 18 year period was evaluated. All patients had a radiologically dilated bowel and a bowel frequency of less than two per week. Twenty two patients had a caecorectal anastomosis, 11 had an ileorectal anastomosis (including one with a previous caecorectal anastomosis and four with a previous sigmoid resection), and seven had a sigmoid resection. The mean (range) age at operation was 35 (17-69) years. All three operations resulted in a normal bowel frequency in more than 80% of patients but no patient with an ileorectal anastomosis experienced recurrent constipation. Thirty four patients experienced pain preoperatively and this was still present in 14 patients postoperatively. One patient died and four required subsequent laparotomy for bowel obstruction. The functional outcome in patients with dilatation of the whole colon and in those with dilatation of the left colon did not differ. Subsequent surgery for constipation was performed in three patients. Colectomy offers good results with few complications in the treatment of idiopathic megacolon, and an ileorectal anastomosis is the preferred operation. PMID- 1773964 TI - Wilson's disease in Scotland. AB - The prevalence and clinical features of Wilson's disease in Scotland were investigated. Thirty three cases were identified but adequate information was available on only 28. In 1989, the prevalence rate was 4 per million. Ten patients with a mean (SEM) age of 18 (1.9) years presented with neurological symptoms, 12 patients aged 14 (1.7) years presented with hepatic symptoms, and six patients aged 12 (0.9) years were asymptomatic siblings of patients with Wilson's disease. Nine (56%) of the 16 patients who underwent liver biopsy on presentation were found to have cirrhosis. Penicillamine treatment was stopped in nine patients because of: abnormal peripheral blood count (6), rash (2), and patient's own choice (1). Nineteen patients were alive in 1989 -12 were well, one had chronic liver failure, four chronic neurological disabilities, and two had both chronic liver failure and neurological disabilities. Twelve patients died from: complications of chronic liver failure (2), acute liver failure (4), pneumonia associated with immobility (4), and other causes (2). Several patients who died had received incomplete medical supervision. PMID- 1773965 TI - Dissolution of cholesterol gall stones using methyltertbutyl ether: a safe effective treatment. AB - Methyltertbutyl ether (MTBE) administered by percutaneous transhepatic catheter rapidly dissolves radiolucent cholesterol gall bladder stones. However, complete dissolution and clearance of non-cholesterol debris is essential to prevent recurrence. In this study we analysed 25 consecutive patients with reference to efficacy and recurrence based on the presence or absence of non-cholesterol stone fragments after dissolution. Placement of the catheter was successful in 24 patients, one patient requiring cholecystectomy for bile peritonitis. MTBE was infused and aspirated continuously, four to six cycles per minute, resulting in rapid stone dissolution (median six hours; range 4-23 hours for solitary stones and median seven hours, range 4-30 hours for multiple stones). In 18 patients who had complete dissolution, four (22%) had recurrent stones within six to 18 months. Five patients had residual debris which failed to clear completely despite bile acid treatment. One patient with an incomplete rim of calcium in a large stone did not respond to MTBE treatment. A further patient required cholecystectomy for symptomatic recurrence. There were no serious side effects observed. MTBE treatment is a rapid, safe, and effective treatment for patients who refuse surgery or who for medical reasons cannot undergo cholecystectomy. The results of this study confirm that complete dissolution of all fragments is essential and may prevent recurrence. PMID- 1773966 TI - Nucleation time of gall bladder bile in gall stone patients: influence of bile acid treatment. AB - The time required for precipitation of cholesterol crystals (nucleation time, NT) was determined and related to the cholesterol saturation in gall bladder bile of gall stone free subjects (n = 11), patients with pigment stones (n = 3), and patients with cholesterol gall stones (n = 30) undergoing cholecystectomy. Seven of the gall stone patients had been treated with chenodeoxycholic acid (CDCA) and nine with ursodeoxycholic acid (UDCA), 15 mg/kg/day for three weeks before operation. NT was longer in gall stone free subjects (mean, 20 days), patients with pigment stones (14 days) and patients treated with CDCA (24 days) and UDCA (17 days) compared with untreated patients with cholesterol gall stones (1.5 days). In spite of low cholesterol saturation and prolonged NT, and in contrast to those treated with CDCA, four of the nine patients treated with UDCA had cholesterol crystals in their bile. These observations give further support to the concept that the mechanism for inducing gall stone dissolution may be different for CDCA and UDCA. PMID- 1773968 TI - Wire guided balloon assisted endoscopic biliary stent exchange. AB - A simple technique of endoscopic stent exchange using a biliary dilatation balloon is described. The technique is appropriate in patients with bile duct malignancy in whom clogging of a previously placed straight stent has occurred. Balloon assisted exchange has been used in 25 patients to date and minimises the risks of failure of stent reinsertion and the need for further procedures in patients with limited life expectancy. PMID- 1773967 TI - Adenoma of the ampulla of Vater: putative precancerous lesion. AB - The histopathology of 12 patients with adenoma of the ampulla of Vater was examined to trace the adenoma-carcinoma sequence of the ampulla of Vater. Immunohistochemistry for carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 was also performed. Four large adenomas with mild dysplasia also had foci of moderate dysplasia while another one contained foci of severe dysplasia (intramucosal carcinoma). Immunohistochemically, adenomas of mild to moderate dysplasia had either linear CEA and CA19-9 immunoreactants at the apical portions, or fine granular immunoreactants in the cytoplasm of adenoma cells. In addition, adenomas of severe dysplasia (intramucosal carcinoma) showed a more diffuse or dense immunoreactivity for these two substances in the cytoplasm. These results are consistent with the adenoma-carcinoma sequence for the ampulla of Vater. The immunohistochemistry for CEA and CA19-9 was representative of the degree of dysplasia in the adenoma cells, but the relationship was not conclusive. PMID- 1773969 TI - Hypertrophic gastropathy with gastric adenocarcinoma: Menetrier's disease and lymphocytic gastritis? AB - Lymphocytic gastritis is a form of gastric inflammation characterised by a pronounced increase in lymphocytes in gastric surface and foveolar epithelium. Lymphocytic gastritis is often associated with endoscopic evidence of 'varioliform gastritis'. Lymphocytic gastritis has recently been reported to be associated with other forms of hypertrophic gastropathies. We present a case of hypertrophic gastropathy with gastric adenocarcinoma, with both Menetrier's disease and lymphocyte gastritis. Immunohistochemical studies showed that the intraepithelial lymphocytes were predominantly alpha/beta T cells as in the normal stomach and not gamma/delta T cells as in coeliac sprue. This case together with the six recently published cases suggests that Menetrier's disease and lymphocytic gastritis may be part of the same disease spectrum. PMID- 1773970 TI - Benign lymphangioma of the jejunal mesentery: an unusual cause of small bowel obstruction. AB - Lymphangiomas are rare tumours of lymphatic vessels, most commonly found in children. We present the unusual case of small bowel obstruction caused by benign lymphangioma in a middle aged woman. PMID- 1773971 TI - Serum and tissue autoantibodies to colonic epithelium in ulcerative colitis. PMID- 1773973 TI - [Drug abuse and pregnancy]. PMID- 1773972 TI - Limitations of faecal chymotrypsin as a screening test. PMID- 1773974 TI - [The pharmacology of drugs (heroin, L-methadone, cocaine, hashish) and their effects on pregnancy, fetus and neonate]. PMID- 1773975 TI - [Drug substitution and withdrawal in pregnancy. Indication, side effects, acute status, monitoring and results]. PMID- 1773976 TI - [Jurisprudence aspects of drug substitution and withdrawal in pregnancy]. PMID- 1773977 TI - [Findings in newborn infants following drug abuse or drug weaning in the mother]. PMID- 1773978 TI - [Drug abuse, pregnancy and HIV infection]. PMID- 1773979 TI - [Psychosomatic aspects of substance dependence during pregnancy, labor and puerperium with reference to the further course]. PMID- 1773980 TI - [Effects of alcohol, tobacco smoke and sedatives on pregnancy]. PMID- 1773981 TI - [Observations on the study by F. Casper, F. Zepp and R. Seufert. The HELLP syndrome. Gynakologe 23: 29-32]. PMID- 1773982 TI - Measurement of von Willebrand factor antigen in plasma and platelets with an enzyme-linked immunosorbent assay based on two murine monoclonal antibodies. AB - Two murine monoclonal antibodies, raised against von Willebrand factor (vWF), were used to construct an enzyme-linked immunosorbent assay (ELISA), for quantitation of vWF antigen (vWFAg) in human plasma and platelets. This assay had a lower limit of sensitivity of 0.0001 IU/ml in buffer, and thus is one to two orders of magnitude more sensitive than other ELISA assays which have been reported. The intraassay, interassay and interdilution coefficients of variation were 4.1, 10.4 and 9.9%, respectively. In normal plasma (n = 20), the vWFAg level was 0.83 (range: 0.42-1.25) IU/ml. In normal washed platelets (n = 10), 0.35 (0.25-0.49) IU/10(9) platelets was found. In plasma obtained from various patient groups the following vWFAg levels (geometric mean and range) were observed: von Willebrand's disease (n = 19): 0.18 (0.02-0.77) IU/ml; patients with liver cirrhosis (n = 20): 3.73 (1.68-9.20) IU/ml; patients with pregnancy-induced hypertension (n = 20): 4.14 (2.28-7.44) IU/ml and patients with malignant disease (n = 10), 2.54 (1.51-5.60) IU/ml. A linear correlation was found between vWFAg levels measured with a polyclonal antibody based Laurell electroimmunoassay (r = 0.92, n = 58) or with a polyclonal antibody based ELISA (r = 0.94, n = 64). The present assay is based on stable and reproducible reagents and allows the specific measurement of vWFAg in plasma and in platelets. This assay may constitute a useful tool for the further investigation of clinical conditions associated with changes in vWFAg levels. In addition, its high sensitivity may facilitate a more detailed study of platelet vWFAg in normal and in pathological conditions. PMID- 1773983 TI - Studies of von Willebrand factor in essential thrombocythemia patients treated with alpha-2b recombinant interferon. AB - The crucial role of the von Willebrand Factor (vWF) and its interaction with platelets in myeloproliferative disorders (MPD) have emerged in recent years. Recently, many authors have reported the therapeutical efficacy of interferon (IFN) in MPD with thrombocytosis in decreasing platelet number. The purpose of our report is to study the modifications of vWF in a series of 20 patients affected by essential thrombocythemia (ET) or MPD with thrombocytosis, treated with alpha 2b recombinant IFN (alpha 2b-rIFN). Patients were studied before treatment and after complete or partial response: vWF-related properties, bleeding time (BT) and ristocetin-induced platelet aggregation (RIPA) were evaluated. Before treatment, we found prolonged BT in 5 patients (25%), abnormal RIPA in 8 (40%), reduced factor VIII coagulant activity (VIII:C) in 2 (10%), reduced vWF-related antigen (vWF:Ag) in 5 (25%) and low vWF:ristocetin cofactor (vWF:Ricof) in 5 (25%). Twelve subjects were evaluated after hematologic remission: in all patients, BT, VIII:C, vWF:Ag and vWF:Ricof were within normal range or upper normal limits. RIPA was abnormal in 7 subjects. Multimer patterns of vWF were performed in 3 patients before and after treatment: 2 of them showed loss of high-molecular-weight multimers that seemed to recover at remission. IFN seems to induce improvement of platelet number and their functions in MPD with thrombocytosis. PMID- 1773984 TI - Effect of fibrinogen fragments D and E on the adhesive properties of human granulocytes to venous endothelial cells. AB - In hyperfibrinolytic conditions, e.g. in disseminated intravascular coagulation or the adult respiratory distress syndrome, high levels of fibrinogen degradation products (FDPs) D and E are found in human plasma. This study investigates the influence of these fragments on cell attachment of human granulocytes in vitro. While leaving unaffected the adhesion of human umbilical vein endothelial cells (HUVEC) on gelatine-coated glass, both FDP fragments at 50 micrograms/ml inhibited granulocyte attachment to glass as well as to HUVEC monolayers. At the same concentration, the fragments diminished the superoxide release of stimulated granulocytes. These results suggest a modulatory role of pathologically elevated FDPs on the granulocyte function cascade. PMID- 1773985 TI - Effective prophylaxis of thrombosis by antithrombin III concentrate in a pregnant woman with congenital antithrombin III deficiency: relations between plasma antithrombin III activity and the plasma levels of hemostatic molecular markers. AB - The value of antithrombin III (AT III) concentrate and a standard criterion for its use were examined in a pregnant woman with congenital AT III deficiency by continuous monitoring of plasma AT III activity and the plasma levels of hemostatic molecular markers. The rates of improvement of various markers after AT III administration (frequency of improvement/frequency of administration) were as follows: fibrinopeptide A (FPA) 82%, D-dimer 70%, fibrinopeptide B beta 15-42 73%, beta-thromboglobulin 60%, and platelet factor 4 50%. There was no significant correlation between the plasma AT III activity and all plasma FPA values, but FPA values of over 3.9 ng/ml showed a significant negative correlation with AT III activity: AT III activity (%) = -6.59 x FPA (ng/ml) + 125, r = -0.851, p less than 0.02. We therefore recommend continuous monitoring of the plasma FPA level and administration of AT III concentrate when the FPA level is elevated. According to the regression line shown above, plasma AT III activity should be raised to 100% to keep the FPA level below 6.0 ng/ml with 95% confidence limit. PMID- 1773986 TI - Hydrogen peroxide as trigger of platelet aggregation. AB - In order to verify if H2O2 affects platelet function, platelet-rich plasma and human washed platelets were incubated with subthreshold concentrations (STC) of collagen or arachidonic acid or ADP and/or with 75-150 microM H2O2. While H2O2 alone did not affect platelet aggregation, it amplified platelet aggregation response in samples stimulated with STC of arachidonic acid and collagen but not in samples stimulated with STC of ADP. When platelets were preventively treated with aspirin, a cyclooxygenase inhibitor, the platelet activation by H2O2 was not observed. Thromboxane A2 (TxA2) was not produced by human washed platelets stimulated with STC of arachidonic acid, collagen or by H2O2 alone. On the contrary, when STC of agonists were tested on platelets supplemented with H2O2 an evident TxA2 production was seen. This effect was prevented by aspirin pretreatment or by the addition of catalase, an enzyme which destroys H2O2. This study suggests that H2O2 triggers the activation of platelets exposed to STC of collagen and arachidonic acid, via the cyclooxygenase pathway. PMID- 1773987 TI - Bleeding time and diagnosis of acute myocardial infarction. PMID- 1773988 TI - Comment on 'Glycometabolic control and fibrinolysis in diabetic patients' by van Wersch et al. PMID- 1773989 TI - Human Achilles tendon: morphological and morphometric variations as a function of age. AB - Aging of human Achilles tendon results in changes in both cellular and fibrous components. Cells flatten and become less numerous. Their thin and long cytoplasmatic projections tend to shorten and diminish in number. Tendon fibers lose their typical undulating appearance and become quite straight. Collagen fibril diameter, small and uniform in the neonatal period, becomes large and extremely variable from adolescence onwards. Age related morphometric changes include a decrease in the average, maximum diameter and density of collagen fibrils and an increase of fibril concentration. In our opinion these morphological and morphometric variations are strictly related to functional requirements. PMID- 1773990 TI - Practical considerations for the use of the pedobarograph. AB - The pedobarograph functions as a device for the dynamic, quantitative measurement of pedal pressures. To date, little attention has been paid to various practical questions concerning its operation. For example, the number and timing of trials sufficient to provide meaningful information upon which to reliably base investigational or management decisions has yet to be addressed. Twenty volunteers were used for the measurement of pedal pressures for 15 trials during three separate sessions. Statistical analysis for the determination of MIVQUE(0) estimates and maximum likelihood estimates were used to determine the individual variability, the variability of the specific area of the foot, the daily variability, and the trial-to-trial variability. This analysis indicated that for the assessment of pedal pressures in a clinical setting, the variance factors were sufficiently minimized by obtaining multiple measurements. The improvement in the estimate of error by obtaining trials on different days was overshadowed by the potential benefit of doing extra trials on a single day. Three trials on 1 day should sufficiently reduce estimates of error for both clinical and investigational purposes. PMID- 1773991 TI - Magnetic resonance imaging of anomalous leg muscles: accessory soleus, peroneus quartus and the flexor digitorum longus accessorius. AB - Since the availability of magnetic resonance imaging (MRI), the suspected diagnosis of an accessory muscle of the lower extremity can now be confirmed without the need for invasive procedures. The accessory soleus, peroneus quartus, and flexor digitorum longus accessorius are anomalous muscles of the lower extremity that can be diagnosed by MRI. These accessory muscles are probably more common than once thought and can now be easily distinguished from other space occupying lesions that can occur around the ankle. MRI of these anomalous muscles enables one to make a definitive diagnosis without a biopsy. In those symptomatic patients, the origins and insertions of these accessory muscles can be accurately evaluated by MRI prior to any anticipated surgical intervention. PMID- 1773992 TI - Posttraumatic proximal migration of the first metatarsophalangeal joint sesamoids: a report of four cases. AB - Four cases are presented with plantar plate injury to the first metatarsophalangeal (MTP) joint and proximal retraction of the sesamoids by the flexor hallucis brevis. No history of dislocation occurred in any patient, although two had associated fractures of a sesamoid bone. Clinical and radiographic aids to the diagnosis are discussed. Clinical findings included diffuse pain beneath the first MTP joint and pain with extremes of joint motion in all patients. The anterior-posterior (AP) radiographic technique was the most helpful in determining the proximal migration of the sesamoids. By taking the AP view with both feet on the cassette and by centering the beam perpendicular to it, the diagnosis of plantar plate disruption can easily be made. Initial treatment of this disorder was nonoperative using a stiff soled shoe. With conservative treatment, two of the patients returned to preinjury activities. One patient required sesamoidectomy for resistant pain, and the final patient is still unable to return to his preinjury job requiring standing and heavy lifting. PMID- 1773993 TI - Pseudoaneurysm of the dorsalis pedis artery after Lisfranc amputation. AB - Pseudoaneurysm formation is usually associated with laceration, fracture, or iatrogenic arterial injury. However, it may also develop as a result of blunt trauma. We report the case of a pseudoaneurysm of the dorsalis pedis artery after a Lisfranc amputation in an individual with diabetes mellitus, Charcot joint changes in the left forefoot, and atherosclerosis of the distal vessels. PMID- 1773994 TI - Congenital dysplasia of the heel fat pad: a case report of a previously undescribed entity. AB - We describe a 13-year-old girl who was born with a congenital anomaly of her left heel fat pad. We call this anomaly congenital dysplasia of the heel pad, due to under development of all elements of the heel fat pad. In the case presented the vertical fibrous septa were missing and the amount of fat and its distribution were abnormal. As a result, the abnormal biomechanical shock absorber mechanism caused a painful callosity formation. A surgical procedure aiming to produce adhesions between the fat pad and the calcaneous in order to decrease the shear of the heel pad was only partially successful. Different types of orthotic devices did not resolve the clinical problem of the painful heel. Such a congenital anomaly has never been described in the English literature, and we coined the term congenital dysplasia for the previously undescribed entity. PMID- 1773995 TI - Rupture of the flexor hallucis longus after hallux valgus surgery: case report and comments on technique for adductor release. PMID- 1773996 TI - Comparison of Chevron osteotomy and modified McBride bunionectomy for correction of mild to moderate hallux valgus deformity. AB - The purpose of this study was to compare the results of the Chevron osteotomy to the DuVries' modification of the McBride procedure using identical criteria in two groups of patients. Thirty-two patients (48 feet) that had a Chevron osteotomy and 10 patients (17 feet) who had a modified McBride bunionectomy without metatarsal osteotomy for treatment of mild to moderate hallux valgus were retrospectively reviewed using subjective and objective criteria. Both groups were matched according to age, severity of deformity, and length of follow-up. Ninety-two percent of patients in the Chevron group and 88% of patients in the McBride group responded that they were either totally satisfied or improved regarding pain relief and appearance of the foot following surgery. Chevron osteotomy resulted in a statistically significant greater correction of the intermetatarsal 1-2 angle than did the McBride bunionectomy. Postoperative metatarsophalangeal joint range of motion was not significantly different for the two groups. Following Chevron osteotomy, five (10%) metatarsal heads exhibited radiographic changes of cyst formation and/or increased osteodensity and three (6%) of the osteotomies healed in a malunited position. One of the three metatarsal head malunions occurred in a patient that also had a lateral capsular release, however, none of the five cases that developed radiographic changes in the first metatarsal head was associated with a lateral capsular release. Lateral capsular release with the Chevron osteotomy did not improve the amount of correction of the hallux valgus deformity and it may be a contributing factor to instability at the osteotomy site leading to a valgus malunion. PMID- 1773997 TI - Early mobilizing treatment for grade III ankle ligament injuries. AB - Eighty patients with grade III lateral ligament ruptures were treated either with total immobilization in a walking plaster cast or early mobilization in a stabilizing orthosis. The criterion for entrance was a talar tilt of more than 9 degrees and an anterior translation of more than 10 mm at stress radiography, a previously stable ankle, and a contralateral ankle showing normal stress radiographic values. Ninety-one percent of the patients were evaluated at 7 weeks, 3 months, and 1 year postinjury. While functionally treated patients reached normal mobility and resumed work and sports earlier than immobilized patients there were no differences between the treatment groups in ankle stability or symptoms during activity after 1 year. Ninety-five percent of the ankles in either group were mechanically stable after treatment. Residual symptoms were present 1 year postinjury in 13% of the functionally treated ankles and in 9% of the cast-mobilized ankles. In lateral ankle ligament ruptures causing gross mechanical instability early mobilization results in a better early functional result; however, at 1 year postinjury there was no statistically significant difference in outcome as compared to cast-immobilized ankles. PMID- 1773998 TI - Basal osteotomy of the fifth metatarsal for the bunionette. AB - A proximal basal chevron osteotomy was carried out on 20 patients (22 feet) with a Tailor's bunion deformity. The follow-up was of a minimum of 3 years for all patients. Direct surgery on the fifth metatarsophalangeal joint for bunionette treatment has often been unsuccessful and there have been recurrences due to metatarsophalangeal instability. Basal osteotomy is therefore preferred. The patients were satisfied. The intermetatarsal 4-5 angle was noticeably reduced. There were no postoperative complications and no recurrences. The fifth metatarsophalangeal joint was corrected despite the absence of direct surgery and remains stable. This operation is recommended for acute bunionettes with intractable plantar keratosis. PMID- 1773999 TI - Distal Chevron metatarsal osteotomy for bunionette. AB - Nineteen distal chevron metatarsal osteotomy operations were performed in 13 patients with painful bunionette. The average duration of follow-up was 7.1 years. Mean forefoot score improved from 35.8 points to 73.9 points out of a possible 75 points. Intermetatarsal 4-5 angle, metatarsophalangeal 5 angle, and forefoot width improved significantly. Overall results were considered good in 17 feet and fair in 2; there were no failures. Complications were transfer metatarsalgia (1 foot) and wound infection (1 foot). Distal chevron fifth metatarsal osteotomy is effective treatment for symptomatic bunionette. PMID- 1774000 TI - Simple bunionectomy with medial capsulorrhaphy. AB - Bunionectomy with medial capsulorrhaphy was performed on 54 feet (37 patients) and follow-up was obtained on 49 feet (33 patients) at a mean of 4.8 years postoperatively. Results were excellent in 17 feet, good in 16, fair in 7, and poor in 9. Mean motion of the first metatarsophalangeal joint was 81 degrees. The primary reason for failure was recurrent deformity. Patients were dissatisfied with the results in 41% of the feet. Mean intermetatarsal 1-2 angle increased 1.7 degrees and mean metatarsophalangeal-1 angle increased 4.8 degrees. The operation was significantly more successful in patients who underwent it for painful medial eminence. Bunionectomy with medial capsulorrhaphy is recommended for elderly patients with symptoms primarily due to prominent medial eminence, and its application for the young patient with significant hallux valgus deformity is limited. PMID- 1774001 TI - Biomechanics of the lateral ligaments of the ankle: an evaluation of the effects of axial load and single plane motions on ligament strain patterns. AB - Strain behavior in the anterior talofibular and calcaneofibular ligaments of the ankle, with and without axial load, was evaluated using human cadaveric specimens, a specially designed instrumented test fixture, and Hall-Effect strain transducers. Ligament strain patterns were significantly altered with axial loading in some conditions. This data may have clinical relevance both in the diagnosis and rehabilitation of lateral ligament injuries. PMID- 1774002 TI - [AIDS--HIV envelope protein improves vaccination response]. PMID- 1774003 TI - [Long-term results of group therapy in heart patients. A retrospective analysis]. AB - Thirty-four patients with coronary heart disease who had regularly participated 1.5 +/- 0.5 times a week in an exercise group were analyzed spiroergometrically on a treadmill and on a bicycle ergometer after an average of 1, 2.5 and 4.5 years; 20 patients were also examined after 6.5 years. The maximum performance and tolerance to exercise were recorded. After one year, an increase in performance and exercise tolerance of 9% was noted. In the subsequent years, performance on the bicycle ergometer stabilized on an elevated level. In the case of treadmill ergometry, no further changes were observed after 1 year of treatment. After an initial increase, the aerobic capacity remained virtually constant over the entire follow-up period. Group exercise in ambulatory coronary patients reveals a training effect in particular in the first year of participation, and stabilization of performance at a high level running counter to the effects of ageing. PMID- 1774004 TI - [24-hour blood pressure monitoring. Validation of a new automatic device]. AB - To validate a new miniaturized 24-h blood pressure measuring device, 42 monitorings were carried out in 20 patients in the following manner: simultaneously with the automatic measurement, the physician involved measured the blood pressure in the usual manner with stethoscope and sphygmomanometer. The following very close agreement was found: Systolic: mean values 148 +/- 18/147 +/ 18 mmHg (Rxy = 0.98); diastolic: mean values 78 +/- 11/80 +/- 10 mmHg (Rxy = 0.96). These small differences show that, on account of its very high sensitivity, the Accutracker II recognizes the onset of the systolic k sound earlier on, and is capable of still detecting k sounds down to the lower diastolic pressures. These data, together with the good handling of the miniaturized device reveal it to be very well suited for the monitoring of anti hypertensive treatment, thus helping to avoid unnecessary medication. PMID- 1774005 TI - [Current chemotherapy in urogenital infections. 3: aminoglycosides, tetracyclines, cotrimoxazole]. PMID- 1774006 TI - [Gonalgia: treatment with therapeutic local anesthesia. Results of a controlled comparative study versus diclofenac]. AB - The effectiveness and tolerance of therapeutic local anesthesia (TLA) with lidocaine was compared with those of oral diclofenac in a controlled, open, randomized study involving 76 patients with gonalgia due to gonarthrosis or patellar chondropathy. During the course of the three-week (maximum) treatment, the summed score of pain at rest, pain on movement, and restricted mobility, taken as the target parameter of effectiveness, decreased significantly more markedly (p = 0.008) under TLA, than under diclofenac. Side effects involving mainly the gastrointestinal tract occurred significantly more frequently in the diclofenac group (p = 0.012). The results of this study indicate that in the treatment of localized joint pain of degenerative genesis, TLA with lidocaine is superior to NSAID treatment in terms of effectiveness and tolerance. PMID- 1774007 TI - [The image of the heart. The origin of the heart symbol--2: The heart symbol in the middle ages and from the baroque era to modern times]. PMID- 1774008 TI - [Thalamic infarcts--clinical aspects, neuropsychological findings, prognosis]. AB - Results of clinical investigations and CCT of 23 patients with thalamic infarctions were evaluated retrospectively. Nineteen patients underwent a clinical and 15 a neuropsychological examination one to 5 years after their stroke. Regarding the affected vascular territory, the patients were divided into the following subgroups: paramedian infarctions (posterior thalamo-subthalamic arteries, 13 patients, among them 5 bilateral infarcts); anterolateral infarcts (tuberothalamic arteries, 5 patients); posterolateral infarcts (thalamo geniculate arteries, 5 patients). The leading symptoms of paramedian thalamic infarcts were disturbance of consciousness, amnesia and vertical gaze palsy. The patients with anterolateral thalamic infarctions became acutely confused and disorientated, whereas those with posterolateral infarcts suffered from focal neurological deficits in the first place. Five patients with leftsided thalamic infarctions of varying localization were aphasic. Two patients died within the observation period. A slight hemiparesis was detected in two patients and a vertical gaze palsy in 4, respectively, by the neurological reexamination one to 5 years after the stroke, whereas the clinical findings in 11 patients were completely normal. However 5 patients had a chronic psychosyndrome. The neuropsychological examination showed in some cases disorders of visual retention and verbal function as well as deficits in concentration. Neither the character nor the degree of the neuropsychological deficits did depend on the affected vascular territory but on the existence of further cerebral infarcts on CT-scan. PMID- 1774009 TI - [Craniocerebral trauma and glioma]. AB - There are only a few well documented cases in the literature which allow for the assumption of traumatic origin of some intracranial tumors. Four cases are presented in whom the authors have accepted the traumatic origin of gliomas because of it's evidence, but--from their scientific understanding of tumor development--without being convinced of such a correlation. It is stressed that scientific points of view and argumentation in social insurance affairs may differ and that they should be carefully distinguished. PMID- 1774010 TI - [Recurrent aseptic meningitis (Mollaret meningitis)--spontaneous and drug-induced origin]. AB - Since its initial description by Mollaret in 1944, the etiology of the chronic aseptic meningitis has remained unknown. This rare disease may cause diagnostic problems if bacterial or viral causes are suspected. A different form of aseptic meningitis may be seen following a variety of drug treatments, especially with non-steroidal anti-rheumatic drugs: In many reports since 1978, meningitic attacks following administration of ibuprofen have been reported. We describe two cases of Mollaret-Meningitis with certain specialities: one case shows clear encephalitic involvement with aphasia in all six attacks. In the other case, five meningitic attacks appeared spontaneously, while two were drug-induced: the first attack was seen after a lumbar myelography with lopamidol and one attack appeared two hours after oral administration of 400 mg ibuprofen. It is suggested that Mollaret-Meningitis is a special form of a drug-induced allergic reaction, the provoking agent of which remains unknown. PMID- 1774011 TI - [Contributory changes in variables of coagulation and fibrinolysis to the patency of coronary arteries in patients with acute myocardial infarction]. AB - Plasma levels of fibrinopeptide A (FPA), D-dimer and tissue-plasminogen activator antigen (t-PA-Ag) were measured serially in 38 patients with acute myocardial infarction undergone emergency coronary angiography and/or PTCR (percutaneous transluminal coronary recanalization). A special attention has been focussed in the possible correlation of the variables of coagulation and fibrinolysis with the degree of patency of infarct-related coronary arteries (IRAs). Before PTCR, 26 patients with completely occluded IRAs had significantly higher plasma levels of FPA when compared with those of 12 patients with incompletely occluded IRAs (33.8 +/- 2.4 vs 11.0 +/- 1.3 ng/ml, mean +/- SD, p less than 0.05, respectively). Successful recanalization were resulted in 19 of 26 patients with completely occluded IRAs. Though plasma D-dimer levels significantly increased after PTCR both in patients with or without successful reperfusion, there were neither differences in the two groups before nor after PTCR (154.8 +/- 1.9 to 257.0 +/- 3.0 vs 131.6 +/- 4.8 to 254.9 +/- 4.1 ng/ml, mean +/- SD, respectively). Coronary angiography in 30 patients, performed about a month after the onset of acute myocardial infarction, revealed good patency (the stenosis was less than 90% evaluated according to the American Heart Association Committee Report in 1975) of IRAs in 17 patients and poor patency (the stenosis was 99% or 100%) of IRAs in 13 patients. The former patients had significantly higher plasma levels of t-PA-Ag after 24 hours from the onset than those of the latter patients (26.6 +/- 10.7 vs 17.4 +/- 4.2 ng/ml, mean +/- SD, p less than 0.05, respectively). These findings suggest that the increase in thrombin activity affects unfavorably the patency of IRAs in the evolving of myocardial infarction, and that the responsiveness of endothelial cells to acute phase stimuli such as thrombin and heparin affects favorably the patency of IRAs in the chronic phase; Elevated plasma levels of D-dimer do not necessarily indicate coronary thrombolysis. PMID- 1774012 TI - [Laboratory diagnosis of left atrial thrombi in patients with mitral stenosis]. AB - Left atrial (LA) thrombi sometimes occur in patients with mitral stenosis (MS) and the systemic embolization due to thrombi causes a serious, occasionally fatal complication. Several clinical techniques have been used to estimate the presence of LA thrombi. However, the hitherto available methods, even an echocardiography which has been most widely used, still have some drawbacks, depending on the size and location of thrombi. The author measured D-dimer, fibrinopeptide A (FPA) and thrombin-antithrombin III complex (TAT) in the patients with MS and evaluated the diagnostic value of these molecular markers to estimate the presence of LA thrombi. Twenty six patients with MS who had undergone cardiac operation were studied. Atrial fibrillation was found in all the patients. Episode of obvious thromboembolic diseases is a criteria of exclusion. Blood was drawn from the brachial vein several days (3 +/- 1 days: mean +/- SD) before the operation. The presence or absence of thrombus was confirmed at the surgery in all the cases. 1) Both levels of D-dimer and TAT were significantly higher in the patients with thrombi than those in the patients without thrombus or those in normal controls (mean: 378, 93 and 64 ng/ml, respectively; p less than 0.01 for both and 9.1, 2.0 and 1.7 ng/ml, respectively; p less than 0.01 for both). However, levels of FPA were not significantly different among the three groups (mean: 7.9, 4.9 and 3.7 ng/ml, respectively; NS for both). 2) both levels of D-dimer and TAT were significantly correlated with the weights of LA thrombus (r = 0.87, p less than 0.01: r = 0.79, p less than 0.01, respectively). 3) LA thrombi (ca. greater than or equal to 2 g) were always confirmed at the surgery in the patients who had levels of D-dimer higher than 200 ng/ml and/or TAT higher than 4 ng/ml. The plasma levels of D-dimer and TAT were further followed after the surgery in the same 18 patients (8 patients who had thrombus, the rest who didn't). 1) In the patients who had thrombi, levels of D-dimer were significantly decreased after the surgery (mean: from 267 ng/ml to 73 ng/ml, p less than 0.05). Levels of TAT were slightly but not significantly decreased (mean: from 82 ng/ml to 76 ng/ml, NS).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1774013 TI - [Long-term hemodialysis and changes in variables of coagulation and fibrinolysis]. AB - The development of hemodialysis treatment has remarkably improved the prognosis of chronic hemodialysis (HD) patients. However, as the patient's survival time is prolonged, vascular damages due to the abnormalities of calcium and lipid metabolism and hypertension has become the important complications in HD patients. In addition to coagulation and fibrinolysis, vascular endothelial function has been pursued to clarify the pathogenesis for occurrence of thrombosis in HD patients with more than ten years' duration. Twenty-two HD patients including twelve of less than ten years' duration and ten of more than ten years' were subjected to this study. Twelve healthy controls were also involved in this study. Fibrinopeptide A (FPA) and thrombin-antithrombin III complex (TAT) as indexes of coagulation, antithrombin III (AT III) as an index of coagulation inhibitor and D-dimer as an index of fibrinolysis were measured. A special attention has been focused in changes in the levels of tissue plasminogen activator (t-PA) activity and antigen and plasminogen activator inhibitor-1 (PAI 1) as indexes of fibrinolysis capacity, representing parameters of vascular endothelial functions. Levels of FPA, TAT and D-dimer were significantly higher in HD patients when compared with those in healthy controls. In particular, levels of FPA were significantly higher in HD patients with more than ten years' duration as compared to those in HD patients with less than ten years'. AT III values were significantly lower in HD patients with more than ten years' duration than those in healthy controls. T-PA activity and antigen levels were significantly lower in HD patients than those in healthy controls. T-PA activity levels were lower in HD patients with more than ten years' duration than those in HD patients with less than ten years'. Among HD patients, a significant negative correlation was found between t-PA activity and hemodialysis duration. PAI-1 values in HD patients were not significantly differ from those in healthy controls. These results suggest that in spite of increased coagulability, fibrinolytic capacity of vascular endothelium decreased in HD patients, and that the incidence is accelerated as hemodialysis duration is prolonged. Therefore, it is concluded that long-term HD patients are in the state of a higher risk of thrombosis. PMID- 1774014 TI - [Membrane cholesterol and insulin receptor in erythrocytes]. AB - The author studied influence of membrane cholesterol on insulin receptor behavior using human erythrocytes after modification of their membrane cholesterol contents. Insulin binding to the erythrocytes containing higher membrane cholesterol which were obtained from alcoholic liver cirrhosis (ALC) and familial lecithin: cholesterol acyl transferase (LCAT) deficiency patients was also examined. 1) Influence of modified membrane cholesterol contents on insulin binding to erythrocytes (in vitro experiments): The cholesterol content of human erythrocyte membranes was modified by incubating the cells with phosphatidylcholine/cholesterol and phosphatidylcholine vesicles. Then insulin binding to the erythrocytes was measured as a function of membrane cholesterol content. Low membrane cholesterol decreased insulin binding at 10 degrees C and 15 degrees C, but increased insulin binding at 25 degrees C and 37 degrees C. Scatchard plot analysis showed that low membrane cholesterol decreased a number of the receptor without alteration of affinity. Phosphatidylcholine spin probe showed a dual effect of cholesterol on membrane fluidity, fluidizing below but rigidifying membranes above 20 degrees C. It is suggested that membrane cholesterol affects insulin receptor behavior through alteration of membrane fluidity, depending on the phase state of the membranes. 2) Insulin binding and membrane lipid composition of erythrocytes from ALC and LCAT deficiency patients: The erythrocytes from both ALC and LCAT deficiency patients are known to have higher content of membrane cholesterol. Insulin binding and membrane lipid composition of erythrocytes in both diseases were measured to see the influence of cholesterol on insulin binding in sites. a) Erythrocytes from ALC patients: In the erythrocytes from ALC patients, cholesterol to phospholipid molar ratio was significantly increased as compared with normal subjects. In phospholipid acyl chains, contents of polyunsaturated fatty acid significantly decreased in ALC patients. Insulin binding to erythrocytes was significantly increased in the patients of ALC. Scatchard plot analysis (at 15 degrees C) showed significant increase of the receptor number in erythrocytes from the ALC patients as compared to the normal subjects, while the affinity did not differ between the groups. The increased cholesterol content in the erythrocyte membranes was suggested to be responsible for the increased receptor number and insulin binding to the erythrocytes from ALC patients. b) Erythrocytes from LCAT deficiency patients: Membrane cholesterol to phospholipid molar ratio was increased in two patients of LCAT deficiency studied. In phospholipid classes, increase of phosphatidylcholine and decreases of both phosphatidylethanolamine and sphingomyelin were observed in the erythrocytes from both patients.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1774015 TI - The anomeric malaise: a manifestation of B-cell glucotoxicity. AB - In non-insulin-dependent diabetic subjects and in various animal models of spontaneous or experimental chronic hyperglycaemia, the secretory response of the pancreatic B-cell to a rapid rise in extracellular D-glucose concentration is characterized by a paradoxical, early and transient fall in insulin output and/or an altered anomeric specificity. These two features of B-cell glucotoxicity may be accounted for by the accumulation of glycogen in the B-cell and the interference of changes in glycogenolysis with the hexose-induced increase in glycolytic flux. The inhibitory action of D-glucose upon glycogenolysis displaying alpha-stereospecificity, the metabolic and secretory response to alpha D-glucose is expected to be more severely affected than that evoked by the beta anomer. Such a preferential alteration of the response to alpha-D-glucose was indeed documented in diabetic subjects, BB rats, duct-ligated rabbits, and adult rats either injected with streptozotocin during the neonatal period or rendered hyperglycaemic by the repeated administration of diazoxide. In these experimental models, the attenuation, suppression or even reversal of the anomeric preference in insulin release appeared related to the severity and duration of the hyperglycaemic state. A clear distinction ought to be made between these features of B-cell glucotoxicity and other etiopathogenic factors of B-cell dysfunction, such as the long term deleterious effect of streptozotocin upon the activity of key mitochondrial dehydrogenases. PMID- 1774016 TI - In vitro and in vivo studies of the properties of an artificial membrane for pancreatic islet encapsulation. AB - Encapsulation of pancreatic islets with an artificial membrane has been proposed as a means of immunoprotection after transplantation. Such a membrane should be biocompatible, nondegradable, and should allow the passage of insulin and glucose while preventing that of antibodies and lymphocytes. Thus, we have studied in vitro and in vivo, the characteristics of an acrylonitrile membrane (AN69, HOSPAL, Sweden) for islet encapsulation. The AN69 membrane composed of a fiber network with a porous structure, allowed a satisfactory passage of glucose (75% of the initial amount within one hour) but not of insulin (only 7%). The morphological state of rat islets cultured on membranes under both conditions for 2 weeks was similar to that of islets cultured on dishes; in addition rat fibroblasts retracted after a 3-day culture. Finally, the membrane was unaltered after a 12 month implantation in the peritoneal cavity of rats. When the surface properties of the AN69 membrane were changed by adsorption of a hydrophilic copolymer or by protein coating, the permeability of the membrane was modified. Glucose and insulin diffusion were significantly decreased after protein-coating, whereas glucose diffusion was preserved and that of insulin doubled after adsorption of a copolymer onto the membrane. In addition, after a 12-month implantation in the rat, the membrane surface treated by the copolymer was altered leading to the adhesion of macrophages. In conclusion, the AN69 acrylonitrile membrane may be useful for pancreatic islet encapsulation; its insulin permeability should be increased by a surface treatment aimed at increasing its hydrophilic properties. However the stability of this treatment seems to be an important factor in preserving the biocompatibility of the membrane. PMID- 1774017 TI - Norepinephrine and dopamine content in the brown adipose tissue of developing eu- and hypothyroid rats. AB - The norepinephrine and dopamine content of interscapular brown adipose tissue of developing rats was studied at intervals from birth to 50 days. Throughout this period, neonatal hypothyroidism is associated with a decreased norepinephrine content and with an increased dopamine content. PMID- 1774018 TI - Insulin clearance during hypoglycemia in patients with insulin-dependent diabetes mellitus. AB - Eight male patients with insulin-dependent diabetes mellitus (IDDM) without residual beta-cell function were studied on two occasions in random order. In one experiment hypoglycemia was induced by a constant rate iv infusion of insulin (0.034 U/kg/h) during 150 minutes. At the other occasion an identical infusion of insulin was given, but this time euglycemia was maintained by a variable iv infusion of glucose. Plasma levels of free insulin were almost identical during the two experiments indicating that insulin clearance is not influenced by hypoglycemia in patients with IDDM. PMID- 1774019 TI - Thermogenic and hormonal responses to palatable protein and carbohydrate rich food. AB - Simultaneous variations of oxygen consumption, and plasma insulin and norepinephrine were measured during the postprandial cephalic and gastrointestinal phases of feeding in six human subjects following the ingestion of various nutrients. On alternative days the subjects were given foods (1280 kjoules) either rich in carbohydrates (sugar pie) or in proteins (fish). Both nutrients produced an initial (0-40 min) enhanced thermogenesis and an early (2 min) cephalic insulin release. During that period, elevations of plasma norepinephrine were also observed with pie feeding at 10 and 30 min and at 10 min with fish. Palatability ratings indicated that both food items were equally tasting. During the gastrointestinal phase (40 to 120 min) the variations of these same parameters including glucagon seem to be explained by the content in carbohydrates and proteins in the food rather than by its palatability. Indeed during that period the protein meal was more thermogenic and the carbohydrate meal induced the expected insulin secretion. These results suggest that the palatability of the food is responsible for the early cephalic increase in postprandial thermogenesis, and for the insulin and norepinephrine release. During the subsequent gastrointestinal phase the increased thermogenesis is related to the composition of the food which exerts its action by the biochemical processes involved in the disposal of the absorbed nutrients. PMID- 1774020 TI - Insulin promotes the release from rat mammary gland plasma membranes of a factor which activates mitochondrial pyruvate dehydrogenase. PMID- 1774021 TI - Hormonal and metabolic effects of beta-endorphin in the elderly. PMID- 1774022 TI - Exercise duration and serum erythropoietin level. PMID- 1774023 TI - [Synthesis of delta virus cDNA of China Sichuan strain]. AB - delta virus cDNA of China Sichuan strain, 1.2 kb in length, was synthesized by extraction of RNA from liver tissue in a patient with subacute severe hepatitis, followed by reverse transcription and polymerase chain reaction (RT-PCR). The result was confirmed by Southern blot hybridization using 32P and biotin labelled delta virus cDNA (HN88, cloned in USA) probes respectively. PMID- 1774024 TI - [An observation on growth hormone levels in patients with chronic renal failure]. AB - Serum levels of growth hormone (GH) in the fasting and postprandial state were observed in 27 patients with chronic renal failure (CRF) [and in 27 normal controls. The results showed that serum levels of GH were significantly higher in CRF patients than in normal controls. Most patients exhibited a "paradoxical rise" of GH following an oral glucose load. There was no difference between GH concentrations in those with impaired glucose tolerance (IGT) and those with normal glucose tolerance (NGT) in the CRF cases. Elevation of GH could be returned to normal by kidney transplantation with the disappearance of the "paradoxical rise" of GH. The mechanism of these abnormalities and the relationship between abnormalities of GH and IGT were discussed. PMID- 1774025 TI - [Gas chromatographic analysis of alcohols, aldehydes and esters in potable spirits]. AB - The determination of alcohols, aldehydes and esters in potable spirits was accomplished with a new kind of chromatographic packing made in China- graphitized carbon black (SHT2), modified with PEG-20M. By means of programmed temperature and direct injection, quantitative measurements of 22 components in potable spirits can be simultaneously finished in 50 min. The detect limit of the method was 1 ppm. The coefficients of variation were less than 10%. The recovery tests of 11 components were carried out and the recoveries were in the range of 81.0-106.8%. The method can be applied not only to hygienic monitoring of methanol, fusel oil and furfural, but also to quantitative monitoring of aromatic components in potable spirits. The measurements of several Sichuan spirits samples were made with satisfactory results. PMID- 1774026 TI - [Research and application of SUPER-1 intellectural instrument used in physiology laboratory]. AB - Research work for making a biomedical signal processing instrument based on the APPLE-II computer is reported in this paper. According to the theory of the computer, two interface boards were designed as the hardware of the instrument. The memorizing waveform program was designed as the main program in the software system. Through a functional extended program, also called software inter face, more than ten programs especially for physiology can be easily linked to the main program. with the combination of both the software and hard ware several parameters of the instrument, such as sampling speed, gain of the amplifier, etc. can be controlled by a closed loop. This instrument is available in the physiology laboratory to replace oscilloscope, recorder, stimulator simultaneously. The functions of the instrument are stronger than those of the conventional instruments. PMID- 1774027 TI - [An experimental study on hepatic arterial embolization with 131I-MMC-GM]. AB - We designed a new gelatin microsphere (GM, 65 micron in diameter), which could combine with mitomycin C and 131I. The test in vitro showed that the GM had excellent drug release effect. Hepatic arterial embolization was carried out in 6 dogs with 131I-MMC-GM. The dogs survived from 4 to 28 days before being killed. Scintigraphy indicated that high radioactivity was concentrated in the liver, but was very low in the blood and thyroid. Pathologic study found that the GM was trapped in hepatic arterioles. The GM was eliminated by foreign body giant cells and the lumen of arterioles was occupied by granulations 14-28 days after operation. 131I-MMC-GM is a multiple anticancer agent which can exert triple action of targeting chemotherapy, internal radiotherapy and arterial embolization. PMID- 1774028 TI - [A study of DEAE ion exchange chromatography for the purification of hen's yolk IgG]. AB - A DEAE ion exchange chromatography procedure performed by using either gradient or stepwise elution was developed for the purification of chicken IgG antibodies from the egg yolk of immunized hens. Following this procedure, highly purified yolk IgG preparations were obtained as identified by Sephadex G 200 gel filtration as well as sodium dodecyl sulfate-polyacrylamide gel electrophoresis. Moreover, this procedure guaranteed the recovery of antibodies of undiminished activity. The results demonstrate that the procedure is simple, reliable and practical for the yolk IgG purification. The establishment of such a method is beneficial to the production and application of egg yolk antibodies. PMID- 1774029 TI - [Screening and identification of monoclonal antibodies against human neutrophil and detection of inhibiting opsonic phagocytic activity]. AB - Using Ficoll-Hypaque gradient centrifugation, we have successfully obtained the neutrophils from normal human donors, which can be used as particle antigens for immunizing BALB/c mice. Hybridomas were produced through the fusion of SP2/0 myeloma cells and splenocytes from immunized BALB/c mice. The ratio of fusion was 1:5. The cells were fused with 30% polyethylene glycol (MW 4000). The rate of fusion was 90%. The antibody producing colonies against the membrane of neutrophils in HAT medium were selected by indirect immunofluorescence assay. Antibody positive rate was 60% (102/170). Limiting dilution was used for colonization of the antibody-producing hybridoma cells. After colonization for three times, one hybridoma cell line was obtained, which could inhibit complement mediated phagocytosis. Culture supernatant was used against class- and subclass- specific rabbit antisera (rabbit anti-mouse IgM, IgG, IgG1, IgGd22, IgG2b, IgG3) in an agar immunodiffusion system, it was shown to be IgG22. PMID- 1774030 TI - [The production of human monoclonal antibodies against Pseudomonas aeruginosa by human-mouse hybridoma technique]. AB - The fusion of peripheral B lymphocytes from human immunized with P. aeruginosa polyvalent vaccine and mouse myeloma cell line SP2/0 was successfully performed. The rate of fusion was 74%(71/96) and the positive rate of antibody was 19.7%. Two hybridoma cell lines (A3 and F8) secreting McAb against P. aeruginosa were obtained after three times cloning by limiting dilution. The human chromosomes together with mouse chromosomes were discovered in karyotype assay of the hybrids. A3 and F8McAbs were human IgG by class determination. These MrcAbs could recognize 43 kd and 36 kd MW specific components of P. aeruginosa antigen by enzyme linked immuno-transfer blot technique. PMID- 1774031 TI - [Model of stimulus train-induced bursting in rat hippocampal slice and the effect of L-glutamate on it]. AB - A train of pulses (60 Hz, pulse duration 100 microseconds, train duration 2s, 2-3 fold maximal intensity) were applied to the CA3 stratum radiatum fiber pathway in rat hippocampal slices in vitro. Recordings of the field potentials were made from the stratum of CA3 pyramidal cells in response to these pulses so that the model of stimulus train-induced bursting (STIB) could be studied. It was a new and valuable model of epileptiform activity in hippocampal slices in vitro and the effect of L-glutamate (Glu) on STIB was also studied. Results showed that: 1. The number of train stimulus for a stable STIB averaged 5.5 +/- 2.1; the induced number of population spikes (PS) increased with an average in 5.2; and the STIB activity was long-last, persisting for up to 3-4 hours following the last train. 2. Superfusions of Glu in concentrations of 1, 2, and 3 mmol/L in hippocampal slices produced inhibition of STIB in CA3, but the first antidromic PS was unaffected, suggesting the site of inhibition is postsynaptic. The mechanisms related to the genesis of STIB and its inhibition by superfusion of Glu were discussed. PMID- 1774032 TI - [Effect of sodium valproate on bicuculline-induced epileptiform activity in rat hippocampal slices in vitro]. AB - Experiments were conducted on the rat hippocampal slices in vitro with the superfusion of bicuculline (Bcl, 10 mumol/L) and stimulation of Schaffer collaterals by single pulse to produce epileptiform activity of the pyramidal cells in CA1 area. In these experiments the effect of constant microinjection of sodium valproate onto the surface of slice on the epileptiform activity was studied. The results showed that the valproate, in concentration of 20, 30, 50 and 100 mmol/L, inhibited the Bcl-induced epileptiform activity in a manner of dose-dependence. It was deduced that the inhibition of epileptiform activity by the valproate is possibly related to the recovery of and increase in the inhibition mediated by GABAergic neurons and may be also to the non-synaptic mechanism of the valproate in rat hippocampus. PMID- 1774033 TI - [Observation of enzyme histochemistry and ultrastructure of brain in kindling rats with epilepsy induced by intraperitoneal injection of coriaria lactone]. AB - Kindling model of epilepsy induced by intraperitoneal injection of Coriaria lactone (CL) was used in the experiment. The dose of CL was 1.25 mg/kg. Thirty rats in various periods of kindling were killed and the materials of cerebral cortex, hippocampus and cerebellum were drawn. The enzyme activities of AchE, NADHD, CCO, LDH, SDH, AcP, ANAE and AkP of these areas were observed with enzyme histochemical techniques. In another three kindled rats, two blank control rats and two NS control rats, the ultrastructure of neurons in hippocampus were observed. The results of experiments showed an increased activity of enzymes related to saccharometabolism and energy metabolism, indicating that the metabolism of brain in rats was increased by repeated kindling seizures. The mechanism of kindling seizure induced by CL may be related to inhibitory effect of CL on AchE activity of brain. The degeneration damage of brain neurons in kindled rats may result from using CL for a long time. PMID- 1774034 TI - [Research on thixotropic properties of whole blood in patients with ischemic stroke and its high risk]. AB - So far, few papers on alteration of thixotropic properties of blood from patients with cerebrovascular disease have been found. We measured the thixotropic parameters of blood from 92 patients suffering from cerebrovascular diseases. These patients were divided into five groups. Group I consisted of 14 male patients with cerebral arteriosclerosis (CA) (aged 61.7 +/- 8.2 years) and Group II, 12 male patients with transient cerebral ischemic attack (TIA) (64.4 +/- 7.8 years). All of patients in groups III (22 male old patients, 66.6 +/- 5.1 years), IV (24 male middle-aged patients 53.7 +/- 2.8 years), and V (20 female patients 58.4 +/- 13.8 years) were suffering from cerebral thrombosis. These 92 patients and 92 selected healthy subjects were pair matched in sex and age. Using paired t test, we compared their thixotropic parameters. The results showed that the yield stress (tau 0), the equilibrium value of the structural parameter (A), the apparent viscosity at 2.37 s-1 (eta s), and non-Newtonian contribution of viscosity (eta s-mu) in groups I, II and III were significantly higher than those in the corresponding control groups. The values of tau 0, A, eta s, (eta s-mu) and eta p of blood in group V were higher than those in the control group; only the values of tau 0, eta p, (eta s-mu) of blood in group IV were higher than those in the control group. No significant difference in the thixotropic parameters was noted among groups I, II and III. The results suggest that the patients with cerebrovascular diseases had evidently increased number and degree of RBC aggregation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774035 TI - [Effects of SC1001-sodium on hippocampal kindled seizures by coriaria lactone in rabbits]. AB - Healthy rabbits weighing 1.7-2.4 kg were used. According to Sawyer's atlas the stainless steel cannula and recording electrode were implanted into the left hippocampus of each animal. The kindling experiments were started one week after the surgical operation. For kindling, all animals received injection of 2 microliters of diluted solution containing 0.55 or 0.32 microgram of coriaria lactone (CL) every second day, through the single stainless steel cannula previously implanted in the hippocampus. Hippocampal EEG of all the animals was recorded by telemetric method and the behavior of them was observed at the same time. Eighteen fully kindled rabbits were separated into three groups. The SC1001 Na group of six rabbits was treated with SC1001 Na (100 mg/kg, i.m.), the PB Na group (six rabbits) received phenobarbital Na (30 mg/kg, i.m.), and the control group of six was treated with placebo (normal saline, i.m., in the same volume as that of the SC1001 Na injection); injections were administered once a day for two courses of treatment (one course of treatment was 1 week). The results of the experiment indicated that SC1001 Na (100 mg/kg) had certain effects on hippocampal kindled seizures induced by CL, but its curative effects were not more notable than those of PB Na (30 mg/kg). PMID- 1774036 TI - [Small-airway lesions induced by inhalation of asbestos dust in dogs- pathological and aetiological studies]. AB - This paper presents the pathological changes of the small airways of dogs inhaling asbestos dust in the workshop of Xin Kong Asbestos Mine for 1 to 3 years. Dogs of the experimental group showed that variable degrees of dust deposition and fibrous tissue reaction were found in all the three types of the small airways-respiratory bronchioles, alveolar ducts and membranous bronchioles of both lungs. The lesions in the lung increased with the duration of exposure. These changes in the canine small airways resulting from asbestos dust were very much similar to those of the humans. In addition, deposited dust collected from the workshop of the asbestos mine, and 50 dust particles selected randomly in foci were identified in situ by energy dispersive X-ray analysis. Findings demonstrated that the majority of the dust particles in the foci was principally mixed silicate dust. Among them asbestos dust predominated absolutely, and there were more amphiboles than chrysotiles. Therefore, it is concluded that the small airway lesions induced in the dogs are mainly due to mixed asbestos dust, and that there appears to exist a dose-response relationship. PMID- 1774037 TI - [Effect of air pollution in MTTp (convenient calculation) of children]. AB - A convenient formula (MTTp = 0.1FVC/2Vp) was derived according to the linear character of each 10% FVC portion on the FVC-t curve proposed by Jordanoglou. It was used to examine 765 healthy school children at the age of 8-13 in the lightly and heavily polluted, and controlled areas in the living quarters in a steel corporation. The results showed that the small airways were more severely affected than the larger ones. MTT45-55% at the middle lung volume had both higher sensitivity and accuracy, and could be considered as a good index for tests on the function of small airways in air pollution while MTT20-30% and MTT70 80% at high and low lung volumes had greater variability and less accuracy. PMID- 1774038 TI - [Study on morbidity and relative factors of postmenopausal osteoporosis in 340 women in Chengdu]. AB - In this cross-sectional study, the radius bone mineral content (BMC) of 340 postmenopausal women (mean age: 53; mean years since menopause: 5.56) were assessed by single photon absorptiometry (SPA) for determining prevalence rate of postmenopausal osteoporosis in Chengdu, and some factors relative to BMC were investigated. Eighty-five of 340 postmenopausal women were diagnosed osteoporosis by SPA. The prevalence rate, which increases with year since menopause and age, is 25%. There is significant increase in prevalence after the age of 60 years or 5 years since menopause. Sixteen factors were analysed by STEPWISE REGRESSION. The variables selected were serum calcium(SCa), serum alkaline phosphatase (SAkP), urine calcium (UCa), urine hydroxypoline (UH), age, and Para. Fisher DISCRIMINANT ANALYSIS was used for diagnosis with these variables, the accuracy of diagnosis being 75.2%. Our study showed that postmenopausal osteoporosis is a common disease in Chengdu. High SCa, UH, age and low SAkP level may be risk factors of osteoporosis. PMID- 1774039 TI - [Synthesis of hexamethyl propylamine oxime and comparative study of its diastereoisomers]. AB - This is a report on the synthesis of hexamethyl-propylene-amine oxime (HM-PAO), a new agent for regional cerebral blood flow (gamma CBF) imaging, the separation of its diastereoisomers (dl- and meso-HM-PAO), and a comparative study of three forms of Tc- 99m labelled HM-PAO (dl-, meso- and mixture-) in chromatography, mice biodistribution and rabbit imaging. The results showed that the Rf value of Tc-99m-dl-HM-PAO (0.8-1.0) on silica G thin layer chromatography with MEK as solvent was different from that of Tc-99m-meso-HM-PAO (0.6-0.8), and that the retention of dl- isomer in the brain was higher and more static than those of meso-and mixture HM-PAO but identical with Ceretec, a dl-HM-PAO kit manufactured by Amersham Inc., England. The primary clinical applications for gamma CBF SPECT imaging demonstrated a satisfactory result. PMID- 1774040 TI - [Common tumors of the fourth ventricle and cerebellum in childhood: evaluation of CT differential diagnosis]. AB - Forty pediatric patients with infratentorial cerebellar astrocytomas, medulloblastomas and ependymomas were evaluated. In most cases it was possible to predict the histological type of these tumors by CT. The search for the residual fourth ventricle cavity and defining its location were the first step in differential diagnosis. The density of tumor on plain scans was of value to distinguish medulloblastomas from astrocytomas. Cerebellar astrocytomas had an obvious tendency to develop cystic change. Especially, the configuration of "Cyst with-mural nodule" was the most specific characteristic in diagnosis. Just like medulloblastomas and ependymomas, cerebellar astrocytomas may have also the tendency to arise at the midline in childhood. The incidence of calcification was rather high in ependymomas. PMID- 1774041 TI - [Relation between the levels of estrogen receptor and progesterone receptor and clinicopathological status in human endometrial carcinomas]. AB - Estrogen receptor (ER) and progesterone receptor (PR) assays were performed by direct fluorescent histochemical methods in 20 endometrial carcinomas and 9 endometria of para-carcinomas. ER + and PR + were found in the patients who had not received chemotherapy and/or radiotherapies. In 4 adenosquamous carcinomas, the contents of ER and PR of adenocarcinoma components were higher than those of squamous carcinoma components. Blocking tests proved the specificity of ER and PR for estradiol and progesterone respectively. The levels of ER and PR in endometria of para-carcinomas were higher than those in carcinomas. There were higher levels of ER and PR in early clinical stage than in advanced stage, in cases free from cervical involvement than in cases cervical involvement, and in well differentiated carcinomas than in poorly differentiated carcinomas. ER and PR contents did not correlate with the depth of myometrial invasion or menopausal status. In the patient group followed up for half a year or more, 4 patients with high-level ER and PR had a good response to 17 alpha-progesterone caprate. The patients with ER + and PR + had a longer survival period than those with ER- and PR-. Our results indicated that the assay of ER and PR might be valuable for predicting the response to endocrine therapy and prognosis for patients with endometrial carcinoma. PMID- 1774042 TI - [Relationship between the bacterial resistance induced by rifamdin and the RNA polymerase]. AB - The results of our experiment in vitro showed that the activity of standard RNA polymerase decreased while the concentration of RFD and RFP increased, indicating that the target site of action of RFD was similar to that of RFP on RNA polymerase. Incorporation of [3H] UR into the RNA of sensitive cells of S. sureus and E. coli was strongly inhibited by RFD, but RFD did not affect the resistant strains. In purified DNA-dependent RNA polymerase of sensitive and resistant strains, the enzyme activity of sensitive E. coli a S. aureus strains was inhibited by RFD, but RFD did not inhibit that of the resistant strains (except the P. vulgaris). It can be concluded that a decreased susceptibility of RNA polymerase to RFD as well as a decreased permeability of bacterial envelope may induce bacterial resistance to the drug. PMID- 1774043 TI - [A new approach to measurement of thixotropic properties of whole human blood]. AB - With the Low Shear 30 rheometer and its accessory instruments, four torque decay curves of whole human blood from a healthy young man were recorded at shear rate 1.285, 1.747, 2.37 and 3.23 s-1 respectively for pretesting. The modified Levenberg-Marquardt non-linear parameter estimating method was used to calculate the thixotropic parameters by following Huang's equation. The results showed that the thixotropic properties of whole human blood could be measured by recording two torque decay curves. This approach is much easier than Huang's method. We have adopted it to measure the thixotropic properties of whole blood from healthy young men (n = 32) and young women (n = 32). The results were comparable to those in Huang's reports of 1976. The coefficients of variations of most parameters in our measurement were less than those in Huang's reports. Meanwhile, we analysed the advantage in using the new method and made some suggestions to improve the measurement accuracy in human blood thixotropy. PMID- 1774044 TI - [Determination of megestrol acetate and estradiol valerate in injection of microencapsulated compound megestrol acetate by secondary derivative spectrophotometry]. AB - The paper reports the simultaneous determination of megestrol acetate and estradiol valerate in the injection of microencapsulated compound megestrol acetate by secondary derivative spectrophotometry. The experimental results showed that the average recoveries of the two drugs were 98.8% and 98.0%, respectively, and that the coefficients of variation were 0.71% and 1.81%, respectively. PMID- 1774045 TI - [Determination of berberine hydrochloride in traditional Chinese medicines containing Coptis chinensis Franch by reversed phase high performance liquid chromatography]. AB - This paper reports a reversed phase high performance liquid chromatography method to determine berberine hydrochloride in Coptis chinensis Franch and in the traditional Chinese medicine containing Coptis chinensis Franch. The result shows that the mobile phase of 0.4mol/L ammonium nitratemethanol (52:48) can give a satisfactory separation. The extraction of sample with 1% H2SO4 solution using the ultrasonic vibration method is simple and easy to operate. PMID- 1774046 TI - [Study on relationship between human ABO blood groups and type A behavior pattern]. AB - Investigation of the relationship between ABO blood groups (ABO BG) and Type A behavior pattern (TABP) was performed. No significant correlation was found between human ABO BG and TABP (P less than 0.05). However, CH and TH + CH scores in individuals with blood type A and type A personality were significantly lower (P less than 0.05). The values of TH-CH scores among tested people were of no statistical significance (P greater than 0.05). Moreover, nearly half of the examinees (41.32%) had higher CH score and the distribution of the individuals was obviously different in statistics (P less than 0.005). In addition, L score of examinees with blood type A and type B personality was relatively lower. PMID- 1774047 TI - [Malondialdehyde-modified-low density lipoprotein in diabetes mellitus]. AB - Malondialdehyde-modified-low density lipoprotein (MDA-LDL), lipid peroxide (LPO), lipid and fasting blood glucose (FBG) were studied in 42 diabetic patients and 20 age-matched controls. The results revealed that both MDA-LDL per L serum and MDA LDL per mol LDL-C of diabetics were higher than those of controls. MDA-LDL/L tended to be much higher in diabetic patients with vascular disease and hyperlipidemia. There was a positive correlation between MDA-LDL/L and LPO, LDL C, TC, respectively. PMID- 1774049 TI - HIV-associated dilated cardiomyopathy. PMID- 1774048 TI - The diagnosis and treatment of donovanosis (granuloma inguinale). AB - Donovanosis is a predominantly tropical cause of genital ulcer occurring chiefly in small endemic foci in all continents except Europe. Diagnosis requires the careful collection, staining and examination of smears or biopsies of characteristic genital and, occasionally, extragenital lesions for demonstration of the pathognomonic Donovan bodies (Calymmatobacterium granulomatis) within histiocytes. Successful isolation of C. granulomatis has rarely proved feasible, the last report being in 1962. Donovanosis has a characteristic histopathological picture which occasionally simulates epithelioma. The antibiotics reported as showing good activity in donovanosis are those with good activity against gram negative bacilli and whose lipid solubility ensures good intracellular penetration. They include streptomycin, chloramphenicol, erythromycin, lincomycin, cotrimoxazole and the tetracyclines. More recently, good results have been reported with norfloxacin and thiamphenicol. The treatment of donovanosis in pregnant women and patients with AIDS poses special problems. Complications of donovanosis such as elephantiasis, stricture and pelvic abscess may require surgery. Contacts should be traced for examination but only treated if lesions are found. PMID- 1774050 TI - Increased incidence of cervical cytological abnormalities in women with genital warts or contact with genital warts: a need for increased vigilance? AB - OBJECTIVE: To determine whether women who have a history of genital warts or whose sexual partners have such a history were more likely to have borderline or dyskaryotic cervical smears than other women. DESIGN: Prospective study conducted over a five month period. SETTING: A genitourinary medicine clinic in Cambridge, UK. PATIENTS: One hundred and eighty five women who attended the clinic during the study period, on whom cervical cytology was performed. Ninety-seven had a history of genital warts and twenty had partners with genital warts. METHODS: Cervical cytology taken by standard methods. Demographic data and sexual history obtained by questionnaire. Colposcopy was performed on patients with a history of warts or wart contact. OUTCOME MEASURED: Relative incidence of cytological abnormalities in the various groups of patients. RESULTS: "Borderline" nuclear change was the most frequent abnormality reported in the wart contact group (six cases) whereas mild dyskaryosis was the most frequent abnormal finding in those women with a history of warts (21 cases). CONCLUSIONS: Women with warts or contact with genital warts were more likely to have borderline or dyskaryotic cervical smears than women without such a history. Recommendations for follow-up of these patients are made. PMID- 1774051 TI - The vagina of women infected with Trichomonas vaginalis has numerous proteinases and antibody to trichomonad proteinases. AB - BACKGROUND: Patients with trichomoniasis have serum antibody to numerous T. vaginalis cysteine proteinases, indicating that the proteinases are expressed in vivo. It was important, therefore, to examine for the presence of soluble trichomonad proteinases and/or antibody to the proteinases in the vagina of infected women. METHODS: Vaginal washes (VWs) from 20 women were examined for the presence of proteinases by electrophoresis using acrylamide co-polymerised with gelatin as the indicator system. Antibody to proteinases in VWs was detected by an immunoprecipitation assay involving protein A-bearing Staphylococcus aureus first coated with anti-human immunoglobulin G (IgG) antibody, which was then added to VWs. For VWs having soluble proteinases, the bacteria were used to determine whether immune complexes between antibody and proteinases were present. VWs without soluble proteinases were incubated with the anti-human IgG treated bacteria before adding to detergent extracts of T. vaginalis. Individual isolates from the patients examined in this study were also analysed by one- and two dimensional electrophoresis for their proteinase content. Finally, VWs were from patients without any history of other sexually transmitted diseases (STDs) as well as from individuals having numerous other STDs, including yeast, group B streptococcus, chlamydia, and syphilis. RESULTS: Approximately one-third of patients had soluble proteinases in the VWs; the remaining two-thirds (70%) of patients and normal women had no detectable proteinases in VWs. Half of the patients without soluble proteinases had IgG which, when bound to S. aureus, immunoprecipitated many proteinases from a detergent extract of T. vaginalis. All soluble proteinases and those precipitated from trichomonal extracts were inhibited by inhibitors of cysteine proteinases. Finally, patients having trichomoniasis in addition to numerous other STD agents, including yeast, group B streptococcus, chlamydia, and syphilis did not have soluble proteinases in VWs. Equally noteworthy, some patients with soluble proteinases in VWs did not have other detectable STD agents. CONCLUSIONS: Proteinases were detected in the vagina of some patients with trichomoniasis, and in most cases the proteinases were complexed with IgG, which was precipitated by S. aureus. Patients without soluble proteinases in VWs also had antibody specifically to trichomonad proteinases, again demonstrating both the expression and immunogenic nature of the proteinases in vivo. The absence of soluble proteinases in normal women and in patients having other STD agents as well as the presence of proteinases in VWs of patients without other detectable STD pathogens reinforced the idea that the proteinases were of T. vaginalis parasite origin. The findings of this study indicate that proteinases may be important to the T. vaginalis-host interrelationship. PMID- 1774052 TI - The susceptibility of organisms associated with bacterial vaginosis to spermicidal compounds, in vitro. AB - OBJECTIVES: Bacterial vaginosis (BV) is a prevalent vaginal infection that is now regarded as a risk factor in more serious pelvic and obstetric complications. Spermicides are known to have antimicrobial activity against other sexually transmitted diseases and the aim of this study was to test whether the causative organisms of BV were also susceptible to spermicides, in vitro. DESIGN: Minimal Inhibitory Concentrations of five spermicidal compounds were determined for the organisms associated with BV, in an agar dilution technique. LOCATION: The Department of Experimental and Clinical Microbiology, University of Sheffield Medical School, UK. SPERMICIDES AND ORGANISMS: Nonoxynol-9, Nonoxynol-11, Docusate sodium, Benzalkonium chloride and Menfegol were tested against 20 strains each of Gardnerella vaginalis, Bacteroides and Mobiluncus organisms, isolated from patients with BV who attended the Department of Genitourinary Medicine, the Royal Hallamshire Hospital, Sheffield. MAIN OUTCOME MEASURES: The susceptibility of BV-associated organisms to spermicidal compounds, in vitro. RESULTS: G vaginalis, Mobiluncus spp, Bacteroides bivius and Bacteroides disiens were all susceptible to the five spermicides tested, with MICs ranging between less than or equal to 19 and 5000 mg/l (0.0019%-0.5%). CONCLUSION: The concentrations of spermicides incorporated in contraceptive preparations are usually between 3% and 8%, which are far in excess of the MICs found for BV organisms. Their usage could exert a significant antimicrobial effect and be a useful prophylactic in preventing the infection. PMID- 1774053 TI - Assessment of psychiatric morbidity in patients attending a colposcopy clinic situated in a genitourinary medicine clinic. AB - OBJECTIVE: To determine the adverse psychological implications of referral for colposcopic screening within a genitourinary medicine clinic. DESIGN: Cross sectional survey. SETTING: A colposcopy clinic held within a genitourinary medicine clinic. SUBJECTS: 160 consecutive women referred to the clinic were assessed for psychiatric morbidity using the General Health Questionnaire (GHQ 28). Women were referred to the colposcopy clinic because of one or more of the following: abnormal cervical cytology, condylomata acuminata, HIV antibody positivity. A history of prior local ablative therapy to the cervix was also included in the analysis. RESULTS: There was no difference in psychiatric morbidity, as detected by the GHQ-28, in women referred to the clinic because of abnormal cervical cytology or condylomata acuminata. The total GHQ-28 scores indicated a significant increase in psychiatric morbidity, with increased sub scores indicating social dysfunction, anxiety and somatic symptoms, in women who had had prior laser therapy to the cervix. Women with HIV infection attending the clinic were noted to have an increase in GHQ-28 sub-scores indicating social dysfunction and depression. CONCLUSIONS: Women who have undergone laser therapy to the cervix may benefit from psychological evaluation and supportive measures if they develop further genital lesions which require colposcopic evaluation. Women with HIV infection need further psychological evaluation prior to planning intervention and preventative strategies. PMID- 1774054 TI - Seroepidemiological study of gonorrhoea in Ethiopian women. 1. Prevalence and clinical significance. AB - OBJECTIVE: To measure the prevalence of gonorrhoea in Ethiopian women attending gynaecologic, obstetric and family planning clinics: to determine the reliability of patient self history of sexually transmitted disease (STD); to correlate the serological diagnosis of gonorrhoea with clinical evidence of pelvic infection in order to define a reliable clinical diagnosis of gonorrhoea in a country where pelvic inflammatory disease is very common but where routine laboratory culture and serological tests for gonorrhoea are unavailable. SUBJECTS: 1851 Ethiopian women: 50% symptomatic, 50% asymptomatic. SETTING: Gynaecological outpatient department, antenatal, postnatal and family planning clinics (Ethiopian Family Guidance Association (EFGA)), in two teaching hospitals and a mother and child health centre in Addis Ababa, Ethiopia. METHODS: The indirect haemagglutination test with gonococcal pilus antigen as an epidemiological tool was used in a cross section study to screen 1851 sera for evidence of past or current gonococcal infection. The gonococcal antibody test (GAT) seropositivity was correlated with patient's history of STD, age, clinic attended and the clinical evidence of infection in "gonococcal target organs" urethra, salpinges or Bartholin glands. RESULTS: Fifty nine per cent of the study group were seropositive for the gonococcal antibody test, 22% with titres greater than or equal to 1/320, indicative of current, recent or recurrent infection. Seropositivity indicating past or present gonococcal infection was highest in those who gave a history of having had treated syphilis (85%), in women aged 40-49 (72%), and family planning attenders (EFGA) (66%) of whom 31% had titres greater than or equal to 1/320. Fifty per cent had clinical evidence of past or present infection in the urethra, salpinges or Bartholin glands. Gonococcal antibodies were present in 54% of women with no evidence of clinical infection, compared with 91% of those with pyosalpinx and 86% of those with triple infection of urethra, salpinges and Bartholin glands. CONCLUSION: The high prevalence of gonococcal antibodies in Ethiopian women, especially in asymptomatic clinic attenders must be of concern for all health workers especially those in gynaecology and obstetrics and the related disciplines of family planning and neonatal paediatrics. While seropositivity was highest in those giving a past history of syphilis, the patient's history of STD was unreliable, as of those who denied having any history of STD, fifty per cent were GAT seropositive. Despite a high correlation between GAT seropositivity with pyosalpinx and clinical evidence of infection in urethra, salpinges and bartholin glands, gonococcal antibodies were present in 54% of women with no clinical evidence of infection. Thus we were unable to define a diagnostic clinical picture of gonorrhoea in Ethiopian women. PMID- 1774055 TI - Seroepidemiological study of gonorrhoea in Ethiopian women. 2. Socioeconomic picture. AB - OBJECTIVES: To determine aetiological factors associated with the prevalence of gonorrhoea in Ethiopian women to enable subsequent formulation of intervention policies. SUBJECTS: 1851 Ethiopian women: 50% symptomatic, 50% asymptomatic. SETTING: Gynaecological outpatient departments, antenatal, postnatal and family planning clinics (Ethiopian Family Guidance Association (EFGA)), in two teaching hospitals and a mother and child health centre in Addis Ababa, Ethiopia. METHODS: Using the indirect haemagglutination test with gonococcal pilus antigen, sera were tested for the presence of gonococcal antibodies indicating past or present infection. The socioeconomic facts were analysed against gonococcal seropositivity of these women. RESULTS: Gonococcal infection was associated with very early age at first marriage and first coitus, more than one sexual partner and marital status/profession. The highest prevalence and titres were found in bargirls (100%) prostitutes (89%) and sellers of local beer (85%). The lowest prevalence and titres were found in the highest income group, those married over the age of 18 years, those with only one husband or sexual partner, and those with a sexual life of less than 5 years duration. CONCLUSIONS: National measures which could contribute to reduction and control of gonorrhoea include effective raising of the age of first marriage and first coitus, as has already been defined by law; the education of all girls up to fifth grade or equivalent; the provision of financial support to prevent widows and divorcees from drifting into prostitution; regular health checks and treatment of prostitutes; and education of men. While gonorrhoea per se is a major public health problem, our findings must have serious implications in the wider context of possible transmission of HIV through the community. PMID- 1774056 TI - Did Catherine the Great of Russia have syphilis? AB - Catherine the Great (1729-96) ruled Russia for the last 34 years of her life. She pursued many reforms with energy, intelligence and political shrewdness. Not least amongst her activities was a serious interest in matters of public health which extended to personal involvement in the care of the venereally infected. This paper suggests that perhaps her zeal in this last was based on more than social awareness. PMID- 1774057 TI - Heterosexual transmission of HBV in Caucasians attending a genitourinary medicine clinic. PMID- 1774058 TI - Comparison of ofloxacin with oxytetracycline in the treatment of non-gonococcal urethritis in men. PMID- 1774059 TI - Location of district genitourinary clinic: hospital or community site? PMID- 1774060 TI - Laboratory techniques for the diagnosis of chlamydia infections. PMID- 1774061 TI - Evidence for genetic heterogeneity in malignant hyperthermia susceptibility. AB - Malignant hyperthermia susceptibility (MHS) is a clinically heterogeneous pharmacogenetic disorder characterized by accelerated metabolism, hyperthermia, and frequently muscle rigidity. MHS is elicited by all commonly used potent inhalation anesthetics and depolarizing neuromuscular blockers and remains an important cause of death due to anesthesia. Recent linkage studies suggest a single genetic locus for this disorder on chromosome 19q13.1. The results of our linkage analyses exclude several loci on 19q13.1 as a site for the gene(s) that produces the MHS phenotype in three unrelated families and clearly establish genetic heterogeneity in this disorder. These results are consistent with the hypothesis that the genetic defect that alters thermoregulation may vary in MHS and that clinical variability in the expression of MHS may be explained by genetic heterogeneity. PMID- 1774062 TI - Molecular linkage of the HLA-DR, HLA-DQ, and HLA-DO genes in yeast artificial chromosomes. AB - Eight major histocompatibility complex (MHC) class II loci and the newly defined Y3/Ring 4 locus were isolated in overlapping yeast artificial chromosome (YAC) clones defining a 420-kb segment of human chromosome 6p21.3. YAC B1D12 spanning 320 kb contained seven of these loci from HLA-DRA to HLA-DQB2. A 330-kb YAC, A148A7, spanned from the HLA-DQA1 locus through the Y3/Ring 4 locus and extended at least 130 kb centromeric of YAC B1D12. Southern blotting demonstrated that YAC B1D12 derived from the HLA-DR3 haplotype and that YAC A148A7 derived from the HLA DR7 haplotype of the heterozygous library donor. A third 150-kb YAC, A95C5, lay within this contig and contained only the HLA-DRA locus. A fourth 300-kb YAC, A76F11, was isolated by chromosome walking from the telomeric end of YAC B1D12. Probes isolated from the ends of the YAC genomic inserts have been used to confirm overlaps between the clones. These analyses demonstrated that the centromeric end of YAC A76F11 used the same genomic EcoRI cloning site as the telomeric end of YAC A95C5. YAC B1D12 used an EcoRI site only 2.1 kb telomeric of the aforementioned EcoRI site. These data suggest that certain EcoRI sites are used preferentially during construction of the library. These YACs complete the linkage of the DR and DQ subregions of the HLA complex in cloned DNA and provide the substrate for precise analysis of this portion of the class II region. PMID- 1774063 TI - Characterization of the murine thrombospondin gene. AB - Thrombospondin is an adhesive glycoprotein that supports cell attachment, spreading, and migration. The murine thrombospondin gene is approximately 18 kb in length and includes 22 exons. Interspecific backcross analysis using progeny derived from matings of (C57BL/6J x Mus spretus) F1 x C57BL/6J mice indicates that the thrombospondin gene is tightly linked to the Fshb, Actcl, Ltk, and B2M loci on murine chromosome 2. The sequence of the murine gene is very similar to that of the human gene in (1) regions of the promoter, (2) the coding region, and (3) the 3'-untranslated region. The predicted amino acid sequence of the mature murine thrombospondin subunit is 95.1% identical to that of the human. The sequences of these two species are most similar at the regions containing the type 1, 2, and 3 repeats as well as the COOH-terminal globular domain. The thrombospondin promoter is similar to the 5' flanking region of some housekeeping and growth control genes in that it contains multiple GC-rich regions and lacks a CAAT box. The presence of various consensus sequences suggests that thrombospondin gene expression is regulated by cAMP, cytokines, and steroid hormones. PMID- 1774064 TI - An interstitial deletion in mouse Y chromosomal DNA created a transcribed Zfy fusion gene. AB - The small portion of the mouse Y chromosome retained in the Sxra transposition is thought to carry at least five genes including, as demonstrated here, the entirety of the zinc-finger genes Zfy-1 and Zfy-2. Sxrb, a derivative of Sxra, was previously thought to retain Zfy-1 but to be deleted for Zfy-2. Here we show that Sxrb differs from Sxra as the result of unequal crossing-over between Zfy-1 and Zfy-2. This unequal crossing-over created a transcribed Zfy-2/1 fusion gene and an interstitial deletion. Our data and previous results together suggest that this deletion encompassed the 3' portion of Zfy-2, the histocompatibility gene Hya, the spermatogenesis factor Spy, and the 5' portion of Zfy-1. We suggest that not only Zfy but also other neighboring genes such as Spy and Hya may exist in two copies on the Y as the result of a large tandem duplication during rodent evolution. PMID- 1774065 TI - Molecular cloning and nucleotide sequence of cDNAs encoding human long-chain acyl CoA dehydrogenase and assignment of the location of its gene (ACADL) to chromosome 2. AB - Long-chain acyl-CoA dehydrogenase (LCAD) catalyzes the first reaction of the mitochondrial beta-oxidation of fatty acids. We isolated and sequenced three cDNA clones encoding human LCAD precursor (p). The cDNAs encompass a 2217-base region including 5, 1290, and 922 bases in the 5'-noncoding, coding, and 3'-noncoding regions, respectively, and encodes the entire pLCAD of 430 amino acids (Mr: 47,656). The N-terminus of the mature human LCAD is currently unknown, but 30 (Mr 3221) and 400 amino acids (Mr: 44,435) of the sequence are considered to constitute the leader peptide and mature protein, respectively, in analogy to its rat counterpart. Human pLCAD cDNA shares 85.3 and 83.7% identical residues with rat pLCAD cDNA at the amino acid and nucleotide levels, respectively. At the amino acid level, human pLCAD shares 30.4 to 32.7% identical residues with three other human enzymes in the acyl-CoA dehydrogenase family, sharing 57 perfectly conserved residues among them. The human pLCAD gene is assigned to chromosome 2, bands q34-q35. PMID- 1774066 TI - Localization of the expressed human p58 protein kinase chromosomal gene to chromosome 1p36 and a highly related sequence to chromosome 15. AB - The gene for the human p58 protein kinase, a cell division control-related gene, has been mapped by somatic cell hybrid analyses, in situ localization with the chromosomal gene, and nested polymerase chain reaction amplification of microdissected chromosomes. These studies indicate that the expressed p58 chromosomal gene maps to 1p36, while a highly related p58 sequence of unknown nature maps to chromosome 15. Assignment of a p34cdc2-related gene to 1p36 may have implications for numerous tumors that involve deletion of this region, including neuroblastoma, ductal carcinoma of the breast, malignant melanoma, Merkel cell carcinoma, and endocrine neoplasia. PMID- 1774067 TI - One subunit of the transcription factor NF-Y maps close to the major histocompatibility complex in murine and human chromosomes. AB - The genes coding for the A and B subunits of the transcription factor NF-Y are assigned by a combination of in situ hybridization and analysis of somatic cell hybrids and recombinant mouse strains. NF-YA is assigned to human chromosome 6p21 and to mouse chromosome 17. NF-YB is assigned to human chromosome 12 and to mouse chromosome 10. PMID- 1774068 TI - Searching protein sequence libraries: comparison of the sensitivity and selectivity of the Smith-Waterman and FASTA algorithms. AB - The sensitivity and selectivity of the FASTA and the Smith-Waterman protein sequence comparison algorithms were evaluated using the superfamily classification provided in the National Biomedical Research Foundation/Protein Identification Resource (PIR) protein sequence database. Sequences from each of the 34 superfamilies in the PIR database with 20 or more members were compared against the protein sequence database. The similarity scores of the related and unrelated sequences were determined using either the FASTA program or the Smith Waterman local similarity algorithm. These two sets of similarity scores were used to evaluate the ability of the two comparison algorithms to identify distantly related protein sequences. The FASTA program using the ktup = 2 sensitivity setting performed as well as the Smith-Waterman algorithm for 19 of the 34 superfamilies. Increasing the sensitivity by setting ktup = 1 allowed FASTA to perform as well as Smith-Waterman on an additional 7 superfamilies. The rigorous Smith-Waterman method performed better than FASTA with ktup = 1 on 8 superfamilies, including the globins, immunoglobulin variable regions, calmodulins, and plastocyanins. Several strategies for improving the sensitivity of FASTA were examined. The greatest improvement in sensitivity was achieved by optimizing a band around the best initial region found for every library sequence. For every superfamily except the globins and immunoglobulin variable regions, this strategy was as sensitive as a full Smith-Waterman. For some sequences, additional sensitivity was achieved by including conserved but nonidentical residues in the lookup table used to identify the initial region. PMID- 1774069 TI - Mouse chromosome-specific markers generated by PCR and their mapping through interspecific backcrosses. AB - We have utilized an oligonucleotide primer from the 3' end of the mouse L1 repeat element for amplification of mouse-specific inter-repeat PCR products from Chinese hamster/mouse somatic cell hybrids. PCR of a Chinese hamster/mouse somatic cell hybrid (96AZ2), containing only mouse chromosome 16, produced a range of mouse-specific bands. Two of the mouse-specific PCR products, of 250 and 580 bp, have been confirmed as originating from mouse chromosome 16 by somatic cell hybrid analysis. Both the 250- and 580-bp PCR products have been sequenced and demonstrate the expected sequence organization. Furthermore, both the 250- and 580-bp markers have been genetically mapped in detail to mouse chromosome 16 by direct hybridization to inter-repeat PCR products of progeny DNAs from Mus domesticus/Mus spretus interspecific backcrosses. PMID- 1774070 TI - Mapping of human chromosome 5 microsatellite DNA polymorphisms. AB - Thirteen moderately to highly informative microsatellite DNA polymorphisms based on (dC-dA)n.(dG-dT)n repeats were mapped to segments of human chromosome 5 using both linkage analysis and a panel of somatic cell hybrids which contained rearranged chromosomes. The markers were distributed throughout most of the length of the chromosome from the regions p15.3-p15.1 to q33.3-qter. Maps of the sites of meiotic recombination within the reference families proved particularly useful for the purpose of integrating new polymorphisms into the existing linkage map. PMID- 1774071 TI - A map of 22 loci on human chromosome 22. AB - We constructed a genetic linkage map of the entire long arm of human chromosome 22 with 30 polymorphic markers, defining 22 loci. The map consists of a continuous linkage group 110 cM long, when male and female recombination fractions are combined; average distance between the loci is 5.2 cM. All loci were placed on the map with high support against alternative orders (odds in excess of 1000:1). The order of loci presented in our map is in full agreement with that of the previous linkage maps of chromosome 22 and with the physical assignment of markers. Two markers included in this map, KI-831 (D22S212) and pEFZ31 (D22S32), allowed us to better define the region of the (11;22) translocation breakpoint specific for Ewing sarcoma. Ten additional polymorphic markers were placed on the 22-loci map with odds lower than 1000:1 against alternative locations. In total, we have introduced 29 new markers on the linkage map of chromosome 22. PMID- 1774072 TI - Linkage of bipolar affective disorders to markers on chromosome 11p is excluded in a second lateral extension of Amish pedigree 110. AB - Linkage between markers on chromosome 11p and bipolar affective disorders can be excluded in a second large lateral extension of the original Amish Pedigree 110. These results, together with previous negative linkage findings, suggest that there is not one single gene on 11p conferring susceptibility for bipolar affective disorders among the Old Order Amish. PMID- 1774073 TI - Cosegregation of porcine malignant hyperthermia and a probable causal mutation in the skeletal muscle ryanodine receptor gene in backcross families. AB - A study of the inheritance of malignant hyperthermia (MH) in the British Landrace breed revealed the same substitution of T for C at nucleotide 1843 in the ryanodine receptor (RYR1) gene that was previously shown to be correlated with MG in five Canadian swine breeds. Cosegregation of the mutation with MH in 338 informative meioses led to a lod score of 101.75 for linkage at Omax = 0.0. The substitution was also associated with a HinPI- BanII+ RsaI- haplotype in this breed, as in the five breeds tested earlier, suggesting its origin in a common founder animal. DNA-based detection of the MH status in 376 MH-susceptible heterozygous (N/n) and homozygous (n/n) pigs was shown to be accurate, eliminating the 5% diagnostic error that is associated with the halothane challenge test and flanking marker haplotyping procedures in current diagnostic use. These results strongly support the view that the substitution of T for C at nucleotide 1843 is the causative mutation in porcine MH and demonstrate the feasibility of rapid, accurate, noninvasive, large-scale testing for porcine MH status using DNA-based tests for the mutation. PMID- 1774074 TI - A substitution of cysteine for arginine 614 in the ryanodine receptor is potentially causative of human malignant hyperthermia. AB - Malignant hyperthermia (MH) is a devastating, potentially lethal response to anesthetics that occurs in genetically predisposed individuals. The skeletal muscle ryanodine receptor (RYR1) gene has been linked to porcine and human MH. Furthermore, a Cys for Arg substitution tightly linked to, and potentially causative of, porcine MH has been identified in the ryanodine receptor. Analysis of 35 human families predisposed to malignant hyperthermia has revealed the presence, and cosegregation with phenotype, of the corresponding substitution in a single family. This substitution, by analogy to the findings in pig, may be causal for predisposition to MH in this family. PMID- 1774075 TI - Chromosomal assignment in mouse of matrix Gla protein and bone Gla protein genes. AB - Matrix Gla protein (MGLAP) and bone Gla protein (BGLAP) are calcium-binding, vitamin K-dependent proteins produced by cells of the osteoblastic lineage. Sequence homology suggests that the genes for these proteins evolved from a common ancestor. Somatic whole cell hybrids and karyotypically simple microcell hybrids were used to map Mglap to mouse Chromosome 6 and Bglap to mouse Chromosome 3. Human MGLAP has previously been mapped to chromosome 12p, a region with homology to mouse Chromosome 6, and human BGLAP has been mapped to chromosome 1q, a region with homology to mouse Chromosome 3. It appears that BGLAP is the third calcium-binding protein that maps to human chromosome 1q and mouse Chromosome 3. PMID- 1774076 TI - The human D5 dopamine receptor (DRD5) maps on chromosome 4. PMID- 1774077 TI - Assignment of human asialoglycoprotein receptor gene (ASGR1) to chromosome 17p11 13. PMID- 1774078 TI - Null-balance transducer for isometric force measurements and length control of single heart cells. AB - Recently, an ultrasensitive, optical-fiber-based force transducer was developed to measure the microscopic force of contraction of single heart cells. Since force in cardiac muscle is length and velocity dependent, it is desirable to maintain a constant (isometric) cell length. The original design permits approximately 1% shortening of cell length to occur during twitch contractions. The shortening can be reduced significantly by adding a piezoelectric bimorph actuator and closed-loop control, as described in this paper. As a result, the effective stiffness of the transducer can be increased by a factor of about 100, and cell shortening reduced to approximately 0.01%. For the force probes typically used, this is equivalent to a movement of less than 20 nm for a typical value of 100 nN peak cell force in single frog ventricular cells. The gain in stiffness is obtained without sacrificing sensitivity, although at the expense of frequency response. The new design also permits control of cell length and is applicable to studies of the mechanical stiffness of cardiac cells. PMID- 1774079 TI - A system to acquire and record physiological and behavioral data remotely from nonhuman primates. AB - We describe an integrated system to record physiological and behavioral variables from nonhuman primates in social groups. The system records data simultaneously from two animals in family groups of five. It synchronizes behavioral and physiological data within 16 ms, either on-line or from recordings. Behavioral data are entered by trained observers on-line or from videotape. Recordings of physiological data are produced on-line as stripchart records, tape recordings on the audio channels of video cassettes, and magnetic disk files. The physiological data include two arterial blood flows, arterial blood pressure and heart rate. The data are transmitted from freely behaving animals to a central site via radio telemetry. The infrared link controls the radio transmitter and physiological signal processing electronics, as well as two sources of drugs for each animal. All of the electronics are contained in a small, light backpack that can be worn by either male or female baboons. PMID- 1774080 TI - Lower extremity angle measurement with accelerometers--error and sensitivity analysis. AB - Closed-loop control techniques for the restoration of locomotion of paraplegic subjects are expected to improve the quality of functional neuromuscular stimulation (FNS). We investigated the use of accelerometers for the assessment of feedback parameters. Previously, the possibility of angle assessment of the lower extremities using accelerometers, but without integration, was demonstrated. The current paper evaluates and assesses this method by an error and sensitivity analysis using healthy subject data. Of three potential error sources, the reference system, the accelerometers, and the model assumptions, the last was found to be the most important. Model calculations based on data obtained by the Elite video motion analysis system showed the rigid-body assumption error to be dominant for high frequencies (greater than 10 Hz), with vibrations in the order of 1 mm resulting in errors of one radial or more. For low frequencies (less than 5 Hz), the imperfect fixation of the accelerometers combined with a nonhinge type knee joint gave an error contribution of +/- 0.03 rad. The walking pattern was assumed to be two-dimensional which was shown to result in an error of +/- 0.04 rad. Accelerations due to rotations of the segments could be neglected. The total error computed for low frequencies (+/- 0.07 rad) was comparable to the experimental difference between the current and the reference system. PMID- 1774081 TI - Simple photon diffusion analysis of the effects of multiple scattering on pulse oximetry. AB - Photon diffusion theory is used to derive analytical expressions that relate the ac-dc intensity ratios measured by transmission-mode and reflectance-mode pulse oximeters to arterial oxygen saturation (SaO2). The effects of multiple scattering are examined by comparing the results of the photon diffusion analysis with those obtained using an analysis based on the Beer-Lambert law which neglects scattering. We show that the difference between the average lengths of the paths travelled by red and infrared photons makes the calibration curve of oximeters sensitive to the total attenuation coefficients of the tissue in the two wavelength bands, as well as to absorption by the pulsating arterial blood. Therefore, the shape of the calibration curve is affected by tissue blood volume, source-detector placement, and other variables that change the wavelength dependence of the attenuation coefficient of the tissue. After evaluating the relationship between SaO2 and the red/IR ac-dc ratio (R) under a variety of physiological conditions, we conclude that, for oximeters utilizing fixed calibration curves based on measurements obtained from normal subjects, errors introduced by interfering variables should be less than a few percent when SaO2 exceeds 70%. Predicted errors at lower oxygen saturation values are substantially greater because R is much more sensitive to interfering variables in this measurement range. PMID- 1774082 TI - Left-ventricular dynamic model based on constant ejection flow periods. AB - Experiments with constant ejection flow periods on the rabbit left ventricle suggest that left ventricular pressure can be described by a time varying three element model consisting of elastance Ee(t), resistance R(t), and series elastance Es(t). Previous experiments demonstrated the existence of a "deactivation effect" after the cessation of a constant ejection flow period, which could be described by a decrease of elastance Ee(t). This paper presents a simulation model based on findings of constant ejection flow experiments, and tested on measured pressure and volume data. The results show that when the model is fitted on one single beat, left ventricular pressure can satisfactorily be described by a three-element model without deactivation. However, the model does not predict isovolumic pressure at end-ejection volume. When isovolumic pressure has to be described by the model as well, introduction of deactivation is necessary. The quality of the model was further tested by fitting it to two beats with different ejection parameters. Deactivation again was necessary for a good fit. Only with a deactivation effect in the model, the component values found are close to the normal range found with CFP experiments in the rabbit left ventricles. From the simulation results it can be concluded that (at least for constant ejection flow periods) elastance, resistance, series-elastance, and deactivation effects all are necessary in describing (and predicting) left ventricular pressure. PMID- 1774083 TI - Feedback control methods for task regulation by electrical stimulation of muscles. AB - Three feedback control algorithms of varying complexity were compared for controlling three different tasks during electrical stimulation of muscles. Two controllers use stimulus pulse width (or recruitment) modulation to grade muscle force (the fixed parameter, first-order PW controller and the adaptive controller). The third controller varies both stimulus pulse width and period simultaneously for muscle force modulation (the PW/SP controller described in the comparison paper). The three tasks tested were isometric torque control, unloaded position tracking, and control of transitions between isometric and unloaded conditions. The first task involved the muscle recruitment nonlinearity. The second task added the effects of muscle length-tension and force-velocity nonlinearities. The third task included a sudden changes in external loading conditions. The comparative evaluation was carried out in an intact cat ankle joint with stimulation of tibialis anterior and medial gastrocnemius muscles. The simplest PW controller demonstrated robust control for all tasks. The PW/SP controller improved the performance of the PW controller significantly for control of isometric torque and load transition, but only slightly for control of unloaded joint position. However, the adaptive controller did not consistently achieve a significant improvement in performance compared with the PW controller for any task. Results suggest that muscle length-tension and force-velocity nonlinearities affect the performance of these controllers similarly within the tested ranges of movement amplitudes and speeds. Abrupt changes in the system, such as those due to recruitment nonlinearity and external loading transitions, tend to limit the performance of the adaptive controller. The study provides guidelines for choosing control algorithms for neural prostheses. PMID- 1774084 TI - Feedback control of electrically stimulated muscle using simultaneous pulse width and stimulus period modulation. AB - This paper considers the closed-loop control of electrically stimulated muscle using simultaneous pulse width and frequency modulation. Previous work has experimentally demonstrated good feedback regulation of muscle force using fixed parameter and an adaptive controller modulating pulse width. In this work, it is shown how the addition of pulse frequency modulation to pulse width modulation can improve controller performance. This combination controller has been developed for both single muscle activation and for costimulation of antagonists. This is accomplished using a single command input. In single muscle operation, the combination of pulse width and stimulus pulse frequency modulation results in better control of transient responses than with pulse width modulation alone; the total number of stimulus pulses is increased, however, when compared with pulse width-only modulation at the muscle fusion frequency. In the case of costimulation, the controller modulates the pulse stimulus periods of the antagonists in a reciprocal manner, to ensure stable and fast responses. That is, the frequency of stimulation of the antagonist is increased when that of the agonist is decreased. This results in better control performance with generally fewer stimulus pulses than those generated by costimulation using only pulse width modulation. This feedback controller was evaluated in animal experiments. Step responses with rapid rise times but without overshoot were obtained by the combined modulation. Good steady-state and transient performance were obtained over a wide range of static lengths and commands, under different loading conditions and in different animals. This controller is a promising potential component of neural prostheses to restore functional movement in paralyzed individuals. PMID- 1774085 TI - A comparison of static and dynamic characteristics between rectus eye muscle and linear muscle model predictions. AB - The characteristics of a muscle model are analyzed using rectus eye muscle parameter values and compared to rectus eye muscle data. The muscle is modeled as a viscoelastic parallel combination connected to a parallel combination of active state tension generator, viscosity element, and length tension elastic element. Each of the elements is linear and their existence is supported with physiological evidence. The static and dynamic properties of the muscle model are compared to rectus eye muscle data. The length-tension characteristics of the model are in good agreement with the data within the operating region of the muscle. With the muscle model incorporated into a lever system to match the isotonic experiment paradigm, simulation results for this linear system yield a nonlinear force-velocity curve. Moreover, the family of force-velocity curves generated with different stimulus rates reported in the literature match the predictions of the model without parametric changes. The results of this paper are important in studies involving the oculomotor plant and oculomotor neural networks. Additionally, these results may be applicable to other muscles. PMID- 1774086 TI - Numerical optimization of 3-D SAR distributions in cylindrical models for electromagnetic hyperthermia. AB - Numerically optimized SAR (specific absorption rate) distributions in a source free 3-D multilayered concentric cylindrical (MCC) model are presented. The fields were expanded in the modes of the MCC. Cost functions which specify mathematically the relative weight assigned to differences between an SAR distribution and a desired SAR distribution were defined. The coefficients of the modes, which minimize the cost function, were obtained using gradient search optimization methods. The optimized SAR distributions shown were computed using three different cost functions and two different radial locations for the center of the region where the desired SAR is largest. A five-layered model, including the outer water layer for cooling and improved matching with the source, was used. The frequency was 70 MHz. The current and charge distributions computed on a perfectly conducting cylindrical surface just outside the model are also shown. The surface current and charge distributions depend strongly on the relative importance of the cost for acute heat and systemic heat. A technique is developed for generating a new set of basis functions for reducing the number of unknowns to be optimized. We suggest that the approach shown could be useful in designing hyperthermia applicators. PMID- 1774087 TI - Quantitative shape descriptors of left-ventricular cine-CT images. AB - In order to assess regional diastolic function of the left ventricle (LV), we use LV cine-CT images to build finite element models. To quantitatively evaluate the accuracy of our geometric reconstruction technique used in building these models, we introduce a new measure of shape-similarity, and compare and contrast the results obtained from the new measure to the results obtained from traditional shape-similarity measures. All of these measures are used to compare the endocardial and epicardial LV contours obtained from cine-CT images of canine hearts with those obtained from video images of the same hearts. Our results show that our imaging procedure accurately reproduces shape, and further suggest that the new descriptor has the sensitivity and resolution required to distinguish between images separated by as little as 3 mm. PMID- 1774088 TI - Deconvolution of tracer and dilution data using the Wiener filter. AB - In the study of living systems it is often necessary to inject or infuse a substance into the peripheral circulation and monitor its subsequent concentration in the plasma with time. Examples abound in the pharmacokinetic study of drugs and in the use of the indicator dilution technique for measuring blood flow. Furthermore, it is often necessary to deconvolve one such measured, and hence noisy, data set with another. One of the standard methods for deconvolving noisy signals is the Wiener filter, which is generally derived as a real window in the frequency domain such that the mean squared error between the estimated deconvolved function and the truth, on average, is minimized. Application of the Wiener filter requires some (often crude) model of the noise to-signal power ratio as a function of frequency. In the pharmacokinetic and indicator dilution situations, however, one invariably has a good model of the actual function to be deconvolved in the form of a sum of decaying exponential functions. Such a model may be employed to calculate the signal-to-noise power ratio for use in the Wiener filter, or alternatively may be directly deconvolved itself. It is shown that better results are achieved with the Wiener filter if the model of the signal is not particularly accurate, whereas with a very accurate model it is better to deconvolve the model itself. The point at which the two deconvolution approaches perform comparably occurs when the error in the model is of a similar magnitude to the noise. PMID- 1774089 TI - Numerical implementation of sealed-end boundary conditions in cable theory. AB - We show that a frequently used numerical implementation of von Neumann boundary conditions (zero inflowing current) in cable theory is incorrect. Correct implementations are given and it is shown that they yield results in good agreement with known analytical solutions. PMID- 1774090 TI - A bivariate version of Andrews plots. AB - A bivariate version of Andrews plots is introduced for naturally paired multivariate data. The bivariate Andrews plots are space curves, and are particularly effective for revealing patterns and clusters when depicted dynamically. Projections of the bivariate Andrews plots recover the familiar univariate Andrews plots. PMID- 1774091 TI - Comparison of four different ovarian stimulation protocols in an in vitro fertilisation & embryo transfer programme. AB - Four different ovarian stimulation protocols were evaluated in an in vitro fertilisation and embryo transfer programme in 208 women (228 treatment cycles). In the rigid protocol (RP), 100 mg of clomiphene citrate (CC) was given from day 3 to day 7 of the menstrual cycle and 300 IU of human menopausal gonadotropin (hMG) was given from day 5 of the menstrual cycle. In the individualised protocol (IP) the same drugs and doses were used as in RP, but the day of initiation of CC depended on the length of the individual's menstrual cycle and hMG was administered from the last day of CC. In the programmed protocol (PP), ovarian function was suppressed with oral contraceptive pills (ethinyl estradiol 30 micrograms and norethisterone 1 mg) started on day 5 of the menstrual cycle for 45 to 70 days. Considering the last day of pill intake as day 0, CC was given for 5 days from day 5 and hMG (300 IU) from day 7. In the alternate day protocol (ADP), 100 mg of CC was administered from day 2 to day 6 and hMG (300 IU) was given on alternate days from day 2 to day 8 or day 10 of the cycle. In all the women, hCG (5000 IU) was administered when the diameter of at least 2 follicles was greater than or equal to 16 mm and estradiol levels were 300 pg/ml/dominant follicle. Patients not showing such a response were not treated further. The cardinal events of IVF-ET such as number of good responders, incidence of oocytes harvested, fertilised and embryos transferred per cycle were compared and it was concluded that the pregnancy rates were highest in women treated by the PP. PMID- 1774092 TI - Prevalence & spectrum of congenital malformations in a prospective study at a teaching hospital. AB - A prospective survey for congenital malformations at birth, at a teaching hospital, over a period of two and half years on 9405 consecutive single births has shown that prevalence of major congenital malformations in live births was 1.6 per cent and in still births 16.4 per cent. There was no significant difference in the prevalence of congenital malformations between Hindus (2.0%) and Muslims (2.7%) but amongst Muslims with consanguinity the prevalence of congenital malformation was 4.6 per cent compared to 2.3 per cent in non consanguineous Muslim spouses (P less than 0.05). Open neural tube defect was the single most common anomaly (31.7% of all malformations) occurring at a rate of 4.7 per 1000 single births, with equal prevalence of anencephaly and meningomyelocoele. Case control study showed that history of concomitant medical illness, drug intake during the first trimester, threatened abortion, hydramnios and pre-eclamptic toxaemia in the current pregnancy were significantly associated with the occurrence of congenital malformations. PMID- 1774093 TI - Adverse foetal outcome in specific IgM positive Chlamydia trachomatis infection in pregnancy. AB - A study was undertaken to determine the adverse foetal outcome in antichlamydial IgM positive asymptomatic pregnant females. An indirect immunoperoxidase assay was done to detect IgM in 78 apparently normal asymptomatic pregnant women during the third trimester and follow up was done till delivery to study the effect of chlamydial infection on foetal outcome. A total of 28 (35.9%) women were positive for antichlamydial IgM while only 3.33 per cent asymptomatic non-pregnant normal women (controls) were positive. 28.7 per cent IgM positive mothers delivered low birth weight (LBW) babies (P less than 0.05), 9.7 per cent had premature labour (PTL) and 4.7 per cent had intrauterine death (IUD). The findings are significant as none of the IgM negative mothers had PTL and IUD and only 2.6 per cent had LBW babies. PMID- 1774094 TI - Normal endoscopic pancreatogram in an Indian referral hospital. AB - A total of 101 normal pancreatograms were analysed in a major referral hospital in India in an attempt to establish normal standards of pancreatic ductal morphology in Indian population. Ductal position, course, caliber, length and variations of anatomy were analysed. Most often (39%) ampulla was seen at the level of second lumbar vertebra, commonly (54%) within 30-39 mm from the lateral margin of right side of corresponding vertebral body. Most common ductal course (21.78%) was ascending-horizontal-horizontal type. Mean ductal diameters in the head, body and tail of the pancreas were 2.63, 1.95, 0.99 mm in individuals aged less than or equal to 40 yr and 3.31, 2.34, 1.23 mm in those greater than 40 yr, respectively. A significant (r = 0.46; P less than 0.001) increase in ductal size was seen between less than or equal to 40 yr and after 40 yr of age. Mean ductal length was 16.10 and 16.58 cm in subjects less than or equal to 40 yr of age and greater than 40 yr respectively. Duct of Santorini was visualised in 6.6 per cent subjects. PMID- 1774095 TI - Prevalence of hepatitis C in transfusion dependent thalassaemics & haemophilics. AB - Seventy thalassaemics (B = 37, EB = 33) and 20 haemophilics (A = 18, B = 1, C = 1) were tested for antibodies to hepatitis C virus (anti-HCV) and markers for hepatitis B virus (HBV). The seropositivity for anti-HCV in thalassaemics and haemophilics was 14.3 and 25 per cent respectively. The subjects who were sero positive to anti-HCV had had additional exposure to HBV. Anti-HCV positivity was not related to the age of the subject nor the number of units of blood and blood components transfused. Screening of blood donors for anti-HCV, apart from HBV, may minimise the hazards of post transfusion hepatitis in high risk recipients like transfusion dependent thalassaemics and haemophilics. PMID- 1774096 TI - Magnesium levels in acute cardiotoxicity due to aluminium phosphide poisoning. AB - Significant hypomagnesemia and hypomagnocytia were observed in patients of aluminium phosphide (AIP) poisoning having evidence of acute cardiotoxicity while magnesium levels were normal in patients of AIP poisoning without shock or cardiotoxicity as well as in controls. There was a direct relationship between electrocardiographic findings and low magnesium levels. The mortality was also related directly to hypomagnesemia. The dose of pesticide also influenced the mortality adversely. Autopsied heart showed changes of toxic myocarditis on histopathology. PMID- 1774097 TI - Role of xanthinol nicotinate in the revival of monkeys subjected to acute haemorrhagic shock. AB - The therapeutic potential of xanthinol nicotinate in the revival of anaesthetised monkeys subjected to acute blood loss was investigated. The arterial pressure was lowered to 40 +/- 5 mmHg by rapid arterial bleeding and was maintained at this level for 2 h. Shed blood was then returned through infusion, to the animals. Animals alive at the end of 72 h observation period were considered as survivors. The test drug was infused 1/2 h prior to and 1/2 h, 1 h, 1 1/2 h and 2 h after the onset of oligaemic hypotension. The animals which received normal saline instead of test drug were treated as control. The physiological and biochemical parameters recorded prior to and after the onset of oligaemic hypotension were heart rate, pulse pressure, electrocardiogram, electroencephalogram (EEG), lactic acid, creatine phosphokinase, urea and glucose. The results showed tachycardia, narrowing of pulse pressure, depression of ST segment with occasional T inversion, slowing of EEG with increase in amplitude, rise in blood lactic acid, creatine phosphokinase, urea and glucose. The magnitude of these responses were proportional to the duration and severity of shock. These changes were markedly attenuated in the drug treated group. Enhancement of survival was observed in drug treated groups as compared to control. It was 10 per cent in control as against 60, 86, 71, 57 and 50 per cent in the groups which received the test drug 1/2 h prior to and 1/2 h, 1 h, 1 1/2 h and 2 h after the onset of oligaemic hypotension. It is concluded that the beneficial effect of the drug in the revival of monkeys subjected to acute haemorrhagic shock may be due to better maintenance of tissue perfusion. PMID- 1774098 TI - Serotonergic modulation of spinal cord sympathetic preganglionic neurone activity in cardiovascular regulation. AB - The present study demonstrates the effect of activation of spinal serotonergic receptors on heart rate, blood pressure and cardiac arrhythmia induced by coronary artery ligation in cervical spinal cord transected and bilaterally vagotomized dogs. Intrathecal injection of serotonin (5-HT) evoked a fall in blood pressure (mean decrease, 16 +/- 3) and a decrease in heart rate (mean change, 24 +/- 6) and these effects were blocked by intrathecal pretreatment with methysergide. The magnitude of ventricular ectopics evoked by coronary artery ligation was decreased by serotonin (mean decrease, 31 +/- 5%), and this effect of serotonin was blocked by methysergide pretreatment intrathecally (mean change, 7 +/- 5%). Methysergide per se, increased the magnitude of ventricular ectopics (mean increase, 24 +/- 5%). The serotonergic receptors of the spinal cord appear to have an inhibitory influence on the cardiovascular functions. PMID- 1774099 TI - Effects of dimethoate on collagen metabolism in rats. AB - The effects of three different doses of dimethoate on the collagen metabolism in the tissues of female albino rats were studied by measuring the specific and total activities of 3H-hydroxyproline in the dermal, gingival and uteral collagen fractions and in the urine. Compared to controls, the total activity of 3H hydroxyproline in the soluble collagen and in the urine at 12 h after the administration of 3H-proline was significantly lower by 44.45 and 58.12 per cent in the higher dose (2.25 mg/100 g body weight) of dimethoate treated groups respectively. The urinary excretion of hydroxyproline and the total activity of urinary 3H-hydroxyproline measured after 28 days of injection of labelled proline were decreased by 45.56 and 32.68 per cent in higher doses of dimethoate treated animals respectively but the excretions of urinary 3H-hydroxyproline were decreased by 6.36 and 2.88 per cent in lower doses of dimethoate (0.56 mg/100 g body weight) treated animals. The results of the present investigation clearly indicate that the synthesis of collagen is decreased in the higher doses of dimethoate treated animals compared to lower doses of dimethoate treated animals. In addition, the rates of catabolism of both soluble and insoluble collagens were decreased in higher doses of dimethoate treated rats. In concludes that the lower doses of dimethoate (0.56 mg) treated rats were less affected than the higher doses of dimethoate (2.25 mg) treated rats. PMID- 1774100 TI - Quantitation of HLA antigens on red cells by immunoradiometric assay. AB - Immunoradiometric assay was employed to quantitate HLA antigens on red cells. Using this technique HLA-B7, HLA-B17 and HLA-A28 were detected on the red cells of all individuals studied irrespective of the serological status of the Bennett Goodspeed (Bg) antigens. However, HLA antigenic sites for serologically Bg positive red cells were significantly more than that for Bg negative red cells (P less than 0.001). Bga positive red cells possessed maximum number of antigenic sites as compared to Bgb and Bgc positive red cells. PMID- 1774101 TI - Dd-antigen-antibody system in five caste groups in north India. AB - Antigen Dd, a polymorphic antigen found in extracts of certain human dandruff specimens, was investigated in five caste groups of north India. The incidence of antigen Dd-positive type varied from 21.21 per cent in Brahmins to 29.08 per cent in the Jat Sikhs of Punjab. However, a high frequency (45%) was observed in the Sunni Muslims of Kashmir, which differed significantly, when compared with different caste groups of Punjab. Family studies on 44 families indicated its inherited nature, the mode of inheritance being autosomal dominant. PMID- 1774103 TI - Concerns regarding the Bethesda System. PMID- 1774102 TI - The Bethesda System for reporting cervical/vaginal cytologic diagnosis: an overview. PMID- 1774104 TI - The Bethesda System: "pro". PMID- 1774105 TI - Human papilloma virus in uterine cervix: a comparison of detection by morphology and by dot-blot hybridization. AB - Colposcopically directed cervical biopsies, smears, and swabs obtained from 210 women with a previous abnormal cervical cytology were evaluated for the presence of human papilloma virus (HPV) using morphology and dot-blot hybridization. The diagnosis of HPV infection in biopsies and smears examined morphologically was rendered using established criteria for condyloma/cervical intraepithelial neoplasia (CIN). In hybridization studies, DNA was isolated from cells obtained from cervical swabs and annealed with probes that detected HPV types 6/11, 16/18, and 31/33/35 using a dot-blot procedure. Ninety-five cases demonstrated morphologic evidence of condyloma/CIN; 51 of these (54%) were positive for HPV DNA (five cases 6/11, 21 cases 6/18, 20 cases 31/33/35, and five cases two different probes). HPV DNA was also detected in 6 of the 115 cases (5.2%) that were morphologically negative (three cases 16/18, three cases 31/33/35). The results demonstrated that morphology was more sensitive than dot-blot hybridization for detection of HPV-related lesions. The dot-blot hybridization did detect HPV DNA in a small percentage of the cases that showed no morphologic abnormality and was useful for typing of the HPV. At this juncture, however, the clinical significance of the latter findings is unclear. PMID- 1774106 TI - Sebaceous tumors arising in ovarian dermoid cysts. AB - The clinicopathologic features of five cases of sebaceous tumors arising in ovarian dermoid cysts and of three previously reported cases are reviewed. They occurred in women with an average age of 58 years and were classified as sebaceous adenoma (five cases), basal cell carcinoma with sebaceous differentiation (two cases), and sebaceous carcinoma (one case). Follow-up information was available for all cases. One patient with basal cell carcinoma with sebaceous differentiation had a pelvic recurrence 2 1/2 years after diagnosis. In no other case did the sebaceous tumor recur or metastasize during follow-up periods of 1 to 6 years. One patient died of a squamous cell carcinoma that arose in the same dermoid cyst as the sebaceous tumor. These tumors represent a rare form of monodermal neoplasia in dermoid cysts. PMID- 1774107 TI - Ovarian and juxtaovarian adenomatoid tumors: a report of six cases. AB - Five ovarian adenomatoid tumors and one juxtaovarian tumor of this type in women 23 to 79 (average 54) years of age are described. Four were less than or equal to 7 mm in diameter; the other two were 1.4 cm and 5 cm. The five ovarian tumors were located predominantly in the hilus, with focal extension into the medulla. Microscopic examination showed the lesions to be characterized by round, oval, or elongated tubules, some of which were cystically dilated, and vacuoles occasionally containing basophilic secretion. Hyaline bodies were present in one case. Follow-up in these cases and the 10 previously reported similar cases that include follow-up information has been benign. The microscopic features of the ovarian adenomatoid tumor are typically diagnostic, but, as illustrated by one of our cases and another in the literature, some features that simulate those of yolk sac tumor may cause diagnostic difficulty when the tumor occurs in a young patient. PMID- 1774108 TI - Non-neoplastic ovarian cysts with ectopic pregnancy. AB - Thirty non-neoplastic ovarian cysts, discovered at laparotomy in association with 27 cases of tubal ectopic pregnancy, were examined to document changes seen in early pregnancy and possibly to identify precursor lesions to the luteinized cysts of later pregnancy. The ages of the patients ranged from 16 to 40 years, and length of gestation varied between 5 and 11 weeks. Of the 30 cysts, 12 were corpus luteum cysts; 10 were called lutein cysts, nonspecific, and had a lining of luteinized cells of a single cell type; three cysts were luteinized follicles; four cysts were unlined or lined by a single layer of cells. The origin of these four was not obvious, and they were called "simple cysts." The last was a granulosa-theca lutein cyst. Corpus luteum cysts are assumed to arise from the corpus luteum, and simple cysts appear to arise from both corpus luteum cysts and other follicular structures. The nonspecific lutein cysts appeared to arise from structures other than the corpus luteum or corpus luteum cysts; these nonspecific lutein cysts may be precursors to the so-called large solitary luteinized follicle cyst of pregnancy. PMID- 1774109 TI - Monoclonal antibody 1BE12 immunoreactivity with human endometrium. Correlations with hormone receptors and proliferation cell markers. AB - The monoclonal antibody (MAb) 1BE12 has recently been reported to react with several human normal and abnormal tissues. In human endometrium, it reacts more strongly with carcinomas than with normal tissue. To investigate the effectiveness of MAb 1BE12 in identifying cell proliferation in human endometrial cancers, 1BE12 immunocytochemical assays (ICAs) were performed on frozen (n = 47) and paraffin (n = 100) sections with subsequent computer-assisted microcytophotometric (SAMBA) evaluation of immunoprecipitate distribution. MAb 1BE12 immunoreactivity was not impaired by tissue fixation and paraffin embedding. It reacted with normal proliferative endometrium but not with normal secretory endometrium, and immunoreactivity increased with the degree of cell proliferation and malignancy, the amount of immunostaining being greater in invasive carcinomas than in normal proliferative endometrium and endometrial hyperplasia. ICAs showed no correlation between MAb 1BE12 immunoreactivity and estrogen and progesterone receptor antigenic sites. On the other hand, MAb 1BE12 staining in frozen sections increased with Ki67, EGFR, pHER-2/neu, and cathepsin immunostaining. These findings suggest that ICAs on frozen and paraffin-embedded biopsy specimens using MAb 1BE12 along with other markers can be useful for early detection and grading of endometrial carcinoma. The relevance of MAb 1BE12 to the selection of patients for laser ablation of the endometrium rather than hysterectomy is also discussed. PMID- 1774110 TI - Acute chlamydial salpingitis with ascites and adnexal mass simulating a malignant neoplasm. AB - Chlamydia trachomatis is a well-known cause of acute and chronic salpingitis, accounting for approximately half of all cases of pelvic inflammatory disease. Typically, patients with acute chlamydial salpingitis present with acute lower abdominal pain, tenderness on bimanual pelvic examination, or vaginal discharge. We describe a case of acute chlamydial salpingitis with marked ascites and an adnexal mass that simulated a malignant neoplasm. Microscopically, a severe lymphofollicular salpingitis and a marked lymphofollicular hyperplasia of the omentum and retroperitoneal lymph nodes were found. Chlamydial inclusions in the fallopian tube epithelium were demonstrated by immunohistochemistry using a mouse monoclonal antibody to a genus-specific outer membrane lipoprotein. Chlamydial infection may cause marked ascites and a palpable adenexal mass and should be considered whenever marked chronic inflammation with a lymphofollicular hyperplasia involves the fallopian tube or other female genital tract sites. PMID- 1774111 TI - Suppressor and protector factors derived from Trypanosoma lewisi. AB - Trypanosoma lewisi is a specific protozoan blood parasite of rats. Normal rats infected 2 h after treatment with plasma from day 8 irradiated (8.5 Gy) infected rats had significantly higher parasitaemia; in contrast, animals infected 7 days post-plasma treatment were significantly protected. Trypanolytic and ablastic antibodies could be demonstrated in the serum of normal rats treated with the plasma; the trypanolytic antibodies were stage-specific. Suppression of normal rat splenocyte responses to Con A and lipopolysaccharide (LPS) stimulation were also observed in the presence of different protein concentrations of whole lysate from epimastigote forms. The suppression by mitogen Con A was ablated by the addition of exogenous IL 2, or by washing cells incubated with the lysate prior to mitogen stimulation. These results indicate that immunoregulatory factors are present in the plasma of rats infected with T. lewisi, and the effect of these factors can be demonstrated in vitro with whole parasite lysate. The restoration of normal splenocyte responses to Con A by addition of exogenous IL 2 or by washing cells suggests that the suppressor factor(s) act(s) on the T cells by inhibiting their proliferation and IL 2 production, and the continued presence of these products is essential in the maintenance of suppression. PMID- 1774112 TI - Detection of resistance to ivermectin in Haemonchus contortus. AB - Infective, third-stage (L3) larvae of Haemonchus contortus isolates resistant to ivermectin (IVM) show a decreased sensitivity to IVM-induced paralysis in vitro. The inhibition of larval motility by IVM can be detected in L3 larvae incubated in the dark on an agar matrix containing IVM, by the failure of affected larvae to move when stimulated by exposure to light. Optimally, avermectin (AVM) potency is quantified after three cycles, each involving storage in the dark for 24 h followed by a brief exposure to light. For IVM-susceptible isolates, a 50% inhibition of motility (LP50) was achieved with IVM concentrations between 0.30 and 0.49 microM, while LP50 values in IVM-resistant isolates ranged from 0.8 to 2.6 microM depending on the in vivo resistance status of the isolate. A limited study of structure-activity relationships within the AVM class indicated that in vitro inhibition of L3 motility was consistent with the known in vivo efficacy of each analogue. Resistance factors for IVM-resistant isolates were dependent on AVM structure with the more polar AVM B2 analogue being a particularly sensitive probe of IVM-resistance status. PMID- 1774113 TI - The parasites of the Polynesian rat within and beyond New Zealand. AB - A list of the ecto- and endoparasites of the Polynesian rat, Rattus exulans, from throughout its geographical range is presented here. The majority of the New Zealand populations included in this survey came from 'exulans only' islands while all but one of the non-New Zealand reports came from places where other rodent species are sympatric. This information is intended among other things to highlight gaps in our knowledge of and stimulate an interest in the parasitology of this rat. PMID- 1774114 TI - The parasites of the Polynesian rat: biogeography and origins of the New Zealand parasite fauna. AB - Unique aspects of the prehistory and current distribution of the Polynesian rat (Rattus exulans Peale) have been applied to the problem of determining the biogeographical origin of its parasites as found on 'exulans only' islands of New Zealand. The database consists of collated records of both endo- and ectoparasites reported from throughout this rat's geographical range. The analytical method is based on the concepts of Sprent (1969. Immunity to Parasitic Animals, pp. 14-17) and includes the formulation and testing of two hypotheses. A total of six 'heirloom' species is identified, and a further seven are classified as 'old souvenirs'. Contrary to prediction, 11 species are considered to be 'new souvenirs', acquired from other rodent species now present in New Zealand. PMID- 1774115 TI - Intermediary carbohydrate metabolism in the adult filarial worm Setaria digitata. AB - Several key enzymes related to carbohydrate metabolism were assayed in Setaria digitata. In the cytosolic fraction pyruvate kinase, phosphoenolpyruvate carboxykinase, malate dehydrogenase, malic enzyme, aspartate transaminase and alanine transaminase were found. Among the TCA cycle enzymes succinate dehydrogenase, fumarate reductase, fumarase (malate dehydration), malate dehydrogenase (malate oxidation and oxaloacetate reduction) and malic enzyme (malate decarboxylation) were detected in the mitochondrial fraction. Only reduced nicotinamide adenine dinucleotide (NADH) dehydrogenase, NADH oxidase and NADH-cytochrome c reductase were found in the mitochondrial fraction. The significance of these results with respect to the metabolic capabilities of the worm are discussed. PMID- 1774116 TI - Experimental regulation of granulomatous reactions around Schistosoma japonicum eggs implanted into the liver of mice. AB - Using a liver model, various granulomatous responses against Schistosoma japonicum eggs were studied in C57BL/6 mice immunized with tissue-extracted eggs prior to challenge implantation with freshly laid eggs. In mice receiving two ip injections of 20,000 eggs, there was little effect on early granuloma formation. Three weeks after implantation, however, tissue reaction accompanied by marked fibrosis was significantly augmented, compared to that in the untreated mice. In contrast, when mice were given four ip injections, the early reaction was accelerated and the subsequent fibrosis came to an end earlier than in the twice immunized or untreated mice. Different routes of injection produced differing effects on 2-week granulomas, with an augmented reaction following two sc injections and a diminished reaction following the same number of ip injections. Histologically, the diminished reaction was characterized by less cellularity, especially in the case of eosinophil infiltration. PMID- 1774117 TI - Ultrastructure of Blastocystis hominis in human stool samples. AB - A study of the ultrastructure of Blastocystis hominis in human stools found morphological differences between the organisms seen and those present in laboratory cultures. B. hominis found in stool samples showed little morphological variation with storage time before fixation, but were consistently smaller (approximately 5 microns in diameter), with a thicker surface coat than the cultured organisms. The large central vacuole, characteristic of the cultured organisms, and accepted as standard morphology of B. hominis, was rarely observed in organisms present in stool samples. Instead, a number of small vacuoles, or possibly a network of interconnected vacuoles, were noted. After short-term culture, organisms from these samples appeared with the typical vacuolated morphology. No large vacuoles were present in organisms obtained at colonoscopy. These results suggest that the vacuolated form as previously described may be an artefact of culture conditions, and that the form of B. hominis present in the gastrointestinal tract is avacuolar. PMID- 1774118 TI - Epidemiology of paramphistomosis in cattle. AB - The epidemiology of paramphistomosis in cattle was studied using tracer calves in a subtropical location in eastern Australia. Two species of paramphistomes were present; Calicophoron calicophorum and Paramphistomum ichikawai. The former species was the most abundant. Gyraulus scottianus and Helicorbis australiensis acted as intermediate hosts, respectively. Paramphistome burdens varied seasonally and were dependent upon the number of infected host snails. Peak fluke burdens and clinical paramphistomosis occurred in late summer in year 1 and early winter in year 2. The peak fluke burdens coincided with prolonged inundation of the grazing areas resulting in rapid multiplication and infection of host snails, and the period after the inundated areas dried out. The prevalence of infection in snails was high in both years, peaking at 98% in year 1 and 58% in year 2. The main host snail, G. scottianus, aestivated and retained infection for at least 24 weeks in soil, and in vegetable debris on the surface of the soil, resulting in rapid reappearance of host snails and infective metacercariae after the onset of seasonal rain. Metacercariae survived on herbage for up to 12 weeks, depending on the environmental conditions. Paramphistome burdens in calves could be predicted from the prevalence of infection in the host snail, the water levels and an index of surface water on the grazing site. Control of paramphistomosis during and after flooding may be achieved by removal of susceptible cattle from pasture or regular treatment during these periods. Strategic treatment during the dry season may reduce contamination of snail habitats and infectivity of the pasture in the following wet season. PMID- 1774119 TI - Purified glutathione S-transferases from parasites as candidate protective antigens. AB - Glutathione S-transferase (GST) activity was detected in larvae of the Australian sheep blowfly Lucilia cuprina, and in the nematode Haemonchus contortus. A specific inhibitor of the enzyme was shown to affect survival of both species of parasite in vitro. GST from both parasites has been purified and partially characterized. Antisera raised to the purified enzymes were shown to inhibit the enzyme activity in vitro. However, the antisera had no effect on the survival of either parasite. PMID- 1774120 TI - A study of the mortality and fecundity of Haemonchus contortus in sheep following experimental infections. AB - The regulation of the fecundity and mortality of H. contortus in sheep was examined using a series of mathematical models. Six-month-old Dorset crossbred lambs were infected once only with various doses of infective H. contortus larvae (500-20,000 larvae). Parasite mortality was found to be an increasing linear function of the magnitude of the initial infection over the range of doses examined. Parasite fecundity was found to remain constant over the intensity and duration of the infection. The average fecundity for H. contortus at the time of slaughter was found to be 7037 eggs per female worm per day. There was no evidence of time-dependent changes in fecundity or density-dependent regulation of fecundity. PMID- 1774121 TI - The relationship between intestinal location and fecundity in adult Trichinella spiralis. AB - Adult female worms recovered from the jejunum of rats infected per os with 1000 larvae of Trichinella spiralis were significantly more fecund (peak jejunal fecundity = 35.7 +/- 3.1 newborn larvae per female) than females recovered from the terminal ileum (9.3 +/- 4.1 larvae per female) in the same infections. The majority of the adult worms were established in those sections of the small intestines that produced the most fecund females (r = 0.92; P less than 0.05). Worm fecundity is believed to be location-specific because adult females that were surgically implanted into the jejunum were significantly more fecund that were implanted into only the ileum. It is concluded that the physico-chemical conditions of the anterior small intestines are optimal for the parasites' reproductive fitness and this exerts a strong selective pressure on habitat selection behavior. PMID- 1774122 TI - The response of cattle vaccinated with hypodermin A to a natural infestation of Hypoderma bovis and Hypoderma lineatum. AB - In this study, we have determined whether immunization with hypodermin A (HA), associated with various adjuvants, could provide protective immunity for calves when challenged with a natural hypoderma infestation. Groups of naive calves were vaccinated with HA antigen alone or with adjuvants [Freund's incomplete adjuvant (FIA) or alumina phosphate (AP)]. Subcutaneous injection with HA antigen with or without adjuvant did not significantly protect calves against a natural hypodermosis infestation. The humoral response during the infestation period was evaluated by ELISA. A significant earlier and greater response was induced in groups vaccinated with HA alone and HA combined with FIA. These results indicate that HA, in this vaccination protocol, induces a very incomplete protection in calves exposed to a natural infestation. PMID- 1774123 TI - Further studies with a strain of Ostertagia ostertagi resistant to morantel tartrate. AB - Two experiments with a morantel resistant strain of Ostertagia ostertagi were carried out. In the first experiment five groups of five calves were infected with 60,000 larvae of this resistant strain. Calves of one group remained untreated, calves of the other groups were treated with morantel tartrate, oxfendazole, levamisole or ivermectin in the recommended doses. It was demonstrated that there was side resistance to levamisole, but not to oxfendazole or ivermectin. Compared with the untreated controls the reduction percentages of the worm burdens were 45.3 (morantel tartrate), 99.7 (oxfendazole), 83.5 (levamisole) and 100 (ivermectin). In the second experiment a comparison was made between the effect of levamisole against a morantel susceptible strain of O. ostertagi and the resistant strain. Two groups of five calves were infected with the susceptible strain and two groups with the resistant one. One group of each pair remained untreated, the other was treated with levamisole. The reduction percentages of the worm burdens were 99.6 (susceptible strain) and 63.6 (resistant strain). This result confirms the efficacy of levamisole to susceptible O. ostertagi and the side resistance of the morantel resistant strain. PMID- 1774124 TI - Premenstrual syndrome. AB - The Premenstrual Syndrome (PMS) was described as a unique entity meriting therapeutic attention in 1931. Although researchers in the area have failed to develop a widely accepted definition of PMS, substantial progress has been made in describing the variety of psychobiological profiles encompassed by this syndrome, particularly with respect to its typical symptoms, cyclical nature, symptoms recurrence and severity. Therapies ranging from diet and exercise to vitamin, hormone and drug treatment have been proposed. While none is more efficacious than placebo, several have been popularized. Our failure to develop adequate treatment may reflect our lack of understanding of either the psychosocial or biological factors involved in PMS. This, in turn, may reflect inadequate theoretical development in this research area. We provide a critical assessment of research on PMS, suggest a framework for theoretical development and advocate research strategies that might provide insights into the etiology of the premenstrual syndrome. PMID- 1774125 TI - Depression, perception of illness and mortality in patients with end-stage renal disease. AB - A role of depression in affecting outcome in patients with end stage renal disease (ESRD) has been suggested but few have assessed psychological parameters and medical factors thought to influence survival simultaneously and prospectively. To assess whether depression or perception of illness influences survival in patients treated for ESRD, we prospectively evaluated fifty-seven patients with ESRD treated with hemodialysis (HD, n = 43) or continuous ambulatory peritoneal dialysis (CAPD, n = 14). Patients were interviewed and completed the Beck Depression Inventory (BDI) and the Illness Effects Questionnaire (IEQ). An ESRD severity coefficient was used to measure chronic illness severity. A cognitive item subset of the BDI (CDI) was used as an additional measure of depression. One and two years later, records were examined to determine survival. When initial results of the assessment of survivors and non-survivors were compared, at one year follow-up, there were no differences in mean age, duration of dialysis, severity scores, BDI or IEQ scores. The initial mean CDI scores in the group of non-survivors, however, were significantly greater than the scores in the survivor group. At two year follow-up, CDI scores were significantly different between groups, and were significant in a hazards regression. Disease severity, age and duration of dialysis were also significantly related to mortality at two year follow-up. We conclude cognitive depression is an important, early, indicator of grave prognosis in patients treated for ESRD. Early recognition of and therapeutic efforts directed toward the treatment of depression might modify outcome in ESRD patients. PMID- 1774126 TI - Childhood hospitalization for psychosocial reasons: the case of gastroenteritis. AB - Nonmedical factors are often important considerations when choosing treatment options for illness. High levels of childhood hospitalization are of concern for psychological as well as medical and economic reasons. This study compared medical and psychosocial attributes of children managed at home or in hospital for childhood gastroenteritis to identify factors differentiating type of care. Parents of children under two years with gastroenteritis managed at home (n = 76) or in hospital (n = 76) were interviewed. Medical details and a range of intra family factors (e.g., parenting skills, marriage) and extra-family factors (e.g., neighborhood, social contacts) were queried. Doctors (n = 6) rated the severity of symptomatology of each case based only on medical details. There was no difference in the medical severity of the gastroenteritis episodes for hospital and home care groups. Instead families were most clearly differentiated using discriminant analysis by social variables; specifically hospital care families had poorer scores than home care families on social contact indices. This highlights the necessity for focusing on the wider social context in efforts at decreasing the incidence of childhood hospitalization. PMID- 1774127 TI - How can we combat excess mortality in Harlem: a one day survey of substance abuse in adult general care. AB - Our hypothesis was that a one-day survey of all patients hospitalized on Adult General Care would demonstrate a need for expanded addiction services in a municipal teaching hospital in East Harlem. We interviewed 276 patients in Adult General Care on February 16, 1990 to assess whether they abused drugs or alcohol or were hospitalized for reasons related to substance use. Of the 276 patients interviewed, 18 percent used alcohol alone, 14 percent used drugs alone, 17 percent used both drugs and alcohol and 2 percent were hospitalized for reasons related to substance use. One hundred forty or 51 percent of all patients were admitted because of substance use and its sequelae or as a result of violence associated with the buying or selling of drugs. The percentage was highest on one medical floor where 89 percent of the patients were substance users and on medical floors in general where the average was 60 percent. Forty patients or 14 percent were known to be HIV seropositive. Given the high mortality in Harlem, the results of our one-day survey indicate a need for expanded addiction services. PMID- 1774128 TI - Fluoxetine and orgasmic sexual experiences. AB - The purpose of this article to describe a unique potential side effect of fluoxetine. A case report of a patient with post stroke depression treated with fluoxetine is presented. Fluoxetine was associated temporally with frequent short episodes of sexual excitement described by the patient as feeling like an orgasm. The relationship was dose dependent. Serotonergic medications, like fluoxetine, may induce sexual stimulation as a side effect. The mechanism for this effect is unclear but patients with organic brain disease may be at higher risk for this complication. PMID- 1774129 TI - Mania in AIDS: clinical significance and theoretical considerations. AB - Cases of mania associated with acquired immune deficiency syndrome (AIDS) are reviewed in an attempt to elucidate patterns that may be helpful in guiding treatment, determining prognosis, and understanding pathophysiology. Fourteen well-described cases in the English language literature were critically reviewed. Data was collected regarding chronological appearance of signs and symptoms, specific psychiatric symptoms, associated neurologic and cognitive function, objective testing of brain structure and function, and outcome. When mania or hypomania occur in the setting of a human immunodeficiency virus (HIV) infection, it frequently occurs once and does not recur. AIDS-associated manic states are adequately responsive to available antimanic agents, however, AIDS patients may be more prone to deleterious side effects. Although mania or hypomania may be the presenting complaints that lead to the discovery of human immunodeficiency virus (HIV) seropositive status, mania tends to occur in people exhibiting signs of immunodeficiency as is exemplified, in the sample, by death occurring within six months of the psychiatric presentation in nearly a quarter of the patients. It is hypothesized that AIDS-related mania and agitated psychosis may be related to increased intracellular free calcium. PMID- 1774130 TI - Molecular anatomy of the neuro-immune connection. AB - Light microscopic immunohistochemistry was employed to elucidate and compare the presence, distribution, and coexistence of various peptides, neuroendocrine markers and enzymes of the catecholamine pathway in nerves supplying lymphoid tissues in a variety of mammalian species. All lymphoid organs and tissues receive innervation by fibers containing dopamine-beta-hydroxylase and/or tyrosine hydroxylase, neural markers like protein gene product 9.5, synaptophysin and neurofilament and a varied spectrum of peptides. The prominent peptides were tachykinins (substance P, neurokinin A), calcitonin gene-related peptide (CGRP), neuropeptide Y (NPY), and vasoactive intestinal polypeptide/peptide histidine isoleucine (VIP/PHI). Opioid innervation was variable. Double immunofluorescence revealed coexistence of tachykinins and CGRP and of tyrosine hydroxylase and NPY. A minor proportion of fibers showed coexistence of NPY and tachykinins and of VIP/PHI and tachykinins. The possible importance of the complex peptidergic innervation of lymphoid tissues in inflammation, allergy, inflammatory pain and psycho-neuro-immuno-endocrine network function is discussed. A special immunomodulatory role of the sensory neurons is suggested. PMID- 1774131 TI - Role of immune cells in the Pavlovian conditioning of specific resistance to cancer. AB - It has been demonstrated that significant protection against YC8 lymphoma can be induced in mice preimmunized with normal DBA/2 spleen cells. The DBA/2 spleen cells used as alloantigens share minor histocompatibility determinants with the YC8 tumor. We have used this model to investigate the nature of the immunity conferred by treatment with the alloantigen and infer that the conditioned resistance observed was maintained by the same effector mechanism. The results demonstrated that repeated immunization of tumor bearing mice with the alloantigen had some beneficial effect as shown by the slower rate of growth of the tumor, and an increase in median survival time over controls. The observations showed however that once tumor was present in vivo, the use of potent tumor specific vaccine can help in increasing survival but can no longer produce high incidence of regressions and cures. Conditioning can potentiate the effects of this treatment by increasing survival and cure. PMID- 1774132 TI - Zinc and bromocriptine long-term administration in patients with prolactinomas: effects on prolactin and thymulin circulating levels. AB - Several studies have demonstrated zinc (Zn), prolactin (PRL) and thymulin (Zn FTS) interplay: Zn inhibits, in a dose related manner, PRL release from lactotropes in vitro and stimulates thymulin synthesis in vivo both in humans and in animals. PRL receptors are present on thymic epithelial cells (TEC); PRL stimulates TEC trophism and activity. Little is known about the influence of PRL on Zn metabolism, though in prolactinomas we found reduced Zn and thymulin circulating levels. For this reason, we evaluated PRL, Zn, bioactive thymulin (Zn FTS) and total thymulin (T-FTS: Zn-bound plus Zn-unbound form) serum levels in 58 patients with prolactinomas (PRL: 253 +/- 263 micrograms/L), Zn (82 +/- 23 micrograms/dl), Zn-FTS (2.2 +/- 0.20 log2(-1] and T-FTS (3.7 +/- 0.25 log2(-1] were significantly lower (p less than .01) than those found in age matched controls. Zn-unbound bioinactive thymulin form (FTS) levels were in the normal range. Bromocriptine administration (Brc) (2.5-5 mg p.o., b.i.d. for 9 months) to 20 patients with microprolactinomas lowered serum PRL levels (10.5 +/- 6.2 micrograms/L) and significantly increased (p less than .01) Zn (118.6 +/- 14.7 micrograms/dl), Zn-FTS (3.96 +/- 0.7 log2(-1)) and T-FTS (4.66 +/- 0.7 log2(1)) circulating levels. ZnSO4 administration (400 mg p.o. daily for 3 months) to 6 patients with microprolactinomas, significantly increased (p less than .01) Zn (136 +/- 18 micrograms/dl), Zn-FTS (4.5 +/- 0.5 log2(-1)) and T-FTS (5.6 +/- 0.9 log2(-1)) levels, while caused only a slight decrease in serum PRL concentrations (from 95 +/- 8 to 75 +/- 9 micrograms/L; p: NS).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774133 TI - Evaluation of NK and LAK cell activities in neoplastic patients during treatment with morphine. AB - The cytotoxic activity of Natural Killer (NK) and Lymphokine Activated Killer (LAK) cells in neoplastic patients with or without antalgic treatment was studied. NK cell activity was found reduced in untreated neoplastic patients when compared to healthy subjects. The atalgic treatment with morphine (orally or intrathecally administered) was able to significantly reduce the mean values of NK cell activity found in cancer patients. In three patients the cytotoxicity of NK cells significantly decreased during transfer from oral to intrathecal administration of morphine. In contrast to the NK cell function, the development of LAK cell activity significantly increased in neoplastic patients when compared to healthy controls. Further increments were obtained during treatment with morphine. The oral treatment with morphine was able to determine a higher induction of LAK cells than the intrathecal administration of the drug. Besides providing new knowledge on the effect of morphine on immune system our findings suggest that, in order to include neoplastic patients in clinical trials of adoptive immunotherapy with LAK cells and interleukin-2 (IL-2), the antalgic therapy with oral administration of morphine may represent a better solution than the intrathecal administration of the drug. PMID- 1774134 TI - Thymic endocrine activity in children with idiopathic growth-hormone deficiency. AB - Experimental and clinical evidences suggest that thymic endocrine function is modulated by the neuroendocrine network and in particular by growth hormone. The plasma of thymulin has been found reduced in congenital hypopituitarism and increased in acromegalic conditions when compared with the values observed in age matched controls. In the present paper we have investigated in congenital GH deficient children the effect of one year therapy with GH on the plasma level of thymulin, IGF-1 and plasma zinc; this last parameter has been checked because zinc is required for thymulin activity and modulates IGF-1 production. The basal thymulin and IGF-1 values are lower in GH deficient children than age-matched controls whereas zinc levels show a slight reduction. GH therapy induces a significant increment both of thymulin and IGF-1 levels and a slight increase of plasma zinc. A positive correlation has been found between zinc values and thymulin activity but not between GH and thymulin. Whether the recovery of thymulin production in GH deficient children by GH therapy is mediated by IGF-1 or by bioavailability of zinc ions remains to be established. PMID- 1774135 TI - Stress-induced resistance to anaphylactic shock. AB - There have been many reports of the immunomodulatory effects of stress, but the influence of stress on anaphylaxis has been given little attention till now. In this study we investigated the influence of tail-shock stress on the course of anaphylactic shock (AS) in the rat. For this purpose, rats were sensitized to ovalbumin and subjected to stress procedure before the induction of AS. In the first series of experiments we used chronic (4 day) stress consisted of 80 inescapable tail shocks delivered at the same time each day. Anaphylactic shock was induced 24 hours later by intraperitoneal injection of 3 mg of ovalbumin. Results showed that stressed rats exhibited lower intensity of three investigated parameters of AS: clinical signs, hematocrit values, and drop of rectal temperature. In order to investigate whether acute stress procedure could also influence course of AS, rats were given various shock doses of ovalbumin immediately after the end of acute (1 day) tail-shock stress. Anti-anaphylactic effect of acute stress was demonstrated to be dose-dependent: the greatest protective effect was in animals that received the highest shocking dose of ovalbumin. Finally, we examined the duration of protective effect of acute inescapable tail shocks on AS, and these results showed that observed anti-AS phenomenon disappears 72 hours after the end of acute stress session. PMID- 1774136 TI - Stress-induced suppression of experimental allergic encephalomyelitis in the rat. AB - Numerous experiments have demonstrated that physical stress can alter immunological parameters. However, little attention has been paid to the interrelationship between stress and autoimmune processes. The present study was designed to determine the influence of electric shock and sound stress on the development of experimental allergic encephalomyelitis (EAE). Ten-week-old male DA rats highly susceptible to EAE were used. Rats were subjected to the stress procedure during 19 days either before or after immunization with intradermal injection of 0.1 ml of an emulsion containing guinea pig spinal cord (20 mg/rat) in an equal volume of complete Freund's adjuvant (CFA). In addition, rats received subcutaneous injection of Bordetella pertussis in the dorsum of the same foot. Electric stress procedure consisted of 80 inescapable, unpredictable tail shocks (5 s, 1 mA) delivered at the same time each day. Sound stress procedure consisted of exposure of rats to a 90 dB fire alarm bell which rings 60 times for 5 s during one hour, at the same time of the day. Rats were observed daily for clinical signs of EAE and survived animals were sacrificed on day 20 after immunization. The brain and spinal cord sections were examined histologically for mononuclear cell infiltrates characteristics for EAE. The results clearly indicate that inescapable tail shocks suppressed the appearance and development of EAE when rats were subjected to stress procedure during 19 days after immunization, but not when rats were stressed during 19 day before the induction of EAE. On the other hand, in rats exposed to sound stress there was only delay in the onset of the disease. PMID- 1774137 TI - Peptidergic innervation of the Bursa Fabricii: interrelation with T-lymphocyte subsets. AB - In birds, B-lymphocytes mature in a special immune organ, the Bursa Fabricii. This organ thus offers unique possibilities for the study of the microenvironment of B-lymphocyte differentiation. We previously reported tachykinin-, vasoactive intestinal peptide-, calcitonin gene-related peptide- and galanin-immunoreactive (ir) fibres in the chicken bursa. As judged from light microscopic studies, each of the peptides was found in fibres contacting B-lymphocytes. Vasoactive intestinal peptide-ir fibres contacted macrophages. Now, we demonstrate neuropeptide Y, indicating the sympathetic nervous system, in fibres associated with arteries, not entering the follicles. CD4- and CD8-positive T-lymphocytes were dispersed in bursal follicles and the connective tissue, most densely in subepithelial regions. We could not find close apposition of fibres with either T cell subset. We conclude that the potential neuro-immune axis in the Bursa Fabricii may represent a neuro-B-cell-link with only indirect participation of T lymphocytes. The sympathetic input may influence the bursal microenvironment primarily by regulating the blood supply. PMID- 1774138 TI - In vivo and in vitro effect of NGF on bursa of Fabricius cells during chick embryo development. AB - NGF exerts a broader biological action than previously believed. The growing evidence of NGF's effect on lymphocytes and the presence of high levels of mRNA for NGF receptors in the embryonic bursa of Fabricius led us to study the action of NGF on bursal cells during chick embryo development. Our in vivo experiments indicate that NGF administration in ovo caused a significant increase in size of the lymphoid follicles in the embryonic bursa at E15. The in vitro experiments demonstrated that NGF exhibits different effects on bursal cells depending on the stage of development. At E9 bursal cells survive for longer periods when NGF is added to the medium. At E15 NGF act as a colony-stimulating factor by significantly increasing the number of colonies in soft agar cultures. PMID- 1774139 TI - Enkephalinase-inhibitors modulate immune responses. AB - Exogenous opioid peptides, and enkephalins in particular, modulate a variety of immune performances in vivo and in vitro. In this study, the immunomodulatory role of endogenous opioids was investigated by means of central and peripheral administration of four peptidase inhibitors in the rat. Animals sensitized with sheep red blood cells (SRBC) were daily treated intraperitoneally (i.p.) with 0.2 mg/kg or 1 mg/kg of each inhibitor, or intracerebroventricularly (i.c.v.) with 0.02 mg/kg and 0.2 mg/kg of bestatin, des-tyrosine-methionine-enkephalin, (Des Tyr1)Met-Enk; and actinonin, and 0.005 and 0.5 mg/kg of N-Carboxymethyl phenilalanine-leucine,(N-C)Phe-Leu. Controls were injected i.p. and i.c.v. with saline. The results revealed that in animals treated i.p. with 0.2 mg/kg of bestatin and (N-C)Phe-Leu potentiated the plaque-forming cell (PFC) response and hemagglutinin production. In contrast, these immune responses were suppressed by 1 mg/kg. On the other hand, i.p. doses of 0.2 and 1 mg/kg of actinonin and (Des Tyr1)Met-Enk potentiated humoral immune responses. When given i.c.v., all of the inhibitors used exerted clear dose-dependent immunomodulatory effects, i.e. increase in the PFC response and hemagglutinin production when given at lower doses (0.005-0.02 mg/kg), and decrease when injected with higher doses (0.2-0.5 mg/kg). These effects of enkephalin-related peptidase inhibitors, applied i.p. and i.c.v., suggest the involvement of endogenous enkephalins in immune mechanisms. PMID- 1774140 TI - Interferon-gamma induced IA antigen expression on cultured neuroglial cells and brain macrophages from rat spinal cord and cerebrum. AB - The inducibility of major histocompatibility complex class II (Ia) antigens on glial cells of the brain suggests that neuroglia have immunoregulatory functions within the central nervous system (CNS), i.e., recognition and presentation of antigens. The aim of the present study was to investigate rat recombinant interferon-gamma (r-IFN-gamma) induced Ia antigen expression in rat cerebral cultures containing type-1 astrocytes and macrophages, and in rat spinal cord cultures enriched in type-2 astrocytes or oligodendrocytes. We compared induction of Ia antigen expression in glial cell cultures derived from Lewis rats, which are very susceptible to experimental allergic encephalomyelitis (EAE), with those from Wistar rats, which are but modestly EAE susceptible. After 5 days in culture we found in Wistar rat type-1 astrocyte-enriched cultures that Ia antigens were expressed by 19% of the astrocytes, whereas we found that in Lewis rat type-1 astrocyte cultures a considerably higher number of astrocytes expressed Ia antigens (53%). However, no significant difference were found in Ia antigen expression between type-2 astrocytes derived from Wistar rat spinal cord (49%) and Lewis rat type-2 astrocytes (56%). In contrast, in oligodendrocyte-enriched cell cultures derived from either Lewis or Wistar rats no Ia antigen expression was found. Interestingly, we found in type-1 astrocyte-enriched cerebral cultures a large number (approx. 46% of the cells) of brain macrophages (amoeboid microglia), all expressing Ia antigens after treatment with r-IFN-gamma. PMID- 1774141 TI - Changes of experimental allergic encephalomyelitis by methionine-enkephalin injected into lateral ventricles of the rat brain. AB - Our previous investigations have shown that the opioid peptide methionine enkephalin (Met-Enk) modulates in vivo a variety of humoral and cell-mediated immune performances. In this study, rats bearing polyethylene cannulae permanently inserted into the lateral ventricles of the brain were used. Experimental allergic encephalomyelitis (EAE) was induced with guinea pig spinal cord in complete Freund's adjuvant injected into the left hind foot pad. The following groups of cannulated rats were tested: nontreated with Met-Enk or saline, intracerebroventricularly (i.c.v.) injected with saline, and i.c.v. treated with low (1 microgram/kg) dose of Met-Enk and high (1 mg/kg) dose of Met Enk. Intact noncannulated rats sensitized for EAE served as an additional control. The results showed that i.c.v. treatment with 1 microgram/kg of Met-Enk significantly increased the incidence and severity of EAE. In contrast, injections of 1 mg/kg of Met-Enk produced a moderate decline of clinical EAE, but marked diminution of inflammatory lesions in the brain. Interestingly, histopathology of EAE was more pronounced in control rats treated i.c.v. with saline. On the other hand, control cannulated rats noninjected with saline exhibited a striking decrease of neurological and histopathological signs of the disease, thus indicating a suppressive effect of stress (surgical procedure) on EAE. In conclusion, the present study showing the central effect of Met-Enk on EAE when peptide was applied in the cerebral cavity, and earlier studies which revealed the peripheral effect on EAE when Met-Enk was administered intraperitoneally, suggests that Met-Enk exerts its immunomodulatory action both centrally and peripherally. PMID- 1774142 TI - The immune-hypothalamo-pituitary-adrenal axis and autoimmunity. AB - Immunoendocrinology is a rapidly expanding field, uncovering numerous bilateral interactions between the immune system and neuroendocrine circuits. Various hormones and neurotransmitters appear to modulate cells of the immune system and likewise cytokines control the function of neuroendocrine system. In the present paper, we discuss some lines of evidence indicating that an immunoendocrine feedback loop, which we term 'immune-hypothalamo-pituitary-adrenal system' is an integral part of the regulation of self tolerance. The finding that pathology of this immunoendocrine feedback loop is related to development of autoimmunity may lead to new prophylactic and therapeutic strategies. PMID- 1774143 TI - Cerebral blood flow and event-related potential in patients with multiple cerebral infarcts. AB - Cerebral blood flow and P300, a long-latency, positive component of the scalp recorded, event-related potential (ERP), were measured in 26 patients with multiple cerebral infarcts (mean age, 65.0 years). Compared with age-matched normal subjects, patients with multiple cerebral infarcts had significantly lower cortical blood flow values and had prolongation of the P300 latency. There was a significant correlation between the P300 latency and the mean cortical blood flow values in patients with multiple cerebral infarcts. These results suggest that, in patients with multiple cerebral infarcts, the cognitive impairment associated with change of the ERP may be related to reduction of cortical blood flow. PMID- 1774144 TI - Expression of tumor necrosis factor alpha in the developing nervous system. AB - We present evidence that tumor necrosis factor alpha (TNF-alpha) is transiently expressed at specific times during embryogenesis in precisely defined areas of the nervous system in two different classes of vertebrates. In murine embryos, TNF-alpha was detected in the brain, neural tube and peripheral mixed spinal nerves. In the chick embryo, TNF-alpha was observed in the brain neuroepithelium and in the developing Purkinje neurons of the cerebellum. Western immunoblot analysis revealed that brain tissue from both mouse and chick embryos contained a 50 kDa protein showing immunoreactivity with anti-TNF-alpha antibody. These results suggest that TNF-alpha participates in the normal development of the vertebrate brain and spinal cord. PMID- 1774145 TI - The relationship of limbic epilepsy to pineal melatonin functions. PMID- 1774146 TI - Zinc deficiency and cerebellar disease. PMID- 1774147 TI - Comparison of neuropsychological, MRI and computerized EEG findings in a case of prosopoagnosia. AB - We present the case of a patient suffering from prosopoagnosia (PA). The MRI, performed at the onset of the disease, showed a lesion, strictly confined to the right temporo-occipital region; whereas the computerized EEG documented a functional impairment of the posterior regions of both hemispheres. A control performed two months later indicated a partial recovery of the neuropsychological deficit coupled with an improvement of EEG abnormalities, which was more prominent on the left side. The usefulness of functional studies in order better to comprehend the anatomical substrates of PA and their prognostic value are briefly discussed. PMID- 1774148 TI - Imaging techniques in the localization of epileptiform abnormalities. AB - The success of surgical intervention in the partial epilepsies is crucially affected by the accuracy of pre- and intraoperative source location techniques. Several approaches to the localization problem have been employed, that with the longest history being scalp-recorded EEG. Despite considerable advances in other imaging technologies such as MRI and PET, localization via the electrical signals generated by epileptic brain continues to provide the data most relied upon in pre-operative assessment. The present paper presents an overview of the contribution of various localization techniques. It is argued that electrical signals of the brain, as represented by EEG and MEG, remain the best methods to locate sources, and that the application of analysis techniques presently under investigation will further improve the accuracy of the non-invasive scalp-EEG approach. PMID- 1774149 TI - Relationship between response latency and amplitude for ganglion and geniculate X and Y-cells in the cat. AB - This study investigates the relationship between visual response latency and amplitude in the retina and dorsal lateral geniculate nucleus (dLGN) of the anesthetized, paralyzed cat. The discharge rate profiles of retinal ganglion and dLGN X- and Y-cells were measured on a trial by trial basis during repeated stimulation with sinusoidal grating patterns. Latencies of response onsets and peaks were regressed linearly against different measures of response amplitude to determine the extent of covariance. In general, response amplitude was a poor predictor of response latency for both retinal ganglion and geniculate cells. The results suggest that response latency, which changes systematically with stimulus spatial frequency and/or contrast, is not a trivial consequence of discharge rate at either level of the visual system. PMID- 1774150 TI - Cognitive neuropsychophysiology of thought imagery versus imagination imagery. AB - The present study was designed to measure patterns of cortical activation during two types of mental imagery: "thought imagery" and "imagination imagery." Topographic cortical power spectrum (CPS) analyses were conducted for 10 subjects during four experimental conditions. EEG was recorded from right and left hemispheres at frontal, temporal, parietal, and occipital leads. Subjects gave rating of visual vividness and quasisensory subjective experience after each imagery condition. Examination of subjects' ratings revealed that they reported significantly greater visual vividness and quasisensory experiences during the imagination imagery condition, as compared to the thought imagery condition. Topographic CPS analyses showed significant individual differences in patterns of brain activation, which were reliable across conditions. Individual differences in lateralization of brain activity were found in terms of an anterior-posterior gradient. Within-subject analyses showed CPS changes as a function of condition. Three major patterns of CPS changes across condition were delineated. PMID- 1774151 TI - Longitudinal measurements of brainstem auditory evoked potentials in patients with dementia of the Alzheimer type. AB - Brainstem auditory evoked potentials (BAEPs) were recorded from 33 patients with mild-to-moderate dementia of the Alzheimer type (DAT) and 16 age-matched normal controls. There were no significant differences between the two groups on any latency measure (wave V latency, I-V and III-V interpeak latencies). Within the DAT group, there was no association between BAEP latency measures and cognitive status, indexed by scores on the Mini-Mental Status Exam (MMSE). Eight of the DAT subjects were retested 6 months and one year later. Despite significant evidence of continued cognitive decline, there were no changes in BAEP latency measures over time. Furthermore, BAEP latency measures at initial testing did not predict the degree of cognitive decline over the one year time interval. The results show that BAEP latency is unaffected in patients with mild-to-moderate DAT. PMID- 1774152 TI - The recognition potential contrasted with the P300. AB - An electrical response of the brain to recognizable images was described. The response (referred to as the "recognition potential") occurred for words, pictures, and faces, but not for non-meaningful control images. It was best recorded from the occipital area. The peak latency was 200-250 ms. It differed from the P300 response in latency, topography, and sensitivity to probability of occurrence. Its amplitude depended on the site of recording and the visual field stimulated. Degradation of the images caused equal increases in reaction time (RT) and recognition potential latency. The results contradicted the proposal that the latency of the P300 can be used as a measure of the timing of stimulus evaluation processes. PMID- 1774153 TI - Characteristics of the inhibition and metabolic inactivation of the yeast TRNA nucleotidyl transferase. AB - 1. Yeast tRNA nucleotidyl transferase is inhibited by low molecular weight compounds present in cell-free extracts. The inhibition produced by the main component(s) is competitive with respect to ATP and is not prevented by metal chelating agents. The major component(s) has been partially purified. It is resistant to heat (90 degrees C, 5 min) and insensitive to digestion by alkaline phosphatase, snake venom phosphodiesterase and inorganic pyrophosphatase, indicating that it is not a nucleotide. 2. Besides the masking of the transferase activity in the crude extracts by the inhibitors, the enzyme is inactivated in nitrogen starved cells. The inactivation also occurs in yeast mutants lacking several proteases and is not prevented by inhibitors of yeast proteases. These results rule out extracellular proteolysis as the cause of inactivation and strength our previous observations on the metabolic inactivation of the transferase in response to nitrogen starvation. PMID- 1774154 TI - Intrinsic fluorescence quenching of glutathione transferase pi by glutathione binding. AB - The binding of the GSH to the GSH transferase pi quenches the protein intrinsic fluorescence more than the binding of GS-Me. The calculated dissociation constants are 38.6 microM and 90.9 microM for GSH and GS-Me, respectively. From the reported data it is evident that the binding of GSH to GSH transferase pi quenches the intrinsic fluorescence with two different mechanisms. The first one is a conformational change induced by the binding of the GSH and it is present also with the GS-Me binding. A second proposed mechanism is a contact quenching between the sulphydryl GSH group and a tryptophan residue. This suggests that at least one of the tryptophan residues is located near the GSH binding site. PMID- 1774155 TI - Development, physicochemical characterization and preclinical efficacy evaluation of a water soluble glucan sulfate derived from Saccharomyces cerevisiae. AB - This report describes the development, characterization and preclinical efficacy evaluation of water soluble glucan sulfate. Glucan sulfate was derived from insoluble beta-1,3-D-glucan isolated from Saccharomyces cerevisiae. The proposed repeating unit empirical formula of glucan sulfate is [(C6H10O5)5.3H2SO4]n. Two polymer peaks were resolved by aqueous high-performance size exclusion chromatography (HPSEC) with on-line multi-angle laser light scattering (MALLS) photometry and differential viscometry. Peak 1 (MW = 1219697 Da) represents approximately 1% of the total polymers, while peak 2 (MW = 8884 Da) accounts for approximately 99% of polymers. 13C-NMR spectroscopy suggests that glucan sulfate polymer strands may be partially cross-linked. Glucan sulfate (250 mg/kg, i.v.) increased (P less than 0.01) macrophage vascular clearance of 131I reticuloendothelial emulsion by 42% (P less than 0.01) and in vitro bone marrow proliferation by 46% (P less than 0.05). Glucan sulfate (250 mg/kg, i.v.) increased (P less than 0.05) median survival time of C57B1/6J mice with syngeneic melanoma B16 or sarcoma M5076. In addition, glucan sulfate immunoprophylaxis increased resistance of mice to challenge with Escherichia coli, Candida albicans or Mouse Hepatitis Virus strain A-59. We concluded that: (1) insoluble beta-1,3-D glucan can be converted to a water soluble sulfated form; (2) glucan sulfate activates macrophages and stimulates bone marrow; (3) glucan sulfate exerts antitumor therapeutic activity, and (4) glucan sulfate immunoprophylaxis will modify the course of experimental infectious disease. PMID- 1774157 TI - Immune response to the Lyme spirochete Borrelia burgdorferi affected by ethanol consumption. AB - Rats fed excessive amounts of ethanol developed marked hematologic and immunologic changes. These included a reversal of the normal lymphocyte to granulocyte ratio in the peripheral blood, lower spleen and lymph node weights and a greatly reduced capacity to express normal cell mediated immune functions, based on poor lymphocyte reactivity in vivo, and in vitro to T and B cell mitogens and borrelial antigens shortly after primary immunization with the bacterial spirochete, Borrelia burgdorferi. Further evidence for impaired immune function caused by ethanol was based on little or no antibody response against Borrelia in rats following in vivo sensitization with B. burgdorferi incorporated in complete Freund's adjuvant. These findings provide substantial direct evidence strengthening the notion that high levels of ethanol ingestion adversely affect the host immune system and can interfere with the immune response to microorganisms. PMID- 1774156 TI - Propranolol treatment affects parameters of human immunity. AB - Elevated sympathetic activity can modulate parameters of immunity. We investigated the role of the low sympathetic activity in resting healthy volunteers by treating them with the beta-adrenergic antagonist propranolol (3 x 40 mg/d for 7 days). Propranolol treatment increased the number of circulating T cells but not that of other white blood cells. Similarly, Con A-stimulated lymphocyte proliferation and IL-2 formation were enhanced. Although the number of circulating NK cells did not change, NK-cell activity was reduced markedly after propranolol treatment. These alterations are not a mirror image of the changes observed under conditions of elevated sympathetic activity but demonstrate that withdrawal of the endogenous sympathetic tone by drugs such as propranolol can modulate parameters of human immunity. PMID- 1774158 TI - Solved and unsolved headache problems. AB - Two unusual cases of vascular headache, one caused by jugular venous compression from a goiter and one triggered by flushing associated with a CGRP-producing renal tumour, are reported. Their histories are compared with those experiencing other headaches of vascular origin. Two patients with a primary neural irritative lesion, one with a sphenoid sinus carcinoma and one with Tolosa-Hunt syndrome, presented with headaches resembling migraine. These case-histories are used to illustrate the interaction of nervous system and vascular system in the production of headache which has implications for the pathophysiology of migraine and cluster headache. PMID- 1774159 TI - Myocardial ischemia related to ergot alkaloids: a case report and literature review. AB - Ergotamine tartrate and methysergide are widely used headache treatments with important vasoconstrictive properties. We report a 31-year-old man with cluster headaches who developed severe, prolonged myocardial ischemia following combination therapy with ergotamine tartrate and methysergide. We reviewed the cardiovascular complications of each agent alone and in combination. Given the pharmacologic similarity of these agents, we propose that they may have additive or synergistic cardiac toxicity, at least in vulnerable individuals. We recommend caution when these agents are used together. PMID- 1774160 TI - Post-traumatic migraine: chronic migraine precipitated by minor head or neck trauma. AB - Minor trauma to the head or neck is occasionally followed by severe chronic headaches. We have evaluated 35 adults (27 women, 8 men) with no prior history of headaches, who developed recurrent episodic attacks typical of common or classic migraine following minor head or neck injuries ("post-traumatic migraine"-PTM). The median age of these patients was 38 years (range 17 to 63 years), which is older than the usual age at onset of idiopathic migraine. The trauma was relatively minor: 14 patients experienced head trauma with brief loss of consciousness, 14 patients sustained head trauma without loss of consciousness, and 7 patients had a "whiplash" neck injury with no documented head trauma. Headaches began immediately or within the first few days after the injury. PTM typically recurred several times per week and was often incapacitating. The patients had been unsuccessfully treated by other physicians, and there was a median delay of 4 months (range 1 to 30 months) before the diagnosis of PTM was suspected. The response to prophylactic anti-migraine medication (propranolol or amitriptyline used alone or in combination) was gratifying, with 21 of 30 adequately treated patients (70%) reporting dramatic reduction in the frequency and severity of their headaches. Improvement was noted in 18 of the 23 patients (78%) who were still involved in litigation at the time of treatment. The neurologic literature has placed excessive emphasis on compensation neurosis and psychological factors in the etiology of chronic headaches after minor trauma. Physicians must be aware of PTM, as it is both common and treatable. PMID- 1774161 TI - Autonomic nervous system function in migraine without aura. AB - Autonomic nervous system functions were studied in 13 females with migraine without aura during headache-free intervals, using physiological, pharmacological and biochemical methods. Heart-rate in the resting condition and blood pressure rises in the cold-face and isometric handgrip tests were higher than in controls. Normal cardiovascular responses to the Valsalva manoeuvre and to noradrenaline infusion suggest that the baroreflex arc is intact. Normal heart rate responses to the Valsalva manoeuvre, to the cold-face test and to deep breathing confirmed a normal cardiac parasympathetic function. Clonidine infusion showed a sedative and depressor effect and an inhibition of plasma NA similar to those occurring in controls, suggesting a normal central sympathetic tone. As a whole, the physiological, pharmacological and biochemical tests were consistent with a non specific sympathetic hyperactivity, but do not confirm any impairment of the autonomic control of the cardiovascular system in migraine patients in headache free intervals. PMID- 1774162 TI - Ketorolac in acute headache management. AB - Twelve patients presenting to an emergency department in headache crisis were treated with Ketorolac tromethamine 60 mg. intramuscularly. All improved sufficiently to require no further emergent treatment. There was statistically significant improvement on all segments of the short form McGill Pain Questionnaire. This open label trial suggests that Ketorolac Tromethamine may be a useful agent in the treatment of headache crisis, and a controlled study to examine this is warranted. PMID- 1774163 TI - Dihydroergotamine suppositories in a headache clinic. AB - Dihydroergotamine (DHE) is available in the United States for parenteral use. We report a preliminary trial of DHE suppositories in an outpatient headache clinic setting. Dihydroergotamine suppositories may be appropriate for patients with catamenial migraine and classic migraine in particular. PMID- 1774164 TI - Home-based multicomponent treatment of pediatric migraine. AB - The present investigation examined a home-based multicomponent treatment program incorporating biobehavioral technology in the treatment of pediatric migraine. Twenty-one children ages 7-12 participated in home-based practice of thermal biofeedback while parents implemented guidelines designed to encourage the use of biofeedback and eliminate support for maladaptive pain behavior. Treatment was introduced sequentially across three groups of children in a multiple baseline design. When subjects and their families were complaint with treatment recommendations, 87% of the children experienced clinically significant reductions in headache activity, with these reductions maintained at 3 and 8 month followups. Treatment outcome was found to be closely related to frequency of home practice, parental support for the use of adaptive coping (biofeedback) rather than maladaptive coping (pain) behaviors, and ability to warm hands. Discussion is provided concerning potential mechanisms of action and directions for future research. PMID- 1774165 TI - Pheochromocytoma presenting with headache, panic attacks and jaundice in a child. AB - Pheochromocytomas can mimic many unrelated diseases due to their various presenting signs; they are encountered very rarely in childhood. Recently, their neuropsychiatric aspects have become a subject of interest for many workers, but most of the findings reported previously have been observed in adults. We present a case report which is unique in that it concerns a child with pheochromocytoma and psychiatric findings consisting of depression and panic disorder, which were interpreted as being directly related to, since they disappeared after the removal of, the tumor. Depression was persistent and accompanied by a constricting-type headache, while panic disorder was acute and accompanied by a migraine-type headache. Another intriguing complication encountered in our case was jaundice; we considered that it could possibly have been due to an adverse effect of catecholamines on hepatocyte function. We conclude that a pheochromocytoma can be confused with neuropsychiatric disorders in children as well as in adults and that it should be considered in the differential diagnosis of such disorders. PMID- 1774166 TI - A cluster analysis of the multidimensional pain inventory. AB - Seventy-nine patients with chronic headaches of diverse causes, recruited from a headache clinic's biofeedback facility, were administered the Multidimensional Pain Inventory (MPI) for measuring the cognitive, behavioral, and affective dimensions of pain. Using the statistical technique of cluster analysis to organize the results, three clusters emerged, and were similar in their characteristics to those named "Dysfunctional", "Interpersonally Distressed", and "Adaptive Coper" by other authors who had applied the Inventory and the cluster analysis technique to other populations (one population containing heterogenous groups of chronic pain patients, and another population of patients suffering from "temporomandibular joint disorders". Additional analyses of our results confirmed that the three groups were distinct from one another; and that age, sex, duration of complaint, and diagnosis, were not factors in the formation of the groups. Our results suggest that the MPI is a valid measure of the cognitive, behavioral and affective aspects of pain. Rather than apply a similar intervention program to all headache patients, it might be more effective to tailor treatment to the variations in these aspects exhibited by patients in the three different clusters. PMID- 1774167 TI - Hemicrania continua in a black patient--the importance of the non-continuous stage. AB - A 52-year-old black female for 19 years had severe intermittent unilateral headaches that demonstrated the "clustering" phenomenon. She was initially diagnosed as having episodic cluster headache. Response to lithium carbonate, ergotamine and courses of corticosteroids was, however, only partial. In December 1989 the headache pattern changed and she developed severe unilateral hemicranial headache that was continuous and non-remitting. This responded immediately and persistently to oral indomethacin. A diagnosis of hemicrania continua (HC) was made. The initial intermittent headache syndrome appears to have been the pre continuous stage of hemicrania continua, and not episodic cluster headache as previously supposed. The pre-continuous phase of hemicrania continua may thus masquerade as episodic cluster headache by reason of its intermittency and "clustering". In this case, the intermittent stage was protracted. This stage may, conceivably, even be a permanent one. To our knowledge, this is the first report of hemicrania continua in a black African. PMID- 1774168 TI - Analgesic-induced headaches: successful treatment with ibudilast. PMID- 1774169 TI - More on perimenstrual migraine. PMID- 1774170 TI - Idiopathic headache as a possible risk factor for phantom tooth pain. AB - Following tooth pulp extirpation, some subjects suffer from persistent pain which affects edentate sites in absence of any local pathology. As regards this peculiar pain, called phantom tooth pain (PTP), what is puzzling is the fact there is a low prevalence of PTP in a very large population showing identical conditions of tooth pulp extirpation. The present investigation indicates that PTP mainly affects migraine (M) and cluster headache (CH) sufferers, whereas it does not affect subjects who have a negative personal and family history for idiopathic headache (IH). These results circumscribe the presence of PTP to a specific section of the population. The present results, besides indicating that PTP may be the result of a peculiar neuronal predisposition relating to IH pathogenesis, suggests some practical therapeutic hints. In fact, successful anti M and anti-CH prophylactic treatment greatly improve PTP syndrome. PMID- 1774171 TI - Sustained visual aura: a totally new variation of migraine. AB - An unusual case of an abnormally long-lasting (over 12 months) visual migraine aura is reported. The absence of signs of a structural lesion, as shown by neuro imaging and clinical investigations, make difficult the differential diagnosis between a new variation and a complication of migraine. PMID- 1774172 TI - Headaches and psychoactive substance use. AB - A number of clinical reports have revealed an association between the use of alcohol and drugs and the onset or exacerbation of headaches. In order to investigate this association systematically and to examine the temporal relationship between onset of headaches and psychoactive substance use, we analyzed responses to a self-report questionnaire from 267 consecutive admissions to a three-week inpatient substance abuse treatment program. The response rate was 89.7%. The following characteristics were noted in the 236 respondents: 1) Over 89% reported having experienced some type of headache. 2) Headache-free individuals were significantly older than headache sufferers. 3) Women were much more likely to have migraine headaches than men. 4) Onset of migraines occurred prior to onset of substance use, while onset of tension headaches occurred after onset of substance use. Although associational data must be interpreted with caution, an intriguing hypothesis compatible with the finding is that migraines may play a role in the genesis of substance use, while substance use may play a role in the genesis of tension headaches. PMID- 1774173 TI - Review article: the medical management of trigeminal neuralgia. AB - Trigeminal neuralgia results from disturbances in the trigeminal root entry zone which generate repetitive action potentials. Drugs which relieve the pain of trigeminal neuralgia depressed these potentials. Anticonvulsants which exert this or related effects, and which have been demonstrated to be efficacious in trigeminal neuralgia, include carbamazepine, phenytoin, clonazepam, and valproic acid. Baclofen may act by facilitating segmental inhibition of the trigeminal complex. The mechanism of action of pimozide for treating trigeminal neuralgia is not known. Carbamazepine is suggested as the drug of first choice; baclofen or clonazepam could be added if carbamazepine monotherapy is ineffective. When these fail, monotherapy with phenytoin, pimozide, or valproic acid would be a reasonable next step. PMID- 1774174 TI - Vascular reactivity during migraine attacks: a transcranial Doppler study. AB - We measured vascular reactivity--expressed i) as decrease in blood flow velocity (cm/sec) per vol% CO2 decrease due to voluntary hyperventilation and ii) as increase of blood flow velocity during the first minute after resuming normal ventilation, per vol% CO2 increase--in the middle cerebral and basilar artery of 48 migraineurs with attacks without aura, and 17 normal controls. We found no differences for both determinants of vascular reactivity between migraineurs during and outside an attack, and between migraineurs and healthy volunteers. We conclude that the vasomotor reactivity is normal during migraine attacks without aura. PMID- 1774175 TI - Transcranial Doppler (TCD) after nitroglycerin in migraine without aura. AB - Nitroglycerin, a vasodilating agent, was administered sublingually in migraine without aura patients and in healthy volunteers. Systolic, diastolic and time mean flow velocity and pulsatility index, were measured by transcranial Doppler sonography in the major intracranial arteries before and after nitroglycerin administration. Following nitroglycerin administration, a significant decrease in systolic and time-mean velocity and pulsatility index was observed in migraine patients, whereas in control subjects only time-mean velocity decreased significantly. Based on those findings we hypothesize a more marked responsiveness to nitroglycerin in migraine patients as compared to healthy subjects. PMID- 1774176 TI - Benign intracranial hypertension--its unusual manifestations. AB - Among our patients with benign intracranial hypertension, we encountered 3 who presented with unusual clinical features. Presentations were pseudotumor without papilledema, unilateral papilledema, and IIIrd and Vth cranial nerve involvement. Lumbo-peritoneal shunt completely resolved the symptoms and signs in 2 of the patients; in the third, symptoms and signs cleared following lumbar puncture. PMID- 1774177 TI - Treatment of tension-type headache with tizanidine hydrochloride: its efficacy and relationship to the plasma MHPG concentration. AB - Seventy-eight patients with tension-type headache (TH) were treated with tizanidine hydrochloride (tizanidine). Plasma 3-methoxy-4-hydroxyphenylglycol (MHPG) and serum free fatty acids (FFA) levels in these patients were determined before the treatment with tizanidine. Eighteen healthy volunteers composed the control group. Four weeks after the treatment with tizanidine 24 (31%) of 78 patients showed excellent improvement (excellent group); 28 (35%) showed moderate improvement (moderate group); 18 (23%) showed mild improvement (mild group); 7 (10%) showed no improvement and one (1%) showed worsening of her headache (no change and worsened group). The plasma MHPG levels in the excellent group were significantly higher than in the other groups, including the control group. The serum FFA levels in the excellent group were significantly higher than in the controls. In this study, 66% of the patients reported improvement in their headaches. Some patients with TH had high plasma MHPG levels and these patients in particular showed excellent improvement after the administration of tizanidine. Though there may be a placebo response to some extent, the clinical usefulness of tizanidine for TH seems to be excellent. Further study is necessary concerning the pharmacological effect of tizanidine and plasma MHPG levels in patients with TH. PMID- 1774178 TI - Long-term effects of biofeedback on migraine headache: a prospective follow-up study. AB - The aim of the present study was two-fold: to assess the long-term effects of biofeedback on migraine, and to determine the extent to which additional treatment after biofeedback treatment is completed can affect follow-up results. Ninety-six women whose migraine had been treated through biofeedback either 2-3 years (shorter follow-up) or 6-7 years (longer follow-up) earlier were divided into four groups according to how long ago they had received their biofeedback treatment and whether or not they had received any additional treatment (whatever the nature) since the posttreatment assessment: shorter follow-up without additional treatment (n = 24), shorter follow-up with additional treatment (n = 22), longer follow-up without additional treatment (n = 24), and longer follow-up with additional treatment (n = 26). Subjects were asked to keep a headache diary for five weeks, as they had done during earlier assessments. Overall, results showed that migraine activity was significantly less at follow-up than at pretreatment. However, whether the observed long-term benefits could be attributed to biofeedback was unclear because medication was found to be as much in use at follow-up as at pretreatment. Results also indicated that 51% of the subjects did seek additional treatment between posttreatment and follow-up. Contrary to expectations, however, additional treatment was not associated with better therapeutic benefits at follow-up. The research and the clinical implications of those findings are discussed. PMID- 1774179 TI - Flunarizine in migraine prophylaxis: an Indian trial. AB - Flunarizine, a calcium channel blocker is considered useful in migraine prophylaxis. We report the first Indian trial with this drug. Fifteen patients with migraine were studied in a 6 months double-blind, placebo-controlled crossover trial. Flunarizine was superior to placebo in reducing the severity and duration of the individual attacks though there was no statistically significant effect on frequency of migraine attacks. The side effects most frequently caused by flunarizine were weight gain and daytime sleepiness. PMID- 1774180 TI - The use of exercise as a method of aborting migraine. AB - Exercise, as a method of migraine management has been discussed theoretically and tested empirically. The consensus is that exercise can help to reduce the frequency, intensity and/or duration of migraine attacks. Conversely, there are case studies which, with few exceptions, suggest that periods of exercise can precipitate a migraine headache. The literature concurs, however, that one should not attempt exercise when in the midst of an attack. The present article presents a case study of a woman who found prompt relief from her migraines with strenuous exercise. PMID- 1774181 TI - A tape-recorded test of hypnotic susceptibility for screening headache patients: a feasibility study of the Harvard Group Scale of Hypnotic Susceptibility, Form A. AB - A study to examine the feasibility of using the Harvard Group Scale of Hypnotic Susceptibility, Form A (HGSHS) as a screening instrument was undertaken at an inpatient headache treatment program. Nine patients diagnosed with chronic daily headache and drug rebound were administered the HGSHS. Analysis of the results showed no significant difference in hypnotic susceptibility when headache patients were compared to a control group. After taking the HGSHS, three of the five subjects who had headache at the time of testing reported a 25% reduction in pain, one was unchanged, and one reported a 13% increase in pain. The results obtained did not suggest a correlation between level of hypnotic susceptibility and reduction of headache. PMID- 1774182 TI - Fluctuating asymmetry in quantitative dermatoglyphic traits: twins and singletons. AB - Fluctuating asymmetry for the digital quantitative value was analyzed in a sample of twins (mono and dizygotic) and singletons. The aim was to check if the influence of twinning on the development is expressed in a higher fluctuating asymmetry in twins than in singletons. The results have shown that significant differences exist among the three groups studied, and these differences are fundamentally expressed when the radial and ulnar counts are considered separately. PMID- 1774183 TI - Characterisation of a tandem repetitive sequence cloned from the deer Capreolus capreolus and its chromosomal localisation in two muntjac species. AB - The isolation and characterisation of a highly repetitive DNA sequence from the genome of the Roe deer Capreolus capreolus is reported. This sequence is characterised by tandem repetition and located within centric heterochromatin as demonstrated by non isotopic in situ hybridisation to the karyotypes of the Indian and Chinese muntjacs. Amplification and/or clustering of these sequences during the drastic karyotype evolution of the genus Muntiacus was noted in the large centromere of the X chromosome of the Indian muntjac. Partial sequence analysis revealed a 62% sequence homology with the sat 1A sequences of Muntiacus muntjak vaginalis. PMID- 1774184 TI - The porcine PGD gene is preferentially lost from chromosome 6 in pig x rodent somatic cell hybrids. AB - The 6-phosphogluconate dehydrogenase (PGD) and glucose phosphate isomerase (GPI) genes are both located on chromosome 6 in the pig (Sus scrofa domestica). Nonetheless, the PGD gene was absent in a total of 17 GPI-positive cell lines found in three independently derived panels of pig x rodent somatic cell hybrids. In most of these cell lines we found an apparently normal pig chromosome 6 at cytogenetic analysis. These results suggest instability of the porcine PGD gene region in interspecies hybrid cells. PMID- 1774185 TI - A cattle breed close to 58 diploid number due to high frequency of rob(1;29). AB - Barrosa cattle, reared in the north of Portugal primarily for meat production, number about 40,000 (about 6% of all cattle in Portugal). Their fertility (number of calves per 100 cows) varies from 60% to 80% and is lower than that of other Portuguese cattle breeds. 195 animals (28 males and 167 females), randomly selected from a large area, were sampled for cytogenetical investigation. The results were the following: (a) 68 (34.9%) animals (7 males and 61 females) had normal karyotypes; (b) 127 (65.1%) were found to be carriers of rob(1; 29), as shown by G- and R-banding; (c) 102 (52.3%) animals (17 (8.7%) males and 85 (43.6%) females) were heterozygous carriers; (d) 25 (12.8%) animals (4 (2%) males and 21 (10.8%) females) were homozygous carriers. C-banding patterns revealed one block of constitutive heterochromatin (HC) in the proximal q-arm region of the translocated chromosome. PMID- 1774186 TI - Effect of low-level pulsed electromagnetic fields on human chromosomes in vitro: analysis of chromosomal aberrations. AB - The effects of extremely-low-frequency pulsed magnetic fields on human chromosomes with respect to the capacity of inducing chromosome breakage were studied. After human peripheral lymphocytes were exposed in vitro to pulsed electromagnetic fields at different intensities, a significant effect was observed for one of the intensities tested (40 Gauss), relative to the control group with respect to the yield of chromosome breakages. PMID- 1774187 TI - Heterosis and the lack of coadaptation in Drosophila nasuta. AB - Natural populations of Drosophila nasuta are polymorphic for several paracentric inversions. Two non-overlapping inversions on the third chromosome (III-2 and III 35) are heterotic in both laboratory and natural populations and display an extreme case of linkage disequilibrium. Intra- and interpopulation crosses involving standard and inverted gene orders of the III-2 and III-35 inversions were made to test if the polygenic complexes within these inversions are coadapted. The inversion heterozygotes formed by the two chromosomes derived from different localities exhibited heterosis since the viability of the heterozygotes was greater than that of either of the two homozygotes. In intrapopulation crosses, the heterozygotes were also heterotic. The present results thus indicated a lack of coadaptation among polygenic complexes within the inversions of D. nasuta. The data suggest that the heterosis produced by these linked inversions is the result of natural selection and epistasis. PMID- 1774188 TI - Allozyme divergence and phylogenetic relationships among Capra, Ovis and Rupicapra (Artyodactyla, Bovidae). AB - Genetic divergence and phylogenetic relationships between the chamois (Rupicaprini, Rupicapra rupicapra rupicapra) and three species of the Caprini (Capra aegagrus hircus, Capra ibex ibex and Ovis ammon musimon) have been studied by multilocus protein electrophoresis. Dendrograms have been constructed both with distance and parsimony methods. Goat, sheep and chamois pair-wise genetic distances had very similar values. All the topologies showed that Capra, Ovis and Rupicapra originate from the same internode, suggesting the hypothesis of a common, and almost contemporaneous, ancestor. The estimated divergence times among the three genera ranged from 5.28 to 7.08 Myr. These findings suggest the need to reconsider the evolutionary relationships in the Capriae. PMID- 1774189 TI - Chromosomal polymorphism and patterns of viability in natural populations of Drosophila melanogaster from cellar and vineyard. AB - Two neighbouring natural populations of Drosophila melanogaster have been analysed, one from a cellar habitat and the other from a vineyard outside. An extensive study of inversion polymorphism in the two populations has been carried out. Furthermore, the relationship between inversion polymorphism and the viability of the second chromosome has been studied. The data regarding the total frequency of inversion-carrying chromosomes indicate a lower frequency in the cellar population than in the vineyard population. Some possibilities that could explain the behaviour of the chromosomes from the cellar in relation to the peculiar environment of this habitat are discussed. New endemic inversions have been detected in both populations. With respect to the fitness component studied, no differences seem to exist between the cellar and vineyard populations. The frequencies of lethal-carrying chromosomes were the same in the two populations (0.267). There were no significant differences between the distribution patterns of the two populations for homozygote or for heterozygote viabilities. Data on allelism rates of lethals and population sizes help us to characterize certain aspects of both populations. PMID- 1774190 TI - A genetic analysis of reproductive barriers in Phacelia dubia. AB - Investigations into the genetic basis of reproductive barriers among recognized and putative varieties in Phacelia dubia have provided evidence that even among closely related taxa, multiple pathways can lead to reproductive isolation. A nuclear-based reproductive barrier, expressed as partial hybrid sterility of both pollen and ovules, isolated each pair of recognized varieties. There was no evidence of pre- or post-fertilization barriers; all reproductive barriers were manifested as hybrid gametic sterility. Reproductive relationships of two putative varieties were studied to examine the early stages of reproductive isolation in this group. Both putative varieties exhibited partial reproductive isolation from the recognized varieties in spite of their lack of morphological differentiation from recognized varieties. The barrier isolating one putative variety was similar to the barrier among recognized varieties. The second putative variety and a recognized variety were partially isolated by a unidirectional, nuclear-cytoplasmic barrier that reduced only pollen fertility. The nuclear-cytoplasmic barrier suggested a new application of Haldane's rule. PMID- 1774191 TI - Genetic variability and gene flow in geographical populations of Ceratitis capitata (Wied.) (medfly). AB - Two African populations of Ceratitis capitata (Kenya and Reunion Isl.) and two Mediterranean ones (Sardinia and Procida Isl.) have been studied for genetic variability at 25 loci by electrophoresis. Wright's FST, Slatkin's Nm* gene flow estimator, Nei's distance (D) together with measures of variability such as H, P, A have been used to compare the population from Kenya with the other three. Parameters using gene frequencies (FST, D, Nm*) indicate the presence of substantial geographic heterogeneity, largely attributable to genetic drift and correlated with dispersion of the medfly from its source area (Subsaharan Africa) to the periphery. The Kenyan population has high genetic variability (assessed by H, P and A), as might be expected given its native status. Significant gene flow estimates between Kenya and the derived Mediterranean populations supports the hypothesis of recent colonization. Part of the geographic heterogeneity is related to the presence of fixed alleles in the more differentiated Reunion population although it maintains the genetic attributes of the ancestral population. Selection or other forces may have played an important role in the differentiation of this population. PMID- 1774192 TI - Male crossing over and genetic sexing systems in the Australian sheep blowfly Lucilia cuprina. AB - Field-female killing (FK) systems based on deleterious mutations and Y-autosome translocations are being evaluated for genetic control of the Australian sheep blowfly, Lucilia cuprina. Experience during field trials has shown that mass reared colonies of FK strains are subject to genetic deterioration, caused mainly by genetic recombination in males. A previous study found higher male recombination frequencies in two Y-linked translocation strains than in chromosomally normal males. However, the results of the present study indicate that breakage of the Y chromosome is neither sufficient nor necessary for increased levels of male recombination. The frequency of male recombination appears to be unrelated to the presence of specific chromosome rearrangements. PMID- 1774193 TI - The contribution of non-MHC genes to susceptibility to autoimmune diseases. AB - Genetic studies of experimental models of autoimmune diseases, including systemic lupus-like syndromes and organ-specific autoimmunity, provide major information on genetic control of autoimmune diseases. In addition to genes known to be linked to the major histocompatibility complex (MHC), these studies point to multiple genes located outside the MHC that influence the onset and the progression of autoimmune diseases. Identification of these genes and of their interrelationships is now a major task that will be facilitated by recent progress in molecular biology and gene mapping. Among candidate genes, antigen receptor genes (i.e., immunoglobulin- and T-cell receptor genes) most likely contribute an important part of the autoimmune susceptibility in several of these animal models. Available linkage data suggest a similar involvement of these antigen-receptor genes in several human autoimmune diseases. In addition to a better understanding of pathogenic mechanisms associated with autoimmunity, the knowledge of these disease-predisposing genes is expected to permit a better classification of often complex syndromes as well as the design of new treatments. PMID- 1774194 TI - Autoimmunity in non-human primates: the role of major histocompatibility complex and T cells, and implications for therapy. AB - Two autoimmune disease models were studied in rhesus monkeys: type II collagen induced arthritis (CIA) and experimental allergic encephalomyelitis (EAE). Unrelated outbred animals were used in these studies. In both models disease resistant and susceptible individuals could be identified. Susceptibility correlated with in vitro cellular responsiveness to antigen in the CIA model. In both models resistant as well as susceptible individuals developed a humoral response to the inducing antigen. However, there is an indication that IgM antibodies play a crucial role in the induction of CIA. No clear association between major histocompatibility complex (MHC) type and disease incidence was found although a higher frequency of a certain DR type was observed in EAE susceptible monkeys. It is likely that both the antigen binding capacity of the MHC class II molecules and the T-cell repertoire play an important role in determining whether disease will develop or not. PMID- 1774195 TI - Gm allotypes influence the production of IgG3 but the effect is age-dependent. AB - Serum concentrations of IgG3 were found to be higher in Gm-f-positive (= b positive) than in f-negative individuals except in young children. Young children aged 3-4 months had a mean concentration of 0.24 g/l of IgG3 regardless of allotype. The concentration gradually rose with age in f-positive individuals to a geometric mean of 0.56 g/l in adults but it remained essentially unchanged in f negative people. A corresponding allotype effect was seen in influenza-specific antibody responses. While the total IgG response (mainly IgG1) was equally strong in f-positive and in f-negative patients, f-positive (= b-positive) patients produced more IgG3 antibodies than f-negative patients. The difference between geometric mean values of opposite homozygotes (f/f versus f-negative) was 2.3 fold (p = 0.0113). This finding indicates that the b-positive gamma-3 allele is more productive than the g-positive allele. PMID- 1774196 TI - Frequency of DPB1*0401 is significantly decreased in patients with allergic asthma in a mulatto population. AB - Allergic asthma (AA) is a multifactorial disease in which the IgE hyperresponsiveness to mite allergens is determinant for its pathogenesis and clinical picture. We have reported previously that IgE responsiveness to mite allergens in AA patients is linked to HLA and possibly controlled by a dominant suppression (Is) gene of that region. The present population study was done to detect alleles involved in the genetic control of mite IgE response that accompanies AA, using polymerase chain reaction and oligonucleotide DNA typing of DP locus. Instead of finding any significant positive association with AA, in this study we found that the allele DPB1*0401 is present mainly in the nonallergic control population and strikingly absent in patients (p less than 0.008), suggesting that this gene could confer resistance to AA and other atopic diseases. Our results add more evidence regarding the existence of Is genes in the HLA region involved in the control of IgE immune response to environmental allergens. Furthermore, they suggest that genes of HLA are important genetic components involved in the etiology of AA. PMID- 1774197 TI - High frequency of the HLA-DRB1*0405-(Dw15)-DQw8 haplotype in Spaniards and its relationship to diabetes susceptibility. AB - A study of DR4 subtypes has been done in Spanish unrelated controls and insulin dependent diabetics by using dot blot hybridization with specific DR4B1 exon-2 oligonucleotides and automated dideoxy DNA sequencing. Dw15-DQw8 is the predominant DR4 subtype present in our normal population (37%); this DR4 frequency characteristic singles out our population from all other Caucasoids tested so far and may also be a marker of the original Iberian paleo-North African population. Dw15-DQw8 is not significantly increased in our insulin dependent diabetics sample and despite its relative high frequency in the control population it does not have a bearing in lowering insulin-dependent diabetes mellitus frequency of DR4-positive Spaniards. In addition, no particular DR4 split is by itself significantly increased in Spanish diabetics; this may indicate that selective diabetogenic environmental factors may be working upon DR4-positive individuals, but on genes (or gene products) other than DR or at least not upon the polymorphic sites of DRB1 exon-2 products. PMID- 1774198 TI - Polymerase chain reaction analysis of transcriptional patterns of expression of class I HLA genes. AB - In order to study transcriptional patterns of expression of individual class I HLA genes we have constructed a series of cDNA libraries from human cell lines including normal lymphoblastoid cell lines MANN and HOM2, two colorectal carcinoma cell lines, WiDr and SW480, and a fetal lung fibroblast cell line, MRC 5. Between 0.5 and 1 x 10(6) independent clones were screened in each library using a class I HLA-specific DNA probe and the frequency of class I HLA cDNA clones was found to vary between 0.23% (WiDr) and 0.76% (HOM2). Polymerase chain reaction (PCR)-based analyses of possible alternative splicing events showed that each of 161 class I HLA cDNA clones which had insert sizes exceeding 0.6 kb exhibited normal splicing patterns for exons 5 and 6. Similar PCR-based analyses in clones with appropriately large inserts revealed no exceptions to the normal splicing patterns for each of exons 2, 3, 4, and 7. Sixty of the class I HLA cDNA clones selected from the WiDr, MRC-5, and MANN cDNA libraries were assigned to individual loci following identification of locus-specific DNA sequences by PCR sequencing across exon 5. The sequences obtained from the 60 clones were each interpreted to correspond to one of the classical loci, HLA-A, HLA-B, and HLA-C. While representatives of the HLA-A locus predominated in the MANN library, HLA-B specific clones were the most abundant in the WiDr and MRC-5 libraries. PMID- 1774199 TI - Detergent enhances binding of a secreted HLA-A2 molecule to solid phase peptides. AB - We have constructed a secreted analogue (sA2) of the human class I molecule HLA A2. sA2 was affinity purified both in the presence and absence of detergent and the effects of detergent on the magnitude and specificity of A2 binding to solid phase peptides tested. sA2 purified in the presence of detergent and detergent solubilized A2 are shown to function comparably in the binding of the synthetic peptide M.Y + 57-68, a known T-cell epitope derived from the influenza A matrix protein. The molecules binding to M.Y + 57-68 typically represent 8% to 10% of the added protein. In contrast, less than 1% of sA2 protein purified in the absence of detergent binds M.Y + 57-68. This reduced binding is not due to a change in the affinity of sA2 for M.Y + 57-68. Addition of detergent at various stages of the purification and iodination procedures indicates that the longer the sA2 molecules are exposed to detergent the better they bind. However, the concentration of detergent during the actual binding assay does not appear to be critical. We also find that while the sA2-detergent and the sA2-no detergent molecules differ in the extent to which they bind various peptides, they do not differ in their patterns of binding. We conclude that detergent probably does not influence the specificity of class I/peptide binding but does increase the number of sA2 molecules that can participate in the binding of peptide either by generating and stabilizing "empty" sA2 molecules or by stabilizing a structure that is more amenable to binding peptide. PMID- 1774200 TI - Gorilla major histocompatibility complex-DRB pseudogene orthologous to HLA DRBVIII. AB - The HLA-DR4 haplotype consists of four DRB genes: DRB1*04, DRBVII, DRBVIII, and DRB4*01, arranged in this order on the chromosome. The DRB1 and DRB4 genes code for beta chains of the alpha beta heterodimers expressed on the cell surface and bearing the HLA-DR4 and HLA-DRw53 determinants, respectively; the DRBVII and DRBVIII are pseudogenes. We found and sequenced a gene closely related to HLA DRBVIII in the genome of the lowland gorilla "Sylvia." We designate this gene Gogo-DRB8. The close relationship between the two genes is indicated by the overall sequence similarity, the absence of recognizable exons 1 and 2 in both genes, the presence of two Alu repeats at corresponding positions, and high sequence similarity between corresponding repeats. The comparison with an outgroup (tamarin) gene and the functional counterparts of the DRB8 gene indicate that DRB8 emerged between 18 and 26 million years ago and became inactivated at the same time as or shortly after its creation. Hence DRB8 has probably existed as a pseudogene since the divergence of apes from Old World monkeys more than 20 million years ago. PMID- 1774201 TI - Activity patterns of primary auditory-nerve fibres in chickens: development of fundamental properties. AB - We have examined the activity patterns of single auditory-nerve fibers in the chicken and tested for possible changes during post-hatching development. For this purpose, we recorded from fibres in the cochlear ganglion of chickens of two age groups (about P2 and P21) and investigated their spontaneous and sound-evoked activity patterns under nembutal-chloralhydrate anaesthesia. The spontaneous activity of primary auditory neurones was irregular, the average rates were between 20.5 (P2) and 23 (P21) spikes/s. Many low-frequency fibres from both age groups showed preferred intervals in their spontaneous activity. Tuning characteristics, including the range of characteristic frequencies, the presence of primary and two-tone suppression, the slopes of tuning-curve flanks and Q10dB values were similar to those previously reported for the starling and were statistically indistinguishable between the two age groups. However, there was a difference in fibre thresholds at the highest frequencies. Systematic differences were also present between the two age groups with regard to some characteristics of the rate-intensity functions. These data indicate that whereas the tuning properties of primary auditory fibres of the chicken cochlea are mature as early as post-hatching day 2, the intensity functions are not. PMID- 1774202 TI - Protein phosphorylation in the organ of Corti: differential regulation by second messengers between base and apex. AB - Major aspects of cellular physiology are regulated by the phosphorylation state of proteins through the action of protein kinases and protein phosphatases. Phosphorylation of proteins by endogenous protein kinase activity was assayed in homogenates from guinea pig inner ear tissues with [gamma-32P] ATP. Phosphoproteins showed distinct distributions in organ of Corti, lateral wall and spiral ganglion. In the organ of Corti, several protein kinase activities were distinguished by their activation by appropriate agonists: protein kinase C, calmodulin-dependent protein kinases and cyclic nucleotide-dependent protein kinases. Twelve putative substrates for these kinases were identified in organ of Corti on the basis of increased 32P-incorporation with addition of lipids, calmodulin, and cyclic nucleotides, respectively. In addition, differences in phosphorylation were observed between the base and apex of the organ of Corti. 32P-incorporation into proteins of molecular weights between 45 and 100 kDa was significantly higher in apical tissue than in tissue from the base. In contrast, phosphate incorporation into proteins of around 29 kDa was much lower in apical tissues than in basal tissues. Furthermore, labeling of both the high and low molecular weight proteins from the apex but not the base markedly increased in response to calcium. These data indicate the presence of differential modes of regulation that may underlie structural and functional gradients along the sensory epithelium. PMID- 1774203 TI - Origin of the click-evoked binaural interaction potential, beta, of humans. AB - The human click-evoked binaural difference waveform has as its most prominent feature the peak, beta, which has been shown to be related to binaural perception. In normal human subjects, we investigated the effect upon beta of (1) delivering the clicks in the presence of high passed masking noise (4000 Hz cut off) and (2) reversing click polarity. In the presence of the masker, little activity occurs at the time the click-evoked beta would be expected. No significant change in beta latency occurs when the click polarity is inverted. We conclude that beta is principally due to the high-frequency components of the broad band click, so that it is through the activity in high characteristic frequency auditory nerve fibers that click-evoked beta is generated. Because the medial superior olive is the major nucleus of the human superior olivary complex, our results suggest that beta is possibly generated by the high-frequency cells of the medial superior olive. PMID- 1774204 TI - First appearance and development of motile properties in outer hair cells isolated from guinea-pig cochlea. AB - Cochleae from fetal guinea-pigs (37 to 64 gestation days, gd) were used to correlate the appearance of motile properties of isolated outer hair cells (OHCs) with the development of specific morphological features. Both the 'fast' electrically-driven and the 'slow' calcium-induced motilities appeared first in OHCs from basal turn of 52 gd fetuses. At 56 gd, most of basal and some apical OHCs responded positively to both types of stimulation. All tested cells were positive at 64 gd. It is noteworthy that this period closely corresponds to the onset and maturation of the gross cochlear potentials. Some structural changes in the organ of Corti may be correlated with the development of OHC motile properties: the acquisition of an adult-like cylindrical shape by the OHC, its lateral detachment from neighboring Deiters cells, and its surrounding by fluid spaces. At the ultrastructural level, the formation of a first layer of laminated cisternae regularly aligned along the OHC plasma membrane from the cuticular plate down to the nuclear level, temporally coincided with the onset of in vitro motility (52 gd). The following days, pillars and a sub-membrane lattice were clearly noticed between the outermost cisternal membrane and the plasma membrane. The results support the ideas that: motile properties observed in vitro reflect the in vivo active mechanisms, and that one single layer of laminated cisternae and its associated sub-plasma membrane material may be needed for OHC motility. PMID- 1774205 TI - Low-frequency detection and discrimination following apical hair cell destruction. AB - This study assessed the effects of apical hair cell destruction on the detection and discrimination of low-frequency stimuli. Monauralized chinchillas were trained using operant conditioning and positive reinforcement to respond to pure tone stimuli in the absence and the presence of a high-pass noise masker. Following the collection of the baseline absolute thresholds, psychophysical tuning curves (PTCs) also were determined at low and high frequencies. Apical hair cells in the experimental ear of each subject then were destroyed by applying a liquid-nitrogen-cooled miniature cryoprobe to the bony wall of the cochlea. Post-cryosurgery, unmasked and masked absolute thresholds and psychophysical tuning curves were re-evaluated. Following cryosurgery, low frequency absolute thresholds increased by 30-50 dB. High-pass masking data suggested that receptors that were unaffected by the masking noise were responsible for the remaining low-frequency hearing. Low-frequency tuning, monitored by assessing changes in PTCs, was significantly altered following apical receptor cell loss, with the most effective maskers located several octaves above the test tone frequency. Following these determinations, one control and two experimental subjects then participated in a third experiment assessing low-frequency discrimination acuity. Some discrimination ability was retained after the cryosurgery; however, these post-lesion difference limens increased when a high-pass noise masker was added to the test environment. At the termination of the behavioral experiment, subjects were euthanized and their cochleae dissected to correlate behavioral and histopathological data. The data suggest that receptors located in frequency regions of the cochlea normally responsive to middle and high frequencies may be responsible for detection and discrimination of low-frequency stimuli in apically damaged cochleae. These data are consistent with other reports which indicate that redundant mechanisms are available for the detection of low-frequency stimuli, and they provide new information regarding how low-frequency stimuli are discriminated throughout the cochlea. PMID- 1774206 TI - Hereditary deafness occurring in cd/1 mice. AB - Different strains of mice provide a valuable research tool for studying both hereditary and acquired forms of deafness. The cd/1 strain has been found to demonstrate hereditary cochlear pathology. The characteristics of hearing loss in cd/1 mice have not previously been reported. In this investigation auditory thresholds were obtained by measuring evoked brain stem responses in subjects of three different ages: 3 weeks, 10 weeks and 6 months. The results were compared with thresholds obtained from CBA/Ca mice (which have normal hearing) and C57BL/6 mice (which are known to have a genetically determined pre-senile progressive cochlear hearing loss). A significant hearing loss was observed which progressed from high to low frequencies, and with age. Extensive degeneration was observed throughout the organ of Corti. cd/1 mice may provide a useful model for studying genetically determined deafness. PMID- 1774207 TI - Brainstem auditory evoked potentials correlate with morphological changes in Gunn rat pups. AB - The relationship of brainstem structure and function in bilirubin encephalopathy is incompletely understood. The present experiments compare quantitative measures of brainstem structures with brainstem auditory evoked potentials (BAEPs) in infant jaundiced (jj) and nonjaundiced (Nj) Gunn rats. Ten jj's from 4 litters were injected with sulfadimethoxine at 11-12 days of age to raise their brain bilirubin concentration. Littermate controls were jj's given saline, and Nj's given sulfadimethoxine or saline. At 15-17 days of age BAEPs were recorded, and rats were prepared for histological examination, as was reported in the previous paper (Conlee and Shapiro, 1991). Significant differences between groups were seen for BAEP wave I latency (P = 0.002). I-II interwave interval (P = 0.001), and amplitudes of waves I, II, III, and IV (each P less than 0.0005) due to increased latencies and decreased amplitudes in the jj-sulfa group. Animals with the most severe BAEP abnormalities had the most severe histological abnormalities. Cochlear nucleus volume had a positive linear correlation with the amplitude of BAEP waves I, II, and IV, and an inverse correlation with wave I latency and I-II interwave interval (P less than or equal to 0.001). The highest correlations were BAEP I-II interwave interval and amplitude of waves I and II with cochlear nucleus volume (r = -0.78, 0.71 and 0.70, respectively, P less than 0.0005).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774208 TI - Morphological changes in the cochlear nucleus and nucleus of the trapezoid body in Gunn rat pups. AB - Mechanisms underlying bilirubin encephalopathy and hearing loss remain poorly understood, including the way bilirubin enters the nervous system and how bilirubin accumulates in circumscribed regions of the brain. The present experiments examined the auditory brainstem in heterozygous (Nj) and homozygous (jj) Gunn rats at an age when serum bilirubin levels were highest, and after brain bilirubin concentration was artificially raised by sulfadimethoxine administration. In four litters of 11-12 days old Gunn rats, Nj and jj littermates received a single intraperitoneal injection of sulfadimethoxine (100 mg/kg) or a comparable volume of saline. At 16-17 days of age, brainstem auditory evoked potentials were recorded to assess the severity of bilirubin toxicity in the Nj and jj animals. Following the recordings, each animal was perfusion-fixed and frozen sections of the brainstem were cut in the transverse plane from medullary through mesencephalic levels. Sections were mounted on slides, stained with thionin and coded to avoid observer bias. Quantitative analysis revealed no differences between saline and sulfa-treated Nj rats for cochlear nucleus volume, or for cell size in the cochlear nucleus or superior olive. In the sulfa-treated jj rats, cochlear nucleus volume, and cross-sectional areas of spherical cells in the anteroventral cochlear nucleus and principal cells in the nucleus of the trapezoid body, were all significantly smaller than in the combined groups of Nj animals. The affected areas in the cochlear nucleus and superior olive are innervated by large axosomatic end-bulbs of Held or calyceal endings, and were associated with bilirubin staining of glia in the most severely jaundiced jj sulfa-treated rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774209 TI - Effects of opening and resealing the cochlea on the mechanical response in the isolated temporal bone preparation. AB - The isolated temporal bone preparation has been used previously for studying the micromechanical behaviour of the cochlea. Mechanical tuning curves have been obtained from several cells and structures within the hearing organ. In order to obtain access to the apical turns the bony shell of the cochlea has to be opened. To study how the opening affects the mechanical response of the cochlea, experiments were performed in which the cochlea was opened and then sealed with a glass window. Responses were measured from the same identified cells in the opened and in the sealed cochlea. The opening of the cochlea reduced the vibration amplitude mainly at frequencies below 300 Hz. Below the mechanical resonance frequency the slope of the tuning curve became steeper. The shape was not affected appreciably above the resonance frequency. The relative vibration amplitude of different cells remained unchanged by opening and closing the cochlea. PMID- 1774210 TI - Incorporation of D-[3H]-glucosamine and L-[3H]-fucose into the developing rat cochlea. AB - The uptake of two tritiated carbohydrates, D-[3H]-glucosamine and L-[3H]-fucose, to the developing rat cochlea was examined using light and electron microscopic radioautography. Both carbohydrates, administered to in vitro developing rat cochleas, shared a similar ultrastructural labeling pattern on the microvilli and apical cell region and on the tectorial membrane (TM) fibrils. On embryonic day 18, the radiolabeling appeared on the apical surface of the undifferentiated epithelium that will develop into both spiral limbus and Kolliker's organ (KO), while on postnatal day (PD) 1, it was only located on the apical surface of the KO. When D-[3H]-glucosamine was administered in vivo to newborn rats, the radiolabeling was observed in the TM covering the KO at PD 3. Lastly, D-[3H] glucosamine administered in vivo to PD 7 rats, appeared at PD 9 in the TM region lying just above the organ of Corti. The present findings support the previously suggested leading role of the spiral limbus and KO in the secretion of the TM during cochlear development. The secretion of carbohydrates, and probably of other matrix components, starts on the spiral limbus and KO region and progressively extends to the organ of Corti. PMID- 1774211 TI - Maturational aspects of periodicity coding in cat primary auditory cortex. AB - The click-following responses for single units in the primary auditory cortex of the cat were explored as a function of age. Recordings were obtained in kittens from 9-53 days of age and assembled in four age groups; 10-15 days, 16-21 days, 22-27 days and 30-60 days. Age group means were compared to results obtained in adult cats. The stimulus consisted of one second long click trains presented every three seconds with click rates ranging from 1-32 clicks per second. The response was characterized by entrainment, rate Modulation Transfer Function (rMTF), vector strength (VS) and temporal Modulation Transfer Function (tMTF). Maturational effects on periodicity coding comprised changes in overall responsiveness as well as click-rate dependent changes. The number of spikes elicited by single stimuli increased on average 3-fold between the second post natal week and adulthood, probably as a result of more efficient synapses in the central auditory pathway and some improvement in thresholds. Adaptation became less pronounced with age; neurons started to respond to the later clicks in the 8/s and 16/s click trains from the third post natal week on. By the end of the first post-natal month the click following responses resembled the adult ones qualitatively, however, increased firing rates and spontaneous rates together with rebound responses continued to produce quantitative differences between the 30-60 days olds and the adults. Limiting rates for the tMTF (50% of the response at 1/s) increased from 6 Hz in the 10-15 day old to 12 Hz in adults. The decrease in the duration of the post-activation suppression coupled with the increased response with age to trains with higher click rates suggested that the maturation of inhibitory processes in the cortex play a major role in this rate dependence. PMID- 1774212 TI - Auditory-nerve spontaneous rates vary predictably with threshold. AB - The variation of spontaneous rate with auditory nerve thresholds is compared with predictions from a simple assumption: that spontaneous and driven activity are basically similar, both being evoked by inner hair cell transmembrane potential. Under this view, spontaneous activity is seen as a response to a standing current within the hair cell and should therefore vary with threshold in a manner predictable from measured rate-intensity functions. A method for comparing spontaneous rates of fibres with differing thresholds is developed and applied to previously-collected data. The results show that spontaneous rates are quite consistent with the hypothesis, indicating no need for more complicated theories of spontaneous activity. PMID- 1774213 TI - Relationship between tone burst discharge pattern and spontaneous firing rate of auditory nerve fibres in the guinea pig. AB - A detailed investigation was carried out of the response of single auditory nerve fibres in the guinea pig to tone bursts. Comparisons were made between the shapes of peri-stimulus-time histograms (PSTHs) of low and high characteristic frequency (CF) fibres grouped according to their spontaneous firing rates (SR). Both low and high CF fibres of high spontaneous rate (greater than 18 spikes/s) exhibited marked rapid adaptation in their PSTH's which became most pronounced at high stimulus intensities. The ratio of onset-to-adapted firing estimated from PSTH data in these fibres increased monotonically as a function of adapted firing rate. The behaviour of fibres with the lowest spontaneous rates (less than 0.5 spikes/s) was markedly different, particularly in fibres from low CF regions. In general, these low-SR fibres showed slower adaptation than high-SR fibres, and a less pronounced onset peak. This was most striking in low CF fibres. Furthermore, the ratio of onset-to-adapted firing rate tended to decrease with increasing stimulus intensity in both low and high CF fibres with low spontaneous firing rates. Low-SR fibres also showed the highest maximum discharge rates to tone burst stimuli. Fibres with medium spontaneous rates between 0.5 and 18 spikes/s displayed intermediate characteristics in their PSTH's. Recent data in the chinchilla (Relkin and Doucet, 1991), suggest that these differences may arise in part from differences in inter-stimulus recovery processes in the different spontaneous rate groups. PMID- 1774214 TI - Shapes of rate-versus-level functions of primary auditory nerve fibres: test of the basilar membrane mechanical hypothesis. AB - Rate-versus level functions (RI functions) for characteristic frequency (CF) stimulation were measured from primary auditory nerve fibres from different spontaneous rate categories in the guinea pig cochlea. Attention was focussed on those fibres that showed clear breakpoints in their RI functions (sloping saturation fibres). A statistical curve fitting procedure to an empirical equation was used to provide a quantitative estimate of the breakpoint position in individual fibres. It was found that, within the limits of reliability of the curve fitting procedure, the breakpoint position was the same in fibres from the same CF regions in any given animal. This result is consistent with the notion that the breakpoint position is determined by global basilar membrane mechanics and not by processes private to each nerve fibre. However, a subgroup of fibres not easily classifiable as sloping-saturation, showed features of their RI functions suggesting that factors other than basilar membrane mechanics could lead to fibre-to-fibre differences in rate-versus-level behaviour. PMID- 1774215 TI - Monoclonal antibodies to inner ear antigens: II. Antigens expressed in sensory cell stereocilia. AB - To develop biological reagents for investigating structure-function relationships in the organ of Corti, we have raised monoclonal antibodies, (MAb) to inner ear tissues. Our first series of antibodies prepared after intrasplenic immunization of mice with guinea pig tissues, identified antigens restricted to supporting cell structures, but no hair cell specific antibodies were developed [Zajic et al., Hear. Res. 52, 59-72, 1991]. In this report we describe the isolation, binding specificity and initial characterization of the stereocilia-binding monoclonal antibodies, KHRI-4, and KHRI-5. Mice were immunized with avian, amphibian and mammalian sensory hair cell-containing tissues and antibodies were screened for selective binding to cochlear extracts in ELISA. In the inner ear, KHRI-4 and KHRI-5 bind specifically to stereocilia in both avian and mammalian cochlear and vestibular tissue preparations using immunofluorescence and immunoperoxidase assays. In other tissues only certain cells of mesothelial origin, such as smooth muscle in gut and the arteriolar vasculature, were stained by KHRI-4 indicating that the antigenic structure defined by this antibody has limited distribution. KHRI-5 binding could be detected in other tissues only at high antibody concentrations suggesting that the gene product identified by this antibody is also weakly expressed in other cell lineages. Western blot analysis showed that KHRI-4 and -5 detect different protein complexes. KHRI-4 identifies an antigenic structure common to gut, cochlea, vestibular tissue and cultured fibroblasts consisting of a approximately 195 and a 230 kDa heterodimer designated p195/230. KHRI-5 binds to a prominent approximately 200-210 kDa band in Western blots of cochlear tissues, gut and fibroblasts. In immunoprecipitation experiments, KHRI-5 precipitated three proteins of Mr approximately 200-210, 230 and 260 kDa indicating that the approximately 200-210 kDa protein carrying the epitope for this antibody is a member of a heterotrimer complex. Our results show that these protein complexes are structural components of stereocilia and that the same proteins are arrayed in conjunction with the actin stress fibers of cultured mesothelial cells. Thus, they are likely to be important for maintaining the actin structure of stereocilia essential to transduction in sensory hair cells. PMID- 1774216 TI - Binaural masking level difference effects in single units of the guinea pig inferior colliculus. AB - We have studied the masking effects of a binaurally presented noise on the responses to binaural signals recorded from low-frequency cells in the inferior colliculus of the guinea pig. The spike rates to the masker and signal + masker were compared to quantify masking at different interaural time delays of the noise. The signal was a 50-ms tone burst at best frequency or a 50-ms segment of a synthetic vowel presented at the best interaural delay of the unit tested. At each noise masker delay, the noise level was adjusted to obtain a criterion spike difference. In most cases, the level required was lowest at the best delay for the noise. The mean difference between maximum and minimum masked thresholds across the cell population was very similar to the human psychophysical masking level difference under the same signal and masker conditions. In another series of tests, we measured the effect of the noise masker on the temporal pattern of the discharge to the signal. The signal used was a 500-ms segment of the synthetic vowel. In virtually all cases the addition of a continuous noise masker reduced the discharge rate synchronized to the fundamental frequency of the vowel. The degree of this reduction was dependent on the interaural time delay of the noise masker. For most units, maximum reduction was seen when the vowel and noise had the same interaural time delay. The similarity between the masking which we have shown physiologically and the reported in a variety of human psychophysical experiments suggests that the processing at levels up to and including the inferior colliculus contributes to the psychophysical BMLD. PMID- 1774217 TI - Biased lineups: sequential presentation reduces the problem. AB - Biased lineups have been shown to increase significantly false, but not correct, identification rates (Lindsay, Wallbridge, & Drennan, 1987; Lindsay & Wells, 1980; Malpass & Devine, 1981). Lindsay and Wells (1985) found that sequential lineup presentation reduced false identification rates, presumably by reducing reliance on relative judgment processes. Five staged-crime experiments were conducted to examine the effect of lineup biases and sequential presentation on eyewitness recognition accuracy. Sequential lineup presentation significantly reduced false identification rates from fair lineups as well as from lineups biased with regard to foil similarity, instructions, or witness attire, and from lineups biased in all of these ways. The results support recommendations that police present lineups sequentially. PMID- 1774218 TI - Driving after stroke: a controlled laboratory investigation. AB - The importance of illness or disability for traffic safety is unknown. By means of a mock car, 46 individuals suffering from left-sided hemiparesis and 67 with right-sided hemiparesis after stroke were compared with 109 healthy controls. Only patients without complicating disorders were included in the study groups. They coped far worse than the control group in almost all respects. Reaction times were longer, not merely for the paretic but also for the contralateral extremities. Strength in the 'healthy' part of the body was also significantly reduced. Sometimes patients completely failed to react to given signals. In right sided hemiparesis a high frequency of directional errors was observed. Neuropsychological functional disorders were well in accordance with the number of erroneous reactions, but to only a minor extent with reaction times. The results of the mock car test could not be predicted on the basis of mere clinical examination. PMID- 1774219 TI - An evaluation of the effectiveness of group therapy for memory problems. AB - OBJECTIVE: To investigate the effectiveness of group treatment for memory problems. DESIGN: A cross-over design was employed to compare the memory improvement of subjects while attending a weekly memory therapy session with a waiting period. SETTING: Outpatients. TREATMENT: A variety of memory strategies were taught, and practical advice was provided in the use of external aids. RESULTS: No improvement in memory function was detected on the Behavioural Memory Test or Subjective Memory Questionnaire. There was an increase in the number of memory aids reported as being used after attending the group (p less than 0.05). The number of items reported on the Subjective Memory Questionnaire as 'bothering' the patient decreased in frequency (p less than 0.05) after group treatment. CONCLUSIONS: Attendance at a memory group increased the use of memory aids but did not affect memory impairment. PMID- 1774220 TI - Isometric back strength in different age groups. AB - Normative data on isometric back strength (IBS) are presented. The IBS of both sexes increased with chronological age, peaked at the third decade of life, and gradually declined thereafter. Males were significantly (p less than 0.001) stronger than females in all age groups, the difference ranging between 16 and 56%. A multiple regression equation was derived to predict IBS, as follows: Male IBS (kgf) = -77.71 - 0.91 age (yrs) + 0.67 height (cm) + 1.50 weight (kg) + 0.24 Quetelet index (R2 = 0.78; SE +/- 16.67 kgf) Female IBS (kgf) = -72.42 - 0.39 age (yrs) + 10.65 height (cm) + 0.08 weight (kg) + 1.04 Quetelet index (R2 = 0.62; SE +/- 10.75 kgf). PMID- 1774221 TI - The RSI syndrome in historical perspective. AB - The pain syndrome repetition strain injury (RSI) has been variously interpreted as a psychogenic disorder, an overuse injury of upper limb musculature, and a state of peripheral neural irritability. A review of the history of work-related upper limb disorders was undertaken to ascertain whether RSI is a new medical phenomenon or an older syndrome in a new guise. In the mid-nineteenth century these disorders were known as either craft palsies or writer's and other occupational cramps. Not withstanding clinical evidence suggesting that most were associated with peripheral neural or muscular dysfunction, a body of influential medical opinion considered them all to be disorders of the central nervous system, appropriately termed the occupation(al) neuroses. During the twentieth century, as discrete occupational upper limb nerve lesions were delineated and the spasmodic form of writer's cramp was recognized as a torsion dystonia, a unifying concept of aetiology for the occupational neuroses of the nineteenth century became untenable. The RSI syndrome of the 1980s can be identified from early case descriptions of both scrivener's palsy and the neuralgic variety of writer's cramp. Contemporary hypotheses proposed to explain RSI are remarkably similar to those proposed for the occupation(al) neuroses. PMID- 1774222 TI - Transformation effector and suppressor genes. AB - Much has been learned about the molecular basis of cancer from the study of the dominantly acting viral and cellular oncogenes and their normal progenitors, the proto-oncogenes. More recent studies have resulted in the isolation and characterization of several genes prototypic of a second class of cancer genes. Whereas oncogenes act to promote the growth of cells, members of this latter class of genes act to inhibit cellular growth and are believed to contribute to the tumorigenic phenotype only when their activities are absent. This new class of cancer genes is referred to by a number of different names including; anti oncogenes, recessive oncogenes, growth suppressor genes, tumor suppressor genes and emerogenes. Although only a few of these cancer genes have been identified, to date, it is likely that many additional genes of this class await identification. A third class of genes, necessary for the development of the cancer phenotype, is comprised of the transformation effector genes. These are normal cellular genes that encode proteins that cooperate with or activate oncogene functions and thereby induce the development of the neoplastic phenotype. The inactivation of transformation effector functions would therefore inhibit the ability of certain dominantly acting oncogenes to transform cells. The approaches outlined here describe functional assays for the isolation and molecular characterization of transformation effector and suppressor genes. PMID- 1774223 TI - Poly(ADP-ribosylation) of atypical CS histone variants is required for the progression of S phase in early embryos of sea urchins. AB - The patterns of poly(ADP-ribosylation) in vivo of CS (cleavage stage) histone variants were compared in sea urchin zygotes at the entrance and the exit of S1 and S2 in the initial developmental cell cycles. This post-translational modification was detected by Western immunoblots with rabbit sera anti-poly(ADP ribose) that was principally reactive against ADP-ribose polymers and slightly against ADP-ribose oligomers. The effect of 3 aminobenzamide (3-ABA), an inhibitor of the poly(ADP-ribose) synthetase, on S phase progression was determined in vivo by measuring the incorporation of 3H thymidine into DNA. The results obtained indicate that the CS histone variants are poly(ADP-ribosylated) in a cell cycle dependent manner. A significantly positive reaction of several CS variants with sera anti-poly(ADP-ribose) was found at the entrance into S phase, which decreases after its completion. The incubation of zygotes in 3-ABA inhibited the poly(ADP-ribosylation) of CS variants and prevented both the progression of the first S phase and the first cleavage division. These observations suggest that the poly(ADP-ribosylation) of atypical CS histone variants is relevant for initiation of sea urchin development and is required for embryonic DNA replication. PMID- 1774224 TI - Mutational analysis of leucine 47 in human epidermal growth factor. AB - Seven site-specific mutants (including changes to other hydrophobic, charged, and heterocyclic amino acids) of leucine 47 of human epidermal growth factor (EGF) were generated by protein engineering and characterized for their activity in three assays: radioreceptor competition binding in membrane fractions, the stimulation of the EGF receptor's tyrosine kinase activity, and the stimulation of thymidine uptake in tissue culture cells. K1/2 (concentration required for half maximum response) values for each of the mutants are reported in the three assays. The results show that the native leucine residue is quite important for EGF activity. Substitutions are tolerated to different degrees, depending upon hydrophobicity and size of the side chain. Substitution with ionic residues led to the most drastic reduction in activity. One-dimensional nuclear magnetic resonance spectroscopy, at physiological pH, of several of the mutants did not detect any major structural perturbations which would account for the loss of activity. The results suggest that the side chain of leucine 47, because of its charge neutrality, size, and hydrophobicity, is highly important, although not absolutely essential for the interaction of EGF with its receptor. A striking finding was the lower (compared with wild type) Vmax values of the mutants in the tyrosine kinase reaction, but these low Vmax mutants, in cell culture experiments, were able to stimulate at high concentrations a growth response equivalent to wild type EGF. PMID- 1774225 TI - Buffering of intracellular calcium in response to increased extracellular levels in mortal, immortal, and transformed human breast epithelial cells. AB - Extracellular levels of calcium at 1.05 mM or higher induce terminal differentiation and senescence in the mortal (MCF-10M) line of human breast epithelial cells, but does not retard the growth or induce differentiation in the immortal (MCF-10A) and oncogene transformed (MCF-10AneoT) lines. Intracellular levels of calcium and inositol triphosphate were determined in MCF-10M, MCF-10A, and MCF-10AneoT, under conditions of low and high extracellular calcium. We hereby report that increases in extracellular calcium is translated into significant increases in intracellular levels of calcium and inositol triphosphate in MCF-10M, but not in MCF-10A and MCF-10AneoT. This difference in the apparent calcium buffering capacity between the mortal and the immortalized human breast epithelial cells could account for the latter's unperturbed growth potential in high extracellular calcium environment. PMID- 1774226 TI - PCR analysis of dystrophin gene mutation and expression. AB - Duchenne muscular dystrophy (DMD) is caused by mutations that impair normal production of dystrophin in muscle and brain tissues. The dystrophin gene is expressed at extremely low levels in both humans and mice, which makes analysis of the 14kb mRNA a difficult task. In addition, 30% of all cases of DMD (and the genetic lesion in all three known mdx mouse models for DMD) are thought to arise from single base mutations, yet methods are not available to routinely identify and analyze these mutations and their effects on disease progression. We have been using the polymerase chain reaction (PCR) to analyze the expression of the murine dystrophin gene. A simple assay is described that distinguishes the murine dystrophin transcripts expressed from either the muscle or brain promoter. In addition, amplification of overlapping segments from the 5' end of the murine transcript has enabled the identification of DNA sequence variations between wild type and mdx mice. These results demonstrate that the mutation in the original strain of mdx mice is distinct from those in two newer mdx isolates and that three independently isolated mdx mutants are available for study of DMD. PMID- 1774227 TI - Honour volume on the occasion of the 60th birthday of Lloyd R. Snyder. PMID- 1774228 TI - Dependence of retention on the organic modifier concentration and multicomponent adsorption behavior in reversed-phase chromatography. AB - A three-parameter equation is derived to express the dependence of the logarithmic retention factor, kappa, on the volume fraction of the retention modulator, phi, in a binary eluent (such as the organic modifier in the hydro organic eluents used in reversed-phase chromatography). It is based on the competitive binary adsorption isotherm of the eluite and the modulator generated by employing the ideal adsorbed solution (IAS) method. The equation is found to describe adequately the trends in the kappa-phi relationship experimentally observed in reversed-phase systems. Furthermore, the expression affords an estimation of the single-component adsorption isotherm of the eluite from the corresponding kappa versus phi plot and thus provides a simple means to gather data of importance in the design of separations by non-linear chromatography. For instance, the method can be used to determine whether a pair of eluite isotherms cross one another, a situation that could lead to difficulties in preparative separations. The inherent limitations of the IAS approach may restrict the usefulness of the expression in specific cases. Nevertheless, the approach presented here establishes an explicit, thermodynamically consistent link between the eluite-modulator multicomponent isotherm and corresponding plots and allows a rational description of the generally observed retention behavior in reversed phase chromatography. The results of this work also illustrate the limitations of the competitive Langmuir isotherm, which is most frequently used to treat competitive adsorption, in the study of the kappa-phi relationship specifically and in investigating and modeling non-linear chromatography at large. PMID- 1774229 TI - Standardization of a multi-wavelength UV detector for liquid chromatography-based toxicological analysis. AB - The performance of a multi-wavelength UV detector for automated drug identification following liquid chromatographic separation was evaluated. The ability of selected wavelength ratios to distinguish two closely related drugs was considered at different concentrations. Calibration of the detector based on wavelength ratios was then utilized to standardize two different detectors and to evaluate instrument-to-instrument variation of a series of detectors. Reproducibility of the second-derivative zero intercept for these drug spectra was also evaluated. Standardization of detector performance by reference to these two parameters permitted the transfer of UV spectral libraries stored on one instrument to another without compromising the reliability of qualitative data. PMID- 1774230 TI - Use of Ce(IV) oxidizing agent for the derivatization of polycyclic aromatic hydrocarbons for liquid chromatography-electrochemical detection. AB - Polycyclic aromatic hydrocarbons (PAHs) were oxidized with Ce(IV), and the resulting quinones were determined by reductive-mode liquid chromatography electrochemical detection. This oxidation is a rapid, automatable step, involving of Ce(IV) reagent to the PAH sample and cleaning up the derivative with C18 solid phase extraction. Using a C18 analytical column and a 2-propanol-phosphate buffer as the mobile phase, detection limits were in the ppb range for naphthalene, phenanthrene and anthracene, with linearity over 3-5 orders of magnitude. Method validation was performed by addition of the PAHs to tap water and determining the levels by reference to a calibration curve. The three PAHs can be simultaneously derivatized and determined under the same chromatographic conditions. Analysis of a motor-oil sample is also shown. PMID- 1774231 TI - Confirmation of domoic acid in shellfish using butyl isothiocyanate and reversed phase liquid chromatography. AB - A simple chemical confirmatory technique has been developed for domoic acid, a neurotoxic amino acid of marine origin. After extraction with water-methanol, the domoic acid-containing extract is analysed directly by reversed-phase liquid chromatography with UV absorption detection at 242 nm. For confirmation of positive results an aliquot of the extract is evaporated to dryness and reacted with butyl isothiocyanate to form a thiourea derivative which elutes later than underivatized domoic acid. No additional sample cleanup is required in order to carry out the derivatization for conformation of domoic acid at the Canadian 20 micrograms/g guideline level in shellfish. In mussel extract, domoic acid was converted to the thiourea derivative with a yield of 86-91% compared to a pure standard carried through the same reaction. The detection limit for the derivative was about 5-10 micrograms/g of equivalent domoic acid in extracts of mussels, clams or oysters. PMID- 1774232 TI - Determination of hydroxy and peroxy acid derivatives of uroporphyrin in the plasma of patients with congenital erythropoietic porphyria by high-performance liquid chromatography. AB - A reversed-phase high-performance liquid chromatographic method is described for the determination of hydroxy and peroxy acid derivatives of uroporphyrin in the plasma of patients with congenital erythropoietic porphyria. The porphyrins were extracted from the plasma with 20% trichloroacetic acid-dimethyl sulphoxide (1:1, v/v). The supernatant after centrifugation was chromatographed on a Hypersil-ODS column by gradient elution with 9% (v/v) acetonitrile in 1 M ammonium acetate buffer (pH 5.16) (solvent A) and 10% (v/v) acetonitrile in methanol (solvent B) as the gradient mixture. The method was also suitable for the preparative isolation of the porphyrins. PMID- 1774233 TI - Isolation of an interleukin 2-binding receptor from activated lymphocytes by high performance immunoaffinity chromatography. AB - Isolation of a lymphokine-binding receptor, from activated lymphocyte membranes, can be achieved by high-performance immunoaffinity chromatography (HPIAC), using immobilized antibodies against human interleukin 2 (IL-2), as the ligand and natural IL-2 as the receptor probe. Activated lymphocytes were reacted with IL-2, sonically disrupted and their membranes solubilized, prior to passage through the HPIAC column. The IL-2 acted as an efficient receptor probe, which helped to maintain the integrity of the receptor during the isolation procedure and also acted as an attachment antigen for the immunoaffinity ligand. Recovery of the bound receptor was achieved by dissociation of the receptor-antigen-immobilized ligand complex by the action of chaotropic ions and collection of the released receptor from the column effluent during the elution phase of the separation. PMID- 1774234 TI - Cascade-mode multiaffinity chromatography. Fractionation of human serum proteins. AB - The group-resolving power of cascade-mode multiaffinity column chromatography (CASMAC), was demonstrated with human serum as a model mixture. More than 99% of the serum proteins were adsorbed in the same high salt-containing buffer on a tandem column consisting of (1) immobilized Zn2+ on triscarboxymethyl diamine gel followed by (2) thiophilic (T) gel, (3) Zn2+ bound to the new tridentate chelating adsorbent dipicolylamine (DPA) agarose, (4) hexyl-thioether C6-S agarose and (5) Ni(2+)-DPA agarose. After the adsorption step the immobilized metal ion affinity gels were attached to the top of tandem columns of other adsorbents (T gel, Sephadex G-25 for desalting and Mono-Q) and the elution conditions were selected such that further group separation was achieved. High resolution, high recovery, easy manipulation and high capacity are characteristic features of the cascade process with these adsorbents. The advantage of CASMAC is particularly striking when, with a given number of adsorbents, the overall number of operations involving adsorption, desorption, washing, buffer change and substance concentration can be effectively minimized. PMID- 1774235 TI - Comparison of power and exponential field programming in field-flow fractionation. AB - Field programming in field-flow fractionation has the purpose of expanding the molecular weight or particle diameter range subject to a single analytical run. The two most widely used field programs are those in which the field strength decays with time according to an exponential function and a power function, respectively. The performances of these two programming functions are compared by obtaining limiting equations showing how retention time tr, standard deviation in retention sigma t, and fractionating power Fd vary with particle diameter d. It is shown that uniform fractionating power (Fd independent of d) can be obtained with power programming but that in exponential programming Fd is always non uniform, varying as d-1/2. In exponential programming a linear relationship arises between tr and log d. This particular relationship is impossible to realize in power programming but an alternative linear relationship can be obtained by plotting tr versus dt/3. These results are made more concrete by plotting and comparing field strength, relative field strength, Fd and tr for specific programming cases. PMID- 1774236 TI - High-performance capillary electrophoresis of proteins. Sodium dodecyl sulphate polyacrylamide gel-filled capillary column for the determination of recombinant biotechnology-derived proteins. AB - Fused-silica capillary columns were filled with sodium dodecyl sulfate polyacrylamide gel and the column effluent was monitored at 214 nm using a commercially available high-performance capillary electrophoresis (HPCE) instrument to separate and rapidly quantify recombinant biotechnology-derived proteins. An excellent linear relationship (r greater than 0.999) exists between the peak migration time and the molecular weights of reference proteins in the range 10,000-100,000 and 40,000-200,000 dalton by use of the capillary columns filled with acrylamide gel at a T composition of 5% and 3%, respectively. The relative standard deviation (R.S.D.) of the peak migration time is ca. 1%. Theoretical plates of 5 X 10(5)-1 X 10(6) per metre are routinely being obtained. Calibration graphs of peak area versus weight of recombinant biotechnology derived proteins are linear (r greater than 0.999) and the proteins may be quantified with an R.S.D. of ca. 3-7%. As little as 50 nmol of a protein may be quantified and an impurity peak of molecular weight ca. 1500 less than that of the parent compound (ca. 60,000 dalton) may be differentiated by HPCE with a gel filled capillary column. PMID- 1774237 TI - A polymeric reagent for derivatization of weak nucleophiles in HPLC-UV. AB - Microporous and macroporous polystyrene beads are modified to contain various activated centers to which are attached a detector-sensitive label useful for analytical-scale derivatization of nucleophilic species. The effect of surface area, porosity, and percent cross-linkage of the polymeric support containing an o-nitro activated ester is investigated. The polymers are characterized by a loading determination to calculate the amount of active acylating reagent incorporated per gram of dry polymer. The kinetics of reaction with substrates of varying steric hindrance vs. solvent strength are determined with the optimized polymeric support and a second polymeric reagent is synthesized based on that support. The second polymer contains a hydroxybenzotriazole functionality. This polymer has increased electrophilicity and is used to prepare a much stronger acylating reagent than the polymeric o-nitrobenzophenol when labeled with 3,5 dinitrobenzoyl chloride. The polymeric hydroxybenzotriazole (HoBTA-DNB) is able to derivatize much weaker nucleophiles such as alcohols, thiols, and phenols at room temperature in less than 30 seconds. PMID- 1774238 TI - Diagnosis of invasive candidiasis by detection of mannan antigen by using the avidin-biotin enzyme immunoassay. AB - The diagnosis of invasive candidiasis was attempted by detection of circulating mannan antigen by using an avidin-biotin-amplified enzyme-linked immunosorbent assay (AB-ELISA), and this method was compared with the conventional culture method. Mannan antigen was detected by AB-ELISA in the sera of 16 (84.2%) of the 19 patients with invasive candidiasis. On the other hand, for 34 immunocompromised candidiasis-free patients, including 8 with aspergillosis or cryptococcosis, mannan antigen was positive during only 1 of the 67 febrile episodes and in the serum of none of the 50 outpatients without infections. The results were also negative for all patients with deep-seated mycoses other than candidiasis. However, the mannan level was low (less than 2.0 ng/ml) in the serum of 63.2% of the patients with invasive candidiasis. The positivity rate of blood cultures was 31.6%, and that of blood cultures and/or cultures of samples from sterile sites combined was 47.4%. The advantages of the diagnosis based on antigen detection by AB-ELISA are considered to be a higher sensitivity and elimination of nonspecific reactions by the introduction of the avidin-biotin system and pretreatment of sera by heating. In addition, it is considered essential for high sensitivity that transient mannan antigenemia be determined frequently so that it is not overlooked. In light of its sensitivity and specificity, this method is considered to be clinically useful in the diagnosis of invasive candidiasis. PMID- 1774239 TI - Detection of Escherichia coli heat-stable enterotoxin genes in pig stool specimens by an immobilized, colorimetric, nested polymerase chain reaction. AB - A combination of selective enrichment by using immunomagnetic separation of F4 (K88)-positive Escherichia coli and a nested colorimetric polymerase chain reaction (PCR) was used on crude clinical and spiked samples for determination of genes encoding heat-stable enterotoxins (STs) Ia (ST Ia) and Ib (ST Ib). The combination increased the sensitivity of the nested PCR compared with that of application onto crude samples. Dead cells were also enriched by use of this technology, giving results that are not available by traditional cultivation as enrichment before PCR. The second step in the PCR was modified to be able to differentiate between ST Ia and ST Ib genes. The colorimetric PCR was performed in a microtiter format, making it useful for automation in clinical laboratories and for the screening of large numbers of samples. PMID- 1774240 TI - Rapid isolation and presumptive diagnosis of uropathogens by using membrane filtration and differential media. AB - Random urine samples from hospitalized patients (n = 550) and seeded sterile filtered urine samples (n = 730) were used to test a membrane filtration technique, Qualture (Future Medical Technologies International, Inc., West Palm Beach, Fla.), for the detection and identification of uropathogens. Results for each sample were compared with those obtained by the calibrated loop (0.01 ml) method to demonstrate the sensitivity of the method as a screening tool and the specificity of the presumptive diagnosis obtained from the pattern of growth on differential media. The medium was supplied as dehydrated nutrient pads (Sartorius AG, Goettingen, Germany) and was activated by rehydration by the addition of the liquid specimen. With a threshold of 10(4) CFU/ml defining a positive culture, the sensitivity of the Qualture was 100%. At lower levels of bacteriuria, the Qualture was more sensitive than the calibrated loop method. Significant infections were presumptively diagnosed at 4 h by filtration rather than at 24 h on agar medium. The specificity of uropathogen identification ranged from 99% for Enterococcus spp. to 83% for Pseudomonas spp. Citrobacter spp. could not be differentiated from Escherichia coli and Providencia spp. could not be differentiated from Proteus spp., which does not create a therapeutic dilemma. Filtration, isolation, quantitation, and presumptive diagnosis are performed in one step, without subculture. Membrane filtration is a sensitive and rapid technique, with the advantage that it can be used as a collection and transport device without the use of growth inhibitors. PMID- 1774241 TI - Detection of astrovirus in pediatric stool samples by immunoassay and RNA probe. AB - Two new astrovirus assays, a rapid biotin-avidin enzyme immunoassay (EIA) and RNA probe hybridization, were developed and compared with an established astrovirus assay, an indirect EIA, and immune electron microscopy. Sensitivity and specificity were evaluated by using a screening panel of 22 astrovirus-positive and 305 astrovirus-negative fecal specimens. The biotin-avidin assay was equivalent in performance to the reference indirect assay, and both could detect about 10 ng of viral protein. Although the probe was more sensitive than either EIA and could detect higher dilutions of virus in tissue culture and stool specimens, it did not detect more astrovirus-positive fecal specimens. Of the 22 astrovirus-positive specimens detected by the EIAs, 20 were confirmed by immune electron microscopy with hyperimmune rabbit antiserum. To determine the usefulness of EIAs for large epidemiologic studies, EIAs were used to screen 1,289 stool specimens from three studies of children with and without diarrhea. Astrovirus was detected in 3.5% of specimens from children with diarrhea and 1.9% of specimens from those without diarrhea. Our results indicate that the biotin avidin EIA is an efficient, sensitive, and specific method for routinely screening large numbers of fecal samples and that its application in epidemiologic studies may yield higher rates of astrovirus infection than have been found previously by other methods. PMID- 1774242 TI - Evaluation of the microbiology of chronic ethmoid sinusitis. AB - In a prospective study, patients with the diagnosis of chronic ethmoid sinusitis were evaluated microbiologically by using biopsy specimens of the ethmoid sinus mucosa. Microbiology cultures were performed on 94 specimens from 59 patients. Staphylococcus aureus and members of the family Enterobacteriaceae were the most frequent classical pathogenic bacteria isolated. Coagulase-negative staphylococci were the most common overall isolates. Streptococcus pneumoniae and Haemophilus influenzae were infrequent isolates. No anaerobes, viruses, or Chlamydia trachomatis organisms were identified. Results of this study showed organism isolation frequencies different from those found in other studies of chronic sinusitis reported in the literature. The predominance of S. aureus and members of the family Enterobacteriaceae could have an effect on the antimicrobial therapy for chronic ethmoid sinusitis. PMID- 1774243 TI - Amplification of Borrelia burgdorferi DNA in skin biopsies from patients with Lyme disease. AB - To determine whether the polymerase chain reaction could contribute to a better diagnosis of Lyme disease, skin biopsy samples from patients suffering from erythema chronicum migrans or acrodermatitis chronica atrophicans were tested for the presence of Borrelia burgdorferi by a polymerase chain reaction assay, which was specific for European strains. The spirochete could not be detected microscopically in any of the 15 biopsy samples obtained from nine patients. However, B. burgdorferi could be isolated from seven of eight of these samples, which indicated the presence of spirochetes. Using a nested polymerase chain reaction, we were able to detect B. burgdorferi-specific sequences in 12 of the 15 biopsy samples. Biopsy samples from three of four patients with erythema chronicum migrans and four of five patients with acrodermatitis chronica atrophicans were found to be positive for B. burgdorferi. The spirochete could be isolated from the biopsy sample, from a patient with erythema chronicum migrans who tested negative, which suggests a false-negative polymerase chain reaction result probably on account of the low number of spirochetes present in the lesion. The positive polymerase chain reaction for lesions from patients with acrodermatis chronica atrophicans supports the concept that B. burgdorferi can persist in the skin over a long period of time. From these results, it was concluded that the polymerase chain reaction is a valuable technique for the diagnosis of Lyme disease. PMID- 1774244 TI - Clinical and laboratory features of Nocardia nova. AB - Recent studies have shown that Nocardia asteroides isolates have five major antibiotic resistance patterns; one of these patterns identifies isolates of Nocardia farcinica. In the current study, we investigated a second pattern characterized by susceptibility to ampicillin and erythromycin. This pattern was seen in 17% of 223 clinical isolates identified by standard techniques as N. asteroides and associated with diseases typical for nocardiae. Biochemically, isolates with this drug pattern were relatively homogeneous and identical to the type strain and previous descriptions of Nocardia nova. The strains studied were unique among nocardiae in having both alpha- and beta-esterase activity (85 and 95%, respectively). However, the arylsulfatase activity at 14 days (75%) and antimicrobial susceptibility patterns, including susceptibility to erythromycin (100%), were the only routinely available methods that would separate N. nova strains from other members of N. asteroides. N. asteroides should be considered a complex because current clinical identification schemes include isolates of N. farcinica and N. nova and may well include additional species. This is the first detailed description of N. nova as a pathogen in humans. PMID- 1774245 TI - 110-kilodalton recombinant protein which is immunoreactive with sera from humans, dogs, and horses with Lyme borreliosis. AB - EcoRI-digested DNA from Borrelia burgdorferi was ligated into the dephosphorylated vector pWR590 and transformed into Escherichia coli DH5 alpha. When the gene library was screened, 20 clones reacted with pooled dog sera with high titers (immunofluorescent antibody titer, greater than or equal to 1,280) to this spirochete. One clone expressed a 110-kDa antigen that reacted strongly with the high-titered pooled sera from dogs with Lyme borreliosis and serum from goats immunized with B. burgdorferi. The 110-kDa protein was serum from goats immunized with B. burgdorferi. The 110-kDa protein was expressed with and without isopropyl beta-D-thiogalactosidase, indicating the protein is not a fusion protein with beta-galactosidase. Monospecific antisera to the 110-kDa antigen recognized a 75 kDa Borrelia protein. Of the sera that reacted with B. burgdorferi by immunoblotting; 57, 100, and 83% of human, dog, and horse serum samples, respectively, reacted with the 110-kDa protein. Sera from individuals that tested negative with a B. burgdorferi lysate with immunoblotting showed no reaction with the 110-kDa protein. The 110-kDa antigen appears to be useful for the diagnosis of Lyme borreliosis. PMID- 1774246 TI - Variability in growth of Neisseria polysaccharea on colistin-containing selective media for Neisseria spp. AB - In a prospective survey of 773 healthy schoolchildren in southern Alberta, Canada, Neisseria polysaccharea was isolated from the pharynxes of only 4 (0.5%) subjects, whereas Neisseria lactamica and Neisseria meningitidis were isolated from 110 (14%) and 15 (2%) children, respectively. These strains of N. polysaccharea, together with three other sporadic isolates from Alberta, Canada, were compared with the type strain from France and strains from Spain and Germany. All strains were phenotypically identical, except that the Canadian and German strains, for which the colistin MICs were 1 mg/liter, failed to grow on Thayer-Martin medium (TMM), whereas the type strain and the Spanish strains, for which the colistin MICs were greater than 7.5 mg/liter, were not inhibited. Multilocus enzyme electrophoresis indicated that six distinct electrophoretic types were present among the seven Canadian strains. Our results show that growth on gonococcal selective media which contain colistin is a variable feature of this taxon. PMID- 1774247 TI - Analysis of the role of flagella in the heat-labile Lior serotyping scheme of thermophilic Campylobacters by mutant allele exchange. AB - Flagellin mutations originally constructed in Campylobacter coli VC167 (serotype LIO8) by a gene replacement mutagenesis technique (P. Guerry, S. M. Logan, S. Thornton, and T. J. Trust, J. Bacteriol. 172:1853-1860, 1990) were moved from the original host into Campylobacter strains of a number of other Lior serogroups by a natural transformation procedure. This is the first report of the use of this transformation method to transfer a mutated locus among Campylobacter strains. Flagellin mutants were constructed in a number of heat-labile LIO serotypes and were serotyped and analyzed by immunoelectron microscopy with LIO typing antisera. In six cases, isogenic nonflagellated mutants were able to be serotyped in the same serogroup as their parent, and immunogold electron microscopy confirmed that antibodies in the typing antisera bound to components on the surface of both parent and mutant cells. However, in only one case, a strain belonging to serogroup LIO4, was a nonflagellated mutant untypeable, and immunogold electron microscopy showed that antibodies bound to the flagella filament of the parent but not to the cell surface. Furthermore, after introduction and expression as a flagellar filament of a LIO8 flagellin gene in this mutant, the strain could not be serotyped. These results indicate that a nonflagellar antigen is often the serodeterminant in the heat-labile Lior serotyping scheme. PMID- 1774248 TI - Use of a urine enzyme immunoassay as a diagnostic tool for Chlamydia trachomatis urethritis in men. AB - We collected first-voided urine specimens from 659 males attending a sexually transmitted disease clinic and performed both enzyme immunoassay (EIA) for detection of chlamydial antigen and leukocyte esterase testing on these urine samples. The overall prevalence of chlamydial urethritis in the study population as determined by culture of urethral swabs was 11%. However, 46% of all men in the study had no symptoms of urethritis. Compared with urethral cultures for chlamydiae, the urine EIA had a sensitivity of 42% and a specificity of 99%. The sensitivity of the EIA strongly correlated with the amount of antigen present in culture as assessed by numbers of inclusion-forming units. The sensitivity of the leukocyte esterase test compared with that of chlamydia culture was 88%. We conclude that in this population of men, which included many patients without symptoms of urethritis, the urine EIA was a relatively insensitive means of screening for chlamydial infection. PMID- 1774249 TI - Proposal of Afipia gen. nov., with Afipia felis sp. nov. (formerly the cat scratch disease bacillus), Afipia clevelandensis sp. nov. (formerly the Cleveland Clinic Foundation strain), Afipia broomeae sp. nov., and three unnamed genospecies. AB - On the basis of phenotypic characterization and DNA relatedness determinations, the genus Afipia gen. nov., which contains six species, is described. The type species is Afipia felis sp. nov. (the cat scratch disease bacillus). Afipia clevelandensis sp. nov., Afipia broomeae sp. nov., and three unnamed not associated with cat-borne disease. All but one strain (Afipia genospecies 3) were isolated from human wound and respiratory sources. All Afipia species are gram negative, oxidase-positive, nonfermentative rods in the alpha-2 subgroup of the class Proteobacteria. They are motile by means of a single flagellum. They grow on buffered charcoal-yeast extract agar and nutrient broth, but rarely on MacConkey agar, at 25 and 30 degrees C. They are urease positive; but they are negative in reactions for hemolysis, indole production, H2S production (triple sugar iron agar), gelatin hydrolysis, esculin hydrolysis, and peptonization of litmus milk. They do not produce acid oxidatively from D-glucose, lactose, maltose, or sucrose. The major cell wall fatty acids are 11-methyloctadec-12 enoic (CBr19:1), cis-octadec-11-enoic (C18:1omega7c), and generally, 9,10 methylenehexadecanote and 11,12-methyleneoctadecanoate; and there are only trace amounts of hydroxy acids. The guanineplus-cytosine content is 61.5 to 69 mol%. A. felis is positive for nitrate reduction and is delayed positive for acid production from D-xylose, but it is catalase negative. A. clevelandensis is negative in all of these tests. A. broomeae is weakly positive for catalase production and acid production from D-xylose, but it is negative for nitrate reduction. PMID- 1774251 TI - Identification of mycobacteria by high-performance liquid chromatography. AB - Mycolic acids extracted from saponified mycobacterial cells were examined as p bromophenacyl esters by high-performance liquid chromatography (HPLC). Standard HPLC patterns were developed for species of Mycobacterium by examination of strains from culture collections and other well-characterized isolates. Relative retention times of peaks and peak height comparisons were used to develop a differentiation scheme that was 98% accurate for the species examined. A rapid, cost-effective HPLC method which offers an alternative approach to the identification of mycobacteria is described. PMID- 1774250 TI - Evaluation of infection with human immunodeficiency virus type 1 by using nonisotopic solution hybridization for detection of polymerase chain reaction amplified proviral DNA. AB - A convenient assay combining solution hybridization and enzyme immunoassay for DNA-RNA hybrids (polymerase chain reaction-enzyme immunoassay [PCR-EIA]) was developed to detect human immunodeficiency virus type 1 (HIV-1) provirus amplified by the PCR and was compared with oligomer hybridization with 32P labeled SK19. In PCR-EIA, a fragment of the HIV-1 gag gene from peripheral blood mononuclear cells was first amplified with primer pair SK38/SK39 or O1/O2. PCR amplified material was reacted in solution with a biotinylated RNA probe. Biotinylated hybrids were measured in a microtiter-plate EIA with antibiotin antibody and a beta-D-galactosidase-conjugated monoclonal antibody to DNA-RNA hybrids. Ten copies of HIV-1 DNA could be detected by PCR-EIA by using two different sets of primers. HIV-1 DNA was detected in 104 of 108 peripheral blood mononuclear cell samples by using SK38/39 and oligomer hybridization, in 104 of 108 samples by using SK38/SK39 and PCR-EIA, and in 104 of 108 samples by using O1/O2 and PCR-EIA. HIV-1 provirus was detected in 107 of 108 samples by using a combination of two sets of primers. One sample from a seropositive patient was negative in all three PCR assays, and six samples gave discordant results between primer pairs. Six of the latter samples scored negative in a PCR for beta-globin but became positive when the sample was diluted before amplification. When applied to clinical samples, PCR-EIA generated results similar to those of an isotopic assay for detection of amplified DNA. PMID- 1774252 TI - Sensitivity of Limulus amebocyte lysate (LAL) to LAL-reactive glucans. AB - The sensitivity of Limulus amebocyte lysate (LAL) to LAL-reactive glucans (LRGs) and lipid A was tested by using commercially available and experimentally formulated LAL reagents. The glucans included two kinds of beta-(1,3)-D-glucans, laminarin and curdlan, and cellulosic material, LAL-reactive material (LAL-RM), extracted from a hollow-fiber (Cuprophan) hemodialyzer. LAL-RM loses its LAL activity when it is digested with cellulase and thus appears to be a beta-(1,4)-D glucan or a mixed glucan containing a substantial proportion of beta-(1,4) linkages. All LAL reagents tested were at least 1,000-fold more sensitive to endotoxin than to LRGs. The presence of the surfactant Zwittergent was shown to interfere with reactivity to LRGs; LAL reagents without added Zwittergent reacted more strongly to LRGs than did the same reagents containing Zwittergent. Chloroform extraction of LAL increased the reagents' sensitivity to both endotoxin and LRGs, but it was not responsible for LRG reactivity. The addition of Zwittergent significantly reduced the sensitivity of LAL reagents to lipid A. LAL without the surfactant was equally sensitive to endotoxin and lipid A. Both curdlan and LAL-RM amplified or enhanced the LAL response to endotoxin. Kinetic turbidimetric studies demonstrated that the enhancement was dependent on the glucan concentration. PMID- 1774253 TI - Rapid detection of type A influenza viruses with monoclonal antibodies to the M protein (M1) by enzyme-linked immunosorbent assay and time-resolved fluoroimmunoassay. AB - Monoclonal antibodies (MAbs) to the M protein (M1) were used in the development of direct detection systems for type A influenza viruses in clinical specimens. Optimal detection by an enzyme-linked immunosorbent assay was achieved when MAbs were used as capture antibodies and rabbit polyclonal antibodies were used as sandwich antibodies. Detection by the enzyme-linked immunosorbent assay required amplification of the virus. direct detection in clinical specimens (nasopharyngeal aspirates) was accomplished when MAbs recognizing two distinct antigenic sites of M1 were used in a time-resolved fluoroimmunoassay. Type A influenza viruses could be detected equally well in specimens obtained during epidemics of both H3N2 and H1N1 influenza viruses. PMID- 1774254 TI - Emergence of a virulent clone of Neisseria meningitidis serotype 2a that is associated with meningococcal group C disease in Canada. AB - Multilocus enzyme electrophoresis was used to characterize 378 isolates of Neisseria meningitidis serogroup C recovered during a period of an increase in group C meningococcal disease in Canada. Thirty-four enzyme electrophoretic types were found among the isolates, which were predominantly (96.0%) serotype 2a. One clone (ET 15), characterized by a rarely occurring allele for the enzyme fumarase, was responsible for a focal outbreak in Ontario followed by the spread of group C disease across the province. This clone, which occurred infrequently among strains isolated in 1986, accounted for over 65% of group C strains associated with meningococcal disease in Canada in 1990. PMID- 1774255 TI - Recovery of vancomycin-resistant gram-positive cocci from pediatric liver transplant recipients. AB - Between November 1988 and October 1989, 49 first-time pediatric liver transplant recipients at the Children's Hospital of Pittsburgh were prospectively monitored for the presence of stool colonization and the development of disease caused by vancomycin-resistant gram-positive cocci (VRGPC). Quantitative stool culturing was done on a weekly basis, and cultures were planted onto a selective medium for VRGPC. Isolates for which the MIC was greater than or equal to 8 were considered resistant to vancomycin. Patients were monitored clinically for the development of infection, and their charts were systematically reviewed for the use of antibiotics. Eighty-six isolates were recovered from 36 of the 49 patients. Enterococcal species were isolated from 31 patients and included Enterococcus gallinarum (n = 28), E. casseliflavus (n = 14), E. faecium (n = 9), E. faecalis (n = 2), E. mundtii (n = 2), and E. durans (n = 1). Stool colonization with vancomycin-resistant enterococci was noted to increase steadily during the first month after transplantation. Only 9 of 31 patients demonstrated clearance of these organisms in serial repeat cultures. Additional isolates of VRGPC included Lactobacillus confusus (n = 13), Lactobacillus spp. (n = 12), and Pediococcus pentosaceus (n = 4). Infection due to VRGPC developed in three patients: a urinary tract infection in two and peritonitis in one. E. faecium was the pathogen in each of these cases. The ranges of MICs of vancomycin were 8 to 32 micrograms/ml for all enterococcal isolates and greater than 128 micrograms/ml for Lactobacillus and Pediococcus isolates. All Lactobacillus and Pediococcus isolates were resistant to teicoplanin, although they were susceptible to daptomycin. All other isolates were susceptible to both teicoplanin and daptomycin. This study demonstrates that stool colonization with VRGPC may be a common and early finding among pediatric liver transplant recipients. However, infection appears to be uncommon. PMID- 1774256 TI - Predicting human immunodeficiency virus type 1-positive sera by using two enzyme immunoassay kits in a parallel testing format. AB - Two algorithms for screening sera for antibody to human immunodeficiency virus type 1 were compared for their efficiency in identifying a true-positive sample in a population with heterogeneous risk factors, using the criteria of specificity and positive predictive value (PPV). In the first algorithm, all sera were screened by using a single enzyme immunoassay (EIA) kit, and a specificity of 98.6% and a PPV of 69.3% was calculated for true-positive sera. The second algorithm employed two different EIA kits in parallel to screen each sample. In the first instance, a specificity and a PPV of 100% was calculated if a positive sample was defined as reactive by both EIA kits; in the second, a specificity of 99.97% and a PPV of 99.4% was obtained if this criterion was extended to include a combination of one reactive and one equivocal result obtained with the two EIA kits. PMID- 1774257 TI - Epidemiology of an endemic strain of beta-lactamase-producing Enterococcus faecalis. AB - Three previously reported beta-lactamase-producing (Bla+) enterococci with distinct but related antibiotic resistance phenotypes, plasmid profiles, and plasmid restriction endonuclease digestion patterns were isolated at the West Haven Veterans Administration Medical Center in Connecticut (WH245, WH257, WH571) in July 1986 and March 1987. In this study, we analyzed the whole-cell DNA of these isolates by using pulsed-field gel electrophoresis of large chromosomal fragments generated by SmaI digestion. The three West Haven isolates showed very similar chromosomal restriction endonuclease digestion patterns; these patterns were distinct from those of Bla+ and Bla- enterococci from other geographic areas and from those of other West Haven enterococci, suggesting an endemic Bla+ strain at this institution. Clinical information regarding these isolates suggests that exposure to the genitourinary clinic, obstructive urinary tract disease, and frequent antibiotic therapy may have been common risk factors for acquisition of this endemic strain. PMID- 1774258 TI - Polymerase chain reaction for detection of the cholera enterotoxin operon of Vibrio cholerae. AB - We report a set of oligonucleotide primers and amplification conditions for the polymerase chain reaction to detect the ctx operon of Vibrio cholerae. The results of this assay on strains of V. cholerae and related organisms were identical with those obtained by the DNA colony hybridization test with the polynucleotide probe. The detection limit of this system was 1 pg of chromosomal DNA or broth culture containing three viable cells. The polymerase chain reaction method could directly detect the ctx operon sequences in rice-water stool samples from patients with cholera. PMID- 1774259 TI - Virulence factors associated with cytotoxic necrotizing factor type two in bovine diarrheic and septicemic strains of Escherichia coli. AB - Forty-three bovine isolates of Escherichia coli producing a second type of cytotoxic necrotizing factor (CNF2) and three K-12 strains carrying different Vir plasmids coding for CNF2 were tested for the presence of several virulence factors. Most of the strains were serum resistant (79%), produced an aerobactin (70%), and adhered to calf villi (53%); some of them produced a colicin (32%) and a hemolysin (9%). These strains were also tested by a colony hybridization assay with gene probes for six toxins (classical heat-stable [STaP and STb] and heat labile [LT-I and LT-IIa] enterotoxins and Shiga-like toxins [SLT-I and SLT-II]) and five adhesion factors (K99, K88, 987P, F17, and F41). Only two gene probes, LT-IIa (9%) and F17A (53%), hybridized with the CNF2 strains. However, antibodies raised against F17 fimbriae did not agglutinate the strains hybridizing with the F17A probe. In contrast, all except one of these strains adhered to calf villi. Interestingly, these two properties, F17A positivity and adherence to calf villi, were the only ones expressed by the K-12 strains carrying different Vir plasmids. In conclusion, this study confirmed that CNF2-producing strains are unrelated to previously described toxigenic E. coli strains and also demonstrated that in half of the strains the production of CNF2 was associated with an adhesion factor genetically related to, but different from, F17, which is more than likely encoded by Vir plasmids. PMID- 1774260 TI - Actinobacillus spp. and related bacteria in infected wounds of humans bitten by horses and sheep. AB - We describe the isolation of Actinobacillus lignieresii and an A. equuli-like bacterium from an infected horse-bite wound in a 22-year-old stable foreman and A. suis from a bite injury in a 35-year-old man who had been attacked by a horse. A. lignieresii was also isolated in pure culture from an infected sheep-bite wound in a rural worker. These species of the genus Actinobacillus are primarily associated with animals and animal diseases and are rarely isolated from humans. The purpose of this report is to raise awareness of the possible occurrence of Actinobacillus spp. in bite wounds inflicted by farm animals and to discuss the difficulties encountered in the identification of species of Actinobacillus and related bacteria. PMID- 1774261 TI - Biotypes of Haemophilus influenzae that are associated with noninvasive infections. AB - In this study, we examined the biotypes of Haemophilus influenzae strains associated with noninvasive infections in hospitalized patients. Over an 18-month period, a total of 388 strains were isolated from patients of various ages (neonates to the elderly), and the biotypes of the strains were determined. Strains of biotype II accounted for 48% of the isolates; this was followed by strains of biotypes III and I (26 and 16%, respectively). The remaining 10% of the isolates were made up of strains of biotypes IV, V, VI, and VII. A total of 6% of strains were capsulated. The distribution of biotypes in specimens from the respiratory tract and associated sites was comparable to that obtained in similar investigations, but examination of isolates from neonatal and genital specimens did not support the concept that H. influenzae biotype IV is a major urogenital pathogen. Conflicting results regarding the incidence of certain biotypes in specimens, particularly those from the urogenital tract, may be due to the selection of different subpopulations of patients. Data relating to the specimens were used to evaluate the association between biotype and clinical diagnosis, the presence of other potential bacterial pathogens in the specimens, and the presence of viruses in the specimens. None of the differences in the distribution of biotypes which were examined was statistically significant. PMID- 1774262 TI - Monoclonal antibody against Porphyromonas (Bacteroides) endodontalis lipopolysaccharide and application of the antibody for direct identification of the species. AB - The aim of the present study was to develop a monoclonal antibody that recognizes the shared antigen of Porphyromonas endodontalis so that we could use the antibody in direct identification and detection of P. endodontalis in infectious material from apical periodontal patients. We established a hybridoma cell line producing monoclonal antibody (BEB5) specific for P. endodontalis. BEB5 antibody reacted with all of the P. endodontalis strains tested, but not with any of the other black-pigmented Porphyromonas and Bacteroides spp. The antibody reacted specifically with the lipopolysaccharide (LPS) of three P. endodontalis strains of different serotypes (O1K1, O1K2, and O1K-). Western blotting (immunoblotting) analysis confirmed the specificity of the antibody to these LPSs, because the antibody recognized the typical "repetitive ladder" pattern characteristic of LPS on sodium dodecyl sulfate-polyacrylamide electrophoretic gels. These observations demonstrate that P. endodontalis LPS is the shared antigen of this species. The antibody can specifically identify P. endodontalis on nitrocellulose membrane blots of bacterial colonies grown on agar. The antibody is also capable of directly detecting the presence of P. endodontalis in infectious material by immunoslot blot assay. These results indicate that LPS is the shared antigen of P. endodontalis and that BEB5 antibody against LPS is a useful one for direct identification and detection of the organisms in samples from apical periodontal patients. PMID- 1774263 TI - Bacillus piliformis flagellar antigens for serodiagnosis of Tyzzer's disease. AB - Purified flagella from multiple isolates of Bacillus piliformis were obtained and examined by electron microscopy. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and Western blot (immunoblot) analyses were used to assess the purity, antigenicity, and cross-reactivity of purified flagellar preparations. SDS-PAGE demonstrated a single, major protein band evident at approximately 53 to 56 kDa in all isolates tested. Results of Western blot analyses indicated a lack of cross-reactivity between flagellar antigens and heterologous isolates. Enzyme-linked immunosorbent assays (ELISAs) were used to compare the efficacies of flagellar preparations from the various isolates as antigens in detecting B. piliformis serum antibodies from several host species. ELISA results indicated that no single flagellar preparation could be relied on to consistently identify serum antibodies in all the host species tested; however, ELISAs that utilized a trivalent flagellar antigen preparation were shown to be specific and sensitive for the detection of antibodies to B. piliformis. PMID- 1774264 TI - A cloned DNA probe identifies Cowdria ruminantium in Amblyomma variegatum ticks. AB - Heartwater, caused by Cowdria ruminantium and transmitted by ticks of the genus Amblyomma, is a constraint to ruminant animal production in sub-Saharan Africa. This rickettsial disease could spread from endemically infected areas of sub Saharan Africa and certain Caribbean islands to other countries, including the United States, in which Amblyomma ticks exist. To detect C. ruminantium in tick vectors and animals, we made DNA probes from C. ruminantium DNA isolated from endothelial cell cultures. Two clones were evaluated; pCS20 from Crystal Springs (Zimbabwe) strain DNA had a 1,306-bp insert, and pCR9 from Kiswani (Kenya) strain DNA had a 754-bp insert. Both DNA probes detected 1 ng of Crystal Springs DNA; however, the pCS20 probe had a 10-fold-greater ability to discriminate between C. ruminantium DNA and DNA from other organisms. Also, the pCS20 probe did not hybridize to 400 ng (highest amount tested) of DNA from bovine cells, 3 protozoa, 3 rickettsiae, and 12 bacteria. In all experiments, C. ruminantium DNA was detected in midguts from 99 of 160 Amblyomma variegatum nymphs infected as larvae and in midguts from 38 of 80 adult ticks infected as nymphs but not in midguts from control nymphs and adults. The presence of C. ruminantium in nymphs and adults was confirmed by transmission of heartwater to goats. The DNA sequences of both probes were determined; synthetic oligonucleotides from pCS20 are recommended as DNA probes for C. ruminantium. PMID- 1774265 TI - Comparative evaluation of three selective media and a nonselective medium for the culture of Helicobacter pylori from gastric biopsies. AB - Plating on solid media is the standard technique used in most laboratories for the isolation of Helicobacter pylori from gastric biopsies. Recently, various selective media were developed for this purpose. We compared and evaluated three selective media, Skirrow's, Dent's CP, and modified Glupczynski's Brussels campylobacter charcoal media, and chocolate agar medium for the isolation of H. pylori. Gastric biopsies taken from a total of 203 patients were plated in parallel on all four media. An isolation rate of 51% (104 of 203) was obtained with a combination of all four media. Of the 104, 92 (88%) were positive with Dent's medium and with modified Glupczynski's medium. Skirrow's medium gave the highest isolation rate, 96% (100 of 104). However, growth of H. pylori was scant (only one to five colonies) when growth occurred on Skirrow's medium alone. Overall, modified Glupczynski's medium provided significantly heavier growth. Chocolate agar medium yielded a 76% (79 of 104) positivity rate. We recommend the use of a combination of two selective media for the maximum recovery of H. pylori from antral biopsies. PMID- 1774266 TI - Characterization of six new capsular types (23 through 28) of Streptococcus suis. AB - Six new capsular types of Streptococcus suis (types 23 to 28) are described. All reference strains were isolated from diseased pigs and were morphologically and biochemically similar to previously described capsular types 1 to 22. Clear and specific reactions were obtained for each of the new capsular types with three different typing techniques; no cross-reactions were detected among them or with other S. suis capsular types. Their capsular material presented similar ultrastructural characteristics, as shown by electron microscopy, and fimbriae similar to those described for other capsular types of S. suis were observed. When untypeable field isolates were tested with antisera raised against the six new capsular types, capsular type 23 appeared to be the most prevalent, representing more than 50% of all these isolates. Most isolates were recovered from cases of pneumonia, septicemia, and meningitis. Presumptive biochemical identification described for S. suis capsular types 1 to 22 may also be used for capsular types 23 to 28. PMID- 1774267 TI - Detection of high-level aminoglycoside resistance in enterococci other than Enterococcus faecalis. AB - The ability of six screening methods to detect high-level aminoglycoside resistance in enterococcal species other than Enterococcus faecalis was investigated. The 85 Enterococcus isolates, which included 55 E. faecium, 11 E. gallinarum, 9 E. casseliflavus, 5 E. raffinosus, 4 E. avium, and 1 E. mundtii, were tested by using aminoglycoside-supplemented brain heart infusion agar (BHI), Remel EF Synergy Quad plates, high-content aminoglycoside diffusion disks, standard (prepared in-house) microdilution panels, Pasco MIC Gram Positive microdilution panels, and Vitek GPS-TA cards. When tested on BHI, 32 and 35 strains showed resistance to gentamicin and streptomycin, respectively. Resistance profiles obtained with Remel EF Synergy Quad plates were in complete agreement with those obtained on BHI. However, growth on Mueller-Hinton agar based plates was not as heavy. Some isolates showed only weak growth and required 48 h for resistance to become evident, especially with swab inoculation of quadrants containing 2,000 micrograms of gentamicin per ml. Profiles obtained by use of the agar-based screens were used as the basis for evaluating the other methods. Disk diffusion showed complete agreement. No false resistance occurred by either microdilution method, but 48 h of incubation was needed for detection of some gentamicin-resistant isolates, and 14% of the streptomycin-resistant strains were not detected by standard microdilution. The Vitek GPS-TA card detected 81 and 100% of the gentamicin- and streptomycin-resistant isolates, respectively. In general, most methods used to detect high-level aminoglycoside resistance in E. faecalis appear to be reliable for the testing of the other enterococcal species. However, further investigations with a greater number of resistant E. raffinosus, E. avium, and E. mundtii isolates, when they are available, will be useful for establishing the full range of enterococci that can reliably be tested by the various methods. PMID- 1774269 TI - Improved adhesive method for microscopic examination of fungi in culture. AB - A new method for the examination of molds that involves the use of a device that dispenses a thin layer of a transparent adhesive material over the surface of a coverslip is described. The advantages of this method over previous methods used for the microscopic examination of molds are delineated. PMID- 1774268 TI - Evidence for long-term memory of the mucosal immune system: milk secretory immunoglobulin A against Shigella lipopolysaccharides. AB - Although the common mucosal immune system has generally been considered to have only short-term memory, recent data suggest that long-term memory exists for Shigella virulence plasmid antigens. Because such antigens might cross-react with environmental antigens, we investigated milk for the persistence of antibodies to the specific Shigella lipopolysaccharide (LPS) antigens. Enzyme-linked immunosorbent assays to detect secretory immunoglobulin A (sIgA) against Shigella flexneri and Shigella sonnei LPS in milk samples were developed; 15 random milk samples tested on different days correlated from one day to the next (P = 0.0001). Of 18 Mexican mothers, 18 (100%) had one or more milk samples positive for anti-S. flexneri LPS, 14 (78%) had one or more milk samples positive for anti S. sonnei LPS, and 14 (78%) had one or more milk samples positive for both. Of 27 Houston mothers, 16 (59%) had one or more milk samples positive for anti-S. flexneri LPS, 7 (26%) had one or more milk samples positive for anti-S. sonnei LPS, and 5 (19%) had one or more milk samples positive for both. Mexican mothers were significantly more likely than Houston mothers to have at least one sample with a positive titer for anti-S. flexneri LPS (P less than 0.02) and at least one sample with a positive titer for anti-S. sonnei LPS (P less than 0.002). Although the Houston women had a lower rate of titer positivity for both Shigella species, the rate was too high to be consistent with short-lived mucosal immunity. It is unlikely that 18 of the 27 Houston women had shigellosis during or just prior to lactation. The data suggest that there exists a long-term hormonally driven memory in the secretory immune system for Shigella spp. PMID- 1774270 TI - Feeding trials of Listeria monocytogenes with a nonhuman primate model. AB - One of the major unanswered questions regarding the presence of Listeria monocytogenes in foods is how many cells must be ingested in order to cause illness. To answer this question, studies were undertaken by using Macaca fascicularis (cynomolgus monkey) as an animal model. Healthy nonhuman primates were dosed with various concentrations of L. monocytogenes suspended in sterile whole milk. Final concentrations of 10(5), 10(7), and 10(9) total cells of the organism were used; a control was also included. Blood samples, as well as fecal and nasal specimens, were taken at various time intervals. Only animals that received 10(9) cells of L. monocytogenes became noticeably ill, with symptoms of septicemia, irritability, loss of appetite, and occasional diarrhea. Monkeys that received 10(7) and 10(9) cells shed L. monocytogenes in the feces for approximately 21 days. In monkeys that received the dose of 10(9) cells, severe lymphopenia and neutrophilia occurred within 48 h. In a separate trial, monkeys received Maalox to reduce the gastric acidity of the stomach. However, no substantial differences were observed between Maalox-treated and control monkeys. PMID- 1774271 TI - Respiratory syncytial virus infection and prevalence of subgroups A and B in Hawaii. AB - Respiratory syncytial virus was isolated from hospitalized children in Hawaii in each month of the year during the period January 1987 to August 1989. Subgroup A and subgroup B strains cocirculated, with subgroup A predominating. There was an alternating early-season and late-season peak incidence cycle as reported elsewhere. PMID- 1774272 TI - Type F botulism due to neurotoxigenic Clostridium baratii from an unknown source in an adult. AB - Type F botulism was confirmed in a 54-year-old male with signs compatible with botulism who reported to the emergency unit of a hospital. Botulinal neurotoxin was detected in the patient's serum and fecal specimens, and a neurotoxigenic organism whose physiologic characteristics correspond to those of Clostridium baratii was isolated. The toxin produced by the isolate was neutralized by type F botulinal antitoxin and cross-neutralized with lower efficiency by type E antitoxin. The patient's food history was not suggestive of botulism, and it seems likely that the illness was due to colonization of the gut. PMID- 1774273 TI - Isoenzyme changes in Candida albicans during domestication. AB - Isoenzyme analysis was performed on multiple strains of two commonly used reference cultures of Candida albicans (B311 and NCPF3153). Whereas strains originating from C. albicans B311 showed no variation in isoenzyme profiles, some strains derived from NCPF3153 were identical to B311 strains but others showed variation in their glucose-6-phosphate dehydrogenase isoenzymes. The results are compared with those from previous analyses with these strains and show that C. albicans can undergo genetic alterations during prolonged maintenance in laboratories. PMID- 1774274 TI - Diagnosis of acute pulmonary toxoplasmosis by visualization of invasive and intracellular tachyzoites in Giemsa-stained smears of bronchoalveolar lavage fluid. AB - Two patients with AIDS presented with pulmonary toxoplasmosis. Diagnosis was achieved by the visualization, in Giemsa-stained smears of bronchoalveolar lavage fluid, of tachyzoites of Toxoplasma gondii that were extracellular and in the process of invading or within pneumocytes. The intracellular localization of tachyzoites facilitated diagnosis by obviating potential confusion of extracellular tachyzoites with cellular debris or platelets. PMID- 1774275 TI - Specific amplification of Rickettsia tsutsugamushi DNA from clinical specimens by polymerase chain reaction. AB - Polymerase chain reaction (PCR) was used to detect Rickettsia tsutsugamushi specific DNA in clinical specimens. The primer pair used for PCR was designed from the nucleotide sequence of the gene encoding the 56-kDa antigen of the Gilliam strain. Theses primers led to a 78-bp fragment by amplifying the genomic DNAs from five serovariants, i.e., the Gilliam, Karp, Kato, Kawasaki, and Kuroki strains of R. tsutsugamushi, and also the DNA from blood clots of patients with scrub typhus, even at the early stage of onset of the disease. This indicates that this method is suitable for the diagnosis of scrub typhus. PMID- 1774276 TI - Identification of Salmonellae with the 4-methylumbelliferyl caprilate fluorescence test. AB - We have tested 750 Salmonella strains and 130 strains of other species of the family Enterbacteriaceae with the 4-methylumbelliferyl caprilate reagent (MUCAP) test. The MUCAP test is a fluorescence test for rapid identification of Salmonella strains. The non-Salmonella strains were strains sent for identification as suspected Salmonella strains and thus have phenotypes similar to those of Salmonella strains. All 748 tested Salmonella strains of subgroups I, II, III, and IV were positive in the MUCAP test. Of the two tested rare Salmonella subgroup V strains, one was positive and the other was negative. In the selected material containing strains with phenotypes similar to those of Salmonella strains, only one Hafnia alvei strain of 130 Enterbacteriaceae bacteria tested was positive. The fluorescence of the H. alvei strain, the six tested Salmonella dublin strains, and the positive Salmonella subgroup V strain was weaker than that of the other salmonellae. The MUCAP assay is simple and is performed within 5 min. With an almost 100% sensitivity for Salmonella strains, apart from a single Salmonella subgroup V strain, we found the MUCAP test to be a convenient complement to traditional biochemical identification methods, especially for atypical and unusual Salmonella strains. PMID- 1774277 TI - Evaluation of cycloserine-cefoxitin-fructose agar and cycloserine-cefoxitin fructose broth for recovery of Clostridium difficile from environmental sites. AB - Cycloserine-cefoxitin-fructose agar (CCFA) and cycloserine-cefoxitin-fructose broth (CCFB) containing either 500 or 250 micrograms of cycloserine per ml were compared for efficacy in the isolation of Clostridium difficile from hospital ward environmental sites. A RODAC imprint technique was used to inoculate prereduced CCFA. Moistened swabs were used to inoculate prereduced CCFB from environmental sites immediately adjacent to the RODAC sample sites. CCFA (6% positive) was significantly more sensitive than CCFB (3% positive; P less than 0.005), regardless of the cycloserine concentration. When the CCFA cycloserine concentration was decreased from 500 to 250 micrograms/ml, the overall rate of positive cultures rose from 4 to 17%. Medium containing 500 micrograms of cycloserine per ml may be too inhibitory to isolate many moderately sensitive strains of C. difficile from environmental sites. Regardless of the cycloserine concentration, the CCFA RODAC imprint technique is superior to the CCFB method. PMID- 1774278 TI - Gas-liquid chromatographic analysis of cellular fatty acids for identification of gram-negative anaerobic bacilli. AB - A commercially available, computer-assisted microbial identification system (MIS) employs gas-liquid chromatographic analysis of cellular fatty acids for bacterial identification. MIS was compared with conventional identification systems. Of 225 gram-negative anaerobes tested, MIS identified 72.4% of the strains to the species level, 88.9% to the appropriate group, and 93.3% to the correct genus. PMID- 1774279 TI - Identification of the latex test-reactive protein of Clostridium difficile as glutamate dehydrogenase. AB - Computer analysis showed that the gene encoding the latex test-reactive protein of Clostridium difficile exhibited high levels of homology with glutamate dehydrogenases from various sources. Further analysis demonstrated that the recombinant protein possessed glutamate dehydrogenase activity. Our results show that the protein that reacts in commercial latex tests for C. difficile is a glutamate dehydrogenase. PMID- 1774280 TI - Inability of cephalothin testing to predict cefprozil susceptibility. AB - The 30-micrograms cefprozil disk and the cephalosporin class (30-micrograms cephalothin) disk were compared for their abilities to predict cefprozil susceptibility by agar disk diffusion testing. High error (5.02% major and 14.11% minor) rates were encountered with the cephalothin disk and were most frequently observed for Escherichia coli and Enterococcus faecalis. The cefprozil disks resulted in rates of 0.05% very major, 0% major, and 3.72% minor errors. Thus, the 30-micrograms cefprozil disk is more desirable for predicting cefprozil susceptibility. PMID- 1774281 TI - Failure of Micro Media FOX Microdilution System to detect decreased susceptibility of Streptococcus pneumoniae to penicillin. AB - Twelve isolates of Streptococcus pneumoniae with decreased susceptibility by oxacillin screen were susceptible by the FOX panel (Micro Media Systems, Cleveland, Ohio), a commercial microdilution system designed for fastidious organisms. These organisms were found to be moderately susceptible or resistant by broth macrodilution and agar dilution methods. This discrepancy indicates that the FOX panel is not reliable for susceptibility testing of S. pneumoniae. PMID- 1774282 TI - Rapid diagnosis of respiratory syncytial virus infection by using Pernasal swabs. AB - The sensitivity and specificity of direct immunofluorescence microscopy performed on Pernasal swab specimens and compared with those of nasopharyngeal aspirates were 93 and 99%, respectively. Posterior nasopharyngeal swabs applied immediately to microscope slides allow a rapid and simple screening procedure for the diagnosis of acute respiratory syncytial virus infections. PMID- 1774283 TI - Immunodiffusion test for diagnosis and monitoring of human pythiosis insidiosi. AB - To facilitate the laboratory diagnosis of human cases of pythiosis insidiosi, an immunological test was evaluated. A soluble antigen was prepared from a human isolate of Pythium insidiosum, an aquatic, thermotolerant oomycete that causes infections in cattle, dogs, horses, and humans. Sera from seven proven cases of disseminated human pythiosis insidiosi were tested in an immunodiffusion test along with appropriate control sera from patients with a variety of actinomycotic, bacterial, and mycotic diseases as well as sera from uninfected individuals. Titers ranged from 1:1 to 1:32 in the seven serum samples from the disseminated cases of pythiosis insidiosi of varying severity. The heterologous sera gave negative reactions. The rapidity and specificity of the immunodiffusion test makes it a useful diagnostic tool for the serodiagnosis of P. insidiosum infections. PMID- 1774284 TI - Ampicillin-resistant Enterococcus raffinosus in an acute-care hospital: case control study and antimicrobial susceptibilities. AB - A prospective study identified 9 (32%) of 28 ampicillin-resistant (MIC greater than or equal to 16 micrograms/ml) enterococcus isolates as Enterococcus raffinosus. A case-control study found no significant differences with respect to underlying diseases, catheterization, or surgery between patients with ampicillin resistant E. raffinosus and those with ampicillin-susceptible Enterococcus spp. Prior treatment with antibiotics and prolonged hospitalization were more frequent among patients with ampicillin-resistant E. raffinosus. Patients with the same strain (determined by plasmid analysis) were frequently hospitalized concurrently. PMID- 1774285 TI - Nontoxigenic strains of Clostridium difficile lack the genes for both toxin A and toxin B. AB - A total of 39 toxigenic and 20 nontoxigenic strains of Clostridium difficile were tested for the presence of either toxin A or toxin B by the polymerase chain reaction (PCR). All toxigenic strains produced cytotoxin as assayed by using highly sensitive fetal lung fibroblasts and were positive for toxin A as well as toxin B in the PCR assay. All nontoxigenic strains failed to produce toxin and were negative in the PCR assay. This study shows that nontoxigenic strains of Clostridium difficile lack the toxin A as well as the toxin B gene. PMID- 1774286 TI - Mycobacterium malmoense: an easily missed pathogen. AB - The BACTEC system (Becton Dickinson, Sparks, Md.) was compared with culture on Lowenstein-Jensen egg medium for the detection of Mycobacterium malmoense in lymph node samples from children with lymphadenitis. It was found to be significantly more sensitive and rapid. The use of the BACTEC system is thus recommended as a complement to culture on solid media for the primary isolation of atypical mycobacteria, such as M. malmoense. PMID- 1774287 TI - Enteroinvasive Escherichia coli: a cause of bacteremia in patients with AIDS. AB - A strain of enteroinvasive Escherichia coli was isolated from the blood of a patient with advanced human immunodeficiency virus disease on repeated occasions, associated with severe diarrheal illness. The isolate was killed in vitro by control sera but not by sera collected from the patient before or after his bacterial illnesses. PMID- 1774288 TI - Arm abscesses caused by Clostridium botulinum. AB - Wound botulism is an uncommon disorder that continues to be rarely reported in the United States. A 34-year-old intravenous heroin user was admitted to the Loma Linda, Calif., Veterans Administration hospital with multiple abscesses on his forearms. His clinical course was compatible with botulism, and his culture and serum were positive for Clostridium botulinum toxin type A. Early culture and/or serum identification can lead to prompt diagnosis, treatment, and improvement in the morbidity and mortality rates of this disease. PMID- 1774289 TI - Isolation of Yersinia enterocolitica serogroup O:8, biogroup 1B. PMID- 1774290 TI - Isolation of Campylobacter spp. from stool specimens with a semisolid medium. PMID- 1774291 TI - Polymerase chain reaction for detection of adenoviruses in stool samples. PMID- 1774292 TI - Protective value of elevated levels of gamma interferon in serum against exoerythrocytic stages of Plasmodium falciparum. AB - In vitro experiments suggested that gamma interferon, CD8+ T cells, and anticircumsporozoite antibodies inhibited the exoerythrocytic stages of malaria parasites. To assess the role played in vivo by these factors, we conducted a prospective study in Madagascar. Forty individuals with a negative blood smear were followed for 8 weeks to detect the appearance of parasites in blood. Nineteen subjects remained negative for malaria, whereas 21 individuals became positive during follow-up. Among these, seven presented with blood parasites within the first 2 weeks and were excluded, as they probably were infected by sporozoites at enrollment. When measured at enrollment, antibodies to the synthetic peptide (NANP)5, lymphocyte proliferation with (NANP)5, and various lymphocytes subsets were similar among individuals that later presented with a Plasmodium falciparum blood infection or were not infected. Conversely, the level of gamma interferon in serum was higher in individuals that did not present with a P. falciparum infection during follow-up. These data suggest that gamma interferon may inhibit the malaria exoerythrocytic stages of development under in vivo conditions, as it does in vitro. PMID- 1774294 TI - Lyme disease assay which detects killed Borrelia burgdorferi. AB - We developed an in vitro assay showing that Borrelia burgdorferi organisms were killed by serum from patients with Lyme disease. Twenty of 20 Lyme disease serum samples caused B. burgdorferi killing in a range of 36 to 99% compared with the mean number of viable spirochetes when sera from 10 healthy individuals were used. The percentage of killing of B. burgdorferi increased with convalescent serum from patients with early Lyme disease. The borreliacidal activity was detectable in some sera diluted 640-fold and was abrogated after treatment with anti-human immunoglobulin G. In contrast, pooled or individual normal human serum did not cause a decrease in the number of viable B. burgdorferi. Borreliacidal activity was also not detected in sera from patients with relapsing fever, rocky mountain spotted fever, syphilis, mononucleosis, rheumatoid factor, or DNA antibodies. Our results show that borreliacidal activity can be used as a specific serodiagnostic test for detecting Lyme disease. PMID- 1774293 TI - Adsorption and biotin-streptavidin amplification in serologic tests for diagnosis of Lyme borreliosis. AB - Serum samples from persons with Lyme borreliosis, periodontitis, or acute necrotizing ulcerative gingivitis were analyzed by an enzyme-linked immunosorbent assay (ELISA) with and without adsorption and amplification procedures. When biotin and streptavidin reagents were used as an amplification procedure in ELISA without the use of commercially prepared sorbent (Treponema phagedenis biotype Reiter), sensitivity increased. Of the 85 serum samples collected from persons with erythema migrans but no detectable antibodies to Borrelia burgdorferi by standard ELISA, 17 (20%) were reactive after amplification. Adsorption of serum samples with a 1:10 dilution of T. phagedenis biotype Reiter sorbent used in conjunction with amplified ELISA also improved the sensitivity of this method. However, cross-reactivity could not be completely eliminated. An adsorbed amplified ELISA may be helpful in the diagnosis of Lyme borreliosis in the laboratory, particularly during early weeks of infection, when antibodies to B. burgdorferi can be present at a low concentration. PMID- 1774295 TI - Pneumonia and empyema infection associated with a Bacillus species that resembles B. alvei. AB - An organism resembling Bacillus alvei was isolated from the lung and pleural fluid of an immunocompetent patient. The isolate differed from the type strain of B. alvei in its ability to reduce nitrate and its inability to produce dihydroxyacetone and acetylmethylcarbinol. The isolate was resistant to ciprofloxacin and showed intermediate susceptibility to vancomycin. PMID- 1774296 TI - Heterogeneity of capsid proteins of echovirus type 25 wild-type strain and prototype strain, studied by using sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting. AB - Sodium dodecyl sulfate-polyacrylamide gel electrophoresis and immunoblotting were used to compare the capsid proteins of 19 antigenic variants of echovirus type 25 wild-type strains isolated in France between 1976 and 1987 with those of the prototype JV-4 reference strain isolated in 1957. Immunoblots were developed by using polyclonal sera from rabbits and mice immunized with the reference strain. Immunoblotting patterns revealed reactivity only against viral protein VP1 for sera from both animals. Comparative immunoblotting patterns showed differences in the electrophoretic mobilities of viral protein VP1, especially for the Montpellier 76.1262 wild-type strain. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis of [35S]methioinine-labeled viral polypeptides revealed that the two variant strains, Montpellier 76.1262 and Thionville 86.222, exhibited significant and reproducible shifts in the relative mobilities of VP1 and VP3 and, to a lesser extent, in those of VP0 and VP2. The relative mobility of VP4 seemed very similar for the JV-4 reference strain and the two variants. Interestingly, the structural differences in VP1 and VP3 of Montpellier 76.1262 were not correlated with the pattern of neutralization by monoclonal antibodies, unlike in our previous study, in which this strain differed from the prototype strain in only two epitopes. We concluded that, in addition to the heterogeneity of their biological and antigenic properties that we observed previously, echovirus type 25 wild-type strains may exhibit differences in their structural proteins. PMID- 1774297 TI - Reproducibility of tolerance tests that are useful in the identification of campylobacteria. AB - Twenty type or other reference strains, each representing a different Campylobacter, Helicobacter, or Arcobacter taxon, were used to assess the reproducibility of 25 phenotypic tests that are used in the identification of such organisms. Twenty-two of the tests depended on growth inhibition, and each of these tolerance tests was performed by using three different basal media. Although the overall reproducibility of the tests with each basal medium exceeded 89%, the proportion of strains that were able to grow in a reproducible manner on the basal media varied from 100% for blood agar and 50% for nutrient agar to 5% for brucella agar. In general, test reproducibility was highest with the basal medium that supported the most luxuriant growth. For the majority of tests, the basal medium which gave the optimum reproducibility could be determined. PMID- 1774299 TI - Effect of agitation of BACTEC 13A blood cultures on recovery of Mycobacterium avium complex. AB - The effect of agitation of BACTEC 13A bottles (Becton Dickinson) on the recovery of Mycobacterium avium complex (MAC) from blood was compared with that of static incubation. A total of 265 blood specimens was inoculated in duplicate into BACTEC 13A bottles. One specimen was statically incubated at 35 degrees C, and the other was incubated with agitation on a Gyrotory shaker at 35 degrees C for the first 2 weeks and thereafter without shaking for up to 12 weeks. Of the 265 specimens, 77 (29.1%) were positive in either one or both of the paired bottles. The average detection times for the shaken and nonshaken bottles were 12.7 and 15.9 days, respectively. A total of 10.4% of the specimens in the shaken bottles became positive 1 week before those in the nonshaken bottles, and 16.9% of the shaken cultures were positive more than 2 weeks before their counterparts. A further 46.8% of the agitated specimens became positive while the corresponding nonagitated cultures remained negative. When both specimens became positive at the same time, 88% of the shaken cultures had higher growth indices than their nonshaken counterparts. A further 11 paired blood cultures were taken from patients known to be infected with MAC to assess the effect of agitation of bottles on the utility of making twice-weekly readings during the first 2 weeks of incubation. Ten of the 11 sets of specimens in the shaken bottles were positive 1 or more weeks before those in the corresponding nonshaken bottles. In the remaining set, both specimens became positive on the same day; however, the growth index of the agitated culture was higher.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774298 TI - Antibody levels and in vitro lymphoproliferative responses to Streptococcus pyogenes erythrogenic toxin A and mitogen of patients with rheumatic fever. AB - We investigated the in vitro lymphoproliferative responses to a streptococcal mitogen and erythrogenic toxin A of children with acute rheumatic fever (ARF) and patients with chronic rheumatic heart disease (CRHD). Antibody levels to the streptococcal products were also analyzed in the sera of those with ARF or chronic rheumatic heart disease as well as in the sera of children with streptococcal pharyngitis or poststreptococcal glomerulonephritis. Our results demonstrated that the individuals had depressed lymphoproliferative responses during the active stage of rheumatic fever. The depressed responses were not found either to be induced by time-sensitive mitogen-specific suppressor cells or to be related to a dose-response phenomenon. On the other hand, antibody levels to the extracellular mitogens were significantly elevated in the sera of children with ARF compared with the levels in the rest of the groups. The hyperresponsiveness noted among children with ARF was found to be at a quantitative level and was not due to recognition of more epitopes, as determined by Western blotting (immunoblotting). The profile of immune responsiveness in children with ARF to the streptococcal extracellular mitogens is discussed in relation to the pathogenesis of disease. PMID- 1774300 TI - Rapid purification of hepatitis B virus DNA from serum. AB - We describe two rapid, simple, and reliable procedures for routine purification of hepatitis B virus (HBV) DNA from serum. HBV DNA could be purified from 24 serum samples in 1.5 to 2 h and was recovered in the initial reaction vessel. Both procedures have in common that HBV DNA is complexed with silica particles in the chaotropic agent guanidinium thiocyanate (GuSCN) but differ in lysis conditions and in the conditions used to elute HBV DNA from the silica particles after purification of the silica-DNA complexes. In one procedure (protocol H), serum HBV lysis was mediated by sodium dodecyl sulfate-proteinase treatment and HBV DNA was subsequently complexed with silica particles in the presence of GuSCN. After washing and drying of the silica-DNA complexes, HBV DNA was eluted from the silica particles in a low-salt buffer. In the other procedure (protocol Y*), serum HBV was directly lysed in GuSCN and HBV DNA was simultaneously complexed with silica particles. After washing and drying of the complexes, HBV DNA was eluted by proteinase treatment in low-salt buffer. Omission of proteinase treatment prevented efficient elution, presumably because of copurification of the protein which is covalently bound to the HBV DNA genome. We show, by Southern blot analysis, that HBV DNA could be reproducibly purified from human serum with the same yields by either procedure (30 to 50% relative to a classic procedure) and apparently independent of serum composition. HBV DNA purified by either method was a good substrate in the polymerase chain reaction compared with DNA purified by the classic procedure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774301 TI - Evaluation of a new tube latex agglutination test for detection of type-specific pneumococcal antigens in urine. AB - A modified tube agglutination test using type-specific latex reagents for detection of pneumococcal capsular polysaccharide antigens in alkalinized, unconcentrated urine samples was evaluated in reconstituted urine samples and in groups consisting of 26 children with clinical and roentgenographic evidence of acute lower respiratory tract infection, six patients with blood culture-proven infection of nonpneumococcal etiology, and 30 healthy individuals. The sensitivity of the tube latex agglutination method for pneumococcal polysaccharides was 2 to 10 times higher than that of the slide agglutination method. Positive antigen findings were obtained for 42% of urine samples from patients with acute lower respiratory tract infection but in neither patients with nonpneumococcal septicemia nor healthy controls. Fifty-five percent of the antigen-positive patients also showed evidence of pneumococcal involvement by pneumococcal antibody assay or antigen detection in acute-phase serum. PMID- 1774302 TI - Identification of clinical isolates of gram-negative nonfermentative bacteria by an automated cellular fatty acid identification system. AB - An automated cellular fatty acid (CFA) bacterial identification system, Microbial Identification System (MIS; Microbial ID, Newark, Del.), was compared with a conventional system for the identification of 573 strains of gram-negative nonfermentative bacteria. MIS identifications were based exclusively on the CFA composition following 22 to 26 h of growth at 28 degrees C on Trypticase soy agar. MIS identifications were listed with a confidence measurement (similarity index [SI]) on a scale of 0 to 1.0. A value of greater than or equal to 0.5 was considered a good match. The MIS correctly listed as the first choice 478 of 532 (90%) strains contained in the data base. However, only 314 (59%) had SI values of greater than or equal to 0.5. Of the 54 strains in which there was not agreement, 37 belonged to the genera Acinetobacter, Moraxella, or Alcaligenes or were Pseudomonas pickettii. Reproducibility studies suggest that SI variation is most likely a function of a difference in culture age at the time of analysis, which is due to the relatively low temperature and time of incubation. Other discrepancies were attributable to insufficiently characterized library entries or an inability to differentiate chemotaxonomically closely related species. The MIS, as the first automated CFA identification system, is an accurate, efficient, and relatively rapid method for the identification of gram-negative nonfermentative bacteria. The development of a CFA library with the media and incubation conditions routinely used for the isolation of clinical pathogens could further decrease the identification time and provide an increase in accuracy. PMID- 1774303 TI - Immunodiagnosis of toxocarosis in humans: evaluation of a new enzyme-linked immunosorbent assay kit. AB - Excretory/secretory (E/S) antigen derived from second-stage larvae of Toxocara canis maintained in defined medium in vitro has been well established worldwide for the immunodiagnosis of human toxocarosis by enzyme-linked immunosorbent assay. Such an enzyme-linked immunosorbent assay, based on the detection of human anti-T. canis (E/S antigen) serum immunoglobulin G, has recently been commercialized by Biokema-Affinity Products (Crissier-Lausanne, Switzerland). This commercial test kit was evaluated with regard to its application in a routine diagnostic laboratory and the reliability of the results. Of 78 patients with suspected clinical toxocarosis, 71 had anti-T. canis antibodies (positive serological result) corresponding to a diagnostic sensitivity of 91%; 14% of serum samples (n = 199) from patients with protozoan or with helminthic infections also showed positive reactions mainly related to infections with Trichinella, Strongyloides, and Fasciola species. An epidemiological study with 1,000 serum samples from randomly selected healthy blood donors and children in Switzerland demonstrated a seroprevalence of 2.7%. The test kit under evaluation had an overall diagnostic sensitivity of 91% and a relative specificity of 86%, the latter being related to some protozoan and helminthic infections. Because of the scarcity of such infections, potential cross-reactivity does not play a major role under the conditions found in the middle part of Europe. In conclusion, the application of the test kit provided for use in this study can be recommended for routine diagnostic use. PMID- 1774304 TI - Rapid, low-technology field- and laboratory-applicable enzyme-linked immunosorbent assays for immunodiagnosis of Schistosoma mansoni. AB - Simple and rapid polystyrene- and nitrocellulose-based enzyme-linked immunosorbent assays were developed for detecting antibodies against adult Schistosoma mansoni microsomal antigens. The polystyrene test uses the Nunc Immuno Stick System. A single dilution of the antibody source being tested, the conjugate, and the substrate (3,3',5,5'-tetramethylbenzidine) are placed in tubes. Dried, antigen-coated polystyrene sticks are then exposed to the reagents by immersion. Once the sticks are sensitized, an entire assay can be completed in 8 min. Positive reactions result in a rich blue color in the substrate tube and can be distinguished with the naked eye. In the nitrocellulose-based test, a nitrocellulose sheet with antigen drawn in a line by pen is cut to produce identical strips. The ligand-binding steps and washings are performed in the troughs of incubation trays. The exposure times required for a single dilution of the antibody source being tested, the conjugate, and the substrate (3,3' diaminobenzidine) are 5 min, 5 min, and 7.5 min, respectively. Once sensitized strips are available, an entire assay can be run in 50 min. Both techniques can assay serum or whole blood. The characteristics of polystyrene- and nitrocellulose-based techniques allow them to be used successfully in field studies and in minimally equipped laboratories. PMID- 1774305 TI - Protein X of Streptococcus agalactiae induces opsonic antibodies in cows. AB - Protein X of Streptococcus agalactiae is a surface protein frequently associated with strains isolated from cases of mastitis of dairy cows. By immunizing cows with purified protein X, we obtained an antibody response which was restricted to X-bearing strains of S. agalactiae in a whole-cell enzyme-linked immunosorbent assay. This response resulted in an increase in the opsonic activity of serum for strains bearing protein X, as assessed through the augmentation of the chemiluminescence response of phagocytosing polymorphonuclear cells and through an increased ingestion of bacteria, although the proportion of ingested bacteria which were killed (about 60%) remained unchanged. Protein X behaved as a target of opsonins and, as such, could be a protective antigen worth incorporating in a vaccine against S. agalactiae mastitis. PMID- 1774306 TI - Effect of beta-estradiol on production of the cell-detaching factor of Trichomonas vaginalis. AB - Despite over 40 years of study, the pathogenetic mechanisms of Trichomonas vaginalis are just starting to be elucidated. We have recently reported that T. vaginalis produces a virulence factor, cell-detaching factor (CDF), that likely causes the cell sloughing seen in clinical disease. This 200-kDa glycoprotein is acid and heat labile and correlates with clinical symptoms. We applied a McCoy cell culture system to study the effects of various concentrations of beta estradiol (10(-6) to 10(-10) M) on T. vaginalis growth and CDF production. T. vaginalis growth was unaffected by the different concentrations of beta-estradiol studied, in comparison with the growth of control cultures without beta estradiol. However, beta-estradiol significantly diminished the activity of CDF at all concentrations and did so most profoundly at 10(-7) and 10(-8) M (P less than 0.0001). This suggests that the symptoms of T. vaginalis infection may be influenced by the vaginal concentration of estrogens, and further studies of the interactions between T. vaginalis and estrogens are warranted. PMID- 1774307 TI - Identification of Mycobacterium gordonae from culture by the Gen-Probe Rapid Diagnostic System: evaluation of 218 isolates and potential sources of false negative results. AB - The Mycobacterium gordonae Rapid Diagnostic System (Gen-Probe, Inc., San Diego, Calif.) was evaluated for sensitivity and specificity as well as for its application in the mycobacteriology laboratory. An 125I-labeled cDNA probe complementary to rRNA was employed. Hybridization of greater than or equal to 10% was considered positive. A total of 218 mycobacterial isolates, including 159 isolates of M. gordonae, were tested. Under optimum conditions, the specificity and sensitivity of the probe were 100 and 98.7%, respectively. A number of discrepancies were observed between the probe and conventional biochemical results in one laboratory. Further studies, designed to resolve these discrepancies, revealed a number of potential technical pitfalls. Hybridization incubation temperatures that varied from the manufacturer's recommended optimum, culture suspensions below the density of a no. 1 McFarland nephelometer standard, and extended storage times of culture suspension all adversely affected the final hybridization values. Additionally, it was determined that in one laboratory incorrect functioning of the sonicator caused false-negative hybridization values. The manufacturer's recommendations should be strictly followed, and the performance of the sonicator should be checked on a scheduled basis. Results show that the probe will allow fast and accurate identification of M. gordonae, thus eliminating time-consuming biochemical testing of this organism. PMID- 1774308 TI - Mycetoma of the foot caused by Cylindrocarpon destructans. AB - A 39-year-old male, originally from Antigua, West Indies, presented with a 12 year history of swelling of the left foot. A pathogen could not be recovered in cultures of three surgical biopsy specimens. During follow-up, pus and grains were expressed from a draining sinus tract and Cylindrocarpon destructans grew in pure culture. Retrospective examination of histologic sections of tissue removed during the third biopsy demonstrated a grain characteristic of eumycotic mycetoma. Although the fungus was susceptible to amphotericin B and ketoconazole in vitro, the patient refused treatment, and the clinical course over almost 19 years has been one of slow but progressive bone destruction. The fungus was identified by its microconidial morphology, the presence of chlamydospores, and an intense brown diffusible pigment. It was compared with another poorly known agent of white grain mycetoma, Phialophora cyanescens, characterized by phialidic conidia, chlamydospores in aggregations, and an intense diffusing pigment. The new combination Cylindrocarpon cyanescens (de Vries et al.) Sigler comb. nov. is proposed. PMID- 1774309 TI - Enzyme immunoassays for invasive Candida infections: reactivity of somatic antigens of Candida albicans. AB - The main problem encountered with serodiagnostic tests for Candida infections is their failure to differentiate between invasive and superficial candidosis. Recent immunoblotting studies suggested that the use of selective somatic proteins of Candida albicans as antigens might be a promising approach toward developing a new generation of serodiagnostic assays. In this study major cytoplasmic protein antigens with molecular weights of 47,000 (47K), 46,000 (46K), 45,000 (45K), and 29,000 (29K) were identified as potential marker antigens for antibody detection in invasive candidosis. Continuous-flow isoelectric focusing was employed to enrich the proteins in two fractions, one of them containing the 47K and 29K proteins and the other one containing predominantly the 47K and 45K major proteins. These antigens and a whole somatic antigen extract were used to establish enzyme immunoassays (EIAs) for antibody detection. Whereas all tests were able to discriminate between patients with invasive candidosis (n = 27) and normal healthy volunteers (n = 167), as proved by graphic marker analysis, the selective antigen EIAs were highly superior to the whole somatic antigen EIA and two serological standard assays (indirect immunofluorescence assay and indirect hemagglutination assay) when a panel of sera from patients with superficial candidosis (n = 34) was used as a negative control group. The use of the 47K-29K antigen fraction allowed the best differentiation between invasive and noninvasive candidosis. The corresponding immunoglobulin G class-specific EIA had a sensitivity of 81.5% and a specificity of 97% for both negative control groups as well. PMID- 1774310 TI - Evaluation of commercial enzyme immunoassays for detection of hepatitis delta antigen and anti-hepatitis delta virus (HDV) and immunoglobulin M anti-HDV antibodies. AB - Panels of hepatitis B virus surface antigen-positive sera from drug abusers were used to evaluate 14 commercial enzyme immunoassays from six companies for detecting hepatitis delta virus (HDV) markers. For detecting hepatitis delta virus antigen (HDAg), the Wellcome, Pasteur and Noctech assays had 100% sensitivity for all 42 HDAg-positive serum specimens that were confirmed in house; the Organon reagents gave 59.5% sensitivity without detergent and 64.3% sensitivity with detergent, but there were 14 discrepant results with and without detergent. The Sorin assay detected HDAg in only 10 of the positive samples (23.8% sensitivity). For the detection of antibody to HDV (anti-HDV) all six commercial enzyme immunoassays were reactive with all 36 anti-HDV-positive specimens that were confirmed in-house. There were no false-positive results with the Wellcome, Noctech, or Sorin assay, but one specimen was false positive by the Organon assay. One HDAg-positive specimen gave a false anti-HDV-positive result in the Abbott assay and an equivocal result in the Pasteur assay (97.8% specificity). For the detection of immunoglobulin M anti-HDV, the Wellcome, Noctech, and Sorin assays agreed for the 38 positives confirmed in-house, except for one false negative with the Sorin test. We conclude that there has been a substantial improvement over previously evaluated assays in sensitivity and specificity of commercial assays for anti-HDV detection, and the sensitivities of immunoglobulin M anti-HDV assays are also comparable. However, there are still major differences in sensitivity among some assays for HDAg detection. PMID- 1774311 TI - Diagnostic potential of baculovirus-expressed rubella virus envelope proteins. AB - The envelope glycoproteins E1 and E2 of rubella virus were abundantly expressed in Spodoptera frugiperda Sf9 insect cells by using a baculovirus expression vector. The recombinant protein products were purified by immunoaffinity chromatography and characterized by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, immunoblotting, and enzyme immunoassay (EIA). The purified recombinant antigen consisted of the envelope polypeptides, corresponding to the viral E1 and E2 proteins, and a polyprotein precursor (molecular mass, 90 to 95 kDa). The antigen was reactive with human convalescent-phase sera in immunoblot analysis, and the reactivity correlated well (r = 0.861) with that of a whole virus antigen when tested by EIA by using a total of 106 rubella virus immunoglobulin G-positive and -negative serum specimens. When the sera from patients with recent rubella virus infection were tested with the recombinant glycoproteins by EIA, the correlation was not as close (r = 0.690). However, all of the 26 serum specimens were reactive with the recombinant antigen. The results demonstrate that these bioengineered antigens have a potential for use in routine diagnostic assays of rubella virus immunity and recent infection. PMID- 1774312 TI - Normally saprobic cryptococci isolated from Cryptococcus neoformans infections. AB - We report two cases in which Cryptococcus laurentii was isolated from surgically resected pulmonary lesions but the cryptococcal cells is tissue reacted positively with a specific fluorescent antibody (FA) conjugate for Cryptococcus neoformans. Both patients had no apparent host defense defects. In both cases, multiple cryptococcal isolates were obtained from tissue, and yeastlike cells consistent with C. neoformans were seen in direct histology. The isolates were identified by assimilation patterns and standard procedures including phenoloxidase reactions. Since C. laurentii was consistently isolated by using stringent procedures, it was considered unlikely that the fungus represented surgical or laboratory contamination. Its presence may be the result of dual infection not detected by FA, but other possible explanations exist. The results show the value of the FA test in diagnostic mycology and call into question previous reports of cryptococci other than C. neoformans as agents of infection. PMID- 1774313 TI - Colonization factors of enterotoxigenic Escherichia coli isolated from children with diarrhea in Argentina. AB - A prospective study was performed to evaluate the presence of colonization factor antigens (CFAs) in enterotoxigenic Escherichia coli (ETEC) strains isolated from 1,211 children with diarrhea in Argentina. One hundred nine ETEC strains that were isolated from seven different laboratories in various regions of the country were tested for CFAs by using monoclonal antibodies against CFA/I and E. coli surface antigens CS1, CS2, and CS3 of CFA/II and CS4 and CS5 of CFA/IV; a polyclonal antiserum against CS6 was used. The CFAs searched for were found in 52% of the ETEC strains: 23% of the strains carried CFA/I, 17% carried CFA/IV, and 12% carried CFA/II. All of the CFA/I strains produced heat-stable enterotoxin, and several of them were of the prevalent serotypes O153:H45 and O78:H12. Among the 19 strains expressing CFA/IV, 16 expressed CS5 and CS6 and produced the heat-stable enterotoxin and most were of serotype O128:H21; the remaining 3 strains produced CS6 only. No ETEC strains expressing CS4 were found. Most (11 of 13) of the CFA/II-carrying ETEC strains expressed CS1 and CS3, and 10 of them were of the O6:K15:H16 serotype and produced both heat-labile and heat stable toxins. As many as 24 of the 109 CFA-negative ETEC strains gave mannose resistant hemagglutination with erythrocytes from different species; 4 strains had high surface hydrophobicity, suggesting the presence of additional, as yet undefined, colonization factors in up to 25% of the ETEC isolates. PMID- 1774314 TI - Characterization of murine monoclonal antibodies against serogroup B salmonellae and application as serotyping reagents. AB - Six murine hybridoma monoclonal antibodies reactive with lipopolysaccharide antigens of Salmonella typhimurium were obtained from a fusion of immune spleen cells from mice immunized with S. typhimurium and NS1 myeloma cells. Four antibodies appeared to be specific for serogroup B salmonellae, while the remaining two antibodies were found to be cross-reactive with Salmonella paratyphi A. The exquisite specificities of the Salmonella serogroup B monoclonal antibodies were demonstrated by their unique reactivities with different serotypes of group B salmonellae but with neither other O serogroups of salmonellae nor a wide spectrum of standard strains of other bacterial species. Serotyping of salmonella strains by the slide agglutination method with two of the serogroup B-specific monoclonal antibodies demonstrated their usefulness as serotyping reagents for the identification of serogroup B salmonellae in a routine diagnostic bacteriology laboratory. PMID- 1774315 TI - Maternal immunity and antibody response of neonatal mice to pneumococcal type 19F polysaccharide. AB - The effect of immunization of mothers on the antibody response of their young to pneumococcal type 19F polysaccharide was studied. When 2-week-old BALB/c mice from mothers immunized with 23-valent pneumococcal vaccine during gestation were given an additional dose of the same vaccine, mouse pneumococcal antiserum, or both, they produced higher titers of antibodies to the 19F polysaccharide (1.87 to 4.66 micrograms of 19F immunoglobulin M [IgM] antibody per ml of serum; 0.45 to 0.81 micrograms of IgG antibody per ml of serum) than the control group that did not receive any treatment after birth (0.69 micrograms of 19F IgM antibody per ml; 0.28 micrograms of 19F IgG antibody per ml) (P less than 0.01). Furthermore, all 11- to 12-week-old monkeys that received an additional dose of 23-valent vaccine, pneumococcal immunoglobulin, or both produced statistically higher titers of IgG antibody to the 19F polysaccharide than did controls at various ages. The titers (micrograms of IgG antibody per milliliter of serum) were as follows: vaccine group, 7.12 +/- 0.96; control group at 4 months of age, 3.82 +/- 0.74 (P less than 0.01); immunoglobulin-treated group, 6.85 +/- 0.76; vaccinated and immunoglobulin-treated group, 7.80 +/- 1.40; control group at 3 months of age, 3.01 +/- 0.61 (P less than 0.01). These results suggest that immunization of mothers under certain conditions, such as with an optimum dose of antigen at a critical period of gestation or postnatal development, could provide young infants with an enhanced antibody response to pneumococcal polysaccharide immunogens. PMID- 1774317 TI - Isolation and continuous culture of Neorickettsia helminthoeca in a macrophage cell line. AB - Experimental evidence is presented supporting the development of a system for the isolation and propagation of a Neorickettsia sp. in a continuous canine macrophage cell line (DH82). To isolate a Neorickettsia sp. pathogenic to the canine species, three naive dogs were fed metacercaria-encysted kidneys of salmon caught in a river where infection of metacercariae with Neorickettsia helminthoeca has been circumstantially known for decades. Clinically, the classic course of salmon poisoning disease developed in all of the dogs. Parasitemia began on day 8 to 11 postinfection, when the dogs developed a febrile peak, and continued until euthanasia. At necropsy, characteristic gross and microscopic lesions of the disease were present. A Neorickettsia sp. was also isolated from liver and spleen samples of these animals. The isolates have been continuously propagated and passed in DH82 cells for more than 6 months. Electron microscopic examination confirmed that the rickettsial organisms multiplied in the membrane bound compartment of DH82 cells and that they morphologically closely resembled rickettsia belonging to the genus Ehrlichia. An indirect fluorescent antibody test using Neorickettsia organisms cultured in DH82 cells showed that all dogs seroconverted 13 to 15 days postinfection. Finally, inoculation of the cell cultured Neorickettsia organisms into a naive dog reproduced clinically typical salmon poisoning disease which was of greater severity and had a more rapid time course than that in the dogs from which the original isolation was made. On the basis of the clinical and pathologic responses of the dogs in our study, we believe that virulent N. helminthoeca was isolated and cultured in a continuous cell line. PMID- 1774316 TI - Detection of Shiga toxin-producing Shigella dysenteriae type 1 and Escherichia coli by using polymerase chain reaction with incorporation of digoxigenin-11 dUTP. AB - A technique has been developed for the detection of Shiga toxin- and Shiga-like toxin type I (ShT/SLT-I)-producing Shigella dysenteriae type 1 and Escherichia coli by using the polymerase chain reaction with the incorporation of digoxigenin 11-dUTP. Target DNA liberated from whole cells was amplified, using primer pairs homologous to the A-subunit genes of ShT/SLT-I. The TTP analog digoxigenin-11 dUTP was incorporated into the reaction mixture, permitting nonradioactive labeling of the amplified DNA. The labeled polymerase chain reaction products were hybridized to specific gene sequences immobilized on a nitrocellulose membrane and detected by using an alkaline phosphatase-conjugated antibody to digoxigenin and the enzyme substrates. Toxin-producing strains of E. coli and S. dysenteriae type 1 were identified as colored spots on the membrane. Because this technique does not require DNA purification, gel electrophoresis, or radioactive DNA probes, it is suitable for the clinical detection of ShT/SLT-I-producing strains of S. dysenteriae type 1 and E. coli. PMID- 1774318 TI - Factors influencing determination of high-level aminoglycoside resistance in Enterococcus faecalis. AB - The ability of seven methods to detect high-level gentamicin (58 strains) and streptomycin resistance (56 strains) among 107 Enterococcus faecalis isolates was investigated at the University of Chicago Medical Center and the University of Nebraska Medical Center. Methods included a standard agar screen plate, high content disk diffusion, Remel (Lenexa, Kans.) EF Synergy Quad plates, standard microdilution panels prepared in house, Pasco MIC Gram-Positive panels (Difco Laboratories, Detroit, Mich.), MicroScan MIC Type 5 dry panels (Baxter Healthcare Corp., MicroScan Div., West Sacramento, Calif.), and Vitek GPS-TA cards (Vitek Systems Inc., Hazelwood, Mo.). Results indicating false resistance were not obtained by any method, and there was 100% agreement between the results of the disk diffusion and standard agar screen methods. Prolonging incubation from 24 to 48 h increased resistance detection for both agar and microdilution screens. EF Synergy Quad plates inoculated with micropipettes detected 100% of the streptomycin- and gentamicin-resistant isolates. Resistance detection for streptomycin and gentamicin, respectively, was 93 and 96% by standard microdilution, 93 and 98% by Pasco panels, 88 and 89% by MicroScan panels, and 88 and 91% by Vitek GPS-TA cards. False susceptibility occurred more frequently with streptomycin-resistant isolates than it did with gentamicin-resistant strains and appeared to be strain related in some instances. The use of an increased inoculum size enhanced resistance detection with these strains, but it complicated interpretation of results and led to the selection of streptomycin-resistant mutants. Until results of further studies delineate optimum test conditions, a delay in the final interpretation of agar and microdilution screen results until 48 h for isolates showing no or light growth at 24 h may help to minimize the occurrence of false susceptibility reporting. PMID- 1774319 TI - Molecular and immunological analysis of a polymorphic periplasmic protein of Borrelia burgdorferi. AB - Borrelia burgdorferi is the causative agent of Lyme disease, a tick-borne spirochetosis with a worldwide prevalence. To assist the categorization and typing of fresh isolates from global foci, we have identified a unique species specific periplasmic protein (P22-A) conserved among all North American and European isolates examined. The gene encoding this antigen was cloned, and the recombinant was used to screen serum collected from experimentally infected animals. Although antibodies were detected in all infected animals at 21 days after inoculation with live, low-passage spirochetes, the response was stronger in other animals that were inoculated with inactivated and lysed bacteria. This result, along with the immune electron microscopy data, suggests P22-A is concentrated in the periplasmic space. The P22-A antigens exhibited size heterogeneity among different isolates, ranging between 20 and 23 kDa, but as a group the P22-A antigens appeared to retain antigenic homogeneity. Thus, P22-A can serve as a structural marker for characterizing new isolates of B. burgdorferi and may prove useful in future serological assays with a mixture of B. burgdorferi-specific antigens. PMID- 1774320 TI - Rapid presumptive identification of black-pigmented gram-negative anaerobic bacteria by using 4-methylumbelliferone derivatives. AB - A rapid method for presumptive identification of black-pigmented gram-negative anaerobic rods was developed. Using filter paper spot tests for indole production, sialidase, alpha-glucosidase, beta-glucosidase, alpha-fucosidase, and trypsinlike enzyme activities, 100% of Porphyromonas gingivalis, Prevotella intermedia, and Bacteroides levii and 89% of Prevotella corporis isolates were correctly identified to the species level. Porphyromonas asaccharolytica and Porphyromonas endodontalis could not be differentiated from each other but could be distinguished from all other species tested. Similarly, Prevotella denticola, Prevotella loescheii, and Prevotella melaninogenica could not be differentiated from each other. The methods described are based on 4-methylumbelliferone derivatives of the various substrates and are simple to perform, rapid (less than 15 min), and applicable to difficult-to-cultivate anaerobic rods. PMID- 1774321 TI - Direct detection of molluscum contagiosum virus in clinical specimens by dot blot hybridization. AB - A dot blot hybridization protocol was developed for the direct detection of molluscum contagiosum virus (MCV) DNA in clinical specimens submitted for virus isolation. Samples were concentrated by high-speed centrifugation and treated with proteinase K; this was followed by a single phenol-chloroform extraction step. The DNA was denatured, and the entire volume was spotted onto a nitrocellulose membrane. A biotinylated DNA probe specific for the BamHI-C region of MCV type 1 was used for hybridization. Evidence of MCV DNA was visualized by using streptavidin alkaline phosphatase conjugate and 5-bromo-4-chloro-3-indolyl phosphate-nitroblue tetrazolium as the substrate. Results showed that nonspecific hybridization does not occur with herpes simplex virus- or orf virus-infected clinical specimens and that dot blotting is more sensitive and reproducible than electron microscopy. PMID- 1774322 TI - Monoclonal antibodies specific for the Escherichia coli heat-stable enterotoxin STb. AB - Protein A-STb and STb-alkaline phosphatase protein fusions were used as immunogen and antigen, respectively, for the generation and screening of monoclonal antibodies to the Escherichia coli heat-stable enterotoxin STb. Following immunization with immunoglobulin G-Sepharose-purified protein A-STb and hybridoma construction, STb-alkaline phosphatase hybrid protein was used in a labeled antigen capture assay to detect the production of STb-specific monoclonal antibody. STb-specific monoclonal antibodies were characterized by using a combination of immunoblotting and synthetic-peptide-based enzyme immunoassay techniques. Four distinct anti-STb antibodies were identified and characterized. PMID- 1774323 TI - Detection and strain differentiation of Chlamydia psittaci mediated by a two-step polymerase chain reaction. AB - Specific and sensitive amplification of major outer membrane protein (MOMP) gene DNA sequences of Chlamydia psittaci was achieved in a two-step polymerase chain reaction. First, oligonucleotide primers specific for 5' and 3' nontranslated regulatory regions of the MOMP gene were used in a polymerase chain reaction to amplify a DNA fragment of approximately 1,400 bp. A portion of this DNA fragment was amplified in a second reaction using a degenerate oligonucleotide primer specific for a DNA sequence contained within the 1,400-bp DNA fragment and one of the first-step primers. This method detected 10 cognate chlamydial genomes. C. psittaci MOMP genes from two avian strains and from mammalian serovars 1, 7, and 8 were amplified and analyzed by restriction endonuclease digestion. MOMP genes from mammalian serovars 2 through 6 and 9 and from strains of C. trachomatis and C. pneumoniae could not be amplified. Restriction endonuclease analysis with HaeIII indicated a close relationship between C. psittaci strains of avian and mammalian serovar 1 lineage, while those of mammalian serovars 7 and 8 exhibited distinct restriction patterns. DNA sequences corresponding to the mammalian serovar 1-wild type parakeet MOMP genotype of C. psittaci were detected in two of seven milk samples from cases of bovine mastitis. PMID- 1774324 TI - Detection by polymerase chain reaction of Treponema pallidum DNA in cerebrospinal fluid from neurosyphilis patients before and after antibiotic treatment. AB - A polymerase chain reaction with nested primer pairs based on the DNA sequence of the 39-kDa bmp gene of Treponema pallidum subsp. pallidum is described. The method allowed the detection of purified T. pallidum DNA equivalent to the amount of DNA in a single bacterium and was specific for T. pallidum subspecies. After concentration of DNA, using diatomaceous earth, it was possible to detect about 100 treponemes in 1 ml of cerebrospinal fluid. Cerebrospinal fluid samples from a total of 29 symptomatic and asymptomatic patients with neurosyphilis were tested for the presence of treponemal DNA before and at various intervals after intravenous treatment with penicillin. Prior to the penicillin treatment, we detected T. pallidum DNA in 5 of 7 patients with acute symptomatic neurosyphilis, in none of the 4 patients with chronic symptomatic neurosyphilis tested before treatment, and in 2 of 16 patients with asymptomatic neurosyphilis. Unexpectedly, T. pallidum DNA was also often detected in cerebrospinal fluid long after intervenous treatment with penicillin, sometimes up to 3 years after therapy. PMID- 1774325 TI - Detection of Pneumocystis carinii sequences by polymerase chain reaction: animal models and clinical application to noninvasive specimens. AB - Pneumocystis carinii is a eukaryotic microbe which causes fatal pneumonia in patients with AIDS. Oligonucleotide primers were used to amplify the 5S rDNA sequence of P. carinii by the polymerase chain reaction (PCR) in various clinical and animal samples. Of 35 independent lung specimens tested, PCR detected the P. carinii sequence in all 23 cases which were known to be P. carinii infected, i.e., 15 from mice, 1 from rat, 3 from human autopsy, and 4 from biopsy of AIDS patients by needle aspiration. The results were consistent with clinical and microscopic diagnosis. The detection was highly sensitive and specific. Direct sequencing of these amplified DNAs revealed homogeneity of 5S rDNA sequences of independent isolates from mice, rats, and humans. Preliminary trials manifested efficacy of the PCR method to detect P. carinii sequences in induced sputum or blood from AIDS patients, the latter case suggesting that P. carinii might enter peripheral blood via phagocytosis or direct intrusion. Development of less invasive or noninvasive PCR diagnostic techniques to detect P. carinii infection would greatly facilitate therapeutic and prophylactic management of P. carinii pneumonia. PMID- 1774326 TI - Pathogenic properties of Edwardsiella species. AB - The pathogenic characteristics of 35 Edwardsiella strains from clinical and environmental sources were investigated. Overall, most Edwardsiella tarda strains were invasive in HEp-2 cell monolayers, produced a cell-associated hemolysin and siderophores, and bound Congo red; many strains also expressed mannose-resistant hemagglutination against guinea pig erythrocytes. Edwardsiella hoshinae strains bound Congo red and were variable in their invasive and hemolytic capabilities while Edwardsiella ictaluri strains did not produce either factor; neither E. hoshinae nor E. ictaluri expressed mannose-resistant hemagglutination nor elaborated siderophores under the tested conditions. Selected strains of each species tested for mouse lethality indicated strain variability in pathogenic potential, with E. tarda strains being the most virulent; 50% lethal doses in individual strains did not correlate with plasmid content, chemotactic motility, serum resistance, or expression of selected enzyme activities. The results suggest some potential important differences in pathogenic properties that may help explain their environmental distribution and ability to cause disease in humans. PMID- 1774327 TI - Outbreak of keratoconjunctivitis due to Salmonella weltevreden in a guinea pig colony. AB - The purpose of this report is to demonstrate that the ability to produce keratoconjunctivitis (KC) is a property found in Salmonella weltevreden. This observation is contrary to previous reports that Salmonella spp. do not produce KC. An outbreak of KC due to S. weltevreden occurred in a guinea pig colony, and the animals carried the organism in the intestinal tract. The same Salmonella serotype that caused an epidemic of diarrhea in humans and a routine laboratory isolate also possessed the ability to induce KC. Unlike Shigella spp. (the prototype organisms positive for KC), S. weltevreden induced KC and bound Congo red dye even when grown at 30 degrees C. It invaded HeLa cells in culture but did not hybridize with a DNA probe for invasiveness of Shigella spp. and enteroinvasive Escherichia coli even though it harbored plasmids. It was susceptible to all the antibiotics tested, was hydrophobic, and showed mannose sensitive hemagglutination. It did not have enterotoxic or cytotoxic activities. PMID- 1774328 TI - Application of an indirect immunofluorescence test for detection of Mycoplasma pneumoniae in respiratory exudates. AB - We prepared polyclonal antibody specific to Mycoplasma pneumoniae and examined the conditions influencing the ability of an indirect immunofluorescence test to detect the specific antigen in respiratory exudates. The antibody did not cross react with normal human serum or with respiratory exudates from 10 healthy persons. Cross-reactivity of the antibody with species of mycoplasmas other than M. genitalium was fully diminished when absorbed with horse serum and yeast extract, components of the culture medium. Though the absorbed antibody cross reacted with M. genitalium, the titer was significantly lower than when tested against M. pneumoniae. Two types of antigen-specific fluorescence were observed in clinical specimens: one is large or small fluorescent granular aggregates found in mucus, and the other is fine fluorescent particles diffused on the entire surface of small epithelial cells. Throat smears from 49 patients with serologically confirmed M. pneumoniae infections were examined by our indirect immunofluorescence method. Positive results were obtained in 42 cases, many of which were positive before a rise in serum antibody titer could be demonstrated, indicating that the method is useful for a preliminary diagnosis at an early stage of the infection. PMID- 1774329 TI - Quantitative analysis of opsonophagocytosis and of killing of Candida albicans by human peripheral blood leukocytes by using flow cytometry. AB - We describe a simple, rapid, automated procedure for measuring opsonophagocytosis and killing of Candida albicans by human peripheral blood leukocytes. Yeast cells are labelled by allowing uptake and cleavage of membrane-permeable bis carboxyethyl-carboxyfluorescein pentaacetoxymethylester to its membrane impermeable fluorescent derivative bis-carboxyethyl-carboxyfluorescein. The yeast cells are added to cell-rich plasma obtained after dextran sedimentation of erythrocytes. Opsonophagocytosis and killing are quantified by using automated fluorescent cell analysis, and the following parameters can be obtained: (i) relative percentage of phagocytes that participate in opsonophagocytosis, (ii) relative percentage of yeast cells that become associated with phagocytes, and (iii) percentage of killing of C. albicans. The first two parameters are obtained through the additional use of a phycoerythrin-conjugated monoclonal antibody that selectively labels monocytes and polymorphonuclear granulocytes in peripheral blood. Killing is assessed by solubilizing blood cells with deoxycholate to liberate yeast cells from the phagocytes. Viable yeast cells retain carboxyfluorescein, but nonviable cells lose the fluorescent marker; thus, the reduction in number of fluorescent particles directly reflects phagocytic killing. Results obtained by the present method correlated excellently with parallel enumerations by colony counting. Test results with seven healthy individuals revealed a marked dissociation between the process of opsonophagocytosis, which was essentially complete after 20 min at 37 degrees C, and killing rates, which were 48% +/- 11% and 63% +/- 9% (standard deviation) after 1 and 2 h, respectively, when yeast cell-to-phagocyte ratios were in the range of 0.5:1 to 2:1. The described assay is unrivaled in simplicity, rapidity, and reproducibility and generates results for a large number of samples within hours. PMID- 1774330 TI - Cross-reacting antigens between Neorickettsia helminthoeca and Ehrlichia species, shown by immunofluorescence and Western immunoblotting. AB - Dogs orally infected with Neorickettsia helminthoeca developed immunoglobulin G titers against Erlichia risticii, Erlichia sennetsu, and Erlichia canis similar to those against N. helminthoeca antigen, as determined by immunofluorescence. Western immunoblotting showed that the major common antigens shared among the microorganisms were 80- or 78-kDa and 64-kDa polypeptides. In contrast, horse anti-E. risticii and anti-E. sennetsu and dog anti-E. canis sera reacted more weakly to N. helminthoeca antigen than to homologous antigens in both immunofluorescence and Western immunoblotting. Antisera raised in other species of animals, i.e., mouse anti-E. canis and rabbit anti-E. risticii and anti-E. sennetsu sera, however, all reacted with the 64-kDa antigen of N. helminthoeca. This strong antigenic cross-reactivity and similarity in Western immunoblotting reaction profiles indicate that N. helminthoeca is antigenically closely related to E. risticii and E. sennetsu and less so to E. canis. In both immunofluorescence and Western immunoblotting, E. canis shared fewer common antigens with E. risticii and E. sennetsu than N. helminthoeca did. It is reasonable to conclude that these results may have both diagnostic and taxonomic significance. PMID- 1774331 TI - Assay for detection of Trypanosoma cruzi antibodies in human sera based on reaction with synthetic peptides. AB - Synthetic peptides modelled according to the amino acid sequences derived from the repeated domains of five Trypanosoma cruzi antigens were used in an immunoradiometric assay to detect antibodies appearing after natural human infections. An enzyme-linked immunosorbent assay and an indirect immunofluorescence assay performed with a complex antigenic mixture from parasites were used as controls. The results indicate that the synthetic peptides were recognized by a large proportion of serum samples collected from 34 patients with Chagas' disease in Chile and point to their possible use in diagnosis. PMID- 1774332 TI - Meningitis caused by Psychrobacter immobilis in an infant. AB - Psychrobacter immobilis was isolated from the cerebrospinal fluid (CSF) and blood of a 2-day-old infant who appeared well except for a fever and a full anterior fontanelle. The infant was treated with antibiotics intravenously. After 48 h, he became afebrile and CSF and blood cultures were negative; he was then discharged. After 96 h of incubation, CSF and blood cultures yielded a gram-negative organism, P. immobilis. The child was readmitted to the hospital, and the same organism was again isolated from his blood and CSF. PMID- 1774333 TI - Chemiluminescence dot blot hybridization assay for detection of B19 parvovirus DNA in human sera. AB - A chemiluminescence dot blot hybridization assay was used for the detection of B19 parvovirus DNA in human sera by using digoxigenin-labeled probes. The probes were revealed immunoenzymatically by use of anti-digoxigenin Fab fragments conjugated with alkaline phosphatase. The chemiluminescence signal was obtained by reacting the labeled probe-target complex with an enzyme-triggerable dioxetane substrate. The emitted photons were detected with instant photographic films. In the search for B19 parvovirus DNA, 2,808 serum samples were analyzed. PMID- 1774334 TI - Detection of equine antibody to Babesia equi merozoite proteins by a monoclonal antibody-based competitive inhibition enzyme-linked immunosorbent assay. AB - A competitive inhibition enzyme-linked immunosorbent assay (CI ELISA) was developed to detect antibody to Babesia equi. One hundred fifty-four equine serum samples from 19 countries were tested for antibody to B. equi by the complement fixation test and by CI ELISA. The CI ELISA and complement fixation test results agreed in 94% (144) of the serum samples tested. The 10 discrepant serum samples were retested and analyzed for ability to immunoprecipitate in vitro translation products from B. equi merozoite mRNA. Five discrepant results were clearly resolved in favor of the CI ELISA, and the remaining five discrepancies were not definitively resolved. PMID- 1774335 TI - Abscess caused by vancomycin-resistant Lactobacillus confusus. AB - Several isolates of vancomycin-resistant Lactobacillus confusus from human sources have been described, but to our knowledge, no well-documented infection attributable to this organism has been published. A thumb abscess caused by this bacterium in a healthy 49-year-old male is reported here. He was successfully treated by surgical drainage and cephalothin. PMID- 1774337 TI - Evaluation of the E test for quantitative antimicrobial susceptibility testing of Helicobacter pylori. AB - The Progressive Diagnostics Manufacturers epsilometer test (E test; AB Biodisk, Solna, Sweden), a quantitative variant of the disk diffusion technique, was evaluated comparatively to an agar dilution method for the antimicrobial susceptibility testing of Helicobacter pylori. A collection of 79 H. pylori clinical strains, including isolates with known resistance to various antimicrobial agents, was tested against 12 different antimicrobial agents. All strains were tested on Columbia agar supplemented with 10% horse blood. Plates were incubated at 37 degrees C in microaerobic atmosphere (5% O2, 10% CO2), and readings were done after 3 days of incubation. In general, E test MICs were easy to interpret and the correlation between MICs by the agar dilution method and the E test was good, with 86 and 99.5% of results being within, respectively, 1 and 2 log2 dilution steps in a total of 936 tests. All strains of H. pylori with documented resistance to the tested agents were detected by the E test. Thus, the E test appears to be an easy and reliable method for determination of MICs of antibiotics for H. pylori, and it may offer an interesting alternative to MIC determination by the agar dilution technique. PMID- 1774336 TI - Outbreak of gut colonization by Pseudomonas aeruginosa in immunocompromised children undergoing total digestive decontamination: analysis by pulsed-field electrophoresis. AB - We analyzed an outbreak of gut colonization by Pseudomonas aeruginosa occurring in an intensive care hematology unit by using conventional typing methods and pulsed-field electrophoresis. In October and November 1989, the feces of four immunocompromised children undergoing total digestive decontamination were colonized by P. aeruginosa. Ten isolates were obtained from the gut flora in pure culture. Retrospective investigations found that one P. aeruginosa isolate from stools of one of the patients was already present at high counts 6 months before the outbreak. This patient had been discharged from the unit in May 1989 and had been readmitted concomitantly with the outbreak. Only pulsed-field electrophoresis could demonstrate that a single epidemic strain was present in the fecal flora of the children. This strain had probably been brought into the unit by the patient with chronic fecal carriage. PMID- 1774338 TI - Levels of cytokines in plasma during Plasmodium falciparum malaria attacks. AB - The variation of levels of tumor necrosis factor, granulocyte-macrophage colony stimulating factor, gamma interferon, neopterin, and interleukin-2 receptors in plasma were monitored in 16 patients presenting with an acute Plasmodium falciparum malaria attack. Relations among cytokine levels and between cytokine levels and hematological and parasitological data were assessed. PMID- 1774339 TI - Elastolytic activity of Bacteroides nodosus isolated from sheep and goats with foot rot. AB - The elastolytic activities of 82 Bacteroides nodosus strains were studied. Two substrates, insoluble elastin and soluble elastin, were used for this purpose. Roughly 15% of the strains which did not digest insoluble elastin were elastolytic with soluble elastin, the latter providing greater sensitivity, speed, and objectivity than its insoluble counterpart. PMID- 1774340 TI - Asymptomatic respiratory tract infection with Chlamydia pneumoniae TWAR. AB - Chlamydia pneumoniae is a newly recognized organism associated with respiratory tract infections. Asymptomatic infection with C. pneumoniae, although it has been suggested to occur, has not been previously documented. We describe two asymptomatic individuals infected with this organism; these infections demonstrate that C. pneumoniae is able to establish a subclinical infection. PMID- 1774341 TI - Selective streptococcal agar versus blood agar for detection of group A beta hemolytic streptococci in patients with acute pharyngitis. AB - In a study on acute pharyngitis in general practice, we compared a selective group A streptococcal agar (ssA) for the recovery of group A beta-hemolytic streptococci (GABHS) with sheep blood agar. All plates were incubated at 36 degrees C in an atmosphere reinforced with 5% CO2 for 48 h with a first reading after 24 h. A total of 197 GABHS isolates were obtained from 721 throat cultures on both media. The recovery of GABHS was significantly higher after 48 h of incubation for both media. With the ssA plate, we detected significantly more GABHS after 24 h as well as after 48 h of incubation. The ssA plate reduced normal flora qualitatively and quantitatively. In conclusion, ssA is more sensitive and specific for the detection of GABHS than sheep blood agar and moreover easier to read. We recommend incubation for 48 h. PMID- 1774343 TI - Pathogenicity of Blastocystis hominis. PMID- 1774342 TI - Comparison of the Clearview Chlamydia test, Chlamydiazyme, and cell culture for detection of Chlamydia trachomatis in women with a low prevalence of infection. AB - Two antigen detection systems, Clearview Chlamydia (Unipath Ltd., Bedford, United Kingdom) and Chlamydiazyme (Abbott Laboratories, North Chicago, Ill.), were compared with culture for the diagnosis of chlamydia infection in women attending gynecological clinics. Chlamydia trachomatis was isolated from 43 (4.5%) of the 965 women tested. In comparison with tissue culture, the Clearview Chlamydia and Chlamydiazyme tests had sensitivities of 79.0 and 74.4%, respectively, and both had a specificity of 99.6%. The results show that the Clearview Chlamydia test is comparable to Chlamydiazyme for the detection of C. trachomatis from endocervical specimens in a population with a low prevalence of infection. PMID- 1774344 TI - Referral keeping in homeless women. AB - We examined factors associated with referral keeping among 118 homeless women screened for health care needs in Seattle. Referral keeping for medical conditions among the homeless was comparable to rates found in general low-income populations (62 percent vs. 65 percent), but their proportion of kept referrals for preventive care was much lower (22 percent vs. 44-51 percent). Referral keeping varied directly with symptom severity. Consistent with this finding was that among interviewed subjects who did not keep the index referral, 37 percent kept other referrals for more severe problems or if the condition worsened. Personal stresses and competing priorities, weighted against perceived medical urgency, were the major factors influencing referral keeping. Screener encouragement and communication of medical urgency were indicated by one-third of the subjects who kept referrals as providing important motivation for treatment. PMID- 1774345 TI - Gay identity and risky sexual behavior related to the AIDS threat. AB - This paper explores the relationship between risky sexual behavior and issues of gay identity in homosexual men. We identify three main conceptual categories important to gay identity: sexual identity, gay social interaction, and identity development milestones. Each of these categories are analyzed as to their predictive effect on risky sexual behavior related to the threat of HIV, at six month and eighteen-month intervals. The results suggest that successful integration into a gay network plays a role in reducing risky sexual behavior among homosexual men, regardless of the chronological timing of personal events marking a gay man's "coming out" history. PMID- 1774346 TI - Obstacles to and future goals of ten comprehensive community health promotion projects. AB - Over 100 project staff, community coalition members, and other representatives from 10 comprehensive community health promotion projects in the western United States were surveyed two years into a three year funding cycle about: (1) the problems or obstacles they judged as preventing successful completion of their current goals and objectives, and (2) future goals and objectives they envisioned for their projects. The key issues confronting respondents were diverse, although issues around the process of implementing community health promotion programs were cited more frequently than issues related to the content of health promotion. When respondents were asked to prioritize Future Goals in the second survey, consensus across communities was obtained despite broad differences in the type of community surveyed and the health problem targeted. This study identifies the common organizational and community development problems faced by newly emerging community health promotion programs and has implications for other communities involved in designing, implementing, and evaluating community-wide health promotion programs. PMID- 1774347 TI - Cervical cancer rates by population size of towns: implications for cancer control programs. AB - Incidence rates and standardized incidence ratios (SIRs) for invasive and in situ cervical cancers diagnosed in 1982-87 were analyzed according to total population size of 148 towns, using data from the population-based Connecticut Tumor Registry. Previous studies have not considered socioeconomic or sociodemographic variables in analyzing cervical cancer rates in urban-rural or population density groups. In multiple regression analyses, increases in SIRs for invasive and in situ cancer from medium-sized to large towns were explained by differences in poverty prevalence or other socio-demographic variables. Nevertheless, cancer screening programs (aimed at preventing invasive cancer through early detection) could be targeted to some extent on the basis of town size category, because larger towns include large numbers of poorer and minority women with higher rates of invasive cervical cancer. SIRs for in situ cancer were significantly elevated in the largest towns (100,000 + total population), and primary prevention programs could target these larger towns with a higher prevalence of poverty. PMID- 1774349 TI - Structure and antigenicity of the skin basement membrane zone. AB - The skin basement membrane zone is comprised of two major ultrastructural regions, four associated structures, and at least 17 different antigens. In this brief review, the ultrastructure, antigenicity, and ontogeny of normal human skin will be discussed in detail, as will alterations in expression or immune response to selected basement membrane components in specific mechanobullous and autoimmune diseases. PMID- 1774348 TI - Traditional birth attendants in an endemic area of tetanus neonatorum in Thailand: pitfalls in the control program. AB - A survey of the characteristics of traditional birth attendants in Krabi Province, Thailand, where the incidence rate of tetanus neonatorum was the highest in the country, was conducted in order to obtain background information necessary for planning a training curriculum and to evaluate previous training courses. Five second year medical students were used as research assistants. After the questionnaire was constructed and tested, the students went to visit a sample of 116 traditional birth attendants (TBAs) to interview them about their personal backgrounds, techniques and practices in delivery and beliefs and attitudes towards midwifery. The study revealed that these TBAs were a mixture of Buddhist and Islamic females whose literacy rate was 53 percent. Ninety-one per cent knew about the availability of an injection for antenatal care at the health center, but only about half knew that it was for tetanus prevention. More than half provided antenatal care at their own home but 85 per cent conducted delivery at the client's home. About eighty per cent of the TBAs claimed that sterilization of instruments was performed. However, dressing of the umbilical cord was done inappropriately using various kinds of powders by about 40 per cent. The majority of TBAs had experience with complicated labors but only 30 per cent were referred, perhaps, due to excessive self-confidence and supernatural beliefs. The trained TBAs possessed a higher level of knowledge of immunization and sterile techniques for cord cutting and dressing of the stumps of the umbilical cord than the untrained group. However, knowledge of sterilization of instruments was not significantly different, indicating a need to improve teaching in this area.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774350 TI - Mast cell degranulation and elastolysis in the early stage of striae distensae. AB - The lesions of nine patients with early striae distensae (SD) during puberty were examined by light and electron microscopy. Specific changes were seen in very early stage SD, and in clinically uninvolved skin 0.5 to 3 cm remote from the edge of the long axis of the SD lesions. Sequential changes of elastolysis accompanied by mast cell degranulation appeared first, followed by an influx of activated macrophages that enveloped fragmented elastic fibers. The relationships among elastic fibers, mast cells, and macrophages seen in the present work suggest their critical roles in the process of SD formation, especially in the early stage. Our results also indicate that the elastic fiber is the primary target of the pathological process, and the abnormalities extend as far as 3 cm beyond the lesion into normal skin. PMID- 1774351 TI - Characterization of the changes in matrix molecules at the dermoepidermal junction in lupus erythematosus. AB - Electron microscopy has revealed that the deposition of immunoglobulin in the skin of lupus erythematosus (LE) patients occurs on and below the basal lamina of the basement membrane (BM). The composition of the BM is now to some extent known, and antibodies have been developed against several of its individual components. In this study, we attempt to elucidate the status of some matrix molecules in the dermoepidermal junction in LE. Lesional and nonlesional skin from LE patients was examined using immunofluorescence microscopy with monoclonal and polyclonal antibodies against 6 matrix molecules. Immuno-electron microscopy using monoclonal antibodies was used to discern changes in type IV and type VII collagen. By immuno-fluorescence microscopy, type IV collagen, type VII collagen, and fibronectin were altered in lesional skin. There was a statistically significant correlation between the presence of immunoglobulin and alteration of type IV collagen and type VII collagen in lesional skin. The alterations in type IV and type VII collagens were confirmed on immuno-electron microscopy which showed fragmentation of staining of both antigenic components, particularly type IV collagen. PMID- 1774352 TI - Pemphigus and the terminal hair follicle. AB - The scalp is frequently involved in the autoimmune skin disease pemphigus. This study demonstrates the distribution of pemphigus antigen in the scalp terminal hair follicle; as well as being found in the epidermis, it is distributed throughout the whole hair follicle outer root sheath and in the dermal bulb matrix cells. The increase in volume of target antigen offered by the follicular epithelium could be a factor determining scalp involvement in pemphigus. PMID- 1774354 TI - DNA ploidy of malignant melanoma determined by image cytometry of fresh frozen and paraffin-embedded tissue. AB - Image analysis of DNA content was performed from single nuclei of melanoma monolayer imprints made from fresh frozen tissue of 14 patients with primary malignant melanoma and 16 patients with local recurrences at the incision site and local or distant metastases. This procedure requires fewer cells and is an advantage when the quantity of tumor available is limited, especially in thin low Breslow depth cutaneous melanomas. Image analysis allowed reproducible measurement of DNA ploidy from 100 cells. The frequency of aneuploidy was similar in primary and metastatic melanomas. Three of 3 patients with euploid primary melanomas showed no evidence of recurrences or metastases, though one died of unrelated disease with short follow-up. The 4 patients with primary melanoma who developed metastases had aneuploid primaries; two of these patients died of metastatic disease. Three of 4 patients with euploid metastatic tumors were free of disease at last follow-up, and 1 patient died with stable disease. Nine of 12 patients with aneuploid tumors died of metastatic disease. The frequency of DNA ploidy in the present image analysis study correlated with previous flow cytometry studies. In 9 patients with primary tumors with a Breslow depth greater than 0.75 mm, the DNA content was also determined in nuclei obtained from formalin-fixed paraffin-embedded tissue. The frequency of aneuploidy was higher in fresh tissue (7 of 9) as compared with paraffin-embedded tissue of the same cases (4 of 9). PMID- 1774353 TI - Ultrastructural localization of HMB-45 binding sites. AB - Three malignant melanomas, two melanoma metastases, two junctional dysplastic nevi, and normal skin were embedded in Lowicryl. Ultrathin sections were incubated with HMB-45 and a gold-labeled anti-mouse antibody. Gold particles indicating the presence of HMB-45 were found in melanosomes Stage 1 and 2 and in the non-melanized portion of melanosomes Stage 3. Melanosomes Stage 4 and melanosome complexes in keratinocytes, as well as in melanophages, were consistently negative. No specific labelling with HMB-45 was seen in eccrine glands of normal skin. PMID- 1774355 TI - Necrotizing eccrine squamous syringometaplasia presenting as acral erythema. AB - Acral erythema (AE) and eccrine squamous syringometaplasia (ESS) are distinctive clinico-pathological entities described in patients receiving chemotherapy for malignancies, mainly myelogenous leukemia. In no case of chemotherapy-induced AE have histopathologic changes of ESS been described. We report a patient with acute myelogenous leukemia who had typical AE due to cytarabine with histopathologic ESS. The latter findings in a case of AE may be a useful diagnostic clue for distinguishing chemotherapy-induced AE from palmo-plantar erythema of graft-vs-host reaction. PMID- 1774356 TI - A new type of connective tissue nevus: isolated exophytic elastoma. AB - An unusual case of isolated exophytic elastic tissue nevi in the scrotal region of a 64-year-old man is described. The histological and ultrastructural findings were those of abundant abnormal elastic fibers and increased reticulin in the dermis. This hamartomatous lesion possesses clinical and histological features previously undescribed in connective tissue nevi. PMID- 1774357 TI - Juxta-clavicular beaded lines: a subepidermal proliferation of sebaceous gland elements. AB - Juxta-clavicular beaded lines typical arise at puberty as an asymptomatic, linear papular eruption involving the neck and supraclavicular areas. This entity appears to be more common in blacks than caucasians, and a female predominance has been noted. Microscopically, the papules noted clinically appear secondary to sebaceous gland hyperplasia, which is particularly prominent in the immediate subepidermal zone. Mild papillated epidermal hyperplasia may be observed. Whereas many regard this entity as an anatomic variant of normal, it may be confused clinically and histologically with a number of pathologic processes. A case of juxtaclavicular beaded lines in a 14-year-old caucasian girl is presented. PMID- 1774358 TI - Cutaneous ganglion cell choristoma. Report of a case. AB - We describe the histological, immunohistochemical, and ultrastructural findings of a cutaneous tumour composed of ganglion cells, without any other proliferating component. As ganglion cells are not normal components of the skin, we propose the term "ganglion cell choristoma" for this lesion. The differential diagnosis of related lesions such as cutaneous ganglioneuroma, well-differentiated metastases from neuroblastoma, autonomic ganglia entrapped by neurofibroma, and reactive processes, and the possible histogenesis of ganglion cell choristoma are discussed. PMID- 1774359 TI - Cutaneous lesions of listeriosis in a newborn. AB - Although HIV-infected patients are commonly infected by organisms that require an intact T cell immune system for control or eradication, there are some exceptions. The intracellular pathogen Listeria monocytogenes is one such organism. Listeriosis occurs primarily in neonates, elderly patients, patients on immune suppressive medications, cancer patients, and during pregnancy. However, listeriosis is an uncommon opportunistic infection in HIV-infected patients. We report a case of listeriosis with cutaneous lesions in a neonate born to an HIV infected woman. PMID- 1774361 TI - Clinical child psychology: perspectives on child and adolescent therapy. PMID- 1774360 TI - Early melanoma: histologic terms. PMID- 1774362 TI - Child therapy training: closing gaps with research and practice. AB - Previous surveys have revealed troubling gaps between training and research and practice in psychotherapy. In this study, a selective review of research on child therapy and therapy training was conducted in order to address questions concerning who, what, how, and when to train child therapists. This review revealed substantial gaps in our current empirical knowledge about child therapy training, but some promising leads as well. A science-based approach to child therapy training is advocated. PMID- 1774363 TI - Child therapy: issues and recommendations. AB - When children or adolescents are clients in receipt of psychological treatment, there are specific issues that require attention. With regard to assessment and diagnosis, researchers and clinicians alike must pay attention to variations across sources of assessment data, the comorbidity of diagnoses, and the potential utility of a "family" (as opposed to child) diagnosis. Considerations of "Who is the client?" and the role of the therapeutic relationship in child therapy are discussed. Specific methodological recommendations regarding randomized clinical trials, control groups, the selection of dependent variables, the manualization of treatments, and the use of tests of clinical and statistical significance are presented. Specific topics for research are recommended. PMID- 1774365 TI - Cultural diversity and treatment of children. AB - The increasing cultural diversity of child clients has produced a cascade of new issues and concerns for psychological practice, theory, and research. Available evidence and pertinent theory are reviewed on such topics as the predictive utility and treatment consequences of ethnic membership, whether treatments should be generic or specific to cultural groups, the degree of privilege that should be accorded to same-culture therapists, and the relative desirability of different modalities of treatment for children of different cultural groups. The concept of cultural compatibility of treatment is explored and evaluated. A broad agenda of hypotheses for research and development is suggested, and some guidelines for clinical practice and policy are proposed. It is concluded that insofar as possible, treatment for all children should be contextualized in their family's and community's structure of meanings, relationships, and language. PMID- 1774364 TI - Effectiveness of psychotherapy with children and adolescents. AB - This article reviews the outcome evidence of psychotherapy for children and adolescents. The questions that guide treatment research, conclusions about alternative treatments, and the impact on different types of problems are reviewed. Alternative treatments for children and adolescents have produced change across a diverse range of emotional and behavioral problems. Progress and advances in treatment research are illustrated by highlighting alternative treatments and factors that contribute to outcome in the treatment of conduct problem children. Although important advances can be readily identified in outcome research, the pace of progress has been thwarted by challenges of the subject matter (e.g., developmental issues, comorbidity, and the diverse parent, family, and other contextual factors in which child dysfunction is embedded) and deficiencies in current research (e.g., ambiguity in the characteristics of the samples, weak statistical power, departure of treatment conditions in research from those that characterize clinical work). Notwithstanding the recency of empirical attention to the topic, progress is evident in developing effective treatments for a wide range of problems. PMID- 1774366 TI - Children in context: the role of the family in child psychotherapy. AB - Over the past several decades, both individual and family-oriented approaches to child therapy have been shown to be of moderate success in reducing children's psychological and behavioral problems. However, the data from comparative outcome research do not yet allow us to determine whether one approach is superior to the other in a broad sense; nor has the research addressed the more prudent question of whether there are specific conditions under which one approach may be preferable to the other. In this article, family factors related to child psychopathology are identified, and it is argued that researchers and clinicians interested in the question of family involvement should increase their focus on the presence of family process variables that may be actively contributing to the child's difficulties. Research issues and clinical guidelines are outlined. PMID- 1774367 TI - Collaboration for child adjustment: issues for school- and clinic-based child psychologists. AB - Therapeutic gains for children may be maximized if the important systems serving their mental health needs develop sophisticated collaborative relationships. School- and clinic-based psychologists may overlook important ways in which they can cooperate. School-based psychologists may not be aware of how to extend or support the therapeutic interventions suggested by other psychologists. Clinic based child therapists may lack a full understanding of both the promise of school-based programs and the constraints under which schools operate. Collaborative efforts between clinic- and school-based practitioners may increase ecologically valid treatment options. This article explores both the gains and the potential pitfalls that may arise when school- and clinic-based practitioners work together. PMID- 1774368 TI - Promoting competent young people in competence-enhancing environments: a systems based perspective on primary prevention. AB - Recent studies indicate that 15-22% of American children and adolescents suffer from diagnosable mental disorders. Researchers estimate that 25-50% engage in risk behaviors for negative health and behavior outcomes, such as drug abuse, unwanted pregnancy, AIDS, delinquency, and school dropout. The prevalence of problem behaviors, as well as current social trends, demands that effective primary prevention programs be developed and disseminated. This article reviews successful family-, school-, and community-based prevention efforts aimed at reducing the incidence and severity of children's psychosocial problems. High quality, comprehensive, competence-promotion programs that focus on both children and their socializing environments represent the state of the art in prevention. Establishing enduring, effective preventive interventions requires increased attention to program design, implementation, and institutionalization. PMID- 1774369 TI - Clinical issues in child and adolescent psychopharmacology. AB - During the past two decades psychopharmacologists have made considerable strides in establishing the safety and efficacy of psychotropic drug therapy for childhood behavior disorders. Most of the research has focused on children with disruptive behavior disorders, autism, or mental retardation, but more recently other disorders such as depression, obsessive compulsive disorder, separation anxiety (school refusal), and Tourette syndrome are also receiving attention. Psychopharmacotherapy has often been a matter of controversy, with most issues pertaining to either the appropriateness of medication (e.g., rationales for treatment, alternative interventions, toxicity, iatrogenic effects) or inadequacies of clinical management (e.g., availability of services, drug assessment procedures, limitations of research). This article presents a brief overview of the safety and efficacy of psychotropic drugs and the issues associated with their use in clinical settings. PMID- 1774370 TI - Liability in child therapy and research. AB - Three areas with special relevance to liability and child therapy are considered: informed consent, confidentiality, and child-abuse reporting laws. In each area, issues that may be confronted in therapy or in research on therapy are discussed, and a sampling of relevant laws is explored. Suggestions for avoiding potential liability and protecting the interests of minor clients are considered. PMID- 1774371 TI - Transgenerational patterns of suicide attempt. AB - The clinical assumption that suicide attempts demonstrate familial aggregation was examined with data from a survey of 2,304 community residents. Approximately 1 in 15 persons (6.6%) in the general population was aware that a parent, sibling, son, or daughter had attempted suicide. Self-reports of suicide attempts were more common among persons with than without a family history of suicide (13.0% vs. 2.8%, p less than .05). Nearly 1 in 4 persons who attempted suicide (24.8%) reported a family history of suicide. In addition to being female and unmarried, respondent mental disorder, parent mental disorder, and parent suicide attempt each exerted independent direct effects on the risk of respondent suicide ideation. Parent attempt was not significantly associated with respondent suicide attempt when a host of risk factors were held constant. Possible mediating factors are discussed, focusing on social isolation as an underlying factor. PMID- 1774372 TI - Issues in the design of studies investigating the behavioral concomitants of foods. AB - This article discusses a number of issues that must be considered when investigating the behavioral effect of foods. These issues include the idiosyncratic response to a specific food, the necessity of identifying the individual sensitive to the food being studied, the necessity of including a washout phase, consideration of withdrawal effects, assessment of change, dietary challenges, and the time parameter necessary for the effect to be demonstrated. These issues must be considered during the design phase to maximize the probability of detecting the true behavioral effect of a specific food or combination of foods. PMID- 1774373 TI - Anticipatory nausea and vomiting in cancer patients. AB - The present study reports on a mediating mechanism for anticipatory nausea and vomiting (ANV) in cancer chemotherapy. ANV is usually explained as a classically conditioned response. However, conditioning models have failed to explain individual variation in ANV susceptibility. On the basis of the positive correlation between degree of autonomic reactivity (AR) and conditionability, it is proposed that individual AR is predictive of ANV development. Of the 31 patients who participated in the study, 74% experienced postinfusion nausea and vomiting (PNV). Of the 23 patients who experienced PNV, 52% developed ANV. AR was recorded in a habituation paradigm before chemotherapy treatment was initiated. The patients in the ANV group showed significantly increased sympathetic reactivity as compared with the no-ANV group, implying that AR is a mediator of ANV development. PMID- 1774374 TI - Relationship of smoking status, energy balance, and body weight: analysis of the Second National Health and Nutrition Examination Survey. AB - The relationship between smoking status and body mass index (weight/height) was evaluated, controlling for demographics, dietary intake, and physical activity. Subjects were 10,778 adult respondents from the Second National Health and Nutrition Examination Survey (NHANES II). Results indicate that never smokers and long-term quitters had similar relative body weights and that low-rate current smokers were not significantly different from never smokers. However, both medium and high-rate current smokers weighed less than nonsmokers and low-rate smokers. When medium- versus high-rate smokers were contrasted, sex interacted with results. Specifically, weight-control properties of smoking were more pronounced in women than men. It is proposed that future research should more closely evaluate metabolic changes as a function of smoking status. PMID- 1774376 TI - The effect of increased mastication by daily gum-chewing on salivary gland output and dental plaque acidogenicity. AB - The effect of increased mastication on plaque metabolism and salivary gland function was determined in 11 human subjects who chewed a sugarless gum for ten minutes of each waking hour for two weeks. Prior to and at the conclusion of the gum-chewing regimen, unstimulated whole saliva and 2% citric-acid-stimulated parotid saliva were collected. Flow rates, pH, and buffer capacity were determined on all saliva samples. In addition, parotid saliva was analyzed for protein concentration and the proteins further studied by SDS-PAGE. The plaque pH response to a 10% sucrose rinse was also measured before and after the regimen. Significant increases were observed in the pH and buffer capacity of unstimulated whole saliva as were similar increases in the flow rate, pH, and buffer capacity of stimulated parotid saliva. Protein concentrations and profiles remained unaffected. In addition, the resting plaque pH and minimum plaque pH reached after a sucrose challenge were both raised significantly, with a significant reduction in the cH area. The results of this study indicate that increased masticatory effort by frequent consumption of sugar-free chewing gum over a prolonged time period resulted in a functional increase in the output of stimulated parotid saliva, as well as in increases in pH and buffer capacity of whole and parotid saliva, which may help to reduce plaque acidogenicity. PMID- 1774377 TI - Permselectivity of sound and carious human dental enamel as measured by membrane potential. AB - A microwell technique was used for determination of the permselectivities of sound and carious enamel in the same slice of tooth. The permselectivity determination was accomplished by drilling microwells in the enamel and filling them with a simulated plaque fluid containing lactate, carbonate, and inorganic ions at concentrations similar to those in resting plaque fluid, but with different concentrations of KCl. The electrical potentials developed across the enamel membrane were measured with microreference electrodes placed in the wells or in the solution outside the tooth. The results showed that the membrane potential was a function of the composition of the solutions separated by the enamel membrane and was independent of the composition of the solutions in the adjacent wells. The enamel was found to be cation-permselective, and sound enamel was more permselective than carious enamel. The flux rate of K+ was estimated from the change in the K+ concentration of the well solution as a function of time. The flux rate and the membrane potential data were used in the Nernst Planck Flux Equation for calculation of the diffusion coefficient of K+ through enamel. The results indicate that the permselectivity of enamel can greatly influence the diffusion of ions through enamel membranes. PMID- 1774375 TI - Cognitive-behavioral stress management intervention buffers distress responses and immunologic changes following notification of HIV-1 seropositivity. AB - Forty-seven asymptomatic, healthy gay men were randomly assigned to a cognitive behavioral stress management (CBSM) condition or an assessment-only control group 5 weeks before being notified of their HIV-1 antibody status. Seventy-two hours before and 1 week after serostatus notification, blood samples and psychometric data were collected. Control subjects showed significant increases in depression, but only slight decrements in mitogen responsivity and lymphocyte cell counts pre to postnotification of seropositivity. Seropositive CBSM Ss did not show significant pre-post changes in depression, but did reveal significant increases in helper-inducer (CD4) and natural killer (CD56) cell counts as well as a slight increment in proliferative responses to phytohemagglutinin (PHA). Individual difference analyses suggest that the psychological buffering and immunomodulating effects of the CBSM manipulation may be attributable, in part, to relaxation skills learned and practiced or to a general willingness to comply with the intervention guidelines. PMID- 1774378 TI - Acid-susceptibility of lesions in bovine enamel after remineralization at different pH values and in the presence of different fluoride concentrations. AB - Artificial caries lesions were created in sound bovine enamel slices demineralized at pH 5.0. The lesions were then remineralized at either pH 5.5 or pH 6.8 in solutions containing either 1.5, 15, or 50 mumol/L fluoride. The remineralized slices were then demineralized at pH 5.0 for investigation of acid susceptibility by means of quantitative microradiography. The results indicated that fluoride, incorporated during the preceding remineralization, had a retarding effect on the demineralization after remineralization, and that for the lowest concentration of fluoride in the remineralizing solution, the inhibitory influence of fluoride depended on the pH of the remineralization solutions used. PMID- 1774379 TI - In vitro demineralization of enamel by F-sensitive and F-resistant mutans streptococci in the presence of 0, 0.05, or 0.5 mmol/L NaF. AB - Lactate production and accompanying enamel demineralization by fluoride-sensitive and fluoride-resistant mutans streptococci were studied in an in vitro demineralization model in the presence of 0, 0.05, or 0.5 mmol/L NaF. The fluoride-resistant strains were derived from laboratory strains or were recently isolated strains from xerostomic patients on high-dose fluoride therapy. The demineralization model was composed of a cell suspension in a glucose-agarose gel overlying a bovine enamel block. Lactate and calcium content of the agarose were determined after 22-hour incubations at 37 degrees C. Fluoride-resistant variants of Streptococcus sobrinus 6715-15 produced less lactate and caused less demineralization than did the parent strain even in the presence of fluoride. On the other hand, fluoride-resistant variants of Streptococcus mutans C180-2 and of S. mutans GS-5 produced more acid and caused greater demineralization than did their respective parent strains, both in the absence and presence of fluoride. Two recently isolated fluoride-resistant S. mutans strains produced more lactate and demineralized enamel more than did two recently isolated S. mutans strains from normal human subjects, both in the presence of 0 and 0.05 mmol/L NaF. It is concluded that adaptation to fluoride resistance does not invariably reduce the cariogenicity of mutans streptococci nor the effectiveness of fluoride in preventing demineralization. PMID- 1774380 TI - In vitro acidogenic potential and mutans streptococci of human smooth-surface plaque associated with initial caries lesions and sound enamel. AB - Samples of human dental plaque were pooled from several "white spot" smooth tooth surface areas as well as from several clinically-sound tooth surface areas in each of 12 caries-positive college students. Each of the two samples from each subject was used for the determination of: (1) pH-lowering potential in vitro involving dispersed plaque suspensions, excess glucose supply, and a 60-minute test, and (2) the proportions of mutans streptococci and lactobacilli. When all subjects were considered, plaques from "white spot" areas, as compared with samples from sound surface areas, were characterized by significantly higher proportions of mutans streptococci, a lower starting ("resting") pH, a faster rate of pH drop between pH 6.0 and 5.0, and a lower minimum pH of the suspension; the lactobacillus proportions were generally very low in both types of plaques. For individual subjects, however, the proportions of mutans streptococci in plaque associated with "white spot" areas showed a wide range (0.001-10.0%), and samples with high as well as low levels of these micro-organisms could exhibit a high rate of pH drop and a low pH minimum. This suggests that, besides mutans streptococci and lactobacilli, other bacteria capable of acidogenesis at a low pH may contribute to the high pH-lowering potential exhibited by many plaques. PMID- 1774381 TI - Mutans streptococci and non-mutans streptococci acidogenic at low pH, and in vitro acidogenic potential of dental plaque in two different areas of the human dentition. AB - Samples of human dental plaque were obtained from sound tooth surfaces in the lower anterior and upper posterior areas of each of 11 subjects with various degrees of caries experience. Both types of plaque were compared for: (1) their pH-lowering potential [pH at 10 and 60 min after sugar addition and the pH drop between 0 and 10 min (delta pH)] with an in vitro method involving dispersed plaque suspensions and excess glucose supply; (2) the proportions of mutans streptococci; and (3) the distribution of the predominant non-mutans streptococci according to their final pH in glucose broth. Compared with plaque from the lower anterior area, plaque from the upper posterior area exhibited a significantly higher pH-lowering potential, i.e., a lower pH at 10 and 60 min and a greater delta pH and significantly higher levels of mutans streptococci. The final pH values for the non-mutans streptococci exhibited a wide range from about 4.4 to over 5.0. The proportions of such organisms designated as capable of acidogenesis at low pH (final pH less than 4.6), whether expressed as a percentage of the total non-mutans streptococci or of the total plaque flora, were significantly increased in plaque from the upper posterior area. The proportions of non-mutans streptococci capable of acidogenesis at low pH in plaque from the upper posterior area were also significantly increased, with decreasing pH values at 10 and 60 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774382 TI - Studies on the subcellular localization of protease and arylaminopeptidase activities in Streptococcus sanguis ATCC 10556. AB - Intact cells of Streptococcus sanguis ATCC 10556 possessed arylaminopeptidases exhibiting activity toward the nitroanilide (NA) derivatives of leucine, alanine, methionine, arginine, or lysine. Weak hydrolytic activity was observed in assays with the NA derivatives of valine, proline, glycine, or glutamic acid. Subcellular localization studies revealed that arylaminopeptidase activities were located in both the cell membrane and cytoplasm. Arylaminopeptidases exhibiting activity toward the leucine, alanine, or methionine NA substrates appeared to be more predominantly associated with the membrane, whereas enzymes exhibiting activity toward arginyl-NA or lysyl-NA were more prevalently located in the cytoplasm. Several results from this study suggest that the membrane-assocaited arginyl and lysyl arylaminopeptidases were located in such a way that their expression was restricted in the intact cell. The addition of 0.5 mol/L NaCl to protoplast preparations derived from mutanolysin-treated cells resulted in an almost complete solubilization of membrane-associated arylaminopeptidase activities. These observations support the conclusion that the association of arylaminopeptidases with the cell membrane may involve hydrophobic or electrostatic interactions, or both. S. sanguis ATCC 10556 also possessed at least one caseinolytic endopeptidase activity. This activity is most likely located near the membrane surface, as no association with the cell wall was evident. The location of membrane-associated endopeptidase and arylaminopeptidase activities, together with intracellular peptidases, is suggested to provide an efficient mechanism for the hydrolysis and subsequent utilization of polypeptide and oligopeptide substrates as sources of amino acids for growth by this microorganism. PMID- 1774383 TI - Changes in acid-phosphate content in enamel mineral during porcine amelogenesis. AB - The present study was undertaken to investigate changes in the acid-phosphate content of porcine enamel mineral during its development and to assess separately the HPO4(2-) pools in labile and stable forms. Enamel samples at the secretory and maturing stages of amelogenesis were obtained from the permanent incisors of five- to six-month-old slaughtered piglets. Human enamel from erupted, extracted teeth, synthetic hydroxyapatite, and carbonatoapatite containing acid phosphate were included as references. The acid-phosphate content of each sample was determined chemically through its pyrolytic conversion to pyrophosphate. The assessment of HPO4(2-) in labile forms was made by analysis of samples preequilibrated with solutions containing 3 mmol/L phosphate at pH11 (to de protonate the HPO4(2-) species on crystal surfaces). The analytical results of porcine enamel samples showed that: (a) the outermost secretory (youngest) enamel contained the highest HPO4(2-), corresponding to about 16% of the total phosphate; (b) the acid-phosphate content decreased gradually to 10% in the inner (older) secretory and to 6% in the maturing tissue; (c) a substantial part of the HPO4(2-) in developing enamel tissue (50-60% of the HPO4(2-) for the secretory enamel) was in labile forms; and (d) the pool of the labile HPO4(2-) decreased with the growth of enamel mineral. In parallel studies with mature human enamel, it was ascertained that the total acid phosphate was only about 3% of the total phosphate, much lower than in developing porcine enamel, and that the labile pool of HPO4(2-) was also small, corresponding to about 15% of the total acid phosphate determined.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774384 TI - The areas of various surfaces in the human mouth from nine years to adulthood. AB - Surface area measurements of five regions of the oral cavity were made from study casts of 57 subjects with an age range from 9.3 to 19 years. While the longitudinal pattern of growth exhibited by the total of the five areas, when subgroups were compared, was characterized by a steady increase to around puberty (13 years), followed by a plateau, different areas showed different patterns of growth. Increase in the surface area of the teeth was associated with the eruption of the second and third molars, whereas the area of the buccal lingual mucosa continued to increase into adult life. The palate, buccal vestibular mucosa, and dorsum of the tongue demonstrated a typically skeletal pattern of growth, i.e., increase until puberty with a rapid cessation thereafter. The results of this study indicate the need for longitudinal data to further knowledge concerning growth of the oral cavity. PMID- 1774385 TI - Dentin bond strength of light-cured glass-ionomer cements. AB - The purpose of this study was to investigate the influence of surface treatments and irradiation conditions on the bond strength of light-cured glass-ionomer cements to dentin. The light-cured glass-ionomer cements used in this study were Vitrabond, XR Ionomer, and Fuji Lining LC. Three experiments were designed to study the influence of the following factors on bond strength to dentin: (1) effect of the surface treatment of the dentin, (2) effect of the irradiation time, (3) effect of an increase in the interval between mixing of the cement and irradiation. Samples were stored in water for 24 hours, after which shear bond testing was performed at a cross-head speed of 1 mm/min. For Vitrabond, the Scotchprep and Gluma 2 treatments gave the greatest shear bond strengths. For XR Ionomer and Fuji Lining LC, the Scotchprep treatment gave the greatest shear bond strengths. The bond strengths for all cements increased with prolonged irradiation time. Bond strengths decreased with a longer elapsed time between mixing and light-curing. This means that light-curing should be done soon after the cement is placed. The failure mode was found to be cohesive in the ionomer. PMID- 1774386 TI - The elastic modulus of the temporomandibular joint disc from adult dogs. AB - The present study was designed to measure the elastic properties of temporomandibular joint (TMJ) discs from six adult dogs. Each disc was divided mediolaterally into medial, middle, and lateral parts. Under tension, the articular disc exhibited a non-linear stress-strain relationship, which could be represented as two lines (two moduli of elasticity) connected at a point of stress around 1.5 MPa. These two elastic moduli of the disc were approximately 44 MPa and 92 MPa in the lower- and higher-stress regions, respectively. Elastic moduli of the articular disc in the middle area were significantly different from that in the lateral area of the disc. The reaction to external force appeared to be different in the medial, middle, and lateral regions of the disc. PMID- 1774387 TI - Reflections on dental research--a proud past and a bright future. PMID- 1774388 TI - High frequency ventilation. PMID- 1774389 TI - High frequency jet ventilation in experimental pulmonary emphysema. AB - The effects of high frequency jet ventilation (HFJV, f = 2 Hz and 8 Hz, I:E = 0.43, FiO2 = 0.4) were studied and compared with intermittent positive pressure ventilation (IPPV, f = 10-14 breaths/min, VT = 15 ml/kg, I:E = 0.5, FiO2 = 0.4) in 8 dogs before and after induction of panlobular emphysema (PLE). PLE increased alveolar-arterial PO2 difference (PA-aO2) during all modes of ventilation, whereas PaCO2 did not change significantly. In both periods of the study, HFJV8 Hz was less effective in terms of CO2-elimination and oxygenation. In the control period, functional residual capacity (FRC) was 937 +/- 212 ml. The increase during HFJV (HFJV2 Hz: 1156 +/- 508 ml, HFJV8 Hz: 1153 +/- 433 ml) did not reach significance (P = 0.09). Closing volume (CV) increased from 1.5 +/- 4.3% of vital capacity (%VC) (IPPV) to 6.3 +/- 7.1%VC (HFJV2 Hz) and 10.8 +/- 9.8% VC (HFJV8 Hz), respectively. In the PLE-period, FRC and CV increased significantly to 1107 +/- 207 ml and 14.1 +/- 7.0% VC respectively during IPPV (P less than 0.05). Application of HFJV neither increased FRC (HFJV2 Hz: 1153 +/- 433 ml, HFJV8 Hz: 1005 +/- 344 nor CV 14.8 +/- 6.0% VC and 13.9 +/- 8.1% VC, respectively). It is concluded that HFJV induces no alveolar overdistension in dogs with emphysematous lungs. PMID- 1774390 TI - Bioimpedance versus thermodilution cardiac output measurement: the Bomed NCCOM3 after coronary bypass surgery. AB - Values obtained for cardiac output (CO) were compared using thermodilution (TD) with those obtained using bioimpedance (Bi) as measured using the Bomed NCCOM3 (Revision 6) in 28 consecutive patients in the first 24 h after coronary artery bypass surgery (CABS). In 46 paired measurements made in the first 12 h after CABS Bi values for CO were significantly lower than TD values, the limits of agreement between the two methods were also unacceptably large (mean Bi 4.38 (SD 1.40) l/min, mean TD 5.46 (SD 1.19) l/min, limits of agreement -3.05 to +0.89). In 55 paired measurements made after 12 h (all in spontaneously breathing patients) there was no significant difference between the two methods and acceptable limits of agreement, mean Bi 5.69 (SD 1.2) l/min mean TD 5.6 (SD 1.2) l/min, limits of agreement -0.99 to +1.17). The significantly lower BiCO values obtained in the first 12 h after CABS show that BiCO measurement is not consistently reliable in the intensive care setting. PMID- 1774391 TI - Acute nondilated anuric obstructive nephropathy on echography: difficult diagnosis in the intensive care unit. AB - Renal echography (RE) is a well recognized, accurate, non-invasive imaging procedure for detecting urinary tract (UT) obstruction in Intensive Care Unit (ICU) patients: a dilated collecting system is usually present but a few cases of nondilated obstructive nephropathy have been previously described. We report the clinical, biological, imaging procedure data and outcome of 6 additional cases of anuric obstructive nephropathy without dilatation on one or more RE. All patients had previous and/or actual history suggestive of UT obstruction. Retrograde ureteropyelography (RUP) was performed in all of them: it provided the diagnosis of obstruction in 4 and was immediately followed by dramatic improvement of renal function in all, including the 2 patients with septic shock from proven or suspected UT origin. The cause of obstruction was a neoplastic retroperitoneal process in 4. We conclude that anuric nondilated obstructive renal failure is not uncommon and should be considered in anuric patients when UT obstruction is likely to occur. The sole visualization of a non-dilated collecting system on RE should lead to repeat RE, especially in hypovolemic anuric patients. RUP provided immediate diagnostic and therapeutic benefits in comparison with other imaging procedures in our series. PMID- 1774392 TI - Prognostic significance of early intracranial and cerebral perfusion pressures in post-cardiac arrest anoxic coma. AB - The prognosis of prolonged cardiac arrests is generally related to brain damage due to the cerebral anoxia. A neurological worsening leading to irreversibility is sometimes associated with an increase in intracranial pressure. We studied for 5 years the early intracranial and cerebral perfusion pressures in 84 patients with deep anoxic coma after cardiac arrest. Intracranial pressure monitoring was set up as soon as possible with an extradural screw over a period of 6 days. No complications occurred using this technique. We recorded the percentage of patients suffering from intracranial pressure peaks over 15 mmHg (a), over 25 mmHg (b) or cerebral perfusion pressures drops under 50 mmHg (c). We obtained during the 1st day of monitoring: (a) 46.4%, (b) 21.4%, (c) 39%; during the 2nd day: (a) 73.6%, (b) 26.3%, (c) 55.9%. Eight patients (9.5%) were still alive after a couple of months, 4 of whom had no neurological sequelae; among the 76 non-survivors 63 (82.9%) had died because of cerebral anoxic damage. A daily comparison between survivors and non-survivors points out that the survivors' intracranial pressures were always lower than in the non-survivors and the survivors' cerebral perfusion pressures higher than in the non-survivors. Moreover, none of the patients showing intracranial peak pressures over 25 mmHg survived without after-effects. It is clear that many patients suffer early periods of high intracranial pressures and low cerebral perfusion pressures leading to a bad neurological prognosis. Intracranial pressure monitoring may allow assessment of patients' neurological status and prognosis after cardiac resuscitation. PMID- 1774393 TI - Continuous arteriovenous haemodiafiltration in the critically ill: influence on major nutrient balances. AB - The impact of continuous arteriovenous haemodiafiltration (CAVHD) on nitrogen, lipid and carbohydrate balance was studied in 9 parenterally fed critically ill patients with acute renal failure. The effects on carbohydrate delivery of varying dialysate glucose concentrations or flow rates were also investigated. The total daily nitrogen loss was a mean of 24.1 g (95% CI 20.9-27.3 g/24 h) with non-urea nitrogen losses of 7.6 g (95% CI 5.6-9.6 g/24 h). Glucose delivery was a mean 5.8 g/h with a dialysate glucose concentration of 1.5% and a flow rate of 1 l/h (95% CI 4.5-7.0 g/h). Carbohydrate delivery increased with increased dialysate glucose concentration (mean 11.4 g/h with 2.5% glucose: 95% CI 9.6-13.1 g/h; mean 14.9 g/h with a 4.25% concentration: 95% CI 10.9-19; and with increased dialysate flow rates (mean 9.6 g/h, 95% CI 6.8-12.4 g/h, using 2 l/h of 1.5% glucose). Only trace amounts of cholesterol and/or triglycerides were detected in occasional ultradiafiltrate samples. CAVHD has an important impact on nitrogen and carbohydrate balance, but not on lipid status. Knowledge of these interactions is crucial for the rational planning of nutritional strategies in the critically ill. PMID- 1774394 TI - Energy expenditure and outcome in patients with multiple organ failure following abdominal surgery. AB - A possible relationship between hypermetabolism (energy expenditure expressed as percentage above the estimated basal metabolic rate) and clinical outcome was investigated in 29 artificially ventilated patients with infection and multiple organ failure following abdominal surgery. The average energy expenditure and hypermetabolism were 126 +/- 19 kJ (30 +/- 5 kcal)/kg/24 h and 36 +/- 12%, respectively. Survivors of the intensive care period (n = 20) had a 15% higher hypermetabolism (41 +/- 11 vs 26 +/- 8%, p less than 0.01) than patients who died in the intensive care unit (n = 9). Six of the patients died after intensive care. On comparing hypermetabolism in survivors (n = 14) and non-survivors (n = 15) of the period of hospitalization, no significant difference was discernible. The results demonstrate that patients with multiple organ failure have a moderate hypermetabolism and suggest that the hypermetabolism is comparatively reduced in patients with a fatal outcome during intensive care. PMID- 1774396 TI - Hyperthermia following cardiopulmonary resuscitation. AB - To clarify the clinical nature of post-resuscitation hyperthermia, we reviewed the charts of 18 patients who had cardiac arrest on arrival and regained cardiovascular stability for a study period of sufficient length. Patients with trauma, burns, poisoning and cerebrovascular accidents were excluded. We analyzed the hyperthermia (above 38 degrees C) occurring in the initial 48 h after resuscitation. After resuscitation, most patients showed a rapid rise in body temperature. Patients with later brain death showed significantly earlier appearance of hyperthermia (6.2 h after cardiac resuscitation; median) and a higher peak temperature (39.8 degrees C; median) compared with patients showing prolonged coma (12.7 h and 38.3 degrees C, respectively). Hyperthermia above 39 degrees C was associated with subsequent brain death. The incidence of factors influencing body temperature did not differ between the brain death and prolonged coma groups. Patients achieving full recovery did not show hyperthermia. In conclusion, hyperthermia is an early indicator of brain damage after resuscitation. PMID- 1774395 TI - Two-stage resuscitation of the cat brain after prolonged cardiac arrest. AB - Following prolonged cardiac arrest, reperfusion of the brain is endangered by the low blood perfusion pressure during the early resuscitation phase. In order to avoid low perfusion brain injury, a two-stage resuscitation protocol was applied to cats submitted to 30 min potassium chloride induced cardiac arrest: first, the heart was resuscitated, followed--after stabilisation of blood pressure--by recirculation of the brain. During cardiac resuscitation the brain was disconnected from the general circulation by inflating a pneumatic cuff around the neck. The results were compared with the outcome of conventional one-stage resuscitation following 15 min cardiac arrest. Cardiac resuscitation was successful in 5 out of 8 animals with 15 min and in 6 out of 13 animals with 30 min cardiac arrest. In successfully resuscitated animals of both groups, brain energy metabolism recovered to normal within 3 h although two-stage resuscitation increased brain ischemia time to 37-61 min. Two-stage resuscitation, in consequence, is a promising approach for revival of the brain after prolonged cardiac arrest. PMID- 1774397 TI - Hemodynamic changes during whole bronchoalveolar lavage in two cases of pulmonary alveolar proteinosis. AB - Five whole bronchoalveolar lavages were performed in 2 patients with pulmonary alveolar proteinosis with continuous monitoring of mixed venous and arterial oxygen saturation. Hemodynamic parameters and gas-exchange status were measured during the different phases of the lavage. In the phase of filled lung, a significant increase of arterial partial pressure (PaO2) and arterial saturation of oxygen were observed, secondary to a decrease in the intrapulmonary shunt. The mean pulmonary arterial pressure, pulmonary vascular resistances and cardiac index were higher during the filling of the lung as compared to the controls. During the empty lung phase, although PaO2 decreased (without reaching statistical significance), due to an increase in the intrapulmonary shunt, the increase in cardiac output during this phase left the oxygen delivery (DO2) unchanged. PMID- 1774398 TI - The effect on serum lipid concentrations of a prolonged infusion of propofol- hypertriglyceridaemia associated with propofol administration. AB - Serum concentrations of triglyceride, cholesterol and high density lipoprotein cholesterol (HDL-cholesterol) were measured in an ICU patient after he had received a 10-day continuous infusion of propofol. No additional parenteral lipid was given in the 72 h prior to initial sampling, but a total of 71 of 10% intralipid had been administered over the remaining 7 days. The total cumulative dose of propofol was 66.1 g (range 0.7-6.4 mg kg-1 h-1). There was no visual appearance of lipaemia. Both the serum triglyceride and cholesterol concentrations increased (triglyceride level increased to 4 times normal whereas the cholesterol elevation was minimal). The HDL-cholesterol concentration decreased. At 72 h after discontinuing the infusion of propofol the triglyceride level remained elevated, the cholesterol concentration had returned to normal and the HDL-cholesterol concentration remained unchanged. The implications of hypertriglyceridaemia are discussed. PMID- 1774399 TI - Sedation by propofol in tetanus--is it a muscular relaxant? AB - We investigated the muscular relaxant properties of propofol in a 54 year-old-man with severe tetanus. Four consecutive boluses of propofol 50 mg i.v. were administered. Mean muscular activity recorded on an electromyography (EMG) decreased from 100 to 10-25 mV within 15 s after each bolus. EMG values were restored to prior levels 10 min after the last bolus. Maximum decrease of muscular activity was observed with propofol blood level between 2.90-3.20 micrograms.ml-1. Neuromuscular function recorded by means of evoked electromyography was not affected by propofol administration. PMID- 1774400 TI - Amrinone for refractory cardiogenic shock following chloroquine poisoning. AB - Cardiac arrhythmias and circulatory collapse account for the high mortality reported after severe chloroquine poisoning. We have recently observed a 17-year old man who ingested an 8 g chloroquine overdose. Cardiac arrest occurred within 1 h. Cardiogenic shock was refractory to epinephrine, dopamine and molar sodium lactate. Amrinone, a bipyridine analog, was then successfully used to improve haemodynamic conditions. PMID- 1774401 TI - Oxalate-induced encephalitis after infusions of sugar surrogates. AB - The case of a 55-year-old female with oxalate-induced lethal encephalitis following infusions of sugar surrogates is reported. Renal failure and subsequent central coma developed following the use of xylitol, fructose and sorbitol above the recommended dosages. The patient died due to raised intracranial pressure. Cerebral damage was caused by encephalitis due to calcium oxalate crystals. Oxalosis induced by sugar surrogates may be explained either by dose-dependent toxic effects or genetically fixed intolerance. PMID- 1774402 TI - On continuous haemofiltration. PMID- 1774403 TI - Mask CPAP and minitracheotomy, a cautionary tale. PMID- 1774404 TI - Abrupt hemodynamic improvement in late septic shock with physiological doses of glucocorticoids. PMID- 1774405 TI - Haemofiltration/haemodialysis in patients with heparin-associated thrombocytopenia. PMID- 1774407 TI - Midazolam for sedation in the paediatric intensive care unit. AB - This retrospective study examines data from 55 patients sedated in a paediatric intensive care unit (PICU) with midazolam. Midazolam sedation was initiated with a bolus of 0.25 mg.kg-1 followed by a continuous infusion of 0.4-4 micrograms.kg 1.min-1. Physiological and metabolic parameters, infusion rates, duration, and sedation scores were monitored. Midazolam infusions were effective in sedating all the children studied during all or part of their PICU admission. The median duration of sedation was 74 h with a range of 4 to 1272 h. Haemodynamics were unchanged. Of the patients 46% were effectively alimented by the enteral route, and enteral alimentation was successful in all patients in whom it was attempted. Unassisted ventilation occurred in 44% of the patients during infusion. Oxygen consumption was 28% lower than in the control. Disadvantages of midazolam infusion have included inability to sedate during extracorporeal membrane oxygenation and development of acute tolerance. PMID- 1774406 TI - Pharmacology of drugs frequently used in ICUs: midazolam and flumazenil. PMID- 1774408 TI - Sedation in the ICU. AB - The effect of midazolam on the induction dose-response curve for alfentanil was studied in non-premedicated ASA physical status I or II patients. The response to the verbal command was used as an end point of anaesthesia. Dose-response curves for midazolam, alfentanil, and their combination were determined with a probit procedure, and compared with algebraic (fractional) analysis of drug interaction. Interaction between midazolam and alfentanil was found to be synergistic (supra additive). The results suggest that the use of this combination is advantageous not only because it helps to achieve different anaesthetic goals with specific drugs (a benzodiazepine for unconsciousness and an opioid for blockade of the responses to noxious stimulation), but also because its components are complementary for unconsciousness. PMID- 1774409 TI - Pattern of acute intoxication in Florence: a comparative investigation. AB - A worldwide analysis of acute intoxications is attempted, trying to weigh their medical and economic burden, and the toll for acute poisonings in terms of morbidity and mortality. The natural history of acute intoxications reveals 2 common patterns, such as the increase in number and the changing profile of acute poisonings. The need for a common taxonomy is emphasised, as a tool to allow a more thorough comparison of the epidemiological records. A deeper insight into the basic mechanisms of acute intoxications is envisaged, with the aim of providing the pharmacological basis of therapeutics in acute poisonings. PMID- 1774410 TI - Flumazenil in the treatment of portal systemic encephalopathy--an overview. AB - Hepatic encephalopathy is a complex neuropsychiatric syndrome associated with acute, subacute and chronic liver failure, involving increased neural inhibition by activation of the GABA/benzodiazepine inhibitory neurotransmitter system. Improvement by GABA and benzodiazepine receptor antagonists as well as by chloride ionophore blockers has been shown in animal experiments. Recent reports indicate that flumazenil may improve hepatic encephalopathy in man. To date 46 episodes of HE in 41 patients have been treated with flumazenil with a short term success rate of 72%. Most of the patients were screened for exogenous benzodiazepines and found negative. These interesting observations should now be investigated in a randomised double-blind controlled study in patients with HE to evaluate the efficiency of this therapy. PMID- 1774411 TI - Normal hearing threshold levels in the low-frequency range determined by an insert earphone. AB - Hearing threshold levels have been determined in the low-frequency range (20-500 Hz) on a group of 30 young normal-hearing subjects using monaural stimulus presentation through an insert earphone (Etymotic Research ER-3A). A retest was performed on half of the group to provide data on test-retest reliability. The mean hearing threshold levels obtained agree closely with the Minimum Audible Field data of ISO 226, however, with some deviation at the very lowest frequencies below 40 Hz. The test-retest difference results yielded mean values that averaged 1.15 dB with an average standard deviation across test frequencies of 3.9 dB. The results show that low-frequency hearing thresholds for pure tones of frequencies from 40 Hz and up can be determined with acceptable validity and reliability by the use of this type of insert earphone. PMID- 1774412 TI - Time-domain observation of otoacoustic emissions during constant tone stimulation. AB - Observation of the otoacoustic emissions (OAEs) evoked during a continuous single stimulus tone have been made on humans using a nonlinear residual time domain technique. The technique, described in this paper, involved the digital summation of responses to contiguous stimulation intervals, some of which included short bursts of a suppressor, or probe, tone. Stimulus intervals are constructed so that both the stimulus and probe tones summed to zero cyclically, leaving a residual response. This residual is attributable to the nonlinearity of the whole acoustic response, as measured in the ear canal, to the stimulus and probe tone complex. A theoretical treatment of this paradigm is presented examining the relation of this residual to the OAE evoked by the stimulus tone. It is shown experimentally that the residual, found at the stimulus tone frequency, has a latency and saturating input-output growth functions indicative of an OAE. The detailed OAE amplitude-versus-frequency variations, and the general latencies of the OAEs in two human ears were measured using both the constant tone evoked residual method described and the click evoked delayed emission method. The results from both methods are in agreement. The frequency-dependent properties of the suppression of the OAE were investigated using various stimuli to probe frequency ratios. The continuous tone time domain residual method has advantages for the observation of stimulus frequency OAEs and for relating these to any distortion product simultaneously generated. PMID- 1774413 TI - Neural correlates of nonmonotonic temporal acuity for voice onset time. AB - Human and chinchilla listeners exhibit nonmonotonic temporal acuity for speech sounds differing in voice onset time (VOT). Characteristics of the neural discharge pattern or of the stimuli themselves that might account for the pattern of temporal acuity have not been described. Responses of chinchilla auditory nerve fibers to syllables from an alveolar VOT continuum were measured. Peak discharge rates and peak response latencies elicited by the syllables with the shortest and longest VOTs were highly variable across groups of neurons with similar characteristic frequencies. For VOTs from the middle of the continuum, peak responses were larger, and response latencies were nearly constant across the same group of neurons. Overall, the magnitude and temporal variability of the responses of populations of primary auditory neurons varied nonmonotonically with VOT, consistent with the pattern of psychophysical temporal acuity for these syllables exhibited by humans and chinchillas. Spectral analyses suggested by the pattern of neural responses indicated that synchronous or correlated spectral cues were available over a wider bandwidth for those syllables from the middle of the continuum for which the neural representation was least variable. PMID- 1774414 TI - Temporal representation of rippled noise in the anteroventral cochlear nucleus of the chinchilla. AB - This paper describes the temporal responses of anteroventral cochlear nucleus (AVCN) units in the chinchilla to rippled noises. Rippled noise is generated when a wideband noise is delayed and added (cos+ noise) or subtracted (cos- noise) to the undelayed noise. Renewal densities were constructed to evaluate synchronous discharges at the delay. In response to rippled noise, AVCN units which show phase locking to best frequency (BF) tones gave renewal densities having major peaks at the delay for cos+ noise, but nulls at the delay for cos- noise. Most AVCN units which did not show BF phase locking gave renewal densities that did not contain features related to the rippled noise delay; a few of these nonphase locked units did show peaks in renewal densities for both cos+ and cos- noises. Synchrony at the rippled noise delay was also demonstrated with evoked potential recording. Autocorrelation functions of the neurophonic potential showed peaks at the rippled noise delay for both cos+ and cos- noises. In addition, peaks could be observed in the autocorrelation functions of neurophonic potentials for rippled noises with delays as short as 1 ms; peaks were never observed in renewal densities of single units for ripple delays as short as 1 ms. The results show that a temporal representation of rippled noise delay does exist in the AVCN and are consistent with current hypotheses regarding functions of AVCN subsystems. The temporal representation of the delay is a presumptive neural code for the pitches of rippled noises. PMID- 1774415 TI - A comparison of steady-state evoked potentials to modulated tones in awake and sleeping humans. AB - Steady-state evoked potential responses were measured to binaural amplitude modulated (AM) and combined amplitude- and frequency-modulated (AM/FM) tones. For awake subjects, AM/FM tones produced larger amplitude responses than did AM tones. Awake and sleeping responses to 30-dB HL AM/FM tones were compared. Response amplitudes were lower during sleep and the extent to which they differed from awake amplitudes was dependent on both carrier and modulation frequencies. Background EEG noise at the stimulus modulation frequency was also reduced during sleep and varied with modulation frequency. A detection efficiency function was used to indicate the modulation frequencies likely to be most suitable for electrical estimation of behavioral threshold. In awake subjects, for all carrier frequencies tested, detection efficiency was highest at a modulation frequency of 45 Hz. In sleeping subjects, the modulation frequency regions of highest efficiency varied with carrier frequency. For carrier frequencies of 250 Hz, 500 Hz, and 1 kHz, the highest efficiencies were found in two modulation frequency regions centered on 45 and 90 Hz. For 2 and 4 kHz, the highest efficiencies were at modulation frequencies above 70 Hz. Sleep stage affected both response amplitude and background EEG noise in a manner that depended on modulation frequency. The results of this study suggest that, for sleeping subjects, modulation frequencies above 70 Hz may be best when using steady-state potentials for hearing threshold estimation. PMID- 1774416 TI - Presbycusis and noise-induced permanent threshold shift. AB - Bies and Hansen [J. Acoust. Soc. Am. 88, 2743-2754 (1990)] have proposed an alternative formulation of the relationship between noise exposure and noise induced hearing impairment to that presented in International Standard ISO 1999, in which they assume that presbycusis and noise-induced permanent threshold shift (NIPTS) are additive on an antilogarithm basis. Data concerning deterioration in hearing threshold levels at 4000 Hz due to aging in war veterans with NIPTS do not support the Bies and Hansen assumption but provide support for the formula for combining presbycusis and NIPTS incorporated in International Standard ISO 1999. PMID- 1774417 TI - Invariance of the Doppler bandwidth with flow displacement in the illuminating field. AB - It is known that if single frequency continuously transmitted ultrasound or electromagnetic energy is reflected from "straight line flow," defined here as one or more scatters moving with constant velocity along an infinite straight line, the Doppler effect will shift the echo spectrum center frequency from the transmitted value, and broaden its bandwidth. It is proved that if such straight line flow is shifted laterally or in range anywhere in the field, i.e., without change of orientation, its Doppler bandwidth remains unchanged. (The "Doppler bandwidth" is here defined as the frequency difference between the extrema of the echo power spectrum.) The theorem holds true even though the time domain echo changes dramatically with motion of the flow path, and is believed to be valid for electromagnetic as well as ultrasound waves. Its implications with respect to flow measurement, as well as preliminary experimental and computational confirmation, will be discussed. PMID- 1774418 TI - Localization of azimuthal sound direction by the great horned owl. PMID- 1774419 TI - Does lithium reduce the mortality of recurrent mood disorders? AB - Numerous follow-up studies have shown that patients with mood disorders who do not receive prophylactic medication are at increased risk of death, particularly from suicide. After 11 years follow-up we compared the mortality of 103 patients attending a lithium clinic with that expected on the basis of age/sex/year specific rates for England and Wales. Only 10 patients died during the study, although the expected number of deaths was 18.31 (P = 0.052, two-tailed) and no deaths from suicide were observed. After correcting for the prevalence of mood disorder in the general population, the relative risk was 0.60 (95% CI 0.29-1.12) which suggests that lithium reverses the excess mortality associated with recurrent mood disorders, including that from suicide. PMID- 1774420 TI - Anthropometric and biochemical assessment of the nutritional state in depression: evidence for lower visceral protein plasma levels in depression. AB - Severe depression is characterized by anorexia and weight loss, symptoms that could endanger the patient's nutritional state. In order to investigate the nutritional state of depressed patients we determined the following in 113 healthy controls and depressed inpatients: (1) anthropometric variables such as body weight, ideal body weight (IBW), percentage of IBW, mean arm circumference, triceps skinfold thickness and arm muscle circumference, and (2) biochemical parameters such as albumin (Alb), prealbumin (Prealb), and transferrin (Tf). We were unable to detect any differences in the anthropometric parameters between healthy controls, minor and major depressed patients. Depressed patients exhibited significantly lower Alb and Tf levels than healthy controls. The drop in both plasma proteins was highly sensitive (72%) and specific (92%) for melancholia. These results may point towards the existence of a disorder in protein homeostasis or protein malnutrition without a marasmic component. PMID- 1774421 TI - Life satisfaction and psychosocial functioning in chronic depression: effect of acute treatment with antidepressants. AB - Social functioning was evaluated in 61 chronically depressed adults with early onset. Patients were treated for 6 weeks in a double-blind trial of phenelzine, imipramine, L-deprenyl, or placebo and functioning was reassessed. The posttreatment social functioning of patients who received drug treatment was superior to the placebo group in the following areas: work functioning, house functioning, relationship with relatives, sex frequency and life satisfaction. These results suggest that psychosocial impairment in some chronic depressives may be a sequaela of depression, rather than a global manifestation of characterological pathology. PMID- 1774422 TI - Event-related potentials and selective attention in major depressive illness. AB - Depressive episodes have been frequently characterized by deficits in information processing efficiency which are particularly evident when required to sustain or focus attention. As cerebral event-related potentials (ERPs) have been shown to reflect various aspects of selective attention and attentional dysfunction, this study attempted to examine ERPs in depressed patients performing a selective auditory attention task. Twenty-nine patients with a diagnosis of major depressive disorder (DSM-III) and 15 normal, non-psychiatric controls served as experimental subjects. Auditory potentials were recorded from the vertex of subjects who listened selectively to a series of tone pips in one ear and ignored concurrent tone pips to the other ear. Tone pips were delivered at short (320-500 ms) interstimulus intervals and subjects were required to detect, within the attended ear, rare 'target' tones of a different pitch than the more frequent 'standard' tones. In addition to behavioral indices of 'hits' and 'false alarms', ERP-derived measures included N1 amplitudes to attended and ignored stimuli, 'coefficients of attention' as calculated from N1 amplitude ratios and the latency onset and amplitude of the 'negative difference' (Nd) wave resulting from the subtraction of attended and ignored waveforms. Behavioral measures indicated that depressed patients were as efficient as controls in task performance and in fact they exhibited a significant left ear advantage in the additional task. Although a significant 'N1 effect' was observed with attended tones eliciting larger amplitudes than unattended tones, ERP measures of selective attention did not tend to differentiate the two groups. PMID- 1774423 TI - Seasonal variation of peripheral thyroid hormone levels in major depression. AB - The seasonal variation in thyroid function tests was examined in 138 patients with major depression. No alterations in thyroxine, free thyroxine index, triiodothyronine, T3 resin uptake and thyrotropin were observed across the four seasons. This applied to both male and female subgroups. These data suggest that seasonality does not account for the wide variability in abnormalities of thyroid function reported in depression. PMID- 1774424 TI - The relationship between perimenstrual depressive mood and depressive illness. AB - In a study of 144 women, mainly self-designated PMS sufferers, the premenstrual depression experienced was, apart from its shorter duration, quantitatively and qualitatively similar to major depressive disorder for a substantial proportion of subjects. The associations with previous history of depression were complex: the severity of premenstrual depression was related to previous history of postnatal depression, whereas its duration (i.e., whether it persisted through longer) was related to a history of treatment with antidepressants. Two independent dimensions are proposed. (i) A menstrual cycle-related factor which in vulnerable women can results in severe and disabling premenstrual dysphoria, and which may be aetiologically related to a subgroup of postnatal depression. (ii) In a minority of women a more general propensity for depressive illness evidence as a tendency for any premenstrual depression to be prolonged. PMID- 1774425 TI - An epidemiological study of REM latency and psychiatric disorders. AB - In an epidemiological population study 87 subjects were studied with home sleep recordings. Nineteen subjects had minor psychiatric disorders: six subjects had a minor depression, six subjects had a generalized anxiety disorder, and seven subjects had a mild vegetative discomfort syndrome. Syndrome profiles of the three groups, using the AMDP system, showed a significantly higher degree of insomnia in the anxiety group than in the depressive group. The mean rapid eye movement (REM) latency in the anxiety group was significantly longer than in the other groups, including normals. The study showed a slight tendency towards a reduced REM latency in the minor depressives, but no statistical significance was obtained. PMID- 1774426 TI - Characterological traits of recovered patients with panic disorder and agoraphobia. AB - Three self-rating personality inventories were administered to 33 patients who had recovered from panic disorder associated with agoraphobia and to 33 healthy subjects matched for sociodemographic variables. The personality inventories comprised the Tridimensional Personality Questionnaire (TPQ), which provides three major dimensions (novelty seeking, harm avoidance and reward dependence), the Anxiety Sensitivity Index (ASI) and the Emotional Inhibition Scale (EIS). Agoraphobic patients reported significantly more TPQ harm avoidance and anxiety sensitivity than controls. Although these findings might have been influenced by residual anxiety symptoms in panic-free patients and could also apply to patients with other anxiety disorders, they suggest that harm avoidance and anxiety sensitivity may be risk factors for developing agoraphobia and panic disorder. There may be overlap between this characterologic cluster and prodromal symptoms of panic disorder with agoraphobia, such as anxiety, phobias and hypochondriasis. PMID- 1774427 TI - The use of conditional probabilities to examine age-period-cohort data: further evidence for a period effect in major depressive disorder. AB - There is growing evidence that rates of major depression have been increasing over this century, with successive birth cohorts showing increased lifetime risks and earlier ages of onset. In this paper, we describe and compare onset rates in six birth cohorts of first degree relatives of probands with affective disorders from the NIMH Collaborative Study, using graphs of conditional probabilities of first onset. There is evidence of a period effect and age-period interaction for both men and women. PMID- 1774428 TI - An analysis of panic symptoms during hypercarbia compared to hypocarbia in patients with panic attacks. AB - Twenty panic disorder patients underwent a 35% CO2 challenge test and a hyperventilation provocation test. CO2-induced anxiety proved to correlate significantly with respiratory symptoms. These symptoms appeared to be considerably more severe during CO2 inhalation than during the hyperventilation provocation test, which induced no significant anxiety. PMID- 1774429 TI - Age and depression. AB - The interaction of age and depression was investigated by comparing differences between elderly (greater than or equal to 60 years old) and younger consecutive in- and out-patient referrals to a tertiary referral mood disorders unit. Older patients with unipolar major depressive episode were more likely to be psychotic and agitated regardless of depressive subtype and less likely to have personality inadequacies or a family history of affective disorder. In this sample, elderly depressives' rating of diagnosis, severity, endogeneity and social impairment were similar, irrespective of age of first onset of depression, but a positive family history and personality abnormalities were less likely in late-onset depressives. PMID- 1774430 TI - Mania and seasonality in the southern hemisphere. AB - Admissions for mania over a 9-year period in New Zealand were analysed, including data from four separate regions spanning nine degrees in latitude. A spring/summer peak of admissions for mania was found. The four regions showed marked, unexpected variability in seasonality. Regression analyses were performed to test the association of admissions for mania, in the month of admission and the previous month, with mean daily temperature, day length, hours of bright sunshine and mean relative humidity plus the rate of change of each of these variables. PMID- 1774431 TI - Effect of antidepressant treatment on platelet 5-HT content and relation to therapeutic outcome in unipolar depressive patients. AB - Platelet 5-HT levels and scores on the 17-item Hamilton Rating Scale for Depression (HRS) were studied in patients with unipolar depression before and after antidepressant treatment. Before treatment there were no differences in platelet 5-HT values or in HRS scores between patients who showed a good and a poor therapeutic response. Repeated administration of 5-HT uptake inhibitors (amitriptyline, clovoxamine, fluvoxamine) for 28 days markedly decreased platelet 5-HT levels. Chronic treatment with trazodone or maprotiline (weak inhibitors of platelet 5-HT uptake) produced no changes in platelet 5-HT levels. No significant correlation was observed between platelet 5-HT concentrations and the HRS scores before or during treatment. The findings suggest that the changes in platelet 5 HT levels after antidepressant treatment are mainly due to the effects of antidepressants on the 5-HT uptake system. PMID- 1774432 TI - Anticryptococcal activity of amphotericin B-stimulated macrophages. AB - Amphotericin B (AmB) and its methyl ester derivative (AME) are immunoadjuvants with macrophage stimulating properties. Cultures containing AmB and murine peritoneal macrophages showed synergistic anticryptococcal activity. The antifungal activity was associated with AmB-stimulated macrophages and with their culture supernatants. Photoinactivation of the residual AmB in the macrophage culture supernatant did not result in the loss of antifungal activity. AmB stimulated macrophage culture supernatants inhibited the growth of C. neoformans in a dose responsive manner and the activity was destroyed by incubation at 100 degrees C but not at 60 degrees C. PMID- 1774433 TI - Interleukin-1 alpha enhances hepatotoxicity of tumor necrosis factor-alpha in galactosamine-sensitized mice. AB - The possible involvement of interleukin-1 alpha (IL-1 alpha) in the pathogenesis of murine hepatitis model induced with galactosamine and lipopolysaccharide (LPS) was investigated. The injection of 10 ng/mouse of LPS in combination with 10 mg/mouse of galactosamine into mice induced hepatic damage at 24 hours. Treatment with anti-mouse IL-1 alpha antiserum 30 min before galactosamine/LPS injection showed a tendency to reduce the liver injury, while pretreatment with anti-mouse tumor necrosis factor-alpha (TNF) antiserum significantly protected mice from liver injury. The use of recombinant murine TNF, instead of LPS, in combination with galactosamine could elicit hepatic damage, whereas recombinant murine IL-1 alpha could not substitute for LPS. However, recombinant murine IL-1 alpha enhanced the hepatotoxic effect of recombinant murine TNF in galactosamine sensitized mice. These results suggest that TNF plays a major role in the pathogenesis of galactosamine/LPS hepatitis in mice and that IL-1 alpha acts synergistically with TNF in this hepatitis model. PMID- 1774434 TI - Effects of the new immunoactive compound FCE 20696 on rat and murine models of autoimmune diseases. AB - FCE 20696 is a new synthetic immunomodulator, capable to induce suppressor cells after repeated oral administrations in mice. We have tested it by oral route in three established models of autoimmunity. Experimental Allergic Encephalomyelitis (EAE) has been induced in rats and FCE 20696 has been given for two weeks before the encephalitogenic stimulus and continued afterwards until the complete recovery. Adjuvant Arthritis (AA) has been induced in rats and FCE 20696 has been given for five weeks starting one week before the induction of the disease. Female NZB/WF1 mice were treated with FCE 20696 biweekly throughout their life, starting from nine weeks of age. In EAE, the compound at dose of 2.5 mg/kg reduced the symptoms of the disease and protected 60% of animals from becoming ill. In the AA model, FCE 20696 at 1.1 mg/kg reduced inflammatory lesions in both the injected and the controlateral legs. NZB/WF1 mice treated with 1.5 mg/kg lived 20 weeks longer than controls and proteinuria of 5 mg/ml or more was delayed by 22 weeks. This drug has a definite value in experimental autoimmunity and seems a good candidate for clinical testing. PMID- 1774435 TI - Modification of mitogen-induced proliferation of murine splenic lymphocytes by in vitro tocopherol. AB - The effect of alpha-tocopherol on in vitro proliferation of murine splenic lymphocyte cultures supplemented with various concentrations of the vitamin has been measured at sub-optimal, optimal and supra-optimal levels of the T-cell mitogen Concanavalin A (Con A). In the concentration range (1-25 micrograms/ml), tocopherol enhanced proliferation when administered up to 24 hours after exposure to sub-optimal and optimal concentrations of Con A; however, at supra-optimal levels of the mitogen, it appeared to inhibit proliferation. In the concentration range 50-100 micrograms/ml, tocopherol supplementation only enhanced proliferation in response to sub-optimal concentration of Con A. The spontaneous proliferation of lymphocytes in the absence of mitogens was increased by tocopherol supplementation at all concentrations tested. In contrast, there appeared to be only slight stimulation of B-cell proliferation in response to optimal concentration of bacterial lipopolysaccharide (LPS) by lower levels of vitamin E. Tocopherol supplementation of cultures over a broad range of concentrations (0.5-100 micrograms/ml) had no significant effect on cell viability before onset of proliferation at 18 hours after exposure to Con A, nor was there evidence of earlier onset of DNA synthesis in response to mitogen in the presence of 5 micrograms/ml of the vitamin. Although macrophage depletion of cultures impaired proliferation induced by Con A, tocopherol supplementation continued to stimulate proliferation at optimal and sub-optimal levels of mitogen. PMID- 1774436 TI - HLA-B8,DR3 T cell impairment is completely restored by in vitro treatment with interleukin-2. AB - The activity of recombinant interleukin-2 (rIL-2) on the in vitro lymphocyte proliferative response to phytohemagglutinin mitogen was investigated in healthy HLA-B8,DR3 positive and negative subjects. The response to mitogen, significantly decreased in HLA-B8,DR3 positive subjects, was completely restored by adding rIL 2. Moreover, in HLA-B8,DR3 positive subjects the in vitro treatment with rIL-2 significantly increased the reduced frequency of mitogen responsive T lymphocyte precursors, as assessed by limiting dilution analysis. These data suggest that a decrease in the size of the pool of T cell precursors able to produce IL-2 is responsible for the impairment of T cell function observed in HLA-B8,DR3 positive subjects. Since in autoimmune diseases it is possible to show the same impairment(s) of T cell functions which can be observed in HLA-B8,DR3 positive subjects, these results could be of practical value for the understanding of pathogenetic mechanism(s) of autoimmune diseases and, in case, for therapeutical purposes. PMID- 1774437 TI - Natural killer (NK) cell generation in bone marrow cultures: role of IL-1 alpha. AB - Previous studies have demonstrated that IL-2 is able to induce the development of NK cells from bone marrow (BM) cultures, and that other cytokines acted synergistically with IL-2 in determining an increase of NK cells development. The addition of TNF alpha greatly enhanced the IL-2-mediated induction of NK effector. However, the effect of IL-2 and TNF alpha could be due to direct stimulation of NK progenitors, or to the endogenous production of other factors, which are then responsible of the development of NK cells. As results show that the mRNA specific for IL-1 alpha could be detected in BM cells cultured with IL 2, but not in that supplemented with IL-2 + TNF alpha, it would seem that this lymphokine plays a role only in IL-2-dependent development of NK cells. Studies with Ab anti-IL-1 alpha, showed that the antibody abrograted the IL-2-driven generation of NK cells, but did not affect the NK differentiation induced by IL-2 + TNF alpha. The cytotoxic cells generated by IL-2 or by IL-2 + TNF alpha had the phenotype of mature NK cells including expression of NK 1.1, asialo GM1, Lyt-5, LFA-1, and Thy-1. These data suggest that in spite of phenotypical and morphological similarity of the cells generated with IL-2 or IL-2 + TNF alpha, the endogenous production of IL-1 alpha, appears functionally important only for the differentiation of NK cells induced by IL-2 alone. PMID- 1774438 TI - Correlation between modification of membrane phospholipids and some biological activity of lymphocytes, neutrophils and macrophages. AB - Our study considered the possibility of modifying the functional response of human neutrophils, of mouse lymphocytes and macrophages treated with phospholipids having different polar groups, different isomerisms with saturated and unsaturated fatty acids from C12 to C20 carbon atoms. The results are as follows. a) Most of the phospholipids containing fatty acids from C12 to C20 cause inhibition of the blastogenic capacity of the polyclonal activators tested. b) The phospholipids tested cause a decrease in adherence of polymorphonuclear leukocytes with the exception of the phosphatidyl-choline containing saturated and unsaturated fatty acids. c) A decrease in polymorphonuclear leukocytes migrational capacity almost always occurs. d) The cells treated with L phosphatidyl-ethanolamine having fatty acids from C14 to C17 show an increase in chemiluminescence; those treated with phosphatidyl-choline and L-phosphatidyl glycerol show a decrease of the chemiluminescence; L-phosphatidic acid and L phosphatidyl-ethanolamine having Microbial fatty acids (FAs) at C16 cause a decrease in the formation of phagolisosomes in the macrophages tested. PMID- 1774439 TI - Hepatic metabolism of vasoactive intestinal polypeptide during liver transplantation in the pig. AB - In order to investigate hepatic clearance of vasoactive intestinal polypeptide we measured its concentration in blood from the common carotid artery, right atrium and portal vein during orthotopic liver transplantation in six pigs. Just after laparotomy we found a significantly higher concentration of vasoactive intestinal polypeptide in portal plasma compared to that of the right atrium (p less than 0.05). This difference was soon eliminated by a fall in portal concentration, and, apart from fluctuations in portal concentration, no significant gradient between portal and atrial blood was recorded during the remaining part of the operation. When portal concentrations exceeded 30 pmol/l, the median reduction after transhepatic passage was 29% (range 16.8%-63.9%), while portal concentrations less than 30 pmol/l had a median reduction of only 6.3% (range 1.4%-16.5%) (p less than 0.05). No gradient between right atrial and systemic arterial blood was recorded. We suggest that a concentration-dependent clearance of splanchnic vasoactive intestinal polypeptide takes place in the porcine liver. PMID- 1774440 TI - A comparison of the direct immunobead test and other tests for sperm antibodies detection. AB - The authors report the results of a correlation study between the direct Immunobead Test (d-IBT) and other techniques for antisperm antibodies detection. The Gelatin Agglutination Test (GAT) and Tray Agglutination Test (TAT) were used to detect antibodies in blood serum and seminal plasma ("indirect methods"). The Direct IgG Mixed Antiglobulin Reaction Test (d-MAR test) was used to detect sperm antibodies bound to the sperm surface ("direct method"). A good concordance between the methods, measured by phi and K tests, was found and satisfactory mathematical models were established by regression analyses. PMID- 1774441 TI - Effect of thyroxine therapy on bone metabolism in substituted hypothyroid patients with normal or suppressed levels of TSH. AB - The statement that pituitary hyperthyroidism reflects peripheral hyperthyroidism is still controversial. To evaluate a possible relationship between the calcium and the thyroid metabolism, 29 women with thyroxine (T4) substituted hypothyroidism were examined. They were separated into two groups, one with normal (0.15 to 6 mU/l) and one with suppressed TSH (less than 0.15 mU/l). All the women were judged euthyroid both by their T4 and T3 and by their clinics. The daily dose of T4 (median 0.15 mg in both groups) had been unchanged and TSH level had been stable during the previous six months. Bone mineral content (BMC) of the lumbar spine, bone mineral density (BMD) of left and right collum femoris, serum alkaline phosphatase activity (AP), serum concentration of osteocalcin (Ost) and urinary excretion of hydroxyproline/creatine (Hpr/crea) were similar in the two groups. Furthermore, sex- hormone-binding-globulin (SHBG) was equal in the two groups, but significantly higher than in normals (p less than 0.01). A significant positive correlation was found between serum Ost and Hpr/crea (p less than 0.05) indicating a balanced state where bone formation equals bone resorption. AP failed to correlate to Ost and Hpr/crea because the AP raises from both bone and liver of bone and liver metabolism whereas the two others predominantly reflect bone metabolism. SHBG, being a marker of liver metabolism, was elevated in both groups, probably because of the oral administration of T4. Our data suggest that euthyroid, T4 substituted patients have a normal calcium metabolism whether TSH levels are suppressed or not. PMID- 1774442 TI - Oxytocin does not modify the prolactin response to metoclopramide in normal women. AB - The present study was undertaken in order to establish whether oxytocin (OT) affects the dopaminergic control of PRL secretion in normal women during follicular, periovulatory and luteal phase of their menstrual cycle. For this purpose, 22 normal women were tested with a lower (1 mg) or higher (10 mg) dose of the dopaminergic antagonist metoclopramide (MCP) with or without the concurrent treatment with OT (2 IU injected plus 0.033 IU/min infused for 2 h). Since OT was found unable to modify the effect of either 1 or 10 mg MCP, in additional experiments the same doses of MCP and OT were administered after dopamine (0.04 micrograms/kg/min for 2 h) infusion. Also in these experimental conditions OT failed to modify the PRL response to MCP. These data argue against a role of OT in modulation of the dopaminergic control of PRL secretion in normal women. PMID- 1774443 TI - Efficacy and tolerability of a long-acting intramuscularly injectable depot preparation of bromocriptine: the results of a double blind study. AB - The tolerability and efficacy of a long-acting im applicable form of bromocriptine (Parlodel LAR) was tested in a double-blind approach in 20 patients with hyperprolactinemia or prolactinoma, 17 of them complaining of persistent side effects on oral treatment with dopamine agonists. The study-code revealed similar characteristics for age, sex, weight, clinical symptoms and previous therapy in both groups but prolactin serum levels were higher in the verum group even though the difference was not significant. In all 10 patients receiving Parlodel LAR prolactin serum concentrations were significantly suppressed and tumor size was reduced in 5 of the 9 patients with visible tumors when controlled after 28 days. In contrast, no significant change in serum prolactin levels was observed in the placebo group and tumor size of all visible tumors was not altered. Side effects typically reported for dopamine agonists started 3 h after application in the verum group and were significantly different to the unspecific side effects reported in the placebo group during the first 72 h. Thereafter systemic tolerability was indistinguishable between both groups. The local tolerability at the injection site was excellent for both, Parlodel LAR and placebo. PMID- 1774445 TI - Doxorubicin for acromegaly: a case report. AB - We report the case of an acromegalic woman, aged 35 years, with a huge GH secreting tumor, repeatedly treated with neurosurgery and radiotherapy, not responsive to bromocriptine (Br) and octreotide (SMS), whose clinical picture evolved to coma due to endocranic hypertension. Since remnant size was too large to be further treated by surgery, chemotherapy with doxorubicin (DOX) (100 mg i.v. every three weeks up to 0.5 mg/m2 over 7 months) was started. Treatment was followed by a rapid improvement of clinical picture with resumption out of coma, progressive decline of GH levels (from 800 ng/ml to 15 ng/ml) and a slight shrinkage of tumor. No side effects were observed during DOX administration. We suggest that in those few acromegalic patients resistant both to SMS and Br, and with poor prognosis, DOX may be effectively used. PMID- 1774444 TI - Transdermal estradiol substitution therapy for the induction of puberty in female hypogonadism. AB - Fifteen patients aged 14.5-27.3 years (mean +/- SE 18.8 +/- 0.9) with pubertal development failure underwent replacement therapy with estradiol (E2) using a transdermal therapeutic system (TTS). Fourteen of them were affected by hypogonadotropic hypogonadism (11 with thalassemia major, 3 with multiple pituitary hormone deficiency), the 15th patient had an asymmetric gonadal dysgenesis (karyotype 45, X 0/46, XY). Two sizes (5 and 10 cm2) of E2 TTS, delivering respectively 25 and 50 micrograms of E2 a day for 3 1/2 days, were used in this study. All patients were initially given the lower dose of 25 micrograms, twice weekly for 3 weeks each month; 6 months after starting therapy, 5-10 mg oral medroxyprogesterone acetate (MPA) daily was added during the third week. Later, the following sequence was used: 25 micrograms E2 TTS (twice weekly), on days 1 through 14, and 50 micrograms E2 TTS (twice weekly), on days 15 through 25 of each month. On days 15 through 25, 5 mg daily of MPA were administered orally. The period of treatment ranged from 0.5 to 3 years. Breast development was obtained in all cases. The vaginal maturation index rose. Ultrasonography showed an increase of uterine size and uterine shape became of pubertal type. Withdrawal bleeding occurred in all patients. Plasma E2 levels rose to normal levels, estrone (E1) levels increased slightly. No change in plasma SHBG levels was observed. Urinary E2, E1 and estriol rose to maximum levels the 3rd day after the application of each system. Neither systemic side effects nor adverse metabolic effects were observed except for an increased sensitivity to the platelet aggregating agents.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774446 TI - Association of a thyrotropin-secreting pituitary adenoma and a thyroid follicular carcinoma. AB - The different factors involved as etiological agents in thyroid cancer have in common long term thyroid follicle stimulation. On this base, a patient with a TSH producing pituitary adenoma could be at high risk for developing thyroid cancer. A patient consulting for a single thyroid nodule was studied in our unit. He was diagnosed as having a TSH-producing pituitary adenoma and the Thyroid nodule was shown to be a follicular carcinoma following removed. We speculate that elevated TSH levels could have contributed to neoplastic transformation of the thyroid in this patient. PMID- 1774447 TI - Urine melatonin in alcoholic patients: a marker of alcohol abuse? AB - Ethanol is known to alter central neurotransmission and endocrine functions. Urine melatonin was studied in 10 male chronic alcoholic patients, before and after two weeks of controlled alcohol abstinence, and in sex and age matched healthy controls. In both groups, 24-hour urines were collected in two fractions corresponding to day- (D) (08:00-20:00) and night- (N) (20:00-08:00) time. Urine melatonin was assayed by RIA after methylene chloride extraction. Twenty-four hour urine melatonin levels were calculated adding up D and N values. In patients during alcohol intake, the 24-hour urine melatonin levels were significantly higher than in controls (p = 0.004, Student's t test). A disruption of the physiological ratio between N and D values was also observed, since the higher melatonin levels occurred in the D fraction. In drinking alcoholics, melatonin D values were significantly higher than the D values found in controls (p less than 0.01, Student's t test) and in the same patients after alcohol withdrawal (p less than 0.05). The N/D ratio approximated 1 during alcohol intake and became larger than 1 after alcohol withdrawal, as in the controls. The melatonin data were correlated with the suppressive effects of dexamethasone (DXT) on cortisol secretion evaluated both during alcohol intake and during abstinence. After alcohol withdrawal, the two (out of 10) patients, who remained unresponsive to the DXT suppression test, showed high D melatonin values and a low N/D ratio. These preliminary data indicate that in chronic alcoholism the pattern of urinary "melatonin- like immunoreactivity" is altered. PMID- 1774448 TI - A simple method for the DNA content assay of culture maintained pancreatic islets of Langerhans. AB - A simple method for assaying DNA content of in vitro culture maintained pancreatic islets is described. By employing lyophilization of the islets and subsequent fluorometric analysis, we have been able to measure DNA from relatively small cell samples. The method may result advantageous, over others, previously reported, since it is less subject to experiment-related interfering conditions. This procedure, which is easy and reliable, even for very low DNA concentrations, seems to be very useful for culture maintained pancreatic islets, since in vitro work conducted with this endocrine tissue is usually associated with small size cell samples. The method may help for a simple assessment of the viable islet cell mass in in vitro studies. PMID- 1774449 TI - Immunodetection of thyroid tumors: role of immuno aggregates. AB - To understand the inconsistent immunodetection of tumors in vivo, a labelled monoclonal antibody (MAb) against a human follicular cancer cell line (UCLA RO 82 W-1) was used as a model for in vitro and in vivo studies. The 131I labelled MAb x RO 82 W-1 bound to its target cells (10% to 70%) mainly because of the generation of immunoglobulin aggregates. Aggregates generated by the freezing process were shown by polyacrylamide gel electrophoresis (PAGE) and their removal by filtration. When the aggregated 131I MAb x RO 82 W-1 was injected into BALB/c mice bearing UCLA RO 82 W-1 tumors, a high tumor/blood ratio was found in the large tumors. The tracer concentrated in the macroscopically visible necrotic part of the tumor was largely responsible for the scintigraphic detection. Irrelevant 131I-IgG also concentrated in necrotic regions of tumors. Scintigraphic detection of thyroid tumors in this model was related to the degree to which labeled aggregates of IgG, regardless of their specificity, localized in necrotic regions of the tumors. PMID- 1774450 TI - Hyperthyroidism due to familial pituitary resistance to thyroid hormone: successful control with 3, 5, 3' triiodothyroacetic associated to propranolol. AB - We herein describe a family with thyroid hormone resistance. Thyroid hormones and basal TSH were elevated. Pituitary tumor or abnormality in thyroid hormone binding proteins were ruled out by appropriate tests. Mother and sister of the propositus presented similar abnormal hormonal features but no hyperthyroidism. Initially the patient was treated with carbimazole (30 mg/day): three months later a dramatic increase in the size of the thyroid gland and in TSH levels (12.5 to 28 mU/l) were noted. Thereafter, dextrothyroxine (D-T4) and 3, 5, 3' triiodothyroacetic acid (TRIAC) were given consecutively and treatment was accompanied by a decrease of TSH levels (2 mU/l) but thyroid hormone remained elevated. The symptoms and signs of hyperthyroidism improved with the addition of propranolol (30-60 mg/day). In conclusion, the present report describes a new family with the syndrome of THR and variable degrees of involvement among relatives. We suggest the usefulness of TRIAC therapy to decrease TSH levels and propranolol to improve thyrotoxicosis due to pituitary resistance to thyroid hormone. PMID- 1774451 TI - Postpartum thyroid dysfunction in an Italian population residing in an area of mild iodine deficiency. AB - We have evaluated the occurrence of postpartum thyroid dysfunction (PPTD) in a group of 372 women residing in area of mild iodine deficiency. Thyroid function and autoimmune status were evaluated by means serum T4, T3, TSH measurement and detecting the presence of positive antithyroglobulin antibodies (AbTg), antimicrosomal antibodies (AbM) and thyroid-peroxidase antibodies (AbTPO) titers in women at parturition, at 1, 3, 6 and 12 months postpartum. New onset transient hypothyroidism occurred in 6.4% of women whereas transient thyrotoxicosis in only 1.8% of women. Transient hypothyroidism was not preceded by thyrotoxicosis as indicated by thyroid function tests and serum Tg concentrations. At parturition, the positivity of AbM and AbTPO titers and the presence of goiter appeared to be a risk factors for the development of PPTD. PMID- 1774452 TI - Ultrasound scanning assessment of L-thyroxine treatment effectiveness in a group of children with diffuse goiter. AB - Ultrasound scanning is an accurate and objective method to assess thyroid volume; therefore it is useful to evaluate the effectiveness of L-thyroxine treatment in reducing goiter size, especially in children where clinical evaluation is inaccurate. In this prospectic study we evaluated the effectiveness of one-year L thyroxine treatment in a group of children with nontoxic diffuse goiter coming from an area with low iodine intake. We examined 11 children (7 females, 4 males), age range 9-14 years. At clinical examination, 6 patients had a goiter classified Ia (according to WHO criteria), 4 had a class Ib and only 1 had a class II goiter. In order to achieve an accurate goiter evaluation, the thyroid volume was determined by ultrasonic scanning with a 5 MHz linear probe before and after treatment. Patients were given a dose of L-thyroxine (1.5-2.0 micrograms/kg/die) in order to significantly reduce serum TSH levels (from 1.8 +/ 0.6 to 0.8 +/- 0.5 mU/l, mean +/- SD). Patients were reexamined at 12 months of therapy and again at 10 months after therapy withdrawal. A significant reduction of the goiter volume (greater than 20%) was obtained in 6/11 (54%) patients, although serum TSH levels were fully suppressed only in one. The mean goiter size reduction in "responders" was -31.2 +/- 9.3% (m +/- SE). After therapy withdrawal goiter size increased in the majority of cases (in 4/11, greater than 20%). Our study demonstrates that L-thyroxine treatment is effective in reducing goiter size in the majority of children with a diffuse goiter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774453 TI - Heterogeneity of serum prolactin in patients with menstrual disorder in conjunction with hyperthyroxinemia. AB - Since the secretion of PRL is regulated by the hypothalamic-pituitary axis, an increase in large molecular size PRL in the serum is most likely due to secretion by the pituitary itself. The present study was performed to investigate the possible occurrence of PRL heterogeneity in 128 subjects with menstrual disorder in conjunction with hyperthyroxinemia (88 with untreated Graves' disease, 40 with subacute thyroiditis) and 50 age- and sex-matched healthy controls. All 128 patients in this study were suffering from amenorrhea or oligomenorrhea at the time of their initial visit. PRL heterogeneity was found in the sera of 5 of 88 (5.7%) patients with untreated Graves' disease, in 2 of 40 (5.0%) patients with subacute thyroiditis, but in none of the normal controls. PRL heterogeneity remained essentially unchanged in patients with Graves' disease over 6 months of treatment; however, in patients with subacute thyroiditis, either big-big PRL or big PRL decreased significantly along with a corresponding increase in little PRL associated with recovery from the illness within 6 months. The menstrual disorders in all patients were restored to normal after restoration to a euthyroid state. The underlying cause of the occurrence of PRL heterogeneity in patients with menstrual disorder in conjunction with hyperthyroxinemia is not known. PMID- 1774454 TI - A case of sparsely granulated growth hormone cell adenoma associated with lymphocytic hypophysitis. AB - Lymphocytic hypophysitis is in itself rare and usually occurs in the postpartum period or the last trimester of pregnancy. It has not been described in combination with a pituitary tumor. A twenty-two year old woman, who had never been pregnant, presented with a history of nine months amenorrhea and spontaneous galactorrhea. She was not taking any medication and had never used oral contraceptives. Physical examination was unremarkable except that whitish fluid could be expressed from both breasts. Her visual fields were normal. Her serum PRL levels was high at 105.7 micrograms/l and increased to 138.4 micrograms/l at 60 minutes in a triple bolus test. GH values were normal and there was no evidence of overproduction of other pituitary hormones. CT scan showed an intrasellar mass with suprasellar extension. A tumor was selectively removed transsphenoidally. Morphologic examination revealed a clinically silent sparsely granulated growth hormone cell adenoma with lymphocytic infiltration of the adjacent pituitary tissue. Postoperatively her menstrual periods resumed and she conceived despite a slightly elevated PRL level. Three months after an uneventful pregnancy and full term delivery her PRL level was 69.9 micrograms/l and increased to 102.2 micrograms/l at 60 min. Basal GH and cortisol levels were normal. She remains well without replacement fourteen months after delivery. This case is of interest because it is the first reported simultaneous occurrence of a pituitary adenoma and lymphocytic hypophysitis and also because the hypophysitis preceded her first pregnancy. PMID- 1774456 TI - Thermometer's acceptance increased slowly. PMID- 1774455 TI - Thyroid consequences of Chernobyl accident in the countries of the European Community. PMID- 1774457 TI - Recent developments in hereditary nephritis (Alport's syndrome). AB - Hereditary nephritis with deafness, or Alport's syndrome, is a familial disorder characterized by progressive renal insufficiency, sensorineural hearing loss and ocular abnormalities. The Alport's nephropathy appears to result from a primary biochemical defect of the glomerular basement membrane, specifically an alteration of type IV collagen. The cardinal clinical manifestation of Alport's is chronic hematuria. End-stage renal disease develops in most affected males, while affected females generally experience a benign renal course. The diagnosis depends on characteristic electron microscopy findings of a variably thickened and thinned glomerular basement membrane with lamellation and basket weaving. Alport's is a genetically heterogeneous disorder with several modes of inheritance. A review of the literature with discussion of the clinical and basic science aspects of hereditary nephritis is presented. PMID- 1774458 TI - Modern management of aneurysmal subarachnoid hemorrhage. AB - This article reviews the modern approach and advances in the management of aneurysmal subarachnoid hemorrhage. Early diagnosis along with aggressive medical and surgical clipping appears to reduce morbidity and mortality. Computed tomography scan is greater than 95% sensitive for diagnosis. Aneurysm clipping within 48 hours has been performed successfully in 44 patients at the Indiana University Medical Center in Indianapolis. Early aneurysm clipping allows a more aggressive approach to managing the 20% to 30% incidence of delayed ischemic vasospasm. These aggressive treatments include transcranial Doppler analysis, volume expansion, hypertensive therapy, hemodilution and calcium channel blockers. Additional treatment strategies are being investigated to prevent vasospasm. PMID- 1774459 TI - Cardiac rehabilitation services: is there a case for it? PMID- 1774460 TI - Gastric infarction: a case report. PMID- 1774461 TI - Thoracic outlet syndrome. PMID- 1774462 TI - Civil War surgery: Gettysburg, summer of 1863. AB - Gettysburg was the site of a bloody three-day battle starting July 1, 1863. Field hospitals became busy during the battle and were established in churches, schoolhouses, barns and private homes. The Union field hospitals treated 20,500 wounded Union and Confederate soldiers. Civil War surgeons had little equipment and knowledge, but we can appreciate their contributions to surgery and service to country. PMID- 1774463 TI - A problem-solving curriculum for active learning. Northwest Center for Medical Education. PMID- 1774464 TI - Free and liposome-encapsulated double-stranded RNAs as inducers of interferon, interleukin-6, and cellular toxicity. AB - Poly(rI:rC) and Ampligen were entrapped in liposomes that were covalently coupled to Protein A, permitting binding to antibodies specific for the major histocompatibility complex-encoded H2K molecule of L929 cells, or to control antibodies. Free and encapsulated polynucleotides were compared for their capacity to stimulate secretion of interferon (IFN) and interleukin-6 (IL-6) and to induce cellular toxicity on L929 cells pretreated with IFN-alpha/beta. Free and encapsulated poly(rI:rC) or Ampligen (poly(rI:rC12-rU] induced similar levels of secretion of IFN over a broad dose range. The activity of the liposome encapsulated polynucleotides was dependent on its binding to an antibody that permitted cell association and internalization; the same liposomes were inactive in the presence of control antibodies. IL-6 secretion was induced by double stranded (ds) RNA in a dose-dependent manner, with a significantly greater effect seen for targeted, liposome-encapsulated material. The marked toxicity of targeted poly(rI:rC), as compared to free poly(rI:rC), was confirmed. Encapsulated Ampligen was less toxic than encapsulated Poly(rI:rC). PMID- 1774465 TI - Tissue distribution of recombinant mouse interferon-gamma and recombinant human interferon-gamma in mice, rats, hamsters, and monkeys. AB - Homologous (mouse) and heterologous (human) recombinant interferon-gamma (IFN gamma) interferons were injected intravenously into C57BL/6 mice. After 5 min, the greatest proportion of the human IFN was found in the liver, whereas no mouse IFN was detected in the liver at this time or later. Similar results were found in rats, hamsters, and cynomolgus monkeys. Thus, the tissue distribution of these two recombinant IFN-gamma in the various species is not determined by species specificity but by the physicochemical characteristics of the molecules. PMID- 1774466 TI - Effect of dsRNA from phi 6 bacteriophage on herpetic infection in cell culture and an animal model. AB - The double-stranded (ds) RNA from phi 6 bacteriophage inhibited herpes simplex virus type 1 (HSV-1) and HSV-2 infection in MA-104 cells but not in Vero cells. HSV-2 was more sensitive to this effect than HSV-1, with the HSV-2 ED50 being 0.25 micrograms/ml and the HSV-1 ED50 1.68 micrograms/ml. On genital infection by HSV-2 in guinea pigs, phi 6 dsRNA was more effective by intravaginal (P less than 0.05) than by intraperitoneal administration. A single dose of dsRNA of 600 micrograms/kg by intravaginal route modified favorably the natural course of the genital herpes in the treated animals (p less than 0.001). Compared with the infected controls, they showed a faster recovery with better healing of lesions; and the number and severity of recurrence was low. No mortality was observed and the control infected animals showed a mortality of 39%. Sera from dsRNA-treated animals showed antiviral activity with a 50% plaque-depressing dose (PDD50) of 10(1.5)/150 microliters; no antiviral activity was found in sera either from control infected or uninfected animals. No adverse effect was observed on the rate of growth of uninfected dsRNA-treated controls. PMID- 1774467 TI - Induction of HLA-DR by interferon-gamma requires a trypsin-like protease. AB - Induction of HLA-DR antigen expression by interferon-gamma (IFN-gamma) is inhibited by trypsin inhibitors and an anti-trypsin monoclonal antibody, but not by chymotrypsin inhibitors, suggesting a requirement for trypsin-like protease (TLP) activity in IFN-gamma-induced HLA-DR expression. Using p-nitroanilide and thioester substrates, TLP activity was demonstrated in cellular extracts of a hybrid epidermal cell line and judged to be essential for HLA-DR expression. TLP activity was inhibited by the trypsin inhibitors soybean trypsin inhibitor, ovomucoid trypsin inhibitor, and tosyl-lysyl-chloromethyl ketone and by an anti trypsin monoclonal antibody, closely paralleling inhibition of HLA-DR expression by such agents. TLP activity was enhanced by exposure to trypsin-linked agarose, indicating that the protease normally exists in an inactive form, perhaps in an enzyme-inhibitor complex or as an activatable proenzyme. Finding glucocorticoids (GC) to also inhibit IFN-gamma-induced HLA-DR expression and to regulate serine protease, especially urokinase plasminogen activator (uPA), activity raised the possibility of GC regulation of TLP activity. However, TLP activity was found to be constitutively expressed, regulated by neither GC nor IFN-gamma, nor was uPA activity involved in HLA-DR regulation. Trypsin inhibitors and GC also inhibited induction of intracellular 2',5'-oligoadenylate (2-5A) synthetase by IFN-gamma. Thus, TLP activity is required for IFN-gamma induction of HLA-DR and 2-5A synthetase. PMID- 1774468 TI - The importance of route of infection in determining the extent of exacerbation of listeriosis by anti-interferon-gamma monoclonal antibody. AB - Treating mice with a neutralizing rat monoclonal antibody (mAb) against murine interferon-gamma (IFN-gamma) prevented them from controlling an otherwise sublethal Listeria infection initiated via an extravascular route, but not via an intravenous route. In mice inoculated extravascularly, anti-IFN-gamma mAb treatment caused rapid uncontrolled growth of Listeria at the site of inoculation, and the continuous systemic dissemination of large numbers of bacteria to the liver and spleen. The infection-enhancing effects of anti-IFN gamma treatment in mice infected intravenously was seen as an increase in the number of bacteria in the liver and spleen, but in subsequent control and eventual resolution of infection beginning 5 days after inoculation. The results serve to show that the exacerbating effect of anti-IFN-gamma treatment on murine listeriosis is greater for infections initiated at extravascular sites. PMID- 1774469 TI - Recombinant human interferon-gamma modulates Rift Valley fever virus infection in the rhesus monkey. AB - Prophylactic treatment of rhesus macaques with 10(4)-10(6) U/kg of recombinant human interferon-gamma (rHuIFN-gamma) modulated Rift Valley fever (RVF) virus infection. IFN was given intramuscularly at 24 h prior to infection and daily thereafter for a total of five doses. After infection, treated monkeys showed no evidence of clinical disease; some had no detectable viremia; when viremia was observed, peak virus titers were decreased compared to control infected monkeys; and only minor and transient perturbations in hematologic and clinical chemistry values were seen. Untreated infected control monkeys developed high-titered viremia, mild to severe clinical disease, and moderate to severe changes in hemostatic parameters and clinical laboratory measurements. No evidence of synergism was noted when RVF virus-infected monkeys were treated prophylactically with combined low doses of rHuIFN-gamma and rHuIFN-alpha A. PMID- 1774470 TI - Mixed lymphocyte-autologous tumor cell reaction in hematological malignancies- effect of interferon-beta and correlation with the expression of MHC class I antigen on tumor cells. AB - The mixed lymphocyte-autologous tumor cell reaction (MLTR) was performed in 15 patients with hematological malignancies. Lymphocyte proliferative response and generation of cytotoxic cells against autologous tumor cells were evaluated and as was the effect of interferon-beta (IFN-beta) (750 IU/ml). Lymphocytes from patients during complete remission had sufficient functions in mixed lymphocyte culture with normal lymphocytes. Tumor cells stimulated allogeneic lymphocytes, although to a generally lesser extent as compared with remission lymphocytes from the same patients. Increased [3H]TdR uptake was observed in 5 patients and was suppressed by the addition of IFN-beta. Autologous tumor cell kill activity was induced by MLTR in 3 patients; IFN-beta-enhanced killing activity was present in these patients as well as in 3 other patients. Tumor cells from the 3 patients with positive autologous tumor cell kill activity had almost the same stimulating capacity as lymphocytes. The expression of MHC class I antigen and IFN-beta enhanced expression was observed in all tumor cells studied by indirect immunofluorescence. These data suggest that some factors on tumor cells, in addition to MHC class I antigen, participate in the generation of cytotoxic cells against autologous tumor cells and its enhancement by IFN-beta. PMID- 1774471 TI - [The effects of calcium concentration of reperfusion solution upon myocardial protection]. AB - The effects of several calcium concentrations in reperfusion solution were studied. Experimental time course was as followed: 20 min working perfusion, 3 min cardioplegic infusion with St. Thomas cardioplegic solution (STS) followed by global ischemia for 30 min at 37.5 degrees C, 15 min early Langendorff reperfusion with reperfusion solution and 5 min late reperfusion with Krebs Henseleit bicarbonate buffer [( Calcium] = 2.5 mM), followed by 20 min working perfusion. Percent recoveries of aortic flow at the Ca concentration of 0, 0.1, 0.6, 1.2, 1.8, 2.5 mM were 0, 14 +/- 1, 43 +/- 4, 64 +/- 3, 55 +/- 2, 59 +/- 1 (%), respectively. Our data indicated that reperfusion solution with less than 1.2 mM calcium reduced the protective properties of STS. PMID- 1774472 TI - [Doppler echographic evaluation of pressure gradients of Bjork-Shiley valve in the aortic position at rest and with exercise]. AB - Pressure gradient across the Bjork-Shiley (B-S) valve in the aortic position was assessed by Doppler echocardiography at rest and with exercise. There was close correlation between peak pressure gradient and area index which is a ratio of geometric orifice area (cm2) to body surface area (BSA) (m2). The correlation coefficient was -0.70 at rest and -0.86 with exercise. High peak pressure gradients with exercise were observed in the patients with 19 mm size (71 mmHg) and 21 mm size (107 mmHg). To avoid residual left ventricular outflow obstruction with exercise, it is considered advisable to use a #19 B-S valve in patients with BSA smaller than 1.1 m2, a #21 B-S valve in patients with BSA smaller than 1.4 m2, a #23 B-S valve in patients with BSA smaller than 1.8 m2, and a #25 B-S valve in patients with BSA smaller than 2.3 m2. If proper size of B-S valve cannot be inserted, aortic or aortic-mitral patch annuloplasty or the use of bileaflet valve are recommended as procedures of choice for small aortic annulus. PMID- 1774473 TI - [Single lung allotransplantation of Japanese monkeys--an immunohistological appraisal of the acute rejection]. AB - Eleven orthotopic single lung allotransplantations of Japanese monkeys (Macaca fuscata) were done without immunosuppression. In the 7 monkeys acute rejection was obvious on chest X-ray and hematoxyline-eosin (HE) staining of the biopsied specimen. On the chest X-ray film, progressive interstitial shadow of the grafts became apparent at the third postoperative day, and they turned out completely radiopaque at the 6th- or 7th postoperative day. The HE staining revealed prominent perivascular edema at the second postoperative day. Perivascular round cell infiltration appeared at the third day and the massive round cell infiltration was observed in the perivascular region, vascular wall and alveolar wall with the thickening of the alveolar wall. Immunostaining with human antilymphocyte monoclonal antibodies was also performed. CD8 positive cells (suppressor/cytotoxic T cell) were observed in the perivascular region at the second postoperative day, and CD8 positive cells and CD4 positive cells increased in number as the rejection progressed. Judging from the positive immunological cross reactivity between Japanese monkey and human, the early diagnosis of the acute rejection of the grafted lung may be possible by detecting the perivascular CD8 cells, even in the human-beings. PMID- 1774474 TI - [Diagnosis of acute aortic dissection with transesophageal echocardiography and results of surgical treatment]. AB - Forty-four consecutive patients with acute aortic dissection from April 1987 to April 1990 were diagnosed with the use of transesophageal echocardiography (TEE) and treated at our institute. In 43 of them (98%, type A: 22 cases, type B: 21 cases), diagnosis was accurate and there were no complications. In one patient with type A dissection, the small intimal flap could not be detected. Emergency operations were performed in the patient with type A and ruptured type B. In type A, operated before cardiac arrest, the operative mortality rate was 20% (4/20). In ruptured type B, the operative mortality rate was 50% (2/4). The result of conservative therapy in the patient with nonruptured type B (17 cases) was satisfactory. The investigation by TEE was carried out without difficulty at the bed side and in the operating room as well, giving precise and rapid information and could be a useful diagnostic mean for acute aortic dissection. PMID- 1774475 TI - [Cardiac assist device with inserted alternate-drive skeletal muscle pump system]. AB - Many studies on a skeletal muscle pump (SMP) for use as a cardiac assist device require preconditioning as a countermeasure to muscle fatigue. However, we conducted experiments in the hope of developing a cardiac assist device with an alternate-drive SMP system requiring no preconditioning. Adult mongrel dogs were used. We prepared a roll-type SMP from a pedicled muscle flap of the latissimus dorsi and major pectoris muscle, and an insert type SMP without separating the latissimus dorsi and major pectoris muscle. The muscles were stimulated at a frequency of 60 rpm at cycles of burst stimulation. Thirty-minute intermittent driving was performed. The hydrodynamic changes were measured at five-minute intervals for a total of three hours. The function of the pumps markedly declined after a few minutes of driving the roll-type SMPs but remained satisfactory after thirty minutes of driving the insert-type SMPs. Consequently, we concluded that dual SMPs, alternately driven through thirty minute intermittent drive and rest intervals, could be useful as cardiac assist devices without preconditioning. PMID- 1774476 TI - [Experimental studies on the effects of superoxide dismutase on warm ischemic reperfusion injury of the lung]. AB - Transient impairment of the transplanted lung in early postoperative period is one of difficult problems in lung transplantation. It is likely that reperfusion injury of the warm ischemic lung is contributory. The purpose of this study is to evaluate the effects of superoxide dismutase (SOD) on reperfusion injury of warm ischemic lung. Thirty mongrel dogs were divided into four groups. In group I (n = 6), the left lung with complete hilar stripping was placed in warm ischemic state under deflation for 1 hour. In group II (n = 9), the left lung with complete hilar stripping was kept in warm ischemic condition under inflation. Group III (n = 6) animals with same manipulation as group I received superoxide dismutase (SOD 20 mg/kg) before reperfusion. Group IV (n = 9) animals underwent same manipulation as group II and received SOD (20 mg/kg) before reperfusion. Before warm ischemia, immediately after reperfusion, and 1 and 2 hours, blood gases, left pulmonary vascular resistance were measured under the occlusion of right pulmonary artery. Extra vascular lung water content (EVLW) was measured at autopsy and lung was processed for histology. In group II, III and IV, blood gases and EVLW showed significantly better values than group I. In group I and III, left pulmonary vascular resistance increased prominently after reperfusion, however did not change in group II and IV. From these results, we concluded that inflated lung reduced the extent of pulmonary edema after reperfusion and SOD was effective in preventing warm ischemic damage even in deflated lung. PMID- 1774477 TI - [Clinical investigation on the adjunctive method in the surgery of thoracic aortic aneurysms--comparison of the temporary bypass and partial extracorporeal bypass]. AB - Since 1980, two different operative strategies were employed during resection to provide distal aortic perfusion by temporary bypass (Group "TB", 39 patients) or partial extracorporeal bypass (Group "PEC", 39 patients) in the operation for the thoracic descending aortic aneurysms or the dissecting aortic aneurysms with DeBakey type III. No significant differences were found in the patient population or the operative procedures between two groups. Mean bypass flow in Group "PEC" was 1850 +/- 70 (ml/min), which is significantly higher than in Group "TB" (1000 +/- 240 ml/min). However, there were no significant differences in the distal aortic pressure between two groups, which was due to administration of vasodilators. Platelet counts in Group "PEC" were significantly lower in the postoperative courses, probably caused by the use of roller pumps or suckers. The incidence of the postoperative renal dysfunction was almost the same in two groups. Cardiac functions during temporary bypass were suppressed by the aortic cross-clamping, therefore, it is necessary to evaluate the cardiac function preoperatively in employing this method. Partial extracorporeal bypass has the disadvantages of the requirement for full heparinization, but it can be indicated to almost all cases, even to the patients with poor cardiac function. It also has the advantage to maintain the distal perfusion in the unexpected intraoperative situations. The method of distal aortic perfusion should be determined by patient related and disease-related factors. PMID- 1774478 TI - [Autologous blood transfusion with recombinant human erythropoietin in heart surgery--studies on the volume of preoperative donation and postoperative administration]. AB - Recombinant human erythropoietin (rHuEPO) was administered to 42 elective heart surgery patients, and the volume of autologous blood donated within the preoperative short period and effects of improving anemia by postoperative rHuEPO administration were studied. rHuEPO (100 U/kg/day) and chondroitin sulfate-iron (40 mg/day) were given intravenously for preoperative 14 days, and each 400 ml of autologous blood was donated on the 14th and 4th day before operation. Reticulocytes increased significantly 3 days after administration (p less than 0.01). The hemoglobin level, 13.4 +/- 1.0 g/dl before the first donation, returned to 13.4 +/- 1.1 g/dl just before operation. 800 ml of autologous blood, needed for usual open heart surgery, may possibly have been donated within 14 days without making patients anemic by intravenous rHuEPO administration. For postoperative rHuEPO administration, the patients were divided into 3 groups: Group I (10 cases): given for 14 days, Group II (12 cases): for 7 days, Group III (20 cases): no administration. Reticulocytes decreased rapidly after termination of rHuEPO administration in each group, and on the 7th day after termination, they returned to the level before administration. The hemoglobin level in Group I was maintained after termination of rHuEPO, and was +2.2 +/- 1.1 g/dl on the 21st postoperative day compared with the level of 1st postoperative day. The hemoglobin level in Group II fell after termination and was +0.9 +/- 0.7 g/dl on the 21st day, this being comparable to the level of Group III. There were significant differences between Group I and II (p less than 0.05), and between Group I and III (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774479 TI - [Transesophageal echocardiography during coronary bypass surgery]. AB - The early diagnosis of intraoperative myocardial ischemia is important because such ischemia can lead to myocardial infarction. Clinical effectiveness of transesophageal echocardiography (TEE) was evaluated for detecting intraoperative myocardial ischemia and for observing the recovery of cardial motion at the end of cardiopulmonary bypass (CPB) in 20 patients who had undergone CABG. After endotracheal intubation, the TEE transducer was introduced into the esophagus to obtain a short axis cross-sectional view of the left ventricle at the level of the papillary muscles. Global LV function was assessed by measuring end-diastolic and end-systolic areas, which were calculated automatically, and the fractional area change (FAC). Regional endocardial wall motion was also analyzed by subdivision into four anatomical segments. The mean FACs were 48% after intubation, 47% after skin incision and 48% after sternotomy. Thereafter it increased significantly to 59% 30 minutes after CPB and 56% at the end of the operation. Thus, global LV function was improved significantly by revascularization. TEE could detect myocardial ischemia more sensitively than ECG. In 9 patients, FAC decreased significantly and new regional wall motion abnormality (RWMA) appeared around the time of sternotomy, but no ECG changes were detected. In another 7 patients, new RWMAs were detected without either a decrease in the FAC or ECG changes. It was found that myocardial ischemia took place more frequently before the initiation of CPB than expected. The recovery of left ventricular wall motion from cardioplegic arrest was able to be monitored visually during the period of weaning from CPB and the TEE could facilitated prompt and exact judgement of weaning from CPB.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774480 TI - [Modified Fontan procedure, is the right atrial pump function necessary or not? Experimental approach using simulation model]. AB - The effect of pulsatile pulmonary flow and the characteristics of pulmonary arterial pressure (PAP) trace were examined using a model simulating the right heart following the modified Fontan procedure. An inlet overflow tank (preload), valveless axial pulsatile pump, Windkessel model (afterload), and an outlet overflow tank (left atrium) were connected in series. Standard conditions were: flow 2.00 l/m, with 12 mmHg preload, 3.0 wood units resistance and left atrial pressure at 6 mmHg. The pump rate was set at 80 bpm. Simulated PAP and pulmonary flow (PF) waves produced by this model closely resembled those obtained from patients who had undergone the modified Fontan procedure. Parameters except preload were fixed and changes in PF were examined at varying preload of 8, 12, 15 and 17 mmHg. At the various preload levels, PF increased to values greater than the PF for the same conditions in the non-pulsatile state. With a preload value of 8 mmHg, PF increased from 1.10 l/m (non-pulsatile) to a maximum of 1.55 l/m at a peak PAP of 14 mmHg. With a preload of 12 mmHg, the PF increased from 2.00 l/m (non-pulsatile) to 2.65 l/m at 19 mmHg peak PAP. A preload of 15 mmHg resulted in an increase in PF from 2.65 l/m (non-pulsatile) to 3.30 l/m at 22 mmHg peak PAP, and when the preload was 17 mmHg the PF increased from 3.15 l/m (non-pulsatile) to 3.80 l/m at 25 mmHg peak PAP. The afterload of this model was fixed so the increase in PF with pulsation suggests a decrease in resistance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774481 TI - [Perioperative cardiac complications of pulmonary operations in patients with/without coronary stenosis]. AB - It has been suggested that the presence of ischemic heart disease correlates with an increased risk of cardiac infarction and fatal arrhythmia following noncardiac operations. To prevent these complications, coronary arteriographies were performed on 55 patients before pulmonary surgery for the assessment of the risk of perioperative cardiac complications. A coronary artery obstruction, with a 50% or greater reduction in the internal diameter was recognized on 21 patients (Group 1) and the other 34 patients showed no significant coronary stenotic lesions (Group 2). Discriminant analysis revealed that cardiac index (p less than 0.025), blood sugar level (p less than 0.05), hyperlipidemia (p less than 0.05) and postoperative cardiac failure (p less than 0.005) correlated independently with coronary artery stenosis. Postoperative cardiac complications were observed in the form of atrial arrhythmias (11%), ventricular arrhythmias (16%) and ischemic ECG findings (17%) in all cases. The rate of occurrence of these complications were not different between the two groups. However, the need for therapeutic procedures for perioperative circulatory failure (18%) was much greater in group 1 (p less than 0.005). This study supports the merits of preoperative coronary arterial angiography and the estimation of the left ventricular function in reducing pulmonary perioperative risk. PMID- 1774482 TI - [Diagnosis and surgical treatment of accessory mitral valve with associated congenital heart disease]. AB - Accessory mitral valve (AcMV) is a rare cardiac anomaly that may possibly cause left ventricular outflow tract (LVOT) obstruction. Five patients who underwent surgical resection of AcMV were reported. All these patients had associated cardiac anomalies, which include transposition of great arteries (TGA) in two cases, ventricular septal defect (VSD) in one, double outlet right ventricle (DORV) in one and membranous septal aneurysm (MSA) in one. Age at operation ranged from 23 days to 22 months. In these cases preoperative pressure gradient across the LVOT ranged from 10 to 35 mmHg. Resection of AcMV was performed together with radical operation for associated anomalies in all the patients. Approach for resection of AcMV consisted of trans-ventricular septum method in 3 patients of VSD, DORV or MSA and trans-pulmonary artery method in 2 cases of TGA. There was no operative death. The postoperative pressure gradient across the LVOT ranged from 0 to 13 mmHg. Two dimensional echocardiography was essential for the accurate preoperative diagnosis of AcMV in 4 out of the 5 patients. The trans ventricular septum method, when the large VSD was present, for resection of AcMV was found to be quite useful especially for neonates in order to obtain an excellent operative field, as compared with the conventional method. PMID- 1774483 TI - [Primary multiple neurilemmoma of the diaphragm]. AB - Primary tumor of the diaphragm is very rare. Furthermore, to our knowledge, no cases of multiple neurilemmoma of the diaphragm have appeared in the literature. A 61-year-old female was admitted to our hospital because of epigastric discomfort. Roentgenologic examination of the chest showed a tumor in the left leaf of the diaphragm. Laparotomy revealed two tumors, one measuring about 5 cm in diameter, and the other about 1 cm in diameter arising from the diaphragm. There was no adhesion to adjacent organs. The two tumors were resected with a part of the left diaphragm. Histological examination revealed benign neurilemmoma of the diaphragm. There has been follow-up on the patient for two and a half years without evidence of recurrence. PMID- 1774484 TI - [Successful surgical management of postinfarction ventricular septal perforation in an 85-year-old woman]. AB - The patient was an 85-year-old woman who developed chest pain on August 6, 1989, and was admitted to our hospital the next day. The diagnosis was acute inferior myocardial infarction. Her general condition was good at first; however, a harsh holosystolic murmur was suddenly heard 13 hours after the onset of infarction. Immediate cardiac catheterization revealed a ventricular septal perforation with a 2.2:1 shunt and total occlusion of the posterior descending artery. IABP was started 3 days after the onset of perforation. PCWP and shunt ratio decreased after starting IAPB; however, lung congestion continued to worsen. An emergency operation was performed on the 5th day after the onset of perforation. The post operative course was uneventful. She is presently doing well 17 months after the surgery. Seven patients more than 80 years old have been surgically treated for postinfarction ventricular septal perforation in Japan and this patient is the oldest. PMID- 1774485 TI - [A case of ruptured aneurysm of the descending thoracic aorta associated with active Behcet's disease]. AB - A 63-year-old male receiving steroid for active Behcet's disease was admitted of massive hemoptysis. A pseudoaneurysm of about 5 cm in diameter caused by rupture of the aortic wall penetrating into the lung was detected on the descending thoracic aorta. Operation was performed using left atrium-femoral artery bypass with centrifugal pump. The technique of graft interposition was selected rather than patch closure to prevent postoperative anastomotic aneurysm. We consider that in the treatment of inflammatory aneurysm, use healthy aortic wall for suture and end-to-end anastomosis are very important. In spite of steroid supplementation, the inflammatory reaction get worse postoperatively and the dosage of steroid had to be increased to control inflammation. The patient is well 20 months after surgery. PMID- 1774486 TI - [One-stage operation in a patient with Marfan's syndrome, severe pectus excavatum and annulo-aortic ectasia]. AB - A case of Marfan's syndrome complicated by annulo-aortic ectasia with pectus excavatum (Wada's 3rd grade classification) and aortic regurgitation (Seller's 1st grade) is reported in a 36-year-old man. We performed one-stage operation combining Bentall's procedure for the annulo-aortic ectasia and sternal elevation for the pectus excavatum. Few reports of one-stage operation for pectus excavatum and annulo-aortic ectasia in Marfan's syndrome have been published. If both diseases are present and surgical indications permit, one-stage operation can be performed to ensure protection of the heart and a satisfactory postoperative course. The best approach to the heart to obtain the most favorable operating field and the best chestplasty method that also assures closure of the median sternotomy are important considerations in one-stage operation. The most appropriate combination of these two operational variables must be assessed in each case. PMID- 1774487 TI - [A successful report of emergency CABG for severe calcified thoracic aorta--the porcelain aorta]. AB - The best management for patients requiring CABG with severe calcification of the thoracic aorta has not be established. To clamp ascending aorta in such cases produce cerebral embolization, aortic dissection or mural laceration. We reported a 60-year-old male for unstable angina with LMT lesion. Emergency CABG using IABP was performed with femoral cannulation, moderate hypothermia and induced ventricular fibrillation. His postoperative course was uneventful and coronary arteriography revealed a satisfactory patent graft of the RITA to the LAD system. PMID- 1774488 TI - [Mitral valve replacement in idiopathic hypereosinophilic syndrome]. AB - Idiopathic hypereosinophilic syndrome (IHES) is a rare systemic manifestation of eosinophilia that may cause endocardial fibrosis and thrombus formation. We presented a 48-year-old man with rapid onset of intractable congestive heart failure during the course of chemotherapy for IHES. After the urgent operation, which included left ventricular thrombectomy and mitral valve replacement the patient was asymptomatic, but died 1 month after operation because of development of IHES. Atrioventricular valve replacement may be beneficial to selected patients with congestive heart failure associated with the cardiac process of the IHES and review of the literature led us to prefer porcine heterograft prostheses in patients with IHES. PMID- 1774489 TI - [Successful mitral valve replacement in osteogenesis imperfecta--a case report]. AB - A 34-year-old man with osteogenesis imperfecta who underwent successful mitral valve replacement due to mitral regurgitation was reported. Cardiac disease associated with osteogenesis imperfecta is very rare and only fifteen patients were operated under the extracorporeal circulation previously. While excessive hemorrhage due to tissue fragility was observed in 7 of 15 patients, perioperative course of the case reported here was completely uneventful. The difference of hemorrhagic tendency as well as etiology of osteogenesis imperfecta will be defined according to the advance of technology in collagen genetics and biochemistry in future. PMID- 1774490 TI - [Successful complete repair of interrupted aortic arch and associated with DiGeorge syndrome in neonate]. AB - We report a rare case of interrupted aortic arch and a right aortic arch associated with DiGeorge syndrome, in neonate. Through a median sternotomy bypass was established placing an arterial perfusion cannula both in the ascending aorta, and in the main pulmonary artery. The right and left pulmonary arteries were temporarily occluded, while this pulmonary cannula perfused the lower part of the body. The arch reconstruction was performed during profound hypothermic total circulatory arrest. The right descending aorta had an adequate length and direct anastomosis was carried out without any tension. The VSD was repaired through a right atrial approach. The patient had hypocalcemia and thymic abnormalities which was consistent with the DiGeorge syndrome. He was treated with calcium gluconate and alfacalcidol, but no serious infection due to immunodeficiency was seen after operation. Post operative catheterization revealed no pressure gradient at the site anastomosis of the aortic arch and satisfactory results. PMID- 1774492 TI - [Intra-pulmonary suture abscess with hemoptysis after partial resection- concerning to the pathogenesis of the suture abscess]. AB - A 53-year-old male with a intra-pulmonary suture abscess was admitted with recurrent hemoptysis. Five year before this admission, he had undergone a partial resection of the left upper lobe for pneumothorax using unabsorbable sutures (braided polyester). Chest CT showed tumor shadow in the left S1(+2) a on admission. Because of recurrent hemoptysis, left upper lobectomy was performed. Hemoptysis was due to the presence of a suture abscess. Pathological and clinical analysis of the intra-pulmonary suture abscess showed that it was caused not only by foreign body reaction but also transbronchial infection. PMID- 1774491 TI - [A case of successful surgical treatment of recrudescent Stanford type A--acute dissection after early thrombogenic closure of dissecting lumen]. AB - A 53-year-old woman was hospitalized with acute chest pain. A CT scan was demonstrated acute type A aortic dissection. The dissecting lumen was already closed with thrombus. A digital subtraction angiography was performed. It showed no intimal tear and a normal aortic figure. She received the medical treatment. On the fourteenth day after her admission, her both femoral arterial pulses were not palpable. A CT scan and an angiogram were performed. The new intimal tear in the ascending aorta was made, and pericardial effusion appeared. With the use of a ringed interluminal graft, an emergency operation was performed. She was discharged in good health. Some cases of early thrombogenic closure of the dissecting lumen in acute aortic dissection were reported. In a few of them, a new intimal tear developed and they lapsed into the recrudescent acute dissection. Thus, more careful medical follow up is necessary in these cases. PMID- 1774493 TI - [The use of Doty's extended aortoplasty in binovular twins with congenital supravalvular aortic stenosis]. AB - Binovular twins with congenital supravalvular aortic stenosis underwent Doty's extended aortoplasty. Neither twins displayed signs of Williams syndrome. Peak systolic pressure gradients of 65 and 70 mmHg, respectively, were measured across the stenotic portion at the ascending aortae. After surgery, the pressure gradients were reduced to 15 and 20 mmHg, respectively, at the aortic valves. No new aortic regurgitation was observed postoperatively. It is important that the ascending aorta, including the stenotic part, is symmetrically incised into the noncoronary and the right coronary sinus of Valsalva. The fibrous ring should be removed as completely as possible. Doty's extended aortoplasty is a safe and effective procedure for supravalvular aortic stenosis. PMID- 1774494 TI - [Marfan's syndrome with annulo-aortic ectasia and ruptured mitral chorda--a case report of combined composite valve graft replacement of the aortic root and mitral valve replacement]. AB - We report a case of Marfan's syndrome with acute heart failure caused by a ruptured mitral chorda that was successfully treated by one operation of combined composite valve graft replacement of aortic root and mitral valve replacement (MVR). A 23-year-old man was admitted to our hospital presenting severe dyspnea and chest pain. Echocardiography and cardiac catheterization studies demonstrated marked annulo-aortic ectasia, aortic regurgitation and significant mitral regurgitation due to a ruptured chorda. In operation, it was found that a chorda of the mitral posterior leaflet had been torn, with the leaflet completely prolapsed to the left atrium, and that the aortic root was dilated to 90 mm in diameter. The ascending aorta was extensively resected leaving those areas of aortic tissue involving the coronary ostia. Then the mobilized coronary arteries were reattached to the composite graft. MVR was performed with preservation of the whole anterior and posterior mitral valve apparatus except for that small part with the torn chorda. Histopathological findings of the aortic wall and mitral valve were compatible with those of Marfan's syndrome. PMID- 1774495 TI - [A combined operation of coronary revascularization, abdominal aortic aneurysmectomy and femoro-popliteal bypass]. AB - A 71-year-old male with abdominal aortic aneurysm, coronary artery disease and obstructive peripheral arteriosclerosis successfully underwent a combined operation of coronary artery bypass grafting (CABG), replacement of abdominal aortic aneurysm and femoro-popliteal bypass. In this combined operation, the right gastroepiploic artery (GEA) is suitable as a bypass graft, because a laparotomy is required for abdominal aortic aneurysmectomy. And the usage of arterial grafts such as GEA and the left internal thoracic artery (LITA) is reasonable in terms of avoiding hazardous proximal anastomosis and reducing the operating time. PMID- 1774496 TI - [A case of pure red cell aplasia appearing after thymectomy]. AB - We present a case of pure red cell aplasia appearing four months after thymectomy for an invasive thymoma. A 61-year-old female whose chest X-ray demonstrated an anterior mediastinal mass was admitted to our hospital. Preoperative examination revealed neither anemia nor myasthenia gravis. During surgery, as it was found that the thymoma had invaded the upper left lobe of the lung and the left diaphragmatic nerve, these tissues were partially resected along with the thymus and the parathymic adipose tissue. Histologically the epithelial cells of the thymoma had round-oval nuclei with predominant lymphatic infiltration. There were some clusters of epithelial cells in the adjacent involuted thymic tissues. After postoperative radiotherapy of 40 Gy, the patient was discharged. About four months after the operation, she was readmitted because of anemia. Bone marrow aspiration demonstrated few erythroblasts but normal findings of granulopoiesis. Chest CT and radioisotopic examination revealed neither metastases nor recurrence of thymoma. Her anemia showed marked improvement by steroid therapy. After she was discharged, her condition has been uneventful in spite of tapering the steroid dose for seven months. PMID- 1774497 TI - [A case of bronchial anastomotic stenosis after right upper sleeve lobectomy treated with silicone stent]. AB - A case treated with silicone stent for bronchial granulomatous stenosis caused by anastomosis after right upper sleeve lobectomy was reported. A 68-year-old man complained of atelectasis of right upper lobe due to squamous cell carcinoma was admitted to our department. We performed right upper sleeve lobectomy. Four weeks after the operation, hemoptysis and dyspnea appeared with developing local empyema. We performed closure of pleural fistula and thoracoplasty, however, did not improve the symptoms. We performed tracheotomy for deteriorating dyspnea. In addition, granulomatous stenosis of bronchial anastomotic site was observed endoscopically. We tried to insert silicone stent into stenotic site. Although, first trial was in failure, we modified the design of the stent and succeeded in fixation of the stent. The airway was completely re-opened and good patency had been maintained for 7 months until his death due to pneumonia. PMID- 1774498 TI - [Follow-up study of patients with achalasia treated by long myotomy + partial fundopexy + posterior fixation based on intraoperative manometry]. AB - Long myotomy (6-8 cm) + partial fundopexy + posterior fixation with intraoperative manometry of the esophagus was performed in 23 cases of esophageal achalasia. These cases ranged from 24-72 years of age (average 42), 11 were males and 12 females. There were 19 primary cases and 4 postoperative cases of recurrence, and the period of their clinical courses ranged from 2 months to 23 years. Concerning the operative procedure, in 22 cases the approach was via an upper midline incision and 1 case the approach was via left thoraco-abdominal incision. Intraoperative manometry was performed to help in judging the extent of each manipulation. With the operative manipulation, the LESP is reduced to 13.0 +/- 6.0 mmHg (39% of the average preoperative value) and HPZ is elongated to 60.9 +/- 14.1 mm (155% of the average preoperative value). Moreover, post-operative manometry data resembled intra-operative data. The effectiveness of the procedure is judged on the basis of the chief complaints, esophagography, endoscopic examination, esophageal manometry and 24-hr pH monitoring. Patients are followed up at 2 weeks, 3 months and 1 year from the operation. Results showed 22 excellent cases (96.65%), 1 fair case (4.34%). These are better results than those of other reports that showed 50-60% excellent results and 30% good results (remaining slight passage disturbance). The reason for this difference is that we obtain sufficient LESP decompression effect (myotomy + submucosal layer ablation) based on intraoperative manometry. In the only case that we judged as fair (a reoperated case after Heller's operation) showed severe EGR totalling 213 min. on 24-hr pH monitoring of the esophagus in the postoperative period and was erosion also seen in the lower esophagus endoscopically. In this case, the LESP was 6.0 mmHg and its HPZ is 27.0 mm, showing a higher HPZ than the non-reflux group. Among the non-reflux group, LESP was as low as 6.0 mmHg, and this case had a remarkable long HPZ of 57.0 mm. In conclusion, even though the LESP is low, it is possible to prevent reflux if the HPZ is sufficiently long. PMID- 1774499 TI - [The effects of magnesium concentration in reperfusion solution upon myocardial protection]. AB - Experimental time course was as follows: 20 min working perfusion, 3 min cardioplegic infusion with St Thomas Cardioplegic Solution followed by global ischemia for 35 min at 37.5 degrees C, 15 min first Langendorff reperfusion with reperfusion solution (RS) with various concentrations of Mg and 5 min second reperfusion with KHBB, followed by 20 min working. Cardiac functions were measured during pre and post working perfusion and CK leakage were measured during reperfusion. Percent recoveries of aortic flow at the Mg concentration of 0, 0.6, 1.2, 3.0, 6.0, 12 mM were 21 +/- 5, 22 +/- 3, 48 +/- 2, 37 +/- 4, 28 +/- 3, 15 +/- 3 (%) (mean +/- SEM), respectively. Our data indicated that 1.2 mM Mg of RS possessed protective properties with bell shaped dose response characteristics. PMID- 1774500 TI - [Usefulness of recombinant human erythropoietin in cardiac surgery with autologous blood transfusion]. AB - The efficacy and method of administration of recombinant human erythropoietin (EPO) in adult cardiac surgical patients when given preoperatively was evaluated. We used EPO intravenously (iv) with 40 mg ferric oxide for a total of consecutive 47 patients. The patients were divided into group A (n = 14; EPO 200 IU/kg iv 3 times a week from 3 weeks prior to surgery to 2 weeks after surgery, donation of 800 ml) and group B (n = 33; EPO 200 IU/kg iv everyday from 8 days prior to surgery to 2 weeks after surgery, donation of 400 ml). Control groups were group AO (n = 11; donation of 835 +/- 33 ml from 14.8 days prior to surgery) and group BO (n = 7; donation of 406 +/- 34 ml at 7.3 days prior to surgery). All the EPO treated patients received no homologous blood transfusion while 2 of patients in group BO received some homologous blood transfusion. A hemoglobin change between pre-donation and surgery was +0.14 +/- 1.3 (g/dl) in group A, +0.04 +/- 1.0 (g/dl) in group B, -1.7 +/- 1.3 (g/dl) in group AO and -1.0 +/- 0.6 (g/dl) in group BO. In a comparison of post-surgical hemoglobin levels between group A and group B, we demonstrated that the level in group B, +2.1 +/- 1.8 (g/dl) was significantly higher than that in group A, +11.1 +/- 1.6 (g/dl) 2 weeks after surgery. There was no evidence to show an aggravation of anemia in the pre surgical period in EPO-treated groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774501 TI - [Treatment of mediastinal infection after coronary artery bypass surgery by transposition of the greater omentum]. AB - From January, 1986 to May, 1990 twenty one adult patients (men 16, women 5, age 64 +/- 7 years old) underwent transposition of the greater omentum to control mediastinal infection after coronary artery bypass surgery. Upon diagnosing mediastinitis, the mediastinum was drained open and irrigated with 0.5% povidone iodine-saline solution until the omental transposition. The interval between the diagnosis of mediastinitis and the omental transposition ranged from 0 to 171 (mean 19) days. Three quarters of the patients had the omentum transposed within 14 days. In nineteen of 21 patients (90%) the mediastinitis was effectively controlled. In the remaining two patients the infection could not be controlled and proceeded to succumb from multiple organ failure. There was no complication related to the omental transposition in itself. We conclude that transposition of the greater omentum is a safe and effective method for treating mediastinal infection after coronary artery bypass surgery. PMID- 1774502 TI - [Usefulness of ulinastatin as a radical scavenger for protection of reperfusion injury after myocardial ischemia in open heart surgery]. AB - The usefulness of ulinastatin for protection of reperfusion injury after myocardial ischemia was evaluated in 25 patients undergone open heart surgery (18 cases with coronary artery bypass grafting and 7 with valve replacements). Twenty five patients were divided into two groups; U (+)-group consisted of 12 patients with ulinastatin (10,000 IU/kg) injected via the aortic root just before aortic declamping, and U (-)-group of 13 patients without ulinastatin. There were no significant differences between the two groups in age, body weight, total cardiopulmonary bypass (CPB) time, and aortic cross clamp time. Blood samples were obtained from coronary sinus before the start of CPB, just before the aortic cross clamp and immediately after reperfusion, and 1 and 3 hours later. Levels of thiobarbituric acid (TBA), alpha-tocopherol (alpha TOC), polymorphonuclear elastase (PMNE), creatine phosphokinase (CK) and creatine phosphokinase isoenzyme (CK-WB) release were measured, and myocardial aerobic metabolism was also evaluated. At each time point after reperfusion, TBA levels in U (+)-group were significantly less (p less than 0.05), and alpha TOC levels were significantly higher (p less than 0.05) than those in U (-)-group. PMNE increased progressively during CPB and showed a peak at 3 hours after reperfusion. And both groups showed increased lactate production and anaerobic metabolism immediately after reperfusion and 1 hour later, as evidenced by changes in excess lactate and redox potential of lactate and pyruvate. There was, however, no significant difference between the two groups with CK-MB as well as CK release.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774503 TI - [Mechanisms of organ failure following cardiopulmonary bypass--preventive effects of ulinastatin]. AB - The causes of organ failure following cardiopulmonary bypass (CPB) were multi factorial. Damage was initiated by elastase which was released from activated granulocytes under conditions of significant reduction in the protease inhibitor level (p less than 0.01). Platelet aggregation, initiated by the CPB, altered the eicosanoid metabolism. As a result, the level of thromboxane A2 increased and became dominant in relation to prostaglandin I2. The increase in endothelin excretion observed during and after the CPB induced a further vasoconstrictive response in the microvasculature and accelerated ischemic cellular damage. Upon completion of the CPB, the elevation of the lysosomal enzyme beta-glucuronidase was influenced by the concentration of elastase (r = 0.78). The endothelin level correlated slightly with the elastase level (r = 0.4) during the CPB. This might indicate that there was an interaction between the activated granulocytes and endothelin production. The increase in the alveolar-arterial oxygen tension difference (Aa-DO2) only correlated with the elastase concentration (r = 0.55). Renal damage, which was detected by an increase in renal tubular enzymes (N acetyl-beta-D-glucosaminidase and gamma-glutamyltranspeptidase), was affected by endothelin (r = 0.68, 0.58) and elastase (r = 0.61, 0.51) respectively, but not by thromboxane B2. Even after the CPB, damage was thought to be perpetuated by the continuous elevation of elastase and endothelin. Since thromboxane A2 dominance subsided immediately after the cardiopulmonary bypass, the effect of thromboxane A2 on the development of organ failure was possibly only influential during the CPB. The cardiac index demonstrated a negative correlation with endothelin (r = -0.69) and a positive correlation with the ratio of TxB2/PGF1 (r = 0.51).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774504 TI - [Comparative analysis of Hancock and St. Jude Medical valve after mitral valve replacement]. AB - Long term results were compared in 81 operative survivors with MVR using Hancock valve (Hancock group) and 83 using St. Jude Medical valve (SJM group). The cumulative follow-up was 709.0 patients-year (p-y) and 175.2 p-y in the Hancock and SJM groups. Twenty-four percent of the patients in the Hancock group was permanently anticoagulated, while 100% of patients in the SJM group anticoagulated. The 7-year actuarial survival rate including early mortality was 79.3 +/- 4.6% for the Hancock and 93.9 +/- 3.0% for the SJM group (p less than 0.01). The survival rate was significantly higher in the SJM group than that in the Hancock group. The 7-year actuarial event free rate of the valve-related complications in the Hancock and SJM groups were as follows; thromboembolism 88.6 +/- 3.8% vs 95.0 +/- 2.8% (NS), hemorrhage, 94.0 +/- 3.0% vs 98.7 +/- 1.8% (NS), paravalvular leak 92.6 +/- 3.2% vs 97.4 +/- 1.8% (NS), infection 93.9 +/- 3.0% vs 100% (p less than 0.05), valve malfunction 78.0 +/- 5.2% vs 100% (p less than 0.001), overall valve related complications 58.9 +/- 5.9% vs 91.1 +/- 3.5% (p less than 0.001), reoperation for valve-related complication 83.1 +/- 4.6% vs 100% (p less than 0.01). The event free rate of reoperation for valve related complication in the Hancock group was significantly lower than that in the SJM group. The Hancock valve had the acceptable antithrombogenicity, but had the limited long-term durability.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774505 TI - [A successful case of concomitant operation for coronary artery disease and rectal cancer in elderly patient]. AB - We report a successful case of 75-year-old man who was simultaneously undertaken CABG for coronary artery disease and Miles' operation for rectal cancer. A concomitant cardiac and rectal operation involves serious problems, such as increasing operative risk, bleeding tendency after cardiopulmonary bypass, infection and radicality against malignancy, however, it should be a definitive method for the selective case. PMID- 1774506 TI - [A case report of right ventricular myxoma which was found by cardiac systolic murmur at a medical examination]. AB - Right ventricular myxoma is very rare with the only 19 cases in the Japanese literature. We report on a 26-year-old woman with a right ventricular myxoma which was found by cardiac systolic murmur at a medical examination and successfully excised. Echocardiography and coronary angiography is very useful in deciding the location of insertion on the right ventricle. Right atriotomy prior to right ventriculotomy was important for right ventriculotomy and necessary for complete excision. Clinical characteristics, and diagnostic and therapeutic aspects are discussed. PMID- 1774507 TI - [Primary pulmonary hemangiopericytoma]. AB - Hemangiopericytoma seldom originates from the lung. Only 63 cases in the English literature and 30 cases in the Japanese literature have been reported. A 38-year old female is presented in this paper. The patient was asymptomatic and was found a coin lesion of the left middle lobe by routine examination. She underwent tumorectomy and has been alive and well for 5 years. 1) The differential diagnosis of hemangiopericytoma from several other tumors is often difficult, as pericytes show no distinctive features on light microscopy. Therefore, it is emphasised that EM studies are obligatory to confirm the diagnosis of this tumor. 2) The origin of vessels with a characteristic staghorn appearance on light microscopy have not been described in previous papers. Bronchial arteriography in this case revealed that tumor vessels arose mainly from the bronchial artery. PMID- 1774508 TI - [A case report of neurinoma originating from the recurrent nerve]. AB - A 55-year-old man was admitted to hospital because of an abnormal shadow on his chest X-ray film. On examination, the patient appeared healthy. CT scan, magnetic resonance imaging, and ultrasonography showed evidence of a tumor. At operation, a tumor was found originating from the left recurrent nerve, and it was removed together with the vagus nerve. The patient had a favorable postoperative course except for hoarseness, and was discharged on the 31st postoperative day. Mediastinal neurinoma originating from the recurrent nerve is rare, and only 20 cases have been reported in Japan. PMID- 1774509 TI - [Modified Fontan operation for a single ventricle with a nonconfluent pulmonary artery]. AB - A 8-year-old boy with a double inlet right ventricle with a non-confluent pulmonary artery was operated on with a modified Fontan operation. He had right isomerism, right aortic arch, bilateral superior caval veins, and left-sided inferior caval vein. Hepatic veins were separately drained to the right-side atrium. Left Blalock-Taussig shunt and right central shunt operations had been previously performed. Firstly, we had reconstructed the central pulmonary artery with a 16 mm porcine pericardial roll to unify the nonconfluent pulmonary arteries. Secondly, about 2 months after the first operation, we performed a modified Fontan operation. Systemic venous return from the inferior caval vein and the hepatic veins were drained to a reconstructed pericardial roll with an intraatrial Gore-Tex graft, and bilateral superior caval veins were also anastomosed to the roll. The structure of the pulmonary arterial system is one of the most important factors to determine the outcome of a modified Fontan operation. Even if the central pulmonary artery is absent, however, a modified Fontan operation is applicable for the patient whose peripheral pulmonary arteries have enough growth. PMID- 1774510 TI - [A probable case of burned-out tumor of the testis detected after treatment for pulmonary choriocarcinoma]. AB - We encountered a patient who was suspected of having a burned-out tumor of the testis, which was detected after he was treated for pulmonary choriocarcinoma. The patient, a 61-year-old man, was found to have an abnormality on chest X-ray film at a medical examination in December 1989. He visited our department on December 19th, and was diagnosed as having cT1N0M0 (stage I) as a result of a thorough examination. He underwent right upper lobectomy and lymph node dissection on February 14, 1990. The lesion was pathologically diagnosed as choriocarcinoma, and after the operation he received orchiectomy and 3 courses of VAB VI therapy. After the chemotherapy, his blood HCG-beta level was normalized from 34 ng/ml to less than 0.10 ng/ml. The chest X-ray revealed complete disappearance of the coin lesion, while chest CT performed on July 25 revealed a small tumor 10 mm in diameter remaining in the left S10. For this tumor, partial resection of the left S10 was performed on August 6. The histopathological examination revealed nodular necrosis and disappearance of the tumor. PMID- 1774511 TI - [A case of total aortic replacement in a patient with Marfan's syndrome]. AB - A 32-year-old male with Marfan's syndrome was admitted to our Department in June, 1989 due to severe back pain that was diagnosed as type III-b dissecting aneurysm. His infrarenal abdominal aorta and bilateral iliac arteries had been replaced in another clinic in 1984 due to true aortic aneurysm. Two years later, Carbrol's operation was performed in our Department for the late development of DeBakey type II dissecting aneurysm. DSA and CT studies indicated the need for total replacement of the entire remaining aorta, since diffuse and extensive dilatation of the false lumen and the presence of an intimal tear at the origin of the left carotid artery were demonstrated. The arch and upper descending thoracic aorta were replaced in June, 1989, and replacement of the total remaining thoracoabdominal aorta was carried out under left heart bypass on September 26, 1989. Abdominal branch arteries and intercostal arteries of the 9th to 11th levels were reattached to the graft as onlay patches. Hoarseness of voice was the only complication. The patient recovered uneventfully and returned to his job after discharge. Although the native aorta had been completely replaced, ambulatory monitoring of the patient's pressure and ECG, performed two months after the operation, showed the normal reflex. PMID- 1774512 TI - [Ventricular septation combined with arterial switch for a patient with double inlet left ventricle with right sided rudimentary right ventricle and ventriculoarterial discordance]. AB - A 5-year-old boy with double inlet left ventricle and ventriculoarterial discordance (SDD type) underwent ventricular septation with arterial switch procedure. Previously he had received pulmonary arterial banding at 3 months-old. Preoperative cardiac catheterization revealed Qp/Qs 1.26, Pp/Ps 0.19 and LVEDV was 315% of normal (as left ventricle). Arterial switch with Lecompte modification was performed in order to separate ventricle with straight patch could be done. Post operative course was uneventful and patient was extubated 4 post operative day. These procedures had employed in this patient as follows; 1) systemic ventricle could be constructed with morphological left ventricle with mitral valve. 2) left ventricular outflow tract stenosis due to ventricular outlet foramen occasionally observed in conventional procedure such as intraventricular rerouting could be prevented, and 3) ventricular septation could be easy and simple with straight patch. PMID- 1774513 TI - [A median sternotomy approach for symptomatic right subclavian artery in the adult]. AB - A case of 33-year-old woman with aberrant right subclavian artery was reported. She was admitted to the hospital complaining of progressive dysphagia of six months' duration. The esophagogram revealed an oblique tubular defect in the superior thoracic esophagus. Aortograms confirmed the presence of an anomalous right subclavian artery arising as a fourth branch of the aortic arch, passing behind the esophagus in its course to the right arm. Operation was performed on Sept. 4, 1990. Through a median sternotomy, the ascending aorta and the two carotids were dissected free. With gentle forward retraction of the ascending aorta to the left, the origin of the aberrant right subclavian artery could easily be exposed. The right subclavian artery was then divided and its origin from the distal aortic arch oversewn. The vessel was removed from the retroesophageal position and blood flow reestablished to the right arm by an end to-side anastomosis to the right carotid artery, using a temporary shunt tube. These procedures were accomplished without difficulty. Postoperatively, the patient made an uneventful recovery and was discharged 16 days after the procedure. A postoperative esophagogram confirmed the removal of the esophageal compression. The blood pressure was equal in the two upper extremities. In follow up study, her symptoms had completely disappeared. PMID- 1774514 TI - [Poly-lactic-acid (PLA) sternal pins for the closure of median sternotomy--report of a case]. AB - Poly-lactic-acid (PLA) sternal pins were used for the closure of median sternotomy in a case of bilateral pneumothorax. After placement 7 sutures of polyester and 2 wires, PLA sternal pins were inserted into the bone marrow of the sternum. The wires were then twisted and tightened, and all sutures were tightened, and the wires were removed. No significant postoperative complications, i.e., osteomyelitis and mediastinitis, sternal dehiscence, or bone marrow dysfunction, were observed. In addition, the PLA sternal pins were absorbed. In the closure of median sternotomy, PLA sternal pins provide stable sternal adhesion, which is essential to the prevention of sternal dehiscence and other complications. Moreover, with the use of PLA sternal pins, the retention of steel wires in the body is unnecessary. PMID- 1774515 TI - [Intra-graft balloon pumping--a clinical case report]. AB - A 29-year-old female underwent tube graft replacement of distal aortic arch and descending aorta for dissecting aneurysm. After 42 minutes of aortic cross clamping the patient was initially weaned satisfactorily from cardiopulmonary bypass (CPB). However, cardiac arrhythmia and cardiac arrest necessitated reestablishment of CPB. Electro-cardiography showed inferior myocardial infarction. To wean CPB intraaortic balloon pumping (IABP) was mandatory. But because of dissecting aortic aneurysm IABP in conventional method was contra indicated. Intra graft balloon pumping (IGBP) was initiated while the patient was on full CPB. A low-porosity woven Dacron tube graft (22 mm) was anastomosed end to-side to ascending aorta. A balloon was inserted into the tube graft to establish IGBP. This IGBP provided effective circulatory assist. The patient was weaned from CPB 1 hours after reestablishment of IGBP. Postoperative course was stable. The patient was returned to the operating room for removal of the balloon 3 days postoperatively. We reported the case for whom IGBP was effective. IGBP was effective circulatory support for the patient when conventional use of IABP was contra-indicated. PMID- 1774516 TI - [Two cases of dissecting aortic aneurysm associated with the right-sided aortic arch]. AB - Two cases of dissecting aortic aneurysm with the right-sided aortic arch were reported. Aortography and chest CT demonstrated DeBakey IIIb dissecting aortic aneurysm in association with the right aortic arch and aberrant left subclavian artery arising from the diverticulum of Kommerell in two cases. In the first patient, a 47-year-old male, the intimal tear was repaired with patch grafting under the femoro-femoral bypass using centrifugal pump. Although the dissected lumen was completely closed with thrombus, paraplegia occurred and its recovery was unsatisfactory. In the second patient, a 53-year-old male, maintained on antihypertensive medication for one month, he expired at home 17 days after discharge. Since this type of dissecting aortic aneurysm is extremely rare, nine reported cases, including our two cases, are reviewed. Accurate diagnosis and careful surgical treatments of this disease are mandatory to obtain the satisfactory outcome. PMID- 1774517 TI - [A case report of chronic traumatic dissecting aneurysm of the thoracic aorta]. AB - A 63-year-old male, who sustained a blunt chest trauma in a traffic accident, was referred to our hospital for his traumatic aneurysm. An operative repair was undertaken 3 months after the trauma. The descending aorta was dissected along 5 cm, and its diameter was about 6 cm. Graft replacement was performed under the left heart bypass by using the BioMedicus centrifugal pump. He is doing well 3 years after the operation. PMID- 1774519 TI - [Physiopathology of liver cirrhosis in relation to the liver lesion]. PMID- 1774518 TI - [Etiology of liver cirrhosis]. PMID- 1774520 TI - [Diagnosis of liver cirrhosis developing from chronic viral hepatitis]. PMID- 1774521 TI - [Diagnosis of liver cirrhosis developing from chronic viral hepatitis--liver function tests]. PMID- 1774522 TI - [Diagnosis of liver cirrhosis developing from chronic viral hepatitis--ultrasonic liver imaging]. PMID- 1774523 TI - [Physiopathology of alcoholic liver cirrhosis--comparison with viral liver cirrhosis]. PMID- 1774524 TI - [Liver cirrhosis with unusual etiology not to be ignored]. PMID- 1774525 TI - [Liver cirrhosis with multiple organ failure]. PMID- 1774526 TI - [Drug therapy and patient management of liver cirrhosis]. PMID- 1774527 TI - [Complication of liver cirrhosis and the counter measures]. PMID- 1774528 TI - [Therapy of esophageal varices complicated with liver cirrhosis]. PMID- 1774529 TI - [Countermeasures for hepatic encephalopathy complicated with liver cirrhosis]. PMID- 1774530 TI - [Therapy of ascites complicated with liver cirrhosis]. PMID- 1774531 TI - [Prognosis of liver cirrhosis]. PMID- 1774532 TI - [Clinical significance of virus markers]. PMID- 1774533 TI - [A case of malignant colonic lymphoma showing various lesions]. PMID- 1774534 TI - [A case of anti-RNP antibody positive malignant rheumatoid arthritis with pulmonary hypertension]. PMID- 1774535 TI - [A case of Cushing's syndrome with diabetes, hypertension and ocular hemorrhage followed by secondary adrenal gland hypofunction]. PMID- 1774536 TI - [A case of pheochromocytoma with hyper-HDL-cholesterolemia]. PMID- 1774537 TI - "Turning back the clock" on serial-stimulus sign tracking. AB - Two experiments examined the effects of a negative (setback) response contingency on key pecking engendered by a changing light-intensity stimulus clock (ramp stimulus) signaling fixed-time 30-s food deliveries. The response contingency specified that responses would immediately decrease the light-intensity value, and, because food was delivered only after the highest intensity value was presented, would delay food delivery by 1 s for each response. The first experiment examined the acquisition and maintenance of responding for a group trained with the contingency in effect and for a group trained on a response independent schedule with the ramp stimulus prior to introduction of the contingency. The first group acquired low rates of key pecking, and, after considerable exposure to the contingency, those rates were reduced to low levels. The rates of responding for the second group were reduced very rapidly (within four to five trials) after introduction of the setback contingency. For both groups, rates of responding increased for all but 1 bird when the contingency was removed. A second experiment compared the separate effects of each part of the response contingency. One group was exposed only to the stimulus setback (stimulus only), and a second group was exposed only to the delay of the reinforcer (delay only). The stimulus-only group's rates of responding were immediately reduced to moderate levels, but for most of the birds, these rates recovered quickly when the contingency was removed. The delay-only groups's rates decreased after several trials, to very low levels, and recovery of responding took several sessions once the contingency was removed. The results suggest that (a) sign-tracking behavior elicited by an added clock stimulus may be reduced rapidly and persistently when a setback contingency is imposed, and (b) the success of the contingency is due both to response-dependent stimulus change and response-dependent alterations in the frequency of food delivery. The operation of the contingency is compared with the effects of secondary reinforcement and punishment procedures. PMID- 1774538 TI - An economic analysis of "demand" for food in baboons. AB - Responding of 6 adult male baboons (Papio c. anubis) was maintained under a fixed ratio schedule of food reinforcement during daily 22-hr experimental sessions. Completion of the ratio requirement resulted in the delivery of a single 1-g food pellet; supplemental feeding was limited to a daily fruit ration. Ratio values were increased on Mondays, Wednesdays, and Fridays according to the following schedule: 2, 4, 8, 16, 32, 64, 96, 128. Responding under each ratio value was examined four times. Under the Fixed-Ratio 2 conditions, food intake ranged between 300 and 600 g. Ratios were increased for each baboon until food intake decreased to about 100 g (20% to 30% of Fixed-Ratio 2 intake). Increasing the response cost increased total time responding and total daily responding in all baboons, but this increase in responding was not sufficient to maintain stable food intake. Baboons responded between 90 and 180 min per day. The highest running response rates were observed under the Fixed-Ratio 2 and Fixed-Ratio 4 schedules. Running rate was similar across the larger ratio values (greater than Fixed-Ratio 8) but was lower than that observed under the Fixed-Ratio 2 and Fixed Ratio 4 schedules. Similar results were observed the four times that each fixed ratio value was tested. Intake as a function of cost was analyzed by fitting data to the nonlinear equation proposed by Hursh, Raslear, Shurtleff, Bauman, and Simmons (1988) for "demand" functions. Demand for food was inelastic over most of the ratio values until food intake decreased to 15% to 55% of baseline. The results indicate that demand functions are appropriate for the study of food intake in baboons, but also caution that intake at the cost when demand shifts from inelastic to elastic and its relationship to maximal intake should also be included in analyses of demand for a commodity. PMID- 1774539 TI - Choice as a function of local versus molar reinforcement contingencies. AB - Rats were trained on a discrete-trial probability learning task. In Experiment 1, the molar reinforcement probabilities for the two response alternatives were equal, and the local contingencies of reinforcement differentially reinforced a win-stay, lose-shift response pattern. The win-stay portion was learned substantially more easily and appeared from the outset of training, suggesting that its occurrence did not depend upon discrimination of the local contingencies but rather only upon simple strengthening effects of individual reinforcements. Control by both types of local contingencies decreased with increases in the intertrial interval, although some control remained with intertrial intervals as long as 30 s. In Experiment 2, the local contingencies always favored win-shift and lose-shift response patterns but were asymmetrical for the two responses, causing the molar reinforcement rates for the two responses to differ. Some learning of the alternation pattern occurred with short intertrial intervals, although win-stay behavior occurred for some subjects. The local reinforcement contingencies were discriminated poorly with longer intertrial intervals. In the absence of control by the local contingencies, choice proportion was determined by the molar contingencies, as indicated by high exponent values for the generalized matching law with long intertrial intervals, and lower values with short intertrial intervals. The results show that when molar contingencies of reinforcement and local contingencies are in opposition, both may have independent roles. Control by molar contingencies cannot generally be explained by local contingencies. PMID- 1774540 TI - Elicited responding in chain schedules. AB - An omission procedure was employed to study elicited pecking in the first component of a two-component chain schedule. Both components were fixed-interval schedules correlated with colored keylights. The first response following the initial-link schedule produced a second fixed-interval schedule. We studied several fixed-interval lengths in two conditions: a standard response-dependent condition and an omission-contingent condition. The omission-contingent condition differed from the response-dependent condition in that responses during the initial fixed interval terminated the trial (omitting the terminal component and grain). If the terminal component was not omitted, a response following the terminal link's requirement produced 4-s access to grain. Pigeons responded during more than 70% of the initial links in the omission-contingent condition and responded during more than 90% of the initial links in the response-dependent condition. In general, rates of responding were consistent with the percentage data. The responding in the omission condition suggests that there may be elicited pecking, in chain schedules using pigeons, that is not the result of contingent conditioned reinforcement. PMID- 1774541 TI - Protocol analysis of the correspondence of verbal behavior and equivalence class formation. AB - In two equivalence experiments, a "think aloud" procedure modeled after Ericsson and Simon's (1980) protocol analysis was implemented to examine subjects' covert verbal responses during matching to sample. The purpose was to identify variables that might explain individual differences in equivalence class formation. The results from Experiment 1 suggested that subjects who formed equivalence classes described the relations among stimuli, whereas those not showing equivalence described sample and comparison stimuli as unitary compounds. Because Experiment 1 only demonstrated a correlation between describing stimulus compounds and the absence of equivalence classes, a second study was conducted. In Experiment 2, equivalence class formation was brought under experimental control through pretraining manipulations that facilitated responding either to stimulus compounds or to relations among stimuli. The results demonstrated that a history of describing stimulus compounds, when compared with describing the relations among the stimuli, interfered with the emergence of stimulus equivalence. These findings clarify individual differences in stimulus equivalence. They also demonstrate the utility of analyzing verbal reports to identify possible variables that can be manipulated experimentally. PMID- 1774542 TI - The transfer of contextual control over equivalence classes through equivalence classes: a possible model of social stereotyping. AB - In Experiment 1, subjects acquired conditional equivalence classes controlled by three male and three female names as contextual stimuli. When equivalence relations were tested using new names not used in training (three male and three female), contextual control remained intact. Thus, generalized control of the composition of conditional equivalence classes by characteristically gender identified names was shown. A basic analysis of this finding was tested in Experiment 2. Contextual equivalence classes were established using as contextual stimuli nonrepresentational visual figures that were members of additional pretrained three-member equivalence classes. When other stimuli in the pretrained equivalence classes were used as contextual stimuli, the conditional equivalence classes remained intact. Control subjects showed that this effect depended on the equivalence relations established in pretraining. The results show that contextual control over equivalence classes can transfer through equivalence classes. The implications of this phenomenon for social stereotyping are discussed. PMID- 1774543 TI - Stimulus equivalence and arbitrarily applicable relational responding. AB - Subjects' responses to nonarbitrary stimulus relations of sameness, oppositeness, or difference were brought under contextual control. In the presence of the SAME context, selecting the same comparison as the sample was reinforced. In the presence of the OPPOSITE context, selecting a comparison as far from the sample as possible on the physical dimension defined by the set of comparisons was reinforced. Given the DIFFERENT context, selecting any comparison other than the sample was reinforced. Subjects were then exposed to arbitrary matching-to-sample training in the presence of these same contextual cues. Some subjects received training using the SAME and OPPOSITE contexts, others received SAME and DIFFERENT, and others received SAME, OPPOSITE, and DIFFERENT. The stimulus networks established allowed testing for a wide variety of derived relations. In two experiments it was shown that derived performances were consistent with relational responding brought to bear by the contextual cues. In contexts relevant to the relation of sameness, stimulus equivalence emerged. Other kinds of relational networks emerged in the other contexts. Arbitrarily applicable relational responding may give rise to a very wide variety of derived stimulus relations. The kinds of performances seen in stimulus equivalence do not appear to be unique. PMID- 1774544 TI - Response patterns and cardiovascular effects during response sequence acquisition by humans. AB - The effects of temporal delays imposed between successive responses and of vitamin C administration were examined on the acquisition of response sequences and on cardiovascular reactivity during sequence acquisition. Thirteen adult subjects (6 female, 7 male), in good health, gave written consent prior to participating in 12 weekly 45-min sessions. Points, exchanged for money after each session, were presented when subjects completed 15-response sequences on a touch-sensitive three-response keypad. A position counter increased from 0 to 14 as subjects emitted correct responses in the sequence. Four novel 15-response sequences were presented each session. No delays were imposed between successive responses during the acquisition of one sequence; delays were imposed immediately following each response during the acquisition of a second sequence, thereby delaying response feedback; delays were imposed following feedback during acquisition of a third sequence, resulting in the removal of the stimulus correlated with sequence position; and, as a control condition, delays were imposed following feedback, but stimuli correlated with sequence position were reinstated prior to the next response during acquisition of a fourth sequence. Subjects were exposed to one of two delay durations (0.2 and 0.5 or 0.5 and 1.0 s) each session, and delay durations alternated every session. During Weeks 5 to 8, subjects received 3 grams of vitamin C per day, whereas during Weeks 1 to 4 and 9 to 12, subjects received placebo under single-blind conditions. All subjects acquired the sequences, as evidenced by decreasing percentages of incorrect responses across trials. When temporal delays were imposed between successive responses during sequence acquisition, acquisition efficiency was enhanced. Examination of response latencies suggested that the status of preceding responses (i.e., correct or incorrect) rather than the status of the position counter influenced subsequent responding. Cardiovascular effects were inversely related to the length of the temporal delay. Neither cardiovascular reactivity or sequence acquisition were related to vitamin C administration. PMID- 1774545 TI - Human choice on concurrent variable-interval variable-ratio schedules. AB - Each of 5 adult male humans sat in a 4 degrees C room where they could warm themselves by illuminating six heat lamps for 10-second periods according to a concurrent variable-interval variable-ratio schedule. Left-button presses on a response panel switched between the schedules and started a 2-second changeover delay. Right-button presses illuminated the heat lamps if assigned by the associated schedule and if the changeover delay had timed out. Panel lights identified the schedule in effect and each effective right-button press. A discrimination procedure--either a multiple variable-interval variable-ratio schedule or the presentation of each schedule individually on alternate days- preceded exposure to the choice procedure for some subjects. For subjects not exposed to a discrimination procedure prior to exposure to choice, or if such exposure failed to result in higher rates to the ratio than to the interval schedule, relative response rates matched relative reinforcement rates. However, if subjects responded at higher rates to the ratio schedule than to the interval schedule during a prior discrimination procedure, relative rates on a subsequent choice procedure deviated from matching in the direction of reinforcement-rate maximizing. In eight of 11 conditions, choice appeared to be governed by maximizing processes. In all cases, human concurrent ratio-interval performances differed from those of nonhumans in that matching was never obtained with local ratio-interval rate differences. PMID- 1774546 TI - Risk-sensitive foraging theory and operant psychology. AB - Hastjarjo, Silberberg, and Hursh (1990) have presented data on the foraging behavior of rats and discussed it in terms of risk-sensitive foraging theory. Because risk-sensitive foraging theory is comprised of several different models, it does not lead to general predictions about when an organism should prefer a foraging option with high variance to a foraging option with low variance. Any comparison of data with the predictions of the theory must be based on an appropriate model. I draw attention to various experiments that are potentially relevant to the results reported by Hastjarjo et al. and show how the time period over which the organism must survive can influence a model's predictions about risk sensitivity. PMID- 1774547 TI - Age differences in the capacity demands of a strategy among spontaneously strategic children. AB - This study examined whether spontaneously strategic children from two age groups differed in the capacity required to execute a strategy. The strategic behavior of younger (grades K and 1) and older (grades 4 and 5) children (N = 104) was assessed on a selective memory task. Children selected objects to view from a larger pool of objects. The most mature strategy (i.e., selectivity) involves opening doors that reveal objects to be remembered and not opening those that do not. In a dual-task procedure in a second session, children performed a finger tapping task simultaneously with the selective strategy. The reduction of rate of finger tapping from the finger tapping baseline to the dual-task trials provided an assessment of the capacity required to execute the strategy. A control group followed the same procedure, but with a simpler door opening selective strategy. A significant age difference in the capacity required for the strategy, even among spontaneously strategic children, suggested that there is further development of strategies even after children spontaneously produce them. Results were discussed in terms of increased strategy effectiveness during development. PMID- 1774548 TI - Establishing mirror-image discriminations with progressively delayed extra stimulus prompts. AB - Progressively delayed extra-stimulus prompts were used to help normal preschool children discriminate left-right mirror-image stimuli. Two issues were addressed, the attention guiding properties of the prompts and the necessity for their gradual elimination. The study consisted of four experiments in which one or multiple prompt conditions were used. Each condition involved three prompts: a reference prompt for indicating the S+ and two superimposed prompts, one on the S+, and one on the S-. The prompts required subjects to respond to the orientation of the S+ (Orientation condition) or to the location of the reference prompt (Location condition); or allowed them to respond to the discriminative shapes of the superimposed prompts (Shape condition). The results showed the following. First, most subjects rapidly learned to respond to the Orientation prompts. Second, delayed orientation prompting was always successful regardless of how the prompts were eliminated. Delay training was never successful in either of the other two conditions. Third, the Orientation condition did not reliably produce learning unless the delayed prompting procedure was used. PMID- 1774549 TI - The influence of children's facial maturity on parental expectations and punishments. AB - It was hypothesized that the perception of maturefaced children as more able to follow complicated instructions, more likely to know right from wrong, more shrewd, and physically stronger than their babyfaced peers would lead parents to assign more demanding tasks to these children and to judge their misbehavior more harshly. Study 1 revealed that parents allocated more cognitively demanding, but not more physically demanding, chores to maturefaced 11 year old depicted in photographs than to babyfaced children of the same age and attractiveness. Study 2 revealed that parents perceived the misbehaviors of maturefaced 4- and 11-year old children as more intentional than those of their babyfaced peers, an effect that was significant only when parents judged children of the opposite sex. Study 2 further revealed that, with perceived intentionality held constant, a babyface mitigated the severity of punishment recommended for relatively serious infractions by preschoolers, while increasing it for older children. The latter finding was discussed in light of other evidence that people react negatively to the disconfirmation of their benign expectations regarding babyfaced individuals, and that parents perceived the misbehaviors as more unexpected for 11 year olds than 4 year olds. PMID- 1774550 TI - A Christmas peril. PMID- 1774551 TI - Nurse practitioners and primary care. PMID- 1774552 TI - Never changing role of the physician. PMID- 1774553 TI - Primary care one more time. PMID- 1774554 TI - Sudden infant death syndrome. Comparison of incidence in four urban Florida counties. AB - The observed incidence of sudden infant death syndrome (SIDS) in Hillsborough County is significantly higher than corrected rates in three other metropolitan areas of the state which have common demographic features. An eight year analysis of data (1979-1986) demonstrates the consistency of the observation. Since SIDS is a postmortem diagnosis of exclusion utilized for deaths of infants for whom no anatomic or biochemical cause can be determined and represents a large segment of deaths between 28 days and one year of age, there is a need to assure that all areas of the state utilize similar criteria for assignment of the diagnosis. PMID- 1774555 TI - Pollution of Florida's rivers. AB - Pollution of Florida's waterways is a serious problem. Sources of pollution include sewage, storm water runoff, faulty septic tanks, improperly constructed landfills, and obstruction by causeway bridges. Some of the major causes and solutions are discussed. PMID- 1774556 TI - Eugene Tubbs Burn Intensive Care Unit. University of Florida Shands Hospital. AB - A four-year update is reported on the Eugene Tubbs Burn Intensive Care Unit at the University of Florida Shands Hospital. Flame (68%) and scald (18%) burns have remained fairly constant over the period. There were 123 inpatients and 356 outpatient visits this past year with an infection rate of 21%. Seventeen patients were age 50 or older and the average body surface area involved of the 9% mortality group was 57.4%. The advantage of a burn team working in a specially designed unit is emphasized. PMID- 1774557 TI - Elevation of eyebrow. PMID- 1774558 TI - Influence of pressure and flow on constriction of blood vessels. AB - Until recently the primary control of vessel diameter, or vascular resistance, has been focused on neuronal influences, circulating vasoactive hormones, and locally released substances such as endothelial derived relaxing factors (EDRF) and metabolites. It is now clear that physical forces interacting with endothelial and vascular smooth muscle cells play an important role in the control of vascular resistance. The forces are pressure which tends to stretch the cells and shear force which is a drag force on the inner surface of the vessel due to blood flow. These forces determine the sensitivity of smooth muscle to various vasoactive substances, cause the release of vasoconstrictor and vasodilator substances from endothelial cells, and alter the myogenic tone of smooth muscle. PMID- 1774559 TI - Management of constipation in the older patient. PMID- 1774560 TI - Lost in space. PMID- 1774561 TI - Heart valve surgery in central Florida. PMID- 1774562 TI - That makes sense. PMID- 1774563 TI - Finding suggest spondylodiscitis. PMID- 1774564 TI - Technique to detect migration of femoral components of total hip arthroplasties on conventional radiographs. AB - Critical to the evaluation of patients with painful total hip arthroplasties and to the assessment of the efficacy of fixation of new prosthetic designs and/or new insertion techniques is the ability to detect migration of the femoral components. The authors present a simple and effective technique using plain radiography that can detect migration of 1 mm with a high degree of accuracy. PMID- 1774565 TI - Program for the prevention of venous thromboembolism in high-risk orthopaedic patients. AB - Postoperative orthopaedic patients remain at risk for venous thromboembolism (VTE) after hospital discharge. Therefore, the authors designed and implemented a program for prevention of VTE that included outpatient adjusted-dose warfarin using twice-weekly prothrombin time (PT) determinations, a dedicated telephone line for PT results, and vigilant nurse-physician supervision to administer prophylaxis to 125 postoperative orthopaedic patients against VTE for an average of 31.4 days after discharge. PT was maintained between 13.2 and 18.3 seconds (1.1-1.5 x control) in the average patient. There was a failure rate of 3.2% and 0.8% for clinically suspected and radiologically confirmed deep venous thrombosis (DVT) and pulmonary embolism (PE), respectively. The rate of bleeding complications was 3.2%, but none of these patients required transfusion or hospital readmission for hemorrhage. The authors conclude that the described program for VTE prevention is a safe, effective, and practical program to administer prophylaxis to postoperative orthopaedic patients against clinically evident VTE for the first month after hospital discharge. PMID- 1774566 TI - Total hip arthroplasty after McMurray's osteotomy. AB - Total hip arthroplasty (THA) was done as a secondary procedure after McMurray's osteotomy in 15 cases, with a time lapse of 14-132 months between the two operations. Marked improvement in pain and function was achieved in 14 cases, although hip stiffness was greater than that in primary THA cases. It was noted that delay in THA enhanced the operative difficulties and decreased the overall improvement obtained. No special femoral component was employed, and extensive soft-tissue dissection was carried out to obtain near-normal hip biomechanics to decrease the chances of long-term loosening. Marked medullary canal distortion was encountered in eight cases. In spite of this, there were no cases with femoral shaft fractures. Trochanteric osteotomy should be employed in cases in which the canal is severely distorted. In these cases, routine antibiotic prophylaxis and adequate preoperative planning should be done. PMID- 1774567 TI - Patient-controlled analgesia in a postoperative total joint arthroplasty population. AB - The present study prospectively evaluated patient-controlled analgesia (PCA) in 94 postoperative primary total joint patients. Total knee arthroplasty patients had significantly higher pain scores than those undergoing total hip arthroplasty. Trochanteric osteotomy patients used less morphine (mean, 37.6 mg) than those undergoing a muscle-splitting (Hardinge) approach. Eighty-eight percent of patients would use PCA again. The authors recommend PCA as a potentially superior form of postoperative pain control in joint arthroplasty patients, but recommend antiemetic usage, generous additional intravenous administration of bolus doses on the floor, trials of higher set doses, and earlier administration of PCA in the recovery room. PMID- 1774568 TI - Prospective randomized trial of sequential compression devices vs low-dose warfarin for deep venous thrombosis prophylaxis in total hip arthroplasty. AB - A prospective randomized trial compared the effectiveness of low-dose warfarin (LDW) to sequential compression devices (SCD) for deep venous thrombosis (DVT) prophylaxis in 95 patients after total hip arthroplasty (THA). Patients were 39 years of age or older, with no history of previous venous disease. Bilateral lower-extremity venography was used for thrombi detection. Venous thrombi occurred in 12 patients (all calf) on LDW (26.6%) and 3 patients with SCDs (one calf, two thigh) (6.0%). The incidence of DVT was significantly higher in the LDW group (P less than .006). In this study of average-risk patients, the use of SCDs significantly outperformed LDW as a prophylactic agent. However, the thrombi that did occur with SCDs were more critical. PMID- 1774569 TI - Tissue growth into porous primary and revision femoral stems. AB - The authors studied 45 uncemented porous-coated femoral stems from 45 patients: 35 primary total hip arthroplasties and 10 revisions of either cemented (7) or uncemented (3) femoral components. Histologic sections were examined quantitatively for type, amount, and distribution of tissue ingrowth; these findings were correlated with clinical and radiographic data. Fibrous tissue ingrowth predominated in both groups. Of the primary arthroplasty group, the grade of bone ingrowth in 8 specimens was none, 14 minimal, 6 moderate, and 7 more extensive. In the revision cases, the grade of bone ingrowth in 5 was none, 3 minimal, and 2 moderate. Bone ingrowth was seen more frequently in the distal porous coating, particularly in the revision cases, and most often where direct stem-endosteal canal contact had occurred. While bone ingrowth can occur in uncemented revision stems, it generally appears less abundantly than in primary total hip arthroplasty. PMID- 1774570 TI - Incidence of deep sepsis in total hip arthroplasty. Survivorship analysis over 17 years from one hospital. AB - Of 3,051 total hip arthroplasties (THA) performed between January 1970 and August 1986, 47 hips in 43 patients developed deep periprosthetic infection. This population was divided temporally into three groups based on changes in our perioperative antiseptic technique. Using survivorship analysis, a significant decrease in the sepsis rate in primary THA was seen in the period since 1974 (P less than .03). Comparing all surgeries in the most recent cohort (1980-1986) to others by a Cox Proportional Hazards model (which accounts for differences in follow-up results), indicates that the relative risk of sepsis has decreased by half in this latest group. Contemporary perioperative antiseptic techniques have lowered the risk of infection in THA. Further significant decreases in sepsis incidence will likely require a reduction in the incidence of infection acquired outside the operating room. PMID- 1774571 TI - Survivorship analysis of the Ring hip arthroplasty. AB - Two hundred fifty-three Ring mark 2 metal-on-metal hip arthroplasties performed between 1968 and 1974 were evaluated using survivorship analysis. Using revision as the criterion for failure, the authors found a cumulative survival rate of 60.4% after 21 years. The results are compared with data from previous studies that used survivorship analysis for metal-on-metal hip arthroplasties, and it is shown that the Ring hip arthroplasty performed as well as the McKee-Farrar prosthesis and better than the Stanmore prosthesis. PMID- 1774573 TI - Rotation affects apparent radiographic positioning of femoral components in total hip arthroplasty. AB - The authors have noted a change in the varus/valgus positioning of femoral components on anteroposterior (AP) radiographs that is dependent on limb rotation after total hip arthroplasty (THA). This effect, called pseudoposition, was demonstrated in six cadaver femurs implanted with an uncemented prosthesis that is noncanal-filling in the AP dimension. The distal tip of the prosthesis was positioned posteriorly in all specimens due to the bow of the femur. External rotation causes pseudovalgus positioning, and internal rotation causes pseudovarus positioning. Awareness of this phenomenon is important in the longitudinal analysis of femoral components after THA and emphasizes the need for standardized radiographic technique. PMID- 1774572 TI - Elevated-rim acetabular components. Effect on range of motion and stability in total hip arthroplasty. AB - The effect of "elevated-rim" (ER) acetabular components on prosthetic range of motion (ROM) and stability was studied in a laboratory simulator using three contemporary total hip arthroplasty (THA) systems. Acetabular components were tested in positions simulating both normal alignment and excess abduction. The geometry of the implants differed between systems--two types were identified, and their effect on ROM in comparison with their corresponding plain liners were quantified. The ability of the liners to improve instability appeared to be dependent on the cause of instability, the orientation of the metal shell and ER liner, and the ER liner geometry. The routine use of ER liners in otherwise satisfactorily positioned acetabular components appeared to offer no demonstrable benefit and raised concern over theoretical disadvantages. The primary indication for these implants appeared to be in cases of instability due to acetabular malposition in which the metal shell is already well fixed by cement or bone ingrowth or cannot be readily changed. PMID- 1774574 TI - Factors related to failure of structural bone grafts in acetabular reconstruction of total hip arthroplasty. AB - Structural bone grafts in acetabular reconstruction of total hip arthroplasty have come into more common usage with the increasing number of revision arthroplasties. The authors present the outcome of 40 bone grafts with follow-up periods of 2-8 years. Primary and revision arthroplasties with both cemented and noncemented fixation are included. Factors that had a statistically significant relationship to failure of the bone graft included fit and fixation of bone graft to host, fit and fixation of prosthesis to host, union of bone graft to host, and the presence or absence of the confluence of the anterior and posterior columns of the acetabulum. Other findings of interest were a higher failure rate of multiple grafts as compared to a single graft and freeze-dried femoral heads. Migration of the socket of more than 3 mm is statistically related to failure of the socket. PMID- 1774575 TI - Trochanteric exostoses following total hip arthroplasty. A complication of trochanteric osteotomy. AB - Trochanteric osteotomy has long been a fundamental part of the technique of the Charnley low-friction arthroplasty. It is, however, not without its complications, the principal one of which is nonunion regardless of the type of fixation used. A previously undescribed complication requiring reoperation is reported with regard to eight cases of primary hip arthroplasty. PMID- 1774576 TI - Recurrent pigmented villonodular synovitis of the hip joint. Case report and review of the literature. AB - A case report of recurrent pigmented villonodular synovitis of the hip joint, which was treated with en bloc resection of the acetabulum and proximal femur, followed by allograft acetabular reconstruction and total hip arthroplasty, is presented. The allograft united and, at 2 years, revealed an excellent clinical result. Treatment rationale and literature are reviewed. PMID- 1774577 TI - Polyethylene synovitis following canine total hip arthroplasty. Histomorphometric analysis. AB - The synovial membrane response to polyethylene wear debris was analyzed in canine total hip arthroplasties (THA). Fifty-four THAs were performed in healthy, mature dogs. None of the arthroplasties demonstrated clinical or radiographic signs of loosening. Synovial membrane biopsies were harvested 4 (n = 13), 6 (n = 5), 8 (n = 8), 12 (n = 15), and 24 (n = 6) months after surgery and were scored for inflammation, polyethylene (PE) wear debris, histiocyte density, and membrane thickness. The amount of PE wear debris tended to increase with time. However, the inflammatory changes within the joint capsule and synovial membrane did not progress, and the total thickness of the alveolar and surface layers decreased (P = .008). It appears that the amount of wear debris at 2 years in canine hip arthroplasties, without evidence of loosening, is well tolerated by the joint capsule. PMID- 1774578 TI - Different mechanical transduction mechanisms for the immediate and delayed responses of rat C-fiber nociceptors. AB - 1. In this electrophysiological study, action potentials from single C-fibers were recorded in fine filaments teased from the rat saphenous nerve. We evaluated the effect of pharmacological agents on the responses of C-fiber mechanoheat nociceptors (C-MH; n = 53) after sustained suprathreshold and subthreshold stimuli. 2. Sustained suprathreshold mechanical stimuli elicit an immediate burst of activity that quickly adapts to a low-level firing that is maintained during the stimulus. Sustained subthreshold stimuli activate C-MHs after a delay and elicit a constant, low-level firing. 3. Gentamicin, a known suppressor of mechanosensory cell activity, blocked the initial rapid burst response to suprathreshold stimuli (n = 11) but had no effect on the adaptive low-level firing. The latency of the delayed activation of C-MHs induced by sustained subthreshold stimuli was not affected by gentamicin. 4. Sphingosine, a protein kinase inhibitor, increased the latency of the delayed activation of C-MHs (n = 7) to sustained subthreshold stimuli; phorbol 12-myristate 13-acetate (TPA), a protein kinase C activator, decreased the latency of the delayed activation of C MHs (n = 9); and 4 alpha-phorbol, an inactive isomer of TPA, had no effect on the latency of the delayed activation (n = 7). Sphingosine, TPA, and 4 alpha-phorbol had no affect on the initial burst response induced by suprathreshold stimuli. 5. K+ channel blockers, 4-aminopyridine (n = 9) and noxiustoxin (n = 5), decreased the latency of the delayed activation of C-MHs to sustained subthreshold stimuli but had no effect on the initial burst response of C-MHs to suprathreshold stimuli.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774579 TI - Interactive effects among several stimulus parameters on the responses of striate cortical complex cells. AB - 1. Although neurons within the visual system are often described in terms of their responses to particular patterns such as bars and edges, they are actually sensitive to many different stimulus features, such as the luminances making up the patterns and the duration of presentation. Many different combinations of stimulus parameters can result in the same neuronal response, raising the problem of how the nervous system can extract information about visual stimuli from such inherently ambiguous responses. It has been shown that complex cells transmit significant amounts of information in the temporal modulation of their responses, raising the possibility that different stimulus parameters are encoded in different aspects of the response. To find out how much information is actually available about individual stimulus parameters, we examined the interactions among three stimulus parameters in the temporally modulated responses of striate cortical complex cells. 2. Sixteen black and white patterns were presented to two awake monkeys at each of four luminance-combinations and five durations, giving a total of 320 unique stimuli. Complex cells were recorded in layers 2 and 3 of striate cortex, with the stimuli centered on the receptive fields as determined by mapping with black and white bars. 3. An analysis of variance (ANOVA) was applied to these data with the three stimulus parameters of pattern, the luminance-combinations, and duration as the independent variables. The ANOVA was repeated with the magnitude and three different aspects of the temporal modulation of the response as the dependent variables. For the 19 neurons studied, many of the interactions between the different stimulus parameters were statistically significant. For some response measures the interactions accounted for more than one-half of the total response variance. 4. We also analyzed the stimulus-response relationships with the use of information theoretical techniques. We defined input codes on the basis of each stimulus parameter alone, as well as their combinations, and output codes on the basis of response strength, and on three measures of temporal modulation, also taken individually and together. Transmitted information was greatest when the response of a neuron was interpreted as a temporally modulated message about combinations of all three stimulus parameters. The interaction terms of the ANOVA suggest that the response of a complex cell can only be interpreted as a message about combinations of all three stimulus parameters.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1774580 TI - A quantitative study of neuronal discharge in areas 5, 2, and 4 of the monkey during fast arm movements. AB - 1. The properties of parietal neurons were studied in four adult rhesus monkeys during fast arm movements. The animals were trained to perform flexion or extension of the forearm about the elbow in response to specific auditory cues. Single neuron activity was recorded in 272 area 5 neurons, 81 neurons of the somatosensory cortex, and 92 neurons of the motor cortex. 2. In area 5, 42% of neuronal changes occurred before movement onset (early changes) and 58% after (late changes), with 21% before the earliest electromyogram. The range of modification in activity took place between 260 ms before movement onset and 180 ms after. Complex receptive fields were found in area 5 with a greater proportion among the late neurons (72%) than among the early neurons (32%). 3. Different patterns of activity were observed in neurons recorded in both movement directions. Reciprocal neurons represented 52% of the motor cortex neurons and 41% of the neurons in the somatosensory cortex but only 14% of the area 5 neurons. Of the remainder area 5 neurons, 46% were direction-sensitive neurons and 39% coactivated neurons. This suggests a more complex encoding of movement direction in area 5 than in area 2 or 4. 4. Temporal characteristics of the neuronal bursts were quantitatively analyzed in areas 5, 2, and 4. Neuronal burst duration was longer in area 5 than in the other areas. Above all, a variability of burst parameters, which did not depend on variable movement execution, was noticed in area 5. Therefore neuronal activity in this cortical area cannot be simply explained by a convergence of sensory and motor inputs but may depend on the behavioral context in which the movement is performed. 5. A correlation between neuronal burst duration and movement duration was found in 41% of area 2 neurons. In area 5, this correlation was observed in 20% of the late neurons and in 14% of the early neurons. A correlation between neuronal discharge frequency and movement velocity was found in 34% of area 2 neurons and 24% of area 4 neurons. About 16% of both late and early neurons in area 5 showed such a correlation. These neurons received polyarticular input, and it is suggested that they may be involved in the kinematic encoding of polyarticular movements. 6. A topographic and functional organization of area 5 was noticed. In anterior area, 5, 83% of the neurons had receptive fields and most of the reciprocal neurons and those exhibiting a correlation with movement parameters were found there.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1774581 TI - Isotropic connections generate functional asymmetrical behavior in visual cortical cells. AB - 1. We study the relationship between structure and function in inhibitory long range interactions in visual cortex. The sharpening of orientation tuning with "cross-orientation inhibition" is used as an example to discuss anisotropies that are generated by long-range connections. 2. In this study, as opposed to the detailed cortex model described in a previous report, a model of the cortical orientation column structure is proposed in which cortical cells are described only by their orientation preference. 3. We present results using different geometric arrangements of orientation columns. In the simplest case, straight parallel orientation columns were used. We also utilized more realistic, curved columns generated by a simple algorithm. The results were confirmed by the study of a patch of real column structure, determined experimentally by Swindale et al. 4. A given cell receives functionally defined cross-orientation inhibition if the cell receives inhibitory input that is strongest along its nonpreferred orientation. On the other hand, a cell is said to receive structurally defined cross-orientation inhibition if the inhibition arises from source cells with an orientation preference orthogonal to that of the target cell. Even though those definitions seem to describe similar situations, we show that, in the general case, structurally defined cross-orientation inhibition does not efficiently sharpen orientation selectivity. In particular, for straight and parallel columns, structurally defined cross-orientation inhibition results in unequal amounts of inhibition for whole cell populations with different preferred orientations. 5. In more realistic column structures, we studied the question of whether structural cross-orientation inhibition could be implemented in a more efficient way. However, for the majority of cells, it is demonstrated that their nonpreferred stimulus will not preferably excite "cross-oriented" cells. Thus structural cross-orientation inhibition is not efficient in real cortical columns. 6. We propose a new mechanism called circular inhibition. In this connection scheme, a target cell receives inhibitory input from source cells that are located at a given distance (the same for all cells) from the target cell. Circular inhibition can be regarded as two-dimensional long-range lateral inhibition. As opposed to structural cross-orientation inhibition, this mechanism does not introduce unwanted anisotropies in the orientation tuning of the target cells. It is also conceptually much simpler and developmentally advantageous. It is shown that this connection scheme results in a net functional cross orientation inhibition in all realistic column geometries. The inhibitory tuning strength obtained with circular inhibition is weak and similar to that measured in reality.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1774582 TI - Differential synaptic effects on physiological flexor hindlimb motoneurons from cutaneous nerve inputs in spinal cat. AB - 1. We previously demonstrated in the spinal cat that superficial peroneal cutaneous nerve stimulation produced strong reflex contraction in tibialis anterior (TA) and semitendinosus (St) muscles but unexpectedly produced mixed effects in another physiological flexor muscle, extensor digitorum longus (EDL). The goal of the present study was to further characterize the organization of ipsilateral cutaneous reflexes by examining the postsynaptic potentials (PSPs) produced in St, TA, and EDL motoneurons by superficial peroneal and saphenous nerve stimulation in decerebrate, spinal cats. 2. In TA and St motoneurons, low intensity cutaneous nerve stimulation that activated only large (A alpha) fibers [i.e., approximately 2-3 times threshold (T)], typically produced biphasic PSPs consisting of an initial excitatory phase and subsequent inhibitory phase (EPSP, IPSP). Increasing the stimulus intensity to activate both large (A alpha) and small (A delta) myelinated cutaneous fibers supramaximally (15-45 T) tended to enhance later excitatory components in TA and St motoneurons. 3. In EDL motoneurons, 2-3 T stimulation of the superficial peroneal nerve evoked initial inhibition (of variable magnitude) in 7/10 EDL motoneurons tested, with either excitation (n = 2) or mixed effects (n = 1) observed in the remaining EDL motoneurons. Saphenous nerve stimuli produced excitation either alone, or preceded by an inhibitory phase in EDL. Increasing the stimulus intensity enhanced later inhibitory influences from superficial peroneal and excitatory influences both from superficial peroneal and saphenous nerve inputs in EDL motoneurons. 4. Short-latency (less than 1.8 ms) EPSPs were observed in a few motoneurons in all reflex pathways examined, except for EPSPs in EDL motoneurons evoked by saphenous stimulation. IPSPs with central latencies less than 1.8 ms were also produced by both saphenous (TA, n = 1; EDL, n = 2) and superficial peroneal (EDL, n = 4) nerve stimulation. 5. The results, in comparison with other reports employing spinal and nonspinal preparations, suggest that removal of influences from higher centers reveals inhibitory circuits from the superficial peroneal and saphenous nerves to EDL motoneurons in the spinal preparation. The inhibitory inputs observed are thought to reflect the activation of "specialized" reflex pathways. Additionally, the demonstration of short-latency EPSPs and IPSPs suggest that the minimal linkage in both the excitatory and inhibitory cutaneous reflex pathways examined is disynaptic. The results are discussed in relation to previous studies on classically conditioned flexion reflex facilitation in spinal cat. PMID- 1774583 TI - Visual responses of pulvinar and collicular neurons during eye movements of awake, trained macaques. AB - 1. We recorded from single neurons in awake, trained rhesus monkeys in a lighted environment and compared responses to stimulus movement during periods of fixation with those to motion caused by saccadic or pursuit eye movements. Neurons in the inferior pulvinar (PI), lateral pulvinar (PL), and superior colliculus were tested. 2. Cells in PI and PL respond to stimulus movement over a wide range of speeds. Some of these cells do not respond to comparable stimulus motion, or discharge only weakly, when it is generated by saccadic or pursuit eye movements. Other neurons respond equivalently to both types of motion. Cells in the superficial layers of the superior colliculus have similar properties to those in PI and PL. 3. When tested in the dark to reduce visual stimulation from the background, cells in PI and PL still do not respond to motion generated by eye movements. Some of these cells have a suppression of activity after saccadic eye movements made in total darkness. These data suggest that an extraretinal signal suppresses responses to visual stimuli during eye movements. 4. The suppression of responses to stimuli during eye movements is not an absolute effect. Images brighter than 2.0 log units above background illumination evoke responses from cells in PI and PL. The suppression appears stronger in the superior colliculus than in PI and PL. 5. These experiments demonstrate that many cells in PI and PL have a suppression of their responses to stimuli that cross their receptive fields during eye movements. These cells are probably suppressed by an extraretinal signal. Comparable effects are present in the superficial layers of the superior colliculus. These properties in PI and PL may reflect the function of the ascending tectopulvinar system. PMID- 1774584 TI - Directional selectivity and spatiotemporal structure of receptive fields of simple cells in cat striate cortex. AB - 1. Simple cells in cat striate cortex were studied with a number of stimulation paradigms to explore the extent to which linear mechanisms determine direction selectivity. For each paradigm, our aim was to predict the selectivity for the direction of moving stimuli given only the responses to stationary stimuli. We have found that the prediction robustly determines the direction and magnitude of the preferred response but overestimates the nonpreferred response. 2. The main paradigm consisted of comparing the responses of simple cells to contrast reversal sinusoidal gratings with their responses to drifting gratings (of the same orientation, contrast, and spatial and temporal frequencies) in both directions of motion. Although it is known that simple cells display spatiotemporally inseparable responses to contrast reversal gratings, this spatiotemporal inseparability is demonstrated here to predict a certain amount of direction selectivity under the assumption that simple cells sum their inputs linearly. 3. The linear prediction of the directional index (DI), a quantitative measure of the degree of direction selectivity, was compared with the measured DI obtained from the responses to drifting gratings. The median value of the ratio of the two was 0.30, indicating that there is a significant nonlinear component to direction selectivity. 4. The absolute magnitudes of the responses to gratings moving in both directions of motion were compared with the linear predictions as well. Whereas the preferred direction response showed only a slight amount of facilitation compared with the linear prediction, there was a significant amount of nonlinear suppression in the nonpreferred direction. 5. Spatiotemporal inseparability was demonstrated also with stationary temporally modulated bars. The time course of response to these bars was different for different positions in the receptive field. The degree of spatiotemporal inseparability measured with sinusoidally modulated bars agreed quantitatively with that measured in experiments with stationary gratings. 6. A linear prediction of the responses to drifting luminance borders was compared with the actual responses. As with the grating experiments, the prediction was qualitatively accurate, giving the correct preferred direction but underestimating the magnitude of direction selectivity observed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1774585 TI - Neuronal activity related to visually guided saccadic eye movements in the supplementary motor area of rhesus monkeys. AB - 1. The purpose of this study was to describe the response properties of neurons in the supplementary motor area (SMA), including the supplementary eye fields (SEF) of three rhesus monkeys (Macaca mulatta) performing visually guided eye and forelimb movements. Seven hundred thirty single units were recorded in the dorsomedial agranular cortex while monkeys performed a go/no-go visual tracking task. The unit activity associated with rewarded, task-related movements was compared with that associated with unrewarded, spontaneous movements executed in the intertrial interval or when the task was not running. A number of neuronal response types were identified. 2. Sensory cells were characterized by their response to the visual and/or auditory target stimuli combined with no discharge associated with eye or forelimb movements. New information was provided about the receptive fields of the visual cells; they varied in size and, although many included the ipsilateral hemifield, they tended to emphasize the contralateral. A significant proportion of the visually responsive cells had receptive fields restricted to within 8 degrees of the fovea. The response latency was relatively long (greater than 90 ms) and variable. 3. Preparatory set cells were activated from the appearance of the target until the presentation of the go/no-go cue. This subpopulation ceased firing 50-100 ms before the movement was initiated. These cells tended to respond best in relation to contralateral movements. The response latency was similar to that of the sensory cells, although some of these units began to discharge in anticipation of predictable target presentations. These neurons were not active before unrewarded, spontaneous saccades. 4. Sensory movement cells comprised the largest population of neurons identified in SMA. They were active from the appearance of the target until after the execution of the saccade. These neurons tended to respond preferentially in association with contraversive saccades. The latency of response to the target was significantly longer than that of the sensory cells. There was a large amount of variability in the time to reach the peak level of activation, and this population of units generally became inactivated shortly after the saccade was initiated. Although there were counterexamples, most sensory-movement cells responded equally in association with visually and auditory guided movements. In addition, these neurons were not active in relation to self-generated eye movements made during the intertrial intervals. 5. Pause-rebound cells were identified by their suppression at the appearance of the target and subsequent discharge associated with the saccade. These units tended to respond preferentially to contralateral targets.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1774586 TI - Neuronal activity related to visually guided saccades in the frontal eye fields of rhesus monkeys: comparison with supplementary eye fields. AB - 1. The purpose of this study was to analyze the response properties of neurons in the frontal eye fields (FEF) of rhesus monkeys (Macaca mulatta) and to compare and contrast the various functional classes with those recorded in the supplementary eye fields (SEF) of the same animals performing the same go/no-go visual tracking task. Three hundred ten cells recorded in FEF provided the data for this investigation. 2. Visual cells in FEF responded to the stimuli that guided the eye movements. The visual cells in FEF responded with a slightly shorter latency and were more consistent and phasic in their activation than their counterparts in SEF. The receptive fields tended to emphasize the contralateral hemifield to the same extent as those observed in SEF visual cells. 3. Preparatory set cells began to discharge after the presentation of the target and ceased firing before the saccade, after the go/no-go cue was given. These neurons comprised a smaller proportion in FEF than in SEF. In contrast to their counterparts in SEF, the preparatory set cells in FEF did not respond preferentially in relation to contralateral movements, even though most responded preferentially for movements in one particular direction. The time course of the discharge of the FEF set cells was similar to that of their SEF counterparts, except that they reached their peak level of activation sooner. The few preparatory set cells in FEF tested with both auditory and visual stimuli tended to respond preferentially to the visual targets, whereas, in contrast, most set cells in SEF were bimodal. 4. Sensory-movement cells represented the largest population of cells recorded in FEF, responding in relation to both the presentation of the targets and the execution of the saccade. Although some of these sensory-movement cells resembled their counterparts in SEF by exhibiting a sustained elevation of activity, most of the FEF sensory-movement cells gave two discrete bursts, one after the presentation of the target and another before and during the saccade. Like their counterparts in SEF, the sensory-movement cells tended to be tuned for saccades into the contralateral hemifield, but this tendency was more pronounced in FEF than in SEF. The FEF sensory-movement cells discharged more briskly, with a shorter latency relative to the presentation of the target, than their counterparts in SEF. In addition, the FEF sensory-movement neurons reached their peak activation sooner than SEF sensory-movement neurons. Most FEF sensory-movement cells exhibited different patterns of activation in response to visual and auditory targets.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1774588 TI - Two kinds of resting discharge in cat muscle spindles. AB - 1. The behavior of primary endings of cat soleus muscle spindles was studied during shortening steps carried out at different muscle lengths. 2. Spindles were of two kinds: one, silent spindles, whose afferents fell silent after the shortening, at least over part of the range of lengths tested. The second, spontaneous spindles, resumed firing at all lengths. 3. For silent spindles, the duration of the silent period, measured at lengths where they did recover a resting rate, depended directly on muscle length and became shorter at longer lengths. This is what would be expected if the slack introduced in the spindle by the shortening step was removed more rapidly at longer lengths by the higher passive tension. For spontaneous spindles, on the other hand, the duration of the silent period after the shortening was largely independent of muscle length and depended on the spindle's rate of firing immediately before the shortening. 4. At intermediate lengths the discharge of slack spontaneous spindles remained unaffected by an isometric muscle contraction. It was therefore not possible to produce a pause in the discharge, behavior normally taken as typical of spindles. The discharge could be interrupted by the contraction if this was combined with a large shortening movement. 5. It is proposed that when intrafusal fibers are slackened by a shortening step, the resting discharge in spontaneous spindles is generated by a maintained depolarization of the annulospiral ending resulting from extension of the terminal coils by forces from within the receptor. A shortening contraction compresses the spirals to interrupt the discharge. The sensory endings of silent spindles remain below threshold until the spirals have been opened out sufficiently by external stretch. PMID- 1774587 TI - Specificity of mono- and divalent salt transduction mechanisms in frog gustation evidenced by cobalt chloride treatment. AB - 1. Discrimination among stimuli with similar physical properties represents a formidable problem in sensory neurophysiology. The differential effect of cobalt chloride treatment on gustatory responses to monovalent and divalent salts may help to explain aspects of how the frog gustatory system encodes these stimuli. 2. Gustatory neural responses recorded from the glossopharyngeal nerve to divalent stimuli (CaCl2 and MgCl2) were inhibited by CoCl2 treatment, whereas monovalent responses (NaCl and KCl) were greatly augmented. Both effects were highly significant and completely reversible. 3. Intracellular recordings from the gustatory receptor cells, which synaptically initiate the impulses in the glossopharyngeal afferents, imply that these neural events are not a simple reflection of the receptor potential magnitude. Monovalent receptor potentials magnitudes (millivolts of depolarization) were enhanced by cobalt chloride, but receptor potentials to divalent stimuli were not inhibited. Rather they were either unaffected (MgCl2) or augmented (CaCl2). 4. Membrane resistance change during salt stimulation with cobalt chloride treatment followed the qualitative pattern observed with the neural response. Membrane resistance (in megohms) of the receptor cell was greater for divalent stimuli with cobalt treatment compared with divalent stimuli alone. Membrane resistance changes for monovalent stimuli were less with cobalt treatment compared with monovalent stimuli alone. These observations indicate that the glossopharyngeal neural response is not a simple reflection of the magnitude of the receptor potential but must be considered in conjunction with membrane resistance as an indicator of synaptic transmission. 5. These data were interpreted in terms of leading models of salt taste transduction, i.e., adsorption theories, phase boundary theories, and the direct penetration theories. Relevant mechanistic considerations for salt taste transduction in the frog include binding by divalents to membrane surface changes and amiloride-sensitive monovalent cation channels. It was concluded that the surface potential alone was not a critical variable in the mechanism of cobalt chloride alteration of salt responses. PMID- 1774589 TI - Effect of muscle length on phasic stretch reflexes in humans and cats. AB - 1. This is a report of the effects at different muscle lengths of the muscle's immediate history on the tendon jerk and Hoffman (H)-reflex in triceps surae of human subjects and cats. 2. In adult human subjects the size of the tendon jerk was measured as electromyogram (EMG) and torque in response to a tendon tap. Before each test tap the muscle was conditioned by a maximum voluntary contraction carried out with the foot either plantarflexed or dorsiflexed by 30 degrees from the test position. After a contraction with the foot dorsiflexed, the subsequent reflex response was smaller than after a contraction with the foot plantarflexed. 3. The same conditioning procedure was carried out with the H reflex. The reflex was elicited by transcutaneous electrical stimulation of the tibial nerve in the popliteal fossa. Here the reflex after a contraction with the foot dorsiflexed was larger than after plantarflexion. In other words, the effects of conditioning were the opposite for the tendon jerk and H-reflex. 4. The effects of muscle conditioning were tested over a range of muscle lengths. As the test length was made progressively longer, that is, the foot more dorsiflexed, the difference in size of the tendon jerk following the two forms of conditioning became less, whereas for the H-reflex it remained the same. 5. These findings were confirmed in cats anesthetized with alpha-chloralose. The tendon jerk was elicited by a quick stretch applied to the triceps surae muscle group, and the H-reflex represented by the monosynaptic reflex recorded from the central, cut end of the ventral root in response to electrical stimulation of the triceps nerve. Muscle conditioning consisted of a 1-s period of stimulation at 20 pulses/s, at fusimotor strength, of the peripheral end of the cut ventral root at a muscle length 5 mm longer or shorter than the test length. In the cat, as in human subjects, the effect of conditioning on the tendon jerk reversed at long muscle lengths, whereas the monosynaptic reflex showed no reversal. 6. It had been proposed previously that the effects of conditioning on stretch reflexes could be explained by development of slack in the intrafusal fibers of muscle spindles after a contraction at a longer-than-test length. The presence of slack lowers the resting discharge of spindles and reduces the afferent response to a tendon tap.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1774590 TI - Temperature neurons in the crotaline trigeminal ganglia. AB - 1. Intrasomal recordings were made with microelectrodes from 153 warm (infrared) neurons in the trigeminal ganglia of 36 crotaline snakes, Trimeresurus flavoviridis. Background discharges were observed at room temperature. The 153 warm neurons were classified into two groups: 81 were sensitive to less than or equal to 10 mg of von Frey hair mechanical stimulation (warm T + M neuron), and 72 were insensitive to up to 100 mg or more of mechanical stimulation (warm T neuron). For T + M and T neurons the receptive fields were all located in the pit organ. The mechanically sensitive field of warm T + M neurons located within the infrared receptive field on the pit membrane was less than 1 mm in diameter, and there was only one field per neuron. 2. Electrophysiological parameters were measured. These measurements included membrane potential, action potential amplitude, time of peaking, time duration at the resting membrane potential level, afterhyperpotential (AHP) height and AHP time to half-decay, and maximum rates of depolarization and repolarization. No difference in action potential parameters between the means of these two submodality groups was observed. 3. Intracellular horseradish peroxidase (HRP) labeling was used for defining the warm neuron profile. The somata of warm T and warm T + M neurons and T- or Y shaped bifurcations of the axon were observed in the ganglion. At the bifurcation point, nodes of Ranvier were observed, but without broad triangular expansion. Diameters of the central axons were thinner than those of the peripheral or stem axons. There were no differences between the mean diameters of the two submodalities. 4. The central axons of warm T and T + M neurons projected to the lateral descending nucleus of the trigeminal nerve (LTTD). Their synaptic boutons were found in the LTTD. No branching of the axons to the principal sensory nucleus or the descending nucleus of the trigeminal nerve was found. These results were the same for six warm T and eight warm T + M neurons. 5. Conduction velocities of the peripheral fibers were measured by stimulating superficial branches of the maxillary nerve electrically. Three groups of conduction velocity were identified in the compound potentials. The conduction velocity of the peak action potential of the warm T fibers was 6.9 +/- 1.2 (SD) m/s (n = 18), that of the T + M fibers 6.7 +/- 0.9 m/s (n = 23). These fell into the second group of the compound potentials.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1774591 TI - Surgical approaches to the clivus and upper cervical spine. AB - The surgical approach to the lesions of the craniocervical junction raises important problems about the choice of the access. The authors debate the advantages and the disadvantages of the principal approaches, presenting their clinical experience of 8 operated patients and discerning between intradural approaches and extradural submucosal or transmucosal approaches. PMID- 1774592 TI - Clinical, morphometric and ultrastructural aspects in a new model of spinal cord compression. AB - A new model of spinal cord compression is presented. Forty-two New Zealand albino rabbits weighing between 1.2 and 1.5 kg were submitted to spinal cord compression to about half of its normal diameter by vascular Sugita's clip to different compression time (sham, 5-10-20 minutes e 1-6-12 hours) and sacrified after 72 hours. The consequent neurological dysfunction size of lesion was graded by Tarlov's scale for voluntar motility. Ultrastructural and morphometrical studies were carried out to evaluate changes in shape, perimeters, axonal and myelin areas of the lateral and the posterior tract of spinal cord. A 10 minute decrease of 50% of the transverse diameter of the spinal cord causes a defined damage. The swelling of myelin is a useful index of the importance of the damage. PMID- 1774593 TI - Spontaneous resolution of subdural hematomas. AB - From a series of 35 cases of subdural hematomas in a 12 months span, 6 cases of subdural hematomas which spontaneously resolved were found. The sizes of these hematomas ranged from the relatively small to the huge. All of these cases displayed little if any neurological deficit when seen by us. It is thought that the mechanisms of resorption are: co-mingling with CSF and redistribution in the more acute variety and in instances of subdural hydromas; and thru the healing and reparative process in the chronic type. PMID- 1774594 TI - Giant aneurysm of the internal carotid bifurcation successfully clipped. Case report and description of postoperative CT scan and MRI modifications. AB - Surgery of giant internal carotid bifurcation aneurysms (GBICAA) is followed by high postoperative mortality and morbidity rate. One case of GBICAA successfully submitted to clipping at the neck is reported and the modifications of CT Scan and MRI pictures described. PMID- 1774595 TI - Bilateral middle cranial fossa arachnoid cysts. A case report. AB - The temporal lobe agenesis syndrome is a rare congenital abnormality. This syndrome frequently has been described in association with arachnoid cysts or abnormal collections of cerebrospinal fluid. Arachnoid cysts develop most frequently in the middle cranial fossa and almost all these cysts are unilateral. Bilateral middle cranial fossa arachnoid cysts are extremely rare and only 9 cases have been reported in the literature. We present an adult case with bilateral arachnoid cysts and temporal lobe agenesis whose mental examination and neurologic assessment is normal. The cysts are demonstrated by CT and metrizamid CT cysternography. PMID- 1774596 TI - Neurocysticercosis treated with praziquantel. Long-term follow-up of a case. AB - The Authors report a case of neurocysticercosis treated with praziquantel and ventriculoperitoneal shunt. The patient presented, at CAT, multiple intracranial calcifications and cysts located in the cerebral parenchyma, ventricular system and subarachnoid cisterns. Praziquantel was orally administered at a daily dosage of 50 mg/kg. Two 15 day cycles of therapy were administered with an interval of one month between them. No significant side effects were observed during the treatment. Serial follow-up CAT scans demonstrated a gradual decrease in size and, finally, total disappearance of the cystic lesions. No neurological disfunction was observed at the last follow-up examination 4 years after treatment. PMID- 1774597 TI - Cerebral echinococcosis multilocularis. Case report. AB - Cerebral occurrence of Echinococcus multilocularis is very rare and there is no widely accepted therapeutical method. In this report we present a case with an intracranial mass lesion and a palpable hepatic mass, which appeared to be due to Echinococcus multilocularis in the histopathological examination. PMID- 1774598 TI - Brain abscess caused by Salmonella typhimurium. Case report and review of the literature. AB - Brain abscess due to Salmonella species are very rare. In this paper a case of brain abscess caused by Salmonella typhimurium is reported. The patient had no history of Salmonellosis. A review of the literature is also presented. PMID- 1774599 TI - Enterogenous cyst of the cervicomedullary junction. A case report. AB - Enterogenous cyst of the cervicomedullary junction extending from C2 level to the anterior aspect of the medulla oblongata was diagnosed in a 23-year-old male with a one month history of episodic tetraparesis and bilateral horizontal nystagmus. The cyst was removed subtotally except for a small portion at the point of the attachment to the anterior aspect of the medulla oblongata by a laminectomy of C1 C2 and a suboccipital craniectomy. Histopathological and immunohistochemical examinations revealed that the cyst originated exclusively from the endoderm. PMID- 1774600 TI - Multiple neurilemmoma of the cauda equina. A case report. AB - A 49-year-old male, with a relatively uncommon multiple neurilemmoma, exhibited symptoms of cauda equina compression. Following a diagnosis of multiple tumor of the cauda equina and extradural cyst, based on myelography and CTM, the tumors at L1-L2, the left S1 nerve root, and left hip were resected. Three years after the operation, the patient is asymptomatic apart from slight numbness in the right hip and there is no evidence of tumor recurrence. The rarity of such a case prompted this report. PMID- 1774601 TI - Sensitized immunochemical method for the specific detection of human haemoglobin in dried biological samples. AB - The authors describe a modified version of counterimmunoelectrophoresis of easy performance and high sensitivity. With this method human haemoglobin can easily and specifically be determined either in fresh or dried biological samples. Glutaraldehyde pretreatment of the samples results in the development of complexes with highly favourable electrophoretic mobility and precipitating capacity. By this chemical modification and use of a double set of samples with varying antigen-antibody proportion, the sensitivity of haemoglobin detection in erythrocyte-containing haemolysate and native blood was 300 ng/ml. The examination is easily performed, and without considerable outlay, even with conventional laboratory facilities. It is equally suitable for the detection of occult colorectal bleeding and for species-specific study of blood stains of unknown origin. The authors succeeded in identifying human haemoglobin even in a 42-month dried blood stain. PMID- 1774602 TI - A filter affinity transfer method for the analysis of rheumatoid factors. AB - Transfer of serum proteins separated by thin layer agarose electrophoresis onto nitrocellulose sheets precoated with purified human polyclonal IgG followed by revelation with enzyme-coupled anti-mu or anti-alpha antisera resulted in the specific detection of rheumatoid factors (RF) belonging to the IgM or IgA classes. Mono- or polyclonality of such RF can be evaluated from the patterns of the blots (sharp bands). In addition, their light chain type can be determined using affinity filters coated with a gamma heavy chain disease protein or with IgG Fc fragments. This simple and rapid procedure allows an easy characterization of monoclonal RF, even if they are present in minute amount amongst polyclonal RF as in certain sera from rheumatoid arthritis patients. PMID- 1774603 TI - Evaluation of HIV P24 antigen, beta 2-microglobulin, neopterin, soluble CD4, soluble CD8, and soluble interleukin-2 receptor levels in patients with AIDS or AIDS-related complex treated with 2',3'-dideoxyinosine (ddI). AB - Circulating HIV P24 antigen, beta 2-microglobulin, neopterin, soluble CD4, soluble CD8, and soluble interleukin-2 receptor were measured in 13 zidovudine intolerant patients (8 with ARC and 5 with AIDS) treated with dideoxyinosine (ddI). Measurements were made at baseline and at several intervals during therapy. Mean levels of HIV P24 antigen decreased early and significantly (P less than 0.01) after 2 weeks of ddI administration and remained low at weeks 8 and 12. In addition, mean SCD8 levels decreased late and significantly (P less than 0.02) after 16 weeks of ddI treatment and remained low at 24 weeks. In contrast, ddI administration had no substantial effect on mean levels of beta 2 microglobulin, neopterin, soluble CD4, and soluble interleukin-2 receptor. ddI administration appears to have been associated with early reduction of HIV P24 antigen levels and later reduction of SCD8 mean levels in these patients. PMID- 1774605 TI - Increased serum alkaline phosphatase activity: a possible indicator of renal damage. AB - Increased levels of serum alkaline phosphatase (ALP) (E.C.3.1.3.1.) were observed in 25 patients with various urological conditions involving the kidneys: malignancy, complicated nephrolithiasis, and surgical and percutaneous manipulations. Other possible sources for increased ALP level, mainly hepatic and osseous, were excluded by history, laboratory tests, and liver and bone imaging. Studies of isoenzymes of ALP did not show a distinctive pattern. ALP levels returned to the normal range by treating the underlying lesions involving the kidney: nephrectomy, complete removal of stones, or removal of nephrostomy. The increase in serum ALP activity may be derived from the injury to the brush border membrane of the renal tubular cells. Renal function impairment and contrast media induced nephrotoxicity may also be responsible for the increased serum ALP. Serum ALP may be a marker for involvement of the kidneys in pathological processes and an indicator of complete treatment. This clinical observation is worthy of further study. PMID- 1774604 TI - Production of a murine monoclonal antibody with anti-HIV-1 neutralizing properties. AB - A mouse monoclonal hybridoma cell line producing IgG 1k to human immunodeficiency virus (HIV-1) gp120 envelope protein was cultured in several systems. A small scale flask culture was essential for characterizing the culture variables of the hybridoma. A dialysis tubing culture appeared to be an excellent alternative to in vivo cultures of ascitic fluid, and gave high mouse monoclonal antibody (Mab) concentrations. Two continuous culture systems were both very effective in producing large amounts of Mabs. The hollow fiber system has the advantage of giving a concentrated product in the harvest. The ceramic core system, on the other hand, allows excellent monitoring of the cellular growth and production phases and gave the highest HIV antigen reactivity/micrograms of the produced IgG. Twelve grams of HIV-1 neutralizing Mabs were produced. The Mab was purified with a yield of 61%. The neutralizing capacity of the Mab was studied in vitro and shown to be excellent with 50% neutralizing titers using 5 ng Mab. The biological half-life of the Mab given intravenously to an HIV-infected individual was shown to be around 30 h. PMID- 1774606 TI - Clinical evaluation of five therapeutic drugs using dry film multilayer technology on the OPUS immunoassay system. AB - Five therapeutic drug assays, carbamazepine, phenobarbital, phenytoin, theophylline, and valproic acid, were evaluated using an automated random access system for performing thin dry film multilayer competitive immunoassays, the OPUS analyzer. All reagents for the therapeutic drug assays are contained in a coated multilayer film chip encased within a plastic bar-coded test module and require no external or supplementary reagents. A serum or plasma sample is applied to the test module by the instrument and the fluorescence intensity from the module is measured after 6 minutes. We found the OPUS assays acceptable for clinical use. Within-run coefficient of variations were 2.3-6.7%, between-run, 2.9-7.6%. These methods correlated well with the Abbott TDx, having correlation coefficients of 0.92-0.97. Because of the instrument design and the stability of the reagents, weekly calibration is not needed and samples can be run immediately upon receipt in a random access fashion or can be batched together. PMID- 1774607 TI - DNA ploidy and cell-cycle analysis: tools for assessment of cancer prognosis. AB - DNA ploidy and cell cycle analysis as measured by flow cytometry (FC) and image analysis (IA) have moved out of the realm of the research laboratory to become valid clinical tests used in the assessment of prognosis of the cancer patient. Although much information on the relationship of DNA ploidy/%S-phase analysis to patient prognosis is available in the literature, the data are not presented in such a way as to be helpful in clinical decision making. Because predictive values and confidence intervals, which measure the likelihood that a given clinical test will rule in or rule out a clinical outcome, were not calculated in previous reviews, conclusions about the clinical utility of these analyses were not possible. Using the available raw data on DNA ploidy and %S-phase analysis from previously published papers, predictive values and confidence limits were calculated for specific clinical presentations. In several such clinical situations (tumor type, stage, etc.), predictive value of greater than 90% was derived. We conclude that in these situations DNA ploidy and %S-phase analysis can be used to predict clinical outcome, to design treatment, and to guide patient management. The evaluation of the clinical utility of these tests must ultimately rest on prospective trials which show that randomized arms respond to treatment regimens dependent upon the DNA ploidy and %S-phase status. PMID- 1774608 TI - An enzyme immunoassay screening test for the detection of total antinuclear antibodies. AB - The enzyme immunoassay antinuclear antibody (EIA ANA) screening test method is a new assay format for the qualitative determination of antinuclear antibodies (ANAs) in human serum or plasma. This assay method collectively detects ANAs against double stranded DNA (dsDNA), SS-A/Ro, SS-B/La, Scl-70, Sm, and Sm/RNP antigens, along with serum positive for peripheral, homogeneous, speckled, nucleolar, and centromere patterns. This assay correlated well with data obtained with hemagglutination tests for specific ANA antigens, with the indirect immunofluorescence (IFA) ANA HEp-2 test, and with the Crithidia luciliae IFA test for anti-dsDNA. This new test procedure is both highly specific and sensitive and substantially decreases the time involved when screening large numbers of patient samples. PMID- 1774609 TI - Concordance of three measures of cocaine use in an arrestee population: hair, urine, and self-report. AB - This article reports on the comparison of self-reported cocaine use with urinalysis outcomes and radioimmunoassay of hair samples for cocaine. The data is based on a voluntary sample of approximately 300 arrestees, tested and interviewed anonymously. The study reports high rates of request compliance for both urine and hair samples, and affirms a relatively high degree of underreporting of cocaine use. Radioimmunoassay of hair appears to detect considerably larger degrees of cocaine use than are detected by urinalysis. The differential rates of detection between hair and urine are less dramatic in subjects who appear to be high rate users. PMID- 1774611 TI - Psychoactive drug research in the Soviet scientific tradition. AB - During the past 200 years, Soviet scientists have extensively investigated and evaluated the effects of psychoactive drugs in humans. An examination of the resultant literature provides insight into the four distinct periods that comprise this era of research. PMID- 1774610 TI - Staying off methadone maintenance. AB - Methadone maintenance is again receiving attention as an intervention for needle use/sharing among intravenous drug users. A major criticism is that methadone has its own addictive properties; consequently, the client is unable to detoxify and stay off opioids permanently. Study respondents had been off methadone for several years and offered their strategies for success. Motivating forces included the freedom and rewards, such as pride and respect. The following helped individuals to get off and stay off methadone: avoidance of opioids; treatment affiliation to supply ideology and to structure and fill free time; employment; social supports, specifically family and role models; modest plans to avoid disappointment; effective coping skills to avoid depression; and aging and burning out. In addition, those individuals who had immersed themselves in the conventional world, especially those having a higher social class status, had a less difficult time staying off methadone. PMID- 1774612 TI - The relationship of psychiatric disorder and conduct disorders with substance abuse. PMID- 1774613 TI - The impact on intravenous drug abusers when an acutely ill person with HIV infection is hospitalized. PMID- 1774614 TI - Therapeutic drugs and drugs of abuse in the era of the drug-free workplace. PMID- 1774615 TI - Conflict in married couples: personality predictors of anger and upset. AB - This research had two central goals: to examine the role of personality in (a) performing actions that anger spouses, and (b) eliciting anger-provoking actions from spouses. Personality data on a sample of married persons (N = 214) were obtained from three sources--self-report, spouse-observer report, and independent interviewers' reports. In a separate session, subjects recorded which of 147 upsetting actions their spouses had performed in the past year. A series of hierarchical multiple regressions revealed the effects of Surgency, Agreeableness, Conscientiousness, Emotional Stability, and Intellect on evoking upset in spouses through condescension (e.g., treating spouse as stupid or inferior), possessiveness (demanding too much time and attention), abuse (slapping spouse), unfaithfulness (having sex with others), inconsiderateness (leaving toilet seat up), moodiness (crying a lot), alcohol abuse (drinking too much alcohol), emotional constriction (hiding emotions to act tough), and self centeredness (acting selfishly). Discussion of this research focuses on the implications of personality for conflict in marital relationships. PMID- 1774616 TI - Parent-offspring and sibling adoption analyses of parental ratings of temperament in infancy and childhood. AB - A first step toward understanding the etiology of personality is to investigate the relative impact of genetic and environmental factors using twin and adoption designs. Twin studies of infants and young children indicate substantial genetic influence for parental ratings of temperament in the preschool years. Adoption studies, however, have not previously been reported during the early years of life. We present parent-offspring comparisons for temperament (emotionality, activity, sociability, and impulsivity) for adopted and nonadopted children yearly from 1 to 7 years of age and their biological, adoptive, and nonadoptive parents. Also presented are correlations for adoptive and nonadoptive siblings when each child was 1, 2, 3, and 4 years of age. In contrast with twin results, little evidence is found for genetic influence. The average correlation between biological parents and their adopted-away children for data averaged over the 7 years is only .03. Similarly, the average parent-offspring correlation in nonadoptive families (.08) is no greater than in adoptive families (.12). Results for nonadoptive and adoptive siblings also indicate little genetic influence. The difference between the twin and adoption results may be due to environmental effects or to nonadditive genetic variance. PMID- 1774617 TI - Self-image and guilt: a further test of the cognitive-developmental formulation. AB - The cognitive-developmental formulation of self-image disparity holds that an increasing disparity between the real and ideal self-image is due to (a) increasing differentiation of the real from the ideal self with maturity and (b) the increased capacity for incorporation of social mores with a greater propensity for guilt as a result. Guilt and self-image disparity were assessed in 47 young adults in Study 1, and in 108 children, of varying intellectual abilities, in the 5th, 8th, and 11th grades in Study 2. In both studies, guilt was related to self-image disparity. At all age levels, guilt was related to a higher ideal self-image. Guilt was related to a higher real self-image among 5th graders, but not among older individuals. Brighter children had a higher ideal self-image, greater self-image disparity, and marginally more guilt than children of average intellectual abilities. Guilt and self-image disparity were not related to grade level. The pattern of findings indicated that self-image is influenced by both cognitive-developmental and experiential determinants. PMID- 1774619 TI - Self- and object-directedness in adult women. AB - Separate factor analyses of items anchoring the opposite ends of a narcissism prototype derived from the California Q-set resulted in three narcissism or self directed factors: Hypersensitivity, Willfulness, and Autonomy; and two factors hypothesized to represent the object-directed line of development: Straightforwardness and Givingness. These five factors were scored in Q-sort descriptions of 103 adult women. Correlates of the factors with the California Psychological Inventory, Adjective Check List, Sentence Completion Test, and life measures supported the usefulness of the distinction between self- and object directedness. Whereas the narcissistic trajectory related to creativity, norm questioning, undercontrol of impulses, independence, and work orientation, the object-directed line of development was associated with prosocial inclinations, suppressive ego control, readiness to accept life demands, and stress on interpersonal relations. PMID- 1774618 TI - The relationship of hardiness, gender, and stress to health outcomes in adolescents. AB - The present study examined the relationship between the hardiness components of commitment, control, and challenge, and the experience of physical and psychological symptoms in a sample of 150 (75 male, 75 female) adolescents. A measure of psychosocial stress was included to permit an examination of whether the hardiness components interact with stress in predicting health outcomes. Analyses revealed main effects of stress, gender, and the hardiness components of commitment and control for several of the health measures. More important was the finding of a consistent interaction of stress, gender, and hardiness for several of the health measures. Whereas low-stress males experienced few physical and psychological symptoms regardless of their levels of commitment and control, high stress males experienced more problems when they were low rather than high in either commitment or control. The hardiness components did not interact with stress in the prediction of health outcomes among females. PMID- 1774620 TI - Effect of alpha-chloralose on disposition and pharmacological action of orally administered chlorzoxazone in rats. AB - The pharmacodynamic behavior of orally administered chlorzoxazone (CZX) was studied in rats. From the time course of CZX plasma concentration data under alpha-chloralose (80 mg/kg, i.p.) anesthesia, it was found that CZX obeyed a one compartment model with first-order absorption. The pharmacological response intensity of CZX on the crossed extensor reflex was closely related to the plasma concentration data via Hill's equation under alpha-chloralose (80 mg/kg) anesthesia, but not at a 150 mg/kg dose. The influence of alpha-chloralose at the latter dose on CZX pharmacokinetics and pharmacodynamics appeared to be due to the pharmacodynamic interaction of alpha-chloralose and CZX, thus suggesting that the pharmacokinetic and pharmacodynamic concept proposed by Smolen was not applicable to CZX's behavior at such a dose in rats. Under alpha-chloralose (80 mg/kg) anesthesia, the biophase compartment was determined to be identical to the central compartment using our proposed model. On the basis of the effect of anesthetics on drug behavior, one may select an appropriate anesthetic dose to evaluate the relationship between the plasma levels and the onset and duration of the drug action. At the higher dose of alpha-chloralose (150 mg/kg), the free fraction of CZX was increased and a possible enhancement in CZX action was suggested. PMID- 1774621 TI - Isolation and identification of the new metabolites of 1-[bis(4-fluorophenyl) methyl]-4-(2,3,4-trimethoxybenzyl)piperazine dihydrochloride (KB-2796) from rat bile, urine and feces. AB - The metabolites of 1-[bis(4-fluorophenyl)methyl]-4-(2,3,4 trimethoxybenzyl)piperazine dihydrochloride (KB-2796) in the bile, urine and feces in rats were investigated after oral administration of [methine-14C], [benzyl-14C] and unlabelled KB-2796. Their structures were characterized by thin layer chromatography, mass spectrometry, proton nuclear magnetic resonance and comparison with synthesized authentic compounds. The main pathways of biotransformation of KB-2796 in rats were: (a) O-demethylation at each methoxy group of the trimethoxybenzyl moiety, (b) N-dealkylation at 1 and 4-position of the piperazine ring and (c) hydroxylation at 5-position of the 2,3,4 trimethoxyphenyl ring. PMID- 1774622 TI - Muscle microdialysis as a model study to relate the drug concentration in tissue interstitial fluid and dialysate. AB - The steady-state dialysis kinetics in buffer, erythrocyte suspension and muscle have been analyzed by clearance theory in the microdialysis study. "Tube" model has been demonstrated to be a useful model to relate the dialysis clearance, CLD, the dialysis flow rate, F, and the permeability rate constant, PA, for microdialysis employing the transcranial type microdialysis probe. The effective dialysis coefficient (Rd), defined as the ratio of the in vivo PA and in vitro PA, was introduced to account for the differences between in vivo and in vitro microdialyses. The Arrhenius plot of the antipyrine permeability rate constant presented a single straight line in the range of 15-37 degrees C with an activation energy of 5.49 kcal/mol. A fairly good correlation was observed between the reciprocal of the permeability rate constant and the root of the molecular weight in the range of 18-1039. On the contrary, the molecular weight and the plasma membrane permeability were not determinant factors for Rd value determined in the erythrocyte suspension (Rd,erythrocyte), while the interstitial fluid space (100-hematocrit)% of erythrocyte suspension plays a dominant factor to change Rd,erythrocyte. The in vivo permeability rate constant was determined in the muscle for [3H]water, [14C]urea, antipyrine and [14C]sucrose under the steady-state condition. No significant difference of Rd in muscle tissue was demonstrated for these four model substances. By using the Rd value, a hypothetical equation has been proposed to relate the concentration in the dialysate and the interstitial fluid at steady-state. PMID- 1774623 TI - Some psychometric characteristics of gender diagnosticity measures: reliability, validity, consistency across domains, and relationship to the big five. AB - Preferences for various occupations, school subjects, everyday activities, and hobbies and amusements were rated by 119 male and 145 female Ss. Discriminant analyses were conducted to compute gender diagnostic probabilities. Ss also rated themselves on Big Five traits and completed the Bem Sex-Role Inventory (BSRI) and the Personal Attributes Questionnaire (PAQ). Results indicated that (a) gender diagnosticity measures showed high reliability, (b) gender diagnosticity predicted sex of S and self-ascribed masculinity (M) and femininity (F) better than contrasted-groups M-F scales, (c) gender diagnosticity measures displayed substantial consistency across domains both within and across the sexes, and (d) gender diagnosticity measures were independent of the Big Five and PAQ and BSRI scales both within and across the sexes, whereas PAQ and BSRI scales loaded highly on Big Five dimensions. PMID- 1774624 TI - Structural flexibility of moral judgment. AB - One of the central assumptions of Kohlberg's theory of moral development--that moral judgment is organized in structures of the whole--was examined. Thirty men and 30 women were given 2 dilemmas from Kohlberg's Moral Judgment Interview, a 3rd involving prosocial behavior, and a 4th involving impaired driving. Half the Ss responded to the prosocial and impaired-driving dilemmas from the perspective of a hypothetical character, and half responded from the perspective of the self. No sex or perspective differences in moral maturity were observed. Ss scored highest in moral maturity on Kohlberg's dilemmas, intermediate on the prosocial dilemma, and lowest on the impaired-driving dilemma. In partial support of Kohlberg's contention that his test assesses moral competence, there was a negative linear relationship between scores on his test and the proportion of Stage 2 judgments on the 2 other dilemmas. An interactional model of moral judgment is advanced. PMID- 1774625 TI - General and relationship-based perceptions of social support: are two constructs better than one? AB - Two hypotheses derived from a theory of perceived social support were investigated: (a) relationship-based perceptions of social support are distinct from general perceptions of support, and (b) measures of each construct contribute uniquely to the prediction of loneliness. Ninety-four male and 116 female undergraduates completed measures of loneliness and general perceived social support and the Quality of Relationships Inventory, a new instrument to assess relationship-based perceptions of social support, conflict, and depth in specific relationships. General and relationship-based perceptions of social support were found to be related, but empirically distinct, constructs. Relationship-based perceptions of support and conflict from mothers and friends each added to the prediction of loneliness after considering the contribution of general perceived social support. Implications of these findings for understanding the perceived social support construct are discussed. PMID- 1774626 TI - Behavior identification as a mediator of dispositional inference. AB - According to Trope's (1986) 2-stage model, the use of situational information ("A was teased") to identify behavior ("A reacted aggressively") may result in subsequent dispositional inferences ("A is an aggressive person") that seem insensitive to situational information. Two determinants of the situational biasing effect on behavior identification were varied, namely, behavior ambiguity and order of situational and behavioral information. It was found that when behavior was ambiguous and preceded by situational information, the latter affected behavior identification but not dispositional inference; in contrast, when behavior was unambiguous or when it was followed by situational information, the latter affected dispositional inference but not behavior identification. Thus, the same conditions that allowed situational information to bias behavior identification also nullified the effect of situational information on dispositional inference. PMID- 1774627 TI - The self and social judgment: effects of affective reaction and "own position" on judgments of unambiguous and ambiguous information about others. AB - Ss who differed in the extremity of self-definition ("own position") with respect to a given trait (sociability, independence, or patience) made trait and evaluative judgments of behavioral stimuli that varied in their descriptive implications for that trait. Across 4 experiments, individual differences in trait ratings of unambiguous information were mediated largely by differences in Ss' affective reactions to these stimuli rather than by direct use of own position as a judgmental anchor. When the target information was ambiguous, however, own position influenced trait judgments independently of Ss' affective reactions to these stimuli. These latter effects were moderated by either encoding or informational mechanisms. A theoretical framework is presented that accounts for these results and predicts how effects of self-knowledge on judgments of others should vary across different trait dimensions. PMID- 1774628 TI - Dynamic role of social support in the link between chronic stress and psychological distress. AB - How a chronic environmental stressor can interfere with the buffering effects of social support by eroding social support was analyzed in this prospective, longitudinal study. A classic buffering effect of support was found after 2 months of exposure to the stressor, household crowding. Crowded residents with low perceived support had greater increases in psychological distress than did crowded residents with high perceived support. However, after 8 months exposure the buffering effect disappeared. Moreover, greater crowding had become directly associated with lower support, which in turn was associated with greater increases in psychological distress. All analyses controlled for prior distress. Under some types of chronic stress, the buffering effects of social support may be short-lived because the stressor eventually erodes social support. PMID- 1774629 TI - Correlates of relationship satisfaction in cohabiting gay and lesbian couples: integration of contextual, investment, and problem-solving models. AB - This study examined the relation between relationship satisfaction and variables representing the contextual, investment, and problem-solving models of intimate relationships. Ss were 75 gay and 51 lesbian cohabiting couples. There were very few instances in which mean levels of model variables differed significantly for gay and lesbian couples. The strength of the correlates of relationship satisfaction rarely differed between gay and lesbian couples. Relationship satisfaction was related to variables from each of the 3 models. Support was obtained for a mediational model that proposed ordered linkages among variables from the 3 models. PMID- 1774630 TI - Transactive memory in close relationships. AB - Memory performance of 118 individuals who had been in close dating relationships for at least 3 months was studied. For a memory task ostensibly to be performed by pairs, some Ss were paired with their partners and some were paired with an opposite-sex partner from another couple. For some pairs a memory structure was assigned (e.g., 1 partner should remember food items, another should remember history items, etc.), whereas for others no structure was mentioned. Pairs studied together without communication, and recall was tested in individuals. Memory performance of the natural pairs was better than that of impromptu pairs without assigned structure, whereas the performance of natural pairs was inferior to that of impromptu pairs when structure was assigned. PMID- 1774631 TI - A general approach to testing multifaceted personality constructs. AB - Some personality characteristics are composed of multiple, distinct subcomponents (e.g., Type A, hardiness, attributional style, self-monitoring). The advantages and disadvantages of 3 typical approaches to testing these constructs are reviewed. An alternative approach based on structural equation modeling is then offered. This approach has many advantages over its alternatives, including the provision of an explicit test of the structure of the multifaceted construct, the simultaneous test of the effects of this general construct and the unique aspects of its subcomponents, and the explicit consideration of measurement error. Although the modeling approach does have limitations, these limitations are equally applicable to all of its alternatives. Indeed, the principal disadvantages of the modeling approach seem to be its statistical complexity and the lack of education regarding its proper use. PMID- 1774632 TI - Self-discrepancies and vulnerability to body dissatisfaction and disordered eating. AB - Two studies explored the relevance of self-discrepancies for body dissatisfaction and disordered eating. In Study 1, actual:ideal self-discrepancies of female undergraduates correlated with body shape dissatisfaction independent of Ss' body mass and number of appearance-related self-beliefs; actual:ought discrepancy was discriminantly associated with anorexic-related attitudes and behaviors. In Study 2 (using a mixed-gender sample), bulimic-related behaviors were associated with a form of actual:ideal discrepancy (unfulfilled positive potential) whereas anorexic-related symptoms were associated with actual:ought discrepancy. Both genders showed the predicted relations between self-discrepancies and disordered eating, and the predicted associations remained even when appearance-related attributes were excluded from scoring of self-discrepancies. PMID- 1774633 TI - Self-serving prototypes of social categories. AB - Why and when do people disagree on their conceptions or prototypes of social categories? In 6 studies, it was revealed that such differences tend to be self serving. Ss tended to endorse self-descriptive attributes as central to their prototypes of desirable social concepts and emphasize features that were not self descriptive in their conceptions of undesirable categories. Such disagreements were constrained to attributes potentially central to the domain in question and did not occur for clearly peripheral features. Self-serving differences in prototype structure were exhibited in social information processing tasks and led to disagreements in judgments of others. Potential mechanisms underlying the development of these egocentric cognitive structures and their implications for self-serving judgments of ability are discussed. PMID- 1774634 TI - Asymmetry of doubt in medical self-diagnosis: the ambiguity of "uncertain wellness". AB - In 2 studies Ss received a clear or an unclear diagnosis, indicating either disease or no disease. In Experiment 1, Ss responded to a hypothetical bacteria test. In Experiment 2, Ss performed 2 saliva tests purportedly measuring risk for pancreatic disorders. Responses to the unclear well diagnosis were unique in several ways. Ss thought the test more invalid, inferred a greater likelihood of illness from a 2nd identical result, saw the disorder as more pernicious, and held no self-protective beliefs about the test or the disease. Moreover, desire for treatment among these Ss was as great as among those receiving a clear diagnosis of illness. Possible mechanisms are discussed, as are potential applications to clinical issues and to the development and maintenance of hypochondriacal health concerns. PMID- 1774636 TI - Gender differences in ego defenses in adolescence: sex roles as one way to understand the differences. AB - Gender differences in ego defenses were hypothesized in adolescence, with greater internalization by girls and greater externalization by boys. Through the inclusion of sex role constructs (masculinity and feminity, agency and communion, and passivity-dependency), relational models as well as psychoanalytic theory were investigated as bases for sex differences. The Berm Sex Role Inventory and the Defense Mechanism Inventory were administered to 66 high school students (31 boys and 25 girls), ages 14-19. As expected, boys scored higher on projection and aggression-outward defenses and girls scored higher on turning against the self, but girls failed to exceed boys on reversal. Multiple regression supported sex roles as moderating variables in gender differences in defenses. Alternative reconceptualizations of sex roles supported aspects of both psychoanalytic and relational models as explanation of gender differences in defenses. PMID- 1774635 TI - Self-reported versus behavioral self-handicapping: empirical evidence for a theoretical distinction. AB - The present study was an investigation of how Ss would respond when given 2 self handicapping options, 1 behavioral (withdrawal of practice effort) and 1 self reported (reporting high levels of stress). Ss anticipating a diagnostic test of intellectual ability were given different instructions regarding the effects of stress and practice on test performance. Ss were told that (a) stress only, (b) practice only, (c) both stress and practice, or (d) neither stress nor practice affected test scores. Ss were then given the opportunity to self-report a handicap on a stress inventory and to behaviorally self-handicap by failing to practice before the test. High self-handicapping men and women showed evidence of self-reported handicapping, but only high self-handicapping men behaviorally self handicapped. However, when both self-handicaps were viable, both high self handicapping men and women preferred the self-reported over the behavioral self handicap. PMID- 1774637 TI - Objective identification of ankle equinus deformity and resulting contracture. AB - A quantitative diagnostic technique is described for identifying contracture at the ankle joint in patients with equinus deformity, hence addressing the shortcoming of the conventional clinical diagnostic procedure. To gain a better understanding of how contracture contributes to equinus deformity, a study was designed that compared the torque about the ankle joint before and after administering a tibial nerve block to equinus patients and to a control group. Functional equinus, manifested by walking and early heel rise, is defined as inadequate dorsiflexion for normal gait. The ability to accurately identify an equinus condition, and contracture as the contributing factor in equinus deformity, has important implications for the type of treatment prescribed and the evaluation of treatment effectiveness. PMID- 1774638 TI - Juvenile hallux valgus with compensated metatarsus adductus. Case report. AB - The authors describe a case report of a patient with compensated metatarsus adductus and juvenile hallux valgus bilaterally. Treatment included closing base wedge abductory osteotomies of metatarsals one through five, modified McBride bunionectomy, Evans calcaneal osteotomy, and a percutaneous tendo Achillis lengthening. The patient maintained excellent correction on the right foot after 6 years. Hallux valgus recurred on the left foot after 2 years. The authors attribute this recurrence to a significant internal femoral torsion on the left leg. The significance of superstructural deformities on juvenile hallux valgus is discussed. PMID- 1774639 TI - Lisfranc's fracture-dislocation. A review of the literature and case reports. AB - The authors present an in-depth discussion of Lisfranc's fracture-dislocations, including classifications, mechanisms of injury, radiographic evaluation, and a literature review. Four cases are presented for review. Lisfranc's fracture dislocation is a rare injury that can lead to prolonged disability if undiagnosed or if there is a delay in treatment. PMID- 1774640 TI - Transmetatarsal amputation. A literature review and case study. AB - The effect of diabetes on the lower extremity can be devastating. Surgical intervention on the diabetic foot must be carefully planned, and long-term results must be anticipated. The authors present a case history of a patient with multiple previous amputations of the forefoot, resulting in a severe deformity and a nonfunctional foot. Transmetatarsal amputation, if performed correctly, should provide a relatively functional extremity. PMID- 1774641 TI - Quantifying magnification in pedal radiographs. AB - Morphometric comparison between metatarsals on pedal radiographs and preserved bone specimens provides a method to quantify the amount of magnification imparted on a radiographic image. Conversion factors are presented for dorsoplantar and lateral projection images, which are of value in the preoperative assessment of patients. Factors that influence radiographic quality are discussed, with an emphasis on the geometry of projecting an accurate image. PMID- 1774642 TI - Foot orthosis for the severe flatfoot in sports. AB - The control of excessively pronating feet in athletes can be a prolonged and frustrating experience for both the doctor and the patient. The inverted orthotic technique has previously been described for making a device that has two basic applications: to control excessive subtalar joint pronation, especially where a Root or modified Root device cannot, and to invert the entire lower limb for such problems as medial knee pain. The authors present two case histories that highlight the indications of this orthotic device for the athletic population. PMID- 1774643 TI - Compartment syndrome of the dorsal aspect of the foot. AB - A second case of compartment syndrome affecting the dorsal aspect of the foot has been presented. The syndrome was arrested by fasciotomy. There were no permanent neurologic, vascular, or musculoskeletal sequelae. Although techniques exist to obtain quantitative measurements of intracompartmental pressure, the diagnosis rests heavily on clinical assessment. Practitioners who encounter trauma victims must recognize the symptoms of the condition and be familiar with the procedures necessary to interrupt it. PMID- 1774644 TI - Bullosis diabeticorum. A report of two cases with a review of the literature. AB - Bullosis diabeticorum is a rare complication of long-standing diabetes mellitus. Bullous lesions, which appear like burn-induced blisters, occur suddenly without trauma in the feet. These bullae heal spontaneously without scarring; however, recurrence is common. The etiology of bullosis diabeticorum remains unknown. Several theories exist as to causal and contributory factors related to this cutaneous manifestation of diabetes mellitus. PMID- 1774645 TI - Juxtamalleolar lipoma with intermediate dorsal cutaneous nerve entrapment. AB - From a review of the literature, it would appear that lipomas of the foot are relatively rare and that, when they do exist, they are of little clinical significance other than cosmetic appearance. The authors presented a case in which the size, location, and character of the mass predisposed the patient to entrapment syndrome of the intermediate dorsal cutaneous nerve. It is important to emphasize, however, that in these cases symptoms are related to a pressure phenomenon and are not a direct result of tumor physiology. PMID- 1774646 TI - Running limb varus. PMID- 1774647 TI - Child's pain. PMID- 1774648 TI - Surface properties of intraocular lens materials and their influence on in vitro cell adhesion. AB - An in vitro model to assess lens epithelial cell adhesion to a variety of intraocular lens materials was developed. Rabbit anterior lens capsules were isolated and cultured in serum-containing medium. Test surfaces included poly(methyl methacrylate), two new silicones (SLM-1/UV, SLM-2/UV), two hydrogels (HEMA, Lidofilcon A), and polytetrafluoroethylene (PTFE). Following the application and culturing of cells on the test surfaces, adherent cells were removed by trypsinization and counted at eight and 24 hours. The material surfaces were characterized by electron spectroscopy for chemical analysis and scanning electron microscopy. The captive bubble technique was also used to assess interfacial free energy. More cells adhered to PMMA than to the other materials tested (P less than .01). The two silicones, HEMA, and PTFE did not differ significantly from each other; Lidofilcon A had the lowest cell adhesion of all materials tested. Cell adhesion results were related to the interfacial free energy of each material. Materials of low (less than 5 ergs/cm2) or high (greater than 40 ergs/cm2) interfacial free energies had lower cell adhesion than materials of intermediate free energies (5 to 40 ergs/cm2) which exhibited the highest cell adhesion. PMID- 1774649 TI - Effects of topical suprofen and flurbiprofen on the miosis produced by anterior chamber irrigation with cholinergic agonists. AB - Pretreatment with topical nonsteroidal anti-inflammatory drugs is common practice to maintain maximal pupil dilation for cataract surgery. Most surgeons also inject a cholinergic agent intracamerally for miosis after intraocular lens insertion. We evaluated the effects of topical suprofen and flurbiprofen on the miosis induced by anterior chamber irrigation with either acetylcholine or carbachol. One eye of 30 pigmented rabbits was dilated with cyclopentolate HCl and phenylephrine HCl. Three groups, each composed of ten eyes, received flurbiprofen, suprofen, or a control. In each group, five eyes received acetylcholine by anterior chamber irrigation and five received carbachol. Pupil diameters were measured with calipers before and five minutes after irrigation by an observer unaware of the treatment regimen. Irides irrigated with carbachol constricted less than those irrigated with acetylcholine (P = .016). In anterior chambers irrigated with carbachol, suprofen was associated with less miosis than either tears (P = .005) or flurbiprofen (P = .009); however, if the infusion was performed with acetylcholine, no differences between the three groups were noted (P = .44). PMID- 1774650 TI - Experimental studies on the development and propagation of shock waves created by the interaction of short Nd:YAG laser pulses with a titanium target. Possible implications for Nd:YAG laser phacolysis of the cataractous human lens. AB - The formation and propagation of shock waves created by the interaction of high powered Nd:YAG laser pulses with a titanium target are photographed and analyzed. The titanium target is located at the distal end of a probe, similar to an irrigation/aspiration probe used in cataract surgery, and the Nd:YAG laser is delivered by a cladded 300 microns quartz fiber. This device, and the results of this study, are being applied to develop a device for fragmenting nuclear material for cataract extraction. PMID- 1774651 TI - Lens epithelial cell density and histomorphological study in cataractous lenses. AB - Human epithelial cell density was determined from flat preparation of 195 cataractous lenses from 108 males and 87 females between 30 and 80 years of age. The mature cataracts had significantly lower cell counts than the other cataracts. Cell density was significantly higher in the females than in the males. Morphohistological study of the epithelia was focused on the following cataract types: (1) nuclear, (2) posterior subcapsular, (3) mature, (4) mixed, (5) hypermature, and (6) black. The major cataractous changes in all types involved vacuolization of the cytoplasm. The mature types of cataractous epithelia showed 56% superimposed cells; the epithelia in nuclear, posterior subcapsular, and black cataracts showed between 6% and 16%. In the hypermature cataracts, four of five tissues analyzed showed superimposed cells. The superimposed areas are probably the source of increased and altered cell activity. We propose that the metaplastic processes leading to posterior capsular opacification originate from these areas. The majority of nuclear and black cataracts were almost similar to the normal human lens epithelium with more or less uniform distribution of cells. Nucleus shrinkage (5 microns) was more evident in nuclear cataracts; in subcapsular cataracts most of the nuclei were large (average 9 microns diameter). Variation in morphological changes like vacuolization of cytoplasm and nuclei, pyknotic nuclei, and superimposed cells was more evident in the mixed type of cataracts. PMID- 1774652 TI - Intraocular lens explantation and exchange. A review of lens styles, clinical indications, clinical results, and visual outcome. AB - We conducted a retrospective review of 102 patients who had intraocular lens (IOL) explantation or exchange over a 7.5 year period. Seventy-one patients had IOL exchange while 31 had lens removal without exchange. Anterior chamber IOLs comprised 66.7% of the lenses removed. The most frequent indication for anterior chamber IOL explantation was pseudophakic bullous keratopathy (PBK), followed by the uveitis-glaucoma-hyphema syndrome and cystoid macular edema. Of the IOLs removed, 17.6% were iris-supported, with PBK being the most common indication for removal. Posterior chamber IOLs comprised 15.7% of the explanted lenses in this series. Lens dislocation/decentration was the leading indication for IOL removal in the posterior chamber IOL group. Among the 71 patients who had IOL exchange, 71.8% received an anterior chamber lens and 28.2% received a posterior chamber lens. Visual outcome following IOL exchange or removal showed that 40 patients (39%) improved, 47 patients (46%) had the same vision, and 15 patients (15%) had worse vision postoperatively. The most common reason for a worsening of vision postoperatively was corneal decompensation, followed by glaucoma and cystoid macular edema. Analysis of the clinical results revealed that 86.3% of the patients who had an exchange with an anterior chamber IOL had a successful outcome with either improvement or stabilization of the ocular condition. Ninety percent of the patients who received a posterior chamber IOL had a successful clinical outcome. PMID- 1774653 TI - Effect of incision direction on radial keratotomy outcome. AB - The goal of maximizing radial keratotomy results by using optical-zone-directed (centrally directed) incisions rather than limbus-directed (peripherally directed) incisions is evaluated in this prospective study. Five patients had bilateral radial keratotomy, with optical-zone-directed incisions in one eye and limbus-directed incisions in the other. The order of surgery and eye was randomly assigned. Patients were evaluated preoperatively, at one week, and at one month. There were no significant differences preoperatively between the two groups of eyes in spherical equivalent or keratometry. At one week postoperatively, however, there were significant group differences in spherical equivalent changes (P less than .010). Eyes with limbus-directed incisions were -2.2 diopters (D) myopic, on average, while eyes with optical-zone-directed incisions were near emmetropic, with a mean spherical equivalent of 0.10 D. Because of these results, we stopped randomizing cases at this point. The difference in surgical effect was still significant at three months (P less than .01); eyes with limbus-directed incisions had an average of 3.5 D less surgical effect than eyes with optical zone-directed incisions. PMID- 1774654 TI - Simultaneous penetrating keratoplasty, extracapsular cataract extraction, and intraocular lens implantation. AB - The postoperative results of 210 consecutive eyes in 177 patients who had simultaneous penetrating keratoplasty, extracapsular cataract extraction, and posterior chamber intraocular lens (IOL) implantation (triple procedure) were reviewed. All procedures were performed by one surgeon between January 1980 and December 1989. The most common diagnosis requiring a triple procedure was Fuchs' endothelial dystrophy. The remainder of the patients required the procedure for either corneal scarring, keratoconus, or Chandler's syndrome. Of the 210 grafts, 191 (91%) remained clear with a mean follow-up of 53 months (range 6 to 116 months). The mean preoperative keratometry (K) reading (n = 161) was 44.51/44.85 (SD 4.86/4.94), and the mean postoperative K reading (n = 111) was 44.29/43.50 (SD 3.83/3.63). The mean IOL power (n = 196) was + 20.87 diopters (D) (SD 2.86). The mean postoperative best visual acuity (n = 166) was 20/65 with a range from 20/20 to less than 20/400, although 61% had 20/50 acuity or better and 92% had 20/100 acuity or better. The mean spherical correction in 155 eyes was - 1.38 (SD 2.89), and the mean positive refractive cylinder was + 3.21 (SD 2.20). One hundred forty six of the 155 eyes with reported refractions (96%) had 6 D or less of refractive cylinder. Correlation of the recipient-donor disparity % and refractive cylinder was significant such that as disparity increased refractive cylinder increased (r = 0.197, P = .021). Correlation of the recipient-donor disparity % and keratometric cylinder indicated a similar trend but was not significant (r = 0.105, P = .310). PMID- 1774655 TI - Hyperopic thermokeratoplasty: clinical evaluation. AB - A new procedure, hyperopic thermokeratoplasty (HTK), developed in the Soviet Union for the correction of hyperopia, uses controlled thermal burns of the corneal stroma with a retractable probe tip preset to penetrate the cornea at 95% depth. The coagulations are applied in a radial pattern for spherical hyperopia. Only the peripheral cornea is treated and the effect is titrated by varying the optical zone and number of rays. The thermal effect flattens the peripheral cornea and steepens the central cornea. In this report, we prospectively evaluated the refractive results of a group of 61 HTK patients. Mean preoperative spherical equivalent was 3.9 diopters (D). Mean follow-up to date is 5.2 months, with 44% of cases evaluated at six months and 31% at one year. The initial effect of surgery (at one day) was a mean decrease in hyperopia of 6.0 D (standard error of the mean [S.E.] = 0.3 D), resulting in a mean spherical equivalent of -2.1 D (S.E. = 0.2 D). There was a steep regression of effect between one day and two months at which point average refraction was close to emmetropia. After two months, there was a gradual but continuing regression of effect, leveling off after six months. At five to six months, 63% of cases were undercorrected by at least a diopter; at 9 to 12 months, 83% of cases were undercorrected. The overall change in spherical equivalent at each time increased as optical zone size decreased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774656 TI - 2% hydroxypropyl methylcellulose as a viscous surgical adjunct. A multicenter prospective randomized trial. AB - A multicenter prospective trial was conducted comparing preoperative and postoperative endothelial cell counts in patients who had extracapsular cataract extraction with posterior chamber lens implantation or phacoemulsification and posterior chamber lens implantation. One hundred sixty six eyes received 2% hydroxypropyl methylcellulose (Occucoat) and 56 eyes received sodium hyaluronate (Healon). The average cell loss in the Occucoat group was 12.1%; in the Healon group it was 10% (P = NS). There was no significant difference between the two groups in intraocular pressure at 24 hours. In this study Occucoat was as effective in protecting the corneal endothelium as Healon. PMID- 1774657 TI - Noninvasive repositioning of a posterior chamber intraocular lens following pupillary capture. AB - A case of pupillary capture of a posterior chamber intraocular lens (IOL) is presented. A nonsurgical approach that may help reposition an IOL optic entrapped in a pupillary capture when chemical mydriasis fails is described. Suggestions for a logical progression of nonsurgical procedures to help release optic capture are presented. Possible causes and preventative measures to decrease the incidence of pupillary capture of a posterior chamber IOL are discussed. PMID- 1774658 TI - Branhamella catarrhalis colonization of exposed nylon sutures. AB - A 63-year-old man who had uncomplicated cataract surgery four years previously complained of having redness, blurred vision, and photophobia in his right eye for one week. Examination revealed numerous exposed nylon sutures with peculiar leaf-like, white deposits surrounding them, associated with underlying conjunctival leukocytic infiltration. Smears of the adherent material showed gram negative diplococci and cultures produced heavy growth of Branhamella catarrhalis. Removal of the offending sutures and fortified topical antibiotic therapy resolved the ocular inflammation. The unique form in which this infection presented is a reminder that ocular surgical patients deserve long-term follow-up for problems like exposed sutures. PMID- 1774659 TI - Modified insertion technique for the SI-18NB intraocular lens. AB - The 14 mm polypropylene haptic structure of the AMO SI-18NB is extremely soft for safe small incision insertion. The material has a tendency to lose its memory and experience a permanent alteration in shape if it is bent too much during implantation. An alternative surgical technique that spares extreme haptic distortion and improves centration of the intraocular lens optic is presented. PMID- 1774660 TI - Consultation section. Postcataract blepharoptosis. PMID- 1774661 TI - Iris claw lens. PMID- 1774662 TI - Transverse astigmatic keratotomy. PMID- 1774663 TI - Adrenergic/anticholinergic responses after photorefractive keratectomy. PMID- 1774664 TI - Haptic breakage in one-piece poly(methyl methacrylate) intraocular lenses. PMID- 1774665 TI - Ciliary sulcus fixation--still a shot in the dark. PMID- 1774666 TI - Uncomplicated cataract surgery in a patient with scleritis. PMID- 1774667 TI - Posterior capsular rupture at hydrodissection. PMID- 1774668 TI - Modified radial iridotomy for small pupil phacoemulsification. PMID- 1774669 TI - Combining epikeratoplasty and photorefractive keratectomy. PMID- 1774670 TI - Restoration of multiple placed endosseous implants when the team approach was not followed: a clinical report. PMID- 1774671 TI - Gingival smile enhancement for the edentulous patient by using a LeFort I osteotomy. PMID- 1774672 TI - An accelerated technique for casting post and core restorations. AB - An accelerated technique for casting a direct-pattern post and core restoration is presented. The entire clinical and laboratory procedure may be completed within 1 hour. The necessity for two appointments for completion of the restoration as well as the necessity of making two provisional restorations may be eliminated. PMID- 1774673 TI - Marginal accuracy of complete crowns made from alternative casting alloys. AB - The marginal accuracy of complete cast crowns made from five alternative casting alloys was measured and compared with that of crowns made from the traditional type III high-gold alloy. The alternative alloys studied were low-gold-palladium, high palladium, silver-palladium, nickel-chrome-molybdenum, and copper-aluminum. The findings indicated that Ag-Pd alloy crowns exhibited the best marginal accuracy among the alternative alloys tested. However, their marginal discrepancy value was still slightly higher than that of crowns made of type III high-gold alloy. Conversely, Ni-Cr-Mo alloy crowns exhibited the poorest marginal accuracy. PMID- 1774674 TI - Ridge contour related to esthetics and function. AB - Maxillary anterior fixed prostheses may be compromised when pontics are adapted to deficient residual alveolar ridges. This study determined the effect of ridge contour on esthetics and function. Thirteen men and 17 women, 23 to 75 years of age, who had received maxillary anterior fixed prostheses during the period 1976 to 1986 participated. A six-item structured interview was conducted for each subject to determine causes of satisfaction or dissatisfaction with esthetics and function. Pontic esthetics were also determined by examination using a 12-point esthetic index that was developed and pretested for this study. Residual ridge contour was classified according to Siebert as being deficient buccolingually (I), deficient apicocoronally (II), or deficient in both areas in combination (III). The results showed that patients with class I ridges had a higher subjective level of satisfaction with their prosthesis than did those with class II or III ridges. Esthetic index scores were significantly higher (p less than 0.05) for type I (10) than for type II (7.4) or III (7.3) using a post hoc Scheffe comparison. These results suggest that consideration be given to ridge augmentation prior to construction of maxillary anterior fixed prostheses, particularly when class II or III defects are present. PMID- 1774675 TI - Pattern of tooth contacts in eccentric mandibular positions in young adults. AB - Tooth contact patterns in laterotrusion, protrusion of the mandible, and in the retruded position were recorded in young men with varying types of occlusion. The tooth contacts were recorded clinically with alginate (irreversible hydrocolloid) indices. In addition, the functional state of the masticatory system was evaluated by the recording of signs and symptoms of mandibular dysfunction and of the abrasion of the teeth. On protrusion, most subjects had contacts only on anterior teeth. Protrusive contacts only on posterior teeth were rare. On laterotrusion, most subjects had group function on the functional side. Contact on the nonfunctional side was found in half of the subjects in a 1.5 mm laterotrusive position and in one third of them in a 3 mm laterotrusive position. No correlation between the types of tooth contacts and mandibular dysfunction was found. PMID- 1774676 TI - Effect of fitting adjustments on compressive strength of a new foil crown system. AB - The effect of die spacing and precementation internal adjustments on the compressive strength of a new ceramic foil crown system was examined in vitro. Twenty-four ceramic foil crowns were made for identical stylized master dies made of polycarbonate filled with 30 wt% carbon. One half of the stone working dies were coated with die spacer and the remaining were left untreated. A special foil used for these crowns was adapted to the working dies under 2500 psi loading. A sculpturing device was used to standardize the size and shape of the ceramic foil crowns. Only crowns made on dies coated with die spacer received precementation fitting adjustment. All crowns in the two groups were cemented with zinc phosphate cement and were subjected to compressive force until fracture occurred. Compressive strength data were analyzed and compared. Results showed that the use of die spacer and internal adjustments increased the compressive strength of the new ceramic foil crown. PMID- 1774677 TI - Vertical root fracture and relative deformation during obturation and post cementation. AB - There are several speculated etiologies of vertical root fractures such as pressure exerted during post placement and excessive forces during lateral condensation. However, there are no reports comparing these two forces by use of the same measurement system. This study determined and compared on single-rooted teeth (1) the amount of strain to the root that occurs during obturation and post cementation and (2) the incidence of incomplete and complete vertical root fractures occurring during the aforementioned procedures. Canals of 32 extracted maxillary central incisors were step-back prepared. Teeth were randomly divided into negative and positive controls and experimental groups. The amount of root distortion was recorded with a strain gauge during each of the following procedures: (1) lateral condensation, and (2) lateral condensation plus cementation of a cast gold post. Relative deformations were compared statistically. Teeth were examined by transillumination and stereomicroscopy for incomplete and complete fractures and compared among groups. Data showed significantly more relative deformation with placement of a post and loading than with obturation alone. The accumulation of strain from both procedures did not significantly increase incidence of vertical root fractures. The results indicate that stresses from cementation of posts is more likely to cause relative deformation of roots. PMID- 1774678 TI - Hardening of dual-cured cements under composite resin inlays. AB - This study was conducted to determine the extent of hardening of three dual-cured cements under composite resin inlays and to determine the effectiveness of a light-reflecting wedge in promoting curing of the cements in the proximal margin. The exposure times needed to optimally harden the cements were determined by directly exposing the cements to the curing light. Composite resin inlays were bonded in an extracted molar with Dual cement, Dicor light-activated cement, and Duo cement. Cure-Thru reflective wedges were placed in the gingival embrasure of half of the specimens. None of the cements hardened completely by 24 hours when we used an exposure time that met or exceeded that recommended by the manufacturers. The chemical-cure component did not completely cure the cements when light was attenuated by the tooth and restoration. The light-transmitting wedge had little effect on hardening of the cements. PMID- 1774679 TI - Comparison of condylar control settings using three methods: a bench study. AB - Articulators that program eccentric condylar pathways minimize occlusal adjustments of dental prostheses. This bench study compared three groups of methods for recording the immediate Bennett shift and the protrusive condylar path of the mandible. The experimental design restricted the variable associated with these methods. The various methods for recording protrusive excursions from best to worst were: (1) electronic pantography (Denar); (2) mechanical pantography (Denar); and (3) simplified mandibular motion analyzers (Whip-Mix and Denar). The methods of recording immediate side shift from best to worst were: (1) electronic pantograph; (2) polyether interocclusal records; (3) mechanical pantography (Denar) and simplified mandibular motion analyzer (Panadent); (4) simplified mandibular motion analyzer (Whip-Mix and Denar); and (5) zinc oxide interocclusal records. PMID- 1774680 TI - Adhesive properties of several impression material systems: Part I. AB - The tensile adhesive bond strength of five impression adhesive systems was studied: polysulfide, polyether, polyvinylsiloxane, condensation silicone impression, and polyvinylsiloxane putty adhesive systems. Results showed no significant difference in adhesive bond strength to autopolymerizing acrylic resin between the former four impression materials studied. Polyether and medium viscosity polyvinylsiloxane demonstrated significantly higher adhesive bond strength to polystyrene than either polysulfide or condensation silicone. The medium-viscosity polyvinylsiloxane impression material showed significantly higher adhesive bond strength to polystyrene than autopolymerizing acrylic resin whereas polysulfide and condensation silicone impression materials adhered significantly better to autopolymerizing acrylic resin than polystyrene. The polyvinylsiloxane putty did not adhere to its impression adhesive. Variation of the speed of tensile testing between 5 to 20 inches per minutes did not affect the adhesive bond strength of a polysulfide impression material. PMID- 1774681 TI - Effect of porcelain crown substructures on visually perceivable value. AB - Factors that will affect the potential color of ceramic restorations must be understood to control variables that exist. Clinical observations of porcelain restorations lead to the hypothesis that certain substructures tend to produce crowns with a lower than expected Value (brightness). This study was done to determine whether a visually perceivable difference could be detected between groups of ceramic crowns with different substructures. Two test groups of crown types with four different porcelain substructures were compared. In the first group, metal ceramic crowns made with either Galaxy or Rexillium III alloys were compared. In the second group, aluminous porcelain jacket crowns with and without a tin-plated, bonded platinum foil internally were compared. Visual analysis showed that (1) in the metal ceramic group, the crowns with the Rexillium III substructure were scored as more often having a lower significant Value, and (2) in the aluminous porcelain jacket group the crowns with the tin-plated, bonded platinum substructures were scored as more often having a lower significant Value. PMID- 1774682 TI - Ulcerative lesions of the palate associated with removable partial denture castings. AB - Regions of inflammation with or without ulceration beneath removable partial dentures have been of concern to prosthodontists for many years. The etiology of these lesions has not been established, but potential factors are microbial infection, obstructive sialadenitis, and allergic-type reactions to the metal framework. A new etiological factor that may be involved is described. Focal pitting corrosion and by-products of corrosion in nickel-chromium alloys are discussed as toxic agents responsible for palatal lesions. Six patient reports that include results of tissue biopsy and EDAX analysis of casting are presented. PMID- 1774683 TI - Cingulum bar as a major connector for mandibular removable partial dentures. AB - In the international literature and textbooks, the cingulum bar as a mandibular major connector is often neglected. It is a viable alternative to a lingual bar where the distance between the marginal gingivae and the mucolingual fold is restricted. It also provides indirect retention and thereby eliminates the need for a conventional indirect retainer. Patient comfort with an RPD with a cingulum bar seems acceptable because the connector forms one unit with the anterior teeth. The replacement of a lost natural anterior tooth with a denture tooth is not difficult. The metal bulk of the bar may be a disadvantage and esthetics may be compromised if spacing is present. Marked lingual inclination of the anterior teeth prevents the use of a cingulum bar. Different laboratory requirements are discussed. PMID- 1774684 TI - Computerized design of speech prostheses. AB - The use of computerized techniques to assist in the design of palatal and/or glossal prostheses is described. Patients with oropharyngeal resection and associated speech impairment are candidates for such prostheses. Procedures discussed allow for the design of some features of the prosthesis, such as shape, location, and tests of its effect on certain speech parameters, prior to actual fabrication. Advantages and current limitations of the techniques are also discussed. PMID- 1774685 TI - Tracheostoma obturator fabrication. AB - Patients with tracheostoma defects who require obturator fabrication present unique functional and anatomic considerations. A new technique for making impressions and rehabilitating patients with these defects is described. PMID- 1774686 TI - Transcranial radiography and linear tomography: a comparative study. AB - There is continual controversy concerning the use of radiographs to determine the position of the mandibular condyle within the glenoid fossa for the diagnosis and treatment of temporomandibular disorders. This study compared joint space measurements from transcranial radiographs and linear tomographs with the anatomic joint space to determine whether condylar position could be accurately recorded radiographically. Anterior, superior, and posterior joint space dimensions were measured from projected radiographs with a sonic digitizer, whereas anatomic joint space dimensions were recorded from the thickness of polyether impressions of the joint space. Posterior/anterior joint space ratios were used to classify relative condylar position as anterior, concentric, or posterior. The Pearson correlations (alpha = 0.05) were calculated to determine the consistency between radiographic and anatomic joint space ratios. The corrected and standard transcranial projections did not accurately reproduce the anatomic joint spaces or the relative condylar positions. Only the corrected tomographic projection accurately reflected the condyle-fossa relationships. PMID- 1774687 TI - The role of muscle deconditioning for occlusal corrective procedures. AB - Research has indicated that the suspension mechanism of the condyle in the fossae is muscular rather than ligamentous. Therefore, in a normal condyle-disk-fossa relationship, variations in muscle tone influence condylar position and function. The proprioception of the muscles, tendons, periodontal membrane, and temporomandibular joints influence the muscle programming of centric occlusion. In many patients the usual chairside muscle deconditioning procedures are too weak and inefficient to overcome habitual closure. The role of long-term and short-term muscle deconditioning for the occlusal correction of centric relation deflective contacts has been discussed. PMID- 1774688 TI - The effect of sucralfate on the growth of cariogenic streptococci. AB - Sucralfate, an aluminum salt of sucrose octasulfate, has been shown to be effective in reducing the discomfort of radiation therapy-induced oral mucositis. This study was done to determine whether sucralfate could be used as a nutritional source for dental caries-producing organisms. Three Streptococcus strains were cultured in a defined medium. Sucralfate powder was evaluated for its ability to be used as a carbohydrate food source by these organisms. The addition of sucralfate alone did not stimulate the organism's growth. The addition of sucralfate and glucose resulted in less growth than the addition of glucose alone. Increasing the sucralfate concentration from 1% to 10% in the glucose-containing cultures resulted in statistically significant growth inhibition (p less than 0.02). Sucralfate appears to have no cariogenic potential and may have some cariostatic potential. PMID- 1774690 TI - A procedure for making a bruxism device in the office. AB - Microtrauma to the temporomandibular joint, the masticatory muscles, and the dentition can be significant in mandibular parafunctional activity such as nocturnal clenching and bruxing. Intraoral therapy can be useful in helping to reduce the deleterious effects of this activity. This article presents an in office procedure for a device to reduce a delay in starting treatment and the time needed for adjustment of the device in the mouth. PMID- 1774689 TI - Wettability of elastomeric impression materials and voids in gypsum casts. AB - Numerous factors are involved in making an accurate void-free dental artificial stone cast or die. The relationship of the wettability of an elastomeric impression material and its interaction with the gypsum slurry is an important factor. This study examined the relative "pourability" of several impression materials by counting the number of resultant voids in artificial stone casts containing 48 point angles. Those elastomers that exhibited the lowest contact angle with water produced artificial stone casts with the fewest voids. Surfactants applied to the impression material significantly reduced the number of voids in artificial stone casts, as did modified elastomers designated by the manufacturer as hydrophilic. PMID- 1774691 TI - Porosity of denture resin cured by microwave energy. AB - This study compared porosity of denture resin cured by microwave energy to denture resin cured by the conventional heat method. Seven groups of 10 samples each were tested. The control samples of methyl methacrylate monomer were cured in a curing tank at 165 degrees F for 9 hours. Four of the six experimental groups, consisting of samples made from Micro Liquid monomer (H.D. Justi Co., Oxnard, Calif.), were cured by microwave energy at varying wattages and times. The other two experimental groups contained samples of methyl methacrylate monomer cured by microwave energy. No significant differences were found in mean porosity between the control group and the four groups of microwave-processed samples that used Micro Liquid monomer. The two groups of microwave-processed samples of methyl methacrylate monomer showed a significantly higher mean porosity. PMID- 1774692 TI - Retentive remount cast for obturator prostheses. PMID- 1774693 TI - Facilitated cement removal between splinted provisional restorations. PMID- 1774694 TI - Prevention of catalyst contamination of vinylpolysiloxane silicone impression material during the impression procedure. PMID- 1774695 TI - Humor in therapy for the mentally ill. AB - There are many benefits of humor as a planned intervention for CMI patients. In addition to physiological, psychological, social, and communicative benefits for the patient are the benefits of humor for the nurse therapist. According to Keller (1984), another legitimate function of humor in therapy is as a source of rejuvenation for the therapist. Working with a population of clients whose progress is sometimes difficult to ascertain can sometimes be draining and may result in burnout if nurses are not periodically rejuvenated. Humor can act as an energizer for both clients and nurses, and can help nurses maintain their equilibrium. Areas for Further Research. Sullivan and Deane (1988) posed five potential areas for study in gerontological-oriented humor, but all of these areas are also applicable in the study of humor among the chronically mentally ill: Identification of any functional level changes and cognitive flexibility resulting from increased humor experiences. Development of humor assessment tools. Identification of environmental variables and barriers that affect the spontaneous occurrence of humor, especially in institutional settings. Exploration of differences in the effects of group and dyadic humor on mental health. Exploration of favorable and unfavorable environmental contexts and outcomes for using therapeutic humor. PMID- 1774696 TI - Deliberate self-injury. Management in a psychiatric setting. AB - Self-injury is a significant clinical problem of psychiatric patients, although the prevalence of self-injury in specific disorders is unclear. Nurses can assess and intervene in the psychological causes and behavioral sequelae self-injury. Each patient's early history, dynamics, and motives for self-injury require evaluation. Behavioral techniques (eg, reinforcement) and psychodynamic techniques, such as exploring feelings and anxiety, can help patients understand their self-destructive tendencies. Patients can learn to anticipate anxiety provoking situations, plan strategies to manage anxiety, cope with feelings, and reduce self-injury. PMID- 1774697 TI - A collaborative model: ambulatory pharmacotherapy for chronic psychiatric patients. AB - 1. Increases in patient acuity and diagnosis related groups limiting hospital lengths of stay have contributed to the heightened demand for structured outpatient programs. 2. The Medication Clinic and Medication Group, a daily functioning outpatient program, is designed to shift the responsibility for medication management from the health-care provider to the patient and family through education and participation. 3. Within the framework of a collaborative practice model, the patient, clinical nurse specialist, and psychiatrist share equal power and responsibility. A phenomenologically oriented approach whereby the health-care provider attempts to understand the patient's illness from the patient's perspective is a crucial component. 4. The Medication Program combines the expertise of nursing and medicine in a complementary fashion, conducive to both revenue-generating activity and cost-effective role use. PMID- 1774698 TI - Medication education: increasing patient compliance. AB - The medication education program described is based on group discussion and individual counseling in a partial hospital setting. It is one model for promoting medication compliance. The important issues are those presented by the patients themselves. Nurses can and must help patients understand the influences on patient decision-making processes and encourage them to make sense of the wealth of information regarding health care and medications now available to them as consumers. Nurses should also introduce patients to the successful methods invented and refined by others to manage medication difficulties. We can also support the patient in the lifelong processes of developing a clearer understanding of their relationships with health-care providers and of promoting sound health practices. PMID- 1774699 TI - On getting it together. PMID- 1774700 TI - Music therapy: harmony for change. AB - 1. Music can be an effective treatment modality for low-functioning clients. With psychiatric clients, music can strengthen ego, increase socialization, decrease psychotic symptoms, and increase activity. 2. In general, music was applied to manage the clients' focal, contextual, or residual stimuli. By directing the use of music at the influencing stimuli, the stimuli was removed, increased, decreased, or altered, thereby changing the clients' ineffective behavior or ability to cope. 3. The music program has proved most effective with clients diagnosed with organic brain damage, mild to moderate mental retardation, and schizoaffective disorder. It is difficult, however, to measure improvement exclusively related to the music program. PMID- 1774701 TI - Drawing a connection from victim to victimizer. AB - 1. The biological basis of the altered alarm/dissociative process during and after sexual trauma impedes the development of information processing essential for discerning intention, personal responsibility, sense of control over events, and trust in others. 2. Once this imbalance occurs, the child is restricted in developing cognitive schema to deal with interpersonal intimacy. This in turn results in secondary patterns of aggressiveness or avoidance. 3. The implication of this biological understanding of trauma and information processing for treatment underscores the necessity of reducing arousal, thus lessening the dissociative process. Drawings of the criminal act and the victim experience elicit cues connecting the two events, facilitating an increase in personal control over repeated aggressive acts. PMID- 1774702 TI - Original Edinburgh Fellowship Examination. AB - The College Fellowship Examination has recently been revised. The original Seal of Cause of the Incorporation of Surgeons, granted in 1505, contained specific instructions regarding required knowledge and examinations, and the records show that oral and practical (and ultimately written) examinations were required from the start before any entrant could be admitted as a master of the Incorporation. Although the original examinations were an 'undergraduate' qualification, and the range of surgical knowledge available limited, the original aims of the examinations do not seem to have greatly altered over the last five centuries. The early records of the College relating to examinations have been surveyed, and an account is given here of examination policy and regulations, together with the topics prescribed to some 50 candidates in the first half of the 18th century. PMID- 1774703 TI - Non-palpable mammographic abnormalities. AB - The radiological characteristics of non-palpable mammographic abnormalities are reviewed and their diagnostic limitations discussed. Alternative methods of detection and diagnosis are reviewed. The development of needle localization for non-palpable mammographic abnormalities is traced from the initial crude excisions through to stereotactic needle localization. Non-palpable carcinomas have a greater proportion of favourable histopathologies. However, the preferred management of these early lesions has yet to be determined. PMID- 1774704 TI - Assessment of the reliability of the symptoms and signs of acute appendicitis. AB - The reliability of the signs and symptoms of acute appendicitis are reviewed. The wide variation in clinical findings when the different studies are compared can probably be explained by the huge quantity of retrospective studies. Migration of pain to the right iliac fossa and/or guarding/rigidity support the diagnosis of appendicitis. The diagnosis of appendicitis should be doubted when anorexia, nausea and vomiting are absent, when symptoms have persisted for more than 72 h without apparent perforation, or when tenderness in the right iliac fossa is absent. Presentation in proximity to menstruation, cervical dislocation tenderness and bilateral adnexal tenderness indicates pelvic inflammatory disease. Small children have high perforation rates because of their uniform response to many illnesses and relative inability to express themselves and cooperate. The clinical findings in young and old patients are similar, except for a higher rate of abdominal distension in old patients. With a more thorough knowledge of the signs and symptoms of acute appendicitis and a constant awareness of its possible presence, it should be possible to increase the diagnostic accuracy. PMID- 1774705 TI - Carbon dioxide laser cordectomy in the management of bilateral vocal cord paralysis. AB - Bilateral vocal cord paralysis is a rare but major complication of thyroid surgery. Since 1983, patients with bilateral cord paralysis have been managed in this department using the carbon dioxide laser. Six patients with bilateral cord paralysis secondary to thyroid surgery underwent partial cordectomy and arytenoidectomy. Two patients were operated on with tracheostomy tubes in situ, and both were successfully decannulated. In the remaining four patients, ventilation was maintained during anaesthesia using a Venturi jet ventilation system. None of these patients required a perioperative tracheostomy. Adequate airway improvement and satisfactory voice quality were achieved. Follow-up ranged from 6 to 17 months. PMID- 1774706 TI - Management of mammillary fistulae. AB - Mammillary fistulae develop between the lactiferous ducts of the breast and areolar skin. Over a 14-year period 41 fistulae were treated in 36 patients (34 women, 2 men). In 24 women at least one subareolar abscess (mean 2.5) had been incised and drained previously. Fourteen fistulae developed after discharge of an inflammatory mass and three after surgical biopsy. Twelve women underwent 13 fistulectomies, two of which required reoperation. The remaining 24 patients with complicated fistulae (n = 28) had previously undergone multiple surgical procedures; 12 patients had 13 fistulae treated by total duct excision and primary closure without antibiotic cover and six fistulae required reoperation. Fifteen fistulae in 12 women were treated by duct excision with either primary closure under antibiotic cover (n = 7) or packing with healing by granulation (n = 8) and only one recurred (P less than 0.05). Operations for mammillary fistulae should be treated as contaminated procedures. In simple cases where no previous surgery has taken place, fistulectomy is appropriate. In complicated cases, treatment should be duct excision with the wound either closed primarily under antibiotic cover or left open to heal by secondary intention. PMID- 1774707 TI - Endoscopic management of bleeding peptic ulcers in Singapore: a multimodality approach. AB - Endoscopic haemostasis is becoming increasingly important in the management of bleeding peptic ulcers. In this study, rather than being confined to one modality of treatment, the endoscopist was allowed to customize the treatment according to the configuration of the ulcer, accessibility, and rate of bleeding in any particular patient. Fifty patients with actively bleeding peptic ulcers or stigmata of recent haemorrhage were treated endoscopically. Initial haemostasis was achieved in 48 (96%) patients. Eleven patients rebled of whom eight underwent repeat endoscopic treatment. Of these eight patients, three rebled of whom two required surgery. Permanent haemostasis was achieved in 43 of 50 patients (86%). The rate of surgery in the endoscopically treated group was 10%. There was one death due to causes not related to bleeding. The multimodality approach is a useful method of treatment in bleeding peptic ulcers, giving flexibility to the endoscopist in deciding on the best way to deal with the problem. PMID- 1774708 TI - Cystic duct occlusion by microwave tissue coagulator in rabbits. AB - In this preliminary study a flexible bipolar microwave electrode, 1.8 mm in diameter, was designed to occlude the cystic duct in 18 rabbits. Thermal model tests were performed to evaluate the effect of the antenna and to master the coagulating condition. Through surgical cholecystostomy, the antenna was inserted into the proximal cystic duct for various coagulation treatments. Cholecystography showed that the cystic duct was occluded minutes to hours after coagulation. Histologically, the microwave technique induced a chronic inflammation and fibrosis which eventually obliterated the coagulated cystic duct permanently. In group A (30 mA for 20 s) the cystic duct epithelium regeneration occurred and surrounding liver damage was limited, while in groups B (50 mA for 10 s) and C (70 mA for 6 s) no epithelium regeneration was observed and injury to the liver was mild to moderate. It was found that microwaves generated at 50 mA for 10 s to occlude the rabbit's cystic duct are effective and less injurious. PMID- 1774709 TI - Audit of pressure sores treated in a regional plastic surgery unit (1971-1990). AB - The results of a previous study of pressure sores over the 10-year period 1971 1980 in this unit were compared with those of the subsequent 10 years, 1981-1990. Factors reviewed included the source of referral, underlying aetiological problems, management and outcome. By combining the two studies a continuous 20 year audit has been obtained. PMID- 1774710 TI - Audit of 'surgery in general' in an African teaching hospital. AB - A 1-year prospective audit of 2233 operations performed by one general surgical unit in a Central African teaching hospital is presented. In addition to the usual 'general surgical' procedures, operations also included emergency craniotomy, reconstructive surgery for open fractures, and hysterectomy. There were 37 (1.7%) postoperative deaths and 45 other deaths in non-operated patients. Ten of 14 deaths due to sepsis in the 20-40-year age group were associated with HIV infection. The implications for teaching and training of surgical specialists in the tropics are discussed. PMID- 1774711 TI - Phytobezoar masquerading as the superior mesenteric artery syndrome: successful endoscopic treatment using a colonoscope. PMID- 1774712 TI - Simultaneous bypass grafting of the superior vena cava and intrathoracic biopsy in fulminant superior vena caval syndrome. PMID- 1774713 TI - Buerger's disease of the rectum: case report and literature review. PMID- 1774714 TI - Plastibell circumcision. PMID- 1774715 TI - Roeder knot for tight corners in conventional abdominal surgery. PMID- 1774716 TI - Treatment of open tibial shaft fractures by delayed closed intramedullary nailing. AB - Forty-seven open tibial fractures in 43 patients were internally fixed by delayed closed nailing after reaming the medullary canal. The procedure was usually undertaken after complete healing of the wound. Early mobilization was encouraged in all cases. In 37 patients (86%) the fractures were caused by road traffic accidents; 21 patients (49%) had other skeletal and soft tissue injuries. All fractures united with a mean of 19 weeks, but five had delayed union. Most patients had a full range of knee and ankle movements. No infection was encountered in the series. PMID- 1774717 TI - Casualty officers under-estimate the blood loss from fractures. PMID- 1774718 TI - Incidence of Campylobacter pylori in a consecutive series of surgical patients referred for endoscopy. PMID- 1774719 TI - Colorectal anastomotic integrity after anterior resection: is there a role for intraoperative testing? PMID- 1774721 TI - What's new in hepatobiliary surgery. PMID- 1774720 TI - Plea for selective operative cholangiography. PMID- 1774722 TI - Stage I endometrial carcinoma. Role of omental biopsy and omentectomy. AB - A prospective, routine histologic assessment of the omentum during primary surgery was conducted on 84 women with stage I endometrial carcinoma between February 1986 and June 1989. The purpose of the study was to determine the true incidence of omental involvement in early endometrial cancer and to detect risk variables associated with such metastases. Omental metastases were found in 7 (8.3%) of 84 patients with stage I endometrial carcinoma. A majority of the metastases (five) consisted of microscopic disease. Factors statistically significantly associated with omental metastasis were adnexal spread, cul-de-sac implantation, papillary serous carcinoma, a positive retroperitoneal lymph node and grade 3 tumor. The study indicated that silent metastases to the omentum frequently are neglected clinically in patients with stage I endometrial carcinoma during primary surgery and that a routine omental biopsy should be part of the procedure. Furthermore, for patients with high-risk variables, a complete omentectomy ought to be considered. PMID- 1774723 TI - Human relaxin. In vitro response of human and pig myometrium. AB - Human myometrial strips were excised at hysterectomy and cesarean section and allowed to contract spontaneously in a water bath. Porcine myometrial strips from midpregnancy were also collected. Recombinant human relaxin completely inhibited spontaneous myometrial activity in the pig at a concentration of 0.6 micrograms/mL, but human relaxin had much less of an effect or no effect on human myometrium at concentrations up to 7.5 micrograms/mL. Any effect of human relaxin on human myometrium was seen only in estrogen-primed human tissues; that effect was never greater than a 5% reduction in amplitude and 50% reduction in frequency. When contractions were stimulated with oxytocin or prostaglandin F2 alpha, relaxin had no inhibitory effect on either porcine or human myometrium at doses up to eight times the concentration of relaxin that had attenuated spontaneous contractions. Pretreatment with progesterone did not enhance the action of relaxin on human myometrium. The limited effect of human relaxin on human myometrium as compared to the marked inhibitory action of both porcine and human relaxin on porcine myometrial activity suggests that the species specificity does not lie with the relaxins but with the target tissues. Human relaxin H2 might not play a major role in the control of myometrial activity in the human. PMID- 1774724 TI - Cervical intraepithelial neoplasia extending to the margins of resection in conization of the cervix. AB - Conization of the cervix is still widely utilized under certain conditions for the diagnosis and treatment of cervical intraepithelial neoplasia (CIN). Little has been written about the management of disease extending to the margins of resection. Ninety-four patients underwent conization of the cervix for cervical intraepithelial neoplasia (CIN). Nineteen (20%) had positive margins of resection; 10 (56%) of them had no evidence of disease in follow-up of one to four years. The inflammatory response of healing may play a role in a cure. Positive margins of resection and persistent disease, noted in 44%, were positively associated with higher grades of CIN and smoking. Smoking was also a risk factor for recurrent disease in those with negative margins of resection. PMID- 1774725 TI - Ovarian surgery on the rabbit. Effect of cortex closure on adhesion formation and ovarian function. AB - Surgical reapproximation of serosal surfaces in an attempt to reduce adhesiogenesis remains a controversial issue. For the reproductive gynecologist, this tenet is especially appropriate to the ovarian cortical surface. Using a rabbit model (n = 22), an ovarian unipolar cautery incision was created, and surgical closure versus nonclosure was evaluated. Closure with continuous 6-0 polyglactin resulted in a significant increase in the degree of ovarian adhesion envelopment versus nonclosure (1.8 +/- 0.2 vs. 0.9 +/- 0.2, P less than .01). Surgical closure also resulted in a significant increase in the vascularity of the adhesions (P less than .05). Despite the increase in adhesion formation, ovarian function, as determined by the mean number of corpora lutea, pregnancies and the nidation index, was not different in sutured ovaries, unsutured ovaries or nonsurgically treated controls. PMID- 1774726 TI - Curettage vs. nonsurgical management in women with early spontaneous abortions. The effect on fertility. AB - Among 114 women with early spontaneous abortions, low beta-human chorionic gonadotropin levels and no ultrasonographically demonstrable residual tissue in the uterine cavity, 68 underwent uterine curettage, and 46 were managed conservatively. No complications, such as bleeding or infection, were observed in either group, and the probability of conception, outcome of subsequent pregnancies and rate of subsequent abortions were similar. Curettage offers no advantage over conservative management in selected patients with early abortions. PMID- 1774727 TI - Nalbuphine after major gynecologic surgery. Comparison of patient-controlled analgesia and intramuscular injections. AB - A randomized investigation compared the efficacy and safety of nalbuphine administered by two methods, a patient-controlled infuser system and intramuscular (IM) injections, after major gynecologic surgery. Forty-seven patients were randomly assigned to receive nalbuphine by either method. The 22 patients using the infuser were given a 2.0-mg, incremental dose with a 10-minute lock-out interval between doses. A similar group receiving 10-15 mg IM every three hours served as the control. Misprogramming, overdosage, depressed respiration and drug dependence were not encountered. Self-administration provided equally satisfactory sedation and more immediate pain relief without painful injections. Although patients with the infuser had the ability to self administer more medication, they did not use higher doses of nalbuphine than did the IM group. The additional cost of the infuser system was offset by the satisfaction expressed by the patients and by the improved nursing efficiency. Nalbuphine administered with a patient-controlled infuser provided an effective balance between analgesia and sedation and offered advantages over IM injections. PMID- 1774728 TI - Serum human chorionic gonadotropin concentration for predicting multiple gestation in pregnancies conceived with superovulation and intrauterine insemination. AB - Assisted reproductive technologies are associated with an increased incidence of multiple gestation. Because they provide precise information on the time of ovulation, those technologies afford an opportunity to analyze the association between multiple gestation and maternal serum human chorionic gonadotropin (hCG) concentrations during early pregnancy. We retrospectively evaluated this association in 76 pregnancies (26 multiple) conceived with superovulation and intrauterine insemination. Using multiple linear regression, we discerned that the number of fetuses surviving the first trimester was directly proportional to the log of the hCG concentrations. The mean + 1 SD for the estimated hCG values of singleton pregnancies was selected a priori as the threshold for detecting multiple pregnancies. This threshold value provided a sensitivity of 73%, specificity of 80% and overall accuracy of 78%. Nine of 11 pregnancies with three or more fetuses had hCG concentrations above the threshold values. Although there is a positive correlation between the number of fetuses surviving the first trimester and the hCG concentration early in pregnancy, the predictive value of the hCG concentration is useful only for excluding most triplet and quadruplet pregnancies. PMID- 1774729 TI - Antepartum fetal blood sampling with cordocentesis. Comparison with chorionic villus sampling and amniocentesis in diagnosing karyotype anomalies. AB - Cordocentesis under ultrasound guidance, or percutaneous umbilical blood sampling, was first reported in 1983 by Daffos et al. Since then the method has gained importance in prenatal diagnosis. In 1,011 cases at a women's clinic in Bonn, Federal Republic of Germany, 35% of the cordocentesis cases were done for blood group incompatibilities plus intravascular transfusion in most of the cases. In the remaining 65% the indications for cordocentesis were a rapid karyotype analysis, diagnosis of fetal infections and determination of fetal acid base status in severe intrauterine growth retardation. Chorionic villus sampling (CVS) and amniocentesis were also performed to detect karyotype anomalies. Amniocentesis constituted 78.8% of the procedures and detected 50% of the karyotype abnormalities. Cordocentesis and CVS constituted 17.3% and 3.9%, respectively, of all the procedures and diagnosed 39% and 11%, respectively, of the abnormalities. Different forms of trisomy were the most common karyotype anomaly. Translocation was noted in 22 cases. Turner's, Klinefelter and triple X syndromes and triploidy were the next major forms. PMID- 1774730 TI - Gestational diabetes and neonatal macrosomia in the polycystic ovary syndrome. AB - Since patients with polycystic ovary syndrome (PCOS) commonly have insulin resistance, albeit with normal glucose tolerance, we evaluated glucose tolerance in PCOS patients exposed to the diabetogenic effect of pregnancy. The clinical material was obtained from two centers, in Springfield, Illinois (22 patients), and New York, New York (31 patients), and the results were compared with a control population with 2,306 consecutive general pregnancies. There were no differences between PCOS patients from the two centers in regard to age or ponderal index (P greater than .1). A review of the medical records showed that the incidence of gestational diabetes in the PCOS patients was 7.5%, similar (P greater than .1) to the 6.6% frequency of gestational diabetes in the controls. The overall incidence of neonatal macrosomia (birth weight greater than 4,000 g) was 7% (4 of 57) among infants born to PCOS women. That was similar to the 12.4% incidence of neonatal macrosomia among infants born to women with normal glucose tolerance and to the 14.5% incidence among infants born to women with gestational diabetes. Preexisting PCOS does not appear to increase the risk of developing gestational diabetes or neonatal macrosomia. PMID- 1774731 TI - Fetal obstructive uropathies. Importance of chromosomal abnormalities and associated anomalies to perinatal outcome. AB - The ultrasound records of 30 fetuses suspected of having an obstructive uropathy were reviewed retrospectively. A prenatal karyotype was obtained with amniocentesis on each patient. After delivery, neonatal urologic records, renal ultrasound reports and autopsy information were reviewed and compared to the ultrasound records and fetal karyotype results. Chromosomal defects were found in 23% of fetuses with a suspected obstructive fetal uropathy. In five patients the chromosomal abnormality was lethal and caused 45% of the perinatal deaths in this series. If a fetus with an obstructive uropathy was female, there was a significant likelihood of an extrarenal anomaly or a complex genitourinary tract malformation. Seventeen percent of patients with an obstructive uropathy had a coexistent extrarenal defect. A prenatal karyotype should be obtained if a fetal obstructive uropathy is suspected antenatally since lethal chromosomal defects are an important cause of perinatal death. A female karyotype may indicate a fetus at higher risk of extrarenal anomalies or complex genitourinary malformations. PMID- 1774732 TI - Prenatal management of twin gestation. Experience with a new protocol. AB - We carried out a prospective cohort study to evaluate the usefulness of a specific protocol of prenatal management of twin pregnancy to decrease the incidence of prematurity in the population. The protocol particularly stressed the importance of early recognition of uterine contractile activity and early work leave (from 28 weeks' gestation). The outcome of 39 consecutive twin pregnancies that used the protocol over a five-year period was compared with the outcome of 76 twin pregnancies followed by private practitioners and delivered at our department. The two groups were comparable with respect to maternal age, parity, gestational age at diagnosis, socioeconomic level and educational level. The incidence of preterm delivery was significantly lower in the study group than in the control group. Even more significant was the difference in the incidence of severe prematurity (less than 34 weeks' gestation) between the two groups. The use of a protocol like ours, which does not include prolonged hospitalization, home bed rest or tocolytic treatment, is recommended. PMID- 1774733 TI - Transient osteoporosis of the hip during pregnancy. A case report. AB - Transient hip osteoporosis is a benign, process mainly affecting men. A 31-year old woman in the 31st week of pregnancy was diagnosed as having the disorder. Impairment of venous flow associated with pregnancy might have been the cause of the osteoporosis and superficial thrombophlebitis. PMID- 1774734 TI - Endosalpingiosis as a source of psammoma bodies in a Papanicolaou smear. A case report. AB - Psammoma bodies are concentric, laminated structures produced by cross-sectioning the tips of calcified papillary formations and are usually associated with papillary carcinoma of the thyroid gland, meningiomas and serous papillary tumors of the ovary. These structures have occasionally been seen in cytologic smears obtained from women with endometrial or ovarian carcinoma. A woman had Papanicolaou smears that continued to show psammoma bodies for over two years, eventually leading to a hysterectomy. Even though the presence of psammoma bodies on a Papanicolaou smear should always alert the physician to the possibility of ovarian carcinoma, leading to a thorough search for this malignancy, a variety of benign conditions, such as endosalpingiosis, may also be associated with this finding. PMID- 1774736 TI - Isolation of Kingella denitrificans from amniotic fluid in a woman with chorioamnionitis. A case report. AB - Kingella denitrificans and Streptococcus agalactiae were isolated from the amniotic fluid of a woman with chorioamnionitis. She was treated with intravenous ampicillin/sulbactam, with a good response. PMID- 1774735 TI - Gonococcal peritonitis after tubal ligation. A case report. AB - Gonococcal peritonitis occurred after a tubal ligation. Falk's postulated benefit of cornual resection as a preventive measure for recurrent infection does not extend to isthmic interruption. Pelvic inflammatory disease should be considered when a sterilized woman presents with an acute abdomen. PMID- 1774737 TI - Unusual metastases from a malignant melanoma. A case report. AB - An unusual case of malignant melanoma metastatic to the lung and to the ovaries occurred 9 and 11 years, respectively, after the initial, extragenital diagnosis. The primary lesion invaded to Clark's level IV with a thickness of greater than 4 mm, normally grave prognostic indicators. A metastatic lung nodule seen radiographically remained unchanged for two years before discovery of the intraperitoneal disease. The case illustrates the clinical variability and unpredictable biologic behavior of malignant melanoma. PMID- 1774739 TI - Vaginal expulsion of a Hulka clip. A case report. PMID- 1774738 TI - Malakoplakia of the female genital tract causing urethral and ureteral obstruction. A case report. AB - Malakoplakia is an uncommon form of inflammatory response, initially described as occurring in the urinary bladder. Malakoplakia of the female genital tract is exceedingly rare. One such case was unusual in that it caused ureteral as well as urethral obstruction. PMID- 1774740 TI - Insulin--sniffing for jabbing. PMID- 1774741 TI - A suggested medical curriculum for learning about complementary medicine. PMID- 1774742 TI - The European Academy of Anaesthesiology--1992 and beyond. AB - The European Academy of Anaesthesiology was founded in 1978 as a means of meeting the challenges resulting from the introduction of the Medical Directives permitting the free movement of doctors within the European Community. The Academy is a scientific forum for anaesthetists throughout Europe--not just the EC countries--and has established its own English-language journal and multi lingual Diploma examination. It is now embarking on a system of hospital recognition linked to intraining examinations. With the help of industry and a professional communications organization, it is also exploring the production of multi-lingual educational packages. It is believed that for effective evolution of hospital practice in Europe, medical specialties need to have their own academic organizations which will develop specialist training and which are in a position to provide appropriate advice to relevant national and European bodies. PMID- 1774743 TI - Anterior pelvic reconstruction with ileum after cancer treatment. AB - Ileum has been used to reconstruct the lower urinary tract in 15 patients (10 women, five men) after treatment for bladder or gynaecological cancer. Seven patients had previously received radical pelvic irradiation. Four methods were used: group 1 (five patients): bladder patch after partial cystectomy or bladder augmentation after clam cystotomy for bladder contracture; group 2 (four patients): bladder replacement after subtotal (supratrigonal) cystectomy; group 3 (two patients): ureteric replacement for lower ureteric obstruction or fistula, and group 4 (four patients): complete replacement of bladder and lower ureters after anterior pelvic exenteration, with creation of neovagina from caecum in the two female patients. Review of the results indicates that ileum provides a versatile and safe material for anterior pelvic reconstruction in cancer patients even after previous pelvic irradiation. PMID- 1774744 TI - Breast liver metastases--incidence, diagnosis and outcome. AB - Breast liver metastases are uncommon and have not been well reported. We studied the clinical outcome of 47 patients who developed liver metastases out of 912 breast cancer patients treated between 1982 and 1987, an incidence of 5.2%. The median disease free interval prior to clinical liver metastases was 20.2 months (range 4-192 months). The most frequent clinical presentations were hepatomegaly (70%) and abdominal pain (34%). The diagnosis was confirmed on ultrasound scan in 72.7% patients. Thirty-one patients (70.5%) received specific treatment with both hormone and chemotherapy but only six showed any evidence of objective response, the majority of whom had metastases only in the liver. The median survival of treated patients was 4 months and absence of jaundice, response to treatment and liver metastases only were associated with significantly better survival. In conclusion breast liver metastases usually present as a manifestation of disseminated disease and have an appalling prognosis. When they occur as an initial site the prognosis is better but very few patients overall respond to conventional treatment. PMID- 1774745 TI - Beneficial effects of pet ownership on some aspects of human health and behaviour. AB - A 10-month prospective study was carried out which examined changes in behaviour and health status in 71 adult subjects following the acquisition of a new pet (either dogs or cats). A group of 26 subjects without pets served as a comparison over the same period. Both pet-owning groups reported a highly significant reduction in minor health problems during the first month following pet acquisition, and this effect was sustained in dog owners through to 10 months. The pet-acquiring groups also showed improvements in their scores on the 30-item General Health Questionnaire over the first 6 months and, in dog owners, this improvement was maintained until 10 months. In addition, dog owners took considerably more physical exercise while walking their dogs than the other two groups, and this effect continued throughout the period of study. The group without pets exhibited no statistically significant changes in health or behaviour, apart from a small increase in recreational walking. The results provide evidence that pet acquisition may have positive effects on human health and behaviour, and that in some cases these effects are relatively long term. PMID- 1774746 TI - An outbreak of chickenpox in a military field hospital--the implications for biological warfare. AB - An outbreak of chickenpox with spread to patients and staff on the isolation ward of a British field hospital during the Gulf war is described. The implications for the design and operation of field hospital isolation units should transmissible biological warfare agents be encountered in any future conflict are discussed. PMID- 1774747 TI - Teenage pregnancy: doubts, uncertainties and psychiatric disturbance. AB - Fifty-two pregnant teenagers were assessed at 'booking' using the General Health Questionnaire (GHQ 28), a locus of control scale, and five visual analogue 'attitude scales'. Thirty-eight were in the antenatal and 14 in the termination clinic. One quarter had probable psychiatric disorder on the GHQ. The GHQ scores correlated outcome of pregnancy (whether about the planned outcome of pregnancy (whether termination or full term). Locus of control correlated with the Depression scale of the GHQ but not with attitude to pregnancy or choice of termination or delivery. Clinic staff should be alert to the psychiatric risks when seeing teenagers who have marked doubts about their plans when pregnant. PMID- 1774749 TI - Cadaver studies of the anatomy of arterial supply to the inferior turbinates. AB - The anatomy of the arterial supply of the inferior turbinate was studied by dissection and serial histological sections. The arrangement was found to be constant, with a single main descending branch of the sphenopalatine artery entering its substance from above, 1-1.5 cm from its posterior border. This artery branches as it passes forwards within the turbinate, remaining close to the bone. As these pass anteriorly they give rise to arterial arcades which remain close to or within the bone, with the main artery increasing in diameter. The implications of these findings are discussed in a surgical context. PMID- 1774748 TI - Use of the emergency ambulance service to an inner city accident and emergency department--a comparison of general practitioner and '999' calls. AB - Over a 2-week period a prospective study was undertaken of patients brought to an inner city accident and emergency department by the emergency ambulance service. Criteria for assessing the appropriateness of use of the emergency ambulance service are not well defined and at worst entirely subjective. The author's finding that, of patients attending after a '999' call, 49.8% were discharged with no follow-up suggests that many of these journeys represented inappropriate use of the emergency ambulance service. Close liaison between senior medical staff and the emergency ambulance service may allow more appropriate and effective use of the service, improving patient care in the pre-hospital setting. PMID- 1774750 TI - A case for the development of departments of gerocomy in all district general hospitals: discussion paper. PMID- 1774751 TI - Contra Davies: Mozart's terminal illness. PMID- 1774752 TI - Mozart's death: a rebuttal of Karhausen. Further evidence for Schonlein-Henoch syndrome. PMID- 1774753 TI - Mr ES: a case for old age psychiatry or Professor Jung? PMID- 1774754 TI - Masson's pseudoangiosarcoma. PMID- 1774755 TI - Infective endocarditis complicated by ruptured cerebral mycotic aneurysm. PMID- 1774756 TI - Renal artery embolism: a rare cause of renal colic. PMID- 1774757 TI - DF2 septicaemia. PMID- 1774758 TI - Hypertrophy of the raphe perinei in male infants. PMID- 1774759 TI - Extrahepatic portal hypertension protein C deficiency and tuberous sclerosis. PMID- 1774760 TI - Cyclical hypothermia: successful treatment with ephedrine. PMID- 1774761 TI - Cocaine as a biological and medical problem. PMID- 1774762 TI - Helping the lab to help us. PMID- 1774763 TI - The history of Cushing's disease. PMID- 1774764 TI - Immunology of the tonsils. PMID- 1774765 TI - Recurrent pancreatitis. PMID- 1774766 TI - Should general practitioners refer more patients to hospital. PMID- 1774767 TI - Expression of cytochrome P-450lpr is developmentally regulated and limited to house fly. AB - Expression of house fly cytochrome P-450lpr was examined using immunoblotting in male and female adult LPR house flies, mixed sex adult house flies at 12 different ages, larvae, and pupae. P-450lpr was expressed in both male and female adult house flies. P-4501pr was clearly present in all adult stages examined, was barely detectable in pupae, and could not be detected in larvae. Thus, cytochrome P-450lpr is developmentally regulated and present in both sexes of house fly. Expression of cytochrome P-450, immunologically homologous to house fly cytochrome P-4501pr, was examined in other species using immunoblot analysis. Eleven animal species were tested in the orders Diptera, Hymenoptera, Lepidoptera, Orthoptera, Acari, and Rodentia, using microsomes in some species from both induced and noninduced animals or insecticide-resistant and susceptible strains. P-450lpr appears to be restricted to house flies, as none of these species contained cytochrome P-450 that reacted with antiserum to cytochrome P 450lpr. PMID- 1774768 TI - Selective erythrocyte potassium efflux following pulse treatment with tellurite. AB - Human erythrocytes exposed to 0.1 mM tellurite (K2TeO3) in an isotonic buffered choline chloride medium for 15 min at 37 degrees C, washed, and incubated further in the absence of the chemical in the buffer, exhibited selective leakiness for potassium within minutes. The potassium efflux curve was sigmoidal, with an initially slow leakage followed by a sharp rise (first-order kinetics) and a plateau by 60 min. After 15 min, 30-50% of the total potassium concentration had leaked from the cells, although less than 1% lysis had occurred. The control cells incubated in buffer with no K2TeO3 exhibited no potassium leakage. The mean volume of the K2TeO3-treated erythrocytes increased and their median density decreased, indicating changes in the colloid osmotic state and physical characteristics of the cells. However, cells pretreated with K2TeO3 exhibited no significant change in glutathione (GSH) concentration and no membrane lipid peroxidation, unlike cells pretreated with t-butylhydroperoxide (Deuticke et al., Biochim. Bio phys. Acta, 899, 125-128, 1987). The enhanced potassium permeability of the K2TeO3-treated erythrocytes preceded the increase in cell volume, intracellular hydration, and a decrease in median density. We suggest that perturbation of the lipid-protein interaction in the membrane by the oxidant alters the potassium permeability and results in the selective leakage with eventual hemolysis. PMID- 1774770 TI - Purified NAD(P)H-quinone oxidoreductase enhances the mutagenicity of dinitropyrenes in vitro. AB - The effect of highly purified rat liver cytosolic NAD(P)H-quinone oxidoreductase [EC 1.6.99.2] on the mutagenicity of 1,3- 1,6- and 1,8-dinitropyrene (DNP) was studied in the Ames Salmonella typhimurium mutagenicity assay. NAD(P)H-quinone oxidoreductase over the range of 0.02-0.8 micrograms/plate (38-1500) units increased up to threefold the mutagenicity of all three DNPs in S. typhimurium TA 98. In TA98NR, a strain deficient in "classical" nitro-reductase, the mutagenicity of 1,6- and 1,8-DNP was essentially unchanged, whereas that of 1,3 DNP was markedly reduced. NAD(P)H-quinone oxidoreductase enhanced the mutagenicity of 1,6- and 1,8-DNP to approximately equivalent extents in TA98NR and TA98. The mutagenicity of 1,3-DNP in TA98NR was potently enhanced by the addition of NAD(P)H-quinone oxidoreductase in a dose-responsive manner. In the presence of 0.8 micrograms NAD(P)H-quinone oxidoreductase, 1,3-DNP displayed a mutagenic response in TA98NR that was comparable to that obtained in TA98. NAD(P)H-quinone oxidoreductase was found to increase the mutagenicity of 1,6- but not 1,3- or 1,8-DNP to mutagenic intermediates in TA98/1,8-DNP6, a strain deficient in O-acetyltransferase activity. The results suggest that NAD(P)H quinone oxidoreductase not only catalyzes reduction of the parent DNP but also that of partially reduced metabolites generated from that DNP. Such reductive metabolism may lead to increased formation of the penultimate mutagenic species. PMID- 1774769 TI - Pentachlorobutadienyl-L-cysteine (PCBC) toxicity: the importance of mitochondrial dysfunction. AB - The relationship between the covalent binding, uptake, and toxicity produced by pentachlorobutadienyl-L-cysteine (PCBC) was examined in rabbit renal proximal tubules (RPT), renal basolateral membrane vesicles, and isolated renal cortical mitochondria. Renal proximal tubules rapidly metabolized PCBC to a reactive intermediate that bound to tubular protein. Approximately 70-90% of PCBC found in the cell at any given time was bound to protein. PCBC initially uncoupled oxidative phosphorylation, followed by a 45% reduction of state 3 respiration and a 90% decrease in cellular adenosine triphosphate (ATP) levels. These events preceded cell death. Isolated mitochondria also metabolized PCBC to a reactive intermediate that bound to mitochondrial protein and initiated mitochondrial toxicity. These results show that PCBC-induced mitochondrial dysfunction occurred as a result of mitochondrial bioactivation and that the mitochondrion is the critical subcellular target in PCBC toxicity. Aminooxyacetic acid (AOAA), an inhibitor of cysteine conjugate beta-lyase, reduced the covalent binding of PCBC equivalents to tubular protein by approximately 90% and decreased but did not prevent the toxic effects produced by PCBC on RPT respiration and cellular ATP levels. AOAA delayed but had no effect on the overall extent of cell death produced by PCBC. The protective effect of AOAA was independent of any effects on PCBC uptake. These results show that AOAA decreased but did not prevent the metabolism of PCBC by cysteine conjugate beta-lyase. The partial inhibition of PCBC metabolism, and hence, PCBC-induced cell death by AOAA, may be related to limited concentrations of AOAA within the tubule cell or mitochondria. PMID- 1774771 TI - Intracellular calcium chelators and oxidant-induced renal proximal tubule cell death. AB - The effect of intracellular calcium chelators on rabbit renal proximal tubule (RPT) cell death induced by t-butyl hydroperoxide (TBHP) and H2O2 was examined. Preincubation of RPT suspensions with 50 microM QUIN 2/AM completely prevented TBHP (0.5 mM) and H2O2 (2 mM) induced cell death [i.e., release of lactate dehydrogenase (LDH)]. QUIN 2/AM, BAPTA/AM, EGTA/AM, and FURA 2/AM, at 5 microM, decreased LDH release (at 6 hr) from 41% to 4%, 21%, 26%, and 33%, and decreased lipid peroxidation (at 1 hr) from 1.0 to 0.1, 0.4, 0.6, and 0.8 nmol MDA/mg protein, respectively, after TBHP exposure. Since oxidant-induced lipid peroxidation and cell death are iron-dependent in this model, these results suggest that the intracellular calcium chelators inhibit cell death by chelating iron. PMID- 1774772 TI - Response of the electrochromic dye, merocyanine 540, to membrane potential in rat liver mitochondria. AB - Merocyanine binds extensively to rat liver mitochondria in spite of the presence of a sulfonic acid group which would suggest only limited penetration through the membrane. Passive binding shows both tight and weak binding components and is dependent on salt concentration and ionic strength in accord with the Gouy Chapman theory. The binding of merocyanine to mitochondria is accompanied by both a fluorescence enhancement and a spectral shift. Induction of an electrical field by either respiration or K+ diffusion potential results in a partial reversal of the spectral shift seen on dye binding. At low temperature, the merocyanine spectral response to an electrical field is biphasic, consisting of a fast phase with a t1/2 of less than 1 sec at 15 degrees C and a slower phase which may vary considerably in rate and extent with conditions. The spectral shift during the two phases appears similar, but differ in sensitivity to ionic strength and temperature. The spectral shift during the fast phase at 15 degrees C indicates that the major component is a decrease in bound monomer and an increase in the aqueous dimer, indicating an "on-off" mechanism. It is suggested that the fast and slow phases of the merocyanine response may be due to two different populations of dye, possibly located at the outer and inner surfaces, respectively, of the mitochondrial membrane. The electrophoretic movement of the dye located in the membrane interior would result in the temperature-sensitive slow phase response. Demonstration of the proportionality of the fast phase response to the magnitude of the membrane potential suggests the usefulness of merocyanine in studies with mitochondrial systems. PMID- 1774773 TI - Extrusion of calcium from a single isolated neuron of the snail Helix pomatia. AB - Simultaneous optical measurements of extra- and intracellular Ca2+ concentrations were carried out on isolated snail neurons injected iontophoretically with Ca2+. The fluorescent indicator Fura-2 was used to measure intracellular concentration of free Ca, and the absorbant indicator Antipyrylazo III to measure changes in extracellular calcium concentration in the micro-chamber containing the cell. The velocity of Ca2+ extrusion from a single cell has been shown to be in accordance with the level of free Ca in the neuronal cytoplasm. After an increase in intracellular free Ca by iontophoretic injection from a microeletrode to 0.2-0.5 microM, the velocity of Ca2+ extrusion from the neuron was approximately 0.3-4.6 microM/sec per cell volume. During caffeine-induced calcium-dependent calcium release of Ca2+ from intracellular stores a stimulation of calcium extrusion took place, reaching the velocity of 5.0 microM/sec per cell volume. PMID- 1774774 TI - Angiotensin II, vasopressin and GTP[gamma-S] inhibit inward-rectifying K+ channels in porcine cerebral capillary endothelial cells. AB - Cerebral capillaries from porcine brain were isolated, and endothelial cells were grown in primary culture. The whole-cell tight seal patch-clamp method was applied to freshly isolated single endothelial cells, and cells which were held in culture up to one week. With high K+ solution in the patch pipette and in the bath we observed inward-rectifying K+ currents, showing a time-dependent decay in part of the experiments. Ba2+ (1-10 mM) in the bath blocked this current, whereas outside tetraethylammonium (10 mM) decreased the peak current but increased the steady-state current. Addition of 1 microM of angiotensin II or of arginine vasopressin to the extracellular side caused a time-dependent inhibition of the inward-rectifying K+ current in part of the experiments. Addition of 100 microM GTP[gamma-S] to the patch pipette blocked the K+ inward rectifier. In cell attached membrane patches two types of single inward-rectifying K+ channels were observed, with single channel conductances of 7 and 35 pS. Cell-attached patches were also obtained at the antiluminal membrane of intact isolated cerebral capillaries. Only one type of K+ channel with g = 30 pS was recorded. In conclusion, inwardly rectifying K+ channels, which can be inhibited by extracellular angiotensin II and arginine-vasopressin, are present in cerebral capillary endothelial cells. The inhibition of this K+ conductance by GTP[gamma S] indicates that G-proteins are involved in channel regulation. It is suggested that angiotensin II and vasopressin regulate K+ transport across the blood-brain barrier, mediating their effects via G-proteins. PMID- 1774775 TI - Intracellular free zinc and zinc buffering in human red blood cells. AB - Zn2+ has been allowed to equilibrate across the red cell membrane using two agents that increase membrane permeability to this ion: the ionophore A23187 and the specific carrier ethylmaltol. Extracellular free Zn2+ was controlled with EGTA (1,2-di(2-aminoethoxy)ethane-NNN'N'tetra-acetic acid] buffers, except in the case of ethylmaltol, which itself acts as a buffer. Measurement of cellular zinc content at different levels of free Zn2+ facilitated the study of intracellular Zn2+ binding. It was also possible to estimate intracellular free Zn2+ concentration in untreated cells using a "null-point" technique. Intracellular zinc was found to consist of an inexchangeable component of about 129 mumol/10(13) cells and an exchangeable component of 6.7 +/- 1.5 mumol/10(13) cells, with a free concentration of about 2.4 x 10(-11) M. The main component of Zn2+ buffering is hemoglobin, with a dissociation constant of about 2 x 10(-8) M. PMID- 1774776 TI - Calcium-dependent zinc efflux in human red blood cells. AB - Zinc efflux from human red blood cells is largely brought about by a saturable mechanism that depends upon extracellular Ca2+ ions. It has a Vmax of about 35 mumol/10(13) cells hr, a Km for external Ca2+ of 1 x 10(-4) M, and a Km for internal Zn2+ of 1 x 10(-9) M. External Zn2+ inhibits with a K0.5 of 3 x 10(-6) M. Sr2+ is a substitute for external Ca2+, but changes in monovalent anions or cations have little effect on the Zn2+ efflux mechanism. It is unaffected by most inhibitors of red cell transport systems, although amiloride and D-600 (methoxyverapamil, a Ca2+ channel blocker) are weakly inhibitory. The transport is capable of bringing about the net efflux of Zn2+, against an electrochemical gradient, provided Ca2+ is present externally. This suggests it may be a Zn2+:Ca2+ exchange, which would be able to catalyze the uphill movement of Zn2+ at the expense of an inward Ca2+ gradient, which is itself maintained by the Ca2+ pump. PMID- 1774777 TI - Ecobehavioural analysis of stereotypic and adaptive behaviours: activities as setting events. AB - The effects of activities and task demands on the rate of stereotypic and adaptive behaviour were analysed within the conceptual framework of setting events. Data on 12 mentally retarded subjects were collected in real time using portable microcomputers during six activities: leisure, pre-vocational training, gym, academic instruction, home living, and lunch. Results showed that stereotypic and adaptive responses occurred in all settings, with the two behaviours occurring simultaneously across both subjects and activities some of the time. Micro-level analysis showed that teacher covert task demand provided the setting event for most of the stereotypic and adaptive responding during each activity. The importance of ecobehavioural analysis in understanding the nature of stereotypy and adaptive behaviour, and the contribution of such an analysis to appropriate and effective intervention were highlighted. PMID- 1774778 TI - The performance of children with a moderate mental handicap on simple counting tasks. AB - This study examines both oral and object counting, and the ability to read numerals in a group of 51 children with a moderate degree of mental handicap. The findings indicate deficiencies in basic counting competencies across a wide spread of ability. There is also evidence for a distinction between oral and object counting on a cognitive skills basis. The findings are discussed within a remediation context. PMID- 1774779 TI - Validation of the Pethna toy through changes in collateral behaviours. AB - The Pethna toy is a recently developed toy designed for people with severe and profound mental handicaps. It delivers sensory consequences for the use of simple manipulanda. Two experimental studies evaluated the Pethna toy by monitoring changes in multiple, collateral behaviours. Experiment I demonstrated statistically significant decreases in turn away and stereotyped behaviour and increases in smiling. Experiment II demonstrated highly idiosyncratic changes in collateral behaviours in three adults with multiple handicaps. In all cases, turn away decreased. The role of response-response relationship, subject attention and relationship of sensory behaviours to stereotypies are discussed. PMID- 1774780 TI - The Motivation Assessment Scale: inter-rater reliability and internal consistency in a British sample. AB - Inter-rater reliability of the Motivation Assessment Scale (MAS) was assessed for independent ratings of 12 adolescents and adults with severe/profound mental handicap. Correlations of item and subscale scores across raters were low. The internal consistency of subscales and total scores of the MAA was high. It is suggested that future research using the MAS should include an analysis of the reliability of this measure and features of the raters and subjects which might limit the robustness of the MAS. PMID- 1774781 TI - AIDS: education and adults with a mental handicap. AB - At present, there is a lot of concern about the acquired immune deficiency syndrome (AIDS). Efforts are being made to educate the public about AIDS, so that individuals can take precautions against acquiring or transmitting the disease. Many people with a mental handicap may not benefit from the current education campaign because of limitations in their general understanding and poor or non existent reading skills. Two cases are presented to illustrate the difficulties encountered in educating people with a mental handicap about AIDS. PMID- 1774782 TI - High-pressure scanning electron microscopy of insulating materials: a new approach. AB - A new SEM technique for imaging uncoated non-conducting specimens at high beam voltages is described which employs a high-pressure environment and an electric field to achieve charge neutralization. During imaging, the specimen surface is kept at a stable low voltage, near earth potential, by directing a flow of positive gas ions at the specimen surface under the action of an electric bias field at a pressure of about 200 Pa. In this way charge neutrality is continuously maintained to obtain micrographs free of charging artefacts. Images are formed by specimen current detection containing both secondary electron and backscattered electron signal information. Micrographs of geological, ceramic, and semiconductor materials obtained with this method are presented. The technique is also useful for the SEM examination of histological sections of biological specimens without any further preparation. A simple theory for the charge neutralization process is described. It is based on the interaction of the primary and emissive signal components with the surrounding gas medium and the resulting neutralizing currents. Further micrographs are presented to illustrate the pressure dependence of the charge neutralization process in two glass specimens which show clearly identifiable charging artefacts in conventional microscopy. PMID- 1774783 TI - Microscopy of cell cultures through thin plastic films. AB - Microscopy of cells growing in vessels containing plastic films as a substrate or as a transparent window is facilitated by a contact cap on the objective or the contact objectives for intravital microscopy. When applied to microscopical examination of living cells through a thin film, the cap considerably improves the conditions of observation with high-power dry objectives and makes it possible to use water- and oil-immersion objectives. PMID- 1774784 TI - Electron energy-loss spectroscopy analysis of adriamycin-plasma membrane interaction. AB - Our previous studies on the mechanism of cytotoxic action of the anti-tumour drug adriamycin (ADR) indicated that this anthracyclinic antibiotic strongly modified the molecular architecture of the plasma membrane of human erythrocytes, presumably becoming incorporated within both lipid layers. In order to verify this hypothesis, electron energy-loss spectroscopy (EELS) has been used to compare the P content in control and ADR-treated erythrocyte ghosts. EELS measurements allowed us to reveal a significant reduction in the P/C ratio in erythrocyte ghosts after ADR treatment. This finding seems to reflect a phospholipid 'dilution' produced by the incorporation of the drug molecules in the membrane layers. A structural model of the ADR-membrane interaction is proposed. PMID- 1774785 TI - Strand symmetry of mutation rates in the beta-globin region. AB - It has been suggested that there may be inequalities in the types of substitution on the two DNA strands (in particular, in the frequencies of transversions from R to Y and from Y to R) due to a higher error rate on the lagging than the leading strand during replication. Reexamination of 11 kb of the beta-globin region sequenced in six primates fails to confirm this suggestion. Examination of the 73 kb beta-globin region sequenced in humans shows that the frequency of pyrimidines in different parts of this region is more variable than expected in a random sequence, but the pattern is more consistent with nonrandomness generated by DNA turnover mechanisms than with strand asymmetry due to a higher error rate on the lagging strand. PMID- 1774786 TI - Evolution of the master Alu gene(s). AB - A comparison of Alu sequences that comprise more recently amplified Alu subfamilies was made. There are 18 individual diagnostic mutations associated with the different subfamilies. This analysis confirmed that the formation of each subfamily can be explained by the sequential accumulation of mutations relative to the previous subfamily. Polymerase chain reaction amplification of orthologous loci in several primate species allowed us to determine the time of insertion of Alu sequences in individual loci. These data suggest that the vast majority of Alu elements amplified at any given time comprised a single Alu subfamily. We find that, although the individual divergence relative to a consensus sequence correlate reasonably well with sequence age, the diagnostic mutations are a more accurate measure of the age of any individual Alu family member. Our data are consistent with a model in which all Alu family members have been made from a single master gene or from a series of sequential master genes. This master gene(s) accumulated diagnostic base changes, resulting in the amplification of different subfamilies from the master gene at different times in primate evolution. The changes in the master gene(s) probably occurred individually, but their appearance is clearly punctuated. Ten of them have occurred within an approximately 15-million-year time span, 40-25 million years ago, and 8 changes have occurred within the last 5 million years. Surprisingly, no changes appeared in the 20 million years separating these periods. PMID- 1774787 TI - Evolution of the dec-1 eggshell locus in Drosophila. I. Restriction site mapping and limited sequence comparison in the melanogaster species subgroup. AB - We have analyzed approximately 18 kb of DNA in and upstream of the defective chorion-1 (dec-1) locus of the eight known species of the melanogaster species subgroup of Drosophila. The restriction maps of D. simulans, D. mauritiana, D. sechellia, D. erecta, and D. orena are shown to have basically the restriction map of D. melanogaster, whereas the maps of D. teissieri and D. yakuba were more difficult to align. However, the basic amount of DNA and sequence arrangement appear to have been conserved in these species. A small deletion of varying length (65-200 bp) is found in a repeated sequence of the central transcribed region of D. melanogaster, D. simulans, and D. erecta. Restriction site mapping indicated that the dec-1 gene is highly conserved in the melanogaster species subgroup. However, sequence comparison revealed that the amount of nucleotide and amino acid substitution in the repeated region is much larger than in the 5' translated region. The 5' flanking region showed noticeable restriction site polymorphisms between species. Based on calculations from the restriction maps a dendrogram was derived that supports earlier published phylogenetic relationships within the melanogaster species subgroup except that the erecta-orena pair is placed closer to the melanogaster complex than to D. teissieri and D. yakuba. PMID- 1774789 TI - Molecular evolution and phylogeny of the Drosophila virilis species group as inferred by two-dimensional electrophoresis. AB - Systematic relationship among the 12 species of the Drosophila virilis species group, and Drosophila robusta, were investigated by the use of two-dimensional electrophoresis (2-DE). A total of 389 protein characters (about 200 loci) were scored and analyzed both phylogenetically and phenetically. The resulting phylogeny was found to be largely concordant with the current views of evolution among these species based on other independent morphological, chromosomal, electrophoretic, and immunological data sets, although some notable differences were observed. The 2-DE data also appeared to be useful for constructing a molecular clock to date the absolute times of divergence among the species. It appears from this analysis that the evolution of the major clades within the species group occurred about 20 million years ago. Previous suggestions that the rate of molecular evolution was different between the virilis and montana phylads was not confirmed. The technique of 2-DE seems to be an excellent tool for reconstructing phylogenies and should be particularly valuable for examining relatively closely related species. PMID- 1774790 TI - Special issue on sinusitis. PMID- 1774788 TI - Structural and phylogenetic analysis of the chicken ventricular myosin heavy chain rod. AB - We have isolated and characterized five overlapping clones that encompass 3.2 kb and encode a part of the short subfragment 2, the hinge, and the light meromyosin regions of the myosin heavy chain rod as well as 143 bp of the 3' untranslated portion of the mRNA. Northern blot analysis showed expression of this mRNA mainly in ventricular muscle of the adult chicken heart, with trace levels detected in the atrium. Transient expression was seen in skeletal muscle during development and in regenerating skeletal muscle following freeze injury. To our knowledge, this is the first report of an avian ventricular myosin heavy chain sequence. Phylogenetic analysis indicated that this isoform is a distant homolog of other ventricular and skeletal muscle myosin heavy chains and represents a distinct member of the multigene family of sarcomeric myosin heavy chains. The ventricular myosin heavy chain of the chicken is either paralogous to its counterpart in other vertebrates or has diverged at a significantly higher rate. PMID- 1774791 TI - Experimental sinusitis in rabbits induced by aerobic and anaerobic bacteria: models for research in sinusitis. AB - Experimental acute sinusitis can be induced in New Zealand white rabbits by Streptococcus pneumoniae serotype 3, or the anaerobe Bacteroides fragilis, after blocking of the sinus ostium. Histological examination of the sinus mucosa in both models reveals edema, dilated venules, leukocytic infiltration, goblet cell formation, as well as localized epithelial lesions. In comparison the bacteroides sinusitis enhances a more pronounced and long-lasting tissue reaction, including periosteal thickening and new bone formation. The sinus mucosal blood flow as measured with microspheres Sn113 is increased as compared to control side in pneumococcal sinusitis. An increased lactate concentration of sinus secretions as well as in the pathological sinus mucosa indicates an anaerobic metabolism. Furthermore, a decreased ATP-content of the sinus mucosa suggests an energy depletion which could impair epithelial function. The anaerobic milieu of the sinus secretion is probably created by the leukocytes as analyzed by the separation of the D- and L-form of lactate. PMID- 1774792 TI - Immunologic aspects of chronic sinusitis. AB - The role of immunological defence mechanisms in the development of acute recurrent or chronic sinusitis is obviously of considerable importance but the incidence of such immune problems is unknown. To elucidate this situation, a prospective study of 47 patients with chronic rhino-sinusitis were examined for abnormalities of serum immunoglobulins, both major class and subclasses. Deficiencies of minor IgG subclasses may be obscured by only measuring the major IgG class and should be specifically sought in clinically suspicious cases. The clinical and therapeutic implications are considered. PMID- 1774793 TI - The technique of endoscopic surgery and diagnosis of frontal recess and sinus disease under local anesthesia. AB - Operations are performed with the patient in a semi-reclining position under local anesthesia. Usually a rigid endoscope (70 degrees) is used for treatment of the nasofrontal-duct. Intranasal procedures are conducted in close anatomical relationship to the ground lamella in the ethmoid sinus. First, the bulla is resected through the middle meatus, then IIIgl is removed and the posterior ethmoid sinus is opened. The upper part of the ethmoid sinus is removed, and then infundibular cells connected to the naso-frontal-duct are cleared and communication with the frontal sinus is enlarged using special forceps. The lateral wall at this portion curves outward superiorly and the roof curves upward anteriorly, and it is necessary that this area be made as smooth as possible. Most cases of suppurative frontal sinusitis are curable just by opening nasofrontal-duct via endonasal approach using an endoscope. PMID- 1774794 TI - Results of endoscopic surgery of the paranasal sinuses and anterior skull base. AB - Based on the experience with more than one thousand endoscopical interventions at the paranasal sinuses, a concept of the surgical treatment of chronic sinusitis is presented. According to the individual localization and extent of pathologic changes, appropriate operations may be selected. They follow the principles of conservative surgery. Regeneration of the diseased mucosa is enhanced by the reestablishment of ventilation and drainage instead of its radical removal. The endoscopical postoperative care is mandatory. A follow-up of 90 cases has evidenced a difference between subjective evaluation and endoscopic findings. Patients with bronchial asthma had benefits from their sinus surgery. Endoscopic management of foreign bodies, dural fistulas and benign tumors at the anterior skull base has also proven valuable. PMID- 1774795 TI - Classical intranasal ethmoidectomy: does the endoscope have a role? AB - The major advantage of intranasal endoscopy is that it allows a magnified view of the osteomeatal region and the frontal recess. Performing intranasal ethmoidectomy with nasal endoscopes may be hazardous, particularly in the hands of inexperienced surgeons. The use of 2-power loops for performing intranasal ethmoidectomy has several advantages, including direct binocular vision and visualization of external anatomic landmarks. The use of loops does not preclude the use of endoscopes. PMID- 1774796 TI - Orbital complications of ethmoiditis: B.C. Children's Hospital experience, 1982 89. AB - Orbital complications of ethmoiditis primarily affect children. Infection proceeds through contiguous spread to the orbit. We undertook a retrospective analysis of all children admitted to British Columbia Children's Hospital in Vancouver with a diagnosis of periorbital and orbital cellulitis due to ethmoiditis between 1982 and 1989. The majority of children presented with periorbital cellulitis, which resolved with aggressive parenteral antibiotic therapy. Five children (17%) progressed to subperiosteal abscess formation as documented by CT scan and required external ethmoidectomy as a drainage procedure. We conclude that early hospitalization and aggressive parenteral antibiotics are effective in resolving periorbital cellulitis. Surgical drainage is indicated when subperiosteal abscess is documented by CT scan. In our series, there were no cases of permanent visual deficit resulting from complications of ethmoiditis. PMID- 1774797 TI - Nasal polyposis: in search of a viral etiology using DNA hybridization. AB - The etiology of nasal polyps is unknown. Numerous theories have been proposed, with allergic and infectious causes predominant. A viral theory was postulated almost 40 years ago. In a pilot project, we studied 15 subjects comprising six controls and nine patients with nasal polyps. No known viruses were cultured from the nasal polyp tissue or nasal mucosal biopsies from the control subjects. DNA Hybridization for Epstein-Barr Virus, Herpes simplex virus, adenovirus type V, and Chlamydia trachomatis were also negative for all tissue studied. The use of molecular biological techniques is not widespread in otolaryngology and this is the first report, to the best of our knowledge, of the application of these techniques for the investigation of the viral etiology of nasal polyps. PMID- 1774798 TI - Diagnosis of rhinoliths with rigid endoscopy. AB - Three cases of rhinolithiasis are presented in which the diagnosis was facilitated by rigid endoscopic nasal examination. Coronal CT scans were used to delineate accurately the size and site of the rhinoliths. Neutron activation analysis was used in their elemental analysis. PMID- 1774799 TI - The secondary middle turbinate. AB - During functional endoscopic sinus surgery, the ethmoidal infundibulum and bulla are accessed through the middle meatus. This paper describes a secondary middle turbinate which arises from the lateral wall of the middle meatus, posterosuperior to the infundibulum and points superiorly within the meatus. A secondary middle turbinate was identified bilaterally in 6 out of 400 coronal CT scans of the nasal cavity and paranasal sinuses. The secondary middle turbinate did not obstruct the osteomeatal complex in any of our patients. PMID- 1774800 TI - Pitfalls in computed tomography of the paranasal sinuses. AB - The advent of functional endoscopic sinus surgery has created the need for high quality radiographic images to assess the paranasal sinuses, document the detailed anatomy of the lateral nasal wall and provide an anatomical map allowing safe functional endoscopic sinus surgery. This paper will discuss our experience of 410 paranasal sinus coronal CT scans performed by the technique described by Zinreich prior to consideration of functional endoscopic sinus surgery. The main indications for the scans were acute recurrent sinusitis, abnormal diagnostic nasal endoscopic examination and persistent facial pain. We will consider both the radiological and surgical difficulties that have arisen from the use of this technique and highlight some of the methods to avoid these difficulties. Claustrophobia and limitation of neck movements, particularly in patients over the age of 60, were the most common factors leading to suboptimal scans. Ensuring that the patient was in a symptom-free interval, the differential diagnosis of the opacified paranasal sinus and patients with gross polypoid disease created the most difficulty in interpretation. The anatomical assessment of the frontal recess and the identification of the optic nerve posterolateral to the posterior ethmoidal cell have created the greatest anatomical difficulty. PMID- 1774801 TI - Ostiomeatal complex risk factors for sinusitis: CT evaluation. AB - The ostiomeatal complex was prospectively evaluated in 100 consecutive patients referred for CT scanning. The degree of nasal septal angulation, uncinate process deviation (U-VS angle), infundibular and middle meatus opacification were correlated with maxillary and ethmoid sinus opacification. Patients with more severe nasal septal deviation and more horizontally-oriented uncinate processes had a higher frequency of sinus opacification. However, the differences between patients with and without CT evidence of sinus disease were very small (1.7 degrees to 3.4 degrees). Infundibular opacification most accurately predicted maxillary (76%), and middle meatus opacification most accurately predicted ethmoid sinus disease (78%). There is a small but statistically significant decrease in U-VS angulation and increase in nasal septal deviation in patients with sinusitis. However, the value of performing these measurements is limited. The evaluation of the degree of nasal septal deviation and uncinate process angulation will be most useful in preoperative planning. PMID- 1774802 TI - Ethmomaxillary sinus and hypoplasia of maxillary sinus. AB - In a series of 410 coronal CT scans performed to assess paranasal sinus disease, we have identified eight cases in which an ethmomaxillary sinus was present. The ethmomaxillary sinus was unilateral in five cases and bilaterally present in three. The sex incidence was equal. Four patients had generalized mucosal disease of their paranasal sinuses which included the ethmomaxillary sinus whereas four patients had osteomeatal complex disease and sparing of their ethmomaxillary sinus. The characteristic radiological features of an ethmomaxillary sinus were drainage into an enlarged superior meatus, reduction in the size of the maxillary sinus and a normal bony orbital cavity. The differential diagnosis of an apparently hypoplastic maxillary sinus is briefly discussed. PMID- 1774803 TI - Computed tomographic findings in atrophic rhinitis. AB - Computed tomography (CT) has been used increasingly in the assessment of patients with symptoms of sinonasal disease since the introduction of functional endoscopic surgery for the treatment of chronic sinusitis. The association of sinusitis and atrophic rhinitis will inevitably lead to more frequent imaging of patients with atrophic rhinitis. Correct interpretation of the CT appearances of atrophic rhinitis is important as misinterpretation may have serious implications during sinus surgery. These appearances have not been described previously. We describe and discuss the CT findings in three patients with clinical evidence of atrophic rhinitis. PMID- 1774804 TI - Bilateral congenital choanal atresia at age 16: an interesting case. AB - A bilateral congenital posterior choanal atresia case diagnosed at the age of 16 is presented. Although bilateral congenital choanal atresia causes acute life threatening respiratory obstruction in newborns, this case was able to compensate by rapidly learning mouth breathing and the diagnosis did escape detection for years. The patient was treated successfully via transpalatal approach. PMID- 1774805 TI - Endoscopic management of severe epistaxis. PMID- 1774806 TI - The cephalic view in nasal photography. PMID- 1774807 TI - Microbiology and histopathology of chronic ethmoiditis. PMID- 1774808 TI - Conservative endoscopic sinus surgery performed from TV monitor using integrated Nagashima endoscopic sinonasal system. PMID- 1774809 TI - Surgical landmarks and resections for the safe performance of conservative endoscopic sinus surgery. PMID- 1774810 TI - The antrum of Highmore or of da Vinci? PMID- 1774811 TI - The autoradiographic binding of [3H] quinuclidinyl benzilate to muscarinic receptors in the spinal cord of the sheep. AB - Autoradiography of [3H] quinuclidinyl benzilate was used to demonstrate the distribution of muscarinic acetylcholine binding in the spinal cord of sheep. Binding was confined to the grey matter of the cord, and was most densely distributed in the substantia gelatinosa region of the dorsal horn, the lamina X region around the central canal, the intermediolateral columns and in various regions of the ventral horn. The use of specific M1 and M2 receptor subtype ligands, pirenzipine and 4-DAMP indicated that both receptor subtypes were present in most regions of dense binding. PMID- 1774812 TI - Pharmacokinetic and tissue distribution study of oxytetracycline in rainbow trout following bolus intravenous administration. AB - Oxytetracycline pharmacokinetics and tissue distribution were studied in rainbow trout following bolus i.v. administration at 5 mg/kg. The mean serum (log) drug concentration data were plotted against time (linear). The decay curve was described by a three-component exponential decay function and a three-compartment model. The t1/2 of rapid distribution was 0.9 h, the t1/2 of the slow distribution was 5.9 h and the t1/2 elimination was 81.5 h. Clearance was 25.4 ml/kg/h and Vd(area) 2988 ml/kg. Regression analysis of the serum levels for the three intervals, 0.5-2.0 h, 6.0-18.0 h, and 24-96 h, indicated that the rates of decay for each interval were 0.6151 h-1, 0.0564 h-1 and 0.0088 h-1 respectively. Rates of equilibration between tissues and serum were determined. Kidney equilibrated the fastest with t1/2 to equilibration of 1.1 h for H (anterior) kidney and 1.98 h for P (posterior) kidney. The highest drug levels were found in the liver and the lowest were in the brain. PMID- 1774813 TI - Pharmacokinetics of intravenous and oral methimazole following single- and multiple-dose administration in normal cats. AB - The pharmacokinetics of methimazole (MMI) administered intravenously and orally were determined in six adult domestic shorthaired cats. There was no significant difference between mean serum MMI concentrations after oral and i.v. administration by 30 min post-MMI administration, indicating relatively rapid and complete absorption of the drug. The bioavailability of MMI ranged from 27% to 100% (mean = 81.1 +/- 11.4%). The mean serum elimination half-life was 6.6 +/- 2.0 h, with a wide range of values (1.9 h to 15.1 h). After repeat i.v. administration of MMI following 2 weeks of oral administration of the drug, no significant difference was found between mean serum concentrations after single dose and multiple-dose administration. No significant change in serum elimination half-life or total body clearance was found after multiple-dose administration of MMI. Two cats with the longest half-lives (9.9 h and 15.1 h), however, did exhibit markedly shorter t1/2 values (3.5 h and 3.3 h, respectively) after multiple-dose administration. Values for central and steady state volumes of distribution also decreased after multiple-dose administration, possibly indicating saturation of thyroid uptake of MMI with chronic administration. These results indicate that MMI has good oral bioavailability and has a longer mean serum elimination half-life than propylthiouracil, the other anti-thyroid drug that has been evaluated in cats. Although no significant change in mean values occurred after multiple-dose administration of MMI, drug-induced acceleration of metabolism may occur in some cats after long-term MMI administration. PMID- 1774814 TI - Pharmacokinetics and bioavailability of 2-mercaptopropionylglycine administered intravenously and orally in dogs. AB - The pharmacokinetic disposition of 2-mercaptopropionylglycine (2-MPG) given as a single intravenous injection and/or as a single oral dose was studied in 9 normal and 13 cystinuric dogs. After intravenous injection of approximately 10 or 20 mg/kg body weight the pharmacokinetics were best described by a three-exponential function. The first phase involved a distribution process apparently including establishment of drug-plasma protein and drug-tissue binding. The second phase involved rapid renal elimination and 60% of the drug was excreted within 3 h of administration. There was also a slow terminal third phase with a long half-life after both intravenous (t1/2 = 23 h) and oral (t1/2 = 22 h) administration. No dose dependency was observed. A deep pool of reversibly tissue-bound 2-MPG was indicated by a Vss of 3.3 +/- 0.9 l/kg body weight and the long terminal elimination phase. Total clearance was estimated as 4.1 +/- 0.9 ml/min/kg body weight. 2-MPG was eliminated mainly by renal excretion, but there was a difference in recovery of dose between normal and cystinuric dogs. During the first 24 h after intravenous and oral administration, 69% and 54%, respectively, of the drug was recovered in the urine of normal dogs. The corresponding figures in cystinuric dogs were 44% and 29%, respectively. The absolute bioavailability (FAUC) was 88 +/- 20% in normal dogs. PMID- 1774815 TI - Distribution of oxytetracycline to tissue cages and granuloma pouches in calves and effect of acute inflammation on distribution to tissue cages. AB - The effect of acute inflammation on oxytetracycline (OTC) distribution was studied in a tissue cage model in calves. An acute inflammatory reaction was induced in tissue cages by injecting lipopolysaccharide (LPS) from Salmonella typhimurium. The distribution of OTC to tissue cage fluid (TCF) was also compared with distribution to fluid from granuloma pouches (GPF). Tissue from LPS-injected cages showed histological changes indicating an acute inflammatory reaction. Concentrations of OTC were higher in LPS cages than in controls; at 1, 2, 4 and 10 h the difference was statistically significant (P less than 0.05). Numerically the overall elimination rate constant (kel) was larger, elimination half-life (t1/2) shorter, peak concentration (Cmax) higher, and time of peak concentration (Tmax) shorter in LPS cages than in controls. The area under the curve (AUC) of OTC was greater and the ratio AUCTCF/AUCserum was higher in LPS cages than in controls. Although statistically significant differences were not found for all the pharmacokinetic parameters, it was concluded that distribution to and elimination from LPS cages were both faster than in controls. Concentration-time profiles of OTC were similar in TCF and GPF in that concentrations were lower and elimination was more prolonged than in serum. Levels were higher in GPF than in TCF up to 3 h after injection; thereafter the relationship was reversed. Distribution to and elimination processes from GPF appeared to be faster than from TCF as numerically kel was higher, t1/2 shorter and Tmax shorter in GPF than in TCF. It was concluded that the granuloma pouch model and the tissue cage model have similarities in distribution and elimination patterns and that differences are most probably due to differences in the ratio of the surface area to the volume. PMID- 1774816 TI - On the construction of shortest confidence intervals and Bayesian highest posterior density intervals. AB - In this note it is argued that the principal characteristic of the confidence intervals proposed by Bartoszynski & Powers (1990) is not primarily the fact that they are of minimum length but that they are Bayesian highest posterior density intervals. A simple iterative process for determining the ends of the interval is presented. PMID- 1774817 TI - Furosemide-induced changes in plasma and blood volume of horses. AB - The effect of furosemide administration (1 mg/kg body weight, i.v.) on plasma and blood volumes in 6 intact and 4 splenectomized horses was measured using Evans blue dye dilution, hematocrit, and hemoglobin and plasma total solids concentrations. Body weight decreased by 33.6 +/- 3.3 and 33.7 +/- 0.8 g/kg 4 h after furosemide administration to intact and splenectomized mares, respectively. Plasma volume, estimated by Evans blue dye dilution, was reduced by 8.3 +/- 3.3% (mean +/- SE) 4 h after furosemide administration. The reduction in plasma volume was first detectable 5-10 min after furosemide administration and was greatest 15 30 min (13.0 +/- 0.8%) after dosing. This study demonstrates that furosemide produces significant and rapid reductions in plasma volume in horses. These decreases in plasma volume only partially resolve 4 h after furosemide administration. PMID- 1774818 TI - Enantioselectivity in the anaesthetic effect of ketamine in dogs. PMID- 1774819 TI - Prazosin and propranolol and the stress response to transport in male goats; a preliminary study. PMID- 1774820 TI - Serum disposition of oral clorazepate from regular-release and sustained-delivery tablets in dogs. PMID- 1774821 TI - Testosterone disposition after intramuscular injection in castrated thoroughbred race horses. PMID- 1774822 TI - New noninvasive assessment of regional left ventricular function by digital subtraction angiography without the use of contrast medium. AB - We have developed a new noninvasive method to evaluate regional left ventricular (LV) function by digital subtraction angiography (DSA) without the use of contrast medium. DSA images of the left ventricle with and without contrast medium were obtained from 35 patients with anterior myocardial infarction (MI) and from 35 control subjects. Using an image-processing computer, regional LV time-density curves were constructed for one cardiac cycle. Regional LV time density curves obtained from DSA without the use of contrast medium presented a pattern similar to those from intravenous DSA. The amplitude of regional LV time density curves in patients with MI decreased along with increasing severity of regional wall motion abnormality assessed by conventional left ventriculography. In attempting semi-quantitative evaluation by DSA without the use of contrast medium, the regional wall motion index (RWI) in the 6 segments of the left ventricle was calculated by normalizing segmental density changes to the maximal segmental density changes. When compared with control subjects, patients with MI have significantly lower RWIs in the anterolateral and apical regions. RWI showed a good correlation with the regional ejection fraction (REF) obtained from intravenous contrast DSA (r = 0.83). RWI decreased with increasing severity of regional wall motion abnormality by qualitative analysis in conventional left ventriculography, being consistent with REF. The diagnostic accuracy of RWI therefore seemed to be comparable to that of REF derived from intravenous contrast DSA. These results indicate that computerized analysis of DSA without the use of contrast medium is a valuable noninvasive method for semi-quantitative assessment of regional LV function. PMID- 1774823 TI - Diagnostic value of integrated ultrasonic backscatter in congestive cardiomyopathy. AB - Congestive cardiomyopathy is a fatal myocardial disease which can be diagnosed by clinical findings, electrocardiography, roentgenography and echocardiography. Tissue characterization and pathology have been determined recently using histogram methods to analyze ultrasonographs. In this study ultrasonic backscatter analysis for differentiation of normal and diseased myocardium was tested. Two-dimensional echo data and radio frequency signals of long-axis views of the left ventricular posterior wall of 10 healthy children and 14 patients with congestive cardiomyopathy in systolic and diastolic phase were digitized online into the computer memory. Cyclic variation was obtained in the control group but no variation was detectable in myopathic hearts. PMID- 1774824 TI - Stenotic lesions and the bifurcation angle of coronary arteries in the young. AB - To determine the genesis of the high incidence of stenotic lesions of the left anterior descending artery (LAD) in the young, we have investigated the anatomical characteristics of coronary arteries in the following 3 groups; young (less than or equal to 40 yr) myocardial infarction (MI) patients with LAD lesions, young (less than or equal to 40 yr) patients without coronary stenosis and aged (greater than or equal to 60 yr) MI patients. The angle between the left main coronary artery (LMT) and the LAD in the young MI patient group (146.7 +/- 7.4 degrees) was significantly wider than those of the young normal (126.0 +/- 13.4 degrees) or the aged MI patient groups (127.1 +/- 18.6 degrees) (p less than 0.01, p less than 0.02, respectively). The angle between the LMT and the left circumflex artery (LCX), and the angle between the LAD and the LCX were not significantly different among the 3 groups. The LMT length in the young MI patient group was 18.3 +/- 4.7 mm, which was not significantly longer than those of the young normal (12.7 +/- 6.9 mm) or the aged patient groups (14.8 +/- 6.0 mm). The internal diameter ratio of the LAD and LCX was also not significantly different among the 3 groups. These results suggest that the angle between the LMT and LAD was significantly wider in young MI patients, and should be regarded as an inherited characteristic influencing the development of coronary atherosclerosis of the LAD, particularly in young MI patients. PMID- 1774825 TI - Are we able to prevent death due to postinfarction cardiac rupture by early diagnosis and surgical treatment? AB - Death from postinfarction cardiac rupture (PCR) may occur in two ways. There are patients who die suddenly without symptoms or with symptoms of less than an hour's duration (sudden cardiac death), whereas other patients die several hours after the onset of the rupture. Ninety-six patients who died from AMI and underwent autopsy have been studied. Sixteen patients displayed a rupture of the free wall of the left ventricle at the site of infarction, cardiac hypertrophy and severe coronary alterations. Six of these patients were included among patients who died suddenly. The other 10 showed signs before death that occurred from 240 to 660 min after their appearance. Signs of impending rupture were appearance or increase of chest pain that was not improved by opiates, preterminal sinus rhythm with an unchanged ST-segment and echocardiographic infarct expansion or pericardial effusion. We propose that the emergence of these signs during AMI suggests an impending rupture. Early surgical intervention is essential to save those patients who survive several hours after the initial signs of PCR. PMID- 1774826 TI - Cardiovascular response to mental stress and to handgrip in children. The role of physical activity. AB - Cardiovascular responses to sympathetic stimulation may be altered in the early phases of life of subjects with a family history of hypertension. The possible influence of physical activity on adrenergic modulation in children is still not well known. In this study we evaluated, in a group of 162 11-year-old children from a secondary school near Naples, blood pressure and heart rate measured 4 times at 3-week intervals at rest and during adrenergic system stimulation by mental arithmetic stress and isometric exercise. Children were divided into sedentary and physically active groups according to the levels of a Saltin modified questionnaire. Family history of hypertension was also investigated. Systolic and diastolic blood pressure at rest were slightly higher in the sedentary group at each control (107/75 +/- 11/11 vs 105/73 +/- 11/11 mmHg at the first and 100/70 +/- 14/14 vs 98/69 +/- 9/9 at the last control); heart rate in the same group was higher as well (91 +/- 11 vs 87 +/- 12 beats/min, p less than 0.02 at the first and 80 +/- 9 vs 77 +/- 11 at the last control). Systolic and diastolic blood pressure increased by 7/15% during mental stress and by 23/45% during isometric exercise in the sedentary group. The corresponding blood pressure increases in the physically active group were 6/12% and 20/40%, respectively. These responses were independent of sex, body weight and family history of hypertension. These results support the hypothesis that regular physical activity in young adolescents only mildly influences resting blood pressure and cardiovascular responses during the stimulation of the sympathetic nervous system. PMID- 1774827 TI - Possible involvement of free radicals and antioxidants in the early stages of the development of cardiomyopathy in BIO 14.6 Syrian Hamster. AB - The BIO 14.6 cardiomyopathic Syrian hamster is a well-known animal model of congestive cardiomyopathy. To evaluate the role of free radicals and antioxidant protection in the pathogenesis of cardiomyopathy in this animal, we studied the concentration of heart mitochondrial free radicals, the activities of glutathione peroxidase (GSHPx) and superoxide dismutase (SOD), and the effect of alpha tocopherol on the early stage of myocardial damage (up to 90 days). The GSHPx activity in BIO 14.6 hamsters was found to be twice that in the normal control hamsters at 30 days of age, while SOD activity was unchanged at 30 and 90 days of age. The concentrations of mitochondrial free radicals in BIO 14.6 hamsters at 40 and 90 days of age were significantly higher than those in the normal control hamsters. A protective effect of alpha-tocopherol therapy was shown in BIO 14.6 hamsters treated during the early stage of cardiomyopathy (up to 90 days). These results show the role of free radicals and antioxidant protection in the pathogenesis of hamster cardiomyopathy. We suspect that an increase in the GSHPx activity in BIO 14.6 hamsters may be due to a compensatory mechanism to counteract oxidative stress, but antioxidant reserve was not sufficient to protect the heart from the toxic effects of increased free radicals in the early stage of cardiomyopathy. PMID- 1774828 TI - Fatty acid composition in 1,2-diacylglycerol of diabetic and insulin-treated diabetic rat hearts. AB - Elevated levels of 1,2-diacylglycerol (DG) have been observed in streptozotocin induced diabetic and insulin-treated diabetic rat hearts. The fatty acid moieties of 1,2-DG are considered to be related to its ability to activate protein kinase C. Therefore, we determined the fatty acids of 1,2-DG by gas chromatography and compared them with those of triglycerides in the myocardium. The triglyceride content returned to control levels after 4 weeks of untreated diabetes followed by 4 weeks of insulin treatment. There was a significant difference in the fatty acid composition of triglycerides between diabetic and control rats. Insulin treatment also returned the fatty acids of triglycerides in diabetes to the profile observed in control rats. On the other hand, insulin treatment of the diabetic rats did not normalize 1,2-DG content and its fatty acid composition. Fatty acid analysis of 1,2-DG showed that its profile in insulin-treated diabetic rats was different from that of either control or diabetic rats, suggesting that insulin-induced 1,2-DG differs from that seen in cases of diabetes. PMID- 1774829 TI - Pravastatin decreases serum lipids and vascular cholesterol deposition in Watanabe heritable hyperlipidemic (WHHL) rabbits. AB - The effects of long term administration of pravastatin (a competitive inhibitor of hydroxymethylglutaryl CoA reductase) were assessed by measuring serum lipids and aortic and coronary atherosclerosis in Watanabe Heritable Hyperlipidemic (WHHL) rabbits. Six-month-old WHHL rabbits were given either 50 mg/kg/day of the drug or vehicle. The rabbits were sacrificed following 6 or 12 months of treatment and serum cholesterol and triglycerides and aortic cholesterol and hydroxyproline were measured. Atherosclerotic plaques in the aorta and coronary arteries were quantified with morphometric methods. Mean serum cholesterol +/- SEM (n) in the control vs. pravastatin groups after 6 months were: 535 +/- 34 (11) vs. 411 +/- 22 (12) (p less than 0.005) and after 12 months 458 +/- 43 (9) vs. 309 +/- 29 mg/dl (12) (p less than 0.005). In the pravastatin group, percent aortic area covered with plaque and aortic cholesterol content were reduced 35% (ns) and 55% (p less than 0.05) at 6 months, and 26% (ns) and 44% (ns) at 12 months, respectively. Little difference was found in serum triglycerides and aortic hydroxyproline in the 2 groups. There was strong correlation of serum cholesterol with aortic cholesterol content (r = 0.61, p less than 0.003) and with the percent aortic plaque area (r = 0.67, p less than 0.001), at 12 months. Morphometric analysis of wall thickness and lumen area of major coronary arteries revealed no significant differences in the 2 groups. In conclusion, pravastatin effectively lowered the serum cholesterol level in an animal model defective in low density lipoprotein receptors; this reduction was strongly correlated with amelioration of such atherosclerotic processes as lipid deposition and plaque formation. PMID- 1774830 TI - Detection of acute myocardial infarction by evaluation of ultrasonic gray levels in dogs. AB - The study tested whether an experimental myocardial infarction can be detected from two-dimensional echocardiograms (2DE) by analysis of regional gray levels. The mid-left anterior descending coronary artery was ligated for 3 hours in 14 dogs (group 1) and for 5 hours in 6 dogs (group 2). 2DE were performed before, and after 3 and 5 hours of coronary artery ligation. The ultrasonic amplitude of the control and infarcted regions were obtained from digitized 2DE in the short axis view, at the mid-papillary muscle level. The mean gray levels (+/- SD) of the control and infarcted regions were compared during end-diastolic stop frames. After sacrifice, the hearts were cut into 1 cm thick slices and stained with 1% triphenyl tetrazolium chloride (TTC) solution. The myocardium was then studied by light microscopy. Computerized tomographic scans were also obtained in vitro from 3 hearts of both groups. There was no difference in mean gray levels of the control region during the experiments. However, in the region of wall motion abnormality (area of infarction), the mean gray levels increased from 49.9 +/- 3.5 (before ligation) to 62.0 +/- 7.4 (after 3 hours of ligation, p less than 0.005) in 10 group 1 dogs, but no differences were seen in mean gray levels (49.6 +/- 3.8 vs 50.4 +/- 4.0) in those without a myocardial infarction in 4 group 1 dogs; gray levels also increased from 50.4 +/- 2.9 (before ligation) to 58.6 +/- 6.1 (after 3 hours of ligation, p less than 0.05) and to 65.0 +/- 4.2 (after 5 hours of ligation, p less than 0.005) in group 2 dogs. The area of left ventricular asynergy corresponded precisely to the area of myocardial infarction, determined by both TTC staining and the computerized tomographic scans. The light microscopy of the infarcted area also demonstrated interstitial edema and polymorphonuclear cell infiltration. PMID- 1774831 TI - Alterations in catecholamine release in the central nervous system of spontaneously hypertensive rats. AB - The aim of the present study was to investigate alterations in catecholamine release in the central nervous system of spontaneously hypertensive rats. Slices of hypothalamus, medulla oblongata and striatum were prepared from spontaneously hypertensive rats (SHR: 9-10 weeks old) and age-matched Wistar Kyoto rats (WKY). The slices were incubated with (3H)norepinephrine (NE) or (3H)dopamine (DA), superfused with Krebs-solution in vitro, and the release of the catecholamines was compared between the two strains. The basal release of hypothalamic (3H)NE did not differ between SHR and WKY slices. However, stimulation (1 Hz)-evoked (3H)NE release was significantly greater in SHR than in WKY (percent fractional release of total tissue NE: WKY 0.494 +/- 0.019%, n = 6, SHR 0.730 +/- 0.053%, n = 6, p less than 0.05). The stimulation-evoked (3H)NE release from the medulla oblongata did not differ significantly between SHR and WKY slices. Finally stimulation-evoked release of striatal (3H)DA was significantly depressed in SHR (percent fractional release of total tissue DA: WKY 2.048 +/- 0.24%, n = 6, SHR 1.460 +/- 0.068%, n = 6, p less than 0.05). These results indicate that the release of hypothalamic NE and striatal DA are altered in SHR. It is suggested that enhanced hypothalamic noradrenergic activity and reduced striatal dopaminergic activity can increase sympathetic outflow to the periphery, which may play a role in the pathogenesis of this form of hypertension. PMID- 1774832 TI - Afterloading increases the left ventricular end-systolic force-length relation slope in dogs. AB - We evaluated the effects of pressure loading produced by gradual aortic occlusion on left ventricular (LV) myocardial contractility by assessing changes in the slope of the LV end-systolic force-diameter (Fes-Des) relation. Eleven adult mongrel dogs were prepared with ultrasonic crystals for measuring LV diameter and a micromanometer for measuring LV pressure. Preload was decreased by vena caval occlusion (VCO), and afterload was increased by aortic occlusion (AOO). The slopes (Ec) and extrapolated diameter intercepts (Do) of the LV Fes-Des relation were determined for each dog from the end-systolic data obtained during VCO and AOO. During VCO and also AOO, the heart rate showed little change (134 +/- 18 vs. 134 +/- 16 bpm in VCO, 135 +/- 16 vs. 132 +/- 17 bpm in AOO). The values of Ec and Do during VCO were 62.8 +/- 15.6 g/cm and 1.20 +/- 0.36 cm, respectively, while during AOO the respective values were 122.6 +/- 18.6 g/cm and 1.66 +/- 0.38 cm. Ec and Do were both significantly increased during AOO in comparison with VCO (p less than 0.001). These results suggest that gradual aortic occlusion increases LV myocardial contractility in anesthetized, open-chest dogs under autonomic blockade. This phenomenon might be related to length-dependent calcium activation. PMID- 1774834 TI - Transesophageal echocardiographic findings of quadricuspid aortic valve. AB - We report a case of a 40-year-old man who had a quadricuspid aortic valve associated with aortic regurgitation. The anomaly was revealed by transesophageal echocardiography (TEE), and confirmed by cardiac surgery. TEE is a useful noninvasive method for identifying the quadricuspid aortic valve. PMID- 1774833 TI - Hypereosinophilic syndrome associated with obliterative left ventricular chamber and systemic obliterative arteriosclerosis. AB - An extremely rare case of hypereosinophilic syndrome is reported. The patient had congestive heart failure due to left ventricular obliteration by a giant thrombus in the apex. Arteriosclerosis obliterans resulted in serious lower extremity gangrene. Combination therapy with a corticosteroid and hydroxyurea caused a marked reduction in eosinophil count, and heart failure recovered in stages. Although the patient was discharged, he returned to our hospital 3 months later with acute myeloblastic leukemia and subsequently died of respiratory failure with pneumonia. PMID- 1774835 TI - Oral prostaglandin E1 derivative (OP-1206) in an infant with double outlet right ventricle and pulmonary stenosis. Effect on ductus-dependent pulmonary circulation. AB - A small-for-gestational-age infant with cyanosis due to double outlet right ventricle with severe pulmonary stenosis and patent ductus arteriosus was treated with oral prostaglandin E1 derivative (OP-1206). The constricting ductus arteriosus dilated and the ductus-dependent pulmonary blood flow increased. The recommended dosage was 1.5-2.0 micrograms/kg/day which was lower than that of intravenous PGE1 or of oral PGE2. The administration interval was 6 hours, which was longer than that of oral PGE2. The patient was treated as an out-patient because continuous intravenous infusion was not necessary. Treatment was continued for 2 months without complication, at which time a Blalock-Taussig shunt operation was performed. Orally administered PGE1 derivative (OP-1206) was found to be equally effective to intravenous infusion of PGE1 for both short and long-term management of cyanotic heart disease in which the pulmonary blood flow is mostly dependent on the patency of the ductus arteriosus. Oral PGE1 derivative (OP-1206) may be a possible substitute for intravenous PGE1 infusion therapy. PMID- 1774836 TI - Hydatid cyst of the interventricular septum. Diagnosis by cross-sectional echocardiography and computed tomography, treatment with mebendazole. AB - Herein we report a case of a cardiac echinococcal cyst located in the interventricular septum and producing a mild obstruction of the left ventricular outflow tract. The cyst was detected by cross-sectional echocardiography and thoracic computed tomography and treated successfully with mebendazole. PMID- 1774837 TI - A case of pericardial lipoma diagnosed by noninvasive techniques. AB - Intracardiac lipomas that consist of mature fat cells with fibrous and myxoid tissues are regarded as rather rare lesions. The diagnosis may frequently be established during surgical intervention or at autopsy. The patient presented is a 23-year-old male who had had no complaints. The lesion had been incidentally detected on x ray examination which had revealed an enlarged heart shadow. His physical examination revealed no abnormality except displacement of the heart to the right and sinus tachycardia. A solid mass derived from the pericardium was observed on CT scans and echocardiography. On CT scans the mass exhibited a density consistent with a lipoma. The patient was operated on and the mass, which was encapsulated and 19 x 17 x 10 cm in size, was removed. Histopathological examination revealed a lipoma. PMID- 1774838 TI - Changes of anionic sites in the mesangium with aging in rats: a comparison of the immersion and intravenous PEI methods. AB - We investigated the changes in anionic sites of the mesangial matrix related to aging in rats, employing polyethyleneimine (PEI) as a cationic probe. We compared the numbers of anionic sites detected by the immersion method and by the intravenous administration of PEI. Analysis of the mean numbers of PEI particles per 0.1 micron2 in the mesangial matrix revealed a significant decrease related to aging. Our results suggested that there was no significant difference in efficacy between the immersion and intravenous methods. Loss of negative charge of the mesangial matrix is believed to promote mesangial dysfunction and the entrapment of macromolecular substances, and so to play an important role in the onset of glomerular sclerosis. PMID- 1774840 TI - Ultrastructural study of normal rat glomeruli by the quick-freezing and deep etching method. AB - The ultrastructural features of isolated normal rat glomeruli were investigated using a new splitting technique and the quick-freezing and deep-etching (QF-DE) method. Examinations were also made of in vivo normal rat glomeruli by the QF-DE method to visualize the glomeruli under near natural conditions. Freeze-fractured capillary loops were observed from the capillary lumen or the urinary space. Foot processes were found to be freeze-fractured horizontally, obliquely or vertically to the glomerular basement membrane (GBM), and a glomerular slit diaphragm, which consisted of sheet-like, ladder-like and zipper-like substructures, was clearly identified. The GBM was classified into three zones, which might correspond to those seen in ultrathin sections, including the lamina densa and laminae rarae externa and interna. The lamina densa was composed of a meshwork filled with fine particles, which might represent products of insoluble proteins. In the laminae rarae, filamentous structures consisting of irregular networks could be observed connecting glomerular endothelial or epithelial cells with the lamina densa. Furthermore, the above findings were obtained from investigations at various consecutive levels of freeze-fractured capillary loops from various angles. The three-dimensional ultrastructure of the glomeruli could be demonstrated at high resolution by the QF-DE method. PMID- 1774839 TI - Immunohistochemical studies of glomerular extracellular components in repeated renal biopsies of patients with IgA nephropathy. AB - Immunohistochemical and light microscopic examinations were carried out to assess the correlation between the progression of glomerular lesions and changes in the intensity of glomerular extracellular components such as type IV and I collagens, laminin and fibronectin, and of IgA deposits in repeated renal biopsies of patients with IgA nephropathy. By light microscopy, the percentage of glomeruli showing glomerular mesangial expansion or sclerosis was found to be significantly higher in the second renal biopsy. Type IV collagen, laminin and fibronectin were also marked in the expanded glomerular mesangium in the second biopsy. Although these components were not observed in the global sclerotic glomeruli, type I collagen was detected in such areas of patients with IgA nephropathy. Patients who revealed high percentages of glomerular sclerosis associated with marked type IV collagen, laminin, fibronectin and/or type I collagen, had high levels of proteinuria and progressive deterioration of renal function. It is concluded that hyperproduction of the above extracellular components mainly in the glomerular mesangium is closely linked to the progression of glomerular lesions in patients with IgA nephropathy. PMID- 1774841 TI - Effect of dietary chloride on spontaneously hypertensive rat. AB - The anionic component of sodium salt has been reported to contribute to hypertension in some animal models and hypertensive patients. In the present study, the anionic effects on exacerbation of hypertension in spontaneously hypertensive rat (SHR) were investigated by chronic loading tests with two sources of sodium, viz. sodium chloride (NaCl; 0.9% solution) and sodium bicarbonate (NaHCO3; 1.28% solution), using SHRs with normal renal function (NRF) and with chronic renal failure (CRF; produced by cryosurgery). In addition, extracellular fluid volume (ECFV: inulin space) was measured in SHRs with NRF and CRF. In the NRF groups, systolic blood pressure (SBP) reached 230 mmHg at Week 13, and there was no significant difference in SBP between the NaCl and NaHCO3 groups. In the CRF groups, SBP of the NaCl group was significantly higher (p less than 0.01) than that of the NaHCO3 group (280 mmHg vs. 230 mmHg at Week 15). ECFV was also greater in the NaCl group than in the NaHCO3 group (ECFV: NaCl vs. NaHCO3, 15.9 +/- 1.7 vs. 14.0 +/- 0.9 at Week 13; and 16.2 +/- 1.1 vs. 14.2 +/- 1.2 at Week 15, respectively). These results indicate that chloride ion plays an important role in the pathogenesis of hypertension in SHR with CRF. Expansion of ECFV is considered to be one of the mechanisms whereby the hypertension is exacerbated. PMID- 1774842 TI - Urine anion gap in patients with chronic renal insufficiency. AB - We investigated the urinary acid excretion and urine anion gap (AG) (Na+ + K(+) Cl-) during NH4Cl-induced metabolic acidosis in 38 normal subjects and 53 patients with chronic renal diseases in order to clarify the significance of the urine AG as a useful marker of the ammonium (NH4+) excretion even in a state of chronic renal insufficiency. The urine pH became higher, and the urinary excretions of titratable acid (TA) and NH4+ decreased significantly, in parallel with a reduction of the creatinine clearance (Ccr). The urinary electrolyte excretion, especially the chloride excretion, also decreased significantly as Ccr fell. As a result, the urine AG increased from negative to positive values, in proportion to the decrease in Ccr with statistical significance. The urine AG showed the most significant correlation with the urine NH4+ excretion (r = 0.707, p less than 0.001). We conclude that the urine AG provides a significant marker of the urine NH4+ excretion even in a state of moderate to severe renal insufficiency. PMID- 1774843 TI - Penile gangrene in a patient with diabetic nephropathy on continuous ambulatory peritoneal dialysis. AB - We report here a case of penile gangrene in a patient with diabetic nephropathy treated by continuous ambulatory peritoneal dialysis (CAPD). The patient demonstrated severe systemic arteriosclerosis. The main cause of the gangrene was considered to be circulatory insufficiency induced by severe arteriosclerosis. Several predisposing factors including chronic renal failure, long-term diabetes mellitus and CAPD-related metabolic changes such as abnormalities of lipid metabolism also appeared to have contributed to the arteriosclerotic changes. The prognosis in cases of this type is thought to be extremely poor. PMID- 1774844 TI - Effect of renal denervation on the development of hypertension in Dahl-Iwai salt sensitive rats. AB - Renal denervation has been shown to delay the onset of hypertension in spontaneously hypertensive rats and DOCA-salt sensitive rats. We investigated the contribution of the renal nerves to the development of hypertension in Dahl-Iwai salt-sensitive (DS) rats. Bilateral renal denervation or sham-operation was carried out in DS rats, and animals were then kept on a high salt diet (study I) or on a normal salt diet (study II). DS rats became severely hypertensive (207 +/ 8 mmHg) after 4 weeks on a high salt diet. They became mildly hypertensive (156 +/- 3 mmHg) after 4 weeks on a normal salt diet. In both studies, renal denervation exerted no effect on the development of hypertension in the DS rats. The urinary sodium excretion, urinary volume, heart rate and body weight were unaltered by renal denervation. These results indicate that the renal nerves do not make a major contribution to the development of hypertension in DS rats. PMID- 1774845 TI - Dietary sodium concentration modifies catecholamine release with stress in spontaneously hypertensive rats. AB - A high sodium diet increased the plasma norepinephrine (PNE) only in resting spontaneously hypertensive rats (SHR). SHR on either a high or low sodium diet showed a greater increase in arterial pressure (AP) than Wistar-Kyoto rats (WKY) with foot shock (FS). However, neither a high nor low sodium diet enhanced the increment of AP in both SHR and WKY with FS. Only a low sodium diet enhanced the increment of PNE and plasma epinephrine in SHR with FS. Extreme restriction of sodium intake might thus enhance the response of sympathetic activation with stressful stimuli. PMID- 1774846 TI - Sympathetic and renin-angiotensin system in conscious rabbits with two-kidney, one clip hypertension. AB - We attempted to clarify the contribution of the altered neural mechanism associated with increased angiotensin II to two-kidney, one clip (2K1C) hypertension on the 3rd and 35th days after renal artery stenosis. 2K1C hypertension was produced in 20 rabbits, and a sham operation was performed in 11 rabbits. Sarl, Ile8 angiotensin II (AIIA) infusion tests and baroreflex sensitivity determinations by bolus injection of phenylephrine were performed on the 3rd and 35th days after renal artery stenosis. The blood pressure was 12 mmHg higher in the hypertensive rabbits than in the sham operated rabbits on the 3rd day after clipping. The blood pressure returned to the control level during the infusion of AIIA. On the 35th day after clipping, AIIA-sensitive or AIIA resistant hypertension developed. The blood pressure was higher in the AIIA sensitive rabbits than in the AIIA-resistant rabbits (131 +/- 5 vs 116 +/- 4 mmHg, p less than 0.05). The baroreflex sensitivity was lower in the AIIA sensitive rabbits than in the AIIA-resistant rabbits (1.8 +/- 0.3 vs 2.8 +/- 0.3 msec/mmHg, p less than 0.05). There was no difference in plasma norepinephrine between the two groups on either the 3rd or 35th day. Thus, impaired baroreflex sensitivity was found in the accelerated hypertension seen in the chronic phase of 2K1C hypertension. Neural mechanisms mediated by the peripheral sympathetic nervous system did not appear to contribute to the development of 2K1C hypertension. PMID- 1774847 TI - Acute thrombocytopenia after intravenous infusion of radiographic contrast medium. AB - Acute thrombocytopenia due to intravenous infusion of radiographic contrast media is extremely rare. We report the first such case in Japan. A 52-year-old male was admitted to hospital because of right ureteral stone. Two hours after drip infusion pyelography, the patient experienced chills and fever. It was shown that his platelet count had decreased abruptly from 233,000 to 8000/mm3. Platelet associated immunoglobulin was not detected. An in vitro test for platelet aggregation by contrast media was negative. Following infusion of hydrocortisone, the platelet count recovered to a normal level within several days. PMID- 1774848 TI - Developmental process of acquired renal cysts and neoplasms in patients receiving chronic hemodialysis: ultrasonographic, morphometric and histopathological studies. AB - The process of development of acquired cysts and neoplasms in the kidneys of patients receiving hemodialysis was investigated. An ultrasonographic study of 329 hemodialysis patients revealed that the size of the kidney decreased in the first 3 years of dialysis, then increased up to 8 years, and thereafter decreased again. Morphometric and histopathological studies were conducted on 31 kidneys removed from 17 patients. The total number of cysts and total volume of cysts increased over the period of 3 to 8 years, and renal size was positively correlated with total cyst volume during this period. The incidences of atypical hyperplastic cysts and microadenomas increased with prolongation of the dialysis period. Three cases of renal cell carcinoma were observed in the present series, of which two exhibited extensive cystic transformation with numerous neoplastic foci. These findings indicate a close relationship between the extent of acquired cysts, dialysis duration and risk of renal neoplasms. PMID- 1774849 TI - Study on the environmental background to aggravating factors for renal function related to pregnancy and delivery in IgA nephritis. AB - Various effects on renal function and factors which tend to cause aggravation in pregnancy and delivery in patients with renal diseases have been described previously. In the present study, the authors undertook personal and telephone inquiries to patients with renal insufficiency due to aggravated renal dysfunction occurring during the course of pregnancy and delivery, and to those showing a favorable course despite renal dysfunction before pregnancy. Sixty-four patients with IgA nephritis were investigated, covering 101 cases of pregnancy in them. The management of the pregnant women and their social and home (family/domestic) environments were taken into consideration, since these are important for giving guidance in their daily life to overcome various factors which influence the course of spontaneous pregnancy and delivery. The following findings were obtained. (1) In patients with hypertension, toxemia of pregnancy, abnormal delivery and abortion were frequently complicated. (2) Patients under greater mental and physical stresses during the course of pregnancy and after delivery showed a poorer prognosis for both mother and fetus. (3) Generally speaking, guidance should be given not to be overconfident or overdefensive in pregnancy. (4) Working women revealed a prognosis which was poorer than that of housewives. PMID- 1774850 TI - Evaluation of parameters for adequate dialysis therapy: (1). Monitoring of parameters by urea kinetic modeling. AB - In an attempt to evaluate the adequacy of regular dialysis therapy, calculations of Kt/V-urea and protein catabolic rate (pcr) from the data of routine laboratory examinations by means of urea kinetic modeling were performed in 59 regular dialysis patients (28 males and 31 females; mean age, 59 +/- 2 years old; mean dialysis duration, 83 +/- 10 months). The mean values of Kt/V-urea and pcr were 1.10 +/- 0.04 and 0.98 +/- 0.03 g/kgBW.day, respectively. The number of patients who were within the optimal range (0.9-1.4 for Kt/V urea and 0.9-1.5 for pcr) was 37 (62.7%) for Kt/V-urea and 38 (64.4%) for pcr. Furthermore, we inferred that, based on an appropriate dietary protein intake, removal of urea by intermittent dialysis should be adjusted to maintain the patient in equilibrium for a defined pre-dialysis plasma urea concentration. From the data obtained, we concluded that: (1) it is possible to apply urea kinetic modeling on the basis of routine laboratory examinations, (2) it is important to maintain the pre-dialysis plasma urea concentration at more than a certain level, and (3) it is also important to control the post-dialysis plasma urea concentration at a low level. PMID- 1774851 TI - [The Saxon-Thuringer Society for Pediatrics. A historical review occasioned by its re-establishment on 7-6-91 in Leipzig]. PMID- 1774852 TI - [Type B Haemophilus influenzae infections: epidemiology, vaccination, chemoprophylaxis]. AB - In the new countries of the Federal Republic Germany the incidence of systemic Hib-infections is lower than in the old FRG. In children under the age of 5 years the incidence of Hib-meningitis is 8/100,000 and of all systemic Hib-diseases about 17/100,000. By Hib-vaccination (PRP-D) severe diseases can be prevented. The recommended chemoprophylaxis with Rifampicin is important in this connection, too. PMID- 1774853 TI - [Prognostic predictive value of neonatal ultrasonic studies of the CNS and of EEG monitoring for the psychomotor development at 1 year of age]. AB - The prognostic value of cranial ultrasound and EEG-monitoring for the developmental outcome at 1 year of age in 209 premature and full-term newborns was studied retrospectively. The first ultrasound examination was performed within the first three days of life. Further investigations were done depending on type of severity of the findings. The investigation was completed by EEG monitoring in 41 patients. The infants were investigated for psychomotor development. 158 infants were found normally developed. Abnormal neonatal ultrasound findings were registered in 18.9% of them. Developmental retardation was observed in 46 infants. 54.3% of them had abnormal ultrasound findings. 2/3 of infants with neonatal major brain insults like IVH III-IV or leukomalacia showed serious neurological handicaps, whereas subependymal bleedings seem to be without influence onto the development. In contrast pathologic EEG's were of higher prognostic value. None of the infants with a abnormal EEG was developed normally. PMID- 1774854 TI - [Relative parathyroid insufficiency in hypomagnesemia]. AB - In patients with normocalcaemic tetany and hyperventilation syndrome (functional breathing syndrome), respectively, the parathyroid function was studied by means of the EDTA test according to Kaiser and Ponsold. In agreement with experimental results on inhibition of the parathyroid hormone release in magnesium deficiency patients with low serum magnesium concentrations show a pathological EDTA test signalling a relative parathyroid insufficiency. PMID- 1774855 TI - [Febrile exanthema following measles vaccination--risk of recurrence in the 2d measles vaccination?]. PMID- 1774856 TI - [Coronary surgery from the aspect of ambulatory care follow-up]. AB - The authors observed for a long-period 453 patients with the ischemic heart disease after the operation of aorto-coronary shunting (ACS). At discharge from the hospital, in 96.9% of the patients operated on, the clinical improvement of the state was noted, in 78.4% of them, the attacks of angina disappeared. Five years later, in 46.1% of the patients examined, there were no stenocardia, in 53.9%, retrosternal pain was noted. According to the findings of repeated coronarography, development of the stenocardiac syndrome is caused by insufficient function of the venous shunts and aggravation of stenosing atherosclerosis. By means of twin pharmacodynamic tests, it was established that monotherapy and combined therapy with calcium antagonists were the optimal ones. PMID- 1774857 TI - [Oxygen exchange and acid-base status in patients with diabetic angiopathy of the lower extremities with different methods of conservative treatment]. AB - In the pathogenesis of III-IV stage diabetic angiopathy, the important place belongs to oxygen deficiency and metabolic acidosis. Introduction into the complex of treatment of the patients of hyperbaric oxygenation and endolymphatic pharmacotherapy contributes to improvement of general state of the patients, alleviation of the course of destructive processes on the extremities, rapid normalization of oxygen exchange in the organism, liquidation of the phenomena of metabolic acidosis. This results in shortening of patients' stay in a hospital and permits to avoid, or postpone performance of amputation of an extremity. PMID- 1774858 TI - [Primary and repeated surgical interventions in children with anorectal atresia and urinary tract fistula]. AB - Experience with the treatment of 70 children with anorectal atresia with a fistula into the urinary tracts is summarized. Comparative analysis of the effectiveness of the different methods of peritoneo-perineal proctoplasty was carried out. The methods for formation of the artificial smooth muscle sphincter of the intestine brought down and anoplasty are suggested. Introduction of these methods permitted to decrease the incidence of postoperative complications and improve a functional result of the operations. The methods for performance of a repeated operation after failed primary correction of a defect are presented. The importance of postoperative rehabilitation of the patients is noted. PMID- 1774859 TI - [Dynamics of the morphological changes in a colonic autotransplant during experimental plastic surgery of the cervical esophagus]. AB - In the experiment on 16 dogs, the morphologic structure of a colonic autotransplant utilized for restoration of a total defect of the cervical esophagus was studied. A segment of the descending colon with terminal inferior mesenteric vein and ostium of the inferior mesenteric artery with a part of the aortic wall was used. Reformation of the intestinal epithelium was noted. By day 21 after the operation, a multilayer squamous epithelium was revealed in the intestinal autotransplant, in the muscular layer--structures of the forming neuromas. No esophageal stenosis was noted. PMID- 1774860 TI - [Pathogenesis of the failure of intestinal anastomosis sutures in peritonitis]. AB - In the experiment on 60 dogs, it was established that the leading causes of unsatisfactory anastomotic healing in peritonitis were the disorders in hemocirculation and morphologic changes in the intestinal wall. This causes unsatisfactory healing of the inverted anastomoses, especially the multilayer ones. The everted suture with wide adaptation of the least changed submucous layer is the most reliable in these conditions. This permitted to use it in 7 patients with a positive result. PMID- 1774861 TI - [Experience in the implantation of permanent electrocardiostimulators in a district hospital]. AB - The experience with implantation of the first 100 cardiostimulators is summarized. The necessity for more wide use of the programmed electrocardiostimulators in the clinical practice is noted. The most effective method for control of the implanted system is the use of the electrocardiostimulation analyser which permits artificial reproduction of the functions of perception and imposing the rhythm of an electrocardiostimulator. PMID- 1774862 TI - [The status of protein metabolism in acute pyo-destructive diseases of the lungs]. AB - Protein metabolism was studied in 145 patients with acute abscesses and gangrene of the lungs. Hypoproteinemia was revealed in 13 patients who subsequently died from aggravation of the process. Hypergammaglobulinemia was caused by a high content of immunoglobulins and high indices of humoral immunity. The indices of protein metabolism normalized more rapidly in positive outcome of the disease. PMID- 1774863 TI - [Diagnosis and treatment of pyo-mediastinitis]. AB - The results of treatment of 53 patients with purulent mediastinitis were studied. The expediency to use the X-ray examination of the esophagus, mediastinum and esophago-fibroscopy was noted. In spreading of the inflammatory process to the TII1--TIV level, the cervical mediastinotomy was performed, below the TIV level- thoracotomy with wide opening of the mediastinum and its drainage, and that of a pleural cavity. Fourteen (26.4%) patients died from purulent complications. PMID- 1774864 TI - [The surgical treatment of the carotid sinus syndrome]. AB - The experience with operative treatment of 27 patients with cardioinhibitory and mixed forms of the carotid sinus syndrome (CSS) is summarized. Continuous endocardial electrocardiostimulation contributing to effective rehabilitation of the patients is a method of choice in cardioinhibitory form of the CSS. Location of an endocardial electrode in the atrium for avoidance of the cardiostimulator syndrome development is preferable. Use of the method in mixed form of the CSS requires further investigation. PMID- 1774865 TI - [Results of the surgical treatment of diseases of the esophagus and cardia]. AB - The experience with treatment of 21 patients with diseases of the esophagus is presented. Of them, 16 were operated on for cancer of the esophagus and cardia. The author considers the operative interventions performed with the use of a combined abdominothoracic approach as the most rational ones in cancer of the abdominal esophagus. PMID- 1774866 TI - [Experience with gastro- and enterostomy in esophageal obstruction]. AB - A variant of forming the permanent tubular gastro- and enterostoma brought out into the intercostal space is suggested. A created fistula is hermetical, safe, convenient in use. PMID- 1774868 TI - [The use of hyperbaric oxygenation in the treatment of patients with disorders of the peripheral circulation in a hospital daycare clinic]. AB - The experience with treatment of 151 patients with obliterative diseases of the vessels of the extremities which was performed under conditions of a day in patient department of the polyclinic with the use of a course of hyperbaric oxygenation was summarized. A native altitude chamber "Oka-MT" was used. The cost effectiveness of introduction of the method is shown. PMID- 1774867 TI - [Characteristics of repeated reconstructive operations on the abdominal aorta and the arteries of the lower extremities]. AB - The peculiarities of repeated reconstructive operations on the abdominal aorta and peripheral arteries in 355 patients are presented. The indications and choice of a method of operation are substantiated. At the immediate postoperative period, a good result was noted in 47% of patients, 13.3% developed thrombosis of allograft, 3.7%-that of autovenous shunt. PMID- 1774869 TI - [The choice of a method of treating chronic disorders of the cerebrovascular circulation]. AB - The results of surgical treatment of 106 patients with occlusive lesions of the brachiocephalic trunk vessels have been analysed. A necessity of reorientation of the conservative approach to the treatment of patients in favour of surgical angioneurology is stressed. PMID- 1774870 TI - [The use of gravitational plasmapheresis in hepatology]. AB - The experience with the use of gravitation plasmapheresis in treatment of patients with jaundice of different genesis is summarized. A technique for performance of plasmapheresis in patients with parenchymatous and obstructive jaundice, number of the manipulations performed, volume of plasma removed, dynamics of normalization of the biochemical indices of the blood of the patients are presented. PMID- 1774871 TI - [The use of antioxidants and preparations improving the microcirculation in the surgical treatment of cancer of the lung in elderly patients]. AB - The effectiveness of antioxidants and preparations improving microcirculation in surgical treatment of 118 elderly patients with pulmonary cancer was studied. The use of antioxidants of tocopherol acetate and retinol acetate in combination with complamin has proved to be the most effective. Reduction in the incidence of cardiovascular and pulmonary complications after the operation was noted. PMID- 1774872 TI - [Anesthesiologic management of surgery of the aorta and the major vessels in patients with diabetes mellitus]. AB - In 23 patients with diabetes mellitus, the effectiveness of anesthesiologic support of the operations on the aorta and major vessels, which was based on combined epidural anesthesia performed using the conventional technique, was analysed. Sugar concentration in the blood was maintained at a level of no more than 11 mmol/l. Use of the method permitted to provide an adequate anesthesia, stable concentration of glucose in the blood, constant aqueous-electrolyte balance and acid-base state. PMID- 1774873 TI - [The effect of hyperbaric oxygenation on the rheologic properties of the blood and its coagulation and anticoagulation system in patients with diabetic angiopathy of the lower extremities]. AB - In 24 patients with III degree diabetic angiopathy of the lower extremities, the changes in rheologic properties of the blood, its coagulative and anticoagulative system under the influence of hyperbaric oxygenation were studied. Hyperbaric oxygenation facilitates the rapid normalization of rheologic properties and general coagulative activity of the blood. Anticoagulative blood system is activated insufficiently, especially fibrinolysis, and that is why it is necessary to prescribe heparin to the patients, and at the necrotic stage, fibrinolysin as well. PMID- 1774874 TI - [The use of island flaps and transplants with a blood supply in the reconstructive microsurgery of injuries to the fingers and hand]. AB - The variants of operative tactics and technique of early microsurgical autoplasty of the extensive crushed and scalped wounds of the digits and hand in 15 patients are presented. Three main groups of the sufferers were distinguished: with scalping of the I digit, with crushing of the digits and a skin defect of the butt-end of a hand stump, with totally scalped wounds of the hand and low third of the forearm. The advantages of the use of reversed flaps of the forearm with suture of a sensory nerve in limited defects, and free transplant of the greater omentum in extensive wounds are shown. PMID- 1774875 TI - [Prevention of acute thrombosis and embolism of the aortic bifurcation and the major arteries of the extremities]. PMID- 1774876 TI - [The use of the method of reference signals in teaching surgical diseases]. PMID- 1774877 TI - [A late diagnosis of actinomycosis complicated by septicopyemia]. PMID- 1774878 TI - [A method of stopping bleeding from esophageal and cardial varices]. PMID- 1774879 TI - [An improved method of draining the thoracic duct]. PMID- 1774880 TI - [A successful treatment of a heart injury]. PMID- 1774881 TI - [Diagnosis of coelomic cysts of the pericardium]. PMID- 1774882 TI - [A successful thrombo-embolectomy from the femoral artery in a patient with acute myocardial infarction]. PMID- 1774883 TI - [Surgical treatment of diaphragmatic relaxation]. PMID- 1774884 TI - [An incarcerated postoperative diaphragmatic hernia]. PMID- 1774885 TI - [An obstruction of a stenosed esophagus caused by a foreign body]. PMID- 1774886 TI - [A foreign body of the esophagus]. PMID- 1774887 TI - [The surgeon's tactics in foreign bodies of the stomach and intestines]. PMID- 1774888 TI - [A foreign body in the abdominal cavity migrating to the sigmoid colon following salpingectomy]. PMID- 1774889 TI - [A foreign body in a duodenal diverticulum]. PMID- 1774890 TI - [Comparative data from computed tomography and echography in diseases of the abdominal cavity organs]. PMID- 1774891 TI - [A mucocele of the vermiform process]. PMID- 1774892 TI - [A new method of differential diagnosis of acute appendicitis]. PMID- 1774893 TI - [Acute intestinal obstruction caused by obturation of the small intestine by a mushroom]. PMID- 1774894 TI - [Torsion of the omental process of the cecum in a patient with acute appendicitis]. PMID- 1774895 TI - [Acute omentitis in emergency surgery of the abdominal cavity organs]. PMID- 1774896 TI - [Surgical treatment of pathology of the brachiocephalic trunk vessels in patients with atherosclerotic lesions of the arteries of the lower extremities]. AB - The experience with preventive revascularization of the brain in 41 patients with associated lesions of the extracranial arteries and arteries of the lower extremities is summarized. The authors noted the high results of staged operative treatment. PMID- 1774897 TI - [Objectives of rational and economic therapy of internal diseases]. PMID- 1774898 TI - [Diagnostic difficulties in infectious subacute endocarditis]. PMID- 1774899 TI - [History of D.I. Mendeleyev's illness]. PMID- 1774900 TI - ["Notes of a young physician" by M.A. Bulgakov]. PMID- 1774901 TI - [Viral hepatitis E: new data]. PMID- 1774902 TI - [The immune system and regenerative processes]. PMID- 1774903 TI - [Cryoglobulinemia in rheumatic diseases]. PMID- 1774904 TI - [Diagnosis and treatment of diseases of the circulatory and respiratory organs at the fronts of World War II 1941-1945]. PMID- 1774905 TI - [Lipid composition of blood sera of elderly and long-lived healthy and sick individuals]. AB - Serum cholesterol (SC), HDL SC and triglycerides were measured in 303 senile patients aged 75-89 and 77 long-livers aged over 90. The concentrations obtained were low in healthy long-livers compared to senile subjects. SC, triglycerides and atherogenic index reached the highest values in senile subjects and long livers with coronary heart disease and abnormal cerebral circulation. Lower levels of HDL SC appeared in the same diseases in senile males and female long livers against healthy subjects of the relevant age group. PMID- 1774906 TI - [Diagnostic value of echocardiography in patients with recurrent myocardial infarction]. AB - Echocardiographic data with calculation of the overall and segmental contractility have been obtained for 46 lethal cases with repeated macrofocal myocardial infarction. Mosaicism of the lesion having at least 2 isolated foci (zones of recent infarction and cicatricial changes) is a specific ECG feature for left-ventricular repeated infarction. Underlying mechanisms of mitral papillar dysfunction in repeated infarction are shown as are the leading factors in the onset of severe cardiac failure most commonly resulting in death: absence of intact myocardium compensatory hyperkinesis and associated extensive affection of the left ventricle. PMID- 1774907 TI - [Familial myxomas of the heart]. AB - An analysis has been made of the clinical, diagnostic, surgical and morphological aspects of familial cardiac myxomas, potentialities of their intravital diagnosis and prevention. No morphological differences were established between familial and sporadic cases of cardiac myxoma. PMID- 1774908 TI - [Combined lesions of the papillary muscle and the adjacent wall of the left ventricle as the causes of post-infarction mitral valve insufficiency]. PMID- 1774909 TI - [Circadian rhythm of cortisol secretion in the acute stage of myocardial infarction]. AB - Patients with macrofocal and transmural acute myocardial infarction (AMI) are reported to have statistically significant rhythms of cortisol secretion though there are cases of dysrhythmia. Circadian rhythms of cortisol secretion are typical for relatively light AMI course while a severe clinical run gives rise to dysrhythmia in the form of infradian neorhythmostasis or dysrhythmostasis of cortisol activity. PMID- 1774910 TI - [Condition of the heart in periodic disease]. PMID- 1774911 TI - [Use of enterosorption for correction of dyslipoproteinemias in patients with ischemic heart disease in geriatric practice]. AB - Sixty patients with coronary heart disease, stable angina pectoris of functional class II and III and dislipoproteinemia (cholesterol greater than 6.5 mmol/l, triglycerides greater than 2.0 mmol/l, the atherogenic index greater than 3.5) were assigned to two groups. 40 patients received enterosorbent (high-porous, small-spherical fraction of CKH carbon). 20 control subjects were treated with placebo. The patients age ranged from 60 to 74. The treatment course lasted for 4 weeks. Evaluation of the treatment results showed that total cholesterol dropped by 20%, triglycerides by 27%, apoB by 32%, apoB-containing lipoproteins by 20%; there were positive changes in circulation, clinical status (in 60% of cases), exercise tolerance (by 12%). Control patients did not present any noticeable shifts. Thus, enterosorption proved an effective modality of dyslipoproteinemia correction in coronary patients of advanced age. PMID- 1774912 TI - [Gastric leiomyomas]. AB - Leiomyomas are rare tumors found as a rule in the stomach (1-2% of all gastric tumor cases) and occasionally in the intestine. Unless they grow large or become ulcerated gastric leiomyomas run a silent course. Otherwise there is epigastric pain, hemorrhage or impaired gastric evacuation. When complicated, the disease presents diagnostic difficulties and is treated surgically. Gastrotomy with dissection of the tumor or local resection of the gastric wall proved a reliable therapeutic means. Gastric resection is indicated in ill-defined tumors or in suspected malignancy. PMID- 1774913 TI - [Malignant hemangioendothelioma of the liver and the living conditions-related and occupational factors]. AB - Malignant hemangioendothelioma of the liver (MHL) is of great interest for epidemiologists in view of its scanty and well-defined etiological factors. The paper presents epidemiological data on MHL in the Trieste area obtained at 46050 autopsies performed in 1969-1988. The results confirm the inference on extremely rare occurrence of MHL sporadic forms, each new case being indicative of emergence of new environmental or occupational oncogenic factors in relevant area. PMID- 1774914 TI - [Leukocytic index of intoxication and immunologic disorders in diffuse suppurative peritonitis]. AB - Expression of total T- and B-population, T-subpopulation lymphocyte receptors and secretion of IgM, IgG and IgA were measured in 112 patients with diffuse purulent peritonitis and 81 healthy donors. Expression of receptors was correlated with the disease severity identified by leukocytic index of intoxication (LII). The latter appeared to accurately reflect the pattern of immunological impairment. Reduced absolute and proportional values of total pools of T-, B-cells and T helpers, but elevated ones of T-suppressors and T-amplifiers occurred in LII less than 2.0. In LII greater than 7.0 there was total suppression of all the cellular populations due to deep lymphopenia. At the terminal stage of peritonitis paralysis of T-helper receptors and B-cells went in parallel with high secretion of serum immunoglobulins. PMID- 1774915 TI - [Choledocholithiasis: rational approach to diagnosis]. PMID- 1774916 TI - [Late results of cholelitholytic therapy of patients with cholelithiasis using chenodeoxycholic and ursodeoxycholic acids]. AB - Specially selected 78 patients with cholelithiasis received drugs of chenodeoxycholic and ursodeoxycholic acids. Concomitant cardiovascular disorders were in 38 of them. Upon the end of the treatment course (12 months, on the average) the patients were examined and it was found that the stones disappeared in 22 of them. Follow-up evidence is available for 18 of these. Choleliths redeveloped in 9 patients (in 11 months, on the average). Of those who got free of choleliths nobody had relapses for 4.5 years. Various methods used in them to prevent lithogeny (diet, drugs) provided no evidence in favour of one of them. 9 patients with recurrent cholelithiasis after cholelitholytic therapy had no gallstone colic for 4.5 years of the follow-up. Considering the fact that preparations from cheno- and ursodeoxycholic acids are effective in only part of the patients, they seem preferable in patients with concomitant disorders (cardiovascular, etc.) to avoid a high operative risk. PMID- 1774917 TI - [Kordaron and functional disorders of the thyroid gland]. AB - The paper presents a brief review of literature data on cordaron action on thyroid function under a prolonged schedule of its use, and a description of 4 cases of thyrotoxicosis developed by males after 2-10 years of cordaron maintenance for paroxysms of cardiac fibrillation in a dose of 200-600 mg. Probability of thyrotoxicosis necessitates an assessment of thyroid function when planning long-term treatment with cordaron. PMID- 1774918 TI - [Acyclovir in the treatment of severe generalized forms of herpes zoster]. AB - Aciclovir administration in 8 herpes zoster patients aged 14-74 to manage resistant generalized herpetic eruption, serous meningitis, meningoencephalitis resulted in a pronounced response in 5 of them. Aciclovir has the advantage of its effectiveness in spite of late treatment (on herpes zoster day 6-22). This is particularly important for those forms of the disease which manifest severe symptoms during the second phase, i.e. disseminated eruption, involvement of brain matter, etc. Two lethal outcomes due to pulmonary artery embolism were unrelated to the drug administration. PMID- 1774919 TI - [Disorders of humoral immunity in nonspecific aortoarteritis]. PMID- 1774920 TI - [Experience with the treatment of patients with ankylosing spondyloarthritis]. AB - Hyperbaric oxygenation (HBO) for ankylosing spondylarthritis was employed in Kuibyshev Medical Institute for 10 years. The response was registered in 94.4% ot 142 patients treated as shown by positive changes in external respiration, performance status, electromyographic, laboratory, biochemical and immunological findings. PMID- 1774921 TI - [Effect of therapeutic plasmapheresis on rheological properties of blood in patients with rheumatoid arthritis]. PMID- 1774922 TI - [Immunologic reactivity in patients with food allergy]. AB - One hundred and twenty patients suffering from food allergy were examined for cellular immunity and allergic reactions according to Gell and Coombs. It was found that food allergy was associated most frequently with immediate allergy characterized by elevated blood IgE level and food antibodies titer in the serum. Less frequent were delayed and immunocomplex reactions occurring in severe and polyvalent allergy. In food allergy the count of T-lymphocytes and T-suppressors is reduced, their activity inhibited. There is a moderate rise in B-lymphocytes and T-helpers levels. The treatment promoted improvement of cellular and humoral immunity, though normal indices got recovered in half the cases only. This fact explains frequent recurrences and dictates the necessity of long-term therapy. Elucidation of the mechanisms underlying food allergy may be helpful in administration of valid pathogenetic treatment. PMID- 1774923 TI - [Clinical value of measuring the activity of serum cholinesterase and its isoenzyme in chronic hepatitis and liver cirrhosis]. AB - Examination was performed of 48 chronic sufferers with persistent hepatitis (PH), 70 with active hepatitis (AH) and 179 with hepatic cirrhosis (HC) by activity of cholinesterase (CE). Lowering of total CE activity proportional to hepatic cellular insufficiency was seen in decompensated HC and chronic AN. CE isoforms (7 in healthy subjects) furnished additional information about its activity. Marked hepatic cell insufficiency in HC patients warrants disappearance of 3-4 CE isoforms. The presence of only one or two of them suggests a lethal outcome. In chronic AN four or less CE isoforms predict development of HC. PMID- 1774924 TI - [Endoscopic sclerotherapy in the treatment of patients with portal hypertension]. PMID- 1774925 TI - [Multiple-primary cancer of the skin]. AB - Fourteen cases of multifocal squamous cell cancer of the skin are analyzed clinicomorphologically. Such form of skin cancer arises typically on the limbs following long-standing lesions: trophic ulcer, osteomyelitis, psoriasis, lupus. The tumors are both synchronous and metachronous. The prognosis is often unfavorable due to late diagnosis. Multiplicity of the lesions could be attributed to lymphogenic or hematogenic subcutaneous metastases in generalization of the malignant process. PMID- 1774926 TI - [Problem of chronic hepatitis (classification, pathogenesis and treatment]. AB - Update information is added to classification of chronic hepatitis. A new form- chronic lobular hepatitis is described as well as characteristic features of immune response to hepatitis B virus (HBV). The findings enable the authors not only to relate autoimmune abnormalities to HBV infection, but to consider them an essential component of this infection. The leading role in pathogenesis of viral hepatic lesions is played by cellular immunity. A sound subpopulation analysis of immunocompetent blood cells was carried out for chronic active hepatitis and hepatic cirrhosis in correlation with HBsAg. It is emphasized that a biological cycle of HBV development determines the type and power of the macroorganism immune response and should be allowed for when designing policy of treatment of chronic hepatic viral diseases. Criteria are proposed for deciding on immunomodulators and immunodepressants for chronic viral and autoimmune hepatitis. PMID- 1774927 TI - [Palindromic rheumatism in the therapeutic practice]. PMID- 1774928 TI - [A case of long-term effective use of plasmapheresis in a patient with rheumatoid arthritis]. PMID- 1774929 TI - [A case of systemic amyloidosis with a predominant cardiac lesion]. PMID- 1774930 TI - [Cancer in aberrant thyroid gland]. PMID- 1774931 TI - [Violent behavior in small children. How does one learn to deal with one's aggression?]. PMID- 1774932 TI - [Psychosocial rehabilitation: an experience in Neufchatel. A trampolineinto life]. PMID- 1774933 TI - [Care of alcoholic patients. Work for specialists]. PMID- 1774934 TI - [The meaning of research in nursing care]. PMID- 1774935 TI - [You will have an operation]. PMID- 1774936 TI - [AMASCO: a second opinion is possible]. PMID- 1774937 TI - [The uncared-for caregivers]. PMID- 1774938 TI - [Self care with the aid of activities of daily living. Evaluate your own health]. PMID- 1774939 TI - [How do nurses use their time?]. PMID- 1774940 TI - [Health nurses have overcome great resistance]. PMID- 1774941 TI - [New poverty in Switzerland. "Poverty makes sick, sickness makes poor"]. PMID- 1774942 TI - [ZOKU too has to raise premiums]. PMID- 1774943 TI - [Continuing education course following the profession. Support in everyday problems]. PMID- 1774944 TI - [Touch is helpful--more than we think]. PMID- 1774945 TI - [Cancer research needs competent nurses]. PMID- 1774946 TI - [History of Hygiene]. PMID- 1774947 TI - [What is the use of nursing research?]. PMID- 1774948 TI - [Drug therapy of glaucoma]. PMID- 1774949 TI - [Don't blow up, man]. PMID- 1774950 TI - [Caring for hospital linnens. Hygiene is the uppermost law]. PMID- 1774951 TI - [Killer proteins--the battle of cell against cell]. PMID- 1774952 TI - Leukapheresis induced changes in cell cycle distribution and nucleoside transporters in patients with untreated acute myeloid leukemia. AB - Bone marrow leukemia cells from eight adults with untreated acute myeloid leukemia (AML) were evaluated before and after three daily leukaphereses to determine if mechanical cytoreduction can modulate the cell cycle distribution. The percentage of cells in S-phase and the proliferative fraction (PF = %S + %G2M) were determined by flow cytometry after dual labeling with bromodeoxyuridine and propidium iodide. Prior to pheresis the median %S and PF were 5.4 and 15.4%, respectively. The median change in %S was +2.5% (range -5.5 to +18.8) with increases greater than or equal to 3.7% in 4/8 patients. The median change in PF was +6.1% (range -13.8 to +25.3) with an increase of greater than or equal to 3.6% in 6/8 patients. The median absolute changes of 2.5 and 6.1% represent increases of 47% for %S and 40% for PF compared to the day 1 (pre pheresis) median values. As the number of nucleoside transporters in the cell membrane [nitrobenzylmercaptopurine riboside (NBMPR) binding sites] has been related to the percentage of cells in S-phase and to cytosine arabinoside (ara-C) cellular pharmacology, these were also measured before and after leukapheresis. Changes in the number of NBMPR binding sites varied widely with a median increase of 365 sites per cell (range -26,061 to +10,396). The change in NBMPR sites was significantly and positively correlated with changes in %S (r = 0.829, p = 0.042). These data suggest that mechanical cytoreduction by leukapheresis can increase the fraction of leukemia cells in S-phase and the PF in some patients with AML. The increase in %S is accompanied by an increase in NBMPR binding sites per cell. These changes in leukemia cell characteristics would be expected to result in an increase in efficacy of ara-C or other S-phase specific agents. PMID- 1774953 TI - Pharmacokinetics of oral all-trans retinoic acid in patients with acute promyelocytic leukemia. AB - It has been shown that patients with acute promyelocytic leukemia (AML3 subtype) treated with all-trans retinoic acid (all-trans RA), 45 mg/m2/day, achieve complete remission through differentiation of the leukemic clone to mature myeloid cells, which die spontaneously. The pharmacokinetics of all-trans RA given by mouth were studied in 15 AML3 patients. Blood samples were drawn for 24 h following a single oral dose of 45 mg/m2 and assayed for all-trans RA and 13 cis retinoic acid (13-cis RA) plasma concentrations by specific high-performance liquid chromatography. In one patient all-trans RA and 13-cis RA levels were below the detection limits at all times. In the other patients, the time to peak concentration of all-trans RA was between 60 and 210 min (median 90 min) after ingestion, with maximum concentrations between 0.03 and 2.5 micrograms/ml (median 0.4 micrograms/ml). These concentrations were within the in vitro differentiating concentration range of all-trans RA for these patients' cells. In nine patients, enterohepatic cycling was suggested by the presence on the concentration versus time curve of a secondary peak that occurred at meal times. The apparent plasma elimination half-life was between 16.8 and 77.4 min (median 30 min). Detectable plasma levels of 13-cis RA in 12 patients indicated in vivo isomerization of all trans RA. Despite the high inter-individual variability of all-trans RA pharmacokinetics in these patients, high blast cell counts and failure to respond to differentiation treatment tended to be associated with low all-trans RA Cmax values and high clearance estimates. PMID- 1774954 TI - Extra translocation +der(1q9p) is a prognostic indicator in myeloproliferative disorders. AB - An identical extra derivative chromosome resulting from a translocation between the long arm of chromosome 1 and the short arm of chromosome 9, +der(1q9p), has been observed in three patients with a myeloproliferative disorder. Two patients had polycythemia vera in transformation (erythroleukemia in one patient and refractory anemia in the second), whereas the third patient had myelofibrosis which later evolved into acute myelomonocytic leukemia. The two patients who developed overt leukemia did not receive any previous cytotoxic treatment. Non isotopic in situ hybridization was performed in two patients, allowing for the localization of the breakpoints in 1q12 and 9q12. A similar rearrangement has been previously described in patients with polycythemia vera, either at diagnosis or in advanced stages of the disease. These data suggest that this chromosome abnormality may be consistently associated with myeloproliferative disorders showing a high propensity to transformation, which is not treatment related, and the finding of the +der(1q9p) may represent a poor prognostic sign when observed in the chronic phase. PMID- 1774955 TI - Childhood acute leukemia with t(11;19) (q23;p13). AB - From 583 cases of acute lymphoblastic leukemia (ALL) and 181 cases of acute myeloid leukemia (AML) in childhood, seven patients were identified to have t(11;19) (q23;p13) by sequential cytogenetic analyses. The t(11;19) was associated with B-precursor ALL at diagnosis in three patients and at relapse in one patient. All four tested patients with B-precursor failed to express the CD10 antigen when the t(11;19) was detected, and one of three patients tested expressed myeloid-associated markers. In three other patients the translocation was detected either at lineage conversion from ALL to M5 AML (n = 2) or from AML to CD10- B-precursor ALL (n = 1). Leukemic blasts of four patients had an entirely different karyotype at the time of lineage conversion or loss of CD10 expression, suggesting an induction of a second neoplasm. Thus the t(11;19) can be found in de novo or secondary acute leukemia with lymphoid (CD10-) or myeloid (monoblastic) phenotype. Further investigation of the gene(s) involved in the 11q23 chromosomal region and the breakpoints in the 19p13 region is needed to understand the leukemogenesis of this apparently heterogeneous group of disorders. PMID- 1774956 TI - Cytogenetic, molecular biological and clinical study of B-cell lymphomas with 14;18 translocation in Japanese patients. AB - To investigate the role of the BCL-2 gene in Japanese patients with B-cell non Hodgkin's lymphoma, karyotypic analysis, DNA analysis and clinical characterization were studied. Ten of 73 patients showed t(14;18) and two patients had variant translocations [t(2;18) and t(18;22), respectively]. Of 42 patients examined at the molecular level, eight patients showed the BCL-2 gene rearrangement detected by mbr probe and two patients by 5'BCL-2 probe. Of the eight patients with the BCL-2 gene rearrangement by the mbr probe, t(14;18) was detected in six patients. A discrepancy in the relationship between the occurrence of t(14;18) and BCL-2 gene rearrangement was recognized. Two patients with obvious t(14;18) showed no rearrangement of the BCL-2 gene by mbr, mcr, nor 5' probe. Cytogenetic analysis is an indispensable tool for investigating lymphomogenesis. The two patients with the variant translocations, t(2;18) and t(18;22), showed breakpoints at the 5' site of the BCL-2 gene and both were histologically of the small lymphocytic type. No examples with the co-existence of both the BCL-2 and c-MYC gene rearrangements were found. The median survival time of the patients with the BCL-2 rearrangement and/or t(14;18) was longer than the patients without the BCL-2 gene rearrangement and translocation and also patients with the c-MYC gene rearrangement and/or translocation. Racial and geographical heterogeneities, variant translocations of t(14;18) and the clinical characteristics of B-cell non-Hodgkin's lymphoma with t(14;18) are discussed. PMID- 1774957 TI - Immunoreactivity of leukemic lymphoblasts of T-cell and B-cell precursor origin with monoclonal anti-GD3 and anti-GM3 antibodies. AB - The glycosphingolipids GD3, GM3, and alpha 2, 3-sialosylparagloboside (SPG) are major gangliosides of lymphoid leukemia cells. The reactivity of two monoclonal anti-ganglioside antibodies, an anti-GD3 (R24) and an antibody cross-reactive to GM3 and SPG (M2590), to blasts of patients with T-cell acute lymphoblastic leukemia (ALL) and B-cell precursor ALL (pre-B-ALL), were compared using indirect immunofluorescence and flow cytometry. Results from 23 patients with T-ALL and eight with pre-B-ALL yielded four subclasses of T-ALL and two subclasses of pre-B ALL. Blasts from most of the patients with T-ALL were R24+M2590- whereas most of the patients with pre-B-ALL were R24-M2590-. Seven of 23 patients with T-ALL had ganglioside immunophenotypes similar to that of pre-B-ALL, i.e. R24-M2590- or R24 M2590+. These subclasses could not be further characterized by additional cell surface immunophenotypic markers or by gene (immunoglobulin and T-cell receptor) rearrangement analysis. The ratio R24/M2590 was less than 1.0 in all patients with pre-B-ALL, and was greater than 1.0 in all patients with T-ALL who were R24 positive, but was not useful in characterizing the double negative T-ALL subclass. To assess whether cryptogenicity of gangliosides due to cell surface protein could account for the low binding of either R24 or M2590, blasts were treated with trypsin before antibody analysis. Whereas the binding of R24 was unchanged after trypsin treatment, binding of M2590 was increased in a number of samples, particularly in those samples which were originally M2590-positive. The results show that comparative staining of T-ALL and pre-B-ALL cells with both anti-GD3 and anti-GM3/SPG antibodies results in a further subclassification of ALL and provides a quantitative assessment of the expression of tumor-associated gangliosides on the blasts of this disease. PMID- 1774958 TI - Diagnostic and prognostic values of in vitro culture growth patterns of marrow granulocyte-macrophage progenitors in patients with myelodysplastic syndrome. AB - The in vitro culture growth of marrow granulocyte-macrophage progenitors (CFU-GM assay) was studied in 102 consecutive patients with newly diagnosed primary myelodysplastic syndrome (MDS) to determine its diagnostic utility and prognostic value. There were 18 patients with refractory anemia (RA), eight RA with ringed sideroblast (RARS), 30 RA with excess of blasts (RAEB), 18 chronic myelomonocytic leukemia (CMML), and 28 RAEB in transformation (RAEB-T). Patients with MDS had a significantly lower number of GM colonies and a significantly higher cluster to colony ratio than those of normal controls and patients with cytopenias of other causes. Six in vitro growth patterns were observed; 85% of patients with MDS showed various abnormal growth patterns, and 42% of all MDS patients exhibited a leukemic growth pattern at diagnosis. None of the 40 patients with cytopenias of other causes had a leukemic type growth. A leukemic growth pattern was rarely observed in patients with RA and RARS (4%), but was common in other subgroups (57%). The distribution of various growth patterns was not statistically different among patients with RAEB, CMML, and RAEB-T. Thirty-six patients developed acute leukemia during the follow-up period. The MDS patients with leukemic type growth were at increased risk of rapid progression to acute leukemia, and they also had a shorter survival time than patients with a non leukemic pattern. These results showed that simply scoring the number of CFU-GM is of limited value for the diagnosis and the prediction of prognosis of MDS, whereas the in vitro marrow culture growth pattern is of prognostic significance independently of the FAB classification. It is concluded that the in vitro growth pattern of marrow CFU-GM is helpful in diagnosing patients with MDS as well as in predicting their clinical outcome. PMID- 1774959 TI - Interleukin-3 dependent mitogenesis in murine cells involves a predominant non protein kinase C (pKC) dependent pathway for c-myc transcription. Role of a myc expression vector in rescuing pKC dependent mitogenesis. AB - The signaling pathways used by interleukin-3 (IL-3) and by active phorbol ester (12-0-tetradecanoyl phorbol-13-acetate, TPA) to stimulate mitogenesis in the growth factor dependent myeloid cell line FDC-P1 were studied by 'reporter' analysis of nuclear proto-oncogene expression. These studies revealed that IL-3 strongly stimulated c-myc expression by a transcriptional mechanism but IL-3 poorly stimulated c-jun expression, a measure of protein kinase C dependent signals. On the other hand, the protein kinase C agonist, TPA, strongly activated c-jun expression but poorly promoted expression (transcription) of c-myc in FDC P1. These findings appeared to correlate with the poor mitogenic capacity of TPA for FDC-P1. However, stable transfection of FDC-P1 with a c-myc expression vector driven by a human methallothionein IIA promoter containing the TPA responsive element (TRE), led to a cell clone, FDMT myc.A1, in which TPA mediated selective transcription of the transfected TRE driven c-myc vector and down-regulated expression of the endogenous c-myc gene. IL-3 selectively failed to stimulate expression of the TRE driven c-myc vector in FDMT myc.A1. Augmented TPA dependent vector derived c-myc expression was accompanied by enhanced mitogenesis of the cell line FDMT myc.A1 compared with FDC-P1. In addition, TPA mediated expression of the transfected c-myc gene in FDMT myc.A1 was accompanied by augmented transcription of c-jun and c-fos in response to TPA. These studies show the importance of a non-protein kinase C dependent pathway for IL-3 mediated c-myc transcription. However, these studies reveal that protein kinase C mediated pathways can be promitogenic, especially when complemented by unregulated c-myc expression (in this case driven by an alternative, TRE containing promoter). PMID- 1774960 TI - Expression of housekeeping genes in Hodgkin's disease lymph nodes. AB - Housekeeping genes, particularly actin, tubulin, and the glycolytic enzyme glyceraldehyde-3-phosphate dehydrogenase (GAPDH), are widely used to estimate the amount and integrity of RNA in Northern blotting. In this work, the most reliable housekeeping gene for gene expression analysis of Hodgkin's disease (HD) lymph nodes was determined by comparing the conventional housekeeping genes, beta actin, beta-tubulin, GAPDH, and the mouse gene LLRep3, that had been used previously in gene expression studies. It was found that the amounts of mRNA in these genes are very heterogeneous in HD lymph nodes. In contrast, their expression was relatively constant in tonsils undergoing a chronic inflammatory process. It is concluded that none of the housekeeping genes tested is suitable for the fine quantitative analysis of gene expression in HD lymph nodes. PMID- 1774961 TI - [Effects of guaranteed care for orthopedic patients]. PMID- 1774962 TI - [Will it be better for the children?]. PMID- 1774963 TI - [Surgical treatment of spondylolisthesis]. PMID- 1774964 TI - [Biochemical diagnosis improved in myocardial infarction]. PMID- 1774965 TI - [Did Mozart have Tourette syndrome?]. PMID- 1774966 TI - [Euthanasia or treatment?]. PMID- 1774967 TI - [High cholesterol levels are not hazardous in healthy pensioners]. PMID- 1774968 TI - [In vitro fertilization. Life situation and expectations of couples waiting for treatment show the need of supportive discussion]. PMID- 1774969 TI - [Urinary incontinence and other urogenital problems in women--cases for primary health care?]. PMID- 1774970 TI - [Hypertriglyceridemia as a vascular risk factor]. PMID- 1774971 TI - [It should be possible to perform ambulatory myelographies at county hospitals]. PMID- 1774972 TI - [Development of the immune system: how maternal immunity influences the child's immunity]. PMID- 1774973 TI - [The CPAP therapy in sleep apnea is a simple treatment tolerated by many]. PMID- 1774974 TI - [A new national disease. Sleep apnea syndrome demands individualized treatment]. PMID- 1774975 TI - [Bone scintigraphy of fractures. Uncertain results in early examinations]. PMID- 1774976 TI - [Ambulatory blood pressure measurement--guidelines for registration and data processing]. PMID- 1774977 TI - [Pressure sensors give a receit for balloon dilatation. Do new sensors improve the pacemaker?]. PMID- 1774978 TI - [Independent research on smoking cessation is needed]. PMID- 1774979 TI - [The tobacco company--does it clear the way for health?]. PMID- 1774980 TI - [Mortality studies in heart failure. The role of ACE inhibitors becomes more important]. PMID- 1774981 TI - [Mass vaccination of infants against H. influenzae type b is desirable and possible]. PMID- 1774982 TI - [Echocardiographic equipment should be a natural part of the equipment in a coronary department]. PMID- 1774983 TI - [Many people change their tires unnecessarily]. PMID- 1774984 TI - [How shall we handle breast milk in the future?]. PMID- 1774985 TI - [Emergency departments are more popular among elderly patients than among young ones]. PMID- 1774986 TI - [Long-term ECG at a health center is easier on the patient and results in more accurate diagnosis]. PMID- 1774987 TI - [Sialic acid in serum as a risk indicator of possibly fatal cardiovascular disease]. PMID- 1774989 TI - [The physical environment in health care facilities is of therapeutic significance]. PMID- 1774988 TI - [Medical and human aspects interact in dignified withdrawal of dialysis treatment]. PMID- 1774990 TI - [A number of problems within vascular surgery should be objects for quality assurance]. PMID- 1774992 TI - [Infusion of calcium chloride into the peripheral veins resulted in deep tissue necrosis]. PMID- 1774991 TI - [Reversal of drug resistance and prediction of the response to cytostatics. Experimental drug therapy for tumors has clinical potential]. PMID- 1774993 TI - [Population-based biological test bank. New possibilities for epidemiologic cancer research]. PMID- 1774994 TI - [Health hunting of the health care system. Do health check-ups cause increased consumption of unjustified health care?]. PMID- 1774995 TI - [Dionysos]. PMID- 1774996 TI - [A consensus document: vision-threatening retinal changes in diabetes]. PMID- 1774997 TI - [Thoracotomies in thoracic injuries--indications and results]. AB - Most thoracic injuries can be treated adequately with intensive care, pleural drainage and judicious physiotherapy. From the total of 571 patients with severe thoracic injuries treated in the Surgical Department of the University of Cologne over the last 10 years, 14% of those with blunt trauma (BT) and 33% with penetrating trauma (PT) underwent thoracotomy. Thoracotomy for PT was usually performed earlier and gave better results than thoracotomy for BT. With one exception, all PT underwent thoracotomy in the first 24 h after admission. For thoracotomy carried out for BT however, 38% took place after 24 h and 21% after 5 days. Postoperative mortality for BT was 3 times higher than for PT (56% vs. 18%). Reasons for this are to be found in the severe thoracic and general injuries associated with BT. The surgical procedure will depend on the type and extent of the thoracic and general injuries and on the general condition of the patient. PMID- 1774998 TI - Hepatic trauma: experience with 135 consecutive liver injuries (1982-1989) and arguments for conservative surgery. AB - Most hepatic traumas are easily cured, but the series of 135 consecutive hepatic wounds reported in the present paper is unusual in that the patients were specifically recruited from among patients subjected to neurosurgical or spinal operations, 25% of whom sustained severe hepatic injuries (classes IV and V) as a result of the surgery. The postoperative mortality was analyzed according to such potentially predictive factors as severity of the hepatic wound, the concomitant extraabdominal lesions, the initial shock, and the kind of surgical treatment. The statistical comparison of the factors affecting the results was analyzed by the Chi-square test. The postoperative mortality rate was 24.4% (33 deaths). This mortality rate is evidently related to the severity of the hepatic lesions and to the frequent associated lesions. The 14 deaths from benign and moderate hepatic injuries were due to concomitant lesions. Among the 19 deaths from severe lesions, 12 were directly related to the severity of the hepatic injury and 7 to associated wounds. Complications directly related to the hepatic trauma occurred in 39 cases with 16 deaths. In general, conservative surgical treatment can be performed with quite low mortality. Among the patients who require hepatic resection one of two dies of hemorrhage or coagulopathy. Among conservative procedures, perihepatic packing has proved to be efficient and safe. If perioperative cholangiography has excluded any leak from a major bilde duct, septic complications are rare. Therefore, the surgical treatment of hepatic trauma should be as conservative as possible, because this can stop hemorrhage and decrease the risk of coagulopathy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1774999 TI - [Scar tissue cancer: observations and results of 23 cases]. AB - The scar tissue carcinoma is a rare disease which arises from the floor of unstable scars, chronic fistulae, ulcera and radiation injuries. The clinical pictures of 23 cases between 1976 and September 1990 have been elucidated. Compared to earlier findings it must now be stated that the development of cancer in stasis ulcera is more frequent than in burn scars or X-ray cancer. Generally, the number of scar tissue carcinomas seems to decrease. Since surgical and adjuvant therapies are--like in any other cancers--limited, prevention and early diagnosis have become of major importance. Though the cancer grows mainly on the body surface and could, therefore, be easily recognised, we still found tumours of remarkable dimension and disturbance, which were either shown to the physician too late or remained unrecognised by the diagnostician. PMID- 1775000 TI - [Validity of nuclear magnetic resonance tomography in evaluation of the traumatized intervertebral disk]. AB - The validity of the magnetic resonance imaging (MRI) in the diagnosis of injured intervertebral discs was examined by a prospective diagnostic study. The golden standard being intraoperative discography. The examinations were carried out on both intervertebral discs adjoining the fractured vertebral body. There were 27 patients with 54 injured discs. The sensitivity of the MRI as a noninvasive method is 96%, the specificity is 75%. These results comply with a validity of 88%. PMID- 1775001 TI - [Pedicled small intestine segment for circular replacement of the extrahepatic bile duct in preserved papillary passage. An animal experiment study]. AB - The effect of a small bowel segment as a extra-hepatic bile duct replacement was examined in 12 pigs followed-up for a period of 420 days. No complications, either during the operation or postoperatively, were observed in any of the animals. The laboratory parameters were within normal range over the entire observation period of 420 days. After 2, 6, and 12 months there was no anastomotic stenosis in the PTC. The intrahepatic biliary tract was not dilated. There was obvious peristalsis of the small bowel transplant towards the papilla of Vater. The autopsy showed that the grafts had healed without any sign of irritation. Histologically the structure of the graft remained undisturbed. There was a clear distinction between the mucosa of the bile duct and that of the small bowel, with no sign of a chronic infection. In the graft as well as in the vascular pedicle the nerve fibres were intact. Liver biopsy showed no pathological changes. In the light of these experiments, a small bowel segment presents a very promising alternative replacement of the extrahepatic biliary tract. PMID- 1775002 TI - [Initial experiences with a new monoclonal antibody in diagnosis of malignant melanomas]. AB - In a study of 17 patients with malignant melanomas in the extremities the sensitivity and specificity of a new monoclonal antibody directed at melanoma cells (BW 575, Behring) were investigated. The specificity was 100%, but the sensitivity 70%. In 3 cases known foci could not be detected. All nodular melanomas and their metastases were detected (9 patients). Repeated examination during the first 24 h after injection of the Tc-99m-marked antibody, and two plane investigations made it possible to detect even small tumors less than 1 cm in diameter and subcutaneous lesions where the melanomas absorbed the antibodies. Due to its high specificity, the antibody seems to be a promising aid in deciding the operative strategy. PMID- 1775003 TI - Effectively and efficiently protecting children in faith healing cases: a proposed statutory revision for state intervention. AB - Parents may be free to become martyrs to themselves. But it does not follow that they are free, in identical circumstances, to make martyrs of their children before they have reached the age of full and legal discretion when they can make that choice themselves. PMID- 1775004 TI - Law, psychiatry and rights. AB - This article deals with the effect of the shift in emphasis from the moral rights to the legal rights concept in psychiatry with reference to matters such as involuntary civil commitment, the right to treatment, the right to refuse treatment, the duty to warn or to protect, the duty to protect future patients from abusive colleagues and the duty to become politically active. PMID- 1775005 TI - Patient advocacy in Austria. AB - A presentation and discussion of a model of patient advocacy that can be viewed as the first comprehensive project of its kind in Austria. This service is in existence as a pilot project in only two psychiatric hospitals where some components of patient advocacy are being tested; the project refers to a concept of advocacy which is part of a draft bill on involuntary commitment that will possibly be passed this year. PMID- 1775006 TI - Legal aspects of work-related eye injuries. AB - As court-appointed medical advisors in the speciality of ophthalmology for the Israeli Labour Courts, we are called upon to assist in making decisions on work related eye injuries or illnesses. In this report we present seven cases of eye injuries which workers claimed were caused by work accidents. Each case helps to illustrate the various guidelines we use in making a medical judgement as to whether or not a specific ocular problem was, indeed, the result of a work accident. PMID- 1775007 TI - The nurse and the law (Part 2). PMID- 1775008 TI - Involuntary discharge of voluntary psychiatric patients. PMID- 1775009 TI - Nigerian juvenile offenders: a case-controlled study. AB - A case-controlled study was carried out on all the 51 juvenile delinquents found in a point prevalence survey of a Nigerian Borstal Remand Centre. Mean age of the delinquents was 17-27 years. They were mostly from the low social class (70.6%) and the commonest reason for admission was for being beyond parental control (68.6%). Identified risk factors found for juvenile delinquency were death of biological mother, parental marital failure, growing up with relatives rather than parents, drug abuse and ordinal position in the family. Possible cultural explanations for some of these observations were proffered. The need to improve on the living conditions of these juveniles and their assessment procedure were highlighted. Finally, it is imperative that the obsolete Nigerian Children and Young Person's Law be updated. PMID- 1775010 TI - Addiction to violence in the United States Vietnam combat veteran. PMID- 1775011 TI - New rulings on psychiatric issues by the Supreme Court of Israel: (Part 2). PMID- 1775012 TI - The impact of the Demjaniuk trial on the psychotherapeutic process in Israel. AB - The Demjaniuk trial was a national experience and people showed great interest in it, more than the organizers of the trial had expected. Many therapists expressed interest in the trial. They stressed the importance of the trial and their identification with it. In some questionnaires, therapists reported dramatic reactions and revival of survivors syndrome. Therapists who were sensitive and perceptive to the subject of the Holocaust reported definite reactions in their patients. On the other hand, therapists who were inclined to isolation, denial and avoidance of this subject, reported that their patients did not react or that their reactions were only superficial. Therapists reported that second generation patients tended to stronger identification with their parents following the trial. The trial served as a catalyst for the treatment and also made them more interested in knowing more about their parents. It broke down a barrier between survivors and those who did not experience the Holocaust, according to one of the therapists. In our opinion, it also broke down a barrier between first and second generation. Many therapists reported strong identification with their patients, especially when both therapist and patient were of the same generation in relation to the Holocaust. Some patients reacted strongly to the trial and needed more frequent treatment sessions, more drugs and sometimes even hospitalization, but in many cases the trial had a positive influence on the therapeutic process and important content emerged in treatment. The trial enabled many patients to work through the mourning process, which previously they did not allow themselves to experience.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775013 TI - Surrogacy: the case for a conventional approach. AB - Legislation for the reproductive technologies made a false beginning when initial legislation chose to obscure the separation of genetic and social/legal parenthood resulting from the use of donor sperm and ova. This initial falsehood is compounding the difficulties of later attempts to deal with more complex issues. The NSW Law Reform Commission's arguments and recommendations with regard to surrogacy illustrate this problem. It is argued that legislation should work from precedent in matters of recognition and transfer of parenthood, and that the social ramifications of the new technologies should be identified as far as possible within existing social determinations. The nature of surrogacy and required legislation is explored in this context, and it is argued that surrogacy should be subject to essentially the same regulation as adoption, thus debarring commercialization but without legislative intervention into the area of private reproductive behaviour. It is suggested that such an approach will effectually discourage surrogacy as it provides no sureties for the 'commissioning' couple. PMID- 1775014 TI - [A screening test to assess the physical development of schoolchildren]. PMID- 1775015 TI - [The participation of the nurse in the sex education of youth]. PMID- 1775016 TI - [Nonspecific ulcerative colitis in children]. PMID- 1775017 TI - [Emergency care in pulmonary edema]. PMID- 1775018 TI - [The current approaches to the problem of arthrosis deformans of the large joints of the extremities]. PMID- 1775019 TI - [The malabsorption syndrome in pediatrics]. PMID- 1775020 TI - [Trophic ulcers of the lower extremities]. PMID- 1775021 TI - [Disordered nasal breathing--one of the causes of the development of maxillodental deformities]. PMID- 1775022 TI - [The bourtree]. PMID- 1775023 TI - [An outstanding physician of the Middle Ages I. Dzhurdzhani]. PMID- 1775024 TI - [The organization of the creative work of students]. PMID- 1775025 TI - [The training of nurses for children's medical institutions]. PMID- 1775026 TI - [We are expanding the international ties of this journal]. PMID- 1775027 TI - [How to help children with retarded mental development in school]. PMID- 1775028 TI - [The information value of a questionnaire screening test in mass examinations of preschoolers and schoolchildren]. PMID- 1775029 TI - [American colleagues in the USSR]. PMID- 1775030 TI - [A device for the mechanical treatment of syringes]. PMID- 1775031 TI - [The effect of different factors on the outcome of humeral trauma]. PMID- 1775032 TI - [The basic principles of treating acute respiratory viral diseases in schoolchildren]. PMID- 1775033 TI - [Amebiasis]. PMID- 1775034 TI - [Viruses and mental disorders]. PMID- 1775035 TI - [Changes in the eyes in myasthenia]. PMID- 1775036 TI - [The antenatal prevention of autonomic vascular dystonia in children]. PMID- 1775037 TI - [The treatment of patients with intestinal fistulae]. PMID- 1775039 TI - [Therapeutic muds]. PMID- 1775038 TI - [Mineral waters in the medical rehabilitation of patients following operations for gastric and duodenal peptic ulcer]. PMID- 1775040 TI - [Contrast diets or semistarvation days]. PMID- 1775041 TI - [Supplemental sources of polyclinic financing]. PMID- 1775042 TI - [The main active substances in medicinal plants]. PMID- 1775043 TI - [A. N. Bakulev (on the centenary of his birth)]. PMID- 1775044 TI - [Methodological recommendations for organizing centralized sterilization departments in treatment and prevention institutions]. PMID- 1775045 TI - 31P MRS of myocardial inorganic phosphate using radiofrequency gradient echoes. AB - Determination of the chemical shift and integral of the myocardial intracellular inorganic phosphate (Pi) resonance by 31P magnetic resonance spectroscopy (MRS) is often precluded due to a large overlapping signal from 2,3-diphosphoglycerate (2,3-DPG) from chamber and myocardial blood. This report demonstrates the use of radiofrequency (RF) magnetic field gradient echoes (RFGE) to eliminate signals from 2,3-DPG in flowing blood, while retaining signals from intracellular myocardial Pi, ATP, and phosphocreatine (PCr). The ECG-triggered 31P spectra were acquired from the myocardium of open chest pigs using a Philips Gyroscan 2-T magnetic resonance spectrometer. A 2.5-cm-diameter surface coil attached to the myocardium was used to provide the RF gradient as well as for excitation and detection of signals. Optimal performance of the RFGE pulse sequence was obtained when the RF gradient pulses were centered at peak diastole or peak systole. Under these conditions, 2,3-DPG signals were completely suppressed, and sensitivity was usually sufficient to allow detection of a well-resolved Pi signal. Myocardial pH determined from RFGE experiments was 7.16 +/- 0.10, and the ratio of the integrals of the Pi and ATP resonances (Pi/ATP) was 0.24. The mean signal-to noise ratio (S/N) for PCr in control spectra acquired in 4 min was 19/1, while the mean S/N for PCr in RFGE-edited spectra acquired in 15 min was 11/1, demonstrating that the present implementation of the RFGE method results in significant loss in sensitivity. These experiments demonstrate that RFGE-editing allows accurate determination of the chemical shift and integral of the Pi resonance in blood-perfused myocardium in situ. PMID- 1775047 TI - Multiexponential proton relaxation in model cellular systems. AB - Water proton relaxation measurements obtained from model cellular systems composed of red blood cell (RBC) ghosts are presented. The purpose of the investigation was to evaluate hypotheses concerning the possible sources of multiple exponential components in similar relaxation measurements made on tissue. Both laboratory frame transverse and longitudinal relaxation rates, as well as rotating frame relaxation rates, were measured in preparations of RBC ghosts and "extracellular fluid" that were, (a) uniformly mixed or (b) compartmentalized by layering, as the concentration of serum albumin was varied in the "extracellular fluid." The data show that although transmembrane exchange is too fast to give rise to multiexponential relaxation, multiple components can result from compartmentalization at the level of the cellular organization and do not necessarily require different tissue types. In addition, the data clearly demonstrate the importance of protein adsorption to cellular membranes as a determinant of the concentration of freely mobile solute protein molecules in tissue fluids. PMID- 1775046 TI - Improvement of spectral resolution in shift-reagent-aided 23Na NMR spectroscopy in the isolated perfused rat heart system. AB - The level of intracellular sodium (Nai) is maintained at approximately 14 mM in healthy myocytes. When myocytes are damaged, Nai increases and therefore the level of Nai may be a means of evaluating myocardial cell integrity. A particularly useful method to monitor Nai levels is 23Na NMR spectroscopy. However, because of the isochronous nature of the extracellular sodium (Nao) and Nai NMR signals, paramagnetic lanthanide shift reagents (LSR), such as dysprosium triphosphate, Dy(PPP)7-(2), have been used to shift the Nao signal. This reveals the unshifted Nai signal and allows the NMR monitoring of Nai in isolated perfused hearts and other systems. A major shortcoming of this method (the "shift only" method) is in the need to minimize the Nao signal by not submerging the perfused hearts in Na(+)-containing buffer. An equally undesirable alternative is the utilization of relatively high concentrations of LSR to shift a large Nao signal sufficiently to enable reasonable resolution and quantitation of Nai. We present here a method, the "shift-relaxation" method, which is a combination of using a mixture of Dy(PPP)7-(2), a shift reagent, and gadolinium triphosphate, Gd(PPP)7-(2), a relaxation agent, with data acquisition using an inversion recovery (IR) pulse sequence. This combination allows differentiation between Nao and Nai by the difference in their respective T1 values in addition to the shift between them. With this technique we can selectively minimize the extracellular signal and therefore minimize the need for a large Dy-induced shift, as well as allow data acquisition on a heart submerged in Na(+)-containing perfusate. The resulting improved discrimination between Nai and Nao at relatively low levels of LSR should be helpful for ultimate in vivo applications and potential clinical applications, where a lower dose of LSR also means a decreased possibility of physiologically deleterious effects. Also included in this paper is a method for the quick determination of an accurate 180 degrees pulse which is required for the optimization of the IR method. PMID- 1775048 TI - Application of continuous relaxation time distributions to the fitting of data from model systems and excised tissue. AB - Biological systems exhibit heterogeneity at many different levels, leading to the expectation of multiple relaxation time components for water protons in tissue samples. Traditional methods which fit the relaxation data to an a priori number of discrete components are open to observer bias in their interpretation of this data, and moreover, are intuitively less realistic for heterogeneous systems than methods which produce continuous relaxation time distributions. Previous validations of continuous distribution techniques have been made on simulated data assuming uniform Gaussian noise. In the current work we have investigated the ability of one particular linear inverse theory technique to reproduce known relaxation time distributions from the data on a controllable model system. Furthermore, using the experience gained on the model system, we have applied this same technique to the analysis of in vitro relaxation time measurements on excised brain tissue and found for water protons in white matter, four reproducible components for the transverse relaxation, whereas gray matter gave rise to only two. The longitudinal relaxation displayed only one component in either white matter or gray matter. PMID- 1775049 TI - Oblique NMR imaging of the uterus in macaques: uterine response to estrogen stimulation. AB - We report methods for quantitative NMR imaging of the primate uterus and the application of these methods of measuring the response of the monkey (Macaca nemestrina) uterus (endometrial volume, myometrial volume, T2 values, myometrial junction zone) to estrogen stimulation. High-field (2.35 T), fat-suppressed, T2 weighted (TE50) oblique methods were used. Slice thickness, location, and angle were varied on each examination to obtain six contiguous slices between the cervix and fundus, regardless of size or orientation of the uterus. Basal endometrial and myometrial volumes were 0.05 +/- 0.01 cm3 and 1.31 +/- 0.23 cm3 in chronically ovariectomized animals. These increased by 15.7 +/- 3.6-fold and 3.1 +/- 0.4-fold, respectively, during 7 days of estrogen stimulation (estradiol benzoate, 5 micrograms/kg sc daily) while myometrial T2 increased from 52 +/- 1 to 67 +/- 4 ms. These changes reversed following menstrual bleeding. PMID- 1775050 TI - A 7Li NMR study of visibility, spin relaxation, and transport in normal human erythrocytes. AB - The behavior of the lithium (Li) ion in normal human erythrocytes has been studied by 7Li NMR. The uptake of Li into the cells was followed as a function of solution conditions, temperature, hematocrit, and blood age using dysprosium tripolyphosphate shift reagent. Under our conditions the uptake of Li increases with increasing hematocrit and blood age. For packed cells the extracellular 7Li spin-lattice relaxation time was only slightly longer than the intracellular relaxation time. Thus, T1 may not be useful for separate observation of intra- and extracellular Li in vivo. The intra- and extracellular T2s were substantially shorter than the corresponding T1s. Also, the intracellular T2 was considerably shorter than that for the extracellular compartment, suggesting that T2 may provide a noninvasive handle for observation of intracellular Li. Nuclear Overhauser enhancements could be observed for both extra- and intracellular 7Li, confirming that dipolar coupling to 1H is a contributing relaxation mechanism. The 7Li NMR visibility was essentially 100% at high Li concentrations, decreasing to about 84% at 1 mM Li. Based on time course studies of the invisibility, and a comparison of NMR and inductively coupled plasma results, it appears that the invisibility of the intra- and extracellular compartments for packed cells is the same. Although a 23Na double-quantum signal could be observed for red blood cells, no double-quantum signal was observed for 7Li. PMID- 1775051 TI - Evaluation of BA1112 rhabdomyosarcoma oxygenation with microelectrodes, optical spectrophotometry, radiosensitivity, and magnetic resonance spectroscopy. AB - We studied tumor tissue oxygenation in the BA1112 rhabdomyosarcoma using micro electrode pO2 measurements, optical spectrophotometry, analyses of cell survival after irradiation, and 31P magnetic resonance spectroscopy (MRS). Studies were carried out in WAG/Rij/Y rats breathing normoxic, hypoxic, and hyperoxic gas mixtures with and without iv administration of perfluorochemical. Significant changes in tissue oxygenation and metabolic status were found when pO2 values, optical measurements of hemoglobin saturation and cytochrome a, a3 reduction oxidation, radiation cell survival determinations, and MRS measurements of phosphometabolite ratios were obtained in rats breathing different gas mixtures. Inhalation of 100% O2 caused increases in tumor pO2, hemoglobin saturation, cytochrome a, a3 oxidation, tumor radiosensitivity, and PCr/Pi, NTP/Pi, and PDE/Pi ratios. Such changes were augmented by pretreatment with iv perfluorochemicals. Inhalation of hypoxic gas mixtures resulted in reductions in the above parameters. These results indicate that tissue oxygenation can be manipulated reproducibly in the BA1112 rhabdomyosarcoma and suggest that 31P MRS can be used to monitor changes in tumor oxygenation in this model system. PMID- 1775052 TI - Temporal and spatial analysis of fields generated by eddy currents in superconducting magnets: optimization of corrections and quantitative characterization of magnet/gradient systems. AB - We propose methods for the spatial and temporal characterization of time dependent magnetic fields generated by eddy currents after switching gradients. For an on-line determination of the temporal variations of the fields, we extract two terms from the unresolved signal of an extended sample, describing the time evolution of a frequency shift gamma delta Bz(t) and of a decay constant k(t). This procedure allows us to optimize interactively the multiexponential pre emphasis as well as any spectral volume selection method with respect to eddy currents. Additionally, we suggest an imaging sequence which allows us to determine the spatial distribution of eddy current fields at a chosen time-point after any gradient sequence to be tested. Expansion of these eddy currents fields into spherical harmonic functions proves the existence of a higher order terms, which cannot be corrected by a standard pre-emphasis device, where time constants and amplitudes are adjusted on the X, Y, Z, and Z0 coils. The proposed numerical analysis gives a tool to characterize any magnet/gradient system quantitatively with respect to eddy current performance. PMID- 1775053 TI - Cholesterol of myelin is the determinant of gray-white contrast in MRI of brain. AB - The relative brightness of adult white matter in T1-weighted MRI arises from myelin, but the mechanisms responsible remain to be clarified. Koenig et al. [Magn. Reson. Med. 14, 482 (1990)] conjectured that the cholesterol of myelin (approximately 30% of its lipid) was responsible. We present 1/T1 and magnetization transfer contrast imaging data [Wolff and Balaban, Magn. Reson. Med. 10, 135 (1989)] on a model system--50% lipid--50% water by weight, with the lipid one-half phosphatidyl choline (PC) and one-half cholesterol--and a control in which the lipid is all PC. The differences between the model and control samples mimic the myelin contribution to white matter in both experiments. PMID- 1775054 TI - Localized in vivo proton spectroscopy of the human kidney. AB - In vivo 1H spectroscopy using the STEAM sequence for localization has been applied to the human kidney in normal volunteers and subjects with successful renal transplants. We show that, within the resolution of our measurements, trimethylamines are present in the spectra from some of the subjects and absent from others. The prominent peak seen at 5.8 ppm in the spectrum is identified as that from urea and not lipid, as previously suggested. PMID- 1775055 TI - Factors in myocardial "perfusion" imaging with ultrafast MRI and Gd-DTPA administration. AB - Ultrafast magnetic resonance imaging (MRI) and first pass observation of an interstitial contrast agent are currently being used to study myocardial perfusion. Image intensity, however, is a function of several parameters, including the delivery of the contrast agent to the interstitium (coronary flow rate and diffusion into the interstitium) and the relaxation properties of the tissue (contrast agent concentration, proton exchange rates, and relative intra- and extracellular volume fractions). In this study, image intensity during gadopentetate dimeglumine (Gd-DTPA) administration with T1-weighted ultrafast MR imaging was assessed in an isolated heart preparation. With increasing Gd-DTPA concentration, the steady-state myocardial image intensity increased but the time to reach steady state remained unchanged, resulting in an increased slope of image intensity change. A range of physiologic perfusion pressures (and resulting coronary flow rates) had insignificant effects on kinetics of Gd-DTPA wash-in or steady-state image intensity, suggesting that diffusion of Gd-DTPA into the interstitium is the rate limiting step in image intensity change with this preparation. Following global ischemia and reperfusion, transmural differences in the slope of image intensity change were apparent. However, the altered steady state image intensity (due to postischemic edema) makes interpretation of this finding difficult. The studies described here demonstrate that although Gd-DTPA administration combined with ultrafast imaging may be a sensitive indicator of perfusion abnormalities, factors other than perfusion will affect image intensity. Extensive studies will be required before image intensity with this protocol is fully understood. PMID- 1775056 TI - Fucose in 1H COSY spectra of plasma membrane fragments shed from human malignant colorectal cells. AB - The methyl-methine cross peak of bound fucose has been assigned in the COSY spectrum of plasma membrane shed from human malignant colorectal cells. This cross peak (1.33-4.27 ppm), which is superimposed on the methyl-methine cross peak of threonine, was assigned following hydrolysis of the sample. Acid hydrolysis led to a 28 +/- 5% reduction in the intensity of the cross peak and the appearance of the alpha and beta forms of fucose. Chemical analysis confirmed the release of free fucose. Lactate anion, which was not perturbed by the hydrolysis, was used as an internal standard. PMID- 1775057 TI - An NMR probe to study function and metabolism simultaneously in isolated human cardiac tissue. AB - Trabeculae isolated from human atrial appendages have been used to study preservation of donor hearts for cardiac transplantation. We have developed a perifusion system equipped with a fiber optic strain gauge to study mechanical performance of human atrial trabeculae (10-20 mg) while simultaneously observing the energetic compounds by 31P NMR spectroscopy. The NMR probe consists of an eight-turn solenoid coil (2.3 mm i.d. x 5 mm length, 24-gauge wire) double tuned to allow observation of 1H and 31P nuclei. The probe and the perifusion system are temperature regulated and permit preservation studies using a variety of small muscles at low temperatures (down to 4 degrees C) as well as at physiological temperature (37 degrees C). 31P NMR spectra suitable for quantification can be obtained from approximately 10 mg of human atrial trabeculae in 15 min. Spectra of 8- to 12-mg mouse extensor digitalis longus or soleus muscle can be obtained in less than 10 min. PMID- 1775058 TI - Magnetic resonance imaging of lipid deposits in human atheroma via a stimulated echo diffusion-weighted technique. AB - NMR images of subintimal lipid deposits within the vessel walls of atherosclerotic human aortas were obtained at 37 and 27 degrees C at 4.7 T. A combination of a stimulated-echo and pulsed-field gradients was used for suppressing the mobile tissue water relative to the less mobile tissue lipids. At 27 degrees C there was also a substantial reduction of the subintimal lipid signal intensity, which is consistent with the characteristic phase transition of cholesteryl esters in human atheroma. These results represent the first direct detection of lipid deposits in nonprotruding atherosclerotic lesions with NMR imaging. PMID- 1775059 TI - 13C NMR visibility of rabbit muscle glycogen in vivo. AB - The integrated 13C NMR intensity of the glycogen C1 resonance was measured in skeletal muscle (biceps femoris region) of nine rabbits under in vivo conditions. Concurrent chemical determinations of glycogen content showed that the in vivo signal was 1.02 +/- 0.06 the intensity of analytical samples, where glycogen is known to be approximately 100% visible. PMID- 1775060 TI - Use of high temperature superconductor in a receiver coil for magnetic resonance imaging. AB - A planar YBa2Cu3Ox (YBCO) coil has been used as a pick-up coil in a nuclear magnetic resonance imager. It was found that the quality factor (Q) of the YBCO coil was greater than its copper counterpart by approaching 50% even in a field of 0.15 T. The Q of the copper coil at 77 K and in a field of 0.15 T was 1200 while that of the YBCO coil under identical conditions was 1700. PMID- 1775061 TI - GRASE (Gradient- and spin-echo) imaging: a novel fast MRI technique. AB - A fast multi-section MR imaging technique is described. Gradient- and spin-echo (GRASE) imaging utilizes the speed advantages of gradient refocusing while overcoming the image artifacts arising from static field inhomogeneity and chemical shift. Image contrast is determined by the T2 contrast in the Hahn spin echoes. A novel k-space trajectory temporally modulates signals and demodulates artifacts. PMID- 1775062 TI - Evolutionary rate of immunoglobulin alpha noncoding region is greater in hominoids than in Old World monkeys. AB - Recent studies on the molecular evolution of primates show that the evolutionary rate among hominoids is considerably slower than that among nonhominoid primates. However, this observation at the nucleotide-sequence level is restricted to the beta-globin family region. In this study, we sequenced orthologous immunoglobulin alpha (C alpha) genes of chimpanzee, gorilla, orangutan, and crab-eating macaque (an Old World monkey) and compared them with that of the human by using noncoding regions for analysis. Since significant differences in rates among hominoids were not found by using the relative rate test, we evaluated the ratio (R) of the evolutionary distance between Old World monkey and human to the distance between orangutan and human. The R value (1.12) for the C alpha gene was much smaller than the expected value (1.38-2.33), showing that the nucleotide substitution rate (= mutation rate per year under selective neutrality) of the C alpha gene is greater in the human lineage than in the Old World monkey lineage. We also did a similar analysis for the gamma 1-, gamma 2-, psi eta-, and delta-globin genes and found a considerable heterogeneity (1.12-2.37) among the R values, including that for the C alpha gene. This indicates that the hominoid slowdown of the evolutionary rate is not a universal phenomenon in primate evolution. PMID- 1775063 TI - MHC class II genes of a marsupial, the red-necked wallaby (Macropus rufogriseus): identification of new gene families. AB - In placental mammals, the class II region of the major histocompatibility complex (Mhc) consists of several gene families which show orthologous relationships in the different species. As these families are not orthologous with the Mhc class II beta-chain-encoding gene families of birds, the different mammalian families must have diverged after the separation of birds and mammals approximately 250 Mya but before the radiation of placental mammals (60-80 Mya). To obtain further information about the origin of the class II genes in mammals, we studied the beta-chain-encoding genes of the wallaby as a representative of marsupials, which split from placental mammals approximately 125 Mya. Three beta-chain-encoding genes were isolated from a red-necked wallaby (Macropus rufogriseus) cDNA library by using a chimpanzee DRB probe, and their nucleotide sequences were determined. The genes are not orthologous to any of the genes in mammals studied thus far but belong to two new families which we designated Maru-DAB and Maru-DBB. One of the three sequences (DAB2) seems to be derived from a transcribed pseudogene; it lacks the codons specifying the first 51 amino acid residues of the beta 2 domain. The fact that the DAB and DBB families have thus far not been found in placental mammals and that none of the DOB, DPB, DQB, or DRB genes seems to be expressed in the one representative marsupial species can be interpreted as suggesting that class II gene families of eutherian and metatherian mammals evolved from different ancestral genes. PMID- 1775064 TI - Phylogenetic relationships and biogeography of xantusiid lizards, inferred from mitochondrial DNA sequences. AB - Portions of two mitochondrial genes (12S ribosomal RNA and cytochrome b) were sequenced in seven species to examine phylogenetic relationships within the lizard family Xantusiidae. Phylogenies derived from these sequences (709 total bp) are concordant and indicate that the Cuban species Cricosaura typica is the sister group to all other xantusiids. The Middle American genus Lepidophyma is the closest relative of Xantusia, and X. riversiana (California Islands) the closest relative of X. vigilis (mainland). These findings are not in agreement either with the results of a recent morphological analysis that united Cricosaura and Lepidophyma as closest relatives or with past studies that have recognized X. riversiana as a separate genus. Levels of sequence divergence, as well as the age and affinities of some mainland fossil taxa, suggest that the origin of Cricosaura was associated with the tectonic evolution of the Greater Antilles in the late Cretaceous. These results further demonstrate that significant resolution of phylogenies can be obtained with relatively short DNA sequences and that these mitochondrial genes are concordant in their estimation of phylogeny. PMID- 1775066 TI - Molecular phylogeny of plethodonine salamanders and hylid frogs: statistical analysis of protein comparisons. AB - The bootstrapping method of determining confidence in the topology of phylogenetic trees has been applied to electrophoretic protein data for two groups of amphibians: salamanders of two North American genera (Aneides and Plethodon) of the tribe Plethodontini and Holarctic hylid frogs. Some current methods of phylogenetic reconstruction for electrophoretic protein data have been evaluated by comparing the trees obtained from molecular data sets with available morphological data. Molecular data on the phylogenetic relationships of Aneides and Plethodon, data obtained from electrophoretic and immunological studies, indicate that Aneides probably was derived from western Plethodon subsequent to the separation of eastern and western Plethodon. Thus Plethodon very likely is a paraphyletic genus. The extremely low rate of morphological evolution in Plethodon compared with that in Aneides causes difficulty in indicating their evolutionary relationships taxonomically because there are no synapomorphic morphological characters that define either eastern or western Plethodon, whereas there are several for the genus Aneides. Thus molecular data alone probably indicate the evolutionary relationships of the species in these genera. Highton and Larson's (1979) arrangement of species of Plethodon into eight species groups is supported. The topologies of the unweighted pair-group method using arithmetic means (UPGMA) and distance Wagner trees were compared with independent morphological and molecular data on the relationships of the 28 plethodonine species. It was found that UPGMA trees indicate relationships that are more in agreement with other information than are those provided by distance Wagner trees. The use of the bootstrap technique indicates that the topologies of UPGMA trees are better supported statistically than are the topologies of distance Wagner trees. Moreover, different addition criteria produce a variety of distance Wagner trees with different topologies, each with several groupings that are not supported statistically. It is concluded that considerable caution should be used in interpreting the topology of distance Wagner trees. Very similar results were obtained with a second data set on 30 taxa of Holarctic hylid frogs. Trees obtained by the neighbor-joining method are more in agreement with UPGMA phenograms and other data, so this method of phylogenetic reconstruction may be useful to systematists not willing to assume constant rates of evolution.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1775065 TI - Comparison of the bindin proteins of Strongylocentrotus franciscanus, S. purpuratus, and Lytechinus variegatus: sequences involved in the species specificity of fertilization. AB - Bindin is the sea urchin sperm acrosomal protein that is responsible for the species-specific adhesion of the sperm to the egg. Two new bindin cDNA sequences that contain the entire open reading frame for the binding precursor are reported: one for Strongylocentrotus franciscanus and one for Lytechinus variegatus. Both contain inverted repetitive sequences in their 3' untranslated regions, and the S. franciscanus cDNA contains an inverted repetitive sequence match between the 5' untranslated region and the coding region. The middle third of the mature bindin sequence is highly conserved in all three species, and the flanking sequences share short repeated sequences that vary in number between the species. Cross-fertilization data are reported for the species S. purpuratus, S. franciscanus, L. variegatus, and L. pictus. A barrier to cross-fertilization exists between the sympatric Strongylocentrotus species, but there is no barrier between the allopatric Lytechinus species. PMID- 1775067 TI - The structure of the Adh locus of Drosophila mettleri: an intermediate in the evolution of the Adh locus in the repleta group of Drosophila. AB - Members of species of the mulleri and hydei subgroups of the repleta group of Drosophila have duplicate Adh genes. The Adh regions of D. mojavensis, D. mulleri, and D. hydei contain three genes--a pseudogene, Adh-2, and Adh-1- arranged 5' to 3'. To understand the evolution of the triplicate Adh structure, we have cloned and sequenced the Adh locus of D. mettleri. This region consists of a 5' pseudogene and a 3' functional Adh gene. On the basis of the structure and nucleotide sequence comparisons of Adh genes of D. mettleri and other species, we propose that an initial duplication of the ancestral Adh gene generated two Adh genes arranged in tandem. The more 5' Adh gene became a pseudogene, while the more 3' gene remained functional through all the developmental stages. A second duplication of this 3' gene resulted in Adh regions with three genes--a pseudogene, Adh-2, and Adh-1. PMID- 1775068 TI - High fidelity of the polymerase chain reaction. PMID- 1775069 TI - Pancreatic polypeptide and the sister group of birds. PMID- 1775070 TI - Monophyly/paraphyly/polyphyly and gene/species trees: an example from Drosophila. PMID- 1775071 TI - The study and teaching of ethics for persons with mental retardation. PMID- 1775072 TI - States' definitions and procedures for identifying children with mental retardation: comparison over nine years. AB - Results of a survey of state departments of public instruction regarding eligibility criteria for the identification of children with mental retardation were reported and compared to those obtained in a review of state guidelines in 1981-1982 and 1985-1986. Results indicated that states continue to vary widely in their definitions and procedures for identifying children with mental retardation. However, over the 9 years covered by the study, more and more states mentioned or specified each of the following types of assessments: IQ, adaptive behavior, and academic achievement. PMID- 1775073 TI - Predictors of urgency of out-of-home placement needs. AB - A random sample of 137 families from an out-of-home placement waiting list were surveyed through structured face-to-face interviews with the primary caregivers. Our purposes were to identify predictors of urgency of a family's placement need and obtain information about needed support services, which might help to maintain the person at home. A hierarchical regression analysis was calculated with caregiver stressors and behavior problems as independent variables and the urgency of out-of-home placement need as the dependent variable. Only caregiver stress variables emerged as a significant predictor. PMID- 1775074 TI - Analysis of minority-status supported employees in relation to placement approach and selected outcomes. AB - The employment outcomes of nonminority and minority-status supported employees in the state of Illinois were examined. Results indicated that minority-status supported employees were younger, had higher IQs, and earned more wages per month than did nonminority supported employees. Few differences between minority subgroups were identified. PMID- 1775075 TI - Establishing mental retardation in capital cases: a potential matter of life and death. AB - Psychological test obstacles to gaining the acceptance of a diagnosis of mental retardation in criminal defendants was described, and the use of the Revised Beta intelligence test with defendants who may be retarded was questioned. A possible modification of the adaptive behavior criterion for criminal defendants was suggested, and some thoughts on the appropriateness of the death penalty for persons with mental retardation were offered. PMID- 1775076 TI - Evaluation of family support services: changes in availability and accessibility. AB - Changes in availability and accessibility of family support services were studied by surveying county mental health authorities in Michigan before and after the implementation of new policy on and funding for such programs. An overall increase in the availability of family support services was found. Access to services as measured by length of time families waited for services remained unchanged following the increase in funds. Policy and funding implications of the study were discussed. PMID- 1775077 TI - Pain insensitivity and indifference: alternative explanations for some medical catastrophes. AB - Communication difficulties are a commonly cited barrier to health-care provision for individuals with developmental disabilities. However, an examination of the medical and psychological literature on pain suggests that alternative explanations for some instances of medical catastrophe are pain insensitivity or pain indifference. Although the proportion of case studies of pain-absent individuals who also have developmental disabilities is much higher than would be expected given the size of this subpopulation, proper incidence studies have not been conducted. Reinterpretation of a study on intestinal obstruction-caused mortality suggests that there is a pressing need for such incidence studies. PMID- 1775078 TI - Blood magnesium levels in a mentally retarded/developmentally disabled seizure population. AB - Blood magnesium levels from a mentally retarded/developmentally disabled population with difficult to control seizure disorders were presented. The role of low blood magnesium with regard to seizure activity and its causes was discussed. PMID- 1775079 TI - Trends in classification usage in the mental retardation literature. AB - Trends in classification usage were analyzed through examination of all issues of Mental Retardation, American Journal of Mental Deficiency, and American Journal on Mental Retardation from 1980 through 1989. The research was undertaken to determine whether the recommendations by Taylor (1980) and MacMillan, Meyers, and Morrison (1980) regarding subject description had been implemented. Results indicated that the system of the American Association on Mental Retardation (previously the American Association on Mental Deficiency) was used in over 50% of the articles, whereas the American Educators system was used in only 10%. A further analysis regarding the use of various classification systems as a function of the age of the subjects was also conducted. Implications of these results were discussed. PMID- 1775080 TI - Endometrial morphology after 12 months of vaginal oestriol therapy in post menopausal women. AB - The endometrial effect of long-term vaginal oestriol (E3) therapy for urogenital atrophy was assessed in 23 post-menopausal women. Hysteroscopic and histological examinations were performed in each patient to assess endometrial atrophy before treatment and after 6 and 12 months of therapy (0.5 mg vaginal E3 for 21 days, then 0.5 mg twice weekly). The primary atrophic picture was confirmed at the end of the 6th month in all but one of the patients. In one case, the histology showed an abnormal stromal reaction with no epithelial alterations. Treatment was continued and after the 12th month complete atrophy was confirmed both hysteroscopically and histologically in all patients. Efficacy as regards vaginal and urogenital complaints was good. Our results demonstrate that in women with endometrial atrophy effective and well-tolerated treatment with vaginal E3 can be safely continued for up to 12 months. PMID- 1775081 TI - Transdermal oestrogen replacement therapy in a Finnish population. AB - In an open, multicentre study, transdermal administration of oestradiol (E2) by means of skin patches was investigated in a Finnish patient population suffering from typical post-menopausal symptoms. A total of 249 women applied a patch twice weekly for 6 months. Whereas 85% of the subjects were experiencing hot flushes and 83.5% sweating before therapy, only 5.7% and 11.8%, respectively, reported these symptoms at the end of the trial. Furthermore, 97.6%, 95.7% and 94.8% of the subjects reported that depression, headache and sleep disturbances, respectively, had disappeared during therapy. Skin irritation occurred in 18.2% of these predominantly fair-skinned women. Frequent sauna bathing did not interfere with the patch therapy. General acceptance of the treatment was excellent, 84.8% of the patients completing the treatment, of whom 78% were willing to continue the treatment after the trial. These results show that transdermal administration of E2 is effective in relieving post-menopausal symptoms. Local tolerability was good and the majority of the patients considered the transdermal treatment to be superior to their previous oral replacement therapy. PMID- 1775082 TI - Neuroendocrine and clinical effects of transdermal 17 beta-estradiol in postmenopausal women. AB - The neuroendocrine and clinical effects of transdermal 17 beta-estradiol (rated at 50 micrograms/day; TTS 50) were studied in 40 postmenopausal women; ten additional postmenopausal women did not receive any drugs. The changes in LH and rectal temperature induced by the infusion of the opioid antagonist naloxone (10 mg i.v. bolus plus 10 mg/h for 4 h) were used to evaluate the central activity of endogenous opioid peptides. TTS 50 increased opioid activity, as evidenced by the restoration of the LH response (P less than 0.01) and the enhancement of the hypothermic effect (P less than 0.05) of naloxone. A greater reduction in hot flushes was observed in TTS 50-treated subjects than in untreated women, with the maximal effect of TTS 50 achieved after 3 months of therapy. TTS 50 did not modify the concentrations of circulating lipids, glucose or liver enzymes but reduced the biochemical parameters indicative of bone reabsorption. Bone density of the distal radius significantly increased during TTS 50 (P less than 0.02), reaching its maximum value after 6 months of therapy. Thereafter bone density declined, but more slowly than in untreated women. Our data suggest that TTS 50 has marked neuroendocrine effects, that it diminishes the incidence of hot flushes and reduces bone demineralization. By contrast, it has a very little, if any, metabolic impact on the liver or on glucose and lipid metabolism. PMID- 1775083 TI - Nasally-administered progesterone: comparison of ointment and spray formulations. AB - The aim of the study was to compare the bioavailability and clinical usefulness of progesterone (P) administered nasally in spray or ointment form. Twenty healthy post-menopausal women were randomly allocated to treatment by either intranasal spray (4 doses of an oil-based P solution at a concentration of 2 mg/0.1 ml, corresponding to a total dose of approximately 11 mg of P) or an ointment (quantity 0.1 ml, P concentration 20 mg/0.1 ml). Circulating P levels were calculated at various time intervals following administration. The spray formulation yielded a mean maximum concentration (CMax) of 3.75 ng/ml after 60 min (TMax) and the area under the curve (AUC) 0-720 min was 1481.6 +/- 343 ng.h/ml. The ointment yielded a mean CMax of 1.19 ng/ml at TMax = 30 min, the AUC 0-720 value being 404.35 +/- 148 ng.h/ml. The study findings confirmed that the intranasal route is a potentially useful alternative for the administration of natural sex steroid hormones, making it possible to avoid first-pass liver metabolism. P administered by spray showed greater bioavailability than it did when administered in ointment form, while both formulations seemed to be acceptable to patients and were probably clinically safe. PMID- 1775084 TI - Endogenous factors affecting bone mineral content in post-menopausal women. AB - Eighty-eight healthy post-menopausal women were divided into two groups, one of 35 subjects who had undergone menopause up to 9 years previously and the second of 53 subjects who were 10 or more years post-menopausal. In each individual we related the bone mineral content (BMC), measured by single photon absorptiometry in the distal forearm, to anthropometric variables and urinary oestrogen excretion. There was a positive association between BMC and both urinary oestrogen excretion and anthropometric variables, but this was statistically significant only in the older women. As expected, BMC in the distal forearm decreased with advancing age, the fall being greatest in the first 9 years after the menopause. We concluded that although a single measurement of urinary oestrogen and anthropometric variables does not provide enough information to predict an individual's BMC, the values obtained may prove of use, along with a single BMC determination, in helping to predict the rate of bone loss. PMID- 1775085 TI - How do androgens affect episodic gonadotrophin secretion in postmenopausal women? AB - In the absence of any significant ovarian oestrogen secretion, as in post menopausal women, the hypothalamic-pituitary axis may still be influenced by the androgens which continue to be produced. The episodic secretion of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) by postmenopausal women was accordingly assessed following short-term androgen antagonism induced by flutamide, a specific androgen receptor blocker. Blood samples were collected at 10-min intervals for 10 h in nine women before and during flutamide administration (750 mg/day for 6 days) for the determination of gonadotrophin and sex hormone concentrations by radioimmunoassay. On both occasions, 25 micrograms of gonadotrophin-releasing-hormone (GnRH) was injected intravenously 8 h after initiation of the blood collections. Flutamide administration decreased (P less than 0.01 or less) androgen concentrations (testosterone, androstenedione and dehydroepiandrosterone sulphate) in relation to baseline values, but did not alter oestrogen (oestrone and oestradiol) or sex-hormone-binding globulin levels. The LH and FSH pulse characteristics (frequency, amplitude, interpulse interval and transverse mean levels) determined by a cluster algorithm in the gonadotrophin secretory profiles did not differ before and during androgen blockade. By contrast, androgen antagonism increased LH (P less than 0.01) and tended to enhance FSH (P = 0.10) FSH release in response to GnRH stimulation. Hence, short-term androgen receptor blockade with flutamide did not greatly affect episodic gonadotrophin secretion. However, the combined evidence of the enhanced gonadotrophin release observed in response to GnRH stimulation and the unchanged gonadotrophin secretion during androgen antagonism suggests that alterations in the magnitude, but not the frequency, of hypothalamic GnRH release had occurred. Even in the presence of substantial serum androgen concentrations, the gonadotrophin pulse rhythm in hypogonadal women constitutes the maximal-rate GnRH-LH release pattern. PMID- 1775086 TI - Screening of HBV-DNA in chronic HBsAg carriers. AB - A series of 52 serum samples from chronic HBsAg carriers was tested for the presence of HBV-DNA by means of the Polymerase Chain Reaction (PCR) and Liquid Phase Hybridization (LPH). The samples were obtained from two groups of patients: group A included 34 chronic HBsAg carriers ("healthy" individuals) without hepatocytolysis or viral replication; group B included 18 chronic HBsAg carriers with signs of hepatocytolysis (ALT levels at least twice the normal value) and activated markers of viral replication. PCR was superior to LPH in group A, with 7/34 versus 5/34 positive samples being detected, respectively. No difference in sensitivity was found between the two techniques in group B, since 9/18 samples were positive both cases. The data stress the need to adopt PCR for the HBV-DNA screening of HBeAg-/HBsAg+-carriers. PMID- 1775087 TI - Biological effects of Veillonella parvula and Bacteroides intermedius lipopolysaccharides. AB - A comparative study on the endotoxic effects of lipopolysaccharide (LPS) from Veillonella parvula ATCC 10790 and from Bacteroides intermedius BMH was performed using an in vivo approach in the C57BL/6 mouse. Phenol-water extracted LPS of such anaerobes was purified by ultracentrifugation and DNase/RNase digestion, and characterized by a metachromatic assay for endotoxins and by electrophoresis on SDS-polyacrylamide gel and silver staining. Mouse LD50 for V. parvula LPS was 1.479 mg and for B. intermedius greater than 3.160 mg. Sublethal amounts of the LPS from anaerobes as well as from facultative aerobes decreased daily water intake and body weight in the mouse. Endotoxin from Salmonella typhimurium SL1102, Escherichia coli 0128:B12 and V. parvula had a strong effect on water intake and body weight, whereas Bacteroides intermedius LPS activity was very weak. The results of the present report suggest that V. parvula LPS has a toxic in vivo activity on mouse, which is comparable to LPS from classic enteric organisms and stronger than B. intermedius LPS. PMID- 1775089 TI - Meningococcal disease in Italy in 1990. AB - The incidence of meningococcal disease in Italy in 1990 was 0.5/100,000 in the general population and 0.7/100,000 in army recruits. The highest proportion of cases (32%) was seen in subjects 1-4 years old. The sex ratio was 1.0 Serogroup B constituted 72% of the isolates; 16% belonged to group A and 12% belonged to group C. The proportion of strains resistant to suphonamides was 56%, while no strain was resistant to minocycline or rifampicin. Two secondary cases, but no comprimary cases occurred among civilians. The predominance of serogroup B and the further decline in military cases constitute the findings of major interest. PMID- 1775088 TI - Low responsiveness to Candida antigens in kidney transplant recipients. AB - Infections caused by commensal microorganisms, such as Candida albicans often represent a severe complication in pharmacologically immunosuppressed kidney transplanted patients. A mannoprotein (MP) antigenic preparation derived from the C. albicans cell wall was used to measure the specific immune responsiveness in 44 kidney transplanted patients and matched healthy controls. Patients immune responses were analyzed considering the transplant age. In group I, patients transplanted from greater than 1 month to less than 12 months were considered, whereas in groups II and III patients had been transplanted 1 to 3 years or 4 to 6 years earlier. A statistically significant low responsiveness to MP was recorded in peripheral blood mononuclear cells (PBMC) from patients belonging to groups II and III. Addition of exogenous IL-2 to PBMC cultures restored MP induced proliferation in about 50% of patients studied. Responsiveness to mitogenic stimulation (PHA and SEB) was in the normal range in all transplanted patients. No correlation could be detected between hyporesponsiveness to MP and C. albicans infections. PMID- 1775090 TI - Seroepidemiology of HIV infection: an early survey in a peripheral area of Uganda. AB - At the end of 1985, when the AIDS epidemic was in its early stages in Uganda, a survey was carried out in a peripheral area of the country. Sera were collected from groups of people, and examined for the presence of HIV infection. The results show a very limited number of positive cases, present only among sexually active subjects. High specificity and sensitivity in the laboratory tests was shown by the Western blot technique. PMID- 1775092 TI - Defective insertion of haemagglutinin as a cause of abortivity of influenza A viruses in HeLa 229 cells. AB - A number of experimental data demonstrate that certain mammalian cells are unable to replicate Influenza viruses type A. In these cellular hosts the viruses can efficiently perform their biological as well as biochemical activities but the production of mature viral particles is greatly restricted. Here we report a study of abortiveness of human and avian type A Influenza viruses in HeLa 229 cells in which the final stages of maturation of viral particles seem to be affected. We show that the incorrect insertion of virus-coded haemagglutinin into the plasma membrane might be the cause of the unpermissive condition of infection exhibited by this cellular host. PMID- 1775091 TI - Evaluation of vaginal microflora in patients infected with HIV. AB - HIV infection is thought to exacerbate the virulence of normal saprophytic vaginal microflora. We studied the vaginal ecosystem of HIV patients to detect the quantitative and qualitative variation of vaginal microorganisms. 15 patients (5 with AIDS and 10 with ARC) were investigated. Vaginal candidiasis was more frequent in this group than in the control groups. Gardnerella was present in 60% of patients generally in association with anaerobic bacteria and Mycoplasma. Among anaerobia, Bacteroides sp and other Gram-negative rods were the most common bacteria. Neisseria gonorrhoeae was absent in all patients tested. Chlamydia trachomatis was recovered in two out of the 15 HIV-positive patients. Aerobic Gram-negative flora was 100-fold that of the control group and anaerobic Gram negative flora 10-fold. PMID- 1775093 TI - Exfoliative toxin production by Staphylococcus aureus strains isolated from animals and human beings in Nigeria. AB - Strains of Staphylococcus aureus isolated from lesions and apparently healthy animals, human diarrhoea and wounds in Nigeria were phage typed and tested for exfoliative toxin (ET) production using the modified Ouchterlony double diffusion test. Thirty-four (4.0%) of 860 strains tested produced exfoliative toxins A (ETA), B (ETB) or a combination. ETA was produced singly by 91.1% of the toxigenic strains. Twenty-six (3.9%) of 666 animal strains were toxigenic compared to 8 (4.4%) of 194 strains from human beings. Overall, a majority of ET producing strains were non-typable (58.8%), followed by phage group II strains (17.7%). The detection of a similar frequency of production of ET by strains of S. aureus from animals and non-scalded skin syndrome cases indicates that animals may serve as a reservoir for human infection. PMID- 1775094 TI - Production of xylanase by Verticillium dahliae. AB - Xylan induced the production of xylanase by Verticillium dahliae. Other cellulolytic enzymes such as glucanase and beta-glucosidase were synthesized in smaller quantities. The process of degradation indicated that xylanase behaved like a typical endo-enzyme causing first production of high mol, wt. products, and indicated that V. dahliae produced at least three enzymes which degrade xylan. PMID- 1775095 TI - Toxin profiles, and cell-surface properties of Salmonella strains isolated from Swedish travelers. AB - Toxin production, cell-surface hydrophobicity and fibronectin-binding properties of 21 Salmonella strains of different species, isolated from Swedish travelers to different parts of the world, were studied. Cell sonicate supernatants from blood agar grown cultures of 80% of the strains induced rabbit skin permeability reaction in the form of induration and/or blueing while 33% of the strains also produced cell necrotizing factor on rabbit skin. Four strains were negative in the rabbit skin permeability test, while only two were negative when tested on CHO cells. When cultured on blood agar, a majority of the strains (17/21) showed low cell-surface hydrophobicity, showing no aggregation even at 1.5 M ammonium sulfate concentration in salt aggregation test (SAT), while only four strains showed high cell-surface hydrophobicity. Furthermore, these strains could be classified as low fibronectin binders due to their poor interaction with fibronectin or its 29 kDa N-terminal fragment. PMID- 1775096 TI - Distribution of Plesiomonas shigelloides in various components of pond ecosystems in Dhaka, Bangladesh. AB - Plesiomonas shigelloides is considered to be a waterborne agent of human gastroenteritis. An ecological study was carried out in five ponds in Dhaka city over a period of one year to elucidate the distribution and seasonality of this organism in various components of pond ecosystems. Samples were collected from hydrophytes, water, phytoplankton and sediment every 15 days over 12 months and cultured for P. shigelloides. P. shigelloides was isolated from a total of 120 samples including 25 (20.8%), 16 (13.3%), 22 (18.3%) and 35 (29.2%) of hydrophytes, water, phytoplankton and sediment samples, respectively. Distinct seasonal patterns of isolation of P. shigelloides were observed in the four components with two distinct peaks. The highest peaks were observed in hydrophytes and water samples in May and in phytoplankton and sediment in November. P. shigelloides was isolated from all components from all ponds during the study period. These results suggest that P. shigelloides is an autochthonous member in the freshwater pond ecosystems in Dhaka, Bangladesh. PMID- 1775097 TI - Platelet aggregation by strains of enterococci. AB - The platelet aggregation capability of whole cells of Enterococcus faecalis, E. faecium and E. avium was tested. The optimum ratios of bacteria to platelets in E. faecalis (strain SMU-37), E. faecium (strain SMU-138) and E. avium (strain SMU 197) were 1.0, 1.2 and 2.0, respectively. During the platelet aggregation induced by the three strains of enterococci, 65-69% of total serotonin was released. The aggregation was totally inhibited by ethylenediaminetetraacetate (10 mM) and apyrase (1 mg/ml), while no effect was shown by aspirin (10 mM), indomethacin (10 mM) and quinacrine (1 mM). By pretreatment of platelet-poor plasma with heat (56 C, 30 min) or zymosan, the reactivities with platelets of each strain of species were markedly diminished. These results suggest that enterococci-induced platelet aggregation was an ion-dependent, cyclooxygenase-insensitive event, and plasma component(s) was (were) required for the reaction. PMID- 1775098 TI - New enzyme immunoassays for specific assay and general detection of Trypanosoma cruzi, epimastigotes. AB - A highly specific competitive enzyme-linked immunosorbent assay for the epimastigote of Tulahuen strain was developed by using the usual 3 immunological reagents, a rabbit antiserum specific for T. cruzi, epimastigote of Tulahuen strain, beta-D-galactosidase-labeled goat anti-rabbit immunoglobulin G and the solid-phase cell fragments of the epimastigote of Tulahuen strain. A new method, the selected antibody enzyme immunoassay (SAEIA) which generally detected all strains of the epimastigote tested with the same working range, was developed by changing only the solid-phase antigen to the epimastigote of Y strain among the 3 immunological reagents. Both assays permitted us to measure accurately as little as 1,000 parasites per assay tube. Scope of the SAEIA was limited to the epimastigote. Both life-cycle forms of T. cruzi which appear in mammals, amastigote and trypomastigote, and other kinetoplastids showed low cross-reaction values by the assay. The assay principle of the new method and a preliminary study to apply the SAEIA for finding the field T. cruzi-infected insect vectors were also reported. PMID- 1775099 TI - Natural killer (NK) cell activating factor produced by a human T-cell hybridoma. AB - A human T-cell hybridoma (KC8-1.10), whose culture supernatant augments peripheral blood lymphocytes (PBL)-mediated spontaneous cytotoxicity against K562 cells, was established. This activity [natural killer (NK) cell activating activity] appears to be not due to interferon-gamma (IFN-gamma) and interleukin-2 (IL-2) for the following reasons: 1) KC8-1.10 produced negligible or small amounts of IFNs and IL-2. 2) The NK cell activating activity in the KC8-1.10 culture supernatant was not neutralized by anti-IFN-gamma antiserum and stable even after pH 2 treatment for 24 hr, which is known to destroy IFN-gamma activity. 3) IL-2-dependent cell line absorbed IL-2 more efficiently than it absorbed the NK cell activating activity, and the latter activity was not retained by Blue Sepharose column in contrast with IL-2. The NK cell activating factor in the KC8-1.10 culture supernatant appears to be a glycoprotein, because the activity was abolished with pronase treatment or with boiling for 5 min and because the activity was retained by concanavalin A- and Pisum sativum agglutinin agarose. Finally it was found that the NK cell activating activity requires Leu 11b+ cells to exert its effect. PMID- 1775100 TI - Metabolism and nutrition in the burned patient. PMID- 1775101 TI - Nutritional monitoring of a pediatric burn patient. AB - The pediatric burn patient presents a particular challenge nutritionally. Nutritional reserves are limited, and excesses are often poorly tolerated. Ongoing monitoring is essential for discovering at an early stage the dynamic shifts in energy, protein, and other nutrients that may be occurring. Adequate enteral intake may be difficult to achieve as a result of repeated holding of feedings on surgery days and gastrointestinal tolerance problems such as poor gastric emptying and abdominal distention. This case report illustrates techniques, such as the nutritional assessment record and parenteral nutrition evaluation form, which may assist the clinician in optimizing the nutritional management of the patient. PMID- 1775103 TI - New food labeling requirements get congressional and presidential approval. PMID- 1775102 TI - Toxic epidermal necrolysis. AB - Toxic epidermal necrolysis is a rapidly progressive dermatologic condition associated with high mortality. Several factors have been implicated in the development of toxic epidermal necrolysis including drugs, vaccinations, infections, and neoplasia. Toxic epidermal necrolysis therapy has been compared with partial-thickness burn injury treatment. The absence of burned tissue can dampen fluid requirements and metabolic needs of toxic epidermal necrolysis in comparison to equivalent burn injury. In the following case report, a 69-year-old woman with multiple medical problems developed toxic epidermal necrolysis after treatment with metolazone and phenytoin. Her measured energy expenditure (3360 kcal) was considerably higher than previously reported caloric expenditure in toxic epidermal necrolysis patients (2500 kcal). PMID- 1775104 TI - Technique for intraduodenal placement of transnasal enteral feeding catheters. AB - Timely initiation of enteral feeding requires efficient placement of nasoenteric feeding tubes. It is generally agreed that postpyloric placement of feeding tubes reduces the risk of regurgitation and aspiration of feeding formulas. The authors describe a simple, economic method of achieving postpyloric placement of feeding tubes in most patients. PMID- 1775105 TI - Nutrition for adult burn patients: a review. AB - Adequate nutritional support is an important aspect of burn therapy. To accomplish this goal, nutrition assessment must be conducted, with particular attention given to the determination of energy and macronutrient needs. Providing these nutrients by the enteral route is recommended. PMID- 1775106 TI - Nutrition support and quality management: a valuable opportunity. PMID- 1775107 TI - Quality of care concepts and nutrition support. AB - The Joint Commission on Accreditation of Healthcare Organizations' (JCAHO) Agenda for Change has refocused and redefined quality monitoring in health care. The JCAHO has operationalized these new concepts of quality monitoring and evaluation by means of a 10-step process that includes the development of clinical indicators. Theoretical frameworks for the 10-step process were drawn from the work of theorists whose applications of quality-monitoring methods occurred in business and industry. An enhanced understanding of the current JCAHO definitions of quality and processes for quality measurement will help practitioners prepare for future accreditation surveys. A review of quality monitoring and evaluation activities in nutrition support has demonstrated a need for more published accounts to document these important activities. PMID- 1775108 TI - Quality assurance for a nutritional support service. AB - Quality assurance programs may significantly influence patient care by providing a systematic mechanism of self-assessment. An effective program should improve the level of care and have a positive effect on the fiscal base of a health care institution. The design of a useful quality assurance program is not a trivial matter. This report describes the details of a functioning quality assurance program developed for a multidisciplinary nutrition support service. The effect that such a program may have on patient care is also illustrated. PMID- 1775109 TI - A nutrition support team quality assurance plan. AB - The Nutrition Support Team at the Veterans Affairs Medical Center is responsible for the development of guidelines related to the provision of both total parenteral nutrition and enteral nutrition support. A Quality Assurance plan which was approved by the Joint Commission on Accreditation of HealthCare Organizations was implemented by the Nutrition Support Team. This plan addresses: nutritional assessment and consultation, indications for enteral and parenteral nutrition support, provision of optimal nutrition support including attainment of nutritional goals, and the prevention, detection, and management of complications. The indicators and criteria for each aspect of care are described. This program has provided documentation of the activities of the Nutrition Support Team as well as data defining the patient population requiring specialized nutrition support, and has helped identify areas where improvement is required. PMID- 1775110 TI - Collecting data for clinical indicators. AB - The Joint Commission for Accreditation of Healthcare Organizations is currently testing clinical indicators that will become an important part of hospital quality assurance programs. Implementation of clinical indicators may necessitate more extensive data collection than is now being done. This article reviews important considerations in the development of a data collection system that facilitates the evaluation of indicators of clinical performance. The evolution of the system currently used by the Nutritional Support Service at Pennsylvania Hospital is provided. PMID- 1775111 TI - National nutrition screening consensus reached. PMID- 1775112 TI - Having the "right stuff" for doing research. PMID- 1775113 TI - Getting started in clinical nutrition research. AB - Conducting nutrition research projects does not require a large, well-funded laboratory and a team of assistants. The main requirement is an inquisitive, creative, and critical mind face to face with an unsolved problem. Nevertheless, the actual process of getting started in clinical nutrition research can present obstacles for the novice clinician that can impede successful implementation and completion of the project. This article reviews the initial steps involved in generating a hypothesis, study design, and preliminary data analysis. PMID- 1775114 TI - A historical perspective and review of the safety of lipid emulsion in pregnancy. AB - Total parenteral nutrition for pregnant patients is essential to maintain or restore optimal nutritional status for both the mother and fetus when adequate protein and caloric intake by the oral or enteral route is not feasible. This report reviews the safety of intravenous lipid emulsions in total parenteral nutrition programs for pregnant patients. Controversy regarding the adverse effects of intravenous lipid emulsion when administered to pregnant patients is based on early reports of the use of cottonseed oil lipid emulsions. The adverse effects reported included infarction of the placenta, ketonemia, increased myometrial activity, and induction of labor. In 32 subsequent case reports in which soybean oil- or soybean/safflower oil-based emulsions were used in total parenteral nutrition programs for pregnant patients, there was no relationship apparent between onset of labor and harmful maternal or fetal effects associated with the administration of lipid emulsion. It appears that the currently available soybean and soybean/safflower lipid-based emulsions can be safely administered to pregnant patients. PMID- 1775115 TI - Total parenteral nutrition in a premature rhinoceros calf. AB - A female black rhinoceros calf developed significant hypoglycemia (blood glucose, 30 mg/dL) and hypothermia (97 degrees F) within 48 hours of birth and refused to nurse. Normal gestation of the black rhinoceros is 15 months, but elongated hoof slippers and low birth weight (30 kg) suggested prematurity in this calf. Clinical symptoms of neonatal sepsis including lassitude and poor sucking continued in spite of the aggressive use of antibiotics, and the calf required mechanical ventilatory support on day 7. Nutritional support including enteral gavage feedings (Pedialyte/4 ounces of SMA [Wyeth Ayerst] with sucraflox) had been instituted and was supplemented with total parenteral nutrition on day 5. Central venous access was obtained via a jugular cutdown. The total parenteral nutrition included appropriate electrolytes and vitamins for the neonatal calf but did not include trace elements. The use of total parenteral nutrition by our zoos for therapeutic purposes is increasing. Experience with total parenteral nutrition in exotic animals such as the black rhinoceros is limited, yet this may be an important therapeutic modality in these animals, particularly those in danger of extinction. PMID- 1775116 TI - Medication-nutrient interactions: hypophosphatemia associated with sucralfate in the intensive care unit. AB - Clinically significant medication-nutrient interactions are of concern to the nutritional support practitioner. To emphasize the possible effect of the aluminum-containing medication sucralfate on serum phosphorus levels, patients admitted to the intensive care unit of a small private hospital were monitored for a 4-week period. Sixteen patients demonstrated low serum phosphorus levels; eight (50%) of these were receiving sucralfate. Eighteen patients had no low phosphorus levels measured; five (28%) patients in this group were receiving sucralfate. The hypophosphatemia observed in these patients was probably multifactorial; respiratory alkalosis and dextrose feeding as well as sucralfate use are consistent with hypophosphatemia. PMID- 1775117 TI - Nursing culture and care. PMID- 1775118 TI - Educational accountability--what ho the 1990s! AB - In this paper the author argues that two major issues for nurse educational planning in the 1990s are developing a higher education ethos within the colleges and the contracts for educational provision. Underpinning each is the concept of educational accountability. PMID- 1775119 TI - Hassles, uplifts, and anxiety reported by Post-RN students in a BScN programme. AB - This study examined the daily hassles, uplifts and anxiety of registered nurse students (Post-RN) during a Community Health Nursing challenge examination in a baccalaureate nursing programme. The objectives of the first phase of this study were 1) to identify the daily hassles, uplifts and anxiety experienced by distance education and on-campus students and 2) to examine relationships among these variables and selected sociodemographic factors. Spielberger's (1983) State and Trait Anxiety Inventory (STAI) and Folkman and Lazarus' (1989) Hassles and Uplifts questionnaire were utilised. State anxiety levels were found to be higher than those of female working adults (Spielberger 1983). As well, on-campus students had higher state anxiety levels than distance education students. Trait anxiety differed significantly by age. Except for employment status, sociodemographic factors had no impact on hassles or uplifts. Unemployed subjects experienced significantly greater intensity of uplifts than subjects employed in a hospital setting. Hassles contributed significantly to the anxiety expressed by registered nurse students. As anticipated for women fulfilling multiple family, work and student roles, time pressure emerged as the most important hassle factor. Future research is planned to further explore hassles, uplifts and anxiety as Post-RN students progress through a baccalaureate nursing programme. PMID- 1775120 TI - Diagnosis related groups: choice, economy and nurse education. AB - The recently created internal market for the NHS has resulted in an increasing interest in the ways that funding is allocated for patient care. Ways in which funding is allocated will affect all nurses at some point. Associated with the issue of funding of patient care have been attempts to identify case-mix. A variety of classification systems are available but the most widely utilised is that of Diagnosis Related Groups (DRGs). This paper outlines the nature of this system and identifies some of the issues surrounding the DRG system and nurse education. PMID- 1775121 TI - Changes in the recruitment pool: the Australian experience. AB - This paper examines the changes in the recruitment pool from which we draw nursing students. In New South Wales, the change in venue from hospital to college institutions has significantly accelerated a change which began more than 20 years ago. College programmes attract more males directly from school and less mature age males than hospital programmes. There is a difference in the socioeconomic level of the household from which nursing draws its recruits in hospital and college programmes. College programmes attract more recruits from lower socioeconomic level households than hospital programmes. In New South Wales, this was found to be particularly so for the female group but not for the male group. From the national perspective, where students had the choice to enter either a hospital or higher education programme to attain a nursing qualification, it was found that there was no difference in the socioeconomic level of the household of origin between students who choose to enter a hospital programme which paid a wage while training and students who choose to enter a higher education programme which offered no such financial reward. This finding remained consistent when the study sample was cross-tabulated by state, gender and age group (young vs mature). PMID- 1775122 TI - Stakeholder evaluation: a model for decision making in problem-based learning. AB - Evaluation of new programmes in education are essential if one is to monitor the extent to which implementation is occurring in the manner that programme developers intended. This paper describes the use of a stakeholder approach in the evaluation of a nursing programme which uses problem-based teaching and learning strategies in curriculum implementation. Some background to the course is provided with a brief description of problem-based learning methodology. The central focus of the paper is on provision of an overview of a decision-making model of evaluation incorporating the stakeholder approach. It is suggested that this approach provided comprehensive feedback on the course implementation process, allowing for decision-making in relation to subsequent maintenance or modification of elements of a pre-service nursing programme. PMID- 1775123 TI - The problem of clinical evaluation--a review. AB - A review of the literature shows that clinical evaluation still poses problems for nurse educationalists despite its prominence in nurse education. Learning in nursing is a complex activity and clinical evaluation needs to take account of this. PMID- 1775124 TI - The mental health component of the general nursing curriculum: a critical review of English National Board guidelines. AB - The role of the mental health component of general nurse training has been the source of much revision and controversy. Although advocates have proposed a psychiatric experience for general nurses for over thirty years it was only in 1977 following a directive from the General Nursing Council (GNC) that it became a compulsory part of general nurse education. However debate continues; it ranges from whether a specialist psychiatric placement has any academic or clinical merit at all to how issues relating to mental health should be addressed most constructively. After only 11 years the 1977 GNC guidelines changed once again making a distinct psychiatric placement no longer compulsory. This paper critically reviews current guidelines and places the debate once again firmly in the public arena. PMID- 1775125 TI - A method of analysing interview transcripts in qualitative research. AB - A method of analysing qualitative interview data is outlined as a stage-by-stage process. Some of the problems associated with the method are identified. The researcher in the field of qualitative work is urged to be systematic and open to the difficulties of the task of understanding other people's perceptions. PMID- 1775126 TI - The use of credit and experiential learning in nurse education. Exciting opportunities for student and tutor alike. AB - This paper considers and analyses the use of Credit Accumulation and Transfer Schemes (CATS) and Assessment of Prior Experiential Learning (APEL) in nurse education. The Council for National Academic Awards (CNAA) initiative in higher education for CATS has opened up many new prospects for post registered nurse education linking 'Project 2000,' colleges of nursing and higher education and allowing nurses to show the qualitative values of their education rather than a quantitative approach. APEL has opened up opportunities for a move away from the traditional patterns of prerequisites for nurse education and openings for direct entry to both basic nurse education and also post registered courses. The recent document on The Report of the Post-registration Education and Practice Project (PREPP) shows that the UKCC are moving rapidly towards a similar programme of study for nurses, midwives and health visitors in line with those undertaken by undergraduate polytechnic students. PMID- 1775127 TI - The new eukaryotic precursor processing proteinases. PMID- 1775128 TI - High level expression of the major transactivation domain of the human glucocorticoid receptor in yeast cells inhibits endogenous gene expression and cell growth. AB - A number of alternative mechanisms by which the DNA-bound glucocorticoid receptor transactivates gene expression have been suggested. The fact that the glucocorticoid and other steroid hormone receptors function in yeast suggests that at least one of these mechanisms has been conserved throughout evolution. Here we show that overexpression of one of the glucocorticoid receptor transactivation domains (tau 1) in yeast causes a reduction in expression of a yeast reporter gene, followed by a severe reduction in the growth rate of the yeast cells. This is analogous to the phenomenon of squelching, first described for the GAL4 protein, and suggests that the tau 1 domain of the glucocorticoid receptor functions by contacting limiting transcription factors needed for efficient gene activity. A similar level of squelching was seen after removal of the up-stream activation sequences from the yeast reporter gene, suggesting that the squelching interactions were with transcription factors needed for the activity of a basal promoter. PMID- 1775129 TI - Domains of the human androgen receptor involved in steroid binding, transcriptional activation, and subcellular localization. AB - A series of human androgen receptor (AR) deletion mutants was constructed to study the relationship between the structural domains and their different functions in the AR protein. Human AR mutants were expressed in COS-1 and HeLa cells to investigate hormone binding, transcriptional activation, and subcellular localization. The wild-type human AR (AR 1-910) was expressed as a 110- to 112 kDa doublet, as revealed on immunoblots. All mutant AR proteins also migrated as doublets, except for one. This AR has a deletion from amino acid residues 51-211 and migrated as a single protein band, possibly due to altered posttranslational modification. The AR steroid-binding domain is encoded by approximately 250 amino acid residues in the C-terminal end. Deletions in this domain as well as truncation of the last 12 C-terminal amino acid residues abolished hormone binding. Cotransfection studies in HeLa cells showed that transcriptional activation of an androgen-regulated reporter gene construct was induced by the wild-type human AR. Mutational analysis revealed two regions in the N-terminal part, encoded by amino acid residues 51-211 and 244-360, to be essential for this transcriptional activation. Deletion of the hormone-binding domain yielded a constitutively active AR protein, indicating that in the absence of hormone this domain displays an inhibitory function. In the presence of its ligand, the wild type AR was located in the cell nucleus. In the absence of androgens the receptor was mainly nuclear, but cytoplasmic localization was observed as well.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775130 TI - In situ hybridization analysis of arginine vasopressin gene transcription using intron-specific probes. AB - In situ hybridization histochemistry with a probe directed against an intron sequence of the rat arginine vasopressin (AVP) gene was used to demonstrate localization and regulation of AVP heteronuclear RNA in discrete brain regions. Hybridization with an AVP intron I (AVPinI) probe revealed specific hybridization confined to cell nuclei of paraventricular nucleus, supraoptic nucleus (SON), and suprachiasmatic nucleus neurons of the rat hypothalamus. Grain counts revealed that the signal generated by the AVPinI probe represented 1.9% of that derived from an AVP exon C probe (AVPexC) in the SON. Interestingly, in the suprachiasmatic nucleus the proportion of AVPinI to AVP exon C ratio was much higher (12%), suggesting either increased transcription of the AVP gene or changes in posttranscriptional RNA processing. Regulatory experiments revealed that 2.6-fold increases in AVPinI signal could be visualized in the SON as little as 30 min after an acute salt load, a period during which no significant change in cytoplasmic AVP mRNA could be observed. In response to chronic salt loading, both AVP heteronuclear RNA and AVP mRNA were up-regulated. These data compared favorably with transcription rate values determined by nuclear run-on assay, suggesting that intronic in situ hybridization affords a relatively reliable method for assessment of rapid changes in gene transcription in individual central nervous system neurons. PMID- 1775131 TI - Regulation of insulin degradation: expression of an evolutionarily conserved insulin-degrading enzyme increases degradation via an intracellular pathway. AB - The insulin-degrading enzyme (IDE) is an evolutionarily conserved enzyme that has been implicated in cellular insulin degradation, but its site of action and importance in regulating insulin degradation have not been clearly established. We addressed this question by examining the effects of overexpressing IDE on insulin degradation in COS cells, using both human IDE (hIDE) and its Drosophila homolog (dIDE). The dIDE, which was recently cloned in our laboratory, has 46% amino acid identity with hIDE, degrades insulin with comparable efficiency, and is readily expressed in mammalian cells. Transient expression of dIDE or hIDE in COS monkey kidney cells led to a 5- to 7-fold increase in the rate of degradation of extracellular insulin, indicating that IDE can regulate cellular insulin degradation. Insulin-degrading activity in the medium was very low and could not account for the difference between transfected and control cells. To further localize the site of IDE action, the fate of insulin after receptor binding was examined. The dIDE-transfected cells displayed increased degradation of prebound insulin compared to control cells. This increase in degradation was observed even when excess unlabeled insulin was added to block reuptake or extracellular degradation. These results indicate that IDE acts at least in part within the cell. The lysosomotropic agents chloroquine and NH4Cl did not affect the increase in insulin degradation produced by transfection with dIDE, indicating that the lysosomal and IDE-mediated pathways of insulin degradation are independent. The results demonstrate that IDE can regulate the degradation of insulin by intact cells via an intracellular pathway. PMID- 1775132 TI - Mediation by calcium of thyrotropin--releasing hormone action on the prolactin promoter via transcription factor pit-1. AB - Mediation by Ca2+ of TRH action on the PRL promoter was investigated by both additivity and pharmacological studies and by techniques that probe more gene proximal events. TRH required the presence of Ca2+ in the medium for stimulation of transient expression in GH3 cells of a PRL-chloramphenicol acetyltransferase (PRL-CAT) construct containing proximal PRL promoter sequences [(-187)PRL-CAT]. Chronic 12-O-tetradecanoyl phorbol-13-acetate down-regulation of cellular protein kinase C did not block induction of expression of (-187)PRL-CAT by either Ca2+ or TRH. In studies with Ca2+ blockers, the Ca2+ flux inhibitors cobalt ion and nimodipine blocked induction of (-187)PRL-CAT expression by either Ca2+ or TRH. On the other hand, the Ca2+ immobilizers 1,2-bis(O-aminophenoxy)ethane-N,N,N',N' tetraacetic acid acetoxymethyltetraester and 8-(N,N-diethylamino)octyl 3,4,5 trimethoxybenzoate blocked induction of expression of this construct by Ca2+ but not by TRH, suggesting that TRH regulation of the PRL promoter may be dependent on Ca2+ fluxes but insensitive to Ca2+ immobilization. We have shown previously that the PRL promoter pit-1 binding site 1P is a TRH response element. In the present studies, Ca2+ regulation studies with 5'-deletion mutants of (-204)PRL CAT showed that (-75)PRL-CAT, containing the single pit-1 binding site 1P, also contains a Ca2+ response element. The observation that two copies of a site 1P oligomer transferred a Ca2+ response to either of the two minimal constructs ( 39)PRL-CAT or (-39)mouse metallothionein-CAT showed that site 1P is an independent Ca2+ response element. Analysis of site 1P mutants yielded a strong correlation between the ability to bind pit-1 and to transfer a Ca2+ response. In addition, coexpression of a mutant pit-1 possessing reduced trans-activational activity strongly inhibited TRH regulation of (-187)PRL-CAT and partially blocked Ca2+ regulation of this construct. We conclude that Ca2+ mediates TRH action on the PRL promoter, and that pit-1 represents a gene-proximal mediator in this signalling pathway. PMID- 1775133 TI - Multiple domains of the glucocorticoid receptor involved in synergism with the CACCC box factor(s). AB - Steroid induction of responsive genes functions through the synergistic activity of steroid receptor-binding sequences with adjacent transcription factor-binding sites. To analyze the mechanism of synergy we tested different human glucocorticoid receptor mutants for synergistic function with another transcription factor in comparison with intrinsic trans-activation obtained with a single receptor binding site (glucocorticoid response element). Multiple domains were found to be involved in synergistic activity of the glucocorticoid receptor with the CACCC box factor. Deletions within the N-terminal receptor half affected simultaneously intrinsic trans-activation and synergism. However, deletion of the hormone-binding domain mainly impaired synergism rather than intrinsic trans-activation, clearly showing that this domain synergizes by a mechanism independent of intrinsic activation. A chimeric protein where the DNA binding domain of the glucocorticoid receptor was replaced by that of the yeast GAL4 protein also showed functional synergism. These data suggest that some of the receptor domains outside the DNA-binding domain synergize by their intrinsic trans-activating property, but the hormone-binding domain contributes to synergism by a different mechanism. PMID- 1775134 TI - A heterologous hormone response element enhances expression of rat beta-casein promoter-driven chloramphenicol acetyltransferase fusion genes in the mammary gland of transgenic mice. AB - Previous studies have demonstrated that the entire rat beta-casein (R beta C) gene and a -524/+490 R beta C fragment-chloramphenicol acetyltransferase (CAT) fusion gene are expressed preferentially in the mammary gland of transgenic mice in a developmentally regulated fashion. However, transgene expression was infrequent, less than 1% of that observed for the endogenous gene, and varied as much as 500-fold, presumably due to the site of chromosomal integration. To determine whether a heterologous hormone-responsive enhancer could be used to increase both the level and frequency of expression in the mammary gland, a fragment derived from the mouse mammary tumor virus long terminal repeat containing four hormone response elements (HREs) was inserted into the R beta C promoter at a site not known to contain transcriptional regulatory elements. Transgenic mice generated which carried HRE-enhanced R beta C-CAT fusion genes expressed CAT activity in the mammary glands of all founder lines examined at levels that were on average 13-fold greater than for lines generated with similar constructs not carrying HREs. In the highest expressing line, the level of HRE enhanced transgene expression was found to be developmentally regulated, increasing 14-fold in the mammary gland from virgin to day 10 of lactation. In this line, expression was also observed in the thymus and spleen; however, the level of CAT activity was 4-fold lower than in the mammary gland and was not developmentally regulated. In adrenalectomized mice, the administration of dexamethasone stimulated CAT expression in the mammary gland but not in the thymus and spleen. These studies demonstrate that in the context of the R beta C promoter, the HRE functions in the mammary gland to increase both the frequency and level of transgene expression. PMID- 1775135 TI - The product of the CYP11B2 gene is required for aldosterone biosynthesis in the human adrenal cortex. AB - The steroid 11 beta-hydroxylase (P450c11) enzyme is responsible for the conversion of 11-deoxycortisol to cortisol in the zona fasciculata of the adrenal cortex. Animal studies have suggested that this enzyme or a closely related isozyme is also responsible for the successive 11 beta- and 18-hydroxylation and 18-oxidation of deoxycorticosterone required for aldosterone synthesis in the zona glomerulosa. There are two distinct 11 beta-hydroxylase genes in man, CYP11B1 and CYP11B2, which are predicted to encode proteins with 93% amino acid identity. We used a sensitive assay based on the polymerase chain reaction to analyze the expression of the CYP11B1 and B2 genes. Transcripts of CYP11B1 were detected at high levels in surgical specimens of normal adrenals and also in an aldosterone-secreting adrenal tumor. Transcripts of CYP11B2 were found at low levels in normal adrenals, but at a much higher level in the aldosterone secreting tumor. CYP11B2 mRNA levels were increased in cultured zona glomerulosa cells by physiological levels of angiotensin-II. The entire coding regions of both CYP11B1 and B2 cDNAs were cloned from the tumor mRNA. Expression of these cDNAs in cultured COS-1 cells demonstrated that the CYP11B1 product could only 11 beta-hydroxylate 11-deoxycortisol or deoxycorticosterone, whereas the CYP11B2 product could also 18-hydroxylate cortisol or corticosterone. A small amount of aldosterone was synthesized from deoxycorticosterone only in cells expressing CYP11B2 cDNA. These data demonstrate that the product of CYP11B2 is required for the final steps in the synthesis of aldosterone. PMID- 1775136 TI - A shared promoter element regulates the expression of three steroidogenic enzymes. AB - The adrenal cortex of the mouse coordinately expresses three cytochrome P450 enzymes that are required for the biosynthesis of corticosteroids: cholesterol side-chain cleavage enzyme (SCC), steroid 21-hydroxylase (21-OHase), and steroid 11 beta-hydroxylase (11 beta-OHase). Within their 5'-flanking regions, we previously identified six elements containing variations of an AGGTC motif that regulated expression in mouse Y1 adrenocortical cells: 21-OHase elements at -210, -140, and -65; SCC elements at -70 and -40; and an 11 beta-OHase element at -310. We demonstrate here that all six elements interact with the same, or closely related, DNA-binding protein(s). First, these elements all formed complexes of similar mobility in gel shift assays, suggesting that they interacted with protein(s) of similar size. Additional larger complexes were seen with those probes containing exact AGGTCA sequences. Second, competition experiments confirmed that the factor(s) interacting with different elements had closely related or identical recognition specificities. Finally, indistinguishable profiles of shift activities were seen upon fractionation of nuclear proteins over sequential chromatographic columns. Collectively, these results suggest that related elements interact with a shared protein to regulate three essential steroidogenic enzymes. An AGGTCA sequence motif comprises the response element for several members of the nuclear hormone receptor family. Oligonucleotide competitions and specific effects of antisera in gel shift assays implicated chicken ovalbumin upstream promoter-transcription factor in the formation of the larger complexes seen with the elements containing exact AGGTCA sequences. Therefore, this member of the nuclear hormone receptor family also may regulate the expression of the adrenal steroidogenic enzymes. PMID- 1775138 TI - [Development of physical performance and endurance in childhood and adolescence]. AB - The information available in sports medicine regarding the development of performance and maximum stress is presented for children and adolsecents, and the importance of age-appropriate sports for general health is also discussed. A description of the five main forms of stress on the motor system follows, i.e., coordination, flexibility, strength, speed, and endurance, and their effectos on the performance parameters boys and girls from childhood to adolescence. Data on cardiopulmonary-metabolic performance parameters are discussed for children and adolescents. These include functional and morphological data on the heart, circulation, respiration, metabolism, and skeletal musculature. Precocious young people are physically capable of a higher performance level and can tolerate more stress than their normal counterparts or those with delayed development. With regard to the five forms of stress mentioned above, health questions related to the ability to tolerate stress and age-related levels of training are dealt with. The negative effects on health are considered with regard to the development of amenorrhea and a decrease in the mineral content of the skeletal system as a result of extensive endurance training. PMID- 1775139 TI - [Physical fitness for sports in the preschool age]. AB - The preschool years are characterized by the learning of combinations of movements that make it possible for children to attain an astonishingly high level of physical performance. With regard to their metabolism and cardiovascular/cardiopulmonary system, they have at their disposal good prerequisites for aerobic endurance training. However, it is a matter of the natural movements involved in playing rather than striving to reach a high level of performance. Sports during the preschool age advances physical development and serves as a form of early prevention of the diseases of civilization. PMID- 1775137 TI - Substitution of aspartic acid-686 by histidine or asparagine in the human androgen receptor leads to a functionally inactive protein with altered hormone binding characteristics. AB - We have identified two different single nucleotide alterations in codon 686 (GAC; aspartic acid) in exon 4 of the human androgen receptor gene in three unrelated families with the complete form of androgen insensitivity. One mutation (G----C) results in an aspartic acid----histidine substitution (with 15-20% of wild-type androgen-binding capacity), whereas the other mutation (G----A) leads to an aspartic acid----asparagine substitution (with normal androgen-binding capacity, but a rapidly dissociating ligand-receptor complex). The mutations eliminate a Hinfl restriction site. Screening for the loss of the Hinfl site in both families with the Asp----Asn mutation resulted in the recognition of heterozygous carriers in successive generations of each. Both mutant androgen receptors were generated in vitro and transiently expressed in COS and HeLa cells. The receptor proteins produced had the same altered binding characteristics as those measured in fibroblasts from the affected subjects. R1881-activated transcription of a GRE-tk CAT reporter gene construct was strongly diminished by both mutant receptors and was only partially restored using a 100-fold higher concentration of ligand compared with wild-type receptor. Thus, aspartic acid-686 appears essential for normal androgen receptor function. Substitution of this amino acid residue, by either histidine or asparagine, results in androgen insensitivity and lack of androgen-dependent male sexual differentiation. PMID- 1775140 TI - [Macrocephaly as the initial manifestation of glutaryl-CoA-dehydrogenase deficiency (glutaric aciduria type I)]. AB - Glutaric aciduria type I is due to an impaired glutaryl-CoA-dehydrogenase with an increased urinary excretion of glutaric and 3-OH glutaric acid. Typically, the clinical course until the sixth month or even 3rd year of life is symptom free, and only later an encephalopathic crisis develops. The only symptom of our 4 patients was macrocephaly (head circumference greater than 97. percentile) in early infancy. 3 of them suffered from an encephalopathic crisis at 8 months to 3 years of age; during that time they lost already established abilities as sitting, walking and speaking, and developed choereoathetotic movements. One child aged 15 months was normal beside it's macrocephalus. All children were treated with a diet low in lysine (80 mg/kg BW/day), tryptophane (21 mg/kg BW/day), and by supplementation of L-carnitine (200 mg/kg BW/day) and riboflavine (200 mg/day) and the motorically disturbed children received Lioresal 1 mg/kg BW/day. The effect of this treatment cannot be evaluated so far, but there is evidence that the dietetic therapy together with carnitine supplementation may prevent further deterioration in affected, or an encephalopathic crisis in unaffected patients. Therefore we suggest to investigate organic acids in urine in every child or infant with macrocephalus to exclude glutaric aciduria type I. PMID- 1775141 TI - [Lyme arthritis in childhood: monarthritis of the knee joint, clinically indistinguishable from monarthritis of unknown origin]. AB - Four children with monarthritis of the knee had no further manifestations of Lyme borreliosis, but a positive antibody titer against Borrelia burgdorferi as measured by Elisa. About 3 years after antibiotic therapy none of the children had arthritis, but one suffered from fibromyalgia and another child had still a vigorous reactivity against Borrelia burgdorferi antigens by Elisa and immunoblot. In this study 4 out of 20 children with recently recognized arthritis had Lyme arthritis which makes it a rather frequent disease. The clinical presentation could not distinguish these 4 children from 4 other children with monarthritis of the knee of unknown origin. In the absence of better diagnostic criteria, the association of monarthritis, not otherwise explained, with a positive Lyme serology seems to be sufficient evidence to establish a diagnosis of Lyme arthritis. After confirmation of the diagnosis children should be treated without delay. PMID- 1775142 TI - [Comparison of thyrotropin (TSH), thyroxine (TT4) and triiodothyronine (TT3) concentration in capillary and venous blood serum in children and adolescents]. AB - The thyrotropin, thyroxine and triiodothyronine concentration was compared in sera from capillary and venous blood (n = 50) using a luminescence-enhanced enzyme immuno assay. The results showed a good correlation (TSH, r = 0.991, TT4, r = 0.988, TT3, r = 0.975) and a linear relationship. It is concluded that serum of capillary blood can be used for the in vitro diagnosis of thyroid function. PMID- 1775143 TI - [Extracorporeal shockwave lithotripsy in the treatment of pediatric urolithiasis]. AB - The 2nd generation lithotripter LITHOSTAR plus was used for extracorporeal shock wave lithotripsy of 9 kidney stones, 2 ureteral calculi and 2 bladder stones in 10 children 15 months to 17 years old. Ultrasonic stone localization was used in 2 children, x-ray guided stone localization in 8 children. General anesthesia was necessary in 6 children. A stone free rate of 60% was achieved after 1 treatment. Except for one 14-year old boy no adjuvant procedures like percutaneous nephrostomy or ureteral stents were applied. No major complications were encountered. PMID- 1775144 TI - [Immunologic complications of visceral leishmaniasis]. AB - This study concerns 3 cases of visceral leishmaniasis with various immunological complications. One patients showed a life-threatening activation of macrophages, characterised by haemophagocytosis in the bone marrow, pancytopenia, hypofibrinogenaemia and hypertriglycerideamia. A selective deficiency of IgG subclasses persisting for months was found in all 3 cases, the clinical relevance of which is unclear. One case manifested the already well known transient decrease of cell mediated immunity to antigens. If early detection and correct management is possible, these complications may be prevented and most cases of visceral leishmaniasis be cured. PMID- 1775145 TI - [Non-epileptic sleep disorders (somnambulism) in epilepsy. Diagnostic and therapeutic possibilities]. AB - The case history of a 15 1/2-year-old boy is presented who suffers from screaming fits during the night and epilepsia. The problem has existed since he was eight. He lives alone with his mother in a "partner-like" relationship. The previous diagnosis, namely epilepsy, has masked any possible psychodynamic element. Our diagnostic instruments were: 1. Standardized diagnostics with DSM III-R; 2. psychoanalytically oriented psychodiagnostics; 3. long term EEG-video-monitoring, which eventually succeeded in differentiating his multiple symptoms. Using these methods we were able to differentiate a sleep disorder (somnambulism) from his grandmal epilepsy. We changed his anticonvulsive pharmacological therapy and introduced an individual psychotherapy ("Katathymes Bilderleben"). This kind of psychotherapy is applied for the first time as a therapy for somnambulism. By using this therapeutic concept we cured our patient from his symptoms. PMID- 1775146 TI - [Acyl coenzyme A dehydrogenase deficiency of medium-chain fatty acids in a 9-year old boy with adymia. A rare mitochondrial cytopathy which may be more common than previously assumed]. AB - The medium-chain acyl-CoA dehydrogenase (MCAD) deficiency of mitochondrial beta oxidation has been identified in a nine-year old boy with a very bland course and easy fatigue as the main symptom. Repeated low frequency stimulation test and EMG for excluding a myasthenia gravis, and screening for urinary organic acid excretion were helpful for the diagnosis. The EMG test at the m. trapezius by stimulation of the n. accessorius showed an extreme decrease of muscle power down to 49%. After i.v. injection of Edrophonium the loss of power of 20% was still significant, so that we could exclude a myasthenia gravis, but we had found signs of a generalised defect in cell chemistry. The diagnosis could be confirmed by a positive 3-phenylpropionic acid-test and moleculargenetic proof of the Adenine to Guanine mutation at position 985 in the MCAD cDNA (G985) with the polymerase chain reaction. The incidence of this organic aciduria is probably 1:60,000 in Germany, but with more attention to this disease and diagnosis of cases with bland courses the incidence will be higher. The MCAD-defect should be considered in the differential diagnosis of patients with Reye syndrome-like encephalopathies, non-ketotic hypoglycaemia or sudden unexpected deaths in infancy. PMID- 1775147 TI - [Nasal encephalocele as a cause of recurrent bacterial meningitis]. AB - Nasal encephaloceles are rare inborn malformations of the central nervous system. We report on a 30 months old boy with recurrent bacterial meningitis where a nasal encephalocele was diagnosed. We describe diagnostic procedures and the development and treatment of this interesting disease. The nasal encephalocele was successfully removed surgically. PMID- 1775148 TI - [Speech cannula for children with tracheotomy and oxygen inhalation therapy]. AB - Because of various possible problems tracheotomy in children should be performed only in urgent cases and should be sewed up as soon as possible. Early language therapy and the use of cannulas with speaking device promote language development. We propose a special silver cannula with speaking device for children with oxygen dependence due to bronchopulmonary dysplasia. PMID- 1775149 TI - [The biological correlates of anxiety in psychiatric diseases]. PMID- 1775150 TI - Isolation and functional characterization of snail hemocyte-modulating polypeptide from primary sporocysts of Schistosoma mansoni. AB - Infection with larval trematodes has been shown to inhibit several snail-host defences, including hemocyte phagocytosis, cytotoxicity, motility, and adherence. Certain plasma factors which mediate snail defence responses, and which may be produced by host hemocytes, also appear to be altered by these parasites. In this study we present protocols for the isolation of 2 proteins from larval Schistosoma mansoni excretory-secretory (ES) products and detail the effects of these components on Biomphalaria glabrata hemocyte protein synthetic/secretory (S/S) activity. Schistosome ES proteins, separated with a combination of membrane ultrafiltration, size exclusion, and ion exchange chromatography, were tested for their in vitro effect on cultured snail hemocytes, in the presence and absence of homologous plasma. A high-molecular-weight ultrafiltration fraction of parasite ES products (H30), in combination with plasma, was found to differentially affect susceptible (M-line) and resistant (10-R2) snail hemocytes. Secretion of metabolically labeled polypeptides by M-line cells was inhibited significantly while the S/S response of 10-R2 hemocyte polypeptides was not affected. In the absence of homologous plasma, little or no differential affect of ES polypeptides on hemocyte S/S activity was seen. Much of the inhibitory activity of H30 was attributable to a partially purified fraction, Peak I (PkI), of ES products. Evidence suggests that, in its native state, PkI is a high-molecular-weight protein aggregate comprising subunits of approximately 22-24 kDa. Thus, PkI, in the presence of homologous plasma components, is a potential mediator of schistosome-induced suppression of polypeptide synthesis or secretion in hemocytes of susceptible snails. In combination with other parasite and host factors, PkI may be involved in the host-parasite interaction which leads to the state of susceptibility or resistance found in our strains of B. glabrata. PMID- 1775151 TI - Diethylcarbamazine inhibits endothelial and microfilarial prostanoid metabolism in vitro. AB - Diethylcarbamazine (DEC) rapidly lowers the number of microfilariae in the peripheral circulation. The mechanism of action is unknown, but may involve alterations of arachidonic acid metabolism in vascular tissues. We studied the effects of DEC on arachidonic acid metabolism by bovine pulmonary arterial endothelium monolayers, human platelets and Brugia malayi microfilariae. DEC at a concentration of 2.5 microM, a level achieved in vivo, rapidly decreased prostacyclin, prostaglandin E2 and thromboxane B2 release from endothelial monolayers by 78% (P less than 0.001), 57% (P = 0.05), and 75% (P less than 0.05), respectively. High-pressure liquid chromatography of extracts of endothelial monolayers incubated with DEC showed similar inhibition of these cyclooxygenase pathway products, but exposure to the drug did not result in formation of new eicosanoids. DEC did not inhibit endothelial phospholipase A2 dependent release of arachidonate from membrane stores, whereas prostaglandin H2 synthase activity (cyclooxygenae, EC 1.14.99.1) was reduced to a degree similar to that effected by acetylsalicylic acid. Microfilarial but not platelet synthesis of cyclooxygenase products was also reduced by DEC. These data suggest that the mechanism by which DEC lowers the level of microfilariae in the circulation may in part involve its effects on host endothelial and parasite eicosanoid production. PMID- 1775152 TI - Biochemical and molecular characterization of Leishmania pifanoi amastigotes in continuous axenic culture. AB - Inability to culture the disease-producing amastigote form of Leishmania has greatly hampered its study. We have biochemically characterized an axenically cultured amastigote-like form of Leishmania pifanoi. This form closely resembles amastigotes in proteinase, ribonuclease, adenine deaminase and peroxidase activity. It also exhibits comparable rates of growth, transformation, synthesis of DNA, RNA and protein, and metabolism of glucose and linoleic acid. It is distinct from promastigotes in these characteristics. The expression of the genes for beta-tubulin and the P100/11E reductase is developmentally regulated in this axenic form as in amastigotes. These results, combined with previous demonstrations of amastigote morphology and antigenicity in the culture form, confirm that Leishmania amastigotes have been successfully propagated in axenic media. This strain should serve as an excellent model for the study of amastigote biochemistry, pharmacology and immunology, and the molecular genetics of the transformation between amastigote and promastigote forms. PMID- 1775153 TI - Primary structure and localization of a conserved immunogenic Plasmodium falciparum glutamate rich protein (GLURP) expressed in both the preerythrocytic and erythrocytic stages of the vertebrate life cycle. AB - A gene coding for a 220-kDa glutamate rich protein (GLURP), an exoantigen of Plasmodium falciparum, was isolated and its nucleotide sequence was determined. The deduced amino acid sequence contains 2 repeat regions. The sequence of one of these was shown to be conserved among geographically dispersed isolates, and a fusion protein containing that sequence was able to stimulate B- and T-cells. Antibodies against GLURP stained erythrocytic stages of the parasite as well as the hepatic stage as detected by electron microscopy. PMID- 1775154 TI - The accumulation and metabolism of a fluorescent ceramide derivative in Plasmodium falciparum-infected erythrocytes. AB - We have examined the accumulation and metabolism of N-[7-(4-nitrobenzo-2-oxa-1,3 diazole)]aminocaproyl sphingosine (C6-NBD-cer) in Plasmodium falciparum FCR-3/A2 infected erythrocytes. C6-NBD-cer transferred to live infected erythrocytes at 2 degrees C to label the infected red cell surface and intracellular parasite membranes. Subsequent incubation for 30 min at 2 degrees C, resulted in a depletion of the ceramide label from the red cell membrane and an accumulation of fluorescence in parasite membranes, by an energy independent process. When the cells were subsequently warmed to 37 degrees C for 30 min, virtually all of the ceramide was converted to N-[7-(4-nitrobenzo-2-oxa-1,3- diazole)]aminocaproyl sphingosine-1-phosphocholine (C6-NBD-Sm). Uninfected erythrocytes were incapble of sphingomyelin synthesis. By fluorescence microscopy, sphingomyelin synthesis in infected erythrocytes occurred in compartments morphologically similar to those accumulating ceramide. To examine the intracellular sites of ceramide accumulation glutaraldehyde fixed cells were labeled with C6-NBD-ceramide and subsequently back extracted to remove excess probe. This resulted in a depletion of label at the red cell membrane but prominent fluorescence remained associated with the parasite. Photobleaching in the presence of diaminobenzidine resulted in precipitates in intraerythrocytic cisternae and the vacuolar membrane surrounding the parasite, rather than a perinuclear Golgi apparatus within the organism. The results support a novel organisation of plasmodial membranes regulating the accumulation and metabolism of C6-NBD-cer in infected erythrocytes. PMID- 1775155 TI - Identification of free and conjugated ecdysteroids in cercariae of the schistosome Trichobilharzia ocellata. AB - Extracts of cercariae of the avian schistosome Trichobilharzia ocellata were analysed for the presence of ecdysteroids by radioimmunoassay, high-performance liquid chromatography monitoring fractions by radioimmunoassay, and gas chromatography/mass spectrometry (selected ion monitoring). Both free ecdysteroids and polar conjugated ecdysteroids were detected in the cercarial extracts. The free ecdysteroid fraction, as well as the hydrolysed polar conjugated ecdysteroid fraction, contained both ecdysone and 20-hydroxyecdysone in approximately equal amounts. The amount of ecdysteroids detected is comparable to those found in other platyhelminths. A possible role for the ecdysteroids in the development of the parasite and/or the interactions between the parasite and its intermediate host, the freshwater snail Lymnaea stagnalis, is discussed. PMID- 1775156 TI - Another 26-kilodalton glutathione S-transferase of Schistosoma mansoni. PMID- 1775157 TI - Biopterin conversion to reduced folates by Leishmania donovani promastigotes. AB - The ability of Leishmania donovani promastigotes to proliferate in folate deficient medium supplemented with pterins suggests that pterins can serve as a source of folate in these parasites [16]. Using reversed-phase high-performance liquid chromatography, the ability of intact L. donovani to transform [3H]biopterin into tetrahydrofolates was demonstrated. Radioactivity was primarily associated with 5-methyltetrahydrofolate and 10-formyltetrahydrofolate. A mutant strain of L. donovani, MTXA5, that was genetically deficient in folate transport capacity and incapable of growing in pterin-supplemented folate deficient growth medium, exhibited a greatly reduced capacity to metabolize [3H]biopterin to reduced folates. These data indicated that wild-type L. donovani promastigotes, unlike mammalian cells, were able to convert biopterin to tetrahydrofolates and supported the hypothesis that folate transport deficiency in mutant organisms is associated with an inability to transform pterins to reduced folates. PMID- 1775158 TI - Proteolytic processing of the Plasmodium falciparum merozoite surface protein-1 produces a membrane-bound fragment containing two epidermal growth factor-like domains. AB - The amino-terminal sequence has been obtained for 2 fragments of the Plasmodium falciparum T9/94 merozoite surface protein precursor (PfMSP1) and these have been compared with the sequence predicted from the gene. These data define the position of these fragments in the precursor and indicate that the C-terminal sequence which is carried into the red cell during invasion consists of 2 epidermal growth factor (EGF)-like domains. A homologous cleavage sequence and domain structure can be identified in the MSP1 molecules of other malarial species. In addition the results suggest that the smaller fragment is not N glycosylated. PMID- 1775159 TI - Pathogenic and nonpathogenic Entamoeba histolytica: identification and molecular cloning of an iron-containing superoxide dismutase. AB - Superoxide dismutase (SOD) activity was determined in the cell lysate of the axenically cultured Entamoeba histolytica isolate HM-1:IMSS. Under anaerobic culture conditions, 18.7 (+/- 4.9) units SOD activity (mg protein)-1 were found. By inhibition studies the activity was attributed to an iron-containing type of SOD (FeSOD). Using degenerate oligonucleotide primers derived from regions highly conserved in prokaryotic FeSOD sequences, a genomic DNA fragment was amplified by the polymerase chain reaction. The fragment was used to isolate FeSOD specific cDNA clones from a pathogenic and a nonpathogenic E. histolytica isolate. A comparison of the 2 sequences revealed 5% nucleotide differences resulting in a single amino acid exchange. The primary structure showed the characteristics of an iron-containing type of SOD with a homology of approximately 55% with other FeSOD sequences. The enzyme was found to be encoded by single copy genes in both the pathogenic and the nonpathogenic E. histolytica, but restriction fragment lengths differed between the 2 groups. In 5 isolates studied, no correlation was found between pathogenic behavior of the amebae and the expression of FeSOD related mRNA. PMID- 1775160 TI - Cloning and sequence analysis of the Schistosoma mansoni membrane glycoprotein antigen gene GP22. AB - A family of Schistosoma mansoni proteins (18-22 kDa, pI 5.3-5.8) are biosynthesized in juvenile worms and immunoprecipitated by antibodies uniquely present in protective Fischer rat antiserum. A cDNA clone, lambda gt11-40, expressing epitopes common to this protein family was used to obtain a genomic DNA clone, by hybridization with a lambda gt11-40 oligonucleotide probe. In the 1.37 kb of genomic DNA sequenced, an open reading frame of 182 amino acids was identified on the strand corresponding to lambda gt11-40 coding sequences, and those of identical independently isolated cDNA clones defining a 25-kDa surface membrane glycoprotein. The new S. mansoni gene is termed GP22. There are two candidate promoters, confirmed by primer extension studies with worm RNA. Promoter 1 (P1) is preceded by a G + C-rich region and potential CAAT sequences, and is to the 5'-side of P2. Transcription from P1 is initiated at 2 different sites, apparently producing mRNAs with different translation start sites (ATG). Decoding these mRNAs yields protein products of 182 (P1), 175 (P1), 140 (P2) and 136 (P2) amino acids. The polypeptides share the following features: a hydrophobic segment near the carboxy terminus sufficient to span a lipid bilayer, with a consensus sequence for thio-esterification by a fatty acid; an external domain containing 2 potential N-linked glycosylation sites; and a candidate leucine-zipper motif, suggesting the protein may exist as a dimer on the worm surface. While sharing these common features in their carboxy terminal regions, the three proteins differ in the length and properties of their amino termini. The 140-amino acid protein has a short hydrophobic amino terminus, while the 175- and 182-amino acid proteins have more extensive hydrophobic sequences, each preceded by a hydrophilic amino terminal sequence. The heterogeneity observed in 2-dimensional gels of the antigen may be explained in part by the size and charge differences among the proteins deduced from the sequence and transcription pattern of this gene. The possibility of stage-specific regulated expression of this candidate vaccine antigen family is an attractive concept, potentially accounting for the phenomenon of concomitant immunity observed in the rat and perhaps other schistosome hosts. PMID- 1775161 TI - Primary structure of a Plasmodium falciparum rhoptry antigen. AB - The high-molecular-weight rhoptry complex of Plasmodium falciparum consists of 3 non-covalently associated polypeptides of 150, 135 and 105 kDa. We present the complete nucleotide sequence of the 105-kDa (RhopH3) component of this complex derived from analysis of genomic and cDNA clones. The genomic structure is unusually complex for P. falciparum, consisting of 7 exons including 2 mini-exons of 19 and 21 amino acids. The sequence lacks tandem repeats and is conserved among several parasite isolates. B cell epitopes that induce antibody responses during natural infection were mapped to five different regions of the polypeptide. PMID- 1775162 TI - Artemisinin (qinghaosu): the role of intracellular hemin in its mechanism of antimalarial action. AB - Artemisinin (qinghaosu), is a promising new antimalarial drug derived from an ancient Chinese herbal remedy. When [13-14C]artemisinin is added to cultures of Plasmodium falciparum, it is converted into a product with different solubility and chromatographic properties than the parent drug. Artemisinin reacts with hemin in aqueous solution to form an adduct with an apparent molecular weight of 914 which has identical chromatographic, solubility, and electrophoretic behavior to the parasite-derived product. The reaction between artemisinin and hemin, when carried out in the presence of red cell membranes, leads to the oxidation of protein thiols. Malarial parasites are rich in hemin; artemisinin's reactivity toward hemin may explain its selective toxicity to malarial parasites. PMID- 1775164 TI - Characterization of acetylcholinesterase molecular forms of the root-knot nematode, Meloidogyne. AB - Multiple molecular forms of acetylcholinesterase have been isolated and characterized from the root-knot nematodes Meloidogyne arenaria and Meloidogyne incognita. The forms of enzyme present in these 2 species are similar but not identical to those that occur in the free-living nematode Caenorhabditis elegans. The 5 enzyme forms exhibit differential solubilities and can be classified into 3 classes, A, B, and C, based on substrate affinity, inhibitor and detergent sensitivity, and thermal inactivation profiles. An unusual class of acetylcholinesterase has been isolated from Meloidogyne which has very high affinity for acetylcholine, but is highly resistant to carbamate and organophosphate inhibitors. The potential roles of the molecular forms in nematode behavior and sensitivity to nematicides are discussed. PMID- 1775163 TI - Histochemical localization of gene expression in Onchocerca volvulus: in situ DNA histohybridization and immunocytochemistry. AB - We report here the development of in situ hybridization and immunohistochemistry protocols which permit the histological identification of gene expression of a cloned antigen of Onchocerca volvulus, OI5, in the parasite. Skin nodules containing female adult worms were fixed in a modified Carnoy's fixative and embedded in paraffin. Histological staining of tissue sections revealed uniformly excellent morphology and RNA preservation. To localize mRNA by in situ hybridization, tissue sections were incubated with biotin-labeled pOI5, the plasmid containing the genomic sequence of the antigen, and hybridization signals were histochemically visualized using a streptavidin-enzyme conjugate and chromogenic substrates. The protein antigen was localized immunohistochemically by incubating the sections with specific antibodies prepared against a recombinant fusion protein containing the OI5 sequence (OI3), and visualized via a secondary antibody-biotin-enzyme conjugate procedure. The results reported here showed distinct localization of the OI5 mRNA and OI3 antigen in specific cellular and tissue regions of the adult parasite, and in microfilariae located within the uteri and in the surrounding host tissue. The specificity and high sensitivity of these histological detection methods should be generally applicable for the characterization of gene expression in the filarial parasite, particularly the insect-borne, infective filarial larvae, which are severely limited in quantity. PMID- 1775165 TI - Carboxy-terminal sequence conservation among variant-specific surface proteins of Giardia lamblia. AB - Antigenic variation in the parasitic protozoan Giardia lamblia was studied by characterizing the expression and genomic organization of a variant-specific surface protein (VSP) gene. Transcripts from this gene, vsp1267, were abundant in the cloned variant WB/1267, but undetectable in the parental clone from which WB/1267 was derived or in variant progeny of WB/1267. Two identical copies of vsp1267 exist in the WB/1267 genome, separated by 3 kb and arranged as convergent transcription units. Primer extension sequencing and S1 nuclease protection analysis suggested that the 5' untranslated region (UTR) of VSP1267 mRNA consists of a single nucleotide (nt). Primer extension sequencing mapped the site of VSP1267 transcript polyadenylation 25 nt beyond the termination codon. vsp1267 contained no introns and predicted a cysteine-rich polypeptide with features common to other VSPs. Comparison of vsp1267 with another VSP gene sequence revealed striking conservation, both at the nucleotide and amino acid levels, and the 3' ends of the genes. An oligonucleotide derived from this region detected size-variant VSP transcripts in 4 of 5 G. lamblia clones analyzed, suggesting the general utility of this probe in studying VSP genes and their expression. PMID- 1775166 TI - Characterization of an hsp70 gene from the human filarial parasite, Brugia malayi (Nematoda). AB - We have previously shown that an Onchocerca volvulus cDNA clone in lambda gt-11 designated OvG15, potentially encoding a peptide homologous to the 70-kDa heat shock protein (Hsp70), was recognized by sera of many individuals living in a zone endemic for lymphatic filariasis and most strikingly by sera from amicrofilaremic individuals including endemic normals, those with chronic symptoms and TPE patients. Few asymptomatic microfilaremics recognized the Hsp70. We have now used the insert from the OvG15 clone to isolate the homologous gene from Brugia malayi and analyze its primary structure and expression. The data presented in this communication describe a heat-inducible member of the hsp70 gene family of B. malayi which demonstrates intriguing features of tissue specific basal level expression, developmental regulation and heat inducibility. PMID- 1775167 TI - Genetic hybrids of Plasmodium falciparum identified by amplification of genomic DNA from single oocysts. AB - Individual oocysts from Plasmodium falciparum-infected Anopheles gambiae and Anopheles stephensi mosquitoes have been examined by the PCR technique, after their removal from the midgut. The DNA obtained from these oocysts has been amplified using oligonucleotide primers specific for part of the merozoite surface antigen MSA-1 gene. This technique distinguishes oocysts which are the products of self-fertilisation events from those which are the products of cross fertilisation between different parasite clones. PMID- 1775168 TI - Dirofilaria immitis superoxide dismutase: purification and characterization. AB - Superoxide dismutase (SOD) was purified to apparent homogeneity from Dirofilaria immitis, the causative agent of Dog Heartworm disease which is prevalent in the Southeastern United States. The enzyme has a molecular weight of 18,000 under denaturing conditions with an isoelectric point of 5.6. Both values are similar to those found for previously purified helminth SODs. The amino acid analysis shows greater similarity with mammalian SODs than with the published Schistosoma mansoni SOD, probably because the S. mansoni enzyme appears to be an extracellular, not a cytosolic, SOD. Although SOD activity is easily detected in D. immitis homogenates, the hydrogen peroxide scavenging activities of catalase and glutathione peroxidase were below the limits of our assay. This suggests that D. immitis primary defense against oxidants may be SOD. We feel that this line of research may provide valuable insights into a vulnerable area of D. immitis that may be a good target for drug therapy. PMID- 1775169 TI - A Plasmodium falciparum blood stage antigen highly homologous to the glycophorin binding protein GBP. AB - We have isolated a gene coding for a protein highly homologous to an antigen known as the glycophorin binding protein (GBP) which was therefore called GBPH. The gene consists of 2 exons interrupted by an intron located at a position corresponding to that of the GBP gene. The deduced amino acid sequence of GBPH comprises 427 residues and is characterized by a signal sequence and by an extended repeat region consisting of 8 units of 40 amino acid residues. The comparison of the amino acid sequences of GBPH and GBP reveals an identity of 69%. Antisera raised against a GBPH fragment that carries part of the repetitive region cross-react with GBP (105 kDa) and additionally detect some bands between 40 and 70 kDa, one of which may correspond to GBPH. The genes coding for GBP and GBPH are located on chromosomes 10 and 14, respectively. The GBP gene is transcribed as a highly abundant 6.5 kb mRNA in the blood-stage form, whereas Northern blot analysis using a GBPH specific probe detects 2 less abundant mRNAs of 2.3 kb and 2.7 kb. Southern blot analysis of P. falciparum DNA identifies a third member of the GBP gene family. PMID- 1775170 TI - Polymorphism of the alleles of the merozoite surface antigens MSA1 and MSA2 in Plasmodium falciparum wild isolates from Colombia. AB - The degree of polymorphism and the allelic distribution of 2 major Plasmodium falciparum merozoite surface antigens (MSA1 and MSA2) have been analysed in clinical isolates from Colombia. DNA was prepared directly from patients' blood and used in PCR reactions to amplify block 2 of MSA1 and the central region from MSA2. Thirty one samples were analysed and a marked degree of length polymorphism was detected, especially for MSA2. A high proportion of multiple bands was also observed, most probably resulting from mixed infections. Allele-specific oligonucleotides were used to type both alleles. For MSA1, 26 out of 31 clinical isolates were of the RO33 type, 15 were MAD20 and three were typed as KI. When the MSA2 allele was analysed, 7 isolates hybridised with a CAMP specific probe and 6 hybridised strongly with an FC27-derived oligonucleotide. Two samples, which showed multiple bands, hybridised with both probes. Interestingly, in 14 out of 27 isolates the MSA2 allele remained unassigned by the specific probes. Five of these were cloned and their DNA sequenced; these sequences are discussed. PMID- 1775171 TI - Sequence of the gene encoding an immunodominant microneme protein of Eimeria tenella. AB - A heterodisperse family of antigens, previously detected on sporozoites and merozoites of Eimeria tenella, has been localised to the microneme organelles within the sporozoite. Sequencing of genomic and cDNA clones shows that the gene for this antigen family contains 4 exons separated by 3 short (519, 226 and 156 nucleotides) intervening sequences and that the predicted polypeptide from the longest open reading frame has 4 structural domains. One of these contains 5 copies of the thrombospondin-like motif, previously identified in the partial sequence of the gene, which is conserved in a variety of molecules which have been demonstrated to have adhesive properties. A second domain of the polypeptide has strong similarity to a conserved region that occurs in another group of molecules which have adhesive properties, including the alpha subunits of several integrins, complement factor Bb and a number of extracellular matrix glycoproteins. Overall the antigen resembles the thrombospondin-related anonymous protein identified in the erythrocytic stage of Plasmodium falciparum. The structure of the gene supports a role for this microneme antigen in cell-cell or cell-matrix interactions. PMID- 1775172 TI - The primary structure of Plasmodium falciparum DNA polymerase delta is similar to drug sensitive delta-like viral DNA polymerases. AB - We report the isolation and sequencing of genomic DNA clones that encode the 1094 amino acid catalytic subunit of DNA polymerase delta from the human malaria parasite Plasmodium falciparum. Protein sequence comparison to other DNA polymerases revealed the presence of six highly conserved regions found in alpha like DNA polymerases from different prokaryotic, viral, and eukaryotic sources. Five additional regions of amino acid sequence similarity that are only conserved in delta and delta-like DNA polymerases, so far, were present in P. falciparum DNA polymerase delta. P. falciparum DNA polymerase delta was highly similar to both Saccharomyces cerevisiae DNA polymerase delta (DNA polymerase III; CDC2) and Epstein-Barr virus DNA polymerase at the amino acid sequence, and the predicted protein secondary structure levels. The gene that encodes DNA polymerase delta resides as a single copy on chromosome 10, and is expressed as a 4.5-kb mRNA during the trophozoite and schizont stages when parasite chromosomal DNA synthesis is active. PMID- 1775173 TI - Identification of paramyosin as a potential protective antigen against Brugia malayi infection in jirds. AB - Vaccination of jirds with irradiated infective larvae of Brugia malayi has been reported to provide partial immunity to larval challenge. In the present study, we found that sera from vaccinated animals recognized larval antigens with apparent molecular weights of 97, 55-60, and 10 kDa that were not recognized by sera from infected animals. A B. malayi cDNA expression library in lambda gt11 was screened to identify clones that were preferentially recognized by sera from immunized animals. One of these clones (BM-5) was chosen for further study. BM-5 contains a 2.1 kb DNA insert and produces a fusion protein with a molecular weight of 185 kDa. Antibody, affinity-purified with the BM-5 fusion protein, binds to a 97 kDa native B. malayi antigen. Immunological studies and partial DNA sequence data confirm that BM-5 encodes paramyosin. Recombinant B. malayi paramyosin is strongly recognized by antibodies in sera from jirds that have been immunized either by injection with irradiated larvae or by chemotherapy abbreviated infection. Most sera from infected jirds do not contain antibody to paramyosin. Additional studies are needed to determine whether paramyosin is actually protective in this filariasis model. PMID- 1775174 TI - Sequence conservation among merozoite apical complex proteins of Babesia bovis, Babesia bigemina and other apicomplexa. PMID- 1775175 TI - Molecular cloning and sequence analysis of a calcium-activated neutral protease (calpain) from Schistosoma mansoni. PMID- 1775176 TI - Molecular cloning and sequencing of the alpha-tubulin gene from Schistosoma mansoni. PMID- 1775177 TI - Degradation of oxidised insulin A and B chains by the major cysteine proteinase (cruzipain) from Trypanosoma cruzi epimastigotes. PMID- 1775178 TI - Regulation of beta-endorphin biosynthesis in the brain: different effects of morphine pelleting and repeated stress. PMID- 1775179 TI - Transcriptional regulation of the rat prodynorphin gene. PMID- 1775180 TI - Regulation of carboxypeptidase E (enkephalin convertase). PMID- 1775181 TI - Use of site-directed mutagenesis to elucidate the active site of neutral endopeptidase 24.11 (enkephalinase). PMID- 1775182 TI - Human cytochrome P450: possible roles of drug-metabolizing enzymes and polymorphic drug oxidation in addiction. PMID- 1775183 TI - Regulation of acetylcholine receptor gene expression. PMID- 1775184 TI - Brain nicotinic receptor genes. PMID- 1775185 TI - Characterization of mammalian potassium channel genes. PMID- 1775186 TI - An approach to the molecular biology of opiate tolerance: identification of opiate-regulated transcripts. PMID- 1775188 TI - Comparison of various spasmolytic drugs on guinea-pig isolated common bile duct. AB - Guinea-pig common bile duct preparations were used to quantify the spasmolytic potency of N-butylscopolamine (NBS), papaverine, gallopamil and nifedipine. A method was developed which allowed the measurement of intraluminal pressure changes in vitro. Barium chloride, carbachol and a solution with elevated potassium concentrations were used to stimulate smooth muscles. Concentration response relationships for the spasmogens as well as for the spasmolytic drugs were evaluated in a cumulative manner. Furthermore, non-cumulative concentration response curves were constructed for carbachol in the absence and presence of NBS. The -log EC50-values of the spasmogens were found to be 3.28 +/- 0.08 (BaCl2), 6.46 +/- 0.07 (carbachol) and 1.31 +/- 0.08 (KCl), respectively. The Emax values of carbachol and potassium were comparable, and were twice as high as the Emax of BaCl2. Papaverine was less potent than the calcium antagonists gallopamil and nifedipine, but proved capable of completely suppressing elevated muscular tone of the common bile duct preparation, independent of the stimulus used. NBS showed a high potency in suppressing only a carbachol-induced pressure increase, while it was rather ineffective when BaCl2 or a high potassium solution was used as the spasmogen. The concentration-response-curve for carbachol was shifted to the right in a parallel manner by NBS. Only a slight depression of Emax was observed. From the results it is concluded that NBS acts mainly as a muscarinic receptor antagonist. The high potency found for the calcium antagonists, gallopamil and nifedipine, in this model may indicate a possible role for these compounds in the treatment of biliary colic. PMID- 1775187 TI - Angiotensin II-induced increase in slowly exchanging 45Ca2+ in relation to contractile responses of rat and guinea-pig aorta. AB - To gain more information about sources of activator Ca2+ involved in the contraction of rat and guinea-pig aorta evoked by angiotensin II and their sensitivity to Ca2+ entry blockers, measurement of slowly exchanging 45Ca2+ was established. A more physiological procedure was used, replacing La(3+)- and EGTA containing solutions by a normal Ca(2+)-containing buffer. It was demonstrated that the angiotensin II-induced increase in slowly exchanging 45Ca2+ in rat aorta was incompletely (by approximately 60%-70%) inhibited by the organic Ca2+ entry blockers nifedipine, verapamil and diltiazem and by other Ca2+ entry blocking compounds like CoCl2 and chlorpromazine. 8-(N,N-diethylamino)octyl 3,4,5 trimethoxybenzoate hydrochloride (TMB-8) was able to inhibit the angiotensin II induced increase in 45Ca2+ content completely, but this may be an intracellular storage effects. By contrast, the organic Ca2+ entry blockers completely inhibited that part of the angiotensin II-induced contraction of rat aorta which was dependent upon extracellular Ca2+. In guinea-pig aorta, the increase in 45Ca2+ content elicited by angiotensin II could be completely suppressed by all compounds under study. The results of these experiments correlated well with data from the functional experiments in guinea-pig aorta. In both preparations the release of Ca2+ from a rapidly as well as a slowly exchanging intracellular pool appears to contribute to the contractile response elicited by angiotensin II. PMID- 1775189 TI - Coenzyme Q10 attenuates cyanide-activation of the ATP-sensitive K+ channel current in single cardiac myocytes of the guinea-pig. AB - The effect of coenzyme Q10 (CoQ10) on the cyanide (CN-)-induced ATP-sensitive K+ channel current (KATP) was examined in single atrial myocytes, using the patch clamp technique. Superfusion of the cells with a CN-/low glucose bathing solution induced an outward current in the whole-cell clamp condition. Glibenclamide (1 microM) abolished this current, indicating that the current was carried through the KATP channel. After steady-state activation by CN-, pinacidil (a KATP channel opener, 300 microM) failed to further increase the current. In cell-attached patches, CN-, when applied to the bath, induced bursting openings of an 80 pS channel (the KATP channel). In cells preincubated for 30 min in a solution containing CoQ10 (100 micrograms/ml), CN(-)-activation of the KATP channel was markedly attenuated both at the whole cell and at the single channel level. At the steady-state effect of CN- in CoQ10-treated cells, pinacidil (300 microM) activated the current to the maximum level achieved by CN- in the control cells. These results suggest that CoQ10 reduces in the CN(-)-induced KATP current not by affecting the channel itself but by preventing depletion of intracellular ATP caused by CN-. PMID- 1775190 TI - Characterization of muscarinic receptors mediating release of epithelial derived relaxant factor (EpDRF) in guinea-pig isolated trachea. AB - Muscarinic receptors mediating the release of epithelial derived relaxant factor (EpDRF) have been studied by using both contractions of the guinea-pig tracheal strip (with epithelium intact or denuded) or a coaxial bioassay assembly (rat anococcygeus-recipient; guinea-pig trachea-donor tissue). Indomethacin (1 microM/1) and physostigmine (0.1 microM/1) were both present throughout the study. In the tracheal strip studies, the potencies and maximal effects of all agonists studied (acetylcholine, arecoline, bethanechol, carbachol, (+)cis dioxolane, ethoxyethyltrimethylammonium, L-660,863, (+/-)methacholine and OXA-22) were not affected or were only slightly (but significantly) reduced by removal of the epithelium. The -log KB for the muscarinic antagonists, atropine, pirenzepine, methoctramine and 4-DAMP (4-diphenyl-acetoxy-N-methylpiperidine) were also not affected and the -log KB values were consistent with M3 muscarinic receptor function. However, the -log KB value of para-fluoro-hexahydro siladifendol (p-F-HHSiD) was significantly (P less than 0.05) increased upon epithelial denudation (epithelium intact, 7.1; epithelium removed, 7.6). The coaxial bioassay assembly provided more convincing evidence for release of EpDRF in that all muscarinic agonists studied caused relaxations of a precontracted anococcygeus tissue. These relaxations were observed only in the presence of a tracheal tube possessing an intact epithelium. The rank order of potencies for agonists at receptors mediating EpDRF dependent relaxation were similar to those estimated at receptors causing contraction. These data suggested that a substantial receptor reserve was associated with the receptors mediating both EpDRF release and contraction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775191 TI - Superoxide dismutase partially prevents sympathetic denervation by 6 hydroxydopamine. AB - The effects of superoxide dismutase (S.O.D.) in two models of chemical denervation induced by 6-hydroxydopamine (6-OHDA) were studied. To evaluate the effects of S.O.D. on in vitro 6-OHDA-induced denervation, fragments of the lateral saphenous veins of mongrel dogs were pre-incubated in oxygenated Krebs Henseleit solution with or without S.O.D. and then incubated under control conditions, with 6-OHDA or with 6-OHDA + S.O.D. Following the incubation period the fragments were repeatedly washed with Krebs solution and then used for determination of noradrenaline and for morphological study. 6-OHDA produced a profound depletion of noradrenaline. This depletion was significantly reduced although not prevented by S.O.D. The protective effect of S.O.D. was concentration-dependent. The ultrastructural study confirmed the 6-OHDA-induced sympathetic nerve degeneration as well as the protective effect afforded by S.O.D. In order to evaluate the effects of S.O.D. on in vivo 6-OHDA-induced denervation, male Wistar rats were anaesthetized and the tail vein cannulated. Saline or S.O.D. were intravenously delivered. 6-OHDA was injected five minutes after the beginning of infusions. Fragments of the left ventricle and vasa deferentia were used for determination of noradrenaline and for morphological study. 6-OHDA produced a significant depletion of noradrenaline in the left ventricle and vas deferens (to 8% and 18% of control values respectively). This depletion was reduced, though not prevented by S.O.D. Morphological data confirmed the neurotoxic effect of 6-OHDA and a protective role for S.O.D.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775192 TI - The steady-state concentration gradient for 3H-noradrenaline generated by uptake1 in the extracellular space of the rat vas deferens incubated with this amine. AB - The rat vas deferens was incubated with 0.2 mumol/l 3H-noradrenaline for 60 min, washed out with amine-free solution for 100 min and then prepared for autoradiography (same tissues as presented by Azevedo et al. (1990) Naunyn Schmiedeberg's Arch Pharmacol 342:245-248). The autoradiographic images were then digitized, and grain density was determined as a function of the distance from the surface of the tissue. When neither monoamine oxidase nor vesicular uptake was impaired, i.e. under control conditions, grain density declined monophasically exponentially towards the centre of the tissue. Tis decline amounted to 0.017 micron-1 or 0.124 varicosity-1, since the average distance between varicosities was calculated to be 7.4 microns. After inhibition of monoamine oxidase and vesicular uptake the rate constant was significantly reduced, and the grain density in close proximity of the surface of the tissue was also reduced. It is proposed that the distribution of grain density observed in controls reflects the steady-state concentration gradient that is generated by uptake1 during the incubation with 3H-noradrenaline. During spontaneous efflux of 3H-noradrenaline one has to distinguish between "re-uptake of the 3H-amine into the leaking varicosity" and "uptake en passant" (during diffusion through the extracellular space). On the basis of the present results, the extent of "uptake en passant" was calculated (with a computer-assisted model) for the spontaneous efflux of heterogeneously distributed 3H-noradrenaline (after wash-out). "Uptake en passant" into varicosities located between the source of efflux and the medium amounted to about 55% of the net leakage of 3H-noradrenaline from all varicosities.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775193 TI - Effects of diazepam on nociception in rats. AB - Acute i.p. injection of diazepam (1 mg/kg) resulted in a moderate increase in the tail-flick latency in rats. Tolerance to this diazepam effect developed after 10 days of diazepam treatment (1 mg kg-1 day-1). The benzodiazepine antagonist Ro 15 3505 only partially reversed the effect of diazepam on nociception. Naloxone (5 mg/kg i.p.) failed to affect the effect of diazepam on nociception, while the kappa antagonist MR 2266 fully antagonized the diazepam-induced increase of the tail-flick latency. Diazepam injected intracerebroventricularly (1, 5, 20 micrograms/rat) did not alter basal nociceptive threshold, however, diazepam injected intrathecally (20 micrograms/rat) prolonged the tail-flick latency. Furthermore, intracerebroventricular injection of muscimol partially antagonized the i.p. diazepam-induced increase of the tail-flick latency. These results suggest that benzodiazepine receptor sites are partially involved in the effect of diazepam on nociception and indicate that an indirect kappa-opioid-receptor mediated mechanism may be involved. The anatomical site of diazepam action on tail-flick latency seems to be at the spinal level. Descending axons to the spinal cord from brain areas reached by intracerebroventricular injection of muscimol seem to modulate the effect of diazepam effect on nociception. PMID- 1775194 TI - Carrier-mediated outward transport of dopamine from adrenergic varicosities of the vas deferens of reserpine-pretreated rats. AB - In vasa deferentia of reserpine-pretreated rats a carrier-mediated (i.e., desipramine-sensitive) outward transport of endogenous dopamine was induced by either tyramine or ouabain. The dopamine taking part in the efflux induced by tyramine (and the concomitant efflux of DOPAC) was derived from ongoing synthesis of dopamine. Inhibition of MAO trebled the rate of spontaneous efflux of dopamine and reduced the spontaneous efflux of DOPAC by 90%. After inhibition of MAO, desipramine caused a further five-fold increase in the basal efflux of dopamine with no change in the basal efflux of DOPAC. Inhibition of COMT failed to affect the spontaneous efflux of dopamine but increased that of DOPAC. It is concluded that, after depletion of the noradrenaline stores by pretreatment with reserpine, an outward transport of axoplasmic dopamine is induced by the same mechanisms that (without any pretreatment with reserpine) are known to initiate an outward transport of noradrenaline. PMID- 1775195 TI - "Real time" measurement of endogenous dopamine release during short trains of pulses in slices of rat neostriatum and nucleus accumbens: role of autoinhibition. AB - Release of endogenous dopamine elicited in slices of rat neostriatum or nucleus accumbens by a single electric pulse or by trains of 4 or 10 pulses was examined using fast cyclic voltammetry. Single electric pulses gave rise to a marked and transient increase in the extracellular concentration of dopamine in the neostriatum (by 0.43 mumol/l) and nucleus accumbens (by 0.39 mumol/l). The overflow elicited by subsequent pulses delivered at a frequency of 0.2 Hz caused separate but much smaller peaks of dopamine concentration, whereas the overflow elicited by subsequent pulses delivered at 1 Hz caused only a shoulder in the descending limb of the peak due to pulse 1. Four pulses at 5 Hz produced a monophasic response that was higher than the single pulse-evoked peak. Nomifensine 1 mumol/l greatly increased and prolonged the evoked overflow of dopamine. In the absence of nomifensine, metoclopramide 0.3 mumol/l did not change the response to a single pulse or 4 pulses delivered at 0.2 Hz but increased the response to 4 or 10 pulses at 1 Hz and to 4 pulses at 5 Hz. In the presence of nomifensine, metoclopramide increased the response to a single pulse as well as, to a greater extent, the response to 4 pulses at 0.2 Hz and 4 pulses at 1 Hz. Sulpiride 1 mumol/l produced effects similar to those of metoclopramide in the neostriatum in the presence of nomifensine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775196 TI - Apparent heterogeneity of cardiac A1 adenosine receptors as revealed by radioligand binding experiments on N-ethylmaleimide-treated membranes. AB - While G protein-coupled receptors are often studied by analyzing antagonist radioligand: "cold" agonist inhibition curves using an independent site model, it is now clear that KL and KH values determined in these analyses are not reliable estimates of the affinities of the agonists for "free" and G protein-coupled forms of the receptor. Thus, such experiments cannot be used to contrast the characteristics of a given type of receptor in different tissues, i.e., to probe for the existence of receptor subtypes. Since treatment with N-ethylmaleimide treatment blocks receptor: Gi/Go protein interactions, such analyses on N ethylmaleimide-pretreated membranes should allow direct assessment of the affinities of competing ligands for the free receptor or for multiple receptor subtypes. As A1 adenosine receptors couple to Gi, and perhaps to Go, we have performed A1 adenosine receptor radioligand "competition" studies first on control, then on N-ethylmaleimide-pretreated bovine cardiac and cerebral cortical membranes. Results of experiments with the antagonist radioligand [3H]xanthine amine congener appeared to be confounded by ligand binding to A2 adenosine receptors present in the cardiac membrane preparations. Further experiments utilized the A1-specific radioligand [3H]1,3-dipropyl-8-cyclopentylxanthine. These experiments confirmed once more that the KL values determined by computer analysis of "competition" curves performed on control membranes are not reliable estimates of the affinities of the competing ligand for free receptors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775197 TI - Further characterization of the effects of imipramine on plateau membrane currents in guinea-pig ventricular myocytes. AB - The effects of imipramine, a tricyclic antidepressant, on action potential characteristics and plateau membrane currents were studied in isolated guinea-pig ventricular myocytes, using the whole cell configuration of the patch-clamp technique. Imipramine (1, 5 and 15 mumols/l) decreased in a concentration dependent manner the amplitude and shortened the duration of the action potential, but it had no effect on resting membrane potential. At all three concentrations tested, imipramine decreased the delayed outward potassium current, this effect being apparently voltage-independent since it did not modify the activation curve. Imipramine, 5 and 15 mumols/l, also produced an inhibition of the peak high threshold calcium current, but did not change the shape of the current-voltage relationship or the apparent reversal potential of this current. Therefore, imipramine probably decreased the maximum available calcium conductance. However, the inward rectifying potassium current was not affected by any concentration of imipramine tested. Imipramine, 1 and 5 mumols/l, shortened the duration of the action potentials elicited in the presence of the inorganic calcium channel blocker cobalt chloride, and at 5, but not at 1 mumol/l, also shortened the action potentials obtained in the presence of the sodium channel blocker tetrodotoxin. Washout of imipramine completely reversed all its effects within 15 minutes. All these results suggest that imipramine at a concentration of 1 mumol/l produced a shortening in action potential duration by inhibiting the late sodium current flowing during the plateau phase of the action potential. At concentrations of 5 and 15 mumols/l the effect of imipramine on action potential duration can also be explained by a blocking effect on the high threshold calcium current. PMID- 1775198 TI - Inhibition of potassium outward currents and pacemaker current in sheep cardiac Purkinje fibres by the verapamil derivative YS 035. AB - The electrophysiologic mode of action and potency of the verapamil derivative YS 035 (N,N-bis-(3,4-dimethoxyphenethyl)-N-methyl amine) were investigated in sheep cardiac Purkinje fibres. Action potential duration measured at a repolarization level of -60 mV (APD-60) and membrane currents recorded with the two microelectrode voltage-clamp technique were evaluated. At 10 mumols/l YS 035 APD 60 was increased to about 115% of reference. Prolongation measured as percentage of the respective control exhibited on the average no dependence on stimulation frequency (0.17-2 Hz). At 100 mumols/l membrane became depolarized to about -50 mV and action potentials could no longer be elicited. Further study was focussed on effects on outward currents, mostly activated at a frequency of 0.05 Hz. Transient outward current (ito) was completely blocked at 100 mumols/l and half maximal inhibition occurred at about 14 mumols/l. Inwardly rectifying potassium current (ik1) was reduced to 47% of reference at 100 mumols/l. An initially activating outward current at positive membrane potentials (iinst) was reduced to 73% at 100 mumols/l. Time-dependent (delayed) outward current (iK) was on the average not affected up to 100 mumols/l. Besides inhibition of repolarizing outward currents YS 035 completely blocked pacemaker current (if) at 100 mumols/l and half-maximal reduction was achieved at 5 mumols/l. YS 035 (1-100 mumols/l) did not clearly affect time constants of activation at selected test potentials (IK: +35 mV; if: -90 mV) or inactivation (ito: 0 mV). Voltage-dependent control mechanisms of currents (ito, if) were not influenced by YS 035 but the amount of available current was reduced.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775199 TI - Effects of the enantiomers of disopyramide and its major metabolite on the electrophysiological characteristics of the guinea-pig papillary muscle. AB - Disopyramide, a Class Ia antiarrhythmic drug, is clinically used as a racemic mixture; R(-)disopyramide and S(+)disopyramide. The major metabolite in man is desisopropyldisopyramide: R(-)desisopropyldisopyramide and S(+)desisopropyldisopyramide. The effects of the four compounds were compared on the electrophysiological characteristics of the guinea-pig papillary muscle using the standard microelectrode technique. At an external K+ concentration of 5.4 mmol/l and a stimulation frequency of 1 Hz, S(+)disopyramide (20 mumols/l) increased action potential duration (APD) by more than 18%, while it was diminished by 6% in the presence of R(-)disopyramide. Resting membrane potential amounted to -87.1 +/- 0.5 mV (n = 14) and -85.6 +/- 1.2 mV (n = 10), respectively. Also a small but significant difference in effect on the maximal rate of depolarization was observed, R(-)disopyramide being more potent, related with a slower recovery of the maximal rate of depolarization. The enantiomers of the metabolite appeared to be three times less potent than those of the parent drug in their effect on the maximal rate of depolarization. The characteristics of the enantiomers of the metabolite correlated with those of the parent drug: also the R(-)enantiomer was more potent in decreasing the maximal rate of depolarization and caused more shortening of the action potential than the S(+)enantiomer. Time constants for onset and recovery of/from rate dependent block of the maximal rate of depolarization were dependent upon the external K+ concentration, both for the enantiomers of the parent drug and those of the metabolite. Onset slowed down while recovery accelerated when external K+ was increased. Time constants were lower for the metabolite. When stimulation interval was shortened, the effect on the maximal rate of depolarisation increased. Only for the metabolite statistical significant stereoselective differences were observed at all stimulation intervals. The effects on the action potential duration were dependent upon stimulation interval; for all enantiomers the action potential duration tended to be relatively (% of control) higher at short stimulation intervals than at large stimulation intervals. The effect on the maximal rate of depolarization was also voltage dependent, but no significant differences were observed between the enantiomers, for the parent drug as well as for the metabolite. PMID- 1775200 TI - Class III antiarrhythmic drugs (amiodarone, bretylium and sotalol) on action potentials and membrane currents in rabbit sino-atrial node preparations. AB - Electrophysiological effects of class III antiarrhythmic drugs (amiodarone, bretylium and sotalol) were examined in spontaneously beating and voltage-clamped rabbit sino-atrial node preparations, using a two microelectrode technique. At 10(-6) mol/l these class III antiarrhythmic drugs prolonged the cycle length significantly, but did not affect the action potential duration. At high concentration (10(-4) mol/l), amiodarone and sotalol prolonged the action potential duration as well as the cycle length. Sotalol 10(-5) mol/l depolarized the maximum diastolic potential. Amiodarone 10(-4) mol/l and bretylium 10(-5) mol/l depressed the maximum rate of depolarization. At concentrations ranging from 10(-7) to 10(-4) mol/l, amiodarone induced dysrhythmia in 5 of 10 preparations and bretylium in 3 of 7 preparations, but sotalol in none of 5 preparations. In voltage-clamped sino-atrial node preparations, all the class III antiarrhythmic drugs decreased the slow inward current in a concentration dependent manner. The steady-state outward and the hyperpolarization-activated inward currents were also reduced. Sotalol (10(-5) mol/l) decreased both the outward current and the hyperpolarization-activated inward current stronger than the slow inward current. In addition, amiodarone (3 x 10(-6) mol/l) depressed the inactivation curve for the slow inward current, but it did not shift the potential of half-maximum inactivation. The drugs also depressed the activation curve for the outward current in a concentration-dependent manner. However, the values of half-maximum activations were not influenced by these drugs as compared to control.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775201 TI - Use of ion channel blockers in studying the regulation of skeletal muscle contractions. AB - Effects of K(+)- and Cl(-)-channel blockers on the muscle contraction of mouse diaphragm in response to direct electrical muscle stimulation were studied. K(+) channel blockers (0.1-1 mmol/l 4-aminopyridine, 0.4-1.2 mmol/l uranyl nitrate and 2-30 mmol/l tetraethylammonium chloride) and a Cl(-)-channel blocker (0.01-0.03 mmol/l 9-anthracene carboxylic acid) increased the contractile amplitudes in a limited extent not to exceed over 50% of control. However, the sequential applications of two different channel blockers at a rather low concentration markedly increased the contractile responses mostly over 300% of control except the combination of 4-aminopyridine and uranyl nitrate. It appears that two K(+) channel blockers synergistically exerted their effects rather than additionally in the regulation of muscle contractions. Investigation on the possible mechanism of the synergistic action of K(+)-channel blockers suggested that prolongation of action potential durations was in a linear correlation with the increased contractions. On the other hand, the contractile potentiation induced by combination of K(+)- and Cl(-)-channel blockers was attributed to the production of repetitive action potential firings (150 +/- 12 Hz) upon a single electrical stimulation. Similar to Cl(-)-channel blocker, low Cl- as well as low Ca2+ enhanced K(+)-channel blockers in producing contractile potentiation accompanied with stimulus-bound repetitive discharges. Tetrodotoxin at a concentration of 0.03 mumol/l which did not affect the twitches evoked by electrical stimulations completely inhibited the contractile potentiation induced by the combined application of K(+)- and Cl(-)-channel blockers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775202 TI - Modulation of intracellular calcium by potassium channel openers in vascular muscle. AB - We investigated two putative K+ channel openers, pinacidil and BRL34915 (cromakalim), and demonstrated their vasorelaxant effectiveness on rat artery contractions induced by K+, tetraethylammonium (TEA), or norepinephrine. The K+ channel opener-induced decrease in tension was rapid, even when tension was stimulated by 100 mmol/l K+. Measurements of intracellular free Ca++ (activity) by ultra-high sensitivity digital imaging microscopy was carried out by briefly loaded fura 2 (fluorescence ratio) quantitation in isolated, contracting cells of rat azygos vein. Submicron resolution was achieved by measuring cytoplasmic Ca(++)-sensitive fluorescence at each pixel, and size and intensity of areas with high Ca++ concentrations, called hot spots, were determined by a computer generated, 3 lambda algorithm. Hot spots, which most likely represent the sites of Ca++ release and re-uptake by Ca(++)-regulatory organelles, increased in size and intensity upon addition of K+ or norepinephrine, reaching an early peak prior to the whole cell average peak in cytoplasmic Ca++ activity. Both norepinephrine and K(+)-induced stimulation resulted in Ca++ activity increases that were primarily due to Ca++ release from storage sites. Reduction of free Ca++ activity to resting or lower levels occurred upon addition of pinacidil or cromakalim. Intracellular Ca++ decreases due to K+ channel openers appeared abruptly beginning at the central portions of the cells, resulting in a pronounced early drop in central Ca++ activity while elevated Ca++ levels persisted at the periphery. While this late stage residual of peripheral Ca++ appears to be a significant step in the vascular muscle relaxant action of both K+ channel opener drugs, the level of Ca++ at peripheral sites was greater in response to pinacidil than to cromakalim. The results of this study suggest that in addition to increasing K+ conductance, pinacidil and cromakalim cause 1) decreased Ca++ activity in central regions of the myocytes, and 2) a shift in Ca++ distribution to primarily subsarcolemmal sites. These observations lead us to hypothesize separate control of peripheral and central Ca++ activity within a vascular muscle cell, with Ca++ redistribution that can be altered by vasorelaxants. We suggest that intracellular Ca++ redistribution may contribute the membrane potential independent part of the vasorelaxant action of the K+ channel openers. PMID- 1775204 TI - Short term volume effects of a hypertonic saline bolus during neurosurgery. AB - Intracranial hypertension which does not respond to customary hyperosmotic agents may successfully be treated with hypertonic saline. The absence of diuresis and the maintainance of intravascular volume are supposed to be the main advantages of hypertonic sodium chloride. Volume overload and toxic hyperosmolality from frequent application of such solutions are possible disadvantages. The presented experiments checked the time course of intravascular volume shifts after a 100 ml 1-molar saline bolus in 14 patients during neurosurgery using plasma protein concentration changes. An initial intravascular volume expansion of about 270 ml remained quite unchanged for the first 8 minutes, followed by a nearly linear decrease. Extrapolation of the curves demonstrated that the preinfusion state would have been reached after about 20 minutes. Osmolality remained increased by about 4 mosmol/kg 15 min after the bolus. Thus it appears that repetitive infusion of these amounts of hypertonic saline will cause no serious volume overload if 30 minutes intervals are kept, but osmolality should be checked before each bolus. PMID- 1775203 TI - Role of nitric oxide formation in the regulation of haemodynamics and the release of noradrenaline and adrenaline. AB - This study in the anaesthetized rabbit aimed at determining the role of nitric oxide (NO), the putative endothelium-derived relaxing factor, in the regulation of haemodynamics and the release into plasma of noradrenaline and adrenaline. Specific inhibition of NO formation was achieved by i.v. bolus injection of L-NG monomethyl-arginine (L-NMMA; 3-100 mg kg-1). Phenylephrine was infused i.v. at constant rates (2.5-20 micrograms kg-1 min-1) in order to assess baroreflex mediated changes in release due to direct peripheral vasoconstriction. Rates of noradrenaline and adrenaline release into plasma were determined by the radio tracer technique. L-NMMA, but not D-NMMA, dose-dependently increased mean arterial pressure and total peripheral vascular resistance, whereas both heart rate and cardiac output decreased concomitantly. The corresponding ED50 values for L-NMMA ranged from 11.2 to 18.5 mg kg-1. Inhibition of NO formation by L-NMMA as well as phenylephrine infusion caused decreases in the plasma clearance of noradrenaline and adrenaline which were correlated with the drug-induced decreases in cardiac output. Both L-NMMA and phenylephrine reduced the rate of noradrenaline release into plasma as they increased total peripheral resistance. Moreover, the curvilinear relationship between these two parameters obtained for L-NMMA was virtually identical to that produced by phenylephrine, indicating that the reduction in noradrenaline release by L-NMMA is mediated solely by the baroreflex. From the L-NMMA-induced maximum inhibition of noradrenaline release, it is concluded that the counter-regulation against peripheral vasodilation by NO accounts for 69% of basal noradrenaline release.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775205 TI - The use of fibrin sealant in cerebrospinal fluid leakage. AB - Cerebrospinal fluid leakage is one of the central problems facing neurosurgeons, both due to its occasional difficulty in management and to the catastrophical significance of ensuing infection. An important tool emerging in the surgical management of CSF leakage is fibrin sealant, the natural coagulation product. Thirteen cases of CSF leakage, due to meningomyelocele, posttraumatic, and secondary to tumor, that were managed surgically with fibrin sealant are presented. Several of the cases were successfully operated upon following failure of conventional surgical techniques. Additional uses of fibrin sealant in neurosurgery are discussed. PMID- 1775206 TI - Pulmonary embolism in neurosurgical patients. AB - We report the outcome of a retrospective study on the frequency of pulmonary embolism during the hospital stay in a series of 7,250 neurosurgical patients. Of 4,500 patients who underwent surgery 25 (0.55%) developed pulmonary embolism at some point after the operation while 5 of the 2,750 patients not operated on (0.18%) developed a fatal pulmonary embolism. We analyze the general risk factors -age, sex, length of stay and paralysis of the limbs. Meningioma was the most frequent intracranial tumor to be affected by this complication. We discuss the connection between thromboembolism and meningioma. PMID- 1775207 TI - Primary calvarial ectopic meningiomas. AB - Meningiomas should be considered as a possible diagnosis when dealing with tumors of the head and neck, even though these lesions may be located outside the cranial cavity. We report three patients who harbored primary ectopic epidural meningioma arising in the right occipital, parietal and left frontal region protruding extracranially through destructed calvarium and also developing intracranially without dural involvement. The diagnostic value of CT scan is emphasized and the relevant literature on ectopic meningioma is reviewed. PMID- 1775208 TI - Intraosseous neurilemmoma of skull--single case report. AB - Intraosseous neurilemmoma is a rare benign tumour of the bone with characteristic radiological and histological features. The most common places of this tumor are mandible, sacrum and vertebral bodies. A case of a not previously reported location of this tumor in the vault of the skull is presented. PMID- 1775209 TI - Intracranial schwannoma of the facial nerve: report of two cases and review of the literature. AB - Two cases of intracranial facial schwannoma growing from the labyrinthine portion of the facial nerve are reported. The clinical, pathological and diagnostic features and treatment of these rare lesions are discussed in the light of the most important literature on this topic. PMID- 1775210 TI - Primary Ewing's sarcoma of the calvarial skull. AB - Primary Ewing's sarcoma of the calvarial skull was diagnosed in a 10-years-old girl. Detailed angiographical investigations were performed in this large tumor, and although the larger part of the neoplasm was supplied by the external carotid artery, an unusual feature was the presence of a very thick arterial feeder, originating from the left callosomarginal artery. The tumor was radically resected. Adjuvant chemotherapy was given, and no recurrence or metastasis occurred during two years, after which the girl was lost for follow-up. PMID- 1775211 TI - A wooden foreign body penetrating the superior orbital fissure. AB - The case of a 12-year-old patient with a wooden foreign body which had penetrated the superior orbital fissure is presented. Using a transethmoidal approach, only some splinters lying in the periorbital soft tissue were removed. The patient became febrile, indicating an infectious complication due to a retained foreign body. This was confirmed by CT scan and MRI demonstrating a main splinter in the superior orbital fissure. Total removal of the wood was achieved via a pterional extradural approach. The difficulties of identifying wooden foreign bodies as well as the topographical problems involved with the approach to the superior orbital fissure are discussed. PMID- 1775212 TI - Congenital myotonic dystrophy associated with a chromosome pericentric inversion. AB - We report two cases of congenital myotonic dystrophy (CMyD) associated with a chromosome abnormality of pericentric inversion. Case 1 was a two-month-old boy, presented with 46 XY, inv (9) (p 11q 13). His father had the same chromosome abnormality without any clinical manifestations. His mother had clinical manifestations of myotonic dystrophy (MyD) but had no chromosomal aberration. Case 2 is a one-month-old girl, presented with 46 XX, inv (4) (p15.31q25). Her mother had clinical manifestations of MyD and the same chromosome abnormality as Case 2, but her father was normal. Our case report may be of value in adding further information on the pathogenesis of CMyD. PMID- 1775213 TI - Contribution of magnetic resonance imaging in the evaluation of microcephaly. AB - Magnetic resonance imaging (MRI) was performed in 33 children using a 2,35 T MR system. The intention was to determine the various types of morphological abnormalities seen in primary microcephaly and the frequency with which they occur. MRI findings were typical for cytomegalovirus infection in six patients. Cerebral malformations were found in 14 cases and patchy white matter lesions in both hemispheres in two subjects. MRI appeared to be abnormal in eight of the remaining 11 children. However, we were unable to provide an exact interpretation of the findings. All the children with MRI abnormalities with the exception of two were neurodevelopmentally deviant. Thus, MRI revealed abnormalities in the majority of infants with primary microcephaly and neurodevelopmental disturbances. It appears to be more sensitive than cranial ultrasound and computed tomography. PMID- 1775214 TI - Predictors of survival and characteristics of childhood stroke. AB - To determine predictors of outcome we reviewed 226 medical records of patients admitted to Children's National Medical Center with the diagnosis of cerebrovascular disease from 1978 to 1988. Ninety-five cases of stroke were identified by either neuroimaging techniques (87), autopsy (7), or clinical examination (1). Causal factors implicated in 89% of the patients included infectious (21%), vascular (18%), hematologic (15%), cardiac (13%) problems, minor trauma (8%) or miscellaneous (14%) causes. Patient outcome (n = 88) included residual impairment in 54%, complete resolution of their initial deficit in 23%, and death in 23%. Among patients with abnormal CT findings (n = 60), a logistic regression model revealed that patients with hemorrhage were at a significant risk (p = 0.0469) for death (odds ratio (OR) = 5.5, 95% confidence interval (CI) 1.2-24.5); those with an altered level of consciousness (stupor or coma) on presentation were also at risk (p = 0.0166; OR = 6.94, CI 1.7-28.5). The sensitivity and specificity of this model were 57% and 93%, respectively. No other clinical, laboratory, or demographic variable analyzed was predictive of outcome. PMID- 1775215 TI - EEG features and their evolution in the acute phase of haemorrhagic shock and encephalopathy syndrome. AB - Serial EEGs have been carried out during the acute phase of haemorrhagic shock and encephalopathy syndrome (HS&E) in 22 infants and children aged 3 months to 14 years. Most patients presented with fits and coma and all had shock with bleeding and disseminated intravascular coagulation (DIC). The initial EEG showed prolonged runs of often rhythmic discharges which fluctuated in amount and amplitude with varying distribution and morphology ("electrical storms"). Over a period of days the "electrical storms" gradually decreased leaving only low amplitude EEG activities or evolving to electrocerebral silence (7 cases). Fifteen patients died and all five children with multifocal "electrical storms" who survived showed gross neurological handicap. The rather distinctive EEG pattern is unusual in the context of an acute encephalopathy outside the neonatal period although similar "electrical storms" may be seen in a less extreme form in infants and children with other conditions associated with DIC. This EEG pattern presumably reflects changes in the cerebral microcirculation which in HS&E are usually relentlessly progressive and associated with devastating cortical damage. PMID- 1775216 TI - A nationwide survey on transient hyperammonemia in newborn infants in Japan: prognosis of life and neurological outcome. AB - A nationwide survey of transient hyperammonemia in newborns was carried out in Japan. A total of 18 patients, consisting of 12 male and 6 female infants, were reported from 11 facilities. These neonates exhibited hyperammonemia with plasma ammonia levels in the range from 124 to 6256 micrograms/dl. Four newborn infants of the 18 died in the neonatal period, and an additional one died in the early infancy. Among the 13 infants who were alive at the time of this survey, 6 had neurological sequelae, including mental retardation, spastic quadriplegia and epilepsy. The multivariate analysis revealed that the Apgar score at 1 minute, peak plasma ammonia concentration, birth weight and sex were significant factors affecting the prognosis of life. PMID- 1775217 TI - Detection of optic pathway misrouting in the human albino neonate. AB - The diagnosis of albinism is indicated by the presence of visual pathway misrouting in which temporal retinal fibers erroneously decussate at the optic chiasm disrupting the normal topographical distribution of retinal geniculate cortical projections. Detection of misrouted fibers is effected by non-invasive electrophysiological assessment of the topographical representation of the visual evoked potential (VEP) following full field monocular stimulation. By combining appropriate state defined neonatal recording procedures with the albino VEP test paradigm, the presence of aberrant optic pathway projections was detected in a five-day-old full-term infant. The electrophysiological signature pathognomonic to albinism was observed within a long (300 ms) latency window of an otherwise normal neonatal luminance flash response. The results of this study indicate that the VEP misrouting test can be extended to reliable albino diagnosis within the neonatal period. PMID- 1775218 TI - EEG findings in hypomelanosis of Ito. AB - The EEG findings in 15 children with Hypomelanosis of Ito have been reviewed and related to the clinical and CT scan data. Although no consistent electroclinical associations were found in the group as a whole, there was some association between the presence of abnormal rhythmic EEG activity and the radiological appearances of neuronal migration defects. In addition, the possibility is raised that there may be a distinctive sub-group of children with Ito's syndrome who present with an early onset of intractable seizures and who have a neuronal migration defect. PMID- 1775219 TI - Transient idiopathic dystonia in infancy. AB - The authors report eight otherwise normal children who presented with transient dystonic postures and/or movements in infancy. The anomalies appeared during the first months of life, progressed during a period then gradually disappeared at follow-up (from 3 months to 5 years). Differential diagnosis with primary orthopedic problems, cerebral palsy and early progressive CNS disease may be difficult at onset of the symptoms. Transient dystonia is probably one of the numerous mechanisms responsible for some abnormalities of tone, posture and movement in infancy and may account for some of the cases labeled as "transient cerebral palsy". Our cases resemble those described by Willemse (19) as "benign idiopathic dystonia in the first year of life". PMID- 1775220 TI - Acute cerebellar ataxia in a child with transient pontine lesions demonstrated by MRI. AB - A case of acute cerebellar ataxia with discrete signs of pyramidal and tegmental involvement is reported, several days after recovery from an upper respiratory infection of unknown etiology. Magnetic resonance imaging showed transient pontine lesions, disappearing in the convalescence phase. Laboratory tests established the etiologic diagnosis of post-infectious encephalitis. An allergic autoimmune response with subsequent demyelinisation is assumed. The important role of MR-imaging in similar acute syndromes is emphasized. PMID- 1775221 TI - Type III collagen deficient EDS IV producing muscular hypotonia with abnormal muscle fibroblasts. AB - Muscle biopsy and fibroblast culture of a floppy child with Ehlers-Danlos syndrome type IV were studied. Biochemical analysis of the tissue showed drastically reduced amount of collagen type III. Electron microscopic examination of muscle as well as of cultured fibroblasts showed grossly dilated and dominated the cytoplasm endoplasmic reticulum. Dilatation may result from storage of an abnormal collagen type III molecule. Our observations indicate that type III collagen deficiency may be present clinically as a congenital muscle hypotonia. Specific ultrastructural abnormalities of fibroblasts found in muscle biopsy can enable the proper diagnosis. PMID- 1775222 TI - Ethanol and magnesium ions inhibit N-methyl-D-aspartate-mediated synaptic potentials in an interactive manner. AB - The role of magnesium ions in the inhibitory effect of ethanol on NMDA receptor mediated population synaptic potentials (pEPSPs) in area CA1 of the hippocampus of the adult rat, was studied. The excitatory amino acid (non-NMDA) receptor antagonist, DNQX and the GABAA channel antagonist, picrotoxin, were used to pharmacologically isolate NMDA-mediated pEPSPs. In the presence of a physiological concentration of magnesium (1.0 mM), ethanol (25-100 mM) inhibited NMDA-mediated pEPSPs, with an apparent EC50 of approximately 50 mM. The ability of ethanol to inhibit NMDA-mediated pEPSPs was reduced when the slices were incubated in the absence of magnesium. Concentrations of ethanol, in the range of 50-200 mM (apparent EC50 100 mM), were required to inhibit NMDA-mediated pEPSPs, in the absence of added magnesium. Combination studies of these two antagonists indicated that the sensitivity of NMDA-mediated pEPSPs to one antagonist was not altered by the presence of the other. This finding suggests that the affinity of each antagonist binding site is not affected by the presence of the other antagonist. In the case of ethanol, its low maximum antagonist efficacy may require larger concentrations of ethanol to inhibit NMDA-mediated pEPSPs, in the absence of other non-competitive antagonists such as magnesium. PMID- 1775224 TI - Chronic ethanol exposure uncouples vasopressin synthesis and secretion in rats. AB - To assess the chronic effect of ethanol on vasopressin release and synthesis, hypothalamic vasopressin mRNA, plasma vasopressin levels and plasma osmolality were measured in control rats and rats exposed chronically to ethanol by vapor inhalation for 8 days. The level of hypothalamic vasopressin mRNA (vasopressin synthesis) was unchanged or significantly decreased in ethanol-treated rats, even when these animals displayed increased plasma osmolality and vasopressin levels. The results suggest that chronic ethanol exposure produces a down-regulation of vasopressin synthesis and/or a disruption of vasopressin synthesis-secretion coupling. These findings may have important implications for evaluation of the hydration state of chronic alcoholics. PMID- 1775223 TI - Effects of morphine on the electrochemical signal modified by noxious stimuli in the nucleus raphe magnus of anesthetized rats. AB - The effects of noxious stimuli and morphine on the serotonergic system in the nucleus raphe magnus were examined by in vivo voltammetry studies, using anesthetized rats. The normal electrochemical signal of 280-300 mV was essentially due to the presence of 5-hydroxyindoles in the nucleus raphe magnus. Heating or pinching produced mean decreases of 21.9 +/- 5.2% and 18.0 +/- 6.1% of control, respectively in the 5-hydroxyindole signal. Non-noxious (brushing or warm water) stimulation did not affect the 5-hydroxyindole signal. A small dose of morphine (0.5 mg/kg, i.p.) enhanced the inhibition of the signal by noxious stimuli but large doses (2.0 or 5.0 mg/kg, i.p.) resulted in lesser reductions of the signal. The value of the 5-hydroxyindole signal was unaffected by morphine alone (0.5, 2.0 and 5.0 mg/kg). Effects of both small- and large-doses of morphine were antagonized by naloxone (1 mg/kg, i.v.). Allopurinol (20 mg/kg, i.p.), a xanthine oxidase inhibitor, decreased the steady signal (40.7 +/- 16.2%). After pretreatment with allopurinol, noxious stimuli-induced decreases, both with and without administration of morphine, were similar to those in nontreated rats. In brief, noxious stimulation was found to decrease 5 hydroxyindole signal in the nucleus raphe magnus; morphine enhanced or attenuated this decrease in the anesthesized rat. PMID- 1775225 TI - Normal release from proactive interference in untreated patients with Parkinson's disease. AB - The relationship of release from proactive interference (PI) to set-shifting, explicit free recall and language remains controversial. We tested 56 patients with Parkinson's disease (PD) who had never received medication and 37 matched normal control subjects on a test of PI release based on semantic category. The PD group showed normal PI release but impaired word recall. PI release was independent of impaired Wisconsin card-sorting test performance, language production, explicit memory, overall cognitive status and severity of depression. The results indicate dissociation between ability to benefit from semantic stimulus properties and processes of explicit memory, set-shifting and expressive language. PMID- 1775226 TI - Mathematical ability and the right-shift theory of handedness. AB - A genetic theory of handedness, the right-shift theory, associates differential patterns of cerebral functioning with contrasting handedness groups and suggests that individuals with an rs + + genotype will be disadvantaged in mathematical performance. This hypothesis is investigated with contrasting handedness groups drawn from a national sample of over 11,000 children from the National Child Development Study. Some differentiation in cognitive performance between handedness groups is found in the direction predicted by the right-shift theory but the level of the findings is not statistically significant. The rs+ +/mathematical deficit hypothesis is not confirmed. PMID- 1775227 TI - The integrity of visual-proprioceptive mapping in cerebral palsy. AB - Existing data on the ability of normal children to make intra-modal and cross modal judgements about limb position are reviewed. A pattern of results emerges which suggests that although young children have difficulty with proprioceptive judgements, their performance is significantly enhanced if the task involves matching vision against proprioception. Some preliminary findings with cerebral palsied children suggest that this advantage may sometimes be lost. It is suggested, however, that the tasks used in previous studies do not allow the precise appraisal of this ability. This study examined intra- and cross-modal judgements in eight normal adults and eight severely cerebral palsied adolescents. In addition to the usual measures of spatial accuracy, joint angle measurements were recorded which allow some appraisal of the information strategy used for respective tasks. The results suggest that the cerebral palsied students had specific problems with mapping between vision and proprioception. This is discussed from a perspective of whether such mapping requires adaptive behaviour within a stable explorative environment, which is disrupted in cases of severe cerebral palsy. PMID- 1775228 TI - Handedness in the human fetus. AB - The developmental origins of behavioural asymmetries, in particular handedness, have aroused considerable interest and debate. Until now such behavioural asymmetries have only been reported after birth. Here we report the existence of handedness before birth, expressed in terms of thumb-sucking by the fetus. Ultrasound observations of fetuses from 15 weeks to term revealed a marked bias for sucking the thumb of the right hand. This preference appears to be maintained throughout pregnancy, is unrelated to fetal position in utero but correlates with head position preference in the supine newborn. The findings indicate that handedness is present prior to birth and the implications of this for the development of laterality are discussed. PMID- 1775229 TI - Right-sided anarchic (alien) hand: a longitudinal study. AB - A patient with a bilateral frontal vascular lesion, encroaching upon the mesial cortex on the left and damage of the corpus callosum showed the 'alien hand' phenomenon on the right. The various hypotheses as to the nature of the lesion for the alien hand phenomenon to appear are discussed. It is proposed that an acute clinical condition, following a lesion of the corpus callosum only, should be differentiated from a chronic condition resulting from the additional fronto mesial lesion. PMID- 1775230 TI - Use of left vs right hand in responding to lateralized stimuli in unilateral neglect. AB - Previous research suggests that contralesional limb activation may reduce the degree of visual neglect shown by hemi-inattentive subjects. The present study examines whether minimal assisted-left-limb activation (pressing a response key with the hemiplegic hand, aided by the ipsilesional hand) resulted in lowered response latencies on the neglected side in a group of six patients showing unilateral left visual neglect. The study was carried out using a simple computerized test of speed of detection of lateralized stimuli, with responses being made on a key located at the body midline. In five of the subjects, there was no evidence of relatively faster response times to contralesional stimuli when the contralesional limb was involved in the responses. In one of these five subjects, there was no hemiplegia, and hence full use of the contralesional limb. Only in one subject did an interaction appear between the side of presentation of the stimuli and limb used. In this case, a small but significant tendency appeared for the subject to make relatively faster responses to left-sided stimuli when using the left hand to make responses. PMID- 1775231 TI - Glial changes following an excitotoxic lesion in the CNS--I. Microglia/macrophages. AB - When an area of the adult rat CNS is depleted of neurons by an in situ excitotoxic injection, afferent axons to the area exhibit morphological alterations reminiscent of growth cones. These morphological changes are likely to be related to the deprivation of target cells. In addition, however, the area of neuronal loss is itself the site of profound changes in glial cell content, and altered axon-glial interactions may play a role in the axonal changes. In an attempt to define these interactions, we have undertaken a systemic study of glial populations in excitotoxically lesioned CNS over time. The microglial/macrophagic response is analysed in this paper; the astrocytic response is described in the companion paper [Dusart et al. (1991) Neuroscience 45, 541-549]. The microglial/macrophagic response was studied following kainic acid-induced neuronal loss in the thalamus of the adult rat. These microglial/macrophagic cells were labeled with the B4 isolectin from Griffonia simplicifolia, and the time-course of their response was studied between one day and one year post-lesion. This time-course study revealed different stages in the evolution of the response. At one day post-lesion, cell counts indicated that there was no increase in the number of non-neuronal cells in the neuron-depleted area. However, activated labeled cells were present in the entire thalamus on the side of the lesion, neuron-depleted or not. They were characterized by both increased lectin-binding and altered morphology when compared to quiescent microglia. In the absence of recruitment and/or proliferation, this result indicates that the early response consisted solely of the activation of resident microglia. By contrast, we observed a progressive increase in the number of non neuronal cells in the lesion from four to 15 days post-lesion. A recruitment of blood-borne monocytes was apparent, and the observation of mitotic labeled cells indicated a proliferation of microglial/macrophagic cells in situ. There was a progressive decrease in the microglial/macrophagic reaction that began one month after lesion. In a thin band of parenchyma surrounding the neuron-depleted area, activated microglial/macrophagic cells were seen contacting neurons, and clusters of glial cells were observed around neurons up to one year post-lesion. These results suggest that neurons around the lesion site itself may be injured, secondarily, from a long term deleterious effect of the inflammatory process. This study allows us to conclude that activated microglia/macrophages are the predominant glial cell type in the excitotoxically lesioned CNS over the first weeks.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1775232 TI - Glial changes following an excitotoxic lesion in the CNS--II. Astrocytes. AB - Astrocytes are involved, as are microglia/macrophages [Marty et al. (1991) Neuroscience 45, 529-539], in the formation of a glial scar after CNS lesions. This study was undertaken to follow the time-course of changes in the morphology and distribution of astrocytes that takes place during the formation of a glial scar after kainic acid injection in the rat thalamus. The astrocytes were identified using an antibody raised against glial fibrillary acidic protein (GFAP) and the progression of their reaction to the lesion was followed from 24 h to one year after the kainate injection. Three periods could be distinguished during the evolution of the astrocytic response in the neuron-depleted area. There was an initial appearance of a large number of GFAP+ cells. These cells displayed profound morphological differences from the normal. They were enlarged, round and devoid of processes. These GFAP+ astrocytes disappeared four days after the lesion. This increase of the GFAP+ cells in the neuron-depleted area may be due to cytoskeletal changes and thus an increased exposure of antigenic sites. In a second period between four and 14 days, the only GFAP+ elements present in the neuron-depleted area were long and straight processes. These processes entered the lesioned area from the periphery and seemed to follow axon bundles. Additionally, during the first weeks, the number of reactive astrocytes increased in a small band just around the area of neuronal loss. The third period began after two weeks. The lesioned area became gradually occupied by GFAP+ astrocytes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775233 TI - Gamma interferon-like immunoreactive material in rat neurons: evidence against a close relationship to gamma interferon. AB - Gamma interferon is a potent immunoregulatory peptide produced by activated lymphocytes. Recently, a gamma interferon-like immunoreactive molecule has been demonstrated immunohistochemically in subpopulations of rat neurons. We have now further characterized this molecule. Western blot analysis of spinal ganglia homogenates revealed a single 60,000 mol. wt band that was immunoreactive with monoclonal antibody DB1 directed against rat gamma interferon. A polyclonal antiserum and the monoclonal antibodies DB10 and DB12 failed to detect this band although all antibodies were able to label the major 18,000 mol. wt band of recombinant gamma interferon on the same blots. The 60,000 mol. wt band was selectively present in homogenates from primary sensory and sympathetic ganglia but was absent from the central nervous system and other peripheral organs, corresponding to the reported immunocytochemical distribution of gamma interferon like immunoreactivity. The 60,000 mol. wt protein does not appear to be glycosylated. It could not be solubilized by detergents such as Triton X-100 and it co-purified with cytoskeleton-enriched preparations. At the nucleic acid level, Northern blot analysis using probes specific for rat gamma interferon mRNA failed to detect specific mRNA in rat spinal ganglia, whereas a strong 1.2 kb signal was detected in activated spleen cells. Functionally, gamma interferon like immunoreactive material is strongly induced in superior cervical ganglion neurons after preganglionic axotomy of the sympathetic chain, but remains constant or slightly decreases in L5 spinal ganglion neurons after sciatic nerve transection. In contrast, major histocompatibility complex antigens are strongly induced on non-neuronal cells in both systems. We conclude that the neuronal gamma interferon-like immunoreactive material is clearly distinct from lymphocyte derived gamma interferon and might not be involved in the control of major histocompatibility complex expression on glial cells. PMID- 1775234 TI - Graft-induced behavioral recovery from subcallosal septohippocampal damage in rats depends on maturity stage of donor tissue. AB - Long-Evans female rats sustained electrolytic lesions of the fimbria and the dorsal fornix and, 10-14 days later, received intrahippocampal suspension grafts of septal-diagonal band tissue from either 14-day-old (Group S14, n = 8) or 16 day-old fetuses (Group S16, n = 10), or of parietal cortex from 16-day-old fetuses (Group Cx, n = 10). Sham-operated (Group S, n = 10) and lesion-only (Group Fifo, n = 21) rats served as non-grafted controls. Spontaneous alternation was assessed in a T-maze at three weeks and two months post-grafting. Home cage and open field activity as well as radial maze learning were assessed from two months post-grafting onwards. Fimbria-fornix lesions induced lasting hyperactivity in both the open field and the home cage, impaired radial maze learning and transiently reduced spontaneous alternation rates. Neither type of graft significantly affected home cage activity. Septal-diagonal band grafts improved open field habituation (within trial decline of ambulatory activity) and radial maze learning; the former was observed only in S16 rats, whereas the latter was observed only in S14 rats. Acetylcholinesterase histochemistry revealed an initial lesion-induced depletion of hippocampal acetylcholinesterase (eight days post-surgery) which was no longer observed at the end of the experiment. Acetylcholinesterase positivity was similar in S14 and S16 grafts, which also contained many choline acetyltransferase-positive neurons. Cortical grafts were found to be almost devoid of acetylcholinesterase positivity and no well-stained choline acetyltransferase-positive neurons could be identified. Septal-diagonal band grafts from 14-day-old fetuses and cortical grafts contained more parvalbumin-positive neurons than septal-diagonal band grafts provided by 16 day-old fetuses. These results suggest that grafts rich in cholinergic neurons may promote behavioral recovery from fimbria-fornix lesion-induced deficits. However, such a recovery may concern different behavioral deficits as a function of the age of the implanted tissue, suggesting that the maturity stage of the donor may critically influence the functional expression in the lesioned recipient. Also, such a recovery does not appear to be related solely to cholinergic hippocampal (re)innervation and might depend on the presence, not only of cholinergic neurons, but also of non-cholinergic neuronal populations, such as parvalbumin-positive (probably GABAergic) neurons. PMID- 1775235 TI - Effects of cholinergic-rich neural grafts on radial maze performance of rats after excitotoxic lesions of the forebrain cholinergic projection system--I. Amelioration of cognitive deficits by transplants into cortex and hippocampus but not into basal forebrain. AB - After ibotenate (10.0 mg/ml) lesions to the nucleus basalis and medial septal regions, at the source of the cortical and hippocampal branches of the forebrain cholinergic projection system, rats displayed long-lasting stable impairment in reference and working memory in both spatial (place) and associative (cue) radial maze tasks. Cell suspension transplants of cholinergic-rich fetal basal forebrain tissue dissected at embryonic day 15 substantially improved all aspects of radial maze performance to a comparable degree whether sited in cortex, hippocampus, or both regions of the host brain. No additive effects were obtained with grafts in both terminal regions, but total graft volume, assessed stereologically, showed a significant negative correlation with error scores. Rats with behaviourally effective grafts, like controls, were disrupted in the place task when tested in dim light which obscured extra-maze spatial cues. Lesioned rats were not affected by change in lighting. Grafts of cholinergic-poor fetal hippocampal tissue did not improve radial maze performance; neither did grafts of cholinergic-rich tissue placed within the host basal forebrain lesion sites. In rats with cholinergic-rich terminal grafts, cortical and hippocampal choline acetyltransferase activity was restored to control level, commensurate with site of transplant, whereas it was significantly reduced in lesioned animals and those with functionally ineffective grafts. The indiscriminate error pattern and insensitivity to changes in lighting shown by lesioned rats suggested that lesioning primarily disrupted attention rather than short- or long-term spatial or associative memory processes. Since rats with cholinergic-rich grafts showed both reduced errors and recovery of stimulus control, the data indicated that grafts affected information processing, rather than changes in motor or motivational processes. Changes in choline acetyltransferase activity and the behavioural efficacy of cholinergic-rich grafts are consistent with the involvement of acetylcholine in the behavioural deficits and recovery displayed by lesioned and grafted groups, but do not rule out contributions from other factors. The equipotency of grafts within each terminal region suggests also that there may be a considerable degree of functional cooperation between the two branches of the forebrain cholinergic projection system. Functional recovery may involve local, nonspecific synaptic or paracrine mechanisms within the target regions, since grafts were efficacious only when placed in the terminal areas, but not when sited homotopically in the basal forebrain, indicating that they did not achieve any functionally significant structural repair to the host brain at that site. PMID- 1775236 TI - Effects of cholinergic-rich neural grafts on radial maze performance of rats after excitotoxic lesions of the forebrain cholinergic projection system--II. Cholinergic drugs as probes to investigate lesion-induced deficits and transplant induced functional recovery. AB - The effects of two doses of muscarinic (arecoline and scopolamine) and nicotinic (nicotine and mecamylamine) cholinergic receptor agonists and antagonists on the radial maze errors of rats, performing poorly after ibotenate lesions to the nucleus basalis and medial septal brain regions, were assessed before and after transplantation of cholinergic-rich and -poor fetal grafts, using tasks which measured short- (working) and long-term (reference) spatial and associative memory. Lesioned rats showed improvement with the agonists, and impairment with the antagonists, at low doses which did not affect the performance of controls; these effects were more marked for working than reference memory, especially in the spatial task. The peripherally acting antagonists N-methylscopolamine and hexamethonium did not affect the performance of control or lesioned rats. Effects of the cholinergic probes were re-examined 16 weeks after grafting, in groups with cholinergic-rich grafts to cortex and/or hippocampus which showed functional recovery, and groups with cholinergic-rich grafts to basal forebrain, or cholinergic-poor grafts to basal forebrain, cortex, and hippocampus, which showed no improvement. All lesioned rats, regardless of site, type, or efficacy of transplant, continued to show marked impairment with the antagonists. Poorly performing grafted animals also showed improvement with the agonists. In rats with behaviourally effective cholinergic-rich grafts, arecoline had no effect, but nicotine substantially increased working and reference memory errors, particularly spatial working memory errors. Rats with grafts in both cortex and hippocampus showed the largest increases in errors after nicotine. These results show that lesioned rats were more sensitive to the bi-directional effects of cholinergic receptor ligands than controls, consistent with a role for acetylcholine in the lesion-induced deficits. The predominant effect of drugs on working memory may also be consistent with disruption of acquisition rather than of storage or retrieval processes in memory, and may be related to impairment of attention. The results further show that, despite behavioural recovery, supersensitive responses to cholinergic drugs were not normalized in rats with cholinergic-rich grafts, and that an additive interaction between graft and host may have occurred in response to nicotine. PMID- 1775237 TI - Neuroendocrine and behavioural responses to hyperosmolality in rats with lesions of the lateral hypothalamus made by N-methyl-D-aspartate. AB - Excitotoxic lesions of rat lateral hypothalamus produce impairments in eating and drinking, but not motor deficits. However, it has not been established what causes these eating and drinking impairments. In the present experiments, drinking, plasma osmolality and arginine-vasopressin concentration were measured in lateral hypothalamic-lesioned and control rats following systemic injection of hypertonic saline. In response to hyperosmolality, N-methyl-D-aspartate-lesioned rats drank significantly less than controls but showed normal increases in plasma osmolality and arginine-vasopressin concentration. This dissociation of neuroendocrine and behavioural responses suggests that the impairment of rats with excitotoxic lesions of the lateral hypothalamus is unrelated to physiological (as opposed to behavioural) mechanisms of homeostasis. PMID- 1775238 TI - The regulation of feeding and drinking in rats with lesions of the lateral hypothalamus made by N-methyl-D-aspartate. AB - Rats bearing excitotoxic lesions of the lateral hypothalamus are hypodipsic and hypophagic, but responses to 24 h food or water deprivation are normal, as are responses to different taste stimuli. The most striking deficit present in lateral hypothalamic-lesioned rats is an inability to respond as controls to dehydrating, dipsogenic or glucoprivic challenges. The present experiments examined the ability of rats bearing bilateral N-methyl-D-aspartate-induced lesions of the lateral hypothalamus to recognize and respond to changes in their internal environments. All of the lesioned rats tested showed mild to moderate hypophagia and hypodipsia, and none responded properly by drinking over 1 h after i.p. injection of hypertonic saline. However, the addition of glucose to the water supply promoted an increase in drinking and a decrease in lab chow consumption to maintain a constant energy intake; the addition of salt to the diet promoted an increase in drinking and no change in eating; 24 h water deprivation induced the same amount of drinking in lateral hypothalamic-lesioned rats as in controls; and injection i.p. of water (but not physiological saline) before drinking water was returned to rats which were 24 h water deprived suppressed drinking. These data suggest that lateral hypothalamic-lesioned rats are in receipt of normal information from their peripheries, and that they can adjust their behaviour over a period of days or minutes to changes in the internal milieu. The most consistent deficit is in responding actively and rapidly to challenging stimuli; the nature of this and the mechanisms which might produce it are discussed. We suggest that the consequences of excitotoxic lesion are better explained by disruption of input to the cortex from the lateral hypothalamus rather than by interference with metabolic processes. PMID- 1775239 TI - Presynaptic autoinhibition of the electrically evoked dopamine release studied in the rat olfactory tubercle by in vivo electrochemistry. AB - Evoked dopamine release was monitored in vivo from the olfactory tubercle of anaesthetized rats by differential pulse amperometry combined with carbon fibre electrodes which, in most cases, were electrochemically treated. Dopamine release was evoked by electrical stimulation of the ascending dopaminergic pathway. The dopamine release evoked by burst stimulation (20 s with a mean frequency of 6 Hz) was dose-dependently decreased by D,L-apomorphine (25-800 micrograms/kg, s.c.) or by quinpirole (50 micrograms/kg, s.c.) while the opposite effect was observed with haloperidol (12.5 micrograms/kg-0.5 mg/kg, s.c.) or with D,L-sulpiride (2 200 mg/kg, s.c.). Neither the D1 agonist SKF 38393 (10 mg/kg, s.c.) nor the D1 antagonist SCH 23390 (0.5 mg/kg, s.c.) affected the evoked dopamine release. Moreover, sulpiride competitively antagonized the effects of apomorphine. The relative amplitude of the apomorphine inhibition was inversely correlated with the stimulation frequency (6 or 9 Hz). The increase induced either by haloperidol or by sulpiride was positively related to the stimulation frequency (from 3 to 9 Hz) and reached a stable value (+700% of the pre-drug-evoked dopamine release) with higher frequencies (from 9 to 20 Hz). This increase also depended on the duration of the stimulation: both single-train (10 pulses) or burst stimulations for 20 s, whose frequency inside the trains was in both cases 14 Hz, evoked a dopamine release which was minimally affected by sulpiride or haloperidol. In conclusion, in physiological conditions the amplitude of the impulse flow dependent dopamine release is regulated by the extrasynaptic extracellular dopamine concentration which varies from 10 to 100 nM. This presynaptic autoinhibition is mediated by autoreceptors of the D2 type and is involved in the nonlinear relationship between impulse flow and dopamine release. PMID- 1775240 TI - Cholinergic modulation of excitability in the rat olfactory bulb: effect of local application of cholinergic agents on evoked field potentials. AB - The effect of exogenously applied cholinergic agents upon mitral-granule cell complex activity of the olfactory bulb was studied in anesthetized rats. Output neurons were activated by electrical paired-pulse stimulation (40-80 ms time interval) applied either to the olfactory nerve (orthodromic stimulation) or to the lateral olfactory tract (antidromic stimulation). Evoked field potentials were recorded in the granule cell layer. Cholinergic agents were introduced close to the mitral cell body layer through a push-pull cannula. With both orthodromic and antidromic stimulations, acetylcholine in the presence of eserine (an acetylcholinesterase blocker), did not alter the conditioning volley, while it induced a significant increase in the amplitude of the test volley. This effect could be replicated using the cholinergic agonist carbachol. This attenuation of the paired-pulse inhibition is due to a reduction of the dendrodendritic inhibitory action of granule cells upon relay cells. Muscarinic and nicotinic transmission were studied using antidromic and orthodromic stimulations, respectively. The selective effect of acetylcholine on the test volley was totally abolished by the blockade of the muscarinic transmission (by atropine). The blockade of the GABAergic transmission (by picrotoxin), could also prevent the acetylcholine-induced effect. The results lead us to propose that in deep bulbar layers, acetylcholine may activate muscarinic receptors situated on second order GABAergic interneurons. These interneurons could in turn inhibit granule cells (first-order interneurons). The nicotinic antagonist d-tubocurarine selectively enhanced the duration of the late component and did not appear to modify early components when stimulation was applied to the olfactory nerve. This effect related to both the conditioning and the test volleys and the enhancement in the duration of depolarization of granule cell dendrites suggests that normal activation of nicotinic receptors contributes to a faster repolarization of granule cells. Since nicotinic receptors belong to the outer glomerular layer, this result points to the existence of interneurons belonging to the periglomerular region where they receive nicotinic input and project to deep layers where they modulate granule cell activity. Taken together, our results suggest the presence of a phasic muscarinic and a tonic nicotinic modulation of bulbar interneuronal activity. Since both could finally reduce the inhibitory action of granule cells, the action of cholinergic afferents would facilitate transmission of bulbar output neurons to central structures. PMID- 1775241 TI - Choline acetyltransferase immunoreactivity in the cat cerebellum. AB - Choline acetyltransferase immunoreactivity was demonstrated in particular projection systems in cat cerebellum by combining immunohistochemistry, retrograde tracing and lesioning paradigms. The monoclonal antibody used in this study recognized a 68,000 mol. wt protein on immunoblots of cat cerebellum and striatum. Choline acetyltransferase immunoreactivity was localized to some neurons and varicose fibers in the cerebellar nuclei, and also to some mossy fibers and endings (rosettes), fiber plexuses around Purkinje cells, granule cells and parallel fibers in the cerebellar cortex. In addition, the presence of choline acetyltransferase-immunoreactive large cells, presumptive Golgi cells, in the granular layer was confirmed. In each cerebellar nucleus, choline acetyltransferase-immunoreactive neurons contained either large, medium-sized or small cell bodies and were distributed evenly in the entire nuclear domain. Large and medium-sized ones were frequently encountered. Choline acetyltransferase immunoreactive mossy fibers and rosettes were most abundant in the vermal lobules I-III, VIII, IX and the simple lobule, moderately accumulated in the vermal lobules IV-VII, X, crus I and crus II, and less abundant in the paramedian lobule, paraflocculus and flocculus. Some granule cells with prominent dendritic claws and bifurcating parallel axons were immunolabeled in the entire vermis with infrequent occurrence in the remaining cortices. Following unilateral lesioning of the cerebellar nuclei with electrocoagulation or kainate injections, a reduction in number of choline acetyltransferase-immunoreactive fibers occurred ipsilaterally in the cerebellar cortex and contralaterally in the red nucleus, ventrolateral thalamic nucleus and ventroanterior thalamic nucleus. In addition, perikarya of some cerebellothalamic neurons were shown to contain choline acetyltransferase immunoreactivity. The results indicate that some nucleocortical, cerebellorubral and cerebellothalamic projections are cholinergic and that a subpopulation of cholinergic granule cell-parallel fibers exists. PMID- 1775242 TI - Topographical organization of climbing fiber pathway from the superior colliculus to cerebellar vermal lobules VI-VII in the cat. AB - Topographical distribution of the climbing fiber responses induced by stimulation of the superior colliculus was investigated in the cerebellar posterior vermis (lobules VI-VII) of the cat. The climbing fiber-responsive areas were distributed longitudinally forming sagittal zones. The sagittal zones responsive to stimulation of the left and right superior colliculus were located on the side ipsilateral to the stimulation, and they were completely segregated. The sagittal zones responsive to stimulation of the caudal superior colliculus were distributed more laterally than those responsive to stimulation of the rostral superior colliculus. Study of the extracellular unit in the inferior olive demonstrated that the climbing fiber responses were relayed in the caudomedial part of the medial accessory olive contralateral to the stimulation. PMID- 1775243 TI - Chemosensitivity of medullary neurons in explant tissue cultures. AB - To determine whether cultured medulla contains chemosensitive neurons which are excited by CO2 and fixed acid and whether this function is specific to the ventral medulla, tissue explants of ventral and dorsal medulla were prepared from neonatal rats and incubated for two to three weeks. Cultures were superfused with artificial cerebrospinal fluid, maintained at 37 degrees C, and pH of the superfusate was varied either with PCO2 (14-71 Torr) at constant HCO3- (22 mM) or HCO3- (10-30 mM) at constant PCO2 (35 Torr). Spontaneous action potentials were recorded extracellularly in 51 ventral and 23 dorsal medullary neurons. Ventral medullary neurons exhibited a steady baseline firing frequency of 4 +/- 0.8 Hz. In contrast, dorsal medullary neurons exhibited two different patterns of spontaneous activity: 11 fired continuously (7.2 +/- 1.4 Hz) while 12 fired with a bursting pattern. Burst duration was 0.80 +/- 0.14 min and cycle time was 1.74 +/- 0.43 min. Decreasing pH with CO2 caused an increase in the activity of 10 of 27 ventral medullary neurons and two of six dorsal medullary neurons with a mean response of 7.5 Hz/pH unit. Varying pH by changing HCO3- had no effect on firing frequency. These results demonstrate that: (i) chemosensitive neurons are present in both ventral and dorsal medullary explant cultures; (ii) these cells only respond to changes in pH induced with CO2; and (iii) about half of the dorsal medullary neurons fire spontaneously with a regular bursting pattern of activity. PMID- 1775244 TI - Opioid synapses on vasopressin neurons in the paraventricular and supraoptic nuclei of juvenile monkeys. AB - Opioid peptide- as well as vasopressin-containing neurons synapse on gonadotropin releasing hormone neurons in juvenile macaques. In this study we performed double label immunostaining for opioid and vasopressin neurons in the paraventricular and supraoptic nuclei in order to assess their interrelationships. Neuroendocrine neurons in the hypothalamus were prelabeled by microinjection of electron-dense retrograde tracer into the median eminence, and were easily identified in frontal Vibratome sections. Sections through the paraventricular and supraoptic nuclei were immunostained for vasopressin with the peroxidase-antiperoxidase technique, and for opioids using the indirect immunogold method. By light microscopy, opioid immunoreactive inputs appeared to innervate an average of 39% of the vasopressin neurons in the paraventricular nucleus and 33% in the supraoptic nucleus, and were more prevalent anteriorly. Clusters of opioid afferents formed cup-like calices around major processes of many vasopressin neurons, especially in the paraventricular nucleus. Electron microscopy revealed that these groups of opioid axon terminals made frequent symmetrical and fewer asymmetrical synapses on both neuroendocrine and non-neuroendocrine vasopressinergic cell bodies and dendrites. Our study did not reveal vasopressin-opioid synapses in these hypothalamic nuclei, but this does not preclude the possibility of their existence elsewhere. These results indicate that opioid afferents modulate vasopressin neuronal activity in the monkey paraventricular and supraoptic nuclei. Previous results have suggested that corticotropin releasing hormone acts via vasopressinergic neurons to stimulate opioid neuronal activity and to inhibit gonadotropin releasing hormone release. Taken together, the data suggest that stressful stimuli could initiate a series of neuropeptidergic interactions which ultimately alter pulsatile gonadotropin releasing hormone secretion and thus gonadotropin secretion in primates. PMID- 1775245 TI - Muscarinic acetylcholine receptors are expressed and enriched in growth cone membranes isolated from fetal and neonatal rat forebrain: pharmacological demonstration and characterization. AB - Nerve growth cones, the motile tips of growing neurites, are closely related to the exact pathway finding, and their roles for synaptogenesis have been proposed to be modified by some neurotransmitters. In the present study, to clarify the expression and the ontogeny of muscarinic acetylcholine receptors in growth cones, growth cone membranes from fetal and neonatal rat forebrain were isolated, and muscarinic receptors in growth cone membrane were pharmacologically characterized, by using the [3H]quinuclidinyl benzilate as a labeled ligand. The specific binding sites for [3H]quinuclidinyl benzilate had already been detected in growth cone membrane on embryonic day (E)17 (Bmax = 557 fmol/mg protein: KD = 19.7 pM) and gradually increased in amount without significant changes in the KD values from E17 to postnatal day (P)5. [3H]Quinuclidinyl benzilate binding sites in growth cone membrane were several times higher than that in the P2-fraction derived membranes, and in perinuclear membranes. Competitive inhibition studies showed that the proportion of high-affinity sites for pirenzepine (M1-subtype) to total [3H]quinuclidinyl benzilate binding sites in growth cone membrane was significantly lower than that in adult synaptic plasma membranes. In contrast, the proportion of high-affinity sites for AF-DX 116 (M2-subtype) was significantly higher than that in adult synaptic plasma membranes (E17 growth cone membrane: M1, 29.5%; M2, 56.9%; adult synaptic plasma membrane: M1, 63.6%, M2, 5.9%). Electron micrographic examination revealed that there were no significant morphological differences among growth cone particle fractions at the developmental stages which we examined, and that mature synaptic elements did not contaminate the growth cone particle fractions. Biochemical examination by electrophoresis and the phosphorylation study of the growth cone particle fractions showed that the protein composition and the phosphoprotein pattern did not change markedly during these stages. Our results suggest that muscarinic receptors were expressed and more concentrated in growth cone membrane than in other membrane portions from perinatal rat forebrain, and that they may play some role in the axonal guidance in growth cone via receptor subtype-specific signal transduction mechanisms. PMID- 1775246 TI - Effect of ambient temperature on sleep-waking cycle in cats with electrolytic dorsolateral pontine tegmental lesions. AB - The effects of ambient temperature on the sleep-waking cycle were studied in intact cats and those with bilateral electrolytic lesions in the pontine tegmentum. At a room temperature of 23 degrees C, the percentage of time spent in paradoxical sleep was significantly lower in the lesioned cats than in intact animals. The mean duration of paradoxical sleep episodes was also decreased in the lesioned animals. The reduction in slow-wave sleep was not significant. At a slightly warmer ambient temperature of 30 degrees C, both the mean duration of paradoxical sleep episodes and the total duration of paradoxical sleep in the lesioned animals were increased toward normal values. Slow-wave sleep increased slightly but not significantly. At a higher ambient temperature of 35 degrees C, as well as at colder ambient temperatures of 15 and 7 degrees C, the durations of both paradoxical sleep and slow-wave sleep were significantly reduced. Under these thermal loads, the reduction in the duration of sleep was significantly greater in the lesioned cats than in the intact animals. The results suggest that: (i) pontine lesions alter the sleep cycle of cats and ambient temperature influences this alteration; (ii) the effects of thermal loads on the sleep cycle are more severe in the lesioned cats; and (iii) a moderately warm ambient temperature (30 degrees C) improves the sleep of pontine-lesioned cats. PMID- 1775247 TI - The effect of procaine injection into the medullary reticular formation on forelimb muscle activity evoked by mesencephalic locomotor region and vestibular stimulation in the decerebrated guinea-pig. AB - The effect of procaine microinjection into the ventromedial portion of the medullary reticular formation on forelimb muscle activity evoked by electrical mesencephalic locomotor region and natural vestibular stimulation has been investigated in the decerebrated guinea-pig. This injection is followed by a reversible increase of the threshold of mesencephalic locomotor region stimulation necessary for the activation of muscle rhythmic activity. Procaine injection is accompanied by reduction of vestibular influence on flexor muscle activity evoked by electrical cutaneous and mesencephalic locomotor region stimulation. Vestibular influence on extensor muscle activity remains unchanged after the injection. The results indicate that medial medullary reticular formation is the site of the convergence of mesencephalic locomotor region and vestibular activity. It is suggested that the vestibular system contributes to the modulation of reticulospinal activity coupled with the initiation and control of locomotion. PMID- 1775248 TI - Is control of secondary hyperparathyroidism optimal with the currently used calcium concentration in the CAPD fluid? AB - Progression of hyperparathyroidism and bone disease on CAPD has been noted by several authors. In our CAPD patients we observed that aluminium-containing phosphate binders were often required because administration of CaCO3 was limited by the development of hypercalcaemia particularly in patients concomitantly requiring calcitriol. We propose that CAPD fluids with lower calcium concentration should be evaluated to facilitate control of plasma phosphate and secondary hyperparathyroidism. PMID- 1775249 TI - Light-chain composition of serum IgA1 and in vitro IgA1 production in IgA nephropathy. AB - A predominant expression of IgA1 in mesangial deposits, serum, and bone marrow culture supernatants has been shown in IgA nephropathy (IgAN). Furthermore an excess of lambda light chains in both mesangial deposits and serum IgA has been observed. However, the origin of mesangial IgA remains controversial. In the present study, we have examined the IgA1 light chain type in IgAN. Total IgA1, IgA1 kappa and IgA1 lambda were measured by ELISA in serum and culture supernatants from spontaneous and pokeweed-mitogen (PWM)-stimulated peripheral blood mononuclear cells (PBMC). We observed an increase in IgA and IgA1 serum concentrations in IgA nephropathy patients, with a ratio of serum IgA1 to total serum IgA identical between patients and controls. The concentration of serum IgA kappa did not differ between patients and controls but patients had a significantly higher concentration of serum IgA lambda. The IgA1 kappa to IgA1 lambda ratio was 1.06 +/- 0.42 in IgAN patients versus 1.55 +/- 0.36 in controls (P less than 0.01). By contrast, the concentrations of IgA1 kappa and IgA1 lambda in PBMC culture supernatants, both spontaneous and PWM-stimulated, were identical in patients and controls. Therefore, there is a specific increase in IgA1 lambda in patients' sera. This contrasts with the normal IgA1 production by PBMC, which are derived from mucosal-associated lymphoid tissues. This suggests that IgA isotypic deregulation is confined to the bone marrow compartment and is not a generalised defect of the IgA system. PMID- 1775250 TI - Effect of aluminium on osteocalcin production in the rat. AB - In renal failure, aluminium is an important factor in the development of osteomalacia. The mechanism by which aluminium produces osteomalacia is not clear; it may be toxic to the osteoblast, and as a result of its effect on osteoblasts, impair mineralisation. Another possibility is that aluminium may directly impair mineralisation independent of osteoblast function. Osteocalcin is considered to be a specific marker of osteoblast activity and its production is stimulated by calcitriol. In the present study, calcitriol-stimulated production of osteocalcin was studied as a marker of osteoblast activity in aluminium toxicity. Four groups of rats were evaluated: (1) normals; (2) normal renal function plus aluminium; (3) renal failure; and (4) renal failure plus aluminium. Osteocalcin production was determined by measuring serum osteocalcin at baseline and after stimulation with calcitriol. In rats receiving aluminium, the baseline serum osteocalcin levels were not different from their respective controls. After stimulation with calcitriol, the increase in serum osteocalcin was less in the renal failure group receiving aluminium. However, when corrected for the number of osteoblasts, the increase in serum osteocalcin was not decreased. In summary, although aluminium administration decreased the number of osteoblasts in rats with renal failure, osteocalcin production by the remaining osteoblasts was not decreased. PMID- 1775251 TI - Aluminium content of water for injection used with recombinant human erythropoietin. AB - Human recombinant erythropoietin is of proven value in the treatment of the anaemia of renal failure. The aluminium content of 36 ampoules of water for injection supplied for use with recombinant erythropoietin has been measured and ranged from 24 to 450 micrograms/l, with a median of 251 micrograms/l. In three samples, which may have been contaminated on opening, the range was from 1770 to 6160 micrograms/l. In Water for Injection BP, values ranged from 66 to 140 micrograms/l with a median of 99 micrograms/l. Reconstituted erythropoietin did not contain any more aluminium than could be accounted for by the water. Ampoules of a second brand of erythropoietin, supplied already in solution, contained from 506 to 837 micrograms/l aluminium (median 682 micrograms/l). In view of the lifelong duration of erythropoietin therapy clinicians and pharmaceutical companies should be aware of this potential problem. Although the amount of aluminium delivered with each injection is usually less than 4 micrograms, it is suggested that active steps are taken to establish a British Pharmacopoeia limit on the aluminium content of injections. PMID- 1775252 TI - Haemodialysis membranes modulate chronically the production of TNF alpha, IL1 beta and IL6. AB - As cytokines may play a role in the adverse effects of haemodialysis, TNF alpha, IL1 beta and IL6 were investigated before the haemodialysis session (chronic effect) and after 30 and 60 min (session effect). We found that haemodialysis exerts a chronic effect on cytokines but the type of haemodialysis membrane, Cuprophan or Hemophan, specifically influences each cytokine. Circulating levels of TNF and unstimulated production of TNF and IL1 by monocytes were increased in patients dialysed with Hemophan, whereas a greater LPS-stimulated production of TNF was observed in patients dialysed with Cuprophan. Both types of membrane induced a higher production of IL6 as compared to controls. The alternate use of Cuprophan and Hemophan demonstrated that the production of TNF and IL1 was dependent on the type of haemodialysis membrane. We also found that Cuprophan induced a reversible decrease of spontaneous and LPS-stimulated production of TNF, IL1 and IL6 during the haemodialysis session. Taken together, these results suggest that Hemophan induced a sustained production of cytokines whereas Cuprophan primed monocytes, probably through the activation of the complement pathway. PMID- 1775253 TI - Influence of high and low sodium dialysis on blood volume preservation. AB - Haemodialysis has a profound effect on fluid balance. Since fluid is initially withdrawn from the intravascular compartment, hypovolaemia is a frequent complication. A fluid shift from the overhydrated interstitium towards the intravascular compartment can counteract hypovolaemia. However, a fast decline in extracellular osmolality may cause an increase in the intracellular volume, reducing the available amount of fluid to compensate for the hypovolaemia. To overcome this problem, the use of alternating high and low sodium dialysate is advocated. In this study six patients were studied during standard haemodialysis (HD) and during dialysis with alternating high and low sodium dialysate (HLSD). Changes in intracellular fluid volume (IFV) and extracellular fluid volume (EFV) of tissue and blood were measured by means of a non-invasive electrical conductivity method. Changes in blood volume (BV) were studied by serial erythrocyte counts. Plasma sodium concentration was determined at regular intervals. The distribution volume of sodium during the high and low sodium episodes of HLSD was calculated according to a mathematical model. HLSD led to fluctations in plasma sodium concentration that induced changes in red cell volume, but not in IFV. Distribution of sodium was largely confined to blood. BV was better preserved during HLSD than during HD, probably due to a higher mean plasma sodium concentration. Postdialysis sodium concentration however, was not significantly different between HLSD and HD. These data suggest that the better BV preservation during HLSD results from an induced osmotic gradient across the capillary wall, rather than from an osmotic gradient across the cell membrane. PMID- 1775254 TI - Detrimental effect of acute renal failure on the survival of renal allografts: influence of total ischaemia time and anastomosis time. AB - In a retrospective study the incidence and consequences of acute renal failure were evaluated in 324 renal transplantations performed in our centre. The overall incidence of acute renal failure was 31.2%. In recipients with acute renal failure, patient and graft survival were significantly worse than in those without acute renal failure (P less than 0.02 and P less than 0.0001 respectively). Acute renal failure also increased the morbidity during the first 3 months after transplantation. Three months after transplantation renal function as determined by serum creatinine and proteinuria, was less satisfactory. Factors influencing the incidence of acute renal failure appeared to be: match grade on the AB locus, percentage of antibodies, duration of dialysis, number of blood transfusions prior to transplantation, anastomosis time and total ischaemia time. Recipients transplanted for the first time were less likely to develop acute renal failure, but also for this group total ischaemia time was a prognostic factor for the development of acute renal failure. When recipients were allocated to different classes of total ischaemia time it appeared that the incidence of acute renal failure differed, especially between groups with total ischaemia time 32-36 h (27%) and 36-40 h (38%). The difference in acute renal failure between these groups was also reflected in a difference in graft survival for total ischaemia time less than 36 h and greater than 36 h. Thus, it appears that acute renal failure has a detrimental effect on graft survival and postoperative morbidity in renal transplantation. Total ischaemia time is one of the prognostic factors for the development of acute renal failure. To improve renal transplantation results it is worth attempting to shorten total ischaemia time. PMID- 1775255 TI - Cadaveric renal transplantation in elderly recipients: is it worthwhile? AB - The aim of this study is to analyse whether or not old age alone significantly affects the outcome of patient and graft survival in cadaveric renal transplantation, and thus whether it should be a selection criterion for induction into transplant programmes, given the current shortfall in donor organs in the United Kingdom. Data is presented on all 307 solitary cadaveric renal allografts performed at Addenbrooke's Hospital, Cambridge between January 1983 and December 1987. Patients are divided into those aged less than 60 years (n = 243) and those aged 60 years and over (n = 45) at the time of transplantation. There is no significant difference in graft survival between the two groups (60.3% and 62.2%) at 18-60 months (mean 42 months) post-transplantation. Patient survival in the two groups is significantly different (83% and 64.4%, P less than 0.01) at the same point. Causes of graft loss, death, and end-stage renal failure are analysed. It is suggested that patients aged 60 years and over may require less immunosuppression but that graft loss from rejection in this group has a high associated mortality. We conclude that cadaveric renal transplantation in the elderly should only be undertaken after careful selection, paying particular attention to evidence of cardiovascular disease and full counselling of the risk of death with these patients. PMID- 1775256 TI - Acute crescentic glomerulonephritis associated with antiglomerular basement membrane antibody in Alport's syndrome after second transplantation. PMID- 1775257 TI - Acute renal failure caused by infiltration of the kidneys by bronchogenic squamous cell carcinoma. PMID- 1775258 TI - Improvement of polymorphonuclear functions in dialysed patients treated with recombinant human erythropoietin need not to be dependent on serum ferritin decrease. PMID- 1775259 TI - Intradialytic erythrocyte volume changes. AB - Haemodialysis (HD) should affect the erythrocytes, which constitute more than 99% of blood cells. The aim of this study was to reinvestigate the intradialytic changes in erythrocyte water content (MCV). MCV was measured during 81 HD (47 uncomplicated, 34 with hypotension), and 16 isolated ultrafiltrations (UF) performed in stable, haemodialysed adults (12 males and 8 females). The MCV following uncomplicated HD (n = 32) did not differ from the predialysis value. Significant MCV increase accompanied the HD initiation (4.9 +/- 9.0 fl, P less than 0.001), UF (2.99 +/- 1.49 fl, P less than 0.001) and hypotension (1.8 +/- 3.1 fl, P less than 0.01). This was independent of sodium and potassium within the cells and plasma. Erythrocyte oedema occurred in situations known to accompany both bioincompatibility reactions and blood volume decrease. Intradialytic MCV increase may reflect a response to these events, possibly hormonal, and needs further investigation. PMID- 1775260 TI - Biocompatibility and membrane development. AB - Development of new biocompatible membranes for clinical application needs the expertise of various specialists, chemists, chemical engineers, and clinicians. As the biocompatibility of a membrane cannot be considered in terms of a single biochemical pathway, due to the interrelation between the complement, coagulation, and inflammatory systems, it is difficult to achieve optimal results with one single polymer. A compromise between different approaches has therefore to be found. Membrane development also needs sophisticated test systems, which simulate the clinical situation as closely as possible. Adequate results are achieved with the 'ex vivo' model, which represents open-loop haemodialysis. The ex vivo model gives good results which are close to those from clinical experiments. PMID- 1775261 TI - Biocompatibility study on cuprophane and polysulphone dialysers. PMID- 1775262 TI - What are the factors contributing to the changes in tissue-type plasminogen activator during haemodialysis? AB - Haemodialysis (HD) is associated with stimulation of the fibrinolytic system. The increase of fibrinolytic activity seems to be primarily due to tissue-type plasminogen activator (t-PA) released from the vessel wall. The aim of our study was to determine whether the t-PA release is the consequence of uraemic intoxication adjustment, extracorporeal circulation effect, heparin administration, or whether a mere reflection of the circadian rhythm of fibrinolysis is involved. To identify the factor, fibrinolytic system parameters were determined during HD, sham HD (SD), after the administration of heparin alone outside HD, and during a control period (CP). The plasma concentrations of t-PA antigen indicate that HD is associated with the release of t-PA from the vessel wall; 3.70 ng/ml before HD, 4.35 (NS) at the 15th min, 4.88 (P less than 0.05) at the 20th min, and 5.09 (P less than 0.05) after HD (medians). The respective values for a CP are 4.05, 4.37 (NS), 4.40 (NS), and 4.22 (NS). The effect of heparin alone and SD was evaluated for 120 min only, with the following t-PA concentrations determined after heparin: 5.10, 6.22 (NS), 4.72 (NS), 4.72 (NS); during SD and 4.50, 5.14 (NS), 5.20 (P less than 0.05). We conclude that t PA is released from the vessel wall during HD. A factor contributing to its release is the extracorporeal circulation system. PMID- 1775263 TI - Haemofiltration or haemodialysis in aluminium elimination? AB - Elimination of aluminium from the body during haemodialysis and haemofiltration was investigated. Without desferrioxamine administration there was no aluminium removal from the body. After DFO administration (1 g intravenously 24-40 h before dialysis or haemofiltration) removal of aluminium during blood purification methods was achieved. During haemodialysis (n = 28, cuprophane plate dialyser with urea clearance 150 ml/min, 5 h) serum aluminium decreased by 41%. Aluminium clearance was 28 ml/min. During haemofiltration (n = 36, polyamide FH 77, volume exchange 60% of body-weight, on-line system) serum aluminium decreased by 66% and a total of 1962 micrograms of aluminium was removed during one procedure. In the 60th minute of the procedure, calculated clearance was 42 mmol/l. Because of the rebound phenomenon it is reasonable to perform two haemofiltrations after a single dose of DFO. Haemofiltration is superior to haemodialysis in aluminium removal from the body. PMID- 1775264 TI - Phagocytic function of neutrophils during dialysis in relation to some immunological findings. AB - Haemodialysis neutropenia and impaired granulocyte function are transitory, but the consequences of altered granulocyte function are observed at the end of haemodialysis. Activity of polymorphonuclear receptor for Fc and C3 complement component, circulating immune complexes and components of complement (C1 inactivator, C4, C3, C3 proactivator) were measured in ten patients before and at the end of haemodialysis. Significant decrease in polymorphonuclear Fc receptor activity (1689 cells/mm3 before and 1277 cells/mm3 after HD) and increase of circulating immune complexes (69.9 micrograms/dl before and 112.7 micrograms/dl after HD) were observed at the end of haemodialysis. A decrease in complement C3 component was observed after haemodialysis (866 mg/l before and 804 mg/l after HD); the other components: C1 inactivator, C4 component, and C3 proactivator, remained unchanged. Increase of circulating immune complexes and decrease of Fc receptor activity correlated with a decrease in phagocytic function of polymorphonuclear leukocytes. PMID- 1775265 TI - Phagocytosis activity of polymorphonuclear cells of normal persons and dialysis patients is influenced by different dialysis membranes. AB - Leukocyte (PMN) functional capacity has been investigated through evaluation of phagocytosis of opsonised yeast cells in a radiometric test system. The PMN of dialysis patients (DP) had a slightly lower ability to ingest opsonised yeast cells in comparison with normal persons (NP), suggesting that an intrinsic cellular defect may exist. Under the influence of six membranes (cellulose acetate, regenerated cellulose, modified cellulose, cuprophane, polysulphone, and polymethylmethacrylate) the phagocytosis index decreased significantly between 10 and 17% in NP and between 13 and 23% in DP. There is a clear correlation with the membrane surface area. These results are not explained by the number of dead leukocytes (4-6.5% in DP and also in NP independently of membrane contact). The direct membrane effect could be responsible for the diminished phagocytic activity of leukocytes in NP and DP. Aqueous extracts of membranes alone resulted in no change of the phagocytic ability of PMN. Extracellular or 'uraemic factors' were excluded by the test procedure. The killing rate of yeast cells by PMN in NP and DP was not influenced in any of the membranes tested. PMID- 1775266 TI - Dialysis membranes decrease immunoglobulin and interleukin-6 production by peripheral blood mononuclear cells in vitro. AB - In order to determine the influence of dialysis membranes on immunoglobulin (Ig) and interleukin-6 (IL-6) production, peripheral blood mononuclear cells (PBMC) from 11 haemodialysis patients were cultured for 7 days on Cuprophan, Hemophan, and polyacrylonitrile flat-sheet dialysis membranes. IL-6, IgG, IgA, and IgM were assayed in the supernatants using ELISA. Pokeweed-mitogen-stimulated IgG production declined significantly from 319 +/- 40 ng/ml on polystyrole to 162 +/- 26 ng/ml on Cuprophan, 135 +/- 25 ng/ml on Hemophan, and 109 +/- 20 ng/ml on polyacrylonitrile. A similar pattern was observed for IgA production by PBMC. In comparison to polystyrole (724 +/- 34 pg/ml), IL-6 production by PBMC was significantly reduced in the presence of Cuprophan (151 +/- 45 pg/ml), Hemophan (167 +/- 6 pg/ml) and polyacrylonitrile (108 +/- 33 pg/ml). The fact that the level of monocyte-derived IL-6, a stimulator of B cells, was decreased suggests that reduced B cell activity may be due to diminished stimulation by monocytes. PMID- 1775267 TI - Dialysis hypersensitivity. PMID- 1775268 TI - Hypersensitivity reactions to ethylene oxide: clinical experience. AB - A hypersensitivity reaction occurring in the first minute of the dialysis procedure was observed in seven haemodialysis patients in one day. Hollow-fibre dialysers were used, five made of saponified cellulose ester (SCE) and two of cuprammonium cellulose (CC). All were sterilised with ethylene oxide (ETO) and used for the first time. The severity of the reactions was grade 2. The whole series of dialysers was examined for the presence of ETO concentration. A significantly higher concentration of ETO was found in the polyurethane potting than in the capillaries. The ETO concentrations were 122, 185, 440, 274, 342, and 280 p.p.m. in the following dialysers: Cordis Dow (cellulose acetate CA), Cordis Dow-Plivadial (SCE), Fresenius C-1.3 (CC), Fresenius E-2 (CC), Fresenius E-3 (CC), and Travenol-Medial S 11 flate plate (CC) respectively. According to the clinical signs, ETO concentrations in the dialysers and the lack of reaction when extensive rinsing was used, it can be presumed that these reactions are related to ETO although other mechanisms cannot be excluded. PMID- 1775269 TI - Suppression of beta 2-microglobulin release from lymphocytes by dialysis membranes. AB - As lymphocytes are one of the main sources of circulating beta 2-microglobulin (beta 2M), the direct effect of different dialysis membranes on beta 2M release from those cells was studied in vitro. Lymphocytes were isolated from 11 long term haemodialysis patients and nine healthy controls. Cells were cultured on flat sheet membranes made from either Cuprophan, Hemophan, or polyacrylonitrile. Polystyrole petri dishes were used as controls. Beta 2M concentrations in the supernatant were measured after 3 and 7 days of culture by ELISA techniques. Beta 2M release from lymphocytes obtained from uraemic patients was almost identical to the release from healthy subjects. In the presence of all three membranes the release of beta 2M was less than that produced on polystyrole. This held true for lymphocytes isolated from both healthy and uraemic subjects. As for the three membranes the release of beta 2M into the supernatants was statistically the same when the adsorptive capacity of polyacrylonitrile was taken into account. However, there was a tendency for Cuprophan to exert the strongest inhibition, while Hemophan and polyacrylonitrile reduced beta 2M release to a lesser degree. Based on these data it seems that prolonged interaction between dialysis membranes and lymphocytes does lead to a reduction in beta 2M release. PMID- 1775270 TI - Beta 2-microglobulin serum concentration and associated amyloidosis in dialysis patients. AB - Using radioimmunological estimation of beta 2-microglobulin (beta 2M), significantly greater serum values were found in 36 dialysis patients (44.4 +/- 20.3 mg/l) in comparison to healthy probands (1.5 +/- 0.2 mg/l). A significant relation to the duration of dialysis, diuresis and serum aluminium and ferritin was found. The used dialysers MLW 1.3/1.8 m2 (regenerated cellulose membrane) did not eliminate beta 2M from the blood. Significantly greater beta 2M concentrations were observed in patients suffering from arthralgia and bone pain, but not in radiologically verified arthropathy and destructive spondylarthropathy. Post-mortem examinations of 13 patients on haemodialysis treatment for between 10 and 90 months revealed synovial beta 2M-derived (AB )amyloid deposits in four patients at different joints, but not in radiologically suspect areas. The results suggest that independent of serum beta 2M, beta 2M derived amyloidosis may occur in elderly patients on dialysis for less than 5 years. Several cases were completely asymptomatic. PMID- 1775271 TI - Pathophysiological effects of a limulus amoebocyte-lysate-positive substance during haemodialysis. AB - The washing solution of a dialyser was collected after recirculation of pyrogen free water through the blood compartment, and the amount of limulus amoebocyte lysate-(LAL)-positive material was measured. Our study shows that the amount of LAL-positive substance on the cuprophane membrane of DIP-02-02 dialyser (USSR) is 5 times greater than in the case of cuprophane membrane of D2 hollow-fibre dialyser (Fresenius). There appears to be an acute increase (0.1 ng/ml) followed by a decline to normal values of LAL-positive substance concentration in the blood of patients in the first hour of haemodialysis using a DIP-02-02 dialyser. We conjecture that the cause of monocyte activation during haemodialysis is the LAL-positive material of the dialyser membrane, which in turn may induce the activation of lipid peroxidation and the increase of prostaglandin E production. However, it is not possible to exclude the likelihood that the origin of endotoxin-like LAL-positive substances lies in the dialysate. PMID- 1775273 TI - Importance of endotoxins in high-flux dialysis. AB - Endotoxins are not only important for inducing pyrogenic reactions during haemodialysis but also for the stimulation of different blood cells. This is followed by the release of interleukin-1 and other powerful biological active substances, resulting in a broad spectrum of biological activities. Permeation of LPS (endotoxins) through dialysis and haemofiltration membranes is of great importance. Using a quantitative turbidimetric method based on the LAL (limulus amoebocyte lysate) test LPS concentrations were measured in a closed in vitro system for 11 different dialysers and haemofilters. To assess the passage of endotoxin through the membrane, permeation was measured from the dialysate to the blood side as well as from the blood compartment to the dialysate side. PMID- 1775272 TI - Improved biocompatibility of extracorporeal circulation by the use of auto oxygenation instead of artificial oxygenator in perfusion circuit. AB - The aim of this study was to determine the biocompatibility of an auto oxygenation technique of cardiopulmonary bypass. Forty patients undergoing coronary bypass surgery were studied in two groups: A (auto-oxygenation, patients' lungs used in cardiopulmonary bypass) and B (conventional technique of cardiopulmonary bypass with bubble oxygenator). The platelet count decreased to 73% of initial value in group B vs only -27% in group A, P less than 0.001. Platelet aggregation to ADP decreased slightly in group A and hardly at all in group B, P less than 0.001. A transpulmonary leukocyte sequestration was greater in group B: 1.46 +/- 0.5 x 10(3)/mm3 vs only 0.34 +/- 0.2 x 10(3)/mm3 in group A, P less than 0.001. The level of C3a increased in group A from 244 +/- 46 ng/ml to 418 +/- 34 ng/ml and in group B from 268 +/- 46 ng/ml to 521 +/- 65 ng/ml, P less than 0.001, but in group A the levels were significantly less, P less than 0.001. The current study clearly confirms the superior biocompatibility of cardiopulmonary bypass with lung over oxygenator. PMID- 1775274 TI - Is urea kinetic modelling an appropriate tool for guiding ultrashort high-flux dialysis therapy? AB - High-flux dialysers are frequently used for highly efficient ultrashort treatment schedules. To avoid the risk of inadequately low dialysis dose in this treatment strategy where 'every minute counts', it is often advocated to monitor the treatment quality by means of urea kinetic modelling (UKM). However, careful computational analysis of concentration curves generated by UKM versus more realistic two-pool model curves indicates the risk of substantial overestimation of the protein catabolic rate (PCR). Therefore conventional UKM should not be used to monitor and/or guide treatment schedules with dialyser urea clearance greater than 250 ml/min and dialysis time less than 3 h. Under these conditions, PCR can be overestimated by as much as 20%. PMID- 1775275 TI - Lighten the load. PMID- 1775276 TI - Implications of the access to Health Records Act 1990. PMID- 1775277 TI - Hepatitis B and the health care worker. PMID- 1775278 TI - Is your hearing really safe? AB - Despite all the recent noise regulations and increasingly heavy HSE fines, many workers are without hearing protection. Dennis Connor, who is the leader of the UK delegation on European Standards CEN, describes why it is vitally important for every worker in a noisy industrial environment to have personal hearing protection. PMID- 1775279 TI - How can you help employees give up? AB - A consultant clinical psychologist who has run smoking withdrawal clinics for the last ten years, believes he has developed a successful programme for smoking cessation based on his own research and clinical experience into the difficulties which thwart people when they try to give up. Dr Allan Norris offers advice to OH professionals on how to help such employees. PMID- 1775280 TI - Musculoskeletal disorders and work. AB - Musculoskeletal problems are an only too regular daily feature of patients attending family practices, OH departments or indeed confronting the first aider. Derek Grimstone, senior employment nursing adviser of the HSE warns that only too frequently the job of the patient is not considered in association with the complaint and gives practical steps to avoid unnecessary suffering by employees in the workplace. PMID- 1775281 TI - Medical reports and the law. AB - Over the past few months several serious and potentially disturbing cases have been raised by occupational health nurses concerning their employers' requests for access to or control over the medical records of their employees. In this, the first of two articles, Gillian Howard examines the legal and ethical issues surrounding the keeping, obtaining and disclosure of medical records and reports. PMID- 1775282 TI - Computerising the OH department. AB - Many OH departments within the public and private sectors of industry are considering the need to install computer systems to record and manage their employee medical records. Michael Barton stresses that consideration has to be given to the reasons for computerisation, clarification of the its benefits and also the importance of dispelling any myths about computer systems before embarking on such a course of action. PMID- 1775283 TI - Handling the pressure on an offshore rig. AB - The chief instigator of offshore stress is time which in oil parlance is money, writes Patrick Whyte, an offshore medical officer. He explains that medical personnel by showing that they practice a healthy lifestyle on the offshore oil rigs can set a practical example of coping with the stressful conditions. PMID- 1775284 TI - So you want to go freelance? AB - Freelance working may seem an attractive alternative when faced with redundancy. Jack Lamport Mitchell discusses the factors which could affect the success or failure of any professional worker contemplating such a move. PMID- 1775285 TI - Guide to the latest European directives. AB - Time is creeping on, and changes in OH legislation will be with us almost before we know it. This guide is intended only to provide a very brief introduction to the latest European Directives on health and safety. PMID- 1775286 TI - Acupuncture treatment for industry. AB - The general public has become increasingly interested in a variety of so-called 'alternative' therapies. These can range from the well-established to the downright eccentric. One of those which has the most scientific research to support it is acupuncture. Dr Paul Marcus explains what acupuncture treatment is, what medical conditions it is best used for and the importance of using medically qualified acupuncturists. PMID- 1775287 TI - AIDS update. PMID- 1775288 TI - Medical reports and the law--2. PMID- 1775289 TI - Rehabilitation of a heavy drinker. AB - Alcohol abuse within the workforce is now a widely recognised problem. Brenda Coldwell describes how cooperation between management, trade unionists and the OH department of a large company helped resolve an employee's destructive drink problem. PMID- 1775290 TI - Avoiding Christmas cholesterol. AB - Judging from your response to our September feature on cholesterol testing providing dietary advice has become of paramount importance to OHNs. The Flora Project for Heart Disease Prevention offers information on the risk factors of high cholesterol and has become a major noninstitutional authority on coronary heart disease. With Yuletide in sight The Flora Project offers advice on a cholesterol-clear Christmas. PMID- 1775291 TI - Guide to the latest European directives--2. PMID- 1775292 TI - The conference syndrome. PMID- 1775293 TI - The quest for stress management. AB - Although much has been written about the debilitating effects of stress at work and courses designed to help staff understand and cope with the problem proliferate, many managers still have to be convinced that stress needs to be tackled--if only because it eats into profits. Occupational psychologist Jack Lamport Mitchell examines two new developments designed to raise stress awareness. PMID- 1775294 TI - Vicarious liability of employers explained. AB - The law on vicarious liability was brought sharply into focus in July when the Court of Appeal reviewed the liability of an employer for the actions of an employee in a contempt of court action. Gillian Howard looks at some recent cases and offers useful advice on how companies can avoid liability in future. PMID- 1775295 TI - Assertiveness: an interpersonal approach. AB - As all aspects of industry and the public sector are reorganised to face the onslaught of the current recession, as well as the impact of a single European market in 1992, so the role and function of OH changes within these organisations. Personal skills of OH nurses that have been adequate in the past may now need to be refined to meet the challenges of the 90s, writes Sue Wheeler lecturer in management development at Birmingham University. PMID- 1775296 TI - A credit to the profession. PMID- 1775297 TI - Testing cholesterol testing. AB - Whether cholesterol testing should be offered by OH services is the subject of lively debate. But the fact is that many OH departments do now offer this form of screening which is well received by the workforce and provides good opportunities for health education. PMID- 1775298 TI - Evaluation of diagnostic procedures in chlamydial eye infection. AB - Sixty-six patients suffering from suspected chlamydial conjunctivitis or keratoconjunctivitis underwent direct examination and culture procedures on specimens from conjunctival swabs and corneal scraping for detection of Chlamydia trachomatis. Patient blood samples were also screened for the presence of antichlamydia IgG and IgA antibodies. Eye positivity was found in 12 and 15% of patients by using culture isolation and direct examination, respectively. In 3 out of the 8 patients with culture-proven chlamydial eye infection, all of them female, C. trachomatis was also isolated from the genital tract. PMID- 1775299 TI - Topical application of ciclosporin ophthalmic solution containing alpha cyclodextrin in experimental uveitis. AB - Ciclosporin (CS) has been shown to be a potent immunosuppressive drug. However, systemic administration of CS has been limited because of its unfavourable side effects. Thus, our attention has been focused on a topical application of CS for ophthalmic diseases. In this study, we examined the influence of a topical application of CS on experimentally induced ocular inflammation. CS was prepared by a new drug delivery system, with alpha-cyclodextrin (CD) as a solvent. Topical 0.075% CD-CS reduced ocular inflammation of rabbits induced by intravitreal injection of bovine serum albumin. The magnitude of efficacy of topical 0.075% CD CS fell within the same level as that of topical 0.02% fluorometholone. However, the topical CD-CS showed no effect on experimental autoimmune uveitis in rats which had been induced by S-antigen or interphotoreceptor retinoid-binding protein. These findings indicate that the topical CD-CS is effective on anterior uveitis. PMID- 1775300 TI - Optimum technique of light brightness assessment in control subjects and patients with ocular hypertension and glaucoma. AB - The light brightness test is an investigation in which crossed polarizing lenses placed in front of each eye are rotated with respect to one another to ellicit any disparity in perception of a diffusely illuminated screen. A number of different strategies can be employed to achieve the aim of determining the degree of disparity which is perceived as equal by the patient. A cohort of 45 control subjects was assessed in order to determine the ranges of brightness disparity accepted as equal for six methods of assessment. The method which gave the optimal confidence limit was to preset one pair of lenses at 0 degrees (maximum transmission) and the other as a fixed reference at 45 degrees. Rotation of the lens set at 0 degrees was carried out until the brightness of an X-ray box is perceived as equal. The strategy was then reversed. A disparity in one or both recordings greater than 76.5% is outside 99% confidence limits for the whole population studied. One of 14 patients with ocular hypertension gave a consistently 'positive' results. For the optimal method, over 60% of patients with glaucoma fell outside 95% condidence limits for normal controls indicating that a disparity in brightness perception between eyes is a common feature in glaucoma, in which the disease process usually affects one eye more than the other. For the patients with chronic glaucoma there was a positive correlation between the difference in brightness perception and the difference in central visual field score, indicating that brightness perception may be subserved by the central 30 degrees of the retina. When combined with visual acuity assessment this easily performed test warrants evaluation as a potential screening test for chronic glaucoma. PMID- 1775301 TI - HLA-DR9 associated with the severity of acute retinal necrosis syndrome. AB - We divided 22 patients with acute retinal necrosis syndrome into two groups depending on whether they had its mild (10 patients) or fulminant type (12 patients) and analyzed human leukocyte antigens, HLA-A, -B, -C and -DR loci, to elucidate immunogenetic differences between these two groups. The frequency of HLA-DR9 was found to be high in patients with the fulminant type (50.0%) compared with that in the patients with the mild type (0.0%), which was significant (p less than 0.05) in a chi 2 test with Yates' correction but did not remain significant when the probability was corrected by the number of antigens tested. The result suggests that immunogenetic predisposition plays a role in aggravation of acute retinal necrosis syndrome. PMID- 1775302 TI - Pressure-induced retinal ischemia in rats: an experimental model for quantitative study. AB - The advent of treatment modalities with the potential to ameliorate retinal ischemic injury calls for methods allowing their quantitative assessment. We thus established a model of pressure-induced retinal ischemia/reperfusion injury in rats. The intraocular pressure (IOP) was raised to 110 mm Hg by cannulation of the anterior chamber for a duration of 0, 90 or 120 min. The eyes were reperfused for 3 or 7 days. Morphologically, retinal injury occurred in a pattern consistent with retinal and choroidal vascular occlusion. Damage increased in severity with prolonged durations of ischemia. Morphometric determination of the mean thickness of inner retinal layers (MTIRL) revealed significant differences between controls and the 90- or 120-min ischemia groups (p less than 0.05 and p less than 0.01, respectively). The difference in MTIRL between 3 and 7 days of reperfusion was not significant. Replacement of normal saline by a solution of 5% dextrose in the hydrostatic device used to increase the IOP led to a decrease in retinal injury after 120 min of ischemia (p less than 0.01). This model combines a relatively simple methodology, cost-effective execution and a fast, semicomputerized method of quantitation. Depletion of carbohydrates during ischemia may contribute to retinal injury in this model. PMID- 1775303 TI - A comparative study of eight intraocular lens calculation formulas. AB - A retrospective study of 183 eyes that had undergone extracapsular cataract extraction and posterior chamber intraocular lens (IOL) implantation was undertaken to compare the accuracy of eight IOL power calculation formulas (modified Binkhorst, Colenbrander, Gullstrand, Fyodorov-Galin-Linksz, Gill, Axt, Donzis-Kastle-Gordon and SRK regression). We found that the regression formulas were more accurate than the theoretical formulas, giving enough approximation to the ideal IOL as to assure its clinical use. We prefer the SRK formula because it is easier and it has a constant A that can be adapted in a personalized way to each surgical team. PMID- 1775304 TI - Titrated scatter treatment in the ETDRS. PMID- 1775305 TI - Multifocal IOLs. PMID- 1775306 TI - Inadvertent intraocular injections. PMID- 1775307 TI - A case-control study of risk factors for postoperative endophthalmitis. AB - The authors conducted a case-control study to identify risk factors for postoperative endophthalmitis. Fifty-four cases of patients who developed endophthalmitis after intraocular surgery at the New York Eye and Ear Infirmary during the period from January 1988 through October 1990 were identified. A control group of 228 patients was randomly selected from the 24,105 patients who underwent intraocular surgery during this same period. Logistic regression analysis identified significant independent risks associated with intraoperative communication with the vitreous cavity (risk ratio 13.7, P less than 0.001) and use of an intraocular lens with haptics made of polypropylene (risk ratio 4.5, P = 0.007). The study predicts that there would be approximately 700 fewer cases of postoperative endophthalmitis annually in the United States (approximately a 50% decrease in incidence) if intraocular lenses with haptics made of polymethyl methacrylate, rather than polypropylene, were used exclusively. PMID- 1775308 TI - Prophylaxis of endophthalmitis with topical povidone-iodine. AB - The authors conducted an open-label nonrandomized parallel trial to examine whether the preoperative application of povidone-iodine to the ocular surface reduces the incidence of endophthalmitis after intraocular surgery. During an 11 month period, topical 5% povidone-iodine was used to prepare the conjunctiva in 1 set of 5 operating rooms, while silver protein solution was used in another set of 5 rooms. In all cases, surgeons continued to use their customary prophylactic antibiotics. A significantly lower incidence of culture-positive endophthalmitis (P less than 0.03) was observed in the operating rooms using povidone-iodine (2 of 3489 or 0.06%) compared with those using silver protein solution (11 of 4594 or 0.24%). Use of topical povidone-iodine in over 3000 cases was not associated with any adverse reactions. In a majority of the observed cases of endophthalmitis, some form of intraoperative communication with the vitreous cavity existed. PMID- 1775309 TI - Recurrence rate and complications after beta irradiation for pterygia. AB - Of 1102 consecutive patients treated with beta irradiation after pterygium removal at the Queensland Radium Institute from 1973 through 1978, 503 had a follow-up ophthalmologic examination in 1989, while a further 82 had at least a 10-year follow-up from ophthalmologic records. One hundred forty-two patients were lost to follow-up because of death, lack of cooperation, and geographical inaccessibility. A further 375 patients could not be located. Of those not followed for at least 10 years, 162 had a follow-up, recorded from ophthalmologic records, of at least 3 months. After an average dose of 22 Gray, there was a recurrence rate of 12%. A further 13% showed some sign of scleromalacia, which included 4.5% of the study group who had severe thinning. PMID- 1775311 TI - Refractive surgery for graft-induced astigmatism after penetrating keratoplasty for keratoconus. AB - Of a series of 201 corneal transplants for keratoconus over a 20-year period, 42 grafts (39 eyes of 38 patients) required further surgery because of intolerable astigmatism (range, -3 diopters [D] to -18 D; mean, 8.9 D). Relaxing incisions, compressive resuturing, and augmented relaxing incisions were the techniques used. All procedures resulted in a similar mean reduction in cylinder -3.6 to 5 D, but the outcome with augmented relaxing incisions was less predictable. Six grafts required two or more procedures for a satisfactory outcome. All patients had corrected visual acuity of 20/30 or better after surgery, and 75% had visual acuity of 20/20 or better. The cumulative time until 90% of the grafts had useful vision was 32 months after refractive surgery. Relaxing incisions offer the prospect of more rapid visual rehabilitation than compressive resuturing. PMID- 1775310 TI - Excimer laser smoothing of a reproducible model of anterior corneal surface irregularity. AB - A reproducible model of an irregular corneal surface was developed to test the ability of the excimer laser to treat such surfaces. Using a 193-nm argon fluoride excimer laser set at a fluence of 160 mJ/cm2, repetition rate of 10 Hz, and 185 pulses, fresh de-epithelialized pig eyes underwent phototherapeutic ablations through a piece of stainless steel wire screen that masked the cornea. This yielded an uneven corneal surface in a grid-like pattern, with the peaks 50 microns higher than the troughs. The eyes then underwent further treatment in an attempt to smooth the center of the irregularity. Hydroxypropyl-methylcellulose 0.3% protected the valleys in 12 eyes; 2 eyes were ablated without a protecting fluid. The same laser, at the above noted settings, was used, except that both 2 Hz and 10 Hz frequencies were used. Immediately after treatment, the eyes were processed for scanning electron microscopy. The eyes treated at 2 Hz showed less surface irregularity than did those treated at 10 Hz. The eyes treated without a protecting fluid, regardless of repetition rate, had the greatest irregularities. This model is simple and reproducible, and the authors' results suggest that modifying the repetition rates of the excimer laser can influence its effectiveness in smoothing irregular corneas. PMID- 1775312 TI - Contact lens-related deep stromal intracorneal hemorrhage. AB - Deep corneal neovascularization is a recently described complication of contact lens wear. Visual loss associated with deep corneal neovascularization has been associated with stromal lipid leakage. Deep intracorneal hemorrhage is rare and has been documented infrequently with the use of contact lenses. The authors present five cases of deep stromal hemorrhage associated with contact lens related deep corneal neovascularization. These patients had no other discernible cause for their vascularization and subsequent hemorrhage. One patient required a penetrating keratoplasty for visual rehabilitation. Contact lenses of all types may cause neovascularization. The deep stromal neovascularization develops insidiously and may progress in the absence of acute symptoms. The presence of deep stromal neovascularization must be watched carefully and managed as a potentially vision-threatening complication of contact lens use. PMID- 1775313 TI - Rhodopsin Thr58Arg mutation in a family with autosomal dominant retinitis pigmentosa. AB - The authors report a family in which a Thr58Arg rhodopsin mutation co-segregates with the disease phenotype of autosomal dominant retinitis pigmentosa (RP) in 16 family members. DNA sequence determination confirms the presence of the same mutation reported previously for one family apparently unrelated to the pedigree now reported. Features of RP in this family included a later onset of symptoms, with night blindness first noticed between ages 12 to 24 years. Although symptoms worsened with age, no complete blindness was observed even with advanced age. Results of psychophysical and electrophysiologic testing showed that a 19-year old affected woman and her 65-year-old affected uncle had relatively similar extent of visual dysfunction, and that the vision of both was better than 2 of their relatives aged 37 and 53 years. This study presents a range of phenotypic similarities and differences observed between individuals whose RP appears to be caused by the same mutation. PMID- 1775314 TI - Regional distribution of retinal degeneration in patients with the proline to histidine mutation in codon 23 of the rhodopsin gene. AB - Mutations in the rhodopsin gene are associated with as many as one quarter of all cases of autosomal dominant retinitis pigmentosa (RP). A number of different rhodopsin mutations have been reported but only the proline to histidine mutation in codon 23 (Pro-23-His) has been well characterized clinically. One recent report described a "sectoral" distribution of the retinal degeneration associated with this mutation, while another reported only that pigment was present in all four quadrants in 13 of 17 patients. This asymmetric distribution of pigmentation and visual field loss may prove to be an important clinical sign of a type of RP with a relatively good visual prognosis. The authors present a family with Pro-23 His rhodopsin-associated RP in which all six affected individuals had a regional distribution of the retinal degeneration in which the inferior hemisphere of the retina was most severely affected. PMID- 1775315 TI - Long-term visual outcome in Terson syndrome. AB - The presentation and long-term visual outcome in 30 eyes with Terson syndrome is evaluated. In 25 of 30 eyes (83%), visual acuity of 20/50 or better was attained. This occurred in 12 of 16 eyes (75%) managed by observation alone and 12 of 14 eyes (86%) treated by pars plana vitrectomy. The most common long-term sequelae in all eyes studied was the formation of an epiretinal membrane. These occurred in 14 of 18 eyes (78%) followed for 3 or more years but accounted for significant visual loss in only 2 eyes. There was no difference in final visual outcome between those patients undergoing vitrectomy and those managed conservatively. However, visual recovery was more rapid in eyes undergoing vitrectomy despite the fact that vitrectomy was reserved for eyes with more dense vitreous hemorrhage. PMID- 1775316 TI - Characterization of functional changes in macular holes and cysts. AB - Precise characterization of functional loss in small retinal lesions is difficult with conventional techniques. Using the scanning laser ophthalmoscope, the authors evaluated functional changes and fixation behavior in 26 eyes with macular holes and 15 eyes with macular cysts. A dense scotoma was present over all macular holes; 24 had no detectable functional alteration at the margins of the hole, and fixation was above the horizontal meridian in all eyes. Nine eyes with cysts had no detectable functional loss over the cyst. Only two eyes had small areas of dense scotoma within the cyst area, and four had areas of relative scotoma. Fixation was central in all eyes. Characterization of functional changes is helpful in differentiating holes from cysts. Photocoagulation at the margin of the holes may result in further functional damage. PMID- 1775317 TI - Fluorescein fundus angiography with scanning laser ophthalmoscope. Visibility of leukocytes and platelets in perifoveal capillaries. AB - The authors performed fluorescein fundus angiography in 130 eyes using a scanning laser ophthalmoscope (SLO). Capillaries were observed in the perifoveal area in 63 eyes. In these 63 eyes, numerous fluorescent dots were seen flowing through the capillaries. This feature allowed identification of the direction and velocity of blood flow in the retinal capillaries. The distance from 1 dot to the next was widely variable and averaged 100 microM. The velocity of flow was faster in precapillary arterioles, slower in capillaries, and again faster in postcapillary venules. The dots were much more numerous in an eye with leukemia and less numerous in an eye with idiopathic thrombocytopenic purpura. Staining of whole blood from three healthy persons with fluorescein sodium resulted in prompt and intense staining of leukocytes and platelets. These findings indicate that the observed fluorescent dots in perifoveal capillaries correspond to leukocytes and platelets in the circulating blood. PMID- 1775318 TI - Combined localized current field hyperthermia and irradiation for intraocular tumors. AB - Ten patients with large melanomas and one patient with recurrent retinoblastoma were treated with combined localized current field (LCF) hyperthermia and iodine 125 irradiation delivered by episcleral plaque. Tumors were heated to 43 degrees to 45 degrees C for 28 to 45 minutes. Localized current field hyperthermia when combined with irradiation appeared to induce rapid tumor necrosis. One eye enucleated 17 hours after treatment showed only focal necrosis of the melanoma, while another eye demonstrated extensive necrosis 60 hours after treatment. In all remaining eyes, tumor regression occurred within the first month of treatment. Complications included cataract formation in six eyes, hemorrhagic retinal detachment in five eyes, and phthisis in two eyes. Complications from combined therapy of large intraocular tumors in this series appeared to result from the rapid necrosis of the tumor and secondary intraocular inflammation. Intraocular temperature dosimetry measurements demonstrated a temperature gradient of not more than -0.23 degrees C/mm-1 per axial millimeter from the episcleral plaque surface to the apex of the tumor. The authors believe that LCF hyperthermia could be a suitable means of application of hyperthermia in patients with intraocular tumors if further modifications were performed to reduce ocular complications. PMID- 1775319 TI - Electroretinogram interpretation in central retinal vein occlusion. AB - The authors report electroretinogram (ERG) data from the initial clinic visit of 39 patients with central retinal vein occlusion (CRVO). No patient had signs of neovascular complications or had received treatment at the time of the ERG examination. Area under the receiver operating characteristic (ROC) curve was used to compare effectiveness of the 4 ERG parameters (Rmax, Log K, b/a wave ratio, and 30 Hz implicit time) in separating those patients who went on to iris neovascularization from those who did not. Rmax is the maximum saturated b-wave amplitude and Log K is the half saturation constant of the Naka-Rushton curve fit to the intensity response data. Discriminant scores, derived using multiple discriminant analysis, were calculated for the total patient groups, CRVO eye alone, and intereye difference. These scores also were compared with the four individual ERG parameters using ROC analysis. Parameters based on amplitude of ERG response, Rmax, and b/a wave ratio are as effective predictors of neovascular response as those interpreted as indicators of retinal sensitivity, such as 30Hz implicit time or Log K. The authors present evidence that loss of b-wave amplitude is not necessarily associated with irreversible loss of inner retinal function. PMID- 1775320 TI - Measurement of intraocular pressure with a flat anterior chamber. AB - When a flat chamber develops in an eye after filtration surgery, management depends on whether the cause is excessive filtration or aqueous misdirection (ciliary block or malignant glaucoma). This diagnosis is often based on the intraocular pressure: low pressure in excessive filtration, high pressure in aqueous misdirection. To determine the accuracy of tonometry when the lens is in contact with the cornea, flat anterior chambers were created in 5 eyes obtained from an eye bank. The pressure in the vitreous cavity was raised and lowered with an infusion line and monitored with a pressure transducer. The intraocular pressure was estimated with a Goldmann applanation tonometer, a Pneumatonometer, and a Tono-pen. The readings poorly represented the actual pressure in the vitreous cavity. The error was 0 to 51 mmHg (mean, 12.8 mmHg) with the Goldmann tonometer, 0 to 33 mmHg (mean, 9.0 mmHg) with the Pneumatonometer, and 1 to 28 mmHg (mean, 13.5 mmHg) with the Tono-pen. Therefore, in the face of a flat anterior chamber, pressure measurements made on the cornea cannot be relied on to distinguish excessive filtration from aqueous misdirection. PMID- 1775321 TI - Noncontact thermal mode Nd:YAG laser transscleral cyclocoagulation in the treatment of glaucoma. Intermediate follow-up. AB - Noncontact transscleral Nd:YAG laser thermal mode cyclocoagulation is known to reduce intraocular pressure (IOP). Thirty-five eyes were treated at a mean of 2.5 Joules and followed for a mean of 28 months. The mean preoperative IOP of 39.8 mmHg (standard deviation, 11.7) was consistently decreased by 45% to 55% over the follow-up period (standard deviation, 19.9 to 30.8), along with a significant reduction of medical therapy. This effect is comparable with that obtained by investigators using much higher energy levels. Successful control was defined as IOP between 5 and 21 mmHg for eyes with visual acuity of counting fingers or better, between 5 and 25 mmHg for eyes with hand motions to light perception, and as control of ocular pain for eyes with no light perception; 71% to 75% of the eyes were successfully controlled for up to 3 years. The use of lower energy levels appears to be associated with a lower incidence of vision loss and, therefore, merits further controlled investigation. PMID- 1775322 TI - Hemorrhage associated with dacryocystorhinostomy and the adjunctive use of desmopressin in selected patients. AB - Of 150 consecutive patients who underwent dacryocystorhinostomy, postoperative hemorrhage requiring treatment occurred in 2 patients, both of whom had endogenous platelet dysfunction without thrombocytopenia. The first patient had macroglobulinemia, and the second patient had congenital platelet hypofunction. Prophylactic 1-deamino-8-D-arginine vasopressin (desmopressin; DDAVP) was used successfully to decrease intraoperative bleeding in the second patient. Of the 15 patients with exogenous platelet dysfunction secondary to the use of aspirin or nonsteroidal anti-inflammatory agents within 1 week of operation, none had hemorrhaging. Dacryocystorhinostomy should be undertaken cautiously and with hematologic consultation in patients with blood dyscrasias. PMID- 1775323 TI - Cutaneous melanoma of the eyelid. Clinicopathologic features. AB - The authors reviewed the clinical and histopathologic features of 32 patients with cutaneous malignant melanoma of the eyelid. The lower eyelid was more frequently the site of origin than the upper eyelid (21 patients, 66% of cases). A clinical diagnosis of melanoma was made in only 2 of 13 patients (15%) for whom the clinical diagnosis was listed. Clinical findings of pigmentation, ulceration/hemorrhage, or growth were documented in 25 (78%) patients. The histopathologic classification of the melanomas included nodular (19 patients, 59%), superficial spreading (7 patients, 22%), and lentigo maligna (6 patients, 19%). Associated histopathologic findings included solar elastosis (13 patients, 41%), nevus (12 patients, 38%), and basal cell carcinoma (4 patients, 13%). One of eighteen patients with follow-up data available died of metastatic melanoma. PMID- 1775324 TI - Superior oblique palsy manifested during pregnancy. AB - The author describes his experience with diplopia during uncomplicated pregnancy in 3 of 25 (12%) women with neurologically isolated unilateral superior oblique palsy. These three patients had visual sensory and ocular motor findings that suggested they had longstanding latent vertical deviations that decompensated during pregnancy. Two of these three women experienced resolution of symptoms shortly after delivery. Increased recognition of the benign association between decompensation of a latent superior oblique palsy and pregnancy may obviate the need to further evaluate such patients with neuroimaging studies or other procedures. PMID- 1775325 TI - An ophthalmologist's definition of ophthalmology. AB - Ophthalmology has long been on the vanguard of medicine and innovation. Ophthalmologists have enjoyed high levels of satisfaction from restoring sight to patients. But the world as we know it has shifted, and now we are burdened by the pressures of modern medicine and a competitive marketplace. Ophthalmology should take the lead in medicine in learning how to weather these crises and how to emerge a revitalized specialty. It seems that the right choice for the specialty of ophthalmology is to reclaim our role as comprehensive providers of total eye care. Ophthalmologists can lead teams formed to provide comprehensive eye care. A dialogue on a consensus definition of the scope of ophthalmology should take place, involving all segments of the profession. Another dialogue that is critical to the future of the specialty is a deliberate examination of the issue of formal accreditation and/or certification of ophthalmologic subspecialties. Ophthalmology needs to define itself for the future. PMID- 1775326 TI - [Congenital pseudarthrosis of the crus in children and its treatment]. AB - In the article are presented the peculiarities of creation and development of congenital false joints of the crus bones, worked out a new modern classification of pseudoarthroses with regard to their etiology and phasic development. For the first time, on the basis of cloning of the osteogenic cells--precursors, there have been carried out studying of osteogenic "potencies" of the zone of congenital false joint and "soundness" of transplanted autospongiosa of the upper flaring portion of the ilium. There is presented a differentiated approach to utilization of different plastic materials (autospongiosa, allogenic decalcified bone matrix). There have been developed new methods of prophylactic and reconstructive--restorative osseoplastic operations in children with false joints of the crus bones. PMID- 1775327 TI - [Immobilization of the limb after surgical treatment of habitual shoulder dislocation]. AB - The authors, on the basis of 20-years experience of treatment of patients with habitual dislocations of the shoulder by the method of tenosuspension, analyse the causes of postoperative recurrencies with the aid of biomechanical, electrophysiologic and roentgenologic methods. There is suggested an expediency of limb immobilization in the post-operative period by means of Dezault's bandage. PMID- 1775328 TI - [Surgical tactics in pathological fractures of the long bones]. AB - In the article is presented an experience of treatment of 201 patient with benign tumours and tumour-like bone affections, aggravated with pathologic fractures. The principal conclusion of the work--early operative treatment of the given pathology (with the exception of dystrophic bone cysts of some types) in contrast to the rooted wait-and-see surgical tactics. PMID- 1775329 TI - [Aneurysmal bone cyst of the vertebra in early childhood]. PMID- 1775330 TI - [Correlations of congenital femoral dislocation and scoliosis]. AB - In the article is analysed the state of spine and hip joints on the basis of comparative appreciation of orthospondylometric and coxometric data in accordance with the roentgenograms in anteroposterior projection. It has been revealed that the point in common between the congenital hip dislocation and scoliosis is the same dysplastic essence. Biomechanical changes, which take part in this community, determine the final formation of pathology of spine and hip joints. In the process of examination of children with congenital hip dislocation recommended detection and preventive treatment of the spine changes and in case of spine pathology the hip joint pathology should be looked for. PMID- 1775331 TI - [Revascularization of avascular spongy bone]. AB - There have been studied the state of blood circulation in proximal parts of femur of 24 dogs (48 hip joints with simulated aseptic necrosis). In the first group of joints there have been carried out revascularization of the head by caudal epigastric artery with commitant veins. The second group have been subjected to tunneling. The third group of joints served as a control. Microcirculation disturbances, ascertained by intraosseous contrast phlebography arteriography and microscopic examination of osseous tissue, indicated that aseptic necrosis of the head of femur in an experiment is accompanied by increased intraosseous pressure, revascularization of an avascular spongy bone causes stable normalization of intraosseous hemodynamics. PMID- 1775332 TI - [Functional state of the respiratory system in the handicapped after amputation of the upper limbs]. AB - There are given the results of study of external respiration function of 45 invalids after amputation of upper limbs, including 20 after amputation of one arm and 25 after amputation of both arms. The study was carried out at rest and with physical loading at veloergometer. Detected disturbances of external respiration function are determined by decrease of reserve capability of respiratory system due to disturbance of dynamic balance of muscular system of shoulder girdle and thorax, muscle atrophy, thorax excursion decrease. There are given recommended locomotory regimens and allowable physical loads and recommendations concerning prosthetics and exercise therapy. PMID- 1775333 TI - [Systemic osteoporosis in women]. AB - This paper is based on investigation of biopsies from the upper flaring portion of the ilium of 53 women, sick of systemic osteoporosis. The results of quantitative evaluation of the osseous tissue parameters by means of histomorphometric method allowed to reveal systemic osteoporosis of 4 types, note distinctions between osseous tissue loss mechanisms in case of systemic osteoporosis and age atrophy of bones. Comparison of osseous tissue quantitative parameters with the peculiarities of microanatomy of trabeculae allowed to verify the degree of disturbance of such remodelling mechanisms as resorption and osteogenesis for each of 4 types. The possibility of fractures of axial skeleton and limb bones at normal value of spongy bone in biopsies from the upper flaring portion of the ilium has been demonstrated. PMID- 1775334 TI - [Treatment of injuries of the talocrural articulation by a delayed functional plaster cast]. PMID- 1775335 TI - [Treatment of diaphyseal fractures of the shin bones using plaster casts]. PMID- 1775336 TI - [A combined method of fixation in the treatment of diaphyseal fractures of the humerus]. PMID- 1775337 TI - [Treatment of children with congenital infundibuliform deformation of the thorax]. PMID- 1775338 TI - [Surgery in spondylolisthesis with scoliosis in children]. PMID- 1775339 TI - [Several aspects of therapeutic use of vibration]. PMID- 1775340 TI - [A method of stabilization of the external malleolus with a defect of the fibula]. PMID- 1775341 TI - [A method for bringing out the tendons in surgery of injuries of flexor tendons of the fingers]. PMID- 1775342 TI - [Improvement of Vinogradov's abduction splint in the treatment of fractures of the humerus]. PMID- 1775343 TI - [Equipment for treatment of the hand]. PMID- 1775344 TI - [A device for the rehabilitation of patients with diseases of the hip joint]. PMID- 1775345 TI - [A hinged compression-distraction device]. PMID- 1775346 TI - [Hospitalization of traumatologic patients in the state of alcoholic intoxication]. PMID- 1775347 TI - [Diagnosis and features of surgical treatment in instability of the shoulder joint]. PMID- 1775348 TI - [Iakov Leont'evich Tsiv'ian]. PMID- 1775349 TI - [Treatment of diaphyseal femoral fractures in patients with associated and multiple traumas]. AB - There has been analysed an outcome of treatment of diaphysial fractures of femur in 124 victims with associated and multiple damages. The analysed group of victims has been urgently subjected to intramedullary nailing osteosynthesis by means of a rod of our construction. Developed and officially approved method of nailing osteosynthesis not only eliminates application of bulky plaster bandages, skeletal traction systems, but ensures mobility, possibility of carrying out the repeated diagnostic and treatment--and--prophylactic measures and, in the indicated cases, repeated operative intervention. Clinical approval of the method of nailing osteosynthesis by means of the rod of our construction allowed to reduce the term of treatment, number of complications, temporary invalidity and invalidism as compared with the group of patients, subjected to conservative treatment. PMID- 1775350 TI - [Biomechanical aspects of total hip joint prosthesis (literature review)]. PMID- 1775351 TI - We are not the cause of soaring costs. PMID- 1775352 TI - RBRVS: a ploy to divide and conquer. PMID- 1775353 TI - Why RBRVS? PMID- 1775354 TI - Implementation of Self-Determination Act begins. AB - As a part of the Omnibus Budget Reconciliation Act of 1990 (OBRA '90), Congress established the Patient Self-Determination Act (PSDA). The PSDA, which becomes effective on December 1, 1991, requires certain Medicare- or Medicaid-reimbursed health care entities to provide adult individuals with information with respect to their right to direct and participate in decisions concerning their health care. PMID- 1775355 TI - HCFA mandates new quality screens (more emphasis on histories and physicals and perioperative monitoring). AB - As standards of care are redefined based on new technology or new constructs of what constitutes quality, we can expect changes in the criteria by which our clinical activities are assessed. This is certainly true for peer review conducted under PRO programs, since the starting point for review is the application of criteria and screens. Review criteria are essentially developed by the PROs and, in Pennsylvania, with assistance of specialty society liaisons. The generic quality screens are HCFA-developed, and their use is mandated. Recently, all PROs received a Directed Change Order (DCO) in which newly revised outpatient generic quality screens were released. PMID- 1775356 TI - A systems approach to medically prescribed functional electrical stimulation. Ambulation after spinal cord injury. AB - A functional electrical stimulation (FES) system for ambulation of spinal cord injured patients has been described to consist of physician prescriptable, commercially available components. The system components are: electrical muscle stimulators, a reciprocating gait orthosis and the electrode delivery system. A systems approach to medically prescribed FES ambulation requires the interfacing of these basic components, each of which has the flexibility to adjust to the optimal configuration for each individual patient. The electrode delivery system is of central importance in interfacing the basic components. This report describes the electrode delivery system, a transcutaneous transducer garment, which allows a variety of electrode configurations and stimulation patterns. The system has been successfully employed on a C7 level tetraplegic patient and a T9 level paraplegic patient. PMID- 1775357 TI - Quality of life among aging spinal cord injured persons: long term rehabilitation outcomes. AB - Until recently, the sequelae of aging with a spinal cord injury (SCI) have not been examined comprehensively by the scientific community. Due to medical advances resulting in extended life expectancies for those with SCI, several investigations have been undertaken. Reviewed in the article are the results of available studies designed to evaluate the quality of life of aging SCI persons and the importance of quality of life to the evaluation of rehabilitation and the importance of quality of life to the evaluation of rehabilitation outcomes. Data indicate that the quality of life enjoyed by those with SCI, young and old, is relatively good and, in the case of older SCI veterans, is actually better than similarly aged able-bodied males. PMID- 1775358 TI - The weight-bearing upper extremity in women with long term paraplegia. AB - Bilateral upper limb pain, isokinetic strength, grip strength, range of motion, and activities of daily living (ADL) performance were compared in 11 women with long term paraplegia and 11 activity-level matched able-bodied women of similar age, to determine whether long term wheelchair use is associated with pain and altered function in the upper extremities. The results suggest that the development of pain in the upper limbs is clearly associated with paraplegia in women (p less than 0.01). Pain was reported most frequently by the paraplegics in the shoulders and secondly in the wrists and hands. ADL where the paraplegics experienced pain most often were work/school, outdoor wheeling, household work/childcare, and loading the wheelchair to and from the car. Whilst paraplegics reported intermittent rather than constant pain, the groups' relatively young age (mean = 43 years) and average duration of injury of only 15 years suggests that preventative and management steps are required to ensure continued independence and quality of life of this group as they age. PMID- 1775359 TI - The influence of the mechanism of cervical spine injury on the degree of the spinal cord lesion. AB - In the years 1965 to 1988, 1687 patients with cervical spine injury were treated in the acute post-traumatic period. In the analysed material commonest cause for the injury was by a flexion mechanism (48%), less frequently compressive (26%), and by a hyperextension mechanism (26%). Radiological changes were related, to some extent, with the patients age. Compression and flexion fractures occur most often in young people, dislocations in older ones, and injuries caused by hyperextension in, most often, elderly age (average age 53 years). The mechanism of the injury influences the degree of the nervous system injury. Serious consequences usually occur with crushing of a vertebral body. Serious neurological disturbance may occur with a flexion mechanism; and rarely such serious neurological disturbances accompany injuries caused by a compression mechanism. There was a complete lesion of the spinal cord in only 11% of patients. Neurological improvement was achieved in 51% of patients; 31% had no improvement, and 18% of patients died during treatment. The best results were observed in the group of typical compression fractures (neurological improvement- 81%), whereas the poorest was found in patients with a crush type of fracture (improvement in 17%, mortality 18%), and in those with dislocation (improvement in 25%, mortality rate--23%). PMID- 1775360 TI - Surgery for progressive Pott's paraplegia (tuberculous paraplegia) AB - This is a study of 20 patients who had surgical intervention for Pott's paraplegia at the Hacettepe University Neurosurgery Department, Ankara. All patients were admitted with progressive paraparesis. Eleven patients had vertebrectomies, 5 laminectomies and in 4 patients costo-transversectomies were performed. The follow-up period ranged from 1 to 10 years. Thirteen patients were found to be normal at follow-up examinations (65%). In 4 patients there was some improvement in their neurological status, and the others had no improvement. PMID- 1775361 TI - Clean intermittent self-catheterisation for quadriplegic patients--a five year follow-up. AB - We present the findings of clean intermittent self-catheterisation (CISC) as a long term method of bladder management for 36 quadriplegic spinal cord injured patients, primarily at C6/C7 level, who were taught CISC between 1983 and 1987. Success in CISC was assessed by a mail survey, a telephone interview, and current sterile urine status. Twenty nine (81%) of 36 patients continued to use CISC after a mean discharge period of 2.9 years (p less than 0.001) with high levels of acceptance. Rao's V discriminant analysis showed success in CISC was affected by the interval between injury and initial self-catheterisation (Canonical Correlation Co-efficient = 1.34). Results of urinalysis for patients continuing CISC were obtained for 18 (62%) patients, 16 (88%) of whom had sterile urine. Implications of these and other findings along with reasons for cessation of CISC are discussed. PMID- 1775362 TI - Pregnancy by gamete intrafallopian transfer (GIFT) with sperm aspirated from the vaso-epididymal junction of spinal injured man: case report. PMID- 1775363 TI - Baclofen-induced frontal lobe syndrome: case report. AB - An 81-year-old man with cervical spondylotic myelopathy developed an acute frontal lobe like syndrome with prominent preservation and an abnormal electroencephalogram after being given seven doses (70 mg) of baclofen for spasticity. The clinical symptoms cleared up in 72 hours after the medication was discontinued. PMID- 1775364 TI - Spinal cord seizures: a possible cause of isolated myoclonic activity in traumatic spinal cord injury: case report. AB - Spinal cord seizures are infrequently reported. They have been associated with intravenous dye placement, transverse myelitis and multiple sclerosis, but never with traumatic spinal cord injury (SCI). We report the case of a 48-year-old SCI male with complete C6 quadriplegia, and apparent spinal cord seizures. These seizures were characterised by myoclonus simplex activity involving the upper extremities only. The lower extremities were spared. The patient was conscious throughout the myoclonic activity and an electroencephalogram of the brain obtained during an event revealed no cortical epiliptiform activity. The seizures lasted approximately 30 seconds to a few minutes, and an acute increase in blood pressure and a decrease in pulse generally occurred 30 to 60 seconds prior to the event. Previously reported spinal cord seizures in multiple sclerosis were frequently treated with carbamazepine. In this case successful treatment was with diazepam. Spinal cord seizures may present in those with traumatic SCI. Benzodiazepines may be useful in the treatment of spinal cord seizures. PMID- 1775365 TI - Tissue PH2 measurement for continuous estimation of blood flow changes in rat kidney cortex and medulla. AB - A method is described for estimation of local blood flow changes in the renal cortex and medulla, based on continuous polarographic measurement of tissue pressure of electrochemically generated hydrogen (PH2). The technique was used in anaesthetized female Wistar rats. The changes in cortical PH2 were negatively correlated with those in flow velocity in the renal artery (Doppler probe). To evaluate the method, PH2 responses to a reduction of renal perfusion pressure (RPP) and to angiotensin II were examined. RPP reduction from 130 mmHg to 104 mmHg increased the cortical PH2 by 3.5% and medullary PH2 by 6.9% (difference significant at P less than 0.02). With RPP reduction from 113 mmHg to 76 mmHg the values were 6.9% and 11% respectively (difference significant at P less than 0.001). Angiotensin II infusion increased cortical PH2 by 8.7% and medullary PH2 by 4.1% (difference significant at P less than 0.005). It is concluded that the method enables continuous estimation of blood flow changes in the renal cortex and medulla. PMID- 1775366 TI - Effects of ryanodine on acetylcholine-induced Ca2+ mobilization in single smooth muscle cells of the porcine coronary artery. AB - To study the essential features of acetylcholine (ACh)- and caffeine-sensitive cellular Ca2+ storage sites in single vascular smooth muscle cells of the porcine coronary artery, the effects of ryanodine on both ACh- and caffeine-induced Ca2+ mobilization were investigated by measuring intracellular Ca2+ concentration ([Ca2+]i) using Fura 2 in Ca(2+)-containing or Ca(2+)-free solution. The resting [Ca2+]i of the cells was 122 nM in normal physiological solution and no spontaneous activity was observed. In a solution containing 2.6 mM Ca2+, 10 microM ACh or 128 mM K+ produced a phasic, followed by a tonic, increase in [Ca2+]i but 20 mM caffeine produced only a phasic increase. In Ca(2+)-free solution containing 0.5 mM ethylenebis(oxonitrilo)tetraacetate (EGTA), the resting [Ca2+]i rapidly decreased to 102 nM within 5 min, and 10 microM ACh or 20 mM caffeine (but not 128 mM K+) transiently increased [Ca2+]i. Ryanodine (50 microM) greatly inhibited the phasic increase in [Ca2+]i induced by 10 microM ACh or 5 mM caffeine and increased the time to peak and to the half decay after the peak in the presence or absence of extracellular Ca2+. By contrast, ryanodine (50 microM) enhanced the tonic increase in [Ca2+]i induced by 128 mM K+ and also by 10 microM ACh in Ca(2+)-containing solution. In Ca(2+)-free solution containing 0.5 mM EGTA, ACh (10 microM) failed to increase [Ca2+]i following application of 20 mM caffeine. The level of [Ca2+]i induced by 20 mM caffeine was greatly reduced, but not abolished, following application of 10 microM ACh in Ca(2+)-free solution.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775367 TI - Modification of K+ channel properties induced by fatty acids in neuroblastoma cells. AB - The effects of fatty acids on voltage-dependent potassium (K+) channels in neuroblastoma cells were studied using the whole-cell current recording technique. At a concentration of 5 microM, unsaturated and medium chain length (C10-C14) saturated fatty acids accelerated the apparent inactivation of the K+ current. This effect was reversed by albumin. In the absence of exogenous fatty acids, albumin slowed the inactivation of the K+ current. The acceleration of the K+ current inactivation induced by unsaturated fatty acids was associated with an increase in the sensitivity of K+ channels to 4-amino-pyridine. It is concluded that kinetic and pharmacological properties of K+ channels are, in part, controlled by membrane fatty acids which, in this way, should contribute to an apparent diversity of K+ channels and the modulation of cell excitability. PMID- 1775368 TI - Glucagon inhibits water and NaCl transports in the proximal convoluted tubule of the rat kidney. AB - The effects of glucagon on water and electrolyte transport in the kidney were investigated on hormone-deprived rats, i.e. thyroparathyroidectomized diabetes insipidus Brattleboro rats infused with somatostatin. Glucagon consistently inhibited the reabsorption of water and Na+, Cl-, K+ and Ca2+ along the proximal tubule accessible to micropuncture, leaving the reabsorption of inorganic phosphate (Pi) untouched. In the loop, besides its previously described stimulatory effects on Na+, Cl-, K+, Ca2+ and Mg2+ reabsorption, glucagon strongly inhibited Pi reabsorption, very probably in the proximal straight tubule. These effects resulted in a significant phosphaturia and considerable reductions of Mg2+ and Ca2+ excretions. The effects of glucagon at both the whole kidney and the nephron levels are very similar to those previously described for calcitonin. In the absence of an adenylate cyclase system sensitive to glucagon and calcitonin in the rat proximal tubule, and from the analogy of their physiological effects with those elicited by parathyroid hormone, it is suggested that glucagon and calcitonin exert their inhibitory effects on Na and Pi reabsorption in the proximal tubule through another pathway, which could be the phosphoinositide regulatory cascade. PMID- 1775369 TI - Slow frequency-dependence of action potential afterhyperpolarization in bullfrog sympathetic ganglion neurones. AB - The after hyperpolarizatin (AHP) which follows the action potential (AP) in bullfrog sympathetic ganglion B-cells involves activation of Ca(2+)-sensitive K+ conductances following Ca2+ influx via Ca2+ channels. The duration of AHPs evoked at 2-s stimulus intervals were 70.05 +/- 3.76% of those evoked at 90-s stimulus intervals (n = 35). Since there was no consistent effect of ryanodine (5 microM), ruthenium red, (300 microM) or dantrolene Na (35 microM) on this frequency dependence, it is unlikely to result from release of Ca2+ from intracellular stores. Ca2+ currents (ICa), studied by means of the whole-cell patch-clamp technique, exhibited a slow frequency dependence as a result of a slow inactivation process which was independent of Ca(2+)-induced ICa inactivation and ICa run-down. There was excellent correlation (r = 0.964) between the estimated changes in Ca2+ influx and the expected activation of the Ca(2+)-sensitive K+ current, IAHP. This result is consistent with the hypothesis that the frequency dependence of the AHP is a consequence of the slow inactivation of ICa. PMID- 1775371 TI - Basolateral uptake and tubular metabolism of L-citrulline in the isolated perfused non-filtering kidney of the African clawed toad (Xenopus laevis). AB - The kidney forms arginine (Arg) by using citrulline (Cit) as precursor, and is the main source of Arg for systemic protein synthesis. Even if the filtered and reabsorbed load (in rats) is sufficient for normal Arg synthesis, the following questions remain. (a) Can Cit be taken up across the contraluminal membrane of the tubule cells also? If so, (b) by what kind of mechanism? And (c) is this Cit, entering the cell from the peritubular side, metabolized to Arg and ornithine (Orn)? Although these questions are raised mainly in connection with mammals, we used the amphibian kidney, which is especially suitable because of its double blood supply, for an initial approach to the problem. After the toad was decapitated, the portal vein, the caval vein and the ureters were catheterized, and the kidneys were perfused through the portal vein (Ringer solution + L- or D Cit + inulin + p-aminohippurate + L-aspartate). Exclusive peritubular perfusion was assured by showing that inulin perfused into the portal vein did not appear in the urine. During perfusion of the portal vein with L-Cit in a physiological concentration (65 mumol/l), an initial peritubular net uptake of L-Cit of 170 +/- 27 (n = 10) nmol.h-1.g kidney-1 (wet weight) was observed, whereas the value for D-Cit (65 mumol/l) was only 18 +/- 7 (n = 6) nmol.h-1.g-1. After perfusion for 50 min, the uptake of L-Cit reached a steady state with an uptake rate of 108 +/- 5 nmol.h-1.g-1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775370 TI - Voltage-dependent K+ channels in the sarcolemma of mouse skeletal muscle. AB - The voltage-dependent K+ channels of the mammalian sarcolemma were studied with the patch-clamp technique in intact, enzymatically dissociated fibres from the toe muscle of the mouse. With a physiological solution (containing 2.5 mM K+) in the pipette, depolarizing pulses imposed on a cell-attached membrane patch activated K+ channels with a conductance of about 17 pS. No channel activity was observed when the pipette solution contained 2 mM tetraethylammonium (TEA), or 2 mM 4-aminopyridine (4-AP). Whole cell recordings from these very small muscle fibres showed the well-known delayed rectifier K+ outward current with a threshold of about -40 mV. The whole-cell current was completely blocked by 2 mM TEA in the bath, suggesting that the TEA-sensitive channels in the patch were also delayed rectifier channels. The inactivation properties of the channels were studied in the cell-attached mode. Averaged single-channel traces showed at least two types of channels discernible by their inactivation time course at a test potential of 60 mV. The fast type inactivated with a time constant of about 150 ms, the slow type with a time constant of about 400 ms. A little channel activity always remained during pulses lasting several minutes, indicating either the presence of a very slowly inactivating third type of K+ channel, or the tendency of the fast inactivating channels to re-open at constant voltage. No difference was seen in the single-channel amplitudes of the different types of K+ channels. The well characterized adenosine-5'-triphosphate-(ATP)-sensitive and Ca(2+) dependent K+ channels, although present, were not active under the conditions used.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775372 TI - On leaking into the lumen, amino acids cross the tubule cells. Secretion of L citrulline in the isolated-perfused non-filtering kidney of the African clawed toad (Xenopus laevis). AB - In our previous studies we were able to show that L-citrulline is taken up across the contraluminal membrane into the tubule cells of the isolated perfused non filtering kidney of the African clawed toad (Xenopus laevis). We have also described the tubular metabolism of the L-citrulline taken up. The remaining question was whether peritubular L-citrulline gains access to the tubular lumen and, if so, by what kind of mechanism. The method was the same as that described in our previous study: the perfusion of the kidneys was performed through both portal veins (2 ml/h into each) with a solution containing inulin. In order to stimulate the urine formation in the non-filtering kidney, we added p aminohippurate to the perfusion solution. In the urine collected from the ureters no inulin could be detected. Thus, the glomeruli were not reached by the perfusate, and no glomerular filtration took place. Upon adding 65 mumol/l L citrulline to the perfusion solution (corresponding to the physiological plasma concentration), a urinary excretion rate of this amino acid of 4.5 +/- 0.4 nmol.h 1.g-1 (n = 6) was determined. During perfusion under the same conditions with D citrulline (65 mumol/l) the excretion rate was only 0.36 +/- 0.1 nmol.h-1.g-1 (n = 5). A similarly low excretion rate was also found with L-citrulline when L phenylalanine (20 mmol/l) was added to the perfusate or when NaCl was substituted by mannitol. These data show that L-citrulline taken up from the contraluminal side of the renal tubular epithelium enters the tubular lumen to a much greater extent than its D-isomer.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775373 TI - Microelectrode studies of toad urinary bladder epithelial cells using a novel mounting method. AB - To optimise the conditions for recording stable membrane potentials, epithelial cells of short-circuited toad bladders were impaled via either their apical or basolateral membranes. Microelectrode impalements via the apical membrane were affected by impalement damage and were typically biphasic, consisting of an initial sharp increase in apical membrane potential (Vsc of around -26 mV), followed by a rapid depolarization of Vsc towards 0 mV in the next 10-20 s. To facilitate basolateral impalement two different methods for mounting bladders were tested. Both mounting methods yielded similar values for Vsc and Ra/Rb (the ratio of apical to basolateral membrane resistance) of around -57 mV and 5, respectively, which were larger than those recorded via the apical membrane and consistent with potential measurements from other tight epithelial tissues. Of the two basolateral mounting methods tested, the agar method gave the most stable impalements, making it possible to use amiloride and Ba2+ to assess for impalement damage. In conclusion, basolateral impalements of agar-mounted toad bladders makes this traditionally difficult tissue amenable to microelectrode studies. PMID- 1775374 TI - Antidromic vasodilation in frog: identification of the nerve fiber types involved. AB - In anesthetized, immobilized frogs arteriolar vasodilation in the submaxillaris muscle in response to electrical stimulation of the submaxillar nerve (peripheral end) was observed directly and vasodilation in the hind leg in response to stimulation of the sciatic nerve (peripheral end) measured by plethysmography. With pulses of 0.1 ms duration at 20 Hz, the threshold for arteriolar vasodilation in the submaxillaris muscle was close to 3 T, where T was the activation threshold of the most excitable fraction of motor fibers of the submaxillar nerve. Atropine had no effect on the arteriolar vasodilation. When the sciatic nerve was stimulated with pulses of 0.1 ms duration, the threshold for vasodilation in the hind leg was 3.6 +/- 1.2 T (mean +/- SEM). The thresholds for excitation of the A alpha beta, A delta and C-afferent fibers in the sciatic nerve and the range of stimulus intensities for recruiting each of these fiber groups were evaluated by recording compound action potentials in the VIII-X dorsal roots. Excitation of A delta-afferent fibers was found to occur in the same intensity range as that which evoked vasodilation in the hind leg. It is concluded that, in the frog, these myelinated afferent fibers are capable of dilating the blood vessels by antidromic action in both submaxillaris muscle and hind leg. This finding is in accordance with recent reports of an antidromic vasodilator action of A delta-afferent fibers in rabbit and rat skin. PMID- 1775375 TI - Kinetic analysis of chloride conductance in frog skeletal muscle at pH 5. AB - At pH 5 the steady-state chloride chord conductance in frog skeletal muscle rises to an asymptotic maximum at very negative voltages and approaches an asymptotic minimum at positive voltages. When a two-pulse test paradigm is used, the conductance computed from steady-state currents during the first (conditioning) voltage step are not duplicated by the conductance at the onset of a second (test) step. If the test step is to a more negative voltage than the conditioning step the steady-state conductance is overestimated; if it is to a less negative voltage the conductance is underestimated. In some fibres the initial currents accompanying steps from the resting potential are inwardly rectified. From this it was inferred that chloride channel conductance is voltage dependent: in those fibres in which no such initial inward rectification was observed it was inferred that at rest the voltage-dependent chloride channels are all closed. Time dependent ("gated") changes of conductance could be reasonably described by a first-order process, but the relaxations were not simple exponentials. Simulation of the experimental set-up predicted the type of deviation from exponentiality seen experimentally, although the observed deviations were often more pronounced than those predicted. PMID- 1775376 TI - Mapping the sequence of contraction of the canine left ventricle. AB - A method has been developed to map the sequence of contraction as measured at the epicardial surface of the anterior free wall of the canine left ventricle during sinus rhythm and electrical stimulation of the ventricle. In an area of 35 x 45 mm, 40-60 white markers were attached to the epicardial surface. The motion of the markers was recorded on video and analysed off-line by computer. In an array of 35 regions, regional surface deformation and epicardial fibre strain were calculated from the motion of the markers. Between all adjacent regions, the differences in timing of contraction were determined by cross-correlation of the related fibre strain signals. A map of the time sequence of contraction has been calculated so that the sum of the squares of the deviations between time intervals of the map and the measurements was minimised. If individual correlation coefficients were found to be less than 0.85, the related time difference was discarded from the analysis. If more than 25% of the time differences were discarded because of this reason, the whole map was obtained by determining time of the negative peak of the second time derivative in the early phase of contraction. The accuracy in time marking was sufficient (+/- 7 ms), as compared to the time differences over the epicardial surface, which were found to be on the average between 10 and 80 ms in case of sinus rhythm and electrical stimulation of the right ventricular outflow tract, respectively. PMID- 1775378 TI - A basolateral K+ conductance modulated by carbachol dominates the membrane potential of small intestinal crypts. AB - The contribution of possible ionic conductances to the membrane potential (Em) of cells in guinea-pig small intestinal crypts has been studied using the nystatin "perforated-patch" approach in current-clamp experiments. Changes in extracellular K+ produced shifts in Em, with a 37 mV change in potential per ten fold increase in extracellular K+ concentration. Reduction of extracellular Cl- by 130 mM led to a 7 mV hyperpolarisation while Na+ replacement was without effect on Em. The muscarinic agonist carbachol produced a hyperpolarisation which could be ascribed to an increase in basolateral K+ conductance. This effect was sustained in the presence of extracellular Ca2+ but was transient in its absence. We conclude that the conductance of the basolateral membrane of small intestinal crypts is mainly K+ selective and can be reversibly increased by muscarinic activation. PMID- 1775377 TI - Possible involvement of a chloride conductance in the transient outward current of whole-cell voltage-clamped ferret ventricular myocytes. AB - The transient outward current was studied, using the whole-cell patch-clamp technique, in isolated ventricular cells from the ferret heart. In the presence of 4-aminopyridine and cadmium chloride which respectively blocked the Ca insensitive and the Ca-dependent outward currents, a residual transient outward current was observed in about 30% of the cells tested. This current was suppressed in external hypochloride solution, completely inhibited by SITS (3 mM) and reversed at the equilibrium potential for chloride ions. This suggests the presence of a chloride permeability which could contribute to the repolarization phase of the cardiac action potential. PMID- 1775379 TI - Trans effects of cellular K and Cl on ouabain-resistant Rb(K) influx in low K sheep red blood cells: further evidence for asymmetry of K-Cl cotransport [corrected]. AB - The electroneutral K-Cl cotransport in low K+ (LK) sheep red blood cells is kinetically asymmetric and thermodynamically outward poised (Delpire and Lauf, 1991a). We have shown previously by trans-inhibition kinetics that Cl- binds prior to K+ to the outside configuration of the carrier. In the present study, we confirm that K+ and Cl- bind randomly to the cytoplasmic aspect of the transporter because K+ in the absence of Cl-, and Cl- in the absence of K+, trans inhibit ouabain-resistant Rb+(K+) influx in these cells. In contrast to the trans inhibition pattern observed outside, neither K+ nor Cl- trans-inhibit K+(Rb+) influx in the presence of the cotransported ion, further supporting the asymmetry of the K-Cl cotransporter. PMID- 1775380 TI - The Swiss Physiological Society. Announcement of the Asher-Hess Award 1990. PMID- 1775381 TI - Neuronal nicotinic acetylcholine receptors expressed in Xenopus oocytes: role of the alpha subunit in agonist sensitivity and desensitization. AB - Neuronal nicotinic acetylcholine receptors (nAChRs) were expressed in Xenopus laevis oocytes after nuclear injection of complementary deoxyribonucleic acid (cDNA) expression vectors. The two receptor subtypes alpha 4/n alpha 1 and alpha 3/n alpha 1 were readily distinguishable from one another by ACh sensitivity and desensitization. alpha 3/n alpha 1 receptors showed lower ACh sensitivity and stronger desensitization than alpha 4/n alpha 1 receptors. Furthermore, although the current/voltage relationship was very similar in both receptor subtypes, the voltage dependence of desensitization was found to be strikingly different. As the n alpha 1 subunit was unchanged, the alpha subunits must be responsible for these functional differences. Symmetric hybrid alpha cDNAs, alpha 4:alpha 3 and alpha 3:alpha 4, were constructed and functional receptors were obtained by co injection with n alpha 1. These hybrid receptors displayed an ACh sensitivity that was mainly defined by the extracellular sequence of the alpha subunit. In contrast, no part of the alpha subunit was found fully to determine desensitization. PMID- 1775382 TI - The predictive value of serum beta-carotene for subsequent development of lung cancer. PMID- 1775383 TI - Long-term storage of red blood cells and correlations between red cell and dietary fatty acids: results from a pilot study. AB - Levels of red blood cell (RBC) fatty acids were determined at baseline and 12 months after storage at -70 degrees C in 15 postmenopausal women to determine whether storage had a detrimental effect on the stability of fatty acids. Four day diet records were also completed at baseline, allowing comparisons between RBC fatty acid levels and fatty acid levels computed from recent dietary intake. The major fatty acid composition of RBCs did not change substantially during 12 months of storage, and, in particular, for n-6 and n-3 fatty acids most correlations between baseline and 12-month values were greater than 0.90. We also found strong positive correlations between RBC and dietary fatty acids, including oleic, linoleic (18:2n-6), total n-6, and the polyunsaturated-to-saturated fat ratio. We concluded that frozen RBCs may be a useful measure of recent dietary intake for epidemiological studies. PMID- 1775384 TI - The influence of topical and systemic vitamin E on ultraviolet light-induced skin damage in hairless mice. AB - Hairless mice were fed diets containing different levels of vitamin E or received topical applications of the vitamin for three weeks before a single exposure equivalent to one minimal erythematous dose of ultraviolet light provided by an artificial sunlight source. Lipid peroxidation and suppression of incorporation of thymidine into DNA were used to estimate the degree of damage caused by the radiation. Restriction of dietary vitamin E had little effect on degree of epidermal lipid peroxidation or on thymidine incorporation into DNA. High dietary levels of the vitamin did not alter the degree of lipid peroxidation; however, the incorporation of thymidine was restored to levels comparable to those of unirradiated animals. Topical administration of a 1% solution of the vitamin in ethanol 1 or 24 hours before irradiation also restored thymidine incorporation and reduced the degree of lipid peroxidation. The results suggest that both dietary and topical vitamin E are effective in protecting the epidermis against some of the early damage induced by ultraviolet radiation. PMID- 1775385 TI - Bile salt/acid induction of DNA damage in bacterial and mammalian cells: implications for colon cancer. AB - Two bile salts, sodium chenodeoxycholate and sodium deoxycholate, induced a DNA repair response in the bacterium Escherichia coli. Similarly, a bile acid and a bile salt, chenodeoxycholic acid and sodium deoxycholate, induced DNA repair (indicated by unscheduled DNA synthesis) in human foreskin fibroblasts. Also, DNA repair-deficient Chinese hamster ovary (CHO) cells were found to be more sensitive than normal cells to killing by bile salts. In particular, mutant UV4 CHO cells, defective in DNA excision repair and DNA cross-link removal, were more sensitive to sodium chenodeoxycholate, and mutant EM9 CHO cells, defective in strand-break rejoining, were more sensitive to sodium deoxycholate than wild-type cells. These results indicate that bile salts/acid damage DNA of both bacterial and mammalian cells in vivo. Previous epidemiological studies have shown that colon cancer incidence correlates with fecal bile acid levels. The findings reported here support the hypothesis that bile salts/acids have an etiologic role in colon cancer by causing DNA damage. PMID- 1775386 TI - Effect of dietary selenium and magnesium on human mammary tumor growth in athymic nude mice. AB - The effect of dietary selenium (Se) supplementation and low dietary magnesium (Mg) on growth of cells of the human mammary tumor cell line (HTB123/DU4475) and the tissue glutathione (GSH) content in female athymic nude mice was studied. Sixty three- to four-week-old female athymic nude mice were randomly divided into six dietary groups of 10 animals. The mice were fed a modified AIN-76A diet with two levels of Mg (100 and 665 mg/kg) and three levels of Se (0.04, 0.2, and 4.0 mg/kg). At the fourth week of dietary treatment, mice were subcutaneously inoculated with 2.5 x 10(6) viable tumor cells on the dorsal lumbar region and then fed their respective diets for another four weeks. Dietary Se supplementation had no significant effect on tumor growth or tissue GSH content. Low dietary Mg limited both tumor growth and tissue GSH synthesis but raised Mg and GSH levels in tumor tissues. The growth of mice fed the diet containing 100 mg/kg Mg and 4.0 mg/kg Se was significantly retarded. This study demonstrated that neither Se deficiency nor Se supplementation had any effect on mammary tumor growth or tissue GSH content in athymic nude mice. Low dietary Mg did retard tumor growth and inhibited GSH synthesis. Low dietary Mg also resulted in an apparent increase in Se toxicity in these animals. PMID- 1775387 TI - Long-term effect of Bifidobacteria and Neosugar on precursor lesions of colonic cancer in CF1 mice. AB - This investigation was undertaken to study the role of Bifidobacteria and bifidogenic factor Neosugar in the process of 1,2-dimethylhydrazine-induced colonic carcinogenesis in CF1 mice. Intestinal colonization and selective proliferation of Bifidobacteria were achieved by oral administration of indigenous Bifidobacteria and the incorporation of 5% Neosugar in the diet of animals. The Bifidobacteria were isolated from the feces of CF1 mice and were identified to be Bifidobacterium pseudolongum biovar b. This incidence of aberrant crypts and foci were significantly lower 38 weeks after the last injection of the carcinogen in animals fed Bifidobacteria than in animals treated with the carcinogen alone. The aberrance also appeared to be confined to the more distal end of the colon in animals fed bifidogenic diet. Such changes in the precursor lesions of colonic carcinogenesis are presumably due to the increase in the number of Bifidobacteria and their acidifying action in the lower intestinal tract of the animals. PMID- 1775388 TI - Dietary cholesterol, fatty acids, and the risk of lung cancer among men. AB - The relation between dietary cholesterol and fatty acids and the incidence of lung cancer was studied among 4,538 Finnish men aged 20-69 years and initially free of cancer. During 20 years of follow-up, 117 lung cancer cases were diagnosed. Cholesterol intake was not associated with lung cancer risk, the age-, smoking-, and energy-adjusted relative risk between the lowest and highest tertiles being 1.0 [95% confidence interval (CI) = 0.6-1.9]. The intake of saturated fatty acids was nonsignificantly related with lung cancer incidence, the relative risk for the lowest compared with the highest tertile being 1.6 (CI = 0.8-3.2). The association was stronger among smokers than among nonsmokers, the relative risks being 2.1 (CI = 1.0-4.3) and 1.3 (CI = 0.4-4.1), respectively. The relative risk among smokers, however, decreased to 1.5 after adjustment for the amount they smoked. In the total cohort, there was a significantly elevated risk of lung cancer among men with a high intake of butter, one of the main sources of saturated fatty acids, the relative risk being 1.9 (CI = 1.1-3.2). The present data do not confirm previous results suggesting that dietary cholesterol predicts the occurrence of lung cancer among men. The association between intake of saturated fatty acids and lung cancer observed in the present study may be partly due to heavy smoking among high consumers of saturated fat. PMID- 1775390 TI - [Progress in the diagnosis of Wegener's granulomatosis]. PMID- 1775389 TI - [Significance of anti-neutrophil cytoplasmic autoantibodies in the diagnosis of Wegener's granulomatosis]. AB - A case of Wegener's granulomatosis (WG) with involvement of the upper and lower respiratory tract and kidneys is presented. Despite specific symptoms the diagnosis was changed several times. Final diagnosis was made with immunofluorescence test for antineutrophil-cytoplasm antibodies (IF-ANCA). In Poland, this is the first report emphasizing the role of ANCA in diagnosis of WG. The significance of this test in diagnosing of WG is presented. PMID- 1775391 TI - [Arrhythmogenic effects of anti-arrhythmia drugs]. PMID- 1775392 TI - [The immunobiological effects of nitrogranulogen. I. Summarizing the results of the immunological studies to date]. AB - It has been shown that nitrogranulogen is a strong inhibitor of human T and B lymphoproliferation, antibody synthesis in vitro and in vivo as well as natural killer (NK) activity. The drug enhances IL 1 secretion, but blocks its cellular interactions. PMID- 1775393 TI - [The immunobiological effects of nitrogranulogen. I. Effect of nitrogranulogen on laboratory and clinical parameters in patients with primary glomerulopathies]. AB - The administration of nitrogranulogen in a dose of 0.01 mg/kg in patients with primary glomerulopathies caused a significant reduction in proteinuria in 10 out of 12 cases. In one patient the effects was striking (fall of proteinuria from 10 g/24 hrs to trace amounts). A trend towards the normalization of helper T lymphocytes (CD4+) was noted as well as a significant drop in NK lymphocytes. No side effects or drug-related complications were observed. PMID- 1775394 TI - [Infectious aortic valve endocarditis. Echocardiographic evaluation]. AB - In the group of 37 patients (pts) with infective endocarditis of aortic valve comparative analysis of echocardiograms with intraoperative or pathomorphological findings was performed. Infection caused development of vegetations in 17 pts, cusp rupture in 7 and perivalvular abscess in 4 pts. Echocardiographic examination enabled diagnosis of vegetations in 16 pts. In 2 pts abscess cavity was shown between mitral and aortic annulus. Two-dimensional echocardiography provided more detailed data concerning number and localization of vegetation, and development of perivalvular abscess cavity. However cusps rupture was shown by M mode echograms in 4 from 7 pts. In the course of antibiotic therapy 7 pts died: from 30 pts treated surgically the result of treatment was beneficial in 27. The examinations confirmed poor clinical prognosis of premature mitral valve closure for the patients with aortic insufficiency. PMID- 1775395 TI - [Acute intermittent porphyria and arterial hypertension]. AB - A group of 40 female patients with acute intermittent porphyria from 5 to 34 years after attacks of porphyria were examined. In two patients arterial hypertension developed before attack. In 18 cases hypertension was observed in different periods of time after attack. The comparison of these findings with epidemiological data of similar group of the Polish population suggests that arterial hypertension develops earlier and more frequently in female patients with acute intermittent porphyria. Periodic control of blood pressure in patients with acute intermittent porphyria is proposed. PMID- 1775396 TI - [Evaluation of various immunologic parameters in patients treated by continuous ambulatory peritoneal dialysis (CAPD)]. AB - The authors investigated some immunologic parameters in 17 patients treated with CAPD during 11.0 +/- 6.8 months. There were no disturbances in humoral immunity. In cell-mediated immunity we observed only skin anergy specially in patients with high peritonitis rate. In this group we observed lower concentration of IgG, C3 complement and fibronectin in peritoneal effluent. PMID- 1775397 TI - The effects of pharmacological agents on the human fetus. PMID- 1775398 TI - Enlargement of the tongue in sudden infant death syndrome. AB - Anatomic details of the infantile oropharynx and relationships to possible airway obstruction in sudden infant death syndrome (SIDS) are understood incompletely. Tonkin recognized this in 1975, suggesting that enlargement of the tongue might be important in SIDS, within the context of other anatomic and physiologic factors unique to early life. We therefore conducted a morphometric study of the tongue in 100 victims of SIDS and 36 control infants; the latter group consisted of infants with the same range in age and body size who had grown normally and died acutely. Highly significant differences in tongue weight, width, and thickness were demonstrated between the two groups by linear regression and analysis of covariance. Two multivariate techniques, stepwise discriminant analysis and factor analysis, identified marked discordance between somatic and lingual size in SIDS and a statistical uniqueness in tongue thickness. Certain explanations for lingual enlargement in SIDS were ruled out: redistribution of fluid and other effects of death, postmortem interval, duration and mode of feeding, and smallness of control tongues. At present, the functional significance of these observations is unclear. The effects of both normal and increased tongue size on airway patency are, however, widely recognized. Further studies of the enlarged tongue, addressing such topics as in situ anatomy and developmental mechanisms, are necessary to establish the potential for pathophysiologic consequences in SIDS. PMID- 1775399 TI - Nonsyphilitic spirochetosis in second-trimester fetuses. AB - Four female fetuses (17-23 weeks) spontaneously aborted by young women (15-19 years old) showed spirochetal microorganisms predominantly in the intestinal lumen and mucosa and to a much lesser extent in other organs. Fetal tissues showed a brisk lymphocytic-plasmacytic response in intestinal mucosa, lungs, and meninges in some cases. In all instances the placenta had chorioamnionitis and severe chronic villitis, with villous vasculitis in some. One fetus had a concomitant cytomegalovirus infection. The observed lesions were reminiscent of Treponema pallidum infections; however, the spirochetes were morphologically different by light and ultrastructural microscopy from T. pallidum and did not react with a silver-enhanced, gold-labeled anti-T. pallidum antibody. In addition, serologic tests for syphilis of the women before or after the abortions were nonreactive. On the basis of clinical pathologic considerations as well as the absence of immunostaining, it is possible also to rule out infections caused by Lyme and relapsing fever Borrelia, Leptospira, and Campylobacter. The spirochetes' prominent tropism for the intestinal tract raises the possibility of a congenital infection with gastrointestinal spirochetal species described in recent years. The placental findings suggest an ascending transamniotic infection, with initial colonization of the intestinal tract and systemic dissemination of the organisms in the fetus and placental villi. PMID- 1775400 TI - Epithelial cell morphology and airspace size in hypoplastic human fetal lungs associated with oligohydramnios. AB - The relative frequency of different types of respiratory epithelial cells in normal fetal lungs (control, CON) and hypoplastic lungs associated with oligohydramnios (OH) was determined at the electron microscopic level and airspace size was measured. At 24+ weeks CON lungs had 82.4 +/- 1.2% undifferentiated cells, 15.9 +/- 1.2% type II cells, and 1.7 +/- 0.4% type I cells (n = 3), whereas OH lungs had 94.6 +/- 2.1% undifferentiated cells, 5.4 +/- 2.1% type II cells, and no type I cells (n = 3). At 36+ weeks CON lungs had 7.8 +/- 3.4% undifferentiated cells, 46.1 +/- 3.1% type II cells, and 46.1 +/- 1.4% type I cells (n = 3), whereas OH lungs had 37.7 +/- 1.2% undifferentiated cells, 42.5 +/- 1.7% type II cells, and 19.8 +/- 0.8% type I cells (n = 3). Differences between CON and OH lungs in the proportions of undifferentiated and type I cells at 36+ weeks were highly significant (p less than .001), whereas type II cell proportions did not differ significantly in either age group. The proportion of lung occupied by airspaces increased from 38.3% at 24+ weeks to 68.7% at 36+ weeks in CON lungs but only from 26.7% to 35.7% in OH lungs. The differences between the groups were significant at both 24+ weeks (p less than .01) and 36+ weeks (p less than .001). Mean airspace size in CON lungs varied from 2.8 x 10( 6) mm2 at 24+ weeks to 4.4 x 10(-6) mm2 at 36+ weeks and in OH lungs from 1.7 x 10(-6) mm2 at 24+ weeks to 2.7 x 10(-6) mm2 at 36+ weeks. These results give quantitative expression to the severity of impaired morphologic maturation in OH lungs. PMID- 1775401 TI - Pulmonary vascular changes in bronchopulmonary dysplasia: a clinicopathologic correlation in short- and long-term survivors. AB - Pulmonary vascular findings in infants with bronchopulmonary dysplasia (BPD) are inconsistent. We compared five infants who fulfilled histologic criteria of BPD (group I; survival up to 1 month) with five controls who died of severe neonatal infection without having been ventilated. Nine infants who survived up to 7 months also fulfilled clinical criteria of BPD (group II). These were compared with three term infants who died of nonpulmonary causes. Lung slices were examined qualitatively and by quantitative histomorphometry. The influence of oxygen concentration and positive pressure ventilation on arterial density was studied. Arterial concentration in group I [2.43 (0.63) vessels/mm2, mean +/- SD] increased significantly compared with the controls [1.64 (0.49) vessels/mm2, mean +/- SD]. Most infants in group II who had cor pulmonale at autopsy had decreased arterial density when compared with normal term infants. Postmortem pulmonary angiography was also consistent with this finding. Total oxygen dose was the factor with the greatest influence on reduced arterial density. Relative wall thickness of vessels less than 75 microns in diameter was not significantly reduced in group I (p greater than .05). Infants from group II with cor pulmonale had an increased wall thickness compared with their controls. The proportion of fully muscularized arteries less than 100 microns in diameter was reduced in group I but increased in group II. We conclude that the reduction of cross sectional perfusion area and abnormal muscularization of more peripheral vessels are important in the pathogenesis of pulmonary hypertension in infants with BPD. PMID- 1775402 TI - Medium-chain acyl-CoA dehydrogenase deficiency: postmortem diagnosis in a case of sudden infant death and neonatal diagnosis of an affected sibling. AB - Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency is an inherited disorder of fatty acid oxidation associated with sudden death in infants and, in its fulminant form(s), a Reye-like syndrome. In an 18-month-old female who died suddenly and unexpectedly, the postmortem diagnosis of MCAD deficiency was made by analysis of organic acids, acylglycines, and acylcarnitines and by analysis of the most common mutation causing MCAD deficiency (A985G) in a sample of heart blood obtained at autopsy and frozen at -20 degrees C for 8 months. The patient was homozygous for A985G and metabolites characteristic of MCAD deficiency were identified. Parents and an older sibling were heterozygous for A985G. The mother was 6 months pregnant when the results were known. At the birth of her male infant, blood spot cards and urine were obtained. The infant was homozygous for A985G by analysis of DNA extracted from blood spots and he excreted metabolites characteristic of MCAD deficiency. These results demonstrate the use of novel molecular and metabolite analysis in making the postmortem diagnosis of MCAD deficiency. The neonatal diagnosis of an affected sib permits the institution of appropriate dietary measures to prevent potentially fatal episodes of illness. PMID- 1775403 TI - Dysplasia of the corpus callosum in identical twins with nonketotic hyperglycinemia. AB - Nonketotic hyperglycinemia (NKH) is an autosomal recessively inherited disorder of the glycine degradation pathway leading to accumulation of glycine in body fluids and tissues. Identical twins with nonketotic hyperglycinemia and dysplasia of the corpus callosum are described in support of the hypothesis that some patients with NKH have a genetic defect of the glycine degradation pathway resulting in abnormal corpus callosal development. It is important to screen for metabolic defects whenever similar structural defects are present. PMID- 1775404 TI - Angiofollicular lymph node transformation in Hodgkin's lymphoma. AB - We present four examples of lymph nodes that have Hodgkin's disease between nodules of angiofollicular hyperplasia, three hyaline-vascular and one plasma cell in type, suggesting the concurrence of the lymphoma with Castleman's disease. Angiofollicular hyperplasia is claimed to be an immune derangement, and its presence in Hodgkin's disease may represent such a situation. PMID- 1775405 TI - The successful medical management of gastric outflow obstruction associated with the use of non-steroidal anti-inflammatory drugs in the elderly. AB - One hundred and nineteen consecutive elderly patients with endoscopically diagnosed peptic ulceration were reviewed. Associated gastric outflow obstruction was present in 10.1%. The presenting clinical features differed significantly from typical younger patients and most (11/12) were taking non-steroidal anti inflammatory drugs, suggesting a possible role for these agents in the pathogenesis of gastric outflow obstruction. These elderly patients have been successfully managed by medical therapy alone. PMID- 1775406 TI - Spontaneous hyphaema as a result of systemic anticoagulation in previously abnormal eyes. AB - Spontaneous hyphaema in patients on systemic anticoagulants has been described in normal eyes and also in eyes with certain intraocular lenses following cataract surgery. These cases are rare and in all the reported cases the hyphaemas resolved without sequelae. Four cases are reported here of spontaneous hyphaemas in previously abnormal eyes of patients on anticoagulants. Three of these patients suffered considerable pain as a result of this. The reasons for this are discussed and early ophthalmic referral recommended if a hyphaema is suspected in these situations. PMID- 1775407 TI - Bickerstaff's brainstem encephalitis associated with typhoid fever. AB - A 14 year old boy developed the syndrome of Bickerstaff's brainstem encephalitis during the course of bacteriologically proved typhoid fever. The clinical course and the results of various neurological investigations are detailed. This report adds a further manifestation to the published neuropsychiatric complications of typhoid fever. PMID- 1775408 TI - Staphylococcal enterotoxins in scarlet fever complicating chickenpox. AB - Two cases of scarlet fever are described, both following super-infection of chickenpox. Enterotoxin B and C producing staphylococci were the only pathogens identified. The role of staphylococcal and streptococcal toxins in the pathogenesis of scarlet fever and toxic shock syndrome is discussed. PMID- 1775409 TI - Clubbing associated with oesophageal adenocarcinoma. AB - A patient with an oesophageal adenocarcinoma, recent onset of digital clubbing, and evidence of increased oestrogen synthesis is presented. In the discussion, some of the theories of the pathogenesis of clubbing are reviewed, together with previous reports of clubbing in gastro-oesophageal disorders. A possible unifying theory is proposed for our case which we believe is the first report of this triple association. PMID- 1775410 TI - Polymyositis complicating D-penicillamine treatment. AB - Although there is good evidence that D-penicillamine can induce polymyositis, the exact pathogenic mechanism remains unclear. We report two patients with psoriatic arthritis and primary biliary cirrhosis respectively, who developed polymyositis while receiving D-penicillamine treatment for their primary diseases. Whether D penicillamine treatment was the sole cause of polymyositis or acted as a trigger for the development of a secondary autoimmune disease is discussed. PMID- 1775411 TI - Pulmonary fibrosis associated with nabumetone. AB - A patient is described who developed a rapid onset of pulmonary fibrosis following treatment with a new non-steroidal anti-inflammatory drug, nabumetone. Resolution of symptoms, physical signs and radiographic changes followed drug withdrawal and steroid therapy. PMID- 1775412 TI - Coeliac disease presenting with cerebellar degeneration. AB - A case of rapidly progressive cerebellar degeneration with bilateral sixth nerve palsies is described in whom investigation revealed the presence of unsuspected coeliac disease. In spite of treatment with a gluten free diet, rapid fatal deterioration occurred. Coeliac disease should be considered in patients with encephalopathy of obscure origin. PMID- 1775413 TI - Thrombolytic therapy in the elderly. PMID- 1775414 TI - Analgesic nitrous oxide: rapid, safe therapy for addictive withdrawal. PMID- 1775415 TI - Resident recognition and treatment of hypercholesterolaemic patients. PMID- 1775416 TI - Spontaneous hepatic rupture due to metastatic malignant melanoma. PMID- 1775417 TI - Retroperitoneal haemorrhage from a renal carcinoma in association with streptokinase therapy. PMID- 1775418 TI - Continuing medical education for general practitioners--MP's flying circus. PMID- 1775419 TI - Dapsone in Henoch-Schonlein purpura--worth a trial. PMID- 1775420 TI - The clinical features of late onset anorexia nervosa. AB - This study examines clinical features of late onset anorexia nervosa. This involved the scrutiny of a large database of patients with anorexia nervosa comprising data gathered at standardized initial assessments over the period 1960 1990. Patients with a late onset were compared to other selected patient samples. The population comprised 12 patients with a first onset of anorexia nervosa at or after the age of 30, 415 patients with an onset after 15 but before 20 and 9 patients with an onset after 15 but before 20 and matched for age at presentation with the late onset group. Features studied included age at menarche, age at onset of anorexia nervosa, age at presentation, duration of illness, weight at presentation, lowest adult weight, highest weight, weight at onset of illness, marital status and parity. Patients with an onset of anorexia nervosa after the age 30 comprised 2% of the total female patient sample. Though such patients were rare, their clinical features were very similar to those of typical patients with adolescent onset. Notably, young and late onset patients had similar durations of illness prior to presentation, and similar proportions had bulimia and defensive vomiting. Feared sexuality, no longer necessary for childbearing, emerged as being of apparent aetiological significance in the late onset group, with the disorder embodying its rejection, as often also seems to be the case with earlier onset. The late onset cases were hard to diagnose and had a poor outcome. The study underlines the importance of considering the diagnosis of anorexia nervosa in older patients, even if there is no earlier history of anorexia nervosa. Such patients are likely to find it easier to conceal the psychological origins of their problem behind the possibility of a primary physical illness, or behind psychiatric diagnoses such as depression, the treatment of which may not threaten their avoidance of normal body weight. PMID- 1775421 TI - Wernicke's encephalopathy and alcohol-related disease. AB - A pilot study of 31 consecutive alcohol-related deaths over an 8-month period revealed the presence of histologically diagnosed Wernicke's encephalopathy in 17 cases. Analysis of the clinical records revealed that a disturbance of the mental state was the commonest finding and neurological signs were present in only 2 of the 17 cases (ataxia 1, peripheral neuropathy 1). Analysis of 22 ward admissions for Wernicke's encephalopathy during the same 8-month period revealed that the diagnosis is easily made when neurological deficits (ophthalmoplegia, ataxia) accompany mental changes and when Wernicke's encephalopathy is the predominant illness. In patients with established alcohol-related disease attention is often directed to the presenting illness so that Wernicke's encephalopathy may easily be overlooked as a cause of deterioration in the mental state in these patients. It is recommended that routine management of patients with alcohol-related disease should include thiamine even if neurological signs are absent. PMID- 1775422 TI - Accidental golf club injuries. AB - Over a 2 month period, 33 patients with injuries caused by golf clubs were identified among attenders at the accident and emergency department at Glasgow Royal Infirmary. The vast majority of these were to the face and head, including three compound skull fractures. Attention is drawn to the average age of those injured (8.1 years) and to the fact that only one of the injuries occurred on a golf course. The dangers of unsupervised experimentation with golf clubs by young children are emphasized. PMID- 1775423 TI - Association of Addison's disease with autoimmune disorders--a long-term observation of 180 patients. AB - This study aimed at evaluating the frequency of autoimmune disorders in Addison's disease. We have observed 180 patients (113 females, 67 males, aged 9-74 years) for 1 to 26 years. Tuberculosis was noted in 54 patients. Autoimmune disorders were found in 80 patients (44%); however, 125 (69%) patients were believed to have an autoimmune origin of adrenocortical insufficiency. In 20 patients two or more autoimmune disorders were found to coexist with Addison's disease. PMID- 1775424 TI - Antibiotic therapy, clinical features and outcome of 36 adults presenting to hospital with proven influenza: do we follow guidelines? AB - The impact of the 1989/1990 influenza epidemic on the Nottingham hospitals was assessed in a retrospective survey. Thirty-six cases of proven influenza were identified, 14 of whom died. Non-survivors were more likely to be confused, uraemic and to lack focal chest signs and symptoms. Antibiotic therapy both prior to admission and following hospitalization was not optimal and, in many cases, failed to follow previously published guidelines. Such guidelines need emphasis during influenza epidemics. PMID- 1775425 TI - Functional bowel symptoms in diabetes--the role of autonomic neuropathy. AB - The autonomic nervous system may have a role in the pathogenesis of irritable bowel syndrome. If so, the occurrence of irritable bowel symptomatology in patients with autonomic neuropathy might indicate which, if any, of these symptoms are dependent on autonomic innervation. The prevalence of abdominal pain, abdominal distension and an abnormal bowel habit was recorded in 200 patients with diabetes, screened for autonomic neuropathy, and 200 matched controls. Constipation was significantly more common in patients with autonomic neuropathy than in those without, or controls (22.0% vs 9.2% vs 6.8%). The prevalence of abdominal pain and abdominal distension was no different in patients with and without autonomic neuropathy and their respective controls. The results of this study suggest that control of bowel habit is more dependent on the total integrity of the autonomic nervous system than the perception of pain or the production of distension. PMID- 1775426 TI - Helicobacter pylori: a Jordanian study. AB - The prevalence of Helicobacter pylori in patients with upper gastrointestinal symptoms in the north of Jordan was studied prospectively. The occurrence of H. pylori was documented histologically and bacteriologically in 169 patients attending endoscopy for upper gastrointestinal symptoms. Our results showed that H. pylori was present in 70% of patients with acute gastritis, 73% of patients with chronic gastritis, 68% of patients with acute on chronic gastritis, 83% of patients with duodenal ulceration, 75% of the patients with gastric ulceration, 64% of patients with no pathology, and 68% of patients regardless of the pathology found. There was a sharp rise in the prevalence of H. pylori with age, up to the age of 40 years with an annual increase in the prevalence of 2%. This study shows that the prevalence of H. pylori in Jordan is similar to that seen in other developing countries with infections occurring at a lower age and with the annual infection rate being double that seen in developed countries. PMID- 1775427 TI - Pneumoperitoneum without peritonitis. AB - We present our experience with 5 patients, all of whom were noted to have radiological signs of pneumoperitoneum in the absence of clinical features of peritonitis. All 5 cases were eventually shown to be due to causes not requiring surgery. We review the numerous unusual causes of pneumoperitoneum which do not require urgent surgical intervention and emphasize their importance in cases where the absence of signs of peritonitis may cause diagnostic difficulty. PMID- 1775428 TI - Enhancement of memory retrieval and attenuation of scopolamine-induced amnesia following administration of 5-HT3 antagonist ICS 205-930. AB - Experimental evidence suggests an important role of serotonin in the process of learning and memory. The present study investigated the effect of 5HT3-receptor antagonist (ICS 205-930) on retrieval of a previously learned aversive habit in the mouse. The effect of ICS 205-930 on scopolamine (3 mg/kg) induced amnesia was also studied. ICS 205-930 (1, 10 & 100 micrograms/kg) produced a dose-dependent increase in latency to cross into the dark chamber. The scopolamine induced memory impairment was significantly attenuated by ICS 205-930 (10 micrograms/kg). These results suggest that memory deficits may be susceptible to attenuation with non-cholinergic treatments. PMID- 1775429 TI - The uptake of bupivacaine in an in situ isolated perfused rabbit lung preparation. AB - A double indicator technique has been used in an in situ isolated perfused rabbit lung model to examine the first pass effect of the lung on systemic bupivacaine concentrations. Bupivacaine (0.5 mg/kg) was given in two consecutive boluses to six in situ isolated perfused New Zealand White rabbit lung preparations. The mean recovery (first bolus) of bupivacaine was 62.6% +/- 6.3 (S.E.M.), and 63.7% +/- 10.2 (second bolus), suggesting bupivacaine accumulation in the lung. The average mean transit time for bupivacaine was 280.5% +/- 24.1 and 264.8% +/- 36.7 longer than ICG (Indocyanine Green) following the first and second boluses respectively (P less than 0.01). There were no differences in the first pass effect of the lung between the first and second boluses of bupivacaine. The profiles of the bupivacaine concentrations suggest that uptake is followed by accumulation and later back diffusion. This has implications for conditions that decrease the uptake and therefore increase the risk of systemic toxicity. PMID- 1775430 TI - Time course study of lipid peroxidation induced by N2-methyl-9 hydroxyellipticinium acetate or celiptium in rat renal cortex. AB - Celiptium is an ellipticine derivative with renal toxic side effects. It has recently been characterized as a lipid overload in proximal tubular cells where loss of total phospholipids (in particular phosphatidylethanolamine) and of polyunsaturated fatty acids are linked to the accumulation of unsaturated free fatty acids and aldehydes. A time course study of celiptium-induced peroxidative damage showed that a single dose of 40 mg/kg of celiptium induced no change in total or individual phospholipids of rat renal cortex. On the other hand, free fatty acids and thiobarbituric acid reactive substances increased as early as 1 hr after celiptium injection. 4-Hydroxynonenal (4-HNE) also increased whereas polyunsaturated fatty acids levels decreased at 6 and 24 hr. After 24 hr no change was detected in microsomal phospholipids. In contrast, the brush-border membranes showed alterations such as decrease in total phospholipids and polyunsaturated fatty acids levels accompanied by increase in aldehydes. It appears that peroxidative damage occurs in brush-border membranes of celiptium treated rat kidneys with preferential losses of phosphatidylethanolamine (PE, 30%) and phosphatidylcholine (PC, 14%). PMID- 1775431 TI - Cellular effects of some metabolic oxidation products pertinent to 4 ethoxyaniline. AB - The toxicity of some metabolic products pertinent to 4-ethoxyaniline in isolated hepatocytes were investigated. The compounds investigated were 4 ethoxynitrosobenzene (1), 4-ethoxy-4'-nitrosodiphenylamine (2), 3,6-bis(4-ethoxy phenylimino)-4-ethoxy-1,4-cyclohexadienylamine (3), 4-(4-ethoxyphenylimino)-2,3 dimethyl-2,5-cyclohexadiene-1-one (4) and 4-(4-ethoxyphenylimino)-2,6-dimethyl 2,5-cyclohexadiene-1-one (5). Of these, 1, 2 and 3 are oxidation products of 4 ethoxyaniline. Compounds 4 and 5 are dimethyl analogues of previously investigated oxidation product 4-(4-ethoxyphenylimino(-2,5-cyclohexadiene-1-one (NEPBQI). Among the investigated compounds, 1 and 2 were the most toxic towards isolated hepatocytes. In hepatocytes treated with compounds 1, 2 and 4, loss of cell viability was also accompanied by surface bleb formation. All compounds except 3 reacted with GSH resulting in depletion of cellular GSH. No formation of GSSG was observed, however. Thus, the GSH depletion was apparently due to conjugate formation rather than oxidation. No superoxide dismutase inhibitable reduction of acetylated cytochrome c was observed, thus none of the compounds undergoes measurable redox cycling. PMID- 1775432 TI - Cardiac uptake kinetics and possible dynamic effects of a new cerebral antiischaemic compound FG 9202 (NBQX) studied in the isolated rabbit heart. AB - Accumulation of the putative drug FG 9202 in isolated rabbit hearts showed monophasic exponential kinetics with a half-life of only 0.59 min. The disposition showed a three-phasic exponential time course with half-lives of 0.34, 1.51 and 15.8 min, respectively, which was interpreted as three-compartment kinetics. FG 9202 accumulated only about 3 times in the myocardium at steady state with 51, 32 and 17% referable to a superficial and two deeper myocardial drug pools. The drug did not significantly affect contraction amplitude or velocity of contraction at increasing concentrations up to 40.6 micrograms.ml-1 (119 microM). Heart beating frequency decreased slightly but only significantly at some of the higher concentrations. Neither dromotropic, bathmotropic nor ischaemic ECG-effects were observed. Coronary flow-rate and myocardial oxygen consumption decreased at the highest drug concentrations. Myocardial efficiency expressed as the ratio of contractile parameters to oxygen consumption showed a minor but insignificant increase at the highest drug-exposure levels. Our findings indicate that FG 9202 is not potentially toxic to the isolated, spontaneously beating rabbit heart in vitro. PMID- 1775434 TI - Validation of virus removal and inactivation procedures. Ad hoc Working Party on Biotechnology/Pharmacy. PMID- 1775433 TI - Acute hepatotoxicity after high-dose methotrexate administration to rats. AB - Acute hepatotoxicity after administration of 10-1000 mg/kg methotrexate (MTX) to rats was studied by monitoring serum transaminases, liver morphology, and disposition kinetics of MTX and 7-hydroxy-methotrexate (7-OH-MTX). Half the control rats and rats administered 1000 mg/kg MTX, had their bile duct cannulated. One to 2 hr after administration of 1000 mg/kg MTX, 50% of MTX treated bile-drained rats (Ebc) developed cholestasis despite similar or larger initial bile flow rates than those which did not develop cholestasis (Ebn, controls). In Ebc animals, peak serum ASAT and ALAT levels were 6- and 4-fold higher than that of the control rats, and morphologically, prominent hepatocytic changes and grossly dilated bile canaliculi were found. Immediately prior to cholestasis, the Ebc animals reached biliary 7-OH-MTX levels (8.3 +/- 1.3 mM, mean +/- S.E.M.) which were equivalent to the threshold level for precipitation of 7-OH-MTX in rat bile in vitro, and 3-fold higher than the corresponding levels of 7-OH-MTX in the bile of Ebn rats. Ninety-five % of the drug in the precipitated material was 7-OH-MTX. Hence, 7-OH-MTX may play a role in acute MTX hepatotoxicity, a dose-limiting toxicity that may not be counteracted by leukovorin rescue. PMID- 1775435 TI - Effect of repeated treatment with antidepressant drugs and electroconvulsive shock (ECS) on the D2 dopaminergic receptor turnover in the rat brain. AB - The effect of repeated treatment with citalopram, (+)oxaprotiline, ( )oxaprotiline, imipramine and ECS on the turnover of dopamine D2 receptors in the rat brain was measured using an N-ethoxycarbonyl-2-ethoxy-1,2-dihydroquinoline (EEDQ)-induced irreversible receptor inactivation method. Repeated treatment with citalopram and ECS, but not with (+) and (-) enantiomers of oxaprotiline and imipramine, significantly decreased the turnover of D2 receptors in the striatum. Neither of the applied repeated treatments changed the turnover of D2 receptors in the limbic system. The results suggest that changes in the turnover of D2 dopamine receptors in striatum may participate in the mechanism of antidepressant action of ECS and citalopram, but not that of (+) or (-)oxaprotiline or imipramine. PMID- 1775436 TI - Dithranol (anthralin)-induced skin irritation in C57BL/6, NMRI and SENCAR mice. AB - Dithranol-induced skin irritation was compared in C57BL/6, NMRI and SENCAR mice, the strains representing different sensitivity to tumour promotion. Skin irritation was assessed using ear thickness and skin weight measurements, visual estimation of back skin irritation and histopathology. Both single and repeated applications of dithranol caused a delayed skin irritation resulting in the maximal response between 7-11 days after the beginning of the treatment. Contrary to the findings with 12-O-tetradecanoyl-phorbol-13-acetate (TPA), C57BL/6 mice were the most sensitive and SENCAR mice the most resistant to the dithranol induced skin irritation up to 30 days from the beginning of the treatment. NMRI mice were intermediate. Differences were found in the ear swelling, epidermal hyperplasia, amount of inflammatory cell infiltrate and skin ulceration. During repeated treatment of about 40 days, however, the responsiveness of SENCAR mice increased over that of C57BL/6 and NMRI mice. SENCAR mice had also more epidermal hyperplasia than the other strains at the end of the 74 day period of 3 times weekly applications. The magnitude of epidermal hyperplasia after long term treatment seems to correlate with the sensitivity to tumor promotion in the different mouse strains. PMID- 1775437 TI - [The importance of parental loss in childhood in depressed and suicidal patients]. AB - A higher incidence of suicide attempts can be proved in 328 patients over the age of 45 years with endogenous or neurotic-reactive depression if they have experienced loss in childhood through death of or separation from one parent. The increased incidence of suicide attempts can largely be attributed to loss of the father. It is not the experience of loss in itself that predisposes to depressive suicidal syndromes, rather there are various decisive factors that determine processing of loss experiences and influence the child's further development. The frequency of suicide attempts in the case of loss of the father does not allow any conclusions about immediate causal connections. Loss of the father is to be understood as part of an overall process in which important interpersonal relationships are altered and reconstructed. PMID- 1775438 TI - [Development promoting environment--contributing factors in inpatient psychotherapy of children and adolescents]. AB - Frame conditions especially in stationary psychotherapy with children and adolescents have the function of development-conducive 'play-pens'. As spaces which can be actively formed they offer room to make new experiences, but also serve as limits and friction surfaces with supporting ego-functions. Regarding the developmental phase of adolescence they also serve adolescents in their conflicts with parental authorities in the process of detaching and spiritualization and depersonalization of super-ego structures. Concerning various disorders adequately formed 'play-pens' also fulfill further specific therapeutic functions: Bordering functions for youths near psychoses, containing functions for borderline disorders and trianguling functions for youths who have disorders in detaching and individualizing. PMID- 1775439 TI - [How reliable is parental disclosure?]. AB - Research on the reliability and validity of retrospective and actual reports of parents is reviewed. Parents seem to be able to report birth weight, age at first walking alone and academic achievement reliably. Correlations between developmental or intelligence test results and parental estimates are moderate to high. Reports of psychopathological symptoms differ considerably between groups of informants. Item content and method can influence the reliability and validity. A general tendency to overestimate their own child could not be demonstrated. PMID- 1775440 TI - [School psychology in conflict between the individual and the system]. AB - Viewing literature about aspects, goals and methods of school psychology a conceptual framework for the work of a school psychological counselling center is described. A broad perspective is intended through two guiding principles: Polarities like individual and system, single case counselling and school organisation development are connected; the role bearers--counsellors and the addressees of this counselling--take part as active and competent fashioners of the guidance process within the system of relationships growing from this process. PMID- 1775441 TI - Current topic: trophoblastic pathology. AB - Selected topics in trophoblastic pathology which are arousing current interest are briefly reviewed. These include the concept of villitis as a non-specific immunological lesion, changing views on the distinction between partial and complete hydatidiform mole, a reconsideration of the role of inadequate placentation in pregnancy hypertension and in spontaneous abortion, the significance of confined placental mosaicism and the importance of infection and defective collagen synthesis in premature rupture of the membranes. PMID- 1775442 TI - Re-evaluation of hydatidiform mole by DNA fingerprint method: the discrepancy in the diagnoses by pathological finding and the DNA fingerprint method. AB - Ten cases of hydatidiform mole (HM) were analysed by the DNA fingerprint method. DNA samples were prepared from HM tissue of HM and maternal and paternal bloods, followed by digestion with HaeIII restriction endonuclease, applied to agarose gel, and then transferred to a nitrocellulose filter. The filter was hybridized using mini-satellite DNA as a probe. A case of partial HM diagnosed by histological findings was revealed to be complete HM using DNA fingerprinting. The case was suggested to be a twin pregnancy with a cHM and an abortion, because the DNA fingerprint of hydropic tissue showed a paternal pattern and that of the non-hydropic tissue did not show such a pattern. DNA fingerprinting was considered to be useful in distinguishing complete HM from partial HM. PMID- 1775443 TI - The artificially perfused guinea-pig yolk sac placenta: transfer and uptake of water, glucose and amino acids. AB - The development of a new technique to investigate maternal-fetal transfer across the near term guinea-pig yolk sac placenta by in-situ perfusion of the yolk sac vessels is described. The maternal-fetal transfer of labeled water, D- and L glucose, O-methyl-D-glucose (oMDG), D- and L-alanine, D- and L-aspartate, L lactate and alpha-amino-isobutyric acid (AIBA) was investigated after injection of these substances into the maternal circulation. After 15 min of perfusion at 0.5 ml/min the water clearance was 132 +/- 12 microliters/min (SEM, n = 30). The clearances for D- or L-glucose were less than 1.2 microliters/min. The activity of label in the venous yolk sac perfusate of all other substances was not different from background activity when 14C-label was used. The clearance of 3H-L alanine approached the clearance value of water. The total uptake (as defined for single-injection double tracer dilution experiments) from the perfusate of D glucose, oMDG, alanine and aspartate in comparison to L-glucose was also studied. Mean D-glucose uptake was 11.2 +/- 1.9 percent (n = 8), it was significantly reduced to 4.9 +/- 2 percent (n = 5) by cytochalasin B (1 X 10(-4) mmol/l), and by increasing concentrations of D-glucose (1 to 20 mmol/l, n = 4). The uptake of oMDG was 8.8 +/- 1.5 percent (n = 8). L-alanine uptake was 25 +/- 3.4 percent, D alanine uptake was 8.3 +/- 1.5 percent (n = 12). Both uptake values were decreased significantly by 10 mmol/l L-alanine, but unaffected by [Na+] (less than 15 mequ/l). There was no uptake of AIBA. The uptakes of L-aspartate were 34.9 +/- 3.7 percent and of D-aspartate 40.4 +/- 4.8 percent (n = 11). Both uptake values were significantly and reversibly reduced by 1 mmol/l L-aspartate and D-aspartate, and by low [Na+] (less than 15 mequ/l). It is concluded that water can move by diffusion from maternal circulation into the yolk sac capillaries in considerable amounts whereas the contribution of the yolk sac placenta to fetal nutrition with D-glucose, L-alanine and L-aspartate is negligible. The membranes of yolk sac cells contain specific transport systems for D-glucose, D-/L-alanine and D-/L-aspartate transfer. The function of the vitelline placenta in the near-term guinea-pig is comparable more to the gut than to the chorio-allantoic placenta. PMID- 1775444 TI - Evidence for modulation of progesterone secretion by calcium and protein kinase C activators in ovine chorionic cells. AB - The hypothesis that calcium-dependent mechanisms may be involved in regulating ovine placental steroidogenesis was investigated using chorionic cells isolated by enzymatic digestion. Treatment of the cells with the calmodulin antagonist trifluoperazine (TFP) or pimozide caused a dose-related inhibition of progesterone (P4) production by 80 percent (P less than 0.001) at 40 microM TFP and 56 per cent (P less than 0.001) at 10 microM pimozide. Moreover, the conversion of 25 hydroxycholesterol (25 OH Chol.) to P4 was impaired in the presence of these compounds. These experiments suggest the involvement of a calcium-calmodulin system in the regulation of ovine placental P4 synthesis. Interestingly, calcium ionophore A23187 caused a gradual decline in P4 secretion and completely blocked it at 1 microM (P less than 0.001) and remains absent even in the presence of 25 OH Chol. In contrast, EGTA increased P4 secretion (P less than 0.01). Further, in the presence of 3 mM EGTA the inhibitory effect of 1 microM A23187 was fully reversed. Taken together these results suggest that extracellular calcium could play a role of negative modulation of P4 secretion in these cells. The possible involvement of protein kinase C (PKC) was tested using tumor-promoting phorbol ester (PMA) or permeant diacylglycerols (OAG or DOG). These compounds were unable to modify basal P4 secretion but reduced 25 OH Chol stimulated secretion to basal level. The phorbol ester that was unable to activate PKC had no effect on the metabolism of 25 OH chol. Thus, PMA and diacylglycerol effects are probably mediated by PKC. These data support the hypothesis that PKC activation plays a role in the modulation of cholesterol side chain cleavage activity in ovine chorionic cells. These results show that calcium dependent processes are involved in both positive and negative control of P4 secretion by ovine placenta. Our results also suggest a role for calmodulin and PKC pathways in modulating this secretion. PMID- 1775445 TI - Human embryo modulates placental function in the first trimester; effects of neural tissues upon chorionic gonadotropin and progesterone secretion. AB - We investigated the effect of embryonal neural and adrenal tissues (7-14 weeks gestational age) upon beta hCG secretion by homologous placental explants in static and dynamic cultures. In static co-culture significant inhibition by SC and brain was noted at 7-9 weeks. Similarly, in superfusion, using a novel co chambering technique there was a significant reduction in the area under the curve but not peak frequency of spontaneous pulsatile beta hCG secretion. Incubations with neural tissues 11 weeks and above caused a stimulatory effect upon beta hCG secretion in both models. The effect of adrenal tissue in static cultures was different, namely slightly inhibitory at 7-9 weeks and inhibitory at 11 weeks and above. In superfusion, the effect of adrenal tissue was not significant. Extracted neural tissue 7-9 weeks incubated with placental explants exhibited inhibitory effects upon beta hCG secretion as well. Buffer-based extracts of neural tissues effect was more pronounced than alcohol-based extracts regarding beta hCG secretion. The effect of extracts was dose-dependent and effects were noted up until a 2000-fold dilution. In contrast, the buffer SC extract had no effect on progesterone (P) secretion while the alcohol extract effect was inhibitory at 7-9 weeks and stimulatory at greater than 11 weeks. Superfused explants pattern of beta hCG secretion was inhibited by one minute pulse of the SC buffer extract. In conclusion, the human neural tissue of embryonal origin may modulate placental hCG and P secretion during early pregnancy. PMID- 1775446 TI - Enterovirus associated placental morphology: a light, virological, electron microscopic and immunohistologic study. AB - The purpose of this study was to identify the possible effect of enteroviruses on placental tissue. Seventy-eight pregnant women were studied throughout their pregnancy: enteroviral infection was detected by faecal viral isolation and seric neutralization of previously identified virus in cell culture. In 19 cases of confirmed maternal infection, placentae were examined grossly, by optical microscopy, immunohistochemical and electron microscopic methods. Ten term placentae from women included in the study, with no clinical, serological or virological evidence of enteroviral infection, were used as control, and examined by gross and optical microscopy. In 17 specimens (echovirus-coxsackievirus) an haematogenous placentitis was suspected on the basis of gross observation. Microscopic lesions were similar to those found in other viral infections, with specific features. The nature of the inflammatory reaction pointed to the presence of an acute type of haematogenous placentitis, not present in placentae of the control group. The authors (AA) comment on the results and present the hypotheses about the available data: (1) maternal enteroviremia and faecal virus shedding without placental invasion, placentary damage being an unspecific consequence of infection; (2) direct virus-induced injury is not the only possible cause for the lesions: (3) placental enteroviral infection occurred with placental pathology but the virus did not cross the organ as the newborn had no signs of infection. PMID- 1775447 TI - Brief communication: human pregnancy sera from sequential stages of gestation are increasingly inhibitory to the growth of trophoblast cells in culture. PMID- 1775448 TI - [Comparative study of E. coli strains producing amino acids]. AB - Transduction of the locus of stability to high threonine concentrations (Thrr) into E. coli str M1 and C600 resulted in enhancements of the amino acid production and retardation of the culture development. Besides the mutation caused increase of the specific activity of glutamate synthase, aspartate kinase and homoserine dehydrogenase. The cells of the mutant strains had poorly developed walls and were smaller than those of the parent strains. PMID- 1775449 TI - [Fermentation micromethod for the quantitative determination of thiamine diphosphate in biological fluids]. AB - An enzymatic micromethod is proposed for quantification of thiamine biphosphate (TBP) at concentrations from 0.5 ng in 0.1-0.2 ml samples of blood or other biological liquids. The dynamics of TBP degradation in blood was studied depending on the time and conditions of storage. A high efficient complex of alcohol dehydrogenase and apopyruvate decarboxylase was isolated from baker's yeasts that can be successfully used for quantitative detection of TBP. The complex was stabilized for further application to biochemical kits for diagnosis of B1-deficiency. PMID- 1775450 TI - [Fluoroimmunometric method of determining digitoxin]. AB - Digitoxin at concentrations up to 5 x 10(-10) M (therapeutic concentrations are 2 x 10(-8) M) can be reliable measured by a fluoroimmunometric method with coproporphyrin as a tracer. The use of nylon filters with immobilized digitoxin to remove an excess of labelled antibodies increases reliability and reduces the time of measurements, and thus simplifies the assay. PMID- 1775451 TI - [A new method of the evaluation of lymphocytes and monocytes during immune response in patients with tuberculosis and sarcoidosis]. AB - Examination which included 21 patients with tuberculosis, 6 with sarcoidosis and 9 healthy volunteers was aimed at determining the amount and intensity of surface fluorescence of CD+3, CD+4, CD+8 lymphocytes and CD14+, KIM+I monocytes. The findings demonstrate that determination of the fluorescence intensity of lymphocytes and monocytes provides a more exact characterization of the morphofunctional state of cells involved in the immune response. It is shown in particular that tuberculosis and sarcoidosis patients exhibit a varying density of the expressed antigenic markers of lymphocytes, which increases only in sarcoidosis, except a suppressor subpopulation (cytotoxic lymphocytes). Patients with tuberculosis had decreased density of CD9+, CD14+ and KIMI markers on the particular subpopulations. PMID- 1775452 TI - [Relations of genetic markers with the development of infiltrative tuberculosis]. AB - The examination included 84 patients with infiltrative pulmonary tuberculosis. A relationship of genetic markers to the development of the disease was studied. The incidence of antigens HLA of I (Cw4) and (DR2) classes is higher in patients with infiltrative pulmonary tuberculosis than that in healthy subjects. The incidence of certain alleles of protein loci is also increased: phenotype CB for locus ACR and phenotype 1-1 for locus ADA. PMID- 1775453 TI - [Low-flow membrane blood gas exchange in the treatment of chronic respiratory insufficiency]. AB - The results of experimental and clinical studies provide evidence that the developed method for treating chronic respiratory failure, i.e. low-flow extracorporeal membranous blood gas exchange, is a pathogenetic method for the management of respiratory failure. Its action is effected through improvement of the organism's oxygen regiment, partial CO2 elimination, improvement of hemodynamic and hemorheological parameters, prevention of damage to lung ultrastructure induced by respiratory failure. PMID- 1775454 TI - [Tuberculosis morbidity in the USSR population and basic trends of its dynamics]. AB - Data on tuberculosis morbidity covering the period 1950-1989 are presented: special features of tuberculosis epidemiology for the studied period are emphasized; grouping of the republics is given by tuberculosis morbidity rates and pattern; difficulties encountered in tuberculosis prevention and detection are discussed which can adversely affect the decline of tuberculosis mortality rates. PMID- 1775455 TI - [Tactics and methods of early detection of tuberculosis in adults]. AB - Difficulties are recently encountered during preventive fluorographic screening of the population due to its reduced effectiveness in a number of regions with a favourable situation and radiophobia of the population. Tactical possibilities of risk group screening, questionnaire and full coverage of those who were not examined for a long time are discussed. Analysis is given to the alternative methods such as thermography, enzyme-linked immunodiagnosis and low-dosage fluorography. PMID- 1775456 TI - [Principles of differential diagnosis of diffuse lesions of the lungs]. AB - Intricate questions related to the differential diagnosis of diverse diffuse pulmonary disorders are analysed in more than 1500 patients. Among them 1100 patients had sarcoidosis, 284 alveolitis of different etiology (including 62 patients with fibrotic alveolitis of autoimmune genesis), 45 rare pulmonary diseases, 5 carcinomatosis and 40 disseminated tuberculosis. 70% of the patients were hospitalized for pulmonary tuberculosis. Each disease had its typical diagnostic algorithm. In most cases (86-98%) the diagnosis was morphologically evidenced by intrapulmonary transbronchial biopsy. The cytogram of bronchoalveolar washout was examined. Immunologic methods and immunodiagnosis were used to specify the patients' immune status. Considerable attention was given to external respiratory function. The diagnosis of disseminated tuberculosis was verified by bacteriologic examinations and tuberculin diagnosis. PMID- 1775458 TI - [Pulmonectomy in tuberculosis surgery]. AB - The results of surgical treatment of 550 patients who were subjected to pulmonectomy for tuberculosis (74.7%) and other respiratory diseases (25.3%) were analysed. Pulmonectomy was either used as an emergency procedure or performed after a short-term intensive preparation depending on the severity of the clinical picture and life-threatening syndrome. New surgical tactics consisting of stage-by-stage and combined surgical interventions has been developed and is used in clinical practice. Pulmonectomy which is performed at the stage of the clinical stabilization of the process is the most effective. Despite high surgical risk, pulmonectomy in progressive and complicated tuberculosis provides clinical effectiveness in 76.9-83.7% of patients. PMID- 1775457 TI - [Pulmonary tuberculosis in patients with mental disorders, drug addiction and substance abuse]. AB - The clinical manifestations, course and outcomes of pulmonary tuberculosis were studied in 215 patients with concurrent severe mental diseases (112 had schizophrenia and 103 other organic diseases of the central nervous system). The patients had mainly disseminated pulmonary tuberculosis with copious bacilli excretion and destruction. Their clinical manifestations and the course of a specific process were mainly progressive. Fatal outcomes were most common in tuberculosis patients with concurrent drug addiction and toxicomania. It is recommended that patients with mental diseases, narcomania and toxicomania should undergo a prophylactic fluorographic screening twice a year. Treatment of patients with tuberculosis and concurrent mental diseases should be combined and carried out by a psychiatrist (narcologist) jointly with a phthisiatrist. PMID- 1775459 TI - [Surgical treatment of tuberculosis of the respiratory organs and lymphadenitis in children and adolescents]. AB - The many-year practice of surgical treatment of 488 children and adolescents (aged 6 months to 17 years) suffering from tuberculosis of the lungs, pleura, intrathoracic and other groups of lymph nodes and other concurrent pulmonary diseases is summarized. Considerable attention is attached to the clinical aspects of complicated and disseminated forms of diseases, indications for surgery with consideration of the changed course of a process during modern surgery. Morphologic and microbiological findings of the material obtained during surgery are given. The results of surgical treatment are provided whose efficiency in various forms reaches 100%. The postoperative clinical cure of tuberculosis is achieved in 98% of the cases, the mortality is 0.43%, as evidenced by long-term observations. PMID- 1775460 TI - [Effectiveness of the use of high-energy lasers in bronchology]. AB - Bronchoscopy by laser radiation was performed in 141 patients. CO2 laser was used in 89 patients: 25 had pulmonary tuberculosis, 6 tumours, 35 stump inflammation, and 23 other diseases. YAG laser was used in 52 patients: 15 of them had tumours, 21 bronchial tuberculosis, 6 osteochondropathy and 10 other diseases. A good therapeutic result was obtained in most patients but in certain cases (malignant tumours) it was palliative. Special features and technical difficulties encountered during work with different types of lasers in fibroscopy under anesthesia and in fibrobronchoscopy under local narcosis are discussed. No complications were registered. Formation of the so-called "white thrombus" at the site of laser photodestruction was described which required removal during control bronchoscopy. PMID- 1775461 TI - [The 70th anniversary of the Central Research Institute of Tuberculosis, USSR Ministry of Health]. PMID- 1775462 TI - [Disorders of the pulmonary function in patients with destructive tuberculosis]. AB - A complex clinicophysiological examination of 100 patients with destructive pulmonary tuberculosis has shown that the most common manifestations of pulmonary dysfunctions in this category of patients are functional changes in lung tissue as hyperinflation and restriction of the lungs and rise or decline of their elasticity. Disorders of bronchial patency and pulmonary gas exchange are second in their detection rate. The most important changes in pulmonary tissue function are hyperinflation and rise of elasticity; disorders of bronchial patency and pulmonary gas exchange are most commonly manifested by impaired minor bronchi and declined lung capacity. Lung restriction and decreased lung tissue elasticity are rather rare. Arterial hypoxemia is mainly found at rest. PMID- 1775463 TI - [Temporary instruction to organize vaccination and revaccination with BCG vaccine during its shortage]. PMID- 1775464 TI - [Reuse of jet injectors of the BI-1M type in the performance of allergic diagnosis]. PMID- 1775465 TI - [Tactics of diabetes mellitus compensation in patients with pulmonary tuberculosis]. PMID- 1775466 TI - [Effects of non-clostridial anaerobic infection on the course of chronic pulmonary tuberculosis in experimental animals]. AB - Influence of non-clostridial anaerobic infection on the course of chronic pulmonary tuberculosis caused by intrapleural administration of BCG used in a vaseline-lanolin mixture was studied experimentally on guinea pigs. Administration of Bacteroides fragilis in the presence of a mild tuberculous inflammation aggravates the course of a specific process promoting pleural empyema development, increase in the size of pulmonary granuloma, extension of pathologic changes into the parenchymatous organs and aggravation of a nonspecific inflammatory reaction. Animals with mixed infection exhibited a longer duration and higher level of M. tuberculosis and B. fragilis excretion than those having a mono-infection. The findings suggest M. tuberculosis and B. fragilis synergism. PMID- 1775467 TI - [Pathomorphological assessment of the therapeutic effect of mycobacteriophages in tuberculosis]. AB - The effect of DS6A mycophage was studied in comparison with that of isoniazid on 30 guinea pigs with disseminated tuberculous infection in order to reveal the therapeutic effect of the mycobacteriophage and tissue reactions caused by it. The mycophage was found to have therapeutic properties in disseminated tuberculosis in guinea pigs but its action is less pronounced than in isoniazid monotherapy. Study of the special features of tissue reactions in mycophage monotherapy has demonstrated that with the mycophage phagocytosis remains incomplete and granulomatous processes that gradually lose morphological signs of tuberculous inflammation and acquire typical features of sarcoidosis develop in the animal organs. PMID- 1775468 TI - [Antituberculosis antibodies detected by an immunoenzyme test in patients with pulmonary tuberculosis]. AB - The method of indirect solid-phase enzyme immunoassay (EIA) was used to detect antibodies in the sera of 166 pulmonary tuberculosis patients and 56 healthy donors. A preparation with a mol. mass of 38-42 kD was used as an antigen which was isolated from the mycobacteria H37Rv by a consecutive separation under high pressure, extraction of KCl cellular membranes and gel-filtration in the gel Toyopearl HW 55F. Antituberculous antibodies (AtAb) were detected by the EIA method in 94% of pulmonary tuberculosis patients which was much higher as compared to the same parameter in healthy subjects (10.7%). Hence, AtAb detection by this method can serve as an additional criterion for tuberculosis diagnosis. The detection rate and AtAb level are higher in fibrocavernous tuberculosis than those in infiltrative tuberculosis. The AtAb detection rate is higher in manifested intoxication than in moderate one or its absence. AtAb are more often detected in chronic than in newly diagnosed tuberculosis, in the disseminated forms than in the limited forms, in pronounced infiltration in the lungs as compared to a moderate form, and also in patients with bacillary excretion than in those whose sputum had no M. tuberculosis. PMID- 1775469 TI - [Associated tuberculous lesions of the lungs and periodontium]. PMID- 1775470 TI - [Lymphosarcoma masked by meningoencephalitis of tuberculous etiology]. PMID- 1775471 TI - [New methods of prevention, diagnosis and treatment of tuberculosis in children]. AB - The follow-up included two groups of schoolchildren: 862 were repeatedly given BCG and 725, BCG-M vaccines. It was demonstrated that both vaccines had the same effectiveness and the latter could also be used. Upright tomographic findings in 70 children showed that it was highly informative for the diagnosis of intrathoracic tuberculosis in children, especially for that of bronchoadenitis. Monitoring of 315 children with destructive pulmonary processes (157 of them had lesions of tuberculous etiology) made it possible to define risk factors of destructive tuberculosis contamination (in particular, genetical predisposition), the diagnostic criteria and high diagnostic value of the enzyme-linked immunoassay (96%). Ultrasound examination of the liver in 121 tuberculosis children enabled one to diagnose the type and etiology of liver affection, to control its state during treatment, to specify the side effects of the drugs and to modulate the therapy. The course and outcomes of tuberculosis were found to be affected by liver affections. The parenteral administration of isoniazid in combination with other drugs was shown to be highly beneficial in disseminated form of tuberculosis in children. PMID- 1775472 TI - In honour of Heikki Luoma on his 65th birthday. PMID- 1775473 TI - Transmission of mutans streptococci. AB - It has been shown that early establishment of mutans streptococci in the mouth of infants increases risk of caries. Extensive studies on the timing of infection, and on sources and routes of transmission of the organism have been performed. Results of many studies suggest that the source of mutans streptococci is the mother, especially her saliva. Methods used to attempt to verify this hypothesis have developed considerably in recent years. Recent research and work in progress using methods based on DNA analysis have increased and will extend knowledge about transmission. This review summarizes the results obtained by different methods of transmission of mutans streptococci. The final goal of studies is to accumulate adequate information for prevention strategies of mutans streptococcal infection. PMID- 1775474 TI - Antibody responses to mutans streptococci in children. AB - Because mutans streptococci (Streptococcus mutans, S. sobrinus) are considered the main causative bacteria in human dental caries, immune responses to these bacteria have aroused much research interest over the last two decades. Studies in man have focused mainly on salivary and serum antibodies developing naturally in response to oral colonization by mutans streptococci, or in relation to the development of dental caries. Although both salivary (IgA) and serum-derived (IgG) antibodies have been shown in many studies to protect against the adherence of and to interfere with the metabolism of mutans streptococci, no conclusive evidence relating to their clinical significance is available. In young children, serum IgG antibodies to S. mutans seem more important than salivary IgA antibodies in relation to protection against dental caries. In studies in animals and, recently, in man, monoclonal IgG antibodies to S. mutans protein antigen I/II ("adhesin") have provided effective protection against mutans streptococci. Whether they could also prevent dental caries in man is not yet known. PMID- 1775475 TI - Therapeutic use of sealants for incipient or early carious lesions in children and young adults. AB - Although the overall caries rate has declined significantly in the past decade, recent studies have shown that caries in occlusal pits and fissures continues to be a significant problem in adolescents and young adults. Radiographic and bacteriologic studies of sealed carious teeth were originally designed to allay the profession's concerns about continued progression of the carious process. These studies have demonstrated that caries is inhibited and may in fact regress under intact sealants. The changes in patterns of caries incidence and the positive results of the sealant studies suggest that alternative approaches to the treatment of incipient or early occlusal caries should be considered. In addition to the radiographic and bacteriological studies of sealed carious teeth, studies on retention over carious pits and fissures, wear, cost effectiveness and changing attitudes of dentists indicate that sealing incipient or early carious lesions is a viable alternative to restoration with amalgam. PMID- 1775476 TI - Oxygen and the sugar metabolism in oral streptococci. AB - Streptococci have several ways of adapting themselves to the constantly changing environment of the human oral cavity. This paper discusses the adaptation of sugar metabolism to variations in oxygen levels. In all streptococci the Embden Meyerhof pathway of glycolysis works under aerobic as well as anaerobic conditions, but pyruvate is converted into different metabolic end products depending on the oxygen levels. Under anaerobic conditions all streptococci form formate, acetate, and ethanol by a pyruvate formate-lyase pathway. If sugar is in excess, they also form lactate using a lactate dehydrogenase. Under aerobic conditions pyruvate formate-lyase is inactivated. This enzyme is then replaced by a pyruvate oxidase in some streptococci and by a pyruvate dehydrogenase in others. The characteristics of these enzymes help streptococci like S. sanguis, S. oralis, S. gordonii, and S. mitis to compete successfully with other bacteria in those sites of the oral cavity that are freely exposed to saliva, while mutans streptococci have to colonize anaerobic sites such as those in-between the teeth and in the occlusal fissures of the teeth. PMID- 1775477 TI - Advances in non-caloric sweeteners with dental health advantages over sugars. AB - Many factors have to be considered in developing new intense sweeteners to replace sugars in the diet for the benefit of dental health. These include their general properties, safety and toxicological evaluation, metabolic fate in the body, regulatory status and dental research documentation. The choice of new sweeteners with improved properties is expanding, with particular attention being paid to multiple sweetening, materials of natural origin and calorie control, as well as dental health gains, the distinction between non-cariogenic and anti cariogenic properties, securing regulatory approval and developing an attractive range of foods and drinks containing the new materials. PMID- 1775478 TI - Plaque fluoride. PMID- 1775479 TI - Sugar, fluoride, pH and microbial homeostasis in dental plaque. AB - Factors that may contribute to the maintenance or breakdown of the oral microflora have been studied in the laboratory using a mixed culture chemostat system. Carbohydrate type had relatively little influence of the proportions of individual species at neutral pH. In contrast, when the pH was allowed to fall following carbohydrate metabolism, the stability of the microflora was markedly perturbed. The proportions of Streptococcus mutans, Lactobacillus casei and Veillonella dispar increased and they became the predominant species, while levels of other Gram-negative organisms and S. gordonii declined. Low levels (1 mmol/l) of sodium fluoride (NaF) had little effect on the microflora at neutral pH. However, when the pH fell following carbohydrate metabolism, 1 mmol/l of NaF slowed acid production and, in so doing, reduced the inhibition of acid-sensitive species, and suppressed the selection of S. mutans under otherwise favourable conditions. These data (and others) suggest that the mode of action of fluoride in human beings might include a subtle but clinically significant antimicrobial effect. These findings have also led to the proposal of a modified hypothesis (the "ecological plaque hypothesis") to explain the role of the resident oral microflora in dental disease. The hypothesis also has implications for treatment and prevention strategies. PMID- 1775480 TI - Relationship between demineralization events in dental enamel and the pH and mineral content of plaque. AB - Acid production in dental plaque from fermentation of dietary carbohydrate does not necessarily lead to demineralization of the underlying enamel. In the past it has been understood that pH buffering by plaque constituents must be overcome to allow the pH to fall, and then the fall must be of sufficient magnitude to exceed a critical pH value, i.e. the point where plaque fluid is just saturated with respect to enamel mineral. An evaluation of the literature suggests, however, that the critical pH is not a fixed value. It changes slowly as enamel mineral solubility changes with repeated pH cycling. Further, plaque mineral ion sinks, in which ions are removed from solution (first described by Luoma in 1964) and ion reservoirs from which ions are added to solution, modulate the critical pH value during plaque pH fall and rise so that its exact value is difficult to predetermine. A solid phase calcium phosphate ion reservoir in plaque may saturate plaque fluid with respect to enamel mineral continuously as the pH falls so that the critical pH is never exceeded. Common ion repression of enamel mineral dissolution is likely to be effective in the order pH greater than Ca greater than P. Plaque fluoride influences enamel dissolution in more than one way. Simultaneous dissolution of hydroxyapatite and reprecipitation of fluorapatite, a process which results in apparent dissolution repression, is probably the most important mechanism initially. This process may coat individual enamel crystals with a F-rich layer so that, while the total F content is rather low, its effective solubility is more like that of fluorapatite. Fluoride in plaque fluid may then repress enamel mineral dissolution by common ion repression. If fluoride action follows this sequence efforts to build F into enamel clinically would be just as important as attempts to maintain F levels in plaque and saliva. PMID- 1775481 TI - Studies of fluoride varnishes in Finland. AB - Despite the artificial fluoridation of drinking water in Kuopio, part of the children have high caries incidence. We therefore started our studies on fluoride varnishes in 1977 in an attempt to find a feasible means of applying fluoride topically in children at high risk of caries. In our first trial, the sodium fluoride varnish Duraphat was found to be effective in preventing caries, but the effectiveness of the silane fluoride varnish Fluor Protector could not be unequivocally established, despite the fact that Fluor Protector deposited markedly more fluoride in enamel than Duraphat. In a second study in children in a low-fluoride area, use of Duraphat was found to be more effective than fortnightly fluoride rinses or Fluor Protector. Increasing the frequency of application from two to four times a year did not increase the effectiveness of Duraphat even in highly caries-prone children in a 2-year trial. On the basis of peak values of fluoride in parotid saliva after application, use of either fluoride varnishes was considered safe. Although the fluoride content of the enamel remained elevated for at least two years after discontinuation of treatment with both varnishes, the caries preventive effect did not continue after the applications were stopped. This shows that increasing the fluoride content of enamel is not the main mechanism by which fluoride varnishes prevent caries, and that the applications need to be continued as long as caries is a problem. PMID- 1775482 TI - Combination chemotherapy of dental plaque infections. AB - Chemotherapy against dental plague micro-organisms has proved effective in combatting both caries and periodontal disease. Chlorhexidine is the drug of choice when a broad-spectrum antiplaque agent is called for. However, because its mechanism of action is unspecific and the high concentrations needed for maximum effect may cause side effects, combination chemotherapy has been suggested. Chlorhexidine has been successfully combined with fluoride and, more recently, with xylitol. The combination allows the use of less concentrated solutions than if the agents were administered alone. Further, the mode of bactericidal action of chlorhexidine, fluoride and xylitol appears to be additive. A new aspect in the prevention is to control the primary bacterial colonization at the very moment when teeth erupt. To achieve this, new ways of delivering chemotherapeutic and other preventive agents are called for. PMID- 1775484 TI - Fluoride balance and tissue concentrations: effect of dose frequency. AB - The possible effects of dose frequency on the bioavailability, balance and tissue levels of fluoride were determined using young adult rats. It was hypothesized that, because of the rapidly exchangeable pool of fluoride in calcified tissues, smaller and more frequent doses of fluoride would increase the retention of fluoride in the body. All groups were fed a low-fluoride, semi-purified diet throughout the six-week study. Group B received water with 25 ppm fluoride ad libitum. Groups C, D, and E received fluoride in amounts similar to that of group B but by ig intubation one or three times each day or by ip injection once each day. Group A received fluoride only in the food. Two 24-h fluoride intake and excretion determinations were made during each week. Plasma, enamel and femur epiphysis fluoride levels were determined at the end of the study. Compared with group B, the average fluoride absorption and balance values were 13% and 10% higher, respectively, in groups C, D and E. Plasma and calcified tissue fluoride levels were also slightly higher in the latter groups but, in general, the differences were not statistically significant. In the ip-injected group, the fecal excretion of fluoride was 96% greater than the amount ingested with the diet which indicated net intestinal secretion. It was concluded that, for a given level of intake, dose frequency has only minor effects on the absorption, balance and tissue levels of fluoride in the rat. The influence of the rapidly exchangeable calcified tissue fluoride pool on the general metabolism of the ion appears to be limited when intake occurs at least once each day. PMID- 1775483 TI - Effect of amine fluoride (AmF)/stannous fluoride (SnF2) toothpaste and mouthwashes on dental plaque accumulation, gingivitis and root-surface caries. AB - The aim of the study was to assess the effect of a toothpaste and mouthwashes containing amine fluoride (AmF) and stannous fluoride (SnF2) on dental plaque, gingivitis and root-surface caries. Forty-four adults participated in a five month double-blind study. The following combinations of toothpastes and mouthwashes were used: (1) AmF/SnF2 toothpaste and AmF/SnF2 (Meridol) mouthwash (20 patients, mean age 45.7 years), (2) sodium fluoride (NaF) toothpaste and NaF mouthwash (24 patients, mean age 48.8 years). The mean values for dental plaque (Silness-Loe index) were clinically and statistically significantly reduced in both groups, the difference being greater in the AmF/SnF2 group. Sulcus-bleeding index values were clinically and statistically significantly decreased in both groups. There was no marked difference between the groups. The root caries index (RCl, Katz) had decreased by the end of the experiment by 10% in the NaF group and by 47.4% in the AmF/SnF2 group. PMID- 1775486 TI - Intakes of magnesium and fluoride, and some systemic effects. PMID- 1775485 TI - Fluoride intake and its safety among heavy tea drinkers in a British fluoridated city. AB - Tea-drinking in very young children has been studied in a British city. The results suggested that the fluoride in tea would, in some cases, be sufficient to influence caries. Clinical findings to some extent supported this. The main purpose of the investigation reported here was to determine maximum possible fluoride intake in adults who were heavy tea drinkers in a fluoridated city and relate it to toxic thresholds. Heavy tea drinkers were traced through Health Visitors and voluntary organizations and the volumes and fluoride concentrations of their drinks were measured. Even the highest intake found (9 mg) is below the probable intake in Bartlett, Texas (8 ppm of fluoride), in relation to which no undesirable symptoms have been reported (Leone et al. 1954). This confirms the safety of fluoridation. The effects on fluoride concentration of evaporating soft and hard fluoride-containing waters to small bulk were compared. The results showed ceilings of 3 ppm of fluoride in hard water and about 14 ppm in soft water, much higher than the levels expected on the basis of the usually stated solubility of CaF2 (16 or 8 ppm of fluoride). However, under normal household conditions, it is most unlikely that dangerous levels of fluoride would be ingested from boiled water. PMID- 1775487 TI - Incisor enamel mottling prevalence in child cohorts which had or had not taken fluoride supplements from 0-12 years of age. AB - Blind photographic assessments were made of the permanent incisors of 322 children who had participated in two successful fluoride drop/tablet hygienist based preventive dentistry programmes. Two groups of four dental and two lay assessors unanimously scored 57% of dentitions as mottling-free. The dental observers unanimously scored 37 children (12%) with some symmetrical homologous tooth-type mottling, although only 13 decisions (4%) were scored "unacceptable easthetically". The lay assessors rated 77 children (24%) with mottling, 15% being easthetically displeasing. However, no significant mottling differences were noted between cohorts which had commenced oral fluoride supplementation at birth and those which either commenced as late as 7 years of age, or which had never taken any such supplementation. Thus other fluoride sources must have been responsible for the non-drop/tablet diffuse symmetrical mottling noted, the most likely being highly fluoridated dentifrices ingested by youngsters unable to control the volume dispensed and swallowed. Hence the evidence does not suggest that this proven caries-inhibiting F- drop/tablet regime dosage should be reduced. There is, however, a clear and continuing need for both the dental profession and the public to be made more aware of the problem of uncontrolled fluoride ingestion from other sources. PMID- 1775488 TI - Posteruptive changes in human dental fluorosis--a histological and ultrastructural study. AB - The aim of the present study was to describe the structural features characterizing the severe grades of human fluorotic enamel (TF scores 5-9) with particular emphasis on the posteruptive changes in severely fluorosed teeth. Dental fluorosis is a subsurface hypomineralized lesion deep to a well mineralized outer enamel surface, which in severe cases breaks apart shortly after eruption. Early signs of posteruptive changes comprise small defects corresponding to the opening of striae of Retzius. The enamel pits which develop after eruption in more severe cases exhibit an increase in mineral content at their base which correspond to the exposed subsurface hypomineralized lesions. Likewise, the extensive removal of surface enamel in the most severe cases of human fluorosis results in a highly varying uptake of mineral into the exposed subsurface hypomineralized lesions. The uptake varies greatly within apparently similar degrees of hypomineralized lesions. In approximal abrasion facets, however, where the subsurface lesions are also exposed, no evidence of mineral uptake was found. At the ultrastructural level, the well-mineralized surface zone consists of large hexagonal enamel crystals separated by rather large intercrystalline spaces in which numerous irregular small crystals are observed. Moreover, the large crystals may exhibit central and peripheral dissolution. In addition, mineral appeared to be deposited into such defects as well as along the side of the crystals, often with the lattices being continuous from the original crystal into the apparently posteruptive formed crystal material. It is concluded that a substantial mineral uptake can take place in exposed porous hypomineralized fluorotic enamel after eruption, but is most likely to be associated with the presence of microbial deposits, the metabolic activity of which may play a keyrole in mineral exchange. PMID- 1775489 TI - Drinks and dental health. AB - The average daily requirement for water in man is 2-3 litres, of which more than half comes from drinks. Although the total consumption of various drinks is quite stable, the choices of beverages are slowly changing. In many Western countries e.g. the use of milk is declining while consumers drink greater amounts of soft drinks, including fruit juices and carbonated beverages. These changes may also affect dental health because of the potential risk of sugar and acid-containing drinks to cause dental caries and erosion. The effects of drinks in the human mouth are, however, strongly related to many individual factors and prediction of dental effects is therefore difficult. Anyway, there are risk patients who should be recognized, and risk products which should be noticed in product formulation. If attention is paid to such factors in the future harmful effects of drinks on teeth may be minimized. PMID- 1775490 TI - Applying preventive principles and materials to the practice of preventive dentistry in public oral health care. AB - It often takes quite a long time before caries preventive methods developed in the universities become adopted in practical use in dentistry. This may happen even though the method has been proved effective in long-term trials. It is most important therefore for the universities and the public dental health organisations to work closely together. This may significantly shorten the time interval between the invention and its practical application. The Public Health Center of Espoo has had the priviledge to work closely together both with the Universities of both Helsinki and Kuopio. Some of the most prominent trials conducted in Espoo or Kuopio that have resulted in practical application at Espoo Public Health Center will be described in the following. PMID- 1775491 TI - Systematic dental health care among Finnish university students. AB - Regular dental examinations and treatment are the cornerstones of good oral health. Regular dental care is provided for Finnish students through free dental examinations in their first, third and fifth years. This paper describes the dental care services by the Finnish Student Health Service to students and reports on the outcome of this systematic dental care, with special reference to needs for treatment of caries, wisdom teeth and attachment tissues. PMID- 1775492 TI - Quantitative histopathology of soft tissue calcifications. AB - Quantitative evaluation of soft tissue calcifications in histological sections, e.g. in connection with nephrocalcinosis, can be based on numerous methods. Staining methods detecting the calcifications do not give a detailed idea about their chemical composition, which can be analysed through electron probe x-ray microanalysis or chemical analysis. When the idea is to compare two groups in terms of calcifications several approaches are possible. Subjective quantitation into several grades will detect larger differences. Morphometrical or stereological methods are to be recommended, however. These methods can be based on volume fraction estimation through point-counting procedures. The point counting method can be adjusted to detect changes at a predefined accuracy level by varying the number of points used in the estimation. Stereological estimation can best be carried out by defining the volume of the organ studied and the volume occupied by the deposits. The volumes as absolute values or as volume fractions can be used to compare the groups studied. Counting of the deposits can be done from single sections or from consecutive sections. The stereological estimates can be based on the formula of Ebbeson and Tang and on the disector principle derived from it. In comparing different groups, parametric statistical methods can be used when absolute volumes of deposits are considered. Nonparametric methods should be used when volume fractions or subjective grades are compared. PMID- 1775493 TI - Cardiovascular disease and magnesium: epidemiological and experimental data. AB - Many epidemiological studies have shown that magnesium in drinking water prevents cardiovascular disease. However, an accepted theory of the mechanism behind cardiovascular disease has so far been derived on the basis of animal experiments. Further research is needed in order to interpret these results in terms of human disease. Further studies in animals are also required. PMID- 1775495 TI - [Nursing care for the heart transplant patient]. PMID- 1775494 TI - Experience and views of caries research and oral health. AB - The main clinical and theoretical studies on caries etiology and prevention and on general health published by the author and his coworkers since the beginning of the 1960s are briefly reviewed. Among the caries prevention methods published by previous authors, the Finnish trials on fissure sealing and fluoride varnishing showed distinct preventive effects. On the basis of these and later supporting findings, these methods were rapidly and widely adopted in the dental health care of Finnish children and adolescents. A chlorhexidine-fluoride mouthrinsing solution, developed by the author, exhibited simultaneous reduction of both caries and gingivitis among high -risk children and this preparation or chlorhexidine-fluoride gels have been widely prescribed for risk subjects, especially those with a caries risk. Despite the good caries prevention results obtained through fluoridation of sugar products and in respective model studies, this procedure has not been passed for commercial use in Finland. The translocation of phosphorus, potassium and fluoride between microbes of dental plaque origin and their environment, including the respective elements of enamel origin, were presented as a partial explanation for the role of phosphates and fluoride in caries etiology and/or prevention. Animal experiments elucidated the killing mechanism of a high single fluoride intake and its prevention by magnesium with explanatory changes in cardiac calcium. On the other hand, experiments on prolonged intakes of low dietary fluoride by rats confirmed earlier findings on the potential of fluoride in preventing calcium salt imbalances in internal organs. This was accomplished with a fluoride intake sufficient for caries reduction. The ability of two strains of the mutans streptococci and a Lactobacillus to invade enamel and dentine and to destory these structures from the inside before the cavitation phase of caries was demonstrated with gnotobiotic rats. The marked caries reduction among Finnish children and adolescents within the past 20 years appears to be due to a number of factors. PMID- 1775496 TI - [Chronic bronchopneumopathies of the obstructive type. The synthesis of a care plan for a patient with obstructive-type bronchopneumopathy]. PMID- 1775497 TI - [The nurse and the terminal patient]. PMID- 1775498 TI - [Ethics and the professional model of nursing services]. PMID- 1775499 TI - [The deontological code: an international comparison]. PMID- 1775500 TI - [The idea launched of forming a federation of professional associations]. PMID- 1775501 TI - [The opportunities and risks of a university education]. PMID- 1775502 TI - [The creation of a nursing service. A personal experience]. PMID- 1775503 TI - [Liposomes: advances in production-technology and therapy]. PMID- 1775504 TI - [Screening and identification of clinically-toxicologically relevant poisons]. PMID- 1775505 TI - [The therapeutic value of triterpene saponins--claims and reality]. PMID- 1775506 TI - Physiology and pharmacology of corticotropin-releasing factor. PMID- 1775507 TI - Serotonin-selective arylpiperazines with neuroendocrine, behavioral, temperature, and cardiovascular effects in humans. PMID- 1775508 TI - Activity of brain serotonergic neurons in the behaving animal. PMID- 1775509 TI - Aspects of chronic oral treatment with thyrotropin-releasing hormone: the hypothalamic-pituitary-thyroid axis in rats. A study with a pharmacological dose of thyrotropin-releasing hormone. AB - The effects of 16 days of oral treatment with thyrotropin-releasing hormone (TRH, 1 mg/24 h) on serum levels of thyrotropin (TSH), thyroxine (T4) and triiodothyronine (T3) and the kinetics of TRH in the blood were studied in normal rats. A second group of animals served as controls. TRH was dissolved by sonification (10 mg/l) and was stable in tap water. TRH was measured by a radioimmunoassay procedure (normal range: 20-80 pmol/l, antiserum K2B9 1:120,000 final dilution). An increase in basal TSH (7,200 +/- 440 ng/l, mean +/- SD) was found after 2 days of treatment (11,420 +/- 810 ng/l), but a significant increase was observed after 5 days of treatment (12,530 +/- 640 ng/l, p less than 0.001). T4 serum concentrations remained in the normal range during the entire period of study, whereas T3 serum concentrations (0.76 +/- 0.1 micrograms/l) were increased to 1.22 +/- 0.2 micrograms/l on day 5 (p less than 0.001). A subsequent decline of TSH, T4 and T3 up to the end of the study was observed. TRHmax concentrations were registered on day 5 (790 +/- 24 pmol/l). The mean value of TRHmax was 723 +/ 34 pmol/l. To improve the stability of TRH in tap water, 1-ml samples of drinking water with dissolved TRH were measured. The mean TRH concentration in drinking water was 73 +/- 1.5% (SD). No significant correlations were found between the area under the curve of TSH (184,340 ng.l-1.24 h) and that of TRH (14,954 pmol.l-1.24 h).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775510 TI - In vitro enantioselective glucuronidation of fenoprofen. AB - The diastereomeric glucuronic acid conjugates are major metabolites of the nonsteroidal anti-inflammatory drug fenoprofen (FEN). Glucuronidation of FEN enantiomers was investigated with liver microsomal preparations from different species (sheep, rabbit, rat and human). The formed R- and S-FEN conjugates can be separated and quantitated directly on a C18 reversed-phase HPLC column using a mixture of acetonitrile and tetrabutylammonium sulfate buffer, pH 2.5, as mobile phase. Applying this analytical procedure, it is possible to characterize enantioselective glucuronidation of FEN. For in vitro procedures, rates of glucuronide formation are substrate (FEN) and cosubstrate (UDP glucuronic acid, UDPGA) dependent with initial rates of glucuronide formation being higher for R- than for S-FEN. The R/S ratio of the formed products was independent of UDPGA (2.5-15 mmol/l) and substrate concentrations greater than or equal to 0.4 mmol/l. Enantioselective cleavage of the formed FEN conjugates by alkaline hydrolysis and hydrolytic enzymes (R greater than S-glucuronide) can be controlled during in vitro studies by pH adjustment and the addition of enzyme inhibitors. PMID- 1775511 TI - Developmental aspects of bladder contractile function: sensitivity to extracellular calcium. AB - The urinary bladders of 1-day and 1-week-old rabbits generate higher intravesical pressures in response to bethanechol and field stimulation than bladders isolated from mature 8-week-old rabbits. Yet the density of cholinergic receptors in the rabbit bladder does not change with maturation (1 day to 8 weeks). In an effort to better understand the molecular mechanisms by which newborn rabbit bladders generate greater pressures than the bladders of adult rabbits, we studied the effect of maturation on the relationship between extracellular calcium and contraction. Our results showed quite clearly that (1) at physiologic concentrations of calcium (2.5 mumol/l), isolated bladder strips of 1-day- and 1 week-old rabbits contracted in response to bethanechol to 98% of their maximal tension as opposed to 68% for their 8-week-old counterparts, (2) the ED50 (for calcium) for the 1-day and 1-week bladders was 0.4 mmol/l whereas the ED50 for the adult bladder strips was 2.2 mmol/l, and (3) the neonatal bladders demonstrated a much greater sensitivity to diltiazem than the adult bladders. The contractile response to calcium of the neonatal bladders was significantly inhibited by 1 mumol/l diltiazem whereas the 8-week-old bladders showed no inhibition at this concentration. In a second series of experiments, the effect of extracellular calcium on concentration was correlated with the intracellular concentration of free calcium using the calcium fluoride FURA-2 and surface spectrofluorometry. These studies confirmed that the increased contractile response of the neonatal bladder strips to calcium or cholinergic agonists was associated with an increase in the maximal intracellular free calcium concentration. PMID- 1775512 TI - Effects of pregnancy on muscarinic receptor density and function in the rabbit urinary bladder. AB - The contractile response of the rabbit urinary bladder to field stimulation consists of both cholinergic and purinergic components. In general, approximately 60% of the contractile response to field stimulation is cholinergic and 40% is purinergic. Although the purinergic response represents a significant proportion of the initial (phasic) pressure response to field stimulation of the isolated whole bladder, it contributes only 10-15% of the ability of field stimulation to empty the bladder. The current study investigates the effects of pregnancy on the contractile responses of the isolated urinary bladder to cholinergic and purinergic stimulation. The results of these studies indicate that pregnancy induces substantial changes in the physiology and pharmacology of the urinary bladder. The following data are consistent with the theory that pregnancy substantially increases the relative purinergic component of the response to field stimulation (and presumably neuronal stimulation): (1) there was a significantly greater response of the bladders isolated from pregnant rabbits to low-frequency field stimulation; (2) atropine was more effective at inhibiting the pressure generation of bladders isolated from virgin female rabbits; (3) field stimulation was more effective at emptying bladders isolated from virgin female rabbits; (4) the response of the bladders from pregnant rabbits to bethanechol was significantly reduced, whereas the response to ATP was significantly increased. In addition to these effects of pregnancy on bladder physiology, pregnancy induced a 50% decrease in the muscarinic receptor density of the urinary bladder body, which correlated very well with the 50% decrease in the contractile response to bethanechol. PMID- 1775513 TI - Isoproterenol prevents oxidant-induced injury in isolated rabbit lungs. AB - Increased vascular permeability in the adult respiratory distress syndrome is due in part to toxic oxygen metabolites. In the present study, we produced lung injury in the isolated rabbit lung with hydrogen peroxide (H2O2) and examined its prevention with isoproterenol. Pulmonary arterial pressure (Ppa) and the fluid filtration coefficient (Kf) were measured as indices of lung injury. Rabbits were divided into two groups, and 7 mmol/l H2O2 was administered in both groups. In one group, isoproterenol (2 micrograms/ml) was administered 10 min before H2O2 injury. Ppa increased transiently after H2O2 administration in the control group but was unchanged in the isoproterenol group. Kf was significantly increased by H2O2 administration in the control group but not in the isoproterenol group. We conclude that H2O2 increases pulmonary vascular permeability and that isoproterenol may protect against H2O2-induced pulmonary injury. PMID- 1775514 TI - Effect of the dopamine beta-hydroxylase inhibitor, SK&F 102698, on blood pressure in the 1-kidney, 1-clip hypertensive dog. AB - The acute and chronic effects of a potent selective dopamine beta-hydroxylase inhibitor, SK&F 102698, were assessed in chronically instrumented 1-kidney, 1 clip Goldblatt hypertensive dogs. Blood pressure measured directly from either a carotid loop or from a vascular access port and cardiac output measured by impedence cardiography were monitored following acute (30 and 100 mg/kg, p.o.) and chronic (30 mg/kg/day for 4 days) administration of SK&F 102698. The data indicate that SK&F 102698 failed to alter blood pressure, cardiac output or total peripheral resistance after either acute or chronic administration. It is concluded that dopamine beta-hydroxylase inhibition with SK&F 102698 is not an effective antihypertensive agent in the 1-kidney, 1-clip Goldblatt hypertensive dog model. PMID- 1775515 TI - Cobalt protoporphyrin regulates body weight in beagle dogs: induction of weight loss in normal animals of stable adult weight. AB - Adult male beagle dogs were treated with 10 weekly intramuscular injections of cobalt protoporphyrin (CoPP; 2 mumol/kg body weight). Treated dogs progressively lost weight to the extent of 20-30% at the end of the treatment period. Weight loss was accompanied by decreased food consumption. Following cessation of therapy with CoPP animal weights returned to pretreatment values within 5 weeks. These treatments were tolerated without detectable adverse side effects, and clinical, laboratory and histopathological analyses were normal. This study extends the spectrum of animals which decrease their body weight in response to CoPP administration from those which gain weight throughout life to those which maintain a stable body weight in adulthood. PMID- 1775516 TI - Effect of neuropeptide Y on isolated rat hearts. AB - Neuropeptide Y (NPY) induces coronary vasoconstriction and an associated negative inotropic effect in the isolated rat heart, but it is unclear whether NPY produces these effects directly or through the mediation of other vasoactive substances. This question has been examined in Langendorff-perfused, paced hearts using constant pressure. In 22 dose-response experiments examining single injections of NPY, 0.05-5 nmol, into the coronary perfusate, dose-dependent reduction of flow and developed pressure was observed. NPY, 0.5 nmol or approximately 5 x 10(-8) M, was chosen for further studies. This dose produced close to maximal effects on coronary flow, -22 +/- 5%, and developed pressure, 14 +/- 5% (mean +/- SD). NPY was examined during infusion of the cyclooxygenase inhibitor indomethacin (n = 6) and the 5-lipoxygenase inhibitor RG 6866 (N-methyl 4-benzyloxyphenyl acetohydroxamic acid, n = 6), using a test dose for both agents of 20 micrograms/min (approximately 3 microM) or vehicle (ethanol, 0.01 ml/min, n = 9). NPY reduced coronary flow in all three groups: vehicle 6.2 +/- 1.1 to 4.6 +/- 1.1 ml/min, indomethacin 7.0 +/- 1.1 to 5.7 +/- 1.0, and RG 6866 7.0 +/- 1.6 to 6.1 +/- 1.6; reductions of 25 +/- 7, 19 +/- 5 and 13 +/- 9%, respectively. The flow reduction was attenuated by RG 6866. Developed pressure was significantly reduced by NPY in vehicle 71 +/- 10 to 62 +/- 11 mm Hg, and indomethacin 70 +/- 10 to 64 +/- 11 but not RG 6866 74 +/- 15 to 71 +/- 15 groups, reductions of 13 +/- 3, 9 +/- 9 and 4 +/- 5%, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775517 TI - Inhibition of aldosterone production and angiotensin action by drugs affecting potassium channels. AB - We screened potassium channel agonists and antagonists in a search for pharmacologic probes of the channels that mediate potassium's effects on adrenal zona glomerulosa cells. Suspensions of bovine cells were tested, and aldosterone was measured by radioimmunoassay. The most potent inhibitors were pinacidil, capsaicin, glyburide, and quinine. These reagents were more potent against aldosterone production than against cortisol production. Aldosterone produced under basal conditions, as well as that stimulated by potassium, angiotensin II, or dibutyryl cyclic AMP, was antagonized. The vasodilatory and aldosterone inhibiting potencies of potassium channel reagents were very different. Candidate antihypertensives with potassium channel activity should be tested for adrenal inhibition. PMID- 1775518 TI - Cerebrospinal fluid pressure of conscious rats after venous constriction at the right atrium. AB - Thoracic shifts of blood stimulate diuresis and natriuresis during spaceflight. The available literature is not conclusive as to whether thoracic afferent neurons are essential for this response. Possibly, an acute elevation in cerebrospinal fluid pressure (CSF-p) activates central compensatory mechanisms. This is because central venous pressure is elevated by thoracic blood shifts and may reduce the pressure gradient for drainage of CSF into the venous sinuses. We tested whether rats with constriction of the venous return at the level of the heart (0.4 mm maximum diameter) had CSF-p different from sham-operated controls. CSF-p in the immediate postoperative period, as well as 1 and 10 days after surgery, were within normal limits and did not differ (p greater than 0.05). Blood collected at the end of the experiment showed no group differences (p greater than 0.05) in the hematocrit, or concentrations of sodium, potassium or vasopressin. Thus, changes in CSF-p, per se, appear to be insufficient to explain the cardiovascular or salt/water balance readjustments observed in spaceflight. It is likely that compensatory systems are highly redundant. PMID- 1775519 TI - Vitamin D suppression of spleen colony formation in radiation chimeras. AB - The effect of vitamin D on spleen colonies in murine bone marrow chimeras was investigated using a single suprapharmacologic dose of vitamin D. The results revealed that vitamin D even without producing hypercalcemia, reduced to a significant degree the number of spleen colonies obtained. This finding is thought to be due to either a direct effect of the vitamin on the capacity of stem cells to multiply or an effect on the number of stem cells that lodge in the spleen. PMID- 1775520 TI - Ritanserin reduces abuse of alcohol, cocaine, and fentanyl in rats. AB - Rats that had received 3% alcohol, 0.01% cocaine, or 0.002% fentanyl as the only beverage over 10 days showed marked preference for the drug solution when water was made available as a second fluid in a separate bottle. Treatment with low doses of ritanserin, a specific central serotonin 5-HT2 antagonist, rapidly reversed drug preference without changing total fluid intake. Quantitatively, the reduction in drug consumption was greater for alcohol than for cocaine and greater for cocaine than for fentanyl. This is probably related to differences in the reinforcing potential of the three drugs. PMID- 1775521 TI - Serotoninergic dysfunction in bipolar disorder. AB - The recent discovery of peripheral markers of central neurotransmitter systems has broadened the scope of biological research in psychiatry. Human platelets resemble presynaptic serotoninergic neurons and permit us to investigate the involvement of the serotonin system in the pathophysiology of mood disorders. In particular, platelets show an active uptake of serotonin and the related 3H imipramine (3H-IMI), similar to cerebral binding sites. We evaluated 3H-IMI binding in a group of 30 bipolar patients as compared with healthy controls. In 20 patients, platelet 14C-5HT uptake was also measured. The results showed no difference in IMI binding parameters between bipolar patients and healthy controls. However, the patients showed a lower Vmax of 14C-5HT uptake than the controls. These findings suggest that bipolarity influences one of the main components of the 5HT transporter complex in platelets. PMID- 1775522 TI - Minaprine and dose response in depression. An investigation of two fixed doses of minaprine compared with imipramine. AB - One hundred and twelve patients suffering from moderate to severe major depression (DSM III) were enrolled into a study to compare the antidepressant activity and side effect profiles of two dosage groups of minaprine (200 mg and 300 mg per day) and one of imipramine (150 mg per day) in psychiatric practice. Eight patients were withdrawn because of unwanted effects (four imipramine, one minaprine 200 mg, three minaprine 300 mg) and seventy-eight spontaneous reports of unwanted effects were made from the imipramine group compared with sixty-four from the minaprine 200 mg and forty-six from the minaprine 300 mg groups. The main efficacy analysis was carried out at 4 weeks on the 89 evaluable patients who completed 2 weeks active treatment, the last observation being carried forward in those patients who did not complete. A secondary analysis was also carried out at 6 weeks. The response in all three treatment groups showed a significant improvement from the severity at entry to the study, and the response rate to minaprine 200 mg daily was similar to that of imipramine (53% vs 54% achieving a reduction of 50% or more on the Hamilton Depression Rating Scale by week 6), although, given the small group sizes, similar efficacy cannot be claimed. In the intention to treat analysis there was a significant dose response relationship with significantly more patients in the lower minaprine 200 mg dose group achieving 50% or more reduction in the Hamilton Rating Scale than the minaprine 300 mg group at week 4 (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775524 TI - Case report of successful treatment of bulimia nervosa with fluvoxamine. PMID- 1775523 TI - Compared efficacy of prazepam and clomipramine in major depression with anxiety: a multicenter controlled study. AB - The efficacy of antidepressants is well established in major depressions, especially those with melancholic features. However, some anxiolytics also appear to have antidepressant properties at least for outpatients. 118 outpatients (25 males, 93 females, age: 18-60) with major depression according to DSM-III criteria, neither melancholic nor suicidal, reaching at least 27 on Montgomery and Asberg depression rating scale (MADRS) and 19 on Hamilton anxiety rating scale (HARS) accepted to participate this double blind study carried out by 15 G.P.s coordinated by 3 psychiatrists. After a one week placebo wash-out-single blind period, they were randomly, double blind, assigned to one of the two following groups: PR treated with prazepam (30-60 mg), a benzodiazepine anxiolytic or CL treated clomipramine, an imipramine antidepressant (75-150 mg). Patients were evaluated at days 0, 7, 14, and 28, using MADRS, HARS, Clinical Global Impression and Hopkins symptoms check list 58. In addition, G.P.s had to meet monthly for a case discussion group. RESULTS: groups were comparable at day 0. A highly significant improvement of MADRS and HARS scores (p less than 0.001) was observed in the total population. For the completer population evolution was also significantly positive in all the parameters studied but, considering MADRS and HSCL scores, a difference in favor of CL is observed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775525 TI - A resonance Raman study of octopus bathorhodopsin with deuterium labeled retinal chromophores. AB - The resonance Raman spectrum of octopus bathorhodopsin in the fingerprint region and in the ethylenic-Schiff base region have been obtained at 80 K using the "pump-probe" technique as have its deuterated chromophore analogues at the C7D; C8D; C8,C7D2; C10D; C11D; C11, C12D2; C14D; C15D; C14, C15D2; and N16D positions. While these data are not sufficient to make definitive band assignments, many tentative assignments can be made. Because of the close spectral similarity between the octopus bathorhodopsin spectrum and that of bovine bathorhodopsin, we conclude that the essential configuration of octopus bathorhodopsin's chromophore is all-trans like. The data suggest that the Schiff base, C = N, configuration is trans (anti). The observed conformationally sensitive fingerprint bands show pronounced isotope shifts upon chromophore deuteration. The size of the shifts differ, in certain cases, from those found for bovine bathorhodopsin. Thus, the internal mode composition of the fingerprint bands differs somewhat from bovine bathorhodopsin, suggesting a somewhat different in situ chromophore conformation. An analysis of the NH bend frequency, the Schiff base C = N stretch frequency, and its shift upon Schiff base deuteration suggests that the hydrogen bonding between the protonated Schiff base with its protein binding pocket is weaker in octopus bathorhodopsin than in bovine bathorhodopsin but stronger than that found in bacteriorhodopsin's bR568 pigment. PMID- 1775526 TI - All-trans-retinal is the chromophore bound to the photoreceptor of the alga Chlamydomonas reinhardtii. AB - Rhodopsin is the general name for a family of visual pigments that receive light and transmit this signal to the rest of an organism. Chlamydomonas reinhardtii is a unicellular eukaryote whose light-tracking system consists of a single eye. Through spectral studies of Chlamydomonas' reaction to light of different wavelengths (action spectroscopy), it has been shown in vivo that the photoreceptor of Chlamydomonas is functionally similar to vertebrate rhodopsin. We seek to characterize the photoreceptor further by identifying the molecule that is incorporated into the rhodopsin of Chlamydomonas forming the chromophore. High performance liquid chromatography analysis of organic extracts of retinaloximes from membrane fractions enriched in eye-spots and in cells virtually free of interfering carotenoids identified syn-all-trans as the existing retinaloxime isomer. We conclude that all-trans-retinal is the native molecule that is available to be incorporated into the rhodopsin of Chlamydomonas and therefore forms the functioning chromophore on binding. PMID- 1775527 TI - Evidence that the repellent receptor form of sensory rhodopsin I is an attractant signaling state. AB - The lifetime of the Halobacterium halobium sensory rhodopsin I (SR-I) photocycle intermediate S373 was modulated by incorporating retinal analogs into SR-I apoprotein in vitro and in vivo. Photocycles by SR-I analog pigments exhibit the same reaction scheme and similar formation rates, but different decay rates, of their S373-like species as monitored by flash spectroscopy in membrane vesicle suspensions. The attractant receptor signaling efficiencies determined by physiological measurements are proportional to the lifetimes of the S373-like intermediates, indicating that S373 is a physiological active conformation (signaling state) of the receptor. A model incorporating this finding into the SR I photocycle is presented. PMID- 1775528 TI - Functional properties of interphotoreceptor retinoid-binding protein. AB - It has been hypothesized that interphotoreceptor retinoid-binding protein (IRBP) functions as a two-way carrier of retinoid between the retinal pigment epithelium (RPE) and rod photoreceptors in the vertebrate eye. This hypothesis has been tested in recent studies that have employed purified, initially ligand-free, bovine IRBP and the "RPE-eyecup" obtained from the toad (Bufo marinus) eye. The present experiments further characterize the IRBP/RPE-eyecup system with respect to (i) the solubilization and protection of retinol by IRBP, and (ii) the time course of IRBP-mediated release of 11-cis retinal by the RPE. The data, together with previous findings in the IRBP/RPE-eyecup preparation, support the view that 11-cis retinal is the principal retinoid released by the RPE into IRBP supplemented aqueous medium, and that IRBP in vivo promotes the regeneration of rhodopsin by facilitating the exchange of retinoid between bleached rods and the RPE. PMID- 1775529 TI - Iodopsin, a red-sensitive cone visual pigment in the chicken retina. AB - The vertebrate retina contains two kinds of visual cells: rods, responsible for twilight (scotopic) vision (black and white discrimination); and cones, responsible for daylight (photopic) vision (color discrimination). Here we attempt to explain some of their functional differences and similarities in terms of their visual pigments. In the chicken retina there are four types of single cones and a double cone; each of the single cones has its own characteristic oil droplet (red, orange, blue, or colorless) and the double cone is composed of a set of principal and accessory members, the former of which has a green-colored oil droplet. Iodopsin, the chicken red-sensitive cone visual pigment, is located at outer segments of both the red single cones and the double cones, while the other single cones and the rod contain their own visual pigments with different absorption spectra. The diversity in absorption spectra among these visual pigments is caused by the difference in interaction between chromophore (11-cis retinal) and protein moiety (opsin). However, the chromophore-binding pocket in iodopsin is similar to that in rhodopsin. The difference in absorption maxima between both pigments could be explained by the difference in distances between the protonated Schiff-bases at the chromophore-binding site and their counter ions in iodopsin and rhodopsin. Furthermore, iodopsin has a unique chloride binding site whose chloride ion serves for the red-shift of the absorption maximum of iodopsin. Visual pigment bleaches upon absorption of light through several intermediates and finally dissociates into all-trans retinal and opsin. That the sensitivity of cones is lower than rods cannot be explained by the relative photosensitivity of iodopsin to rhodopsin, but may be understood to some extent by the short lifetime of an enzymatically active intermediate (corresponding to metarhodopsin II) produced in the photobleaching process of iodopsin. The rapid formation and decay of the meta II-intermediate of iodopsin compared with metarhodopsin II are not contradictory to the rapid generation and recovery of cone receptor potential compared with rod receptor potential. The rapid recovery of the cone receptor potential may be due to a more effective shutoff mechanism of the visual excitation, including the phosphorylation of iodopsin. The rapid dark adaptation of cones compared with rods has been explained by the rapid regeneration of iodopsin from 11-cis retinal and opsin. One of the reasons for the rapid regeneration and susceptibility to chemicals of iodopsin compared with rhodopsin may be a unique structure near the chromophore binding site of iodopsin. PMID- 1775530 TI - Applications of dye-sensitized photoreactions in neurobiology. PMID- 1775531 TI - Preclinical examination of first and second generation photosensitizers used in photodynamic therapy. AB - Numerous photosensitizers with absorption peaks spanning the 600-800 nm "therapeutic window" have been and continue to be synthesized. Structural modifications of the dyes can then be made in order to improve tumor deliverability and retention. Chemical alterations can also enhance the yields of light generated reactive oxygen species. Utilization of lipoproteins, emulsions and antibody conjugates can enhance the selectivity of drug localization. Most cell types and subcellular structures are highly photosensitive and biochemical analysis indicates that cellular target sites associated with PDT correlate with photosensitizer location. In vivo data suggest that vascular and direct tumor cell damage as well as systemic and local immunological reactions are involved in PDT responsiveness. Additional mechanistic, synthetic and developmental studies are required in order to fully appreciate the potentials of PDT. However, continued enthusiasm and support for basic PDT research (as observed during the past 8 years) will depend to a large extent on the outcome of the current clinical trials. PMID- 1775532 TI - The hairless mouse and photoaging. PMID- 1775533 TI - Photocycle kinetics: analysis of Raman data from bacteriorhodopsin. AB - A recently developed algorithm for analyzing photocycle kinetics was applied to recently obtained Raman data for the time course of bacteriorhodopsin (bR) and its intermediates, L, M, N and O. The algorithm allows all possible transitions between any of the intermediates in the kinetic model. The best fit to all the Raman data required the transitions L in equilibrium with M in equilibrium with N ---O----bR and also the branch L in equilibrium with N. The rates are moderately well determined and smooth as a function of pH. From the ratios of forward and backward rates the differences in free energy of the L, M and N states are no larger than 1.5 kcal. The possibility that only the sum of the L and N concentrations is well determined, but not the individual L and N concentrations, was investigated. The model L in equilibrium with M in equilibrium with N----O--- bR satisfactorily fitted condensed L + N data and gave predicted individual L and N concentrations considerably different than those measured individually. The possibility of Raman invisible states, such as two Ms or two Ns was also investigated. Models with two Ns were not successful and it cannot yet confidently be concluded which model with two Ms is best. However, the model, L in equilibrium with M1----M2----N----O----bR plus the branch L----N, fits the data better with the same number of parameters as the best model with only one M intermediate. This provides strong support for two Ms in the bR photocycle. PMID- 1775534 TI - Rotational diffusion effects on absorbance measurements: limitations to the magic angle approach. AB - Optical absorbance changes are commonly used to characterize intermediates which appear in the bleaching sequence of rhodopsin and in the photocycle of bacteriorhodopsin. Absorbance changes can be caused by an intermediate's rotational diffusion, and when this occurs it can distort absorbance changes due to the structural evolution of intermediates. Linear polarization of an optical probe source at 54.7 degrees (the magic angle) relative to the polarization direction of a linearly polarized actinic source has often been used to eliminate signals due to rotational diffusion. We used Jones calculus to investigate the validity of the magic-angle strategy. Taylor expansion of the result in powers of the absorbances of the bleached ground state and of the intermediates leads to a relatively simple expression which can be used to determine whether rotational contributions are likely under various experimental conditions. This expression shows that in first order no dichroism-dependent term appears in the absorbance measured at magic angle. In second order, however, linear dichroism contributes to signals. For the sequence of rhodopsin intermediates: rhodopsin hv--- bathorhodopsin in equilibrium BSI----lumirhodopsin, where BSI is a recently discovered blue-shifted intermediate, we determined the magnitude of the dichroism signals to be, on average, less than 2% of the true absorbance change due to the intermediates themselves (and hence undetectable). Freedom from dichroism artifacts in this case results from the fact that the transition dipoles of these intermediates are similar to that of rhodopsin. Larger and certainly detectable dichroism signals are predicted to occur, even at the magic angle, for later intermediates which have transition dipole moments which differ significantly from that of rhodopsin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775535 TI - Ring oxidized retinals form unusual bacteriorhodopsin analogue pigments. AB - Three ring oxidized retinal analogues have been isolated from the exhaustive oxidation of all-trans retinal. All-trans 4-oxoretinal and 2,3-dehydro-4 oxoretinal have similar absorption maxima to that of all-trans retinal and have been shown to be in the 6-s-cis conformation in solution. Pigments formed with bacterioopsin exhibit absorption maxima (520 nm) blue-shifted from that of bacteriorhodopsin (bR), indicating a disturbance of the external point charge by the electronegative carbonyl moiety at the 4 position. The third analogue contains a ring contracted to a cyclopentenyl-alpha,beta-dione. Unlike the majority of retinals, this analogue displays a 6-s-trans conformation in solution and has a red-shifted absorption maximum at 435 nm. The resulting bR analogue pigment (515 nm) is formed five times faster than the other oxoretinal pigments. All three oxoretinal pigments show an irreversible 20 nm blue shift upon exposure to white light. The 4-oxo and 2,3-dehydro-4-oxoretinal pigments, after irradiation, undergo a small reversible blue shift (4-8 nm) on dark adaptation. These two pigments pump protons, although with slowed photocycle kinetics, demonstrating that these structural changes (addition of the carbonyl at the C-4 and insertion of a double bond in the ring) do not block the function of the pigment. Extraction of the C-15 tritiated analogue retinals from illuminated and non-illuminated pigments of all three oxoretinals yield identical results. Therefore, any crosslinking of these oxoretinals to the protein is by linkages which are unstable to the extraction procedures. PMID- 1775536 TI - Membrane lipid influences on the energetics of the metarhodopsin I and metarhodopsin II conformational states of rhodopsin probed by flash photolysis. AB - We have investigated the relationship between rhodopsin photochemical function and the retinal rod outer segment (ROS) disk membrane lipid composition using flash photolysis techniques. Bovine rhodopsin was combined with various phospholipids to form recombinant membrane vesicles, in which the lipid acyl chain composition was maintained at that of egg phosphatidylcholine (PC), while the nature of the headgroups was varied. The ratio of metarhodopsin II (MII)/metarhodopsin I (MI) in these recombinants produced by an actinic flash was investigated as a function of pH, and compared with the photochemical activity observed for rhodopsin in native ROS membranes and dimyristoylphosphatidylcholine recombinants. In recombinants made with lipids derived from egg PC, as well as in native ROS membranes, MI and MII were found to be present in a pH-dependent, acid base equilibrium on the millisecond timescale. The recombinants made with phospholipids containing unsaturated acyl chains were capable of full native-like MII production, but each demonstrated a titration curve with a different pK. In addition, some of the recombinants exhibited apparent deviations from the Henderson-Hasselbalch curve shape. The presence of either phosphatidylethanolamine (PE) or phosphatidylserine (PS) headgroups appeared to increase the amount of MII produced. This may result from alteration of the curvature free energy, in the case of PE, and from the influence of the membrane surface potential in the case of PS. An investigation of the effects of temperature on the MI-MII transition in native ROS membranes and the recombinants was also carried out.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775537 TI - The majority of potassium ions in muscle cells is adsorbed on beta- and gamma carboxyl groups of myosin: potassium-ion-adsorbing carboxyl groups on myosin heads engage in cross-bridge formation during contraction. AB - High-molecular weight poly(ethylene glycol) (PEG-8000) in the bathing medium prolongs the survival of 2-mm-wide frog muscle segments with open ends. In a PEG 8000-containing medium Rb+, K+, and Na+ in the muscle segments reached new diffusion equilibrium in 2-4 hours. At this new equilibrium, the cell's preference of K+ over Na+ was preserved but very much weakened. Studies of the influence of pH on the equilibrium distribution of labelled Na+ in 2-mm-wide muscle segments confirmed the prediction that beta- and gamma-carboxyl groups, carried respectively on aspartic and glutamic acid residues of intracellular proteins, adsorb K+, Na+ and other monovalent cations. These carboxyl groups have a characteristic pKa between 3.65 and 4.25. A pKa of 3.85 was observed. These findings, when seen in the light of other relevant information available, led to the conclusion that beta- and gamma-carboxyl groups on myosin molecules adsorb- in a close contact one-ion-one-site fashion--the majority (67% to 80%) of K+ in resting muscle cells. Other evidence suggests that in muscle contraction, the K(+)-adsorbing beta- and gamma-carboxyl groups on myosin heads form salt linkages with cationic sites on actin, displacing and releasing the adsorbed K+. Present and earlier findings together offer support for an earlier suggestion that the formation and dissociation of these salt-linkages may underlie the force generating, cyclic formation and dissociation of cross-bridges during muscle contraction. PMID- 1775538 TI - Effect of parathyroidectomy on calcium and phospholipase A2 in the liver of carbon tetrachloride-treated rats. AB - The present study shows that carbon tetrachloride fails to cause hypercalcemia in the serum and liver of rats after parathyroidectomy. Secondly, a diminution in the activity of calcium-dependent proteolytic enzyme, phospholipase A2 occurs in parathyroidectomized rats, suggesting a plausible protective mechanism against carbon tetrachloride toxicity. PMID- 1775539 TI - A physiologist's views on the animal rights/liberation movement. PMID- 1775540 TI - Nobel Prize for medicine awarded to APS honorary member. PMID- 1775541 TI - Physiology as integrative biology. PMID- 1775542 TI - Impaired biphasic insulin release in mildly diabetic rats bearing a chronic portal vein catheter. AB - Using a new technique of chronic portal vein catheterization in freely moving rats, we investigated the insulin release to intravenous (IV) glucose (0.5 g/kg) injection in mildly diabetic (35 mg/kg streptozotocin, IV) rats. In nondiabetic rats, plasma insulin of the portal vein showed a clear biphasic release pattern, which peaked within two min after glucose injection, reached a nadir between three and six min, then began to rise to a second peak between 7 and 10 min, and reached a second nadir at 14 min. In mildly diabetic rats, a biphasic insulin release was evident, but both the first and the second phase insulin releases were impaired. In spite of this impaired insulin release, glucose intolerance was mild. Simultaneous blood sampling from the portal and peripheral veins after IV glucose injection revealed that diabetic rats showed diminished hepatic insulin extraction. These results suggest that the biphasic insulin release to glucose is impaired in mildly diabetic rats, but diminished hepatic insulin extraction contributes at least to keeping glucose tolerance mild. PMID- 1775543 TI - Role of the ventromedial nucleus of hypothalamus in the male-induced enhancement of lordosis in female rats. AB - The involvement of the ventromedial nucleus of the hypothalamus (VMH) in the mating-induced enhancement of lordosis in ovariectomized estrogen-primed rats was investigated. In the first experiment, females with bilateral VMH or sham lesions were primed with 2 micrograms estradiol benzoate, and 48 h later they were subjected to repeated-mating tests. The VMH-lesioned rats failed to exhibit lordosis during the tests; however, the sham-operated females exhibited a gradual increase in lordosis quotient (LQ) with repetitive matings. In the second experiment, ovariectomized females were bilaterally implanted with estradiol (E2) or cholesterol (C) in the VMH, 48 h prior to behavioral testing. Repeated-mating induced elevation in LQ was observed in the females when they were bilaterally implanted with E2 in the VMH; C was ineffective. To exclude the possibility of the spread of E2 to areas adjacent to VMH, plasma-luteinizing hormone (LH) was measured. Elevation in the circulating LH levels following ovariectomy was not suppressed in the females following bilateral E2 implants in the VMH, suggesting that the effect of estrogen is localized within or immediately around the VMH. The results suggest that the integrity of the VMH is critical for the potentiation of lordosis behavior in ovariectomized estrogen-primed females by male-originating sensory cues, and that selective priming of the VMH with estrogen is sufficient for the male-induced enhancement of lordosis. PMID- 1775544 TI - Quality-specific differences in rat taste detection performance as a function of stimulus volume. AB - Taste detection performance for representatives of the four taste qualities as a function of stimulus volume (5 x 10(-4) to 1 x 1(-1) ml) was examined in rats using high-precision gustometry, computer-controlled operant procedures, nonparametric signal detection measures of sensitivity and responsivity, and blind control procedures. The overall sensitivity index was positively related to stimulus volume (rs = .60), with optimal detection performance attained with a 5 x 10(-3) ml stimulus volume for salty tastants and a 1 x 10(-2) ml stimulus volume for the other taste qualities. The overall responsivity index was inversely related to stimulus volume (rs = -.47), especially for sour and bitter tastants. These results are consistent with prior observations and demonstrate that operant methods using small tastant samples produce sensitive estimates of the rat's taste detection performance and response bias. PMID- 1775545 TI - Characterization of the raphe nuclei of the reptile Ctenosaura pectinata. AB - The brain stem of the lizard Ctenosaura pectinata was studied in 10 microns thick sections following the Nissl and eosin-hematoxilin techniques. Furthermore, the distribution of serotonin-containing neuronal somata in this encephalic region was determined by means of an indirect immunofluorescence technique using a specific antibody to serotonin. Two of the cellular groups of the brain stem were identified as the superior and inferior raphe nuclei, which show serotonergic cells of variable size (between 17 and 30 microns). The results obtained in the present study together with information coming from other authors, suggest that serotonergic neuronal systems placed at brain stem level of vertebrates are phylogenetically ancient. PMID- 1775546 TI - Alarm substance emitted by rats in the forced-swim test is a low volatile pheromone. AB - A series of studies was conducted to determine if the alarm substance produced by rats in the forced-swim test satisfies criteria for pheromones: well-defined behavioral effect, species specificity, minimal influence of experience and control for nonspecific arousal. The alarm substance satisfied these criteria. Additional studies involving activity testing in the presence of the alarm pheromone and preference/avoidance for odors emanating from cylinders containing the pheromone indicated it has very low volatility. PMID- 1775547 TI - Weekly rhythms of spontaneous nutrient intake and meal pattern of humans. AB - Weekly variations in the nutrient intakes and the meal patterns of humans were investigated by paying 323 adult humans to maintain a 7-day diary of everything they ate, when they ate it, and their subjective states of hunger, depression, and anxiety. A marked weekly rhythm of nutrient intake was observed, with a greater total caloric intake and larger meal sizes on weekends associated with an increase in the duration of the meals and the number of other people present. The number of other people present had both significantly larger univariate correlations with meal size and multivariate Beta coefficients predicting meal size on weekends than on weekdays. The results support a hypothesis that the heightened intake on weekends results from increased social facilitation of intake resultant from a greater number of other people present at weekend meals and a greater flexibility to extend the duration of the meals on weekends. PMID- 1775548 TI - Role of the medial and lateral septum in a variable goal spatial problem solving task. AB - Rats with lesions to the medial (MS) or lateral septal (LS) nuclei were compared to normal controls (CNT) in the acquisition of a spatial working memory task. In this task, animals were first allowed to explore the unbaited three-table apparatus before being fed on one of the two possible goal tables. Animals were then tested on their ability to return to the table where they just had been fed. Only rats with medial septal damage were clearly impaired on this problem, an impairment that dissipated over days. In contrast, the performance of LS rats was not significantly different from controls. During the second phase of the experiment, the same animals received either atropine sulphate (50 mg/kg, IP), atropine methylnitrate (50 mg/kg, IP), or an equivalent volume of saline. Atropine sulphate produced a sharp decrease in performance by all subjects. Meanwhile, atropine methylnitrate produced a mild temporary deficit only in LS rats. Overall, these results confirm that the medial septum plays a crucial role in the acquisition of problem solving. In addition, these results also suggest that the lateral septum may play a possible role in some form of spatial behavior easily disrupted by atropine methylnitrate. PMID- 1775549 TI - Effects of ovarian hormones on sexual receptivity, proceptivity, and motivation in olfactory bulbectomized female rats. AB - The purpose of the present experiment was to assess the effect of olfactory bulbectomy and ovarian hormones on female sexual motivation. Ovariectomized female rats underwent either bilateral bulbectomy or sham surgery. Females received one of four subthreshold hormone treatments: 0% estradiol (E2) plus 500 micrograms progesterone (P), 100% E2 alone, 10% E2 plus 500 micrograms P, or 100% E2 plus 500 micrograms P. Sexual motivation (as indicated by a female's preference for a sexually active male over a castrated male) and proceptivity (dart and ear wiggling sequences) were measured in a three compartment partner preference apparatus. Sexual receptivity (lordosis) was measured separately in a glass arena with a sexually active male. Results showed that olfactory bulb removal facilitates sexual receptivity and proceptivity in females exposed to 10% or 100% E2 in combination with 500 micrograms P. In contrast, sexual motivation was only demonstrated by olfactory bulbectomized females which received 100% E2 in combination with 500 micrograms P. These findings support the hypothesis that olfactory bulbectomy induces a behavioral hypersensitivity to estrogen, and suggest that sexual motivation is an estrogen-mediated response which requires a higher level of estrogen stimulation than sexual receptivity and proceptivity. PMID- 1775550 TI - Lead effects on food competition and predatory aggression in Binghamton HET mice. AB - The ubiquity of lead in our environment, its toxic nature and its potential to alter behavior of humans and animals has stimulated much research. In addition to the well known, but complex, changes in activity and performance of learned tasks following exposure to lead, an increasing body of literature suggests that changes in social behavior also occur. This study examined the impact of ingesting a 0.5% lead acetate solution (as the only available fluid)--a protocol that results in ca. 100 micrograms/dl blood-levels in our Binghamton Heterogenous (HET) mice--on food competition in both male and female HET mice. Effects of this lead exposure on cricket predation by the same HET mice also were observed. Our results from the food competition study (Experiment I) show, compared with water controls, that such exposure to lead increases both food possession time and amount of social contact after food consumption; but very little agonistic behavior took place in either the water control or lead-exposed competition testing sessions. In the cricket predation observations (Experiment II) there was a tendency for lead exposure to reduce the latency of males to attack, and the indication that lead-exposed females initially attacked a cricket's legs more often than any of the other groups. In fact, suggestions of such gender x treatment interactions occurred in both the food competition and the predation work. Overall, we believe our results, in conjunction with other relevant literature, suggest that exposure to lead reduced the individual's general fitness, even when levels are relatively low. PMID- 1775551 TI - Lack of amiloride sensitivity in SHR and WKY glossopharyngeal taste responses to NaCl. AB - To explore possible functional strain differences in taste receptors located on the posterior tongue, we recorded electrophysiological taste responses from the glossopharyngeal nerve of spontaneously hypertensive (SHR) and Wistar-Kyoto (WKY) rats. Multifiber responses to a concentration series (0.5 M to 2.0 M) of NaCl, KCl and NH4Cl were recorded before and after lingual application of the epithelial sodium transport blocker, amiloride. Responses to a concentration series (0.0025 M to 0.1 M) of quinine hydrochloride were also recorded. When expressed relative to the 0.5-M NH4Cl response, responses to the monochloride salts were equivalent between SHR and WKY. Surprisingly, NaCl responses were not suppressed by the sodium transport blocker, amiloride. This is in direct contrast to the dramatic suppression observed in the chorda tympani. Also, relative responses to quinine were greater in the glossopharyngeal nerve of SHR than WKY. These results indicate that taste receptors innervated by the glossopharyngeal nerve lack amiloride sensitivity and that posterior taste receptor function to monochloride salts is equivalent between SHR and WKY. PMID- 1775552 TI - Attenuated cardiovascular, neuroendocrine, and behavioral responses after a single footshock in central amygdaloid lesioned male rats. AB - The effect of bilateral electrolytical CEA lesioning on behavioral, cardiovascular and neuroendocrine changes has been studied in male Wistar rats before, during and shortly after a brief aversive stimulus of an unavoidable footshock. Blood samples were withdrawn via a permanent heart catheter. Lesioning of the CEA abolished completely the immobility response normally seen after a footshock. Lesions failed to affect the early tachycardiac response compared to sham-lesioned controls, but the poststress recovery was attenuated, probably due to diminished vagal activation. Furthermore, the magnitude of the responses of all measured hormones (epinephrine, norepinephrine, corticosterone and prolactin) appeared to be attenuated in the lesioned rats. These results suggest that the CEA plays an important and general role in the behavioral, autonomic and hormonal output during a brief unavoidable, unconditioned footshock. This is in contrast with the selective role of the CEA in vagal (parasympathetic) and on inhibitory (immobility) behavioral responses following conditioning. PMID- 1775553 TI - Central amygdala lesions affect behavioral and autonomic balance during stress in rats. AB - The effects of a bilateral electrolytical lesion of the CEA on the behavioral and sympathetically induced cardiac response in the shock-probe/defensive-burying test have been analyzed in male Wistar rats. Lesions in the CEA failed to affect defensive burying and accompanying tachycardiac response as compared to sham lesioned controls during the presentation of the electrified shock probe (unconditioned test). However, CEA lesioning attenuated the bradycardiac response and the immobility behavior during the late part of the test. Retention of this behavior one day after the exposure to the probe (conditioned test) was attenuated by the lesion. However, when the lesion was placed after the unconditioned test situation, retention of the burying was not affected, but the animals failed to show immobility behavior. These results, in agreement with former studies, suggest that the CEA is involved particularly in the organization and/or expression of the passive component of the behavior and the parasympathetic outflow during stress. The active component, i.e., burying behavior, and the accompanying tachycardiac response remains unaffected unless the acquisition of the stress response took place with damaged CEA. PMID- 1775554 TI - Dipsogenic and feeding influences of intraventricularly infused anionic choline solutions. AB - Chloride and bicarbonate solutions of choline were infused into the anteroventral part of the third ventricle of two different groups of rats through chronically implanted stainless steel cannulae. Dipsogenic and feeding responses elicited by these solutions were studied by observations taken at half hour intervals up to two h and then, after 24 h of infusions. Results were compared with the control response evoked by similar infusion of artificial cerebrospinal fluid (aCSF). Food and water intakes were recorded in different groups (n = 18 each) of rats. Dipsogenic response elicited by choline chloride solution in the observation taken 24 h after infusion, however, was higher only as compared to the control. Dipsogenic effect of bicarbonate solution was not significantly different from the control in the first two observations (30 and 60 min), but in the later observations (90, 120 min and 24 h), it was significantly higher. None of the choline solutions significantly alter feeding response within 2 h of infusions. However, in the observation taken 24 h after infusion, the response evoked by choline chloride was greater than that elicited by aCSF. The results support our earlier observation that chloride concentration of third ventricular CSF significantly influences water and food consumption. Intraventricularly administered choline also appears to have positive influence on these behaviors. PMID- 1775555 TI - Insulin secretion to glucose stimulus in pancreatic islets isolated from rats fed unbalanced diets. AB - To verify the effect of different energetic sources on insulin secretion, just weaned male Wistar rats were divided into four groups fed as follows: high carbohydrate (HC), high protein (HP), high lipid (HL) and balanced (C) diets during five weeks. Body weight gain and daily food intake were similar among the four groups. Insulin content of the isolated islets was not different; however, insulin release to a high glucose concentration (16.7 mM) stimulus was clearly higher in islets isolated from rats fed a balanced diet as compared to the other groups (HC, HP and HL). The rates of insulin secretion in islet perfusates from rats fed unbalanced diets were also decreased, although 45Ca2+ outflow rate (FOR) was similar in all groups. Since the rate of U-14C-glucose oxidation was decreased in islets isolated from rats fed unbalanced diets, this could be one of the mechanisms for the reduced rates of insulin release observed. Therefore, the increased supply of specific fuels provoke metabolic alterations in B-cell leading to changes in insulin secretion. PMID- 1775556 TI - Female genotype influences the behavioral performance of mice selected for reproductive traits. AB - The behavioral performance of mice that differ in regularity of the estrous cycle and litter size was studied after female exposure to a male of the same or a different strain. Emotional reactivity was measured using the pole, straightaway and open field tests. Factor interpretations of emotionality included motor discharge, autonomic imbalance and acrophobia. Mice characterized by regular estrous cycles and large litters (line E) were more explorative and emotionally reactive with respect to motor discharge and autonomic imbalance. In contrast, mice with less regular estrous cycles and small litter size (line CN-) were more acrophobic. These strain differences in behavioral performance were influenced by the genotype of the female rather than the cohabitating male. PMID- 1775557 TI - Flavor preferences conditioned by sugars: rats learn to prefer glucose over fructose. AB - The reinforcing effects of glucose and fructose were compared using flavor preference conditioning paradigms. Female rats given access to flavored glucose and flavored fructose solutions developed preferences for the glucose- over the fructose-paired flavor, as well as for unflavored glucose over unflavored fructose. This effect was obtained with 8% and 32% solutions, and with nondeprived and deprived rats. In most cases, the glucose preference was not immediate but appeared only after the rats had one-bottle experience with the two sugars. Female rats also preferred a glucose-paired flavor over a flavor that was paired with a noncaloric saccharin solution. A similar but somewhat weaker preference was displayed for a fructose-paired flavor over a saccharin-paired flavor. Both male and female rats acquired preferences for flavored chow that was paired with the intake of a 32% glucose solution over flavored chow paired with 32% fructose intake. Together, these results indicate that glucose has more potent postingestive reinforcing effects than does fructose. This may explain why rats consume more glucose than fructose in one-bottle acceptance as well as two bottle preference tests. PMID- 1775558 TI - Effects of single and long-term droperidol administration on open-field and stereotyped behavior of rats. AB - The effects of single and long-term droperidol administration on rat open-field and apomorphine-induced stereotyped behavior were studied. A single dose of droperidol decreased dose dependently not only locomotion and rearing frequencies in the open-field but also the apomorphine effects. Long-term droperidol administration induced significant tolerance to all parameters of activity recorded in the open-field. Unlike other dopamine blockers, droperidol withdrawn from long-term droperidol administration wasn't able to increase rats' open-field parameters significantly. However, like other dopamine blockers, droperidol withdrawn produced an augmented responsiveness to apomorphine-induced stereotyped behavior. These results suggest that the supersensitivity of central dopamine receptors developed after droperidol treatment may have peculiar characteristics. PMID- 1775559 TI - Influence of brain embryonic tissue transplantation (early period) on rat's reactions of avoiding zoosocial and artificial stimuli. AB - The effect of the influence of brain tissue transplantation on behavior avoidance as zoosocial and artificial stimuli was examined in rats after unilateral transplantation of embryonic tissue to the cortex parietal region. Pieces of neocortex and hippocampus (NC + HC) were introduced to one group of twenty rats. Pieces of amygdala and hypothalamus (AM + HT) were introduced to twenty other animals composing a second group. Ten intact animals served as a control group. In the group receiving transplants of AM + HT, by one week after surgery the number of animals avoiding zoosocial stimulus was significantly increased. In the group receiving transplants of NC + HC, by one week after transplantation, a considerable increase in the time of avoiding artificial aversive stimuli was observed for most of the animals. PMID- 1775560 TI - Trot-gallop gait transitions in quadrupeds. AB - Although the kinematics, mechanics, energetics and mathematics of trot-gallop gait transitions have been discussed in previous papers, no one article has tried to assimilate all the information. This review paper does this and includes a summary of the relatively new engineering (mathematical) approach to analyzing these transitions developed by Schoner et al. (29). The paper also presents unpublished data on gait transitions in cats and monkeys, and attempts to develop some general principles pertaining to trot-gallop transitions. Finally, the paper highlights areas where additional information is needed. PMID- 1775561 TI - A technique to anesthetize turtles with ether. AB - A technique to anesthetize turtles with ether is presented, in which a plastic cannula is passed through the glottis into the trachea. This procedure avoids apnea and allows ether vapours obtained from a chamber to be introduced, by the animal respiratory movements or by means of a pump, into the animal lungs. The anesthesia is rapidly obtained and lasts from 45-90 minutes. The time of recovery from anesthesia ranged from 60-90 minutes. With this technique no deaths were observed and the same animal could be anesthetized repeatedly. PMID- 1775562 TI - Conditioned taste aversion induced by estradiol pellets. AB - In two experiments, ovariectomized rats were given a novel diet prior to the implantation of a fused pellet of estradiol (E2 pellet). In short-term (3 weeks) ovariectomized rats, the suppression of food intake induced by estrogen was not affected by the introduction of the novel diet. However, a sensitive two-choice preference test revealed that subjects implanted with the E2 pellet had a lesser preference for the novel diet than controls implanted with the vehicle pellet. In long-term (18 weeks) ovariectomized rats, implantation of the E2 pellet had a large effect on the consumption of the novel diet. Intake was reduced to less than 1 g in all subjects on Days 3-7 after E2 pellet implantation. A subsequent two-choice preference test indicated the presence of a strong aversion to the novel diet in the estradiol-treated rats relative to the controls. These experiments show that estradiol can induce conditioned taste aversions that have either no effect on intake or totally suppress food intake, depending upon postovariectomy time. PMID- 1775563 TI - A measure of lateral paw preference in the mouse. AB - A lateral paw preference testing unit is described. Mice are allowed access to preferred food with either their left or right forepaw, and the amount eaten with each paw is measured. The unit allows easy measurement and quantification of this behavior, without requiring food deprivation or continuous monitoring of the subjects, and may be performed in the subject's home cage. Its reliability under a number of conditions is reported. The results do not correlate with those obtained using the Collins paw preference test. PMID- 1775564 TI - A computer-aided procedure for measuring Lashley III maze performance. AB - As an animal swims through the Lashley III maze, an observer types into a Macintosh computer the path taken. The computer program, Observe Software, then breaks the string of choices into two-step sequences and counts the number of such sequences. These data are then sent to a spreadsheet, where the sequences are sorted into forward and backward responses. Forward choices are Correct Path, T Choice Errors and Cul Entry Errors. All backward choices are errors, by definition. They are classified as T Choices, Cul Entries, Cul Exits, and Return to Start. The animal's behavior is then described by the various error classes plus a measure called Learning Index. Examples of learning by rats and mice are presented. PMID- 1775565 TI - Heterosexual activity and cycle length variability: effect of gynecological maturity. AB - Previous studies linking heterosexual activity to women's menstrual cycle variability have failed to take into account the effects of gynecological maturity. One hundred thirty-two women, all at least seven years postmenarche and not using birth control pills, completed daily records of their cycles and their heterosexual behavior. Data from women classified as sexually celibate or as regularly sexually active (having sex at least once per week in every nonmenstruating week) replicated previous findings while controlling for gynecological maturity: Women classified as celibate had more variable cycles than women who engaged regularly in heterosexual activity. An interaction between gynecological maturity and sexual status was also found, precluding a comparison involving women who were sexually active on an irregular basis. The interaction revealed that increased gynecological maturity is associated with less variable cycles in the sexually sporadic women, but is not associated with cycle variability in either celibate or sexually regular women. Possible biological mechanisms for these findings and their implications are discussed. PMID- 1775566 TI - Motor responsiveness to stimuli presented during sleep: the influence of time-of testing on sleep stage analyses. AB - The relationship between time-of-night of testing (circadian factors) and motor responsiveness to stimuli presented during different stages of sleep was examined. Nine males slept for two nonconsecutive nights in the laboratory. On Night 1, tympanic temperature was assessed at 30 min intervals. On Night 2, responsiveness was assessed with an incremental series of tones presented in sleep stages 2, 3/4, and REM throughout the night. Subjects were instructed to make a microswitch closure to the tones. Results showed that for all stages, responsiveness decreased across thirds of the night. Because the distribution of each sleep stage differed across the night, the effects on responsiveness due to time-of-testing and to sleep stage were confounded. When time-of-testing was held constant, responsiveness was greater in stages 2 and REM than in stage 3/4. When time-of-testing was not held constant, effects nearly opposite of the latter could be demonstrated. PMID- 1775567 TI - Blood pressure responses and drinking following central angiotensin II in adult rats guanethidine-sympathectomised at birth. AB - Rats pups were sympathectomised with daily, for 3 weeks, injections of guanethidine (0.01 ml/g body weight), starting the second day after birth. They were separated from their respective dams at 6 weeks, and when they had reached their adult weight (350 g), the males were used to study the role of the sympathetic nervous system in the blood pressure and drinking responses to central injections of angiotensin II (AII, 250 ng). Littermates injected with 0.15 NaCl served as controls. Mean blood pressure was similar in both experimental and control groups (118 +/- 6 versus 128 +/- 4 mmHg) though the sympathectomised rats had a less stable baseline blood pressure than the controls. AII injected into the third cerebral ventricle produced similar increases in blood pressure and drinking responses in both groups. From these results we conclude that other systems appeared to have compensated for the lack of the sympathetic nervous system in normal blood pressure regulation and in stimulated (AII) blood pressure increases. PMID- 1775568 TI - Why are natural plant medicinal products effective in some patients and not in others with the same disease? AB - We had previously found that the clinical efficacy of natural medicinal products was significantly enhanced by pretreatments of the natural compounds with far infrared radiation heating and brewing that effected degradation of high molecular polymers to yield free forms of low molecular monomers with anti oxidant activity. The gastric samples from the patients were incubated with untreated or treated natural products, and the resulting materials assayed in vitro for the capacity to scavenge reactive oxygen species (ROS). The gastric fluid of patients who had responded to the untreated natural products showed a significantly greater scavenging ability than did the patients who had not responded to these agents. Similarly, the gastric fluid of patients who responded only to the treated, commercial products also showed a slightly greater scavenging ability than did those who failed to respond to any agent, treated or untreated. Acid and pepsin contents were demonstrated in largest amounts in the gastric juice from the patients who had responded well to the untreated natural medicines. Furthermore, the materials incubated with gastric fluid from the responding patients produced an increase in the free forms of alpha-tocopherol, beta-carotene, and flavoprotein as compared with the fluids of nonresponding patients. These findings suggest that one of the factors determining the clinical response to natural herbal medicinal products is the ability of the patient's digestive system to degrade the product to liberate bioactive low molecular compounds from repeating polymers. PMID- 1775569 TI - An experimental evaluation of possible teratogenic potential in Boerhaavia diffusa in Albino rats. AB - The present study was undertaken to evaluate any possibility of teratogenic effects in Boerhaavia diffusa (Punarnava), a widely used herbal medicine for renal and urinary tract diseases by Ayurvedic physicians in India. The ethanolic extract of Boerhaavia diffusa (BDE) was administered daily in a dose of 250 mg/kg, body weight p.o., to pregnant albino female rats during the entire period of gestation. BDE was found to be devoid of any teratogenic effect as litter size and survival rate of foetuses were the same as for the normal control group and no foetal anomaly could be detected. PMID- 1775570 TI - Cardiotonic action of plumbagin on guinea-pig papillary muscle. AB - Plumbagin, an active principle from Plumbaginaceous plants, produced a triphasic inotropic response (first positive, second negative, and third positive phases) in guinea-pig papillary muscle. The inotropic potency of plumbagin at the first positive phase was pD2 6.40, and the methylation of 5-hydroxy group of plumbagin reduced the potency. The triphasic pattern of inotropism of plumbagin was unaffected by reserpine or propranolol treatments. Plumbagin did not produce the positive inotropic effects under anoxic conditions or in the presence of mitochondrial oxidative phosphorylation inhibitors such as 2,4-dinitrophenol and dicumarol. PMID- 1775571 TI - Effect of gomisin A in the prevention of acute hepatic failure induction. AB - Nearly all rats develop massive hepatic cell necrosis and die upon intravenous administration of heat-killed Propionibacterium acnes followed by a small amount of Gram-negative lipopolysaccharide 7 days later. However, when such an experimental liver disorder is induced in rats raised for 4 or more weeks on food containing 0.06% of gomisin A extracted and purified from Schizandra chinensis, the survival rate rises, histological changes of the liver improve remarkably, and splenocyte reactivity to phytohemagglutinin and pokeweed mitogen as well as splenocyte interleukin 1 productivity are retained. These results suggested the possibility that the development of acute hepatic failure may be prevented with the oral administration of gomisin A. PMID- 1775572 TI - Immunomodulatory activity of polysaccharide from Acanthopanax obovatus roots. AB - The effects of the Acanthopanax obovatus polysaccharide (AOPS) as well as its combination with cyclophosphamide (CY) or prednisolone on immune responses were investigated in mice. AOPS (250 mg/kg i.p. x 5) increased the spleen weight and the number of spleen cells, and augmented the phagocytosis of peritoneal macrophages both in normal mice and in immunosuppressed mice. In a haemagglutinin assay AOPS increased the production of specific antibodies and antagonized the suppressive effect of CY. AOPS not only enhanced the degree of in vitro spleen cell-mediated red blood cells (SRBC) hemolysis (quantitative hemolysis of SRBC) but also restored the suppressive effect of CY completely. From these results, AOPS was shown to have an enhancing and a modulating activity on immune responses. PMID- 1775573 TI - Antiamoebic and antiplasmodial activities of alkaloids isolated from Strychnos usambarensis. AB - Seven alkaloids isolated from Strychnos usambarensis have been assessed for in vitro activities against Entamoeba histolytica and Plasmodium falciparum and for in vivo activity against Plasmodium berghei in mice. Strychnopentamine and 3',4' dihydrousambarensine were highly active against P. falciparum in vitro, but were inactive and non-toxic against P. berghei in vivo. Usambarensine, usambarine, and 18,19-dihydrousambarine were highly active against E. histolytica in vitro, but were less active against P. falciparum in vitro. Nb-Methylusambarensine was less active against both protozoa than was usambarensine, and akagerine possessed little antiprotozoal activity. Structure-activity relationships are discussed in the context of the reported cytotoxic and pharmacological properties of these alkaloids. PMID- 1775574 TI - Antimalarial activity of Tanzanian plants and their active constituents: the genus Uvaria. AB - Petroleum ether, dichloromethane, and methanol extracts of leaves, stem, and root bark of nine Uvaria species: U. dependens, U. faulknerae, U. kirkii, U. leptocladon, U. lucida ssp. lucida, Uvaria sp. (Pande)k U scheffleri, and U. tanzaniae were tested for their in vitro activity against the multidrug resistant K1 strain of Plasmodium falciparum. The IC50 values of the extracts varied between 5 and 500 micrograms/ml. The most active extracts were obtained from the stem and root bark of U. lucida ssp. lucida and Uvaria sp. (Pande) and the root bark of U. scheffleri, all of which had IC50 values between 5 and 9 micrograms/ml. Among the compounds isolated, uvaretin, diuvaretin, and (8',9' dihydroxy)-3-farnesylindole were the most active (IC50 = 3.49, 4.20, and 2.86 micrograms/ml, respectively). PMID- 1775575 TI - Comparison of the antimicrobial and cytotoxic activities of twenty unsaturated sesquiterpene dialdehydes from plants and mushrooms. AB - Twenty unsaturated sesquiterpene dialdehydes were tested for antimicrobial, algaecidal, cytotoxic, and mutagenic activity. In addition to the known antifungal activity, polygodial (1) also exhibited antibacterial and cytotoxic activity; epipolygodial (2) was slightly less active. The most active compounds were: isovelleral (7), isoisovelleral (8), velleral (20), and methylmarasmate (6). With the exception of velleral (20), they also exhibited mutagenic activity in the Salmonella/microsome assay. Derivatization to less polar compounds usually increased the antimicrobial and cytotoxic effects and reduced mutagenicity, while the introduction of hydroxyl groups had the reverse effect. PMID- 1775576 TI - Chemical, physiological, and toxicological aspects of the essential oil of some species of the genus Bystropogon. AB - The composition of the essential oils of Bystropogon plumosus, B. origanifolius var. palmensis, B. wildpretii, B. maderensis, and B. canariensis var. smithianus were studied by GLC and GLC/MS. The first four species provide relatively similar oils characterized by monoterpene ketones as the main constituents while the last species is quite different with main constituents consisting of mono- and sesquiterpene hydrocarbons. In B. plumosus the ontogenetic variation of the monoterpene ketones was studied for a period of four years. During this time the behaviour of pulegone was inversely correlated with that of menthone and isomenthone. Pulegone was the most active compound of the monoterpene ketones in antimicrobial tests using three species of bacteria and fungi, respectively. PMID- 1775577 TI - T-cadinol: a pharmacologically active constituent of scented myrrh: introductory pharmacological characterization and high field 1H- and 13C-NMR data. AB - Fractionation of an ethyl acetate extract of scented myrrh (resin of Commiphora guidottii Chiov., Burseraceae), using the guinea pig ileum test to monitor pharmacological activity, resulted in isolation of the sesquiterpene (+)-T cadinol. High field NMR spectroscopy yielded new detailed 1H- and 13C-NMR data for the compound. T-cadinol was shown to have a concentration-dependent smooth muscle relaxing effect on the isolated guinea pig ileum and a dose-dependent inhibitory effect on cholera toxin-induced intestinal hypersecretion in mice. PMID- 1775578 TI - [Isolation of the antiphlogistic principle from Epilobium angustifolium]. AB - From the leaves of Epilobium angustifolium L. (Onagraceae) an antiphlogistic principle was isolated and identified as myricetin 3-O-beta-D-glucuronide. This novel flavonoid exhibited a very strong anti-inflammatory effect on carrageenan induced edema in the rat hind paw (more than ten times more effective than indomethacin) and an inhibitory effect on prostaglandin biosynthesis (as effective as indomethacin). PMID- 1775579 TI - Identification and HPLC quantitation of the sulfides and dialk(en)yl thiosulfinates in commercial garlic products. AB - The content of dialk(en)yl thiosulfinates, including allicin, and their degradation products has been determined by high performance liquid chromatography (HPLC), using the respective determined extinction coefficients, for a number of commercially available garlic products. Quantitation has been achieved for the thiosulfinates; diallyl, methyl allyl, and diethyl mono-, di-, tri-, tetra-, penta-, and hexasulfides; the vinyldithiins; and (E)- and (Z) ajoene. The thiosulfinates were found to be released only from garlic cloves and garlic powder products. The vinyldithiins and ajoenes were found only in products containing garlic macerated in vegetable oil. The diallyl, methyl allyl, and dimethyl sulfide series were the exclusive constituents found in products containing the oil of steam-distilled garlic. Typical steam-distilled garlic oil products contained about the same amount of total sulfur compounds as total thiosulfinates released from freshly homogenized garlic cloves; however, oil macerated products contained only 20% of that amount, while garlic powder products varied from 0 to 100%. Products containing garlic powder suspended in a a gel or garlic aged in aqueous alcohol did not contain detectable amounts of these non-ionic sulfur compounds. A comparison of several brands of each type of garlic product revealed a large range in content (4-fold for oil-macerates and 33 fold for steam-distilled garlic oils), indicating the importance of analysis before garlic products are used for clinical investigations or commercial distribution. PMID- 1775580 TI - [Formation of allicin from dried garlic (Allium sativum): a simple HPTLC method for simultaneous determination of allicin and ajoene in dried garlic and garlic preparations]. AB - In garlic (Allium sativum L.) the enzyme alliin lyase catalyzes the cleavage of alliin into allicin which reacts further to furnish ajoene. A simultaneous determination of allicin and ajoene is introduced which, in contrast to the determination of alliin only, allows for the testing of the activity of alliin lyase. It can be demonstrated that at a pH value of less than 3 the enzyme produces only small amounts of allicin. For this reason preparations from garlic should be administered only as enteric-coated formulations. PMID- 1775581 TI - New perylenequinones from Shiraia bambusicola. AB - Two new perylenequinones, named hypocrellin B and C, together with the known hypocrellin A were isolated from the stromatal tissues of Shiraia bambusicola. The structures of these compounds, including the absolute stereochemistry, were determined. PMID- 1775582 TI - Cytotoxic clerodane diterpenes from Polyalthia longifolia. AB - Bioassay-directed chemical investigation of the stem bark of Polyalthia longifolia Thw. (Annonaceae) has led to a novel clerodane diterpene, 16-oxo cleroda-3, 13(14)Z-dien-15-oic acid, which was named polyalthialdoic acid (3). The bioassays also led to the previously known related diterpenes, kolavenic acid (2) which has not been reported as a constituent of this plant, and 16 alpha hydroxy-cleroda-3,13(14)Z-dien-15,16-olide (1) which is previously known to be in this plant. These structures were identified by chemical and spectroscopic methods. All three compounds (1-3) were significantly bioactive in the brine shrimp bioassay; they strongly inhibited the growth of crown gall tumors on potato discs; and they were cytotoxic in three human tumor cell lines. These activities suggest potential antitumor applications. Compound 3 was the most active (ED50 values ca. 6 x 10(-1) micrograms/ml in the human tumor cell culture systems). PMID- 1775583 TI - Echinacea: anatomy, phytochemical pattern, and germination of the achene. AB - The achenes (fruits) of the therapeutically used Echinacea species E. purpurea, E. angustifolia, and E. pallida can be differentiated structurally (shape, anatomy) as well as phytochemically (essential oil components, alkamides). During germination in all three species dodeca-2E, 4E, 8Z, 10E(10Z)-tetraenoic acid isobutylamide (8/9) is mainly formed. Besides this a number of alkamides typical for the root of E. purpurea are synthesized in moderate amounts. Also, alkene derivatives of isovalerianic acid are produced. It is an interesting fact that neither 2-monoene alkalmides nor polyacetylenes could be detected during achene germination. PMID- 1775584 TI - Alkaloids from Dehaasia incrassata. PMID- 1775586 TI - 29th annual meeting of the American College of Neuropsychopharmacology. San Juan, Puerto Rico, December 1990. PMID- 1775585 TI - Lepenine and denudatine: new alkaloids from Aconitum kusnezoffii. PMID- 1775587 TI - Myo-inositol attenuates two specific behavioral effects of acute lithium in rats. AB - Acute and chronic lithium treatment reduces levels of brain myo-inositol in rats. Several biological effects of lithium can be reversed in vitro by addition of myo inositol. The ability of myo-inositol to reverse behavioral effects of lithium was tested using chronic inositol administration or acute intracerebroventricular (i.c.v.) injections. Chronic myoinositol elevated activity during the first 10 min in an open field, but did not reverse lithium-induced hypokinesia. Myo inositol (i.c.v.) reversed the suppression of rearing behavior 24 hrs after an acute dose of lithium (5 mEq/kg) but did not attenuate hypokinesia 24 hrs after a high dose of lithium (10 mEq/kg). Myo-inositol, but not the inactive isomer chiro inositol (i.c.v.), also significantly prolonged the latency to clonus in the lithium pilocarpine seizure model. These studies suggest that reduction of brain myo-inositol may be a critical mechanism for the behavioral effects of lithium. PMID- 1775588 TI - Muscarinic receptor regulation and protein kinase C: sites for the action of chronic lithium in the hippocampus. AB - Regulation of muscarinic receptor activity in critical regions of the limbic system may represent a site for the therapeutic action of lithium. Muscarinic receptors in the hippocampus are coupled to phosphoinositide (PI) hydrolysis and the generation of the second messengers inositol (1,4,5) trisphosphate [Ins (1,4,5)P3] as well as diacylglycerol (DAG), which can directly activate protein kinase C (PKC). Since lithium may affect the regeneration of critical receptor coupled pools of phosphatidylinositol 4,5-bisphosphate, studies in our laboratory have investigated the effects of chronic lithium on the regulation of the muscarinic receptor response. We have recently demonstrated that, following chronic administration of atropine in control and chronic lithium animals, there is an up-regulation of muscarinic receptor binding sites in the hippocampus; however, a concomitant sensitization of the carbachol-stimulated PI response is observed only in control animals. We have so far detected no effects of either in vitro or in vivo lithium on muscarinic receptor interactions with G proteins. However, we have observed a reduction in the in vitro phosphorylation of a major PKC phosphoprotein substrate in the rat hippocampus, following chronic lithium treatment. This effect may be related to long-lasting changes in regulation of receptor activity. PMID- 1775589 TI - Signal transduction modulation by lithium: cell culture, cerebral microdialysis and human studies. AB - Considerable evidence suggests that signal transduction pathways are targets of lithium (Li) action. A number of investigators have reported that Li attenuates both adenylate cyclase (AC) activity and phosphoinositide (PI) turnover in rodents and in humans, thus "dampening" these systems. We have studied selected components of these second-messenger systems in a series of clinical and preclinical investigations. To overcome confounding effects of alterations in mood state, we examined AC activity and G-protein ribosylation in peripheral blood cells from 10 healthy volunteers, prior to and following 14 days of Li administration. Basal and postreceptor [cesium fluoride (CsF) or Gpp(NH)p] stimulated AC activity were unaffected in lymphocytes. In contrast, both basal and stimulated AC activity in platelets were significantly augmented, compatible with an attenuation of Gi function. Ribosylation of platelet Gs by cholera toxin was unchanged, whereas that of Gi by pertussis toxin (PT) was increased. Given that undissociated G protein is the preferred substrate for PT, our results suggest that Li interferes with subunit dissociation and the subsequent activation of Gi. To determine if Li has similar effects on Gi in the central nervous system, we measured extracellular (EC) cyclic adenosine monophosphate (cAMP) in rat brain by in vivo microdialysis, revealing a dose-dependent increase in cAMP by norepinephrine (NE) antagonized by propranolol. Chronic (4-week) Li doubled basal EC cAMP, while decreasing the fractional response to 100 microM NE. Thus, using in vivo microdialysis, we observed the reported reduction in NE stimulated AC activity, but only as a function of elevated basal cAMP. Increased basal AC activity has been observed following chronic Li in both humans and rat tissues but generally has not been considered relevant. The PI generating system is another proposed major target for Li that we have studied using an in vitro cell culture model of peripheral blood cells. Chronic (6-day) exposure of neutrophil-like HL60 cells to 1 mM LiCl did not affect agonist fMet-Leu-Phe (fMLP) induced PI turnover. In contrast, Li attenuated both agonist and phorbol ester stimulated Na+/H+ exchange, suggesting reduced protein kinase C (PKC) function. Western blot analysis revealed altered levels of PKC in both membrane and cytosolic fractions. The functional consequences of these complex effects on the two major signal transduction pathways and their interactions in the intact living organism remain to be elucidated. PMID- 1775590 TI - Statistical efficiencies that the FDA should encourage. AB - The Food and Drug Administration (FDA) has a dual responsibility to the public of protecting against unsafe or ineffective drugs while efficiently licensing new drugs that are safe and effective. Balancing these two responsibilities requires correct safeguards that are also efficient in minimizing time, cost, and patient exposure to ineffective or unsafe experimental conditions. Reliance on statistical probabilities that do not relate to the question being asked, conservatively biased tests of significance, statistically inconsequential interim-analysis procedures, and largely superfluous active control groups in three-arm designs are discussed as problems. In each of these cases, design and analysis methods that are both correct and more efficient are available. Their use can reduce sample-size requirements and enhance power for documenting meaningful treatment effects. PMID- 1775591 TI - To increase power in randomized clinical trials without increasing sample size. AB - The power of a randomized clinical trial (RCT) depends on two factors: sample size and effect size. Most psychiatric research design strategies focus on increasing sample size, despite major problems in recruiting large numbers of subjects or funding such costly studies. It is possible to increase power in RCTs in a variety of ways without increasing sample size, in essence by increasing effect size by decreasing within-group variance. Such strategies are presented and discussed. PMID- 1775592 TI - A note on randomization and selection bias in maintenance therapy clinical trials. AB - In this article we demonstrate that even in randomized controlled clinical trials, unobserved confounding variables can bias the outcome of a study. For the case of a two-phase maintenance therapy trial where patients who respond to treatment during the acute phase are then randomized to a maintenance therapy, we show explicitly the role that confounding may play in biasing the interpretation of the results of such a trial. We suggest an alternative design to deal with the problem of a selection effect for treatment responders in the acute phase of the trial by randomizing patients at the outset of the study to both an acute and maintenance therapy. PMID- 1775593 TI - Clinical factors that may confound the assessment of drug efficacy. AB - The development of new chemical classes of psychotherapeutic drugs offers the potential for new patterns of drug efficacy as well as decreases in side effects. However, the determination of drug efficacy can be confounded by sample selection and outcome determination factors. The ability of selected clinical factors of both types to affect the outcome of antipsychotic drug trials is reviewed. Suggestions for future clinical drug trials are made. PMID- 1775594 TI - Results of extended peptide T administration in AIDS and ARC patients. AB - We report here the extended Phase I testing of d-ala-Peptide-T-amide (Peptide T) in open trial. The drug was given intravenously in doses ranging from 0.1 to 3.2 mg/kg/day to 14 acquired immunodeficiency syndrome (AIDS) and AIDS-related complex (ARC) patients for 12 weeks. Following a 4-week off-drug period, the first 6 patients finishing the intravenous testing were continued on intranasal drug, 25 mg/day, for 8 weeks. Control subjects were tested on the same neuropsychologic tests, but did not receive drug. Minimal evidence of toxicity was found. Performance increments in cognitive and neuromotor function were observed in patients with moderate neuropsychologic impairment compared with controls. Changes in constitutional symptoms included weight gain averaging 2 kg and reported improved sense of well-being. The latter findings were independent of variation in cognitive and neuromotor function. Measures of immunologic function and antiviral activity did not change significantly during the study. These data provide a scientific rationale for Phase II testing of Peptide T in human immunodeficiency virus-1 (HIV-1) patients focusing on neuropsychiatric outcome. PMID- 1775595 TI - Effect of desipramine on inositol phosphate formation and inositol phospholipids in rat brain and human platelets. AB - To examine the mechanism of action of antidepressant drugs, we studied the effect of desipramine (DMI) in vitro on agonist-stimulated inositol phosphate formation and inositol phospholipids in rat brain and human platelets. We observed that DMI inhibited thrombin-stimulated 3H-inositol bisphosphate (IP2) and 3H-inositol trisphosphate (IP3) but not 3H-inositol monophosphate (IP1) formation in human platelets. DMI also inhibited norepinephrine (NE) and serotonin (5-HT) stimulated 3H-IP1 formation in rat cerebral cortex. DMI increased levels of all three 3H inositol phospholipids, 3H-phosphatidyl inositol (PI), 3H-PI-4-phosphate (PIP), and 3H-PI 4,5-bisphosphate (PIP2), in both platelets and rat cortex. The decreased formation of inositol phosphates and increased levels of [3H]-PI, [3H] PIP, and [3H]-PIP2 by DMI appears to be due to the inhibition of the enzyme phospholipase C rather than its effects on receptors. It is thus possible that interaction of tricyclic antidepressant drugs with the PI-signaling system may be related to their mechanism of action. PMID- 1775596 TI - Antidepressant interactions with corticotropin-releasing factor in the noradrenergic nucleus locus coeruleus. AB - Corticotropin-releasing factor (CRF) has been implicated as a neurotransmitter in the noradrenergic nucleus, locus coeruleus (LC), and is thought to be hypersecreted in depression. Therefore, the hypothesis that antidepressants interfere with CRF neurotransmission in the LC was tested. The acute and chronic effects of desmethylimipramine (DMI), sertraline (SER), phenelzine (PHE), mianserin (MIA), and cocaine (COC) were quantified on LC spontaneous discharge, LC sensory-evoked discharge, LC activation by intracerebroventricular (i.c.v.) administered CRF, and LC activation by stress in halothane-anesthetized rats. No consistent effect of the drugs on LC spontaneous discharge rate or sensory responsiveness was observed after acute administration. LC spontaneous discharge rates in rats chronically administered the drugs were similar to rates recorded in matched controls, with the exception of PHE and COC. In these rats, LC spontaneous discharge rates were lower than those of untreated rats. Interestingly, LC responses to repeated sciatic nerve stimulation (as measured by the ratio of evoked-to-tonic LC discharge rate) were enhanced in rats chronically administered SER and PHE. This is opposite to the reported effects of i.c.v. administered CRF. This was not observed with chronic administration of DMI, MIA, or COC. The most striking effect associated with chronic administration of DMI and MIA was the attenuation of LC activation by hemodynamic stress. Because this activation requires CRF release in the LC region, and because none of the antidepressants altered LC activation by i.c.v.-administered CRF, the data suggest that chronic administration of either antidepressant, DMI or MIA, results in attenuation of stress-elicited CRF release in the LC.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775597 TI - Who should receive antidepressants: suggestions from placebo treatment. AB - Placebo-controlled antidepressant clinical trials consistently show that a depressive episode lasting more than a year is associated with a relatively low placebo response rate. The response to antidepressants, however, appears unrelated to episode duration. PMID- 1775598 TI - Anger attacks in depressed outpatients and their response to fluoxetine. AB - "Anger attacks" are spells of anger that are inappropriate to the situation and have physical features resembling panic attacks. The Anger Attacks Questionnaire, designed to assess these attacks, was administered to 79 consecutive patients (25 men and 54 women, mean age 38.8 +/- 10.3 years) diagnosed as having major depression with the Structured Clinical Interview for DSM-III-R. Of these 79 depressed patients, 34 (13 men and 21 women) reported having anger attacks according to our criteria. The prevalence of anger attacks in a group of 31 younger depressed patients (48%) was significantly higher (p = .048) than that of 29 normal controls (21%) of similar age. Of the 79 depressed patients, 19 (7 men, 12 women) were treated openly with fluoxetine at 20 mg/day for at least 8 weeks. At pretreatment, 9 patients (47%) had reported anger attacks, only 3 (16%) continued to report them after treatment, and the difference was statistically significant (p less than .05). PMID- 1775599 TI - Saliva and plasma desipramine levels in Asian and Caucasian volunteers. AB - Thirty-seven healthy volunteers (18 Asian, 19 Caucasian) ingested a single desipramine (DMI) dose of 1.0 mg/kg of body weight. Saliva and plasma samples were obtained at 1, 3, 5, 7, 12, 24, 48, 72, and 96 hrs after dosing. A nested repeated-measures analysis of variance (ANOVA) design was used to determine if the plasma/saliva DMI ratio varied between Asians and Caucasians over time. Regression analysis was used to assess the ability of saliva DMI to predict plasma DMI at any time point. The ANOVA results indicated no significant differences in DMI plasma/saliva ratios between Asians and Caucasians. There was a major effect of sampling time on the DMI plasma/saliva ratio (p = 0.0001), with the ratio falling from 1.78 at 1 hr to 0.15 at 96 hrs. At any given time at least 24 hrs after the dose, there was a significant relationship between saliva and plasma levels across individuals. However, across subjects, the 95 percent confidence limits for predicting plasma DMI from saliva DMI levels were relatively large. The potential roles and limitations of saliva DMI in pharmacokinetic studies and clinical drug monitoring are discussed. PMID- 1775600 TI - Mianserin in the treatment of ethanol withdrawal in the rat: prevention of behaviors indicative of anxiety. AB - The present investigation was a pilot study to determine whether a single dose of mianserin, which produces long-term down-regulation of serotonin1C (5-HT1c) and 5 HT2 receptors, would prevent anxiogenic behaviors occurring during ethanol withdrawal as evaluated in the elevated plus maze. Male Long-Evans hooded rats were fed a liquid diet containing 4.5 percent ethanol for 4 days. Mianserin (20 mg/kg, i.p.) was injected on the morning of the third day of ethanol administration, or 48 hrs and 7 days prior to testing. When animals were tested either 12 hrs (acute withdrawal) or 5 days (protracted withdrawal) after the last dose of ethanol, anxiogenic behaviors were observed as a significant reduction in both percentage of open-arm entries and time spent on the open arms. In contrast, these anxiogenic behaviors were prevented by pre-injection with mianserin 48 hrs or 7 days prior to testing. Attenuation of this important symptom of ethanol withdrawal is of particular importance because, in addition to the nonaddicting properties of mianserin relative to current anxiolytics, the beneficial effects appear to be long lasting and can be achieved with a single dose. PMID- 1775601 TI - Verbal memory and plasma drug concentrations in elderly depressives treated with nortriptyline. AB - Performance on a verbal memory task and affective state were assessed in geriatric major depressives before and during 6 weeks of treatment with nortriptyline (NT) in a fixed-dose design study. Higher plasma NT concentration was associated with poorer free recall but better affective outcome. In contrast, higher plasma Z-10-hydroxynortriptyline (Z-10-OH-NT) concentration was associated with more efficient free recall. Concentration-effect relationships were noted in patients later classified as cognitively unimpaired using the Dementia Rating Scale after optimal treatment, rather than in those with residual cognitive impairment. PMID- 1775602 TI - Effects of nortriptyline on memory self-assessment and performance in recovered elderly depressives. AB - The effects of nortriptyline (NTL) on memory were compared with those of placebo (PBO), in elderly subjects after recovery from a major depression. Subjective and objective memory was assessed using a repeated-measures discontinuation design. Average immediate, but not delayed, free recall, on a 20-item selective reminding test was adversely affected by medication. Free recall on placebo was stable over four learning trials and at delay. A different pattern of responses occurred on nortriptyline: Performance dropped off significantly on learning Trial 2, remained worse than placebo through Trial 4, but improved after a 15-min delay. Performance on measures of immediate and delayed recognition memory were comparable on nortriptyline and placebo. Discontinuation of nortriptyline resulted in significant improvement on a subset of nine memory self-assessment items. On questions addressing ability to retrieve recently learned information, subjects reported the greatest improvement while on placebo compared with nortriptyline. PMID- 1775604 TI - Do blood pressure and age predict response to tacrine (THA) in Alzheimer's disease? A preliminary report. AB - Recent studies in major depression suggest that a pretreatment systolic orthostatic blood pressure (PSOP) fall of greater than or equal to 10 mm Hg in response to changing from a supine to a standing position may predict response to antidepressant treatment in older depressed patients. Because orthostatic blood pressure response is regulated, in part, by central cholinergic and noradrenergic systems, and both are implicated in Alzheimer's disease, PSOP was assessed as a predictor of initial response in Alzheimer's disease outpatients in a treatment protocol with tacrine, a cholinesterase inhibitor. We found that the magnitude of PSOP fall and increasing age each contributed to the prediction of response to tacrine. These results may suggest a relatively greater involvement of other neurotransmitter systems in younger, nonresponding Alzheimer's disease patients, and the results differ from those of a previous study. PMID- 1775603 TI - Pretreatment postural blood pressure drop as a possible predictor of response to the cholinesterase inhibitor velnacrine (HP 029) in Alzheimer's disease. AB - The failure of cholinesterase inhibitors to produce noticeable improvement in about half of patients with Alzheimer's disease (AD) may result from heterogeneity of neurotransmitter abnormalities in this disorder. This study examined whether pretreatment postural blood pressure (BP) drop, which presumably reflects sympathetic response, differed in patients who were responders or nonresponders to the cholinesterase inhibitor, HP 029. Twenty-three AD patients completed a double-blind dose-finding phase of a clinical trial in which four doses of HP 029 and placebo were administered. Evaluation for efficacy occurred after 7 days of treatment at each dose. Of the 23 patients, 12 were classified as responders in the dose-ranging phase of the study. Nonresponders demonstrated significantly greater decreases in pretreatment systolic postural BPs when going from a supine to sitting position than did responders. The greater postural BP drop in nonresponders may identify a subgroup of AD patients that responds poorly to cholinesterase inhibitors. PMID- 1775605 TI - Effects of long-term continuous infusion of the muscarinic cholinergic agonist arecoline on verbal memory in dementia of the Alzheimer type. AB - Alzheimer's disease (AD) is accompanied by depletion of cholinergic markers in the central nervous system. In an attempt to improve cognitive function in AD, arecoline (a muscarinic cholinergic receptor agonist) was given to patients with probable or possible AD in a two-phase design, and verbal memory function was examined. First, escalating doses of arecoline, range .5-40 mg/day, were administered by continuous intravenous infusion over a 2-week period. Based on neuropsychological test performance, an optimal dose of arecoline was identified, and this dose then was infused continuously for 5 days in a double-blind, placebo controlled, counter-balanced trial. Long-term recall on a selective reminding task was significantly improved (from 11.8 to 20.1 words, p less than .05) during dose finding by arecoline at 4 mg/day. Two of eight patients were nonresponders; that is, they showed no improvement at any dose during the dose-finding study. Responders demonstrated significant improvement on total recall (p less than .05) during the double-blind study. These results indicate that some patients demonstrate reliable improvements of verbal memory during arecoline treatment. PMID- 1775606 TI - Rapid serotonin depletion as a provocative challenge test for patients with major depression: relevance to antidepressant action and the neurobiology of depression. AB - Brain serotonin (5-HT) content is dependent on plasma levels of the essential amino acid, tryptophan (TRP). We have previously reported on the effects of rapid dietary TRP depletion in psychiatric patients; this study extends those reports and summarizes the effects of rapid TRP depletion on mood in depressed patients. One hundred and fifteen depressed (according to DSM-III-R) patients (69 drug free and symptomatic; 46 in clinical remission after antidepressant treatment) received tryptophan depletion testing in a double-blind, placebo-controlled, crossover fashion. Of 69 symptomatic, drug-free, depressed patients, 30 percent were unchanged the day of the tryptophan-free drink (TFD), but became clinically less depressed the day after the TFD. Although 80 percent of monoamine oxidase inhibitor- or fluvoxamine-treated patients experienced a depressive relapse during TRP depletion testing, only 18 percent of desipramine-treated patients relapsed. Brain 5-HT function may be intimately involved in the modulation of some affective states and in the mechanism of action of some antidepressant medications. PMID- 1775607 TI - The use of antidepressants for negative symptoms in a subset of schizophrenic patients. AB - The authors used a randomized, placebo-controlled design to assess the therapeutic efficacy of adjunctive imipramine, added to fluphenazine decanoate and benztropine, among well-stabilized, negative-symptom schizophrenia and schizoaffective disorder patients who additionally met operationalized criteria for postpsychotic depression. The outcome of the imipramine-treated group was superior in both global ratings and a specific negative-symptom scale. Exacerbation of psychotic symptomatology was not found to be problematic. The implications of this study are discussed in terms of a potential strategy for pharmacotherapy among certain negative-symptom patients and in terms of its relevance to a possible pathophysiological basis for the negative-symptom state. PMID- 1775608 TI - Depression as a prognostic factor for pharmacological treatment of cocaine dependence. AB - Pharmacotherapy response in depressed (n = 20) vs. nondepressed (n = 74) cocaine abusing methadone maintenance patients was compared in a 12-week, randomized, double-blind trial using amantadine at 300 mg daily (n = 33), desipramine at 150 mg daily (n = 30), and placebo (n = 31). Starting in Week 3, the depressed patients on medications reported significantly less cocaine usage than the depressed patients who received placebo. By Week 10, the medicated depressed patients (in treatment) reported a 96 percent decrease in cocaine usage and a 68 percent decrease in cocaine craving. During the last 2 weeks of treatment, 42 percent of the urine toxicologies of the medicated depressed patients were cocaine free, compared with only 6 percent of the placebo depressed patients. Also, the placebo nondepressed patients had significantly better treatment outcome compared with the placebo depressed patients. Thus, depression appears to be an important predictor of poor treatment outcome with relapse prevention therapy alone and of good response to cocaine abuse treatment with medication. PMID- 1775609 TI - Daily monitored cardiovascular effects of carbamazepine in chronic crack cocaine users. AB - During a 20-day, double-blind, placebo-controlled, fixed-dose outpatient trial of carbamazepine (either 200 mg or 400 mg) for potential anticocaine treatment effects in volunteers who were unmotivated for treatment and who lacked any external coercion for cocaine abstinence, we monitored cardiovascular effects in 30 subjects on a daily basis. All individual cardiovascular measures obtained were within clinically normal limits. Corrected QT interval under carbamazepine was shorter than under placebo condition, although both were in the normal range. Systolic pressure was elevated by 2.1 mm Hg. No differences in pulse rate were found. With carbamazepine and concurrent ad lib cocaine use, heart rate was significantly, although not clinically, elevated (mean increase = 2.3 beats/minute). The analysis of these approximately 600 observations indicates that carbamazepine in cocaine users, alone and in combination with ad lib street crack use, causes no clinically significant cardiovascular effects. PMID- 1775610 TI - Effects of unilateral-nondominant vs. bilateral ECT on memory and depression: a preliminary report. AB - Reported are preliminary results from a randomized, double-blind study comparing the differential effects of unilateral-nondominant (UND) and bilateral (BL) electroconvulsive therapy (ECT) on memory function and clinical efficacy. The study included the serial administration (before, shortly after, and 6 months following a course of ECT) of behavioral ratings and memory tests for dominant and nondominant, anterograde and retrograde memory functions. Thus far, clinical improvement shortly after a course of ECT and 6 months later was significant for the entire sample and did not differ between the UND and BL groups. Most memory ratings worsened significantly after ECT, but returned to baseline levels 6 months later. Surprisingly, the scores generally did not differ between the UND and BL groups at any time point. Clinical implications for choice of administration are discussed. PMID- 1775611 TI - Serotonergic responsivity in eating disorders. AB - Evidence suggests that serotonin may play a role in the pathogenesis of eating disorders. In this ongoing study, serotonin-mediated physiological responses and whole-blood serotonin content are measured in young women with an eating disorder during the active phase of the illness and at the conclusion of inpatient treatment. The responsivity of central nervous system (CNS) serotonergic pathways is assessed by neuroendocrine challenge with a 60-mg oral dose of dl fenfluramine, an indirect serotonin agonist, whereas the responsivity of the platelet serotonin2 (5-HT2) receptor complex is evaluated by measurement of the magnitude of serotonin-amplified platelet aggregation. Compared with normal controls, eating-disorder patients have exhibited a trend toward reduced prolactin responses to fenfluramine challenge at both the initial and followup assessments. Patients also have exhibited a substantially wider range of serotonin-amplified platelet aggregation responses than have controls; normal weight bulimic patients have had significantly greater responses than both anorexic restrictors and normal subjects. These preliminary results suggest potential alterations in serotonin-mediated responses in eating-disorder patients that may vary with the diagnostic subgroup. PMID- 1775612 TI - Predictors of side effects associated with lithium administration in children. AB - Data were pooled from three controlled and double-blind studies of lithium carbonate involving a total of 48 hospitalized children, and secondary data analyses were conducted. The objective was to assess whether there is a relationship between a child's chronological age and side effects associated with lithium administration. Two dependent measures of side effects were investigated: number of side effects per child and number of episodes of side effects per child. The children were diagnosed as having conduct disorder with a profile of severe aggressive and explosive behavior; their ages ranged from 5.08 to 12.92 yrs (mean, 9.23 yrs). For the entire sample of 48 children, the effect of age on side effects was statistically significant (p = .057); younger children had more side effects than older children. This relationship continued to hold after adjustment for weight, serum lithium levels, optimal dose, and duration of optimal dose. PMID- 1775613 TI - Nicotine potentiates the behavioral effects of haloperidol. AB - Nicotine potentiates the catalepsy produced by haloperidol. Furthermore, nicotine as an adjunct to haloperidol produces a remarkable improvement in motor tics in Tourette's syndrome (TS) patients. The present experiments (1) compared the ability of nicotine to potentiate the catalepsy produced by haloperidol or the selective D1 dopamine receptor antagonist SCH 23390 and (2) examined the effects of various doses of nicotine (0.1, 0.2, or 0.3 mg/kg) on haloperidol-induced (0.1, 0.2, or 0.4 mg/kg) catalepsy and locomotor hypoactivity. In the first experiment, nicotine produced a five-fold increase in catalepsy following haloperidol but had no effect on the catalepsy produced by SCH 23390. In the second experiment, nicotine potentiated the cataleptic effects of both the 0.2 and 0.4 but not the 0.1 mg/kg dose of haloperidol. Haloperidol (0.1 and 0.4 mg/kg) also produced a dose-related decrease in locomotion that was significantly potentiated by nicotine (0.1 mg/kg). Nicotine alone did not produce catalepsy or any significant changes in locomotion. These results indicated that nicotine's potentiation of haloperidol-induced catalepsy is likely related to striatal D2 receptor mechanisms. Nicotine potentiated the locomotor effects of doses of haloperidol that were previously found to be subcataleptic, indicating that catalepsy testing may actually underestimate the behavioral interaction between haloperidol and nicotine. Nicotine may prove useful for treating neuroleptic responsive disorders such as TS, schizophrenia, and Huntington's disease. PMID- 1775614 TI - Long-term alprazolam use: abuse, dependence or treatment? AB - Concern about persistent benzodiazepine use should be informed by data about reasons for such use. Consecutive long term alprazolam users (n = 25) admitted to an advertised outpatient program for discontinuation were characterized with respect to alprazolam use patterns and lifetime and current Axis I and II disorders. Patient characteristics were: females 50 percent; mean age, 46 +/- 12 yrs; prior medication use--benzodiazepines, 47 percent, antidepressants, 23 percent; median duration of use 104 +/- 96 wks; median daily dose, 0.5 mg; continued effectiveness of alprazolam 50 percent. Over the duration of use patients shifted their initial pattern of use from as prescribed to a self controlled "as required" basis (p less than .05). Interviews using the Structured Clinical Interview for DSM-III-R (SCID) yielded diagnoses of DSM-III-R alprazolam dependence in all patients plus at least one additional psychiatric diagnosis in 65 percent (Axis I 65%; Axis II 39%). Most persistent alprazolam use does not represent abuse or addiction as usually understood. These data are most consistent with the interpretation that alprazolam is the most recent benzodiazepine used by patients to help control clinically important psychopathology and that most users make efforts to control or stop use. PMID- 1775615 TI - Foreign body aspiration: experience at the University Pediatric Hospital. AB - Fifty eight patients were admitted to the University Pediatric Hospital with the diagnosis of foreign body aspiration from August 1986 to January 1991. Of this 58 admissions, 40 records were analyzed for incidence, clinical and radiological manifestations, morbidity and nature of the foreign material in an effort to compare our findings with those of other centers, including another previous study in our institution. Our data reveals that the event of aspiration of a foreign body was most common between 1 to 2 years of age, this comprises 18 (45%) of the cases; male to female ratio was 1:3; 17 (42.5%) cases were diagnosed during the first 24 hours of the event and another 42.5% were diagnosed after 48 hours. Coughing and a choking episodes were the most common signs of presentation with hyperaeration of the lung as the main radiological finding. The left main stem bronchus as the lodgement site and the peanut as the foreign object were the most common findings. The mortality ratio was 7.5%. It is important to make parents and health providers aware of patients at risk and knowledge of basic life support measures. PMID- 1775616 TI - Pheochromocytoma: a twenty year experience at the University Hospital. AB - During the past 20 years (1970-90), we had 24 patients with pheochromocytoma: 19 diagnosed clinically and 5 post-mortem. Their ages ranged from 17 to 74 (mean, 43.2 years). Males (n = 14) outnumbered females (n = 10), a 1.41:1 M:F ratio. A majority were symptomatic (95%), with a typical triad of headaches, palpitations and diaphoresis. Most frequent finding was hypertension (95%). It was sustained in 60% and paroxysmal in 35%. In 6 patients (25%) pheochromocytomas were bilateral, all familial. Fifteen were solitary adrenal tumors (63%); 3 (12.5%) were extra-adrenal: 2 intra-abdominal, and 1 cardiac paraganglioma of right atrium. Of 6 familial cases, 4 were associated to Von Hippel-Lindau (VHL) disease, while 2 were multiple endocrine neoplasia (MEN-II) patients. All familial cases were bilateral and in the adrenals. There were no malignancies. Among the 19 clinical cases pre-operative Dx was made by positive urine VMA or catecholamines urine levels: (95 and 100% sensitivity respectively). Preoperative visualization by CT or MRI was done in 62% of the most recent patients. In 5 earlier cases the diagnosis was made post mortem: 3 died of cerebral hemorrhage, 1 with a pons infarct and 1 with congestive heart failure (CHF). There were 2 post-operative deaths and another died 13 years later from thyroid medullary carcinoma. Of the 19 operated, 13 (68%) were cured. Thus pheochromocytomas retain considerable morbidity and some mortality. These rare tumors constitute a clinical diagnostic challenge yet a rewarding therapeutic experience for the alert physician. PMID- 1775617 TI - Electrocardiographic demonstration of dual atrioventricular nodal pathways in children. AB - Dual atrioventricular nodal pathways, as evaluated by electrocardiography, were found in two children without arrhythmias over a six year period. Although none have developed tachycardia, they have the substrate to develop atrioventricular reentrant tachycardia. PMID- 1775618 TI - The University of Puerto Rico and the University of Cadiz: a model of international academic cooperation. PMID- 1775619 TI - [Importance of the family as a resource in social support in Puerto Rico]. AB - In this article we examine the role of the family in the provision of social support by studying the identity of persons which the participants consider available for providing support. We define social support as that human relationship in which socio-emotional (closeness, intimacy counseling), instrumental (goods and services) and recreational (companionship for recreation) resources are interchanged. Based on a probabilistic sample of the adult (17-68 yrs.) population, 912 persons were successfully interviewed (response rate = 90.4%) using a structured interview schedule. Results indicate that close relatives (parents, brothers/sisters, sons/daughters) are the main resource of all types of support, not only of the general population but also of specific demographic groups defined by their gender, age (17-39, 40-68) and schooling (0 11, 12 + yrs). The marital partner was also identified as an important support resource, especially emotional and recreational; more distant relatives were also important for providing instrumental support. Although the compared groups showed many similarities, they also differed in various aspects both when individually and jointly analyzed. It is concluded that the family is very important in the provision of social support in Puerto Rico (PR). PMID- 1775620 TI - Education for public health in Puerto Rico: 1940-1942. AB - Formal training in public health in Puerto Rico began in 1940 when a degree granting Division of Public Health was established within the existing School of Tropical Medicine. The division was sponsored by five institutions--the Puerto Rico Department of Health, the U.S. Public Health Service, the Children's Bureau, the University of Puerto Rico, and Columbia University--each which had a different concept of the aims, scope and character of the training. Conflicts relating to these issues were exacerbated by managerial and budgetary problems, and the program began fitfully and with great difficulties. As a result, the training which was planned in 1940 and launched in 1941 was scrapped or redesigned the following year. PMID- 1775621 TI - [The use of evaluation results in decision making: presidential level]. PMID- 1775622 TI - The value of assessment in the decision making process. AB - The use of the term "assessment" and the technique of "Outcomes Assessment"- measuring tool (based on achievements) used by accreditation agencies--has caused great impact on educational institutions despite the fact that, to a certain extent, it has always been used in the educational systems. The goal of every educational institution is to achieve academic excellence. Excellence has been defined through resources--based on the possession of resources--and through its, reputational excellence--the position held in the reputational hierarchy of institutions. A third approach, denominated "Talent Development" as defined by Alexander Astin,--based on the institution's ability to develop the talent of its resources to a maximum level--is suggested. A suitable educational environment is required to encourage the achievement of this goal. The use of this model for "Outcomes Assessment" could be the most valuable tool in measuring the institutional effectiveness in reaching its goals. PMID- 1775623 TI - [The use of evaluation results in decision making and its articulation with distinct levels of academic management: department level, challenges and answers]. PMID- 1775624 TI - [Distribution and regulation of endothelin gene expression]. PMID- 1775625 TI - [Endocrine aspect of endothelin]. PMID- 1775626 TI - [Import of precursor proteins by isolated intact chloroplasts]. PMID- 1775627 TI - [Useful cell lines other than mammalian ones (I)--Fish cell lines]. PMID- 1775628 TI - [Natural C-P compounds--30 years' review]. PMID- 1775629 TI - [Studies on oryzacystatins]. PMID- 1775631 TI - [Useful cell lines other than mammalian ones (II)--Insect cell lines]. PMID- 1775630 TI - [Adhesion molecules and immunological disorders]. PMID- 1775632 TI - [Protein translocation by cell-free systems of Saccharomyces cerevisiae]. PMID- 1775633 TI - Stimulation of prostaglandin D2 receptors on human platelets by analogs of prostacyclin. AB - RS-93427, a novel analog of prostacyclin, increased adenylate cyclase activity in human platelet membranes (EC50 = 42 nM) to approximately the same maximum level as that produced by prostacyclin (EC50 = 87 nM). The concentration-response curve for RS-93427 appeared to be monophasic. However, a selective prostaglandin D2 antagonist (BW A868C) significantly reduced the stimulation of adenylate cyclase produced by low concentrations of RS-93427 (3.2 to 32 nM). RS-93520, a stereoisomer of RS-93427, also stimulated adenylate cyclase activity but in a biphasic pattern. BW A868C reduced the activation produced by low concentrations of RS-93520 with a 100-fold shift in the response curve. Maximum stimulation by RS-93520 (4.5-fold) was less than that obtained with prostaglandin D2 (7.3-fold). Thus, the stimulation of adenylate cyclase activity by low concentrations of RS 93520 is due to an interaction with prostaglandin D2 receptors while the activation by RS-93427 is mediated by both prostacyclin and prostaglandin D2 receptors. Additional data in support of these conclusions was obtained when these prostaglandins were tested as inhibitors of ADP-induced platelet aggregation in the presence or absence of BW A868C. The potent stimulation of prostaglandin receptors with chimeric molecules provides some insight into the structural features required for receptor activation. PMID- 1775634 TI - Arachidonic acid metabolism and prostaglandin production by primate preimplantation blastocysts. AB - Preimplantation embryos of many species are known to synthesize prostaglandins. These tissue hormones are believed to influence embryonic metabolism, as well as embryo-maternal interaction during implantation although their putative role(s) remains obscure. Here, prostaglandin production by blastocysts from cynomolgus monkeys (Macaca fascicularis) was examined qualitatively during in vitro culture. Tritium labelled arachidonic acid was metabolized to 6 keto-prostaglandin F1 alpha, 2,3-dinor-prostaglandin F1 alpha and thromboxane B2, as characterized by HPLC separation. Also, 6-keto-prostaglandin F1 alpha, and thromboxane B2 as characterized by HPLC separation. Also, 6-keto-prostaglandin F1 alpha and thromboxane B2 were identified by specific RIA's. Our data suggest that the main arachidonic acid metabolites produced by blastocysts of cynomolgus monkeys are prostacyclin and thromboxane. PMID- 1775636 TI - Role of prostaglandins and leukotrienes in the synergistic effect of oxytocin and corticotropin-releasing hormone (CRH) on the contraction force in human gestational myometrium. AB - We have recently demonstrated that corticotropin releasing hormone (CRH) potentiates the contractile response to oxytocin of human gestational myometrium, using a high flow microsuperfusion system and electrical field stimulation. We now report this potentiation to be equivalent to that of 1 nM prostaglandin F2 alpha (PGF2 alpha), while 10 nM PGF2 alpha did not potentiate the response to oxytocin. Prostaglandin E2 (PGE2) also showed no augmentation of the contraction force of the myometrium in response to oxytocin. The CRH potentiated response was inhibited by the lipoxygenase and cyclooxygenase inhibitor BW755C (1 microM) and by indomethacin (0.1 microM), but not by the lipoxygenase inhibitor BW4C (1 microM). Measurements of prostaglandins in the superfusate showed no significant trends. It is concluded that the potentiation of contraction force to oxytocin by CRH is dependent on prostaglandins, probably PGF2 alpha and that leukotrienes, generated via the lipoxygenase pathway are not involved. PMID- 1775635 TI - Vitamin D3 stimulates the production of prostacyclin by vascular smooth muscle cells. AB - The effects of vitamin D3 on the production of prostacyclin (PGI2) by cultured rabbit vascular smooth muscle cells (VSMCs) were investigated. PGI2 synthesis by VSMCs was significantly increased in the presence of 1,25-dihydroxyvitamin D3 (1,25(OH)2D3) and 1 alpha hydroxyvitamin D3 (1 alpha(OH)D3) at 48 hours [1,25(OH)2D3 greater than 1 alpha(OH)D3]. Physiological concentration of 1,25(OH)2D3 (10(-10) M) significantly increased the synthesis of PGI2. Further, we observed that treatment with 1,25(OH)2D3 significantly induced the activity of cyclooxygenase without changing the activity of phospholipase A2. These findings suggest that the mechanism of action of 1,25(OH)2D3 on the synthesis of PGI2 is mediated by the cyclooxygenase pathway. It seems possible that vitamin D3 is a vasoactive agent and may play a protective role in the development of atherosclerosis. PMID- 1775637 TI - Prostaglandin E and E2 alpha secretion by glandular and stromal cells of the pig endometrium in vitro: effects of estradiol-17 beta, progesterone, and day of pregnancy. AB - Prostaglandins (PGs) are believed to play important roles in the establishment of pregnancy. Glandular and stromal cells were isolated from pig endometrium on days 11 through 19 of pregnancy and cultured in the presence of estradiol-17 beta (E2) and progesterone (P4) to determine the effect of day of pregnancy and steroids on the secretion of PGE and PGF2 alpha. Estradiol at concentrations between .01 and 1 microM did not affect PGE and PGF2 alpha secretion into the medium by glandular and stromal cells. Progesterone (.1 microM) suppressed (P less than .001) PGE and PGF2 alpha production from both cell types. Glandular cells secreted more (P less than .01) PGF2 alpha than PGE, whereas stromal cells collected on days 11, 12, 13, and 19 secreted more (P less than .05) PGE than PGF2 alpha. Stromal cells isolated from tissues collected on day 13 of pregnancy produced PGs with higher (P less than .01) PGE:PGF2 alpha ratio than those from tissues harvested on other days of pregnancy. Glandular cells isolated from tissues collected on days 13 and 19 and stromal cells isolated from tissue collected on day 13 of pregnancy secreted more (P less than .05) PGE and PGF2 alpha than cells isolated on other days of pregnancy. We conclude that: 1) P4 has a suppressing effect on PG secretion; 2) endometrial glandular and stromal cells each produce a unique profile of PGs; and 3) endometrial cells harvested on different days of pregnancy secrete different amounts of PGE and PGF2 alpha. PMID- 1775638 TI - Examination of the effects of piriprost (U-60,257B) on alkaline phosphatase activity of rat endometrial stromal cells in vitro. AB - Previously, piriprost (U-60,257B; an inhibitor of leukotriene (LT) synthesis) was shown to increase alkaline phosphatase (ALP) activity in cultured endometrial stromal cells (1). The present study investigated the mechanism of action of piriprost in this system. Sensitized rat endometrial stromal cells were isolated and cultured for up to 72 hr with various treatments. Piriprost (100 microM) was found to decrease 5-hydroxyeicosatetraenoic acid (a 5-lipoxygenase product) by 53% after 72 hr which provided evidence that 5-lipoxygenase was being inhibited by piriprost. Lactate dehydrogenase (LDH) activity confirmed that piriprost was not toxic to the cells. The possibility of piriprost acting in an analogous manner with that of PGs was examined. Three microM PGE2 or 20 microM carba prostacyclin (CP), an analogue of PGI2, maximally increased (p less than 0.01) ALP activity at 72 hr and the further addition of 100 microM piriprost to PGE2 or CP caused an additional, additive increase in ALP activity. This indicated that the mechanism of action of piriprost was probably different from that of PGE2 or PGI2. The possibility that piriprost was shunting arachidonic acid into PG production was examined. Ten microM indomethacin (an inhibitor of PG synthesis) caused a decrease (p less than 0.01) in ALP activity and a 99% reduction in PGE2 at 72 hr. The effects of the combination of 100 microM piriprost and 10 microM IM were statistically additive, suggesting that the effects of piriprost were not due to an increase in PG production. These studies suggest that the effects piriprost on possible in vitro decidualization may be due to inhibition of 5 lipoxygenase. PMID- 1775639 TI - The effect of platelet activating factor on ovulation. AB - The mechanism of ovulation has been compared to an inflammatory reaction. Platelet activating factor (PAF) is an important mediator of inflammation as it may induce the production of prostaglandins and lysosomal enzyme. We evaluated the potential role of PAF in PMSG-HCG induced ovulation using CV3988, a specific PAF receptor antagonist in a superovulated ICR mice (9-12 weeks old). CV3988 blocked the ovulation in a dose dependent manner, and the significant reduced ovulatory efficiency was observed at more than 500 micrograms dose (p less than 0.001). The ovulatory efficiency reduced by CV3988 was reversed by PAF in a dose dependent manner. In vitro fertilization (IVF) rate of follicular oocytes with treatment of CV3988 was not different from that of ovulated ova without treatment. These results suggest that PAF may be involved in the ovulation process but the presence of PAF may not be essential for the fertilization of the ova as IVF. PMID- 1775640 TI - [Have early disorders increased?]. AB - The author rejects the proposition, encountered in some parts of the psychoanalytic and social-science literature, that certain types of disturbances correspond to certain epochs or forms of society. Instead he reminds us of the core of the psychoanalytic theory of representation according to which every formation of inner structure is an individual creative innovation that eludes normative interpretation. PMID- 1775641 TI - [Limits in the world of the patient. Psychoanalysis in the '90's]. PMID- 1775642 TI - [Perversion of utopia. Clinical and ideologic aspects of J. Chasseguet-Smirgel]. AB - The author criticizes Chasseguet-Smirgel's generalized negative conception of utopia. He points out the constructive and progressive aspects of utopia. PMID- 1775643 TI - [Reality consists of differences. Discussion comment to J. Chasseguet-Smirgel on the occasion of the presentation of Rolf Vogt's paper: on the "archaic matrix of the oedipus complex"]. PMID- 1775644 TI - [Anna Freud exposes herself to criticism. "The ego and and the mechanisms of defense" under the magnifying glass]. AB - In the early 1970's members and guests of the Hampstead Clinic, under the guidance of Joseph Sandler, discussed Anna Freud's The Ego and the Mechanisms of Defence, which had been published in 1936, with its author. Elrod presents this discussion in excerpts and emphasizes the undogmatic approach to psychoanalytic theory evident in Anna Freud's and Joseph Sandler's contributions. PMID- 1775645 TI - [Fear of breakdown]. PMID- 1775646 TI - Across-channel masking of changes in modulation depth for amplitude- and frequency-modulated signals. AB - This study examines a form of masking that can take place when the signal and masker are widely separated in frequency and cannot be explained in terms of the traditional concept of the auditory filter or critical band. We refer to this as across-channel masking. The task of the subject was to detect an increment in modulation depth of a 1000-Hz sinusoidal carrier. The carrier could either be sinusoidally amplitude modulated or sinusoidally frequency modulated at a 10-Hz rate. Modulation increment thresholds of this "target" signal were measured for the target alone, and in the presence of two interfering sounds with carrier frequencies of 230 and 3300 Hz. When the interfering sounds were unmodulated, they had no effect on modulation increment thresholds. When the interfering sounds were either amplitude or frequency modulated, thresholds increased. Amplitude modulation (AM) increment thresholds were affected by both amplitude modulated and frequency-modulated interference. Similarly, frequency modulation (FM) increment thresholds were affected by both amplitude-modulated and frequency modulated interference. For both types of signal, the interference was tuned for modulation rate; across-channel masking was greatest when the interfering sounds were modulated at rates close to 10 Hz, and declined for higher or lower rates. However, the tuning was rather broad. When the target and interfering sounds were modulated at the same rate, there was no effect of the relative phase of the modulators. Two possible explanations for the results are discussed. One is based on the idea that carriers that are modulated in a similar way tend to be perceptually "grouped". The other is based on the idea that there are "channels" in the auditory system tuned for AM and FM rate. Neither explanation appears completely satisfactory. PMID- 1775647 TI - Relative contributions of envelope maxima and minima to comodulation masking release. AB - Comodulation masking release (CMR) is a phenomenon that demonstrates the sensitivity of the auditory system to across-frequency differences in the temporal modulation pattern of a complex waveform. In this paper, we review briefly some of the data on the physical parameters that affect CMR and describe models that have been proposed to account for CMR--namely, models based upon envelope equalization/cancellation, across-frequency envelope correlation, and "dip listening". The present literature is ambiguous with regard to the relative importance of energy in the peak and dip regions of the waveform envelope. We therefore performed a series of experiments to investigate this issue. In the first experiment, we examined CMR for signals that resulted either in a uniform increment or in uniform decrement in the masking noise centred on the signal frequency. This was accomplished by using a 20-Hz-wide noise band centred on 700 Hz as both the masker and as the signal, adjusting the phase angle between the signal and masker to either 0 degree (increment) or 180 degrees (decrement). Conditions were examined where either zero, one, two, four, or six comodulated flanking bands were present. Results indicated positive CMRs for all conditions in which a comodulated flanking band was present. CMR increased as the number of flanking bands increased for intensity increments, but not for intensity decrements. The remaining experiments examined conditions where signals were present only in masker peaks, or only in masker dips. The results of these experiments indicated relatively large CMRs when the signal occurred in dip regions, but no CMR when the signal occurred in peak regions. Whereas some of the results of the above experiments would be difficult to account for in terms of the dip listening hypothesis of CMR, the present findings did indicate that the stimulus cues that give rise to CMR appear to be derived primarily from the dip regions of the masking noise. PMID- 1775648 TI - Spectral, intensive, and temporal factors influencing overshoot. AB - Threshold was measured for a 10-msec, 4.0-kHz signal presented near the onset or in the temporal centre of a 400-msec noise masker. Overshoot, the difference (in dB) between these two thresholds, was seen only for masker bandwidths wider than a critical band. The threshold near masker onset, and hence overshoot, could be reduced by the presence of an additional noise that was presented continuously or gated on and off prior to masker onset. The spectral, intensive, and temporal properties of this effect were studied. When the additional noise was continuous and either bandpass filtered with a variable bandwidth or notch filtered with a variable notchwidth, the results indicated that energy both near and remote from the signal frequency contributed to the reduction in overshoot. The effect of this additional noise was highly dependent upon its relative level. When the additional noise was 400 msec in duration and the delay between its offset and the onset of the masker was varied, overshoot "recovered" to its maximum value within about 50 msec. Finally, as the duration of the additional noise was varied from 3 to 400 msec while the time between its offset and masker onset was fixed, the reduction in overshoot was virtually complete for durations of about 25-50 msec. The results are consistent with the notion that overshoot at least partly reflects peripheral adaptation, and that this adaptation is not restricted to the signal frequency channel but, rather, extends in both directions over several channels. PMID- 1775649 TI - Effects of phase changes in low-numbered harmonics on the internal representation of complex sounds. AB - A series of experiments investigated the effect of phase changes in low-numbered single harmonics in target sounds that were either synthesized steady-state vowels fo periodic signals having only a single formant. A matching procedure was sued in which subjects selected a sound along a continuum differing in first formant frequency in order to get the best match with the target sound; perceptual effects of the phase manipulations in the target were detected as a change in the matched first formant frequency. Stimuli had to contain at least three harmonics to produce the effect, but id did not require a particular starting phase of the components. A suppression phenomenon is discussed, in which phase changes alter the phase-locking characteristics of auditory fibres tuned to low-numbered harmonics. PMID- 1775650 TI - The perception of back vowels: centre of gravity hypothesis. AB - According to the formant centre of gravity (FCOG) hypothesis, two vowel formants in close proximity are merged during perceptual analysis, and their contribution to vowel quality depends on the centre of gravity of the formant cluster. Findings consistent with this hypothesis are that two formants can be replaced by a single formant of intermediate centre frequency, provided their separation is less than 3-3.5 Bark; and that changes in their relative amplitudes produce systematic shifts in vowel quality. In Experiment 1, listeners adjusted the frequencies of F1 and F2 in a synthesized 6-formant vowel (with the F1-F2 separation fixed at 250 Hz, i.e. less than 3 Bark) to find the best phonetic match to a reference vowel with modified formant amplitudes. Contrary to FCOG predictions, F2 attenuation did not produce lower frequency matches. Raising the amplitude of F2 led to predicted upward shifts in formant frequencies of the matched vowel, but with increased variability of matches for some stimuli. In Experiment 2, listeners identified synthesized vowels with a range of separations of F1 and F2. Formant amplitude manipulations had no effect on listeners' judgements when the fundamental frequency was low (125 Hz). Small shifts in vowel quality appeared for stimuli with a high fundamental (250 Hz), but the shifts were significantly larger for F1-F2 separations greater than 3.5 Bark. These effects of formant amplitude are qualitatively different from those observed with single-formant vowels and are generally incompatible with a formant-averaging mechanism. PMID- 1775651 TI - Spectral weights and the profile bowl. AB - In these experiments, listeners detected changes in the shape of a complex spectrum that varied in overall level. With multicomponent complexes, a typical finding is that the listeners were more sensitive to changes made in the middle components of the spectrum than to changes made at either edge. We used a technique developed by Berg (1989) to estimate the weight listeners attached to the different components of the spectrum in making these judgements. For reasons not understood, the pattern of spectral weights was nearly optimum for a change made in the middle component of the spectrum and much poorer when the change occurred at either edge. PMID- 1775652 TI - Perception of spectral changes in multi-tone complexes. AB - Amplitude changes of the spectral components of a complex tone, relative to each other, are usually well perceived, even if the over-all intensity is kept fixed. Three experiments are reported: Experiment 1 dealt with the detectability of amplitude changes in two-tone complexes of fixed frequencies. Experiment 2 examined detection of slope changes in ramp-shaped spectral envelopes of two- and three-tone complexes as a function of spectral spacing. As a control experiment for some conditions a roving intensity level was used. Experiment 3 investigated the detectability of changes in the spectral slope of multi-tone complexes as a function of the number of components. The results of the experiments show that detection of spectral changes in a sound is strongly dependent on the frequency spacing of the components. It is concluded that the auditory system is capable of comparing the relative energy distributions over different critical bands. Within a critical band there exists an optimum frequency separation with respect to the detection of relative amplitude change. PMID- 1775653 TI - The detection of a tone added to a narrow band of noise: the energy model revisited. AB - In an effort to determine whether cues related to changes in energy contribute to the detection of a tone added to a narrow band of noise, we examined the effect of level variation on detection thresholds. In the first experiment, the level of each waveform was randomly varied on each presentation. Level variation had only marginal effects on performance. In addition, detection thresholds were obtained using bands of noise with equal energy across intervals. Neither increasing nor decreasing the variance of the noise-alone and tone-plus-noise energy difference distributions altered the detectability of a tone added to noise. Thus, the changes in energy that are concomitant with the addition of the tone are not the sole cue for the detection of the tone. In a second experiment, three psychometric functions were measured. One function was determined using no level variation, one was measured in the presence of level variation, and one was measured in the context of level variation, but for trials without level variation. The context of level variation slightly reduced detectability. In a third experiment, we compared detectability in three conditions: no level variation, across-trial level variation, and across-interval level variation. The thresholds obtained in the absence of level variation were superior to those measured in the presence of level variation, regardless of the manner in which the level variation was incorporated. PMID- 1775654 TI - Lateralization of very-short-duration tone pulses of low and high frequencies. AB - The position and image-width of the simultaneous images produced by very short tone pulses were measured as a function of interaural time difference (ITD) at both low- (250 and 800 Hz) and high- (2500 and 8000 Hz) frequencies using a direct-estimation technique. Primary images are lateralized towards the ear receiving the leading stimulus. At low frequencies image position is proportional to interaural phase-difference (IPD) below 90 degrees and remains at the lead-ear for larger values. At high frequencies images are reported is proportional to ITD up to 500-1000 microseconds. Secondary images are reported on the opposite side of the head for IPDs greater than 180 degrees at low frequencies, and at ITDs greater than 500 microseconds at high frequencies. Image width is approximately constant for all ITDs and both images at a given frequency, but becomes more compact as frequency increases. The data are discussed in terms of onset cues and stimulus fine-structure cues. The best explanation is in terms of an onset mechanism, but one that is calibrated in terms of IPD at low frequencies. The existence of double images is explained in terms of a breakdown in the mechanism determining fusion. PMID- 1775655 TI - A computer model of auditory stream segregation. AB - A computer model is described which simulates some aspects of auditory stream segregation. The model emphasizes the explanatory power of simple physiological principles operating at a peripheral rather than a central level. The model consists of a multi-channel bandpass-filter bank with a "noisy" output and an attentional mechanism that responds selectively to the channel with the greatest activity. A "leaky integration" principle allows channel excitation to accumulate and dissipate over time. The model produces similar results to two experimental demonstrations of streaming phenomena, which are presented in detail. These results are discussed in terms of the "emergent properties" of a system governed by simple physiological principles. As such the model is contrasted with higher level Gestalt explanations of the same phenomena while accepting that they may constitute complementary kinds of explanation. PMID- 1775656 TI - Frequency selectivity for hearing-impaired and broadband-noise-masked normal listeners. AB - When evaluating frequency selectivity, it is difficult to determine if the deviation from normal performance observed for hearing-impaired listeners reflects abnormal cochlear function or normal, level-dependent changes in frequency selectivity. This experiment was designed to investigate the dependence of frequency-selectivity measures on threshold and signal level. Auditory-filter characteristics, critical ratios, forward-masked psychophysical tuning curves, and narrowband-noise masking patterns were obtained from normal-hearing listeners in quite and in the presence of broadband noise at five levels. These findings were then compared to previously obtained frequency-selectivity measurements for subjects with mild-to-moderate sensorineural hearing loss whose absolute thresholds are comparable to the normal-hearing listeners' masked thresholds. The results suggest that frequency selectivity deterioriates as threshold increases for all subjects. However, the poor frequency selectivity exhibited by hearing impaired listeners may not be explained entirely by the effects of threshold and signal level. Nevertheless, because frequency selectivity is poorer in the normal auditory system at higher stimulus levels, the deviation from normal performance observed for hearing-impaired listeners may not be as large as previously suggested. PMID- 1775657 TI - Binaural loudness matches in unilaterally impaired listeners. AB - Binaural loudness matching data using a 21FC adaptive procedure were obtained in high-frequency, unilateral cochlear-impaired listeners. The matches were obtained at frequencies where both ears had similarly normal thresholds, and also at other frequencies where the impaired ear had various degrees of hearing loss. In these listeners, one presumed difference between the ears is the limited or altered spread of excitation in the impaired ear. In agreement with previous studies using other approaches (Hellman, 1974, 1978; Hellman & Meiselman, 1986; Moore, Glasberg, Hess & Birchall, 1985; Schneider & Parker, 1987), the results of the present study suggest that both the range and the slope of loudness growth function are not dependent on the spread of excitation, but instead are related primarily to the degree of threshold elevation at the test frequency. Following this suggestion, a spread-of-excitation-independent model, based upon a group of neurons with the same characteristic frequency (CF) but different thresholds, is proposed to account for loudness growth in both normal and recruitment cases. In particular, it is shown quantitatively that a compressed distribution of thresholds due to threshold elevation may be responsible for loudness recruitment in sensorineural hearing loss. PMID- 1775659 TI - Formant transition duration and amplitude rise time as cues to the stop/glide distinction. AB - There is some disagreement in the literature about the relative contribution of formant transition duration and amplitude rise time in signalling the contrast between stops and glides. In this study, listeners identified sets of /ba/ and /wa/ stimuli in which transition duration and rise time varied orthogonally. Both variables affected labelling performance in the expected direction (i.e. the proportion of /b/ responses increased with shorter transition durations and shorter rise times). However, transition duration served as the primary cue to the stop/glide distinction, whereas rise time played a secondary, contrast enhancing role. A qualitatively similar pattern of results was obtained when listeners made abrupt-onset/gradual-onset judgements of single sine-wave stimuli that modelled the rise times, frequency trajectories, and durations of the first formant in the /ba/-/wa/ stimuli. The similarities between the speech and non speech conditions suggest that significant auditory commonalities underlie performance in the two cases. PMID- 1775658 TI - Vowel and consonant recognition with the aid of a multichannel cochlear implant. AB - In this report we review the vowel and consonant recognition ability of patients who use a multichannel cochlear implant and who achieve relatively good word identification scores. The results suggest that vowel recognition is accomplished by good resolution of the frequency of the first formant (F1) combined with poor resolution of the frequency of the second formant (F2). The results also suggest that consonant recognition is accomplished (1) by using information from the amplitude envelope, including periodicity/aperiodicity, as cues to manner and voicing, (2) by using F1 as an aid to the identification of manner and voicing, and (3) by using information from cochlear place of stimulation to provide a very crude indication of the shape of the frequency spectrum above 1 kHz. PMID- 1775660 TI - Single band amplitude envelope cues as an aid to speechreading. AB - Amplitude envelopes derived from speech have been shown to facilitate speech reading to varying degrees, depending on how the envelope signals were extracted and presented and on the amount of training given to the subjects. In this study, three parameters related to envelope extraction and presentation were examined using both easy and difficult sentence materials: (1) the bandwidth and centre frequency of the filtered speech signal used to obtain the envelope; (2) the bandwidth of the envelope signal determined by the lowpass filter cutoff frequency used to "smooth" the envelope fluctuations; and (3) the carrier signal used to convey the envelope cues. Results for normal hearing subjects following a brief visual and auditory-visual familiarization/training period showed that (1) the envelope derived from wideband speech does not provide the greatest benefit to speechreading when compared to envelopes derived from selected octave bands of speech; (2) as the bandwidth centred around the carrier frequency increased from 12.5 to 1600 Hz, auditory-visual (AV) performance obtained with difficult sentence materials improved, especially for envelopes derived from high-frequency speech energy; (3) envelope bandwidths below 25 Hz resulted in AV scores that were sometimes equal to or worse than speechreading alone; (4) for each filtering condition tested, there was at least one bandwidth and carrier condition that produced AV scores that were significantly greater than speechreading alone; (5) low-frequency carriers were better than high-frequency or wideband carriers for envelopes derived from an octave band of speech centred at 500 Hz; and (6) low frequency carriers were worse than high-frequency or wideband carriers for envelopes derived from an octave band centred at 3150 Hz. These results suggest that amplitude envelope cues can provide a substantial benefit to speechreading for both easy and difficult sentence materials, but that frequency transposition of these signals to regions remote from their "natural" spectral locations may result in reduced performance. PMID- 1775661 TI - Crossmodal integration in the identification of consonant segments. AB - Although speechreading can be facilitated by auditory or tactile supplements, the process that integrates cues across modalities is not well understood. This paper describes two "optimal processing" models for the types of integration that can be used in speechreading consonant segments and compares their predictions with those of the Fuzzy Logical Model of Perception (FLMP, Massaro, 1987). In "pre labelling" integration, continuous sensory data is combined across modalities before response labels are assigned. In "post-labelling" integration, the responses that would be made under unimodal conditions are combined, and a joint response is derived from the pair. To describe pre-labelling integration, confusion matrices are characterized by a multidimensional decision model that allows performance to be described by a subject's sensitivity and bias in using continuous-valued cues. The cue space is characterized by the locations of stimulus and response centres. The distance between a pair of stimulus centres determines how well two stimuli can be distinguished in a given experiment. In the multimodal case, the cue space is assumed to be the product space of the cue spaces corresponding to the stimulation modes. Measurements of multimodal accuracy in five modern studies of consonant identification are more consistent with the predictions of the pre-labelling integration model than the FLMP or the post-labelling model. PMID- 1775662 TI - A further examination of attentional effects in the phonemic restoration illusion. AB - Models of how listeners understand speech must specify the types of representations that are computed, the nature of the flow of information, and the control structures that modify performance. Three experiments are reported that focus on the control processes in speech perception. Subjects in the experiments tried to discriminate stimuli in which a phoneme had been replaced with white noise from stimuli in which white noise was merely superimposed on a phoneme. In the first two experiments, subjects practiced the discrimination for thousands of trials but did not improve, suggesting that they have poor access to low-level representations of the speech signal. In the third experiment, each (auditory) stimulus was preceded by a visual cue that could potentially be used to focus attention in order to enhance performance. Only subjects who received information about both the identity of the impending word and the identity of the critical phoneme showed enhanced discrimination. Other cues, including syllabic plus phonemic information, were ineffective. The results indicate that attentional control of processing is difficult but possible, and that lexical representations play a central role in the allocation of attention. PMID- 1775663 TI - The interlingual identification of Spanish and English vowels: orthographic evidence. AB - When someone who is learning a second language (L2) produces a sound in the L2 using a familiar, native-language (L1) category, the L2 sound is said to have been "identified with" an L1 sound. Although interlingual identification exerts a powerful influence on L2 pronunciation, it is still poorly understood. Orthographic classification was used here to assess the interlingual identification of Spanish and English vowels. Sixty native speakers of Spanish in three experiments judged the vowels /i/, /I/, /e/, and /ae/ in multiple tokens of English words ("beat", "bit", "bet", "bat") spoken by ten native speakers of American English. The subjects labelled each English vowel by circling one of the five letters used to spell the vowel phonemes of Spanish (viz. less than i greater than, less than e greater than, less than a greater than, less than o greater than, less than u greater than) or by circling "none" if they thought they had heard a vowel not found in Spanish. Subjects who spoke English as an L2 used the "none" label more often than did Spanish monolinguals, suggesting that L2 learning heightens bilinguals' awareness of cross-language phonetic differences. Experienced Spanish speakers of English did use the "none" label more often than did inexperienced subjects (42% vs. 18%). A few subjects used the "none" label consistently for /ae/ and /I/, suggesting that they may have regarded these vowels as "new" (i.e., non-Spanish). However, the group data provided little support for the hypothesis that the adult Spanish learners of English treated either /ae/ or /I/ as new. The great majority of subjects, even those highly experienced in English, identified English /ae/ with their Spanish /a/. PMID- 1775664 TI - The use of prosody in highlighting alterations in repairs from unrestricted speech. AB - A speaker has several ways in which he or she may highlight the fact that an error or imprecision of speech has been made and subsequently altered. The three principal ones are by signalling through the structure of the speech that surrounds the error (the repair-syntax), by the use of prosody, and through the semantic content. The role of prosody in the correction process is investigated in the current studies. Analysis of the prosody of a number of errors and their alterations drawn from unrestricted speech are reported. The analysis shows that pauses occur at the moment of interruption and that an increase in stress occurs at the start of the alteration. Pauses could indicate the moment of interruption, and stress could highlight what has been altered. Two sets of perceptual experiments were carried out to assess whether these cues are salient for listeners who hear constructions containing an error and its alteration. Two paradigms were employed in each set of experiments: (1) direct judgement about the comprehensibility of sentences containing errors and alterations, and (2) repeating a message that had an error and alteration without the error. The effects of stress and pauses on (Experiments 1A and 1B) or pauses around (Experiment 2A and 2B) the alterations were assessed. In the first set of experiments it was shown that pauses and stress help listeners process repairs. When a word is spoken in error, the speaker may repeat a section of speech immediately preceding the alteration and/or a section immediately following that word. Inclusion of these repeated sections allows assessment of whether pauses signal where the interruption occurred. The second experiment shows that the placing of the pause before the retrace, rather than at other locations, indicates to listeners where the repair starts. PMID- 1775665 TI - Routes through the face recognition system. AB - Two experiments are reported which seek to examine the proposition first put forward by Hay and Young (1982), that recognition of a known person after seeing his or her face proceeds through a series of sequentially organized stages. In both experiments subjects were shown a selection of famous and unfamiliar faces and required to state whether each face was familiar. They were then asked to recall semantic information and the person's name. Of all the possible response types, only some are predicted by models derived from Hay and Young (1982), and only these responses were observed in Experiment 1. In order to give as complete an account as possible of the slips and errors made by subjects, they were interrogated some days after completing the testing phase in Experiment 2. As in the first experiment, the results supported the view that distinct but successive stages are involved in everyday face recognition. The method developed here provides an extension of the "dairy" type of study of everyday recognition errors into laboratory conditions, which confirms the findings of studies of everyday errors and provides strong support for sequential models. PMID- 1775666 TI - Does attention have different effects on line orientation and line arrangement discrimination? AB - Visual search and texture segregation studies have led to the inference that stimuli differing in the orientation of their component line segments can be distinguished without focal attention, whereas stimuli that differ only in the arrangement of line segments cannot. In most of this research, the locus of attention has not been explicitly manipulated. In the first experiment presented here, attention was directed to a relevant peripheral target by a cue presented near the target location or at the fovea. Effects of attention on orientation discrimination were assessed in a two-alternative forced-choice task with targets that were either: (1) lines that slanted obliquely to the right or left, or were horizontal or vertical, or (2) Y-like targets that had a short arm leading obliquely right or left of a vertical line. In some groups, a four-alternative forced-choice test with lines at 0 degree, 45 degrees, 90 degrees, and 135 degrees orientations was used. Discrimination of these targets (i.e. targets that differ in the orientation of component line segments) was only minimally facilitated as the time between the onset of the valid cue and the onset of the target (cue-target stimulus onset asynchrony, SOA) was increased from 0 or 17 msec to 267 msec. In contrast, discrimination of targets that did not differ in the orientation of component line segments but differed in line arrangement (T like characters), was greatly facilitated by longer cue-target SOAs. In Experiment 2, a cue misdirected attention on 20% of the trials. A decrement occurred on incorrectly cued trials in comparison to correctly cued trials for both types of stimuli used (lines and Ts). The results from these experiments suggest that discrimination of line orientation benefits less from focal attention than does discrimination of line arrangement, but that both discriminations suffer when attention must be disengaged from an irrelevant spatial location. PMID- 1775667 TI - Central and peripheral precuing of forced-choice discrimination. AB - There are suggestions in the literature that spatial precuing of attention with peripheral and central cues may be mediated by different mechanisms. To investigate this issue, data from two previous papers were reanalysed to investigate the complete time course of precuing target location with either: (1) a peripheral cue that may draw attention reflexively, or (2) a central, symbolic cue that may require attention to be directed voluntarily. This analysis led to predictions that were tested in another experiment. The main result of this experiment was that a peripheral cue produced its largest effects on discrimination performance within 100 msec, whereas a central cue required approximately 300 msec to achieve maximum effects. In conjunction with previous findings, the present evidence for time differences between the two cuing conditions suggests that more than one process is involved in the spatial precuing of attention. PMID- 1775668 TI - Reaction time analysis with outlier exclusion: bias varies with sample size. AB - To remove the influence of spuriously long response times, many investigators compute "restricted means", obtained by throwing out any response time more than 2.0, 2.5, or 3.0 standard deviations from the overall sample average. Because reaction time distributions are skewed, however, the computation of restricted means introduces a bias: the restricted mean underestimates the true average of the population of response times. This problem may be very serious when investigators compare restricted means across conditions with different numbers of observations, because the bias increases with sample size. Simulations show that there is substantial differential bias when comparing conditions with fewer than 10 observations against conditions with more than 20. With strongly skewed distributions and a cutoff of 3.0 standard deviations, differential bias can influence comparisons of conditions with even more observations. PMID- 1775669 TI - Inhaled therapy in COPD: what are the benefits? PMID- 1775670 TI - Pregnancy and the asthmatic. PMID- 1775671 TI - Who needs referral to the hospital asthma specialist? PMID- 1775672 TI - Patient education, self-management plans and peak flow measurement. PMID- 1775673 TI - Acute severe asthma. PMID- 1775674 TI - Time of development of tuberculosis in contacts. AB - The British Thoracic Association has recommended that close contacts of smear positive cases of tuberculosis be followed up for at least 2 yrs (Tubercle 1978; 59: 245-259) but Selby et al. have recently suggested that a reduction in duration of follow up may be appropriate (Respir Med 1989; 83: 353-355). We have reviewed the results of contact procedures in Leeds to determine whether our experience supports reduction in the duration of follow up of contacts of patients with tuberculosis. In the 5-yr period 1983-87 there were 555 cases of tuberculosis (135 in Asians) of whom 42 (7.6%) were identified by contact procedures. In addition, contact procedures identified 35 children who were given chemoprophylaxis for positive Heaf tests (grade 2 or more). Of the 42 contacts with tuberculosis, 30 (71%) were diagnosed at the first visit, eight (19%) were diagnosed 6 months later and four (10%) were diagnosed 16-24 months after their initial clinic attendance. Five of the 42 contacts with TB were Asian, two of whom were diagnosed late. Seven out of ten non-Asian contacts who were diagnosed late had initial Heaf reactions of grade 1 or 2. All cases diagnosed late were contacts of a sputum-positive source. Poverty, as defined by residence in the Leeds Urban Priority Area, was associated with an increased risk of 3.3-fold for tuberculosis and a sixfold risk for chemoprophylaxis diagnosed by contact procedures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775675 TI - Relationship between changes in diurnal variation of expiratory flows, lung volumes and respiratory symptoms after acute asthma. AB - We looked at the comparative recovery of asthma symptoms and changes in airflow obstruction after an acute exacerbation of asthma in 26 asthmatics, aged 18-69 years (mean = 43). In the 4 weeks following the acute episode, they recorded their respiratory symptoms and twice-daily peak expiratory flow rates (PEFR). In 14 subjects, lung volumes were also measured on days 1, 7 and 30. Mean initial FVC and FEV1 [+/- SEM (% predicted)] were 2.30 +/- 0.16 (61%) and 1.18 +/- 0.08 (39%). The rate of improvement of airflow obstruction initially paralleled that of asthma symptoms in subjects with mild or with a recent onset of asthma. On the first study day, diurnal variation of PEFR was minimal, increased rapidly during the first week of treatment and stabilized thereafter. Mean daily delta PEFR was significantly higher in the first than at the fourth week (P = 0.005). Recovery of asthma symptoms was associated with an overall reduction in FRC and RV but there was no significant correlation between FRC or RV and dyspnea score or PEFR. Perception of airflow obstruction was generally lower, improvement of symptoms slower and of smaller amplitude in those with long-standing asthma. In conclusion, during recovery from acute asthma: (1) diurnal variation of PEFR is initially minimal, increases rapidly after beginning steroids and stabilize in the two following weeks; (2) in patients with more than mild or long-standing asthma, and magnitude and range of perception of asthma symptoms is reduced and correlates less with PEFR; and (3) no significant correlation could be found between FRC or RV and dyspnea score or PEFR. PMID- 1775676 TI - Effect of controlled-release salbutamol in predominantly non-reversible chronic airflow obstruction. AB - We conducted a multicentre, randomized, double-blind, placebo-controlled, parallel group study to determine the efficacy of controlled release salbutamol (SCR) tablets in clinically stable patients with predominantly non-reversible chronic airflow obstruction (CAO). Patients received either 8 mg SCR or matching placebo tablets twice daily for 6 weeks. Fifty-eight patients (30 on SCR and 28 on placebo) completed the study. Outcome measurements included FEV1, FVC, 6-min walking distance, and patient assessment of efficacy recorded at the clinic visits and twice daily PEFR measurements plus daytime symptom score recorded in diary cards. The absolute change between baseline and 6-week measurements with SCR was compared to that with placebo. Favourable trends were observed with SCR for all variables tested except FVC. The only significant difference between SCR and placebo was in FEV1 where there was a small net change of 95 ml in favour of SCR. We conclude, therefore, that the effects of lung function of long-term bronchodilator therapy with SCR in patients with stable non-reversible CAO are slight, and are likely to be of limited clinical benefit. PMID- 1775677 TI - Hypothalamo-pituitary-adrenal axis suppression in asthmatics inhaling high dose corticosteroids. AB - The frequency of hypothalamo-pituitary-adrenal (HPA) axis suppression in asthmatics taking high dose (greater than 1000 micrograms daily) inhaled corticosteroids is unknown. HPA function was studied in 78 adult asthmatics taking long-term inhaled corticosteroids (median dose 1600 micrograms, range 1200 2650 micrograms daily). All patients except one were using metered dose aerosols; 15 were using large volume spacer devices. Median duration of high dose therapy was 13 months (range 1-54). Sixty-nine patients were taking beclomethasone dipropionate (1500 micrograms, n = 36; 2000 micrograms, n = 26, greater than 2000 micrograms, n = 7) and nine budesonide (1200 micrograms, n = 2; 1600 micrograms, n = 6; 1800 micrograms, n = 1). Four patients, all of whom were taking greater than 2000 micrograms beclomethasone dipropionate, were taking 200-400 micrograms of their total dose intranasally. Twenty-six patients had discontinued long term systemic corticosteroid treatment (at least 5 mg prednisolone daily, or equivalent, for a minimum of 6 months) between 7 months and 22 years prior to assessment. All patients had measurements of 9 am serum cortisol and 24-h urine free cortisol excretion and a short tetracosactrin test. Subnormal results were: 9 am cortisol less than 190 nmol l-1; rise in serum cortisol in response to tetracosactrin less than 200 nmol l-1 and/or achieved cortisol less than 500 nmol l-1; urine free cortisol less than 80 nmol 24 h-1. Hypothalamo-pituitary-adrenal suppression was defined as subnormal results in at least two of the three tests. Tests were performed at least 2 weeks after completion of any short course prednisolone treatments. Suppression was found in 16 (20.5%) patients (1500 micrograms, n = 6; 1600 micrograms, n = 1; 2000 micrograms, n = 7; 2400 micrograms, n = 2). Risk factors identified for this suppression were: (a) previous requirement for long-term systemic corticosteroids (10/26, chi 2 = 6.1, P less than 0.02); and (b) increasing duration of high dose inhaled therapy (median 28.5 months in suppressed vs. 12 months in normal, P less than 0.05). No clear relationship was identified between HPA function and dose, even when corrected for body surface area and there was no relationship between suppression and number of short courses of prednisolone in the preceding 12 months. Screening tests of HPA function should be performed in all asthmatics taking greater than or equal to 1500 micrograms inhaled corticosteroid daily. Unless function has been shown to be normal, all patients taking these doses should carry steroid cards. PMID- 1775678 TI - Screening for hypothalamo-pituitary-adrenal axis suppression in asthmatics taking high dose inhaled corticosteroids. AB - High dose inhaled corticosteroids may cause suppression of the hypothalamo pituitary-adrenal (HPA) axis. Several tests are available to screen for this suppression but it is not clear which is the most useful. HPA function was assessed in 78 adult asthmatics inhaling long-term, high dose (median 1600 micrograms; range 1200-2650 micrograms) beclomethasone dipropionate (n = 69) or budesonide (n = 9). Screening tests performed in all patients were 9 am serum cortisol, short tetracosactrin test and 24-h urine free cortisol excretion. Eleven patients also underwent insulin stress tests. Subnormal results were: 9 am cortisol less than 190 nmol l-1; urine free cortisol less than 80 nmol 24 h-1; rise in cortisol in response to tetracosactrin or hypoglycaemia less than 200 nmol l-1 and/or achieved cortisol less than 500 nmol l-1. HPA suppression (defined as subnormal results of at least two of the three initial tests and/or subnormal response to hypoglycaemia), was found in 16 patients. In the 11 patients who underwent insulin stress tests, results of all initial tests were normal in three, one test was abnormal in three and two tests were abnormal in four patients. All three tests were abnormal in the remaining patient. The response to hypoglycaemia was normal in the three patients whose screening tests were all normal; HPA suppression was present in seven patients and one patient had a borderline result. Close correlation was observed between the maximum cortisol during hypoglycaemia and both urine free cortisol (rs = 0.84; P = 0.001) and post-tetracosactrin cortisol (r = 0.75; P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775680 TI - Bronchiolitis obliterans and Mycoplasma pneumonia. PMID- 1775679 TI - Systemic effects of inflammation in bronchiectasis. AB - A group of bronchiectatic subjects in the clinically stable state were studied for systemic evidence of inflammation. The following parameters were evaluated: body weight, serum albumin, serum globulin, serum alpha 1-antitrypsin (alpha 1 AT) and peripheral white cell count. For serum albumin and globulin, comparison was made between subjects with bronchiectasis and control subjects with no known pulmonary disease matched for sex and age, and for serum alpha 1 AT and peripheral white cell count, matched for smoking habit as well. The bronchiectatic subjects showed systemic effects of inflammation as indicated by lower body weight and serum albumin (P less than 0.01), higher serum globulin (P less than 0.001), serum alpha 1 AT (P less than 0.05) and total leucocyte count (P less than 0.05). Differential white cell count showed that the elevation was distributed in most cell types. Correlation matrix was done for the above systemic parameters and indices of airway inflammation including sputum volume, purulence, and polymorph count and FEV1. There was an inverse correlation between total peripheral WBC count and FEV1 in percentage of predicted (P less than 0.01), and a positive correlation between sputum purulence and sputum polymorph score (P less than 0.05). This suggests that host peripheral leucocyte response may be a factor in the determination of lung function. PMID- 1775682 TI - Tuberculosis--on the increase? PMID- 1775683 TI - Smoking and prevention. PMID- 1775681 TI - Objective thoracic CT scan findings in a Bhopal gas disaster victim. PMID- 1775684 TI - Squamous cell carcinoma in sheep in Saudi Arabia. AB - Squamous cell carcinoma was recorded in 22 Nadji and 3 Maeimi sheep aged 3-6 years, of which 22 were females. Sixteen tumours involved the eyes, 7 occurred in the skin at different body sites, one developed in the ear and another in the rectum. In five cases secondary deposits were seen in the lymph nodes, nasal passages and upper lip. Surgical treatment was successful in the early stages of tumour development, but in advanced cases recurrences were noted. Histologically the tumours were typical for squamous cell carcinoma and most of them were well differentiated. Solar radiation was pointed out as a possible factor in the aetioloy of the tumour. PMID- 1775685 TI - Pathogenesis of Aspergillus fumigatus infection in pigeons in the Sudan. AB - The pathogenesis of a pigeon isolate of Aspergillus fumigatus in a local breed of pigeons in the Sudan was tested. The spores inoculated intravenously resulted in an acute disease with 100% of mortality within six days. At necropsy, pinpoint and miliary lesions were prominent in the liver, spleen, lungs and kidneys. Histopathological examination detected lesions in the liver, heart, lungs, kidneys, spleen and brain. Hyphae and/or spores were encountered in all these organs. The presence of A. fumigatus was confirmed by reisolation from the liver, lungs and kidneys. PMID- 1775686 TI - Some considerations on veterinary drug use and supply in Nigeria. AB - There is widespread misuse of veterinary drugs in Nigeria resulting from controlled and unsupervised drug administration, underdosing and incomplete treatment. Development of resistance and toxicity are common consequences of this misuse. Drug shortage, uneven distribution, preponderance of fake and/or expired drugs and inadequate local drug production are some of the problems identified in veterinary drug supply. All these problems have an adverse effect on animal health and productivity and are related to an improperly coordinated veterinary service and the non-existence of national veterinary drug policy. Suggested solutions include rehabilitation and restructuring of the veterinary service, improved funding to support drug purchase, installation of self-servicing revolving funds, partial privatization, drug manufacture and appropriate legislations for veterinary drugs. These proposals are expected to overcome bottlenecks encountered in drug supply, distribution, delivery, prescription and use. Projections and plans must also be made toward the local development and manufacture of drugs for animal disease. PMID- 1775687 TI - Egg drop syndrome '76 in poultry and other avian species in Nigeria. AB - A sero-epidemiological survey of EDS '76 antibodies was carried out in chickens, guinea fowls, ducks and pigeons in various locations in Nigeria with the haemagglutination-inhibition test. Infection rates of 67.43, 79.68, 73.91 and 86.66% were obtained for chickens, guinea fowls, ducks and pigeons respectively. The high prevalence rates observed in these non-chicken species suggest that they should be considered as important in the epidemiology of EDS '76 in poultry in Nigeria. An extensive survey is recommended together with vaccination. PMID- 1775688 TI - [Note on the lessons of rinderpest control in Chad since 1935]. AB - The policy of rinderpest control in Chad has passed through various phases over sufficiently long periods to validate certain concepts such as that of the usefulness of perifocal vaccination of populations which have not been previously vaccinated. After studying the reliability of data regarding livestock, vaccinations and pathology and after having reviewed the various types of vaccine used, it can be concluded that perifocal vaccination, even in conjunction with the systematic vaccination of young, has not enabled rinderpest to be brought under control in Chad. Only systematic livestock vaccination can control and eradicate the disease. A table illustrates the vaccination operations and monitoring systems used. PMID- 1775689 TI - [A new case of Mycobacterium bovis pulmonary tuberculosis in the dromedary (Camelus dromedarius) in Mauritania]. AB - A case of pulmonary tuberculosis is described in a dromedary from Nouakchott (Mauritania). Gross lesions affected pulmonary parenchyma, diaphragmatic pleura, pericardium and regional lymph nodes: caseo-calcified nodules, miliary tubercles and haemorrhagic "pendeloques". Microscopically lesions were characterised by granulomatous tissue, epithelioid cells, necrotic material in the centre. No Langhans giant cells were seen. Mycobacterium bovis was isolated from these samples. PMID- 1775690 TI - Virulence factors in Escherichia coli strains isolated from pigs in the Ribeirao Preto region, State of Sao Paulo, Brazil. AB - Three-hundred faecal swabs were obtained from pigs with diarrhoea in farms located in different areas of the Ribeirao Preto region in the State of Sao Paulo. One-hundred Escherichia coli strains were isolated and tested for production of thermolabile (TL) and thermostable (STRa and STb) enterotoxins, and for the presence of colonization factors F4, F5 and F6. The strains were also tested for sensitivity to 14 antibiotics and chemotherapeutic agents. Twenty-four Escherichia coli strains produced enterotoxin STb, 5 produced LT and 3 produced STa. In the mannose-resistant haemagglutination reaction, one strain reacted positively with sheep, chicken, horse and human red blood cells and another reacted positively with guinea pig, sheep, chicken, horse and human red cells. However, both strains were negative for colonization factors F4, F5 and F6 when submitted to the slide agglutination test. All Escherichia coli strains were resistant to at least one antibiotic, the highest percentages being obtained for resistance to penicillin, tetracycline and cephalotin. In addition to the importance of the virulence factors normally encountered in enterotoxigenic Escherichia coli strains from pigs, the present results show the possible existence of new colonization factors other than F4, F5 and F6 participating in E. coli-induced pigs colibacillosis in the Ribeirao Preto region. PMID- 1775691 TI - Haematology of experimental Trypanosoma brucei gambiense infection. II. Erythrocyte and leucocyte changes. AB - Chronic Trypanosoma b. gambiense infection of rabbits induced mild anaemia which was initially macrocytic normochromic, but became later microcytic hypochromic. Moderate anisocytosis and poikilocytosis were evident from 14 days post infection (p.i.). Nucleated red cells which were observed prior to the infection (normal feature of rabbits) declined in number as the infection progressed. Leucocytosis with neutrophilia, eosinophilia, monocytosis and terminal lymphopaenia were also observed. The main changes in the morphology of leucocytes were the presence of atypical lymphocytes as well as increased levels of band neutrophils in the peripheral circulation. It is concluded that the main erythrocytic and leucocytic changes in the T.b. gambiense infection were mild anaemia which was terminally microcytic hypochromic and transient leucocytosis due to neutrophilia and monocytosis. PMID- 1775692 TI - Prevalence of Sarcocystis species in sheep and goats in northern Nigeria. AB - Tissue samples comprising the oesophagus and diaphragm were collected from 400 sheep and 400 goats slaughtered at the abattoirs in the study area. Out of this number, 36 were positive for Sarcocystis cysts (sarcocysts) in sheep and 56 in goats. The sarcocysts in sheep measured 35.7 to 500 microns lengthwise and the cyst-wall 2.4 microns. They were identified to be Sarcocystis tenella. The cysts in goats measured 98 to 700 microns and the cyst-wall 2.7 microns. They were identified to be Sarcocystis capracanis. In both animals species, the sarcocysts were more frequent in the oesophagus than in the diaphragm. All sarcocysts seen were microscopic. PMID- 1775693 TI - [Main features of helminth parasitism in cattle in Ituri (Haut-Zaire). III. Geographic distribution and prevalence of the main helminths]. AB - A necropsic survey, carried out in eleven slaughterhouses in Ituri (Haut-Zaire), has permitted to define the geographic distribution and prevalences of the main cattle helminths. Trematodes, except the paramphistomes, had a very heterogeneous distribution. Prevalence of Fasciola gigantica ranged from 9 to 72% according to the sites, but these variations were not linked to topographic or climatologic parameters. The infection with Schistosoma bovis was much variable as well (12.5 to 72%) and seemed absent from the central high altitude area. The occurrence of Dicrocoelium hospes was restricted to the northern part of Ituri with a moderate prevalence of about 35%. By contrast, nematodes had a fairly homogeneous distribution in Ituri. Prevalences were high for gastro-intestinal strongyles of the following genera, Haemonchus, Cooperia and Oesophagostomum (over 60%). Cysticercosis (Cysticercus bovis) occurred in 10 to 14% of cattle in the middle and south areas of Ituri whereas the north areas were nearly free. PMID- 1775694 TI - Susceptibility to homologous reinfection with Fasciola gigantica in goats. AB - Goats previously infected with 100 viable Fasciola gigantica metacercariae and treated with rafoxanide (Ranide, 7.5 mg/kg) at week 4 were not protected against subsequent homologous challenge with 250 metacercariae administered two weeks later. Reinfection resulted in more severe hepatic lesions and a higher percentage of flukes recovered as compared with primarily infected controls. However, the size of flukes originating from the second (challenge) infection was considerably reduced. The plasma enzyme activity of aspartate amino-transferase (AST), glutamate dehydrogenase (GD) and sorbitol dehydrogenase (SD) increased to a similar extent with primary and challenge infections. However, the plasma antibody response to F. gigantica was less pronounced in reinfected goats. PMID- 1775695 TI - Studies on west African dwarf sheep: incidence of perinatal mortality in Nigeria. AB - A study was conducted on the incidence of perinatal lamb mortality with extension up to 30 days of age (PMR 30) in West African Dwarf sheep in Ibadan, Nigeria, over a three year period. An overall PMR 30 of 19.9% was recorded. This consisted of an abortion rate of 3.0%, a still-birth rate of 2.7% and a neonatal lamb mortality rate of 15.6% up to 30 days of age (LMR). Abortion rate was significantly higher in pregnancies with multiple foetuses and during the dry sea son (P less than 0.01 and P less than 0.05 respectively). Conversely, the still birth rate was slightly higher in single lambs (P less than 0.05). The LMR for males (17.1%) and that for females (13.4%) were not significantly (P greater than 0.05) different. Also the LMR for single-born (14.4%), twin-born (15.4%) and triplets (26.7%) did not significantly differ (P greater than 0.05). The optimum birth weight for survival of the breed appeared to be 2.6 to 3 kg. Regression analysis showed a 28.3% increase in birth weight and all live-born lambs with birth weights of 0.9 kg or less died during the neonatal period. About two-thirds (67.2%) of all neonatal deaths occurred during the first week of life. There was no significant effect of season on LMR. The perinatal mortality rates recorded among West African Dwarf sheep in this study do not seem to significantly differ from corresponding figures recorded in other parts of the world. PMID- 1775696 TI - [Mortality and morbidity in a cohort of elderly Parisian managers followed for 14 years]. AB - A randomized sample of 180 male managers, 63-64 years old received a standardized medical examination at the four times of a longitudinal study (1975-78-82-88). The prevalence and incidence rates of principal chronic diseases were evaluated according to ICD-9. The incidence rates of surgery operations and death were calculated. The prevalence and incidence rates of some diseases definitely increase with age. On the contrary, the rates of others diseases declined. The individual differences in morbidity indexes are large and increased with age. The morbidity index is lowest at the beginning of the seventies. Cancers and cardiovascular diseases were respectively the first and second causes of death. PMID- 1775697 TI - [Causes and risk factors in post-neonatal mortality in France in 1987 according to a national survey]. AB - A stagnation in postneonatal mortality (28 days-1 year) is reported in France as in other similar countries. More than fifty per cent of these deaths are registered under the sudden infant death syndrome, a cause which is classified in the symptoms and ill-defined conditions chapter of the International Classification of Diseases. To establish the actual rate of sudden infant death syndrome (SIDS) it was necessary to carry out a specific retrospective survey. All postneonatal deaths (3917) registered in France from September 1986 to December 1987 were studied by means of questionnaires sent to the certifying doctor and to the families. The sudden infant death rate is estimated at 1.2 per 1,000 and the risk factors of the total postneonatal deaths are birthweight, prematurity, transfer into neonatal care unit, and age of the mother. PMID- 1775698 TI - [Study of the method of transmission in an epidemic of gastroenteritis in an extended care service, Florida, 1989]. AB - In January 1989 and outbreak of gastroenteritis (GE) occurred among the residents and the employees of the Extended Care Unit (ECU) of a Florida hospital. There were 14 cases (38.9%) among the 36 ECU patients and 10 (19.2%) among the 52 employees. The illness was characterized by watery diarrhea, fever, abdominal cramps and headache. Bacterial and viral investigations were negative. The incidence density rate of GE for patients in double occupancy room was nine times greater one to three days after a roommate had been ill than at any other time during the outbreak (p = 0.02). Patients who received higher level of nursing and medical care were five times more likely to develop GE than the other patients (p = 0.054). Health workers who reported contact with symptomatic patients were 2.5 times more likely to become cases than the other workers (p = 0.3). These data suggest that the infection was transmitted from patient to patient by contact with health care workers. PMID- 1775699 TI - Smoking habits and sporting activity among adolescents in north Italy. AB - A cross-sectional survey of the smoking habits of 330 17-19 year-old males practising physical activity as members of sports teams, and of 366 male students in the same age range was carried out in Brescia, North Italy. A total of 23.3% of the athletes and 30.9% of the students smoked at least one cigarette a week (chi 2 = 4.60, p less than 0.05), and 17.3% and 19.7% smoked at least one cigarette a day, respectively (chi 2 = 0.51; p greater than 0.05). The smoking athletes had on average 50.3 cigarettes/week and students 47.0 (t-test: 0.46; p greater than 0.05). No difference was found with respect to age at their first experience with smoking, while athletes began to smoke regularly before than students, proportionally (chi 2 for linear trend: 5.29, p less than 0.05). Sporting activity was negatively associated with current smoking by multiple logistic regression: the odds ratio of current smoking for athletes with respect to students was 0.5 (95% CI: 0.4-0.8). Among a set of social, environmental and behavioural variables, best friend's and girlfriend's smoking was the one most strongly associated with current smoking in both groups. PMID- 1775700 TI - [Evaluation of quality of care in the United States]. AB - Quality assessment in the USA has been undertaken during the past twenty years by different institutions sponsored by the Congress, the government and professional associations. The evaluation tools which were developed reflect both the diversity of the American medical scene fashions in health care management. They evolved from norms to incentives, but each step in this evolution left its marks in the form of regulations, financial incentives and traditions. PMID- 1775701 TI - [Veterinary epidemiology]. AB - The author describes the specifics of veterinary epidemiology, in particular its domain and objectives. The large diversity of data sources are partly limited by the lack of standardized nomenclature and registries in many animal species. Even if veterinary epidemiology benefits from methods developed in the last thirty years in human epidemiology, it differs from human epidemiology by: the broad spectrum of animal species and its differences in longevity, pathology and genetics, the extend of control measures available and their direct effect on the epidemiology of the diseases, the priority of cost efficacy of disease control and epidemiological surveillance. The future of veterinary epidemiology lays in new areas, such as herd management and economics, genetic selection and molecular biochemistry, and geriatric epidemiology in pets. PMID- 1775702 TI - [Declared utilization of prophylactics. Results of a KABP survey in Ile-de-France -1990]. PMID- 1775703 TI - [Report on cholesterol levels of Spanish children and adolescents. Group of Experts of Spanish Societies of Arteriosclerosis, Cardiology, Pediatrics, Nutrition and Preventive Medicine]. AB - The epidemiological association between blood cholesterol levels and the development of clinical complications of arteriosclerosis, particularly coronary heart disease, is presently well established. The importance of measuring blood cholesterol levels in children and adolescents is supported by numerous evidences: beginning of arteriosclerosis in infancy, relationship between the extent of fatty streaks as determined by post mortem examination of accidentally dead children and previous blood lipid levels, aggregation in children (as in adults) of elevated blood cholesterol levels with other cardiovascular risk factors, tracking of high cholesterol levels (and of other risk factors) from childhood to adolescence and early adulthood, and association of risk factors in children with a parental history of cardiovascular disease. The few epidemiological studies of blood cholesterol in children published in Spain have demonstrated relatively high mean values of blood cholesterol at all ages, which are similar or even higher than those obtained by the LRC Program in the United States during the 1970's. The present report constitutes a metaanalysis of data provided by the authors of 21 Spanish studies, both published and unpublished, carried out during the 1980's on the blood lipid levels of children and adolescents (0-18 years-old) including a total of 19,630 subjects (10,834 males, 8,102 females, and 694 newborns). All data were obtained in cross-sectional studies of normal populations employing different biochemical and statistical methods, thus limiting the value of the conclusions on the true values of blood cholesterol in Spanish children and its changes during recent years. Weighted means were calculated for the means of the different studies taking into account the number of cases in each population, and the distribution in percentiles by age and sex of total cholesterol, triglycerides, LDLc, and HDLc were estimated. For the overall study population, the mean blood cholesterol level and the moderate risk percentile (75) and high risk percentile (95) for both sexes were 173 mg/dl (4.5 mmol/l), 200 mg/dl (5.2 mmol/l), and 225 mg/dl (5.8 mmol/l), respectively. Such levels are between 10 and 15 mg/dl (0.3 and 0.4 mmol/l) higher than those of the LRC Program, and a clear rise was observed from the early to the late 1980's. The present levels of blood cholesterol in children and adolescents have a great potential impact for Public Health policy in Spain. As it occurs in adults, the distributions of blood cholesterol levels in children of different populations reflect their coronary heart disease mortality rates.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1775704 TI - [Transesophageal echocardiography in the selection of patients prior to percutaneous mitral valvuloplasty. Study of 71 consecutive patients]. AB - We studied 71 consecutive patients with mitral stenosis candidates for mitral valvuloplasty by means of transthoracic (TTE) and transesophageal echocardiography (TEE). We compared the information obtained by the two methods with respect to: mitral valve morphology (echocardiographic score), severity of mitral regurgitation, prevalence of atrial thrombus and incidence of spontaneous contrast in the left atrium. The assessment of valvular thickening, mobility and calcification was similar by the two methods. The assessment of the subvalvular disease was significantly lower by TEE than the assessed by TTE (1.66 +/- 0.6 vs 2.12 +/- 0.5; p less than 0.001). The total "score" obtained by TEE was significantly lower than the "score" obtained by TTE (7.32 +/- 1.9 vs 7.88 +/- 1.8; p +/- 0.001), but when we classified the patients in groups according to the "score", there were no significant differences between the groups obtained by the two methods. We detected mitral regurgitation in 27 patients (38%) by TTE and in 36 (50%) by TEE. The difference in the quantification of the mitral regurgitation was no more than one grade in any case. Atrial thrombus were detected in 16 patients (22%) by TEE and in 2 patients by TTE. Spontaneous contrast was seen in 53 patients (75%) by TEE and in only 1 by TTE. We conclude that TEE is essential in detecting atrial thrombus, but does not provide any new information about mitral valve morphology and mitral regurgitation in the selection of patients for percutaneous mitral valvuloplasty. PMID- 1775705 TI - [Heart malformations in trisomy 13 and trisomy 18]. AB - Congenital heart diseases were studied in children diagnosed of trisomy 13 and trisomy 18 in our hospital between January 1973 and July 1990. Twenty patients with trisomy 18 were diagnosed (18 females and two males). All had cardiac malformations. The findings were: ventricular septal defect in 16 cases (80%), valvular anomalies in 12 (63%), patent ductus arteriosus in nine (47%) and atrial septal defect or patent foramen ovale in 7 cases (36%). We found some complex congenital cardiac diseases: one atrioventricular canal, one tetralogy of Fallot, one hypoplastic left ventricle with mitral atresia and double outlet right ventricle, one case of univentricular heart with aortic outlet from a rudimentary cavity, a right ventricular atresia with pulmonary and tricuspid valves atresia. Nine cases of trisomy 13 were diagnosed (seven females and two males). We found: ventricular septal defect in 7 cases (77%), valvular disease in five (100% of the necropsy studies), secundum atrial septal defect in 4 patients (80%) and patent ductus arteriosus in two. Two cases presented hypoplastic left ventricle with aortic arch hypoplasia, one of them had subaortic stenosis and left superior vena cava being connected to the right atrium via coronary sinus; one case showed fibroelastosis. Our results have been similar to the previously reported and confirm the invariably presence of cardiac malformations in these syndromes. These malformations are an important sign of suspicion in fetal ultrasonography. PMID- 1775706 TI - [Chronic heart insufficiency (III). Evaluation of the functional capacity in patients with chronic heart insufficiency]. PMID- 1775707 TI - [Anomalous origin of the right coronary artery from the left sinus of Valsalva. Apropos of 2 cases]. AB - Anomalous origin of right coronary artery from the left sinus of Valsalva is a uncommon congenital anomaly which is difficult to demonstrate angiographically. For many years pathologists classified it as a minor anomaly of no clinical significance. It has only recently been associated with significant manifestations of myocardial ischemia. These manifestations have included acute myocardial infarction, angina pectoris, syncope, ventricular tachycardia and fibrillation, and sudden death. Two patients with this anomaly are reported. One patient had angina pectoris in the absence of significant atheromatous coronary lesions. In the second patient the aberrant origin of the right coronary artery was associated to aortic valve disease. The possible physiopathology mechanisms responsible for manifestations of myocardial ischemia in patients with this anomaly are analyzed. PMID- 1775708 TI - [Double subvalvular aortic stenosis (fixed and dynamic) diagnosed by ECHO Doppler]. AB - Fixed subvalvular aortic stenosis is an uncommon cause of left ventricular outflow obstruction which occasionally can be found in association with dynamic muscular obstruction. In the past, the diagnosis of this association has been difficult and relied upon cardiac catheterization and angiography. To our knowledge, no case of this pathology diagnosed by echo and Doppler has previously been reported. We present a case of double subvalvular aortic stenosis in a 35 years old patient which illustrates the feasibility of detection with echo and Doppler of both types of subvalvular aortic obstruction. PMID- 1775709 TI - [Acute pericarditis as initial clinical manifestation of hypereosinophilia syndrome]. AB - The case of a patient in whom acute pericarditis was the initial manifestation of an idiopathic hypereosinophilia is reported. Endomyocardial abnormalities were not found by echocardiography. Response to prednisone therapy was good; symptoms, pericardial effusion and eosinophilia early disappeared after therapy. Some clinical aspects of this uncommon disease are discussed. PMID- 1775710 TI - [Gene therapy]. PMID- 1775711 TI - [Modulation of respiratory smooth muscle reactivity by epithelial factors]. AB - The epithelium of the pulmonary airways plays a complex role in the modulation of bronchial smooth muscle reactivity thanks to the metabolic properties and the mobilisation of contractant and relaxant factors which may issue directly from the epithelial cells or surrounding cells. The expression of these epithelial factors varies along the length of the tracheo-bronchial tree and with the species of animal being considered. Neuronal cells and inflammatory cells may equally intervene and interfere with relaxant and contractant factors depending on the epithelium. But the greatest difficulty in characterising these epithelial factors residues in the functional antagonism between relaxant and contractant factors when they are jointly expressed. Amongst factors depending on the respiratory epithelium prostaglandin E2 would be one of the relaxing factors and Calcitonin Gene-Related Peptide (CGRP), one of the contracting factors. PMID- 1775712 TI - [Bronchial inflammation in asthma. Evaluation by bronchial biopsies]. AB - Our understanding of the pathogenesis of asthma has benefitted as a result of bronchial endoscopic techniques linked to studies of bronchoalveolar lavage (LBA) and bronchial biopsy. By using modern biochemical and immunohistochemical methods as well as ultrastructural studies we are better able to specify the importance of bronchial inflammation. Currently we underline the role of epithelial lesions and of intraepithelial lesions and sub-basal inflammation. The responsibility of eosinophils in the epithelial disorder has been proved in vivo by the evidence of cationic protein found both in the LBA liquid and by the tissue localisation thanks to immunological markers. An understanding of the infiltrates and of the state of cellular activation in situ constitutes an initial step in the comprehensive of inflammation; however, these studies do not yet allow us to fully understand the mechanisms of regulation and also the trigger factor in cellular dysfunction which may be the cause. The pseudo-thickening of the basal membrane and sub-epithelial fibrosis are poorly understood, but is probably involved in epithelial repair. The histopathological mechanisms which underly the bronchial aging are equally poorly understood. In the future a better understanding of these problems of neuro-inflammatory disturbances and of epithelial permeability should facilitate the therapeutic approach. PMID- 1775713 TI - [Detection of bronchial cancer. Realities and perspectives]. AB - Primary bronchial cancer is responsible for at least 20,000 deaths per year in France. The treatment of cancer in the clinical phase remains disappointing. Numerous trials, which are reviewed here chronologically, have looked for a way to improve the prognosis by an earlier detection of this tumour. Unfortunately numerous methodological approaches have not been able to avoid the fact that the real value of such an early diagnosis is not always known. The only clear conclusion of these studies is that cytological examination of the expectorate does not lead to an improved survival in patients when compared to that which is obtained with the single radiographic film. However, taking account of the natural history of the disease, it is probably necessary to abandon the concept of an early diagnosis of a tumour which is already too late; it is towards a search for pre-cancerous lesions which are still reversible that the research effort should be turned. PMID- 1775714 TI - [Study of high-resolution thoracic computerized tomography and bronchoalveolar lavage in 36 patients presenting with systemic disease and a normal thoracic radiography]. AB - Systemic diseases such as scleroderma (ScI), rheumatoid polyarthritis (PR), Gougerot-Sjogren Syndrome (GS) have a well known propensity for the lungs. Previous studies have shown evidence of disturbed alveolar cell repair as evidence of a sub-clinical alveolitis. The significance of such cases of latent alveolitis remains to be specified. To determine if latent alveolitis was associated with interstitial chest disease which was undetectable by chest X-ray, 36 consecutive patients had an BAL and a high resolution computered tomographic examination (HRTC) (Scl: n = 21; PR: n = 9; GS: n = 6). The patients had normal respiratory function and chest X-ray was normal. Our results showed 17 out of 36 (47%) with a latent alveolitis (the percentage of lymphocytes and of alveolar polymorpho-nuclear neutrophils was superior or equal to 18 and 4% respectively) (Scl: 12/21; PR: 1/9; GS: 4/6). In the cases of scleroderma a neutrophil alveolitis was predominant (9/12) and was associated in 2 cases with a honeycomb lung and evidence of fibrotic lesions using TDM-HR. Those examinations using HRTC which were normal were equally associated with a latent alveolitis (Scl: 6/12; PR: 1/6; GR: 4/5). These results suggest that the alveolitis can preceed the anatomical damages. These results need to be confirmed in a larger series and the value of early treatment should be evaluated. PMID- 1775716 TI - [Respiratory patterns induced by bent posture in COPD patients]. AB - Three body positions were studied in order to determine their influence on the respiratory pattern in 7 subjects with chronic airflow obstruction. The positions were sitting lying back (AR), sitting with the trunk leaning forwards (AP) and standing with the trunk leaning forwards (DP). Compared to sitting lying back, sitting in the forward position favoured diaphragmatic improvement and improved the length/tension relationship of the diaphragmatic fibres and of its mechanical coupling with the thoracic cage; as a result the diaphragm took a more important part in the overall inspiratory effort thus relieving the thoracic inspiratory muscular effort. In relation to AR, the standing, leaning forward (DP) increased the end expiratory level and gave rise to the development of active expiration. This change in the usual respiratory manner enables the diaphragm to benefit on inspiration from the help bought by the restoration of the potential energy stored up in the respiratory system during the course of expiration. PMID- 1775715 TI - [Bronchiolitis obliterans with severe obstructive ventilation disorder after a bone marrow transplant. Study of 7 cases]. AB - In 40 to 60% of bone marrow grafts there are pulmonary complications of which the most frequent is the occurrence of an interstitial pneumonia. We report 7 cases here of a more rare complication, that of bronchiolitis obliterans (BO). Between December 1979 and November 1989, 7 patients (3.4% of our cases of GMO) have developed over several months a chronic obstructive respiratory failure (a mean VEMS of 43% of the theoretical value) in the year following the transplantation (mean delay 190 days). 6 patients presented with cutaneous, digestive or hepatic signs of chronic graft v host illness (GVH) whereas the prevalence of this complication in the population studied was 17%. Treatment combining bronchodilators and immunosuppressants was only successful in 2 cases and the outcome was fatal in the 5 other cases as a result of respiratory failure (mean delay 208 days between the appearance of respiratory symptoms and death). The pathogenesis of BO after GMO remains poorly understood. It may rest on an immune process during the course of which the BO would be the result of a chronic pulmonary GVH. Another hypothesis is that the state of the immunosuppression in these patients would favour the appearance of a bronchiolitis of an infectious origin, particularly viral. The prognosis of BO after GMO is very poor and in the absence of specific effective treatment the therapeutic strategy remains essentially that of prevention by the early detection of respiratory anomalies. PMID- 1775717 TI - [A predominant manifestation of pleural cryptococcosis in acquired immunodeficiency syndrome]. AB - Systemic cryptococcosis occurs in at least 6% patients with human immunodeficiency virus infection (HIV). The lung infection by cryptococcus neoformans, less frequently observed than meningeal involvement, consists usually in focal parenchymal mycosis. Authors report an apparently isolated pleural cryptococcosis in a 41 years old mal with HIV infection. Diagnosis was performed initially by pleural and bronchial alveolar lavage (BAL) fluid culture. Characteristic cryptococcosis pathological and histologic findings from thoracoscopy and open pleural biopsy are described. Cryptococcus capsular polysaccharides stainings and thoracoscopy interests are emphasized. PMID- 1775718 TI - [Pseudo-tumor of Castleman: particular aspects of thoracic localization. Two case reports]. AB - The pseudo-tumours of Castleman, irrespective of whether their histological type is plasmocytic or hyalino-vascular, are most often found in the mediastino pulmonary area. 2 rare aspects of their thoracic localisation are reported with the occurrence of a pleural effusion and the localisation to the chest wall itself. PMID- 1775719 TI - [Unusual clinical presentation of a thoracic form of a malignant dysembryoma. A case report]. AB - We report here the medical history of a patient diagnosed with teratocarcinoma presenting with a pleural mass without mediastinal involvement as well as typical paraneoplastic hypertrophic osteoarthropathy. This atypical observation is discussed as well as data from the literature on thoracic localisations of extragonadal malignant germ cell tumours. PMID- 1775721 TI - The effect of chronic administration of doxorubicin on the rat cardiac and hepatic glutathione redox system. AB - The effect of chronic administration of doxorubicin on the rat heart and liver glutathione redox system was studied. Rats were administered doxorubicin, 1 mg/kg, ip., three times a week, on Monday, Wednesday and Friday. One week was skipped and then the cycle repeated for a total of one, four, seven or ten doses. It was determined that treatment in this manner had no effect on rat heart glutathione, glutathione peroxidase or glucose-6-phosphate dehydrogenase, at any of the time intervals tested. However, hepatic glutathione content was found to be moderately increased after the fourth dose and glucose-6-phosphate dehydrogenase activity was found to be markedly increased after the seventh and tenth doses. Hepatic glutathione peroxidase was not affected. These results suggest that the cardiac glutathione redox system does not respond to chronic administration of doxorubicin. In contrast, the hepatic systems do respond, which may explain the apparent resistance of this organ to doxorubicin toxicity. PMID- 1775720 TI - [Pleuropericarditis and Pyoderma gangrenosum during remission of a hemorrhagic rectocolitis]. AB - We report the case of a 17 year-old woman who had a pleuro-pericarditis after remission of an ulcerative colitis. The patient had a rapid and complete recovery with steroids. This extra-intestinal complication can develop during all the stages of the disease and its diagnosis can be very difficult. PMID- 1775722 TI - An experimental study on mandibular movement and osteoporosis. AB - In order to clarify the relationship between mandibular movement and osteoporosis, the authors secured the temporo-mandibular joints of 8-week-old rats to immobilize their jaws; then conducted histologic studies chronologically, up to the fifth week. After three weeks, an expansion of the marrow cavity and a reduction of the trabecular were observed in the mandibular process and mandibular fossa. During the fifth week, an osteoporosis-like state was clearly observed. Further, an irregularity in the form of mandibular process was recognized, as well as a remarkable disturbance caused by cartilaginous ossification of the articular cartilage of the condyle. PMID- 1775723 TI - Effects of age and cardiac shunts on the measured uptake of nitrous oxide in children. AB - The uptake of nitrous oxide (N2O) was calculated by using a new application of pharmacokinetics involving cumulative fractional expired N2O concentration at 90 percent steady state. The effect of age on N2O uptake was investigated in 33 normal children undergoing non-cardiac surgery. Uptake was also investigated in 17 children with right-to-left cardiac stunts and 18 children with left-to-right shunts undergoing corrective or palliative cardiac surgery. There was a significant correlation of N2O elimination half-life (T1/2) with age for normal children (p less than 0.001), and for children with right-to-left (p less than 0.001) or left-to-right (p = 0.05) shunts. Elimination T1/2 in children with left to-right shunts correlated significantly with the calculated shunt fraction (p less than 0.05). By providing a useful means for comparison, this method of measuring N2O uptake permits determination of the effects of age, weight and cardiac shunts on the uptake kinetics of N2O. PMID- 1775724 TI - Biological changes in the regenerating and intact rat liver following exposure of the organ to lasers. AB - This study is among the first employing anatomical partial hepatectomy and exposure of the remnant organ to lasers before closure for comparison of biological changes with those of exposed sham-operated groups and the respective controls. Adult male rats were partially hepatectomized leading to removal of two thirds of the organ and the lateral lobe exposed to Argon (514 nm, 270 mW-3.0 W for up to 120 s; tunable dye, 630 nm, 200 and 500 mW for up to 240 s) and Nd:YAG (1064 nm; 3-8 W, 60-180 s) lasers. Sham-operated rats were treated similarly and with several, 1 or 2 additional sites in the quadrate lobes were irradiated. Possibly, liver damage and penetrability were somewhat greater for the intact rats treated with the Nd:YAG laser and which also displayed liver profile changes over the controls in contrast to the partially hepatectomized. In general, the extent of liver regeneration over a period of 10 days post-operative was not affected by the laser treatment. The mixed function oxidase system reflected small decrements in aminopyrine demethylase and in benzo[a]pyrene hydroxylase for adjacent lesion-free microsomes from the partially hepatectomized and intact groups exposed to Nd:YAD laser (5.0 W, 120 s), respectively. PMID- 1775726 TI - A large amount of endothelin-1 is present in human breast cancer tissues. AB - Endothelin (ET)-1 concentration was measured in tissue extracts from 157 human breast cancers, 26 benign breast tumors and 10 normal breast tissues. ET-1 was detectable in all tissue extracts by specific radioimmunoassay, the concentration ranging from 0.12 to 11.95 pg/mg protein. ET-1 concentration was significantly higher in tissue extracts from breast cancer than in those from benign breast tumor or normal control tissue, suggesting that this peptide is synthesized by breast cancer cells. When 157 breast cancer specimens were categorized into 4 groups in terms of clinical staging, no significant difference was found among these clinical staging groups. Furthermore, no significant associations were observed between ET-1 concentrations and the age of patients, tumor size, lymphnode involvement, histological type or steroid hormone receptor status. PMID- 1775725 TI - Lethality, hexobarbital narcosis and behavior in rats exposed to atrazine, bentazon or molinate. AB - Previous findings from our laboratory suggested a possible interaction of atrazine, bentazon and molinate with other environmental and/or occupational poisons. The aim of this research was to obtain further toxicological information by using phenobarbital-induced rats and to characterize the effects of these herbicides on the hepatic microsomal metabolism of xenobiotics. Acute experiments have shown that the LD50 is augmented by the barbiturate pretreatment when atrazine is used, remains unchanged in the case of bentazon, but is lowered when molinate is given. Recrystallized atrazine, in the absence of the wetting compounds, elicits the same acute toxicity found when animals are challenged with a commercial preparation. No significant sex-related differences have been observed. In long-term treatment with these toxicants, atrazine shortened the hexobarbital narcosis, but no effect was observed after administration of either bentazon or molinate. Further studies on hexobarbital sleeping time demonstrated that females are more susceptible than males to the narcotic effect of this compound. The induction-like effect of atrazine exposure has been confirmed, mainly in young animals. At the end of the sleeping time, the actual serum concentration of hexobarbital is practically the same, and is not related to the length of the sleeping time. The absence of behavioral alterations in the open field tests exclude possible neurological effects of the triazine herbicide. In conclusion, these data demonstrate that atrazine by itself induces the hepatic pharmacometabolic system, while its metabolites result less toxic than the parent compound. On the contrary, metabolic transformations render the toxic effects of bentazon more severe. PMID- 1775727 TI - Muscarinic M2 receptors in rat brain labeled with [3H] AF-DX 384. AB - The muscarinic antagonist AF-DX 384 (5,11-dihydro-11-(((2-(2 ((dipropylamino)methyl)-1- piperidinyl)ethyl)amino)carbonyl)-6H-pyrido(2,3b)(1,4) benzodiazepin+ ++-6-one methansulfonate) was used to label cholinergic muscarinic receptors of the M2 subtype in rat brain. In the brainstem [3H] AF-DX 384 labeled a single population of binding sites with Kd = 3-4 nM and Bmax = 430-610 fmol/mg of protein. The pharmacological profile of these sites was similar to that observed with the muscarinic M2 agonist [3H] AF-DX 116. Muscarinic M2 receptors were unequally distributed in rat brain regions: in brainstem, about 80% of total muscarinic receptors (measured with [3H] quinuclidinyl benzilate) were labeled by [3H] AF-DX 384, while in other brain areas they represented only a fraction of total binding. Because of its high specific binding, high affinity and specificity, [3H] AF-DX 384 represents a useful novel ligand to study M2 receptors in brain tissue. PMID- 1775728 TI - Pharmacological actions of chemically-modified phospholipase A2 from the venom of Trimeresurus flavoviridis on the smooth muscle of the rat stomach fundus. AB - The pharmacological activities of Trimeresurus flavoviridis phospholipase A2 (PLA2) and their chemically-modified PLA2 were characterized by measuring the contraction of rat stomach fundus strips. The native PLA2 produced a contraction of rat fundus strips. The alpha-amino-modified enzyme induced an almost identical contraction of the fundus with that of the native enzyme, whereas His-modified and Lys-modified enzymes induced a markedly decreased contraction as compared with the native enzyme. These results demonstrate that lysine and histidine residues but not the alpha-amino group in the PLA2 molecule are essential for contractile activity of the stomach fundus. PMID- 1775729 TI - Comparative protective effects of vinconate, baclofen, and pentobarbital against neuronal damage following repeated brief cerebral ischemia in the gerbil brain. AB - We investigated the neuroprotective effects of vinconate (a vinca alkaloid derivative), baclofen (a GABAB receptor agonist), or pentobarbital (a GABAA receptor-effector) on neuronal damage following repeated brief cerebral ischemia in the gerbils. The animals were allowed to survive for 7 days after two or three 2-min ischemic insults induced by bilateral occlusion of the common carotid arteries. Morphological changes were evaluated in hippocampal CA1 sector and selectively vulnerable areas after two or three 2-min ischemic insults at 1-h intervals, respectively. Pretreatment with vinconate significantly reduced histopathological neuronal damage to the hippocampal CA1 sector following two 2 min ischemic insults. However, pretreatment with baclofen and pentobarbital failed to prevent neuronal damage. Pretreatment with vinconate also prevented neuronal damage to the frontal cortex, parietal cortex, and striatum following three 2-min ischemic insults. Nevertheless, this drug failed to prevent neuronal damage to the hippocampal CA1 sector and the thalamus. Results suggest that vinconate, a vica alkaloid derivative, can prevent neuronal damage after repeated brief cerebral ischemia, but not GABAergic agents, such as baclofen and pentobarbital. These findings are of interest in relation to the mechanisms of neuronal damage induced by repeated brief cerebral ischemia. PMID- 1775730 TI - A new model for studying microcirculatory changes during dermal wound healing. AB - Intact blood supply by microcirculation to a wounded site is an indispensable prerequisite for normal tissue regeneration. However, microvascular changes taking place in the healing process of skin wounds are not understood due to the fact that only few models allow chronic in vivo studies on skin microcirculation. Therefore, we have modified the hairless mouse ear model with the purpose of a quantitative in vivo study of microhemodynamic changes throughout the healing process. Following the creation of a standardized skin wound on the ear of the homozygous hairless mouse (hr/hr), microvessel diameters, red blood cell velocities, wet weight, and leucocyte content of the ear tissue were determined. Surface area of the wound was assessed until complete closure was achieved. By repeated measurements at identical sites over the entire healing period, a distinct pattern of microvascular changes could be observed: microvessel diameters increased to a maximum a few days after wound creation, whereas red blood cell velocities reached their highest values at a later point in time and were still elevated after complete reepithelization of the wounds. Edema and leucocyte content of the ear tissue was most prominent in the early healing phase and gradually decreased to normal values thereafter. These results demonstrate changes of the microvasculature of the hairless mouse ear to injury, which are in accordance to other more indirect studies on this topic. Therefore, we conclude that the model presented is suitable for prolonged quantitative analysis of microcirculation during normal wound healing and may be used to assess microvascular changes taking place during wound healing in pathologically altered tissue. PMID- 1775731 TI - Lysosomal storage of glycogen as a sequel of alpha-glucosidase inhibition by the absorbed deoxynojirimycin derivative emiglitate (BAYo1248). A drug-induced pattern of hepatic glycogen storage mimicking Pompe's disease (glycogenosis type II). AB - Effects of the two absorbable alpha-glucosidase inhibitors miglitol (BAYm1099) and emiglitate (BAYo1248) on hepatic and muscular glycogen concentrations were investigated in the rat after 3, 7, and 28 days. Both compounds were (orally) administered at very high doses (5-50-500 mg/kg b.wt.). In a second experiment, glycogen storage after oral administration of acarbose (1000 mg/kg b.wt.) was studied after 7 days. In a third protocol, hepatic glycogen concentrations were investigated in the fed rat after 7 days of either inhibitor at the respective highest dosage. In fasted rats, emiglitate induced a significant, dose-dependent increase of hepatic glycogen concentrations, which--at the dose of 500 mg/kg b.wt.--were present after 3, 7, and 28 days, but resulted in a significant increase of the liver weight after 28 days only. Light and electron microscopy proved that the increase in hepatic glycogen was due to lysosomal storage of glycogen only. Emiglitate in the amount of 5 mg/kg b.wt. did not induce significant changes either of glycogen concentrations or at the EM-level. While emiglitate also increased hepatic glycogen at a dosage of 50 mg/kg b.wt., miglitol led to significant storage of hepatic glycogen after 3, 7, or 28 days at the highest dose only. With miglitol (500 mg/kg b.wt.), only insignificant lysosomal storage of glycogen could be detected by electron and light microscopy, and liver weight was essentially unaffected. Both compounds displayed a dose dependent tendency towards higher glycogen concentrations in the soleus muscle, which was significant with the highest dosage of either inhibitor. At an oral dose of o.i.d. 1000 mg/kg b.wt., the almost unabsorbable alpha-glucosidase inhibitor acarbose induced significantly increased glycogen concentrations both in the liver and in the soleus muscle after 7 days. With respect to an enormous enlargement of the lysosomes (EM) and in the absence of cytoplasmatic alpha glycogen, this accumulation of glycogen must be attributed to lysosomal storage. In fed rats, all alpha-glucosidase inhibitors investigated significantly decreased postprandial hepatic glycogen concentrations (emiglitate greater than miglitol greater than acarbose), thereby reflecting the modulation of absorption. It is concluded that in the rat acarbose at approximately 1000 x ED50 may penetrate the intestinal mucosa at amounts significant enough to induce lysosomal storage of glycogen. Miglitol may cause some hepatocellular, lysosomal glycogen storage at a dose of 500 mg/kg b.wt., but no glycogen storage could be proven up to 100 x ED50 over 28 days.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1775732 TI - Mechanisms involved in resistance of preirradiated Chinese hamster V79 cells to cytotoxic drugs are multifactoral. AB - We found previously that Chinese hamster V79 cells irradiated with multiple fractions of gamma rays (0.3 Gy of gamma rays daily, five times per week over 12 weeks) become resistant to N-methyl-N'-nitro-N-nitrosoguanidine (MNNG) and vincristine sulfate (VCR), sensitive to methotrexate and cis dichlorodiammineplatinum (II), but exhibit no change in their sensitivity to gamma rays and ultraviolet light. The aim of this study was to elucidate the mechanisms by which these cells acquire the resistance to MNNG and VCR. Flow cytometric analysis shows this induced resistance is not the result of parasynchronization, i.e. the selective killing of the cells in the sensitive part of the cell cycle. The levels of protective molecules, glutathione, and metallothioneins were significantly increased in V79 cells irradiated with multiple fractions of gamma rays. Addition of verapamil reverses the resistance of these cells to VCR, suggesting the involvement of plasma membrane-associated P glycoprotein in acquiring resistance to VCR. We infer that mechanisms of resistance to MNNG and VCR are multifactoral, involving changes in the plasma membrane as well as an increase in the cellular levels of glutathione and metallothioneins. Both mechanisms may be responsible for the non-effectiveness of the treatment for cancer, in which radiotherapy is used during or before chemotherapy. PMID- 1775733 TI - Effects of enhancement and antagonism of 5-hydroxytryptamine activity on metoclopramide-induced aldosterone secretion in man. AB - This study examines the contribution of the serotonergic system to metoclopramide induced aldosterone secretion. Six normal male volunteers, at 13 h, 9 h, and 2 h before the i.v. bolus of 10 mg metoclopramide, received the following pre treatments in a single-blind cross-over randomized sequence: fluoxetine 20 mg, metergoline 6 mg, pizotifen 0.5 mg, or methysergide 2 mg. One regimen consisted of metoclopramide alone. Pizotifen and fluoxetine pre-treatment increased metoclopramide-induced aldosterone secretion significantly after 15 min, for the duration in the case of fluoxetine, and up to 90 min with pizotifen. The increase with metergoline was never significant, while methysergide had a negligible influence. Serotonin is postulated to play an intermediary role in acetylcholine facilitated aldosterone release. The mechanism of fluoxetine-mediated serotonin increase is a re-uptake inhibition and that of pizotifen is suggested to be the elimination of an auto-inhibitory mechanism. PMID- 1775734 TI - The effect of pancreatic islets on transplanted hepatocytes in the treatment of acute liver failure in rats. AB - We previously reported that co-transplantation of hepatocytes and islets of Langerhans in the spleen reduces the mortality rate after 90% hepatectomy in the rat. In the present study, we examined whether implantation of isolated hepatocytes into the pancreas is as efficient as co-transplantation of hepatocytes and islets in this respect. We found that cotransplantation of hepatocytes and islets into the renal subcapsule reduced the long-term (30-day) mortality rate after 90% hepatectomy from 100% to 36% (P less than 0.05) when performed the day before the hepatectomy. In contrast, there was no significant reduction of mortality when the hepatocytes were transplanted into the pancreas. The results show that a close proximity of transplanted pancreatic islets to the hepatocytes is of critical importance for the improved survival in acute liver failure. PMID- 1775735 TI - [Intravascular echography]. PMID- 1775736 TI - [Ultrafast CT for calculation of pulmonary blood volume]. PMID- 1775737 TI - [Magnetic resonance angiography and spectroscopy in cardiovascular disease]. PMID- 1775738 TI - [Cardiac imaging by digital subtraction angiography (DSA)]. PMID- 1775739 TI - [Positron emission tomography, update]. PMID- 1775740 TI - [Percutaneous cardiopulmonary support and autologous blood perfusion to support high risk elective coronary angioplasty]. PMID- 1775741 TI - [Protective effects of selenium on ultrastructural changes in heart muscles with experimental free-glucose and anoxia in organ culture]. AB - Fetal hearts taken from the 16th to 18th day of pregnant mice were cultured in MEM + 0.5 microgram/ml of sodium selenite [Na2SeO3] (MEMS), and in MEM alone with oxygen for 24 hours, and then the two groups of hearts were exposed to 10, 15, 20, 30, 40, 60 min and a long term of anoxia in glucose-free MEMS and glucose free MEM respectively. Results showed that the survival and beating of the cultured fetal mouse hearts with experimental free-glucose and anoxia were prolonged by selenium. The application of lanthanum as a marker demonstrated that the permeability function of myocardial cell membrane and mitochondrial membrane of early experimental anoxia were protected by selenium. By using electron microscopy when structural damages occurred, it was shown that the time of occurrence of irreversible injuries could be postponed by selenium. From the fact that ribosomes increased in the cell of selenium-treated hearts, we concluded selenium may play a promotive role in the synthesis of protein in experimental free-glucose and anoxic conditions. PMID- 1775743 TI - [Relationship between QRS transition zone and the interventricular septum: using CT scan]. AB - The relationship between the QRS transition zone of the standard 12-lead ECG and interventricular septum was studied. The position and the angle to the horizontal line of the interventricular septum were evaluated with computed tomography (CT) and compared to the QRS transition zone. The subjects were 36 patients with no cardiovascular diseases. The patients were divided into 3 groups according to the position of QRS transition zone: V1-V2 (8 cases), V3-V4 (21 cases), and V5-V6 (7 cases). The interventricular septum on CT was directed to the anterior chest wall between V3 and V4 in all 3 groups. The mean value of the interventricular septal angle did not differ from group to group, 52.1 degrees for V1-V2 group, 49.8 degrees for V3-V4 group, 48.2 degrees for V5-V6. It was concluded that the direction of the interventricular septum was not one of the major determinants of the QRS transition zone in the standard 12-lead ECG. PMID- 1775742 TI - [Effects of ouabain, caffeine, and diltiazem, on spontaneous cyclic Ca2+ release from sarcoplasmic reticulum in the skinned papillary muscles of guinea pigs]. AB - The aim of this study was to assess whether ouabain has a direct action on the sarcoplasmic reticulum (SR) sufficient to be responsible for the mechanism of the inotropic action, and whether caffeine and diltiazem, which inhibit ouabain induced afterpotential and after-contraction, can inhibit the effects of ouabain on the SR. As one of the functions of SR, spontaneous cyclic contractions (cyclic Ca2+ release from the SR) in saponin-treated skinned fibers of guinea pig papillary muscles were used. Ouabain 10(-9)-10(-7) M increased the frequency of cyclic contractions and induced an incomplete muscle relaxation. Caffeine 1-5 mM and diltiazem 1-5 mM induced a sustained tension. In the fibers treated with ouabain, caffeine and diltiazem induced a sustained tension. In Brij-58 treated skinned fibers, 10(-9) M ouabain did not change the Ca2+ sensitivity of the contractile system. It is now known that ouabain increases intracellular calcium transients. An incomplete muscle relaxation of cyclic contractions seems to be due to both increased SR Ca2+ release and decreased Ca2+ reuptake by SR. Thus, we suppose that ouabain-induced increase in intracellular calcium transients is due to increased intracellular Ca2+, which may be one of the mechanisms in the inotropic action. The masking effects of caffeine and diltiazem on the ouabain induced increase in cyclic contractions seem to be responsible for the inhibitory effects of drugs on digitalis-induced afterpotential and after contraction. PMID- 1775744 TI - [Cardiac mast cells in myocardial diseases]. AB - Mast cells play a role in inflammation and immunological reactions. Cardiac mast cells with their granules are demonstrated easily by toluidine blue staining. We evaluated cardiac mast cells in endomyocardial biopsy specimens in patients with acute myocarditis (n = 17), idiopathic dilated cardiomyopathy (n = 17), idiopathic hypertrophic cardiomyopathy (n = 17) and control subjects (n = 12). Cardiac mast cells increase to an extreme degree in patients with acute myocarditis (2.4 counts/mm2) and increase relatively in patients with idiopathic dilated cardiomyopathy (1.4 counts/mm2). Patients with idiopathic hypertrophic cardiomyopathy (0.4 counts/mm2) were similar to control subjects (0.5 counts/mm2). Cardiac mast cells increased in accord with the severity of cellular infiltration and of interstitial fibrosis except for some cases with very severe fibrosis. In the acute myocarditis group, cardiac mast cells were well demonstrated in the early stage of the illness. But degranulations of mast cells did not give us any significant information in this study. Evaluation of cardiac mast cells will provide us with a new aspect in studying primary myocardial diseases. PMID- 1775745 TI - [Exercise and dipyridamole-loading in evaluation of ischemic coronary lesion and coronary reserve in children with Kawasaki disease]. AB - In order to compare the clinical effects of exercise-loading and intravenous dipyridamole-loading tests in evaluating ischemic coronary lesion and coronary reserve, we evaluated changes in ECG, 201-Tl scintigraphy, coronary flow and myocardial metabolism in 10 patients with Kawasaki disease (age range: 7-16 years). Although both loading tests affect coronary hemodynamics and myocardial metabolism by different mechanisms, both were equally effective in detecting ischemic coronary lesion and reduced coronary reserve. On the other hand, when considered on the basis of clinical examination methods used, the dipyridamole loading test was more effective for evaluating clinical symptoms and ECG, while exercise-loading was more effective for evaluating 201Tl scintigraphy and supply demand balance. These results suggest that, in the evaluation of ischemic coronary lesion, assessment of clinical effects by a combination of several examination methods is required. PMID- 1775746 TI - [Prediction of late restenosis using early treadmill exercise testing after PTCA]. AB - The purpose of this study was to evaluate the capability of treadmill exercise testing early after percutaneous transluminal coronary angioplasty (PTCA) for prediction of restenosis during the follow-up period. Subjects were comprised of 30 patients with single vessel disease, in whom angiographic success immediately after PTCA was obtained. Follow-up coronary angiography at a mean of 3.5 months after initial PTCA demonstrated restenosis in 15 patients. Treadmill exercise testing was conducted before PTCA (pre-EX), at a mean of 11 days after PTCA (early-EX), and at a mean of 3.2 months after PTCA (late-EX). The degree of residual stenosis immediately after PTCA measured using videodensitometry was similar in both the groups with and without restenosis. In the non-restenosis group, Functional aerobic impairment (FAI), myocardial aerobic impairment (MAI), and heart rate impairment (HRI) measured in the early-EX period improved significantly compared to that in the pre-EX period (p less than 0.05, p less than 0.01, and p less than 0.05, respectively). There were no significant changes in the restenosis group. Using exercise parameters before and soon after PTCA, a discriminant analysis was made between these groups. The formula was defined as follows; Z = 0.0178 x (FAI of pre-EX) +0.0543x (FAI of early-EX) +0.0513x (MAI of pre-EX) -0.1056x (MAI of early-EX) -0.3135. Under this formula, 14 of the 17 patients with Z less than 0 had restenosis during the follow-up period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775747 TI - [Prediction of severity of coronary artery disease by treadmill exercise testing]. AB - Coronary angiography was performed in 250 patients with a significant ischemic ST segment change detected by symptom-limited maximum treadmill exercise testing, and relationship between anatomical severity of coronary artery disease and parameters in exercise testing was studied. The age of the patients ranged from 34 to 76 years (188 men, 62 women). One-vessel disease (1VD) was presented in 82 patients, two-vessel disease (2VD) in 42, three-vessel disease or left main coronary disease (3VD) in 26, and no significant stenosis was presented in 100 subjects (Normal). Functional aerobic impairement (FAI) was evaluated in each group as a parameter of exercise capacity, myocardial aerobic impairment (MAI) and heart rate impairment (HRI) were also evaluated as a parameter of maximum myocardial oxygen requirements and maximum heart rate, respectively. Using these parameters, discriminant analysis was performed to compare the group with significant coronary artery disease and the Normal group. Also, to compare the group with multi-vessel disease and the group with less than 2VD. Also, the 3VD group and the group with less than 3VD. FAI, MAI and HRI were significantly different (p less than 0.0001) in each group. The discriminant formula to separate the group of significant coronary artery disease from the Normal group was Z = -1.049 + 0.02 [FAI] +0.08 [MAI] +0.03 [HRI]. According to this formula, sensitivity was 92.5% and specificity was 71.5%. The discriminant formula to separate the group with multi-vessel disease from the group with less than 2VD was Z = -4.731 + 0.07 [FAI] +0.106 [MAI] +0.02 [HRI]. According to this formula, sensitivity was 96.3% and specificity was 78.8%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775748 TI - [A case of ruptured distal arch aneurysm associated with postoperative unilateral respiratory disorders]. AB - This paper describes a patient with ruptured distal arch aneurysm associated with postoperative unilateral respiratory disorders whose life was able to be saved by surgery. The patient was a 68-year old male who underwent emergency surgery due to sealed rupture of distal arch aneurysm while preparing for selective surgery. Artificial graft replacement of the distal arch was carried out under centrifugal pump bypass. Respiration was controlled using differential lung ventilation (DLV) techniques. This was done because weaning from the respirator was difficult due to decreases in lung-thorax compliance on the opened chest side after surgery. Weaning from the respirator was achieved on the 10th day of illness after surgery. Postoperative prognosis of ruptured thoracic aneurysm is extremely poor, with high mortality being attributable to the fact that most patients are elderly and the incidence of respiratory and cardiovascular complications is very high. In addition, problems are often encountered in postoperative respiration management in patients with thoracic aneurysm who need open chest surgery. DLV seems to be a useful support in such patients who have underlying respiratory disorders. PMID- 1775749 TI - [Reflections about the present and future of hearing aids]. AB - For a long time hearing aids were the only solution for the deaf to perceive speech and sounds. Today, among the new deaf-aids, acoustic amplification still offers the easiest and most versatile means of combatting the majority of such handicaps. However, due to the fundamental inadequacy of amplification in compensating frequency selectivity, audiologist are obliged to pay particular attention to the improvement of the signal/noise ratio and to observe a rigourous procedure in choosing and fittings hearing aids to the user. In the future, signal processing in digital devices should contribute to enhancing the efficacy of the prosthesis. PMID- 1775750 TI - [Implantable hearing aids]. AB - The purpose of these hearing aids is to improve the quantity and quality of amplification of the sound wave. Their operating principle is based on the existence of a transducer which transforms the electric signal captured by the microphone into a mechanical, vibrating wave. This transducer can act either directly on the temporal bone by short-circuiting the middle ear (and is then called a bone conduction implant) or directly on the ossicular chain (in which case it is called an ossicular transduction implant). A) There are 2 types of bone conduction implant: the "Audiant Bone Conduction" system of Hough-Vernon (Xomed), where an outside electromagnetic coil sends signals transcutaneously to a magnetic screw embedded on the temporal bone. Bone conduction must be normal. The "Bone Anchored Hearing Aid" (Nobelpharma) where the outside electromagnetic coil sends signals directly to the magnetic screw that is percutaneous. The mean thresholds in bone conduction can reach up to 45 dB. The drawbacks of this system lie in its inaesthetic appearance and the risk of infection. B) With ossicular transduction implants, the transducer may be: either an electromagnetic coil influencing a magnet fixed to the tympanum, on the ossicular chain, or replacing an element of the ossicular chain (these hearing aids are marketed by Richards); or a piezo-electric crystal which produces vibrations when it is subjected to an AC current, and which can be positioned on the stapes (Yanagihara). This system consumes less energy, gives excellent results for the high frequencies, but is more cumbersome. PMID- 1775751 TI - [Bone anchored hearing aid. Results of bilateral applications]. AB - In our experience B.A.H.A. (Bone Anchored Hearing Aid) with its direct bone conduction brings a better hearing rehabilitation for patients with draining ear and further more with major aplasia. 23 patients were tested, 12 have got a bilateral hearing aid, 5 unilateral. They reported a better comfort, a more natural sound and a better discrimination in noise. A bilateral application brought them a stereoacousy with a special directivity, we also note improvement of hearing by different hearing tests. PMID- 1775752 TI - [Biomaterials in otology]. AB - Biomaterial may be biological or non-biological in origin. Only the latter will be considered here. Their possible use in otology is threefold: ossiculoplasty: the author recalls the different materials used during the past 30 years. Today, it seems that only certain ceramics are able to compete with auto and homografts. Hydroxylapatite ossicles are a perfectly good alternative; canal wall reconstruction in radical operations: in this context their role appears to be less satisfactory than that of autografts; cavity obliteration: very useful and effective when performed in the correct situation and under certain well-defined technical conditions. After outlining the different materials used in the past 30 years, the author draws upon the experience of his own school to give his personal opinion. PMID- 1775753 TI - [General principles of conception of cochlear implants]. AB - Cochlear implants have greatly been developed on last ten years. Their diversity makes their use and choice more complex. The authors expose simply the physiopathology of the implanted auditory system and basic principles of cochlear implants. Cochlear implants are caracterised by the number of channels and electrodes (monochannel, multichannel), the strategy of encoding (analogiq, digital), the transmission of signal (per-cutaneous, electro-magnetic induction), the site of stimulation (extra or intra-cochlear), the signal wave (sinusoid, pulse), the diffusion of current (monopolar, bipolar). PMID- 1775754 TI - Cochlear implants, acquisitions and controversies in the adult patient. AB - The cochlear implant field is rapidly progressing in the clinical field. This progress has produced new information regarding choice of devices, selection criteria, and surgical techniques. Some of these points remain controversial, and the authors try to determine their real value. PMID- 1775755 TI - [Cochlear implants in children: acquisitions and controversies]. AB - This paper analyzes the main difficulties encountered in cochlear implants in children. Neurophysiological data indicate that cochlear implants should be put during the first 3-4 years of life. The principal controversies concern: the indications of cochlear implants, the type of implant (mono or multichannel), surgical problems, problems of implant set-up, strategy of rehabilitation. PMID- 1775756 TI - Cochlear implantation in child. AB - Implants in children of the Nucleus 22-channel system have recently been approved in the United States by the Food and Drug Administration (FDA). Several questions still remains, however, concerning patient selection. This paper presents a statistical method of reporting results and its application to two populations of cochlear implant candidates: congenitally deaf children, and profoundly deaf children with meningitis as the cause of their deafness. It has been suggested that as these two groups may have significantly lower performance than other populations, it may not be appropriate to select them as implant candidates. The statistical method used aggregated single-subject, repeated measures data to reach conclusions on performance. Findings for congenitally deaf subjects evidenced significant improvements over preoperative performance. Results for post-meningitic children showed no significant difference in overall performance compared to non-meningitic children. PMID- 1775757 TI - [The choice between mono- and multielectrode implants in rehabilitation of total deafness in young children]. AB - We underline the necessity to supply a prelingually totally deaf patient with some sound information before the critical age of about 5-8 years, which we had previously experimentally demonstrated on the guinea pig. Multichannel cochlear implant is the most efficient and must be placed most of cases. However, specially in case of total ossified cochlea, single channel cochlear implant is the only usefull. The respective indications of these two different systems are discussed as a function of pronostic preoperative data, cochlear total ossification, and financial considerations. The decision to supply a young totally deaf child with a cochlear implant must be considered as an emergency. PMID- 1775758 TI - [Multi-electrode extra-cochlear implants]. AB - From july 1987 through july 1989, we have performed eight extra-cochlear implants for the rehabilitation of bilateral total deafness. In this paper we develop this experience, to give the positive aspects but also the negative ones and we give the reasons why we prefer currently the intra-cochlear implant. However this implant and its method are a good solution in case of an ossified cochlea. PMID- 1775759 TI - [The "Ineraid" multichannel cochlear implant]. AB - In Geneva from 1985 to November 1990, we have implanted 21 Ineraid TM multichannel-cochlear implants in 18 totally deaf patients. On the basis of our experience we have divided the patients in 2 categories: optimal cases and difficult cases. Optimal cases had post lingual deafness and adequate anatomical conditions for implantation. They all recovered understanding of free running speech without lip-reading. Difficult cases had ossified cochlea or pre-and perilingual deafness: results are variable and less predictable. The cochlear implant is both an artificial sense organ and a prosthetic device. With the aid of the prothesis the patient can hear. When the processor stops functionning the patient is again totally deaf. Implanted deaf patients require life-long technical and medical support. PMID- 1775760 TI - Experience with the Nucleus multichannel cochlear implant. AB - We have seen using the Nucleus multichannel cochlear implant since 1984, with more than 200 patients operated. Out of 152 adults, ten have ailed, either because of explants, or because of other causes especially psychological causes. Out of 53 children, only one child seldom wears his device. For the post-lingual adults, the vocal training is very short, during the three weeks hospitalisation necessary to place and to check the implant. The children need a much longer training period, which takes place in a special and pluridisciplinary cochlear implant center. PMID- 1775761 TI - [Cochlear implants, which one to choose?]. AB - The choice of a cochlear implant is a difficult one. A given type of implant does not yet correspond to a given type of patient. Our indications have to be refined by acquired experience and through the improvement of tests prior to implanting. The implants available present different features, but they all improve the communication of the profoundly deaf to different degrees, by attenuating their tinnitus. PMID- 1775762 TI - [Dyslexia: neuropsychological and neurolinguistic aspects]. AB - A brief review is given of the contribution of neuropsychological diagnostic methods and neurolinguistic diagnostic investigations. Through the analysis of errors, neurolinguistic examinations today make it possible to isolate in dyslexic populations at least three groups with clear-cut characteristics, requiring a distinct remedial approach. Neuropsychological investigations, and in particular their cross-matching with radiological neuro-imaging methods, serve to evidence the specificity of the cerebral organization of dyslexics. PMID- 1775763 TI - [The child with dysphonia and its rehabilitation]. AB - The purpose of this article is to answer the following questions: whom to rehabilitate and when? As from when, and on what criteria? For what goal and how? For how long? With what results? The author describes a procedure based on a system of values or a philosophy or rehabilitation consisting of offering the child an improved being and an encounter with his or her voice to get to like it. PMID- 1775764 TI - [Phoniatric record during voice rehabilitation for kissing nodules in a child]. AB - Dysphonia in the child occurs relatively frequently. More often than not it is the result of strain, but a phoniatric examination is worthwhile to determine whether or not vocal rehabilitation is required, the purpose being to make the child aware of the vocal gesture and correct his or her vocal attitude. A phoniatric follow-up can sometimes determine the need for surgery when the nodules hinder the vocal development of a young singer. PMID- 1775765 TI - [Voice and emotion]. AB - Voice and emotion are partly linked. The voice reacts to and translates emotion, but can also be seen as an instrument to release emotion. Emotion is a source of wealth for the voice, bringing it to life, giving it meaning and content. The voice, by serving emotion, enriches and enhances it. PMID- 1775766 TI - [Functional anatomy of the pharynx]. AB - The pharynx, as the junction of the aero-digestive pathways, is situated in the centre of the cervico-facial region. The description of its anatomic components will be complemented by a study of the muscular-aponeurotic features, that the pharynx forms with its surrounding regions, presenting a complex velo-pharyngo facial structure, the anatomic unity of which will be confirmed by a functional unit. PMID- 1775767 TI - [The voice of laryngectomized patients after receiving colonic or other intestinal transplant]. AB - This study reports the experience of our Rehabilitation Centre for laryngectomees un Albi regarding the acquisition of an esophageal voice in cases of circular total pharyngolaryngectomy, with restoration of continuity through intestinal or colic transplantation. Among eight rehabilitated patients, we obtained six good results with a voice allowing a conversation easily understood by relatives and friends. Thus, we think this continuity restoration method gives good phoniatric results. PMID- 1775768 TI - [Management of unilateral vocal cord paralysis]. AB - The phoniatric analysis evaluates the importance of the vocal disorder and the appearance of the larynx what permets to find five clinical cases. For each one, there is a precise treatment: no treatment, rehabilitation with precises exercises in each case, collagen injection, early or secondary to rehabilitation. The rehabilitation will be intensive and done as soon as possible. It is based on a well known body proprioception. Intrinsic laryngeal muscles work, breathing exercises, exercises aimed at restoring the laryngeal sphincter will precede the pure vocal work. Author's experience shows that the results are good if rehabilitation is well indicated from the beginning and the patient with good motivations. PMID- 1775769 TI - [Gerda Alexander eutonia]. AB - One of the most important objectives of euronia is to find the adequate tonus in situations of total rest or of maximum dynamism. The dimension of tonic mastery together with relaxation make eutonia an extremely useful method in phoniatrics and orthophony. PMID- 1775770 TI - [Tubal rehabilitation: modalities, evaluation and prospects]. AB - Having defined tubal rehabilitation, the authors present the notions required for effective performance. Its efficacy is examined through the opinions of the ENT physician and of the orthophonic logopedist. PMID- 1775771 TI - Cancer clinical trials. PMID- 1775772 TI - History of clinical trials. AB - Advances in medical treatments have occurred because of the application of new knowledge gained from clinical experiments conducted over the last 250 years. New sources of compounds with anti-tumor activity in human cancer are constantly under investigation. The development of a new drug is a complex process: screening, formulation, production, toxicology studies, FDA approval, and evaluation in phase I, II, and III clinical trials. PMID- 1775773 TI - Cancer clinical trials. Clinical trials programs. AB - The National Cancer Institute (NCI) is the largest single sponsor of studies using anti-neoplastic agents with over 100 compounds currently in various stages of clinical testing. Most of the clinical trials are conducted by the NCI sponsored cooperative oncology groups and community oncology programs, cancer centers, and the pharmaceutical industry. These organizations conduct studies both independently as well as in a collaborative fashion. PMID- 1775774 TI - Planning and implementing clinical trials. AB - Careful planning and organization are essential in the design and conduct of a clinical trial. The clinical protocol provides a framework that describes the proposed experiment and outlines the means for achieving specific endpoints. Protecting research participants and assuring quality control are important to the conduct of clinical trials. the participation and responsibilities of oncology nurses contribute to the success of clinical trials. PMID- 1775775 TI - Cancer clinical trials. Companion studies. AB - Nursing companion studies may accompany research in a variety of disciplines but most often are associated with medical research. Companion studies include "collaborative-companion" studies and "parallel-companion" studies and rely on a variety of methods. The majority of nursing companion studies have focused on the areas of treatment effects or symptoms, cancer control, and rehabilitation, however, there are many other areas that provide opportunity for independent nursing research. PMID- 1775776 TI - Obstacles to implementing cancer clinical trials. AB - There are numerous obstacles to implementing and conducting clinical trials. Patient accrual and the costs of clinical trials are difficult problems for researchers. Additional obstacles to implementing clinical trials are patient related, physician-related, and nurse-related barriers. PMID- 1775777 TI - The professional role for nurses in clinical trials. AB - This article has examined the role of the nurse in clinical trials, particularly the clinical, administrative, and research roles. Components of each role and characteristics essential for the implementation of each role have been examined. The nursing role in clinical trials research is undergoing major transformation from the perception of the nurse as a data collector for medical research to the recognition of the nurse as an essential member of the research team with a multifaceted role. Miaskowski identifies two factors influencing the development of oncology nursing practice; scientific and technological advances and societal factors relating to the perception of cancer as a disease and changes in the nursing profession. Certainly it is recognized that progress in basic science research will lead to an increase in the complexity and number of clinical trials. Nurses have clearly implemented the roles necessary to be vital participants and have contributed to answering questions leading to improved treatments for the patients with cancer. PMID- 1775778 TI - Preparing nurses for clinical trials: the cancer center approach. AB - How do you prepare the nursing staff for the implementation of a new phase I drug protocol? It is the nursing educator who assists the staff nurses to competently and confidently learn to provide direct care and support to patients in clinical trials. Preparation of the nursing staff involves an analysis of the proposed study's impact on nursing, orientation of the study, periodic updates, specialized training if necessary, and facilitation of patient teaching. PMID- 1775779 TI - The community hospital perspective of clinical trials and the role of the nurse educator. PMID- 1775781 TI - Cancer clinical trials. New challenges for nurses in clinical trials. PMID- 1775780 TI - Ethical issues in clinical trials. AB - The oncology nurse may assume many different roles in clinical trials, including direct care provider, educator, advocate, data collector, primary investigator, and member of the IRB. Regardless of the role, the nurse is in a key position to promote the interests of the individual subject as well as helping to assure that the clinical trial is conducted with scientific and ethical integrity. The nurse can help to assure that the subject is adequately informed and facilitate rational decision making. The nurse can also assure that the requirements of the protocol are consistently attended to and that subjects are well monitored and data precisely collected. "In oncology, perhaps more than in any other medical specialty, there is a blurring of the distinction between research, therapeutic innovation, and medical practice. The frontiers of knowledge in cancer are continuously advancing. The final step in the process of procuring usable knowledge is the clinical trial, a meeting place of the practice of medicine and clinical research. Because of this there are many ethical considerations which must be attended to in the justification of and conduct of a clinical trial. PMID- 1775782 TI - [HTLV-I retrovirus in Chile: study on 140 neurological patients]. AB - We screened 140 patients with different neurological diseases for the presence of anti HTLV-1 virus antibodies. ELISA test confirmed with Western Blot analysis was performed in CSF and blood. Positive findings were obtained in 23 out of 52 patients with progressive spastic paraparesis (44%). All patients with multiple sclerosis, polymyositis, amyotrophic lateral sclerosis or chronic polyneuropathy were negative. Patients with progressive spastic paraparesis and positive HTLV-1 antibodies were most commonly women (78%) and middle aged (mean 46 years old), with a history of surgical interventions (70%) or blood transfusion (35%). A slowly progressive spastic paraparesis with asymmetric onset and minimal sensory complaints was observed in some cases. Mononuclear pleocytosis in the CSF was observed in 35% with an increased IgG index in 88%. A delayed latency and low amplitude of somatosensory evoked potentials was observed in 89% of patients. PMID- 1775783 TI - [Human recombinant erythropoietin (rH-EPO) in chronic hemodialysis patients]. AB - We studied 7 patients on chronic hemodialysis before and after 12 weeks of therapy with human recombinant erythropoietin. The drug was administered intravenously, 3 times a week at doses increasing from 50 to 125 U/kg. Dialysis was performed for 4 hr, 3 times a week and no blood transfusions were used during the study. An increased tolerance to daily physical activities was observed in all patients. Hematocrit increased from 19 +/- 3.4 to 28 +/- 4.1 and hemoglobin from 6.7 +/- 1.3 to 9.4 +/- 1.5, p less than 0.01. No changes were detected in blood pressure, weight, liver function tests and nutritional values. No patient developed either absolute (ferritin less than 30 ng/ml) or relative iron deficiency (transferrin saturation less than 20%) during the study. Efficiency of dialysis remained unaltered. No secondary effects from the drug were observed. Thus, this study confirms the clinical usefulness of human recombinant erythropoietin in patients with chronic renal failure and anemia on chronic dialysis. PMID- 1775785 TI - [Mitral valve prolapse associated with Basedow's disease and active hyperthyroidism. Preliminary report]. AB - We performed 2 dimensional echocardiograms to investigate the presence of mitral valve prolapse (MVP) in 21 patients with Graves disease and active hyperthyroidism. 22 healthy subjects were used as a control group. The incidence of MVP was 24% (n = 5) in hyperthyroid patients compared to 5% (n = 1) in normals (NS by Fisher's exact test). Age, T3 and T4 levels were similar in hyperthyroid patients with and without MVP, but the clinical course was longer in the former. A study in a larger group of patients may help establish the increased incidence of MVP in hyperthyroidism. PMID- 1775784 TI - [Autoimmune polyglandular syndrome. Clinical experience in 21 cases]. AB - The autoimmune polyglandular syndrome is characterized by the association of 2 or more endocrine disorders of autoimmune origin which may coexist with autoimmune disorders in other organs. Roughly 25% of patients with an autoimmune endocrinopathy show evidence of autoimmune disease elsewhere. We report 21 patients with autoimmune polyglandular syndrome classified according to Neufeld. PMID- 1775786 TI - [Variation of bone density in relation to age: analysis of 259 necropsies]. AB - In a previous study we reported a relatively low incidence of hip fracture in our population compared to figures reported elsewhere and speculated that this could be related to differences in bone density. Accordingly, we measured bone density in 259 subjects at necropsy. In 172 males we found that bone density decreased from 0.88 g/cc at age 21-30 to 0.80 at age 70 (NS). In women, density decreased from 1.0 at age 21-30 to 0.84 at age 50, 0.69 at age 60 and 0.64 in those older than 70 years (p less than 0.01). These figures are higher than those reported from USA at all ages and could explain the lower incidence of hip fractures in our population. PMID- 1775787 TI - [Clinical significance of cervical arthropathy in patients with vertigo]. AB - We performed a thorough neuro-otological evaluation and a radiological study of the cervical spine in 102 patients with vestibular symptoms. A group of 20 asymptomatic subjects served as control. Some degree of cervical spondylosis was found in 121 of 122 patients but also in the majority of control subjects. No relationship was observed between the degree of cervical spondylosis and vestibular abnormalities. Instead, the latter were strongly related to age. Thus, an age dependent microvascular damage may be more likely as an etiological factor for vestibular symptoms in the elderly. PMID- 1775788 TI - [Serum level determination of local anesthetics using high pressure liquid chromatography]. AB - We report a high resolution liquid chromatography method for simultaneous determination of lidocaine, mepivacaine and bupivacaine in serum using cyclicine as a standard. Drugs are extracted from serum using dichloromethane in an alkaline medium type columns in a mobile phase with 0.1 M phosphate buffer at pH 7.5, methanol and acetonitrile (33:17:50) were used for separation. Spectrophotometric measurement was performed at 207 nm. In a concentration ranging from 0.5 to 8 micrograms/ml, r values of 0.997, 0.989 and 0.998 were obtained for lidocaine, mepivacaine and bupivacaine, respectively. The coefficient of variation estimated at 2 micrograms/ml was 2, 19, 2.76 and 2.48%, respectively. A maximal error of 4.5%, 3.6% and 2.9% found for "inter day" repeated measurement at the above concentration for each drug. Thus, high sensitivity, reproducibility and relative simpleness of the method are demonstrated for its clinical use in determination of serum levels of local anesthetics. PMID- 1775789 TI - [Antiviral therapy with recombinant alpha-interferon in chronic B virus hepatitis]. AB - Two patients with chronic Hepatitis B virus infection were treated with recombinant alpha-interferon. A positive response with seroconversion from HbeAg to Anti HBe and loss of HBsAg and appearance of Anti-HBs was obtained in one patient. Clinical characteristics and factors that may influence the response are discussed in the light of a review of the literature. PMID- 1775790 TI - [Acquired immunodeficiency syndrome associated with infection by HTLV-1 virus: a clinical case]. AB - A 51 year old man with acquired immune deficiency syndrome for 2 years developed a chronic leukemia/T cell lymphoma. Anti HTLV-1 antibodies were confirmed by Western Blot. In the last months he developed hypercalcemia and leukocytosis of 130,000. Necropsy confirmed the diagnosis of Leukemia/T cell lymphoma without cutaneous involvement. PMID- 1775791 TI - [Complicated primary splenic cyst: a clinical case]. AB - A 16 year old man developed progressive swelling at the left hypochondrium over a 3 month period. Non painful splenomegaly was shown by physical examination and confirmed by ultrasonography and scintigraphy. Successful splenectomy disclosed a primary splenic cyst. The patient recovered uneventfully. PMID- 1775792 TI - [Relations of the physician and his patients in today's medicine: background and perspectives]. AB - In the last decades, demographic, economic and social changes along with the explosive development of scientific and technological aspects in medicine have modified public expectations in health care. The doctor-patient relation has been modified accordingly. Access of all patients to the most sophisticated medical care seems increasingly difficult and may be considered utopic. Thus, education of both medical students and general public must be urgently directed towards the primary and secondary prevention of most common diseases. The doctor-patient relation must be strengthened in the framework of a solid humanistic and scientific basis. PMID- 1775793 TI - [The training of medical specialists according to the needs of the country]. AB - The system that has been operating in Chile for the training of medical specialists since 1952 is reviewed. The original system was based on the concept of a medical residency and remained under the tuition of the University of Chile Post Graduate School. The financial support came mostly from the National Health Service and the training took place in general hospitals belonging to that Institution. In the last 15 years, other Medical Schools have opened their programs and changes in the structure and financing of medical care have profoundly affected the number and financing of medical residencies, many of which are not funded at all. A thorough study of the number and spectrum of medical specialists that are needed in this country is proposed. Also, measures to increase the number and funding of post graduate training places are encouraged. PMID- 1775794 TI - [Campylobacter laridis: first clinical isolation and identification of a reservoir in Chile]. PMID- 1775795 TI - [University and creativity]. AB - The University is a natural environment for the development of the creative aspects of man. Professional training and the solution of specific problems, though important, are secondary objectives. For those working in the University, freedom must be turned into a way of living; thus, creativity becomes possible. The University belongs to the nation and not to governments. This is the origin of the autonomous nature of the University and more than a privilege, it must be viewed as a basic requirement for creativity. The University is basically democratic since creativity is not related to race, religion, or politics. Finally, it is hierarchical since credit must be given to talent, training and experience. PMID- 1775796 TI - [Atmospheric pollution in Santiago]. PMID- 1775797 TI - The issue of disseminating nursing and caring research to nurses. PMID- 1775798 TI - Students' mental health problems: a critical inquiry. AB - The aim of this study was to examine the subjective and environmental factors underlying students categorized as "single reports" reporting to the Academic Mental Health Consulting (MHC) units in Poland. An attempt was made to verify a common assumption that so called low-achieving students use the health care system to find legitimate excuses for their academic and personal failures. Obtaining a doctor's certificate explaining their health status provides people with many "privileges". This study revealed a discrepancy between the "official" description of 1740 student files and their subjective reasons for contacting the MHC obtained through a questionnaire. The study further revealed a lack of student follow up as recommended by the MHC. The study findings seem to confirm the assumed misuse of the health care system by underachieving students. A recommendation was made as how we can reduce this misuse of students services. PMID- 1775799 TI - A phenomenological hermeneutic access to research of the old age area. Experience with application of the qualitative research interview. AB - The purpose of this article is to describe the phenomenological, hermeneutic research as a scientific research method. We shall introduce the scientifically theoretical placing of the qualitative research interview and the implementation of the interview, through presentation of twelve aspects which have functioned as a scientific-theoretical/methodical guide for the whole process of interviewing. Finally, we shall briefly discuss problems connected with using the qualitative research interview as the primary method of the research process. The experience concerning the use of the qualitative research interview was gained through a study on life-style specific ways of coping with a temporary period of illness and rehabilitation of the old. A final presentation of the results of the whole study and a discussion of these are being finalized for publication. PMID- 1775800 TI - Psychosocial adjustment to cystectomy for bladder carcinoma and effects on interpersonal relationships. AB - Postoperative adjustment and the psychosocial consequences of cystectomy were studied in 34 patients with bladder carcinoma. Urinary diversion was accomplished via a conduit in 20 patients and a continent caecal reservoir in 14. Interviews with the patients were conducted according to a semistructured outline. The great majority adjusted fairly well, mainly due to support from family members. Help was provided by medical staff in only a few cases. While relationships with friends were unchanged, those with spouse/partner were commonly disturbed by sexual problems and presence of a urostoma. The mode of urinary diversion had no influence on the studied variables. Despite a high acceptance level of their malignant affliction, several patients did not accept their present situation. Lack of psychologic support from the health services was a common experience. PMID- 1775801 TI - Evaluating the nursing and educational perspectives of nurse instructors. AB - The nursing and educational perspectives of nurse instructors (NIs) were compared. Three nursing perspectives (professional, vocational and technical) and two educational perspectives (inner teaching and outer teaching) were measured by quantitative methods. The evaluation of the perspectives was carried out by a questionnaire (sent to 268 NIs, of whom 72% responded) with both closed-ended and open-ended questions. Factor analysis produced the following factors: 1) a technical nursing perspective and an outer teaching perspective (unqualified NIs and older NIs had a more technical nursing perspective and a more marked outer teaching perspective); 2) a professional nursing perspective; and 3) an inner teaching perspective. It was shown by discriminant analysis that NIs displaying features (2) and (3) were qualified NIs. PMID- 1775802 TI - The sucking behaviour of two patients in the final stage of dementia of the Alzheimer type. AB - Two patients in the final stage of dementia of the Alzheimer type (DAT), who could no longer be given nutrition by assisted feeding, were given fluids by means of the sucking ability they still retained. They sucked more slowly under nutritive than under non-nutritive sucking conditions. The sucking efficiency of one of them improved during training. The status of the patients in the final stage of their dementia differed from one another, which might explain the difference in outcome. It is therefore suggested, that the use of the patients' sucking ability could serve as a complement and/or an alternative feeding technique when assisted spoon-feeding becomes extremely difficult or impossible. It is considered to be more gentle and natural than the present feeding techniques. PMID- 1775803 TI - The autonomy of nurses in high dependency care. Conflicts of loyalties and their consequences for patient care. AB - The aim of this study is to enquire into the kind of ethical dilemmas reported by nurses in the high dependency health care sector. Nurses from different intensive care units at one British hospital were interviewed. The interviews, which were tape recorded, show that nurses often found themselves in conflict between the patient's interests and those of other people, such as physicians, relatives, other patients, colleagues, etc. Competing loyalties and role conflicts contributed to complicate the nurses' ethical problems. PMID- 1775804 TI - Who cares for the caregiver? Factors exerting influence on nursing home admissions of demented elderly. AB - Forty-six demented elderly and their caregivers previously studied with respect to strain on caregivers; were studied one year after the initial assessment with respect to institutionalization. Patients admitted to a nursing home, showed more pronounced mental and behavioural disturbances. Cognitive functions, gender, marital status and living conditions did not differ between the two groups. The caregivers of institutionalized demented were older, they expressed more feelings of anger and despair and more often requested the care receiver transferred to a nursing home. PMID- 1775805 TI - Care of demented patients with severe communication problems. AB - Two time-studies and an interview study were carried out at a geriatric clinic. The aim was to elucidate how much time caregivers use for direct patient care in their contact with severely demented patients compared with non-demented patients as well as how they experience the care of demented patients in a task assignment care system. The analysis showed that more time was used to help non-demented patients than demented patients with the same ADL-performance. Five types of patient reactions to communicative attempts made by the caregivers were described: the patient seems to enjoy contact, he avoids contact, contact leads to aggression, he reacts only sporadically to contact and he does not show any reactions to it. The caregivers described negative reactions to demented patients with communication problems. Communication problems seem to be a threat to caregivers' commitment. PMID- 1775806 TI - Breast cancer management at Memorial Sloan-Kettering Cancer Center. PMID- 1775807 TI - Mammographic detection of breast cancer and preoperative needle localization. AB - Since its early clinical use during the 1960s, mammography has become a widely accepted screening method for breast cancer. Its utilization may be capable of diminishing mortality by 40%. Screening programs have been instituted, and their cost effectiveness depends on the locale and age of the population screened. Mass screening has resulted in large numbers of nonpalpable lesions being biopsied. Needle localization techniques allow for these to be performed with a minimal chance of missing the lesion, while removing only a small volume of breast tissue. Although most lesions biopsied will be benign, 20-30% of those excised at any institution should be malignant. Consultation with experienced mammographers may be desirable when recommending mammography-based biopsy. The rate of detection of malignancy is higher in women who have a prior history of ipsilateral or contralateral breast cancer. PMID- 1775808 TI - Surgical considerations in needle localization procedures. AB - There is an increasing need for needle localization biopsies. Cancers so detected are usually at an earlier stage and should result in an increased cure rate. The surgeon involved in these procedures should, of necessity, be proficient in evaluating mammographic abnormalities, since there is considerable variation in the way they are reported by various radiologists. Localization can be accomplished with various hooked wires or dye, but accuracy of placement is more important than the method used and this point is well understood by cooperative radiologists. Since 70-80% of these lesions will be benign, cosmesis should be kept in mind. Incisions should be placed centrally, if possible, and the volume excised should be minimal and not lead to deformity. When poorly localized, excision of these lesions can be a trying experience for the experienced surgeon. PMID- 1775809 TI - Pathological assessment of nonpalpable breast lesions. AB - Effective pathological examination of breast specimens from patients with nonpalpable radiologically detected lesions requires close cooperation among the pathologist, surgeon, and radiologist. Whenever possible, excision of the lesion should be documented by specimen radiography of the intact excisional biopsy. Diagnosis of the lesion and evaluation of margins should be based on permanent paraffin sections. Frozen section examination is not recommended routinely but may be employed in exceptional circumstances. Thermal damage to the tissue caused by electrocautery scalpels can reduce hormone receptor levels and can interfere with histological diagnosis. PMID- 1775810 TI - Management of the high-risk patient. AB - While breast cancer is affecting American women at an epidemic rate, certain patients are identified as being at particularly high risk because of environmental, endocrine, genetic, and pathologic risk factors. Risk assessment, dietary, and psychological counseling, as well as breast cancer screening, are the function of a high-risk breast cancer program. Our own program is discussed. PMID- 1775811 TI - Primary treatment for breast cancer. AB - Adequate local-regional treatment of patients with primary operable breast cancer involves controlling multicentric disease in the breast, and axillary dissection to stage the disease and control it in the axilla, when present. Two options, showing equal survival rates in prospective, randomized studies, are breast preservation and mastectomy. In breast preservation, adequate tumor excision with clear histologic margins and axillary dissection is followed by breast irradiation. The mastectomy option involves no radiation therapy and can be followed by reconstruction. Careful selection of patients and detailed description of the pros and cons of each approach should be undertaken on an individual basis. PMID- 1775812 TI - Radiation therapy in breast conservation patients and postmastectomy. AB - Radiation has played a continuous but changing role in the management of breast cancer. At Memorial Hospital, the past 10 years have seen a marked increase in breast conserving therapy, and changing indications for postmastectomy adjuvant radiation. PMID- 1775813 TI - Adjuvant systemic therapy for early breast cancer. AB - Systemic therapy (chemotherapy or hormonal therapy) as an adjuvant to modalities of local control is now an integral part of the management of almost all patients with primary breast cancer metastatic to axillary lymph nodes. In addition, recent data suggest an expanding role for such treatments in patients without axillary involvement. Although some node-negative patients should probably not receive adjuvant therapy, the precise criteria to be used for selection are still under active discussion in the literature. Of the two types of systemic treatment, it is generally accepted that chemotherapy is indicated for premenopausal patients and that tamoxifen is useful for postmenopausal patients whose tumors contain estrogen or progesterone receptors. The recent analysis of several studies has suggested that chemotherapy may add to the benefits of tamoxifen in some postmenopausal patients as well. A possible role for tamoxifen in younger patients is being evaluated. For patients at relatively low risk of systemic relapse (i.e., those with zero to three involved axillary lymph nodes), no chemotherapy regimen has yet shown an advantage over 6 months of cyclophosphamide, methotrexate and 5-fluorouracil. For patients at high risk, however, doxorubicin-based regimens have demonstrated benefits. High-dose chemotherapies, some involving autologous bone marrow support, are being investigated for patients with ten or more involved nodes who are at very high risk of the eventual development of stage IV disease. PMID- 1775815 TI - Breast reconstruction following mastectomy. PMID- 1775816 TI - Bilateral breast cancer. AB - Bilateral breast cancer has a cumulative incidence of 7% to 20% in patients with primary operable breast cancer, and the majority of these lesions are metachronous. A consensus on the management of the contralateral breast has been elusive. Much of the confusion arises from the fact that there exist marked differences of opinion regarding the impact of a second primary breast cancer on the overall prognosis. The risk of developing a contralateral breast cancer is influenced by the age of the patient, the presence of in situ disease, lobular histology of this new lesion, multicentricity, exposure to certain types of ionizing irradiation, and, possibly, family history of breast cancer. Management options include observation (clinical and mammographic surveillance), contralateral biopsy, and, rarely, prophylactic mastectomy. It is hoped that trials of breast cancer prevention, employing drugs such as tamoxifen, will identify agents capable of abrogating the risk of contralateral breast cancer and improve the ultimate outcome. PMID- 1775814 TI - Salvage mastectomy. AB - Local-regional relapse after breast-conserving surgery and radiation therapy is operable and not associated with concurrent distant metastases in most cases. Salvage mastectomy results in local-regional control for most patients. The extent of the surgery relates to the extent of the local-regional recurrence and does not carry an increased complication rate. The outcome of salvage mastectomy depends on the disease-free interval from initial breast-conserving surgery and radiation therapy to local-regional recurrence. Additional factors, such as the extent and histologic type of the recurrence, as well as the axillary lymph node status, either at the time of initial breast conservation or at salvage mastectomy, may influence outcome and require further study. Prospective trials are required to determine the safety of further breast-conserving surgery after local-regional relapse and the role of systemic therapy in improving postsalvage survival. PMID- 1775817 TI - Pregnancy-associated breast cancer. AB - The incidence of pregnancy-associated (PA) breast cancer is rising, as childbirth is being delayed to the women's 30s and early 40s, when breast cancer is more frequent. Most reports consider "PA breast cancer" as that being diagnosed during pregnancy, or within one year after. The delay of diagnosis often seen in PA breast cancer may be due to physician oversight or reluctance to perform a biopsy during pregnancy. Two-stage procedures are favored in this setting, with biopsy under local anesthesia, then extent-of-disease work-up and definitive treatment, usually mastectomy. The use of scans for staging, and irradiation for treatment, is avoided, where possible, due to fetal risk. Likewise, chemotherapy is carefully gauged to avoid fetal damage. With these precautions, the prognosis for women with PA breast cancer, stage for stage, is similar to that of women of the same age treated at the same time period at MSKCC. PMID- 1775818 TI - Management of occult breast cancer presenting as an axillary metastasis. AB - The presentation of cancer in an axillary lymph node without an obvious primary site is a diagnostic challenge. This is particularly true in female patients. A diagnosis of metastatic adenocarcinoma consistent with occult breast primary requires further prompt therapy. PMID- 1775819 TI - Male breast cancer. AB - Breast cancer in the male is an uncommon disease, occurring less than 1% as often as in females. Because of its rarity, this disease has not been as extensively studied as its female counterpart. Male breast cancer is evaluated and managed in a fashion very similar to that for female breast cancer. Primary management in early stage disease is usually a modified radical mastectomy. First line hormonal therapy for metastatic disease, in our institution, is tamoxifen for patients with positive estrogen receptors. Second line therapy consists of progestins or antiandrogens/LHRH analogs. No firm recommendations can be made concerning adjuvant systemic therapy. However, it is likely that studies from female patients are adaptable. Unfortunately, carcinoma of the male breast is such an infrequently encountered tumor that unfamiliarity with the disease can lead to delays in diagnosis and treatment. An increased awareness of the disease may be expected to result in earlier detection and institution of therapy at a stage when cure may be possible. PMID- 1775820 TI - Psychological reactions to breast cancer in the pre- and post-surgical treatment period. AB - Breast cancer has been widely studied with respect to its psychological impact because it is a disease which threatens an organ that is intimately associated with self-image, self-esteem, sexuality, femininity, and reproductive and nurturing capacity. Breast cancer is a significant stress for any woman; however, women vary widely in their response to diagnosis and treatment. In this manuscript we review the following issues: social, psychological, and medical variables that contribute to the psychological response, and the usual responses of women in the pre- and postsurgical treatment period. PMID- 1775821 TI - Breast cancer rehabilitation. AB - The Breast Surgery Rehabilitation Group (BSRG), established initially in 1970, assists patients at Memorial Sloan-Kettering Cancer Center (MSKCC) with psychical and emotional recovery from breast cancer surgery and promotes return to preoperative activities. The team includes a physical therapist, social worker, and nurse. Attendance at sessions is prescribed by all physicians on the Breast Service. Problems such as threat to life by cancer and emotional impact of breast loss are addressed, in addition to aid in actual physical recovery from surgery with exercise instruction and interaction with other women in the group who have a similar diagnosis. The information and support provided in this way help the patient to achieve a sense of control in a situation that threatens their emotional and physical world. PMID- 1775822 TI - [Pick's disease. Anatomo-clinical point of view]. AB - For historical reasons, Pick's disease is sometimes misunderstood in the medical literature. However, clinical signs are quite typical, and different from those of Alzheimer's disease. The disease is characterized by a circumscribed fronto temporal atrophy, without senile lesions. Neuronal loss and ballooned neurons are present in the atrophic cortex. In about 30 p. 100 of cases, Pick's bodies are present, with various shapes, perhaps depending upon the duration of the disease process. Other lesions are described. The symptomatology is characterized by personality changes of the frontal type, associated with verbal and behavioural stereotypies, and bulimia. There is a striking normality of the EEG, and CT scan shows the fronto-temporal cortical atrophy and atrophy of the caudate nucleus. In most cases, memory for recent events is quite normal, but sometimes an amnestic syndrome is closely related with an unusually severe atrophy of the hippocampus. The consequences of atrophy of the caudate nucleus are debated, since extrapyramidal symptoms appear to be mild and late. PMID- 1775823 TI - [Historical note: Desire Bourneville (1840-1909)]. PMID- 1775824 TI - [Risk factors in amyotrophic lateral sclerosis. Initial results apropos of 35 cases]. AB - A retrospective study of endogenous and exogenous risk factors in amyotrophic lateral sclerosis (ALS) was conducted in 35 ALS patients and 35 healthy controls, using guided questioning. No significant correlation was detected between the disease and most of the environmental factors explored. A significant difference (p less than 0.05) was found between patients and controls in only two parameters: 1) occurrence of injuries during the year that preceded the diagnosis of ALS (usually localized to the limbs), and 2) regular practice of sports in adulthood. It appeared that injuries often revealed but could not be considered as a possible cause of the disease. Analysis of the sport activities was not sufficient for a definite conclusion. On the other hand, 11 p. 100 of ALS patients had a family history of ALS, and 25 p. 100 (as against 8 p. 100 of controls) had a history of degenerative disease of the nervous system. These results should lead to a reconsideration of genetic factors or to a search for exposure of several members of the same family to toxic or infectious environmental factors. PMID- 1775825 TI - [Vertebrobasilar arterial dolichoectasia. Complications and prognosis]. AB - Symptomatic dolichoectasia of the vertebrobasilar system was found in 23 patients (16 males and 7 females, mean age: 62 years) during a 13-year period. Arterial hypertension was noted in 20 cases and associated aortic ectasia in 4. The malformation was identified in all patients on CT completed by angiography in 19, MRI in 7. Autopsy was performed in 5 cases. Fourteen subjects (group 1) presented with a vascular event (ischemic in 13) affecting the brainstem and/or cerebellum. Nine other patients (group 2) had a chronic symptomatology resulting from compression of the cranial nerves, central nervous system and/or CSF pathway. Two patients died of stroke within the first month (rupture of the ectasia in one and occlusion in the other one). The 21 survivors were followed for a mean period of 45.3 months. Eight patients had a stroke, with a significantly higher incidence in group 1 than in group 2 (p less than 0.05). Ten patients (5 in each group) developed progressive dementia possibly resulting from multiple cerebral infarction, hypertensive leucoencephalopathy, and/or hydrocephalus. Twelve patients died during the follow-up (4 of stroke, 6 of profound mental and motor deterioration, one from ruptured ectatic aorta, and the last one of unrecognized cause). The actuarial survival rate was 60% after 3 years of follow-up. Except for the incidence of stroke, inaugural manifestations (stroke vs nervous compression) did not seem to influence the long-term prognosis. PMID- 1775826 TI - [Course of central somatosensory conduction in a case of vitamin B12 deficiency]. AB - We report clinical and neurophysiological data of a 58 year-old man with vitamin B12 deficiency and a 6 years follow-up. The initial clinical disorders did not permit a clear distinction between peripheral and central nervous system disease. Detailed analysis of the somatosensory central conduction time (measured from onset latencies of N11 and N20) showed clear evidence of slowed down conduction at spinal cervical level (reflected by the N11-P14 interval) whereas supraspinal conduction (as shown by the P14-N20 interval) was normal. The patient's condition improved under treatment, and the somatosensory central conduction time was progressively shortened. After 6 years of treatment, the neurological examination and the somatosensory central conduction interval were normal. However, analysis of the spinal conduction still showed slowed down conduction. PMID- 1775827 TI - [Effect of diabetes mellitus and blood glucose on the size of cerebral infarction and causes of death. Neuropathological study of 77 cases of infarction in the sylvian artery area]. AB - The influence of diabetes mellitus and hyperglycemia on cerebral infarction has been studied on 77 patients who died of infarcts in the territory of the middle cerebral artery. The size of the infarcts was assessed by transferring the surface of the infarcted area onto 8 schematic drawings corresponding to 8 brain slices and measuring this surface by means of a planimeter. An infarction volume index (IVI) was calculated by measuring the ratio of the infarcted area to the theoretical area of the middle cerebral artery territory on the 8 slices. The causes of death were assessed by full post-mortem examination. There was no statistically significant difference in size of infarcts and causes of death between diabetics and non-diabetics. However, the stroke-to-death interval was shorter (p = 0.05) in non-diabetic patients. It appears from this study that diabetes mellitus has no deleterious effect on cerebral infarction. Equally, there were non statistically significant differences in size of infarcts, stroke to-death interval and causes of death between patients with and without hyperglycemia. PMID- 1775828 TI - [Thalamo-peduncular germinoma]. AB - A 24 year-old patient presented with chronic intracranial hypertension, palsy of both abducens nerves and upward gaze, and right hypoesthesia. CT scan and MRI showed a left thalamic tumor infiltrating the left cerebral peduncle. A stereotactic biopsy revealed a germ cell tumor. Following radiotherapy the patient recovered except for ophthalmoplegia. The tumor totally disappeared on CT scan and MRI. PMID- 1775829 TI - [Comparison between x-ray computed tomography and magnetic resonance imaging after transient ischemic accidents]. AB - We studied 18 patients with transient ischemic accidents (TIA) and normal CT scan during the first 24 hours. MRI was performed 9 days later on average. MRI revealed abnormalities in 10 patients (56 p. 100), but only 5 of them (27 p. 100) had lesions corresponding to TIAs, and in every case these were in the carotid territory. In the 7 patients with clinical signs of TIA in the vertebro-basilar territory, MRI was always negative. In 5 patients (27 p. 100), MRI showed abnormalities that were unrelated to TIA. This study suggests that MRI is of limited value in detecting brain tissue abnormalities and is perhaps not more sensitive than CT in vertebro-basilar TIA. However, in view of the small number of patients these results must be interpreted with caution. PMID- 1775830 TI - [Epidural angiolipoma and multiple familial lipomatosis]. AB - In a 35-year old woman presenting familial multiple lipomatosis, spastic paraparesis developed and became worse under tetracosactide therapy. Signs of spinal cord compression at T3 were present. CT and MRI revealed a fat-containing epidural tumour (angiolipoma). The association of angiolipoma with familial multiple lipomatosis has not yet been reported. This association supports the theory that angiolipomas are hamartomatous lesions. The deterioration observed under tetracosactide suggests that iatrogenic epidural lipomatosis is due to the development of a pre-existing lipoma. PMID- 1775831 TI - [Sarcoidosic pachymeningitis: course with corticosteroid therapy in magnetic resonance imaging]. AB - Cranial pachymeningitis is a rare manifestation of sarcoidosis, corresponding to a pseudo-tumoral thickening of the meninges. We report the case of an African patient who presented with isolated headaches. CT-scan and MRI showed the topography of the lesions and their regression under corticosteroid therapy. PMID- 1775832 TI - [Severe amblyopia and Alzheimer' disease]. AB - A 69-year-old woman developed a rapid and severe visual loss and became nearly blind in a few weeks. As she also presented with memory loss and other disturbances of cognitive functions, with progressive deterioration over one year, a probable Alzheimer's disease was diagnosed. Cerebral CT scan and magnetic resonance imaging were normal. However, clinical and electrophysiological (visual evoked potentials) data indicated an impairment of the primary visual pathways rather than a degeneration of the secondary visual cortex. This case is compared with and discussed in relation to recent reports concerning retinal and optic nerve damage in Alzheimer's disease. PMID- 1775833 TI - [Presentation at Pitie-Salpetriere hospital. December 1989. Vertigo, dysarthria and hemiparesis in a 71-year-old woman]. PMID- 1775834 TI - Brucellosis: an unusual diagnosis for a seronegative patient with abscesses, osteomyelitis, and ulcerative colitis. AB - A 16-year-old girl developed multiple subcutaneous abscesses, osteomyelitis, and severe colitis. On the patient's second admission, a single blood culture--and, subsequently, a specimen of pus--yielded Brucella melitensis biovar 1. A second set of serologic tests, including the rose bengal test, the standard tube agglutination test, the CF test, and Coombs' test, were all negative for Brucella on the patient's second admission and 1 month later. However, a lymphocyte proliferation assay with extracted antigen of Brucella was markedly positive. Thus, this case illustrates that patients with B. melitensis infection may have a unique clinical presentation and that the lymphocyte proliferation assay is an important diagnostic tool for patients whose serologic test results are negative but for whom brucellosis is suspected. PMID- 1775835 TI - Pertussis encephalopathy in an adult: case report and review. AB - A 39-year-old man developed paroxysmal cough, occasional vomiting after cough, and subconjunctival hemorrhage. His illness was complicated by episodes of seizure, with clonic movements of the arms and legs, brief loss of consciousness, and confusion. The episodes were triggered by mild, unremarkable coughing paroxysms. A diagnosis of pertussis was confirmed serologically by measurement of IgG, IgA, and IgM antibodies to pertussis toxin and filamentous hemagglutinin. Serologic studies confirmed the presence of Bordetella pertussis infection in the patient's 10-year-old daughter and suggested that his wife was infected as well. This case report illustrates the occurrence of typical pertussis with serious complications in an adult. Further research is required to determine the scope of this problem and the need for a program of adult immunization against pertussis. PMID- 1775836 TI - Infections due to Stomatococcus mucilaginosus: 10 cases and review. AB - We describe 10 new cases of bacteremia due to Stomatococcus mucilaginosus and review eight other cases that have been described in the literature. The most common clinical presentations were endocarditis, catheter-related infection, and septicemia. Commonly associated risk factors were intravenous drug abuse, cardiac valve disease, the presence of foreign bodies (especially indwelling vascular catheters), and immunocompromised states. S. mucilaginosus bacteremia is readily treatable with antibiotics. This organism is of low virulence, but appears to be an emerging pathogen. Infection due to S. mucilaginosus is likely to be underreported because the organism may be easily misidentified and information on it is not included in the databases of many automated microbiologic identification systems. PMID- 1775837 TI - Use of the polymerase chain reaction for the specific and direct detection of Clostridium difficile in human feces. AB - The polymerase chain reaction was used for the detection of Clostridium difficile, the etiologic agent of antibiotic-associated colitis. An upstream primer identical to a coding region (segment I) of the C. difficile 16S rRNA gene and a downstream primer complementary to a highly conserved region of eubacterial 16S rRNA served to amplify a targeted 270-base-pair fragment of genomic DNA. This technique allowed the detection of as few as 10 C. difficile organisms among 10(6) Escherichia coli bacteria. This level of sensitivity represents a 100-fold increase over that of conventional anaerobic culture. C. difficile was detected in DNA extracted directly from the stools of 23 patients with antibiotic associated colitis and from those of four patients with diarrhea whose stools had been negative for C. difficile when assessed in a cytotoxicity assay. No amplification products were found in the stools of asymptomatic patients. When detected in stools of symptomatic patients, amplification products of C. difficile were confirmed by Southern blotting with a nonradioactive, horseradish peroxidase-catalyzed, chemiluminescent probing system in which biotin-labeled oligonucleotides were used. This system discriminates between C. difficile and similar organisms, such as Clostridium sordellii and Clostridium bifermentans. The combination of the polymerase chain reaction with enzyme-linked probing results in a faster and more sensitive assay for C. difficile than standard culture. PMID- 1775838 TI - Use of ciprofloxacin for successful eradication of bacteremia due to Campylobacter cinaedi in a human immunodeficiency virus-infected person. AB - A 36-year-old homosexual man who was infected with human immunodeficiency virus presented with a 2-month history of fever and intermittent diarrhea. Stool cultures were negative for bacterial pathogens, ova, parasites, and acid-fast organisms. An initial blood culture became positive after 5 days for a curved, gram-negative rod that was identified later as Campylobacter cinaedi. The patient received a series of antibiotic regimens, including a 2-week course of erythromycin followed by a 2-week course of tetracycline, but follow-up blood cultures continued to yield C. cinaedi. The patient was then treated with a 2 week course of oral ciprofloxacin; he remained asymptomatic 11 weeks later, at which time a blood culture was negative for C. cinaedi. To the best of our knowledge, this is the first documented case of symptomatic bacteremia due to C. cinaedi that was successfully treated with ciprofloxacin. PMID- 1775839 TI - Splenic tuberculosis in patients with AIDS. AB - Splenic tuberculosis is an uncommonly considered diagnosis in clinical practice. We report splenic tuberculosis in three patients with AIDS who were admitted to the hospital because of fever and constitutional syndrome. In all of the patients, abdominal sonography and abdominal computed tomography revealed multiple hypoechoic and hypodense lesions, respectively. In two patients needle aspiration of the spleen with sonographic control was the diagnostic procedure. In the third patient the diagnosis was confirmed after splenectomy. In AIDS patients tuberculosis must be included in the differential diagnosis of hypoechoic and hypodense lesions by means of sonography and computed tomography, respectively, especially in those patients with active tuberculosis. PMID- 1775840 TI - Infections with Pseudomonas paucimobilis: report of four cases and review. AB - Pseudomonas paucimobilis (formerly CDC group IIK, biotype 1) is a strictly aerobic, nonfermenting, oxidase- and catalase-positive, gram-negative bacillus that is widely distributed in water and soil. Its name derives from the difficulty encountered in demonstrating its motility, even in liquid media. This microorganism is responsible for two types of infection in humans: sporadic or community-acquired infections, probably of endogenous or environmental origin (bacteremia, meningitis, urinary tract infection, and wound infection); and outbreaks of nosocomial infection associated with the contamination of sterile fluids employed in hospitals. We present four cases of infection caused by P. paucimobilis (two of bacteremia, one of leg ulcer infection, and one of cervical adenitis). The majority of infections produced by P. paucimobilis have a good prognosis; no deaths related to this entity have been reported in the literature. The published results of susceptibility tests suggest that the aminoglycosides (either alone or in combination with a beta-lactam antibiotic) or the quinolone may be the agents of choice in the treatment of these infections. PMID- 1775841 TI - Disseminated infection with Fusarium in recipients of bone marrow transplants. AB - Clinical data from 10 episodes of disseminated infection with Fusarium among eight recipients of bone marrow transplants and from 31 cases reported previously in the literature were analyzed in an effort to characterize the natural history of this rare infection and its response to therapy. The characteristic signs of fusarial infection--disseminated skin nodules, fungemia, and multiple-organ involvement--are results of its propensity for early spread. From a review of the literature and our own experience, it appears that recovery of phagocytic mechanisms (the primary immunologic defenses against Fusarium) in the form of rising neutrophil counts is mandatory for clinical resolution. Even after a graft begins to function adequately, Fusarium may not be completely eradicated, as evidenced by the high incidence of recurrence among patients with subsequent neutropenic episodes. Fusarium is highly resistant to conventional antifungal drugs in vitro, but its progression may be slowed by intensive antifungal therapy until the recovery of adequate neutrophil levels. PMID- 1775842 TI - Hematogenous dissemination of Mycobacterium tuberculosis in patients with AIDS. AB - Proof of hematogenous dissemination of Mycobacterium tuberculosis was initially reported in the early 1900s and was noted to be most frequent in patients with miliary tuberculosis. More recently, M. tuberculosis bacteremia has been reported in human immunodeficiency virus (HIV)-infected patients. We describe 13 adult HIV infected patients in whom hematogenous M. tuberculosis dissemination was evident. Although for most patients whose bone marrow aspirate cultures yielded M. tuberculosis a chest roentgenogram revealed a miliary pattern, roentgenograms for those with M. tuberculosis bacteremia usually revealed evidence of lobar or diffuse infiltrates. Most patients with M. tuberculosis bacteremia had other risk factors for M. tuberculosis, and many had a rapid death, suggesting acute fulminant infection. Our own experience suggests that there are various syndromes associated with hematogenous dissemination in patients infected with M. tuberculosis. PMID- 1775843 TI - Gonococcemia associated with adult respiratory distress syndrome. AB - We report a case of gonococcemia that was associated with adult respiratory distress syndrome (ARDS). To our knowledge, this is only the third reported case of ARDS associated with gonococcemia. This is the first reported case of ARDS associated with gonococcemia that was documented by positive results of blood cultures and measurements of wedge pressure obtained by a catheter in the pulmonary artery. We also believe that this is the first reported patient who required mechanical ventilation under positive end-expiratory pressure. This patient made a full recovery. Gonococcemia associated with ARDS continues to occur rarely in patients despite the prevalence of disseminated gonococcal infection. The reason for the infrequent occurrence of ARDS with disseminated gonococcal infection remains uncertain. PMID- 1775844 TI - Epidemiological spectrum and current treatment of listeriosis. AB - To reassess the epidemiology and treatment of listeriosis in the United States, we reviewed greater than 120 cases of listeriosis from four medical centers in three geographically separated cities: Los Angeles County-University of Southern California Medical Center (LAC-USCMC); Rush-Presbyterian-St. Luke's Hospital, Chicago; the University of Illinois Hospital, Chicago; and Vanderbilt University Hospital, Nashville, Tennessee. The epidemiological pattern at LAC-USCMC was relatively narrow; more than two-thirds of the cases occurred during the perinatal period. Cases at Vanderbilt University Hospital represented the opposite end of the spectrum; the majority of these occurred in nonpregnant, older adults who had received organ transplants. An intermediate pattern of cases was observed at the two medical centers in Chicago. Potential risk factors included pregnancy, neonatal status, organ transplantation, renal failure, malignancy, systemic lupus erythematosus, steroid therapy, and AIDS (two cases). Antimicrobial agents noted to be effective were, as expected, penicillin and ampicillin; the cephalosporins were ineffective. The mortality associated with listeriosis occurred mainly among premature infants and stillbirths delivered from infected pregnant women and was markedly less among neonates and adults. PMID- 1775845 TI - Catheter-related infections caused by the Mycobacterium fortuitum complex: 15 cases and review. AB - Fifteen cancer patients have developed catheter-related infections caused by the Mycobacterium fortuitum complex (M. fortuitum and Mycobacterium chelonae) at M. D. Anderson Cancer Center since 1978. Eleven patients had bacteremia and four had catheter site infections. Nine infections were caused by M. fortuitum and six by M. chelonae. All four bacteremic patients whose catheters were initially removed and who were treated with antibiotics recovered, whereas for all of the seven bacteremic patients whose catheters remained in place, the infection relapsed or treatment failed. Six (86%) of the latter group ultimately responded to additional antibiotic therapy when the catheter was removed. Successful treatment of local catheter infections was accomplished by catheter removal alone or in combination with antibiotic therapy. Fourteen additional cases have been reported, and eight (57%) of these patients also had underlying cancer. Patients with septicemia or an infection at the catheter insertion site responded to catheter removal and appropriate antibiotics. Patients with infection in the catheter tunnel (tunnel infection) responded only after surgical excision of the tissue surrounding the infected tunnel. M. fortuitum complex is a cause of catheter-related bacteremia in patients with cancer. Appropriate treatment consists of antibiotic therapy and catheter removal. Tunnel infections usually also require surgical excision. PMID- 1775846 TI - Fever, leukopenia, and a cutaneous lesion in a man who had recently traveled in Africa. PMID- 1775847 TI - Estrogens and infection. AB - The multiple effects of estrogens on infectious processes are only beginning to be understood. The existence of such effects is suggested by gender-related differences in the incidence and severity of some infections and by the association of certain infections with predictable hormonal changes. Current information indicates that estrogens may depress cell-mediated immunity, impair the activity of natural killer cells, and suppress some aspects of neutrophil function. Estrogens potentiate the production of systemic antibody, but local antibody responses may be impaired. Direct effects of estrogens on microorganisms have thus far been best studied in fungi; these hormones may either stimulate or suppress fungal virulence, depending on the species involved. Recent research also suggests responsiveness to estrogens in a wider variety of microorganisms. Studies in cell culture, animals, and humans indicate that pregnancy, estrogen supplementation, and menstrual stage can affect the acquisition and severity of certain bacterial, parasitic, and viral infections. This interaction depends on multiple attributes of both the microbe and the host in a given setting and thus may lead to disparate outcomes; however, there appears to be a predisposition to increased infectious morbidity in certain high-estrogen states. In view of the widespread use of estrogen supplementation, the clinical impact of estrogens on the incidence and outcome of infection needs to be better defined. PMID- 1775848 TI - Hemolysis and infection: categories and mechanisms of their interrelationship. AB - Different cause-and-effect relationships between hemolytic and infectious processes are categorized in a clinically useful manner as follows: infections causing hemolysis by invasion of red blood cells (RBCs), by hemolysins, or by immune mechanisms; oxidative damage to RBCs during infections; hemolysis secondary to infection-induced pathologic processes; hemolytic effects of antimicrobial therapy; and predisposition of an individual to infection caused by an underlying hemolytic disorder or therapy for that disorder. The mechanisms of these interrelationships are discussed in detail. PMID- 1775849 TI - The ecology of Cryptococcus neoformans and the epidemiology of cryptococcosis. AB - The ecology of Cryptococcus neoformans and the epidemiology of cryptococcosis are reviewed. Two varieties of C. neoformans have been recognized. C. neoformans variety neoformans has been found in nature worldwide, primarily in association with bird droppings, although nonavian sources have also been found. Most cases of human cryptococcosis are caused by this variety. C. neoformans var. gattii has recently been isolated in nature in association with Eucalyptus trees. Infections caused by this variety occur mainly in tropical and subtropical regions. Because exposure to C. neoformans is probably common and clinically apparent cases of cryptococcosis in healthy hosts are rare, it is presumed that most people can mount adequate host defenses upon exposure to the organism. At least 5%-10% of patients with AIDS become infected with Cryptococcus; the epidemiology of this infection is different in many respects from that seen in patients without AIDS. PMID- 1775850 TI - In vitro susceptibility vs. in vivo efficacy of various antimicrobial agents against the Bacteroides fragilis group. AB - In vitro susceptibility testing is only one step in the evaluation of the potential efficacy of antimicrobial agents against the Bacteroides fragilis group. An assessment of in vivo efficacy, with a consideration of the factors that can best be studied in an infected host, is also an integral part of this process. Abscess models in rodents have been used to correlate in vitro activity with in vivo efficacy against this group of microorganisms. For metronidazole, clindamycin, moxalactam, and cefoxitin, the correlation was strong; for chloramphenicol and carbenicillin, it was not. In vivo studies of mixed infection with the B. fragilis group and Escherichia coli showed that cefoxitin and imipenem were effective; in contrast, cefotetan was not effective against resistant strains. Only strains susceptible to ceftizoxime in the agar dilution test were also affected by this drug in vivo. The so-called inoculum effect noted with ceftizoxime may explain this finding. In vivo elimination of encapsulated organisms of the B. fragilis group was found to be more difficult than elimination of unencapsulated isolates. The beta-lactamase produced by Bacteroides species can protect the enzyme-producing organism as well as its partners in mixed infections from the effects of beta-lactam antibiotics. These data illustrate the complexity and difficulties encountered when in vitro activity is correlated with in vivo efficacy. PMID- 1775851 TI - Editorial response to Brook: Comparison of in vivo methods for determination of antimicrobial efficacy. PMID- 1775852 TI - Vertebral osteomyelitis and aortic lesions: case report and review. AB - Coexistence of vertebral osteomyelitis and lesions of the aorta is rare but may be lethal if not diagnosed promptly and treated effectively. We describe a patient who was treated at the Cleveland Clinic Hospital, and we review 69 additional cases reported in the literature. The native aorta was involved in 66 cases; four patients developed infection of prosthetic aortic grafts. The most common aortic lesions associated with vertebral osteomyelitis were mycotic aneurysms, infected aneurysms, and pseudoaneurysms. The wide variety of pathogens involved included salmonellae and other gram-negative bacilli, mycobacteria, gram positive cocci, and fungi. In some cases infection was polymicrobial. The condition was associated with protean clinical manifestations. Diagnosis was frequently delayed, and mortality was 71%. In some instances surgical procedures at sites of unsuspected aneurysms precipitated life-threatening hemorrhage. Therapy with antimicrobial drugs alone was insufficient. The best results were achieved when specific drug therapy was combined with resection of the infected aorta or aortic graft, thorough debridement, and extraanatomic bypass grafting. PMID- 1775853 TI - Pleuropulmonary infections caused by Eikenella corrodens. AB - A case of pleuropulmonary infection caused by Eikenella corrodens is reported, followed by a review of clinical cases reported in the English-language literature since 1970. On the basis of this review, the predisposing factors, clinical features, and principles of diagnosis and treatment of this infection are outlined. Although infection may occur at any age, it seems to occur most often in patients less than or equal to 14 or greater than or equal to 44 years of age. Adult patients commonly have some underlying medical illness, pleuropulmonary malignancy being the most common. Patients present with a variable combination of fever, cough, and pleuritic chest pain. Four radiographic patterns may be seen: pleural effusion, pneumonia, cavitation, or a combination of these. Ampicillin and penicillin G are effective therapeutic agents; although the susceptibility of E. corrodens to penicillin G has been accepted as the rule, it may not always prevail. The need for increased awareness of this organism as a cause of pleuropulmonary disease is stressed because it is resistant to clindamycin, an agent that is increasingly used to treat anaerobic pleuropulmonary infections. PMID- 1775854 TI - Metronidazole-induced acute pancreatitis. AB - Three cases of metronidazole-induced acute pancreatitis have been reported recently in three women who were being treated for nonspecific vaginitis. We report the fourth such case in a 63-year-old woman with long-standing Crohn's disease who developed acute pancreatitis that was temporally associated with the initiation of metronidazole therapy for a rectovaginal fistula. No other risk factors for pancreatitis were identified except for possibly Crohn's disease itself. We review the literature with regard to metronidazole-induced acute pancreatitis and suggest a possible mechanism. Metronidazole should be considered as a possible cause of acute pancreatitis, and its use should be discontinued if no other risk factor is found. PMID- 1775855 TI - Seroepidemiology of pertussis in Italy. AB - During 1988 and 1989 the prevalence of serum IgG antibodies to pertussis toxin in a sample of 3,875 unvaccinated, apparently healthy persons between the ages of 1 year to 19 years was estimated by enzyme-linked immunosorbent assay. The participants were recruited by means of systematic cluster sampling from public and private schools in five geographic areas of Italy. The overall prevalence of IgG antibodies was 80.8%, with a steady increase from 33.5% among 1- to 3-year old children to 95% among 17- to 19-year-old individuals. The prevalence of natural immunity was 50% and 75% at the ages of 4 and 6 years, respectively. No gender-related difference in immunity was observed. For children greater than 10 years of age, the seroprevalence of pertussis antibodies was significantly higher in northern regions than in southern regions until the age of 17-19 years, when the pattern reversed. There was no association of a child's immune status with the father's number of years of schooling or with family size. For children aged 1-3 years, serologic studies showed that the history of pertussis reported by parents in questionnaires was highly specific (97.6%) in predicting antibody status, with positive and negative predictive values of 90.5% and 79.2%, respectively. However, 20.8% of children had antibodies to pertussis toxin even though they had no history of whooping cough. PMID- 1775856 TI - Experimental infection of human subject with Strongyloides species. AB - Because of excellent and readily available animal models of infection with Strongyloides species, much of the basic biology of the parasite was understood by the early 1930s. Only selected issues of major physiologic importance were left to be addressed by intentional human infections. Concern about the strongyloides hyperinfection syndrome and the parasite's characteristic refractoriness to drug therapy led investigators of experimental human infections to act as subjects. This article reviews studies that describe experimental human infection with Strongyloides stercoralis and Strongyloides fulleborni as well as other Strongyloides species. These studies address two main issues: the clinical manifestations associated with the prepatent and early patent phases of infection, and the development of immunity to reinfection in individuals previously infected. The possible conclusions from these studies are discussed in the context of the current understanding of natural human and experimental animal infections. PMID- 1775857 TI - Some aspects of Rocky Mountain spotted fever as shown by recent investigations. 1909. PMID- 1775858 TI - The life and career of Howard Taylor Ricketts. PMID- 1775859 TI - Did scarlet fever and rheumatic fever exist in Hippocrates' time? AB - Case histories recorded by Hippocrates around 400 B.C. describe the clinical manifestations of scarlet fever and rheumatic fever, although the entities are not identified by name. Although the descriptions are not as detailed or complete as they would be today, they strongly suggest the existence of scarlet fever and rheumatic fever at that time. Hippocrates' references to these illnesses were presumably the first to be documented and/or discovered, as a thorough search of the worldwide medical literature revealed no prior descriptions. PMID- 1775860 TI - Tumor necrosis factor in patients with leptospirosis. PMID- 1775861 TI - Fatal necrotizing otitis externa in a patient with AIDS. PMID- 1775862 TI - A case report of Escherichia vulneris urosepsis. PMID- 1775863 TI - Prognosis of enterococcal endocarditis. PMID- 1775864 TI - Splenic abscess due to Fusobacterium necrophorum. PMID- 1775865 TI - Pneumonia due to Bordetella bronchiseptica in a patient with AIDS. PMID- 1775866 TI - A case of human endocarditis due to Streptococcus suis in North America. PMID- 1775867 TI - Bacteremia due to Erysipelothrix rhusiopathiae in immunocompromised hosts without endocarditis. PMID- 1775868 TI - Bronchiolitis obliterans-organizing pneumonia associated with Cryptococcus neoformans infection. PMID- 1775869 TI - Pyomyositis due to group C streptococci in a patient with AIDS. PMID- 1775870 TI - Anaerobic bacteremia: declining rate over a 15-year period. PMID- 1775871 TI - Role of altered drug metabolism in virus-drug interactions. PMID- 1775872 TI - [Respiratory involvement in AIDS]. AB - This review paper is divided into three parts. The first two parts are devoted to an analytical description of the clinical, diagnostic, prognostic and therapeutic aspects of the various bronchopulmonary and pleural lesions observed in AIDS. The third part presents an overall view of the main diagnostic and therapeutic approaches in the main clinical situations covering all respiratory disorders. PMID- 1775873 TI - [Specific provocation tests]. AB - The authors describe the methodology of allergen challenge tests, with special attention to some particular aspects, such as the allergenic extracts and their biological activity, and the methods used in aerosol administration and in measurements of bronchial obstruction. They present the results of their personal experience, concerning interindividual variations in a sensitized population and the reproducibility of the immediate reaction revealed by dose-response curves. Comparisons of allergen tests with exposure to allergens under physiological conditions are discussed. In occupational asthma the exposure tests sometimes constitute the only diagnostic method, owing to ignorance of the responsible mechanisms and to the multiplicity of incriminated substances. However, these tests are not without danger and must be performed by well-trained medical and paramedical teams. PMID- 1775874 TI - [Lung diseases and treatment with methotrexate in rheumatoid arthritis]. AB - Methotrexate (MTX) is used as sequential treatment of rheumatoid arthritis in doses ranging from 5 to 20 mg per week, but its effectiveness is impaired by undesirable and sometimes severe side-effects, notably on the lungs. We report three cases of lung disease in patients with rheumatoid arthritis under MTX therapy. Two patients had a lung infection caused by Escherichia coli and Pneumocystis carinii respectively and the third patient was a case of fatal pneumonia imputed to MTX. The signs and symptoms of these acute infectious or iatrogenic lung diseases are not specific. Bronchial endoscopy with bronchoalveolar lavage usually leads to a diagnostic of opportunistic infection, but it may also show an isolated excess, in both number and percentage, of alveolar leucocytes, pointing to a drug-induced pneumopathy. Acute respiratory failure due to MTX-induced pneumonia is not uncommon. It rapidly regresses either spontaneously or under corticosteroid therapy, but a number of deaths, as in our last patient, have been reported. The occurrence of these lung diseases is unrelated to the total dose of MTX. Reintroducing MTX does not mean that the condition will necessarily recur, but this can only be done in the absence of any other possible treatment. PMID- 1775875 TI - [Indications and results of exercise rehabilitation in patients with chronic obstructive lung diseases]. AB - The aim of physical exercise retraining in patients with chronic obstructive lung disease undergoing rehabilitation is to increase the anaerobic work capacity with a rise in VO2 max. Exercise programmes must take into account the duration, frequency and intensity of exercise. In these patients, numerous factors limit physical exercise, including (a) decreased ventilatory capacity and respiratory muscles fatigue; (b) decreased efficacy of the pulmonary gas exchanges; (c) altered pulmonary vascular bed with altered cardiovascular response. The most widely used training methods are walking (or running), practising on a conveyor belt and using an ergometric bicycle. The last named seems to be the best method to evaluate the physiological effects of exercise or for experimental studies. Patients who are fit to participate in a retraining programme must be in a stable period and have a stable pharmacological regimen; they must be subjected to a preliminary exercise test in order to evaluate the main physiological parameters and to obtain information on their tolerance to exercise, on the presence of lactic acidosis and on the degree of hypoxaemia and hypercapnia. In the absence of contra-indications, a training programme can be set up with 30 to 45 minutes of exercise per day at least 3 to 5 times a week during 5 to 8 weeks, with a load amounting to 50-60% of VO2 max. Two questions remain to be answered: (a) is oxygen therapy useful during retraining; (b) what effect has training on survival? PMID- 1775876 TI - [Geriatric AIDS (6 years after pneumonectomy). Apropos of a case]. AB - The authors report a case of AIDS in a 77-year old man, 6 years after pneumonectomy for epidermoid lung cancer. They take this opportunity to review the epidemiological, clinical and prognostic characteristics of geriatric AIDS. PMID- 1775877 TI - [Demons-Meigs syndrome caused by ovarian goiter]. AB - In a 66-year old woman, progressive worsening of an exertional dyspnoea revealed the presence of an abundant right pleural effusion. The patient had a right ovarian mass, highly suspect at ultrasonography. Thoracoscopy showed a macroscopically normal pleura with normal cytology and histology. The ovarian tumour was very irregular, but it was found to be benign at histology. This gonadic goitre of the right ovary was entirely removed, and the pleural effusion did not recur. PMID- 1775878 TI - [Precordialgia caused by idiopathic pneumomediastinum]. PMID- 1775879 TI - [Group of Psychological Support to the Students of the School of Medicine of the Universidade de Sao Paulo]. PMID- 1775880 TI - [Pancreatic trauma: analysis of 29 cases]. AB - PURPOSE: To investigate the relationship between complications and the kind of pancreatic lesion and surgery performed. KIND OF STUDY: Retrospective. PLACE: The patients were operated on at the Pronto Socorro--Mandaqui Hospital Complex, from January 1987 to January 1990. PATIENTS: The authors analyzed 29 patients victims of penetrating or blunt abdominal trauma who were operated on in that period. 27 of them were male. 20 (69%) were shotgun victims; 5 (17.2%) were victims of cold steels; and 4 (13.8%) were victims of blunt trauma. INTERVENTIONS: In pancreatic head lesions (5 cases), hemostasis and drainage were performed in three cases; duodenopancreatectomy in one case; and suture in one case. In traumas to the pancreatic body (13 cases), six pancreatectomies, five drainages, and two sutures were performed. In traumas to the pancreatic tail (11 cases), six pancreatectomies, four sutures and one drainage were performed. MEASURES AND RESULTS: Complications occurred in all patients with pancreatic head lesions, in eight patients with trauma to the pancreatic body, and in five patients trauma to the pancreatic tail. The most frequent complications were intracavitary abscesses (seven cases), and pancreatic fistulae (five cases). Morbidity rate was 72.4% and mortality rate was 17.2%. CONCLUSION: The authors conclude that indication of pancreatectomy in ductal lesions should be done, exception being made to cases of pancreatic head trauma, for which a suture or simple drainage can be used in superficial lesions. In doubt, an expert surgeon may be called. PMID- 1775881 TI - [Diagnosis of deep venous thrombosis of the lower limbs by computed tomography]. AB - In the CT scan of a patient with knee tumor and deep vein thrombosis confirmed by phlebography, the casual observation of a thrombus image in the vein was made, characterized by wall contrastation in opposition to a lack of luminar contrastation. Then, CT scans of the lower limbs and the pelvic region were performed in 14 patients with suspected DVT, who were followed consecutively. Diagnosis of ruptured Baker cyst was made in one patient and DVT in 13 patients. DVT was demonstrated in both lower limbs of three patients. Diagnosis of DVT was confirmed in six of seven exams involving the legs. CT scan could detect thrombi in muscular veins and in deep femoral and internal iliac veins. In six patients with suspected pulmonary embolism, CT scan was also made of the thoracic region and showed pleuropulmonary involvement concomitant with lower limb DVT. The characteristic image of DVT in CT is that of a contrasted ring. Its brightness may be due to contrastation of the venous wall through its vasa vasorum, whereas the thrombus obstructs the luminar flow of the contrast medium. Reproducibility of the characteristic image of thrombus presence in the vein at different levels of the lower limbs and pelvic region gives CT the status of alternative diagnosis means for DVT. False negatives and false positives should be evaluated. PMID- 1775882 TI - [Alcoholism]. AB - The main purpose of this article is to evaluate the incidence of alcoholism in three different groups from the poor segments of the population. Two types of questionnaires--CAGE and SADD--were applied to 334 men. Incidence of alcoholism in each group was: group I--134 homeless men, without a regular job, sheltered in a public institution, 55.9%; group II--106 unskilled male workers, working in construction sites, 43.4%; group III--94 unskilled male workers, working for a public institution, 23.4%. Results show a very high incidence of alcoholism in these segments of the Brazilian population. PMID- 1775883 TI - [Sex crimes and forensic sexology: analytic study]. AB - Most victims of sexual violence tended to at the IML (Forensic Medicine Institute) are female (94.14%) and predominantly under 18 years of age (72.39%). 60.67% filed a complaint for rape. Out of these cases, 44.63% presented a complete hymen and only in 13.30% of the cases a characterized rape was attested to. 21.38% filed a complaint for seduction. Out of these, 78.05% were between 14 and 18 years of age, and 67.18% of them presented their hymens with non-recent ruptures. In only 9.37% of the complaints for seduction the hymen presented recent ruptures. The cases with complaints of libidinous acts other than carnal conjunction represented 17.95%, predominantly male (56.65%) and under 14 years of age (83.33%). The complaints could be confirmed in only 30% of the cases. 91.83% were anal coitus. As for the time elapsed between the assault and the examination, 11.20% showed up within the first 24 hours; 44.79% within 1 to 7 days; 8.07% within 7 to 15 days and 30.21% after 15 days. In short, just about half of the cases showed up for examination in the first week. Therefore, the authors conclude that there is a low positiveness in the examinations, related to several aspects such as the small percentage of victims that seek the IML in time, the lack of traces, the lack of concepts and the difficulty of conforming the cases to the law. PMID- 1775884 TI - [Behavior of cystic tumor of the ovary after wait-and-see management and hormonal treatment]. AB - The authors have analyzed the results of the treatment of benign ovarian cysts with 30-49mm (group I) or more than 50mm in diameter (group II). 40 patients were treated with progestogen, 41 with contraceptive pill, and another 48 patients were only observed without any treatment (control group). Ovarian cyst regression was observed in 84.6% of patients in group I, and in 83.3% of patients in group II; 85.4% of patients in group I and 88.9% of patients in group II were treated with contraceptive pill; 92.5% of patients in group I and 93.1% of patients in group II were treated with progestogen. The authors have concluded that hormone treatment is not necessary to induce functional regression of ovarian cysts. PMID- 1775885 TI - [The main pathologies in obese outpatients]. AB - PURPOSE: the authors intended to evaluate obese patients and to analyze the incidence of related diseases in an outpatient population. TYPE: prospective study. PLACE: General Medicine Outpatient Clinic (Escola Paulista de Medicina) in Sao Paulo, Brazil. PATIENTS: 94 patients, 29 males and 65 females, ages ranging from 18 to 74. Overweight ranging from 21% to 93%. RESULTS: most prevalent diseases were: hypertension (51.06%), diabetes (38.29%), dyslipemias (31.91%), varicose veins (28.72%, osteoarthrosis (27.65%, and intertriginous dermatitis (19.14%). CONCLUSIONS: Hypertension, diabetes, and dyslipemias were the most prevalent diseases. High incidence of varicose veins, and osteoarthrosis were also observed. Diabetes and dyslipemias were most prevalent among the most obese patients. Hypertension, however, was not related to obesity severity. PMID- 1775886 TI - [Growth stimulus of the paranasal sinuses with tissue expanders]. AB - Various congenital craniofacial deformities show hypoplastic paranasal sinus. The Treacher Collins, the Apert and Crouzon Syndromes and the Hemicraniofacial Microsomy, among others, are typical examples of this observation. Stimuli to the growth of the paranasal sinus during the facial growth period could sensibly improve the treatment of deformity, or even avoid later surgeries. Since their introduction in plastic surgery, tissue expanders are progressively acquiring greater importance in many areas of the specialty. This is a safe and simple alternative to solve difficult cases. It has been demonstrated that real tissue growth occurred in all layers of cutaneous tissues subjected to expansion, including the induction of mitoses. Recent works showed that microorbits could be corrected through the introduction of expanders in their orbits. The authors proposed that to stimulate the growth of paranasal sinus, tissue expanders should be introduced bilaterally in the maxillar, frontal, ethmoidal and sphenoidal sinus, which should promote the development of the face. The expansion induced should be controlled and gradual through injections of small amounts of saline in each session. This project includes the cautious design of the size and shape of the expanders as well as the care with adequate draining of the sinusal cavity and the possible mechanical atrophy of the mucosal lining of the sinus. PMID- 1775887 TI - [Augmentation mammaplasty with multiple 40cc prostheses introduced by transareolar incision]. PMID- 1775888 TI - [Cytogenic anomalies and placental function]. AB - Over the past few years growing knowledge of placental cytogenetics has led to the surprising observation that the chromosomal constitution of the placenta is not always identical to that of its fetus. This information comes primarily from three sources: analyses of chorionic villi obtained by choriocentesis (chorionic villus sampling); studies of abortions, particularly spontaneous ones; and analyses of extrafetal tissues performed following dubious prenatal diagnoses, or to investigate fetal pathologies such as intrauterine growth retardation. Our personal data and those reviewed in this article allow the conclusion that chromosomal aberrations, particularly in the mosaic state, are frequent in the placenta, and that at least some of these have less severe consequences when present in extrafetal tissues than when present in the fetus itself. The types of chromosomal errors observed differ according to the method of ascertainment, in spontaneous abortions for example as compared to pregnancies developing as far as the third trimester. The presence of a partially aneuploid placenta may be compatible with a continuing pregnancy, but be associated with problems such as inadequate fetal growth. PMID- 1775889 TI - [Selective salpingography and tubal interventional radiography]. AB - The study involved 70 patients considered to be sterile and in whom hysterosalpingography showed no tubal passage. Selective catheterisation enabled opacification under pressure in more than 80 p. cent of cases, with perfect visualisation of the entire tubes and significant peritoneal passage. In the presence of obstructive stenosis, disobstruction-reacanalisation using a soft probe was attempted with success in more than one case out of two. Future perspectives of selective salpingography appear to be very large. This technique seems to have a large number of indications apart from transport problems: recanalisation, sterilisation, and tubal antibiotic sensitivity studies. PMID- 1775890 TI - [Perinatal neurology: panoramic view]. AB - Four of the most typical anatomo-clinical syndrome of perinatal brain damage are schematically described, concerning risk circumstances, pathology, signs and symptoms, investigations and long term prognosis. The goal of this oversimplistic approach is to offer to the obstetricians some clues about expectation and decisions in various categories of risk. The relation Maturation-Brain damage, the respective role of mechanical and asphyxic insult are discussed. A rough estimation of the risk of severe sequelae according to birth weight is proposed, with implications on prevention of brain damage. PMID- 1775891 TI - [Psychogenic sterility]. AB - A question underlies this statement: is one justified in offering medically assisted methods of procreation to couples with low fertility attributable to no identifiable cause? This question is based on the clinical experience of a psychoanalyst who has been working in the medical field of sterility for the past 15 years. Furthermore, this statement invites physicians to reflect on the possibilities open to them to take a request for a child in a way other than its face value. What then is one to make of the symptom of infertility with no cause as a response of the body to a problem which is not consciously identified by the subject affected. PMID- 1775892 TI - [The administration of micronized progesterone in the treatment of threatened premature labor]. AB - A randomised double-blind placebo-controlled trial concerning the treatment of threatened premature labour was undertaken using the following methodology: beta mimetics were given intravenously to all patients (44) and micronised progesterone or the placebo were prescribed orally after randomisation (22 patients in each group). The mean index of prolongation of pregnancy was similar in both groups. However, the mean duration of the intravenous infusion and the mean dose of beta-mimetics administered intravenously were significantly lower in the oral progesterone group (p less than 0.01). Similarly, there was a significant (less than 0.05) decrease in the mean duration of hospitalisation. The cost and risks of treatment are thus significantly reduced when beta-mimetics and oral progesterone are used in combination. PMID- 1775893 TI - [Future----past----present?]. PMID- 1775894 TI - [Private is beautiful? Clarity in the objectives and consistency in the instruments]. PMID- 1775895 TI - [Nursing research: a reality or an omen? The case of acute myocardial infarct. The GISSI Nursing working group]. AB - Research articles on AMI patient, published on the nursing journals indexed in the Index Medicus were reviewed, to focus on the relevance and methodological reliability of aims, size of the samples, design, instruments used. Some comments on the problems and limits of nursing research in this special area are presented, in the perspective of planning a major collaborative study. PMID- 1775896 TI - [A seriously ill patient at home]. AB - Too often the gap between a technically and scientifically correct language and the accessibility a of contents is very difficult to bridge. The experience presented is an excellent example of message oriented to relatives of dying patients: the focus is practice oriented; useful and essential messages are conveyed in a simple but not trivial form. PMID- 1775897 TI - [A rereading of the updates: from 1982 to 1990]. AB - The 10 years of life of the Rdl are the occasion for a reflection on trends which can be identified through the analysis of the "Updates" which have been published. A comprehensive evaluation of this section of the Rdl may be seen also as the opportunity to plan future programs. PMID- 1775898 TI - [What is new in psychiatry. I]. PMID- 1775899 TI - [Hepatitis B and the "new" hepatitides C and E]. PMID- 1775900 TI - [What is being said about the elderly]. PMID- 1775901 TI - [Conflict between psoas and total hip prosthesis]. AB - This conflict leads to a chronic irritation of the psoas by the antero-medial part of the cup, but it has been poorly described in the past. A study of six patients suffering from this trauma, and who were re-operated revealed that the muscle was worn thin in front of the prominent cup. In the case of 4 of the 6 patients pain had started to occur shortly after total hip replacement. The following symptoms were noted among all 6 patients: pain was suffered during flexion--extension movements--walking up stairs--arising from a chair. Pressure on the medial part of the groin was painful, especially during active elevation of the lower limb. Passive mobility was normal and painless. Psoas bursitis was observed in three cases. The main cause of this conflict is the protrusion of the cup beyond the antero-medial edge of the acetabulum; this protrusion may be either due to a bone graft or a bit of cement, but most often an acetabular insufficiency (congenital dysplasia) favors the formation of this anterior overhang. The spiral cup screwed into the bone can be especially aggressive when it protrudes. Treatment includes the resection of the overhang, but post operative results will be uncertain unless the resection is really complete. In the case of 4 patients the results of such an intervention were only mild to poor. This problem can be avoided by proper care and preventive measures in the original replacement avoiding all projections beyond the anterior edge of the acetabulum--cup, bone graft, cement, especially if dysplasic.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1775902 TI - [Calcifications after intra-disk injection of triamcinolone hexacetonide in lumbar disk hernia. Evaluation of therapeutical results in 3 years]. AB - The development of disk or epidural calcifications is a frequent possibility following intra-disk injection of triamcinolone hexacetonide. It was found 10 times in 26 follow-up CT scans obtained 2 to 3 years after the injection. These calcifications are often clinically silent, but they sometimes accompany a recurrence of the initial painful symptomatology. Furthermore, evaluation at 3 years of therapeutic results in a previously published series of patients who had received an intra-disk injection of triamcinolone hexacetonide showed a marked decrease in favourable results (30% vs 67% at 6 months). These two arguments: disappointing long term results and possibility of disk calcifications, are felt by the authors to justify abandoning the technique of triamcinolone hexacetonide by intra-disk injection in the treatment of lumbar disk prolapse. PMID- 1775903 TI - [Stress fractures during fluoride therapy. Physiopathological value of histomorphometry]. AB - Bone histomorphometry was carried out in 11 women, aged 53 to 80 (mean = 69.6), treated with fluoride for vertebral osteoporosis for more than 6 months and having suffered one or more stress fractures (1 to 4 sites, mean = 1.7 sites) during that time. Classical contraindications were complied with in all cases but 2 patients did not have any combined calcium supplement. In 6 cases, histomorphometry showed no sign (notably hyperosteoidosis) of the effects of fluoride on bone. Bone trabecular volume was markedly below the fracture threshold in 4 patients. This group refractory to fluoride included the two patients who had received no calcium supplement. In 5 cases, histomorphometry showed hyperosteoidosis of normal or low thickness, with a normal mineralisation rate, reflecting the effects of fluoride on bone. However, bone trabecular volume remained below the fracture threshold in all cases. In all 11 cases, bone structure studied in polarised light was lamellar and there was no increase in cortical porosity. These results suggest that the imputability to fluoride of peripheral bone accidents must be viewed very relatively (the persistence of an insufficient bone trabecular volume being the feature usually found) or, at any event, that its possible iatrogenic effect is not linked to bone remoulding abnormalities. PMID- 1775904 TI - [Seronegative rheumatism of late onset. Incidence and atypical forms of spondylarthropathy]. AB - The authors reviewed the files of male patients who have been hospitalized over a 12 year period for a rheumatoid-factor negative arthritis beginning after age 50. Polymyalgia rheumatica, psoriasis or crystal-induced arthritis were excluded. The remaining 105 observations were classified according to published criteria in rheumatoid arthritis (RA), reactive arthritis or ankylosing spondylitis (AS). Twenty-nine patients had RA and 29 had AS with equal numbers of axial and peripheral types. Four patients had reactive arthritis, one of them had also AS. Forty-four patients had "unclassified arthritis". Among the latter, 14 were B27 positive, 21 were B27 negative, 9 were not typed. Some features were more frequent in B27+ patients: an assymetrical oligoarthritis of the lower limbs with minimal signs of inflammation at synovial analysis or at synovial biopsy; frequent unilateral edema; marked, constitutional signs; very high ESR. Nine patients, all B27+, met the diagnostic criteria of spondylarthropathy. B27 typing thus appears relevant to the classification of late-onset, seronegative rhumatisms. PMID- 1775905 TI - [Dermatopolymyositis and cyanoacrylate glue. Apropos of 3 cases]. PMID- 1775906 TI - [Hip and spinal ossification enthesopathies induced by etretinate therapy in peripheral psoriatic arthritis]. AB - The occurrence of ossifying enthesopathy during treatment with synthetic retinoids (etretinate, isotretinoin and acitretin) is a side-effect more and more frequently recorded. The authors report here a new case in a patient with a severe psoriatic arthritis. This observation is characterized by the size of ossifications on hips and lumbar spine which appeared after two years of etretinate therapy. The interest of this observation lies in the fact that ossifications occurred while the patient was treated with long-term corticotherapy. The disease for which retinoids are prescribed does not seem to influence the occurrence of those lesions and it is likely that the responsibility of these molecules is entire. Lesions are enthesitis ossification. They are frequent during these treatments (average of 70%) after an average time of 24 to 36 months for etretinate and of 10 months for isotretinoin. Lesions are asymptomatic in about 50% of the cases. After discontinuation of treatment, lesions become quiescent and does not disappear. Growth hormone or abnormalities in vitamin A metabolism could play a role in the physiopathology of lesions. PMID- 1775907 TI - [Calcificated necrotic inflammatory granuloma after intradiscal injection of triamcinolone hexacetonide]. AB - Recently, it has been demonstrated that symptomatic epidural calcifications represent a complication of intradiscal injection of triamcinolone hexacetonide (Hexatrione). Out of our three cases, pathological examination showed lesions of necrosis with granulomatous inflammatory reaction and bone metaplasia. Necrosis seems to be the primary cause of calcifications so we propose to call the lesion inflammatory and necrotic granuloma. The incidence of these granulomas is unknown. They are unpredictable and appear with a mean range of a year following the intradiscal injection. The treatment is surgery if they become symptomatic. PMID- 1775908 TI - [Ulnar nerve compression at the elbow caused by synovial cyst of rheumatoid origin]. AB - The authors report on a case of a fifty year old white woman affected by a rheumatoid arthritis of 3 year duration who develops a progressive ulnar nerve compression by a synovial cyst of the right elbow joint. Surgical procedure confirms the articular and rheumatoid origin of the synovial cyst and obtains complete healing of the motor and sensory deficit without recurrence of the synovial cyst. Synovial cysts are rare at the elbow joint where they cause as an exception a compression of the ulnar nerve, the authors having found only five cases in the literature. PMID- 1775909 TI - [Patellar metastasis revealing epidermoid carcinoma]. PMID- 1775910 TI - [Diffuse joint chondrocalcinosis revealing Bartter's syndrome. Apropos of 2 cases]. PMID- 1775911 TI - [Arthropathy with achilles tendon involvement induced by pefloxacin. Apropos of a case]. PMID- 1775912 TI - [Treatment of headache after accidental dural puncture during epidural blood tamponing]. PMID- 1775913 TI - [Effect of oxaceprol on the structure of proteoglycans synthesized by articular chondrocytes from calves]. AB - Calf articular cartilage fragments were incubated in vitro in the absence and presence of 170 micrograms N-acethyl-trans-4, hydroxyproline (oxaceprol) and 20 muCi [35S]-Na2SO4 per ml of culture medium. Newly synthesized 35S labeled proteoglycans (35S-PGs) were extracted with buffered 4M guanidinium chloride (GdmCl) solvent and then characterized with respect to their hydrodynamic sizes, capacity to interact and form aggregates with hyaluronic acid (AH) and the length and composition of their glycosaminoglycan (GAG) side chains. It was demonstrated that extracted 35S-PGs synthesized in the presence of the oxaceprol are not significantly different from the molecules synthesized in the absence of this compound. PMID- 1775914 TI - [Spondylo-epiphyseal dysplasia with ankylosing development. Apropos of a case]. PMID- 1775915 TI - [Historical form of primary hyperparathyroidism. Apropos of a case]. PMID- 1775916 TI - [Post-fracture osteolysis of the pubis simulating malignant lesion]. PMID- 1775917 TI - [Hip algodystrophy with bascule in Lobstein's disease]. PMID- 1775918 TI - Helicobacter pylori. AB - Helicobacter pylori is a unique pathogen and the leading cause of chronic gastric inflammation. For many individuals the organism is of low virulence, causing only mild inflammation and generating few, if any, dyspeptic symptoms. For those with more severe inflammation, H. pylori infection may be causal in the generation of dyspeptic symptoms. H. pylori infection appears to be the dominant factor in peptic ulcer disease. Events considered to be of importance are a disturbed gastrin homeostasis and the development of gastric metaplasia in the bulb. The most important argument in support of the dominant role of H. pylori in duodenal ulcer disease is the markedly reduced ulcer relapse after successful eradication. Eradication proves to be difficult, presumably because of the peculiar habitat of the organism. Currently the best pharmacologic approach is triple therapy, combining a bismuth salt, metronidazole, and amoxycillin or tetracycline. PMID- 1775919 TI - Mechnisms of injury and sequelae of Helicobacter pylori infection. Concluding commentary--the basic scientist's viewpoint. PMID- 1775920 TI - Mechanisms of injury and sequelae of Helicobacter pylori infection. Concluding commentary--the gastroenterologist's viewpoint. PMID- 1775921 TI - Helicobacter pylori infection and inflammation. AB - Helicobacter pylori infection and chronic active gastritis are inextricably linked, and this organism is almost certainly responsible for inducing the resulting inflammatory changes. Acute ingestion studies have confirmed that H. pylori infection causes acute gastritis, and the progression to chronic gastritis has been documented. Duodenitis and H. pylori infection often occur concurrently, but colonization is restricted to those with significant gastric metaplasia. The association between H. pylori-induced inflammation and symptoms is at present unclear. In some treatment studies H. pylori eradication has been associated with a symptomatic response, whereas the acute inflammatory response appears frequently to subside H. pylori infection of the gastroduodenal mucosa is associated with both mucosal and systemic antibody responses. The mucosal response occurs both within the stomach and locally in the duodenum in patients with duodenitis. Mucosal cellular responses also appear active in patients with H. pylori gastritis. Cytokines are produced locally, which could have significant pathophysiologic effects. The concurrent use of non-steroidal anti-inflammatory agents in patients with H. pylori-induced gastritis may modify the subsequent inflammatory response. Although H. pylori is a major and consistent stimulus for inflammation within the gastroduodenal mucosa, our understanding of the development of these responses is far from complete. Inflammatory mediators are released during infection and probably play a major role in modulating the subsequent mucosal immune responses. PMID- 1775922 TI - Virulence factors of Helicobacter pylori. AB - Helicobacter pylori can be considered a very successful organism effectively colonizing the majority of the world's population. Although various disease states associated with this infection have been described, the mechanisms of pathogenicity remain unknown. The easiest virulence factors to identify are those enabling the organism to colonize the hazardous microenvironment of the gastric epithelium, survive at this site, and multiply sufficiently for transmission to a new host. The factors identified to date include the bacterial enzymes urease and catalase, flagella, and lectin-like adhesins. In addition, it is proposed that the organism has evolved mechanisms to avoid the local antibody responses of the host. Several putative virulence factors that could directly cause gastroduodenal damage have also been identified. These include the direct tissue damage by cytotoxins or the products of urease activity and the indirect tissue damage due to disruption of mucin integrity. Such mechanisms may contribute to peptic ulcer formation; however, the chronic superficial gastritis most frequently associated with this infection is probably caused by immunopathologic events mediated by the host in response to the continued antigen load on the gastric mucosa. PMID- 1775923 TI - Helicobacter pylori urease: properties and role in pathogenesis. AB - Urease (urea amidohydrolase, EC 3.5.1.5) catalyzes the hydrolysis of urea to yield ammonia and carbon dioxide. Research on this enzyme has gained momentum since the discovery of Helicobacter pylori as a causative agent of human gastritis. The remarkably high urease activity of each organism has served as the basis of diagnostic tests for the presence of the organism in the urease biopsy test and urea breath test. Urease undoubtedly plays a central role in H. pylori pathogenesis. Hydrolysis of urea with generation of ammonia may enable survival of this acid-sensitive organism in the gastric mucosa. Ammonia generated by urea hydrolysis may also produce severe cytotoxic effects within gastric epithelium. The enzyme also elicits a strong immune response during acute infection, suggesting that this abundant antigen is readily available to the immune system. An increase in serum IgG titer is predictive of ongoing infection. Much progress has been made with regard to the molecular biology of urease. The high molecular weight protein (estimated by several investigators to be 300-520 kDa) has been purified, revealing two distinct subunits of 29.5 kDa and 66 kDa, a unique subunit structure as compared with other microbial ureases. However, amino acid sequences are nevertheless well conserved when compared with other bacterial ureases and that of the jack bean, Canavalia ensiformis. Furthermore, genes encoding urease of H. pylori have been cloned, sequenced, and amplified by the polymerase chain reaction. PMID- 1775924 TI - Mucolytic effects of Helicobacter pylori. AB - The mechanisms associated with colonization of human gastroduodenal mucosa by Helicobacter pylori remain unclear. To colonize gastric-type epithelium H. pylori must enter the gastric lumen, resist damage by all bactericidal factors operating within the acidic gastric milieu, penetrate the mucus gel despite highly viscous and hydrophobic properties of the mucus layer, and, finally, secure optimal conditions for its further multiplication. Since the H. pylori microorganism has been seen freely spread throughout the entire mucus layer thickness as well as in intimate contact with surface epithelium, the interrelationship between this spiral microorganism and the mucus seems to be of paramount importance. H. pylori has been shown to affect adversely the chemical and physical properties of the mucus layer. Therefore, the mucus layer compromised by the presence of this microorganism may become an easy target for acid and peptic damage, which ultimately leads to mucosal pathology, inflammation and/or peptic ulcer disease. PMID- 1775925 TI - Interactions between Helicobacter pylori and the local mucosal immune system. AB - The recognition that Helicobacter pylori is associated with an array of gastric disorders immediately raises several issues with regard to the role of the local immune system. The belief that the harsh gastric environment limits or prevents infection has perhaps dismissed studies into the immunology of the stomach as a low priority. Now, in combination with our understanding of local immune reactivity in pernicious anaemia, an interest in defining the contribution of the immune response in the pathogenesis of disease associated with H. pylori has fueled a great deal of interest. Furthermore, the evidence of local immunity to this bacteria has kindled interest that gastric immune/inflammatory responses may contribute to the treatment or prevention of a gastric infection. PMID- 1775926 TI - Possible mechanisms and mediators of gastritis associated with Helicobacter pylori infection. AB - There is a growing body of evidence suggesting that Helicobacter pylori plays a pathogenic role in gastric and duodenal ulceration. A strong association between infection with this organism and the presence of active chronic gastritis in the antrum has been documented. However, the mechanism through which this gastritis and the associated degenerative changes in the mucosa are produced is not fully understood. It is possible that the bacterium itself produces chemotactic factors that recruit granulocytes into the mucosa, although there is scant evidence to indicate the importance of any one mediator over others. Several inflammatory mediators have potent vascular effects, which could predispose the mucosa, in a region of infection, to ulceration. One such mediator, platelet-activating factor, is produced by H. pylori. Further characterization of the mechanism through which H. pylori contributes to the development of gastritis and the inflammatory mediators involved will be facilitated by the development of relevant animal models. PMID- 1775927 TI - Helicobacter pylori and gastric acid secretion: the ulcer link? AB - Helicobacter pylori is a recognized cause of chronic active gastritis and is frequently associated with peptic ulcer disease, but its effect on acid secretion is unclear. Transient hypochlorhydria occurs with acute infections. Despite the theoretical possibility of an increase in parietal cell mass or a response to stimulation occurring secondary to the associated hypergastrinaemia observed with H. pylori, no consistent increase in basal, pentagastrin-stimulated acid secretion or 24-h intragastric acidity has been reported. Although H. pylori is accepted as one of the many factors involved in peptic ulcer disease, and eradication results in decreased ulcer recurrence, its pathogenic role is still poorly understood. The progression of chronic active gastritis to atrophic gastritis and hypochlorhydria may in part explain the natural tendency for duodenal ulcer disease to resolve. PMID- 1775928 TI - Helicobacter pylori--some what, why, and how morphologic issues. AB - This paper questions, and attempts to answer or speculate on, some of the morphologic questions about Helicobacter pylori in the stomach and duodenum. These include whether H. pylori can survive intact through the entire intestine, why organisms are found between rather than over the entire cells, why pedestals are relatively infrequent, possible advantages of attachment rather than a luminal existence, the nature of the inflammatory cascade from chronic inflammation to local erosion, possible mechanisms by which H. pylori causes chronic duodenitis, and the different ways that gastric metaplasia can occur in the duodenum. PMID- 1775930 TI - Spiral organisms: what are they? A microbiologic introduction to Helicobacter pylori. AB - The stomach provides a hostile environment to most microorganisms owing to the antibacterial effect of gastric acidity. However, over the period of mammalian evolution a highly specialized group of bacteria has evolved to inhabit the gastric mucosa. The common features of these bacteria that allow survival in the stomach and colonization of their natural ecologic niche, mucus, are a specialized form of motility, microaerophilism, and very high activity of the enzyme urease. Other important adaptations have been the acquisition of sophisticated mechanisms to evade host defences, and in certain cases tissue damage may result. The most important of these usually spiral-shaped bacteria is Helicobacter pylori. It is proposed that this bacterium is the human gastric spirillum that in most persons lives in harmony with its natural host, resulting in asymptomatic infection. However, if as yet undefined conditions are present, serious disease may result-that is, peptic ulceration. A consequence of long-term infection may be atrophic gastritis, which sets the scene for gastric carcinoma. The more the microbiology of the stomach is studied, the more species of Helicobacter are discovered, such as H. mustelae in the ferret, H. felis in cats and dogs, and 'Gastrospirillum hominis' in primates, cats, dogs, and pigs. These other helicobacters provide us with a wide spectrum of animal models of gastroduodenal disease. To understand mechanisms of pathogenesis, it is suggested that systematic study of all members of the genus will identify important colonizing factors and provide a realistic perspective on the putative virulence factors that have been proposed for H. pylori to date. PMID- 1775929 TI - Helicobacter and hypergastrinemia: the Quisling option. AB - Helicobacter infection of the gastric antrum is linked to the development of duodenal ulcer. A key element could be the associated hypergastrinemia. This brief commentary seeks answers to the following questions: 1) Does hypergastrinemia occur? 2) How does it occur? and 3) Does it matter? PMID- 1775931 TI - Helicobacter pylori infection and gastroduodenal injury by non-steroidal anti inflammatory drugs. AB - Helicobacter pylori infection with active gastritis is comparably common in non steroidal anti-inflammatory drug (NSAID) users and controls. The prevalence of active acute gastritis and its severity relate to H. pylori infection and not to use or non-use of NSAIDs. In individual patients active gastritis may deteriorate during long-term NSAID therapy but is rare in aspirin users. Among NSAID users those with H. pylori gastritis appear to have more dyspeptic symptoms, repeated intolerance to different NSAIDs, and often a history of ulcer disease. For current ulcers, NSAID use, chemical gastritis, and active gastritis due to H. pylori are independent risk factors. For gastric ulcer the risks are additive. For duodenal ulcer only H. pylori is a clearly defined risk factor: duodenal ulcers may not occur in H. pylori-negative NSAID users. In gastroduodenal mucosa NSAIDs may augment acute inflammation caused by H. pylori, and inflammation may exacerbate the biochemical injury to these tissues caused by NSAIDs. PMID- 1775932 TI - Helicobacter pylori, causation, change in natural history, and why Helicobacter positive duodenal ulcers should not be routinely treated. AB - The relationship between Helicobacter pylori and duodenal ulcer is reviewed with regard to the following epidemiologic issues: causation, change in natural history, and whether there is sufficient evidence to treat H. pylori-positive peptic ulcers routinely. There is mounting evidence for a pivotal role of H. pylori as a precipitating cause of duodenal ulcers. There is insufficient data to conclude that eradication of H. pylori alone will cure peptic ulcer disease--that is, preventing instead of controlling relapse. H. pylori-positive duodenal ulcers should not be routinely treated because eradication rates need to be improved, metronidazole resistance is an increasing problem, and side-effects of currently used triple combination treatments are substantial. PMID- 1775933 TI - Intrinsic factor secretion and cobalamin absorption. Physiology and pathophysiology in the gastrointestinal tract. AB - Intrinsic factor is produced by the gastric parietal cell. Its secretion is stimulated via all pathways known to stimulate gastric acid secretion: histamine, gastrin, and acetylcholine. There is, however, a different mode of secretion for both substances: atropine, vagotomy, and H2 receptor antagonists inhibit both intrinsic factor and acid secretion, but secretin and the hydrogen-potassium ATPase antagonist omeprazole have no effect on intrinsic factor while substantially reducing acid secretion. Cobalamin in food is bound to animal protein. Cobalamin deficiency due to inadequate dietary intake is rarely seen in extreme vegetarians (vegans). In the stomach cobalamin is liberated from its protein binding by peptic digestion and bound to R-proteins. Hypochlorhydria or achlorhydria, whether medically induced or not, may impair cobalamin uptake. The cobalamin-R-protein complex is split by pancreatic enzymes in the duodenum, where cobalamin is bound to intrinsic factor. Pancreatic insufficiency may lead to cobalamin deficiency. Lack of intrinsic factor is the commonest cause of cobalamin deficiency; very rarely, aberrant forms of intrinsic factor are produced, but the clinical syndrome is similar. Gram-negative anaerobe bacteria bind the cobalamin-intrinsic factor complex, and bacterial overgrowth of the small intestine diminishes cobalamin resorption. Parasitic infections with fish tape-worm and Giardia lamblia are also associated with cobalamin malabsorption. The cobalamin-intrinsic factor complex binds to the ileal receptors in the terminal ileum. Cobalamin absorption may be impaired after resection or by diseases affecting more than 50 cm of the terminal ileum, such as Crohn's disease, coeliac disease, tuberculosis, lymphoma or radiation. There is clearly a wide diversity in the aetiology of cobalamin deficiency, which requires a versatile diagnostic approach. PMID- 1775934 TI - Recent advances in the management of gastro-oesophageal reflux disease. AB - The basis of treatment of reflux oesophagitis is change in behaviour and lifestyle. In the presence of mild symptoms antacids/alginate may be instituted. In case of Savary grade I and II oesophagitis at endoscopy, H2-receptor antagonists (H2RAs), alone or in combination with a prokinetic or mucosaprotective agent, are the first choice of treatment. Drug treatment should be continued for at least 8-12 weeks. In case of resistance to treatment or in case of severe and/or complicated reflux oesophagitis, omeprazole should be prescribed. Maintenance treatment is necessary in patients with severe reflux oesophagitis and in patients with quick relapses, once therapy has stopped. Full dose H2RAs are required to prevent recurrences. In case of resistance to H2RAs, omeprazole should be used. Anti-reflux surgery should be considered in patients, especially at young age, who have an insufficient response to medical management, due either to lack of compliance or to therapeutic failure. PMID- 1775935 TI - Total parenteral nutrition: practical recommendations and new developments. AB - In this article the general guidelines for a nutrition schedule and new developments in the field of parenteral nutrition are discussed. The present possibilities for parenteral nutrition do not imitate the normal physiologic diet completely. The most frequently used calculation of the energy expenditure is estimated by a formula using weight, height, and age and was developed in healthy persons. It does not always represent the real caloric demands of a patient. Complications, partly due to parenteral nutrition, are noted. In severely ill patients hyperglycaemia and liver function disorders are frequently observed. Parenteral nutrition results in atrophy of the intestinal mucosa. Deficiencies in trace elements and vitamins are diagnosed despite calculated adequate nutritional support because the demands are underestimated. New developments in parenteral nutrition include a better method to determine the nutritional demands in clinical practice, administration of hormones to improve the nitrogen balance, and development of new lipid emulsions and amino-acid solutions. Studies provide more insight into the physiologic process of trace element metabolism, and methods are being developed to define a real deficiency. PMID- 1775936 TI - Determination of faecal chymotrypsin concentration and 72-hour faecal chymotrypsin output in the detection of pancreatic steatorrhoea. AB - In 96 consecutive patients who underwent a 72-h faecal fat determination because of suspected nutrient malassimilation (maldigestion and/or malabsorption) faecal chymotrypsin (F-Chym) was estimated with a commercial photometric test (Monotest Chymotrypsin), comparing F-Chym concentrations in the first 24-h stool with the total 72-h F-Chym output. In the first 24-h faeces, the F-Chym concentration, calculated as a mean of three random samples, did not significantly differ from a single value obtained after homogenization. In known pancreatic disease, a F-Chym concentration less than 3.0 U/g wet faeces distinguished well between steatorrhoic patients (n = 12) and nonsteatorrhoic (n = 13) (positive predictive value (PV), 91%; negative PV, 86%) but was less suitable as a screening test for pancreatic steatorrhoea in the unselected patient group (positive PV, 61%; negative PV, 98%). Although the estimation of 72-h F-Chym output could differentiate between various subgroups of patients to a certain extent, the positive PV for discovery of pancreatic steatorrhoea in a single patient was low. Four patients had excessively high F-Chym output and increased bile acid excretion after ileal resection (n = 3) and radiation ileitis (n = 1), respectively, possibly indicating the removal of an inhibitory mechanism of pancreatic and biliary secretion in these conditions. PMID- 1775937 TI - Photodynamic therapy for gastrointestinal tumors. AB - Photodynamic therapy is based on the administration of a compound that is preferentially accumulated by a tumor and which causes tumor destruction after exposure to light of a specific wavelength. The photosensitizers most commonly used in treating tumors of the gastrointestinal tract are porphyrins- hematoporphyrin derivative and dihematoporphyrin ether. These compounds have been used with success to produce reduction in tumor size of esophageal, gastric, and colorectal cancers. In some instances long-lasting complete remission have been observed after photodynamic therapy. New developments include photosensitizers that react to light of a longer wavelength, which is able to penetrate tissue to a greater depth, the use of 5-aminolevulinic acid, which is preferentially converted to porphyrin in malignant cells, and combination of photodynamic therapy with thermic laser, radiotherapy, or chemotherapy. PMID- 1775938 TI - Surgical suppression of gastric acid secretion. Lessons from long-term follow-up studies. AB - This paper reviews data from case controls studies, cohort studies, and long-term follow-up papers of over 30,000 patients following surgical reduction of gastric acid secretion 20-40 years postoperatively. There is an increase in gastric cancer which becomes highly significant 20 years after Billroth II resection and rises thereafter, many studies showing a three- or four-fold increase compared with a non-operative control or contrast population. There is little doubt that surgical depression of gastric acid secretion is associated with the development of carcinoma of the stomach. The mechanisms by which this development may occur are discussed. PMID- 1775939 TI - Primary non-Hodgkin's lymphoma of the stomach: endoscopic diagnosis and the role of surgery. AB - Primary non-Hodgkin's lymphoma of the stomach represents a minority of 1-7% of all gastric malignancies. Symptoms are non-specific. At endoscopy three main patterns can be recognized: ulceration, diffuse infiltration, or a polypoid mass. Endoscopic biopsy results may be false-negative (up to 8%) owing to submucosal localization. The new technique of endoscopic ultrasonography is accurate in measuring depth of infiltration and regional lymph nodes. Preoperative diagnosis altered the indication for surgery. Without resection an excellent local tumour control (stage I, 85%, and stage II, 69%) can be achieved, leading to a fair prognosis: 5-year relapse free survival in stage I, 83%, and in stage II, 58%. Intra-abdominal recurrences were scarce (2%), and severe complications such as perforation and life-threatening haemorrhage were seldom present (4%). Thus, resection is not necessary, but early recognition is highly significant. Favourable results can be achieved by irradiation or chemotherapy with irradiation. PMID- 1775940 TI - Long-term results after liver transplantation in adults. AB - The prospects for patients who survive the first year after liver transplantation are discussed. The 10-year survival for these patients is more than 80%. The quality of life is good, as measured on self-assessment scales. Pregnancy is possible. The main side-effects of drugs concern osteoporosis (corticosteroids), deterioration of renal function (cyclosporine), and de novo malignancies. Recurrence of original disease is at present of clinical importance for Budd Chiari syndrome and hepatitis B and D. Recurrence of primary biliary cirrhosis is still under discussion. PMID- 1775941 TI - Calcium and the prevention of colon cancer. AB - Diet is a major determinant of colon cancer risk. Calcium may protect against colon cancer, presumably by binding cytotoxic bile acids and fatty acids. Numerous studies support this proposition. In subjects at risk for colon cancer oral calcium supplementation has been shown to reduce rectal epithelial proliferation rate, thereby supposedly decreasing cancer risk. In contrast to the original hypothesis that phosphate counteracts the effect of calcium, evidence has now been provided that phosphate is crucial for the intraluminal binding of bile acids in complexes of calcium, phosphate, and bile acids. Supplemental calcium has been shown to reduce the cytotoxic potential of fecal water, which is probably attributable to the profound effect of calcium on bile acid and fatty acid metabolism. However, some reservation with regard to the protective ability of calcium seems to be warranted as we found that oral calcium supplementation caused an increase in epithelial proliferation rate in the sigmoid of patients with adenomatous polyps. Further controlled studies evaluating the effects of calcium on the epithelium of different parts of the colon should now be performed. PMID- 1775942 TI - Severe, longstanding constipation in adults. Indications for surgical treatment. AB - In recent years new techniques for the investigation of colonic motility and defaecation mechanism have been developed. On the basis of the results of these studies it has been suggested that there might be an indication for a surgical approach to the distressing problem of constipation. Because this approach is still controversial, it seems to be appropriate to review the suggested indications for the use of surgery in the treatment of constipation and to discuss the results as reported in the literature so far. PMID- 1775943 TI - Cholesterol crystal embolization and the digestive system. AB - Atherosclerotic vascular disease can give rise to provoked or spontaneous cholesterol crystal embolization to organ systems. Lodging in downstream arterioles, these crystals can produce granuloma formation, infarction, ulceration, and perforation. Histologic sections of the tissue concerned invariably show pathognomonic empty needle-shaped clefts left by the crystals after processing of the material. In the digestive system these events can cascade to many and often misleading presentations. They can be the cause of massive bleeding, acute acalculous cholecystitis, pancreatitis, or teleangiectasis with chronic intractable blood loss. Owing to the progressive nature of the disease the treatment options described in this paper can only give temporary, but nevertheless often worthwhile relief. PMID- 1775944 TI - Clinical aspects of lactose intolerance in children and adults. AB - The principal carbohydrate of human milk is the disaccharide lactose. In human and all mammalian species, lactose is hydrolyzed in the small intestine by lactase-phlorizin hydrolase, also abbreviated as lactase. The absence of lactase results in the passage of undigested lactose into the large intestine and is associated with a well-known clinical syndrome: lactose intolerance. Low lactase levels result either from intestinal injury or, as in the majority of world's adult population, from alterations in the genetic expression of lactase. In this review terminology, pathophysiology, symptoms, diagnostic procedures, and therapy of lactose intolerance will be discussed. PMID- 1775945 TI - The effect of perioperative blood transfusion on recurrence after primary operation for Crohn's disease. AB - The effect of perioperative blood transfusion on recurrence after primary operation was retrospectively studied in a group of 104 patients with Crohn's disease. Patients who had minor procedures like strictureplasty, segmental small bowel resection, and operation for perianal fistula were excluded. Patients who had more extensive surgery were selected, to have an approximately equal distribution of blood transfusion in the different subgroups. Sixty-six female and 45 male patients were included; 65 patients had perioperative blood transfusion and 39 did not. Irrespective of blood transfusion it was confirmed that patients with small-bowel localization have a better prognosis than patients with combined or colonic localization. Patients who had resection of a specimen of less than 30 cm or more than 70 cm had a worse prognosis than the others. The reason for this observation is unclear. Except for patients with colonic localization only, blood transfusion was about equally distributed among patients with ileocaecal localization (19 of 36) and patients with ileal disease (17 of 34). Perioperative blood transfusion had no effect on disease recurrence, either for the whole group of transfused patients or for any of the subgroups, apart from those with colonic localization only. They had a significantly lower recurrence, as diagnosed before 60 months of follow-up. This is ascribed to the fact that these patients had large colonic resection with a lower chance of having active recurrent disease. In conclusion, we could not confirm the protective effects of blood transfusion on recurrence of Crohn's disease, as observed by others. PMID- 1775946 TI - The management of non-steroidal anti-inflammatory drug-induced gastroduodenal ulcers. AB - The risks associated with NSAID-induced gastroduodenal lesions are now relatively well defined. Identification of high-risk patients is important for prophylactic treatment or for maintenance treatment with gastric acid-suppressing medication during NSAID therapy. If patients develop a gastric ulcer and continue to take NSAIDs, all available evidence suggests that strong acid-suppressing therapy is important. Good healing rates have been described with conventional doses of H2 antagonists, but studies with higher doses have to be awaited. Small prepyloric or antrum ulcers will probably react well to conventional H2 antagonists; larger crater-like ulcers are probably best treated with omeprazole. When patients develop a duodenal ulcer and continue to take NSAIDs, all available evidence suggests that excellent treatment results can be obtained with conventional doses of H2 antagonists. PMID- 1775947 TI - 5-Hydroxytryptamine and 5-hydroxytryptamine-3 receptor antagonists. AB - 5-Hydroxytryptamine (5-HT) is present throughout the gastrointestinal tract, which acts as the major reservoir of this substance in the body. Its physiologic role has not been clearly established, although it seems likely that 5-HT is involved in the regulation of aspects of intestinal motility such as peristalsis and the migrating motor complex. In disease states the contribution of 5-HT is perhaps more clearly established, particularly its role in chemotherapy-induced emesis, in the carcinoid syndrome, and, possibly, in mediating the effect of some intestinal secretagogues, notably cholera toxin. Many of the functions of 5-HT in the gut have been elucidated as a result of the development of antagonists to 5 HT receptors. However, some of these compounds have 5-HT agonist activity as well as 5-HT receptor blocking activity, making interpretation of their effects in health and disease difficult. Nevertheless, 5-HT receptor antagonists are finding an important place in the management of the carcinoid syndrome and in chemotherapy-induced emesis and may well evolve as important agents for modulating gut motility and for inhibiting secretory states in the small and large intestine. The suggestion that 5-HT3 receptor antagonists might also modulate visceral sensation in the gut is of great interest because of their potential to relieve symptoms of functional bowel disorders such as pain, urgency, and bowel frequency. PMID- 1775948 TI - Two metamodels of causal effects. AB - Two metamodels, termed Model S and Model V, are proposed for definition, measurement, and generalization of quantitative causal effects. The effect is defined as a part change in score in Model S and as a part change in variance in Model V. Two additional changes, total and remainder change, are defined. The latter is due to all other factors or variables than the cause, while total change is the sum of remainder and effect change. Furthermore, it is shown how contrafactual concepts, which imply that some parts of the study situation are supposed to be otherwise, enter into the metamodels. Casual effects are defined and measured in terms of non-contrafactual concepts, except that statistical induction includes contrafactual as well as non-contrafactual inferences. Non statistical generalization involves both kinds of inferences. Contrafactual definitions are considered inadequate, and a contrafactual interpretation of statistical adjustment is unnecessary and should be replaced by a non contrafactual one. PMID- 1775949 TI - School performance and IQ-test scores at age 13 as related to birth weight and gestational age. AB - The cohort in the present longitudinal research program consisted of 873 children in an entire school grade, in a Swedish community. The present results showed a main effect of birth weight; low birth weight (LBW) children had lower school performance and intelligence-test (IQ) scores at age 13 than did normal birth weight (NBW) children irrespective of parental SES. Second, there was no significant main effect of gestational age (GA) on scholastic performance and IQ test scores. Third, there was a significant main effect of the combination of birth weight and GA on scholastic performance and IQ-test scores. The LBW children born at term (38-40 pregnancy weeks; pw) had significantly lower scores and school grades as compared to the control group while the LBW children born with short gestational age (34-37 pw) and with very short gestational age (less than 34 pw) had significantly lower scores and marks in fewer areas of academic attainment. PMID- 1775950 TI - Effects of day care and maternal teaching on child educability. AB - Two groups of matched mother-child pairs, a day care sample (N = 38) and a home reared sample (N = 38) participated in a study testing mothers for degree of decentred teaching and children for degree of decentred educability. The children were seven years old. Mother and child were tested in separate settings, thus preventing interdependency among scores. The study used a matched-pair design with control of five background variables; age of the child, mother's educational level, mother's occupational status, family SES level, and type of family. The results showed strong positive effects of both day care experience and maternal teaching on child educability. Day care experience improved the educability of children independent of the mother's teaching strategy and gender of the child. PMID- 1775951 TI - Cognitive processes among skilled miniature golf players: effects of instructions on motor performance, concentration time, and perceived difficulty. AB - Highly skilled miniature golf players were examined on a simplified miniature golf task under different instructional conditions. Results indicated that requirements to attend to a variety of technical aspects of the game during preparation impaired motor performance, whereas providing players with those aspects of the game they reported thinking of did not affect motor performance. Data on concentration time and perceived difficulty indicated that increasing cognitive demands were associated with a decline in motor precision. The overall pattern of results was interpreted such that attention directed at technical aspects of the game interfered with the players' normal cognitive activity. Susceptibility to interference is a characteristic feature of controlled cognitive operations. Thus, the present results are consistent with the view that conscious cognitive activity may support motor behavior also at late stages of skill development. PMID- 1775952 TI - Visual evoked potentials elicited by subjective contour figures. AB - In order to investigate the relationship between the appearance of illusory figures and the wave form of visual evoked potentials (VEPs), 8 different visual pattern stimuli were presented to 8 normal subjects. Four of the stimuli (experimental stimuli) produced subjective figures and contours (squares and discs). The 4 other stimuli (reference stimuli), although equal to the experimental stimuli in the amount of physical energy, did not produce the illusion of squares or discs. Electrodes were placed on the scalp at central and occipital locations. Three prominent peaks in the occipital record were observed in all subjects. An amplitude difference of VEP N180 (N2) between the subjective figures and the reference stimuli was found in the values for each subject. Enhancement of the VEP of the illusory figure stimuli was observed for a specific component (N2), whereas the amplitude values at the central components and the occipital P120 (P2) and P280 (P3) were almost the same as the reference values. The VEP (N2 component) amplitude enhancement at the occipital area for subjective figure stimuli suggests that illusory contour formation takes place at higher levels in the visual system. This was known from experiments using dichoptic presentation. PMID- 1775953 TI - Mood and realism of confidence judgements of one's own answers to general knowledge questions. AB - This study examines the effect of a depressed mood on the realism of subjects' confidence judgements of the correctness of answers to general knowledge questions. Research conducted on how mood influences cognitive processes gives reason to expect that a depressed mood might increase the realism of individuals' confidence ratings. Sixty subjects were divided into three conditions, two of which were given mood induction, one condition into an elated-happy mood and one condition into a depressed-sad mood. As evidenced by subjects' responses to mood scales only the depressed condition was affected by the mood induction. All subjects answered 93 general knowledge questions and rated their confidence in the correctness of the answer given. Subjects were instructed to think aloud when answering the last 31 questions. The conditions did not differ with respect to the proportion of questions answered correctly, mean level of confidence, nor with respect to three measures of the realism in subjects' confidence ratings (calibration, over/underconfidence and resolution). The results were the same when questions answered with and without think aloud instructions were analysed separately. PMID- 1775954 TI - Maturity of personality and family communication. AB - The psychodynamic and the communication/systemic perspectives are commonly considered as two entirely different approaches to psychopathology. The current study is an effort to bridge these opposing perspectives empirically. Maturity of personality, measured according to psychoanalytic principles by the Consensus Couples Rorschach, and relationship control in family communication, as measured by a new coding system (RCC) in an observational study, were related. The results indicate that low level of maturity is associated with egocentric and self disqualifying communication in situations of conflict, but not in situations involving no or moderate conflict. Additionally, mature wives were prone to react to situations involving perceptual conflict by communicating dominantly, whereas immature wives communicated in more submissive ways. Reversely, the more mature the husbands were, the more they displayed a submissive style of communicating when in conflict. PMID- 1775955 TI - Toward healthy longevity. Lessons in food and nutrition policy development from Finland and Norway. AB - For a variety of health, economic and social reasons, many countries are increasingly concerned about diet-related health problems impairing the quality and length of life. This article presents an analysis of the implementation of food and nutrition policies in Finland and Norway which are intended to address both the supply and demand aspects of food and dietary issues. The purpose was to identify policy problems and illustrate ways they have been addressed in order to be useful to other countries involved in developing such policies. The paper is based on on-site studies conducted in 1990, 1987, and 1980. Major findings indicate mixed progress due in part to problems in implementation. These include: development of an effective strategic capacity for planning, advocacy, coordination, and evaluation; integration into the health services system and other policy sectors; development of decentralized infrastructure for deploying policy; accuracy in public information on food and nutrition; the use of government market power, and social equity in the distribution of policy benefits and costs. PMID- 1775956 TI - Cardiovascular risk factor characterisation of women in the community of Stromstad, Sweden, compared with other female populations. AB - Statistics on the community level have revealed an increased mortality from cardiovascular diseases, especially stroke, among women in the community of Stromstad situated in the northern part of the County of Goteborg and Bohus near the Norwegian border. Based on prevalence data from a population study in Stromstad, to which all women aged 45-64 were invited and 86% attended, it was, however, concluded that history of cardiovascular diseases including stroke were not more common in Stromstad than in Gothenburg and Copenhagen. Traditionally accepted risk factors could not explain an increased mortality from these diseases in Stromstad, as these factors did not differ between Stromstad and a number of other communities, with which Stromstad was compared. It seems reasonable also to take other factors into consideration in order to explain the increased mortality, e.g. socio-economic factors and softness of the drinking water. PMID- 1775957 TI - Social network and social support predict improvement of physical working capacity in rehabilitation of patients with first myocardial infarction. AB - A cohort of 50 patients under 70 years of age who had suffered their first myocardial infarction (MI) entered an exercise-based rehabilitation programme. An extensive personal interview concerning psychosocial factors, including social network and social support, as well as an assessment of an array of clinical and laboratory variables was made before the patients were discharged from the hospital. A follow-up 6 months later of the 40 patients that completed the programme showed that material social support and social anchorage at baseline predicted improvement in physical working capacity, independently from age, gender and important clinical variables. The authors conclude that psychosocial factors could be predictors of equal importance as many of the standard risk factors and clinical assessments in the rehabilitation of a majority of post-MI patients. It is suggested that training programmes should provide opportunities for involvement of the patients' social network, in order to benefit from optimal social support during the rehabilitation process. PMID- 1775958 TI - A suggestion for improving intelligibility in multivariate confounder adjustment using alcohol intake and birth weight as an example. A 'confounder score' approach in analyzing continuous data. AB - Adjustment for multiple confounding is usually done by applying some kind of regression model. This requires assumptions about the type of relationship between the exposure of interest and outcome. It has been suggested to use confounder scores within strata of which the relationship can be scrutinised without such assumptions. Adjusting continuous outcomes for confounding factors, like birth weight for gestational age and lung function measures for age, is sometimes done by using the ratio of the observed outcome to an outcome expected from a reference series external to the study, with a concomitant risk of introducing new confounding. In some cases, the ideas from both these approaches can, slightly modified, be successfully combined. By using an internal rather than an external reference series, i.e. a group within the data with constant exposure, expected values for outcome can be derived as the fitted values from some model, appropriate for the purpose, depicting outcome conditional on all the potential confounders that are registered and for which control is desired. The relationship between the exposure of interest and the outcome, now represented by the fractional departure for each individual from the value expected conditional on her/his confounder status, can be scrutinised without any assumptions about the form of this relationship but, contrary to the confounder score approach, on the basis of the entire data set. This method also provides a way of presenting the relationship of interest, adjusted for confounding, that is easier to understand than the traditional regression approach. The impact of alcohol intake during pregnancy on birth weight will be given as an example. PMID- 1775959 TI - Causes of death in a cohort of 50,465 young men--validity of recorded suicide as underlying cause of death. AB - We studied causes of death in a cohort of all young males (n = 50,465) conscripted for military service in 1969-70. Six hundred eighty three deaths occurred in the cohort during the follow-up through 1983. Injury-related deaths accounted for 75% of all deaths. Of these, 38% were definite suicides, 10% undetermined suicides and 30% motor vehicle accidents. The validity of officially recorded causes of death was studied by scrutinizing all death certificates (n = 683) and forensic reports, including police reports, toxicological and histological data, from a sample (n = 322) of deaths with unclear circumstances. Of 161 officially recorded suicides (E950-959), only one case was reevaluated into poisoning, "undetermined" (E980). Of 47 cases officially recorded "undetermined" (E980-989), 9 were reevaluated into definite suicide (E950-959) although we believe that this is still an underestimation of "true" suicide cases. An alcohol concentration of more than 0.1 g% was found in 45% of all violent deaths (E800-999), 34% of all suicides and 60% of all "undetermined" deaths. We conclude that the causes of death in most cases of injury related death in young age are recorded with high accuracy. Reevaluation of recorded deaths from "undetermined" causes revealed a number of definite suicides, although the "true" number of suicides is difficult to assess even after close scrutiny of the information available. PMID- 1775960 TI - Social variation in infant mortality in a core city of Finland during the 19th and early 20th centuries. Positive effect of industrialization? AB - The aim of this study was to examine social variation (social class, legitimacy) in infant mortality in a core municipality (Viipuri) in Finland from 1819 to 1918. Data were obtained from the Population Change Tables of Finnish, Swedish and German parishes of the town of Viipuri. During the 19th and early 20th centuries the German parish socially had the highest rank and the Finnish one the lowest while the Swedish parish held an in-between position. The study period was divided into the preindustrial period (until 1868) and the period of industrialization (from 1868 onwards). Results of the study indicated a clear association between social class and infant mortality in the preindustrial period; in the period of industrialization the association was also clear but smaller. Legitimacy as a determinant of infant mortality became more marked towards the early 20th century. Industrialization brought with it some factors, such as numerous public health measures, which benefited the legitimate infants and narrowed their social group differences. PMID- 1775961 TI - Smoking by physicians in Scandinavia: 1952-1989. AB - The purpose is to describe smoking behaviour of physicians and of the general population in the Scandinavian countries. Data on smoking behaviour in physicians and in the population at large were collected from 14 surveys. The smoking prevalence dropped among male and female physicians in the period under study. Changes for the general male population were similar, but smoking among the general female population changed little. If the present changes continue, physicians could be a smokefree profession by the year 2000. PMID- 1775962 TI - Anxiety towards the AIDS patient. PMID- 1775963 TI - Chronic achilles tendonitis. PMID- 1775964 TI - HIV protection through testing? PMID- 1775965 TI - Overwhelming postsplenectomy sepsis twenty-two years after operation risks management and prevention. AB - A new case of fatal postsplenectomy sepsis occurring 22 years after operation for splenic rupture is described. There are now 30 published cases in which this complication occurred 10 or more years after operation. The microorganism responsible for the vast majority of cases is Streptococcus pneumoniae. The causative pathogen identified in the present case was a Viridans Streptococcas, Strep. sanguis, an opportunistic, low virulence pathogen. The clinical presentation of this patient is characteristic of the syndrome of overwhelming postsplenectomy infection and exemplifies the dramatic suddenness with which it develops. PMID- 1775966 TI - Fostering humanism: collaboration and medical ethics. PMID- 1775967 TI - Lithium induced renal toxicity--a review of the literature. AB - Lithium therapy is widely accepted as efficacious treatment for bipolar affective disorder. However, long term usage of lithium raises concern of side effects involving multiple organ systems, particularly renal function. A review of the literature indicates no significant effects on glomerular filtration rate. The main renal consequences of chronic lithium therapy are decreases in renal concentrating capacity. Treatment recommendations to diminish these renal toxic side effects of lithium therapy are reviewed. PMID- 1775968 TI - Theory and application of early systemic therapy. PMID- 1775969 TI - Adjuvant and neoadjuvant treatment of head and neck cancers. PMID- 1775971 TI - A review of the role of radiation therapy in the treatment of patients with breast cancer. AB - Irradiation has been used to treat cancer of the breast since 1895. Over the period between 1895 to the present, the therapeutic use of irradiation has evolved from a cauterizing agent to a sophisticated use of theory and practice to cause tumor cell death while at the same time producing maximum normal tissue sparing. The use of radiation has made it possible for the surgeon to use conservative breast sparing surgery to obtain excellent cosmetic results, while at the same time producing a local control equal to that of mastectomy. For the patient, conservative surgery becomes a better option than mastectomy because it not only produces local control equal to that of mastectomy, but gives the wonderful added benefit of a more superior and pleasing cosmetic result. PMID- 1775970 TI - Adjuvant and neoadjuvant treatment of breast cancer with chemotherapy and/or endocrine therapy. PMID- 1775972 TI - Adjuvant therapy of upper gastrointestinal tract cancers. PMID- 1775973 TI - Adjuvant therapy in colorectal carcinoma. PMID- 1775974 TI - The role of adjuvant radiation in the treatment of rectal cancer. PMID- 1775975 TI - The evolving role of chemotherapy for muscle infiltrating bladder cancer. AB - In order to improve survival in a disease where the majority of deaths occur from metastases, the integration of systemic chemotherapy is crucial. Research efforts must continue to focus on refining case selection criteria, improving complete response proportions, and overcoming drug resistance. The blanket recommendation of a single therapeutic strategy such as radical surgery, chemotherapy, or radiation therapy to all patients is quickly becoming an outdated approach. Refinements in the understanding of the clinical, pathologic, and molecular features of urothelial tumors will ultimately improve case selection. Evaluation of NM23 RNA levels, or DNA ploidy and T138 surface antigen expression, which have been shown to correlate with metastatic potential, may hold important therapeutic implications. The use of hematopoietic growth factors has the potential to improve both the tolerance of chemotherapy and complete response proportions, a prerequisite for cure. A recent report from Japan of granulocyte colony stimulating factor with MVAC and other chemotherapy regimens for urothelial tumors corroborated an initial report in reducing the duration of neutropenia. However, the dose response curves for most of the known active agents are not well defined and, ultimately, new agents and strategies will be required. Gallium nitrate, when administered by continuous intravenous infusion, has significant single agent activity in cisplatin-refractory patients with 9/31 responses (29%), including 6 CRs (19%) and further studies are warranted. Drug resistance remains a major obstacle, and as the mechanisms are unravelled, more rational therapies can be designed. For example, resistance to Adriamycin (doxorubicin; Adria Laboratories, Columbus, OH) and vinblastine, two components in the MVAC regimen, are mediated in part by the MDR1 gene. Attempts are ongoing to identify prospectively those tumors with high levels of expression that may be more amenable to treatment with drugs that are not affected by this mechanism. The neoadjuvant approach allows an in vivo assessment of response to chemotherapy as well as the potential for bladder preservation. In most cases additional therapy directed at the primary is required as clinical understaging is a significant problem and pCR proportions are less than 30%. For some patients, initial surgery followed by treatment based on pathologic criteria may represent a better strategy. In these cases the recommendation for adjuvant treatment potentially limits therapy to a population of patients for whom therapy is essential. Based on available data, this would include patients with positive lymph nodes at the time of surgery. Ideally, patients with invasive bladder cancer should be entered into clinical trials designed to assess the impact of these strategies on survival.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1775976 TI - Management of stage I and II ovarian carcinoma. PMID- 1775977 TI - Adjuvant therapy for sarcomas. AB - Adjuvant therapy is currently established in the treatment of osteosarcoma, Ewing's sarcoma and rhabdomyosarcoma. Of the 12 reported randomized studies of adjuvant chemotherapy for soft tissue sarcoma, only 2 show a significant overall survival advantage for chemotherapy (the most important endpoint). In three randomized trials, the survival of the observation arm exceeds that of the chemotherapy arm. In two additional studies, subset analyses currently indicate a significant DFS advantage for adjuvant chemotherapy in extremity lesions, but no significant improvement in survival. Although initial NCI reports showed significantly prolonged survival for the subset of chemotherapy-treated extremity primaries, survival on longer follow-up is no longer significantly different. In the subset analysis of retroperitoneal sarcomas in the same NCI study, the survival of the control group is superior to the treatment group. Doxorubicin associated cardiotoxicity has occurred in about 10% of treated patients, occasionally contributing to treatment-related deaths. Based on these data, adjuvant chemotherapy should be considered investigational for adult soft-tissue sarcomas of any primary site. Future randomized trials should include patients at high risk for metastases (large, high-grade lesions) with a reasonable likelihood of local control by radical resection, or resection with uninvolved margins and subsequent radiotherapy. Low-grade sarcomas are currently cured by surgical resection in 80% of cases, and thus should not be included in adjuvant trials. PMID- 1775978 TI - Future potential of adjuvant and neoadjuvant therapy. PMID- 1775979 TI - [Against the marginalization of the love of Christmas Day]. PMID- 1775980 TI - [The deontology of prenatal diagnosis and genetic counseling]. PMID- 1775981 TI - [The elements for an ethical assessment]. PMID- 1775982 TI - [How to measure arterial pressure with accuracy]. PMID- 1775983 TI - [Ethics and genetics]. PMID- 1775984 TI - [The risks of infection due to ophthalmic solutions]. PMID- 1775985 TI - [The conservative treatment of breast cancer. The current possibilities]. PMID- 1775986 TI - [Aging and disease]. PMID- 1775987 TI - [The nursing intervention plan]. PMID- 1775988 TI - [Death, hand in hand]. PMID- 1775989 TI - [The return to independence]. PMID- 1775990 TI - [The dependent elderly]. PMID- 1775992 TI - How I treat my patients with hypertension. PMID- 1775991 TI - [A day center for Alzheimer's patients cared for in a home]. PMID- 1775993 TI - Why rheumatology? PMID- 1775994 TI - Serodiagnosis of melioidosis in Singapore by the indirect haemagglutination test. AB - Melioidosis is endemic in Singapore, with diagnosis dependent upon both bacteriological culture and serodiagnosis. Using the polysaccharide (melioidin) sensitized turkey red cells in the indirect haemagglutination test (IHAT), 20 (100%) of the Pseudomonas pseudomallei culture-positive cases were detectable by the IHAT with titles ranging from 1:16 to 1:32, 768. Eight of these patients who died within a few days after the IHAT was performed had titres ranging from 1:16 to 1:1028. Five culture-negative patients, with clinical symptoms suggestive of melioidosis infection and who responded to treatment with ceftazidime, showed IHA titres between 1:64 and 1:8,192. One hundred and twenty one sera from patients with pneumonia, abscesses, or diabetes mellitus were IHAT negative. The IHAT showed good specificity since negative titres were seen in tests using sera from 2 patients with culture-positive Pseudomonas aeruginosa and 4 patients positive for Legionella. IHAT negative results were obtained from tests of 50 normal blood donors and 50 sewerage workers. Of 683 national servicemen tested, 5 (0.73%) had IHAT titres ranging from 1:16 to 1:128. Unlike hyperendemic areas such as Thailand where interpretation of IHAT is seriously hampered by IHA titres found in one-third to half of the population, serodiagnosis of melioidosis by the sensitive IHAT may be employed in Singapore as a routine procedure since background IHA titres are low. PMID- 1775995 TI - A comparison of fetal biparietal diameter measurements between local Chinese and Caucasian populations. AB - Since the advent of ultrasound, various workers have published nomograms of the fetal biparietal diameters (BPD). In the Singapore General Hospital, the nomogram established by Campbell and Newman was adopted initially for our multi-racial society. Data from the cross-sectional study of the 1442 BPD measurements of the Chinese fetuses between 17 to 40 weeks showed that the mean BPD values of the Chinese fetuses are lower than the Caucasians. The 2 standard errors of the BPD of the Chinese fetuses does not lie within the 2 standard errors of the BPD of the Caucasian fetuses. The reasons for the difference remain speculative. The presence of the statistical difference between the two means and the 2 standard errors establishes the need for constructing nomograms for our own local reference. PMID- 1775996 TI - A radiological survey of diverticulosis in Singapore. AB - Three hundred and sixty one consecutive barium enemas done at a general hospital were reviewed prospectively to determine the frequency and anatomic distribution of diverticulosis in Singapore. The frequency of 28% is comparable to previous American and European studies and higher than previous Asian studies. There was also a predominance of purely right-sided disease with the caecum and/or ascending colon involved in 71% of patients. This anatomic distribution of diverticulosis is quite different from that seen in Caucasian populations where the disease mainly involves the left side of the colon and is probably a function of genetic and racial factors. PMID- 1775997 TI - The functional status of elderly Chinese 75 years and older. AB - The functional status of a random sample of 180 elderly Chinese 75 years and older, living in the community in Singapore was assessed. The questionnaires used were the Older Americans Resources and Services (OARS) and the Geriatric Mental State (GMS) schedules. The subjects were divided into two age groups: (i) 75-79 and (ii) 80 years and above. On the social resources rating scale, 29.2% of the younger age group and and 22.4% of the older group had unsatisfactory social relationship or uncertain availability of help if needed. About 8.9% of the younger group and 23.9% of the older group needed assistance everyday in some activities of daily living. Moderate and severe impairment of mental health was noted in 22.1% and 26.9% of the two groups respectively. Only 1.7% of the sample had moderate and severe impairment in both social resources and activities of daily living. The significance of this study on needs and services for elderly people in the future, is discussed. PMID- 1775998 TI - Cost-effectiveness analysis of medical and surgical treatment for duodenal ulcer in Singapore. AB - A mathematical model involving transitions between possible states of duodenal ulcer was used to calculate the costs of various treatments, medical and surgical, which are available for the long-term management of duodenal ulcer. Costs of medical and surgical treatment were based on costs incurred at the National University Hospital, Singapore as at 1990. Elective surgery incurs a high cost, both financial and in terms of mortality, at the outset with minimal additional costs subsequently. The various medical options cost less initially but their costs are cumulative and eventually overtake the costs of surgical treatment. These calculations are based on the use of a proprietary preparation of a histamine-2-blocker. If a generic preparation is used, medical treatment becomes considerably cheaper over a 15 year period. PMID- 1775999 TI - Early congenital syphilis: experience with 13 consecutive cases seen at the University Hospital, Kuala Lumpur. AB - While it is not difficult to recognise the classical clinical features of congenital syphilis in most cases, some of them may present with unusual manifestations which can defy early diagnosis. We report our experience with 13 cases of early congenital syphilis over a period of 10 years from 1980 to 1989. Twelve of the thirteen patients were less than 3 months at presentation. There were two infants born prematurely and six of the babies were born with a low birthweight (less than 2.5 kg). All but four patients survived following treatment. Skin lesions either in the form of typical vesiculobullous eruption over the palms and soles or a maculopapular skin rash over the body were the most common presentation and was seen in 10 patients. Splenomegaly with or without hepatomegaly was the most consistent physical sign. Radiological changes in the form of periostitis and/or metaphysitis were seen in all cases where an X-ray of the long bones was performed. An elevated serum immunoglobulin M, though non specific for the disease, was found to be a useful screening test for recent infection. PMID- 1776000 TI - Cigarette smoking among school children in Singapore. Part III--Knowledge and attitudes towards smoking. AB - In the third article in this series which mainly assesses the knowledge of school children on the harmful effects of smoking, findings showed that the majority (90%) of school children surveyed were aware of the harmful effects. Current smokers appeared to be the least knowledgeable (69.4%) whilst non-smokers (89.3%) and experimenters (93.7%) were the most knowledgeable. Lung cancer (49%), smoking is bad for health (25%), smoking is bad for passive smokers (7%) and for heart disease (6%) were the most common responses given by the children on the specific ill effects caused by smoking. Smokers and non-smokers alike agreed that smoking is addictive, the proportions agreeing, once again, being lowest among smokers and highest among non-smokers. This trend was also observed when respondents were asked for their attitudes towards smoking--whether cigarette smoking was harmful and whether smoking made a person popular. The majority of respondents felt that a boy or girl who smoked "looked bad"--39% thought so of boys, while a higher proportion (55%), had the same impression of girls. The main reasons for giving up smoking given by ex-smokers were its harmful effects on health (49%), there being no more "kick" to it (16%), peer pressure (13%) and the disapproval of parents and teachers (13%). Among current smokers, at least half stated that they would like to stop smoking. Most of them had tried to kick the habit before but failed in their attempts. Finally, among the non-smokers, only 0.4% of boys and 0.1% of girls indicated that they might smoke in the future. PMID- 1776001 TI - Treatment of acute soft tissue trauma with a topical non-steroidal anti inflammatory drug (biphenylacetic acid 3% gel). AB - Non-steroidal anti-inflammatory drugs (NSAIDs) have been shown to be effective in the treatment of acute soft tissue injuries. However, taken orally, NSAIDs have a definite incidence of gastro-intestinal toxicity. Since acute soft tissue trauma is normally localised, use of a topical NSAID may eliminate this undesirable side effect. This study was designed to evaluate the efficacy and safety of a topical NSAID, biphenylacetic acid 3% gel (Traxam) in the treatment of soft tissue trauma. Thirty-two patients (22 males and 10 females) with acute soft tissue trauma were enrolled at the Department of Orthopaedic Surgery, National University Hospital, Singapore from 7 June 1988 to 28 March 1989. Each patient was treated for a period of one week with bipenylacetic acid 3% gel (Traxam), 60 mg three times a day. Statistically significant improvement was found in pain, swelling and functional impairment in all patients assessed at day 3 and day 7 after the injury. The speed of recovery was enhanced. The medication was found to be well tolerated and safe. PMID- 1776002 TI - Glenohumeral abduction and the long head of the biceps. AB - The role of the long head of the biceps in glenohumeral abduction and the accompanying external rotation is an unsettled issue. Automatic external rotation however has been previously demonstrated during passive abduction, with intact long head and the absence of factors traditionally considered to influence the rotation such as the coracoacromial arch and muscles surrounding the joint. The present study on the anatomy of the tendon of the long head in relation to passive abduction shows that not only is the tendon likely to be harmed by forced abduction without external rotation but the course of the tendon itself is such that activity in the long head during abduction is likely to influence external rotation that in turn prevents tendon impingement between greater tuberosity and glenoid labrum and allows glenohumeral abduction to be carried further towards completion. PMID- 1776003 TI - The Mentakab Hypertension Study project. Part I--Complicated hypertensives in hospital: who are they? AB - Consecutive hypertensives admitted with cardiovascular complications were studied. One hundred and eight complicated hypertensives (10%) out of 1,066 medical admissions were seen in the three month study. Thirty three per cent had cerebrovascular disease, 30% ischaemic heart disease, 2% had malignant hypertension and 85% had hypertensive heart disease. All patients had uncontrolled hypertension at admission (mean blood pressure 184/115 mmHg). Twenty four patients (22%) were newly diagnosed; of the rest of previously diagnosed hypertensives (78%), 3% had never been on treatment and 56% had dropped out of treatment, which explained their ineffective blood pressure control. However, 18% of patients had apparently been on regular follow up and treatment, and yet their blood pressure control was poor. Many patients had evidence of renal disease. The prevalence of cardiovascular risk factors was also high; 56% had hypercholesterolaemia; 46% had hypertriglyceridaemia; 44% smoked, 38% were overweight or obese, and 18% were diabetic. This indicates that hypertension is best regarded as an ingredient of a cardiovascular risk profile and its management requires multifactorial correction of all risk factors identified. PMID- 1776004 TI - The Mentakab Hypertension Study project. Part II--Why do hypertensives drop out of treatment? AB - Sixty hypertensives admitted into medical wards were interviewed in depth to determine reasons for their previous drop out of treatment. Eighty five percent of the patients were lacking in motivation. This was related to patients' lack of understanding concerning hypertension and its treatment, erroneous beliefs concerning hypertension held by patients and patients' perceived barrier to treatment. The evidence for these reasons were as follows: 95% of the patients were unaware that hypertension is a long term condition requiring life-long treatment, 60% were unable to state the likely consequences of uncontrolled hypertension, 78% equated relief of symptoms like headache, dizziness with control of hypertension, 52% believed long term consumption of 'western' medication was harmful, 12% believed they had been cured by traditional (bomoh or sinseh) treatment, 72% complained of long waiting time required to obtain care. Economic reasons however were unimportant. Patient education and more convenient clinic locations are necessary but insufficient to ensure compliance. They are particular elements, among others, of a 'good' doctor-patient relationship, which fundamentally is the critical determinant of compliance. PMID- 1776005 TI - Enterococci highly resistant to penicillin: characterizing isolates from Singapore hospitals. AB - Enterococci are increasing in importance as nosocomial pathogens and causes of severe sepsis in immunocompromised patients. From September to November 1989, a survey of 898 enterococcal isolates showed that 52 had acquired high-level resistance to penicillin and ampicillin (MIC greater than 100 mg/l). These were all Enterococcus faecium, did not produce beta-lactamase and showed high-level resistance to gentamicin and streptomycin as well. The majority were urinary isolates, but a few caused bacteraemia in severely ill patients. The potential spread of these highly-resistant enterococci would limit the therapeutic options for systemic infections. PMID- 1776006 TI - Air in the cervical annulus--the lucent cleft sign. AB - The lucent cleft sign is a sign of soft tissue injury. It was first described as a sign of acute cervical injury but it is neither confined to cases of trauma nor the cervical region. The sign is also seen in degenerative disease and in the lumbar spine. The lucent cleft sign is seen anteriorly, as an area of hyperlucency above the superior end plate of the vertebra. It is the result of a partial tear of the annulus. In complete avulsion, the sign may be absent and the radiograph, completely normal. We report our experience of 15 patients with the lucent cleft sign. Our patients are relatively young (commonest age group 30-35 years) and the majority (10 patients) had a history of acute trauma. Four patients had non-specific (3 cervical and one lumbar) aches while in the last patient, the lucent cleft was an incidental finding. Although we only documented the disappearance of the sign in 4 patients, we believe that with healing, the sign will eventually disappear. Although the sign is transient, it is useful as it may be the only sign present in cases of trauma. PMID- 1776007 TI - Lymphangioleiomyomatosis--treatment with progesterone. AB - Lymphangioleiomyomatosis is a rare devastating disease affecting women mostly of child-bearing age. It presents with spontaneous pneumothorax, chylous effusions, hemoptysis and progressive breathlessness. Most patients die from respiratory failure within 10 years. There are no controlled studies on the efficacy of various treatment regimens. We report our experience with progesterone therapy in three patients. Two failed to respond, one died about 11 years after presentation and another after 5 1/2 years. The third patient has survived 11 years after onset of disease. PMID- 1776008 TI - The role of community health care team in the care of the elderly. AB - The Community Health Care Team plays an important role in helping the elderly maintain an independent life in the community for as long as possible. It does this by emphasizing preventive Geriatric Medicine, provision of supportive and care services and ensuring emotional and physical support for carers. Each member of the Community Health Care team plays an important role and works together as a team to ensure that appropriate services are provided for the varied needs of the elderly in the Community. In Singapore, Community Health Services for the elderly are provided mainly by the Home Nursing Foundation (HNF). Services available at the moment include domiciliary nursing service, rehabilitation and day care carried out at the Senior Citizen's Health Care Centres and Home rehabilitation programme undertaken by trained Staff Nurses. Close liaison is maintained with the Geriatric Department in Tan Tock Seng Hospital. Support groups in existence include a Stroke Club and a Carer's group. Respite care is presently provided by certain voluntary Homes on an ad-hoc basis. The aim of effective community based care for the elderly should be adequate provision of services followed by the effective use of resources. PMID- 1776009 TI - Hypertension in the elderly. AB - Hypertension is a common finding in the elderly. Appropriate treatment would reduce the incidence of strokes and cardiovascular events. Caution is however indicated in the selection of whom to treat and how treatment is carried out. Treatment should be initiated only if advantages outweigh disadvantages for that individual patient. Treatment has to be tailored to the individual patient. PMID- 1776010 TI - An overview of eye problems in Singapore's elderly. AB - Medical problems increase in frequency with advancing age. Ophthalmic problems are no exception, and add to disability in the elderly. Cataract, glaucoma, diabetic retinopathy, retinal detachment and age-related maculopathy are common blinding problems in middle-aged to elderly patients. If recognised early and properly managed, useful vision can be preserved in many cases. However, despite increasing awareness of conditions such as acute angle-closure glaucoma and diabetic retinopathy, patients are still presenting too late to the eye clinics. Successful management and rehabilitation of the patient depend upon greater awareness and early diagnosis, and requires cooperation between all medical personnel who deal with elderly patients. PMID- 1776011 TI - Laboratory tests in rheumatic diseases: a guide for clinicians. AB - In the practice of rheumatology, just as in other disciplines of medicine, laboratory tests are meant to supplement a thorough history and physical examination. The clinician should have a purpose for ordering each test; to screen for a disorder, confirm a diagnosis, exclude a possible diagnosis, monitor therapy or determine prognosis. Many of the rheumatic diseases have in common processes and features that are inflammatory and many of the tests merely establish the presence of an inflammatory process. The measurement of ESR and C reactive protein are two such tests most widely used. The systemic rheumatic diseases also manifest serologically with the continual production of non-organ specific autoantibodies. Few of these antibodies are specific for a particular disease. The majority of the autoantibodies are positive in various disease states and are only useful as adjuncts to the diagnosis of rheumatic diseases. This discussion deals with commonly ordered tests in rheumatic diseases; how to use the tests appropriately while keeping in mind their limitations. PMID- 1776012 TI - Angioimmunoblastic lymphadenopathy--a fulminant case. AB - A 60 year old male presented with pruritus, excoriations and enlargement of several groups of lymph nodes associated with constitutional symptoms following the intake of an aspirin preparation. Lymph node biopsy established the diagnosis of angioimmunoblastic lymphadenopathy. The need to be aware of this condition is highlighted when patients present with clinical features suspicious of lymphoma. PMID- 1776013 TI - Apparent change of Rhesus blood group typing in a case of ulcerative colitis. AB - An interesting case of ulcerative colitis with an apparent change of Rhesus blood group typing is described. To our knowledge, this has not been reported before. We postulate that during the initial active phase of ulcerative colitis, an unknown D-like antigen, possibly bacterial in origin, could temporarily give rise to a Rhesus D-positive blood group typing in a patient with Rhesus D-negative blood type. Interestingly, with continuous immunosuppressive therapy for ulcerative colitis, the patient did not develop anti-D antibodies despite multiple transfusions with D-positive blood. PMID- 1776014 TI - Genitourinary trauma. Part 3. The genital system. PMID- 1776015 TI - Prostate Awareness Week: how we did it! PMID- 1776016 TI - Primary intervention--a rewarding challenge in nursing. PMID- 1776017 TI - Implementation of a screening program for carcinoma of the prostate. PMID- 1776018 TI - Turning obstacles into opportunities. PMID- 1776019 TI - Pillow talk. PMID- 1776020 TI - An instructional model for T.U.R. PMID- 1776021 TI - Confidentiality revisited. PMID- 1776022 TI - Pancreas transplantation: a nursing overview. PMID- 1776024 TI - Magnetic resonance evaluation of anterior cruciate ligament repair using the patellar tendon double bone block technique. AB - The magnetic resonance (MR) appearance of the anterior cruciate ligament reconstruction was determined in 20 clinically stable and 2 clinically unstable knees for a total of 22 examinations. All patients studied had undergone knee reconstruction using the patellar tendon as graft material. The reconstructed anterior cruciate ligament varies in appearance. It appeared as a thick, well defined, low signal band on T1- and T2-weighted sagittal and coronal images in 14 of 22 examinations. The remaining 8 knees showed a graft having one or more thin and attenuated, low signal intensity bands in the sagittal and/or coronal plane. In 3 of these cases, the grafts appeared thicker in the coronal plane. All cases, including the two clinically unstable knees, showed no break in graft continuity. Arthroscopy confirmed an intact but lax graft in the clinically unstable knees. PMID- 1776023 TI - Sclerosing bone dysplasias--a target-site approach. AB - Sclerosing bone dysplasias are a poorly understood group of developmental anomalies, much of whose etiology is still obscure. The list of conditions constituting this group is relatively short: osteopetrosis (Albers-Schonberg disease), pycnodysostosis (Maroteaux-Lamy disease), enostosis (bone island), osteopoikilosis, osteopathia striata (Voorhoeve disease), progressive diaphyseal dysplasia (Camurati-Engelmann disease), hereditary multiple diaphyseal sclerosis (Ribbing disease), four types of endosteal hyperostosis (van Buchem disease, Worth disease, Nakamura disease, and Truswell-Hansen disease), dysosteosclerosis, metaphyseal dysplasia (Pyle's disease), craniometaphyseal dysplasia, melorheostosis (Leri disease), and craniodiaphyseal dysplasia. There are instances in which two or more of the above disorders coexist. These are termed "overlap syndromes", most commonly involving osteopathia striata, osteopoikilosis, and melorheostosis. A classification of these dysplasias is elaborated based on a targetsite approach that views them as disturbances in development associated with the processes of either endochondral or intramembranous bone formation, or both. Accumulated evidence suggests that many of these disorders stem from common defects in bone resorption and/or formation during the processes of skeletal maturation and modeling. Finally, the subgroup of overlap syndromes is emphasized as indicating a strong interrelationship between the sclerosing dysplasias of bone, with perhaps a common pathogenesis for many. PMID- 1776025 TI - Lumbar platyspondyly--characteristic sign of Ehlers-Danlos syndrome. AB - Three patients with Ehlers-Danlos syndrome have been observed to have isolated flattening of the lumbar vertebral bodies. Flattening of the lumbar vertebrae with normal appearance of the rest of the spine may be an important radiological clue to early recognition or confirmation of the diagnosis of Ehlers-Danlos syndrome. PMID- 1776026 TI - Comparison of dual photon and dual energy X-ray bone densitometers in a clinic setting. AB - In clinical practice, decisions must be made about whether and how to convert to newer technologies. To address this issue, two separate studies were conducted. We evaluated the relationships between results of lumbar spine measurements using two dual photon absorptiometry (DPA1 and DPA2) instruments and one dual energy X ray (DXA) instrument with the same subjects (49 volunteers), and also in 65 patients who were measured on the DPA1 and DXA machines. Second, we measured the lumbar spine and the proximal femur in three groups of 12 female volunteers three times on one instrument within 1 week. We purposely simulated a busy clinic setting with different technologists, older radioactive sources, and a heterogeneous patient group. The comparison study indicated a significant difference between the mean bone density values reported by the machines, but the results were highly correlated (R2 = 0.89-0.96). The short-term precision errors (coefficients of variation) differed among the instruments, ranging from 1.3% (DXA of the spine) to 5.1% (DPA1 of the spine), and in the femoral neck, 2.3% and 2.4% (DXA and DPA1, respectively) versus 3.5% by DPA2. This study emphasizes the differences between instruments, the potential for greater error in busy clinic environments, and the apparent superiority of dual energy X-ray absorptiometry under these less than ideal conditions. PMID- 1776027 TI - Clavicular overgrowth in association with cystic hygroma. AB - Cystic hygroma is a rare congenital abnormality of the lymphatic system of the neck which is now considered to form part of a spectrum of lymphangiomatous malformations. Lytic bone lesions are described in systemic lymphangiomatosis and bony overgrowth (hemihypertrophy) in association with angiomatous malformations of the limbs. Two infants with ipsilateral clavicular overgrowth adjacent to cystic hygromas are reported. This association has not been recorded previously; the possible etiology is discussed. PMID- 1776028 TI - Stability of osteochondral fragments of the femoral condyle: magnetic resonance imaging with histopathologic correlation in an animal model. AB - The stability of surgically induced osteochondral fragments of the femoral condyle was examined by magnetic resonance imaging (MRI) using T1- and T2 weighted spin echo sequences in 7 dogs; contrast-enhanced T1-weighted spin-echo sequences were also obtained. Animals were sacrificed between the 34th and 196th day after surgery. MR images were compared with the histopathologic findings. Two loose and five stable fragments were found after injection of contrast medium. With the loose fragments, a well-defined line of high signal intensity between the fragment and the epiphysis showed marked enhancement. Histological examination revealed vascularized granulation tissue at the interface. Stable fragments also showed a similar, but irregularly defined line on plain sequences, but no enhancement after injection of contrast medium; histological examination showed no granulation tissue at the interface but intact bone trabeculae within the completely repaired fracture. Fibrocartilaginous repair at the articular cartilage surface also showed enhancement. Contrast-enhanced MR imaging allowed an exact delineation of the line of separation of unstable osteochondral fragments in this animal model with differentiation from a similar line occurring in stable fragments. However, this interface line in relation to stable fragments could not be explained histologically and probably reflects differences of binding or distribution of protons in healing osteochondral fragments. PMID- 1776029 TI - Case report 685: Ossifying fibromyxoid tumor of the soft parts of the upper arm. AB - We report an unusual case of an ossifying tumor arising in the deep soft tissue adjacent to the humerus of a 72-year-old woman. The tumor exhibited sarcoma-like features histologically, although its clinical course unexpectedly differed from that of a malignant tumor. We diagnosed this particular case as an ossifying fibromyxoid tumor of soft parts, which has been recently described by Enzinger et al.. This is another example of an ossifying soft-tissue tumor which simulates a malignant sarcoma. PMID- 1776030 TI - Case report 700: Primary intracortical osteosarcoma of femur, sclerosing variant, grade 1 to 2 anaplasia. AB - We report a case of intracortical OS of the mid-femur in a 43-year-old man. The patient is the oldest reported to date. Histologically, the tumor was a sclerosing variant of OS with extensive "normalization" of nuclei. This is the most common histological subtype of intracortical OS. The patient was treated by en bloc resection without preoperative or systemic chemotherapy and is without evidence of disease with 15 months' follow-up. PMID- 1776031 TI - Case report 701: Prostaglandin E1 (PGE1) periostitis. AB - A case of periosteal new bone in a newborn is presented. The periostitis resulted from long-term therapy with PGE1, which was administered to maintain patency of the ductus in a neonate with ductal-dependent cyanotic congenital heart disease. The features of PGE1 periostitis and the differential diagnosis are reviewed. PMID- 1776032 TI - Case report 702: Langerhans cell histiocytosis (LCH) of the skin, skull, and mandible with calcifications in associated soft-tissue masses. AB - We have presented the clinical and radiographic findings (plain films and CT study) of a 22-month-old boy with multiple destructive cranial and mandibular lesions of LCH. An unusual feature was the presence of adjacent, relatively large, soft-tissue masses, with numerous small discrete calcifications, possibly related to previous intralesional steroid injections. PMID- 1776033 TI - Case report 703: Multifocal osteosarcoma. AB - There are two theories concerning the origin of multifocal osteogenic sarcoma: In one, the lesions all arise synchronously as multiple, simultaneously appearing, primary tumors, and in the other, there appears to be one dominant site with early and rapidly progressive metastatic disease. We believe that our patient fits into the second group with a primary right (distal-end) femoral osteogenic sarcoma with early and rapid metastasis. Bone scan, chest CT, and MRI examinations played an essential role in the initial evaluation and follow-up of this patient with osteosarcomatosis. The multiple modalities also offered a greater sensitivity in the detection and for the surveillance of the progression of the condition. PMID- 1776035 TI - The reaction of private physicians to price deregulation in France. AB - French private physicians are paid on a fee-for-service basis and nearly all of them are under contract to the Social Security, which refunds part of the medical fee to the whole population. Previously the prices of medical services were fixed, but since 1980, a new option has been possible: a doctor can choose to fix the price of his services freely, provided he pays a higher social insurance contribution. But the amount refunded by Social Security does not vary, so that the consumer has to bear the extra charge. Our purpose here is to identify the factors that influence the physician's option. In Section 2, we define a model of the private physician's economic behaviour, of the classic income-leisure type. In Section 3, empirical tests are performed on a sample of observations in 95 'departements', gathering information about private GPs on the one hand, and the whole population on the other. According to our results, GPs' decisions depend on characteristics of both supply of and demand for GPs' services. One of our conclusions is that GPs seem to make up for low activity levels with higher prices, on condition the income of their practice allows it. PMID- 1776034 TI - Case report 704: Extraskeletal osteosarcoma of the thigh with several suspected skeletal metastases and extensive metastases to the chest. AB - A case of extraskeletal osteosarcoma occurring in its most common location, the thigh, is reported. Particular emphasis is given to demonstrating the spectrum of radiological findings, including CT, MRI, and scintigraphy and to illustrate that this entity can metastasize to bone. PMID- 1776036 TI - Self-reported symptom distress in cancer patients: reflections of disease, illness or sickness? AB - This article examines the relationships between symptom distress in a heterogeneous group of cancer patients and a number of possible explanatory variables, categorized as demographic, medical/clinical, individual/psychosocial and variables related to patients' views of care provided by the health care system. A series of explorative multiple regression analyses were undertaken to this end. The data are derived from a cross-sectional study of cancer patients diagnosed in 1987 at one general hospital in the greater Stockholm area, using semi-structured interviews in conjunction with McCorkle and Young's Symptom Distress Scale, Antonovsky's Sense of Coherence Questionnaire, Cutrona and Russell's Social Provisions Scale and Smilkstein's Family APGAR. Symptom distress is studied as a cumulative index, as well as in terms of the sub-indexes of pain, appetite/nausea, functional aspects, psychological aspects and social aspects. When the four categories of explanatory variables are combined, considerably higher levels of variance are explained for all 6 indexes of the Symptom Distress Scale, than when the regression analyses are performed separately with each distinct category of explanatory variables. This provides a statistical illustration of the multifaceted and complex nature of symptom distress. The data are presented in the context of a conceptual discussion about the meaning of symptoms. Symptom distress, in this study, appears to reflect both personal and cultural experiences, that is 'illness' and 'sickness' processes, rather than primarily medical/clinical variables, or 'disease'. Antonovsky's salutogenic model is suggested as a fruitful framework for further analysis. PMID- 1776037 TI - Exempting the poor: the experience of Thailand. AB - Fee exemption schemes are widely recommended but little analysed. This paper analyses the operation of the Free Medical Care Project in Thailand, which enables those classified as poor to receive free treatment at government facilities. The paper concentrates in particular on the size and geographical distribution of the group eligible for free care, and on the extent to which the geographical distribution of the budget matches the geographical distribution of the poor. By analysing published data available at national level, information is produced on numbers of people eligible for free care, on the numbers who receive free care, and on the geographical distribution of the free medical care budget. Comments are also made on how the project appears to be operating at health facility level. The paper goes on to consider whether the equity effects of the project could be improved by reorganizing the project, and what impact reorganization might have on the costs of the project. PMID- 1776038 TI - The impact of family presence on the physician-cancer patient interaction. AB - Physician behaviors were studied in 473 interactions between oncologists and adult cancer outpatients. Ninety-nine of these interactions occurred when family members were present during the visit. Patients with family members present were likely to be sicker as demonstrated by a poorer performance status. Contrary to earlier reports, age of the patient did not predict whether the patient was likely to be accompanied by a family member. The physician behaviors were factor analyzed to produce six factors and a multivariate analysis of variance was conducted using the presence of family and performance status as independent variables. The time the physician spent in the patient's room, patient satisfaction and quality of life were also examined in separate analyses. The time the physician spent with the patient was greater when family were present. The results showed that, in general, physicians provide more information when patients are accompanied by family members, or if no family are present, when the patient has a worse performance status. Patient satisfaction and quality of life were rated lower for patients with a worse performance status and were not impacted by physician behaviors. Physicians' behavior was affected by both the presence of a family member, and the patient's performance status. PMID- 1776039 TI - Prescription intentions in relation to therapeutic information: a study of 117 French general practitioners. AB - In 1987 we conducted a mailed questionnaire survey involving 250 GPs, randomly drawn from the 3061 GPs in the 'Rhone-Alpes' region in France, in order to study how general practitioners (GPs) react to information about drugs in terms of their prescribing practices. The aim of the questionnaire was to investigate the GPs reactions (prescription intentions) to 25 statements containing information concerning drugs. These included results from randomized clinical trials with adequate clinical criteria (pertinent information), but there were also some statements containing non-relevant information such as intermediate criteria, physiopathological or pharmacological information, and some containing general information such as advice from colleagues, the established position of the drug etc. The GPs were also asked through which channels they commonly received therapeutic information (i.e. medical journals, conferences). A total of 117 GPs returned completed questionnaires. We found the prescription intentions, for pertinent information to be between 76.9% and 95.7%, whilst the intentions, as a result of personal knowledge and/or success with a drug were around 93%. More theoretical information resulted in prescription intentions which were more widely scattered (between 23.1% and 80.3%), and for external advice the intentions were not as high but they were also widely scattered (between 3.4% and 65%). The search for latent dimensions corresponding to GPs reactions to therapeutic information, with both principal component analysis and Rasch Modelling, showed that two orthogonal latent dimensions, i.e. 'sensitivity to clinical and theoretical information', and 'sensitivity to external standards', best explained the responses to the questionnaire. These two dimensions appeared to be independent of age, sex, medical school and type of practice (urban, rural). The use of the journal 'Prescrire' by GPs was found to be significantly associated (P less than 0.005) with low scores, or good quality of perception of pertinent information in the first dimension. The use of specialists' prescriptions was associated with similar scores for the first dimension, but also with poor quality of perception of pertinent information scores (i.e. high scores) for the second dimension. These results could be used to draw up proposals for the improvement of post-graduate medical education, which should take into consideration these two dimensions of therapeutic information assessment by doctors, in order to obtain better quality of perception profiles for information assessment and prescription by doctors. PMID- 1776040 TI - Intellectual, social and nutritional status of children in an Ethiopian orphanage. AB - Children at the Jimma community orphanage between the ages of 5 and 14 years were given a battery of tests to assess their intellectual, social, and nutritional well-being relative to a group of family-reared controls. On two tests of intellectual ability, the Ravens Progressive Matrices and the Conservation test, the orphanage children performed as well as the family children. Children who entered the orphanage at an early age scored higher than those who entered later. On social-emotional measures of self-esteem, the orphanage children scored higher than or similar to the controls. However, in terms of their relationships with adults, the orphanage children reported fewer interactions and weaker attachments to adults. This was largely determined by the higher child: adult ratio in the orphanage than in family homes. Also, the orphanage children were more likely to be stunted but not more likely to be wasted than the family children. The former was attributed to the malnutrition experienced by children before they entered the orphanage, which in many cases was during the 1984 famine. Stunting was associated with lower Ravens scores. The generally favourable status of the orphanage children can largely be attributed to the noninstitutional orphanage rather than to their preorphanage family life. This raises disturbing questions about family life under conditions of economic stress. PMID- 1776041 TI - Employment and low birth weight in black women. AB - Recent studies have not shown adverse effects of employment during pregnancy on the pregnancy outcome, but most have not successfully distinguished factors due to work-related physical and mental strain from differences in social, economic and cultural characteristics between employed and non-employed women. We analyzed data from the Alameda County Case-Control Study of Low Birth Weight to address the question of employment as a risk factor for low birth weight in more depth. Subjects in the study were singleton infants without congenital malformations born in 1987 to black or white, non-hispanic residents of Alameda County, a large urban community in California. Cases were all infants weighing less than 2500 g at birth; controls were chosen at random from the infants weighing 3000 g or more. The mothers of 377 black cases, 389 black controls, 233 white cases and 239 white controls could be located and interviewed. This analysis excluded the white women because evidence of response bias in regard to employment was found for them but not for black women. The percentage of black women in the study who were employed during pregnancy was 49.9%. Employment was associated with a significantly lower relative risk of low birth weight before and after controlling for age, parity, smoking, heavy alcohol use, prior low birth weight infants and low pre-pregnancy weight. After adjustment for known risk factors for low birth weight, employment explained more of the variance of low birth weight than other commonly used measures of 'social class', including income, education and marital status.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1776042 TI - Knowledge and perceptions about AIDS among married women in Bangkok. AB - People's knowledge and perceptions about AIDS are critical in efforts to combat the further spread of this disease. Using data from a study on "Determinants and Consequences of Contraceptive Use Patterns in Thailand", this paper investigates the knowledge and perceptions about AIDS among ever-married women in Bangkok Metropolis. Differentials in knowledge and perceptions are investigated by socio economic subgroups. The results indicate the need to inform and educate people about AIDS, especially those in low-income groups or with lower levels of education. PMID- 1776043 TI - Parental responses to consanguinity and genetic disease in Saudi Arabia. AB - In-depth interviews of 36 Saudi families whose children suffered from neuro metabolic disorders were conducted at a specialist hospital in Riyadh in order to examine parental understanding of disease and attitudes towards future births and consanguineous marriages. Parents had difficulty accepting a genetic explanation for diseases that did not affect all children at the time of birth; they also expressed religious or folk beliefs to account for illness. Coping behaviours included denial and resignation to the situation, divorce and remarriage. Some families adopted a cautious approach to cousin marriages and future births; this was significantly related to their education level, but not to previous infant deaths. Awareness of medical facts brought little emotional comfort to parents but allowed for preventive measures through screening adult carriers and identifying affected infants. This study presents new material from Saudi Arabia to strengthen current awareness that the range of religious beliefs, social attitudes and reproductive behaviours adopted by families in a society undergoing rapid change is of direct relevance to health care. PMID- 1776044 TI - Cigarette smoking and employment status. AB - The smoking habits and health knowledge of the unemployed and the full-time workers were investigated in a cross-sectional study of over 10,000 men and women throughout Scotland. For both sexes (age range 40-59 years), the proportion of current smokers and ever smokers was found to be considerably higher among the unemployed. Only a small part of the difference could be explained by standardisation for social class. The unemployed smokers had began to smoke at an earlier age, with significantly more smoking whilst still at school. Amongst current smokers, the unemployed males reported smoking fewer cigarettes a day, whereas unemployed women smoked more than their full-time counterparts. The reported levels were confirmed by the biochemical measures of smoking; serum thiocyanate and expired air carbon monoxide levels. In contrast to their differences in smoking habit, the two groups were very similar in their knowledge of the hazards of smoking. Smoking habits among the unemployed reflect a complex interaction of financial and both current and previous social factors. Such relationships present a particular challenge to health promotion campaigns. PMID- 1776045 TI - Tobacco, politics and economics: implications for global health. AB - This paper examines the expanding presence of multinational cigarette companies into almost every country in the world, and discusses the health implications of this global penetration. Cigarettes deserve special attention because tobacco is the only legally available consumer product that is harmful to one's health when used as intended. A temptation exists to blame governments for the existence of health-threatening products within their borders. However, this paper illustrates the extent to which extra-national forces influence domestic policies and circumstances. Cigarette smokers are often blamed for their lethal habit, despite billion-dollar promotional schemes which attract people to smoking, obscuring the harmful consequences of consuming a highly addictive drug. Multinational cigarette companies are increasingly targeting Asian and Third World populations. To facilitate this market penetration, political avenues are often pursued with considerable success, disregarding the health implications associated with cigarette tobacco. The use of tobacco in development programs (e.g. the U.S. 'Food for Peace' program) has political and economic implications for donor and recipient countries, and lucrative advantages for the tobacco companies. However, this paper recommends that corporate profits and foreign policy should not be pursued at the expense of tobacco-related diseases and premature deaths among Third World peoples. PMID- 1776046 TI - The second fatal impact: cigarette smoking, chronic disease, and the epidemiological transition in Oceania. AB - The island countries of Oceania are now experiencing the epidemiological transition which has shifted patterns of morbidity and mortality from primarily infectious to mainly noncommunicable diseases. Prominent among these are many ailments known to be linked to or caused by tobacco smoking--especially to smoking of flue-cured, commercially made cigarettes. Cigarette manufacture by major tobacco transnational corporations began in the Pacific during the mid 1950s and production has grown rapidly since then. Cigarettes have been marketed aggressively, with a result that they have increasingly replaced the smoking of home-grown and twist tobacco. The history of tobacco production and marketing is sketched, and the literature on chronic diseases related to smoking is summarized for the Pacific region. The rise of anti-smoking movements in Oceania is then discussed, with particular attention to the PNG case during the 1980s. PMID- 1776047 TI - To smoke or not to smoke: a decision theory perspective. AB - Although smoking as a customary behavior is currently becoming outmoded, and may even be viewed as a 'deviant' behavior; its use persists among certain social groups in our own and other societies. We address this issue by describing the inherent design features and benefits of tobacco, and tobacco smoking, and propose that its use be conceptualized as a reasoned act based upon its subjectively perceived net worth to the individual. A survey of the scientific literature is made and cross-cultural examples are used. PMID- 1776048 TI - Starting to smoke in the Navy: when, where and why. AB - Smoking rates among U.S. military men are much higher than those in the general population. A previous study compared the smoking rates of male recruits coming into the Navy with those of a shipboard sample to find out whether the Navy was attracting or creating smokers. Twenty-eight percent of the incoming recruits were smokers, whereas 50% of the shipboard men were smokers. These findings suggested that the Navy environment somehow encouraged smoking. The present study followed a group of male recruits for one year after they entered the Navy to determine when, where, and why they started smoking during their first year in the service. Two hundred and sixty-two of the original 682 participants returned the one-year follow-up information. Twenty-eight percent of the sample were self reported smokers upon entry into the Navy. One year later 41% classified themselves as smokers. Of those who started smoking (either for the first time or again after having quit) during their first year, 42% started within their first two months of service (i.e. during recruit training), and another 32% started during their third month in the Navy. In addition to the 42% who started during recruit training, 39% started while attending training school, and 15% started while stationed aboard a ship during their first year in the Navy. The most frequently cited reasons for starting to smoke were: curiosity, friends smoking, calming effect, and wanted to be 'cool'. Because many individuals begin smoking soon after joining the Navy, effective prevention programs need to be implemented in recruit training and repeated in early training schools. PMID- 1776049 TI - Sociocultural factors associated with smoking behavior by Puerto Rican adolescents in Boston. AB - This study examined cigarette smoking among Puerto Rican adolescents in the Boston area in its sociocultural context by describing who uses cigarettes, and by identifying factors that encourage or discourage cigarette use. The study, conducted from 1986-87, used two approaches. The first was to survey 605 Puerto Rican households with adolescents 11-20 years old. Households were identified from a random sample of census blocks in five neighborhoods. In each household, interviews were completed with one adolescent and his or her female caretaker. The second approach was to conduct ethnographic interviews with 40 adolescents selected through a purposive sample of survey respondents from three of the study neighborhoods. Bivariate and multivariate statistical analyses were used to examine the relationships between smoking behavior and characteristics of the adolescents. The results of these analyses were examined in light of the ethnographic data. Overall, 13.7% reported smoking in the month preceding the interview. Smoking was most prevalent among males 17-20. Patterns of smoking were associated with teens' social networks. The Puerto Rican adolescents in this study were more likely to smoke when their friends and household members smoked, if they participated in recreational activities such as sports or unsupervised games, and if they were not in school. These effects varied according to the gender of the respondent. PMID- 1776050 TI - A new stage, a new life: individual success in quitting smoking. AB - This paper posits an anthropological perspective on smoking cessation that considers both the social context for cigarette use and disuse, and the construction of meanings for the quitting process. With reference to the dialectic of person and individual propounded by Burridge (1979), four case studies of cigarette smokers are presented to elucidate the quitting process in the context of achieving a 'new stage, a new life'. At certain times, events-that happen may cause persons to act as individuals; by seizing the moment in this way, they achieve a moment of individuality in which roles, desires, and objectives for living are recreated and transformed. PMID- 1776051 TI - A model for quality of life after laryngectomy. AB - In this paper we propose a theoretical model for quality of life after laryngectomy. By combining findings from literature, relevant factors for determining quality of life are presented. The importance of these factors is exemplified by interviews with laryngectomies. The practical purpose is to embed this model in a patient's choice process between surgery and radiotherapy, the two main treatments of laryngeal cancer. It is argued that such a decision is at best made by a cooperation of patient, physician and social worker or psychologist. PMID- 1776052 TI - Predictions of epidemiology and the evaluation of cancer control measures and the setting of policy priorities. AB - Cancer incidence predictions may be constructed for administrative and scientific purposes. For administrative purposes it is often important that the predictions come true. The resources planned on the basis of the predictions and allocated on the diagnostics, treatment and rehabilitation can then be optimally utilized. However, predictions that do not materialize can also be useful. The effects of intervention or early detection programmes express themselves as failures of predictions that have been made in the absence of such programmes. Predictions of cancer incidence in Finland are used as examples. The prerequisite for the predictions is a well-functioning population-based cancer registry. The predictions were constructed using time trends and differentials in cancer incidence with or without the aetiological or other risk factors. Short-term, 10 15 year predictions with no explicit use of risk factors, have proven successful with most cancers, e.g. those of the colon, rectum, pancreas and urinary organs, and lymphomas. The marked prediction failures have occurred for cancers of the lung and breast. Predictions for these cancers have been improved by taking aetiological or other risk factors explicitly into account. The cancer consequences of the preventive cardiovascular programme in North Karelia have been evaluated using predictions. The effectiveness of screening for cervical cancer at population level was predicted on the basis of estimated parameters of the natural history of the disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1776053 TI - The application of operational research (OR) procedures to maternal mortality from puerperal sepsis in a rural community. AB - An operation research (OR) procedure on maternal mortality from puerperal sepsis was carried out in Irepodun Local Government Area of Kwara State of Nigeria. The study involved ten focus groups discussion (FGD) in two districts of the Local Government Area. The findings were analysed from three broad perspectives, that is, consumers' views, providers' views and community decision takers' views. In general, the analysis revealed that the community knowledge of puerperal sepsis is poor. In addition, limited access and prohibitive cost of orthodox health care services prevented the community from full utilization of the few available health care centres in the community. The study also revealed that there is urgent need to introduce three key interventions for an improved maternity care in the community. These interventions are community health education, health institutions development and community participation in provision of ancillary services such as transportation. PMID- 1776054 TI - Onset and duration of breast feeding among Israeli mothers: relationships with smoking and type of delivery. AB - A study of 190 mothers of firstborn, 6 month-old infants showed that different mechanisms affect onset and duration of breast feeding. Maternal education is related both to onset and duration of breast feeding; more highly educated women begin breast feeding and they breast feed for a longer period. Type of delivery is significantly associated with onset of breast feeding, even when controlling for educational level: cesarean delivered women are less likely to begin breast feeding than mothers delivered vaginally, although once breast feeding has begun, type of delivery no longer plays any role. Smoking is associated only with duration of breast feeding and not with onset. Among those women who breast feed for a long period, all are non-smokers. Women usually do not resume smoking immediately after giving birth which may explain why smoking is associated only with duration and not with onset of breast feeding. The results suggest the importance of influencing mothers so they do not resume or, at least, delay resumption of smoking as long as possible after parturition, in order to increase the likelihood of breast feeding. Caesarean delivered women should be encouraged to begin breast feeding while still in hospital. PMID- 1776055 TI - Predictors of health in new mothers. AB - This survey study was conducted to determine the variables that predict mothers' mental health, work readiness, and use of health services several weeks after they give birth to, or adopt a baby. Regression analyses on 313 married women (108 first-time adoptive mothers, 72 first-time biological mothers, and 133 controls) showed a strong link between biological mothers' postpartum health and their infants' health; this relationship was not observed for adoptive mothers and their infants. Biological mothers' postpartum health problems were also related to their smoking, fatigue, and current work at a job; further, their readiness to work at a job two months postpartum was greater if they were in good general health, had not had a cesarean section, and were not currently breastfeeding. The results suggest that many mothers continue to have unique health needs several weeks after delivery and, if substantiated by future studies, these findings may have implications for postpartum health care practices and for maternity leave policy. PMID- 1776056 TI - [The third generation oral cephalosporins]. PMID- 1776057 TI - [Lavage of the ear in children]. PMID- 1776058 TI - [Course to follow in case of epistaxis]. PMID- 1776059 TI - [Laryngo-tracheal-bronchial foreign body. The course to take]. PMID- 1776060 TI - [Esophageal foreign body. Course to follow]. PMID- 1776061 TI - [Recent esophageal burn. Course to follow]. PMID- 1776062 TI - [Sinusitis]. PMID- 1776063 TI - [Quality of life and cancer. Care of the patient with laryngectomy and his family: a new approach]. PMID- 1776064 TI - [Specificity of geriatric care]. PMID- 1776066 TI - [Failure]. PMID- 1776065 TI - [Is there any specificity in geriatric care?]. PMID- 1776067 TI - [Here and now...]. PMID- 1776068 TI - [Activities towards a meaningful life]. PMID- 1776069 TI - [The place of the nurses' aide]. PMID- 1776071 TI - [The aged and their quality of life. Old age follow each other but they no longer resemble each other]. PMID- 1776070 TI - [The geriatric nursing team]. PMID- 1776072 TI - [The teaching of psychology in nursing schools]. PMID- 1776073 TI - [Internal communication. The art of staff management]. PMID- 1776074 TI - [Breaking the image of geriatrics. The reawakening of a service]. PMID- 1776075 TI - [Measures to save nursing centers]. PMID- 1776076 TI - [Psychiatric disorders during cranial trauma]. PMID- 1776077 TI - [The workshops at Haye Berou]. PMID- 1776078 TI - [Therapeutic approach to a patient]. PMID- 1776079 TI - [Intervention using the plastic arts]. PMID- 1776080 TI - [Surveillance of AIDS in France. (Situation as of June 30, 1991)]. PMID- 1776081 TI - [Admission center for elderly persons]. PMID- 1776082 TI - [Emergency placement in a retirement home]. PMID- 1776084 TI - [Residence in the fourth age]. PMID- 1776083 TI - [The admission. Breaks and continuity]. PMID- 1776085 TI - [Birth of a planning council at Andilly]. PMID- 1776086 TI - [The loss and suspension of time]. PMID- 1776087 TI - [Rights of aged, dependent persons in institutions]. PMID- 1776088 TI - [Charter of the rights and liberties of aged, dependent persons]. PMID- 1776089 TI - [Haye Berou Center]. PMID- 1776090 TI - [Determination of costs of examinations and paraclinical health service procedures and public health on the basis of their work intensity]. AB - Methodological approaches to the estimation of cost (prices, tariffs) of investigations and procedures of auxiliary curative and diagnostic service according to their technological and complex labour-consuming nature are provided. Using the unified norms of time and production for estimations would help define unified prices for medical services of analogical type and provide performance-related incentives for health workers. PMID- 1776091 TI - [Noise, infrasound and vibration as factors of urban environment]. PMID- 1776092 TI - [Background factors and the degree of risk in home injuries]. AB - Based on a large amount of statistical information and using correlation and dispersion analysis, an influence of background factors on the probability of home injuries has been studied. It has been shown that the availability of background factors increases the risk for home injuries. The individual background factors are of primary importance for the probability of home injuries occurrence. The determination ratio of individual factors constitutes 70.1%. Among them the most prevalent are: insufficient sleep and visual disturbance. As far as external background factors of home injuries are concerned one can say that a weak and statistically invalid feedback is established. PMID- 1776093 TI - [Medico-tactical aspects of the initial stage of elimination of disaster consequences]. AB - One of the main postulates in the organization of activities to eradicate the consequences of catastrophes is the principle of priorities in the delivery of medical care for the victims, effectiveness of which to a large extent depends on the clear view of medical personnel about their actions. Health workers and, first and foremost, physicians finding themselves at the place of a catastrophe are forced to take the responsibility for the organization of emergency relief operations and delivery of medical care up to the moment when the information on the accident becomes known outside the catastrophe focus and before the arrival of competent specialists. PMID- 1776094 TI - [Use of discriminant analysis in the development of a prognostication system for complications of hypertension]. AB - The knowledge of unfavourable factors affecting the course of essential hypertension (EH) cannot solve the problem of identifying persons for differentiated follow-up and treatment of those with the increased risk for EH complications. In order to elaborate the system of prognosing acute complications of EH among rural population a prospective and retrospective methods of observation were used. To develop a system of prognosing a discriminant analysis was used. The individual risk for acute complications in EH is determined by available signs according to the working table by finding the algebraic sum of prognostic coefficients. The result is compared with the scale of threshold value of summarized influence of factors. PMID- 1776095 TI - [Preparation of higher-qualification personnel at a medical institute under conditions of restructuring medical education in the country]. PMID- 1776096 TI - [New information technologies in the keeping, recording and processing of medical documentation based on personal computers]. AB - The main methods of organizing the information technology for medical documentation keeping, registration and processing are considered. Suggestions are made of a new information technology which expects to make use of personal computers and is based on built-in logical trees of various medico-biological information most frequently used in the department of the given profile. A description is provided of the first version of the system which is realizing the technology on IBM PC HT/AT computer. PMID- 1776097 TI - [Psychological training at a medical institute]. AB - The need in psychological training of physicians has been on the rise. The article considers the principles of elaborating the programme of psychological training in medical education and also provides a detailed description of the "Complex programme for psychological training of physicians" developed and realized at the Ryazan Medical Institute named after I.P. Pirogov. PMID- 1776098 TI - [Medical errors and physician's conscience: an excursion into the history of national medicine in the 19th and the beginning of the 20th century]. PMID- 1776099 TI - [Monastery medicine in ancient Russia]. PMID- 1776100 TI - [I. E. Diad'kovskii in the Caucasus]. PMID- 1776101 TI - [An outstanding national scientist (the 125th anniversary of the birth of A. A. Kuliabko)]. PMID- 1776102 TI - [Experience in the historical periods of the development of the Moscow I. M. Sechenov Medical Academy]. PMID- 1776103 TI - [Pharmacy Order (the 410th anniversary of the state management of medical activities in Russia)]. PMID- 1776104 TI - [Present-day diagnosis and problems of public health economics]. PMID- 1776105 TI - [Culture of cells forming granulomonocytic colonies in bone marrow (GM-CFU) in myelodysplastic syndromes and their relation to hematological findings and FAB subtype]. AB - The results of "in vitro" culture of granulomonocytic precursor cells (CFU-GM) of the bone marrow from 44 patients were analysed in the present work. The correlation with the patient's haematological characteristics, their FAB subtypes (i.e., 6 cases of refractory anaemia (RA), 11 of acquired sideroblastic anaemia (ASA), 15 cases of refractory anaemia with excess blasts (RAEB), 5 cases of RAEB in transformation (RAEBT) and 7 cases of chronic myelomonocytic leukaemia (CMML), and the survival were examined as well. The technique used for cell culture was that of Pike and Robinson, following the classification proposed by Florensa for estimating the growth patterns. Anomalies of the myeloid clonal proliferation were found in 81% of the cases. There was direct correlation between the number of aggregates and the polymorphonuclear cell count, whereas the highest number of blast cells coincided with increased number of clusters in cultures. CNNL showed the highest aggregate counts. The B growth pattern (both colony and aggregate growth) was most frequently seen in CMML; pattern C2 (decreased colonies with increased aggregate count) appeared in RAEB, RAEBT and CMML, and pattern C3 (decrease of both colony and aggregate counts) was found only in RA and ASA. None of the culture findings appreciably associated with the survival. PMID- 1776106 TI - [Chronic lymphatic leukemia. I. Clinico-biological features and survival analysis. Study of 187 patients]. AB - A review was carried out of 187 previously untreated cases of chronic lymphocytic leukaemia diagnosed between 1969 and 1988. The median age of the patients was 65 years (range, 36-87). There were 118 males (M/F ratio, 1.7). In accordance with Rai's staging system the patients were distributed as follows: 0.29%; I, 20%; II, 25%; III, 13%; IV, 13%, and according to Binet's staging the distribution was: A, 55%; B, 21%; C, 24%. The most frequently found physical findings were lymph node enlargement (55%), splenomegaly (32%) and hepatomegaly (28%). Anaemia was present in 20% of the cases and thrombocytopenia in 13%. The mean lymphocyte count was 62 x 10(9)/L (range, 6-475 x 10(9)/L). Bone marrow infiltration of over 80% was seen in 46% of the patients. Bone marrow biopsy was performed on 97 patients, the diffuse pattern of involvement being most commonly found (44%). Increased BUN (55%), alkaline phosphatase (42%) and LDH (38%) were the most frequent biochemical alterations. Hypogammaglobulinaemia was present in 55% of the patients, IgM being the most commonly affected immunoglobulin (66%). Monoclonal gammopathy was seen in 4% of the cases. LDT, measured in 75 patients, was less than a year in 32%. No antileukaemic drugs were needed in 34% of the patients. When concluding this study, 100 patients had died. The median survival was 57 months and death was related to chronic lymphocytic leukaemia in 53% of such patients. PMID- 1776107 TI - [Chronic lymphatic leukemia. II. Analysis of prognostic factors and development of survival predicting models. Study of 187 patients]. AB - The univariate analysis of prognostic factors showed the value of clinical variables (age, symptoms, lymph node enlargement, splenomegaly, hepatomegaly, clinical stage), haematological variables (haemoglobin, platelet count, leucocyte count, lymphocyte count, bone marrow involvement and biopsy pattern, cleaved lymphocytes, prolymphocytes, LDT) and biochemical variables (BUN, creatinine, calcium, phosphorus, uric acid and albumin). The multivariate analysis chose the combination of Rai's stage, age, cervical lymph node involvement, phosphorus and BUN. Two predictive models capable of separating appropriately low, intermediate and high risk groups were developed and validated. The results were compared with others in the literature. The interest of predictive models arising from multivariate analysis is stressed. PMID- 1776108 TI - [Cytogenetic and molecular aspects in MALT lymphomas]. AB - Cytogenetic and molecular results in 10 patients with extranodal lymphoma (MALT): 5 low grade and 5 high grade, were compared with the results observed in nodal lymphomas. This study suggests that there are cytogenetic differences between extranodal and nodal low grade lymphomas. Both molecular analysis by conventional Southern blot with probes for the major and minor regions of bcl-2 gene, and PCR analysis with primers from these regions, showed that t (14; 18) is a sporadic event in MALT lymphomas. PMID- 1776109 TI - [Cytochemical detection of lymphocyte 5'-nucleotidase in chronic lymphatic leukemia]. AB - 5'-Nucleotidase is a degrading purine ectoenzyme acting at alkaline pH. It is located in both B and T lymphocytes and its study is of interest in chronic lymphoproliferative diseases. The present work compiles the cytochemical study of lymphocyte 5'-nucleotidase in a control group consisting of 277 haematologically normal subjects and a series of 77 chronic lymphocytic leukaemia (CLL) patients; phenotypic studies had been carried out in 40 of these last. The results were expressed as percentage of 5'-nucleotidase positive lymphocytes, and the value (means +/- SD) for the control group was 25 +/- 7, that of the CLL group being 10.7 +/- 18.12. Increased lymphocyte 5'-nucleotidase was present in a minority of the cases (13%), but the significance of this finding is unknown and unrelated to any clinical or cytomorphological data. Although lacking any statistical value, those B-CLL lymphocytes expressing surface IgM and IgD (thus being more mature cells) showed higher 5'-nucleotidase values than those cells expressing only IgM. This finding suggests that a given lymphocytic population would be more immature the lower 5'-nucleotidase value it may express. The incorporation of 5' nucleotidase determination into the cytochemical study of CLL is encouraged as it is frequently decreased in this disease; at the same time, the enzyme may provide some information on the maturity of the leukaemic population involved. PMID- 1776111 TI - [Massive intravascular hemolysis in septicemia caused by Clostridium perfringens]. AB - A case of massive haemolytic anaemia in the course of a C. perfringens sepsis of hepatic origin is presented. The diagnosis was strongly suggested by the presence of intragranulocytic capsulated bacilli in a Giemsa stained peripheral blood smear. The patient developed disseminated intravascular coagulation. The outcome was fatal and the patient died eight hours after admission. We review the aetiopathogenesis, diagnosis and therapy of haemolysis in Clostridium perfringens infections. PMID- 1776110 TI - [Focal hepato-splenic mycosis caused by Trichosporon beigelii in a patient with acute leukemia]. AB - We report a case of infection produced by Trichosporon beigelii in a patient with acute leukaemia. In spite of treatment with amphotericin B the patient died and the necropsy studies showed only involvement of liver and spleen without disseminated infection. Focal hepatosplenic fungal infection has been recognized with increasing frequency in recent years as a serious complication in immunosuppressed patients. Usually it is produced by Candida spp and this is the first case described in the literature due to the newly recognized fungus T. beigelii. PMID- 1776112 TI - [Anti-Ge2 in a Ge: -2, -3 patient]. AB - The first report of anti-Ge2 in our country, found in a Ge: -2, -3, A1B Rh+ patient is presented. The IgG + IgM antibody reacted in a low ionic strength medium, with a titre of 128. ABO compatible red blood cells labelled with 51Cr had a very shortened life span, with high haemolytic rate. The transfusion problems posed by this patient and the therapeutic autotransfusional approach carried out are commented. PMID- 1776113 TI - [Antibodies against mezlocillin and cefonicid in a patient with immune hemolytic anemia]. PMID- 1776114 TI - [Polycythemia vera associated with multiple myeloma]. PMID- 1776115 TI - [Solid neoplasms associated with multiple myeloma]. PMID- 1776116 TI - [Bone marrow necrosis and acute lymphoblastic leukemia]. PMID- 1776117 TI - [Hereditary sideroblastic anemia in 3 Canary Island families]. PMID- 1776118 TI - [Prevention and treatment protocols of thromboembolic disease]. PMID- 1776119 TI - Structure of the 70-kilodalton heat-shock-related proteins. PMID- 1776120 TI - Heat-shock proteins and autoimmunity in humans. AB - T cells and antibodies against self and non-self hsp are present in both patients and healthy controls. T cells responding to hsp65 can be involved in autoimmune diseases, this was demonstrated for two site-specific animal autoimmune diseases: AA in Lewis rats and diabetes (IDDM) in NOD mice. In human ReA there is evidence for a direct stimulation of joint T cells by antigens of the organisms causing the infection which precedes the joint inflammation. The individual antigens of the triggering bacteria still have to be defined, but hsp65 may be of importance since this is one of the molecules recognized by synovial T cells in ReA patients. In RA there are no clear data implicating an infection in the initiation of joint inflammation, but mycobacteria have been suggested to be involved. We have discussed experimental findings which are in favor of, or in contradiction with, a role of mycobacterial antigens--particularly hsp65--in the etiology of RA. T cells recognizing hsp65 and other mycobacterial antigens are present in the joint, but there is no indication for a specific involvement of one or a limited set of (myco)bacterial antigens in the pathogenesis of RA. PMID- 1776121 TI - The 65-kDa heat-shock protein in the pathogenesis, prevention and therapy of autoimmune arthritis and diabetes mellitus in rats and mice. PMID- 1776122 TI - Management of posterior uveal melanoma. AB - In recent years, there have been a number of advances in the diagnosis and management of patients with malignant melanoma of the posterior uvea (ciliary body and choroid). This review provides a brief update on the current status of diagnostic modalities, such as fluorescein angiography, ultrasonography, computed tomography, magnetic resonance imaging, fine needle aspiration biopsy, and the radioactive phosphorus uptake test. Following that is a more detailed review of the current controversy regarding the natural course of uveal melanomas and the available therapeutic modalities. Current indications, techniques, complications, and results are provided for various forms of management, such as observation, laser photocoagulation, plaque radiotherapy, charged particle radiotherapy, local tumor resection, enucleation, and orbital exenteration. PMID- 1776123 TI - Secondary optic nerve tumors. AB - Secondary tumors of the optic nerve are more common than primary optic nerve tumors. The involvement of the optic nerve may arise from direct invasion from intraocular malignancies, from hematopoietic malignancy, from meningeal carcinomatosis, or from distant primary tumors. Orbital tumors rarely invade the optic nerve, and brain tumors involve it only in their late stages. PMID- 1776124 TI - Magnetic resonance imaging of the optic chiasm. AB - Magnetic resonance imaging (MRI) has become an important diagnostic modality for the evaluation of patients with chiasmal or perichiasmal disease. In this review, normal chiasmal anatomy and various pathologic conditions will be illustrated to demonstrate the advantages of MRI over computed tomography (CT). MRI is the neuroimaging method of choice in chiasmal evaluation, but sometimes it may be complemented by CT scanning. PMID- 1776125 TI - Bilateral iris tumors in an immunosuppressed child. AB - A seven-year-old iatrogenically immunosuppressed girl developed simultaneous bilateral iris tumors associated with granulomatous iridocyclitis, splenomegaly, and an immunoblastic pleocytosis. Serologic studies suggested a current active Epstein-Barr virus infection. Tumor biopsy showed a polyclonal plasmacytoid lymphoproliferative process, establishing the diagnosis of posttransplant lymphoproliferative disorder. Low-dose local irradiation produced rapid and complete iris tumor regression with restoration of vision in both eyes. To our knowledge, this is the first report of ocular involvement in posttransplant lymphoproliferative disorder. PMID- 1776126 TI - Acute anterior uveitis and HLA-B27. AB - Acute anterior uveitis is a common ocular disease characterized by inflammation of the iris and ciliary body. In the majority of patients presenting with an acute attack of anterior uveitis, the only clues to the pathogenesis of this disease are its close association with the genetic marker HLA-B27 and the likely triggering role of a variety of gram negative bacteria. HLA-B27 acute anterior uveitis appears to be a distinct clinical entity frequently associated with the seronegative arthropathies, such as ankylosing spondylitis and Reiter's syndrome. Recent advances in our understanding of the structure and function of class I HLA molecules have revealed their fundamental function in antigen presentation and this has led to a reevaluation of their role in disease predisposition. PMID- 1776127 TI - A difficult choice: a laboratory or a clinical career? PMID- 1776128 TI - Effects of neurotensin on midbrain dopamine neurons: are they mediated by formation of a neurotensin-dopamine complex? AB - The effects of neurotensin on midbrain dopamine neuron activity were studied in brain slices using single-unit recording techniques. At low concentrations (0.2 10 nM), neurotensin attenuated dopamine-induced inhibition without a significant effect on the basal firing rate. At higher concentrations (greater than 10 nM), however, it consistently caused an increase in cell activity. At even higher concentrations (greater than 100 nM), a sudden cessation of cell activity preceded by an increase in firing rate was observed. Whether this effect of neurotensin was due to depolarization inactivation or to a toxic effect of the peptide at high concentrations remains to be determined. To determine whether the effects of neurotensin were mediated by formation of a neurotensin-dopamine complex, several neurotensin analogues were studied. Neurotensin (8-13), which binds to both neurotensin receptors and dopamine, mimicked the effects of native neurotensin. Neuromedin N, which competes with neurotensin for the same receptor but does not bind to dopamine, also mimicked the effects. However, neurotensin (1 11), which forms a complex with dopamine but is inactive in competing for neurotensin receptors, was ineffective. In addition, the excitatory effect of neurotensin was not attenuated in the presence of dopamine receptor blockade by sulpiride. These results suggest that formation of a neurotensin-dopamine complex may not account for the action of neurotensin on dopamine cells. When combined with the fact that there is a high density of neurotensin receptors on dopamine cells, our results support the suggestion that the observed effects of neurotensin on dopamine neurons are most likely mediated by an activation of neurotensin receptors. PMID- 1776129 TI - Heterogeneous binding of [3H]4-DAMP to muscarinic cholinergic sites in the rat brain: evidence from membrane binding and autoradiographic studies. AB - The present study shows that [3H]4-DAMP binds specifically, saturably, and with high affinity to muscarinic receptor sites in the rat brain. In homogenates of hippocampus, cerebral cortex, striatum, and thalamus, [3H]4-DAMP appears to bind two sub-populations of muscarinic sites: one class of high-affinity, low capacity sites (Kd less than 1 nM; Bmax = 45-152 fmol/mg protein) and a second class of lower-affinity, high capacity sites (Kd greater than 50 nM; Bmax = 263-929 fmol/mg protein). In cerebellar homogenates, the Bmax of [3H]4-DAMP binding sites was 20 +/- 2 and 141 +/- 21 fmol/mg protein for the high- and the lower-affinity site, respectively. The ligand selectivity profile for [3H]4-DAMP binding to its sites was similar for both the high- and lower-affinity sites; atropine = (-)QNB = 4-DAMP much greater than pirenzepine greater than AF-DX 116, although pirenzepine was more potent (16-fold) at the lower- than at the high-affinity sites. The autoradiographic distribution of [3H]4-DAMP sites revealed a discrete pattern of labeling in the rat brain, with the highest densities of [3H]4-DAMP sites present in the CA1 sub-field of Ammon's horn of the hippocampus, the dentate gyrus, the olfactory tubercle, the external plexiform layer of the olfactory bulb and layers I-II of the frontoparietal cortex. Although the distribution of [3H]pirenzepine sites was similar to that of [3H]4-DAMP sites in many brain regions, significant distinctions were apparent. Thus, both the ligand selectivity pattern of [3H]4-DAMP binding and the autoradiographic distribution of sites suggest that although the high-affinity [3H]4-DAMP sites may consist primarily of muscarinic-M3 receptors, the lower-affinity [3H]4-DAMP sites may be composed of a large proportion of muscarinic-M1 receptors. PMID- 1776130 TI - Distribution of cocaine recognition sites in monkey brain: I. In vitro autoradiography with [3H]CFT. AB - The cocaine analog [3H]CFT ([3H]WIN 35,428) was used to map and characterize cocaine recognition sites in the squirrel monkey brain by quantitative autoradiography. Coronal tissue sections were incubated with 5 nM [3H]CFT to measure total binding or with [3H]CFT in the presence of 30 microM (-)-cocaine to measure nonspecific binding. High densities of [3H]CFT binding sites were present in dopamine-rich brain regions, including the caudate nucleus, putamen, nucleus accumbens, and olfactory tubercle. In each of these regions specific binding was greater than 90% of total binding. Several additional brain regions exhibited intermediate densities of [3H]CFT binding, including the substantia nigra, the zona incerta, the amygdala, and the hypothalamus. Low, though measurable levels of binding were observed in the bed nucleus of the stria terminalis, the ventral tegmental area, the medial preoptic area, the pineal, the hippocampus, and thalamic central nuclei. Near-background levels of binding were found in white matter, cortical regions, globus pallidus, and cerebellum. The pharmacological specificity of [3H]CFT binding in various brain regions was determined in competition studies using [3H]CFT and a range of concentrations of selected monoamine uptake inhibitors. In all brain regions examined, stereoselective inhibition of [3H]CFT binding was observed for the (-) over the (+) isomer of cocaine. For other drugs tested, competition experiments indicated a rank order of potency of GBR 12909 greater than or equal to CFT greater than bupropion, suggestive of binding of [3H]CFT to elements of the dopamine transport system. The results demonstrate that although densities of [3H]CFT binding sites are highest in the caudate nucleus, putamen, and nucleus accumbens/olfactory tubercle, significant levels of binding can be detected in other brain regions that may contribute to the behavioral and physiological effects of cocaine. PMID- 1776131 TI - Effects of endogenous dopamine on kinetics of [3H]N-methylspiperone and [3H]raclopride binding in the rat brain. AB - Competition by endogenous dopamine with the binding of D2 dopamine receptor ligands may be important in the interpretation of positron emission tomography (PET) neuroreceptor studies. PET studies with N-methylspiperone (NMSP) have revealed increased D2 dopamine receptors in schizophrenia, whereas studies with raclopride (RAC) have not detected such differences. This may be due, at least in part, to differences in competition with endogenous dopamine for ligand binding. To determine effects of endogenous dopamine on in vivo receptor binding, adult male rats were preinjected with amphetamine and reserpine prior to [3H]NMSP or [3H]RAC. Striatal to cerebellar ratios of ligand binding were determined. To approximate the conditions of a PET study, a kinetic model was employed to examine effects of pharmacologically increasing brain dopamine levels (amphetamine pretreatment) on PET ligand binding. In these experiments, tail veins and arteries were cannulated and kinetic parameters determined from normalized integral plots in rats treated with amphetamine prior to radioligand injection. Both [3H]NMSP (43.5%) and [3H]RAC (41.5%) binding were significantly decreased after amphetamine pretreatment, whereas after reserpine pretreatment [3H]RAC binding was increased (52.7%). Kinetic studies revealed a marked resistance of [3H]NMSP to competition with endogenous dopamine released by amphetamine. In contrast, kinetic parameters of [3H]RAC were markedly reduced at all time intervals. This suggests significant differences in competition with endogenous dopamine by [3H]NMSP and [3H]RAC, determined kinetically. These findings may have important implications for the interpretation of PET neuroreceptor studies. PMID- 1776132 TI - Excitatory responses to serotonin (5-HT) in neurons of the rat piriform cortex: evidence for mediation by 5-HT1C receptors in pyramidal cells and 5-HT2 receptors in interneurons. AB - As a prerequisite to pharmacological analysis of the excitatory effects of serotonin (5-HT) on piriform pyramidal cells and interneurons, this study first examined the physiological characteristics of these two cell types. Intracellular recordings confirmed that the subpopulation of 5-HT-activated cells located at the border of layers II and III are indeed interneurons. Voltage clamp recordings in pyramidal cells showed that the increase in excitability produced by 5-HT in these cells was the result of voltage- and Ca(2+)-dependent outward currents with the characteristics of IM and IAHP. Pharmacological studies were designed to discriminate 5-HT2 from 5-HT1C responses in interneurons and pyramidal cells of piriform cortex. The 5-HT antagonist spiperone, which has a much higher affinity for 5-HT2 receptors than for 5-HT1C receptors, blocked the excitatory effect of 5 HT at lower concentrations in interneurons (IC50 = 31 nM) than in pyramidal cells (IC50 = 2.1 microM). Similarly, ritanserin, a drug which also has a higher affinity for 5-HT2 than 5-HT1C receptors, blocked the effect of 5-HT at lower concentrations in interneurons (IC50 = 400 nM) than in pyramidal cells (IC50 = 8.1 microM). In contrast, LY 53857, an antagonist with higher affinity for 5-HT1C than for 5-HT2 receptors, blocked the effect of 5-HT at lower concentrations in pyramidal cells (IC50 = 26 nM) than in interneurons (IC50 = 364 nM). The 5-HT1C partial agonist/5-HT2 antagonist mCPP produced agonist-like effects in only 66% of pyramidal cells tested indicating that not all pyramidal cells may express 5 HT1C receptors. In that both spiperone and ritanserin have higher affinity for 5 HT2 receptors than for 5-HT1C receptors and LY 53857 has a higher affinity for 5 HT1C receptors than for 5-HT2 receptors, these data suggest that in piriform cortex excitatory effects of 5-HT are mediated by 5-HT1C receptors in pyramidal cells an by 5-HT2 receptors in interneurons. PMID- 1776133 TI - Compartmentation and glycoprotein substrates of calpain in the developing rat brain. AB - An activated form of calpain I associates with telencephalic membranes in a developmentally regulated fashion during early postnatal ontogeny. During this period, the cytoskeletal component spectrin is available and appears to be differentially susceptible to calpain-mediated cleavage. Lectin blotting techniques demonstrated that the leupeptin-sensitive action of calpain is primarily directed toward large proteins which are glycoconjugate in nature; neuronal cell adhesion molecules are among the glycoproteins whose associations with the telencephalic membranes decrease due to calpain activity. These data suggest that cytoplasmic calpain is translocated to the membrane during early brain development in order to act on the cytoskeletal and adhesive structures responsible in part for neuronal shape and function. PMID- 1776134 TI - Changes in dendritic spine morphology in response to increased availability of monoamines in rat medial prefrontal cortex. PMID- 1776135 TI - Congenital antithrombin III deficiency (AT-III Kyoto): identification of a point mutation altering arginine-406 to methionine behind the reactive site. AB - A Japanese patient with congenital antithrombin III (AT-III) deficiency, named AT III Kyoto, is associated with reduced levels (60% of normal) of AT-III antigen, progressive activity and heparin cofactor activity. The antithrombin III gene of this patient was investigated by polymerase chain reaction (PCR) method followed by direct DNA sequencing analysis, which revealed a G to T transitional mutation resulting in the conversion of arginine-406 to methionine in exon 6. Arginine-406 is located at the 12th amino acid residue from the reactive site on the C terminal side of AT-III in a core region of the molecule which has been highly conserved during evolution of serine protease inhibitor (serpin) family. It is concluded that AT-III Kyoto is a newly described mutation which is similar to AT III Utah and lends support to the idea that the conserved region near the reactive site is important in maintaining biological function of the AT-III molecule. PMID- 1776136 TI - Platelet function abnormalities in 6-12 month-old Watanabe heritable hyperlipidemic (WHHL) rabbits. PMID- 1776137 TI - Comparative study on the in vitro effectiveness of antithrombotic agents. AB - The synthetic low molecular weight inhibitors MD 805, FUT-175 and FOY as well as heparin and r-Hirudin were compared for their in vitro antithrombotic potencies and protease specificities. The amidolytic activity of thrombin and the plasma coagulation were effectively inhibited by MD 805 and, in particular, by r Hirudin. FUT-175 and FOY revealed only weak inhibition. None of the synthetic substances discriminated between alpha-, beta- and gamma-thrombin. Beside r Hirudin only MD 805 revealed a relatively good specificity for thrombin. On the contrary, FUT-175 and FOY are unspecific and can not be classified as thrombin inhibitors. PMID- 1776138 TI - Fibrinolysis after acute ischemic stroke. PMID- 1776139 TI - Purification and characterization of rabbit factor IX and its existence as a two chain factor IX alpha in circulating plasma. AB - The long term objective of this study is to immunodeplete rabbits of factor IX as a means of developing a rabbit model for hemophilia B for use in studies of tissue factor-dependent blood coagulation. As a first step, we have purified rabbit factor IX by basically two different methods: (1) conventional chromatography utilizing DEAE-Sephadex and heparin-agarose column chromatography (2) immunoaffinity chromatography on monoclonal anti-rabbit factor IX IgG column. Purified rabbit factor IX migrated as a single band with an apparent molecular mass of 76 kD on nonreduced SDS-PAGE. On reduced SDS-PAGE the majority of factor IX migrated as a two-chain molecule (molecular masses 51 and 28 kD) and a faint band corresponding to 78 kD. We have shown that the purification of rabbit factor IX as a two-chain molecule is not due to the partial proteolysis of factor IX during its purification from commercially obtained rabbit plasma. Analysis of 3H labelled rabbit factor IXa on SDS-PAGE revealed that, in contrast to human factor IXa, carbohydrate was found associated with the heavy chain of activated factor IX (H beta) after release of the activation peptide. Further understanding of the molecular properties of rabbit factor IX and the generation of neutralizing monoclonal and polyclonal antibodies will facilitate the development of a rabbit model for hemophilia B. PMID- 1776140 TI - The effect of the carboxy-terminal lysine of urokinase on the catalysis of plasminogen activation. AB - When single-chain pro-UK is activated by plasmin or kallikrein, the Lys158-Ile159 bond is cleaved, leaving a C-terminal lysine on the A-chain (Lys-UK). Two-chain, high molecular weight urokinase (UK) purified from urine, however, has been shown to contain a phenylalanine residue as the C-terminal of the A-chain (Phe-UK). Since C-terminal lysine residues have a strong binding affinity for plasminogen that may promote its activation, we undertook kinetic studies comparing plasminogen activation by Lys- and Phe-UK. A two-stage method was employed in order to minimize factors known to interfere with plasminogen activation and plasmin determination. The Lys-UK was prepared by plasmin activation of pro-UK purified from human fetal kidney cell culture medium. The Phe-UK was prepared by carboxypeptidase B (CpB) treatment of Lys-UK. Removal of the C-terminal lysine of Lys-UK by CpB produced small but significant increases in the Michaelis constants for the activation of both Glu- and Lys-plasminogen. The apparent Michaelis constants for Glu-plasminogen activation by Lys- and Phe-UK were 3.7 microM +/- .36 microM and 5.9 microM +/- .70 microM, respectively and the Michaelis constants for Lys-plasminogen activation by Lys- and Phe-UK were 5.4 microM +/- .72 microM and 15.2 microM +/- 1.4 microM, respectively. The catalytic efficiency (kcat/Km) of Lys-UK was approximately 2-fold greater than that of Phe-UK for the activation of either Glu- or Lys-plasminogen. When the fibrinolytic activities of Lys- and Phe-UK were compared in a plasma milieu no significant differences were detected. In conclusion, the findings indicate that the C terminal lysine on the A-chain of UK significantly promotes the catalysis of plasminogen in a purified system. However, the higher catalytic efficiency of Lys-UK was not found to induce significant acceleration of clot lysis at pharmacological concentrations in plasma. PMID- 1776141 TI - Coagulation and fibrinolysis in patients with chronic renal failure undergoing conservative treatment. AB - Eighteen patients with chronic renal failure due to primary glomerular disease undergoing conservative treatment (CRF patients) were studied to evaluate whether coagulation and fibrinolytic activity in plasma are enhanced in the patients. We measured plasma levels of coagulation-fibrinolysis parameters including thrombin antithrombin III complex (TAT) (an index of thrombin formation), alpha 2-plasmin inhibitor (alpha 2 PI)-plasmin complex (alpha 2 PIC) (an indicator of plasmin production) and cross-linked fibrin degradation products (XL-FDP) (an index of fibrinolysis secondary to coagulation). There was no correlation between plasma levels of TAT, alpha 2PIC and XL-FDP and serum creatinine levels in CRF patients. Both fibrinogen and TAT were found to be significantly higher in CRF patients than in normal controls. TAT was negatively correlated with serum albumin or total protein. Antithrombin III (ATIII) activity was significantly lower in CRF patients than in normal controls. CRF patients showed significantly but slightly higher alpha 2 PIC and XL-FDP when compared to normal controls. These results suggest that TAT, alpha 2PIC and XL-FDP are good indicators of coagulation fibrinolysis even in patients with decreased renal function. Coagulation activity is significantly increased in CRF patients but fibrinolysis secondary to coagulation is only slightly enhanced. PMID- 1776142 TI - Inhibition of platelet aggregation by some flavonoids. AB - The inhibitory effects of five flavonoids on the aggregation and secretion of platelets were studied. These flavonoids inhibited markedly platelet aggregation and ATP release of rabbit platelets induced by arachidonic acid or collagen, and slightly those by platelet-activating factor. ADP-induced platelet aggregation was also suppressed by myricetin, fisetin and quercetin. The IC50 on arachidonic acid-induced platelet aggregation was: fisetin, 22 microM; kaempferol, 20 microM; quercetin, 13 microM; morin, 150 microM less than IC50 less than 300 microM. The thromboxane B2 formations were also inhibited by flavonoids in platelets challenged with arachidonic acid. Fisetin, kaempferol, morin and quercetin antagonized the aggregation of washed platelets induced by U46619, a thromboxane A2/prostaglandin endoperoxides mimetic receptor agonist. In human platelet-rich plasma, quercetin prevented the secondary aggregation and blocked ATP release from platelets induced by epinephrine or ADP. These results demonstrate that the major antiplatelet effect of flavonoids tested may be due to both the inhibition of thromboxane formation and thromboxane receptor antagonism. PMID- 1776143 TI - [In memoriam Prof. G.M.H. Veeneklaas (1909-1991)]. PMID- 1776144 TI - [Pearson's syndrome: a multi-system disorder based on a mt-DNA deletion]. AB - In 1979 Pearson described a syndrome, in which the main symptoms were severe sideroblastic anemia and exocrine pancreas dysfunction. The aetiology was still unknown. A decade later, the Pearson syndrome can be described as a lethal multisystem disorder, in which the bone marrow and exocrine pancreas show major dysfunction, but also other organs (like kidneys, liver, gut and skin) can be affected. These patients also show growth retardation. The study of the mitochondrial DNA allowed identification of a deletion in the mitochondrial DNA. The case of a patient suffering from Pearson's syndrome is reported. PMID- 1776145 TI - [Congenital hypoplastic anemia in The Netherlands (1963-1989)]. AB - Congenital hypoplastic anemia (CHA; syn: Diamond-Blackfan syndrome) is a rare disorder with one of two patients a year in the Netherlands. To get a better understanding of this disorder in the Netherlands we conducted a national retrospective study over a 25-year period (1963 till 1989). The medical reports of 19 patients who fulfilled the diagnostic criteria for CHA were studied. Almost all patients were diagnosed during the first three months of life. Dysmaturity was found in 50% of the patients and in 25% physical anomalies were observed. In 17 patients the bone marrow showed a hypoplastic erythropoiesis, but in 2 patients erythropoiesis was quantitatively normal. All patients were treated with prednisone and 74% of them responded initially. Five of these patients (26%) had a complete remission and 4 of them (21%) are in remission on low dose prednisone maintenance-treatment. Remarkably one patient went only into remission at the age of 17 years. Nine patients (47%) are transfusion-dependent and one patient has a stable hemoglobin level of about 5.0 mmol/l without treatment. This study further shows that the chance of achieving a remission was positively correlated with an early start of prednisone treatment and negatively with the manifestation of symptoms on the first day of life. PMID- 1776146 TI - [One thing begets another]. AB - In this article the signs and symptoms as well as the course and complications are described of a feverish disease contracted by a fourteen year old boy after spending summer-holidays in the southern part of France. In retrospect this disease could be diagnosed as 'Mediterranean spotted fever' In the same period of these manifestations also a partial loss of sight at one eye occurred; although serology tests of antibody titers were negative, it was attributed to chorioretinitis due to activation of a congenital toxoplasmosis. The course was further complicated by an acute renal insufficiency during treatment of the chorioretinitis with high doses sulfadiazine. A short contemplation on the various clinical syndromes is presented. PMID- 1776147 TI - [Purulent parotitis in an infant]. AB - A sibling was taken into hospital at the age of 3 weeks with an acute suppurative parotitis of the left parotid. Since birth, the child had suffered from recurrent infections. Her mother was known with recurrent furunculosis. Ultrasonography of the left parotid showed a diffuse enlarged parotid with multiple areas of necrosis. After a diagnostic puncture, a penicillin resistant Staphylococcus aureus was found. Therapy consisted of intravenous antibiotics. PMID- 1776148 TI - [An infant with short stature and red cheeks (Rothmund-Thomson syndrome)]. AB - An infant with short stature and progressive skin lesions of cheeks and dorsum of the hands is described. Further problems such as recurrent diarrhoea and respiratory infections suggested zinc-deficiency, malabsorption-syndrome, Bloom syndrome and early Lupus Erythematosus respectively. Finally Rothmund-Thomson syndrome was diagnosed. This rare genetic disorder is characterized by variable expression of typical cutaneous changes, cataracts, skeletal anomalies, short stature, abnormal hair growth and defective nails and teeth, mental retardation, hypogonadism and a typical facial appearance. PMID- 1776149 TI - [Frequency of hospitalization for respiratory disorders in 0-14-year-old children]. AB - National hospital admission frequencies were analysed for asthma (ICD-9 code 493), acute bronchi(oli)tis (ICD-code 466), pneumonia and influenza (ICD-code 480 487), and chronic obstructive pulmonary disease (ICD-code 490-492 and 496) for 1980-1989 by sex and according to age (0-4 years, 5-9 years, and 10-14 years). Rates per million of the childhood population per year were calculated and time trend analyses performed by least squares regression. In the age group 0-4 years the admission rates for the respiratory diseases were highest and a general tendency towards increasing rates was present, and significant trends were found for asthma and acute bronchi(oli)tis. In the age groups 5-9 years and 10-14 years the admissions rates were considerably lower and fluctuated with no trends to point to except for a significant increasing trend for acute bronchitis in girls aged 5-9 years and a significant decreasing trend for asthma in boys aged 10-14 years. From the presented data it can be concluded that in childhood the health issue with respect to the respiratory diseases concerns the very young in particular. PMID- 1776150 TI - [A rare anomaly of the ureter. Right ureter with retrocaval course]. PMID- 1776151 TI - [Vesico-intestinal fissure: a multidisciplinary problem]. PMID- 1776152 TI - Acute effects of human growth hormone on liver cells in vitro: a comparison with livers of mice transgenic for human growth hormone. AB - We have examined the effects of human growth hormone (hGH), in concentrations comparable to those measured in plasma of transgenic mice expressing foreign GHs, on rat liver cells in culture. This treatment produced, within 24 and 48 hr, extreme heterogeneity in liver cell size, enlargement of nuclei, increase in the numbers of large nucleoli and nuclear protrusions, as well as appearance of numerous lipid droplets and accumulation of glycogen. These changes most likely indicate massive metabolic alterations and resemble changes present in vivo in the livers of mice transgenic for hGH and other foreign GHs. Since morphological alterations in vitro were apparent within 24 hr, we conclude that GH acutely and directly affects liver cell morphology and function in vitro and that the pathological lesions in vivo in the livers of transgenic mice are very likely a consequence of GH action. PMID- 1776153 TI - Further observations of stage-specific effects seen after short-term hypophysectomy in the rat. AB - Although hypophysectomy has been a popular tool to study the effects of hormone deprivation as well as concomitant or subsequent hormone supplementation, there is relatively little morphological information available on the structural manifestation of pituitary removal on the testis. In the report, changes, in addition to those previously reported after short-term (6 days) hypophysectomy in the rat (Russell and Clermont, 1977), are described. Membrane-bound vacuoles (primarily) appeared within the basal region of the Sertoli cell at approximately the level of Sertoli-Sertoli junctions. In stages VIII through XI elongating spermatids were abnormal and manifested manchette indentation of the nucleus, a variety of other abnormal head shapes, acrosomal breaks and enlargement of the subacrosomal space. These defects were interpreted as the effect of declining hormonal levels in stage VII on spermatids that had survived the stage VII hormone sensitivity known to occur with severe hormone depletion. Abnormalities in the flagellum involving the mitochondrial sheath and fibrous sheath were detected. Preleptotene spermatocytes degenerated and could be identified in the process of doing so near the base of the seminiferous epithelium. The contact of preleptotene spermatocytes with the basal lamina was also significantly reduced. The results show that both Sertoli cell and germ cell abnormalities were present although germ cell abnormalities could be a secondary consequence of lack of appropriate stimulation of the Sertoli cell. Degeneration of basal compartment germ cells shows that germ cells other than those located in the adluminal compartment are vulnerable to hormonal withdrawal. The question of how hormone effects are mediated in the testis at midcycle to produce these effects is discussed. PMID- 1776154 TI - Distribution, morphology and epithelial interactions of bovine spermatozoa in the oviduct before and after ovulation: a scanning electron microscope study. AB - In cows undergoing spontaneous oestrous cycles and mated during the first 6 hours of oestrus, the distribution of spermatozoa in the oviduct isthmus and changes in their surface membranes and neighbouring epithelium have been examined shortly before and after ovulation. In agreement with previous histological studies, relatively few spermatozoa were detected in the oviduct lumen: most were located in the caudal isthmus before ovulation, frequently among folds and in the presence of a viscous secretion. A majority of spermatozoa in this region showed strands and droplets of secretory material distributed over the anterior portion of an intact head before ovulation, whereas distribution of material over the post-nuclear cap of spermatozoa close to vesiculation or already acrosome-reacted was characteristic of the post-ovulatory situation. These changes in sperm head membranes were viewed as an expression of the completion of capacitation, and seemingly permit microvillous engagement with the rostral tip of the head. In conjunction with a narrow lumen and viscous secretions in the caudal isthmus, microvilli may thus serve to regulate periovulatory sperm progression towards the site of fertilisation, and be the basis of intermittent phases of adhesion to the oviduct epithelium as seen by phase-contrast microscopy. Although cilia do not similarly engage the heads of bull spermatozoa (cf. boar spermatozoa), they may act to regulate progression of capacitated spermatozoa by contacting the principal piece of the flagellum. In the light of these observations, changes in the molecular composition of sperm surface domains during the process of capacitation in vivo now require specific definition. PMID- 1776155 TI - An integrated exposure/pharmacokinetic based approach to the assessment of complex exposures. Lead: a case study. AB - A problem in evaluating the hazard represented by an environmental toxicant is that exposures can occur via multiple media such as water, land, and air. Lead is one of the toxicants of concern that has been associated with adverse effects on heme metabolism, serum vitamin D levels, and the mental and physical development of infants and children exposed at very low environmental levels. Effects of lead on development are particularly disturbing in that the consequences of early delays or deficits in physical or mental development may have long-term consequences over the lifetime of affected individuals. Experimental and epidemiologic studies have indicated that blood lead levels in the range of 10-15 micrograms/dl, or possibly lower, are likely to produce subclinical toxicity. Since a discernible threshold has not been demonstrated, it is prudent to preclude development of a Reference Dose (RfD) for lead. As an alternate, the U.S. Environmental Protection Agency (U.S. EPA) has developed the uptake/biokinetic lead model that provides a means for evaluating the relative contribution of various media to establishing blood lead levels in children. This approach will allow for the identification of site- and situation-specific abatement strategies based on projected blood lead levels in vulnerable human populations exposed to lead in air, diet, water, soil/dust, and paint; thus making it possible to evaluate regulatory decisions concerning each medium on blood levels and potential health effects. PMID- 1776156 TI - Interspecies scaling of anesthetic potency. AB - Anesthetic potency data for 11 volatile anesthetics were correlated against body weight in multiple mammalian species, including man. The results indicate that the alveolar concentration necessary to produce anesthesia is approximately constant across species. Because alveolar ventilation rates scale with the 0.75 power of body weight, this implies that administered dose measured in mg/kg0.75/day produces the same anesthetic effect in all species. This analysis provides further support for the use of a mg/kg0.75/day interspecies scaling metric for acute toxic effects. PMID- 1776157 TI - Effects of methanol vapors on testosterone production and testis morphology in rats. AB - Potential toxic effects of methanol vapors on testicular production of testosterone and the morphology of testes were investigated using normal or methanol-sensitive folate-reduced rats. Methanol inhalation at the level of the current permissible exposure limit, 200 ppm, for up to six weeks (8 hours/day, 5 days/week), did not reduce serum testosterone levels in normal rats. Testes isolated from methanol-exposed (200 ppm) rats had the same capability as those from air-exposed rats in synthesizing testosterone whether testes were incubated in the absence or presence of hCG. The testes-to-body weight ratio of rats exposed up to 800 ppm methanol for up to 13 weeks (20 hours/day, 7 days/week) were not different from those of the air-exposed rats. Furthermore, methanol had no adverse effect on testicular morphology at the end of the 13 week exposure period at 800 ppm in either normal rats or folate-reduced methanol-sensitive rats when they were 10 months old at the time of examination. Thus, these data indicate that low level methanol may not cause an inhibitory effect on testosterone synthesis contrary to previous literature reports. However, a greater incidence of testicular degeneration was noticed in the 18 month old folate-reduced rats exposed to 800 ppm for 13 weeks (20 hours/day, 7 days/week), suggesting that methanol may have a potential to accelerate the age-related degeneration of the testes. PMID- 1776158 TI - Mortality of 11,500 nickel workers--extended follow up and relationship to environmental conditions. AB - An extended follow-up from 1977-84 was achieved in a cohort of 11,567 nickel workers engaged in mining, milling and smelting originally studied from 1950-76. Exposure data were incorporated into the analysis. One nasal cancer occurred. The lung cancer Standardized Mortality Ratio beyond 15 years from first exposure was significantly high overall (128) and in miners (153). However, detailed analyses by era of first mining and duration of mining, as well as cumulative exposure to different nickel species, did not appear consistent with an occupational etiology since significant trends were not observed. At the levels of exposure incurred, large increases in lung and nasal cancer, observed in nickel refineries elsewhere, did not occur. PMID- 1776159 TI - Repeated-dose gavage studies on polychlorotrifluoroethylene acids. AB - C8 polychlorotrifluoroethylene (pCTFE) oligomers accumulate preferentially in the liver during long-term oral exposure and appear to be more hepatotoxic than C6 oligomers. A repeated-dose gavage study was initiated to determine the relative contributions of the corresponding C6 (trimer) and C8 (tetramer) acid metabolites to the toxicity of pCTFE in the male Fischer 344 rat. Test animals were dosed once per week for various time periods up to one year. A depression (p less than 0.05) in mean body weight occurred in the highest dose tetramer acid (2.16 mg/kg) group. An increase in hepatic peroxisomal beta-oxidation activity was found in the 2.16 mg pCTFE tetramer acid/kg dose group at the 3-, 6-, and 9-month sacrifice periods. An increase in relative liver weight was seen at all sacrifice periods in this dose group. Hepatocellular cytomegaly was a common finding in the higher dose tetramer acid groups but not in the trimer-treated rat groups. PMID- 1776160 TI - Effects of a 13-week chloropentafluorobenzene inhalation exposure of Fischer 344 rats and B6C3F1 mice. AB - Chloropentafluorobenzene (CPFB) has been identified as a candidate simulant for nonpersistent chemical warfare agents. Acute toxicity studies have shown that CPFB has limited adverse effects on laboratory animals. A 21-day inhalation study of rats and mice to 2.5, 0.8, and 0.25 mg CPFB/liter resulted in reduced weight gain in male and female rats exposed at the high concentration only and identified the liver as a potential target organ. This multiconcentration inhalation study was designed to detect a no-observable-effect level associated with repeated exposure to CPFB. Male and female rats and mice were exposed to 250, 50, or 10 mg CPFB/m3 (0.25, 0.05, or 0.01 mg CPFB/liter) for 13 weeks. No treatment-related effects on body weight, clinical chemistries, mortality, absolute or relative organ weight or histopathology were noted. PMID- 1776161 TI - Reanalysis of epidemiological data for selenium anti-cancer activity. AB - Investigations of the health effects of selenium have repeatedly noted an inverse relationship of selenium (both soil and human sera) and decreased prevalence of cancer. This has been found in cross sectional, case-control and ecological study designs. Reanalysis of age-adjusted death rates by cancer site revealed a significant inverse relationship for lung and all cancer with blood selenium. Methodological problems in this type of research is discussed. PMID- 1776162 TI - Modulation of B cell maturation and migration to the thymus of SJL mice. B cell migration to the thymus. AB - The direct linkage of the B cell maturation process and infiltration of the thymus with mature B cells was studied in SJL mice. Phenotypically and functionally, B cells in the thymus of old SJL mice are mature B cells; IgM+, IgD+, Ly-1-, and evince a high proliferative response to lipopolysaccharide and a low one to dextran sulphate. Memory B cells can be found in the thymus of mice immunized with T-dependent or T-independent antigens. Chronic depletion and B cell maturation arrest induced by fractionated total lymphoid irradiation or by neonatal splenectomy eliminate B cells from the thymus and block their migration from the periphery to the thymus. When examined in adoptive transfer experiments, thymus B cells were found to possess a normal migration pattern and homing receptors; their migration pattern did not differ from that of lymph node or splenic B cells. It is evident, therefore, that the large number of normal functioning B cells in the thymus of SJL mice reflects a massive infiltration of the thymus by mature B cells from the periphery due to thymus dysfunction rather than to an abnormal in situ differentiation of intrathymic B cell precursors. PMID- 1776163 TI - Thymocyte development in an in vitro constructed chimera of irradiated fetal thymus and lymphohemopoietic cells. AB - An in vitro model of irradiated thymus-BM chimera was constructed to analyze the developmental interactions of donor and recipient type thymocytes. The experimental system was based on exposing 14-day fetal mouse thymuses to graded doses of irradiation and then reconstituting them with cells from various lymphohemopoietic origins. Values of donor vs. recipient type cells in chimeric thymuses varied with radiation dose, cell inoculum size and time between irradiation and cell seeding. During an 11 day organ culture period, thymocyte progenitors differentiated in this thymic microenvironment and expressed T-cell surface markers. The pattern of expression of T-cell surface markers in these cultures was similar to that in intact fetal thymic explants. PMID- 1776164 TI - Effect of age on the proportion of mouse bone marrow cells migrating in response to newborn thymus supernatant. Cell migration and thymus evolution in mice. AB - The effect of mouse age on the in vitro migration of hemopoietic precursor cells from bone marrow of C57BL/6 to thymic supernatant from newborn mice was studied to determine whether a reduction in the migratory readiness or number of precursor cells might at lest partly explain thymic involution due to aging. The percentage of bone marrow cells migrating to the thymic supernatants increased to age of 7 weeks, and then decreased progressively. Thymus weight underwent almost exactly the same evolution. The decline of the population of migration-ready T precursor in adult mice may this explain age-related thymic involution. PMID- 1776165 TI - Primary culture of rat thymic non-lymphoid cells: influence of culture time on the expression of macrophage differentiation antigens defined by monoclonal antibodies. AB - A panel monoclonal antibodies (mAbs) raised to rat thymic non-lymphoid cells has been shown to discriminate between distinct subpopulations of macrophages depending on their anatomic localization in the thymus. These reagents were used in this study to examine the expression of macrophage-associated antigens in primary culture of rat thymic stromal cells. The phenotype of both adherent macrophage (AM) monolayers and non-adherent cells (NAC) released in culture medium was studied at different time points after cultivation. More than 95% AM expressed ED1 and R-MC 38 antigens (pan-macrophage markers), class I MHC antigens (OX-18) and iC3b receptor recognized by OX-42 mAb. Most of them (70-85%) were reactive with ED2, R-MC 40, 41 and 42 mAbs specific for cortical and cortico medullary zone (CMZ) macrophages. A much smaller percentage was positive with R MC 43/44 and R-MC 46/47 mAbs staining CMZ/medullary macrophages and a subset of cortical macrophages, respectively. A minor subset of AM expressed class II MHC molecules which progressively decreased during cultivation. NAC were phenotypically heterogeneous. In comparison with adherent cells they contained a lower percentage of cortical/CMZ phenotype macrophages. In addition, NAC were slightly enriched in R-MC 43+ cells and more significantly expressed IA/E antigens (85-95%). ED3, R-MC 39 and 45 mAbs reactive with thymic macrophages in situ were mostly non-reactive with AM and NAC in culture. PMID- 1776166 TI - Competing promoters in prokaryotic transcription. AB - Two (or more) bacterial promoters are often found in close proximity, and may compete for the binding of RNA polymerase. These competing promoters have interesting characteristics in vitro and analysis of the competition should be valuable to kinetic studies of more complex transcription systems. PMID- 1776167 TI - Prokaryotic transcriptional enhancers and enhancer-binding proteins. AB - A number of prokaryotic enhancer-binding proteins activate transcription by specialized forms of RNA polymerase. The enhancer-binding proteins catalyse isomerization of the initial complex formed between RNA polymerase and a promoter from the closed to the open state. To do so, one class of enhancer-binding proteins contacts its cognate polymerase by DNA loop formation but the other, which is represented by a single member, does not. Despite this difference, both classes of enhancer-binding proteins must hydrolyse ATP to catalyse open complex formation. PMID- 1776168 TI - The complexities of eukaryotic transcription initiation: regulation of preinitiation complex assembly. AB - Individual steps in the assembly of RNA polymerase II and general initiation factors into a preinitiation complex serve as points of control for activators, whose functions require additional cofactors. The full range of induction by activators appears to involve both the reversal of negative constraints and net positive effects on promoter interactions with general factors. PMID- 1776169 TI - RNA polymerase-associated transcription factors. AB - Proteins that bind to RNA polymerase regulate initiation and termination of transcription in bacteria. Recently, such RNA polymerase-associated proteins were also found to be essential for accurate transcription by eukaryotic RNA polymerase II. PMID- 1776170 TI - RNA polymerase III (C) and its transcription factors. AB - Transcription of small genes by RNA polymerase III or C (pol III) involves many of the strategies that are used for transcription complex formation and occasionally the same components as those used by RNA polymerase II or B (pol II). Transcription complex formation is a multistep process that leads to the binding of a single initiation factor, TFIIIB, which in turn directs the selection of pol III. The general transcription factor TFIID can be involved in both pol II and pol III transcription. These and other similarities point towards a unifying mechanism for eukaryotic transcription initiation. PMID- 1776171 TI - Diversity and specificity in transcriptional regulation: the benefits of heterotypic dimerization. AB - Many eukaryotic transcription factors contain domains that mediate the formation of homo- and heterodimers. The widespread occurrence of such domains suggests that they are important to the genetic regulatory apparatus. In this review we explore the contributions that heterotypic dimerization may make to the generation of regulatory diversity. PMID- 1776172 TI - Regulatory crosstalk at composite response elements. AB - Transcriptional regulatory factors from different families interact with each other when bound to DNA at composite response elements. This level of communication has two striking consequences: ubiquitous factors can effect cell specificity, and closely related factors from a given family can produce very different regulatory patterns. PMID- 1776173 TI - Transcriptional control in hepatocytes: a window on development. AB - The unique phenotype of each differentiated cell in an animal (or plant) arises from selective expression of genes in a cell- or tissue-specific fashion, which is controlled primarily at the level of transcription. This review will focus on transcription factors that regulate cell-specific transcription in one intensely studied cell type, the hepatocyte or parenchymal liver cell. All of the recently isolated transcription factors that are important in hepatocyte-specific gene expression were identified in adult liver and there are strong hints that some of these may play an important role in embryogenesis. PMID- 1776174 TI - Transcriptional regulation in the eukaryotic cell cycle. AB - Cell-cycle-regulated transcription is a characteristic feature of complex cell cycles in organisms as divergent as yeasts and humans. Increasing evidence suggests that transcriptional regulation may control key events in the eukaryotic cell cycle. In this review we will address the mechanisms that may regulate transcription during the cell cycle and the roles which periodic transcription may serve in the control of cell cycle progression. PMID- 1776175 TI - New developments of a transcription factors database. PMID- 1776176 TI - [Sleeping pills--still a problem]. PMID- 1776177 TI - [Reduction of the use of hypnotics by health education. Results from a controlled intervention study in a local community]. AB - The object of this investigation was to study the effect of a wide informative campaign on the sale of hypnotics in Holbaek. An informative health campaign was carried out via the media and the general practitioners for a period of 16 weeks. The campaign in the media consisted of a weekly article by the journalists in the local newspaper, a weekly advertisement in the daily and weekly newspapers, mention in the local radio daily and in the weekly medical programme and a leaflet about sleep handed out by the general practitioners. Twelve general practitioners elected to participate in the intervention programme: all patients who sought hypnotics had to come to an interview about the sleep problem. The control consisted of the remaining eight general practitioners in Holbaek. The sale of hypnotics was registered by the pharmacists during five weeks prior to, six weeks during and three and 15 months after the campaign. Five weeks before the campaign, the sale of hypnotics was 2.05 defined daily doses per patient (1.69 in the intervention group and 2.49 in the control group). During the last five weeks of the campaign, the sale had declined by 24% and by 29% in the follow up period. The decline commenced immediately in the intervention group but was only partly stable. After approximately eight weeks of the campaign, stable declines had occurred in both groups. Fifteen months later, the sale of hypnotics was approximately 39% lower than at the commencement of the campaign. PMID- 1776178 TI - [Sensation disorders and pain in spinal cord lesions]. AB - In addition to the well known paraplegia or tetraplegia, lesions of the spinal cord frequently cause a series of disturbances of sensation in the segments around or distal to the lesion. Disturbances of sensation in spinal cord lesions are painful or non-painful. The painful and also the non-painful sensations may represent irritative and withdrawal phenomena. A series of central neurogenic pains seem to be best explained by spontaneous neuronal activity in sensory spinal cord neurones which have lost the peripheral, segmental and descending neuronal control from the nervous system. Surgical treatment of pain in cases of spinal cord lesions is rarely considered apart from root-avulsion where surgical lesion in the superficial part of the posterior horn is effective. No specific treatment is as yet available for pain and disturbances of sensation in cases of spinal cord injury. However, on the basis of our limited knowledge of the pathogenesis of these symptoms, future therapeutic strategy will be directed towards not only the peripheral but also the central points of attack. Treatment of painful conditions in patients with spinal cord injuries, as in other states of chronic pain, should also include social and psychological support. PMID- 1776179 TI - [Steele-Richardson-Olszewski syndrome. Progressive supranuclear paresis]. AB - The signs and symptoms of the Steele-Richardson-Olszewski syndrome (SRO) are described and the therapeutic possibilities are outlined. Two cases are presented. SRO must be suspected when a patient over the age of 40 years presents axial rigidity, dementia, pseudobulbar palsy, and supranuclear ophthalmoplegia. PMID- 1776180 TI - [Streptokinase as routine treatment in acute myocardial infarction. The effect on pain, arrhythmias and mortality assessed by a historical cohort study]. AB - It has been demonstrated that treatment with streptokinase (SK) in acute myocardial infarction (AMI) has an effect in reducing the mortality. The object of this study was, by means of a historical cohort study in a Danish Cardiological Department, to illustrate the effect of streptokinase on the course of pain, occurrence of arrhythmia and the lethality. Seventy-six patients with their first AMI treated with SK and low-dosage acetylsalicylic acid were compared with 76 patients with their first AMI who were not treated with SK. The median value of the employment of intravenous analgesics was significantly lower in the SK group (20 mg nicomorphine compared with 41 mg nicomorphine) as compared with the control group. Similarly, the duration of pain was briefer in the SK group (3.5 hours compared with 24 hours). Significantly more patients in the control group developed atrial fibrillation (12 patients compared with two). No differences were observed in the occurrence of arrhythmias endangering life in the two groups. Four patients in the SK group died during hospitalization whereas 14 died in the control group (p = 0.02). It is concluded that administration of SK intravenously combined with low-dosage acetylsalicylic acid in the acute phase of myocardial infarction has the effect of reducing 1) the duration of pain and thus the consumption of analgesics, 2) the number of cases of atrial fibrillation and 3) the lethality during the period of hospitalization. PMID- 1776181 TI - [Attitude of general practitioners to treatment of their own cardiac arrests occurring outside hospital]. AB - By means of an anonymous investigation, all 375 general practitioners in the County of Arhus were questioned about their attitudes to treatment of cardiac arrest occurring in themselves outside hospital. Treatment is undertaken in a heart ambulance (with DC-equipment but without qualified medical staff). In addition, they were questioned about therapeutic wishes if primary resuscitation with ventilation and cardiac massage were administered by a layman. The same question was repeated after the practitioners had read an up-to-date article about the results of treatment of cardiac arrest outside hospital. Finally, the practitioners were asked whether they consider that the remainder of the population should be treated as they wished. 81% of the practitioners replied to the questionnaires. The results are presented in tabular form. Reading of the article altered the replies given by the practitioners only to a limited extent. After reading of the article, 79.7% did not wish resuscitation if the total time interval from cardiac arrest to commencement of treatment by the ambulance staff was six minutes or more. This is significantly less than the average time interval in cases of ambulance turn out on account of cardiac arrest. Should the primary resuscitation be administered by a layman, 66.8% do not wish resuscitation by the ambulance staff in the same situation. 82.8% of the practitioners agreed that the population as a whole should have the same populations as themselves. 6.4% disagreed. On the basis of these results possible alterations in the current treatment for cardiac arrest outside hospital are discussed. PMID- 1776182 TI - [Ambulatory orthopedic surgery]. AB - A one year survey of the patients assessment of out-patient orthopaedic surgery in local anaesthesia is presented. The report is based upon questionnaires (including 15 items) of 529 operations performed on 495 patients. A large group of knee arthroscopies are included. We found that many orthopaedic operations, formerly treated as in-patient procedures could be carried out in the out-patient clinic with only a minimal complication rate. 77% of the patients experienced no problems other than pain in their home following the out-patient surgical procedure. Nearly 80% of the patients would choose out-patient surgery in case of a new identical operation. 30% of the patients found the administration of the local anaesthesia very painful and 41% experienced discomfort and pain following surgery. In addition, a brief analysis of the economical aspect is given. In conclusion, out-patient orthopaedic surgery is well accepted by the patients. The use of local anesthesia alone is not always sufficient and administration of an oral analgesic drug both before and after the surgical procedure is recommended. PMID- 1776183 TI - [Diagnosis of carotid artery sclerosis with Doppler ultrasound. Description of the method and a prospective comparison with arteriography]. AB - The ultrasound Doppler method for examination of the carotid artery is described. Out of a total of 370 patients examined with ultrasound Doppler for suspected arteriosclerosis in the carotid artery in 1988, 27 were also submitted to digital subtraction arteriography (DSA). The accuracy of the ultrasound examination was compared with DSA 90% (43/48) when differentiating between normal and affected carotid arteries, and 85% (41/48) when differentiating between stenoses of more than or less than 50%. All of the occlusions were correctly identified. It is concluded that ultrasound Doppler examination is an accurate method for diagnoses of stenosis in the carotid artery. PMID- 1776184 TI - [Neuroborreliosis--a diagnosis easily overlooked]. AB - Neuroborreliosis is the commonest complication of untreated erythema migrans. The case histories of two patients with well documented neuroborreliosis are presented. In these patients, the symptoms, which consisted only of pain, did not immediately raise the suspicion of a neuroinfection. Intravenous penicillin therapy proved curative. Examination of the cerebrospinal fluid for pleocytosis and Borrelia antibodies confirmed the diagnosis. In cases of suspected erythema migrans and subsequent neurological symptoms, lumbar puncture is recommended even in cases where the only symptom is pain. PMID- 1776185 TI - [Prevention of the TURP syndrome by using the Swan-Ganz catheter in a patient with severe aortic stenosis]. AB - A patient with a severe valvular aortic stenosis, who required transurethral resection of the prostate, was monitored with a Swan-Ganz catheter. Overloading of the patient due to absorption of irrigating fluid was quickly reflected by elevation of pulmonary artery pressure PAP and pulmonary capillary wedge pressure PCWP, while the central venous pressure CVP was unchanged. Monitoring of PAP and PCWP may prevent the development of the TURP-syndrome in patients with compromised left sided cardiac function. PMID- 1776186 TI - [Life-threatening streptococcus A infections]. PMID- 1776187 TI - [Light therapy of manic depressives]. PMID- 1776188 TI - [Should food in hospitals be prepared according to patients' needs or dietitians' conscience?]. PMID- 1776189 TI - [The temperature in medical practice]. PMID- 1776190 TI - [Fever and acute phase reaction as a link in the cytokine-mediated cellular language]. PMID- 1776191 TI - [Oral measurement of body temperature. Clinical use of an electronic thermometer (Craftemp)]. AB - A comparative investigation was undertaken of body temperature measured orally and in the axilla with an electronic thermometer (Craftemp) and also rectally with a mercury thermometer. The measurements were performed by the caring staff in a medical department on a total 266 patients. Out of 891 sets of measurements, 27.9% of the oral and 43.1% of the axillary temperature measurements were found to deviate by 1.0 degrees and 1.5 degrees C, respectively, from the rectal temperature measurements. It is concluded that the buccal cavity and the axillary fossa are not suitable sites of measurement of body temperature with Craftemp. PMID- 1776192 TI - [Measurement of basal temperature with the Tempadot disposable thermometer for oral use]. AB - Twenty-two healthy women of fertile age who participated in an immunological investigation recorded basal temperature curves (BTC) with the object of illustrating the course of the menstrual cycle by means of daily measurements of the morning temperature with the Tempadot disposable thermometer for oral use. The total of 63 BTC's were assessed on the basis of the requirement of normal diphasic curves. The number of diphasic BTC was less than anticipated. In addition, four other healthy women measured the morning temperature daily with the Tempadot disposable thermometer orally and with a mercury thermometer rectally for a calendar month. It is concluded that employment of the Thermadot disposable thermometer orally is associated with great unreliability even in this material where the measurements were carried out on repeated occasions by young healthy persons. PMID- 1776193 TI - [Oral contra rectal measurement of body temperature]. AB - The electronic thermometers for oral use employed in Middelfart Hospital (Ivac, TN III and Crafttemp) were compared with mercury thermometers for rectal use. Employment of all the thermometers in question in a water bath revealed considerable accuracy where the mercury thermometers were concerned but considerable divergence and deviations where the electronic thermometers were concerned and this was particularly marked with increasing temperature. Pyrexia is defined as temperature greater than or equal to 37.0 degrees C orally and greater than or equal to 37.5 degrees C rectally. In the clinical investigation of the ability of establishing the diagnosis of pyrexia in 147 patients a true negative diagnostic frequency (diagnostic sensitivity) for the electronic thermometers was found to be 0.94 as compared with the mercury thermometers employed rectally which is considered to be satisfactory as a screening method but, with the limits chosen, a true positive diagnostic frequency (diagnostic specificity) of 0.37 was found. No significant differences in the median temperature were found as regard age greater than or equal to 70 years or prostheses in the lower jaw. It is recommended that a raised temperature on oral measurement with the thermometers mentioned above should be controlled with rectal measurement with a mercury thermometer. PMID- 1776194 TI - [An alternative to rectal measurement of body temperature with a mercury thermometer]. AB - An investigation was undertaken to demonstrate whether rectal Craftemp measurement of the temperature is a useful alternative to measurement of rectal temperature with a mercury thermometer. Measurements of temperature for more than 60 seconds on 57 patients hospitalised in a medical ward revealed a mean temperature difference of 0.2 degree C with a range of -0.3-0.7 degree C. Measurements for over two minutes on 23 patients revealed a mean temperature difference of 0.1 degree C and with a range of -0.2-0.2 degree C. The time of measurement recommended by the manufacturers of one minute is too short and should be two minutes. Craftemp measurement of the temperature is an employable but relatively expensive alternative to measurement of temperature with a mercury thermometer. PMID- 1776195 TI - [Only rectal temperature measurements are suitable for routine temperature measurement]. AB - A new rapid electronic thermometer (V.C.T. TERUMO) has been introduced to Danish hospitals. Oral and rectal V.C.T. measurements were compared with rectal measurements with mercury thermometers. In addition, rectal V.C.T. measurements in the wards were compared with rectal measurements with mercury thermometers. A total of 91 patients participated in the investigation. The average differences between the electronic rectal and oral compared with recordings by mercury thermometers were found to be 0.02 degree C and 0.75 degree C, respectively, under optimal conditions for measurement while the corresponding scatters of difference in temperature were 0.17 degree C and 0.74 degree C, respectively. The average difference between rectal temperature measurements with mercury thermometers and rectal V.C.T. measurements carried out during daily routine circumstances was 0.08 degree C while the scatter of the difference in temperature was 0.26 degree C. It is concluded that rectal V.C.T. measurements are just as suitable as rectal measurements with mercury thermometers and employment of rectal V.C.T. thermometer measurements is recommended in the daily hospital routine. Employment of oral and axillary measurements is discussed and not recommended. PMID- 1776196 TI - [Color Doppler ultrasound. Principles, technique and clinical use possibilities]. AB - The medical ultrasound, the Doppler frequency shift is the difference between the frequency of the transmitted and reflected ultrasound. This is due a relative movement between the reflector (most frequently the red blood cells) and the ultrasound transducer. The ultrasound apparatus registers this difference in frequency and calculates the linear rate of flow employing the Doppler equation. The Doppler analysis is presented acoustically, graphically or by means of a colour code. In pulsed Doppler technique, conventional ultrasound scanning can be combined with Doppler analysis. Important indications are: differentiation between vascular and non-vascular structure, documentation of flow and determination of the direction of flow, diagnosis and quantitation of arterial stenoses and assessment of transplants. PMID- 1776197 TI - [Experimental clinical transplantation in patients with Parkinson disease. Experimental background and clinical picture]. AB - In this review the experimental background for treatment of patients with Parkinson's disease by intracerebral transplantation is presented. Intracerebral transplantation has been performed either with the patients own adrenal medulla or with human fetal dopaminergic neurons obtained from abortions. Intracerebral transplantation of adrenal chromaffin cells to rodents has shown poor cell survival and minor, transient effects on experimentally induced parkinson-like symptoms. Intracerebral autotransplants of medullary adrenal tissue to patients with Parkinson's disease have shown corresponding, minor improvements in the parkinson status. Animal experiments with grafting of developing fetal dopaminergic neurons have been more rewarding and resulted in reversal of parkinson-like symptoms. Experimental transplantations with human fetal dopaminergic neurons to patients with Parkinson's disease have not entirely lived up to these expectations. At a recent meeting, arranged to set up a European network for research and information, it was agreed that more animal experiments, in particular including non-human primates are needed. Regarding the clinical trials with transplantation of human fetal dopaminergic tissue coordination of neurological test procedures performed pre- and posttransplantation was strongly recommended. PMID- 1776198 TI - [The market of synonymous preparations in Denmark 1985-1990. A comparison of prices and quantities on the market]. AB - The development of the market for synonymous drugs is investigated on the basis of groups of synonymous drugs in oral dosage forms where the difference between the price of the original preparation and the synonymous preparation(s) is at least 10%. The number of synonymous preparations has increased from 124 distributed among 76 groups in 1985 to 210 distributed amon 102 groups in 1990. In 1990, the total sale of synonymous groups constituted 31% of the total drug turnover. The cheap preparations constituted 47% of the sale in the synonymous groups. In 1985, the distributions were 27% and 44%, respectively. In 1990, the cheap preparations constituted 56% of the synonymous groups for preparations on the Danish market for the entire period form 1985 to 1990. Measured quantitatively (in defined daily dose), the consumption of the cheap preparations is greater than that indicated by the sale, 68% and 53%, respectively for the 15 largest synonymous groups in 1990. Consumption of the cheap preparations is high (75%) in group A (alimentary tract and metabolism) and considerably less (33%) in group R (respiratory system). Greater consumption of cheap preparations is observed within the synonymous groups with the greatest sale. The price level of the original preparations was only altered in a few cases after the synonymous preparations were marketed. PMID- 1776199 TI - [Spiral fracture of the humerus during arm wrestling]. AB - The authors present the case of a body-builder who sustained a spiral fracture of the humerus during arm wrestling (Indian wrestling). The cause of the fracture and the underlying mechanism are discussed and it is concluded that it appears appropriate to warn body-builders and weight-lifters against arm wrestling. PMID- 1776200 TI - [A case of adiposis dolorosa--Dercum's disease]. AB - Adiposis dolorosa or Dercum's disease consists of a painful progressive localized state of obesity with four cardinal symptoms: a) painful circumscribed or diffuse fatty deposits, b) generalized obesity in women usually of menopausal age, c) asthenia, weakness and frequently tendency to fatigue and d) mental phenomena including emotional instability, depression, epilepsy, mental confusion and true dementia. Only a few cases in men have been described. The pain may be treated with intravenous administration of lignocaine or oral mexitil while no causal treatment is known. An illustrative case is reported. PMID- 1776201 TI - [Malaria chemoprophylaxis]. PMID- 1776202 TI - [Alternative treatment of stress incontinence]. PMID- 1776203 TI - [The intraurethral plug. A new alternative in the treatment of women with stress incontinence]. AB - The intraurethral plug has been developed for treatment of women with stress incontinence. The plug is made of thermoplastic-elastomeric material and consists of a meatus plate, a soft stalk and one or two beads along the stalk. The individual plug is constructed on the basis of the result of the urethral pressure profile. The plug is removed manually prior to micturition and after micturition a new plug is introduced by the patient. A plug with two beads was employed in period 1 (seven days) and a plug with one bead for period 2 (seven days). Twenty-two patients completed period 1. Eight of these patients did not complete period 2, mainly on account of unchanged incontinence during period 1 or repeated loss of the plug with one bead. In periods 1 and 2, 73% and 79% of the patients, respectively, were both subjectively and objectively continent or considerably improved. This preliminary investigation demonstrates that the intraurethral plug may be an alternative form of treatment of women with stress incontinence. PMID- 1776204 TI - [Neurogenic pulmonary edema]. AB - Neurogenic pulmonary oedema (NPE) is a recognized, serious, relatively uncommon, acute complication of cerebral insults of various types. Despite numerous animal experimental investigations and case reports, the pathological physiology is not yet elucidated. An acute cerebral insult with raised intracranial pressure is accompanied by violent activation of the sympathetic system and increase in the concentrations of circulating catecholamines. Probably, hydrostatic influences and altered capillary permeability both play roles in the pathogenesis. Acute increase in the total vascular surface in the lungs may also be contributory. Treatment includes intubation and positive pressure ventilation, diuretics, infusion of synthetic catecholamines, alpha-receptor blockades and reduction of raised intracranial pressure by hyperventilation and drainage of liquor. The optimal treatment of NPE is not yet established on account of insufficient knowledge of the pathological physiology. PMID- 1776205 TI - [Chronic meningococcemia. A review and a report of 4 cases]. AB - Four cases of chronic meningococcacemia (CM) are described. The diagnosis was based on recurring fever, exanthema, arthralgia/arthritis and positive blood culture with Neisseria meningitidis. The meningococcal antibody-test (MAT) was positive in all of the three patients tested. None of the patients had positive throat culture for Neisseria meningitidis. All patients had leucocytosis during the febrile periods. The symptoms lasted for 5-150 days before the diagnosis was made. These findings are discussed in relation to the literature. PMID- 1776206 TI - [Screening for neuroblastoma in infants aged 6 months. A method of testing]. AB - In a number of cases, neuroblastoma (NB) may be diagnosed by routine screening of the urine for vanillinic-mandelic acid (VMA) and homovanillinic acid (HVA) in symptomfree infants at the age of six months. Early diagnosis of this disease may possibly improve the prognosis. The object of this project was to establish a method of measuring VMA and HVA concentrations in urine collected on filter paper and to assess participation by the parents as regards three different methods of collecting urine with the object of establishing a population screening programme for NB in Denmark. A total of 1,111 infants aged 6-8 months participated in the investigation. The equipment for testing the urine was given in three different was: 1) By the health nurses (County of Arhus), 2) By the general practitioner at the 6-month vaccination (County of Ringkobing) and 3) By post (County of Viborg). In Arhus, the health nurses delivered the equipment to 96.7% of the age group concerned. Altogether, urine samples were obtained from 673 infants (61%). Participation was greatest in the County of Arhus (66%) and the County of Ringkobing (62%) and lowest in the County of Viborg (54%). Two infants were found with marginally raised VMA or HVA but these values were found to be normal on repeated examinations. No cases of neuroblastoma were found in the material nor in the screened group in the course of 1 1/2 years after the conclusion of the investigation. In just over 3% of the cases, renewed urine samples had to be sent on account of too little urine on the filter paper. If current population investigations reveal that screening for neuroblastoma can alter the course of the disease in children, the method described here may form the basis for introduction of population investigations in Denmark. PMID- 1776207 TI - [The whiplash injury. An overlooked and casually treated syndrome]. AB - The whiplash trauma is defined as hyperextension followed by hyperflexion of the cervical spine or the reverse. The lesion occurs mainly in the occupants of a motor vehicle into which another vehicle collides from behind. Even when there is no radiographic evidence of injury, considerable lesions of the soft tissues may, nevertheless, be present. Review of the literature and the present authors' investigations reveal that up to 80% of the patients have chronic symptoms and 10% of these are severe enough to cause incapacity. The therapeutic regimen has not been well investigated but, at present, intermittent cooling and support by a collar for a few days followed by rapid mobilizing and exercises within the limit of pain are recommended. PMID- 1776208 TI - [Unicompartmental knee alloplasty by the St. Georg method. A follow-up of 42 knees after 5-10 years]. AB - The results are presented of 42 arthroplasties by the St. Georg method in 37 patients who could be followed-up clinically and radiologically after median periods of observation of 66 months. The HSS-scoring method (Hospital for Special Surgery Score) was employed to assess the results. Good or excellent results (HSS score greater than 69 points) were obtained in 79% of the arthroplasties and 86% were relieved of pain on weightbearing. In selected patients, the St. Georg hemiarthroplasty is found to be a usable alternative to total condylar arthroplasty in the treatment of unicompartmental osteoarthritis of the knee. PMID- 1776209 TI - [The value of daily allowance certificates for sociomedical treatment]. AB - In the Tarup district of Odense, an investigation was carried out concerning certificates in connection with maintenance allowances during a period olf two months. A total of 148 maintenance allowance certificates were collected consecutively for one month. Correspondingly, 81 certificates concerning 44 cases which were the subjects of sociomedical analysis were collected during the subsequent month, Four fifths of the certificates were written by the general practitioners. About half of the certificates were only of limited value for analysis of the cases, while one fifth supplied constructive supplementary information. Women in the age group 40-49 years were overrepresented and conditions in the locomotor system predominated (30-50%). These were followed by mental problems and disturbances with 14% and 11%, respectively. Great differences were found between the durations of sick-leave as assessed in the certificates and the factual durations. As assessment of the duration of sick leave is important for the course of the maintenance allowance, an alteration in the certificate forms is proposed so that maintenance allowance cases are easier to classify. PMID- 1776210 TI - [Adrenomyeloneuropathy]. AB - A case of adrenomyeloneuropathy is presented. The clinical picture is characteristic with slowly progressive spastic paraparesis, relatively mild peripheral neuropathy and adrenal insufficiency. Dietary therapy may prevent further progression of the neurologic symptoms. PMID- 1776211 TI - [Poisoning by kidney beans (Phaseolus vulgaris)]. AB - During recent years, numerous new and exotic fruits have become available in Denmark. However, some of these may be potentially hazardous if incorrectly prepared. Some leguminous plants, in particular, contain considerable amounts of toxic lectins. The authors report two persons who developed severe symptoms of poisoning including diarrhoea, vomiting, muscular pain, rhabdomyolysis and toxic myocarditis after consuming raw and insufficiently cooked kidney beans (Phaseolus vulgaris). Meticulous instructions about handling should accompany the sale of potentially hazardous vegetables such as these. PMID- 1776212 TI - [The AIDS/HIV situation in Greenland 1991]. PMID- 1776213 TI - [How can medical science fight for research support grants in the future?]. PMID- 1776214 TI - [Colonic cancer--the screening program in Fyn]. PMID- 1776215 TI - Effect of L-arginine and an arginine-containing pentapeptide on canine femoral arterial blood flow. AB - The amino acid L-arginine is a precursor of endothelium derived relaxing factor (EDRF). The pentapeptide 6A (Ala-Arg-Pro-Ala-Lys) released by plasmin degradation of fibrinogen also contains arginine and relaxes vascular smooth muscle by releasing EDRF (nitric oxide). To determine and compare the effects of L arginine, peptide 6A and a combination of L-arginine and peptide 6A on femoral artery blood flow and vascular resistance, anesthetized mongrel dog were administered saline, L-arginine, D-arginine, peptide 6A and L-arginine + peptide 6A in a random order. L-arginine and peptide 6A both induced an immediate dose dependent short-lasting increase in femoral blood flow and a decrease in vascular resistance. Peptide 6A exerted a much greater (P less than 0.01) vasodilatory effect than did L-arginine at the same molar concentration suggesting that properties besides the arginine content are important in the effect of the pentapeptide. D-arginine had much less effect than L-arginine, indicating that the effect of L-arginine may be related to its utilization for synthesis of EDRF. When the peptide 6A was given soon after L-arginine, its effect on blood flow was not greater than that of L-arginine alone suggesting that L-arginine in a large amount makes guanylate cyclase less available for the more active peptide. PMID- 1776216 TI - Sleep disturbances in asthma: theophylline versus enprofylline. AB - A double-blind cross-over study was performed on 22 asthmatic patients receiving maintenance treatment with theophylline who, in a previous study, had reported sleep problems. In one of two three-week periods the theophylline medication was replaced by an equipotent dose of slow-release enprofylline. Analysis of sleep questionnaires answered after each treatment period, and sleep diaries filled in throughout the study, showed no significant differences in the quality of sleep between the treatments. Peak expiratory flow (PEF) in the morning did not differ between the treatment periods, but mean PEF in the evening was slightly higher (20 l/min) during theophylline treatment. It was concluded that replacement of theophylline by enprofylline did not improve the quality of sleep subjectively in this group of theophylline treated asthmatics. The results suggest that adenosine receptor antagonism may not be a significant cause of sleep disturbances in asthmatic patients who are receiving theophylline as maintenance treatment. PMID- 1776217 TI - Brain damage in alcoholics without neuropsychological impairment. A population study. AB - Computed tomography (CT) of the brain and neuropsychological assessment was performed in a random sample of 195 men to investigate the relationship between drinking of alcohol and brain damage. This sample from the general population was divided into subsamples on the basis of their self-reported loss of control over drinking, morning drinks and blackouts. The consumption of hepatotoxic drugs was also investigated. For this the material was divided into four groups with regard to both alcohol consumption and use of hepatotoxic drugs: Group IA, low or moderate alcohol consumption and no use of such drugs; IB, low or moderate alcohol consumption with use of such drugs; IIA, high alcohol consumption with no use of such drugs; and IIB, high alcohol consumption with use of such drugs. Group IIB was found to have a higher incidence of cortical and subcortical changes than group IA. Differences in CT variables were observed between the 4 groups IA-IIB, but there were no differences in the results of neuropsychological assessment. Thus, an alcoholic could have progressive cortical and subcortical changes without any neuropsychological impairment at all. Neither the duration of self-reported loss of control over drinking nor the amount of alcohol consumed per drinking occasion were found to be associated with cognitive impairment, but both showed a relationship to cortical and subcortical CT changes. PMID- 1776218 TI - Calcified leiomyosarcoma simulating uterine myoma in a patient with long-standing anaemia. AB - A case of small bowel leiomyosarcoma in a 75-year-old woman is reviewed. The patient had an unexplained anaemia with occult blood in the faeces for at least 15 years. The value of different radiological investigations in patients with suspected gastrointestinal bleeding is discussed. The possible significance of calcifications visible on plain abdominal films is emphasized. PMID- 1776219 TI - Phosphorylation/dephosphorylation and the regulation of fibrinogen and complement factor C3. PMID- 1776220 TI - Dephosporylation with alkaline phosphatase of histone and fibrinogen phosphorylated with protein kinase C in vitro. AB - Alkaline phosphatase from calf intestinal mucosa dephosphorylated histone H1 and fibrinogen that had been phosphorylated with protein kinase C. The reaction velocity was dependent on the ionic strength of the buffer; decreasing with increasing concentration. The pH optimum was around 7, which is lower than pH optima described for other kinds of substrates. (32P) phosphorylated fibrinogen was dephosphorylated about 20 times faster than (32P)phosphohistone on a weight basis and the reaction continued linearily with time for the longest time tested (3 hs) even at 37 degrees C. As alkaline phosphatase is present in the blood the possible physiological significance of the dephosphorylation of phosphofibrinogen is discussed. PMID- 1776221 TI - Comparison of the sedative effects of medetomidine and xylazine in horses. AB - The sedative effects in horses of the new alpha 2 agonist medetomidine were compared with those of xylazine. Four ponies and one horse were treated on separate occasions with two doses of medetomidine (5 micrograms/kg bodyweight and 10 micrograms/kg bodyweight) and with one dose of xylazine (1 mg/kg bodyweight) given by intravenous injection. Medetomidine at 10 micrograms/kg was similar to 1 mg/kg xylazine in its sedative effect but produced more severe and more prolonged ataxia, and one animal fell over during the study. Medetomidine at 5 micrograms/kg produced less sedation but a similar degree of ataxia to 1 mg/kg xylazine. PMID- 1776222 TI - Effect of clenbuterol administered during the expulsive stage of bovine parturition on uterine activity and the fetus. AB - The effect of an intravenous injection of 0.3 mg clenbuterol on myometrial activity, fetal heart rate and fetal outcome was studied in three groups of animals: six heifers in active labour at term, in which fetal oversize was diagnosed just before the drug was injected and whose calves were delivered by caesarean section within 50 minutes; four cows at the start of the expulsive stage of parturition which had been induced with flumethasone on day 270 of gestation; and in four parturient cows which had had electrodes implanted on the myometrium at least one week before calving was induced with flumethasone on day 270. Electrocardiograph electrodes were placed on the calf and an intrauterine pressure catheter was inserted between the calf and the uterine wall upon rupture of the amniotic membrane. Clenbuterol induced a significant decrease of myometrial activity for at least 20 minutes. Recovery was most rapid in the heifers in which an obstetrical examination had taken place during active labour. There was no significant effect on basal fetal heart rate but decreases in heart rate were absent as long as uterine contractions were inhibited. The fetal outcome, judged either before or at birth by blood pH, base-excess and PCO2 and by a clinical examination, was not adversely affected. PMID- 1776223 TI - Effect of an isoxsuprine-resin preparation on blood flow in the equine thoracic limb. AB - The effects of an oral isoxsuprine-resin preparation on the blood flow in the thoracic limb of seven horses was determined by thermography. Treatment with the oral resin preparation resulted in increased skin temperatures compared with the non-medicated controls. The maximal temperature differences, 2.2 degrees C for the horses treated with 0.9 mg/kg and 1.8 degrees C for the horses treated with 1.2 mg/kg, occurred four hours after dosing. Plasma total isoxsuprine, determined in three horses, was detectable two hours after oral dosing and maximal eight hours after dosing, but free isoxsuprine could not be detected. Receptor binding studies demonstrated strong alpha-receptor binding, and this binding was so strong that even at isoxsuprine concentrations below the detection level receptors could have been stimulated. PMID- 1776224 TI - Colorectal intussusception in a young cat. PMID- 1776225 TI - Increase of anthelmintic resistance in sheep in The Netherlands. PMID- 1776226 TI - Prevalence of parafilaria lesions in slaughter cattle in Zimbabwe. PMID- 1776227 TI - Detection of scrapie-associated fibrils in scrapie in goats. PMID- 1776228 TI - Cardiomyopathy in adult Holstein Friesian cattle in Britain. PMID- 1776229 TI - Scrapie investigation. PMID- 1776230 TI - Detection of toxoplasma DNA in ovine samples. PMID- 1776231 TI - Facial swelling in cattle and horses. PMID- 1776232 TI - Gastric granulomatous cryptococcosis mimicking gastric carcinoma in a dog. AB - An ulcerated lesion resembling a tumour in the lesser curvature of the stomach of a 3-year-old male Dobermann pinscher was found to be caused by Cryptococcus neoformans. The dog had been vomiting for two months and had slight leucocytosis and anaemia. Biopsies of the ulcerated lesion revealed granulomatous inflammation and many cryptococci, which were particularly prominent in PAS and mucicarmine stained sections. No other lesions were found at necropsy. PMID- 1776233 TI - Investigations with enzyme-linked immunosorbent assays for Trichinella spiralis and Toxoplasma gondii in the Dutch 'Integrated Quality Control for finishing pigs' research project. AB - In the framework of the Dutch field trial 'Integrated Quality Control (IQC) for finishing pigs' ELISA (screening) techniques were used to detect animals seropositive for Toxoplasma gondii and/or Trichinella spiralis. The aim was to determine whether farms which consistently delivered seropositive pigs could be detected and monitored (defined as 'problem farms'). The investigation involved 120 farms and three slaughterhouses, and a total of 23,348 serum samples were examined. In addition, all pigs were also screened for the presence of Trichinella spiralis with the digestion method (pooled samples). The prevalence of seropositivity for Trichinella spiralis and Toxoplasma gondii was 0.3% and 2.1% respectively. Parasitological examinations concerning T. spiralis were negative. Considering the characteristics of the used methodology, the conclusion was drawn that there were no parasitological or serological indications for T. spiralis infections, and that with respect to T. gondii the infection rate seemed to be equally low for all farms involved. In addition, a longitudinal pilot study during a whole finishing period was undertaken at two finishing farms. Animals seropositive for Toxoplasma gondii were found from the earliest days of the finishing period. Housing and management may (still) play an important role in the prevention of contact with this parasite. PMID- 1776234 TI - Effects of a deficient magnesium supply during the dry period on bone turnover of dairy cows at parturition. AB - The bone activity and bone mineral content in rib bones resected from 33 dairy cows between 3 and 8 h after parturition were measured, and the effects upon them of a deficient supply of dietary magnesium (Mg) during the last seven weeks of pregnancy were studied. The cows were fed a diet containing either 0.22% magnesium (low Mg) or 0.82% magnesium (high Mg) in the dry matter (DM), and the potassium content of both rations was increased to approximately 4.1% in the DM to reduce the absorption of magnesium. In the cows fed the low-Mg diet a fall in plasma Mg concentration was observed. In the low-Mg, low-parity cows the plasma Mg concentrations at parturition were higher than in the low-Mg, high-parity cows, i.e. 0.83 mmol/l and 0.54 mmol/l, respectively. After parturition four cows in the low-Mg, high-parity group showed clinical signs of hypocalcaemia but none of the other groups did so. The bone formation in low-parity cows was significantly (P less than 0.05) affected by Mg supply, with higher percentages of both trabecular surface covered by osteoid and osteoid volume in the low-Mg group. In the high-parity cows no significant differences in bone formation were found between the low- and high-Mg groups. An inadequate Mg supply resulted in a significantly (P less than 0.05) higher Ca content in the bone ash of low-parity cows and a significantly (P less than 0.05) higher bone ash percentage in the bone of high-parity cows. PMID- 1776235 TI - The prevalence of anthelmintic resistance of horse strongyles in The Netherlands. AB - A survey to determine the prevalence of anthelmintic resistance of horse strongyles was carried out with 616 horses on 22 farms. The tested drugs were cambendazole, pyrantel pamaote and ivermectin. Based on egg count reduction tests the efficacy of cambendazole varied from 0% to 93% and of pyrantel from 93% to 100%. Ivermectin treatments were 100% effective on all farms. Larval cultures after cambendazole treatments revealed exclusively cyathostome larvae. After pyrantel treatments besides cyathostome larvae other types of larvae were also found. After ivermectin treatments only a few cyathostome larvae were observed. It can be concluded that benzimidazoleresistance of cyathostomes is very common and widespread in the Netherlands. This means that benzimidazoles and pro benzimidazoles should be excluded for strategic use in horses. PMID- 1776236 TI - Novel oxidative pathways of sulphapyridine and sulphadiazine by the turtle Pseudemys scripta elegans. AB - The sulphonamides sulphapyridine and sulphadiazine show novel hydroxy metabolites in the turtle Pseudemys scripta elegans. In the excreta of the turtles the monohydroxy metabolites 4-hydroxy- and 5-hydroxysulphapyridine and the dihydroxy metabolite 4,5-dihydroxysulphapyridine were detected. Of sulphadiazine only dihydroxy metabolites 4,5- and 4,6-dihydroxysulphadiazine were detected. About 70 90% of the dose of sulphapyridine was recovered, while this figure varied between 48 and 69% for sulphadiazine. PMID- 1776237 TI - The biology and pathobiology of the intestinal intraepithelial lymphocyte: a review of the literature. AB - Intraepithelial lymphocytes represent a population of lymphocytes situated in the epithelial layer of all mucosae. In this report their biological and pathobiological features, with emphasis on intestinal intraepithelial lymphocytes, are reviewed. PMID- 1776238 TI - Comparison of the metabolism of four sulphonamides between humans and pigs. AB - Pigs are unable to form N1-glucuronides of sulphadimethoxine and sulphamethomidine, while humans are able to do so. Pigs and humans are able to oxidise sulphapyridine and form the O-glucuronide. The double conjugate N4 acetylsulphapyridine-O-glucuronide is formed in humans but not in pigs. Sulphadiazine is mainly acetylated in both humans and pigs. A hypothesis about N1 glucuronidation is presented. PMID- 1776239 TI - Fluorocarbon-based in vivo oxygen transport and delivery systems. AB - The approval of Fluosol, a fluorocarbon emulsion for oxygenating the myocardium during the transluminal coronary angioplasty procedure, is a landmark in the field of injectable oxygen carriers, the so-called blood substitutes. This review discusses the advances made since this first emulsion was initially developed about 12 years ago. Attention is focused on the progress achieved in the preparation and selection of new, better-defined and faster-excreted fluorocarbons, and better surfactants, improved emulsions, knowledge of structure/property relationships along with an improved understanding of the physiologic response to their administration. These advances have led to the development of a second generation of highly concentrated, fluid and stable injectable oxygen carriers suitable for a broad range of clinical applications. Prospects for further progress and future generations of emulsions are also outlined. PMID- 1776240 TI - Safety of intravenous immunoglobulin preparations: a prospective multicenter study to exclude the risk of non-A, non-B hepatitis. AB - The risk of non-A, non-B hepatitis transmission by an intravenous immunoglobulin (IVIG) preparation was assessed in a prospective multicenter trial in 68 patients with primary immunodeficiency disorders (40 children or adolescents and 28 adults). During the 4-week prestudy evaluation period the clinical examinations and liver function tests including alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, alkaline phosphatase, and bilirubin were normal in all patients. The treatment consisted of three infusions of 200 mg IVIG (pH 4; pepsin procedure) per kilogram body weight at 2-week intervals. During the observation period of 24 weeks following the first infusion of the study IVIG, the patients were monitored at regular time intervals. No clinical and laboratory signs of hepatitis or liver dysfunction were noticed. All patients completed the study. In 5 patients, one isolated alanine aminotransferase value and in another patient one gamma-glutamyl transpeptidase value were moderately elevated, but always below 2.5 times the upper limit of the reference range. Similar isolated and transient elevations were observed for aspartate aminotransferase and alkaline phosphatase. It was concluded that the IVIG preparation did not transmit non-A, non-B hepatitis or other viral liver diseases. PMID- 1776241 TI - Kinetic aspects of the removal of IgG and inhibitors in hemophiliacs using protein A immunoadsorption. AB - Seven patients with hemophilia A and B and 3 patients with acquired hemophilia were treated on 13 and 4 occasions, respectively, with protein A immunoadsorption to reduce anti-factor VIII or IX antibodies. Usually the patients were treated on 2 consecutive days. On each treatment day an average of 3 (range: 1.02-5.83) plasma volumes were processed in the congenital patients and 1.5 (range: 1.02 2.90) in those with acquired hemophilia. Plasma levels of IgG decreased from 18.9 +/- 1.9 to 3.1 +/- 1.2 g/l in the congenital group, and from 11.5 +/- 2.3 to 2.3 +/- 0.6 g/l in the acquired group. In the congenital hemophiliacs a corresponding reduction in inhibitor level of 70-95% was regularly seen; in 1 exceptional patient the inhibitor was reduced from 4,350 to 12 Bethesda Units/ml (BU/ml) during 5 days of treatment. In the congenital hemophiliacs immunoadsorption was followed by factor infusion to peak levels between 8 and 215 IU/dl. In the patients with acquired hemophilia a satisfactory reduction in inhibitor levels was obtained in 2 of the 4 treatments, which were followed by DDAVP or factor infusion. Some recommendations for the use of protein A immunoadsorption in the treatment of hemophilic patients will be given. PMID- 1776242 TI - Relative functional binding activity of IgG1 and IgG3 anti-D in IgG preparations. AB - The intention to replace polyclonal IgG anti-D with human monoclonal antibody in the prophylaxis of haemolytic disease of the newborn requires knowledge concerning the relative content of IgG1 and IgG3 anti-D in prophylactic IgG preparations that are in present use. This has been carried out using a functional assay in which the absolute amount of IgG1 and IgG3 anti-D present on red cells was determined after incubation with IgG preparations. The assay was carried out by flow cytometry on 17 samples; expressed as a percentage of the total, the average value for the amount of IgG3 anti-D on the cells was 8% (range 1-18%). Similar measurements were also made on the anti-D present in 18 samples of antisera; IgG3 anti-D formed a larger fraction of the total, the average value being 17% (range 0-60%) confirming previously reported estimates. It is suggested that some of the low values found for IgG3 in IgG preparations may be due do preferential loss during production. PMID- 1776243 TI - Characterization and quantification of anti-T in human serum using a reliable hemolysis test. AB - The need of fresh-frozen donor plasma with a low level of anti-T has been emphasized recently. Anti-T, as administered by transfusion of fresh-frozen plasma, has been accused repeatedly of enhancing hemolysis in septic children with T transformation of red cells. Therefore, a new hemolysis test for the quantification of anti-T in human serum has been developed. With our test, anti-T poor plasma donors can be found. Additional results raise substantial doubt as to the pathogenetic role of anti-T in the development of the hemolytic-uremic syndrome, found in septic children with red-cell T transformation. It is impossible to predict in vivo hemolysis induced by anti-T knowing the temperature characteristics and the ionic conditions causing this antibody to mediate hemolysis in vitro. Obviously, T transformation itself plays the major pathogenetic role in these patients, and not the presence of anti-T. In the case of disseminated intravascular coagulation, a content of anti-T cannot be construed as prohibiting transfusion of fresh-frozen plasma to such patients. PMID- 1776244 TI - Flow-cytometric analysis of erythrocytic blood group A antigen density profile. AB - Blood group A antigen density on red blood cells (RBC) was studied using flow cytometry (FCM) and fluoresceinated polyclonal and monoclonal IgG anti-A antisera. Agglutination was a problem, which could only be solved by prefixation of the RBC with glutaraldehyde or formaldehyde. However, this treatment resulted in a significant reduction of the number of antigen sites as compared to the native (i.e. nonfixed) RBC. Two major new findings came out of this study: (1) A antigen density on native RBC seems to be higher than previously recognized, and (2) A antigen density distribution is probably non-Gaussian. The absolute number of A antigen sites was determined, using a human polyclonal IgG antiserum and commercially available absolute fluorescence standards. The site numbers on fixed RBC were comparable to those found by earlier radioimmunological studies (x 10(6)/RBC): A1, 1.07 +/- 0.28; A2, 0.21 +/- 0.09; A1B, 0.79 +/- 0.26 sites (mean +/- SD). The values found for native RBC were considerably higher (x 10(6)/RBC): A1, 2.86 +/- 0.95; A2, 0.47 +/- 0.29; A1B, 1.98 +/- 0.58 sites (mean +/- SD). With the 1 monoclonal and the 3 polyclonal antisera used in this study, and in contrast to Rh D, the erythrocytic A antigen density distribution of a given sample is highly asymmetrical. This non-Gaussian distribution profile does not seem to be affected by such factors as antibody heterogeneity, variability in antibody fluoresceination range, RBC density and reticulocyte content. This suggests that the asymmetrical A antigen distribution may be an intrinsic property of the RBC population. PMID- 1776245 TI - Assignment of the Auberger red cell antigen polymorphism to the Lutheran blood group system: genetic justification. AB - Family studies have provided the final piece of evidence for the assignment of Auberger to the Lutheran blood group system. Lods derived from combined paternal and maternal meioses (zeta = 10.83 at theta = 0.00) strongly support the contention that a single gene controls the expression of both Au and LU antigens. Consequently, the International Society of Blood Transfusion Working Party on Terminology has designated Aua and Aub as LU18 and LU19, respectively. PMID- 1776246 TI - Hepatitis C antibody prevalence in Saudi Arabian blood donors. PMID- 1776247 TI - [Heart transplantation in childhood]. AB - This report presents 5 children, in whom a heart transplantation was performed at the II. Chirurgische Universitatsklinik of Vienna. At the time of transplantation the age of the children was 2, 3, 6, 10, and 14 years. The preoperative diagnosis was dilative cardiomyopathy in two patients, hypertrophic cardiomyopathy, right ventricular decompensation after atrial repair of TGA and a tumor of the heart in the other patients. Three children are alive and well. One child suffered from severe postoperative complications and 1 child died because of rejection of the heart. Indication, follow-up, complications of the therapy and the position of heart transplantation in children are discussed. PMID- 1776248 TI - [Risk of complications of early coronary angioplasty after thrombolysis in acute myocardial infarct]. AB - The present study reports on the complication rates in 143 patients who underwent percutaneous transluminal coronary angioplasty (PTCA) within 4 weeks after thrombolysis for acute myocardial infarction. The results were analyzed with respect to the time between thrombolysis and PTCA. PTCA was successful in 130 patients (91%). The mortality was 0.7% (1 patient). Severe complications occurred in 9 further patients (7%): 8 reinfarctions (6%) and one patient with a large haematoma of the groin requiring surgical treatment (0.7%). The total complication rate, including milder was 24%. A comparison of patients treated with PTCA within the first 4 days after thrombolysis (group I, n = 67) with patients dilated between 5 and 28 days after thrombolysis (group II, n = 76) resulted in a complication rate of 33% in group I and 16% in group II (p less than 0.01). This important difference was due to the higher frequency of ischaemic complications in group I than in group II (28% versus 12%). Besides reinfarction (7.5% in group I versus 4% in group II), prolonged ischaemic episodes were the most frequent cause of complications. Our results demonstrate a very high risk of complications if PTCA is performed within the first 4 days after thrombolysis for acute myocardial infarction. PMID- 1776249 TI - [Methanol metabolism in chronic alcoholism]. AB - Serum methanol concentrations (SMC) exceeding 10 mg/l are highly suggestive of long-term alcohol intoxication and can be considered as marker for chronic alcohol abuse. Endogenously formed or consumed methanol is almost exclusively metabolized by alcohol dehydrogenase. As long as blood alcohol concentrations exceed 0.2-0.5 g/l methanol cannot be metabolized and accumulates. In a prospective study on 78 patients admitted for alcohol detoxification, elevated SMC up to 78 mg/l were found, with a mean SMC of 29.4 mg/l. No correlation was demonstrated between SMC and severity of the alcohol withdrawal syndrome. Further clinical, forensic and biochemical aspects of methanol metabolism are discussed. PMID- 1776250 TI - [Determination of tuberculostearic acid--progress in early diagnosis of tuberculous meningitis]. AB - Rapid diagnosis of cerebral tuberculous meningitis is of the greatest importance in determining the outcome of therapy. Since tubercle bacilli are often not seen on microscopy of the cerebrospinal fluid, and culture of Mycobacterium tuberculosis takes many weeks, there is a need for more rapid and sensitive confirmatory tests. The importance of the detection of tuberculostearic acid in the cerebrospinal fluid in combination with magnet resonance imaging will be shown in this case report. PMID- 1776251 TI - [The Bochum worksheet for the ethical practice of medicine]. PMID- 1776252 TI - [Brief definitions of concepts in medical ethics. 16. Informed consent]. PMID- 1776253 TI - [Standard ethical principles in differential ethics]. AB - Patient oriented clinical ethics does not require the presentation of general ethical theories, rather the differentiating micro-allocation and mix-allocation of moral midlevel principles. PMID- 1776254 TI - [Coronary artery anomalies in adulthood]. AB - In a series of 3000 consecutive coronary angiographies carried out in adults (period October 1988 through February 1991) the incidence of coronary artery anomalies was investigated. Among these there were 7.2% of patients with left-, 3.8% with right-sided and 89% with bilateral coronary artery supply. 10 cases revealed a double left anterior descendent artery (LAD), whereas in 2 patients the left circumflex artery (CX) was missing. In approximately 1% of patients origin anomalies of coronary arteries were observed, above all of the right coronary artery (RCA). A pronounced kinking of the coronaries was seen in 22 cases (11 LAD, 11 RCA) and a bridging in 2.5% of patients (74 LAD, 1 CX, 1 RCA). Of the latter, there were 21 hemodynamic active stenoses (more than 75% diameter stenosis) of which in 12 cases this narrowing was the sole cause for the heart complaints. During the same period there were 8 patients with coronary anomalies leading to shunt development out of which a 30-year-old female revealed clinically a coronary steal phenomenon. Aneurysms of the coronary arteries were observed in 54 cases (2%) whether congenital or acquired could not be ascertained. In total, there were 194 coronary anomalies in the total series (6.5%) being clinical significant in 22 cases (0.7%). PMID- 1776255 TI - [In what manner does regular training prolong life?]. AB - Regular endurance exercise prolongs life mostly by reducing the cardiovascular risk. Many mechanisms might be involved and it is not possible to define their relative importance. Possibly, hemodynamic effects contribute to quality of life and the ability of exercise to influence classical cardiovascular risk factors eventually prolongs life. In any case, regular exercise is certainly an excellent means of primary prevention of atherosclerotic diseases. PMID- 1776256 TI - [Cyclosporin A in atopic dermatitis: therapeutic effect and effect on allergic reactions are dissociated from each other]. AB - Fourteen patients with severe chronic atopic dermatitis were treated with cyclosporin A (CyA, Sandimmun; 5 mg/kg/day) for 7-16 weeks. All showed a marked clinical improvement and half could omit topical corticosteroid treatment during therapy. Adverse effects were minor, but two patients relapsed despite continued treatment. In the others, the disease recurred soon after stopping CyA. Serum IgE levels and prick-test responses were unchanged by CyA. Immediate and late-phase cutaneous responses to intradermal house dust mite antigen (HDM) were significantly increased during treatment; but a delayed response, present at 24 and 48 h, was unaffected. Four of six patients challenged with HDM patch tests to tape-stripped skin during treatment showed eczematous reactions at 48 h. Thus, cyclosporin A has a powerful therapeutic effect in atopic dermatitis but does not reduce allergic responses to inhalant antigens. PMID- 1776257 TI - [A comparison of the effects of verapamil and nifedipine on the quality of life]. AB - Aspects of quality of life (symptoms, psychological well-being and activity) were evaluated by self-administered questionnaires in a 4 months randomized double blind trial of titrated doses of verapamil slow release (n = 41) compared with nifedipine retard (n = 40). An untreated diastolic blood pressure of 95 to 115 mm Hg was required for inclusion in the trial. The mean age in both groups was 55 years. A significant difference between the two drugs was found in the average reporting of symptoms with an increase on nifedipine (p less than 0.01). The reporting of swollen ankles and flushing (p less than 0.05) increased on nifedipine, and nocturia (p less than 0.05) increased on verapamil. Measures of psychiatric morbidity tended to improve on verapamil and deteriorate on nifedipine. Only the change in cognitive function was significant between the drugs, being worse on nifedipine (p = 0.05). There was no difference between the two groups in the fall in diastolic blood pressure (average 18 mm Hg on nifedipine and 17 mm Hg on verapamil). There was a significantly greater fall in systolic blood pressure on nifedipine (23 mm Hg) compared with verapamil (13 mm Hg) (p less than 0.01). The two drugs differed in their effects on measures of quality of life. The improvements in symptomatic complaints and psychological well-being on verapamil may have been due to inclusion in a trial, although we cannot exclude the possibility of a drug effect. Conversely the increase in symptoms and self-assessed cognitive impairment on nifedipine were considered to be side-effects of the drug. PMID- 1776258 TI - [Women and AIDS. Summary of important results of a social science research project]. PMID- 1776259 TI - tert-Butylbicycloortho[3H]benzoate (3H-TBOB) toxicokinetics and disposition in rats. AB - 1. Toxicokinetics of tert-butylbicycloortho[3H]benzoate (3H-TBOB) administered into the right atrium of rat heart can be described by the biexponential equation: ct = Ae-1.6t + Be-0.013t. 2. The fast initial phase of 3H-TBOB decline in blood (t1/2 = 0.5 min) is due to its absorption by lungs. 3H-TBOB is then transferred into liver, the primary organ of its metabolic detoxication. The high apparent distribution volumes for 3H-TBOB (1.3 and 7.1 l/kg for the initial and the terminal phase, respectively) are probably due to its lipophilicity and partitioning into lipoid tissue membranes. 3. Acid-labile TBOB is not completely hydrolysed in gastric fluid. A portion of 3H-TBOB administered into the stomach is absorbed within 3 min into the circulatory system. 4. Intra-arterially administered 3H-TBOB distributes in the brain in a lateral and regional pattern. 5. Two types of 3H-TBOB metabolites are excreted in urine and faeces. Both are more polar than the parent compound. The major components of the fraction were tentatively identified as hippuric and benzoic acid. PMID- 1776260 TI - Regioselectivity and stereoselectivity of the metabolism of the chiral quinolizidine alkaloids sparteine and pachycarpine in the rat. AB - 1. The metabolism of (-)-sparteine and (+)-sparteine (pachycarpine) was investigated in male Sprague-Dawley rats by g.l.c.-mass spectrometry, and 13C- and 2H-n.m.r. spectroscopy. The structure of the major metabolite of (-) sparteine was confirmed to be 2,3-didehydrosparteine by g.l.c.-mass spectrometry after alkaline sample work-up. 2H-n.m.r. spectroscopy showed that this metabolite exhibits the structure of the carbinolamine (2S)-hydroxysparteine in aqueous solution of neutral pH. No other metabolites with an enamine structure were observed by g.l.c.-mass spectrometry and 13C-n.m.r. spectroscopy. 2. Pachycarpine is metabolized in vivo and in vitro stereoselectively to the aliphatic alcohol (4S)-hydroxypachycarpine as the main metabolite. 3. The formation of the 2,3 didehydrosparteine proceeds via stereospecific abstraction of the axial 2 beta hydrogen atom. Inhibition in vitro studied with purified rat liver microsomes demonstrated that both sparteine enantiomers are metabolized by the same cytochrome P450 isozyme. Therefore this enzyme exhibits marked substrate and product stereoselectivity for the metabolism of the two enantiomeric quinolizidine alkaloids. PMID- 1776261 TI - Effects of simvastatin, a lipoprotein-lowering drug, on the hepatic enzymes involved in drug metabolism in the Wistar rat. AB - 1. Simvastatin, a competitive inhibitor of 3-hydroxy-3-methyl glutaryl CoA reductase, lowers the plasma cholesterol level and has been approved for treatment of hyperlipoproteinaemia. 2. Simvastatin has been studied for its effects on hepatic microsomal drug metabolism in rat. No induction of 7 ethoxyresorufin-O-deethylase (EROD), ethoxycoumarin-O-deethylase (ECOD) and of UDP-glucuronosyltransferases were found, in vitro, after administration of 0.5, 1.5 and 10 mg/kg per day for 22 days. 3. Epoxide hydrolases (microsomal and cytosolic) were also unchanged after treatment with simvastatin. 4. No increase of the palmitoyl CoA oxidase activity or of mitochondrial glycerol phosphate dehydrogenase activity occurred. 5. Fatty acid distribution in rat liver microsomal phosphatidylcholines showed a significant decrease of C16:1 and a significant increase of C20:4 acids. PMID- 1776262 TI - Absorption and disposition of epithiosteroids in rats (1): Route of administration and plasma levels of epitiostanol. AB - 1. Absorption and disposition of epitiostanol (EP) were determined following intramuscular (i.m.), intravenous (i.v.) and oral administration of 14C epitiostanol (14C-EP) to rats. 2. When 14C-EP was administered orally, radioactivity was absorbed from the gastrointestinal tract and appeared in the systemic circulation, but no unchanged EP was detected in the plasma. EP was extensively metabolized by first-pass metabolism in the intestinal mucosa and liver, and because of the low biological activity when given orally, EP should be given by injection. 3. The EP plasma concentration/time curve following i.m. administration is analysed by a flip-flop model (ka less than kel), because the ka for EP remaining at the i.m. injection site was less than the kel for i.v. injection. PMID- 1776263 TI - Absorption and disposition of epithiosteroids in rats (2): Avoidance of first pass metabolism of mepitiostane by lymphatic absorption. AB - 1. Absorption of mepitiostane (MP) from the gastrointestinal tract was examined using thoracic duct-cannulated rats. 2. When 14C-MP was administered into the small intestine, 34% of the radioactivity was recovered in the 6-h thoracic duct lymph. More than 90% of this radioactivity was due to unchanged MP and most of the MP in the lymph was carried in the lipid core of the chylomicrons and VLDL. 3. Radioactivity in the portal blood was extensively extracted by the liver and excreted into bile as polar metabolites. Thus, most unchanged MP which entered the systemic circulation following oral administration was drug absorbed via the intestinal lymphatics. 4. MP avoids the first-pass effect by lymphatic adsorption. PMID- 1776264 TI - Sulphation of the flavonoids quercetin and catechin by rat liver. AB - 1. The isolated perfused rat liver forms three sulphated metabolites from each of the flavonoids, quercetin and catechin: these are secreted into the bile and the perfusate. 2. Quercetin gives two double conjugates, containing sulphate and glucuronic acid, and one sulphate: catechin gives one such double conjugate and two sulphates. 3. This sulphation is not inhibited by 60 microM 2,6-dichloro-4 nitrophenol which almost completely inhibits the sulphation of harmol in this perfused liver system. 4. The sulphation of harmol by the perfused liver is not inhibited by the flavonoids. 5. Unfractionated sulphotransferases from rat liver catalyse sulphate conjugation of quercetin and catechin in vitro by a reaction inhibited by pentachlorophenol or dichloronitrophenol: the flavonoids inhibit the sulphation of 4-nitrophenol by this system. 6. The results with the two systems are discussed and shown to be compatible. PMID- 1776265 TI - Comparison of the effects of inducers of cytochrome P450 on Mongolian gerbil and rat hepatic microsomal monooxygenase activities. AB - 1. Basal cytochrome P450 content (nmol/mg protein) was higher in gerbil (1.10 +/- 0.01) than in rat (0.81 +/- 0.05) hepatic microsomes. Pretreatment of gerbils with phenobarbitone and beta-naphthoflavone increased P450 contents by 200% and 60% respectively. 2. 7-Ethoxycoumarin O-deethylase, coumarin 7-hydroxylase and 4 nitrophenol hydroxylase activities were generally higher in gerbil liver microsomes, whereas erythromycin N-demethylase, and 7-ethoxyresorufin and 7 pentoxyresorufin O-dealkylase activities were higher in rat microsomes. Microsomal benzphetamine N-demethylase activities were similar in both species. 3. Induction of specific cytochrome P450 isozymes increased similar monooxygenase activities of rat and gerbil microsomes. Phenobarbitone, beta-naphthoflavone, isoniazid and pregnenolone 16 alpha-carbonitrile principally increased benzphetamine N-demethylase, 7-ethoxyresorufin O-deethylase, 4-nitrophenol hydroxylase and erythromycin N-demethylase activities respectively. 4. Constitutive 7-ethoxyresorufin and 7-pentoxyresorufin O-dealkylase activities were markedly lower in gerbil microsomes compared with rat microsomes, and pretreatment of gerbils with cytochrome P450 inducers did not significantly increase these activities. 5. Hepatic microsomal coumarin 7-hydroxylase activities were approximately 30-200 times greater (depending on the inducer) in the gerbil than in rat. The gerbil, due to is high coumarin 7-hydroxylase activity, would appear to be a more appropriate species than rat for investigations of coumarin metabolism and toxicity relevant to humans. PMID- 1776266 TI - Metabolism of 14C-dichloroethyne in rats. AB - 1. The metabolism of 14C-dichloroethyne was studied in rats by inhalation in a dynamic nose-only exposure system. 14C-Dichloroethyne was generated in 95-99% yield from 14C-trichloroethene by alkaline dehydrochlorination. 2. After inhalation of 20 ppm and 40 ppm dichloroethyne for 1 h, the retention rates were 17.6% and 15.6% of the radioactivity introduced into the exposure system, respectively. During the period of observation (96 h), almost quantitative elimination of the dose was observed. Elimination with urine accounted for 60.0% (40 ppm) and 67.8% (20 ppm) of absorbed radioactivity and elimination with faeces for 27% (40 ppm) and 27.7% (20 ppm), 3.4-3.5% remained in the carcasses. 3. Metabolites of dichloroethyne identified are: N-acetyl-S-(1,2-dichlorovinyl)-L cysteine, dichloroethanol, dichloroacetic acid, oxalic acid and chloroacetic acid in urine; N-acetyl-S-(1,2-dichlorovinyl-L-cysteine in faeces. 4. In bile of rats exposed to 40 ppm of dichloroethyne, S-(1,2-dichlorovinyl)glutathione was the only metabolite identified. Biliary cannulation did not influence the renal excretion of N-acetyl-S-(1,2-dichlorovinyl)-L-cysteine, indicating that glutathione conjugate formation occurs in the kidney. 5. The results suggest that two metabolic pathways are operative in dichloroethyne metabolism in vivo. Cytochrome P450-dependent oxidation represents a minor pathway accounting for the formation of 1,1-dichloro compounds after chlorine migration. The major pathway is the biosynthesis of toxic glutathione conjugates. Organ-specific toxicity and carcinogenicity of dichloroethyne is due most likely to the topographical distribution of gamma-glutamyl transpeptidase which is concentrated mainly in the kidney in rats. PMID- 1776267 TI - Decrease in albendazole sulphonation during experimental fascioliasis in sheep. AB - 1. The in vivo S-oxidation of albendazole was measured from the pharmacokinetic profile of albendazole sulphoxide and sulphone determined in young male sheep receiving oral albendazole (1.9 mg/kg). Studies were carried out before, and each month after, oral infestation by 150 metacercariae of Fasciola hepatica. 2. Parasitic pathology was ascertained by clinical observation of animals, and the increase in plasma antibodies directed against liver flukes. 3. Rate of conversion of sulphoxide to sulphone and rate of sulphone elimination, were respectively decreased by 47% and 87% at week 8 post-infection, whereas significant increases in the area under plasma sulphone concentrations versus time curve and mean residence time, occurred 4-12 weeks following the infestation. 4. A 58% decrease in albendazole sulphonation was demonstrated in liver microsomal preparations obtained from 8-week-infected sheep, while there was no change in the FAD-directed sulphoxidation of albendazole. 5. The transient impairment of albendazole sulphonation could be related to the decrease in liver microsomal cytochrome P450-dependent monooxygenases observed in sheep with a similar parasitic pathology. PMID- 1776268 TI - Metabolism of a new thiazolidinedione hypoglycemic agent CP-68,722 in rat: metabolite identification by gas chromatography mass spectrometry. AB - 1. After i.v. administration to rat of CP-68,722, a new thiazolidinedione antidiabetic drug, four metabolites were excreted in bile, as glucuronide conjugates. 2. Incubation of the drug with a rat liver microsomal preparation yielded the four in vivo metabolite aglycones and several additional in vitro metabolites. 3. Seven in vivo-generated metabolites were isolated by h.p.l.c. Each metabolite was converted to stable isotope labelled or non-labelled derivatives. Capillary g.l.c.-mass spectrometric analysis of the derivatives indicated that five metabolites result from hydroxylation and one from oxidation to the chromanone. The sites of metabolism were deduced from the electron ionization spectra. 4. Authentic standards for five metabolites were synthesized. Agreements of mass spectra and chromatographic retention times confirmed the five proposed structures. Two metabolites, detected only in vivo, await structure confirmation. PMID- 1776269 TI - Medicinal azides. Part 8. The in vitro metabolism of p-substituted phenyl azides. AB - 1. A series of p-substituted aromatic azides was synthesized and their metabolism investigated in suspensions of mouse liver microsomes and mouse hepatocytes. Metabolite analysis was performed by h.p.l.c. 2. On incubation with microsomes under anaerobic conditions p-nitro, p-cyano- and p-chlorophenyl azide afforded metabolites which co-chromatographed with the respective aromatic amines. The rate at which p-nitrophenyl azide was metabolically reduced was approximately 20 fold that observed for p-cyano- and p-chlorophenyl azide. 3. Phenyl azide, p methoxyphenyl azide and the aliphatic congener, phenethyl azide, did not furnish detectable amounts of metabolites on incubation with microsomes under anaerobic conditions. When phenyl azide and p-methoxyphenyl azide were incubated with hepatocytes or microsomes under aerobic conditions the resulting chromatograms furnished peaks which co-eluted with authentic p-hydroxyphenyl azide. 4. The microsomal reduction of p-nitrophenyl azide was dependent upon the presence of viable microsomes and NADPH, and on the absence of oxygen above the incubation medium. PMID- 1776270 TI - Protooncogene expression in rat liver by polychlorinated biphenyls (PCB). AB - 1. The expression of 10 protooncogenes was studied in control rat liver and at various times after exposure to polychlorinated biphenyls (PCB), a known tumour promoter. 2. The expression of protooncogenes in liver is more pronounced in those rats treated with PCB beginning at weaning ('weanlings') than in adult rats. 3. The RNA levels of c-Ha-ras, c-raf, c-yes, c-erbA and c-erbB are elevated after PCB feeding. 4. Nuclear run-on transcription analysis revealed that the altered expression of the protooncogenes is transcriptionally regulated. 5. In one group the prompt rise of the protooncogene transcription rate is followed by a decline (c-Ha-ras, c-raf c-yes). In a second group a further increase in transcription at later feeding times (c-erbA, c-erbB) was observed. 6. A correlation between the altered expression of these protooncogenes and the action of PCB as a tumour promotor remains to be determined. PMID- 1776272 TI - The metabolism of 4-aminobiphenyl in rat. IV. Ferrihaemoglobin formation by 4 aminobiphenyl metabolites. AB - 1. Rats dosed with nitrosobenzene (56 mumol/kg), 4-chloronitrosobenzene (53 mumol/kg), 3,4-dichloronitrosobenzene (53 mumol/kg), 4-ethoxynitrosobenzene (86 mumol/kg), 4-nitrosobiphenyl(nitroso-BP, 55 mumol/kg) or 2-nitrosofluorene (256 mumol/kg) had maximal ferrihaemoglobin (HbFe3+) concn of 69, 68, 69, 67, 55 and 42% after 15, 25, 48, 35, 80 and 115 min, respectively, indicating differences in solubility of the nitrosoarenes in body fluids. 2. Nitroso-BP and 3-hydroxy-4 aminobiphenyl (3-hydroxy-ABP) catalytically oxidized HbFe2+ in bovine erythrocytes in vitro; nitroso-BP was three times as active as 3-hydroxy-ABP. 3',4'-Dihydroxy-4-aminobiphenyl (3',4'dihydroxy-ABP) showed only low catalytic activity, and seven other ABP metabolites exhibited only marginal activity. 3. Nitroso-BP was inactive in solutions of purified human Hb, but 3-hydroxy-ABP catalytically oxidized HbFe2+, indicating that nitrosoarenes oxidize HbFe2+ in erythrocytes in vitro and in vivo by a mechanism different from that of o aminophenols. The second-order rate constant for HbFe2+ oxidation by 3-hydroxy ABP at 37 degrees C was k2 = 19.1 +/- 1.31/mol per s. PMID- 1776271 TI - Protein binding, nuclear translocation and biliary secretion of metabolites of 3' methyl-N,N-dimethyl-4-aminoazobenzene during hepatocarcinogenesis in rats. AB - 1. The hepatic content, biliary excretion, cytosolic protein binding and nuclear translocation of metabolites of i.v. administered 14C-3'-methyl-N,N-dimethyl-4 aminoazobenzene (3'-methyl-DAB) were investigated in rats at various stages of 2 acetamidofluorene (AAF)-induced hepatocarcinogenesis. 2. At nodular and post nodular stages biliary excretion of radioactive metabolites was decreased, although hepatic content of radioactivity was similar to controls not dosed with AAF. The secretion in bile of a major azo dye binding protein was also decreased at these stages. 3. Binding of dye metabolites to cytosolic proteins was decreased by 40% at nodular and post-nodular stages compared to controls. 4. Translocation in vitro of dye metabolites from cytosol to nucleus at nodular and post-nodular stages was 40% less than that of controls. Since specific soluble proteins control translocation from cytosol into the nucleus (and bile), this decreased binding of metabolites may explain the diminished translocation of carcinogen metabolites into the nucleus. PMID- 1776273 TI - Purification and characterization of a microsomal cytochrome P-450 IIB enzyme from sheep lung. AB - 1. Cytochrome P-450 was purified to apparent homogeneity from pulmonary microsomes of female sheep. 2. Sheep lung P-450 was isolated in the low spin state with a lambda max in the CO-reduced vs CO difference spectrum of 450nm with no detectable absorbance at 420 nm. 3. The minimum mol. wt, determined by SDS PAGE, was 51,400 daltons. Examination of substrate specificity of sheep lung P 450 indicated N-demethylation of benzphetamine, cocaine and N dimethylnitrosamine. Nicotine was also metabolized by sheep lung P-450, but little turnover was observed with benzo[a]pyrene. 4. The amino acid composition and N-terminal sequence was highly similar to rat or rabbit members of the P-450 IIB gene subfamily. Antibodies raised in rabbit to sheep lung P-450 cross-reacted on Western blots with rabbit lung P-450 IIB4. 5. The P-450 isolated in this study comprises 75% of total P-450 in sheep pulmonary microsomes. Small amounts of this isozyme were also detected in sheep liver. These results show that, as is the case in rabbit and rat, the major constitutive P-450 in sheep is a member of the IIB gene subfamily. PMID- 1776274 TI - Inhibition of microsomal lipid peroxidation by alpha-tocopherol and alpha tocopherol acetate. AB - 1. The antioxidant effects of alpha-tocopherol and alpha-tocopherol acetate were assayed for the (a) oxygen uptake, (b) chemiluminescence and (c) malondialdehyde formation, of tert-butyl hydroperoxide-supplemented rat liver microsomes. 2. Oxygen uptake was inhibited 60% by both alpha-tocopherol and alpha-tocopherol acetate with the half-maximal effect at 5 nmol tocopherol/mg protein. Chemiluminescence and malondialdehyde formation were equally inhibited 35% by both tocopherols with half-maximal effects at 2 nmol tocopherol/mg protein. 3. The rate of O2 uptake by tocopherol-supplemented microsomes was dependent on O2 concentration. A 60% inhibition by 5 nmol tocopherol/mg protein at 0.2 mM O2 is decreased to 5% inhibition at 0.6 mM O2. 4. The inhibition of O2 uptake, chemiluminescence and malondialdehyde formation indicate that both alpha tocopherol and alpha-tocopherol acetate have similar effects as free radical traps in the hydrophobic domain of biomembranes. The different inhibition observed at different O2 concentrations indicate competition between vitamin E and O2 by unoxygenated lipid radicals. PMID- 1776275 TI - The potential of antioxidant enzymes as pharmacological agents in vivo. AB - 1. Oxygen radicals have been associated with a number of unrelated pathological processes including ageing, radiation sickness, inflammation, oxygen toxicity, reoxygenation of ischaemic tissues, etc. The partial reduction of oxygen to superoxide anion (O2-.) and H2O2 leads to the formation of more deleterious species such as hydroxyl radical (OH.) starting a chain reaction ultimately causing lipid peroxidation and cell death. 2. To prevent the increased steady state concentration of oxygen radicals many researchers have designed potential treatments including the i.v. injection of antioxidant enzymes or enzyme derivatives with longer half-life in circulation (i.e. enzymes encapsulated in liposomes or covalently modified). 3. Tissue distribution and half-life in circulation depend upon the type of enzyme being used as well as whether the enzyme is or is not in its native form. 4. This review comments on some of the scenarios where these enzymes have been utilized, and discusses relevant problems of stability of different enzymes in circulation. PMID- 1776276 TI - Oxy-radical metabolism and control of tumour growth. AB - 1. The content of oxy-radical scavenging enzymes is decreased in Morris hepatomas in a fashion which is inversely related with the growth rate of the tumour. 2. Hepatoma microsomal membranes are more resistant than normal rat liver membranes to lipid peroxidation induced in vitro by organic hydroperoxides or superoxide radicals. 3. In tumour membranes the most relevant rate-limiting factor of peroxidation is the low availability of polyunsaturated fatty acids (PUFA). Besides lipids, some proteins (particularly cytochrome P-450) act as controlling factors of peroxidation. 4. Tumour microsomes are more ordered and less fluid than liver microsomes. The latter, exposed to superoxide radical attack, exhibit chemical (fatty acid composition) and physical (molecular order) properties that are similar to those of transformed cell membranes. 5. These data indicate an aberration in the oxy-radical metabolism of cancer cells, and a sequence of events is hypothesized that could drive the transformed cell towards uncontrolled proliferation. PMID- 1776277 TI - Glutathione depletion: its effects on other antioxidant systems and hepatocellular damage. AB - 1. The mechanisms of the liver damage produced by three glutathione (GSH) depleting agents, bromobenzene, allyl alcohol and diethyl maleate, were investigated. 2. With each toxin liver necrosis was accompanied by lipid peroxidation that developed only after severe depletion of GSH. 3. Changes in antioxidant systems by alpha-tocopherol (vitamin E) and ascorbic acid were studied. A decrease in the hepatic level of vitamin E, and a change in the redox state of vitamin C (increase in oxidized over reduced form) were evident whenever extensive lipid peroxidation developed. However, in the case of bromobenzene intoxication these alterations preceded lipid peroxidation, and may be an index of oxidative stress leading to subsequent membrane damage. 4. Experiments carried out with vitamin E-deficient or supplemented diets indicated that pathological phenomena occurring as a consequence of GSH depletion depend on hepatic levels of vitamin E. In vitamin E-deficient animals, lipid peroxidation and liver necrosis appeared earlier than in animals fed the control diet. In animals fed a vitamin E supplemented diet, bromobenzene and allyl alcohol had only limited toxicity, and diethyl maleate none, in spite of similar hepatic GSH depletion. Thus, vitamin E may largely modulate the expression of toxicity by GSH-depleting agents. PMID- 1776278 TI - Alcohol-induced oxidative stress in rat liver. AB - 1. Livers from rats treated acutely with ethanol showed increased chemiluminescence, malondialdehyde production, and diene formation. Previous administration of (+)-cyanidanol-3 completely abolished acute ethanol-induced chemiluminescence. 2. Rats fed alcohol liquid diets for 3 weeks showed significant increases in microsomal and mitochondrial malondialdehyde formation, and in microsomal H2O2 and O2-. generation. 3. Rats fed a solid basal diet plus ethanol solution for 12 weeks also showed increased microsomal production of O2-. and increased content of microsomal cytochrome P-450. Hydroperoxide-induced chemiluminescence was higher in homogenates, mitochondria and microsomes from ethanol-treated rats than from controls. Vitamins E and A were more effective inhibitors of hydroperoxide-stimulated chemiluminescence in liver homogenates from ethanol-treated rats than from control animals. 4. Results are consistent with peroxidative stress leading to increased lipid peroxidation in liver of rats fed ethanol both acutely and after long-term dosing. PMID- 1776279 TI - Are free radicals involved in lead poisoning? AB - 1. The enolamine form of 5-aminolaevulinic acid (ALA), a haem precursor that accumulates in lead poisoning and in acute intermittent porphyria (AIP), undergoes fast autoxidation at slightly alkaline pH with concomitant generation of reactive oxygen species. 2. The transmembrane potential, Ca2+ ion fluxes and state-4 respiratory rate, of isolated rat liver mitochondria are severely affected by mM addition of ALA; the toxic role of ALA-produced oxygen radicals was demonstrated by use of appropriate scavengers. 3. Induction of superoxide dismutase biosynthesis in lead-exposed workers, in AIP carriers and in ALA treated rats, is viewed as a protective response against oxygen radical toxicity. 4. 5-Aminolaevulinic acid-generated oxygen radicals, together with Pb-stimulated Fe-dependent lipid peroxidation, might be involved in the aetiology of the neuropsychiatric manifestations of both plumbism and acute intermittent porphyria. PMID- 1776280 TI - 2,2'-Azo-bis-amidinopropane as a radical source for lipid peroxidation and enzyme inactivation studies. AB - 1. 2,2'-Azo-bis-amidinopropane (ABAP) thermal decomposition produces free radicals that initiate the lipid peroxidation of erythrocyte ghost membranes. 2. Addition of 6-n-propyl-2-thiouracil decreases the rate of the process, both by decreasing consumption of the natural antioxidants of the membranes and by direct interaction with the free radicals involved in the lipid peroxidation. 3. Peroxyl radicals produced in ABAP thermal decomposition inactivate lysozyme, horseradish peroxidase (HRP) and glucose oxidase, in that order. The number of enzyme molecules inactivated per radical introduced into the system increases with enzyme concentration. 4. Competitive studies employing mixtures of enzymes show that the order of reactivity of these enzymes towards the peroxyl radicals is the opposite to that obtained for the rate of enzyme inactivation. It is concluded that inactivation efficiency is determined mainly by the average number of free radicals that must react with an enzyme molecule to produce its inactivation, and that this number is directly related to the molecular weight of the enzyme. PMID- 1776281 TI - [Diagnostic procedures supplementing mammography]. PMID- 1776282 TI - [Diagnosis of metastasis of breast cancer to the thorax and bones]. PMID- 1776284 TI - [Breast cancer]. PMID- 1776283 TI - [Tumor markers in diagnosis of breast cancer]. PMID- 1776285 TI - [Breast cancer--epidemiology and prevention]. PMID- 1776286 TI - [Nutrition and risk of breast cancer]. PMID- 1776287 TI - [Fibrocystic mastopathy and risk of cancer from the viewpoint of the pathologist]. PMID- 1776288 TI - [Clinical diagnosis of breast cancer]. PMID- 1776289 TI - [Cytodiagnosis of benign and malignant changes in the breast]. PMID- 1776290 TI - [Monoclonal antibodies in diagnosis of breast cancer]. PMID- 1776291 TI - [Significance of the proliferative activity of breast cancer for prognosis and therapy]. PMID- 1776292 TI - [Screening mammography and its significance for decreasing breast cancer mortality]. PMID- 1776293 TI - [Unemployment: psychosocial symptoms, possible health effects and their management]. PMID- 1776294 TI - [From structure to function--on the change in scientific thinking]. PMID- 1776295 TI - [Poisoning in childhood--a retrospective study of 1970-1990]. PMID- 1776296 TI - [Forensic medicine in Prussia and the law for local physicians of 1899]. PMID- 1776297 TI - [Medicine and language--communication and history]. PMID- 1776298 TI - [Autochthonous parasitic zoonoses--a current problem. 1: General aspects and protozoan-induced zoonoses]. PMID- 1776299 TI - [Ambulatory morbidity from claims. A preliminary analysis for the region of the former DRG]. PMID- 1776300 TI - [Recommendations for the indication-justified use of antibiotics. 3: macrolides, lincosamide, glycopeptide antibiotics, fusidic acid, fosfomycin]. PMID- 1776301 TI - [Epidemiology of gallbladder stones in men]. PMID- 1776302 TI - [Quadriplegia and family environment]. PMID- 1776303 TI - [Confusion in old age--what is it?]. PMID- 1776304 TI - [International statistical classification of diseases, injuries and cause of death]. PMID- 1776305 TI - [Hermann Nothnagel (1841-1905)--attempt at an appreciation at his 150th birthday]. PMID- 1776306 TI - [Electrophysiological anti-arrhythmia effects of tiracizine in ventricular tachycardia]. AB - The electrophysiologic effects and antiarrhythmic efficacy of tiracizine, a new class I antiarrhythmic drug, were studied in 16 patients with documented sustained ventricular tachycardia (VT) after intravenous drug application and in 6 patients after oral drug administration by means of programmed ventricular stimulation (PVS). After intravenous tiracizine (0.3 mg/kg) the VT was no longer inducible by PVS in 3 of 16 patients and became nonsustained in another patient. In 11 of 13 patients with further inducible VT the cycle duration of VT increased after tiracizine (mean 29 ms). After oral tiracizine (150-225 mg/day) the VT induction was suppressed in one patient. In a second patient the VT became nonsustained. Cycle length of VT in 4 patients with persistent induction of VT was longer after therapy (mean 88 ms). Antiarrhythmic efficacy of intravenous or oral tiracizine can be expected in at least one third of patients with VT. PMID- 1776307 TI - [Effect of the ACE-inhibitor captopril on the blood pressure and kidney function of patients with essential and renal hypertension]. AB - We retrospectively analysed the effects of a 12-month treatment with captopril (Tensiomin) in 46 patients. All of the patients had hypertension lasting for years (9 essential, 37 with chronic renal failure), 32 of them had proteinuria. Captopril was given in addition to, or in exchange for, other antihypertensive drugs. Under treatment with ACE-inhibitors, a small but significant decrease in diastolic blood pressure (0.4 torr/month) and in proteinuria (0.19 g/month) was seen (regression analysis). Discriminant analysis showed proteinuria and diastolic blood pressure to be the more modifiable, the younger the patients, the higher the proteinuria at the beginning and the longer the history of hypertension. Serum creatinine, blood urea nitrogen, serum protein and serum potassium did not change. PMID- 1776308 TI - [Serological diagnosis of viral hepatitis]. AB - The differentiation and classification of different types of viral hepatitis was essentially improved in the laboratory diagnosis by the direct determination of the virus in serum, viral antigens or their antibodies. Especially for the hepatitis B it is possible to recognize the infectivity by the serum marker HBeAg, the prognosis by seroconversion (HBeAg/HBeAb), the epidemiology, and vaccination prophylaxis, respectively. Without doubt, immunological marker have an increasing significance for prophylaxis, diagnosis, and therapy of viral hepatitis. PMID- 1776309 TI - [Epidemiology of attempted suicide]. AB - We studied 153 patients admitted to our observation ward after attempted suicide within the last 12 months. The time of attempt, age and sex distribution, social status, kind of suicide attempt and therapeutic procedures were registered. Our analysis showed, that exogenous factors like weather and season (April, November/December) must be considered as important for the time of suicide attempt. Furthermore we noted, that vacations, young age, isolation and unemployment were conducive to suicide attempt. Geriatric attempted suicides differed from those of other age groups in motivation and methods. They may represent on own entity of disease. PMID- 1776310 TI - [The introduction of thermodynamics in the theory of the microcirculation]. AB - By application of thermodynamics on the theory of microcirculation in tissues one must implicate the fact that both phenomena convection and diffusion through semipermeable membranes take place in "non opened" compartments. Based on this precondition the present paper shows that the known calculations by Kedem and Katchalsky and others are insufficient in order to describe the above mentioned processes and that the reflection coefficient delta is not relevant to the real movement of molecules through capillary walls. Furthermore, the basic equation of the microcirculation is to be improved by a diffusion component in order to represent a better approximation of the exchange situation in tissues. PMID- 1776311 TI - [History of medical graduation and special graduation system exemplified by Halle (III)]. AB - The history of the development of the doctoral theses in the field of medicine is demonstrated at the instance of the University of Halle. The changes concerning contents and organisation are shown which took place at the Medical School opened in 1694 in the course of 250 years. In this part of the treatise is accentuated above all the situation of the forties of our century, in which the processes of academic graduation more than ever before could become a political fact. PMID- 1776312 TI - [Gestational age and birth weight. 3. Ponderal Index, fetal acid-base metabolism and hypotrophy]. AB - 3rd communication: Ponderal-Index, fetal acid-base balance, acidotic risk and minimal placental weight (MPW). The Ponderal-Index of Rohrer (RI), the weight centile of the newborn and the fetal weight-length-coefficient (FWLC) were evaluated and compared as to the correlation with the variables of the fetal acid base balance. Using the example of continuous nicotine abuse in pregnancy, a new variable, the minimal placental weight (MPW), was defined. Its clinical applicability was preliminarily tested on the basis of selected cases. RI, FWLC and fetal weight-centiles show highly significant correlations with variables of the fetal acid-base balance. The closest statistical correlation was found for the fetal weight-centile. RI and FWLC did not proof to offer any advantages over this variable. The curve of the acidotic risk of the newborn showed a u-shaped distribution with maximum values in SGA-infants as well as macrosomic babies. Complex umbilical cord-entanglement were more frequently encountered in SGA fetuses. Macrosomic infants did not show an increased risk in this respect. The preliminary data of this evaluation suggest a predictive value of the MPW for the acidotic risk of the newborn. PMID- 1776313 TI - [The cervix at term--an ultrasonographic study]. AB - Transvaginal sonography with a 5 MHZ probe was used to measure the cervical length, width and the internal os. We examined 37 Primiparae (group 1) and 36 Multiparae (group 2) in the 40th and 41st gestational week vagino sonographically. All pregnancies were uncomplicated. For comparison between the datas of shortening and thickening of cervix the students t-test showed a significance of p less than 0.05. We registered vagino-sonographically that under painless uterine contractions the cervix shortened with an increase of thickness, while the internal os was constant and opened at least. A reformation of cervix in the relaxation phases was seen. PMID- 1776314 TI - [Precipitable C4-poor immune complexes in HELLP syndrome and pre-eclampsia]. AB - In 16 patients with HELLP syndrome and 10 patients with preeclampsia, laser nephelometric analysis of PEG-precipitated immunocomplexes revealed a decrease in the complement component C4. This is interpreted as a further indication of an immunologic component in the pathogenesis of these disorders. PMID- 1776315 TI - [Serotonin antagonism and uterine activity]. AB - The influence of naftidrofuryl, a serotonin blocking agent on the spontaneous motility of 25 myometrial strips collected during cesarean section was investigated. A highly significant (p less than 0.0001) reduction of the uterine activity after the application of naftidrofuryl 10(-6) was observed. PMID- 1776316 TI - [Analysis of neonatal and fetal blood for the diagnosis of congenital toxoplasmosis infection]. AB - A total of 175 serum samples, including 35 obtained from neonates and 5 from fetuses in whom connatal toxoplasma infection was suspected, were simultaneously tested for toxoplasma-specific IgA and IgM antibodies by immunosorbent agglutination assay (ISAGA). If sufficient serum was available, IgM-IIFT (Remington test) was also performed prior to and following IgG absorption. All the control samples from children not infected with toxoplasma (SFT negative, or titers less than or equal to 1:256) were negative in the IgA and IgM ISAGA. Of the 35 congenitally infected children, results were positive in 91.4% in the IgA and/or the IgM ISAGA. Of 5 fetuses with positive results in animal experiments 3 were positive in the IgM ISAGA. The serum from the fourth fetus was low positive in the IgM IIFT, while that from the fifth fetus was both IgM- and IgA-negative. The results of this study show that several methods should always be used simultaneously to detect connatal toxoplasma infection. PMID- 1776317 TI - [Transvaginal Doppler ultrasonographic patterns of total uterine perfusion in the development of utero-placental insufficiency with pre-eclampsia]. AB - In the case reported pathological flow velocity was detected by means of transvaginal Doppler imaging from the 7th week onwards. In correlation with pathological flow patterns placental insufficiency with pre-eclampsia developed later in the pregnancy. In the 29th week caesarean section became necessary because of a severe hypertensive crisis and pathological CTG's. PMID- 1776318 TI - [The treatment of acute fatty liver of pregnancy using plasma exchange]. AB - A 33-year-old gravida 6, para 5, developed acute fatty liver of pregnancy at 35 weeks' gestation. This clinical picture was seen after caesarean section and delivery of a healthy infant. Post partum hepatic dystrophy associated with coma hepatica, acute renal failure and disseminated, intravascular coagulation was successfully treated with three large-volume plasmaphereses using FFP exchange plasma in combination with haemodialysis. The patient survived and her liver function was restored to normal. PMID- 1776319 TI - [Acardius in twin pregnancy]. AB - The acardius is a rare but severe congenital anomaly. It occurs only in the context of multiple pregnancies and vascular anastomosis between the involved fetus and a multiple in cases of monochorionic placenta. The prenatal diagnosis of an acardius always has to be presumed in a multiple pregnancy within which a twin pair grow whenever cardiac activity can not be proved echographically. We present an acardius in a spontaneous twin pregnancy and discuss--based upon literature research--pathogenetic mechanisms, pathologic-anatomic and echographic conditions as well as therapeutic approaches in favor of the healthy multiple. PMID- 1776320 TI - [Fryns syndrome--pre and postnatal diagnosis]. AB - Fryns, in 1979, delineated an autosomal recessive lethal syndrome of multiple congenital malformations, including diaphragmatic defect, craniofacial anomalies and distal limb hypoplasia. So far, 33 cases of Fryns syndrome have been published. We here report the fourth case of Fryns syndrome with consanguinous parents. It was the second child of healthy Turkish parents (first cousins). Pregnancy was complicated by massive polyhydramnios since week 32. Imperforate anus and diaphragmatic defect was detected by ultrasound. Spontaneous delivery occurred in week 37, the child died 5 hrs after birth. Major symptoms were a partial aplasia of the left diaphragm, coarse facies, absent nails of the fifth fingers and fifth toes, VSD, imperforate anus and cerebellar heterotopia. We discuss, in the context of our observation and of the reports in the literature, the possible heterogeneity of Fryns syndrome and the possibility of prenatal diagnosis. PMID- 1776321 TI - [Down-regulation and hibernating myocardium]. AB - Some homeothermic animals can survive adverse conditions by hibernation, i.e., by reducing their body temperature in accordance with ambient temperature, thus reducing metabolism and vital functions. Six years ago, the term hibernation was introduced to describe a particular state of the myocardium. Although the meaning is different from that used in zoology and, thus, is misleading, it is used increasingly to describe a condition induced by moderate reduction in coronary flow. Some evidence in the literature suggests that the myocardium can actively reduce its mechanical function as a consequence of reduced coronary flow in order to prevent ischemia-induced injury. It is conceivable that the hibernating myocardium is the result of such a down-regulation of function. The hibernating myocardium can be characterized by decreased function in the hypoperfused area, which still exhibits active metabolism and remains viable. This is in contrast to "stunned" myocardium, which represents dysfunction during postischemic reperfusion, i.e., with coronary blood flow being close to normal. In analogy to hibernation in its original meaning, down-regulation and hibernating myocardium are considered to represent a protective mechanism, because such myocardium can quickly regain its initial function after restoration of physiologic blood flow. Because hibernating myocardium is salvageable, it has to be distinguished from other dysfunctional tissue that has lost its function due to ischemic damage, so that appropriate clinical interventions can succeed in restoring normal coronary blood flow. PMID- 1776322 TI - ["Hibernating myocardium". Time for a change of paradigm?]. PMID- 1776323 TI - [Successful high-frequency catheter ablation of an accessory atrioventricular conduction pathway in atrial fibrillation]. AB - This report describes the case of a 41-year-old patient with Wolff-Parkinson White syndrome and recurrent, highly symptomatic episodes of atrial fibrillation (with rapid heart rates of a mean of 250 beats/min) in whom transvenous catheter ablation of the accessory pathway was successfully performed in a relatively short time during the arrhythmia. The feasibility of an abbreviated approach to the relatively time-consuming ablation procedure in Wolff-Parkinson-White syndrome is discussed. PMID- 1776324 TI - [Significance of catheter ablation as emergency intervention in patients with sustained monomorphic ventricular tachycardia]. AB - Treatment of incessant ventricular tachycardia (VT) refractory to antiarrhythmic drugs and DC cardioversion is difficult and still debated. We performed catheter ablation (CA) of sustained monomorphic ventricular tachycardias (VT) with high energy DC shock (360-400 Joule) in 11 patients (pts) with incessant VT (duration greater than 24 h), refractory to antiarrhythmic drugs and DC cardioversion. Ten pts suffered from coronary disease and one pt from dilated cardiomyopathy. DC energy was delivered either at the site of the earliest endocardial activation (EEA) (six pts) or at the area of slow conduction (ASC) (five pts). In nine pts incessant VT could be terminated by DC ablation; two pts had to undergo emergency endocardial resection. During the mean follow-up of 31 +/- 26 (1-66) months nonfatal VT recurrences occurred in five pts with CA at the EEA and in one pt with CA at the ASC. We conclude that CA of incessant VT is an effective approach to terminate VT. However, there is a high incidence of nonfatal recurrence after CA, particularly when DC energy is delivered at the earliest site of endocardial activation. PMID- 1776325 TI - [Collaterals do not prevent infarcts in subacute vascular stenosis following initially successful vascular stent implantation]. AB - Sufficient collateralization may prevent acute myocardial infarction despite complete obstruction of a coronary artery. Nevertheless, it is unclear if collaterals which regressed after restoration of antegrade flow may be recruited fast enough to prevent myocardial infarction in case of subacute coronary artery thrombosis. In 50 patients (pts) (48 males, two females, age 60 +/- 7.6 years) with high-grade coronary artery stenosis and collaterals from the contralateral non-diseased coronary artery, stenting devices (Palmaz-Schatz) were implanted. In seven patients subacute thrombosis of the stent occurred. Six patients developed myocardial infarcts with a CKmax greater than 100 U/l (mean 943 +/- 635 U/l). One patient was treated by intravenous thrombolysis, three pts with acute PTCA, one patient with both, and one patient had CABG after unsuccessful PTCA; no patient died. There was no statistical correlation to the degree of collateralization and time after, or location of stent implantation, most likely because of the small number of cases. CONCLUSION: This retrospective study shows that collaterals in humans with a high-grade coronary artery stenosis which has regressed after restoration of sufficient antegrade blood-flow cannot be recruited fast enough to prevent myocardial necrosis in case of subacute coronary artery occlusion. This is in contrast to earlier results obtained in animal studies. PMID- 1776326 TI - [Results of myocardial scintigraphy in patients with left bundle-branch block using Tl-201 and Tc-99m-MIBI]. AB - Tl-201 myocardial scintigrams in patients with left bundle-branch block (LBBB) are frequently non-diagnostic with respect to presence or absence of coronary artery disease (CAD). The new myocardial perfusion tracer Tc-99m-MIBI requires a different protocol due to its insignificant redistribution. Therefore, scintigraphic patterns in LBBB cannot be deduced from experiences with Tl-201. In a total of 132 patients with LBBB, 81 studies were carried out with Tl-201, another 81 studies with Tc-99m-MIBI. In 30 patients both radiopharmaceuticals were employed. 72% of the Tl-201 scintigraphies in constant LBBB resulted in a reversible septal deficit and 9% in a constant septal deficit. In contrast, 70% of the Tc-99m-MIBI scintigraphies resulted in a constant septal deficit and only 19% in a reversible septal deficit. Similar "discrepancies" were found in LBBB patients in whom CAD has been angiographically excluded (N = 17). All patients, however, with LAD or RCA stenoses and constant LBBB showed reversible septal deficits with either tracer, Tl-201 (N = 12) or Tc-99m-MIBI (N = 10). It is concluded: 1) that the majority of patients with LBBB has reduced septal perfusion, 2) that this reduction is typically stress-independent in absence of CAD, and 3) that this stress-independent perfusion deficit is, in general, only differentiated from stress-induced ischemia (in case of CAD) with using the Tc 99m-MIBI protocol. PMID- 1776327 TI - [Styropore compression bodies in the management of puncture wounds following angiography or vascular interventions]. PMID- 1776328 TI - [Inhibition of thrombocyte function in coronary heart disease. Results with molsidomine (Corvaton)]. PMID- 1776329 TI - [Effect of SIN 1 on the interactions of endothelial cells and thrombocytes]. AB - A new method has been developed to investigate the direct effect of endothelial cells on platelet aggregation in the presence of cultured confluent human EC monolayers. The inside of the disk shaped cuvettes are covered by human umbilical vein ECs. The cuvettes rotate in the light beam of a photometer. In these cuvettes the effect of different aggregation inducers was inhibited in a concentration-dependent manner, e. g. for collagen at 0.5 microgram/ml, ADP at 5 x 10(-7) M, epinephrine at 5 x 10(-7) M and thrombin at 0.05 U/ml final concentration. (Platelet count 5 x 10(5)/microliters). Higher concentrations of the inducers led to irreversible platelet aggregation and were used for testing of antiplatelet drugs. In this system we detected a synergism between the antiaggregatory effect of the EC monolayer and that of SIN 1 (Cassella, Frankfurt/Main) the main metabolite of Molsidomine. 10 micrograms/ml PRP of SIN 1 alone partially inhibited platelet aggregation induced by 1 microgram/ml collagen and 10(-6) M ADP respectively in uncovered aggregation cuvettes. In the presence of an EC monolayer complete inhibition of platelet aggregation was obtained at a 5-fold final concentration of both inducers. After pretreatment of ECs with 1 mmol ASA over 30 min. the antiaggregatory effect of SIN 1 decreased, but was more pronounced (50%) than in uncovered cuvettes (25%). PMID- 1776330 TI - [Inhibition of platelet activation by endothelium-derived relaxing factor EDRF/NO and NO releasing dilator substances]. AB - Several circulating agonists and hydromechanic factors such as the viscous drag induced shear forces of the bloodstream stimulate the release of EDRF/NO from endothelial cells. Abluminally released EDRF controls vascular tone, luminally released EDRF diffuses into the platelets, especially when they come into contact with the endothelial cell lining. Stimulating soluble guanylate cyclase in the platelets causes a rise in cGMP and a reduction in intracellular Ca(2+) concentrations which suppresses platelet adhesion and aggregation, and potentiates the effects of PGI2-induced cAMP-increases. Nitrovasodilators which spontaneously release NO, such as molsidomine and sodium nitroprusside, can substitute for diminished EDRF-release from deficient endothelial cells and, likewise, suppress platelet aggregation in vitro and in vivo. PMID- 1776331 TI - [Interaction between thrombocytes and the coronary system in the presence of SIN 1 and nitroglycerin after endothelial damage]. AB - For further examination of the interaction of platelets with coronary endothelium in more detail, porcine platelets were infused into the coronary system of isolated, Langendorff-perfused rabbit hearts. The hearts were preincubated with very low activity of collagenase inducing functional endothelial lesion characterized by 50% reduction of EDRF-dependent dilation. Platelet infusions into those hearts were accompanied by a sudden myocardial failure and a significant retention of the platelets infused. When in addition to platelets the hearts were perfused with SIN 1 or GTN the global coronary flow did not fall below critical values. Moreover, the platelet recovery was not any longer diminished. After heart passage the platelets aggregation was more inhibited with SIN 1 than with GTN. SIN 1 and GTN in concentrations applicated to the heart could not inhibit porcine platelet aggregation, thus the aggregation behaviour reflects the different availability for platelets of the liberated NO during coronary passage. PMID- 1776332 TI - [Nitric oxide dependence of the anti-thrombotic effect of sydnonimines in coronary arteries of swine]. AB - The metabolites of sydnonimine-derivatives generate nitric oxide (NO) and inhibit, like NO, platelet aggregation and adhesion. The purpose of the present study in anesthetized pigs was to examine if sufficient NO is generated by 3 sydnonimine-derivatives in vivo in order to prevent platelet-dependent arterial thrombosis. Stenosis of mechanically damaged coronary arteries resulted in cyclical blood flow reductions due to recurrent formation and embolization of platelet-thrombi. Injection of molsidomine (0.3 mg/kg) significantly reduced the frequency of cyclical flow reductions by 66%: 1.8 +/- 0.8/30 min versus 5.3 +/- 0.5/30 min before injection (p less than 0.01, n = 6). Molsidomine decreased arterial blood pressure by 34 +/- 7 mmHg (systolic) and 23 +/- 6 mmHg (diastolic) in these animals. Two further sydnonimine-derivatives were studied at a dose with similar hemodynamic effects. The onset of action of CAS 936 (2 mg/kg) was slow as compared to molsidomine. Therefore, CAS 936 reduced the frequency of cyclical flow reductions by 29% in the first hour following injection, but by 50% (p less than 0.05, n = 7) during the second hour. The remaining flow cycles were very small (mean size reduction 88%). C 89-4095 (0.6 mg/kg) prevented cyclical flow reductions nearly completely (reduction by 93%, p less than 0.01, n = 6). The subsequent injection of oxyhemoglobin reinitiated cyclical flow reductions in all three treatment groups. The antihypertensive drug dihydralazine (0.25 mg/kg) reduced blood pressure in 6 pigs by 38 +/- 3 (systolic) and 35 +/- 5 (diastolic) mmHg but had no effect on the frequency of cyclical coronary flow reductions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1776333 TI - [Endothelial factors and thrombocyte function]. AB - Platelet activity in circulating blood is controlled by platelet-vessel-wall interactions. This includes the generation of endothelium-derived factors, such as the arachidonic acid metabolite prostacyclin and endothelium-derived relaxing factor (EDRF), probably NO, generated from L-arginine. Both compounds inhibit platelet function and are arterial vasodilators. Endothelial dysfunction, e.g. during advanced atherosclerosis, is associated with reduced local formation of these compounds. This may result in platelet hyperreactivity and an increased risk of acute thrombembolic complications. Exogenous administration of synthetic PGI2-mimetics inhibits platelet function. This is a short-term action and the dosage is limited by systemic hypotension. NO-donators (molsidomine, organic nitrates) inhibit platelet-related vasospasm in stenosed coronary arteries in animal experiments. The significance of antiplatelet effects of organic nitrate vasodilators regarding their antianginal effectivity requires further study. PMID- 1776334 TI - [Thrombocyte aggregation and fibrinolysis in healthy probands treated with molsidomine, isosorbide-5-mononitrate and placebo]. AB - Twelve healthy volunteers received either a single oral dose of molsidomine (4 mg), isosorbide-5-mononitrate (ISMN, 20 mg), or placebo in a randomized, double blind fashion. Blood was drawn prior to, as well as 30 and 60 min after intake of the respective drug. Platelet aggregation and the plasma levels/activity of plasminogen activator (tPA) and its inhibitor (PAI-1) were determined. In contrast to ISMN and placebo, molsidomine provoked a significant reduction in platelet aggregability. No alteration in plasma tPA concentrations was observed independent of whether molsidomine, ISMN, or placebo was applied. However, plasma PAI-1 activity was considerably reduced following molsidomine, but not altered following ISMN or placebo. We conclude that a single oral dose of molsidomine, but not of ISMN inhibits platelet aggregation and increases the fibrinolytic potential in healthy volunteers. PMID- 1776335 TI - [Effect of molsidomine on fibrinolytic activity: a double-blind, randomized study]. AB - The influence of molsidomine on endogenous fibrinolytic activity was studied in a double-blind, randomized, placebo-controlled trial involving 12 male healthy volunteers. When measured 3 h after oral intake of molsidomine (16 mg, slow release formulation) the activity of tissue plasminogen activator (t-PA) in plasma was significantly increased from 1.1 +/- 0.1 to 1.6 +/- 0.1 IU/ml. In contrast, the activity of plasminogen activator inhibitor (PAI-I) decreased from 17 +/- 2 to 12 +/- 1 AU/ml. The ratio of t-PA/PAI-I (x 100), calculated as index for the endogenous fibrinolytic activity increased significantly from 8.1 +/- 1.1 to 14.5 +/- 1.6. The ratio was unaltered after intake of placebo. Additionally, collagen-induced platelet aggregation was significantly inhibited following intake of molsidomine. The results demonstrate a significant increase in endogenous fibrinolytic activity after oral intake of molsidomine. These effects may be of therapeutic value in patients with coronary heart disease and unstable angina. PMID- 1776336 TI - [Synergism of PGI2 and molsidomine in arterial occlusive disease]. AB - In order to test the hypothesis, whether molsidomine acts as an in-vivo NO-donor, we examined the synergism of PGI2 and molsidomine in patients with peripheral vascular disease. The effect was quantified by measuring the platelet uptake at atherosclerotic lesion sites, as well as measuring the platelet survival after radiolabelling the autologous platelets with 111Indium-oxine. The combination of both substances achieved a significantly higher (p less than 0.01) benefit in comparison to single administration of either of the components. This synergism was shown via a decrease in thrombogenicity and a prolongation in platelet survival. These data indicate that a potentiating synergism of hemostatic regulation can be achieved via an in-vivo interaction between NO and PGI2. PMID- 1776337 TI - [Effect of molsidomine on thrombocyte aggregation in unstable angina pectoris after parenteral administration of nitroglycerin]. AB - In the present study, we took whole blood from 12 patients treated with heparin, acetylsalicylic acid, and nitroglycerin i.v., to measure the aggregability of platelets after acute and prolonged i.v. application of nitroglycerin and after oral application of molsidomine. Aggregation was induced by platelet-activating factor (PAF). As a measure for platelet aggregability, we determined the PAF concentration needed to induce irreversible aggregation (threshold dose) and the maximum slope of the aggregation curve with 50 nM PAF. At the beginning, 1 h after the onset of nitroglycerin infusion (3 mg/h), 24 h and 1 h after increasing the nitroglycerin dose (5 mg/h), neither the maximum slope nor the threshold dose for PAF-induced aggregation differed significantly. However, after additional oral application of molsidomine the maximum slope of the aggregation curve decreased significantly. These data indicate that molsidomine decreases the aggregability of platelets in patients, even after pretreatment with heparin, acetylsalicylic acid, and nitroglycerin. PMID- 1776338 TI - [Modification of thrombocyte function in diagnostic and therapeutic interventions in cardiology]. AB - In patients with coronary heart disease platelet activity may be pathologically increased. Administration of platelet inhibitor drugs is an established treatment principle. The interactions between platelet activation, platelet inhibitor drugs like acetylsalicylic acid (ASA) or molsidomine and the endogenous fibrinolysis were studied in three trials. Platelet aggregation and thromboxane synthesis are dose- dependently inhibited after oral intake of ASA (0, 10, 30, 100 or 500 mg/d) Additional intake of the antianginal agent and nitric oxide donator Molsidomine (8 mg) results in a synergistic platelet inhibitor effect characterized by a significantly delayed aggregation response. In a group of patients with coronary artery stenoses platelet activity was markedly enhanced, when compared to healthy individuals. During physical exercise platelet activity was even further enhanced and plasma t-PA-activity was increased by a factor of 2.2. The stimulation of the endogenous fibrinolytic system was markedly reduced when compared to healthy subjects. Following successful coronary angioplasty 393 patients were randomized to receive either molsidomine (2 x 8 mg/d) or ASA (1 x 500 mg/d) plus nifedipine (3 x 20 mg/d). Coronary angiography performed after the 6 month treatment period revealed a restenosis rate of 29% in the molsidomine group and of 33% in patients treated with ASA + nifedipine. This difference was not statistically significant. PMID- 1776340 TI - [A new generation in varicose vein surgery?]. AB - A new generation of varicose vein surgery is arising. Its invasivity is about half of what it has been. Therefore patients spend less time in hospital, their incapacity of work is reduced, they have less complications and the cosmetic results are much better. This progress has been made possible by different means. First of all smaller incisions are used for every step of the stripping procedure. Varicose branches are removed with small hooks through incisions of only 1-5 mm in length. Other techniques also help to reduce invasivity and to improve the results, such as the endoscopic treatment of Cockett's perforators, the skin closure with isoelastic adhesive tape and the bloodless operation field by Lofqvist's new roll-on tourniquet. The new diagnostic techniques help in two ways. First, they let the surgeon further reduce invasivity and second they allow for more dependable results. These newer operative techniques call for additional education. It is provided by the specialties which are engaged in phlebologic surgery anyhow, i.e. angiology, vascular and general surgery, dermatology and general medicine. PMID- 1776339 TI - [Platelet aggregation with SIN 1: comparison with isosorbide-5-mononitrate and acetylsalicylic acid]. AB - SIN 1, the bioactive metabolite of molsidomine, not only appears to lack the problem of inducing nitrate tolerance, but also exerts antiaggregatory and fibrinolytic properties. These effects, which either are not or only in part shared by the drug isosorbide-5-mononitrate, might be beneficial in the prevention of thromboembolic complications in cardiovascular disease. In contrast to the effects of acetylsalicylic acid, SIN 1 already inhibits aggregation during the first phase of aggregation, and it inhibits aggregations induced by agonists that are not or only marginally influenced by acetylsalicylic acid (such as the aggregation induced by platelet activating factor). Thus, the antiaggregatory effects of molsidomine cannot replace the effects of acetylsalicylic acid, while a combination of both drugs might be of benefit in the treatment of patients with cardiovascular disease. PMID- 1776341 TI - Serum plasmalogens in ischemic cerebrovascular disease. AB - Plasmalogens, a subclass of glycerophospholipids are ubiquitous constituents of cellular membranes and serum lipoproteins. Comparing concentrations of plasmalogens in sera from patients suffering from ischemic cerebrovascular disease with serum levels in a normal population significantly lower values were found for patient sera. PMID- 1776342 TI - Immunohistochemical investigation of pericytes in chronic venous insufficiency. AB - Patients with chronic venous insufficiency show typical glomerulum like alterations of cutaneous capillaries. Objective of this study was to determine any changes of the alignment of pericytes around cutaneous capillaries in CVI patients. Skin biopsies from the area of the medial malleolus were taken from 42 patients with CVI, 5 healthy individuals and 11 cadavers without history of CVI. Sections were stained with HHF35, anti alpha and gamma muscle actin with the avidin-biotin-peroxidase method (ABC) and anti vimentin with the alkaline phosphatase anti-alkaline phosphatase technique (APAAP). The stage of stasis dermatosis was assessed and sections were examined for pericyte changes. Among the collective of 42 patients with CVI, 31 patients showed slight or severe pericyte changes, 11 patients were without changes. None of the sections from cadavers or healthy patients showed any pericyte changes. Pericytes are among other functions possibly involved in microvasculature regulation and wound healing. Thus destruction of the pericyte envelope might lead to microcirculatory dysfunction. This could be one of the causes that lead to leg ulcers in CVI. PMID- 1776343 TI - Morphology of chronic venous insufficiency--light and electron microscopic examinations. AB - The morphology of chronic venous insufficiency (cvi) as seen by light and by electron microscopy with additional immunohistological examinations is described. The course of events follows the well-known pattern of "injury and repair". The tissue injury is due to an increased capillary permeability induced by rise of the intravenous ambulatory pressure. This results in the formation of a pericapillary edema ("halo"). No evidence of a pericapillary fibrin deposition could be found, but fibrinogen might well be extravasated together with erythrocytes. The accumulation of cell debris and metabolites around the capillaries induces a secondary ("resorptive") inflammation with mobilisation of white blood cells and formation of a granulation tissue. Occlusion of small blood vessels is responsible for the development of micronecroses. These lesions have to be repaired by a new granulation tissue. Finally a fibrous scar tissue with impaired microcirculation results. Persistence of the venous stasis prevents a restitution of the tissue. Only by permanent elimination of the venous stasis, a restitution of the scar tissue may be achieved. PMID- 1776344 TI - [Improvement in noninvasive diagnosis of the greater and lesser saphenous vein insufficiency with duplex sonography]. AB - When compared with the phlebogram, the duplex examination proves to be a suitable procedure for diagnosing the incompetence of the junction of the long saphenous vein and of the short saphenous vein. The sensitivity and the specificity of the duplex at the junction of the long saphenous vein amounts to 0.96 and 0.75 respectively and at the junction of the short saphenous vein they are 0.90 and 0.67 respectively. PMID- 1776345 TI - Cost effectiveness of non-invasive tests including duplex scanning for diagnosis of deep venous thrombosis. A prospective study carried out on 511 patients. AB - Recent studies have elucidated the cost-effectiveness of various diagnostic methods used to detect deep venous thrombosis (DVT) of the lower limbs. These methods include Doppler, plethysmography and labelled fibrogen tests. However, duplex scanning has recently proven to be a more reliable examination. With a view to establishing a realistic appraisal of matters as they stand, the authors have carried out a prospective study to compare the relative cost-effectiveness of purely physical examination, duplex scanning associated with strain-gauge plethysmography, contrast venography indicated for each proximal DVT, and contrast venography as a first-choice examination. 511 consecutive patients suspected of DVT of the lower limbs were examined using the various non-invasive methods cited above. 185 of the patients underwent contrast venography. When compared with those of the non-invasive tests, the results of the latter examination provided for extrapolation to the total population of 511 patients so as to better evaluate costs. We are able to conclude that physical examination alone is neither cost-effective nor risk free. Non-invasive tests, which are more reliable, provide annual savings greater than 1,500,000 FF ($ 240,000) with respect to venography. Performing venography for each proximal DVT increases spending by little: savings are again greater than 1,200,000 FF ($ 192,000). PMID- 1776346 TI - Ischemic venous thrombosis. AB - Eight patients were treated for ischemic venous thrombosis of the extremities. The patients were evaluated retrospectively concerning their history, clinical signs and symptoms, management and follow-up. Neoplastic disease and immobility were the major etiological factors. Once diagnosed, an urgent combined medical and surgical approach proved to be successful in all patients as far as restoration of blood flow to the limb was concerned. PMID- 1776347 TI - [Embolic occlusion of arteries of the upper extremity]. AB - Ninety-nine patients underwent embolectomy of upper extremity arteries; in 12% of the cases reoperation and in 4% amputation was necessary. Thrombosis is the cause of reocclusion of the brachial artery, based on endothelial lesions of the axillary passing into the brachial artery. At autopsy studies these andothelial lesions were verified by histological and electron-microscopical examinations in a high percentage. Therefore embolectomies should be performed very carefully by means of thin fogarty catheters. Postoperative anticoagulant therapy seems to improve the survival rate. PMID- 1776348 TI - Primary varicose veins: hemodynamic principles of surgical care. The case for the ambulatory stab evulsion technique. AB - The recently accumulated hemodynamic and anatomic data on primary varicose disease, coupled with concomitant quest for maximal efficiency, cosmesis and saphenous vein preservation, is changing the surgical approach to the classical stripping operation. The long convalescence, with possible loss of income, the possible permanent nerve injury, and the possibility of removing normal truncular veins, makes the stripping operation, in many cases, an overkill. In contrast, the ambulatory stab evulsion phlebectomy (truncal and tributary), performed with the specially designed hooks and, performed in conjunction with ligation of the most proximal source of reflux (escape point), will effectively abolish the regurgitant flow and lower the existing increased ambulatory venous pressure. It will remove the tributary varicosities and thus disconnect all possible (distal) perforators, while undamaged veins, potential graft materials, are left in situ. The incisions of 1.5-3 mm, will guarantee excellent cosmesis, and due to minimal trauma, saphenous and sural nerve injury can be avoided as well. Performed in an ambulatory setting, under loco-regional anesthesia, which permits immediate resumption of the normal daly activities, makes the method appealing from the cost efficient point of view too. This hemodynamically and anatomically sound technique is however dependent on precise clinical as well as non invasive (Doppler ultrasound, air-plethysmography, and in certain cases duplex imaging) evaluation of each case, permitting the tailoring of an individualized treatment protocol for each patient. PMID- 1776349 TI - Extracranial carotid artery aneurysms. AB - A material of eighteen patients with carotid artery aneurysms is presented. Mean age of the patients was 57.9 +/- 15.1 years. Most of the patients were asymptomatic or had only a pulsating mass on the neck. One patient had stroke and five TIA. Most common etiology was arteriosclerosis. Two patients got contralateral and two ipsilateral hemiparesis, one patient was unconscious immediately after the operation. Shunt was used on four of these patients. Three patients died, two for neurological reasons and one myocardial death. During the follow up time there were no carotid related diseases. Two patients died of cancer and two of heart attacks. Mean follow up time was 78.6 months. Eight patients attended the follow up studies which were performed by duplex scanning or angiography. They were free of neurological symptoms and their carotid arteries were patent. PMID- 1776350 TI - [Risk factors for early fatality of ruptured abdominal aortic aneurysms]. AB - Early mortality (EM) following surgery for ruptured abdominal aneurysm continues to be extremely high. In the literature EM still ranges between 30 and 85%, despite improvement of surgical intervention and perioperative management in the recent years. Numerous studies investigate intra- und postoperative parameters, but little is known about preoperative transportation circumstances and the clinical condition prior to intervention. The transportation system at our clinic allowed a complete retrospective assessment of these parameters which were included into the evaluation of the risk factor analysis of the study. From 1974 to 1986 142 patients (131 male, 11 female, mean age: 68.8 years [46-89 years]) were operated on ruptured abdominal aneurysms. Time intervals prior to admission and surgical intervention as well as perioperative data were retrospectively assessed. The patients were divided in: deceased (D) within 30 days and survivors (S). Late survival was assessed either by letter or telephone interview. Age and sex showed no influence on the early mortality. Transportation time and time interval: admission/operation were similar in both groups. The shockindex showed a significant difference. D: 1.1 +/- 0.27; S: 0.8 +/- 0.16. Anuria was seen in 66% of the diseased and 26% of the surviving patients. If free perforation was detected 20 of 30 patients died. The total amount of transfusion differed significantly: D: 6.8 +/- 2.51; S:3.9 +/- 2.01. If diaphragmal X-clamp was necessary 7 of 8 patients died. The necessity of catecholamine support postoperatively was 64% for deceased patients. Dialysis was necessary in 77.8% of the deceased patients. 84% of D developed an ileus and 67% of D developed a pneumonia.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1776351 TI - [Increase in skin blood circulation and transcutaneous oxygen partial pressure of the top of the foot in lower leg immersion in water containing carbon dioxide in patients with arterial occlusive disease. Results of a controlled study compared with fresh water]. AB - Semi-quantitative Doppler laser flowmetry and measurement of transcutaneous oxygen partial pressure (TCPO2 in mmHg) are reliable, non-invasive methods of continuous measurement suitable for underwater use. We measured the effect of aqueous CO2 (succinate + sodium bicarbonate = Kao Bub; 1400 mg CO2 per kg water) compared with fresh water (both at 34 degrees C, depth of leg immersion 35 cm, immersion time 20 min) on circulation and TCPO2 in the feet of 15 patients with bilateral stage-II occlusion of the Aa. fem. superf. intraindividually in a randomised, crossover trial. Measurements were made at the same time of day on two consecutive days. No change in either cutaneous microcirculation or TCPO2 was observed during immersion in fresh water. During immersion in a CO2 bath both culaneous blood flow (as expressed by Doppler laser flux) and the amplitude of the Doppler laser vasomotion flux increased more than threefold (p less than 0.001, Wilcoxon), while sitting TCPO2 increased by over 10% (from 63 to 71 mmHg; p less than 0.001). The observed changes in oxygen dissociation and cutaneous microcirculation may help to provide an explanation for the well-known therapeutic effect of CO2 baths in all stages of occlusive arterial disease. PMID- 1776352 TI - Drug therapy of diabetic neuropathic foot ulcers: transvenous retrograde perfusion versus systemic regimen. AB - Concerning the resistance of diabetic neuropathic plantar ulcers (DNPU) against systemically applied drugs, the "Retrograde Venous Perfusion" (RVP) was introduced by C. Ferreira in 1988. An isotonic saline solution containing gentamycin, buflomedil, dexamethasone, heparin and lignocain is injected into a dorsal foot vein under arterial occlusion of the lower leg. In the present study RVP treatment (1/90-12/90) was done in 20 patients with DNPU and the results were compared to a control group (CG) treated with systemic i.v. infusions (n = 20). After 10 days of treatment ulcers were closed in 6 vs. 0 (CG) patients, size diminuted in 10 vs. 3. Non responders were not observed under RVP in contrast to CG (7/20 cases). In 4 of 5 RVP patients with secondary osteomyelitis, yet in none of 7 CG cases some restoration of osteolytic lesions was seen. Rate of toe amputation dropped from 20% (CG) to 0%, mean time of hospitalization was cut by 7 days in the RVP group. Planimetry of the ulcered areas confirmed remarkable diminution in the RVP group. Considering the striking differences between either regimen, RVP can be recommended for treatment of DNPU especially when complicated by osteomyelitis. PMID- 1776353 TI - Laser Doppler vasomotion among patients with post-thrombotic venous insufficiency: effect of intermittent pneumatic compression. AB - Laser Doppler fluxmetry (LDF) was used to measure skin blood flux and its vasomotion, i.e. rhythmical variations in nineteen patients with post-thrombotic venous insufficiency, and in eight healthy control subjects before and after a single intermittent pneumatic compression treatment session. Following the compression treatment session skin blood flux increased and vasomotion was seen in all the patients. The transcutaneous oxygen tension also increased slightly, but significantly, from 25.4 (range 3-56) mmHg to 30.8 (range 7-61) mmHg (p less than 0.01). It is suggested that IPC treatment decreases venous distention and venous pressure thereby decreasing vasocontrictor stimulus. This seems to restore normal skin blood flow including vasomotion. PMID- 1776354 TI - [Thoracic outlet syndrome and tumor embolism]. AB - This is probably the first report of a rare tumor-embolization from a leiomyosarcoma into the brachial artery simultaneously linked with a thoracic outlet syndrome. After transaxillary rib resection and thromboembolectomy only histological examination of the resected specimen allowed the final diagnosis: leimyosarcomatous embolus. PMID- 1776355 TI - [Differential diagnosis of the "fat leg"--a case report]. AB - This is a report about a patient, who came to our hospital because of a painful thickening of her left calf. She was treated with Heparin 48,000 IU/24 hours. A crural vein thrombosis was suspected. Instead of improvement of the symptoms the diameter of the leg grew until the state of a complete Compartment-syndrome. After exact inspection (Sonography, Computertomogramm) we found a hematom of the calf, caused by a rupture of the tibial part of the gastrocnemius muscle. Fasciotomies and evacuation of the blood brought a restitutio ad integrum. Diagnostic methods and faults are discussed. PMID- 1776356 TI - [Zapping disease--a new scourge of God]. PMID- 1776357 TI - Synonymous codon usage in Saccharomyces cerevisiae. PMID- 1776358 TI - Activity of promoter mutants of the yeast ribosomal RNA gene with and without the enhancer. AB - The promoter and enhancer of the rRNA gene of Saccharomyces cerevisiae have been studied using a nuclease S1 protection assay to detect transcripts of an rRNA minigene in transformed yeast. Analysis of 5' deletion mutants showed that DNA between -163 bp and -155 bp was important for promoter activity and that some DNA between -155 bp and -145 bp was essential. The importance of DNA far upstream from the initiation site was confirmed by showing that minigene expression was much reduced by linker scanner mutations clustered around -148 bp, -133 bp and 100 bp, and was abolished by mutations clustered around -118 bp. The enhancer for rRNA biosynthesis increased transcription from all of the five mutated promoters that were tested. The magnitude of the enhancer effects on weakly active promoters was two- to three-fold less than on the wild-type promoter. Expression of a minor transcript in a 5' deletion to -10 bp was substantially reduced by a mutation which altered two base pairs in the core sequence of the promoter proximal REB1 binding site. PMID- 1776359 TI - An efficient transformation procedure enabling long-term storage of competent cells of various yeast genera. PMID- 1776360 TI - The ureidoglycollate hydrolase (DAL3) gene in Saccharomyces cerevisiae. AB - The DAL3 gene has been sequenced and found to encode a 195 amino acid protein with a molecular weight of 21,727. The four carboxy-terminal amino acids of DAL3 product (Cys-Ile-Ile-Ile) are homologous to those (CAAX) previously shown to be the primary structural signal for post-translational farnesylation of yeast RAS protein and mating factor. This modification is reported to be responsible for membrane localization of proteins containing it. The upstream region of DAL3 contains six copies of a sequence that is homologous to the positively acting DAL UASNTR reported to be required for transcriptional activation of the DAL5 and DAL7 genes. Missing from the DAL3 upstream region were any sequences related to those shown to be required for a DAL7 response to inducer, the UIS element. This correlates with the previous report that DAL3 expression is independent of the allantoin pathway inducer. PMID- 1776361 TI - Functional analysis of a conserved amino-terminal region of HSP70 by site directed mutagenesis. AB - Hsp70 proteins have been highly conserved throughout evolution. As a first step in a structure-function analysis of hsp70, we constructed and analysed the consequences of mutations in a portion of the SSA1 gene, a member of the Saccharomyces cerevisiae HSP70 multigene family, that encodes a nearly invariant region near the amino terminus. Analysis of strains expressing SSA1 proteins with alterations at positions 8, 11 and 15 showed that these conserved residues within this region are critical for normal functioning of the protein. SSA1 protein containing either of two changes at position 15 was able to slightly complement the inviability of an ssa1ssa2ssa4 strain, but was inactive in other complementation assays. The other mutant proteins tested were unable to complement any tested phenotype. Effective interallelic complementation of several phenotypes was observed when a mutant protein substituted at position 8 was expressed in the same cell with either of two proteins carrying substitutions at position 15, suggesting that hsp70 acts as a multimer. Evidence from previous studies suggests that hsp70 proteins engage in ATP-driven cycles of binding and release from peptides. The ability of the mutant proteins to bind ATP and a peptide was tested. The Ssa1p carrying a substitution at position 8, which inhibits growth of cells carrying wild-type SSA proteins, showed a defect in release from a peptide relative to wild type. Two mutations, one each at position 8 and 15, resulted in accumulation of phosphorylated isoforms which may be a normal, transient hsp70 intermediate. PMID- 1776362 TI - Cell wall glucomannoproteins of Saccharomyces cerevisiae mnn9. AB - Mannoproteins were isolated from Saccharomyces cerevisiae mnn9 mutant cell walls by laminarinase digestion and purified by affinity and anion-exchange chromatography. The purified mannoprotein fraction contained three predominant proteins with molecular masses of 300 kDa, 220 kDa and 160 kDa. These compounds were absent in an SDS extract of cell walls or in a hot-citrate extract of mnn9 cells. The carbohydrate part of the purified mannoproteins consisted of (N acetyl)glucosamine, mannose and glucose in a molar ratio of 1:53:4. O Glycosidically linked chains, containing 70% of the mannose, were released by mild beta-elimination. N-Glycosidically linked chains, representing 80% of the (N acetyl)glucosamine and 20% of the mannose, were released by peptide N-glycosidase F (PNGase F) digestion. Complete degradation of protein by alkaline hydrolysis released besides the N- and O-glycosidically linked chains, another type of carbohydrate chain containing the residual (N-acetyl)glucosamine, mannose and most of the glucose in a molar ratio of 1:17:18. Glucose was beta-glycosidically linked. The results indicate that beta-glucose is linked to PNGase F-resistant N linked chains present on cell wall mannoproteins. We propose that these chains are responsible for the linkage between mannoproteins and glucan in the cell wall. PMID- 1776363 TI - Yeast mutant affected for viability upon nutrient starvation: characterization and cloning of the RVS161 gene. AB - In yeast, nutrient starvation leads to entry into stationary phase. Mutants that do not respond properly to starvation conditions have been isolated in Saccharomyces cerevisiae. Among them the rvs161 mutant (RVS for Reduced Viability upon Starvation) is sensitive to carbon, nitrogen and sulphur starvation. When these nutrients are depleted in the medium, mutant cells show cellular viability loss with morphological changes. The mutation rvs161-1 is very pleiotropic, and besides the defects in stationary phase entry, the mutant strain presents other alterations: sensitivity to high salt concentrations, hypersensitivity to amino acid analogs, no growth on lactate or acetate medium. The addition of salts or amino acid analogs leads to the same morphological defects observed in starved cells, suggesting that the gene could be implicated mainly in the control of cellular viability. The gene RVS161 was cloned; it codes for a 30,252 daltons protein. No homology was detected with the proteins contained in the databases. Moreover, Southern analysis revealed the presence of other sequences homologous to the RVS161 gene in the yeast genome. PMID- 1776364 TI - Repression of a mating type cassette in the fission yeast by four DNA elements. AB - The fission yeast, Schizosaccharomyces pombe, expresses one of two alternative mating types. They are specified by one of two determinants (M or P) present at the mat1 locus. In addition, silent copies of M and P are present on the same chromosome. In the present work we demonstrate that the difference between the active and the silent stage of the P determinant is controlled by four repressive elements that are located at the silent locus. There are two elements to the left and two to the right of the mating type cassette. Both elements to the left and either one of the two elements to the right are required for an effective blockage of transcription. When they are combined, the four elements define a highly efficient silencer functionally similar to the HMRE and HMLE and HMLI silencers in Saccharomyces cerevisiae. In addition, the DNA surrounding the silent P locus confers symmetric partitioning in mitosis to Schizosaccharomyces pombe ars plasmids. PMID- 1776365 TI - The SEC11 gene is situated adjacent to DAL81 on the right arm of chromosome IX in Saccharomyces cerevisiae. PMID- 1776366 TI - The complete sequence of a 7.5 kb region of chromosome III from Saccharomyces cerevisiae that lies between CRY1 and MAT. AB - We report the sequence of a 7.5 kb region lying between the CRY1 and MAT loci of chromosome III from Saccharomyces cerevisiae. This region lies in the overlap between two major contigs used for the generation of the complete nucleotide sequence of this chromosome. Comparison of this sequence with those reported previously for this overlap [Thierry et al. (1990) Yeast 6, 521; Jia et al. (1991) Yeast 7, 413] reveals 38 nucleotide differences, 45% of which generate changes in the amino acid sequences of the four genes in this region (YCR591, YCR592, YCR521 and YCR522). These differences appear to reflect true sequence polymorphisms between the two yeast strains used to generate the clones used in the sequencing project. Three of the four genes in this region display weak homologies to proteins in the PIR database. Some properties of YCR521 are analogous to those of ribosomal protein genes. However, the functions of all four genes remain obscure. PMID- 1776367 TI - Basic cell metabolism of articular cartilage. Manometric studies. AB - Basic metabolism generates energy by the anaerobic or aerobic metabolization of glucose. The articular cartilage obtains the substrate and oxygen from the synovial fluid. Their concentrations within the cartilage diminish with increasing proximity to the basal layer at the bone-cartilage boundary. The gradients depend upon the cell density and the consumption by the cells. The gradient of the partial oxygen pressure (PO2) could provide the conditions for the Pasteur effect, which, however, has not yet been clearly observed. Metabolic reactions of chondrocytes to positive or negative glucose gradient have not hitherto been examined, and are the object of the present study. The oxygen consumption (QO2) in the articular cartilage of pig femoral heads was measured manometrically (Warburg technique) in the absence of glucose and in its presence in concentrations of 1.25 to 10.0 mM. There was a close correlation between the QO2 and the concentration and consumption of glucose having the nature of a glucose-induced respiratory suppression (Crabtree effect). The consumption of glucose, which did not rise in proportion to its concentration, did not exceed 15.7 mumol/gdw/h. The maximum lactate production of 20 to 23 mumol/gdw/h was attained at 5 mM glucose and showed no further increase at higher substrate concentrations. This stoichiometric "lactate deficiency" means that the absorbed but not glycolyzed glucose is channeled into synthesizing and storage processes. In glucose-free incubation, despite aerobic conditions, lactate was utilized by the chondrocytes only at unphysiologically high concentrations greater than 10 mM. Potassium cyanide reduced the QO2 by only 80-90% as a sign of the activity of non-mitochondrial oxidases. With monoiodoacetate (MIA), respiration fell dramatically during the 4 h of substrate-free incubation. It can be concluded from the results that, under physiological conditions, the glucose level in the synovia reduces the consumption of oxygen in the well-glucose-supplied upper layer of the articular cartilage, thus allowing an oxidative compensation of the diminishing glycolysis in the basal zone. The Crabtree effect, which is demonstrated for the first time in chondrocytes, thus seems to have the role of an essential regulatory mechanism in the basic metabolism of the cartilage. PMID- 1776368 TI - [Rheumatologic and radiologic symptoms of secondary hyperparathyroidism: retrospective long-term study of 175 chronic hemodialysis patients]. AB - Despite recent improvements of hemodialysis (HD) techniques, symptoms due to secondary hyperparathyroidism (HPT) contribute to longtime complications of HD patients. The aim of the present retrospective study was to determine the incidence and localization of radiological joint and bone lesions in 175 patients on chronic HD. In 108 patients the diagnosis of HPT was made by radiologic criteria. 56% had radiomorphologic lesions of the hands, 45% of the acromio clavicular (AC) joint, 31% of the shoulder, and 27% of the pelvis. No sex difference was found for prevalence of HPT in these patients, nor was one found for any of the underlying renal diseases. There was a negative correlation between elevated serum parathyroid hormone and serum aluminum concentrations. In 111 patients the history of bone and joint pain was evaluated. 54% of these patients suffered from bone pain, arthralgia, and morning stiffness. Radiological lesions of AC-joint correlated with shoulder pain in 38%. Our data show that even in the predialytic phase of renal insufficiency x-rays of the shoulder are helpful in early diagnosis of HPT. Skeletal manifestations specific for one of the underlying renal diseases do not exist. Elevated PTH levels are a good indicator of HPT in these patients, whereas low levels of PTH do not exclude radiological manifestations. In contrast to beta 2-microglobulin amyloidosis, pain does not occur during rest and is not worsened during HD. Treatment with non steroidal antiinflammatory drugs led to pain relief in the majority of patients. Pain history in patients on chronic HD provides important information concerning the differential diagnosis of HPT/beta 2-microglobulin amyloidosis. PMID- 1776369 TI - [Pyridinoline-containing collagen degradation products in urine in coxarthrosis]. AB - High-performance liquid chromatography of collagen degradation products in human urine for diagnosis of osteoarthrosis was introduced by Macek and Adam (6) in 1987. The aim of the present study was to demonstrate the clinical usefulness of this method in a group of 20 patients with osteoarthrosis of the hip and 10 healthy volunteers. There were no significant differences in number or intensity of the detected signals between the two groups. The results of this study show that the determination of collagen degradation products is not useful for diagnosis or for the control of therapy in patients with osteoarthrosis. PMID- 1776370 TI - D-penicillamine-induced agranulocytosis: hematological remission upon treatment with recombinant GM-CSF. PMID- 1776371 TI - [Monoclonal CD4 antibodies in psoriasis and psoriatic arthritis]. PMID- 1776372 TI - [Results of surgical therapy of esophageal carcinoma]. AB - In esophageal cancer radical resection of the affected segment is the therapy of choice for tumours confined to the wall. Palliative resection at advanced tumour stages does not improve survival and markedly increases mortality. Neither chemotherapy nor radiation influence the survival rates. Tumours of the middle third are resected by the thoracic approach, while tumours of the lower third may be resected by blunt dissection. The best reconstruction is achieved by interposition of the stomach. The jejunum or colon may be interposed in the case of a previous gastric resection. In our department, postoperative mortality was 8.8%, corresponding to 137 operations with stomach interposition. The 5 year survival rate was 39.9% in stage I and II and 10.6% in stage III and IV. Complications and mortality were markedly increased in advanced tumour stages. The thoracic approach was not correlated with higher postoperative lethality. PMID- 1776373 TI - [The biological behavior of exocrine pancreatic carcinoma from a pathological anatomical viewpoint. A contribution to the problems of surgical therapy]. AB - The general biologic behaviour of exocrine pancreatic cancer was examined retrospectively in a total of 840 autopsies (382 males, aged 31-86 [average 66.5] and 458 females, aged 2-90 [average 72]). 95 % of autopsies showed definable tumours (caput 64%, corpus 17%, cauda 14%), in 5% the gland was diffusely permeated by cancer tissue. 19.5% had no metastases, whereas in 80.5% carcinomatosis was diagnosed. In 7% only locoregional metastases of the lymph nodes could be found. Tumour sizes were observed in the range of 0.3 to 14 cm. All carcinomas below the size of 1 cm were free of metastases. In tumours larger than 2 cm, the formation of metastases increased sharply. In sizes more than 3 cm complications were important for the prognosis. Carcinomatosis proceeds cascade fashion with high first rate metastatic spread into the liver. 6% of liver metastases were solitary ones, 94% were multiple. In 171 cases malignancy grading was performed. Free of metastases were 50% of the decreased with grade-I carcinomas, 21% with grade-II-carcinomas and 7% with grade-III-carcinomas. These data comment on the possibilities and limitations of curative cancer resection from a morphological view. PMID- 1776374 TI - [2 rare pancreatic tumors as incidental findings. A case report]. AB - We report two cases of rare tumours of the pancreas: one case of a cystadenoma and one case of a PP-oma with no hormonal activity. Both cases were discovered accidentally while screening examination of other reasons. Guided by these cases we draw the following conclusions: 1. Ultrasound is the outstanding screening in diagnosis of rare pancreas tumours. 2. Surgery is the treatment of choice. 3. Final diagnosis can only be made by histology. 4. Immunohistochemistry is the best method in differentiation of endocrine tumours. PMID- 1776375 TI - [Effects of fecal bile acids on experimental colon carcinogenesis]. AB - Because of the in a controversial way held discussion on an possibly existing connection between bile acid metabolism and the development of colonic carcinomas experimental researches on this problems were carried out with Wistar rats. Two test series with altogether 130 animals manifested independently from each other the result of a provable connection. During model tests small bowel resections and colon exclusion operations were realized. The carcinoma protection was accomplished by 1.2 dimethylhydrazine administered for 14 weeks in a doses of 20 mg/kg body weight. The carcinoma was proved after a 32-weeks-period. It was shown that in case of shortening the ileum more than in case of reduction of the jejunum on the left-side colon adenocarcinomas develop and the amount of the excreted fecal bile acids is the highest one. In bypassing the left-side section of the colon carcinomas develop also on the left side of the colon. But their number is significantly lower than of those on the right side. The test results indicate a causal connection. PMID- 1776376 TI - IgM rheumatoid factor in cattle immunized against babesiosis. AB - Polyclonal bovine IgM-rheumatoid factors (IgM-RFs) were examined in sera of cattle immunized against babesiosis. An enzyme-linked immunosorbent assay (ELISA) was used enabling rapid screening of serum samples. Results obtained indicate a rise of serum IgM-RF levels with age in healthy bovines. However when animals of similar age and pertaining to the same herd were examined, levels of serum IgM-RF exhibited a wide distribution range. Mean values in 60 sera of 2 yrs old clinically healthy heifers originating from a single herd were of 452.60 +/- 201.26 e.u. at 1 in 1,000 serum dilution and of 202.37 +/- 137.86 e.u. at 1 in 4,000 serum dilution. In a herd where repeated vaccination of dams against babesiosis was carried out 3 to 6 weeks before delivery either with live Babesia bovis parasites or soluble antigens of in vitro grown organisms, no significant differences in mean IgM-RF values were found between revaccinated animals and a control group. Nor did the mean values of serum IgM-RF of calves born to the respective groups of dams exhibit significant differences. It thus appears that immunization of healthy cattle against this parasite does not affect mean serum IgM-RF levels. PMID- 1776377 TI - Comparison of surface antigens of some Campylobacter fetus subsp. fetus strains of ovine origin by polyacrylamide gel electrophoresis and immunoblotting. AB - Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting were used to identify and to compare the surface antigens of eight C. fetus subsp. fetus strains. Seven strains (one of serogroup A and six of serogroup B) were isolated from aborted ovine fetuses, while one strain (serogroup A) originated from an aborted calf fetus. Saline extracts at 56 degrees C and 100 degrees C were used as antigens. Antisera were produced in rabbits. In saline extracts (56 degrees C) of the strains at least 19 fractions were identified by SDS-PAGE, with molecular masses ranging from approx. 4,800 to 205,000. The major bands appeared at 205,000, 66,000, 31,500, 25,000, 21,000 and 17,500. Despite the fact that the strains were cultured from 4 different sheep flocks and belonged to serogroup A or B, the SDS-PAGE profiles of the strains were very similar. When boiled (100 degrees C) extracts were used, a band migrating at 32,500 in sheep strains and a band at 97,500 in the calf isolate were missing. Most of the bands obtained by SDS-PAGE could be identified also by the immunoblot procedure. A or B type specificity of the ovine isolates was due to an LPS fraction, migrating at approx. 21,000, while the other LPS fractions appearing under this region although reacted with antisera did not influence the type specificity. Using alkaline extracts (pH 12) in SDS-PAGE, LPS fractions gave more pronounced profiles. In two of our C. fetus subsp. fetus isolates, plasmids with a molecular mass of 31,500 were identified. PMID- 1776378 TI - Assessment of strategy in selective dry cow therapy for mastitis control. AB - Seven hundred and three cows were treated at drying off, using three main types of therapy: control, long-acting intramammaria and short-acting intramammaria. Selective dry cow therapy in infected quarters was used. Of the cows with one or two infected quarters one to six weeks before drying off, 57.7 per cent had one or more new infected quarters at drying off. Thus selective dry cow therapy on quarter basis determined from the results of samples taken one to six weeks before drying off would give "inadequate" therapy (i.e. new infection in non treated quarters at drying off) for more than 50 per cent of the cows. For those cows given "adequate" therapy (no new infection at drying off) long-acting therapy, short-acting and control yielded 53.6%, 49.3% and 30.7% healthy cows respectively two to five weeks post partum. In cows with "inadequate" therapy the treatment groups yielded 42.9%, 52.9% and 29.7% healthy cows respectively. Our conclusion is that if long-acting intramammaria are to be used, all the quarters of infected cows should be treated, whereas if short-acting preparations are to be used, treatment can be restricted to infected quarters only. PMID- 1776379 TI - The barren camel with endometritis--isolation of Trichomonas fetus and different bacteria. AB - This study constitutes the first reported isolation of Trichomonas fetus from the uterus of breeding camels. Twenty-four of 68 camels, which were barren for 1-4 years were found to be positive for T. fetus. One preputial washing of a camel bull which had served the herd was found to be positive for T. fetus. The uterine flora of all camels were examined. Ten different bacterial and 2 fungal species were isolated. All samples were negative for Campylobacter sp., Taylorella equigenitalis and Streptococcus zooepidemicus. PMID- 1776380 TI - Contribution to the prophylaxis of chicks aspergillosis: study of the contamination of a hatchery by Aspergillus fumigatus. AB - Contamination of a hatchery by Aspergillus fumigatus has been studied for 8 weeks from eggs to day old chicks. We have shown that the contamination of the hatchery originates on the egg shell and that each time the eggs are manipulated, spores of Aspergillus fumigatus are thrown into suspension in the air. Thus it seems necessary to bring eggs with as few as possible spores of Aspergillus fumigatus on their shell into the hatchery. Prophylaxis of aspergillosis should be foreseen from the conception of the hatchery: the ventilation system and the internal lay out should be designed to prevent dispersion and accumulation of Aspergillus fumigatus spores during the processing of the eggs through the hatchery. PMID- 1776381 TI - Growth of Staphylococcus aureus and Streptococcus species in bovine mammary secretions during the nonlactating and peripartum periods following intramammary infusion of lipopolysaccharide at cessation of milking. AB - The objective was to determine if induced mammary inflammation at cessation of milking influenced growth of gram-positive mastitis pathogens in mammary secretions, particularly during early involution. Growth of all mastitis pathogens evaluated was similar in cell-free fat-free mammary secretions from LPS infused and control glands. These data indicate that intramammary infusion of LPS at cessation of milking did not alter growth of gram-positive mastitis pathogens in mammary secretion during the nonlactating period. Stage of lactation and the nonlactating period influenced bacterial growth and marked differences between bacteria and among strains of a bacterial species were observed. Staphylococcus aureus grew well in secretions collected during late lactation, but growth decreased during early- and mid-involution and increased again in secretions obtained near parturition. Streptococcus agalactiae and Strep. uberis grew better in mammary secretion obtained during involution than in secretions collected during late or early lactation. Streptococcus dysgalactiae grew well in mammary secretions at all time periods. These data demonstrate the variability of mastitis pathogen growth during physiologic transitions of the bovine udder. PMID- 1776382 TI - Clinical selection criteria for secondary examinations of the health-status of broiler flocks. AB - Results of post-mortem and laboratory examinations of broilers sampled randomly or selected by clinical symptoms were compared. The male:female-ratio was in all cases nearly equal for randomly sampled and selected birds. Regarding post-mortem findings, differences dependent on selection criteria were observed: in randomly sampled birds the frequency of breast-blisters and plantar inflammations was higher than in selected broilers, whereas in the latter osteodystrophy and bursal atrophy were seen more frequently. Alterations of joints and tendon-sheaths caused by a reovirus-arthritis in one flock were seen in same frequency in randomly sampled and selected birds, respectively. Parasitological examinations revealed the highest coccidial lesion scores in selected birds with lameness or slightly retarded growth but when dwarfism birds were included into calculations, there was no significant difference among both groups. Results of bacteriological and serological examinations showed no differences between the groups. PMID- 1776383 TI - Long-term follow-up of a febrile convulsion cohort. AB - Determining the clinical prognosis a 16-year follow-up study of a clinic-based FC cohort was made. The cohort comprises 528 FC children under 5 years of age at first clinic visit. Thirty-nine patients (7.4%) were found to have developing non febrile seizures (FCC). Discrimination formula was applied; differences in actual cumulative FCC rates differed: a) whether the discriminant score was plus or minus (15%, 31/208 and 2.5% 8/320, respectively; p less than 0.001); b) whether the discriminant score was plus or minus in the group with no medication (47%, 22/47 and 3%, 6/229; p less than 0.001); and c) whether the treatment was applied or not in the group with plus value (6%, 9/161 and 47%, 22/47; p less than 0.001). No difference was detected whether the treatment was introduced or not in the group with a minus discriminant score (2%, 2/91 and 3%, 6/229, ns). The effective prediction and prevention for the FCC development were thus proved. Correlation between the number of predictive eight-risk factors and rates of FCC development are analyzed. PMID- 1776384 TI - Status epilepticus: clinical experience with two special devices for continuous cerebral monitoring. AB - Continuous cerebral monitoring (CCM) was performed on 34 patients in status epilepticus (SE), using changes in amplitude detected by the cerebral function monitor (CFM) and changes in frequency detected by compressed spectral array (CSA). The EEG was used intermittently to help identify seizure patterns obtained with these methods. Seventeen patients in clinically manifest SE also had non convulsive seizures. In 17 patients, SE was refractory to conventional anticonvulsants, requiring treatment with pentobarbital or paraldehyde. In these patients, CCM provided dynamic electroencephalographic monitoring of burst suppression and prompt detection of breakthrough seizures. Patients in SE should undergo CCM to differentiate between non-convulsive seizures and post-ictal state both of which may produce prolonged unresponsiveness following clinical seizures. CCM after data reduction with the two special devices used is a viable and practical alternative to continuous conventional EEG monitoring during SE. However, in order to evaluate the sensitivity and specificity of these methods, it will be necessary to design a study in which both the EEG and the devices using data reduction be used continuously and concurrently. PMID- 1776385 TI - Parkinson's disease incidence: magnitude, comparability, time trends. AB - In this study, we reviewed incidence surveys of Parkinson's Disease (PD) from all over the world, published during the period 1945-1989, using reported quality criteria. In addition, we compared age-specific PD incidences from selected observations by stratified analysis. Crude incidences were described for 11 populations, and age-specific incidences for three of them: Iceland, Rochester (Minn, USA), and Turku (Finland). Effect modification by age was detected: a) by comparing incidences by age at diagnosis with incidence by age at clinical disease onset; and b) when only data on onset of disease was computed. For disease onsets, the incidences in Rochester for the period 1955-1966, and in Turku (Finland) during the interval 1968-1970, were lower than that in Iceland for the period 1958-1960: RR = 0.58 95% CI (0.41, 0.83), and RR = 0.67 95% CI (0.51, 0.87), respectively. For the Rochester population aged 40-69 years, a statistically significant 56% decrease in the incidences of Parkinsonism onsets during the period 1945-1966 was found. Validity problems in comparing PD incidences and the role of PD underdiagnosis were emphasized. We concluded that: a) stratified analysis is more suitable than standardization when comparing incidences for etiological purposes; b) the incidence of PD was highest in Iceland; and c) in Rochester, PD incidence under the age of 70 decreased with time. PMID- 1776386 TI - Parkinsonism mortality in the US, 1. Time and space distribution. AB - We studied the time-space variations of mortality for parkinsonism in the US during the periods 1962-1985 and 1971-1978 from statistics on primary cause-of death and multiple causes-of-death, respectively. Linear regression analysis and a test for significance of spatial clustering were used. For parkinsonism as a primary cause-of-death, up to the late 1970's there was a decrease in mortality for the age groups below 75 and stable rates for the age group 75 years and over. A moderate decrease among those below 75 years, and a sharp increase in mortality among those over 74, were observed for the period since the late 1970s. The variation of the age-specific mortality during the period 1962-1985 ranged from 100% in the age group 35-44 years to +98% in those aged over 84 years. Within the same age group, the variations across time of mortality due to, and related to parkinsonism, for the period 1971-1978, were similar. In the spatial analysis, an association between mortality related to parkinsonism and geographical latitude was found. We conclude that: 1) parkinsonism at death is widely distributed; 2) the changes across time can not be explained by a reduction in general mortality; 3) improvements in diagnostic ascertainment and reporting among the elderly may have particularly occurred during the last decade; and 4) the disorder has been progressively confined to the elderly by diminishing in the younger birth cohorts. PMID- 1776387 TI - The influence of pregnancy on relapses in multiple sclerosis: a cohort study. AB - The influence of pregnancy on the relapse rate (number of relapses per person per year) in MS was analysed for 52 women who had a pregnancy during the disease. The relapse rate was lower during the pregnancy-year (9 months of pregnancy and 6 months immediately post partum) than the non-pregnancy time. There was a heterogeneous pattern during the pregnancy-year with a sharp decrease in the relapse rate observed during pregnancy and a slight non-significant increase in the puerperium: both these relapse rates were compared with figures observed in the same group of women during the non-pregnancy time. Pregnancy does not appear to be a period at greater risk for exacerbations but, on the contrary it seems to act, on the whole, as a protective event. These data allow physicians to provide reassuring counselling to women. PMID- 1776388 TI - Selegiline and cognitive function in Parkinson's disease. AB - Eighteen patients with Parkinson's disease were treated with placebo for 4 weeks and with the MAO-B inhibitor selegiline for 8 weeks without levodopa in a randomized double-blind clinical study. The maximum dose of selegiline was 30 mg/day and the patients' cognitive functions were evaluated before treatment and at week 12 when they were either on 30 mg selegiline or placebo. A series of neuropsychological tests were used to study general cognitive reasoning, memory, visuospatial abilities, attention, cognitive flexibility, motor functions and depression. Specific cognitive effects were not observed. Slight improvement occurred mainly in learning (easy word associations) which may reflect a limited, nonspecific arousal effect. PMID- 1776389 TI - Study of cytoskeletal proteins in fibroblasts cultured from familial Alzheimer's disease. AB - Cytoskeletal proteins of the cultured fibroblasts obtained from Alzheimer's disease patients were studied. Western blotting studies of tubulin, actin, and vimentin showed no difference between Alzheimer and the control fibroblasts. Western blotting studies of vimentin revealed five partial degradation products in 50 K-57 K Da. molecular size region, but no difference in the degradation pattern was noticed between Alzheimer and the control fibroblasts. The size of fodrin molecule, however, was quite different between Alzheimer and the control fibroblasts. Comparing the molecular size of fodrin purified from the bovine brain, it is concluded that fodrin in Alzheimer fibroblasts is not degraded, while significant amount of fodrin in the control fibroblasts is partially degraded resulting in the smaller size of the 160 K and 200 K Da. molecular weight products. PMID- 1776390 TI - Evaluation of 110 consecutive patients with dementias: a prospective study. AB - We prospectively investigated 131 consecutive cases (both in- and outpatients) of suspected dementia to evaluate the relative frequency of different types of dementia in Chinese patients. Dementia was confirmed in 110 cases (84.0%). In contrast to the Western series, vascular dementia (39.1%) was slightly more frequent than the Alzheimer's disease (36.4%). Twelve cases (10.9%) of potentially treatable dementia were found. Careful clinical observation was the most useful part of the evaluation. CT scan of brain was the most useful laboratory test. PMID- 1776391 TI - Brain atrophy in Werdnig-Hoffmann disease. AB - CT scan imaging of the brain was done in eight children with Werdnig-Hoffmann Disease. Seven of them showed generalized cerebral cortical atrophy and one had low attenuated, non-enhancing areas in the white matter involving both frontal lobes. These changes could be due to repeated episodes of hypoxic injury. PMID- 1776392 TI - Motor neuron disease and dementia reported among 13 members of a single family. AB - All 49 members of four generations of a family were identified. In the first three generations eight members were afflicted with dementia, whereas in the fourth generation only one was demented but three of four were afflicted with motor neuron disease and they also had slight cognitive deficiencies. The pattern of heredity is compatible with dominant autosomal inheritance. Neuropsychological testing revealed affection mostly of the frontal lobes. A pedigree and six case reports are presented. PMID- 1776393 TI - Serum auto-antibodies in Alzheimer's disease. AB - The prevalence and clinical significance of non-CNS auto-antibodies in the serum of patients with probable and possible Alzheimer's disease (AD) was determined. Serum was obtained from 88 patients and 55 normal controls. Serum from each subject was tested for the presence of seven different auto-antibodies. Auto antibodies were detected in 44% of the subjects with probable AD, 70% with possible AD with cerebrovascular disease (CVD), 45% with possible AD and other disease and 42% of normal controls. Although a subpopulation of AD patients with CVD showed a trend to an increased predisposition to develop autoimmune disease, these results do not support the relationship of AD and serum auto-antibodies or autoimmune disease. PMID- 1776394 TI - Semiquantitative regional cerebral blood flow evaluation using 123I-IMP SPECT in a case showing transient ischemic attack caused by putaminal hemorrhage. AB - A 69-year-old woman presented a transient cerebral ischemic attack, showing left arm weakness and slurred speech which recovered within 4 h of onset, while computed tomography indicated a putaminal hemorrhage. The regional cerebral blood flow distribution, measured semiquantitatively by use of 123I amphetamine emission tomography, was disturbed, which persisted more than one month up to a maximum of 4.5 months from the onset of symptoms. This case illustrates a variety of putaminal hemorrhage of good functional and vital prognosis, and provides an example in which the regional cerebral blood flow disturbances might persist for more than one month up to 4.5 months after the occurrence of a transient ischemic attack caused by a putaminal hemorrhage. PMID- 1776395 TI - Intrathecal synthesis of IgM in early multiple sclerosis. PMID- 1776396 TI - Rett syndrome. PMID- 1776397 TI - Sneddon's syndrome. PMID- 1776398 TI - Decline in dental caries and public oral health care of adolescents. AB - The adequacy and appropriateness of the oral health service were evaluated from patient records of 15-year-olds in Helsinki in 1976 and 1986. The subjects selected for the study represented the whole age group participating in public oral health service in the 2 years in question. During the 10 years, substantial decreases were seen in the mean numbers of dental visits (from 4.0 to 2.4) and fillings (from 2.9 to 1.2). The greatest decrease was seen in the number of fillings made in incisors. Slightly fewer preventive measures were carried out in 1986 than 10 years earlier, but no focusing on risk patients was seen. In the 2 years studied, 15-year-olds in the high-risk group received applications of topical fluorides and instructions on oral hygiene as often as those in the low risk group. A major problem seemed to be the increasing number of unfinished courses of treatment among high-risk patients. We conclude that patients with a higher risk of caries should receive more attention with regard to both the preventive treatment given and ways of motivating them to complete their treatment courses. PMID- 1776399 TI - Formation of fluoride on enamel in vitro after exposure to fluoridated mouthrinses. AB - The aim of this study was to quantify the formation of alkali-soluble fluoride (loosely bound fluoride such as calcium fluoride-like material and absorbed fluoride) and alkali-insoluble fluoride (firmly bound fluoride or apatitically bound fluoride) when fluoride mouthrinsing solutions were applied on sound human enamel in vitro. Two commercial products containing 0.2% or 0.05% NaF were used during 30 sec, 60 sec, 5 min, and 60 min. The formation of loosely bound fluoride was determined by KOH extraction and visualized by scanning electron microscopy. The firmly bound fluoride was measured by three consecutive acid etchings of the enamel. Even during short periods of application there were deposits on the enamel surface. The amount of deposit increased with time of exposure to the 0.2% NaF solution. Only after treatment for 60 min with 0.05% NaF were significant amounts of alkali-soluble fluoride deposited. No measurable amounts of firmly bound fluoride were observed. PMID- 1776400 TI - Oral symptoms in bulimia nervosa. A survey of 34 cases. AB - Bulimia nervosa is increasingly recognized as an eating disorder with significant medical and dental complications, including increased caries rate, thermal hypersensitivity, enamel erosion, xerostomia, and parotid gland hypertrophy. This article reviews the oral manifestations in bulimia nervosa and presents a questionnaire study of oral symptoms in 34 women with bulimia nervosa. Twenty three (68%) of the subjects reported dental symptoms, such as hypersensitive teeth (47%), tooth pain (18%), dental fractures (6%), and subjectively increased caries rate (29%). Twelve women (35%) reported dry mouth or dry eyes as a daily experience, and 10 (29%) reported intermittent parotid gland swelling. To the author's knowledge, this is the first report that evaluates the frequency of subjectively experienced oral symptoms in bulimia nervosa. PMID- 1776401 TI - Eruption pattern of permanent teeth in a rural community in northeastern Finland. AB - Cross-sectional data on permanent tooth eruption were collected by examining the children and adolescents 5-15 years old in a northeastern municipality of Finland. There were 1008 subjects in the whole sample, 483 girls and 525 boys. The results showed statistically significant differences between the girls and boys in timing of eruption of some permanent teeth, indicating earlier eruption in girls than in boys. This difference was most clearly seen in the second phase of the mixed dentition. Interindividual variation in the emergence age was also wider in the second phase of the mixed dentition. The present results seem to indicate earlier eruption of the permanent teeth in rural children in northeastern Finland than in other parts of the country. PMID- 1776402 TI - Low concentrations of inorganic mercury inhibit in vitro autonomic transmission in the presence of albumin. AB - The influence of albumin, 4.5 and 45 g/l, on the effects of Hg2+, 10(-9)-10(-3) M, on the neuromuscular transmission of the isolated guinea-pig ileum and vas deferens was investigated. Hg2+, 10(-9)-10(-6) M, transiently increased the basal tone of the ileum in Tyrode solution without albumin. Albumin, 4.5 g/l, reversed this stimulant effect but enhanced the contractile response to direct muscle stimulation. This contractile response also increased in the vas deferens. Albumin, 45 g/l, obliterated the stimulant effects of Hg2+ on the smooth muscle of the ileum but not of the vas deferens. The effects caused by higher concentrations of Hg2+, 10(-5)-10(-4) M, were only partly inhibited when albumin was present. When neurogenic contractions were elicited in the presence of albumin (45 g/l), Hg2+, 10(-9)-10(-4) M, reduced the contractions in both organs. Consequently, Hg2+ in concentrations presently considered acceptable in blood plasma (10(-9)-10(-8) M) suppressed both cholinergic and adrenergic neuromuscular transmission even in the presence of albumin. PMID- 1776403 TI - Albumin inhibits effects of Cu2+ on autonomic postganglionic transmission of guinea-pig ileum and vas deferens. AB - The influence of albumin, 4.5 and 45 g/l, on the effects of Cu2+, 10(-9)-10(-3) M, on the neuromuscular transmission of the isolated guinea-pig ileum and vas deferens was investigated. Low concentrations of Cu2+, 10(-9)-10(-6) M, caused a slight and transient increase of the contractile response to direct muscle stimulation of the vas deferens. Albumin at 4.5 g/l inhibited this effect. The basal tone of the ileum increased transiently when Cu2+ was added in the presence of albumin, 4.5 g/l. A stimulant action of Cu2+, 10(-9)-10(-6) M, was seen on both organs, when contractions were induced by nerve stimulation. All these effects were inhibited by albumin, 45 g/l. Higher concentrations of Cu2+, 10(-5) 10(-4) M, increased the basal tone of the ileum and the vas deferens. In the presence of albumin, 45 g/l, this stimulating effect of Cu2+ appeared in higher concentrations. The results suggest that Cu2+ is more likely to influence the function of neuronal tissues when the concentration of protein is low. PMID- 1776404 TI - Vitamin B status and response to replacement therapy in patients with burning mouth syndrome. AB - The aim of the study was to determine, in a group of patients with therapy resistant burning mouth syndrome (BMS), the possible deficiency of vitamins B1, B2, and B6 and the effect of proper vitamin replacement therapy. Sixteen individuals, aged 47 to 81 years, participated in the study. All underwent a base line examination comprising anamnestic information, subjective assessment of symptoms, dietary registration, salivary analysis, and serum analysis of thiamine (B1), riboflavine (B2), and pyridoxine (B6). Fifteen individuals had low thiamine and/or riboflavine levels in accordance with suggested levels in the literature and were given replacement therapy. No effect on BMS of vitamin replacement therapy or placebo therapy could be demonstrated. PMID- 1776405 TI - Dental conditions in a Swedish population aged 45-69 years. A questionnaire study. AB - A questionnaire study was performed on 3000 randomly sampled individuals aged 45 69 years living in Orebro county, Sweden. The response rate was almost 80%. The purpose was to describe dental conditions in this population, especially differences in dental conditions between various socioeconomic groups. Only 9% of the studied population were totally edentulous, and edentulousness was concentrated to the older age groups. Eighteen per cent of the population had all their teeth remaining. Removable dentures were worn by only 23% of the subjects. The results indicate further improvement of dental conditions in the age group 45 69 years in in Orebro county and presumably in the whole country. The results also indicate an improved gender equality with regard to dental status. On the other hand, socioeconomic inequalities were closely related to variations in dental conditions. PMID- 1776406 TI - Frequency distribution of IOP. Analysis of a material using the gamma distribution. AB - The results of a population-based (age greater than or equal to 65 years) examination of the frequency distribution of IOP are reported. 3726 eyes in 1887 individuals were included in the examination. By consistent use of conventional, well-defined criteria, glaucoma was diagnosed in 6.4% of the individual eyes. In the total material, the average IOP was 18.0 mmHg. Average IOP was 28.7 mmHg in eyes with glaucomatous damage, vs 17.2 mmHg in the normal eyes. Variance of IOP was much higher in the glaucoma group as compared with the normal group. The IOP frequency distribution curve did not fit with a Gaussian curve; it was asymmetric, skewed to the right. The distribution curve obtained by plotting the recorded frequencies was disturbed by irrelevant irregularities, both random and systematic. The irregularities could be evened out by the application of regression analysis, using the equation for the gamma distribution. The IOP frequency distribution is well represented by a gamma distribution curve. The fit is improved by excluding eyes with extremely high and low IOP. PMID- 1776407 TI - The probability of having glaucoma at different IOP levels. AB - The probability of having glaucoma is indicated by the quotient (number of eyes with glaucoma)/(number of eyes in the total population). This quotient was calculated for each value of IOP. The number of eyes at each IOP value was taken from IOP frequency distribution curves for glaucomatous and normal eyes, calculated from values obtained by a population survey. By plotting the probability of having glaucoma vs IOP, a sigmoid curve was obtained. The curve indicates that while the glaucoma probability is near zero at IOP = 18 mmHg, it is 0.5 at 27-28 mmHg, and the probability approaches 1, i.e. certainty, at an IOP around 35 mmHg. The frequency distribution of the tolerance limit of IOP was calculated by derivation of this curve. The distribution of IOP tolerance limit was close to a normal distribution with average = 27.9 mmHg and standard deviation = 3.2 mmHg. PMID- 1776408 TI - Pseudo-exfoliation, IOP and glaucoma. AB - On the basis of a glaucoma survey in a total population greater than or equal to 65 years of age, the IOP in eyes with and without pseudo-exfoliation (PE) has been compared. The average IOP was 22.2 mmHg in eyes with PE versus 17.4 in eyes without. The corresponding averages in eyes without glaucomatous damage were 18.6 and 17.1 mmHg, and in eyes with glaucoma 31.5 and 25.5 mmHg. The IOP elevation connected with the PE process was 4.8, 1.5, and 6.0 mmHg in the total, normal and glaucomatous population, respectively. The IOP frequency distribution curves of these 3 groups were compared. The right shift of the distribution curves of the PE groups was more pronounced at high pressure levels. The PE process seems to elevate the IOP particularly in eyes with a high IOP, which is in correspondence with hydrodynamical laws. At a certain IOP, the probability of having glaucomatous damage was higher in eyes with PE than in those without, indicating an increased vulnerability of PE eyes to an elevated IOP. PE may be a glaucoma risk factor also on its own, i.e. independent of the pressure elevation connected with this syndrome. PMID- 1776409 TI - Chronic open-angle glaucoma and advanced visual field defects in a defined population. AB - In a case-finding study in a municipality in central Sweden, 128 cases of chronic open-angle glaucoma with visual field defects (VFD) were found. The prevalence amounted to 1.4% in those greater than or equal to 45 years of age. Sixty-three percent had capsular glaucoma. Advanced visual field defects (AVFD), i.e. a restriction of the visual field to a diameter of less than or equal to 20 degrees, were seen in 49 patients. Four patients had AVFD in both eyes. Patients with AVFD were older, had had the disease longer, had higher mean initial intraocular pressure (IOP), and had more extensive VFD at the time of diagnosis. When age and duration were taken into consideration, the risk of developing AVFD was 14 times greater in those with VFD stage III at the time of diagnosis, i.e. a Bjerrum scotoma with nasal breakthrough or more widespread VFD. An IOP of greater than or equal to 35 mmHg signified that the risk of having VFD stage III at the time of diagnosis, when age and type of glaucoma were taken into consideration, was 8.6 times greater than if the IOP was less than 35 mmHg. PMID- 1776410 TI - Blood-retina barrier permeability in diabetes during acute ACE-inhibition. AB - We assessed the acute effect of ACE-inhibition (captopril) on blood-retina barrier (BRB) permeability in 10 hypertensive insulin-dependent diabetic patients with background retinopathy in a double-masked placebo controlled cross-over study. All patients underwent ophthalmological examination, fundus photography, fluorescein angiography, vitreous fluorometry, and continuous blood pressure recording within 3 h of the drug/placebo administration. The decrease in mean arterial blood pressure, from placebo treatment 149/92 +/- 17/7 to captopril treatment 132/83 +/- 14/7 mmHg (mean +/- SD), P less than 0.01 was not accompanied by a significant decrease in BRB permeability, which was 2.51 (1.24 9.15) with placebo and 3.02 (1.25-13.93).10(-7) cm/s during captopril treatment (geometric mean and-range), NS. Our study suggests that abnormal leakage through the BRB in hypertensive insulin-dependent diabetic patients with background retinopathy is caused predominantly by structural changes in the retinal vessels whereas hydrostatic forces play a minor role. PMID- 1776411 TI - Influence of glucose, fructose and aldose reductase inhibition on retinal sorbitol metabolism. AB - The sorbitol shunt has been studied in bovine retinal tissue at incubation times from 1 to 24 h. It was shown that an elevated glucose concentration (22 mM) of the medium was accompanied by a slight increase in sorbitol content already after 3 h. At longer incubation times, but lower glucose concentration (11.1 mM) there was a similar increase. Addition of an aldose reductase (AR) inhibitor prevented the sorbitol increase. Addition of fructose to the medium significantly increased the sorbitol accumulation above the effect seen with glucose alone and this effect was not influenced by the AR inhibitor. Thus the sorbitol concentration in the retina may be increased after a short incubation time and further enhanced by the presence of fructose. PMID- 1776412 TI - Topographical analysis of peripheral vs central retina with pattern reversal visual evoked response and the scanning laser ophthalmoscope. AB - The contribution of the central and the surrounding peripheral retina to the pattern reversal visual evoked response (PVER) was analyzed simultaneously using double frequency stimulation and the Fast Fourier transform (FFT) method. The Scanning Laser Ophthalmoscope (SLO) was used to project the pattern stimulus, a square subtending 10 degrees on a side, on a specific location in the fundus and to monitor accurately the stimulus' position during PVER testing. When the stimulus area on the central retina was less than or equal to 50 min of arc on a side, or 0.69% of the total area was stimulated (a square of 10 degrees on a side), the contribution from the central retina was negligible, and the PVER was dominated by surrounding peripheral retinal activity. When the stimulus area of the central retina was greater than or equal to 100 min of arc on a side, or 2.78% of the whole area was stimulated, activity from the central retina became more evident. When the stimulus area projected on the central retina became 150 min on a side (6.25% of the area or greater), activity from the central retina showed an increase and exceeded that of the peripheral retina. When the central area became larger, its activity dominated the PVER, and the contribution from the peripheral retina became negligible at this stage. The PVER was highly dependent upon the activity of the central retina, and activity levels from the central and surrounding peripheral retina were correlated. PMID- 1776413 TI - Image analysis of changes in drusen area. AB - Computerized image processing was used to analyze color fundus photographs of 11 patients (22 eyes) with macular drusen who were followed for more than 2 years (mean follow-up, 4.7 years). Significant changes over time (more than +/- 20% of baseline area) were measured in the surface area of macular drusen in 18 of 22 (82%) eyes. An increase in the drusen area was associated significantly with eyes with mostly hard drusen and an initially smaller drusen area; but a decrease was associated with eyes with mostly soft drusen and an initially larger drusen area (P less than 0.01). The mean absolute rate of change in the drusen area was more than twice as great in eyes with mostly soft drusen compared with those with mostly hard drusen (P less than 0.05). All eye pairs studied showed a concomitant increase or decrease in the drusen area. PMID- 1776414 TI - Digitizing 35 mm colour slides for computerized general image handling in ophthalmology. AB - Standard personal computers with appropriate graphic user interfaces can now be configured for work with near photographic quality colour image handling. Advantages and limitations of digitized colour image work, including cost considerations, are discussed in relation to some common ophthalmic photography situations. Practical methods are briefly described. Future developments are outlined, particularly methods for direct acquisition of high quality colour images and image compression/reduction. PMID- 1776415 TI - Intraocular microdialysis with permanently implanted probes in rabbit. AB - The technique of microdialysis in vivo, much used in brain experiments, has been adapted for intraocular use. A new probe was designed, made from a soft tube with the dialysis membrane mounted in a fenestrated protecting sleeve, facing one side. A special surgical procedure was developed for the long-term implantation of the probes. They stay functional in the eyes for several weeks or more. Previously published intraocular microdialysis studies were short-term experiments. The acute surgical trauma is likely to affect the concentration of many compounds in the vitreous, and this effect is minimized with long-term probes. PMID- 1776416 TI - Secondary IOL power calculation. A comparison of an optical and a biometric method. AB - In 40 aphakic eyes undergoing secondary IOL implantation, the axial length was calculated optically as well as measured by ultrasound, and the two methods of axial length determination were compared to evaluate the accuracy in the calculation of secondary IOL power. The mean refractive prediction error (+/- SD) was 0.18 diopters (+/- 0.96) and -0.37 diopters (+/- 0.83) using the optical and the biometric method, respectively. The difference in mean value was significant, whereas the variation around the mean value was not found to be significantly different between the two methods. A calculated axial length may offer a valuable alternative to biometry in the aphakic eye, increasing the accuracy of secondary IOL power calculation. PMID- 1776417 TI - Congenital ectopia lentis and secondary buphthalmos likely occurring as an autosomal recessive trait. AB - A family from Turkey with congenital ectopia lentis, likely occurring as an autosomal recessive trait, is presented. No systemic disorders such as homocysteinuria, Marfan's or Weill-Marchesani's syndromes were found in any of the patients. However, all patients except one were less than 2 years old when first examined so that lens luxation must have happened very early in life. Besides almost total lack of zonular threads the patients presented anomalies of ocular dimensions with increased corneal diameters and axial lengths, and in several cases glaucomatous distension of the optic discs could also be found. A possible explanation for these buphthalmic changes and their relation to lens luxation taking place very early in life is proposed. The importance of early diagnosis and treatment is discussed. PMID- 1776418 TI - Corneal alkali burn in the rabbit. Waterbalance, healing and transparency. AB - Healing following a standardized central corneal alkali wound was studied morphologically in New Zealand white rabbits up to one year after the initial wound. Clinical examination, light and transmission electron microscopy was performed. The study was focused on how permanent scar tissue formed. Following the penetrating alkali injury, all cells (epithelium, keratocytes and endothelium) in the wound area disappeared. The fibroblasts/keratocytes repopulated an extensively swollen central corneal stroma. Cells and extracellular matrix filled stromal lacunae in an irregular fashion and upon deswelling the lacunae remained as irregularities in the stroma, reducing the transparency. In the periphery of the wound repopulation occurred in a less swollen stroma and normal cytoarchitecture and transparency resumed. It appears that the degree of swelling decides the degree of scar tissue formation in the corneal stroma following alkali wound healing. PMID- 1776419 TI - Superficial keratectomy with the 193 nm excimer laser: a reproducible model of corneal surface irregularities. AB - Rough corneal surfaces may be smoothed by performing a superficial keratectomy with the 193 nm excimer laser. In order to smooth an irregular surface, a substance must be used during ablation to protect low corneal areas so that high spots are ablated preferentially. A simple, accurate, and reproducible method for modelling various corneal surface irregularities was developed. The technique uses the excimer laser to imprint the patterns of various metallic grids onto the stromal surface. The model was used to facilitate a comparison of three potential smoothing agents: 0.5% tetracaine, 2% hydroxypropylmethylcellulose, and a fluorescein-containing hyaluronate preparation. Preliminary results indicate that tetracaine may be the most efficacious smoothing agent. PMID- 1776420 TI - Biochemical changes in rabbit sclera following destruction of pigment epithelium. AB - The long-term effect of destruction of the pigment epithelium by sodium iodate on the biochemistry of rabbit sclera was studied in one group with intravenous injection of sodium iodate, and in a second group with injection of sodium iodate into the right eye. Intravenous treatment produced a non-significant increase in the uronic acid concentration. In the second group the untreated fellow eye was microscopically intact, but was shown (as the treated eye) to alter the concentration of uronic acid in different parts of the sclera. All eyes from treated animals exhibited changes in the relative content of the various glycosaminoglycans and in the content of hydroxyproline, hydroxylysine and proline. This work indicates that the pigment epithelium may play a key role in the control mechanism of the scleral connective tissue, and this again has major implications in terms of a possible medical treatment of axial myopia. PMID- 1776421 TI - The brightness-sense comparison in patients with optic nerve hypoplasia. AB - The brightness-sense has been assessed for a cohort of individuals with optic nerve hypoplasia, and for a group of normal subjects. It was found to be significantly impaired in the worst eye as compared to the fellow eye in patients with asymmetrical bilateral optic nerve hypoplasia. No difference in brightness between the two eyes was perceived in two patients with segmental optic nerve hypoplasia. The brightness-sense comparison test has not hitherto been applied to patients with optic nerve hypoplasia. The test is simple to use and provides an additional investigative tool for the clinician to detect optic nerve dysfunction. PMID- 1776422 TI - Contrast sensitivity in radial keratotomy. AB - In a prospective study, contrast sensitivity function was determined before and one month postsurgery in 15 consecutive cases of radial keratotomy. The results obtained pre-operatively were compared to those of an age-matched, emmetropic reference group also comprising 15 persons. Three different test conditions were employed. High luminance background levels of 130 cd/m2, low luminance levels of 3.5 cd/m2 and low luminance levels completed with a central glare source of 7.5 lux. Using an eight-incisional radial keratotomy technique with a 3 mm optical zone, a median reduction in myopia of 3.5 diopters was observed. Corrected visual acuity was not affected by the surgery. The contrast sensitivity functions of the myopic group pre-operatively compared to the post-operative values showed no significant difference for any of the three test conditions. Compared to the reference group, the myopic group pre-operatively demonstrated a statistically significant reduced contrast sensitivity for all test conditions. PMID- 1776423 TI - A clinical comparison of optical and ultrasonic pachometry. AB - Central corneal thickness (CCT) of normal and oedematous corneae was measured in a study comparing a modified Haag-Streit optical pachometer and an ultrasonic pachometer (Teknar Ophthasonic, preset velocity 1630 m/s). Sixty-eight patients were examined before and after cataract extraction with implantation of an anterior chamber lens. Mean values of CCT before operation were 531 +/- 4.9 (SEM) micron by optical pachometry and 524 +/- 4.7 microns when measured by ultrasound (not significantly different). On the first post-operative day the values were 618 +/- 8.4 and 602 +/- 7.6 microns for optical and ultrasonic measurements, respectively (significantly different, 2P less than 0.001). Correlation analysis showed a high dependence between the methods with coefficients of correlation being 0.955 before and 0.958 after the operation. Linear regression analysis revealed small, but significant differences between the techniques. The difference between the two methods increased with increasing corneal hydration, whereas it could not be ascribed to sex, age, or intraocular pressure. It is concluded that for clinical purposes optical and ultrasonic pachometry techniques are comparable. PMID- 1776424 TI - Pseudoexfoliation syndrome and diabetes mellitus. AB - The frequency of pseudoexfoliation syndrome (PXF) was determined prospectively in 2 outpatient cohorts: a normal control group and a diabetic group with or without evidence of diabetic retinopathy. Four hundred and eighty-nine normal patients over the age of 50 years (group A) were compared with 325 diabetic patients of comparable age (group B). Within the diabetic cohort 121 patients did not exhibit signs of diabetic retinopathy, whereas the rest were suffering from either background diabetic retinopathy (143), or proliferative diabetic retinopathy (61). Pseudoexfoliation syndrome was present in 23.7% of patients in group A and 11% of patients in group B. Within the latter group, PXF was significantly less prevalent in the subgroup consisting of patients with proliferative diabetic retinopathy (3.2%). Correlating well to the age, PXF was significantly less prevalent for the age group 60-70 and greater than 70 for these patients. These results indicate that PXF occurs less frequently in diabetics with background diabetic retinopathy and even less so in the presence of proliferative diabetic retinopathy. PMID- 1776425 TI - Migration of rabbit corneal endothelial cells on vitreous strands. An organ culture experiment. AB - Anterior vitreous synechia, sometimes seen as a complication after anterior segment surgery, has been mimicked in organ culture experiments. A specimen consisting of a cornea with a vitreous strand adhering to the posterior surface has been kept in culture medium for 6 and 12 days. Migration of corneal endothelial cells onto the surface of the vitreous strand started after 6 days, and the surface of the strand was partly or almost totally covered by corneal endothelium after 12 days. At this stage the cells were elongated and directed along the strand. In clinical situations a vitreous strand adhering to the cornea may exert traction on the retina. This traction may be caused by contraction of actin filaments in endothelial cells covering the strand. This experimental model may be used in attempts to modify the behaviour of the cells by pharmacological manipulation. PMID- 1776426 TI - The effect of sodium-hyaluronate on scar tissue formation under a subconjunctival silicone implant in the rabbit. AB - The effect of sodium-hyaluronate on scar tissue formation under a subconjunctival silicone implant was examined in twenty rabbits. During the follow-up period histological sections for evaluation of local reaction and thickness of fibrous tissue were made at day 7, 17, 30 and 60. Although no statistically significant difference could be shown the thickness of scar tissue under the implant in hyaluronate injected eyes was greater than in control eyes during the first seventeen postoperative days, after which the difference started to diminish. Also the inflammatory response in hyaluronate injected eyes in the early postoperative period was more noticeable than in control eyes. PMID- 1776427 TI - Unilateral naso-orbital meningocele and bilateral congenital fistulae of the lacrimal passages. AB - Orbital meningocele is the protrusion of a sac containing cerebrospinal fluid into the orbit, through a defect called cranium bifidum. Although the occipital and frontal basis of the cranial cavity constitute the two most frequent localizations, this pathology may rarely be located in the naso-orbital region. Other developmental anomalies of the eyes may accompany the anomalies of the bony orbit. The case described in the present paper had a right naso-orbital meningocele associated with bilateral fistulae of the lacrimal passages which represents a very rare condition. PMID- 1776428 TI - Pseudallescheria Boydii keratitis. AB - Pseudallescheria Boydii is one of the rarer organisms known to cause mycotic keratitis, only 13 previous cases having been reported in the literature. What is believed to be the first case of Pseudallescheria Boydii keratitis successfully treated with topical Miconazole is reported here. PMID- 1776430 TI - Medical use of ultrasound. PMID- 1776429 TI - Non-secretory superficial epithelial cells. PMID- 1776431 TI - [Functional stenosis of the hypopharynx and cervical esophagus]. PMID- 1776432 TI - [Hypopharyngeal stenosis caused by extrinsic compression]. PMID- 1776433 TI - [Treatment of benign stenosis of the hypopharynx and cervical esophagus caused by caustics and iatrogenic]. PMID- 1776434 TI - [Radiotherapy in the treatment of carcinoma of the cervical esophagus: contribution, criteria of integration, limitations]. PMID- 1776435 TI - [Relations and variability of the stapedial reflex threshold and psychoacoustic discomfort threshold]. AB - Ten normal hearing subjects were subjected to repeated measurement of the stapedial reflex threshold (RT) and loudness discomfort threshold (DT) during five separate sessions. On the average DT was 4.8 dB higher than the RT. The sessions did not affect the intra-individual variance of either threshold. A regression analysis demonstrated that a significant linear relationship exists between RT and DT. However, DT may be lower than RT when the latter is shifted towards its upper variance boundary. Hence, RT and DT are not equivalent as indicators of the upper limit of loudness tolerance; since DT revealed a low intra-subject variance, such a psychoacoustic measurement may be reliably used for clinical purposes. PMID- 1776436 TI - [Invasion of the thyro-hyoid-epiglottic space by carcinoma of the vestibulum laryngis: prognostic and therapeutic implications]. AB - Invasion of the thyro-hyoid-epiglottic (TIE) space in supraglottic carcinoma is a frequent occurrence which, in most cases, only reveals itself upon post-surgical histology. In order to verify the current feeling that subclinical invasion does not in any way worsen prognosis the authors performed a retrospective study on the oncological results of 98 patients with T1-T2 supraglottic carcinoma. Of these 67 were treated by supraglottic laryngectomy while 31, taken as controls, had undergone total laryngectomy because of contraindications of a general nature. Histological examination of the surgical samples showed signs of space invasion in 60% of the cases. In these cases, there was a higher percentage of poor results (greater than 20%; mainly T recurrence) no matter what type of surgery had been performed. Therefore, subclinical invasion of the space must be considered as having an effect on prognosis and the authors feel that, whenever the pre-operative semiological criteria are insufficient to optimize surgical results, the patients presenting subclinical invasion of the space should be subjected to complementary radiotherapy. PMID- 1776437 TI - The effect of hypoallergenic formula on the occurrence of allergic diseases in high risk infants. AB - To study the influence of hypoallergenic milk on the occurrence of allergic diseases, thirty-three high risk, normal full-term newborns were divided into two groups with comparable family allergy score (FAS) and cord serum IgE. Group A consisted of 18 babies fed since birth with regular formula, while group B included 15 babies fed breast milk and/or NAN H.A. (Hypoallergenic infant formula) for the first 6 months of life. Close clinical observations for the appearance of atopic dermatitis, allergic rhinitis and wheezing as well as serial examination of total serum IgE and milk-specific IgE antibodies were done during the first year of life. The results showed: 1) Infants fed regular formula had a higher incidence of moderate to severe atopic dermatitis (AD) and allergic rhinitis (AR) than those fed NAN H.A. (39% vs 13% for AD; and 33% vs 13% for AR), but the difference was not significant. There was no difference in the incidence of wheezing between these two groups; 2) There was no relationship between cord blood IgE and FAS; 3) Neither the cord blood IgE nor FAS influenced the occurrence of allergic diseases and total serum IgE at one year of age; 4) Hypoallergenic milk (NAN H.A.) could support normal growth and development. In conclusion, a higher incidence of moderate to severe AD and AR was found in high risk infants fed regular formula than in those fed hypoallergenic milk. However, a study with a larger number of babies and a longer period of follow-up is needed to obtain a solid conclusion. PMID- 1776438 TI - Efficacy and safety of oral cefixime therapy in common infectious diseases in children. AB - Twenty-nine children, including 20 boys and 9 girls, were enrolled in an open trial of oral cefixime therapy for common pediatric infectious diseases. Patients aged between 0.5 month and 12 years with a mean +/- standard deviation of 2.3 +/- 2.8 years. The diagnoses included 10 of acute otitis media, 2 of purulent rhinitis, 4 of acute enterocolitis, and 13 of urinary tract infection. Most children received 6-12 mg/kg/day of cefixime granules, orally twice daily for more than five days. All 10 cases (100%) of acute otitis media and 2 cases of purulent rhinitis were either cured, or improved by oral cefixime treatment. None of them was microbiologically evaluable. Four cases (100%) of acute enterocolitis, 3 due to Salmonella group B, one due to Shigella flexneri, were also successfully treated with bacteria eradication. However, the cure rate of 13 cases of urinary tract infection was only 85% (11/13). Seven Escherichia coli and 4 Proteus mirabilis infections were eradicated, whereas one each of Enterobacter cloacae and Klebsiella pneumoniae infections did not respond to treatment; these two cases had a complicated course. The overall cure and improvement rate was 93%. Although five patients had transient episodes of mild diarrhea, no significant adverse reaction was observed. In summary, oral cefixime given twice daily was effective and safe in the treatment of a variety of common infectious diseases in pediatric patients. PMID- 1776439 TI - [Microcolon in newborns: clinical significance and differential diagnosis]. AB - Microcolon is a radiological finding of a colon of tiny caliber on barium enema examination. There are no absolute standards for measurement of this condition which is probably caused in utero by lack of appropriate distention of the colon with intramural content. A review was undertaken of 228 barium enema examinations of newborns admitted to Mackay Memorial hospital from January 1987 to December 1988. Twenty cases (8.7%) were regarded by the same radiologist as microcolon. Among them, ileal atresia was found in nine cases (45%); colonic atresia in two cases (10%); total colon agangliosis in three cases (15%); prenatal volvulus in two cases (10%); meconium ileus in two cases (10%); duplication of ileum in one case (5%): and megacystis-microcolon-intestinal hypoperistasis (MMIHS) in one case (5%). The characteristic features of plain abdomen and barium enema study were discussed. The finding of a microcolon on contrast enema study in newborn with lower gastrointestinal obstruction signifies that it may rise from lower gastrointestinal obstruction above colon, external compression, or motility disorder of the intestine itself. The outcome of microcolon seems to depend on its underlying causes. In those caused by obstruction, only the caliber may return to normal within days after removal of the obstruction. PMID- 1776440 TI - [Control of staphylococcal skin infections in a nursery]. AB - Outbreaks of skin infections due to Staphylococcus aureus continue to be a major problem in newborn nurseries. In this report, we described how the staphylococcal skin infections were controlled in the nursery during the last 5 1/2 years. An outbreak of staphylococcal skin infection (totally 29 cases) developed in January 1985, and declined dramatically to 3 cases in March of the same year when 3% hexachlorophene (HCP) bathing was used (period 1-January 1985 to March 1985). The infections increased to 30 cases in May when HCP bathing was discontinued and was replaced by baby soap baths (period 2-April 1985 to May 1985). Once again, HCP bathing (period 3-June 1985 to January 1987) was reinstituted and infection rate was reduced. After discontinuation of HCP (period 4-February 1987 to March 1987), another outbreak of staphylococcal skin infection reappeared. It was controlled again with HCP bathing (period 5-April 1987 to April 1988). Daily baby soap baths were continued during period 6 (May 1988 to October 1988), and skin infections increased again. Finally in period 7 (November 1988 to June 1990), daily baby soaps were reinstituted and a triple dye was applied daily to the cord and to the surrounding skin (1 inch diameter) until discharge. During this period, staphylococcal skin infections was reduced to 1-4 cases and no more outbreaks occurred. Our data confirmed that 3% HCP bathing of newborns reduced the infection rate of Staphylococcus aureus during an endemic period, and supported that triple dye may be an alternative to HCP for preventing staphylococcal skin infection in a newborn nursery. PMID- 1776441 TI - [Clinical observation of neonatal meningitis caused by flavobacterium meningosepticum]. AB - From January 1981 to December 1988, we collected 11 cases of neonatal meningitis caused by Flavobacterium meningosepticum. The 6 male and 5 female newborns ranged from 3 days to 20 days old. Birth body weight varied from 1100 gm to 3600 gm. Seven cases were premature or small for date. Nosocomial infection was noted in 7 of these 11 cases. Clinically, lethargy and poor activity were the most common symptoms. Cyanosis, fever and convulsion were the next. There were 9 cases showing pleocytosis, increased protein and decreased glucose level in the cerebrospinal fluid examination. The organisms isolated in all 11 cases were susceptible to piperacillin, resistant to ampicillin, aminoglycosides and cephalosporin. Five patients were treated with antibiotics other than piperacillin for 5 to 18 days. Three patients died; hydrocephalus was the cause of death in 2 of them. Two patients were discharged against advice. Among the remaining 6 cases we gave piperacillin for 3 weeks, one case developed hydrocephalus but eventually succumbed to K. pneumoniae sepsis. Out of five surviving cases, 3 developed hydrocephalus (VP shunt performed in two). The other two patients were discharged without neurological deficit. In conclusion, neonatal Flavobacterium meningosepticum meningitis was more frequent in premature or small for date babies, and it usually appeared in nosocomial infection. The prognosis was poor and piperacillin was proved to be the drug of choice. PMID- 1776442 TI - Niemann-Pick disease type B with ocular involvement: report of a case. AB - Niemann-Pick disease (NPD) type B was diagnosed clinically and enzymatically in a 5-year-old girl presenting with failure to thrive, hepatosplenomegaly, diffuse interstitial infiltration of both lungs on chest roentgenograms, cherry red spot, and foam cells in the bone marrow aspirate. Intelligence and neurological examination were normal, sphingomyelinase activity was severely deficient in cultured skin fibroblasts. We present the first case of NPD type B in Taiwan and relevant literatures were reviewed. PMID- 1776443 TI - Tuberous sclerosis with cardiac rhabdomyoma manifested by fetal bradycardia: report of a case. AB - This is a case of neonatal tuberous sclerosis associated with cardiac rhabdomyoma and manifested by fetal cardiac arrhythmia-bradycardia. The prenatal echocardiography showed multiple cardiac tumors which occupied the left and right ventricles. The largest one measured 5.2 cm in diameter. It was found to be 4.5 x 4.1 x 3.5 cm in size at autopsy. A postnatal cranial echogram showed multiple subependymal nodules. The patient expired after 7 hours of life. The autopsy findings confirmed the diagnosis. The mother of the patient had adenoma seb'aceum on the face and an ungual fibroma on the left little finger. Cranial computerized tomography revealed a small calcified tubercle. PMID- 1776444 TI - Ataxia-telangiectasia associated with torticollis: report of a case. AB - Ataxia-telangiectasia (A-T) is an autosomal recessive, multisystem disease characterized clinically by the onset of progressive cerebellar ataxia at about one year of age, followed by the development of fan-shaped telangiectasia of bulbar conjunctiva, usually at four- to six-years of age; and frequent sinopulmonary infections. The outstanding pathological findings in the central nervous system in A-T are loss of Purkinje cells and, to a lesser degree, basket and granular cells of the cerebellum. Although choreoathetosis and myoclonic jerks had been described in patients with A-T, torticollis has never been reported in the literature. A 7-year-old girl with A-T and torticollis is therefore presented in this paper. PMID- 1776445 TI - Hirschsprung's disease: an analysis of 104 cases. AB - One hundred and four cases of Hirschsprung's disease in infants and children diagnosed at the National Taiwan University Hospital during the period of 1984 to 1989 were analysed for demographic patterns, clinical manifestations, accuracy of various diagnostic procedures, especially the reliability of suction biopsy, and postoperative course. The important symptom constellation included abdominal distention, delayed meconium passage, and tight anus in the biopsy-positive group. Complementary diagnostic procedures were mandatory for accurate diagnosis, since 26% of the patients (7 of them with ultrashort segment) were diagnosed over a period of more than two months. The first biopsy in 25% of the patients aged less than 1 month could not be interpreted, and in 27.6% of this subgroup the radiological pictures were inconclusive. Further scrutiny of clinical manifestations together with other elaborate study including repeated rectal biopsies may be required for establishing a definite diagnosis of the disease. The surgical mortality is low, but surgical morbidity remains high and needs further improvement. PMID- 1776446 TI - A clinical observation of achondroplasia. AB - Twenty-five cases of achondroplasia followed for a period of recent three years are reviewed. There were 17 males and 8 females. Twelve cases (48%) visited us before one-year-old. Familial vertical transmissions were noted in only three patients (12%) and others were new mutations. Patients usually had typical rhizomelic short stature, large head, frontal bossing and trident fingers. Their heights were around four standard deviations below the 50th percentile of the normal growth curve. The head girths of several patients were above the 97th percentile of the normal growth curve, but were normal in a special growth chart for achondroplasia. No mental problem was noted in our patients. Three of the seven patients older than five years had severe leg bowing and kyphosis, and the oldest one (17-years-old) had nerve compression symptoms. Genetic counselling and the management of complications in achondroplasia are important. PMID- 1776447 TI - [Staphylococcal colonization rate on neonatal nares and umbilical cord in a newborn nursery]. AB - Staphylococcus aureus and Staphylococcus epidermidis were the most important gram positive pathogens found in a five-year study (1985-1989) of nosocomial infection in this hospital. They caused 56.2% of all nosocomial infections in this newborn nursery, particularly skin infections. To determine the reasons, and to decrease effectively the neonatal staphylococcal colonization rate, three different disinfection methods were selected for management of neonatal umbilical cords. A total of 1578 swabs from neonatal nares and umbilical cords were collected. During the first period no disinfectant was applied to the cord after bathing the baby. Beta-iodine in alcohol and bacitracin ointment were used for the second and the third periods, respectively. The result showed a significant difference (P less than 0.05) in staphylococcal colonization rate on neonatal umbilical cord using different disinfectants even after the first day. The same result for neonatal nares was also found, after infants had been in the nursery for two days. During the third period, no case of skin infection was found. Most Staphylococcus aureus isolated were resistant to ampicillin, erythromycin, tetracycline and penicillin. The percentage of this antibiogram found in neonatal nares and umbilical cords was 44% and 56% respectively. Besides nosocomial infection control and surveillance of medical personnel, environment, materials, instruments and isolation techniques, it is really necessary to choose an effective disinfectant (bacitracin ointment is recommended) to reduce the staphylococcal colonization in newborn nurseries. PMID- 1776448 TI - [An index for childhood nutrition--"chung-hsin" index]. AB - For evaluation of growth and development of children, a nutritional index is one of the most important guides. Many methods have been proposed to estimate the index. Kaup's Index is one, used frequently to check the nutritional condition, but it is unsuitable for evaluation of infants under three-months-old. From July 1, 1986 to June 30, 1989, random selection of 274 normal, full-term newborns was made at Taipei Municipal Chung-Hsin Hospital; others studied were 477 normal healthy infants and preschool children from the well-baby clinic, and 629 normal healthy students from kindergartens and elementary schools in nearby downtown and rural area of Taipei County. Body weights (by gram) and body heights (by centimeter) were checked before eating. Naked for children under 3-years-old; those older were checked when wearing only underwear. The nutritional index was calculated by formula of 3 square root of W/Lx100 (Temporarily called "Chung-Hsin Index"). The distribution of Chung-Hsin Index was comparable to kaup's Index for children of three months or older. Under three months the distribution of Kaup's Index cannot be adapted as well as the Chung-Hsin Index. In conclusion, it was found that extraction of the cubic root of body weight and body height among normal newborns showed normal distribution. The Chung-Hsin Index, 3 square root of W/Lx100, which was based on the idea of normal distribution, is suitable for evaluation of the balance of body weight and body height not only in children under 3 months, but also in children up to 15 years old. PMID- 1776449 TI - [Complications in the use of mechanical ventilator in newborns: one year's experience]. AB - A retrospective study was undertaken of 175 patients (119 males, 56 females) admitted to the neonatal intensive care unit of Mackay Memorial Hospital during the period of July 1, 1985 to June 30, 1986 who received mechanical ventilation during their stay at the hospital. Upon reviewing the clinical histories of these patients, the complication rate of mechanical ventilation was 31.9%. The percentages of each complication were: pneumothorax 50.0%, pneumomediastinum 5.2%, pulmonary interstitial emphysema 1.7%, atelectasia 13.8%, pneumonia 13.8%, chronic lung disease 13.8%, nasopharyngeal infection 1.7%. Survival rate of these ventilated patients with or without complication was not significant statistically (69.2% vs 65.6%). However, with regard to the hospital course, cases with complication had a significantly longer duration of ventilator usage, hospital stay and oxygen usage than uncomplicated cases. In conclusion, experienced personnel are needed to supervise the use of mechanical ventilation in neonates, and a team of well-trained nurses working in the neonatal intensive care unit are essential to minimize complications. PMID- 1776450 TI - Subcutaneous fat necrosis of newborn: report of two cases. AB - Subcutaneous fat necrosis of newborn (SFNN) is an uncommon disorder. Submandibular lesion and tissue eosinophilia have not been documented. Two patients with unusual location and unusual pathological findings are reported. Both patients were giant babies, delivered by vaginal route spontaneously with birth injury. Asymptomatic subcutaneous nodules were found over the submandibular area at the ages of 16 and 6 days respectively. Nodules disappeared spontaneously at the age of one month in the first, and two months in the second patient. Histopathological examination of the nodules revealed features typical for SFNN: lobular panniculitis with fat necrosis and radiating needle-shaped clefts within multinucleated histiocytes. In addition to mononuclear cells, eosinophils were abundant in the infiltrate. Because of these unusual features, it is suggested that SFNN should be considered in the differential diagnosis of submandibular subcutaneous nodule in the newborn, clinically; and of lobular panniculitis with eosinophilia, histologically. PMID- 1776451 TI - Crisis in Gaucher disease simulating osteomyelitis: report of one case. AB - An 11-year-old boy with Gaucher disease developed acute bone pain of the left thigh, accompanied by fever and signs of inflammation. Initially he was treated as osteomyelitis with antibiotics. Cultures of blood and aspirate of a subperiosteal hematoma were negative for bacterial growth. Tc99m bone scan revealed relatively decreased uptake over the involved area, and the findings of magnetic resonance imaging were typical for Gaucher crisis. Although Ga 67 imaging was positive, the diagnosis of a bone pain crisis rather than an infection was made. Antibiotics were discontinued without sequelae. Differential diagnosis between Gaucher crisis and osteomyelitis is discussed. PMID- 1776452 TI - [Myoclonic epilepsy with ragged-red fibers: report of one case]. AB - Myoclonic epilepsy with ragged-red fibers (MERRF) is one of the mitochondrial encephalomyopathies. This article presents a nine-year-old boy who had been noted to have psychomotor retardation since infancy, and had progressive myoclonic epilepsy since he was four. The myoclonic epileptic seizures were refractory to the conventional anticonvulsants. The brain MRI, echocardiography and brainstem auditory-evoked-potential showed negative findings, but electroencephalography showed episodic generalized spike wave complexes. Oral glucose lactate stimulation test revealed abnormal elevation of lactic acid, and muscle biopsy showed ragged-red fibers. Subsarcolemmal accumulations of mitochondria with abnormal cristae in the muscle cells were noted under electronmicroscopic study. The patient was administered coenzyme Q 90 mg per day orally, with dramatic improvement in myoclonic seizures. The patient is still being followed up as an outpatient. PMID- 1776453 TI - [Ventriculo-peritoneal shunt in the treatment of schizencephaly with infantile spasm: report of one case]. AB - Schizencephaly is a rare congenital cerebral malformation, which usually produces static neurological symptoms. Occasionally, mass effect on the schizencephalic cavity may cause progressive neurological deficit. Surgical intervention is, therefore, needed to relieve the increased intracranial pressure. This article presents a 7-month-old girl who had suffered from right hemiparesis since birth, and head nodding of four weeks' duration. A brain CT revealed a cleft, along the left Sylvian fissure, which communicated with the lateral ventricle. The septum pellucidum was absent. Midline structures had shifted to the right hemisphere. The CT finding was consistent with a diagnosis of schizencephaly with mass effect. The infant received a ventriculo-peritoneal shunt operation. At postoperative follow-up which has continued for eight months, no further head nodding, an improvement of hemiparesis and psychomotor development were noted. PMID- 1776454 TI - Peritonitis in children with nephrotic syndrome. AB - In a retrospective review of 300 children with nephrotic syndrome seen at National Taiwan University Hospital throughout the 12-year period from 1978 to 1990, 20 episodes of peritonitis were identified in 17 patients (7.4%). Gram negative bacilli (E. coli and Klebsiella pneumoniae) were the majority of pathogens, accounting for 55% of all the cases. Streptococcus pneumoniae were cultured from only 15% of the patients. An additional 15% had negative culture results, but were clinically responsive to penicillin. In 15% of cases the cause was unknown. Clinically, peritonitis was characterized by abdominal pain (100%), abdominal tenderness (100%), rebounding pain (85%), leukocytosis (85%), and fever (75%). Based on this data, it seems reasonable to initiate antimicrobial therapy in nephrotic children with suspected peritonitis, using a combination of penicillin plus either an aminoglycoside or a broad-spectrum cephalosporin. This regimen should be continued until culture results are available. PMID- 1776455 TI - Analysis and clinical correlates of the 14 and 6 Hz positive electroencephalographic spikes in Chinese children. AB - From January 1987 to March 1991, electroencephalographic (EEG) analysis and clinical correlates of the 14 and 6 Hz positive spikes were studied retrospectively in 2,026 Chinese patients, ranging in age from 1 to 18 years. All of them were the first-evaluation patients of Pediatric Neurology Clinics, National Taiwan University Hospital, each had had through EEG examinations (including waking and natural sleep records) and detailed medical records. The major findings of the present study are: (1) The overall incidence of the 14 and 6 Hz positive spikes in the series was 2.52% (51/2,026), and that in the age subgroup 1-5 years was significantly lower than those in the subgroups 6-10 years (p less than 0.0001) and 11-15 years (p less than 0.01). (2) 38 out of 51 cases (74.5%) with 14 and 6 Hz positive spikes presented normal EEG background activity. (3) 7 out of 51 cases (13.7%) had coincided negative spikes in frontal areas, and 12 out of 51 cases (23.5%) were associated with other focal or generalized paroxysmal discharges. (4) From the analysis of the clinical manifestations in the 51 cases with the 14 and 6 Hz positive spikes, the episodic attacks of headache, abdominal pain or other autonomic symptoms were most common (49%, 25/51 cases). Of the 25 cases, 19 cases (37.2%, 19/51 cases) were finally diagnosed as autonomic seizure or abdominal epilepsy and 3 cases were diagnosed as migraine. 3 of 10 cases with convulsive seizure or complex partial seizure were associated with autonomic symptom. (5) The etiology in 36 out of 51 cases (70.6%) remained unknown.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1776456 TI - Quantification of arylsulfatase B activity and diagnosis of Maroteaux-Lamy syndrome. AB - Mucopolysaccharidoses (MPS) are a group of inherited lysosomal storage disorders, each with deficiency of an enzyme degrading glycosaminoglycans (GAG). To increase the ability to differentiate each of the disorders, the N-acetyl-galactosamine-4 sulfatase (arylsulfatase B) activity was measured in human peripheral leukocytes and skin fibroblasts. The assay employed p-nitrocatechol sulfate as an artificial substrate, and barium salt as an inhibitor to arylsulfatase A. Applying this method, a case of Maroteaux-Lamy syndrome (MPS type VI) was recognized in a six year-old girl who had cloudy cornea, coarse-appearing face, mucopolysacchariduria, and white cell metachromasia. Her body height and mentality were normal. Arylsulfatase B activity in her skin fibroblasts was around 5% of normal. Diagnosis of MPS VI, especially in its milder form, depends on enzyme test. PMID- 1776457 TI - Urinary N-acetyl-beta-glucosaminidase in children with idiopathic nephrotic syndrome. AB - Twenty-one nephrotic children, aged 2 to 15 years, were studied for their urinary N-acetyl-beta-glucosaminidase (NAG) and daily urinary total protein, in a total of 35 episodes. Among them, 18 patients had urinary NAG levels (77.3 +/- 112.1 u/g Cr) above normal mean + 2 SD for age, while 3 had normal levels during the nephrotic stage. No or poor correlation was found between urinary protein and NAG. In eight of these patients, urinary NAG levels during heavy proteinuria and after remission were evaluated. No significant change was detected. These observations suggest that urinary NAG excretion in nephrotic children is not caused by an increased glomerular permeability to macromolecules. Instead, the elevated urinary NAG may reflect the activity of associated renal tubular dysfunction or tubulointerstitial involvement in the nephrotic syndrome. PMID- 1776458 TI - [Tumors detected in renal ultrasonic screening]. AB - A program of rapid mass screening of kidneys was conducted with ultrasound for initial detection of renal and the adjacent organ abnormalities in school children and neonates in Taipei area from March 1987 to December 1990. More than a half million population were examined and the frequency of the abnormality was approximately 0.5%. Of the patients 22 had a tumor, including 13 boys and 9 girls. Age ranges were from neonate to 15 years. The tumor site for 19 patients was in the retroperitoneal space, 6 cases from the kidney, 3 cases from the adrenal gland, 1 case from the pancreas, and 9 cases from retroperitoneal tissue. The other three cases had tumor in the mediastinum, ovary or bladder. In this series, 20 cases received surgery. Pathological examination revealed 8 cases to be malignant, and 12 to be benign lesions. This experience would seem to indicate that rapid renal ultrasonic mass screening may be useful for early detection and management of tumors of the kidney and its adjacent organs. PMID- 1776459 TI - [Comparison of rapid latex and conventional methods for the identification of Staphylococcus aureus]. AB - Rapid latex agglutination assay, staphaurex (Wellcome Diagnostics) was compared with the tube coagulase, thermo-stable nuclease, deoxyribonuclease and mannitol fermentation test for the identification of Staphylococcus aureus. A total of 277 clinical isolates of Staphylococcus aureus, 201 Staphylococcus epidermidis, and 25 Staphylococcus saprophyticus were tested. The results showed that sensitivities were: staphaurex, 99.6%; rabbit plasma, 99.6%; human plasma, 99.2%; thermostable nuclease, 100%; deoxyribonuclease, 100%; mannitol fermentation, 98.9%; as for specificities results showed: staphaurex, 96.6%; rabbit plasma 100%; human plasma, 100%; thermo-stable nuclease, 98.7%; deoxyribonuclease 95.7%; mannitol fermentation, 91.1%; respectively. In our study, staphaurex is recommended because it is simple to operate, save in time and economic in cost. PMID- 1776460 TI - [A study of serum phosphorus and renal phosphate excretion in children of different age groups]. AB - To further elucidate the data of high serum phosphorus concentration reported for foreign children, this study compared the values of serum phosphorus concentration in ethnic Chinese children with foreigners' results, and investigated the potential causes of high serum phosphorus concentration. This study included 33 healthy term male neonates from 2-3 days to 5-7 days old, 1,094 children of 6-18 years old (elementary school-senior high school) and 62 adults. A total of 1,189 persons were studied. Value of serum phosphorus concentration showed no significant difference between boys and girls, and no age dependency; there was notable change in serum phosphorus concentration in growing children of different ages. The mean values of serum phosphorus concentration of neonates aged 2-3 days and 5-7 days (7.20 mg/dl and 7.65 mg/dl, respectively) were the highest; boys aged 6-11 years 5.15-5.50 mg/dl and girls aged 6-11 years 5.14-5.28 mg/dl were the second; boys aged 12-18 years 4.31-4.94 mg/dl and girls aged 12-18 years 4.44-4.96 mg/dl were the lowest. These findings are similar to the conclusions of foreign reports that the older the subjects of the study, the less their serum phosphorus concentration. The maximal transport rates of tubular phosphate reabsorption were determined from a Walton-Bijvoet nomogram using the side-rule method they recommend. The renal phosphate threshold concentration of neonates aged 2-3 days 8.41 mg/100 ml GFR and 5-7 days 7.76 mg/dl GFR was also the highest; boys aged 6-11 years 5.84-6.32 mg/dl GFR and girls aged 6-11 years 5.82-6.10 mg/dl GFR and 5.44-6.10 mg/dl GFR was the second; adult males 3.51 mg/dl GFR and adult females 3.62 mg/dl GFR was the lowest. Increased intestinal absorption of phosphorus, low GFR and low clearance of phosphorus might be the contributing factors to cause high serum phosphorus concentration. Although high renal phosphate threshold capacity is important, increased absorption of phosphorus by G-I tract seems to be another factor in accordance with the need of phosphorus of the growing body cells. PMID- 1776461 TI - Idiopathic dilated cardiomyopathy complicated with brain embolism: report of one case. AB - Idiopathic dilated cardiomyopathy complicated with brain cardioembolism is rarely documented by both 2-dimensional echocardiography and cranial computed tomography in pediatric patients. A 2-year-old girl developed hemiparalysis 15 months after diagnosis of idiopathic dilated cardiomyopathy. The 2-dimensional echocardiograms of left ventricular thrombi, computed tomographic findings of brain embolism, clinical course, treatment and outcome are presented. Previous reports of idiopathic dilated cardiomyopathy in children are reviewed. PMID- 1776462 TI - [Penicillin-resistant pneumococcal meningitis: report of two cases]. AB - Cases of penicillin-resistant pneumococcal meningitis have been reported in other countries since 1977, but never before reported in Taiwan. In 1990, two cases of the disease were diagnosed here. Case one was a two-year-old boy who had had fever and vomiting for several days prior to admission. Under the impression of meningitis, a spinal tap was done. The CSF yielded pneumococcus, which was misinterpreted as sensitive to penicillin. Penicillin (400,000 units/kg/day) was given parenterally without effect. On the 12th day after admission, another spinal tap still yielded pneumococcus. This time the sensitivity test was reread with great care, and then reported to be penicillin-resistant pneumococcus. Minimal inhibitory concentration (MIC) of penicillin was performed simultaneously and it revealed 0.1 microgram/ml. Vancomycin (60 mg/kg/day) was substituted for penicillin. The patient became afebrile two days later, and was discharged ten days later without sequelae. Case two, a five-month-old girl, was diagnosed to have meningitis because of fever, vomiting, tense fontanel and seizure on admission. After a spinal tap was done, she was put on ampicillin and cefotaxime. The fever subsided two days later. At that time, the CSF was reported to grow pneumococcus, again misread as sensitive to penicillin. The antibiotics was switched to penicillin, but fever recurred. The second spinal tap still yielded pneumococcus which was sensitive to penicillin but resitstant to oxacillin. Based on experience with the first case, penicillin was changed to vancomycin, and performed MIC immediately. The MIC was 1.0 microgram/ml. The patient became afebrile two days later, and was discharged in good condition after ten days of treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1776463 TI - [Non-surgical treatment of spinal epidural abscesses: report of one case]. AB - Spinal epidural abscesses (SEA) are uncommon in children. This paper reported a two-year-old boy who was noted to have neck stiffness, with local tenderness posteriorly. Bacterial meningitis was suspected initially in terms of the finding of the cerebral spinal fluid; antibiotics were prescribed. Three days later another spinal tap was performed because of persistent high fever and irritability. A pus-like material drained out as the needle punctured into the spinal region. A magnetic resonance image (MRI) scan of the spine revealed a SEA, with extensive involvement from the second cervical spine to the lumbosacral spine region. Culture of the pus, as well as the blood and CSF, were positive for Staphylococcus aureus. Because of extensive involvement of the spinal epidural space, the patient was again given antibiotics: Prostaphllin and Amikin intravenously for six weeks instead of laminectomy. Then the oral antibiotic (Keflex) was given to the patient for another three months after the boy was discharged from the hospital. A review of the literature shows the incidence of SEA to be increasing and the bacterial spectra to be broadening because of increasing use of immunosuppressing drugs or antibiotics, and the increase in numbers of immunecompromised patient. The clinical symptoms and signs of the SEA were non-specific, but SEA can be early diagnosed by computurized tomography (CT) scan or MRI scan with caution. The literature suggests that, if the patient's condition fits the criteria for non-surgical treatment, antibiotic therapy is the first choice for preventing the complication of spinal deformity, especially in children. PMID- 1776464 TI - Transferrin receptors and selective iron deposition in pancreatic B cells of iron overloaded rats. AB - Iron overload was produced in Wistar rats by repeated intraperitoneal injections of ferric nitrilotriacetate (Fe(3+)-NTA) for one to six months. Pancreatic tissues from these iron-overloaded rats and untreated controls were examined for insulin (for B cells), glucagon (for A cells), transferrin receptor (TfR), transferrin (Tf) and ferritin (Ft) using immunohistochemical methods, and for iron by histochemical Berlin blue staining. In the islets of iron-overloaded rats, increased Ft staining appeared prior to deposition of Berlin blue-stainable iron, and the staining intensity of Ft and iron was stronger in B cells than in A cells. In the islets of untreated control rats, the staining intensity of TfR was stronger in B cells than in A cells. TfR staining of the islets was weaker in iron-overloaded rats than in the controls. These findings suggest that 1) iron uptake by islet cells in vivo is regulated and mediated by TfR, 2) intracytoplasmic Ft transforms into stainable iron in iron-overloaded rats, and 3) predominance of TfR expression in B cells may result in selective deposition of iron and predispose B cells to damage and diabetes mellitus in iron-overloaded rats. PMID- 1776465 TI - Focal segmental glomerular hyalinosis and/or sclerosis in rats with congenital unilateral hydronephrosis. AB - Focal segmental glomerular hyalinosis and/or sclerosis (FSHS) was observed in five Wistar-Imamichi rats with congenital unilateral hydronephrosis (CUH rats). Marked proteinuria (164.9 +/- 138.4 mg/day) was observed in the CUH rats. Immunoperoxidase staining for IgM, C3 and IgG was positive in the glomeruli, showing in a focal, segmental pattern that corresponded to the areas of FSHS seen by light microscopy. These glomerular findings were extremely similar to those of human focal glomerular sclerosis (FGS). FSHS was found to be common to both the hydronephrotic kidney and the contralateral kidney without hydronephrosis. Morphometry revealed that the glomerular area of the juxtamedullary glomeruli was greater than that of superficial glomeruli in control rats (11,037 micron2 vs. 6,847 microns2). On the other hand, glomerular hypertrophy was observed in non sclerotic glomeruli of CUH rats (superficial glomeruli; 12,477-16,123 microns2, juxtamedullary glomeruli; 14,635-18,418 microns2). Also, a decreased in the number of glomeruli within the range 1.8-4.1 per unit area (1 mm2) was seen in CUH rats compared with control rats (mean 4.4). These results suggest that the increased rate of development of FSHS is based on hyperfiltration in the remaining functional nephrons. PMID- 1776466 TI - Use of patients' sera for immunoperoxidase demonstration of infectious agents in paraffin sections. AB - Using patients' sera diluted from 1:10 to 1:1,000 as the primary antibodies in indirect immunoperoxidase staining, the authors visualized a variety of infectious agents in formalin-fixed, paraffin-embedded tissue sections. The target lesions included 1) pyoderma caused by Staphylococcus aureus, 2) cryptococcal infection, 3) dermal sporotrichosis, 4) colon ulcer caused by amebic dysentery, 5) cutaneous leishmaniasis, and 6) chronic liver abscess containing ova of Ascaris lumbricoides. The infectious agents were clearly identified in the respective lesions. Paraffin sections of other kinds of infectious lesions served as controls to clarify the specificity of the immunostaining. While the sera of patients with bacterial and fungal infection showed a wide range of cross reactivity against bacteria and/or fungi, those with parasitic infection exhibited a relatively good specificity for the pathogen. Almost no immunoreactivity of endogenous human IgG in the paraffin sections was demonstrated under the conditions of this study. This approach can be used in diagnostic pathology, particularly when specific heteroantisera or monoclonal antibodies are unavailable. PMID- 1776467 TI - Pathological features of renal cell carcinoma incidentally discovered at autopsy. AB - Renal cell carcinomas incidentally discovered at autopsy (IRCs) were retrospectively analyzed to determine whether they had any pathological features differing from clinical renal cell carcinomas (CRCs): From 7,970 autopsy cases, there were 51 cases (0.65%) of renal cell carcinoma (RC) including 42 men and 9 women (ratio 4.6:1). The mean age of RC cases was 66.3 +/- 12.9 (range of 20 to 91 years). Of the 51 RC cases, approximately half of them (25/51) were IRC cases. No difference was shown in age and sex between IRC and CRC cases. Mean tumor size of IRC was 2.6 +/- 2.5 cm in diameter. This was significantly smaller (P less than 0.01) than that of CRC (7.3 +/- 2.8 cm). Histologically, both grade 1 and clear cell type were significantly more predominant among IRC cases than CRC cases (P less than 0.01 and P less than 0.05, respectively). Only one out of 25 cases of IRC had distant metastasis, as compared to 23 out of 26 CRC cases (88.5%). These pathological features indicate that the incidentally discovered renal cell carcinoma may have less malignant potential than clinical tumors. Unexpectedly, the majority of the IRC cases (88.0%) were associated with advanced neoplasia of other sites, as compared to only 19.0% of CRC cases (P less than 0.01). PMID- 1776468 TI - Melanocytic schwannoma in the spinal canal. AB - A case of melanocytic schwannoma, a rare form of schwannian neoplasm, in the thoracolumbar spinal canal of a 52-year-old man is presented. Histopathologically, the tumor was composed of irregularly interlacing spindle shaped cells showing cystic degeneration, with occasional pigmented tumor cells. The tumor cells showed a low degree of nuclear pleomorphism without any mitotic figures. These histological features were considered to be consistent with a benign schwannian tumor showing pigmentation. Most of the pigments were considered to be melanin histochemically and immunohistochemically. According to the pathological features of the present tumor and those described previously in the literature, the neoplastic Schwann cells were assumed to have melanogenetic capacity, and the concept of the common neural crest origin of Schwann cells and melanocytes appeared to be demonstrated in the present tumor. PMID- 1776469 TI - Necrotizing sialometaplasia in the mouth floor secondary to reconstructive surgery for tongue carcinoma. AB - Necrotizing sialometaplasia is a benign inflammatory process, which histologically can mimic squamous cell carcinoma. A 63-year-old man underwent left hemiglossectomy involving transplantation of a myocutaneous flap for squamous cell carcinoma of the tongue. One month after the operation, necrotizing sialometaplasia occurred in the minor salivary gland tissue of the mouth floor, compressed by the necrotic flap. This case is very unusual because of the occurrence of necrotizing sialometaplasia in the floor of the mouth. The etiology of the lesion was considered to be ischemia secondary to compression by the necrotic myocutaneous flap. PMID- 1776470 TI - Myxoid leiomyosarcoma of the kidney accompanying ipsilateral ureteral transitional cell carcinoma. A case report with cytological, immunohistochemical and ultrastructural study. AB - The authors report a case of myxoid leiomyosarcoma of the kidney accompanying ipsilateral ureteral transitional cell carcinoma. A 74-year-old male patient complained of turbid urine and macroscopic hematuria. He also complained of left back pain, appetite loss and weight loss. Computed tomography revealed a large mass in the left retroperitoneum. Urine cytology disclosed two types of malignant cells, atypical spindle-shaped cells and transitional cell carcinoma. Left total nephro-ureterectomy was performed. The left kidney was occupied by a 6 x 4 x 4 cm, multinodular and mucinous tumor. A transitional cell carcinoma of the left ureter was also observed. The renal tumor was composed of atypical spindle-shaped cells in the mucinous stroma, which showed positive immunoreactivity for anti muscle-specific actin and anti-desmin antibodies. The ultrastructural examination revealed intracytoplasmic microfilaments with dense bodies, pinocytotic vesicles and junctional structure. These findings were suggestive of the myogenic feature of the case. Urine cytology revealed a number of sarcoma cells in this case since the sarcoma cells markedly invaded the renal pelvis and were apt to separate individually in myxoid stroma. Simultaneous and ipsilateral double malignancies of the renal sarcoma and ureteral transitional cell carcinoma have never been reported in the literature. PMID- 1776471 TI - Ovarian sex cord tumor with annular tubules. Report of a case. AB - A 23-year-old woman underwent resection of a tumorous right ovary after long standing irregular genital bleeding. The tumor measured 50 x 30 mm and had a yellowish-white solid cut surface with scattered small cysts. The light microscopic diagnosis was a sex cord tumor with annular tubules. Ultrastructurally, the tumor cells had Charcot-Boettcher filaments and showed vimentin positivity by immunohistochemistry. A three-dimensional reconstruction study proved that the tumor cell nests had a ovoid outer margin and contained blind-ended ellipsoid hyaline bodies. This tumor is presumed to be a variant of sex cord/stromal tumor showing differentiation predominantly to Sertoli cells. PMID- 1776472 TI - A testicular teratoma with rhabdomyosarcoma and seminoma. AB - A case of testicular mixed germ cell tumor with teratoma in a 36-year-old Japanese male is reported. Histologically, it was strongly suggested that the rhabdomyosarcoma had originated from the mesenchymal element of the teratoma. A review of the literature revealed six definitive and two possible previous cases of testicular rhabdomyosarcoma with teratoma, either with or without other germ cell malignancies. However, the present case associated with seminoma as a germ cell tumor is the first of its kind to be reported. In contrast to the poor prognosis observed in the previous cases, the present patient remains free of disease 3 years and 3 months after orchiectomy, chemotherapy and irradiation. PMID- 1776473 TI - Inhibition of human cancer cell lines in vitro with mono- and polynucleotides containing 5-mercaptocytosine bases. AB - Partially thiolated polycytidylic acid (5-mercaptopolycytidylic, MPC) and its double-stranded complex with polyinosinic acid [poly (I)].poly(I).MPC, were assayed in both antiproliferative and cytotoxicity tests against human cell lines: lung carcinoma A549, colon carcinoma HT-29, osteosarcoma HOS, and amnion cells (WISH). Inhibitory effects of MPC were noted in the antiproliferative assay with ID50 of 7, 24, 33, and 35 micrograms.ml-1, and in the cytotoxicity test with ID50 of 164, 174, 210, and 290 micrograms.ml-1 against the HOS, A549, HT-29, and WISH cells respectively. Comparison with the corresponding partially thiolated mononucleotide (5-mercapto-CMP + CMP) and the nucleoside (5-mercapto-cytidine) demonstrated that MPC was a more potent antiproliferative agent than either of its monomeric constituents. The inhibitory effect of MPC upon the incorporation of [3H]thymidine into the DNA of growing A549 cells paralleled its antiproliferative activity. PMID- 1776474 TI - Prevention of ocular inflammation by matrine, prednisolone, and cyclooxygenase and lipoxygenase inhibitors. AB - Lens protein-induced ocular inflammation in rabbits was used to study the action mechanism of some anti-inflammatory agents. Indomethacin, a cyclooxygenase inhibitor, markedly reduced PGE2 and PGF2 alpha in the iris and ciliary body at 2 h but PGE2 only at 4 h. REV 5901, a lipoxygenase inhibitor, only significantly reduced PGE2 levels in the ciliary body at 4 h. PGF2 alpha levels were not affected by REV 5901. When indomethacin and REV 5901 were combined, both PGE2 and PGF2 alpha were suppressed at 2 and 4 h in both iris and ciliary body. Neither matrine nor prednisolone produced significant effects on the levels of PGE2 and PGF2 alpha. However, prednisolone exhibited the greatest reduction in chemotaxis of leukocytes followed by REV 5901. Indomethacin, on the contrary, produced a significant increase in chemotaxis of leukocytes. Matrine produced a decrease in leukocyte counts but was not statistically significant. These results indicate that indomethacin is effective in the early phase of inflammation to reduce PG's production whereas prednisolone and REV 5901 were more effective in the late phase of inflammation. Combined use of REV 5901 and indomethacin could become a drug of choice for the treatment of ocular inflammation without inducing corticosteroidal side effects. PMID- 1776475 TI - Positive inotropic and toxic action of direct lytic factor on isolated working guinea pig hearts. AB - The positive inotropic and the toxic effects of direct lytic factor (DLF) on the isolated working guinea pig hearts were studied. As compared with baseline values, DLF 1-10 micrograms.ml-1 increased aortic flow up to 138% cardiac output 116%, left ventricular pressure volume work 136%, left ventricular pressure 114%, dP/dtmax 130%, Vmax 128%, and mean aortic systolic pressure 114%, but coronary flow was decreased by 16% on an average (n = 6). However, heart rate remained constant, myocardial oxygen consumption and efficiency were changed little. The cardiotonic effect of DLF was also observed by recording the isometric contractions of the isolated guinea pig papillary muscles and by determining the left ventricular pressure and dP/dtmax in anesthetized dogs. Neither spontaneously beating rate of right atrium nor the excitability of left atrium in vitro was affected by DLF. The results show that DLF is one of the cardiotonic agents without chronotropic effect and its coronary vasoconstriction effect plays an important part in heart failure. PMID- 1776476 TI - Effects of phencyclidine on contractile forces of isolated rabbit papillary muscles. AB - Phencyclidine (PCP) (0.01-50 mumol.L-1) and its analogue, TCP (0.01-50 mumol.L-1) exhibited positive inotropic effects on electrically stimulated rabbit papillary muscle preparations. Dextrorphan (5 or 10 mumol.L-1) antagonized the actions of PCP in non-competitive manner (pD'2 = 5.25). This demonstrated the involvement of PCP receptors in the positive inotropic effects of PCP. By using high performance liquid chromatography with electrochemical detector (HPLC-ECD), an increase of DOPAC content was found in bath medium after PCP addition. Each of the dopamine receptor antagonists SCH23390, haloperidol and sulpiride (1 mumol.L-1) attenuated the maximal inotropic effects of PCP. These results suggest that PCP induces positive inotropic effects by increasing the release and/or blocking the uptake of dopamine. PMID- 1776477 TI - Influences of a novel immunopotentiator polyactin A on interleukin 1 production and responsiveness in mice. AB - Effects of a novel immunopotentiator Polyactin A (PAA), developed in China, on production and responsiveness of murine interleukin 1(IL-1) were investigated. The results demonstrated that: (1) PAA 0.01-100 micrograms.ml-1 directly induced IL-1 synthesis and secretion from murine peritoneal macrophages (PMO) and markedly enhanced IL-1 production of the mouse PMO stimulated by lipopolysaccharides (LPS) of E coli; (2) IL-1 release from the PMO cultured in PAA 0.1 micrograms.ml-1 was detectable as early as 2 h after the incubation, peaked at 24 h, and then decreased gradually; (3) PAA stimulated and enhanced both IL-1 synthesis and release, but its effect on IL-1 release was stronger; (4) PMO from the mice given po PAA 200 mg.kg-1.d-1 for 7 d produced a higher level of IL-1 than those from control group, and the increase in extracellular IL-1 was more significant than that in intracellular one; (5) in vivo, PAA had no effect on IL-1 receptor expression and IL-1 responsiveness of murine lymphocytes, but eliminated the suppressing effects of cyclophosphamide (Cyc) on IL-1 receptor expression and IL-1 responsiveness of mouse lymphocytes. The above findings provide new explanation for action of PAA and new basis for wider clinical applications of PAA. PMID- 1776478 TI - A Bayesian graphic method for predicting individual phenytoin dosage schedule. AB - A simple and practical graphic method based on Bayesian feedback theory for predicting individual phenytoin dosage was evaluated. Compared with the mathematical calculation, the graphic method only needs one pair of steady-state phenytoin concentration-dose data to predict individual phenytoin dosage. The observed drug levels were compared with predicted ones in 12 epileptic out patients with a correlation coefficient of 0.94. The mean error between the observed and predicted phenytoin levels was 0.62 mg.L-1. The mean kinetic parameters Vm and Km obtained from the graph were 7.01 +/- SD 0.88 mg.kg-1.d-1 and 4.93 +/- 0.91 mg.L-1, respectively. PMID- 1776479 TI - [Circadian changes of acetylcholine, choline acetyltransferase, acetylcholinesterase and muscarinic receptors in mouse brain]. AB - By means of radioisotope, the daily changes of cholinergic nervous markers, acetylcholine (ACh), choline acetyltransferase (ChAT), acetylcholinesterase (AChE) and muscarinic receptors in the mouse brain were measured in September and October. The mice were housed 5 animals to a cage under natural light-dark cycle (12 : 12) for 7 d in the laboratory room at 18-22 degrees C. The determinations of ACh were taken, every 2 h, to assess the brain ACh of 5 mice for 24 consecutive hours. M-cholinergic receptors, ChAT and AChE activity were examined at 10:00, 16:00 and 22:00. The results demonstrated that the ACh contents, ChAT activity and muscarinic receptor Bmax value were high at 10:00, low at 16:00 and 22:00. However, AChE maximum activity was found at 16:00, minimum activity at 22:00. But the affinity of muscarinic receptors to [3H]QNB did not show any significant daily changes. These data strongly suggested that in mouse brain the cholinergic nervous markers showed a clear daily rhythm. PMID- 1776480 TI - [Parenteral magnesium sulfate exerts no central anticonvulsant action]. AB - It was said that parenteral magnesium (MS) had a central anticonvulsant action responsible for controlling seizures in eclampsia of pregnancy. The present study was carried out to examine this statement. In conscious rabbits, MS 214 mg.kg-1 iv quickly relieved them from convulsion induced by sc pentylenetetrazol, yet spikes of high frequency in electrocorticogram burst inceasingly. Judging from electrocorticogram changes, MS 220 mg.kg-1 iv did not raise the electroshock seizure threshold. In mice, MS 430 mg.kg-1 did not significantly increase the LD50 of ip pentylenetetrazol. However, in anesthetized rats, MS 250 mg.kg-1 ip lowered the hypertensive response to angiotensin amide and norepinephrine. These results indicated that parenterally administered MS exerted no demonstrable central anticonvulsant action, and its benefits gained in the treatment of eclampsia of pregnancy might derive from its peripheral action, such as reduction of vascular response to pressor substances. PMID- 1776481 TI - [Enhancing effect of protein kinase C activation on high K(+)-induced norepinephrine release]. AB - Raising the concentration of K+ in the superfusion medium increased the release of [3H]norepinephrine ([3H]NE) from rabbit hippocampus slices preincubated with [3H]NE. This evoked [3H]NE release was modulated by presynaptic alpha 2 adrenergic, presynaptic opioid kappa- and A1-adenosine receptors and augmented with increasing K+ concentration (20-120 mmol.L-1). The enhancement or inhibition of this release by activator (phorbol ester) or inhibitor (polymyxin B) of protein kinase C was blocked by tetrodotoxin and reduced with increasing K+ concentration. It was suggested that the Na(+)-influx was involved in the protein kinase C effect on the K(+)-evoked [3H]NE release. PMID- 1776482 TI - [Effect of argipressin and its related compounds on corticotropin releasing hormone contents in hypothalamus of rats]. AB - The paper mainly stresses on the effect of argipressin (Arg), 2-destyrosyl-3 desphenyl-alanyl-9-desglycyl-amide-Arg (Arg4-8), [1-deaminopenicillamine, 2-(o methyl)tyrosine]-Arg (DPArg) and Arg antiserum on corticotropin releasing hormone (CRH) contents in median eminence (ME) and the level of plasma corticosterone after injected into the third ventricle of rats. The results show: 1) the CRH contents in ME significantly reduced with icv 100, 200, and 800 ng of Arg; 2) 100 ng of Arg4-8 and Arg antiserum (2 microliters, 1:1 diluted with 0.9% saline) increased CRH contents in ME and enhanced plasma corticosterone; 3) DPArg had no effect on CRH level but blocked the inhibitory role of Arg on central CRH. These results suggest that Arg acts as an inhibitory factor in regulating central CRH level and V1 receptor is involved. PMID- 1776483 TI - [Effects of metoclopramide on slow response action potentials of myocardium]. AB - The effects of metoclopramide (Met) on the action potential of rabbit sinus node cells and slow response action potential of guinea pig papillary muscles were studied with the intracellular microelectrodes. Met 10 mumol.L-1 prolonged the action potential duration at 90% repolarization (APD90) of SA node cell and sinus cycle length (SCL). Met 100 mumol.L-1 caused a decrease in action potential amplitude (APA), Vmax and the slope of phase 4 of action potential of SA node cell. APD90 and SCL were prolonged further. For slow response action potential induced by KCl (25 mmol.L-1), Met 100 mumol.L-1 produced a decrease in APA and depolarization rate. Met 10 mumol.L-1 began to suppress the spontaneous electrical activities induced by barium ion. These findings suggest that Met probably has the effect of blocking calcium inward current in myocardium. PMID- 1776484 TI - [Anti-arrhythmia and vegetative nervous system effects of anisodamine]. AB - Anisodamine (Ani) is an alkaloid first isolated in China from the root of Anisodus tanguticus. Ani 10, 15 mg.kg-1 i.v. markedly shortened the duration of arrhythmias induced by aconitine (10 micrograms.kg-1 i.v.) or by BaCl2 (2 mg.kg-1 i.v.) in anesthetized rats. Ani significantly effected on arrhythmias induced by early coronary artery ligation in rats by reducing total numbers of ectopic beats and shortening the duration of ventricular tachycardia and ventricular fibrillation 30 min after coronary ligation. The incidence of ventricular fibrillation of mice induced by chloroform were reduced from 100% to 20% and 10% by i.v. Ani 1 and 10 mg.kg-1 respectively. Ani 0.05, 0.25 mumol.L-1 prolonged the duration of neurologic refractory period of isolated guinea pig left atria and 10 mg.kg-1 i.v. had no effect on tachycardia induced by i.v. isoproterenol (0.01 mg.kg-1) but blocked the stimulation of nervi vagus. After i.v. Ani 15 mg.kg-1 P P, P-R and QT-c intervals on the ECG were prolonged. Mean arterial pressure and diastolic pressure were reduced but systolic pressure was not effected. PMID- 1776485 TI - [Anti-arrhythmia and anti-lipid peroxidation effects of methylflavonolamine]. AB - Effects of methylflavonolamine (MFA) on arrhythmias induced by myocardial reperfusion were studied with rat hearts in situ and in vitro. In pentobarbital anesthetized rats, MFA (20 mg.kg-1, i.v.) pretreatment reduced the incidence of reperfusion-induced ventricular fibrillation after left descending coronary artery ligation (15 min) and reperfusion (3 min) (28.6% vs 85.7% in control, P less than 0.05). Malondialdehyde (MDA) production (85 +/- 9 nmol/g wet wt) was inhibited in myocardium from the reperfused area in comparison with control (133 +/- 15 nmol/g wet wt). In isolated rat hearts with local ischemia (15 min) and reperfusion (1 min), MFA 5 mumol.L-1 (perfused 10 min prior to coronary artery ligation) prevented reperfusion-induced arrhythmias (0% vs 85.7% in control, P less than 0.01). In myocardium from the reperfused area, superoxide dismutase (SOD) and catalase (Cat) activity was increased and xanthine oxidase (XOD) activity, MDA production and nonesterified fatty acids (NEFA) contents were decreased. The results show that MFA prevents reperfusion-induced arrhythmia by inhibiting lipid peroxidation and regulating the metabolism of NEFA. PMID- 1776486 TI - [Distribution of muscarinic receptors of different affinities in smooth muscle of human stomach]. AB - Muscarinic receptors of high and low affinity were found in the fundus and the body of human stomach through the contraction experiment combined with ligand method in vitro. The 2 types of muscarinic receptors with different affinity regulated respectively the contractions of the longitudinal and the circular muscle of human gastric fundus and gastric body. However, in the antrum exists only one kind of muscarinic receptors of high affinity, which regulated the contractions of the longitudinal and the circular muscles of human stomach. The contractile force of the longitudinal muscle induced by exogenous ACh in the fundus and that in the body of human stomach were found to be similar to each other. The contractile force of the circular muscle in the body was found to be the strongest, and the contractile force of both longitudinal and circular muscles in antrum was weaker. PMID- 1776487 TI - [Pharmacokinetics of norethindrone enanthate 200 mg after intramuscular injection in 25 Chinese women]. AB - Pharmacokinetic profile was studied in 25 healthy fertile Chinese female volunteers after im norethindrone enanthate (NET-EN) 200 mg. The results were compared with the data from British women in our previous paper. Following a single im NET-EN 200 mg, the times to reach peak levels of NET-EN and NET were 4.0 +/- 2.8 d and 5.4 +/- 2.0 d, and their peak values were 5.0 +/- 1.8 and 12.6 +/- 0.9 ng.ml-1, respectively. Mean elimination T1/2 of NET was significantly longer than that of NET-EN. Mean apparent elimination T1/2 were 14.8 +/- 3.8 d for and 11.4 +/- 5.7 d for NET-EN. The elimination rate of NET in Chinese women was significantly slower than that in British women. There was no significant ethnic difference in absorption kinetics of NET and NET-EN. PMID- 1776488 TI - [Endocrine activity of pseudolaric acids A and B and their effects on sex hormones, prostaglandins, uteri, and fetuses]. AB - Two novel diterpendoids, pseudolaric acids A and B (PA, PB) first isolated from the root of Pseudolarix kaempferi Gorden in China, have been reported to possess significant antifertile activities in rats, hamsters, rabbits, and dogs. The present study demonstrated that neither PA nor PB had estrogenic and antiestrogenic activities, they also did not inhibit deciduous formation. When an effective dose of PB 30 mg.kg-1 was given on d 6 of pregnancy and the hormonal determinations were done on d 8 and d 12 of pregnancy, the progesterone, estradiol and prostaglandins E, F levels in plasma and the uterine prostaglandin E, F levels were not significantly reduced vs those of the control rats. The human uterus was used as the experimental material in vitro. PA and PB 200 micrograms.ml-1 cultural medium (McCoy's 5a medium) damaged only a part of the decidual and trophoblast cells. In partially depolarized isolated uterine smooth muscles of early pregnant rats, PA and PB caused a decline in the contractile tension. A low dose of PB 2 mg.kg-1.d-1 was given ig on d 6-12 of pregnancy in rats caused the body weight and the length of fetuses and the placental weight value significantly lower than those of the control. Thus, ischemia due to the vasoconstrictor effect is probably of great, and sometimes of supreme, importance. PMID- 1776489 TI - Ocular and cardiovascular pharmacology of tetramethylpyrazine isolated from Ligusticum wallichii Franch. AB - Tetramethylpyrazine (TMP), the active principle in Ligusticum wallichii, D timolol, and L-timolol were compared for their effects on retinal and choroidal blood flow (RCBF), blood pressure (BP), and heart rate (HR). TMP (10 mg.kg-1) increased RCBF by 44% and did not affect systemic BP or HR. D-Timolol (4 mg.kg-1 iv) had a tendency to increase RCBF but did not affect systemic BP and HR either. L-Timolol (0.4 mg.kg-1 iv), on the other hand, decreased RCBF by 18% and reduced both systemic BP and HR. In isolated preparations, TMP increased coronary artery blood flow with slight vasodilation, but vasoconstriction in renal, femoral and mesenteric arteries. These results indicate that TMP could be used to prevent or alleviate certain ischemic retinal degenerations without producing significant cardiovascular side effects. The in vitro vasoconstriction actions of TMP (0.2 mg.ml-1) were blocked by propranolol and phenoxybenzamine, indicating that adrenergic mechanism might be involved in TMP action. PMID- 1776490 TI - In honour of Jan-Otto Ottosson. PMID- 1776491 TI - In honour of Jan-Otto Ottosson. PMID- 1776492 TI - Some themes from the philosophy of psychiatry: a short review. AB - Some major themes in the philosophy of science are briefly reviewed, considering epistemological, ontological and ethical problems in modern psychiatry. A conception of realism at the ontological, empiricism at the methodological level and humanistic ethics is proposed. Meta-psychiatry is suggested as a theoretical discipline integrating clinical research methodology and philosophy of science. PMID- 1776493 TI - An interactionistic integrating view of depressive disorders and their treatment. AB - The development of a depressive disorder is often considered from the perspective of biological causation, mental processes, or with a focus on possible social determinants, even though the possible concomitance of factors belonging to the different domains is generally acknowledged. In this article, a further development of an interactional model previously described is presented. The model is focused on the concept of individual vulnerability, which is assumed to result from a continuous interplay of the individuals with their environment, and from the effect of factors belonging to different domains that interact. A closer definition of individual vulnerability suggests that it consists of the interaction of biological characteristics of the person and a basically dysfunctional self-schema. Empirical studies in support of some of the hypotheses which can be derived from the model are briefly reviewed, and the implications of the model for the treatment of depression is underscored. PMID- 1776494 TI - What is an adequate treatment in convulsive therapy? AB - The parameters of the induction of an effective electroconvulsive therapy (ECT) treatment are poorly defined. We find variations in outcome, with changes in electrode placement and energy levels, despite measures of motor seizure duration greater than 25 s. To maximize the outcome of ECT, attention is again focused on the electrophysiologic and biochemical features of seizures, much as Ottosson studied them in 1960. PMID- 1776495 TI - Electroconvulsive therapy in the Nordic countries, 1977-1987. AB - In 1977 a questionnaire was sent to all psychiatric departments in the Nordic countries: Sweden, Norway, Denmark, Finland and Iceland, concerning indications for electroconvulsive therapy (ECT) and the use of unilateral and bilateral treatment, respectively. The inquiry was repeated in 1987 and the answers compared with those obtained in 1977. In addition, the answers from Denmark were compared with previously performed inquiries. The use of exclusively unilateral treatment (U) and of both unilateral and bilateral treatment (UB) has increased in most of the countries and exclusively bilateral treatment (B) has decreased drastically. In Denmark the situation has not changed for ECT in endogenous depression and acute delirium, and the use in reactive psychosis, mania and schizophrenia decreased somewhat during the 1970s and then again stabilized or increased during the 1980s. Nearly all departments in the Nordic countries used ECT in endogenous depression in 1977 and were still doing it in 1987. In mania, about 50% of all departments have found ECT indicated occasionally or exceptionally both in 1977 and 1987. Manic-depressive mixed states have been regarded as an indication in somewhat more than two thirds of departments, increasing during the period. The use of ECT in schizophrenia has been rare and somewhat decreasing, but still about half of the departments apply it once in a while. In reactive psychosis the use of ECT decreased slightly, but in 1987 it was still in use for this indication in about 50% of all departments. In acute delirium there has been an overall increase in the use of ECT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1776496 TI - Lithium and electroconvulsive therapy: adversaries, competitors, allies? AB - As treatments for manic-depressive illness, lithium and electroconvulsive therapy (ECT) share the properties of efficacy, diagnostic specificity, and action on both mania and depression. Therapeutic and prophylactic similarities and dissimilarities are analyzed, as well as the use of lithium continuation treatment following ECT. Possible adverse interaction is discussed, and a strategy is proposed for studying biologic modes of action. PMID- 1776497 TI - The Cronholm-Ottosson Depression Scale: the first depression scale designed to rate changes during treatment. AB - In 1960 Ottosson published the first specific depression rating scale (the Cronholm-Ottosson Depression Scale) designed to be sensitive in measuring change during antidepressive therapy. Ottosson and his group have never used factor analysis to validate the scale, as the items of the scale were used factor analysis to validate the scale, as the items of the scale were selected on a preconceived idea for homogeneity, i.e. having a monotonic correspondence to the underlying dimension of severity of depression. The most appropriate method of testing the construct validity of the Cronholm-Ottosson Depression Scale is latent structure analysis. Using the original Ottosson data, a latent structure analysis has been made showing that the 8 items of the scale are homogeneously related, i.e. can be ordered on one dimension of severity of depression. The descriptive statistic of a 50% reduction of pretreatment score (or more) equaled the global clinical score of moderate to excellent improvement. Both scales showed that, already after 4 electroconvulsive treatments, about 80% of depressed patients who received adequate fits had moderate to excellent improvement, whereas only around 40% of depressed patients who received inadequate fits improved moderately or excellently. PMID- 1776498 TI - The natural history of anxiety disorders. AB - The article reviews research and presents our results on the natural history of 2 forms of anxiety disorder, panic disorder and generalized anxiety disorder. Data from our epidemiological cohort study give evidence of premorbid anxiousness and overadaptation already in childhood. Distressing conditions in the family are more prevalent among subjects with anxiety disorders or major depression than among controls. Anxiety disorders frequently begin between age 20-30 and can be triggered by life events. The course is often characterized by a certain chronicity that manifests itself in residual symptoms and mild impairment in social roles even after many years and is frequently complicated with depression. The best predictors are severity and duration of symptoms, as well as comorbidity with depression. Future studies of the natural history should take into account these factors in multivariate approaches. PMID- 1776499 TI - Interaction between genetic vulnerability and family environment: the Finnish adoptive family study of schizophrenia. AB - A nationwide Finnish sample of schizophrenics' offspring given up for adoption was compared blindly with matched controls, that is, adopted-away offspring of nonschizophrenic biologic parents. The adoptive families were investigated thoroughly by joint and individual interviews and psychologic tests. Biologic parents were also interviewed and tested. Among the 144 index and 178 control offspring, the percentage of both psychoses and other severe diagnoses (borderline syndrome and severe personality disorder) was significantly higher in the index adoptees than in the matched control adoptees. Of the 15 psychotic adoptees in the total sample to date, 13 are offspring of schizophrenics and 2 are control offspring. Both global clinical ratings and test data for the adoptive, rearing parents also correlate with the symptomatic status of the adoptees. A prospective, longitudinal study of adoptees at risk is being undertaken to explore the direction of effects between adoptees and adoptive parents. PMID- 1776500 TI - Expressed emotion: a Swedish version of the Camberwell Family Interview. AB - A Swedish version of the Camberwell Family Interview (CFI), a psychiatric, semistructured interview schedule for assessing a family's emotional atmosphere, is described. Thirty-two relatives of patients with schizophrenic disorders, according to DSM-III criteria, were interviewed. Eighteen relatives were interviewed twice, before and after one part of a psychoeducational programme. The total number of interviews analysed was 50. Two independent investigators rated the audiotape-recorded interviews to test the interrater reliability of 5 different measures of expressed emotion (critical remarks, hostility, emotional overinvolvement, warmth and positive remarks). High interrater reliabilities were found for the frequency scales, i.e. critical remarks and positive remarks. For the global scales the interrater reliabilities were lower. The use of only one interviewer, the interviewer being one of the raters and shortage of co-training probably influence the reliability. The CFI schedule could probably gain in clarity, structure and shortness in a revised form, although the interview time cannot be reduced to less than 1.5 h. The ratings of measures of expressed emotion are quite complicated and require extensive and specific training of the raters. The total procedure is complex, time-consuming and not easily learned. In its present form, the CFI probably discourages clinicians and researchers from using it. PMID- 1776501 TI - Traditional perceptions and treatment of mental disorders in western Ethiopia before the 1974 revolution. AB - This article describes the traditional concepts and treatment of mental disorders in the Oromo areas in western Ethiopia before the revolution in 1974. There are three traditional cultural influences operating: traditional Oromo thinking, the Coptic church and the Islamic culture. One important element in traditional Oromo thinking is that each person is believed to possess an ayana, which is a special divine agent that can descend upon people, but also means a person's character and personality. In the traditional Oromo society, the Kallu is the religious leader who, through an ecstatic ritual technique, can investigate the causes of the disorder and advise what to do. Mental disorders are generally explained as resulting from disturbances in the relationship between people and divinity. The second important cultural element in western Ethiopia is the orthodox Coptic church, which usually looks upon mental disorders as possession by evil spirits, which are thus treated by specially gifted priests and monks by praying and giving holy water or eventually exhortation. According to Islamic teaching in the area, mental disorders are caused by evil spirits sent by God to punish the unfaithful people. Some Muslim sheiks treat mental cases with prayers, but herbal remedies are also used. There is a great intermingling of these different cultural and religious elements and people attend different healers and religious leaders more depending on the reputation of the person than on cultural and religious affiliation. PMID- 1776502 TI - Ethical aspects of psychological autopsy. AB - Survivors of suicide victims are usually vulnerable to new traumatic experiences. Researchers who have used the method of psychological autopsy, including interviews with survivors, have paid little attention to ethical questions. The purpose of this article is to discuss such issues based on empirical data. Data and experiences from 3 studies of suicide among men (n = 271), women (n = 104) and youth (n = 58) are presented; the last 2 also include telephone follow-up by an independent researcher who measured the reactions of the interviewees to the main interviews. The ethical problems for 3 groups of agents (informants and other relatives, including the deceased; the researcher; and the research) are discussed according to 3 basic ethical principles (nonmaleficence, beneficence and respect for autonomy). Many of the interviewees still had signs of crisis reactions and thus constituted a vulnerable group. Nevertheless, drop-out was infrequent. Nor did we find any interviewee who was hurt by the interview, even if the possibility cannot be excluded in a few cases (less than 4%). Many of the interviewees seem to benefit from the interview. The interviews ought to be done by researchers prepared to meet people in crisis situations. The informants had different opinions on whether letter or telephone was the best method for first contact. Tape-recording was generally accepted. It seems to be possible and advisable to further change the design to better meet the needs of the interviewees, without violating the requirements of the researcher and the research. PMID- 1776503 TI - Specific concordance index defines the physiological lag between LH and progesterone in women during the midluteal phase of the menstrual cycle. AB - Using a recently developed statistically based method for assessment of the degree of concordance, we evaluated the degree of specific concordance (SC) between luteinizing hormone (LH) and progesterone secretory patterns. Eight healthy women volunteered for this study, undergoing a 12-h pulsatility study, sampling every 10 min. LH and progesterone pulse frequencies were estimated with the program DETECT (9.75 +/- 1 and 11.5 +/- 0.9 pulses/12 h, respectively; mean +/- SEM). The temporal relationship between LH and progesterone secretions was evaluated with cross-correlation analysis and with the computation of the SC index. Cross-correlation showed concordance between LH and progesterone (p less than 0.05) at a range of lag between 0 and 40 min, while the SC index indicated that LH and progesterone pulses were significantly (p less than 0.05) and maximally correlated at 10-min lag. In conclusion, our data demonstrated that the specific concordance confirms the statistically significant concordance of LH and progesterone secretory events in women during the midluteal phase. In addition, the use of this new, objective, statistically based approach permits, compared to traditional cross-correlation analysis, a more precise definition of the physiological time lag for temporal coupling of secretory events between the two hormones. PMID- 1776504 TI - Pituitary gonadotropin responsiveness to repeated gonadotropin releasing hormone (GnRH) stimulations in patients with chronic anovulation. AB - To evaluate whether repeated gonadotropin releasing hormone (GnRH) stimulations were superior to single GnRH administrations for the accurate assessment of pituitary gonadotropin responsiveness, the GnRH-stimulated luteinizing hormone (LH) and follicle stimulating hormone (FSH) responses of 49 hyperandrogenic patients (HA) were compared with those of 20 hypogonadotropic patients (HH) and of 24 normally cycling women (N). Blood samples were obtained at frequent intervals during GnRH administrations (25 micrograms twice within 2 h). Unstimulated LH concentrations were higher (p less than 0.001) in HA than in N and HH women. However, basal FSH levels differed only in HA from HH women (p less than 0.001). Following either GnRH stimulation, increased (p less than 0.01) LH and FSH releases were noted in all N, HA and HH women. The GnRH-stimulated LH and FSH responses to either GnRH injections were highest (p less than 0.01) in HA and lowest (p less than 0.01 vs. N) in HH women. The net LH and FSH increases over unstimulated concentrations (delta LH or FSH) in response to either GnRH stimulation were highest (p less than 0.01 or less) in HA women. By contrast, no differences were determined in the delta LH and FSH levels between the first and second GnRH stimulations within each group. These observations document different unstimulated and stimulated gonadotropin concentrations in normal cycling and anovulatory women. Gonadotropin responses to single GnRH administrations differ for anovulatory patients. Since the gonadotropin responses to the second GnRH stimulation are comparable to those during the first GnRH injections, repeated GnRH stimulations may not help to distinguish the degree of pituitary responsiveness in ovulatory from anovulatory women. PMID- 1776505 TI - Menotropins as a possible risk factor for premature deliveries in triplet pregnancies. AB - This study was undertaken in order to evaluate pregnancy outcome in three groups of triplet conceptions. Of 36 delivered triplet gestations, seven were spontaneous, 12 achieved using clomiphene citrate and 17 induced by menotropins. The mean gestational age (weeks) at delivery was 36.5 +/- 1.0 SD, for spontaneous and clomiphene citrate pregnancies it was 35.9 +/- 1.9 SD which differed significantly from that in pregnancies induced by menotropins which was 32.9 +/- 3.7 SD. Similarly, triplets born following menotropin treatment had a significantly lower gestational weight (g) of 1656 +/- 516 SD vs. 2015 +/- 198 SD and 2176 +/- 315 SD for spontaneous and clomiphene citrate gestations, respectively. It is concluded that triplets following menotropins are at an increased risk for premature delivery and low birth weight. PMID- 1776506 TI - Endocrine and biological factors influencing implantation of human embryos following cryopreservation. AB - Several parameters affecting survival and implantation of frozen-thawed embryos were studied. Of 386 embryos frozen in dimethylsulfoxide (DMSO) or in 1,2 propanediol (PROH), the survival rate was 63.5% (245/386). Three different methods of cycle preparation were compared prior to thawed embryo replacement. The pregnancy rate was 16.1% (9/56) in spontaneous cycles; 11.4% (5/44) in an ovarian stimulation protocol; and 9.5% (4/42) with estrogen and progesterone substitutional therapy (p = NS). There was no difference in the estradiol/progesterone ratio among the three different protocols during the early luteal phase of the cycle, which may indicate that implantation of thawed embryos could be related to their developmental potential rather than to the endometrial environment. In the spontaneous cycles, when endometrium was synchronized or advanced to embryonic stage up to 32h, implantation rate was 29.2%. PMID- 1776507 TI - A new oral slow release form of bromocriptine, Parlodel SRO, in the chronic treatment of 26 hyperprolactinemic patients. AB - Parlodel SRO, a new slow release form of bromocriptine, was studied in 26 patients with tumoral and non-tumoral hyperprolactinemia. Prior to the treatment, serum prolactin (PRL) levels ranged from 45 ng/ml to 7000 ng/ml and they decreased to within the normal range in all but one patient after 7 days-1 year of treatment with this new formulation of bromocriptine. The clinical improvement paralleled the normalization of PRL secretion. Tolerability was rated good or very good in 24 patients, even in the three patients who had been intolerant of oral Parlodel. In conclusion, Parlodel SRO administered as a single daily dose resulted in very effective lowering of serum PRL in patients with hyperprolactinemic disorders. PMID- 1776508 TI - Extreme elevation of serum CA-125 in two women with severe endometriosis: case report. AB - Two women with elevated preoperative serum CA-125 levels were found to have extensive endometriosis - one, the highest level related to endometriosis ever reported in the English literature. Endometriosis was found to be etiologic as seen by the prompt reduction in serum CA-125 levels following surgical treatment limited to endometriosis. Thus, a very high CA-125 level does not necessarily forebode ovarian malignancy. PMID- 1776509 TI - Acute revascularization for progressing stroke. AB - The effectiveness of acute stage vascular reconstruction in cases of progressing stroke is reported. The clinical material consists of 28 cases of progressing stroke in the anterior circulation upon which vascular reconstruction was performed. Following admission, brain protective substances (500 ml mannitol, 500 mg vitamin E, 500 mg phenytoin) and dextran, were administered to the patients, and induced hypertension was also performed. Changes in symptoms were then observed and vascular reconstruction was carried out in cases where symptoms progressed. The vascular lesion was on the internal carotid artery in 8 cases and on the middle cerebral artery in 20 cases. Complete disappearance of neurological symptoms was obtained in 12 cases, whereas only mild neurological symptoms remained but a return to normal social life was possible in 11 other cases. Symptoms remained in three cases and there were two fatalities. In a long-term follow-up study, there were no cases of aggravation of symptoms due to ischaemic stroke. Moreover, the reconstruction was judged as effective on the basis of cerebral blood flow and metabolism. We concluded that acute vascular reconstruction for progressing stroke under the administration of brain protective substances is effective in preventing the progression of neurological symptoms. PMID- 1776510 TI - Pyramidal tract lesions in comatose patients. AB - In 197 comatose patients transcranial magnetic evoked potentials were registered to investigate the integrity of the pyramidal tract. Findings were compared to somatosensory, visual and auditory evoked potentials. Preservation, abnormalities and absence of evoked potentials were related to survival and non-survival. Transcranial magnetic and somatosensory evoked potentials proved to be of high prognostic value. While the accuracy of prediction of a fatal outcome based on transcranial magnetic evoked potentials was close to 90%, the prediction of survival was less dependable. Transcranial magnetic evoked potentials are concluded to be a valuable adjunct to the neurophysiological assessment of the comatose patient. PMID- 1776511 TI - Medical complications and mortality of patients in the postcomatose unawareness (PC-U) state. AB - Almost half of all patients with traumatic brain injury who remain unconscious for more than one month will not recover consciousness and will remain in a state of prolonged postcomatose unawareness (PC-U). The aim of this work is to present the survival rate and medical complications of such patients. The survival time of the 62 patients studied ranged from 2 to 115 months, with a median of 15.5 +/- 22 months. Cumulative mortality figures were 15% at 3 months, 40% at 6 months and 60% and the end of the first year. The figures at the end of the second, third and fifth years were 86%, 87% and 94%, respectively. This type of data may aid in decisions regarding the management of these patients. The longer survival with better treatment of patients in a state of PC-U poses severe ethical, medical, legal and economic problems with which society will have to deal. PMID- 1776512 TI - Investigations on oscillating flow spectra as a Doppler ultrasonographic sign of intracranial circulatory arrest. AB - In a total of 90 patients with intracranial hypertension and subsequent intracranial circulatory arrest, the cerebral basal arteries were examined with transcranial Doppler ultrasonography. In order to explain the development of the various forms of oscillating flow, a blood-pressure cuff was placed on the distal forearm of 25 healthy subjects to investigate the flow spectra in the proximal arteries in the presence of increasing stream resistance. With raising the pressure of the cuff, the changes in the Doppler sonographic flow spectra were simulated as in case of increasing intracranial pressure. As intracranial pressure increases at constant systemic blood pressure values, the flow velocity spectrum changes in a typical manner. At the stage of oscillating flow, characteristic changes in the flow spectra can be observed. Investigations showed that compliance is reduced in a distal to proximal direction. This means that a different frequency spectrum can be recorded in distal branches of the middle cerebral artery than in the proximal carotid artery at the same point in time. By examining the flow velocity spectra from the brachial artery, it was possible to understand better the typical course of an intracranial circulatory arrest resulting from increased stream resistance. PMID- 1776513 TI - Brain death: determination with brain stem evoked potentials and radionuclide isotope studies. AB - Thirty-three patients fulfilling the clinical criteria for brain death were tested by Brainstem Auditory Evoked Potentials (BAEP) and Radionuclide Cerebral Angiography and Brain Perfusion Studies. There was a significant correlation between the BAEP and radionuclide study outcomes. All patients with absence of BAEP showed no cerebral perfusion. These findings, added to the clinical findings, resulted in a final diagnosis of brain death in all patients. It is concluded that BAEP and Radionuclide Cerebral Perfusion studies are useful adjuncts for proving that brain death has really occurred. PMID- 1776514 TI - The value of autopsies in neurosurgery. AB - Many previous studies have reported the value of autopsy in assessing clinical diagnostic accuracy. None of them however, assessed the value of autopsies in a specific clinical speciality. The authors reviewed the findings of 123 consecutive neurosurgical autopsies with reference to the premortem clinical diagnoses. The study showed that 7% of cases had a wrong clinical diagnosis and in 9% of cases the clinical diagnosis was incomplete. Only in 5% of all cases knowledge of the autopsy findings would have led to a change in management and outcome. The autopsies also confirmed that 11% of cases died following a surgical complication and in 3% of cases the primary cause of death was non-neurosurgical. The latter was a previously unrecognised finding in 8% of autopsies. The autopsy will remain a valuable means of clinical audit and the increasing financial pressures to reduce the number of autopsies should be resisted. PMID- 1776515 TI - Neuropeptide Y levels in central and peripheral cerebrospinal fluid in patients with intracranial disorders. AB - Neuropeptide Y (NPY) was measured in central and peripheral cerebrospinal fluid (CSF) in patients suffering from various intracranial disorders. The central NPY like immunoreactivity (LI) level showed a concentration of 129 +/- 19 pmol.l-1 and was significantly increased (p less than 0.05) compared to peripheral CSF (73 +/- 9 pmol.l-1). From five patients with subarachnoid haemorrhage the CSF NPY-LI levels reached 154 +/- 47 pmol.l-1. In five patients peripheral and central CSF was collected at the same occasion and the CSF NPY-LI concentration was 76 +/- 17 pmol.l-1 in peripheral and 142 +/- 23 pmol.l-1 in central CSF (p less than 0.01), respectively. In a reference group of 9 patients, who were examined by lumbar myelography because of suspected intervertebral herniated discs, the peripheral CSF NPY-LI concentration was 59 +/- 5 pmol.l-1 a value which was also significantly lower compared to NPY-LI levels in central CSF. Thus it is obvious that NPY is present in human CSF with a relatively higher concentration in central than in peripheral CSF at least in patients with disorders of the central nervous system, suggesting a central origin of the NPY. PMID- 1776516 TI - Acute effects of a pedicled omental graft on cold-induced brain oedema in cats. AB - When used as a prophylactic measure and in chronic experiments, omental transposition has been shown to reduce ischaemic and traumatic oedema in the spinal cord and ischaemic oedema in the brain. We designed this experiment to evaluate the acute effects of a pedicled omental graft on cold-induced brain oedema in cats. Focal oedema was induced in the left frontoparietal region of the brain of nine anaesthetized cats. In five cats, a laparotomy was done and a pedicled omental graft was placed on the lesioned left hemisphere immediately after the cold lesion was made. All cats were sacrificed 72 hours later, and the water content of the white matter was determined in the lesioned and the normal hemispheres. The mean water content of the lesioned hemisphere of the treated group of animals was not significantly different from that of the control group. We conclude that a pedicled omental graft failed to reduce vasogenic oedema in an acute model and probably has no role in the acute management of brain oedema. PMID- 1776517 TI - Transoral transpalatal removal of a giant premesencephalic clivus chordoma. AB - Due to their surgical inaccessibility and resistance to radiotherapy, clivus chordomas represent a formidable therapeutic challenge. The transoral approach to chordomas of the clivus has been usually restricted to relatively small or midsized neoplasms, located at the lower end of the clivus or at the anterior clival-cervical junction. In this report the transoral transpalatal transclival removal of a giant recurrent chordoma occupying the whole length of the clivus with considerable premesencephalic extension and brain stem compression is described. Regression of preoperative symptoms without additional postoperative morbidity could be achieved by radical transoral tumour extirpation documented by magnetic resonance imaging. PMID- 1776518 TI - Cranioplasty of an extremely large cranial defect caused by transitional meningioma with a knitted polypropylen-polyester prothesis "Codubix". AB - The authors report a case of transitional cell meningioma of the convexity which destroyed a large portion of the calvarium and invaded subcutaneous tissue. The tumour was totally removed and a large cranial defect/430 cm2 in size/was filled with a polypropylenopolyester knitted prothesis "Codubix" with an excellent result. The problems of chronioplastic closure of such an unusually large skull defect and the advantages of the use of the material "Codubix" are discussed. PMID- 1776519 TI - Haemangiopericytoma presenting with intracerebral haemorrhage. Case report and review of literature. AB - A case of an intracerebral bleeding from haemangiopericytoma is reported. To our knowledge it is the first published case. The literature concerning apoplectic presentation of brain tumours is reviewed. PMID- 1776520 TI - Giant supratentorial meningeal haemangiopericytoma in a newborn. AB - A brain tumour in a newborn is rare. The incidence of congenital tumours is 0.34 per one million births. We report a case of a huge right hemispheric tumour operated upon successfully in a child 5 days old, who had a total tumoural excision and an uneventful outcome with 5 months follow up. This tumour appears to be the first meningeal haemangiopericytoma described in a newborn. Adequate treatment and histological findings are discussed. meningeal haemangiopericytomas are now considered as originating in pericytes, in the light of recent immunopathological results, and are to be separated from true meningiomas. PMID- 1776521 TI - Sensory and motor trigeminal evoked potentials to localize the position of trigeminal electrodes. PMID- 1776522 TI - Three-dimensional time-of-flight MR-angiography and the surgical indication of brainstem cavernomas. AB - This study was designed to assess the diagnostic value of 3D time-of-flight MR angiography in cerebral cavernomas. In seven patients, nine out of ten cavernomas were removed by microsurgery. While MR-angiography demonstrated well branches of brain arteries adjacent to the lesions, no flow signal in the vascular malformations was observed. On the other hand, there was a high intensity signal induced by methaemoglobin in those three patients with brainstem cavernomas who had experienced a significant bleeding attack seven months prior to admission. It had a spotted appearance in MR-angiography with volumes of the largest spots around 1.8 cm3. It is suggested that this spot signal could be used as a path marker for the surgical approach in brainstem cavernomas. PMID- 1776523 TI - MRI in multiple vascular lesions: identification of the ruptured malformation. AB - 4 patients were recently admitted for subarachnoid haemorrhage with multiple vascular lesions. 3 of them presented with multiple aneurysms, and one with an aneurysm associated with an arteriovenous malformation. In these 4 cases identification of the ruptured lesion was difficult in spite of clinical examination, CT scan, and complete panangiography; on magnetic resonance imaging (MRI) was found a signal hyperintensity, mainly on T2 weighted views, corresponding to blood clots around the ruptured aneurysm. This signal hyperintensity was completely absent in the vicinity of the associated vascular lesion, which appeared only as a signal void corresponding to the blood flow inside the unruptured lesion. Therefore MRI can be used in such cases to identify the ruptured lesion, so permitting the choice of the best approach and strategy of treatment. PMID- 1776524 TI - Evaluation of brain SPECT in the diagnosis and prognosis of the normal pressure hydrocephalus syndrome. AB - From January 1989 to September 1990 fourteen patients with the Normal Pressure Hydrocephalus (NPH) syndrome were diagnosed in our Service. All patients were studied by CT-Scan, Radionuclide Cisternography and brain Single Photon Emission Computed Tomography (SPECT). In this series, the predictive value of the brain SPECT was assessed. A statistically significant relationship between SPECT patterns and clinical outcome was found. The patients who showed a Dementia Alzheimer Type (DAT) pattern on SPECT had worse results. The results are discussed and compared with those reported by other authors. PMID- 1776525 TI - Do intracranial arteriovenous malformations cause subarachnoid haemorrhage? Review of computed tomography features of ruptured arteriovenous malformations in the acute stage. AB - Computed tomography features of ruptured arteriovenous malformations in the acute stage were reviewed. Intracerebral or intraventricular haemorrhage was the major finding, and primary subarachnoid haemorrhage was disclosed to be rare. This observation supports the concept that arteriovenous malformations should not be included in the main pathological conditions causing subarachnoid haemorrhage. This information is of value in identifying the source of intracranial haemorrhage in patients with the coexistence of an arteriovenous malformation and an aneurysm, and provides a significant guideline for treatment. PMID- 1776526 TI - Formation of new aneurysms. Report of five cases. AB - Among 964 patients diagnosed and treated for intracranial aneurysms in 5 evidence of formation of new aneurysms was found. Repeat angiography, performed after the second SAH, revealed new aneurysms on arteries normal on previous angiograms; there were multiple aneurysms in 3 cases. In 4 cases, the aneurysms were formed within 3 to 6 years. In the authors' opinion, the possibility of formation of new aneurysms after the cure of a demonstrable one, should be considered in all aneurysmal patients, especially in multiple cases. Possible mechanisms of development of new aneurysms are discussed. PMID- 1776527 TI - Behavioural, electrocortical spectrum power and body temperature changes after microinfusion of some lymphokines in the rat brain. AB - Interleukin-1, interleukin-2 and interleukin-3 injected into the third cerebral ventricle produce typical behavioural sedation and/or sleep and ECoG synchronization in rats. Much smaller doses were required to produce similar behavioural and ECoG spectrum power effects after infusion of interleukins into the locus coeruleus. Interleukin-1 and interleukin-3 induced pyrogenic effects while interleukin-2 produced no pyrogenic actions. These effects were blocked by specific anti-interleukin receptors monoclonal antibodies. In addition, naloxone was able to antagonize the central effects of IL-2 but it did not affect the typical changes induced by IL-1. These results are consistent with the hypothesis that the behavioural, body temperature and ECoG changes of these lymphokines are mediated by specific receptors. PMID- 1776528 TI - Plasticity of neuroendocrine-immune interactions during aging. AB - Intact neuroendocrine-immune interactions are essential for the development and functional maintenance of both systems. Normal physiological aging appears to be, in part, dependent on age-related modifications of neuroendocrine-immune interactions. The thymus plays a major role in this context. Experimental manipulation at the thymic or neuroendocrine level may reciprocally correct the age-associated dysfunctions, suggesting the reversible nature of such phenomena. PMID- 1776529 TI - Effects of nimodipine on psychological-stress situation in aged rats. AB - Female aged rats treated with nimodipine, a calcium-blocker dihydropyridine derivative, were submitted to a psychological-stress situation. Nimodipine at the doses of 3 and 6 mg/Kg antagonized the stress-related body-weight decrease and lethality. These findings seem to validate the role of Ca-mediated mechanisms in the physiopathology of stress and the protective effects of the Ca-blockers in the stress-related illnesses. PMID- 1776530 TI - Effects of benzodiazepines on the immune system. AB - Benzodiazepines (BDZ) are psychotropic drugs largely used in patients with affective disorders. As far as their effects on the immune system are concerned, a few studies have been carried out until now. Diazepam is inhibitory in vitro for the phagocytic functions and the antibody synthesis, being its action mediated via specific receptors on immunocompetent cells. On the contrary, alprazolam results to be enhancing for the antibacterial activity exerted by normal human peripheral blood T lymphocytes in vitro. Taken together, these data point out the different role which BDZ play on the immune response. PMID- 1776531 TI - Alprazolam enhances the antibacterial activity exerted by normal human peripheral blood lymphocytes. AB - The effects of two benzodiazepines, diazepam and alprazolam, have been evaluated on the in vitro antibacterial activity exerted by human peripheral blood lymphocytes (PBL). Results demonstrate that diazepam has no influence on this PBL function, while alprazolam is able to enhance this activity in six out of nine normal donors considered. The possible therapeutical implications of these data are discussed. PMID- 1776532 TI - The ovary and the immune function: our experience. PMID- 1776533 TI - T cells expressing IL-2 receptor in migraine. AB - We studied a group of migraine patients for circulating immune complexes, lymphocyte subpopulations, IgG4 and anti-IgG antibodies, before, after 4 hours and after 72 hours a specific challenge test. We found an increased incidence of circulating immune complexes. Total T cells showed a marked increase after challenge test. The most important finding was the presence of T-activated cells. Also K and NK cells showed an early increase after the challenge. In commenting the outcomes of this investigation, it must be stressed that the evidence of an early lymphocyte activation after the challenge test indicates an involvement of interleukin-2 related receptor in food-induced migraine. The results have reinforced the idea of immune mechanism involvement in food-induced migraine, but it seems to be localized at different step from that until now hypothesized, with the involvement of the complex cytokines network. PMID- 1776534 TI - Role of thymic hormones in neuroimmunomodulation. Their use in patients with phobic disorders. AB - Many evidences support the existence of a bilateral connection between the thymic gland and the hypothalamic-pituitary-adrenal axis (HPAA). In this respect, neurohormones such as the adrenal corticotropin hormone and glucocorticoids cause thymic involution, while the growth hormone and the prolactin upregulate thymic functions. On the other hand, a thymic hormone, the thymosin fraction 5, activates the HPAA, thus closing-up the regulatory loop between immune system and nervous system. In this review, a clinical trial with two thymic hormones (Timostimolina and Thymopentin) in agoraphobic patients with phagocytic dysfunctions is reported. Results obtained indicate that both substances lead to a partial and temporary immunological recovery, since a further depression of phagocytic activities occurs in coincidence with panic attack. The use of alternative immunomodulators in these patients is discussed. PMID- 1776535 TI - Psychological behaviour and immunodepression in women with breast cancer. PMID- 1776536 TI - A comparison of self-help approaches to smoking cessation. AB - The current study evaluated the effectiveness of widely used self-help materials for quitting smoking. Five hundred and seventy smokers volunteered during a baseline survey to participate in the evaluation. After random assignment, 200 were mailed National Cancer Institute (NCI) "Quit for Good" materials, 200 the Minnesota "Quit and Win" program, and the remaining 170 were assigned to a nonintervention control condition. Results at 7-month follow-up failed to indicate treatment effects either for abstinence or for reported quit attempts. A number of smokers quit prior to the mailing of self-help materials, suggesting that a telephone prompt in itself may have been an important stimulus to cessation. Overall abstinence at follow-up was 10%. Contrary to expectation, successful participants were less likely to use a number of specific preparation strategies for quitting. The results are instructive in providing a large-scale assessment of self-help materials in a population of smokers that was not specifically seeking treatment. PMID- 1776537 TI - Partner interaction and smoking cessation: a pilot study. AB - This was an exploratory study of precessation interaction between 21 smokers and their partners enrolled in a partner support smoking treatment program. The aim was to identify the partner interactions and proposed quitting strategies that were associated with cessation. Significant results (p less than .05) and trends (p less than .10) were reported. Both smoker and partner interactions predicted cessation. Failure to quit was predicted by smokers' negative behavior (prosmoking statements, interrupting the partner, and criticism/rejection of help) and by partners' suggestion to disengage from the quitting process. Partner's suggestion to disengage may be a reaction to the smokers' negative behavior because it was positively correlated with it. Successful quitters and their partners proposed more self-help strategies than did nonquitters and their partners. Nonquitters proposed more cooperative strategies than did successful quitters. Thus, suggesting strategies that encourage autonomy and self-mastery, rather than dependence on another person, may lead to more positive outcomes. PMID- 1776538 TI - Assessing the congruence between physician behavior and expert opinion in smoking cessation counseling. AB - This study examines the degree of transfer of smoking cessation innovation from research to health care settings by comparing frequency-of-practice ratings by a national sample of family practice physicians (n = 903, response rate = 70%) and importance ratings by smoking cessation and prevention experts (n = 58, response rate = 84%) for 14 counseling techniques. The physician survey elicited a profile that combines traditional and behavioral techniques--discussing smoking with patients, encouraging goal setting, suggesting specific steps for quitting, and presenting pamphlets. They refer to others infrequently and rarely report planning for follow-up about smoking. The experts rated these selected techniques as moderately to highly important. They favored a behavioral approach coupled with active follow-up. The major differences between physician and expert rankings were that the experts placed higher priority on planned follow-up and a lower priority on pamphlets. The uneven quality of counseling reported by physicians suggests that weighting their responses according to expert opinion would provide a more sensitive profile. Scaled weighting produced scores that may help researchers define a composite quality-quantity measure of activity. PMID- 1776539 TI - Cue reactivity in alcohol abusers: stimulus specificity and extinction of the responses. AB - Sixteen alcohol abusers who had completed detoxification were presented with seven different types of alcohol and non-alcohol related stimuli. The sight and smell of the alcoholic beverage most commonly consumed by each subject elicited the largest change in response for measures of heart rate, desire to drink, and self-reported withdrawal symptoms. Beverages progressively more different from the preferred one produced responses of consistently lower magnitude. In the second phase of the study, 10 subjects were exposed to 20 presentations of the sight and smell of their preferred drink. A gradual reduction in the magnitude of the response for all three measures was observed over the 20 presentations. These results were discussed in terms of a conditioning interpretation of cue reactivity. They indicate the need for cue exposure programs to be based on the particular drinking history of the individual. PMID- 1776540 TI - Detection of alcohol problems in a hospital setting. AB - Three hundred and six adult medical and family practice inpatients at a university-affiliated teaching hospital were assessed for problem drinking using: (1) a short questionnaire containing the CAGE (a 4-question, self-report screening measure), and (2) a standardized review of medical records (an examination of specific blood chemistries and the physicians' and nurses' notes). Each patient completed one of two randomly assigned questionnaires containing the CAGE within the first 48 h of admission: a "Health Habits Questionnaire" or an "Alcohol Questionnaire." No significant differences were found between the two questionnaires with regard to the number of CAGE items endorsed. Overall, 16.9% of the subjects endorsed two or more CAGE items. Using the chart screening method, 11.4% of the total subjects were considered "probable" or "definite" problem drinkers. The screener's reading of the physicians' notes was the variable most important in determining overall chart screening assessment. The correlation between the two screening measures was relatively low (r = .38, p less than .001), suggesting that the two measures identify different populations of problem drinkers. PMID- 1776541 TI - On being led into temptation: "counterregulation" of dieters after smelling a "preload". AB - In the present study, it was found that dieters lost control over their food intake and "counterregulated" after merely smelling a "preload," while dieters without a "preload" were able to maintain control over their food intake. Nondieters, however, even ate marginally less after smelling a "preload" than they did in a no-preload condition. Apparently, actually breaking one's diet and such subsequent thoughts as "I've blown my diet, I might as well continue to eat" is not necessary for counterregulation to occur. The observation that merely smelling a "preload" is sufficient to produce "counterregulation" in dieters but not in nondieters challenges the explanatory power of the widely held cognitive explanation of experimental counterregulation in preloaded dieters. An explantation in terms of conditioning is put forward. PMID- 1776542 TI - The individual and combined effects of cognitive therapy and nutrition education as additions to a behavior modification program for weight loss. AB - This study examined the effectiveness of the addition of cognitive and nutritional interventions to a behavioral treatment for obesity. Sixty-nine overweight subjects were randomly assigned to either behavior therapy plus cognitive therapy (BT + CT), behavior therapy plus nutrition education (BT + NE), behavior therapy plus cognitive therapy and nutrition education (BT + CT + NE), or behavior therapy plus social support (BT). Repeated measures multivariate analyses of variance indicated that there were significant differences across time, but not between treatment conditions, for physiological measures of obesity. The effects of the behavioral intervention resulted in a significant increase in reported usage of behavioral weight control techniques. Cognitive groups reported more adaptive weight-related cognitions than noncognitive groups, and all treatment groups demonstrated a significant increase in adaptive thoughts about weight. A significant time main effect for nutrition indicated that positive change in diet existed for subjects regardless of treatment. These results highlight the need for comprehensive pretreatment assessment and individualized treatment for obesity. PMID- 1776543 TI - School adjustment of children of alcoholic fathers: comparison to normal controls. AB - The present study used objective indices of academic performance to test the hypothesis that children of alcoholic fathers (COA's) have poorer school adjustment than children of nonalcoholic parents (non-COA's). Subjects were 39 children of male alcoholics treated for alcoholism in a VA program and 33 control children whose nonalcoholic parents (matched on demographic indices) reported low marital conflict. The results showed that daughters of alcoholics, but not the sons, showed more variability than controls in their school attendance. There was suggestive evidence that they also missed more school days than controls, with a reversed pattern for the sons of alcoholics. Generally, however, the COA group was not compromised academically and did not show more conduct problems compared to controls. Within the COA group, long-term paternal drinking adjustment (years of problem drinking and total number of hospitalizations for drinking) appeared to be related to poorer GPA, while short-term adjustment (alcohol-related days in jail and number of days drinking in year previous to treatment) were more related to poorer attendance. The results are discussed in terms of the mechanism of the effect of paternal drinking on children's school adjustment and the difficulty in making generalizations about the consequences of being the child of an alcoholic. PMID- 1776544 TI - Evaluation of a mass media community smoking cessation campaign. AB - The effectiveness of a smoking cessation campaign that included both printed and televised materials was evaluated in registrant and randomly acquired samples of smokers during the first month postcampaign and again at 3 months. Registrant and random samples differed on several sociodemographic variables. Registrants had much higher rates of abstinence at both times compared to the randomly acquired group. Nicotine gum replacement was used more frequently among the registrant group. Fifteen percent of registrants who had not attempted to quit at Time 1 were abstinent 3 months postcampaign. Registering to participate in print and televised cessation programs may be related to a change in smoking behavior. PMID- 1776545 TI - Depression, dietary restraint, and binge eating in female runners. AB - Female runners (n = 174) were assessed on their levels of dietary restraint, depression, and binge eating, as well as a number of exercise variables. Thirty eight (19%) of the women in the sample were found to meet diagnostic criteria for DSM-IIIR Bulimia Nervosa. The level of exercise was unassociated with any of the affective and eating variables as was the risk for meeting diagnostic criteria for bulimia nervosa. Severity scores for depression in bulimic runners were notably lower than in earlier nonexercising samples. The relationships between the variables were similar to those found in previous research, with dietary restraint, particularly in interaction with depression, predicting the severity of binge eating in both bulimic and nonbulimic runners. These data suggest that bulimia, rather than anorexia, may be the most prevalent eating problem in female runners. PMID- 1776546 TI - Personality and family features of adolescent girls with eating symptoms: evidence for restricter/binger differences in a nonclinical population. AB - Conflicting evidence exists concerning a "restricter/binger" dichotomy aligned with personality traits of obsessionality versus impulsivity, and family traits of enmeshment versus incohesion. The present study explored relationships among reported personality and family traits, on the one hand, and subtypes of eating symptoms, on the other, in a sample of 715 high-school girls. Symptomatic eaters (most displaying subclinical eating problems) consistently displayed more Mood Problems, Body Concerns, and Self-Criticism than did asymptomatic girls. Differences were observed between restrictive eaters and binge eaters on other variables: Restrictive types were more Perfectionistic, whereas bingers were more Impulsive and rated their families as more Incohesive. Results were discussed in the light of two views on restricter/binger differences. That they reflect: (a) premorbid features acting in predisposition to the eating disorders (EDs). (b) state-dependent features associated either with restrictive or binging phases of eating disturbances. PMID- 1776547 TI - Gender differences in using alcohol to cope with depression. AB - To examine gender differences in alcohol consumption as a function of mood and expectancies, 32 nondepressed and 32 moderately depressed male and female social drinkers were compared during a 15-minute taste-rating session. Results indicated that depressed subjects tended to consume more alcohol than nondepressed subjects and men consumed more alcohol than women. Depressed men drank more and drank more per sip than all other subjects. Three depressed men consumed more than all other subjects. Depression and anxiety decreased over time for all subjects. However, a Sex x Depression x Time interaction showed that only depressed men and nondepressed women were substantially less depressed after drinking. The nondepressed women, compared to the depressed men, consumed less alcohol and reported a greater increase in positive mood. Men expected more global positive effects from drinking than women, suggesting the tension reduction hypothesis (TRH) is mediated by gender-specific expectancies. PMID- 1776548 TI - Methodological note: corroboration of self-reported smoking status using significant other reports. AB - Significant other reports (SORs) are commonly used in smoking cessation studies to verify self-reports of smoking status. This report focuses on factors related to the smoker and significant other, which can affect self-reported classification of smoking status when using SORs. Data used in this analysis were collected from a cohort of 107 smokers who participated in a smoking cessation program. Participants were contacted at 1, 3, and 6 months after quitting to obtain self-reports of smoking status. SORs also were obtained at each assessment period. The highest discrepancy rate between self-report and SOR was observed among slippers, followed by relapsers, and abstainers, respectively. In addition, corroboration of smoking status was influenced by the social context in which the significant other was likely to see the smoker. PMID- 1776549 TI - A comparison of smokeless tobacco and smoking practices of university varsity and intramural baseball players. AB - To examine the smokeless tobacco (ST) and smoking practices of collegiate varsity and intramural baseball players, 284 undergraduate athletes at two major Southwestern universities were surveyed using a questionnaire previously developed to measure use among this population. About one-fourth of all athletes were current ST users and 4% smokers. Over half of varsity players (53%) compared to 25.9% of intramural players used one or both forms of ST. Varsity players were about 20 times more likely to use ST as to smoke, while intramural players were about five times as likely to use ST than to smoke. On both teams, use of chewing tobacco was associated with use of snuff. Smoking was not associated with ST use in either group. Mean ages for initiation for all products was 15, and for quitting, 18. There was no evidence that one form of tobacco served as a gateway for the other among these young adult athletes. Over a fourth of all users started after age 17, suggesting that college is an appropriate locus for both ST prevention and cessation programming. Such programs for this population must address the unique characteristics of the social environment in collegiate baseball. PMID- 1776550 TI - Differences and similarities in development of drinking behavior between alcoholic offspring of alcoholics and alcoholic offspring of non-alcoholics. AB - Self-reported initial, early, and long-term drinking behaviors, experiences, and consequences were obtained from male alcoholics completing inpatient treatment. Subjects were recruited and selected on the basis that they met DSM-III criteria for diagnosis of alcohol dependency and that their biological fathers were alcoholic (FHP; Family History Positive) or that they had no biological family history of alcoholism (FHN; Family History Negative). Results indicated that FHP subjects rated their initial taste of beer higher than FHN subjects, that FHP subjects began tasting and subsequently regularly drinking alcohol at an earlier age than FHN subjects and that there was significantly shorter elapsed time between initiating regular drinking and developing alcoholic-symptomatic problems in living among FHP alcoholics than FHN alcoholics. Although there were a few other significant differences, the drinking-behavioral histories of the two groups were remarkably similar and parallel. Taken together, results suggest that familial risk factors primarily influence the rate at which alcoholic drinking and alcoholism develop, rather than the form or pattern of alcoholic drinking. PMID- 1776551 TI - Cognitive dissonance in tobacco smokers. AB - The knowledge and beliefs about smoking of smokers, non-smokers, and ex-smokers were examined within a cognitive dissonance framework. The 186 respondents completed a questionnaire concerned with smoking habits, knowledge of the effects of smoking, beliefs about smoking, and estimates of risk of lung cancer to themselves and to the average Australian smoker. Smokers estimated their risk of contracting lung cancer as greater than the risk non-smokers or ex-smokers saw for themselves, but less than the risk for the average Australian smoker. No differences were found in the amount of factual knowledge about the effects of smoking. However, smokers endorsed significantly more rationalisations and distortions of logic regarding smoking than did non-smokers or ex-smokers. Smokers may experience cognitive dissonance as a result of using tobacco despite its well-publicised ill-effects, and it may be that interventions targeting rationalisations for smoking will be useful in smoking cessation. PMID- 1776552 TI - Experience with alcohol and ability to discriminate legal intoxication status: a field study. AB - The research on blood alcohol level (BAL) discrimination training indicates that normal social drinkers can be taught to estimate successfully their level of intoxication. These studies show, however, that prior to training, skills for estimating intoxication are poor. The current study was undertaken to demonstrate that a sample of individuals in an actual drinking setting would have difficulty in estimating their blood alcohol level. It was expected that greater experience with alcohol would be associated with poorer abilities to discriminate legal intoxication. Subjects were 99 volunteers selected from the patrons of two bars. Participants completed a brief questionnaire assessing their typical alcohol use, the number of drinks consumed on this particular occasion, and whether they believed that they were currently over the legal limit for intoxication. A breathalyzer was used to determine actual level of intoxication. Results generally supported the hypotheses. Situational factors, including experimenter and drinking location, affected accuracy of estimations. Actual BAL also had a significant effect on accuracy. Errors in estimation were most often in the direction of overestimating intoxication. There was also a sex of subject effect, with males being heavier drinkers and estimating intoxication more poorly than females. Results are discussed in terms of situation and expectancy effects. PMID- 1776553 TI - A longitudinal evaluation of dietary restraint and its relationship to changes in body weight. AB - The purpose of this investigation was to evaluate the impact of changes in dietary restraint (chronic dieting) on changes in body weight over time. Subjects were 305 (98 male, 207 female) adults. At pretest, subjects completed a restrained eating questionnaire (Herman & Polivy, 1980), as well as reporting height, weight, gender, race, and age. Subjects were recontacted 2 1/2 years later and were reassessed on these same variables. Results indicated that restrained eating scores showed a high degree of consistency over a 2-1/2-year period (intraclass correlation = .74). Over time, males gained more weight than females and normal-weight subjects gained more weight over time than overweight subjects. No relationship was found between dietary restraint and weight gain over time. The potential interactions between energy balance and body weight are discussed. PMID- 1776554 TI - Estimation of percent overweight within families. AB - When height and weight cannot be directly measured percent overweight can be estimated using self-reported height and weight, reports of others for height and weight, and matching of body shape to silhouettes. The present study assessed the relative benefits of each method for estimating percent overweight within families, as well as the potential for using matching of silhouettes for diagnosing obesity. Analysis of the relationship between percent overweight and silhouette ratings showed increases in percent overweight across the silhouettes. Correlations between self- or other-reported and measured percent overweight showed that self-reports correlated very highly with measured reports of percent overweight (r = .97, .96 for parents and children, respectively), but parent reports of their spouses and children percent overweight were lower (r = .87, .87) and child reports of sibling or parent percent overweight were even lower (r = .75, .75). Significant increases in accuracy of diagnosing obesity were observed when the combination of adjusted self-reports and silhouettes were used in comparison to self-reports alone. PMID- 1776555 TI - Cervical cancer and methods of contraception. AB - When evaluating whether the use of a particular method of contraception is associated with an increased or decreased risk of cervical cancer, it is important to be aware of the epidemiological factors which might lead to incorrect conclusions. After careful consideration of the issues, and examination of the available data, it is concluded that women who use oral contraceptives are possibly at increased risk of invasive cervical cancer; users of barrier methods probably have a decreased risk (although the protective effect may differ between the various types of barrier method); and that users of other methods of contraception do not have an altered risk. PMID- 1776556 TI - Oral contraceptive steroids--pharmacological issues of interest to the prescribing physician. AB - Oral contraceptive steroids (OCS) are well absorbed from the gastrointestinal tract in humans. However, while the progestogens are almost completely bioavailable, ethinylestradiol (EE2) is subject to extensive first pass metabolism consisting chiefly of conjugation with sulfate in the gut wall. Both EE2 and progestogens are well absorbed in patients with an ileostomy or with diseases such as cystic fibrosis or Crohn's disease. However in patients with celiac disease (gluten-sensitive enteropathy) the gut wall is less able to conjugate EE2 and thus its bioavailability is increased. The bioavailability returns to control values as the disease is improved following gluten withdrawal. Other drugs that are conjugated with sulfate, such as vitamin C and paracetamol, compete for available sulfate when coadministered with OCS leading to high plasma levels of EE2. Enzyme-inducing agents such as rifampicin, phenobarbitone, phenytoin and carbamazepine reduce blood levels of the OCS leading to contraceptive failure. In the case of anticonvulsants (but not rifampicin) this can be easily overcome by increasing the dose of OCS used. Broad-spectrum antibiotics are reported to cause failure of contraception by interfering with the enterohepatic circulation of EE2 but limited systematic studies show no evidence of such an interaction. Nevertheless practitioners are advised to recommend the use of alternative contraceptive precautions for women receiving broad-spectrum antibiotics concurrently with their OCS preparation. PMID- 1776557 TI - Intrauterine devices in nulliparous women. AB - The majority of studies on the clinical events following the insertion of an intrauterine device for contraception have observed a higher frequency of adverse effects in nulliparous women. In this review, the significance of nulliparity on the occurrence of medical removal for bleeding and pain, expulsion and pelvic inflammatory disease is estimated. The possible role of the anatomy of the pregravid uterus is discussed, and results obtained through a selective measurement of the endometrial cavity in a population of nulligravidas is presented. It is concluded that IUDs should not be the first choice of contraception in nulliparous women because of an increased risk of long-term adverse effects. The relationship between the length of the intrauterine device and the length of the endometrial cavity does not seem to be of clinical significance for the performance of IUDs in nulliparous women. PMID- 1776558 TI - RU486 combined with PG analogs in voluntary termination of pregnancy. AB - This French study evaluates the clinical results of administering RU486 with prostaglandin analogs in early pregnancy. Since 1986, RU486 has been used with prostaglandin analogs to interrupt pregnancies of less than 49 days' amenorrhea. Success rate among 10,250 cases was 95.3%. Failures involve ending of pregnancy without expulsion (2.8%), and ongoing pregnancy (1.1%). Two cases of cardiovascular complications following administration of the prostaglandin have occurred. The majority of users prefer this method because it eliminates need for surgery and anesthesia, and it allows the patient to take an active role in the procedure. PMID- 1776559 TI - RU486 and the early nineties. AB - RU486 is a very powerful antisteroid hormone compound. Its antiprogestin activity particularly leads to clinical application in reproductive medicine. Its use for voluntary pregnancy interruption is only one aspect of its medical potentiality. PMID- 1776560 TI - Effects of an aqueous extract of cotton seed (Gossypium barbadense Linn.) on adult male rats. AB - Twenty adult male rats per group in 4 treatment groups were injected intraperitoneally at 08.00 hours with 0.1 ml of an aqueous cotton seed extract (Gossypium barbadense Linn.) (Malvaceae) in concentrations of (a) 105.25, (b) 21.21, (c) 4.65, (d) 2.325 mg ml-1 (kg body weight)-1, respectively. A fifth group (control) was given 0.1 ml of pyrogen free distilled water per rat. Five rats per treatment group were sacrificed at 2, 8, 24 and 168 hours respectively after treatment. Plasma follicle stimulating hormone (FSH) and luteinizing hormone (LH) showed no change. Plasma testosterone was lower (p less than 0.05) than that of control at 2 and 8 hours, with recovery by 168 hours post treatment. Plasma creatinine was raised by 2 hours, with recovery by 8 hours. Plasma urea rose gradually but persistently to a maximum of 168 hours. Plasma aspartate (AST) and alanine (ALT) transaminases were significantly higher (p less than 0.001) than that of controls throughout the study. Testicular histology showed early germ cell disorganization followed by progressive fibrosis (sperm cytoskeleton) by 24 hours. There was evidence of recovery by 168 hours. It is concluded that aqueous extract of cotton seed meal contains substances that can rapidly cause damage to testicular, liver, kidney and muscular tissues. PMID- 1776561 TI - Successful sustained lactation following postpartum tubal ligation. AB - This study was undertaken to see whether tubal ligation performed within days postpartum, and associated with a delay in the initiation of breastfeeding, exerts a disruptive influence on successfully establishing lactation among the rural population of northern Thailand. Lactational performance of 12 rural northern Thai mothers was not affected by the delay in reunion of mothers with their babies as a result of postpartum tubal sterilization procedure when compared with a group of 8 other healthy mothers and babies. The volume of breast milk transferred, frequency of breastfeeding and the total feeding time spent on the breast were similar on days 15, 45, 90, 180 and 360 postpartum. This finding suggests that the pattern of intense breastfeeding activity as practiced by this group of mothers has a stronger influence on prolonged and successful lactation than early contact in the immediate postpartum period. PMID- 1776562 TI - Assessment of luteal function after surgical tubal sterilization. AB - To evaluate ovarian luteal function after tubal occlusion, a group of women who underwent Pomeroy sterilization were studied. A prospective group I (n = 16) were followed for one year and scheduled for blood sampling every other day during their luteal phase before surgical procedure and at 3 and 12 months thereafter. Group II (n = 15) included women who were studied during their luteal phase at 1 or 5 years post-surgery. Mid-luteal progesterone and estradiol serum levels were calculated by estimating the average of at least 3 values of serum samples obtained in days 20-25 of a menstrual cycle. The data suggest that no major changes occur in ovarian function after surgical tubal occlusion, as assessed by the mid-luteal hormone serum levels, and underscore the safety of this procedure. PMID- 1776563 TI - The Norplant removal training and service at Dr Kariadi Hospital, Semarang, Indonesia. AB - The mean of the Norplant usage period of 338 acceptors was 44.4 months. Most users had poor education and low incomes; the lower their socioeconomic status, the longer they used the Norplant implant. Return to fertility 3 months after removal was 38.46%; after 6 months, 71.43%; after 9 months, 74.46%; and after 12 months, 75%. The continuation rate at year one was 82.84%; year 2, 74.85%; year 3, 68.34%; year 4, 64.79%; while year 5 was 8.58%. The mean removal time was 21 minutes. There was a very significant difference between trained and untrained removers in the duration of removal. The average number of capsules removed was 5.64. There was no significant difference between trained and untrained removers in successful capsule removal. Reasons for removal were expired date and non medical complaints such as changing to other contraceptives and the wish to become pregnant; medical complaints were dizziness, vertigo, spotting and amenorrhea. Removal was prompted by acne, metrorrhagia, two or more medical complaints, menorrhagia, physical pain, tenderness at insertion site and spotting. There were no pregnancies found among acceptors. However, 5.92% of the acceptors were pregnant at the time of insertion because of misdiagnosis. It can be concluded that Norplant is effective, safe and acceptable but removal needs trained persons. PMID- 1776564 TI - Piecing together the puzzle of basal forebrain anatomy. PMID- 1776565 TI - Calcium-binding protein (calbindin D-28k) immunoreactive neurons in the basal forebrain of the monkey and the rat: relationship with the cholinergic neurons. PMID- 1776566 TI - Glutamate-like immunoreactivity is present within cholinergic neurons of the laterodorsal tegmental and pedunculopontine nuclei. PMID- 1776567 TI - Neuromodulatory actions of dopamine and cholecystokinin in the ventral striatum. PMID- 1776568 TI - The cholinergic basal forebrain: a critical role in cortical arousal. PMID- 1776569 TI - Basal forebrain modulation of cortical cell activity during conditioning. PMID- 1776570 TI - Electrophysiological studies of the functions of the nucleus basalis in primates. AB - In summary, the studies reviewed here have indicated which neural functions might be directly influenced by the nucleus basalis. Basalis neurons do not appear to be directly involved in trial-specific memory because, in memory tasks, they have non-differential responses that do not correspond to the information being remembered by the monkey. Similarly, basalis neurons do not appear to be related to movements because, in a go/no-go task, similar neuronal responses occur whether the animal moves or does not move, and, in a delayed response task, different neuronal responses occur during the same arm movement made under different conditions. Basalis neurons also respond differently to the same sensory stimuli presented under different conditions, which indicates that the nucleus basalis is not involved in basic sensory perception. The responses of basalis neurons therefore appear to be strongly influenced by the context or behavioral significance of stimuli. Many basalis neurons respond to appetitive stimuli. In trained animals, the most frequently observed responses have been to a water reward or to stimuli that consistently precede the reward. In naive, thirsty animals, a large proportion of basalis neurons respond to the delivery of water. However, a large number of neurons also respond to an aversive air puff, which indicates that the nucleus basalis cannot be exclusively related to appetitive stimuli. Although some basalis neurons apparently respond only to the appetitive stimulus and others respond only to the aversive stimulus, the majority appear to respond similarly to both stimuli. In particular, almost all of the neurons whose response magnitudes covary with the volume of the water respond similarly to the air puff. Hence, the neurons that appear most likely to be related to the appetitive component of the water are also responsive to an aversive stimulus. Basalis neurons may therefore be related to some common characteristic of aversive and appetitive stimuli, such as the arousing quality of these stimuli. The hypothesis that most basalis neurons are particularly responsive to arousing stimuli could account for the abundance of responses to rewards and stimuli associated with rewards. These phasic responses of basalis neurons are hypothesized to be related to a transient increase in the cortical activation component of arousal, just as the tonic activity of basalis neurons appears to be related to sustained cortical activation. PMID- 1776571 TI - The relationship between learning, memory and neuronal responses in the primate basal forebrain. PMID- 1776572 TI - The contribution of basal forebrain to limbic-motor integration and the mediation of motivation to action. AB - The contribution of hippocampal glutamatergic and VTA dopaminergic inputs to the nucleus accumbens and the role of accumbens--ventral and subpallidal GABAergic pathway in integrating the limbic signals into motor responses via pedunculopontine nucleus were examined with electrophysiological and behavioural techniques. Stimulation of hippocampal input to the accumbens activates GABAergic output to the subpallidal area which leads to suppression of spontaneous firing of subpallidal neurons, while activation of dopamine receptors in the accumbens suppresses GABAergic output to subpallidal area and thus increases the firing of picrotoxin-sensitive ventral pallidal neurons. However, both treatments induced hypermotility suggesting the functional heterogeneity of the ventral and subpallidal areas in "limbic-motor integration". Furthermore, both hippocampal output signals and dopaminergic input to the accumbens descend via ventral and subpallidal areas serially to the pedunculopontine nucleus, the region of the mesencephalic locomotor region. In addition, a parallel ascending pathway from the subpallidal area to the mediodorsal nucleus, and subsequently to the medial prefrontal cortex, probably mediates behaviour, e.g. food hoarding, that requires higher cognitive processing. PMID- 1776573 TI - Functional output of the basal forebrain. PMID- 1776574 TI - Effect of GABAergic and glutamatergic drugs injected into the ventral pallidum on locomotor activity. PMID- 1776575 TI - GABAergic and enkephalinergic regulation of locomotion in the ventral pallidum: involvement of the mesolimbic dopamine system. PMID- 1776576 TI - Basal forebrain involvement in self-administration of drugs of abuse. PMID- 1776577 TI - Basal forebrain cholinergic system: a functional analysis. AB - This chapter has been organized empirically, focusing on the types of approaches that have been taken to understand BFCS function. This approach reflects the state of our knowledge about the behavioral and psychological functions of the BFCS. Considerable information has been gathered in the very short time that the BFCS has been the object of intense investigation. The results from the neurotoxic lesions and from the HACU studies provide some points of consistency and some puzzling differences. Both approaches to the study of basal forebrain function suggest that the MSA is involved in tasks that require spatial working memory; MSA lesions impaired choice accuracy, and HACU in the HIP was increased after performance. The pattern of results in simpler tasks is more difficult to interpret. In a left-right reference memory discrimination in a T-maze, MSA lesions did not impair acquisition or performance, whereas HACU in the HIP was activated during performance. This pattern of results suggests that although the MSA is engaged during this type of task, its activity is not necessary for normal performance. These, and other comparisons indicate the need for a systematic analysis of task demand (Olton, 1989b). Parametric manipulations of different task demands in a systematic fashion can indicate the extent to which the BFCS is involved in the function associated with each parametric manipulation. Ultimately, of course, the organization of this material should focus on particular psychological functions, rather than the techniques and procedures used to gather the information. Achieving this goal is going to require careful attention to the design of behavioral experiments so that definitive conclusions can be made about the extent to which the BFCS is involved in a given psychological function. A systematic application of task analysis can achieve this goal (Olton, 1986, 1989a, 1989b). For example, BFCS lesions in rats impair choice accuracy in spatial working memory tasks, and performance in these tasks engages the HACU system, at least in the HIP. If the spatial functions of this task involve the BFCS, then a nonspatial version of the task should produce a different pattern of results. If the spatial nature of the task is unimportant for BFCS function, then a nonspatial version of the task should produce the same results. By systematically changing one characteristic of the task at a time, the contribution of each component can be assessed.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1776578 TI - Choline-induced spatial memory facilitation correlates with altered distribution and morphology of septal neurons. PMID- 1776579 TI - In vitro cell cultures as a model of the basal forebrain. AB - The basal forebrain has attracted considerable attention because of its putative role in complex functions such as learning, memory and behavioral state control as well as its vulnerability in neurological disorders such as Alzheimer's Disease (AD). The finding that nerve growth factor provides trophic support for the cholinergic basal forebrain neurons has stimulated further interest in understanding trophic interactions of basal forebrain neurons as well as in possible trophic factor therapeutic strategies for disease states. Our laboratory has utilized primary cell cultures and developed immortalized central nervous system cell lines to study the trophic interactions that establish and maintain the septohippocampal pathway, a basal forebrain component which plays an essential role in cognitive function and is prominently affected in AD. The results of our primary cell culture studies have demonstrated the importance of trophic signals elaborated by the hippocampus in mediating the development of septal cholinergic neurons. Nerve growth factor plays an important role in this process, but it cannot account for all of the trophic signals elaborated by authentic hippocampal target cells. The development by this laboratory of clonal cell lines of septal and hippocampal lineage offers the prospect of investigating both the response to and elaboration of neural trophic signals at a more precise level of resolution than can be achieved with primary cultures. The technology and information that is generated from the engineering of such cell lines will also serve as a strategy to study trophic interactions in other brain circuits in future years, and to investigate possible changes or dysfunctions that occur neurological diseases. PMID- 1776580 TI - Afferents to basal forebrain cholinergic projection neurons: an update. PMID- 1776581 TI - The epidemiology of dementia in patients with Parkinson's disease. PMID- 1776582 TI - Pathology in the cholinergic basal forebrain: implications for treatment. PMID- 1776583 TI - Beyond the cataract: visual and functional disability in elderly people. PMID- 1776584 TI - Opportunistic screening of visual acuity of elderly patients attending outpatient clinics. AB - A standard Snellen letter chart was used to screen the visual acuities of 202 elderly patients while they attended outpatients clinics. Patients overestimated the adequacy of their vision: only 34 patients reported inadequate vision while 72 had significant measured visual impairment. Of these, 30 patients had refractive errors and 42 primarily non-refractive problems. Thirty patients were examined by an ophthalmologist, of whom 24 had previously undiagnosed conditions. Eighteen patients had treatable conditions, predominantly cataracts and glaucoma. Ten patients with untreatable conditions had the benefit of a definitive diagnosis, most commonly of age-related macular degeneration, and an assessment of eligibility for registration of blindness. The routine assessment of elderly patients should include objective screening of their visual acuity. PMID- 1776585 TI - The prevalence of dementia in a total population: a comparison of two screening instruments. AB - Two short screening tests for dementia, the Information/Orientation (IO) sub-test of the Clifton Assessment Scale (CAPE) and the Mini-Mental State Examination (MMSE) were included in a survey of 1579 elderly people of a large general practice. All those scoring 21 and under on the MMSE, a one in two sample of those scoring 22, 23 and a one in ten sample of the remainder were investigated further using the Cambridge Examination for Mental Disorders of the elderly (CAMDEX). The prevalences of moderate to severe dementia and mild to severe dementia determined from the CAMDEX interview were 4.8% and 14.2%, respectively. For detection of moderate to severe dementia, a cut-point of 21/22 on the MMSE gave a sensitivity of 100%, specificity of 85% and an overall prevalence of 19.7%; mild to severe dementia was best detected by a cut-point of 23/24 giving a sensitivity of 89%, specificity of 81% and prevalence of 28.5%. A cut-point of 7/8 on the IO sub-test gave a sensitivity and specificity for detecting moderate to severe dementia of 87% and 97%, respectively, with a prevalence of 7.3%; for mild to severe dementia a cut-point of 10/11 gave a sensitivity of 67%, specificity of 94% and prevalence of 14.7%. PMID- 1776586 TI - Lack of knowledge of symptoms of hypoglycaemia by elderly diabetic patients. AB - The knowledge of symptoms of hypoglycaemia of 45 consecutive elderly diabetic patients was assessed during a structured interview and compared with that of an age-matched non-diabetic control group. Twenty-three (88%) patients taking oral hypoglycaemic agents (OHAs) and six (32%) insulin-treated patients denied any knowledge of hypoglycaemia. There was no significant difference in knowledge of 14 symptoms of hypoglycaemia between the non-diabetic controls and the combined diabetic (OHA and insulin) groups, but insulin-treated patients were slightly more knowledgeable than patients taking OHAs. Fourteen (54%) of the OHA group were taking either glibenclamide or chlorpropamide which have been associated with severe and prolonged hypoglycaemia. Elderly diabetic patients are unlikely to respond to the warning symptoms of hypoglycaemia and caution should therefore be exercised when prescribing for these patients. PMID- 1776587 TI - Surgical treatment of cervical spondylotic myelopathy in elderly patients. AB - A retrospective study was carried out of the outcome of surgical decompression of cervical spondylotic myelopathy in 21 elderly patients. The presenting symptoms and signs were similar to those in younger patients. The indication for surgery was recent progressive neurological deficit. Assessment of pre-operative state was based on information from hospital records. Post-operative evaluation was made from a home visit in 17 cases (mean age 71) after a mean post-operative period of 19 months (3 patients had died in the interim and one had emigrated). Objective functional improvement was found in the upper limb in 58% and in the lower limb in 71%; the remainder were unchanged. Surgical decompression in cervical spondylotic myelopathy is a safe procedure, which benefits appropriately selected elderly. PMID- 1776588 TI - Influence of sex and age on vitamin A and E status. AB - Vitamins A and E were determined in the serum of 80 free-living healthy elderly subjects and in 80 healthy younger adults. Mean values and normal ranges were established for both groups and the influence of sex and age studied. We found a significantly lower level of vitamin A in the elderly men and women and a higher level of vitamin E in elderly women, relative to their younger counterparts. These differences may be related to life-style and age-associated physiological changes and justify the use of age-corrected standard values. PMID- 1776589 TI - Longitudinal changes of serum albumin in elderly people living in the community. AB - The relationship of serum albumin at baseline to mortality, and longitudinal changes of serum albumin were investigated in a 10-year longitudinal study of 421 (197 men, 224 women) community residents aged 69-71. The 10-year survival rate was the lowest in the first quartile of serum albumin at baseline, followed by the second quartile, and third and fourth quartiles (p less than 0.05). In both sexes, 10-year survival curves did not differ between the group with diseases or disabilities at baseline or over time and the group without them. PMID- 1776590 TI - Age and the rate of induction of aryl hydrocarbon hydroxylase in isolated peripheral blood monocytes. AB - We have measured the rate of induction of the microsomal monooxygenase enzyme aryl hydrocarbon hydroxylase (AHH) in isolated peripheral blood monocytes from young and elderly donors. There was no effect of age on rate of induction. The mechanisms underlying impaired induction of drug metabolism in elderly people remain to be clarified. PMID- 1776591 TI - A single-dose study of the pharmacodynamic effects of chlormethiazole, temazepam and placebo in elderly parkinsonian patients. AB - Nine elderly parkinsonian volunteers took single doses of 384 mg of chlormethiazole, 10 mg of temazepam and placebo capsules in a double-blind three way cross-over study on separate visits at least one week apart. In the 6 hours following the dose, the level of drowsiness, performance on a series of psychomotor tests, effects on parkinsonian symptoms and signs, and standing and lying blood pressure were recorded. Chlormethiazole produced drowsiness on all tests and impaired psychomotor performance, as compared with placebo, without affecting parkinsonian symptoms and signs, or postural blood pressure. Temazepam was consistently less potent than chlormethiazole on tests of drowsiness and psychomotor performance. Both treatments were well tolerated. It is suggested that chlormethiazole is safe to use as a hypnotic at this dosage in this group of patients with Parkinson's disease, while temazepam did not appear to be effective as a hypnotic at this dosage. PMID- 1776592 TI - Melatonin levels in hospitalized elderly patients: a comparison with community based volunteers. AB - Twenty-one-hour melatonin plasma profiles were studied in 15 normal elderly volunteers from the community, and eight who had been in hospital for more than six weeks and who had not been exposed to strong natural lighting. The hospital group had significantly higher daytime plasma melatonin levels, an earlier nocturnal rise, and the timing of their secretory profiles was more variable. These results suggest that currently used artificial and supplementary natural lighting may not be sufficient to suppress melatonin secretion adequately during daylight hours nor act efficiently to entrain day/night secretion of melatonin in a physiological circadian manner. Raised melatonin levels by day and variable secretory profiles at night may account for certain mood and sleep disorders observed in institutionalized people. PMID- 1776593 TI - Fractures of the hip and distal forearm in West Africa and the United Kingdom. AB - Comparison of age- and sex-specific incidence rates of fractures of the proximal femur and the distal forearm showed significantly lower rates in Ibadan than in two urban centres in England, with risk ratio of up to 20. In the Ibadan data no evidence of higher rates in women or of a prominent age-associated increase in rates was observed. PMID- 1776594 TI - Effects of ageing and physical training on the peripheral sweat production of the human eccrine sweat gland. AB - Epidemiological studies suggest that thermoregulatory function declines with ageing. Therefore, it was the purpose of this study to examine the effects of physical training and ageing on the peripheral sweat rate of the human sweat gland. Maximum oxygen uptake and peripheral sweat rate (pilocarpine iontophoresis) were determined in 40 male volunteers (10 sedentary younger men, 10 endurance-trained younger men, 10 sedentary older men, and 10 endurance trained older men). Maximum oxygen uptake and peripheral sweat rate were significantly (p less than 0.05) greater in the two endurance-trained groups compared to their sedentary counterparts. Furthermore, when matched for maximum oxygen uptake, younger and older men had similar mean peripheral sweat rate values. These results suggest that participation in lifelong aerobic exercise may retard the decrease in peripheral sweat production usually associated with ageing. Further work is needed, however, to determine if such changes can improve overall thermoregulatory function in elderly people. PMID- 1776595 TI - How common are epileptic seizures in old age? AB - A large primary-care computerized database was searched to determine the incidence and prevalence of epilepsy and epileptic seizures in old age compared with the general population. The prevalence of subjects with a diagnosis of epileptic seizures was higher in older age groups: 10.9/1000 for sexagenarians, 12.0 for septuagenarians and 13.1 for those over 80, compared with 9.0/1000 in the overall population. The overall prevalence in subjects aged over 60 was 11.8. Annual incidence rose even more sharply in old age: 76/100,000 for sexagenarians, 147 for septuagenarians, and 159 for those over 80, compared with an overall population incidence of 69/100,000. The overall incidence in subjects over 60 was 117. Of incident cases requiring treatment, 35.5% were over 60 years old. Our findings are in keeping with other recent epidemiological studies and in part reflect the age-associated increase in the prevalence of cerebrovascular disease. They have implications for the organization of services for elderly people, for the education of general practitioners and hospital doctors and for directing epilepsy research. PMID- 1776596 TI - Carotid sinus syndrome--clinical characteristics in elderly patients. AB - Carotid sinus massage was carried out on 130 consecutive patients referred for investigation of dizziness, syncope or unexplained falls. Carotid sinus syndrome was diagnosed in 33 for whom no other cause of symptoms was identified. Right sided hypersensitivity was more frequent than left-sided. Thirty per cent identified a prodrome before syncope and 30% had retrograde amnesia for the event. In 52%, symptoms were precipitated by head movement and in 48% by vagal stimuli. Seven described 'drop attacks' but symptoms were reproduced with carotid sinus massage during head-up tilt. Injuries, including fractured neck of femur, were sustained by the majority. Carotid sinus massage should be performed routinely on all elderly patients who have symptoms of unexplained dizziness, falls or syncope. Cardiac pacing relieves syncopal symptoms in those with a predominant cardio-inhibitory response and recurrent syncope. PMID- 1776597 TI - Medications and multiple falls in elderly people: the St Louis OASIS study. AB - The purpose of this study was to identify associations between the use of commonly taken medications and groups of medications and the risk of falls in elderly people living in the community. A stratified random sample of 1358 persons aged 65 years and over was selected from the 15,000 members of an educational organization for functionally independent, community-dwelling elderly people in St Louis, Missouri. Twenty-seven per cent of subjects reported at least one fall in the past year and 8% reported two or more falls. After adjusting for potential confounders (including age, sex, relevant medical conditions, health status, cognitive impairment, use of alcohol, depression and use of other medications), the following medications were found to be important risk factors for multiple falls: diazepam [odds ratio (OR): 3.7, 95% confidence interval (CI): 1.5-9.3], diltiazem (OR: 1.8, 95% CI: 0.8-4.1), diuretics (OR: 1.8, 95% CI: 1.2 2.8) and laxatives (OR: 2.1, 95% CI: 1.0-4.5). We conclude that caution is needed before prescribing diuretics and psychotropics, especially diazepam, for elderly people. The safety of diltiazem in this age group should be assessed further. PMID- 1776598 TI - The euthyroid sick syndrome. PMID- 1776599 TI - [Congenital (genetic) abnormalities and genes]. PMID- 1776600 TI - [The etiology of central serous chorioretinopathy]. AB - We found several fluorescein fundus angiographic findings of the retinal pigment epithelium in the experimental central serous chorioretinopathy (ECSC) i.e.; the typical leaking spot (smoke-stack type or inkblot type), acute retinal pigment epitheliitis-like, APMPPE-like, triangular syndrome-like, drusen-like lesions, and retinal pigment epithelium decompensation during the observations of the six months period in the same monkey. Immediately after onset of ECSC, we found that the typical leaking spot appeared after retinal venous filling phase or appeared in the margin of the choroidal filling delay. The leaking spot, acute retinal pigment epitheliitis-like, APMPPE-like and drusen-like lesions spontaneously healed without scar formation and were related to the mild choroidal ischemia. These findings correspond to those seen in human central serous chorioretinopathy. As an initial change, choroidal neovascularization in the macula was also found in the eye with recurrent or chronic ECSC by electron microscopy. Considering the fluorescein fundus angiographic findings of this monkey, it was suggested that the recurrent or chronic, mild choroidal ischemia seems to play an important role in the development of the choroidal neovascularization. Therefore, we believe that the ECSC is an animal model of the human central serous chorioretinopathy. We also found that the development of ECSC produced by intravenous injection of the adrenalin in rabbits is completely suppressed by the pretreatment of alpha-adrenergic receptor blocking agent and is incompletely suppressed by the pretreatment of beta adrenergic receptor blocking agent and ganglionic blocking agent. These results strongly suggest that the stress plays an important role in the development of the central serous chorioretinopathy. PMID- 1776601 TI - [The molecular genetics of color blindness]. AB - The gene structures of three color pigments have been reported by Nathans et al. in 1985. One copy of red gene and 1 to 3 copies of green genes are tandemly repeated on X chromosome. As the structures of red and green genes are highly homologous (96%) and tandemly repeated, they cross-over on chromosome during meiosis and hybrid genes were produced. The function of these hybrid genes exhibits abnormal spectrum for red and green light. The 5' portion of the gene determines which cone cell type express the gene and the 3' portion of the gene determines the type of spectrum. In the 3' portion, exon 4 are associated with a small shift of spectrum and exon 5 determines a large shift of spectrum. For example, a hybrid gene with 5' region of red and 3' region of green is expressed in the red cones and exhibits green spectrum. Abnormality of color perception depends on the hybrid ratio of red and green genes. PMID- 1776602 TI - [Developmental mechanisms of congenital eye abnormalities]. AB - Experimental teratology in mice was studied to clarify the developmental mechanisms of congenital eye abnormalities. Pregnant Jcl: ICR mice were treated intraperitoneally with ochratoxin A on day 7 of pregnancy. The offspring were grossly observed on day 9, 10, 11, 12, 13, 14, 16 or 18 of gestation, or at the second or fourth week after birth. Then, the eyes were histologically examined in serial sections. Mother mice were injected with ochratoxin A on day 8, 9, 10 or 11 of pregnancy, and the eyes of fetuses were examined on day 16 of gestation to determine the critical periods for the congenital eye abnormalities. Pregnant C57BL/6NJcl mice were also given an intraperitoneal injection of ochratoxin A on day 7 of pregnancy, and the eyes of offspring were observed grossly and histologically on day 16 or 18 of gestation, or at the second or fourth week after birth. Fetal and postnatal eyes showed various kinds and degrees of developmental abnormalities histologically. They included anophthalmia, microphthalmia, aphakia, mesenchymal dysgenesis of the anterior segment, faulty separation of the lens vesicle, developmental abnormalities of the vitreous, faulty closure of the embryonic fissure, retinal rosette formation and aberrant optic nerve fiber. Since anophthalmia, microphthalmia and aphakia caused by the developmental disturbances of the optic and lens vesicles were not established in the fetuses whose mothers were treated with ochratoxin A after day 9 of pregnancy, the critical periods for these abnormalities were considered to be on day 8 of gestation or earlier. Mesenchymal dysgenesis of the anterior segment, faulty separation of the lens vesicle and developmental abnormalities of the vitreous were frequently observed in the fetuses whose mothers were injected with ochratoxin A on day 7, 8 or 9 of pregnancy. It was considered that there was a correlation between the critical periods for these three abnormalities and the stage of the neural crest cell migration around the optic vesicle. Mesenchymal dysgenesis of the anterior segment observed in mice corresponded to the Axenfeld Rieger syndrome or Peters' anomaly encountered clinically. Processes of production of these abnormalities based on the faulty migration of the neural crest cells which form the ocular anterior segment were demonstrated.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1776603 TI - [The development of human trabecular meshwork]. AB - The fetal development of the trabecular meshwork of the human eye was quantitatively studied by light and electron microscopy. From the 20th fetal week onward, the progressive thickening of the trabecular meshwork was achieved mainly by the widening of intertrabecular spaces, whereas the thickness and the number of trabeculae were almost constant. Significant alterations in the number of trabecular meshwork cells did not occur with development. However, a decrease in trabecular meshwork cellularity occurred by the widening of intertrabecular spaces. As development proceeded, there was an increase in the proportion of the width of the posterior trabecular meshwork, which is the main site of aqueous drainage, in accordance with the increase of aqueous production. PMID- 1776604 TI - [Aging effects on the light response of the interphotoreceptor matrix as revealed by binding of Ricinus communis agglutinin-1]. AB - This study intended to explore whether the light response of the interphotoreceptor matrix (IPM) is affected by aging. The binding pattern of fluorescence-labeled Ricinus communis agglutinin-1 (RCA) to IPM was examined histochemically in 2 month-old and 1.5 year-old rats under light- and dark adapted conditions. Two month-old animals showed obvious light-evoked changes in the rod associated IPM: the photoreceptor inner segment zone showed a greater fluorescence than the outer segment zone in the light, whereas the staining intensity of the former was less than that of the latter in the dark. On the other hand, 1.5 year-old rats did not show such light-evoked IPM responses as in 2 month-old animals: no light-dark differences were found in RCA-1 binding. The scarce, linear, preferential binding of RCA-1 to the cone-associated IPM was the same in both lighting conditions independent of the age. PMID- 1776605 TI - [Changes in retinal electrical response due to different size of experimental retinal detachment]. AB - To investigate the influence of the size of detachment to function of the detached retina, transretinal ERG (TR-ERG) was recorded from experimentally detached retina. Retinal detachment 4 or 8 mm in diameter was made by injecting sodium hyaluronate in the subretinal space. The TR-ERG was recorded for two hours from the detached retina by a double barreled microelectrode of which a longer tip entered into the subretinal space of the detached retina while a shorter one remained in the vitreous. Vitreal ERG (VERG) was simultaneously recorded between the shorter electrode and a scleral electrode. The b-wave amplitude of the TR-ERG recorded from the retina with 4 mm detachment decreased two hours after detachment, whereas the b-wave recorded from the retina with 8 mm detachment remarkably decreased 30 min after detachment and was stable up to two hours. There were no significant differences in amplitudes of VERG b-waves between 4 and 8 mm detachments during the experimental course. Less extensively detached retina maintained its function to a greater degree than the largely detached retina. The volume of the subretinal space may influence the viability of the detached retina by changing the concentration of nutrients. PMID- 1776606 TI - [Pointing response in normal subjects]. AB - Eye-hand open-loop pointing responses were examined in five normal subjects, with visual cues for relative target localization. Pointing errors differed significantly with the position of the target. In some cases, pointing responses in the dark were significantly different from those in the light. Pointing shifts were also significant between the responses immediately after putting the experimental device on and those 15 minutes after. From these results, it was speculated that visual localization and eye-hand coordination may be influenced by the visual context and the passage of time. PMID- 1776607 TI - [Close association of Streptococcus sanguis and Behcet's disease]. AB - The oral flora of patients with Behcet's disease was investigated and compared to that of controls. The proportion of Streptococcus (S.) sanguis in the flora of patients with this disease was always higher than that of healthy controls. It is noteworthy that serotypes of S. sanguis in the oral flora of patients were different from controls. Immune responses against S. sanguis were also examined in the patients. Antibody titers against S. sanguis were higher in patients than in controls. Furthermore, the patients showed significantly increased skin reactivity to S. sanguis. These results suggest that uncommon serotypes of S. sanguis play an important role in the pathogenesis of Behcet's disease. PMID- 1776608 TI - [Analysis of 7 cases with intracavernous aneurysm]. AB - Intracavernous sinus aneurysm is rare and consists of approximately 3% of intracranial aneurysm. Since this aneurysm increases gradually in size and causes various neurological signs, differential diagnosis is necessary. In this report, seven cases of intracavernous sinus aneurysm were analyzed. In conclusion, oculomotor or abducens nerve palsy were seen in most cases. Though trigeminal nerve palsy was suspected in many cases, it was actually seen only in one case. Most cases developed slowly and progressively. One case showed an acute onset and the differential diagnosis from internal carotid-posterior communicating aneurysm was needed. To diagnose intracavernous sinus aneurysm, computed tomography scan was very valuable. PMID- 1776609 TI - [A case of recurrent corneal erosion caused by self-inflicted injury]. AB - A 20-year-old female developed periodically recurrent corneal erosion in a 10mm diameter area of the central cornea. Since the episodes of corneal erosion occurred suddenly in the early morning every 6-7 days and since medical treatments could not prevent recurrence, we suspected that the corneal erosion was due to self-inflicted injury such as mechanical damage and/or topical application of toxic drugs. Psychological tests also indicated that the patient had a tendency towards hysteria. The corneal erosion has not recurred since we completely protected both her eyes at night. These findings strongly suggested that the cause of this corneal erosion was due to self-inflicted injury. PMID- 1776610 TI - Contemporary results of carotid endarterectomy. AB - Forty-four patients underwent fifty carotid endarterectomies in the first eighteen months of a new solo practice of cardiovascular and thoracic surgery in Montgomery. Thirty-six of the patients (82%) were symptomatic. Important operative details including continuous EEG monitoring, "selective" shunting, "open" endarterectomy and complete heparinization were employed throughout the study. There were no deaths and no strokes. Two patients (4%) had transient cranial nerve palsy and one patient (2%) had a transient ischemic attack consisting of dysarthria. One patient (2%) had a wound hematoma requiring reoperation. These results, in light of recent medical trials and randomized medical and surgical studies, encourage the continued place of carotid endarterectomy in the treatment of significant carotid disease in both symptomatic and asymptomatic patients. PMID- 1776611 TI - When providing state-of-the-art medical care is not enough. PMID- 1776612 TI - The health care 'industry'. PMID- 1776613 TI - Invited commentary on R. A. Fisher. PMID- 1776614 TI - Host and environmental factors influencing the peripheral blood leukocyte count. AB - The peripheral leukocyte count is an important predictor of mortality. Hence, host and environmental factors influencing the peripheral leukocyte count are of interest. The authors studied 8,635 subjects, aged 30-74 years, who were seen as part of the National Health and Nutrition Examination Survey II in 1976-1980, and sought to assess the relation of age, sex, obesity (body mass index), alcohol use, and various parameters of cigarette smoking to the peripheral leukocyte count using multiple regression analysis. Various parameters of cigarette smoking were statistically significant independent predictors of the peripheral leukocyte count with higher leukocyte counts seen among current smokers, relative to former or never smokers. Among current smokers, a dose-response relation was seen for cigarettes/day and total pack-years smoked. A dose-response relation with pack years and years since quitting was seen in former smokers. Other variables that were statistically significant independent predictors of a higher peripheral blood leukocyte count were younger age, male sex, increased body mass index, and decreased alcohol consumption. Although the specific cell or cells responsible for these relations are not defined by this analysis, the results support the suggestion that a number of host and environmental factors can influence cellular markers of inflammation. PMID- 1776615 TI - The non-iron-deficiency-related difference in hemoglobin concentration distribution between blacks and whites and between men and women. AB - The relation of hemoglobin concentration to transferrin saturation had two distinct phases in the data of adult men and women (aged 18-44 years) collected in the first National Health and Nutrition Examination Survey (NHANES I): 1) a stable, linear phase of hemoglobin concentration in the range of normal transferrin saturation, and 2) a dramatic fall in hemoglobin concentration as the degree of transferrin saturation decreased below the linear range. This study confirmed that over the linear range of the hemoglobin concentration-transferrin saturation curve, where subjects were adequately iron-nourished, whites had systematically higher hemoglobin concentration values than blacks (0.61 g/dl); also, males had higher values than females (1.895 g/dl). The effects of race and sex on hemoglobin concentration were additive. The variance of the hemoglobin distribution in blacks was also greater than that in whites. Socioeconomic status and smoking status could not explain the above race and sex differences. The impact on the prevalence estimate of reducing the hemoglobin cut-off by 0.5 g/dl is substantial enough to justify a separate standard for blacks. PMID- 1776616 TI - Blood pressure in schoolchildren in northwest India. AB - Blood pressure was determined among 2,453 schoolchildren aged between 7 and 16 years in the northwest Indian town of Chandigarh to establish the norms. The percentiles were calculated for each age group in both sexes. Both systolic and diastolic blood pressure had a positive correlation with age, weight, height, and body surface area (r = 0.112-0.178, p less than 0.01). There was no difference in the systolic and diastolic pressures of boys compared with girls of corresponding age. The upper limits of normal (90th percentile) systolic/diastolic pressure were 113/74, 119/76, and 126/79 in children aged 7-9 years, children aged 10-12 years, and adolescents aged 13-16 years, respectively. The lower limits of hypertension (95th percentile) for systolic/diastolic pressure were 119/80, 124/81, and 132/82 in each of these groups, respectively. The 99th percentile values indicative of severe hypertension for systolic/diastolic pressure in these groups were 128/88, 135/88, and 149/89, respectively. The 90th percentile of height and weight shown in the percentile table should be taken into consideration whenever blood pressure exceeds the 90th percentile for age and sex while planning the management of an individual. PMID- 1776617 TI - Variability and tracking of nutrient intakes of preschool children based on multiple administrations of the 24-hour dietary recall. AB - The authors measured intra-individual day-to-day variation and tracking of nutrient intakes among 181 preschool children (53% male, 45-60 months of age at baseline, 93% Hispanic) recruited through a hospital-based pediatrics practice in New York City. From 1986 to 1989, 24-hour dietary recalls were administered on seven occasions (four times in year 1 and three times in year 3) to the children's mothers. Median follow-up (midpoint of year 1 to midpoint of year 3) was 19.3 months. The reliability of estimates (intraclass correlation coefficients) of energy and nine nutrients obtained from a single administration of the dietary recall ranged from 0.15 to 0.38. Based on unadjusted nutrient intakes, 33.1-55.6% of children in the top quintile of intake at year 1 remained in the top quintile, and 58.3-83.3% in the top two quintiles, at year 3. Of the children in the lowest quintile at year 1, 27.8-50.0% were in the lowest quintile and 55.6-80.6% in the lowest two quintiles at year 3. Consistency of classification decreased when intakes were adjusted for energy intake. Correlations between mean energy and unadjusted nutrient intakes at year 1 and year 3 ranged from 0.27 to 0.45. When energy intake was controlled, correlations decreased for most but not all nutrients (range, 0.09-0.59). Correction of correlations of energy and energy-adjusted nutrients for residual intra individual variation yielded correlations between mean intakes at year 1 and year 3 in the range 0.15 to 0.71. These data indicate that despite considerable residual intra-individual day-to-day variability of dietary intakes there is substantial tracking of underlying diets among preschool children over a 19-month period. PMID- 1776618 TI - The validity of self-reported and surrogate-reported cataract and age-related macular degeneration in the Beaver Dam Eye Study. AB - The validity of reported ocular disease was investigated in a population-based epidemiologic study of persons aged 43-86 years residing in Beaver Dam, Wisconsin. In a telephone survey conducted from September 1987 through May 1988, histories of cataract and age-related macular degeneration were obtained from the subject for 2,155 cases and from a surrogate for 1,433 cases. Within 2 years, these persons underwent a complete ocular examination. At that time, an "in person" self-reported history of eye disease was obtained and disease presence was determined based on ocular photographs. The reporting methods, telephone versus in-person and surrogate versus subject, were compared and the validity of each assessed. Reporting methods were in agreement in better than 90% of all cases. Reporting of cataract showed a sensitivity of 20.4 for surrogate by telephone, 30.2 for self-report by telephone, and 37.8 for self-report at the examination. Sensitivity of reported age-related macular degeneration was poorer, with the highest rate of 17.9 for the "in-person" self-report. Specificity was better than 90.0 for all reporting methods for both cataract and age-related macular degeneration. These data suggest that estimates of prevalence of ocular disease should not be based solely on reported histories, and that clinical determinations are necessary. PMID- 1776619 TI - Occupational risk of hepatitis B for police and customs personnel. AB - A cross-sectional study was undertaken in 1987 to establish whether New Zealand police and customs officers are at excess risk of hepatitis B virus infection as a consequence of occupational exposure to human blood and penetrating injury. The study population comprised all full-time police (n = 5,193) and customs officers (n = 1,026) excluding only a small number on special duty who had already been immunized. The control group comprised the civilians employed by both organizations (n = 964). The prevalence of hepatitis B markers in the control group, when standardized for age, sex, and ethnic distribution, was 13.4%, which agrees well with New Zealand blood donor figures. The prevalence ratios for police officers and customs officers compared with the civilians (adjusted for age, sex, and ethnic distributions) were 0.82 (95% confidence interval (CI) 0.63 1.06) and 0.49 (95% CI 0.34-0.70), respectively. Multivariate analysis was used to further explore the differences in marker prevalence among the three groups, but failed to demonstrate any significant association between occupational variables and marker prevalence. There was an association between time spent living in high-risk areas of the country and marker prevalence. The authors conclude that the question as to whether police personnel should be immunized begs the wider issue of whether or not the whole New Zealand population should be so protected. PMID- 1776620 TI - The time interval between death and next-of-kin contact and its effects on response rates and data quality. AB - The relation of the interval of time between death and next-of-kin contact to outcome variables including response rates and data quality was examined in a nationally representative sample of 17,713 deaths of persons 25 years of age or older that occurred in the United States in 1986. For most of the outcome variables examined, the length of time had little effect, although there was a small decrease in the response rate and a small increase in the refusal rate for contact 40 or more weeks after death. The small decrease in the response rate and small increase in the refusal rate for the longest interval examined held for most decedent background characteristics examined (age, race, cause of death, and type of informant.) Authorizations to contact health care facilities signed by the respondents decreased slightly as the interval increased. The rate of returned mailed questionnaires passing quality and consistency edits increased slightly with time since death. Substantive responses (versus blanks, don't knows, etc.) decreased as time since death increased. Certain questions such as those on income and birth control pill use showed a decrease in response with time since death. Overall, the effects of longer time intervals between death and next-of-kin contact were less than expected on response rates and data quality, although our findings may reflect the high overall response rate, 90.5%, leaving little opportunity for significant areas of nonresponse. PMID- 1776621 TI - Re: "When genius errs: R. A. Fisher and the lung cancer controversy". PMID- 1776622 TI - Re: "A prospective population-based study of alcohol use and non-insulin dependent diabetes mellitus". PMID- 1776623 TI - Re: "The impact of dietary measurement error on planning sample size required in a cohort study". PMID- 1776624 TI - Re: "The time interval between death and next-of-kin contact and its effects on response rates and data quality". PMID- 1776625 TI - Re: "A method for estimating year of birth using Social Security number". PMID- 1776626 TI - Autosomal recessive ectodermal dysplasia: I. An undescribed dysplasia/malformation syndrome. AB - We describe 27 individuals of 7 families related to each other with high probability who showed manifestations of ectodermal dysplasia and other anomalies affecting females as severely as males with variable expressivity. All parents were normal. These families were detected in a relatively isolated and inbred population with very small neighbouring communities from a Caribbean Sea island, Margarita Island, in Northeastern Venezuela (Nueva Esparta State). The clinical picture common to all patients could not be classified within the heterogeneous group of known ectodermal dysplasias and the published cases do not resemble our patients. We believe that this condition constitutes a newly recognized autosomal recessive dysplasia/malformation syndrome of ectodermal dysplasia. PMID- 1776627 TI - New syndrome: mother and son with hypertelorism, downslanting palpebral fissures, malar hypoplasia, and apparently low-set ears associated with joint and scrotal anomalies. AB - We report on a mother and son with a similar syndrome of hypertelorism and telecanthus, epicanthal folds, downslanting palpebral fissures, ptosis, broad nasal bridge, malar hypoplasia, thin upper lip, smooth philtrum, and apparently low-set prominent ears. The son also has a hypoplastic shawl scrotum, cryptorchidism, and genu valgum. His language development was delayed at 18 months, but subsequently improved and was normal at age 3. The mother has the additional findings of marked cubitus valgus, hyper-extensible joints, dull normal intelligence and a bleeding diathesis. This pattern of multiple congenital anomalies may represent a new syndrome. PMID- 1776628 TI - Problems in ascertainment of transmitting males in Martin-Bell syndrome. AB - The difficulty of assigning families affected with the Martin-Bell syndrome (MBS) into the category of male transmission is emphasised and illustrated by examples of 3 MBS families. These examples demonstrate how the ability to detect transmitting males depends on the number of generations available for investigation, and also on the "spread" of clinical investigation across many branches of the family regardless of what appears to be an unremarkable family history. Some unusual properties of male transmission are shown, and the problem of selective ascertainment of the particular MBS male individuals in different generations in a set of pedigrees is discussed. PMID- 1776629 TI - Generalized chondrodysplasia punctata with shortness of humeri and brachymetacarpy: humero-metacarpal (HM) type: variation or heterogeneity? AB - We report on a girl with symmetrical rhizomelic shortness of the upper limbs and punctate epiphyseal calcifications noted at birth. Presumably she has normal height, but short nose, short hands, and normal mentation; and on roentgenograms short and wide humeri, symmetrical brachymetacarpy, especially of the 4th metacarpals, and hypoplastic distal phalanges, sagittal clefting of vertebral bodies, and punctate calcifications at various areas including the entire spine, sacrum, hands, feet, trachea, and thyroid cartilage. It is an apparently new syndrome of chondrodysplasia punctata (CP), quite distinct from the classic form (Conradi-Hunermann type), as well as the other well-defined forms of CP. We thus suggest the term chondrodysplasia punctata, humero-metacarpal (HM) type. PMID- 1776630 TI - Apparently new MCA/MR syndrome in sibs with cleft lip and palate and other facial, eye, heart, and intestinal anomalies. AB - We report on a sister and brother with severe mental retardation, bulbous tip of the nose, long columella, cleft lip and palate, heart and intestinal anomalies, and growth retardation. This appears to be a previously unreported, autosomal recessive condition, given high resolution prometaphase chromosomes are normal. PMID- 1776631 TI - First report of management and outcome of pregnancies associated with hereditary orotic aciduria. AB - Two pregnancies in a 25-year-old woman with hereditary orotic aciduria who was managed prenatally on uridine therapy are described. The first pregnancy resulted in an infant with multiple congenital anomalies and a 47,xx,inv(4)(p12q25), +der(22)t(11;22)(p23;q11) karyotype. The proposita was found to be a carrier of a de novo 11;22 translocation and a pericentric inversion of chromosome 4. Subsequently, several carriers of orotic aciduria in this family were identified with the inverted chromosome 4. The second pregnancy resulted in a normal male with an inverted chromosome 4. PMID- 1776632 TI - Cataract, hypertrichosis, and mental retardation (CAHMR): a new autosomal recessive syndrome. AB - We have studied 2 Egyptian sibs (the offspring of normal first cousins) with congenital cataract, hypertrichosis, mental retardation, and normal chromosomes. Review showed that the condition of our patients was not similar to any previously reported entity. POSSUM lists 84 syndromes with any of the above 3 main traits. Two disorders with cataract and mental retardation, Martsolf syndrome and Mollica-Pavone-Anterer syndrome, have overlapping manifestations and therefore are particularly differentiated from our cases. We suggest that the association of congenital cataract, hypertrichosis, and mental retardation observed in this report represents a new autosomal recessive syndrome. PMID- 1776633 TI - New form of postaxial acrofacial dysostosis? AB - We report on a 2-month-old Sephardic Jewish girl with bilateral and symmetrical deficiency of the fifth digital rays of all 4 limbs, combined with severe deformations and other malformations of the limbs. These findings were associated with orofacial malformations, as well as with visceral anomalies differing from those found in other postaxial deficiency syndromes. Parents were closely consanguineous. We assume this patient represents a new form of postaxial acrofacial dysostosis. PMID- 1776634 TI - True agonadism: report of a case analyzed with Y-specific DNA probes. AB - We report on a 5-year-old girl with a male karyotype (46,XY), severe psychomotor and physical retardation, minor anomalies, and female external genitalia with a blindly ending vagina. She has normal adrenal function, prepubertal serum gonadotropin and testosterone levels, which did not rise after hCG stimulation. On abdominal exploration no gonads were found, and only mesonephric and Mullerian remnants. She was HY positive, and no deletion was detected in the Y chromosome using 5 different probes. Although a genetic defect is not excluded, pregnancy complications suggest an environmental insult to the developing testes. PMID- 1776635 TI - De novo duplication of 17p [dup(17)(p12----p11.2)]: report of an additional case with confirmation of the cytogenetic, phenotypic, and developmental aspects. AB - We describe an apparent de novo duplication of bands 17p11.2 and p12. A comparison of the manifestations of a previously reported case with a similar karyotype [Magenis et al., Am J Med Genet 24:415-420 (1986)] and of our own case seems to indicate a characteristic pattern which includes prenatal and postnatal growth retardation, facial changes, club feet, and mild developmental deficits. The prominent facial changes are a relatively triangular face, downslanted palpebral fissures, malocclusion, and abnormal ears. In addition, this condition appears to be milder than other duplications of the short arm of chromosome 17, namely trisomy 17p and dup(17)(p11.2----cen). PMID- 1776636 TI - Problems in diagnosis and delineation of inherited disorders in highly inbred populations. AB - Two families were chosen as examples of the problems that may arise in the identification of inherited disorders in populations in which the rate of consanguineous marriages is high. In the first family, mentally retarded children of both sexes were born to 4 sisters married to close relative, and the possibility of an autosomal recessive disease was raised. The diagnosis of an X linked disease, Martin Bell Syndrome, was made after the results of the chromosome analysis were at hand. In inbred communities, individuals affected with X-linked diseases are often born to parents who are related. In the second family two different autosomal recessive disorders were diagnosed among the children of a couple originating from a very inbred community. One of the children was affected with both disorders. The finding of two sibs with different symptoms may suggest that they have the same syndrome, and the differences in manifestations represent variability. The possibility that there may be more than one common abnormal gene in very inbred communities must be kept in mind, in particular when one is dealing with syndromes in which the diagnosis is based on clinical symptoms only. Another problem is that when the child has a complex unknown syndrome, the possibility that the child is affected simultaneously with 2 different genetic disorders should be raised. PMID- 1776637 TI - Relative order and location of DNA sequences on chromosome 21 linked to familial Alzheimer disease. AB - Recently, a gene causing familial Alzheimer disease (FAD) was linked to DNA probes on chromosome 21 by genetic analysis. To investigate the precise physical location of these DNA probes, we have constructed a physical map of this region of chromosome 21 by using quantitative Southern blot analysis of cell lines aneuploid for parts of chromosome 21. The following DNA sequences were investigated: D21S16, D21S13, FB68L (cDNA probe for the amyloid protein precursor [APP] gene), and D21S1. We find that all DNA probes are located in the same region of chromosome 21, in q11.2-q21.05. We further show that D21S16 must be centromeric to D21S13, because D21S16, but not D21S13 is present in one copy in a cell line with deletion of the region 21pter-21q 11.2. High resolution chromosome analysis is presented to define this breakpoint. This new panel of aneuploid cell lines will allow the rapid mapping of new DNA probes in the vicinity of the FAD gene. PMID- 1776638 TI - Gardner syndrome in a boy with interstitial deletion of the long arm of chromosome 5. AB - We described a 15-year-old boy with Gardner syndrome (GS), mental retardation, and craniofacial abnormalities. High-resolution banding analysis showed an interstitial deletion of the long arm of chromosome 5 (q22.1----q31.1). The breakpoints in the present case and in 3 previously reported 5q- patients with adenomatous polyposis coli suggest that the gene responsible for GS/or familial polyposis coli (FPC) is in the 5q22 region, a result consistent with the findings of linkage studies. PMID- 1776639 TI - Autosomal recessive cerebellar hypoplasia and endosteal sclerosis: a newly recognized syndrome. AB - We describe a brother and sister and an unrelated boy with congenital cerebellar hypoplasia and endosteal sclerosis. All 3 children presented with ataxia and developmental delay, and were found to have microcephaly, short stature, oligodontia, strabismus, nystagmus, and congenital hip dislocation. A previously published case is reviewed. The disorder appears to represent a newly recognized autosomal recessive syndrome. PMID- 1776640 TI - Molecular analysis of Gaucher disease: screening of patients in the Montreal/Quebec region. AB - Gaucher disease, the most prevalent lysosomal storage disease, is an autosomal recessive sphingolipidosis resulting from deficient glucocerebrosidase activity. Genomic DNA of the structural gene of glucocerebrosidase from normal individuals and fifteen unrelated patients with the three clinical forms of Gaucher disease from the Montreal/Quebec region were amplified by the polymerase chain reaction technique. Allele-specific oligonucleotide dot blot hybridization and restriction fragment length polymorphism were used to screen for five of the mutations [mutations 120, 370, 415, 444 (Nci), and 463] in exons 5, 9, and 10 of glucocerebrosidase gene. It was noted that all of the patients had at least one of the known mutant alleles. However, 9 patients (9/15 = 60%) had an unknown allele. Mutation 370 in exon 9 was present in the heteroallelic form in eight out of the nine patients with type 1 Gaucher disease, but was present in none of the six patients with type 2 or type 3 Gaucher disease. The Nci mutation in exon 10 was present in the heteroallelic form in three patients with type 1 Gaucher disease and in either the heteroallelic or homoallelic form in all of the six patients with type 2 or type 3 Gaucher disease. The 415/Nci mutations were found in a mildly affected 29-year-old patient with type 1 Gaucher disease, as well as in an infant with the type 2 form. These findings demonstrate the clinical and molecular genetic heterogeneities of Gaucher disease, the presence of unknown Gaucher allele(s) in most (60%) of the patients surveyed, and the occasional inexplicable lack of phenotype-genotype correlation among some patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1776641 TI - Campomelia, polycystic dysplasia, and cervical lymphocele in two sibs. AB - We report on 2 sibs with a similar MCA pattern consisting of generalized lymphedema, cervical lymphocele, shortness of limbs, bowed long bones, and multicystic kidneys with fibrotic liver or pancreas. To our knowledge, this is the second observation of such a combination of defects in sibs, and it confirms the existence of the syndrome reported by Cumming et al. [1986] and its autosomal recessive inheritance. PMID- 1776642 TI - Essential osteolysis associated with nephropathy, corneal opacity, and pulmonary stenosis. AB - We report on 5-year-old girl with essential osteolysis, nephropathy, corneal opacity, and valvular pulmonary stenosis. The patient was initially seen for evaluation of flexion contractures at wrists, elbows, and knees. Radiographic examination showed osteolytic changes primarily involving the hands and feet. She had persistent proteinuria; renal biopsy disclosed focal glomerulosclerosis in 1/3 of glomeruli. Electron microscopic study of skin fibroblast showed dilated and vacuolated rough endoplasmic reticulum. To our knowledge essential osteolysis associated with the aforementioned disorders has not been previously reported. PMID- 1776643 TI - Hallermann-Streiff syndrome: a review. AB - The Hallermann-Streiff syndrome is characterized by dyscephaly, hypotrichosis, microphthalmia, cataracts, beaked nose, micrognathia, and proportionate short stature. Cause is unknown; sporadic occurrence is the rule. Data presented in this review include the characteristics of pregnancy, growth and development, principal manifestations, radiographic and ophthalmological characteristics, and the results of cephalometric study. Potential complications in the syndrome are related to the narrow upper airway associated with the craniofacial configuration. Severe complications may include early pulmonary infection, respiratory embarrassment, obstructive sleep apnea, and anesthetic risk. Topics for future study are suggested. PMID- 1776644 TI - Congenital cataracts in mother, sister, and son of a patient with Hallermann Streiff syndrome: coincidence or clue? AB - The son of a patient with Hallermann-Streiff Syndrome (HSS) was found to have congenital cataracts, but no other findings of the syndrome. Similar findings were reported in the patient's mother and sister. The significance of this observation is uncertain. PMID- 1776645 TI - Hallermann-Streiff syndrome with hypopituitarism contributing to growth failure. AB - A 35-month-old black boy with Hallermann-Streiff syndrome (HSS) was evaluated for anterior hypopituitarism when he presented with ketotic hypoglycemia, microgenitalia, and short stature. Endocrine evaluation showed a low T4 and TSH levels, suggesting hypothalamic hypothyroidism; this was confirmed by TRH stimulation. Metyrapone test confirmed ACTH deficiency as a contributing factor to the ketotic hypoglycemia. A superagonist GnRH test suggested hypothalamic GnRH deficiency. Growth hormone provocative testing conclusively demonstrated complete growth hormone deficiency. MRI investigation of the brain suggested hypopituitarism. Although facial findings were not completely classical of the HSS, we suggest these may be somewhat altered due to his racial back-ground. We recommend endocrine evaluation of HSS patients with manifestations suggesting hypopituitarism since treatment of this condition will improve the quality of life of these patients. PMID- 1776646 TI - Radiological findings in Hallermann-Streiff syndrome: report of five cases and a review of the literature. AB - Hallermann-Streiff syndrome (HSS) is a rare disorder with an associated constellation of radiological findings that may aid in the diagnosis of affected individuals. We reviewed the skeletal surveys of 5 affected individuals and noted some characteristic and constant findings. Radiological findings can include a large, poorly ossified skull with decreased ossification in the sutural areas. There was an increase in the number of Wormian bones. Severe mid-facial hypoplasia was present along with a prominent nasal bone. The skull films also showed an abnormally obtuse or nearly straight gonial angle. The teeth appeared small. The long bones were thin and gracile in appearance and often showed poor demarcation of the cortex from the medullary portion. Abnormal bowing of the radius and ulna was seen neonatally in 2 cases. There was widening at the metaphyseal ends of the long bones. The ribs were thin, but normal in length. The vertebral bodies were noted to be small and 3 cases had platyspondyly. There was a decreased number of sternal ossification enters. The metacarpals were also thin and gracile in appearance with metaphyseal widening. We conclude that these characteristic radiological findings in the newborn with HSS can aid in the diagnosis, and a skeletal survey in suspected individuals may be valuable in confirming the diagnosis. PMID- 1776647 TI - Respiratory obstruction and cor pulmonale in the Hallermann-Streiff syndrome. AB - The risk of respiratory death in the Hallermann-Streiff syndrome is not insignificant, particularly in the neonatal period and in infancy. Upper airway obstruction may result from small nares and glossoptosis secondary to micrognathia, which sometimes lead to cor pulmonale. I report on a patient with such problems. PMID- 1776648 TI - Tracheomalacia in Hallermann-Streiff syndrome. AB - We report on a white boy with Hallermann-Streiff syndrome (HSS) who also had tracheomalacia. Chronic respiratory insufficiency led to biventricular failure and death at age 6 months. There have been no previously reported cases of Hallermann-Streiff syndrome with documented tracheomalacia. However, there may be cases in which tracheomalacia may have been present, but not diagnosed. The literature contains 6 HSS cases with severe respiratory symptoms. Tracheomalacia should be considered in a patient with HSS who presents with an unusual cry, stridor, choking, or apnea. With the availability of surgery and supportive treatment, early diagnosis of tracheomalacia in these patients may prevent death and secondary neurologic insult from acute hypoxia. PMID- 1776649 TI - Jeune syndrome and cystinuria. PMID- 1776650 TI - Dermatoglyphic analysis of autistic Basque children. PMID- 1776651 TI - Terminal deletion of chromosome 10q26 due to a paternal translocation [(7;10)(q36;q26)]. PMID- 1776652 TI - Complete sequence of human cardiac alpha-myosin heavy chain gene and amino acid comparison to other myosins based on structural and functional differences. AB - We have obtained the 5820 nucleotide sequence encoding all 1939 amino acids of the human cardiac alpha-myosin heavy chain (alpha-MHC), as established by dideoxy sequencing of cloned cDNA, genomic DNA and polymerase chain reaction (PCR) amplification products. This sequence represents overlapping fragments of the entire coding sequence. Amino acid sequence comparison of the human cardiac alpha MHC with the published human cardiac beta-MHC have demonstrated that there are, at least, 7 isoform-specific divergent regions, including functionally important binding protein-related sites such as ATP, actin and myosin light chain. It has been reported that in the rat, there are 8 isoform-specific divergent regions. The 7th divergent area (residue area 1633-1657, which is thought to mediate thick filament formation) in the light meromyosin region in the rat is not apparent in the human. The amino acid compositions of cardiac alpha- and beta-MHCs in the human and the rat, and human embryonic skeletal muscle and chicken gizzard smooth muscles were compared. Amino acid sequences in cardiac alpha- and beta-MHCs in the human and the rat are well conserved. In the head portion, the amino acid composition divergence of human cardiac alpha-MHC is ranked between rat cardiac alpha-MHC and human cardiac beta- or rat cardiac beta-MHC; human skeletal muscle MHC is the most divergent of the myosin isoform examined. These data predict that human cardiac alpha-MHC may have undergone evolutionary changes toward obtaining the biochemical and physiological properties of cardiac beta-MHC. PMID- 1776653 TI - On lumping and splitting: a fetus with clinical findings of the oral-facial digital syndrome type VI, the hydrolethalus syndrome, and the Pallister-Hall syndrome. AB - The three midline malformation complexes, the oral-facial-digital syndrome type VI (OFDS VI) or Varadi syndrome, the hydrolethalus syndrome (HS), and the Pallister-Hall syndrome (PHS) have been described as distinct genetic entities. Here, we report a fetus with a combination of clinical findings of all 3 syndromes similar to the twin fetuses described in the accompanying paper (Hingorani et al., 1991). The phenotypic overlap in these fetuses with the OFDS VI, HS, and PHS raises the question as to whether or not they indeed represent separate genetic entities as previously assumed. PMID- 1776654 TI - Modern human origins in Australasia: replacement or evolution? AB - The controversies surrounding the origins of modern humans have spawned two competing hypotheses, namely Replacement and Multiregional Evolution. The first suggests that modern Homo sapiens evolved first in Africa, as late as 140 ka, and subsequently inhabited the balance of the Old World. Conversely, the second hypothesis posits that modern humans evolved principally from local populations of archaic hominids indigenous to the major regions of the Old World. The hominid mandibular remains (ca. 1 Ma) from Sangiran, central Java, Indonesia, were studied in order to test these hypotheses. Non-metric comparisons were performed between these fossils and aboriginal H. sapiens from Africa and Australia. The Replacement model would be supported by a unique Afro-Australian grouping while Multiregional Evolution would be suggested by a Sangiran-Australasian group which would exclude the modern Africans. These data support the Multiregional Evolution hypothesis in that a plurality (eight) of the seventeen non-metric features link Sangiran to modern Australians, while only three exclusively group the humans from Africa and Australia. These results are suggestive of morphological continuity, which implies the presence of a genetic continuum in Australasia dating back at least one million years. PMID- 1776655 TI - Is the Narmada hominid an Indian Homo erectus? AB - In 1982 a fossil hominid calvaria was found in a middle Pleistocene deposit in the central Narmada valley of Madhya Pradesh, India, and was assigned to the new taxon Homo erectus narmadensis. Subsequently, morphometric studies of the specimen were conducted by two separate research teams from France and the United States, both in collaboration with Indian colleagues. Results of the most recent study, which includes morphometric and comparative investigations, lead to the conclusion that "Narmada Man" is appropriately identified as Homo sapiens. While the calvaria shares some anatomical features with Asian Homo erectus specimens, it exhibits a broader suite of morphological and mensural characteristics suggesting affinities with early Homo sapiens fossils from Asia, Europe, and Africa as well as demonstrating that the Narmada calvaria possesses some unique anatomical features, perhaps because the specimen reflects the incoherent classificatory condition of the genus Homo. PMID- 1776656 TI - Genetic variation of the mitochondrial DNA genome in American Indians is at mutation-drift equilibrium. AB - Several surveys have found evidence for founder effects in Amerindian mitochondrial DNA because of the existence of rare Asian morphs in high frequencies in some Amerindian populations and the occurrence of several new morphs not seen elsewhere in the world. These reports, however, do not address whether or not the present genetic variation in the mtDNA genome in Amerindians has reached the steady-state distribution predicted by the mutation-drift theory of population genetics. The present work suggests that in three Amerindian populations (Pima, Maya, and Ticuna) a steady state has apparently been reached, and hence the initial founder effect has probably dissipated during the evolution of Amerindians in the New World. This result is consistent with the genetic variation in nuclear genes in similar populations, shown through surveys of protein variation in earlier work and, more recently, in studies of restriction fragment length polymorphisms. PMID- 1776657 TI - Principal components analysis of regional bone density in black and white women: relationship to body size and composition. AB - Black and white women in the United States differ with respect to bone mass and the risk of developing osteoporosis. It has been suggested that greater body size among U.S. blacks may contribute to greater bone density in this group. It is not known whether the fat or lean component contributes more to this relationship. Bone density was measured at seven sites in 161 normal black and white women using single and dual photon absorptiometry. The first principal component accounted for 73% of the variance in the sample and constitutes an index of skeletal mass. The second principal component added another 10% and contrasts the axial and appendicular sites. Both the regional bone densities and the first principal component showed significantly greater bone densities for blacks; adjustment for body size reduced bone mass differences by approximately 50%. Body composition analysis done on a subset of these women indicated that the fat component of body mass may be the more important factor in its effect on bone mass. PMID- 1776658 TI - Percent osteonal bone versus osteon counts: the variable of choice for estimating age at death. AB - Ahlqvist and Damsten's (1969) modification of the Kerley (1965) method for histological age estimation uses percent osteonal bone, rather than actual osteon counts, in order to eliminate the difficulty of distinguishing between intact and fragmentary osteons. Since their method has been developed for the femur only, and several more recent methods have been proposed that utilize percent osteonal bone, a study was undertaken to ascertain the relative value of percent osteonal bone compared with osteon counts to estimate age at death for the radius, tibia, and fibula. First the question of how much of the cross-section of a bone should be sampled was addressed by comparing the results of regression against age for percent osteonal bone derived from sampling only four fields with those derived from the entire cross-section of the radius. A significant age association was found only when the entire cross-section was sampled. In order to evaluate the relative merit of using either percent osteonal bone, or osteon counts to estimate age, each variable was regressed against age. Significant correlation coefficients were found for all three bones when the independent variable was osteon counts. When percent osteonal bone was employed, a significant correlation was found only for the radius. Stepwise linear regression found osteon counts for the fibula alone to be the best age predictor. Finally, a repeated measures analysis of variance revealed that percent osteonal bone and osteon counts both differ among the three bones within an individual. Based upon these results, osteon counts, rather than percent osteonal bone, should be the variable of choice when developing histological age predicting methods. PMID- 1776659 TI - Mechanical implications of chimpanzee positional behavior. AB - Mechanical hypotheses concerning the function of chimpanzee anatomical specializations are examined in light of recent positional behavior data. Arm hanging was the only common chimpanzee positional behavior that required full abduction of the humerus, and vertical climbing was the only distinctive chimpanzee positional behavior that required forceful retraction of the humerus and flexion of the elbow. Some elements of the chimpanzee anatomy, including an abductible humerus, a broad thorax, a cone-shaped torso, and a long, narrow scapula, are hypothesized to be a coadapted functional complex that reduces muscle action and structural fatigue during arm-hanging. Large muscles that retract the humerus (latissimus dorsi and probably sternocostal pectoralis major and posterior deltoid) and flex the elbow (biceps brachii, probably brachialis and brachioradialis) are argued to be adaptations to vertical climbing alone. A large ulnar excursion of the manus and long, curved metacarpals and phalanges are interpreted as adaptations to gripping vertical weight-bearing structures during vertical climbing and arm-hanging. A short torso, an iliac origin of the latissimus dorsi, and large muscles for arm-raising (caudal serratus, teres minor, cranial trapezius, and probably anterior deltoid and clavicular pectoralis major) are interpreted as adaptations to both climbing and unimanual suspension. PMID- 1776661 TI - American Association of Physical Anthropologists. Membership list. PMID- 1776660 TI - Body size, locomotion, and long bone cross-sectional geometry in indriid primates. AB - The geometry of the midshaft cross-sections of the femur and humerus of five indriid species was analysed. Internal (marrow cavity) and external diameters were measured on X-rays in the anteroposterior (a-p) and mediolateral (m-l) planes; cross-sectional areas, second moments of area, and section moduli were calculated using formulae for a hollow ellipse. Cortical thickness, robusticity indices (relating external diameters to the length of the bones), and a-p/m-l shape variables were also calculated. Model II regression was supplemented by analyses of correlation between size and shape. Indriids are saltatory, i.e., their locomotion is dominated by the hind limbs. Accordingly, the femur is more rigid than the humerus, and it shows a consistent difference between the a-p and m-l planes in measures related to bending strength. Cortical thickness varies considerably both within and across species. The type specimen of the new species Propithecus tattersalli is virtually indistinguishable from P. verreauxi on the basis of its long bone cross-sectional geometry. Femoral robusticity is uncorrelated with size, but humeral robusticity decreases significantly with increasing size. Femoral shape variables (a-p/m-l) are all negatively correlated with body size, indicating that m-l dimensions of the femur increase at a faster rate than do a-p dimensions. The highly loaded plane of movement seems to be more reinforced in the smaller species. Contrary to static biomechanical scaling predictions of positive allometry, all cross-sectional parameters scale relatively close to isometry. It is concluded that either changes in locomotor performance must compensate for the weight-related increase in forces and moments or that the larger-bodied animals operate appreciably closer to the limits of their safety margins. PMID- 1776662 TI - [Exostosis of the external auditory canal]. PMID- 1776663 TI - [Determination of the phase of synthesis by means of bromodeoxyuridine. Its clinical application in oncology of the head and neck]. AB - Tumour cell kinetics properties studied by the bromodeoxyuridine method, are useful in the prognosis and therapeutic planning of oncologic patients. In this paper the AA. review some clinical applications of this method, with special emphasis on head and neck tumours. PMID- 1776664 TI - [Congenital cholesteatoma of the middle ear]. AB - The AA. inform about 8 patients suffering from congenital cholesteatoma of the tympanomastoidal cleft. They underline the difficulties for achieving a correct diagnosis when the eardrum remains intact and remark the need to keep in mind this process for differential diagnosis of the conductive hypoacusis in childhood. As a matter of fact the AA. emphasize the few cases of recurrences after surgery, in contrast with that of relapses in child's acquired cholesteatoma. PMID- 1776665 TI - [Mucocele, a clinical and therapeutic study]. PMID- 1776666 TI - [Cervical ankylosing hyperostosis as a cause of dysphagia. A case report and review of the literature]. AB - Presenting the case of a 56-year-old man diagnosed of an idiopathic ankylotic hyperostosis, with pronounced osteophytosis of the neck and bulged rear wall of the oropharynx, producing dysphagia as associated ENT symptom. Some clinical, diagnostic and therapeutic aspects of the case are contemplated by the AA. PMID- 1776667 TI - [Myringoplasty. A prospective study of 238 cases]. AB - It has been made a review of 238 myringoplasties done in the last three years (1988-90) at the Santa Creu i Sant Pau Hospital. In this work are only contemplated the plain myringoplasties. Tympanoplasties because cholesteatoma and ossiculoplasties are excluded. Some characteristics are studied: age, sex, ear state, kind of perforation, ossicular chain state and others. Anatomical and functional results are analyzed as also the relationship between the type of perforation with the audiometric loose and anatomic success. PMID- 1776668 TI - 2-Nitro-5-(6-bromohexanoylamino)benzoic acid test paper method for detecting microorganisms capable of producing cephalosporin acylases. AB - A novel method for detecting microorganisms capable of producing cephalosporin C (CPC) acylase and/or 7-(4-carboxybutanamido)cephalosporanic acid (GL-7-ACA) acylase has been developed. The method is based on the degradation of 2-nitro-5 (6-bromohexanoylamino)benzoic acid (NBHAB), a chromogenic substrate, into yellow 2-nitro-5-aminobenzoic acid by the action of the CPC acylase or the GL-7-ACA acylase. This method is very sensitive and quite specific, and has been successfully applied to screen the acylases from a variety of bacteria. A large number of colonies isolated on a plate surface from more than 67 samples and several known bacteria were tested by the NBHAB paper. Five NBHAB-positive strains and isolates were obtained. They were further examined by the reaction of their bacterial cells upon CPC and GL-7-ACA, respectively, and by thin-layer chromatography in order to distinguish the CPC acylase from the GL-7-ACA acylase. PMID- 1776669 TI - Assay of 3-hydroxy-3-methylglutaryl CoA reductase activity using anionic-exchange column chromatography. AB - A rapid, easy, and sensitive method is described in this paper for the assay of 3 hydroxy-3-methylglutaryl CoA (HMG CoA) reductase, a key enzyme in cholesterol biosynthesis. [14C]HMG CoA was used as the substrate and the product formed, i.e., [14C]mevalonate, was allowed to be converted to its lactone form (mevalonolactone) in the presence of HCl. The reaction mixture was applied to a column containing an anionic exchanger. The column was made up of QAE-Sephadex (A25, formate form) packed to a height of 4 cm in Pasteur pipets. Under these conditions, mevalonolactone was not retained by the column and was eluted with ammonium formate solution while HMG CoA, being negatively charged, was retained by the gel and eluted by HCl above 0.05 M. Determination of the amount of radioactivity in mevalonolactone was then used to quantitate the activity of HMG CoA reductase. This assay has been successfully used for determining the activity of this enzyme in a microsomal fraction prepared from the liver of the rat. PMID- 1776670 TI - High-performance liquid chromatography of N-alkylprotoporphyrins: an investigation of their formation and loss under chemical and enzymatic conditions in vitro. AB - A new technique for resolving N-alkylprotoporphyrins into each structural isomer is described. The technique has been used to investigate the rate of formation and loss of N-alkylporphyrins during reaction of the parent porphyrin with alkyl iodides and to establish the conditions required for optimal yields of the various isomers. Preferential loss of the isomers bearing the N-alkyl group on one of the vinyl-substituted pyrrole rings is observed on prolonged incubation and HI generated during the reaction has been shown to be responsible. A method for detection and partial resolution by HPLC of N-alkylprotoporphyrins produced by liver microsomes in vitro is also described. Microsomes from rats induced with 3-methylcholanthrene produce significantly more N-ethylprotoporphyrin from either 4-ethyl-3,5-diethoxycarbonyl-1,4-dihydro- 2,6-dimethyl-pyridine or ethylhydrazine than do microsomes from control animals, but the isomeric composition of the isolated N-alkylporphyrin differs from that reported in vivo. Evidence that authentic N-alkylporphyrins are lost during incubation with microsomes has been obtained, and here again, the isomers bearing the N-alkyl group on vinyl substituted pyrrole rings are preferentially lost. Experiments with 14C-labeled N methylprotoporphyrin show that approximately 40% of the lost porphyrin could be recovered bound covalently to the microsomal pellet. PMID- 1776671 TI - Double mixing stopped-flow method for the study of equilibria and kinetics of dimer-tetramer association of hemoglobins: studies on Hb Carp, Hb A, and Hb Rothschild. AB - A double mixing stopped-flow method is described for studying the dimer-tetramer equilibria of oxyhemoglobins and the kinetics of association of unliganded dimers. The three hemoglobins studied were: Hb Carp, Hb A, and Hb Rothschild (Trp beta 37 (C3)----Arg). The new method reproduces the data obtained for oxyHb A by other established methods. In agreement with previous studies, the new method indicates little, if any, dissociation of oxyHb carp into dimers even in 2 M urea solutions (0.1 M Bis-Tris pH 7.0). OxyHb Rothschild, on the other hand, is extensively dissociated into dimers (K(Hb4L4 in equilibrium with 2Hb2) = 37.3 x 10(-6) M) and the rate constant for the association of deoxy dimers of Hb Rothschild is about one-tenth of the value for Hb A indicating that the deoxy tetramer of Hb Rothschild is at least 10 times more dissociated into dimers than deoxyHb A. PMID- 1776672 TI - Preparation of NADH/NADPH using cetyltrimethylammonium bromide permeabilized baker's yeast cells. AB - Alcohol dehydrogenase (ADH) and glucose-6-phosphate dehydrogenase (G6PDH) activities of cetyltrimethylammonium bromide permeabilized baker's yeast whole cells were employed to prepare reduced nicotinamide nucleotides NADH and NADPH from their corresponding oxidised forms. Both NADH and NADPH were found to be stable in the presence of permeabilized cells under the conditions of preparation. No dephosphorylation of NADP+ to NAD+ or of NADPH to NADH was found. Reduction is complete and the prepared NADH and NADPH are chromatographically pure. Since readily available Baker's yeast cells were used instead of expensive isolated enzyme the method described here is simple, economical, and easy to scale up. PMID- 1776673 TI - Polyacrylamide gel electrophoresis of reducing saccharides labeled with the fluorophore 2-aminoacridone: subpicomolar detection using an imaging system based on a cooled charge-coupled device. AB - Numerous monosaccharides and oligosaccharides were derivatized at their reducing end groups with the fluorophore 2-aminoacridone. The resulting fluorescent compounds were separated by PAGE using two different buffer systems. One of these, a Tris borate buffer, enabled all of the fluorescent saccharide derivatives tested to be electrophoresed and various positional isomers, anomers, and epimers could be separated. The other system consisted of a discontinuous Tris-HCl/Tris-glycine buffer and enabled the electrophoresis of acidic, but not neutral, saccharide derivatives. The acidic and neutral saccharides could thus be distinguished unequivocally. The fluorescent labeling procedure was virtually quantitative and as little as 0.63 pmol could be detected photographically when gels were illuminated by uv light. When gels were viewed using an imaging system based on a cooled charge-coupled device, as little as 0.2 pmol was detected. The method may be useful for the structural analysis of the carbohydrates of glycoconjugates and other naturally occurring oligosaccharides. PMID- 1776674 TI - Use of exoglycosidases from Mercenaria mercenaria (hard shelled clam) as a tool for structural studies of glycosphingolipids and glycoproteins. AB - The hepatopancreatic extract of M. mercenaria (hard shelled clam) was found to be a rich source for at least 16 different glycosidases. These glycosidases were successfully employed for the degradation of oligosaccharides, glycolipids, and glycoproteins at analytical as well as preparative levels. The identified glycosidases differ considerably in their stability profiles with respect to time and temperature of storage and presence of glycerol. However, most of the enzymes show higher activity at pH 4.5 than at pH 7.0, and could be bound on a DEAE CL-6B Sepharose anion-exchange column suggesting similar charge characteristics on the protein surface. A Gal beta 1, 3R linkage-specific beta-galactosidase activity has also been detected in the glycosidase-enriched fraction and has been utilized to obtain quantitative conversion of the ganglioside GM1 to GM2 on a preparative scale. The glycosidase-rich extract does not have detectable protease activity at the pH of optimal glycosidase activity (pH 4.5) and, hence, can be safely used for specific hydrolysis of carbohydrate moieties of glycoproteins and glycopeptides. This is the first report to characterize a repertoire of glycosidases from an inexpensive, dependable and convenient source that can be easily employed for compositional studies involving glycoconjugates. PMID- 1776675 TI - Detection of plant virus coat proteins on whole leaf blots. AB - Coat proteins of several different plant viruses were transferred from entire leaves of infected hosts to nitrocellulose membranes in 2 min using a hydraulic laboratory press. Protein transfer was even across the leaf as evidenced by India ink staining of blots. Coat proteins of four different viruses were detected using virus specific IgG. The presence of viral coat proteins was observed as small intense spots whose distribution was irregular and coincided most frequently with the presence of chlorosis on the leaves. Detection was sensitive, and accurately reflected the distribution of virus symptoms across leaves. PMID- 1776676 TI - A stable diazo photoaffinity label with high absorptivity and effective photoactivation beyond 300 nm. AB - The sulfosuccinimidyl active ester of 3-(3-carbethoxy-4-diazo-5-oxo-2-pyrrolin-1 yl)propanoic acid (DIAZOPY-SE) has been synthesized for use as a photoaffinity labeling reagent. This compound was obtained from commercial chemicals by a four step synthesis requiring no complex procedures or special apparatus. The active ester efficiently derivatizes protein amino groups with the chromophore 3 carbethoxy-4-diazo-5-oxo-2-pyrroline (DIAZOPY, epsilon 8800 M-1 cm-1 at lambda max 330 nm), which on irradiation yielded products expected from formation of a reactive carbene intermediate. Brief irradiation of DIAZOPY in 2-propanol using wavelengths greater than 300 nm for photolysis yielded mainly an isopropyl ether resulting from insertion of the carbene into the O-H bond of the alcohol. Formed concurrently and to a somewhat lesser extent was an isopropyl ester, resulting from a ring-contracting Wolff rearrangement of the carbene and subsequent reaction with isopropanol. Analogous products were produced by photolysis in 2 propanol of DIAZOPY-PA (for DIAZOPY propanoic acid), the carboxylic acid precursor of DIAZOPY-SE. Facile protein derivatization by DIAZOPY-SE was demonstrated using actin and sheep IgG. Actin labeled with DIAZOPY-SE and irradiated while in the F-actin (reversibly polymerized) form was crosslinked to yield a covalently-linked dimer, illustrating the potential of the reagent in photoaffinity applications. Advantages of DIAZOPY-SE as a photoaffinity labeling reagent include ease of synthesis, chemical and photostability, efficient photolysis at wavelengths greater than 300 nm, and a capacity for crosslinking by carbene insertion processes. PMID- 1776677 TI - A sensitive radioenzymatic assay for (S)-5-formyltetrahydrofolate. AB - A highly sensitive, radioenzymatic method has been developed for the specific and quantitative estimation of (S)-5-formyltetrahydrofolate. This method is based on enzymatic cycling of the 5-formyl derivative to methylenetetrahydrofolate followed by entrapment into a stable ternary complex with thymidylate synthase and tritiated fluorodeoxyuridylate. Determination of bound radiolabeled ligand permits estimation of the original folate. The initial cycling step is catalyzed by the enzyme, methenyltetrahydrofolate synthetase, which is specific for the (S) diastereomer of 5-formyltetrahydrofolate and generates a product which can be further cycled to tetrahydrofolate using either 10-formyltetrahydrofolate deacylase or glycinamide ribonucleotide transformylase. Tetrahydrofolate is ultimately converted to the entrapable methylene derivative in the presence of excess formaldehyde. Using this assay recovery of reference (S)-5 formyltetrahydrofolate was linear over the range 0.03-1.9 pmol with an average recovery of 83 +/- 2%. The method has been applied to estimation of plasma (S)-5 formyltetrahydrofolate from a volunteer who had been administered (R,S)-5 formyltetrahydrofolate. Where comparison was possible, estimation of plasma (S)-5 formyltetrahydrofolate by this one step ternary complex-based method yielded results that were very similar to those observed by Straw et al. (Cancer Res., 44, 3114, 1984) who used an HPLC-based method for separation of diastereomeric mixtures of reduced folates and microbiological growth dependence to determine (S)-5-formyltetrahydrofolate. PMID- 1776678 TI - Elimination of interfering substances in the presence of detergent in the bicinchoninic acid protein assay. AB - Substantial time and effort are necessary to eliminate interference due to thiols and reducing sugars in the bicinchoninic acid protein assay when detergents such as sodium dodecyl sulfate (SDS) are present. A method to eliminate these interfering substances based on the binding of proteins to positively charged nylon membranes at pH 8.5 followed by methanol and aqueous washes is described. Color development using bicinchoninic acid occurs in solution with only a minor contribution from the nylon membrane itself. The retention of most proteins on the membrane is nearly quantitative and is only slightly decreased by high salt or detergent in the assay mixture. The interference due to thiol compounds such as beta-mercaptoethanol and dithiothreitol is completely eliminated while that due to reducing sugars such as glucose is substantially reduced. Therefore, the amount of protein dissolved in the sample buffer used for SDS-polyacrylamide gel electrophoresis (2% SDS and 5% beta-mercaptoethanol) can be determined with this bound protein assay. PMID- 1776679 TI - A sensitive nonisotopic method for the determination of intracellular azidothymidine 5'-mono-, 5'-di-, and 5'-triphosphate. AB - In order to analyze the efficacy of azidothymidine (AZT), it is important to know intracellular concentrations of AZT metabolites. However, it has been impossible to measure intracellular AZT 5'-monophosphate (AZT-MP), AZT 5'-diphosphate (AZT DP), and AZT 5'-triphosphate (AZT-TP) without using isotopes. In the present study, we developed a new method to measure intracellular AZT metabolites without radiolabeled compounds. The method employed was a high-performance liquid chromatography (HPLC) system programmed for column switching technique, in which two columns were used: column 1 (TSK-G2000-SW, 300 x 7.5 mm) to preseparate AZT metabolites from major cell components, and column 2 (YMC-A-312-ODS, 150 x 6 mm) to determine the metabolites. The limit of detectability of this system was 3.3 pmol/injection. When MT-4 cells were incubated with various concentrations of AZT, intracellular concentrations of AZT-MP increased in parallel with extracellular AZT. Those of AZT-DP and AZT-TP, however, reached plateaus at 5 and 2 microM of AZT, respectively. In MT-4 and Molt-4 cells incubated with 5 microM AZT, concentrations of AZT-MP increased time dependently, while the AZT-DP/AZT-MP ratios decreased with time. These data suggest that high dose of AZT may not necessarily increase intracellular concentration of AZT-TP. The concentrations of AZT metabolites in peripheral blood mononuclear cells in a patient with AIDS and an asymptomatic carrier were measured; the concentrations were comparable to those in cultured cells. Quantitative analysis of intracellular AZT metabolites without the use of isotopes will increase safety and convenience of measurement, and take an effective step in studying pharmacokinetics of AZT in clinical materials. PMID- 1776680 TI - Purification of rough-type lipopolysaccharides of Neisseria meningitidis from cells and outer membrane vesicles in spent media. AB - A procedure for the purification of Neisseria meningitidis lipopolysaccharide (LPS) from outer membrane vesicles (OMV) in spent growth media was developed. Five different LPS strains of group A N. meningitidis were grown in tryptic soy broth with vigorous aeration for 36-48 h, and centrifuged to collect both cells and supernatants. The amount of LPS in the OMV in the supernatants was higher or at least equal to that in the cells. The OMV in each supernatant were concentrated, pelleted by ultracentrifugation, and treated with 2% sodium deoxycholate to dissociate LPS from OMV. The LPS was then separated from capsular polysaccharides, proteins and phospholipids by gel filtration on Sephacryl S-300 column in 1% sodium deoxycholate, and precipitated from the column fractions in 70% ethanol. In addition, LPS was also extracted from cells with hot phenol water, ultracentrifuged once after treatment with ribonuclease, and purified on Sephacryl S-300. When compared with an improved phenol-water extraction method, the LPS obtained from either OMV or cells by the above methods gave a 40-180% increase in yield. The LPS also had much higher activities in limulus amebocyte lysate assay, rabbit pyrogenic test, and enzyme-linked immunosorbent assay. The LPS purified from cells and from OMV were indistinguishable by sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis. PMID- 1776681 TI - Modeling of immunosensors under nonequilibrium conditions. I. Mathematic modeling of performance characteristics. AB - Immunosensors for the detection of small analytes that use analyte-enzyme conjugates as signal generators require special attention if operated under nonequilibrium conditions. If the size of the analyte and the analyte-enzyme conjugate differ substantially, the two antigens do not diffuse at the same rate. This can cause time-dependent shifts in the sensitivity of competitive immunoassays. Therefore, immunosensors operating at short incubation times require precise timing that meets closely the specifications for which the sensors were calibrated. As an example, we have analyzed kinetic binding curves for the quantitative determination of progesterone with an immobilized monoclonal antibody and a conjugate between horseradish peroxidase and progesterone as signal generator. Mathematical paradigms have been developed to simulate the diffusion, antigen-antibody complex formation, and competitive binding processes in this analytical system. Dose-response curves obtained under nonequilibrium conditions can vary substantially from those obtained at equilibrium of antigen antibody interaction. The degree of this variation depends on the performance characteristics of the major components of the immunosensor. The developed mathematical solutions reflect experimental results and can be used to model optimal conditions for immunosensors operating under nonequilibrium conditions. In this paper (Part I), we report on the mathematical modeling of the interaction between analyte, analyte-enzyme conjugate, and an immobilized antibody. In Part II (W. Schramm and S.-H. Paek (1991) Anal. Biochem. 196), we present experimental results and compare them with the theoretical models. PMID- 1776682 TI - Modeling of immunosensors under nonequilibrium conditions. II. Experimental determination of performance characteristics. AB - In an attempt to optimize immunosensors operating with an immobilized antibody as binding protein and an analyte-enzyme conjugate as signal generator that is significantly larger in molecular size than the analyte, in a previous communication (Part I) (S.-H. Paek and W. Schramm (1991) Anal. Biochem. 196) we developed mathematical models for the prediction of performance characteristics. These models are compared in this contribution with experimentally obtained results. As an example, a monoclonal antibody to the steroid hormone progesterone has been used as binding protein, an 125I-progesterone derivative, and a progesterone-horseradish peroxidase derivative as tracers for signal generation. A minimum of parameters needs to be experimentally determined to calculate the performance: the amount of immobilized antibody, the diffusion coefficient of antigens, the thickness of the penetration layer, and the on- and off-rates for binding of the antigen to the antibody. We have described simple methods to obtain these data for the labeled antigen and for the unlabeled analyte that does not provide a signal per se. Kinetic binding curves for antigen-antibody complex formation obtained with the mathematical models correlated well with experimentally obtained results for antigens of different sizes. Although equilibrium of the antigen-antibody complex for the enzyme-labeled analyte conjugate requires about 4 h in the absence of free analyte, dose-response curves can be obtained after 5 min and the relative position of these curves does not change significantly after 30 min. Using a total volume of 200 microliters for the analytical procedure in microtiter wells, agitation as a means to accelerate convective diffusion during an incubation period of 30 min is not necessary with the analyte-enzyme conjugate. However, immunosensors using large analyte-enzyme conjugates as signal generators for the detection of small analytes require strict control of the incubation time if operated within short periods of time (less than 30 min). PMID- 1776683 TI - A universal method for two-dimensional polyacrylamide gel electrophoresis of membrane proteins using isoelectric focusing on immobilized pH gradients in the first dimension. AB - Two-dimensional gel electrophoresis with immobilized pH gradients in the first dimension, initially applied for the separation of soluble and total cellular proteins, has been extended to the analysis of membrane proteins. We show that the usual procedures lead to artifacts and irreproducible results due to aggregation and precipitation of proteins and protein-phospholipid complexes during isoelectric focusing (first dimension) and sodium dodecyl sulfate (SDS) gel electrophoresis (second dimension). Optimized solubilization procedures for hydrophobic membrane proteins are presented and the use of dilute samples is shown to be essential to overcome the major problems in isoelectric focusing. Increased volumes of samples dissolved in rehydration buffer are applied by direct rehydration of dry immobilized pH gradient (IPG) gels. Isoelectric focusing in 2% 3-[(3-cholamidopropyl)dimethylammonio]-1-propanesulfonate (CHAPS) without urea gives good results as does 2% Nonidet-P40 with 8 M urea. Heat denaturation should be avoided. An optimized equilibration procedure for IPG gel strips in SDS sample buffer prior to separation in the second dimension was developed that minimizes loss of proteins and results in high-resolution two dimensional electropherographic maps with a minimum of streaking. The gel strips are partially dehydrated at 40 degrees C and shortly reswollen in situ on the SDS slab gel in SDS-sample buffer containing agarose. PMID- 1776684 TI - Automated precolumn fluorescence labelling by carbodiimide activation of N acetylaspartate and N-acetylaspartylglutamate applied to an HPLC brain tissue analysis. AB - An automated method is described to couple carboxyl-containing metabolites to the fluorophore 2-aminoanthracene in aqueous solution (containing 75% methanol) in the presence of N,N-dicyclohexylcarbodiimide. The reaction was optimized for N acetylaspartate (N-Ac-Asp) and N-acetylaspartylglutamate (N-Ac-Asp-Glu). The reactions occurred within 5 min at room temperature in the presence of 0.5-2 mM HCl. At concentrations of electrolytes exceeding 10 mM the coupling reaction became suboptimal. Derivatization was performed in a commercial precolumn derivatization unit. Additional tubing was needed to provide the reagents prior to reversed-phase HPLC and fluorescence detection. The assay is linear over at least three orders of magnitude; as little as 1 pmol could reproducibly be assayed in 100 micrograms wet weight brain tissue extracted with a mixture of methanol and 4 mM HCl (9:1, v/v). N-Ac-Asp and N-Ac-Asp-Glu levels in several brain regions and spinal cord were similar to those so far reported. The compounds could not be detected in peripheral tissue. The advantages, prospects and limitations of the present approach over existing methods to estimate water soluble carboxylic acids is discussed. PMID- 1776685 TI - Fluorometric determination of phosphatidylcholine as a measure of phospholipid methylation. AB - The successive methylation of phosphatidylethanolamine to phosphatidylcholine (phospholipid methylation) has been measured by the incorporation of S-[methyl 3H]adenosylmethionine or colorimetric assay of phosphatidylcholine extracted from adipocyte plasma membranes. A fluorometric assay for phosphatidylcholine was developed to measure phospholipid methylation. This assay is 10 times more sensitive than the colorimetric assay and demonstrates no significant interference with other methylated phospholipids. The fluorometric assay was used to determine a biphasic insulin dose response in adipocyte plasma membranes. This fluorometric assay for phosphatidylcholine represents an alternative method for monitoring phospholipid methylation, especially when increased sensitivity is required. PMID- 1776686 TI - Spectrophotometric assay and electrophoretic detection of trans-feruloyl esterase activity. AB - Wheat bran cell walls were subjected to mild acid hydrolysis and the major phenolic product was purified and identified as 5-O-(trans-feruloyl) arabinofuranose. Sensitive continuous and stopped, microtiter plate-based spectrophotometric assays for trans-feruloyl esterase activity were developed using this compound as substrate. Procedures were also developed for the detection of trans-feruloyl esterase activities on gels following electrophoresis using this compound. These procedures are applicable to other natural feruloyl esters derived from plant cell walls by enzymatic hydrolysis. The extracellular trans-feruloyl esterases of Aspergillus niger 814 grown on 1% wheat bran were fractionated by anion-exchange chromatography and isoelectric focusing. These studies indicate that there are multiple forms of trans-feruloyl esterase but that most activity is associated with a major isozyme with a pI of 3.2. PMID- 1776687 TI - A rapid colorimetric assay for heparinase activity. AB - A rapid, sensitive, assay for enzymes that degrade heparin is described. The procedure is based on the interference of heparin with color development during the interaction of protein with the dye Coomassie brilliant blue. The loss of this property when the glycosaminoglycan is degraded by heparinase can be used to quantify activity of the enzyme in pure form, or in complex biological samples such as tissue homogenates or serum. The assay is also suitable for studying dependence of heparinase activity under conditions such as varying pH and temperature. PMID- 1776688 TI - Determination of serum cholinesterase activity by liquid chromatography with electrochemical detection. AB - A sensitive enzymatic assay to measure cholinesterase activity in serum using liquid chromatography with electrochemical detection has been devised and used to examine cholinesterase inhibition in mice treated with diisopropyl phosphorofluoridate. Acetylcholine was used as substrate, and a postcolumn reactor containing immobilized choline oxidase converted the enzymatic product, choline, and the internal standard, ethylhomocholine, into the electrochemically active H2O2. The postcolumn reactor also contained acetylcholinesterase to allow the indirect detection of the substrate. Assay optimization included investigations of substrate concentration, buffer pH and ionic strength, enzyme concentration, incubation time, and reaction termination method. The optimized procedure is applicable to samples with activities of 0.11 to 269 mmol/ml/h. Intrasample coefficient of variation for mouse serum samples was 1.7% (n = 12), while intersample coefficient of variation was 8.0% (n = 5). The mean +/- SE serum cholinesterase activity found for controls and mice treated with diisopropyl phosphofluoridate (6.3 mg/kg, ip, 24 h prior) was 158.7 +/- 5.7 mumol/ml/h and 36.6 +/- 3.1 mumol/ml/h, respectively (P less than 0.001). PMID- 1776689 TI - Biotinidase radioassay using an 125I-biotin derivative, avidin, and polyethylene glycol reagents. AB - A radioassay for determining biotinidase activity in human serum was developed, using N-[beta-(4-OH-3-125I-phenyl)ethyl]-biotinamide in combination with biocytin as the substrate, avidin as a binding protein, and polyethylene glycol as a separation reagent. The gamma-emitting 125I-biotinamide (= tracer) was synthesized by coupling (pH 8.5, 20-22 degrees C, 90 min) N hydroxysuccinimidobiotin to 125I-tyramine. Using polyethylene glycol as a separation reagent, it was possible to eliminate several problems that were encountered when other separation reagents were used. Biotinidase activity was evaluated following the cleavage of the 125I-biotinamide and expressed in fmol of tracer cleaved.min-1.ml-1 in the presence of 9 nmol of biocytin. Under the conditions used, the time response of the assay was linear up to 3 h. The method is simple to perform, more sensitive than the previously described methods, and reproducible (intra- and interassay CVs of 4.9 and 10.2%, respectively) and allows the simultaneous handling of more than 100 samples in less than 3 h. PMID- 1776690 TI - Development of an automatic machine for in situ hybridization and immunohistochemistry. AB - An instrument for the automation of in situ hybridization and immunohistochemistry has been developed. This machine is capable of analyzing 20 microscope glass slides via all of the steps required for colorimetric in situ hybridization or immunohistochemistry. The slides are placed specimen-side down on a specialized Teflon slide-holder set in the reaction chamber of the machine. The system uses a unique type of capillary action between the slide and the holder. The holder has two small holes and is designed to apply, incubate and sequentially add and remove reagents from the slide surface. The system performs the complete processes of in situ hybridization and immunohistochemistry from dewaxing to colorization. Some applications were carried out using this instrument. Cultured cells infected with cytomegalovirus, adenovirus, or herpes simplex virus were hybridized with homologous biotinylated probes, and showed strong purple signals with alkaline phosphatase in the presence of nitroblue tetrazolium and 5-bromo-4-chloro-3-indolyl phosphate. Automatic in situ hybridization using other colorimetric detection systems (e.g., peroxidase labeled probes/diaminobenzidine/H2O2) was also examined in cells infected with Chlamydia trachomatis and in paraffin-embedded hepatic tissue sections from patients with hepatitis. For conventional immunohistochemical staining, formalin fixed and paraffin-embedded tissues were used. Glial fibrillary acidic protein and gamma-immunoglobulins were detected automatically in human brain white matter and tonsillar tissues, respectively, as peroxidase-based reddish signals. The intensity of staining was equal to that achieved by manual methods. PMID- 1776691 TI - Monoclonal antibody-mediated solid-phase assay for mammalian O6-alkylguanine DNA alkyltransferase activity. AB - We describe a sensitive, rapid, and simple assay for mammalian O6-alkylguanine DNA alkyltransferase (O6-AGT) utilizing solid-phase DNA as the substrate and a monoclonal antibody (Mab)-based immuno-slotblot (ISB) for quantitation of O6 ethylguanine (O6-EtG). lambda-phage DNA was treated with N-ethyl-N-nitrosourea and immobilized on newly developed hydrophilic latex beads. After incubation with cell extracts to be assayed for O6-AGT activity, the substrate DNA could be isolated easily by a brief centrifugation through 50% glycerol. The amount of O6 EtG retained in the substrate DNA was determined by ISB using the anti-(O6-ethyl 2'-deoxyguanosine) Mab ER-6. As little as 2 fmol of O6-AGT per reaction tube can be reproducibly measured by this procedure, which is suitable for handling large numbers of samples within a short time (e.g., 80 samples within 2 days). In normal and malignant cells, respectively, O6-AGT activity protects against O6 alkylguanine-mediated mutagenesis and oncogenesis following exposure to N-nitroso carcinogens or confers resistance against cytocidal anti-cancer drugs such as chloroethylnitrosoureas and related compounds. The analysis of cellular O6-AGT activity by a highly sensitive, routinely applicable method is, therefore, of particular interest in studies related to carcinogenesis, molecular epidemiology, and clinical oncology. PMID- 1776692 TI - Regeneration of enzyme activity after western blot: activation of RNase L by 2-5A on filter--importance for its detection. AB - A rapid and convenient new procedure for detecting RNase L activity following Western blot by renaturation of the enzyme on the nitrocellulose sheets is described. This method allows the simultaneous analysis of enzymatic activity (e.g., cleavage of poly(uridylic acid)-3'-[32P]pCp) and RNase L binding to radioactivE probes (e.g., 2-5A-3'-[32P]pCp) in the same sample. Unlike previously published methods, this procedure eliminates interference from proteases or other RNases during the analysis of RNase L activity. The detection of RNase(s) L is also affected by the presence of endogenous 2-5A, 2-5A derivatives, or other possible "inhibitors" in cell extracts; this Western blot assay allows of RNase(s) L to be detected independently of intracellular 2-5A or analogs. Differences between the procedures used so far and this Western blot technique can indeed be demonstrated. It is shown with this Western blot assay that although RNase L has been described as a protein of 185-200 kDa under nondenaturating conditions, its 80-kDa (and 40-kDa) component is able to bind 2 5A and to cleave poly(uridylic acid) in a 2-5A-dependent way, independently of other subunit(s) or cofactor(s). PMID- 1776693 TI - Electrochemical release of ethidium into and fluorescence detection of DNA ethidium complexes in the diffusion layer at a carbon paste electrode. AB - The electrochemically controlled release of the ethidium cation from the surface of carbon paste composite electrode was demonstrated using laser-induced fluorescence detection. The electrode contained an ethidium tetracyanoquinodimethane salt. The following experimental parameters were varied in order to optimize the fluorescence intensity: carbon paste composition, electrode potential, voltage pulse time, and laser power. In the presence of calf thymus DNA the fluorescence signal from the diffusion layer was linearly dependent on the logarithm of the DNA concentration over the range from 0.1 to 10(4) ppb. PMID- 1776694 TI - Preparation and application of a fluorescein-labeled peptide for determining the affinity constant of a monoclonal antibody-hapten complex by fluorescence polarization. AB - A simple and rapid method for determining the affinity constant of a monoclonal antibody-peptide complex under equilibrium conditions is presented. A peptide corresponding to sequence 178-185 of meningococcal strain MC50 class 1 outer membrane protein, which is recognized by monoclonal antibody MN12 (mouse IgG2a), was synthesized. After fluorescein was coupled to the peptide, the peptide fluorescein conjugate was used for binding studies with MN12, employing fluorescence polarization of the fluorescein label to probe the bound fraction of the peptide. Scatchard analysis showed that the affinity constant was pH dependent. Storage of MN12 under alkaline conditions resulted in a loss of antigen-binding sites, but did not alter the affinity constant. Sips plots showed a homogeneity index of unity. PMID- 1776695 TI - Kinetic analysis of the free-radical-induced lipid peroxidation in human erythrocyte membranes: evaluation of potential antioxidants using cis-parinaric acid to monitor peroxidation. AB - cis-Parinaric acid (PnA), cis-trans-trans-cis-9, 11, 13, 15-octadecatetraenoic acid, is fluorescent (epsilon = 74,000 at 324 nm) when partitioned into a lipid environment and the fluorescence is destroyed upon reaction with free radicals. It has been used to monitor semiquantitatively free-radical-induced lipid peroxidation in human erythrocyte membranes. We have applied this assay to the quantitative evaluation of potential antioxidants. The kinetics of the reaction of PnA with free radicals were measured in erythrocyte ghosts. After initiation of free radical generation by cumene hydroperoxide and cupric ion, a steady-state rate of fluorescence decay is rapidly established. In the steady state the oxidation of PnA and, hence, the loss of fluorescence is a first-order process. In the presence of antioxidants, such as vitamin E, the rate constant of fluorescence loss decreases, thereby indicating that the antioxidant decreases the steady-state concentration of free radicals. By adding various concentrations of potential antioxidants, pseudo-first-order rate constants [k1] which measure the reactivity of antioxidants with free radicals were determined. Results show that, when incorporated into erythrocyte membranes, U-78, 517f, a vitamin E analog, is a potent free radical scavenger, being approximately 50% as effective as vitamin E and 10-15 times more potent than the aminosteroids evaluated (see Table 1). PMID- 1776696 TI - High-performance liquid chromatographic determination of alpha-acetyldigoxin in Digitalis lanata leaves. AB - An analytical method for the determination of alpha-acetyldigoxin in Digitalis lanata leaves by HPLC has been developed. The procedure consists of extraction of dry leaf powder with 50% methanol and cleanup by a Sep-Pak C18 cartridge prior to HPLC analysis. The quantitation is carried out by the incorporation of beta methyldigoxin as an internal standard. HPLC is performed on an octylsilyl bonded silica column with acetonitrile/methanol/water (100/11/188, v/v). The effluent is monitored by uv absorption at 220 nm. The amount of alpha-acetyldigoxin per 100 mg of dry leaf powder is estimated at 5.55 +/- 0.21 micrograms (mean +/- SD). The average recovery of alpha-acetyldigoxin from added samples is 97.2%. The present method is sensitive, reliable, and relatively simple. Application of this HPLC method to the analysis of samples obtained by fermentation of the leaf powder is also demonstrated. PMID- 1776697 TI - Mathematical theory of complex ligand-binding systems applied to free triiodothyronine immunoassays. AB - A theoretical basis for direct immunoassays of free hormones in serum is presented. The multiple-ligand/multiple-site binding theory employed makes it possible to predict the distribution of hormones among exogenous and endogenous binding proteins in the assay mixture. The model allows simulation of assay systems involving any number of ligands and binding sites. The simulation of an assay of free triiodothyronine illustrates the way in which assay parameters such as antibody concentration, antibody affinity, serum dilution, and labeled hormone interactions with serum binding proteins affect the validity of free hormone assays. The simultaneous equations describing these complex binding systems at equilibrium were solved on a personal computer, with the use of commercial mathematics software. This general method for solving and modelling free hormone assay systems provides a tool for predicting the behavior of free-hormone assays. PMID- 1776698 TI - Role of charge suppression and ionic strength in free zone electrophoresis of proteins. AB - The free zone electrophoretic mobility of proteins can be predicted from the protein's amino acid content by applying a model based on the Debye-Huckle-Henry theory and Henderson-Hasselbalch equation. Calculated mobilities are always greater than actual mobility but a pH-independent proportionality (described by the constant FZ) is found between the two. Thus, determination of a protein's mobility at one pH allows, with the use of the model and FZ, calculation of its mobility at other pH conditions. This leads directly to optimum conditions for the electrophoretic resolution of proteins in capillary zone electrophoresis. The fundamental nature of FZ is examined and found to be a function of a proteins molecular weight, charge, and solution ionic strength. This work aids in explaining the form of previously proposed empirically based equations for peptide and protein mobility. PMID- 1776699 TI - Stable isotopes for determining biokinetic parameters of tellurium in rabbits. AB - We have compared the use of stable and radioactive isotopes for determining the concentration of tellurium in body fluids of animals and man, specifically in the blood plasma of rabbits. Particular effort has been devoted to developing a sample-processing technique that allows the total amount of tellurium and isotope ratios to be measured by graphite furnace atomic absorption spectrometry (GFAAS) and secondary ion mass spectrometry (SIMS), respectively. The procedure employed in the SIMS analysis is discussed in detail. Investigations on the plasma clearance and the fractional intestinal absorption were carried out on four rabbits. Tracer solutions containing stable tellurium enriched in 124Te or 126Te and radioactive tellurium (121mTe or 123mTe) were administered by gavage and/or intravenously. Blood samples were drawn during the first 2 days after application. The activity of the separated plasma was measured by standard gamma ray spectrometry. After wet ashing and solvent extraction with MIBK the samples were analyzed for stable tellurium. A detection limit of 1 ng/mL of plasma could be achieved with GFAAS. For SIMS analysis the processed samples were deposited on high-purity graphite backings. Reliable isotope ratios could be determined with sample fractions containing 1 ng of tellurium or even less. The results obtained by applying stable isotopes were found to be in good agreement with the data achieved by using radioactive tracers. Studies on the intestinal absorption and the metabolic behavior of tellurium in human volunteers may thus be performed with stable isotopes. PMID- 1776700 TI - NCAM in developing mouse gonads and ducts. AB - The expression of the Neural Cell Adhesion Molecule, NCAM, in mouse gonads and ducts was studied from fetal life to maturity. The methods used were immunocytochemical staining and Western blotting. The immunocytochemical studies showed that the only structures that remain NCAM-positive throughout life were the mesonephric-derived rete ovarii and rete testis. Also in the fetal gonads some somatic cell lining the groups of differentiating germ cells were stained. In the immature as well as in the mature ovary the granulosa cells and oocytes of growing and large follicles--but not of small follicles--were stained. A particularly strong staining of the cytoplasm of the oocyte, healthy as well as atretic, was seen. All cells of the testis remained negative except for weakly stained residual bodies and late spermatids. At all ages the male ducts showed only weak staining, whereas in the female Mullerian duct the epithelium became strongly positive at puberty. The stroma of the Mullerian duct was positive during a transitory period around day 16 of fetal life in both sexes. One dimensional gel immunoblotting of total protein from gonads, rete and ducts from immature and mature mice showed that only the two largest isoforms of NCAM (NCAM A and NCAM-B) were present. The gonads and the rete of both sexes and the adult uterus expressed only NCAM-B, whereas NCAM-A was also detected in the adult epididymis. The present findings suggest that NCAM may be involved in the normal development and formation of both the gonads and ducts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1776701 TI - Glial cell differentiation in neuron-free and neuron-rich regions. I. Selective appearance of S-100 protein in radial glial cells of the hippocampal fimbria in human fetuses. AB - The proliferative cells of the developing hippocampal fiber tract fimbria have only the potential for gliogenesis; thus the developing fimbria provides an ideal model for the study of the development and differentiation of its constituent glial cells. In the first stage of development, the fimbrial primordium can be distinguished morphologically, and during the second stage, the fimbria becomes a well-defined fiber tract. In the third stage, a divergent immunocytochemical staining pattern clearly demarcates the neuron-free fimbria from the hippocampus, where a mixed neuro- and gliogenesis occurs. The distinct expression of S-100 protein in radial glial cells is restricted to the fimbria. During the final stage of development, the ventricular lining of the fimbria will mature into an ependyma. It is suggested that the S-100-positive radial glial cells of the fimbria, which probably retain their proliferative capacity, represent a homogeneous population of precursor cells that will give rise to the glial cells of the adult fimbria. The appearance of S-100 in the fimbrial radial glial cells seems to occur coincidentally with the establishment of hippocampal commissural connections. The S-100-positive radial glial cells of the fimbria may guide and segregate populations of growing axons by providing physical and chemical cues. Thus, S-100 protein per se seems to be intimately involved in modulation and regulation of axonal growth and patterning. PMID- 1776702 TI - Glial cell differentiation in neuron-free and neuron-rich regions. II. Early appearance of S-100 protein positive astrocytes in human fetal hippocampus. AB - The development of the human fetal hippocampus and dentate gyrus has been studied immunocytochemically. The first glial cells to appear are vimentin-positive radial glial cells. A gradual transition from vimentin to glial fibrillary acidic protein (GFAP) reactivity in the radial glial cells occurs at week 8. The GFAP positive radial glial cells transform into astrocytes from week 14. A population of small S-100-positive somata which morphologically and spatially are distinct from GFAP-positive radial glial cells and their transformed progeny, are found as early as week 9.5 in the hippocampus during the period of peak neurogenesis. The well-defined immunoreactivity of the morphologically homogenous cell subpopulation for S-100 protein, which has been used as an astrocytic marker in the adult hippocampus, indicates that astrocytes may differentiate at very early gestational ages in human fetuses. The S-100-positive astrocytes are thought to be derived from ventricular zone cells, which at the time of their appearance do not express any of the applied astrocytic markers (S-100, GFAP, vimentin). It is suggested that the S-100-positive astrocytic cell population interacts with the first incoming projection fibers, so modulating the pattern of connectivity. PMID- 1776703 TI - Immunocytochemical distribution of glial fibrillary acidic protein in the central nervous system of the Japanese quail (Coturnix coturnix japonica). AB - In the present study we detailed the distribution of GFAP-immunopositive structures within the central nervous system of the Japanese quail. Different fixation and embedding procedures were applied. The best results were obtained on frozen cryostatic sections from freshly dissected brains subsequently fixed by a short immersion in cold acetone. Immunopositive structures were observed both with immunofluorescence, and with immunoperoxidase methods. Immunoreactive cell bodies and processes were observed within the whole central nervous system, and different cell types can be identified on the basis of their topographical location and morphology. A first class of astrocytes is composed of intensely stained unipolar cells lining the inner surface of the pia mater and the large blood vessels. A second type is represented by multipolar astrocytes of variable size, provided with an irregular cell body. The last type is represented by similar elements, showing an immunonegative cell body, that can be identified only by the presence of converging processes. These three types of cells, and several isolated processes, show a differential distribution within the quail central nervous system, both in the grey and in the white matter. Present results suggest that GFAP may represent a good marker for at least part of the astroglial population in quail. PMID- 1776704 TI - Translocation of fibronectin-coated and uncoated latex beads in avian embryonic limb buds. AB - Latex beads were implanted into the chick wing bud to determine whether parameters other than active movement, for example matrix-driven translocation and growth of the limb bud, were responsible for the extensive re-allocation of myogenic cells that occurs during limb development. Latex beads were implanted into nine stage 20-24 Hamburger and Hamilton (H.H.) wing buds, and were allowed to develop for 3 days before examination. In all cases, it was found that most of the latex beads (86.57% +/- 11.4%) were confined to the implantation site. A small percentage of beads was observed in the connective and myogenic regions proximal and distal to the graft side. In general the displacement of these beads was relatively short, although in one specimen a few beads were translocated to regions as far as the autopod. The surface of the latex beads was also coated with fibronectin prior to transplantation, to ascertain whether the extracellular matrix can influence the translocation of beads within the limb bud. Ten specimens were examined, and as for uncoated latex beads, most of the fibronectin coated beads (87.14% +/- 11.67%) were contained within the transplantation site. Again a small percentage of beads was found in the connective and myogenic but not in the chondrogenic tissues proximal and distal to the graft side. In one specimen fibronectin-coated beads were translocated to regions in the autopod, but in general, bead displacement was relatively short. In sum, latex beads can not move to any great extent within the limb bud, and the coating of these beads with fibronectin did not influence bead translocation. PMID- 1776705 TI - Ultrastructural changes in the gracile nucleus of the rat after sciatic nerve transection. AB - Ultrastructural changes in the gracile nucleus of the rat have been examined after peripheral nerve injury. The sciatic nerve of adult rats was transected at mid-thigh level, and after survival times ranging from 1 day to 32 weeks sections from the gracile nucleus were prepared for electron microscopic examination. Unoperated animals served as controls. Atypical profiles were regularly observed in the experimental cases at post-operative survival times from 3 days up to 32 weeks. It was sometimes not possible to classify these as preterminal axons or terminals, because synaptic contacts could not be identified. The two most common changes throughout the entire post-operative period were greatly expanded myelinated axons, or unmyelinated profiles containing numerous mitochondria, osmiophilic dense bodies and vacuoles. Atypical profiles were occasionally observed in unoperated control animals. The results clearly show that various types of degenerative changes occur in the gracile nucleus after peripheral nerve injury. These changes differ markedly from previously described transganglionic changes in other systems. It cannot be excluded that some of the changes reflect growth-related reactions, although the typical features of axon regeneration could not be found. PMID- 1776706 TI - A scanning electron microscope study of the neck segment of the rabbit nephron. AB - The three-dimensional structure of the neck segment (NS) of the rabbit nephrons was studied by scanning electron microscopy (after fracture, micro-dissection, or after corrosion nephron casts), and by the air-cast method. The NS was observed at the glomerulotubular junction in 68.5% of all nephrons. In every case the NS appeared as a straight tube with its long axis oriented radially in relation to the glomerulus. Although the external diameter of the NS was smaller than that of the proximal tubule, its luminal diameter was greater. No valve-like structures were observed. Three cell types were observed in the NS: parietal-like, tubule like, and intermediate. Parietal-like cells showed the same morphology as the parietal cells of the Bowman's capsule. Parietal-like cells constituted the only cell type in 25% of the NS. Tubule-like cells showed morphologic characteristics similar to proximal tubule cells; however, their microvilli were less numerous and exhibited an irregular pattern. Intermediate cells presented an intermediate morphology between tubule-like and parietal cells. In 75% of all NS, the three cellular types were present at the same time. The presence of tubule-like and intermediate cells is interpreted as the result of metaplasic transformation of the parietal cells. Our observations suggest that, in rabbits, the presence of the NS can be explained on the basis of phenotypical lability of the cells located at the glomerulo-tubular junction. PMID- 1776708 TI - Sequencing and genetic analysis of a bovine DQB cDNA clone. AB - A BoLA-DQB cDNA clone (BoLA-DQ beta-1) was isolated by screening a bovine lymphoblastoid cDNA library with a HLA-DQB genomic clone. The DNA and predicted protein sequences were compared to class II sequences from cattle and other species. BoLA-DQ beta-1 has 92.0% similarity to the coding regions of two previously sequenced BoLA-DQB genomic clones and 69.6% similarity to a BoLA-DR beta pseudogene. However, the first domain encoded by BoLA-DQ beta-1 has 94 amino acids; one more than the predicted size of the products encoded by two previously sequenced bovine DQB genes (BoDQ beta-Q1 and BoDQ beta-Y1). Comparing all coding regions, BoLA-DQ beta-1 has greater nucleotide similarity to HLA-DQB sequences than to I-A beta, HLA-DRB and I-E beta sequences. Like the HLA-DQB gene product, the cytoplasmic domain of the predicted protein encoded by BoLA-DQ beta-1 is eight amino acids shorter than that of I-A beta, HLA-DRB and I-E beta molecules. Six clone-specific amino acid substitutions were identified in the beta 1 domain of BoLA-DQ beta-1, including an unusual cysteine residue at position 13 which is believed to be positioned on a beta-strand and face into the antigen recognition site. Southern blot analysis of PvuII-digested genomic DNA from a paternal half sibling family (sire, and six dam-offspring pairs) using BoLA-DQ beta-1 as a probe, revealed five allelic PvuII RFLP patterns, including two patterns not previously described, that cosegregated with serologically-defined BoLA-A (class I) alleles. The evolution, polymorphism and function of a transcriptionally active BoLA-DQB gene can now be readily studied using this DQB cDNA clone as a source of allele and locus-specific oligonucleotide primers. PMID- 1776707 TI - Quantitative and ultrastructural study of ascending projections to the medial mammillary nucleus in the rat. AB - We analyzed the termination pattern of axons from the superior central nucleus and the ventral tegmental nucleus of Gudden within the medial mammillary nucleus (MM) in the rat. The neuropil of the MM consists of two classes of terminals, that is, terminals containing round synaptic vesicles and forming asymmetric synaptic contact, and terminals containing pleomorphic synaptic vesicles and forming symmetric synaptic contact. The number of axodendritic terminals with round vesicles is almost equal to that of terminals with pleomorphic vesicles. Almost all axosomatic terminals contain pleomorphic vesicles with symmetric synaptic contact. Injection of WGA-HRP into the central part of the superior central nucleus permitted ultrastructural recognition of many anterogradely labeled terminals within the median region of MM. The labeled terminals contacted mainly intermediate (1-2 microns diameter) and proximal dendrites (more than 2 microns diameter) as well as the neuronal somata. Serial ultrathin sections of neurons of the median region of the MM revealed that 37% of the axosomatic terminals were labeled anterogradely. The pars compacta of the superior central nucleus had reciprocal connections with the median region of MM. The axon terminals from this nucleus occupied 53% of axosomatic terminals, and contacted mainly intermediate dendrites. Following injection of WGA-HRP into the ventral tegmental nucleus, many labeled terminals were found in the medial and lateral regions of MM. They contacted mainly intermediate dendrites as well as neuronal somata. In the medial region, 78% of axosomatic terminals contacting retrogradely labeled neurons were labeled anterogradely. All labeled terminals from these nuclei contained pleomorphic vesicles, and made symmetric synaptic contact. PMID- 1776709 TI - Production of alloantisera against class II bovine lymphocyte antigens (BoLA) by cross-immunization between class I matched cattle. AB - This paper describes the production of alloantisera directed against bovine major histocompatibility complex (MHC) (BoLA) class II antigens in animals whose MHC phenotypes had been defined by one dimensional isoelectric focusing. Animals of closely matched BoLA class I types were selected by serology and subsequently typed for class I and class II by 1D-IEF of immunoprecipitated antigens. Those with similar class I type by both methods, but differing at the class II locus, were chosen for reciprocal immunization. Cross-immunization was by two skin implantations 6 weeks apart. The resulting antisera showed low titre after the first immunization and elevated titre 3 weeks after the second immunization. The sera reacted strongly with cells expressing specific BoLA class II antigens. The pattern of reactivity correlated well with IEF class II typing on a panel of animals representing all of the class II IEF types present in the Friesian population. PMID- 1776710 TI - Production and characterization of alloantisera specific for bovine class II major histocompatibility complex antigens. AB - Ten alloantisera defining five major histocompatibility complex (MHC) class II specificities of the bovine lymphocyte antigen (BoLA) complex were produced and characterized. Eight antisera defining four of the specificities were generated by immunizing cattle with class I compatible-class II incompatible lymphocytes. The alloantiserum defining the fifth class II specificity was produced by skin implant immunization. A pregnancy serum specific for one of the class II specificities was also identified. The class II antigens recognized by these antisera were designated 'Dx' antigens to indicate that they are BoLA-D region antigens encoded by one or more undetermined class II loci. The molecules identified by the alloantisera are heterodimers composed of a 34-kd alpha and a 26- to 28-kd beta chain, and are expressed on B-lymphocytes but not on resting T lymphocytes. In family studies the BoLA-Dx antigens segregated in linkage with the BoLA-A locus alleles. Most of the BoLA-A alleles present in the Cornell Holstein herd at a high frequency were found to exist in gametic association with two or more serologically defined class II haplotypes. On the basis of a population study it was determined that three pairs of class I and class II alleles (w10-Dx4, w31-Dx5, and c3-Dx2) were present in the Cornell herd at significantly increased frequencies. PMID- 1776711 TI - Dinucleotide repeat polymorphism at the bovine locus FSHB. PMID- 1776712 TI - [Concentration of zinc, copper, selenium and aluminium in nutritive solutions for parenteral administration]. AB - Total parenteral nutrition (TNP) therapy is widely used. However the quantitative requirements or the toxicity of trace elements in parenteral solutions are difficult to assess. This paper deals with a study performed by the Trace Element Commission of the Societe Francaise de Biologie Clinique. Trace metals (zinc, copper, selenium and aluminium) which are mainly involved in TPN solutions are analyzed in 12 different parenteral nutrition solutions commercially available. This multicentric assay (5 different sites of analysis) shows that a slight pollution can be noted for nearly all the solutions examined. But at this level (10 mumol/l for the most concentrated solution), the zinc intake cannot induce any toxicity. For copper and selenium the results indicated a negligible pollution. Small-volume solutions added with zinc, copper and selenium are correctly supplemented. As regard aluminium pollution, 4 solutions among 12 contain non negligible amounts of aluminium. The consequences of this TPN overload especially for young infants, indicate that the struggle against this pollution has to be strengthened. PMID- 1776713 TI - [Inflammatory reaction markers and nutritional markers in HIV infection]. AB - A protein profile has been monitored during human immunodeficiency virus (HIV) infection. The investigation concerned 60 patients suffering from acquired immunodeficiency syndrome (AIDS), 24 asymptomatic HIV-antibody seropositive subjects and 22 healthy HIV-antibody seronegative, individuals voluntary blood donors. Data show that retinol-binding protein, thyroxin-binding prealbumin and beta 2-microglobulin are already modified in HIV infection (p less than 0.05) whereas the other protein alteration becomes apparent during AIDS. These studies demonstrate that severe, but progressive malnutrition occurs in patients with AIDS. On the other hand nutritional abnormalities can be shown to have a deleterious effect upon the disease course as revealed by increasing alpha-1-acid glycoprotein and C-reactive protein levels for 60 to 70% of patients. PMID- 1776714 TI - [Atypical urinary excretion of catecholamines and their catabolites in a case of pheochromocytoma]. PMID- 1776715 TI - International Federation of Clinical Chemistry (IFCC) scientific division IFCC recommendation. Recommendation on sampling, transport and storage for the determination of the concentration of ionized calcium in whole blood, plasma and serum. AB - The substance concentration of ionized calcium (cCa2+) in blood, plasma or serum preanalytically may be affected by pH changes of the sample, calcium binding by heparin, and dilution by the anticoagulant solution. pH changes in whole blood can be minimized by anaerobic sampling to avoid loss of CO2, by measuring as soon as possible or by storing the sample in iced water to avoid lactic acid formation. cCa2+ and pH should be determined simultaneously. Plasma or serum: if centrifuged in a closed tube and measured immediately the pH of the sample will be close to the original value. If delay has occurred between centrifugation and the measurement, causing substantial loss of CO2, equilibration of the sample with a gas mixture corresponding to PCO2 = 5.3 kPa prior to the measurement is recommended. Conversion of the measured values to cCa2+ (7.4) is only valid if the pH is in the range 7.2-7.6 Ca2+ binding by heparin can be minimized by using either of the following: a final concentration of sodium or lithium heparinate of 15 IU/ml blood or less, by use of calcium titrated heparin with a final concentration less than 50 IU/ml blood. Dilution effect can be avoided by use of dry heparin in capillaries or syringes. When heparin solutions are used errors due to dilution or calcium binding can be reduced using syringes with a heparin solution containing free calcium ions corresponding to the mean concentration of ionized calcium in normal plasma. Conditions for blood collection, storage, and transport to avoid preanalytical errors are described. PMID- 1776716 TI - International Federation of Clinical Chemistry. Scientific division committee on analytical systems. IFCC guidelines (1990) for selection of safe laboratory centrifuges and for their safe use with general purpose appendices concerning centrifuge nomenclature, quantities and units, and calculation of centrifugal acceleration. PMID- 1776717 TI - [Clinical ethology: a study of stereotypies]. AB - According to ethological procedures and concepts, the author tries to describe the shape and the functional value of stereotyped movements in disabled children. These pathological behaviors are not a fixed response, they take place within an intricate behavioral sequence which associates many items; they are one aspect of a pathological answer to social stimulation. They prove the disabled child's intense motivation to communicate, but show the impossibility for him to do so. The inability to generate an adapted behavioral sequence shows that the deficit concerns an essential interaction process. PMID- 1776718 TI - [Elaboration of criteria for major depression adapted to Black Africa]. AB - The authors state that there is no diagnostic criteria for major depression adapted to Africa. Using available data about the clinical aspect of depressive disorders in African patients, they suggest criteria derived from DSM III. With regard to the American ones, the following modifications are brought to these criteria: dysphoric mood is no longer a compulsory criterion and two new criteria are included, concerning ideas of persecution and somatic complaints. PMID- 1776719 TI - [Management of the adult population in ten psychiatric sectors. A new active file from a single year]. AB - In 1983, a study was conducted during one year on the active file of patients of ten public psychiatric sectors. In the first part of this study, the social characteristics of the patients were compared to those of their population of reference. This comparison defined a profile of the psychiatric patients. It also showed that males had a socio-demographic profile differing significantly from the general population by age, marital and occupational status. For females, differences were found by age, marital status and nationality. Considering professional status, a remarkable similarity exists between the females and the general population. PMID- 1776720 TI - [Pseudo-schizophrenic forms of mood disorders]. PMID- 1776721 TI - [Clinical aspects of anxiety disorders in children]. PMID- 1776722 TI - [Statistical study of mental disorders in New Caledonia]. AB - 315 patients admitted to the psychiatric hospital of Nouville, New-Caledonia, during the year 1987, are examined. There are several ethnies: Melanesians, Europeans, Wallisians. Europeans are admitted for depression, suicide and neurotic troubles. On the contrary Melanesians and Wallisians are admitted for acute and chronic psychotic troubles above all. Maniac-depressive illness exists in every ethny. There are a lot of psychopathological hypothesis. Indigenous medicine of Melanesians in New-Caledonia has a great part in the distribution of diagnostics. PMID- 1776723 TI - [Lasthenie de Ferjol syndrome. Apropos of a case]. AB - After a brief review of literature, the authors report a case of the "Lasthenie de Ferjol" syndrome. From clinical observations, they establish theoretical landmarks and underline the necessity for searching the meaning. PMID- 1776724 TI - [The substitute children. Stendhal or the man of pseudonyms]. PMID- 1776725 TI - [Computerized systems in hospitals in the USA and Quebec]. PMID- 1776726 TI - Pathologic changes in olfactory neurons in Alzheimer's disease. AB - Olfactory deficits and degenerative changes in central olfactory pathways are prominent in patients with Alzheimer's disease (AD). We hypothesized that peripheral olfactory neurons that reside in the nasal epithelium would show degenerative changes similar to the characteristic pathologic features of AD brain. Immunohistochemical studies of nasal tissue taken at autopsy reveal extensive degeneration in the sensory epithelium as well as abnormal neurites that share immunoreactive epitopes with dystrophic neurites and neurofibrillary tangles of the AD brain. The neuritic masses are stained with well-characterized monoclonal antibodies that do not normally stain olfactory neurons but which are very reactive with dystrophic neuritic structures and neurofibrillary tangles in AD brain. These include antibodies to phosphorylated and nonphosphorylated neurofilament subunits, tau, and also ALZ50, which is characteristically reactive with AD but not with normal brains. Such changes are present in 81% of AD patients. Similar accumulations of ectopic neurites are found in the olfactory epithelium of about 22% of non-demented patients. Preliminary statistical analysis fails to reveal any age-linked association. It has been proposed that the aged monkey is a good model for AD inasmuch as amyloid accumulations similar to those of humans are found in monkey brain. We examined a series of 13 rhesus monkeys, including aged animals with behavioral deficits. Although the olfactory epithelium was very similar to that of humans, no abnormal olfactory structures were observed. Aged rhesus monkeys do not appear to be a good model for the neuritic abnormalities of AD. PMID- 1776727 TI - Biologic effects of nerve growth factor on lesioned basal forebrain neurons. PMID- 1776728 TI - Why do phospholipid levels decrease with repeated stimulation? A study of choline containing compounds in rat striatum following electrical stimulation. PMID- 1776729 TI - Mechanisms of amyloid deposition in Alzheimer's disease. AB - At the cellular level, Alzheimer's disease (AD) must be the result of neuronal dysfunction and degeneration leading to a reduction in synaptic density. Filamentous deposits of amyloid, which define the disease at the molecular level, occur within perikarya, axons, dendrites, and terminals of neurons as neurofibrillary tangles (NFT), in the extracellular neuropil as amyloid plaques (APC), and around blood vessels as amyloid congophilic angiopathy (ACA). These fibrillar amyloid protein aggregates are also found in the brain of all individuals with Down's syndrome after the age of 30 years. The amyloid deposits apparently occur in the terminal zones of neurons that develop NFT. It is suggested that amyloid deposition is of fundamental significance in AD and that a thorough understanding of amyloid formation will eventually lead to successful therapeutic intervention in AD. As elucidation of the reasons behind amyloid deposition must shed some light on the pathogenesis of AD, we review the current state of knowledge on the nature of the AD amyloid protein, its origin, and its formation. Although there is yet no agreement about the chemical nature of the amyloid protein of NFT, the major constituent of both APC and ACA has been shown to be a 4.5-kD amyloid protein originally termed "beta-protein" or "amyloid A4" which we now denote as "beta A4." Amyloid beta A4 protein is proteolytically derived from a transmembrane protein termed amyloid precursor protein (APP) which is encoded by a widely expressed gene on chromosome 21. Our present results are consistent with the possibility that amyloid formation requires membrane damage or APP molecules that are not or are incorrectly integrated into membranes. To allow the generation of the C-terminus of beta A4, one proteolytic cleavage step has to occur in the sequence that normally forms the transmembrane domain of the APP proteins. This cleavage is crucial for amyloid formation because we could show that the ability of synthetic beta A4 to form amyloid depositions is mainly based on hydrophobic parts of the sequence that have to interact with each other and build up large aggregates under physiologic conditions. Membrane association of APP is expected to interfere with this cleavage and the process of aggregation. PMID- 1776730 TI - Pathologic changes in the olfactory system in aging and Alzheimer's disease. PMID- 1776731 TI - Platelet protease nexin-2/amyloid beta-protein precursor. Possible pathologic and physiologic functions. AB - The amyloid beta-protein and its parent protein, amyloid beta-protein precursor (APP), are major constituents of neuritic plaques and cerebrovascular deposits in Alzheimer's disease and Down's syndrome. We reported that the protease inhibitor protease nexin-2 (PN-2) is the secreted form of APP that contains the Kunitz protease inhibitor domain. Previous studies suggested that circulating forms of PN-2/APP exist. Recently, we reported that PN-2/APP is a platelet alpha granule protein and is secreted upon platelet activation. Subsequent studies revealed that platelets are the major circulating repository for PN-2/APP and may contribute to its deposition in Alzheimer's disease. Protease inhibition measurements demonstrated that PN-2/APP is a potent inhibitor of certain serine proteases, particularly intrinsic blood coagulation factor XIa. Together, these findings indicate that PN-2/APP regulates blood coagulation, and possibly other proteolytic events, at sites of vascular injury. PMID- 1776732 TI - Serum amyloid P in Alzheimer's disease. Implications for dysfunction of the blood brain barrier. AB - We describe widespread serum amyloid P (AP) immunoreactivity in cerebral lesions including neurofibrillary tangles, senile plaques, and vessels in Alzheimer's disease (AD). To elucidate the mechanisms of its origin in cerebrospinal fluid and localization in brain, we searched for AP mRNA by the polymerase chain reaction. Our findings show that with the exception of liver, AP mRNA was not detectable in any of the brain regions tested or choroid plexus. These observations support extravasation or transport of this serum protein across the blood-brain barrier or the blood-cerebrospinal fluid barrier in the brain of subjects with AD. PMID- 1776733 TI - Studies of amyloid beta-protein precursor expression in Alzheimer's disease. AB - The generation of the beta/A4 peptide and its accumulation into insoluble amyloid deposits represent key events in the neuropathologic process of Alzheimer's disease (AD). This posit has gained further support from recent reports that beta/A4 is directly responsible for the death of neurons. Potential therapies for AD aimed at abating the production of beta/A4 will require the basic knowledge of where it comes from. The 4.2-kD peptide is derived from a much larger amyloid precursor protein (APP) encoded by a gene that produces multiple transcripts. Employing in situ hybridization with biotinylated oligonucleotide probes, we set out to define which forms of the precursor are synthesized in affected regions of AD brain (e.g., hippocampal formation) and to determine the cell populations responsible for their manufacture. PMID- 1776734 TI - Hereditary cerebral hemorrhage with amyloidosis--Dutch type: a congophilic angiopathy. An overview. AB - Hereditary cerebral hemorrhage with amyloidosis--Dutch type (HCHWA-D) is characterized by recurrent cerebral hemorrhages and dementia at a relatively young age. The symptoms are caused by extensive deposition of amyloid in cerebral arterioles and leptomeningeal arteries. A point-mutation in the beta-protein precursor gene on chromosome 21 is the underlying cause of the disease. This paper summarizes the clinical, radiologic, pathologic, and genetic features of this disease, with special attention to the relation between HCHWA-D and Alzheimer's disease, which is also characterized by beta-protein deposition. PMID- 1776735 TI - Studies on the proteolytic degradation of the beta-protein precursor by proteases purified from Alzheimer's disease brain. AB - In Alzheimer's disease, Down's syndrome, hereditary cerebral hemorrhage with amyloidosis of Dutch origin, and normal aging, amyloid accumulates in the brain parenchyma and blood vessels. The major protein in the deposits is the beta protein, a 4-kD peptide possibly generated by an abnormal degradation of its precursor, the beta-protein precursor (beta PP). We found, as a second component of the brain amyloid, the serine protease inhibitor alpha 1-antichymotrypsin (ACT). Inasmuch as ACT is tightly associated with the beta-protein and is never found in other amyloidoses, we hypothesized a role for ACT in the degradation of the beta PP. We used synthetic peptides made according to the sequence flanking the N-terminus of the beta-protein to screen brain fractions for protease activity. After several purification steps, two protease fractions were found that can cleave the peptide between methionine and aspartic acid, aspartic acid being the N-terminus of the beta-protein. One protease is activated by calcium and inhibited by ACT, beta PP containing the Kunitz-type inhibitory domain, diisofluorophosphate, and 1,10-phenanthroline. This protease fraction is also able to degrade the beta PP in vitro. The second protease is a metal-dependent cysteine protease. PMID- 1776736 TI - Clinical and pathologic features of chromosome 21-linked familial Alzheimer's disease. PMID- 1776737 TI - Genetic characterization of a novel familial dementia. AB - Clinical and neuropathologic findings from a Danish family in which a dementing illness is segregating as an apparent autosomal dominant disorder were previously described (Gydesen et al. 1987). We present here genetic findings from this family in which linkage analysis has excluded Huntington's disease and chromosome 21-encoded Alzheimer's disease. None of the known prion mutations has been detected in affected individuals from this family. However, linkage analysis with the prion gene has been uninformative. This family probably represents a novel genetic dementia. PMID- 1776738 TI - Cellular distribution and expression of cortical acetylcholine receptors in aging and Alzheimer's disease. AB - Ligand binding studies show marked reductions of nicotinic, but not of muscarinic binding sites in Alzheimer's disease. Using monoclonal antibodies we studied immunohistochemically the expression of the respective receptor proteins in the frontal cortex of middle-aged (55 +/- 5 yr) controls, age-matched controls (73 +/ 6 yr), and patients with Alzheimer's disease (74 +/- 5 yr). Density of nicotinic cholinoceptive neurons was 8000/mm3 for middle-aged controls and 4000/mm3 for age matched controls, but only 900/mm3 in Alzheimer's brains (p less than 0.0001). Densities of muscarinic cholinoceptive and of Nissl-stained neurons were not significantly different between the groups, pointing to a selective decrease of nicotinic receptor protein expression in cortical neurons with aging and in Alzheimer's disease. PMID- 1776739 TI - Olfactory capacities in aging and Alzheimer's disease. Psychophysical and anatomic considerations. AB - Age-related alterations in the ability to smell are well documented. For example, more than three-fourths of individuals over the age of 80 have major difficulty detecting and identifying odors. Furthermore, olfactory dysfunction is among the first signs of Alzheimer's disease (AD). Indeed, the olfactory pathways of patients with AD evidence disproportionate numbers of neuritic plaques and neurofibrillary tangles relative to other sensory pathways, suggesting that the olfactory system may be the site of first involvement of the AD process. In this article, the literature related to age- and AD-related alterations in olfactory perception has been briefly reviewed, and several current hypotheses regarding the physiologic basis for these changes discussed. PMID- 1776740 TI - Alzheimer lesions in the entorhinal region and isocortex in Parkinson's and Alzheimer's diseases. AB - Neuropathologic examination in elderly individuals and patients with Parkinson's disease with and without dementia reveals abundant isocortical amyloid deposits with no or only a few neuritic plaques, neuropil threads (NT), and neurofibrillary tangles (NFT), whereas NT and NFT may be present only in the entorhinal region of the parahippocampal cortex. In Down's syndrome, Alzheimer's disease, and Parkinson's disease, early neuronal degeneration with deposition of NT and NFT may selectively involve layer pre-alpha (II) of the entorhinal region (Brodmann 26 area) forming the origin of the glutamatergic perforant pathway. Its bilateral destruction isolates the hippocampus from isocortical influx. Comparative studies in a series of aged subjects and those with Parkinson's disease show that psychostatus correlates better with the number of NT and NFT in the entorhinal region than in hippocampal area CA-1 and isocortex. This pattern of neuronal degeneration may explain cognitive impairment in early stages of both Alzheimer's and Parkinson's diseases. PMID- 1776741 TI - Maintenance of neuronal plasticity in the reticular core and changes in trophic activity in Alzheimer's disease. AB - 1. Neuronal loss in Alzheimer's disease (AD) is accompanied by a proliferative response of the remaining neurons. 2. Different cell types are differently involved in the process of degeneration and proliferation in AD. 3. The extent of dendritic growth in AD is related to the formation of amyloid, not preamyloid. 4. Proliferative changes similar to those observed in AD can be induced in an animal model as a response to neuronal death. 5. The processes of degeneration and proliferation in AD are probably associated with an increase in trophic activity. PMID- 1776742 TI - The impact of human immunodeficiency virus on cognitive function. AB - It is now recognized that human immunodeficiency virus (HIV) can directly impact on cognitive function, particularly in patients with AIDS. Whether HIV affects neuropsychologic performance in otherwise asymptomatic seropositive individuals is controversial, and several large studies have not detected performance changes in the asymptomatic patient. However, our work and the work of several other groups suggest that the influence of HIV on cognition may be detected even at this early stage. PMID- 1776743 TI - Acetyl-L-carnitine: a drug able to slow the progress of Alzheimer's disease? AB - Defects in cholinergic neurotransmission do not, by themselves, constitute the sole pathophysiologic concomitants of Alzheimer's disease (AD). Recent findings point out that abnormalities in membrane phospholipid turnover and in brain energy metabolism may also characterize AD. Acetyl-L-carnitine (ALC) is an endogenous substance that, acting as an energy carrier at the mitochondrial level, controls the availability of acetyl-L-CoA. ALC has a variety of pharmacologic properties that exhibit restorative or even protective actions against aging processes and neurodegeneration. A review of a series of controlled clinical studies suggests that ALC may also slow the natural course of AD. PMID- 1776744 TI - Efficacy of CDP-choline in the treatment of senile alterations in memory. AB - Alterations in membrane function may occur as a consequence of aging because of a decrease in the synthesis or an increase in the catabolism of choline and ethanolamine glycerophospholipids, leading to impairment in cognitive function. Experimental studies have shown that the administration of CDP-choline increases the total amount of phosphatidylcholine and other related phospholipids in the brain and in some cases may enhance neurotransmission. Clinical assessments and neuropsychologic tests in patients with cerebral insufficiency, chronic cerebrovascular disease, and dementia suggest that CDP-choline may improve some of the memory deficits associated with aging. PMID- 1776745 TI - Use of phosphatidylserine in Alzheimer's disease. PMID- 1776746 TI - Essential fatty acids in Alzheimer's disease. AB - Concentrations of essential fatty acids (EFAs) in plasma and red blood cell phospholipids were found to be abnormal in patients with Alzheimer's disease. A double-blind, placebo-controlled trial of treatment with EFAs plus appropriate antioxidants was carried out in 36 patients with Alzheimer's disease. After 20 weeks both the EFA and placebo groups had improved, but the degree of improvement was consistently greater in the EFA group. PMID- 1776747 TI - Evaluation of HP 029 (velnacrine maleate) in Alzheimer's disease. AB - HP 029 (1,2,3,4-tetrahydro-9-aminoacridin-1-ol-maleate) is a cholinesterase inhibitor and one of a series of compounds synthesized at Hoechst-Roussel Pharmaceuticals Inc. (HRPI) as a potential therapeutic agent for senile dementia of the Alzheimer type (SDAT). An ongoing clinical development program for HP 029 (velnacrine maleate) reflects a rational, traditional progression from therapeutic concept through clinical evaluation. Prior to the initiation of outpatient studies, sufficient data had been obtained from normal volunteers and hospitalized patients to support the following conclusions: the pharmacokinetic profile of HP 029 in young and elderly normal men is predictable; tolerance and safety data for HP 029 using normal volunteers poorly correlates with experience in patients with SDAT; patients with SDAT exhibit marked intersubject variability in tolerance within a suspected therapeutic dose range; mandatory endpoints for drug discontinuation for outpatients can be reliably established in an inpatient environment. Subsequently, Protocol 201 was initiated as a multicenter, multistage investigation of HP 029 in patients with probable SDAT (NINCDS-ADRDA criteria). A dose-ranging component determined patient eligibility for a subsequent dose-replication phase based upon explicit safety and efficacy criteria defined within protocol. One a priori specified interim analysis was conducted by the sponsor (HRPI) for administrative purposes after completing approximately 50% of the planned sample (September 1989). Results suggested that (1) beneficial effects of HP 029 existed on key and secondary measures for the approximately 30% of enrolled patients; (2) interim results would provide an accurate reflection of the results at the conclusion of the study (1991); (3) HP 029-induced hepatocellular injury appeared to be a reversible, predominantly dose related event; and (4) cholinergically mediated adverse events are infrequent and clinically inconsequential at dosages less than or equal to 225 mg/day. Post hoc hypotheses based on the interim dataset suggest that: (1) carry-over effects of HP 029 exist within a dose-ranging/dose-replication paradigm that militate against the utility of an "enriched population" design; (2) beneficial effects are more robust on initial exposure to HP 029 with effects discerned on both memory and arousal; (3) patient characteristics associated with toxicity or response are not identified; (4) dosage reduction in subsequent efficacy trials may reduce hepatocellular injury and yield clinically unimportant differences in overall efficacy results. PMID- 1776748 TI - Potential clinical use of an adrenergic/cholinergic agent (HP 128) in the treatment of Alzheimer's disease. AB - A novel compound designated HP 128, which manifests adrenergic and cholinergic properties, was administered for 10 days to patients with Alzheimer's disease in a double-blind, placebo-controlled trial. All patients who entered the trial had previously failed to respond to a structurally related cholinesterase inhibitor without adrenergic properties (HP 029). The primary purpose of the study was to assess the safety and tolerance of HP 128. Efficacy measures were obtained to generate hypotheses for possible future studies. In the dosage range examined, HP 128 was safe and well tolerated. Effects on clinical measures of dementia severity were equivocal. PMID- 1776749 TI - Cholinesterase inhibition in the scopolamine model of dementia. AB - Scopolamine produces a satisfactory model of the attentional and secondary memory deficits seen in Alzheimer's disease (AD) that can be used to screen compounds for potential therapeutic usefulness. Physostigmine, which is known to enhance memory in AD, produced marked and widespread antagonism of the scopolamine induced impairments, indicating the sensitivity of the model and establishing its relevance for the clinical situation. HP 029, a novel anticholinesterase, also exhibited widespread potency in the model, and in an international trial with patients with AD, it subsequently showed improvement on similar measures, demonstrating the predictive use of the scopolamine model. PMID- 1776750 TI - Pharmacologic and clinicopharmacologic properties of SDZ ENA 713, a centrally selective acetylcholinesterase inhibitor. PMID- 1776751 TI - Effect of citalopram, a selective 5-HT reuptake blocker, in emotionally disturbed patients with dementia. AB - In patients with Alzheimer's disease and vascular dementia, there are symptoms not only of cognitive impairment but also of emotional disturbance. Postmortem human brain studies have shown a disturbed metabolism of serotonin and overactivity of neuroendocrine-controlling factors in the hypothalamus. Treatment with a selective 5-HT reuptake blocker, citalopram, causes a significant reduction in postdexamethasone cortisol levels. Citalopram in patients with dementia disorders produces no improvement in psychomotor and cognitive behavior, but symptoms of emotional disturbance are reduced. Citalopram does not have a pure antidepressant effect; rather, the drug is considered an emotional stabilizer. PMID- 1776752 TI - Visual function in Alzheimer's disease and normal aging. AB - We examined a wide range of visual behaviors in 59 patients with Alzheimer's disease (AD), 35 elderly control subjects, and 12 young control subjects. A subset of the patients with AD received neuro-ophthalmologic and electrophysiologic examinations in order to evaluate the integrity of the retino calcarine pathway. Patients with AD showed significant, selective losses in visual function, including color discrimination, stereoacuity, contrast sensitivity, and backward masking, but not in critical flicker fusion. The deficits were not attributable to clinically apparent lesions of the retina or optic nerve. We therefore suggest that AD lesions in primary visual and posterior association cortices underlie the observed behavioral abnormalities. PMID- 1776753 TI - Effect of BMY 21502 on classical conditioning of the eyeblink response in young and older rabbits. AB - BMY 21502, a substituted pyrrolidionone, has been found to enhance a simple form of learning in older rabbits. In humans, this simple type of learning, classical conditioning of the eyeblink response, declines in normal aging and is seriously impaired in Alzheimer's disease (AD). We have demonstrated that eyeblink classical conditioning reliably discriminates patients diagnosed with probable AD from non-demented, age-matched elderly subjects. Older organisms can be classically conditioned, but they condition at a much slower rate than younger organisms. Our preliminary analyses indicate age differences in distribution of protein kinase C in the hippocampus. Here we also report that older rabbits that are administered two different doses of BMY 21502 classically condition at a rate approximating that of young rabbits. PMID- 1776754 TI - Characterization of an experimental autoimmune dementia model in the rat. AB - Alzheimer's disease (AD) and other age-related cognitive deficits are associated with autoimmune phenomena. We recently showed that AD sera contain IgG that binds specifically to the heavy molecular weight neurofilament protein (NF-H) of Torpedo cholinergic neurons. We presently examined the behavioral effects of the induction of such antibodies in rats by prolonged immunization with Torpedo cholinergic NF-H. Immunohistochemical studies revealed the accumulation of IgG in the septum and hippocampus and in white matter tracts of these rats. T-maze alternation and discrimination tests revealed that immunization impaired the short-term working memory of the rats but had no effect on their reference memory. This impairment in short-term memory was reversed by treatment with the acetylcholinesterase inhibitor physostigmine. This animal model, termed experimental autoimmune dementia (EAD), may replicate immunologically induced pathogenic processes in AD. PMID- 1776755 TI - Age-related changes in memory and their pharmacologic modulation. AB - A passive avoidance procedure was used to measure the ability to learn and remember to avoid a noxious stimulus in 13-month-old mice and to test the effects that treatment with cytidine(5')-diphosphocholine (CDP-choline) had on these processes. Half of the mice received 500 mg/kg per day CDP-choline orally for 4 months, and the two groups were compared with a third group of younger animals (4 month-old mice). The older mice showed marked impairment in the execution of these tests; however, those treated with CDP-choline had significant improvement in their performance 24 hours after learning the task. PMID- 1776756 TI - Age-related impairment of signal transduction and its correction with antioxidants. PMID- 1776757 TI - An anatomic substrate for visual disconnection in Alzheimer's disease. AB - During a recent clinical and neuropathologic evaluation of a large population of brains collected at autopsy, attention was drawn to a subset of Alzheimer's disease (AD) patients presenting with prominent visual symptomatology as the first sign of the disease. In this population, a shift in the distribution of pathologic profiles had occurred such that the primary visual areas and the visual association areas had an increased number of lesions, whereas the prefrontal cortex had fewer lesions than usually observed in AD. Previous quantitative analyses have shown that generally in AD, primary sensory cortical areas are less damaged than association areas of the frontal and temporal lobes, as demonstrated by the laminar and regional distribution of two neuropathologic hallmarks of the disease, neurofibrillary tangles and neuritic plaques. Furthermore, the distribution of pathologic lesions in the AD cases with visual symptomatology revealed the disruption of specific visual association pathways, which are normally affected to a lesser degree in AD. These data suggest that in some cases of AD, the particular psychologic and neurologic symptomatology may be caused by the selective loss of specific corticocortical systems, as reflected by a differential distribution of the neuropathologic markers of the disease. PMID- 1776758 TI - Retinal degeneration in the macula of patients with Alzheimer's disease. AB - Recent reports (Hinton et al. 1986; Blanks et al. 1989) document the involvement of the retina in the constellation of neurodegenerative changes present in Alzheimer's disease (AD). These studies demonstrate the degeneration of large numbers of optic nerve axons and loss of retinal ganglion cells (RGCs) in patients with AD, but the quantitative changes in the retina of patients with AD compared with age-matched controls have not been examined. An important question is whether the lesion affects the macula, the area of highest visual acuity and the region of the greatest density of cone photoreceptor cells and RGCs. Additionally, it is unknown if patients with AD have a uniform thinning of cells in the ganglion cell layer (GCL) or if there is a differential loss of the medium to large-sized cells, as suggested earlier (Bassi et al. 1987) and documented histopathologically in some areas of the central nervous system of patients with AD (Kemper 1984). If patients with AD were to show a differential loss of large versus small RGCs with characteristic differences in density, distribution, central projections, and physiologic properties (see review by Rowe and Stone 1977), then a loss of the visual functions normally ascribed to these classes of mammalian RGCs might be expected. This quantitative study of the retinal lesions in the macula of patients with AD provides important data on the progression of the disease and may eventually be the basis for diagnostic procedures for assessing the severity of AD. PMID- 1776759 TI - Abnormalities of glucose metabolism in Alzheimer's disease. AB - In normoglycemic patients with either incipient early-onset or incipient late onset dementia of the Alzheimer type, the predominant disturbance consisted of a significant reduction in cerebral glucose utilization. Alterations in cerebral blood flow and oxygen consumption first occurred in late-onset dementia types. In advanced late-onset dementia, these parameters had decreased most severely. The calculated ATP production rate from glucose indicated a drastic loss of energy in all patients studied. As not all oxygen consumed by the brain was used for glucose oxidation, oxidation of substrates other than glucose (endogenous amino acids and free fatty acids) is assumed to minimize the energy loss from glucose. The possibility that the abnormalities in oxidative and energy metabolism in dementias of the Alzheimer's type are due to metabolic abnormalities in glycolytic glucose breakdown and pyruvate oxidation, rather than to an uncoupling of oxidative phosphorylation, is discussed. PMID- 1776761 TI - SPECT in early- and late-onset Alzheimer's disease. AB - We assessed with SPECT the influence of age of onset in Alzheimer's disease in patients who were matched for severity of disease with early and late onset of the disease. Twenty-six patients, severity-matched according to scores on Mini Mental State Examination, were compared to nine controls. Comparison of the temporoparietal cerebellar ratio (TPC) revealed a statistically significantly lower ratio in the early-onset group compared to the late-onset group of patients. These results are in agreement with other imaging, structural, and neurochemical studies, supporting the view of heterogeneity of Alzheimer's disease according to age of onset. PMID- 1776760 TI - Abnormalities of energy metabolism in Alzheimer's disease studied with PET. AB - Positron emission tomography (PET) is currently the only technology affording three-dimensional measurement of the brain's energy metabolism which is closely coupled to brain function. Studies of glucose metabolism by PET of (18F)-2-fluoro 2-deoxy-D-glucose are therefore widely applied to show the contribution of various brain structures in the performance of a variety of tasks or their participation in functional deficits associated with various diseases. Although glucose metabolism decreases slightly with age to a regionally different degree, most types of dementia show severe changes in glucose metabolism. Alzheimer's disease (AD) is characterized by metabolic disturbances most prominent in the parietotemporal association cortex and later in the frontal lobe, whereas primary cortical areas, basal ganglia, thalamus, brainstem, and cerebellum are not affected. It is this typical pattern that distinguishes AD from other dementia syndromes. A ratio calculated from the metabolic rates of glucose of "affected" and "nonaffected" brain regions was able to separate patients with AD from age matched controls and permitted the discrimination of patients with cognitive impairment of other origin in 85%. The discriminative power can be further improved by activation studies. A continuous visual recognition task increased the metabolic rate in normal subjects by 21% and in patients with AD by 6% on average, with significant regional differences. During activation the significant relation between severity of disease and temporoparietal metabolic rate became even stronger. In the assessment of effects of treatment on disturbed metabolism, PET studies demonstrated an equalization of metabolic heterogeneities in patients responding to a muscarinergic cholinagonist, whereas general increases in glucose utilization were observed with piracetam, pyritinol, and phosphatidyl-serine. The therapeutic relevance of such metabolic effects, however, must be proved in controlled clinical trials. PMID- 1776762 TI - Does cerebrovascular insufficiency contribute to Alzheimer's disease? AB - The differential diagnosis of vascular dementia (VD) and Alzheimer's disease (AD) based on clinical assessment and neuropsychologic testing is still associated with a relatively high degree of inaccuracy compared to neuropathology standards. This is especially true in the identification of mixed forms between AD and VD. The present study investigates the potential of neuroimaging methods in providing additional information in dealing with this problem. Magnetic resonance imaging (MRI) of the brain identified a relatively high percentage (39%) of patients with AD (with ischemia scores of 4 and less) with basal ganglia hyperintensities and also demonstrated basal ganglia lacunae and infarcts in some of these patients. These findings indicate that in these cases a vascular component, consistent with the mixed form of dementia, may contribute to the etiology of the disease. These findings also underscore the clinical usefulness of MRI in the further differentiation of the dementias. PMID- 1776764 TI - Specificity of functional changes during normal brain aging. AB - Although there is no question that age-related alterations in neural function occur in the central nervous system (CNS) of mammals, these changes tend to be somewhat circumscribed rather than completely global, even in pathological conditions. Examples of this kind of specificity of functional neural change are drawn from experiments on the electrophysiology of the senescent rat hippocampus. PMID- 1776763 TI - Aluminum, Alzheimer's disease, and the olfactory system. AB - In Alzheimer's disease, it has been recognized that there is a dramatic tendency for the development of neurofibrillary tangles among neurons of cortical regions associated with the olfactory system. We have demonstrated that neurofibrillary tangle-bearing neurons contain dramatically elevated levels of aluminum. The olfactory system, the only portion of the central nervous system with exposure to the external environment, is uniquely capable of uptake and transneuronal spread of exogenous substances. We argue that inasmuch as aluminum is not employed in any physiologic process, these deposits must arise from exogenous sources. Using parkinsonism-dementia complex of Guam as a model, we present data which suggest that the olfactory system is particularly vulnerable to damage and is affected very early in the disease. This supports the concept that etiologic agents of importance to this epidemic may be airborne in nature and may enter the central nervous system via the olfactory pathways. PMID- 1776765 TI - The synthesis of nerve growth factor and brain-derived neurotrophic factor in hippocampal and cortical neurons is regulated by specific transmitter systems. AB - Both nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF) exert neurotrophic actions on the cholinergic neurons of the basal forebrain nuclei. These neurotrophic factors are synthesized by hippocampal and cortical neurons that are located in the projection field of the basal forebrain cholinergic neurons. Both in vivo and in vitro the levels of NGF- and BDNF-mRNAs are increased up to 20-fold by kainic acid via non-NMDA glutamate receptors. Enhancement of the effectiveness of the GABAergic system by benzodiazepam or direct GABA agonists blocks the effect of kainic acid and reduces the basic levels of NGF- and BDNF-mRNAs. Whereas the increases in both NGF- and BDNF-mRNAs above normal levels are mediated by non-NMDA receptors, maintenance of the normal levels of NGF- and BDNF-mRNAs seems to be mediated predominantly by NMDA receptors. The regulation of NGF and BDNF synthesis via specific transmitter systems is discussed in the context of the refined tuning of synaptic functions, the potential implications for memory functions, and the possible therapeutic consequences for the treatment of Alzheimer's disease. PMID- 1776766 TI - Trophic factor effects on septal cholinergic neurons. AB - The role of trophic factors in the adult central nervous system (CNS) is poorly understood. One system that may require trophic factors, particularly nerve growth factor (NGF) and brain-derived growth factor (BDNF), for normal function in the adult CNS is the cholinergic projection from the basal forebrain to the hippocampus. To study the nature of this requirement we ablated target neurons in the hippocampus that normally produce NGF and BDNF; we found no loss of cholinergic neurons or cholinergic phenotype in the medial septum in young adult rats. In similarly treated aged rats (24-33 months), some reduction in cholinergic phenotype was found, in the absence of cell death for up to 90 days. Thus, these cholinergic neurons either do not require trophic support for survival, or are able to obtain trophic factors from other sources for the duration of the experiments. In vitro, NGF withdrawal from septal neurons initially grown in the presence of NGF did not result in the death of old cholinergic neurons in these tissue cultures but did result in a down-regulation of transmitter-associated enzymes, accompanied by cholinergic cell shrinkage and a reduction in fiber density. Together, these findings suggest that target derived factors may not be required for the survival of mature septal cholinergic neurons, but may be involved in maintenance of cholinergic and structural phenotype. PMID- 1776767 TI - Serum alpha-1 acid glycoprotein levels in acute idiopathic anterior uveitis. AB - Serum alpha-1 acid glycoprotein levels were measured in 56 patients with acute idiopathic anterior uveitis and 42 healthy subjects by a radial immunodiffusion method. The levels were found to be increased significantly in moderate and severe types of uveitis; they were normal in mild type. Serum alpha-1 acid glycoprotein levels closely paralleled the severity of the disease. The serum levels of this protein returned to normal after clinical improvement. PMID- 1776768 TI - Prognosis of keratoplasty in viral keratitis. AB - We reviewed 45 eyes with active or inactive herpetic keratitis that underwent penetrating keratoplasty. In Group I, 15 eyes underwent penetrating keratoplasty without prior optical iridectomy. In Group II, 15 eyes underwent penetrating keratoplasty after prior optical iridectomy. In Group III, 15 eyes underwent penetrating keratoplasty with pupilloplasty after prior optical iridectomy. Graft clarity of 3+ or more was obtained after one year in 67%, 33%, and 60% of eyes in Groups I, II, and III, respectively. Visual outcome of 6/24 or better was found in 53% of all eyes during the one-year follow-up. The occurrence of cataract both pre- and postoperatively could have been a result of prolonged use of corticosteroids and/or uveitis. Although there were several variables apart from preoperative vascularization and cataract, prior optical iridectomy was identified as a risk factor with regard to post-operative complications, final visual acuity, and graft clarity. PMID- 1776769 TI - Methicillin-resistant Staphylococcus aureus corneal ulcers. AB - Three patients with corneal ulcers had gram-positive cocci isolated on initial scrapings. There was no response to topical fortified aminoglycosides or cephalosporins. Cultures revealed methicillin-resistant Staphylococcus aureus that was sensitive only to topical vancomycin eye drops. Because the microbiologic spectrum is similar, vancomycin should be considered instead of a cephalosporin in the treatment of corneal ulcers to cover methicillin-resistant S. aureus and S. epidermidis. PMID- 1776770 TI - Flash visual-evoked potentials and flash electroretinography in the preoperative visual prognosis of eyes with cataracts. AB - This study evaluated the reliability of flash visual-evoked potentials and flash electroretinography in the prognosis of postoperative visual acuity after cataract extraction. We tested 94 patients with cataract in whom the preoperative visual acuity ranged from light perception to 3/10. On the basis of the electrophysiologic tests, we formulated three types of preoperative visual prognosis: high, intermediate, and poor. To assess the postoperative visual acuity, all subjects were followed for at least three months after cataract extraction. Visual acuity was subdivided in three arbitrary classes: less than or equal to 1/10, between 2/10 and 5/10, and between 6/10 and 10/10. Finally, we evaluated the reliability of our preoperative prognosis. Statistical analysis of our results (using the chi-square test) showed our predictions were highly significant for the total sample, revealing a strict correlation between our prognosis and the final visual acuity. PMID- 1776771 TI - Lid lag in hyperkalemic periodic paralysis. AB - We report the case of a patient with hyperkalemic periodic paralysis and lid lag. The myotonic origin of this rare finding is discussed. PMID- 1776772 TI - Clinical course of multifocal choroiditis: photographic and angiographic evidence of disease recurrence. AB - Multifocal choroiditis is a syndrome that simulates the presumed ocular histoplasmosis syndrome but, in addition, includes vitritis and anterior uveitis. Because of its relatively recent acceptance as a distinct clinical entity, there is little information available on the long-term natural history of this condition. We managed three cases of multifocal choroiditis with recurrent active inflammation. Two patients had new peripheral chorioretinal lesions in previously normal retina, and the other had both peripheral chorioretinal scars and new swelling of the disc. PMID- 1776773 TI - The nature, causes, and visual outcome of ocular trauma requiring posterior segment surgery at a county hospital. AB - Fifty consecutive, severe ocular trauma cases with posterior segment involvement underwent vitreoretinal surgery over a 14-month period at a county hospital. Forty-five (90%) of the patients were boys and men, and the mean age was 27 years. The injuries were the result of assaults in 37 cases (74%), industrial accidents in six (12%), accidents involving children at play in six (12%), and child abuse in one (2%). Twenty-five (50%) of the injuries were inflicted by firearms, by knives or sharp objects in ten (20%), by baseball bats in two (4%), by broken glass in two (4%), and unknown in 11 (22%). Twenty-six (52%) were penetrating injuries, of which eight were double perforations. There were ten (20%) intraorbital foreign bodies and three (6%) intraocular foreign bodies. Forty-three (86%) of the cases had initial visual acuities of 20/400 or worse. After a minimum of six months' follow-up, 48.8% improved two or more lines visually, and 69.4% were anatomic successes. Unlike other ocular-trauma studies, where industrial accidents and sports-related injuries were the most common causes of the trauma, assaults with firearms were the most common cause of ocular trauma at this county hospital. The visual and anatomic surgical results, however, were similar to those of other ocular-trauma studies. PMID- 1776774 TI - Two cases of cicatricial pemphigoid showing atypical immunofluorescent findings. AB - We describe two patients with the clinical symptoms of cicatricial pemphigoid (CP). Biopsy specimens of the conjunctiva were taken. Histologic examination revealed subepidermal bullae and infiltration of inflammatory mononuclear cells. Direct immunofluorescent study showed immunoglobulins bound to the basement membrane zone (BMZ) in these patients. The patients also had intercellular immunoglobulin deposition in the conjunctival epithelium. No circulating anti-BMZ antibodies were detected, but one patient had a circulating antiintercellular antibody. Rare cases of CP with atypical immunofluorescent findings are reported. PMID- 1776776 TI - [Relation between laboratory tests and densitometry values: characterization of the baseline profile in a perimenopausal population at anamnestic risk for osteoporosis]. AB - The relationship between usual laboratory indexes of bone metabolism and dual photon densitometry in perimenopausal women at anamnestic risk for osteoporosis are studied. One hundred and twenty five women, with one or more risk factors for osteoporosis, have been investigated by: plasma calcium, phosphorus, osteocalcin, ALP-bone-isoenzyme, PTH, and 24 hours urinary calcium and hydroxyproline, besides dual photon densitometry of lumbar spine. Laboratory indexes are indicated as "above normal values" and, within the range of normality, "at lower limits", "average values", and "at upper limits". More than 90% of patients show laboratory findings at the upper limits. Furthermore, 46% of them show both hydroxyproline greater than 20 mg/24 h and urinary calcium greater than 200 mg/24 h; 81.7% osteocalcin greater than 7.00 ng/ml and plasma calcium greater than 4.9 mEq/l; 87.9% osteocalcin greater than 7.00 ng/ml and urinary calcium greater than 200 mg/244; 86.4% densitometric values less than 0.700 g/cm2 and osteocalcin greater than 7.00 ng/ml. Our at risk population shows a wide agreement among the laboratory indexes, to indicate an increased bone metabolism. PMID- 1776777 TI - Bacterial interactions in the intestine of the newborn delivered by cesarean section. AB - The purpose of this study was to clarify the role of the intestinal anaerobic bacteria colonizing the intestine of the newborn delivered by cesarean section. Control of the intestinal microecology is dependent on many factors including intestinal peristalsis, the intraluminal environment, and microbial interactions, that deter the overgrowth of pathogens populations. Numerous factors help achieve this normal balance. The effect of feeding seems to induce bacteriological changes. PMID- 1776775 TI - [Spinocellular carcinoma of the vulva. Critical review of the surgical case histories from 1967-1989]. AB - A critical review of the surgical treatments performed during the years 1967 to 1989 in cases of squamous cell vulvar cancer at the 1st Department of Obstetrics and Gynecology of the University of Milan has been carried out. Two hundred and seventy cases of primary squamous cell vulvar carcinoma have been studied after a restaging according to recent FIGO recommendations. Depending on the type of surgical approach the early and late complications and the 5 year-cancer-related survival have been analyzed. The present investigation supports the importance of a complete and accurate surgical staging of vulvar carcinoma, particularly as far as it concerns the lymph nodes status. Thus, performing a node dissection in case of an invasive neoplasia is extremely important, not only for a precise staging but mainly for a prognosis formulation. In fact, 5 year cancer related survival dramatically falls from almost 90% to 25% in case of pelvic node metastasis. PMID- 1776778 TI - [Premature birth and perinatal mortality 1982-1988. I]. AB - The Authors analyzed the premature deliveries performed between 1982 and 1988 at the IV Clinica Ostetrica e Ginecologica of the University of Milan at the S. Gerardo Hospital, Monza, 1267 newborns out of 12507 were preterm. The rate was between 8.7 and 11.0% (average 9.8%). The early neonatal mortality is 10.6% (excluding malformed newborns, 8.3%), the late neonatal mortality is 12.7% (excluding malformed newborns, 9.8%). The early mortality is significantly lower starting from the 32nd week of pregnancy (35.4% vs 3.2%) and with a newborn's weight greater than 1500 grams (36.9 vs 3.2%). The early mortality is lower for females (8.4%) than for males (11.1%). In spite of other Authors, the early mortality is significantly higher than for AGA newborns (19.4 vs 7.9%). The causes of the early mortality are analyzed in detail. PMID- 1776779 TI - [Adenomyosis: trans-myometrial biopsy]. AB - Myometrial biopsies were taken on 45 women less than 40 years old either by laparoscopy or laparotomy, searching for adenomyosis "in vivo". A positive response of 5 cases (11.11%) may prove adenomyosis to affect significantly young women too and not to be closely connected with the usually reported pathogenetic factors. PMID- 1776780 TI - [Sex behavior and sexually transmitted diseases in drug-dependent women: study of 465 cases]. AB - 465 intravenous drug abuser (IVDA) women were studied to evaluate the prevalence of sexually transmitted diseases, 2207 university students have been considered as control group. A complete gynecological evaluation with Pap smear and cervico vaginal cultures were performed. Informations on sexual and behavioural patterns were collected using a standard questionnaire. IVDAs show early onset of sexual activity (15 vs. 18 yrs) and many sexual partners; just a small percentage of them use condom, efficacious in the protection against venereal diseases. These peculiar behavioural patterns and the immunodeficiency ascribable to the drug abuse may condition the high frequency of viral and bacterial infections of lower genital tract (53% vs 0.8% and 67% vs 10% respectively). Cervical intraepithelial neoplasia has been found significantly more frequently in IVDA women (16%) than in control group (1%) p less than .01. PMID- 1776781 TI - [Leishmania tropica in Morocco. IV--Intrafocal enzyme diversity]. AB - Ecoepidemiological analysis of a Moroccan focus of leishmaniasis caused by Leishmania tropica revealed considerable enzymatic diversity. Seven zymodemes belonging to the complex were identified in 149 strains isolated from humans, dogs, and the vector Phlebotomus sergenti. Three distinct subgroups were identifiable, two of which were in turn, composed of three "small variant" zymodemes. The diversity appears to be related to the age of the focus, which may have allowed colonization by zymodemes of different geographic origins. Diversification into "small variants" is apparently the result of recent mutation, possibly associated with genetic exchange. PMID- 1776782 TI - The murid filaria Monanema martini: a model for onchocerciasis. Part I. Description of lesions. AB - A study of the anatomo-pathological lesions induced by Monanema martini, a filaria with skin-dwelling microfilariae, was performed using 65 Lemniscomys striatus fixed from 30 minutes to 36 months after inoculation of the infective larvae, 5 Arvicanthis niloticus and 3 Meriones unguiculatus fixed during the patent phase, and controls. Attempts at quantification of lesions in L. striatus was made. Approximately 20% of L. striatus had microfilariae in the eyeballs, and many more presented ocular lesions. The delay of the patent period seems to have more effects on the gravity of lesions than repeated inoculations. The location of the lesions and parasites presuppose that microfilariae enter the eyeball through the lymphatic capillaries of the irido-corneal angles. Cutaneous lesions were often severe: there is a parallel between the importance of lesions and the abundance of microfilariae. Larvae are responsible for damage to various structures of the lymphatic system (thrombo-lymphangitis, acute or granulomatous lymphadenitis...) into which they migrate, explaining the mechanism of elephantiasis. These rodent lesions appear similar to those observed in human onchocerciasis and lymphatic filariasis. Whatever the M. martini stage and the organ examined, major lesions belonged to the inflammatory process. Various types of inflammatory reaction (acute, subacute, or chronic inflammation, scarring sclerosis etc.) can co-exist within a single tissue area. The accidental escape of a microfilaria from a lymphatic capillary into the connective tissue (including the corneal stroma) induces an inflammatory reaction. Thus M. martini, as human Onchocerca species, causes a chronic disease, associating recent lesions to old ones. PMID- 1776783 TI - Helminthfauna of Microtus (Microtus) cabrerae (Thomas, 1906) (Rodentia: Arvicolidae) in the Iberian peninsula: faunistic and ecological considerations. AB - Faunistic and ecological study of parasitic helminths of Microtus (Microtus) cabrerae (Thomas, 1906) (Rodentia: Arvicolidae) in the Iberian Peninsula. 70 specimens have been dissected, coming from 8 enclaves located in three Spanish provinces; 6 species of helminths have been detected (1 Digenetic Trematode, 4 Cestodes and 1 Nematode). Structure of helminthfauna of M. (M.) cabrerae in relation to remaining Iberian Arvicolids and the most conditioning ecological factors of the helminthfauna of the Rodent are analyzed. PMID- 1776784 TI - [Leishmania tropica in Morocco. III--The vector of Phlebotomus sergenti. Apropos of 89 isolates]. AB - In a Moroccan focus of cutaneous leishmaniasis caused by Leishmania tropica, 7,907 female sandflies captured with CDC traps were dissected from summer to autumn 1989. Among species of the genus Phlebotomus, only P. sergenti harbored promastigotes. Eighty-nine strains belonging to the complex L. tropica were isolated. The frequency of vector infection was zero in June, rose to 1.3% in August, and reached 9.9% in October, which indicates that the period of high risk is at the end of the hot season. Out of 89 strains isolated, 74 were completely typed and corresponded to the following four zymodemes: MON-102 (one strain), MON 107 (56 strains), MON-122 (two strains), and MON-123 (15 strains). Only the first two were observed in humans. The distribution of zymodemes MON-102 and MON-107 was very different in humans, dogs, and the vector. In one of the sites surveyed, which was strongly dominated by MON-107, the absence of human cases involving this zymodeme suggests the existence of a wild reservoir. PMID- 1776785 TI - [Role of radiotherapy in cancer of the ethmoid. Retrospective study of a series of 24 cases]. AB - From april 1978 to december 1988, 24 patients were treated were by radiotherapy at the Bergonie Foundation cases were for ethmoidal cancer cases. Twenty two for initial treatment and two refermed for local recurrence. The mean age was 51.4 years and the sex ratio was 5.2 (21 men/4 women). Histologically there were 15 adenocarcinomas, 3 squamous carcinomas, 4 undifferentiated carcinomas and 2 esthesioneuroblastomas. According to the classification of the University of Florida, they were retrospectively classified as stage I = 9 pts, stage II = 5 and stage III = 10. Twenty one patients had postoperative radiotherapy and 3 had exclusive radiotherapy. The average dose was 55.3 Gy. Local control was obtained in 12 pts. Seven patients have recurred locally (within an average period of 12 months) and 5 patients showed progression of disease after treatment. The overall actuarial survival and the disease free survival at 5 years were respectively 50% and 53%. The actuarial survival by stage at 2 years and 5 years was: stage I (88% and 61%), stage II (100% and 50%), stage III (0%). The prognosis of ethmoidal cancer is strictly correlated to local control. For this reason, radiotherapy (with or without surgery) remains important in the treatment of this disease. PMID- 1776786 TI - [Pleural involvements in thymoma. Apropos of 5 cases and review of the literature]. AB - The authors report five cases of pleural involvement in patients with thymoma. In 3 cases these sites were not directly related to the primary and in 1 case they constituted the first event in the disease. CT and MRI allow effective assessment of these pleural lesions ... provided this phenomenon, reported in the literature, is well known by the radiologist. PMID- 1776787 TI - [Duplex Doppler ultrasonography of intra-renal arteries. Normal and pathological aspects]. AB - Duplex Doppler ultrasonography may explore renal perfusion in frequent diseases such as renal obstruction, reno-vascular hypertension, acute or chronic renal failure or diabetic renal complications by measuring Pourcelot's resistive index (RI) of renal parenchyma arteries for each kidney. A statistical and prospective study was performed on 574 patients. In healthy patients, the RI values, equal for each kidney were included in 0.45 and 0.7 (mean RI = 0.59). For other values, there was a renal pathology. Patients with idiopathic hypertension (mean RI = 0.59) or non obstructive dilatation (mean RI = 0.61) did not have an RI significantly different from healthy patients. In cases of renal obstruction, there was a significant increase in the RI for the pathological kidney (mean RI of 0.73). The sensitivity and the specificity was 100% for acute obstructions examined during the first 48 hours. In contrast, in case of renal artery stenosis greater than 70% there was a significant decrease in the RI for pathological kidney. So the RI increased significantly in both kidneys: when there was renal failure with active disease within the tubulo-interstitial compartment (mean RI of 0.77); in all cases of diabetic nephropathy (mean RI of 0.74) where the RI increased early before laboratory signs. Duplex Doppler ultrasonography may be an original method for renal explorations by providing not only morphological data but also physiological data with the perfusion study. PMID- 1776788 TI - [Megacalyces or Puigvert's disease. Apropos of 2 cases]. AB - Megacalyces is an uncommon congenital urinary anomaly consisting of oversized calyces and a renal pelvis of normal caliber. The under development of the pyramids with lack of projection of the papillae into the calyces probably produces the dilatation of the calyces. The diagnostic criteria are the characteristic appearance of the calyces, the normal caliber of the pelvis and ureter, and the absence of vesico-ureteral reflux. Two cases of congenital megacalyces are presented. PMID- 1776789 TI - [Intradural hydatidosis of the thoracic spine. Apropos of a case]. AB - The authors report a case of subdural spinal hydatid cyst. A diagnostic error was responsible for a communication between the cavity and the arachnoid space during resection of the cyst. Despite of this incident no other site was detected in this patient. PMID- 1776790 TI - [Thrombosis of the aorta in newborn infants]. AB - The authors report a case of a neonate presenting with thrombosis of the abdominal aorta following catheterisation of the umbilical artery. The diagnosis was established by ultrasonography in a context of isolated anuria. Immediate disobstruction by Fogarty's method results in cure. PMID- 1776791 TI - [6 para-esophageal cysts. Discussion on their origins]. AB - Para-oesophageal cyst is a rare lesion which can be classified, by its origin, as a gastrointestinal duplication. It is mostly encountered in children. Since 1977, we have observed 6 cases in adults, and 5 out of 6 presented as postero-inferior mediastinal tumors. Pre-operative diagnosis is difficult: when the lesion is intramural, the only other diagnosis is leiomyoma; in other cases, a bronchogenic cyst or a posterior mediastinal enteric formation can be discussed. Surgical findings and histological criteria allow a precise definition of these cysts, which lie at least partially in the wall of the oesophagus. There was a histological association of respiratory mucosa and musculosa, either of type or associated with cartilaginous islets. The definition of the clinical classification is easier with a good knowledge of the histogenesis. PMID- 1776792 TI - [Desmoid fibroma of soft tissues of extra-abdominal site: review of the literature apropos of a case of a tumor situated at the posterior side of the thigh]. AB - The authors report a case of desmoid fibroma on the posterior surface of the thigh in a woman during the post-partum period. This is a rare site for this tumour. CT scan combined with MRI appears to be useful for diagnosis. Treatment is strictly surgical, but depends on the histological benign nature and the local malignancy. Surgery is generally conservative with risks of recurrence and occasionally amputation is necessary. PMID- 1776793 TI - [Intra-duodenal development of low choledochal diverticula. Apropos of 2 cases]. AB - Two cases of intraduodenal development of a low choledochal diverticulum were observed during the last ten years. Preoperative diagnosis of this biliary malformation is difficult. Clinical presentation consisted of chronic upper abdominal pain and high gastrointestinal obstruction, without either cholangitis or pancreatitis. In both patients, treatment consisted of resection of the diverticulum and suture of its neck via a transduodenal approach. The post operative course was uneventful and long-term follow-up (2 and 11 years) is satisfactory, showing that cure has been achieved by means of this simple and radical procedure. This particular biliary anomaly must therefore be distinguished from other diverticula of the common bile duct, because of its clinical presentation, diagnostic approach and treatment required. PMID- 1776794 TI - [Fractures-luxations of the Lisfranc joint. Apropos of 39 cases]. AB - Lisfranc fracture-dislocations are relatively rare (two per thousand). They generally occur in multiple trauma victims and may pass unnoticed. Open reduction followed by pinned osteosynthesis and plaster immobilisation ensures a good anatomical and functional result. PMID- 1776795 TI - [Physical and biophysical aspects of high energy intracardial electrical discharges. 4. Effects of fulguration beads in an isotropic diphasic medium]. AB - Study of the effects of fulgurating electric shocks on an isotropic protein gel more supple than ordinary myocardium provides better understanding of the mechanical effects of fulguration on biological tissues. With a shock and energy level of the type used clinically, a central crater is produced measuring 4 to 6 mm in diameter and a few millimetres deep, surrounded by a crown 30 mm in diameter. Damage due to the mechanical effects of fulgurating shocks is thus 3 to 15 times greater than the size of the electrode. The size of lesions is generally proportional to the energy level and is greater at the anode than cathode. It is also greater with impulses having a short rise time. When the electrode is almost parallel to the wall, the surface area of mechanical lesions is larger and more irregular and it is less deep than when the electrode is perpendicular to the gel. PMID- 1776796 TI - [Prognostic value of exercise angioscintigraphy in coronary disease]. AB - Multivariate survival analysis (MSA) was applied to 97 patients with coronary disease using the Cox model and a stepwise regression procedure. Seventeen variables including data based upon clinical examination, exercise testing (ET), and exercise angioscintigraphy (EAS) as well as coronary arteriography were studied in each patient. During the monitoring period (interval: 1-57 months), 38 patients sustained a cardiac event (recurrence of coronary disease or death). Neither resting left ventricular ejection fraction, nor coronary anatomy were significant prognostic variables. The only two variables identified by MSA were a variable of EAS: corrected ejection fraction at maximum exercise (p less than 0.008), and a variable of ET: maximum heart rate during exercise (p less than 0.03). This study shows that the prognosis of a coronary disease patient can best be assessed by two variables which are both exercise parameters. PMID- 1776797 TI - [Partial abnormal pulmonary venous return. An underestimated and unknown association in Turner-Ullrich syndrome. Presentation of an original case]. AB - The authors report the case of a 59-year-old woman with a complex cardiac lesion consisting of degenerative major mitral insufficiency masking partial abnormal pulmonary venous return. These cardiac abnormalities fell within a context of genetic disease since the patient had Turner's syndrome, confirmed at the age of 58 by a 45 x 0 karyotype. They detail the originality of the clinical manifestations of partial abnormal pulmonary venous return and review the literature concerning cardiac malformations in Turner's syndrome. PMID- 1776798 TI - [Dissecting aneurysm of the left iliac artery disclosing Marfan's disease]. AB - Marfan's syndrome only very rarely presents as a peripheral arterial complication. In the case described, dissection of the left iliac artery in a 52 year-old man presented as intermittent claudication of sudden onset and enabled the diagnosis of previously unrecognised Marfan's syndrome on the basis of great height, a dorsal kyphoscoliosis, a positive family history and aortic abnormalities. Treatment based upon vasodilators and platelet antiaggregation enabled a favourable outcome with frequent monitoring. PMID- 1776799 TI - [Torsades de pointes and prolongation of the duration of QT interval after injection of droperidol]. AB - Following a case of torsades de pointe (TDP) after the injection of droperidol (D), the authors studied the electrocardiographic variations caused by the drug. Fifty five unselected patients under the same conditions (general anesthesia) were given D (0.25 mg/kg IV). Significant prolongation of the QT interval was seen in 70% of cases by the end of the first minute. QT interval and the ratio of QTm (measured) over QTt increased from 387 +/- 34 ms to 423 +/- 37 ms (p less than 0.0001) and from 1.06 +/- 0.08 to 1.28 +/- 0.1 (p less than 0.001) respectively. These changes could favourise the onset of TDP. Although exceptional in terms of the extensive use of the neuroleptic in question, this possibility indicates the need for monitoring of the duration of QT before and during treatment with droperidol and for prescription of the drug to be avoided in circumstances known to be propitious to this arrhythmia (bradycardia, hypokalemia, anti-arrhythmic drugs). PMID- 1776800 TI - [Disseminated intravascular coagulation and chronic aortic dissection]. AB - The authors report a case of chronic dissection of the aorta discovered during the evaluation of disseminated intravascular coagulation. The first signs of bleeding occurred 4 years after the initial aortic trauma at the time of unclamping of the aorta during an aorto-coronary bypass. This case was characterised by the severity of coagulation abnormalities, the severe thrombocytopenia and that of platelet aggregation events. PMID- 1776801 TI - [Ventriculo-arterial malpositions with ventricular septal defect. Surgical indications]. AB - Cardiac anomalies with ventriculo-arterial malposition are defined as malformations in which the aortic and/or pulmonary rings are in abnormal relation with the atrioventricular rings. When a high ventricular septal defect is also present, resection of the conal septum enables the reconstitution of normal or close to normal anatomy, without tubal interposition. Experience based upon 188 operations leads us to suggest surgical indications based upon the positions of the aortic and pulmonary rings in relation to the atrioventricular valves. Creation of the left ventricle-aorta channel may require widening of a tight ventricular septal defect, or result in resection or tilting of the conal septum onto which the tricuspid is inserted. Otherwise, left ventricle-aorta passage will be made impossible by the interposition of a straddling mitral or of tricuspid insertions which come to be inserted around the aortic ring. If the pulmonary ring is in a high, normal, position, it will not interfere with fashioning of the left channel. If situated too low, it must be shifted and reimplanted on the right ventricle. Creation of the right ventricle-pulmonary artery channel depends upon the presence or absence of concomitant pulmonary artery hypertension. In the presence of pulmonary artery hypertension, devalvulation and hence pulmonary reimplantation is poorly tolerated and is therefore contraindicated. If the pulmonary ring is in a high position (tricuspid pulmonary distance of one normal aortic diameter for the child or more), partitioning without pulmonary displacement is the best solution.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1776802 TI - [Quantification of mitral valve diseases by Doppler]. AB - Echo Doppler makes a fundamental contribution to the non-invasive quantification of mitral valve disease. It enables calculation of gradients and of orifice surface area in mitral stenosis. The quantification of mitral insufficiency is also possible though more difficult: it is based upon the combination of semi quantitative and quantitative methods, in particular the calculation of regurgitation fraction obtained by comparison of flow rates at different orifices in cases of pure regurgitation. Finally, the calculation of pulmonary artery pressures from a Doppler record in tricuspid and pulmonary insufficiency can be used to assess the effects of mitral valve disease on the pulmonary circulation. Echo Doppler thus provides a reliable non-invasive hemodynamic assessment of mitral valve disease and should lead to a reduction in the number of invasive investigations in this type of valve disease. PMID- 1776803 TI - [Comparative efficacy of sustained release verapamil and captopril in mild to moderate arterial hypertension by ambulatory measurement and occasional measurement]. AB - The evaluation of mild to moderate hypertension must be carried out under the conditions in which treatments are usually prescribed, i.e., in general practice. After specific training of the physicians in the methods used, we evaluated the efficacy and safety of a new formulation of verapamil by comparing it with a reference drug: captopril. The main assessment criterion was the restoration of normal blood pressure in mildly to moderately hypertensive patients (blood pressure in excess of 160/95 mmHg). Blood pressure was evaluated by two methods: a mercury column sphygmomanometer, after the patient had rested in a half-sitting position for 10 minutes, and the ambulatory measurement of blood pressure (AMBP) using the SpaceLabs system. The results of this study involving 40 patients followed up for 3 months by 8 GPs in collaboration with our blood pressure unit were as follows: on verapamil, 47% of patients recovered normal values after 30 days of treatment and 71% after 60 days (with no change in dosage). On captopril, the normalization rates were 22 and 27% respectively. The highly significant reduction of blood pressure found by the "occasional" measurement for both treatments (p less than 0.001) was only faintly reflected by AMBP. Verapamil induced a reduction of nighttime blood pressure with no significant impact on heart rate. The clinical, paraclinical and electrocardiographic safety of both treatments was good. PMID- 1776804 TI - Growth, growth hormone and the somatomedins: a historical perspective and current concepts. PMID- 1776805 TI - A critical assessment of current analytical methods for the routine assay of serum total protein and recommendations for their improvement. PMID- 1776806 TI - Diagnosis of the abuse of magnesium and stimulant laxatives. AB - A reliable diagnosis of laxative abuse can only be reached by chemical analysis. We report a modified thin layer chromatography approach for the detection and confirmation of over-the-counter colonic stimulant laxatives. Potential interference by dietary and drug components chemically similar to anthraquinones was investigated and the method was found to be specific in this respect. The diagnosis of magnesium laxative abuse is more difficult since magnesium is a component of body fluids. By inducing diarrhoea with magnesium salts in volunteers we have established that the diagnosis can be made by measuring magnesium concentrations in stool water, with 30 mmol/L being an appropriate cut off concentration. PMID- 1776807 TI - Estimation of fetal lung maturity by assessment of lamellar body particle concentration. AB - The concentration of lamellar bodies expressed as the optical density at 700 nm in amniotic fluid samples was calculated after centrifugation of the samples to obtain the lamellar bodies in a relatively pure form. The lamellar body concentrations obtained were compared with lecithin-sphingomyelin (L/S) ratios from the same samples. The advantages of the method compared with the L/S ratio are discussed as is the dependence on total volume that the method shares with all other procedures which depend on the measurement of a single concentration. PMID- 1776808 TI - The determination of oxalate in urine and plasma by high performance liquid chromatography. AB - We describe a simple, sensitive assay for oxalate in urine or plasma. Acidified urine is pretreated by dilution with neutral phosphate buffer and passage through a C18 cartridge. Stabilized plasma is diluted with neutral acetate buffer and oxalate extracted using a strong anion exchange cartridge. Treated samples are applied to an ion-paired chromatographic system and oxalate detected electrochemically. Recovery of oxalate from augmented samples exceeded 97% from both urine and plasma. Within- and between-assay coefficients of variation assessed at three concentrations were, respectively, better than 4.1% and 8.4% for urine and 3.9% and 5.2% for plasma. The reference range for urinary oxalate excretion is 109-497 mumols/24 h. The range for plasma oxalate concentration is 0.6-2.8 mumols/L or 0.7-3.9 mumols/L after an overnight fast or without dietary restriction, respectively. Urine and plasma oxalate concentrations from this method, gave correlation coefficients (r) of 0.97 and 0.98, respectively, when compared with those from established oxalate oxidase based assays. PMID- 1776809 TI - A broad spectrum immunoassay using fluorescence polarization for the detection of amphetamines in urine. AB - Rapid immunoassays are widely used to screen for amphetamine abuse. Broad spectrum immunoassays are the most useful for this purpose followed by physicochemical techniques for verification and identification of particular drugs. We describe the production of an antiserum with a broad specificity for the amphetamine group of drugs. The antiserum was produced in a sheep using an immunogen linking amphetamine to keyhole limpet haemocyanin via an N-aminobutyl bridge. This antiserum was used to develop a fluorescence polarization immunoassay for application to urine samples. A limited investigation into the use of saliva as an alternative sample was also performed. The effects of chemical modifications to the basic amphetamine structure on antibody binding are discussed. PMID- 1776810 TI - Plasma C1 inhibitor in malignant diseases: functional activity versus concentration. AB - Plasma C1 inhibitor (C1-INH) was determined in 64 patients with different malignant diseases and in 58 healthy persons. C1-INH antigen concentration was measured by radial immunodiffusion (RID), whereas its functional activity was assayed with chromogenic substrate. Within-run and day-to-day precision of both methods were good, with CVs ranging from 3.6 to 5.4%. Plasma C1-INH antigen concentrations were significantly higher in the patients than in healthy controls (P = 4.0 x 10(-3)), as were their C1-INH functional activities (P = 3.5 x 10( 3)). C1-INH activities obtained in the patient plasma samples were in correlation with their antigen concentrations (r = 0.914), showing that C1-INH synthesized in malignant disease was functional. However, the specific activity of the C1-INH (functional activity/antigen concentration ratio) was significantly lower in the patient group as compared with the controls (P = 2.1 x 10(-6)), indicating partial inactivation of plasma C1-INH in malignant diseases. The C1-INH specific activity in patients was inversely proportional to its antigen concentration. PMID- 1776811 TI - Apolipoprotein E phenotyping: a word of caution. AB - Using two different techniques, phenotyping and genotyping, we have studied allelic variation at amino acids 112 and 158 of the apolipoprotein E gene locus in 52 patients with insulin-dependent diabetes and in 58 non-diabetic controls. Phenotypes were determined by isoelectric focusing and immunoblotting of delipidated, neuraminidase-treated plasma. Genotypes were determined by using the polymerase chain reaction to amplify a 227 base pair fragment of the apolipoprotein E gene spanning both allelic sites. This was then digested with the restriction endonuclease CfoI and the alleles identified by polyacrylamide gel electrophoresis. Discrepancies between phenotype and genotype were observed in 16 (15%) of the individuals studied, 7 (13%) in the diabetics and 9 (17%) in the controls. From these results it is concluded that isoelectric focusing can lead to the erroneous assignment of apolipoprotein E phenotype even after pretreatment with neuraminidase. It is suggested that genotyping by DNA analysis is the method of choice in determining apolipoprotein E status. PMID- 1776812 TI - Collection and storage of capillary blood in glass fibre filters for glycated haemoglobin measurement by a microcolorimetric method. AB - A filter method for collection and storage of capillary blood spots for glycated haemoglobin (gHb) has been developed. Glass fibre filters (GFB) impregnated with 0.8 M boric acid were used to collect and store capillary blood. Haemoglobin from the dried blood spots was eluted into water and determined by Drabkin's method, while gHb in the eluates was determined by the microcolorimetric method. The intraassay coefficients of variation (CVs) were 4.5, 4.5 and 3.1% at 882, 1101 and 1704 pmol HMF/mg Hb, respectively. The corresponding inter-assay CVs were 8.6, 8.6 and 6.3%, respectively. A total of 63 paired capillary and venous blood samples were measured by both the direct and GFB method. The GFB method showed excellent correlation with the direct method (r = 0.948 and r = 0.994) after 7 and 14 days' storage at room temperature. The GFB method will enable prior collection and postage of blood samples by patients. PMID- 1776813 TI - The relative clotting activity of glycated and non-glycated forms of fibrinogen. PMID- 1776814 TI - Equilibrium dialysis free T4: an evaluation of its clinical usefulness as a supplementary test in the routine laboratory. PMID- 1776815 TI - Biological variation of urinary oxalate in different specimen types. PMID- 1776816 TI - Measurement of creatinine in peritoneal dialysis fluid. PMID- 1776817 TI - Creatine kinase in diagnosis of myocardial infarction. PMID- 1776818 TI - Alkaline phosphatase and rickets in the premature infant. PMID- 1776819 TI - Hypertonic versus isotonic salt bridges in ion-selective electrode based clinical analysers. PMID- 1776820 TI - Biological markers of dietary intake, with emphasis on fatty acids. AB - The level of certain polyunsaturated fatty acids in body fluids or tissues can be a valid indicator of their consumption in man. In 59 housewives studied over a 2.5-year period we found a correlation of 0.70 between the intake of linoleic acid, assessed as the mean of nineteen 24-hour recalls, and the level in fat tissue [Van Staveren et al.: Am J Epidemiol 1986; 123:455-465]. In 58 adult men supplemented with fish oil capsules for 1 year, the rise of eicosapentaenoic acid levels in erythrocyte membranes was strongly and specifically related to the rise in intake. We conclude that epidemiological studies of the role of these fatty acids in health and disease could fruitfully employ these markers of dietary intake. PMID- 1776821 TI - Effect of dietary avocado oils on hepatic collagen metabolism. AB - The effect of various avocado and soybean oils on collagen metabolism in the liver was studied in growing female rats for 8 weeks and in day-old chicks for 1 week. In comparison with rats fed either refined avocado oil, refined or unrefined soybean oils, rats fed unrefined avocado oil showed a significant decrease in total collagen solubility in the liver, while there were no changes in total collagen, protein and moisture content. Chicks fed unrefined avocado oil as compared to those fed refined avocado oil also showed a decrease in hepatic total soluble collagen while hepatic total collagen remained unaffected. Electron micrographs and light-microscope examinations of rats' liver revealed collagen accumulation in the periportal location. This is suggestive of the early stages of fibrosis. PMID- 1776822 TI - Effect of dietary treatment on the lipid, lipoprotein and fatty acid compositions in type IV familial hypertriglyceridemia. AB - The effects of a 2-month dietary treatment (1,625 +/- 177 kcal, 40 +/- 2.3% carbohydrate, 35 +/- 3.7% fat, 25 +/- 2% protein, polyunsaturated/saturated fat ratio = 1.02 +/- 0.06) on the overall composition of serum lipids, lipoproteins and the fatty acid composition of cholesterol esters and phospholipids in very low (VLDL), intermediate (IDL), low (LDL) and high (HDL) density lipoprotein in 5 patients with primary familial hypertriglyceridemia type IV were assessed. The data were compared with those for 9 normolipidemic subjects. Treatment decreased serum triglycerides (-52%) and total cholesterol (-12%) due to decrease in free cholesterol (-30%). It produced a significant decrease in all the constituents of VLDL (-58%), but the VLDL remained significantly higher after treatment than those of control subjects. The diet caused a decrease in triglycerides (-16%, 29% and -33%, respectively), and an increase in cholesterol in IDL, LDL and HDL. The IDL level in the treated patients remained significantly higher than in the controls. The LDL cholesterol/HDL cholesterol ratio was unchanged after treatment. The fatty acid compositions of the patients before treatment and the controls were not significantly different. The diet caused a decrease in palmitoleic and oleic acids in the cholesterol ester fraction and an increase in linoleic acid, but this was significant only in VLDL and HDL. The diet decreased the eicosapentaenoic acid but the drop was only significant in IDL and LDL. There was also a decrease in linolenic acid, only significant in IDL. The diet induced only minor changes in the phospholipid fractions. We concluded that a single nutritional regimen can effectively decrease the serum lipids and normalize the lipoprotein composition of type IV hypertriglyceridemic patients. PMID- 1776823 TI - Obesity, diet and body temperature. AB - Studies conducted thus far on the pathogenesis of obesity have not clearly determined the role of body temperature in the energy balance. In an attempt to explore this relationship further, research has been undertaken, a part of which is represented by the present investigation carried out on 22 adult males: 11 having a BMI less than or equal to 25 (group A) and 11 with BMI greater than 25 (group B). Body temperature was measured by mouth and on the skin surface (in 4 points according to Ramanathan) on 2 consecutive days (every 30 min from noon to 6:30 p.m.), the 1st day with the participants fasting and the 2nd day after consumption of a meal whose energy content represented a part (45%) of the 24 hour energy intake of the subjects, as previously ascertained by a survey of their food consumption. The study was carried out under frequently checked microclimatic conditions. During the week prior to the measurements, the alimentary consumption of the subjects was monitored by direct weighing for 5 consecutive days. A significant rise in body temperature, probably due to dietary thermogenesis, was observed in group A (internal temperature: F = 13.05; skin temperature: F = 6.48) as well as in group B (internal temperature: F = 24.88; skin temperature: F = 5.35) after the meal. However in group B the skin temperature showed a smaller increase than in group A (delta t degree 0.31 vs. 0.49) and an earlier trend towards the basal values (nearly 5 vs. 6 h after the meal). In both groups a decrease in the skin delta t degrees is evident at 3 and 3.5 h, respectively, after the meal, followed by a more remarkable increase in this difference between the 4th and the 5th hour. The meaning of this decrease as well as the difference in body temperature versus caloric intake is discussed. Normal weight individuals demonstrated a positive correlation (r = 0.83) between usual caloric intake per square meter of body surface and fasting internal body temperature. This correlation was not observed in subjects with BMI greater than 25. PMID- 1776824 TI - Selected nutrient intakes of middle-aged men in southern Germany: results from the WHO MONICA Augsburg Dietary Survey of 1984/85. AB - In the WHO MONICA Augsburg survey of 1984/85 dietary intake was assessed in an age-stratified cluster sample of 899 men aged 45-64 years by 7-day records. The mean energy intake was 2,609 kcal (10.9 MJ), 15.9% of which came from protein, 38.1% from fat, and 36.6% from carbohydrate. A remarkably high proportion of 9.4% was derived from alcohol. Saturated fatty acids accounted for 14.6% of total energy, monounsaturated fatty acids for 13.2% and polyunsaturated fatty acids for 5.2%. The results showed that current dietary habits do not conform with the national nutritional guidelines. PMID- 1776825 TI - Bioavailability assessment of the lipophilic benfotiamine as compared to a water soluble thiamin derivative. AB - The bioequivalence of thiamin in 2 therapeutically used preparations was tested in 10 healthy young men. Thiamin was orally administered either as lipophilic benfotiamine or as water-soluble thiamin mononitrate. Biokinetic data, measured as area under the curve and maximal concentration in plasma and hemolysate after ingestion, demonstrated a significantly improved bioavailability from the lipophilic derivative despite an ingested dose of only 40% as compared with the water-soluble salt. A superior cellular efficacy of benfotiamine was also concluded from the short-term stimulation of the thiamin-dependent transketolase activity in erythrocytes. PMID- 1776826 TI - Effects of oral ribose on muscle metabolism during bicycle ergometer in AMPD deficient patients. AB - Three patients with AMP deaminase deficiency (AMPD deficiency) performed exercise on a bicycle ergometer with increasing work load without and with administration of ribose (3 g p.o. every 10 min, beginning 1 h before exercise until the end). The patients performed exercise until heart rate was 200 minus age. Maximum capacity was not increased by administration of ribose, but postexertional muscle stiffness and cramps disappeared almost completely in 2 of 3 AMPD-deficient patients. Plasma concentrations of lactate and inosine were increased in AMPD deficient patients after oral administration of ribose. Our data suggest that ribose may both serve as an energy source and enhance the de novo synthesis of purine nucleotides. PMID- 1776827 TI - Effects of long-term administration of acetaminophen on the nutritional utilization of dietary protein. AB - The effect of long-term administration of acetaminophen to rats on the dietary protein utilization was investigated using protein-sufficient and protein deficient diets. Fat digestibility, food efficiency and some hepatic parameters were also determined. Results showed that there was a significant decrease in the nitrogen metabolic utilization in the protein-sufficient treated animals compared to the untreated group (0.59 +/- 0.03 vs. 0.75 +/- 0.03, p less than 0.001). The protein-deficient diet and the administration of the drug resulted in lower nitrogen metabolic utilization in either of the two metabolic balances (days 4-11 and 36-42). These changes were not accompanied by variations in the nitrogen digestibility coefficient. PMID- 1776828 TI - Hyperthermia potentiates the cytotoxic activity of 1-hexylcarbamoyl-5 fluorouracil in sarcoma-180 cells and human malignant tumor cells. AB - The sunergic effects on sarcoma-180 (S-180) cells and on human malignant tumor cells between 1-hexylcarbamoyl-5-fluorouracil (HCFU), a lipophilic masked compound of 5-fluorouracil (5-FU), and hyperthermia were investigated. After the S-180 cells had been exposed to 77 microM of the drug for 3 days, with or without heat (43 degrees C) treatment for 2 hr, the succinate dehydrogenase (SD) activity was assayed to determine cell viability. The SD activity of S-180 cells treated with HCFU combined with heat decreased to about 7.8% of findings in the control cells. When the S-180 cells were implanted in a pad of the left posterior inferior foot of a mouse, the size of the tumor markedly decreased in case of exposure to HCFU and heat, compared with findings in other groups. Body weight of the mice remained stable after these procedures. Decrease in the SD activity of 6 human gastric cancers and 7 colorectal cancers exposed to HCFU combined with heat was compared with findings in the other groups. The SD activity markedly decreased when the cells were exposed to HCFU combined with heat. These results suggest that HCFU plus hyperthermia treatment is effective in the host with a malignancy and that the toxicity is minimal. PMID- 1776829 TI - Increased expression of the proto-oncogene, c-myc, in human neuroblastoma cells by reversible inhibition of cell growth. AB - Expression of the proto-oncogenes N-myc and c-myc in the human neuroblastoma cell line, IMR32, was examined after reversible inhibition of DNA synthesis by treatment with deferoxamine. After 48 h treatment with 10(-5) M deferoxamine, the number of c-myc expressing cells doubled, while N-myc expressing cells did not change. The expression level of c-myc in each cell also increased. These results suggested that the synthesis of cellular factor(s) involved in the degradation of c-myc RNA or its product was suppressed by reversible inhibition of cell growth. The regulatory mechanisms of expression of N-myc and c-myc may be distinct. PMID- 1776830 TI - Involvement of p53 gene in the allelic deletion of chromosome 17p in human ovarian tumors. AB - Previous reports have shown that one copy of the chromosome 17 was frequently lost in human ovarian cancers (1). The position of the allelic deletion has not been mapped and involvement of p53 gene has not been determined. In this study, we have shown that in human ovarian carcinoma, the commonest region of allelic loss in chromosome 17p is 17p 13.3 (65%) and 17p13.1 (63.7%; 6 out of 9 informative cases). Allelic loss was also observed at region 17p12 - 11.1 but at a lower frequency (38.6% to 37.5%). The pattern of allelic loss of p53 gene was consistent in both primary and secondary metastatic tumors of the same patient. No gross rearrangement of p53 was however observed at the remaining allele using Southern blot analysis. Allelic loss of p53 gene was closely associated with 17p 13.3, the terminal portion of chromosome 17p. The high frequency of allelic loss of p53 gene in ovarian carcinomas conformed with recent findings in cancers of colon, breast, lung and brain suggesting inactivation of p53 gene play a rate limiting step in pathogenesis of human malignancies. PMID- 1776831 TI - The role of ethanol in oncogenesis of the upper aerodigestive tract; inhibition of DNA repair. AB - When cells of four lymphoblastoid lines were pulse treated with bleomycin for 10 min and reincubated in control medium or medium containing 0.5% ethanol, the frequencies of chromatid breaks steadily dropped as incubation time increased. At 5 hr after the pulse, the break/cell rate was reduced to a level slightly higher than that of the untreated cell populations. When the cells were reincubated in medium containing 2% ethanol, the chromatid breakage rates remained high throughout the 5-hr period. Apparently DNA repair processes were inhibited by 2% ethanol. However, this inhibition phenomenon could be reversed when ethanol was removed from the growth medium. The finding that ethanol inhibits DNA repair helps explain why ethyl alcohol has been regarded as a cocarcinogen in head and neck cancers. PMID- 1776832 TI - Antitumor effect of pyridoglutethimide, an aromatase inhibitor, on 7,12 dimethylbenz(a)anthracene-induced mammary tumors of rat. AB - The antitumor effects of pyridoglutethimide (PG; 3-ethyl-3-(4-pyridyl) piperidine -2, 6-dione), a new analogue of aminoglutethimide (AG), were examined in rats with DMBA-induced mammary tumors. On the day following ovariectomy, the DMBA treated rats were divided into four groups. The rats in each group (n = 25) received testosterone (20 mg/kg/day) or testosterone (20 mg/kg/day) with PG or AG (50 mg/kg/day) daily 6 times per weeks for 4 weeks; tumor volume was measured once weekly. Mammary tumors were dramatically increased after the administration of testosterone. However, in the rats receiving PG or AG simultaneously with testosterone, the tumors were significantly reduced with decrease of serum estradiol levels. Thus PG may suppress the growth of estrogen-dependent mammary tumors. PMID- 1776833 TI - Application of anti-sialyl Lea monoclonal antibody, KM231, for immunotherapy of cancer. AB - A mouse monoclonal antibody (MoAb), KM231 raised against human gastric cancer was found to recognize sialyl Lea -epitope expressed on glycoprotein and glycolipid with high affinity. KM231 reacted with many human gastrointestinal cancer tissues and could detect the antigen shed in sera of cancer patients. The present study was designed to evaluate competence of KM231 for immunotherapy of cancer. We first confirmed that KM231 could probe the cancer cells in vivo by injecting biotinylated KM231 into nude mice bearing human colorectal carcinoma cell, SW1116. Light- and electron-microscopic examination showed that the MoAb was localized in the tumor tissues and bound to the plasma membrane and cytoplasmic endosomes. Imaging studies with 125I-labeled KM231 revealed specific localization of the antibody in SW1116 tumors transplanted into nude mice. From Scatchard analysis of KM231 binding, the number of KM231 molecules bound to per SW1116 cell was calculated approximately 1.9 x 10(6) and the association constant was 1.3 x 10(8) liter/mol. We made KM231-ricin A chain immunotoxin for evaluating the tumoricidal effect of KM231. The immunotoxin exerted strong cytotoxicity toward sialyl Lea-expressing tumor cells specifically in vitro, but not toward sialyl Lea non-expressing cells. The in vivo tumoricidal effect of the immunotoxin was examined on ascites and subcutaneous xenograft tumors in nude mice. Three intraperitoneal injections of the immunotoxin (1.6 x 10(-6) mol) into nude mice bearing SW1116 ascites tumor resulted in extension of survival by 204% compared with controls. Further, repeated intraperitoneal administration of the immunotoxin (1.4 - 2 x 10(-6) mol) significantly inhibited the growth of established subcutaneous tumor (ratio of tumor inhibition = 0.7 - 0.54). These results indicated that KM231 has the ability to probe sialyl Lea-expressing tumor cells in vivo with high efficiency and to become tumoricidal drug when it conjugated with cytotoxic reagents like ricin A chain. PMID- 1776834 TI - Breast cancer cell kinetics: immunocytochemical determination of growth fractions by monoclonal antibody Ki-67 and correlation with flow cytometric S-phase and with some features of tumor aggressiveness. AB - In operable breast cancer, cell kinetics can be utilized in the prediction of the clinical outcome of patients. The discovery of monoclonal antibodies recognizing antigens related to cell proliferation has permitted the assessment of cell kinetics by rapid and practical immunocytochemical methods. It is claimed that the Ki-67 mouse monoclonal antibody recognizes an antigen expressed in proliferating cells but not present in quiescent (G0) cells. To study the relationship between Ki-67 score and DNA flow cytometric S-Phase Fraction (SPF), the latter being one of the most widely used methods to assess cell kinetics, we compared these two techniques of measurement in 122 breast carcinomas using both for each specimen. In this series 90% of tumors were Ki-67 positive, with a median value of 7.5% (range 1% to 70%). DNA flow cytometric analysis revealed that 69 tumors (57%) were aneuploid, whereas 53 were diploid. The median SPF value was 8% for diploid and 15% for aneuploid tumors (range 2% to 32%). Ki-67 scores were significantly higher in the DNA aneuploid compared to the diploid carcinomas (p = 0.015). Overall, a good correlation was found between Ki-67 and SPF values both in diploid (r = 0.60) and in aneuploid (r = 0.38) tumors. High Ki 67 scores were associated with the presence of axillary lymph node metastases (p = 0.0023) and poor histologic differentiation (p = 0.0028). Menopausal status, tumor size and peritumoral vessel invasion were unrelated to the Ki-67 score. Over-expression of the Epidermal Growth Factor receptor (EGF-r) and the c-erbB-2 oncogene were not correlated with Ki-67 staining. In conclusion, in this study Ki 67 immunostaining correlated with other indices of cell proliferation (SPF and Grade) and with some features of tumor aggressiveness (DNA aneuploidy and lymph node metastases) but seemed to be independent of some biological markers (EGR-r and c-erbB-2). Since the major objective for assessing proliferative status in Stage I-II breast carcinoma is to determine prognosis, it will have to be evaluated whether the determination of the Growth Fraction has comparable or even greater prognostic value than other cell kinetics markers. PMID- 1776835 TI - Dialysable factors from human leukocyte extracts activating human NK cytotoxicity against tumor cells: identification of factor-producing leukocyte subpopulations. AB - Dialysable human leukocyte extracts (10 kDa molecular weight cutoff) contain at least three cytotoxicity-stimulating factors CySF-L1, CySF-L2 and CySF-L3, activating natural killer (NK) cytotoxicity of human peripheral blood mononuclear cell (PBMC) against tumor cells when PBMC were pre-incubated with the factors for 72h prior to cytotoxicity assays. The factors could be separated by ion exchange chromatography on Dowex 50WX2. The leukocyte subpopulations producing these factors could be identified: CySF-L1 was detected in granulocyte extracts and T lymphocyte extracts, CySF-L2 in granulocyte extracts and monocyte extracts, CySF L3 in T lymphocyte extracts and in B lymphocyte/NK cell extracts. All three factors were also present with low concentrations in fresh human plasma. The effector cells activated during pre-incubation of PBMC with the factors were partly identical: CySF-L1 and L2 activated the NK cytotoxicity of monocytes and of NK cells whereas CySF-L3 only stimulated the cytotoxicity of NK cells. All three factors stimulated LAK-like cytotoxicity since the effector cells showed enhanced activity not only against standard NK targets like K562 tumor cells but also against NK-insensitive targets like DAUDI cells and HT29 tumor cells. PMID- 1776836 TI - Hypercalcemia associated with adenocarcinoma of the rectum. A case report and review of the literature. AB - Hypercalcemia is a well described complication of cancer both in solid tumor and hematologic malignancies. Metastatic adenocarcinoma of the rectum has not been reported to be associated with hypercalcemia. We report a case of a patient with metastatic adenocarcinoma of the rectum to the liver with hypercalcemia. Evaluation for other causes of hypercalcemia was negative. We suggest that adenocarcinoma of the rectum can lead to the development of hypercalcemia. PMID- 1776837 TI - Binding of aflatoxin B1 to DNA inhibited by ajoene and diallyl sulfide. AB - Components of garlic have been shown to inhibit a variety of tumors induced by chemical carcinogens. In this study we determined the effects of ajoene and diallyl sulfide (DAS), two organosulfur compounds of garlic, on the metabolism and DNA binding of aflatoxin B1 (AFB1) using rat liver 9000Xg supernatant as the metabolic activation system. Organosoluble and water-soluble metabolites of [3H]AFB1 were isolated by reverse-phase high performance liquid chromatography (HPLC). The effects of ajoene and DAS on glutathione-S-transferase (GST) were determined using 1-chloro-2,4-dinitrobenzene as the substrate. Ajoene and DAS at 100 mg/ml inhibited [3H]AFB1 binding to calf thymus DNA and adduct formation. They decreased the formation of both organosoluble and water-soluble metabolites of [3H]AFB1. Neither compound significantly affected GST activity. These results indicate that ajoene and DAS affected AFB1 metabolism and DNA binding by inhibiting phase I enzymes and may therefore be considered as potential cancer chemopreventive agents. PMID- 1776838 TI - Survival in breast cancer and age at start of oral contraceptive usage. AB - In general, findings in studies on oral contraceptives (OCs) and breast cancer have not indicated prognosis to be worse among users of OCs. In few studies, however, has age at the start of OC usage been considered as a prognostic factor. In the present study, prognosis in breast cancer is compared with OC usage, particularly with age at the start of OC usage, among 193 consecutive patients at the Department of Oncology, University Hospital, Lund. An earlier series of 193 breast cancer patients at Malmo General Hospital is included for comparisons. In the Lund series, five-year survival was 62% among women who started to use OCs before the age of 20.78% among those who started to use OCs between the ages of 20 and 25, and 86% among non-users and those who started to use OCs after the age of 25 (p = 0.009, test for homogeneity). Although age was found to be a prognostic factor in the Lund series (RR = 0.90, p = 0.001), this was not so in the earlier (older) Malmo series. The relationship with age differed significantly between the two series (p = 0.003), suggesting the apparent effect of age at diagnosis to be a cohort effect due to the introduction of OCs during the 'sixties. The age-specific relationship between survival and OC usage would seem to indicate the presence of a biological mechanism in which OCs may participate during precancerous and early stages of breast cancer. PMID- 1776839 TI - Biodistribution of iodine-125 and indium-111 labeled OV-TL 3 intact antibodies and F(ab')2 fragments in tumor-bearing athymic mice. AB - The monoclonal antibody OV-TL 3, directed against an ovarian carcinoma-associated antigenic determinant, was tested as a vehicle for radioimmunolocalization of ovarian carcinomas in athymic mice bearing NIH:OVCAR-3 xenografts. The biodistribution of intact. OV-TL 3 was compared with the distribution of OC 125. Tumor uptake with OV-TL 3 was significantly higher than with OC 125, and almost 7 times higher than with a non-specific control antibody (OV-TL 19). Administration of a mixture of intact OV-TL 3 and OC 125 did not improve tumor uptake in comparison with OV-TL 3 alone. Subsequently, intact OV-TL 3 and its F(ab')2 fragments were labeled with either 111In or 125I. The highest tumor uptake was obtained with 111In-labeled intact OV-TL 3 (14.7% ID/g, 48 hr p.i.). For both antibody forms uptake of 111In in liver, spleen and kidneys was very high. Furthermore, 111In cleared more slowly from most tissues than 125I. As a result, tumor/tissue ratios with 111In-labeled OV-TL 3 were lower than with 125I-labeled OV-TL 3. The highest tumor/tissue ratios (6.9 to 53) were obtained with 125I labeled OV-TL 3 F(ab')2 fragments, 48 hr post injection. 111In-labeled OV-TL 3 F(ab')2 has already been shown to be a clinically useful label for the detection of ovarian cancer. The results of our comparative animal study suggest that these clinical results may even be improved by using 123I-labeled OV-TL 3 F(ab')2. PMID- 1776840 TI - Changes in biochemical laboratory investigation in patients treated with constant infusion recombinant interleukin-2. AB - Eight patients with metastatic hypernephroma were treated with constant infusion recombinant Interleukin-2 (rIL-2), changes in renal and hepatic function and protein levels were monitored during 2 cycles of treatment. The rIL-2 infusion caused a reversible fall in ures and a non-reversible rise in creatinine. Liver function tests (bilirubin, ALT, ALP and GGT) rose during rIL-2 treatment and had returned to pretreatment levels 3 weeks after the last day of rIL-2. There was also a reversible fall in serum protein levels during rIL-2 infusion. Although constant infusion rIL-2 ameliorated much of the severe toxicities usually seen with high-dose bolus rIL-2, the non-reversible rise in serum creatinine levels is not a previously reported feature of rIL-2 therapy. PMID- 1776841 TI - Sp1 specific binding sites within the human H-ras promoter: potential role of the 6 bp deletion sequence in the T24 H-ras1 gene. AB - Transcriptionally active domains have been identified and located within the 5' region of the human normal and mutant T24 H-ras1 promoters, and have been characterised by linkage to the coding sequences of the bacterial chloramphenicol acetyltransferase (CAT) gene or by using DNaseI foot-printing analysis of the promoter sequence. It has been shown, using the latter method, that Sp-1 transcription factor binds to six GC sequences within the H-ras promoter. In the present study we have used unfractionated nuclear protein preparations from HeLa cells and a gel retardation assay to analyse specific binding of nuclear protein preparations from HeLa cells and a gel retardation assay to analyse specific binding of nuclear factors to several oligonucleotide sequences of the human H ras1 promoter. Our data demonstrate the presence of three Spl specific binding sequences in the T24 promoter, one of them containing a Sp-1 consensus GGCGGC absent in the normal H-rasl promoter. PMID- 1776842 TI - Endometrial hyperplasia following estrogen treatment without the addition of gestagen. A follow-up study after withdrawal of estrogens. AB - From December 1980 to February 1991 24 patients with endometrial hyperplasia after estrogen treatment were followed-up at the Department of Obstetrics and Gynecology, University Hospital, Lund, Sweden. All were referred for post menopausal bleeding. They were followed-up with abrasio three and nine months after the initial diagnosis. Seven patients demonstrated cystic glandular hyperplasia (CGH), six adenomatous hyperplasia (AD) and eleven atypical hyperplasia (AT). In the CGH-group five revealed atrophic endometria and one developed into endometrial carcinoma. In the AD-group two patients refused follow up, four had atrophic endometria, in the AT-group five developed atrophia, one refused follow-up, one developed CGH, while three developed carcinoma. All four carcinomas in the series developed within the first three months of follow-up. The frequency of carcinomatous development was much higher for exogen estrogen induced hyperplasias compared to earlier findings for endogenously estrogen induced endometrial hyperplasias. It is recommended that non-opposed estrogen treatment should be used in rare circumstances under close follow-up and that patients developing endometrial hyperplasias are followed-up until the hyperplastic changes have disappeared. PMID- 1776843 TI - Cytotoxic effects of a new antitumor antibiotic, FK973, in malignant glioma. AB - A novel antitumor antibiotic, 11-acetyl-8-carbamoyloxymethyl-4-formyl-14-oxa-1, 11-diazatetracyclo [7.4.1.0(2,7).0(10,12] tetradeca-2,4,6-trien-6,9-diyl diacetate, FK973, was obtained as a fermentation product from Streptomyces sandaensis. This drug showed excellent cytotoxic effects on human glioblastoma and medulloblastoma and murine glioma (203 glioma) cells. The antitumor effects were also observed in ACNU-resistant glioma cells. The median survival time (MST) of MG models was 15 days. When they were treated with FK973, their MST was prolonged to 21 days. FK973 showed no apparent damage to murine brain cells. PMID- 1776844 TI - Concomitant radiation-doxorubicin administration in locally advanced and/or metastatic soft tissue sarcomas: preliminary results. AB - Doxorubicin was administered by continuous infusion at a dosage of 12 mg/sqm/day for 5 days concomitantly with radiation treatment (150 or 200 cGy/day for trunk or extremity lesions, respectively) for 5 days. The 5-day cycles were repeated every 3 weeks. Seventeen patients, 5 of whom were pretreated, entered the study; all were assessable for toxicity and 15 for response. The overall objective response rate was 46% (7/15): 1 complete and 6 partial responses. Response rate reached 54% in only non-pretreated patients (6/11) and 75% in patients with PS less than or = 2 (6/8). No disease progression was observed during treatment. The median duration of complete or partial responses was 28 weeks (range 5-86). Toxicity was low and treatment very well tolerated. In our preliminary analysis, the response rate obtained with this combined chemo-radiotherapic regimen was encouraging and the toxicity was acceptable. PMID- 1776845 TI - Amplification of the epidermal growth factor receptor gene in human gliomas. AB - Biopsy specimens of 19 human gliomas (10 glioblastomas, 2 anaplastic astrocytomas, 4 astrocytomas, one mixed glioma, one oligodendroglioma and one ependymoma) were examined for amplification of tumour-related genes located on chromosome 7: the proto-oncogene c-erb-B1 (encoding the epidermal growth factor receptor (EGFR], the proto-oncogene c-met, the platelet-derived growth factor A chain gene, and the plasminogen activator inhibitor type-1 gene. Gene amplification was observed in 6 glioblastomas, and the EGFR gene was the only chromosome-7-gene examined that was amplified. The selective EGFR gene amplification in human glioblastomas suggests its potential role in the progression of some of these tumours. PMID- 1776846 TI - Antitumor effect of lonidamine alone or combined with tamoxifen or medroxyprogesterone acetate in breast cancer cells. AB - The effect of Lonidamine (LND) alone or combined with the antiestrogen Tamoxifen (TAM) or Medroxyprogesterone acetate (MPA) on cell proliferation and steroid hormone receptor content of a human estrogen sensitive breast cancer cell line was investigated. LND has a direct growth inhibitory action, even if used at relatively low concentrations (10(-7) M), and shows the maximum effect at 10(-4) M. The combination of LND with the antiestrogen does not produce a potentiation of the TAM-induced reduction of cell number, while the association of the drug with MPA seems more effective with respect to MPA alone, at least at certain concentrations. The negative interference observed between LND and TAM may be due to the LND-induced decrease of estrogen receptor levels. PMID- 1776847 TI - Correlation of total (TSA) and lipid and bound (LSA) sialic acid levels with cytology of cyst or body fluids in cancer patients. AB - In this preliminary study, aiming at the early diagnosis or the confirmation of neoplastic spreading, the levels of sialic acid (TSA and LSA, total sialic acid and "lipid bound" sialic acid) were measured and correlated with the corresponding cytologic findings in 111 body or cystic fluid samples taken from patients with suspected or confirmed cancer. The samples were classified according to the body fluid origin: peritoneal (35), breast cyst (22), pleural (21), thyroid gland cyst (5), renal cyst (5), ovarian cyst (6), bronchial washing (3), douglasic cavity (3) and various other origins (11). It was found that 32.43% of the samples were TSA positive, 44.14% LSA positive, 20.75% cytologic and 8.49% cytology suspect (positive + suspect = 29.24%). Thus, the combination of a tumor biomarker with the corresponding cytology of the body fluid gives the best possible results, as regards both the confirmation of positive cytology and the detection of possible metastases, as well as the monitoring of the disease after treatment. PMID- 1776848 TI - Flow cytometric and immunohistochemical analysis of p62c-myc oncoprotein in the bronchial epithelium of lung cancer patients. AB - The expression of p62c-myc in bronchial resection lines (BRLs) from lung cancer and control patients, has been examined by immunohistochemistry and parallel flow cytometry using antibodies directed against the p62c-myc oncoprotein. Both methods indicated a marked increase in nuclear p62c-myc levels in BRLs from tumour cases as compared to control BRLs. Immunohistochemistry also revealed greater cytoplasmic positivity in BRLs from cancer patients than from control cases. Flow cytometric quantitation of nuclear p62c-myc confirmed the immunohistochemical findings demonstrating that the median level of nuclear p62 myc fluorescence in BRLs from tumour cases was 1919 fluorescence units (FU) (range:216-7367 FU) and 144 FU (range:0-1365 FU) for non-tumour control BRLs. No consistent difference in p62c-myc fluorescence was observed between BRLs from smokers and non smokers. Both methods indicated that in lung tumour cases, nuclear p62c-myc was increased in histologically normal and abnormal BRLs, suggesting that hyperexpression of this protein is an early event preceding detectable morphological change. These results suggest that increased p62c-myc levels may be an early event in the pathogenesis of lung cancer. PMID- 1776849 TI - Studies on the interaction and exchange of inhibitors and proteases on the surface of tumour cells in frozen sections. AB - We have used frozen sections of squamous cell carcinoma as a convenient source of a cell surface protease associated with tumour cells. This protease has been referred to as guanidinobenzoatase (GB) and is now known to be functionally identical to tissue plasminogen activator (t-PA). The use of a fluorescent competitive inhibitor of GB enabled the enzymic status of GB to be determined, i.e. was the enzyme active, latent or removed from our test system. The cell surface GB was then demonstrated to interact with extractable cytoplasmic inhibitors obtained from these sections. We then used a protected form of the GB in the absence of these internal inhibitors; such sections were used to transfer the GB to fibrin fibrils, thus exposing the presumptive receptor on the tumour cell surfaces. Texas red labelled t-PA was then shown to bind to the tumour cells in these pretreated sections from which the GB had previously been removed. We believe that the surface of tumour cells can be used to study the interaction of the naturally occurring inhibitors with GB and also that the cell surface receptors for GB can be used to study the binding of t-PA to cell surfaces. PMID- 1776850 TI - Doxorubicin storage in myocardial tissue of reserpine- and nicardipine-pretreated rats. AB - While reserpine and nicardipine pretreatment induced a more or less marked decrease in typical red-orange doxorubicin fluorescence in certain rat tissues, such as spleen, kidney and large intestine, the myocardial tissue (right atrium and left ventriculum) did not show any significant variations in nuclear doxorubicin storage. This different behaviour of cardiac tissue may be related to the well-known doxorubicin cardiotoxicity. PMID- 1776851 TI - Relationship between 43 kDa epidermal growth factor-related clonogenic activity and clinical parameters for breast cancer. AB - The clonogenic activity of a previously purified 43 kDa EGF-related protein (16) was estimated in the urine of breast cancer patients. Increase of activity was statistically significant in lymph node-positive patients, in a group of patients with larger carcinomas, with accelerated tumor growth, in premenopausal patients and younger age and in estrogen receptor negative patients. In 31 patients the activity was estimated during polychemotherapy before surgery. Differences between the values at the begin and the end of treatment were compared between all groups by the Kruskal-Wallis test (p = 0.02). Patients with progressive disease showed increasing activities (mean values from 315 to 811) while in those with complete remission activity decreased (from 449 to 213). Partial- and non responders showed no change. In a long-term follow-up study with 25 patients the pre- and postoperative activities were estimated. In 17 of 18 patients who had no local recurrence or metastasis the activity declined after surgery, whereas in 6 of 7 patients who died, activity increased 2-5 fold prior to death. A life table analysis with a total of 101 patients revealed a trend to shorter survival in the group with higher activity (p = 0.042). These observations suggest a role for the EGF-like growth factor activity in the expression of the malignant phenotype and may have significance for breast cancer diagnosis and prognosis. PMID- 1776852 TI - Prognostic indices in endometrial adenocarcinoma stages I and II. A study based on clinical, histopathological and flow cytometric variables. AB - In a prospective study including 447 patients with endometrial adenocarcinoma stages I and II, clinical and flow cytometric variables were studied in univariate and multivariate analyses. During the follow-up period of 3 to 65 months, 41 patients died of their disease and 26 patients died of intercurrent disease. Based on the results of multivariate analyses, five different prognostic indices were constructed. Using these indices, individual index values were calculated for each patient. The index values were correlated with survival and were used to identify a small high-risk group (10% of the patients) and a large low-risk group (90% of the patients). Indices 1 and 2 were constructed for pre treatment situations. Index 1 included age and histopathologic grade and identified a small high-risk group and a large low-risk group with a 3-year survival of 62% and 91% respectively. Index 2 also comprised S-phase fraction and distinguished a high-risk group with a 3-year survival of 54% from a low-risk group with a 3-year survival of 93%. Indices 3 and 4 were constructed for patients after surgery, when the degree of residual myometrial tumor invasion was known. Index 3 included age, histopathologic grade and residual myometrial invasion rendering a 3-year survival of 44% and 93% for the high- and low-risk groups respectively. Index 4 also comprised S-phase fraction and identified a high-risk group and a low-risk group with 3-year survival figures of 59% and 96%, respectively. Index 5 included age and histopathologic grade and was constructed for post-treatment situations in unoperated patients. The index separated a high risk group from a low-risk group with a 3-year survival of 56% and 88%, respectively. In summary, the results from our study show that the prognostic indices made it possible to identify high and low-risk groups in different clinical situations which may prove useful in selecting candidates for future trials with adjuvant or reduced treatment. PMID- 1776853 TI - Accumulation of polyamine analogs in red blood cells: a potential index of tumor proliferation rate. AB - It has previously been demonstrated that during Lewis lung carcinoma (3LL) growth, red blood cell (RBC) spermidine (Spd) levels change concominantly with the tumor volume and [14C] Spd accumulates in proportion with the tumor volume, if [14C] putrescine (Put) is administered. In the present study we substituted a non-radioactive analogue for labelled Put with the aim to perform human studies, should the method prove suitable to quantify malignant cell proliferation intensity. 2-Methylputrescine (2MPut) is an excellent substrate of spermidine synthase and is transformed in vivo into methylspermidine (MSpd) and 6 methylspermine (6MSpm). After a single i.p. dose of 2MPut, MSpd accumulated in RBC of mice with 3LL xenografts. The concentration of MSpd correlated directly with tumor progression. No significant amounts of MSpd were found in RBC of normal mice. It appears that 2MPut has the potential to become a new tool in tumor diagnostics. PMID- 1776854 TI - Antagonism of prolactin binding by cyclosporine A on MCF7 breast tumour cell line. AB - Cyclosporine A (an immunosuppressive cyclic undercapeptide) acts as an antagonist to prolactin receptors on a breast tumour cell line (MCF7) which is known to express specific prolactin receptors. The competition between cyclosporine A and prolactin to prolactin receptors was demonstrated by measuring the decreased specific 125I-labeled prolactin-binding to prolactin receptors in the presence of increasing concentrations of cyclosporine A. Moreover, cyclosporine A inhibiting effects on the cell growth were investigated in this mammary cancer (MCF) by measuring the cell DNA content with flow cytometry. Our results should prove very useful in understanding the mechanisms of prolactin regulation of DNA synthesis in tumorigenesis of the mammary gland. PMID- 1776855 TI - The effect of doxorubicin, daunorubicin and 4'-epidoxorubicin on the exogenous c myc promoter in mouse erythroleukemia cells. AB - The recombinant plasmids p324, p330 and p323 carrying the aminoglycoside phosphotransferase (aph) gene and 5' flanking c-myc sequences linked to the reporter gene chloramphenicol acetyl-transferase (cat) were introduced into the mouse erythroleukemia cell line F412B2TK- and stable transfectants resistant to geneticin were obtained. The effects of three anthracycline compounds, doxorubicin, daunorubicin and 4'-epidoxorubicin, were studied using a large range of drug concentrations. It was found that 4'-epidoxorubicin and daunorubicin stimulate cat-gene expression with maximum effect at a concentration of 1 micrograms/ml, while doxorubicin enhances transcription from c-myc promoter at 5 micrograms/ml. PMID- 1776856 TI - Progesterone androstenedione testosterone and clinical characteristics in endometrial carcinoma. AB - Serum concentrations of progesterone (P), androstenedione (A) and testosterone (T) were measured in 128 postmenopausal women with endometrial adenocarcinoma. The correlations between these hormones were studied and related to such clinical parameters as: stage, histopathology, age, gynaecological history, body mass index and related diseases. In previous studies we have shown the relations between oestron (E1) and oestradiol (E2) serum concentration and clinical parameters. A clear correlation was seen between E1 and E2. Both E1 and E2 also strongly correlated with BMI. In this study androstenedione is found to correlate with E1 and E2, p less than 0.03 and p less than 0.02 resp. Progesterone and E1 were correlated, p less than 0.01, but not P and E2. Testosterone correlated with E1, p less than 0.002, E2, p less than 0.003 and A, p less than 0.02. None of the hormones P, A or T correlate with BMI. Androstenedione and age, and A and menopausal years showed a negative correlation, p less than 0.01 for both. Testosterone correlated with menopausal years, p less than 0.03; and correlated negatively with years of menstruation, p less than 0.03. These results do not support the hypothesis that A is the exclusive precursor for conversion to E1 in fat tissue. The correlation between P and E1 could indicate a relation to steroids higher up in the synthesis chain. The influence of P, A and T on the investigated clinical factors can not be strong, since correlations are virtually missing. PMID- 1776857 TI - Interferon alfa 2a in superficial bladder cancer prophylaxis: toleration and long term follow-up. A phase I-II study. AB - Twenty patients (17 M., 3F., -mean age 61.5 yrs) affected by superficial bladder tumors (TINOMO) were included in the study. All patients had cold mucosa biopsy to exclude the presence of dysplasia or CIS; the histopathological grade was G1 in 19 cases and G2 in 1. The treatment was started between 3 to 7 days after radical TUR with intravesical instillations of recombinant Interferon alfa 2a, at the daily dose of 54 million/Units for 5 days for 2 consecutive weeks. No systemic adverse effects were observed. Local toleration and efficacy were assessed by cystoscopy, performed at the end of treatment after 6 weeks and then at three month intervals. At the first control 15% of patients showed an early local reaction with bollous oedema surrounding the resected area (with spontaneously disappeared after few days). No other abnormal findings were observed at the 6-week control. After a median follow-up of 98 weeks, 15 of the 19 evaluable patients (79%, C.I. 60-91) were disease-free. The median relapse time was 39.9 weeks, while clinical and local tolerance were optimal. These preliminary data confirm the complete absence of toxicity of Interferon alfa 2a administered at relatively high doses intravesically and indicate that this compound has some effect on superficial bladder cancer. PMID- 1776858 TI - Medical cancer patients and intensive care. AB - Between November 1985 and October 1989, 1413 patients were admitted to the medical intensive care unit (ICU) of our cancer hospital. Data collected at admission and during the ICU stay were analysed for: 1) medical problems and treatment modalities requiring the admission; 2) types of underlying disease; 3) mortality during intensive care; 4) nursing requirements. Of the 1413 admissions, 1220 were for solid tumors (mainly ovarian cancer, breast cancer and lung cancer) and 144 for hematological malignancies. Overall mortality during the ICU stay was 10%. There was a relative lack of nurses, as shown by the evaluation of the nursing activity with the TISS. 621 admissions were because of a medical emergency such as hypercalcemia or respiratory failure. Overall mortality was 22%. Of 64 patients treated by artificial ventilation, 46 (72%) died during their ICU stay. 732 admissions were made in order for administration and monitoring of special treatment or new therapeutic modalities including phase I drug infusion, intraperitoneal chemotherapy, intensive (megadosage) chemotherapy, lipophilic drug containing liposomes and coadministration of platinum derivatives. Our experience emphasizes the role of ICU facilities in modern oncology for both optimal supportive care in emergency cases and the safe development of new anticancer modalities. PMID- 1776859 TI - C-myc overexpression, c-mil, c-myb expression in a breast tumor cell line. Effects of estrogen and antiestrogen. AB - In breast tumor cell lines, c-myc amplification is frequently associated with estrogen unresponsiveness. We, however, succeeded in characterizing an estrogen responsive cell line VHB1 derived from a duct cell carcinoma, which exhibits c myc amplification and overexpression. We therefore studied the effects of estrogen and antiestrogen on c-myc expression in this particular cell line. We also investigated these effects on the expression of c-mil and c-myb oncogenes, also expressed but not amplified in VHB1 cells. Short-(1 h) and long-(72 h) term stimulations were performed. Our experiments showed that estradiol (E2 10(-8) M) was still able to stimulate c-myc expression equally either after short or long term treatment. In the same way, the antiestrogen 4-hydroxytamoxifen equally decreased c-myc expression but the reversal effect of E2 after long-term antiestrogen treatment was more pronounced than after short-term treatment. The effects of E2 and 4-OH Tam on the expression of the not-amplified c-mil and c-myb oncogenes were stronger than those observed on c-myc expression; however, the E2 reversal effect was identical either after short or long-term antiestrogen treatment. Our results may enlighten some aspects of the complex action of some of the early- and late-growth regulated genes in breast cancer. PMID- 1776860 TI - Membrane gangliosides and immuno-mediated cytolysis in drug sensitive and treatment-induced multidrug resistant human ovarian cancer cells. AB - The pattern of cytoplasmic membrane gangliosides and two cellular features which have been reported to be related to the expression of different membrane gangliosides, namely adhesion to solid substrates and susceptibility to the lytic activity of immune effector cells, have been investigated in drug sensitive A2780 human ovarian cancer cells and in two treatment-induced multidrug resistant sublines (A2780-DX1 and A2780-DX3). The total membrane gangliosides content of A2780 sensitive cells was comparable to that of the two multidrug resistant (MDR) sublines, but the acquisition of the MDR phenotype was characterized by an increased expression of the polysialylated gangliosides (particularly the disialoganglioside GDIa) and decreased expression of the monosialoganglioside GM2. The kinetics of cellular adhesion (both to plastic culture dishes and to extracellular matrix coated dishes) were similar in the three cell lines, indicating that the gangliosides profile seems not to be relevant for cell adhesivity to the above mentioned substrates. When human peripheral blood lymphocytes in toto (PBL) and two lymphokine activated (LAK) T cell subpopulations (CD3+4-8- and CD3-16+) were used as effector cells against A2780 (sensitive) and A2780-DX3 (highly resistant) cells, cytolysis of target cells was more efficient against the A2780-DX3 subline, suggesting a possible role of the ganglioside GD1a as a target structure for LAK immunotherapy. PMID- 1776861 TI - Adjuvant hormone treatment and chemotherapy in postmenopausal women with operable breast cancer: a retrospective analysis. AB - Two hundred consecutive postmenopausal women with operable breast cancer and metastatic axillary nodes were treated during the period January - December 1981 with adjuvant chemotherapy (CMF) or hormonal treatment (tamoxifen). The distribution of receptor status (estrogen or progesterone), number of axillary metastatic nodes (less than = 3 or greater than 3), surgical treatment and size of the primary tumor were homogeneous in both groups. Receptor status and number of axillary lymph nodes were correlated with adjuvant treatment efficacy. Ten year disease-free survival (DFS) was higher in the TAM-treated (72%) than in the CMF-treated group (52%) (p less than 0.01). In patients with less than = 3 axillary metastatic nodes, those treated with TAM had a higher DFS rate than those treated with CMF (75% vs 59%, p less than 0.01). There was no difference in DFS between CMF-and TAM-treated groups within the greater than 3 metastatic lymph node patients. In ER + primary tumors, DFS was higher in the subset treated with TAM (62%) than with CMF (51%) (p less than 0.05), whereas no difference in DFS was observed in ER- patients between the two treatment groups. Considering the TAM group, DFS was better (p less than 0.01) for ER+ cases than for ER- cases only at 5 years of observation. In the CMF group, DFS was not influenced by ER status. PgR content did not affect DFS in either adjuvant treatment group. PMID- 1776862 TI - Synthesis of bombesin analogs by the Fmoc method. AB - Bombesin synthesis has previously been achieved by the Merrifield method. Severe conditions and repetitive acidic treatments have led to the selection of a milder method for improving effectiveness. This study describes a new technique for the synthesis of bombesin and its analogs based on the use of fluorenylmethoxycarbonyl (Fmoc) protected amino acids and continuous flow solid phase procedure. Peptide elongation is realized by the intermediaries of derived pentafluorophenyl ester amino acids. Peptides of different lengths were synthesized in order to determine the minimal length of peptide chain needed to obtain immunoreactivity comparable to that of natural bombesin. Purification and analysis of the products by FPLC and amino acid determination were performed. Immunoreactivity study of these peptides was measured by a competition radioimmunoassay with an antiserum directed against the C-terminal portion. Results suggest that a decapeptide analog is sufficient for bombesin to be recognized by the antibody or as a carrier in targeting therapy. PMID- 1776863 TI - Cytotoxic activity of synthetic aza alkyl lysophospholipids against drug sensitive and drug resistant human tumor cell lines. AB - The anti-tumor cytotoxic activity of four newly synthesized aza alkyl lysophospholipids (AALP), namely BN 52205, BN 52207, BN 52208 and BN 52211, was investigated. Using the 51Cr release assay, the four compounds were endowed with cytotoxic activity, in a concentration-dependent fashion, against various human tumor cell lines of different histological origin. Two different mechanisms appear to be involved in the AALP-mediated cytotoxicity. A rapid membrane damaging effect was observed in less than one hour's incubation of tumor cells with AALP and cytotoxicity was temperature-independent when AALP were used at greater than or equal to 200 micrograms/ml. A slower cytotoxic mechanism was observed after 18 hours incubation at 37 degrees C when AALP were used at concentrations of 30-100 micrograms/ml. The pattern and magnitube of the cytotoxic activity achieved with all the 4 AALP compounds tested were similar and the cytotoxicity mediated by combination of two compounds was additive. In addition to the cytotoxic effect, the AALP compounds also exerted a cytostatic anti-tumor effect, as assessed by inhibition of 3H TdR incorporation. Using a variety of human tumor cell lines as targets, the cytotoxic effect observed with the AALP was noted with tumor cells that were either sensitive or resistant to TNF-alpha and/or chemotherapeutic drugs such as mitomycin C, adriamycin and cis platinum. The LD50 toxicity in mice was 100-125 mg/kg. The present findings demonstrate that AALP are cytotoxic to a variety of human tumor cell lines and do not appear to discriminate between drug/cytokine sensitive or resistant cells. Thus the present study suggests that some aza alkyl lysophospholipids may be considered as potential anticancer agents. PMID- 1776864 TI - Augmentation of cisplatin (DDP) cytotoxicity in vivo by DL-buthionine sulfoximine (BSO) in DDP-sensitive and-resistant rat ovarian tumors and its relation to DNA interstrand cross links. AB - DDP treatment (1.2 mg/kg x 5) prolonged the mean survival time (MST) of rats bearing an experimental ovarian tumor (0-342) from 16.4 to 51.1 days, with one of ten rats surviving more than 90 days. Administration of D,L - buthionine sulfoximine (BSO) (24 and 2 h prior to DDP, respectively) before the last two doses of DDP had no significant effect on DDP therapeutic activity, while daily combination of DDP with BSO (BSO 2 h prior to DDP) throughout the treatment significantly increased MST to 69 days (p less than 0.05, vs. DDP alone), with three of ten rats surviving more than 90 days. In the DDP resistant counterpart (0-342/DDP), on the other hand, DDP alone showed only a slight increase of MST (11.6 days in DDP group vs. 10.7 days in control group), addition of BSO to DDP treatment further prolonged MST to 13.3 days (p less than 0.01 vs. DDP alone). The formation of DNA interstrand cross links (DNA-ISCL) was found to be higher in 0-342 than in 0-342/DDP cells in vitro with a maximum at 24 h following 1 h exposure to DDP. BSO depleted the intracellular GSH level in a dose - and time - dependent manner in the two cell lines. Pretreatment with BSO resulted in a 7.4% increase in DNA-ISCL by DDP in 0-342 cells but a 39% increase in 0-342/DDP cells, which may partially account for chemosensitization of BSO to DDP in vivo. Our result that the chemosensitizing effect of BSO, through depletion of cellular GSH, is more significant in the DDP sensitive O-342 tumor than in its DDP resistant subline in vivo underlines that BSO should be used as a chemosensitizer in combination with DDP at the beginning of chemotherapy for clinical trial. PMID- 1776865 TI - Study of in vitro drug sensitivity on a newly established cell line from a primary bronchial epidermoid carcinoma of human origin (NSCLCN6). AB - We studied a cell line established from a primary non-small-cell lung cancer (non SCLC) of human origin and characterized by midly differentiated epidermoid carcinoma, a human karyotype and keratin expression. Doubling time was about 48 h in vitro and 12 days when transplanted into nude mice. In vitro, this cell line was mainly sensitive to dactinomycin and mitotic poisons such as Vinca alkaloids. Most chemotherapeutic drugs proved ineffective. Our findings are comparable to previous results in patients who showed 30% objective response and less than 5% complete response regardless of the therapeutic associations used against non SCLC. Our line would also seem to provide a good model for studying new potentially antitumor substances. PMID- 1776866 TI - [Hemangioma of the renal calyx]. AB - A case of renal hemangioma in a child is reported. The patient presented with severe painless hematuria. Intravenous pyelography showed a filling defect in the middle calyx of the right kidney. Ultrasonography showed a hypoechoic zone in the renal sinus. Hematuria was unilateral on right side at cystoscopy. Total nephrectomy was performed. The diagnosis was confirmed by histology. PMID- 1776867 TI - [Renal cysts at Yaounde (Cameroon). Prevalence and echographic profile]. AB - Few studies have addressed the prevalence of renal cyst in African countries south of the Sahara, although this condition is highly prevalent in other parts of the world. To determine the prevalence and the clinical and sonographic features of renal cysts in a population of black africans, we reviewed 1,527 consecutive sonograms performed at the Yaounde Teaching Hospital in Cameroon in patients aged 0 to 82 years. We found 47 patients harbouring at least one renal cyst (prevalence 3.08%). Prevalence of renal cyst increased with age, from 0% before the age of 20 to more than 10% after the age of 70. Most of the renal cysts found were solitary and caused no symptoms. Both sexes and both kidneys were equally affected. Diameter of the cyst exceeded one centimeter in most instances. Drainage under ultrasonographic control was performed in one case. Overall, in our institution in Yaounde prevalence of solitary renal cyst was lower than in Western studies but clinical and sonographic patterns were consistent with previous data. PMID- 1776868 TI - [Spontaneous subcapsular hematoma of the kidney]. AB - A case of spontaneous subcapsular hematoma of the kidney is reported. CT scan findings and etiologies are examined in the light of previously published data. An etiology-specific therapeutic strategy for subcapsular hematoma of the kidney is proposed. PMID- 1776869 TI - [Urinary tuberculosis and bladder tumors. A case report]. AB - The authors report the case of a patient presenting with both a bladder tumor and urinary tract tuberculosis. The bladder tumor was treated by transurethral resection and instillation of mitomycin C. The author describes this case and discusses this unusual association. PMID- 1776870 TI - [One-stage surgical correction of complex urethral stenoses with a pedicled skin graft]. AB - The author reports his experience and the results of a series of 104 patients suffering from urethral strictures, operated by the same operator from September 1984 to March 1990 and treated by the same surgical method: one stage urethroplasty using a pedicled skin graft. The principles which guided his technique are: complete exposure of the pathological tissue, appropriate size and cut of the graft from a healthy skin zone, careful dissection of the pedicle, elliptical anastomosis at each end and sparing of the corpora cavernosa. Eighty percent of the urethral strictures encountered in the series were complex and situated in various locations: 19 were penile, 55 were bulbar perineal, 30 were bulbar membranous. The urethral strictures were fistulated for 31 cases, multi operated in 32 case, half of the cases had upstream repercussions from the stenosed zone, and 17 cases had an accompanying pathology. Ninety-one percent of the patients benefited from a patch graft designed to widen the stenosed zone, while a tubular graft was performed for 13 patients to reconstitute a neo urethra. For a large number of the cases studied, postoperative follow-up was done for two years and for some cases exceeded two years. The operative results were quickly obtained. Good results observed after 3 months generally did not deteriorate thereafter, whereas bad results observed immediately after operation are not definitive since they can be reoperated by the same technique. For 82.7% of the patients, definitive cure was obtained, while 96% of the total number of patients showed considerable improvement. The intermediate results, average (13.6%) and the bad results (3.6%) both show the same inducing factors: past history of localized dilatory manipulations, infected areas but mostly defective application of management techniques. The superiority of this type of surgical technique and its reliability are stressed in the discussion. Also analysed are the following: the difficulty encountered in the management of stenoses of penile sites, the images which appear on the urethrographic controls and the cases where the choice of the tubular graft is appropriate, the problem of draining and the appropriate type and method of draining. Six years of experience in the utilisation of our technique, one-stage urethroplasty using a pedicled skin graft, leads the author to consider the technique as reliable and useful for the management of urethral strictures, especially for difficult multi-operated, infected, fistulated strictures. For these cases, our technique constitutes the best indication. PMID- 1776871 TI - [Dietetic approach to renal lithiasis]. AB - Because of the diversity and importance of dietary factors in the pathogenesis of renal stones, a nutritional survey must be carried out in order to determine the quantity of protein, calcium, oxalate, sodium, sugar, vitamin D, vitamin C, ingested and the fluid intake and the quality of the drinking water. Although defects are observed in all parameters, it is essential to reduce the intake of protein, calcium, oxalate, sodium, vitamin D, vitamin C as well as increase the sucrose intake and recommend dietary therapy based on mineral water rich in bicarbonate. PMID- 1776872 TI - [Study of anti-lithogenic action of zinc sulfate in experimental lithiasis in the rat]. AB - Sodium oxalate injected into young rats, via the intraperitoneal route, at a dose of 8 mg per 100 g of body weight, induced death in 50 p. cent of animals, and induced calcium oxalate crystals in renal tissue. When a zinc solution was administered prior to sodium oxalate, at the dose of 12 micrograms/100 g of body weight, the mortality rate decreased, and at the same time oxalate and calcium deposits were significant reduced (respectively P less than 0.01; P less than 0.01). The same results were found when zinc was administered at 24 micrograms/100 g of body weight, however, oxalic accumulation was found to be significantly lower in this group than in the group treated at 12 micrograms. This protection against calcium oxalate deposits was complete in the animals treated with various doses of zinc, because compared to reference animals, which received distilled water, calcium accumulation in these groups was not different and oxalate accumulation was also found to be lower (respectively P less than 0.05; P less than 0.001). Microscopic examination showed calcium crystals only in the group treated with sodium oxalate, localized preferentially in the renal papilla. All these experiments conclude on the total inhibitory effect of zinc on experimental lithiasis induced by oxalic acid, even though it was administered at a dose of only 12 micrograms/100 g of body weight. PMID- 1776873 TI - [Comparative study between the anti-lithogenic action of zinc and copper against oxalic lithiasis in the rat]. AB - Intraperitoneal injection of sodium oxalate, at the dose of 8 mg/100 g of body weight, induced into rats oxalate and calcium deposits in renal tissue, compared to animals which received distilled water (respectively P less than 0.05; P less than 0.05). However, when a zinc solution was administered previously, at the dose of 24 micrograms/100 g of body weight, oxalate and calcium accumulation was found to be significantly lower than in the group treated exclusively with sodium oxalate. Similar results were found when the metal used was copper, but oxalate accumulation was found to be significantly higher in this group than in the group treated with zinc (P less than 0.01). Compared to reference animals, which received distilled water, oxalate accumulation was found to be significantly decreased in the groups treated with both zinc (P less than 0.001) and copper (P less than 0.01), whereas calcium accumulation was found to be similar. Microscopic examination showed calcium crystals only in the group treated with sodium oxalate, preferentially localized in the renal papilla. These results suggest that zinc and copper, when administered at the dose of 24 mu/100 g of body weight, completely protect against experimental lithiasis induced by oxalic acid. However, the inhibitory effect of zinc was more pronounced than that of copper, especially against oxalate accumulation. PMID- 1776874 TI - Inhibitory effect of (S)-HPMPC, (S)-HPMPA, and 2'-nor-cyclic GMP on clinical ocular adenoviral isolates is serotype-dependent in vitro. AB - Currently, there is no effective treatment for ocular adenoviral infections that occur in epidemics worldwide, produce significant patient morbidity, and cause substantial economic losses. We tested several new antivirals in vitro, and found that (S)-HPMPC, (S)-HPMPA, and 2'-nor-cyclic GMP demonstrated significant serotype-dependent inhibitory activity by plaque reduction assay (ID50 = 0.017 17.0 micrograms/ml) against common clinical ocular isolates and standard adenoviral serotypes (Ad 1, Ad 5, Ad 8, and Ad 19). (S)-HPMPC was the least toxic (CD50 in A549 cells = 306 micrograms/ml), and (S)-HPMPC and (S)-HPMPA had high selectivity indices. PMID- 1776875 TI - Cellular uptake of phosphonylmethoxyalkylpurine derivatives. AB - The cellular uptake of the phosphonylmethoxyalkylpurine derivatives HPMPA and PMEA has been studied in H9 cells. The two compounds exhibited an identical pattern of permeation in this cell line. Uptake did not occur via the nucleoside transport system, but through a different mechanism which, for its slow kinetics and temperature-dependence, is compatible with an endocytosis-like process. The amount of cell-associated drug increased up to one hour post-incubation. PMID- 1776876 TI - Single-dose administration of 9-(2-phosphonylmethoxyethyl)adenine (PMEA) and 9-(2 phosphonylmethoxyethyl)-2,6-diaminopurine (PMEDAP) in the prophylaxis of retrovirus infection in vivo. AB - 9-(2-Phosphonylmethoxyethyl)adenine (PMEA) and 9-(2-phosphonylmethoxyethyl)-2,6 diaminopurine (PMEDAP) are selectively inhibitory to human immunodeficiency virus and other retroviruses. We have now investigated the effects of different PMEA and PMEDAP treatment schedules in newborn mice infected with Moloney murine sarcoma virus (MSV). Administration of a single dose of PMEA or PMEDAP on the day of MSV inoculation conferred a greater protective effect against MSV-induced tumor formation than when this dose was divided over two, four or seven injections per week. Also, the therapeutic index of PMEA and PMEDAP was increased if administered as a single dose. Furthermore, PMEA and PMEDAP afforded a marked antiviral protection if administered within one day before MSV infection. Thus, single doses of PMEA or PMEDAP, when administered shortly before or after MSV infection, appear to be effective in preventing the manifestations of the retroviral disease. PMID- 1776878 TI - Imaging in congenital deafness. PMID- 1776877 TI - Kawasaki disease: recent advances. PMID- 1776879 TI - Cranial magnetic resonance imaging in patients with tuberous sclerosis and normal intellect. AB - The pattern of cerebral hamartomas among a population of patients with tuberous sclerosis and normal intellect was determined. All patients with tuberous sclerosis over 5 years old with normal intellect who were resident in the Bath health district were offered cranial scanning by magnetic resonance imaging. Cerebral axial and coronal images were obtained in 10 mm contiguous sections with a Picker 0.5 tesla magnetic resonance imaging unit. The number, size, and distribution of lesions found was recorded. Eleven of 13 eligible patients underwent scanning. Two patients had normal scans. Seven patients had between one and five subependymal nodules. Nine patients had between two and nine cerebral tubers best seen on T2 weighted images. Our findings suggest that the wrong conclusions may be drawn if the number of lesions alone is used to predict neurological outcome in tuberous sclerosis. PMID- 1776881 TI - Ultrathin flexible bronchoscopy in neonatal intensive care units. AB - Thirty seven flexible bronchoscopies were performed in 33 infants in a neonatal intensive care unit, using a 2.2 mm flexible ultrathin bronchoscope. Twenty eight procedures were performed via an endotracheal tube or tracheostomy and nine in spontaneously breathing infants. Indications for endoscopy included persistent atelectasis and/or emphysema (n = 21), unexplained acute respiratory distress (n = 10), stridor (n = 3), assessment of congenital abnormalities of the tracheobronchial tree (n = 2), and follow up of an endobronchial granuloma during the course of corticosteroid treatment (n = 1). Abnormal airway dynamics and/or abnormal structure were seen in 23 of 37 cases. In 54% of the procedures, the results of bronchoscopy had a direct effect on further management. The procedure was well tolerated and completed in less than two minutes. Our results suggest that the ultrathin flexible bronchoscope improves airway exploration and the understanding of respiratory disorders during the first months of life, particularly in ventilated infants. PMID- 1776880 TI - IgG subclass specific antibody response in recurrent bronchitis. AB - The IgG subclass specific immune response against pneumococcal type 3 polysaccharide antigen before and after immunisation in healthy children and children with recurrent bronchitis was studied. Recurrent bronchitis was defined as three or more episodes a year, during at least two consecutive years, of bronchopulmonary infection, productive cough with or without fever, and/or diffuse rales by physical examination. Twenty five patients and 15 healthy children were selected. The patient group had lower concentrations of IgG1 and IgG2 specific pneumococcal antibodies compared with healthy children, regardless of whether or not the total IgG2 concentration was low. The children with recurrent bronchitis showed a greater increase in IgG1 and IgG2 antibodies after immunisation than the controls. It is concluded that children with recurrent bronchitis show a decreased humoral immune response to pneumococcal type 3 polysaccharide antigen. This finding suggests that a defect in the humoral immune response against polysaccharide antigens is an important cause of recurrent bronchitis in childhood. PMID- 1776882 TI - Iron status, energy intake, and nutritional status of healthy young Asian children. AB - The iron status, dietary intake, and protein energy nutritional status of healthy Asian children ranging in age from 4 to 40 months was investigated. The serum ferritin, erythrocyte zinc protoporphyrin, haemoglobin and mean corpuscular haemoglobin concentrations, and mean corpuscular volume were determined in a community study of 138 children. Protein energy nutritional status was estimated by anthropometry and a four or five day weighed dietary inventory was completed by 97 children. Concentrations of the serum ferritin, haemoglobin, and mean corpuscular haemoglobin, and the mean corpuscular volume decreased progressively with increasing age. The mean values for these four indices were significantly lower in toddlers between 21 and 23 months age than in infants less than 6 months old. The mean erythrocyte zinc protoporphyrin was high in the first six months, later falling and rising again to peak in the 21 to 23 month age group. Thirty five per cent of children were iron deficient (serum ferritin concentration less than 10 micrograms/l) and low values for the mean corpuscular volume and mean corpuscular haemoglobin were observed in 33% and 35% respectively and 17% were anaemic (haemoglobin concentration less than 110 g/l). No association was observed between biochemical iron status and the dietary intake of energy or iron. Nor was there an association between protein energy nutritional status and iron status. Screening for iron deficiency in communities at risk is recommended and nutrition education using trained link workers is preferred to prophylactic iron treatment. PMID- 1776883 TI - Diet and faecal flora in the newborn: iron. AB - The faecal flora of a baby receiving a modern infant formula is substantially different from that of a breast fed baby. This difference is a little less when whey based formulas are used. The addition of bovine lactoferrin has no effect and there is some evidence that the presence of added iron in a formula moved the faecal flora further away from that of a breast fed baby. the iron content of currently used infant formulas is much higher than that of breast milk. The effect of the addition of iron to both whey and casein based formulas on the faecal flora was examined in further detail. Faecal flora were examined at 14 days of age in 33 babies receiving a whey formula fortified with iron, 29 babies receiving a whey formula without iron, 29 babies receiving a casein formula fortified with iron, and 24 babies receiving casein formula without iron. Subsequently fewer babies in each group were examined at week 7, 11, and 15. The addition of iron to both casein and whey formulas discouraged colonisation and growth of staphylococci and bacteroids but encouraged the colonisation and growth of clostridia and enterococci. The type of protein and not the iron content had more effect upon the growth of bifidobacteria; both whey formulas, fortified or not, encouraged the colonisation by bifidobacteria. If an infant formula, for use in the first few months, is to mimic the physiological effects of breast milk, there may be microbiological arguments for not fortifying it with iron. However, large empirical trials would be necessary before advocating such a policy. PMID- 1776884 TI - Intraluminal biliary obstruction. AB - Jaundice caused by intraluminal bile duct obstruction in infancy is rare but may occur in association with biliary sludge, inspissated bile plugs, or gall stones. Nine boys (aged 2 weeks-6 months) with obstruction caused by inspissated bile (n = 7) or gall stones (n = 2) are presented. Haemolysis was not a factor in the patients' histories but an abnormal entry of the common bile duct into the third part of the duodenum was demonstrated in two and one had an asymptomatic haemangioma. Ultrasonography was the most useful investigation. Surgical removal of the bile duct obstruction was necessary in eight cases and included biliary tract drainage in six and cholecystectomy for changes of cholecystitis in four. Obstruction resolved spontaneously in one infant after percutaneous cholangiography. There were no postoperative complications. PMID- 1776885 TI - Compliance assessed by the Medication Event Monitoring System. AB - The accurate assessment of patient compliance is especially crucial in evaluating the efficacy of a new treatment. Because of the problems associated with parenteral desferrioxamine, the development of a safe, effective, and convenient iron chelator is of high priority. The high morbidity and mortality associated with iron overload requires careful evaluation of the ability of any new agent to promote long term effective iron chelation. Patients' compliance with an orally available chelating agent, 1,2,-dimethyl-3-hydroxypyrid-4-one (L1), that has been demonstrated to induce in vivo iron excretion equivalent to that of desferrioxamine during supervised short term administration, was examined. Compliance was assessed in seven patients by patient interview, by daily diaries reviewed monthly with each patient, and with the use of the Medication Event Monitoring System (MEMS) standard pill bottles with microprocessors in the cap that record the timing and frequency of bottle openings. L1 was dispensed in MEMS containers to the patients, who, unaware of their significance, recorded compliance using a daily diary. Overall compliance rate (% of prescribed doses taken) measured by MEMS was 88.7 +/- 6.8%. When 'doubling of doses' was accounted for, significantly poorer compliance with L1 was noted by MEMS (91.7 +/- 7.4%) than by patients' diaries (95.7 +/- 5.2%). There was no significant difference in patient compliance recorded between the first and last 30 day period of drug administration. MEMS can eliminate the confounding variable of erratic patient compliance in the evaluation of a new drug's efficacy. As MEMS cannot distinguish a missed dose from one doubled at the next bottle opening, the use of patient diaries is a useful adjunct to the accurate assessment of compliance and should be combined with the use of MEMS. PMID- 1776886 TI - Impaired pubertal growth in acute lymphoblastic leukaemia. AB - The growth of 182 patients who were long term survivors of childhood acute lymphoblastic leukaemia was retrospectively analysed. All remained in first remission and were treated with either 1800 or 2400 cGy of cranial irradiation. None had been treated with either testicular or spinal irradiation. Ninety three (51 boys, 42 girls) were treated with 2400 cGy and 89 (42 boys, 47 girls) were treated with 1800 cGy cranial irradiation. All patients were treated with standard chemotherapy including intrathecal methotrexate in similar dose regimens in either group. Mean age (SD) at diagnosis in the group treated with 2400 cGy was 4.8 (2.6) years and mean age in the group treated with 1800 cGy was 6.5 (3.3) years. Mean height SD score at diagnosis in the 2400 cGy group was +0.29 and final height achieved was -0.63. Mean height SD score at the start of treatment in the group treated with 1800 cGy was +0.40 and mean final height was -0.53. There was a similar reduction in height SD score in both groups during the pubertal growth spurt. The decrement in height SD score was greater when treatment was administered at less than 7 years of age in either dose regimen, both in prepubertal and pubertal growth. However, the decrease in height SD score was found to be greater in girls than boys. There was a trend in both sexes for the onset of puberty to be at a younger age with a lower treatment dose of radiotherapy. However, in girls treated with the lower dose regimen there was a significant reduction in the mean age of onset of puberty which was 9.9 years. Our data suggest that girls treated at less than 7 years of age have a severe impairment of pubertal growth, which is probably a combination of the dual endocrinopathy of premature puberty and growth hormone insufficiency. PMID- 1776887 TI - Frequent symptoms after DTPP vaccinations. AB - A prospective study of minor reactions after the four combined vaccinations for diphtheria, tetanus, pertussis, and poliomyelitis (DTPP) was performed in 540 infants in the Netherlands. An analysis was made of the symptoms observed by the infants' parents after 2026 inoculations. The aim was to assess the frequency, association, and risk of recurrence of minor reactions. These were designated as fever (greater than or equal to 38.0 degrees C), local reactions, crying, and other general symptoms (changes in sleeping or eating patterns, vomiting, drowsiness, fretfulness). Fever occurred after 67.7% of inoculations, one or more local reactions after 66.2%, and increased crying after 64.4%. After 80% of inoculations, one or more other general symptoms occurred. Only 4.4% of inoculations were followed by no minor reaction. Fever rarely occurred as an isolated symptom; it showed a significant association (i) with one or more local reactions, (ii) with increased crying, and (iii) with two or more other general symptoms. Chances of fever, redness at the inoculation site, and crying after inoculation increased with repeat inoculations if these reactions had occurred after preceding inoculation(s). PMID- 1776888 TI - Enhanced thrombin generation in patients receiving intensive care. AB - Thrombin-antithrombin III complex (TAT) concentration was measured in 27 control and 155 intensive care patients to (a) establish normal reference ranges, (b) measure thrombin generation in critically ill patients, and (c) determine the characteristics of the TAT assay for the diagnosis of disseminated intravascular coagulation (DIC) in children. The normal reference range was 1-4.3 micrograms/l (median 2.3 micrograms/l), and 89.7% of patients had raised TAT concentrations. Median TAT concentrations in the presence of DIC (27 micrograms/l) were significantly higher than in its absence (8 micrograms/l). Sensitivity, specificity, and positive and negative predictive values of the assay were 97.3%, 28.3%, 76.3%, and 81.3%, respectively, at a cut off of 4 micrograms/l. Excess thrombin production occurs in the majority of critically ill children. The TAT assay is potentially useful in the diagnosis of DIC in children. PMID- 1776889 TI - Troublesome crying in infants: effect of advice to reduce stimulation. AB - The observation that babies with troublesome crying improve quickly in hospital suggested that, if true, a common, quickly reversible, factor may operate. Histories from parents of such babies suggest that much work goes into trying to console them. It is hypothesised that this may lead to excessive stimulation and the improvement seen in hospital reflects a reduction in stimulation. Two studies were undertaken. (1) Carers were asked to agree to randomisation of their infants to hospital or home management. Those at home were advised to reduce stimulation. A 10 point questionnaire was used to describe distress in mothers of subjects and age matched controls. (2) A randomised controlled study compared advice to reduce stimulation with an empathic interview using a +5 to -5 scale to chart change. In the first study too few subjects agreed to randomisation and thus a rigorous study to validate the observation could not proceed. There was good evidence, however, that crying improved. Results from the home group justified the second study. The median distress score for subjects was 7/10 and for controls 3/10 (p less than 0.001). In the second study at seven days, 18/22 subjects given advice scored +2 or better on the change chart for crying, compared with 7/20 of those who did not receive advice (p less than 0.01). After the latter received advice 79% improved (95% confidence interval 61 to 97%). For babies under 12 weeks, the customary upper limit for a diagnosis of colic, 14/15 subjects advised improved compared with 6/12 who were not advised (p less than 0.02). These studies have shown that infants with troublesome crying admitted to hospital seem to improve quickly as do those whose carers are advised to reduce stimulation. PMID- 1776890 TI - Differences in postperinatal infant deaths between north and southern Derbyshire. AB - In depth confidential inquiries on all post-perinatal infant deaths were carried out for two years in North and Southern Derbyshire District Health Authorities in order to explore why the postperinatal death rates and cot death rates have been consistently higher in Southern than in North Derbyshire. It was found that the death rates for probably inevitable deaths and for 'idiopathic' cot deaths were the same in both districts. The differences in the death rates lay in the group of partly explained cot deaths. Adverse social factors associated with each death were recorded and an estimate made of their relevance to the individual deaths. The group of deaths most amenable to intervention was those of category B (partly explained cot deaths). As judged by the Jarman index there are more areas of deprivation in Southern than in North Derbyshire. PMID- 1776891 TI - Long term health implications of fitness and physical activity patterns. AB - Northern Ireland has the highest incidence of coronary heart disease (CHD) in the world. The physical fitness, activity patterns, health knowledge, attitudes, and dietary habits of a random, stratified sample of 3211 Northern Irish children, comprising 1540 boys and 1671 girls, age range 11-18 years were examined. At all ages boys were significantly more active than girls. The most important finding was an appreciable decline in physical activity levels after the age of 14 years reaching extremely low levels in older girls. While 75% of exercise taken was not related to school, physical education classes constituted the only exercise taken by one third of pupils. Girls had healthier nutritional habits and were more inclined to employ weight control measures than boys. There was a preponderance of children with a higher body mass index indicating a tendency to obesity in the child population. Over 20% of school leavers of both sexes regularly smoked cigarettes and 20% regularly drank alcohol. The postulated relationship between childhood inactivity, adult sedentary lifestyle, and increased risk of CHD raises serious cause for concern regarding the future cardiovascular health of many children. PMID- 1776892 TI - Effects of oral phosphocysteamine and rectal cysteamine in cystinosis. AB - Diurnal variation in leucocyte cystine and the effects of equimolar single doses of oral phosphocysteamine and rectal cysteamine were studied in eight patients with cystinosis, aged 1.8-16.5 years. No significant diurnal variation in leucocyte cystine was found. Absorption of cysteamine was reduced after rectal administration compared with the oral dose: mean (SD) peak concentration 17.2 (6.3) mumol/l v 36.4 (5.5) mumol/l at 40 min and mean (SD) area under the curve 22.3 (14.3) v 59.4 (33.1) mumol/h/l. Oral phosphocysteamine significantly reduced the mean (SD) leucocyte cystine from 8.09 (0.47) to 3.26 (1.48) nmol 1/2 cystine/mg protein at three hours. At 12 hours the mean leucocyte cystine was significantly lower than the pretreatment concentration. Rectal cysteamine did not significantly reduce the mean leucocyte cystine concentration. In conclusion, phosphocysteamine suspension may be administered every 12 hours. Rectal cysteamine administration is feasible but higher doses are required before efficacy can be judged. PMID- 1776893 TI - Autonomic dysfunction and severe hypoglycaemia in insulin dependent diabetes mellitus. AB - The aims of the present study were to investigate the relationship between severe hypoglycaemia and autonomic dysfunction in diabetic children, and to assess the glycaemic response to an insulin infusion test. In a one year period, 12 of 69 diabetic patients (17%) experienced at least one severe episode of hypoglycaemia, defined as an event which required outside assistance. All patients underwent five cardiovascular autonomic tests. Seven of the hypoglycaemic patients showed three or more abnormal autonomic tests. Among the 57 non-hypoglycaemic diabetics, there was no patient with three or more abnormal tests. In hypoglycaemic diabetics with and without autonomic dysfunction, and in eight healthy age matched subjects an insulin infusion test was performed. A pronounced blood glucose decline and a subnormal increase in heart rate during insulin infusion were obtained in patients with autonomic dysfunction. Thus, severe hypoglycaemia may be due to impaired defence mechanisms against blood glucose decline in diabetic children with autonomic dysfunction. PMID- 1776894 TI - Intraosseous infusion for resuscitation. AB - An 11 week old infant who had a cardiac arrest secondary to gastrointestinal haemorrhage and was successfully treated using intraosseous infusion is reported. The child was discharged with no apparent neurological deficit. PMID- 1776895 TI - Severe nephropathy in three adolescents with cystic fibrosis. AB - Renal involvement has rarely been reported in patients with cystic fibrosis. We describe severe nephropathy with a rapidly fatal outcome in three adolescents with cystic fibrosis, and evaluate the important repercussions that the nephrotic syndrome had on the precarious clinical situation of these patients. PMID- 1776896 TI - Nutritional manipulation in the management of dumping syndrome. AB - Two children with Nissen's fundoplication and either gastrocystoplasty or pyloroplasty developed dumping syndrome. Correction of their blood glucose abnormalities, resolution of symptoms, and weight gain were effectively achieved by addition of fats and uncooked corn starch (50 g/l) to their feeds. PMID- 1776897 TI - Pigmented villonodular synovitis. AB - Pigmented villonodular synovitis (PVS) is an uncommon, usually monoarticular disorder encountered mainly in adults. A boy and a girl, both 7 years old, were referred because of recurrent knee effusions. Both were medically treated for other rheumatic disorders for five years. PVS was diagnosed by arthroscopy and synovectomy was curative in both cases. PMID- 1776898 TI - Helen Mackay and anaemia in infancy--then and now. PMID- 1776900 TI - Statistics from the inside. 2. Significance tests. PMID- 1776899 TI - Management of intractable epilepsy. PMID- 1776901 TI - Adolescent psychoses: treatment and service provision. PMID- 1776902 TI - Tests for growth hormone secretion. PMID- 1776903 TI - The reliability of height and height velocity in the assessment of growth. PMID- 1776904 TI - Terbutaline powder in asthma exacerbations. PMID- 1776905 TI - Day case ligation of patent ductus arteriosus in premature infants. PMID- 1776906 TI - Absent or reversed end diastolic flow velocity in the umbilical artery and necrotizing enterocolitis. PMID- 1776907 TI - Body water measurements in growth disorders. PMID- 1776908 TI - [Operation for breast cancer]. PMID- 1776909 TI - Changes in the latency of the maximum positive peak of visual evoked potential during anesthesia. AB - The relationship between the latency of visual evoked potential (VEP) and the anesthetic concentration was investigated in surgical patients in order to examine the applicability of VEP in monitoring of the depth of anesthesia. The VEP was recorded with a standard EEG electrode from the midline parietal region in reference to both earlobes linked to the ground. An array of light-emitting diodes mounted in opaque goggles was used to stimulate both eyes simultaneously and photic stimuli were delivered at random inter-pulse intervals with uniform distribution ranging from 2 to 5 seconds. Fifty trials of data were averaged to estimate that Pmax latency, i.e., the latent period from the photic stimulus to the maximum positive peak arising after 170 msec. Increases in the Pmax latency following the administration of anesthetics and restorations to preanesthetic values after recovery from anesthesia were found. A significant correlation was demonstrated between the Pmax latency and the inspiratory concentration of enflurane. The latency of the Pmax showed a drastic and a sensitive prolongation from about 200 msec in the awake state up to about 600 msec at the stage where the EEG exhibits large-voltage slow waves. Thus the measurement of the Pmax latency of VEPs was found to be useful for monitoring the depth of anesthesia. PMID- 1776910 TI - Clinico-pathological features of liver metastases from colorectal cancer in relation to prognosis. AB - Twenty-nine patients undergoing hepatic resection for colorectal metastases from 1980 to 1986 were studied. The overall cumulative survival rates were 82%, 63% and 32% at 1, 2 and 3 years, respectively. The possible prognostic factors, i.e., Dukes' staging of the primary lesion, the number of metastatic nodes, synchronous versus metachronous appearance of metastases, and curative versus non-curative resection were estimated. Evaluation of those categories did not provide any significant information for prognosis after hepatic resection for liver metastases. The growth patterns of the tumor boundary were classified into three types as sinusoidal, expansive, and mixed. There was no significant difference in the survival rates among these groups. The significant factor affecting prognosis was only whether the secondary tumors were encapsulated or not. Patients with encapsulated tumor of the interval longer than 2 years between colon resection and hepatic resection had a significantly better survival rate. PMID- 1776911 TI - [A study of collateral circulation in acute stage of occlusion of the middle cerebral artery]. AB - Collateral circulation of angiogram in occlusion of main trunk of the middle cerebral artery in acute stage was studied in detail, and compared with the extent of the low density area on CT. Territory of the middle cerebral artery in the lateral view of angiogram was divided into three regions. Collateral circulation time was measured with the period from the maximum filling of carotid siphon to the retrograde maximum filling of collateral circulation. With these studies, the following conclusions were obtained. 1) The degree of collateral circulation is classified into three types. One type with good collateral circulation is type I. Another type with moderate collateral circulation is type II. A further type with poor collateral circulation is type III. Angiographic circulation time in each branch of the middle cerebral artery is measured in each type. 2) There is a tendency that types with the better development of collateral circulation have the smaller low density area on CT. In type I, the smallest low density area on CT appears in the territory of basal ganglia or around corona radiata. In type II or III, the medium or large low density area on CT appears in cortical and/or subcortical territory of the middle cerebral artery. 3) There is a tendency that types with the worse development of collateral circulation have the later collateral circulation time in each region. If collateral circulation time is later than 4 seconds, it is impossible to avoid the appearance of the low density area on CT in C region. In the same way, in B region, it is later than 5 or 6 seconds, in A region, it is later than 7 seconds. But, in type II or III, there are a few cases in which it is impossible to avoid the appearance of the low density area on CT, even if collateral circulation time is earlier than those mentioned. As mentioned above, classifying of collateral circulation is possible to expect the extent of the low density area on CT, and measurement of collateral circulation time is able to estimate the appearance of the low density area on CT. In type I and II, superficial temporal artery to middle cerebral artery anastomosis is apt to make the low density area narrow on CT, and to prevent the appearance of hemorrhagic infarction. PMID- 1776912 TI - Arthroscopic resection of the shelf (mediopatellar plica) in the knee under local anesthesia in outpatient clinic. AB - Forty-two knees with symptomatic mediopatellar plicae (shelves) were managed using the operative method under local anesthesia. Of these, thirty-one knees had isolated mediopatellar plicae, and eleven had other associated intra-articular pathologic condition, such as meniscal tear, lateral patellar tracking, osteochondritis dissecans, and minor osteoarthritic changes. The clinical results were excellent or good in thirty-seven (88%) patients, fair in five patients after an average follow-up of twenty-five months. No case showed deterioration after surgery. Because there are no definitive criteria for the indication of shelf resection, arthroscopic resection of the shelf under local anesthesia is recommended if there is any possibility of it being the cause of knee pain. PMID- 1776913 TI - Friedrich's disease: a case report. AB - An eight-year-old girl was presented with painful swelling of the sternoclavicular joint. Radiological and scintigraphic examinations lead to a diagnosis of Friedrich's disease, aseptic necrosis of the sternal end of the clavicle. It is a rare condition which is to be differentiated from osteomyelitis, arthritis, or tumor. Because it is a self-resolving, benign condition, awareness of this disease will save the patient from unnecessary surgery. PMID- 1776914 TI - [Surgical research from the view point of cytokine]. PMID- 1776915 TI - Changes of A, B and D cells in Langerhans islets in pancreatic cancers of hamsters. AB - In order to clarify the effect of pancreatic hormones on the oncogenesis of pancreatic cancer, the kinetics of the B, A and D cells in the islets of Langerhans were studied in hamsters with pancreatic cancer induced by di-iso propanol nitrosamine (DIPN). Tumors appeared histologically 8 weeks and duct adenocarcinomas became evident 12 weeks after the administration of DIPN. Although the area of the islets did not change in 8 to 16 weeks, the numbers of B cells was decreased 8 weeks after the administration of DIPN and of A and D cells was decreased at 16 weeks. The area occupied by B cells in proportion to the number of islet cells showed a significant decrease 8 weeks after the administration of DIPN. Since insulin has been reported to have a trophic effect on the exocrine pancreas, our findings suggest that pancreatic B cells start to decrease at the same time that pancreatic cancer begins to form. Thus, insulin appears to play an important role locally in the oncogenesis of pancreatic cancer in acinar cells. PMID- 1776916 TI - Effects of pH on the cold preservation of the isolated rat heart. AB - Storage solutions of varying pH have been used for the simple cold preservation of the heart for transplantation. However, few studies have focused on the optimal pH for a storage solution. In the present study, we investigated the effects of storage solutions with 5 different pHs (6.60, 7.00, 7.40, 7.80, and 8.20 at 4 degrees C) on cardiac function, the leakage of cytosolic enzymes, and the myocardial metabolites content. We used the isolated perfused working rat heart model and a 6-hour preservation period in the different storage solutions. We found that cardiac function was best preserved at a pH of 7.00 or 7.80. In the hearts preserved at a pH of 7.00 or 7.80, the leakage of creatine kinase and lactate dehydrogenase was significantly less than at a pH of 7.40 (p less than 0.01). ATP was maintained at a significantly higher concentration in the pH 7.00 solution as compared with the other solutions (p less than 0.01). No significant differences were observed in the creatine phosphate and lactate levels among the five different pH groups. The results showed that the cardiac function and other parameters of cold-preserved hearts were relatively well maintained at both a pH of 7.00 and 7.80, suggesting the possible existence of a biphasic optimum pH for cold preservation. PMID- 1776917 TI - [An experimental study on the hemodynamics of the gastric tube for esophageal reconstruction]. AB - Though gastric tubes are most frequently used for reconstruction of esophagus, high rate of suture insufficiency at the site of anastomosis including minor leakage still remains as a nuisance problem. As causes for suture insufficiency at the site of anastomosis, not only systemic factors such as hypoproteinemia, pulmonary function disorder, etc. but also local factors such as insufficient blood flow in gastric tube, mechanical tension on the suture site, etc. have been pointed out. The author studied hemodynamics of the gastric tube in mongrel dogs under various conditions in detail with hydrogen gas clearance method and obtained the following results. 1. When gastric tube of greater curvature with diameter of about 3 cm (hereinafter referred to as gastric tube) is made from the whole gastric tube of one dog, tissue blood flow of the oral end of the gastric tube increased by 76%. 2. When tension of 500 g was loaded to the gastric tube in the direction toward head, tissue blood flow of the oral end of the gastric tube decreased by 12%. 3. When the gastric tube was incised circumferentially through seromuscular layer, tissue blood flow of the oral end of the gastric tube made no remarkable change. 4. In the gastric tube, measurement of tissue blood flow was possible from the terminal pulsating branch of the right gastroepiploic artery for 6 cm toward the oral site. Tissue blood flow decreased as the site of measurement became closer to the oral edge of the gastric tube in proportion to the distance. In the cases whose sutures were performed at 3 cm and 4.5 cm oral from the terminal pulsating branch of the right gastroepiploic artery, any leakage was not seen. However in 2 cases of 5 whose sutures were performed at 6 cm, leakages were observed. 5. When sympathetic nerve around the common hepatic artery was removed, tissue blood flow of the gastric tube increased as much as 53%. 6. In cases whose sympathetic nerve were untouched, tissue blood flow of the oral end of the gastric tube was measured everyday for one week after the operation. For three days after operation, the blood flow remained low but from the 4th postoperative day it gradually increased and on the 7th postoperative day it was about 45% of that of preoperative stomach and 124% of that at the time of the gastric tube preparation. 7. In cases with sympathetic nerve resection, the tissue blood flow of the oral end of the gastric tube was observed for one week after operation.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1776918 TI - [Simple process of management of central venous catheter]. AB - In our institution, central venous catheterization is a routine procedure in terms of keeping the veins in terminal cancer patients and postoperative patients, as well as on purpose to perform high calorie transfusion. Here we describe our efforts to simplify the process. The process is characterized by the intermittent transfusion with filling up of 100-fold diluted heparin; no use of filter at the usage; but free side infusion from a trigonal active plug, which is also used for blood transfusion. These patients are permitted to bathe and stay out. During a recent 2 years, a total of 111 patients was managed with this process. Duration of catheterization ranged from the shortest of 5 days to longest of 96, with a mean of 27.5 and total days of 3058. Catheter-induced fever as a complication was observed in only 3 cases (2.7%). This procedure has a considerably simplified process, which can be said to depart from the conventional ones in terms of keeping clean, however, in actual clinical routine, it is extremely safe and valuable. PMID- 1776919 TI - [Experience of coronary artery bypass grafting with internal thoracic artery]. AB - Between March 1990 and May 1991, twenty-nine patients underwent coronary artery bypass grafting. The mean number of grafts was 2.7 +/- 0.9 grafts per patient. 28 patients (96.6% of all cases) underwent CABG with the internal thoracic arteries. The perioperative mortality was 3.4% (1/29 cases). The postoperative coronary angiography at one month revealed that the early patency of total grafts, of internal thoracic artery grafts and of saphenous vein grafts were 96.7% (58/60 grafts), 100% (29/29 grafts), 93.5% (29/31 grafts) respectively. The early patency of internal thoracic artery graft was better than of saphenous vein graft. PMID- 1776920 TI - The effect of ageing on mucin contents in mouse submandibular glands. AB - There may be deleterious effects if there is an age-dependent reduction in mucin composition or content in salivary glands. To assess whether there was an effect of age in submandibular glands from male mice aged 3 months, 10 and 20 months and 27, 29 and 30 months, mucin, protein and sialic acid were quantitated. Changes in wet weight per gland and protein per gland were highly significant (p less than 0.001), as tested by analysis of variance, and the means for both were highest in middle aged glands. While sialic acid per gland showed no significant change from middle aged to old glands, mucin per gland showed an age-related decrease (p less than 0.01) when comparing either young or middle aged glands with old glands. PMID- 1776921 TI - Increased mucin levels in submandibular glands of aged male mice after chronic isoproterenol treatment. AB - Mucin levels are reduced in submandibular glands of mice during ageing. Isoproterenol (IPR) was given to mice 27 and 29 months old to assess whether levels of mucin could be restored to levels similar to those in younger mice. When compared with controls, mucin levels per gland were significantly elevated (p less than 0.05) after IPR treatment, and exceeded the peak amounts in young animals. Mucin concentrations were also higher after IPR. These observations support the contention that the gland has the ability to return to or exceed pre senescent levels of mucin. Mean sialic acid levels were elevated in each experiment after IPR treatment. There was evidence for significant diurnal variation in mucin in the aged control animals, but little evidence for such a relationship in the IPR-treated animals. After administration of pilocarpine there was a modest stimulation of sialic acid and protein levels in 20-month-old animals while mucin levels showed virtually no indication of stimulation. PMID- 1776922 TI - Regulation of cell-surface galactosyltransferase in isoproterenol-treated mouse parotid glands. AB - Chronic injection of isoproterenol into mice resulted in hypertrophy and hyperplasia of the parotid gland. As previously described for the rat, cell proliferation was accompanied by an increase in total membrane-associated galactosyltransferase. A plasma membrane localization was determined by fluorescence-activated sorting of intact cells. Co-administration of the galactosyltransferase modifier protein, alpha-lactalbumin, or the calmodulin inhibitor, trifluoperazine, blocked acinar cell proliferation by 96 h post treatment but not at 24 h. While alpha-lactalbumin appeared to interfere with galactosyltransferase-substrate interactions, trifluoperazine prevented the appearance of cell-surface enzyme in isoproterenol-treated animals. PMID- 1776924 TI - In vitro release of elastase from human blood and gingival crevicular neutrophils. AB - Peripheral PMNs were collected from blood, and crevicular PMNs separated by filtration from gingival washings in 13 patients, aged 22-75 y, who had varying degrees of gingivitis and periodontitis. After pre-incubation with cytochalasin B, the same number of crevicular and peripheral cells were incubated either in PBS (with Ca2+ and Mg2+) (spontaneous release) or in the same buffer containing increasing concentrations of FMLP (stimulated release); elastase activity was measured in the supernatant by a fluorometric technique. There was a higher spontaneous release of enzyme from crevicular than from peripheral neutrophils. The average elastase activity in the supernatant of 1 x 10(4) crevicular cells was more than five times higher than that obtained from the same number of peripheral cells. However, stimulated crevicular PMNs liberated smaller amounts of enzyme than did stimulated peripheral PMNs. These results suggest that crevicular PMNs are already releasing elastase, and are consistent with the possibility that lysosomal enzymes contribute to tissue damage during gingivitis and periodontitis. PMID- 1776923 TI - Antimicrobial proteins in human unstimulated whole saliva in relation to each other, and to measures of health status, dental plaque accumulation and composition. AB - Saliva antimicrobial proteins may interact in a common system to influence the oral ecology. Clinical studies of antimicrobial protein action thus may require a multiple-protein approach. Multivariate statistical methods have been used to describe possible patterns of interaction for lysozyme, lactoferrin, salivary peroxidase and secretory IgA in stimulated parotid saliva. However, oral microbes are most likely to encounter antimicrobial proteins in mixed resting saliva. Relationships among levels of lysozyme, lactoferrin, salivary peroxidase, and secretory IgA therefore were investigated in whole saliva from 216 subjects, and an attempt made to relate interperson variation in those proteins to differences in health and status, and dental plaque accumulation and composition. All proteins were significantly (alpha = 0.05) correlated with each other (r = 0.38 0.52, p less than 0.001). There was only one axis of common variation among proteins, and that axis was significantly correlated (p less than 0.001) with total protein (r = 0.84) and flow rate (r = -0.56). That pattern deviated from the previous finding that proteins of acinar origin tended to vary independently from proteins of ductal origin in stimulated parotid saliva. The difference between parotid and whole saliva may reflect constitutive secretion of all proteins at low levels of stimulation. Common variation of unstimulated saliva proteins suggests that antimicrobial actions can be compared in subjects at population extremes. There were no significant associations between antimicrobial proteins in whole saliva and measures of health status or plaque accumulation. However, the proportions of Streptococcus sanguis were significantly correlated with lysozyme (r = -0.26), lactoferrin (r = -0.34), peroxidase (r = -0.30), total protein (r = -0.37), flow rate (r = 0.24) and principal-components scores (r = 0.33) in a subset of subjects (n = 85) where commercial biochemical tests were used to supplement species identification by colony morphology. Those findings may indicate that saliva antimicrobial proteins can affect the composition of dental plaque. PMID- 1776925 TI - Effect of parasympathectomy on the histochemical maturation of myoepithelial cells of the rat sublingual salivary gland. AB - This effect of parasympathectomy was assessed by fluorescent microscopy using nitrobenzoxadiazole-phallacidin, which is known for its specific binding to actin filaments. Resection of the chorda tympani within 48 h after birth inhibited the normal formation of actin in the myoepithelial cells and the maturation of myoepithelial cells. The effect of denervation decreased progressively if the operation was delayed. Denervation 30 days after birth had no effect on development and differentiation of myoepithelial cells. Moreover, the procedure produced no histochemical changes in the myoepithelial cells in mature rats, even two months later. These findings suggest that the parasympathetic innervation is closely involved in the maturation of myoepithelial cells. Further, its involvement is limited to the first 48 h after birth, during which it exerts its neurotrophic effect on the myoepithelial cells present in all the acinar buds. PMID- 1776926 TI - A model for optimum functional human jaw movements based on values associated with preferred chewing patterns. AB - Jaw movements during voluntary chewing were recorded from 15 normal subjects with a sirognathograph. A computer program was used to provide a graphic display of the closing strokes in the frontal plane. A record was made of the side from which the jaw approached a central occlusal position. An average of 90 closing strokes was recorded for each subject. In 10 of the subjects, statistical differences were found between the use of the right- and left-hand sides. In these subjects this preference was confirmed by analysis of results from a second set of observations. A model was derived, using multiple regression analysis, which identified a relationship between four jaw-movement variables and an index of preference. A broad chewing pathway, with a bilateral distribution, together with a wide sagittal pathway were characteristics associated with preference. An indication of optimal jaw-movement patterns may be derived from identifying movement variables associated with preferred chewing. PMID- 1776927 TI - Relationship between total and ionized calcium concentrations in human whole saliva and dental plaque fluid. AB - Ionized and total calcium were determined with an ion-selective electrode in unstimulated whole saliva and in simultaneously collected plaque fluid. The mean ionic and total concentrations in saliva from 20 subjects were 0.53 and 1.03 mmol/l respectively, and in plaque fluid 0.64 and 1.20 mmol/l. The total calcium concentration in saliva was closely related to the total calcium concentration in plaque fluid (r = 0.95, p less than 0.001) as was the ionized calcium concentration in saliva to that of plaque fluid (r = 0.84, p less than 0.001). PMID- 1776928 TI - Three-dimensional analyses of human bite-force magnitude and moment. AB - The effect of the three-dimensional orientation of occlusal force on maximal bite force magnitude was examined in seven human subjects at three different unilateral anteroposterior bite positions (canine, second premolar and second molar). At each position, bite-force magnitude was registered in 17 precisely defined directions using a three-component force transducer and a feedback method. In addition, to assess the efficiency of transfer of muscle to bite force, for bites produced in the sagittal plane, moment-arm length was determined and the produced bite-force moment calculated. The results showed that the largest possible bite force was not always produced in a direction perpendicular to the occlusal plane. Generally, maximal bite force in medial and posterior directions was larger than that in, respectively, corresponding lateral and anterior directions. In each direction the produced force was larger at the posterior bite point than at the anterior bite point. The combined moment produced by the jaw muscles was largest for vertical bites, smallest for posteriorly directed bites and intermediate for anteriorly directed bites. In the case of vertically and anteriorly directed bites the produced moment did not vary significantly with the bite position. Hence, for these bite positions the jaw closing moment of the muscles must have kept constant. In the case of posteriorly directed bites the produced moment decreased when bite position changed from the anterior to the posterior side of the dentition. This indicated that jaw muscle activity had declined. PMID- 1776929 TI - Histological observation of large light cells that seem to be surviving hypertrophic chondrocytes in the rat mandibular condyle. AB - Large light cells (more than 20 microns dia), including some with mitotic figures, appeared to be surviving hypertrophic chondrocytes. Thus at least a few hypertrophic chondrocytes in the rat mandibular condyle may survive, be released into the primary spongiosa, and divide. PMID- 1776930 TI - The precision of motor control in human jaw and limb muscles during isometric contraction in the presence of visual feedback. AB - Experiments showed that the human capacity to maintain a particular isometric force in the presence of visual feedback during a force-level, pursuit-tracking experiment is less developed for the jaw-closing muscles than for the limb muscles. This finding may indicate that the projection on the trigeminal motoneurone pool from visual inputs is poor, or that the trigeminal effector system itself is less finely tuned. PMID- 1776931 TI - Serological response to Actinobacillus pleuropneumoniae serovar 7 infection in a commercial pig herd. AB - Serological responses to Actinobacillus pleuropneumoniae serovar 7 infection were monitored by enzyme-linked immunosorbent assay in a cohort of 66 pigs between weaning and market. Antibody concentrations were high (63/65 seropositive) at 4 weeks of age but declined to low levels from 8 to 12 weeks. Mean antibody concentrations rose significantly (p less than 0.001) between 12 and 23 weeks. Between 8 and 23 weeks of age, 33 (51.5%) of 64 surviving pigs seroconverted to A pleuropneumoniae serovar 7. Peak antibody concentrations in the seroconverting pigs usually (28/33) occurred at 23 weeks. Seroconversion to A pleuropneumoniae during the grower/finisher phase was not significantly associated (p greater than 0.05) with passive antibody concentrations at 4 weeks of age, lack of vaccination against Mycoplasma hyopneumoniae, or weaning weight. Pleuropneumonic lesions were evident at slaughter in 4 (6.3%) of 64 pigs. A pleuropneumoniae serovar 7 was isolated from 2 of 4 lungs with pleuropneumonia and from another lung with lesions considered typical of enzootic pneumonia. PMID- 1776932 TI - Cardiac changes in experimental hyperthyroidism in dogs. AB - Injection of triiodothyronine (T3) (1 mg/kg per day subcutaneously for 14 days) to 10 healthy dogs produced a hyperthyroid state characterised by high serum T3 concentrations, hypokalaemia, hyperactivity, loss of weight, diarrhoea and thirst. Electrocardiographic measurements showed that these dogs had an increase in heart rate of 63 +/- 11 beats/min with a significantly increased T wave amplitude without changes in R wave amplitude. Echocardiographic measurements showed no changes in fractional shortening and no evidence of ventricular hypertrophy, in contrast to reports in humans, cats and rats. However, the smooth muscle of the coronary arteries was markedly hypertrophied, which may cause a decrease in myocardial perfusion. PMID- 1776933 TI - Progressive ataxia associated with degenerative thoracic myelopathy in Merino sheep. AB - A neurological disorder in Merino sheep, characterised clinically by progressive posterior ataxia and microscopically by Wallerian degeneration in thoracic segments of the spinal cord, is described. Animals of both sexes were affected, with the earliest onset of disease being at 5 months of age. Most affected animals died before 2 years of age. The clinical, pathological and epidemiological features suggest that this degenerative thoracic myelopathy is a previously unrecognised entity differing from other reported causes of ataxia in sheep in Australia. PMID- 1776934 TI - The effects of Arctotheca calendula (capeweed) on digestive function of sheep. AB - The effects of Arctotheca calendula (capeweed) on digestive function in the rumen, caecum and colon of sheep were studied. Three groups of 2-year-old Merino wethers were compared: 13 grazing capeweed-free pasture for 23 days; 8 fed 700 g of lucerne hay daily for 18 days, and 13 fed 6 kg of freshly cut capeweed (dry matter 11.3%) daily for 7 days. Capeweed did not cause diarrhoea and based on measurements of products of fermentation in the rumen, the plants were as nutritious as pasture containing grasses and clovers. The main disadvantage of capeweed in this single feeding trial was that sheep eating it lost body weight due to their inability, or lack of incentive, to consume enough dry matter. PMID- 1776935 TI - Toxigenic type D Pasteurella multocida and progressive atrophic rhinitis in New South Wales pig herds. PMID- 1776936 TI - Eimeria alabamensis and Eimeria brasiliensis in cattle in northern Queensland. PMID- 1776937 TI - Anticoagulant in the tick Ixodes holocyclus. PMID- 1776938 TI - Trichostrongylus axei infection as a cause of deaths and loss of weight in sheep. PMID- 1776939 TI - Corynetoxin poisoning in sheep in the south-east of South Australia associated with annual beard grass (Polypogon monspeliensis). PMID- 1776940 TI - Haematological and biochemical reference values for grazing Saanen goats. PMID- 1776941 TI - Gilruth Prize. Professor Kenneth Vincent Finlayson Jubb. PMID- 1776942 TI - Seddon Memorial Prize. Dr Helen Scott-Orr. PMID- 1776943 TI - Kesteven Medal. William Anthony Geering. PMID- 1776944 TI - Evolution and path models in human behavioral genetics. AB - The evolutionary implications of the path-analysis model most often used in human behavior genetics are examined. With directional selection, a model of pure vertical environmental transmission does not respond in a fully adaptive fashion. Unless the coefficients of transmission are exactly 0.50, the population mean will not equilibrate at the selective optimum over time. If there is both genetic and vertical environmental transmission, then the population mean can equilibrate at the selective optimum. In the presence of genetic transmission, vertical environmental transmission increases population fitness and has a strong effect on the rapid movement of the mean toward the selective optimum. This raises the intriguing paradox of why empirical evidence suggests that vertical environmental transmission is usually small when it possesses such important fitness properties. PMID- 1776945 TI - Decreased metabolic rate as an acrolein resistance mechanism in Drosophila melanogaster. AB - Using several mutant strains of Drosophila melanogaster, with different degrees of spontaneous activity, we have studied whether a decreased metabolic rate, measured by oxygen consumption, might be one of the mechanisms involved in acrolein resistance, such as predicted by Hoffmann and Parsons (1989a, b). The results agree with this prediction. PMID- 1776946 TI - Female sexual receptivity is defective in juvenile hormone-deficient mutants of the apterous gene of Drosophila melanogaster. AB - During reproductive maturation of female insects, the acquisition of sexual receptivity is coordinated with ovarian development. Juvenile hormone regulates vitellogenesis in the ovaries, but the action of this hormone in the development of sexual behavior is less well-understood. A strain of Drosophila melanogaster carrying a mutation in the apterous gene (ap4) was known to exhibit arrested vitellogenesis (rescuable by applying exogenous juvenile hormone), sterility of both sexes, and a deficiency of juvenile hormone. In this study, we examined the effects of mutations of ap on female receptivity and its relationship to juvenile hormone. We observed abnormally low female receptivity in homozygous ap strains, and heteroallelic combinations of ap mutations exhibited low receptivity. For female receptivity, ap showed no dominance (i.e., ap/ap+ was intermediate between ap/ap and ap+/ap+). Low receptivity mapped genetically to the ap locus. The reduction in female receptivity in these mutants is positively correlated with levels of juvenile hormone synthesized by their corpora allata. PMID- 1776947 TI - Sex ratio, relative frequency, and mating success in two genotypes of Drosophila melanogaster. AB - When two types of Drosophila are in competition, the frequency dependence of mating success is measured routinely in our laboratory and many others by direct observation of mating pairs in observation chambers. In these experiments, the Sex Ratio (number of males divided by the number of females) is usually 1:1. Various authors have shown that the male sexual activity depends on the Sex Ratio. We wished to investigate a possible influence of Sex Ratio on the frequency dependence of mating success and the "rare-type advantage." "General" Sex Ratio changes do affect mating success. The influence of the so-called "relative" Sex Ratio (number of males of the first type, A, divided by number of females of the second type, B) seems very low. Male Ratio and Female Ratio changes (i.e., changes of Genotype Ratio for one sex only, the number and type of the other sex flies remaining constant) have approximately the same influence: in these experiments the relative success of both types is also frequency dependent. PMID- 1776948 TI - Effects of naloxone on seizure latencies of black (a/a) Mongolian gerbils (Meriones unguiculatus). AB - The effects of the opiate antagonist, naloxone, on seizure tendencies of the black or nonagouti line of Mongolian gerbils (Meriones unguiculatus) carrying the a/a coat color allele was investigated. The animals were tested under the following conditions: mock infection; 0.9% NaCl injection; and naloxone at doses of 1, 2, 5, and 10 mg/kg body weight. The results indicated that when naloxone was at doses of 2 mg/kg body weight and higher, there was an increase in the animals' seizure latencies relative to that manifested under the basal condition. PMID- 1776950 TI - Isolation of two endo-beta-N-acetylglucosaminidases with different specificities from Pseudomonas sp. AB - Two endo-beta-N-acetylglucosaminidases (PI and PII) have been isolated from the culture fluid of Pseudomonas sp. The substrate specificity of the PI enzyme was very similar to that of Endo-H from Streptomyces plicatus. On the contrary, the PII enzyme had a novel substrate specificity that degraded both high-mannose type and hybrid type oligosaccharides derived from ovalbumin, and the core structure of complex type oligosaccharides derived from human transferrin and porcine pancreatic lipase. PMID- 1776949 TI - Genetics of Type A behavior in two European countries: evidence for sibling interaction. AB - Young male twins in The Netherlands and England completed the Jenkins Activity Survey (Dutch and English versions, respectively), a measure of Type A behavior. Separate model fitting analysis revealed a similar pattern of variance estimates and associated goodness of fit across the two countries. The data were then analyzed concurrently, with a scalar parameter included to account for differences in variance due to the disparity of the measurement scales. A model including additive genetic and individual environmental effects gave a good explanation to the data. The heritability estimate was 0.28. Models of social interaction and dominance explained the data even better, the former being preferred. The twins' parents were included in the analysis to examine population variation for Type A behavior intergenerationally. There was evidence for individual environmental experiences having a greater influence on Type A behavior in the older generation. PMID- 1776951 TI - Simple and rapid measurement of platelet-activating factor (PAF) in whole blood. AB - A simple assay of platelet-activating factor (PAF) in whole blood was developed, employing acetone extraction and thin layer chromatography (TLC) purification of blood sample. The activity of acetylhydrolase present in blood sample was almost completely suppressed by ice-cold acetone extraction, and other inhibitory substances interfering the activity of PAF were effectively removed from the acetone extract by TLC. Then, the treated samples were subjected to a conventional PAF bioassay using rabbit platelets. The recovery rate of PAF by the above procedure was constant and feasible (46-48%). The lower limit of the present assay was estimated to be 1.0 x 10(-10) M. Employing the present method, it was able to determine the amount of PAF in blood (1.2-6.0 x 10(-10) M) of 6 out of 14 septic patients, while no significant PAF activity was detected in the samples from 6 healthy subjects. These results indicate a potential application of the present method in the clinical assay of PAF in blood. PMID- 1776952 TI - Widespread phylogenetic distribution of a protein methyltransferase that modifies L-isoaspartyl residues. AB - Protein L-isoaspartyl methyltransferase is implicated in the repair or degradation of age-damaged proteins that contain atypical, L-isoaspartyl residues. The enzyme has previously been demonstrated in a variety of vertebrates and in the bacterium S. typhimurium (O'Connor, C.M. and Clarke, S. (1985) Biochem. Biophys. Res. Commun. 132, 1144-1150). We report here that the enzyme is present in a mollusc (great slug), a crustacean (pill woodlouse), a fungus (mushroom), and a plant (wheat germ). Using mushroom as an example, we show that the enzyme activity may, in some instances, require a partial purification before its presence is clearly detectable. Our findings significantly extend the known phylogenetic distribution of this enzyme and suggest that it may play an indispensable role in protein metabolism. PMID- 1776953 TI - Transglycosylation activity of endo-beta-N-acetylglucosaminidase from Arthrobacter protophormiae. AB - Endo-beta-N-acetylglucosaminidase from Arthrobacter protophormiae has transglycosylation activity. Treatment of (Man)6(GlcNAc)2Asn with the enzyme in the presence of free N-acetylglucosamine gave a mixture of (Man)6GlcNAc and (Man)6GlcNAc beta 1----4GlcNAc mixture. N-Acetylglucosamine at the reducing end of the latter sugar chain was found by HPLC of the carbohydrate composition and of an exoglycosidase digest of the pyridylamino derivative of the reducing-end residue, and by 400 MHz 1H-NMR spectroscopy. PMID- 1776954 TI - The regulation of rat brain pyruvate kinase by estradiol-17 beta. AB - The effect of estradiol-17 beta on the activity of pyruvate kinase from rat brain was investigated at initial stages of hormone administration. After estradiol treatment the rise of pyruvate kinase activity was found in the firmly bound synaptosomal fraction, whereas pyruvate kinase activity in soluble and weakly bound fractions has been reduced. The activation of the enzyme was also discovered after glutaraldehyde fixation on synaptosomal membranes. The possible mechanism of extragenomic estradiol action is discussed. PMID- 1776955 TI - dsDNA-stimulated phosphorylation of a 72-kDa nucleoprotein accompanies PMA induced HL-60 leukemic cell differentiation. AB - PMA treatment of human leukemic cells resulted in a significant increase in the phosphorylation of a 72-kDa protein, which was abrogated by treating the nuclear extracts with DNase I, but additionally stimulated by adding DNA. To be active, DNA must be double-stranded with an average size of 300 base pairs, but shows no apparent species- or sequence-specificity. NP-72 isolated from control or PMA treated nuclei with 1 mM ATP lacked phosphorylating activity, suggesting it to be a substrate for a dsDNA-stimulated protein kinase(s). Simultaneous exposure of HL 60 cells to PMA and the protein kinase C inhibitor staurosporine diminished the phosphorylation of NP-72. These data suggest that leukemia cell differentiation is accompanied by the induction and/or activation of a dsDNA-stimulated protein kinase whose protein substrates include NP-72 and whose activity is directly or indirectly influenced by protein kinase C. PMID- 1776956 TI - Effects of chemically defined tannins on poly (ADP-ribose) glycohydrolase activity. AB - Three classes of chemically defined tannins, gallotannins, ellagitannins and condensed tannins were examined for their inhibitory activities against purified poly (ADP-ribose) glycohydrolase. Ellagitannins showed higher inhibitory activities than gallotannins. In contrast, condensed tannins, which consist of an epicathechin gallate (ECG) oligomer without a glucose core were not appreciably inhibitory. Kinetic analysis revealed that the inhibition of ellagitannins was competitive with respect to the substrate poly(ADP-ribose), whereas gallotannins exhibited mixed-type inhibition. These results suggest that conjugation with glucose of hexahydroxy-diphenoyl (HHDP) group, which is a unique component of ellagitannins, potentiated the inhibitory activity, and that the structure of ellagitannins may have a functional domain which competes with poly(ADP-ribose) on the poly(ADP-ribose) glycohydrolase molecule. PMID- 1776957 TI - Fluidity of human erythrocyte ghosts. AB - The fluidity, defined by its two components, the order parameter, S, and the rotation correlation time, tau c, was studied on healthy human erythrocytes ghosts. We also measured ghost protein, cholesterol and phospholipid contents as well as acetylcholinesterase activities. No statistically significant difference was evidenced between erythrocyte ghosts from men and women. Whereas tau c values did not significantly vary among sample elements, variations of ghost order parameters about the mean were explained at 61% by changes in cholesterol contents and, to a lesser extent, in protein contents. No relationship was evidenced between ghost order parameter values and those of corresponding acetylcholinesterase activities. Liposomes prepared from ghost lipid extracts had much lower order parameter values than did corresponding ghosts. A few experiments were performed in the same way on ghosts from sickle blood. This disease appeared to decrease the bilayer lipid motionnal freedom as an increase of the order parameter values was evidenced. PMID- 1776958 TI - Effect of monosodium glutamate treatment during neonatal development on lipogenesis rate and lipoprotein lipase activity in adult rats. AB - Monosodium glutamate (MSG) has been shown to alter several neuroendocrine functions in neonatally treated rats. To evaluate possible alterations in lipogenesis rate and lipoprotein lipase (LPL) activity, male and female rats were injected during the neonatal period with MSG or saline (controls). In male MSG rats, an increase in lipogenesis of liver and retroperitoneal adipose tissues was observed. Triton WR 1339 (an LPL inhibitor) administration decreased retroperitoneal lipogenesis in these animals. In female rats, MSG-treatment increased lipogenesis only in gonadal and retroperitoneal adipose tissues. No change was observed in hepatic lipogenesis and the Triton administration did not change retroperitoneal lipogenesis. LPL activity was increased in the gonadal and retroperitoneal adipose tissues in male and female MSG-treated rats. These data suggest that there is a specific sex-dependent response in the development of MSG induced obesity. PMID- 1776959 TI - Deoxycorticosterone, 18-OH-deoxycorticosterone and corticosterone determination by high performance liquid chromatography in monolayer adrenal cell culture. AB - Reversed-phase HPLC offers a rapid, qualitative as well as quantitative method for separation and determination of deoxycorticosterone, 18-OH deoxycorticosterone and corticosterone in primary culture of adrenocortical cells. The resolution is sufficient for the purpose of quantitative determination. The limitation of this method lies in its sensitivity for serum steroid determination, but is perfectly applicable at cell cultures where the concentration of these steroids is highest. PMID- 1776960 TI - Synthesis of maltotriose by maltase purified from rabbit kidney. AB - To clarify the enzyme participates in maltotriose synthesis, we purified maltase from rabbit kidney using 2-amino-2-hydroxymethylpropane-1,3-diol (Tris) affinity column chromatography. The purified enzyme possessed specific activity of 33.7 mumol/mg/min and estimated molecular weight of 350,000 dalton, as judged by SDS polyacrylamide gel electrophoresis, comparable with those reported from rat kidney. Moreover this enzyme possessed not only maltase (maltose----glucose) but also amylomaltase (maltose----maltotriose) activity, and both activities were inhibited by Tris in a dose-dependent manner with similar IC50 values. From these results, we concluded that maltotriose was synthesized by maltase in vitro and that kidney maltase may participate in sugar metabolism in vivo. PMID- 1776961 TI - Protective effect of oleanolic acid and ursolic acid against lipid peroxidation. AB - In a search for plant products against cancer, the protective effect of two plant products, ursolic acid isolated from Ocimum sanctum and oleanolic acid from Eugenia jumbolana against free radical induced damage was studied. Three different standard systems viz., ascorbic acid, carbon tetrachloride, ADP/Iron were used to induce lipid peroxidation in isolated rat liver microsomes in vitro. Both oleanolic acid and ursolic acid offered remarkable protection of 90% and 60% respectively. Both the compounds did not induce lipid peroxidation by themselves that improved the therapeutic application. PMID- 1776962 TI - [Effective synthesis and cloning of the human interleukin-2 gene and its analog: expression of the interleukin-2 gene in E. coli cells]. AB - Artificial DNA fragments encoding human interleukin-2 (133 a.a.) and its analogue (deletion of 14 C-terminal a.a.) were prepared by means of the DNA polymerase I mediated extension of synthetic polynucleotides having short overlapping sequences at their 3'-ends. The fragments were cloned in specially designed pFH type plasmids and then excised by the FokI and other restriction endonucleases to yield the subfragments with the structurally predetermined 5'-unique cohesive ends. The complete synthetic gene was constructed by one or two-step ligation. The expressed IL-2 was tested by analysing the T-cell proliferation activity of E.coli crude lisates containing the pEXIL2 expression plasmid. PMID- 1776963 TI - [Modification of nucleic acids by reactive oligonucleotide derivatives having a 5'-terminal nitrogen yperite residue, covalently bound with linkers of varying length. Conformation dynamics of group reactivity in complementary complexes]. AB - By optimizing the length of a linker bearing 5'-terminal alkylating 4-[methyl-(2 chloroethyl)amino]benzylphosphoramide residue, a reactive oligodeoxyribonucleotide derivative has been constructed with an optimal ability to alkylate nucleic bases in a double-stranded region of the complementary complex between a target NA and the addressed oligonucleotide. A such oligonucleotide could be useful for modifying the target NA if the nucleophilic sites of its single-stranded 3'-terminal region are protected due to a specific tertiary structure. A molecular mechanical modelling suggested that the insertion of two additional methylene groups into the standard linker provides an optimal increase in the efficiency of the modification of the base sites exposed into the major groove of the complementary complex. Synthesis of an oligonucleotide derivative with the modified linker and experiments on the target alkylation showed a 2-3 fold increase of the modifying ability as compared with the reagent having the standard linker. The conformational dynamics of the reactive group is discussed. PMID- 1776964 TI - [Oligodeoxynucleotides, containing 6-O-alkylated guanine segments recognized by HaeIII restriction endonuclease]. AB - A series of self-complementary decadeoxynucleotides containing a native or modified HaeIII site GGCC (with one or both guanine residues 6-O-cetylated) have been synthesized by the phosphotriester approach. The nonmodified decanucleotide is normally digested with snake venom phosphodiesterase as well as with HaeIII and BspI restriction endonucleases, whereas the bulky 6-O-alkyl substituent strongly inhibits the VPDE hydrolysis and completely prevents digestion with the endonucleases. PMID- 1776965 TI - [Introduction of aminoalkyl groups into prepared synthetic oligodeoxyribonucleotides by transamination of cytosine residues]. AB - The bisulphite-catalysed transamination of cytosine residues by means of ethylenediamine generally used for the natural nucleic acids modification has been extended on relatively short synthetic oligonucleotides. One of the aminoalkyloligonucleotides thus obtained has been used for preparing a biotinylated hybridisation probe. PMID- 1776966 TI - [Polyphotobiotin--a new reagent for introducing biotin into nucleic acids]. AB - A new reagent, polyphotobiotin (PPhB), for labelling DNA probes has been obtained using low molecule oligoethylenimine (M 600 Da). Photoreactive group of PPhB is 4 azido-salicylic acid. The procedure is simple and quick, the reaction time being about 20 min. PPhB-labelled DNA has the same efficiency in the hybridisation analysis as DNA labelled with Bio-4-dUTP via PCR. PMID- 1776967 TI - [RNA ligase from bacteriophage T4. VIII. Solid phase enzymatic synthesis of oligoribonucleotides]. AB - A method of the solid-phase enzymic synthesis of oligoribonucleotides has been suggested. The donor is fixed through its 3'-end on a water-insoluble matrix followed by the stepwise RNA ligase- and T4 polynucleotide kinase-assisted coupling of trinucleoside diphosphates in the 5'-direction. As an example, (pA)6pAox was immobilised on Biogel P-300 hydrazine and the RNA ligase-catalyzed addition of acceptor ApApA to the donor gave (Ap)9 with the 50% yield. PMID- 1776968 TI - [Structure of the O-specific polysaccharide chain of Yersinia aldovae lipopolysaccharide]. AB - O-specific polysaccharide has been isolated on mild hydrolysis of lipopolysaccharide from Yersinia aldovae and shown to consist of 2-acetamido-2 deoxy-D-glucose, D-glucose, 2-acetamido-2-deoxy-D-galactose, and 3,6-dideoxy-3- [(R)-3-hydroxybutyramido]-D-galactose in molar ratio 2:2:1:1. Acid hydrolysis, methylation, solvolysis with anhydrous hydrogen fluoride, 1H and 13C NMR studies indicated the polysaccharide to be composed of hexasaccharide repeating units of the following structure: [formula see text]. PMID- 1776969 TI - [Synthesis and antibacterial activity of eremomycin esters through the carboxyl group]. AB - Methyl, benzyl and diphenylmethyl esters of the glycopeptide antibiotic eremomycin were obtained by its treatment with corresponding diazoalkanes. The esters have high antibacterial activity but are less active than the parent antibiotic. PMID- 1776970 TI - [Inhibition of activity of purine nucleoside phosphorylase with N9- and N7-(beta D-glucofuranuronosyl)purines and 8-substituted N9-(beta-D ribofuranosyl)purines)]. AB - In an effort to develop more potent inhibitors of purine nucleoside phosphorylase (PNP, EC 2.4.2.1) as immunosuppressive and anticancer chemotherapeutic agents, the affinity of the electrophoretically homogeneous enzyme from rabbit kidney for sixteen N9- and N7-beta-D-glucofuranuronosides and for C8-substituted beta-D ribofuranosyl purines was determined. In all cases N7-substituted analogues of hypoxanthine and guanine were twice more active inhibitors of PNP than N9 substituted compounds. No effective inhibitors were found among the C8 substituted analogues, apparently due to the bulky C8-groups hindering rotation around the glycosidic bond and thus preventing optimal binding with the enzyme. PMID- 1776971 TI - Sympathetic stimulation-evoked overflow of norepinephrine and neuropeptide Y from the heart. AB - Neuropeptide Y (NPY) and norepinephrine are released together on sympathetic activation. To compare the time courses of NPY and norepinephrine washout from cardiac tissues, we measured the overflow of NPY-like immunoreactivity (NPY-LI) and norepinephrine in coronary sinus blood before, during, and after 3-minute trains of ansae subclaviae stimulation in 13 anesthetized dogs. We also measured vagally induced cardiac cycle length responses before and after ansae stimulation. Ansae stimulation increased NPY-LI and norepinephrine overflow from the heart in a frequency-dependent manner (p less than 0.02). After stimulation of the ansae at 5 and 10 Hz, the peak norepinephrine overflows decayed by 90% within 2 minutes, but the NPY-LI overflows required 17 +/- 11 and 35 +/- 21 minutes, respectively, to decay by 90%. Cardiac vagal effects were inhibited after 5- and 10-Hz ansae stimulations, and the peak inhibitions decayed by 90% after 19 +/- 7 and 39 +/- 16 minutes, respectively. The 90% decay times of the NPY-LI overflows were longer (p less than 0.003) than those of the norepinephrine overflows but did not differ significantly (p greater than 0.4) from the 90% decay times of the inhibition of vagal effects. We characterized NPY-LI in coronary sinus and arterial plasma by reversed-phase high-performance liquid chromatography. Before ansae stimulation, the main peak of NPY-LI in the plasma had a retention time similar to that of the oxidized human NPY-(1-36) standard. During ansae stimulation, however, there was a substantial increase in the peak of NPY-LI that eluted in a position similar to that of the monoxidized human NPY (1-36) standard. These data support the hypothesis that neurally released NPY mediates the sympathetically evoked inhibition of vagal effects and indicate that the time course of removal of NPY from the heart differs substantially from that of norepinephrine. Moreover, under basal conditions, most NPY in the circulation is present in the oxidized form or as a fragment of the 36-amino-acid peptide. In contrast, cardiac sympathetic stimulation evokes the overflow of monoxidized NPY (1-36) into the coronary sinus plasma. PMID- 1776972 TI - [A histopathological study of toxicity of tetraethoxysilane intraperitonealy administrated to ICR mice]. PMID- 1776973 TI - [Carpal tunnel syndrome--pathogenesis and treatment]. PMID- 1776974 TI - Diagnostic value of serological tests for melioidosis in an endemic area. PMID- 1776975 TI - The effect of serum from patients with acute myocardial infarction on in vitro lymphocyte reactivity. II. Inhibition of IL-2 production. AB - Culture supernatants from concanavalin-A (con-A)-activated peripheral blood lymphocytes from healthy controls grown in the presence of sera from 20 patients 24 hours and 1 week after acute myocardial infarction (AMI) were tested for their mitogenic activity and for the presence of interleukin-2 (IL-2). Binding of exogenous IL-2 to activated lymphocytes from 10 patients was also determined. In supernatants prepared in the presence of patients' as compared to control sera, a significantly decreased mitogenic activity and IL-2 content were found. The mitogenic activity and IL-2 content in culture supernatants prepared with patients' sera collected 24 hours after the AMI (AMI I) and one week thereafter (AMI II) were significantly suppressed, and the degree of suppression in the 24 hour sera was significantly higher than in those collected after one week. No significant differences were observed in the binding capacity to exogenous IL-2 of activated patients' and control lymphocytes. The possibility is that immunosuppressive factors in the patients' sera, including cortisol, may suppress the patients' immune response acting through inhibition of IL-2 production. PMID- 1776976 TI - A novel positively-charged lipid 1,2-bis(hexadecylcycloxy)-3-trimethyl aminopropane (BisHOP) enhances the adjuvant effect of liposomes on encapsulated tetanus toxoid. AB - A novel positively charged lipid, 1,2-bis(hexadecylcycloxy)-3 trimethylaminopropane-HCl (BisHOP), when incorporated into the bilayers of phosphatidylcholine (PC) and distearoyl phosphatidylcholine (DSPC) dehydration rehydration vesicles (DRV), was shown to have a powerful effect in enhancing the IgG1 response to tetanus toxoid encapsulated within the liposomes. The adjuvant effect was significantly greater when 20% BisHOP was incorporated as compared to 10% incorporation and to control PC and DSPC DRV. Plain, uncharged DSPC DRV were found to have a greater adjuvant effect than plain PC DRV on the entrapped tetanus toxoid after a single intramuscular injection. Even though antibody levels at 8 weeks post-injection were similar for 20% BisHOP PC and DSPC DRV, the rate of rise of antibody titres was more rapid for 20% BisHOP DSPC than for 20% BisHOP PC DRV. These results suggest that faster and higher titers of antibodies may be obtained by optimal manipulation of the charged and non-charged lipid components of liposomes. PMID- 1776977 TI - Basement membrane antibodies in Alport's syndrome. AB - By the indirect immunofluorescent technique, sera from patients with Alport's syndrome showed a reaction with the basement membrane of the capillary wall of glomeruli and peritubular vessels and nearby interstitial tissue of normal monkey and mouse kidney as a substrate. It also revealed bright staining to the matrix surrounding the clusters of EHS tumor cells and stromal tissues. These reactions were caused by autoantibodies present in these sera. These findings were supported by the detection of antilaminin, nidogen and anti collagen type VI in the sera by ELISA method. These evidences suggest that the Alport's patients developed stage of autoimmunity. The exact causes were not so clear, but seemed to be due to multiple factors. PMID- 1776978 TI - Association of rhinitis in adult asthmatic. AB - In a study of 124 adult patients with bronchial asthma, 65% of them had associated rhinitis. In the asthmatics who had associated rhinitis, both diseases usually started within two years of one another but either disease might develop first. In 21% of the patients, asthmatic attacks were preceded or precipitated by rhinitis symptoms. In the patients who had asthma alone or those associated with rhinitis, no significant difference were found in terms of age and sex distribution, age of onset, and a positive family history of asthma, rhinitis or allergic diseases. Response to skin prick test using six different types of allergens also showed no difference in the two groups of patients. Sensitivity to house dust was common among both groups of patients as well as in the normal controls suggesting a common occurrence of house dust mite in our community and making the skin prick test using this allergen unsuitable as a test for atopy in our population. PMID- 1776979 TI - Effect of allerglobuline injection on serum immunoglobulin levels in ENT patients. AB - Allerglobuline is a human gammaglobulin preparation which has been reported to have a protective effect against Type I allergic diseases and chronic infection of the upper respiratory tract both in adults and children. This study included 64 patients suffering from perennial allergic rhinitis and/or chronic infection of the nose, paranasal sinuses and pharynx. All patients received Allerglobuline 10 ml intramuscular injection once a week for 5 times then once a month for another 3 times. Blood samples were taken before the first and after the last injections to assay for the levels of Igs G, A, M and E. The therapeutic responses were evaluated after the fifth injections by dividing into 5 grades (from Grade I = excellent to Grade V = no response). Statistical analysis revealed that there was no significant difference between the pre- and post treatment levels of Igs, G, A and M. But the level of IgE decreased significantly after 8 injections (p less than 0.001). There was no correlation between the level of immunoglobulins and grade of therapeutic responses. But the number of patients who respond satisfactorily to Allerglobuline treatment increased from 62.26% after 5 injections to 77.36% after 8 injections. This difference does not reach the statistically significant level but is noteworthy. PMID- 1776980 TI - The study of bronchial hyperresponsiveness in asthmatic children by forced oscillation technique. AB - We have studied the bronchial hyperresponsiveness (BHR) of children with normal controls and asthma by methacholine inhalation challenge, using a forced oscillation method. Four parameters, respiratory conductance (Grs), bronchial responsiveness (PD35Grs), bronchial sensitivity (Dmin) and reactivity (SGrs) were studied. There were three patterns of dose-response curves identified in this study, which were significantly correlated to the clinical severity of asthma. (r = 0.846, p less than 0.001, Spearman's rank correlation). There were significant negative correlations between control Rrs (Rrs cont.) and age (r = 0.514, p less than 0.001) or body height (r = 0.685, p less than 0.001). Positive correlations between SGrs and subjects' age (r = 0.457, p less than 0.001) and body height (r = 0.496, p less than 0.001) were also noted. In the normal controls, Dmin and PD35Grs were over 25 units and 50 units, respectively. The Grs for normal children was statistically higher than that of asthmatic children (p less than 0.05). In the asthmatic children, there were significant differences among all subgroups in PD35Grs (p less than 0.001) and Dmin (p less than 0.01). In summary, the bronchial provocation test using the forced oscillation technique is simple, fast and easy to be applied to children. In addition to being capable of investigating BHR, it may offer valuable information for the clinical diagnosis and treatment of asthmatic children. PMID- 1776981 TI - Fractionation and immunological characterization of allergens and allergoids of Prosopis juliflora pollen. AB - Allergoids of Prosopis juliflora pollen were prepared by formalinization of crude allergen and glycoprotein. Fractionation of crude allergen and allergoids on Sephadex G-100 resulted in separation of proteins of varying molecular size and a glycoprotein of 81 to 13 KD. Allergoids prepared from the glycoprotein fractionated into two proteins of approximately 200 KD and more than 200 KD. Crossed immunoelectrophoresis indicated 12 and gel diffusion test 3 precipitating antigens incrude allergen extract; by these tests allergoids depicted 8 and 3 precipitin bands, respectively. The precipitin analysis showed heterogeneity of allergenic determinants and also variation in cross-immunogenicity of the formalinized derivatives. The skin prick and radioallergosorbent tests depicted greater activity of fractionated crude allergens than the allergoids. The above tests suggest altered and concealed antigenic determinants as result of formalinization of P. juliflora pollen which, however, showed reduced allergenic activity relative to the native allergen. PMID- 1776982 TI - The effect of serum from patients with acute myocardial infarction on in vitro lymphocyte reactivity. I. Inhibition of mitogen stimulation. AB - Sera from 20 patients obtained within 24 hours and one week after acute myocardial infarction (AMI) were tested for their immunomodulating effect on concanavalin-A (con-A) stimulated lymphocyte cultures from 11 healthy unrelated donors. Individual control sera from 21 healthy donors and 5 pools of control sera were used for comparison. Cortisol levels were tested in patients' and controls' sera. A significantly higher suppressive effect was seen in the presence of patients' sera taken at 24 hours than corresponding sera taken one week later. However, the suppressive effect after one week was increased as compared to control sera. A significant correlation between the degree of suppression and the cortisol level in corresponding sera was observed. An increased immunosuppression was observed with increased cortisol levels. PMID- 1776983 TI - [Post-radiotherapy xerostomia in patients with oral cancer. Changes in salivary inorganic components and immunoglobulins]. AB - Following therapeutic doses of irradiation to the salivary glands the glandular tissues suffer an early degeneration of the serous cells and focal necrosis of the parenchyma. Xerostomia is present and persist for a time, depending upon the dose of irradiation. PMID- 1776984 TI - [Influence of patient's personal characteristics on anxiety level, oral hygiene, pain intensity at infiltrative anesthesia puncture and time of professional care]. AB - A total of 76 dental patients (46 women and 30 men) were surveyed in order to investigate the relationships of dental anxiety with another indexes. Patient's appearance had significant influence (P less than 0.05) on dental anxiety, oral hygiene, pain intensity to local anesthesia infiltrate and on efficiency of routine dental procedures. PMID- 1776985 TI - [Lupus erythematosus. 1. Etiopathology, pathology and clinical findings with special reference to the oral mucosa]. AB - Based on current evidence from the literature the authors outline the concept, epidemiology and pathogenesis of lupus erythematosus as well as the histopathological, immunopathological and clinical diagnosis of the disease. An original iconography of the latter aspects is given. PMID- 1776986 TI - [Lupus erythematosus. 2. Prognosis, treatment, outcome and stomatological management]. AB - Based on current evidence from the literature, the prognosis, treatment and outcome of lupus erythematosus are presented with special reference to difficulties encountered in the management of patients with involvement of the oral cavity. Original iconography of illustrative treated cases is included. PMID- 1776987 TI - [Iatrogenic risks in orthodontic treatment]. AB - This first task of a dentist, regardless of his speciality, is to maintain de dentoperiodontal unit in the best of conditions and prevent possible iatrogenic damage. Particularly in orthodontic treatment, a sort of scaling of the dental crown in the debanding phase is advisable. PMID- 1776988 TI - [Incipient cariogenic demineralization of human enamel]. AB - 32 teeth (12 premolars and 20 molars) were studied under light microscopy, polarized microscopy, transparence light microscopy and scanning electron microscopy. These teeth presented changes in colour in their free and proximal surface as well as close to pits and fissures. As an extra diagnostic test the PAS reaction was used to assess descalcifying processes in both light and transparence microscopy. Polarized light was used to assess normal enamel. Scanning electron microscopy corroborated the lesions produced in the enamel surface in the form of micropores. PAS reaction diagnosed decalcifying processes in yellow, brown and brownish stains. White staims not always were PAS-positive and when they reacted in the same manner as other positive stains, with the immersion technique. This penetrated 40-60 umtrs. and in some areas in relation to lamellae they reached dentin. Light, polarized and scanning electron microscopy showed the presence of micropores in the external surface of enamel in PAS-positive cases. The possibility of a modified PAS technique to use in clinical practice is discussed. It is concluded that PAS relation is useful as "ex situ" test to detect the first signs of mineral salt loss at the enamel surface. More research is needed to transfer these results to clinical practice. PMID- 1776989 TI - Development of glial fibrillary acidic protein immunoreactivity in thyroidectomized rats. AB - The majority of astroglia develop postnatally in rats. GFAP (glial fibrillary acidic protein)-immunoreactivity appears mainly during the 2nd and 3rd postnatal weeks throughout the brain. Hypothyroidism inhibits, among others, the cell proliferation, maturation, and migration of neurons. However, hardly any data on the effect of hypothyroidism on GFAP-immunoreactivity are available in the literature. In our experiments, thyroidectomy was performed between the 3rd and 5th postnatal days. Operated and control animals from the same litter were perfused transcardially and processed for immunohistochemistry in parallel after 2, 3, and 4 wk. On the basis of serial sections, the development of GFAP immunoreactivity was not generally affected by hypothyroidism. We could observe only two phenomena that showed a tendency of retardation in the operated animals: (1) the decrease of the strong GFAP-immunopositivity of white matter tracts (for example, internal capsule and pyramidal tract) and (2) the gradual disappearance of the GFAP-immunoreactive radial fibers (for example, in the neocortex, in the olfactory bulb, and around the 3rd ventricle). PMID- 1776990 TI - Biochemical, morphological, and functional changes during peripheral nerve regeneration. AB - The success of axon regeneration after nerve injury should be judged by the extent to which the target organs regain their function. Recovery of muscle contraction involves axon regeneration, reestablishment of nerve-muscle connections, recovery of transmission, and muscle force. All these processes were investigated under the same experimental conditions and correlated in order to better understand their time-course and interdependence. The sciatic nerve of a rat was crushed in the thigh. The ingrowth of regenerating motor axons into the soleus (SOL) and extensor digitorum longus (EDL) muscles was monitored by measuring the activity of choline acetyltransferase (ChAT), a marker enzyme for cholinergic nerve terminals, in the muscles. The electron microscopic cytochemistry of acetylcholine esterase (AChE) was used to estimate the reestablishment of neuromuscular junctions in these two muscles. The recovery of muscle contraction was followed by measuring the force of isometric contraction in the triceps surae muscle in vivo. The pattern of ChAT recovery during reinnervation was similar in the EDL and SOL. The statistically significant increase of ChAT activity in these muscles, 14 d after the nerve crush, signified the entry of regenerating axons into the calf muscles. Electron microscopic cytochemistry revealed the first small nerve endings in contact with the denervated end plates 12 d after denervation. Subsequently, the number of reinnervated motor end plates and the surface area of the neuromusclar junctions steadily increased. The recovery of muscle force started between d 14 and 21 after the nerve crush. Thirty-five days after denervation, the difference between the muscle force of the reinnervated muscle and the control became statistically insignificant. Morphological normalization of the motor end plates was practically complete 33 d after denervation, concomitant with the normalization of the muscle force. At that time, however, ChAT activity in both muscles was still clearly subnormal (33.5% in EDL and 45% of the control in SOL) and therefore does not reflect the true extent of muscle force recovery. Yet, it seems that in spite of this, the regenerated nerve terminals contained sufficient amounts of acetylcholine (ACh) to trigger normal muscle contractions. PMID- 1776991 TI - Antibodies to tubulin and microtubule-associated proteins. A study in diabetes mellitus, systemic lupus erythematosus, and rheumatoid arthritis. AB - We report the results of a study of serum antibodies to proteins of the nerve cytoskeleton in patients with Type I and Type II diabetes mellitus, both with and without clinical signs of diabetic neuropathy. In contrast to previous reports, elevated levels of antibody to tubulin or glycated tubulin were not associated with either diabetes or diabetes with related neuropathy. Similarly, clinical evidence of neuropathy in patients with diabetes did not relate to increased levels of antibody to native or glycated microtubule-associated proteins (MAPs). The levels of antibody to MAPs and glycated MAPs were higher in control subjects over the age of 45 years compared with younger control subjects. Increased levels of antibody to tubulin and glycated tubulin were found in the sera of patients with systemic lupus erythematosus, but not rheumatoid arthritis. PMID- 1776992 TI - Rat brain metabolism enzyme activity variations following He-Ne laser irradiation. AB - In order to gain insight into the metabolic modifications induced in rat brain tissues by helium-neon (He-Ne) laser irradiation, in the research described here, we investigated the variations in the activity of the enzymes aspartate transferase (AST, EC 2.6.1.4), both cytosolic and mitochondrial, glutamate dehydrogenase (GIDH, EC 1.4.1.3), and total superoxide dismutase (SOD, EC 1.15.1.1), in the brain of rats treated with a very small dose (1.08 J) of He-Ne laser radiation. The rats were sacrificed 4 h after the treatment. The enzymes were evaluated spectrophotometrically in brain extracts of irradiated animals and also in untreated rats (controls) and rats that underwent simulated treatment (stressed). The data obtained from 5-10 animals assayed individually showed that, in the in toto brain tissues of the irradiated rats compared to the stressed rats, there was a marked increase of total SOD, together with an appreciable decrease of cytosolic AST, and insignificant variations in mitochondrial AST and GIDH. Stress alone caused a considerable decrease of total SOD and small but statistically significant increases of s-AST, m-AST, and GIDH. PMID- 1776993 TI - Toxicity of MPTP and structural analogs in clonal cell lines of neuronal origin expressing B type monoamine oxidase activity. AB - The toxicity of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP), its oxidized metabolite, and two recently synthesized 2'-alkyl derivatives of MPTP (methyl and ethyl), found to be more toxic in vivo in mice, have been compared in two neuroblastoma hybrid cell lines (NCB-20 and 140-3) that express the B form of monoamine oxidase (MAO), as tissue culture models for the mode of action of MPTP in the central nervous system. Unlike previously reported studies with cultured cells of neuronal origin expressing only MAO A, both of these cell lines were sensitive to MPTP. Consistent with the in vivo findings, the 2'-alkyl derivatives were much more toxic than MPTP and comparable to the oxidized metabolite MPP+ in their effects on cell survival and morphology. The cells could be protected against the reduced toxins, but not MPP+, by either the MAO A selective inhibitor, clorgyline or the MAO B selective inhibitor, deprenyl. The effectiveness of the MAO inhibitors in blocking the action of the reduced toxins was consistent with their ability to inhibit MAO activity in the cell cultures, but did not reflect MAO-substrate specificity of the toxins. Inhibitors of serotonin and dopamine uptake, which have been found to protect against MPTP toxicity in vivo, were generally ineffective in the cell cultures, with the exception of a marginal increase in survival of MPP(+)-treated 140-3 cells in the presence of the serotonin uptake inhibitor fluoxetine. These findings are discussed in relation to proposed in vivo mechanisms of MPTP cytotoxicity. PMID- 1776994 TI - [Pseudobactin and pseudobactin A variants: new pyoverdin type peptide siderophores from Pseudomonas fluorescens "E2"]. AB - From a strain of Pseudomonas fluorescens pseudobactin and several related compounds were isolated and their structures were elucidated. In this way a reference compound (5) could be obtained for the unambiguous determination of the absolute configuration of C-1 of the pyoverdin chromophore in newly isolated representatives of this class. PMID- 1776995 TI - X-ray studies on phospholipid bilayers. XI. Interactions with chloramphenicol. AB - Chloramphenicol is a widely used antibiotic with low levels of toxicity. However, scanning electron microscopy revealed morphological changes in human erythrocytes when they interacted in vitro with therapeutical concentrations of chloramphenicol. To explain this shape change, a study concerned with the possible interactions of this antibiotic with bilayers built-up of phospholipids located in either side of the red cell membrane was performed by X-ray diffraction. Results indicated that chloramphenicol was unable to perturb in any significant extent the structure of the phospholipids under study. The only noticeable effects were phase transitions produced to dimyristoylphosphatidylethanolamine bilayers. PMID- 1776996 TI - Phenotypic traits and regulatory role of RNA folding in molecular selection. AB - We concentrate on instances in which the phenotypic expression of information encoded in an RNA primary sequence might be revealed by the folding of the RNA itself. We have discovered that this situation finds concrete realization in the design of RNA molecules capable of maximizing the rate of autocatalytic synthesis when incubated with viral Q beta-replicase. This requires that we introduce the notion of phenotypic traits at the molecular level. Thus, the problem of finding RNA sequences whose phenotype favorably influences propagation amounts go finding RNA sequences which fold so as to optimize enzymatic performance and are in addition endowed with the proper recognition sites. The proof that these two problems are indeed equivalent has two steps: First we predict the metastable folded structures formed as a template RNA chain grows by sequential incorporation of nucleotides. The transient folded states appear to be involved in the regulation of the enzyme activity and they occur in a manner which is "oblivious" of thermodynamic time scales. Secondly, we compute the time-dependent activation energy for relaxation of each intermediate structure. This is done to establish constraints necessary for optimization of the regulatory role of RNA folding. The search for prospective template sequences is subject to such constraints. Our results aim at elucidating an optimization process realized by molecular selection in de novo (template-free) RNA synthesis by Q beta-replicase. We argue that the phenotype which mediates selection is given by metastable folding which emerges together with the printing of the genotype, that is, within the time span of a replication turnover. PMID- 1776997 TI - Specific crystal chemical interactions between carcinogenic aromatic compounds and cholesterol. AB - Polycyclic aromatic hydrocarbons and aromatic amines exercise a highly specific influence on the crystallization of cholesterol. The strength of these non covalent, presumably epitaxial interactions correlates with the carcinogenic activity of these substances. The presented results are in support of the assumption that a specific process of adsorption and crystallization with cholesterol of the plasma membrane takes place during the initial phase of the carcinogenesis by aromatic compounds. PMID- 1776998 TI - Studies in enteric anthelmintics: activity profile of prodrug of a bisbenzimidazole [1]. AB - The comparative anthelmintic activity of a possible prodrug, 2,2' dicarbomethoxyamino-5,5'-dibenzimidazolyl methanol (2) with its parent compound 2,2'-dicarbomethoxyamino-5,5'-dibenzimidazolyl ketone (1) and the reference drug mebendazole (3a) is reported. At a dose of 25 mg/kg, compound 2 was 100% effective against Ancylostoma ceylanicum in hamsters. Compound 2 also exhibited a similar order of activity against Syphacia obvelata, Hymenolepis nana and H. diminuta at a dose of 100 mg/kg. The drug exhibited lethal effects against metamorphic forms of A. ceylanicum at a dose of 100 mg/kg. However the trichostrongylids, Nippostrongylus brasiliensis remained unaffected up to a dose of 250 mg/kg of 2. Both 1 and 3a exhibited inferior activity than 2 except against adult A. ceylanicum. The activity of 1 and 2 has been explained on the basis of their ability to resist systemic hydrolysis resulting in higher concentration of the active drug in biophase. PMID- 1776999 TI - Propagation of voltage transients in arborized neurites of Retzius cells of the leech in culture. AB - Propagation of electrical signals is studied in Retzius cells of the leech in culture using voltage-sensitive fluorescent dyes at a spatial resolution of 8 x 8 microns 2 and 14 x 14 microns 2 and at a sampling interval of 0.12 ms. The neurons are stimulated by a microelectrode impaled in the soma. Action potentials of a half width of 2-3 ms are triggered close to the end of the primary neurite dissociated from the leech. They propagate back to the soma at invariant half width at a velocity of 50-230 microns/ms. They pervade extended aborized secondary neurites which are grown on extracellular matrix protein. Their width is enhanced up to a factor two. The velocity is around 100-150 microns/ms such that delays up to 3.5 ms are observed. Accordingly the neuritic trees are not isopotential. The features of propagation are found to be incompatible with passive spread. PMID- 1777000 TI - Directed cell movement with steric exclusion. AB - The space-dependent density of cells is evaluated for the following situation: (i) The cells are forced to make a directed movement (ii) the space for the cellular migration is restricted. The steady state distribution density is obtained when the drift current density equals the diffusion current density. The analogy to the Boltzmann statistics is shown. In a further step the cellular volume is introduced. For this case the density distribution is described in analogy to the Fermi statistics. The necrotactic response of granulocytes is used to verify the model. PMID- 1777001 TI - Growth inhibitions on human cancer cell cultures with the indole sulphur containing phytoalexins and their analogues. AB - Cell growth inhibitions on human cancer cell cultures were determined for the indole sulphur-containing phytoalexins cyclobrassinin, brassilexin (previously isolated from vegetables of the Cruciferae family) and their synthetic analogues 5-methoxybrassilexin and homocyclobrassinin. The most biologically active of these products is brassilexin (LD50 = 8 micrograms/ml). PMID- 1777002 TI - [The scientific accomplishments of coworkers of the Bernhard Nocht Institute between 1900 and 1960. A short historical review]. AB - The historical review presents outstanding scientific achievements obtained by members of the institute during the first 60 years of its existence. They may be summarized as follows: 1. The significance of Gustav Giemsa for stabilizing the Romanowsky stain and revealing its mechanism. 2. The discovery of the etiology of typhus fever by Enrique da Rocha-Lima. 3. The discovery of the extra erythrocytic stage of avian malaria parasites by Eduard Reichenow and Lilly Mudrow. 4. The discovery of the etiology and life cycle as well as the classification of the causative agent of Echinococcus multilocularis by Hans Vogel. 5. Demonstration of the development of specific immunity to Schistosoma japonicum in Rhesus monkeys by Hans Vogel. The studies of Bernhard Nocht and his associates in the twenties are presented in short reviews. PMID- 1777003 TI - [The emission of heavy metals with dust suspensions at 33 selected measuring points in the former East Germany (time period 1983-1988)]. AB - 2200 weekly samples of airborne particulate matter from 33 measuring sites have been obtained by 12 district institutes of hygiene (Gera, Chemnitz, Leipzig, Dresden, Erfurt, Frankfurt, Magdeburg, Neubrandenburg, Rostock, Cottbus, and Berlin). After pressure digestion of the impacted membrane filters the concentrations of 15 elements (Ca, Mg, Sr, Ba, Be, Fe, Al, Ti, Cr, Mn, V, Zn, Cu, Pb, and Cd) were analysed by ICP-Spectrometry. The Immissions were calculated using the air sample volumes. Measuring points with very high immissions are: steel plant Riesa, district Dresden (nonferrous and ferrous metals), Drubeck, near to the copper plant Ilsenburg (nonferrous metals), Lead paint plant Ohrdruf, district Erfurt (highest Pb-Immission: 3137 ng/m3), Special glass plant Weisswasser, district Cottbus (Ba, Pb and Cd), Leipzig (dust and all other elements). Four groups of measuring site with different characteristic types of immissions could be distinguished by means of factor and cluster analysis. The separation of these groups by discriminant analysis was significant (P greater than 0.95). The seasonal trends showed maximal values in winter and minimal values in summer. PMID- 1777004 TI - [Modification of the nitrate content of groundwater near the surface by agricultural soil use in the example of Styria]. AB - In a one year study, nitrate concentrations of superficial ground water were determined in Styria. Of 3931 samples, 21.1% were above 30 mg, 10.1% above 50 mg and 1.5% above 100 mg NO3/1. The contaminated areas lie exclusively in the Styrian tertiary basin, especially in the loose fluvoglacial deposits downstream of Graz. These areas are further characterized by a high population density, intensive cultivation of maize and intensive animal farming (pig breeding). Aside from toxicological aspects, increased nitrate concentrations are an indicator of human influences on the environment, which no longer permit the exclusion of substances potentially deleterious to health in the ground water. The areas are of great interest from the point of view of water supply and distribution because of the great quantities of water to be found there. PMID- 1777005 TI - Preliminary investigation of suitable bacteria strains for the detection of bacteriophages in environmental polluted surface waters. AB - Different host-specific bacteriophages were monitored in several water systems together with the usual faecal contamination indicator bacteria (thermotolerant coliforms). The host bacteria used for the plaque assay were E. coli K12, E. coli K12 Hfr, E. coli CHfr and S. typhimurium LT2F+. S. typhimurium LT2F+ showed significantly lower phage counts than the three E. coli strains. The phages specific for E. coli K12 (somatic phages) were in high correlation (r = 0.86, r = 0.91; P less than 0.001) with other coliphages, but not with phages specific for S. typ. LT2F+ (r = 0.33; P less than 0.05). There was an high degree of correlation among phages of E. coli K12 Hfr, E. coli C Hfr and S. typhimurium LT2F+ (pilus F-carrying bacteria) (r = 0.96, r = 0.73, r = 0.75; P less than 0.001). Good correlation was seen between faecal coliforms and male-specific phages but not among faecal coliforms and E. coli K12-specific phages (r = 0.30; P less than 0.05). The relative suitability of host strains when using phages in the evaluation of faecal and viral pollution of aquatic environments is discussed. PMID- 1777006 TI - Improved recovery of Legionella from water samples by use of black membrane filters. AB - A higher recovery of Legionella bacteria from water samples was achieved using black filters that were directly placed on agar plates after filtration, compared to the traditional method using white filters that are shaken in buffer after filtration. Up to 100 times more Legionella colonies/100 ml were found using black filters compared to the traditional method. The two filtration methods revealed, however, no big differences with pure culture experiments. Treatment with acid solution, directly on the filters without dilution of the concentrated sample, effectively reduced the number of accompanying bacteria. PMID- 1777007 TI - [Decreasing oxytetracycline resistance in Enterobacteriaceae in veterinary and health conditions after exchange of this substance in animal nutrition]. AB - The national strategy for the use of chemotherapeutics under which there is a distinction between therapeutics and growth promoters for all uses (human medicine, veterinary medicine, animal nutrition) has resulted in a distinct reduction of the selection pressure and a decrease of the OTC resistance among Enterobacteriaceae in the eastern German Lander (formerly GDR) due to a reduction of OTC feeding after 1981 and the final prohibition in 1983. In the following years Enterobacteriaceae were investigated as infectious pathogens for humans and animals using antibiograms. On the one hand, the OTC resistance of porcine and bovine E. coli strains decreased only by 27% and 17%, respectively, during the 1980 to 1988 period, on the other, the OTC resistance of bovine S. typhimurium dropped by 65%, porcine S. typhimurium by 50%, bovine S. dublin by 50%, porcine S. choleraesuis by 30% to a resistance level of about 13% (1989) demonstrating a reduced pressure of resistance. At the same time, OTC resistance became diminished from 50% and 70%, respectively, to 30% also in Enterobacteriaceae (E. coli, Klebsiella) and enterococci isolated from urine and wound infections of patients in the non-agricultural population although therapeutic habits had remained unchanged. The results shown point to a spreading of resistance plasmids which has to be expected far beyond the field of OTC use, for example after the use of antibacterial growth promoters in livestock farming. Control measures should be introduced. PMID- 1777008 TI - Serum resistance properties of Klebsiella pneumoniae and K. oxytoca isolated from different sources. AB - A total of 481 K. pneumoniae and K. oxytoca strains from different sources was examined with respect to sensitivity to normal human serum. K. oxytoca strains much more frequently proved to be serum resistant than K. pneumoniae isolates. Environmental strains of both species showed greater serum sensitivity than fecal or clinical isolates. While K. oxytoca strains isolated from feces and clinical specimens showed similar frequencies of serum resistant isolates, fecal K. pneumoniae strains less often were serum resistant than clinical K. pneumoniae isolates. Clinical Klebsiella strains appear to be more related to strains isolated from feces than to those isolated from the environment. PMID- 1777009 TI - Autoreactive T cells from MRL-lpr/lpr mice secrete multiple lymphokines and induce the production of IgG anti-DNA antibodies. AB - The study of T cells in individuals with systemic lupus erythematosus has been limited because a specific marker for the disease has not been identified. To approach this issue, we isolated autoreactive T cell clones from lupus-prone MRL mice, a strain that develops an accelerated form of lupus. These CD4+ T cell clones grew spontaneously from unimmunized mice, and were maintained in culture by intermittent stimulation with syngeneic antigen presenting cells in the absence of exogenous antigen. One autoreactive T cell clone, termed ARTC-1, previously reported to have atypical MHC requirements for activation (both I-Ak and I-Ek were required) and to stimulate B cell proliferation and Ig production in vitro, was found to have an unrestricted pattern of lymphokine secretion. Following stimulation, it produced IL-4, IFN-gamma and IL-2. ARTC-1 induced B cell proliferation both by cell contact and through secretion of soluble lymphokines. B cell proliferation by cell-cell contact was MHC restricted in a manner analogous to ARTC-1 activation by APCs; the B cell response was inhibited by both anti-I-Ak and anti-I-Ek antibodies. The ARTC-1 B cell interaction was also found to result in the production of IgG autoantibodies. These observations suggest that cells such as ARTC-1, if unregulated, could lead to B cell stimulation and autoantibody production in vivo, in the absence of exogenous stimulation. Furthermore, IFN-gamma production by ARTC-1 could also result in enhanced class II expression, leading both to additional T-B cell interactions and to T cell interactions with endogenous cells capable of expressing class II antigens in other organs. PMID- 1777010 TI - Phenotypic analysis of skin infiltrates in comparison with peripheral blood lymphocytes, spleen cells and thymocytes in early avian scleroderma. AB - University of California at Davis line 200 (UCD-200) chickens develop a hereditary connective tissue disease characterized by severe lymphocytic infiltration, vascular occlusion and fibrosis of skin and internal organs. To identify cellular immunological abnormalities in the acute inflammatory disease stage of this animal model for progressive systemic sclerosis (PSS) we investigated the phenotypic characteristics and function of peripheral blood lymphocytes (PBL), spleen cells and thymocytes in comparison with skin infiltrating cells. Immunofluorescence and immunohistochemical analysis using monoclonal antibodies revealed the overwhelming majority of skin infiltrating mononuclear cells in the deeper dermis and subcutaneous tissue to be T cell receptor alpha/beta (TcR2)+/CD3+/CD4+/class II+ cells, a small portion (5-10%) of which were interleukin 2 (IL-2) receptor positive. In contrast, the inflammatory infiltrate in perivascular areas of the papillary dermis was constituted of mainly TcR gamma/delta (TcR1)+/class II- lymphocytes. Only few B cells (T/B cell ratio greater than 5) were detected. These diseased chickens showed significantly reduced percentages and numbers of circulating peripheral T cells exhibiting TcR1, TcR2, CD3, CD4 or IL-2-receptor, probably owing to an increased influx into lymphoid organs and affected tissues. In contrast to healthy chickens, the thymi of UCD-200 animals revealed fewer cells expressing TcR1, TcR2 and class II antigen, suggesting an altered intrathymic maturation of the T cell lineage. Functional in vitro studies showed a significantly decreased T cell mitogen induced proliferation rate associated with a decreased capacity to produce IL-2 and to express IL-2 receptors. In contrast to the deficient in vitro IL-2 production the sera of UCD-200 chickens contained significant levels of IL-2 bioactivity. The alteration of T lymphocyte physiology in UCD-200 chickens adds, at least in part, to the parallels between this animal model and its human counterpart. These data confirm our hypothesis that the PSS-like disease of UCD 200 chickens includes a numeric and/or functional alteration of peripheral T cell subsets, especially of TcR1 positive cells, in contrast to the pronounced accumulation in the afflicted tissues. PMID- 1777011 TI - Genetic control of inflammatory arthritis and glomerulonephritis in congenic lpr mice and their F1 hybrids. AB - MRL-lpr/lpr mice spontaneously develop a complex immunological disease characterized by glomerulonephritis, inflammatory erosive arthritis and the production of rheumatoid factors (RF) and anti-DNA antibodies. We have previously reported that, of congenic lpr strains, only MRL-lpr/lpr mice develop synovial pathology suggesting that both the lpr gene and another gene(s) in the MRL background are necessary for the development of arthritis. To define further the genetics of arthritis and its relationship to glomerulonephritis and autoantibody production, we studied disease expression in MRL-lpr/lpr and C57BL/6-lpr/lpr mice and their offspring (BM-lpr/lpr and MB-lpr/lpr). At 6 months of age these mice were killed and bled, and their kidneys and knee joints were removed for pathological studies. Fourteen of 28 MB-lpr/lpr mice displayed synovial hypertrophy, while eight of 28 had significant synovial inflammation. BM-lpr/lpr mice showed similar changes: nine of 22 and eight of 22 exhibited synovial hypertrophy and inflammation respectively. Joints from MRL-lpr/lpr mice revealed 13 of 17 with synovial hypertrophy and 12 of 17 with inflammation, while none of 14 B6-lpr/lpr mice had synovial changes. Renal pathology was minimal in the F1 mice with only mild hypercellularity in seven of 21 MB-lpr/lpr and five of 22 BM lpr/lpr mice. All MRL-lpr/lpr mice, in contrast, had marked glomerular changes with 12 of 17 exhibiting glomerular crescents. Only one F1 mouse had both arthritis and renal abnormalities. IgM RF levels were elevated in all four experimental groups, but did not correlate with the presence or severity of arthritis. IgG RF levels were elevated in the MB-lpr/lpr and MRL-lpr/lpr mice, but did not correlate with the degree of arthritis. These results indicate that renal disease and arthritis develop independently in lpr mice, possibly on a genetic basis, and that the presence and titer of autoantibodies do not correlate with tissue injury. PMID- 1777012 TI - Immunological effects of high dose administration of anti-CD4 antibody in rheumatoid arthritis patients. AB - A phase I/II trial of the anti-CD4 monoclonal antibody (mAb) was undertaken in seven rheumatoid arthritis patients in order, (1) to investigate changes in clinical symptoms and possible side effects, and (2) to study the pharmacokinetics and to determine the dose required to achieve saturation of antibody binding sites on blood leucocytes. BL4mAb is a murine IgG2a which binds to the group 2B epitope of the V1 N terminal domain of the CD4 molecule. It inhibits syncitium formation by human immunodeficiency virus-infected cells. BL4 was administered by one hour-long intravenous infusion each day, for 10 days. Doses were steadily increased from 20 mg/d to 40 mg/d in the first three patients (group I) in an attempt to reach a serum antibody residual level sufficient to saturate CD4+ circulating cells. The three other patients (group II) received a dose of 40 mg/d during 10 consecutive days. One patient who presented chills and mild fever during the first BL4 infusion was not included in the analysis. No clinical side effects were observed in the six other BL4-treated patients. Clinical parameters of disease activity were improved within the first 14 days. Clinical improvement was still significant at day 30 in five patients, but at day 60, only the Ritchie index was still below pretreatment levels. Delayed type hypersensitivity reactions decreased in the three patients who exhibited positive reactions before BL4 administration. A transient drop in peripheral blood CD4+ lymphocyte counts occurred during each infusion in the first days of treatment. Pre-infusion CD4+ lymphocyte counts were moderately decreased within the first 8 days, but rose to pretreatment levels 3 days after the last infusion. BL4 residual levels in serum steadily increased to reach 8.0 micrograms/ml in group I and 9.8 micrograms/ml in group II. Saturation of BL4 binding sites was achieved after 2 days of treatment in all patients of group II but in only one of group I. Four out of six patients produced antibodies against the anti-CD4 mAb. Immunization appeared between days 12 and 50. This study shows that saturation of anti-CD4 mAb binding sites can be achieved by infusions of high doses (40 mg/d) of BL4 without clinical side effects. The results would encourage further placebo controlled trials, since no definite conclusion can be drawn from the present study as regards clinical efficacy. PMID- 1777013 TI - Human monoclonal antibodies demonstrate polyreactivity for histones and the cytoskeleton. AB - Systemic lupus erythematosus (SLE) and other autoimmune diseases are characterized by immune responses to intracellular, highly conserved antigens such as DNA and histone. In this study, peripheral blood lymphocytes (PBL) from a patient with histone autoantibodies were used to prepare IgM human-human hybridoma cell lines. Indirect immunofluorescence (IIF) was used to identify monoclonal antibodies that bound to cytoskeletal and other cytoplasmic constituents. These supernatants did not bind double-stranded or single-stranded DNA. However, immunoblotting revealed that 7/20 hybridomas selected for their binding to cytoskeletal components produced antibodies that also bound mammalian and avian histones. When peptide fragments of histone were used in immunoblotting experiments, it was found that the monoclonal antibodies bound to the carboxyl terminus of H1, a region previously shown to bind autoantibodies from sera of patients with SLE and drug-induced lupus (DIL). When the amino acid sequences of histones and cytoskeletal components were compared using the Swiss-Prot protein data bank, it was confirmed that there are eight regions of similarity. While the significance of polyreactive human monoclonal antibodies to cytoskeletal components and histones is not understood at present, it is possible that the human histone antibodies represent polyreactive antibodies that arise through the mechanism of molecular mimicry. PMID- 1777014 TI - Soluble interleukin-2 receptor in sera of patients with Graves' disease. AB - Activation of T lymphocytes has been found to be associated with an increase in soluble interleukin-2 receptor (sIL-2R) levels. The aim of this study was to investigate serum levels of sIL-2R in 20 untreated patients with Graves' disease and to relate these levels to disease activity and to TSH-receptor, anti thyroglobulin, anti-microsomal and anti-eye muscle antibodies. sIL-2R levels were significantly increased in newly diagnosed Graves' patients compared with controls (667 +/- 270 vs 205 +/- 45 U/ml) (P less than 0.001). The sIL-2R levels were higher in patients with active infiltrative ophthalmology than in those without eye symptoms (810 +/- 313 vs 525 +/- 180 U/ml). All patients were treated with methimazole for at least 12 months. sIL-2R levels were normalized by methimazole treatment in the majority of patients without ophthalmopathy but not in those with ophthalmopathy. In five patients sIL-2R serum levels were studied after interruption of thyrostatic therapy. An increase was observed in three patients and hyperthyroidism subsequently relapsed in two of these. Furthermore, a correlation was found between soluble interleukin-2 receptor levels and TSH receptor antibodies but not with other immune parameters examined. Serum sIL-2R represents a useful marker of immunological activity in Graves' disease. PMID- 1777015 TI - The immunoregulatory influence of transforming growth factor beta in thyroid autoimmunity: TGF beta inhibits autoreactivity in Graves' disease. AB - The immunoregulatory influence of transforming growth factor beta (TGF beta) was studied in patients with Graves' disease and in normal controls. Special attention was given to determine how TGF beta affects the interaction between thyroid epithelial cells and T lymphocytes. Human recombinant TGF beta 1 (rTGF beta 1) was immunosuppressive in patients with Graves' disease and in controls. In both groups it inhibited the proliferation of peripheral blood mononuclear cells and of peripheral and thyroid derived T cell lines and clones in response to non-specific stimuli. It also decreased the number of serine esterases expressing cytotoxic T cells and suppressed the recognition of thyroid epithelial cells by thyroid autoantigen specific T cell clones. Inhibition of autoantigen recognition was not only observed when rTGF beta 1 was added to the thyroid epithelial cell/lymphocyte co-culture, but was also found when thyroid epithelial cells were preincubated with rTGF beta 1, which was then removed before the initiation of co-culture. This was probably as a result of a decrease in the antigenicity of the target cells, as rTGF beta 1 also suppressed thyroid peroxidase as well as HLA class II autoantigen expression, in cultured thyroid epithelial cells. These results demonstrate that TGF beta may exert a variety of down-regulatory influences in Graves' disease. It may be of importance for the suppression of autoaggression in persons predisposed to autoimmunity; may be quantitatively overrun by immunostimulatory influences in the acute phase of the disease; and may be important for the induction of remission in patients with Graves' disease. PMID- 1777016 TI - A coordinated approach to treat chronic disorders. AB - Many non-infectious diseases are the product of similar life-styles and correspond to the same risk factors. WHO has launched Inter-Health, a global initiative directed at a group of such chronic diseases. In view of similarities in their treatment and prevention, the coordinated approach is expected to bring good results. PMID- 1777018 TI - AIDS programmes in transition. AB - National AIDS programmes of industrialized countries are moving from rapid growth to consolidation. This transition should afford opportunities for strengthening the approaches to AIDS prevention. PMID- 1777017 TI - Neonatal tetanus: countdown to 1995. AB - Progress in the campaign against neonatal tetanus in South and Central America and the Caribbean is reviewed. The main emphasis is on immunizing women of childbearing age who live in high-risk areas, although importance also attaches to routine tetanus toxoid treatment, adequate care during the prenatal period and delivery, and epidemiological surveillance. PMID- 1777019 TI - Against a sea of troubles: AIDS control in Uganda. AB - HIV infection has spread at an alarming rate in Uganda and is continuing to do so. Polygamy and other long-standing cultural practices on the one hand, and certain life-styles adopted under Western influence on the other, have done much to make the AIDS epidemic so severe. Women are potentially a force for confronting the situation, provided that they are made aware of their rights and empowered to take decisive action in education and other fields in defence of themselves, their children and, indeed, the whole of society. PMID- 1777020 TI - Commerce in human organs: the international response. PMID- 1777021 TI - Ethics and the environment. PMID- 1777022 TI - The freedom to condemn tobacco advertising. AB - Following the publication of a booklet by two Swedish government bodies and an international nongovernmental organization, in which tobacco advertising techniques were strongly criticized, Sweden's Tobacco Trade Association lodged a complaint with the country's Parliamentary Ombudsman. The Ombudsman, rejecting the main part of the Association's case, ruled that the government authorities had a constitutional right to express opinions on tobacco advertising and that these could hardly be expected to be neutral or free from challenging statements. PMID- 1777023 TI - Longer, healthier and happier lives. AB - In Singapore an effort is being made to keep elderly people physically and mentally fit for as long as possible so that they can maintain their normal daily activities and living arrangements. In order to care for the growing proportion of older people both humanely and in a manner that society can afford, measures are being taken to encourage the revival of the extended family system whereby the elderly reside with their younger relatives. The placing of older people in institutions is being kept to a minimum, partly because they prefer to live with their children and partly because special homes are very expensive. PMID- 1777025 TI - "Clean air" at the European Commission. PMID- 1777024 TI - Funds for making vaccines, not war! PMID- 1777026 TI - Smoke-free taxis? PMID- 1777027 TI - World Health Forum should be obligatory reading! PMID- 1777028 TI - Achieving better immunization coverage in Ethiopia. PMID- 1777029 TI - Joint vaccination programmes for humans and animals. PMID- 1777030 TI - Community health volunteers: a waste of precious resources? PMID- 1777031 TI - Ex-servicemen as volunteer health workers. PMID- 1777032 TI - More data needed on cerebral malaria. PMID- 1777033 TI - Why patients prefer referral hospitals. PMID- 1777034 TI - Study the patient's history before giving antibiotics! PMID- 1777035 TI - Healthy people-in numbers the world can support. PMID- 1777036 TI - Carers assess their own performance. PMID- 1777037 TI - Medical education for primary care. AB - A move away from undue specialization in undergraduate medical courses is desirable in the interest of strengthening primary care. Ways of achieving this are discussed with particular reference to proposals made by the World Federation of Neurology Research Group on Neurological Education. PMID- 1777038 TI - WHO and industry collaborate to combat AIDS. PMID- 1777039 TI - HIV and HBV transmission in the health care setting. PMID- 1777040 TI - Studies on an adherent variant of the human promyelomonocytic HL60 leukaemia cell line that constitutively expresses 25-hydroxyvitamin D3-24-hydroxylase activity which is inhibited by 1 alpha,25-dihydroxyvitamin D3. AB - The constitutive expression of 25-hydroxyvitamin D3-24-hydroxylase (25-(OH)D3-24 hydroxylase) activity has been studied in an adherent variant (Ad-HL60) of the human promyelomonocytic leukaemia cell line HL60. The Ad-HL60 cells have a more differentiated phenotype than the non-adherent cells from which they were derived, and synthesized 1.88 +/- 0.07 (+/- S.E.M.) pmol 24,25-(OH)2D3/h per 10(6) cells following culture in RPMI-1640 medium containing less than 0.02 nM 1 alpha,25-(OH)2D3. They also synthesized 1.66 +/- 0.05 pmol 24,25-(OH)2D3/h per 10(6) cells following culture in 1 alpha,25(OH)2D3-free medium supplemented with 1 g bovine serum albumin/l instead of 10% serum. In contrast, non-adherent HL60 cells required exposure to 10-100 nM 1 alpha,25-(OH)2D3 to induce equivalent 24,25-(OH)2D3 synthesis. The 25-(OH)D3-24-hydroxylase expressed by Ad-HL60 cells had an apparent Michaelis constant of 1 microM and maximal rate of 20 pmol/h per 10(6) cells with substrate concentrations from 0.012 to 1.2 microM/incubation (5 500 ng/ml). Furthermore, 24,25-(OH)2D3 synthesis was inhibited in a dose dependent manner by ketoconazole (0.01-10 microM), suggesting that the enzyme is cytochrome P-450 dependent. Ad-HL60 cells expressed approximately 3500 specific receptors for 1 alpha,25-(OH)2D3/cell with a dissociation constant of 40 pM. Following exposure to 0.1-100 nM 1 alpha,25-(OH)2D3, Ad-HL60 cell proliferation was significantly inhibited compared with controls grown in medium containing less than 0.02 nM 1 alpha,25-(OH)2D3 for 96 h. Expression of 25-(OH)D3-24 hydroxylase was also inhibited in a dose- and time-dependent manner; however, expression of nonspecific esterase was not induced. Both of these findings are contrary to those previously demonstrated for non-adherent HL60 cells, whereas the dose-dependent inhibition of cell proliferation by 1 alpha,25-(OH)2D3 occurs in both adherent and non-adherent phenotypes. These observations on Ad-HL60 cells represent the first description of a cell type in which 1 alpha,25-(OH)2D3 appears to inhibit 25-(OH)D3-24-hydroxylase activity. The Ad-HL60 cells also constitutively metabolized 1 alpha,25-(OH)2D3 in a manner consistent with formation of 1 alpha,25-(OH)2D3 without previous exposure to 1 alpha,25-(OH)2D3. In contrast, many other cell types, including non-adherent HL60 cells, require exposure to 1 alpha,25-(OH)2D3 to induce metabolism of 1 alpha,25-(OH)2D3 to 1 alpha,24,25-(OH)3D3, a reaction that represents the initial step for catabolism of 1 alpha,25-(OH)2D3 to calcitroic acid. PMID- 1777041 TI - Influence of chronic restraint stress on pro-opiomelanocortin mRNA and beta endorphin in the rat hypothalamus. AB - It has been postulated that some endocrine responses to stressful stimuli are mediated through the activation of hypothalamic pro-opiomelanocortin (POMC) derived peptides. The aim of the present study was to analyse the effect of chronic stress on expression of the POMC gene in the medial basal hypothalamus and pituitary, and on serum concentrations of LH, beta-endorphin and corticosterone. Adult male rats were killed after being subjected to restraint stress for 6 h/day over 2, 3 or 4 days. Chronic restraint induced an increase in serum concentrations of beta-endorphin and corticosterone and a decrease in serum LH levels. To determine whether chronic stress induced any change in POMC synthesis, a dot-blot method was used to measure POMC mRNA levels. No significant changes were detected either in the beta-endorphin content or in POMC mRNA levels in the medial basal hypothalamus after 2, 3 or 4 days of chronic restraint. This observation contrasts with the stimulation of POMC mRNA levels in both lobes of the pituitary. The data suggest that although chronic restraint induces an increase in POMC synthesis and secretion in the pituitary and a decrease in LH secretion, it has no effect on hypothalamic POMC neurones. PMID- 1777042 TI - 4 S oestrogen receptor isoforms and their distribution in breast cancer samples. AB - The variability in the profile of oestrogen receptor (ER) isoforms in breast tumours has been studied. Using low-resolution isoelectric focussing (IEF), two major ER isoforms with isoelectric point (pI) values of 6.1 and 6.6 could be identified, with corresponding sedimentation coefficients in sucrose density gradients of 8 S and 4 S respectively. Using high-resolution IEF or immunoblotting, the pI 6.6 form (4 S) was shown to be composed of three different species, with pI values of 6.3, 6.6 and 6.8, while the oligomeric pI 6.1 protein (8 S) did not show charge heterogeneity. Data were obtained on the soluble receptors from supernatants of 42 ER-positive primary breast tumour homogenates using high-resolution IEF to obtain ER isoform profiles. It was found that 54.7% of tumours contained the isoforms at pI 6.6 and 6.1, while only 11.9% contained the full complement of isoforms (pI 6.1, 6.3, 6.6 and 6.8). Of the tumours studied, 11.9% contained isoforms of pI 6.1, 6.6 and 6.8, with 14.3% containing isoforms with pI 6.1, 6.6 and 6.3. Very few tumours contained only one isoform, with 4.8% of tumours containing a single isoform at pI 6.1 and 2.4% of tumours containing only the isoform at pI 6.6. All four ER isoforms were also shown to be present in some tumours by immunoblotting using antibody H222 and, in addition, high-resolution IEF indicated that all isoforms bind oestradiol, diethylstilboestrol and tamoxifen. The variability in the ER isoform profile may have a bearing on the known variability of tumour response to endocrine therapy and prognosis. PMID- 1777043 TI - Quantitative comparison of insulin-like growth factor mRNA levels in human and rat tissues analysed by a solution hybridization assay. AB - In this study a solution hybridization assay was evaluated for its application to the measurement of levels of specific mRNAs. The evaluation included parameters such as incubation time, hybridization stringency and probe concentration/structure. Both short (50 bases derived from synthetic oligonucleotides) and long (125-147 bases) RNA probes, derived from cloned sequences, could be used to obtain quantitative information on specific mRNA species. The solution hybridization assay was used to compare the levels of insulin-like growth factor-I (IGF-I) and IGF-II mRNAs in various rat and human tissues. In the rat the liver was the main source of IGF-I mRNA (approximately 400 molecules/cell), but significant levels were also found in extrahepatic tissues such as fat and muscle (3-50 molecules/cell). Human liver contained approximately 100-fold less IGF-I mRNA than rat liver. Human fat, muscle and placenta contained levels of IGF-I mRNA (2-8 molecules/cell) similar to those in the liver. Levels of IGF-II mRNA in rat and human tissues were similar, in that the expression was greatest in the placenta (approximately 200 molecules/cell). Species differences were evident, however, since human liver and fat contained significant amounts of IGF-II mRNA (15-20 molecules/cell), while the rat counterparts had almost undetectable levels. Young and old rats were used to examine the influence of age on the expression of IGF-I and GH receptor mRNAs in the liver. Levels of both IGF-I mRNA and GH receptor mRNA were found to decrease with age (2.8-fold and 1.7-fold respectively). It is concluded that low levels of IGF mRNAs can be detected using the solution hybridization assay and that there are considerable species differences within and between tissues with regard to steady-state levels of IGF-I and IGF-II mRNAs. PMID- 1777044 TI - Expression of a growth hormone-responsive exon of the ovine insulin-like growth factor-I gene. AB - The sheep insulin-like growth factor-I (IGF-I) gene encodes mRNAs containing three different 5'-untranslated sequences as a consequence of alternate splicing of leader exons. Using a combination of RNase protection and primer extension assays, we have mapped the transcriptional start sites of one of the leader exons, exon 1A. Transcription from exon 1A appeared to initiate from multiple points within a 20 bp region situated about 60 bp upstream of the exon 1A splice site. The presence of this transcript in the liver of animals treated with GH was enhanced five- to tenfold and contributed to about 95% of the total hepatic increase in IGF-I mRNA. This exon is generally expressed in a number of tissues immediately after birth; by about 4 weeks postpartum, however, expression is confined to liver. The regulation of hepatic and non-hepatic IGF-I synthesis by GH may involve different mechanisms. PMID- 1777045 TI - Localization of the sites of synthesis and action of prolactin by immunocytochemistry and in-situ hybridization within the human utero-placental unit. AB - While the fetal pituitary synthesizes and releases prolactin, it is also produced within the utero-placental unit during pregnancy in women and has been localized in the amnion, chorion and decidua. However, it is not clear whether prolactin is synthesized within all these non-fetal pituitary tissues. We have investigated prolactin production and its gene expression using tissue culture, immunocytochemistry and in-situ hybridization techniques. Prolactin was immunolocalized not only in the decidua but also in amnion and trophoblast cells. In contrast, the in-situ hybridization results showed that silver grains, formed by specific hybridization of a prolactin cDNA probe to prolactin mRNA, were confined to decidual cells of early and term pregnancy. The results from tissue cultures correlated well with those of in-situ hybridization, that is that only the decidua made detectable prolactin, while it was undetectable in the culture medium from trophoblast tissue, irrespective of the stage of pregnancy. This study, for the first time, establishes that only decidualized cells are involved in biosynthesis of prolactin; other prolactin-containing cells in the amnion and trophoblast appear to sequester prolactin, possibly via receptors, suggesting that prolactin may play an important paracrine role within the amnion and syncitio- and cytotrophoblast of the utero-placental unit. PMID- 1777046 TI - External quality assessment programme for in vitro allergy tests: ISS/CNR scheme- the first one organized in Europe by government--and European scheme "Galileo". AB - Accordingly with the new tendency of employing Rast Units (RU) instead of Rast Classes (RC) in the specific-IgE testing field, is necessary that internal Quality Control (QC) and external Quality Assessment (QA) programmes take account of these RU. So far only few experiences of controlling and assessing the quality concerned with RU, have been carried out. In Italy, a National QA-scheme organised by the National Health Institute (ISS) and the National Research Council (CNR), which involves about 90 laboratories, is starting just now, and a commercial QA programme (Galileo), started in 1989, by now is the only one which helped valuate each laboratory's performance for specific-IgE assays. The results collected in a 12 months period were elaborated in different ways as they were expressed in RC or in RU and the trial confirms that the specific-IgE testing field is still far from reaching the reliability already established for other assays. So we hope the National and the Galileo schemes will help stimulate major improvements in internal precision and in between-laboratories agreement. PMID- 1777047 TI - Immunotherapy of asthma. AB - A questionnaire in 1965 indicated that immunotherapy (IT) was accepted for pollen and house-dust induced allergy. There was less agreement over its use for food and drug induced allergy, as well as acute reactions to bacteria. In spite of this there is renewed controversy at the present time. A special risk of side effects has always been accepted, which seems to vary in intensity with the country in which the procedure is performed. In France deaths are rare, but in Great Britain and USA there have been many serious reactions, including deaths from anaphylactic shock. Expression of side effects seems to depend at least partly, on the schedule of injections used. The clearest results of IT are to be found in young adult (teenage) patients, but chronic infections decrease its efficacy. Good compliance by patients is essential. PMID- 1777048 TI - Immunotherapy of extrinsic asthma. AB - It is an elegant treatment of IgE allergic inflammation in the airways. It must be started very early in the allergic disease together with allergen avoidance, prevention, optimal symptomatic and antiinflammatory treatment and general health care. PMID- 1777049 TI - Epidemiology of childhood asthma. AB - There is considerable concern in several countries that the death-rate for asthma is rising among children. Hospital admission-rates have been rising steeply in England and Wales, as in other countries; the rise does not seem to be attributable to the admission of less severe cases. The possibility of increasing prevalence is difficult to assess because of the lack of a clear-cut definition of asthma and the consequent uncertainty as to whether children are now labelled as asthmatic who formerly would not have been. Repeat surveys using identical methodology are needed to provide reliable information. In 1973 a survey was conducted in South Wales among 12-year old children, and repeated in the same area in 1988. An increase has occurred in reported asthma, in relevant symptoms, and in exercise-induced bronchospasm. Data from Sweden, Finland, New Zealand and elsewhere suggest that the rise in asthma is a worldwide phenomenon, and is associated with some environmental factors in the developed countries. The cause of the increase is a matter of speculation. PMID- 1777050 TI - Development of asthma in children. AB - Asthma is a multifactorial disease on genetic basis. Its development is influenced by maternal and environmental factors, i.e. allergens and adjuvants. Early identification of candidates at high risk for development of asthma will enable giving recommendations on preventive measures focussing on exposure to tobacco smoke and other pollutants, indoor and outdoor allergens and possibly viral infections during infancy. PMID- 1777051 TI - [Delayed-release salbutamol, a new beta-mimetic with prolonged action. Results of a comparative study against theophylline L.A]. AB - Salbutamol controlled-release (CR), a new salbutamol formulation, was compared in asthmatic patients to another long-acting bronchodilator, theophylline L.A., in a randomized (2 salbutamol, 1 theophylline), multicentre, parallel-group study. Among the 83 patients who met the inclusion criteria (mean age 41 years), 55 received salbutamol CR and 28 received theophylline L.A. during 6 weeks. At the end of the study, there was a significant difference (p less than 0.05) in favour of salbutamol CR for FEV1 (2.53 l versus 2.13 l) and VC (4.23 l versus 3.50 l). FEF25-75 and PEF were higher with salbutamol CR, respectively 2.06 l sec-1 versus 1.86 l sec-1 and 6.03 l sec-1 versus 5.03 l sec-1. PEFR, measured by the patient, improved more with salbutamol CR than with theophylline L.A., with a significant difference as from the third week. There was a significant difference at the end of the study too, both morning (408 l min-1 versus 350.1 l min-1, p less than 10( 3] and evening (408.9 l min-1 versus 353 l min-1, p less than 10(-3]. Salbutamol CR and theophylline L.A. were considered as well tolerated, respectively by 95.5% of the patients in the salbutamol group and 92.3% of the patients in the theophylline group. There were equal numbers of minor and usual adverse events in the two groups. Salbutamol CR showed a better efficacy in airways obstruction without systemic safety problems. It is therefore an excellent treatment for patients requiring bronchodilator maintenance therapy. PMID- 1777052 TI - [Laryngeal dyspnea and hypersensitivity to isocyanates]. PMID- 1777053 TI - [Adaptation of energy metabolism in under-fed ruminants. Quantification in the whole animal and body tissues]. AB - Ruminants respond to underfeeding by a progressive adaptation until a new equilibrium between dietary supply and requirements is reached. The resulting drop in maintenance energy requirements originates from a decrease in basal metabolism that depends on the level and duration of undernutrition. These modifications are not totally accounted for by changes in live weight but might be explained by differential changes in individual tissue weight and metabolism. Tissues contribute to whole animal expenditure in a disproportionate manner relative to their weight. Thus digestive tract, liver and muscle masses contribute 5-11, 1-2.5 and 35-50% to live weight but about 16-29, 17-31 and about 16% to whole animal energy expenditure, respectively, because of differences in tissue metabolic activity. Underfeeding results in a decrease in the contribution of viscera to energy expenditure, whereas results on muscle mass are scarce. These changes in contribution are due to changes in tissue mass, nutrient supply (blood flow) and/or in metabolic activity. PMID- 1777054 TI - Effect of an acute exposure of rat testes to gamma rays on germ cells and on Sertoli and Leydig cell functions. AB - Germ cells and Sertoli and Leydig cell functions were studied from 7 to 180 days after an acute exposure of 2-month-old rat testes to 9 Gy of gamma rays. Body weight, testis and epididymal weights were recorded. Sertoli cell parameters (androgen-binding protein, ABP, in caput epididymis and plasma follicle stimulating hormone, FSH) and Leydig cell parameters (plasma luteinizing hormone, LH, testosterone and prostate and seminal vesicle weights) were determined together with the number of germ cells and Sertoli cells. Irradiation did not affect body weight but significantly reduced testicular and epididymal weights from day 7 and day 15 post-irradiation respectively. The cells killed by irradiation were mainly spermatogonia and preleptotene spermatocytes engaged in replicating their DNA at the time of exposure, but all spermatocytes seemed damaged as they gave abnormal descendent cells. By day 34, only elongated spermatids remained in a few tubules and thereafter very little regeneration of the seminiferous epithelium occurred, except for one rat which showed a better regeneration. Levels of ABP decreased by day 15 when the germ cell depletion had reached the pachytene spermatocytes, whereas FSH and LH levels rose when the number of elongated spermatids decreased. Levels of testosterone and the weight of the seminal vesicles did not change; occasionally, the prostate weight was slightly reduced. These results support our hypothesis that pachytene spermatocytes and elongated spermatids are involved in influencing some aspects of Sertoli cell function in the adult rat. PMID- 1777056 TI - Influence of age at nutritional restriction on growth and sexual development of gilts. AB - Large White females were fed on a plane of nutrition close to ad libitum during the entire experimental period (CTRL group, n = 48) or restricted during a limited period of their growth (RP1 group: 28-62 kg, RP2 group: 64-96 kg, RP3 group: 97-131 kg, n = 48/group). Blood samples were taken before 200 and 230 days of age in order to detect cyclic gilts by assaying their progesterone levels. Animals were slaughtered at approximately 260 d of age and their genital tracts were examined. Overall feed intake, feed conversion ratio and daily gain were significantly lower in restricted than in CTRL gilts (average daily gain: 678, 680, 668 and 741 g/day respectively in RP1, RP2, RP3 and CTRL groups, P less than 0.05). At slaughter, animals from the 3 restricted groups has similar live weights but were lighter (152 vs 164 kg live weight, P less than 0.05) and leaner than CTRL (fat thickness: 29.5, 30.5, 28.0 and 34.1 mm respectively, in RP1, RP2, RP3 and CTRL groups). Respectively, 9, 43 and 76% of the gilts were puberal at 200, 230 and 260 days of age. The percentage of cyclic females was not influenced by treatment at 200 and 260 days of age while it was higher in CTRL (50%) and RP1 (56%) groups than in RP2 (35%) and RP3 (29%) groups at 230 days of age (P less than 0.05). At 260 days of age, ovarian and genital tract weights were not influenced by treatment either in prepuberal or in cyclic gilts.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777055 TI - [Comparative digestive and metabolic utilization of beans, lentils and chick peas in the rat]. AB - Faba bean, lentil or chick-pea raw seeds were used as the only protein food in the rat. The balanced diet was designed to suit growth requirements. Nitrogen apparent digestibility coefficient (CUDa) was 72% in the faba bean, 75% in the lentil, 76% in the chick-pea groups respectively, but the CUDa of some essential amino acids were much lower: 52-51-71% for methionine, 60-39-78% for cystine, 73 71-75% for valine, while arginine CUDa values (87-87-82) were higher than all other AA CUDa values. Growth rate (8.9-6.7-9.1 g/d) and food intake index (2.1 2.5-2.2) were satisfactory. Blood and muscle free amino acid concentrations related to digestible intake showed that methionine from the 3 legumes, threonine from chick-pea, arginine and lysine from faba bean were not fully available. PMID- 1777057 TI - [Ruminal digestion and intestinal absorption of lupine proteins extruded in the lactating cow]. AB - Four lactating cows fitted with permanent ruminal, duodenal and ileal cannulae were used to study the effect of extrusion of whole lupin seeds at 195 degrees C (Lupinus albus cv Lublanc) on organic matter (OM) and nitrogen (N) degradation in the rumen and their flow to and absorption from the small intestine. Raw whole lupin seeds (RWLS) and extruded whole lupin seeds (EWLS) were fed in diets containing 15.5% crude protein and composed of 22.6% whole lupin seeds, 56.5% corn silage, 10.2% corn grain and 10.7% Italian ray-grass on a DM basis, supplemented with vitamins and minerals. Chromium ethylenediaminotetraacetic (Cr EDTA) and ytterbium chloride (YbCl3) were used as liquid and particulate markers respectively, while purines and 15N ammonium sulfate were utilized as bacterial markers. Cows fed EWLS had a similar ruminal ammonia N and volatile fatty acid concentrations and efficiency of bacterial protein synthesis compared to those fed the RWLS diet. Total tract OM and N digestion were not affected by inclusion of EWLS instead of RWLS; the corresponding mean values were 70 and 71%. Apparent degradation of OM and N in the rumen were 44 and 64% for diets containing RWLS, and 40 and 39% for EWLS diets. Feeding diets including EWLS both increased non ammonia N and dietary N flow to the duodenum compared with diets containing RWLS (472 vs 357 g/d) and (263 vs 153 g/d) respectively. Absorption from the small intestine (g/d and % entering) of dietary N was higher for EWLS diets (146 vs 62 g/d; 34 vs 15%). The PDIA, PDIE and PDIN contents (g/kg of DM) of RWLS were 18, 94 and 245 respectively; the corresponding values after extrusion were 145, 220 and 220. PMID- 1777058 TI - [Reproduction of French Angora rabbits: ovulation in the female, semen production in the male]. AB - Ovulation rate and semen quality in French Angora rabbits were investigated to determine the potential of improving breeding practices in this breed. The proportion of does ovulating and their ovulation rate were studied in 40 females, as well as sexual behaviour and semen quality in 8 males. The experiments took place in autumn 1987 and were repeated in winter. Three groups of does were injected with 25, 50 IU hCG or 0.8 microgram GnRH (groups 1, 2 and 3, respectively). Another group was mated and served as a control (group 4). Hormonal treatments improved the proportion of does which ovulated (95, 90, 74 and 28% in groups 1-4, respectively; P less than 0.05) but did not change their ovulation rate (10.9 +/- 0.7, 10.7 +/- 0.7, 11.3 +/- 0.8 and 8.9 +/- 1.3 corpora lutea per ovulating female, groups 1-4, respectively; m +/- SEM, NS). In males, two ejaculates were collected twice weekly for 3.5 weeks from 8 bucks. Ejaculates obtained in March were better than those collected in November (volume: 0.33 vs 0.23 ml, P less than 0.01; raw motility: 5.2 vs 3.9, P less than 0.01; individual motility: 2.7 vs 2.1, P less than 0.05; number of living spermatozoa per ejaculate: 71 vs 28 x 10(6), P less than 0.01, respectively). These results suggest that artificial insemination may be utilized to improve reproductive performance in French Angora rabbits. PMID- 1777059 TI - Seasonal changes in plasma concentrations of gonadotropins and in the responsiveness of the pituitary and testis to GnRH in a desert rodent, the sand rat (Psammomys obesus). AB - The male sand rat (Psammomys obesus), captured alive in the Sahara desert in the area of Beni-Abbes (Algeria), exhibited seasonal changes in plasma concentrations of LH, characterized by an increase in early summer. Administration of a standard dose of GnRH (200 ng/100 g body weight) failed to elicit significant season dependent changes in LH release, whereas the increase in plasma testosterone was maximum in June-July and quite small between November and March-April. The present results suggest that the summer seasonal onset of the testicular endocrine activity of the sand rat is due to increases both in LH release and in testis sensitivity to gonadotropin. PMID- 1777060 TI - Effect of dietary lysine level on lipogenesis in broilers. AB - From 3-7 weeks of age, male and female broilers were fed ad libitum on 1 of the 8 experimental diets. These diets were isoenergetic (13.6 kJ/kg) and isoproteic (186 g/kg) and provided 7 to 14 g/kg lysine. The growth performances, the abdominal fat proportion and hepatic malic enzyme activity (malate dehydrogenase with decarboxylating EC 1.1.1.40) were measured. All parameters varied when dietary lysine concentration was increased from 7 to 9 or to 11 g/kg. The lysine requirement in the finishing period for minimum abdominal fat proportion was higher than for minimum feed conversion ratio, itseful higher than for maximal growth rate. Malic enzyme activity varied with abdominal fat proportion, and this variation could explain the reduction in fatness. However, an excess of lysine did not amplify the reduction of fat deposit. PMID- 1777061 TI - Effects of a low dietary linoleic acid level on intestinal morphology and enterocyte brush border membrane lipid composition. AB - The influence of low dietary linoleic acid level (an essential fatty acid deficiency) on the intestine mucosal morphology and the purified brush border membrane (BBM) lipid composition was investigated in the rat. Electron micrographs and morphometric measurements showed that villi and crypt sizes as well as the ultrastructure of epithelial cells were altered. Cholesterol (CHOL) and phospholipid (PL) levels, CHOL/PL ratio and PL class distribution were not changed by the low linoleate diet. However, the fatty acid composition of phospholipids was markedly modified in the enterocyte BBM, showing elevated amounts of palmitoleic (16:1n-7), oleic (18:1n-9) and 5,8,11-eicosatrienoic (20:3n-9) acids and, by contrast, depressed linoleic (18:2n-6) and arachidonic (20:4n-6) acid levels. Although the underlying mechanisms remain unknown the results obtained suggest that essential fatty acids (EFA) could be directly involved in the trigger action of the observed alterations, as regards both their dynamic (metabolic) and structural roles. PMID- 1777063 TI - New antiepileptic drugs. PMID- 1777064 TI - Felbamate. PMID- 1777062 TI - Effects of thyroid state alterations in ovo on the plasma levels of thyroid hormones and on the populations of fibers in the plantaris muscle of male and female chickens. AB - Propylthiouracil (PTU), thyroxine (T4) or thyreoliberin (TRH) were injected in ovo to modify the thyroid state of chicken embryos. Significant sexual differences were observed in the effects of these treatments on the plasma concentrations of thyroid hormones and on plantaris muscle characteristics (DNA, RNA, populations of muscle fibers) in 3- and 35-day old male and female chickens. The T4 plasma concentration is lower in control males; it is decreased in PTU treated females and in the T4 treated females at 35 days. The T3 plasma concentration is lowered at 3 days in all treated chickens and also at 35 days in the TRH treated animals. The slow (STnO) and the fast (FTOG) fibers of the plantaris are always more numerous in males. In controls, the number of FTOG fibers remains steady between 3 and 35 days; at the same time, the number of STnO fibers rises in males only. Both PTU and T4 treatments increase the number of the FTOG and the STnO fibers respectively before and after the 3rd day. TRH treatment increases the number of STnO fibers at 3 and 35 days in males, but reduces it at 3 days in females. Thus changes in the number of FTOG fibers can be induced during in ovo myogenesis, whereas the number of STnO fibers may increase after hatching. PMID- 1777065 TI - Gabapentin. PMID- 1777066 TI - Lamotrigine. PMID- 1777067 TI - Loreclezole. PMID- 1777068 TI - Losigamone. PMID- 1777069 TI - Oxcarbazepine. PMID- 1777070 TI - Ralitoline. PMID- 1777071 TI - Remacemide. PMID- 1777072 TI - The influence of antiepileptic drugs on the natural history of epilepsy. PMID- 1777073 TI - Stiripentol. PMID- 1777074 TI - Tiagabine. PMID- 1777075 TI - Vigabatrin. PMID- 1777076 TI - Zonisamide. PMID- 1777077 TI - Kinetics, metabolism and effects of carbamazepine-10,11-epoxide in man. PMID- 1777079 TI - Lamotrigine in refractory epilepsy: a long-term open study. PMID- 1777078 TI - Gabapentin. PMID- 1777081 TI - Genetic animal models for generalized non convulsive epilepsies and new antiepileptic drugs. PMID- 1777080 TI - Vigabatrin. PMID- 1777082 TI - Anticonvulsant activity of some calcium antagonists in genetically epilepsy prone rats. PMID- 1777083 TI - The brain distribution of old and new antiepileptic drugs. PMID- 1777084 TI - Evaluation of clinical efficacy in antiepileptic drug trials. PMID- 1777085 TI - Mental deterioration in a population with intractable epilepsy. PMID- 1777086 TI - Pharmacokinetics and interactions of the new antiepileptic drugs. PMID- 1777087 TI - The efficacy and safety of new antiepileptic drugs. PMID- 1777088 TI - Eterobarb. PMID- 1777089 TI - Thrombotic microangiopathies. PMID- 1777090 TI - Immune markers in hematologic malignancies. AB - The precise delineation of biologic traits that distinguish normal hematopoietic cells from their malignant counterparts is of fundamental importance in understanding all aspects of hematologic malignancies. An increasingly sophisticated technologic battery has been utilized to dissect out these differences--primarily utilization of monoclonal antibodies, by immunoperoxidase, immunoalkaline phosphatase and flow cytometric techniques. An even more basic understanding of normal and malignant hematopoietic cells has begun to evolve as molecular biology begins to unravel gene misprogramming by Southern and Northern blot analysis and the polymerase chain reaction. These techniques not only help distinguish a normal cell from a malignant one, but characterize the malignant clone as B-lymphoid, T-lymphoid or myeloid and allow further subcategorization within these broad lineages. These distinctions are vital to the entire spectrum of basic and clinical research involving hematologic malignancies and are assuming an increasingly important role in their diagnosis, prognosis and treatment. PMID- 1777091 TI - Melanoma: new biology; new therapy. PMID- 1777092 TI - [Management of status asthmaticus in children]. AB - Acute bronchial asthmatic episodes represent one of the most common respiratory emergencies in medical practice. Its maximum expression "status asthmaticus", is an entity of low incidence in our medium, still it is a risk to the physical integrity of the patient. The management of an acute attack of asthma can be focused on doing away with the bronchial spasm and decreasing the inflammatory effects, as well as improve the movement of secretion and this way, maintain adequate alveolar ventilation. The full knowledge of the physiopathology behind the illness and medical treatment used to improve the patient's well-being, are necessary for the patient's full recuperation. The different components which comprise the integral management of an episode of status asthmaticus are analyzed in unison, emphasizing the data included in the clinical chart, medical management and other therapeutic measures employed. PMID- 1777093 TI - [Diagnosis of streptococcal pharyngo-tonsillitis: clinical criteria or coagglutination?]. AB - With the purpose of evaluating the usefulness of clinical data and a coagglutination test for the diagnosis of streptococcal pharyngeal tonsillitis, a study was carried out comparing both methods with the standard pharynx culture (gold standard). One hundred and forty-one patients clinically diagnosed with pharyngeal tonsillitis were analyzed. 80 other patients diagnosed with rhino pharyngitis were used as control groups as well as a group of 66 healthy patients. It was found that the presence of pus in the tonsils and the absence of rhinorrhea and/or a productive cough were isolated clinical variables which showed a significant difference when comparing those cases with a positive or a negative culture (P less than 0.01). These clinical data had a sensitivity and adequate negative predictive values (68 to 83% and 90 to 92%, respectively); specificity was 44 to 74% and the positive predictive value from 24 to 36%. The gathering of combined clinical indexes with different symptoms and signs, were not greater than isolated data. The coagglutination test in those cases of pharyngeal tonsillitis showed greater better specificity (98%) and positive predictive value (93%), but saw no improvement in sensitivity (72%) nor in the negative predictive value (91%), which is why when faced with a negative coagglutination test, it is still necessary to perform a throat culture due to the risk which the patient may be exposed to when no treatment is given. The analysis of the advantages and disadvantages in the routine use of coagglutination and cultures in their particular cases, allows us to conclude that in daily clinical practice the use of clinical criteria is of greater usefulness.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777094 TI - [Mortality in children under 5 years of age in families of marginal settlements in Guadalajara]. AB - The purpose was, to determine the frequency of infant mortality in the marginal areas of Guadalajara and, find its association with sociodemographic and economical factors, which are known as determinant of the nutritional status of children. There were included 898 families in a cross sectional design among children who applied to the food supplementation program of ONI of Guadalajara. Through an interview and home visit, it was obtained information about sociodemographic and economical characteristics and food habits. The data was recorded and analyzed by the Dbase III Plus and Epi-Info program. It was also used Chi square test and Odds Ratio for the statistical analysis. Education of the mother and income per capita for feeding (as a percentage of the minimum salary) had a significantly and inverse association with infant mortality (P less than 0.0001 and P less than 0.001 respectively). There was also major mortality among children with no social security (P less than 0.05). The Odds Ratio for infant mortality was of 3.02 for education of the father, 8.42 for education of the mother and 6.8 for income per capita for feeding. Meanwhile the level of education and the economical situation of the studied population remain so low, it seems improbable to decrease the rate of infant mortality. PMID- 1777095 TI - [Growth curves for premature infants during the 1st year of life]. AB - A 107 newborn premature children were anthropometrically evaluated during the first 12 months of their lives at the Growth Clinic of the National Institute of Perinatology in Mexico City. The study was longitudinal and included variables such as weight, height, cephalic, thoracic, abdominal and bronchial perimeters. The data are show in percentiles of 10, 50 and 90 for each variable. A symmetrical logarithmic behavior throughout the entire curve was seen with each of the six indicators evaluated, whose greatest percentage increase within the growth rate was generally seen during the first semester, decreasing during the second. It was seen that once the child reaches one, the premature infant reaches the full-term child (50 percentile) in weight, height and cephalic perimeter. In addition, the average speed of growth was four times greater for weight, two times greater for height and similar for the cephalic perimeter of the premature child with respect to the full-term infant. We conclude that it is useful to count on specific growth curves for premature children since their speed and rhythm of growth are different than for the full-term child during the first year of life. PMID- 1777096 TI - [Congenital atresia of the vagina]. AB - The articles includes eight cases of congenital atresia of the vagina seen and studied at the Pediatric Surgery Department. All cases were congenital five of them corresponded to the Mayer-Rokitansky-Kuster-Hauser Syndrome an the remaining three to congenital adrenal hyperplasia. No other malformations were associated to any of the cases. The karyotype, hormones and secondary sexual characteristics were normal in those cases of Mayer-Rokitansky-Kuster-Hauser Syndrome. In the other three cases of congenital adrenal hyperplasia the karyotype was found to be 46XX, the 17-ketosteroids and pregnanediol were high and the patients were found to have hirsutism and were virilized. The ultrasonography, CAT and magnetic resonance scans showed excellent anatomical information on the congenital vaginal atresia and the intrapelvic organs. No other invasive study was needed to confirm its existence. Six of the patients were operated using the McIndoe and Bannister technique while on the other two the Tobin and Day technique was used. Post surgical complications included vaginal stenosis in two cases within the first three months. The article includes an analysis of the complications and both the anatomical and functional results obtained. PMID- 1777097 TI - [Physiopathology, diagnosis and treatment of acute renal insufficiency]. AB - Fifty-two clinical charts of children who had been discharged from this hospital, after being treated for acute renal failure, were analyzed to determine the incidence, presentation and results of the treatment used. We found that 0.7% of the total number of children admitted developed this complication and that 4/5 of them were under two years old. The initial illnesses were gastroenteritis, bronchial pneumonia, cyanogenic cardiopathies and sepsis. Some of the patients had hypoxic episodes or went into hypovolemic shock or a combination of both. In half of the patients diagnosis was reached from anamnesis, from of oliguria, acidosis and nitrogen retention. In the rest from whom a urine sample was obtained, the diagnosis was confirmed when the FeNa was higher than 2 and because the U/P osmolarity and urea were under 1.3 and 5 respectively. The oliguric type of acute renal failure was seen in 65% of the cases; the non-oliguric type in 35%. In the first group the mortality rate reached 6.5% even though a third of them were placed under dialysis. Yet, in another 7 cases, dialysis could not be used because the child was in shock. Of the 18 cases of non-oliguric acute renal failure, 12 recovered; only 3 required dialysis. We conclude that the high mortality rate in cases of acute renal failure depends on the severity of the underlying illness, the age of the patient and the delay in the diagnosis of the disease. The use of dopamine and furosemide, as well as the application of hemoperfusion instead place of peritoneal dialysis in neonates with sepsis, could improve results. PMID- 1777098 TI - [Intracardiac catheter fragment. Presentation of a clinical case]. AB - This is a case report of a 2 year/5 month old female patient with a venous catheter fragment lodged in her right heart and pulmonary artery. The patient was familiar to us because of her ventricular septum defect and pulmonary hypertension secondary to the heart defect. Routine X-rays showed a fragment of the catheter lodged in the heart. The physical examination showed nothing more in addition to that derived from the ventricular defect. Her records included a clavicular phlebotomy at 2 months when suffering from a severe case of dehydration. The cardiac catheterization done at 16 months confirmed the finding of the fragment, which was extracted transluminally. The intracardiac extraction of the venous catheter and the simultaneous closure of the septal defect comprised the treatment applied. PMID- 1777099 TI - [Noma: presentation of a case]. AB - The noma has been rarely seen during these last decades. It is of an infections etiology, primarily affecting malnourished or immunodeficient children. It is easily confused with neoplastic tumors, tuberculosis, mycosis or gangrene ecthyma which may condition errors in treatment with severe undesirable side-effects. It has recently been associated to AIDS. A case is reported, comments are included on the diagnostic method, medical and surgical treatment and the results obtained. PMID- 1777100 TI - Amphetamine-induced behavioral phenotype in a hypoxanthine-guanine phosphoribosyltransferase-deficient mouse model of Lesch-Nyhan syndrome. AB - In humans, congenital deficiency of the enzyme hypoxanthine-guanine phosphoribosyltransferase (HPRT) results in a disorder known as the Lesch-Nyhan syndrome. Patients with this disorder exhibit a prominent neurobehavioral phenotype that results in part from dysfunction of catecholaminergic systems in the striatum. HPRT-deficient mice produced as animal models for this syndrome curiously exhibit no spontaneous neurobehavioral abnormalities. However, the present study demonstrates that HPRT-deficient mice are more sensitive than their HPRT-normal littermates to the ability of amphetamine to stimulate locomotor or stereotypic behaviors. This behavioral supersensitivity to amphetamine indicates the existence of an underlying subclinical abnormality of catecholaminergic systems in the brains of HPRT-deficient mice, analogous to findings in human Lesch-Nyhan patients. PMID- 1777101 TI - Both hypoxia and milk deprivation diminish metabolic heat production and ultrasound emission by rat pups during cold exposure. AB - Rat pups (7-9 days of age) were made cold and hypoxic simultaneously while interscapular temperature, rectal temperature, and ultrasound emission were monitored. These hypoxic pups cooled faster than control pups, which indicates decreased thermogenesis and decreased oxygen consumption, and produced less ultrasound. In a separate experiment, pups deprived of milk for 24 hr cooled faster and also produced less ultrasound than did nondeprived littermates. Further analyses revealed that those pups that cooled the slowest (and thus used the most oxygen) vocalized the most, both among control animals as well as across the two manipulated groups. This finding suggests that ultrasound emission covaries with thermogenesis. The observed pattern is opposite to that predicted by traditional communication hypotheses of rat pup vocalizations and favors understanding the sounds as symptoms of laryngeal braking. PMID- 1777102 TI - Acquisition and retention by hippocampal rats of simple, conditional, and configural tasks using tactile and olfactory cues: implications for hippocampal function. AB - Hippocampal rats were given simple, conditional, and configural tasks that required them to pull up strings to obtain food pellets. The tasks contrasted string size, odor, location, paired string size and location, or compounds of string size and odor. There was no anterograde or retrograde amnesia for the simple discriminations or for simple discrimination components of the other tasks. Hippocampal rats also learned conditional and configural tasks, although they were impaired on the configural task. Finally, the rats were impaired in postoperative retention of the conditional but not the configural task, although they displayed savings in relation to naive rats on the conditional task. The results do not support theories that the hippocampus is essential for conditional or configural learning but may support a modified form of configural theory in which the hippocampus contributes to, but is not essential for, learning or retention of configurations. PMID- 1777103 TI - Effects of corticosterone on response consolidation and retrieval in the forced swim test. AB - In the forced swimming test, adrenal hormones regulate immobility time during a test swim given 24 hr after the initial training swim (e.g., the deficit in adrenalectomized animals is reduced when animals are given corticosterone [B] immediately after the training session). In this study, adrenalectomy decreased and B restored immobility during the test swims. The effects of adrenalectomy were completely reversed by 1 mg/kg doses of B, which results in plasma B levels that are comparable to values under basal resting conditions. Higher doses of B had no further effect. B given before or immediately after training partially reversed the effects of adrenalectomy. The complete reversal of the effects of adrenalectomy, however, required the presence of B during both training and testing, suggesting that B plays a role in the consolidation-retention and retrieval of the immobility response. PMID- 1777104 TI - A direct projection from the central nucleus of the amygdala to the acoustic startle pathway: anterograde and retrograde tracing studies. AB - Previous work has shown that lesions of the central nucleus of the amygdala block fear-potentiated acoustic startle and that electrical simulation of the central nucleus enhances acoustic startle in rats. In the present study, the anterograde tracer Phaseolus vulgaris-leucoagglutinin was used to identify and delineate the course of a direct projection from the central nucleus of the amygdala to the nucleus reticularis pontis caudalis, a nucleus in the acoustic startle circuit. Experiments using the retrograde tracer Fluoro-Gold confirmed this and indicated that the rostral part of the medial subdivision of the central nucleus of the amygdala contains the cells that project to the startle circuit. With this information, lesion studies (see companion article Hitchcock & Davis, 1991) may be used to determine whether this projection plays a role in fear-potentiated startle. PMID- 1777105 TI - Frontal brain asymmetry and immune function. AB - The relation between brain activity and the immune system was evaluated by assessing immune responses in 20 healthy women who manifested extreme differences in the asymmetry of frontal cortex activation. One group showed extreme and stable left frontal activation; the other group showed extreme and stable right frontal activation. As predicted, women with extreme right frontal activation had significantly lower levels of natural killer cell activity (at effector:target cell ratios of 33:1 and 11:1) than did left frontally activated individuals. This difference did not extend to two other immune measures, lymphocyte proliferation and T-cell subsets. However, higher immunoglobulin levels of the M class were observed in the right frontal group. In this study, the immune patterns could not be accounted for by plasma cortisol levels, anxiety- and depression-related symptomatology, or recent health histories. These findings support the hypothesis that there is a specific association between frontal brain asymmetry and certain immune responses. PMID- 1777106 TI - Prefrontal cortex self-stimulation and energy balance. AB - The relation between sulcal prefrontal cortex (SPC) and medial prefrontal cortex (MPC) self-stimulation and energy balance was investigated in rats. SPC but not MPC self-stimulation induced feeding but not the gnawing of wooden blocks. SPC but not MPC self-stimulation enhanced weight gain over several weeks of exposure to stimulation. Food deprivation (48 hr but not 24 hr) increased SPC self stimulation rates under a 5-s fixed-interval reinforcement schedule and decreased current thresholds for SPC self-stimulation. MPC self-stimulation was unaffected by food deprivation. Insulin (4 U/kg) and 2-deoxy-D-glucose (300 mg/kg) inhibited both SPC and MPC self-stimulation, probably through interfering with performance. Satiety induced by prolonged intake of a sweetened solution or deprivation induced feeding moderately facilitated SPC self-stimulation. Overall, it appears that SPC but not MPC self-stimulation modulates, and is modulated by, energy balance. PMID- 1777107 TI - Central gustatory lesions: II. Effects on sodium appetite, taste aversion learning, and feeding behaviors. AB - Intake and taste reactivity tests were used to determine the effects of bilateral lesions of the gustatory portions of the nucleus of the solitary tract (NST), the parabrachial nucleus (PBN), and the ventral posteromedial nucleus of the thalamus (VPMpc) on several complex ingestive behaviors. In the 1st experiment, lesions of the PBN and the NST blocked, and VPMpc lesions impaired, the behavioral expression of salt appetite. In the 2nd experiment, alanine was paired with injections of LiCl. Control rats as well as rats with NST and VPMpc lesions acquired the taste aversion, but rats with PBN lesions did not. In the 3rd experiment, all animals increased their food intake after injections of 2 U/kg insulin and 250 mg/kg 2-deoxy-D-glucose, and their food intake was suppressed after nutritive stomach loads. PMID- 1777108 TI - Taste reactivity responses elicited by reinforcing drugs: a dose-response analysis. AB - A series of 3 experiments with Sprague-Dawley rats measured taste reactivity (TR) responses elicited by sucrose that was paired on 5 occasions with various doses of d-amphetamine (0, 1, 2, 5, or 10 mg/kg), nicotine (0, 0.4, 0.8, 1.2, or 2.0 mg/kg), or morphine (0, 2, 8, 20, or 80 mg/kg). The TR responses elicited by flavors paired with each of these drugs were compared with those elicited by flavors paired with lithium. The only doses of d-amphetamine and nicotine that effectively conditioned aversive TR responses were high doses that have also been demonstrated to be incapable of producing a place preference. Extremely high doses of morphine were incapable of producing aversive TR responses. It is suggested that aversive TR responses are only produced by doses of agents that are not reinforcing in other paradigms. PMID- 1777109 TI - An ontogenetic comparison of ethanol-mediated taste aversion learning and ethanol induced hypothermia in preweanling rats. AB - To examine the interactive effects of ethanol (EtOH) and ambient temperature, 10 , 16-, and 20-day-old rat pups ingested pairings of sucrose solution and various doses of ethanol (intubated intragastrically) and were then exposed to relatively low or relatively high ambient temperatures. Ten- and 20-day-old pups required a higher EtOH dose than did 16-day old pups for conditioning of a sucrose aversion and for hypothermia. These age-related differences might be due to ontogenetic changes in the production and accumulation of acetaldehyde, a metabolite of EtOH. For all ages, EtOH-induced hypothermia was necessary for conditioning of the taste aversion, which is in accord with results of previous tests with adult rats (Cunningham, Hawks, & Niehus, 1988). PMID- 1777110 TI - Trigeminal lesions and maternal behavior in Norway rats: I. Effects of cutaneous rostral snout denervation on maintenance of nurturance and maternal aggression. AB - Cutaneous desensitization of the upper, rostral snout by bilateral section of the infraorbital nerves in lactating Norway rat dams markedly, but transiently, disrupted retrieval and licking of pups, nursing behavior, and fighting with a strange male intruder. Removal of the mystacial vibrissae, which provide major inputs to the infraorbital nerves, or cutaneous desensitization of the chin by bilateral sectioning of the mental nerves did not disrupt these behaviors. However, cutaneous desensitization of both the upper and lower rostral snout exacerbated and prolonged the effects produced by infraorbital denervation alone. The control of maternal behavior and aggression by somatosensory reflexes and the possible bases for rapid behavioral recovery after partial trigeminal sensory denervations are discussed. PMID- 1777111 TI - Effects of cadmium on cocaine-induced changes in activity. AB - Adult male rats were exposed to a diet that contained 100 parts per million added cadmium or a control diet for 72 days before being tested in a Digiscan activity monitor. During the 1-hr test period, each animal's baseline activity levels were recorded for 20 min. Animals then received intraperitoneal injections of 0, 10, 20, or 40 mg/kg cocaine HCl, and their activity levels were recorded for the remaining 40 min of the test session. The results showed that the 10, 20, and 40 mg/kg doses of cocaine produced behavioral activation in the control-diet animals. For cadmium-treated animals, cocaine-induced behavioral changes at the 10 mg/kg dose were not observed, but increased activity was evident at the two higher doses. PMID- 1777112 TI - Nonencapsulated hemoglobin-based red blood cell substitutes: an updated view. AB - The characteristics and properties of the nonencapsulated hemoglobin (Hb)-based materials which have been used as substitutes for red blood cells are reviewed. The chemical and physical criteria such as oxygen dissociation, oxygen carrying capacity, antigenicity, viscosity, and circulatory retention time are described. The critical issue of Hb purity assurance testing is examined. The methods of the analyses which should be used to evaluate the lipid purity, endotoxin levels, and protein profile of Hb solutions are described. Additionally, the various approaches to Hb isolation, purification, and production are examined. PMID- 1777113 TI - High performance affinity chromatography of Bacillus neutral proteases. AB - Bacillus neutral proteases were purified using bacitracin-silica as an affinity medium. Several chromatographic procedures were investigated, including high speed runs on columns with 40- to 60-microns silica particles. The high speed procedure enabled the purification of 4.9 mg of B. subtilis neutral protease directly from 165-ml culture supernatant within 1.5 h. The neutral proteases of B. polymyxa and B. stearothermophilus were also purified. The latter enzyme was further concentrated by a second affinity chromatography step, using Sepharose with glycyl-D-phenylalanine as a ligand. During the purification procedures isopropanol was used to prevent autodigestion of the enzymes. PMID- 1777114 TI - A large-scale purification of beta-glucuronidase from human liver by immunoaffinity chromatography. AB - We intend to purify beta-glucuronidase from human liver in a large quantity in order to facilitate the study of its biochemical structure and pathophysiologic roles in cholelithiasis and carcinogenesis. The initial purification procedure involved: (1) liver homogenization, (2) 25-45% saturated ammonium sulfate fractionation, (3) heat denaturation of protein at 56 degrees C, (4) gel filtration with Bio-Gel P-300 gel, (5) anion exchange chromatography with DEAE agarose, (6) cation exchange chromatography with CM agarose, and (7) hydroxyapatite chromatography (overall yield, 1%; overall purification, 169X). The final product was used to immunize rabbits and BALB/c mice for production of polyclonal and monoclonal antibodies, respectively. The antibodies, mainly IgG, were purified by using gamma-Protein A agarose column chromatography. The purified IgG, after periodate oxidation, was coupled to hydrazide gel by formation of a stable covalent hydrazone bond linkage. The new purification procedure involved the initial first three steps, followed by (4) polyclonal IgG immunoaffinity chromatography and (5) monoclonal IgG immunoaffinity chromatography (overall yield, 6.1%; overall purification, 3720X). Polyacrylamide gel electrophoresis indicated minor contaminants in the final product which could be further purified by electroelution. It is concluded that beta-glucuronidase constitutes 0.016 mg per gram of wet liver tissue and can be obtained on a large scale in a highly purified form within a 2-day cycle. PMID- 1777115 TI - Investigation of the UDP-glucose dehydrogenase reaction for a coupled assay of UDP-glucose pyrophosphorylase activities. AB - An optimized coupled enzyme assay for UDP-glucose pyrophosphorylase (EC 2.7.7.9) using UDP-glucose dehydrogenase (EC 1.1.1.22) is presented. This optimized assay was developed by a detailed investigation of the kinetics of the UDP-glucose dehydrogenase reaction. In addition the data provide a basis for the enzymatic synthesis of UDP-glucuronic acid. The results demonstrate that the two binding sites of the dehydrogenase differ since a different modulation of the enzyme activity and stability is observed after preincubation with UDP-glucose or NAD+ at various pH values. This is of general interest for the preparation of assay mixtures where UDP-glucose dehydrogenase is used as an auxiliary enzyme. PMID- 1777116 TI - Characterization of commercial Trichoderma reesei cellulase preparations by denaturing electrophoresis (SDS-PAGE) and immunostaining using monoclonal antibodies. AB - Fifteen different cellulase preparations from Trichoderma reesei, obtained either commercially or from pilot plants, were analyzed by sodium dodecyl sulfate polyacrylamide gel electrophoresis and immunoblotting using monoclonal antibodies against two cellobiohydrolases (CBH I, CBH II), an endoglucanase (EG I), and beta glucosidase. The staining patterns were compared with the activities of the preparations against filter paper (FPU), carboxymethylcellulose (CMC-ase), cellobiose (beta-glucosidase), and azocasein (protease). Variable amounts of proteolytic degradation products of CBH I, CBH II, and EG I were seen in most samples, and only half of them contained intact beta-glucosidase. The degree of proteolysis did not correlate with any significant difference in the respective activities of these preparations against filter paper cellulose or carboxymethylcellulose. In more than 50% of all cases a decreased beta glucosidase activity and the absence of intact beta-glucosidase protein in Western blots was observed in preparations displaying high proteolytic activity. PMID- 1777117 TI - Authenticity and reconstitution of immobilized enzymes: characterization and denaturation/renaturation of glucoamylase II. AB - Glucoamylase II (GA II) immobilized to Eupergit C and CIZ as a porous and nonporous matrix shows enzymatic characteristics indistinguishable from those of the free enzyme, except for reduced specific activity. Since this decrease is equally observed for both matrices, it has to be ascribed to nonproductive fixation of the enzyme or steric hindrance rather that perturbations caused by "inner diffusion" effects. Authenticity refers to the optimum pH for catalytic activity, Michaelis constants for starch and maltoheptaose, as well as identical stability toward temperature, pH, and guanidinium chloride (GdmCl). On the basis of these data, the two-state mechanism observed for the equilibrium transitions of the free enzyme may be assumed to hold also for the immobilized enzyme. Renaturation after preceding denaturation in 6.4 and 7 M GdmCl leads to widely differing yields depending on the conditions. Shifting the denaturant concentration stepwise back to nondenaturing GdmCl concentrations leads to a broad range of "hysteresis" accompanied by aggregation. Rapid dilution of the free and immobilized enzymes at pH greater than 6 and sufficiently low protein concentration leads to reactivation yields of 80 and 45%, respectively. For the free enzyme, reconstitution at lower pH is determined by the kinetic competition of folding and aggregation. In the case of the immobilized enzyme, "entangling" of the matrix with the unfolded polypeptide chain competes with renaturation. PMID- 1777118 TI - Stabilization of recombinant proteins from proteolytic degradation in Escherichia coli using a dual affinity fusion strategy. AB - A dual affinity fusion approach has been used to study the expression and secretion of labile recombinant proteins in Escherichia coli. Here we show that three small eukaryotic proteins (human proinsulin, a thioredoxin homologous domain of rat protein disulfide isomerase, and the extracellular domain of the alpha 1.2-chain of a human T-cell receptor) are stabilized in vivo using a dual affinity fusion strategy, where the gene encoding the desired product is fused between two genes encoding two different affinity domains. Relatively high yields of full-length product were obtained for all three proteins as compared to when fused to a single fusion partner. Despite the use of a signal peptide, significant amounts of the disulfide protein isomerase and T-cell receptor gene products were maintained in the cytoplasm, while the proinsulin fusion was efficiently secreted to the periplasm. Interestingly, the E. coli heat shock proteins DnaK and GroEL were associated with the fusion proteins isolated from the cytoplasm. PMID- 1777120 TI - Gellan gum biosynthetic enzymes in producing and nonproducing variants of Pseudomonas elodea. AB - A pathway for the synthesis of the repeating tetrasaccharide units in gellan gum from Pseudomonas elodea is proposed. The enzymes presumed to be involved in the synthesis of the activated precursors UDP-glucose, TDP-rhamnose, and UDP glucuronic acid were detected and assayed in crude cell extracts of the gellan producing (Gel+) P. elodea ATCC 31461. The levels of UDP-glucose pyrophosphorylase and TDP-glucose pyrophosphorylase were higher in cells grown in media leading to higher gellan yields. Moreover, these enzymes exhibited lower values in cells of a Gel- variant, spontaneously obtained from the Gel+ wild type. The activation or repression of their synthesis is thought to be involved in the expression of the mucoid phenotype. Nevertheless, based on results here reported, the involvement of other enzymes, that catalyze steps downstream from the formation of the precursors cannot be excluded. PMID- 1777119 TI - Murine red blood cells as efficient carriers of three bacterial antigens for the production of specific and neutralizing antibodies. AB - Three bacterial toxoids, CRM 197 (mutagenized diphtheria toxin), tetanus toxoid (formaldehyde-treated tetanus toxin), and PT-9K/129G (double mutant of pertussin toxin) were encapsulated within red blood cells (RBCs) of B6D2F1 and Balb/C mice according to a mild procedure based on hypotonic dialysis-isotonic resealing that yielded undamaged RBCs. The toxoid-loaded RBCs were injected intravenously in order to immunize animals and their effects were compared to those of identical amounts (30-95 micrograms per mouse subdivided into multiple injections) of the corresponding free toxoids injected intravenously in saline. Sera from treated mice were collected and tested for titers of specific antibodies against each of the three antigens and also for titers of neutralizing antibodies, i.e., affording protection from toxic effects induced by the corresponding native toxins. In all experiments, significant seroconversion was observed with both immunization systems. Titers of both specific and neutralizing antibodies against CRM 197 and tetanus toxoid were several-fold higher upon immunization with the RBC-encapsulated toxoids, than with the free toxoids. These differences were not due to qualitatively different recognition patterns of antigenic determinants by the two types of sera. Conversely, intravenous immunization with pertussis toxoid either as RBC-encapsulated or as free antigen elicited a comparably high production of specific and of neutralizing antibodies. These data demonstrate that properly engineered RBCs behave as natural carriers and possibly adjuvants for antigens of vaccinal interest. PMID- 1777121 TI - Immunological versatility and carbon regulation of Cellulomonas fimi endo-1,4 beta-glucanases. AB - More than 10 protein molecules with endo-1,4-beta-glucanase activity were identified by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and zymogram in Cellulomonas fimi culture supernatants, grown in CMC as carbon source. These molecules are shown to belong to at least four immunologically different groups, against three of which polyclonal antibodies were raised. The protein species used as antigens showed significant differences in cross reactivity, carbon regulation, and affinity to crystalline cellulose. Three intracellular precursors of the first group were detected, two of which were under carbon catabolite control with the third apparently being synthesized constitutively. In the extracellular environment this group showed the largest versatility in protein molecules. The second group appeared to originate from two intracellular precursors both synthesized constitutively and subject to minor extracellular modifications as compared to the first group. The main extracellular protein of this group showed high affinity toward crystalline cellulose. One intracellular precursor was identified for the third group, which was subject to carbon catabolite control. Only one extracellular molecule without binding ability to crystalline cellulose corresponded to this precursor, indicating that the latter was resistant to proteolytic modifications after excretion. It appears that the C. fimi cellulases are more complex than expected and reconstitution of the whole system will be difficult. PMID- 1777122 TI - Acetylcholinesterase inhibition by pitofenone: a spasmolytic compound. AB - Pitofenone, a spasmolytic compound, inhibited the acetylcholinesterase activity from bovine erythrocytes and from electric eel. It is a potent inhibitor of this enzyme from the two sources, with Ki values of 36 and 45 microM, respectively. Of the five compounds structurally related to pitofenone, only those containing a piperidine moiety show acetylcholinesterase inhibition. All these inhibitions are reversible, linear, and noncompetitive in nature. A qualitative correlation between the anticholinesterase and the corresponding antimuscarinic activity for some of these compounds was apparent. Good separation of these two effects would be a desirable feature for newer muscarinic antagonists. PMID- 1777123 TI - Role of oxygen and metal ions in the instability of streptolysin O. AB - Thiol-containing preparations of streptolysin O (SLO) and pure cysteine generate superoxide radicals in alkaline buffer on autoxidation of the thiol groups. Autoxidation is stimulated by cupric ions. Reconstituted SLO preparations accumulate hydrogen peroxide with a concomitant loss of activity on storage at room temperature. Short-term protection of hemolytic activity was achieved by inclusion of catalase in the preparation; no apparent protection was observed by superoxide dismutase, whereas 1,10-O-phenanthroline offered long-term protection of the hemolysin. PMID- 1777124 TI - Quantitative changes of wall polysaccharides in an immobilized yeast. AB - Whole cells of Saccharomyces cerevisiae were covalently linked to modified polyphenyleneoxide. The immobilization was accompanied by retention of cell division and increased concentrations of wall alkali-insoluble glucans and mannan. PMID- 1777125 TI - Positive effect of GAC gene product on the mRNA level of glyoxalase I gene in Saccharomyces cerevisiae. AB - A DNA fragment carrying a part of the structural gene for yeast (Saccharomyces cerevisiae) glyoxalase I was cloned from a lambda gt11 expression library using anti-glyoxalase IIgG as a probe. By Northern blotting analysis, the amount of glyoxalase I mRNA was found to increase in yeast cells containing plasmids carrying the GAC gene, which is a positive regulator for yeast glyoxalase I activity. This suggests that the GAC gene product may accelerate the transcription of glyoxalase I gene or may have some positive effects on the accumulation of glyoxalase I mRNA in yeast cells. PMID- 1777126 TI - Homologous fibronectin enhances healing of excised wounds in rats. AB - In order to evaluate the effects of a topical application of homologous fibronectin on the healing of skin wounds, we made 2 excisional wounds on the back skin of each rat, applied ointment with or without fibronectin purified from citrated homologous plasma, and evaluated the effect according to wound size and microscopic findings. Excised lesions treated with carrier alone, but the difference was significant only in the early phase of wound healing, 2 and 3 days, according to wound size and microscopic changes. A significant decrease in wound size could be found in both groups, treated with ointment containing and not containing fibronectin, between day 4 and 9 when wound contraction was a major contributor to wound closure. Therefore it can be concluded that topical application of fibronectin has a beneficial effect on wound healing during its early phase, but no significant influence on wound contraction. PMID- 1777127 TI - Anesthetic management of Jehovah's Witness patients. AB - When a Jehovah's Witness patient rejects transfusion because of his religious doctrine, the anesthesiologist is required to make an important decision. Each doctor must approach his patient respecting the patient's wishes as much as possible, while still taking into account his own ethical criteria, moral judgement of the patient, and knowledge of medicine. This writer briefly examined the basis of the religious doctrine of a Jehovah's Witness advocate and consulted a scholar of the criminal court about the legal interpretation of the doctor's behavior in our present situation where no detailed judicial precedent was available. I summarized medical solution here by referring to foreign records of medical studies and case reports in the hopes that it may aid in anesthetic management of Jehovah's Witness patients. PMID- 1777128 TI - Effect of glucose on the expression of c-myc gene in cultured RINm5F cell. AB - The study was designed to examine the effect of glucose on the expression of c myc gene in cultured RINm5F cells. After monolayer culture was established in RPMI 1640 media supplemented with 10% fetal calf serum (FCS), the cells were cultured in various concentrations of glucose and 1 or 10% FCS for another 24 hours. A mRNA was extracted from the cultured cells by a single step method, and Northern analysis was done to detect RNA band. A 0.5 kilobase single band was detected as c-myc mRNA. The expression of c-myc gene mRNA was reduced with increased concentration of glucose with 1% FCS. However, supplementation of 10% FCS abolished the effect of glucose on expression of c-myc gene. These findings suggested that glucose in conjunction with other growth promoting factors played an important role in expression of oncogene and cell growth in RINm5F cells. PMID- 1777129 TI - Proptosis from a cephalhematoma in a twelve-year-old girl--a case report. AB - We report a unique case of a 12-year-old girl with unilateral proptosis form orbital extension of an extensive bilateral cephalhematoma. Loss of vision in the left eye due to severe proptosis was reversed by prompt aspiration and tarsorrhaphy. PMID- 1777130 TI - Lymphomatoid granulomatosis with isolated involvement of the brain--case report. AB - Lymphomatoid granulomatosis usually presents as a primary lung affliction with secondary metastatic spread to the central nervous system(CNS), and its initial manifestation purely as a CNS disease is rare. A 57-year-old man with histologically proven lymphomatoid granulomatosis of the brain as the sole manifestation of the disease is presented. PMID- 1777131 TI - Atypical clinical manifestations of amebic colitis. AB - Amebic colitis is a disease revealing diverse clinical manifestations and endoscopic gross features and often confused with other types of colitis. In case of misdiagnosis as an idiopathic inflammatory bowel disease or delayed recognition of intestinal amebiasis, an undesirable outcome may occur resulting from erroneous administration of steroids or delayed antiamebic treatment. To demonstrate the pitfalls in the diagnosis and treatment of intestinal amebiasis, 3 cases of amebic colitis with atypical clinical manifestations are presented in this paper. In conclusion, despite the low sensitivities of routine stool examination for parasite and histopathologic confirmation in biopsy specimen, every effort must be made to find amebic trophozoites either in fresh stool or biopsy specimens for prompt and correct diagnosis of amebic colitis when we manage patients with chronic intestinal ulcerations, even though their clinical course and endoscopic findings are not typical of amebiasis. Moreover, following initial successful anti-amebic therapy, more careful clinical, endoscopical, and parasitological follow-up should be done for the early detection of recurrence. PMID- 1777132 TI - Neonatal hemochromatosis--report of an autopsy case. AB - A case of neonatal hemochromatosis in a 3-hour-old male is described. He presented with hypotonia, mild jaundice, and respiratory difficulty immediately after birth. He had no evidence of congenital infection, immune-related hemolysis or exogenous iron uptake. Postmortem examination revealed abnormal facial features. The organs were of normal weight for his age except a small liver and lungs, and a large spleen. The most prominent changes were in the liver and pancreas. The liver was coarsely nodular and fibrotic. The lobular architecture was totally distorted by innumerable multinucleated giant cells, loss or collapse of the hepatocytes, and diffuse fibrosis. A large amount of hemosiderin was seen in the liver, pancreatic acini and thyroid follicular cells. Scanty amount of hemosiderin was also found in the myocardial fibers and renal tubular cells. The pancreas showed hyperplasia and hypertrophy of the islets. The spleen showed severe congestion and a moderate extramedullary hemopoiesis but no deposits of hemosiderin. This patient had three siblings died in neonatal period, one of which had clinical features of neonatal hemochromatosis. PMID- 1777133 TI - A case of Creutzfeldt-Jakob disease. AB - Creutzfeldt-Jakob disease (CJD) is presumably caused by a slow infectious pathogen or prion. The principal clinical features of Creutzfeldt-Jakob disease are dementia, pyramidal and extrapyramidal symptoms and signs, cerebellar dysfunction, and myoclonus. The patient rapidly deteriorates, declines to a vegetative state, becomes comatous, and is ultimately dead within several months. The authors present a case of Creutzfeldt-Jakob disease, proved by clinical findings, typical serial EEG, and pathologic features. PMID- 1777134 TI - Human fibroblasts in idiopathic retroperitoneal fibrosis express HLA-DR antigens. AB - Idiopathic retroperitoneal fibrosis (IRF) is a rare human disease characterized by non-neoplastic fibroblastic proliferation associated with chronic inflammatory cells; its pathogenesis is obscure. We undertook an immunohistochemical study for the expression of HLA-DR antigens and other immune-related markers by retroperitoneal proliferating fibroblasts and inflammatory cells from 2 IRF patients. Patterns of immunoreactivity were compared with those expressed by human nodular fasciitis (NF) and granulation tissue. In IRF, most fibroblasts immunostained strongly for HLA-DR antigens, whereas fibroblasts in NF and granulation tissue did, not immunostain at all. The fibroblasts did not immunostain for interleukin 2 receptor, C3b receptor, CD-4, CD-8, or Leu-M1 in any of the tissue studied. Most macrophages and lymphocytes in IRF and NF immunostained Strangly for HLA-DR antigens. In IRF, the CD-4 and CD-8 immunostained T-lymphocytes appeared equally distributed. The expression of HLA DR antigens by fibroblasts in IRF indicates that this rare disease may indeed be an immune-associated hypersensitivity disorder. PMID- 1777135 TI - Pedunculated leiomyoma of scrotum. AB - Leiomyoma may originate at any anatomic location of smooth muscle in the genitourinary system. The kidney capsule is the most common site for the genitourinary leiomyomas. Leiomyoma origination from the scrotum is rare. The previous reported cases presented as small, firm, nontender, slowly enlarging freely movable masses within the scrotum. We report a case of leiomyoma of the tunica dartos, a benign lesion arising from the wall of the left scrotum. It presented as a pedunculated lesion with a surface ulceration, which need to be differentiated from squamous carcinoma of the scrotum. It was treated with a simple surgical excision. PMID- 1777136 TI - Reporting structural equation modeling results in Psychology and Aging: some proposed guidelines. AB - Structural equation modeling (SEM) is now widely used in social and behavioral science research. SEM provides the possibility of fitting, and evaluating the fit, of well-specified, theoretical models to empirical data--more generally, of testing elaborated psychological theories. The options available to users of these approaches are many and varied. Popular SEM computational software packages, such as LISREL and EQS, provide a large amount of information, and there is some uncertainty as to what should be routinely reported. A series of guidelines are proposed for reporting SEM results in articles submitted to Psychology and Aging. The suggested guidelines ask authors using SEM methodology to provide important analysis information that will enable readers to evaluate the findings. PMID- 1777137 TI - Depression and cognitive change among institutionalized aged. AB - Interrelations between depression (Geriatric Depression Scale) and cognitive impairment (Blessed test) were examined among 201 nursing home and congregate apartment residents in a 2-year, 3-wave study. In structural equations models that controlled autocorrelations and within-occasion correlated residuals, introducing paths from depression to subsequent cognitive status significantly reduced unexplained variance, whereas paths from cognitive status to subsequent depression did not. Subsidiary analyses indicated that the relation of depression to subsequent cognitive status was strongest among persons with borderline (vs. impaired or intact) cognitive status, but only for the first time interval. Discussion addresses explanations for obtained results and implications for monitoring and treating depression among elderly long-term care residents. PMID- 1777138 TI - General cognitive slowing in the nonlexical domain: an experimental validation. AB - Older and younger adults were tested on 4 nonlexical tasks: choice reaction time, letter classification, mental rotation, and abstract matching. A positively accelerated relation was observed between older and younger adults' latencies. Consistent with general slowing, the relation observed with the same subjects in each condition was more than 3 times as precise as in a comparable meta-analysis. Further analyses compared the ability of various models to describe the present data and also to predict the data on the basis of parameters estimated from a previous meta-analysis. Compared with linear models, the information-loss and overhead models provided more accurate accounts of general cognitive slowing in the nonlexical domain. PMID- 1777139 TI - Lexical but not semantic priming in Alzheimer's disease. AB - The hypothesis that patients with Alzheimer's disease (AD) have a disturbance in semantic processing was tested using a new lexical-priming task, threshold oral reading. Healthy elderly controls showed significant effects of priming for word pairs that are associatively related (words that reliably co-occur in word association tests) and for word pairs that are semantically related (high frequency exemplars that belong to the same superordinate category but are not high-frequency associates). AD patients showed effects of priming for associatively related words but not for word pairs that are related only by shared semantic features. These results are consistent with the hypothesis that semantic processing is impaired in AD and suggest that independent networks of relationships among words and among concepts in semantic memory may be differentially disrupted with various forms of brain damage. PMID- 1777140 TI - Nuisance parameters in the assessment of noncognitive manifestations of dementia. AB - Measures of noncognitive disturbances in dementia typically rely on ratings by informants. In this study, method variance in measures of affect, behavior, and functional competence was evaluated by comparing ratings from 2 types of informants (spouse vs. child) in patients with probable Alzheimer's disease. No differences were observed on 5 variables; for 2 measures of behavior disturbance and 1 measure of functional disability, ratings obtained from child informants were significantly higher than spouse ratings for patients at comparable levels of dementia severity. Although the effect of the rater dimension was relatively small and selective, the findings suggest the need for further research on potential sources of bias in the ratings of noncognitive features of the dementia syndrome. PMID- 1777141 TI - Age and reading: the impact of distraction. AB - Older and younger adults read aloud and answered questions about texts that did or did not have distracting material interspersed amid target text. When present, distracting material occurred in a different type font from that of target material. Across 2 experiments, distracting material was meaningless, meaningful but unrelated to the text, or meaningful and text related. Subjects were instructed to attend only to the target text. Reading time measures indicated that compared with younger adults, older adults have a more difficult time ignoring the distracting information, particularly information meaningfully related to target text. Verbal ability differences among older, but not younger, adults moderated distraction effects. Age differences in inhibitory attentional mechanisms were considered as processes influencing distraction effects. PMID- 1777142 TI - Are age differences in consistent-mapping visual search due to feature learning or attention training? AB - In this experiment, the ability of young and old adults to differentially modify the attention-attraction strength of targets and distractors relative to feature differentiation was examined. Eight young and 8 old subjects were trained for 8,000 trials in conditions that allowed maximal target-distractor strength differentiation, inhibited target-distractor strength differentiation but facilitated feature differentiation, or inhibited both target-distractor strength differentiation and feature differentiation. Age-related performance was assessed between and within conditions during training and with reversal conditions where the roles of targets and distractors were switched. The pattern of data during training and at reversal supports the proposal that age differences in extended practice visual search are due to differences in the ability to differentially strengthen targets and distractors. PMID- 1777143 TI - Age-associated memory impairment diagnoses: problems of reliability and concerns for terminology. AB - Objective memory criteria for diagnosing age-associated memory impairment (AAMI), age-consistent memory impairment, and late-life forgetfulness (LLF) were applied to 523 cognitively normal older persons divided into 2 groups on the basis of the clinical memory assessment battery they received. Seventy-seven percent of Group 2 and 98% of Group 1 met the Crook et al. (1986) cognitive criteria for AAMI on at least 1 test. Rates based on individual tests varied from 7% to 96%. Objective cognitive criteria for LLF were met by no members of Group 1 but by 31% of Group 2. Results suggest that, as proposed, the criteria for age-related diagnoses lack reliability. Concerns regarding the diagnosis of normal memory in older populations are considered. PMID- 1777144 TI - The relation between source memory and aging. AB - Previous research has shown that elderly adults have difficulty recalling the source of recently acquired facts but does not indicate whether source memory is more impaired than fact memory. This study examined old and young subjects' memory for novel facts that had been read to them by 1 of 2 experimental sources either in a random order or in a blocked order. When fact memory was equated in young and old at different levels of performance, the elderly exhibited disproportionate source memory deficits in the blocked condition but not in the random condition. Results suggest that the relation between fact and source memory in the elderly varies across experimental conditions. PMID- 1777145 TI - A 2-year longitudinal study of depression among Alzheimer's caregivers. AB - Results from a 2-year (4 waves) longitudinal study show strong evidence for patient decline and high levels of depressive symptomatology among caregivers. Female caregivers reported high, stable rates of depressive symptomatology throughout the study, whereas male caregivers exhibited significant increases in depression over time. Cross-sectional multivariate analyses revealed significant positive relationships between depression and number of patient problem behaviors, negative social support, and concern about financial resources; negative relationships were found between depression and social support, quality of prior relationship, and satisfaction with social contacts. Three significant independent predictors of change in depression were found: Lower depression scores at Time 1 were related to increases in depression over time; men were more likely than women to experience increases; and a decline in social support resulted in increased depression. PMID- 1777146 TI - Gender differences in affiliation and instrumentality across adulthood. AB - This secondary data analysis tests the hypothesis that gender differences decline across adulthood. Six measures tapping 3 dimensions of affiliation and instrumentality were selected from the cross-sectional sample surveys of The Quality of American Life (1971) and Americans View Their Mental Health (1976). In both studies, approximately 2,200 adults who had been selected from probability samples of households in the continental United States were interviewed. For each measure, the variance explained by age, sex, and Age x Sex interaction terms was compared with the variance explained by age and sex alone. The addition of the interaction terms does not significantly increase the R2 for any of the measures, arguing against a late-life convergence of men's and women's orientations. Although the release from active parenting has been proposed as a basis for declining gender differentiation, limiting the analyses to respondents with children does not change this conclusion. PMID- 1777147 TI - Aging and suppression: memory for previously relevant information. AB - In the 1st part of the experiment, older and younger adults read a series of high cloze sentence frames, each missing its final word (e.g., "She ladled the soup into her____."). Subjects were instructed to predict the ending for each. For critical sentences, the predicted final word (bowl) was not shown. Instead, an unexpected but acceptable ending (lap) was provided as the target. On a subsequent indirect memory test in which subjects generated endings to medium cloze sentences, older adults showed reliable retention of both the disconfirmed (bowl) and target (lap) endings. Younger adults showed retention of only the targets. Results are consistent with the Hasher and Zacks (1988) view that the impaired inhibitory mechanisms of older adults impede the abandonment of no longer-relevant thoughts. PMID- 1777148 TI - Age-related increases in the effects of automatic semantic activation. AB - Automatic semantic activation was assessed in a version of the flanker task, in which nominally irrelevant words were presented above and below a target word. The category membership of the flanking word was consistent, inconsistent, or neutral with respect to the target word. Older adults showed greater inhibition and equivalent facilitation in the time taken to classify the target words than did younger adults in 2 of 3 experiments, in contrast to previous findings. The present results are generally consistent with 3 dominant perspectives in cognitive aging: the complexity hypothesis, environmental support, and the inhibition-deficit view. Manipulation of the overall magnitude of the flanker effect produced results most consistent with the inhibition-deficit view that older adults are less able to inhibit automatic processes than are younger adults. Some problems with the inhibition-deficit view are also discussed. PMID- 1777149 TI - Effects of aging on priming and skill learning. AB - This study examined the effects of aging on 2 kinds of implicit memory; repetition priming and skill learning. In Experiment 1, older adults showed less improvement in the skill of reading inverted words than did young adults, but priming performance did not differ for the 2 age groups. Similarly, in Experiment 2, in a partial-word identification task, skill learning was observed only for young adults, whereas there was no age difference in priming. Experiments 1a and 2a, however, showed that when older adults were presented with more perceptual information than were young adults, the age deficit in skill learning was eliminated. These results indicate that skill learning is impaired under data limited conditions, whereas priming is unaffected under these conditions. It is proposed that the age deficit in skill learning is related to a deficit in perceptual organization and reorganization. PMID- 1777150 TI - The age context of performance-evaluation decisions. AB - Organizational demography contends that demographic characteristics of individuals, examined at individual, dyadic, group, and organizational levels of analysis, exert significant effects on organizational processes. The purpose of this article was to test the contextual effects created by the interaction of work-group age composition and supervisor age on supervisor evaluations of subordinate performance. Two competing models of age demography were tested. The similarity model predicts that supervisors similar in age to the work group they supervise will issue generally higher performance ratings. The dissimilarity model, developed in this article, predicts the opposite. Support was indicated for the dissimilarity model. Implications of the results are discussed. PMID- 1777151 TI - Young and old faces in young and old heads: the factor of age in face recognition. AB - Research on aging and face recognition has shown age-related differences that are reflected most clearly in false-alarm errors. Elderly subjects exceed young adults in false recognitions that new faces are "old." To determine if this difference between young and elderly subjects might differ for young versus elderly faces, an experiment was conducted in which half of the young and elderly subjects studied and recognized young and middle-aged faces, and the remainder studied and recognized middle-aged and elderly faces. Replicating prior research, age-related deficits in recognition accuracy (d') were reduced with older faces, and this effect generalized from measures of face recognition to measures of face picture recognition. However, the age-related increase in false recognitions of faces was not affected by face age. PMID- 1777152 TI - Adjustment of caregivers to depressed older adults. AB - In this research, older adults (N = 150) hospitalized for major depression and their wife, husband, daughter, or son caregivers were interviewed. The primary purpose of the research was to evaluate the ability of caregiver background characteristics, patient illness characteristics, caregiver coping, and strategies for managing the patient at home to predict caregiver adjustment. Among the caregiver characteristics, being in functional health, being male, and being a spouse caregiver were associated with better adjustment. Husbands evidenced the best adaptation to caregiving and daughters the poorest. Patient illness characteristics were not related to caregiver adjustment. Coping with caregiving stresses by using tension reduction and deliberate effort behaviors and managing the patient with criticism and guidance were related to poorer caregiver adjustment. PMID- 1777153 TI - Genetic mediation of the relationship between social support and psychological well-being. AB - This study assessed genetic and environmental influences on the association between social support and psychological functioning using the combined adoption/twin design from the Swedish Adoption/Twin Study of Aging. A subsample of 424 twin pairs, 50 years and older, was used: 64 pairs of identical twins reared apart, 95 pairs of identical twins reared together, 132 pairs of fraternal twins reared apart, and 133 pairs of fraternal twins reared together. Multivariate model-fitting analyses indicated that the relationship between the perceived adequacy of social support and psychological well-being (depression and life satisfaction) was mediated in part by genetic factors. PMID- 1777154 TI - Automatic semantic priming with various category relations in Alzheimer's disease and normal aging. AB - The 6 experiments reported here tested the effects of various category relations on automatic semantic priming in 20 Alzheimer's disease (AD), 20 older control, and 22 younger control subjects. The tasks were either word pronunciation or lexical decision; the prime-target stimulus-onset asynchrony (SOA) was always 250 ms. A variety of category relationships between prime and target were examined: highly associated category comembers, subordinate-superordinate or superordinate subordinate pairs, and pairs selected on the basis of category typically to form typical-typical, atypical-typical, typical-atypical, and atypical-atypical pairings. Both for AD versus older control subjects and for older versus younger control subjects, no significant group differences were found in the magnitude of overall semantic priming or in the effects on priming of factors pertaining to the prime-target relationship. PMID- 1777155 TI - Effects of short-term retrieval on adult age differences in long-term recall of actions. AB - In Experiment 1 young and elderly subjects either recalled or repeated after every block of 4 actions, whereas control subjects received neither interpolated short-term recall nor action repetition. On a later long-term memory test, experimental subjects, regardless of age or condition, recalled slightly more actions than control subjects. In Experiment 2 young adult and elderly subjects received 12 short-term memory trials in which 2 actions were performed on each trial, but only 1 was cued for recall after a brief retention interval filled with a distracting activity. On a later long-term memory test for the actions performed on the short-term trials, both young and elderly subjects recalled significantly more previously cued than noncued actions. The Age X Cuing Condition interaction was negligible. Prior retrieval of actions appears to enhance later recall regardless of age but seemingly only when prior retrieval requires considerable cognitive effort (as in Experiment 2). PMID- 1777156 TI - Four pathways in the analysis of adult development and aging: comparing analyses of reasoning about personal-life dilemmas. AB - Four systems for analyzing thinking about 2 personal-life dilemmas, as discussed by 29 men and 35 women (ages 35-85), were compared. Kohlberg's (1976) moral judgment stages, Kegan's (1982) ego-development stages, Gilligan's (1982) moral orientation system, and Suedfeld and Tetlock's (1977) integrative complexity scoring were used. Subjects completed Kohlberg's (Colby & Kohlberg, 1987) standard moral judgment measure, a self-concept description, and several questionnaires. The Kohlberg, Kegan, and integrative complexity codings of the dilemmas were positively related to each other and to the standard Kohlberg moral stage scores. There were no age-group differences and few gender differences on the measures. However, education, role-taking skills, and greater sensitivity to age changes in the self positively predicted higher stage scores across maturity. PMID- 1777157 TI - Role of ring oxidation in the metabolic activation of 1-nitropyrene. AB - Nitrated polycyclic aromatic hydrocarbons are wide-spread environmental pollutants that have been detected in photocopier toners, airborne particulates, coal fly ash, and diesel engine exhaust emissions. 1-Nitropyrene, a representative nitropolycyclic aromatic hydrocarbon present in diesel particulates, is a mutagen in Salmonella typhimurium and a tumorigen in laboratory animals. The activation of 1-nitropyrene to a bacterial mutagen has been attributed to nitroreduction; however, the metabolic pathways involved in its metabolism to a tumorigen are not known, but may involve nitroreduction, ring oxidation, or a combination of the two. In these experiments, we examined the importance of ring oxidation in the activation of 1-nitropyrene (99.85 to 99.98 percent 1-nitropyrene, 0.15 to 0.02 percent 1,3-, 1,6-, and 1,8-dinitropyrene by mass spectral analyses) to a mammalian-cell mutagen and carcinogen. Chinese hamster ovary cells were used to assess the mutagenicity of ring-oxidized 1 nitropyrene metabolites. In the absence of a rat liver 9,000 x g supernatant, 6 hydroxy-1-nitropyrene, 1-nitropyrene-9,10-oxide, and pyrene-4,5-oxide were the most mutagenic compounds tested. 3-Hydroxy-1-nitropyrene, 8-hydroxy-1 nitropyrene, and 1-nitropyrene-4,5-oxide were weaker mutagens, whereas pyrene and 1-nitropyrene were essentially nonmutagenic. The order of mutagenic potency with S9 was: 1-nitropyrene-4,5-oxide greater than 6-hydroxy-1-nitropyrene approximately 1-nitropyrene-9,10-oxide greater than 1-nitropyrene approximately 3 hydroxy-1-nitropyrene approximately 8-hydroxy-1-nitropyrene greater than pyrene approximately pyrene-4,5-oxide, with the last two compounds being nearly nonmutagenic. The epoxide hydrase inhibitor 1,2-epoxy-3,3,3-trichloropropane increased the mutation frequency fivefold. In addition, guinea pig liver microsomes and Aroclor-induced rat liver microsomes, which increased the formation of 1-nitropyrene-4,5-oxide and 1-nitropyrene-9,10-oxide, increased the mutagenic response. Incubation of 1-nitropyrene-4,5-oxide with calf thymus DNA resulted in the formation of three DNA adducts. A similar adduct pattern was observed when Chinese hamster ovary cells were incubated with the oxide. Inclusion of a nitroreductase, xanthine oxidase, in the in vitro incubations resulted in the formation of an additional adduct identified as N-(deoxyguanosin 8-yl)-1-aminopyrene. This adduct was not observed in Chinese hamster ovary cells treated with 1-nitropyrene-4,5-oxide. 1-Nitropyrene-9,10-oxide reacted with calf thymus DNA to give an adduct pattern similar to that observed with 1-nitropyrene 4,5-oxide. The distribution of adducts was not affected by conducting the reactions in the presence of xanthine oxidase.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1777158 TI - Genetic variability affects the detection of HIV by polymerase chain reaction. AB - Nine isolates of HIV-1 obtained from Congolese AIDS patients were amplified by the polymerase chain reaction (PCR) using primer pairs and oligomer probes derived from the HIV-1 LAV-BRU (BRU) sequence. When compared to BRU, two isolates exhibited a significant decrease of PCR efficiency with a given primer pair. Moreover, the DNA amplified from two other isolates did not hybridize with the corresponding probe despite efficient PCR. Base substitutions were detected in the regions of proviral genomes involved in oligonucleotide annealing and were assumed to be responsible for the failure of both amplification and probing. Our data confirm that the genetic variability of HIV-1 may reduce the efficiency of PCR as a diagnostic procedure, especially in the case of African isolates. PMID- 1777159 TI - Oligomeric nature of transmembrane glycoproteins of HIV-2: procedures for their efficient dissociation and preparation of Western blots for diagnosis. AB - Western blot (WB) analysis of various strains of HIV-2 indicated that transmembrane glycoprotein (TMP) of HIV-2 exists as trimers. These trimers have molecular weights and electrophoretic mobilities in the region of the major external glycoprotein, gp120, resulting in WB misidentification during diagnosis. A simple and rapid procedure was developed using trichloroacetic acid (TCA) to efficiently dissociate oligomeric forms of the TMP to monomers prior to the preparation of WB. This procedure permitted the unambiguous identification of antibodies to gp120 and to the TMP. Use of HIV-2 WB strips without any oligomeric forms of the TMP demonstrated (1) that cross reactivity of HIV-1-positive specimens on HIV-2 WB was mainly directed to Gag and Pol proteins, with some reactivity to gp36/gp41 TMP, but none to gp120; (2) that these strips can substantially reduce the number of specimens falsely identified as dually (HIV-1 and HIV-2) reactive; and (3) that HIV-2-positive specimens reacted to viral gp120 in a strain-specific manner, demonstrating high antigenic variation in this glycoprotein. It is recommended that this general procedure of viral protein dissociation be used for HIV-2 WB preparation. PMID- 1777160 TI - Comparative humoral responses to HIV-1 p24gag and gp120env in subjects from East Africa and the UK. AB - We compared 1616 sera from HIV-1-infected subjects and matched HIV-negative local controls in Uganda, Kenya and the UK. Sera were screened for specific antibody to HIV-1 p24 Gag and gp120 Env proteins and for p24 antigenaemia. In contrast to the UK, the majority of African HIV-1-infected subjects maintained detectable anti p24 antibodies. However, lower reactivity of anti-p24 was observed in African AIDS patients, compared with those with asymptomatic HIV-1 infection. This reduction in anti-p24 reactivity with more advanced clinical stage was less marked in African HIV-1 infection than in the UK. Correspondingly, p24 antigenaemia was more common in patients with AIDS from the UK than in African patients (65 versus 4%). Reductions in anti-gp120 reactivity were observed in African AIDS patients, compared with the asymptomatic group. However, median reactivity of anti-gp120 in UK patients remained unchanged in both asymptomatic and AIDS subjects. The differences in humoral response to p24 and gp120 between Africa and the UK are semi-quantitative rather than qualitative and could be explained by initial higher antibody response to HIV-1 in African subjects. PMID- 1777161 TI - Beta 2-microglobulin levels in drug users: the influence of risk behaviour. AB - beta 2-microglobulin (beta 2M) levels were measured in 217 Edinburgh drug users to assess their usefulness as a marker for HIV-related disease. Eighty HIV seronegative drug injectors had significantly higher levels than 100 HIV seronegative blood-donor controls. Amongst 137 asymptomatic HIV-seropositive drug users, those who were defined as continued drug users had significantly higher beta 2M levels and percentages of CD3+ T lymphocytes with DR Class II expression than non-injecting drug users. beta 2M levels correlated with the percentage of activated DR+ CD3+ T lymphocytes. These findings indicate that changes in beta 2M levels may reflect differences in drug-injecting behaviour and are not influenced solely by HIV status or progression. These changes in beta 2M probably represent differing degrees of immunostimulation resulting from the antigenic challenges afforded by continued or frequent drug injection. It is important to establish normal ranges for beta 2M from HIV-seronegative controls who are matched with respect to risk group and behaviour. All these factors should be taken into account if beta 2M is to be used as a marker of HIV progression. PMID- 1777162 TI - Bloody needles: the volumes of blood transferred in simulations of needlestick injuries and shared use of syringes for injection of intravenous drugs. AB - Residual HIV-infected blood in needles and syringes is a source of HIV infection. Using radiolabelled blood we have stimulated needlestick injuries and sharing of syringes by intravenous drug users and quantified the volumes of blood which could be transferred to recipients in these situations. Up to 0.75 microliters of blood was transferred in needlestick simulations, but there was a large variation. In simulations of needlesharing, seven to ten times more blood was transferred from the index user to the first sharer when 2 ml syringes were used compared with 1 ml syringes. Washing with water was not effective in removing 'infected' blood from a syringe. PMID- 1777163 TI - Trimethoprim-sulfamethoxazole reaction simulating Pneumocystis carinii pneumonia. PMID- 1777164 TI - Soluble CD4 enhances antiviral activity of anti-HIV serum in vitro. PMID- 1777165 TI - Shigella in HIV infection. PMID- 1777166 TI - Immunoglobulins and beta 2-microglobulin in HIV-1-infected children in rural Zaire. PMID- 1777167 TI - Oesophageal candidiasis in people with primary HIV infection. PMID- 1777168 TI - Pokeweed mitogen-stimulated peripheral blood mononuclear cells from at-risk seronegative subjects produce in vitro HIV-1-specific antibodies. PMID- 1777169 TI - Outcome of untreated Mycobacterium avium-intracellulare complex infection in AIDS. PMID- 1777170 TI - Mycobacterium bovis and AIDS. PMID- 1777171 TI - Progressive multifocal leukoencephalopathy in AIDS. PMID- 1777172 TI - Hemolytic uremic syndrome associated with HIV infection. PMID- 1777173 TI - Transmission of Pneumocystis carinii from AIDS patients to other immunosuppressed patients: a cluster of Pneumocystis carinii pneumonia in renal transplant recipients. AB - Five renal transplant recipients developed Pneumocystis carinii pneumonia (PCP) over a 22-month period, while no cases had been observed over a 5-year period in 114 transplanted patients treated with the same immunosuppressive protocol. All patients were HIV-negative, and no modification in diagnostic techniques for P. carinii could account for this observation. All five patients developed PCP within 2 months of an acute graft rejection episode. All of them attended the same outpatient facility as AIDS patients attending the hospital, where they shared the waiting and treatment rooms. Comparison of cases with matched controls was possible in three instances and revealed that the cases had had more outpatient clinic encounters with AIDS patients who had presented, or subsequently developed, PCP. This observation suggests that AIDS patients developing PCP may transmit the infection to other immunosuppressed patients. PMID- 1777174 TI - The efficacy and safety of zidovudine with or without acyclovir in the treatment of patients with AIDS-related complex. The European-Australian Collaborative Group. AB - Our objective was to evaluate the efficacy and safety of zidovudine (250 mg every 6 h) alone or in combination with acyclovir (800 mg every 6 h) as treatment for AIDS-related complex (ARC). A double-blind, controlled clinical trial of 6 months therapy was conducted at teaching hospital ambulatory clinics in eight European countries and Australia; 199 patients were studied. Time to development of AIDS defining opportunistic infections (OI) and AIDS-associated neoplasms, survival, performance status, body weight and CD4+ cell counts were measured. During the study six (9%) zidovudine recipients, five (7%) combination recipients and 12 (18%) placebo recipients developed AIDS-defining OI; the probability of developing an OI was 0.23, 0.09 and 0.08 for the placebo, zidovudine and combination recipients, respectively. Four patients in the placebo group, three in the zidovudine group and one in the combination group died during the study. Patients receiving zidovudine with or without acyclovir had moderate increases in CD4+ cell counts compared with placebo recipients and serum HIV p24 antigen level decreased significantly in all those receiving zidovudine. Fourteen (21%) patients in the zidovudine group and 16 (24%) in the combination group experienced bone-marrow suppression compared with three (5%) placebo recipients. Red-cell transfusions were administered to 6, 19 and 13% of placebo, zidovudine and combination recipients, respectively. These data confirm the efficacy of zidovudine therapy after 4 weeks' treatment in the reduction of development of OI in patients with ARC and support the use of a maintenance dose of 250 mg zidovudine 6-hourly. Given the increased development of OI in the treated groups compared with placebo during the first 4 weeks of therapy, we cannot exclude an initial adverse effect of zidovudine and recommend caution in the use of a loading dose of zidovudine. At 6 months there was no apparent difference in efficacy between the combination of zidovudine and acyclovir compared with zidovudine alone. Moreover, the addition of high-dose acyclovir resulted in a minimal increase in the risk of toxicity. PMID- 1777175 TI - A recombinant HIV provirus is synergistically activated by the HIV Tat protein and the HSV IE1 protein but not by the HSV IE3 protein. AB - To study the effects of regulatory proteins encoded by herpes viruses on the HIV long terminal repeat (LTR) in the presence or absence of HIV-encoded regulatory products, we prepared a proviral construct containing 5' and 3' HIV LTR, but lacking the coding sequences of any HIV proteins. This construct allowed the effects of herpesvirus regulatory proteins on the HIV LTR to be assessed in a construct similar to the HIV provirus whilst also allowing their interactions with HIV-encoded regulatory proteins to be studied. In this system, the herpes simplex virus (HSV) protein IE1 (ICPO) but not the IE3 (ICP4) protein can activate the HIV LTR, whereas both proteins are active on a single plasmid-borne HIV LTR. Although the activation of the LTR by IE1 is strongly stimulated by the HIV Tat protein, it can also be observed in the absence of Tat, indicating that HSV infection via IE1 has the potential to activate an entirely silent, latent HIV provirus. PMID- 1777176 TI - Characterization of N-myristoyl transferase inhibitors and their effect on HIV release. AB - Acylation of virus proteins is an important covalent modification which has been shown, in many cases, to be necessary for their normal function. Furthermore, it has been shown that cerulenin, an inhibitor of this process, inhibits formation of vesicular stomatitis virus and Rous sarcoma virus in infected cultures, as well as acylation of HIV proteins. However, in agreement with earlier reports, we found that the acylating enzyme, N-myristoyl transferase, was unaffected by cerulenin which did, however, inhibit protein synthesis, thereby making interpretation of its effects difficult. Analogues of myristic acid were found to inhibit acylation in intact cells without toxic effects on protein synthesis or mitochondrial function. Myristic acid analogues were also shown by an in vitro assay to act directly on the acylating activity (N-myristoyl transferase). Furthermore, myristic acid analogues were found to inhibit HIV release from HIV infected cells and glucosamine, which has recently been shown to be a non competitive inhibitor of N-myristoyl-transferase, also inhibited HIV release. PMID- 1777177 TI - Latent Haemophilus influenzae pneumonia in patients infected with HIV. AB - Pneumonia caused by common pyogenic bacteria occurs frequently in HIV-infected patients. Its clinical presentation has been described as being similar to that seen in non-immunosuppressed hosts but clearly different to that of opportunistic pneumonias. An atypical presentation has rarely been seen. In a 10-month period, we saw 12 HIV-infected patients who presented with Haemophilus influenzae pneumonia which was clinically and radiologically indistinguishable from Pneumocystis carinii pneumonia. Ten of the patients were intravenous drug users and were in different stages of HIV disease. The clinical picture was characterized by a prolonged course (median 4 weeks), non-productive cough, dyspnoea, and absence of findings usually present in bacterial pneumonia. Laboratory data frequently showed absence of leukocytosis, increased lactate dehydrogenase levels, hypoxaemia, and decreased CD4+ cell counts. All presented with interstitial or mixed bilateral infiltrates. Resistance to ampicillin and trimethoprim-sulphamethoxazole were each found in seven cases. Eleven patients were cured with antibiotic therapy, although five relapsed. H. influenzae pneumonia should be considered in HIV-infected patients who present with pulmonary symptoms and bilateral infiltrates of subacute or chronic onset. Clinical resolution of pneumonia is the usual outcome, but recurrences of infection are frequent. PMID- 1777179 TI - The role of captopril scintigraphy in the diagnosis and management of renovascular hypertension: a consensus conference. Cleveland, Ohio, November 28 29, 1990. PMID- 1777178 TI - Knowledge, attitudes, and perceived risk of AIDS among urban Rwandan women: relationship to HIV infection and behavior change. AB - We examined factors associated with perceived risk of AIDS, behavior change, and HIV infection in a representative sample of 1458 child-bearing urban women in Rwanda, central Africa. Although 68% of women reported only one lifetime partner, and the majority (87%) lived with a husband or steady partner, the prevalence of HIV antibodies was still high (32%). Before receiving their HIV test results, the women completed a questionnaire about AIDS knowledge, attitudes, and practices. Knowledge about HIV transmission was high, with 96-98% of women correctly identifying the three primary routes of infection. However, only 16% of women reported taking any action to avoid AIDS in the previous year, and most (11%) had done so merely by asking their male partners to change their behavior. Only 7% of women had ever tried condoms, and many (68%) thought they could be dangerous to use. Women who perceived themselves at risk of AIDS (57%) were more likely to report changing behavior; they were also more likely to be infected with HIV. Other factors associated with behavior change included having known someone with AIDS, having discussed AIDS with a male partner, and believing that condoms are not dangerous. Future interventions should enhance perception of risk, encourage male sexual partners to reduce risky behavior, and increase familiarity with condoms. PMID- 1777180 TI - The diagnosis of renovascular hypertension. A clinician's viewpoint. AB - The sensitivity and specificity of screening and diagnostic studies for renovascular hypertension has been the focus of debate and disappointment for many years. The use of these studies has been further restricted by the insistence of clinicians that studies provide visual identification of the anatomy of the renal vasculature. Digital subtraction angiography continues to provide an increasingly attractive alternative offering visualization of the renal arteries. Reevaluation of screening and diagnostic studies is needed to determine their potential value, particularly in patients with atherosclerotic renovascular disease and renal insufficiency and in assessing the potential salvability of the ischemic kidney. PMID- 1777181 TI - Renal physiology of renal artery stenosis. Implications for captopril-stimulated renography. AB - Captopril-stimulated renography is emerging as a useful diagnostic tool for the evaluation of the hypertensive patient suspected of having renovascular hypertension (RVHT). This overview focuses upon the alterations in renal hemodynamics and function induced by renal artery stenosis (RAS) and reviews the effects of angiotensin-converting enzyme (ACE) inhibition upon blood pressure and kidney function in the various experimental models of RVHT. Understanding the effects of ACE inhibition upon the kidney distal to a stenosis and appreciating the potential effect of sodium balance or antihypertensive medications are crucial in anticipating the putative changes in the radionuclide studies of the renovascular bed following ACE inhibition. PMID- 1777182 TI - Captopril renography. Considerations in the selection of radiopharmaceuticals, provocative agents, and hypertensive subjects. AB - Captopril renography is an excellent technique for investigating renovascular hypertension and other renal disturbances. However, many variables affect the usefulness of renographic data. The choices of radiopharmaceutical, converting enzyme inhibitor, and the type of imaging done must be made with care. Additionally, the method for selecting a study population must be carefully examined. Incorrect choices can render a study's data valueless. In this paper we delineate the questions that need to be considered before undertaking a renographic study. PMID- 1777183 TI - European Captopril Radionuclide Test Multicenter Study. Preliminary results. Inspective renographic analysis. The European Captopril Radionuclide Test Multicenter Study Group. AB - Captopril radionuclide test (CRT) has been introduced in clinical practice as a screening test for renovascular hypertension, since it allows the detection of the decrease of glomerular filtration rate that may be induced by angiotensin converting enzyme inhibition (25 mg oral captopril) in kidneys ipsilateral to a renal artery stenosis. However, due to the low prevalence of the disease, experiences in single centers may hardly satisfy the need for representative series of patients to validate the test. Nineteen centers participated in a collaborative study (CRT European Multicenter Study) that collected data from 424 patients. Here we report on the first results obtained by inspective renographic analysis. The captopril radionuclide test greatly potentiated the diagnostic performance of conventional renography and the accuracy was maximal when relying simply on postcaptopril findings alone. Specificity was 84.1% in the overall population and 91.8% in uncomplicated patients without nephropathy and renal insufficiency. Taking into account the sole arteriographic diagnosis, sensitivity was 73.2% or 90.7% for the subjects with unilateral or bilateral stenosis and an angiographic degree of stenosis greater than or equal to 70%. On the other hand, when a successful outcome of blood pressure after revascularization or nephrectomy was considered as the gold standard for the diagnosis of renovascular hypertension, a high sensitivity was obtained (92.7%). Moreover, the test became negative after intervention in the great majority (88%) of patients who had a positive preintervention CRT and a normalization of blood pressure after revascularization.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777184 TI - Captopril renography in the diagnosis of renovascular disease. AB - Several investigators have reported methods for the use of renal scintigraphy in the diagnosis of renal artery stenosis. We report the experience of Duke University Medical Center, and offer some suggestions for standardizing and optimizing the use of this potential screening tool. We evaluated 140 clinically selected hypertensive adults with postcaptopril renal scintigraphy (renography), pre- and postcaptopril peripheral renin activity, and conventional renal arteriography. Postcaptopril renography (using 99mTc diethylenetriaminepentaacetic acid (DTPA) to measure glomerular filtration and [131I]iodohippurate to measure renal plasma flow) was considered abnormal if one kidney contributed 47% or less of total activity. Postcaptopril renin was considered elevated if it was at least 4 ng/mL/h. Renovascular disease was defined as 50% or greater main renal artery stenosis. Of 140 subjects, 31 (22%) had significant renovascular disease. Captopril-stimulated DTPA renography suggested asymmetric function in 24 (74%) of these, but was also abnormal in 61 of 109 (56%) with normal renal arteries. Captopril-stimulated hippuran renography performed in a similar manner. Captopril-stimulated renin activity was elevated in only 58% of subjects with renal artery stenosis, and had a false positive rate of 24%. These data differ from reports from other centers, perhaps due to differences in renography methods, criteria for interpretation of renography, and/or patient selection criteria. PMID- 1777186 TI - The use of captopril-DTPA scanning in the diagnosis of atherosclerotic renal artery stenosis in patients with impaired renal function. AB - We have analyzed our use of captopril-diethylene-triaminepentaacetic acid (DTPA) scanning in patients presenting to the Royal Free Hospital predominantly with renal impairment. The sensitivity was found to be as good in patients with bilateral disease or disease of a single kidney as in patients with unilateral disease. On a number of occasions, though, the scan suggested unilateral disease when bilateral disease existed. There were, however, a large number of patients for whom captopril-DTPA scanning was not performed because of severe renal impairment or the possibility of renal artery stenosis in a single functioning kidney. PMID- 1777185 TI - The Einstein/Cornell collaborative protocol to assess efficacy and methodology in captopril scintirenography. Early results in patients with essential hypertension. Report of the Einstein/Cornell Collaborative Hypertension Group. AB - We have established an ongoing prospective investigation of hypertensive patients to examine the rates of false results in captopril scintirenography. This study is being conducted at the Albert Einstein College of Medicine and the Cornell University Medical Center. Two large populations will allow an accurate assessment of both false positive and false negative results. We report here the results from the first 30 patients, results which will be useful in defining the bounds for future studies. PMID- 1777187 TI - Diagnosis of renovascular hypertension after renal transplantation. AB - Hypertension in renal transplant recipients is an important risk factor for graft function and cardiovascular morbidity and mortality. The mechanisms of posttransplant hypertension are not well understood. Most of the time, the nature of this hypertension is multifactorial. Rejection, both acute and chronic, recurrent renal disease, graft renal artery stenosis, native kidney disease and drug therapy with steroids and cyclosporin have all been implicated. Where a single cause can be identified, the therapy can be rational and often very successful. For this reason, the diagnosis of graft renal artery stenosis is important, because percutaneous transluminal angioplasty or surgery can lead to the cure of hypertension and improvement of the graft function. Noninvasive testing, using captopril renography for the diagnosis of hemodynamically significant renal artery stenosis, presently yields encouraging results. PMID- 1777188 TI - The mechanism and diagnostic value of angiotensin I converting enzyme inhibition renography. AB - The effect of angiotensin converting enzyme (ACE) inhibition on the sensitivity of radionuclide renography in the diagnosis of a unilateral renal artery stenosis was tested both in a conscious dog model and in the human situation. ACE inhibition (10 mg enalaprilic acid, intravenously) markedly improved the sensitivity of [123I]hippuran renography in 10 renovascular hypertensive dogs with a mild to moderate unilateral renal artery stenosis from 50 to 100%. This improved sensitivity was due to an ACE-inhibition-induced delayed tracer handling at the stenotic side without an appreciable change in the renographic curve at the contralateral side. A similar phenomenon was observed in 15 hypertensive patients with an angiographically proved unilateral renal artery stenosis. Both [123I]hippuran and 99mTc-diethylenetriaminepentaacetic acid (DTPA) handling was delayed on the stenotic side after oral enalapril treatment. However, only a moderate increase in sensitivity was observed comparing control renograms to ACE inhibition renograms: from 87 to 93% for hippuran, and from 60 to 86% for DTPA. Eight of these 15 patients underwent either surgery or angioplasty resulting in a successful correction of the stenosis. Hypertension was more or less cured in five patients. Each of these patients had shown an ACE-inhibition-induced change in the renogram at the stenotic side, suggesting that such a response may predict the curability of the hypertension. However, of the three patients that showed no blood pressure change upon successful revascularization, two showed a positive ACE-inhibition renogram. In conclusion, in an ideal setting as obtained in animal experiments, ACE inhibition improves the sensitivity of renographic studies to 100%. However, its value in the clinical setting needs more standardization. PMID- 1777189 TI - Report of the Working Party Group for Patient Selection and Preparation. AB - Captopril renography is a valuable test in the diagnosis of patients with renal artery stenosis. We examined the criteria for selecting patients for this procedure and the best methods for preparing the patient for renography. PMID- 1777190 TI - Report of the Working Party Group on Determining the Radionuclide of Choice. AB - There are a variety of radiopharmaceuticals that can be used to perform captopril renography effectively. We examined a number of technetium and iodine compounds and the circumstances under which each radiopharmaceutical compound is the compound of choice. Considerations of cost, ease of use, reliability, dosage, and the effects of different protocols were all examined. PMID- 1777191 TI - Diagnostic criteria of renovascular hypertension with captopril renography. A consensus statement. PMID- 1777192 TI - Noninvasive respiratory monitoring during ventilatory support. AB - Noninvasive monitoring is commonly used during ventilatory support. This monitoring includes pulse oximetry, capnography, transcutaneous monitoring, monitoring of respiratory mechanics, and indirect calorimetry. There are advantages and disadvantages to each of these forms of monitoring and the technical ability to use each of them must be balanced against clinical usefulness. PMID- 1777193 TI - The art and science of mechanical ventilator adjustments. AB - This article describes how information from mechanical ventilator settings, ABG, pulse oximetry, and capnography are useful in making therapeutic changes in mechanical ventilator settings. The nurse can use trial and error or apply scientific principles to adjust mechanical ventilator settings efficiently to correct abnormalities in ventilation or oxygenation. Consistent application of these principles improves nursing assessment and interventions as well as prevents undue pain and expense on the patient's behalf. PMID- 1777194 TI - Weaning from mechanical ventilation: old and new strategies. AB - The strategies available for weaning patients from mechanical ventilation are many: T-piece mode, SIMV, PSV, and combinations of each. T-piece trials alternating with SIMV or AC provide periods of spontaneous breathing with rest on the ventilator. Decreasing SIMV rates gradually increases the patient's independence and spontaneous breathing; however, may result in an increased work of breathing with some systems. Alternatives such as flow-by and the addition of PSV may assist in the reduction of airway resistance. PSV weaning alone or in combination with SIMV or T-piece trials reduces work of breathing, promotes respiratory muscle training, and improves patient-ventilator interaction. Schuster states "the specific weaning technique employed is often less important than the care with which it is applied." PMID- 1777195 TI - Pulmonary rehabilitation for mechanically ventilated patients. AB - Pulmonary rehabilitation for the mechanically ventilated patient is a complex process requiring the teamwork of many disciplines. The physician, pulmonary CNS, respiratory therapist, physical therapist, occupational therapist, dietician, speech pathologist, social worker, and chaplain all work together in a coordinated effort. Daily assessment of patient changes and tolerance to therapy is necessary to progress the patient to a relatively independent state. When communication among the team members is effective, few problems go unnoticed. The primary goal of pulmonary rehabilitation is to return patients to their highest functional capacity to enhance their independence and personal ego strength, whether on or off a ventilator, part or all of the time. If chronic mechanical ventilation is the reality, pulmonary rehabilitation must promote a quality lifestyle of independence and autonomy. PMID- 1777196 TI - Prolonged ventilator dependence: economic and ethical considerations. AB - Patients who receive ventilator treatment tend to be older and sicker than ever before, factors that contribute to the complexity of ventilator weaning. The provision of prolonged ventilator support entails a commitment of expensive hospital resources, yet survival is often poor. Consideration must be given to limiting ventilator treatment in instances when benefit is highly unlikely or when the burdens of treatment outweigh benefits. Decisions to withhold or withdraw mechanical ventilation must be made with full knowledge and understanding of relevant ethical principles. If ventilator support is to be terminated, this should be accomplished according to institutional protocols that take into account these ethical considerations, as well as the medical and legal facts that apply. PMID- 1777197 TI - Mechanical ventilation considerations in complex congenital heart disease. AB - It is the philosophy of our institution to provide primary surgical repair of complex congenital heart defects to avoid pulmonary and myocardial damage that occurs over time. Application of knowledge of the normal physiology and a clear understanding of the physiologic alterations of complex lesions are essential in understanding the effect of positive-pressure ventilation in complex CHD. The care and management of patients with CHD have a great deal to do with ventilatory management, which can be life-threatening when not fully understood but lifesaving when mastered. A dedicated team approach enhances communication and collaborative practice, which provides optimal patient management and outcome. PMID- 1777198 TI - Pressure-controlled inverse-ratio ventilation. AB - The routine use of PCIRV in adult critical illness remains an area of considerable controversy and debate. This stems in large part from a lack of well controlled studies demonstrating improved patient outcome over conventional mechanical ventilation techniques. Although it is unlikely that clinicians will stop using PCIRV until such data are available, nurses and other caregivers should exercise caution whenever this form of therapy is employed. PMID- 1777199 TI - Effects of mechanical ventilation on hemodynamic waveforms. AB - Interpreting hemodynamic waveforms in the critically ill patient requires an understanding of the influence of breathing on waveform values. Included in this understanding is differentiating between physiologic changes associated with breathing and artifact associated with an atmospheric (not pleural) referenced transducer system. Techniques such as airway pressure measurement can aid the clinician in the identification of specific points in the respiratory cycle. This article provided a review of the major respiratory factors influencing waveform values, both physiologic and artifactual. Application of principles outlined in this article should improve the accuracy associated with interpreting hemodynamic waveforms. PMID- 1777200 TI - Pulmonary complications from enteral nutrition. AB - Complications of enteral nutrition may compromise respiratory function by direct mechanical injury by feeding tubes, aspiration of formula, or alterations in metabolism. Although much of the data reviewed in this paper were published more than 10 years ago, these studies still comprise most of the literature on pulmonary complications of enteral nutrition. Many of the products that are described in these older studies no longer exist or are not widely used. Additional research is needed to determine whether the enteral formulas and delivery devices that have recently been developed are associated with a similar incidence of misplacement, aspiration, or displacement as that previously reported. PMID- 1777201 TI - Use of sedation and neuromuscular paralysis during mechanical ventilation. AB - Pharmacologic therapy can be a necessary adjunct with mechanical ventilation. The treatment of pain and anxiety and the suppression of the patient's respiratory drive may be necessary to facilitate effective ventilation and oxygenation. The critical care nurse must be clear as to the expected outcomes of this therapy. In addition to the traditional drugs for sedation and analgesia, neuromuscular blocking agents may be required to improve ventilatory assistance. The patient must be continually evaluated for the appropriateness and method of dosing, adequate sedation and analgesia, and adverse effects. Patient safety is one of the primary concerns of the critical care nurse during this time. PMID- 1777202 TI - Hypertension and hypothermia in the acute postoperative period. AB - The past decade has witnessed the addition of newer and more sophisticated pharmacologic agents and technologies into the treatment regimes for postoperative hypertension and hypothermia. Although these additions have resulted in improved patient outcomes and understanding of physiologic principles in some areas they have also assisted in highlighting many new areas where nursing and medical research is further required. PMID- 1777203 TI - Recognition and management of bleeding following cardiac surgery. AB - The major hemorrhagic disorders are associated with malfunction of three physiologic systems either separately or in combination: (1) abnormalities of platelets, (2) abnormalities of blood vessels, and (3) abnormalities of plasma coagulation factors. Platelets contribute to hemostasis not only by participating physically by occluding rents and tears in small vessel but also by involving the coagulation process through their biochemical activities. It is small wonder that platelet dysfunction is the most common cause of nonsurgical bleeding following CPB; however, the potential for hyperfibrinolysis cannot be overlooked. New laboratory tests and therapeutic approaches have allowed for more accurate diagnosis and more appropriate therapy in a variety of bleeding events following CPB. PMID- 1777204 TI - Neurologic dysfunctions following cardiac surgery. AB - This article has discussed three major categories of neurologic injury following cardiac surgery. The primary pathophysiologic mechanisms for cerebral injury are thought to be related to reperfusion phenomena and neuronal cellular changes, hypoperfusion, and microemboli while on CPB. The type of symptoms the patient manifests range from fatal cerebral injury to more commonly seen episodes of mild, transient confusion. Preoperative, intraoperative, and postoperative risk factors are discussed. The critical care nurse's role in assessing early detection of changes, offering reassurance to both the family and patient, and providing continuity of care are summarized. PMID- 1777205 TI - Techniques for measuring arterial pressure in the postoperative cardiac surgery patient. AB - Blood pressure measurement and management of the cardiac surgical patient do not appear to be simple processes. The critical care nurse needs to understand thoroughly the many technical and physiologic variables pertaining to the equipment used (i.e., cuff size, stethoscope placement, automated device cycling patterns, and monitoring system accuracy and reliability); the patient (i.e., cardiac output, PVR, hypothermia, and placement site and length of the intra arterial catheter); and the relationship of indirect to direct measurement. The choice of therapy, i.e., volume or drug therapy (vasodilator or vasopressor), should be based on a thorough understanding of the technical and physiologic factors influencing the readings and their relationship to indirect and direct measurement of the blood pressure. Once the nurse understands the correlation of the indirect and direct blood pressure readings, choosing the pressure reading that one "likes" will no longer be an issue. PMID- 1777206 TI - Nursing management of postoperative dysrhythmias. AB - Clinical decision making about postoperative dysrhythmias requires the specialized skills and knowledge of the critical care nurse. During the immediate postoperative period, the critical care nurse must be aware of physiologic alterations and factors that may predispose the cardiac surgery patient to dysrhythmias. Correction of these physiologic alterations is usually the first step in postoperative dysrhythmia management. Should dysrhythmias develop following cardiac surgery, the critical care nurse may use management options that are not available in other surgical or medical patients. AEGs and pacing to suppress ectopy, to augment cardiac output, or to overdrive tachydysrhythmias are some of the available options. The advent of external, temporary DDD pacing will augment these management options. The challenges presented by these options emphasize the vital role of the critical care nurse in postoperative dysrhythmia management. PMID- 1777207 TI - The Ross procedure: aortic valve replacement using autologous pulmonary valve. AB - The use of pulmonary autologous valve in aortic valve replacement pioneered by Dr. Donald Ross in 1967 has been employed in young patients for more than two decades with impressive results. This procedure is recommended for young patients with isolated aortic disease who are expected to have a longer life span. Because of its lack of tissue degenerative changes, the autologous pulmonary valve has the potential to function longer than other biologic valves and mechanical valves while exhibiting the same inherent hemodynamic advantages. The assessment of the long-term performance of the pulmonary autograft in the aortic position suggests that the pulmonary autologous valve is the best choice for isolated aortic valve replacement in young patients. PMID- 1777208 TI - Heart assist devices: state of the art. AB - The various types of available mechanical assist devices are discussed in this article. Nursing care (both intraoperatively and postoperatively) and complications are also reviewed. PMID- 1777209 TI - Advances in ablation surgeries for dysrhythmias associated with Wolff-Parkinson White syndrome. AB - Management of dysrhythmias associated with WPW syndrome must be individualized. A detailed EPS in selected patients should be done to assess the location of accessory pathways and the efficacy of antiarrhythmic medications. Palliative treatment used in the prevention of SVT would include a pharmacologic approach or perhaps an antitachycardia pacemaker. Curative methods for treating the SVT associated with accessory pathways of WPW syndrome include ablative techniques. Surgical ablation is currently accepted as the gold standard of treatment, but catheter ablation offers promising hope as an adjunctive therapy in treating patients with WPW syndrome. PMID- 1777210 TI - Prostaglandins for the control of pulmonary hypertension in the postoperative cardiac surgery patient: nursing implications. AB - Right ventricular failure associated with pulmonary hypertension is a potential complication in selected cardiac surgical patients following cardiopulmonary bypass. Treatment modalities are generally focused on reduction of right ventricular afterload. PGE1 infusion is one method of providing afterload reduction by its vasodilating action on the pulmonary vasculature. Nursing management of the patient receiving PGE1 requires a thorough knowledge of the hemodynamic alterations occurring in right ventricular failure and pulmonary hypertension, as well as the effect of PGE1 on these hemodynamic parameters. The nurse must understand the rationale for concomitant administration of a vasoconstrictor with the PGE1 as well as possible methods of administering these agents. Lastly, recognition and management of possible adverse effects associated with PGE1 infusion are essential components of nursing care. PMID- 1777211 TI - The elderly heart surgery patient. AB - As our elderly population increases, we will be seeing more elderly heart surgery patients. Because of aging's effects on the body, the elderly have different needs from and are more prone to complications of surgery than the younger patient. Drug toxicity, pulmonary complications, unstable hemodynamics, decreased infection defense, impaired swallowing reflexes, and altered skin function are some of the critical problems seen in this group after heart surgery. The aged patient poses some unique challenges for the critical care nurse that, if met, result in a great feeling of achievement when the patient is returned to a normal and prolonged life. PMID- 1777212 TI - Brain monoamine metabolism and rotational behaviour induced by experimental herpes simplex virus encephalitis. AB - The motor behaviour and brain concentrations of dopamine, noradrenaline, serotonin and their metabolites have been examined in rabbits with experimental herpes simplex virus (HSV) brain infection achieved by unilateral corneal inoculation. The animals showed altered motor behaviour, consisting of a posture tilting to the side of inoculation and circling in the same direction, that began on day 4-5 post inoculation, and was most vigorous on day 7 post inoculation. Compared with controls, the concentration of 5-hydroxyindoleacetic acid was increased in the caudate nucleus on both sides and that of serotonin was decreased in the nucleus accumbens on the side of inoculation. The circling of the animals correlated positively with the ratio of homovanillic acid concentrations between the left and right caudate nucleus, although the actual concentrations did not differ from the controls. The posture asymmetry correlated with the ratio of the left and right nucleus accumbens homovanillic acid concentrations. The results demonstrate that experimental HSV infection in the brain alters motor behaviour, in association with changes in brain dopamine and serotonin metabolism in the major ascending monoamine systems. PMID- 1777213 TI - Effects of ageing on the content in sulfur-containing amino acids in rat brain. AB - Concentrations of the sulfur-containing amino acids methionine, homocysteic acid, cysteic acid and taurine were measured in brain structures of young and old Wistar rats in an attempt to establish a possible link between the increase in oxidative stress with ageing and changes in tissue levels of these amino acids. Contrary to data reported by others, in all brain structures of young and old rats homocysteic acid levels could not be quantified. Compared with young rats, in old animals taurine and methionine concentrations significantly decreased in striatum and cortex; decreased taurine levels were also found in nucleus accumbens and cerebellum and lower concentrations of methionine were found in midbrain, hippocampus and pons-medulla. Cysteic acid levels either did not change or significantly increased in cortex and hippocampus. These results are discussed taking into account the biosynthesis of sulfur-containing amino acids in rat brain and the decrease in glutathione in relation to oxidative stress with ageing. Changes in aspartic acid, glutamic acid, serine, glutamine, glycine and GABA concentrations with ageing were also determined in the same brain structures and were in good agreement with those previously reported (Strolin Benedetti et al., 1990 a, b). PMID- 1777214 TI - The effect of methamphetamine on the release of glutamate from striatal slices. AB - One postulated role of dopamine in the striatum is to reduce neuronal activity in cortico-striatal glutamergic terminals. We investigated the effects of methamphetamine, which displaces dopamine, on glutamate release from rat striatal slices. Methamphetamine significantly reduced K(+)-stimulated (45 mM) glutamate release. In slices prepared from rats treated 8 days previously with methamphetamine there was enhanced (approximately 200%) release of glutamate. This study demonstrates that dopamine has a modulatory effect on glutamate release in the striatum. PMID- 1777215 TI - Recurrent spontaneous abortion: where do we stand now? PMID- 1777216 TI - Prevention of coronary heart disease in Finland--application of the population strategy. AB - The North Karelia Project was the first population-based cardiovascular disease prevention programme. Even though it achieved, as compared to the reference population, a sizeable reduction in smoking and small effect in blood pressure and serum cholesterol levels, the effect on coronary and cardiovascular mortality of the programme remains equivocal. This is mainly due to shortcomings in the original study design and unanticipated start of the national decline in coronary mortality at the same time with the programme. North Karelia Project contributed, however, to the initiation of national activities in the prevention of cardiovascular disease. These have produced a favourable trend in lipids in the whole Finnish population. The recommendations and activities by national authorities and organizations have suffered, until recently, from orientation towards screening and individual risk factors. The success in North Karelia in early 1970's in the reduction of smoking has still not occurred nationally. Further emphasis is needed in the population approach and in the integration of preventive activities into the community and legislation. PMID- 1777217 TI - Hematopoietic growth factors in clinical hematology. AB - Five primary hematopoietic growth factors have been extensively evaluated in trials in patients with inadequate blood cell formation. Results have convincingly demonstrated that various chronic anemias can be corrected with erythropoietin. Similarly, there is no doubt that granulocyte-macrophage colony stimulating factor (GM-CSF) and granulocyte colony stimulating factor (G-CSF) increase the number of leukocytes and improve the function of cells in patients with congenital and acquired leukopenias. Recent studies indicate that interleukin-3 (IL-3) and macrophage colony-stimulating factor (M-CSF) can also stimulate blood cell production in patients. As a result, morbidity and perhaps mortality associated with severe cytopenias can be reduced substantially. PMID- 1777218 TI - Anaesthesia for ambulatory surgery: firm definitions of "home readiness" needed. PMID- 1777219 TI - Hormone receptors as prognostic factors in female breast cancer. AB - The oestrogen (ER) and progesterone receptor (PR) status in a series of 281 women with breast cancer (followed up for a mean of 8.5 years) was correlated with eight histological variables, seven nuclear morphometric factors and two mitotic indices. Sex steroid receptor status was not significantly related to tumour size, axillary lymph node status or tumour recurrence. Sex steroid receptors were related to histological grade (P less than 0.0001), nuclear grade (P less than 0.0001), tumour necrosis (P = 0.0003), tumour circumscription (P = 0.0027), inflammatory cell reaction (P = 0.007), intraductal growth pattern (P = 0.0378), and tubule formation (P = 0.0432). Receptor status was also significantly related to nuclear morphometric variables (P less than 0.001) and mitotic indexes (P less than 0.001). In univariate analysis, ER (P = 0.2) and PR (P = 0.1) negatively predicted the recurrence free survival. Cancer related survival was predicted by ER (P = 0.0068) and PR (P = 0.0027). In small (diameter less than or equal to 2 mm) axillary lymph node negative tumours, ER (P = 0.09) and PR (P = 0.1) had some value in predicting the survival. The survival advantage of steroid receptor positive tumours was not due to adjuvant hormone therapy. Sex steroid receptors had independent predictive value in multivariate survival analysis and also in small (diameter less than or equal to 20 mm) tumours. The results indicate that sex steroid receptor negativity is related to several malignant histological features in breast cancer and hormone receptors have prognostic value. Their prognostic influence seems to be mediated through the different proliferation rates in receptor positive and negative breast carcinomas. PMID- 1777220 TI - Coenzyme Q10, alpha-tocopherol and free cholesterol in HDL and LDL fractions. AB - Twenty-three randomly selected plasma samples from apparently healthy, middle aged men were analysed for coenzyme Q10 (CoQ10), alpha-tocopherol (AT) and free cholesterol (FC) in: 1) whole plasma, 2) the HDL lipoprotein fraction after LDL precipitation (VLDL + LDL). CoQ10, AT and FC in plasma averaged 0.69 +/- .11, 6.74 +/- 1.78 micrograms x ml-1 and 0.59 +/- .11 mg x ml-1 and in HDL 0.17, 3.24 micrograms x ml-1 and 0.17 mg x ml-1 or 29, 48 and 29% of plasma values. Amounts of CoQ10 and AT were correlated to that of FC in all pools. The amount of HDL CoQ10 but not of HDL-AT fell, with the HDL-FC expressed as the fraction of plasma FC. In all pools, N-AT versus AT initially increased and then levelled off, indicating saturation like conditions in contrast to CoQ10. Thus, CoQ10 and AT are differently allocated in HDL and LDL. This might have a bearing both on the suggested lipoprotein protection against peroxidation by these two antioxidants, but also on the distribution and allocation in different organs of CoQ10 and AT by HDL and LDL transportation. PMID- 1777221 TI - Impact of prematurity on perinatal mortality and morbidity. AB - Severe prematurity is a prime factor causing perinatal mortality or morbidity. In Finland 1% of babies are born before 32 completed weeks of pregnancy and 0.9% are delivered with a birth weight of 1500 g or less. Since transport of a baby in utero is preferable to transporting a neonate, approximately 85% of infants below 1000 g and 90% of infants between 1000 to 1499 g are delivered in departments with facilities for neonatal intensive care. The rate of caesarean delivery is approximately 50% in pregnancies between 26 and 28 weeks, while the overall caesarean section rate is 15%. Deaths of low birth weight babies account for 66% of the total perinatal mortality and those of very low birth weight babies 46%. Intrauterine deaths constitute two thirds and neonatal deaths one third of perinatal mortality among very low birth weight babies. In Turku, neonatal survival rate for infants of 500 to 749 g was 61.5% and for infants of 750 to 999 g, 77.3%. In Turku respiratory distress syndrome is one of main complications of prematurity that has led to death in 11.2% of infants in recent years. Of the survivors, 85% have been healthy at the age of two years. The incidence of the bronchopulmonary dysplasia among very low birth weight infants has been 19.7%. In recent years, the incidence of severe brain haemorrhage has been 32% among infants with a birth weight below 1000 g. PMID- 1777222 TI - Is pre-eclampsia preventable? AB - Pre-eclampsia is characterised by reduced utero-placental blood flow which in turn results from vascular damage occurring early in pregnancy. Endothelial damage and reduced prostacyclin and nitric oxide synthesis will initiate excessive platelet aggregation, fibrin deposition and vascular occlusion. Prevention of pre-eclampsia is dependent on affecting this process. Antiplatelet therapy is being assessed as a prophylaxis. Screening tests using increased platelet turnover as their basis are also being assessed. PMID- 1777223 TI - Mechanisms of perinatal brain damage. AB - Although the perinatal brain is more resistant towards hypoxia-ischemia than at any later stage of development, perinatal asphyxia still contributes to permanent brain damage in survivors. This short review focuses on the discussion of mechanisms of late neuronal death, i.e. cerebral damage related to lack of oxygen but caused by mechanisms during the stage of reoxygenation. Evidence is presented to indicate that the transient, dense glutamatergic innervation of basal structures of the perinatal brain may induce brain damage via overflow of excitatory amino acids during oxygen lack, causing a longstanding overstimulation of excitatory neurons. Oxygen derived free radicals may be generated during reoxygenation by several mechanisms, including the oxidation of hypoxanthine and arachidonic acid accumulated in the cerebral insterstitium during hypoxia. The increase of the intracellular concentration of free Ca-ions contributes to these events. Possible avenues for prevention of post-asphyxial brain damage include glutamate receptor antagonists, calcium antagonists, antioxidants, free radical scavengers, inhibitors of libid peroxidation and blockers of arachidonic acid metabolism. PMID- 1777224 TI - New non-invasive methods for the investigation of cerebral oxidative metabolism and haemodynamics in newborn infants. AB - Magnetic resonance spectroscopy and near infrared spectroscopy provide complimentary information about cerebral oxidative metabolism and haemodynamics and are valuable methods for investigating normal brain development and the pathogenesis of perinatal brain injury. Magnetic resonance spectroscopy can be used to measure in brain tissue the concentrations of important phosphorus compounds that are involved in oxidative metabolism, notably adenosine triphosphate, phosphocreatine and inorganic orthophosphate: intracellular pH can also be estimated. Abnormalities indicating impaired oxidative phosphorylation have been detected in a range of situations where hypoxic-ischaemic brain injury was known or suspected to have occurred, such as birth asphyxia and periventricular leucomalacia. Following acute cerebral injury a latent period of many hours has frequently been found before evidence of impaired oxidative phosphorylation developed, suggesting the possibility of effective early treatment. The extent of the metabolic impairment was related to long term outcome. Near infrared spectroscopy provides cotside information about cerebral oxygenation and haemodynamics. Quantitative information can be obtained about oxyhaemoglobin, deoxyhaemoglobin and the redox state of cytochrome aa3. Methods have been described for calculating cerebral blood flow, oxygen delivery, blood volume and carbon dioxide reactivity; and maturational changes are being defined. In birth-asphyxiated babies, abnormalities are detectable well before oxidative phosphorylation becomes impaired. PMID- 1777225 TI - Pathogenesis of respiratory failure in the preterm infant. AB - Respiratory failure in the preterm results from not only surfactant deficiency but also the immaturity of a number of other elements that have a structural basis. Airway, alveolar, fluid clearance, and epithelial and endothelial barrier functions also are important to lung function. Immaturities in these lung elements have identifiable adverse consequences for lung function such as pulmonary interstitial emphysema and pulmonary edema. The maturation of each of these elements appears to be achievable by agents such as corticosteroids, and maturation will result in an improved response to surfactant treatments. While surfactant treatments can improve respiratory failure by minimizing lung injury, other aspects of lung immaturity continue to contribute to respiratory compromise in the preterm. A thorough understanding of respiratory failure in the newborn depends on a better appreciation of the contribution of immaturity of the different structural elements of the lung on lung function. PMID- 1777226 TI - Factors affecting surfactant responsiveness. AB - There is a wide variability in the therapeutic responsiveness to exogenous surfactant, a drug that has become generally available for the treatment of lung immaturity and respiratory distress syndrome. Recent studies have demonstrated evidence that therapies decreasing lung edema improve the effectiveness of surfactant substitution. In addition, exogenous surfactant may acutely decrease pulmonary perfusion since the airway pressures are effectively transmitted to airspaces, compressing alveolar capillaries, especially in hypovolemia. Therapies aimed at decreasing lung edema, improving cardiac output, and stepwise weaning from oxygen and ventilatory pressures are cornerstones in the successful management of patients undergoing surfactant therapy. PMID- 1777227 TI - Diaper industry workshop identifies research needs to minimize environmental impacts. AB - The diaper industry workshop focused on four important issues: public health and safety, recycling, composting, and product life cycle analysis techniques. A majority of participants believed that the health and safety issues related to diapers currently receive more public scrutiny than is warranted. They concluded that there is probably no significant public health and safety problems related specifically to diaper handling, recycling, or disposal in properly operated and constructed landfills. Because diaper disposal is a highly visible public issue, however, more definitive health and safety studies should be conducted on the handling and processing of diapers. This would clearly enable public health officials to define any health and safety issues related to diaper handling and to dispel unwarranted fears about health problems associated with diapers. PMID- 1777228 TI - A framework for risk characterization of environmental pollutants. AB - Risk characterization is defined by both the U.S. National Academy of Sciences and the U.S. EPA as the estimation of human health risk due to harmful (i.e., toxic or carcinogenic) substances or organisms. Risk characterization studies are accomplished by integrating quantitative exposure estimates and dose-response relationships with the qualitative results of hazard identification. A Risk Characterization Framework has been developed to encourage a systematic approach for analysis and presentation of risk estimates. This methodology subdivides the four common components of the risk assessment process into ten elements. Each of these elements is based on a term in a predictive risk equation. The equation allows independent computations of exposure, dose, lifetime individual risk, and risk to affected populations. All key assumptions in the predictive risk equation can be explicitly shown. This is important to understand the basis and inherent uncertainties of the risk estimation process. The systematic treatment of each of the ten elements in this framework aids in the difficult job of comparing risk estimates by different researchers using different methodologies. The Risk Characterization Framework has been applied to various indoor and outdoor air pollutants of a carcinogenic nature. With further development, it also promises to be applicable to noncarcinogenic effects. PMID- 1777230 TI - The Odor Impact Model. PMID- 1777229 TI - The potential inhalation hazard posed by dioxin contaminated soil. AB - Mathematical models and field data were used to estimate the airborne concentrations of 2,3,7,8 tetrachlorodibenzo-p-dioxin (TCDD) vapor and particulates which could originate from soil containing 100 ppb TCDD. The model of Jury et al. (1983) and the box approach were used to predict the concentration of TCDD vapor from soil. The daily soil temperature was assumed to vary between 20 degrees C and 40 degrees C for six months of the year to account for diurnal warming and cooling of the soil. The depth of contamination was 50 mm. The model predicted average vapor flux rate for TCDD from soil for this temperature profile was 1.5 x 10(-14) mg/sec-cm2. The upper-bound estimates of the TCDD vapor concentration on-site at 40 degrees C and 20 degrees C were 2.5 pg/m3 and 1.8 pg/m3, respectively. Using a recently proposed unit risk value (URV) of 2.9 x 10( 6) (pg/m3)-1 [slope factor = 1.0 x 10(-14) (mg/kg-day)-1], the maximum plausible cancer risk is about 1 x 10(-5). If one accepts the EPA URV of 3.3 x 10(-5) (pg/m3)-1 (slope factor = 1.2 x 10(-13) (mg/kg-day)-1), then the risk is no greater than 1 x 10(4). A maximum TCDD vapor concentration of 0.21 pg/m3 was predicted 100 meters downwind (for summer days). The on-site concentration of TCDD in suspended particulate was estimated to be 1.4 pg/m3 (based on a TSP level of 0.07 mg/m3 from site soil). For persons exposed to vapors and particulates about 100 meters off-site, the exposure was about 10-fold less.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777231 TI - Extraction of mercury from groundwater using immobilized algae. AB - Bio-Recovery Systems, Inc. conducted a project under the Emerging Technology portion of the United States Environmental Protection Agency's (EPAs) Superfund Innovative Technology Evaluation (SITE) Program to evaluate the ability of immobilized algae to adsorb mercury from contaminated groundwater in laboratory studies and pilot-scale field tests. Algal biomass was incorporated in a permeable polymeric matrix. The product, AlgaSORB, packed into adsorption columns, exhibited excellent flow characteristics, and functioned as a "biological" ion exchange resin. A sequence of eleven laboratory tests demonstrated the ability of this product to adsorb mercury from groundwater that contained high levels of total dissolved solids and hard water components. However, use of a single AlgaSORB preparation yielded nonrepeatable results with samples collected at different times of the year. The strategy of sequentially extracting the groundwater through two columns containing different preparations of AlgaSORB was developed and proved successful in laboratory and pilot-scale field tests. Field test results indicate that AlgaSORB could be economically competitive with ion exchange resins for removal of mercury, with the advantage that hardness and other dissolved solids do not appear to compete with heavy metals for binding capacity. PMID- 1777232 TI - Growth of certain myeloid leukemic cells can be stimulated by interleukin-2. AB - The effect of recombinant interleukin-2 (IL-2) on the proliferation of T-cell depleted leukemic blasts was evaluated in 23 patients with acute myelogenous leukemia (AML). For this purpose, the effect of IL-2 on cell growth, [3H] thymidine incorporation into the blasts and the expression of IL-2 receptors on cell surface using T-cell depleted blasts were studied. The results showed that IL-2 stimulated [3H]-thymidine incorporation significantly in blasts of 8 out of 23 cases of AML. An IL-2 induced increase in cell number was directly demonstrated in seven out of eight IL-2 responsive patients studied. IL-2 stimulated the proliferation of blasts in monocytic lineage (M4 and M5), but not all M4/M5 leukemics responded to rIL-2. Stimulation of the growth of leukemic cells was not correlated with the expression of Tac antigen on the cell surface, but it was significantly correlated with the expression of IL-2 receptor (IL-2R) beta chain on the cell surface. These results indicate that IL-2 is an active growth factor in certain myeloid leukemia cells, especially of monocytic type. PMID- 1777233 TI - Investigation of interleukin 2 receptors on human endothelial cells. AB - We have demonstrated that both recombinant and purified IL-2 exert a direct effect on quiescent human microvascular endothelial cells in vitro, causing the cells to enter the cell cycle and proliferate (Hicks et al., 1989). In this study we have identified IL-2 receptors (R) on both human umbilical vein (HUVEC) and neonatal foreskin (HCEC) endothelial cells. The techniques used to identify the receptors included proliferation studies, flow cytometry and immunofluorescence. Results indicate that both HUVEC and HCEC possess low numbers of receptors since both cell types proliferate in response to IL-2. The number of receptors on the cell surface vary according to passage number and culture conditions. Immunofluorescent studies show discrete areas of staining on the cell membrane. These combined results suggest that human vascular endothelial cells possess IL 2R. PMID- 1777234 TI - Biologically active basic fibroblast growth factor migrates at 27 kD in "non denaturing" SDS-polyacrylamide gel electrophoresis. AB - Using mild conditions of SDS-PAGE, i.e. no heating of the sample, and the PhastSystem (Pharmacia), we found that bFGF, either natural bovine or recombinant human migrated at a 27 kD position in addition to the classical 18 kD one. By the cell-blot technique, we found that the biological activity toward rat astroblasts and 3T3 mouse fibroblasts was always restricted to the 27 kD band. Partial heat denaturation experiments revealed a close correlation between the remaining biological activity of bFGF in solution and the ratio of the 27 kD band versus the 18 kD band seen on SDS gels. These observations suggest that the bFGF which is biologically active in solution migrates at an apparent Mr of 27 kD in our conditions of electrophoresis, keeping its biological activity after electrophoresis, and the molecules which are inactive (denatured) in solution migrate at 18 kD and remain inactive. These experimental conditions, in which the biological activity appears to be preserved, could be referred to as "non denaturing SDS-polyacrylamide gel electrophoresis" and could be useful, associated to cell-blot, for the search and characterization of new growth factors active on cells in culture. PMID- 1777236 TI - Improved healing of tympanic membrane perforations with basic fibroblast growth factor. AB - We have investigated the effects of basic fibroblast growth factor (FGF) on the healing of tympanic membrane (TM) perforations. In the first series of experiments, a simple, round 1-mm perforation was made in the membrane and the effects of basic FGF examined. In a second series of experiments, basic FGF was tested on 2-mm perforations in which the borders were folded inward in order to delay normal healing. Topical applications of saline or basic FGF were administered onto gelfoam overlays of the TM perforations in 51 guinea pigs by delivering 5 microliters aliquots of PBS or 5 microliters of PBS containing 1 microgram of basic FGF on the day of surgery and daily thereafter. Repair of the lesions was evaluated 3, 5 or 8 days after surgery. The results show that basic FGF mediates faster healing of TM perforations by inducing rapid proliferation of the subepithelial connective tissue layer. PMID- 1777235 TI - Basic fibroblast growth factor stimulates glomerular mesangial cell proliferation through a protein kinase C-independent pathway. AB - Basic Fibroblast Growth Factor (bFGF) is shown to be a potent mitogen for cultured glomerular mesangial cells. bFGF induces an increase in cell number and stimulates DNA synthesis measured by [3H]thymidine incorporation in normal as well as in protein kinase C-depleted cells. The ED50 observed in both cases are nearly identical (approximately 0.04 nM) and maximal responses are obtained at 1 nM. Staurosporine, a potent protein kinase C inhibitor, does not prevent bFGF from inducing mitogenesis. On the contrary, the tumour promoting phorbol ester 12 O-tetradecanoylphorbol 13-acetate (TPA) and the bradykinin derivative Des Arg9bradykinin that we have previously shown as mitogens for mesangial cells, fail to trigger DNA synthesis or cell proliferation upon staurosporine treatment or in protein kinase C-depleted cells. bFGF is unable to induce the association of the enzyme to membranes, the so-called translocation process, although the growth factor induces a slight production of diacylglycerol. Using a highly resolutive two-dimensional electrophoresis, we show that bFGF, in contrast to TPA, is unable to stimulate the phosphorylation of a Mr 80,000/pI 4.5 protein, a major and specific protein kinase C substrate. By contrast, bFGF stimulates the phosphorylation of a Mr 28,000/pI 5.7-5.9 protein in normal as well as in protein kinase C-depleted cells while TPA induces this protein phosphorylation only in normal cells. Our results suggest that bFGF exerts its proliferative action on mesangial cells through a protein kinase C-independent pathway and that the growth factor does not activate anyway the enzyme in this cell type. PMID- 1777237 TI - Immediate early gene responses of NIH 3T3 fibroblasts and NMuMG epithelial cells to TGF beta-1. AB - Transforming growth factor beta has a wide range of physiological effects on cell growth and metabolism. We have previously reported on the rapid induction of jun transcription factors in TGF beta-treated cells. Here we show that the early genomic response to TGF beta-1 includes activation of a broad spectrum of serum inducible genes both in NIH 3T3 fibroblasts and in NMuMG epithelial cells, which are growth-stimulated and growth-inhibited by TGF beta, respectively. Of particular interest is the presence of a putative nuclear DNA-binding receptor (N10) and zinc finger transcription factors (Krox 20 and Krox 24) among the TGF beta-induced genes. In addition to the stimulatory effects of TGF beta, expression of a few genes including c-myc is decreased in both types of cells. In cells transformed by neu or ras oncogenes the immediate early mRNA responses to TGF beta are deregulated. Our results suggest that certain transcription factors are required for both positive and negative regulation of cell proliferation by TGF beta, and that their relative concentrations may determine the subsequent cellular responses. PMID- 1777238 TI - TGF-beta 1 accelerates wound healing: reversal of steroid-impaired healing in rats and rabbits. AB - TGF-beta modulates events of normal wound healing through multiple pathways that influence cell infiltration, proliferation, angiogenesis, extracellular matrix synthesis and remodeling. The effects of topically applied TGF-beta 1 on wound healing in two models of healing were evaluated when the healing response was impaired by the administration of methylprednisolone to rats or rabbits. TGF-beta 1 increased the healing of linear incision wounds on rats, as measured by breaking strength, to that of normal rats. Full thickness open wounds were also created on the inner ears of rabbits to simulate a non-contracting wound with limited blood supply. Healing was further impaired by the administration of methylprednisolone. The single application of TGF-beta 1 improved the healing of open wounds. TGF-beta 1 stimulated increased granulation tissue formation, as well as reepithelialization. The amount of granulation tissue and epithelialization were similar to wounds from normal-healing control rabbits. The delayed healing caused by methylprednisolone permitted the evaluation of multiple applications of TGF-beta 1 to wounds. Two applications of TGF-beta 1 spaced 7 days apart further improved the healing response when compared to a single application. Thus, single or multiple topical applications of TGF-beta 1 reversed impaired healing conditions secondary to methylprednisolone when used on incisional or open wounds. These observations support the hypothesis that growth factors, such as TGF-beta 1, may be useful as accelerators of wound repair in patients with impaired healing conditions. PMID- 1777239 TI - Cloning and overexpression of TGF-beta 1 cDNA in a mammary adenocarcinoma: in vitro and in vivo effects. AB - It has been suggested that transforming growth factor beta (TGF-beta) may be a potential negative autocrine growth regulator of carcinomas including mammary carcinomas. To directly test this hypothesis we have cloned and expressed human TGF-beta 1 cDNA in a murine mammary adenocarcinoma which is normally growth inhibited by addition of exogenous TGF-beta in vitro. A number of transfectants over-expressing the foreign TGF-beta 1 mRNA were selected and compared to transfectants which did not overexpress the exogenous TGF-beta 1 cDNAS. Cell lines overexpressing the transfected TGF-beta 1 mRNA were found to produce total levels of TGF-beta 7 to 10 fold greater than the parental cells or control transfected clones. However, when levels of active fractions of TGF-beta were compared in cell lines overexpressing TGF-beta 1 to those which did not, no differences were found. This suggests that the activation mechanism is not necessarily induced or altered by increasing levels of latent TGF-beta 1 production in a given tumor cell line. The basal in vitro doubling time of TGF beta 1 overexpressing clones was identical to the control populations. Similarly, in vivo tumor growth rates after s.c. injection were similar to that of the parental line. Thus the precise role of TGF-beta in mediating either the in vitro or in vivo growth control of a sensitive mammary adenocarcinoma cell line remains unclear. It may be that cellular over-secretion of latent TGF-beta must be coupled with enhanced cellular TGF-beta activation prior to any observed effect on growth rate in vitro or in vivo; this latter event may constitute the "rate limiting" step of TGF-beta activity on tumor behavior. PMID- 1777240 TI - Expression of recombinant TGF-beta 2(442) precursor and detection in BSC-40 cells. AB - Analysis of cDNA clones encoding transforming growth factor (TGF)-beta 2 predicts two different precursor proteins derived by alternative mRNA splicing; a 414 amino acid precursor [TGF-beta 2(414)] and a 442 amino acid precursor [TGF-beta 2(442)]. The two proteins differ by a 28 amino acid insertion within the pro region of TGF-beta 2(442). In order to characterize the TGF-beta 2-related proteins encoded by the TGF-beta 2(442) cDNA and determine whether it could, in fact, direct the synthesis of active growth factor, we have expressed this gene in Chinese hamster ovary (CHO) cells and, after amplification with methotrexate, obtained stable clones secreting TGF-beta 2(442). The TGF-beta 2 secreted by these cells was latent as acidification was necessary to detect optimal biological activity. In addition to mature TGF-beta 2, high molecular weight pro region containing proteins were also secreted as analyzed by immunoblotting using site-specific anti-peptide antibodies. These proteins migrated differently than those secreted by CHO cells transfected with cDNA encoding TGF-beta 2(414), indicating that structural differences exist between the two complexes. An anti peptide antiserum was produced in rabbits against the 28 amino acid insert region of TGF-beta 2(442). This sera was then used to detect the presence of TGF-beta 2(442) in serum-free media conditioned by BSC-40 cells. Since the TGF-beta 2(442) precursor is produced and secreted by a non-recombinant cell line, this suggests that it may play a physiological role in regulating the activity of TGF-beta 2. PMID- 1777241 TI - Expression of retrovirally transduced IL-1 alpha in IL-6-dependent B cells: a murine model of aggressive multiple myeloma. AB - Retroviral-mediated gene transfer was employed to introduce an IL-1 alpha cDNA into an IL-6-dependent murine B-cell line. Bone marrow metastases and bone lesions were frequently observed following intravenous injection of these B cells into syngeneic mice. Because the retroviral vector also contained the neomycin phosphotransferase gene, metastatic cells could be easily recovered from bone marrow by addition of G418 to the culture medium. Interestingly, the metastatic B cells were found to retain their IL-6 dependency through several transplant generations. By comparison, intravenous injection of autonomously-growing B-cell lines generated in vitro by retroviral introduction of an IL-6 cDNA rarely resulted in bone marrow metastases. These results demonstrate that abrogation of growth factor dependency is neither necessary nor sufficient for the in vivo growth and dissemination of tumor cells in this experimental system. It is proposed that the increased metastasis of the IL-1 alpha-producing B-cells to bone marrow is due to alterations in cell adhesion molecules. The B-cell bone marrow metastasis model described here may be useful for studies of bone marrow homing and for evaluation of therapeutic regimens for multiple myeloma. PMID- 1777242 TI - Growth regulation of hematopoietic cells. An overview. AB - The production of mature blood cells is absolutely dependent on a small pool of pluripotent stem cells with high proliferative and self-renewal capacities. The hematopoietic stem cells develop gradually from pluripotent to unipotent, committed progenitor cells during which process they lose their self-renewal capacity. This development is dependent on interactions with specific hematopoietic growth factors, which by binding to surface receptors on the stem cells stimulate them to proceed to the next step of differentiation. During recent years several of the hematopoietic growth factors have been purified to homogeneity, their primary protein as well as genetic structures have been determined and today they are available for clinical trials as recombinant proteins produced in bacteria, yeast or mammalian cells. Our present knowledge sustains the notion that IL-3, and to a lesser extent GM-CSF, play a major role in multipotent hematopoietic stem cell survival, proliferation and differentiation into stem cells with restricted maturation programs. The programmed unipotent stem cells need stimulation by erythropoietin, G-CSF, M-CSF and IL-5 to proliferate and mature into their end stage products erythrocytes, neutrophils, monocytes and eosinophils respectively. Other cytokines such as IL 1, IL-4 and IL-6 fulfil important functions as cofactors in these processes and several others play the part of tentative physiological inhibitors. During the past decade major progress has been made in our understanding of the complex interplay between stem cells, accessory cells, growth factors, and their receptors, and the clinical trials now undertaken will certainly bring even more basic knowledge to the field of hematopoietic growth regulation. PMID- 1777243 TI - Assessment of human tumour proliferation using bromodeoxyuridine--current status. AB - The study of human tumour proliferation has been facilitated by the development of monoclonal antibodies recognizing halogenated pyrimidines. Flow cytometry can be used to detect the incorporation of bromodeoxyuridine (BUdR) into DNA simultaneously with the measurement of total DNA content. We have studied in excess of 600 tumours using in vivo administration of BUdR. The cell kinetic information generated from this approach is more complete than can be obtained from in vitro incubation with DNA precursors such as tritiated thymidine (3HTdR) or by single parameter DNA analysis. The duration of S-phase (Ts) can be estimated in addition to the labelling index (LI). From these two parameters, the potential doubling time (Tpot) can be calculated. Our data show a wide variation in Ts as well as LI, making both these parameters important variants in determining overall proliferation. Although there is tremendous variation in Tpot between tumours of the same and different types, the median values are surprisingly short at around 5 days. A close relationship exists between the presence of DNA aneuploidy and the proliferation parameters. The clinical relevance of Tpot is currently being assessed independently in two trials of accelerated versus conventional fractionation. PMID- 1777244 TI - Therapy of colorectal carcinoma with monoclonal antibodies (MAb17-1A) alone and in combination with granulocyte monocyte-colony stimulating factor (GM-CSF). AB - A mouse monoclonal antibody (MAb17-1A) (IgG2A) against colorectal carcinoma cells was used to treat patients with metastatic disease. Major direct effector functions of MAb seem to be ADCC (antibody dependent cellular cytotoxicity), CDC (complement dependent cytolysis) and apoptosis ('programmed cell death'). Thus, a high tumor cell saturation of the MAb should be achieved. Increasing doses of MAb to the patients increased the total area under the concentration curve and thus the exposure of tumor cells to MAb. However, the response rate (with complete + partial + minor response + stable disease defined as response) was not augmented. In total, 10/52 (19%) patients responded and in fact lower doses (less than 2 g) might induce a higher response frequency (9/52) than higher doses (greater than 2 g) (1/52). During treatment, the numbers of cytotoxic cells (lymphocytes and monocytes) increases in the tumor lesion and complement components were deposited. As ADCC may be important, effector mechanism attempts were made to augment the cytolytic capability of the effector cells by simultaneously giving the patients GM-CSF. The combination of MAb17-1A + GM-CSF augmented the ADCC activity of blood mononuclear cells and a heavy infiltration of monocytes could be noted in the tumor. Out of 15 available patients 6 (40%) showed a response. PMID- 1777245 TI - Ras p21 expression in relation to histopathological variables and prognosis in colorectal adenocarcinoma. AB - Ras gene protein products (p21) reacting with the monoclonal antibodies ras 11, DWP, R256 and E184 were studied with an immunohistochemical method which was applied to 17 normal and 79 colorectal adenocarcinoma specimens. Normal colorectal epithelium showed positive staining for ras 11 in 35% of the cases, but not for DWP, R256 and E184. The antibodies showed positive staining in colorectal adenocarcinomas in 76, 53, 29 and 35% of the cases respectively. The degree of staining for ras 11 was significantly related to the grade of differentiation and increased from Dukes stage A to C. Strong staining for ras 11 predicted a significantly shorter recurrence-free interval (p less than 0.001). In Cox's regression analysis, the degree of staining for ras 11 was a prognostic factor independent of the grade of differentiation and Dukes stage (p less than 0.01). The results indicate that the enhanced expression of pan ras p21 may provide an important biological marker for determining prognosis in colorectal adenocarcinomas. PMID- 1777246 TI - Cellular B-2 microglobulin expression as a prognostic indicator in renal cell carcinoma. AB - The expression of B-2 microglobulin (B-2M) on tumor cells and their normal cell counterparts in 39 patients with renal cell carcinoma was studied and correlated to tumor stage and survival. The median survival time of patients with localized disease (stage I) whose tumors expressed B-2M was 10.2 years while the median survival time for patients whose tumors did not express B-2M was only 3.6 years (p less than 0.001). For patients with more advanced disease (stages II, III, IV) whose tumors expressed B-2M, median survival time was 3.6 years compared to 2.0 years in patients whose tumors did not express B-2M, a non-significant difference. It is suggested that the tumor cell membrane expression of B-2M may serve as an indicator of good prognosis in early renal cell carcinoma. PMID- 1777247 TI - Acute radiation effects on saliva composition in rats with different vitamin A levels in serum. AB - Irradiation of the head and neck often causes loss of salivary gland function which may lead to severe oral discomfort. The effects of a single dose of 25 Gy given to rats with different serum levels of vitamin A were studied. The salivary secretion rate as well as concentrations of protein, hexosamine, amylase and electrolytes, and the activities of two antibacterial glycoproteins were measured. At an adequate level of vitamin A in the diet, irradiation significantly reduced whole saliva secretion rate, and decreased the concentration of salivary sodium, calcium and hexosamine as well as the activity of a glycoprotein agglutinating a serotype c strain of S. mutans. Peroxidase, amylase and potassium were not significantly affected. The reductions seen at an adequate level of vitamin A were not reduced by supplementation of excess dietary retinol. The damage caused by irradiation was enhanced by vitamin A deficiency as seen in the reduced protein and hexosamine concentrations. PMID- 1777248 TI - Radioprotection by MPG of mice ovaries exposed to sublethal gamma radiation doses at different postnatal ages. AB - Female Swiss albino mice were exposed at 1, 3 or 6 weeks of age respectively to sublethal doses (0.6, 1.2 and 2.4 Gy) of gamma radiation in the presence or absence of 2-mercaptopropionylglycine (MPG). Ovaries were histologically examined at different intervals after irradiation and the follicles were counted. Most follicular depletion had occurred already at postirradiation day 1 and the depletion then gradually continued. At day 35 after irradiation a few follicles could still be found in mice exposed at 1 week of age while all follicles were eliminated in mice exposed at 3 and 6 weeks of age. In MPG-treated animals the depletion of follicles was significantly less pronounced and obviously MPG to some degree protected the ovaries from radiation damage. PMID- 1777249 TI - Radiotherapy of metastatic spinal cord compression. PMID- 1777250 TI - Carcinoma of the anal canal in a patient with AIDS. PMID- 1777251 TI - Incomplete Currarino syndrome with a presacral leiomyosarcoma. PMID- 1777252 TI - Further study on selective transmission of mitochondrial DNA in heteroplasmic lines of Drosophila melanogaster. AB - The temperature-dependent transmission of mitochondrial DNA (mtDNA) was investigated in heteroplasmic lines of Drosophila melanogaster established by germ-plasm transplantation. Using D. melanogaster, D. simulans and D. mauritiana as germ-plasm donors, five recipient-donor combinations of heteroplasmy, differing from those previously examined (Matsuura et al., 1991), were constructed. For intraspecific reciprocal combinations, donor mtDNA in one combination was retained at 25 degrees C but was almost lost by the tenth generation at 19 degrees C. In the reciprocal, the proportion of the same type of recipient mtDNA decreased more quickly at 19 degrees C than 25 degrees C. Decreasing rates at 19 degrees C in the reciprocals differed from each other. For interspecific combinations, two species were used as germ-plasm donors. Donor mtDNA derived from D. simulans was lost at both temperatures and the rate of decrease was greater at 19 degrees C than 25 degrees C. The proportion of donor mtDNA derived from D. mauritiana increased at a greater rate at 25 degrees C than 19 degrees C when using two different strains of D. melanogaster as recipients. These results suggest that both the nuclear and two types of mitochondrial genomes are involved in the selective transmission of mtDNA. PMID- 1777253 TI - Mutability of constitutive heterochromatin (C-bands) during eukaryotic chromosomal evolution and their cytological meaning. AB - A quantitative analysis of the alterations of constitutive heterochromatin in eukaryotic chromosomal evolution was attempted using the accumulated C-banding data available for mammals, amphibians, fish, ants, grasshoppers, and plants. It was found that these eukaryotes could be classified into two types by their C banding patterns: 1) Type I included mammals, fish, and ants, and 2) Type II included amphibians, grasshoppers, and plants. C-bands were rather scarce in Type I eukaryote chromosomes and were found around the pericentromeric region when present at all, whereas the predominance of interstitial or terminal C-bands was found in Type II eukaryote chromosomes. The Type I and II C-banding patterns can best be interpreted by assuming that in the former group of eukaryotes the saltatory increase in constitutive heterochromatin occurs preferentially at the pericentromeric regions of telocentric chromosomes induced by centric fission, with C-bands being eliminated almost completely by centric fusion and/or pericentric inversion. On the other hand, C-bands appear in the Type II eukaryotes both interstitially and in the telomeric regions of chromosomes, and there may be no effective mechanism to eliminate these bands once they are integrated. PMID- 1777254 TI - [Surgical treatment of congenital mitral valve insufficiency]. AB - The experience of surgical treatment of 55 congenital mitral incompetence patients aged 3 to 34 years is analysed. Patients with the anomalies of the conotruncus, mitral stenosis, and open atrioventricular conduit were not included into the analysis. The preoperative clinical status of all the patients was evaluated as functional class III-IV. Twenty-one patients had attendant septal defects. Lung hypertension of group II was seen in 14 patients and of hemodynamic group IIIA in five patients. Pronounced disorders of intracardiac hemodynamics and circulatory impairments were indications to an operation. Failure of the mitral valve to close was secondary to several developmental defects. Deformities of the septa and of the chordal and papillary apparatus varied greatly. The mitral incompetence degree was aggravated in most patients by dilatation of the fibrous ring. The diversity of the morphological causes underlying mitral incompetence dictated a strictly individualized approach to the choice of the type and volume of a surgical intervention. Ten of the 55 patients underwent mitral valve replacement; various types of valvuloplasty were done to 45 patients. General hospital mortality rate was 10 percent; good and satisfactory outcomes were seen after reconstructive operations. Analysis of the outcomes of surgery for congenital mitral incompetence has shown that reconstructive operations on the valve are effective enough and may be recommended as a method of choice. Annuloplasty is required in most reconstructive procedures; in young children preference should be given to suture annuloplasty. PMID- 1777255 TI - [10 years' experience of heart valve bioprostheses. Present status and future development]. AB - Long-term results of mitral valve replacement with bioprostheses of three original designs are overviewed. Refinement of the supporting framework design, and of modelling and conservation methodologies has made it possible to improve the survival rates and provided for the absence of specific complications in two groups of patients. Experimental evidence allows for anticipating an increase in the terms of bioprostheses performance. PMID- 1777257 TI - [Basic results of studies of acute circulatory disorders and further steps in the study of cardiac insufficiency]. PMID- 1777256 TI - [Adaptive transformation of the architectonics of the left ventricle at long periods following implantation of an apico-aortic conduit (based on data from an experimental study)]. AB - An original morphological study has been conducted to identify the mechanisms underlying the morphofunctional transformations of the left-ventricular structures taking place at late terms after implantation of the apico-aortal conduit. Analysis of the moulds of the left-ventricular cavity has convincingly demonstrated the peculiar changes in its structures bringing about alterations in the blood ejection mechanism on creation of a new outflow tract from the left ventricle of the heart. The conclusions derived from this work are essential not only for implantation of the apico-aortal conduit but for understanding the mechanisms of blood ejection in some congenital heart diseases. PMID- 1777258 TI - [Massive arterial air embolism--a complication of heart surgery with extracorporeal circulation (clinical picture, prevention, treatment)]. AB - Based on the literature data, the discussion covers the causes, preventive measures, and treatment of massive arterial air embolism, which is one of the most dangerous complications of artificial circulation (AC). Cerebral retroperfusion, hyperbaric oxygenation, low-temperature AC, and long-term administration of antihypoxic agents in the postoperative period have been considered most effective in the management of air embolism. The authors present their experience of successful management of four massive arterial air embolism cases, which is 0.22 percent of AC-assisted operations performed since 1984. Combined retrograde cerebral reperfusion and hypothermic AC have been used in the cases under discussion. Since it is impossible to determine the extent of embolism-associated brain damage and the limits of reliability of the applied therapy, it is essential in each embolism case to make use of all therapeutic means that are available in the given situation to combat this grave complication. PMID- 1777259 TI - [Possibilities of the combined use of transesophageal electrostimulation of the heart and physical load in the diagnosis of paroxysmal reciprocal atrioventricular tachycardia]. AB - Possibilities of using transesophageal electrostimulation of the heart in combination with a physical load were studied in 38 patients with paroxysms of reciprocal atrioventricular (AV) tachycardia. The study has shown that the physical load exerts a pronounced influence on the induction, persistence, and electrophysiological parameters of AV tachycardia, significantly increases the functional capacity of the anterograde conduction along the anomalous tract, and reduces the efficacy of vagal techniques in alleviating paroxysms of AV tachycardia. PMID- 1777260 TI - [Frame-mounted anastomosis of veins using a microsurgical technique and demineralized tubular allobone]. AB - The experimental-morphological analysis covers the results of 62 operations for establishment of major vein anastomosis. In three series of experiments microsurgical suturing was used, while the control series employed the techniques of general surgery. In the microsurgery group, the best outcome (100 percent patency without anticoagulant administration) was achieved in cases when the venous anastomosis was protected by the demineralized tubular bone. Good outcomes were seen in cases with application of the original technique of mounting the venous anastomosis on rings of tubular bone. The advantages of microsurgical frame-mounted suturing of major veins over the general surgical techniques are demonstrated. PMID- 1777261 TI - [An experimental study of biomaterials resistant to calcinosis and thrombosis]. AB - Creation of hemocompatible materials resistant to calcinosis for plastic cardiosurgery call for employment of combined methods of their evaluation in experiment. The present study deals with some biochemical and physico-chemical aspects of biomaterial calcification inhibition on reduction of their porosity by means of N-vinylpyrrolidone, and also on immobilization of diphosphonates, phosphonates, and anti-aggregants. The method of radiation copolymerization was employed for immobilization of active agents. The effects of different biotissue specimens of varying modifications (pig aortal valves and cattle pericardium) and of Lavsan (polyethyleneterephthalate) on coagulation factor activation were studied in vivo (in goat) and in vitro. The specimen surface was inspected prior to and after the contact with blood and plasma using the techniques of scanning electron microscopy and photoelectron spectroscopy. The influence of the modifications on the calcium and phosphorus accumulation were studied after subcutaneous implantation of the specimens to rats, and the aggregating capacity of blood platelets was determined in incubation of Lavsan treated with an anti aggregant. Combined studies revealed the optimal modification routine and the most active agents enabling one to obtain biomaterials that not only are resistant to calcification but also possess good hemocompatibility. PMID- 1777262 TI - [The immunomodulators levamisole and dibazole in the prevention of acute postoperative pleural empyema as one method of preoperative preparation]. AB - Numerous methodologies had been suggested to prevent postoperative pyothorax, but the tendency towards reduction in the incidence of this condition couldn't be seen. Forty patients with different lung diseases (malignant tumours, abscesses, bronchiectases) were examined. Twenty patients received low-dose levamisole and dibazole pre- and postoperatively, while to the remaining 20 patients these immunomodulators were not administered. All the 40 patients underwent radical operations. Immunoassay was undertaken in both groups in the preoperative period and at days 7, 14, and 21 postoperatively. As a result it was found that the group of patients devoid of immunoprophylaxis showed development of pyothorax in 5 percent of the cases. The groups of patients exposed to preventive measures including low doses of levamisole and dibazole did not show septic complications in the pleural cavity. PMID- 1777263 TI - [Thoracomyoplastic operations in the surgery of tuberculosis of the lungs]. AB - Different variants of thoracomyoplasty were performed on 532 patients with fibrous-cavernous tuberculosis and tuberculous empyema of the pleura. Treatment outcomes have shown that the range of applications of thoracomyoplastic procedures is wide enough: (1) as an independent procedure; (2) as prevention of postresection complications; and (3) as one-stage method to eliminate caverns and empyemas in the presence of bronchial, esophageal, thoracic fistulas and defects of the chest wall. Improvement of the operative technique, application of new technical means enable one to increase the efficacy of surgical treatment of patients with common and complicated tuberculosis of the respiratory organs and chronic non-specific diseases of the lungs. PMID- 1777265 TI - [A combination of Fallot's tetralogy and double aortic arch: a successful 2-stage correction]. PMID- 1777264 TI - [Disorders of trace element metabolism and their correction using artificial nutrition in patients with cancer of the esophagus in the preoperative period]. AB - Findings of research into disorders of the micronutrient exchange in esophageal carcinoma patients are overviewed. The micronutrient level in the plasma, erythrocytes, and urea was estimated by means of emission plasma spectroscopy. Patients with esophageal carcinoma were found to have pronounced changes in the micronutrient exchange on their admission into the clinic. These changes were corrected by means of artificial nutrition, which included preparations with directed action and micronutrients. After the course of therapy a tendency towards normalization of the micronutrient exchange was observed. PMID- 1777266 TI - [Balloon catheter mitral valvuloplasty in a patient with mitral stenosis and paroxysmal nodular tachycardia]. PMID- 1777267 TI - [Removal of a giant coelomic cyst of the pericardium and mitral commissurotomy]. PMID- 1777268 TI - [Use of a delayed suture of the sternum in the treatment of acute cardiac insufficiency]. PMID- 1777269 TI - [Penetrating knife wound of the chest wall with multiple wounds of the lung and wounds of the infra-lobar branch of the pulmonary trunk in a 7-old child]. PMID- 1777270 TI - [Extirpation of the trachea with autoplasty using left lung bronchi]. PMID- 1777271 TI - [Report of the symposium on the use of the preparation vasoprostan in the treatment of arterial occlusive diseases of the extremities (meeting report)]. PMID- 1777272 TI - The role of ethnic monitoring in general practice. PMID- 1777273 TI - Continuing education for general practice: a life long journey. PMID- 1777274 TI - Factors influencing waiting times and consultation times in general practice. AB - Using data collected from 85 general practitioners in Lothian, large variations were found in the time patients wait for and spend with their doctor. This study, which sets consultations into their administrative framework, examines factors which cause this variation. Consultation time was found to be affected by the total number of patients attending a particular surgery, while waiting time was found to be affected by an individual patient's place within that surgery queue. Taking these two results together suggests that patients seen at the end of large surgeries are likely to get a different service from their doctor than they would have done earlier in the session, or when attending a less busy surgery. Possible strategies are discussed for reducing average waiting times, thereby decreasing the relative cost of consultation to patients. PMID- 1777275 TI - Factors affecting women's response to an invitation to attend for a second breast cancer screening examination. AB - A survey was conducted to study the impact of women's previous experiences of breast cancer screening on their subsequent readiness to reattend. Women aged 45 64 years from three general practices were invited to attend for a second breast cancer screening test at a mobile clinic. Of the 1582 women who were invited, 1408 (89.0%) reattended. A questionnaire about their experience of the previous screening test was completed by 641 women who attended and 124 who did not attend the second test. Twenty six per cent of the women had found the previous test painful, and a minority also reported embarrassment (7%) or distress (6%). Women who did not reattend were significantly more likely than those who did to report the previous screening test as embarrassing or distressing and were significantly less likely to have found the clinic staff helpful or attendance for screening worthwhile or reassuring. No significant difference was found in the reattendance rate of women who had experienced a false positive result at the previous screening test compared with the remaining women. These results show that there may be substantial scope for reducing non-attendance by improving the way the service is provided, thereby enhancing the overall impact of breast cancer screening. PMID- 1777276 TI - General practitioners' experience of the chronic fatigue syndrome. AB - In order to examine the prevalence of patients with symptoms fulfilling the criteria for the chronic fatigue syndrome an extensive survey was carried out of general practitioners on 10 local government lists in two health boards (91% response rate). At the same time practitioners' attitudes to the syndrome and their experience in terms of workload and the characteristics of patients affected were documented. The majority of general practitioners (71%) accepted the existence of chronic fatigue syndrome, but 22% were undecided. The doctors reported a prevalence among their patients of 1.3 per 1000 patients (range 0.3 2.7 for the 10 areas) with a peak in the 30-44 years age group. Female patients were more commonly affected than males (sex ratio 1.8:1.0), but the severity of illness and the use of general practitioner's time was the same among male and female patients. Patients in occupations where they were exposed to infection were affected (teachers and students, 22% of sample; hospital workers, 7%), but many patients were unskilled (8%) and skilled workers (9%). Patients suffering from the chronic fatigue syndrome appear to be a real and distinct group for general practitioners and may represent a substantial part of the workload of doctors in particular areas. PMID- 1777277 TI - Differences in the attitudes of men and women practitioners to responsibility and competence. AB - A study has been carried out to predict the prescribing and referral behaviour of general practitioners by measuring their attitudes to their roles. Part of this study involved determining whether women doctors accept greater responsibility and feel more competent than men when undertaking those tasks for which they are said to be suited. In May 1987 a postal questionnaire was sent to all 525 general practitioners in contract with Avon family practitioner committee. Replies from 82 women and 289 men showed that women accepted more responsibility for sex related tasks. For other medical tasks, including those of a technical and traditional nature, men accepted both more responsibility and felt more competent than did women respondents. Contrary to expectations, women did not accept more responsibility or feel more competent than men for psychosocial tasks. The results are discussed in the context of the role of women within medicine. PMID- 1777279 TI - The psychiatric discharge summary: a tool for management and audit. AB - The aims of this study were to review the information needs of general practitioners in relation to the discharge of mentally ill patients; to design a discharge summary that would meet these needs and evaluate its use by junior hospital staff; and to assess the usefulness of this summary for audit. The information needs of general practitioners were identified from a review of the literature and from discussions with local general practitioners. A prototype discharge summary was designed and reviewed by a panel of general practitioners, regional advisors and course organizers from the south east Thames region. It was used for all patients discharged from the acute psychiatric ward in Hither Green Hospital over a 10 month period. One copy was given to the patient to take to the general practitioner, one was posted to the general practitioner and a final copy was kept in the patient's hospital records. The senior house officers found the summary easy to complete. It reduced uncertainty about what data to provide, and helped to focus on the most critical information needed by general practitioners for continuity of care. Using a pre-coded data collection sheet, analysis of the information on the summaries was easily done. It provided a rapid audit of caseload, diagnoses, therapy, methods of admission and discharge, length of stay, risk factors and roles of all involved in future management. This information can be of use to the psychiatric team, general practitioners and hospital managers and could be the first step towards the development of shared care. PMID- 1777278 TI - Patients' choice of general practitioner: importance of patients' and doctors' sex and ethnicity. AB - The relative importance of sex and ethnicity in patients' choice of doctor is not known. A total of 1633 consultations at a health centre in Bradford, with a mixed ethnic list, were examined over a four week period to test the relative importance of these variables. Patients had the choice to consult any one of: a male Asian, a male white or a female white doctor. Asian patients, irrespective of sex, were significantly (P less than 0.001) more likely to consult the Asian doctor then either of the other two doctors, though a greater proportion of Asian women than men consulted the female white doctor. Although the sex of the doctor was important in patients' choice, for Asian patients the doctor's culture and language were more important. PMID- 1777280 TI - Patients not seen in three years: will invitations for health checks be of benefit? AB - An attempt has been made to evaluate the evidence for the likely benefit or otherwise, of the obligatory three-yearly checks as defined within the terms of service for doctors in general practice introduced to British general practitioners in April 1990. The content, interval, age groups, ethics, organizational cost, yield and outcome of the three-yearly checks are examined. No particular evidence is apparent which should deflect general practice from its present opportunistic approach to screening, and the already established national screening programmes. PMID- 1777281 TI - Telephone answering times in NHS hospitals. PMID- 1777282 TI - Primary care management of urinary tract infection in children. PMID- 1777283 TI - Computer assisted learning for general practice. PMID- 1777284 TI - Curettage and cautery of skin conditions in general practice. PMID- 1777285 TI - Longer booking intervals in general practice: effects on doctors' stress and arousal. PMID- 1777286 TI - Training in general practice: the other side of the coin. PMID- 1777287 TI - Asthma care in general practice--time for revolution? PMID- 1777288 TI - Which antidepressant? PMID- 1777289 TI - Sampling endocervical cells on cervical smears. PMID- 1777290 TI - Management of weight problems. PMID- 1777291 TI - Patient participation groups. PMID- 1777292 TI - Working in partnership with nurses. PMID- 1777293 TI - AIDS: knowledge, skills and attitudes among vocational trainees and their trainers. AB - In order to assess the adequacy of learning about the human immunodeficiency virus (HIV) and the acquired immune deficiency syndrome (AIDS) in vocational training for general practice, a postal questionnaire survey was carried out among trainers and their trainees in seven health regions of England and Scotland. A total of 616 trainers (62%) and 538 trainees (58%) responded to the questionnaire asking about their knowledge, skills and attitudes regarding HIV and AIDS. Trainees' principal difficulties with HIV and AIDS resembled those of general practitioners currently in practice. More than 60% of trainees lacked knowledge about HIV and AIDS in babies, 50% would not accept intravenous drug misusers onto their list, only 12% found it easy to discuss sex with homosexual male patients, and only 37% felt able to offer counselling about HIV and AIDS. Trainees who had had a tutorial on HIV and AIDS as part of vocational training were significantly more knowledgeable than the remainder (P less than 0.01). In addition, trainees who found workshops on HIV and AIDS useful were more willing than others to take on drug misusers (P less than 0.05) and more confident in their ability to counsel patients with HIV infection (P less than 0.01). No significant associations were found between the trainers' own knowledge, attitudes and skills regarding HIV and AIDS and those of their trainees. It is concluded that there is a need to improve teaching about HIV and AIDS in vocational training for general practice. All general practitioner trainees should receive a tutorial to update their knowledge about HIV and AIDS, and attend a suitable workshop to challenge unfavourable attitudes and improve confidence in counselling. PMID- 1777295 TI - Management of acute asthma attacks in general practice. AB - A prospective study was carried out in a semirural group practice between June 1988 and December 1989 to investigate acute asthmatic attacks treated with nebulized salbutamol. Questionnaires were completed by the attending doctor and by the patient (or his or her parent). Sixty nine episodes, occurring in 52 patients, were recorded during the 18 month study period. The majority of the attacks were managed exclusively in the community, with hospital admission occurring on only three occasions, one patient being admitted twice. A large proportion of the patients had a severe attack of asthma as judged by their previous history. Oral steroids were prescribed in 62.3% of attacks, oral theophyllines in 31.9% and antibiotics in 37.7%; the salbutamol nebulizer was used on more than one occasion during 41.2% of attacks. Significant morbidity was experienced by the patients during the studied attack, with 85% suffering sleep disturbance and two thirds being unable to attend work or school. Only 52.5% of patients were on prophylactic treatment and 37.5% of the patients had discontinued some aspect of their asthma therapy in the three months prior to the attack. Patients' and doctors' views about the cause of the attacks differed widely: patients most commonly cited infection (26/41) and allergy (8/41) with only two patients citing poor compliance or inadequate treatment. Although doctors also attributed the cause of many attacks to infection (33/64), they cited poor compliance or inadequate treatment in 28 of 64 responses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777294 TI - Two-year follow up of the management of chronic or recurrent cough in children according to an asthma protocol. AB - To test the hypothesis that many children with a chronic or recurring cough have asthma, 106 children with cough were treated according to an asthma protocol. At the end of 16 weeks, all but two of the children who completed this phase of the trial were free of cough. At a two-year follow up 97 children were reviewed: 71 were now diagnosed as having an asthmatic condition, 34 of whom required regular medication. The original histories of those who developed asthma were compared with those who had no further respiratory symptoms. The results suggest that many children with a chronic or recurring cough have a mild form of asthma, known as cough variant asthma, which is responsive to asthma therapy. Many will subsequently develop mild to moderately severe asthma. Those who subsequently develop an asthmatic condition are statistically more likely to have a family history of asthma or a personal history of atopy. The children are also more likely to have exercise-induced cough or nocturnal exacerbation of their cough. Managing a persistent or recurring cough according to an asthma protocol could mean that many asthmatic children will be diagnosed and treated earlier in the natural history of their illness. PMID- 1777296 TI - Assessment of a screening process to detect patients aged 60 years and over at high risk of hypothyroidism. AB - General practitioners are increasingly expected to screen elderly patients for common disorders, such as hypothyroidism, and the identification of at-risk patients by simple means would reduce the financial and other costs of such screening. A general practice based study of 1193 patients aged 60 years and over has been carried out to investigate the usefulness of the following factors in identifying those in whom biochemical testing for hypothyroidism would be indicated: personal history or family history of thyroid disease, symptoms of thyroid disease and body mass index. Of the 190 patients with either a personal or family history of thyroid disease, 28 (14.7%) had an elevated concentration of thyroid-stimulating hormone. Thus, 66 of the 94 patients (70.2%) with elevated concentrations of thyroid-stimulating hormone had no such thyroid history. Similarly, only nine (4.7%) of the patients with a personal or family history of thyroid disease required thyroxine replacement therapy. Thus, 22 of the 31 patients (71.0%) requiring such treatment had no such history. Discriminant analysis of the responses of women patients to questions concerning personal or family history of thyroid disease, the presence of symptoms of hypothyroidism, their age and body mass index identified only 51.3% of those with an elevated thyroid-stimulating hormone concentration and 77.2% of those with normal thyroid stimulating hormone. Analysis of the responses of the men patients was even less discriminating.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777297 TI - Self help programme for anxiety in general practice: controlled trial of an anxiety management booklet. AB - Behavioural methods of treating anxiety have been shown to be highly effective but are not widely available in general practice where most people suffering from anxiety are treated. This study reports a development in service delivery which is simple, inexpensive and does not make great time demands on general practitioners or require them to extend their training and expertise. The study shows that for patients suffering from panic disorder or generalized anxiety disorder the use of an anxiety management booklet in addition to their usual treatment from their general practitioner produces clinically and statistically significant improvements. Of particular importance is the speed of response to the booklet. Within the first two weeks those patients who received the booklet were significantly less anxious than the controls. The booklet was acceptable to patients and recommendations are made about how to incorporate it into clinical practice. PMID- 1777298 TI - The menopause and hormone replacement therapy: views of women in general practice receiving hormone replacement therapy. AB - Women's views on the menopause and hormone replacement therapy were explored using a questionnaire given to women attending one general practice who were having hormone replacement therapy under the supervision of their doctor. Sixty four women (67%) responded. Although only 5% of women had requested hormone replacement therapy from their general practitioner the majority of women indicated that they had been helped by hormone replacement therapy. Eight per cent of women were using hormone replacement therapy primarily to treat menopausal symptoms with only 6% of women using it primarily as prophylaxis against osteoporosis. Many women were correctly informed about the effects of hormone replacement therapy but mistaken beliefs about its side effects may indicate the need for further health education. The desire for further information was striking: 59% of women wanted further information about hormone replacement therapy, and 80% of women would have liked to have had more information about the menopause before its onset. The media appeared to be an important source of information about health matters: 61% of women obtained information about hormone replacement therapy from either the television, magazines or newspapers. The role of the media and health workers in health education is discussed. PMID- 1777299 TI - Spirituality, healing and medicine. AB - The natural science base of modern medicine influences the way in which medicine is delivered and may ignore the spiritual factors associated with illness. The history of spirituality in healing presented here reflects the growth of scientific knowledge, demands for religious renewal, and the shift in the understanding of the concept of health within a broader cultural context. General practitioners have been willing to entertain the idea of spiritual healing and include it in their daily practice, or referral network. Recognizing patients' beliefs in the face of suffering is an important factor in health care practice. PMID- 1777301 TI - Sudden infant death syndrome. PMID- 1777300 TI - Lay epidemiology and the rationality of responses to health education. AB - Health education has long been seen as an important component of primary care, and under the new contract has become routine. It is important to consider the likely impact of general practitioners' endeavours in the light of the experience of health education to date. Despite decades of efforts directed towards reducing the population's adherence to practices deemed harmful to health, it must be acknowledged that the impact of such activity has been disappointing. This paper considers some cultural origins of public scepticism to health education messages, and argues for a more balanced presentation of current knowledge concerning the causes of disease and the probability that individuals will benefit by changing their behaviour. PMID- 1777304 TI - Measurement of capillary cholesterol in hyperlipidemia. PMID- 1777303 TI - Health checks in general practice: a comparison of two invitation letters. PMID- 1777302 TI - Management of needlestick injuries. PMID- 1777305 TI - Cryotherapy ineffective for ingrowing toenails. PMID- 1777306 TI - Asthma care in general practice. PMID- 1777307 TI - Premenstrual syndrome. PMID- 1777308 TI - Curettage and cautery of skin conditions in general practice. PMID- 1777309 TI - Doctors and pharmacists--working together. PMID- 1777310 TI - General practitioners and work in the third world. PMID- 1777311 TI - What patients think of the way their doctor dresses. PMID- 1777313 TI - Cervical smears: reaching the target payment level. PMID- 1777312 TI - Stroke and the carer. PMID- 1777314 TI - Irritable bowel syndrome. PMID- 1777315 TI - [Regional Ethics Committee--experiences from REC I]. PMID- 1777316 TI - [The NSF in Europe. Norwegian Nurses' Association and the EEC]. PMID- 1777318 TI - [Answer to a summons for discussion. Are we the architects of our health?]. PMID- 1777317 TI - [Everyday routines. Advice about hand hygiene for health personnel]. PMID- 1777319 TI - [Practice as professional enhancement for nursing faculty--necessary to remain professionally up-to-date?]. PMID- 1777320 TI - [Nordland model--we put the words to practice!]. PMID- 1777321 TI - [Pelvic instability--painful women's illness without status]. PMID- 1777322 TI - [The use of catheters. Clean intermittent catheterization]. PMID- 1777323 TI - [New field of work. Liver transplantation]. PMID- 1777325 TI - [Quality in nursing. Project "Quality assurance in nursing services". Status report]. PMID- 1777324 TI - [Focus on theory. Nursing sciences--nursing care themes and consumer competence]. PMID- 1777326 TI - [Quality in nursing. Clearer duties and rights. Interview by Siv Barstad]. PMID- 1777327 TI - [Senile dementia in community health services in Vestfold 1989-90. Occurrence and need for protective units]. PMID- 1777328 TI - [Epilepsy. It does not show on the outside]. PMID- 1777329 TI - [AIDS in Africa. Team work with medicine men and birth attendants]. PMID- 1777330 TI - [Pharmacology (12). Pain-killing agents--history]. PMID- 1777331 TI - [Care at life's end]. PMID- 1777332 TI - [A communication model. Children with cancer need understanding. How to communicate with kindergartens, schools and school friends]. PMID- 1777333 TI - [Epilepsy. Personal contact]. PMID- 1777334 TI - [Epilepsy--not what I am]. PMID- 1777335 TI - [Diabetic ulcer--causes and treatment]. PMID- 1777336 TI - Predictors of relapse in sexual practices among homosexual men. AB - Selected sociodemographic, psychosocial, and behavioral variables were used to predict maintenance or relapse in sexual practices over a 1-year interval in a cohort of homosexual men in Chicago. Univariate analyses and multivariate logistic regression were used to define predictive models for safer practices separately for insertive and receptive and sex. Demographic and psychosocial variables were not associated with subsequent relapse. Neither was HIV serostatus. Using more rigorous multiple logistic regression, only monogamous relationships, less peer support, and less assertiveness in negotiating safer sex appeared to predict relapse to less safe practices. The importance of interpersonal variables and social norms for future interventions among homosexual men is discussed. PMID- 1777337 TI - Dedicated to the memory of Ronald R. Jerrell. PMID- 1777338 TI - Sexual risk behavior, AIDS knowledge, and beliefs about AIDS among predominantly minority gay and bisexual male adolescents. AB - Current sexual risk behavior, AIDS knowledge, and beliefs about AIDS prevention were examined among 59 black and Hispanic male adolescents attending a community center for gay and lesbian youth. Most (73%) were sexually active in the last 3 months, with a median of 2.0 partners and with only 21% reporting consistent condom use. These youths demonstrated moderately high AIDS knowledge (82%) and positive beliefs endorsing AIDS prevention (71%). When risk pattern was defined on the basis of partners, risk acts, and condom use, positive AIDS prevention beliefs were significantly and inversely associated with the high-risk pattern, but not with abstinence. These results suggest that youths who frequently engage in high-risk acts need intervention targeting changes in beliefs and behavior, as well as knowledge. PMID- 1777339 TI - The impact of experience with AIDS on HIV testing and counseling practices: a study of U.S. infectious disease teaching hospitals and Minnesota hospitals. AB - A survey on HIV antibody testing practices was sent to the 200 hospitals in the United States that conduct infectious disease (ID) fellowship training and to all 171 short-term care Minnesota hospitals. Responses were obtained from 124 U.S. ID hospitals (62%) and from 133 (78%) Minnesota hospitals. The U.S. ID hospitals estimated that consent for HIV antibody testing is obtained 70.1% of the time, that consent is both obtained and documented 54.3% of the time, and that risk reduction counseling in conjunction with such testing is provided 51.4% of the time. The Minnesota hospitals estimated that consent for HIV antibody testing is obtained 35.2% of the time, that consent is both obtained and documented 25.7% of the time, and that risk-reduction counseling in conjunction with such testing is provided 21.8% of the time. Wide variance was noted in both the U.S. and Minnesota responses. Those U.S. hospitals serving higher numbers of persons with AIDS gave higher estimates for each of the 3 items (p less than .05); similar findings were noted among the Minnesota hospitals. The data suggests that standard clinical use of HIV testing remains deficient. PMID- 1777340 TI - Public perception of risk of AIDS in health care settings. AB - Our nationwide telephone survey conducted in 1988 (n = 2,000) reveals that the public perceives a considerable risk of contracting AIDS during routine transactions in health care settings. In addition to previously noted public concerns about getting infected with the AIDS virus through blood transfusions and blood donations, respondents also think that AIDS can be transmitted through contact with HIV-infected health care workers during routine treatment in medical or dental offices and in hospital emergency rooms. Effective education programs must be developed to address these public concerns. PMID- 1777342 TI - Effects of subject variables on attitude change and knowledge acquisition in an AIDS education program. AB - The need for improved knowledge and attitudes about HIV infection and HIV infected clients has been documented, as has the effectiveness of AIDS education programs in affecting change in these characteristics of health care workers. Analyzing a sample of 336 health care providers, the current study assessed the impact of subject variables on knowledge and attitude change for health care providers after educational programs of 4 to 8 hours. Results indicated that several subject characteristics were significantly related to pretest levels of attitudes and knowledge. However, these same subject variables did not affect the degree of change on the attitude and knowledge scales. The importance of AIDS educators understanding the impact of subject variables on change is discussed. PMID- 1777343 TI - AIDS knowledge, perception of risk, and behaviors among female sex partners of injection drug users. AB - Interviews were conducted with 137 female sex partners of male injection drug users to provide quantitative and qualitative information regarding their AIDS knowledge, attitudes, and specific risk behaviors. Levels of knowledge regarding HIV transmission and prevention were high, with an average of 81.8% correct on a 16-item test. Most women (87.5%) believed that there was at least some chance they would become HIV infected. Substance abuse was prevalent; 67.2% used non injection drugs (44.5% used crack cocaine), and 32.1% reported prior use of injection drugs. One fifth had engaged in prostitution. Although AIDS knowledge was high, almost all (94.9%) reported engaging in unprotected vaginal intercourse during the previous 6 months, and 6.6% reported anal intercourse without a condom. Among women who did not report consistent condom use, the most frequently stated reasons for non-use of condoms were dislike by their male partner (26.9%) and/or personal dislike of condoms (23.1%). A disturbing pattern of increased risk was observed among black interviewees, who were more likely than Latinas or whites to have contracted syphilis, have multiple sex partners, engage in prostitution, use crack cocaine, and drink alcohol daily. PMID- 1777341 TI - Pregnancy, STDS, and AIDS prevention: evaluation of New Image Teen Theatre. AB - New Image Teen Theatre combines peer education and theatre in an informative and entertaining package. This study was undertaken to assess the effectiveness of New Image Teen Theatre on altering teenagers' attitudes, knowledge, and intentions regarding sexual behavior. A total of 143 adolescents between the ages of 13 and 19 viewed the performance. The performance focused on the prevention of pregnancy, AIDS, and STDs and included content aimed at increasing communication. Teen participants completed pretest and posttest questionnaires. Almost half of the adolescents reported having engaged in sexual intercourse. About one third of the sexually active reported never using birth control, and only 21% reported consistent use of condoms. These results confirm adolescents' risk for pregnancy, STDs, and AIDS in particular. Following the performance, the teens reported significantly more willingness to discuss sexual issues with others, significantly greater intention to use birth control (for sexually active teens), and demonstrated significantly greater sexual knowledge. Furthermore, they indicated that they had experienced more positive emotions than negative emotions while viewing the production. Results suggest that theatre education may set the stage for more comprehensive interventions designed to prevent pregnancy, STDs, and AIDS. PMID- 1777344 TI - AIDS risk knowledge, attitudes, and behavioral intentions among multi-ethnic adolescents. AB - The purpose of this study was to determine how much young adolescents know about AIDS and AIDS risk and to identify areas of confusion that might serve as important targets of educational intervention. A multiethnic (43% white, 33% black, 18% Latino) sample of 303 seventh-grade students (48% male) in 3 schools in the greater New York area completed questionnaires assessing knowledge, attitudes, and behavioral intentions concerning AIDS and AIDS risk. Consistent with previous studies with older adolescents, the major finding in this study was that young adolescents had a high degree of knowledge concerning AIDS and AIDS risk. There were 2 areas of confusion concerning AIDS risk. Specifically, 31% of adolescents did not correctly identify "not having sex" as the most effective way of preventing AIDS, and 33% believed that AIDS could be spread through casual contact. Findings are discussed in terms of their implications for prevention. PMID- 1777345 TI - AIDS education resource materials for second level schools produced by the Departments of Health and Education in Ireland. PMID- 1777346 TI - [Immunogenetics: the clinical and population aspects. The complement system (4.)]. PMID- 1777347 TI - [Medical complications connected with the use of drugs]. AB - Aside from disease induced by the direct pharmacological effect of heroin or cocaine, the occurrence of several medical complications not directly related to the drug itself is becoming an increasingly serious problem. In addition to the well-known occurrence of infective diseases, including AIDS, related to the i.v. use of heroin, heroin addicts also seem significantly more at risk for chronic nephropathy. Amyloidotic nephropathy is especially frequent in addicts who use heroin by subcutaneous route (skin popping); it seems to be mediated by an immunologic mechanism. Amyloidotic nephropathy is the main cause of renal failure among drug addicted subjects. Cardiovascular and cerebrovascular diseases are the most frequent medical complications observed in cocaine users. However, the occurrence of infective disease, such as endocarditis or hepatitis related to the parenteral use of the drug, is becoming frequent in these patients. Pulmonary disease is also common due to the route of administration of crack. These medical complications of drug addiction belong to the specific field of internal medicine and should be promptly recognized and treated by the physician. PMID- 1777348 TI - Emerging strategies for the prevention and treatment of diabetic eye disease. AB - Diabetic retinopathy (DR) is the major cause of blindness in the working age groups of industrialized countries, and a programme has been launched by the World Health Organization (WHO) and the International Diabetes Federation (IDF) to reduce its morbidity in Europe. Retinopathy progresses slowly, and even when it becomes sight-threatening, may not present visual symptoms. When symptoms do occur, it is often too late to restore full vision or to stop further deterioration by retinal photocoagulation. For photocoagulation to be maximally effective, treatable sight-threatening retinopathy must be identified while still asymptomatic by means of regular fundus examination of all diabetic patients. Given the absence of effective medical treatment, prevention of retinopathy depends on mass screening. The WHO and IDF recommend that internists in charge of diabetic patients perform a fundus examination at least every two years if retinopathy is absent, or as frequently as necessary otherwise. Patients at risk should be referred for assessment and treatment to ophthalmic facilities. Either direct ophthalmoscopy or retinal photography are suitable methods. The setting up of nation-wide screening programmes is essential for coordinated action. Pilot studies have proven that screening is an effective means for decreasing diabetes related blindness and the human and social costs attached to it. PMID- 1777349 TI - ECG-gated thallium-201 myocardial SPECT in patients with old myocardial infarction compared with ECG-gated blood pool SPECT. AB - We evaluated one of the merits of ECG-gated thallium-201 single photon emission computed tomography (g-T1 SPECT), i.e., the ability to appreciate left ventricular (LV) wall motion. LV wall motion assessed by g-T1 SPECT and by ECG gated Blood Pool SPECT (g-BP SPECT) was classified into three grades and compared segment by segment. T1-201 uptake by g-T1 SPECT was also classified into three grades and compared with those of wall motion in g-BP SPECT. Fifty patients with prior myocardial infarction were injected intravenously at rest with 111 to 185 M Bq (3 to 5 mCi) of Tl-201. The left ventricular regions were divided into anterior, septal, inferior and lateral segments (50 patients X 4 segments = 200 segments in total). The grades of wall motion and Tl-201 uptake detected by g-Tl SPECT correlated well with those of wall motion in g-BP SPECT (94.5% and 85%, respectively). With g-Tl SPECT it was possible to evaluate left ventricular wall motion, providing clear perfusion images. PMID- 1777350 TI - Metabolic reserve in normal myocardium assessed by positron emission tomography with C-11 palmitate. AB - Positron emission tomography (PET) with C-11 palmitate has been used in estimating the myocardial utilization of free fatty acid. To assess the metabolic reserve in normal subjects, a PET study was performed at control and during dobutamine infusion at 2 hour intervals in 5 normal subjects. Following monoexponential curve fitting of the time activity curve of the myocardium, the clearance half time (min) and residual fraction (%) were calculated as indices of beta-oxidation of free fatty acid. A significant increase in the heart rate and systolic blood pressure were observed during dobutamine infusion (65 +/- 5 vs 100 +/- 29 bpm, p less than 0.05 and 119 +/- 12 vs 144 +/- 16 mmHg, p less than 0.01, respectively). The clearance half time and the residual fraction were significantly decreased (23.4 +/- 2.6 vs 15.8 +/- 2.3 min and 67.0 +/- 2.5 vs 58.6 +/- 4.0%, P less than 0.05, each). When the left ventricular myocardium was divided into 4 segments, these indices were similar at control and uniformly decreased without regional differences during dobutamine infusion. These data suggest that beta-oxidation of free fatty acid may be uniformly increased in the left ventricular myocardium in relation to the increase in cardiac work in normal subjects. PET with C-11 palmitate at control and during dobutamine infusion is considered to be promising in assessing metabolic reserve in the myocardium. PMID- 1777351 TI - Tc-99m labeled tissue-type plasminogen activator: preparation, stability and preliminary imaging of thrombus-bearing rats. AB - Tissue-type plasminogen activator (t-PA) is a thrombolytic agent that directly binds to fibrin formed in clots. In terms of radiolabeling and nuclear imaging, t PA has several advantages in Tc-99m labeling: it is stable in acidic solution at pH 3, which is suitable for labeling Tc-99m by a method of stannous reduction and blood disappearance after administration is rapid, which is desirable for imaging targets using short-lived radionuclides. Recombinant t-PA was labeled with Tc-99m by a method of stannous reduction without significant degradation of biochemical activity, over 95% of which was retained after the labeling procedure. Labeling efficiency in paper chromatography was over 98%. The moiety of hydrolyzed Tc-99m that was not eluted through the Sephadex column was estimated to be less than 10%. Tc-99m labeled t-PA, however, appeared to become unstable when diluted with normal saline. Nevertheless, in in vitro fibrin binding, Tc-99m labeled t-PA showed high affinity with fibrin: 80% of 100 ng/ml of Tc-99m t-PA bound to 10(-5) mol of the fibrinogen. Preliminary animal studies also showed a concentration of Tc-99m labeled t-PA at fresh thrombi formed in the inferior vena cava. Tc-99m labeled t-PA appears to have potential for thrombus imaging and the preparation of an instant kit. PMID- 1777352 TI - Limited value of delayed radiothallium image in the diagnosis of nodular goiter. AB - To test whether delayed thallium image can improve the diagnostic accuracy of thyroid tumor, we have reviewed 35 patients with cold nodules of proven histopathology. Early and delayed images were taken 10-20 min and 3-4 hr postinjection, respectively. In this study, a thyroid nodule was interpreted as malignant if it had normal or increased uptake on early scan and more residual radioactivity than paranodular tissue on delayed scan. In the eighteen patients who had carcinoma, a disappointing 44% false negative rate was observed. No significant difference was seen between retention-positive and negative cases in tumor size or histological type of cancer. Nor could any demographic bias explain the low sensitivity. Of the six false negatives, macroscopic cystic degeneration was seen in two cases, but tumors in the other four were grossly solid. Considering the histological heterogeneity often seen within a thyroid tumor, the portion with increased retention of radiothallium may be too small to be detected in the false negative cases. Furthermore, 3 false positive readings were obtained in 17 patients with benign conditions. We conclude that the contribution of the delayed thallium image was quite limited in predicting or ruling out malignancy in nodular goiters. PMID- 1777353 TI - Variations in radioimmunoscintigraphic detection of tumor showed by five monoclonal antibodies to carcinoembryonic antigen. AB - Radioimmunoscintigraphy using mouse monoclonal antibodies to various parts of a carcinoembryonic antigen (CEA) molecule was performed. Four radiolabeled antibodies (F4-82, 28A, F3-30, F33-104) were injected into tumor transplanted nude mice to compare the accumulation of these antibodies in tumors. The four antibodies were accumulated selectively in CEA- producing tumors. The tumor visualization correlated with the tumor/blood radioactivity ratio, whereas the tumor/blood radioactivity ratio did not correlate with the in vitro percent binding to tumor cells or the in vivo percent injected dose in CEA-producing tumors. Among the four antibodies, F33-104 showed the highest tumor/blood radioactivity ratio and the best image quality in any CEA-producing tumor. These results suggest that the antibody which has a high tumor/blood ratio rather than high total tumor uptake may be useful for radioimmunoscintigraphy. PMID- 1777354 TI - Comutagenesis of sodium arsenite with ultraviolet radiation in Chinese hamster V79 cells. AB - Solar ultraviolet radiation has been associated with the induction of skin cancer. Recent studies have indicated that near-ultraviolet, especially UVB, is mutagenic. Exposure to trivalent inorganic arsenic compounds has also been associated with increased skin cancer prevalence. Trivalent arsenic compounds are not mutagenic per se, but are comutagenic with a number of cancer agents. Here, we test the hypothesis that arsenite enhances skin cancer via its comutagenic action with solar ultraviolet radiation. Irradiation of Chinese hamster V79 cells with UVA (360 nm), UVB (310 nm) and UVC (254 nm) caused a fluence-dependent increase in mutations at the hprt locus. On an energy basis, UVC was the most mutagenic and UVA the least. However, when expressed as a function of toxicity, UVB was more mutagenic than UVC. Nontoxic concentrations of arsenite increased the toxicity of UVA, UVB and UVC. Arsenite acted as a comutagen at the three wavelengths; however, higher concentrations of arsenite were required to produce a significant (P less than 0.05) comutagenic response with UVB. The increased mutagenicity of UVB and UVA by arsenite may play a role in arsenite-related skin cancers. PMID- 1777355 TI - Complexes of mycobactin from Mycobacterium smegmatis with scandium, yttrium and lanthanum. AB - The interaction of cations of group IIIb elements (Sc, Y, La) with mycobactin S in ethanol leads to the formation of 1:1 complexes which closely resemble the known aluminium compound with respect to ultraviolet absorption and fluorescence emission spectra. Determination of molar stoichiometry by spectrophotometry shows that this method can be conveniently applied to the estimation of purity in mycobactin samples. Hydrolytic dissociation measurements based on aqueous extraction of the labelled complexes in heterogeneous phase indicate a pronounced gradation in cation-binding stability, which increases from La (rapid and complete dissociation) to sc (approximately 24% dissociation under similar conditions). The observed properties of the complexes are rationalized by semi empirical model calculations, which suggest that ionic radius effects resulting from interaction of the IIIb cations with mycobactin S would not favour octahedral coordination of these elements as in the stable Fe(III) complex. PMID- 1777356 TI - Effects of iron(III) analogs on growth and pseudobactin synthesis in a chromiumtolerant Pseudomonas isolate. AB - The growth and siderophore production of a fluorescent Pseudomonas species isolated from soil contaminated with chromium was found to be influenced by the presence of trivalent cations. Overproduction of pseudobactin occurred when the isolate was grown in media containing 1 mM Cr(III) under iron-limited conditions but not when Fe(III) was added at 10 microM. Pseudobactin synthesis was derepressed in iron-limited cultures containing 1 mM Sc(III) or Y(III), examples of group III-B elements. We found that Al(III), Ga(III) or In(III), representative metals from group III-A, repressed synthesis of pseudobactin under iron-deficient conditions. Analogs of Fe(III) were found to inhibit growth of the Pseudomonas isolate in iron-limited media and the trivalent metals listed in order of decreasing toxicity were as follows: Ga greater than In greater than Sc greater than Cr greater than Y greater than Al. The inhibition of growth by 1 mM In(III), Sc(III) and Ga(III) was greater during iron-limited growth than in media containing 10 microM Fe(III). These data show that, although the metal analogs of Fe(III) have similar chemical and physical characteristics, the physiological response of the fluorescent pseudomonad when grown in the presence of these metals varied markedly. PMID- 1777358 TI - Transformation of hemopoietic cells by raf and myc oncogenes: a new perspective on lineage commitment. AB - The effects of the raf and myc oncogenes on murine hemopoietic cells are quite distinct. The raf-1 gene, which encodes a serine/threonine kinase that is involved in signal transduction, preferentially transforms erythroid cells, whereas myc, which encodes a DNA-binding protein, induces lymphoid and myeloid neoplasms. Together, raf and myc form a potent leukemogenic combination and they act synergistically to transform cells from all hemopoietic lineages. Strikingly, the expression of exogenous raf and myc in lymphoid and erythroid cells enables these cells to change lineages and become myeloid cells, an observation that raises interesting questions concerning commitment to specific lineages. PMID- 1777357 TI - Biosorption of copper by yeasts. AB - The ability to accumulate copper from aqueous solutions was determined with different yeast species. Yeast cells did not show any significant differences in process kinetics. The uptake was very fast and was influenced by environmental factors. The metal-accumulating capacity differed among the tested strains. The yeast Candida tropicalis and Pichia guilliermondii were chosen for extensive research. Cells of the stationary growth phase were able to adsorb a high amount of copper. The uptake capacity decreased with increasing biomass concentration. Copper adsorption obeyed the Freundlich isotherm. Optimal pH range was between 5 and 7. The biomass could be used repeatedly for biosorption after desorption by mineral acids. PMID- 1777359 TI - Abnormal patterns of DNA methylation in human neoplasia: potential consequences for tumor progression. AB - An imbalance of DNA methylation, involving widespread hypomethylation, regional hypermethylation and increased cellular capacity for methylation, is characteristic of human neoplasia. This imbalance begins in preneoplastic cells and becomes more extensive throughout subsequent stages of tumor progression. In normal cells, a primary function of DNA methylation may be to modulate compartmentalization of DNA to ensure that regional areas of transcriptionally active chromatin replicate earlier than the bulk transcriptionally inactive chromatin. We argue here that the altered methylation patterns observed during tumor progression, especially regional hypermethylation, may mark--or even help to establish--abnormalities of chromatin organization. In turn, these changes in chromatin structure may, through direct transcriptional inactivation of genes, predisposition to mutations, and allelic deletions, mediate the progressive losses of gene expression associated with tumor development. PMID- 1777360 TI - Radioprotection with cytokines--learning from nature to cope with radiation damage. AB - The quest for methods to protect cells from the damaging effects of ionizing radiation led to the observation that cytokines, endogenously produced hormone like polypeptides, are radioprotective. Interleukin-1 and tumor necrosis factor alpha, given before irradiation, can protect mice from doses of radiation that would be fatal to untreated animals. At lower doses of radiation, the hemopoietic growth factors, interleukin-1, interleukin-4, interleukin-6, tumor necrosis factor-alpha, interferon, and leukemia inhibitory factor can promote recovery when administered after irradiation. Exposure to ionizing radiation selectively induces expression of some cytokines. Recent work suggests that certain cytokines may initiate autocrine/paracrine regulated recovery and repair pathways. Thus, the radioprotective and therapeutic effects of supplementary pharmacological doses of cytokines may act by amplifying innate defenses to ionizing radiation. PMID- 1777361 TI - A role for arachidonic acid and its metabolites in the regulation of p21ras activity. PMID- 1777362 TI - Hematopoietic stem cells, 1961-1991 (meeting report) PMID- 1777363 TI - The Faculty of Pharmaceutical Medicine. PMID- 1777364 TI - Comparison and reproducibility of transthoracic bioimpedance and dual beam Doppler ultrasound measurement of cardiac function in healthy volunteers. AB - 1. We compared the ease of use and reproducibility of two noninvasive methods, transthoracic electrical bioimpedance (TEB) (BoMed NCCOM3-R7) and non-imaging dual beam Doppler ultrasound (Quantascope--Vital Science), in cardiac output (CO) and stroke volume (SV) measurement in healthy volunteers at rest and during physiological stress, both short term and from day to day. 2. The TEB method was easier to use and not dependent on the operator. The TEB method was more reproducible both in the short term and from day to day. Both devices were able to detect CO and SV changes under physiological stress, but were less reproducible day to day during exercise. 3. At supine rest, the within subject coefficient of variation between time point for TEB was 4.6% for CO and 6.1% for SV, and 7.9% for CO and 7.4% for SV with Doppler. 4. The results from each device showed a linear correlation coefficient (r) of 0.69 for CO (P less than 0.0005) and 0.64 for SV (P less than 0.0005). The correlation coefficient improved to 0.76 (P less than 0.0005) when only changes in CO and SV were considered. There was no systematic difference in the changes detected by the two methods, but the individual variation was wide. PMID- 1777365 TI - N-acetylation phenotyping using dapsone in a Jordanian population. AB - 1. The N-acetylation of dapsone (DDS) was studied in 160 unrelated healthy Jordanian volunteers. 2. The frequency of slow acetylators determined using the plasma monoacetyldapsone (MADDS) to DDS ratio (MADDS/DDS), was 67.5% with a 95% confidence interval of 59 to 76%. Slow acetylators had an acetylation ratio of less than 0.42. 3. Applying the Hardy-Weinberg Law, the frequency of the recessive allele controlling slow acetylation was found to be 0.82 +/- 0.02. 4. The frequency distribution histogram of the plasma MADDS/DDS ratio showed an apparent trimodal pattern. The number of homozygous (n = 16) and heterozygous (n = 36) rapid acetylators derived from the observed data did not agree with those predicted for the respective rapid acetylators (n = 5 and n = 47) according to the Hardy-Weinberg Law. The suggested antimode used to discriminate the two groups was 0.82. 5. The mean plasma concentration of MADDS and the mean plasma acetylation ratio were about three times lower in slow than in rapid acetylators. However, there was no difference in mean plasma DDS concentration between slow and rapid acetylators. 6. There was a significant correlation (r = 0.853, P less than 0.001) between plasma MADDS concentration and the acetylation ratio. For DDS such a correlation was absent (r = 0.059, P = 0.23). PMID- 1777366 TI - Alpha 1-acid glycoprotein (orosomucoid) and plasma protein binding of quinine in falciparum malaria. AB - 1. Plasma concentrations of alpha 1-acid glycoprotein (AAG) and plasma protein binding of quinine were measured in 97 Thai adults with acute falciparum malaria. There was a linear relationship between log AAG and percentage quinine binding (r = 0.71, P less than 0.001) in vivo, which was similar to that observed in vitro; the slopes and intercepts of the regression lines at AAG concentrations of 1 g l 1 were -8.94 and -8.41, and 7.2% and 10.9%, respectively. 2. Hill plots from these data suggest a single high affinity quinine binding site on each molecule of AAG. 3. Plasma AAG concentrations were consistently raised in acute malaria, and were higher in patients with cerebral malaria [2.03 (0.51) g l-1, mean (s.d.)], and conscious patients with severe malaria [1.93 (0.53) g l-1] than in patients with uncomplicated infections [1.55 (0.58) g l-1], P = 0.008. Plasma protein binding of quinine was correspondingly higher and thus the proportion of free drug was lower in the severe groups; 5.5 (2.4)% compared with 7.2 (1.9)%, P = 0.03. 4. Following recovery from malaria, plasma AAG concentrations fell by an estimated 0.05 g l-1 day-1 to levels that were approximately half (median 45%) the admission value at 28 days. 5. AAG is the principal binding protein for quinine in plasma. Changes in plasma concentrations of this acute phase reactant account for the increased plasma protein binding of quinine in acute malaria. PMID- 1777367 TI - Effect of Plasmodium falciparum malaria infection on the plasma concentration of alpha 1-acid glycoprotein and the binding of quinine in Malawian children. AB - 1. We have measured plasma concentrations of alpha 1-acid glycoprotein (AGP) in 18 healthy children and 85 children with falciparum malaria in Malawi. In addition, we determined the degree of protein binding of quinine (QN) in the plasma of 52 of the patients and each of the healthy controls. 2. The mean plasma AGP concentration was higher in patients than in controls (P less than 0.0001) and remained elevated 3 weeks after complete resolution of malaria infection. 3. The mean unbound QN fraction was significantly less (P less than 0.00001) in patients with malaria (0.128 +/- 0.037) than in controls (0.193 +/- 0.051) and significantly higher (P = 0.02) in convalescence (0.153 +/- 0.067) than during acute illness. 4. There were highly significant negative correlations between plasma AGP concentration and the free QN fraction in spiked plasma samples (r = 0.534, P less than 0.0001, n = 93) and in clinical samples (r = -0.484, P less than 0.00001, n = 225). There was a significant positive correlation between plasma concentrations of AGP and another acute phase reactant, C reactive protein (P less than 0.001). PMID- 1777368 TI - The kinetics of cyclosporine and its metabolites in bone marrow transplant patients. AB - 1. The pharmacokinetics of cyclosporine (CsA) and the time course of CsA metabolites were studied in five bone marrow transplant patients after intravenous (i.v.) administration on two separate occasions and once after oral CsA administration. 2. Cyclosporine and cyclosporine metabolites were measured in whole blood by h.p.l.c. 3. Cyclosporine clearance after i.v. administration decreased from 3.9 +/- 1.7 ml min-1 kg-1 to 2.0 +/- 0.6 ml min-1 kg-1 after 14 days of treatment. The mean +/- s.d. absolute oral bioavailability of cyclosporine was 17 +/- 11%. 4. Hydroxylated CsA (M-17) was the major metabolite in blood. There were no significant differences in the mean metabolite/CsA AUC ratios between the first and second i.v. studies. 5. After oral administration, the metabolite to CsA AUC ratios were higher for most metabolites compared to those observed in the second i.v. study, suggesting a contribution of intestinal metabolism to the clearance of CsA. PMID- 1777369 TI - The prediction of steady-state plasma phenobarbitone concentrations (following low-dose phenobarbitone) to refine its use as an indicator of compliance. AB - 1. A model for predicting the steady-state plasma concentration of phenobarbitone following low-dose phenobarbitone used as an indicator of compliance was derived using data for 10 healthy volunteers. 2. Each volunteer was given a single 30 mg oral dose of phenobarbitone and the pharmacokinetics were described. Subsequently, volunteers were given phenobarbitone 2 mg daily for 28 days and a further pharmacokinetic profile determined during and after this period. 3. An initial predicted estimate of steady-state plasma drug concentration was made using each volunteer's demographic details. This estimate was revised by Bayesian analysis using single timed samples (24, 48, 72 or 96 h) following the single dose. 4. The model was tested on a further 10 healthy volunteers given a single 8 mg dose and who were subsequently given 2 mg daily for 28 days. 5. The revised estimate of peak steady-state plasma phenobarbitone concentration utilising the 96 h post-single dose concentration (356 ng ml-1) was least biased (mean prediction error +/- 95% CI = 10.6 +/- 19.8 ng ml-1) and most precise (root mean square error +/- 95% CI = 28.3 +/- 19.0 ng ml-1). In all cases the peak or trough steady-state drug concentration was within 13% of the predicted value. 6. The model reflected compliance accurately in a further eight volunteers with simulated partial (two-thirds) compliance. 7. The use of a predictive model using Bayesian analysis to estimate expected steady-state plasma phenobarbitone concentrations could increase further the usefulness of low-dose phenobarbitone as an indicator of compliance. PMID- 1777370 TI - Differential effects of valproic acid and enzyme-inducing anticonvulsants on nimodipine pharmacokinetics in epileptic patients. AB - 1. The single dose pharmacokinetics of orally administered nimodipine (60 mg) were investigated in normal subjects and in two groups of epileptic patients receiving chronic treatment with hepatic microsomal enzyme-inducing anticonvulsants (carbamazepine, phenobarbitone or phenytoin) and sodium valproate, respectively. 2. Compared with the values found in the control group, mean areas under the plasma nimodipine concentration curve were lowered by about seven-fold (P less than 0.01) in patients taking enzyme-inducing anticonvulsants and increased by about 50% (P less than 0.05) in patients taking sodium valproate. 3. Nimodipine half-lives were shorter in enzyme-induced patients than in controls (3.9 +/- 2.0 h vs 9.1 +/- 3.4 h, means +/- s.d., P less than 0.01), but this difference could be artifactual since in the patients drug concentrations declined rapidly below the limit of assay, thus preventing identification of a possible slower terminal phase. In valproate-treated patients, half-lives (8.2 +/- 1.8 h) were similar to those found in controls. PMID- 1777371 TI - A comparison of the central nervous system effects of caffeine and theophylline in elderly subjects. AB - 1. The effects of oral administration of 250 mg caffeine or theophylline and placebo on subjective ratings and psychological test performance were studied in a double-blind crossover experiment in 20 healthy elderly subjects. 2. Performance on the continuous attention task showed a significant improvement compared with placebo with both active treatments. Performance with caffeine was significantly better than with theophylline. Mean error index scores (normalised AUCs) were: placebo--0.130; caffeine--0.083; theophylline--0.093. No other objective measure shows significant treatment effects. 3. Subjective ratings showed that subjects felt significantly more alert on caffeine than on either theophylline or placebo. Subjects also rated themselves as more energetic and interested on caffeine than on placebo. 4. Plasma concentrations of caffeine were lower than those of theophylline (mean 5.76 and 8.72 mg l-1 respectively at 2 h post-drug. 5. These results suggest that caffeine is a more potent CNS stimulant than theophylline. PMID- 1777372 TI - The effects of captopril vs atenolol on memory, information processing and mood: a double-blind crossover study. AB - 1. Measures of memory, information processing ability, mood states and trait anxiety were estimated in a double-blind, double-dummy, randomised cross-over trial which compared the effects of atenolol (50 or 100 mg once daily) and captopril (25 or 50 mg twice daily), each taken for 6 weeks. Eighteen patients with mild to moderately severe hypertension were included. 2. There were no significant differences in systolic or diastolic blood pressure reduction between the two drugs. Pulse rate was slower after atenolol treatment (P less than 0.05). 3. Patients undertook practice on the psychological test battery prior to the treatment phases of the study in order to minimise practice effects. 4. There were no significant differences between the treatments on any of the measures of memory or information processing. 5. Patients reported feeling less anxious during treatment with atenolol (P = 0.02). 6. There were no differences between the drugs in their cognitive effects. The present study has the advantages of using an extensive battery of standard tests in a group of well-practised patients. The decreased anxiety reported with atenolol treatment may have clinical value and probably reflects the well-known effect of beta-adrenoceptor antagonist drugs on the somatic symptoms of situational anxiety. PMID- 1777373 TI - The pharmacokinetics of dermatan sulphate MF701 in healthy human volunteers. AB - 1. The pharmacokinetics of dermatan sulphate MF701 were studied in 12 healthy males after administration of single intravenous bolus (200 mg), intramuscular (100 and 300 mg) and oral (1 g) doses. The study was conducted according to a within-subject crossover design in two paired blocks. 2. Plasma drug concentrations were measured using a competitive binding assay and a range of biological activity assays, including a sensitive catalysed thrombin inhibition test. 3. Following intravenous administration, plasma concentrations of dermatan sulphate determined by competitive binding assay were described by a two compartment open model with an initial t1/2, in of 0.6 h and a t1/2,z of 7.5 h. Biological activity assays were insufficiently sensitive to detect the second phase, and therefore yielded apparent monoexponential kinetics. 4. After intramuscular injection the apparent bioavailability of dermatan sulphate was 16 20%. Plasma drug concentrations increased in proportion to dose when measured by competitive binding assay. Low concentrations persisted for more than 24 h at the higher dose, and these may prove therapeutically relevant on chronic administration. 5. We confirm that dermatan sulphate is the only glycosaminoglycan known to generate significant plasma concentrations following oral administration. Oral bioavailability was estimated to be 7%. PMID- 1777374 TI - The basis of the histamine assay in skin. AB - 1. The assay of wheal response to histamine injected sub-epidermally has been reviewed. Several discrepant claims were found in earlier work. 2. The saline control injection may evoke a wheal, which if present should be allowed for in the assay procedure. 3. There was no evidence for a limb dominance effect. 4. Using a 3.26 mM (1 mg ml-1) standard solution of histamine acid phosphate (1.18 mM as free base) and 0.1 ml injections, the straight central portion of the assay curve was found to be between 0.3 and 2.3 x 10(-3) mM, as free base, with an ED50 of about 0.018 mM histamine base. PMID- 1777375 TI - Effects of H1-receptor blockade with terfenadine in nocturnal asthma. AB - 1. In a single-blind placebo controlled study we have measured peak flow (PEFR) at 04.00 h and 16.00 h in eight asthmatics 6 h after placebo or terfenadine 120 mg, to determine if diurnal variation in histamine mediated effects contribute to nocturnal bronchoconstriction in asthma. 2. On placebo there was a significant diurnal variation in mean PEFR of 41 l min-1 (P less than 0.05). Terfenadine improved 04.00 h baseline mean PEFR from 242 to 278 l min-1 (P less than 0.05) but a 38 l min-1 diurnal variation in mean PEFR persisted (P less than 0.05). 3. We conclude that H1-receptor blockade with terfenadine may produce modest nocturnal bronchodilatation but does not influence the diurnal variation in PEFR in asthma suggesting that H1-receptor mediated effects are not important in the pathogenesis of nocturnal asthma. PMID- 1777376 TI - The interactions between nisoldipine and two beta-adrenoceptor antagonists- atenolol and propranolol. AB - 1. The interactions between the dihydropyridine calcium antagonist nisoldipine and two beta-adrenoceptor blocker drugs (atenolol and propranolol) were investigated in two groups of healthy normotensive subjects. 2. The steady state plasma concentrations of both beta-adrenoceptor blockers were significantly altered by the addition of nisoldipine: for propranolol there were significant increases in Cmax, by about 50%, and in AUC by about 30% and for atenolol there was a significant increase in Cmax, by about 20%. 3. The addition of nisoldipine was also associated with significant changes in apparent liver blood flow (measured by indocyanine green clearance) from 1.4 to 2.4 l min-1 in the atenolol group and from 1.3 to 2.3 l min-1 in the propranolol group. 4. Both nisoldipine beta-adrenoceptor blocker combinations were associated with small enhanced blood pressure reductions e.g. from 104/60 with atenolol alone to 98/50 mm Hg with the combination but there was no alteration to the extent of beta-adrenoceptor blockade (as assessed by bicycle ergometry). 5. This pharmacodynamic profile in healthy normotensives is consistent with the known therapeutic efficacy of such combination treatments in patients with hypertension and angina. 6. It is suggested that there is a pharmacokinetic component to the efficacy of this type of combination, perhaps reflecting vasodilator-induced changes in drug absorption and/or hepatic extraction. PMID- 1777378 TI - Pharmacokinetics of molsidomine and its active metabolite, linsidomine, in patients with liver cirrhosis. AB - The pharmacokinetics of molsidomine were investigated in six healthy volunteers and in seven patients with alcoholic cirrhosis. After a 2 mg oral dose, molsidomine elimination half-life was prolonged in cirrhotic patients (13.1 +/- 10.0 h vs 1.2 +/- 0.2 h, P less than 0.01) because of a decrease in its apparent plasma clearance (CL/F) (39.8 +/- 31.9 ml h-1 kg-1 in patients with cirrhosis vs 590 +/- 73 ml h-1 kg-1 in volunteers). The elimination half-life of the active metabolite, linsidomine (SIN-1) was also prolonged in cirrhotic patients (7.5 +/- 5.4 h vs 1.0 +/- 0.19 h, P less than 0.05). The AUC values of both molsidomine and linsidomine were increased in the cirrhotic group, but the increase in the former was considerably greater than in the latter as shown by the significant decrease of the ratio AUClinsidomine/AUCmolsidomine x 100 (4.5 +/- 6.1 in cirrhotic patients vs 23.5 +/- 3.4 in healthy volunteers, P less than 0.001). These results suggest that liver cirrhosis profoundly alters the pharmacokinetics and metabolism of molsidomine. PMID- 1777379 TI - Penetration of minocycline into lung tissues. AB - The penetration of minocycline into different lung tissues and bronchial mucus was studied in 17 patients undergoing pulmonary surgery for cancer. The patients received oral minocycline 100 mg at night for 3 days preceding surgery. Minocycline concentrations were measured in plasma samples collected before the operation and in tissues and mucus taken from in and around the part of the lung that was surgically removed. Mean tissue or mucus concentration to plasma concentration ratios were 3.78 +/- 1.10 for lung parenchyma, 4.04 +/- 1.31 for bronchial walls, 3.37 +/- 1.00 for pulmonary arterial walls, 1.99 +/- 1.80 for intraluminal mucus collected from bronchi located in healthy tissue proximal to the tumour, 5.16 +/- 3.26 for intraluminal mucus collected in a bronchus distal to the tumour, and 3.06 +/- 1.99 for catheter-collected mucus from the trachea and principal bronchi. These results indicate that minocycline is found in high concentration in all types of lung tissue and mucus in man. PMID- 1777380 TI - Growth of Listeria monocytogenes in vacuum-packed, smoked salmon, during storage at 4 degrees C. AB - Samples of smoked salmon of different hygienic quality were inoculated with low (6 cfu/g) and high (600 cfu/g) levels of a mixture of three strains of Listeria monocytogenes, after which they were vacuum-packed and stored at 4 degrees C for up to 5 weeks. L. monocytogenes grew well during storage in all the inoculated sample groups. Growth was, however, slightly faster in the fish with the better hygienic quality. The smoked salmon was still sensorically acceptable after 4 weeks. All three strains were found after 4 weeks in the fish with the better quality, while only two strains were recovered after the same time from the poorer quality salmon. PMID- 1777377 TI - The response to the first dose of an angiotensin converting enzyme inhibitor in uncomplicated hypertension--a placebo controlled study utilising ambulatory blood pressure recording. AB - 1. The importance of total dose to the initial hypotensive response with an angiotensin converting enzyme inhibitor (quinapril) was assessed using a suggested 'maintenance' dose (20 mg) or matched placebo in a randomised double blind study in patients with uncomplicated hypertension. 2. Thirty-two patients were recruited who were not on therapy or had not received diuretic therapy in their existing drug treatment in the preceding 4 weeks. Secondary causes of hypertension had previously been excluded and sustained clinic blood pressures of SBP greater than 160 mmHg and/or DBP greater than 90 mmHg were taken as indications for a trial of adjuvant or monotherapy with an ACE inhibitor. 3. After uneventful supervised therapy with quinapril in an open pilot study (n = 5) 27 patients entered a double-blind, randomised, crossover study of quinapril or placebo using ambulatory monitoring to assess BP response. 4. All patients remained asymptomatic and both therapy and monitoring were well tolerated. A smooth onset of antihypertensive effect was noted with an overall 24 h placebo corrected fall in systolic BP of 9.9 mmHg (7.2-12.6 95% CI) and diastolic BP of 6.4 mmHg (4.2-8.8) with no significant effect on heart rate. Individual placebo corrected maximal responses during the first 8 h following quinapril showed a wide range for both systolic (+1.56 to 44.0 mmHg) and diastolic (+2.3 to -35.6 mmHg) pressure. Larger falls tended to be associated with higher baseline pretreatment pressures but in no case did absolute systolic pressure fall below 100 mmHg during the first 8 h following administration of placebo or quinapril.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777381 TI - Characterization of Staphylococcus aureus and Salmonella spp. strains isolated from bovine meat in Zaire. AB - A large majority (87.4%) of 190 Staphylococcus aureus isolates from fresh beef in Lubumbashi (Zaire) belonged to the human St. aureus ecovar; 81.2% of the phage typed human strains were partially or solely lysed by phages of group III. Thirteen of the 52 tested strains (25.0%) were enterotoxin producers; nine of these (69.2%) were positive for staphylococcal enterotoxin A. Sixteen serotypes were identified among the 122 Salmonella isolates and nearly all these strains were susceptible to the 8 different antibiotics tested. PMID- 1777382 TI - A new plate medium for rapid presumptive identification and differentiation of Enterobacteriaceae. AB - A new selective differential agar medium for rapid presumptive identification of Enterobacteriaceae from water and food samples is described (EMX ID agar). By a combination of fluorogenic and chromogenic substrates, the medium detects the presence of beta-D-glucuronidase, beta-D-galactosidase, beta-D-xylosidase, tryptophane deaminase and H2S; additionally, cytochrome-oxidase and indole production can be demonstrated. This medium provides an inexpensive means for simple and rapid presumptive identification of E. coli and coliforms and for the differentiation within the Klebsiella-Enterobacter and the Proteus-Providencia Morganella group. Furthermore, it allows to distinguish between the H2S-positive Enterobacteriaceae Citrobacter freundii, Salmonella spp., S. arizonae, Edwardsiella, Proteus mirabilis, P. vulgaris and some oxidase-positive bacteria. PMID- 1777383 TI - A rapid polymerase chain reaction (PCR)-based assay for the identification of Listeria monocytogenes in food samples. AB - A rapid and simple assay has been developed which allows specific detection of Listeria monocytogenes within 3.5 h in cultures prepared from suspect food samples and propagated 48 h in selective medium. The assay is based on PCR technology, and uses a specific primer set derived from sequences located down stream of the hlyA gene. The specificity of the primer set was confirmed by testing 115 L. monocytogenes, 14 L. innocua, 5 L. seeligeri and 4 L. ivanovii isolates. The assay was compared to standard microbiological tests and gave identical results for 83 food samples, including 32 positives. These field trials indicate that the assay developed provides an alternative detection system for L. monocytogenes in foods, which can be used by the food industry. PMID- 1777384 TI - Contribution of different yeasts isolated from musts of monastrell grapes to the aroma of wine. AB - Volatile substances of wines obtained by fermentation of musts from 'Monastrell' grapes (Alicante, Spain) was studied for yeast isolated from such musts. The results of the statistical treatment performed show the importance of yeasts of low fermentative power, particularly Kloeckera apiculata, in the production of volatile substances. Saccharomyces cerevisiae var. chevalieri was found to be the most important yeast of high fermentative power. PMID- 1777385 TI - Inhibition, survival and growth of Listeria monocytogenes on poultry as influenced by buffered lactic acid treatment and modified atmosphere packaging. AB - The effect of the treatment with various concentrations (2%, 5% and 10% w/v) of lactic acid/sodium lactate buffer (pH 3.0), modified atmosphere (MAP) packaging (90% CO2 and 10% O2) and 10% (w/v) lactic acid/sodium lactate buffer (pH 3.0) combined with MAP on Listeria monocytogenes Z7 serotype 1 and on the shelf life of chicken legs stored at 6 degrees C was investigated. The initial contamination level of L. monocytogenes on the chicken legs surface was 8.3 x 10(2) cfu/cm2 of skin. After 2 days of storage at 6 degrees C the number of L. monocytogenes on legs treated with 2%, 5%, 10% lactic acid/sodium lactate buffer (pH 3.0) and 10% lactic acid/sodium lactate buffer (pH 3.0) combined with MAP was significantly lower than the initial number of L. monocytogenes. Later, growth of L. monocytogenes was observed. After 13 days of storage at 6 degrees C the number of L. monocytogenes on legs treated with 10% lactic acid/sodium lactate buffer (pH 3.0) combined with MAP was still similar to the initial number. Legs treated with 2%, 5%, 10% lactic acid/sodium lactate buffer (pH 3.0), MAP and 10% lactic acid/sodium lactate buffer (pH 3.0) combined with MAP, have a shelf life at 6 degrees C of respectively 8, 9, 10, 13 and 17 days. This means a prolongation of 2, 3, 4, 7 and 11 days, respectively for storage at 6 degrees C. The antimicrobial effect of lactic acid buffer systems (pH 3.0) increased with increasing concentrations of lactic acid in the buffered system. The best results were obtained by the combined use of 10% acid/sodium lactate buffer (pH 3.0) and MAP. PMID- 1777386 TI - Dietary exposure to aflatoxin in Benin City, Nigeria: a possible public health concern. AB - A total of 100 samples of various foods comprising of 10 samples each of garri (Manihot utilis Pohl), beans (Phaseolus lunatus), yam flour (Dioscorea rotundata), cassava flour (Manihot esculentum), melon (Citrulus lunatus), onion (Allium cepa), rice (Oryza sativa), plantain (Musa paradisiaca), red pepper (Capsicum annuum L., Solanaceae) and eggs were screened for the presence of aflatoxins. Fifty percent of yam flour; 40% of cassava flour; 30% of garri; 20% of beans and melon and 10% of rice yielded aflatoxin. The implications of this incidence of aflatoxin in common foodstuff found in this community is discussed. PMID- 1777387 TI - The presence of enterotoxigenic Clostridium perfringens strains in faeces of various animals. AB - The presence of Clostridium perfringens in faeces of horses, cattle, poultry and pigs was determined. C. perfringens was detected in 24%, 36%, 80% and 2% of the faecal samples, respectively. Faecal samples containing enterotoxigenic strains as assessed by colony hybridization amounted to 14%, 22%, 10% and 0% respectively. PMID- 1777388 TI - Occurrence of Yersinia spp. in foods in Brazil. AB - Over the past 9 years, 468 bacterial strains isolated from raw and pasteurized milk, beef and pork, bovine and chicken liver, chicken heart, gizzards and lung sausage, hamburger, cheese and lettuce in different regions of the State of Sao Paulo and in the city of Rio de Janeiro were received by the Reference Laboratory for Yersinia in Brazil. All were confirmed to be Yersinia spp. The 468 Yersinia isolates were grouped as 184 strains because some of the bacteria isolated from the same food sample belonged to the same species, and were considered to be a single strain. The Yersinia food strains were classified as Y. enterocolitica (46), Y. intermedia (67), Y. frederiksenii (20), Y. kristensenii (8) and 43 of them were biochemically atypical. Pathogenic types were not detected. PMID- 1777389 TI - The influence of Lactobacillus plantarum culture inoculation on the fate of Staphylococcus aureus and Salmonella typhimurium in Montasio cheese. AB - The growth and survival of Staphylococcus aureus and Salmonella typhimurium were investigated during the manufacturing and ripening of raw milk Montasio cheese. Initial inoculated populations in the cheese milk were about 10(5) cfu/ml for S. aureus and 10(6) cfu/ml for S. typhimurium. Samples of curds and cheeses were taken during manufacturing and storage and analysed for pH and microbial populations. S. aureus increased slightly in number during the early period of ripening and attained a population of about 10(6) cfu/ml during the remaining period of storage. S. typhimurium decreased during cheesemaking and storage but persisted through 90 days. The addition of Lactobacillus plantarum culture (0.2% v/v) produced a marked reduction in populations of the test strains in 10 days of storage. Enterotoxin A was not detected in Montasio cheese even with a S. aureus population of 1.1 X 10(7) cfu/ml. L. plantarum strains were also tested by the spot method and the associative growth approach for their antagonistic activity against S. aureus and S. typhimurium. The compound excreted by L. plantarum was active only toward S. aureus. Furthermore, its activity was destroyed by protease treatment. These results indicated that while the growth of S. typhimurium is reduced by the acid production, S. aureus inhibition can be ascribed to bacteriocin production. PMID- 1777390 TI - Quality assurance. Read all about it. PMID- 1777391 TI - Quality care. PMID- 1777392 TI - Auditing quality. PMID- 1777393 TI - Quality assurance. Leaving it on the plate. PMID- 1777394 TI - Quality assurance. Senior Monitor. PMID- 1777395 TI - Augmentative communication systems taught to cerebral-palsied children--a longitudinal study. II. Pragmatic features of sign and symbol use. AB - Pragmatic analysis of the sign and symbol utterances produced by 40 language impaired, cerebral-palsied children in semi-structured conversational settings revealed severe restrictions in the range of communicative functions that were used. The children were able to communicate certain conversational acts effectively, but over 80% of all utterances expressed just four communicative functions. There were also some significant gaps, with certain functions not being used at all. The children's progress was followed up at 6-month intervals over a period of 1 1/2 years. Few changes were found in the range and relative frequencies of communicative functions expressed over time. There were few significant differences between the symbol and sign users on these measures, which suggests that overall neither augmentative mode facilitated greater communicative use than the other. PMID- 1777396 TI - Augmentative communication systems taught to cerebral-palsied children--a longitudinal study. III. Teaching practices and exposure to sign and symbol use in schools and homes. AB - A longitudinal study of augmentative communication training with 40 language impaired, cerebral-palsied children examined the teaching practices adopted in schools, and the extent to which teachers and parents used the augmentative systems with the children. The study found limited exposure to sign and symbol training in formal teaching sessions and in other school settings, and teachers made relatively few attempts to foster spontaneous use of the systems and generalisation outside of formal training settings. Exposure to augmentative communication in the children's homes was equally limited, and a significant number of parents expressed reservations about the value of the systems for their children. These findings may at least partly account for the children's limited progress in sign and symbol acquisition and use over an 18-month period, which was documented in two earlier reports. PMID- 1777397 TI - The use of strategies to increase speech intelligibility in cerebral palsy: an experimental evaluation. AB - The effects of strategies on the intelligibility of cerebral-palsied speech were experimentally evaluated. Listeners were asked to identify words in sentences spoken by subjects whose dysarthria was rated to be either moderate or severe. Results indicated that strategies increased intelligibility and that different strategies were appropriate at different levels of severity. Use of initial letter cueing achieved the greatest gains for the more severely impaired speakers but, for the less severely impaired, the gains achieved by providing visual cues were the same as those achieved by letter cueing and could not be improved upon by repetition. Listeners' experience of dysarthric speech and the redundancy of the test sentences were also manipulated. Previous experience did not influence recognition and redundancy only appeared to have an influence at higher levels of intelligibility. The role of strategies in improving intelligibility is discussed. The results suggest that many speakers will be unable to use simple strategies to improve intelligibility to levels that may be needed for adequate information transfer. PMID- 1777398 TI - Sentence processing deficits: a replication of therapy. AB - This paper describes the replication of a therapeutic programme originally used by one of the authors, Byng (Cognitive Neuropsychology, 1988, 5, 629-676) to remediate a specific sentence processing deficit. Our patient is shown to have similar although not identical deficits to those of one of the patients (JG) described in that programme. Sentence comprehension and production both improved as a result of therapy. The pattern of results observed gave further insights into both the nature of the patient's deficit and the mechanism of therapy. PMID- 1777399 TI - Speech disorders in systemic amyloidosis. AB - The purpose of this study was to define more completely the speech disorders that can occur in systemic amyloidosis. Fifty-nine patients with histologically established primary systemic amyloidosis were studied. Of this group, 81% had abnormal voice quality, 43% had abnormal pitch, 7% had abnormal resonation and 15% had abnormal articulation. Twenty-two patients also had abnormal findings at laryngeal examination, consisting of bowing, oedema, thickening, dry irritation and polypoid changes of the vocal folds. Macroglossia was found in 17% of the patients and submandibular swelling in 10%. These results support previous studies which showed that abnormal phonation is a sign of systemic amyloidosis and that abnormal voice is by far the most common abnormal speech sign. The relationship between amyloid deposit and dysphonia was not clear. In 23 patients who had laryngeal examinations, no evidence of actual amyloid deposits was documented. PMID- 1777400 TI - Opportunities for using computers in speech and language therapy: a study of one language unit. AB - Whilst the use of information technology is increasing in importance as an aid to speech and language therapy, its introduction has so far been unsystematic. Systems analysis methodologies for assessing how information technology can best be employed have been developed for use in the business world. The present study used one such methodology--Checkland's soft systems--to investigate which aspects of the activities of one language unit were most likely to be improved or helped by the introduction of new technology. Such an approach was found to yield useful insights and several opportunities for increased computer use were revealed. However, it was also concluded that, to take maximum advantage of new technology, changes would need to be introduced and resources made available at a higher organisational level than that of the individual unit or department. PMID- 1777401 TI - Early second language acquisition: a comparison of the linguistic output of a pre school child acquiring English as a second language with that of a monolingual peer. AB - Two pre-school children were recorded at regular intervals over a 9-month period while playing freely together. One child was acquiring English as a second language, whilst the other was a monolingual English speaker. The sociolinguistic domain was such that the children were likely to be motivated to communicate with each other in English. A variety of quantitative measures were taken from the transcribed data, including measures of utterance type, length, type-token ratios, use of auxiliaries and morphology. The child for whom English was a second language was found to be well able to interact on equal terms with his partner, despite being somewhat less advanced in some aspects of English language development by the end of the sampling period. Whilst he appeared to be consolidating his language skills during this time, his monolingual partner appeared to be developing rapidly. It is hoped that normative longitudinal data of this kind will be of use in the accurate assessment of children from dual language backgrounds, who may be referred for speech and language therapy. PMID- 1777402 TI - Paradigms, methods and the epistemology of speech pathology: some comments on Eastwood (1988). AB - Eastwood argues that speech pathology lacks core paradigms (British Journal of Disorders of Communication (1988) vol. 23, pp. 171-184). She suggests that a main reason for this failure is a reliance on conventional (experimental) scientific method, and that the use of qualitative methods may provide a more fruitful approach. The present paper contends that, whilst increased attention might usefully be paid to qualitative methods, the issue of method is secondary in the development of paradigms. Further, an analysis of the knowledge base of speech pathology shows that the discipline is an epistemological hybrid which, sui generis, resists conceptual unification and the development of a high paradigmatic consensus. Hence, the prospect of attaining core or over-arching paradigms for speech pathology is small. The present need is to develop a range of interesting and fruitful ideas and hypotheses for the several different facets of speech pathology, rather than to be too concerned about the development of over-arching paradigms and issues of method. PMID- 1777403 TI - Comments regarding Dodd and Iacano (1989): 'phonological disorders in children: changes in phonological process use during treatment'. PMID- 1777404 TI - The facts behind the figures: a reply to Enderby and Davies (1989). AB - In 1989, Enderby and Davies discussed the type and pattern of speech and language therapy provision which would be required to service the needs of the speech- and language-impaired population of the UK, on the basis of statistical information drawn from a wide range of sources. In this paper, some methodological issues arising from their study are addressed and an argument made that alternative models of service provision should be considered when planning for future needs. PMID- 1777405 TI - Selective variceal decompression: current status. AB - Since its introduction into clinical practice in 1967, selective variceal decompression by means of a distal splenorenal shunt (DSRS) has become one of the more commonly performed portal-systemic shunting procedures in the treatment of variceal hemorrhage throughout the world. In addition to selective decompression of gastroesophageal varices, the DSRS provides the advantages of preservation of portal perfusion of the liver and maintenance of intestinal venous hypertension. Many large, uncontrolled series and the majority of controlled randomized studies have demonstrated a lower incidence of encephalopathy after the DSRS than after nonselective shunt procedures. A secondary advantage of the DSRS is that the hepatic hilum is avoided, thus making subsequent liver transplantation a less formidable procedure. None of the studies have shown an advantage to this shunt with respect to long-term survival in patients with alcoholic cirrhosis. However, some of the large, uncontrolled series have shown that survival is significantly improved in patients with non-alcoholic cirrhosis compared to nonselective shunt procedures in the same population. Controlled trials comparing the DSRS to endoscopic sclerotherapy have shown that chronic endoscopic variceal sclerosis is an appropriate initial therapy for most patients as long as shunt surgery is readily available if sclerotherapy fails. PMID- 1777406 TI - Chronic rejection and extrahepatic biliary tract obstruction 8 years after orthotopic liver transplantation using the gallbladder-conduit technique. AB - A case of delayed biliary obstruction and cholangitis, occurring in the setting of chronic allograft rejection, 8 years after liver transplantation using the gallbladder-conduit, is presented. Extrahepatic biliary obstruction may be seen in the late follow-up of liver grafting and rejection phenomena may play a significant role in the development of such obstruction. PMID- 1777407 TI - Clinical evaluation of tumour marker combinations in the differential diagnosis of benign and malignant liver disease. AB - CEA, CA19-9 and CA50 are tumour associated antigens defined by monoclonal antibodies which have been raised against adenocarcinoma cell lines. The aim of this study was to determine whether their combined use could improve diagnostic accuracy in patients with primary and secondary liver tumours. An immunoradiometric assay was used for the detection of CEA and CA19-9 and the Delfia system for CA50. Serum was collected from 65 normal subjects, 40 with hepatobiliary carcinoma (26 primary, 14 secondary) and 17 with benign hepatobiliary disease. The cut-off levels were calculated as the mean of the control group plus 2 standard deviations. All three antibodies contributed to improving the correct classification of secondary liver tumours (multivariant discriminant analysis p less than 0.05), but only CA19-9 and CA50 contributed to the diagnosis of primary liver tumours (multivariant analysis p less than 0.05). The diagnostic accuracy versus benign disease was 81% for primary carcinoma and 91% for secondary carcinoma. Combined use of CEA, CA19-9 and CA50 helps to differentiate benign from malignant hepatobiliary disease. PMID- 1777408 TI - Short intussusception valves prevent reflux after jejunal interposition bilioduodenal anastomosis. AB - Short whole circumference and semi-circumference intussusception valves were created in interposition cholecysto-jejunal-duodenal conduits in pigs to determine which method best prevented gastrointestinal reflux into the biliary tract. Following intravenous injection of 99 mTc-HIDA the time interval for its excretion from the liver and appearance in the duodenum was not different in either whole or semi-circumference valve animals or in controls without valves. After intragastric administration of 99 mTc-DTPA the relative radioactivity of gallbladder contents (reflux) in the cohort without valves was significantly higher than in both cohorts with valves. Animals with semi-circumferential valves in turn had significantly higher levels of nuclide than those with whole circumference valves. Reflux was observed grossly in 100% of animals without valves, in 20% of those with semi-circumference valves, and in no animals with whole circumference valves. This study indicates that both whole and semi circumference intussusception valves placed in jejunal biliary conduits allow unimpeded flow of bile into the gastrointestinal tract. Whole circumference valves are more effective for prevention of reflux than semi-circumferential valves. PMID- 1777409 TI - Metabolic alterations in obstructive jaundice: effect of duration of jaundice and bile-duct decompression. AB - We examined the effect of prolonged bile duct obstruction, and subsequent biliary decompression, on biochemical and metabolic parameters, using a reversible jaundice model in male Fischer 344 rats. The animals were studied after biliary obstruction for varying periods (4 days, one week, and two weeks) and following decompression. They were sacrificed one or two weeks following decompression. All the rats were compared to sham operated, pair-fed, controls. Obstructive jaundice rapidly increased bilirubin, liver enzymes, serum free fatty acid, and triglyceride levels. Glucose levels were significantly decreased in the jaundice rats compared to their pair-fed controls. Only after two weeks of jaundice was significant hypoalbuminemia observed. Following decompression, all biochemical and metabolic values gradually returned to normal levels, except for albumin. Hypoalbuminemia was not reversed within the two-week post-decompression period. The rats jaundiced for two weeks had significantly higher mortality, compared to the other groups. We conclude that prolonged jaundice adversely affects the metabolic capacity of the rats, with albumin concentration being markedly decreased, and that biliary decompression could not reverse completely all the alterations seen with cholestasis, especially following two weeks of bile duct obstruction. PMID- 1777410 TI - Chronic obstructive pancreatitis as a delayed complication of pancreatic trauma. AB - Increasing surgical experience with the immediate consequences of pancreatic injuries has resulted from parallel growth in the volume of motor vehicle accidents and societal violence. However, few surgeons are aware that complications may be considerably delayed following pancreatic trauma, occurring in some cases months to years after apparent recovery from the original injury. In four patients with blunt pancreatic trauma initially treated by non-operative means, stricture of the main pancreatic duct developed over a period of months as a result of progressive fibrosis at the site of ductal injury. Pancreatic duct hypertension was demonstrated to be present in the obstructed duct, and secondary changes of chronic pancreatitis developed in the obstructed segment of the gland ("upstream" chronic pancreatitis). Seven similar patients with delayed onset of chronic obstructive pancreatitis after pancreatic trauma were found in the literature. Symptoms related to these acquired ductal strictures are most commonly those of abdominal pain and recurrent episodes of acute pancreatitis. Recognition of post-traumatic chronic obstructive pancreatitis principally involves awareness that injuries to the pancreatic duct can produce remote complications. Pancreatoenteric drainage, or resection of the obstructed segment of pancreas, provides prompt and effective relief. PMID- 1777411 TI - t(10;11)(p13-14;q14-21): a new recurrent translocation in T-cell acute lymphoblastic leukemias. Groupe Francais de Cytogenetique Hematologique (GFCH). AB - A workshop held by the "Groupe Francais de Cytogenetique Hematologique" has identified a t(10;11)(p13-14;q14-21) in four acute lymphoblastic leukemias of T cell lineage. The immunophenotypes were consistent with immature thymocytes. This translocation is therefore a new candidate for a recurrent translocation in early T-cell leukemia. A similar translocation has been reported as a rare change in early pre-B lymphoid leukemias and also in myeloid leukemias. It is not known whether the similar cytogenetic changes involve different molecular breakpoints or whether the same rearrangement affects a multipotential stem cell capable of lymphoid and myeloid differentiation. PMID- 1777412 TI - Cytogenetic findings in aneurysmal bone cysts. AB - Cytogenetic analysis was performed on samples from ten patients diagnosed with aneurysmal bone cyst. Six of the patients were male and four were female, with ages ranging from 7 to 24 years. Results were obtained in eight of the cases; all were karyotypically normal. PMID- 1777413 TI - Consistent chromosome abnormalities in squamous cell carcinoma of the vulva. AB - Six squamous cell carcinomas of the vulva (SCV) were karyotyped in short-term culture and in early passages as established cell lines. Each tumor was cytogenetically distinct, contained multiple chromosome rearrangements, and was karyotypically stable in culture. Heterogeneity within individual tumors was manifested by the presence of more than one clonal population, but the clones within each tumor were closely related to one another. Seven consistent chromosome abnormalities found in five of the six tumors were: losses of 3p14 cen, 8pter-p11, 22q13.1-q13.2, and the short arm of the inactive X; chromosome gains involving 3q25-qter and 11q21; and rearrangement breakpoints at 5cen-q12. Ten additional chromosome changes were observed in four of the six SCVs, and together, 22 changes occurred in at least three of the tumors. Two specific losses, 10q23-q25 and 18q22-q23, were present in all four tumors that exhibited biologically aggressive behavior in vivo, but these losses were not found in the tumors of the two long-term survivors. These findings indicate that: 1) SCVs are genetically complex, but homogeneous; 2) loss of 18q22-q23 and loss of 10q23-q25 may be associated with a poor prognosis; and 3) development and progression of SCV appear to result from cumulative effects of altered gene dosage at multiple, consistent loci. PMID- 1777414 TI - Gene amplification and gene dosage in cell lines derived from squamous cell carcinoma of the head and neck. AB - Gene amplification and related alterations in gene dosage were analyzed in a series of 34 cell lines derived from different human head and neck squamous cell carcinomas (SCCHN). INT2 gene amplification was observed in 62%, MYC gene amplification in 24%, and EGFR gene amplification in 21% of the cell lines. There was a strong correlation between EGFR gene amplification and increased copies of the ERBB2 gene on chromosome 17, suggesting a synergistic selection for these two genes either during cancer progression or in culture. Two abnormalities showed a significant correlation with clinical course: MYC gene amplification showed an inverse correlation with tumor recurrence (r = -0.44, p = 0.01), and a small increase in MYCL gene copies on chromosome I correlated with the presence of metastases (r = 0.61, p = 0.001). This altered MYCL gene dosage might represent a chromosome translocation rather than true gene amplification. In addition to gene amplification, 79% of the cell lines had increased copies of chromosome 8. Comparison of the cell lines with several of the corresponding primary tumors demonstrated that most gene amplifications were already present in the primary tumors, although some appeared de novo in cell culture. These studies indicate that gene amplification, especially of INT2, is a prominent abnormality in head and neck squamous cell cancer. Aneuploidy and chromosomal lesions other than gene amplification were also found to alter the dosage of several oncogenes specifically. PMID- 1777415 TI - Variant translocations of chromosome 13 in alveolar rhabdomyosarcoma. AB - In three cases of alveolar rhabdomyosarcoma with variant translocations, two tumors contained an identical translocation, t(1;13)(p36.1;q14); the third tumor contained a t(8;13)(p21;q14). All three patients were 2 years old, markedly younger than the median age for patients with t(2;13)-positive alveolar rhabdomyosarcoma. The alteration of genetic material on chromosome 13 may be of primary importance in the development of alveolar rhabdomyosarcoma. PMID- 1777416 TI - Regulated expression of immunoglobulin trans-mRNA consisting of the variable region of a transgenic mu chain and constant regions of endogenous isotypes. AB - Our previous work demonstrated that chimeric immunoglobulin mRNAs (trans-mRNAs) composed of a transgenic VHDJH region and endogenous CH sequences could be synthesized, most likely by a trans-splicing mechanism, in a transgenic line carrying a rearranged human membrane-type mu chain gene. In this study we further investigated regulation of trans-mRNA expression. Regulated expression of different gamma subclasses of trans-mRNA was similar to that of class switching: IL-4 together with lipopolysaccharide (LPS) predominantly increased the amount of gamma 1 trans-mRNA whereas LPS alone mainly induced gamma 3 and gamma 2b trans mRNAs. Expression of the gamma class trans-mRNAs was preceded by germline transcription from the corresponding CH genes, but the co-existence of such germline transcripts and transgene transcripts was not sufficient for trans-mRNA production. Transforming growth factor-beta induced germline transcripts of the alpha chain CH gene but had no obvious effects on alpha trans-mRNA induction. Both C alpha gene alleles were used in trans-mRNA but in different frequencies. We could also detect trans-mRNA expression in another transgenic mouse line which carries a rearranged mouse VHDJH-C mu gene. These results indicate that trans mRNA synthesis is not restricted to either a particular transgenic line or an isotype, but is a general mechanism to express a second isotype with the VH regions of rearranged mu chain transgenes. PMID- 1777418 TI - Molecular definition of human beta 2-glycoprotein I (beta 2-GPI) by cDNA cloning and inter-species differences of beta 2-GPI in alternation of anticardiolipin binding. AB - Human beta 2-glycoprotein I (beta 2-GPI) is involved in cardiolipin (CL) binding of anticardiolipin antibodies (aCL) in systemic lupus erythematosus (SLE). We examined the inter-species differences of beta 2-GPI in alternation of CL binding of aCL. beta 2-GPI preparations were obtained from human, bovine, and rat sera by sequential CL--polyacrylamide affinity, DEAE--cellulose, and anti-human IgG conjugated Sepharose CL-4B column chromatography, and they had apparent molecular weights of 50, 53, and 55 kDa respectively. Human beta 2-GPI not only enhanced CL binding by aCL in SLE but also depressed it by those in syphilis. Either bovine and rat beta 2-GPI exerted no or quite small inhibition of the binding of syphilitic aCL compared with human beta 2-GPI whereas all three species of beta 2 GPI generated binding of aCL in SLE to a similar degree. Further, a complete cDNA clone, p beta 2-GPI, was isolated from a human hepatoma cell line, HepG2, and its nucleotide sequence was analyzed. The sequences of bovine and rat counterpart molecules (beta 2-GPI) are highly homologous to that of the deduced sequence, and their corresponding regions are 84.0 and 82.5% identical to the complete domain and to the amino acid sequence 53-326 of human beta 2-GPI respectively. One of major differences appears at position 154 in human beta 2-GPI, and might be associated with the inhibitory effect on the binding of syphilitic aCL. The sequencing analysis of these beta 2-GPI proteins might provide leads to functional sites of domains which would be associated with such serological phenomena. PMID- 1777417 TI - Clonal analysis of B lymphocyte responses to Plasmodium chabaudi infection of normal and immunoprotected mice. AB - Parasite infection causes marked perturbations in the host immune system, as shown by hypergammaglobulinemia, autoimmunity and immune depression, but there is little information on the number, specificities and performance of B cell clones activated in the course of infection. We have addressed these questions in a model of murine malaria induced by Plasmodium chabaudi, where primary infection results in very marked B cell responses that shift in Ig isotype pattern in immunoprotected animals, and where immunity can be transferred to naive recipients by injection of serum from late, but not early, infection. We have quantitated B cells responding to infection in two distinct functional compartments, namely blast cells and Ig-secreting cells, and compared normal with immune animals. We have also determined the frequencies of clonal specificities towards several autoantigens (DNA, myosin, transferrin and red cells), non-self protein or polysaccharide antigens (KLH, levan and dextran), and parasite antigens in both compartments, by measuring blast cell reactivities in limiting dilution analyses and Ig secretion in ELISASPOT assays. This experimental design allowed us to assess the specificity of the B cell responses, to compare the clonal composition of these two B cell compartments, and to evaluate putative specific response regulation at the step of terminal differentiation. Our results show that, in this particular experimental system: (i) B cell responses in primary infection are truly non-specific while immune animals show a greater ability to control the massive non-specific response; (ii) parasite specific B cells, particularly those committed to IgG production, are selectively stimulated in immune individuals; (iii) autoreactive B cells are not selectively stimulated, but increased autoantibody production may result from perturbation in the control of terminal differentiation in the respective clones; (iv) clones with specificity to some non-self antigens (e.g. KLH and dextran) are selectively engaged and regulated, which might have implications for the immunosuppression following infection. PMID- 1777421 TI - Interpopulational allogeneic reactions in the colonial protochordate Botryllus schlosseri. AB - Botryllus schlosseri is a cosmopolitan encrusting colonial tunicate which undergoes a natural transplantation reaction. When the growing edges of two colonies come into direct contact by interaction between their extracorporeal blood vessel termini, the ampullae, they either reject each other or fuse. This phenomenon is controlled by a single gene locus (Fu/HC) with multiple codominantly expressed alleles. Rejecting colonies share no alleles. Here we analyze allogeneic responses of Monterey (Mon), California, versus Woods Hole (WH), Massachusetts, colonies. Of 42 Mon x WH pairs tested, allogeneic rejection reactions occurred in all. Necrotic lesions (points of rejection, PORs) were produced and developed only by Woods Hole ampullae, either within the Woods Hole tunic, in the borderline between the paired colonies, or within the Monterey tunic. Four types of PORs were characterized. All types involved reactions of blood cells and vessels, including infiltration, hemorrhage formation, retraction and ampullae amputation. These findings were observed in single WH x Mon pairs, in multiple subclones of WH x Mon from two parental colonies (seven independent colony pairs were assayed), and on multiple repeats of interactions from pairs that had already undergone a rejection reaction. In all cases, the range of reaction types, the location of PORs, and the timing of the responses could be found in primary as well as repeat reactions. PMID- 1777419 TI - AIC2A is a component of the purified high affinity mouse IL-3 receptor: temperature-dependent modulation of AIC2A structure. AB - IL-3, a potent hemopoietic growth factor, interacts with distinct classes of receptor, one of high affinity and the other of low affinity. The gene for a 115 kDa, low affinity IL-3 binding protein (AIC2A) was recently cloned. Ligand affinity purification was used to show that the AIC2A gene product participates in the formation of a high affinity IL-3 receptor (IL-3R). Cells were incubated with biotin-IL-3 at 4 degrees C and IL-3 bound to the low affinity site was removed by washing, cells were detergent extracted, and then streptavidin - agarose was used to purify proteins bound to biotin-IL-3. A 115 kDa phosphotyrosine (Ptyr)-containing protein was specifically purified and its identity as AIC2A was shown in Western assays using polyclonal anti-AIC2A antibodies. A brief temperature shift of the intact, biotin-IL-3-treated cells from 4 to 37 degrees C, prior to receptor purification, results in structural and compositional changes in the IL-3R, including: (i) a 10-20 kDa increase in the apparent Mr of both the AIC2A and the Ptyr antigens, and (ii) the association of a serine/threonine kinase. These observations indicate that in its native environment, the low affinity IL-3 binding protein, AIC2A, participates to form the high affinity IL-3R and is a substrate for a tyrosine kinase. Moreover, a ligand-induced, temperature-regulatable structural change in the IL-3R may be of importance in the transduction of information through the receptor, as suggested by the enhanced association of the IL-3R with a serine/threonine kinase. PMID- 1777420 TI - Molecular genetic features reflecting the preference for isotype switching to IgA expression by Peyer's patch germinal center B cells. AB - It has proven difficult to evaluate the functional potential of germinal center (GC) B cells, including those from Peyer's patches (PP), by either in vivo or in vitro methods. Thus, rather than assess secreted Ig product as an indicator of functional potential we have instead sought to detect mRNAs related to the various Ig heavy chains in GC B cells from PP by in situ hybridization. We have found that the GCs of PP contain the vast majority of B cells with easily detectable levels of mRNA alpha. These levels are intermediate between those of small resting B cells and plasmablasts. When PP B cells are enriched for cells bearing GC markers, approximately 50% contain mRNA mu and 40% mRNA alpha. Similar enrichment for sIgA+ B cells gave 50% of cells with easily detectable mRNA alpha and few if any positive for mRNA mu. The sizes of these mRNAs were similar to those encoding the membrane and secretory form of mu and alpha chains. No C alpha germ-line transcripts could be detected by Northern analyses using a probe for sequences 5' to the alpha switch regions. Finally, GC and sIgA+ cells from PP also showed the absence of a portion of their genomic DNA for CH genes 5' of C alpha. Thus, it seems likely that most of the GC cells expressing mRNA alpha have undergone conventional VDJ recombination to C alpha at the DNA level in order to switch to the expression of IgA. Our findings reflect the extraordinary preference for switching to IgA by GC cells in PP. PMID- 1777422 TI - Comparison of IgD+ and IgD- thoracic duct B lymphocytes as germinal center precursor cells in the rat. AB - Genetically marked thoracic duct B cell subpopulations rich in either IgD+ or IgD B cells were transferred to non-irradiated, congenic rats in order to compare the capacities of IgD+ versus IgD- B cells to form germinal centers (GCs). This comparison was made quantitatively based on flow cytometric analyses of lymph node cells prepared from chimeric rats 7 days after s.c. immunization. Donor origin and host-origin B cells were distinguished using anti-Igk antibodies, and GC B cells were distinguished from other B cells in suspension by their lack of labeling with the mAb HIS22. IgK+ HIS22- lymph node cells corresponded well to GC B cells: they contained many large cells, were IgM+ but mostly IgD-, expressed relatively lower levels of IgM than HIS22+ B cells, and increased in number and frequency in response to antigen. Results from flow cytometric analyses, corroborated by immunofluorescence histochemical studies, showed that cell-for cell, IgD- B cells from GCs much more efficiently than IgD+ cells. B cell populations enriched for IgD- cells became relatively more distributed to GCs than to other lymph node B cell areas and gave rise to many more GC B cells of donor origin per transferred B cell than whole, unseparated thoracic duct B cells (for which greater than 97% were IgD+). IgD- B cells from rats primed deliberately with antigen also became relatively more distributed to GCs and gave rise to more GC B cells of donor origin than either IgD+ B cells from primed donors or IgD- B cells from unprimed donors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777423 TI - Sequential shifts in the three major glycosphingolipid series are associated with B cell differentiation. AB - Cell surface glycolipid expression as well as total glycolipid content of various B cell lines, representative of different B cell stages, and normal B lymphocytes were examined. Glycolipids, made up of a carbohydrate chain attached to a lipid called ceramide, are classified in four main 'series'. These series are defined according to the identity and chemical bonding of the sugars closest to the ceramide moiety. The pre-B cell lines contained lacto-series type II chain-based glycolipids and II3-alpha-N-acetyl-neuraminosyllactosylceramide (GM3) ganglioside. Upon differentiation, the lacto-series synthesis was shut down whereas compounds of the globo-series appeared: resting lymphocytes and lymphoblastoid cell lines (LCL) expressed GM3, globotriaosylceramide (Gb3), and globoside (Gb4). At a later stage of B cell differentiation, biosynthesis of the ganglio-series was extended and myeloma cells expressed II3-alpha-N-acetyl neuraminosylgangliotriosylceramide (GM2). At the cell surface, in addition to Gb3, that we previously described as specifically expressed on Burkitt's lymphoma cells and on a subset of germinal centre tonsillar B cells, two glycolipids seemed specific of certain B cell lines: Gb4 was strongly positive on six out of eight LCLs and on the low buoyant density fraction of tonsillar B lymphocytes, whereas GM2 ganglioside was only detected on the two myeloma cell lines. These results, demonstrating the stage-dependent expression of certain glycolipids, suggest that these carbohydrate molecules could play functional roles during B cell differentiation. PMID- 1777424 TI - Antigen targetting with monoclonal antibodies as vectors--II. Further evidence that conjugation of antigen to specific monoclonal antibodies enhances uptake by antigen presenting cells. AB - Immunization of rats with haptenized monoclonal antibodies (mAbs) against accessory cells enhances anti-hapten antibody responses. To see whether the mAb conjugates really targetted the antigen (hapten) to the antigen presenting cells, we have investigated the lymph node distribution of locally injected radiolabelled conjugates. Compared with control conjugates, i.e. haptenized non binding mAbs, a much larger proportion of the specific conjugates were retained in the draining lymph nodes. Whereas control conjugates were rapidly phagocytosed and degraded by macrophages, the specific conjugates were associated with the targetted accessory cells, which were radiolabelled for extended periods. Haptenated MRC OX6 (anti-MHC class II) gave strong labelling of interdigitating cells (IDC) in the paracortex with 70% of IDC still labelled by 4 days and 15% by 16 days following injection. By Western blots intact OX6 conjugates were still detected in the draining lymph node as long as 3 days after injections, whereas control conjugates were hardly detectable even by 24 h. The findings substantiate the idea that mAbs can be exploited for vectorial transport of antigens to accessory cells. PMID- 1777425 TI - Skewed B cell VH family repertoire in Bcl-2-Ig transgenic mice. AB - The proto-oncogene Bcl-2 is normally expressed in B lineage cells in a stage specific manner and extends cell survival. Deregulated Bcl-2 expression has been shown to cause a major expansion in surface IgM and IgD positive B cells. In this report, the influence of deregulated expression of Bcl-2 on the VH repertoire of B cells was studied. This was accomplished by stimulating B cells from both adult and fetal Bcl-2-Ig transgenic mice and their normal littermates using the polyclonal activator lipopolysaccharide. Activated cells were then analyzed by in situ hybridization using radiolabeled C mu and VH gene probes. The D-proximal VH families 7183 and Q52 were preferentially expressed in the adult transgenic mice compared to their normal littermates. VH 7183 and Q52 were also over-represented in fetal transgenic mice but not to a greater extent than that observed with normal fetuses. These results demonstrate that the overproduction of Bcl-2, which prolongs cell survival independent of affecting proliferation, substantially alters the VH gene repertoire. PMID- 1777427 TI - Fat fractal and multifractals for protein and enzyme surfaces. AB - The roughness and irregularity of the surfaces in the protein and enzyme are fractal features that may be characterized by fractal dimensions and mass exponents. The surface fractal dimensions calculated by the variation method are different from those obtained by other methods, since the former is applicable to the self-affine system. Thus the results reported here are reliable for the surfaces. However, the fat fractal and multifractal features of proteins and enzymes are studied by simulation. The surface mass exponents are regarded as another kind of scaling exponent, and the spectrum f(alpha) provides further detailed information about the surfaces of enzyme and protein. The applications of the spectrum f(alpha) to the enzymatic reactions is also discussed. PMID- 1777426 TI - Cloning and sequence analysis of a novel beta 2-related integrin transcript from T lymphocytes: homology of integrin cysteine-rich repeats to domain III of laminin B chains. PMID- 1777428 TI - Small-angle X-ray study on the quaternary structure of erythrocruorin from Caenestheria inopinata. AB - The erythrocruorin of the clam shrimp Caenestheria inopinata was studied in sodium phosphate buffer at pH 6.8 by small-angle X-ray scattering. The following molecular parameters were determined: radius of gyration 4.77 +/- 0.05 nm, maximum dimension 14.0 +/- 0.5 nm and a volume of 640 +/- 40 nm3. A model which fits the experimental data well is presented. The model is composed of 10 subunits arranged symmetrically in two layers, whereby five subunits are always forming a ring. PMID- 1777429 TI - Degradation of beta-lactam antibiotics in the presence of Zn2+ and 2-amino-2 hydroxymethylpropane-1,3-diol (Tris). A hypothetical non-enzymic model of beta lactamases. AB - The system composed of 2-amino-2-hydroxymethylpropane-1,3-diol (Tris) and Zn2+ catalyses the degradation of cephalosporins. The beta-lactam opening fits to a first-order process, with a constant directly proportional to the zinc ion concentration. The pH and Tris concentration dependency displayed by the first order constant, as well as the nature of the degradation products point to a mechanism that can be considered as an extension of that proposed for the benzylpenicillin degradation. The mechanism proposed here, and the values of the kinetic constants calculated, as compared with those of beta-lactamases, lead to the conclusion that the Tris-Zn2+ system simulates the catalytic action of the serine beta-lactamases rather than the action of the Zn(2+)-dependent type of enzymes. PMID- 1777430 TI - Analysis of hydrodynamic data for denatured globular proteins in terms of the wormlike cylinder model. AB - Hydrodynamic data, i.e. intrinsic viscosity and sedimentation coefficient, for denatured globular proteins in 6 M guanidinium chloride have been re-analysed in terms of the Yamakawa-Fujii theory of the wormlike cylinder model. Molecular parameters thus obtained ((mean value of R2 0/M) infinity, the Kuhn statistical segment length and the molecular weight per unit contour length) are in better agreement with the values obtained theoretically or by other methods than those evaluated on the basis of the model of non-draining random coil. PMID- 1777431 TI - Equilibrium binding of four anthracyclines to nucleic acids: thermodynamic properties and sequence selectivity. AB - The thermodynamic parameters of the interaction of the two anthracyclines 13 dihydrodaunomycin and marcellomycin with calf thymus DNA were examined by equilibrium binding studies. Enthalpy and entropy changes of the binding of both drugs show salt dependence profiles that cannot be rationalized by the polyelectrolyte theory. This feature is common to other anthracycline compounds. The nucleotide sequence binding preferences of daunomycin, adriamycin, 13 dihydrodaunomycin and marcellomycin have been studied by monitoring the degree of protection from cleavage by restriction endonucleases of linearized pBR322. Differential protection of pBR322 DNA against the cleavage of Bgl I and Ava II suggests that these drugs recognize changes in the sequences near the enzyme recognition site. Alterations of the electrophoretic restriction pattern of pBR322 in the presence of anthracyclines are dependent on time and on concentration. These results are discussed in relation to the existence of nucleotide sequences with different affinity for these drugs. PMID- 1777432 TI - Conformational study of signal peptides of the LamB protein. AB - A molecular mechanics study of a portion of the signal peptide of LamB protein, a mutant and two revertants, has been carried out. The peptides studied are: (I) Leu-Pro-Leu-Ala-Val-Ala-Val-Ala-Ala-Gly-Val for the wild type signal peptide; a mutant which shows no export capability (II), Leu-Pro-Val-Ala-Ala-Gly-Val; and two revertants with replacements of Pro by Leu (III), and Gly by Cys (IV) respectively. The results found are in agreement with the experimental data available; the aim of this work being to provide evidence of conformational features necessary along the export mechanisms. The present study suggests that both an alpha helix formation capability and a certain hydrophobicity of the peptide chain are the characteristics required for export competence. PMID- 1777433 TI - Three-dimensional reconstruction of innermost chorion layer of Drosophila grimshawi and Drosophila melanogaster eggshell mutant fs(1)384. AB - A low-resolution three-dimensional structure of the crystalline innermost chorionic layer (ICL) of the Hawaiian species Drosophila grimshawi and the Drosophila melanogaster eggshell mutant fs(1)384 has been calculated from electron microscope images of tilted negatively stained specimens. The isolated ICL of Drosophila grimshawi is a three-layer structure, about 36 nm thick, whereas the ICL of Drosophila melanogaster eggshell mutant fs(1)384 is a single layer, about 12 nm thick. Each unit in both crystalline structures includes octamers made up of four heterodimers. Crosslinks between the structural elements, both within and between unit cells form an interconnecting network, apparently important in maintaining the integrity of the layer. A model which may account for the ICL self-assembly formation in vivo and the ICL observed lattice polymorphism is proposed, combining data from the three-dimensional reconstruction work and secondary structure features of the ICL component proteins s36 and s38. PMID- 1777434 TI - A lipophilic heparin derivative protects elastin against degradation by leucocyte elastase. AB - An oleolylated derivative (I) of partially N-desulphated heparin was prepared containing an average number of three oleoyl residues for one molecule of heparin. The inhibitory capacity of I (IC50 = 0.55 microM) for leucocyte elastase resembles that of heparin (IC50 = 0.2 microM). In contrast to heparin, I is also an inhibitor of porcine pancreatic elastase (IC50 = 0.68 microM) and it also has the capacity to protect elastin fibres against the degradation by leucocyte elastase. When insoluble elastin is pretreated with I its degradation by leucocyte elastase is inhibited by almost 90% while pretreatment of elastin with heparin exhibited only a moderate effect on elastolysis (10% inhibition). PMID- 1777435 TI - Application of appropriate statistical methods in experimental surgery. PMID- 1777436 TI - Neutrophil chemotaxis and neutrophil elastase in the aortic wall in patients with abdominal aortic aneurysms. AB - To test the hypothesis that elastin-derived peptides (EDP) from human aortic tissue may be chemotactic for inflammatory cells, we studied the chemotaxis of neutrophils and monocytes to EDP derived from abdominal aortic aneurysm (AAA), aortic occlusive disease (AOD), and control aortas. In addition, we determined if neutrophils deliver neutrophil elastase to the aorta in vivo by staining for neutrophil elastase (NE) throughout the course of abdominal aortic aneurysms with the monoclonal antibody to human NE. EDP from AAA, AOD, and control tissue demonstrated significant chemotactic activity for both neutrophils and monocytes. All neutrophils had a greater attraction to EDP from AAA tissue compared to AOD and control aorta. Neutrophils from AAA patients were more attracted to EDP of AAA tissue than were neutrophils of AOD or control patients attracted to their respective aortic EDP. Neutrophil elastase stained positive in the adventitia and thrombus throughout the course of the aneurysm, but was not found in the intima, media, or plaque of the aorta. PMID- 1777437 TI - Pentagastrin stimulates potassium absorption from the rat colon. AB - Pentagastrin is trophic to the colon but the physiologic effects of pentagastrin are incompletely known. We compared in vivo potassium (K+) absorption from the colons of pentagastrin-treated (PG, n = 13), sham (S, n = 12), and control (C, n = 3) Sprague-Dawley rats during continuous intraluminal K+ perfusion. Preoperative intraperitoneal injections were administered to PG (pentagastrin 0.25 mg/kg in 2 mL 0.9% NaCl q 12 h x 48 h) and S (2 mL 0.9% NaCl q 12 h x 48 h). Under xylazine anesthesia, cannulae were placed in the cecum, rectum, and femoral artery of each rat. Intraluminal perfusion was performed for 2 h at 30 mL/min with 40 meq/L KCl in 0.9% NaCl (PG and S) or 0.9% NaCl (C). We monitored serum sodium (Na+) and K+ every 15 min, and the affluent and effluent Na+ and K+ every 30 min. At each interval past 60 min, we observed higher serum K+ in PG compared with S and C (P less than .002) and higher K+ in S compared with C (P less than .05). No changes in serum Na+ occurred. We conclude that pentagastrin stimulates potassium absorption from the colon. PMID- 1777438 TI - Morphological and functional evaluation of peripheral nerve regeneration in the rat using an expanded polytetrafluoroethylene (PTFE) microprosthesis. AB - The aim of our study was to evaluate in the rat the ability of a polytetrafluoroethylene microprosthesis (PTFE), to guide the peripheral nerve regeneration between the two extremities of a transected sciatic nerve. In 15 adult male Wistar rats, weighing 200 g, a segment of the right sciatic nerve was resected, leaving a gap of about 1 cm, bridged with microprosthesis, using our original microsurgical technique. Neurophysiological evaluations were performed at 6 and 9 months post-operatively to study the distal motor latency either in the right sciatic nerve or in the unoperated control side. In all the rats myoelectrical responses with an increased latency of the operated side were produced from the interosseous muscle of the foot. The animals were sacrificed 9 months post surgery. Histological sections at the level of the graft were done in all the rats, and in 10 animals biopsies of the tibialis anterior muscle (TA) of each side were performed. An active process of axonal regeneration was documented inside the graft, with no infiltration of nerve fibers through the wall of the prosthesis. A connective fibrous reaction was present around the external wall of the graft. Muscle biopsies showed definite signs of muscle reinnervation, with residual features of variable degree of denervation. These findings stress and confirm the ability of the PTFE graft to allow effective regeneration in a peripheral nerve gap in the rat. PMID- 1777439 TI - Restoration of paralyzed orbicularis oculi muscle function by controlled electrical current. AB - A canine model of facial nerve paralysis was studied to apply controlled electrical current to the peripherally denervated orbicularis oculi muscle, in the attempt to effectively restore the absent function of this denervated muscle. After unilateral facial nerve neurotmesis was performed in eight dogs, the denervated orbicularis oculi muscles of four dogs were electrically stimulated for 75 postoperative days (40 min/day). Denervated and normal orbicularis oculi muscles were electrophysiologically studied and compared with the Student t test. During the study period, minimum closure of denervated treated orbicularis oculi muscles was evoked with average stimulus strength (80-ms duration) of 1.61 +/- 0.22 log mA x ms, not significantly different from that of denervated nontreated or normal orbicularis oculi muscles. From days 10 through 30 only, maximum closure of denervated treated orbicularis oculi muscles was achieved with mean pulse strength (80-ms duration) of 2.37 +/- 0.09 log mA x ms, significantly lower (P less than .01) than that evoking the same type of contraction from denervated nontreated muscles (80-ms duration, mean 2.83 +/- 0.10 log mA x ms). In addition, denervated treated muscle pulse strength eliciting maximum contraction was not significantly different from that of normal orbicularis oculi muscles during the same period. This finding was not observed, however, from day 40 through the end of the study. This investigation demonstrates (1) the transient reversal of denervation changes of paralyzed orbicularis oculi muscle by daily electrical stimulation, and (2) the feasibility of restoring orbicularis oculi muscle function by controlled electrical current. PMID- 1777440 TI - In vivo study of an elastomer end-coated polytetrafluoroethylene vascular prosthesis. AB - Polyurethane end-coated polytetrafluoroethylene (PTFE) grafts (elastomer PTFE grafts) were implanted in 12 female adult mongrel dogs to assess patency, intimalization, tissue incorporation, and technical suitability of the material as a vascular graft. Each dog had bilateral aortoiliac grafts placed, one a standard PTFE and the other an elastomer PTFE graft. The length of the grafts was 7-8 cm and the diameter was 6 mm. The grafts were harvested at intervals to 120 days postoperatively. The elastomer PTFE grafts showed superior longitudinal elasticity, retention of shape, and no graft tearing with suture tension; however, no significant difference in bleeding was noted at the anastomoses between the standard and elastomer PTFE grafts. Satisfactory patency was obtained with both standard (8/10) and elastomer PTFE grafts (9/10) at 90-120 days. No significant difference in the thickness of intima and the length of pannus ingrowth was noted between the standard and elastomer PTFE grafts. No outer tissue incorporation was seen at the elastomer-treated graft segments as opposed to the well-incorporated untreated segments. In conclusion, elastomer end-coating of a PTFE vascular prosthesis provided excellent handling characteristics without detracting from patency; however, the lack of outer tissue incorporation may be a potential disadvantage in its clinical use. PMID- 1777441 TI - Experimental cholelitholysis with the pulsed tunable dye laser. AB - This study evaluates the pulsed tunable dye laser with wavelength 504 nm, frequency 10 Hz, and pulse width 1.2 microseconds for cholelitholysis. Power of 10-40 kW was directed through a 250-microns quartz fiber optic to ablate 55 gallstones (removed from 14 patients). The fiber was positioned in direct contact with the stones under saline. Power delivery was begun at 10 kW and increased in 10-kW increments until litholysis began. The range of power and energy necessary to fragment the gallstones was evaluated on four common bile ducts (fresh autopsy specimens). Following fragmentation, all stones were analyzed. There were 35 cholesterol stones (3 calcified) and 20 bilirubin stones (4 calcified). Size ranged from 0.012 to 7.56 cm3 (mean 0.96 +/- 1.41 cm3). Energy necessary for fragmentation ranged from 0.4 to 11.2 J (exposure time 1.0-28 s). Power necessary for fragmentation was 20 kW for 2/55 stones and 40 kW for 53/55 stones. At 40 kW (40 mJ/pulse), common bile duct perforation occurred within 1.1 +/- 0.1 s (0.44 +/- 0.04 J). The pulsed tunable dye laser can fragment gallstones of all compositions. The threshold for fragmentation is 40 kW, but common bile duct perforation occurs at this power. We conclude that laser radiation sufficient to fragment gallstones can injure the common bile duct. PMID- 1777442 TI - Leukocyte redistribution and eicosanoid changes during the autoperfused working heart-lung preparation. AB - We studied the role of leukocyte redistribution and eicosanoid changes in the early stages of instituting 16 rabbit autoperfused working heart-lung preparations (AWHLP). Physiological changes occurring during the transition from the intact animal to the AWHLP may determine the survival and viability of the organ blocks for transplantation. White blood cell (WBC) count decreased from 5,160/microL to 1430/microL (P less than .01) at 60 min of autoperfusion. Differential WBC counts performed in ten of these AWHLP revealed a 63% decrease in lymphocyte count and an 88% decrease in the granulocyte count at 60 min. Thus, the predominant leukocyte remaining in the circulation was the lymphocyte. Blood samples were collected from the intact animal and from the AWHLP for assay of the stable metabolites of thromboxane A2 (TxA2) and prostacyclin (PGI2). Transition from the in situ heart-lung block to the in vitro AWHLP stage caused significant changes in these metabolites. The PGI2 metabolite 6-ketoprostaglandin F1a (6KPGF1a) increased from 2680 +/- 487 to 4339 +/- 478 (pg/mL), P less than .05, while the TxA2 metabolite, thromboxane B2 (TxB2) decreased from 618 +/- 105 to 289 +/- 63 (pg/mL). However, assays of 11-dehydro-TxB2 (11-DHT), a longer lived metabolite of TxA2 (n = 7) increased (668.4 +/- 84.6 to 946.4 +/- 43.7, P less than .05). The transition from the in situ heart-lung block of the intact animal to the AWHLP involves significant physiological changes. Redistribution of leukocytes occurs with a predominant decrease in the granulocyte count, while levels of bioactive lipid mediators show a distinct large rise in the PGI2 metabolites and a lesser increase in TxA2 metabolites.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777443 TI - Aortic endothelial and smooth muscle cell co-culture: an in vitro model of the arterial wall. AB - Interactions between vascular endothelial (EC) and smooth muscle cells (SMC) contribute both to the normal function of the vascular wall and to the pathogenesis of lesions such as atherosclerosis and fibrointimal hyperplasia. However, study of these interactions has been hampered by the difficulty in growing these two cell types in simultaneous culture. Methods using conditioned media, shared media, and bilayer culture have been described, but none is well suited to the study of vascular cell interactions. We report a method for EC-SMC co-culture that preserves bilayer morphology, allows independent study of the cells and their matrices after intervention, remains stable over long periods in culture, and permits study of changes in cell-cell interaction with growth of the cells to confluence. This simple bilayer co-culture system simulates the in vivo situation and may enhance our understanding of EC-SMC interactions. PMID- 1777444 TI - Rabbit model for evaluation of a long small-caliber vascular graft. AB - We developed an experimental method for evaluating the properties and healing process of a long, small-caliber vascular graft in a small animal. Eight rabbits were used. A left thoracotomy was performed and the thoracic aorta was isolated. The aorta was clamped and excised in the middle without a temporary shunt. A 15 cm-long by 4.0-mm-ID segment of a vascular graft was implanted end to end. After the blood flow of the aorta was restarted, the long graft remained in a big loop shape in the thoracic cavity and showed no tension. The major advantage of this technique is that, although it is simple, we are still able to evaluate a long, small-caliber vascular graft in a small animal. PMID- 1777445 TI - Modification to the RITARD surgical model. AB - The Removable Intestinal Tie-Adult Rabbit Diarrhea (RITARD) procedure is the surgical model of choice for studying pathogenesis of diarrheas of Campylobacter, Escherichia coli, and Aeromonas origin. Other than nonhuman primates, the RITARD rabbit is the only model that closely resembles human infection. Classically, the RITARD model is created by isolating the terminal ileum using umbilical tape placed in a slipknot fashion, and injecting the occluded segment with the organism of choice. The slipknot is removed at 4 h postinoculation and patency of the gut reestablished. We found removal of the umbilical tape to be extremely difficult, usually requiring a second surgery to gently untie the material and prevent destruction of the fragile intestinal tissue. This complication of the described procedure appeared to be related to the absorptive and abrasive nature of the tape material. The modification described uses the same idea, but a different material and a different knot pattern. The tubing was easily removed at the prescribed 4 h postsurgery, without an additional surgery. The tubing did not adhere to or damage the gut, yet did provide the occlusive seal required for a 4 h static gut. Histologically, no evidence of pressure could be found at the tie site. PMID- 1777446 TI - Rapid in-line blood warming using microwave energy: preliminary studies. AB - The management of massive blood loss resulting from trauma or surgery necessitates rapid transfusion capability. Hypothermia secondary to shock, transfusion, and prolonged surgical procedures significantly increases morbidity and mortality in these patients. Transfusion at high flow rates frequently exceeds the warming capacity of conventional blood-warming devices, whose inherent resistance also limits the maximal flow rates. Microwave ovens are capable of blood warming, but have been associated with unacceptable hemolysis. We have investigated the possibility of using microwave energy to provide rapid in-line blood warming. Fresh blood from 10 human subjects was warmed from an average of 18 degrees C to temperatures ranging from 37 to 39 degrees C at flow rates from 250 to 500 mL/min. Laboratory analysis of free plasma hemoglobin, haptoglobin, hematocrit, hemoglobin, and electrolytes showed no difference between heated and control samples. LDH was elevated in those samples warmed repeatedly, but remained within the normal range. These data indicate the potential for further investigation utilizing properly controlled microwave energy for in-line blood and fluid warming. PMID- 1777447 TI - Miniaturized heart-lung machine. AB - The miniaturized heart-lung machine consists of commercially available roller pumps, a flexible heat exchanger, a newly devised bubble oxygenator, and polyethylene cannulas and silicone tubes. The minimum and maximal priming volume of the entire system is 4.7 and 16.7 mL, respectively. The efficiency of the system is reflected in an heat transfer coefficient ranging from 0.96 to 0.31 at flow rates between 1 and 20 mL/min, a high value of oxygen uptake in the range of 0.061 mL O2/min mL blood-1, and low blood trauma with plasma hemoglobin concentrations of 47.5 +/- 5.0 mg/dL after 60 min of in vitro perfusion. The system is a simple, reliable, and efficient miniaturized heart-lung machine for use in small animals. PMID- 1777448 TI - The Robertson-Brosens-Dixon hypothesis: evidence for the role of haemochorial placentation in pregnancy success. PMID- 1777449 TI - Elective section after two sections--where's the evidence? PMID- 1777450 TI - Abortion in Poland. PMID- 1777451 TI - Erythrocyte hydration in normal human pregnancy. AB - OBJECTIVE: To determine whether the fall in plasma osmolality in normal human pregnancy resulted in cellular overhydration. DESIGN: The changes in erythrocyte hydration, potassium and total osmoles in response to a decrease in osmolality in vitro and associated with the fall in plasma osmolality in normal pregnancy were determined. SUBJECTS: Fifty-one women were studied serially during pregnancy and again 20 weeks after delivery. RESULTS: Erythrocytes from pregnant women exposed in vitro to a 29.9% osmolality decrement had a 28.5% increase in cell hydration. At 14 weeks gestation although plasma osmolality was lower than after delivery (281.1 vs 291.6 mosmol/kg; P less than 0.001) both erythrocyte hydration (1.83 l/kg dry weight cells) and potassium (264 mmol/kg) contents were reduced from the nonpregnant values (1.88 l/kg; P less than 0.01; 272 mmol/kg; P less than 0.001). For the remainder of pregnancy plasma osmolality remained at this lower level but cell hydration and potassium both increased to values at 38 weeks gestation that were greater than in the nonpregnant state (1.92 vs 1.88 l/kg; 287 vs 272 mmol/kg). CONCLUSIONS: These findings suggest that a loss of cell osmoles may be a primary event affecting cell hydration in pregnancy and plasma osmolality is then reduced to maintain normal cell hydration. Subsequent changes in cell hydration were led by changes in intracellular osmole content. PMID- 1777452 TI - Insufficient remodelling of the uterine connective tissue in women with protracted labour. AB - OBJECTIVE: To investigate the association between a slow progress of labour and insufficient remodelling of the uterine connective tissue. DESIGN: An open comparative study. SETTING: Danderyd Hospital, Department of Obstetrics and Gynaecology, referral centre. SUBJECTS: Eleven women (study group) in oxytocin augmented labour but with an unripe cervix in whom vaginal delivery could not be accomplished and 12 women (normal labour group) in normally progressing spontaneous labour and a favourable cervix but who needed to be delivered by caesarean section due to signs of fetal distress. INTERVENTIONS: At caesarean section tissue specimens were obtained from the fundus, the isthmus and the cervix uteri. MAIN OUTCOME MEASURES: Collagen concentration and extractability, collagenolytic activity expressed as DNP-peptide hydrolytic activity and the concentrations of sulphated glycosaminoglycans (S-GAG) and hyaluronic acid (HA) in the tissue specimens. RESULTS: Statistically significantly higher concentrations and lower extractability of collagen in the isthmus and the cervix uteri was found in women with slow progress of labour compared with those with normal labour. CONCLUSIONS: An insufficient remodelling of the connective tissue in the cervix and isthmus uteri may contribute to slow progress of labour. PMID- 1777453 TI - Fetal heart rate and intrauterine growth. AB - OBJECTIVE: To assess whether fetal heart rate in early and late pregnancy relates to size at birth. DESIGN: Prospective study of fetal heart rates in early and late pregnancy. SETTING: Princess Anne Hospital, Southampton. SUBJECTS: 63 primigravid women. MAIN OUTCOME MEASURES: Anthropometric measurements made on the newborn infant. RESULTS: There were no differences in heart rate between the sexes at 18 weeks gestation but by 36 weeks the boys had rates which were 4.4 beats lower than those of the girls. Higher fetal heart rate at 18 weeks was associated with lower ponderal index, smaller head circumference and smaller mid arm circumference. There were no trends in fetal heart rate at 36 weeks with any birth measurements. CONCLUSION: Babies born at term who have a pattern of neonatal measurements which reflect growth retardation have raised heart rates in early pregnancy. Influences which impair fetal growth appear to take effect early in gestation. PMID- 1777454 TI - Chromosome abnormalities detected in chorionic villus biopsies of failing pregnancies in a subfertile population. AB - OBJECTIVE: To determine the range and prevalence of chromosomal abnormalities occurring in failing pregnancies in subfertile women. DESIGN: Prospective biochemical and ultrasound monitoring of all pregnancies conceived between 1988 and 1990 in a subfertile population. SETTING: A single-centre specialist fertility clinic in Perth, Western Australia. SUBJECTS: Tissue from 50 early pregnancy losses was successfully cultured for chromosomal analysis from 46 pregnancies comprising 29 anembryonic pregnancies, 9 miscarriages and 8 ectopic pregnancies. MAIN OUTCOME MEASURES: Impending pregnancy loss was identified at an early stage. Chromosomal analysis was performed on chorionic villi obtained before the diagnosis became clinically evident. RESULTS: Significant chromosomal abnormalities were identified in 54% (14/26) of early pregnancy losses where gamete manipulation was involved and 45% (9/20) of those following spontaneous conception. The most common abnormalities were trisomies (12 pregnancies, mainly trisomy 16), triploidies (3 pregnancies) and monosomy X (3 pregnancies). An excess of female fetuses was noted with only 24% of conceptuses (11/46) bearing a Y chromosome. CONCLUSIONS: The data indicate a similar rate of chromosomal abnormalities underlying pregnancy losses at earlier stages of pregnancy and after infertility treatments as that reported from the general population. Gamete manipulation does not appear to confer a higher rate of chromosomal abnormalities in ensuing pregnancies. PMID- 1777455 TI - Emergency cervical cerclage. AB - OBJECTIVE: To assess the efficacy of emergency cervical cerclage. DESIGN: Retrospective review of patients who underwent emergency cervical cerclage between August 1986 and August 1989. SETTING: University College and the Middlesex Hospitals obstetric unit, a neonatal referral centre. SUBJECTS: 19 women between 16 and 28 weeks gestation with a cervical dilatation between 3 and 10 cm. There were two twin pregnancies. INTERVENTIONS: Amniocentesis and bacteriological assessments were performed prior to cerclage and prophylactic antibiotics were given. Insertion of sutures was aided by a combination of techniques described previously. MAIN OUTCOME MEASURES: Prolongation of gestation and pregnancy outcome. Bacteriological findings at delivery and maternal and fetal morbidity were also recorded. RESULTS: Membranes remained intact in all the women after cerclage. Fifteen live babies were born and 13 of them survived (survival rate 63%). Gestation was prolonged from between 1 and 19 weeks in these patients and the gestational age at delivery ranged from 25 to 41 weeks. All eight intrauterine or neonatal deaths were associated with infection. Infecting organisms included Escherichia coli, Gardnerella vaginalis, Mycoplasma hominis, Trichomonas vaginalis and Fusobacterium spp. Pregnancy was prolonged for less than or equal to 5 weeks in these infected pregnancies. A cervical laceration occurred in a patient who had the suture inserted at full dilatation and subsequently laboured, but there were no other maternal complications. CONCLUSIONS: Emergency cervical cerclage can prolong pregnancy and influence the outcome favourably. PMID- 1777456 TI - Platelet reactivity and serum thromboxane B2 production in whole blood in gestational hypertension and pre-eclampsia. AB - OBJECTIVE: To determine the nature and extent of changes in platelet reactivity in gestational hypertension and pre-eclampsia (using whole blood techniques which may be more physiological than those previously employed). DESIGN: Cross sectional observational study. SUBJECTS: 8 normal primigravidae, 16 women with gestational hypertension and 12 women with pre-eclampsia, studied at around 36 weeks gestation. RESULTS: Platelet reactivity (aggregation and release reaction) induced by stimulation with adrenaline was decreased in the pre-eclamptic group. Serum thromboxane B2 production was unchanged in both hypertensive groups compared with the control group. CONCLUSIONS: In the context of evidence of platelet activation in pre-eclampsia, our findings are interpreted as reflecting platelet exhaustion. PMID- 1777457 TI - Is oral contraceptive use still associated with an increased risk of fatal myocardial infarction? Report of a case-control study. AB - OBJECTIVE: To investigate the association between fatal myocardial infarction and use of modern low-dose oral contraceptives. DESIGN: A case-control study. SETTING: General practices throughout England and Wales. SUBJECTS: 161 women aged under 40 dying from myocardial infarction during 1986-1988. Living controls (2 per case), matched for age and marital status, were chosen from general practice lists. Information was collected during structured interviews with general practitioners, and from postal questionnaires sent to surviving partners of the cases and to control women. MAIN OUTCOME MEASURES: Mortality from myocardial infarction in relation to many risk factors, notably oral contraception, as measured by relative risk. RESULTS: After allowing for the confounding effects of medical risk factors and for surgical sterilization, the overall relative risk associated with both current and past use of oral contraceptives was estimated to be 1.9 (95% CI 0.7 to 4.9, and 1.0 to 3.5 respectively). The relative risk associated with current use of preparations containing 50 micrograms of oestrogen, however, was estimated to be 4.2 (0.5 to 39.2). At least some of the relative risk associated with oral contraceptive use is likely to be attributable to the confounding effect of cigarette smoking, but it is impossible to estimate how much from the available data. CONCLUSIONS: If there was an increased risk of fatal myocardial infarction associated with oral contraceptive use in 1986-1988 it is likely to have been less than two-fold; in this study risks were slightly, but not significantly, elevated with both current and previous use. It may be that any increase in risk is associated solely with the older combined preparations containing 50 micrograms of oestrogen. PMID- 1777458 TI - Conservative laparoscopic treatment of ectopic pregnancies using the CO2-laser. AB - OBJECTIVE: To assess the feasibility of CO2-laser-endoscopic surgical treatment for large and/or ruptured ectopic pregnancies, and to compare the results with those of microsurgical salpingotomy. DESIGN: A retrospective review of all women treated for an ectopic pregnancy during a 6-year period, 1984-1989. During 1988 and 1989 treatment was randomized by the day of admission, depending only upon the surgeon in charge, some performing a linear salpingotomy (n = 42) and some a CO2-laser laparoscopy (n = 34) in all women haemodynamically stable. SETTING: Department of Obstetrics and Gynaecology, University Hospital Gasthuisberg, Leuven. SUBJECTS: 135 women with ectopic pregnancies of whom 76 were included in the randomized series between 1988 and 1989. Overall 11 were treated by pelvic lavage, 78 by laparotomy and 46 by laparoscopic procedures. MAIN OUTCOME MEASURES: Postoperative complications, duration of hospital stay. Cumulative pregnancy rates after the procedures. RESULTS: The two groups of women analysed in the randomized series were comparable for duration of amenorrhoea, diameter of the ectopic pregnancy and prevalence of 'ruptured' ectopics, but the duration of stay in hospital was much shorter (mean 2.9, SD 1.8 days) for the 34 women treated by laparoscopy than for the 42 women treated by laparotomy (mean 6.8, SD 1.6 days). The postoperative cumulative pregnancy rate was higher in nulliparous women with a history of infertility or pelvic inflammatory disease (PID), when treated with CO2-laser-laparoscopy (P = 0.009). The recurrency rate was low (less than 5% in both groups). Overall in the women treated by laparotomy, postoperative cumulative pregnancy rates were lower following excision or adnexectomy than after a microsurgical linear salpingotomy (P = 0.01). Four women treated by laparoscopy required a second procedure. CONCLUSION: Endoscopic treatment of large and/or ruptured ectopic pregnancies is feasible and resulted in a shorter hospital stay and, in nulliparous women with a history of PID or infertility, in higher cumulative pregnancy rates, than after microsurgical salpingotomies. PMID- 1777459 TI - The role of Chlamydia trachomatis and Neisseria gonorrhoeae in the aetiology of ectopic pregnancy in Gabon. AB - OBJECTIVE: To study the association between ectopic pregnancy and Chlamydia trachomatis and Neisseria gonorrhoeae. DESIGN: A prospective observational study with two comparison groups. SETTING: A general hospital in Franceville, Gabon. SUBJECTS: Forty-five women with ectopic pregnancies and two comparison groups each of 45 women, one at 5 to 12 and the other at 32 to 41 weeks gestation. MAIN OUTCOME MEASURES: Serum levels of IgG and IgA antibodies to C. trachomatis (L1 and rMOMP) and N. gonorrhoeae (pili) in all the women. In the women with ectopic pregnancy peritoneal adhesions were scored and in 40 women samples of tube were cultured for organisms being studied. RESULTS: IgG and IgA antibodies to C. trachomatis (L1) were detected in 84% of the ectopic group and 53 and 39% of the comparison groups (P less than 0.0001). IgG and IgA antibodies to N. gonorrhoeae occurred in 49, 28 and 18% and 49, 28 and 26% of the groups but the differences were not statistically significant. Adhesions were positively associated with the antibodies. C. trachomatis was cultured from the tubes of 71% of the women with ectopic pregnancy. CONCLUSIONS: Infection with chlamydia, and probably with N. gonorrhoeae, is an important factor in the causation of ectopic pregnancy in Gabon. PMID- 1777460 TI - An audit of the management of ectopic pregnancy. AB - OBJECTIVE: To estimate the local incidence of ectopic pregnancy and to review the management of ectopic pregnancy with reference to those misdiagnosed at presentation. To establish management guidelines to be applied to all possible ectopic pregnancies. DESIGN: A review of all ectopic pregnancies presenting over a 2-year period, and of emergency gynaecological admissions during 4 months. SETTING: A teaching hospital. RESULTS: The local rate of ectopic pregnancy was similar to that seen in other UK studies. Nineteen (13%) women with ectopic pregnancies were sent home with an incorrect diagnosis. Eight were recalled but eight required emergency admission and one died at home. Undue confidence in ultrasound reports and failure to follow up inconclusive histology results were a feature in cases where patients were not recalled. A set of simple management guidelines has been drawn up. Amongst general gynaecological admissions 1 in 12 of all first trimester complications was an ectopic pregnancy. Amongst apparently true uterine miscarriages 20% of histological examinations were inconclusive and histology and ultrasound examinations failed to confirm a uterine miscarriage in 14% of apparently true missed miscarriages. CONCLUSIONS: Ectopic pregnancy is common amongst first trimester complications. Adherence to simple management guidelines would minimize the number of patients requiring emergency admission, though up to 20% of patients with apparently true uterine miscarriages would also require further investigation. PMID- 1777461 TI - Colposcopically directed punch biopsy: a potentially misleading investigation. AB - OBJECTIVE: To determine the relation between the histology of an initial colposcopically directed punch biopsy and a subsequent diathermy loop excision biopsy of the transformation zone, and the effect of lesion size on this relation. DESIGN: Prospective observational study of loop diathermy excision biopsies of the cervical transformation zone. SETTING: Academic unit colposcopy clinics at The Birmingham and Midland Hospital for Women and Dudley Road Hospital, Birmingham. SUBJECTS: 243 women managed by colposcopy and directed punch biopsy followed by loop diathermy excision. OUTCOME MEASURES: The histology of the punch biopsy and the excised transformation zone and the size of the abnormal lesion. RESULTS: In 132 (54%) of the 243 women the histology of the punch biopsy and loop excision specimen did not agree. In 62 (47%) of these 132 women a more severe lesion was found in the excised transformation zone, including three unsuspected adenocarcinoma in situ and one stage Ia1 cancer. In 39 (41%) of the 96 women in whom a lesion of CIN 3, or greater severity, was found in the loop excision specimen, the paired punch biopsy had suggested a lesion of lesser severity. In small area lesions, the punch biopsy was more likely to show more severe disease than the loop excision specimen (P = 0.0014). CONCLUSIONS: The results suggest that directed punch biopsy is an inadequate endpoint by which to judge the severity of an epithelial lesion. The findings have important implications for patient management and the design of trials and cast doubt on the results of studies using punch biopsy as an endpoint. PMID- 1777462 TI - Presence of an oestradiol receptor-related protein in the skin: changes during the normal menstrual cycle. AB - OBJECTIVE: To investigate the presence of an oestradiol receptor-related protein (P29) in skin and skin organelles, and to assess changes in its content during the normal menstrual cycle. DESIGN: An observational study. SETTING: King's College School of Medicine and Dentistry, London. SUBJECTS: Twenty-one premenopausal women with regular menstrual cycles undergoing gynaecological surgery. They were allocated to proliferative or secretory phases of the menstrual cycle on the basis of menstrual dating and histological examination of an endometrial sample. INTERVENTIONS: Small full thickness sections of skin (about 5 mm in depth) taken from the anterior abdominal wall at hysterectomy or laparoscopic sterilization. MAIN OUTCOME MEASURES: The concentration of the oestradiol receptor-related protein in skin and its organelles was assessed semi quantitatively, using a monoclonal antibody technique. The intensity of staining was compared between the proliferative and secretory phases of the cycle. RESULTS: The receptor-related protein was consistently observed in epidermis, sebaceous glands, hair follicles and sweat ducts; there was no significant difference in its concentration between the proliferative and secretory phases of the menstrual cycle. The protein was not present in dermis and sweat ducts. CONCLUSIONS: Epidermis and some skin organelles contain an oestradiol receptor related protein and must be considered as oestrogen target tissues. However, the content of this protein does not appear to change significantly during the normal menstrual cycle. PMID- 1777463 TI - Assessment of urinary symptoms in early pregnancy. AB - OBJECTIVES: To determine the correlation between lower urinary tract symptoms and urodynamic findings in early pregnancy. SETTING: The termination clinic and gynaecology ward at King's College Hospital. DESIGN: Observational study. SUBJECTS: 47 women before termination of pregnancy at between 6 and 15 weeks. INTERVENTIONS: Women filled in symptom questionnaires and then had urodynamic investigations, consisting of uroflowmetry and subtracted provoked cystometry. MAIN OUTCOME MEASURES: The occurrence of lower urinary tract symptoms and their association with urodynamic findings. RESULTS: Lower urinary tract symptoms were fairly common but there was poor correlation with the urodynamic findings. CONCLUSIONS: The findings suggest that lower urinary tract symptomatology alone is insufficient to study lower urinary tract dysfunction in pregnancy. PMID- 1777464 TI - Sensory urgency: how full is your bladder? AB - OBJECTIVE: To investigate whether women with sensory urgency have an abnormal perception of bladder fullness. DESIGN: Prospective observational study. SETTING: Urodynamic Unit, St George's Hospital, London. SUBJECTS: 15 women with sensory urgency, 15 women with idiopathic detrusor instability and 15 without symptoms of frequency or urgency (control group). INTERVENTIONS: All the women attended for cystometry. Each was asked to complete a visual analogue score of how full she perceived her bladder to be on a scale from 1 to 10. This was done before filling cystometry and at three times during bladder filling. At each time actual filled volume was noted. MAIN OUTCOME MEASURES: Maximum bladder capacity and individual perception of bladder fullness. RESULTS: Women with sensory urgency and detrusor instability had similar maximum bladder capacity although values in both groups were significantly lower than in the control group; thus percentage of maximum bladder capacity was used for analysis. Linear regression was performed for each group of patients and a predicted visual analogue score at 25, 50 and 75% of capacity calculated. These were compared between groups by rank analysis of variance. There was no significant difference between sensory urgency and detrusor instability. However, at 25, 50 and 75% of capacity, both groups had a significantly higher score than the control group. CONCLUSIONS: This abnormal perception would explain symptoms of frequency and urgency in these two groups. These results also confirm the similarity between detrusor instability and sensory urgency. PMID- 1777465 TI - Pregnancy in Crigler-Najjar syndrome. Case report. PMID- 1777466 TI - Maternal trauma and cerebral lesions in preterm infants. Case reports. PMID- 1777467 TI - Retention of the second twin: a viable option? Case reports. PMID- 1777468 TI - Twin pregnancy in a patient with idiopathic long QT syndrome. Case report. PMID- 1777469 TI - Avicenna's recipe for contraception. PMID- 1777471 TI - Difficulties in the diagnosis of congenital toxoplasmosis by cordocentesis. PMID- 1777470 TI - Management of tubal infertility in the 1990s. PMID- 1777472 TI - Psychiatric morbidity and acceptability following medical and surgical methods of induced abortion. PMID- 1777473 TI - Pre-eclampsia and phospholipid antibody. PMID- 1777474 TI - Intrauterine pressures in labours induced by amniotomy and oxytocin or vaginal prostaglandin gel, compared with spontaneous labour. PMID- 1777475 TI - Genome informatics. PMID- 1777476 TI - Insertional versus targeted mutagenesis in mice. AB - Recent innovations in mutagenesis techniques for mice have the potential to revolutionize the molecular genetic analysis of mouse development. Insertional mutagenesis by the introduction of exogenous DNA into the mouse germline hs permitted the molecular cloning and analysis of several novel genes important for early embryonic development. Targeted mutagenesis by homologous recombination in embryonic stem cells permits, in theory, the production of mutations in any cloned gene. The complementary information being obtained from these two mutagenesis procedures is shedding new light on the genes important for early mouse development, and the roles these genes play in that process. PMID- 1777477 TI - Sex, promiscuity, and the bacterial cell. Bacterial Conjugation Systems sponsored by the European Molecular Biology Organization, Schloss Ringberg, Germany, June 30-July 4, 1991. PMID- 1777478 TI - All this and SH2. Seventh Annual Meeting on Oncogenes sponsored by the Foundation for Advanced Cancer Studies, Frederick, MD, USA, June 24-29, 1991. PMID- 1777479 TI - Capsid caper in Cable. XIIth International Conference on Bacteriophage Assembly, Cable, WI, USA, June 11-16, 1991. PMID- 1777480 TI - Cloning of R kappa B, a novel DNA-binding protein that recognizes the interleukin 2 receptor alpha chain kappa B site. AB - Transcriptional activation of the interleukin-2 receptor alpha (IL-2R alpha) gene in T cells is dependent on a regulatory element that can bind NF-kappa B but differs in sequence and function from the kappa B site of the immunoglobulin (Ig) enhancer. To define the molecular basis of gene-specific regulation by this variant kappa B site, we have used electrophoretic mobility shift assays to characterize a novel gene product, designated R kappa B, that binds preferentially to the related kappa B site in IL-2R alpha. A cDNA encoding this 107-kD protein has been isolated from a lambda gt11 expression library by screening with a probe containing the IL-2R alpha kappa B site. R kappa B is a tissue-specific transcription factor that contains an amino acid sequence similar to a discrete region of the myogenic regulatory protein MyoD, but is unrelated to other DNA-binding proteins, including those belonging to the rel/dorsal gene family. This novel kappa B binding protein may therefore contribute to the regulation of distinct cellular and viral genes with variant kappa B sites. PMID- 1777481 TI - Three basic regions in adenovirus DNA polymerase interact differentially depending on the protein context to function as bipartite nuclear localization signals. AB - Adenovirus DNA polymerase (AdPol) contains three clusters of basic amino acids within the N-terminal 48 amino acids: RARR, which begins at amino acid 8, RRRVR, which begins at amino acid 25, and RARRRR, which begins at amino acid 41. These clusters are designated BS I, BS II, and BS III, respectively. (The amino acid codes are: R, arginine; A, alanine; V, valine.) Mutational analysis of these noncontiguous clusters showed that AdPol contains a novel organization of bipartite nuclear localization signals (NLS) that interact differentially to serve in the nuclear targeting of AdPol or of chimeric proteins in which AdPol is linked to Escherichia coli beta-galactosidase (beta-gal). The region containing BS I and BS II functioned interdependently as an NLS for the nuclear targeting of AdPol, for which BS III was dispensible. However, the region containing BS II and BS III constituted a second and more efficient bipartite NLS for the nuclear targeting of the AdPol-E. coli beta-gal fusion protein. Moreover, deletion or limited insertion of amino acids in the spacer region between BS II and BS III did not affect their nuclear targeting function for these fusion proteins. Chou Fasman predictive analysis of protein secondary structure in the vicinity of the bipartite NLS sequences supports a model in which protein conformation in the spacer region may play an important role in bringing these clusters of basic amino acids into close proximity, allowing them to function as nuclear targeting signals for this class of nuclear proteins. PMID- 1777482 TI - Description of a baby machine for Saccharomyces cerevisiae. AB - A method for the continuous withdrawal of newly formed daughter cells from a growing population of Saccharomyces cerevisiae is described. An exponential-phase culture of cells was immobilized onto a surface and then flushed continuously with culture medium. Upon division of a cell in the immobilized population, the mother cell remained attached to the surface and the daughter cell was released. The method can be applied to research on the cell cycle, the segregation of components between cells, and cellular aging. PMID- 1777483 TI - Activity of the kappa B enhancer of the interleukin-2 receptor alpha chain in somatic cell hybrids is accompanied by the nuclear localization of NF-kappa B. AB - The two nuclear proteins NF-kappa B (consisting of subunits p50 an dp65) and the DNA-binding subunit of NF-kappa B (p50) by itself, also called KBF1, are constitutively expressed and localized in the nucleus of the human T-cell line IARC 301.5. In order to define the roles of these two factors, which bind to the same kappa B enhancers, in transcription activation we have prepared somatic cell hybrids between IARC 301.5 and a murine myeloma. Most hybrids express both KBF1 and NF-kappa B in their nuclei, but one hybrid expresses only KBF1. The kappa B enhancer of the gene encoding the interleukin-2 (IL-2) receptor alpha chain (IL 2R alpha) is functional only in the hybrids expressing nuclear NF-kappa B. These findings show that nuclear NF-kappa B is necessary to activate the kappa B enhancer, while KBF1 by itself is not sufficient. We propose that KBF1 is a competitive inhibitor of NF-kappa B and discuss how these factors may be involved in the transient expression of IL-2 and IL-2R alpha genes during the immune response. PMID- 1777484 TI - Changes in hsp70 alter thermotolerance and heat-shock regulation in Drosophila. AB - To test the role of the heat shock protein hsp70 in induced thermotolerance and in the regulation of the heat-shock response, we established cell lines with altered expression of the Hsp70 gene. Underexpressing cells were created by transformation with antisense Hsp70 genes, and overexpressing cells by transformation with extra copies of the wild-type gene. Expression at normal temperatures was achieved by placing Hsp70 coding sequences under the control of the metallothionein promoter. Cells that expressed mutant hsp70s were created by transforming cells with deletion and frameshift mutations. The results indicate that hsp70 plays a major role in both thermotolerance and regulation. Surprisingly, they also indicate that these functions can be separated. Overexpression affected thermotolerance more than regulation; underexpression affected regulation more than thermotolerance. A carboxyl-terminal deletion of Hsp70 had a severe dominant-negative effect on thermotolerance but only a minor effect on regulation; an amino-terminal deletion strongly affected regulation but not thermotolerance. A model that explains these observations is presented. PMID- 1777485 TI - alpha-2,8-Polysialic acid is the neuronal surface receptor of antennapedia homeobox peptide. AB - A synthetic peptide that is 60 amino acids in length and corresponds to the homeobox sequence of antennapedia protein (pAntp) is specifically and efficiently captured by neurons in culture and conveyed to their nuclei. The internalization process is followed by a strong induction of neuronal morphological differentiation. In the study described here, all treatments masking or removing the alpha-2,8-polysialic acid (PSA) chains specific to the neuronal cell adhesion molecule (NCAM) were found to block the penetration of pAntp and abolish its morphogenetic effects. Structural comparison between PSA and double-stranded DNA suggests that a sequence of eight sialic acid residues can mimic one large groove of the DNA. We propose that this structural similarity is the basis for the property of NCAM polysialic acid to participate in the internalization of the homebox polypeptide. PMID- 1777486 TI - Day case surgery in childhood from the parents' point of view. AB - 294 parents whose children underwent day case surgery received a questionnaire covering the topics postoperative analgesia, memory of pain, sleep patterns and assessment of the time spent in the hospital. A total of 80.6% of the questionnaires were returned. We were not able to recognize any indications of behavioral disturbances, in particular disturbances of sleep. The need for analgesics was surprisingly low following release from the hospital. However, even on the third postoperative day 16.8% of the children still had unpleasant or strong memories of the pain they had experienced. Improvement in this area might be achieved by the application of nerve blocks, possibly in combination with analgesics. Further possibilities for improvement exist with premedication. The long waiting periods between hospital admittance and commencement of surgery were found to be very unpleasant. During surgery psychological counseling of the parents should be made possible. PMID- 1777487 TI - A detailed description of soft tissue morphology in unilateral cleft lip and palate cases--a study applying a new soft tissue analysis. AB - More than 1,500 CLP patients have been treated in Berne using a protocol which has always remained fundamentally the same. Even though--from birth to 20 years of age--the finest possible plastic surgery, orthodontics and prosthodontics were undertaken, the specialists involved considered that the patient, at the end of treatment, still possessed a CLP appearance to some extent. Neither the cephalometric analyses, nor the occlusal findings, however, provided any explanation for this, and a new method of soft tissue analysis was therefore developed to provide a detailed picture of the tissue overlying the skeletal profile. This involved taking sagittal cephalometric hard tissue landmarks and locating the equivalent points on the soft tissues. The corresponding hard and soft tissue points were then related to each other both horizontally and vertically. In this way, the soft tissue width along the entire profile could be defined together with the angles around the curvature of the face. Such an analysis makes it possible to describe the soft tissue profile in individual cases and to compare cleft and non-cleft populations. In the present study 25 males (mean age 18) and 23 females (mean age 16.7) with unilateral complete CLP were analysed to define in detail the criteria forming the "cleft palate face". PMID- 1777488 TI - The effect of steroid treatment on corrosive oesophageal burns in children. AB - A retrospective study was done on corrosive oesophageal burns to ascertain the preventive effect of corticosteroids on stricture development. Within the last 12 years 351 children were admitted to our medical centre with a history of corrosive agent ingestion. In 235 of these the diagnosis of oesophageal burn was confirmed by means of oesophagoscopy. Children admitted within the first 48 hours received steroid, antibiotic and fluid therapy while fluid and antibiotics were given, if needed, in the rest. Forty-six of the children were lost to follow-up. The type of corrosive agent, the admission period, the degree of the burn and the stricture development were used as parameters. Stricture development was found statistically significant in late admitted patients vs. early admissions. This retrospective study suggests the effectiveness of corticosteroid treatment in preventing the stricture development. PMID- 1777489 TI - Patient complications during extracorporeal membrane oxygenation (ECMO). AB - Extracorporeal membrane oxygenation (ECMO) has rapidly become the treatment of choice for critically ill newborns with reversible pulmonary disease not responding to conventional treatment. Since 1987 ECMO has been available at our hospital and up to December 1989 11 patients were treated. Several patient complications were seen. The aim of this study was to register the incidence and treatment of these complications and to compare our results with international ECMO experience. It is concluded that many of the complications seen during ECMO can be successfully managed. PMID- 1777490 TI - Free autogenous muscle transplantation in children. Long-term results. AB - For more than 15 years we have been using free muscle transplantation in the treatment of anal incontinence in children. This method implies transposition of a striated muscle, usually the palmaris longus, two weeks after denervation, to the perirectal area as a U-sling around the rectum corresponding to the location of the so-called puborectalis muscle. We have now evaluated the long-term results in all 26 children operated on by this method. Before the operation all children were totally incontinent after a primary repair. At follow-up after an average of 11 years and 4 months, 60% of the cases were regarded as good, 16% as fair, 8% as improved and 16% as failures. In our opinion, free muscle transplantation offers a good chance of achieving acceptable continence in a majority of incontinent children. PMID- 1777491 TI - MR imaging in hemophilic arthropathy. AB - 20 children with hemophilia were examined with Magnetic Resonance Imaging (MRI) to determine if MRI could be used to assess hemophilic arthropathy, especially in the early stages. 28 joints of the appendicular skeleton were imaged, including 17 knees, 10 ankles and 1 elbow. The results were compared to clinical and plain radiographic assessments and to the surgical findings when synovectomy was performed. MRI is able to evaluate the components of hemophilic arthropathy such as fluid effussion, synovial hypertrophy, the status of the articular cartilage, and bony lesions. These lesions can be discovered at an early stage when plain radiographs are still normal. MRI seems to be useful for the selection of patients needing early treatment of hemophilic arthropathy and in monitoring response to therapy. PMID- 1777492 TI - Tubular adenoma of the breast in a pregnant girl: report on a case. AB - A rare case of a tubular breast adenoma in a 13-year-old pregnant girl is presented. The tumor which developed during pregnancy measured 10 x 8 x 4 cm, was well demarcated and could be totally removed. PMID- 1777493 TI - A rare case of congenital esophageal obstruction by double membranes: a case report. AB - An infant with a rare type of congenital esophageal obstruction by double membranes is presented. This anomaly has, we believe, not been described so far. On the suspicion of an esophageal atresia the child was operated upon but an unexpected anomaly was found. PMID- 1777494 TI - Occlusion of liver veins (Budd-Chiari syndrome) in childhood: a case report. AB - The Budd-Chiari syndrome is a rare cause of portal hypertension during childhood. We report on a 2-year-old boy suffering from liver congestion and ascites. No cause for the occlusion of the liver veins was found. There was an almost complete occlusion of the subdiaphragmatic vena cava due to compression by a hypertrophic lobus caudatus. Normal venous pressure could be demonstrated below this subtotal occlusion while numerous venous collaterals into the areas of the venae azygos and hemiazygos were encountered. A mesocaval shunt operation, therefore, seemed to be appropriate. There was, however, no decrease in production of ascites postoperatively. Repeat cavography now showed an elevation of venous pressure caused by the additional inflow of portal blood which could not, as expected, be compensated by caval collaterals. Therefore, a mesoatrial shunt was performed eight days after the first operation. However, even this additional shunt did not decrease the enormous production of ascites, and the child finally died. Hemodynamic and lymphodynamic pathways of the Budd-Chiari syndrome are discussed. Possibly a mesoatrial shunt in the first place, followed by a mesocaval shunt, would have been the better operative strategy. PMID- 1777495 TI - Perforated nonspecific ulcer of the colon in children. AB - Nonspecific ulceration of the colon is rarely seen in children. The most common location is the cecum, but the left colon is the involved segment in 15% of patients. We describe two affected children, who presented acutely with free colonic perforation. In the first patient, treatment consisted of exteriorization followed by delayed closure, and in the second child of localized excision followed by primary two-layer suture. Both patients recovered uneventfully. PMID- 1777497 TI - Cloacal exstrophy: a case report. AB - A case of an extremely rare type of cloacal exstrophy in a male infant with a normally developed subvesical part of the urinary system and external genitalia but absent distal colon segment is presented. The patient also had omphalocele, upper urinary tract anomalies and sacrococcygeal teratoma. PMID- 1777496 TI - Peno-scrotal transposition and the caudal regression syndrome. AB - Peno-scrotal transposition is a rare condition of variable severity, often associated with the Caudal Regression Syndrome. A case of incomplete peno-scrotal transposition, with a perineal anorectal duplication, vesico-ureteric reflux and thoracic hemivertebrae is presented. The literature is reviewed. PMID- 1777498 TI - Changes in cocaine use after entry to methadone treatment. AB - A cohort sample of 93 addicts admitted to methadone maintenance in four clinics was followed-up for one year to determine change, and predictors of change, in cocaine use. Any use of cocaine in the preceding month decreased from 84% of subjects at admission to 66% at follow-up, and mean days of cocaine use per month for those still using decreased from 16 days to 9 days. Any drug injection in the preceding month decreased from 100% of subjects at admission to 39% at follow-up, among those remaining in the program. Continuance/cessation of cocaine use was not associated with program retention, but cocaine users were more likely to be administratively discharged. Reported symptoms of depression and speedballing at admission were significant predictors of continuance/cessation of cocaine use at follow-up. State-of-the-art cocaine abuse treatment, with attention to treatment of depression, would enhance the value of methadone maintenance for patients with dual heroin/cocaine addiction. PMID- 1777499 TI - Cardiovascular evaluation after withdrawal from chronic alcohol or cocaine alcohol abuse. AB - Alcohol ingestion commonly accompanies cocaine abuse, but the effects of chronic cocaine-alcohol abuse on the circulation are undefined. Therefore, to test for evidence of cocaine-alcohol cardiac dysfunction and interference with cardiovascular nervous system reflexes, 10 normal volunteers (group I), 8 asymptomatic alcoholic patients (group II), and 15 age matched, asymptomatic cocaine and alcohol abusers (group III) underwent screening two-dimensional echocardiography, electrocardiography, a series of autonomic nervous system tests, and upright bicycle exercises. Echocardiographic indices did not differ among groups. R wave voltage was increased in group III, probably primarily due to a smaller body surface area. Heart rate (HR) and/or systolic blood pressure (SBP) responses to 60 degree tilt and to hyperventilation differed in group III (decreased HR response, while SBP increased inappropriately). Despite excellent exercise tolerance, HR response to exercise in group III (compared to group I) was decreased. These results suggest impairment of certain autonomic nervous system reflexes and, possibly, sinus node dysfunction from cocaine-alcohol abuse. PMID- 1777500 TI - Preventing HIV transmission in drug treatment programs: what works? AB - The AIDS epidemic has dramatically affected drug treatment programs, creating both an epidemiological crisis and a psychological one. A paramount question for treatment program staff is how to prevent patients from acquiring or spreading HIV. The health belief model has been useful in generating prevention approaches, including programs that raise the threat of infection, provide alternative behaviors, and build social support. Some of these programs have been effective in changing attitudes and reducing the behaviors that put drug users at risk for acquiring or transmitting HIV. Future research will develop collaborative studies, disseminate techniques to drug treatment programs, and develop more powerful interventions for patients who continue with risky behaviors. PMID- 1777501 TI - The Tacoma Syringe Exchange. AB - For over a year, the Tacoma Syringe Exchange has been operating in spite of existing drug paraphernalia laws. One hundred fifty-four subjects have been interviewed regarding drug injection practices for the month prior to first use of the exchange and for the most recent month since using the exchange. Statistically significant reductions in mean frequency of obtaining used syringes, and in mean rate of passing on used syringes, have been reported. Mean number of times bleach was used to disinfect contaminated syringes has risen. The exchange continues to attract mainly men, median age 35, with a long history of injection. No differences have been observed in mean number of injections per month. In order to increase utilization, new sites are planned, but expansion has been hampered by a series of legal problems. Since the exchange draws many difficult to reach individuals, it is an important location for STD screening and drug treatment recruitment. Documentation of participation patterns and barriers to exchange use, and effects upon HIV serological status are recommended. PMID- 1777502 TI - Organizing as a new approach to AIDS risk reduction for intravenous drug users. AB - This paper looks at an innovative approach to AIDS risk reduction among intravenous drug users who are not in treatment. The new method utilizes an organizing model that involves the mobilization of drug users to promote risk reduction. This strategy targets the group as well as the individual for change. Standard outreach techniques have had some success in achieving HIV risk reduction, particularly for behavior that reduces risk through altering drug use behavior, but still leaves many users at risk. Intravenous drug users in the Netherlands and gays in the United States have organized around HIV-related issues with some success. Preliminary evidence from New York City suggests that organizing drug users may be an effective approach for achieving significant HIV risk reduction for individual users as well as those they associate with. PMID- 1777503 TI - Why woman partners of drug users will continue to be at high risk for HIV infection. AB - Women infected with Human Immunodeficiency Virus (HIV) via a sexual relationship with an infected drug using partner are the second largest group of women diagnosed with AIDS in this country. Since 1983, they have been the most rapidly growing subgroup of adults with AIDS, and the increase has been even more rapid among black and hispanic women. Because they are a diverse group and are not readily identified, women partners of drug users and their needs have been unknown to or neglected by service providers and programs that could help them avoid becoming infected. More complete understanding of their characteristics and needs can help in the development of sensitive educational, preventative, and therapeutic strategies to help slow the dramatically increasing burden of AIDS related morbidity and mortality among them and their families. PMID- 1777504 TI - Epidermal growth factor and transforming growth factor-alpha: differential intracellular routing and processing of ligand-receptor complexes. AB - Two structurally related but different polypeptide growth factors, epidermal growth factor (EGF) and transforming growth factor-alpha (TGF-alpha), exert their activities after interaction with a common cell-surface EGF/TGF-alpha-receptor. Comparative studies of the effects of both ligands have established that TGF alpha is more potent than EGF in a variety of biological systems. This observation is not explained by differences in affinities of the ligands for the receptor, because the affinity-constants of both factors are very similar. We have compared the intracellular processing of ligand-receptor complexes using either EGF or TGF-alpha in two different cell systems. We found that TGF-alpha dissociates from the EGF/TGF-alpha-receptor at much higher pH than EGF, which may reflect the substantial difference in the calculated isoelectric points. After internalization, the intracellular TGF-alpha is more rapidly cleared than EGF, and a substantial portion of the released TGF-alpha represents undegraded TGF alpha in contrast to the mostly degraded EGF. In addition, TGF-alpha did not induce a complete down-regulation of cell surface receptors, as observed with EGF, which is at least in part responsible for a much sooner recovery of the ligand-binding ability after down-regulation, in the case of TGF-alpha. These differences in processing of the ligand-receptor complexes may explain why TGF alpha exerts quantitatively higher activities than EGF. PMID- 1777506 TI - Carboxy-terminal truncations of epidermal growth factor (EGF) receptor affect diverse EGF-induced cellular responses. AB - The binding of epidermal growth factor (EGF) to its receptor induces tyrosine phosphorylation of phospholipase C gamma (PLC gamma), which appears to be necessary for its activation leading to phosphatidyl inositol (PI) hydrolysis. Moreover, EGF-receptor (EGF-R) activation and autophosphorylation results in binding of PLC gamma to the tyrosine phosphorylated carboxy-terminus of the receptor. To gain further insights into the mechanisms and interactions regulating these processes, we have analyzed transfected NIH-3T3 cells expressing two EGF-R carboxy-terminal deletion mutants (CD63 and CD126) with reduced capacity to stimulate PI hydrolysis, Ca2+ rises, and DNA synthesis. In fact, the CD126 mutant lacking 126 carboxy-terminal amino acids, including four tyrosine autophosphorylation sites, was unable to stimulate PI hydrolysis or Ca2+ rise in response to EGF. Surprisingly, EGF binding to the cell lines expressing CD63 or CD126 mutants was followed by similar stimulation of tyrosine phosphorylation of PLC gamma. Our results suggest that although necessary, tyrosine phosphorylation of PLC gamma may not be sufficient for stimulation and PI hydrolysis. It is clear, however, that the carboxy-terminal region of EGF-R is involved in regulation of interactions with cellular targets and therefore plays a crucial role in postreceptor signaling pathways. PMID- 1777505 TI - Isoprenoid pathway activity is required for IgE receptor-mediated, tyrosine kinase-coupled transmembrane signaling in permeabilized RBL-2H3 rat basophilic leukemia cells. AB - Previously, we reported that the isoprenoid pathway inhibitor, lovastatin, blocks the activation by IgE receptor cross-linking of 45Ca2+ influx, 1,4,5-inositol trisphosphate production, secretion, and membrane changes (ruffling, spreading) in intact RBL-2H3 rat basophilic leukemia cells. These results indicated that an isoprenoid pathway intermediate, very likely an isoprenylated protein, is importantly involved in the control of IgE receptor-mediated signal transduction. Here, we show that 20 h of pretreatment with lovastatin also inhibits antigen induced secretion and membrane responses in streptolysin O-(SLO)-permeabilized cells. However, lovastatin does not inhibit secretion stimulated by the nonhydrolyzable GTP analog, GTP gamma S. Furthermore, the membrane responses to GTP gamma S persist, although in an attenuated form, in lovastatin-treated permeabilized cells. The relative insensitivity of GTP gamma S-induced responses to lovastatin was one of several indications that antigen and GTP gamma S may activate separate pathways leading to transmembrane responses in permeabilized cells. Further experiments showed that the beta-thio derivative of GDP, GDPBAS, inhibits the secretory and membrane responses to GTP gamma S, as expected for a GTP-binding protein-dependent signaling pathway, while having little effect on antigen-induced responses. Conversely, genistein blocks the secretory and membrane responses to antigen, as expected for a tyrosine kinase-dependent pathway, without altering the GTP gamma S-induced responses. From these results, and from additional data from cells treated with tyrphostins and sodium orthovanadate, we propose that IgE receptor-mediated secretion from permeabilized RBL-2H3 cells occurs by a tyrosine kinase-dependent pathway that requires isoprenoid pathway activity for function. We propose further that RBL-2H3 cells contain a separate GTP-binding protein-mediated signaling pathway whose direct activation by GTP gamma S is either independent of isoprenoid pathway activity or depends on the activity of an isoprenylated protein that is not significantly depleted after 20 h of lovastatin treatment. PMID- 1777508 TI - Men and nursing: can they make a difference? PMID- 1777507 TI - p42/mitogen-activated protein kinase as a converging target for different growth factor signaling pathways: use of pertussis toxin as a discrimination factor. AB - Mitogen-activated protein (MAP) kinase is a 42-kDa serine/threonine-specific protein kinase that requires phosphorylation on both tyrosine and threonine residues for activity. This enzyme is rapidly and transiently activated in quiescent cells after addition of various agonists, including insulin, epidermal growth factor, platelet-derived growth factor, and phorbol esters. We show here that addition of the growth factors thrombin or basic fibroblast growth factor to CCL39 fibroblasts rapidly induces tyrosine phosphorylation of the p42 MAP kinase protein and concomitantly stimulates MAP kinase enzymatic activity. To elucidate the signaling pathways utilized in this activation, we took advantage of the sensitivity of CCL39 cells to the toxin of bordetella pertussis, which ADP ribosylates two Gi proteins in this cell system. We show that pretreatment of cells with the toxin inhibited thrombin stimulation of MAP kinase by greater than 75% but had no detectable effect on the stimulation induced by basic fibroblast growth factor. We also demonstrate that these two growth factors that synergize for mitogenicity are able to cooperate in activation of MAP kinase and that this synergism is partially sensitive to pertussis toxin. Finally, we describe a 44 kDa protein, the tyrosine phosphorylation of which appears to be coregulated with p42 MAP kinase. We conclude that p42 MAP kinase (and the pp44 protein) are at or are downstream from a point of convergence of two different receptor-induced signaling pathways and might well play a key role in integrating those signals. PMID- 1777509 TI - Men and nursing: a growing trend. PMID- 1777511 TI - Administering medications. PMID- 1777510 TI - Nurses stress the health in health care. PMID- 1777513 TI - PRT adds new dimension to hospice care. PMID- 1777512 TI - Nurses at risk. RNABC calls for guidelines to protect health workers from hepatitis-B. PMID- 1777514 TI - In praise of casual nursing. PMID- 1777515 TI - Was Dr. Welby really a nurse? PMID- 1777516 TI - [Biochemical kinetics of plasmid replication processes]. AB - Two groups of plasmid replication reactions occurring during the growth of cell populations were kinetically characterized: 1) short-term intermediate processes coupled with changes in plasmid concentrations in host cells and occurring in the first few generations; 2) long-term processes resulting in the loss of plasmids and occurring during prolonged cultivation of cells. It was shown that first group processes are determined by the ratios of plasmid replication rates relative to cell growth. Using growing populations of E. coli as examples, it was shown that the shape of kinetic curves reflecting the plasmid copy number depends on the nature of their replicon. In this case plasmids with ColE1 replicon exhibit kinetic behaviour of the first type (temporal loss of plasmid copy number in the cells), whereas plasmids with p15 replicon display the second type behaviour consisting in the decrease of the plasmid copy number followed by its short-term drastic increase. For both types of kinetic behaviour a kinetic description adequately reflecting these processes is given. It is supposed that the loss of plasmids during long-term cultivation of cell populations may be associated with both segregation (lower growth rates of plasmid-containing cells in comparison with cells containing no plasmids) and mutation mechanisms. Kinetic descriptions of both mechanisms are proposed and principles of their discrimination are formulated. Practical recommendations for the prevention of the plasmid loss by the cells that are based on theoretical data are given. PMID- 1777517 TI - [Features of peroxidase oxidation of amidopyrine and its analogs]. AB - Peroxidatic oxidation of N-alkyl and sulfalkyl-substituted 4-aminopyrazolones (amidopyrine and metapyrine) is mediated by oxyperoxidase, whereas the oxidation of non-substituted 4-aminoantipyrine occurs via the classical peroxidase cycle, without oxyperoxidase accumulation. The free radicals formed at the first step of the oxidation cycle show a tendency for disproportionation and exchange. During catalysis in heavy water the oxidation of substituted aminopyrazolones is accelerated by plant peroxidase. This effect is due to the activation of the second oxidative state of the enzyme. Complete peroxidatic oxidation of amidopyrine results in the formation of several reaction products. The main product is not identified as dioxypyramidone formed via nonenzymatic peroxidatic oxidation. The oxidation of the indicator (azopyram) which represents an amidopyrine-aniline mixture results first in the formation of amidopyrine radicals. The reaction product (dye) is formed via the binding of these radicals to aniline radicals. The latter are predominantly formed via a nonenzymatic route during the reduction of the amidopyrine radicals by aniline. Similar to the formation of azopyram and the full oxidation of amidopyrine, this reaction is accompanied by the displacement of the substituents from the 4-amino group. PMID- 1777518 TI - [Interaction of menadione and duroquinone with Q-cycle during DT-diaphorase function]. AB - The interaction of quinones (menadione and duroquinone) with DT-diaphorase and mitochondrial electron transport chain translocators at low (120 mosM) and high (400 mosM) values of the medium tonicity in the quinone concentration range of 6 90 microM was studied. It was shown that with a rise in menadione (K3) concentration the number of electron transport carriers interacting with it increase. At K3 concentration of 6 microM the latter is reduced by DT-diaphorase and fully oxidized via the Q-cycle. At K3 concentration of 15 microM the latter is also reduced by DT-diaphorase via the Q-cycle, but in this case the oxidation is incomplete (about 30% K3H2 is oxidized by the terminal part of the respiratory chain). At 90 microM K3 50% of quinone is reduced by DT-diaphorase and 50% by the respiratory chain NADH dehydrogenase complex enzymes; about 30% of K3H2 is oxidized via the Q-cycle, about 20%--by the terminal part of the respiratory chain and about 50%--by O2 without cytochrome oxidase. Unlike menadione, duroquinone (6-90 microM) is reduced only by DT-diaphorase and is oxidized in all cases by cytochrome oxidase. It was shown that the increase in the mitochondrial matrix volume in low tonicity media decreases the rate of the DT-diaphorase shunt operation. PMID- 1777519 TI - [Cellobiohydrolase from Clostridium thermocellum, synthesized by a recombinant E. coli strain]. AB - Clostridium thermocellum cellobiohydrolase was isolated in preparative amounts from the recombinant strain of E. coli K12 C600 carrying plasmid pCU 304 with a C. thermocellum chromosomal DNA insertion. The isolation procedure included chromatography on Ultrogel AcA 44, ion-exchange chromatography on DEAE-Sepharose CL-6B, rechromatography on Ultrogel and FPLC on Mono Q resulting in a 17.6% yield and 1530-fold purification. According to data from sodium dodecylsulfate polyacrylamide gel electrophoresis performed under nondenaturing conditions and analytical gel isoelectrofocusing, the enzyme preparation contains only one active protein band with Mr 56.2 +/- 1.0 kDa and pI 4.15. The enzyme does not reduce the viscosity of the CM-cellulose solution but forms reducing sugars from this soluble substrate. Cellobiose (93-97%) is the major component produced by the enzyme from crystalline and amorphous cellulose (specific activity 2.3 x 10( 3) and 2.8 x 10(-2) U/mg, respectively). The activity optimum of the enzyme is at pH 5.6, 60 degrees C. The half-inactivation time at 60 degrees C and 65 degrees C is 450 and 15.5 min, respectively. The action pattern of the enzyme on the low molecular fluorogenic cellooligosaccharides suggests that the enzyme pertains to typical cellobiohydrolases. PMID- 1777520 TI - [Status of the antioxidant system and lipid peroxidation in rat liver after poisoning animals with aminobiphenyl]. AB - It was found that intoxication of animals with aminobiphenyls leads to the activation of such glutathione-dependent enzymes as glutathione-S-transferase and glutathione reductase. This is accompanied by the induction of activities of individual isoforms of the multifunctional family of glutathione-S-transferases. There was a decrease in the glutathione peroxidase activity after intoxication with benzidine derivatives. It was found that the GSH content in rat liver decreased after benzidine intoxication and sharply increased after effects of 3,3'-dimethylbenzidine and 3,3'-dimethoxybenzidine. In all cases studied there was a diminution in the level of diene conjugates. It was supposed that the specificity of the catalytic glutathione redox system reaction is due to structural peculiarities of the aminobiphenyls being injected. Analysis of functional pairs of glutathione-dependent enzymes revealed a certain imbalance in the antioxidant system function after aminobiphenyl poisoning. PMID- 1777521 TI - [Interaction of rabbit skeletal muscle glycogen synthase I with substrate analogs -oxo-UDP hydrazones]. AB - Inhibition of rabbit skeletal muscle glycogen synthase I was studied by using several synthetic substrate analogs: dansylhydrazone of oxo-UDP, 3-hydroxy-2 naphthoylhydrazone of oxo-UDP, salicyloylhydrazone of oxo-UDP, 1-oxyl-2,2,5,5 tetramethylpyrrolidine-3-carbonylhydrazone of oxo-UDP, N' (dansyl)hydrazinocarbonylhydrazone of oxo-UDP and N'-(fluorenylidene-9) hydrazinocarbonylhydrazone of oxo-UDP. All these compounds (with the exception of the nitroxyl-containing hydrazone) were characterized by a nonlinear dependence of the reverse reaction rate on the analog concentration in Dixon coordinates. The parabolic type of inhibition was due to the fact that the analogs tested except for the nitroxyl-containing hydrazone were able to interact both with the active center of the enzyme and with the FMN-binding site. The inhibition constants for oxo-UDP hydrazones were calculated for the both centers; their comparison revealed that the affinity of the analogs for the FMN-binding site increased with an increase in the radical hydrophobicity. These data suggest that the site with a high binding affinity for FMN is hydrophobic in nature. Apparently, isoalloxasine-like compounds display the highest affinity for this site. PMID- 1777522 TI - [Oligomeric forms of recombinant interleukin-2]. AB - Human recombinant interleukin 2 produced by Escherichia coli gives rise to oligomeric forms that are stable to complete denaturation. The appearance of these forms is preceded by the formation of oligomers sensitive to reduction. These processes depend on the cell status and seem to be associated with aggregation of the reaction product. PMID- 1777523 TI - [Study of the pyruvate dehydrogenase complex by circular dichroism]. AB - A comparative study of the pyruvate dehydrogenase complex and its pyruvate dehydrogenase component was carried out by using the circular dichroism method. It was found that the spectral properties of the pyruvate dehydrogenase complex are determined by those of its first component: i) the spectrum of the thiamine pyrophosphate-free pyruvate dehydrogenase complex displayed the main characteristics of the pyruvate dehydrogenase component; ii) the appearance of the charge transfer complex band during thiamine pyrophosphate saturation was revealed for the both proteins; iii) in both cases the charge transfer complex band disappeared after the interaction of the holoform with pyruvate and reappeared after the addition of dithiothreitol used as a deacetylating reagent. Coenzyme A in the same reaction selectively deacetylated the pyruvate dehydrogenase complex (but not its pyruvate dehydrogenase component). The spectral dynamics of pyruvate dehydrogenase reflects the functional changes in the enzyme active centers during the catalytic act. The similarity of the spectral behaviour of pyruvate dehydrogenase within the complex structure and in the isolated state provides support for the earlier proposed mechanism of the pyruvate dehydrogenase action and ensures a methodological basis for its direct investigation within the complex structure. PMID- 1777524 TI - [A rapid method of preparing the (H3-H4-H2A-H2b)(2) histone octamer in large quantities]. AB - A simple and fast method for isolation of large amounts of the histone octamer (H2A-H2B-H3-H4)2 is proposed. This method is based on chromatin adsorption by hydroxyapatite with subsequent extraction of the histone octamer with 50 mM sodium-phosphate buffer containing 4 M NaCl pH 8.0. It was shown that the properties of the histone octamer isolated by this extractive procedure are identical with those of the histone octamer obtained by elution on a Sephadex G 100 column. The histone tetramer (H3-H4)2 and dimer (H2A-H2B) were obtained after gel filtration on Sephadex G-100 in 50 mM sodium-acetate (pH 5.6). PMID- 1777525 TI - [The role of covalent binding and lipid peroxidation in liver damage by carbon tetrachloride]. AB - 4-[N-sodium-N-(5-ethyl-1,3,4-thiadiazol-2-yl)]- sulphanylamido-5-methoxy-1,2 benzoquinone selectively inhibiting lipid peroxidation (LPO) was used to study the hepatotoxic effect of carbon tetrachloride in vivo. It was found that inactivation of the liver microsomal oxidation system during the first few hours after CCl4 injection is due to covalent binding rather than LPO. PMID- 1777526 TI - [Dynamics of the lipoprotein distribution in early hypercholesterolemia characterizes the activation of cholesterol transport]. AB - Using gradient gel electrophoresis, the levels of major classes of rabbit blood sera lipoproteins were studied over a period of 28 days. Hypercholesterolemia persisted up to the 4th day with a subsequent decrease. This was paralleled with an increase in the levels of triglyceride-rich and apoB-containing particles. The decrease of the electrophoretic mobility of low density lipoproteins correlated with an increased content of the intermediate fraction. On the 28th day after the beginning of experiment the concentration of total high density lipoproteins showed an increase. The subfractional redistribution of HDL3 and HDL2 subclasses pointed to the stimulation of the accepting process and the overall reverse cholesterol transport system. A comparison of experimental results with literary data allowed to conclude that the relative decrease of the serum cholesterol level typical of hypercholesterolemia of one month duration is due to the activation of specific and nonspecific preventive mechanisms. PMID- 1777527 TI - Feeding patterns in bulimia nervosa. AB - We characterized the naturalistic feeding patterns of 54 women with bulimia nervosa and 11 matched controls over a continuous 24-hr period in a feeding laboratory. Overall, bulimic women consumed more calories in 24 hr (4446 +/- 584 kcal) than did controls (1845 +/- 649 kcal). Bulimic women consumed a wide range of caloric intake, with 44% overeating and 19% undereating in comparison to the range of controls. In addition, bulimics showed a disruption of circadian feeding patterns. For overeating bulimic women, the majority of meals were of normal size and frequency. Increased caloric intake in the group of overeating bulimic women was mainly due to the fact that 37% of their meals were greater than 1000 calories. Large meals occurred predominantly during the afternoon and evening and consisted primarily of dessert and snack foods. Importantly, the percentage of fat, but not carbohydrates, consumed increased as meal size, and 24-hr caloric intake increased. This study is the first to describe the naturalistic feeding characteristics of a large number of bulimics by direct observation. These findings are consistent with previous self-reports and extend and replicate previous laboratory studies. We think that laboratory studies are a reasonable replica of naturalistic feeding and should facilitate further investigation of the psychological and physiological correlates of feeding behavior in eating disorders. PMID- 1777528 TI - Topography of mobility and complexity parameters of the EEG in Alzheimer's disease. AB - Mobility and complexity, Hjorth's parameters of the electroencephalogram (EEG), were calculated in 16 electrodes in a group of 14 patients with probable Alzheimer's disease (AD) and 14 healthy controls. Mobility was decreased in the AD group, differences reaching high levels of significance over all the electrodes. Complexity was increased significantly in the AD group only in five electrodes. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated for mobility at each electrode, considering only those AD patients with the lowest cognitive impairment. Sensitivity and negative predictive value were 100% at all the electrodes. Specificity and positive predictive value at several electrodes reached highly acceptable proportions, such as 71% or more for the former, and 64% or more for the latter. Implications of mobility in the early diagnosis of AD are discussed. PMID- 1777529 TI - Reduced natural killer cell cytotoxicity in depression but not in schizophrenia. AB - A reduction of natural killer (NK) cell activity has been found in hospitalized patients with major depressive disorder. To examine whether a reduction of NK activity is found in other psychiatric patients or related to the nonspecific effects of hospitalization, NK cell cytotoxicity was compared in hospitalized depressed patients, schizophrenic inpatients, and two groups of controls separately age matched to each patient group. NK activity was significantly (p less than 0.01) lower in depressed inpatients than control subjects. However, in the hospitalized schizophrenic patients values of natural cytotoxicity did not differ from controls. These findings suggest that reduced NK cytotoxicity in depression is independent of the effects of hospitalization. PMID- 1777530 TI - Restless legs syndrome induced by lithium. PMID- 1777531 TI - Calcium channel blocker nimodipine for primary degenerative dementia. PMID- 1777532 TI - ECT in long-term follow-up of BPD. PMID- 1777533 TI - Environmental effects on creatinine, and on urinary-free cortisol. PMID- 1777534 TI - Helping minorities become physicians. PMID- 1777535 TI - To prisons or hospitals: race and referrals in juvenile justice. PMID- 1777536 TI - A challenge to child advocates. PMID- 1777537 TI - Financing adolescent mental health services. PMID- 1777538 TI - Community-oriented primary care. PMID- 1777539 TI - Toward an African-American perspective on bioethics. PMID- 1777540 TI - Prenatal care use and health insurance status. AB - Many observers explain the prevalence of inadequate prenatal care in the United States by citing demographic or psychosocial factors. But few have evaluated the barriers faced by women with different health insurance status and socioeconomic backgrounds. In this study of 149 women at six hospitals in Minneapolis, insurance status was significantly related to the source of prenatal care (p less than .0001). Private physicians cared for 52 percent of privately insured, 23 percent of Medicaid-insured, and two percent of uninsured women. Public clinics were the primary source of care for Medicaid and uninsured women, who, compared to privately insured women, experienced longer waiting times (p less than .001) during prenatal visits and were more likely (p less than .01) to lack continuity of care with a provider. Multiple measures, including expanding Medicaid eligibility, may help correct these problems. PMID- 1777541 TI - Nurse-midwifery services in one multi-ethnic, underserved community. AB - Through a nurse-midwifery service in a mixed urban and rural agricultural community, we compared maternal risk factors, prenatal care, labor and delivery, and adverse birth outcomes in low-income Mexican-American Hispanic, white (Caucasian), and Southeast Asian women--a three-way analysis rarely reported in the literature. Southeast Asian women were older and had more children. Hispanic women bore children at a younger age. Both Southeast Asians and Hispanics made fewer prenatal visits than did Caucasian women, and used less analgesia and anesthesia during delivery. The incidence of Cesarean section (7.7 percent) and low birthweight (5.9 percent) was compared to local, state, and national reference statistics. Prospective case-controlled studies and cost/benefit analyses of nurse-midwifery services could yield more definitive information. But until more precise data are collected for birth certificates, these studies will be difficult. PMID- 1777542 TI - Smoking cessation among blacks. AB - The burden of cancer on the U.S. black population has been compounded by a high prevalence of smoking among blacks. Lung cancer among blacks is a serious public health problem, with a mortality rate of 119 per 100,000 among black males compared to 81 per 100,000 for white males. Blacks, both male and female, have lower quit rates for smoking than does the general U.S. population. Why more blacks than whites continue to smoke is not clear, but the National Cancer Institute has recently funded several research projects to facilitate smoking cessation among blacks. It appears from preliminary findings that smoking cessation efforts among blacks are most successful if they use broadcast media that reach black audiences, if they tailor their print materials to address the needs of black smokers, and if black community networks are utilized. PMID- 1777543 TI - Colchicine in primary biliary cirrhosis. AB - Colchicine, which has been used for hundreds of years in the treatment of gout, has found a new use in the treatment of cirrhosis. In the experimental animal, and in vitro, colchicine decreases inflammation, inhibits collagen synthesis and also increases collagen degradation by activating collagenase. Many of the putative beneficial actions of the drug in cirrhosis, as well as its toxic side effects, are due to the fact that it binds to tubulin and thereby disrupts microtubules; however, it is unclear which of these actions, mostly demonstrated in the experimental animal, are present in the doses currently used in man. There have been 4 controlled trials of colchicine in various forms of cirrhosis, three of which have concerned primary biliary cirrhosis. Data are currently available on 146 colchicine-treated patients, of which 92 had primary biliary cirrhosis. Colchicine improves the conventional liver function tests in primary biliary cirrhosis and also reverses the basic defect in hepatic excretory capacity characteristic of this disease. The drug appears to have no significant effect on symptoms, clinical features or liver histology, but in 2 of the 3 primary biliary cirrhosis trials, as in the Mexican study of alcoholic and post-hepatitic cirrhosis, colchicine treatment was associated with improved survival. PMID- 1777544 TI - Cyclosporin in inflammatory bowel disease. PMID- 1777545 TI - The place of cisapride in therapeutics: an interim verdict. PMID- 1777546 TI - Omeprazole. AB - Omeprazole is a potent and effective antisecretory drug. Benefits in gastric and duodenal ulceration nevertheless seem marginal because standard treatments are very effective. More obvious advantages are discernible in oesophageal reflux disease where more profound acid inhibition may be needed to obtain symptom relief. Fears of important adverse effects either through inducing ECL cell hyperplasia or outright carcinogenesis, do not seem firmly founded, nor is there convincing evidence of significant interactions with other xenobiotics. Nevertheless, continued caution seems justified. PMID- 1777547 TI - Fate of orally ingested enzymes in pancreatic insufficiency: comparison of two pancreatic enzyme preparations. AB - The effect on steatorrhoea of a pH-sensitive enteric-coated pancreatic preparation (Eurobiol 25,000) was compared with a conventional pancreatic enzyme preparation (Eurobiol) in six adult patients with exocrine pancreatic insufficiency. In addition, the fate of orally ingested pancreatic enzymes in the upper digestive tract was evaluated by measuring gastric and duodenal pH, amount of enzymes in the stomach, duodenal enzyme output, and fat absorption at the angle of Treitz for the 4 hours following a standard meal. When compared with placebo, Eurobiol and Eurobiol 25,000 reduced daily faecal fat excretion by 24% (not significant) and 43% (P less than 0.05), respectively. With the conventional preparation, enzyme output and fat absorption at the duodeno-jejunal flexure were significantly improved (P less than 0.05). Marked inter-individual differences in duodenal enzyme recovery (lipase 3% to 80%; chymotrypsin 26% to 100%) and, consequently, in the reduction of steatorrhoea (0% to 67%) were observed, with the gastric emptying rate emerging as a key determinant factor. With the enteric coated preparation, enzyme output and fat absorption at the duodenojejunal flexure were not significantly improved. Discrepancy between the marked reduction of faecal fat excretion and the low duodenal enzyme recovery could indicate that enzyme delivery from microtablets occurs further down in the small bowel. Efficacy of enteric-coated preparations could be enhanced by adding unprotected enzymes, especially in patients with rapid gastric emptying. PMID- 1777548 TI - Pattern of breathing during upper gastrointestinal endoscopy: implications for administration of supplemental oxygen. AB - Cardiopulmonary complications account for half the deaths associated with upper gastrointestinal endoscopy. The incidence of hypoxia at the time of upper gastrointestinal endoscopy can be greatly reduced by the administration of supplemental oxygen via nasal cannulae. Using dual thermistors in the mouth and nostrils of patients undergoing upper gastrointestinal endoscopy, the present study demonstrates that most patients breathe predominantly via the oral, rather than the nasal, route following intubation of the oesophagus. The implication from the study is that, if supplemental oxygen is to be used in 'at risk' patients, it would be logical to employ an oral, rather than nasal, route of administration. PMID- 1777549 TI - Effect of omeprazole on intestinal output in the short bowel syndrome. AB - Ten patients with an end jejunostomy and one with a jejuno-rectal anastomosis (jejunal length 30-140 cm) ate a constant chosen diet for 2 control days, and 2 test days when 40 mg omeprazole orally was taken each morning. In the 7 patients with a net secretory output of fluid, there was a mean reduction in wet weight of 0.66 kg/24 h (range -0.16 to 1.45 kg/24 h; P less than 0.05) and sodium 46 mmol/24 h (-51 to 135 mmol/24 h; N.S.); the four patients with net absorption of fluid showed no reduction in intestinal output. One patient with 30 cm jejunum responded little to oral but did so to intravenous 40 mg omeprazole twice a day with a reduction in wet weight of 3.00 kg/24 h and sodium 157 mmol/24 h. In one patient oral 40 mg omeprazole daily gave equivalent results to oral 300 mg ranitidine twice daily; in 2 others it was equivalent to intravenous 50 micrograms octreotide twice daily. Omeprazole reduces the intestinal output in patients with the short bowel syndrome and a net secretory output, but not enough to prevent the need for parenteral fluid and electrolyte replacement. PMID- 1777550 TI - Effect of anti-obesity drugs promoting energy expenditure, yohimbine and ephedrine, on gastric emptying in obese patients. AB - The effect of ephedrine, a non-selective adrenoreceptor agonist, and yohimbine, a selective alpha 2-adrenolytic drug, on gastric emptying of a radiolabelled solid meal was examined in groups of 8 (all women) and 15 (4 men and 11 women) obese patients, respectively. Patients were given orally, double-blind in random order, placebo or 50 mg ephedrine in the first group, and placebo or 15 mg yohimbine in the second group, 1.5 h prior to the gastric emptying measurement performed with the use of a gamma camera. Yohimbine did not significantly affect gastric emptying--the fraction of the meal retained within the stomach at the end of the examination (that is after 90 min), F90, amounted to 71.0 +/- 3.8% (placebo) and 66.8 +/- 4.1% (yohimbine); the gastric emptying index, Ix, was 0.737 +/- 0.106 min-1 x 10(-2) (placebo) and 0.885 +/- 0.128 min-1 x 10(-2) (yohimbine). A significant delay in gastric emptying was observed after administration of ephedrine: F90 increased from 70.3 +/- 5.1% after placebo to 80.9 +/- 3.0% after ephedrine, P less than 0.02, and Ix decreased from 0.747 +/- 0.142 min-1 x 10(-2) to 0.461 +/- 0.080 min-1 x 10(-2) after ephedrine, P less than 0.02. We conclude that the inhibitory influence of ephedrine on gastric emptying, and thus possibly on satiety, makes it a candidate for trial as pharmacological support of a low energy diet treatment of obesity. PMID- 1777551 TI - Protection from gastrointestinal side-effects by azapropazone by its incorporation into a glucose-sodium acid citrate formulation. AB - Addition of glucose and sodium citrate to azapropazone, in proportions of 1:1:1 by weight reduced gastric mucosal damage in rats and there was a trend towards reduction in radiolabelled faecal red cell loss in human volunteers compared with that with azapropazone alone. The glucose and citrate did not affect the pharmacokinetics of azapropazone, or its therapeutic efficacy. While no difference was observed in endoscopic injury and in symptomatic gastrointestinal complaints in a multicentre comparison in rheumatic patients, a striking reduction in symptoms was observed in those patients with a history of severe gastrointestinal intolerance to non-steroidal anti-inflammatory drugs. PMID- 1777553 TI - Thyroid atrophy in myxedematous endemic cretinism: possible role for growth blocking immunoglobulins. AB - We have examined the ability of IgGs obtained from 8 endemic cretins to inhibit TSH-stimulated thyroid cell growth in culture. Clinical and laboratory evidence for hypothyroidism was present in six subjects; the two remaining patients had borderline low serum T4, normal T3 and exaggerated TSH response to TRH. In six patients 2 mg IgG exhibited an inhibitory effect in the cellular growth expressed by a diminished incorporation of 3H-thymidine into the DNA of TSH-stimulated FRTL 5 cells (range: 26-87% inhibition). Seven patients presented clinically with thyroid atrophy of relatively small thyroid enlargements for the degree of chronic iodine deficiency that was present in the area. The remaining subject had a large multinodular goiter and IgG purified from this patient had no inhibitory effect in the FRTL-5 cellular growth. A direct relationship was noted between the degree of thyroid growth inhibition (%) and the basal serum TSH concentration. We conclude that the presence of thyroid growth inhibiting immunoglobulin may be related to the absence of thyroid growth or even thyroid atrophy in endemic cretins. PMID- 1777552 TI - Short report: the effect of omeprazole on Helicobacter pylori and associated gastritis. AB - Twenty-one patients with endoscopically confirmed duodenal ulceration, who had failed to heal with an H2-antagonist, were given omeprazole 20 mg o.m. for four weeks. Four antral biopsies from each patient were taken at endoscopy before, at the end of, and four weeks after treatment. Rapid urease test, culture, histopathology and transmission electron microscopy were carried out on these biopsies to determine the presence of Helicobacter pylori and improvement of gastritis. After four weeks of treatment, duodenal ulceration was healed in 16 (79%) of the patients; H. pylori was not detected by culture in 11 (50%) of the patients, and the associated gastritis improved in 12 (54%) patients. Four weeks after cessation of treatment the organism was cultured from antral biopsies of 18 (86%) of the patients and all of these had gastritis. Omeprazole treatment healed duodenal ulceration, improved gastritis temporarily, and suppressed but did not eradicate H. pylori. PMID- 1777554 TI - Experimental autoimmune oophoritis. II. Both lymphoid cells and antibodies are successful in adoptive transfer. AB - Experimental autoimmune oophoritis can be readily induced by passive transfer of peripheral blood lymphocytes, lymph node cells, spleen cells, T- and B-enriched cell suspensions, immune serum and gamma globulins, from ovary antigen immunized rats to naive recipients. Adoptive transfer was markedly enhanced when recipient rats were injected simultaneously with sensitized lymphoid cells and anti-ovary antibodies. Histologically, this passively induced disease was much the same as the actively induced disease. By syngeneic lymph node assay it was shown that regional lymph nodes of neonatally thymectomized rats did not enlarge upon injection of EAOO lymphocytes which otherwise produced a marked effect in lymph nodes of normal recipient rats. Therefore, it appears that enlargement of the draining lymph node was dependent on the participation of host T cells. The possibility that development of EAOO may involve cooperation between antigen reactive and effector classes of lymphocytes was discussed. PMID- 1777555 TI - Effects of ginkgolide B, a platelet-activating factor inhibitor on insulitis in the spontaneously diabetic BB rat. AB - The BB rat spontaneously develops insulin-dependent diabetes mellitus (IDDM) in association with marked insulitis in the islet of Langerhans. Since platelet activating factor (PAF-acether) is involved in allergic and inflammatory reactions, we tested a PAF antagonist, Ginkgolide B (BN 52021) for potential effects on islet inflammation and diabetes. Diabetes prone BB/Wor rats were treated daily from weaning at 25 days until 105 days of age with either saline (n = 30, controls), 10 (n = 25, low dose) or 20 (n = 30, high dose) mg/kg body weight of BN 52021. The overall incidence of IDDM was unaffected by treatment. Quantitative analysis of insulin area showed a dose-dependent protection of beta cells by Ginkgolide B, reflected in a 6- (low dose) to 8-fold (high dose) (P less than 0.01-0.005) increase in the insulin/glucagon cell ratio compared to the saline treated rats. Ginkgolide B reduced severe insulitis from 84% in the saline rats developing IDDM to 59% (n.s.) in the low and to 33% (P less than 0.001) in the high dose group. These data suggest that PAF inhibitors may prove useful in immunomodulator therapy of IDDM since beta cells are preserved. PMID- 1777556 TI - Prevalence of autoantibodies to thyroperoxidase in patients with various thyroid and autoimmune diseases. AB - An original radioimmunoassay for quantitation of circulating autoantibodies (aAb) to thyroperoxidase (TPO) proved to be well suited for large scale routine testing. The present study was aimed to assess the prevalence of aAb to TPO in patients with various thyroid and autoimmune disease and, for comparison, in women referred for reproductive disorders and indication of in vitro fertilization. Anti-TPO aAb were measured in sera from 32 healthy subjects and 262 patients thoroughly investigated for thyroid dysfunction. As determined in healthy subjects, the normal level of aAb to TPO in serum ranged from 0.30 to 3.07 mg/l (of affinity-purified) anti-TPO aAb. Anti-TPO and anti-MIC aAb levels were both normal in 115 patients and correlated well (r = 0.835, P less than 0.001) in the remaining 147 patients. Coexistence of normal level of anti-TPO aAb and abnormal level of anti-MIC aAb was found in 4 patients and ascribed to a lack of specificity or sensitivity of the test for anti-MIC aAb. Coexistence of abnormal level of anti-TPO aAb and normal level of anti-MIC aAb was found in 67 patients of whom 62 presented only slightly elevated (3.1 to 10.0 mg/l) anti-TPO aAb concentration; the 5 remaining patients, all with overt thyroid autoimmune disease, showed anti-TPO levels between 10.7 to 100.7 mg/l.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777557 TI - Anti-thyroid peroxidase antibodies in thyroid disorders and non-thyroid autoimmune diseases. AB - A new commercial method for measurement of anti-thyroid peroxidase (anti-TPO DYNOtest, Henning, Berlin) was evaluated in normal subjects and in patients with autoimmune thyroid and non-thyroid diseases, and compared to an immune fluorescence method for measurement of anti-microsomal antibodies (MicAb), and a radioimmunological method for quantifying thyroglobulin antibodies (TgAb). The majority of normal subjects had anti-TPO levels below 52 U/ml and patients with Hashimoto's thyroiditis had levels above 200 U/ml, with a good correlation to MicAb. In other autoimmune thyroid diseases the correlation was less pronounced. In non-thyroid autoimmune diseases MicAb showed falsely positive reactions in the presence of other autoantibodies, e.g. mitochondrial antibodies. The present study indicates that the anti-TPO method should probably replace measurements of MicAb for routine clinical use, thus providing a sensitive, precise, antigen specific method with the ability to reveal quantitative fluctuations. The study also indicates that TgAb could be abolished in routine diagnosis of autoimmune thyroid diseases and be reserved for special clinical situations, research purposes as well as measurement in sera before evaluation of serum thyroglobulin levels. PMID- 1777558 TI - Enhanced percentage of Leu M3+DR+ and Leu M3+CD25+ cells in newly diagnosed IDDM patients. AB - The percentage of Leu M3+DR+ and of Leu M3+CD25+ cells was determined by means of immunofluorescence analysis in a group of patients with insulin dependent diabetes mellitus (IDDM). Our results show that an increased percentage of these cells may occur in the early stage of the disease. These data provide evidence for a "phenotypical" activation of Leu M3+ cells at the onset of the disease and warrant future studies to evaluate the potential role of these cells in the pathogenesis of IDDM. PMID- 1777559 TI - Class II major histocompatibility complex antigen expression on unstimulated and gamma-interferon stimulated monocytes from patients with multiple sclerosis, rheumatoid arthritis and normal controls. AB - HLA-DR, HLA-DQ, and HLA-DP antigen expression was assessed by immunofluorescent flow cytometry on monocytes from 19 patients with active multiple sclerosis (MS), 19 with inactive MS, 7 patients with early active rheumatoid arthritis (RA), and 19 normal controls. Percentage positivity and median channel fluorescence (MCF) were determined after separation of the monocytes (TO) and following 48 h culture with (T48 + IFN) and without (T48) recombinant gamma interferon (rIFN-gamma). The percentage positivity of the cells was normal at TO for all groups of patients for each of the HLA types but statistically significantly increased above normal, on monocytes from patients with inactive MS, after culture with rIFN-gamma. At TO, the MCF values for HLA-DQ, and HLA-DP were statistically significantly increased above normal on monocytes from patients with active MS indicating some pre-programming of the cells in vivo. After culture, when the carry-over from baseline TO values was eliminated, the increment in MCF for HLA-DR, on monocytes from patients with inactive MS, was statistically significantly lower than normal in the non-gamma-IFN cultures but was normal in the presence of rIFN-gamma. Conversely, the increment in MCF for HLA-DP on monocytes from patients with active MS was significantly lower than normal after culture with rIFN-gamma. Therefore, the stimulation required to increase antigen density on cells already expressing antigen may be different to that required to stimulate de novo expression on negative cells. Both systems appear to be abnormal in MS, possibly reflecting differences in disease activity, while only one system appears abnormal in RA. PMID- 1777560 TI - Anesthetic inhibition of firefly luciferase, a protein model for general anesthesia, does not exhibit pressure reversal. AB - The surprising observation that pressures of the order of 150 atmospheres can restore consciousness to an anesthetized animal has long been central to theories of the molecular mechanisms underlying general anesthesia. We have constructed a high-pressure gas chamber to test for "pressure reversal" of the best available protein model of general anesthetic target sites: the pure enzyme firefly luciferase, which accounts extremely well for animal potencies (over a 100,000 fold range). We found no significant pressure reversal for a variety of anesthetics of differing size and polarity. It thus appears that either firefly luciferase is not an adequate model for general anesthetic target sites or that pressure and anesthetics act at different molecular sites in the central nervous system. PMID- 1777562 TI - Rapid changes in flagellar rotation induced by external electric pulses. AB - The bacterial flagellar motor is the only molecular rotary machine found in living organisms, converting the protonmotive force, i.e., the membrane voltage and proton gradients across the cell membrane, into the mechanical force of rotation (torque). We have developed a method for holding a bacterial cell at the tip of a glass micropipette and applying electric pulses through the micropipette. This method has enabled us to observe the dynamical responses of flagellar rotation to electric pulses that change the membrane voltage transiently and repeatedly. We have observed that acceleration and deceleration of motor rotation are induced by application of these electric pulses. The change in the rotation rate occurred within 5 ms after pulse application. PMID- 1777561 TI - Raman spectroscopy of filamentous bacteriophage Ff (fd, M13, f1) incorporating specifically-deuterated alanine and tryptophan side chains. Assignments and structural interpretation. AB - Structural interpretation of the Raman spectra of filamentous bacteriophages is dependent upon reliable assignments for the numerous Raman vibrational bands contributed from coat protein and packaged DNA of the virion. To establish unambiguous assignments and facilitate structural conclusions derived from them, we have initiated a systematic study of filamentous bacteriophage Ff (fd, f1, M13) incorporating protein subunits with specifically deuterated amino-acid side chains. Here, we report and interpret the Raman spectra of fd virions which incorporate: (a) a single deuterio-tryptophan residue per coat protomer [fd(Wd5)], (b) ten deuterio-alanines per protomer [fd(10Ad3)], and (c) both deuterio-tryptophan and deuterio-alanine [fd(Wd5 + 10Ad3)]. The unambiguous assignment of coat protein Raman bands in normal and deuterated isotopomers of fd establishes the validity of earlier empirical assignments of many key Raman markers, including those of packaged ssDNA (Thomas et al., 1988). Present results confirm that deoxyguanosine residues of the packaged ssDNA molecule depart from the usual C2'-endo/anti conformation characteristic of protein-free DNA in aqueous solution, although C2'-endo/anti conformers of thymidine are not excluded by the data. The combined results obtained here on normal fd, and on fd incorporating deuterio-tryptophan [fd(Wd5) and fd(Wd5 + 10Ad3)], show also that the microenvironment of the single tryptophan residue per coat protomer (W26) can be clearly deduced as follows: (a) The indole 1-NH donor group of each protomer in fd forms a moderately strong hydrogen bond, most likely to a hydroxyl oxygen acceptor. (b) The planar indole ring exists in a hydrophilic environment. (c) The torsion angle describing the orientation of the indole ring (C3-C2 linkage) with respect to the side-chain (C alpha-C beta bond) is unusually large, i.e., magnitude of X2,1 approximately 120 degrees. With respect to alanine isotopomers, the present results show that alanine residues, and possibly other methyl containing side chains, are significant contributors to the fd Raman spectrum. The present study provides new information on protomer side chains of fd and demonstrates a Raman methodology which should be generally useful for investigating single-site interactions and macromolecular conformations in other nucleoprotein assemblies. PMID- 1777563 TI - Direct determination of crystallographic phases for diffraction data from lipid bilayers. I. Reliability and phase refinement. AB - Direct analysis of lipid lamellar packing based on the probabilistic estimate of sigma 1- and sigma 2-triplet phase invariants is evaluated here for a large variety of bilayer structures than examined in an original study of this problem (Dorset, D.L., 1990. Biophys. J. 58:1077-1087). Using x-ray crystal structures of five phospholipids, three glycerides and two cerebrosides, lamellar diffraction data were generated at the approximately 3 A resolution often found experimentally from oriented multilayers. For structures where no significant density occurs at the unit cell origin, the ab initio phase determination is successful for six of the ten structures. A seventh structure can be solved if a limited set of sigma 2-triples are used to determine the initial phase set based on the hierarchy of the A2 values. Bilayers, e.g., with solvent at the origin, can be analyzed if a modified criterion for accepting phase estimates for sigma 1 triples is used, as suggested by the distribution of normalized structure factors and the number of probable single-valued phase domains. In all cases, partial phase determinations can be refined effectively by density modification ("flattening") of the hydrocarbon region in real space. A figure of merit suggested by Luzzati et al. (Luzzati, V., A. Tardieu, and D. Taupin. 1972. J. Mol. Biol. 64:269-286) used to evaluate the success of such refinement can be supplemented by an evaluation of density smoothness, which can also detect the presence of near structure homomorphs not identified by the former test for density flatness. PMID- 1777564 TI - Direct determination of crystallographic phases for diffraction data from lipid bilayers. II. Refinement of phospholipid structures. AB - Using a systematic approach for the acceptance of crystallographic phase assignment, based on the evaluation of triplet structure invariants, electron and x-ray diffraction data from phospholipid multilamellar arrays are analyzed by direct methods. After calculation of Fourier maps with a partial set of phased structure factor magnitudes, the structure is refined in real space by flattening of the hydrocarbon region of the bilayer and an optimal solution is sought either by the calculation of [delta rho 4] suggested by Luzzati, where rho is the structure density or by a test of density smoothness [magnitude of delta rho/ delta r magnitude of], where r positions are located along the normal to the lamellar surface. Reanalyses of previously determined structures sometimes lead to new conclusions (e.g., a possible similarity of the electron density profile for DL-DMPE and L-DMPE, and a clear indication of the fatty acid adduct in the mixed L-DPPC/palmitic acid bilayer). Because of presumed secondary scattering perturbations (primarily to the least intense reflections), the refinements of the electron diffraction intensities are less easily evaluated than those carried out with x-ray diffraction data. PMID- 1777565 TI - Atomic force microscopy of supported planar membrane bilayers. AB - Membrane bilayers of dipalmitoyl phosphatidylcholine (DPPC) and dipalmitoyl phosphatidylethanolamine (DPPE) adsorbed to a freshly cleaved mica substrate have been imaged by Atomic Force Microscopy (AFM). The membranes were mounted for imaging by two methods: (a) by dialysis of a detergent solution of the lipid in the presence of the substrate material, and (b) by adsorption of lipid vesicles onto the substrate surface from a vesicle suspension. The images were taken in air, and show lipid bilayers adhering to the surface either in isolated patches or in continuous sheets, depending on the deposition conditions. Epifluorescence light-microscopy shows that the lipid is distributed on the substrate surfaces as seen in the AFM images. In some instances, when DPPE was used, whole, unfused vesicles, which were bound to the substrate, could be imaged by the AFM. Such membranes should be capable of acting as natural anchors for imaging membrane proteins by AFM. PMID- 1777567 TI - Effect of geometrical irregularities on propagation delay in axonal trees. AB - Multiple successive geometrical inhomogeneities, such as extensive arborization and terminal varicosities, are usual characteristics of axons. Near such regions the velocity of the action potential (AP) changes. This study uses AXONTREE, a modeling tool developed in the companion paper for two purposes: (a) to gain insights into the consequence of these irregularities for the propagation delay along axons, and (b) to simulate the propagation of APs along a reconstructed axon from a cortical cell, taking into account information concerning the distribution of boutons (release sites) along such axons to estimate the distribution of arrival times of APs to the axons release sites. We used Hodgkin and Huxley (1952) like membrane properties at 20 degrees C. Focusing on the propagation delay which results from geometrical changes along the axon (and not from the actual diameters or length of the axon), the main results are: (a) the propagation delay at a region of a single geometrical change (a step change in axon diameter or a branch point) is in the order of a few tenths of a millisecond. This delay critically depends on the kinetics and the density of the excitable channels; (b) as a general rule, the lag imposed on the AP propagation at a region with a geometrical ratio GR greater than 1 is larger than the lead obtained at a region with a reciprocal of that GR value; (c) when the electronic distance between two successive geometrical changes (Xdis) is small, the delay is not the sum of the individual delays at each geometrical change, when isolated. When both geometrical changes are with GR greater than 1 or both with GR less than 1, this delay is supralinear (larger than the sum of individual delays). The two other combinations yield a sublinear delay; and (d) in a varicose axon, where the diameter changes frequently from thin to thick and back to thin, the propagation velocity may be slower than the velocity along a uniform axon with the thin diameter. Finally, we computed propagation delays along a morphologically characterized axon from layer V of the somatosensory cortex of the cat. This axon projects mainly to area 4 but also sends collaterals to areas 3b and 3a. The model predicts that, for this axon, areas 3a, 3b, and the proximal part of area 4 are activated approximately 2 ms before the activation of the distal part of area 4. PMID- 1777568 TI - Phases of phosphatidyl ethanolamine monolayers studied by synchrotron x-ray scattering. AB - For the first time, phospholid monolayers at the air/water interface have been studied by x-ray diffraction and reflection all along the isotherm from the laterally isotropic fluid (the so-called LE phase) to the ordered phases. The model used to analyze the data, and the accuracy of the parameters deduced, were tested by comparing the results obtained with two lipids having the same head group but different chain lengths. Compression of the fluid phase leads predominantly to a change of thickness of the hydrophobic moiety, much less of its density, with the head group extension remaining constant. The main transition involves a considerable increase (approximately 10%) of the electron density in the hydrophobic region, a dehydration of the head group and a positional ordering of the aliphatic tails, albeit with low coherence lengths (approximately 10 spacings). On further compression of the film, the ordered phase undergoes a continuous transition. This is characterized by an increase in positional ordering, a discontinuous decrease in lateral compressibility, a decrease in chain tilt angle with respect to the surface normal towards zero and probably also a head group dehydration and ordering. PMID- 1777566 TI - Propagation of action potentials along complex axonal trees. Model and implementation. AB - Axonal trees are typically morphologically and physiologically complicated structures. Because of this complexity, axonal trees show a large repertoire of behavior: from transmission lines with delay, to frequency filtering devices in both temporal and spatial domains. Detailed theoretical exploration of the electrical behavior of realistically complex axonal trees is notably lacking, mainly because of the absence of a simple modeling tool. AXONTREE is an attempt to provide such a simulator. It is written in C for the SUN workstation and implements both a detailed compartmental modeling of Hodgkin and Huxley-like kinetics, and a more abstract, event-driven, modeling approach. The computing module of AXONTREE is introduced together with its input/output features. These features allow graphical construction of arbitrary trees directly on the computer screen, and superimposition of the results on the simulated structure. Several numerical improvements that increase the computational efficiency by a factor of 5-10 are presented; most notable is a novel method of dynamic lumping of the modeled tree into simpler representations ("equivalent cables"). AXONTREE's performance is examined using a reconstructed terminal of an axon from a Y cell in cat visual cortex. It is demonstrated that realistically complicated axonal trees can be handled efficiently. The application of AXONTREE for the study of propagation delays along axonal trees is presented in the companion paper (Manor et al., 1991). PMID- 1777569 TI - Retinal analog restoration of photophobic responses in a blind Chlamydomonas reinhardtii mutant. Evidence for an archaebacterial like chromophore in a eukaryotic rhodopsin. AB - The strain CC-2359 of the unicellular eukaryotic alga Chlamydomonas reinhardtii originally described as a low pigmentation mutant is found to be devoid of photophobic stop responses to photostimuli over a wide range of light intensities. Photophobic responses of the mutant are restored by exogenous addition of all-trans retinal. We have combined computer-based cell-tracking and motion analysis with retinal isomer and retinal analog reconstitution of CC-2359 to investigate properties of the photophobic response receptor. Most rapid and most complete reconstitution is obtained with all-trans retinal compared to 13 cis, 11-cis, and 9-cis retinal. An analog locked by a carbon bridge in a 6-s trans conformation reconstitutes whereas the corresponding 6-s-cis locked analog does not. Retinal analogs prevented from isomerization around the 13-14 double bond by a five-membered ring in the polyene chain (locked in either the 13-trans or 13-cis configuration) do not restore the response, but enter the chromophore binding pocket as evidenced by their inhibition of all-trans retinal regeneration of the response. Results of competition experiments between all-trans and each of the 13-locked analogs fit a model in which each chromophore exhibits reversible binding to the photoreceptor apoprotein. A competitive inhibition scheme closely fits the data and permits calculation of apparent dissociation constants for the in vivo reconstitution process of 2.5 x 10(-11) M, 5.2 x 10(-10) M, and 5.4 x 10( 9) M, for all-trans, 13-trans-locked and 13-cis-locked analogs, respectively. The chromophore requirement for the trans configuration and 6-s-trans conformation, and the lack of signaling function from analogs locked at the 13 position, are characteristic of archaebacterial rhodopsins, rather than the previously studied eukaryotic rhodopsins (i.e., visual pigments). PMID- 1777570 TI - Dynamics of the inward rectifier K+ current during the action potential of guinea pig ventricular myocytes. AB - The potassium selective, inward rectifier current (IK1) is known to be responsible for maintaining the resting membrane potential of quiescent ventricular myocytes. However, the contribution of this current to the different phases of the cardiac action potential has not been adequately established. In the present study, we have used the action potential clamp (APC) technique to characterize the dynamic changes of a cesium-sensitive (i.e., Ik1) current which occur during the action potential. Our results show that (a) Ik1 is present during depolarization, as well as in the final phase of repolarization of the cardiac action potential. (b) The current reaches the zone of inward-going rectification before the regenerative action potential ensues. (c) The maximal outward current amplitude during repolarization is significantly lower than during depolarization, which supports the hypothesis that in adult guinea pig ventricular myocytes, Ik1 rectification is accentuated during the action potential plateau. Our results stress the importance of Ik1 in the modulation of cell excitability in the ventricular myocyte. PMID- 1777571 TI - Dynamical search for bis-penicillamine enkephalin conformations. AB - Quenched molecular dynamics is used as a conformational search technique for the constrained cyclic analog [D-Pen2,D-Pen5]enkephalin (DPDPE) in a continuum solvent. The results show a Gaussianlike distribution of conformations as a function of energy, unlike the distributions found for simple liquids which have sharp bands for different crystal forms and broad glasslike states are found. The lowest energy conformers have structural features in common with those obtained from constrained searches based on energy minimization. (Hruby, V. J., L-.F. Kao, B. M. Pettitt, and M. Karplus. 1988. J. Am. Chem. Soc. 110:3351-3359). Many of the low energy configurations are amphiphilic with the carbonyl groups on one surface and the hydrophobic groups on the other. This supports the conclusions from the previous modeling study, which yielded amphiphilic structures as the most probable conformations of DPDPE when NOE data were included. PMID- 1777572 TI - Recognition processes at a functionalized lipid surface observed with molecular resolution. AB - The specific binding of proteins to functionalized lipid monolayers on aqueous subphases was characterized by neutron reflectivity and fluorescence microscopy measurements. Due to the high affinity and high specificity of their noncovalent interaction, streptavidin (SA) and biotin (vitamin H) were chosen as a model system to investigate the structural characteristics of a recognition process on a molecular length scale. Changes in the neutron reflection from the surfaces of NaCl aqueous (H2O or D2O) protein solutions (10(-8) M SA) were used to monitor the interaction of the protein with a monolayer of a biotinylated lipid in situ. Refinement of the reflectivity data and independent fluorescence microscopic observation of the interface using FITC-labeled SA showed that the protein forms macroscopically homogeneous (and presumably crystalline) domains covering a large portion of the surface. Moreover, the neutron reflection experiments clearly showed the formation of a monomolecular protein layer with an effective thickness, dp = 43.7 +/- 2 A. The area per protein molecule occupied in the film was A0 = 2860 +/- 200 A2 and nw = 260 +/- 100 water molecules were associated with each protein molecule. Quantitative binding was found to occur at biotin surface concentrations as low as 1 molecule/1,250 A2 (compared with approximately 1 molecule/40 A2 for dense packing). This study demonstrates the application of a promising new tool for the systematic investigation of molecular recognition processes in protein/lipid model systems. PMID- 1777573 TI - Microscopic versus macroscopic diffusion in one-component fluid phase lipid bilayer membranes. PMID- 1777574 TI - Effect of ethidium on the torsion constants of linear and supercoiled DNAs. AB - The torsion elastic constants (alpha) of linear pBR322 (4363 bp) and pUC8 (2717 bp) DNAs and supercoiled pBR322 and pJMSII (4375 bp) DNAs are measured in 0.1 M NaCl as a function of added ethidium/base-pair (EB/BP) ratio by studying the fluorescence polarization anisotropy (FPA) of the intercalated ethidium. The time resolved FPA is measured by using a picosecond dye laser for excitation and time correlated single photon counting detection. Previously developed theory for the emission anisotropy is generalized to incorporate rotations of the transition dipole due to excitation transfer. The excitation transfers are simulated by a Monte Carlo procedure (Genest et al., Biophys. Chem. 1 (1974) 266-278) and the consequent rotations of the transition dipole are superposed on the Brownian rotations. After accounting for excitation transfer, the torsion constants of the linear DNAs are found to be essentially independent of intercalated ethidium up to a binding ratio r = 0.10 dye/bp. Dynamic light scattering measurements on linear pUC8 DNA confirm that the torsion constant is independent of binding ratio up to r = 0.20 dye/bp. If alpha d denotes the torsion constant between ethidium and a base-pair, and alpha 0 that between two base-pairs, then our data imply that alpha d/alpha 0 lies in the range 0.65 to 1.64 with a most probable value of 1.0. The torsion constants of supercoiled DNAs decrease substantially with increasing binding ratio even after accounting for excitation transfer. At the binding ratio r* = 0.064, where the superhelix density vanishes and superhelical strain is completely relaxed, the torsion constant of the supercoiled pBR322 DNA/dye complex lies below that of the corresponding linear DNA/dye complex by about 30%. This contradicts the conventional view according to which linear, nicked circular, and supercoiled DNA/dye complexes with r = r* should coexist with the same concentration of free dye, display the same distribution of bound dye, and exhibit identical secondary structures, twisting and bending rigidities, and FPA dynamics. These and other observations imply the existence of metastable secondary structure in freshly relaxed supercoiled DNAs. A tentative explanation is presented for these and other unexpected observations on supercoiled DNAs. PMID- 1777575 TI - The molecular basis of chemomechanical coupling in muscle and in other biological engines. AB - It is argued that the force driving muscular shortening (psi) differs from that (phi) responsible for rigor tension generation. psi is associated with ATP induced dissociation of actomyosin (a.m.), whereas phi is due to an isomerization reaction of a.m., following the hydrolysis of ATP. Both forces are intimately coupled with appreciable changes in the structure of the hydration shell of a.m., mainly at the interface between the two proteins, which involve the release of stored energy. When an active muscle is allowed to shorten freely, psi gives rise to a sliding distance (s.d.) delta l1 which differs in character and in magnitude from the s.d. (delta l2) observed when a muscle which had developed rigor tension isometrically is released. The maximal values of the two forces (psi 0 and phi 0) as well as delta l2 are calculated on the basis of experimental data. The forces and their corresponding s.d.'s are related through the standard free energies of the chemical reactions which are responsible for them. It is claimed that the same mechanochemical (m.c.) mechanisms operate also in all microtube-based locomotion and force-generation systems and, furthermore, that practically the same values of psi 0, phi 0, delta l1, and delta l2 are shared by the two types of biological m.c. convertors. PMID- 1777576 TI - Equilibrium and kinetic studies of the binding of tri- and tetra-anionic ligands to bovine serum albumin. AB - The binding of tri- and tetra-anionic azo dyes (Amaranth, Ponceau 4R, and Ponceau 6R) to bovine serum albumin (BSA) at pH = 7.0 and 25 degrees C has been studied by equilibrium dialysis, spectrophotometry, and by stopped-flow and temperature jump methods. Equilibrium dialysis revealed that BSA has one primary binding site and about two secondary sites for each dye. The values of the binding constant for the primary site show that the stability of the complex at the primary site progressively increases with an increase in the number and the density of anionic charges on ligand. Kinetic data have been found to be consistent with a scheme in which a rapid bimolecular binding is followed by two isomerizations of the complex (in the case of Amaranth) or by one isomerization (in the cases of Ponceau 4R and Ponceau 6R). Equilibrium and rate constants for each step of the scheme were determined. From the results it was found that the increment of the number and the density of anionic charges on ligand accelerates the forward process of the final isomerization step but retards the backward one of it, resulting in the enhancement of the stability of the complex at the primary site. On the basis of these results and the structure of the ligands, the detailed binding mechanism has been discussed in the light of the electrostatic interaction between the ligands and the binding site on BSA. PMID- 1777577 TI - Interfacial thermodynamics of protein adsorption and ion co-adsorption. III. Electrochemistry of bovine serum albumin adsorption on silver iodide. AB - An experimental analysis of charge regulation in protein adsorption is presented. The model system consists of colloidal particles of the slightly water soluble salt silver iodide as the adsorbent and the protein bovine serum albumin as the adsorbate. Protein adsorption experiments corroborate earlier findings that albumin adsorbs maximally close to the isoelectric point of the protein. The adsorption is reversible with respect to protein-protein exchange. The charge regulation is studied by novel potentiometric titrations. The Galvani potential of the adsorbent, partially covered with protein, is varied by the addition of AgNO3/KI while the pH is kept constant by means of a pH-stat. It is shown that the ion co-adsorption is a linear decreasing function of the blank surface charge density. The results are consistent with thermodynamics: for the first time a few phenomenological linkage relations between the ion co-adsorptions and chemical potentials are verified experimentally. The charge regulation is interpreted in terms of a contact layer model, which explains the ion co-adsorption by compounded ion exchange equilibria in the small layer of atomic contact between adsorbed protein and surface. PMID- 1777579 TI - Birefringence of actin. AB - The total strain birefringence of F-actin isolated from chicken gizzards was measured as a function of elongation in thin transparent films. Each film held at a certain elongation in a jig was allowed to swell in a penetrating but nondissolving liquid. Seven liquids with different refractive indices were employed. The thickness of the film in each swelling liquid was obtained once equilibrium was established. At each elongation, from 0 to 16%, a Wiener curve was obtained. The minima of the Wiener curves yielded the intrinsic birefringence of F-actin as a function of elongation. The intrinsic birefringence increases with elongation up to 16%, above which the thin films break. The form birefringence at a set refractive index also increases with elongation. The implication of the strain birefringence of F-actin is discussed as it affects the optical properties, mainly light scattering, of tissues such as the fiber cells of lens of the eye. PMID- 1777578 TI - Thermally induced conformational transition of double-stranded xanthan in aqueous salt solutions. AB - The thermally induced conformational transition of double-stranded xanthans (degree of pyruvate substitution, DSp = 0.45) having Mw = 3.1, 5.7, and 20.3 x 10(5) has been studied in aqueous salt solutions by high-sensitivity differential scanning calorimetry (DSC). The double strandedness of these samples in the ordered conformation was ascertained by the value of mass per unit length, ML = 2090 +/- 270 g mol-1 nm-1, which was determined from the contour length obtained by electron microscopic observations and the molecular weight by light scattering measurements. The temperature at half completion of the transition T 1/2 for these samples increased linearly with the logarithm of the cation (Na+, K+) concentration. The plot of 1/T1/2 vs the natural logarithm of cation (Na+) concentration in mM for the sample with Mw = 5.7 x 10(5) (15-SX) yielded the equation 10(3)/T1/2 = 3.45-0.159 ln [Na+]. The specific enthalpy delta hcal for 15-SX, essentially independent of salt concentration above 20 mM, was 8.31 +/- 0.39 J/g (SD, n = 6). No systematic dependence of molecular weight on the transition temperature and the enthalpy was observed. Application of the Manning polyelectrolyte theory to the system using the DSC data suggested that the separation of the double strand of xanthan into two single chains was not completed at the temperature where the endothermic peak was finished. This suggestion is consistent with recent findings by light scattering measurements as a function of temperature. Our DSC study was extended to include four other samples from various sources. It was found that T1/2 and delta hcal depend on the pyruvate contents of the samples. For example, the t1/2 (t1/2/degrees C = T1/2/K 237.15) values for samples with high pyruvate content (DSp = 0.9) and depyruvated (DSp = 0.14) in 20 mM aqueous NaCl were 48.8 and 85.3 degrees C, respectively. Two other samples showed relatively broad DSC curves having shoulders, which were resolved into two independent components. Thermodynamic parameters for each component were examined as a function of salt concentration, and the results obtained were interpreted in terms of the heterogeneity of the pyruvate content of the samples. PMID- 1777580 TI - Determining molecular weight distributions of antigen-antibody complexes by quasi elastic light scattering. AB - Physiological properties of soluble antigen-antibody (Ag-Ab) complexes depend in part on the size of the complexes. In previous work, the size distribution and structure of model Ag-Ab complexes were determined by electron microscopy. In this study, we used constrained regularization analysis of quasi-elastic light scattering data to estimate molecular weight distributions of model Ag-Ab complexes. A conformational model was necessary to determine appropriate correlations between molecular weight and diffusion coefficient, and to estimate particle structure factors. Porod-Kratky theory proved to be an adequate conformational model for these purposes. The molecular weight distributions determined by constrained regularization compared favorably with distributions obtained either by electron microscopy or by thermodynamic modeling. PMID- 1777581 TI - Conformational correlatives of DNA band compression and bidirectional migration during field inversion gel electrophoresis, detected by quantitative video epifluorescence microscopy. AB - Individual DNA molecules in the Mb size range were monitored by epifluorescence video microscopy during field inversion gel electrophoresis (FIGE). DNA migrating in an agarose gel gives rise to characteristic V-conformational elements and when doing so exhibits a reduced mobility. When the V-conformational elements per DNA molecule are few, the degree of retardation appears proportional to the number of V's, and since larger DNA species exhibit more V's, to DNA size. For a particular pulse frequency, the proportionality breaks down progressively as the number of V conformational elements per DNA molecule increases. The loss of proportionality between DNA length and migration rate is being correlated with the macroscopically observed loss of electrophoretic size discrimination known as band compression. For a particular pulsing frequency and size class of DNA, the loss of size discrimination is thought to be due to the different orientations of migration, caused by the asymmetric distribution of V-conformational elements when the number of these elements is moderate. Small and very large DNA by contrast migrate with the direction of the biased field. These events, analyzed by microscopic measurement, are consistent with the known macroscopically observed double-valued mobilities in FIGE. PMID- 1777582 TI - Comparison of the bis-intercalating complexes formed between either ditercalinium or a flexible analogue and d(CpGpCpG)2 or d(TpTpCpGpCpGpApA)2 minihelices: 1H- and 31P-NMR analyses. AB - The 400-MHz 1H- and 162-MHz 31P-nmr have been used to study complexes constituted by (a) the d(TpTpCpGpCpGpApA)2 or the d(CpGpCpG)2 self-complementary oligonucleotides and (b) two bifunctional 7H-pyrido [4,3-c] carbazole dimer drugs, the antitumoral ditercalinium (NSC 366241), a dimer with a rigid bis piperidine linking chain and its pharmacologically inactive analogue, a dimer with a flexible spermine-like linking chain. Nearly all proton and phosphorus signals have been assigned by two-dimensional (2D) nmr (correlated spectroscopy, homonuclear Hartmann-Hahn, nuclear Overhauser enhancement spectroscopy, 2D 31P (1H) heteronuclear correlated spectroscopy and 31P-31P chemical exchange experiments). Both drugs bis-intercalate into the two CpG sites. The complexes show small differences in the position of the 7H-pyrido [4,3-c] carbazole ring into the intercalation site and possibly in the ribose-phosphate backbone deformation. However, the inactive analogue exhibits a longer residence lifetime in octanucleotide than the ditercalinium does. All these results are discussed in terms of differences in dimer activities. PMID- 1777583 TI - Drug-DNA interactions: spectroscopic and footprinting studies of site and sequence specificity of elliptinium. AB - The binding of the antitumoral ellipticine derivative 2-methyl-9 hydroxyellipticinium acetate (elliptinium; NMHE) to DNA was analyzed by the combined use of DNase I footprinting and spectroscopic methods. Using two fragments of pBR322 DNA, five discrete NMHE binding sites of 5-7 protected base pairs (bp) were detected by footprinting at 4 degrees C on the analyzed regions. These corresponded to alternating pyrimidines and purines. The inactive derivative 2-methyl ellipticinium acetate L(NME) lacking a hydroxy group failed to demonstrate DNA protection even at low temperature. Ultraviolet-absorption and 1H-nmr analysis was performed using two autocomplementary octanucleotides d(TGACGTCA) (I) and d(ACTGCAGT) (II). The uv-absorption titrations resulted in an intercalative binding mode for NMHE in the oligomers. Analysis of the derived biphasic Scatchard plots yielded two binding sites corresponding to approximately 6-bp and 2-bp sizes and characterized by apparent association constants K1 approximately 10(8) M-1 and K2 approximately 10(6) M-1, respectively. The 1H-nmr analysis of exchangeable (imino) protons and nonexchangeable protons performed in the one- and two-dimensional modes confirmed the intercalation of NMHE, and further revealed the existence of multiple sites on DNA. Assuming that imino resonance line width concerned the sole kinetic effects, 10-ms order lifetimes were estimated for the drug-oligonucleotide complexes at 7 degrees C, pH 7, and 0.1 ionic strength. Finally, examination of every drug-DNA spectra in the light of the footprinting results indicated that there was a preference for binding of NMHE to the CpG (octamer I) and TpG (octamers I and II) steps. PMID- 1777584 TI - A reexamination of 25Mg2+ NMR in DNA solution: site heterogeneity and cation competition effects. PMID- 1777585 TI - Cardiovascular complications in renal failure. AB - Cardiovascular diseases are a leading cause of death in end-stage renal disease (ESRD) largely as a result of the progressively increasing age of ESRD patients and the broad constellation of uremia-associated factors that can adversely affect cardiac function. Hypertension, one of the leading causes of renal failure, is a major culprit in this process, causing left ventricular hypertrophy, cardiac chamber dilation, increased left ventricular wall stress, redistribution of coronary blood flow, reduced coronary artery vasodilator reserve, ischemia, myocardial fibrosis, heart failure, and arrhythmias. In addition to impairing the coronary microcirculation, hypertension may contribute to the development of atherosclerotic coronary artery disease, particularly in the presence of the many lipid abnormalities observed in ESRD. These patients have reduced high-density lipoprotein cholesterol and increased plasma triglyceride concentrations, and there is a defect in cholesterol transport. Other abnormalities that may contribute to atherosclerotic coronary artery disease in ESRD are reduced high-density lipoprotein cholesterol synthesis and reduced activity of the reverse cholesterol pathway. Treatment with fibric acids, nicotinic acids, and lovastatin may be useful in lowering cholesterol and triglyceride concentrations in some of these patients. The incidence of coronary artery disease in ESRD populations is difficult to determine. About 25 to 30% of ESRD patients with angina have no evidence of significant coronary artery disease, and an undetermined number have silent coronary disease. The presence of resting electrocardiographic abnormalities caused by hypertension or conduction defects makes it difficult to accurately diagnosis coronary artery disease in ESRD populations by noninvasive methods, including exercise testing and thallium scintigraphy with or without the use of dipyridamole. Hypotension is a frequent complication of the dialytic process. Many factors have been implicated, including autonomic neuropathy. There is no consensus on the function of the efferent limb of the sympathetic nervous system. The afferent limb (arterial baroreflex function) is felt to be impaired. Further, there may be defects in the ability of the cardiovascular system to respond to sympathetic nerve activity. Most studies of autonomic function have used indirect measurements. Studies are underway that use techniques to assess sympathetic function directly. Such experiments with microneuropathy suggest greater skeletal sympathetic muscle discharge in uremic patients than in normal patients. PMID- 1777586 TI - Thymus-mediated immune tolerance to renal allograft is donor but not tissue specific. AB - Studies were conducted in Lewis (RT1l) rats to determine whether the process of unresponsiveness to kidney graft induced by the intrathymic glomerular transplantation were donor-strain specific as suggested by previous studies (Remuzzi et al., Lancet 1991;337:750-752). When glomeruli from Sprague-Dawley rats were injected in the thymus of Lewis rats, the subsequent kidney graft from a "third party" Brown-Norway (RT1n) rejected within 9 to 14 days. Moreover, an alternative site for glomerular antigen inoculation, such as i.p. administration, failed to induce a state of unresponsiveness to renal allograft. Whether tolerance was tissue specific was investigated by intrathymic injection of a preparation of donor blood cells that only included white cells. Such a maneuver, followed 10 days later by a kidney transplant, allowed indefinite renal graft survival in all animals, whereas all rats injected intrathymically with blood cell medium alone rejected the kidney graft in 8 to 11 days. Shortening the time interval between intrathymic injection of blood cells and kidney transplantation still allowed the graft to survive indefinitely. Finally, Lewis (RT1l) rats with chronic renal failure injected intrathymically with blood cells from Brown-Norway (RT1n) rats tolerated indefinitely a subsequent kidney graft from the same donor. These findings indicate that (1) the induction of immune tolerance to renal allograft induced by intrathymic injection of antigens is donor but not tissue specific; (2) the time interval between intrathymic injection of donor cells and the subsequent kidney transplantation can be reduced to 24 h; and (3) uremia does not preclude the possibility of renal allograft tolerance after the thymus procedure. PMID- 1777587 TI - Endothelium-derived relaxing factor and the vascular reply to systemic hypertension. AB - Endogenous nitric oxide is an important modulator of vascular smooth muscle tone. The role of nitric oxide in the vascular adaptation to systemic hypertension was examined by using N omega-monomethyl-L-arginine (L-NMMA; 110 micrograms/kg/min), a competitive inhibitor of the conversion of L-arginine to nitric oxide. L-NMMA or saline vehicle (9.6 microL/min) was infused i.v. into several rat models of acute and chronic systemic hypertension. The response to L-NMMA was compared either in uninephrectomized Sprague-Dawley rats treated with deoxycorticosterone on either a high- or low-sodium diet or in untreated uninephrectomized rats on normal chow. Hypertensive deoxycorticosterone rats had a significantly greater pressor response to L-NMMA (139 +/- 2 to 169 +/- 3 mm Hg; N = 9) than did normotensive uninephrectomized rats (112 +/- 4 to 129 +/- 3 mm Hg; N = 7) or deoxycortisterone treated rats on a low-sodium diet (108 +/- 2 to 121 +/- 3 mm Hg; N = 9). By contrast, hypertension induced by the vasoconstrictor angiotensin II did not have an enhanced response (134 +/- 3 to 154 +/- 4 mm Hg; N = 7) nor did spontaneously hypertensive rats (164 +/- 4 to 175 +/- 4 mm Hg; N = 6). This dose of L-NMMA had minimal effects on renal hemodynamics in the normotensive and hypertensive animals, except for those receiving angiotensin II where it led to substantial reductions of inulin and para-aminohippurate clearance. In conclusion, these data point to a role for nitric oxide in the vascular adaptation to volume-mediated hypertension, an effect that was not observed in vasoconstrictor-induced hypertension. PMID- 1777588 TI - Hemin and L-arginine regulation of blood pressure in spontaneous hypertensive rats. AB - Perturbation in heme metabolism is known to affect the level and activity of hemoproteins, including cytochrome P450-dependent arachidonic acid metabolism. The latter has been associated with elevation in blood pressure seen in spontaneously hypertensive rats. The effect of heme arginate and its components, arginine and heme, on cytochrome P450 levels and blood pressure in spontaneously hypertensive rats were studied. Administration of heme arginate or heme alone at doses of 9 to 30 mg/kg body wt/day for 4 days resulted in a marked decrease of blood pressure in spontaneously hypertensive rats, whereas blood pressure in rats receiving the vehicle control was not affected. Similarly, L-arginine, but not D arginine, in a dose-dependent manner decreased blood pressure in spontaneously hypertensive rats. The maximal change in blood pressure was achieved at 100 mg/kg body wt of arginine and was associated with a significant increase in heme oxygenase activity. A higher concentration (500 mg/kg) did not cause an additional decrease in blood pressure but further increased heme oxygenase activity. The arginine-induced heme oxygenase activity was suppressed by Sn protoporphyrin. Administration of heme to spontaneously hypertensive rats resulted in an accumulation of heme oxygenase mRNA, which was accompanied by an increase in enzyme activity. The increase in heme oxygenase activity was also prevented by Sn-protoporphyrin. It is postulated that heme treatment resulted in an increase in heme oxygenase mRNA, which consequently led to a diminution of cellular heme and depletion of hemoproteins, such as the cytochrome P450 arachidonate metabolizing enzymes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777590 TI - Sieving and reflection coefficients for sodium salts and glucose during peritoneal dialysis in rats. AB - The two-part studies reported herein address peritoneal membrane ultrafiltrate (UF) characteristics during peritoneal dialysis exchanges in rats. In the studies of part 1, the sieving coefficients for sodium, chloride, and total solutes during hydrostatic UF after instillation of rat serum into the peritoneal cavity of rats were calculated. Thirty-six rats were divided into six groups (N = 6) according to the following peritoneal dialysis exchange cycle times: 60, 120, 180, 240, 480, and 960 min. Thirty milliliters of pooled rat serum were infused i.p. with the animal being conscious except during infusion and drainage. The study showed in the early phase of exchanges, when oncotic and osmotic pressure gradients were absent, net UF presumably due to capillary hydrostatic pressure and sodium sieving during such UF. Sieving coefficients for sodium (0.72), chloride (0.77) and total solutes (0.73) were determined by using standard formulae. In the second part of these studies, the kinetics of fluid movement after the instillation of 5% dextrose solution into the peritoneal cavity of rats were analyzed. A very low UF rate was observed early in the exchange when the glucose gradient between the dialysis solution and blood was at its peak. The UF rate gradually increased as the sodium entered the dialysis solution from the blood. At the time of low UF rate with high glucose gradient, presumably the osmotic pressure generated by the glucose in the dialysis solution was countered by the osmotic pressure of solutes in plasma, i.e., sodium and its anions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777589 TI - Preventing Staphylococcus aureus infection during chronic peritoneal dialysis. AB - In the interest of studying the prevention of chronic peritoneal dialysis infections, serial studies of the bacterial epidemiology in peritonitis and of antibiotic prophylaxis, respectively, were carried out. For 18 months, prospective evaluation of catheter exist site cultures, performed at the time patients developed acute peritonitis, showed that Staphylococcus aureus peritonitis was associated with concordant S. aureus at the exist site in 85% of cases, significantly more frequent than that for other organisms (P less than 0.02). Furthermore, active inflammation along with concordant culture results at the exit site characterized more than 60% of S. aureus peritonitis cases, also significantly more than that for other organisms (P less than 0.01). Over the ensuing 2 yr, patients beginning chronic peritoneal dialysis with a new percutaneously placed catheter were prospectively entered into a randomized, controlled trial of long-term antibiotic prophylaxis with trimethoprim sulfamethoxasole. Patients receiving prophylaxis tended to have fewer episodes of peritonitis; however, the lower rate of peritonitis reached statistical significance only comparing patients who were S. aureus carriers at entry into the study to patients who were not S. aureus carriers. In particular, the prophylaxis trial seemed to reduce the specific incidence of S. aureus peritonitis overall, with S. aureus appearing in only 2 of 28 total peritonitis episodes among treated patients as compared with 11 of 37 total episodes among non-treated patients (P less than 0.01). Further analysis of the time to first peritonitis suggests that the effect of prophylaxis was most prominent during the first 3 months of therapy (P less than 0.02) rather than later in the course of treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777591 TI - Low-density lipoprotein uptake and cholesterol accumulation by cultured renal cells. AB - The uptake of low-density lipoprotein (LDL) and the accumulation of cholesterol were assessed in opossum kidney (OK) and Madin-Darby canine kidney (MDCK) cells. OK and MDCK cells were grown to confluency on Millicell well inserts. The uptake of human LDL across the apical and basolateral surfaces of OK and MDCK cells was assessed by the degradation of internalized (125I)LDL to trichloroacetic acid soluble products. LDL uptake via the apical surface of OK cells increased linearly with LDL concentration, indicating nonreceptor-mediated uptake. In contrast, LDL uptake via the basolateral surface of OK cells and both apical and basolateral surfaces of MDCK cells followed a saturable pattern. In addition, (125I)LDL bound to the apical membrane of MDCK cells, but not to the apical membrane of OK cells, was displaced by heparin and by excess of unlabeled LDL. Exposure to LDL (100 mg/mL) resulted in an increase in total cholesterol content of OK and MDCK cells (23 and 18%, respectively). Most of the increase in total cholesterol content with LDL exposure resulted from increased free cholesterol content in MDCK cells and esterified cholesterol in OK cells. The differences in cholesteryl ester formation were consistent with the slower rates of (14C) oleate incorporation into cholesteryl ester and lower cholesterol esterifying activity observed in MDCK cells compared with that in OK cells. These results demonstrate that LDL uptake can be receptor or nonreceptor mediated, depending upon the renal cell type and the surface exposed to LDL, and that LDL exposure leads to increased cholesterol content in OK and MDCK cells. PMID- 1777592 TI - Calbindin-D9k and parvalbumin are exclusively located along basolateral membranes in rat distal nephron. AB - There is strong evidence that vitamin D-dependent Ca(2+)-binding proteins, i.e., calbindin-D9k and calbindin-D28k, facilitate diffusion of Ca2+ through the cytosolic compartment of renal and intestinal cells, which transport Ca2+ transcellularly. In the study presented here, parvalbumin, calbindin-D9k, and calbindin-D28k were localized precisely by immunocytochemistry in rat kidney. Antisera recognizing specifically the thick ascending loop of Henle, the connecting tubules and collecting ducts, and the intercalated cells of the collecting ducts were used to identify different cell types. In rat kidney cortex, parvalbumin and calbindin-D9k colocalized in the thick ascending loop of Henle, the distal convoluted tubule, the connecting tubule, and the intercalated cells of the collecting duct. Strikingly, in all responsive cells, parvalbumin and calbindin-D9k were exclusively present in a thin layer along the basolateral membrane. In contrast, calbindin-D28k was only present in the distal convoluted and connecting tubule, where it was evenly distributed through the cytosol. In conclusion, the exclusive localization of parvalbumin and calbindin-D9k at the basolateral membrane of immunopositive renal cells implies their involvement in the regulation of transport processes located in these membranes rather than a role as intracellular Ca2+ buffer and Ca2+ shuttle between the two opposing membranes. PMID- 1777593 TI - Effects of recombinant human growth hormone in adults receiving maintenance hemodialysis. AB - Administration of recombinant human growth hormone stimulates protein synthesis, decreases urea generation, and improves nitrogen balance in individuals with normal renal function. However, little information is available concerning the effects of growth hormone in patients with renal disease. This pilot study evaluated urea kinetics and clinical/metabolic responses to short-term growth hormone administration in five clinically stable adult patients requiring maintenance hemodialysis for end-stage renal failure. The dialysis prescription, medications, and oral calorie and protein intake of each patient remained constant during an initial control week and a subsequent 2-wk growth hormone treatment period. During treatment, growth hormone (5 or 10 mg) was administered s.c. immediately after each dialysis session. Protein and calorie intake, vital signs, body weight, and other clinical parameters remained stable throughout the 3-wk study. BUN values fell significantly (approximately 20 to 25%) during growth hormone administration compared with control week values. Similarly, urea kinetic modeling demonstrated a significant reduction in urea generation and the protein catabolic rate during each week of growth hormone treatment. Plasma insulin-like growth factor I levels rose significantly, and serum phosphorus and intact parathyroid hormone levels fell significantly during growth hormone administration. Serum glucose and other blood values remained stable. This preliminary study suggests that growth hormone administration reduces urea generation and improves the efficiency of dietary protein utilization in stable adult hemodialysis patients. Growth hormone may be a useful adjunctive therapy to diminish body protein catabolism in this patient population. PMID- 1777595 TI - Geographic variation in the incidence of treated end-stage renal disease. AB - To facilitate identification of geographic clusters of areas with high or low incidence of treated end-stage renal disease, the 1983 to 1988 incidence by county was studied among whites and nonwhites less than 60 yr of age in the United States. End-stage renal disease incidence counts for 1983 to 1988 were obtained from the United States Renal Data System data base and linked to the 1985 county population obtained from U.S. Census data. Maps were smoothed by the method adopted by the National Cancer Institute that smooths only according to variability of the local rates, ignoring geographic information on clustering of events. In addition to identifying specific counties with exceptionally high or low incidence, geographic patterns were observed with many similarities across whites and nonwhites: notably high rates of disease in areas of the Southwest, the Southeast and in counties with Native American reservations and low rates in the West and Northwest. On the basis of these findings, several hypotheses are presented to explain the observed variation in treated end-stage renal disease incidence rates. PMID- 1777594 TI - Hysteresis of the parathyroid hormone response to hypocalcemia in hemodialysis patients with low turnover aluminum bone disease. AB - During the study of parathyroid function in 19 hemodialysis patients with low turnover aluminum bone disease, it was observed that serum parathyroid hormone (PTH) levels were higher during the induction of hypocalcemia than during the recovery from hypocalcemia. This type of PTH response has been termed hysteresis. Hypocalcemia was induced during hemodialysis with a calcium-free dialysate. When the total serum calcium level decreased to 7 mg/dL, the dialysate calcium concentration was changed to 3.5 mEq/L and the dialysis session was completed. One week later, hypercalcemia was induced during hemodialysis with a high-calcium dialysate. The mean basal PTH level was 132 +/- 37 pg/mL (normal, 10 to 65 pg/mL; immunoradiometric (IRMA), Nichols Institute, San Juan Capistrano, CA) and increased to a maximal PTH level of 387 +/- 91 pg/mL during hypocalcemia. For the same ionized calcium concentration, the PTH level was higher during the induction of hypocalcemia than during the recovery from hypocalcemia. Conversely, for the same ionized calcium concentration, the PTH level was greater when hypercalcemia was induced from the nadir of hypocalcemia than when hypercalcemia was induced from basal serum calcium. The set point of calcium (defined as the serum calcium concentration required to reduce maximal PTH by 50%) was greater during the induction of hypocalcemia than during the recovery from hypocalcemia (4.44 +/- 0.10 versus 4.25 +/- 0.09 mg/dL; P = 0.03). The mean basal ionized calcium concentration and the mean ionized calcium concentration at the intersection of the two PTH-calcium curves were the same (4.61 +/- 0.13 versus 4.61 +/- 0.12 mg/dL).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777596 TI - Heparin increases hillock formation in mesangial cell cultures. AB - Mesangial cells in culture develop hillocks, which are composed of aggregates of cells, necrotic cellular debris, and extracellular matrix material. The significance and mechanism of their formation are unknown. To determine whether a proliferative component is involved in hillock formation, cells were treated with heparin or irradiated to inhibit proliferation. Heparin caused a 50% inhibition of mesangial cell growth and stimulated hillock formation three-fold to fourfold. Irradiated cells developed hillocks to the same extent as did nonirradiated cells, and the addition of heparin also increased hillock formation threefold to fourfold. Dextran sulfate and chondroitin B sulfate had no effect on mesangial cell hillock formation. Mesangial cells cultured in the presence of 50 micrograms/mL of heparin were less tightly adhered than nontreated cells, as assessed by a trypsin adhesion assay (control cells, 12% detached; heparin treated cells, 72% detached). Thus, it appears that heparin, a glycosaminoglycan with potent antimitogenic activity, stimulates mesangial cell hillock formation, possibly by decreasing cell adhesion. PMID- 1777597 TI - Cardiac growth factors. AB - The role of polypeptide growth factors in cardiovascular ontogeny, function, and pathologic states is poorly understood. Recent investigations demonstrate that the myocardium produces both known and novel growth factors, which are highly regulated during development and disease, and have suggested that peptide growth factors may direct cardiac organogenesis and adaptation. Aspects of growth factor production, transduction, and action in myocardium are distinct to the cardiac muscle lineage and were not foreseen from results in simpler systems. Transforming growth factor beta 1 and fibroblast growth factors (FGFs) selectively up-regulate an ensemble of tissue-specific genes associated with the fetal myocardium. One of these, encoding the skeletal muscle isoform of alpha actin, is activated by basic FGF yet is inhibited by acidic FGF. A serum response element of this gene is selectively induced, in cardiac myocytes, by basic FGF but not acidic FGF. Thus, cardiac muscle is an especially intriguing model for the analysis of growth factor signalling pathways that control differentiated gene transcription. PMID- 1777598 TI - The growth and differentiation of mast cells. AB - Mast cells (MCs) are local immune cells involved in host defense mechanisms and allergic response. They usually develop from MC committed progenitor cells which in turn are derived from uncommitted hemopoietic stem cells. MC precursors are supposed to develop in the bone marrow (bm) cavities as well as in extramedullary tissues. MC precursor cells also have the potential to circulate in the blood stream. After homing in the tissues they give rise to mature MCs. Recruitment and differentiation as well as terminal maturation of MCs is regulated by a complex network of factors. Two major arms of control have been delineated based on in vitro studies and experimental animal models. The first involves the response of the progenitor cells to growth inducing cytokines, such as IL-3. This type of control promotes the generation of MC precursor cells. The second arm of control involves the microenvironmental network interacting with the MC progenitors. It consists of both stroma cell- and immune cell-derived differentiation factors and the direct interaction of cells. It may be important for homing of MC progenitors during embryogenesis and probably throughout life. The stromal component also determines terminal differentiation towards a particular type of MCs and also supports in vitro development of MCs in long term cultures. Growth and function of the mature MCs in the various tissues may be triggered by additional factors including the interactions of MCs with other leukocytes and nerve cells. The coupling of MC activation processes with subsequent proliferation may be a triggering factor in allergic disease. This article attempts to provide a synthesis of current knowledge on MC development.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777599 TI - Human interleukin-4: an immunomodulator with potential therapeutic applications. AB - Human interleukin-4 (IL-4) is a 20kDa cytokine produced by activated T cells and has an extensive range of stimulatory and inhibitory effects on the wide range of cells which express its receptor. It specifically promotes the immunoglobulin class switch to IgE and IgG4 and potently co-stimulates with CD40 monoclonal antibodies the long term proliferation of human B cells. It has variable effects on T cells, but predominantly has inhibitory actions on monocytes suggesting a potential therapeutic role as an anti-inflammatory agent. There is evidence for indirect anti-cancer activity of IL-4 both in animal models and in in vitro studies on human tumour infiltrating lymphocytes. In addition, IL-4 directly inhibits the in vitro proliferation of the majority of B cell neoplasms. Phase I studies of IL-4 in patients with cancer have commenced and promising observations have been made in patients with haematological malignancies receiving low, well tolerated doses. PMID- 1777600 TI - Intracerebral delivery of growth factors: potential application of genetically modified fibroblasts. AB - To date, a number of different growth factors (e.g. nerve growth factor, brain derived neurotrophic factor, neurotrophin-3, ciliary neurotrophic factor, and fibroblast growth factor) have been shown to act as a neurotrophic and/or neurotrophic agents on distinct neuronal populations within the peripheral and central nervous system. Knowledge as to how most of these factors influence the development and regeneration of growth factor-sensitive neurons has been obtained from in vitro examination. A new approach that can be used to assess the effects of growth factors on neuronal groups in vivo is the combined use of gene transfer and intracerebral grafting techniques. The present article explores the potential use of grafting genetically modified fibroblasts within the nervous system as a delivery method for growth factors. PMID- 1777601 TI - Requirement of both interleukin 3 and interleukin 6 for the growth of primitive hemopoietic progenitors. AB - Using a serum-free culture system, we studied the interaction of interleukin 3 (IL-3) and interleukin 6 (IL-6) in the development of primitive hemopoietic progenitors. A time-course study showed that total colony formation supported by 200 U/ml of IL-3 alone failed to reach the level obtained by the combination of 40 ng/ml of IL-6 and IL-3 in culture containing bone marrow cells of 5 fluorouracil (5-FU) -treated mice. Extremely high concentrations (1,000 U/ml, 10,000 U/ml) of IL-3 also required the presence of IL-6 for the sufficient development of primitive progenitors. The depletion of phagocytic and T cells from crude bone marrow cells of 5-FU-treated mice did not influence the requirement for both factors. These results suggest the existence of primitive progenitors which require both IL-3 and IL-6 for development. The delayed addition of IL-6 to a culture initiated with IL-3 failed to restore total colony growth to the levels obtained by culture initiated with the two factors simultaneously. The results suggest that some primitive hemopoietic progenitors requiring both IL-3 and IL-6 for the substantial growth may be unable to survive in the presence of IL-3 alone. PMID- 1777602 TI - Long-term bone marrow failure accompanied by skin pigmentation. AB - A rare case of long-term bone marrow failure with skin pigmentation is presented. The patient was a female with a long history of anemia and skin pigmentation since childhood, although she had no malformations nor chromosomal abnormalities. Hematological improvement has been maintained by the administration of prednisolone. This case may differ from other disorders known as congenital aplastic anemia. PMID- 1777603 TI - A C----G mutation at nt position 6 3' to the terminating codon may be the cause of a silent beta-thalassemia. AB - We describe the hematological and clinical data for a young Greek patient with beta-thalassemia intermedia and for several members of her family. The patient had inherited the common IVS-I-1 (G----A) mutation from her mother, while the second beta-globin gene had a C----G mutation at position 6 3' to the terminating codon (term. + 6). Her father and three additional relatives with a heterozygosity for this newly discovered mutation had no hematological abnormalities, normal Hb A2 values, and a nearly normal in vitro chain synthesis ratio. Analyses of nearly 500 additional beta-thalassemia and normal chromosomes failed to detect this mutation which eliminates it as a common polymorphism. Although our findings may indicate a rare polymorphism, the probability that it represents the cause of diminished beta chain synthesis is very high indeed. We suggest that the C----G mutation in this untranslated region of the beta-globin gene causes a slight decrease in the stability of the mRNA which becomes clinically important only in situations when beta chain synthesis in trans is eliminated. PMID- 1777604 TI - Glucose-6-phosphate dehydrogenase deficiency and diabetes mellitus. AB - This hospital-based study demonstrates a statistically significant higher prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency among the Saudi patients with diabetes mellitus (12.4%) as compared to healthy population controls (2.0%) (p less than 0.008). The nature of this association is difficult to explain. In view of a higher frequency of G6PD deficiency among diabetics, it is suggested that all patients with diabetes be screened for this enzymopathy in order to avoid the use of certain drugs or toxic agents that can produce hemolysis. PMID- 1777605 TI - Retrospective analysis of late intensification therapy with high-dose methotrexate for standard-risk acute lymphoblastic leukemia in childhood (CCLSG S811 study). The Children's Cancer and Leukemia Study Group. AB - Using the CCLSG-S811 protocol for children with standard-risk acute lymphoblastic leukemia (ALL), late intensification therapy (LIT) with high-dose methotrexate (HD-MTX) was conducted without randomization. Of 118 eligible patients, 114 attained complete remission and 82 maintained continuous complete remission (CCR) for at least 3 years, completing the entire S811 regimen. Among the latter, 74 patients received LIT with HD-MTX between 2-3 years after CCR onset. MTX (2,000 mg/m2 per dose per week) was administered by 24 h infusion and three doses were given every 12 weeks. Leucovorin rescue (15 mg/m2 i.v.) every 6 h was initiated 12 h after the end of MTX infusion for seven doses. As regular maintenance chemotherapy, intermittent (Regimen A) or continuous (Regimen B) MTX plus 6 mercaptopurine (6MP) combined with pulses of prednisolone and vincristine was administered (Koizumi S, Fujimoto T, Takeda T, et al. Cancer 1988; 61: 1292 1300). Retrospective analysis revealed that patients on Regimen A who started LIT earlier (within 2 years of CCR onset (n = 23)) showed a higher rate of event-free survival (EFS) at 8 years (95.5% +/- 4.4%, mean +/- S.E.) than patients who started LIT later (2.5 years after CCR onset (n = 18, 66.2% +/- 11.3%, p less than 0.01)). In addition, the superiority of four or five courses of the LIT (n = 39) as compared to 2 or 3 courses (n = 35) was noted for both regimens. The data suggest that early and aggressive LIT with HD-MTX may improve the long-term survival of childhood ALL patients. PMID- 1777606 TI - Modified CHOP in an aged patient with non-Hodgkin's lymphoma and probable extensive pulmonary involvement. AB - A 75-year-old female was admitted to our hospital because of shortness of breath and palpitations. Chest roentgenogram together with a CT scan showed multiple nodular shadows in both lung fields, with hilar lymphadenopathy. The cervical lymph nodes were enlarged, and were biopsied to reveal diffuse large T-cell non Hodgkin's lymphoma. Extensive pulmonary involvement was suspected and treatment with a modified CHOP regimen was begun. Following therapy, pulmonary symptoms were remarkably improved, and chest roentgenogram revealed virtually complete clearance of lung lesions. No severe side effects were observed as a result of the therapy. PMID- 1777607 TI - The ultrastructure and distribution of fibrinogen, von Willebrand factor, and glycoprotein IIb/IIIa complex in platelet alpha-granules by cryo-ultramicrotomy. AB - Transformation upon mild stimulation and the ultrastructure of blood platelet alpha-granules were examined using cryo-ultramicrotomy. An ultrastructural study found not only round, but also elongated and drumstick-shaped alpha-granules and rod-like structures protruding from round alpha-granules. Some elongated alpha granules showed distinctive cross-striations in the short axis with a periodicity in the order of 19-22 nm. Gold particle-labeled fibrinogen (Fbg) was observed on elongated alpha-granules having cross-striations. Electron-dense nucleoids were observed on some round alpha-granules. An electron-dense nucleoid, intermediate zone, and an electron-lucent matrix were noted in round alpha-granules by gold particle-labeled Fbg in the intermediate zone. Gold particle-labeled von Willebrand factor (vWF) was observed in alpha-granules except in nucleoid zones. Labeling for Fbg was also observed in rod-like structures protruding from round alpha-granules. Gold particle-labeled glycoprotein (GP)IIb/IIIa complex was observed on the inner face of alpha-granule membranes. A few elongated and drumstick-like alpha-granules were found on freshly fixed platelets. Elongated alpha-granules were only found in a small percentage of washed and collagen stimulated platelets. Cryo-ultramicrotomy is useful for examination of the distribution of intracellular antigens. PMID- 1777608 TI - [Peptidergic modulation of the vagal effect on heart rhythm]. AB - In 20 experiments on anesthetised cats burst stimulation of peripheral cut end of right vagus nerve leads to synchronisation of cardiac and vagus rhythms. Inhibitory effect of dalargin was caused by a decrease of tonic component while secretin would selectively inhibit synchronizing component. The observed results testify to existence of selective peptidergic modulation of vagus influence on the cardiac rhythm. PMID- 1777609 TI - [Resistance of skeletal muscle and small intestine vessels in hypercapnia after the block of the structures of ventral surface of the medulla oblongata]. PMID- 1777610 TI - [Action of an enkephalinase blocker on the effect of acupuncture in acupuncture sensitive and resistant rabbits]. AB - In unanaesthetized acupuncture-sensitive rabbit d-phenylalanine injection didn't change the EP in response to tooth pulp electrostimulation, but prolonged the analgetic effect of auriculo-acupuncture stimulation 15 Hz expressed by decreasing of the amplitude of N1P2 component EP. In acupuncture-resistant rabbit d-phenylalanine injection induced analgetic effect which was enhanced and prolonged by auriculo-acupuncture stimulation. It's suggested that the recovery of pain sensibility after acupuncture analgesia is determined by enkephalinase's mechanism activation which is activated permanently in acupuncture-resistant rabbits. PMID- 1777611 TI - [Effects of adaptation to stress exposure and periodic hypoxia on bioelectric activity of cardiomyocytes of isolated heart in ischemia and reperfusion]. AB - Action potential (AP) of cardiomyocytes was recorded in experiments on isolated perfused according to Langendorf rat hearts. The effect was estimated of preliminary adaptation to intermittent hypobaric hypoxia or to repeated short term stress exposure on the resting potential (RP) and the amplitude and duration of action potential (APD) in global ischemia and reperfusion. It was shown that adaptation to hypoxia is more effective in prevention of ischemic fall of RP, AP and APD. In reperfusion, the parameters enumerated restored more quickly and efficiently in hearts from adapted to stress animals. PMID- 1777612 TI - [Effects of extreme factors and antioxidant alpha-tocopherol on the intensity of blood plasma chemiluminescence]. AB - It was established in experiments on rats that intensity of "fast flash" of iron induced chemiluminescence of biological samples containing microvolumes of blood plasma correlate with resistance of organism to severe hypoxia. The new method is promising for the estimation of the sensitivity of intact organism to severe hypoxia, for registration of antioxidant therapy effects and for studying the mechanisms of extreme factors influence on the organism. PMID- 1777613 TI - [Effects of ethanol and limontar in the antenatal period of development on lipid peroxidation process and antioxidant defense system in the brain and liver tissue of fetal and newborn rats]. AB - The process of lipid peroxidation and the system of antioxidant defense in brain and liver of fetuses on the 20th day of gestation and 1 day old rats after antenatal exposure to ethanol and limontar were studied. It was shown that antenatal exposure to ethanol led to activation of the process of lipid peroxidation in brain and to inhibition of of the enzyme system of antioxidant defense in liver of fetal and newborn rats. Limontar promoted the normalization of both the process of lipid peroxidation and the system of antioxidant defense. PMID- 1777614 TI - [Effects of verapamil on the activity of Ca2+, Mg2+-dependent endonucleases in the nuclei of the dog liver during prolonged hypovolemic shock]. AB - In the experiments of 23 mongrel anesthetized dogs it was established that the blockade of calcium channels with verapamil (0.1 mg/kg) significantly decreased the activity of Ca2+, Mg(2+)-dependent endonucleases in the nuclei of canine liver (after four hours of arterial hypotension, arterial pressure--40 mm Hg). Verapamil was injected intravenously 30 min before the beginning of haemorrhage. The infusion of verapamil to intact animals does not change the activity of the investigated DNA-endonucleases. The obtained experimental data demonstrate that verapamil effectively blocks the activity of endonucleases in the nuclei of canine liver in the conditions of an increasing permeability of hepatocytes' membranes which integrity is deranged during hypovolemic shock. The present investigation reveals a new molecular mechanism of defense of hepatocytes from the damaging effect of one of the pathogenetic factors of a terminal process, namely an increase in the activity of Ca2+, Mg(2+)-dependent endonucleases in the nuclei of the liver. PMID- 1777615 TI - [Experimental assessment of hemodynamic effectiveness of the method of dynamic cardiomyoplasty in the surgical treatment of severe left ventricle insufficiency]. PMID- 1777616 TI - [Role of gastric mucosa prostaglandins in the development of ulcer lesions in liver cirrhosis]. AB - The amount of prostaglandins (PD) E, F2 alpha and I2 (measured as 6-keto-Pg F1 alpha) in endoscopic biopsy specimens of gastric corpus' mucosa also as the concentration of Pg E and F2 in gastric juice of cirrhotic patients without or with gastric and duodenal ulcer were measured by radioimmunoassay. Release of Pgs with gastric juice (in the basal state and after histamine stimulation) was also significantly less in these patients. It was concluded that the severe disturbance of endogenous biosynthesis Pgs in gastroduodenal mucus of cirrhotic patients may play an important role in the development of ulcer disease in these patients. PMID- 1777617 TI - [Disorders of oxidizing metabolism as a criterion of evaluation of the course of wound healing in experimental animals]. AB - The authors carried out 90 experiments in fertile male Wistar rats and 10 experiments in rabbits with noncomplicated and complicated (infectious) wounds. We have revealed in the first 24 hours the characteristic changes of pro- and antioxidation potentials and acid-alkaline condition of blood plasma. The increasing of specific activity of LPO product by 30-40% and the decreasing of hydroperoxides level in comparison with the initial levels of these indicators and the decreasing of blood pH point out the possibility of purulent inflammation development in postoperative wounds. We can use the special treatment of purulent inflammatory wounds in early stages of its development by the meaning of prognostication of wound healing that is very valuable in medical practice. PMID- 1777618 TI - [Neurophysiological mechanisms of the antihypertensive effect of clopheline in pain]. AB - In experiments on conscious and unanesthetized cats it was shown that clopheline in analgesic doses do not change the pain baroreflex blood pressure regulation and mild brain antinociceptive sympathoactivating influences. The clopheline antihypertensive effect was due to nonopiate direct sympathoinhibitory effect realized by suprasegmental level of vasomotor regulation. PMID- 1777619 TI - [Normalizing effects of antidepressive imipramine on reorganization of circadian motility in light period shift in pinealectomized rats]. AB - A change in the reorganization of the circadian motor activity following a 10 hour shift in the photo period was observed in the pinealectomized rats. After antidepressant imipramine (10 mg/kg, 14 days), such reorganization of the circadian rhythm was also changed in the intact animals. At the same time imipramine eliminated the disruption in the resynchronization of the daily motility following pinealectomy. PMID- 1777620 TI - [Effects of transcranial laser irradiation in near infrared range on antinociceptive reactions in mice after administration of diazepam, clopheline and morphine]. AB - The experiments were carried out on white mice whose brain was irradiated transcranially with laser light in infrared range. Exposure to irradiation was 20 min. In one group of animals only laser light was used, in others laser was combined with morphine (3mg/kg), clonidine (0.5 mg/kg), and diazepam (1 mg/kg) injected intraperitoneally. The nociceptive reactions were studied with the help of "tail-flick" and "hot-plate" tests. It was found that laser light did not modify significantly the results of both tests. Moreover, it didn't influence the antinociceptive properties of morphine, clonidine and diazepam in the "hot-plate" test. In the "tail-flick" test laser light did not affect the action of clonidine, but provided naloxone-independent antinociceptive reaction with diazepam and increased the antinociceptive effect of morphine. Laser irradiation of the brain did not cause any significant morphological changes. These results suggest the possibility of modulating antinociceptive actions of morphine and diazepam by laser irradiation of the brain. PMID- 1777621 TI - [Neuropharmacological activity of cerucal and haloperidol by intraperitoneal and intrastriatal administration in rats]. AB - The effects of three-week administration of cerucal and haloperidol were compared in two ways of injections--intraperitoneal 10 mg/kg and intrastriatal 5 micrograms/l microliter. Both of the ways produce the inhibition of rats locomotor activity, but only after the intraperitoneal haloperidol injection the cataleptic status was observed. The inhibition of avoidance conditioning in shuttle box was registered in each haloperidol microinjections, but in case of cerucal intrastriatal microinjection this effect in first 4-5 days of experiment was limited. No any muscular deviation after cerucal injection (systemic and intrabrain) were observed. The antihyperkinetic activity and striatal mechanisms of cerucal and their application in neurology were discussed. PMID- 1777622 TI - [Systemic and regional hemodynamics during audiogenic convulsions in rats genetically epilepsy-prone]. AB - Changes in systemic and regional hemodynamic during sound-induced convulsions were measured with microsphere technique in genetically epilepsy-prone rats of Krushinsky-Molodkina (KM-rats) strain. Blood pressure increased from 103 till 178 mm Hg and cardiac index rose from 27.3 till 49.3 ml/min/100 g b. w. during convulsions. Blood flow was increased in the brain and in the heart by 140-700%, whereas in most of internal organs it was decreased by 40-94%. PMID- 1777623 TI - [Changes in the activity of antioxidant enzymes and level of lipid peroxidation in the embryo brain tissue during prenatal action of ethanol]. AB - Catalase, superoxide dismutase (SOD) activity and level of lipid peroxidation in embryo brain of 13-17-th day were evaluated during ethanol consumption by pregnant rats. The level of lipid peroxidation was more higher in alcohol groups, than in control groups. At the same time the reduced glutathione content was decreased by 13% in the brain of 15-th day embryos under the same conditions. One can draw a conclusion that the elevated level of lipid peroxidation may be a consequence of activated free radical mechanisms or consequence of reduced activity of a non-enzymatic antioxidant system. PMID- 1777624 TI - [Effects of synthetic cholecystokinin analog on hormone secretion in fetal human pancreatic tissue culture]. AB - We have investigated the effects of Pro-Met-Asp-Phe-NH2 (PMAP) on insulin and glucagon release from human fetal pancreatic microfragments in vitro. Four batches of precultured microfragments were incubated for 24 hrs in medium containing 5.5 mM glucose, 17 mM glucose, 1 microM PMAP or 1 microM PMAP plus 17 mM glucose. PMAP significantly enhanced both basal and glucose-stimulated insulin release (2.2- and 4.1-fold, respectively). Glucagon secretion was markedly inhibited by glucose (17 mM). PMAP neither affected the basal glucagon release nor potentiated the inhibitory action of glucose on glucagon release. Hence, PMAR selectively regulates insulin production in human fetal islet tissue without affecting glucagon production. Our results suggest that the substances similar or related to PMAP may prove to be of clinical value in drug correction of diabetes mellitus. PMID- 1777625 TI - [Effects of serotonin-IA receptors on amino acid and dopaminergic responses of neurons]. AB - By using intracellular technique the authors studied the responses of frog spinal motoneurones and rat dorsal root ganglion evoked by GABA, L-aspartate and dopamine in the presence of 5-hydroxytryptamine and its 1A-agonists or without them. It is shown that buspirone, campirone and serotonin increase the GABA effects but inhibit the effects of aspartate via the GABA- and NMDA-receptors modulation. PMID- 1777626 TI - [Effects of morphine on adenylate cyclase activity in lymphocytes of healthy subjects and patients with alcoholism and opiate addiction]. AB - The morphine dose 10(-7) M had practically no effect on adenylate cyclase (AC) activity in lymphocytes of healthy controls (n = 20). The same dose of morphine had a pronounced stimulating effect on the AC activity in lymphocytes of alcoholics in withdrawal (n = 16). In the group of opiate addicts in withdrawal (n = 9) morphine had also a stimulating effect, which differed significantly from controls (33.7 +/- 13.8; P. 0.02). The range of fluctuation of morphine influence on AC activity during the first week of hospitalization was 162.9 +/- 33.0% in alcoholics and 30.4 +/- 4.6% in opiate addicts (P 0.01). PMID- 1777627 TI - [Neurotropic effects of luliberin analog in rats with different sensitivity to ethanol]. AB - Luliberin's analogue (surfagon) has been established to activate shock-induced aggression of short-sleeping (SS) and long-sleeping (LS) rats in painful stress. The using of the castration and hypophysectomy has proved this effect to result from the direct neurotropic action of peptide. It has been shown, that SS rats differ from LS ones by more expressed reducing of painful aggressive and reference reactions after castration and hypophysectomy as well as by definitive peculiarities of peptidergic effects of surfagon. PMID- 1777628 TI - [Effects of growth factors on growth of stromal CFU-f in mouse bone marrow cell cultures]. AB - Purified mouse IL-1 at doses 15-100 mu/ml inhibits the growth of stromal clonogenic cells /CFU-f/ both in full bone marrow cell cultures /F-cultures/ and in adherent bone marrow cell cultures /A-cultures/. Rec. human TNF-alpha inhibits growth of these cells at doses greater than 50 u/ml, but stimulates it /in 1.5 fold increase/at low doses /0.1-20 u/ml/ in cultures of both types. Rec. mouse IL 3 at doses 0.8-50 mu/ml slightly increases/in 1.6 fold increase/the in vitro growth of CFU-f and inhibits it at low doses in F-cultures. In A-cultures this factor stimulates CFU-f growth at all doses tested, but this stimulating effect takes place if only explantation density of mouse bone marrow cells in sufficiently high. PMID- 1777629 TI - [Oxidative phosphorylation in liver mitochondria in toxic form of experimental form of influenza]. AB - The effect of free radical processes on the oxidation-phosphorylation activity in the liver of CBA-mice has been studied, using a model of toxic form viral infection. The EPR-spectroscopic and electrochemical methods applied in the study of animals infected with pathogenic form of the influenza virus made it possible to reveal a decrease in the activity of the respiratory chain in mitochondria. This seems likely to be due to accumulation of endogenic nitric oxide in the liver tissue. PMID- 1777630 TI - [Assessment of interleukin-1 beta mRNA expression in the norm and pathology]. AB - We investigated cytoplasmic RNA from the peripheral blood cells of pollinosis patients. Increased levels of IL-I mRNA were registered in neutrophils of patients suffering from pollinosis for a long time. Neutrophils from patients at the time of exacerbation of pollinosis responded to stimuli less than the cells from healthy donors. During remission the activated neutrophils from pollinosis patients and those from healthy donors had same levels of IL-I mRNA. PMID- 1777631 TI - [The neuroendocrine system and specific factors of immunity in pesticide poisoning]. AB - Experiments performed effects of chronic administration of organophosphate pesticide "Antio" (dose 1/100 LD50) on specific factors of immunity and corticosterone (CS) levels in the blood. Adult male Wistar rats were used in all experiments. The immunological indexes were increased, CS levels were decreased. PMID- 1777632 TI - [Level of antibodies to different determinants of Streptococcus group A polysaccharide and autoantibodies to basal layer of the skin epithelium in rheumatism]. AB - Direct dependence was established between the presence of autoantibodies reacting with the basal layer of the skin epithelium (BLSE) and the high level of antibodies to the streptococcal group A polysaccharide (APS). By the primary active rheumatic fever (PARF) autoantibodies to the BLSE are revealed. By the recurrent active rheumatic fever (RARF) and in the control sera, autoantibodies reacting with the BLES, apparently, are directed to the rhamnose determinants of APS. These data confirm: different level of antibodies to the GS and to the rhamnose determinants of APS by PARF, RARF and in the control sera; the experiments of the autoantibody inhibition, reacting with the BLSE by the APS or the polysaccharide of streptococci A-variant, containing only the rhamnose determinants. PMID- 1777633 TI - [Comparison of proliferative and immunoglobulin-secreting capacity of peripheral blood lymphocytes of healthy persons and patients with B-cell immunoproliferative diseases]. AB - The proliferative response and in vitro immunoglobulin production induced polyclonal activators were studied in 12 patients with multiple myeloma (MM) and in 15 healthy individuals. The spontaneous production of IgM was decreased. PWM induced immunoglobulin production of the peripheral blood lymphocytes was the same. PMID- 1777634 TI - [Goblet cell antigen revealed by monoclonal antibody D12]. AB - An antigen from meconium was revealed by monoclonal antibody D 12 (IgM). This antigen was heat liable substance with relative m. m. about 400-600 kD. Reactions on histological slides with MAb D 12 were blocked up after processing tissues by neuraminidase and become stronger after processing tissues by NaIO4. Antigen D 12 was found in goblet cells of fetal and definitive colon and in analogous cells of trachea and bronchi. PMID- 1777635 TI - [Effects of estrogen on the uterus of mice of different strains]. AB - The strain differences in the response of uterus to the administration of exogenous oestrogen was studied. The uterus of mouse strain CBA appeared to be more susceptible than in strains C57B16 and C3HA, this manifested itself in a lower threshold for development of pseudoestrus and a more pronounced increase of uterine weight. PMID- 1777636 TI - [Dynamics of proliferative activity of cultures of organotypic epithelial mesenchymal recombinants from embryonic lungs of intact and urethane-receiving mice]. AB - The dynamics of proliferative activity of cells was studied in the cultures of organotypic recombinants obtained from embryonic lung epithelium (E) and mesenchyma (M) of the intact and treated transplacentally by urethane mice (strain A). The labelling index (LI) of E and M in the aggregates obtained from treated embryonic lungs (EtMt) was significantly higher than LI in the aggregates from intact embryonic lungs (EiMi) in all days of cultivation (4-7-14). M from the treated embryonic lungs stimulated LI of the intact E (EiMt) but M from the intact embryonic lungs decreased LI of the treated E (EtMi). PMID- 1777637 TI - [Effects of polysaccharide from Thuja occidentale L. on stromal precursor cells of hematopoietic microenvironment in mice]. AB - The effect of high molecular polysaccharide subfraction from Thuja occidentale L. (TPS) on stromal precursor cells of hematopoietic microenvironment under the "steady-state" conditions and after sublethal irradiation was investigated. The stromal precursor cells of different stages of differentiation were detected by the implantation of mouse bone marrow under the renal capsule of syngeneic intact recipients and chimeras. It was shown that TPS did not occur the toxic influence on the stromal precursor cells and provided the defense effect on them under the strong (6 Gy) radiation damages. PMID- 1777638 TI - [Role of bacterial agglutination in wound infection]. AB - Method of study of bacterial agglutination by means of serum taken from patients with wound infections was suggested. It was found out that agglutination suppresses viability of microbial cells in the center of agglutinate and reduces the risk of bacterial spreading from the wound over the body. PMID- 1777639 TI - [Mechanism of accumulation of prion amyloid in the CNS in experimental amyotrophic leukospongiosis]. AB - The mechanism of accumulation of prion amyloid in guinea pig CNS in experimental slow virus disease--amyotrophic leuco-spongiosis (AL) was studied. The complex histochemical, immuno-cytochemical and ultrastructural studies revealed specific amyloid deposits in a few brain capillaries and in most of pia matter vessels. Taking into account the high AL agent titer in spleen throughout the disease period, conclusion was drawn of entering AL agent in CNS through blood-liquor barrier and blood-brain barrier. It was supposed that primary immune system damaging took place in AL pathogenesis. PMID- 1777640 TI - [Pathomorphology of adrenergic and cholinergic structures of sympathetic nerve ganglia in experimental burn injuries]. AB - Changes in adreno- and cholinergic structures of sympathetic nerve ganglia (superior cervical, stellate, and splanchnic ganglia of the solar plexus) were studied in 15 male white rats aged 5-7 months, b. m. 200-250 g, 3, 7, and 11 days after burn injury (Stages IIIA, IIIB, involving 20-25% of body surface) and in 5 reference animals. The sections were treated in 2% glyoxylic acid solution and by the Karnovsky-Roots technique. Reduced catecholamine concentrations were revealed in sympathetic nerve ganglia neurons in the early periods after burn injury; the mediator reserves are recovered to a certain measure in later periods after thermal injury. The detected shifts in the sympathetic nerve ganglia neurons correlate with the detected shifts in the cardiovascular system. PMID- 1777641 TI - [Immunohistochemical localization of cytochrome P-450]. AB - Distribution of different forms of cytochrome P-450 (forms C, D and B) in human placenta by immunohistochemical methods on light microscopy level with colloid gold was studied. Positive reaction with cytoplasm of endothelial cells, called the "epithelioid" plates of chorionic villi was found. Trophoblastic and stromal cells were not stained. PMID- 1777642 TI - [Electron microscope-radioautography study of inveterate non-healing wounds]. AB - Morphological and functional peculiarities of long non-healing wound granulation tissue cells have been studied. The cell functional and proliferating activities were defined by electron-microscopic radioautography of 3H-uridine and 3H thymidine incorporation. There are few vessels and the lumens are narrow. The walls of the most of the vessels are in the state of destruction. There are multiple macrophages with phagosomes filled with detritus. Fibroblasts have endoplasmic reticulum with widened small canals. Not multiple collagen fibers have broken periodic striation. PMID- 1777644 TI - [Reparation of the vascular wall after laser recanalization of the artery (characteristics of changes in the vascular wall at a late period after laser recanalization)]. AB - Chronic experimental studies were carried out on 9 mongrel dogs. To study the reparation processes in the arterial wall after laser intervention, arteries of different anatomic zones were irradiated with laser: descending and abdominal aorta, iliac, femoral and axillary arteries. To make a laser trauma, two types of laser catheters were used: a) with the light guide with diameter of 400 and 600 microns; and b) with a quartz tip at the end. The laser light source was a laser of Cu vapors, and ND; YAG laser. Laser energy was transmitted in the form of individual impulses with the duration of 2-5 sec, and power of 8-10 watt. Histological studies of the preparations of the irradiated arterial wall were performed at periods: 1-3-7-16-28 days, and 2-8 months. Characteristic signs of the vascular wall reparations are given. The analysis of the experimental results showed that by the 28-th day after laser trauma, on the site of laser irradiation a connective tissue scar was formed substituting the defect in the vascular wall and covered from the lumen side with a thin continuous layer of endothelium without any signs of inflammatory infiltration. The development of intimal hyperplasia is not excluded, as well as of inflammatory reaction with the following thrombotic occlusion of the artery lumen. The study results can be used in clinical practice in order to determine the optimum tactics and performance of laser recanalization of the artery, as well as the treatment after the laser intervention. PMID- 1777643 TI - [Immunomorphological characteristics of mesenteric lymph nodes and lymphoid nodules of the intestines of animals after clinical death]. AB - The results obtained allow to determine, that the pathomorphologic changes (the hemorrhages, the stasis, the edema, the reduction of lymphoid tissue), the quantitative changes of immunoglobulin's cells in the intestine lymphoid tissue were detected. These influences had observed the persistence of enterobacteria, that was shown to observe the translocation from the intestine to the mesenterial lymph nodes during two weeks of postresuscitation period. PMID- 1777645 TI - [Immunomorphological analysis of prolonged intoxication by low doses of herbicide simazine]. AB - Dynamic investigation of several immunologic data and complex morphologic study of the thymus of rats fed for a long time (6 months) by very low doses of herbicide simazine have been carried out. Chronic simazine treatment resulted in the development of the secondary immunodeficient state with the damage of T lymphocytes. The morphologic signs of this process were the disarray in thymus structure (dystrophic changes and intercellular contact break of nurse cells, sclerosis of microvessel walls and stromal elements), severe decrease of the T lymphocyte number in peripheral blood, inhibition of phagocytosis reaction of neutrophils. PMID- 1777646 TI - Caffeine inhibits development of benign mammary gland tumors in carcinogen treated female Sprague-Dawley rats. AB - The purpose of this study was to assess the influence of caffeine on the incidence of benign mammary tumors in carcinogen (DMBA) treated female Sprague Dawley rats. Four different animal models were used in these studies, i.e., the administration of DMBA to: [1] 55 day old virgin rats; [2] 53 day old ovariectomized, estrogen treated virgin rats; [3] 135 day old virgin rats and [4] 135 day old parous rats. A high incidence of benign mammary fibroadenomas was observed in each of the four animal models. In addition, in the estrogen treated ovariectomized animals, a high incidence of secretory mammary gland cysts was observed. Caffeine (500 mg/L drinking water) was administered daily throughout the study commencing 3-31 days after carcinogen treatment. Caffeine treatment significantly (P less than 0.05 to P less than 0.001) reduced the incidence of benign mammary fibroadenomas in the 55 day old virgin rat model (P less than 0.01), in the 53 day old estrogen treated ovariectomized virgin rat model (P less than 0.05 to P less than 0.001) and in the 135 day old virgin rat model (P less than 0.05). The number of benign mammary fibroadenomas was reduced by caffeine in the 135 day old parous rat model but this reduction was not significant (P less than 0.10). In addition, in the estrogen treated ovariectomized virgin rat model, caffeine significantly (P less than 0.05 to P less than 0.001) reduced the incidence of mammary gland cysts. Caffeine treatment either increased or had no significant effect on body weight gains, depending upon the animal model.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777647 TI - Placental isoferritin (PLF) in comparison with MCA and CEA in advanced breast cancer--first data from a pilot study. AB - The development of new and effective marker substances has optimized tumor-marker guided follow-up programs to monitor generalization of disease and to assess the therapeutic outcome. Isoferritins of placental origin were first determined in the serum of patients with lymphoproliferative disease by way of the recently developed monoclonal antibody CMH-9. We have set up an Austro-Israeli working group and analysed 64 patients in terms of the sensitivity of placental ferritin (PLF) compared with the standard markers carcinoembryonic antigen (CEA) and mucinous-like cancer-associated antigen (MCA) in patients with metastatic breast cancer. We have additionally evaluated the importance of combined marker determination. Analysis of the data in view of site of metastatic spread yielded satisfying results both for PLF (sensitivity 70.4%) as well as MCA (sensitivity 76.9%) for visceral metastases; a combination of these two markers revealed a striking sensitivity of 88.4%, which, however, could not be improved by adding the third marker (CEA). With regard to non-visceral metastases, CEA and MCA were clearly superior. PMID- 1777648 TI - Regulation of initiation of protein synthesis by insulin in skeletal muscle. AB - Protein synthesis is impaired in skeletal muscle and heart from diabetic rats. In muscles composed primarily of slow-twitch fibres (e.g. heart or soleus), the inhibition of protein synthesis can be accounted for entirely by a decrease in the amount of RNA. In contrast, in muscles of mixed fibre composition (e.g. gastrocnemius or psoas), the inhibition of protein synthesis is associated with an impairment in peptide-chain initiation. We have found that the inhibition of peptide-chain initiation that occurs in muscles composed of mixed fast-twitch fibres involves eukaryotic initiation factor 2B (eIF-2B). Thus, eIF-2B activity is inhibited in gastrocnemius and psoas but not heart or soleus from diabetic rats. In other systems eIF-2B activity is regulated by phosphorylation of the alpha-subunit of a second initiation factor, eIF-2. However, we have found no change in the phosphorylation state of eIF-2 alpha in either fast- or slow-twitch muscles from diabetic compared to control animals. Instead, the available evidence suggests that eIF-2B activity may be modulated by an alternate mechanism such as a change in the extent of phosphorylation of the 82,000 Mr subunit of the factor or a change in the NADPH/NADP+ ratio. PMID- 1777649 TI - Recent trends in the epidemiology of diabetes mellitus in European and Mediterranean countries. PMID- 1777650 TI - Renal function in non-insulin-dependent diabetes mellitus: purposes and design of the Diabetic Renal Disease Study. AB - Type 2, non-insulin-dependent diabetes mellitus accounts for 60% of the end-stage renal disease attributed to diabetes in the United States, yet little is known about glomerular function or the development of renal disease in this type of diabetes. The Diabetic Renal Disease Study (DRDS) is a longitudinal study designed to elucidate the natural history of renal disease and to characterize glomerular function throughout the course of renal disease in type 2, non-insulin dependent diabetes mellitus. The study is being conducted among the Pima Indians from the Gila River Indian Community in Arizona because they experience a very high rate of type 2 diabetes mellitus, which often develops at a young age and which is frequently associated with the development of renal disease. Glomerular filtration rate, renal plasma flow, albumin and IgG excretion, level of vasoactive hormones, retinal damage, and glomerular capillary permeability to dextrans of different sizes will be assessed at regular intervals over 48 months in six groups of subjects representing a range of glucose tolerance from normal to diabetes, and among the diabetic subjects, a range of proteinuria from normal to overt diabetic nephropathy. The DRDS is designed to provide new information on the functional determinants of renal disease in type 2, non-insulin-dependent diabetes mellitus and will serve as the basis for designing intervention strategies. PMID- 1777651 TI - Fresh human islet transplantation to replace pancreatic endocrine function in type 1 diabetic patients. Report of six cases. AB - The aim of this study was to evaluate the feasibility of islet allografts in patients with type 1 diabetes mellitus. Six patients received human islets from either one or two donors via the portal vein, after (n = 4) or simultaneously with (n = 2) a kidney graft. The patients with functioning kidney grafts (nos. 1 4) were already on triple immunosuppressive therapy (cyclosporine A, azathioprine, prednisone). Prednisone was increased to 60 mg/day for 15 days after the islet transplant in patient 1. Patients 2-4 and the patients who underwent a simultaneous kidney-islets graft (nos. 5, 6) also received antilymphocyte globulin. Intravenous insulin was given for the first 15 days to maintain blood glucose concentrations within the normal range. Patient 1 rejected the islets within 15 days of islet transplantation. In patient 2, a 25% reduction in insulin requirement was observed and 12 months after transplantation post prandial serum C-peptide was 1.5 ng/ml. In patient 3, the insulin requirement decreased from 40 to 8 units/day with a post-prandial serum C-peptide of 4.1 ng/ml 12 months after islet transplantation. In patient 4 the post-prandial secretion of C-peptide increased to 6.4 ng/ml. Six months after the islet infusion, insulin therapy was discontinued and HbA1c, 24-h metabolic profile and oral glucose tolerance test remained within the normal range. He had remained off insulin for 5 months until recently, when foot gangrene paralleled a worsening of post-prandial glycaemic control. Twelve months after transplantation he is receiving 8 units insulin/day.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777652 TI - Apolipoprotein (a) levels in type 1 and type 2 diabetes mellitus. AB - Type 1 and type 2 diabetes mellitus are both characterized by increased cardiovascular mortality and morbidity. Since several reports have indicated that apolipoprotein (a) [apo(a)] levels are positively associated with an increased risk of macrovascular disease, we investigated whether apo(a) levels are elevated in both types of diabetes mellitus and may thus represent an independent risk factor for atherosclerotic disease. Apo(a) concentrations in type 1 diabetic patients were not significantly different from matched controls (276 +/- 78 vs 149 +/- 46 units/l). Type 2 diabetic patients had considerably higher levels of apo(a) than matched controls (471 +/- 89 vs 221 +/- 61 units/l, P = 0.06), though the difference was not statistically significant. However, concentrations of apo(a) were above 300 units/l in 36% of type 1 and 67% of type 2 diabetic patients, but in only 14% and 25% respectively of matched control subjects. Plasma triglycerides were positively and independently correlated with apo(a) levels in both diabetic and non-diabetic subjects. On the other hand, no significant correlation was found between apo(a) levels and glycosylated haemoglobin, total cholesterol or high density lipoprotein cholesterol in any of the groups studied. In conclusion, apo(a) levels are not significantly elevated either in type 1 or type 2 diabetic patients without proteinuria and in moderate metabolic control; however, levels above 300 units/l were 2.6 times more frequent in both types of diabetes mellitus than in carefully age-, sex-, and weight matched control subjects. PMID- 1777653 TI - Effect of sulphonylurea on glucose-stimulated insulin secretion in healthy and non-insulin dependent diabetic subjects: a dose-response study. AB - The effect of a rapid-acting sulphonylurea, glipizide, on the dose-response relationship between the beta-cell response (insulin and C-peptide secretion) and the ambient plasma glucose concentration was examined in 12 healthy and 6 non insulin-dependent diabetic subjects. The subjects participated in two sets of experiments which were performed in random order: (A) four hyperglycaemic clamp studies, during which the plasma glucose concentration was raised for 120 min by 1 (only in healthy subjects), 3, 7, and 17 mmol/l; and (B) the same four hyperglycaemic clamp studies preceded by ingestion of 5 mg glipizide. All subjects participated in a further study, in which glipizide was ingested and the plasma glucose concentration was maintained at the basal level. In control subjects in the absence of glipizide, the first-phase plasma insulin response (0 10 min) increased progressively with increasing plasma glucose concentration up to 10 mmol/l, above which it tended to plateau. Glipizide augmented the first phase insulin response without changing the slope of the regression line relating plasma insulin to glucose concentrations. The second-phase plasma insulin response (20-120 min) increased linearly with increasing hyperglycaemia (r = 0.997). Glipizide alone increased the plasma insulin response by 180 pmol/l. A similar increase in plasma insulin response following glipizide was observed at each hyperglycaemic step, indicating that glipizide did not affect the sensitivity of the beta-cell to glucose. First-phase insulin secretion was reduced in the type 2 (non-insulin-dependent) diabetic patients, and was not influenced by glipizide.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777654 TI - Coronary heart disease and diabetic retinopathy in newly diagnosed diabetes in Da Qing, China: the Da Qing IGT and Diabetes Study. AB - In 1986, 110,660 of 281,589 residents aged 25-74 years in Da Qing, Hei Long Jiang Province of China, were surveyed. Based on the results of a 75-g oral glucose tolerance test, 630 subjects were found to have previously undiagnosed diabetes according to 1985 WHO criteria. Among them, 600 diabetics aged 35-74 years (288 men, 312 women) and 410 non-diabetics of similar age with normal glucose tolerance (207 men, 203 women) were examined to determine the prevalence of retinopathy and coronary heart disease (CHD) and to evaluate associated characteristics. Retinal examinations of 423 newly diagnosed diabetics showed that 15.4% had several microaneurysms and/or small intraretinal haemorrhage, 5.5% soft exudates, 7.1% hard exudates, and 2.3% proliferative retinopathy. Among 220 non-diabetics, 13.6% had one or two microaneurysms and/or small intraretinal haemorrhage, and only 1.4% had a few soft exudates; half of the non-diabetics with retinopathy had hypertension. CHD, according to Minnesota coding (1.1-1.3, 5.1-5.3 and 7.1) of resting electrocardiograms, was ten times more frequent in the diabetics (3.59%) than in the controls (0.32%), after adjusting for age and sex. Multiple regression analysis showed that plasma glucose concentration was a risk factor for retinopathy after adjusting for age, sex, body mass index (BMI), smoking and blood pressure. Two-hour plasma glucose concentration (after adjusting for age, sex, BMI, smoking and blood pressure) and blood pressure (after adjusting for age, sex BMI, smoking and 1-h or 2-h plasma glucose level) were associated with CHD among the diabetics and non-diabetics and among the diabetics alone. Thus, both micro- and macrovascular complications occur frequently in previously undiagnosed Chinese diabetics and the frequency of CHD is markedly increased compared to the low frequency among Chinese non-diabetics. PMID- 1777656 TI - Ceramic restorations: cast metal and cast glass. AB - Pertinent articles published between October 1989 and September 1990 related to metal-ceramic and all-ceramic crowns are reviewed. The main topic groupings are: 1) color and esthetics with metal-ceramics; 2) bond strength of metal and ceramic materials; 3) all-ceramic alternatives; and 4) the porcelain surface. Research published during this period advanced knowledge of photospectrophotometry and thermomechanical compatibility of porcelain-metal systems. Deficiencies in fit and strength for some all-ceramic systems are described. Further evidence was published supporting the efficacy of polishing porcelain. Additional documentation regarding the etching of ceramic materials, including Dicor (Caulk Company Ltd., Milford, DE) was produced. More research into use of titanium and titanium alloys as substructures for ceramic materials is required. PMID- 1777655 TI - Glycerol metabolism in humans: validation of 2H- and 13C-labelled tracers. AB - For a tracer to be valid it must follow the metabolism of the tracee without distortion. Especially when the tracer contains several deuterium substitutions, the tracer can be altered or degraded differently from the metabolite it is to trace or be subject to distorting isotope effects. To determine whether 2H5 glycerol is a valid tracer for following glycerol kinetics, 2H5-glycerol and [2 13C]glycerol tracers were infused simultaneously in six healthy postabsorptive adult subjects. After 90 min of tracer infusion, epinephrine was also infused for 60 min to stimulate lipolysis and increase glycerol flux. Glycerol flux increased from 2.2 +/- 0.3 to 6.7 +/- 0.4 mumol/kg per minute (with the 13C tracer) and from 2.2 +/- 0.3 to 6.7 +/- 0.3 mumol/kg per minute (with the 2H tracer) when epinephrine was infused. There was no significant difference in glycerol flux measured with the 2H tracer compared to the 13C tracer either under basal or a stimulated flux condition. These results indicate that 2H5-glycerol is a valid tracer for measuring glycerol metabolism in humans. PMID- 1777657 TI - Oral implants. AB - Today, more and more evidence suggests that even small changes in hardware for oral implants may jeopardize its biocompatibility. Even the manner in which the hardware is sterilized can influence cellular adhesion. This review discusses the surface characteristics, configuration, and success rates of various oral implants, as well as the complications that can result following implantation. PMID- 1777658 TI - Electronic technology for clinical prosthodontics. AB - A review of the literature on electrodiagnostic devices indicates that current studies have not substantiated claims regarding the utility of these devices in clinical dentistry. Research design problems, such as inadequate control subjects and use of inappropriate statistical tests, limit the conclusions that can be drawn from the results of these studies. Further research, including measurements of sensitivity and specificity, is needed in order to indicate the diagnostic utility of jaw tracking or electromyography in clinical dentistry. PMID- 1777659 TI - CAD/CAM imaging in dentistry. AB - CAD/CAM (computer-assisted design/computer assisted manufacturing), although devised 20 years ago, has only been available for routine dental practice for 2 years. As a supplement to the conventional methods for making dental prostheses, CAD/CAM will have profound effects on the dental profession. CAD/CAM will improve versatility, accuracy, and cost effectiveness and will be a part of routine dental practice by the beginning of the 21st century. PMID- 1777660 TI - Maxillofacial prosthetics. AB - Investigations are continuing in methods to preserve the dentition and to improve the quality of tissues for the patient receiving radiation to the head and neck. Increased knowledge related to obstructive sleep apnea presents the prosthodontist with an opportunity to provide support during the treatment of these patients. Advances in implant prosthodontics have increased our capability to rehabilitate the patient with intraoral or facial defects. Advances have been made in the use of light-cured materials as well as in the utilization of microwave energy to fabricate prostheses. Unfortunately, the ideal material to be used as a soft liner or for maxillofacial restoration continues to elude the profession. PMID- 1777661 TI - Adhesion and tooth-colored restoratives. AB - Research aimed at developing durable adhesion between esthetic restorative materials and tooth surfaces has been progressing for over 35 years. Inherent deficiencies in many esthetic materials have directed research toward new adhesive agents and modifications in application techniques. Overcoming these deficiencies has been difficult and many questions remain despite encouraging developments. A new generation of resin dentin-bonding agents has surfaced and may further adhesive efforts with modern composite resins. The glass-ionomer cement continues to establish itself as a valuable adhesive direct restorative material. Recent advances in glass-ionomer technology have given rise to new lining materials that may also complement composite resin behavior. The use of dentin conditioners or pretreatments has been explored and may enhance the adhesion of esthetic restoratives as well. Finally, a better understanding of application techniques and of the tooth surface itself may offer new insights into developing more stable adhesion with esthetic restorative materials. PMID- 1777663 TI - Root caries. AB - Increasing interest in root caries has resulted in several reports during the year. Problems with diagnosis, epidemiology, structural histopathology, and treatments have clarified some problems concerning root caries. Only active lesions should be registered, but it is important to search for lesions in the periodontal pocket. In several countries, root caries have been found in 30% to 50% of elderly people. In structural investigations, remineralization may occur as irregular precipitation of crystals clearly distinguishable from those of normal sound dentin. Presence of plaque with gram-positive bacteria is closely associated with root caries. Treatment with varnish containing chlorhexidine and thymol may have a reducing effect. Little has been written about the operative treatment of root caries. PMID- 1777662 TI - Tooth-colored inlays. AB - There is an increasing need for conservative treatment with tooth-colored inlay restorations due to esthetic concerns and the decreasing acceptance of amalgam. The use of ceramic materials has become possible by using adhesive luting techniques, in which enamel and ceramic inlays are etched and luted with composite resins. The weakest point is still the poor tensile strength of brittle inlay materials, so most efforts are concentrated on strengthening porcelains by ion exchange, tempering, or improving the composition. Despite the fact that adhesively luted inlays show good marginal adaptation, the luting composite layer is worn out because of the low filler fraction of the resins. For composite inlays, the same resins are used as for direct placement. Despite more effective curing techniques, the wear behavior of composite inlays may have been improved, but it is still less than ideal. In clinically orientated studies, it is clearly demonstrated that the luting procedure is technically sensitive with all systems. The clinical experience is limited to only a few years, so to assess the longevity of adhesively luted inlays, more clinical studies must be done. However, tooth-colored inlays are the most esthetic, conservative restorations dentistry has ever offered its patients. PMID- 1777664 TI - Dental bleaching. AB - Bleaching techniques of both vital and nonvital teeth are reviewed. Current techniques and their origins are investigated, and the appropriate uses for various methods examined. The current research shows that bleaching, while highly effective, must be viewed with caution. The bleaching process cannot be viewed as entirely benign. The influx of bleaching agents prescribed for home administration use by dentists is particularly deficient in the amount of independent, refereed research on their long-term effects on oral tissues. PMID- 1777665 TI - Occlusal considerations in restorative dentistry. AB - This article reviews the recent literature related to occlusal considerations in restorative dentistry. The major topics include the assessment and treatment of occlusal wear, the controversies surrounding treatment position of the mandibular condyles, occlusal considerations in osseointegrated prostheses, the two-way relationship between occlusal factors and temporomandibular disorders, design criteria and longevity studies in resin-bonded, fixed-partial dentures, and a potpourri of articles on other topics of interest. Five textbooks and 32 journal articles are cited. PMID- 1777666 TI - The treatment of endodontically treated teeth. AB - Recently published studies on the treatment of endodontically treated teeth have confirmed and expanded on the restorative directions outlined in earlier work. The significance of endodontic treatment in reducing tooth strength has been questioned, and the potential influence of previous operative cavity designs highlighted. Other work has supported the contention that following the placement of a well-fitting crown, the strength of the post foundation, the core foundation, or both is relatively unimportant in determining the overall strength of endodontically treated teeth. In particular, it appears unnecessary to incorporate a ferrule effect as part of a post-and-core foundation. It seems that the height of the remaining tooth structure between the core and the crown margin is a much more significant factor in determining the fracture resistance of these teeth. Many articles have demonstrated the potential influence of material interactions at all stages of the restorative process. Further work in this area is likely to greatly complicate clinical decision making when restoring endodontically treated teeth. PMID- 1777667 TI - Current developments in esthetic dentistry. AB - Current developments in esthetic dentistry center around new techniques and materials that improve the clinician's ability to provide esthetic services. These developments include the availability of improved composites for anterior and posterior use, a new generation of dentin bonding agents, bonded ceramic restorations, and more efficient and predictable ways to whiten teeth. There is a better understanding of factors contributing to the esthetic value of restoration as well as their longevity. New bonding techniques to dentin enable practitioners to perform difficult restorative procedures in a conservative manner, producing results that are highly esthetic and physiologically tolerable. The use of dental porcelains has expanded from the traditional applications in crowns and bridges to veneers, inlays, onlays and all-porcelain bridges that are directly bonded to teeth. Computer-designed and fabricated inlays and onlays are now an available treatment modality, with a reported 3-years follow-up looking very promising. The increasing public demand for esthetic dental procedures has made the discipline a significant part of dental practice and boosted interests and understanding of procedures, such as tooth bleaching and peridontal surgery, for improved esthetics. PMID- 1777669 TI - Noble alloys in dentistry. AB - Noble metals used for dental castings continue to consist of alloys of gold, palladium, and silver (not a noble metal), with smaller amounts of iridium, ruthenium, and platinum. The majority are used as a backing for ceramic baking, with the rest used as inlays, onlays, and unveneered crowns. Base metal alloys, principally made of nickel, chromium, and beryllium have gained widespread usage, especially in the United States, due to their lower cost and higher mechanical properties. The current literature, for the most part, cites the use of noble alloys as controls for trials of alternative materials. Direct gold (gold foil) still retains a following and a number of new patents were founded. PMID- 1777668 TI - Dental amalgam alloys. AB - Dental amalgam, which constitutes nearly 75% of all restorative materials used in dental practice, has been used successfully for almost 150 years. Dental amalgam is low in cost, easy to use, consistent, and durable. Although amalgams have been challenged by more esthetic restorative materials and by fears of mercury toxicity, amalgams continue to be the materials of choice by most practitioners. This review discusses the advantages and disadvantages of amalgam alloys and predicts that one day, amalgam probably will be replaced by more esthetic materials that truly bond to all hard tooth surfaces. PMID- 1777670 TI - Nonprecious cast-metal alloys in dentistry. AB - This review of selected articles from October 1989 to October 1990 is divided into two sections: a review of clinical studies and a review of laboratory studies for nonprecious cast metals. The clinical articles are centered on biological compatibility issues, such as taste anomalies (dysgeusia) attributed to cast metals and allergy correlation to base metals, and on technique and longevity evaluations involving resin-bonded fixed partial dentures. Laboratory articles are mainly devoted to metal preparation before bonding of etched or resin-bonded fixed partial dentures and the estimated bond strengths of the metal castings. Other selected articles are based on studies of physical properties and physical testing of nonprecious alloys, such as modulus of rupture, to determine ceramic compatibility, castibility testing, marginal fit of fixed partial dentures, and flexure testing of of traditional and experimental designs for cast major connectors. Additionally, a low-cost method of titanium casting is reviewed. PMID- 1777671 TI - Dental cements. AB - A wide variety of dental cements continues to be used in clinical dentistry. No new system has been developed in the last few years, but the continued development of the glass ionomer and adhesive resin cements has extended clinical techniques and led to a decline in the use of the traditional phosphate and zinc oxide-eugenol materials. The more critical manipulation of the newer materials has led to problems related to marginal leakage and to pulpal sensitivity. Strong bonding to metallic surfaces can be achieved by appropriate surface treatments, but bonding to the tooth surface is less certain. More longer-term clinical research is required before new and improved cementing systems can be developed. PMID- 1777672 TI - Denture materials and acrylic base materials. AB - Modifications in denture plastics, including acrylics containing butadiene styrenes, block copolymers to increase toughness, and those with added soluble heavy-element salts to increase radiopacity are described. Developments in processing of denture bases by microwave, laser, and injection methods are described. Also reviewed are acrylics and their dimensional stability, including the effect of artificial salivas on properties. In addition, the rheological, glass transition, dynamic, impact, and fatigue properties of denture acrylics are presented. Adhesion of polymers to plastics and metals is reviewed, as well as the biocompatibility and adhesion of organisms to denture plastics. Soft denture materials are reviewed with respect to research on new materials and to clinical evaluations of existing products. Finally, studies on the wear of denture teeth are summarized. PMID- 1777673 TI - Structure and sequence analysis of the human activin beta A subunit gene. AB - The cloned genomic DNA containing the human activin beta A subunit gene were analyzed by restriction endonuclease mapping, Southern blotting and DNA sequencing. The activin gene is composed of two exons interrupted by the 9-kb intron. The TATA, CCAAT and CT-stretch sequences were found in the 5'-flanking region of the gene. An intronic sequence contained SV40 enhancer core element in the vicinity of the exon 1. In the 3'-flanking region, we identified eight consensus polyadenylation sequences, five ATTTA motifs, CA element consisting of (CA)14, AP-1 binding site and two SV40 enhancer core elements. A dot matrix analysis revealed the high degree of conservation between the human and rat sequences within the 3'-flanking region, suggesting a possible functional significance. PMID- 1777674 TI - Molecular cloning and sequencing of Australian black bream Acanthopagrus butcheri and barramundi Lates calcarifer fish growth hormone cDNA using polymerase chain reaction. AB - The complementary DNA (cDNA) encoding the preprotein growth hormone (pre-GH) from two Australian marine fish species, namely Acanthopagrus butcheri and Lates calcarifer, have been isolated, cloned and sequenced. The sequences were amplified from reverse transcribed total RNA of whole brains using Polymerase Chain Reaction (PCR) and oligonucleotide primers corresponding to the 5' and 3' regions of Pagrus major. Use of PCR offers a rapid method of isolating fish GH cDNA sequences for commercial and taxonomic applications. Sequence comparison indicates a high degree of conservation for GH cDNAs within the family Sparidae. PMID- 1777675 TI - Characterization of an unusual human histone H3.3 pseudogene. AB - The analysis of a genomic loci containing human histone H3.3 processed pseudogenes, has revealed two regions that are unusually rich in other retroposons. At one of the loci the H3.3 pseudogene is itself interrupted by 2 Alu repetitive sequences. The characterization of these two recently transposed Alus provides confirmation of the "multiple origin" hypothesis of these repetitive elements. The unusual occurrence of 3 different types of retroposons in a small region suggests that there may be particular chromosomal regions that are hot spots for retroposon insertion. PMID- 1777677 TI - Nucleotide sequence of a human heart cDNA encoding the mitochondrial phosphate carrier. AB - We have isolated and characterized a full length cDNA clone encoding the precursor of the human heart mitochondrial phosphate carrier protein. The entire clone is 1330 bp in length with 5'- and 3'-untranslated regions of 48 and 184 bp, respectively. The open reading frame encodes the mature protein consisting of 312 amino acids, preceded by a presequence of 49 amino acids. The amino acid sequence of the mature human phosphate carrier is 93.6, 94.2 and 33.6% identical to that of the phosphate carrier from beef, rat and yeast, respectively. Like other mitochondrial transport proteins, the human phosphate carrier has a tripartite structure. Each of the three repeats contains two hydrophobic regions which presumably span the membrane in the form of alpha-helices. PMID- 1777676 TI - The rat thymidine kinase gene 5' region: evolution of a promoter. AB - The nucleotide sequence of the rat thymidine kinase (tk) gene 5' region was determined and compared to the 5' sequences of the tk gene from mouse, human, hamster and chicken. This analysis revealed the highest degree of homology to be between the rat and the mouse sequences and correspondingly greater sequence variation relative to the other species. There has apparently been an especially high rate of change in regions that have been demonstrated to be protein binding regions in some of these promoters. This has led to changes in the potential transcription factors bound by some of these promoters. PMID- 1777678 TI - Long range and symmetry considerations in the DNA. AB - The common description of DNA is that of a polymer composed of overlapping dinucleotide base pairs. Conformational, thermodynamic and flexibility calculations of the DNA are frequently based on that description. As demonstrated by the good fit with experimental data, such as the free energy of opening the double stranded DNA and the correspondence between the DNA crystal and computed structures, this approach is to a large extent a faithful reproduction of the DNA. Here I show that longer range effects should be considered as well. Statistically strong longer-range sequence patterns are described. Such sequence preferences are clearly translated in the DNA into long range structural propagation. Long range effects have also been observed in some experimental studies, like gel mobility and patterns of DNA cleavage. Long range structural effects are the likely explanation of the effect of mutations at a distance from a protein binding site. They might also aid in understanding DNA looping. PMID- 1777679 TI - Colorimetric quantification of in vitro-amplified template DNA to be used for solid phase sequencing. AB - A protocol for colorimetric determination of DNA amplified by the polymerase chain reaction (PCR) and subsequently immobilized to a solid support is described. The protocol consists of three steps: (i) binding of PCR amplified lac operator-containing DNA to magnetic beads; (ii) binding of a Lac repressor-beta galactosidase fusion protein to the lac operator and (iii) colorimetric detection of the immobilized beta-galactosidase. In practice, steps (i) and (ii) are performed concurrently. The protocol is well suited both for manual and automated procedures and the immobilized template can, after melting, be used directly for solid phase sequencing. The assay is used to demonstrate that template concentration is important for the quality of sequence data obtained from an automated DNA sequencer. PMID- 1777680 TI - [Diagnostic significance of secretory IgA coated yeast cells in oral candidiasis]. AB - The significance of in vivo IgA coated yeast cells for the diagnosis of candidiasis of the oral mucosal membranes was evaluated by direct immunofluorescence in 42 patients with or without clinical symptoms, shown to be positive for yeast growth in the cultural test. Most of the patients with clinically suspected candidiasis of the mucosal membranes gave positive results by serologic assays in contrast to the majority of symptomless patients. The diagnostic approach proved to be essentially consistent with the clinical signs, persistance of infection, response to antifungal therapy and quantitative cultural data. PMID- 1777681 TI - [Endodontic treatment of a "peculiar" upper central incisor]. AB - The Author presents a clinical case of a maxillary central incisor where the periapical radiograph revealed a process of fusion, an internal resorption, the presence of a "dens invaginatus" and an important periapical radiolucency. In this tooth was located, treated and filled three different root canals. PMID- 1777682 TI - [In vitro and in vivo biocompatibility tests of some endodontic cements]. AB - The major goal of endodontic therapy has been achieved by condensing filling materials into the root canal. It is not uncommon to find excess material in the periapical tissue. It therefore becomes obligatory to use filling materials that have acceptable biocompatibility. The purpose of this investigation was to obtain a "toxicity profile" of some root canal materials and to compare our observations to study results found in literature. Gutta-percha and five endodontic filling cements were tested in vivo and in vitro. The in vivo biocompatibility involved the placement of the test material in 10 mm teflon tubes with an outer diameter of 1,3 mm which were then implanted subcutaneously into rats. The implants were left in situ for periods of 30 and 90 days. The hemolysis test was used for in vitro evaluations. The histological examination showed cellular responses of different intensity and extent. In some cases severe infiltration of inflammatory cells and areas with necrostis were observed. As a result, the root canal materials evaluated showed slight, moderate, and severe reactions, therefore, a different pattern in tissue response. PMID- 1777683 TI - [Radiographic interpretation of experimentally produced osseous lesions in the human mandible]. AB - Using rotary instruments drilled bony cavities which differed in diameter and depth into a human jaw. X-rays were taken and developed employing a very precise and accurate technique to obtain high definition radiograph. From a careful study of these x-rays it was found that localized lesions in cancellous bone alone are difficult to visualize on x-rays, whereas they are easily noticeable when the cortical bone is involved. PMID- 1777684 TI - [Root resorption. 2. Therapy]. PMID- 1777685 TI - [Morphological characteristics of spreaders]. AB - Different kinds of spreaders can be used in the lateral condensation technique. Selection of condensation instruments must not be empirical because the quality of the filling partly depends on the compatibility between the spreader and the prepared root canal. The shape of the instrument should allow for easy insertion to the proper length without any interference. On these bases the Authors evaluated and compared the morphology of some spreaders, and gave data and directions how to rationally use these instruments in clinical practice. PMID- 1777686 TI - The demographic and psychiatric characteristics of 110 personal injury litigants. AB - One hundred ten litigants who were suing for emotional damages were assessed by the author for medical-legal reasons. Most of the plaintiffs were involved in motor vehicle accidents and suffered from "whiplash" injuries. Semi-structured interviews were used to reach criteria based on DSM-III-R diagnoses. Requests for consultation, on average, came 25 months after the patient's accident. Approximately 70 percent of patients had evidence for continuing physical injuries to account for the physical and emotional symptoms. The most common DSM III-R diagnoses were psychiatric condition affecting physical illness (N = 56), major depression (N = 27), and somatoform disorder (N = 12). Alternative diagnoses relating the effect of the accident on the patient's life included: emotional reaction to physical condition (N = 29), difficulty coping with developmental tasks (N = 20), severe depression (N = 20), aggravation of normal premorbid personality (N = 18), aggravation of abnormal premorbid personality (N = 14), phobia (N = 7), no permanent effect (N = 12), and independent illness (N = 2). Severe emotional problems and disability are common among litigants. The causes of their suffering are more complex and less poorly understood than is assumed from the pejorative labels that are sometimes applied. Lawyers and the courts need the help of psychiatrists to understand this suffering. Empirical data such as these may lead to better classification systems and improve our understanding and treatment of these patients. PMID- 1777687 TI - Opinions by AAPL forensic psychiatrists on controversial ethical guidelines: a survey. AB - A survey was conducted of a sample of AAPL members to determine their opinions on the inclusion of controversial ethical guidelines for forensic psychiatry. Members appear to appreciate the need to consider traditional Hippocratic values as at least one consideration in their functioning as forensic psychiatrists. They appear to balance their duties to an evaluee with duties to society and the legal system and to appreciate the responsibilities of multiple agency. Support was shown for interpreting ambiguities in AAPL's current guidelines in the directions indicated by most of this survey's proposed guidelines. PMID- 1777689 TI - Just say no to the charges against you: alcohol intoxication, mental capacity, and criminal responsibility. PMID- 1777688 TI - Perry v. Louisiana: can a state treat an incompetent prisoner to ready him for execution? PMID- 1777690 TI - Women clinicians and patient assaults. AB - Although there has been an increased awareness of the problem of assaults against clinicians, this is the first report to specifically focus on issues related to women clinicians and patient assaults. The author discusses issues related to women's feelings of vulnerability and lack of authority. She describes special risks for women clinicians including sexual assaults, rape fantasies, and maternal transferences, which can lead to assaults, and vulnerability during pregnancy. In addition, the author discusses psychological reactions after assaults and makes recommendations for preventing assaults. PMID- 1777691 TI - Estimating mental health needs and service utilization among prison inmates. AB - A sample of 3,684 inmates in the New York State prison system was surveyed in May 1986 to determine the prevalence of psychiatric and functional disability and service utilization. It was estimated that 5 percent had a severe psychiatric disability, and 10 percent had significant psychiatric disability. The higher the level of disability, the greater the proportion of inmates that had received mental health services in the last 30 days and in the last year. Still, 45 percent of the severe disability group had no service contacts in the last year. Patterns of utilization differed significantly by sex (a greater proportion of women received services) and by race (a greater proportion of whites received services). The clinical factors associated with receipt of services varied considerably between men and women. PMID- 1777692 TI - Psychiatrists injured by patient attack. AB - The seven staff psychiatrists injured by patient attack in a large forensic hospital in five years were compared with the 47 who were not injured by attack. Thirteen percent of the psychiatrists were injured by patient attack (2.6 percent per year); 5.5 injuries per 100 person-years occurred. This rate is comparable to the rate of injury from patient attack noted among ward nursing staff during the same period. Younger psychiatrists, and psychiatrists more recently out of residency, were more likely to be injured. Male psychiatrists were injured at a rate approximately 50 percent higher than female psychiatrists, and graduates of university-affiliated residencies were three times as likely to be injured as graduates of public-sector residencies, though these differences did not reach statistical significance. A slightly higher rate of injury was noted among graduates from non-North American medical schools. Board-certification and length of service in the hospital were not related to being injured. PMID- 1777693 TI - [Application of quantitative autoradiography to the measurement of brain function activity in rats during post-natal development]. AB - Quantitative autoradiographic techniques for the measurement of local cerebral functional activity have been set up in the rat during postnatal development and applied to the measurement of local cerebral glucose and beta-hydroxybutyrate utilization as well as of local cerebral blood flow from 10 to 35 days after birth. These techniques have shown transient peaks of cerebral activity for both energy metabolism, expressed in terms of glucose plus beta-hydroxybutyrate utilization, and blood flow from 14 to 17 days of postnatal age. These methods which allow the mapping of functional activity simultaneously in all cerebral regions of conscious animals represent a tool of choice for the study of metabolism and blood flow regional changes, particularly in pathological situations. PMID- 1777694 TI - Three-dimensional specimen reconstruction by confocal microscopy and digital image processing. AB - In a confocal microscope point-wise illumination of the specimen is used, often in the form of a focused laser beam that is scanned in a raster pattern. The reflected or fluorescent light from the specimen is focused onto a small aperture in front of the detector. This imaging method has advantages such as improved resolution and less stray light. In addition optical sectioning is possible, whereby thick specimens can be studied layer by layer without the need for mechanical sectioning. By combining information from a large number of optical sections, registered at different depths, a three-dimensional reconstruction of the specimen can be made. Digital image processing can be used both for producing images for visual display and for extracting quantitative information. Quantitative evaluation is hampered in many cases by factors such as absorption, scattering, and refraction of the light travelling through the specimen volume. PMID- 1777695 TI - DNA ploidy status in the diagnosis and prognosis of cancer. AB - DNA ploidy status of tumour cells is becoming a part of patient's record, because it brings an objective assessment of diagnostic and prognostic significance. DNA ploidy status in diagnosis--DNA ploidy status of some tumour types can be used as an adjunct to cytologic or histologic examination and provide an additional diagnostic information. For example, small cell lung carcinoma cells may be difficult to differentiate from cells of other benign neuroendocrine tumours. By computing the DNA malignancy grade, as defined by Bocking A. et al., it was possible to distinguish levels of malignancy among neuroendocrine tumours. Thus we were able to demonstrate that typical carcinoids may be differentiated from small cell carcinomas and atypical carcinoids. DNA ploidy status in prognosis--A large number of studies strongly support a correlation between DNA ploidy patterns and clinical course of malignant tumours. However, the prognostic value of DNA ploidy status has to be evaluated in relation to conventional clinico pathologic characteristics, by multivariate analysis in order to demonstrate its independent contribution. For example, we demonstrated, in a prospective study of 211 colorectal adenocarcinomas, that ploidy status was an independent predictor of prognosis only in the early stages of the disease (Dukes' A, B, C), but not when advanced stages-(Dukes' D) were considered. In conclusion, DNA ploidy status may be used as an important objective parameter either in diagnosis or in prognosis, complementary to the traditional clinico-pathological characteristics. PMID- 1777696 TI - [Ultrastructural abnormalities of the human spermatozoa: a way to study the processes of sperm differentiation]. AB - Quantitative ultrastructural analysis of abnormal human spermatozoa allows to elucidate processes and cellular constituents involved in the spermatid differentiation. Data lead to investigations in immunocytochemistry. The factors involved mainly concern cytoskeletal elements as in the case of round-headed spermatozoa, macrocephalic spermatozoa and spermatozoa with flagellar architectural anomalies. PMID- 1777697 TI - Quantitative receptor autoradiography and image analysis. PMID- 1777698 TI - Functional anatomy of the circulus arteriosus cerebri (WillisII). AB - The requirements for understanding the role played by the circle of Willis in the cerebral circulation are two-fold: 1. The basic patterns of blood flow in the circle of Willis should be studied in relation to the interindividual variation of the circle itself and 2. The interindividual variation should be investigated in a quantitative way and possible hemodynamically induced relations should be clarified. With regard to the first question an extensive study on mathematical models of the cerebral circulation was performed, revealing that flow patterns can be understood by applying the principles of the Wheatstone bridge, known from electric circuit theory. With this knowledge the question of the variability was investigated. For this purpose 19 measurements of 100 circles of Willis were obtained from human cadavers. This data set was analysed using both bivariate and multivariate statistical techniques. The result of this analysis indicated that several sources of variation are involved. The first one is the size: some people have larger vessels than others, probably depending on age sex and genetic factors. Other sources of variation appeared to be of hemodynamic origin. The clear hemodynamic relation between vessel sizes in the circle of Willis indicate that they are adapted to the amount of flow, just like vessels elsewhere in the body. For instance, the size of the posterior communicating artery reflects the relative contribution of the anterior (carotid) and posterior (vertebral) vessels to the cerebral circulation. Furthermore, a relation could be established between the variations of the major cerebral vascular territories and the circle of Willis, both during development and in adults.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777699 TI - [Histomorphometry and photodensitometry of osteons with hypercalcified ring of human compact bone]. AB - Osteons with hypercalcified ring were measured by photodensitometry and histomorphometry in the tibial diaphysis of 20 male and female subjects died from 23 to 93 years, the age-related decrease of cortical bone volume corresponded to wide Haversian canals. However, the osteons with a hypercalcified ring had a narrow canal. Moreover, the radio pacity of the hypermineralized ring was 20 to 30% higher than the adjacent parts of the osteon and the central part was nearly never less mineralized than the peripheric one. So the hypercalcified ring did not appear to be an arrest line. It may be suggested that it constitutes a sign of cortical bone senescence. PMID- 1777700 TI - Ultrastructural detection of cellular and viral RNA with biotinylated DNA probes. AB - We describe a procedure for detecting and localizing cellular rRNA and HIV virus RNA, based on in situ hybridization at the ultrastructural level. After contact with ultrathin sections of cells embedded in Lowicry K4M, biotinylated DNA probes yield specific hybrids identified by a colloidal gold immunocytochemistry marker. The cellular transcripts are preferentially located in the ribosome structures of the cytoplasme and in the dense fibrillar component of the nucleolus. With the HIV probe, viral RNA molecules, were observed over infected cell and some extracellular viral particles. In the cytoplasm the hybridization signal is detected frequently at the periphery close to the plasma membrane, whereas the gold signal associated with virions is localized mainly over the center (core) of the particle. PMID- 1777701 TI - Retrieval of data from human computerized chromosome data bases. PMID- 1777702 TI - Construction of band-specific DNA-libraries by microdissection of GTG-banded human chromosomes and universal enzymatic DNA amplification. PMID- 1777703 TI - [Chromosome abnormalities and pathology of reproduction]. PMID- 1777704 TI - Biographical data on the anatomist: Jean Leo Testut (1849-1925). PMID- 1777705 TI - Transplacental effect of environmental pollutants on interstitial composition and diffusion capacity for exchange of gases of pulmonary parenchyma in neonatal rat. PMID- 1777706 TI - [The average and facial esthetics. Contribution of the factorial analysis of correspondences]. AB - A reciprocal averaging is made upon curves of cutaneous facial profile divided in 6 zones and analyzed by 2 index for each zone. Sex of subjects is considered. The main results is first opposition between ridge nose and other regions, then between lips and surrounding zones. Male distribution is more spread than female one. The females are to be distinguished by plainly and upper situated nose concavity. Sexual differentiation is not observed after first axis, and individual typology exist alone in following axis. PMID- 1777707 TI - Spinal cord mensuration--a comparative study on the spinal cord segments and spinal nerves in Zambian goats. AB - It has been known that the relative length of spinal cord and its segmental volume in domestic animals has established that the dynamics of spinal cord is directly related with the functions of the limbs and in particular to their feeding habits. Bilateral rostrocaudal measurements of spinal nerves involving their root attachment length, root emergence length, interroot length, segment length and cross sectional area were recorded on the dorsal and ventral surfaces of each segment of the spinal cords of five local healthy Zambian goats. We identified that the brachial and lumbar enlargements have involved identical number of spinal cord segments. Brachial and lumbar enlargements extended from C6 to T1 and L4 to L7. The average length of spinal cord was 59.9 cm and it extended up to caudal end of 5th sacral vertebrae. The root emergence length appeared to decrease gradually from C2 segment, which remained less variable in thoracic and lumbar segments and then receded sharply through sacral segments. The dorsal nerves entered spinal cord over a greater area than ventral because of more spinal rootlets. The greatest segment length lied in mid cervical region and then from lumbar segment it decreased sharply up to the end of sacral segments. It is concluded that these goats have a feeding habit similar to that of cattle rather than resting their forelimbs on the shrubs while nibbling the leaves as recorded in Asian goats. It also confirmed that the shrubs were more drooping along with grasses in the Gwembe Valley of Zambia. PMID- 1777708 TI - [Contribution of electron microscopy and in situ hybridization in the study of lymph node and spleen lesions in HIV infections]. PMID- 1777710 TI - [Functional aspects of lymphatic drainage of the human ovary in vivo explored with isotopic lymphography]. AB - Pelvic lymphoscintigraphy with 99 m Tc colloid injected directly in mesovarium during coelioscopy is able to schon that: drainage of ovaries' lymph is taken up by pelvic, paraortic or both lymph nodes, during genital activity ovarian lymph often diffuse in the other side of the pelvis with a true regional circulation. PMID- 1777709 TI - 3D microanatomy of human parotid gland. AB - We have performed a scanning electron microscope study on human parotid gland. By using a variety of techniques of maceration and digestion we have shown the 3D morphology of cells and of isolated endpieces. PMID- 1777711 TI - [Radiographic study of the lumbar spine bearing weight in weight lifters]. AB - Radiographies of lumbar spine at rest in standing position and upon a force of 100kg were undertaken in 19 young sportsmen. If comparison between two pictures demonstrated important modification in few subjects, statistical study shown only little variations. Clinical studies in weight lifters demonstrated effectively few lesions with a good training, it's possible to modifiate pelvic orientation and this pelvic support permits a optimal posture for the lumbar spine. PMID- 1777712 TI - Renal ultrastructure in acute renal failure. PMID- 1777713 TI - [Importance of electron microscopy in dermatology]. PMID- 1777714 TI - Location of rRNA gene transcription sites within Ehrlich tumor cell nucleoli. AB - The nucleolus is the morphological visualization of ribosome biogenesis. The spatial distribution of nucleolar DNA has been investigated in Ehrlich tumor cells by various immunogold labelling techniques. The DNase 1-sensitive regions within the nucleolus have been identified by in situ nick-translation at the ultrastructural level. The precise nucleolar location of rDNA and rRNA has been further specified by in situ hybridization and electron microscopy. Our results indicate that the fibrillar centers are the sole nucleolar structures where DNase 1-hypersensitive sequences, rDNA and rRNA are located together. These findings strongly suggest that rRNA gene transcription takes place within the confines of the fibrillar center, probably close to the boundary regions to the surrounding dense fibrillar component. PMID- 1777715 TI - Postnatal development of the prostate. AB - Postnatal development of the human prostate proceeds in the phases: (i) a regression period after birth, (ii) a quiescent period up to 12-14 years, and (iii) a maturation period between 14 and 18 years. During postnatal development no lobe formation is observed, but rather a differentiation gradient within the epithelial ducts. Morphogenesis and differentiation of the epithelial cords starts in an intermediate portion of the epithelial anlage and proceeds to the urethral and subcapsular portions. The latter is reached by about 17-18 years. Epithelial anlagen initially consist of a multilayered squamous or cuboidal epithelium which is transformed into a pseudostratified epithelium consisting of secretory, basal, neuroendocrine and mucous cells. The latter are lost during maturation. Secretion starts in adluminal cells (on day 12 in rat) which represent the major compartment of dividing cells. Onset for the expression of different secretory proteins (acid phosphatase, prostate specific antigen, beta microseminoprotein) is identical in the individual secretory cell of the human prostate. Immature glandular outpocketings display a positive immunoreaction for basic fibroblast growth factor (bFGF) in the epithelium. Since no sign of leakage into the stroma is visible, the action of bFGF during epithelial/stromal interaction remains to be established. PMID- 1777716 TI - [Prostatitis]. PMID- 1777717 TI - [Prostatic organogenesis and its morphometric characteristics]. AB - The prostatic organogenesis had been often studied, since 90 years, with the aim of finding an embryologic cause for the adult pathology. But the prostatic anatomy and morphogenesis had been recently reviewed. The author, with personnal results and an analysis of the literature, shows here the prostatic development. It is in agreement, morphometrically, with the general development of the fetus, and the importance of hormonal factors, androgenic as oestrogenic ones, is specified. PMID- 1777718 TI - [Abnormalities of prostatic morphogenesis]. AB - The author shows here some malformations of the prostatic development, with personal cases and a revue of the literature. Often, these malformations happen with many other regional abnormalities, as Prune-Belly syndrome or Vacterl sequence, or deficiencies of the androgenic receptors. PMID- 1777719 TI - [Adenocarcinoma of the prostate: histology and histoprognosis]. PMID- 1777720 TI - [Contribution of electron microscopy to the study of anthracycline cardiotoxicity]. PMID- 1777721 TI - A correlative TEM-SEM study of the human urethral glands. AB - The authors have carried out in TEM and SEM a correlative study on human urethral glands. In addition they have studied, at TEM level, the immunohistochemical localization of blood group substances. PMID- 1777722 TI - [Prostatic sarcoma: point of view of the pathologist]. AB - The authors describe here briefly the different prostatic sarcomas and insist on the very peculiar entity called inflammatory pseudo- sarcoma or spindle cell post operative nodule. PMID- 1777723 TI - [Gaba innervation of serotonergic neurones innervating the thoracic marrow of the rat. Immunocytochemical and autoradiographic combination after retrograde axonal transport with tritiated serotonin ]. AB - Anatomical relationship between GABA terminals and serotonergic neurons that innervate the thoracic spinal cord was studied using combined methods: autoradiography following (3H) 5-HT retrograde transport and immunocytochemistry for GABA. Following (3H) 5-HT injections into the thoracic spinal cord, serotonergic neurons of raphe pallidus and magnus were specifically radiolabelled. At optic and electron microscopic levels, radiolabelled cells of raphe magnus and pallidus were in contact with GABA immunoreactive pre-synaptic nerve terminals. Some radiolabelled cell bodies were contacted by both GABA immunoreactive and immunonegative terminals. These results indicate the existence of a direct GABAergic input onto the medullary serotonergic neurons projecting to the thoracic spinal cord and suggest both GABAergic and non-GABAergic regulation of these serotonergic neurons. Thus, combination of both a specific tracing technique and immunocytochemistry offers considerable advantages of specificity and sensibility for the study of interrelationship between chemically defined neuronal pathways and/or of transmitter co-existence. PMID- 1777724 TI - In vivo imaging of functional neuroanatomy: positron emission tomography. PMID- 1777725 TI - [Brain lesions in Alzheimer's disease: contribution of ultrastructural observations]. PMID- 1777726 TI - [Brain imaging: neuropathologic applications to Alzheimer's disease: role of tomodensitometry and endocrine evaluation]. PMID- 1777727 TI - Hypothalamic noradrenergic pathways exert an influence on neuroendocrine and clinical status in experimental autoimmune encephalomyelitis. AB - The immunomodulatory action of corticosteroids and the ability of central noradrenergic systems to activate the hypothalamic-pituitary-adrenal (HPA) axis led us to investigate the relationship between neuroendocrine status and the clinical course of encephalomyelitis (EAE) following adrenalectomy and depletion of noradrenaline (NA) centrally or peripherally. A significant inverse correlation was found between hypothalamic NA and serum corticosterone (CS) at peak clinical signs of EAE in all the sham groups or when NA was depleted only in the peripheral nervous system. A positive correlation was found between serum CS and disease severity, and in all experimental groups with intact peripheral and/or central noradrenergic pathways a uniformly increased splenic NA content was also observed at peak disease. Administration of 6-OHDA i.p. to neonatal or adult Lewis rats produced a significant depletion of splenic NA alone which resulted in increased disease severity, despite the fact that circulating CS was elevated. Thus the rise in the NA content of lymphoid tissue at peak clinical signs contributes to recovery. A single i.c.v. injection of 6-OHDA into the hypothalamic region resulted in an 80% reduction in NA content, which subsequently modified the clinical severity of EAE. Serum CS levels rose preclinically in the treated group and remained high despite milder clinical disease than that seen in the sham group. The overriding immunoregulatory influence of glucocorticoids is demonstrated by the rapid onset of clinical EAE and morbidity in adrenalectomized animals. However, the strong inverse correlation found between hypothalamic NA and circulating CS indicates that regulation of the HPA axis may ultimately be controlled by central sympathetic pathways. PMID- 1777728 TI - Cytokine production and lymphocyte transformation during stress. AB - The production of interleukin-1 beta (IL-1 beta) and interferon-gamma (IFN gamma) and blast transformation in peripheral blood mononuclear cells were assessed in medical students writing an academic examination. Blood samples were obtained on three occasions: (1) 1 month prior to the examination during a period of relatively low academic demand; (2) immediately after the examination; and (3) 10 days later. Results indicated that immune responses were significantly different immediately after the examination compared with the baseline and postexam measures. Lymphocyte responsiveness to both concanavalin A and pokeweed mitogen was decreased, as was the production of IFN gamma, supporting earlier reports of immunosuppression after relatively commonplace stressors. In contrast to predictions, IL-1 beta production was significantly elevated after the examination. Cortisol levels were also measured, but did not change across the three sample points. Our finding of an increase in IL-1 beta production suggests that stress may have different effects on different cell populations by enhancing the responses of monocytes and depressing those of lymphocytes. PMID- 1777729 TI - Behavioral conditioning prolongs heart allograft survival in rats. AB - Conditioned immunosuppression using a taste aversion paradigm has been demonstrated in a number of laboratory models but few reports have demonstrated changes in immunity sufficient to be of clinical relevance. The experiments reported here demonstrate that the survival of heart allografts in rats can be prolonged by behaviorally conditioned immunosuppression using cyclosporin A (CsA) as an unconditioned stimulus in taste aversion conditioning. Conditioned animals received saccharin as the conditioned stimulus paired with an injection of CsA at 10 and 6 days prior to transplantation. They were reexposed to saccharin alone 1 day prior to and 3 days after transplantation. On these occasions the conditioned group displayed taste aversion behavior when offered saccharin and a significant prolongation of heart graft survival was observed compared to the conditioned and nonconditioned control groups. These experiments suggest that behaviorally conditioned immunosuppression may have important clinical implications as an adjunct to drug treatments in transplantation medicine. PMID- 1777730 TI - Alterations in specific antibody production due to rank and social instability. AB - Separate studies examined the influence of the social environment of male cynomolgus macaques on primary and secondary antibody responses to immunization with tetanus toxoid. All animals showed evidence of both primary and secondary anti-tetanus antibody response. In the first study, subordinate animals had a greater primary antibody response to tetanus toxoid, while a single social reorganization (acute stressor) did not influence the response. In the second study, social rank was not associated with the secondary antibody response but repeated social reorganizations (chronic stressor) resulted in a greater level of specific antibody production in comparison to nonreorganized controls. These effects could not be accounted for on the basis of nonspecific differences in total serum IgG or serum albumin. PMID- 1777731 TI - The effect of restraint stress on the kinetics, magnitude, and isotype of the humoral immune response to influenza virus infection. AB - The stress of physical restraint has been shown to modulate the cellular immune response during a viral infection. We have studied the effects of stress on the humoral immune response during infection by influenza virus. Restraint stress altered the kinetics of the antibody response; seroconversion in the IgG and IgA isotypes was delayed in virus-infected C57BL/6 mice subjected to repeated cycles of physical restraint. However, the magnitude and isotype of the mature antibody response were unaffected during the plateau phase; no significant differences were observed between restrained/infected and nonrestrained/infected mice. Thus, the time during infection at which the antibody response was measured was a significant variable in the study of stress-induced alterations of the host's response to a replicating viral antigen. While restraint stress did not significantly affect the magnitude or class of the humoral response, it did alter the kinetics of response. PMID- 1777732 TI - Mast cells in female mouse lymph nodes. AB - This study was designed to examine the possible role of sex steroid hormones on mast cells localized in uterus draining lymph nodes (UDLN) in mice. Young virgin estrous animals had more mast cells than diestrous animals in both the UDLN and popliteal lymph nodes (PLN). In retired breeders there were no differences in mast cell numbers of estrous and diestrous animals. There were no differences in mast cell numbers among weanling and older animals in diestrous in the UDLN but, in the PLN, mature animals in either diestrous or estrous had more mast cells than the PLN of weanlings. In mature animals, ovariectomy did not alter mast cell number in either node. However, ovariectomy of weanlings increased mast cell numbers in the PLN but not in the UDLN. These results suggest that the UDLN behaves as a nonclassical target organ for the endocrine system, with mast cell number variations related to gonadal steroid levels. PMID- 1777733 TI - Europe's chance to ban tobacco advertising. PMID- 1777734 TI - Six horsemen ride out: WHO initiates a new programme on substance abuse. PMID- 1777735 TI - Social and cultural preconditions of Alcoholics Anonymous (AA) and factors associated with the strength of AA. AB - In 1986, AA activities (a minimum of five groups) typically occurred in non socialist, non-Islamic countries with a GNP per capita above US$ 1000. From 1965 to 1986, the share of English speaking and Scandinavian countries of all AA groups diminished, and the share of Central and Southern European, and particularly of Latin America, increased. Correlation analysis of countries fulfilling the typical preconditions of AA indicates changes in the relationships of AA to social background factors. In 1965, AA was strongest in the wealthiest countries, but no such correlation was observed in 1986. The rate of growth of AA has been higher in Roman Catholic countries. Wine consumption is negatively and beer consumption positively correlated to the strength of AA. Cross-sectional strength of AA is not related to spirits consumption, but its rate of growth has been higher in countries where spirits are consumed. The first wave of diffusion brought AA to the Anglo-Saxon and Protestant world. The second wave covered American and European Catholic countries, and bridgeheads have been established in newly industrialized nations. Still, AA remains a phenomenon of developed and wealthy societies. PMID- 1777736 TI - Effectiveness of three types of spouse-involved behavioral alcoholism treatment. AB - Treatment was provided to 45 alcoholics and their spouses in one of three out patient behavioral treatment conditions: (1) minimal spouse involvement (MSI) (n = 14), (2) alcohol-focused spouse involvement (AFSI) (n = 12), or (3) alcohol focused spouse involvement plus behavioral marital therapy (ABMT) (n = 19). Subjects were followed for 18 months after treatment. Subjects in all conditions reported significant decreases in frequency of drinking and frequency of heavy drinking, and reported increased life satisfaction. This information was corroborated by independent reports of the spouses. Patterns of outcome varied across the three treatment conditions, with ABMT subjects showing gradual improvement in proportions of abstinent days and abstinent plus light drinking days over the last 9 months of follow-up. Subjects in the other two treatment conditions showed gradual deterioration in proportion of abstinent days and abstinent plus light drinking days. Subjects assigned to the ABMT condition were less likely to experience marital separations, and reported greater improvement in marital satisfaction and subjective well-being than the other experimental groups. Clinical and theoretical significance of these findings are discussed. PMID- 1777737 TI - Young people's alcohol consumption in public drinking places: reasoned behaviour or related to the situation? AB - Two contrasting perspectives are used to study correlates of young people's (16 25 years) alcohol consumption in public drinking places. One perspective is the theory of reasoned behaviour, or the Fishbein-Ajzen model, extended with self efficacy. The other perspective assumes that exposure to drinking situations and aspects of the actual drinking situation (size of drinking group and group pressure) determine young people's alcohol consumption. Multiple regression analysis shows that variables indicating situational influences are correlated with the alcohol consumption of young men and women, even when controlling for the Fishbein-Ajzen variables. Among young men frequency of visiting public drinking places contributes more to the explained variance than the four Fishbein Ajzen variables together. Young people's alcohol consumption in public drinking places appears to be less fully controlled by alcohol-specific beliefs, norms and perceived skills than the Fishbein-Ajzen model assumes. The Fishbein-Ajzen variables are only weakly correlated with the variables indicating situational influences. It is concluded that, from the individual's perspective, the influence of situational factors means that part of his consumption is determined by more or less accidental circumstances like the opportunities to drink, the size of the drinking group and group pressure. PMID- 1777738 TI - Individual and family characteristics of middle class adolescents hospitalized for alcohol and other drug abuse. AB - The frequency of alcohol and drug use, abuse and severity of dependence, and personality and family characteristics in 280 female and male hospitalized adolescents in treatment for chemical dependence and 120 middle class adolescents were examined. A MANOVA showed that parents' drug and alcohol use was a main effect, increasing frequency of use and severity of dependence upon alcohol and drugs in both groups of adolescents. Sexual and physical abuse studied in the patient group also functioned as a main effect. Patients reported significantly less family interests, and participation in intellectual, cultural and social activities, but more control than the comparison group. It was concluded that adolescent alcohol and other drug abuse is part of a biopsychosocial syndrome of problem behavior, which includes the problem behavior of parents and the interacting family unit. PMID- 1777739 TI - Changes in the use of drugs among Norwegian youth year by year from 1968 to 1989. AB - The Norwegian National Institute for Alcohol and Drug Research has each spring, since 1968, conducted a survey of the youth of Oslo, the capital of Norway, to determine their use of drugs and their attitudes towards them. These and other surveys, as well as data from the police, provide a basis for a description of certain main traits in the development of drug use in Norway. The surveys suggest -amongst other things--that there has been no increase in the use of drugs among young people in Norway since the beginning of the 1980s. Cannabis is by far the illicit drug most commonly used, and use of drugs like amphetamines, cocaine and heroin seems to be rather limited. The surveys also suggest that alcohol consumption and tobacco smoking declined somewhat among Norwegian youth towards the end of 1980s. PMID- 1777740 TI - Epidemiological surveillance of opioid-related episodes in an emergency room of Barcelona, Spain (1979-1989) AB - In the early 80's opioid addiction was a low prevalence problem in Spain, grew enormously during that decade and became the most important risk factor for AIDS in recent years. The limitations of assessing the prevalence of illegal drug use by means of standard epidemiological methods lead, worldwide, to the use of indirect indicators. A Register of Toxicological Emergencies, developed for research purposes and containing data from 1979 to 1989 at the Hospital del Mar (Barcelona) is described. Results for opioid-related emergencies are presented, showing an epidemic increase in the number of such emergencies after 1981. The total number of opioid-related emergencies was 18,042 with a mean of 2.23 opioid related emergency admissions per client throughout the whole period, implying that some 8000 persons were seen. In episodes from non-arrestees, mean age increased slightly over time, the male/female ratio being 2.5; withdrawal was the more frequent reason for attendance (53%), overdose accounting for 9% of admissions, and other medical conditions for 33%. Non-arrested women were more likely to attend for other medical conditions and overdoses than men. The importance of this kind of register as well as its limitations for assessing the trend of opioid use prevalence is discussed. PMID- 1777741 TI - The development and initial validation of a questionnaire on smoking urges. AB - A 32-item questionnaire on smoking urges was administered to 230 daily cigarette smokers assigned to one of three levels of cigarette deprivation (0, 1 or 6 hours). Factor analyses showed that a two-factor solution best described the item structure for each of the three deprivation levels and for the entire sample. Factor scales of 15 and 11 items derived from rotation to simple structure were highly reliable, 0.95 and 0.93, respectively, and moderately correlated (r = 0.71). Average scores on both scales increased significantly with level of deprivation, and the Factor 1 scale was significantly higher than the Factor 2 scale at all levels. Factor 1 scale items reflected primarily intention and desire to smoke, and anticipation of pleasure from smoking. Factor 2 scale items were comprised primarily of anticipation of relief from negative affect and nicotine withdrawal, and urgent and overwhelming desire to smoke. PMID- 1777742 TI - Estimating hidden populations: a new method of calculating the prevalence of drug injecting and non-injecting female street prostitution. AB - This paper outlines a new method we have developed for estimating the prevalence of streetworking prostitution and the proportions of female street-working prostitutes who are injecting drug users. This method is based on the capture/recapture approach and involves distinguishing new fieldwork contacts from repeat field work contacts. The size of the overall population can be modelled from records of the increasing ratio of repeat to new fieldwork contacts. The method may have a relevance beyond a concern with prostitution and drug injecting, and may be of value in estimating other hidden populations. PMID- 1777743 TI - A comparison of relapsed and non-relapsed abstinent pathological gamblers following behavioural treatment. AB - Eighteen pathological gamblers reporting abstinence at a 2-9-year follow-up period were classified into two samples; those reporting complete abstinence, or those abstinent with intermittent relapse episodes. Results indicated that both samples improved significantly on post-treatment psychological and demographic measures, and did not differ from each other. It was concluded that a subgroup of gamblers may experience intermittent brief relapses that are not invariably associated with a continued return to addictive gambling habits. Complete abstinence as a criterion for successful treatment outcome may be too stringent in that it fails to acknowledge the possibility of continued abstinence following brief episodes of relapse. PMID- 1777744 TI - The use of a breathalyser as a treatment strategy in long-term alcohol abuse. PMID- 1777745 TI - Arenaviral haemorrhagic fevers. AB - Three arenaviruses--Lassa, Junin and Machupo--cause severe haemorrhagic disease in humans: Lassa fever, Argentine haemorrhagic fever and Bolivian haemorrhagic fever, respectively. These conditions are a source of considerable economic hardship in endemic areas and remain a worldwide concern for public-health officials. They are characterised by an insidious onset of influenza-like symptoms followed, in severe cases, by a generalised bleeding diathesis, encephalopathy and death. Central to studies of their pathogenesis is evidence for cellular dysfunction disproportionate to overt histopathology. Recent studies of patients with Lassa fever indicate that platelet and possibly endothelial-cell dysfunction play an important role in the bleeding tendency. The platelet defect appears to be mediated by an inhibitory factor in plasma; the nature of this is uncertain but it seems to be neither viral protein nor virus antibody. A similar inhibitor has since been demonstrated in patients with Argentine haemorrhagic fever. Plasma from patients with Lassa fever also profoundly modulates the amount of superoxide generated by normal neutrophils in response to the chemotactic peptide f-met-leu-phe, suggesting the inhibitor(s) has global effects on cellular function. These findings may have important implications for future therapeutic strategies. PMID- 1777746 TI - Therapy associated leukaemia. AB - A dose related risk of acute leukaemia, myelodysplasia and other cancers is seen in patients treated with certain drugs, particularly alkylating agents, and radiotherapy either alone or in combination. Treatment associated acute myeloid leukaemia (tAML) and myelodysplasia have biological and clinical features in common and are distinct from the corresponding de-novo disorders. tAML generally occurs between 2-11 years from administration of chemo/radiotherapy with few cases thereafter. Patients may present with myelodysplasia and severe cytopenia with abnormalities in all cell lines or as an acute leukaemia which may be difficult to classify because of multi-lineage involvement. Clonal cytogenetic abnormalities usually including either loss or interstitial deletion of the long arm of chromosomes 5 or 7 are frequently identified. Critical regions deleted in all patients with these lesions have been localised at 5q23-32 and 7q22-31; regions carrying the genes for several haemopoietic growth factors, receptors and oncogenes. The prognosis of patients with tAML is poor with low remission rates and a median survival of 6 months. Complex karyotypes or lesions of chromosomes 5 or 7 seen in the majority of cases are associated with a particularly poor outlook. The risks of this most serious complication of therapy should be weighed carefully against possible benefits. PMID- 1777747 TI - Platelet procoagulant activity: physiological significance and mechanisms of exposure. AB - This review describes an important function of blood platelets in the hemostatic process: the formation of a procoagulant surface. Two essential steps of the coagulation cascade, the formation of factor Xa and the formation of thrombin, require a catalytic surface on which the enzyme complexes can be assembled. This catalytic surface is provided by the phospholipids of the platelet plasma membrane. However, in the quiescent platelet, the negatively charged phospholipids which are essential to the catalytic properties of the surface, are located in the cytoplasmic leaflet of the membrane. Dependent on the activator, the normal asymmetric distribution of phospholipids is lost, resulting in the formation of a procoagulant surface. Although platelets are primarily predestined to exhibit this function, certain pathological conditions can lead to exposure of a procoagulant surface in other cells as well. Current views to explain the mechanisms of exposure of a procoagulant surface include the role of the cytoskeleton, the formation of microvesicles from the plasma membrane as well as the contribution of a membrane protein, which actively transports specific phospholipids from the outer-to inner leaflet of the membrane bilayer. PMID- 1777748 TI - Clinical indications for desmopressin (DDAVP) in congenital and acquired von Willebrand disease. AB - In the majority of patients with congenital and acquired von Willebrand disease (vWD), desmopressin (DDAVP) is able to increase circulating factor VIII coagulant (VIII: C) to levels sufficient to secure satisfactory hemostasis. The bleeding time (BT) is also often normalized. In this review, all cases of vWD treated with DDAVP for the prevention or control of hemorrhage and reported in the literature for whom at least basal and peak values of VIII:C were available have been analysed. When reported, the effect on the BT was also considered. It appears that, in keeping with clinical experience gained with blood products, the correction of VIII:C defect is often sufficient to secure normal hemostasis. The only significant exception is mucosal bleeding, for which the correction of BT also appears to be necessary. Several patients (mainly with type I vWD) with basal VIII:C levels of 5-10% have been successfully treated to prevent bleeding after tooth extractions and minor surgery and to control spontaneous and post traumatic bleeding. Experience with DDAVP in major surgery is still limited, so that the compound cannot be recommended for routine use. In acquired vWD, a trial with DDAVP is advised before resorting to substitutive therapy with blood derivatives. Since side effects to DDAVP treatment are limited and no major complications have been consistently demonstrated, DDAVP can be proposed as the treatment of first choice for most patients with vWD. The recent availability of concentrated preparations of DDAVP for intranasal administration and the demonstration that the subcutaneous route is an effective and simpler alternative to the intravenous route should further facilitate its use and make home-therapy feasible. PMID- 1777749 TI - Lupus anticoagulant. AB - Acquired antibodies to phospholipids form a heterogeneous group, which may be detected in vitro by the inhibition of phospholipid dependent tests of coagulation (lupus anticoagulant) and also by immunological assays, such that a combined approach is required for their reliable detection. While initially described in sufferers from systemic lupus erythematosus, these antibodies are increasingly recognised in a broad spectrum of disease, most importantly in relation to thromboembolism and recurrent fetal loss; occasionally they may also be found in otherwise healthy individuals. The mechanisms underlying the prethrombotic state associated with these antibodies have not been defined, although interference with the natural anticoagulant systems seems possible. Identification of antiphospholipid in subjects with spontaneous thromboembolism may influence therapeutic decisions, while their presence in women with recurrent fetal loss has lead to attempts to alter the outcome of further pregnancies with anticoagulant and immunosuppressive regimens, however the optimum management has not yet been determined. The recognition of these antibodies and their clinical associations is therefore highly relevant to clinical and laboratory haematology. PMID- 1777750 TI - Modifying perioperative blood loss. AB - Fears about the risks of disease transmission through the transfusion of homologous blood, as well as problems with blood supply and cost have increased the interest in reducing perioperative bleeding. This article discusses the causes of non-surgical perioperative bleeding and attempts to reduce perioperative bleeding with pharmacological agents. There is particular emphasis on the effects of cardiopulmonary bypass on haemostasis as the majority of studies have been conducted in this area. The agents discussed include the use of fibrin sealants, antiplatelet agents such as dipyridamole and prostacyclin analogues, antifibrinolytics and the effects of desmopressin and aprotinin. Currently high dose aprotinin would appear to be the most efficacious method of reducing perioperative bleeding in cardiac surgery, although a full risk benefit analysis is not yet possible. The effectiveness of aprotinin and tranexamic acid in reducing the 'oozing' seen in any surgical patient suggests the contribution of fibrinolysis in causing perioperative bleeding has not been fully evaluated. More research is required in this actively growing area. PMID- 1777751 TI - Cell cycle regulation. AB - Over the past few years there has been a resurgance of interest in the cell cycle. The excitement has mainly been due to the fact that researchers all over the world who had been working on seemingly different processes in yeast, fruit flies, frogs and man have found that many of the processes and individual proteins have been highly conserved. In essence, what regulates the cell cycle in yeast also works in man. This review is biased towards cell cycle regulation in mammalian cells but we have also covered what is known about similar mechanisms in other organisms to provide a broader perspective to the field. We outline what is currently known about the cell cycle and the key points at which cell proliferation is controlled. We summarise recent work on cell cycle control genes and antioncogenes and the post-transcriptional regulation of the proteins for which they code. Finally we cover the relationship between the cell cycle and differentiation. PMID- 1777752 TI - From Freud to cognitive science: a contemporary account of the unconscious. AB - We present an account of two influential approaches to the unconscious; those of Freud and of cognitive science. It is argued that although Freud's ideas require updating in some respects, in other ways many of them have stood the test of time. We describe the similarities and differences between the two approaches and the attention each pays to innate cognitive and emotional competencies. Finally, we provide a contemporary cognitive account of the unconscious that attempts to combine the best both approaches within an information-processing framework. PMID- 1777753 TI - Reliability and validity of a psychotic traits questionnaire (STQ). AB - The 'schizotypal personality' (STA) and 'borderline personality' (STB) scales of the STQ were administered to two groups: normal subjects who had completed the questionnaire on a previous occasion, four years earlier, and a 'clinical' sample, consisting of members of a self-help support group for people who at some time in the past had been psychiatrically diagnosed as suffering from a psychotic illness, mainly schizophrenia. As predicted, the latter had significantly higher scores than controls on both STQ scales, certain items also being particularly discriminating. Within the control group a test-retest analysis revealed correlations which, depending on scale and gender, were around .60. It was concluded that the STQ is a valid measure of psychotic traits and that scores on the questionnaire have good long-term stability. The results are discussed against the background, and in support of, a continuity view of psychosis. PMID- 1777754 TI - Strict and inconsistent discipline in childhood: consequences for adolescent mental health. AB - Recent reviews have suggested an association between discipline experienced in childhood and the development of later psychopathology. As part of a longitudinal study of the health and development of a large sample of New Zealand children, maternal reports of strict and inconsistent discipline were obtained when the sample members were aged 7 and 9 years. It was found that inconsistency was associated with early behaviour problems, but strictness was not. At age 15 years the prevalence of DSM-III disorders in the sample was established. Univariate analyses showed significant associations between inconsistency and low levels of strictness with externalizing disorder. Logistic regression analyses demonstrated that in the presence of other predictor variables including childhood problem behaviour, these associations only approached significance. However, when the two ratings were combined, rates of disorder for those who experienced more relaxed and inconsistent discipline were double the rates found in the sample remainder. No significant association was found between discipline and internalizing disorder. PMID- 1777755 TI - The prevalence of cognitive impairment in a community survey of multiple sclerosis. AB - A one in two alternate sample (N = 200) from a population-based register of 411 people with multiple sclerosis (MS) was studied. Out of this sample, 147 people with MS and 34 people with rheumatoid arthritis were interviewed at home and completed a battery of neuropsychological tests. Cognitive impairment was found in 46 per cent of those with MS, with memory impairment in 34 per cent and failure on tests of frontal lobe function in 33 per cent. Physical disability was associated with cognitive impairment. Memory impairment was more common in those who had had MS for 10 years or more. A significant minority of people with mild physical disability and some who had had MS for less than a decade nevertheless had cognitive impairment. Relationships between cognitive impairment, other disease variables and psychosocial factors were examined. Counselling and rehabilitation programmes for people with MS and their families should take account of cognitive deficits that may be present. PMID- 1777756 TI - Memory loss following radiotherapy for nasal pharyngeal carcinoma--an unusual presentation of amnesia. AB - In this article we describe a patient who developed amnesia several years after receiving a second course of radiotherapy treatment for nasopharyngeal cancer (NPC). Detailed assessment of memory indicated a marked anterograde impairment for verbal material with less impaired non-verbal memory. A dense retrograde deficit was also present, reflected in both poor event memory and loss of general knowledge. Performance on other tests indicated a mild intellectual deficit but no other cognitive impairments. The findings indicate a striking memory disorder arising from late temporal lobe necrosis. These findings stress the importance of assessing neuropsychological sequelae when evaluating the long-term outcome of radiotherapy for NPC and other cancers of the head and neck. PMID- 1777757 TI - Visual perceptual organization in schizophrenic patients. AB - Place & Gilmore (1980) proposed that schizophrenic patients are deficient in the perceptual organization of visual stimuli. According to their theory, the patients should be less influenced by global characteristics of visual displays. In the present experimental approach, 24 schizophrenics, 12 alcoholics and 24 healthy controls were asked to identify the number of lines presented for 23 ms on a video screen. In one condition, the stimuli were identical to those used by Place & Gilmore: up to six lines were shown at the corners of an imaginary hexagon; all lines were either in the same direction ('homogeneous') or differed in orientation ('heterogeneous'). In another condition the lines appeared at 10 different positions within the same field. The results of Place & Gilmore were not replicated; schizophrenics were only less influenced than the control group by different directions of the lines when three lines were presented. When more lines were presented, schizophrenics had the same advantage from homogeneity as the controls. If the basic configuration was a hexagon and six lines were presented, schizophrenics were able to profit very strongly from the global Gestalt. In summary, global characteristics of the visual displays do not facilitate visual information processing by schizophrenics as they do in the case of controls. However, if the basic Gestalt properties are strong enough, schizophrenics can take advantage of it. Thus the deficit of schizophrenics described by Place & Gilmore is relative and not absolute. PMID- 1777758 TI - Behaviour modification by successive approximation: Saxon age examples from Bede. AB - This paper describes the treatment of a case of mutism in Saxon England. The shaping procedure employed was similar to that reported in modern behaviour modification studies. The paper quotes from a seventh century papal letter showing an understanding of the principle of shaping as applied to populations. PMID- 1777759 TI - Relationships between mental adjustment to HIV diagnosis, psychological morbidity and sexual behaviour. AB - This paper examines patterns of psychological adjustment in a small sample of asymptomatic HIV antibody positive men. Comparison is made with data available on male cancer patients. HIV positive men reported greater degrees of anxious preoccupation and hopelessness, and lower levels of the more adaptive 'fighting spirit' response. In HIV-infected men, depression correlated positively with frequency of high risk sexual practices. PMID- 1777760 TI - An exploratory study of drawings by bereaved children. AB - Bereaved and non-bereaved children made drawings of a person, themselves, their family, and a topic of their choice; the drawings were then analysed to investigate whether the experience of bereavement was expressed in drawing in any reliable way. Bereaved children were no more likely than non-bereaved children to include indicators of emotional disturbance in their human figure drawings. Bereaved children, however, were reliably more likely than non-bereaved children to include themselves in a drawing of their family. PMID- 1777761 TI - Reminiscing as a technique in the group psychotherapy of depression: a comparative study. AB - Reminiscing as a technique of group psychotherapy for severely depressed hospitalized patients was found by patients and staff to be more efficacious than the traditional reflective non-directive group psychotherapy approach. The therapeutic potential of reminiscing in combatting depressed mood was supported by the present findings. The suitability of reminiscing to the difficult task of handling groups of severely depressed hospitalized patients was demonstrated. PMID- 1777762 TI - Concurrent validity for the Rust Inventory of Schizotypal Cognitions. AB - The present study evaluated the concurrent validity of the Rust Inventory of Schizotypal Cognitions (RISC) using the MMPI and the Psychosis Proneness Scales. Multiple regression techniques applied to the RISC and the other measures employed offer support for the validity of this measures as a screening instrument for use in non-clinical samples. PMID- 1777763 TI - Estimating premorbid intellectual level in dementia using the National Adult Reading Test: a Canadian study. AB - Twenty elderly demented subjects were compared with 20 elderly controls using a neuropsychological test battery which included the National Adult Reading Test (NART) and the WAIS-R. Significant differences emerged between the two groups on all of the cognitive measures administered, with the exception of the NART and the Verbal-Performance IQ discrepancy. Models were constructed using the normal controls as subjects where NART errors and WAIS-R Vocabulary age scaled scores were regressed against WAIS-R FSIQ and WAIS-R VIQ. These regression equations were then used to estimate premorbid intelligence levels in the demented sample, and these estimates were compared with the 'current' measures (WAIS-R FSIQ and WAIS-R VIQ). NART estimated IQs were significantly higher than Vocabulary estimated IQs, which in turn were significantly higher than WAIS-R FSIQ and WAIS R VIQ. These results confirm that the ability to pronounce irregular words correctly remains relatively unimpaired in dementia. PMID- 1777764 TI - Predicting clinical engineering workload requirements. PMID- 1777765 TI - Design and evaluation of a ribaviran aerosol administration system. PMID- 1777766 TI - Quality management, Deming principles, and clinical engineering. PMID- 1777768 TI - The accuracies of four stereotactic frame systems: an independent assessment. AB - An independent examination of the accuracy and precision of each of four stereotactic frame systems is provided. The effects of scan slice thickness and angle on system performance are also examined. The frame systems' performances for entry points as well as target points are measured. PMID- 1777767 TI - Intermittent-flow expiratory ventilation (IFEV): delivery technique and principles of action--a preliminary communication. AB - The ventilator support utilized in acute respiratory failure can exacerbate an underlying lung injury. Various ventilation techniques have been introduced to prevent such damage by limiting tidal volume and inflation pressure, ensuring uniform expansion of the lung, and stabilizing lung volume during expiration. Acceptance of such methods has been limited. Intermittent-flow expiratory ventilation (IFEV) is the latest development in limited-excursion pulmonary ventilation. The method involves the delivery of fresh gas to the respiratory tree during expiration, thereby flushing out the anatomic deadspace and ensuring that the gas initially delivered to the alveolus with the succeeding inspiration is able to participate in gas exchange. By eliminating end-tidal gas in the conducting air passages, series deadspace is functionally reduced, permitting lowering of tidal volume and airway pressures without a corresponding reduction in CO2 removal. This effect may benefit patients who have acute lung injury by permitting ventilator settings with lower tidal volumes and peak airway pressures. The technique of IFEV delivery, a successful clinical application, and possible ways to improve IFEV efficiency are discussed. PMID- 1777769 TI - A catheter-based enzyme-coupled electrode for measurement of lactate. AB - An enzyme-coupled electrode was incorporated into a catheter to measure the concentration of lactate solutions. The sensor output was found to be linearly dependent on the lactate concentration. The average nonlinearity over a sample of nine catheters was 5.88% full scale. Hysteresis for the device was low, with an average of 4.54% full scale. Preliminary results indicate that in-vivo measurements may be possible, which are not possible with other lactate measurement methods. PMID- 1777770 TI - Noninvasive measurement of arterial oxyhemoglobin saturation with a heated and a non-heated skin reflectance pulse oximeter sensor. AB - The feasibility of measuring arterial oxyhemoglobin saturation (SaO2) noninvasively using a skin reflectance pulse oximeter sensor attached to the scalp, neck, and thigh regions of anesthetized swine was investigated. The optical reflectance sensor used consisted of a pair of red and infrared light emitting diodes and a concentric array of six identical photodiodes. Two prototype sensor assemblies were evaluated: one assembly housed only the optical sensor, whereas the other also included a miniature heater. Measurements made from the scalp and neck regions were obtained with the non-heated skin reflectance sensor, and measurements from the thigh were made with the heated prototype. Each sensor was interfaced to a commercial transmittance pulse oximeter adapted to perform as a reflectance pulse oximeter. SaO2 values obtained by the reflectance pulse oximeters (SpO2(r) were compared simultaneously with SaO2 values obtained from arterial blood samples and analyzed in vitro with a CO oximeter. The equations for the best-fitted linear regression lines describing the relationships between SpO2(r) and SaO2 values in the range between 30 and 100% were: SpO2(r) = 10.7 + 0.90 (SaO2), n = 321, r = 0.97; SpO2(r) = 16.72 + 0.82 (SaO2), n = 217, r = 0.95; and SpO2(r) = 20.21 + 0.77 (SaO2), n = 37, r = 0.97 for the neck, thigh, and scalp measurements, respectively. The regression analysis revealed significant correlation and a relatively small standard error of estimate (SEE = 4.05% for the neck, 4.79% for the thigh, and 3.50% for the scalp measurements). This study demonstrated the feasibility of measuring SaO2 noninvasively over a wide range of values utilizing the principle of reflectance pulse oximetry. PMID- 1777772 TI - Action on exercise. PMID- 1777771 TI - Strategies for effective corporate participation in standards development and implementation. AB - There has to be a champion of EC 1992 preparedness within each company or division. For large corporations whose divisions have relatively similar products and operations, more centralized coordination may be useful. The cooperation of companies, organizations, and individuals in standards-setting activities like those of AAMI will help ensure that all suppliers to the European Community are operating on a level playing field. I have described how we are taking advantage of our experience and staff resources in the United States and Europe in order to avoid delays or difficulties in obtaining the CE mark. High-quality assistance is also available to smaller companies. Internal auditors can receive lead assessor training through contract courses as our corporate auditors did. Several medical device, quality control, and quality assurance magazines and newsletters routinely publish information on EC 1992. Finally, there are numerous consultants working actively in this area. The Journal of the American Society of Quality Control periodically publishes a list of consultants in various areas of specialization. PMID- 1777773 TI - Psychology of athletic performance. 1970. PMID- 1777774 TI - Motor racing accidents at Brands Hatch, 1988/9. AB - Little is known about the incidence of injury to race track motor-cyclists and car drivers. In a 1-year study at Brands Hatch, 70 of 33,184 competitors required hospital treatment. We found this injury rate to be higher than on the public highway. However, the anatomical distribution of injury caused by motor-bike accidents is similar to that found on the public highway. Motor-cyclists are more likely than car drivers to sustain limb trauma requiring outpatient treatment only. The number of participants requiring admission to hospital is broadly similar for car and bike races, being less than 0.1%. PMID- 1777775 TI - Sports injury registration: the Fysion Blesreg system. AB - Fysion Blesreg is a new system on which sports assistants (trainers, masseurs, physiotherapists and physicians) can rely for quick and straightforward registration and retrieval of personalized injury data. Registration of injury data can provide a clear picture of the injury mechanism, which in turn can lead to effective preventive measures and a decline in sports injuries. The two components of the Fysion Blesreg system are registration forms and computer software. Registration forms are filled out when the competition starts (zero form), and when injuries occur (team cards and players' cards). Data are collected for the individual (zero form), the sports activity (team card), and the cause, nature and treatment of the injury (player's card). All data are entered into the computer with an MS-DOS based computer program, and can in various ways be reported or graphically reproduced. PMID- 1777776 TI - Sledging injuries in the fens: an unlikely epidemic? PMID- 1777777 TI - Connective tissue massage. AB - Connective tissue massage (CTM) is a manipulative technique that facilitates the diagnosis and treatment of a wide range of pathologies. Observation and subsequent manipulation of the skin and subcutaneous tissues can have a beneficial effect upon tissues remote from the area of treatment. These effects appear to be mediated by neural reflexes that cause an increase in blood flow to the affected region together with suppression of pain. CTM is becoming accepted more widely as research confirms the claims of an expanding population of practitioners. PMID- 1777778 TI - St. Andrew's Ambulance Association experience at Ibrox and Hampden Parks. PMID- 1777779 TI - An unusual squash injury. PMID- 1777780 TI - Upper limb fractures in rugby in Huddersfield 1986-1990. AB - Most injuries sustained by rugby players affect the soft tissues, and fracture is relatively uncommon. Whereas the lower limb is most affected in footballers, the upper limb tends to be injured in rugby players. Thirty consecutive fractures and ten dislocations affecting the upper limb, sustained by 35 rugby players, are reported. PMID- 1777781 TI - Bilateral osteochondritis dissecans of the elbow treated by Herbert screw fixation. AB - The case of a 15-year-old boy, a high-performance motocross rider, who developed bilateral osteochondritis dissecans of the elbow is described. Both lesions were successfully treated by Herbert screw internal fixation. PMID- 1777782 TI - Stress fractures of the hip in Royal Marine recruits under training: a retrospective analysis. AB - At the Commando Training Centre, Royal Marines (CTCRM), a retrospective analysis of the occurrence of one form of stress fracture--that of the hip--has shown that this fracture is a significant cause of morbidity in the recruits. Most fractures presented in the last few weeks of training, which may reflect the increasing workload that the training involves. Two different fracture sites are identified, but there is no discernible difference in presentation or outcome between them. The condition may be easily misdiagnosed as a more trivial injury. A careful history and examination, and a low threshold for radiographic and scintigraphic investigation are important for diagnosis, and to avoid the catastrophic failure of the fracture seen in one of our patients. PMID- 1777783 TI - Acquired venous aneurysms. AB - A case is reported of acquired venous aneurysms in the superficial forearm veins of an oarsman. The aetiology, presentation and complications are discussed. PMID- 1777784 TI - Injuries in high-skilled and low-skilled soccer: a prospective study. AB - Fifty-five male soccer players organized in three teams, one high and two lower ranking, were followed prospectively during 1 year to register the rate, type and severity of injuries in highly skilled and low-skilled players. The injury rate of the low-skilled players was significantly higher than that of the better players. The reason for this is that low-skilled players play in more competitions. and this is where injuries tend to occur. When we stratified on game/practice, the low-skilled players' excess risk disappeared and no difference was found in the severity of injuries. Different ways of collecting data in epidemiological studies of soccer are discussed and it is concluded that the most precise and accurate collection of data can only be obtained by direct supervision and examination of soccer players in the field. PMID- 1777785 TI - Dietary intakes of age-group swimmers. AB - The purposes of this study were to collect information regarding the dietary habits of male and female age-group swimmers and report the energy consumptions of these athletes in relation to their daily training demands. Twenty competitive swimmers, who were training 6000 m per day 6 days a week, recorded all fluid and food consumed during a 4-day period. Dietary analysis revealed that 11 swimmers (55%) had calcium intakes below recommended dietary allowances (RDA), while 13 (65%) had iron intakes lower than RDA. Despite identical training loads and body mass, male swimmers had significantly greater (P = 0.004) daily mean (s.d.) energy consumption (3072(732) kcal, 12.9(3.1) MJ) than females (2130(544) kcal, 8.9(2.3) MJ) and were maintaining energy balance. Although the contribution of carbohydrate to total daily energy intake was the same for male (55%) and female swimmers (56%), the females ingested significantly less (P = 0.011) carbohydrate (292(87) g) than the males (404(88) g) and could be considered deficient in dietary carbohydrate with respect to their daily training demands. PMID- 1777786 TI - Evaluation of knee braces in Swedish ice hockey players. AB - In this retrospective investigation we have determined the rate and types of knee injuries among Swedish ice hockey players, and related these data to the use of knee braces. Thirty-seven of the originally selected 50 hockey teams (74%) of elite or first division calibre took part in the study, and 600 players answered a questionnaire. A total of 254 previous knee injuries sustained while playing hockey were reported by 243 players; tears of the medical collateral ligament (60%), meniscus (15%) or anterior cruciate ligament (12%) were the most commonly reported injuries. Prophylactic knee braces were worn by 138 (23%) of the players. Of these, 122 (88%) had earlier sustained a knee injury, and 16 had not. A total of 17 knee injuries had occurred while the players were wearing a brace. Six of these players had previously uninjured knees while 11 had repeat injury in a brace despite earlier successful rehabilitation or operation. The most common injury in braced knees was a tear of the medial collateral ligament. We conclude that the number of knee injuries is high among Swedish ice hockey players, and that the efficacy of functional knee braces to reduce knee injuries is questionable. PMID- 1777787 TI - Accuracy of pulse oximeters in estimating heart rate at rest and during exercise. AB - Pulse oximeters are being widely used for non-invasive, simultaneous assessment of haemoglobin oxygen saturation. They are reliable, accurate, relatively inexpensive and portable. Pulse oximeters are often used for estimating heart rate at rest and during exercise. However, at present the data available to validate their use as heart rate monitors are not sufficient. We evaluated the accuracy of two oximeters (Radiometer, ear and finger probe; Ohmeda 3700, ear probe) in monitoring heart rate during incremental exercise by comparing the pulse oximeters with simultaneous ECG readings. Data were collected on eight men (713 heart rate readings) during graded cycle ergometer and treadmill exercise to volitional fatigue. Analysis by linear regression revealed that general oximeter readings significantly correlated with those of ECG (r = 0.91, P less than 0.0001). However, comparison of heart rate at each level of work showed that oximeter readings significantly (P less than 0.05) under-estimated rates above 155 beats/min. These results indicate that the use of pulse oximeters as heart rate monitors during strenuous exercise is questionable. This inaccuracy may well originate from the instability of the probes, sweating, other artefacts during exercise, and measurement of different components in the cardiovascular cycle. PMID- 1777788 TI - Lactic acid recovery profiles following exhaustive arm exercise on a canoeing ergometer. AB - In this study lactate removal rates were monitored in ten subjects during a 30 min recovery period following exhaustive arm exercise. Each subject experienced three recovery regimens on different occasions in random order. One recovery period consisted of supine rest while the other two were active, one incorporating low intensity arm exercise and the other consisting of low intensity leg exercise. Lactate clearance rates showed a significant difference between the recovery regimens, and a posteriori test indicated a significant difference between leg exercise and arm exercise in the recovery period and also between leg exercise and rest. There was no significant difference in lactate clearance between arm exercise and rest in the recovery period. PMID- 1777789 TI - Tarzan swings: a dangerous new epidemic. AB - Accidental injury in school children was thought to be unpreventable. This series presents the results of 24 consecutive patients with 29 fractures as a result of a fall from a 'Tarzan' rope swing. Twenty-six of the fractures involved the upper limb, 11 patients required hospitalization with operative intervention and 13 required outpatient care only. These types of injury are preventable. The morbidity and pain that these young patients suffer can be avoided. PMID- 1777790 TI - Gender verification in sport. PMID- 1777791 TI - Lumbar vertebrae anomalies and their significance in a young gymnast. PMID- 1777792 TI - Lumpy skin disease, an African capripox virus disease of cattle. AB - Lumpy skin disease is an infectious viral disease of cattle, which often occurs in epizootic form. The disease is characterized by the eruption of nodules in the skin, which may cover the whole of the animal's body. Systemic effects include pyrexia, anorexia, dysgalactia and pneumonia; lesions are often found in the mouth and upper respiratory tract. The severity of the disease varies considerably between breeds and strains of cattle. Many cattle suffer severe emaciation and loss of production for several months. The skin lesions cause permanent damage to the hides. The mode of transmission of the disease has not been clearly established. Contact infections do not readily occur and the evidence from the epizootiology strongly suggests that insect vectors are involved. The disease has been confined to sub-Saharan Africa, until it recently appeared in epizootic form in Egypt and in Israel. Transmission occurs in a wide variety of biotypes, from semi-desert to temperate grasslands and irrigated land. It has the potential to extend its range further. PMID- 1777793 TI - Observations on the experimental pathogenicity and toxigenicity of Mortierella wolfii strains of bovine origin. AB - Four strains of Mortierella wolfii isolated from cattle in Britain were compared in pathogenicity and toxigenicity with a strain isolated from a cow with the mycotic abortion-pneumonia syndrome in New Zealand. All strains produced acute lethal infection in rabbits after intravenous inoculation of mycelial suspensions and all produced subacute mycotic encephalitis in mice after intracerebral injection. They also produced an acid-stable, heat- and trypsin-labile toxin in vitro. The action of the toxin was exerted mainly on the kidneys in rabbits and mice and produced effects distinct from those resulting from infection with M. wolfii. PMID- 1777794 TI - Responses of dairy cows to badger urine and faeces on pasture with reference to bovine tuberculosis transmission. AB - Grazing cattle were observed when they encountered badger urine or faeces which, in all but the first study, came only from badgers which were not infected with bovine tuberculosis. The faeces were very strongly avoided and there was generally a strong avoidance of ingestion of badger urine. There was no evidence that cattle were attracted to badger latrines in an area where some infected badgers were present and cows actively avoided faeces up to 28 days old which was placed on grass turves or on pasture. 99.3% of cows took no bites from small grass plots contaminated with faeces and 88.7% of cows took no bites from urine treated plots. There was generally avoidance of pasture treated with badger urine up to 14 days old. However, two cows out of 240 were willing to graze close to faeces and seven out of 240 were willing to graze near urine. Contaminated herbage was eaten most when attractive herbage became scarce. Wet weather did not reduce the strength of avoidance of urine. Some cows responded to badger urine, and to a lesser extent to faeces, by more sniffing, particularly when herbage was scarce. The odour of faeces, and sometimes that of urine, often resulted in the ejection of mouth contents. As a consequence of their avoidance of badger faeces and urine, the vast majority of cows are unlikely to contract tuberculosis from infected badgers by ingestion. Most cows totally avoid badger products so they are unlikely to be infected via inhalation. However, the small minority of unselective cows must be more at risk and this finding warrants further investigation. PMID- 1777795 TI - Renin-aldosterone system and arginine vasopressin in diarrhoeic calves. AB - Plasma renin activity, plasma aldosterone and arginine-vasopressin concentrations were determined in five diarrhoeic and five healthy newborn calves. In animals suffering from diarrhoea these three parameters were 10-15 times higher than those observed in controls. These results suggest that the hormonal systems that control fluid and electrolyte homeostasis are highly stimulated by dehydration and salt depletion induced by faecal losses of water and sodium in calves affected with diarrhoea. PMID- 1777796 TI - Effects of poor pasture conditions and type of feeding on some biochemical values of gobra zebu in Senegal. AB - Blood samples were obtained from 70 healthy gobra zebu from three different farms each one with a different feed (natural pasture, concentrates and groundnut hay) to exhibit the influence of type of feeding. To evaluate effect of poor pasture conditions, animals in an extensive system on natural pasture were sampled twice with a monthly interval in the late dry season. Blood samples were analysed for calcium, inorganic phosphate, total protein, glucose, urea, creatinine and haematocrit. Poor pasture conditions caused a decrease of plasma components such as haematocrit, total protein, inorganic phosphate, glucose and urea. The impact of type of feeding by comparing values from animals grazed on natural pasture with those from animals which received concentrates showed significantly higher values of total protein, urea and inorganic phosphate for animals fed with concentrates. Comparison between animals grazed on natural pasture and those which received groundnut hay indicate a significantly higher value of total protein and urea for animals fed with groundnut hay. PMID- 1777797 TI - Cytogenetic analysis of a canine haemangioendothelioma: a case report. AB - An 8-year-old German Shepherd bitch developed a haemangioendothelioma in the mammary region. The cytogenetic characterization of the tumour cells revealed a chromosome number of 80 plus a double minute. Several aberrations were detected: trisomies 4, 35, and 38, a centric fusion 8/22 and a tandem translocation 9/23. PMID- 1777798 TI - Use of tetracycline sorbate for the treatment of Aspergillus fumigatus infection in broiler chicks. AB - The efficacy of tetracycline sorbate (Pimafungil; contains 20% tetracycline sorbate w/v) was evaluated for treatment of Aspergillus fumigatus in naturally infected broiler chicks. The drug was administered to a group of 160 infected broiler chicks at 200 mg/l of drinking water, daily and consecutively for 5 days. Another group of 100 infected broiler chicks was kept as untreated controls. The chicks of the treated group showed appreciable improvement in clinical symptoms, mortality, body weight and recovery as shown by absence of gross and histopathological lesions and of the fungus. PMID- 1777799 TI - Treatment of experimental trypanosomiasis in pigs. AB - The therapeutic activity of difluoromethylornithine (DFMO), diminazene aceturate (Berenil) and their combination against chronic trypanosomiasis was investigated in experimental Trypanosoma brucei brucei infections of growing pigs. DFMO (300 mg/kg/day orally for 10 days), diminazene aceturate (7 mg/kg in single intramuscular injection) and a combination of the two agents at the above dosages produced varied periods of aparasitaemia in the treated pigs. Relapse parasitaemia occurred in all treatment groups, with diminazene aceturate providing the longest relief period of 17 days, combination treatment 11 days and DFMO 6 days. The packed cell volume, blood haemoglobin concentration and red cell count values decreased after the pigs were infected with the parasites. The values improved following treatment with the agents and their combination. PMID- 1777800 TI - Experimental infection of dexamethasone-treated goats with Pasteurella haemolytica A2. AB - Sixteen goats either subjected to transport stress or without transport stress were treated with dexamethasone for 3 days prior to infection with P. haemolytica serotype A2 intranasally. The transport-stressed and dexamethasone-treated goats in the first group had various degrees of pulmonary lesions and the organism was re-isolated from the nasal cavity, lymph nodes and lungs. None of the goats treated with dexamethasone only were infected with P. haemolytica and had no lesions of pneumonic pasteurellosis. Treatment with dexamethasone alone failed to induce experimental infection by P. haemolytica except in combination with another stress factor. PMID- 1777801 TI - Infection of goats with Haemonchus contortus and Trichostrongylus colubriformis: histopathology and pH changes. AB - Two groups of goats were experimentally infected with Haemonchus contortus and Trichostrongylus colubriformis, and killed at various days after infection (DAI). The percentage of worms that established in the abomasum and the small intestine was low. At necropsy, abomasums from infected goats had thickened walls and oedematous folds. At 7 DAI there was an initial infiltration of eosinophils and some neutrophils which tend to increase with age of infection. The mean pH of the abomasum in goats infected with H. contortus was 5.43 (range 5.3-5.7), while that of the control goats was 3.30 (range 2.8-3.7). PMID- 1777802 TI - Somatic cell counts of ewes' milk. AB - The somatic cell counts of ewes' milk were determined by an electronic particle counter (Coulter Counter). Of 1408 apparently normal milk samples, 98.2% had a somatic cell count lower than 1.0 x 10(6) cells/ml and 85.8% of 254 bacteriologically positive samples had a count higher than 1.0 x 10(6) cells/ml. Values exceeding 1.0 x 10(6) cells/ml are indicative of subclinical mastitis, if samples were collected from clinically healthy mammary glands. PMID- 1777803 TI - A report of Froin's syndrome in five ovine thoracolumbar epidural abscess cases. AB - An epidural abscess involving the thoracolumbar spinal cord was considered the probable cause of pelvic limb paresis in those sheep where analysis of lumbar cerebrospinal fluid (CSF) samples revealed a significant increase in protein concentration (P less than 0.05) and some increase in total white blood cell concentration and neutrophil percentage. There was no significant increase in protein concentration in the corresponding cisternal samples. This phenomenon caused by blockage to CSF flow is not dissimilar to that of Froin's syndrome in man which has been reported as a result of localized spinal meningitis (Brain, 1985). PMID- 1777804 TI - Vertebrate craniofacial development: the relation between ontogenetic process and morphological outcome. AB - Many structures that are present, often transiently, in the head of extant vertebrate embryos appear to be segmentally organized. These include the brain, particularly the hindbrain (e.g., rhombomeres), and adjacent axial structures such as paraxial mesoderm (e.g., somites, somitomeres) and neural crest cells. Also present in the head are additional sets of serially arranged structures that develop in more ventral and lateral locations. Examples of these are epibranchial placodes, aortic arches, and pharyngeal pouches. All these embryonic structures are frequently used both individually and collectively as characters to assist in defining homologies. New cell labeling and identification methods are providing detailed accounts of cell movements and tissue lineages that reveal a range of disparate behaviors not previously appreciated. The well-known migrations of neural crest cells bring all but the neurogenic members of this mesenchymal population form dorsal, axial locations into ventral and rostral locations where they largely surround the pharynx, stomdeum, and prosencephalon. Equally dramatic movements of neural plate cells, myoblasts, angioblasts, and placode-derived cells have recently been documented. These movements may occur in concert with those of other nearby tissues (e.g., branchiomeric myoblasts, neural crest cells, and surface ectoderm) or may be independent (e.g., placodal neuroblasts). Migrating cells may be clustered and follow definable pathways towards their destination (e.g., neural crest cells), or they may be solitary and wander invasively without a prespecified destination (e.g., angioblasts). These extensive morphogenetic movements bring cells into contact with a greater variety of other tissues and matrix environments than has heretofore been recognized. Moreover, because of these rearrangements, the cells present in a particular location, such as a branchial arch, may trace their ancestry to many axial levels, which complicates the analyses of segmental relations. Comparative morphological studies of craniofacial development have recently been augmented by descriptions of the sites and times of expression of many matrix components, growth factors and their receptors, and regulatory genes. Particularly important has been the discovery of a network of genes called the homeobox family. These genes are similar in their sequence and their organization along a chromosome to genes that establish the spatial identity of prospective body parts in drosophila. The combination of cellular and molecular descriptive studies of vertebrate craniofacial development provide exciting opportunities to catalogue patterns of gene expression and morphogenesis during the gastrula, neurula, and early organogenesis stages. Moreover, such data form the basis for proposing and then testing hypotheses about the mechanisms controlling cell movements, tissue formation, and the assembly of functionally integrated sets of structures.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1777805 TI - Pedigrees of neurobehavioral circuits: tracing the evolution of novel behaviors by comparing motor patterns, muscles, and neurons in members of related taxa. AB - Comparisons of homologous elements in neurobehavioral circuits that have diverged during speciation to mediate different behaviors should reveal the nature of evolutionary changes in nervous systems. When the pedigree of a particular behavior can be traced-by comparing motor patterns and their neural substrates in related taxa whose phylogeny is known from other (non-neurobehavioral) criteria divergent and convergent evolutionary changes can be distinguished and the order of their occurrence reconstructed. An example of reconstructing a behavioral pedigree (for the novel mode of swimming in the crab Emerita [Hippidae]) is presented, and implications about the evolution and organization of neurobehavioral circuits engendered by this and some other studies of functionally defined neuronal networks are reviewed. Specific neural differences in related animals can only be attributed to natural selection when they can be related to species differences in function or behavior. Differences that cannot be so related, as well as apparently non-adaptive characters in individual nervous systems, are attributed to ontogenetic processes, which apparently, in some cases, introduced and, in other cases, resisted change through evolutionary time. More expressly-comparative investigations of discrete neurobehavioral circuits are needed for an understanding of the interdependence of evolutionary processes and ontogenetic and functional constraints on the organization of neuronal systems. PMID- 1777806 TI - Evolution of homologous vocal control traits. AB - Evolutionary neurobiologists want to know how neuronal properties (or traits) have been modified to subserve adaptive changes in behavioral phenotypes. Homology can provide a conceptual framework to distinguish the separate contributions of phylogenetic factors and current adaptive modifications to extant traits and behaviors. In this essay, a suite of nine vocal/sonic motor traits are compared in two orders of teleost fishes, the Batrachoidiformes and Scorpaeniformes. Only three of the traits are modified among Scorpaeniformes, the more advanced group. The large number of conserved characters among the study species suggests their sonic motor systems are homologs. This conclusion is consistent with the known phylogeny of teleosts and further implies that homologous sonic motor traits are more extensively modified among more recently evolved members (in this case the Scorpaeniformes) of the teleostean lineage. Since homology implies a common ontogenetic history for any trait, modifications thereof can potentially be linked to changes in identifiable developmental events, which themselves are homologs. Several hypotheses are proposed to account for the origins of modified sonic traits. The further demonstration that modified traits of the sonic motor system are in fact adaptations sets the stage for behavioral ecological studies that attempt to understand why the modified traits underlie behavioral changes that increase an individual's fitness. PMID- 1777807 TI - Evaluation of species-specific biochemical variation as a means for assessing homology in neuronal populations. AB - The phylogenetic history of neurons, as derived from the establishment of homologies, has been thought to be useful for furthering the understanding of nervous system function and behavior. The sensitivity of current biochemical and molecular techniques has been heralded as the ultimate means to establish neuronal phenotype and, thus in, turn to assess neuronal homology among species. Studies delineated in this review define the caveats associated with over reliance on such an approach, even when an in-depth understanding of the biochemical and genetic makeup of homologous neuronal populations is available. PMID- 1777808 TI - Homology and evolutionary origins of the 'neocortex'. AB - The telencephalon of mammals is characterized by the presence of a hexalaminated structure on its external surface, with specific auditory, visual, somatosensory and motor regions. Due to its seeming unique presence in mammals, it is frequently designated as the neocortex. The evolutionary origins of the so-called neocortex have long puzzled comparative neuroanatomists, in view of the seeming absence of a neocortical-like anlage in nonmammalian amniotes. The resolution of this puzzle requires analysis of both adult and embryonic brains. Experimental neuroanatomical, physiological and behavioral methods applied to adult avian and reptilian brains have finally clarified several fundamental questions regarding the origins of 'neocortex' and have indicated that these origins can be viewed as consequent to two separate events: (1) The elaboration of constituent neuronal populations and their associated connections that are common to the telencephalae of both nonmammalian and mammalian amniotes. In mammals these populations are found within the so-called neocortex. In birds and reptiles, most of these neurons are found within the dorsal and dorsolateral ventricular ridges (DVR and DLVR). (2) In mammals, the components of the DVR and DLVR are incorporated into the thin overlying pallium to form a laminated 'neocortex'. Analysis of development in domestic chicks suggests that the DVR is one of several prosencephalic neuromeres ('Prosomeres') that contribute to the ontogeny of comparable structures in birds. Perhaps in mammals, as well, cortical development is consequent to incorporation of these several prosomeres into proliferative ependyma of the pallial mantle. PMID- 1777810 TI - Episodic and semantic memory in early versus late onset Alzheimer's disease. AB - The aim of this study was to replicate and extend previous work demonstrating selective impairment of semantic, but not episodic, memory in late versus early onset Alzheimer's disease (AD). Measures of episodic and semantic memory were administered to 12 pairs of patients; early (less than or equal to 62) and late (greater than or equal to 68) onset pairs were matched on dementia severity and education. As hypothesized, the groups did not differ on the three episodic memory measures but did on two of three semantic memory measures. In conjunction with prior research, these findings indicate that late onset AD is characterized by more profound impairment on measures of semantic processing. PMID- 1777809 TI - Right hemisphere participation in reading. AB - This study examined whether the right hemisphere's contribution to lexical semantic processing is greatest when it is "disinhibited." Skilled reading may require the controlled modulation of interhemispheric interaction: the left hemisphere (or some other control mechanism) may regulate the subprocesses of reading by selectively "inhibiting" and "disinhibiting" right hemisphere function. Right-handed undergraduates concurrently performed two tasks: a lateralized semantic or rhyme task and a verbal memory task. It was hypothesized that right hemisphere reading processes would be disinhibited when the left hemisphere was "occupied" with the memory task. This hypothesis was supported for a subgroup of subjects who showed evidence of inhibition of right hemisphere function (i.e., left hemisphere dominance for lexical processing) when the lateralized semantic task was performed alone. Across subjects, there was a strong correlation between the degree of left hemisphere dominance in the single task semantic conditions and the degree of disinhibition of right hemisphere function in the dual-task semantic condition. PMID- 1777811 TI - Functional lateralisation of pitch accents and intonation in Norwegian: Monrad Krohn's study of an aphasic patient with altered "melody of speech". AB - The present article provides a linguistic analysis of Monrad-Krohn's famous description of a patient with deviant prosody (1947). Monrad-Krohn found it particularly striking that the patient's "melody of speech" had been damaged although her musical abilities showed no impairment. The patient had suffered a traumatic motor aphasia as the result of a shrapnel wound in Broca's area. In East Norwegian, accented syllables are associated with one of two pitch patterns, either a fall in pitch or a low-level pitch. The patient had trouble producing the distinction between these two accents. Monrad-Krohn's description also suggests that she may have accented words in contexts where they should have been unaccented, with the result that these syllables (erroneously) received one of the two pitch patterns. It is suggested that her apparently deviant sentence intonation could, in some cases, be the "secondary" result of a tendency to produce full vowels in positions where a reduced vowel would be expected, thus abnormally prolonging an otherwise appropriate rising pitch pattern. PMID- 1777812 TI - Perception of visual letter strings in a case of left neglect: manipulation of the word form. AB - Patients with lesions in the right parietal lobe neglect the left side of nonwords much more than the left side of words. This has been interpreted in terms of a more automatic process in reading words. The case of a patient with left visual neglect after a vascular right parietooccipital lesion is presented. He showed the phenomenon of a word superiority effect over nonword in reading at the beginning in a clinical test with static cards; 6 months later, after some recovery, the same phenomenon could be demonstrated only with tachistoscopic presentation, and it occurred even inside the good right visual hemifield. The word form of visually presented stimuli was manipulated, showing that there was a striking effect particularly when spacing the letters of words in a task that requires naming the stimulus. The patient's performance is interpreted in terms of an attentional deficit occurring at an early level of spatial information processing. PMID- 1777813 TI - Text-level representations as one determinant for lexical retrieval and sentence production deficits in aphasia: comments on L. B. Zingeser and R. Sloan Berndt "Retrieval of nouns and verbs in agrammatism and anomia". AB - This note discusses the explanation put forward by Zingeser and Berndt (1990) in their attempt to account for agrammatism by reference to word-level representations. These authors have suggested that agrammatism could be the expression of some particular difficulties with the lexical retrieval of verbs. The present discussion suggests an alternative explanation making reference to text-level representations, and particularly to the lexicalization of predicates. PMID- 1777814 TI - Binding of [3H]cholecystokinin in the ventromedial hypothalamus is modulated by an afferent brainstem projection but not by ovarian steroids. AB - The ventromedial nuclei (VMN) of the hypothalamus are innervated by cholecystokinin-immunoreactive (CCK-IR) fibers originating in the dorsal parabrachial nuclei (PBS). They also contain high levels of receptors for CCK and binding of [125I]CCK to these receptors is modulated by estrogen. In the present study, we show that unilateral lesion of the PBS increases the binding of the sulphated octapeptide of [3H]cholecystokinin ([3H]CCK) within the ipsilateral VMN of the hypothalamus, but not within other brain nuclei that contain receptors for CCK. Thus, CCK fibers originating in the PBS selectively innervate the VMN and CCK receptors within the VMN are postsynaptic to parabrachial afferents. However, treatment of ovariectomized rats with estradiol benzoate and progesterone did not affect the binding of [3H]CCK in the VMN, even after lesion of the parabrachial afferents. PMID- 1777815 TI - High affinity binding of transferrin in cultures of embryonic neurons from the chick retina. AB - Immunohistochemical and autoradiographic analysis of neuronal cultures from embryonic day 8 (E8) and day 11 (E11) chick retina indicate that transferrin receptors and binding sites are present on soma and neurites. Cultures maintained in the presence of transferrin expressed elevated transferrin binding due to an increase in the number of transferrin receptors. Cultures from E11 neural retina exhibited a decrease in transferrin binding when compared to E8 cultures. This appears to be due to a decrease in the number of binding sites. Neurons maintained in a transferrin-free medium supplemented with 0.4 microM of iron sulfate generally expressed slight increases in transferrin binding. PMID- 1777816 TI - Relationships between hair-follicle afferent axons and glycine-immunoreactive profiles in cat spinal dorsal horn. AB - In order to identify synapses between hair-follicle afferent axons and glycine containing structures in cat spinal cord, semithin sections containing physiologically identified primary afferent boutons which had been filled with horseradish peroxidase (HRP) were reacted with anti-glycine antiserum, while adjacent ultrathin sections were examined for synaptic contacts. Four axodendritic synapses between hair-follicle afferent boutons and glycine immunoreactive dendrites and 4 axoaxonic synapses in which HRP-filled boutons were postsynaptic to immunoreactive axons were identified. These results suggest that glycine is involved in the spinal processing of input from A beta hair follicle afferent axons. PMID- 1777818 TI - The fine structure of the S-100 protein positive cells in the rat pituitary gland: an immunoelectron microscopic study. AB - We examined the fine structure of rat folliculo-stellate (FS) cells of the anterior pituitary and pituicytes of the neural lobe using immunoelectron microscopy for S-100 protein. The study proves that S-100 protein is solely expressed in the FS cells and pituicytes. However, the ultrastructural differences between these two cell types demonstrated in this study may argue against the hypothesis that the FS cells and the pituicytes have a common origin. PMID- 1777817 TI - Extracellular dopamine increases in the neonatal olfactory bulb during odor preference training. AB - Young rats learn to approach an odor that has been paired with tactile stimulation. This attraction is accompanied by changes in the metabolism and anatomy within the olfactory bulb glomerular layer. In this study, we examined the changes that occur in the olfactory bulb during early olfactory learning, rather than after such pairings have occurred. Specifically, we determined whether the pairing of an odor with tactile stimulation would produce a modified response by olfactory bulb glomerular-layer neurons. To monitor one large subgroup of these neurons during early learning, we used in vivo microdialysis to assess the activity of dopaminergic neurons in the olfactory bulb of postnatal day (PND) 3 rats during simultaneous presentation of odor and tactile stimulation, tactile stimulation alone, odor alone, or clean air alone. Clean air evokes no change in extracellular dopamine (DA), while both odor alone and stroking alone induce prolonged increases in DA peaking at about 200% of baseline. The combination of odor and tactile stimulation, which allows an olfactory preference to be formed, induces a prolonged increase in DA which peaks at about 400% of baseline. The level of the DA metabolite 3,4 dihydroxyphenylacetic acid (DOPAC) increases only in pups receiving both odor and tactile stimulation and peaks at about 200% of baseline. With the exception of the pups exposed to clean air, all groups show an increase in homovanillic acid (HVA) of between 150-200% following stimulation. The large and prolonged increase in DA may be linked to the longer term anatomical and physiological changes in the glomerular layer of the bulb that form as a consequence of early olfactory preference training. PMID- 1777819 TI - Long experimental durations are required for double label [14C]- and [3H]2 deoxyglucose autoradiographic methods. AB - Double-label 2-deoxyglucose (2-DG) studies using sequential [14C]- and [3H]2-DG injections demonstrate increased [14C]2-DG uptake during the first and second stimulation periods. To understand why this occurs, the rat mystacial vibrissae were stimulated at various times following [14C]2-DG injection. Local cerebral glucose utilization (LCGU) increased when whisker stimulation was performed at 0 90 min following [14C]2-DG injection. LCGU did not increase when whisker stimulation was performed at 90-150 min following [14C]2-DG injection. To minimize contamination of the two tracers in double label 2-DG mapping studies, the time between [14C]- and [3H]2-DG administration should be increased to 90 min. PMID- 1777820 TI - Localization of GAD- and GABA-like immunoreactivity in ground squirrel retina: retrograde labeling demonstrates GAD-positive ganglion cells. AB - Glutamic acid decarboxylase (GAD)- and gamma-aminobutyric acid (GABA)-like immunoreactivity was examined in the retina of the 13-lined ground squirrel (Spermophilus tridecemlineatus). Labeling was observed in the inner nuclear layer (INL), inner plexiform layer (IPL) and ganglion cell layer (GCL). The immunoreactive cell bodies in the inner third of the INL were 6-13 microns in diameter and, because of their size and location it was considered that these were amacrine cells. Labeling in the IPL was concentrated in 5 bands corresponding to laminae 1a, 1c, 2, 4 and 5. In the GCL a heterogeneous population of neurons exhibited GAD- and GABA-like immunoreactivity. The soma diameters of the GCL cells ranged from 5 to 17 microns. These may represent displaced amacrines and/or ganglion cells. To determine if any of the immunoreactive cells in the GCL were ganglion cells, double labeling experiments were performed using rhodamine latex microspheres ('beads') as retrograde neuronal tracers. Rhodamine beads were injected into the superior colliculus, and retinas with retrogradely labeled ganglion cells were subsequently incubated with the anti-GAD antiserum. These experiments revealed a small population of GAD positive ganglion cells, setting a lower limit for the total number of GABAergic ganglion cells. PMID- 1777821 TI - Depletion of glutathione interferes with induction of glycerolphosphate dehydrogenase in the brains of young rats. AB - In the rat brain hydrocortisone induces the enzyme, glycerolphosphate dehydrogenase (GPDH), during the first postnatal week. The present studies focused on a hypothetical role for glutathione-S-transferase (GST) in that phenomenon. Two forms of GST, Yb and Yp, had been detected in glial cells in mature rat brains, and it was suggested that they might function in hormone transport. Now GSTs have also been observed in the brains of 1-day-old rats. Two glutathione-depleting agents, buthionine sulfoximine and cyclohexene-1-one, were administered to rats, along with hydrocortisone, during the first postnatal week. Hydrocortisone or a depleting agent alone was administered to control animals. During the early days of the experiment there were lower GPDH specific activities in brains from the animals given hydrocortisone plus a depleting agent than in those from animals given hydrocortisone alone. Depleting agents alone did not affect the specific activities of GPDH. It is suggested that one function of the GST in rat brain is transport of hydrocortisone between or within glial cells. PMID- 1777822 TI - Optical methods can be utilized to map the location and activity of putative motor neurons and interneurons during rhythmic patterns of activity in the buccal ganglion of Aplysia. AB - We sought to develop a map of the locations of neurons that are active during patterned activity in the buccal ganglion of Aplysia using optical techniques. Staining ganglia with a voltage-sensitive absorbance dye (JPW 1124) did not prevent them from generating patterned activity similar to that observed before staining, in response to shock of the esophageal nerve. Absorbance changes were monitored with a 124-element photodiode array, while extracellular electrodes monitored activity of the 6 buccal nerves. Optical and extracellular spikes were grouped with the aid of a template matching program; a total of 120 distinct units were detected in one 15 s recording. Optical signals (83 units) were found in the region of the ganglion containing mainly large neurons. Of these, 13 were detected on both optical and extracellular electrode recordings, suggesting that they might be motor neurons, while 25 of the optically detected neurons appeared not to be correlated with extracellular activity, suggesting that they might be interneurons. It was not possible to determine whether the remaining 45 optically identified units did or did not have correlated nerve activity. The ganglionic locations of putative motor neurons corresponded to the locations of large neurons identified by backfilling nerves of other buccal ganglia, and were consistent with the locations of putative motor neurons found in two other ganglia studied using optical methods. Thus, optical methods have generated a map of the locations and activity patterns of putative motor neurons and interneurons in the buccal ganglion that may be involved in the generation of rhythmic patterns. PMID- 1777823 TI - Regulation of muscarinic receptors by intrahippocampal injections of gallamine. AB - Multiple intrahippocampal injections of gallamine impair performance of a representational memory task in rats. The binding of [3H]-(-)-quinuclidinyl benzilate (QNB) to rat brain sections was measured to determine if changes in receptor binding were associated with the deleterious effects of gallamine. [3H] (-)-QNB binding to sections taken from gallamine-injected animals was compared with binding in saline-injected control animals. Autoradiographic analyses indicated an increase in [3H]-(-)-QNB binding sites within all layers of the cerebral cortex and in the superior colliculus in gallamine-treated animals as compared to saline-injected controls. Significant increases were noted in cortical layers IV and V (P less than 0.025) in gallamine-treated animals. No significant changes (P greater than 0.05) in the number of binding sites were observed in the hippocampus, neostriatum or various thalamic nuclei. The ability of unlabeled pirenzepine, gallamine and carbamylcholine to inhibit 0.2 nM [3H]-( )-QNB binding also was measured to determine changes in the distribution of receptor subtypes. No significant changes were observed in any brain region for the binding of the selective antagonists pirenzepine and gallamine or the agonist carbamyl-choline. Although other possibilities are considered, the data suggest that an increase in the number of muscarinic receptors may contribute to the observed behavioral deficits associated with long-term gallamine treatment. PMID- 1777824 TI - The proliferative response of S-100 protein-positive glial cells to injury in the neonatal rat brain. AB - Astroglial proliferative response to unilateral injury of the cerebral hemisphere was studied in newborn rats using [3H]thymidine autoradiography combined with immunocytochemical staining for S-100 protein as an astroglial marker. The animals received [3H]thymidine at different intervals following injury and the distribution of double-labeled cells was recorded 4 h after each [3H]thymidine injection. The reactive proliferation of all cells within the investigated areas was detectable as early as about 2 h after injury. However, the quantitative increase in astroglial mitotic rate could be first detected on day 1 following the injury and the reactive changes were observed until day 8. They were regarded as evidence for the ability of astroglia to proliferate in response to injury in the neonatal brain. Since the astroglial divisions occurred mainly at the lesion site, the post-traumatic gliosis could be considered not only a result of astrocyte migration towards the lesion but also an effect of local mitotic activity. PMID- 1777825 TI - Electrophysiological study of the response of medial prefrontal cortex neurons to stimulation of the basolateral nucleus of the amygdala in the rat. AB - The neural connections from the basolateral nucleus of the amygdala (BLA) to the medial prefrontal cortex (MPC) in urethane-anesthetized rats were investigated. Extracellular recordings were made from 200 neurons with spontaneous firing in the MPC, and the BLA was electrically stimulated. The most frequent response to BLA stimulation was inhibition (63.5%). Excitatory responses were found in 17 units (8.5%), while 56 neurons (28%) did not change their spontaneous firing after BLA stimulation. Inhibitory responses showed a wide range of latencies, suggesting the coexistence of mono- and polysynaptic pathways. On the contrary, the excitatory responses seem to be mediated by a monosynaptic pathway. BLA projections to the MPC play a predominantly inhibitory role in the spontaneous activity of prefrontal neurons. This inhibition may modulate central motor systems and motivated behaviors. PMID- 1777826 TI - Atopic disease and food allergy. PMID- 1777827 TI - Domestic mites: their role in respiratory allergy. PMID- 1777828 TI - Nasal hyperreactivity: its pathogenesis and clinical significance. PMID- 1777829 TI - Relationships of haptoglobin level to FEV1, wheezing, bronchial hyper responsiveness and allergy. AB - The relationships of haptoglobin level to respiratory and allergic parameters have been assessed in an epidemiological study conducted in a working population surveyed twice 5 years apart. At the first survey conducted in 892 working men, haptoglobin level was significantly related to FEV1 (r = -0.18; P less than 0.001) and smoking habits. After adjustment for smoking, a history of wheezing was significantly related to lower haptoglobin level. A second survey conducted in 304 men of the original sample 5 years later confirmed that haptoglobin was related to FEV1 (r = -0.21; P less than 0.001) and that wheezing was significantly related to hypohaptoglobinaemia (lower decile; P = 0.04). Men who exhibited bronchial hyper-responsiveness to methacholine had haptoglobin levels 0.35 g/l higher than those who did not (P = 0.01). Haptoglobin level was unrelated to IgE level and skin prick tests. These results support the hypothesis of the role of inflammation in both lower lung function and bronchial hyper responsiveness. They suggest that some heterogeneity exists within subjects with a history of wheezing. PMID- 1777830 TI - The 40-kilodalton allergen of Candida albicans is an alcohol dehydrogenase: molecular cloning and immunological analysis using monoclonal antibodies. AB - To characterize the 40-kilodalton (kD) major allergen of Candida albicans (C. albicans), six monoclonal antibodies (MoAbs) against this allergen were generated. In SDS-polyacrylamide gel electrophoresis and immunoblot analysis, these MoAbs showed four different reaction patterns to antigens of six different Candida species. With the exception of one MoAb, other MoAbs were resistant to periodate treatment indicating non-carbohydrate epitopes were probably being recognized by these MoAbs. These MoAbs were used in the molecular cloning and immunological analysis of the gene coding for the 40-kD allergen. Nucleotide sequence determination of the two lambda gt11 cDNA clones obtained showed that the 40-kD allergen is an alcohol dehydrogenase (ADH) which shares a 70% amino acid sequence homology with the ADH isozyme I of Saccharomyces cerevisiae. This finding was confirmed by positive immunological response of the lysates of the clones obtained and a preparation of ADH of Saccharomyces cerevisiae to various MoAbs and to IgE antibodies in sera of allergic patients. PMID- 1777831 TI - Evaluation of a multiple food specific IgE antibody test compared to parental perception, allergy skin tests and RAST. AB - This study was set up to evaluate the food panel of a multiple specific IgE antibody assay in 67 atopic asthmatic children by comparing it to the conventional radioallergosorbent test (RAST) and skin-prick tests (SPT) and then comparing the results of these investigations with the parents' perceptions of food related problems. Fifteen food specific IgE antibodies were measured using the multiple chemiluminescence assay (MAST-CLA). IgE antibodies to five of these food allergens were also measured by conventional RAST and SPTs were performed in 43 using 11 standardized food extracts matched to the multiple allergosorbent chemiluminescent assay (MAST-CLA) profile. SPT and MAST-CLA results showed good agreement with one another, range 68.8-96.7% (average 87%), with significant correlation for most allergens tested. MAST-CLA was discrepant with RAST and/or SPTs in 58/210 (27.6%). A questionnaire was sent to the parents to determine their perception of food related symptoms. Sixty-two (92%) questionnaire replies were received, of which 56% reported symptoms with food. The most frequent symptom perceived to be due to food intolerance was behavioural disturbance. The commonest foods implicated were additives (39%), egg (27%), milk (26%), chocolate (23%) and orange (15%). History, SPT, MAST-CLA and RAST were compared for five allergens in 42 patients (210 values). In 14/210 (6.7%), all the tests were negative despite reported symptoms. Conversely in 49/210 (23.3%) at least one test was positive without symptoms. This study did not support a benefit of multipole testing instead of individually selected RASTs or SPTs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777833 TI - Reliability of respiratory symptoms to diagnose atopy. AB - As reliance of responses to epidemiological questionnaires on atopic symptoms is doubtful, we studied the predictive value of these questions relative to atopy, defined by the presence of serum specific IgE, taking into account some extraneous variables such as age and sex. The study population included 2067 adults, 20-60 years old. The protocol consisted of a standardized questionnaire and an evaluation of serum specific IgE using the Phadiatop (Pharmacia Diagnostics, Uppsala, Sweden) test. The predictive value of each symptom suggestive of atopy was quite low, but was much dependent on age and sex. Women more often than men reported atopic symptoms in the absence of atopy. Similarly, the predictive value of each symptom decreased with age. Thus atopic symptoms do not have the same value as predictors of atopy. These findings have both clinical and epidemiological important implications. PMID- 1777832 TI - Eosinophils, secretory responsiveness and glucocorticoid-induced effects on the nasal mucosa during a weak pollen season. AB - This study examined the seasonal effects on eosinophils and secretory responsiveness of the nasal mucosa in 22 patients with allergic rhinitis due to birch pollen (11 patients received placebo and 11 budesonide, 200 micrograms once daily in each nostril). The pollen counts during the study season were too low to produce a significant symptomatology. Hence, our findings demonstrate threshold alterations of the airway mucosa in allergic rhinitis and their inhibition by anti-inflammatory drug intervention. The patients were monitored for 8 weeks with daily recordings of pollen counts and symptom scores. Once every week a series of laboratory tests was carried out: the local eosinophil influx was determined using a Rhinobrush technique; the levels of eosinophil cationic protein (ECP) were analysed in nasal lavage fluids; and the secretory response to intranasal methacholine was measured. Treatments started after a 2-week run-in period. The proportion of eosinophils increased markedly in the placebo group and was elevated also during the last two study weeks when the pollen counts were practically nil. The secretory responsiveness to methacholine increased during the pollen season and returned to baseline towards the end of the study period. The topical glucocorticoid treatment reduced the proportion of eosinophils, the ECP levels, and the secretory response to methacholine compared to placebo. We conclude that the increased traffic and activity of eosinophils and less conspicuously the increased secretory responsiveness are expressions of the mucosal inflammation that precede the development of symptoms in seasonal allergic rhinitis. PMID- 1777834 TI - Cord serum IgE: an insensitive method for prediction of atopy. AB - Cord total serum IgE has been advocated as a screening test to detect infants at high risk of allergy who would be suitable for preventive measures. In a population based prospective study to look at the predictive capacity of cord IgE and family history of atopy 1111 one-year-old infants were followed-up. Cord IgE was measured using the EIA ultra technique (Pharmacia, Uppsala, Sweden). Atopic symptoms developed in 255 (23%) at one year, 183 (16.5%) had probable atopy (clinical disorder but negative skin prick test (SPT)) and 72 (6.5%) had definite atopy (clinical disorder with positive SPT). There was no difference in the mean cord IgE levels in infants with or without atopic manifestations. The cut-off for IgE was taken at 0.6 ku/1. The specificity of the test was 92% but the sensitivity was only 8.5%. The positive and negative predictive values were 24% and 78% respectively. Family history of atopy is far more sensitive in detecting infants at risk of atopy and little is added by knowledge of cord IgE. PMID- 1777836 TI - Homoeopathy and hayfever. PMID- 1777835 TI - TNF alpha mRNA expression in allergic inflammation. AB - Using the technique of in situ hybridization, we have attempted to identify messenger RNA for tumour necrosis factor-alpha (TNF alpha) in cells infiltrating allergen-induced late phase reaction (LPR) of the skin and the nose of atopic subjects. We have also compared the number of TNF alpha mRNA positive cells in bronchoalveolar lavage (BAL) from atopic asthmatics and normal controls. Twenty four hours after local allergen challenge, 12/14 skin biopsies and 9/10 nasal biopsies had positive hybridization signals for TNF alpha mRNA whereas only 4/14 and 2/10 biopsies were positive in the relevant diluent controls. Compared with diluent sites significantly increased numbers of cells expressing mRNA for TNF alpha were observed in the LPR of skin (P less than 0.004) and nose (P less than 0.006). All BAL from asthmatics (n = 10) and from normal volunteers (n = 10) had cells showing positive hybridization signals for TNF alpha mRNA but these were at increased frequency in asthmatics (P less than 0.001). These results suggest that TNF alpha may be an important cytokine in atopic allergic inflammation. PMID- 1777837 TI - Route of administration of adrenaline for the treatment of anaphylactic reactions to bee or wasp stings. PMID- 1777838 TI - Hayfever in the United Kingdom. AB - In the U.K. allergy to grass pollen is the single most important cause of seasonal allergic rhinoconjunctivitis (hayfever). The prevalence of the disease appears to be increasing, although the precise reasons for this are at present unknown. The introduction of non-sedating H1-selective antihistamine drugs and local corticosteroids has been an important therapeutic advance. Immunotherapy (desensitization) has a part to play in the treatment of hayfever unresponsive to anti-allergic medication but because of the danger of systemic reactions its use is limited to specialized centres. PMID- 1777839 TI - Evidence against the involvement of a cytochrome P-450 mechanism in pulmonary hemodynamics in the newborn pig. AB - Control mechanisms operating through a cytochrome P-450 system have emerged lately as a possible important determinant of pulmonary hemodynamics. Their action may be expressed in the adjustment of vascular tone under both physiologic and pathophysiologic conditions. One such condition is the pulmonary constrictor response to hypoxia. The identity of the effector agent, or agents, is not known, though there are data implicating monooxygenase products of arachidonic acid. From this premise, we wanted to evaluate the effect of cytochrome P-450 inhibitors on basal pulmonary vascular tone during normoxia, and their effect upon hypoxic pulmonary vasoconstriction response. Experiments were performed in an isolated, perfused lung preparation from 1- and 7-day-old piglets, and the effects of two cytochrome P-450 inhibitors (metyrapone and ketoconazole) were tested on the perfusion pressure. At 10(-5) and 10(-4) M, metyrapone caused a modest, but significant, increase in pulmonary pressure (p less than 0.05) in 7 day-old preparations, while it was without effect in the 1-day-old preparation. Similarly, ketoconazole at concentrations from 10(-6) M upwards increased the perfusion pressure in the older animal (p less than 0.01). Responses to the inhibitors were not seen in preparations that had been pretreated with a cyclooxygenase inhibitor (indomethacin, 2.8 x 10(-6) M) or a dual cyclooxygenase lipoxygenase inhibitor (BW755C, 10(-5) M). Hypoxic vasoconstriction was marginally enhanced by 10(-4) M metyrapone, while it was affected inconsistently by 10(-5) M ketoconazole. We conclude that vasoactive agents formed through cytochrome P-450 reactions have a minor role, or no role at all, in the control of pulmonary hemodynamics in the newborn pig. PMID- 1777840 TI - Rate of fatigue during repeated submaximal contractions of human quadriceps muscle. AB - Our purpose was to determine the effect of eight different combinations of contraction intensity, duration, and rest on the rate of fatigue in vastus lateralis muscle. A single combination consisted of contractions at 30 or 70% maximal voluntary contraction (MVC), held for 3 or 7 s with 3- or 7-s rest intervals. Contractions were repeated until the subject could not hold the force for the requisite duration. At regular intervals during each experiment, a brief MVC, a single twitch, and the response to eight stimulation pulses at 50 Hz were elicited. The rate of fatigue was the rate of decline of MVC calculated from regression analysis. Mean rate of fatigue (n = 8) ranged from 0.3 to 25% MVC/min and was closely related (r = 0.98) to the product of the relative force and the duty cycle. Force from 50 Hz stimulation fell linearly and in parallel with MVC. Twitch force was first potentiated and then fell twice as fast as 50 Hz stimulation and MVC (p less than 0.05). Differentiated twitch contraction and relaxation rates were higher at potentiation and lower at the limit of endurance, compared with control values (p less than 0.05). The maximal electromyogram decreased 25% and the submaximal EMG increased to maximal by the end of the protocol, indicating that the entire motor unit pool had been recruited. The close relation between rate of fatigue and the force x time product probably reflects the off-setting interaction of contraction amplitude, duration, and rest interval. This occurs despite the changes in twitch characteristics and the apparent recruitment of fast fatiguing motor units. PMID- 1777841 TI - Effects of tetanic stimulation on monosynaptic and dorsal root reflexes in kittens. AB - The effects of tetanic stimulation of peripheral afferents were examined on monosynaptic reflexes and dorsal root reflexes in kittens of various ages. Concomitantly recorded monosynaptic and dorsal root reflexes resulting from the stimulation of muscle nerves showed similar post-tetanic changes, namely, predominantly post-tetanic depression in neonates and post-tetanic potentiation in older kittens or adults. However, the changes in post-tetanic responses expressed as a percentage of control in dorsal root reflexes were much smaller than those in monosynaptic reflexes. When dorsal root reflexes originating from muscle and cutaneous afferents were compared, dorsal root reflexes from the latter behaved quite differently. For all ages, post-tetanic effects on dorsal root reflexes arising from cutaneous afferents were either insignificant or very small. The possible mechanisms underlying differences in post-tetanic effects from muscle and cutaneous afferents in adults and neonates are discussed. PMID- 1777842 TI - Bioavailability of aspirin and salicylamide following oral co-administration in human volunteers. AB - BC powder (I) is a commercially available analgesic containing the active ingredients aspirin and salicylamide. The kinetics of I, BC powder minus aspirin (II), and BC powder minus salicylamide (III) were evaluated in 13 volunteers. Ten minutes after administration of I, aspirin reached a maximum concentration of 12.9 micrograms/mL, while salicylamide concentration reached a peak value of 3.4 micrograms/mL. However, when III was administered, aspirin was not detected at 10 min and only reached a concentration of 0.4 microgram/mL at 2 and 6 h. Furthermore, the area under the plasma concentration versus time curve for aspirin when III was administered was sixfold less compared with treatment with I. The area under the curve for aspirin metabolites was significantly different in I versus III. After treatment with II, a delay in salicylamide peak concentration was observed. Gentisamide was not detected throughout the study. This study demonstrates that salicylamide significantly enhances plasma levels of aspirin with potential therapeutic implications. PMID- 1777843 TI - A north-temperate migratory bird: a model for the fate of lipids during exercise of long duration. AB - Changes in deposition and the utilization of lipids during one night of migratory activity (nocturnal physical activity) were investigated in dark-eyed Juncos (Junco hyemalis) held in large outdoor aviaries. During vernal migration (May), captive Juncos were sampled at the beginning and conclusion of one night of nocturnal restlessness. Comparisons of variables were drawn with control samples collected from birds in March. Measurements included body weight, fat stored in subcutaneous depots (adiposity), adipose and muscle lipoprotein lipase activity, and fat cell lipolysis. During the migratory period, body weight and adiposity were increased over levels measured in the March birds (p less than 0.01). On the other hand, neither body weight nor adiposity were significantly altered as a result of nocturnal physical activity and no significant changes were observed in adipose lipoprotein lipase activity. Fat cell lipolysis was lower at the beginning than at the end of nocturnal physical activity while, the opposite was observed for muscle lipoprotein lipase activity (p less than 0.05). These results suggest that the amount of work of one night of nocturnal physical activity modifies both muscle lipoprotein lipase activity and fat cell lipolysis in an interrelated fashion. This phenomenon could act to direct a steady supply of fatty acids to the site of energy utilization, i.e., flight muscles. PMID- 1777844 TI - Nitric oxide may be the final mediator of nonadrenergic, noncholinergic inhibitory junction potentials in the gut. AB - This study tested the hypothesis that the final mediator of nonadrenergic, noncholinergic (NANC) inhibitory junction potentials (ijps) and associated relaxation responses was nitric oxide (NO) or a related substance and not vasoactive intestinal polypeptide (VIP). We used opossum esophagus body circular muscle and canine intestine circular muscle. In both these tissues, ijps had reversal potentials near the potassium equilibrium potential, (EK); in esophagus the ijps were apamin insensitive, but in the intestine they were partially apamin sensitive. N omega-Nitro-L-arginine methyl ester (NAME) (10(-5) to 5 x 10(-4) M) abolished ijps in both tissues, an effect overcome by 10(-3) M L-arginine but not D-arginine. NAME increased input resistance of esophagus tissues in the double sucrose gap but caused no significant depolarization in the sucrose gap or in studies with microelectrodes. Contractions and basal tension were increased in both tissues by NAME. The apamin sensitive and insensitive ijp components in canine muscle were both abolished by NAME, but the time course of this abolition was different for the two components. Methylene blue (10-50 microM) with variable rapidity and extent inhibited ijps in both tissues, but L-arginine could not overcome this effect. Methylene blue, like NAME, did not depolarize detectably but enhanced the contractile activity. VIP (10(-6) M) had very small effects in both tissues, little or no hyperpolarization and increased input resistance in esophagus, these effects were not changed by NAME, and VIP did not affect ijps. We conclude that NO may be the final mediator of NANC-initiated inhibitory junction potentials in gastrointestinal circular smooth muscle. PMID- 1777845 TI - Protective effects of ceruloplasmin against electrolysis-induced oxygen free radicals in rat heart. AB - The potentially injurious effects of oxygen-derived free radicals (OFR) on the myocardium can be prevented in part by pretreatment with OFR scavengers or antioxidants. Since ceruloplasmin (CP) has been shown to possess potent antioxidant activity and scavenge a variety of OFR in vitro, we have undertaken to study its protective effects against myocardial injury induced by OFR. CP was freshly purified by a fast method that minimized proteolytic enzyme degradation. Free radicals were generated by the electrolysis (10 mA DC current for 1 min) of a Krebs-Henseleit solution perfusing an isolated rat heart preparation under constant pressure conditions. CP (0.25 microM) afforded 80 and 63% protection (n = 8, p less than 0.05), respectively, against the deleterious effects of electrolysis-induced OFR on left ventricular pressure and coronary flow. The increase in left ventricular end diastolic pressure used here as an index of heart failure did not occur in the presence of 0.25 microM CP. Moreover, CP significantly reduced the increase of norepinephrine washout in the effluent perfusate after electrolysis suggesting a protection against free radical-induced injury to sympathetic nerve endings. PMID- 1777846 TI - Interleukin-6 is a centrally acting endogenous pyrogen in the rat. AB - Intracerebroventricular (i.c.v.) injection of human recombinant interleukin-6 (IL 6; 20-100 ng) caused significant increases in colonic temperature and resting oxygen consumption (VO2) in conscious rats. These effects were prevented by pretreatment with a cyclooxygenase inhibitor (flurbiprofen, 1 mg/kg, i.p.) or a corticotrophin-releasing factor antagonist (alpha-helical CRF9-41, 25 micrograms, i.c.v.). Higher doses of IL-6 (i.c.v.) caused only small changes in VO2 and temperature, and very high doses given intravenously (i.v.) (4 micrograms/kg) were required to stimulate these parameters. Central injection of anti-rat IL-6 antibody inhibited the effects of interleukin-1 beta (i.c.v.) or endotoxin injection (i.p.) on colonic temperature and VO2 in conscious rats. These data indicate that IL-6 is an important endogenous pyrogen that acts within the central nervous system. PMID- 1777847 TI - Failure of oxygen radical scavengers to modify fatigue in electrically stimulated muscle. AB - We used in situ gastrocnemius muscle of anaesthetized dogs to test the hypothesis that O2 radical production during muscle contraction contributes to fatigue. Muscle tension was measured with a force transducer and blood flow was monitored with an electromagnetic flow probe. Muscle contractions were produced by stimulating the nerve for 15 min at 20 Hz, 12 trains/min, and a duty cycle of 0.25. Three groups of seven animals were given an infusion of 0.2 mL.min-1 of either saline, low-dose oxygen radical scavengers (250 IU.mL-1 superoxide dismutase, 640 IU.mL-1 polyethylene glycol (PEG)-catalase, 0.25 mg.mL-1 deferoxamine, and 0.1 mg.mL-1 oxypurinol), or high-dose oxygen radical scavengers (3300 IU.mL-1 superoxide dismutase, 6600 IU.mL-1 PEG-catalase, 2.5 mg.mL-1 deferoxamine, and 0.1 mg.mL-1 oxypurinol). Blood flow and vascular resistance of the gastrocnemius muscle during stimulation did not differ among groups. After 15 min of stimulation, the developed tension (represented as a percentage of initial tension developed) was 66 +/- 7% in the saline treated group, 70 +/- 6% in the low-dose group, and 70 +/- 4% in the high-dose group. The change in tension during recovery was not significant in the control or low-dose groups. However, there was partial recovery in the high-dose group. In conclusion, in this preparation, oxygen radical scavengers did not delay the development of decreased muscle tension. PMID- 1777848 TI - Attentional factors in visual field asymmetries. AB - Over the past 30 years, numerous studies have reported left/right asymmetries in visual field performance, with performance generally superior in the right visual field for verbal tasks and in the left visual field for spatial tasks. These asymmetries parallel those found in neurological studies of hemispheric specialization. Consequently, many investigators have concluded that visual hemifield differences are primarily a reflection of the functional differences between the two cerebral hemispheres. However, alternative explanations proposing that visual field effects are dependent on other factors such as inadequate fixation, eye movements during presentation, postexposural scanning, and attentional biases have been offered. The potential impact of each of these factors on visual field differences are reviewed and discussed. Evidence is provided suggesting that attention and hemispheric functional differences interact to produce the magnitude and direction of visual field differences. PMID- 1777849 TI - Concurrent language and motor performance in bilinguals: a test of the age of acquisition hypothesis. AB - The objective of the present study was to test the hypothesis that the age at which a second language is acquired influences the pattern of cerebral lateralization associated with that language. Subjects who differed in terms of the age at which they had acquired their second language (English or French) were tested on a concurrent task paradigm involving motor and language performance. Hemispheric processing was inferred from the pattern of lateralized and generalized interference between the tasks. No support was found for the age-of acquisition hypothesis. Instead, the data indicated a language-specific effect. Regardless of age of acquisition and of whether the first language was English or French, bilingual subjects showed lateralized interference effects consistent with left-hemisphere processing when reading in English and translating from French into English, but no lateralized interference when reading in French and translating from English into French. Whether this effect reflects characteristics of the two languages or the influence of social factors in subject-experimenter interaction is considered. PMID- 1777850 TI - Sex differences in human brain size and the general meaning of differences in brain size. AB - Contrary to commonly held convictions, there is no clear association between brain size and body parameters in humans. Within sexes, once age and health status are controlled for, there is no significant association between brain size and body height for females. For males, body height accounts for no more than .04% of the variance in brain size. The relation between brain weight and body weight is even less clearly defined. Nevertheless, there are large and significant differences in brain size between the sexes. If no adequate body parameters can be found that scale to brain size within the sexes, the marked dimorphism between males and females makes it even more difficult to find a common set of parameters that allow evaluation of brain size differences between sexes. Within and across sexes, there is no convincing link between a limited measure of behavioural capacity (IQ) and brain size. This leads to the more general question: Why would one expect such a link, and, if it is not found, what does this mean in the context of general theories of cortical function? PMID- 1777851 TI - Growth characteristics and expression of iron-regulated outer-membrane proteins of chemostat-grown biofilm cells of Pseudomonas aeruginosa. AB - An in vitro chemostat system was used to study the growth and the expression of iron-regulated outer-membrane proteins (IROMPs) by biofilm cells of Pseudomonas aeruginosa cultivated under conditions of iron limitation. The population of the planktonic cells decreased when the dilution rate was increased. At a dilution rate of 0.05 h-1, the populations of planktonic cells of both mucoid and nonmucoid P. aeruginosa were 3 x 10(9) cells/mL. This value dropped to 5 x 10(6) cells/mL when the dilution rate was increased to 1.0 h-1. The reverse was observed for the biofilm cells. The number of biofilm cells colonising the silicone tubing increased when the dilution rate was increased. The number of biofilm cells of the mucoid strain at steady state was 2 x 10(8) cells/cm (length) when the dilution rate was fixed at 0.05 h-1. The figure increased to 8 x 10(9) cells/cm when the dilution rate was increased to 1.0 h-1. The population of biofilm cells of the nonmucoid strain was 9 x 10(7) cells/cm (length) when the dilution rate was 0.05 h-1. It increased to 2 x 10(9) cells/cm when the dilution rate was set at 1.0 h-1. The expression of IROMPs was induced in the biofilm cells of both mucoid and nonmucoid strains when the dilution rates were 0.05 and 0.2 h-1. IROMPs were reduced but still detectable at the dilution rate of 0.5 h 1. However, the expression of IROMPs was repressed when the dilution rate was increased to 1.0 h-1. The data suggest that the biofilm cells of P. aeruginosa switch on the expression of IROMPs to assist iron acquisition when the dilution rate used for the chemostat run is below 0.5 h-1. The high affinity iron uptake system is not required by the biofilm cells when the dilution rate is increased because the trace amount of iron present in the chemostat is sufficient for the growth of adherent biofilm cells. PMID- 1777852 TI - Colicins G and H and their host strains. AB - Escherichia coli strains CA46(pColG) and CA58(pColH) each apparently synthesized two generally similar bactericidal colicin proteins whose molecular weights were approximately 5,500 and 100,000. These proteins were more resistant to trypsin than representative colicins A, D, E1, and V. The smooth wild-type strains harbouring plasmids pColG and pColH were serotyped O169:NM and O30:NM, respectively, being typically associated with nonpathogenic E. coli of human origin. Rough and semirough variants, which were selected using resistance to novobiocin, were intrinsically insensitive to almost as many colicins (10 tested) as their parents. For this reason the wild-type strains would not be useful for identifying colicins G and H on the basis of immunity. The O antigenic side chains of both wild-type strains shielded three of the six bacteriophage protein receptors tested. PMID- 1777853 TI - Serine proteinase of Renibacterium salmoninarum digests a major autologous extracellular and cell-surface protein. AB - Renibacterium salmoninarum is a pathogen of salmonid fish that produces large amounts of extracellular protein (ECP) during growth. A proteolytic activity present in ECP at elevated temperatures digested the majority of the proteins in ECP. This digestion was also associated with the loss of ECP immunosuppressive function. In vitro activity of the proteinase in ECP was temperature dependent: it was not detected in an 18-h digest at 4 and 17 degrees C but became readily apparent at 37 degrees C. Proteinase activity was detected at bacterial physiological temperatures (17 degrees C) in reactions incubated for several days. Under these conditions, digestion of partially purified p57, a major constituent of ECP and a major cell-surface protein, yielded a spectrum of breakdown products similar in molecular weight and antigenicity to those in ECP. This pattern of digestion suggests that most of the immunologically related constituents of ECP are p57 and its breakdown products. The proteolytic activity was sensitive to phenylmethylsulfonyl fluoride, methanol, and ethanol and to 10 min incubation at temperatures above 65 degrees C. Electrophoretic analysis of the proteinase on polyacrylamide gels containing proteinase substrates indicated the native form to be 100 kDa or greater. The enzyme was active against selected unrelated substrates only when coincubated with a denaturant (0.1% lauryl sulfate) and (or) a reducing agent (20 mM dithiothreitol). PMID- 1777854 TI - Purification, characterization, and biological effects of a second bacteriocin from Enterococcus faecalis ssp. liquefaciens S-48 and its mutant strain B-48-28. AB - Enterococcus faecalis ssp. liquefaciens S-48 (producer of the peptide antibiotic AS-48) and its mutant B-48-28 (AS-48-) secrete the bacteriocin Bc-48. This substance has been purified to homogeneity from culture supernatants of strain B 48-28; it consists of a protein (80 kDa) stable from pH. 5.5 to 9.0 and sensitive to temperatures above 45 degrees C and to proteases. Its inhibitory spectrum is restricted to strains of Enterococcus faecalis. Bc-48 inhibits protein synthesis but does not affect amino acid uptake. A partial reduction of cell viability, together with autolysis, is also observed. Bc-48 differs from peptide AS-48 in both its molecular properties and mode of action. PMID- 1777855 TI - Reversibility of oxygen switch-off effect on Bacillus polymyxa nitrogenase. AB - The objective of this study was to analyse in vivo the effect of oxygen on the nitrogenase of Bacillus polymyxa. The culture technique employed in this study prevented spore formation by B. polymyxa during the entire period of exposure to acetylene. Under these conditions the acetylene-reduction assay allowed quantification of nitrogenase activity over long incubation periods (44 h). Nitrogenase activity was highest in cells harvested in the late logarithmic phase. At PO2 of 0.19 and 0.37 kPa, acetylene reduction was inhibited by 80 and 100%, respectively. This switch-off effect could be reversed through oxygen exhaustion, either by flushing the culture with N2 or by cellular respiration, suggesting a respiratory protection mechanism for the nitrogenase complex in B. polymyxa. Oxygen consumption measured by a closed-chamber respirometer showed a linear increase up to a PO2 of 0.2 kPa. Above 0.3 kPa a saturation in oxygen consumption was observed. Exposure to high oxygen pressures resulted in an irreversible loss of nitrogenase activity. The oxygen inhibition pattern was shown to be similar to that in other microaerophilic and anaerobic nitrogen fixing microorganisms. PMID- 1777856 TI - Survival and injury of Escherichia coli, Campylobacter jejuni, and Yersinia enterocolitica in stream water. AB - Experiments were done to describe the survival and injury of three strains each of enteropathogenic Escherichia coli, Yersinia enterocolitica, and Campylobacter jejuni in agricultural surface water. Bacterial suspensions within membrane diffusion chambers were immersed in two large vessels of stream water that were held at 6 and 16 degrees C and changed daily. The results of daily plate counts, using selective and nonselective media, revealed some variation among strains and genera. Injury increased rapidly in all of the bacteria examined during an initial 4-day period of population stability. Bacterial persistence was generally prolonged at 6 degrees C, while the occurrence of injury was directly related to temperature. However, both survival and injury in C. jejuni were less dependent on temperature, while Y. enterocolitica displayed the greatest survival at both 6 and 16 degrees C. These results suggest that surface water in the temperate zone might serve as a persistent vehicle for the transmission of these enteropathogenic bacteria between animals and humans. PMID- 1777857 TI - The biotransformation of tranylcypromine by Cunninghamella echinulata. AB - When incubated alone for 7 days with the fungus Cunninghamella echinulata, tranylcypromine was extensively metabolized. As observed in mammalian systems, N acetyltranylcypromine was the major metabolite recovered along with lesser amounts of 4-hydroxytranylcypromine, as its N,O-diacetyl derivative. The rate and extent of tranylcypromine biotransformation was affected by whether incubation was on either 30 degrees or flat brackets with a gyratory shaker. There is a strong association between the rate of biotransformation and the utilization of glucose, formation of ammonia, and pH. The slowest rates of biotransformation and metabolic response were observed with the large fungal pellets formed during incubation on flat brackets. These findings raise the possibility that, as in mammalian systems, fungal metabolism of xenobiotics can be affected by nutrient and environmental conditions. PMID- 1777858 TI - Optimal growth temperature for the isolation of Plesiomonas shigelloides, using various selective and differential agars. AB - The growth characteristics of known strains of Plesiomonas shigelloides were compared with those of Aeromonas species (the major competing species in environmental waters) on plesiomonas differential agar, inositol brilliant green bile salt, and modified salmonella-shigella agar at incubation temperatures of 37, 42, and 44 degrees C. Using local isolates from clinical and environmental sources, optimal growth conditions, as determined by colony counts and the colony characteristics, plesiomonas differential agar proved to be ideal when incubated at 44 degrees C. Contrary to earlier recommendations for 48 h incubation, the colonies could be recognized readily after an incubation of 24 h. PMID- 1777859 TI - Intracellular location of enzymes involved in citrate production by Aspergillus niger. AB - The intracellular distribution and maximal activities of nine enzymes involved in the biosynthesis and degradation of citric acid in Aspergillus niger were determined under conditions of growth and of citric acid production. Under these conditions the intracellular location of the enzymes in most cases resembled that described for other filamentous fungi. Pyruvate carboxylase was found predominantly or exclusively in the cytosol. A single isoenzyme of NADP isocitrate dehydrogenase was present, which appeared to be localised in the mitochondrion. No significant differences in maximal enzyme activities were observed except for NADP-isocitrate dehydrogenase, which showed decreased activity in production-phase mycelia. The results obtained support the scheme proposed by C.P. Kubicek for the intracellular organisation of citric acid formation but provide little evidence that this process is controlled at the level of the biosynthesis of any of the enzymes examined here. PMID- 1777860 TI - Susceptibility of congenitally immunodeficient mice to a nonencapsulated strain of Cryptococcus neoformans. AB - The susceptibility of congenitally immunodeficient mice to a nonencapsulated strain of Cryptococcus neoformans (strain M7) was evaluated. Gnotobiotic mice with defined congenital defects in innate immunity (beige) or cell-mediated immunity (athymic) or with combined defects in innate and cellular immunity (beige athymic) were i.v. challenged with C. neoformans M7. The nonencapsulated strain of C. neoformans produced a persistent low-grade infection in the brains of all immunodeficient and immunocompetent mice used in this study. Immunocompetent mice (nu/+;bg/+) and immunodeficient bg/bg mice readily cleared nonencapsulated cryptococci from their kidneys, liver, lungs, and spleen. In contrast to nu/+ mice, nu/nu mice had a reduced capacity to clear nonencapsulated cryptococci from their kidneys and liver after i.v. challenge. Both bg/bg-nu/nu and bg/bg-nu/+ mice developed a low-grade infection in their kidneys, liver, lungs, and spleen, which was maintained throughout the 21-day study. Persistent infections were not due to reversion to an encapsulated state. These data indicate that a capsule may not always be necessary for C. neoformans to survive, in vivo, in tissues of immunodeficient and immunocompetent mice. PMID- 1777861 TI - Changes in rates of synthesis of individual proteins in a psychrophilic bacterium after a shift in temperature. AB - In the psychrophilic bacterium Vibrio sp. strain ANT-300, which has the ability to grow efficiently between 13 and -2 degrees C, with an optimum at 7 degrees C, cells in steady-state growth at 0 and 13 degrees C appeared to exhibit different patterns in the levels of certain individual proteins. With a shift in temperature, the steady-state level of individual proteins was achieved only after dramatic transient changes in the rates of synthesis of a small number of those proteins whose levels would be adjusted. Upon a shift up from 0 to 13 degrees C, the rates of synthesis of at least 25 proteins increased transiently, while increased rates of synthesis of 39 proteins were induced immediately upon a shift down from 13 to 0 degrees C. The proteins of which the levels would be adjusted were synthesized at differential rates, which varied conspicuously with respect to timing after the shifts in temperature. Such changes appear to be active regulatory responses to changes in temperature. PMID- 1777862 TI - A zinc-binding protein in a metal-resistant strain, Alcaligenes eutrophus CH34. AB - Synthesis of a zinc-binding protein was induced when Alcaligenes eutrophus CH34 was grown in the presence of high concentrations of zinc (2.3 mM). The zinc binding protein has a low content of cysteine and a high content of acidic amino acids and, thus, differs from metallothionein. PMID- 1777863 TI - Assessment of two commercial agglutination kits for detecting Escherichia coli heat-labile enterotoxin. AB - Two commercial agglutination kits, a reserved passive agglutination test (VET RPLA) and a staphylococcal coagglutination test (Phadebact ETEC-LT Test), were compared with two cell culture assays (Y-1 and Vero) and GM1 ganglioside enzyme linked immunosorbent assay (GM1-ELISA) for sensitivity in detecting Escherichia coli heat-labile enterotoxin (LT). Of 48 toxigenic strains, 23 were positive by all assays. One strain was negative only by the Phadebact test. Four strains, all LT-II producers, were positive by cell culture only. For LT-I detection, the Phadebact test was the least sensitive but was simple and rapid; VET-RPLA was simple, sensitive, and a good substitute for cell culture or GM1-ELISA. PMID- 1777864 TI - Polyamine distributions in the Falvobacterium-Cytophaga-Sphingobacterium complex. AB - Homospermidine was found as the major polyamine in one newly described species of Flavobacterium (F. indologenes), in three species of Sphingobacterium (S. mizutae, S. multivorium, and S. spiritivorum), and in 10 species of Cytophaga (C. aquatilis, C. arvensicola, C. heparina, C. hutchinsonii, C. johnsonae, "C. keratolytica," C. lytica, C. marinoflava, C. uliginosa, and "C. xantha"). These bacteria also all contain putrescine and agmatine as minor components. Flavobacterium indologenes and C. johnsonae contain an unusual diamine, 2 hydroxyputrescine, as a major polyamine. The polyamine distributions of four other species originally included in Flavobacterium (F. acidurans, "F. dormitator," "F. tirrenicum," and Halomonas halmophila), whose taxonomic positions are or were uncertain, were different from the group mentioned above. They either contain spermidine as the major polyamine or lack any polyamine. These results suggest that homospermidine can serve as a chemotaxonomic marker to delineate true members of the Flavobacterium-Cytophaga-Sphingobacterium complex. PMID- 1777865 TI - History of the early development of electroencephalography and clinical neurophysiology at the Montreal Neurological Institute: the first 25 years 1939 1964. PMID- 1777866 TI - Development of surgical therapy of epilepsy at the Montreal Neurological Institute. AB - Wilder Penfield's development of surgical methods for treating focal cerebral seizures, beginning with his early work in Montreal in 1928, is reviewed. The reliance on seizure pattern and focal brain pathology was enormously enhanced by the advent of EEG and direct electrical recording from the cortex during surgery. The recognition in the early 1950's of mesial temporal structures in the pathogenesis of temporal lobe epilepsy with automatism lead to more rational and successful surgical treatment. Positron emission tomography and especially magnetic resonance imaging have recently added to the essential diagnostic information of focal epilepsy provided by EEG. PMID- 1777867 TI - Preoperative electroencephalographic investigation in temporal lobe epilepsy: extracranial and intracranial recordings. AB - Preoperative EEG investigations of patients with temporal lobe seizures include extracranial interictal and ictal recordings during wakefulness and sleep, including long-term EEG and video-monitoring. Interictal epileptiform discharges when evaluated conservatively and in conjunction with other EEG and non-EEG localizing information, provide valuable guidance for the identification of the area to be resected, as do ictal recordings. When extracranial EEG features in conjunction with non-EEG data provide conflicting localizing information, intracranial recordings with stereotaxically implanted depth and epidural electrodes are used. Intracranial recordings must be designed to avoid biasing the exploration strategy in favor of one's preferred localizing hypothesis. Patients with evidence for bitemporal epileptogenic dysfunction in extracranial EEG recordings are suitable candidates for intracranial recordings. The majority of the patients explored in this manner show that all or more than 80% of their seizures arise from one temporal lobe. Excision of that lobe yields satisfactory results in a fair proportion of these patients. The number of satisfactory outcomes is however, still somewhat less than in patients with unilateral temporal foci in extracranial EEG recordings. PMID- 1777869 TI - Preoperative electroencephalographic localization of large epileptogenic zones in the frontal and temporal lobes. AB - The concept of epileptogenic zone is defined as a large area of cortical neurons arranged in concentric circles of variable degrees of epileptogenicity. This is particularly so in frontal lobe epilepsy since the interictal and ictal epileptic abnormalities are poorly localized, often absent and at times misleading in terms of localization. In temporal lobe epilepsy, the epileptogenic zones may be more restricted. PMID- 1777868 TI - Preoperative electroencephalographic investigation in frontal lobe epilepsy: electroencephalographic and electrocorticographic recordings. AB - The first section of this article deals with specific anatomic and pathophysiologic factors which contribute to a poor EEG localization of the interictal epileptic abnormality and to the unreliable seizure onset localization commonly reported in patients with frontal lobe epilepsy. The localizing effectiveness of long term EEG monitoring was reviewed in four different groups of frontal lobe epileptic patients who underwent preoperative EEG investigation with extracranial and intracranial electrodes. The results of this study reveal a continuum distribution of interictal epileptic disturbances, ranging from focal abnormalities to lobar or multi-lobar epileptogenesis. A frontal lobe localization of the seizure generator based on ictal recordings obtained with extracranial electrodes is rather poor and much more reliable results can be obtained by depth-electroencephalography. PMID- 1777870 TI - [Introduction to the clinical study of postrolandic epileptic seizures]. AB - We reviewed, in 145 epilectics studied with SEEG, 800 clinical and electrographic seizures originating from the post-rolandic areas (590 spontaneous Sz and 260 induced by stimulation). The intra-cranial electrodes were implanted using a technique described by Talairach et al. (1974). Seizure onsets were recorded in the centro-parietal region (64 patients) in the parietal and in the occipital region. Additionally in 15 patients, mixed Sz onset were recorded. One hundred and eight (108) patients underwent surgical removal of their epileptic focus. (69 on the right, 39 on left.) 65% were cured (Sz free or occas Sz, f/up 3 years). The main ictal cal features are discussed. Emphasis is placed on the role of the operculo-insular cortex in the functional organization in man, based on Sz arising from the supra-temporal (fronto-pariental) cortex. The study of the pattern of onset and spread of seizures originating in the post-rolandic areas and of their clinical correlates allow a topographic differential diagnosis. PMID- 1777871 TI - Localization of epileptic foci in children. AB - Electroencephalographic and neuro-imaging data were correlated with the lobe of cortical resective surgery among 48 patients age 16 years or less with medically intractable partial seizures. Decisions about surgery were determined by clinical judgement and therefore our results reflect the weight of these factors in clinical practise. Neuro-imaging disclosed a lesion over the operated lobe in 32 patients (67%). Multiple EEGs demonstrated a most active spike focus over the operated lobe in 32 patients (67%). Although only 34 patients had a recorded seizure, this clearly arose over the operated lobe in 23 (68% of the 34 patients; 48% of series). Persistent focal delta activity appeared in 20 of the 48 patients (42%). No instance was encountered in which false lateralization of regional or focal interictal EEG spikes or delta when normal apiculate phenomena were excluded. Thus, the scalp EEG remains a valuable guide to epileptogenesis, even among young patients, and should continue to play a major role in determining the region of cortical resection. Effectiveness of cortical resection for seizure control was clearly better among patients with a single major lesion and among those with normal intelligence. PMID- 1777872 TI - Relationships between interictal spiking and seizures: human and experimental evidence. AB - Epileptic seizures of focal origin often occur unpredictably as do interictal spikes. It is often assumed that spikes increase prior to seizures of focal origin and that antiepileptic medication affects spikes and seizures in a parallel fashion. We review evidence that this assumption is invalid and that there is a clear dissociation between spikes and seizures: increases in spiking before seizures have not been clearly documented; decreases in antiepileptic medication do not result directly in increased spiking; seizures are often followed by long-lasting increases in spiking; finally, seizures are no more likely when spikes are frequent than when spikes are rare. It therefore appears that spikes and seizures are two quite distinct phenomena, both originating in the epileptic focus but varying over time differently from what is most often believed. PMID- 1777873 TI - Electroencephalography, magnetic resonance imaging and pathology in patients treated surgically for temporal lobe epilepsy. AB - In a consecutive series of 40 patients selected by EEG studies for surgical treatment of temporal lobe seizures, magnetic resonance imaging showed structural lesions in 25% and signal abnormalities, usually in the mesial temporal region, in another 35%. Pathological changes included structural lesions in over 30% of patients and sclerosis of the amygdala in almost half of the series. These findings further substantiate the implication of the amygdala in the pathogenesis of temporal lobe seizures with automatism and amnesia. PMID- 1777874 TI - Neuronal migration disorders: a contribution of modern neuroimaging to the etiologic diagnosis of epilepsy. AB - Computed tomography and magnetic resonance imaging enable the identification of neuronal migration disorders during life. Several specific syndromes have been identified and early diagnosis of previously unrecognized entities is now possible. We report 51 patients with imaging. Thirty-two had a single widespread cortical dysplastic lesion. Twenty-eight had focal corticectomies. From a pathological standpoint, these encompassed focal cortical dysplasia (14 cases) and forme fruste of tuberous sclerosis (10 cases). These two groups of patients were indistinguishable from the clinical and radiological standpoint. In only two was the MRI examination normal. In addition, there were 10 with bilateral perisylvian dysplasia, four with diffuse cortical dysplasia or the "double cortex" syndrome, three with hemimegalencephaly, one with megalencephaly, and one with nodular neuronal heterotopia. The electroclinical and imaging findings led to the development of specific surgical strategies for the alleviation of the intractable seizures in each of these radiologically-defined syndromes. PMID- 1777875 TI - PET scanning in partial epilepsy. AB - Many biologically active tracers are available for positron emission tomography (PET) investigations, but most studies of epilepsy have utilized 18F fluorodeoxyglucose (FDG) to measure local cerebral metabolic rate for glucose. Over 70% of patients with medically refractory partial seizures demonstrate an interictal zone of hypometabolism corresponding to the epileptogenic region. This metabolic defect commonly involves the temporal lobe in patients with complex partial seizures of mesial temporal origin, and is encountered less consistently with seizures of extratemporal neocortical origin. Although false localization is less likely with FDG-PET than with EEG, the hypometabolic zone merely reflects a focal functional deficit and its epileptogenicity must still be demonstrated electrophysiologically. When hemispherectomy or large multilobar resections are planned in small children, FDG-PET also provides useful supporting evidence that the contralateral hemisphere is functioning normally. It is difficult to obtain FDG-PET scans and to interpret results during spontaneous partial seizures. Ictal scans can be more easily obtained with single photon emission computed tomography (SPECT), which may provide information for planning surgical resections. PMID- 1777876 TI - Temporal lobe surgery for epilepsy: neuropsychological variables related to surgical outcome. AB - A retrospective study of 383 patients who had undergone either left or right anterior temporal lobectomy (varying with respect to the amount of hippocampus excised) revealed that there were no significant differences in surgical outcome between those patients having a large and those patients having a small hippocampal removal. Although left temporal-lobe excisions were significantly smaller than right temporal-lobe excisions, both medially and laterally, patients with left temporal-lobe removals had an overall better surgical outcome. Patients in the successful surgical-outcome group did better than the unsuccessful surgical-outcome group on a variety of cognitive measures, including tests of intelligence, delayed verbal memory, and verbal fluency. The results suggest that, for many patients with medically intractable epilepsy, an anterior temporal lobectomy including the amygdala may suffice to reduce their seizure frequency. PMID- 1777877 TI - Relative localizing value of common tests used in the preoperative investigation of epileptic patients. AB - We have compared the relative localizing value of common tests in the presurgical evaluation of epilepsy in 73 patients with depth electrode (SEEG) confirmed epileptogenic foci and excellent surgical outcome. We found the tests of abnormality (CT, amytal, neuropsychology) to be frequently non-informative and often discordant with SEEG. The EEG was concordant with the SEEG in 38% of cases and provided lateralization in 78%. EEG was less localizing than ictal behavior in frontals but not in temporals. The need for SEEG is rather evident in these results but could become attenuated by the development of the localizing power of scalp EEG. PMID- 1777878 TI - Temporal lobectomy: review of 100 cases with major hippocampectomy. AB - One hundred consecutive patients between 1961 and 1980, with temporal lobectomy including excision of half or more of the hippocampal formation, have been analyzed for degree of reduction of seizures. Thirty-nine percent have become and remained seizure free for follow-up period of 2 to 24 years (median 12 years). Another 24 patients achieved a marked reduction in seizure tendency as defined in the report and 25 showed a lesser degree of improvement. In fifteen patients no change in seizure frequency was recorded. Thus in this series of 100 patients, a complete or marked reduction of the seizure tendency was achieved in 63%. PMID- 1777879 TI - Temporal lobectomy with amygdalectomy and minimal hippocampal resection: review of 100 cases. AB - The evidence for the role of the amygdala in temporal lobe seizures is supported by this follow-up (2-20 years) of 100 patients who were treated surgically by excision of the antero-lateral temporal cortex, most or all of the amygdala and minimal resection of the hippocampus. The findings showed 53 patients seizure free or with rare or occasional seizures, 10 patients with marked seizure reduction and 37 with moderate or less reduction of seizures. The results are the same as in another 100 patients where, in addition, half or more of the hippocampus was resected. PMID- 1777880 TI - Tailoring of cortical excisions for frontal lobe epilepsy. AB - Follow-up data of 2 to 49 years' duration are presented on 257 patients with cortical excisions for non-tumoral frontal lobe epilepsy. Twenty-six percent have become and remained seizure free. Another 30% have had a marked reduction of seizure tendency. Thus a total of 56% have had a long term complete or marked reduction of seizure tendency after the cortical resection. The cortical resections were classified into 5 regional categories. Forty-seven percent of patients with anterior frontal resections were in the seizure free category, as were 35% of patients with excisions limited to the convexity cortex and 32% of patients with maximal or near maximal frontal lobectomy. Only 18% of patients with frontal parasaggital excisions were in the seizure free category, and 10% of the patients who had excision of frontal cortex plus limited excision of adjacent central and/or temporal cortex. PMID- 1777881 TI - Surgery for central, parietal and occipital epilepsy. AB - Patients with epileptogenic lesions that are more or less restricted to the central, parietal or occipital regions represent 14% of our total epilepsy surgery series and consisted of 322 patients at the end of 1980. Tumoral or major vascular lesions were present in 117 patients (37%), but this report is limited to the remaining 203 patients (63%) with non-tumoral epileptogenic lesions. The presumed etiology was birth trauma or anoxia in 25%, postnatal brain trauma in 25%, and unknown in 24%, miscellaneous lesions were present in 16%, post inflammatory gliosis or multiple factors were present in the remaining 10%. Follow-up data of 2-51 years' duration (median 18 years) are available for 186 of these 203 patients. Sixty-three patients (34%) remain seizure-free. Forty-two patients (23%) have a marked reduction of seizures. The remaining 81 patients (44%) have a lesser reduction. The variation in clinical seizure patterns is considerably greater than in temporal lobe epilepsy. Focal sensorimotor phenomena are common at the onset, whether the seizures begin in the central region or further posterior. The success following cortical resection is equally gratifying and the failures just as distressing as in surgery for epilepsy, involving other brain regions. PMID- 1777882 TI - Selective amygdalohippocampectomy: indications and follow-up. AB - Selective amygdalohippocampectomy (AHE) offers a real chance of cure only in patients with well-defined, precisely localized "epileptogenic area", i.e. seizure focus. Therefore, a priori only a small proportion of all patients with epilepsy can meet the criteria for selective surgical interventions. From the evidence in patients meeting the criteria for AHE, we conclude that this technique is to be preferred to the "standard" anterior temporal lobectomy and represents a more selective but still effective surgical treatment of epilepsy. PMID- 1777883 TI - Relevance of removal of limbic structures in surgery for temporal lobe epilepsy. AB - We have briefly reviewed the experimental and clinical evidence for the importance of the amygdala and hippocampal formation in temporal lobe epilepsy. More specifically, we have analyzed our own experience in patients with temporal lobe epilepsy investigated with intracerebral stereotaxic electrodes and operated by various modalities of resection. Our results, in agreement with previous experimental and clinical work, provide further evidence for an overwhelming predominance of limbic participation in temporal lobe epilepsy. As a result, more and more selective procedures are being carried out involving the mesial structures. However, this shift has been slow and progressive because of the proven value of cortico-amygdalo-hippocampectomy which provides excellent results on seizure tendency with low morbidity. PMID- 1777884 TI - Electrophysiological analysis of human neocortex in vitro: experimental techniques and methodological approaches. AB - In this review we summarize a number of technical and methodological approaches that have been used in our laboratory to study human brain slices maintained in vitro. The findings obtained in the course of these studies appear to be relevant in establishing the mechanisms that underlie physiological phenomena of the human brain such as synaptic plasticity or responses to neuroactive drugs. Moreover, these data are important for understanding certain fundamental mechanisms of epilepsy. In this respect, however, we caution that the mechanisms that apply to different forms of clinical epilepsy might be difficult to find given the variability present in the pathogenesis of human epilepsy. PMID- 1777885 TI - Biochemical markers of excitability in human neocortex. AB - We measured biochemical markers of excitability in brain excised for neurosurgical therapy of epilepsy. Intraoperative electrocorticography was used to identify and compare samples from regions of persistent interictal spike discharges and areas of the cerebral convexity which were free of interictal spiking. We found that interictal spiking was associated with elevated tissue levels of the excitatory amino acids glutamic acid (26%, p less than 0.001) and aspartic acid (25%, p less than 0.05). There was also a significant increase in the activity of the enzymes glutamic acid dehydrogenase (20%, p less than 0.01) and aspartate acid aminotransferase (18%, p less than 0.01) which are involved in their formation. There was no change in the levels of the inhibitory neurotransmitters GABA or taurine. We also found a significant increase in the activity of tyrosine hydroxylase (52%, p less than 0.001), the rate controlling enzyme in catecholamine biosynthesis. There was a reduction in the density (Bmax) of cortical alpha-1 adrenoceptors (26%, p less than 0.01) and a concomitant diminution of receptor coupled phosphatidylinositide metabolism (21%, p less than 0.01). This blunting of inhibitory noradrenergic transmembrane signaling may contribute to a relative imbalance between excitatory and inhibitory mechanisms in epileptogenic neocortex. PMID- 1777886 TI - Bilateral pathological damage in temporal lobe epilepsy. AB - Patients with drug-refractory temporal lobe epilepsy can be treated successfully with surgical resection of one temporal lobe, especially when the resection includes the hippocampus. Although intrahippocampal recordings usually localize seizure onsets to one hippocampus, there are bilaterally-independent interictal spikes, occasional contralateral seizure onsets and post-resection seizures that implicate contralateral damage and epileptogenicity. Post-mortem non-quantified studies of both hippocampi in epileptics have revealed incidences of bilateral hippocampal sclerosis, mostly being asymmetric. The present paper reports on two post-mortem cases of bilateral, asymmetric cell loss in patients with physiologically-verified hippocampal epilepsy. In one patient the damage was severe bilaterally, but only slightly greater damage in one hippocampus. In the second patient, damage in one hippocampus was as severe as in the first patient; however the contralateral hippocampus appeared undamaged. However, cell counts revealed losses of over 30% in three different hippocampal subregions, indicating a mild form of asymmetric bilateral damage in patient two. PMID- 1777887 TI - Surface ictal electroencephalographic patterns in frontal vs temporal lobe epilepsy. AB - The effectiveness of long term EEG monitoring in the localization of the epileptic focus was studied in 37 patients with temporal lobe epilepsy comprising 190 recorded seizures, in 19 frontal lobe epileptic patients with 172 recorded seizures and in 12 additional patients which were classified as fronto-temporal. In the temporal lobe group, 49/190 seizures began focally (26%) and 20/190 seizures exhibited a regional onset (10%). In the frontal lobe group, only 21 out of 172 seizures (12%) had a focal ictal onset. 41/172 seizures began regionally (24%). In the fronto-temporal group, 31/55 seizures disclosed a focal EEG onset (57%). This study demonstrates that there is a two-fold increase in seizures beginning focally in the temporal lobe epilepsy group versus the frontal lobe group. PMID- 1777888 TI - Chronic renal failure. PMID- 1777889 TI - Growth hormone physiology: current concepts. AB - Growth hormone (GH) influences a range of physiological functions, including renal plasma flow and glomerular filtration rate. Cells that secrete GH comprise a relatively large percentage of the total population of pituitary cells. The secretory activity of these cells is primarily regulated via peptide neurohormones from the hypothalamus. Direct influences of certain other factors have also been described. Human GH is present as a heterogeneous mixture of at least 20 molecular forms, most of which are 22,000 or 20,000 molecular weight monomers. Following release from the pituitary gland, GH circulates in either a 'free' form or bound to GH binding proteins. These binding proteins may have important effects on GH clearance and GH action at the level of the target tissue. The effects of GH are mediated, to a large extent, by insulin-like growth factors, formerly known as 'somatomedins'. The secretory pattern of GH is episodic, and occurs in bursts of varying frequency, amplitude, and duration. Changes in the pattern of GH secretion and its control occur with age. Recent data suggest that the specific characteristics of GH secretory bursts in humans are important to normal growth during childhood and adolescence. PMID- 1777890 TI - Growth hormone metabolism in uremia. AB - The influence of chronic renal failure (CRF) on growth hormone (GH) and insulin like growth factor I (IGF-I) metabolisms is not well understood. Clinical studies on GH secretion in CRF have yielded conflicting results. In vitro, pituitary GH secretion has been shown to be unimpaired in moderate uremia. CRF reduces binding of GH to liver as a result of decreased number of GH receptors. CRF induces elevation of serum GH concentrations and does not modify the circulating values of IGF-I. However, the somatomedin bioactivity of uremic serum is depressed, and unsaturated low-molecular-weight IGF-I-binding proteins have been suggested to act as inhibitory factors of IGF-I action. Circulating GH and IGF-I do not necessarily reflect the state of GH and IGF-I in tissues, and further investigations on the effect of CRF on GH and IGF-I metabolisms at the growth plate level are clearly required. PMID- 1777891 TI - Dietary manipulation and progression of chronic renal failure. AB - Examination of the effects of dietary manipulation on progression of chronic renal failure (CRF) has been of interest for two reasons: dietary protein restriction is an effective method of ameliorating uremic symptoms and studies of changes in serum creatinine (and later, creatinine clearance or glomerular filtration rate, showed that the course of renal insufficiency is predictable. Results from studies of patients and animals with CRF suggested that a low protein, phosphorus-restricted diet could slow the rate of loss of renal function. Animal studies have identified several mechanisms for progressive renal damage. These include glomerular hypertension causing capillary damage, glomerular damage from hypertrophic stimuli or hypermetabolism, calcium phosphorus deposition and nephrotoxicity of the diet. The scientific basis for these different mechanisms will be discussed and each mechanism will be analyzed in terms of experimental studies in patients with CRF. PMID- 1777892 TI - Renal functional reserve. AB - The available data on renal reserve and on the fraction of filtration capacity utilized at rest in childhood are analyzed both in healthy state and in renal disease. The methodological problems which might have biased available information are also discussed. PMID- 1777893 TI - Anemia of chronic renal failure: treatment with erythropoietin. AB - Twenty-three anemic children with end-stage renal failure (ESRD), aged 0.1-19.0 years (X +/- SD, 8.3 +/- 5.7 years), were treated with intravenous recombinant human erythropoietin (rHuEPO). Eleven were on conservative treatment and their estimated glomerular filtration rate (EGFR) was 11.8 +/- 3.8 ml/min/1.73 m2; 7 were on continuous ambulatory peritoneal dialysis (CAPD) and 5 on chronic hemodialysis. rHuEPO was given once a week in predialysis and CAPD children and thrice weekly in patients on hemodialysis. The initial dose of 50 U/kg/week was increased gradually up to a target hemoglobin of 10-12 g/dl. After 4.3 +/- 1.3 months of treatment, hemoglobin increased from 7.4 +/- 1.3 to 10.7 +/- 1.4 g/dl (p less than 0.001). An hemoglobin concentration of 11.4 +/- 0.9 g/dl was maintained with a rHuEPO dose of 289 +/- 86 U/kg/week. The response was similar in predialysis, CAPD, and hemodialysis children. No change in renal function was observed in predialysis children, EGFR being 11.8 +/- 3.8 and 10.8 +/- 1.7 ml/min/1.73 m2, before and after rHuEPO therapy. All children improved appetite, physical activity, and the sense of well-being. Four developed mild hypertension that was easily controlled with antihypertensive therapy. Heparin dose had to be increased during the hemodialysis sessions to avoid clotting of the filter. Serum calcium increased from 9.9 +/- 0.9 to 10.5 +/- 0.9 mg/dl (p less than 0.001). Serum aluminium levels also increased from 65 +/- 17 to 100 +/- 15 micrograms/l, p less than 0.01. A linear correlation (r = 0.58, p less than 0.01) between aluminium levels and rHuEPO dose was found.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777894 TI - Hypertension in children and adolescents with chronic renal failure and end-stage renal disease. AB - The incidence of hypertension (HT) in renal parenchymal disease of the young is very high, varying from 38 to 78%. This points to the central role of the kidneys in normal blood pressure control. HT in chronic renal failure (CRF) and end-stage renal disease (ESRD) depends on the nature of the underlying disease. The degree of renal failure has a highly variable effect. The clinical signs and symptoms of this form of HT are often superimposed on those of the basic (renal) disorder. The pathogenesis of HT in CRF is dominated by volume- and renin-mediated mechanisms. In addition, a wide variety of humoral and neural factors play a role. The HT seen in patients on renal replacement therapy (RRT) and after renal transplantation (Tx) poses special problems. In this paper these various aspects of HT in CRF are discussed and the principles of treatment are reviewed. It has been shown beyond any doubt that control of HT in young patients with CRF and ESRD, treated conservatively or on RRT and after renal Tx is of utmost importance for their long-term outcome. This is an important challenge for all pediatricians looking after young patients with CRF and ESRD. PMID- 1777895 TI - Renal bone disease in pediatric patients receiving treatment with maintenance peritoneal dialysis. AB - The present review summarizes the characteristics of renal bone disease in pediatric patients treated with maintenance peritoneal dialysis. Fifty-eight patients underwent iliac crest bone biopsy after double tetracycline labeling, measurements of aluminum in bone and various serum biochemical determinations including serum PTH, alkaline phosphatase, calcium, phosphorus and aluminum. Evidence of osteitis fibrosa was present in 45% of patients and mild lesions of secondary hyperparathyroidism were found in an additional 25%. Thus, secondary hyperparathyroidism remains the predominant bone lesion despite the use of oral calcitriol. Evidence of aluminum accumulation was substantially less prevalent, findings not surprising due to the widespread use of calcium carbonate as the main phosphate binder agent. However, aplastic bone lesion without aluminum staining was present in the majority of patients with low-turnover lesions of the bone without osteomalacic findings. The long-term evolution of such lesions remains to be evaluated. The potential value of alternative modes of calcitriol administration for the control of secondary hyperparathyroidism is discussed as well as the differences in the bioavailability of sterol according to the different routes for calcitriol administration. PMID- 1777896 TI - Long-term complications of renal transplantation. AB - Excellent survival data and rewarding rehabilitation have been reported following kidney transplantation. Annual mortality decreases with time after transplantation and has dropped below 2% in children and below 3% in young adults. No major single cause of death has been identified. Short-term graft survival rates are still improving but no major breakthrough in long-term graft maintenance has been achieved. The major cause of graft failure is chronic rejection. Major causes of morbidity in long-term graft recipients are: hypertension occurring in 65-75% of the recipients, avascular necrosis of the bone resulting in severe disabling in 4% of transplant recipients and growth retardation. Also, in patients receiving a kidney transplant during childhood, an increased risk of de novo malignancy development was reported. Full rehabilitation is often hampered by physical disabilities and will restrict social life. However, the possibility of obtaining employment is not different from that of the general population. The evaluation of morbidity in long-term kidney transplant survivors requires the collaboration of larger pediatric transplantation centers. PMID- 1777897 TI - Decreased hospitalization and increased height velocity in focal segmental glomerulosclerosis responsive to ciclosporin A. AB - Eleven pediatric patients with nephrosis and focal segmental glomerulosclerosis were treated with long-term (8-38 months) ciclosporin A in combination with steroids. All had abnormal height-velocity curves and multiple hospitalizations for complications of nephrosis. Eight patients attained remission with a dramatic improvement in growth and decrease in necessity for hospitalization for therapy of nephrosis complications, while maintaining adequate renal function. Three nonresponders developed end-stage renal disease. Long-term ciclosporin A therapy may be of benefit in steroid-resistant nephrosis in childhood. PMID- 1777898 TI - Antimouse antibody response after OKT3 administration for steroid resistant rejection. AB - OKT3 has become one of the more effective antirejection therapies for patients receiving kidney transplants. However, its usefulness is diminished or blocked by the development of antimouse/anti-OKT3 antibodies. We evaluated 17 children receiving OKT3 for steroid-resistant acute rejection for the development and persistence of antibodies after therapy. OKT3 was successful in reversing acute rejection in 14 of 17 patients. Eight children developed antimouse antibodies, 7 at a low titer (1:100). The retesting of all children 6 months later showed no detectable antibodies. Children develop anti-OKT3 antibodies at a rate similar to adults and with time lose detectable levels which may have significance if a subsequent course of OKT3 is needed. PMID- 1777899 TI - Renal handling of hydrogen ion excretion in relation to maturity indices in premature infants fed human milk. AB - In 40 premature infants fed human milk with an actual gestational age of 261 +/- 16 days and an actual body weight of 1.06-2.75 kg, 44 urine samples were collected, and blood acid-base status was measured on day 32 (+/- 16) of life. In the urine, the following results (mean +/- SD) were obtained: urine pH 6.05 +/- 0.65, titratable acidity 0.24 +/- 0.14 mmol/kg/day, ammonium 0.78 +/- 0.25 mmol/kg/day, net acid excretion 0.83 +/- 0.47 mmol/kg/day. There was no significant correlation between renal net acid or ammonium excretion and actual body weight. However, urine pH was positively correlated with body weight. Obviously, premature infants with an actual body weight below 1.5 kg need a higher stimulation of renal hydrogen ion secretion to excrete the same amount of ammonium than those with an actual body weight of about 2.5 kg. The limited renal acidification capacity of very low birth weight infants is a risk factor for the development of late metabolic acidosis. PMID- 1777900 TI - A simple method for percutaneous renal biopsy. AB - A technique for percutaneous renal biopsy in children is described which combines the use of ultrasound guidance and a disposable automatic biopsy device. Twenty five biopsies in 22 children were performed using the Bard Monopty biopsy instrument. Adequate tissue was obtained to aid in diagnosis in 24 of 25 cases. Complications inclused 2 small perinephric hematomas. We conclude that the Bard Monopty biopsy device in association with ultrasonography provides for a safe and reliable technique to perform percutaneous renal biopsy in children. PMID- 1777901 TI - Nephrocalcinosis and idiopathic hypercalciuria. AB - In a sample of 28 children diagnosed as having idiopathic hypercalciuria, ultrasound studies showed nephrocalcinosis in 6 cases, the rest having normal sonographs. On biochemical comparison, the two groups were statistically distinguishable by means of three parameters. The group with nephrocalcinosis showed higher values of calciuria and calciuria versus magnesuria ratio (p less than 0.05), as well as lower maximum urinary osmolality (p less than 0.01) than the group with normal sonographs. A negative correlation was found between the calciuria values and the values obtained from the concentration test (p less than 0.05). At present, the factors favoring the deposit of calcium salts in children with idiopathic hypercalciuria are not yet fully known. PMID- 1777902 TI - Sickle cell glomerulopathy with focal segmental glomerulosclerosis. AB - Sickle cell disease is known to cause glomerulopathy, including focal segmental glomerulosclerosis (FSGS). Patients who have sickle cell glomerulopathy with FSGS are thought to have a poorer prognosis than patients who have sickle cell glomerulopathy without this lesion. The former patients are more likely to have persistent proteinuria and eventually develop end-stage renal disease. We present a boy with sickle cell glomerulopathy and FSGS who is younger than patients with similar findings reported previously. The histopathology of his renal lesions is remarkable for segmental ultrastructural changes in the glomerular basement membranes and endothelial cells. We speculate that these changes are precursory to the pathogenesis of glomerular sclerosis in patients with sickle cell disease. PMID- 1777903 TI - Sonographic findings in infantile idiopathic nephrotic syndrome. AB - Abnormal sonographic findings were obtained in all cases of infantile idiopathic nephrotic syndrome (IINS). Hyperechoic renal parenchyma, subcapsular hypoechoic band and loss of cortical medullary differentiation were the commonest abnormalities. There was no specific sonographic difference between the different types of IINS. The subcapsular hypoechoic band is also not diagnostic for IINS. Abnormal sonographic findings indicate renal biopsy to identify specific types of IINS. PMID- 1777904 TI - Subclavian vein stenosis: complication of subclavian vein catheterization for hemodialysis. AB - Subclavian vein catheterization is a relatively safe procedure. Few long-term complications have been reported. We recently diagnosed subclavian vein stenosis in a 14-year-old peritoneal dialysis patient. The stenosis occurred 2 years after the use of a subclavian vein catheter for temporary hemodialysis. Stenosis became clinically apparent by progressive painless swelling of the right arm and was documented by venography. PMID- 1777905 TI - Hypercalcemia, hypertension and acute renal insufficiency in an immobilized adolescent. AB - Immobilization hypercalcemia was initially described by Albright in 1941, and has most often been noted in adolescent males, presumably because their high rates of skeletal growth increase the likelihood that alterations in the equilibrium between bone deposition and resorption will have clinically apparent effects. The etiology of immobilization hypercalcemia is controversial, but is thought to result from normal levels of PTH acting with increased activity in the abnormal environment of immobilized bone. We describe a patient, immobilized following the resection of a large, locally invasive tumor, who developed hypercalcemia in conjunction with renal insufficiency and hypertension. The pathophysiology of immobilization hypercalcemia is discussed, as are the potential contributions of renal feedback mechanisms to the patient's hypertension and renal insufficiency. PMID- 1777906 TI - IgA nephropathy as a possible cause of renal insufficiency following liver transplantation. AB - Three years following successful liver transplantation, a child developed proteinuria, hematuria and hypertension in the setting of progressive renal insufficiency. These abnormalities did not resolve with lower doses of ciclosporin. Because multiple drugs were required to control the hypertension and because no other etiology of the urinary abnormalities could be found, a renal biopsy was performed. The renal biopsy revealed findings consistent with severe IgA nephropathy, including glomerulosclerosis, segmental crescents, mesangial cell and matrix expansion, mesangial deposits, and positive immunofluorescence for IgA. PMID- 1777907 TI - Severe hemolytic uremic syndrome associated with rhabdomyolysis and insulin dependent diabetes mellitus. AB - Hemolytic uremic syndrome has been associated with insulin-dependent diabetes mellitus eight times in the past, while the hemolytic uremic syndrome and rhabdomyolysis association has been described once. The occurrence of both conditions in a patient with the hemolytic uremic syndrome has not been reported. In this report, we described a 28-month-old girl who presented with severe hemolytic uremic syndrome muscle weakness and elevated muscle enzymes. Later, she developed hyperglycemia and ketosis requiring initiation of insulin therapy. The current literature was reviewed, and a hypothesis for the mechanism of injury and the multisystemic nature of this syndrome is presented. In patients with the hemolytic uremic syndrome, identification of potential extrarenal involvement is important as it may determine the final outcome of this disease. PMID- 1777908 TI - Bloody diarrhea in hemolytic uremic syndrome. PMID- 1777909 TI - In vivo mechanisms of myocardial functional stability during physiological interventions. AB - Metabolic regulatory mechanisms are designed to maintain stable myocardial function during extremes in physiological insult; they can now be studied in vivo and may provide insight into mechanisms of altered myocardial functional decompensation during disease processes. To determine mechanisms of myocardial stability during hypoxia and acute pressure loading, creatine kinase (CK) kinetics (forward rate constant, Kf, and flux of phosphocreatine, PCr, to adenosine triphosphate, ATP), and nicotinamide adenine dinucleotide (NADH) redox state were determined with 31P nuclear magnetic resonance (NMR) and NADH fluorometry, respectively, and correlated with heart work (heart rate x systolic blood pressure, HR x SBP), cardiac output (CO) and O2 consumption (MVO2) in 15 anesthetized open chest dogs. Hypoxia (PaO2 of 30-35 mm Hg) was produced in 6 dogs with an inspired O2/N2 of 200/3,000. Cardiac loading was produced in 9 dogs by administration of norepinephrine (NE, 1 micrograms/kg/min). Each dog acted as its own control. Baseline NADH fluorometry, 31P-NMR saturation transfer and cardiac function measurements were performed simultaneously in each dog, after which the experimental interventions were made. Similar increases in HR x SBP, CO, and MVO2 which occurred during both interventions were associated with different bioenergetic responses. During NE infusion, the Kf of CK increased from control; during hypoxia, the Kf decreased from control (p less than 0.05). Flux of PCr----ATP was significantly lower during hypoxia than during NE infusion (p less than 0.05). PCr was decreased significantly during NE infusion (p less than 0.05). In addition, NADH redox state increased (from baseline of 100%) during hypoxia (140 +/- 10%) and decreased during NE infusion (78 +/- 6%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777910 TI - Insulinemia and blood pressure responses to oral glucose load in primary hypertensive patients. AB - Fourteen hypertensive patients and 14 normotensive control subjects were submitted to the oral glucose test and their plasma potassium, glucose and insulin levels were measured. Cardiovascular responses were evaluated by blood pressure and pulse rate measurements. Five of 14 hypertensive patients were hyperinsulinemic and had higher blood glucose levels, suggesting insulin resistance. Systolic blood pressure, heart rate and double product increased significantly in normotensive subjects and slightly in hyperinsulinemic patients, but not in normoinsulinemic hypertensive patients. These results seem to indicate the presence of insulin resistance in a particular group of primary hypertensive patients and a smaller cardiovascular response after glucose overload. PMID- 1777911 TI - Acetylcholine, Ca2+ overload and oscillatory potentials in isolated ventricular myocytes. AB - The events caused by overdrive-induced calcium overload were studied in guinea pig isolated ventricular myocytes. Overdrive may induce oscillatory potentials (Vos) and a prolonged depolarization (Vex), as well as the underlying currents (Ios and Iex, respectively). Acetylcholine (ACh) reduced or abolished these events, an action which was blocked by atropine. Norepinephrine exaggerated the effects of overdrive, and ACh markedly antagonized such an enhancement. Caffeine at low concentrations increased both Ios and Iex whereas at high concentrations caffeine abolished Ios but increased Iex. Quinacrine abolished both events. Voltage clamp depolarizing steps abolished Ios (and did not reverse it). Thus, the effects of Ca overload are antagonized by ACh in the absence and presence of sympathetic enhancement. Also, the mechanism underlying Ios appears to involve an electrogenic Ca extrusion and not an increase in a nonspecific conductance. PMID- 1777912 TI - Heparin pharmacokinetics and in vitro anticoagulant activity in patients receiving nonionic radiographic contrast media. AB - Nonionic radiographic contrast media are used frequently in diagnostic and interventional angiography. However, there is concern that they may possess thrombogenic properties, and some studies have suggested that patients receiving nonionic contrast media are difficult to systemically anticoagulate with intravenous heparin. To investigate the potential effects of nonionic contrast media on systemic anticoagulation during diagnostic cardiac catheterization, pharmacokinetics and in vitro anticoagulant activity following a 3,000 U intravenous heparin bolus were assessed in 12 patients assigned randomly to either an ionic or a nonionic contrast agent. Independent of contrast agent, all patients exhibited biphasic (nonlinear) heparin pharmacokinetics characterized by an initial rapid disappearance phase, followed by a second slower phase. Each patient achieved a therapeutic plasma heparin concentration (greater than or equal to 0.2 U/ml) within 10 min of receiving the bolus, and maintained this level throughout the procedure. Heparin anticoagulant activity, as estimated by a standard activated partial thromboplastin time (APTT) was not affected differently by nonionic as compared with ionic contrast media (p greater than 0.05). Each patient rapidly achieved a level of systemic anticoagulation commonly considered therapeutic (APTT greater than or equal to 1.5 times the control), and maintained this level throughout the procedure. In both groups, APTT correlated directly with plasma heparin concentration (r = 0.95; p less than 0.0001), and inversely with the total amount of contrast media used during the procedure (r = 0.25; p = 0.01). Plasma heparin concentration did not correlate with total contrast media (r = -0.16; p greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777913 TI - Effect of nisoldipine on exercise performance in heart failure following myocardial infarction. AB - The effects of the second generation calcium channel blocking drug nisoldipine on subjective and objective measurements of exercise performance were studied in 19 patients with moderate to severe heart failure (9 New York Heart Association functional class 2, 9 class 3 and 1 class 4) due to fixed ventricular dysfunction following myocardial infarction. Nisoldipine (10 mg 3 times daily) or placebo were administered for 8 weeks in a double-blind parallel study, assessing exercise performance by symptom-limited treadmill exercise testing using a modified Naughton protocol. Nisoldipine was well-tolerated and produced a small increase in peak estimated workload performed (6.2 +/- 2.9 to 8.2 +/- 3.0 METs, p = 0.06). The rate of perceived exertion (Borg scale) increased from 17.5 +/- 2.2 to 18.8 +/- 1.2 (p less than 0.02). The higher workload was performed at a lower peak systolic blood pressure (p = 0.03), higher peak heart rate (p = 0.06) and identical double product (NS). There was no change in resting and peak heart rate and blood pressure or in exercise performance in patients receiving placebo. Resting left ventricular ejection fraction, measured by radionuclide ventriculography, was unchanged after 8 weeks both in the placebo (21 +/- 9 to 20 +/- 9%) and nisoldipine (34 +/- 17 to 36 +/- 19%) groups. PMID- 1777914 TI - Seminars in thrombosis, thrombolysis and vascular biology. 3. Platelet activity in cardiovascular disease. AB - Platelets contribute to normal hemostasis by adhering to subendothelial tissues after vascular damage has taken place and then recruiting additional platelets through the process of aggregation. Activation of the coagulation cascade ultimately results in fibrin deposition. In pathological conditions, thrombogenic surfaces act as a nidus for platelet adherence and thrombus formation. The ability of platelet-inhibiting agents to prevent or impair platelet-mediated thrombotic and thromboembolic events is of vital importance in the prevention and treatment of cardiovascular diseases, including myocardial infarction, unstable angina and stroke. They also serve as important adjuvants following percutaneous transluminal coronary angioplasty and saphenous vein bypass grafting. Future investigations will likely uncover additional indications. PMID- 1777915 TI - Relative prognostic value of clinical heart failure and early echocardiographic parameters in acute myocardial infarction. AB - The relative prognostic value of clinical heart failure and early M-mode and 2 dimensional echocardiographic indexes of left ventricular performance was compared in a study of 205 consecutive patients with acute myocardial infarction (AMI). Statistical analysis showed that an early wall motion score was a stronger predictor of 1-year mortality than the occurrence of clinical heart failure early, late or at any time during the hospital course of AMI. The finding of clinical heart failure had an independent prognostic value of intermediate strength. M-mode echocardiographic parameters only had a weak independent prognostic value, possibly related to their content of information on left ventricular end-systolic dimension. PMID- 1777916 TI - Prognosis following interventional therapy for acute myocardial infarction: utility of dipyridamole thallium scintigraphy. AB - A variety of methods for risk stratification after acute myocardial infarction have been successfully employed, however, little attention has been focused on patients who have received reperfusion therapy. The present report examines the utility of dipyridamole thallium scintigraphy in the prediction of late cardiac death or recurrent myocardial infarction in patients who have received thrombolytic therapy. Prospectively, 71 patients who presented with myocardial infarction and were treated with recombinant tissue plasminogen activator (and frequently percutaneous transluminal coronary angioplasty) were enrolled in the study. The primary end points during the follow-up period of nearly 2 years were recurrent infarction or death, which occurred in 10 patients. Although cardiac events were significantly related to either the performance of late myocardial revascularization or the presence of a residual coronary artery stenosis at discharge, no scintigraphic variable was found to be predictive of myocardial infarction or death. Thus, this report is the first to suggest limitation of scintigraphic techniques with regard to prognostic value in myocardial infarction survivors treated with reperfusion techniques. This selected population may have physiologic differences as compared with post-infarction studies performed before the advent of thrombolytic agents. Caution is therefore advised in extrapolating results of earlier reports to the ever increasing percentage of patients receiving recannalization therapy. PMID- 1777918 TI - Quantitative assessment of lysosomal size, number and enzyme activity in mouse kidney during maturational development. AB - Image and cytochemical analyses were undertaken to determine possible correlation between the number and size of acid phosphatase-positive granules (lysosomes), and variation in acid phosphatase (AcP) activity in the proximal tubule cells of mouse-kidney during growth and development. Eighteen ddY strain mice ages: 1 day, 1 and 2 weeks, and 1, 2 and 10 months were used. The lanthanide-based method for the ultrastructural localization of AcP-activity was employed. The number and size of AcP positive granules were quantitatively analyzed by image analysis, and AcP activity by X-ray microanalysis. Significance was evaluated by 2-tailed Student's t-test for the difference between means. AcP activity was observed in the lysosomes and the reaction product appeared dense and heterogeneous. In some cells, it appeared apparently homogeneous. The results showed that the number and size of AcP Positive granules (lysosomes) increased significantly from the first day after birth, recorded a peak in one week time and thereafter, it gradually declined until the 10th month. The result of X-ray microanalysis demonstrated a variation in accordance with the degree of AcP activity at different ages of the animals studied. The AcP activity decreased significantly from day one and progressively until the 10th month. From the results of the present work, it could be inferred that the changes in size and number of AcP positive granules, at least, at the early stage, and/or the variation in AcP activity are related to the growth and development of the animal. PMID- 1777917 TI - Effect of long-term n-butanol ingestion on rat brain polypeptide synthesis directed by endogenous messengers. AB - Long-term ingestion of sublethal n-butanol doses by rats led to a noteworthy increase in the resistance of in vitro brain ribosomal function to the acute inhibitory action of ethanol and isopropanol. Withdrawal of n-butanol did not change this adaptation process immediately. The step affected seems to be the elongation of polypeptide chains. The dependence of in vitro translation on incubation temperature was affected by the adaptation process, the translation system of chronic animals being less stimulatable than that of control animals at low temperature. PMID- 1777919 TI - [Development of a bioassay from gonadal cellular cultures of the snail Helix aspersa: influence of nerve ganglion extracts on the synthetic activity of the target cells]. AB - To realize bioassays a primary culture method was carried out with dissociated cells from the garden snail gonads. ADN and protein syntheses of gonadal cells were estimated using the liquid scintillation method. The gonadal cells were obtained from either adults of Petits Gris and Gros Gris, or young Gros Gris. The results were remarkably homogeneous. The brain extracts added to the culture medium had an inhibitory dose dependent effect on the synthetic activity of gonadal cells. The effected bioassays permit quantitative estimation on the variations of the brain extracts effect in relation to the physiological states of the snail and on the evolution of target cells' receptors during the growth of Gros Gris. PMID- 1777920 TI - 31P and 1H NMR studies of ethanolamine-linked phosphoglycerides metabolism in human T lymphocytes. AB - Aqueous and organic extracts of peripheral human T lymphocytes and of T lymphoblastoid cell lines have been examinated by 31P and 1H NMR spectroscopy in order to study the metabolism of ethanolamine (Etn) linked phosphoglycerides. The results show that the Etn concentration in the culture medium determines the composition of Etn-containing metabolites and phospholipids. The effect of phorbol esters, stimulating the synthesis and the breakdown of choline-containing phospholipids has been also studied. A phorbol 12-myristate 13-acetate (PMA) dependent membrane phosphatidylethanolamine hydrolysis, presumably mediated by protein kinase C activity, has been demonstrated. PMID- 1777921 TI - Surface characteristics of thymocytes in glucocorticoid treated rats using rosette-formation technique and surface marker analysis. AB - Glucocorticoid (GC) treatment is known to induce destruction of cortical thymocytes and then their reconstitution. By using the rats treated with GC, we examined the relationship between rosette-formation and surface markers (CD4 and CD8) for clarifying the processes of differentiation and maturation in rat thymocytes. Thymus weight and thymocyte count began to decrease immediately after GC administration and became minimal on 5-7 days, followed gradual recovery. The percentage of rosette-forming thymocytes began to decrease immediately after GC treatment and became minimal on 5 days, followed by recovery to the normal level by the 10th to 14th day after treatment. During the analysis of the changes in the percentage of 4 subsets (CD4-8-, CD4+8+, CD4+8+, CD4-8+) of rat thymocytes after GC treatment, the percentage of CD4+8+ cells was found to change in close relation to the change in the percentage of rosette-forming lymphocytes, suggesting that rosette-forming thymocytes are CD4+8+ cells. These results suggest that the treatment induces destruction of GC-sensitive thymocytes, possibly rosette-forming cells, followed by migration of precursor T cells (CD4-8 cells) in the thymus, and that the precursors change into rosette-forming cells (CD4+8+ cells) in the thymus, followed by differentiation and maturation into non rosette-forming cells (CD4+8- or CD4-8+ cells). PMID- 1777922 TI - Effect of different hypolipemic agents on rat liver peroxisomal and mitochondrial functions and biogenesis. AB - The effect of four fibrate analogues (i.e. clofibrate, ciprofibrate, clobuzarit and 2,4-dichlorophenoxyacetic acid (2,4-D), an active herbicide molecule) were tested on the biogenesis of liver mitochondrial and peroxisomal proteins by rat in vivo treatment at 100 ppm for 26 weeks. The evaluations were done at different levels: somatic index, histochemistry electron microscopy, enzymatic activities on purified peroxisomes and mitochondria, polypeptides electrophoresis and immunolabeling, and finally mRNA hybridization with specific DNA probes. This work shows that the tested hypolipemic agents are strong peroxisomal proliferators especially ciprofibrate, while mitochondria are weakly affected. However, the four fibrates gave different effects, especially 2,4-D which modifies mitochondrial polypeptide pattern. Post-transcriptional study of mRNAs level shows a slight increase in catalase mRNA despite the potential of hypolipemic agents. The peroxisomal acyl-CoA oxidase mRNA content is enhanced with ciprofibrate treatment as well as mitochondrial R-3-hydroxybutyrate dehydrogenase (BDH) mRNA level. Finally, the dual action of ciprofibrate on content and on enzymatic activity of BDH (a lipid metabolism related enzyme) reveals that such a molecule may have differential regulatory effects (positive on gene transcription or mRNA stability and negative on catalytic enzyme activity). PMID- 1777923 TI - Angioma fusiform cells stimulated by conditioned medium from melanoma cells secrete a neomatrix which plays a role in "in vitro metastasis". AB - The rebuilt tumor model is a three dimensional mass of tumoral cells and angioma fusiform cells in collagen. Rebuilt tumors can give rise to "in vitro metastases" and these metastases depend on the presence of a neomatrix secreted in vitro by rebuilt tumor cells. This study defines the origin of the neomatrix and its role in "in vitro metastasis". Fusiform cells of angioma origin (AF3cells) were stimulated ten-fold by growing them in conditioned medium from a human melanoma cell line (MM2). The stimulated AF3 cells produced a dense neomatrix that was firmly attached to the culture flask. The AF3 cells were removed and MM2 cells were grown on this neomatrix. They gave rise to tumorous nodules very like the "in vitro metastases" produced by rebuilt tumors. The MM2 conditioned medium contained basic fibroblast growth factor, which could account for the angiogenetic activity of the tumoral cells. The fusiform cells of angioma origin that are stimulated by cancerous conditioned medium, are responsible for secretion of the neomatrix which plays a role in "in vitro metastasis". PMID- 1777924 TI - Amphiphile-induced erythrocyte shape change and simultaneous tetraethylammonium ion uptake. AB - Amphiphile-induced tetraethylammonium ion (TEA+) uptake into human erythrocytes was examined along with cell shape change. A TEA(+)-sensitive electrode was used to determine the amount of uptake. TEA+ was preferentially incorporated into erythrocytes when amphiphiles changed cell shape to an invaginated form. This was contrasted with the release of acetylcholinesterase outside cells which occurred markedly with the amphiphiles, causing the crenated form. It was suggested that the invagination of erythrocyte membrane stimulated the formation of vacuoles, in which TEA+ existing in an external medium was entrapped. PMID- 1777925 TI - Studies on the chemical modification of monensin. III. Synthesis and sodium ion transport activity of macrocyclic monensylamino acid-1,29-lactones. AB - Monensylglycine (2a) was lactonized to macrocyclic monensylglycine-1,29-lactone (3a) by Corey's method. Lactonization of monensylamino acids (2b--d) to monensylamino acid-1,29-lactones (3b--d) was carried out by utilizing the template effect of K+ ion. Monobenzyl esters of dicarboxylic monensylamino acids (5e--f) also were lactonized followed by debenzylation to yield carboxylic monensylamino acid-1,29-lactones (3e--f). Sodium ion transport activity of monensin (1) and the lactones (3) was measured in a liquid membrane and in guinea pig erythrocyte membrane. Monensylaspartic acid-1,29-lactone (3e) exhibited 2.5 times higher activity than 1 in the liquid membrane. Monensylalanine-1,29-lactone (3b), monensylphenylalanine-1,29-lactone (3c), and monensyltyrosine-1,29-lactone (3d), having smaller Na+ ion transport activity than 3e, showed weak antibacterial activity, while 3e was inactive in biological tests, probably due to the lower lipophilicity. PMID- 1777926 TI - 3-O-alkylascorbic acids as free radical quenchers. II. Inhibitory effects on some lipid peroxidation models. AB - We previously found that 3-O-dodecylcarbomethylascorbic acid (3-RASA,3,HX-0112) exhibited a potent inhibitory effect on biochemical lipid peroxidation and that 3 RASA (3) alleviated myocardial lesions induced by ischemia-reperfusion treatment in rats. In this study we examined the mode of action of 3-RASA (3) on the inhibition of lipid peroxidation. There was no reducing activity by 3-RASA (3) (i.e., no oxide was produced) against ferric ions and superoxide anion radicals. The low reducing activity of 3-RASA (3) against a radical as compared to that of alpha-tocopherol was obtained by using a stable radical. However, 3-RASA (3) had a potent inhibitory effect, almost equal to that of alpha-tocopherol, in the model of lipid peroxidation dependent on enzymatic superoxide generation. 3-RASA (3) very strongly inhibited the chain-reaction of the peroxidation induced by Fe(2+)-linoleic acid hydroxyperoxide. On the basis of these findings, it appears that the anti-lipid-peroxidative effects of 3-RASA (3) are due to the inhibition of the radical chain-reaction, as a chain-breaking antioxidant. PMID- 1777927 TI - Quantitative structure-activity relationship of catechol derivatives inhibiting 5 lipoxygenase. AB - Various catechol derivatives (beta-substituted 3,4-dihydroxystyrenes, 1 substituted 3,4-dihydroxybenzenes, and 6-substituted 2,3-dihydroxynaphthalenes) were synthesized and their inhibition of 5-lipoxygenase was assayed. Their structure-activity relationships were examined quantitatively with substituent and structural parameters and regression analysis. The variations in the inhibitory activity were explained in bilinear hydrophobic parameter (log P) terms, and steric (molecular thickness) and electronic (proton nuclear magnetic resonance (1H-NMR) chemical shift of the proton adjacent to the catechol group) parameter terms. The hydrophobicity of the inhibitor molecule was important, and the optimum value of logP was about 4.3-4.6, beyond which inhibition did not increase further. A lower electron density of the aromatic ring containing the catechol group and the greater thickness of the lipophilic side chains were unfavorable to the activity. The results added a physicochemical basis for the selection of candidate compounds for developmental studies. PMID- 1777928 TI - Studies on hypotensive agents. Synthesis of 1-substituted 3-(2-chlorophenyl)-6 ethoxycarbonyl-5,7-dimethyl-2,4(1H,3H)-quinazoline diones. AB - 3-(2-Chlorophenyl)-6-ethoxycarbonyl-5,7-dimethyl-2,4(1H,3H)-quinazoline dione was newly prepared. 1-Hydrogen atoms of the compound were variously substituted in order to test for their hypotensive activities on relaxing effects of the blood vessels. The compounds with 2-(1-pyrrolidinyl) ethyl, 2-(1-piperidinyl)ethyl, 3 (dimethylamino)propyl, and 3-(N-benzyl-N-methylamino)propyl moieties showed significant activity. The 2-(1-piperidinyl)ethyl compound possessed activity approximately 23 times more potent than papaverine, however, it was less potent than cinnarizine. PMID- 1777929 TI - Studies on uricosuric diuretics. II. Substituted 7,8-dihydrofuro[2,3-g]-1,2 benzisoxazole-7-carboxylic acids and 7,8-dihydrofuro[2,3-g]benzoxazole-7 carboxylic acids. AB - A series of substituted 7,8-dihydrofuro[2,3-g]-1,2-benzisoxazole-7-carboxylic acids 9 and 7,8-dihydrofuro[2,3-g]benzoxazole-7-carboxylic acids 12 were synthesized and evaluated for uricosuric and diuretic activities in rats. Many of the benzisoxazole derivatives 9 showed uricosuric and only weak diuretic activities, whereas the benzoxazoles 12 exhibited potent diuretic activities with little affecting urate excretion. Among these compounds, 5-chloro-7,8-dihydro-3 phenylfuro[2,3-g]-1,2-benzisoxazole-7-carbo xylic acid (9b, AA-193) was found to be a potent uricosuric agent without diuretic activity and was selected for further development. PMID- 1777930 TI - Enzyme immunoassay for the drug of anti-ulcer using avidin-biotin system. AB - We have developed a competitive enzyme immunoassay for a drug, which was a newly synthesized anti-ulcer agent, using an enzyme immunoassay. The polyclonal anti drug antibody coupled to biotin, peroxidase labeled drug derivatives as a tracer, and a small column of Sepharose 4B covalently bound to avidin were used in the assay. This assay is simple and rapid, and the sensitivity and the measuring range can be controlled by the flow rate of the substrate solution. The correlation between serum drug concentrations (0.1-10 micrograms/ml) measured by gas chromatography and this assay was good (r = 0.991). This principle for the assay is very practical and applicable to the enzyme immunoassay for small and large molecules. PMID- 1777931 TI - Partial degradation and biological activities of an antitumor polysaccharide from rice bran. AB - A rice bran polysaccharide designated RON was subjected either to partial hydrolysis with formic acid or to partial degradation by ultrasonic irradiation. A significant change in the molecular size was also observed during simple chromatography of RON on a strongly acidic ion exchange resin, although the apparent molecular weight of RON had been assumed to be more than 1 x 10(6) daltons (Da). This fact indicates that RON exists as molecular aggregates, presumably mediated by metal cations. Degradation products with average molecular weights above ca. 1 x 10(4) Da which were obtained by any of the three methods still retained the following activities of RON: in vivo antitumor activity against Meth-A fibrosarcoma in mice by oral administration, and in vitro macrophage stimulatory effects to induce tumoricidal activity and interleukin 1 production. This molecular size was proven to be the minimum requisite for these activities because smaller fragments were scarcely active. The aggregation was characteristic of RON but not essential for its antitumor activity because definite, though slightly reduced, activity was exhibited even by the smaller fragments obtained after the ion exchange resin treatment. PMID- 1777932 TI - Production of aliphatic aldehydes on peroxidation of various types of lipids. AB - IN vitro peroxidation by air, or xanthine-xanthine oxidase (xanthine-XOD) was performed to estimate the production of aliphatic aldehydes from free polyunsaturated fatty acids (PUFA), triglycerides, phospholipids and rat liver microsomes and mitochondria. The aldehyde contents in peroxidized lipids were determined by liquid chromatography and fluorescence detection. In both peroxidation, pentanal, (E)-4-hydroxy-2-nonenal (4-HN), and hexanal were produced from omega-6 PUFA rich lipids and propanal was markedly enhanced by increasing the degree of fatty acid unsaturation. The ratios of 4-HN to hexanal production in xanthine-XOD peroxidation of the omega-6 PUFA rich lipids, and rat liver microsomes and mitochondria were much higher than those in air peroxidation. The ratios (4-HN/hexanal) obtained in microsomes and mitochondria by xanthine-XOD were similar to those in rat liver observed in vitamin E deficient studies. The determination of these aldehydes may be useful to estimate the kinds of fatty acids peroxidized and investigate in vivo lipid peroxidation mechanism. PMID- 1777933 TI - Metabolic fates of L-tryptophan in Saccharomyces uvarum (Saccharomyces carlsbergensis). AB - The metabolism of L-tryptophan by Saccharomyces uvarum (carlsbergensis) was investigated by simultaneous measuring of fluxes through kynureninase, through transaminases and into protein using L-[methylene-14C] and L-[side chain-2,3 3H]tryptophan. In yeasts cultivated in synthetic medium (S medium), the flux into protein was predominant, closely followed by the flux leading to 2-3H liberation. The proportion of L-tryptophan metabolized via the latter flux increased over 10 fold (75% of total tryptophan metabolized) as the concentration of L-tryptophan was raised from 5 x 10(-5) to 5 x 10(-4) M. L-Tryptophan metabolized via the kynureninase flux was less than 5% of total tryptophan metabolized. In yeast extract-polypepton-glucose medium (YPG medium), more tryptophan was incorporated into protein than in the S medium. Contribution of the kynureninase flux remained very low. Tryptophan metabolism via each flux changed depending on the growth phase. 2-3H liberation was shown to be primarily due to tryptophol synthesis by high performance liquid chromatography (HPLC) and nuclear magnetic resonance (NMR), indole-3-acetic acid and kynurenic acid also contributing to 2-3H liberation but to a much lesser extent. 2-3H liberation increased dose dependently at tryptophan concentration higher than 10(-5)M, while the kynureninase flux reached its plateau at 10(-5)M. Formation of tryptophol and indole-3-acetic acid via indole-3-pyruvic acid and indole-3-acetaldehyde with indole aldehyde as a by-product was confirmed using exogenous tryptophan metabolites with indole rings. PMID- 1777934 TI - Effect of cysteine on bovine serum albumin (BSA) denaturation induced by solar ultraviolet (UVA, UVB) irradiation. AB - Long-term exposure to natural sun-light (UVA, UVB) induced fluorescence and caused disulfide bond formation in bovine serum albumin (BSA). The addition of cysteine enhanced the bond formation to such an extent that a solution of BSA was transformed into an insoluble gel. The disulfide bonds in the gels are derived from internal-SH groups of protein. This reaction occurred even if cysteine was added after exposure to ultraviolet (UV)-irradiation. Fluorescent substances seem to be involved in this reaction. On the other hand, low concentrations of cysteine (less than 5 mM) inhibited both fluorescence and disulfide bond formation. The addition of glutathione to BSA produced the same effect as that of cysteine. The addition of thiourea to BSA solution inhibited fluorescence, but did not inhibit disulfide bond formation. We assume that external-SH compounds such as cysteine and glutathione, which have high reactivity with hydroxyl radicals (.OH), act not only as free-radical scavengers, but also as radical mediators in the polymerization of protein through disulfide cross-links induced by UV-irradiation. Solar UVA as well as UVB irradiation are shown to have the same effect on the protein polymerization. PMID- 1777935 TI - Influence of isosorbide dinitrate concentration on its skin permeability from adhesive matrix devices. AB - Adhesive matrix devices containing a model drug, isosorbide dinitrate (ISDN), were prepared with three different types of pressure sensitive adhesives (PSAs). ISDN permeation through excised hairless rat skin from the different devices was measured in vitro. For each PSA type, the steady state permeation rate of ISDN increased proportionally with an increase of ISDN concentration in the PSA and reached a maximum level at a certain concentration. Although the concentrations reaching the maximum skin permeation level varied among PSA types, the maximum rate for each PSA type was largely similar to that for ISDN aqueous suspension. The release rate of ISDN from devices was too fast to influence the skin permeation rate for all devices. In the PSA of devices showing maximum skin permeability, ISDN crystalline was observed by polarizing microscopy and differential scanning calorimetry. These results suggest that the skin permeation of ISDN from adhesive matrix devices was controlled by the thermodynamic activity of the drug in the PSAs. PMID- 1777936 TI - Effects of 2-(E-2-decenoylamino)ethyl 2-(cyclohexylethyl) sulfide on various ulcer models in rats. AB - The effects of 2-(E-2-decenoylamino)ethyl 2-(cyclohexylethyl) sulfide (compd. III 1a) on various experimental ulcers were investigated. The oral administration of compd. III-1a at doses ranging from 30 to 300 mg/kg inhibited the acute gastric ulcerations induced by ethanol, HCl.aspirin and indomethacin in rats. Compound III-1a significantly inhibited the water immersion stress-induced gastric ulcer at doses of 3 mg/kg, p.o. The anti-ulcer activity of plaunotol as a reference drug was equivalent on an ethanol-induced ulcer to that of compd. III-1a, but weaker on HCl.aspirin, indomethacin and stress-induced ulcers than that of compd. III-1a. On indomethacin-produced gastric antral ulcer, compd. III-1a showed the same significant inhibitory activity as spizofurone did at a dose of 100 mg/kg, p.o. Compound III-1a also inhibited hemorrhagic shock-, diethyldithiocarbamic acid (DDC)-and platelet activating factor (PAF)-induced ulcers dose-dependently. Plaunotol only showed significant inhibitory activity on PAF-induced ulcer in these three ucler models. The consecutive administration of compd. III-1a (100 mg/kg, p.o.) twice a day significantly accelerated the healing of an acetic acid induced ulcer and that of plaunotol (200 mg/kg, p.o.) showed the same activity. Moreover, orally administered compd. III-1a at a dose of 100 mg/kg decreased the gastric acid secretion in pylorus-ligated rats. The results in the present study suggest that compd. III-1a has the dual action on ulcer formation. PMID- 1777938 TI - Studies on antiatherosclerotic agents. Synthesis of 5-substituted derivatives of 7-ethoxycarbonyl-6,8-dimethyl-1(2H)-phthalazinone.off. AB - Several 5-substituted derivatives of 7-ethoxycarbonyl-6,8-dimethyl-1(2H)- phthalazinone were prepared by means of nitration, reductive amination, and diazonium decomposition. The substituents introduced included NO2, NH2, F, Cl, CN. Among the derivatives, the fluorine compound was obtained only in poor yield because intramolecular cyclization occurred predominantly. PMID- 1777937 TI - Further studies on the anti-ulcerogenic effects of compound, 2-(E-2 decenoylamino)ethyl 2-(cyclohexylethyl) sulfide. AB - Tha anti-ulcerogenic mechanism of 2-(E-2-decenoylamino)ethyl 2-(cyclohexylethyl) sulfide (compd. III-1a) was investigated in various gastric defensive factors. Compound III-1a maintained the high molecular glycoprotein (relative content of Fr. I hexose) and accelerated hexosamine synthesis which were reduced by water immersion stress. But plaunotol did not have these actions. The lipid peroxide level in the gastric mucosa from water immersion stressed rat was lowered by the administration of compd. III-1a. Compound III-1a maintained prostaglandin E2 (PGE2) and PGI2 contents which were reduced in the early phase of the stress and accelerated PGs synthesis in the late phase of the stress. Furthermore, compd. III-1a maintained phospholipase A2 (PLA2) activity which was reduced by the stress. The plaunotol treated group showed the same tendency as the compd. III-1a treated group on the lipid peroxide level, PGE2 and PGI2 contents, and PLA2 activity, but the potency of plaunotol was less than that of compd. III-1a. Compound III-1a accelerated gastric cell proliferation in pyloric glands of hydrocortisone treated rats. Tetragastrin accelerated significantly the cell proliferation in fundic glands. The sucralfate treated group showed the same tendency as the compd. III-1a treated group but the potency of sucralfate was less than that of compd. III-1a. The results in the present study suggest that compd. III-1a has a protective action on gastric mucosa. PMID- 1777940 TI - An enkephalin-degrading aminopeptidase from rat brain catalyzes the hydrolysis of a neuropeptide, kyotorphin (L-Tyr-L-Arg). AB - We studied the hydrolysis of a neuropeptide kyotorphin (L-Tyr-L-Arg) by an enkephalin-degrading aminopeptidase purified from cytosol of rat brain in vitro. The purified enzyme was homogeneous as judged by sodium dodecyl sulfate (SDS) polyacrylamide gel electrophoresis (PAGE), gel filtration and isoelectric focusing. The aminopeptidase with an apparent molecular weight (Mr) = 98000 catalyzed the hydrolysis of Leu- and Met-enkephalins with Km values of 125 and 142 microM, respectively. The enzyme activity was inhibited by bestatin, amastatin and puromycin but not by pepstatin, leupeptin and phenylmethanesulfonyl fluoride (PMSF). Kyotorphin was degraded by the aminopeptidase at pH 7.0, and the Vmax and Km values were 9.2 mumol/min/mg protein and 95 microM, respectively. The Km value for kyotorphin was compatible to those for Leu- and Met-enkephalins. Taken together, these results suggest a possible involvement of the enkephalin degrading aminopeptidase in cytosolic degradation of kyotorphin in neuronal cells of rat brain. PMID- 1777939 TI - Detection of 8-hydroxy-2'-deoxyguanosine in deoxyribonucleic acid by the 32P postlabeling method. AB - Using synthesized 8-hydroxy-2'-deoxyguanosine 3'-monophosphate as a marker, the 32P-postlabeling method was adapted with minimum modifications for the analysis of 8-hydroxy-2'-deoxyguanosine (8-OH-dG) content in deoxyribonucleic acid (DNA). This method allows the analysis of one 8-OH-dG per 10(4) DNA nucleotides with only 10 pmoles of nucleotides required. The amounts of 8-OH-dG in DNA detected by the postlabeling method correlated well with the electrochemical detection method but were consistently lower. PMID- 1777941 TI - Dissolution and bioavailability of phenobarbital in solid dispersion with phosphatidylcholine. AB - The dissolution of phenobarbital (PB) from solid dispersion with phosphatidylcholine (PC) was studied. PB was present in an amorphous state in solid dispersion (PB-PC) if the mole fraction of PB was under 0.75. Thus, supersaturation was observed when an excess amount of PB-PC was dispersed in pH 1.2 and 6.8 media. The degree of supersaturation was largest when the mole fraction of PB was 0.25, although it was only 1.3-fold of the PB solubility in this case. Dissolution from PB-PC was rapid and complete in both pH 1.2 and 6.8 media regardless of the mole fraction of PB, above 90% within 5 min. Bioavailability after the oral administration of PB-PC to rabbits with a dose of 15 mg/kg equivalent to PB was compared with that of PB crystals. The area under the plasma concentration curve was bigger, but not significant. The maximum concentration was significantly higher, and the time to maximum concentration was significantly faster. These results indicate that the absorption rate became high with PB-PC because the dissolution was rapid. PMID- 1777942 TI - Insulin-carrying microspheres, in vitro studies. AB - Loading and release characteristics of insulin-carrying albumin and starch microspheres have been studied in vitro. The sorption characteristics of 125I labelled insulin onto albumin microspheres were studied and were found to be completed within 5h, and the loading capacity was found to be 0.14% w/w. Insulin did not show any sorption into the matrix of the starch microspheres. The release characteristics were analyzed by high performance liquid chromatography. About 80% was released within 5-10 min from albumin microspheres and starch microspheres, respectively. PMID- 1777943 TI - Atomic force microscope images of the surfaces of aspirin crystals at submolecular resolution. AB - The atomic force microscope has been developed and used to image arrays of molecules at the (001) and (100) faces of aspirin crystals in water and in air. Lattice spacings composed of methyl groups and the part of the phenyl groups on the surface of the (001) in water, are consistent with X-ray diffraction data. The surface of (100) face which shows most perfect cleavage in bulk, is more difficult to image. This initial success in imaging at drug crystal surfaces clarified the different structural behavior at the submolecular level for three crystal faces, and the close relationship to the differences in the dissolution velocity. PMID- 1777944 TI - Isolation, sequence and bacterial expression of a cDNA for chalcone synthase from the cultured cells of Pueraria lobata. AB - cDNA clones for chalcone synthase (CHS) of Pueraria lobata cultured cells were isolated by screening the cDNA library using CHS cDNA of Phaseolus vulgaris as a probe. Analysis of nucleotide sequences of the cloned cDNA revealed a 1170-bp open reading frame that encoded a 390-amino acid polypeptide with an Mr of 43,000. The full-length cDNA was cloned into the expression vector pT7-7. CHS activity was found in the crude extracts of transformed E. coli after induction and two protein bands of ca. 43 and 34 kd were hybridized with anti-persley CHS antiserum. PMID- 1777945 TI - Cardiac contractility and blood flow distribution following resuscitation with 7.5% hypertonic saline in anesthetized dogs. AB - We examined the specific effects of 7.5% hypertonic saline (HTS) on myocardial performance and regional blood flow and compared the efficacies of HTS and lactated Ringer's solution (LR) for hypovolemic resuscitation. Studies were performed in anesthetized dogs subjected to rapid hemorrhage to decrease mean arterial pressure by 50% over 60 min. The animals were resuscitated with either HTS (n = 8) at 5 ml/kg or LR (n = 7) at a dose required for equivalent restoration of cardiac output. Cardiac contractility was assessed using the slope Ees of the left ventricular end-systolic pressure-diameter relationship and regional blood flow was measured using radioactive microspheres. At 10 min after resuscitation, mean arterial pressure increased from 45.1 +/- 2.5 to 77.7 +/- 3.2 mmHg with HTS and 50.9 +/- 2.5 to 80.1 +/- 3.2 mmHg with LR. Resuscitation with either fluid caused significant increases in heart rate and similar decreases in vascular resistance. Cardiac contractility (Ees) did not change significantly with LR, whereas with HTS, Ees increased from 14.8 +/- 0.9 during hemorrhage to 19.4 +/- 1.6 as compared with a baseline value of 13.4 +/- 1.5 mmHg/mm. Hemorrhage decreased blood flow to various organs by 50% to 70% of baseline. Except for better improvement in splenic and hepatic perfusion with HTS, similar restoration of blood flow to the heart, muscle, skin, kidney, and jejunum was observed at 10 min after resuscitation with either fluid. In this animal model of rapid and severe hemorrhagic shock, HTS given at approximately one-sixth the volume of LR was equally effective in providing temporary restoration of hemodynamic function.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1777947 TI - Tumor necrosis factor (cachectin) in the biology of septic shock syndrome. AB - The high mortality of septic shock syndrome has prompted extensive investigation into its pathogenesis. Tumor necrosis factor (TNF), a cytokine that is often over produced during Gram-negative or Gram-positive infection, occupies a critical role in triggering this catastrophic illness. The net effects of TNF are dependent upon its concentration in certain vital tissues, and may be dissociated from the presence of the invading pathogens. Agents that inhibit TNF have been developed; these protect against shock and tissue injury and are currently being investigated in clinical trials of septic shock syndrome. PMID- 1777946 TI - Calcium-dependent and calcium-independent protease activities in skeletal muscle during sepsis. AB - Sepsis was produced in rats by implanting into their abdominal cavities fecal pellets containing Escherichia coli (10(2) colony-forming units [CFU]) and Bacteroides fragilis (10(4) CFU). Control rats were implanted with sterile pellets. A febrile response and hyperlactacidemia marked the onset of the septic injury. Control and septic rats were killed 24 and 48 hr after implantations, and posterior leg muscles were removed. Muscles were homogenized to prepare soluble fractions containing calcium-independent lysosomal (cathepsins B and L) and calcium-dependent cytosolic (calpain) proteases. Cathepsin and calpain activities were then assayed using standard procedures. There were no alterations in cathepsins B or L activities during sepsis. Calpain activity in septic muscle was significantly higher than that in control muscles. In vitro calpain sensitivity to Ca2+ was also higher in septic muscle than in controls. The cysteine protease inhibitor leupeptin caused a quantitatively greater inhibition of calpain activity in septic than in control muscles. These data indicate that whereas sepsis has no effect on Ca(2+)-insensitive lysosomal proteases, it is associated with an elevation of the Ca(2+)-dependent cytosolic protease activity. PMID- 1777948 TI - Imbalance between plasma levels of thromboxane B2 and 6-keto-prostaglandin F1 alpha during subacute endotoxin-induced hyperdynamic sepsis or multiple organ failure syndrome in sheep. AB - We compared the time course of plasma and pulmonary lymph levels of thromboxane B2 (TxB2) and 6-keto-prostaglandin (PG)F1 alpha during the development of either the hyperdynamic phase of sepsis or of the multiple organ failure syndrome (MOFS) associated with sepsis in 26 chronically instrumented awake sheep with intravascular catheters and a chronic pulmonary lymph fistula. Using a continuous i.v. infusion of Escherichia coli endotoxin administered at a rate of 20 ng.kg 1.min-1 (group E20, n = 9) resulted in hyperdynamic septic shock with more than 75% of animals surviving after 72 h of continuous endotoxin administration. Infusing endotoxin at a higher dosage (40 ng.kg-1.min-1; group E40, n = 9) resulted in the development of respiratory failure and MOFS with death occurring within 55 hr of endotoxemia. Eight similarly instrumented sheep served as controls. Administration of endotoxin produced within 4 hr in both endotoxin groups a significant increase in arterial plasma concentration of TxB2, which was not significantly different between both endotoxin groups. Thereafter, plasma TxB2 concentrations progressively decreased in the E20 group to reach at 36 hr values significantly lower than those measured in control sheep not given endotoxin. In the E40 group, plasma TxB2 concentrations returned to baseline values during the development of a MOFS. The time course of TxB2 concentrations in pulmonary lymph in both endotoxin groups was similar to that measured in each group in plasma. 6-Keto-PGF1 alpha concentrations in arterial plasma and pulmonary lymph were significantly higher than in controls during the first 20 hr following the start of endotoxin infusion in both endotoxin groups and were not different between these groups. Thereafter, plasma and pulmonary lymph 6-keto PGF1 alpha concentrations progressively returned to baseline values in the E20 group and remained at these levels up to the end of the study period (72 hr). In the E40 group, plasma 6-keto-PGF1 alpha concentrations also decreased to baseline values during the second day of endotoxemia but then significantly increased in sheep that survived more than 36 hr and developed a hypodynamic septic state. During the first 24 hr of endotoxemia, the plasma TxB2/6-keto-PGF1 alpha ratio was similar in controls and in both endotoxin groups. During the second study day, TxB2/6-keto-PGF1 alpha ratio progressively decreased in both endotoxin groups to reach and maintain values significantly lower than those measured in controls at 36 hr in the E40 group and at 52 hr in E20 group.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1777949 TI - Hepatic insufficiency and increased proteolysis, cardiac output, and oxygen consumption following hemorrhage. AB - Thirty dogs underwent hemorrhage over a 60-min period to a predetermined O2 debt of 60-120 mL O2/kg, monitored with a Beckman metabolic cart, and then were resuscitated with 120% of the shed volume. Twenty survived and were followed over the next 7 days. On day 4, hepatic insufficiency was suggested by an elevation in [total amino acids] and [lactate] and a decrease in [urea] and [branched-chain amino acids]/[aromatic amino acids]. Net whole body catabolism on day 4 is suggested by a decrease in [glutamine] and an increase in plasma [3 methylhistidine], [phenylalanine], and [tyrosine]. These changes were significantly related to cardiac index, mean blood pressure, [lactate], O2 debt, and shed volume during the hemorrhage 4 days earlier. On day 7 there was a significant increase in the cardiac index and the VO2. These data suggest that hemorrhage induces sequelae similar to major injury or sepsis: hepatic insufficiency, net catabolism, hypermetabolism, and a hyperdynamic circulation. The hyperdynamic circulation may be necessary to meet increased tissue delivery requirements for O2 and amino acids. PMID- 1777950 TI - Relationship of plasma amino acids to oxygen debt during hemorrhagic shock. AB - Thirty dogs underwent hemorrhage over a 60 minute period to a predetermined O2 debt of 60-120 mL O2/kg, quantified real-time by a Beckman metabolic cart; they were then resuscitated with 120% of the shed volume. The [total amino acids], [lactate], and [alanine]/[glutamine] rose during hemorrhage and resuscitation. Blood pressure, VO2, cardiac index, circulating amino acid pool, and systemic amino acid transport decreased during hemorrhage, but rose during resuscitation. The [total amino acids], [alanine]/[glutamine], cardiac index, blood pressure, and [lactate] were significantly related to O2 debt. The O2 debt during hemorrhage was substantially better related to [lactate] compared to shed volume or blood pressure. The changes in [total amino acids] and [alanine]/[glutamine] and their relationship to O2 debt suggest a hemorrhagic-induced alteration in tissue amino acid kinetics. These data further suggest that using a metabolic substrate parameter such as O2 utilization is useful to stratify other cellular alterations such as amino acid uptake and release and lactic acidosis. PMID- 1777951 TI - Portal venous compliance in canine endotoxin shock. AB - The response of the small intestinal vascular bed to endotoxin and ibuprofen was determined in mongrel dogs under pentobarbital anesthesia. Blood flow was measured in the superior mesenteric artery and pressures in the artery and portal vein. Venous compliance was calculated from the rate of pressure rise in the occluded portal vein at a constant arterial inflow. The response to endotoxin was followed for 1 hr, ibuprofen was given, and the response was followed for a second hour. Arterial pressure and mesenteric flow decreased after endotoxin, accompanied by an increase in venous compliance and in the compliance/resistance ratio. Treatment with ibuprofen increased arterial pressure but did not improve blood flow; however, it effectively reversed the changes in compliance. The results indicate a loss of arterial vasomotor tone in response to endotoxin which is not shared by the portal venous system. This may result in fluid loss into the intestinal bed. Ibuprofen restored arterial tone and released the venous constriction, but did not significantly alter the metabolic responses to endotoxin. PMID- 1777952 TI - Insulin-inhibiting effects of epinephrine are blunted during endotoxicosis in the rat. AB - This study was conducted to examine the conditions under which epinephrine (EPI) blocks glucose-induced hyperinsulinemia in normal and endotoxic rats. Nutritional state (fasting vs. feeding) and anesthetic state (conscious vs. sodium pentobarbital anesthesia) were explored as factors that could influence the effects of epinephrine on immunoreactive insulin (IRI) levels. Exogenous epinephrine infusion into control rats significantly blunted hyperinsulinemia in response to an exogenous glucose challenge in fed rats, but not fasted rats. Endotoxin-treated rats (3.3 mg/kg) showed endogenously elevated levels of both EPI and IRI during the hyperglycemic period that is characteristic of early endotoxicosis. All endotoxic rats showed hyperinsulinemia in response to an exogenous glucose challenge, despite the simultaneous presence of elevated catecholamine levels. However, hyperinsulinemia (induced by glucose challenge) was two-fold higher in pentobarbital-anesthetized, endotoxic rats (both fed and fasted) than in respective control rats under the same conditions. These results show that fasted rats are resistant to the insulin-inhibiting effects of epinephrine. In addition, since hyperinsulinemia occurs during endotoxicosis (in both fed and fasted states) despite the presence of elevated catecholamine levels, the results indicate that endotoxin treatment decreases the inhibitory effects of epinephrine on insulin levels. This effect is potentiated by pentobarbital anesthesia and is more pronounced in the fed rat than in the fasted rat. PMID- 1777953 TI - High-dose corticosteroid therapy in human septic shock: has the jury reached a correct verdict? AB - Many studies have been published concerning high-dose corticosteroids (HDC) in septic shock. Most of them have been criticized for not adhering to methodologic standards. Four studies were published during the 1980s taking into consideration the criticism of previous trials. The general conclusion following these trials was the HDC should not be used in the treatment of septic shock. The aim of this review is to compare these trials as regards their aims, study design, results, and conclusions. The validity of the data presented is discussed. It is concluded that there is no unequivocal evidence that HDC is beneficial in septic shock, but it must be realized that there are tremendous difficulties in obtaining the true state of affairs in clinical trials regarding patients in septic shock. Accumulated data indicate that HDC, given as one single dose during the initial hours of gram-negative septic shock, more likely than not has a beneficial effect on mortality. PMID- 1777954 TI - Impaired carnitine transport in the rat heart during E. coli sepsis. AB - To determine the mechanism for the reduced content of myocardial carnitine during gram-negative sepsis, carnitine transport was examined in isolated perfused hearts. Rats were injected i.v. with 8 x 10(7) live colonies of E. coli per 100 g body weight or physiological saline. All rats were fasted after injection for 22 hr to equalize the differences in food intake. Total carnitine uptake in the hearts from both groups was essentially linear between 10 and 20 min of perfusion with 40 microM of carnitine. However, total uptake was significantly reduced by approximately 30% in the hearts from the E. coli-treated rats. In addition to the significant reduction in total carnitine uptake at 40 microM, uptake was significantly lower at 100 microM perfusate carnitine in hearts from E. coli treated rats. However, total uptake was not significantly different between the groups at 200 and 300 microM perfusate carnitine. Carnitine uptake in the presence of 0.05 M mersalyl acid was comparable in both groups of hearts at all perfusate carnitine concentrations indicating no change in the diffusion component of transport in the hearts from the fasted E. coli-treated rats. The reduction in total uptake at 40 microM and 100 microM of perfusate carnitine was due to a 42% and 26%, respectively, decrease in the carrier-mediated uptake. This data suggests that the reduced content of myocardial carnitine in fasted E. coli treated rats is due to the decrease in the carrier-mediated component of transport. PMID- 1777955 TI - Renal function and metabolism during endotoxemia in rats: role of hypoperfusion. AB - Renal failure often complicates endotoxin shock. This might be due to renal hypoperfusion, but endotoxemia could also have additional effects. We studied in anesthetized rats renal plasma flow (RPF), glomerular filtration rate (GFR), and metabolism (ATP, CrP = creatine phosphate, energy charge = [ATP + 0.5 ADP]/[ATP + ADP + AMP], lactate, glucose) during endotoxin shock (Escherichia coli endotoxin, 10 mg/kg for 60 min; n = 10) and "balloon shock" (balloon inflated in vena cava below renal vein to cause comparable decreases in cardiac output and RPF as in endotoxin-treated rats; n = 10). A third group of rats served as controls (n = 10). At t = 0 infusion of endotoxin was started. At t = 90 min, when cardiac output was low and serum lactate was high (indicating shock), GFR and RPF were obtained from plasma disappearance rates (from t = 90 to t = 135 min) of 125I thalamate and 131I-hippurate, respectively. Experiments ended at t = 135 min. In both shock groups RPF decreased (by ca. - 75% compared with control rats), but filtration fraction only increased (by 72%) in the "balloon shock" rats. In renal biopsies lactate concentration increased more (by 407 vs. 167%) and ATP decreased more (by -63 vs. - 35%) during endotoxin shock than during "balloon shock"; the endotoxin-treated rats also showed a significant decrease in CrP (by - 58%), energy charge (by - 31%), and glucose concentration (by - 34%), and an increase in the number of leukocytes in the glomeruli (by 730%). Renal function and metabolism thus was more affected in this hypodynamic form of endotoxin shock than in "balloon shock." This may be caused by the effects of endotoxin on sticking of leukocytes and renal metabolism. PMID- 1777956 TI - Effect of cyclic stretch on endothelial cells from different vascular beds. AB - Endothelial cells (EC) mediate many of the organ responses to shock. Much of our knowledge of EC are obtained from cell culture studies. However, compared to the dynamic milieu in vivo, the stationary environment for large-vessel EC may be artificial and inappropriate. In this study, the morphology, growth rate, and production of prostacyclin (PGI2) by EC obtained from different vascular beds under stationary and dynamic conditions were examined. EC were harvested from the thoracic aorta (Ao), pulmonary artery (PA), and vena cava (VC) of the same calves and exposed to 0.5 sec 24% deformation alternating with 0.5 sec relaxation (i.e., 60 cycles/min). Our results show that in response to the cyclic regimen, VCEC were elongated perpendicular to the force vector and their actin filaments aligned in the same direction, while AoEC and PAEC did not exhibit any morphological changes. The growth rate of AoEC (but not PAEC or VCEC) was significantly enhanced when stimulated by cyclic stretch. In addition, AoEC demonstrated an increased PGI2 synthetic activity with cyclic stretch, while PAEC and VCEC were unaltered. We conclude that the maintenance of EC phenotype and function is dependent on the hemodynamic milieu in vivo and may be influenced by the vascular origin of the cultured EC. PMID- 1777957 TI - Total body blood volume redistribution in porcine E. coli septic shock: effect of volume loading, dobutamine, and norepinephrine. AB - The purpose of the present study was to determine the effect of volume loading alone (CONTR) vs. volume loading in combination with dobutamine (DOBU) or norepinephrine (NOR) on total body blood volume distribution in septic shock. After instrumentation, injection of in vitro labelled 99mTc red blood cells, and baseline measurements, anesthetized, ventilated pigs (n = 21) received 3 4.10(8).kg-1 live E. coli bacteria intravenously. Images of thorax, abdomen, and hindlimb were obtained by using a gamma camera simultaneously with hemodynamic measurements. E. coli infusion resulted in a decrease in arterial pressure, ventricular filling pressures, and cardiac output with a concomitant increase in pulmonary arterial pressure. Blood volume was redistributed from the heart, lungs, spleen, abdomen, and leg to the liver. After randomization, the CONTR group (I, n = 5) was subjected to volume loading, and treatment groups (each n = 8) received volume loading in combination with DOBU (group II, 5-10 micrograms/kg/min) or NOR (group III, 0.25-0.50 micrograms/kg/min). As compared to volume loading alone, DOBU and NOR increased cardiac output but only NOR restored arterial pressure. Volume loading increased blood volume in all regions studied; however, it was unequally distributed amongst organs with a preference for the liver. Neither DOBU nor NOR influenced the partitioning of the infused volume between organs. However, NOR prevented pooling of blood in the leg. PMID- 1777958 TI - Comparison of the efficacy of mechanistically different antioxidants in the rat hemorrhagic shock model. AB - Four pharmacological mechanisms for antagonizing free radical generation or reactions were compared in terms of their efficacy in attenuating hemorrhagic shock in rats. These included opposing superoxide generation by xanthine oxidase (e.g., oxypurinol), inhibiting arachidonic acid oxidation by cyclooxygenase (e.g., ibuprofen), chelating iron (e.g., desferal), and inhibiting lipid peroxidation (e.g., tirilazad mesylate [U-74006F] and U-78517G). Animals were hemorrhaged to a mean arterial pressure (MAP) of 43-45 mmHg where they were held for 2 hr. Five minutes prior to the end of the hemorrhage period, either vehicle, U-74006F (10 mg/kg), U-78517G (10 mg/kg), oxypurinol (10 or 25 mg/kg), desferal (10 or 25 mg/kg), or ibuprofen (10 mg/kg) was administered i.v., followed by the reinfusion of shed blood. In vehicle-treated animals, MAP declined progressively over the 2 hr post-reinfusion. Ibuprofen, desferal, and oxypurinol treatments each failed to attenuate this decline. In contrast, both U-74006F and U-78517G resulted in a significantly improved maintenance of MAP. Evidence of shock induced lipid peroxidation was observed in terms of a 73.8% depletion in liver vitamin E content at 2 hr post-reinfusion in vehicle-treated rats. This decrease was prevented by both U-74006F and U-78517G. Inhibition of free radical-induced lipid peroxidation appears more effective for attenuating free radical pathophysiology in hemorrhagic shock that attempting to inhibit specific pathways of oxygen radical generation. PMID- 1777959 TI - Influences of traumatic brain injury on the outcomes of delayed and repeated hemorrhages. AB - Effects of traumatic brain injury (fluid percussion) on outcomes of hemorrhage, either delayed (70.5 min after the injury) or repeated (0.5 min after injury, then followed by a delayed hemorrhage), were examined in 4 groups of 10 anesthetized rats. Comparisons were made for delayed hemorrhage following sham injury (A1) vs. injury (A2) and for repeated hemorrhage following sham injury (B1) vs. injury (B2). No significant differences were observed in MAP, Cl, HR, SVI, SVRI, and CVP between groups A1 and A2. Hemodynamic recovery was significantly better in B1 than B2 at 70 min after the initial hemorrhage. The respective values of MAP and Cl for the groups B1 and B2 at 70 min were 65 +/- 3 vs. 56 +/- 4 mmHg and 220 +/- 15 vs. 182 +/- 15 ml/min/kg. Brain trauma did not affect survival rate (90 vs. 100%) following delayed hemorrhage, but significantly worsened the outcome of repeated hemorrhage. The 130 min survival rates for groups B1 and B2 were 50% and 10% (P = 0.08), respectively; their survival curves were significantly different (P = 0.02). Our data indicate that brain trauma has greater impact on responses to immediate hemorrhage than delayed hemorrhage, suggesting that traumatic brain injury may have a time-dependent effect on the response to hemorrhage. PMID- 1777960 TI - Hemodynamic variables and plasma levels of PGI2, TXA2 and IL-6 in a porcine model of recurrent endotoxemia. AB - The pulmonary and systemic hemodynamic effects of recurrent endotoxemia were studied in pigs over a 48-hr period. Six pigs of the test group were given 0.5 micrograms/kg of an E. coli endotoxin (WO111: B4) over 60 min at the beginning and in the middle (22 hr) of the experiment. Three pigs given the same amount of physiological saline solution served as controls. The hemodynamic response to the first LPS injection was characterized by severe pulmonary hypertension, a significant increase in systemic vascular resistance, and a marked decrease in cardiac output. Circulating TxB2 levels were higher than those of 6-keto-PGF1 alpha levels, so that the first response to LPS is influenced by the vasoconstrictive actions of TxA2. With the second LPS application, the pulmonary response was attenuated, although a significant increase of pulmonary artery pressure and pulmonary vascular resistance occurred. Once again systemic vascular resistance rose and cardiac output decreased, but this time plasma levels of 6 keto-PGF1 alpha were greater than those of TxB2. Toward the end of the experiment, we noted the progressive onset of a hyperdynamic and hypotensive state. Systemic vascular resistant index decreased to 50% of the baseline value. IL-6, a cytokine of systemic importance during the course of septic shock, markedly and significantly peaked after each LPS injection. Circulating plasma levels in response to recurrent endotoxemia are described. PMID- 1777961 TI - Use of antioxidant therapy in shock and trauma. AB - Antioxidant therapy can be defined in the clinical setting as any process that prevents or decreases oxidant injury. A number of common clinical approaches to the shock and trauma patient can be considered as preventing oxidant damage. In fact, their beneficial effects may be related more to antioxidant activity than is currently recognized. In addition, there are a number of new drugs, many of them already clinically used for other indications, that have antioxidant and general inflammatory activity and are either undergoing or are about to undergo clinical testing. The era of antioxidant therapy has arrived. PMID- 1777962 TI - Mechanized assay of plasma prekallikrein by activation with Pseudomonas aeruginosa elastase and amidolysis of chromogenic substrate. AB - An automated assay of plasma prekallikrein is described. Prekallikrein was converted to kallikrein with Pseudomonas aeruginosa elastase, and the hydrolytic activity of kallikrein to H-D-Pro-Phe-Arg-paranitroanilide subsequently measured. The conversion was complete within 8 minutes and the amidolytic activity remained stable at least another 10 min at 37 degrees C. This method worked in plasma deficient in Hageman factor (blood coagulation factor XII). Using anti prekallikrein antibody and plasma deficient in prekallikrein, the amidolytic activity generated in normal plasma was identified as due to kallikrein. With plasma samples, the coefficients of variation (CV) for multiple measurements within run (n = 10) and between run (n = 10) were as low as 5.0% and 6.6%, respectively, and the minimum measurable concentration of prekallikrein in plasma was 10% of the normal level. PMID- 1777963 TI - Human aortic elastin from normal individuals and atherosclerotic patients: lipid and cation contents; susceptibility to elastolysis. AB - Aortic elastins, isolated from 30 humans of different ages, were purified by alkaline extraction, and separated into two groups depending on the presence of atherosclerotic plaques and calcification (grades 0 and 1). It was confirmed that the severity of atherosclerosis increases significantly with age (P less than 0.001) and elastin content decreases with atherosclerosis (P less than 0.001). The hydrolysis of the aortic elastins using pancreatic porcine elastase (PPE) was studied. It was observed that increased elastolytic activities are connected with severity of atherosclerosis (P less than 0.001) and both Vm and Km apparent kinetic parameters are affected (P less than 0.001). Correlation tests have shown that enzymatic hydrolysis is significantly modified by cholesterol (P less than 0.05), calcium (P less than 0.001) and magnesium concentrations (P less than 0.01) but only cholesterol changes significantly Vm and Km parameters. PMID- 1777964 TI - Development of enzyme-linked immunosorbent assay for free human pro-colipase activation peptide (APGPR). AB - Human pancreatic colipase is secreted as the inactive form procolipase. Activation involves tryptic cleavage of an N-terminal pentapeptide Ala-Pro-Gly Pro-Arg (APGPR) which is known as procolipase activation peptide (CLAP). N terminally haptenised synthetic APGPR was used to generate specific C-terminally directed anti-APGPR antibodies. The antiserum was used to develop a competitive enzyme linked immunosorbent assay (ELISA) specific for free CLAP with a detection limit of 12 nmol/l and an intra-assay coefficient of variation (CV) of 3.28% and an inter-assay CV of 5.82%. The release of immunoreactive CLAP from human pancreatic juice and chicken pancreas upon trypsinisation was demonstrated, as well as the absence of reactivity of the antisera with procolipase from which the CLAP is released. APGPR was found to be unstable in biological fluids. Immunoreactivity is rapidly lost with half life of 5 min and 4 h in human serum and urine respectively. This loss of reactivity can be significantly slowed by the addition of 20 mmol/l Zinc ions (Zn2+), while ethylenediaminetetra-acetic acid (EDTA) and other protease inhibitors were ineffective. In serum the moiety responsible for loss of immunoreactivity was found to have an estimated molecular mass of 200,000-300,000 Da. CLAP assay specifically reports procolipase activation and may help elucidate the mechanism of satiety as well as contribute to the recognition and understanding of the role of procolipase activation in diseases states such as pancreatitis. PMID- 1777965 TI - Biochemical properties of blood cells from histiocytosis X patients. PMID- 1777966 TI - Stability of platelet activating factor (PAF) in human saliva. Quantitation by radioimmunoassay. AB - Platelet activating factor (PAF) is thought to mediate many inflammatory processes and its involvement in health and disease may be clarified by examining PAF levels in human secretions. The known presence of PAF, the ease of obtaining samples and the relative stability of PAF in saliva, makes this fluid a preferred source for examination of PAF in health and disease. The activity of PAF acetylhydrolase (the PAF degrading enzyme) in saliva was 1,000-fold lower than that found in human plasma. Extraction of saliva with chloroform/methanol/water resulted in 70-90% recovery of PAF. Using the radioimmunoassay (RIA), PAF levels in the range 0.5-21 ng/ml were found in normal human salivas. These values were significantly higher than those reported from bioassay studies based on washed platelets. The validity of the RIA was checked by isolating and quantitating the PAF fraction from whole saliva extract, and by treatment of the extracts with the enzyme phospholipase A2. Direct comparison of salivary PAF levels, determined by both platelet aggregation (PA) and RIA confirmed our original finding that values obtained were lower using the bioassay method. Furthermore, these bioassay values compared favourably with those in the literature. Investigations revealed the presence of a substance(s) in saliva which inhibited PAF-induced platelet aggregation but which did not affect the radioimmunoassay. PMID- 1777967 TI - Immunological assay of erythrocyte acetylcholinesterase. AB - An immunoassay for the quantitation of erythrocyte surface acetylcholinesterase is described; using a red cell suspension, bound mouse monoclonal acetylcholinesterase antibody is detected by an alkaline phosphatase conjugated rabbit anti mouse IgG. Extraction is not required. In addition, the activity of erythrocyte surface acetylcholinesterase using dithiobisnitrobenzoate to detect released thiocholine has been measured. The coefficient of variation for each method is 7%. Reference ranges have been established for healthy adults and cord blood. PMID- 1777968 TI - Serum amyloid P component in chronic renal failure and dialysis. AB - A normal reference interval for serum amyloid P component (SAP) concentration in the serum was established in 500 healthy adult individuals (274 women, 226 men), by electroimmunoassay calibrated with standards of highly purified, isolated SAP. The mass of SAP in these was determined from the extinction coefficient of SAP at 280 nm measured here precisely for the first time by spectrophotometry and cryogenic drying. The mean (SD, range) SAP concentration was significantly lower in women: 24 mg/l (8, 8-55), compared to 32 mg/l (7, 12-50) in men (P less than 0.001). In renal insufficiency patients, 38 with chronic renal failure, 79 on hemodialysis and 66 on continuous ambulatory peritoneal dialysis, the mean values for SAP concentration were all significantly higher than normal (range of means, 39-59 mg/l in men and 35-42 mg/l in women), but did not correlate with serum creatinine, duration of dialysis or the presence of an acute phase response. The metabolism of SAP is thus altered in renal failure and is not normalized by dialysis, but it is not clear whether this is relevant to the pathogenesis of dialysis related arthropathy and amyloidosis. PMID- 1777969 TI - Increased elastase-alpha 1-antitrypsin complex in fulminant hepatic failure: relationship to bacterial infection and activation of coagulation. AB - To study the effect of infection, a frequent complication of fulminant hepatic failure (FHF), on the release of elastase from polymorphonuclear leucocytes and its inhibition in circulation we have measured the concentrations of alpha 1 antitrypsin, which binds and inhibits elastase in the circulation, and of elastase-alpha 1-antitrypsin complex, in 30 patients with FHF. Elastase-alpha 1 antitrypsin complex was significantly increased in FHF as compared to controls (303 +/- 51 micrograms/l compared to 37 +/- 5 micrograms/l; n = 10; P less than 0.001) demonstrating activation of leucocytes in FHF. Infection caused greater release of leucocyte elastase, complex levels were significantly greater in patients who were infected when compared to those who were not (463 +/- 84 micrograms/l; n = 13 compared to 180 +/- 46 micrograms/l; n = 17; P less than 0.01). Also patients who survived had significantly lower complex levels than those who did not (212 +/- 49 micrograms/l; n = 18 compared to 440 +/- 94 micrograms/l; n = 12; P less than 0.02). alpha 1-Antitrypsin activity was not significantly different from control subjects (0.99 +/- 0.06 U/ml compared to 0.97 +/- 0.05 U/ml). However alpha 1-antitrypsin activity was significantly higher in patients who survived (1.17 +/- 0.05 U/ml; n = 18) compared to those who did not (0.71 +/- 0.03 U/ml; n = 12; P less than 0.001) and patients who died had significantly lower levels than control subjects (P less than 0.01) indicating the importance of maintenance of normal inhibitor levels in patients with FHF. The leucocyte activation and release of elastase in FHF was linked to activation of the coagulation system; elastase--alpha 1-antitrypsin complex levels correlated significantly with thrombin-antithrombin III complex levels (r = 0.68; P less than 0.001) and inversely with fibrinogen (r = -0.71; P less than 0.001). PMID- 1777970 TI - Usefulness of faecal water potassium/sodium ratios in the investigation of diarrhoea. PMID- 1777971 TI - Impossibility to study crystalluria directly with Coulter Counter. PMID- 1777972 TI - Glycohistones in diabetic human liver. PMID- 1777973 TI - CA 15-3 and carcinoembryonic antigen in the clinical evaluation of breast cancer. AB - The individual and combined value of CA 15-3 and carcinoembryonic antigen (CEA) as breast cancer tumor markers was investigated in longitudinal studies. Patients included women at high risk for recurrence after primary therapy or undergoing treatment for metastatic disease. During follow-up, recurrent disease was documented in 33 of 39 (85%) patients including 11 with local recurrence and 22 with distant metastases. At the time recurrence was first documented by objective criteria 23 of 33 (70%) of the patients presented with abnormal CA 15-3 levels (greater than 36.7 U/ml) compared with 19/33 (58%) with abnormal CEA levels (5 ng/ml). Tumor marker elevations predominated in patients with advanced disease indicating that CA 15-3 and CEA are not reliable for the detection of early breast cancer. Both markers were helpful in monitoring therapeutic response since antigen levels correlated closely with disease status. PMID- 1777974 TI - The effects of common matrices for assay standards on performance of 'ultra sensitive' immunometric assays for TSH. Report of a joint WHO/IFCC collaborative study. AB - This report describes the results of a collaborative study organized by a joint working group of IFCC and WHO and involving nine manufacturers of TSH immunometric assay kits. The study was designed to determine whether a calibrator with a common matrix gives better between-laboratory agreement for calibration of serum samples than the various kit calibrators, and to assess various materials for their suitability for use as common matrices. Kit calibrators or calibrators consisting of the IRP for TSH made up in two common matrices, (1) serum from patients with untreated thyrotoxicosis or (2) serum taken from subjects treated with suppressive doses of triiodothyronine, gave similar results for the between laboratory variation of estimates of TSH concentration for a range of serum samples. Dose-response curves for the two calibrators in 'common' matrices were similar to one another and to those for the kit calibrator. However, the occurrence of non-specific serum effects is shown by the comparison of results for these calibrators with results for calibrators made up in a third common matrix, serum treated with wheat germ lectin. Dose-response curves for this calibrator were dissimilar to those for the other calibrators and between laboratory variation for estimates in terms of this latter calibrator showed a substantial increase. Moreover, although the between-laboratory variances for estimates of the TSH concentration in terms of each of these calibrators (except those made up in serum treated with in the wheat germ lectin) were similar for any one sample from five hyperthyroid patients, the variances were not consistent between samples, even for samples with similar mean TSH concentrations. These results suggest that a major factor in the between-laboratory variation, especially in the region near 'zero dose', is sample-related, and is caused by particular samples interacting differently with different assay systems. In general, it would appear that for the well controlled 'ultra-sensitive' TSH immunometric assay kits, included in this study, between-laboratory agreement of estimates of the TSH concentration in serum samples is not likely to be substantially improved by use of a common matrix for the standards. PMID- 1777975 TI - Effect of simvastatin on the apparent size of LDL particles in patients with type IIB hyperlipoproteinemia. AB - After 15 weeks of simvastatin therapy (20 mg/day), low density lipoprotein particle size in sera of 16 patients with type IIb hyperlipoproteinemia increased significantly from 233 +/- 5.0 A to 237 +/- 7.0 A (P less than 0.05), analyzed by 2-16% polyacrylamide gradient gel electrophoresis. Under simvastatin therapy the concentrations of total cholesterol, total triglyceride, very low density lipoprotein cholesterol and triglyceride, low density lipoprotein cholesterol and apolipoprotein B in serum fell significantly by 30%, 30%, 43%, 28%, 36% and 26%, respectively, and the concentration of high density lipoprotein cholesterol rose significantly by 14%. The changes of low density lipoprotein particle size induced by simvastatin therapy were correlated best with the changes of very low density lipoprotein triglyceride concentration (r2 = 0.438, P less than 0.01). Our results suggest that simvastatin therapy, additionally to a reduction of the serum cholesterol concentration, increases low density lipoprotein particle size which may contribute to reduction of the risk of coronary heart disease in patients with type IIb hyperlipoproteinemia. PMID- 1777976 TI - Energy metabolism during damaging contractile activity in isolated skeletal muscle: a 31P-NMR study. AB - Creatine kinase (CK) release in response to excessive electrically stimulated contractile activity has been studied in isolated rat soleus muscles. The exacerbation of CK release induced by contractile activity was found to be directly related to the length of time for which the muscle was stimulated and indirectly related to the recovery of force following the end of stimulation. 31P NMR studies were undertaken using a recirculating superfused muscle preparation and demonstrated that muscles subjected to two different stimulation protocols (stimulation for 0.5 s every 2 s in oxygenated medium or for 1.5 s every 2 s in anoxic medium) had similar falls in ATP content and pH despite a substantially greater release of CK from the muscles stimulated under anoxia. However, stimulated muscles under anoxia showed a more rapid fall and reduced recovery of phosphocreatine and a greater sustained elevation of inorganic phosphate than muscles in oxygenated medium. It is concluded that only part of the increased loss of CK from muscles stimulated in anoxic medium can be explained by release from cells which have lost energy supplies and therefore that other mechanisms must exist which allow release of CK and other cytosolic enzymes from muscle cells. PMID- 1777977 TI - Abnormal serum immunoglobulin concentrations in patients with diabetes mellitus. AB - Since the recently reported relationship between serum fructosamine and IgA concentrations appears to throw doubt on the clinical utility of fructosamine as a measure of hyperglycemic status if IgA concentration is not taken into account, we studied serum immunoglobulin concentrations in 169 diabetics and their relationship with various clinical and analytical parameters. Over 41% of the patients studied had abnormal serum IgA concentrations. Serum IgA concentration was negatively correlated with serum albumin, and among IDDM patients was positively correlated with age (so that the prevalence of abnormal IgA was 57.7% among IDDM patients aged over 30 years). Among NIDDM patients, abnormal IgA concentrations were especially prevalent among those being treated with oral hypoglycemics. Abnormal IgA was also more frequently found in both IDDM and NIDDM patients, who had been under treatment for 10 years or more. Abnormal IgG concentrations were found in 11.8% of the diabetics, and the mean IgM concentration found in the patients was 41.6% lower than in the normoglycemic group. We conclude that abnormal serum IgA concentrations are very common in diabetic patients and that further research should be carried out to verify whether the determination of serum immunoglobulins, IgA in particular, is of clinical use for monitoring diabetes or evaluating its secondary effects. PMID- 1777978 TI - Determination of apolipoprotein E phenotypes from stored or postmortem serum samples. AB - In order to assess the validity of Apo E phenotyping from stored specimens, phenotypes determined from fresh serum samples were compared with those from stored (8 years at -20 degrees C) samples from the same individuals (n = 42). The effect of early postmortem period on Apo E phenotype determinability was studied by taking four duplicate blood samples from eight cadavers 2, 6, 12, and 24 h after death. Apo E phenotyping was performed directly from serum by isoelectric focusing and immunoblotting. From the cadavers, the same Apo E phenotypes were obtained 2, 6, 12, and 24 h after death. After eight years' storage five out of ten Apo E4/4 phenotypes were falsely recorded as Apo E4/3 and one out of six Apo E4/3, one out of 12 Apo E4/2 were falsely interpreted as Apo E3/3. Phenotypes Apo E2/2 (n = 2), Apo E3/2 (n = 10), and Apo E3/3 (n = 2) were correctly assessed after 8 years of storage. In the total material, 17% (7/42) of Apo E phenotypes were incorrectly assessed after the storage. PMID- 1777979 TI - Detection of the most common mutation of adenine phosphoribosyltransferase deficiency among Japanese by a non-radioactive method. AB - About 79% of all the Japanese patients with adenine phosphoribosyltransferase (APRT) deficiency have been estimated to possess at least one APRT*J allele with a substitution of ACG for ATG at codon 136. We developed a non-radioactive method for diagnosing genotypes of this disease. Part of the genomic DNA including the mutation site of the APRT*J allele was amplified using polymerase chain reaction and the amplified product was dot-blotted onto nylon membranes and then hybridized with either APRT*J-specific or non-APRT*J-specific synthetic oligonucleotides labelled at the 5' termini with biotin in the presence of non labelled competitive synthetic sequences. The temperature was gradually decreased during the hybridization. When competitive sequences were omitted, difference in the intensity of the hybridization between APRT*J-containing and non-containing samples was not sufficiently clear to differentiate the genotypes. When an excess amount of competitive sequences was added in addition to biotin-labelled oligonucleotides, this method effectively differentiated samples containing only APRT*J alleles from those containing only non-APRT*J alleles. The present method was also useful to differentiate samples with both APRT*J and non-APRT*J alleles from those having only either of the alleles. An equivalent procedure using competitive sequence for hybridization and gradually decreasing the temperature will be useful for detecting point mutations in other genes. PMID- 1777980 TI - Rapid automated quantitation of isoleucine, leucine, tyrosine and phenylalanine from dried blood filter paper specimens. AB - Isothermal and isocratic HPLC chromatography for rapid quantitation of isoleucine and leucine (merged peak), tyrosine and phenylalanine from a single dried blood filter paper specimen (1/8" dot blot) is described. The net chromatography time of the relevant peaks is less than 3 min. The results can be used to screen for PKU, MSUD, and tyrosinemia in one single assay. The advantage for early determination of PKU by simultaneous quantitation of both phenylalanine and tyrosine with the determination of their ratio is discussed. Using a dual column system this procedure might be suitable for large-scale newborn screening. PMID- 1777981 TI - Urinary oligosaccharide excretion and severity of galactosialidosis and sialidosis. AB - Urinary oligosaccharides of galactosialidosis and sialidosis patients were investigated by the Bio-Gel P-4 column chromatography in order to delineate each clinical subtype biochemically. The levels of urinary oligosaccharides (nmol/mg creatinine) in late infantile-type galactosialidosis patients with early onset and severe clinical manifestations were 2.5 times the levels in juvenile/adult type patients. Galactosyl oligosaccharides which had not been reported in the analysis of galactosialidosis urine were identified in the urine of patients of both subtypes. The structures of the urinary oligosaccharides in late infantile type patients were the same as those in the juvenile/adult-type patients. The levels of urinary oligosaccharides in the infantile-type sialidosis patients were 3.5 times the levels in late-type patients who were less severely affected. The structures of oligosaccharides in the urine of infantile-type patients were the same as those in the urine of late-type patients, but more high-molecular weight sialyl oligosaccharides were excreted in the urine of infantile-type patients than in the urine of late-type patients. The structures of 7 different kinds of sialyl oligosaccharides that have not been previously reported were identified in the urine of both galactosialidosis and sialidosis patients. Sialidosis patients excreted relatively more sialyl oligosaccharides than did galactosialidosis patients. PMID- 1777982 TI - High-performance liquid chromatography of urinary oligosaccharides in the diagnosis of glycoprotein degradation disorders. AB - Urinary oligosaccharides can be separated by high-performance anion-exchange chromatography using a Dionex CarboPac PA1 column, elution with aqueous sodium hydroxide and sodium acetate solutions and detection by pulsed amperometry. Each of the urines of patients with glycoprotein degradation disorders yielded a pattern of oligosaccharide excretion unique for that disorder, facilitating an unambiguous diagnosis. The method is sensitive (10 microliters of urine required) and fast (40 min). PMID- 1777983 TI - The glycoconjugate content of human faeces and ileostomy effluents. AB - Normal human faeces and effluent from terminal ileostomies in patients with ulcerative colitis were collected. The results for ileostomy effluent given as g/24 h (mean +/- SD; n = 12) were as follows: wet weight, 897 +/- 120; total dry weight, 84 +/- 8; non-diffusible dry weight 46 +/- 5. The corresponding results for faeces (n = 6) were 104 +/- 24; 26 +/- 6; 19 +/- 5. Whereas approximately 15% of the total dry weight of ileostomy effluent appeared to consist of mucin derived material, only trace amounts of such material could be detected in faeces. PMID- 1777984 TI - Phospholipase A2 is associated with albumin in patients with acute pancreatitis. AB - Evidence for the association of serum phospholipase A2 (PLA2) (EC 3.1.1.4) and serum proteins was examined. The effect of this on the PLA2 results from patients diagnosed as having acute pancreatitis was investigated. Two distinct zones of PLA2 activity were found on agarose electrophoresis of purified human PLA2 in the presence of albumin, and in the sera from the acute pancreatitis patients. One of the zones was coincident with albumin. To investigate this finding, a comparison of the PLA2 activity in sera and protein-free ultrafiltrates prepared from the sera of the same patients, showed that PLA2 was not completely ultrafiltered as would be expected from its molecular weight. The PLA2 method used employed a radiolabelled E. coli membrane-phospholipid substrate. It has been previously shown that there is an association between PLA2 and albumin and there is good evidence that albumin interferes with certain methods used for the measurement of PLA2. The recovery of PLA2 activity from the ultrafiltrates of patients' serum was highly variable and it may be that serum proteins, in particular albumin, provide a protective 'buffer' against small increases in PLA2 activity. Inhibitor proteins such as lipocortin which were originally postulated as binding to the enzyme, have been subsequently shown to be substrate-binding agents. However, direct protein effects may be a factor in the inconsistent PLA2 results reported in studies of patients with acute pancreatic disease. PMID- 1777985 TI - A re-evaluation of the lipid-bound sialic acid determination. AB - The origin of serum sialic acid measured in the lipid-bound sialic acid determination reported by Katopodis et al. (1980) was investigated in detail. By varying the experimental conditions of sample preparation the protein, lipid and sialic acid contents of the methanol-water extract obtained from human sera were analyzed and compared in healthy controls and cancer patients. Using polyacrylamide gel electrophoretic and gel chromatographic methods it has been shown that most of the lipid-bound sialic acid was attributed to the acid alpha 1 glycoprotein (orosomucoid) fraction of human sera. Based on these observations a re-evaluation of the molecular background of the LBSA determination seems to be necessary. PMID- 1777986 TI - Deoxycholic acid is not reconverted to cholic acid in humans--a study by isotope ratio mass spectrometry. PMID- 1777987 TI - Assay of plasma glycine by HPLC with electrochemical detection in patients undergoing glycine irrigation during gynaecological surgery. AB - A method for the measurement of plasma glycine by HPLC with electrochemical detection after derivatization with phenylisothiocyanate (PITC) is described. The absorption of glycine in eighteen women undergoing intrauterine glycine irrigation during transcervical resection of endometrium was assessed by measurement of plasma glycine before, immediately after and 24 h after surgery. The plasma glycine concentration was normal in all women before surgery (range 120-386 mumol/l) but had risen dramatically in some patients after surgery (range 180-24,800 mumol/l) before returning to normal levels over the following 24 h (range 173-553 mumol/l). No clinical consequences were observed despite the large increases in plasma glycine; mild hyponatraemia occurred in only one patient. These findings, albeit in a limited number of patients, support the hypothesis that the symptoms sometimes associated with the use of glycine buffers are most likely due to water overload with hyponatraemia rather than a toxic affect of glycine itself. PMID- 1777988 TI - Urinary hydroxyproline and serum alkaline phosphatase in sickle cell disease. AB - Serum alkaline phosphatase, alkaline phosphatase isoenzymes, and urinary hydroxyproline excretion were studied in 20 young adult sickle cell patients and 58 matching normal controls. Total alkaline phosphatase was significantly higher in the sickle cell patients than in controls. Heat inactivation test and isoenzyme electrophoresis indicated that bone is the predominant isoenzyme in patients. Hydroxyproline excretion was significantly higher in the sickle cell patients than in controls. Serum total alkaline phosphatase correlated well with urinary hydroxyproline excretion in sickle cell patients (r = 0.73). Both alkaline phosphatase and hydroxyproline increased with age in the sickle cell patients. This study suggests that delayed growth and/or bone destruction may contribute to the elevated levels of alkaline phosphatase and urinary hydroxyproline. PMID- 1777989 TI - Rapid and sensitive discriminating determination of acetylcholinesterase activity in amniotic fluid with a choline sensor. AB - A simple method for the separate determination of acetylcholinesterase and butyrylcholinesterase activities in amniotic fluid is reported. This determination is performed with an enzyme electrode involving an immobilized choline oxidase membrane associated with the amperometric detection of hydrogen peroxide. Acetylcholine or butyrylcholine, in the presence of samples containing acetylcholinesterase or butyrylcholinesterase are specifically hydrolyzed, the formation of choline being detected vs time by the sensor with no need for a selective inhibitor. The dynamic linear ranges for acetylcholinesterase and butyrylcholinesterase are respectively 100 microU to 10 mU and 30 microU to 3 mU per ml sample. PMID- 1777990 TI - Serum levels of human alkaline phosphatase isozymes in relation to blood groups. AB - By use of sensitive immunocatalytic assays, based on isozyme specific monoclonal antibodies, the activities of the three main human alkaline phosphatases were determined in serum. The activities were related to ABO blood groups and secretor phenotypes. The activity of intestinal alkaline phosphatase was found to be strongly correlated with ABO blood groups and secretor phenotypes, while neither the placenta alkaline phosphatase activity nor the tissue unspecific alkaline phosphatase activity demonstrated any dependence on blood groups or secretor phenotypes. Non-secretors, independent of ABO blood groups, demonstrated low activities of intestinal alkaline phosphatase in serum, amounting to approximately 20% of the activities in the secretor groups. Within the secretor group, the lowest activities were observed for blood group A (2.8 +/- 1.1 IU/l; mean +/- SEM) and the highest for blood groups B and O (14.1 +/- 1.1 IU/l and 19.0 +/- 2.5 IU/l, respectively). These results confirm that the activities of intestinal alkaline phosphatase in serum have to be related both to ABO blood groups and to secretor phenotypes in order to be informative in clinical contexts. PMID- 1777991 TI - Glycosylation of alpha 1-acid glycoprotein in relation to duration of disease in acute and chronic infection and inflammation. AB - Microheterogeneity of acute phase proteins frequently differs in acute and chronic types of inflammation. However, it is unknown whether these changes depend on the duration of the inflammation in a given disease. We therefore investigated the microheterogeneity of alpha 1-acid glycoprotein (AGP) in sera from patients with acute and chronic bacterial infection in comparison to rheumatoid arthritis and ankylosing spondylitis. In acute bacterial infection Con A-reactivity of AGP was significantly elevated. By contrast, AGP in chronic bacterial infection showed the same glycosylation pattern as rheumatoid arthritis and ankylosing spondylitis being characterized by a decreased reactivity to Con A. Serial measurements in individual patients with bacterial infections showed a transition from the initially elevated to decreased reactivity to Con A as the disease became chronic. PMID- 1777992 TI - Effect of acute hyperinsulinemia on fatty acid composition of serum lipids in non insulin-dependent diabetics and healthy men. AB - The fatty acid pattern of serum phospholipids, cholesteryl esters, triglycerides and free fatty acids was measured before and after a 5-h two-step euglycemic hyperinsulinemic clamp (75 and 1400 microU/ml) in 21 non-insulin-dependent diabetics and 14 age-, weight-, and sex-matched healthy controls. Acute hyperinsulinemia was associated with a statistically significant increase in essential fatty acid and a decrease in non-essential fatty acid contents in triglycerides while the levels of serum triglycerides and free fatty acids dropped in both groups. The fatty acid composition of phospholipids and cholesteryl esters remained unchanged as did the levels of serum phospholipids, total cholesterol and HDL cholesterol. PMID- 1777993 TI - Azopigments from serum biliprotein and accuracy of total bilirubin measurement. PMID- 1777994 TI - Lysosomal enzymes and severity of saphen varicosis. AB - The severity of the varicosis estimated clinically and histologically is well correlated with the seric levels of beta-acetylglucosaminidase and beta glucuronidase. No correlations are observed with the arylsulfatase level in serum nor with the levels in venous tissue for the three enzymes. PMID- 1777995 TI - Elevated plasma histamine in sickle cell anaemia. PMID- 1777997 TI - Variations in relative concentrations of variants of human alpha 1-acid glycoprotein after acute-phase conditions. PMID- 1777996 TI - Prenatal diagnosis of isovaleric acidemia by fast atom bombardment and tandem mass spectrometry. PMID- 1777999 TI - Measurement of ornithine carbamyl transferase (OCT) in plasma by means of enzymatic determination of ammonia. PMID- 1777998 TI - Identification of renal calculi by their Raman spectra. PMID- 1778000 TI - A practical new assay for determining N-acetyl-beta-D-glucosaminidase activity in urine. PMID- 1778001 TI - Improved method for the determination of the magnesium concentration of mononuclear blood cells. PMID- 1778003 TI - Level is not a synonym of concentration. PMID- 1778002 TI - Changes in lipid peroxidation and antioxidant enzyme activity of human red blood cells after myocardial infarction. PMID- 1778004 TI - De novo 13q partial duplication identified by cytogenetic, biochemical and molecular approaches. AB - A 3.5-month-old female infant manifesting dysmorphic facies, developmental delay and failure to thrive was referred for cytogenetic evaluation. Peripheral lymphocytes revealed three chromosomally distinct cell lines: 46,XX/46,XX,10p+/47,XX,10p+,+mar. Dermal fibroblasts revealed only the 46,XX,10p+cell line. High resolution G-, R-, and Q-banding suggested that the extra chromosomal material (10p+) represented a duplication of the segment 13q14- --13qter. Parental karyotypes were normal. As absolute identification of de novo chromosomal abnormalities, based solely on cytogenetic studies, is sometimes difficult, both biochemical and molecular approaches were undertaken to elucidate this abnormality in more detail. Dosage effects were examined using esterase D (localized to 13q14.1) and the DNA probes p1E8 and p9A7 (localized to 13q22 and 13q31/32, respectively). These studies suggested the presence of only 2 copies of esterase D, but 3 copies of both DNA probes, allowing identification of the breakpoint at 13q14.2. PMID- 1778005 TI - Strengths and weaknesses in the cognitive profile of youngsters with Prader-Willi syndrome. AB - In this report we present the results of a study of the intellectual functioning and cognitive profile of 26 Prader-Willi syndrome (PWS) patients. The mean IQ score was 62.3 (range 39-96). In 13 patients a significant difference between verbal and performance IQ was found. In 10 of them the performance IQ was higher than the verbal. The results of subtest analysis indicate that cognitive strengths are more visible than cognitive weaknesses. Highest scores were noted especially in the performance scale, i.e. Block Design (9 children) and Coding or Mazes (5 children). Analysis of all available data indicates that PWS patients score better on visual motor discrimination skills than on auditory verbal processing skills. These results are promising for intervention programs and education strategies. PMID- 1778006 TI - Tests of performance of four semi-automatic metaphase-finding and karyotyping systems. AB - Four commercially-available semi-automatic cytogenetic systems (Cytoscan, Ibas, Magiscan and Miamed) have been evaluated for both metaphase-finding and karyotyping performances, using a common set of test slides and uniform criteria. Comparisons have been made in respect of timings, number and nature of operator interactions, and false positive and negative rates. Amongst the general conclusions are the importance, for metaphase-finding performance, of a facility for ranking candidate metaphases according to their 'analysability', the need for some systems to reduce the time taken to relocate candidate metaphases, and the ability of all systems tested to detect analysable metaphases that were initially overlooked by a skilled cytogeneticist. In spite of automation, karyotyping remains a highly interactive process, strongly dependent on the skill and judgment of the operator, and therefore difficult to evaluate fully objectively. PMID- 1778007 TI - Cohen syndrome: fertility in a female patient. AB - In this report we describe fertility in an adult female with Cohen syndrome. She gave birth to a son, now 1.5 years old, with discrete facial stigmata and slight psychomotor retardation. PMID- 1778008 TI - An autosomal recessive form of benign familial neonatal seizures. AB - We present a consanguineous sibship with benign familial neonatal seizures. The mode of transmission of the disorder in this family seems to be autosomal recessive, which is contrary to the usual autosomal dominant type. Linkage analysis failed to show tight linkage between the disease locus and the autosomal dominant locus assigned to chromosome 20q. We thus conclude that benign familial neonatal seizures is a genetically heterogeneous type of epilepsy. PMID- 1778009 TI - Robertsonian translocations in Prader-Willi syndrome. PMID- 1778010 TI - Epidemiology of premature rupture of the fetal membranes. PMID- 1778011 TI - The role of corticosteroids in the management of patients with preterm premature rupture of the membranes. PMID- 1778012 TI - Mechanical factors in the etiology of premature rupture of the membranes. AB - The physiologic cascade that results in PROM is cyclic and probably can be entered at many points--through the production of collagenases, peroxidases, phospholipases, or prostaglandins. It can be initiated or exacerbated by bacteria. In addition, PROM is the result of direct bacterial insults or host mediated autodestruction in response to bacterial presence or challenge. It may be affected by physical properties and stresses that are mechanical. This review of the mechanical factors that support normal chorioamnion membranes may provide an understanding of where the support can be eroded, thus leading to PROM. With this basic overview of the pathophysiology contributing to PROM, the clinician can justify clinical decisions better, depending on the patient's presentation and gestational age. The judicious use of various tocolytic agents, antimicrobial agents, and/or corticosteroids singly or in combination is predicated on the effect each of these iatrogenically administered agents will have on the mother and fetus. As more investigations are done, we will gain greater insight into the mechanical factors involved in causing PROM. PMID- 1778013 TI - Detection of premature rupture of the membranes. AB - One of the most common problems an obstetrician faces is evaluation of a patient for PROM. Proper assessment of the patient requires a careful integration of history, physical examination, and clinical testing. The most commonly used tests are analysis of vaginal pH with nitrazine paper and evaluation of vaginal secretions with the arborization test. When history, nitrazine, and arborization testing are used in combination, 90% of cases will be diagnosed correctly. When the diagnosis is questionable, other modalities, including ultrasound evaluation and intraamniotic dye injection, should be used as indicated. PMID- 1778014 TI - Management of premature rupture of membranes in term patients. PMID- 1778015 TI - Management of preterm premature rupture of membranes. AB - The variables enumerated in the preceding paragraphs and the constantly changing and improving technology in neonatal care mean that the data on which to base the best management plans of PPROM are not yet available. Rather, we must be willing to revise our approach to the treatment of this entity constantly as new information is found. However, several important changes in the management of these patients over the last few years were implemented and have had a significant impact on the outcome of these neonates. The use of routine prophylactic intrapartum amnioinfusion is one of these. Although preliminary, the data on prophylactic antibiotic use are promising and have brought us closer to the concept of treating occult intraamniotic infections with antibiotics rather than immediate and indiscriminate delivery. The identification of several factors such as interleukin-1, neutrophil activating peptide-1/interleukin-8, and tumor necrosis factor (TNF) in patients with idiopathic preterm labor may allow us to determine the pathophysiologic mechanism by which preterm labor leading to PPROM is initiated and allow us to tailor treatment specifically. For instance, in such patients, uterine activity may respond to antibiotic therapy rather than the usual tocolytics. Unfortunately, measurements of such factors are not yet widely available and remain primarily research tools. However, these recent findings give us a glimpse of what lies ahead. It is entirely conceivable that a symposium on the management of PPROM eventually will have a section devoted to its prevention that is based on an understanding of its pathophysiology. PMID- 1778016 TI - Antibiotic therapy in preterm premature rupture of membranes. PMID- 1778017 TI - The use of tocolytics in patients with preterm premature rupture of the membranes. PMID- 1778018 TI - Complications of prolonged PROM and oligohydramnios. PMID- 1778019 TI - Microbial invasion of the amniotic cavity in premature rupture of membranes. PMID- 1778020 TI - Antepartum surveillance in patients with preterm premature rupture of the membranes. PMID- 1778021 TI - Physiologic hair growth. PMID- 1778022 TI - Clinical and laboratory evaluation of hirsutism. PMID- 1778023 TI - Hirsutism in polycystic ovary syndrome: current concepts. PMID- 1778025 TI - Virilizing ovarian tumors. PMID- 1778024 TI - Adrenal dysfunction and hirsutism. PMID- 1778026 TI - Iatrogenic causes of hirsutism. PMID- 1778027 TI - Treatment of hirsutism. PMID- 1778028 TI - Lipid metabolism and hyperandrogenism. AB - Hyperandrogenism and lipid metabolism were shown to be related intimately. Any discussion of the nature of their relationship must include other clinical and metabolic variables such as hyperinsulinemia and UBO. Despite the many correlations among each of these factors, the appropriate sequence in the pathogenesis of these conditions has not been defined. Do conditions that result in insulin resistance (e.g., genetic defects, insulin receptor antibodies, and obesity) also lead to the development of hyperandrogenemia by direct or indirect ovarian stimulation by insulin? Does hyperandrogenism of ovarian or adrenal origin cause abnormal upper body fat distribution, in turn leading to lipid abnormalities and insulin resistance? Regardless of the issue of mechanism of causality, women with hyperandrogenism are thought to be at greater risk for cardiovascular morbidity and mortality than their normoandrogenic counterparts. These women often are obese, hypertensive, and sedentary; ingest diets high in saturated fats; and have glucose intolerance and/or insulin resistance. All these abnormalities are well known independent risk factors for the development of lipid abnormalities and cardiovascular disease. Whether hyperandrogenism is a secondary consequence of any of these or whether it is an independent contributor to lipid aberrations requires future study. Treatment strategies for hyperandrogenic women, however, should not only be directed toward alleviation of the cosmetic problem of hirsutism but also toward the prevention and treatment of cardiovascular morbidity using modalities aimed at eradicating hyperinsulinemia, hypertension, and dyslipidemia. These modalities should include modifications in diet, exercise, and weight in addition to pharmacologic and/or surgical manipulation. Weight reduction will reduce many cardiovascular risk factors. Obesity is easier to target because of the many risk factors that result in it.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778029 TI - Insulin and related peptides in hyperandrogenism. PMID- 1778030 TI - Quantitative aspects of ultraviolet erythema. PMID- 1778031 TI - Correlation between Korotkoff's sounds and ultrasonics of the brachial artery in healthy and normotensive subjects. AB - The clinical measurement of blood pressure is generally obtained by auscultation for Korotkoff's sounds over the brachial artery using a sphygmomanometer and cuff. Real-time two dimensional ultrasound and Doppler techniques were used to study the brachial artery movements and blood flow patterns during these pressure measurements. Simultaneous recordings of Korotkoff's sounds were obtained. A strong correlation in time was demonstrated between Korotkoff's five phases, brachial artery wall movements and specific blood flow patterns. The evidence largely supports what to date has been speculation as to the origin of Korotkoff's sounds in that Korotkoff's phases 1 and 3 appear to be produced by vigorous arterial wall motion and phase 5 by cessation of this movement. Phase 2 is produced by blood flow disturbance. Furthermore, the lack of correlation between phase 4 and any specific vascular event may go some way to explaining why in clinical practice phase 5 readings are now preferred for diastolic pressure. PMID- 1778032 TI - An evaluation of the Deltatrac indirect calorimeter by gravimetric injection and alcohol burning. AB - We evaluated a 'state of the art' open hood type of indirect calorimeter (Deltatrac, Datex) to determine its stability and precision, and related these to in vivo measurements made with the same type of calorimeter. Three Deltatrac Metabolic Monitors were investigated at two centres over a period of twelve months by two methods of recovery: (i) gravimetric injection of a nitrogen/CO2 gas mix and (ii) ethanol burning using the manufacturers approved apparatus. We compared machine variation with in vivo variation in measurements of oxygen uptake and carbon dioxide production at rest in healthy subjects. The Deltatrac recovery of both oxygen and carbon dioxide was on average 4.8% and 4.7% higher respectively for the alcohol burning method. We suspected that this apparent over recovery was because the alcohol burner produced a resistance to the airflow generated across the canopy. By gravimetrically injecting the gas mix into the canopy hose whilst the alcohol burner was attached we were able to confirm this error. There was no significant change in recovery for any of the Deltatracs by either method over the year of evaluation. The between-study variation for the machine and in vivo measurements were less than 4%, and the within-study variations were less than 6% and less than 7%, respectively. These studies re emphasise that careful evaluation of commercially produced indirect calorimeters is essential before clinical measurements are made. PMID- 1778033 TI - Development of an indirect calorimeter for use in infants and young children. AB - A low cost, 'open-circuit', flow-through system, using a closely fitted facemask has been developed for the determination of oxygen consumption and carbon dioxide production in spontaneously breathing infants and children. PMID- 1778034 TI - Non-invasive in vivo near-infrared optical measurement of the penetration depth in the neonatal head. AB - The non-invasive optical technique of near-infrared spectroscopy (NIRS) was used to measure the depths of light penetration at four wavelengths in the NIR region. Near-infrared absorbance measurements were carried out on 10 preterm infants. The apparent absorbance data (in optical density units) collected at 775, 805, 845, and 904 nm were measured at different positions on the head. Linear relationships that satisfy the Lambert law were obtained when the apparent absorbance at a given wavelength was plotted against the inter-optrode distance. From the slopes of the resulting straight lines, the depth of penetration of the NIR light was calculated and found to be independent of the position of the probes on the head. Calculated average values of the depth of penetration of near-infrared light in the whole neonatal head ranged between 6.3 and 8.5 mm. PMID- 1778035 TI - Correction of pneumotachograph signal for changes in viscosity during nitrogen washout. AB - Changes in gas viscosity during the nitrogen washout test will affect pneumotachograph measurements. A digital correction technique, using estimates of viscosity derived from measurements of gas concentration, has been described and was examined in this study. The pneumotachograph gain varied directly with argon concentration (coefficient of correlation = 0.995, P less than 0.01) indicating that a simple correction was legitimate. This was tested with an in vitro model, giving very consistent estimates of volume (FRC) despite variations in the ventilation pattern, which were slightly underestimated due to incomplete mixing in the system. Alveolar mixing efficiency (AME) was also reproducible but, like studies in man, fell when low tidal volumes were used. In a repeatability study in six volunteers, examined six times on each of two days, FRC and AME were also reproducible (average coefficient of variation within subjects of 4.97% and 4.34% respectively), considerably better than another reported study using conventional flow measurements. This method appears to be a useful addition to existing techniques for studying nitrogen washout. PMID- 1778036 TI - A study of skin temperatures, sweat rate and heat loss for burned patients. AB - The influence of the thermal environment on heat losses from patients with severe burns has been studied. Burn wounds were several degrees cooler than intact skin when patients were admitted to hospital. Wound temperatures gradually increased, becoming similar to those of intact skin by three days after injury. Temperatures of intact skin in peripheral regions of burned patients were raised. Evaporation of fluid from wounds of patients with 15-36% burns increased heat loss by 50-120 W, but sweating could increase heat losses by several hundred watts. Patients with large percentage burns tended to sweat less than others with smaller burns, under the same conditions. Patients with over 30% burns could be treated at air temperatures up to 35 degrees C without inducing sweating in the Intensive Care Room, which had forced airflow and good temperature control. Patients treated in standard wards where it was difficult to maintain a constant air temperature were more likely to sweat. PMID- 1778037 TI - Repeatability of dynamic eye pupil response measurement using the Pupilscan instrument. AB - The repeatability of pupil response measurements made with the Pupilscan instrument has been assessed. Two operators made 32 repeat recordings of the pupil response in each eye of eight normal subjects over four days. A total of 512 recordings were made and the results analysed by variance analysis. Room light levels were carefully controlled. The instrument measured initial pupil diameter, and after a 0.2 s light stimulus measured minimum and final diameters, maximum diameter change, constriction velocity and time to minimum diameter. For all measurements except time to minimum, there were significant differences (P less than 0.001) between the normal subjects. Day-to-day variation was also significant (P less than 0.005), but did not mask the differences between subjects. It is concluded that the average of at least four repeat measurements are made, giving error ranges similar to those observed from day-to-day changes. PMID- 1778038 TI - Magnetostrictive calibration of a precision optical measurement device for studies of tooth eruption. AB - In order to calibrate a precision-measuring instrument for studies of tooth eruption, a calibration device capable of repositioning an optical grating in steps accurate to at least 0.02 microns was required. At this level, piezoelectric and similar pushers encounter problems. A new calibration device based on the magnetostrictive properties of nickel was developed. Accuracy better than 0.02 microns was verified by relating its movements to the wavelength of the green line of mercury, and the device was successfully used to calibrate the instrument for establishing tooth position. Magnetostriction offers a way to calibrate precision measurement instruments for other applications. PMID- 1778039 TI - Studies on the effect of the third dimension on a two-dimensional electrical impedance tomography system. AB - This work is based on the Applied Potential Tomography (APT) system developed in Sheffield and the results specifically relate to this system. Using a cylindrical phantom containing saline, the effects of extended layers in the third dimension on the two-dimensional tomographic images have been studied. Experimentally obtained magnitudes of pixel values corresponding to different conditions in the third dimension are presented. Analysis of these data brings out two phenomena: (i) layers of changed resistivity out of the electrode plane can appear as both increased and decreased resistivity in the image; and (ii) the position of the maximum resistivity change in the image occurs at increasing distances from the edge of the phantom, as the layers of resistivity change are introduced further from the electrode plane and they have a one to one relationship. An intuitive interpretation related to perturbation of equicurrent surfaces in the third dimension has been suggested to explain these phenomena. PMID- 1778040 TI - Medical technology transfer--the way ahead, and the role of professional bodies. PMID- 1778041 TI - The spectral expansion of a head model in electrical impedance tomography. AB - This paper examines whether electrical impedance tomography (EIT) can provide information of use to magneto-encephalographic modelling (MEG). The EIT image domain is expanded in a complete set of orthogonal basis images, the number of which is given by the number of independent measurements (104 for 16 electrodes). They are ordered according to their sensitivity to data noise, with more centrally located features and higher spatial frequency components appearing towards the higher terms in the series, in the case of uniform resistivity distribution. This indicates that the resolution can be improved at the expense of degrading signal-to-noise in the reconstructed image. Applied to an approximate model of the head, the technique generates a set of basis images that emphasises central features of the head. PMID- 1778042 TI - Calculation of static susceptibility maps using the reciprocity theorem. AB - In performing measurements of magnetic susceptibility of human tissues, it is useful to calculate the field produced by a magnetisation distribution over a relatively large measurement area. This involves costly computations that can be made easier by the use of the reciprocity theorem. PMID- 1778043 TI - Magnetocardiographic localisation and modelling. AB - In our magnetocardiographic (MCG) localisation studies, two modelling approaches have been applied: (a) modelling the sources with dipole and quadrupole moments in a general multipole expansion and using a homogeneous, semi-infinite volume conductor, and (b) using a single current dipole source in a homogeneous, realistically shaped torso. Both approaches have been successfully applied in localising the premature ventricular excitation site in patients suffering from the Wolff-Parkinson-White syndrome. In addition, we have participated in developing a model of propagation of electrical activation in the ventricles. Anisotropic conductivity properties and spiral arrangement of myocardial fibres are included in the model. PMID- 1778045 TI - Modelling the fetal magnetocardiogram. AB - During gestation the abdominally recorded fetal ECG (FECG) changes as a result of changes in the conductive medium. In particular, a minimum occurs in the FECG amplitude around 30 weeks of gestation. Based on the results of an extensive FECG study, the effect of these changes on the fetal MCG are simulated. It is shown that the FMCG amplitude is not greatly affected by the changes in the conductive medium. The FMCG waveform, however, is. PMID- 1778044 TI - Measurement of gastrointestinal transit time by means of biomagnetic instrumentation: preliminary results. AB - The measurement of gastrointestinal transit time, GITT, is of particular interest in the study of gastrointestinal activity and in the diagnosis of some pathologies. In the present work we report the measurements of GITT obtained by applying the biomagnetic method. PMID- 1778046 TI - Computer simulation of the heart magnetic field dynamics. AB - A personal-computer based model, which enables the investigation of the correlation between the temporal dynamics of the magnetic field distribution and electrophysiological processes during ventricular depolarisation, has been tested. The activation sequence following a stimulus to the atrioventricular node or directly to the ventricular myocardium can be simulated in isotropic conditions and visualised in a three-dimensional presentation. The corresponding behaviour of the distribution of the normal component of the magnetic field is calculated using a simple algorithm. Colour animation is used to observe the simulated magnetic field dynamics and to compare them with measured data. PMID- 1778047 TI - Comparison of magnetoencephalography with other functional imaging techniques. AB - Recent advances in instrumentation and analysis in biomagnetism offer a unique tool for studying the spatiotemporal evolution of spontaneous brain activity as well as activity evoked by a stimulus. The overall performance characteristics of this and other techniques used to study the dynamics of brain function are compared. Particular emphasis is placed on defining the general spatiotemporal window of brain activity that each technique makes accessible. Similarities and differences associated with diverse modelling schemes for extracting source current density properties from electrographic recordings are stated. PMID- 1778048 TI - Anatomical correlates for magnetoencephalography: integration with magnetic resonance images. AB - We have implemented an initial version of software for the integration of magnetic resonance imaging (MRI) and magnetoencephalography (MEG). The package displays MRI images and performs basic image processing. The coordinate systems of the two methods are matched with the help of markers fixed on known head landmarks and a 3D digitiser. The spherical conductor model can be individually fitted to the shape of the brain in the region of interest. The computed source locations can be instantly superimposed on the MRI images during the analysis. Examples of localisation results from a healthy subject and an epileptic child are discussed. PMID- 1778049 TI - Experiences in data analysis and modelling with a multichannel biomagnetic system. AB - Evaluation of MEG/MCG data, measured with the Siemens biomagnetic multichannel system KRENIKON, in patients with epilepsy, infarction, Wolff-Parkinson-White (WPW) syndrome or extra systoles are in good agreement with the results of different investigation techniques. The evaluations have been performed using an equivalent current dipole model within a sphere or a half-space with homogeneous conductivity. In cases where the current dipole model is not adequate, multiple dipoles or complete distributions of current sources have to be considered. Results from simulations and applications to in vivo data and the influence of geometries better adjusted to realistic geometries are discussed. PMID- 1778050 TI - Integrated imaging of neuromagnetic reconstructions and morphological magnetic resonance data. AB - New neuromagnetic imaging methods provide spatial information about the functional electrical properties of complex current distributions in the human brain. For practical use in medical diagnosis a combination of the abstract neuromagnetic imaging results with magnetic resonance (MR) or computed tomography (CT) images of the morphology is required. The biomagnetic images can be overlayed onto three-dimensional morphological images with spatially arbitrary selectable slices, calculated from conventional 2D data. For the current reconstruction the 3D images furthermore provide a priori information about the conductor geometry. A combination of current source density calculations and linear estimation methods for handling the inverse magnetic problem allows quick imaging of impressed current source density in arbitrary volume conductors. PMID- 1778051 TI - Analysis of the neuromagnetic data on the frequency responsivity of the human brain: a progress report. AB - The study of the responsivity of the human brain at different rates of sensory stimulation has provided several pieces of information on brain functionality. The new analysis technique used in this study permits us to investigate the dynamics of these responses and to obtain a larger amount of statistical data to allow for fine frequency discrimination. This allows us to suggest, for example, phase locked systems as models for synchronisable spontaneous activity. Absence of subject fatigue during the repetition of the stimulation paradigm, as well as the presence of a 'learning period' characterised by transient dynamics of the responses, are also discussed. PMID- 1778052 TI - Dipole modelling of eye activity and its application to the removal of eye artefacts from the EEG and MEG. AB - The spatio-temporal dipole model approach has been used to identify the difference dipoles arising from changes in the ocular dipoles due to eye movements and blinks. Based on these results a method has been developed to remove eye artefacts from electrical or magnetic data. The method avoids distortions due to the head model by determining the spatial distribution of the signals from the eyes empirically. Using simultaneous modelling of the EEG or MEG activity with dipole sources distributed within the head together with the empirically determined spatial eye components, the eye activity can be estimated and removed from the EEG or MEG. This greatly reduces the distortion to the topography that is a concomitant of previous eye artefact correction methods. The advantages of the method are illustrated using simulated and real electrical data. PMID- 1778054 TI - Biomagnetism: analysis and modelling. A workshop. Swansea, 23-26 September 1990. PMID- 1778053 TI - Biomagnetic study of cardiac arrhythmias. AB - Clinical magnetocardiographic mapping was initiated in the Cardiovascular Biomagnetism Unit of the Catholic University of Rome about 10 years ago. Since then several hundred patients have been investigated. However, the most interesting data have been collected after the development, in 1984, of the present laboratory configuration, which allows simultaneous MCG mapping and invasive electrophysiological procedures. Perspective studies have been carried out to validate the accuracy of MCG for localisation of arrhythmogenic structures and for early detection of patients at risk of sudden death. Although the diagnostic applicability of the method is still under evaluation, preliminary results are reported, concerning 120 patients, investigated between 1985 and 1990, with cardiac arrhythmias associated with ventricular pre-excitation, ischaemic heart disease or cardiomyopathies. PMID- 1778055 TI - A comparison of normal and tangential magnetic field component measurements in biomagnetic investigations. AB - Because of the way most available hardware gradiometers are designed and in view of the prediction, by theory, that the normal magnetic field component provides all available information on the intrinsic current source, MEG and MCG measurements generally consider only the field vector normal to the head or truck surface. However, when looking for single events, the information contained in the normal component often cannot be fully sampled, because the sensor array has limited dimensions and therefore covers only a fraction of the field's spatial extension. Simulation of a current dipole in a sphere using realistic parameters shows that there is a considerable area where the amplitude of the tangential field components is larger than that of the normal one. Measurements using a 28 channel magnetometer system with normal and tangential pick-up coils and a current dipole in a phantom model confirm this prediction; depending on dipole orientation, the signal-to-noise ratio (SNR) could improve by a factor of up to 20 if the total field was considered instead of only the normal component. MCG recordings with the same instrument demonstrated a broad area above the heart where the tangential SNR was clearly better than the normal one. Preliminary measurements indicate that tangential components can also be recorded in the MEG; it is suggested that they may help source localisation. PMID- 1778056 TI - Magnetic fields of the brain analysed by a multiple dipole approach using factor analysis. AB - Sudden spatial changes in consecutive dipole localisations suggest that often a single-moving-dipole algorithm is inadequate. This is particularly important in the case of widespread activity in the brain, where one extremum may be extinguished by another. One example of widespread activity is the alpha rhythm. The application of factor analysis may give information about the presence of different active sources. The alpha rhythm showed two to three significant factors. This suggests that the apparent movement suggested by single-dipole localisation may be caused by the superposition of the fields of two spatially and temporally distinct sources. Field maps which are very similar to a dipole pattern may be caused by a superposition of the fields of several sources. PMID- 1778057 TI - Individual versus averaged data in the analysis of auditory evoked electrical potentials. AB - Interpretation of multichannel electric potentials in terms of equivalent dipolar sources has often been based upon the analysis of averaged data, i.e. of the grand averages of the individual recordings obtained from normal subjects. Some considerations are presented here to show that the above procedure may lead to erroneous results. Examples of individual data fits are discussed in relation to the possibility of (i) defining a 'norm' and (ii) extracting some information about the 'resolving power' of the electric method. PMID- 1778058 TI - A simulation study of the resolving power of the biomagnetic inverse procedure. AB - In order to get a rough idea of the resolving power of the biomagnetic inverse procedure, simulation studies with a time-dependent two-dipole model have been carried out. Holding the locations and the directions of the dipoles constant (fixed-dipole approach), the inverse problem was solved simultaneously for all sampling times within a 300 ms window. The spatial resolution was found to be highly dependent on the angle between the dipole moments and the properties of the superimposed noise. The results suggest that, in practice, the spatial resolution of the fixed-dipole approach will be of the order of 1 cm at best. PMID- 1778059 TI - Tikhonov regularisation approach to dynamic biomagnetic imaging. AB - We describe a method of identifying the distributed sources associated with biomagnetic data sets. The technique is based on Tikhonov regularisation. An algorithm has been implemented in FORTRAN on a PC/AT computer. Its predictions are stable with respect to measurement noise. PMID- 1778060 TI - The use of the asymptotic expansion to speed up the computation of a series of spherical harmonics. AB - When a function is expressed as an infinite series of spherical harmonics the convergence can be accelerated by subtracting its asymptotic expansion and adding it in analytically closed form. In the present article this technique is applied to two biophysical cases: to the potential distribution in a spherically symmetric volume conductor and to the covariance matrix of biomagnetic measurements. PMID- 1778061 TI - The finite element method for a realistic head model of electrical brain activities: preliminary results. AB - In order to model the brain's electrical activity realistically, the finite element method has been used to compute the potential distribution due to a current dipole. This approach has the advantage over the boundary element method of being able to consider anisotropies of the different conducting sub-volumes. The forward solution has been evaluated in the particular case of a three-layer concentric sphere isotropic head model of the head where an analytical formula is known. The errors on the dipole position and orientation have been estimated in the inverse problem procedure. PMID- 1778062 TI - On the forward solution of electroencephalography and magnetoencephalography. PMID- 1778063 TI - Stimulus representation: a subprocess of imprinting and conditioning. AB - We suggest a way to reconcile imprinting and associative learning that respects the real differences between the two phenomena but helps to recognize underlying commonalities. Rather than treating each type of learning as the manifestation of a unitary mechanism, we approach learning as a combination of separate subprocesses. Exploration of the literature regarding one of these subprocesses, namely, that governing the representation of stimuli, revealed striking similarities between imprinting and conditioning. These similarities suggest predictions for fresh experimental work that will help to uncover the general rules by which combinations of stimulus features are represented in memory. PMID- 1778064 TI - Do rhesus monkeys (Macaca mulatta) attribute knowledge and ignorance to others? AB - The ability of 4 rhesus monkeys (Macaca mulatta) to understand the causal connection between seeing and knowing was investigated. The subjects were tested to determine if they could discriminate between information provided by experimenters who randomly alternated between roles of guesser and knower. In a series of tests, the knower either hid food under 1 of 3 cups or watched as someone else hid the food. The guesser waited outside the room or covered her or his head until the food was hidden. The subjects watched this procedure occur but could not see which cup the food was hidden under. The knower pointed to the correct cup while the guesser pointed to an incorrect one. None of the macaques provided any evidence that they realized the different states of knowledge possessed by the guesser and knower. The results are consistent with the hypothesis that rhesus macaques are incapable of making inferences about the mental states of others. PMID- 1778065 TI - Molar characteristics of exploratory and investigatory behavior in the rat (Rattus norvegicus). AB - Despite clear functional significance, understanding of exploratory behavior is hampered by the lack of a careful descriptive account. This article reports extensive descriptions of rats' behavior in a stable environment and after environmental change. For 7 nights, 12 male Long-Evans rats (Rattus norvegicus) were given access to a large arena. Subjects budgeted session time differently across days, spending less time in the home cage and more time interacting with objects. Locomotion and general activities were typically unchanged over days. Several measures of object interaction showed systematic changes across sessions for the nonmanipulable object but not for the manipulable object. Finally, exploratory and spatial locomotor patterns were modified in response to the addition or removal of objects. These results indicate that exploratory and investigatory behaviors are lawful and orderly expressions of spontaneous behavioral organization. PMID- 1778066 TI - Washing, drying, and anointing in adult humans (Homo sapiens): commonalities with grooming sequences in rodents. AB - Very few behavioral patterns generalize across human and nonhuman species. We describe washing, drying, and anointing sequences in humans (Homo sapiens) that may have analogies with other species. The rank ordering of washing, drying, and anointing body parts was obtained over 3 successive days for 37 men and 60 women. Variation in rank ordering of body parts was nonrandom, and a cephalocaudal progression was evident for each behavior. Reliability of the behaviors as well as the correlations across rankings were highly significant, which indicates a generalized cephalocaudal progression for all 3 behaviors. Women's anointing was most variable, which suggests a more specific function. The cephalocaudal action pattern described for humans is similar to that for Mongolian gerbils and laboratory rats. Cross-species functions, such as these, may add to our understanding of common developmental and learning processes. PMID- 1778067 TI - Conditional withholding of proboscis extension in honeybees (Apis mellifera) during discriminative punishment. AB - Proboscis extension conditioning of honeybee workers was used to test the ability of bees to respond to appetitive and aversive stimuli while restrained in a harness that allows subjects to move their antennae and mouthparts (Kuwabara, 1957; Menzel, Erber, & Masuhr, 1974). Subjects were conditioned to discriminate between two odors, one associated with sucrose feeding and the other associated with a 10 V AC shock if they responded to the sucrose unconditioned stimulus (US) in the context of that odor. Most Ss readily learned to respond to the odor followed by sucrose feeding and not to the odor associated with sucrose stimulation plus shock. Furthermore, in the context of the odor associated with shock, significantly more subjects withheld or delayed proboscis extension on stimulation with the sucrose US than they did in the context of the odor associated with feeding. Thus, restrained honeybees can readily learn to avoid shock according to an odor context by withholding proboscis extension to a normally powerful releaser. Analysis of individual learning curves revealed that subjects differed markedly in performance on this task. Some learn the discrimination quickly, whereas others show different kinds of response patterns. PMID- 1778068 TI - Cognitive development in kittens (Felis catus): an observational study of object permanence and sensorimotor intelligence. AB - Spontaneous behavior of kittens (Felis catus) was filmed from birth until the end of Month 5 and coded according to Piagetian criteria of sensorimotor intelligence (SI) and object permanence (OP). Data revealed that Stages 2, 3, and 4 of SI were reached at Days 10, 26, and 45, respectively, whereas Stages 2, 3, and 4 of OP were reached at Days 31, 37, and 41, respectively. Spontaneous search behavior was exhibited both in searching for an object that disappeared and in hiding while moving toward a target object. From Day 45 on, search behavior was integrated into a playful social interaction in the form of hide-and-seek. Hence, kittens' spontaneous activity provided them with contexts in which OP was necessary for activity. Lastly, it is proposed that the mobility of both social and physical objects triggered circular activity in this species. PMID- 1778069 TI - Effects of short-term isolation on the locomotor activity of the angelfish (Pterophyllum scalare). AB - Two experiments were conducted to test in angelfish (Pterophyllum scalare) some implications of Gallup and Suarez's (1980) ethological model of open-field behavior and to differentiate between the initial locomotor effects of a novel environment and those of isolation per se. Juveniles placed alone in a novel environment initially showed increased locomotion compared with their previous level when kept as a group and with that of fish placed in the novel environment in groups of three and five. When placed alone in a novel tank, individuals that had already been isolated for 10 days moved about less than those that had been isolated for 4 days. During isolation, angelfish significantly reduced activity to a minimum after 3 to 4 days, and after 10 days the level was still lower than in the group situation. The results suggest that, in addition to birds and rodents, Gallup and Suarez's model is applicable to fish and may account for the effects of longer exposure to a novel environment. PMID- 1778070 TI - Social responding to mirrors in rhesus monkeys (Macaca mulatta): effects of temporary mirror removal. AB - As a result of a long-term, longitudinal project initiated in 1978, a pair of rhesus macaques (Macaca mulatta) housed together in front of a mirror all their lives now exhibit relatively little interest in their reflection. Previous work has shown, however, that simply moving the mirror to a new location produces a short-term reinstatement of social responding to their images. As an extension of these findings, in this study the mirror was left in the same position but turned away from the cage. On turning the mirror back to face the cage 5 days later, both animals reacted as if confronted with another pair of monkeys and directed a burst of social responses at the mirror. PMID- 1778071 TI - Effect of food competition on aggregation: evidence for social recognition in the plains garter snake (Thamnophis radix). AB - Competition for food and aggregating behavior were examined in plains garter snakes (Thamnophis radix), in 11 groups of 1 noncompetitor and 2 competitors. Aggregation data were obtained in 48 daily scans. During food competition, success at obtaining food was asymmetrical across pairs. For aggregation, competitors were mostly associated with noncompetitors. After removal of noncompetitors, competitors were more likely to be solitary, but associations between competitors increased. After a 5-month separation, 5 of the original groups were reconstituted; aggregation patterns similar to the 1st experiment were observed. In a 3rd experiment, unfamiliar animals with and without competitive experience did not aggregate preferentially. Garter snakes discriminate on the basis of sex and species; in this study individual relationships (prior competition) affected aggregation, and the data suggest individual recognition both occurs and persists over time. PMID- 1778072 TI - Generative aspects of manipulation in tufted capuchin monkeys (Cebus apella). AB - Evaluating the cognitive and ontogenetic bases of tool use in primates requires comparative data on the generative nature of manipulation, including the frequency and variety of combinations of actions and objects. Thirty-one tufted capuchins (Cebus apella) of 3 age groups devoted significant proportions of time to interaction with objects and substrates. Activity that combined an object with a substrate occurred often; activities that combined 2 portable objects were less frequent. Predictions drawn from neo-Piagetian theory of an ontogenetic link between combinatorial behaviors and the onset of tool use were not supported. The frequency and generative nature of capuchins' manipulative activity, particularly acts combining objects and substrates, could account for their proclivity to use tools. The use of tools by capuchins need not involve the representational abilities proposed by neo-Piagetian theory. PMID- 1778073 TI - "Panic-like" symptomatology in schizophrenic and schizoaffective patients with postpsychotic depression: observations and implications. AB - Approximately one quarter of a series of 45 schizophrenic and schizoaffective patients with operationally diagnosed episodes of postpsychotic depression were also found to have anxiety symptoms consistent with the panic-attack syndrome. The incidence of such attacks was distributed across all demographic groups. Heuristic and treatment implications of this observation are considered. PMID- 1778074 TI - Characteristics of panic attack subtypes: assessment of spontaneous panic, situational panic, sleep panic, and limited symptom attacks. AB - We report the analyses of daily journal descriptions of 790 self-defined panic attacks from 59 patients meeting DSM-III criteria for panic disorder or agoraphobia with panic attacks. The DSM-III-R specified symptoms occurred with frequencies ranging from choking (17% of attacks) to palpitations (63% of attacks). The mean weekly panic attack severity correlated significantly with the number of symptoms per attack, but not their weekly frequency. Within a given person, situational and spontaneous panic attacks did not significantly differ over a number of characteristics, including severity, duration, frequency per week, diurnal distribution, and the number of symptoms per attack. Limited symptom attacks were less severe, but were otherwise similar to panic attacks. Also, panic attacks during sleep were less frequent than panic attacks in the awake state, but did not significantly differ on other descriptive characteristics. These data support the validity of the symptoms specified for panic attacks by DSM-III-R. They also suggest that within an individual, panic attacks of various subtypes may be descriptively similar, despite the differing contexts in which they arise. In addition, these data question the diagnostic significance of the limited symptom attack-panic attack distinction. PMID- 1778076 TI - The relationship of social phobia subtypes and avoidant personality disorder. AB - The diagnoses of social phobia (SP) and avoidant personality disorder (APD) have evolved from different historical sources, but their criteria appear to converge in DSM-III-R. Fifty anxiety disorder clinic patients with DSM-III-R SP were evaluated for presence of DSM-III-R APD. APD was present in 89% of those with the generalized subtype of SP (GSP) and 21% of those with the discrete subtype of SP (DSP). The findings are discussed in conjunction with other recent reports showing substantial overlap between GSP and APD. PMID- 1778075 TI - Current perspectives on anxiety disorders in children and adolescents: an overview. AB - This report provides an overview of the status of child and adolescent anxiety disorders. General biological and theoretical concepts of anxiety are reviewed, as are current diagnostic systems. We then examine developmental, epidemiologic, and clinical data, as they add to our understanding of child and adolescent anxiety disorders. A brief discussion of the assessment and treatment of childhood anxiety is also included. Some areas of future research are identified. PMID- 1778077 TI - Axis IV: a reliable and valid measure of psychosocial stressors? AB - DSM-III axis IV, Severity of Psychosocial Stressors, has been a disappointment to many because of the apparently infrequent use of the axis in clinical and research settings. This report is a review of literature on the use, reliability, and validity of axis IV. Although the concept of multiaxial evaluation has considerable appeal, clinicians have not routinely used axis IV, possibly because they do not fully understand the complexities involved in making ratings. The relatively few published empirical studies on axis IV indicate modest reliability and limited validity, beyond the value in identifying severe psychosocial stressors for the purpose of planning clinical interventions. The results of this review have led the DSM-IV Multiaxial Issues Work Group to consider several options for major changes in the format of axis IV to be recommended to the DSM IV Task Force. PMID- 1778078 TI - Personality pathology in bulimics versus controls. AB - The Millon Clinical Multiaxial Inventory (MCMI) was administered to 37 bulimic women, as well as 32 female general psychiatric outpatients and 30 normal women in order to assess contrasts in prevalence of various types of personality pathology among the three groups. Bulimic women displayed significantly greater pathology on scales measuring dependent and avoidant characteristics. However, they were not significantly different from female psychiatric outpatients with regard to most types of personality pathology. Results are discussed within the framework of previous literature on personality characteristics and disorders within the bulimic population. PMID- 1778079 TI - Alcoholism and depressive disorders in opioid addicts and their family members. AB - The co-occurrence of alcoholism and depression was examined in 201 opioid addicts and their 877 first-degree relatives using direct interviews and structured family history based on the Schedule for Affective Disorders and Schizophrenia (SADS) Research Diagnostic Criteria (RDC) method. Familial alcoholism was more frequent in alcoholic than nonalcoholic proband addicts, and primary depression was more frequent in relatives of depressed than nondepressed addicts. An association was suggested between secondary, but not primary, depression and alcoholism in females. PMID- 1778080 TI - Schizophrenic patients with depression: psychopathological profiles and relationship with negative symptoms. AB - This study investigates the occurrence of depression and related psychopathological features in chronic schizophrenics and attempts to examine whether depressive symptoms are independent of negative symptoms. We found that 54% of our sample of 240 chronic schizophrenics exhibited moderate to severe depression. Independent t tests showed that those high in depression tended to exhibit significantly more positive symptoms as defined by the Positive and Negative Syndrome Scale (PANSS). Those with high depression do not exhibit significantly worse negative symptoms compared with low depression, clearly differentiating depression from negative symptoms. Results and the relationship to a previous factor-analytic study of schizophrenic symptoms are discussed. PMID- 1778081 TI - Psychiatric stigma in non-Western societies. AB - Factors bearing on social stigma in persons with a psychiatric illness are the subject of this review of the literature. The review concentrates on material pertaining to non-Western societies. This is a topic that has not received much systematic attention. The cultural meanings associated with psychiatric illness are examined. Emphasis is given to societies ordinarily studied by anthropologists and social historians of non-Western medicine. Stigma is variable in the more elementary societies. It is present in India and especially China, and studies suggest the social stigma is less prevalent in Islamic societies. It is important to distinguish between how psychiatric illness is handled in community settings as versus in the system and tradition of medicine. PMID- 1778082 TI - Seasonal mood symptoms in bulimia nervosa and seasonal affective disorder. AB - Mood and appetite disturbances are commonly found in bulimia nervosa and seasonal affective disorder (SAD). To investigate seasonality of mood symptoms, we administered the Seasonal Pattern Assessment Questionnaire (SPAQ) to 38 consecutive bulimic patients, 38 age- and sex-matched SAD patients, and 25 age- and sex-matched normal controls. The SPAQ is a reliable, retrospective, self rated questionnaire that assesses seasonal changes in mood, sleep, weight, and social activity. The SAD patients had significantly higher Global Seasonality Scores (GSS) than the bulimic patients, who had higher scores than the control group (F = 78.6, df = 2.98, P less than .0001). Forty-two percent of bulimics met case-finding SPAQ criteria for SAD, compared with none of the control group (chi 2 = 14.1, df = 1, P less than .0005). These data suggest that a significant number of unselected bulimic patients have seasonal mood symptoms as severe as that seen in SAD. We propose that a common neurobiologic abnormality, such as serotonergic dysfunction, may underlie the common symptoms found in bulimia and SAD. PMID- 1778083 TI - The sequence of improvement of the symptoms encountered in patients with panic disorder. PMID- 1778084 TI - Comparative clinical evaluation of the activity of Ser-316 suppository in the treatment of lumbar osteoarthrosis. AB - In a double-blind, randomized study, 47 patients suffering from lumbar osteoarthrosis were treated with either Ser-316 suppository (horse immune serum directed against bone and parathyroidal glands) or placebo over a period of 6 months at a dose of 3 suppositories/week. Efficacy was assessed based on the reduction in severity of pain on motion, consumption of paracetamol tablets, functional disability in normal and professional life; on the improvement of motility as shown by fingers-floor distance, Schober Index, extension, lateral flexions; and on the global evolution of the disease. Statistically significant improvements for fingers-floor distance, lateral flexions, paracetamol consumption, pain on motion, disability in normal life and evolution of the disease were seen in the Ser-316 group compared with the results obtained in placebo-treated patients, and were evident mainly from the third month of treatment. Globally, 17 (74%) of 23 patients receiving Ser-316 were considered by both patients and physician to have shown a good or excellent response compared with only 3 (14%) of 22 patients on placebo. There were no reports of any adverse reactions in either treatment group. PMID- 1778085 TI - Changes in blood pressure, serum potassium and electrolytes with a combination of triamterene and a low dose of chlorthalidone. AB - A controlled study was carried out in patients with mild to moderate hypertension to compare the efficacy and tolerability of chlorthalidone alone and chlorthalidone combined with the potassium-sparing diuretic triamterene. After a 4-week period on placebo, 129 patients were allocated at random to receive 1 tablet daily of either 25 mg chlorthalidone (67 patients) or 25 mg chlorthalidone plus 50 mg triamterene (62 patients) for 10 weeks. Ninety-one patients (48 who had received chlorthalidone alone and 43 the combination) entered the third part of the study. During this 6-week period there was a partial crossover, approximately half continuing with their existing medication and the other half with the alternative treatment. All patients were then treated for a final 2 weeks with placebo. The placebo periods were single-blind, the active treatment periods were double-blind. Patients were seen at regular intervals throughout the trial. At each visit, measurements were taken of blood pressure and pulse rate and routine haematological and biochemical tests made. The results showed that both treatments produced similar, clinically significant reductions in blood pressure within the first 4 weeks of active medication and by the end of the 10 week period 51% of those on chlorthalidone alone and 57% on the combination showed a decrease of at least 10 mmHg or to less than 90 mmHg in standing diastolic pressure. Serum potassium decreased with both therapies but was less with the combination than with chlorthalidone alone, and the incidence of a serum potassium less than 3.5 mmol/l was significantly less with the combination. After crossover, blood pressure control was maintained but serum potassium decreased in patients changed from the combination to chlorthalidone alone and increased in those changed from chlorthalidone alone to the combination. Few adverse effects were reported and were generally mild and similar in frequency with the two therapies. PMID- 1778086 TI - Lifestyle changes in mild asthma during intermittent symptom-related use of terbutaline inhaled via 'Turbohaler'. AB - Beta 2-agonist therapy effectively relieves asthmatic symptoms, but an improvement in patient lifestyle has not been demonstrated. This open study in which patients acted as their own controls, assessed the efficacy and acceptability of intermittent symptom-related use of terbutaline inhaled via 'Turbohaler', and its influence on the lifestyle of 1133 inhaler-naive, mild asthmatics treated in general practice. A 1-week run-in period was followed by 4 weeks' treatment with inhaled terbutaline (500 micrograms as required). Peak expiratory flow rate (PEFR) and 'Turbohaler' technique were assessed at clinic visits. Diary cards, completed daily, assessed: the number of terbutaline inhalations, the relief obtained after use, the severity of asthma symptoms (cough, morning wheeze, nocturnal wheeze and wheeze on activity), and lifestyle indices (sleep disturbance, work/school days lost, limitation of normal activity). After terbutaline treatment, PEFR increased by 54 +/- 2 l/min (p less than 0.001), the severity of asthma symptoms was almost halved (p less than 0.001), with over two-thirds (65% to 76%) of patients reporting improvements in each variable, and the adverse effect of asthma on lifestyle was at least halved (p less than 0.001). Improvements in lung function, asthma symptoms and lifestyle were comparable for all sub-groups: adults (greater than 16 years), school-age children (6 to 16 years) and preschool children (less than or equal to 5 years). This study not only confirmed the efficacy and acceptability of intermittent symptom-related use of terbutaline inhaled via 'Turbohaler', but also demonstrated that its use enhanced patients' lifestyles. PMID- 1778087 TI - Bioequivalence between two furosemide-spironolactone formulations: a pharmacokinetic and pharmacodynamic approach. AB - Two formulations of the drug combination furosemide (20 mg)-spironolactone (100 mg) were tested for bioequivalence in a randomized crossover trial in 12 healthy volunteers. By comparing the AUC values derived from drug serum concentrations, bioequivalence was only achieved for canrenone, the main metabolite of spironolactone, but not for furosemide. A significant difference in the tmax values indicates sustained release of furosemide from one of the formulations. By contrast, bioequivalence was achieved if pharmacodynamic criteria, such as urine volume and Na+ and Cl- excretion over a period of 12 hours, were used. Fractional measurements of urinary volume and electrolyte excretion (0 to 3 h, 3 to 6 h, 6 to 12 h) correlated with the different tmax values for both formulations. These data indicate that bioequivalence is more conclusively verified on the basis of pharmacodynamic parameters than on the basis of pharmacokinetic parameters. These considerations are applicable in particular to drugs displaying large inter individual variations in serum levels and/or a poor correlation between serum levels and effect. PMID- 1778088 TI - Efficacy and tolerability of diclofenac dispersible in elderly patients with osteoarthritis. AB - The efficacy and tolerability of a new dispersible formulation of diclofenac were evaluated in a randomized, double-blind, placebo-controlled, multi-centre study in patients aged 60 to 80 years suffering from osteoarthritis. A total of 314 elderly patients with a mean age of 68.9 years received either 50 mg diclofenac dispersible or placebo 3-times daily for a period of 4 weeks, with paracetamol being allowed as rescue analgesic for both treatment groups. The study consisted of a baseline evaluation and two follow-up visits after 14 and 28 days of treatment. The following clinical parameters were assessed: pain at rest, on movement and on local pressure; global severity of pain; effect of pain on daily activity; duration of stiffness after immobility; rescue analgesic consumption; overall opinion of the investigator on efficacy; and occurrence of adverse events. At either one or both post-treatment assessments, diclofenac dispersible was found to be significantly superior to placebo for almost all measures of efficacy (p less than or equal to 0.05). Thirty (14.4%) patients out of 208 assessed in the diclofenac group reported adverse events compared to 18 (17%) out of 106 who received placebo; therapy was discontinued prematurely due to poor tolerability in 4.8% and 5.7% of patients, respectively. The adverse events were predominantly related to the gastro-intestinal system and were mostly mild to moderate in severity. The results of this 4-week study thus demonstrate that diclofenac dispersible is not only effective in treating osteoarthritis in the elderly but also has an acceptable tolerability profile in a patient population which is especially vulnerable to adverse effects induced by non-steroidal anti inflammatory drugs. PMID- 1778089 TI - A comparison of a single occasion treatment of head louse infestation with phenothrin liquid shampoo or a carbaryl lotion. AB - Fifty subjects with head louse infestation were recruited into a controlled trial to compare a phenothrin liquid shampoo with a carbaryl lotion. Twenty-seven subjects were treated with phenothrin and 23 with carbaryl, each formulation being applied only on a single occasion. Subjects were inspected for evidence of live lice and eggs at 24 hours and 3 to 4 weeks after application of treatment. The results showed that both the phenothrin liquid shampoo and the carbaryl lotion were effective in killing adult lice and viable eggs. No statistically significant difference in treatment efficacy was observed between the two groups. Fewer side-effects, however, were observed with the phenothrin liquid shampoo than with the carbaryl lotion. These results indicate that, when applied as a single treatment, a phenothrin liquid shampoo was as effective as a carbaryl lotion in eradicating head lice and eggs. PMID- 1778090 TI - Clinical efficacy and tolerability of tenoxicam in African patients with osteoarthritis, rheumatoid arthritis, tendinitis and/or bursitis: an open study. AB - An open clinical evaluation was carried out in 736 African out-patients suffering from rheumatic and inflammatory disorders to assess the efficacy and tolerability of tenoxicam in relieving the signs and symptoms of their condition. On entry, all previous treatment was discontinued and patients received a simple daily dose of 20 mg tenoxicam orally for 15 days in the case of those with rheumatoid arthritis or tendinitis, or for 30 days in those with osteoarthritis. Paracetamol was allowed as a rescue analgesic. Subjective verbal scale assessments were used to determine levels of pain at rest, on movement and at night, sleep disturbance and functional incapacity, on entry and during treatment. At the end of the study period, both physicians and patients gave an overall opinion of the clinical response to tenoxicam, and patients were asked how their current compared with their previous treatment. The results showed that approximately 90% of patients had an excellent or good response to tenoxicam with marked improvement in all the signs and symptoms evaluated. Moreover, tenoxicam proved to be well tolerated, only a small number of patients reporting adverse events, mainly gastro intestinal. PMID- 1778091 TI - Cholesterol requirement for growth of IR983F and P3X63-Ag8-U1 myeloma cells in serum-free medium. AB - Cholesterol, a major lipid component of the plasma membrane, is thought to have profound effects on the structure and function of cells. Most animal tissues are capable of synthesizing cholesterol de novo from acetate; however, there are relatively few mammalian cells in vitro expressing an absolute requirement for an exogenous source of cholesterol. In this paper, it was shown that both IR983F (983) rat myeloma cells and P3X63-Ag8-U1 (P3U1) mouse myeloma cells which had been cultivated in serum-free medium containing cholesterol for more than 6 months still required cholesterol in vitro for growth in serum-free medium. Optimal growth of 983 and P3U1 occurred in cholesterol concentrations of 15 and 5 micrograms/ml, respectively. Moreover, it was demonstrated that the cholesterol could be replaced by human low density lipoprotein in a concentration of 10 micrograms/ml but not by mevalonic acid lactone. In contrast to the parental myeloma cells, hybridoma cells derived from the mouse myeloma cells which had been cultivated in serum-free medium containing cholesterol for more than 6 months did not require cholesterol. PMID- 1778092 TI - Tissue reaction following a second exposure to amosite asbestos. AB - An inherently long latency period exists between the time of asbestos exposure and the development of asbestos related clinical signs in man. By this stage the events reflect the cumulative responses and offer little with regard to characterizing the acute inflammatory reactions. Similarly, studies of asbestos induced diseases employing animal models have often emphasized the investigation of chronic events, particularly the development of fibrosis and/or cancer. However, short-lived neutrophils, which exhibit a substantial potential to produce tissue damage through the generation of superoxide radicals and elastase, have been shown to constitute a component of the acute response to asbestos in this animal model. Repetitious exposures to asbestos could logically simulate extensions of this acute response and thus be an important contributor to the development of fibrosis. In order to assess this concept, animals received two exposures to asbestos. The parenchyma exhibited both 'established' lesions consisting primarily of foci of closely-packed, fibre-laden macrophages within alveoli, and 'new' lesions consisting of a mixed cell inflammatory response (including neutrophils and macrophages) as well as considerable alveolar exudate. Repeated infiltration of neutrophils to the site of renewed lung injury following a second exposure to asbestos may correspond to events occurring in human lungs exposed similarly to repeated exposures of the dust. PMID- 1778093 TI - A coupled morphological and biochemical study on the cellular localisation of the intra-adrenal renin granules in rats. AB - The effects of prolonged (3-week) sodium restriction on the rat zona glomerulosa (ZG) were investigated by ultrastructural stereological and biochemical techniques. The plasma level of aldosterone was increased, and this was coupled with a notable decrease in the volume density (Vv, microns 3/100 microns 3 of cell) of lipid droplets in ZG cells. Renin-like activity (RLA) underwent a significant rise in ZG, and Vv of dense bodies significantly rose in ZG cells. Since RLA and dense-body Vv displayed a highly significant linear correlation (r = 0.884; n = 22, P less than 0.01), the hypothesis is advanced that part of the dense bodies may be granules of prorenin or renin, and that ZG parenchymal cells are directly involved in the intra-adrenal renin production. PMID- 1778094 TI - Prevalence of swallowing complaints and clinical findings among 50-79-year-old men and women in an urban population. AB - To determine the prevalence of swallowing and esophageal complaints in the general population, 300 men and 300 women were asked to answer a mailed questionnaire. The participation rate was 92.5%. Complaints were reported by 35%. The most common complaints were symptoms associated with gastroesophageal reflux (GER) and globus sensation, both with a rate of occurrence of 20%. Obstruction of the bolus reported by 3% was the individual symptom that most frequently brought patients to the doctor. To validate the questionnaire and to study possible organic causes behind these symptoms, 46 persons with symptoms were invited to undergo further examination. Cineradiography of the pharynx revealed that 7 of 14 patients with symptoms of GER had abnormalities in the esophagus. Eleven of 55 patients with GER symptoms at least once a week underwent endoscopy. One case of erosive esophagitis and one case of gastric ulcer were diagnosed. Four of nine patients with obstructive symptoms had defective closure of the laryngeal vestibule shown by cineradiography. Endoscopy in four patients with obstructive symptoms revealed benign findings. Thus, an epidemiologic study of patients with swallowing symptoms documented a low incidence of serious organic disease. PMID- 1778095 TI - Dysphagia and its consequences in the elderly. AB - This investigation was designed to study to what extent dysphagia in the elderly is accompanied by other chest symptoms and if it leads to a reduction in body weight and quality of life. To this end 796 persons, randomly taken from a population register, replied to a questionnaire concerning swallowing difficulties and other chest symptoms. Chest pain, heartburn, and regurgitation occurred significantly more frequently in subjects who admitted feelings of obstruction in the throat or chest during the ingestion of food (p less than 0.001) than in the rest, as did so-called heart problems (p less than 0.05). People with dysphagia had more often gained weight over the last 5 years than people without dysphagia (p less than 0.05). Psychosocial problems in those with dysphagia were given as anxiety at mealtimes and the wish to eat alone. Of those with dysphagia, 40% had consulted a physician, but despite this these patients had as many problems as those who had not seen a doctor. It is apparent that difficulty in swallowing in the elderly leads to physical and psychosocial problems that may reduce their quality of life. PMID- 1778096 TI - Effects of drugs and electrical field stimulation on isolated muscle strips from rabbit pharyngoesophageal segment. AB - Muscle activity of isolated muscle strips from the middle pharyngeal constrictor, the inferior pharyngeal constrictor, the cricopharyngeal muscle, and the cervical esophagus of the rabbit was studied in organ baths in response to drugs and electrical field stimulation. These muscles of the pharyngoesophageal segment seem to lack an autonomic adrenergic and cholinergic innervation, as determined by responses to specific drugs. The nerve-evoked contractile responses of the two lower muscles of the segment were almost completely abolished by the curarelike drug gallamine, suggesting a somatic cholinergic nerve supply. However, in the two upper muscles, the major part of the response was resistant to gallamine, which suggests involvement of non-adrenergic, nonmuscarinic, nonnicotinic receptors in the transmission of nerve impulses in these muscles. These results suggest a differential innervation of the upper and lower pharyngeal muscles. PMID- 1778097 TI - The value of muscle studies. PMID- 1778098 TI - Masticatory ability in experimentally induced xerostomia. AB - The masticatory ability of 15 nondysphagic volunteers with complete natural dentition was tested using different chewing parameters including preparation of a two-color plastic chewing gum (bolus shape, and color mixture), particle reduction of a piece of silicone, and number of strokes before swallow of almonds. The tests were performed under conditions of normal salivation and experimental oral dryness caused by intramuscular injection of methylscopolamine. The chewing gum tests as well as the silicone particle reduction tests were not influenced by lack of salivation. The number of chewing strokes prior to the initiation of swallowing of almonds was significantly increased. Oral dryness seems to cause accumulation of particles in the oral cavity from friable food and the particulate material is not transported posteriorly into a "ready-to-swallow" positioning. The absorption of saliva by dry oral content such as an almond further impaired oral manipulation of food. PMID- 1778099 TI - Chewing and the dimension of the pharyngoesophageal segment. AB - Masticatory efficiency was evaluated in 21 adults for four chewing parameters: mixing of a color-patterned chewing gum mass, shaping of a chewing gum mass, particle reduction of a silicone tablet, and number of chewing strokes before the first swallow of an almond. The results of these tests were correlated with the dimension of the pharyngoesophageal (PE) segment during swallow of liquid barium and solid meat. The transverse width of the PE segment during swallow of liquid barium correlated significantly with the chewing parameters. The sagittal width of the PE segment during swallow of liquid barium correlated only weakly with the chewing parameters. The PE segment dimension during swallow of a solid meat bolus did not correlate with the chewing parameters. The results suggest that there is feedback during chewing and swallowing between the PE segment and the oral cavity. PMID- 1778100 TI - Oropharyngeal and esophageal function in scleroderma. AB - Fifty-one patients with systemic sclerosis (scleroderma) underwent videofluoroscopy during barium swallow to evaluate the incidence of oropharyngeal deglutition abnormalities and to correlate the radiologic patterns of esophageal motility abnormalities with patients' clinical features. Thirteen patients (26%) showed swallowing dysfunction, (e.g., oral leakage, retention, penetration, mild or moderate aspiration, and upper esophageal sphincter incoordination). These dysfunctions were more severe in patients with prominent esophageal dysmotility. Normal esophageal motility was not associated with swallowing alterations. Patients with an oropharyngeal disorder had a higher incidence of pulmonary disease. The clinical picture of the above-mentioned 13 patients was more severe, based on the duration of Raynaud's phenomenon and duration of skin sclerosis. Patients with primary Raynaud's phenomenon had no oral or esophageal abnormalities. The esophageal phase of swallowing was abnormal in 80% of the patients with scleroderma. Esophageal dysfunction, therefore, seems to be frequent in the early stages of the disease. However, patients with advanced or extensive disease may have normal esophageal function. PMID- 1778101 TI - Foreign bodies in the esophagus. A study of causative factors. AB - Two hundred and twenty-nine patients were studied in an attempt to determine the main causative factors behind their having a residual foreign body in the esophagus. Strictures were present in 13%. Fifty-two percent of the patients with stricture had been hospitalized more than once for treatment of foreign body impaction; this was the case in only 8.5% of the rest of the patients (p less than 0.001). More than half of the patients aged 15 years or younger had a foreign body in the hypopharynx. This location was extremely uncommon in adults (p less than 0.001). The hypothesis of spasm distal to an esophageal foreign body as the cause for obstruction in patients without esophageal stricture was supported by the following findings: spontaneous disimpaction occurred in more than one-third of the patients and became more frequent as time progressed; 63% of 16 patients given spasmolytic drugs experienced spontaneous disimpaction of the foreign body; half of the patients had the foreign body in the proximal esophagus distal to the narrower passage of the upper esophageal sphincter; foreign body impaction in the esophagus turned out to be a once-only event in 86% of the patients; and 21% of the patients had a disorder of the central nervous system and had been hospitalized significantly more often because of food impaction than the other patients. The findings indicate that adults with a history of impaction of foodstuff lacking sharp bones and who do not have stricture suffer food impaction because of spasm of the esophageal smooth muscle, and can be treated accordingly. PMID- 1778102 TI - Upper esophageal sphincterotomy in dysphagic patients with and without a diverticulum. AB - Symptoms of high dysphagia are sometimes too readily interpreted as symptoms of globus. When patients have unmistakable difficulties during meals, focused diagnostic procedures are indicated. The upper esophageal sphincter (UES) is the key structure at the transition from hypopharynx to esophagus. In many disorders presenting with dysphagia, the UES mechanism remains intact and can cause the symptoms. Especially in patients with a hypopharyngeal (Zenker's) diverticulum and in patients with a hypopharyngeal paralysis due to a neurologic disorder, sphincterotomy may be indicated. In the microendoscopic treatment of Zenker's diverticulum, a transmucosal sphincterotomy is created and at the same time a more ample overflow from diverticulum to esophagus is effected. In view of our results in 507 patients we are justified in maintaining that this procedure can be regarded as a safe and effective treatment. In patients with neurologic dysphagia, sphincterotomy by an external approach can ensure adequate passage of food from the hypopharynx to the esophagus, resulting in marked improvement of the dysphagic symptoms. Our technique and results of external approach sphincterotomy are described here. PMID- 1778103 TI - Endoscopic dilatation and surgical myectomy of symptomatic cervical esophageal webs. AB - During a 10-year period a cervical esophageal web or stricture was diagnosed at rigid endoscopy in 57 patients. Of these patients 72% had restricted their dietary habits because of their symptoms of dysphagia. Cineradiography of the pharynx had revealed abnormalities in 90% of the patients. Dilatation of the webs was performed with semisolid bougies, the endoscope itself, or with balloon inflation. Twelve patients were treated by myectomy of the cricopharyngeal muscle because of unsatisfactory results from the dilatation treatment. Cineradiographic outcome and improvement in dietary habits as a result of the treatment are reported. PMID- 1778104 TI - [Injuries to permanent incisors in the child and adolescent. Emergency treatment]. PMID- 1778105 TI - [Aime Lagache (1839-1915): Dentist, called the Child of Giberne]. PMID- 1778106 TI - [Behavior of the facial vertical dimensions of occlusion and rest in a sample of adults of all ages, dentate and edentulous]. PMID- 1778107 TI - Heterogeneity in diabetes mellitus: a lesson in the complexity of human disease. PMID- 1778108 TI - Transplantation of beta cells from transgenic mice into nude athymic diabetic rats restores glucose regulation. AB - We have shown that elevated plasma D-glucose levels in experimentally-induced diabetic nude athymic rats can be reduced by intraperitoneal transplantation of microcarrier-attached insulin producing beta cells from the mouse pancreatic beta cell line, beta TC-1. The reduction in the level of hyperglycemia was observed as early as two days following cell transplantation and was associated with a concomitant increase in plasma insulin levels. beta TC-1 cell transplanted diabetic rats had plasma D-glucose levels similar to those found in non-diabetic control animals and remained normoglycemic throughout the 39 day experimental period. The beta TC-1 cell transplanted diabetic rats also had near normalization of body weight, food and water intake and of urine output when compared to control diabetic and non-diabetic rats. Similarly, they exhibited improved blood glucose clearance following intravenous D-glucose administration. These results suggest that beta TC-1 cells regulate D-glucose homeostasis following transplantation into diabetic rat recipients in a manner similar to that of endogenous pancreatic beta cells. PMID- 1778109 TI - Variation of endogenous insulin secretion in association with treatment status: assessment by serum C-peptide and modified urinary C-peptide. AB - The variation of endogenous insulin secretion in association with fasting plasma glucose (FPG) level and the modality of treatment was assessed using serum C peptide levels before and after breakfast and the corrected value of 24-h urinary C-peptide (24 h-UCP) in inpatients with non-insulin-dependent diabetes mellitus. The corrected value calculated as 24 h-UCP/(urinary C-peptide to creatinine clearance (CCP/CCR) ratio in the fasting state x 10) was correlated with the sum of day-long serum C-peptide levels (r = 0.93) more closely than the measured value of 24 h-UCP (r = 0.79) in 9 patients. In 52 patients treated with diet alone, 38 with sulfonylurea and 28 with insulin, fasting serum C-peptide level did not vary with FPG level, and the increment of serum C-peptide level after breakfast and the corrected value of 24 h-UCP decreased with the rise in FPG level in each treatment. These indexes were the lowest in insulin treatment among the patients with similar FPG levels. In conclusion, 24 h-UCP was demonstrated to be able to reflect day-long endogenous insulin secretion more faithfully after the correction with the CCP/CCR ratio. It was estimated that the insulin response to breakfast and day-long insulin secretion decreased with the rise in FPG level, but basal insulin secretion was maintained over a wide range of FPG levels in each treatment. Endogenous insulin secretion seemed to be somewhat suppressed or rested by exogenous insulin in insulin-treated patients. PMID- 1778110 TI - The transport of vitamin E in plasma and its correlation to plasma lipoproteins in non-insulin-dependent diabetes mellitus. AB - It is known that plasma low density lipoproteins (LDL) contain a great amount of vitamin E and that LDL enter cells via the specific receptor-mediated mechanism. In this study, we aimed to investigate the transport of alpha-tocopherol from plasma to tissues in subjects with non-insulin-dependent diabetes mellitus (NIDDM) with poor glycaemic control; and the relationships between alpha tocopherol and plasma lipid and lipoprotein levels. alpha-Tocopherol determination was carried out by colorimetric assay according to the modified micromethod of Fabianek et al. The mean plasma alpha-tocopherol and (LDL + VLDL) alpha-tocopherol levels increased significantly in the diabetic group as compared to control (P less than 0.05 and P less than 0.02), whereas the high density lipoprotein (HDL)-alpha-tocopherol level was significantly lower in the diabetic group than that in the controls (P less than 0.05). Correlations between plasma alpha-tocopherol levels showed close positive relationships (r = 0.87, r = 0.75 and r = 0.78, respectively, P less than 0.001). A strong positive correlation was also observed between alpha-tocopherol and the cholesterol content, either in the HDL or in the (LDL + VLDL) fractions (r = 0.75 and r = 0.77; P less than 0.001). These findings indicate that there is a direct positive relationship between lipid and alpha-tocopherol concentrations. The increased level of alpha tocopherol in the LDL + VLDL fraction and decreased level in HDL in these patients could be attributed to the impairment of the cholesterol uptake of the cells by the receptor mediated mechanism. PMID- 1778111 TI - Familial and sporadic insulin-dependent diabetes: evidence for heterogeneous etiologies? AB - Heterogeneity within insulin-dependent diabetes mellitus (IDDM) has been hypothesized, but few studies have focused on differences which may exist between familial and sporadic IDDM cases. Presenting characteristics for 330 white, newly diagnosed IDDM cases were evaluated. Familial cases were older (10.2 +/- 5.1 years vs 7.9 +/- 4.2 years, P = 0.010) and had, on average, less severe metabolic disturbances at presentation, as demonstrated by lower mean hemoglobin A1 (12.6 +/- 2.4% vs 14.4 +/- 2.6%, P = 0.001) and mean insulin dose at discharge (0.62 +/ 0.35 U/kg/day vs 0.85 +/- 0.29 U/kg/day, P less than 0.001), and higher mean plasma bicarbonate concentrations (19.3 +/- 3.9 mmol/l vs 15.8 +/- 5.9 mmol/l, P = 0.023) and mean plasma C-peptide levels (0.35 +/- 0.36 pmol/ml vs 0.14 +/- 0.15 pmol/ml, P less than 0.001). Further analyses on a subset of IDDM cases (n = 100) indicated that initial differences in metabolic indices observed at diagnosis were no longer apparent at one-year post-diagnosis. These results suggest that the etiology of familial and sporadic IDDM is similar and that the less severe presentation observed at diagnosis in the familial cases may be due to earlier identification of the disease, reflecting increased parental knowledge of diabetic symptoms and/or frequent testing for diabetes. PMID- 1778112 TI - Carnitine improves peripheral glucose disposal in non-insulin-dependent diabetic patients. AB - To investigate the effects of carnitine on insulin sensitivity in non-insulin dependent diabetes, insulin-mediated glucose disposal was measured in nine diabetic patients (age 54 +/- 3 years, BMI 27 +/- 1 kg/mq) during a primed (3 mmol) constant (1.7 mumol/min) intravenous infusion of carnitine. In control experiments, the same patients received saline instead of carnitine. Plasma glucose concentration was maintained constant at the level of 100 mg/dl during both studies while plasma insulin was raised to a plateau of 60 microU/ml. Despite similar insulin levels, whole-body glucose utilization was higher with carnitine (4.05 +/- 0.37 mg/kg/min) than saline infusion (3.52 +/- 0.36). Blood lactate concentrations were similar in the basal state and decreased significantly during carnitine infusion (P less than 0.05-0.005), whereas it remained substantially unchanged during saline infusion. Plasma FFA decreased to a similar level (0.1 mmol/l) in both studies. We conclude that an acute carnitine administration is able to improve insulin sensitivity in NIDDM patients. The lactate data suggest that this effect may at least in part be mediated by carnitine activation of pyruvate dehydrogenase. PMID- 1778114 TI - Species richness and selenium accumulation of plants in soils with elevated concentration of selenium and salinity. AB - Field studies were conducted in soils with elevated concentrations of Se and salinity at Kesterson, California. Biomass distribution, species richness, and selenium accumulation of plants were examined for two sites where 15 cm of surface soil was removed and replaced with fill dirt in the fall of 1989, and two sites were native soil cover. The Se concentrations in the top 15 cm of fill dirt ranged from undetectable to 36 ng g-1. For the native soil sites, Se levels ranged from 75 to 550 ng g-1. Soil Se concentrations below 15 cm ranged from 300 to 700 ng g-1 and were comparable between the fill dirt and the native soil sites. At least 20 different plant species were brought into the two fill dirt sites with the top soil. Avena fatua L., Bassia hyssopifolia Kuntze Rev. Gen. Pl., Centaurea solstitialis L., Erysimum officianale L., Franseria acanthicarpa Cav. Icon., and Melilotus indica (L.) All. contributed over 60% of the total biomass. Only 5 species were found in the native soil sites, and salt grass (Distichlis spicata L.) was the predominant species and accounted for over 80% of the total biomass. Between 1989 and 1990, two years after the surface soil replacement, the two fill dirt sites had a 70% reduction in species richness. Plant tissue selenium concentrations were found to be quite variable between plant species and between sites of sampling. At the fill dirt sites, the plant species with deep root systems accumulated greater amounts of selenium than the shallow-rooted species. The soil selenium concentration of the field soil had no negative effect on pollen fertility, seed set, and seed germination for the plant species examined. However, seedling growth was impaired by the soil selenium concentrations. This suggests that a selection pressure of soil Se concentration may have been imposed on plant species such as M. indica in an early stage of its life cycle. PMID- 1778113 TI - A comparison of the clinical features and vascular complications of diabetes between migrant Asians and Caucasians in Leicester, U.K. AB - 907 consecutive patients, (456 Asian and 451 Caucasian) were assessed, employing a similar methodology to the multi-centre WHO study. The Asians were older at diagnosis (46.5 years compared with 40.6 years, P less than 0.01); they had a shorter duration of diabetes (6.3 years versus 11.4 years, P less than 0.1), a higher rate of diabetes in the first degree relatives (29.5% compared with 16%, P less than 0.1), less ketonuria at presentation (85.3% compared with 47.8%, P less than 0.1), and fewer were treated with insulin (31.4% compared with 68.7%). Comparing the prevalence of complications between Asians and Caucasians, the ischaemic heart disease rate was similar; peripheral vascular disease was less (3.7% Asian, 9.3% Caucasian, P less than 0.05); retinopathy was less (11.6% Asian, 32.3% Caucasian, P less than 0.01) but renal disease was more (22.3% Asian, 12.6% Caucasian, P less than 0.01). After adjusting for age, sex, duration of diabetes, age at diagnosis, hypertension, smoking and treatment with or without insulin, these differences remained significant. Multivariate logistic regression failed to reveal a significant contribution due to any of the above variables, or due to body mass index (BMI), haemoglobin A (HbA1), or physical activity in the prevalence of complications in Asians compared with Caucasians. Marked heterogeneity in the complications of diabetes in the two ethnic groups studied was found, but must be confirmed from population-based studies. PMID- 1778115 TI - Selenium accumulation and selenium tolerance of salt grass from soils with elevated concentrations of Se and salinity. AB - Biomass production, selenium accumulation, and the role of the bioextraction of selenium by salt grass (Distichlis spicata L.) in soils with elevated concentrations of Se and salinity at Kesterson, California, were studied. Salt grass contributed more than 80% vegetative coverage and 90% dry weight in the grassland communities where the soil Se concentrations were 100 times (1000 to 3000 micrograms kg-1) higher than the Se concentrations found in soils of the control sites. No evidence for evolution of Se tolerance was found in the salt grass populations. The successful colonization of salt grass in the soil with elevated Se and salinity is attributable to the presence of high concentrations of soil sulfate. Salt grass accumulated less Se than other salt-tolerant plant species existing in the same area, and no predation of animals and insects on salt grass has been noticed. Salt grass can transpire substantial amounts of volatile Se through its plant tissue. Under field conditions, a 1-m2 salt grass plot may produce 180 micrograms volatile selenium per day. However, no reduction of soil Se concentration in the salt grass habitat was detected over a period of 1 year. A long-term monitoring of Se status is needed in order to make predictions of the effectiveness of efforts to clean up Se-contaminated soils through the use of native plant species. PMID- 1778116 TI - Changes in humoral and cell-mediated immune responses and in skin and respiratory surfaces of catfish, Saccobranchus fossilis, following copper exposure. AB - Immunologic responses and stereoscan analysis of the skin and gill surfaces were performed in the air-breathing catfish, Saccobranchus fossilis (Bloch) following sublethal exposure to copper. At 0.056, 0.1, and 0.32 mg/liter of Cu, a dose dependent decrease in red and white blood cell counts, hemoglobin content, and packed cell volume values were observed at the end of experiment, i.e., 28 days. Fish exposed to Cu concentrations had lower antibody titer values, reduced numbers of splenic and kidney plaque-forming cells, and higher counts of splenic lymphocytes when compared to the control group. Cellular immune responses were evaluated by the rejection of eye allografts. Fish exposed to 0.32 mg/liter for 28 days showed 2-3 days delay in the eye-allograft rejection. Reduced phagocytic activity against sheep red blood cells was observed in Cu-treated fish. Exposure to 0.32 mg/liter of Cu for 7 days causes surface architectural abnormalities in the arrangement of microvilli on the surface of superficial epidermal cells of the skin. Hypersecretion of mucous, loss of shape, size, and structural arrangement of epidermal cells, and mucous goblet cells were observed following Cu exposure. An increased number of active tubular dilated mucous cells were also noticed. Accumulation of mucous suggests a molecular interaction between mucous glycoproteins and toxic Cu ions. Fish exposed to 0.32 mg/liter for 7 days showed edema, fusion of secondary gill lamellae at many places, and degeneration of epithelial cells. Marked ultrastructural alterations in the arrangement of microridges and intervening grooves of gill lamellae were noted. It is suggested that these degenerative changes in gill lamellae are responsible for respiratory and osmoregulatory dysfunction. PMID- 1778117 TI - Application of the Hydra attenuata assay for identifying developmental hazards among natural waters and wastewaters. AB - This study concerns application of the Hydra attenuata assay to detect the developmental toxicity potential of various aqueous samples. First, the assay was modified for testing aqueous samples because water quality has a major impact on aquatic toxicity testing and the results thus obtained. Ranges of sample pH, salinity (conductivity), and hardness were examined for their adverse effects upon the hydra. Adult hydra were unaffected morphologically by pH 5.5-9.5, and the artificial embryo ("embryo") developed normally in a pH range of 6.25 to 8.25. For water hardness, the minimal affective concentration was 1000 mg/liter (as CaCO3) in adults and 625 mg/liter in the embryos; the NOAELs for these were 750 mg/liter in the adult and 250 mg/liter CaCO3 in the embryo. Salinity in excess of 5 ppt was lethal to adults and embryos, indicating the assay may not be applicable to marine or highly saline samples. Finally, grab samples were tested from rivers in Maryland, Pennsylvania, New Jersey, and Delaware, some of which are impacted by industrial and agricultural activities, as well as several samples of industrial wastewaters from one major facility. The assay functioned normally with these diverse samples and yielded results that can be used in assessing the potential developmental hazard of these materials. PMID- 1778118 TI - Acetylcholinesterase activity in the common prawn (Palaemon serratus) contaminated by carbaryl and phosalone: choice of a method for detection of effects. AB - Organophosphorus compounds and carbamates are pesticides which inhibit acetylcholinesterase activity. The toxicity of phosalone and carbaryl was studied for 29 days in the adult common prawn (Palaemon serratus). Induction thresholds for inhibitory effects were determined and the toxicity of these two pesticides was investigated. For monitoring purposes, several methods of assessing the effects of these two pesticides in the marine environment are considered and discussed. PMID- 1778119 TI - Effects of ultraviolet radiation on the primary production of natural phytoplankton assemblages in Lake Michigan. AB - Inhibition of primary production of offshore Lake Michigan phytoplankton assemblages by solar ultraviolet radiation (SUVR) was observed from April to October in 1986 during in situ incubations in special Plexiglas chambers. Inhibition of primary production by SUVR was observed to a depth of 6 m and at intensities which were approximately 1% of the UV-B intensity at the lake surface. Significant inhibition of primary production by SUVR was restricted to the top third of the euphotic zone. The order of relative sensitivities of offshore Lake Michigan phytoplankton assemblages during different seasons to inhibition by SUVR were spring ED50 = 17.6 kJ/m2 UV-B) greater than fall (ED50 = 30.5 kJ/m2 UV-B) greater than summer (ED50 = 131.6 kJ/m2 UV-B). A hazard assessment model predicted a significant reduction (13%) in areal (total water column) primary production for offshore Lake Michigan due to current SUVR intensities. Concern about possible increased reduction of primary production in the North American Great Lakes due to depletion of the stratospheric ozone layer appears to be unwarranted. PMID- 1778120 TI - Shared governance for nursing: a model for professional growth. PMID- 1778121 TI - Sleep deprivation and intensive care unit psychosis. PMID- 1778122 TI - Nurses' practice of breast cancer screening and early detection: results of a pilot survey. AB - Nursing has a professional responsibility to participate in cancer screening and early detection. Nurses represent the largest professional group in the health care workforce and are presently an underutilized potential resource for implementing breast cancer screening and early detection. Development of a reliable and valid instrument which could be used to evaluate the effectiveness of mechanisms designed to increase nursing's role in breast cancer screening and early detection is needed. The questionnaire tested in this pilot study represents an initial attempt at fulfilling this need. This questionnaire in its present form may be used to evaluate the results of intervention studies aimed at increasing nurses' practice of breast cancer screening and early detection. For example, the questionnaire could be used as an evaluation tool to examine the effectiveness of educational programs regarding breast cancer screening and early detection. It may also be used as an outcome measure to evaluate change in practice activities such as the effect on nursing practice of including questions on the nursing history and assessment form related to BSE, clinical breast exam and mammography. Results of nursing action in breast cancer screening and early detection could have a significant impact on the achievement of the NCI's year 2000 goal of a 30% reduction in breast cancer mortality. PMID- 1778123 TI - Short bowel syndrome: an infant's story. PMID- 1778124 TI - Clinical excellence: a cognitive process. PMID- 1778125 TI - Valvular heart disease in the older adult: a case study presentation. AB - Mr. C's case was interesting from both a medical and nursing point of view. He presented both medical and nursing challenges. For medicine, the major challenge was the decision of whether or not to do open heart surgery on a patient with an ejection fraction of 20-30%. For nursing, the major challenge was increasing Mr. C's motivation to participate in his care and to learn essential new behaviors to practice at home. Mr. C was able to be discharged to his home in stable condition with information he needed to achieve his new self-care behaviors. Mr. C's case offers many possibilities for future research. To be more specific, the study could focus on the open heart surgery patient. A study could also be done in this same area looking at how patient education impacts motivation and increasing readiness to learn. This case demonstrates how important collaboration and consistency are in following a plan of care to positively effect the patient's progress. Often times there is more than one health care professional involved in the teaching of the patient. To be most effective, the teaching plan must be consistent with all involved. This is achieved through good communication among health team members regarding what the patient has been taught, what he understands, and additional teaching needs of the patient (13). Keeping these points in mind will help guide the nurse in her quest to provide the patient with the best possible care. PMID- 1778126 TI - Who talks to horses anyway? PMID- 1778128 TI - Therapeutic use of self. PMID- 1778127 TI - Invasive line monitoring: maintaining reliability. PMID- 1778129 TI - Transference and countertransference in nursing. PMID- 1778130 TI - Scenarios that demonstrate transference/countertransference phenomena. PMID- 1778131 TI - Credibility and the new graduate. PMID- 1778132 TI - The invisible wound. PMID- 1778133 TI - Use of fluorescent electronic endoscopy in the evaluation of peptic ulcers. AB - Serial changes in the color tone of the mucosa after fluorescein administration in patients with peptic ulcers were evaluated using an electronic endoscope. In the healing and scar (S1) stage of a peptic ulcer, more intense fluorescence was observed in the lesion than in the surrounding normal mucosa shortly after intravenous injection of fluorescein. On processing of the electronic endoscopic fluorescent images using HSI transformation the difference between the lesion and normal areas could be clearly identified. This difference in the fluorescent image between the lesion and the surrounding normal mucosa may be associated with changes in the mucosal blood flow and cellular functions in the lesion. Fluorescent electronic endoscopy with fluorescein thus seems to be a useful technique for examination of the gastrointestinal mucosa. PMID- 1778134 TI - Two-dimensional computer color graphics of gastric mucosal blood distribution in normal subjects and ulcer patients. AB - The mucosal blood volume in 20 to 24 different regions of stomach was estimated by reflectance spectrophotometry during endoscopy, and an image showing mucosal blood distribution was made by two-dimensional computer color graphics with the aid of a personal computer. In 55 normal controls, the estimated mucosal blood volume (EMBV) was greater in the corpus mucosa than in the antral mucosa, and less in the lesser curvature than in the greater curvature. The volume in the anterior and posterior walls was almost the same. In 15 patients with active gastric ulcers in the angular region, the EMBV was decreased in all regions in the stomach. In 37 patients with healing ulcers, the EMBV increased, resuming the same levels as in normal controls. However, the EMBV around the ulcer increased remarkably at this stage. In 35 patients with ulcers in the scarring stage, the distribution of the EMBV was similar to that in the normal controls. These hemodynamic changes were shown clearly in a color display with the aid of a personal computer. This method could offer new possibilities in endoscopic research. PMID- 1778135 TI - Analysis of mucosal blood hemoglobin distribution in gastric ulcers by computerized color display on electronic endoscopy. AB - A technique of computerized color display was used to analyze the mucosal blood hemoglobin distribution in patients with gastric ulcers. Using an electronic endoscope, red and green images (Vr and Vg) obtained separately from the electronic endoscopic image were transferred to an image analyzer and a computer. The mucosal hemoglobin content was calculated at each pixel of the image using the formula: index of hemoglobin content = 32[log2(Vr/Vg)]. Forty endoscopy examinations were performed in 15 patients with small ulcers (less than or equal to 1 cm) in the gastric angle and 5 normal subjects. The index of hemoglobin content ranged from 24 to 40 in the normal subjects. The index for the area around an active ulcer was mostly below 33. In cases of ulcers in the healing stage it increased to more than 40. The index was still above 40 in ulcer scars in the S1 stage, but within normal range in most of the mucosa in the S2 stage. Thus, the mucosal blood hemoglobin distribution can be assessed by computerized color analysis in patients with gastric ulcers at various stages. PMID- 1778136 TI - Frequency and spectrum of microorganisms isolated from biopsy specimens in chronic colitis. AB - In 109 patients with chronic diarrhea colonic biopsies were examined for the presence of specific microorganisms. A positive result was obtained in 48% of patients with ulcerative colitis, 50% with Crohn's disease, 21% with non-specific colitis and 36% with non-specific proctitis. Chlamydiae were found most frequently in all groups. Obligate enteropathogenic bacteria were isolated in only three cases of nonspecific colitis. Of the facultatively enteropathogenic organisms Klebsiella and Pseudomonas aeruginosa were isolated in 31% and 24%, respectively, of patients with ulcerative colitis, in 21% and 7% of patients with Crohn's disease, and in 10% and 6% of patients with non-specific colitis. Whereas chlamydial proctitis is a well-known disease, the results of this study point also to a possible pathogenic role of chlamydiae in the proximal colon. Facultatively enteropathogenic organisms causing acute diarrhea might have aetiologic relevance in some cases of chronic non-specific colitis. PMID- 1778137 TI - Clinical value of pulse oximetry during routine diagnostic and therapeutic endoscopic procedures. AB - The clinical utility of transcutaneous oxygen saturation monitoring during routine diagnostic and therapeutic esophagogastroduodenoscopy and colonoscopy was assessed in 271 consecutive patients. The mean patient age was 56 years (range 14 86 years). The mean preprocedure oxygen saturation was 94% (range 81-100%). The mean dosages of intravenous meperidine, diazepam and midazolam if administered were 50 mg, 6.4 mg and 3.3 mg, respectively. The largest mean decrease in oxygen saturation of all procedures compared to the preprocedure measurement was 3.2% (p = .0001) and occurred immediately after administration of intravenous medication and endoscope intubation. Colonoscopy and esophagogastroduodenoscopy patients experienced similar decreases in oxygen saturation. The patient's age and sex, type of procedure and physician performing the procedure did not affect the degree of desaturation. The largest mean decrease in oxygen saturation observed was less than that considered normal during sleep. The clinical value of transcutaneous oxygen saturation monitoring in routine diagnostic and therapeutic esophagogastroduodenoscopy and colonoscopy is not supported by the findings of this study. PMID- 1778138 TI - A randomised controlled trial to evaluate the effects of flumazenil after midazolam premedication in outpatients undergoing colonoscopy. AB - The degree of sedation and amnesia, subjective assessment of awakening and side effects after intravenous injection of 3-4 mg midazolam and 1 mg flumazenil or placebo were studied directly after colonoscopy, and on the first and the eight day. A total of 91 patients were studied; 45 patients were given flumazenil and 46 patients a placebo. Five minutes after injection of the test drugs all 45 patients given flumazenil but only 38 patients given the placebo were alert (p = 0.006). All three response criteria (for sedation, amnesia and subjective assessment of awakening) were fulfilled by 84.4% of the patients given flumazenil and 45.7% of the patients given the placebo (p = 0.0002). Thirty minutes after injection of the test drugs dizziness, nausea, and fatigue were found in 3 patients given flumazenil and in 10 patients given placebo. One day after colonoscopy 9 of 45 patients (20%) given midazolam and flumazenil complained of fatigue and 9 of 46 patients (19.5%) given midazolam and placebo. Eight days (+/- 1 day) later two patients in each group complained of headache, nausea and fatigue. No patient developed phlebitis at the injection site. Flumazenil seems to be a safe and efficient drug for reversing the sedative effect of midazolam, premedication after colonoscopy. However, resedation due to the effects of midazolam may occur. Flumazenil thus permits administration of a higher dose of midazolam without prolongation of the surveillance time. Improved exploitation of time, space and nursing resources is thus possible without jeopardizing patient safety, although caution is necessary since patients may not be fit to resume all normal activities. PMID- 1778139 TI - Longitudinal comparative study on the influence of computers on reporting of clinical data. AB - The impact of the clinical database system SISCOPE on medical services was evaluated and objective data compiled on the quality of information recording and reporting using a fully structured data entry system compared to traditional free text reporting. 1565 upper endoscopy reports produced with SISCOPE over a period of 12 months were assessed for completeness and compared to 152 and 208 free text reports done 4 months before and 1 month after the study period, respectively. Data on four common gastrointestinal findings (esophageal varices, ulcers, polyps and tumors) were evaluated. Physicians' compliance with the new system was good, as reflected by a constant level of quality of reporting over time, although a very slight decline in the ratio of computer generated reports to the total number of examinations was noted. Structured reports had an 18% missing data rate and contained 60% more relevant information than free text reports, which had a 48% missing data rate. No educational effect of the system was seen as missing data rates returned to pre-computerization levels just one month after the end of the study. It is concluded that menu-driven structured data entry systems result in production of far superior reports as compared to free text systems, probably due to their reminder effect. PMID- 1778140 TI - A new pull-through trocar technique for percutaneous operative endoscopy. AB - A pull-through trocar is described which establishes a percutaneous access to the stomach and may immediately be used for endoscopy. The trocar is placed in a similar fashion to PEG probes. The technique was evaluated in animals. Using rigid endoscopes and instruments introduced through the trocar operative manipulations of the gastric wall were carried out. There were no severe complications. The new method extends the scope of percutaneous therapeutic endoscopy (minimal invasive surgery) by permitting direct access to the interior of the stomach. PMID- 1778141 TI - Blood flow measurement at endoscopy. PMID- 1778142 TI - Monitoring during gastrointestinal endoscopy: how much is necessary? PMID- 1778143 TI - Treatment of a gastric bezoar by extracorporeal shock wave lithotripsy. AB - A bezoar of the stomach was diagnosed by X-ray and endoscopy in an 8-year-old boy who presented with intermittent dull epigastric pain. Attempts at endoscopic extraction failed because of the size and hardness of the bezoar. Extracorporeal shock wave lithotripsy was therefore applied using ultrasound to locate the bezoar. Disintegration of the bezoar and spontaneous evacuation of the fragments was achieved. PMID- 1778145 TI - Epinephrine: which solution? PMID- 1778144 TI - A hamartoma of the colon with unusual features. AB - An unusual case of colonic hamartoma in a 67-year-old man is reported. Colonoscopy polyp surveillance revealed a polypoid lesion of the sigmoid colon which had the characteristics of a hamartoma on microscopic examination. The lesion, which was classified as a colonic hamartoma, is described. Review of the literature revealed no previous report of such a colonic poylp. PMID- 1778146 TI - Gastric ulcer and cholestasis following injection therapy of bleeding duodenal ulcers. PMID- 1778147 TI - An unusual complication of sclerotherapy. PMID- 1778148 TI - Lack of evidence of upper gastrointestinal endoscopy as a risk factor for transmission of hepatitis B virus. PMID- 1778149 TI - Presence of sebaceous glands in the esophagus. PMID- 1778150 TI - Prospective evaluation of renal function following ERCP. PMID- 1778151 TI - Percutaneous transhepatic papillotomy. PMID- 1778152 TI - Exophthalmus in Graves' disease: luxation of the eyeball at endoscopy. PMID- 1778153 TI - Progress in identifying the aetiologies of infectious foal diarrhoea. PMID- 1778154 TI - Blood gas and acid-base status--art, science and relevance. PMID- 1778155 TI - Equine monocytic ehrlichiosis (Potomac horse fever): a review. AB - In the late 1970s, a new infectious disease in horses, involving acute enteritis, was recognised in the Potomac River area of Maryland, U.S.A. The causative agent was identified subsequently as a new species of rickettsial organism, later named Ehrlichia risticii. Since then, the disease has been reported in many other states, and in enzootic areas vaccination is common. Signs associated with the clinical disease included depression, fever, anorexia, decreased or absent intestinal sounds, profuse watery diarrhoea and laminitis. However, considerable variation in clinical manifestations has been reported in both the natural and experimental disease. Accurate diagnosis depends on serological testing; currently, the immunofluorescent antibody test (IFA) is used widely, although an enzyme-linked immunosorbent assay (ELISA) has been developed recently. Mortality in untreated cases is 15 to 35 per cent. Antibiotics of the tetracycline series have shown activity against the organism in vitro, in an in vivo murine model and appear to be useful in clinical cases. PMID- 1778157 TI - Radiographic, high detail radiographic, microangiographic and histological findings of the distal portion of the tarsus in weanling, young and adult horses. AB - Clinical radiographic (LM and D35L-P1MO views), high detail radiographic, microangiographic and histological findings of the distal portion of the tarsus of 16 horses (five weanling, four young and six adult), without known clinical histories, were evaluated to determine the sensitivity of clinical radiographs for the detection of abnormalities in the distal tarsus and the prevalence of abnormalities in this population. Clinical radiographic and high detail radiographic abnormalities were observed in at least 30 per cent of the tarsi examined. Statistical agreement between observations from clinical radiographs and corresponding post mortem high detail radiographs was not good for subchondral bone plate irregularities and joint margin changes. Three patterns of sclerosis of the medullary spongiosa were visualised on high detail radiographs: thickening of the subchondral bone plate was seen commonly in the weanling group, whereas arching and bridging patterns were more prevalent in the young and adult groups. Bone production on the dorsal cortex of the central and third tarsal bones did not increase with age. Abnormalities in vascular perfusion and articular cartilage histology were observed in association with subchondral bone plate irregularities and focal regions of osteopenia observed on high detail radiographs. PMID- 1778156 TI - Blood gas analyses on equine blood: required correction factors [see comment]. AB - Correction factors have been determined to obtain the best estimates of PO2, PCO2 and pH in equine blood with standard blood gas and pH electrodes. There was a significant difference between the PO2 readings for tonometred blood of most horses and the equilibrating gas. Thus, if the PO2 electrode is calibrated with a gas, an electrode correction factor should be obtained by tonometring a blood sample from each horse. This factor was not dependent on packed cell volume. No such correction is required for the PCO2 electrode. If the animal's temperature differs from that of the analyser, the PO2, PCO2 and pH values must be corrected to the animal's body temperature. Temperature correction factors determined for equine blood were similar to those for human blood. Failure to make temperature corrections can result in errors for PO2 and PCO2 of 6 to 7 per cent per degree of temperature difference. PMID- 1778158 TI - Traumatic injuries involving tendons of the distal limbs in horses: a retrospective study of 55 cases. AB - Fifty-five horses were presented to Colorado State University Veterinary Teaching Hospital between 1st of January 1980 and 31st of December 1989 for treatment of distal limb lacerations involving flexor tendons (n = 35) or extensor tendons (n = 20). Of the 35 flexor tendon lacerations, 11 horses were killed without treatment and 24 horses were treated. Twenty-two horses were included in determining outcome. Four (18 per cent) returned to their original level of use, nine (41 per cent) returned to limited riding, seven (32 per cent) returned to breeding or pasture soundness and two (9 per cent) were killed. Eighteen of the 20 horses with extensor tendon lacerations underwent treatment and 15 had sufficient follow-up to determine outcome. Seven (47 per cent) returned to their original or intended use, five (33 per cent) returned to limited use, one (7 per cent) was used for breeding and two (13 per cent) were killed. Results for horses with extensor tendon lacerations support previous reports that these injuries can be treated successfully. Results for horses having flexor tendon lacerations were better than in previous reports. PMID- 1778159 TI - Histopathological and ultrastructural changes in simulated large colonic torsion and reperfusion in ponies. AB - This investigation examines the histological and ultrastructural lesions of the colonic mucosa during terminal experimental infarction and subsequent reperfusion. Four ponies were anaesthetised and subjected to surgical torsion of the colon. Biopsies were collected at hourly intervals for 3 h, at which point the torsions were corrected. Circulation was re-established for 2 h and the bowel was re-biopsied at hourly intervals. The ponies were killed while under anaesthesia. During the 3 h experimental infarction, the bowel became macroscopically thickened and dark purple. Histologically, the mucosa degenerated from Grade 0 to Grade 3. Ultrastructurally, there was progressive micro-vascular distension with erythrodiapedesis and damage to the interstitial cells. Spaces developed between the bases and sides of the columnar epithelial cells and sloughing followed subsequently. During the 2 h reperfusion interval, the mucosa continued to degenerate rapidly to a Grade 5, and was characterised by extensive interstitial damage, oedema, cellular swelling, necrosis and mitochondrial damage. The results showed that the experimentally infarcted colonic mucosa degenerated sequentially. Following circulatory reestablishment, continued rapid mucosal degeneration characteristic of reperfusion injury occurred. Reperfusion injury is probably responsible, at least in part, for the often poor outcome of infarcted bowel in horses following surgical correction. PMID- 1778160 TI - Bronchoalveolar lavage findings in horses with exercise intolerance. AB - Significant differences were detected by bronchoalveolar lavage (BAL) between horses racing successfully and those showing exercise intolerance. Neutrophil percentage, haemosiderophage percentage and total bacterial numbers were significantly elevated in horses with exercise intolerance. BAL provided a more accurate indication of the incidence and extent of exercise induced pulmonary haemorrhage (EIPH) than visual inspection. PMID- 1778161 TI - Desmitis of the accessory ligament of the deep digital flexor tendon: 27 cases (1986-1990). AB - Desmitis of the accessory ligament of the deep digital flexor tendon (ALDDFT) was diagnosed in 27 horses between September 1986 and December 1990. The first observed clinical sign in four horses was localised swelling in the proximal metacarpus. Twenty horses became lame suddenly during a work period and most developed swelling within 24 h of exercise. The injury was confirmed by ultrasonographic examination. Ten of 13 horses with uncomplicated desmitis of the ALDDFT resumed full work, within three to nine months of the onset of clinical signs, without recurrence of clinical signs in the period of follow-up (nine months to four years). Three horses presented with concurrent acute desmitis of the ALDDFT and superficial digital flexor (SDF) tendonitis and two horses had a history of SDF tendonitis; none of these resumed full work. PMID- 1778162 TI - Risk factors associated with injuries in thoroughbred horses. AB - A case-control study was conducted on Thoroughbred horses to identify factors associated with the risk of breakdown on racetracks. A total of 310 cases (breakdowns) were identified from the Horse Identification Department records kept by the chief examining veterinarian of New York Racing Association. For each case, two control horses were selected randomly from the Daily Racing Form Inc. records. Multiple logistic regression analysis was used to identify and quantify the risk of factors associated with breakdown, while simultaneously controlling for the effect of other putative factors. Factors associated with risk of breakdown were: track (horses raced on Saratoga racetrack were at a lesser risk of breakdown), track composition/condition (turf tracks had a lower risk compared to dirt), number of seasons in race, racing in a later race, number of starts per year, the total number of starts, season (summer had a higher risk than winter or spring) and age of the horse. PMID- 1778163 TI - Therapeutic management of ocular squamous cell carcinoma in the horse: 43 cases (1979-1989). AB - The records of 50 horses with ocular squamous cell carcinoma (OSCC) presented to the University of Florida Veterinary Medical Teaching Hospital over an 11 year period were reviewed to determine the influence of therapy on the outcome of the case. Follow-up information was obtained for 43 of the 50 cases. The disease was more prevalent in the light horse breeds; however, the draft breeds also were at risk. There was no sex predisposition and the average age was 11.8 years. Tumour recurrence was significant when surgery alone was performed. The eyelid and nictitating membrane were the primary sites for tumor recurrence. Cases in which adjunctive therapy was used correlated with a lower rate of recurrence. PMID- 1778164 TI - The body condition of feral ponies on Assateague Island. AB - The summer body condition of 47 adult feral ponies on Assateague Island (off the coast of Maryland, USA) was assessed in June 1988 using a visual body condition scoring system. Winter body condition for 36 of the ponies was assessed in February and March, 1989. The ponies were categorised by gender, reproductive status and location on the island, and body condition scores of the ponies in each category were then compared by statistical analyses. No significant seasonal differences were found in the body conditions of the ponies. However, body condition of stallions was better than that of mares. Also, lactating mares had lower body condition scores than non-lactating mares. Finally, in the summer, ponies on the southern part of the island were in better condition than those on the northern end where food and other resources were more limited. Thus gender, reproductive status and habitat, according to the criteria of this study, all had an effect on the body condition of Assateague Island feral ponies, whereas seasonal effects were not evident. Future studies could clarify the correlation between the condition of the mares during the breeding season and birth rate and survival of foals the following spring. PMID- 1778165 TI - The genetic basis of equine allergic diseases. 1. Chronic hypersensitivity bronchitis. AB - The genetic influence on chronic hypersensitivity bronchitis (CB) was investigated in families at two studs and among half-siblings of three affected and three non-affected sires at several farms. The family members at the two studs were born and raised under the same conditions, whereas the half-siblings were kept individually under very different conditions and were exposed to various environmental factors. The diagnosis was based on long-term observations and multiple clinical examinations at each of the two studs. In the half-sibling group, the diagnosis was based on the individual history and on a thorough clinical examination. The history of all horses suggested the disease was caused by allergies (symptoms provoked by hay). Statistical analysis of the data in the first study showed that a greater percentage of off-spring of two affected parents developed CB (9 of 13) than those with only one affected parent (23 of 48) and those with two healthy parents (5 of 29). The distributions of the affected offspring in these three categories (none, one or both parents affected) differed significantly (P less than 0.005) from what would have been expected without a genetic effect. The tendency to develop the disease was inherited equally from dams or sires. In the second stud fewer animals (n = 42) were included in the study, but the results were similar. Parents without a history of CB produced off-spring with a low incidence of disease (1 of 16) compared with a higher incidence among descendants of one or two affected parents (10 of 26; P = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778166 TI - Measurement of cardiac dimensions with two-dimensional echocardiography in the living horse. AB - Two-dimensional echocardiography (2DE) was performed on 22 unsedated Thoroughbred and part Thoroughbred horses weighing between 411 and 650 kg to establish normal reference values for 2DE measurements. Animals stood during examinations performed with a 3.5 MHz mechanical sector transducer using various transducer positions and tomographic planes. Right ventricular diameter (RVD), ventricular septal thickness (VSTh), aortic diameter (AoD), area of the chordal lumen of the left ventricle (CTA), left ventricular diameter (LVD) and left atrial diameter (LAD) were determined at ventricular end-diastole (Ed) and/or end-systole (Es). Fractional shortening (FS) of the left ventricle and end-systolic left atrial to aortic ratio (LAD-Es:AoD-Es) also were calculated. Echocardiographic data were related to body weight by linear regression analysis. Intra-observer variability was checked in five horses by measuring each parameter during each of 10 consecutive cardiac cycles. The 2DE data were compared with M-mode values in published reports. In the 18 horses whose weight did not exceed 551 kg, repeatable recordings of good quality were obtained, and 2DE measurements could be made using intra-cardiac reference points. Increasing body weight proved to impose substantial limitations on measurements taken with the available machine and transducer. This problem might be overcome by using probes of lower frequency or equipment with higher quality image display at greater depth. The following parameters correlated significantly to body weight: VSTh-Es (r = 0.69; P less than 0.01). AoD-Es (r = 0.64; P less than 0.01) and CTA-Es (r = 0.84; P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778167 TI - Influence of age on neutrophil function in foals. AB - Functional activities (phagocytosis and killing) of neutrophil leucocytes (NL) and immunoglobulin G concentrations were evaluated in six healthy foals from birth to 6 months of age. Peripheral blood NL were reacted with Streptococcus equisimilis in 20 per cent pooled equine serum for 30, 60 and 90 mins and functional activities of NL were determined using a fluorochrome microassay. Values for foal NL function were compared with those of healthy adult horses (n = 28). Foal neutrophil function was influenced by age. Killing capacity of NL decreased, whereas phagocytic capacity increased, until 113 days of age, after which a reversal in trends became apparent. Immunoglobulin G concentrations changed significantly over time and were lowest at 29 to 56 days of age. All foal values for NL function fell within the range of normal values established for healthy adult horses. PMID- 1778168 TI - Mononuclear cell infiltration of the equine endometrium: immunohistochemical studies. AB - Endometrial sections from mares with varying degrees of mononuclear cell infiltration were examined for immunoglobulin (Ig)A-, IgM-, IgG(T)- and IgG(Fc) containing cells, luminal and glandular epithelial cell Ig-staining and free interstitial Ig-staining, using a peroxidase anti-peroxidase technique. Mares with mild to moderate (Group 2) and mares with severe diffuse mononuclear cell infiltration, superimposed by acute endometritis (Group 3), had significantly higher numbers of Ig-containing cells than genitally-normal mares (Group 1). The differences between Groups 1 and 3 were significant for all four isotypes. In Groups 1 and 2, numbers of IgA-containing cells were significantly larger than numbers of IgM- and IgG(T)-containing cells. Generally, more glandular epithelial cells stained for IgA and IgM than for IgG(T) and IgG(Fc), and Ig-staining for all isotypes increased from Group 1 to Group 3. Free interstitial staining did not appear to differ among the three groups, but IgG(Fc)- and IgG(T)-staining generally was more intense than IgA- and IgM-staining. The efficiency of uterine defence in the mare does not seem to depend solely on humoral factors, and defects involving other components of the defence system may contribute to failure of the uterus to clear infection. PMID- 1778169 TI - Equine synovial tendon sheaths and bursae: a transmission electron microscope study. AB - A transmission electron microscope study was undertaken to investigate the details of the synovial tendon sheath and bursal lining in horses. The lining cells appeared to be fibroblasts and were buried in a finely granular ground substance. Generally these cells had poor cytoplasmic organelles, sparse short profiles of rough endoplasmic reticulum (RER), few scattered ribosomes and, occasionally, a poorly developed Golgi complex. However, a few lining cells appeared more active, having pronounced RER with dilated cisternane. The surface of the lining cells, particularly those with dilated RER, had filipodia of different shapes, which in some instances appeared to surround a detached matrix. This feature might indicate that these cells are capable of phagocytosis. In young animals, the lining was more or less akin to that of the adult. However, the lining cells were virtually indistinguishable from the fibroblasts in the subconnective tissue. PMID- 1778170 TI - Diagnosis of pulmonary valve endocarditis in a horse. PMID- 1778171 TI - Arterioureteral fistula in a colt. PMID- 1778172 TI - Steroid hormones: synthesis, metabolism, and action in health and disease. PMID- 1778173 TI - Steroid and thyroid hormone receptors. AB - The identification, cloning, and characterization of steroid and thyroid hormone receptors have revealed much about the mechanisms of hormone action. While their remarkable similarities reflect evolutionary conservation of useful structural and functional motifs, differences in their gene number and organization, mRNA regulation, nuclear localization, target gene specificity, and transcriptional activation properties undoubtedly stem from the duplication and subsequent divergence that follows from the specialization of function in higher organisms. Further study of the nuclear receptors will clarify the shared and individual strategies used by hormones to regulate gene expression. It will be particularly important to understand the actual molecular mechanisms by which simultaneous binding of hormone and target gene by a receptor signals the transcriptional apparatus. Finally, the identification of novel putative receptors indicates that the biology of hormones that act in the cell nucleus will be even more complicated and exciting than ever imagined. PMID- 1778174 TI - Plasma steroid-binding proteins. AB - Two steroid-binding proteins circulate in plasma, corticosteroid-binding globulin and sex hormone-binding globulin. They both have several different but connected, physiologic functions. Each is the major determinant of the concentration of the physiologically important hormones that they bind. CBG regulates the concentration of free cortisol and progesterone, and SHBG regulates the concentration of free testosterone, dihydrotestosterone, and, to a lesser extent, estradiol. It is this small free fraction of the appropriate hormone that is the active principal in affecting hormone action. In the past few years, it has been shown that both of these proteins have high affinity, specific receptors on the plasma membranes of a variety of cells. It has also been shown that when SHBG's binding sites are occupied it cannot bind to its receptor; only unliganded SHBG can. There are, as yet, no published reports on the control of CBG binding by steroids. For both SHBG and CBG, if an appropriate steroid is present when the binding protein is itself bound to its receptor, rapid induction of adenylate cyclase activity and the accumulation of intracellular cAMP occur. Finally, CBG has been shown to be a member of the superfamily of serine proteinase inhibitors. When it is exposed to a serine protease, it is cleaved and release all, or most, of its bound cortisol. PMID- 1778175 TI - Congenital adrenal hyperplasias. AB - The congenital adrenal hyperplasias (CAH) are a very common group of genetic disorders of steroid hormone synthesis. The genes encoding each of the steroid biosynthetic enzymes have now been cloned, and the mutations in these genes that cause the various forms of CAH are being determined. The emerging picture is substantially different from traditional views of CAH. Examination of the clinical findings in each form of CAH from a molecular genetic perspective simplifies understanding of these complex and closely related syndromes. Because mild forms of CAH are being recognized with increasing frequency, and severely affected patients now survive and reproduce, these disorders are of interest to endocrinologists dealing with all age groups. PMID- 1778176 TI - Steroid hormone-producing tumors of the adrenal, ovary, and testes. AB - Steroid hormone-synthesizing tumors are rare and may be difficult to diagnose and treat. This article focuses on adrenal tumors as models for the even less common tumors of the ovary and testes, and emphasizes useful diagnostic procedures and pitfalls as well as treatment options. Ovarian and testicular steroidogenic tumors are categorized and discussed in terms of the generalizations that can be derived from adrenal neoplasia. PMID- 1778177 TI - Ovarian hyperandrogenism and androgen-producing tumors. AB - The ovary is an active source of androgen secretion. This is regulated largely by LH but by insulin and other factors as well. Functional states include PCO as well as stromal hyperthecosis, which often mimics a neoplasm. Ovarian neoplasms are often gonadotropin responsive. Both functional and nonfunctional tumors may give rise to elevated androgen levels. Clinical history and the accurate assessment of testosterone measurements aid in the correct diagnosis of an androgen-secreting tumor. Imaging techniques, particularly vaginal ultrasound, are extremely valuable in making the diagnosis. Selective venous catheterization, although useful, should not be the primary diagnostic technique. PMID- 1778178 TI - Insulin as an effector of human ovarian and adrenal steroid metabolism. AB - Evidence is accumulating that insulin is a potent effector of human steroid hormone metabolism. In this article, we have reviewed primarily in vivo studies showing that physiologic elevations in serum insulin levels can increase circulating ovarian androgens, decrease serum levels of adrenal androgens, and decrease serum SHBG levels. In addition, insulin resistance at the level of the adrenals appears to be associated with loss of responsiveness to the suppressive effect on adrenal androgens. We have proposed an integrated hypothesis as to how these complex actions of insulin might all come into play in the genesis of a common endocrinopathy--PCO. At least one clinically relevant aspect of these findings is that therapies aimed at reducing the magnitude of hyperinsulinemic insulin resistance in women with PCO may ameliorate the hyperandrogenism. One example of this possibility is the well recognized observation that substantial weight loss is associated with a reduction in serum androgen levels and clinical manifestations of hyperandrogenism in this disorder. PMID- 1778179 TI - Pharmacologic manipulation of steroid hormones. Adjunctive therapies in cancer of the breast. AB - Tamoxifen is the endocrine treatment of choice for hormone-responsive early and advanced breast cancer. Newly developed biodegradable luteinizing hormone releasing hormone super agonists represent a practical and effective treatment for metastatic disease in premenopausal women. Progestins or aromatase inhibitors are useful therapies in patients who relapse from antiestrogens. Currently, there is no indication that improved survival can be achieved by combined endocrine therapy or combined chemo-hormonal therapy. PMID- 1778180 TI - Endocrine therapy for prostate cancer. AB - Prostate cancer is the most frequent cancer in men. A discovery of major importance in the endocrinology of prostate cancer is that the testes contribute only 60% of total androgens in adult men; the remaining 40% are synthesized in peripheral tissues, including the normal and cancerous prostate, from inactive androgen precursors of adrenal origin. Using a combination therapy that includes a pure blocker of the androgen receptor or antiandrogen and castration (medical with luteinizing hormone-releasing hormone agonist or surgical by orchiectomy), the duration of response and survival have been demonstrated to be prolonged for the first time in advanced prostate cancer. PMID- 1778181 TI - The steroid hormone antagonist RU486. Mechanism at the cellular level and clinical applications. AB - The cellular and molecular mechanism of RU486, a steroid hormone antagonist, is discussed in detail. Principally, RU486 opposes the action of two types of hormones: progesterone and glucocorticosteroids. The clinical applications are also described, as well as the future outlook. PMID- 1778183 TI - Metabolic studies using 13C nuclear magnetic resonance spectroscopy. PMID- 1778182 TI - Update on the metabolic effects of steroidal contraceptives. AB - Modern oral contraceptive pills are safe and show minimal metabolic effects that have little clinical significance to smoking and reproductive age (even up to menopause). Multiphasic and 30 to 35 micrograms EE fixed combination pills are preferable to higher dose EE pills. Triphasic pills with norgestrel or norethindrone, monophasic norethindrone pills, and combination pills with the newer progestins are all probably metabolically comparable. The levonorgestrel implant is convenient, reversible, and effective and eliminates estrogenic metabolic effects. Metabolic benefits of the pill may include less acne, better preservation of bone mass, and less blood loss. Women who smoke should be encouraged to stop. Women with risk factors for atherosclerosis such as smoking, lipid abnormalities, diabetes, or hypertension should avoid combination pills. Women with a history of pregnancy, steroid-related thrombophlebitis, or thromboembolic disease should not use estrogen-containing pills. PMID- 1778184 TI - Tubulin and microtubules. PMID- 1778185 TI - The urea cycle: a two-compartment system. AB - Channelling and enzyme localization remain controversial; they have been proposed for a number of metabolic pathways, especially glycolysis and the tricarboxylic acid cycle. One aspect that is often overlooked in discussions of channelling is that very tight channelling is readily accepted in pathways which occur in enzyme complexes, for example fatty acid synthetase, the 2-oxoacid dehydrogenase complexes and the protein synthesis/ribosome complex. As a metabolon the urea cycle is presently unique since it covers two conventional compartments. For the urea cycle, channelling appears to be almost complete with varying degrees of tightness at each step. Since a considerable portion of the nitrogen for urea synthesis is derived within the hepatocyte from amino acids, does this means that numerous enzyme-enzyme associations are required for this metabolon? Another important, as yet unaddressed, question is what are the consequences of channelling to theories of metabolic regulation? The answers will no doubt be forthcoming in the next few years as the concept of metabolons gains or loses acceptance. PMID- 1778186 TI - Antibody engineering: an overview. AB - We can now isolate and manipulate antibody genes. Mouse antibodies can be humanized, resulting in chimaeric or reshaped antibodies. Antibody engineering is useful in large scale production of antibodies, in production of active antibody fragments, bifunctional, single-domain and catalytic antibodies, and has lead to the production of novel expression systems useful in many other areas. It allows production of new antibody conjugates, e.g. antibody-toxin or antibody-enzyme linked proteins. Engineered antibodies have many potential applications e.g. imaging, therapy and biosensors. PMID- 1778187 TI - Structure and function of ribonuclease A binding subsites. AB - Ribonuclease A binds nucleic acids through multiple electrostatic interactions between the phosphates of the polynucleotide and the positive groups (side chains of lysines and arginines) of the protein subsites. The bases only play a significant role in the binding at the active site. The active centre p1R1B1 sites determine the specificity of the catalytic cleavage. The phosphate-binding subsites p2 (Lys-7 and Arg-10), p1 (Lys-41, His-12 and His-119) and p0 (Lys-66) are essential for an effective catalysis and are conserved in all mammalian pancreatic ribonucleases. Additional phosphate-binding subsites confer further catalytic efficiency, probably by avoiding non-productive binding. The minimum chain size for optimum catalysis is probably longer than six or seven nucleotides. The full occupancy of binding sites by the long chain polynucleotides would explain the preference of the enzyme for these substrates. The multiplicity of binding subsites is responsible for the helix-destabilizing activity of ribonuclease A. Its capacity for destroying the secondary structure of single-stranded nucleic acids may be of importance for the complete hydrolysis of RNA in the digestive tract. A large variety of proteins, with very different structures and functions, interact with nucleic acids. An analysis of their binding properties shows that there is no general model for protein-nucleic acid interaction. However, the vast amount of work on the ribonuclease A binding subsites should serve as a model for the study of the binding properties of many other proteins that recognize nucleic acids. PMID- 1778188 TI - Predictability of aortic dissection as a function of aortic diameter. AB - The role of aortic diameter on the occurrence of type A dissection was investigated in 73 patients with dilated ascending aorta at the time of pre operative evaluation. Using transthoracic echocardiography for diagnosis and measurements, 54 patients were identified with type A dissection (group 1) and 19 without dissection (group 2). The true mean aortic diameters were identical (6.0 +/- 1.3 cm in group 1 and 6.4 +/- 1.4 cm in group 2; mean +/- SD; ns) as were the indexed aortic diameters (ratio of diameter/body surface area; 3.2 +/- 0.8 cm.m-2 and 3.4 +/- 0.7 cm.m-2, respectively; ns). However, the individual diameters showed a pronounced scatter in both groups (range from 3.6 +/- 11.0 cm). Of the 73 patients, 66 had surgery (47/54 with and 19/19 without dissection) and seven patients were treated medically. Emergency surgery was performed in 45/66 patients (all with acute type A dissection) and elective repair in 21/66 (19 without and two with chronic type A dissection). In-hospital mortality was 18% in the emergency group, 5% in the elective group and 57% in the medical group. It is concluded that patients with dilated ascending aorta have a substantial incidence of acute dissection. Their clinical course is unpredictable: acute dissection occurs in some, and in others the ascending aorta continues to enlarge without dissection. Because patients with dissection often arrive too late for elective repair and have to be operated on as emergencies with a higher operative risk, we recommend elective surgery before the diameter of the ascending aorta has reached 6 cm. PMID- 1778189 TI - Radiofrequency catheter ablation in recurrent ventricular tachycardia. AB - Catheter ablation by radiofrequency energy was carried out in 10 patients with one type of recurrent monomorphic sustained ventricular tachycardia resistant to medical antiarrhythmic management. Electrophysiological studies before ablation included activation and pace-mapping. In all patients, the origin of the tachycardia was localized in the left ventricle: in the septum in six, at the posterolateral wall in three and anterobasal in one. The earliest onset of endocardial activation preceding the QRS complex during ventricular tachycardia ranged between -45 and -90 ms. Transcatheter ablation was performed with a bipolar or quadripolar catheter using a radiofrequency generator (HAT 100, Osypka). No complications occurred during the ablation procedure. Thereafter, in all patients, the clinical tachycardia was no longer inducible by programmed stimulation. During a follow-up period of 22 to 32 months including eight patients, the tachycardia recurred in two; one of these patients subsequently died suddenly. A third patient had one episode of a new type of sustained ventricular tachycardia some hours after catheter ablation. In the remaining patients, there was no recurrence of symptomatic tachycardia under maintenance of the antiarrhythmic management which, prior to ablation had been ineffective. Thus, our preliminary results suggest that radiofrequency catheter ablation might be beneficial for these high risk patients. PMID- 1778190 TI - Attenuation of nitrate effect during an intermittent treatment regimen and the time course of nitrate tolerance. AB - The long-term efficacy of transdermal nitrate therapy, in particular the ability of a single patch to provide 24 h prophylaxis against angina, has been questioned. Two mechanisms have been suggested for this loss of effect: the development of pharmacological tolerance, and premature patch exhaustion. This study was designed to investigate this problem, and in particular to investigate the time course of treatment failure. It comprised a randomized, double-blind, cross-over comparison of transdermal glyceryl trinitrate and matching placebo transdermal patches. Significant treatment effects were demonstrated by several criteria for 8 h of continuous therapy, with some limited effect persisting for 15 h. Loss of effect began to develop very soon after treatment was initiated and progressed in a steady, linear fashion so that there was virtually no treatment effect after 24 h. In contrast, during intermittent therapy, treatment effects were maintained on the second day following a nitrate-free interval. Significant benefit was demonstrated for up to 32 h (i.e. 8 h of treatment on day 2). Both nitrate-free intervals (12 and 16 h) seemed to be equally effective in maintaining efficacy after 3 h of treatment on the second day, although this was still somewhat attenuated compared with day 1. These results confirm that loss of therapeutic efficacy of transdermal nitrate is due to the development of tolerance and not premature patch exhaustion. In contrast to previous studies, however, they suggest that tolerance can only partly be reversed by intermittent therapy and also that the onset of tolerance is so rapid that it is well established in less than a day's treatment. PMID- 1778191 TI - A comparison of sustained release verapamil versus atenolol for 24 h protection from exercise-induced angina pectoris. AB - We have compared the efficacy of a once daily 360 mg sustained release preparation of verapamil (SRV) with that of once daily 100 mg atenolol in exercise-induced angina. The study was randomized, double-blind and cross-over in design involving 30 patients with chronic stable angina. A 2-week run-in placebo phase was followed by two 4-week periods of active treatment. Patients underwent exercise stress tests at 6 and 24 h post-dose at the end of each treatment phase. After the placebo phase, patients had significantly increased times to both 1 mm ST depression and angina at 6 h (afternoon stress test) compared to 24 h post dose (morning test). The two treatments were found to be equivalent in terms of several indices of anti-anginal efficacy. The only significant differences between treatments were in relation to indices of heart rate, which were consistently lower with atenolol than with SRV. We conclude that once daily sustained release verapamil 360 mg has equivalent anti-anginal efficacy to once daily atenolol 100 mg. A lower angina threshold seems to occur in the morning in patients with ischaemic heart disease suggesting a diurnal variation. PMID- 1778192 TI - Intravenous nitroglycerin suppresses exercise-induced arrhythmias in patients with ischaemic heart disease: implications for long-term treatment. AB - We studied 20 patients with ischaemic heart disease, who consistently developed complex ventricular arrhythmias during exercise testing. Treadmill exercise was performed twice, both during the placebo infusion and then during intravenous administration of nitroglycerin, titrated to reduce systolic blood pressure by 10 mmHg. Exercise duration in those administered placebo was 7.8 +/- 1.7 and 7.9 +/- 1.5 min, respectively (ns); angina developed in five patients and ischaemic ST changes in 10. In those administered nitroglycerin, exercise duration increased to 8.4 +/- 2 min (P less than 0.05). Diagnostic ST segment depression was observed in only two patients and only one had angina. Ventricular arrhythmias, consistently present during both tests on those administered placebo, were dramatically reduced by nitroglycerin in all 20 patients. There were 455 (mean 35.8 +/- 16.8) and 418 (mean 34.4 +/- 11.1) ventricular ectopic beats in the two exercise tests on those administered placebo and 11 in those receiving the nitroglycerin infusion (mean 0.6 +/- 0.1) (P less than 0.001). There were 28 and 29 couplets in those receiving placebo (ns) and none in those receiving nitroglycerin (P less than 0.001). Ventricular tachycardia was present in six and eight patients who received placebo but in none in those administered nitroglycerin (P less than 0.001). Abolition of exercise-induced arrhythmias was maintained during chronic treatment with oral coronary vasodilators. Prevention of exercise-related arrhythmias by nitroglycerin appears a good indicator of their ischaemic origin and may provide valuable information for long-term prophylaxis with oral vasodilators, thus avoiding antiarrhythmic agents with their potential side effects. PMID- 1778193 TI - The effects of nisoldipine on the total ischaemic burden: the results of the ROCKET study. AB - This study was designed to examine the effects of nisoldipine (relative to placebo), a new dihydropyridine calcium entry blocking agent, in the treatment of silent ischaemia in conventional doses. A total of 409 patients with proven coronary artery disease were screened and of this 64 had at least six episodes or a total duration of 30 min of ST segment depression (1 mm lasting at least 1 min) over 48 h. Fifty-two patients ultimately completed a randomized double-blind cross-over study comparing nisoldipine 5 mg twice a day, nisoldipine 10 mg daily and placebo. There was a reduction in the ST segment integral and number of episodes of ST segment depression when compared to placebo on treatment with nisoldipine 5 mg twice a day and nisoldipine 10 mg daily. However, the confidence limits were wide and crossed the no-treatment effect line. In addition, the nisoldipine doses neither affected the circadian distribution of ischaemic episodes nor caused an alteration of the workload achieved either at peak exercise or at 1 mm ST segment depression measured 24 h after nisoldipine 10 mg or 12 h after nisoldipine 5 mg. We conclude that frequent silent ischaemia in patients with proven coronary artery disease is relatively uncommon; it accounts for approximately 16% of patients with positive exercise. In these patients nisoldipine, given as 5 mg twice a day and 10 mg daily, showed no significant therapeutic effects, either on the frequency or severity of silent ischaemia. New formulations of slow release nisoldipine are consequently being developed so that a fuller 24 h therapeutic profile may be obtained. PMID- 1778194 TI - The electrophysiological effects of flosequinan. AB - We have evaluated the acute electrophysiological effects of flosequinan in 18 patients with normal ventricular function. Following intravenous infusion of flosequinan 100 mg over 1 h, mean (SD) systolic blood pressure fell from 131 +/- 19 to 120 +/- 22 mmHg (P less than 0.02) and there was significant shortening of sinus cycle length (732 +/- 151 to 575 +/- 93 ms, P less than 0.001), AH interval (110 +/- 45 to 71 +/- 19 ms, P less than 0.01), QRS duration (98 +/- 28 to 91 +/- 26 ms, P less than 0.02) and QT interval (373 +/- 47 to 337 +/- 35 ms, P less than 0.001), but no change in sinus node recovery time, intra-atrial conduction time, HV interval or the corrected QTc interval. There was a reduction in both anterograde atrioventricular Wenckebach cycle length (299 +/- 53 to 259 +/- 52 ms, P less than 0.01) and retrograde ventriculoatrial Wenckebach cycle length (375 +/- 77 to 300 +/- 56 ms, P less than 0.01). There was no change in atrial or ventricular effective refractory period (ERP) but atrial functional refractory period (FRP) shortened (233 +/- 31 to 212 +/- 24 ms, P = 0.07) as did ventricular FRP (249 +/- 24 to 234 +/- 21 ms, P less than 0.01). Patients received an oral dose of flosequinan 50 mg 12 h later. By 24 h, sinus cycle length, QRS duration and the QT interval had all returned towards baseline values, but ventricular ERP had lengthened (199 +/- 22 to 215 +/- 26 ms, P less than 0.06).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778195 TI - The comparative value of exercise echocardiography and 99m Tc MIBI single photon emission computed tomography in the diagnosis and localization of myocardial ischaemia. AB - To determine the relative value of exercise two-dimensional echocardiography and 99m Tc methoxyisobutylisonitrile single photon emission computed tomography (MIBI SPECT) for the detection of myocardial ischaemia, 103 consecutive patients with either proven or suspected coronary artery disease, who were referred for perfusion scintigraphy, were studied by a combination of the two techniques during the same symptom-limited upright bicycle exercise test. Appropriate echocardiographic images were recorded both at rest and immediately post-exercise and subsequently analysed by means of digital cine loop processing. Both echocardiographic and MIBI SPECT images were visually analysed. For each technique, three different responses to exercise were defined: normal (absence of rest and exercise abnormalities); ischaemic (transient scintigraphic perfusion defects and transient wall motion abnormalities during exercise echocardiography); and fixed abnormalities (fixed scintigraphic perfusion defects; echocardiographic wall motion abnormalities at rest without worsening after exercise). To allow a valid comparison of each technique in localizing ischaemia, the left ventricle was divided into the following six major regions for both methods: anterior, posterolateral, inferior, interventricular septum (subdivided in anterior and posterior septum) and apex. Eleven of the 103 patients had to be excluded from the final analysis because of unsatisfactory examinations: seven with non-interpretable exercise echocardiograms and four with non-interpretable MIBI SPECT images. The response to exercise was concordantly classified by both techniques in 84% of patients (k = 0.78). Exercise echocardiography revealed the presence of ischaemia in 38 and MIBI SPECT in 45 patients (agreement = 77%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778196 TI - Diagnostic value of two-dimensional echocardiography in cardiac hydatid disease. AB - Echinococcal infection of the heart is rare. The preoperative findings, with special attention to two-dimensional echocardiography (2DE), of six patients with cardiac echinococcosis and their surgical and pathological correlations are reported. Cardiac hydatid cysts (HCs) were located in the cardiac apex in three patients, in the upper part of the interventricular septum extending towards the anterior aspect of the heart in one and in the postero-superior right atrial wall in another patient. The remaining patient had multiple intrapericardial cysts. In three patients the cysts presented as well defined, rounded, echolucent masses within the myocardial wall bulging into the cardiac chambers. In two patients, the cysts had ruptured into a cardiac chamber with loss of the characteristic 'cystic' appearance; these cysts presented as an echogenic or solid mass protruding into a cardiac chamber. Finally, another patient had one HC with echolucent appearance and another HC in a different location with echogenic appearance; this last cyst corresponded to a degenerated HC. In two cases the cyst showed a loculated internal aspect. In one patient the myocardial segment involved by the cyst had a dyskinetic movement. In all six patients, 2DE accurately demonstrated the location and morphological details of the cardiac cysts, permitted recognition of the ruptured and/or degenerated cysts and was superior to thoracic computed tomography and angiography in the preoperative assessment of these patients. Nuclear magnetic resonance imaging (one patient) gave no further information to that obtained by 2DE. We conclude that 2DE is the technique of choice for an early diagnosis of this rare entity. PMID- 1778197 TI - The value of 2-D Doppler echocardiography in the evaluation of asymptomatic patients with Mustard operation for transposition of the great arteries. AB - 2-D Doppler echocardiography was used to assess the occurrence of haemodynamic abnormalities in 45 asymptomatic patients, aged 4 to 16 years (median 7.4) after a Mustard operation for transposition of the great arteries. The findings were compared with those derived from cardiac catheterization. Thirty-five cardiac lesions were correctly diagnosed by 2-D Doppler echocardiography in 23 patients, but on six occasions, minor abnormalities were missed. 2-D Doppler echocardiography demonstrated systemic venous pathway obstruction of more than 3 mmHg at cardiac catheterization in nine patients, and in five of the six patients with pulmonary venous channel obstruction. A left ventricular outflow tract obstruction (pressure difference greater than 15 mmHg) was diagnosed correctly by Doppler echocardiography in seven patients. Baffle leakage was found in two patients with a left to right shunt of 25% or more of pulmonary blood flow, but was missed in five out of nine patients with small shunts. Tricuspid regurgitation was well defined in eight patients. The absence of symptoms and a routine examination after a Mustard operation do not rule out haemodynamic abnormalities. However, these, with the possible exception of minor baffle leakage, can be detected by 2-D Doppler echocardiography. PMID- 1778198 TI - Significance of a mitral regurgitation systolic murmur complicating a first acute myocardial infarction in the coronary care unit--assessment by colour Doppler flow imaging. AB - To determine the prevalence and significance of a systolic mitral murmur heard after a first acute myocardial infarction (MI), we studied 186 consecutive patients in the coronary care unit (CCU) during a one-year period. Fifteen patients had a murmur as a result of mitral regurgitation (MR) (prevalence 8%) documented by colour Doppler flow imaging. It was heard before the third day of hospitalization in 10 (67%) patients, and on the third day itself in the remainder. The severity of MR was graded semi-quantitatively: moderate in 12 (80%) patients, and mild, moderate to severe and severe in three respectively. The direction of the MR jet, determined by colour flow imaging, improved the information obtained by two-dimensional echocardiography (2D echo) that could only diagnose mitral leaflet abnormality in seven (47%) patients. In 10 of 15 (67%) patients, the 2D echo ejection fraction was greater than or equal to 40% and in eight (53%) the wall motion score obtained by analysing 11 left ventricular (LV) segments was less than or equal to 8. Two (13%) patients died in the CCU, four (27%) had LV failure, one angina and eight (53%) remained asymptomatic in the hospital. Of 171 patients without a systolic murmur, 22 (13%) had LV failure, 13 (8%) angina and 25 (15%) died during the in-hospital stay (P NS for these complications between patients with and without MR murmur). During a follow-up of 12-24 months, one MR patient died, and seven (47%) remained asymptomatic. We conclude that the prevalence of MR systolic murmurs in acute MI patients is low.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778199 TI - Work absenteeism in men who are labelled hypercholesterolaemic at screening. AB - Screening participants are frequently informed that they are hypercholesterolaemic. This study aimed at analysing whether such information induces a feeling of ill health, reflected in increased work absenteeism. A total of 1594 male construction workers aged from 20 to 59 years participated in an occupational health based screening programme. Men with plasma cholesterol greater than or equal to 6.9 mmol.l-1 (n = 184) were informed that they were hypercholesterolaemic and that they were at increased risk for heart attack. Comparison of health insurance data for the calendar year before and after screening, revealed that the relative risk for an hypercholesterolaemic subject to increase the annual number of sick-listing episodes was 1.01 (95% confidence interval: 0.93-1.10 compared to normocholesterolemic men. The annual number of days on sick leave carried a relative risk of increasing by 0.92 (95% confidence interval: 0.75-1.14). The results suggest that if patients know they are hypercholesterolaemia it does not necessarily mean that they perceive themselves as really ill. PMID- 1778200 TI - Successful catheter ablation by radiofrequency energy of posteroseptal accessory pathway in a patient with drug refractory Wolff-Parkinson-White syndrome. AB - A 45-year-old patient with the Wolff-Parkinson-White syndrome suffering from recurrent intractable reciprocating atrioventricular tachycardia (RAVT) is reported. He used amiodarone, sotalol, quinidine, propafenone and flecainide unsuccessfully. An electrophysiological study (EPS) performed with four catheters localized the site of the anomalous pathway in the ostium of the coronary sinus. In this region we could also record a Kent potential. In the ostium of the coronary sinus, radiofrequency energy was repeatedly applied until the conduction over the accessory pathway was abolished both in the anterograde and the retrograde direction. The Kent deflection detectable before ablation, could not be detected after it. During follow-up (1 month) the patient remained asymptomatic and the control EPS showed no evidence of pre-excitation, either anterogradely or retrogradely. PMID- 1778201 TI - Single coronary artery, anomalous origin of the right coronary artery from the left anterior descending artery. AB - We present a patient with an abnormal origin of the right coronary artery from the left anterior descending artery. The patient had chest pain probably related to myocardial ischaemia. This anomaly is very rare and has previously been reported in only three cases. The abnormal vessel travelled rightwards and remained anterior to the main pulmonary artery, it was free of significant stenosis. The mechanism of anterior myocardial ischaemia remains unexplained. PMID- 1778202 TI - Radiation protection for the parent and child in diagnostic nuclear medicine. PMID- 1778203 TI - Low density lipoprotein labelling characterizes experimentally induced atherosclerotic lesions in rabbits in vivo as to presence of foam cells and endothelial coverage. AB - The entry of autologous iodine-125 low density lipoprotein (125I-LDL) into the aortic wall in rabbits was measured. After abdominal endothelium abrasion with a Fogarthy catheter the animals were fed a 1% cholesterol-supplemented diet for 4 weeks. The animals were killed 1-48 h after administration of 25 muCi 125I-LDL. Local entry of radiolabelled LDL was estimated and correlated to endothelial surface lining and foam cell content, both controlled morphologically. Endothelialized segments showed the lowest entry of 125I-LDL, the maximum uptake was reached at around 8 h. In de-endothelialized segments the entry was higher and the peak later (12 h), while in re-endothelialized segments a continuous increase in 125I-LDL entry up to 48 h was measured. Number and extent of foam cells correlated with the entry of LDL. The data indicate the usefulness of LDL radiolabelling for qualitative in vivo information on surface lining and foam cell content. PMID- 1778204 TI - Autologous low-density lipoprotein labelling allows characterization of human atherosclerotic lesions in vivo as to presence of foam cells and endothelial coverage. AB - The monitoring of local vascular kinetics after injection of autologous radiolabelled low-density lipoprotein (LDL) allows characterization of human atherosclerotic lesions as to the presence of foam cells and the quality of endothelial coverage. The following evidence exists: (1) dynamic imaging reveals two types of visual LDL accumulation in the vascular bed, one increasing, becoming visible sometimes only as late as after 24 h, and the other one appearing very early on, but decreasing with time; (2) the accumulation of iodine 123 LDL or iodine-131 LDL in the vascular bed shows three major types of local kinetic curves, which correlate with scintigraphic findings; (3) the accumulation of radiolabelled LDL in the vascular bed of humans in vivo is similar to its uptake in de- and re-endothelialized vessels of experimental animals using 125I LDL; (4) morphological control in endarteriectomy samples confirms the hypothesis that this promising new approach may for the first time allow the in vivo monitoring of preclinical lesions in humans. PMID- 1778205 TI - Isolation of mono- and di-iodine 125 tyramines for conjugation labelling. AB - Here we describe a method for isolating mono- and di-iodine 125 tyramines from a crude tyramine radio-iodination reaction mixture. Tyramine was radio-iodinated according to a modified chloramine-T method. Mono- and diforms were separated from each other, as well as from free 125I and unreacted tyramine, by means of paper electrophoresis or thin-layer chromatography. Both 125I-tyramine derivatives finally obtained were pure and had high specific activities, which averaged 2500 Ci/mmol for mono-125I-tyramine and 5000 Ci/mmol for di-125I tyramine. Due to their characteristics, these derivatives can be used for labelling various substances indirectly and preparing in vivo and in vitro tracers of high purity and specific activity, when conjugation labelling is required. PMID- 1778206 TI - Quantification of ocular inflammation with technetium-99m glucoheptonate. AB - Histological and morphometric evaluation of ocular inflammation is difficult, particularly when there is extensive ocular involvement with abscess formation and necrosis. A quantitative imaging procedure applicable to humans would be important clinically. To establish such a procedure, turpentine-induced ocular inflammation was obtained by subconjunctival injection in the right eye of 55 rabbits. The left eye was used as control and injected with a volume of saline equal to the volume of turpentine in the right eye. Volumes of turpentine or saline were 0.02, 0.04, 0.06, 0.2 and 0.6 ml, and the rabbits were divided into groups 1-5, according to these volumes. Imaging was performed 48 h after turpentine injection and 6 h after intravenous injection of 10 mCi of technetium 99m glucoheptonate (99mTc-GH). An inflammatory reaction index (IRI), defined as the ratio of counts of the right eye divided by counts of the left eye, was used. IRIs were proportional to the degree of inflammation and allowed the distinction of 3 subgroups: one represented by group 4, one by group 5 and one by groups 1, 2 and 3. This method of quantification of ocular inflammatory processes using 99mTc GH is original, rapid, non-invasive, reproducible and safe, although unable to differentiate inflammatory processes caused by doses of turpentine which are very small and close to each other. It is conceivable that its application to humans will bring new insight into the ocular inflammatory process and response to therapy. PMID- 1778207 TI - A new method for quantification of image distortion due to pile-up in scintillation cameras. AB - Characterization of the count-rate performance of scintillation cameras should include not only the specification of count losses. At high count rates, there is also an image distortion due to the mispositioning of pile-up events. In this paper a simple and clinically relevant procedure to quantify this distortion is presented. The images of a square uniform technetium-99m phantom at high and low count rates are used. The fraction of the total counts being correctly positioned is determined as the peripheral count density divided by the total average count density. This ratio, corrected for the camera non-uniformity at low count rates, is called the 'positioning ability'. According to the National Electrical Manufacturers' Association (NEMA), the 'system count rate performance with scatter' should be reported as the measured count rate giving 20% count losses. In this paper it is suggested that this measure be complemented by a measure of the fraction correct positioned events at this count rate. This fraction, the 'high count rate positioning ability', can be easily and accurately measured using our method. The method has been tested on two different scintillation cameras. For one of them the high count rate positioning ability was determined as 91% at a measured count rate of 30,000 s-1 with 20% count losses. For the other camera, the corresponding figures were 88% at 59,000 s-1 and close to 100% at 38,000 s-1, before and after the installation of a new pile-up rejection circuit, respectively. PMID- 1778208 TI - Evaluation of a technique for the intraoperative detection of a radiolabelled monoclonal antibody against colorectal cancer. AB - Occult tumour deposits may be localised at operation with a radiation detecting probe following the administration of a radiolabelled monoclonal antibody (MoAb) recognising a tumour-associated antigen. We have recently evaluated the clinical usefulness of this technique in detecting primary colorectal tumours targetted with an indium-111 MoAb. In the present study the physical characteristics of the two detector systems used were investigated; a sodium iodide [NaI(Tl)] scintillation detector and a cadmium telluride (CdTe) semiconductor probe. Limitations of the technique in use have been examined by testing the statistical significance of tumour detection using an abdominal phantom based on the currently available clinical biodistribution data for tumour uptake of radiolabelled MoAbs. The effect of tumour volume, antibody uptake, collimation and counting conditions was examined. Results indicate that tumours of 10 ml volume may be detected with the NaI(Tl) probe at the lowest levels of radiolabelled antibody uptake currently reported in the literature but that at higher published levels, lesions as small as 1 ml may be identified with both detector systems. Detector sensitivity and limited antibody specificity restrict the usefulness of the technique, although moderate improvements in tumour uptake may allow the detection of tumour deposits not clinically apparent. The statistical significance criterion used for this study could be an accurate and reliable indicator for tumour detection in vivo. PMID- 1778209 TI - Anomalies in reduction-mediated technetium-99m labelling of monoclonal antibodies. AB - A reduction-mediated technetium-99m labelling method has been evaluated with a range of tumour-specific monoclonal antibodies. Antibodies reduced with 2 mercaptoethanol (2-ME) had free sulphydryl groups, but their number was much higher than could be accounted for by only limited intra-chain reduction of disulphide bonds. Reduced antibody could be labelled efficiently with 99mTc using an methylene diphosphonate (MDP) bone-scanning kit, although this seemed to depend on the presence of residual 2-ME in the preparations. With a carcinoembryonic antigen (CEA)-specific antibody, immunoreactivity of labelled antibody was confirmed, and after injection into nude with CEA-producing xenografts there was localisation into the tumours. Sephacryl S300 gel filtration showed the radiolabel eluting at a single discrete peak at the expected 150 kDa. However, examination of all of the labelled antibodies by polyacrylamide gel electrophoresis (PAGE) and autoradiography showed the presence of a large number of radiolabelled low molecular weight degradation products of the antibodies. These degradation products seemed to be formed in previously reduced antibodies during processing for PAGE, indicating some fragility of the reduced antibody. PMID- 1778210 TI - Radioimmunoimaging of subacute infective endocarditis using a technetium-99m monoclonal granulocyte-specific antibody. AB - Immunoscintigraphy with a technetium-99m murine monoclonal IgG1 antibody directed against non-specific cross-reacting antigen (NCA-95) and carcinoembryonic antigen was performed with 20 patients with suspected subacute infective endocarditis (SIE) and 6 controls with suspected inflammatory/infectious disease elsewhere in the body. Immunoscintigraphy and echocardiography localised SIE in 11 of 15 patients in whom the disease could be confirmed. In 4 patients with validated SIE, the immunoscan was abnormal, and the echocardiogram was normal. In another 4 patients, the result was exactly the opposite. These findings suggest that the combination of immunoscintigraphy and echocardiography improves diagnostic efficacy in patients with suspected SIE. PMID- 1778211 TI - Increment of brain temporal perfusion during auditory stimulation. Preliminary study with technetium-99m HMPAO SPET. AB - A study on the dynamic exploration of the auditory pathway is presented, in which technetium-99m hexamethylpropylene amine oxime single-photon emission computed tomography (SPET) was used in volunteers with normal hearing. Changes in 99mTc HMPAO distribution were calculated using a region of interest/whole-brain count ratio. The results showed a temporal perfusion increment of 17% (right) and 19% (left) during tonal supraliminar stimulation, which was significantly different from the control ROI. Sensitivity tests for the method were requested before any clinical application. PMID- 1778213 TI - Radionuclide blood pool scintigraphy in a child with intestinal arteriovenous malformation (juvenile angiodysplasia). A case report and review of the literature. AB - Arteriovenous (AV) malformation or angiodysplasia of the gastrointestinal tract is a very rare cause of bleeding in children. These lesions are congenital anomalies and thought to be of hamartomatous origin. We report on a 4-year-old child with an AV malformation of the distal ileum treated by local resection. A brief review of the relevant literature is included. The importance of radionuclide blood pool scanning in the evaluation of these patients is emphasized. PMID- 1778212 TI - Radionuclide therapy of the thyroid. AB - Radionuclide therapy has a proven place in the management of patients with thyroid disease. Iodine-131 therapy has been established as both successful and safe in treating patients with thyrotoxicosis and thyroid malignancy. Protocols for patient treatment are now standardised, although some variation in practice exists across Europe. There remains much confusion as to which patients should be selected for treatment with radio-iodine for thyrotoxicosis and what dose should be administered. A review of the literature reveals that many of the theoretical hazards of treatment with radio-iodine have not been encountered despite many years of usage. New therapies for medullary thyroid cancer are now being evaluated and recent promising developments are discussed in detail. PMID- 1778214 TI - The incidence of non-iatrogenic human anti-mouse antibodies and their possible clinical relevance. PMID- 1778215 TI - Specific or non-specific uptake of monoclonal antibodies. PMID- 1778216 TI - Of Mozart and MIBI: the importance of being earnest. PMID- 1778217 TI - Cytokines and their interactions with other inflammatory mediators in the pathogenesis of sepsis and septic shock. PMID- 1778218 TI - Retinyl esters in chylomicron remnants inhibit growth of myeloid and lymphoid leukaemic cells. AB - We have studied the effects of retinyl esters in chylomicron remnants on cell growth and differentiation of myeloid and lymphoid leukaemic cells. Ten mumol l-1 retinyl ester in chylomicron remnants effectively reduced proliferation of the myeloid leukaemic cell lines HL60, U937 and KG-1, and induced differentiation of 68% and 53% of the HL60 and U937 cells, respectively, in 5 days. While no effect on cell growth of the lymphoid cell lines Daudi, Raji and SOS was observed, 10 mumol 1-1 retinyl esters in chylomicron remnants reduced the growth of the B lymphoid cell line Reh by more than 50%. Primary cell cultures from six patients with acute leukaemia (four non-lymphocytic and two lymphocytic) were incubated with chylomicron remnant retinyl esters and proliferation was measured by means of thymidine incorporation. Among the myeloid leukaemic cells, the monomyelocytic, the two promyelocytic and the monoblastic leukaemic cells were growth inhibited. Chylomicron remnants had no effect on the growth of the c-ALL primary culture, but reduced proliferation of the T-ALL primary culture by approximately 20% after 48 h. These data suggest that high doses of retinol may be used in the treatment of some forms of acute leukaemia. PMID- 1778219 TI - Effect of medium- and long-chain triglyceride infusion on lipoprotein and hepatic lipase in healthy subjects. AB - Plasma lipolytic activity and hydrolysis of intravenous fat were studied in six healthy subjects during infusion of a long-chain triglyceride (LCT) fat emulsion (Intralipid 20%) or of a medium-chain triglyceride (MCT)/LCT emulsion (Lipofundin MCT 20%). The fat emulsions were infused continuously at a rate of 0.17 g triglyceride kg-1 body weight (BW)h-1 for 6 h in random order at 7-day intervals. A continuous infusion of glucose (0.18 g kg-1 BW h-1) was administered for a period of 7 h and was started 1 h before the lipid infusion. Infusions of both types of fat increased plasma triglyceride (TG), free fatty acid (FFA) and lipoprotein lipase (LPL) levels and steady-state values were present during the 3rd to 5th h of infusion. MCT/LCT infusion resulted in higher plasma levels at steady-state of TG (3.63 +/- 0.45 [SEM] vs 2.73 +/- 0.45 mmol l-1; P less than 0.05), FFA (1.05 +/- 0.08 vs 0.54 +/- 0.04 mmol l-1; P less than 0.01) and LPL (4.6 +/- 0.6 vs 2.6 +/- 0.5 mU ml-1; P less than 0.05) in comparison with LCT administration. There was a positive correlation between plasma LPL activity and TG concentration (r = 0.77; P less than 0.001) when data for the two infusions were combined. Although the same amount of fat was infused on a weight basis, the molar infusion rate was 40% higher with MCT/LCT than with LCT infusion, due to differences in molecular weights (634 vs 885 Da).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778220 TI - Expression of transferrin receptors by monocytes and peritoneal macrophages from renal failure patients treated by continuous ambulatory peritoneal dialysis (CAPD). AB - Approximately 20% of monocytes and peritoneal macrophages from renal failure patients undergoing continuous ambulatory peritoneal dialysis (CAPD) were transferrin-receptor (TfR) positive by immunofluorescence, whereas cells from normal controls were generally TfR negative, as were monocytes from rheumatoid arthritis patients and from renal failure patients treated by haemodialysis. There was a significant correlation between the length of time on CAPD and the proportion of TfR-positive blood monocytes. CAPD peritoneal macrophages possessed 6.7-37.1 x 10(3) transferrin binding sites per cell, with a Ka of 3-25 x 10(7) mol l-1. In culture, monocytes from CAPD patients showed a progressive decrease in TfR expression, while in contrast about 20% of monocytes from normal controls which were originally 100% TfR negative expressed TfR after 3 days in culture. These findings indicate that regulation of TfR in monocytes/macrophages is complex, and that frequent removal of peritoneal cells during dialysate exchange may place a strain on the bone marrow, resulting in the release of an increasingly immature population of TfR positive monocytes to the circulation in CAPD patients. PMID- 1778221 TI - The influence of fractions of abnormal erythrocytes on aggregation. AB - Erythrocytes with abnormal shapes and deformability reduce cell aggregation and hence sedimentation. It is not known what influence small fractions of these abnormal cells have on the sedimentation behaviour of normal cells. We have used three different methods to alter erythrocyte properties (glutaraldehyde, heat treatment, and metabolic depletion). The admixture of such cells in increasing fractions to normal cells affected the sedimentation behaviour in three different ways. Heat-treated erythrocytes decreased the sedimentation proportionally. Small fractions of glutaraldehyde-treated cells increased the sedimentation, which was explained by a pro-aggregatory change of surface properties by glutaraldehyde. With 50% or more glutaraldehyde-treated cells sedimentation was inhibited, which was due to excessive formation of aggregates occupying the entire tube. The presence of small fractions of echinocytes produced by metabolic depletion decreased cell sedimentation disproportionally, which was explained by an inability of spiculated cells to form aggregates with normal erythrocytes. These results indicate that erythrocyte sedimentation is affected by fraction of abnormal cells in a complex way. Many diseases are characterized by fractions of abnormal erythrocytes. Our results may, therefore, contribute to a better understanding of these conditions. PMID- 1778222 TI - Effects of muscarinic blockade on insulin secretion and on glucose-induced thermogenesis in lean and obese human subjects. AB - To determine whether hyperinsulinaemia of human obesity is dependent on the activity of the parasympathetic nervous system, and whether activation of the parasympathetic nervous system plays a role in glucose-induced thermogenesis, the metabolic effect of a continuous intravenous glucose infusion [44.4 mumol kg-1 body weight (bw) min-1] with or without atropine infusion was assessed in 11 obese patients and 10 lean controls. Compared with lean controls, obese patients had increased basal and glucose-stimulated plasma insulin and C-peptide concentrations and increased plasma glucose concentrations during glucose infusion. Glucose oxidation during i.v. glucose was lower in obese patients than in lean controls. Glucose-induced thermogenesis was similar in obese patients and in lean controls. Atropine infusion did not affect basal plasma glucose, insulin or free fatty acid concentrations nor glucose-stimulated plasma glucose, insulin, C-peptide, glucagon or free fatty acid concentrations in both groups of subjects. Glucose and lipid oxidation rates and glucose-induced thermogenesis were also unaffected by atropine administration. It is concluded that (1) glucose stimulated hyperinsulinaemia in human obesity is not dependent on a hyperactivity of the parasympathetic nervous system, which indicates that human obesity is different from most animal models of obesity; (2) glucose-induced thermogenesis is similar in obese and lean subjects when a similar load of glucose is administered; (3) inhibition of the parasympathetic nervous system does not affect the thermic effect of i.v. glucose. PMID- 1778223 TI - A 'Fish-eye disease' familial condition with massive corneal opacities and hypoalphalipoproteinaemia: clinical, biochemical and genetic features. AB - A Caucasian family of mediterranean origin comprising a patient whose parents were first cousins, his wife and their three children, and his two sisters have been studied. The patient and his two daughters were afflicted with the same corneal opacities and hypoalphalipoproteinaemia. The disease was shown to be transmitted as a non-sex-linked recessive trait. The corneal opacities develop at the end of the second decade of life and consist of numerous minute greyish dots in the entire corneal stroma that give the cornea a misty appearance. Vision slowly deteriorated from 40 years of age. At about 50 years of age, except in one of the two daughters who showed Marfanoid syndrome, the three patients had good general health and no symptoms of atherosclerosis. Biochemical investigations showed hypoalphalipoproteinaemia (with a faint fast-moving HDL band on polyacrylamide gel gradient electrophoresis and small arcs of HDL2 and HDL3 of low mobility determined by agarose gel immunoelectrophoresis), low total cholesterol (3.5-4.9 mmol l-1), slightly decreased cholesteryl ester/total cholesterol ratio (0.52-0.63), extremely low HDL cholesterol (0.20-0.21 mmol l 1), mild hypertriglyceridaemia (1.94-3.80 mmol l-1), and striking deficiency in apo A-I and apo A-II (0.45-0.72, 0.08-0.16 g l-1, respectively). The esterification of HDL cholesterol was low while that of LDL and VLDL was nearly normal. Other laboratory values were normal. The HDL subspecies and major apolipoprotein isoforms have been studied to differentiate FED from Tangier disease, LCAT deficiency, as Apo A-I, A-II, C-II, C-III deficiencies and variants.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778224 TI - Blockade of glucocorticoid receptors prevents the increase in urea synthesis after hysterectomy in rats. AB - The postoperative increase in hepatic conversion of amino nitrogen to urea nitrogen seems to be a primary cause of post-surgical catabolism. The importance of glucocorticosteroids for the spontaneous urea nitrogen synthesis rate (UNSR) and for the maximally amino acid-stimulated capacity of urea nitrogen synthesis (CUNS) was investigated 3 and 24 h postoperatively, respectively, in hysterectomized rats. Corticosteroid effects were neutralized by glucocorticoid receptor blockade by the pharmacological analogue RU486. Hysterectomy doubled UNSR from 3.16 +/- 0.20 to 6.12 +/- 0.27 mumol (per min per 100 g body weight) after 3 h (P less than 0.01) and increased CUNS by 40% from 7.47 +/- 0.30 to 10.29 +/- 0.41 mumol (per min per 100 g body weight) after 24 h (P less than 0.01). These changes were both normalized by the receptor blockade. Hysterectomy decreased total blood alpha-amino nitrogen concentration by 25% from 3.4 +/- 0.2 to 2.6 +/- 0.2 mmol l-1 (P less than 0.05) 3 h after surgery, which was normalized by glucocorticoid receptor blockade. Hysterectomized rats lost 10 +/- 1 g the first 24 h after surgery. The blockade reduced the weight loss to 6 +/- 1 g body weight (P less than 0.05) without changing food intake. The results indicate that glucocorticoid action plays a major role in the postoperative increase in hepatic amino nitrogen conversion. PMID- 1778225 TI - Short- and long-term effects of a dopamine agonist (lisuride) on sex-specific behavioural patterns in rats. AB - Lisuride induces in juvenile male and especially in female rats a significant increase of the male-typical initiating activity in tests on social play-fighting behaviour. In neonatally castrated as well as in prenatally stress exposed males, castrated in adulthood, which exhibit under androgen substitution alone bisexual or even predominantly heterotypical sexual behaviour, additional treatment with lisuride resulted in a temporary normalization of sexual orientation in the homotypical male direction, limited to the duration of treatment. In castrated androgen-treated females, lisuride induces a partial conversion of sexual orientation to the heterotypical male direction. When intact newborn females or neonatally castrated males were treated with lisuride during the early postnatal differentiation period of the brain (day 2-12) or, on the other hand, during the peripuberal maturation period (day 26-40), it was found that early postnatal as well as peripuberal activation of the dopaminergic system in females resulted in permanent partial masculinization of sexual orientation. Comparable trends were observed after peripuberal androgen administration in females. In neonatally castrated males, the demasculinized play-fighting as well as the sexual orientation could be normalized--at least in part--by early postnatal or peripuberal lisuride administration. These findings confirm once more our previous reports that neurotransmitters can act directly as organizers of the brain. This holds true not only for the differentiation period but also for the maturation period of the brain. PMID- 1778226 TI - The influence of fetal adrenals on the androgen levels during brain differentiation in human subjects and rats. AB - Measurements of plasma total and free testosterone (T) levels in human subjects from fetal to postpubertal life showed about twofold higher total T and 15-fold higher free T levels in female fetuses than in female adults. The ratios between the sexes were only moderate in fetal life. Between the 17th and 31st week of pregnancy the ratios (male:female) of total T were found to be 6.6 in week 17, 1.5 in week 22, 2.3 in week 28 and 1.2 in week 31 of pregnancy compared to 16.2 in adulthood. The corresponding ratios of free T were calculated to be 5.6 in week 17, 1.4 in week 22, 0.9 in week 28 and 0.7 in week 31 of pregnancy compared to 34 in adulthood. In amniotic fluids, we measured even an overlapping of T values between the two sexes. The reason for the observed striking difference of T levels between the sexes in fetal and postpubertal life may be the high adrenal activity and secretion rate in fetal life during brain differentiation. In rats, the contribution of adrenals to plasma T levels is only moderate and much smaller than in human beings. As measured in adult female rats, the portion was found to be about 20% only, contrary to about 60% in women. The main sources of T in female rats appear to be the gonads. The mainly gonadal secretion may be the reason that exposure of pregnant rats to stress diminished the T levels in male fetuses, but did not significantly elevate the T levels in females.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778227 TI - Gene- and environment-dependent neuroendocrine etiogenesis of homosexuality and transsexualism. AB - Sexual brain organization is dependent on sex hormone and neurotransmitter levels occurring during critical developmental periods. The higher the androgen levels during brain organization, caused by genetic and/or environmental factors, the higher is the biological predisposition to bi- and homosexuality or even transsexualism in females and the lower it is in males. Adrenal androgen excess, leading to heterotypical sexual orientation and/or gender role behavior in genetic females, can be caused by 21-hydroxylase deficiency, especially when associated with prenatal stress. The cortisol (F) precursor 21-deoxycortisol (21 DOF) was found to be significantly increased after ACTH stimulation in homosexual as compared to heterosexual females. 21-DOF was increased significantly before and even highly significantly after ACTH stimulation in female-to-male transsexuals. In view of these data, heterozygous and homozygous forms, respectively, of 21-hydroxylase deficiency represent a genetic predisposition to androgen-dependent development of homosexuality and transsexualism in females. Testicular androgen deficiency in prenatal life, giving rise to heterotypical sexual orientation and/or gender role behavior in genetic males, may be induced by prenatal stress and/or maternal or fetal genetic alterations. Most recently, in mothers of homosexual men--following ACTH stimulation--a significantly increased prevalence of high 21-DOF plasma values and 21-DOF/F ratios was found, which surpassed the mean + 1 SD level of heterosexual control women. In homosexual men as well--following ACTH stimulation--most of the 21-DOF plasma values and 21-DOF/F ratios also surpassed the mean + 1 SD level of heterosexual men. In only one out of 9 homosexual males, neither in his blood nor in that of his mother increased 21-DOF values and 21-DOF/F ratios were found after ACTH stimulation. In this homosexual man, however, the plasma dehydroepiandrosterone sulfate (DHEA-S) values and the DHEA-S/1000 x A (A = androstenedione) ratio were increased before and after ACTH stimulation. Furthermore, highly significantly increased basal plasma levels of dehydroepiandrosterone sulfate were found in male-to-female transsexuals as compared to normal males, suggesting partial 3 beta-ol hydroxysteroid dehydrogenase deficiency to be a predisposing factor for the development of male-to-female transsexualism. PMID- 1778228 TI - The sexological concept of bipotentiality. PMID- 1778229 TI - Contemporary psychoanalysis and homosexuality. AB - In this paper, I contrast older, traditional, psychoanalytic ideas about homosexuality, with those put forth at a panel on homosexuality at the American Psychoanalytic Association in 1983 (and subsequently). I focus particularly on relationships between cross-gender behavior during childhood and adulthood homosexuality; sexual orientation and personality functioning; determinants and intrapsychic consequences of homophobia, countertransference issues in working psychoanalytically with gay and bisexual patients; the sexual orientation of the analyst (i.e. should gay patients be treated only by gay analysts?). Changing psychoanalytic ideas about sexual orientation reflect the increasingly widespread recognition by psychoanalysts of the necessity to integrate psychoanalytic theory with advances in neurobiology, particularly neuroendocrinology. PMID- 1778230 TI - Sexual dimorphism of the human brain: myth and reality. AB - Many neuroanatomical sex differences have been identified in both animals and humans, which may form the neural bases for sex-specific behavior and reproductive as well as non-reproductive functions. The present essay gives a brief review of the findings on sex differences in the human brain. Our observations on the human hypothalamus revealed that the shape of the suprachiasmatic nucleus (SCN)--a structure involved in the regulation of circadian rhythms and reproductive cycles--is elongated in females and more spherical in males. In addition, an extremely large SCN was observed in the brains of homosexual men who died from AIDS. Both the volume of the SCN and the number of vasopressin neurons were about twice as large as in a male reference group. In contrast to the SCN, in which only shape differences were found in relation to gender, the volume and cell number of the sexually dimorphic nucleus of the preoptic area (SDN-POA) showed a marked sexual dimorphism. The mean volume of the SDN-POA was 2.2 times larger in males than in females and contained about twice as many cells. The function of this sexually dimorphic area in humans is not known, but presumably it is involved in the control of male sexual behavior. The fact that no differences in either volume or cell number were observed between the SDN-POAs of homo- and heterosexual men indicates a selectivity of the SCN in this respect and contradicts the view that male homosexuals have a 'female' hypothalamus. PMID- 1778232 TI - History of sexology in eastern Europe. AB - Out of the eastern european countries the greatest development of medical sexology occurred and a new independent branch of medicine came about in the following three: Czechoslovakia, Poland and Soviet Union. The focus of the article will be dedicated to the state of sexology in the mentioned three countries. PMID- 1778231 TI - Recidivous offence in sadistic homosexual pedophile with karyotype 48, XXXY after testicular pulpectomy. A case report. AB - The case of recidivous sexual offender with genetically caused mental retardation and primary hypogonadism (Klinefelter's syndrome with karyotype 48, XXXY) is described. He was examined after sadistic abuse of a boy aged 13 that he had committed 19 years after performed testicular pulpectomy. Plasmatic level of testosterone was found 4x higher than mean level in men after orchidectomy. Histological examination of residual scrotal tissues proved that the source of androgens were hyperplastic nodules of extratesticular Leydig cells. PMID- 1778233 TI - Sexology in The Netherlands. PMID- 1778234 TI - VIP, vagina, clitoral and periurethral glans--an update on human female genital arousal. AB - The sexually quiescent human vagina is a just moist, potential space with a minimal blood flow and very low luminal oxygen tension. The first measurable sign of sexual arousal is an increase in the blood flow. This creates the engorged condition, elevates the luminal oxygen tension and stimulates the production of surface vaginal fluid by an increased plasma transudation that saturates the fluid reabsorptive capacity of the epithelium. The vaginal lubrication created allows painless penile penetration and coital movements. The mechanisms underlying the changes appear to be mediated by Vasoactive Intestinal Peptide (VIP). VIP is present in nerves closely applied to blood vessels in the vaginal wall. Administration of VIP either intravenously, or by subepithelial injection in the vaginal wall, increases vaginal blood flow and induces vaginal fluid production. Increases in vaginal blood flow by sexual arousal are not blocked by atropine injection indicating that cholinergic mechanisms are unimportant. All the present evidence suggests that the local vaginal release of VIP induces the vaginal changes of arousal. Discourse on vaginal and pudendal anatomy (Sevely, 1987) has proposed that the female glans of the clitoris is not the true homologue of the penile glans because it has no urethral opening. The speculative suggestion is that the true female glans is the area surrounding the urethral opening (which has no specific anatomical name). Preliminary studies indicate that the area of this tissue (periurethral glans) decreases on vaginal penile insertion and reappears on withdrawal indicating that it is moved during coitus. How important such movement is to stimulate erotic sensation and how sensitive this area is to erotic stimulation are unanswered questions. PMID- 1778235 TI - Sexual dysfunction in patients with hypothalamo-pituitary disorders. AB - Four different studies of sexual problems and sexual dysfunction in patients with hypothalamo-pituitary disorders have been undertaken and data about the sex life of the patients have been correlated with diagnosis, tumour extension and pathology, endocrine insufficiency and pituitary hormone hypersecretion. In the first study 48 out of 53 (76.2%) adult males with pituitary tumours reported decreased or absent sexual desire. The corresponding figure in the second study was 29 out of 37 (78.4%) among adult males with pituitary tumours and hyperprolactinaemia. Twenty (31.7%) and 18 (48.6%) patients, respectively, reported decreased sexual desire as the first symptom of their tumour. A highly significant correlation between a decrease in serum testosterone and a decrease in sexual desire was found. Some males with normal serum testosterone but hyperprolactinaemia also reported decreased sexual desire. In the third study, 109 females (aged 20-60) with morphologically verified hypothalamo-pituitary disorders, 68 (62.4%) had noticed a decrease in sexual desire. This problem was registered for 53 (84.1%) out of the 63 women in this group who had hyperprolactinaemia but only in 15 (32.6%) out of the 46 women with normal serum prolactin (p less than 0.001). In the last study 48 women with well-defined hypothalamo-pituitary disorders underwent a comprehensive interview about sexual function and sexual appreciation. Thirty-eight (79.2%) of the women had developed a lack of or a considerable decrease in sexual desire. Problems with lubrication or orgasms were reported by 31 (64.6%) and 33 (68.7%) of the women, respectively. Preservation of normal menstrual pattern, age, and intrasellar tumour growth was correlated to normal sexual desire and function.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778236 TI - Testosterone and musical talent. AB - Two recently published hypotheses on the biological basis of special talents are discussed in relation to experimental data obtained from musical composers, instrumentalists, painters, and non-musicians, and from adolescent boys and girls with different levels of musical capacities. Both hypotheses assign an important influence to prenatal testosterone effects on the developing brain. Geschwind and Galaburda (1985) predict that subjects with special talents may have anomalous hemispheric dominance for verbal material. This was confirmed experimentally in adolescents and in adults using a dichotic listening task to assess functional lateralization. Hassler and Nieschlag (1989) expect musicians of both sexes to be psychologically androgynous and to have current testosterone levels that differ from sex-typed males and females. Salivary testosterone was measured in adults and in adolescents. Creative musical behavior was associated with very low testosterone values in males, and with high testosterone levels in females. Sexual activity level and motivation did not differ between males with testosterone levels less than or equal to 200 pmol/l and those with greater than 220 pmol/l. We tentatively suggest from our data that, among a complex interaction of biological and social factors, an optimal testosterone range may exist for the expression of creative musical behavior. Exceeding the range in the course of adolescence may be detrimental for musical creativity in boys. PMID- 1778237 TI - Serum chloride in the differential diagnosis of hypercalcemia. AB - In hospitalized patients primary hyperparathyroidism (HPT) and neoplasms account for more than 90% of all hypercalcemias. Measurements of parathyroid hormone, particularly when combined with dynamic tests using calcitonin and EDTA have a high specificity and sensitivity in the differential diagnosis of hypercalcemia but are time-consuming and costly for screening purposes. Most chemical autoanalyzers beside serum calcium also measure serum chloride, phosphate and albumin. In order to evaluate how these simple variables could differentiate between HPT and hypercalcemia due to malignant disorders, 110 measurements from HPT subjects and 111 measurements from cancer patients with hypercalcemia were used. Serum chloride was best among the simple variables to separate the two disorders and classified 84% of the hypercalcemic subjects correctly. When serum phosphatase and albumin were added giving the formula (serum chloride-84) x (albumin-15)/phosphate, only 3% of the cancer and 4% of the HPT subjects were misclassified when borderline values (400-500) were excluded (5% of the sample). In conclusion, while other more sensitive and expressive tests exist to establish the cause of hypercalcemia the above mentioned formula is a cheap and easy screening test for a preliminary diagnosis. PMID- 1778238 TI - Prospective investigations of long-term normoglycaemic BB/OK-rats: serial determination of glucose tolerance, insulitis, B-cell volume density and pancreatic insulin content. AB - Pancreatic tissue was obtained by repeated surgical biopsies from BB/OK rats (n = 62), which maintained normoglycaemia up to 250 days. The tissue was used to determine pancreatic insulin content, islet volume density, pancreatic B-cell volume density and the presence of mononuclear cell infiltrations within and around pancreatic islets (insulitis). The BB/OK rats were also characterized by determination of glucose tolerance. In 50 d old BB/OK rats lymphatic infiltration of pancreatic islets are rare. The mean value of relative B-cell volume density amounted to 0.71 +/- 0.05% and the pancreatic insulin content was 21.31 +/- 1.29 pmol/mg wet weight. 70 d old BB/OK rats are characterized by an identical relative B-cell volume density and pancreatic insulin content, although in 70% of the animals an invasion of immunocytes could be observed. At an age of 90 and 120 d the BB/OK rats were characterized by an increased number of islets having insulitis accompanied by a decrease of pancreatic insulin content and B-cell volume density. The individual evaluation of the investigated BB/OK rats revealed in each animal the presence of insulitis accompanied by a decreased B-cell volume density and a diminished pancreatic insulin content. Animals older than 120 d do reenhance the pancreatic insulin content and B-cell volume density attended by an impairment of glucose tolerance. The results suggest that all BB/OK rats are characterized by a spontaneous pancreatic B-cell destruction, which was arrested and/or interrupted in the animals maintaining normoglycaemia up to 250 d. PMID- 1778239 TI - Sucrose feeding at weaning alters the preference for sucrose in adolescence. AB - The present studies were undertaken to examine the hypothesis that sucrose feeding at weaning may alter the preference for sucrose in the adolescence. Chronological changes of hypothalamic dopamine (DA), its metabolite, 3,4 dihydroxy-phenylacetic acid (DOPAC) and norepinephrine (NE) contents were also measured by HPLC. In 21 day-aged rats, 10% sucrose or water was given as drinking water for 3 weeks. From 9 weeks, all animals were maintained under a free choice between 30% sucrose solution and water. Sucrose-ingested rats more preferred to 30% sucrose solution than control rats and body weight gain of sucrose group was significantly greater than that of controls. Hypothalamic DA content was significantly decreased at 6 and 13 weeks and the DOPAC/DA ratio increased at 3, 6, and 13 weeks later. In contrast, hypothalamic NE concentration was not changed at all. The data obtained herein suggest that sucrose feeding at weaning alters the preference for sucrose, resulting in an overweight gain, and that the observed increase of hypothalamic DA metabolism may be involved in the altered preference for sucrose. PMID- 1778240 TI - Assessment of cold induced alterations in catecholamine turnover of lean and glutamate-treated obese rats. AB - Excretion of norepinephrine (NE) and vanillylmandelic acid (VMA) in urine as well as NE-turnover in tissues from lean and glutamate-treated obese rats were determined in warm and cold environment. NE-and VMA-excretion in urine was elevated by cold exposure, indicating an activation of the sympathetic nervous system in animals of both groups. Organspecific NE-turnover responds with higher sensitivity to cold in obese rats but without complete compensation in brown adipose tissue. Urinary NE- and VMA- excretion as well as NE-turnover in organs confirmed that cold exposure activates the sympathetic nervous system. Measurement of NE-turnover in tissues gives organspecific information regarding alterations in sympathetic activity during cold exposure, whereas excretion of NE and VMA in urine is a summarizing measure for the whole body turnover only. PMID- 1778241 TI - Inhibition of prostaglandin synthesis and the release of vasopressin and oxytocin from the rat neurohypophysis: in vitro studies. AB - The basal and K(+)-evoked release of vasopressin (VP) and oxytocin (OT) from the neurointermediate lobes in vitro was determined under conditions of indomethacin induced inhibition of prostaglandin (PG) synthesis. The in vivo treatment with indomethacin (IM), administered to donor animals, did not modify the release of VP during resting conditions as well as during the potassium stimulation; on the contrary, both base-line and K(+)-evoked release of OT was significantly inhibited under such conditions. Incubation of neurointermediate lobes in a solution containing indomethacin resulted in an inhibition of VP and OT release both during resting conditions and during depolarization due to excess potassium. PMID- 1778242 TI - A clinicomorphological study of pituitary tumors associated with the clinical syndrome of acromegaly. AB - Transsphenoidal adenomectomy was done on 125 acromegalics. A clinicomorphological study was performed on 113 of these patients. The distribution of morphological types of tumors was similar in both sexes. In the total group it was: sparsely granulated GH cell adenomas 52.8%, densely granulated 25.7%, mixed somatotroph and lactotroph adenomas 15.9%, plurihormonal adenomas 1.8%, acidophil stem cell adenomas 2.6%, and oncocytoma 1.8%. The GH plasma level in male patients was significantly higher than in female patients. In both sexes GH secretion was highest in patients with mixed GH and PRL cell adenomas followed by patients with densely granulated GH cell adenomas. Plasma PRL levels were significantly elevated in all males, except for those with densely granulated GH adenomas where prolactinemia was normal. The mean plasma PRL levels were also elevated in females with highest values in mixed somatotroph and lactotroph adenomas. The PRL levels in female patients with densely granulated GH cell adenomas are more elevated than in female patients with sparsely granulated GH cell adenomas. PMID- 1778243 TI - [Principles and methods of occupational psychophysiological selection of deep water divers]. AB - A complex of methods is suggested for professional psychophysiological selection of deep divers: the count of signals under time deficit conditions, simple and complex coordination of analyzers function, tepping test, the study of attention concentration using the Ivanov-Smolensky tables and finding of numbers with switching. This complex together with assessment of number range by deviation method allows making correct prediction during selection of specialists with high probability equal to 0.9. The efficiency of professional selection increases due to the reliable correlation between the results of psychophysiological research and predisposition to development of decompressive disease. PMID- 1778244 TI - [Biochemical indicators of oxygen poisoning]. AB - Content of extra erythrocyte hemoglobin (EEH), total peroxidase activity (TPA), tseruloplasmin oxidase activity (TOA) and chemiluminescence intensity have been investigated in plasma. The dose-dependent changes of EEN, TPA, TOA are shown in experiments on the animals under hyperbaric oxygen (HBO) pressure (0.2, 0.3, 0.5, 0.7 MPa from 30 min. to 120 min.) and EEH, TPA--under hyperbaric air (1.1 MPa; 4 hours). All these parameters have been studied in patients treated with HBO for the assessment of HBO efficacy in the clinical investigations. These biochemical parameters may be used as informative tests of the functional state of the organism under HBO and hyperbaric air. PMID- 1778245 TI - [Adaptive reactions in humans during repeated exposure to deep-water saturation immersion]. AB - Evaluation of changes in respiration circulation and respiratory gas transport has shown that long-term influence of hyperbaria gives rise to phase changes and promotes a shift to a new level of the functional state of aquanauts. It is established that the postdecompression syndrome is characterized by the lability of main parameters of breathing and circulation, depression of gas exchange, disorders of bronchial permeability, relaxation of the cardiac pump function, decrease of physical workability against the background of inhibition of the adrenal cortex and weakening of the non-specific immunoresistance. Examination of 145 deep divers has revealed regularities of readaptation dynamics and has permitted a conclusion on an increase of unfavourable tendencies in the ventilatory pulmonary function and cardiac pump function under repeated effect of saturated diving. The normative values of external respiration are worked out as applied to divers. Some new approaches to the technology of medical providing of deep divings and correction of non-specific professional pathology of acquanauts are physiologically substantiated proceeding from tendencies of shifts in the periods between divings and diving norms. PMID- 1778246 TI - [Effect of metabolites on the activity of enzymes protecting the stability of the erythrocyte membrane in experimental decompression sickness]. AB - Metabolites have been studied for their effect (sodium succinate, thiamine, riboflavin) on the pentosophosphate pathways and glutathione reductase. The possible mechanisms of its influence on the membrane stability of erythrocytes in decompression disease are discussed. PMID- 1778247 TI - [Predicting the genome response of the somatic cells of divers to hyperoxic medium]. AB - Cytogenetical consequences of high oxygen pressure action (HOB) have been studied in professional and nonprofessional divers after deepening. Blood samples of subject from both groups were treated with HBO in vitro to compare individual reaction of the somatic cells genome to HOB. The present study reveals that HBO increases the level of chromosome aberrations, and individual response to HBO differs. There is a correlation between the level of chromosome aberrations in vivo and in vitro. This indicates that blood treatment in vitro can reveal the sensitivity of the genome in human before HBO treatment. According to the data in vitro 2 groups of the genome response to HBO: up to 20% and higher than 20% aberrations are distinguished. PMID- 1778248 TI - [Potentiating the regional effect of hyperbaric oxygenation in Raynaud's phenomenon]. AB - A usual method of hyperbaric oxygenation is insufficiently effective at the late stages of Raynaud's phenomenon. A new "chamber-in-chamber" method of HBO permits essentially improving the results at these stages. Two versions of the new method should be used, each for its own indications. Intermittent pneumo-compression without rarefaction in the small chamber is good for "functional" Raynaud's phenomenon, whereas in "organic" Raynaud's phenomenon both intermittent compression and rarefaction are necessary. PMID- 1778249 TI - [High density respiratory syndrome: I. Oscillations of flow-volume curves during forced respiration in dense gas media]. AB - 33 divers exposed to high pressure have been examined in three series. The dynamics of the forced breathing parameters has been studied: I--helio or neon oxygen medium under pressure of 1.078-3.53 MPa (11-36 kg/m2) with density to 32.7 kg/m3; II--nitrogen-oxygen medium under 0.274-0.882 MPa (2.8-9.0 kg/m2) with density of 11.7 kg/m3; III--under the same conditions, as II, but using bronchospasmolytics (stimulators of 2-adrenoreceptors: astompent, salbutamol, berotec) under hyperbaria. A new phenomenon: high-density breathing syndrome is revealed. It includes appearance of oscillations of respiratory flows against the background of a decrease of forced breathing rate in dense gas medium and has a common mechanism of appearance both during inhale and exhale. High hydrostatic pressure and narcotic qualities of inert gases can have a modulating effect. Evidences are obtained that tremor phenomena observed during high pressure nervous syndrome can influence the biomechanics of forced breathing at hyperbaria. A high correlation between amplitude modulation of electromyograms of breathing muscles and pneumotachogram oscillations within the range, corresponding to the frequency of physiological tremor, allowed assuming that tremor of breathing muscles induced by high-density gas medium action is one of factors responsible for appearance of respiratory flows oscillations. PMID- 1778250 TI - [High density respiratory syndrome: II. The mechanics of forced respiration with artificial resistive load under normobaric pressure]. AB - The dynamics of forced inhale (I series) and exhale (II series) parameters with additional external artificial resistive load was studied under normobaric conditions. The artificial resistance to breathing increased stepwise using removable diaphragms with sequential decrease of hole diameter from 25, 17, 13, 9, 7.5, 4.5 to 3 mm. While studying forced inhale the diaphragms were set up at Fleish pipe airflow input. In the case of forced inhale the diaphragms were set up at the pipe output. A phenomenon is revealed which consists in appearance of respiratory flow oscillations on the "flow-volume" curves during forced breathing with an increase of resistive load. Frequency maxima of the oscillations were located within the range of 6-15 Hz. The possible mechanisms for appearance of respiratory muscle tremor and respiratory flow oscillations are under discussion. PMID- 1778251 TI - [Functional state of various physiological systems of the human body during respiration of neon-oxygen mixture at depth up to 400 meters]. AB - Hyperbaric neon-oxygen mixture has been studied for the effect of its high density under pressure of 41 ata on basic physiological functions of human organism. Typical changes of the cardiorespiratory system and tissue respiration parameters are revealed. Changes in physical working capacity are shown. Exposure to gaseous medium of high pressure and density is accompanied by the development of some compensatory-adaptive reactions. The possibility to perform mid-hard physical work is attained with overstrain of respiration and circulation function. PMID- 1778252 TI - [High density respiratory syndrome: III. The functional role of oscillation of respiratory flow during respiration in dense gas media]. AB - It is found out that when reaching critical density of gas medium (20.4-24.0 kg/m3), the relative power of oscillations on the "flow-volume" curves and pneumotachograms sharply increases. At the same time the maximal rate of exhale, rates of expiratory flows in large bronchi decrease significantly and the rates of expiratory flows in bronchi of middle and small calibers reduce to zero. Within the range of densities of different gas medium (from 1.3 to 32.7 kg/m3) the changes in the relative power of oscillations of respiratory flows correlate well with the changes in permeability of upper respiratory tracts (r = -0.932 +/- 0.054). A regression equation describing this dependence is obtained. A detailed description is given to symptoms of high-density breathing syndrome: a decrease in rates of gas flows in tracheobronchial tree, early development of dynamic compression of airway, tremor of breathing muscles and appearance of respiratory flow oscillations, pronounced dyspnea and hypoventilation of alveoli. A hypothetic scheme of its development is presented. The functional significance of respiratory flow oscillations as a mechanism improving gas exchange in gas media with extremely high density is under discussion. PMID- 1778253 TI - [Status of the spinal inhibitory reactions in humans subjected to hyperbaric oxygenation]. AB - The state of human spinal inhibition responses under normo- and hyperbaric pressure (6.5 ata) was comparatively studied. The paired stimulation method has been used to estimate resetting of tested monosynaptic reflex in the 20-900 ms interval of paired stimulation at rest or against the background of supraspinal modulation of spinal reflective processes (Jendrassik manoeuvre, voluntary plantar flexion) were studied. The depression of inhibition reactions under hyperbaric pressure identical to that during the supraspinal modulation under normobaric conditions is shown. It is supposed that these influences on spinal reflection processes are caused by the same neuronal mechanism. PMID- 1778254 TI - [Conditions for the development of isobaric counterdiffusion of inert gases and the criteria of its evaluation]. AB - Investigation of superficial counterdiffusion of nitrogen against helium has been carried out to evaluate a possibility of its progress in divers (107 tests) under pressures equivalent to 32-450 m of sea water when breathing trimix being saturated in heliox at a constant ambient pressure without changing chamber environment. Breathing gas mixture contained 248-800 kPa of nitrogen, while chamber heliox media contained some additions of nitrogen (6-108 kPa). Clinical manifestations of breathing trimix (itching and gas bubble formation) were studied in divers. The development of counterdiffusion depends on the partial pressure of nitrogen not only in the breathing gas mixture but also in the chamber media. The breathing nitrogen level being increased and (or) decreased in the chamber media, the counterdiffusion symptoms grow relative to the number (%) of cases. Minimal critical values of nitrogen partial pressure gradients in the mixture which induce counterdiffusion skin lesions are 260-320 kPa on the average for the nitrogen concentration in the chamber mixture to 30 kPa. Isobaric supersaturation due to inert gases countertransport in body tissues as a result of gas-switching from heliox to trimix is responsible for the syndrome development. PMID- 1778255 TI - [Effect of hyperbaric oxygenation on central hemodynamics and oxygenating function of the lungs in open-heart surgery]. AB - The dynamics of some oxygenating pulmonary function (OPF) indices has been studied in 33 patients with coronary cardiac disease and rheumatic lesions of cardiac valves 4-6 hours after surgery in response to a single hyperbaric oxygenation (HBO) session (1.5 ata, 45 min) in the immediate postoperative period. It is found that in the presence of slight or, on the contrary, pronounced arterial hypoxemia, no significant negative OPF changes were observed. At the same time, a temporary increase in the alveolo-arterial gradient has been found in some patients. The comparison of data on the systemic blood flow with the OPF indices permits suggesting the prevalent role of the membrane component in a PaO2 decrease in patients after using assisted circulation. PMID- 1778256 TI - [Various mechanisms of regulation of lipid peroxidation in human erythrocytes after long-term exposure to hyperbaric oxygenation]. AB - Intensity of lipid peroxidation and activity of antioxidant protection enzymes in erythrocytes were measured in three experiments with 10-24 days exposure of aquanauts under 4.6 and 5.1 MPa. It is established that there is no pathological intensification of lipid peroxidation when oxygen partial pressure in breathing gas mixture is optimal. This process is under reliable control by modulation of antioxidant enzymes activity. The high sensitivity of these research methods allows using them to determine exposure limitations under high pressure and optimal oxygen concentrations in breathing gas mixture. PMID- 1778257 TI - [Nitrogen metabolism in humans during long-term exposure to hyperbaric conditions]. AB - Results from studies of nitrogenous exchange in a man during long exposure to the hyperbaric conditions (4.1, 4.6, 5.1 MPa, that corresponds to 400, 450 and 500 m) have shown that catabolism of proteins in man under conditions of high pressure of gas and aquatic environments is intensified due to the primarily intensive muscular work. The experimental ration which has been corrected from test to test by the results of studies practically completely satisfies the increasing demands of the organism in proteins, that is evidenced for by the stable content of total protein and its fractions in blood. PMID- 1778258 TI - [Effect of hyperbaric factors on the biochemical and hematological indicators in rats (in vivo) and in humans (in vitro)]. AB - The influence of hyperbaric factors on complex of biochemical and haematological parameters was examined in rats (in vivo) on donor blood samples. It was established, that the sojourn in heliox under the pressure 6.1 MPa and rO2 60 kPa results in activation of lipid peroxidation, alteration of erythrocyte oxygen transport function and the suppression of lipid metabolism. There are no significant alterations of these parameters in the comparative experiment with the pO2 40 kPa. The decompression of donor blood samples from 5.1 MPa to 0.1 MPa during 50 minutes had no significant influence on complex of biochemical, haematological and immunological parameters as compared to control probes. PMID- 1778259 TI - [Evaluation of energy metabolism and physical work capacity of divers for determining the optimal oxygen level during breathing gas mixture under pressure up to 5.1 MPa]. AB - A complex evaluation of energy metabolism, oxygen-transport function of blood and physical work capacity of aquanauts has been performed during three imitation divings at depths of 400, 450 and 500 m in heliox as a breathing medium. These experiments have shown that optimal levels of partial oxygen pressure in artificial chamber environment are 30-33 kPa at 4.1 MPa, 32-35 kPa at 4.6 MPa and 33-34 kPa at 5.1 MPa. It is established that 24-days exposure of aquanautes to 4.6 MPa and 10-days exposure to 5.1 MPa yield no unfavourable changes of the examined organism functions. The activated lipid exchange in combination with stable carbohydrate catabolism, the elevated levels of oxygen consumption and its partial pressure in blood and transient fluctuations of erythropoiesis activity are interpreted as compensatory responses of diverse organisms under the influence of hyperbaric factors. PMID- 1778260 TI - [Immunologic response of divers working in the conditions of increased microbial contamination of water under pressure up to 5.1 MPa]. AB - The complex investigation of immune and nonspecific reactivity of 30 aquanauts was carried out during five experimental saturation divings up to 350-500 m accompanied by an increase of microbic contamination in water of the hyperbaric chamber. Peculiarities of humoral immune response and phagocyte functions were found to depend on the inflammatory disease of aquanauts. It is concluded that the situational transitory immune deficiency development under the influence of hyperbaric factors is possible and changes in the microbe spectrum are real. PMID- 1778261 TI - [Status of the main functional systems in humans after long-term exposure to hyperbaric medium]. AB - The exposure of divers to hyperbaric conditions under pressure of 4.6 MPa induced development of astheno-neurotic disorders with cardiovascular component against a background of pronounced fatigue. A decrease of the pulmonary ventilation function in the form of bronchial obstruction syndrome was observed as well. On the 10-15th day of the postdiving period asthenia phenomena extinguished and the pulmonary function tended to restoration. On the 30th day of postdiving period all the functional systems were normalized. The professional activity of divers for many years gives rise to the formation of adaptive reaction (increase of vital capacity of lungs and maximal ventilation of lungs), on the one hand, and to pathological disorders, such as arterial hypertension and bronchial obstruction syndrome, on the other hand. PMID- 1778262 TI - Dietary effects of propylene glycol alginate in humans. AB - Following a 7-day control period, five male volunteers consumed a weight of propylene glycol alginate corresponding to 175 mg/kg body weight for 7 days, followed by 200 mg propylene glycol alginate per kg body weight for a further 16 days. Measurements before and at the end of the 23-day period of dietary supplementation showed that propylene glycol alginate had little effect on faecal parameters (pH, water content, daily wet and dry weights). The dietary transit time remained constant for three volunteers, increased for one, and decreased for one. The ingestion of propylene glycol alginate had no significant effect on (a) haematological indices, (b) plasma biochemistry parameters, (c) urinalysis parameters, (d) blood glucose and plasma insulin concentrations, (e) breath hydrogen concentrations. No allergic responses were reported by, nor observed in, any of the volunteers. The study therefore indicates that the ingestion of propylene glycol alginate at a high level for 23 days caused no adverse dietary or physiological effects; in particular, the enzymatic and other sensitive indicators of adverse toxicological effects remained unchanged. PMID- 1778263 TI - Dietary effects of sodium alginate in humans. AB - Following a 7-day control period, five male volunteers consumed a weight of sodium alginate corresponding to 175 mg/kg body weight for 7 days, followed by 200 mg sodium alginate per kg body weight for a further 16 days. Measurements before and at the end of the 23-day period of dietary supplementation showed that sodium alginate acted as a faecal bulking agent for all volunteers, giving a significant (p less than 0.01) increase in daily wet weight, and also increases in the water content and daily dry weight, but no change in faecal pH. Although the dietary transit time remained constant for two volunteers, it decreased for two, and increased slightly for one, with little resulting change in the overall mean value. The ingestion of sodium alginate had no significant effect on (a) haematological indices, (b) plasma biochemistry parameters, (c) urinalysis parameters, (d) blood glucose and plasma insulin concentrations, (e) breath hydrogen concentrations. No allergic responses were reported by, nor observed in, any of the volunteers. The study therefore indicates that the ingestion of sodium alginate at a high level for 23 days caused no effects other than those normally associated with a polysaccharide bulking agent; in particular, the enzymatic and other sensitive indicators of adverse toxicological effects remained unchanged. PMID- 1778264 TI - Determination of total non-sulphonated aromatic amines in tartrazine, sunset yellow FCF and allura red by reduction and derivatization followed by high performance liquid chromatography. AB - Free and bound non-sulphonated aromatic amines (NSAA) are determined in the food colours tartrazine, sunset yellow FCF and allura red. After reduction of the bound amines with sodium dithionite, the NSAA are extracted into chloroform, then transferred to aqueous acid solution, diazotized with sodium nitrite and coupled with 2-naphthol-3,6-disulphonic acid, disodium salt (R-salt). Reversed-phase ion pair liquid chromatography and an absorbance detector at 512 nm are used to analyse the coloured derivatives. Samples of dyes were spiked with known amounts of aniline, 1-naphthylamine, 2- and 4-aminobiphenyl, 4-aminoazobenzene, benzidine, p-cresidine or 4-nitro-p-cresidine bound to R-salt. Recoveries averaged 90% in tartrazine, 65% in sunset yellow FCF and 71% in allura red. Detection limits ranged between 2 and 32 ng/g. A survey of 24 commercial samples revealed levels up to 520 micrograms/g total NSAA. The majority of NSAA are bound to the coupling compound during the manufacturing process and less than 7% remain as free amines in the dye. PMID- 1778265 TI - Influence of nitrate, ascorbic acid, and nitrate reductase microorganisms on N nitrosamine formation during Korean-style soysauce fermentation. AB - Traditional Korean soysauce samples were collected from households in Chinju, Gyeongnam, Korea and analysed for volatile N-nitrosamines. Five of 24 samples contained NDMA (range = 1.6-10.4 micrograms/l) which was the only volatile N nitroso compound found. Soysauce made from well water contained NDMA more often (4 of 6 samples) than soysauce made from tap water (1 of 18). This suggests that the water source is a determinate in the NDMA content of soysauce, probably due to a higher nitrate content of well water. The source of salt used did not clearly influence NDMA content. Soysauce was prepared in the laboratory using traditional methods but with 0 to 400 mg/l nitrate and in some cases made 6.5 to 65 mM in ascorbic acid and fermented for 120 days. The NDMA content of the samples was positively correlated with increasing nitrate concentration. Nitrate at 400 mg/l resulted in an NDMA content of 203 micrograms/l. Ascorbic acid substantially inhibited NDMA formation. All samples contained large numbers of nitrate reductase-containing organisms (greater than 1 x 10(7) CFU/ml). PMID- 1778266 TI - Surveillance and control of aflatoxin contamination of dried figs and fig paste imported into the United Kingdom. AB - Samples of dried figs and fig pastes from Turkey supplied voluntarily by UK importers and retailers during the period November 1988 to January 1989 showed both a high incidence and high levels of contamination with aflatoxins. In the samples tested, 24% had total aflatoxin concentrations above 10 micrograms/kg, with the highest level being 165 micrograms/kg. More rigorous monitoring of the 1989 fig harvest was undertaken on bulk consignments for all figs from Turkey entering the UK. For whole dried figs 20 kg samples were taken (as 20 sub samples), and for fig paste 5 kg samples were taken (again as 20 sub-samples). Figs were minced, blended with water and mixed prior to sub-sampling for analysis. Analysis was by immunoaffinity column clean-up with HPLC determination of aflatoxins with fluorescence detection. Examination showed that 11% of 112 consignments of fig paste and 9% of 93 consignments of whole dried figs were contaminated with total alfatoxin concentrations above 10 micrograms/kg, with the highest level of contamination being 40 micrograms/kg. As a result of this surveillance programme 14 consignments of figs were refused entry into the United Kingdom. PMID- 1778267 TI - The preparation, validation and certification of the aflatoxin content of two peanut butter reference materials. AB - The preparation of two peanut butter reference materials and the certification of their aflatoxins B1, B2, G1, G2 and total aflatoxin contents is described. The materials were prepared and certified within the BCR Programme of the Commission of the European Community as part of a broad activity to improve accuracy and agreement of measurements of importance in food and agriculture (Wagstaffe and Belliardo 1990). Reference material RM 385 was prepared from naturally contaminated peanuts, roasted and ground into a paste and then blended with uncontaminated peanut butter to achieve the desired aflatoxin concentrations. Details are given of the blending and canning procedure, and the checks to ensure homogeneity and stability of the material. Reference material RM 401 was similarly prepared but from an uncontaminated peanut butter. The certification exercise was carried out by nine laboratories using a variety of extraction and clean-up procedures, but all using high performance liquid chromatography (HPLC) as the determinative stage although operating under a variety of chromatographic conditions. RM 385 was certified as containing aflatoxins B1, B2, G1 and G2 at levels of 7.0 +/- 0.8 micrograms/kg, 1.1 +/- 0.2 micrograms/kg, 1.7 +/- 0.3 micrograms/kg and 0.3 +/- 0.2 micrograms/kg respectively (total aflatoxin content of 10.1 +/- 1.5 micrograms/kg) and RM 401 as containing aflatoxin B1, B2 and G2 at less than 0.2 micrograms/kg and aflatoxin G1 at less than 0.3 micrograms/kg (total aflatoxin content less than 0.9 micrograms/kg). The materials are intended for the verification of methods used to determine aflatoxins in nuts and nut products. PMID- 1778268 TI - Occurrence of aflatoxins and aflatoxin-producing moulds in fresh and processed meat in Egypt. AB - A survey was carried out to detect aflatoxins and isolate aflatoxigenic moulds contaminating fresh and processed meat products. The fungal contamination was examined in 215 samples of fresh and processed meat products and 130 samples of spices used in the meat industry collected from different local companies in Cairo, Egypt. Processed meat products such as beefburger, hot-dog, kubeba, sausage, luncheon meat had the highest count of moulds as compared with fresh and canned meat. Out of 150 samples of meat products and 100 samples of spices, aflatoxin B1 was detected in five samples of beefburger, (8 micrograms/kg), four samples of black pepper (35 micrograms/kg), and four samples of white pepper (22 micrograms/kg). Aflatoxins B1 and B2 were detected in one sample of kubeba (150 micrograms B1/kg and 25 micrograms B2/kg); hot-dog (5 micrograms B1/kg and 2 micrograms B2/kg) sausage (7 micrograms B1/kg and 3 micrograms B2/kg) and luncheon meat (4 micrograms B1/kg and 2 micrograms B2/kg). Also, aflatoxins B1 and G1 were detected in two samples of turmeric (12 micrograms B1/kg and 8 micrograms G1/kg) and coriander (8 micrograms B1/kg and 2 micrograms G1/kg). Aspergillus flavus (24 isolates), and Aspergillus parasiticus (16 isolates) were the predominant aflatoxin-producing moulds isolated from both processed meat products and spices. Aflatoxins were absent in fresh meat, canned meat, salami, beefsteak and minced meat. The contamination of processed meat with aflatoxin was shown to correlate with the addition of spices to fresh meat. PMID- 1778269 TI - Metallic contamination in oyster and other seafood in Hong Kong. AB - Heavy metal contamination in seafood is of great concern in places suffering from pollution. A survey has been carried out since 1986 to monitor the contents of seven heavy metals: antimony, arsenic, cadmium, chromium, lead, mercury and tin in oyster and other types of seafood. The daily intakes were estimated and compared to the Provisional Tolerable Weekly Intake (PTWI) or maximum acceptable daily load recommended by FAO/WHO Expert Committee on Food Additives (1984). In general, the levels were low and left comfortable margins to both the acceptable limits and the local regulatory levels with the exception of arsenic, the average intake of which was close to the PTWI. PMID- 1778270 TI - Chemometric differentiation of raw and commercial milk by trace elements using principal component analysis. AB - Nine trace elements (Cr, Mn, Fe, Ni, Cu, Zn, Mo, Cd, and Pb) were determined in the dissolved ash of 36 samples of raw milk. The distribution of the concentration of each element was first investigated by means of a test of normality. The matrix of the correlation between the concentrations of the elements was then used as a starting matrix for principal component analysis. Nine variables were reduced to four principal components, accounting for 75% of the total variance. The biophilic elements Mn-Fe and Cu-Mo were positively associated with the first two principal components, while Cr was correlated to the third and Ni and Cd with the fourth principal component. Pb and Zn are both negatively correlated to the first principal component. Comparison with 42 samples of a commercial milk, by using a two-dimensional plot of the principal component scores, rendered possible the differentiation between raw and commercial milk. PMID- 1778271 TI - Levels of specific polychlorinated biphenyl congeners in fatty foods from five Canadian cities between 1986 and 1988. AB - A total of 155 fatty food composites from five major Canadian cities were analysed for 36 selected polychlorinated biphenyl (PCB) congeners. Total PCB congener levels of more than 1 ng/g (wet weight) were found in fresh water fish, canned fish, butter, marine fish and cheese, with fresh water fish (18.7 ng/g) containing 5 to 10 times more total PCBs than the other four food commodities. Milk (2%), cooking oils/salads and canned meat soup contained less than 0.1 ng/g (wet weight). The observed total PCB residue levels in fatty foods were well within the Canadian guidelines for fish, dairy products, poultry, eggs and beef. The most predominant congeners found in fish, butter, cheese, meat and poultry were the 2,2',4,4',5-, 2,3',4,4', 5-pentachloro-, 2,2',3,4,4',5'-, 2,2',4,4',5,5' hexachloro- and 2,2',3,4,4',5,5'-heptachlorobiphenyls. The predominant congener pattern was not always evident in other dairy products (e.g. ice cream) and processed foods (e.g. canned meat soup). An attempt was made to relate the intake of PCB congeners from fatty foods with congener levels found in adipose tissue of Canadians. The estimated daily intake of some specific PCB congeners from fatty foods, in most cases accounted for more than half the total deposit of these congeners in adipose tissue of Canadians. PMID- 1778272 TI - Polycyclic aromatic hydrocarbons in olive oils on the Italian market. AB - The six olive oils and seven virgin olive oils which are most consumed in Italy were analysed for 28 polycyclic aromatic hydrocarbons (PAHs). The aim was to evaluate whether a carcinogenic hazard for the general population can derive from the dietary intake of this food, which is consumed particularly highly in the Mediterranean area. The analytical method involved extraction by liquid-liquid partition, filtration on silica gel, clean-up by thin-layer chromatography on silica gel, and analysis by high-resolution gas chromatography with a flame ionization detector. The 3- and 4-ring PAHs which are most abundant in the environment were found in all samples, at individual levels up to ca. 40 micrograms/kg (for phenanthrene); no important difference was observed between olive oils and virgin olive oils. PAHs which are most suspected of being carcinogenic for humans were not detected (limit of detection, ca. 3 micrograms/kg). The average yearly intake of the detected PAHs through this food was estimated at ca. 0.56 mg per capita. PMID- 1778273 TI - Food surveillance in the Basque country (Spain) I. The design of a total diet study. AB - A total diet study has been initiated in the Basque country (Spain), the purpose of which is to provide estimates of the average intake of both food contaminants and certain nutrients. The types and quantities of foods that make up the average Basque 'Total Diet' are based on the results of surveys carried out between 1988 and 1990. These surveys have identified the major items in the national diet (91 categories of foods) which are combined for the total diet study, for analysis, into 16 groups of similar foods. Each group is being analysed for selected contaminants of concern which initially are: heavy metals (mercury, lead, cadmium and arsenic), organochlorine pesticides (HCB, HCH (alpha, beta, gamma, delta), DDT (DDE, TDE), dieldrin, aldrin, endrin, heptachlor, heptachlor epoxide, endosulfan and methoxychlor) and selected trace element nutrients (zinc, selenium and iron). In the milk and dairy products groups an assessment of aflatoxin M1 contamination is also being carried out. PMID- 1778274 TI - Nutritional requirements for detoxication of environmental chemicals. AB - The biological defence systems against oxygen radical toxicity and chemical toxicity, and their component enzymes, are described, and the nutritional requirements for biological defence against chemical and oxygen toxicity, including calories, protein, lipids and lipotropes, vitamins and minerals, are reviewed in the context of their contribution to the mechanisms of detoxication. Modulation of the cytochromes P-450, and hence toxicity, by dietary components are considered; the P450I family, induced by food pyrolysis mutagens, and the P450IIE family, induced by alcohol and fasting, contribute substantially to chemical toxicity and carcinogenicity. It is concluded that: (i) the detoxication system of terrestrial fauna has evolved over greater than 300 million years to protect animals from dietary plant toxins; (ii) protection against chemical and oxygen toxicity requires all categories of nutrients; and (iii) the role of food and nutrition in detoxication is essential to survival. PMID- 1778275 TI - [Dental photography of static subjects. 12]. PMID- 1778276 TI - [Dowel cores, traditional and alternative. Bond test]. AB - PMF represents today the best solution for the functional rescue of a tooth cured by endodontics. After a careful analysis of the international literature the Authors in this study examined the resistance of four different kinds of PMF under laboratory conditions, applying external pressure to them until a steady rise in lateral direction caused a fracture in the specimens under study. On the basis of the results obtained, the Authors deducted that among different models tested, traditional long modified PMF is the most adapt for tolerating load of compression to preserve the integrity of the dental residual structures. PMID- 1778277 TI - [Endo-periodontal relations. Microbiological and clinical aspects]. AB - Periodontics and endodontics share common objectives and common field of interest. Both disciplines treat lesions of the periodontal tissues; in their marginal aspect the first, in the periapical aspect the latter. These relationships have not been well understood for a long time. This article is a review of the literature on the topic aimed at clarifying the anatomic, microbiological, pathogenetic relationship in the periodontal and endodontic lesions. PMID- 1778278 TI - [Gingival sulcus and retraction techniques. Anatomo-histological aspects]. AB - Retraction of gingival margin means a very important step to take a precise impression. Most used methods are electrosurgery and retraction's fibres. This study compares both techniques analysing the reaction of gingival tissues by anatomical-histological observation. PMID- 1778279 TI - [Proglumetacin in acute periodontitis. Effectiveness and tolerance]. AB - The Authors show the results of a clinical trial carried out on two groups of patients affected by acute periodontitis. Patients were treated with proglumetacin or ketoprofen, respectively; the efficacy and tolerability of these two drugs were analyzed. PMID- 1778280 TI - [Extracellular matrix in gingival fibroblasts]. AB - Primary cultures of human gingival fibroblasts from patients of different age have been established. Histotype characterization has been confirmed by ultrastructural morphology and by the positivity of intermediate filament vimentin. Extracellular matrix expression has been analyzed by immunocitochemistry. Our data demonstrate that the extracellular matrix of human gingival fibroblasts is composed of type IV collagen, other than fibronectin and type I-III collagens. PMID- 1778281 TI - [Mucocele of the minor salivary glands. 2. Diagnosis and therapy]. AB - The Authors analyze clinical features of minor salivary glands mucocele and describe surgical treatments; three cases are reported. PMID- 1778282 TI - [Salivary gland calculi with ambulatory treatment]. AB - The surgical treatments suggested on selected patients are: --local anaesthesia, normally, when the calculus are located in the terminal seats of Wharton's and Stenone's duct; --general anaesthesia, as a rule, in surgical enucleation of the calculus seated up the duct or inside the gland. PMID- 1778283 TI - [PTA palatal appliance for brain-damaged patients]. PMID- 1778284 TI - Effect of thermal stress on serum prolactin, cortisol and plasma arginine vasopressin concentration in the pregnant and non-pregnant state. AB - The thermal responses of serum prolactin, cortisol and plasma arginine vasopressin were studied on pregnant and non-pregnant women. Group I consisted of 15 healthy non-pregnant women, group II of 23 women 13-14 weeks pregnant and group III of 23 women 36-37 weeks pregnant. Blood samples were taken before the stress (21-23 degrees C), at the end of a 20 min stay in a heat chamber (70 degrees C, 15% relative humidity) and 20 min and 45 min after the stress (21-23 degrees C). The rectal temperature increased 0.3-0.4 degrees C. Serum concentration of prolactin increased from the pre-stress level by 82% in group I (NS), by 25% in group II (P less than 0.05) by the end of the stress but declined steadily in group III by 12% till the end of the recovery period (P less than 0.001). The cortisol concentration increased only in group II during the recovery period (54-72%, P less than 0.05). In this group the subjects who felt discomfort after the stress had higher cortisol levels already before the stress. Arginine vasopressin levels increased significantly only in group I by 17% (P less than 0.05) and there were no differences in the proportional changes between the groups. The response of prolactin to thermal stress seems to be abolished at late pregnancy while the responses of cortisol and arginine vasopressin are not influenced by pregnancy. PMID- 1778285 TI - Outcome of the second labour in patients whose first labour was prolonged: the Dublin experience. AB - This observational study examined the outcome of the second delivery in patients whose first labour was prolonged. The onset of labour was defined as that time when the diagnosis of labour was made on admission to the delivery unit. The first labour was defined as prolonged when delivery occurred more than 12 h later. The study was confined to those patients (n = 66) who had a prolonged first labour with a single, live fetus and cephalic presentation during 1984-1987 and who had a subsequent labour. Sixty-one of the 66 patients (92%) delivered vaginally, and 5 were delivered by emergency caesarean section. Forty-six (70%) delivered within 6 h of admission. Although all 66 had received oxytocin in their first labour, only 8 (12%) required oxytocin in their second labour. Fourteen (82.4%) of the 17 patients with a previous caesarean section had a vaginal delivery. These results indicate that compared to the first labour the duration of the second labour and the oxytocin requirements in the second labour were significantly reduced. These findings are reassuring for patients who have had a long difficult first labour. PMID- 1778286 TI - The effect of squatting on pelvic dimensions. AB - Lateral X-ray pelvimetry was performed on 63 women in the sitting and squatting positions on the 5th or 6th post-natal day to assess whether squatting has any effect on pelvic dimensions. Four assessors measured the inlet and outlet pelvic dimensions from 25 cases with good radiographic views in order to minimise observer bias. There was no statistically significant change in pelvic dimensions with squatting. Some possible explanations are discussed. PMID- 1778287 TI - The benefit of external cephalic version with tocolysis as a routine procedure in late pregnancy. AB - The effectiveness of external cephalic version with tocolysis when routinely used in the 37th week of gestation is reported. The procedure had earlier been ruled out in our department, was found effective in a prospective study, and afterwards settled as a routine. Among 1038 women with single breech presentation, 882 could be offered an attempt of external cephalic version during the period 1982-1988. Attempt of version was carried out in 316 women resulting in a vertex presentation at delivery in 100. The success rate on average was 35%. The estimated reduction of breech deliveries was 100/1038 = 9.6%. As the mean caesarean section rate in women with breech presentation was 81% during the period studied, the estimated reduction in the number of caesarean sections during those seven years was 81. Thus the total caesarean section rate (11.3%) was estimated to be reduced by 0.4%. No immediate serious complications were associated with the procedure. Two cases of intra-uterine fetal death occurred 2 and 5 weeks, respectively, after successful, uncomplicated version to vertex presentation. No obvious connection with the external cephalic version could be demonstrated. The effectiveness of version as a routine procedure is less than expected from reports of prospective trials of external cephalic version carried out by a few investigators, but the results may realistically illustrate what is achieved in the long term. PMID- 1778288 TI - Ectopic pregnancy and infertility following treatment of infertile couples: a follow-up of 929 cases. AB - A follow-up analysis was made of 929 infertile couples, with special attention paid to ectopic pregnancy. The conception rate was 46%, and 9% of the pregnancies were ectopic. Previous ectopic pregnancy, an industrial occupation and smoking reduced the fecundity and increased the risk of ectopic pregnancy. Tubal damage as a verified reason for infertility and its treatment also increased the risk of ectopic pregnancy. Stepwise logistic regression analysis showed the strongest association with ectopic pregnancy to exist in the case of women with a previous ectopic pregnancy (9.9-fold risk) rather than women with primary infertility. Treatment of tubal damage by salpingostomy entailed a 6.0-fold risk and treatment by other methods a 2.8-fold risk. Women working in industry had a 3.5-fold risk of ectopic pregnancy compared with those in other professions. PMID- 1778289 TI - The mast cell and histamine concentration of the human post-menopausal uterus. AB - Mast cells and histamine concentrations have been studied in uteri removed by hysterectomy from women in their post-menopausal years. Mast cell numbers were expressed as mean numbers/mm2 following fixation in 10% formalin and staining with Azure B. The majority of mast cells, in both the endometrium and myometrium, were very densely stained. Mast cells in the myometrium showed a significant negative correlation with years post-menopausal (rs = -0.52, P less than 0.05). Extracted histamine from uterine tissue was condensed with o-phthaldialdehyde to form a fluorophore and its fluorescence was measured at 450 microns using a spectrofluorometer. No significant correlation was found between histamine concentrations in the uterine wall and years post-menopausal. PMID- 1778290 TI - Clear ovarian cyst aspiration guided by vaginal ultrasonography. AB - Thirty patients with clear ovarian cysts underwent aspiration guided by vaginal ultrasound. In 23 cases a complete aspiration was accomplished. In 4 only partial aspiration was possible, and in the remaining 3 failed aspiration led to surgery. Histological findings correspond to retroperitoneal lipoma and mucinous cystadenoma (2 cases). Malignant cells were not detected in the fluid of any of the 27 aspirates. Eight of the ten patients presenting with abdominal pain experienced a relief following aspiration. Recurrence of the cyst occurred in 12 cases (40%) with significantly smaller dimensions (P less than 0.01). Vaginal ultrasound aspiration of clear cyst is easy and safe and can be considered as an outpatient procedure. PMID- 1778291 TI - Quantification of Candida albicans morphology in vaginal smears. AB - The morphology index (Mi) of Candida albicans cells was determined by microscopic image analysis in vaginal smears from 26 patients. The morphology of the cells typically showed a broad distribution of forms, but the mean Mi was greater than 2.0 in 23/26 instances, indicating a preponderance of pseudohyphal and hyphal forms. No association could be found between Mi and the clinical assessment of signs or symptoms of Candida infection. Comparison of these 26 patients with 43 others who had Candida-positive vaginal smears but with fewer than 15 fungal cells in the smear revealed significantly lower scores for vulvovaginal symptoms among the latter. PMID- 1778292 TI - Urethral isolation of Chlamydia trachomatis in women with urinary incontinence. AB - The overall prevalence of Chlamydia trachomatis (CT) infection in 168 patients with urinary incontinence was 7.7%. However, in patients with urethral instability CT was found significantly more often than in those with stable urethra (P less than 0.001). Clinical and urodynamic improvement followed the treatment with doxycycline in 8 out of 9 patients with urethral instability. According to our results urethral infection with CT may play an important role in the etiology of urge incontinence and urethral instability. PMID- 1778293 TI - Medical induction prior to surgical evacuation of hydatidiform mole: is there a greater risk of persistent trophoblastic disease? AB - A retrospective study was undertaken to assess whether stimulation of uterine contractility prior to surgical evacuation of a molar pregnancy will lead to an increased frequency of persistent trophoblastic disease. Forty-seven patients treated with chemotherapy for persistent trophoblastic disease after a hydatidiform mole between 1971 and 1988 were evaluated. The use of medical methods in this study group was compared to a control group of 219 patients with hydatidiform mole not requiring further treatment. A medical method, mainly treatment with prostaglandins, was used in 61.7% in the study group compared to 35.2% in the control group. This difference was, however, due to different stage distribution in the groups. Persistent disease was significantly correlated to uterine size and medical methods were mainly used in patients where uterine size corresponded to 15 weeks gestation or more. In this subset of patients, a medical method was used in the same frequency in both groups. Thus, large uterine size seems to be an independent risk factor. We conclude that stimulation of uterine contractility, which in Sweden is frequently used before surgical evacuation of the uterus in patients with hydatidiform mole and large uteri, carries no additional risk. PMID- 1778294 TI - Regional brain blood flow and oxygen supply in guinea pig fetuses near term. AB - To examine brain blood flow and oxygen supply to 14 brain regions in fetal guinea pigs near term, 6 fetuses were catheterized under general anaesthesia of the dam between days 61 and 63 of pregnancy. Fetal arterial blood pressure was measured and a blood sample was taken from the right axillary artery to determine fetal blood gases and acid-base balance. Isotope-labelled microspheres were then injected in a lateral saphenous vein and a reference blood sample was taken from the right axillary artery according to Carter and Gu. Preductal arterial haemoglobin oxygen saturation ranged from 16-33% (26.7 +/- 6.3 mean +/- SD) and pH from 7.08-7.30 (7.20 +/- 0.09); oxygen content varied between 3.0-6.7 ml/dl. Blood flow to the whole brain was 105-258 ml/min per 100 g (167 +/- 58), oxygen supply to the brain was 6.6-10.7 ml O2/min per 100 g (8.0 +/- 1.6). Both regional brain blood flow and oxygen supply were significantly different in the various brain parts. They were highest in the spinal medulla and in other parts of the brain stem and lowest in the cerebrum. Brain blood flow increased significantly with increasing pCO2 and systolic blood pressure and with decreasing haemoglobin oxygen saturation, pH, base excess, and arterial oxygen content. On the other hand, except for the mid portion of the spinal medulla, there were no correlations between blood gas and acid-base balance variables and the oxygen supply to the whole brain or to various regions of the brain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778295 TI - Tubal schistosomiasis as a cause of ectopic pregnancy in endemic areas?; a report of three cases. AB - Tubal schistosomiasis as a cause of ectopic pregnancy is uncommon. We are reporting three cases of tubal pregnancies in which the histopathological examination showed a bilharzial disease of the tube. Schistosomiasis to Schistosoma haematobium occurs in Gabon with an incidence of 8% to 44% of the adult population, and schistosoma ova have been found in 2.5% of histopathological examinations in removal of any genital tissue. Even if schistosomiasis was not the main causative agent of infertility, in this population which has the lowest fertility index in subsaharan Africa, it might impair an already altered tubal function by salpingitis. We suggest that parasitic examination should be made as a part of the management program of infertility and after an ectopic pregnancy in endemic areas. PMID- 1778296 TI - Endometriosis of the perineum; report of two new cases and a review of literature. AB - The incidence of endometriosis at the episiotomy site is quite rare. We have experienced two cases of perineal endometriosis over a 9 year period. The typical clinical history and local findings enable us to make the correct diagnosis of both cases. The treatment of choice is complete surgical excision of endometrial tissue and usually obtains permanent cure. A review of the English literature showed there were 66 cases reported previously. The possible pathogensis of endometriosis and various modality of treatment were also discussed. PMID- 1778297 TI - The validation of a computerized system for the interpretation of the antepartum fetal heart rate tracings (version 89/2.34). AB - We have developed a knowledge-based system for the interpretation of the antepartum fetal heart rate tracings. This study consists of four groups of patient: (1) 49 normal pregnancies with a normal perinatal outcome; (2) 13 normal pregnancies with abnormal perinatal outcome; (3) 33 high-risk pregnancies with abnormal perinatal outcome; and (4) 16 high-risk pregnancies with normal perinatal outcome. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of our expert system (version 89/2.34) were estimated to be 60.0, 85.7, 75.0 and 75.0%, respectively. When the normal pregnancies with abnormal outcome and the high-risk pregnancies with normal outcome were excluded from the population, sensitivity, specificity, PPV and NPV were calculated to be 57.7, 82.9, 68.2 and 75.6%, respectively (corrected values). The prevalance of abnormal outcome for this study was 41.7%. PMID- 1778298 TI - The role of ligand in estrogen receptor regulation of gene expression. AB - We believe that steroid binding is not required for receptor binding to DNA, but instead induces a conformational change in the receptor domains involved in the protein-protein interactions proposed above. Data from Hansen and Gorski (1986), and more recent studies (M. Fritsch and J. Gorski, unpublished results) strongly suggest that the steroid binding domain when bound to estrogens undergoes a dramatic change in conformation characterized by a loss of hydrophobic surface. This marked change in the steroid binding domain probably affects the so-called dimerization region located in this domain and thus the interaction of receptor with nuclear proteins in vivo. In our working model, ER is bound to specific DNA sequences or response elements of a variety of genes with or without estrogen. Ligand binding induces conformational changes in the steroid binding and perhaps other domains of the receptor that in turn change receptor interaction with the transcriptional machinery. The nature of this change is not at all clear at present, and the possibility of enzymatic modification of receptor or associated transcription factors should not be excluded. Whatever the mechanism of receptor action on transcription, we expect it kinetically will be closely related to the occupancy of the receptor with estrogen. Finally, any model of ER interactions with target genes also needs to account for the drastic ligand effect on the extractability of all ER from the nucleus. PMID- 1778299 TI - Placental neurohormones: secretion and physiological implications. PMID- 1778300 TI - Aldosterone biosynthesis in bovine, rat and human adrenal: commonalities and challenges. PMID- 1778301 TI - Antagonistic effects of dexamethasone and 1,25-dihydroxyvitamin D3 on the synthesis of nerve growth factor. AB - Dexamethasone is known to decrease the pool of nerve growth factor (NGF) mRNA in various experimental systems. The negative regulatory effect of the glucocorticoid was first observed in mouse fibroblast-like L929 cells, and was subsequently reported to take place in many experimental systems, including in vivo following sciatic nerve injury. Conversely, another steroid hormone, 1,25 dihydroxy-vitamin D3 (1,25-(OH)2D3) was recently reported to promote NGF synthesis in mouse L929 cells. The present work was undertaken to investigate the effect of the concomitant addition of both steroids to L929 cells. Measurements of NGF mRNA and assays of the mature protein secreted by the cells provide evidence that the negative regulation exerted by dexamethasone may be counteracted in a dose-dependent manner by the positive action of 1,25-(OH)2D3, and vice versa. Therefore, the expression of the NGF gene can be regulated in a subtle way by the balance between the two steroids. It may be expected on the basis of these observations that in tissues that are responsive to both hormones, administration of 1,25-(OH)2D3 should be able to reverse the down-regulation of NGF synthesis elicited by glucocorticoids. PMID- 1778302 TI - A synthetic peptide corresponding to hFSH-beta-(81-95) has thioredoxin-like activity. AB - The thioredoxin-like activity of human follicle stimulating hormone (hFSH), hFSH beta-(83-88) peptide amide (hFSH-beta-(83-88) which has a sequence similar to the thioredoxin active center (-His-Cys-Gly-Lys-Cys-Asp-)) and thioredoxin-(31-36) peptide amide (TD-(31-36) which contains the redox-active dithiol of thioredoxin (-Trp-Cys-Gly-Pro-Cys-Lys-)) was characterized by their ability to reactivate reduced and denatured bovine pancreatic ribonuclease (RNase). This assay reflects the recently recognized ability of thioredoxin to catalyze disulfide bond formation in proteins. Compared to uncatalyzed refolding of reduced, denatured substrate, hFSH was approximately 10-fold more active than thioredoxin on a molar basis. The catalytic activity of hFSH-beta-(83-88) and TD-(31-36) was equivalent to that of an equimolar concentration of thioredoxin. Screening of 11 overlapping peptide amides representing the entire primary structure of hFSH-beta-subunit indicated that hFSH-beta-(81-95), which contains the sequence similar to the thioredoxin active center within a receptor-binding region of the hFSH-beta subunit, possesses strong thioredoxin-like activity and was more active than an equimolar concentration of thioredoxin. In contrast, hFSH-beta-(33-53), a thiol containing peptide which corresponds to a second FSH receptor-binding domain but lacks the sequence similar to the thioredoxin active center, was inactive. Synthetic peptide amides corresponding to other regions of hFSH-beta-subunit were less effective than hFSH-beta-(81-95) in reactivating reduced and denatured RNase. Our data provide evidence that the recently reported thioredoxin-like catalytic activity of FSH may be due, at least in part, to the redox-active dithiol present within a receptor-binding domain of its beta-subunit, and thus may have a physiological role in receptor binding or signal transduction. PMID- 1778303 TI - Primary structure and tissue distribution of anglerfish carboxypeptidase H. AB - Most peptide hormones are synthesized as part of larger precursor proteins which must be processed after translation to generate bioactive peptides. This usually involves cleavage of the precursor by an endopeptidase at sites marked by basic amino acids, followed by removal of N- or C-terminal basic residues by the action of an aminopeptidase or carboxypeptidase. These processing events have been observed in a variety of species, from yeast to mammals. As part of an effort to characterize prohormone processing enzymes in the anglerfish, Lophius americanus, we have cloned and sequenced a cDNA for the fish prohormone processing carboxypeptidase H (CPH). Polyadenylated RNA from anglerfish (AF) islet organs was used to construct a cDNA library in phage lambda gt11. The library was screened with a probe derived from the cDNA for rat CPH. A 2400 base pair AF cDNA clone was isolated. This cDNA encodes a polypeptide which is similar in size and composition to mammalian CPH. The sequence data indicate that the AF CPH precursor is a 454 amino acid polypeptide. The derived amino acid sequence of the putative fish CPH is 81% homologous to the rat and bovine CPH enzymes. Significantly, all of the amino acid residues thought to be important for metal ion and substrate binding, glycosylation, and catalytic activity of mammalian CPH are conserved in the fish enzyme. Northern hybridization using RNA from AF tissues indicates that a 2.5 kb fish CPH mRNA is expressed in brain, pituitary and islet organs, but not in other tissues which do not secrete peptide hormones. PMID- 1778304 TI - A synthetic peptide encompassing two discontinuous regions of hFSH-beta subunit mimics the receptor binding surface of the hormone. AB - Synthetic peptides corresponding to discontinuous segments of the hFSH-beta subunit, amino acids 33-53 and 81-95, have been shown to interact with the follicle-stimulating hormone (FSH) receptor. In this study, we demonstrate that hFSH-beta-(33-53)-(81-95)-peptide amide, a synthetic peptide encompassing these binding regions, possesses higher affinity for the FSH receptor than either synthetic hFSH-beta-(33-53) or hFSH-beta-(81-95). This increased affinity suggests that each binding component is effectively interacting with the receptor, providing evidence that these two separate receptor binding regions of hFSH-beta form a continuous binding surface on the native molecule. These results also suggest that binding surfaces of very complex proteins, such as the heterodimeric glycoprotein hormone FSH, may be mimicked by a linear arrangement of its binding domains. A model based on energetics of the peptide-receptor interaction is also described. The results indicate that the affinity (Ka) of a peptide containing different binding domains can be approximated utilizing the product of the affinity constant of each binding domain (Ka = k1.k2...kn). PMID- 1778305 TI - Protective immunogenicity of synthetic peptides selected from the amino acid sequence of Bordetella pertussis toxin subunit S1. AB - Five synthetic peptides identified as antigenic sites on the S1 subunit of pertussis toxin (PT) were coupled to the diphtheria toxin cross-reactive mutant protein CRM 197 or BSA. All peptide conjugates were immunogenic in animals. Two peptide-CRM-conjugates, corresponding to amino acids 1-17 and 169-186, induced especially high antibody titers against native PT in mice (Balb/c, C57/Black and outbred NMRI) as measured by ELISA. Upon in vivo PT challenge (0.5 microgram toxin) of the NMRI mice both the CRM and BSA conjugates of these two peptides fully protected the mice from PT induced leucocytosis. Some of the protected mice receiving peptide 1-17 conjugate had very low antibody titers against PT but high titers against the peptide as measured by ELISA, showing that PT-ELISA does not always reflect in vivo protection. A booster response against PT was noted upon challenge with PT in mice receiving peptide 1-17 or peptide 169-186 conjugate. Antibodies against peptide 170-186 could not be evaluated by ELISA since conjugates of this peptide (like PT itself) bind to immunoglobulins. They may also caused clustering of CHO cells. Rabbit antiserum to the peptide 1-17-CRM conjugate was highly efficient in inhibiting the ADP-ribosylating activity of PT with bovine transducin as substrate whereas the rabbit antiserum raised against the peptide 169-186-CRM conjugate neutralized the clustering effect of PT on CHO cells. Thus there is no concise correlation between the in vivo protection against PT challenge and the in vitro methods used for measuring antibody levels against PT (neutralization of the enzyme activity, the CHO cell clustering activity and titers in PT-ELISA). The CRM-conjugates of these two peptides constitute the first synthetic pertussis vaccine candidate with the ability to provide a chemically well defined, safe and efficient pertussis vaccine. PMID- 1778306 TI - History of the development of pertussis vaccine. AB - Bordetella pertussis and the disease whooping cough have mysterious unique features among bacterial infectious diseases. Numerous studies gradually provided information that permitted the development of a pertussis vaccine and the assessment of its potency relative to human efficacy. The advances in the understanding of B. pertussis, its pathogenicity and immunity that led to the development of a pertussis vaccine are presented. PMID- 1778307 TI - Monoclonal antibodies against the enzymatic subunit of both pertussis and cholera toxins. AB - A synthetic peptide corresponding to amino acids 6-17 of the A subunit of pertussis toxin was synthesised and used for the immunization of Balb/c mice and the subsequent production of monoclonal antibodies (MAbs). This peptide contains a region of eight amino acids which is homologous to a region in the cholera toxin A subunit. The properties of two of the resultant MAbs are described. Both of the antibodies (CP7-3003F7, an IgG3 and CP7-3004G6X1, an IgG1) react in an ELISA with the peptide and with intact pertussis toxin, pertussis toxin A subunit and cholera toxin A subunit, but do not react significantly with pertussis toxin B subunit, intact cholera toxin, or cholera toxin B subunit. Competition ELISA assays in which the peptide, the intact toxins and the toxin subunits were compared with respect to their ability to inhibit the binding of the MAbs to peptide-coated ELISA plates demonstrated that only pertussis toxin A subunit was as active, on a molar basis, as the peptide. Western blot analyses of the holotoxins confirmed that both MAbs were reactive only with the toxin A subunits. The MAbs were unable to neutralize the activity of cholera toxin or pertussis toxin in a Chinese hamster ovary (CHO) cell assay. Both were also unable to neutralize either the ADP-ribosylation activity or the NAD-glycohydrolase activity of the pertussis toxin A subunit. The significance of these results with respect to the role of this conserved site in the activity of these two toxins is discussed. PMID- 1778308 TI - Evaluation of antibodies elicited by immunization with pertussis toxin. AB - The monoclonal antibody termed 1B7 neutralizes pertussis toxin in vivo in cell culture systems and can also passively protect mice from a challenge with live Bordetella pertussis (9). It has been suggested that most other independently derived neutralizing monoclonal antibodies recognizing the S1 subunit apparently recognize the same epitope as 1B7, and that the S1 subunit contains only one immunodominant protective epitope (1). These antibodies have been termed Class A antibodies (8) and inhibit the ADP-ribosyltransferase but not the NAD glycohydrolase activity of the toxin (7). We are testing the hypothesis that immunization with inactivated preparations of pertussis toxin that lead to protection are associated with the production of Class A antibodies. If true, then identification of Class A antibodies in sera might provide a serological correlate of protection. If false, then development of assays designed to detect the important protective antibodies are necessary. Our initial results suggest that Class A antibodies are not the predominant neutralizing antibody in mice immunized with vaccines containing formalin-treated pertussis toxin. PMID- 1778309 TI - Potency assay and characterization of lymphocytosis promoting factor in whole cell and acellular pertussis vaccines. AB - Potency assay in mice to evaluate the immunogenic properties of a number of candidate Lymphocytosis Promoting Factor (LPF) antigen in whole cell and acellular pertussis vaccines is described. Potency was estimated both by the conventional WHO intracerebral challenge test and an LPF-toxin challenge method. The latter method involved intraperitoneal injection of dilutions of test and reference preparations followed by challenging the animals 28 days later by LPF combined with AlPO4 adjuvant and estimating the total white blood cells three days after challenge. The method has been in routine use for the past four years and has given consistent results with reproducible specific activity and ED50 values. LPF antigen prepared by different chemical treatment or by genetic alteration of the molecule showed differences in specific activity, although different batches made by the same procedure appeared to give consistent values. Only two preparations, did not give specific activity close to what was given by LPF in whole cell vaccine by the LPF challenge method. Some preparations did not give any activity. In the intracerebral challenge method, many preparations failed to protect, while some gave a low degree of protection. The content of residual ADP ribosylating activity also varied. These three tests can be used for characterizing the LPF antigen of acellular pertussis vaccines. PMID- 1778310 TI - An improved ELISA system for the measurement of IgG antibodies against pertussis toxin (PT) and filamentous hemagglutinin (FHA) in human sera. AB - We have developed a modified assay method for the measurement of antibodies against PT and FHA. Polystyrene balls coated with purified PT and FHA were incubated with standard or test sera, washed, incubated with goat anti-human IgG F(ab')2 conjugated with horseradish peroxidase and then washed again. Peroxidase activity was then measured by color development using o-phenylenediamine. The anti-PT and anti-FHA IgG titers were determined using calibration curves. The assay standard curves for anti-PT and anti-FHA were both linear from 1 to 100 ELISA units per milliliter (EU ml-1), and the assay sensitivity was calculated to be 1 EU ml-1 in both cases. Intra- and inter-assay CVs were both less than 10%. Inter-laboratory assay CVs calculated from the results from four different facilities were 3.3-34.6% (average 14.5%) and 2.1-30.3% (average 13.6%) for anti PT and anti-FHA IgG, respectively, and the correlation coefficient between the Chinese hamster ovary (CHO) cell assay and the anti-PT PS-ball ELISA assay was 0.959. Using this assay method we obtained in a highly sensitive and reproducible measurement of IgG antibodies against PT and FHA in human sera. This assay should be especially useful for the determination of low concentrations of these antibodies. PMID- 1778312 TI - Simple and efficient method for clinical isolation of Bordetella pertussis. AB - Commercially available Amies transport medium with charcoal and three isolation media were tested to assess their efficiency in the clinical isolation of B. pertussis. First, the isolation rates of B. pertussis were compared between direct inoculation of nasopharyngeal specimens and inoculation after being stored in Amies transport medium for eight hours or less. The organism was detected in 43 specimens from 29 patients with at least one of the two inoculation methods. The comparative isolation rates were 81% (35 of 43) for both direct inoculation and transport medium. Second, nasopharyngeal specimens were incubated for five days at 35 degrees C on the three media; Bordet Gengou Medium (BG) with 5 micrograms of CEX per ml, Cyclodextrin Solid Medium (CSM) with 5 micrograms of CEX per ml, and Charcoal Agar with 40 micrograms of CEX per ml. The organism was detected from 44 nasopharyngeal specimens of 20 patients on at least one of the three tested media. The comparative isolation rates were 91% (40 of 44) on BG with 5 micrograms of CEX per ml, 93% (41 of 44) on CSM with 5 micrograms of CEX per ml, and 91% (40 of 44) on CA with 40 micrograms of CEX per ml. Although no differences in the isolation rates were observed among the three media, the appearance of the colonies was earlier by one day on BG than the other two media. The detection of B. pertussis was occasionally easier on CA than on the other two because of its higher suppression of nasopharyngeal flora.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778311 TI - Effect of serum treatment on pertussis antibody determination by ELISA. AB - Determination of anti-PT and anti-FHA antibodies by ELISA and neutralization titer by CHO-cell method were performed with inactivated and uninactivated human sera. The findings were as follows: in inactivated sera, higher anti-PT ELISA antibody titers were shown compared with the titers determined with corresponding inactivated sera, especially in sera having low ELISA antibody titers; however, anti-FHA ELISA antibody titers remained identical, with the uninactivated or inactivated sera. CHO-cell neutralization titer remained identical and stable between the uninactivated and inactivated sea. CHO-cell neutralization titers correlated with anti-PT ELISA antibody titers in sera without inactivation. Anti PT ELISA antibody titers in inactivated sera, however, did not correlate with the corresponding CHO-cell neutralization titers. These results suggest the possible existence of (a) substance(s) with affinity to PT which enhance(s) the ELISA reaction when sera are inactivated. Therefore, the inactivation of sera is not favorable for anti-PT determination by ELISA. PMID- 1778313 TI - Structural and biological comparison of lipopolysaccharides (LPS) from Bordetella species. AB - Lipopolysaccharides (LPS) isolated from Bordetella pertussis (Bp), B. parapertussis (Bpp), and B. bronchiseptica (Bbs) were analysed for their chemical composition, molecular heterogeneity, and immunological and biological properties. All LPS contained heptose, KDO, GlcN, uronic acid, phosphate, and fatty acids. The fatty acids C14:0, C16:0 and 3-OHC14:0 were common to all LPS preparations. By SDS-PAGE, Bp-LPS had two bands of low molecular mass, and Bpp- and Bbs-LPS showed a low molecular mass band together with ladder bands of high molecular mass. Immunological assays demonstrated that Bp-LPS reacted with antisera prepared from Bp and Bpp; Bpp-LPS reacted with antisera against Bpp and Bbs, and Bbs-LPS reacted with antisera against any of the three species. Bp-LPS showed biological activities comparable to those of E. coli LPS in terms of lethal toxicity, pyrogenicity, mitogenicity, macrophage activation, and induction of tumor necrosis factor. All activities of Bpp-LPS, except mitogenicity, were lower than those of E. coli LPS. Biological activities stronger or comparable to those of E. coli LPS were observed for Bbs-LPS. PMID- 1778314 TI - Production of a safe, potent and immunogenic partially purified acellular pertussis vaccine using simple indigenous techniques. AB - Partially purified acellular pertussis vaccine was prepared from Bordetella pertussis strains 10536, 134, Tohama and 509 using simple indigenously available techniques. The Stainer-Scholte (SS) medium with methylated-beta-cyclodextrin was the most suitable for production of acellular pertussis vaccine. For preparation of the vaccine, 5 day cultures of B. pertussis grown under stationary conditions at 35 degrees C were treated twice with ammonium sulphate and prospective protective antigens were extracted. The extracts contained pertussis toxin (PT), filamentous hemagglutinin and agglutinogens. These extracts were treated with formaldehyde and glutaraldehyde separately for detoxification of PT. The formaldehyde treatment of acellular preparations affected the potency and did not destroy the toxic effects of PT completely. Active PT was found in formaldehyde detoxified acellular pertussis vaccine (FDAPV) preparations by the Chinese hamster ovary (CHO) cell assay, the test for leucocytosis promoting factor (LPF) and the histamine sensitization (HS) test. The FDAPV preparations did not pass the mouse weight gain test (MWGT). The glutaraldehyde treatment had lesser adverse effects on potency than the formaldehyde treatment and the glutaraldehyde detoxified preparations did not show active PT by CHO cell assay, the test for LPF and the HS test. The mice tolerated high doses (up to four human doses) of GDAPV which passed the MWGT showing higher weight gains. Both FDAPV and GDAPV showed immunogenicity against agglutinogens and PT in mice. The GDAPV is a safe and potent vaccine. The total protein content of GDAPV was about 5 times lesser than that of whole cell pertussis vaccine. PMID- 1778315 TI - Further evaluation of the pertussis component vaccine produced by apoceruloplasmin affinity chromatography. AB - The heat-treated apoceruloplasmin (Apocp) is a useful protein as an affinity ligand for the purification of pertussis toxin (PT). The amounts of Apocp in the purified antigens or the pertussis component vaccine were determined. Anti-Apocp antibodies were not detected by the passive cutaneous anaphylaxis (PCA) test in rats. No anti-Apocp antibody was detected after hyperimmunization of rabbits with the vaccine. Apocp was not detected in PT and filamentous hemagglutinin (FHA) by ELISA using rabbit anti-Apocp IgG. In the experiments using 125I-labelled Apocp, 125I-Apocp was not detected in either PT or FHA which were purified by 125I labeled Apocp-Sepharose, DEAE Sepharose, and cellulose sulfate chromatography. The contents of human DNA were also determined to be less than 10 pg per 1 mg of Apocp, by the dot-blot hybridization method using the 32P-labeled DNA probe of Alu sequence. In the tests for the presence of inapparent viruses, HBs antigen and HTLV-III antibody, no contamination was found in either the Apocp or in the vaccine. Large amounts of various viruses, which were intentionally added to the Apocp (spiking test), were completely inactivated by heating at 65 degrees C for 18 hr. Both the Apocp and the vaccine passed the general pharmacology and acute toxicity tests. From these results, the heat-treated Apocp was considered to be a suitable affinity ligand for the purification of the antigens for the pertussis component vaccine. PMID- 1778316 TI - A novel bivalent acellular pertussis vaccine based on the 69 kDa protein and FHA. AB - A combination of the 69 kDa outer membrane protein and filamentous hemagglutinin (FHA), both isolated from pertussis toxin (ptx) minus mutants of B. pertussis, is protective in the mouse intracerebral challenge potency test ("Kendrick test"). A combination of the same 69 kDa protein and lymphocytosis promoting factor (LPF, pertussis toxin, PTX) is approximately 15 times less effective. The data show that the 69 kDa protein in tandem with FHA is the most relevant combination for mouse protection, and may be a more suitable acellular pertussis vaccine candidate than the LPF/FHA combination which has never been satisfactorily protective in the mouse test. However, the preparation of the 69 kDa protein of acceptable quality is still difficult. Attempts were made at screening the most suitable batches of the preparation by exploiting some recently discovered properties of the 69 kDa protein, i.e. its chromatofocusing pattern and lymphocyte affinity. Although both these properties may differentiate 69 kDa preparations, none of them was able to replace the mouse intracerebral challenge potency test for the final quality assessment. PMID- 1778317 TI - Comparison of toxicities of acellular pertussis vaccine with whole cell pertussis vaccine in experimental animals. AB - There is no suitable animal model for pertussis encephalopathy in humans. In this study, we have compared the toxicity of acellular pertussis vaccine with whole cell pertussis vaccine in mice or guinea pigs. Two lots of acellular and two lots of whole cell vaccine produced in different countries were assayed in the test. 1. There was no statistical difference in mouse protective potency between these acellular or whole cell pertussis vaccines. 2. There were no differences in chemical ingredients between acellular and whole cell pertussis vaccines except for protein nitrogen content. The protein nitrogen content of whole cell vaccine was at least three times higher than that of the acellular product. 3. Anti-PT antibody productivity of the acellular vaccine was higher than that of the whole cell vaccine. 4. Anti-agglutinogen antibody productivity of the whole cell vaccine was higher than that of the acellular vaccine. 5. There was no pyrogenic activity with the acellular vaccine, but high pyrogenicity was seen with whole cell vaccine. 6. There was high body-weight decreasing toxicity in mice and guinea pigs by the whole cell vaccine. 7. The mice died when they received whole cell pertussis vaccine iv, but no deaths occurred in the mice which received acellular pertussis vaccine. PMID- 1778318 TI - Analysis of antibody profiles in children with whooping cough. AB - Development of antibody titres in non-vaccinated children with whooping cough of different duration (all confirmed by positive culture) were investigated by ELISA using lymphocytosis promoting factor (LPF, pertussis toxin), filamentous haemagglutinin (FHA), 69 kDa protein and lipopolysaccharide (LPS) as antigens. The antibody responses occur in three different patterns: Firstly, the LPF antibody response develops very quickly starting with the first day of clinical cough with all three classes, IgG, IgM and IgA appearing simultaneously; LPF antibody appears to be a dominant feature. Secondly, FHA and 69 kDa antibodies appear, starting as IgM with the shift to IgG and IgA later. The third pattern is represented by LPS antibody, the IgA appearing early, but with IgM predominant. Higher titres of IgG reacting with LPS were observed in vaccinated children. Transplacental transfer of antibody was also studied. All antibody titres determined in maternal blood and cord blood were proportional except for anti-LPS antibody which was retarded. Most IgG antibody was IgG1 subclass; surprisingly the 69 kDa antibody consisted of a mixture of approx. 90% IgG1 and 10% IgG4. PMID- 1778319 TI - Two trials of an acellular DTP vaccine in comparison with a whole-cell DTP vaccine in infants: evaluation of two PT doses and two vaccination schedules. AB - The present trials being carried out in Switzerland and Turkey, the reactogenicity and immunogenicity of acellular DTP vaccines containing either 25 micrograms or 8 micrograms of PT and 25 micrograms of FHA were compared with those of a conventional whole-cell DTP vaccine during a primary vaccination course following either a 0-1-2 schedule starting at three months of age (Switzerland) or a 0-2-4 schedule starting at two months of age (Turkey). The whole-cell vaccine was associated with significantly more local reactions than the acellular vaccines; general reactions were also more frequent among whole cell recipients. The 25 micrograms PT dose vaccine was no more reactogenic than the 8 micrograms PT dose vaccine. There was no evidence of increases in frequencies of local or general reactions from one acellular vaccine dose to the next. The 25 micrograms PT dose acellular DTP vaccine resulted in immune responses to all four antigens (PT, FHA, diphtheria and tetanus toxoids) at least equivalent to those observed with whole-cell vaccination. Significantly lower anti-PT antibody levels were seen with the 8 micrograms PT dose vaccine. PMID- 1778320 TI - Clinical use of Biken acellular DPT in two-month old infants. AB - We have examined the antibody titer and side effects in two-month-old infants (1.5-2.5) who received vaccinations of acellular DPT Combined Vaccine Adsorbed "Biken" Lots 22 and 23. We observed high-antibody titers far in excess of prevention levels. No particular increase in side effects was observed in the two month-old infants, except a normal increase in once-only side effects. The results suggest that this vaccine can protect infants under one year of age, who are especially liable to be affected by this illness. PMID- 1778321 TI - Pathophysiology of reactions associated with pertussis vaccine. AB - Many adverse clinical events occur after pertussis immunization in children, but the pathophysiology is not well understood. It has been suggested that some of these adverse events may be due to biologically-active LPF and endotoxin present in DTP vaccines. Fifty-six children were studied who experienced severe reactions (fever greater than or equal to 40.5 degrees C, seizures, persistent crying greater than or equal to 3 hours or hypotonic-hyporesponsive episodes) within 48 hr of DTP immunization. Leukocytosis with neutrophilia was noted acutely (after vaccination) compared to follow-up (approximately one month later). No changes in insulin or glucose values were noted. Utilizing the CHO cell assay, no biologically-active LPF was found in the acute sera of children who had DTP associated seizures. We found no evidence that biologically-active LPF or altered insulin/glucose metabolism were related to severe DTP-associated reactions. PMID- 1778322 TI - Immunologic evaluation of a pertussis toxoid vaccine. PMID- 1778323 TI - Introduction to the International Symposium on Pertussis Evaluation and Research on Acellular Pertussis Vaccines. PMID- 1778324 TI - A phase II multicenter evaluation of several candidate pertussis vaccines in infants. PMID- 1778325 TI - Relationship between bacterial meningitis and acellular pertussis vaccine. AB - We studied case reports of bacterial meningitis and estimated its incidence per 100,000 in three areas of Osaka Prefecture which differed in population and vaccination schedule for the years of 1987 and 1988. To estimate incidence, we used a simple mathematical method derived from surveillance data for a reported number of exanthem subitum to obtain a coverage constant. With this coverage constant, we estimated the incidence of bacterial meningitis per 100,000 population for each area. In the Toyono area, with a population of about one million, the acellular pertussis vaccine series is started in children of three to six months of age and the incidence of bacterial meningitis per 100,000 was 1.95 in 1987 and 5.35 in 1988. Conversely, in Osaka City and Sakai City, with populations of about 2.6 and 0.8 million, respectively, the vaccine is given to children over two years of age and the incidence of bacterial meningitis per 100,000 was estimated to be 6.25 and 3.23 in 1987 and 14.62 and 1.07 in 1988, respectively. Thirteen cases of bacterial meningitis had been reported by Minoh City Hospital, in the Toyono area, and the Osaka City Infectious Disease Center in 1987 and 1988. Patients were seven males and six females and aged from less than a month to four years old. In six, the causal agent was Haemophilus influenzae type B, in three, Group B streptococcus, in two, Neisseria meningitidis and in one, Listeria monocytogenes. Only one of the thirteen patients had received an acellular pertussis vaccine.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778326 TI - Safety follow-up in a cohort of Biken acellular DPT vaccine recipients in Japan. AB - In October 1984 in Sweden, a phase II trial of Biken acellular Pertussis vaccine was started and in 1986, a phase III trial of the same vaccine was begun. During the phase III trial, there were three cases of deaths out of 1,385 of study children at two, four and ten weeks after the second dose of the vaccine, due to severe invasive bacterial infections such as H. influenzae, Pneumococcus, or Meningococcus infection. A number of arguments arose about the results of the Phase III trial. No one can either prove or disprove the association between invasive bacterial infection and administration of acellular pertussis vaccine. The purpose of this paper is to discuss the side effects of Biken acellular DPT vaccine. The pediatricians inquired about the physical status of the children who received Biken acellular DPT vaccine. During the observation period, three out of 940 infants suffered from infectious diseases. One suffered from measles, the other from varicella and the last from mumps. Our retrospective study did not reveal any severe invasive bacterial infection cases cases such as the ones experienced in Sweden. PMID- 1778327 TI - The Swedish efficacy trial of acellular pertussis vaccines--update and time for reflection. AB - The trial cohort from the Swedish efficacy trial conducted during 1986-1987 is still under non-blinded surveillance. During post-trial follow-up until March 11, 1990, efficacy of the mono-component vaccine, JNIH-7, was estimated to be 65% (95% confidence interval, CI, 49-76%) and the efficacy of the two-component vaccine, JNIH-6, to 77% (95% CI 64-85%). For culture-confirmed cases with more than 30 days of cough efficacy for JNIH-7, was 79% (95% CI 66-87%) and for JNIH 6, 92% (95% CI 83-96%). The data indicate that two doses of acellular pertussis vaccine provide protection for 3 1/2 years or more. Continued analysis of data from the trial suggests that acellular pertussis vaccines protect against typical illness to the same extent as whole cell vaccines and that protection against infection may be augmented by adding one or more components to a pertussis toxoid based vaccine. In spite of promising efficacy data, acellular pertussis vaccines are still not licensed outside Japan. The need for direct comparisons with efficacy and safety of whole cell vaccines will be discussed and salient problems of case definitions and case ascertainment in clinical trials will be emphasised. PMID- 1778328 TI - Mixed outbreak of Bordetella pertussis and Bordetella parapertussis in an apartment house. AB - From September through November of 1985, a mixed outbreak of Bordetella pertussis and Bordetella parapertussis occurred in an apartment house in Ashikaga City, Japan. Bacteriological and serological investigations were conducted on seven families, comprising 13 adults and 19 children, living in the same apartment house and having social contacts. For all the subjects, cultivation of nasopharyngeal mucus and measurement of pertussis agglutinin antibody, anti-PT antibody, and anti-F-HA antibody were performed. On the basis of the clinical, bacteriological or serological findings, seven children of three families (families A, B and C), including the first child patient (index case) of family A, were diagnosed as having infections caused by B. pertussis, or B. parapertussis or both. B. pertussis and/or B. parapertussis were isolated from six of the seven child patients. B. pertussis alone was isolated from three children (one in each family), and two of them had not been vaccinated. B. parapertussis alone was isolated from two children, while both bacteria were isolated from one child. Those three children from whom B. parapertussis was isolated were in family C, which was the last of the three families to develop symptoms of infection. Josamycin had been administered to two of the three children from whom B. parapertussis was isolated before the nasopharyngeal mucus specimen was collected. In one of the two children from whom only B. parapertussis was isolated, the significant elevation of anti-PT antibody titer was observed, which was indicative of a mixed infection with B. pertussis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778330 TI - Epidemiology of pertussis in Hungary. AB - Reliable data in Hungary on the incidence of pertussis have been available since the introduction in 1931 of obligatory notification. Immunization against pertussis was introduced compulsorily in 1953 with a combined diphtheria-tetanus pertussis vaccine. Since that time the method of preparation, quality and quantity of the vaccine as well as its immunization schedule underwent several important modifications. As a result of vaccination the incidence of pertussis dropped from 56.967 cases (594.4 per 100,000 inhabitants) in 1953 to 16 cases (0.2 per 100,000 inhabitants) in 1989. PMID- 1778329 TI - The epidemiological situation of pertussis in the Federal Republic of Germany. AB - Whooping cough continues to be a major childhood disease in parts of West Germany. At age six, more than one third of the children in our area have had pertussis according to parental information, whereas only 12% received a specific vaccination. During a four-year period from 1984 to 1987, a total of 2,881 clinically diagnosed cases of whooping cough were investigated. The children had a mean age of 4.1 years, 11% of all patients were younger than one year and 6% of the patients were adults with a mean age of 35.8 years. No sex difference was observed in children (less than 20 years) with clinically overt whooping cough. The seasonal distribution showed that whooping cough was present throughout the year, peaking in early winter. In relation to clinical symptoms, the isolation rate of Bordetella pertussis or Bordetella parapertussis from nasopharyngeal swabs continuously decreased with the duration of paroxysms, starting with 56% positive swabs on day 1. Titers (greater than or equal to 1:100) of IgA antibodies to B. pertussis antigens increased with the duration of paroxysmal coughing. B. pertussis, however, was also isolated from 152 of 964 patients without the clinical signs of whooping cough. IgA-antibodies were also found in 522 patients with non-typical respiratory symptoms, but not in healthy blood donors. Children with clinically diagnosed whooping cough were compared to a group of children showing the symptoms but without any clinical or laboratory signs of whooping cough. We can assume from our data that the incidence and duration of non-paroxysmal coughing, the nocturnal increase in coughing, fever, auscultatory findings and a contact anamnesis occurred with a similar frequency in the whooping cough group and the control group. Apart from the typical paroxysmal fits, whooping and vomiting were found significantly more often in the pertussis group. At least 19% of patients with a recent infection with B. pertussis, however, were not diagnosed by clinical symptoms. The leukocyte count differed only marginally between the three groups and was of no great diagnostic value. A relative lymphocytosis, however, was found significantly more often in whooping cough patients and in patients with laboratory-diagnosed infection with B. pertussis. Our study indicates that part of the symptomatology and some laboratory findings in whooping cough patients in endemic areas of West Germany may differ from the classical form of the disease. Furthermore, our data stress the importance of an accurate procedure in diagnosing B. pertussis infection, and this can be facilitated by a combination of bacteriological and serological tests. PMID- 1778331 TI - Clinical studies on efficacy and safety of an acellular pertussis vaccine in Aichi Prefecture, Japan. AB - Of 342 cases with pertussis notified from 1986 through 1989 in Aichi Prefecture, Japan, 331 (96.8%) were unimmunized children. To confirm the clinical efficacy of the acellular pertussis vaccine combined with diphtheria and tetanus toxoids (ACP DT i.e.) used in the mass immunization, a prospective household case contact study has been conducted since 1983. Of 56 unimmunized children, 48 developed clinically diagnosed pertussis, and of 80 children who received recommended doses of the vaccine, only four contracted the disease after the household exposure. There were no serious systemic adverse reactions including high fever, encephalopathy, shock or death attributable to the mass immunization with ACP-DT. Severe local reactions occurred in 2.5/100,000 recipients of a third and fourth dose of the vaccine during 1984-1989. PMID- 1778332 TI - Calculation of efficacy of acellular pertussis vaccine from the number of pertussis patients and vaccinees in three areas. AB - A study is presented of the efficacy of acellular pertussis vaccine based on the number of pertussis patients and its relationship to vaccination rate in three demographic areas of Osaka Prefecture, Japan. In three separate areas within Osaka Prefecture, the pertussis vaccine is given to children three to six months of age, and in the other two it is given to children two years of age or older. Use of a mathematical method to correct the reported number of pertussis patients per 100,000 population with a constant obtained from analysis of the reported number of exanthem subitum cases allowed us to compare the number of pertussis patients in the three areas with each other. Vaccination rate by age and incidence of pertussis in each city revealed the efficacy of acellular pertussis vaccine to be 94.8%. PMID- 1778333 TI - Japanese clinical experiences with acellular pertussis vaccines. PMID- 1778334 TI - Clinical trials in the United States and Japan with the Lederle-Takeda and Takeda acellular pertussis-diphtheria-tetanus (APDT) vaccines. The Multicenter APDT Vaccine Study Groups. AB - The results of the following studies are reported: a longitudinal double blind trial comparing Lederle-Takeda APDT vaccine with Lederle DTP vaccine in two, four and six month old infants; two double blind similar APDT vs DTP trials in 18 month old and four to six year old children; a large longitudinal open trial with APDT in two, four and six month old infants and a household contact efficacy trial with Takeda APDT in Japan. APDT vaccine recipients had a lesser frequency and less severe reactions than whole cell vaccine recipients. Antibody responses to lymphocytosis-promoting factor and agglutinogens were higher in DTP recipients; APDT recipients had a better serologic response to filamentous hemagglutinin. Equivalent 69K protein antibody responses were seen. Vaccine efficacy in the household contact study was 98% (95% CI = 84% to 99%) against classical pertussis and 81% (95 CI = 64% to 90%) if all respiratory illnesses are considered. PMID- 1778335 TI - Construction and characterization of genetically inactivated pertussis toxin. AB - Pertussis toxin has been shown to be an important virulence factor and an antigen which will probably be essential to a pertussis vaccine. Inactivation of the pertussis toxin was required due to the pharmacological properties associated with this toxin. However, chemical inactivation has the potential of altering important epitopes or of failing to inactivate the toxin. Cloning and sequencing of the pertussis toxin operon has permitted the introduction of specific mutations in the S1 gene which have been shown to have a profound effect on the subsequent enzyme activity. Various mutations were constructed, re-assembled into the pertussis toxin operon and returned to the Bordetella pertussis chromosome for expression. Pertussis toxin, with lysine substituted for arginine at position 9 in the S1 subunit (PTA-K9) was assembled and expressed to wild type levels. Substitution of codons for aspartic acid, glycine and glutamine, for that of glutamic acid at position 129 were incorporated into the PTA-K9 construction. Virulence of these constructed B. pertussis strains and ADP-ribosylation by their toxoids were greatly reduced relative to that found with the wild type. Additionally, PTA-K9 was found to have reduced leukocytosis promotion and histamine sensitization activities. Finally, PTA-K9 was shown to be a protective immunogen in both intracerebral and aeorosol challenge assays. PMID- 1778336 TI - The molecular engineering of pertussis toxoid. AB - The demand for a safer pertussis vaccine has led to the development of acellular vaccine products. We have sought to manufacture a component vaccine based upon the genetic inactivation of pertussis toxin derived by recombinant DNA technology and protein engineering. Rational site-directed mutagenesis of the S1 subunit of pertussis toxin has resulted in an enzymatically-deactivated polypeptide which retains its immunogenic potential. Mutagenic analysis of the other subunits of this toxin has permitted a delineation of the structural determinants involved in its recognition of cellular receptors. The in vitro assembly of holotoxin species possessing selectively engineered subunits may facilitate the production of a molecularly-defined genetic toxoid for pertussis prophylaxis. PMID- 1778337 TI - Expression of the S1 sub-unit of pertussis toxin using a recombinant baculovirus. AB - The full-length genome of the S1 sub-unit containing the native signal sequence was inserted downstream of the polyhedrin promoter of Autographa californica nuclear polyhedrosis virus. A large amount of 28 Kd protein, which was larger than the authentic S1 sub-unit (26 Kd), was detected in insect cells infected with the recombinant virus by Coomassie blue staining after resolving by SDS PAGE. Although the level of expression of the recombinant S1 sub-unit was high, immunoblotting and N-terminal sequencing analyses of the expressed product revealed that the signal sequence of the S1 was poorly processed in the insect cells. In vitro assembly of the recombinant S1 sub-unit with native B oligomer to form holotoxin was low, based on an estimation of both cell cytotoxicity against Chinese hamster ovary (CHO) cells and binding activity to haptoglobin and anti-B oligomer antibody. PMID- 1778338 TI - Genetic and immunological studies on polypeptides encoded by the vir locus of Bordetella pertussis. AB - We report here the results of genetic and immunological studies of the vir locus of Bordetella pertussis. These studies have allowed the determination of the cellular compartment that each of the vir-encoded polypeptides occupies, and have allowed the detection of each of them in crude extracts of Bordetella pertussis cells. From these studies it can be seen that the vir locus encodes two polypeptides, one a transmembrane sensing and signalling protein and the second a cytoplasmic regulatory protein. These proteins belong to the family of bacterial regulatory proteins known as two-component systems. A simple model for signal transduction in this organism is put forward. PMID- 1778339 TI - Characterization of mutant strains producing pertussis toxin cross reacting materials. AB - We have isolated 120 mutant strains producing pertussis toxin (PT) cross reacting materials (CRMs) from B. pertussis, strain Tohama, phase I by nitrosoguanidine treatment. Strains producing higher PT tend to show higher virulence in mice. No direct correlation between the virulence and other factors, such as filamentous hemagglutinin, adenylate cyclase or dermonecrotic heat labile toxin, was found. Most CRMs were less reactive to the anti-S1 monoclonal antibody, 1B7. When the PT CRMs produced by strains 69D, 74E or 79G, which were less or non-toxic, were mixed with A protomer purified from native PT, the PT activity assayed by clustering of CHO-cells increased significantly, but not when they were mixed with B oligomer. These CRMs may be composed of defective S1 and intact S2, S3, S4 and S5. Molecular sizes of PT CRMs outside and inside the cells were analysed by sucrose density gradient centrifugation. The sizes of the CRMs were in the range of 10K to 210K, but the biological activity of PT was detected at only the same molecular size, 106 K, as native PT. The majority of the CRM was released into culture medium if all five subunits were assembled; otherwise they accumulated inside the cell without completion of assembly to form the hexamer in the PT form. One of the non-toxic mutants named 79G showed one point mutation from G to A at the 730th base from the Eco R1 site of the PT gene. Replacement of Cys-41 with Tyr-41 in S1 must have resulted from this mutation. 79G PT composed of S234 (5) was accumulated both inside and outside the cells because the mutant S1 could not form the disulfide bond in the molecule to form the hexamer with the B oligomer, and also S1 must be degraded because of its instability in the cells. Nevertheless 79 GPT showed high immunoprotectivity in mice by active or passive immunization against ic or aerosol challenge with B. pertussis, strain 18323, respectively. It may have a proper conformational structure for protective immunogenicity and could become a good candidate strain for production of a safer and effective pertussis vaccine in the future. PMID- 1778340 TI - Neurophysiology of lower-limb function in hemiplegic children. AB - Equinus in hemiplegic children is multifactorial. In some cases it is due to a short muscle, in others to simple foot-drop, tonic spasticity, rigidity, compensation for a short limb, fixed flexion contracture at the hip, dominantly inherited forefoot deformity, forefoot equinus secondary to chronic toe-walking, or abnormalities of the visco-elastic properties of the muscle, with true intramuscular contracture. This neurophysiological study confirms that hemiplegia in children is not a homogeneous condition. Some have tonic spasticity; some, although stiff, show electrical silence on stretching; some appear to have a short muscle, with no hypertonicity; and others have hypertonicity in relation to position (i.e. rigidity). A short muscle is not always associated with tonic spasticity with reciprocal inhibition. Weakness can occur without spasticity. Speed of movement of toes, ankle and hip is also significantly reduced. PMID- 1778341 TI - Cerebral palsy in Saudi Arabia: a case-control study of risk factors. AB - There is increasing evidence that cerebral palsy (CP) in developed countries results mainly from antenatal factors, whereas reports from developing countries suggest that perinatal and postnatal factors may be more important because of less than optimal delivery conditions. The authors studied 103 Saudi children with CP and compared their antecedent factors with those of a control group. The major risk factors identified were a history of CP in a sibling and consanguinity of the parents. Low birthweight (less than 2000g), gestational age less than 32 weeks, twin pregnancy and respiratory distress were significantly more frequent among CP cases than controls. The results suggest that antenatal factors, including inherited ones, play a major role in the pathogenesis of CP in Saudi Arabia, which is contrary to previous reports from this region. Their contribution to the pathogenesis of CP in developing countries may be greater than previously assumed. PMID- 1778342 TI - Bowel and bladder control of children with myelomeningocele: a Nordic study. AB - The urinary and bowel control was studied of 527 children with myelomeningocele aged between four and 18 years. Information was obtained from medical records and by parent questionnaire. 44 had normal urinary control, 50 had a urinary diversion and the remaining 433 had neuropathic bladder without urinary diversion, of whom 31 per cent expressed their bladder manually and 40 per cent used clean intermittent catheterisation (CIC). 60 per cent needed assistance emptying their bladder. Children using CIC were more continent and needed less help, but were more often treated with antibiotics. Of the 527 children, 412 had disturbed bowel control. 212 evacuated their bowels manually, of whom 90 per cent needed assistance. Parents judged urinary incontinence to be very stressful for 37 per cent of the children and faecal incontinence for 33 per cent. The authors conclude that social urinary continence should be defined as the ability to keep dry for three hours or more. PMID- 1778343 TI - Hearing-impaired autistic children. AB - The charts of 46 children diagnosed as deaf and autistic were reviewed. Nearly one-fifth had normal or near-normal non-verbal intelligence and only one-fifth had severe mental deficiency. The severity of the autistic behavior was related to the severity of the mental deficiency, but not to that of the hearing loss. In 11 of the 46 children, autism went unrecognized for over four years after the diagnosis of hearing loss, and in 10 the hearing loss went unrecognized for several years after the diagnosis of autism. The educational experience of some children was generally disastrous because of the frequently late and incorrect diagnoses and the lack of specialized facilities for hearing-impaired autistic children. PMID- 1778344 TI - A new system for cotside display and analysis of the preterm neonatal electroencephalogram. AB - Continuous EEG monitoring is considered to be a sensitive indicator of changes in cerebral function. This paper describes a system for cotside display and analysis of EEG discontinuity and amplitude in one-minute epochs, with provision for simultaneous recording of the EEG. It has been successfully used to monitor continuously the EEGs of more than 30 babies in a neonatal intensive care unit for periods of up to nine days. This system rapidly provides indications of changes in cerebral function, which can allow early intervention and possible prevention of morbidity. PMID- 1778345 TI - Psychiatric morbidity among children with sickle-cell disease. AB - The prevalence of psychiatric morbidity was investigated among 84 children with sickle-cell disease (SCD) and 84 healthy matched controls, using Rutter's Behaviour Questionnaires. The prevalence of psychiatric morbidity on the parents' and teachers' scales, respectively, was 26.2 and 22.6 per cent for children with SCD and 4.8 and 6.0 per cent for controls. Boys with SCD had significantly higher mean scores than girls, with older children having higher scores than younger ones. Behavioural deviance in seven children occurred both at home and in school, while in 27 it was situational. 34 children had psychiatric morbidity: 14 were neurotic, 11 were antisocial, six were antisocial and neurotic, and the diagnostic category for each of the remaining three differed. Behavioural problems among children with SCD and implications for therapy and prevention are discussed. PMID- 1778346 TI - Krabbe disease in monozygotic triplets. AB - The authors report an extremely rare case of monozygotic triplets with globoid cell leukodystrophy (Krabbe disease). Born to healthy, non-related, heterozygous parents, all three girls presented with typical signs of beta galactocerebrosidase deficiency before one year of age and died within the first 41 months of life. The literature is briefly reviewed. PMID- 1778347 TI - The surgical management of drooling. AB - As with all branches of surgery, selection of the appropriate operative procedure for a particular patient involves careful weighing of all the alternatives and full discussion with the patient and carers. Each of the procedures described has its devotees and detractors. For an individual patient, however, the risks of each, the likely postoperative course and the results of the surgery--both in terms of the expected chance of improvement in drooling and the presence or otherwise of residual scarring or taste--must be balanced to determine the optimum plan for treatment. The long-term results of submandibular duct transposition for drooling in the author's own institution have recently been reported. An initial improvement in the drooling of all patients was maintained for at least two years in 17 of 20 patients. Only two patients experienced complications requiring further surgery (ranulas in each case). It is suggested that these very satisfactory results, achieved without external scarring and without compromising the sense of taste, support the contention that submandibular duct transposition is the surgical treatment of choice for children and young people with cerebral palsy who drool excessively. PMID- 1778348 TI - Delayed eruption of secondary dentition associated with phenytoin therapy. PMID- 1778349 TI - Failure to thrive on chloride-deficient formula. PMID- 1778350 TI - Congenital varicella infection. PMID- 1778351 TI - In vivo use of neutral radiolabelled molecular probes to evaluate blood-ocular barrier integrity in normal and streptozotocin-diabetic rats. AB - Evidence suggests that the consequences of diabetes mellitus are numerous and that net changes in ocular barrier permeability are necessarily complex functions of changes at specific anatomical loci. In this study we explore changes in blood aqueous and vitreous permeability in streptozotocin-diabetic rats using five stable radiolabelled probes. Three probes, (3H)-L-glucose, (14C)-sucrose and (14C)-carboxylinulin are relatively large molecules and are expected to move into ocular humours via paracellular routes. Two probes, (14C)-urea and (14C) glycerol, are small and likely have a trans-cellular component to permeability. Pulse-chase kinetic studies follow the appearance of test molecules into ocular humours with rate constants estimated via linear modelling. Larger neutral probes L-glucose, sucrose and carboxylinulin entered the aqueous humour of control rats slowly via routes that presumably circumvent tight-junctioned barriers. These slow-entry rates were found to increase in diabetic animals suggesting an increase in passive paracellular permeability with significant variation among animals. In contrast, aqueous entry rates of smaller probes urea and glycerol were decreased in diabetic animals suggesting that these probes cross membranes and cells less efficiently in diabetic animals. The magnitude of these changes increased with the length of exposure to diabetes. Paralleling the aqueous humour studies, we found a significant but variable increase in vitreous entry rate with L-glucose, sucrose and carboxylinulin, but a decrease in entry rates with small probes urea and glycerol. These results suggests that diabetes-related blood ocular permeability changes are complex and depend on the size and properties of the probe as well as the degree of diabetes exposure. PMID- 1778352 TI - Ontogenesis of insulin processing in fetal rat hepatocytes. AB - We studied insulin processing and hepatic glycogenesis in cultured hepatocytes isolated from rat fetuses of 17, 19, and 21 days of gestation. Steady-state insulin binding increased by 250% between days 17 and 19, from 145 +/- 8 to 361 +/- 52 fmol/mg protein, and by an additional 40% (405 +/- 69 fmol/mg protein) by 21 days of gestation. At 37 degrees C, 125I-insulin was rapidly (t 1/2 less than 5 min) internalized by hepatocytes at all three ages, reaching maximal levels (63 76% of the total cell-associated radioactivity) by 15 min. 125I-labelled degradation products appeared rapidly (t 1/2 less than 15 min) within the cells. Yet, the majority (68-77%) of the intracellular radioactivity consisted of intact 125I-insulin, even after 4 h at 37 degrees C. Hepatocytes pre-loaded with 125I insulin and then acid-stripped of surface-bound radioactivity, rapidly released both intact 125I-insulin (retroendocytosis) and its radiolabelled degradation products. While intact insulin was initially released more rapidly (t 1/2 less than 6 min), and reached a plateau after 15-30 min, the degradation products continued to accumulate in the medium for at least 4 h. Methylamine inhibited intracellular 125I-insulin degradation at all three gestational ages and also blocked insulin-stimulated glycogenesis in 19- and 21-day hepatocytes, without altering basal glycogen synthesis. Insulin-stimulated glycogenesis was not induced in 17-day fetal rat hepatocytes in control or methylamine-treated cultures. We conclude that both degradative and retroendocytotic pathways for processing insulin are present in fetal rat hepatocytes by 17 days of gestation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778353 TI - UK Prospective Diabetes Study (UKPDS). VIII. Study design, progress and performance. AB - The UK Prospective Diabetes Study (UKPDS) is a multi-centre, prospective, randomised, intervention trial of 5100 newly-diagnosed patients with Type 2 (non insulin-dependent) diabetes mellitus which aims to determine whether improved blood glucose control will prevent complications and reduce the associated morbidity and mortality. Newly presenting Type 2 diabetic patients aged 25-65 years inclusive, median age 53 years, median body mass index 28 kg/m2 and median fasting plasma glucose 11.3 mmol/l, were recruited and treated initially by diet. Ninety five percent remained hyperglycaemic (fasting plasma glucose greater than 6 mmol/l) and were randomly allocated to different therapies. In the main randomisation, those who were asymptomatic and had fasting plasma glucose under 15 mmol/l were allocated either to diet policy, or to active policy with either insulin or sulphonylurea aiming to reduce the fasting plasma glucose to under 6 mmol/l. Over 3 years, the median fasting plasma glucose in those allocated to diet policy was 8.9 mmol/l compared with 7.0 mmol/l in those allocated to active policy. The Hypertension in Diabetes Study has been included in a factorial design to assess whether improved blood pressure control will be advantageous. Patients with blood pressure greater than or equal to 160/90 mm Hg were randomly allocated to tight control aiming for less than 150/85 mm Hg with either an angiotensin-converting enzyme inhibitor or a Beta-blocker or to less tight control aiming for less than 200/105 mm Hg. The endpoints of the studies are major clinical events which affect the life and well-being of patients, such as heart attacks, angina, strokes, amputations, blindness and renal failure. To date, 728 patients have had at least one clinical endpoint. Surrogate endpoints include indices of macrovascular and microvascular disease detected by ECG with Minnesota Coding, retinal colour photography and microalbuminuria. The studies also aim to evaluate potential risk factors for the development of diabetic complications such as smoking, obesity, central adiposity, plasma LDL- and HDL cholesterol, triglyceride, insulin, urate and other biochemical variables. The studies are planned to terminate in 1994, with a median follow-up of 9 years (range 3-16 years) for the glucose study and 5 years (range 2-6 years) for the hypertension study. PMID- 1778355 TI - Effect of human C-peptide on glucose transport in in vitro incubated human skeletal muscle. AB - Muscle specimens from the quadriceps femoris muscle were obtained from eight healthy subjects by means of an open muscle biopsy and prepared for in vitro incubation. C-peptide at 0.5, 1.0 and 2.5 nmol/l increased 3-0-methylglucose transport by 38% (NS), 64% (p less than 0.05), and 64% (p less than 0.05) respectively. Glucose transport increased 1.8-fold in the presence of 0.3 nmol/l of insulin (p less than 0.05). Glycogen content in muscle strips exposed to C peptide at a concentration of 1 nmol/l increased significantly by 22% (p less than 0.05). In conclusion, C-peptide stimulates the rate of 3-0-methylglucose transport in in vitro incubated human skeletal muscle strips in a dose-response manner. These observations suggest that C-peptide may contribute to the regulation of carbohydrate metabolism in human skeletal muscle. PMID- 1778354 TI - Prevention of type 2 (non-insulin-dependent) diabetes mellitus by diet and physical exercise. The 6-year Malmo feasibility study. AB - From a previously reported 5-year screening programme of 6,956 47-49-year-old Malmo males, a series of 41 subjects with early-stage Type 2 (non-insulin dependent) diabetes mellitus and 181 subjects with impaired glucose tolerance were selected for prospective study and to test the feasibility aspect of long term intervention with an emphasis on life-style changes. A 5-year protocol, including an initial 6-months (randomised) pilot study, consisting of dietary treatment and/or increase of physical activity or training with annual check-ups, was completed by 90% of subjects. Body weight was reduced by 2.3-3.7% among participants, whereas values increased by 0.5-1.7% in non-intervened subjects with impaired glucose tolerance and in normal control subjects (p less than 0.0001); maximal oxygen uptake (ml.min-1.kg-1) was increased by 10-14% vs decreased by 5-9%, respectively (p less than 0.0001). Glucose tolerance was normalized in greater than 50% of subjects with impaired glucose tolerance, the accumulated incidence of diabetes was 10.6%, and more than 50% of the diabetic patients were in remission after a mean follow-up of 6 years. Blood pressure, lipids, and hyperinsulinaemia were reduced and early insulin responsiveness to glucose loading preserved. Improvement in glucose tolerance was correlated to weight reduction (r = 0.19, p less than 0.02) and increased fitness (r = 0.22, p less than 0.02). Treatment was safe, and mortality was low (in fact 33% lower than in the remainder of the cohort).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778356 TI - Effects of inhaled phosgene on rat lung antioxidant systems. AB - A concentration-response and C x T study were undertaken to determine the effect of phosgene (COCl2) inhalation on pulmonary antioxidant processes as determined by changes in endogenous glutathione (GSH) and antioxidant-associated enzymes (GSH peroxidase, GSH reductase, glucose-6-phosphate dehydrogenase, and superoxide dismutase). Rats were exposed to 0.0, 0.1, 0.25, 0.5, and 1.0 ppm phosgene for 4 hr and 0.25 ppm phosgene for 8 hr. The endpoints were assayed at 0, 1, 2, 3 and 7 days after exposure cessation. The lowest effective concentration was 0.1 ppm phosgene (increases in measured variables from 8 to 35% above control values). At all concentrations, major effects were observed 1 to 2 days after exposure (12 to 159% above control), peaking at 2 to 3 days postexposure (11 to 253% above control), and in some cases were still evident 7 days (10 to 65% above control) after exposure. The C x T study using the same dose (120 ppm-min), but different times and concentration (0.25 ppm for 8 hr and 0.5 ppm for 4 hr), showed a concentration dependence. The peak antioxidant enzyme changes observed for the higher concentration (0.5 ppm) were at least double those observed for the lower concentration (0.25 ppm). These enzyme changes were similar to those reported for the oxidants O3 and NO2. Although the suspected mechanism of initial damage between phosgene and these oxidants is different (acylation vs oxidation) the biological result is similar (i.e., damage, repair, and influx of cells), thus eliciting similar biochemical changes in response to pulmonary injury.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778357 TI - Biochemical and morphologic responses of rat nasal epithelia to hyperoxia. AB - While performing its functions in olfaction, modification of inspired air, and protection of the lower respiratory tract from high concentrations of potentially harmful inhalants, the nasal mucosa can be injured by a number of inhalants. In this study, F344/N male rats were exposed to filtered air or hyperoxia (85 or 87% oxygen), 24 hr/day, 7 days/week, for 1 (acute exposure) or 11 (chronic exposure) weeks. There were distinct differences between the different epithelial regions examined in replicative and morphologic responses as well as altered enzyme activities in response to oxygen exposure. Neither acute nor chronic hyperoxic exposure caused degenerative, necrotizing, or inflammatory changes in any of the nasal epithelial examined. Hyperoxia-induced hypertrophy, but not hyperplasia, of the non-ciliated cuboidal (NCC) epithelium occurred after both acute and chronic exposure. Cell replication was increased in portions of the NCC and respiratory epithelia after acute hyperoxia exposure. There were significant increases, compared to controls, in the specific activity of glucose-6-phosphate dehydrogenase in the nasal turbinates, maxilloturbinates, and lateral wall epithelium (NCC epithelium), the nasal septum (respiratory epithelium), and the ethmoturbinates (olfactory epithelium), and in the specific activity of glutathione peroxidase in the NCC epithelium and ethmoturbinates after acute hyperoxia exposure. The specific activity of cytochrome P450-dependent monooxygenase-catalyzed O-deethylation of 3-cyano-7-ethoxycoumarin was significantly decreased, compared to controls, in the NCC epithelium. These results suggest that hyperoxia exposure induces morphologic and biochemical alterations in nasal epithelia which appear to be protective responses of certain cell types to hyperoxia. PMID- 1778358 TI - Fertility and perinatal/postnatal studies in rats with the angiotensin-converting enzyme inhibitor, quinapril. AB - Quinapril, an inhibitor of angiotensin-converting enzyme (ACE) and an antihypertensive agent, was evaluated in rats for effects on fertility, reproduction, and perinatal and postnatal development. In a fertility study, male rats were treated by gavage for 60 days prior to and during mating and female rats were treated by gavage for 14 days prior to mating, during mating and gestation, and during lactation with doses of 0, 10, 50, or 100 mg quinapril/kg body wt. There were no significant effects on body weight, food consumption, fertility indices, fetal development, or neonatal growth, survival, development, behavior, or reproduction. In a perinatal/postnatal study, administration of quinapril to females at doses of 25, 75, or 150 mg/kg during late gestation and lactation had no effects on parturition, lactation, or postnatal development, but a significant decrease in neonatal body weight during the suckling period was observed at all doses. In a subsequent study, female rats were given 150 mg/kg during late gestation, lactation, or late gestation and lactation. No adverse effects were seen in the dams or the offspring, and no reduction in neonatal body weight was observed. Kidneys from pups whose mothers received quinapril during gestation and/or lactation had minimal juxtaglomerular cell hypertrophy, characteristic of treatment with ACE inhibitors. Low levels of quinaprilat (the major and pharmacologically active metabolite of quinapril) were detected in fetal blood and in neonatal blood, indicating offspring exposure to quinapril. Milk quinaprilat concentrations were 3-5% of the plasma concentrations 3-5 hr after dosing. These studies demonstrate no adverse effects of quinapril on fertility, reproduction, or perinatal and postnatal development. PMID- 1778359 TI - Effects of CI-949, a novel antiallergy compound, on host resistance in mice. AB - The effect of CI-949, a novel inhibitor of allergic mediator release, on immune function was assessed with holistic mouse models of immunocompetence. Resistance to the bacterial pathogens Listeria monocytogenes and Streptococcus pneumoniae and the B16F10 melanoma cell line was used to evaluate the potential of CI-949 to affect immune function. CI-949 treatment of female B6C3F1 mice increased pulmonary tumor burden at 100 mg/kg/day in the B16F10 melanoma model, with a no effect level of at least 50 mg/kg/day. A correlation was seen between decreased clearance of the B16F10 cells and increased tumor burden. However, CI-949 produced this effect only at the maximum tolerated dose. No effect of the drug was seen in the S. pneumoniae model. Host resistance to L. monocytogenes was increased after CI-949 administration, with the no adverse effect level in this model being at least equivalent to the top dose of 100 mg/kg/day. Therefore, the immune system does not appear to be adversely affected or to be a specific target for CI-949 even at an overtly toxic dose. PMID- 1778360 TI - The fungicide benomyl (methyl 1-(butylcarbamoyl)-2-benzimidazolecarbamate) causes testicular dysfunction by inducing the sloughing of germ cells and occlusion of efferent ductules. AB - Adult male Sprague-Dawley rats (100 days of age) were given single oral doses of the fungicide benomyl (methyl 1-(butylcarbamoyl)-2- benzimidazolecarbamate) in dosages ranging from 25 to 800 mg/kg body weight. The testis and excurrent ducts were examined at 2 and 70 days posttreatment to determine the chemical effects on spermatogenesis and the epididymis. Primary effects seen at 2 days postexposure were testicular swelling and occlusions of the efferent ductules. Mean testis weight peaked with 400 mg/kg. Premature release of germ cells (sloughing), detected even with the lowest dosage (25 mg/kg), was the most sensitive short term response to benomyl. Sloughing was found primarily in Stage VII of the spermatogenic cycle at the lower dosages, but at higher dosages sloughing extended into all stages except for Stages VIII-XI. Occlusions of the efferent ductules of the testis were dose-dependent and correlated with testis weight. Sperm and sloughed germ cells were compacted in the ductal lumen of occluded ductules, which were surrounded by two to four layers of polymorphonuclear leukocytes and other inflammatory cells. Although the caput epididymidis contained sloughed germ cells and appeared swollen, evidence of permanent occlusion was not found. The long-term (70 days) effects of benomyl were decreased testis weight (at 400 mg/kg), dose-dependent increases in seminiferous tubular atrophy, and increases in the number of reproductive tracts containing occluded efferent ductules. Fibrosis, granulomas, and abnormal growth were long term consequences of occluded ductules, which were present 100% of the time in testes containing 26-100% seminiferous tubular atrophy. Only a few testes were found to be completely regressed. Occlusion of efferent ductules and disruption of the seminiferous epithelium by sloughing of germ cells are overlapping dose dependent mechanisms responsible for short- and long-term effects of benomyl on the rat testis. PMID- 1778362 TI - Effectiveness of oral pyridostigmine pretreatment and cholinolytic-oxime therapy against soman intoxication in nonhuman primates. AB - Nonhuman primates which were fed Mestinon (pyridostigmine) syrup-impregnated food biscuits (40 mg per animal) exhibited a reproducible inhibition of whole blood cholinestrase activity of 40 to 50% for a period of 1 to 6 hr. Pyridostigmine pretreatment was supplemented by therapy with two doses of an antidotal combination (A,TM,B) consisting of 0.05 mg/kg atropine, 2.24 mg/kg TMB-4, and 0.4 mg/kg benactyzine which assured survival in five of six animals following three separate exposures to 10 LD50 soman. The protective period of this oral dose of pyridostigmine supported by A,TM,B therapy was between 1/2 and 8 hr. Oral pyridostigmine pretreatment in combination with atropine therapy (three doses of 0.07 or 1.00 mg/kg im) also saved monkeys exposed to 10 LD50 soman; however, the period of recovery was prolonged. Oral pyridostigmine pretreatment did not alter the lethality of soman in the absence of A,TM,B or atropine therapy. PMID- 1778361 TI - Effectiveness of oximes 2-PAM and HI-6 in recovery of muscle function depressed by organophosphate agents in the rat hemidiaphragm: an in vitro study. AB - Phrenic nerve diaphragm muscles of young adult rats were used to study the ability of the oximes 2-PAM and HI-6 to recover muscle function depressed by organophosphate (OP) agents. The single twitch of diaphragm muscles which were exposed to soman (0.2 microM) recovered after washing with saline for 3 hr, but the muscles pretreated with sarin (0.4 microM), VX (0.2 microM), or tabun (0.4 microM) showed only partial recovery. In addition, after 3 hr washing, the muscles pretreated with soman as well as with tabun did not recover the tetanus sustaining ability (TSA), yet complete recovery was observed with muscles pretreated with sarin and VX. These results indicate that the OPs have different effects on muscle contractile properties and that VX- and sarin-pretreated muscles recover equally well after wash with physiological solution. The recovery of twitch tension of diaphragm muscles by 2-PAM and HI-6 was similar to that achieved by washing with saline for 3 hr for sarin- and soman-exposed muscles. The most remarkable differences were seen in the recovery of TSA. Both 2-PAM and HI-6 recovered the TSA of muscles that were pretreated with sarin and VX. Although 2-PAM recovered the TSA after tabun pretreatment, HI-6 had no discernible effect. On the other hand, HI-6 recovered the TSA of soman-pretreated muscles but 2-PAM did not. The effectiveness of muscle function recovery was not related to the oximes' ability to reactivate AChE, thus indicating that the recovery of muscle contractility may be attributed to a direct effect of these compounds on the muscle. PMID- 1778363 TI - Evaluation of the immunotoxicity of orally administered 2-methoxyacetic acid in Fischer 344 rats. AB - We previously demonstrated that the glycol ether 2-methoxyethanol (ME) is immunotoxic in the rat. In this study, the immunotoxicity of 2-methoxyacetic acid (MAA), the principal metabolite of ME, was evaluated in adult male Fischer 344 rats. Rats were dosed by gavage with MAA on 10 consecutive days at dosages ranging from 50 to 200 mg/kg/day. Thymic involution, in the absence of body weight loss, was observed at 100 and 200 mg/kg/day MAA. Lymphoproliferative responses to the mitogens concanavalin A, phytohemagglutinin, and pokeweed mitogen were also reduced at these dosages. The in vitro generated cytotoxic T lymphocyte response was reduced at 200 mg/kg/day MAA. The mixed lymphocyte reaction and natural killer cell activity were unaffected by exposure to MAA. Enumeration of splenic lymphocyte populations revealed a reduction in the percentage of W3/25-positive cells at 100 and 150 mg/kg/day and an increase in the percentage of OX39-positive cells at 200 mg/kg/day; however, no changes in the absolute number of either of these subsets were observed. The plaque forming cell (PFC) response to trinitrophenyl-lipopolysaccharide (TNP-LPS) was suppressed at 50-200 mg/kg/day MAA, while the PFC response to sheep red blood cells (SRBC) was elevated at 50 mg/kg/day. Immunization of rats with TNP-LPS or SRBC followed by oral exposure to MAA at 4 and 28 hr postimmunization resulted in the suppression of the PFC response to TNP-LPS and SRBC at dosages of 100 and 200 mg/kg and 200 and 400 mg/kg, respectively. Equal suppression of the PFC response to TNP-LPS was achieved at equimolar concentrations of ME and MAA. The effects of MAA on the immune system of the rat presented here are very similar to results reported from this lab for ME-induced immune alterations. These results, along with results of experiments in which ME-induced suppression of the PFC response to TNP-LPS was reversed by 4-methylpyrazole, an inhibitor of the oxidation of ME to MAA by alcohol dehydrogenase, indicate that MAA is the proximate immunotoxicant following exposure to the glycol ether 2-methoxyethanol. PMID- 1778364 TI - Efficacy evaluation of physostigmine and anticholinergic adjuncts as a pretreatment for nerve agent intoxication. AB - Pretreatment of nonhuman primates with physostigmine (Phy) and scopolamine or physostigmine and trihexyphenidyl 25 min before exposure to 2 LD50 soman im resulted in complete survival without convulsions or loss of consciousness. When identically pretreated animals were challenged with 5 LD50s of soman followed by atropine and 2-PAM therapy 1 min later, all animals experienced a loss of consciousness for approximately 10 min followed by functional recovery within an additional 20 min. These findings indicated that a pretreatment regimen composed of Phy and cholinolytic is capable of protecting primates from an absolute lethal dose of soman with rapid recovery from incapacitation. PMID- 1778365 TI - The noninvasive mouse ear swelling assay. I. Refinements for detecting weak contact sensitizers. AB - The noninvasive mouse ear swelling assay (MESA) is a model for delayed-type hypersensitivity that holds promise as a testing protocol for allergic contact dermatitis (ACD). The MESA employs only topical sensitization on the abdomen and does not use injections, adjuvants, anesthesia, occlusion, or disruption of the stratum corneum. Five days after induction, the ears are challenged topically and ear swelling measurements taken at 24, 48, and 72 hr indicate the extent of ACD. In this study, refinements of the assay were explored in BALB/cBy mice using dinitrofluorobenzene (DNFB) and dinitrochlorobenzene (DNCB). A complete dose response curve was developed for DNFB and the dose which sensitized half the mice in a group (SD50, 0.001%, w/v) was used to test noninvasive enhancement protocols. Several triple-dose protocols tested produced no increase in responsiveness and daily dosing showed a trend toward tolerance induction yielding 20% positive responses. Dietary vitamin A supplementation produced a dramatic enhancement of the responses: ear thickness increase was doubled and the SD50 sensitized 94 to 100% of the mice in the vitamin A groups. We conclude that the MESA allowed identification of ACD potency for known sensitizers at very low concentrations which do not produce ACD with other techniques. The importance of dose-response studies for avoiding the high-dose reduced-response region was also shown. Based on the observation that the vitamin A-augmented MESA was considerably more sensitive than with regular feed, a companion study (P.S. Thorne. C. Hawk, S.D. Kaliszewski, P.D. Guiney, Fundam. Appl. Tox. 17, 807-820, 1991) presents tests of the enhancements to the MESA developed in this work, using weak sensitizers and complex mixtures. PMID- 1778366 TI - The noninvasive mouse ear swelling assay. II. Testing the contact sensitizing potency of fragrances. AB - The noninvasive mouse ear swelling assay (MESA) for contact allergy testing was evaluated using fragrance components and complex fragrance mixtures. The test materials represented weak sensitizers and nonsensitizers. Two versions of the MESA were investigated. Both were noninvasive and utilized only topical abdominal dosing and ear challenge with single applications in BALB/cBy mice. The vit A MESA differed from the regular MESA only in that mice were maintained on a diet with 17-fold higher levels of vitamin A (vit A) acetate beginning 3 weeks prior to induction. Sensitization reactions were determined by measuring the mean increase in ear swelling over baseline at 24, 48 and 72 hr postexposure. Irritation dose-response curves facilitated choosing a high nonirritating challenge dose. Sensitization dose-response curves were developed for cinnamaldehyde (CINN) and a complex fragrance mixture, F-16. From these curves, the SD50 was determined. This value represents the dose which sensitized half the animals and serves to rank the potency of compounds for allergic contact dermatitis and to compare values among different assays. The SD50 for CINN was 21.6% while the SD50vit A for F-16 was 26.6%. The other fragrance, isoeugenol (ISOE), and fragrance mixtures, F-07 and F-22, were also found to be weak sensitizers in the MESA and vit A MESA. The results in the MESA for CINN and ISOE were in the range observed with guinea pig test protocols but showed that the MESA was more sensitive than human test protocols. Two of the fragrance mixtures tested in the MESA gave comparable results in the Buehler guinea pig assay. However, the third (F-22) was negative in the Buehler assay and the MESA, but positive in the vit A MESA. The results of this work with weak sensitizers and the companion study (Thorne et al., 1991) with potent sensitizers at low doses illustrate that the noninvasive MESA is as sensitive as many standard guinea pig assays. In addition, it is easier and much less expensive to perform. The vit A MESA has the sensitivity and predictive power needed to test compounds and mixtures for contact sensitizing potency. PMID- 1778367 TI - Exposure to inhaled isobutyl nitrite reduces T cell blastogenesis and antibody responsiveness. AB - Isobutyl nitrite is a drug of abuse popular among male homosexuals and among adolescents. In order to approximate the nitrite exposures of inhalant abusers, mice were treated with 900 ppm isobutyl nitrite in an inhalation chamber for 45 min per day for 14 days. After 14 consecutive days of exposure to isobutyl nitrite, mice weighed an average of 4% less than mice exposed to air. The spleens of nitrite-exposed mice weighed 15% less and had 24% fewer cells per spleen than those of controls. Adjusted for equal cell numbers, T cell mitogenic and allogeneic proliferative responses were significantly reduced by 33 and 47%, respectively. The frequency of T-dependent plaque-forming cells (PFC) was inhibited by 63% and the total number of PFC per spleen was reduced by 72% in nitrite-exposed mice. In contrast, B cell proliferative responses to LPS were unaltered, suggesting that the toxicity of isobutyl nitrite did not affect all lymphoid cells equally. The data suggest that habitual inhalation of isobutyl nitrite could impair immune competence and that toxicity appeared to be directed toward T cell functions. PMID- 1778369 TI - [The specific spectral characteristics of the EEG of children with difficulties in learning to read]. PMID- 1778368 TI - [The functional characteristics of physiological systems in schoolchildren during muscular activity]. PMID- 1778370 TI - [The energy and physiological "costs" of muscular work in children 7 to 17]. PMID- 1778371 TI - [The characteristics of the age-related development of the respiratory system in children 6 to 15]. PMID- 1778372 TI - [The age-related characteristics of the dopaminergic regulation of prolactin and luteinizing hormone secretion in boys from 3 to 15]. PMID- 1778373 TI - [The functional organization of the developing brain (the age-related characteristics and patterns)]. PMID- 1778374 TI - [The characteristics of the skin-temperature reactions and enzyme status of preschool children]. PMID- 1778375 TI - [The "age-related minimization" of areas of the brain participating in the systems support of mental functions: the arguments pro and con]. PMID- 1778376 TI - [The principle of the dominant in the basis of a system for raising and educating preschoolers and schoolchildren]. PMID- 1778377 TI - [The interhemispheric asymmetry of the EEG alpha rhythm during cognitive activities with different rates of success]. PMID- 1778378 TI - [The development of bimanual coordination in children: the role of interhemispheric connections]. PMID- 1778379 TI - [The neurobiological causes of school dysadaptation]. PMID- 1778380 TI - [The electrophysiological correlates of perceptive strategies and the role of the genotype in shaping their variability]. PMID- 1778381 TI - [A neurophysiological analysis of interhemispheric interaction during visual perception in children]. PMID- 1778382 TI - [The psychophysiological factor of the systems development of visual perception in children and adolescents with normal and below-normal vision]. PMID- 1778383 TI - [Generalized mastocytosis--hemoblastosis of mast cells]. AB - A review of literature has been presented including current data on bone marrow genesis functional role of mast cells in the human body, as well as characteristics of the main clinical variants of mastocyte tumor proliferations (solitary mastocytoma, urticaria pigmentosa, generalized mastocytosis). Clinicomorphological picture and positive results of the treatment with the Soviet cytostatic spirobromine of two patients suffering from generalized mastocytosis are described. PMID- 1778384 TI - [Dynamics of serum ferritin level at various points in the course of acute leukemia]. AB - Dynamics of serum ferritin levels was studied in 87 adult patients with varying forms of acute leukemia at different stages of the disease development (the first attack, complete and non-complete remission, the first and second relapse, terminal stage). A direct correlation has been established between ferritin concentration and the disease course phase. It has been shown that ferritin is a universal criterion for the evaluation of leukemia process activity useful for all forms of acute leukemia: lymphoblastic, non-lymphoblastic and low-percent. PMID- 1778385 TI - [Latent gastro-intestinal hemorrhages as symptoms of hemorrhagic syndrome in acute leukemia]. AB - A clinicoradiologic investigation of latent gastrointestinal hemorrhages was conducted in acute leukemia patients with the use of 51Cr. A total of 26 patients suffering from varying forms of leukemia with no external hemorrhages were investigated. Latent gastrointestinal hemorrhages were detected in 50% of the patients. A definite relationship has been revealed between the hemorrhage degree and the leukemic process stage, in acute periods of the disease the volumes of gastrointestinal hemorrhages significantly exceed the permissible volumes. The authors have shown that the method of quantitative determination of latent gastrointestinal hemorrhages with the use of 51Cr, due to its accuracy and informative value, can be recommended for practical use and scientific investigations. PMID- 1778386 TI - [Individual prognosis of chronic B-lymphoid leukemia course]. AB - The characteristics of T- and B-lymphocyte content in chronic B-lymphoid leukemia (B-ChLL) patients with progressing and stable variants of the disease course, and the possibilities of their use for the individual prognosis of the course were studied. A total of 28 patients with stable and 35 patients with progressing variants of B-ChLL were investigated. T-(total and active) and B-lymphocytes were assayed in the spontaneous rosette-formation test. The individual prognosing of stable and progressing variants of B-ChLL course is possible basing on integral evaluation of total and active T-lymphocytes and B-lymphocytes with receptors to mouse red blood cells in two-dimensional parameter systems with counting the summary prognostic coefficient. PMID- 1778387 TI - [Analysis of chromosome aberrations and prognosis of bone marrow syndrome severity in acute radiation injuries in man]. AB - Biological dose indication using chromosomal aberrations analysis is a reliable method of diagnosing acute radiation disease and prognosing bone marrow syndrome severity. Cytogenetic methods permit one not only to estimate the mean radiation dose in the subjects exposed that is most important in case of relatively uniform irradiation, but also to reveal the non-uniformity of radiation exposure. Estimation of aberrant cells in bone marrow puncture biopsy specimens obtained from different sites of the hemopoietic tissue and analysis of chromosomal aberrations in peripheral blood lymphocyte cultures can be used for this purpose. Materials including those obtained at the Chernobyl accident were analyzed with the use of the above methods, their advantages and shortcomings are considered, and equations of dose-response curves are presented. PMID- 1778388 TI - [Stem cells, clonality and leukemia]. AB - The data we review suggest newer concepts regarding the biology of leukemia. First, all leukemias may originate in a multipotent stem cells. Second, leukemia phenotype may reflect where the leukemia clone expands rather than the site of transformation. Third, preleukemia may always antedate leukemia. And finally, remission and cure may result from re-establishing preleukemia rather than eradicating leukemia cells of favoring their maturation. Also, leukemia and at least some cases of aplastic anemia may represent different ends of a spectrum of one disease. PMID- 1778389 TI - [Treatment of childhood acute lymphoblastic leukemia with a high risk of exacerbation]. PMID- 1778390 TI - [Neutropenia in newborns. Diagnosis and therapy]. PMID- 1778391 TI - [Alloimmune neutropenia in newborns]. AB - Investigations were conducted in 4 infants with alloimmune neutropenia caused by leuko-agglutinins (2 cases) and granulo-cytotoxins (2 cases) detected in the mothers' and infants' sera. Anti-granulocytic antibodies reacted with granulocytes of the child and father but did not react with the mother's own cells. A more severe clinical course (repeated pyo-inflammatory diseases, sepsis) was recorded in infants with alloimmune neutropenia caused by granulo-cytotoxins, alloimmune neutropenia was characterized by disorders in neutrophil phagocytic activity (mainly, due to decreased digestive capacity of cells), inhibition of colony-forming capacity of precursor-cells of granulocytopoiesis; a tendency to T lymphocytopenia was noted during the study of cellular immunity parameters. Prognosis was favourable in all the cases of neutropenia. The maximum term of neutropenia duration was 6 months. The catamnesis has shown that the development of the infants is normal and they fall ill not often. PMID- 1778392 TI - [Reversibility of the development of malignant lymphoma with 7-years of leukemization, associated with the development of chronic myeloleukemia]. AB - A case of typical Ph-positive chronic myelogenous leukemia developed in a 58-year old female with a 7-year history of chronic lymphoproliferative disease is described. With the second disease progression, the features of lymphoid proliferation disappeared almost completely. Possible causes of this rare combination of two diseases are discussed. PMID- 1778393 TI - [Determination of blood groups in the ABO system using monoclonal antibodies]. PMID- 1778394 TI - [What is the therapeutic effectiveness of organofluorine emulsions substituting in acute blood loss?]. PMID- 1778395 TI - [The 90th anniversary of D. N. Ianovskii's birth]. PMID- 1778396 TI - [Acute leukemia in middle-aged and elderly people]. AB - A total of 98 acute leukemia patients were investigated and 336 case histories were analyzed. All the patients were divided into 5 groups according to their age. Clinicohematological picture of acute leukemia in middle-aged and senile subjects was characterized by low leukemic infiltration of the bone marrow and more pronounced suppression of normal hemopoiesis. PMID- 1778397 TI - [Biochemical and cytochemical criteria for predicting the course of acute lymphoblastic leukemia in children]. AB - Cytochemical parameters of intracellular metabolism of leukemia cells and bone marrow polyamines were studied in 113 acute lymphoblastic leukemia patients aged from 1 to 14 years. The parameters analyzed characterized the severity of the disease course, cytostatic therapy effectiveness and primary resistance. It is shown that determination of biochemical and cytochemical criteria before the beginning of acute lymphoblastic leukemia therapy may be conducive to the correct choice of treatment. PMID- 1778399 TI - Synthesis and post-translational modifications of an epididymal androgen dependent protein family. AB - During the annual cycle of the lizard Lacerta vivipara dramatic changes in the secretory activity of the epididymis were observed. These changes and changes in morphology correlate with the plasma and epididymal testosterone concentrations. The secretory proteins contain a major group of immunorelated components referred to as LI to L1X. They consist of a group of nine proteins Mr 19,000 which can be separated according to pI 3.5 to 8.7. Post-translational modifications may be responsible for their pI diversity. All the L proteins are glycosylated (fucose, N-acetylgalactosamine and or N-acetylglucosamine) but only LVI glycosylation was inhibited with tunicamycin. Phosphorylation is unique to LV protein and none of the L proteins are sulfated. All L proteins appeared sequentially during the annual cycle and in organotypic culture when incubated in the presence of testosterone (150, 500, 1000 nM) in a time dependent manner. PMID- 1778398 TI - Characterization of dissimilar steroid productions by granulosa, theca interna and theca externa cells during follicular maturation in the turkey (Meleagris gallopavo). AB - Unlike the established models for steroidogenesis in the rat and human, we have previously demonstrated that in the turkey progesterone (P), androgen (A), and estrodiol (E) are primarily produced by the granulosa, theca interna, and theca externa cells, respectively. In the present study, experiments were conducted to further characterize steroid productions by these cell types during follicular maturation. In Experiments 1 and 2, granulosa cells and theca internal cells, respectively, from the larger (F1) and fifth largest (F5) preovulatory follicles were incubated (1 x 10(5) cells/ml) with ovine luteinizing hormone (oLH) or porcine follicle stimulating hormone (pFSH) for 5 hr. Granulosa production of P from both follicles was stimulated in response to oLH, with both basal and LH stimulated P production greater in the larger F1 than in the smaller F5 follicle. No A or E production was detected in granulosa cells from either follicle size tested. Theca interna cell productions of P and A were stimulated by oLH in the smaller F5, but not in the larger F1, with both basal and stimulated levels of A greater in F5 than in F1. Medium content of E was non-detectable in cultures of theca interna cells from all follicles tested. In Experiment 3, theca externa cells were incubated (1 x 10(6) cells/ml) from F1 and F5 follicles. The theca interna cells from F5 and the seventh largest follicle (F7) were pooled (1 x 10(5) cells/ml) to provide substrate(s) for theca externa steroidogenesis. Theca externa cells were incubated alone and in combination with the pooled theca interna cells and with or without oLH or pFSH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778400 TI - Variations of vitamin D-like reactivity in the crustacean Orchestia cavimana during the molt cycle. AB - An investigation into vitamin D-like molecules has been performed on whole extracts of the terrestrial amphipod Orchestia cavimana, using a sensitive nonequilibrium assay employing 1,25-(OH)2 D receptor from calf thymus. Relatively large amounts of these secosteroid-like molecules were observed and they varied in concentration according to the stages of the molt cycle. The amplitude of these variations reaches a ratio of about 40 from the minimum in premolt to the intermolt sharp peak. PMID- 1778401 TI - Testosterone levels in the Tasmanian bettong (Bettongia gaimardi). AB - The Tasmanian bettong (Bettongia gaimardi) is a small macropodid marsupial that is a continuous breeder. This study has partitioned testosterone into three fractions that vary to some extent throughout the year, coinciding with peaks and troughs in breeding, body weight, and testes volume. The three fractions determined were free, albumin bound, and sex hormone binding globulin (SHBG) bound testosterone. Concentrations of both albumin and SHBG varied significantly throughout the year with peaks in SHBG coinciding with lowered levels of free testosterone. Testosterone was also measured during maturation of male bettongs. There were significant regressions between weight or testes volume and the combined free and albumin bound testosterone. Maturity started near age 30 weeks and a body weight of 1.5 kg and was accompanied by a brief surge in testosterone levels. PMID- 1778402 TI - Reproduction in the Mexican leaf frog, Pachymedusa dacnicolor. V. Immunohistochemical localization of gonadotropin-releasing hormone in the brain. AB - The presence and distribution of immunoreactive gonadotropin-releasing hormone (GnRH) in brains of adult male and female Pachymedusa dacnicolor has been studied immunohistochemically using antisera against mammalian, chicken-II, and salmon GnRHs. The distribution map of the immunoreactive-GnRH elements in the brain of P. dacnicolor is extremely simple, being limited to the anterior preoptic area infundibulum-median eminence circuit. No sex- or reproductive status-related difference in either the distribution pattern or intensity of immunoreaction was revealed in this study. This is also the first immunohistochemical evidence of the presence of different structural forms of GnRH in the brain of an amphibian. PMID- 1778403 TI - Purification and electrophoretic analysis of glycosylated chicken growth hormone (G-cGH): evidence of G-cGH isoforms. AB - It has been shown that chicken growth hormone (cGH) exhibits functional and molecular heterogeneity. Mass and charge variants have been described in fresh pituitary extracts and in pure preparations of the hormone. In an attempt to further study the molecular heterogeneity of cGH we have purified the glycosylated variant of this hormone by affinity chromatography and analyzed it by different electrophoretic methods. Purification was achieved by homogeneizing chicken pituitaries in a protease inhibitor solution (0.5 mM PMSF and aprotinin, 50 KIU/ml); the supernatant of the alkaline extract (pH 9.5) was precipitated with 0.15 M ammonium sulfate and metaphosphoric acid, pH 4.0. The supernatant from this step was further precipitated with 80% ammonium sulfate, pH 6.5. After dialysis and lyophilization, the extract was chromatographed in a Con A-Sepharose column. The fraction eluted with 10 mM alpha-methylmannoside (which contained the glycoproteins) was passed through an immunoaffinity column (anticGH). Glycosylated cGH (G-cGH) was obtained pure after this step. Pure G-cGH was analyzed by nondenaturing electrophoresis (ND-PAGE), SDS-PAGE, isoelectrofocusing (IEF), and bidimensional electrophoresis (2D-PAGE) followed by Western blot and staining either with a specific antibody or with peroxidated Con A. Results showed that monomeric G-cGH has a MW of 29 kDa (under reducing conditions) and is heterogeneous, showing at least three important charge variants with pIs 6.5, 6.7, and 7.2. Mass variants of G-cGH were also detected under nonreducing conditions. Bidimensional analysis revealed that the charge variants had a similar MW (29 kDa). PMID- 1778404 TI - Effect of triiodothyronine supplementation on thyrotropin-releasing hormone induced growth hormone secretion in sex-linked dwarf and normal chicks. AB - The effect of a dietary triiodothyronine (T3) supplement, of either 0.1 or 0.5 microgram/g of feed, was studied on the thyrotropin-releasing hormone (TRH) induced growth hormone (GH) secretion in sex-linked dwarf (dw) or normal (Dw) chicks of both sexes. In normal chicks, 0.1 microgram/g T3 decreased plasma GH levels before TRH as well as the GH increase after TRH, and 0.5 microgram/g T3 totally suppressed any response to TRH, either at 4 or at 7 weeks of age. Dwarf chicks were more sensitive to TRH than normals when receiving either 0 or 0.1 microgram/g T3; 0.5 microgram/g T3 abolished the difference between genotypes at 4 weeks of age but not so clearly at 7 weeks of age, where dwarf females showed a slight but still significant GH increase after TRH. Interactions between genotype, TRH injection, and T3 treatments were often significant at 4 weeks of age and even more at 7 weeks of age. Dwarf chicks receiving 0.1 microgram/g T3, expected to have normal plasma T3 levels, showed a higher GH response after TRH. This suggests that other hormones may be involved in the regulation of this response, particularly IGF-I, which is known to remain at a low level in T3 treated dwarf chicks. PMID- 1778405 TI - Regulation of secretion of the teleost fish hormone stanniocalcin: effects of extracellular calcium. AB - The release in vivo and in vitro of stanniocalcin (STC) from the corpuscles of Stannius (CS) of the rainbow trout and the European eel was studied. Intraperitoneal injection of CaCl2 (2.45 mmol.kg-1 fish) leads to an elevation of both ionic and total calcium in the plasma and results in the release of STC from the CS into the blood. Release of STC in vitro is not affected at "physiological" (1.0-1.5 mM) or lower Ca2+ levels in the incubation medium. High levels of Ca2+ (2.5 mM and higher), however, stimulate the release of STC, in particular that of stored STC. We hypothesize that variations in extracellular Ca2+ in the normocalcaemic range do not directly regulate STC release. PMID- 1778406 TI - Neuroendocrine regulation of osmotic and ionic concentrations in the hemolymph of the freshwater shrimp Macrobrachium olfersii (Wiegmann) (Crustacea, Decapoda). AB - Putative neuroendocrine mediation of osmotic and ionic responses to acute exposure to high salinity medium was investigated in the freshwater shrimp Macrobrachium olfersii (Wiegmann). Homogenates of supra-esophageal or thoracic ganglia, prepared from shrimps exposed to seawater of 21% S for 6 hr, were injected into the abdominal musculature of shrimps previously exposed to freshwater and subsequently exposed to either freshwater or seawater (21% S). Osmotic, sodium, chloride, potassium, magnesium, and calcium concentrations were determined in hemolymph samples removed by intracardiac puncture at time = 0, 1, 3, or 6 hr after homogenate application. Control shrimps were injected with filtered seawater, isosmotic to the hemolymph, and treated similarly. In control shrimps, the osmotic, Na+, Cl-, K+, Mg2+, and Ca2+ concentrations in the hemolymph increased (P less than or equal to 0.05) after 1-hr exposure to seawater. In shrimps injected with homogenates of supra-esophageal ganglion and exposed to seawater, osmotic and ionic concentrations in the hemolymph did not vary with exposure time; in injected shrimps exposed to freshwater, Na+, Cl-, K+, and Mg2+ concentrations decreased (P less than or equal to 0.05) with time. In shrimps injected with homogenates of thoracic ganglion and exposed to seawater, hemolymph osmotic, K+, and Mg2+ concentrations increased (P less than or equal to 0.05); Na+, Cl-, and Ca2+ concentrations remained unchanged. In injected shrimps exposed to freshwater, hemolymph osmotic concentration alone increased (P less than or equal to 0.05) after 1 hr, all other ionic concentrations remaining unchanged. These data suggest that neurofactors apparently located within the ganglia of the central nervous system of M. olfersii may alter the apparent ionic permeabilities of this shrimp, depending on the salinity characteristics of the external medium. The data support the notion that invasion of the freshwater biotope by estuarine crustaceans has necessitated the evolution of specific physiological mechanisms capable of compensating for the osmotic dilution and ion loss typically encountered by such organisms. PMID- 1778407 TI - Humoral factor mediates acetylcholine-induced endothelium-dependent relaxation of chicken aorta. AB - A superfusion cascade system was used to determine whether endothelium-dependent vasorelaxation induced by acetylcholine (ACh) is mediated by a humoral factor(s) in the domestic fowl. An abdominal aorta (5 cm in length) with intact endothelium, excised from the donor bird, was mounted in an organ bath and perfused with avian Ringer solution. The vasorelaxing activity of the effluent was determined by an endothelium-denuded aortic ring (bioassay ring) equilibrated and precontracted with phenylephrine (PHE) (10(-6) M). The effluent (containing PHE) from the donor aorta with intact endothelium did not significantly change the PHE-induced tension of the bioassay rings. ACh (10(-6) M), when added to the perfusion medium that runs through the control polyethylene tubing, produced further contraction of the PHE-precontracted endothelium-denuded bioassay rings, whereas ACh caused relaxation of the rings when added to the perfusate that passes through the endothelium-intact donor aorta. The ACh-induced relaxation of the bioassay ring was slightly potentiated by superoxide dismutase (100 U/ml). Hemoglobin (10(-5) M) increased the basal tension of the bioassay rings and completely inhibited the ACh-induced relaxation of the rings. These results suggest that ACh-induced relaxation of fowl aorta is, at least partially, mediated by a humoral factor(s) that resembles endothelium-derived relaxing factor demonstrated in mammals. PMID- 1778408 TI - Characterization of a specific estrogen receptor in the oviduct of the little skate, Raja erinacea. AB - In this study we report the first estrogen receptor to be characterized in an oviparous elasmobranch. The skate receptor has high affinity for estradiol (Kd = 0.7 nM), binds both estradiol and the synthetic estrogen DES, and exists in low quantities (50-100 fmol/g oviduct). The receptor displays rapid binding kinetics with half-times of 5 min at 22 degrees and 77 min at 4 degrees. DEAE-Sepharose chromatography reveals one receptor moiety which elutes between 0.13 and 0.14 M KCl. By sucrose gradient ultracentrifugation sedimentation coefficients of 3.6 S under high-salt (0.5 M KCl) and 6.0 S under low salt (0.01 M KCl) conditions were obtained. Using Sephadex G200 gel filtration chromatography, a Stokes radius (Rs) of 2.8 nm and an estimated molecular weight of 43 kDa were calculated. DNA cellulose elution profiles reveal that the receptor elutes as one peak between 0.34 and 0.36 M NaCl (as compared to 0.20-0.22 M NaCl in mammals and birds and 0.55 M for dogfish). Although some differences are noted between the elasmobranch ER and those of other vertebrates (e.g., dissociation kinetics, DNA affinity), in general it can be said that the skate ER is a "classical" ER in most respects. It is suggested that this steroid receptor has played a key role in the reproductive tract functions of nutrient provision, embryo protection, and as a conduit to the external environment since the earliest chordate era, approximately 400 million years ago. PMID- 1778409 TI - The complete amino acid sequences of two variants of growth hormone from Atlantic cod. PMID- 1778410 TI - Gonadotropin-releasing hormone (GnRH) in bony fish that are phylogenetically ancient: reedfish (Calamoichthys calabaricus), sturgeon (Acipenser transmontanus), and alligator gar (Lepisosteus spatula). AB - Three species of fish that are phylogenetically older than other members of the bony fish lineage were selected to determine if gonadotropin-releasing hormone (GnRH) is present in their brains. Brain extracts were prepared from each species and found to contain immunoreactive (ir) GnRH. To further characterize the molecular forms of GnRH in each species, the extracts were injected into a high pressure liquid chromatograph (HPLC). The elution time of each GnRH-like form was compared to those of the synthetic forms of the five known GnRHs. Several antisera were used to detect both the synthetic and unknown GnRHs in the HPLC fractions. All three species of fish had two forms of GnRH: a dominant form that is mammalian GnRH-like (mGnRH), and a minor form of irGnRH material that is similar to chicken GnRH-II (cGnRH-II). The other known forms of GnRH (salmon, lamprey, and chicken-I) were not detected. The appearance in these ancient bony fish of a mammalian-like form of GnRH, which has not been found in the jawless or cartilaginous fish studied to date, suggests that mGnRH arose in a common phylogenetic ancestor of the bony fish and tetrapods. This mGnRH-like molecule is known to have been conserved in the amphibian and mammalian lineage, but not in the reptilian or avian line. In addition, the presence of a cGnRH-II-like molecule in the bony fish examined here, and in the cartilaginous fish studied earlier, implies that this form of GnRH may have been present in an ancestor common to both of these classes of fish. PMID- 1778411 TI - Evaluation of a specific gonadotropin-releasing hormone binding protein in the serum of goldfish: a study on the influence of sex, season, GnRH injection and estradiol treatment in vivo. AB - A gonadotropin releasing hormone (GnRH) binding protein (GnRH-BP) from goldfish serum was isolated and characterized. In the present studies, the differences in serum titer of GnRH-BP between male and female goldfish, and between goldfish at different stages of gonadal development, were investigated. The effects of estradiol (E2) treatment or multiple injections of [D-Arg6-Pro9-NEt]-salmon GnRH (sGnRH-A) treatment on the serum titer of GnRH-BP were also studied. GnRH-BP in individual serum samples was quantified with a ligand binding assay using 125I sGnRH-A as tracer; GnRH-BP-tracer complex was separated from free tracer by gel filtration using Sephadex G-50 mini-columns. GnRH-BP was detected in every individual sample; however, no differences between males and females, nor seasonal changes in either sex, were detected. Serum total protein content doubled with E2 treatment, but no effects of E2 on GnRH-BP titer were detected. Long-term treatment with sGnRH-A stimulated an increase in serum gonadotropin levels; the long-term treatment with sGnRH-A did not alter the serum titer of GnRH-BP. Although the GnRH-BP is present in excess relative to the low concentration of GnRH in goldfish serum, it is not a major component of serum proteins. It is concluded that the serum titer of GnRH-BP was not fine tuned by GnRH, gonadotropin, or estradiol. Therefore physiological regulators have yet to be discovered. PMID- 1778412 TI - Stress and cortisol treatment changed affinity and number of glucocorticoid receptors in leukocytes and gill of coho salmon. AB - To determine whether glucocorticoid receptors were altered during observed changes in immune function after stress or cortisol treatment, we conducted a series of experiments in which juvenile coho salmon (Oncorhynchus kisutch) were acutely or chronically stressed or fed a single meal containing cortisol. We then determined glucocorticoid receptor (GR) binding in cell-free gill preparations and whole leukocytes from spleen and anterior kidney using the synthetic hormone triamcinolone acetonide as radioligand. The affinities of GR were consistently lower in all tissues from chronically stressed fish than in tissues from controls; however, numbers of GR increased in whole leukocytes and decreased in gill. Acute stress had no affect on GR in gill and did not affect the affinity of GR in anterior kidney leukocytes, but did increase the number of GR in those leukocytes. Acute stress reduced affinity and increased numbers of GR in splenic leukocytes, suggesting heterogeneity of response to stress. Feeding cortisol to fish resulted in changes in GR from gill similar to those caused by chronic stress. Incubating leukocytes in cortisol for 3 or 24 h prior to assaying GR resulted in increased number and decreased affinity of GR in anterior kidney leukocytes, but had no effect on cells from spleen. PMID- 1778413 TI - Effects of mammalian gonadotropin-releasing hormone on plasma level of prostaglandin F2 alpha in the water frog, Rana esculenta. AB - The present investigation was performed to evaluate the effects of mammalian gonadotropin-releasing hormone (mGnRH) on prostaglandin F2 alpha (PGF2 alpha) plasma level in adult male and female water frog, Rana esculenta, during three different periods of the reproductive cycle: recovery period (October), breeding period (May), and postreproductive period (June). Intact, hypophysectomized (HYP), gonadectomized (GON), and hypophysectomized-and-gonadectomized (HYP/GON) animals were injected with 0.6 micrograms of mGnRH and sacrificed 1 hr and 5 hr after peptide administration. Some of each of the groups were sacrificed without having received mGnRH. PGF2 alpha plasma levels were assessed by radioimmunoassay. Hypophysectomy induced a significant increase of PGF2 alpha levels in October and June males. mGnRH induced a significant increase of PGF2 alpha plasma levels only in HYP and HYP/GON frogs. The tissue target of this GnRH action is, at present, unknown, although interrenals could be putative responsive tissues. At present, it is also difficult to assign any physiological role to observed phenomena unless to suppose that the pituitary inhibition is not constant throughout the year. It cannot be excluded that the prostaglandin induction depends on a local paracrine action of GnRH, which could be performed outside any pituitary control. PMID- 1778414 TI - Subcellular responsiveness of amphibian growth hormone cells after TSH-releasing hormone stimulation. AB - Pituitary GH cells from adult male Rana perezi frogs were investigated in vivo and in vitro after stimulation with synthetic thyrotropin-releasing hormone (TRH). The volume density (Vv) of the secretory granules (SG), rough endoplasmic reticulum (ER), and Golgi complex (GC), and the numerical density (Nv) of the granules were estimated by ultrastructural morphometry. GH-producing cells were identified by the immunocytochemical colloidal-gold method, using anti-ovine-GH as primary antiserum. The animals involved in the in vivo experiment were given daily injections of synthetic TRH into the dorsal lymph sac. In vitro, hemipituitaries were cultured in a superfusion system. TRH caused cytological changes in GH cells both in vivo and in vitro. In vivo, GH cells showed a 27% decrease in the Nv of the SG after 8 hr of treatment and an increase Vv of the GC (1.6 fold) and ER (2.7 fold) after 48 hr of treatment compared to the cells in control animals. Cells tended to recover control values after 6 days. The in vitro administration of TRH induced a 48% decrease in the number of SG in GH cells after 24 hr, although the development of the biosynthetic machinery (GC and ER) was not enhanced. These results clearly indicate that, at the dose used in vitro, TRH only stimulates the release of GH in the short-term while, in vivo, it promotes long-term synthesis of new hormone. The data obtained suggest that TRH modulates the secretion of GH in amphibians by acting directly upon GH cells, while the effect on the synthesis might be mediated by other hypothalamic factors influenced by TRH. PMID- 1778415 TI - Synthesis of 3-furylmethylpenicillin using an enzymatic procedure. AB - 3-Furylmethylpenicillin was synthesized in vitro from 3-furylacetic acid, 6 aminopenicillanic acid (6-APA), CoA, ATP and Mg2+. The reaction was catalyzed in two steps by the enzymes phenyl-acetyl-CoA ligase (PCL) from Pseudomonas putida and acyl-CoA: 6-APA acyltransferase (AT) from Penicillium chrysogenum. PCL catalyzes the activation of 3-furylacetic acid to 3-furylacetyl-CoA (3-F-CoA) and AT acylates the amino group of 6-APA with the 3-furylacetyl moiety of 3-F-CoA, releasing CoA and 3-furylmethylpenicillin. PMID- 1778416 TI - Chloride fluxes across Acholeplasma laidlawii membranes. AB - Chloride fluxes across the cytoplasmic membrane of Acholeplasma laidlawii were studied by using the chloride sensitive fluorescent dye, 6-methoxy-N (sulfopropyl)quinolinium. Chloride was found to penetrate the membrane passively. Chloride flux was dependent upon the transmembrane electric potential. PMID- 1778417 TI - Specific binding of lactoferrin to Aeromonas hydrophila. AB - The interaction of lactoferrin (Lf) with Aeromonas hydrophila (n = 28) was tested in a 125I-labeled protein-binding assay. The mean per cent binding values for human Lf (HLf) and bovine Lf (BLf) were 13.4 +/- 2.0 (SEM), and 17.5 +/- 2.7 (SEM), respectively. The Lf binding was characterized in type strain A. hydrophila subsp. hydrophila CCUG 14551. The HLf and BLf binding reached a complete saturation within 2 h. Unlabeled HLf and BLf displaced 125I-HLf binding in a dose-dependent manner, and more effectively by the heterologous (1 microgram for 50% inhibition) than the homologous (10 micrograms for 50% inhibition) ligand. Apo- and holo-forms of HLf and BLf both inhibited more than 80%, while mucin caused approx. 50% inhibition of the HLf binding. Various other proteins (including transferrin) or carbohydrates did not block the binding. Two HLf binding proteins with an estimated molecular masses of 40 kDa and 30 kDa were identified in a boiled-cell-envelope preparation, while the unboiled cell envelope demonstrated a short-ladder pattern at the top of the separating gel and a second band at approx. 60 kDa position. These data establish a specific interaction of Lf and the Lf-binding proteins seem to be porins in A. hydrophila. PMID- 1778418 TI - Secretion of oligomeric Val8-human calcitonin by Saccharomyces cerevisiae. AB - Monomeric human calcitonin (hCT) gene and oligomeric hCT genes composed of two, three or four head-to-tail linked monomers were fused in-frame to the yeast alpha factor leader coding sequence wild-type and fragile mutant Saccharomyces cerevisiae strains were transformed with the constructed plasmids and the yield of recombinant protein secreted into the culture medium was measured. The yeast cells secreted equal (molar) amounts of all of the hCT variants. The recombinant proteins remained stable in the growth medium for at least 3 days. The fragile cells secreted about 30% more hCT as compared to the wild-type yeast cells. PMID- 1778419 TI - High level production of Escherichia coli outer membrane proteins OmpA and OmpF intracellularly in Bacillus subtilis. AB - A high yield of Escherichia coli outer membrane proteins OmpA (about 200 mg/l) and OmpF (about 100 mg/l) was obtained in Bacillus subtilis when produced intracellularly. The yield was more than 100-fold higher than the yield of these proteins by a similar vector containing the complete signal sequence of alpha amylase of B. amyloliquefaciens. Both proteins isolated after breakage of the B. subtilis cells by low-speed centrifugation were about 70% pure and could be solubilized by Sarkosyl, SDS and guanidine hydrochloride. PMID- 1778421 TI - The role of the O antigen in adjuvant activity of lipopolysaccharide. AB - Adjuvant activities of isogenic Salmonella enterica, serovar Typhimurium, O-6,7 and O-4,5,12 lipopolysaccharide (LPS), lipid A and Bordetella pertussis LPS were compared by immunizing groups of mice subcutaneously with diphtheria and tetanus toxoid vaccine alone or mixed with one of the LPS derivatives. Five weeks later the mice were bled and the tetanus and diphtheria antibodies in the sera were measured. All the LPS derivatives efficiently increased the antibody responses when compared to the vaccine alone, but the mannose-rich O-6,7 LPS and lipid A were significantly more potent than O-4,5,12 LPS and B. pertussis LPS. We conclude that the quality of the O antigen influences the adjuvant activity of LPS. PMID- 1778420 TI - Detection of hepatitis B virus DNA by polymerase chain reaction in HBsAg negative Senegalese patients suffering from cirrhosis or primary liver cancer. AB - The polymerase chain reaction was used to search for hepatitis B virus (HBV)-DNA sequences in the sera of HBsAg-negative Senegalese patients suffering from liver cirrhosis or liver cancer. Amplified HBV-DNA sequences were detected by hybridization with a digoxigenin-labelled HBV-DNA probe. HBV-DNA was detected in 17% of HBsAg negative Senegalese subjects from the general population and in 44% and 58% of the patients suffering from cirrhosis or primary hepatocellular carcinoma (PHCC) respectively. In the control group, amplified HBV-DNA was detected in 25% of the subjects without HBsAg and anti-HBs antibodies, and in 6% of subjects positive for anti-HBs antibodies. This study confirmed the hypothesis that there is an etiologic link between HBV and PHCC in HBsAg-negative patients. PMID- 1778422 TI - Loss of secreted hemolysin activity in the mutant strain Hsb. 1 is due to a lesion in a plasmid copy number locus. AB - Further studies have been carried out on mutation hsb which was previously suggested to block hemolysin secretion (Munoa et al., 1988, FEMS Microbiol. Lett. 56: 167-172). We show that the reported reduction in the extracellular hemolytic activity of mutant Hsb. 1 is due to lower hemolysin synthesis and that this is itself a consequence of a decrease in plasmid copy number. We suggest that the hsb is identical to the pcnB lesion located at minute 3.6 of the chromosome. PMID- 1778423 TI - Biological characterization of the lytic cycle of actinophage phi A7 in Streptomyces antibioticus. AB - Some basic parameters of the lytic development of phage phi A7 in Streptomyces antibioticus are described. One-step growth experiments demonstrated that at 28 degrees C phi A7 has a latent period of about 60 min and an exponential growth period of about 35 min. The average burst size ranged from 70-100 plaque forming units per infected cell. At the same temperature 50% of the virions were adsorbed to germ tubes of S. antibioticus in about 10 min. This corresponds to an adsorption constant of 6.5 x 10(-10) ml/min. The phage was unable to adsorb the host at other stages of the life cycle (spores or mycelium). Divalent cations are not required for phi A7 stability but Ca2+ proved to be essential for adsorption and also for a later stage of the vegetative development of the phage. PMID- 1778424 TI - Rapid genotyping of the Chlamydia trachomatis major outer membrane protein by the polymerase chain reaction. AB - Twenty one Chlamydia trachomatis reference strains and 40 clinical isolates belonging to the lymphogranuloma venerum (LGV) and trachoma biovars were genotyped by differential restriction mapping of the major-outer-membrane-protein gene (MOMP) obtained by the polymerase-chain reaction (PCR). AluI digestion of the PCR product distinguishes eight MOMP-genotypes corresponding to 8 serovars. Six additional enzymes (NlaIII, CfoI, EcoRI, HinfI, DdeI and FokI) further permit the discrimination of 10 MOMP-genotypes corresponding to the 10 remaining serovars of the species. AluI alone allows direct typing of 78% of the clinical isolates. AluI digestion patterns of mouse C. trachomatis biovar, a C. pneumoniae and two C. psittaci strains, studied for comparison, were clearly distinguishable from one another and from the C. trachomatis LGV and trachoma strains. These results indicate that MOMP genotyping by PCR is a valuable molecular tool for studying C. trachomatis epidemiology. PMID- 1778425 TI - Cloning and nucleotide sequencing of the gene encoding the beta-lactamase from Citrobacter diversus. AB - The gene coding for the class A beta-lactamase of Citrobacter diversus has been cloned and sequenced. It contains the information for a 294-amino-acid precursor protein, including a 27-residue N-terminal signal peptide. The deduced sequence of the N-terminal portion of the mature protein is in excellent agreement with that determined by microsequencing of the protein and readily explains the pI differences observed between the naturally occurring forms I and II of the enzyme. The sequence of the mature protein exhibits a very high degree of similarity with that of the Klebsiella oxytoca class A beta-lactamase. PMID- 1778426 TI - Mutagenesis of the cyanobacterium Spirulina platensis by UV and nitrosoguanidine treatment. AB - The production of Spirulina platensis cells resistant to 8-azaguanine or beta-(2 thienyl)-DL-alanine following mutagenesis with N-methyl-N'-nitro-N nitrosoguanidine (MNNG) and UV-irradiation is described. The conditions for the mutagenesis were determined by monitoring cell viability and the appearance of the two types of mutants as a function of the stage of growth of the tricomes and the length and the conditions of the treatment. The optimal conditions for UV and MNNG mutagenesis were found to be 1-3 min irradiation and 30 min incubation with 50 micrograms MNNG/ml of tricomes derived from cultures entering stationary phase sonicated for 10 s and 5 s respectively. Under these conditions beta-(2-thienyl) DL-alanine-resistant mutants appeared at a frequency greater than or equal to 10( 4) and greater than or equal to 10(-5) following UV- and MNNG-mutagenesis, respectively. Mutants resistant to 8-azaguanine were found at a frequency approx. 10(-5) only after MNNG mutagenesis. A few chlorate-resistant mutants were also obtained following UV treatment. PMID- 1778428 TI - Subcellular localization of glutamate dehydrogenases and alanine aminotransferase in epimastigotes of Trypanosoma cruzi. AB - The subcellular localization of NAD- and NADP-linked glutamate dehydrogenases (GDH-NAD and GDH-NADP), alanine aminotransferase (ALAT) and aspartate aminotransferase (ASAT) in epimastigotes of Trypanosoma cruzi was studied by digitonin extraction from whole cells, subcellular fractionation by differential centrifugation and isopycnic ultracentrifugation. All enzymes presented both a cytosolic and a mitochondrial form; in addition, GDH-NADP seems to have a third, still undefined, localization. The results are compatible with the existence of two pathways for the production of L-alanine linked to the reoxidation of glycolytic NADH, one operative in the mitochondrion and the other in the cytosol, and perhaps responsible for the existence of the two alanine pools detected by 13C-nuclear magnetic resonance (B. Frydman et al., Eur. J. Biochem. 192 (1990) 363-368). PMID- 1778427 TI - B-lymphocyte mitogenicity and adjuvanticity of an ornithine-containing lipid or a serine-containing lipid. AB - An ornithine-containing lipid (Orn-L) or a serine-containing lipid (Ser-L) from Flavobacterium meningosepticum exhibited strong mitogenicity for the splenocytes from both LPS-responder C3H/HeSlc and LPS-low-responder C3H/HeJ mice. The potency of the lipoamino acids was the same as that of LPS for responder mice. The lipoamino acids were B-lymphocyte mitogens. Furthermore, Orn-L or Ser-L exhibited strong adjuvanticity. Compared with the adjuvanticity of LPS, the activity of Orn L was rather high. Based on these data, together with the previously reported data of macrophage activation, we propose that the lipoamino acids are non-toxic, potent immunoactivators. PMID- 1778429 TI - Expression of nrdA and nrdB genes of Escherichia coli is decreased under anaerobiosis. AB - By using plasmid nrdA-lacZ, nrdAB-lacZ, and nrdB-lacZ gene fusions, the expression of nrdA and nrdB genes of Escherichia coli under anaerobiosis has been studied. The results obtained show that cells of E. coli growing under either fermentative or nitrate respiring conditions present a lower basal level of both nrdA and nrdB genes transcription from the nrdPA promoter. On the other hand, transcription of the nrdB gene from the internal nrdPB promoter was not affected by the absence of oxygen. Moreover, the DNA damage-mediated inducing factor of these nrd genes was the same in both aerobic and anaerobic cultures. PMID- 1778430 TI - Relationships between phosphatidylcholine content, chitin synthesis, growth, and morphology of Aspergillus nidulans choC. AB - The phosphatidylcholine (PC) content of Aspergillus nidulans choC was varied by growing the auxotroph in medium containing various concentrations of choline chloride. Direct linear correlations were observed between PC content and in vivo chitin synthase activity, between in vivo chitin synthase activity and mean hyphal extension rate, and between mean hyphal extension rate and hyphal growth unit length; hyphal growth unit length is a measure of hyphal branching. Further, there was a correlation between PC content and colony radial growth rate. Thus, membrane composition is an important determinant of both hyphal (and colony) extension rate and mycelial morphology. PMID- 1778431 TI - Direct amplification and sequencing of the 16S ribosomal DNA of an intracellular Legionella species recovered by amoebal enrichment from the sputum of a patient with pneumonia. AB - DNA coding for the 16S rRNA of an intracellular bacterium was directly amplified from lysed cells of a host amoebae using the polymerase chain reaction and primers specific for eubacteria. The amoebae had been used to recover an uncultured bacterium observed in the sputum of a patient with pneumonia. The amplified DNA was sequenced directly and compared with published 16S rRNA sequences. The analysis revealed that the intracellular bacterium is a member of the genus Legionella and that it is different from species, including L. pneumophila, for which 16S ribosomal RNA sequence data are available. PMID- 1778432 TI - Taxonomic considerations of Bartonella bacilliformis based on phylogenetic and phenotypic characteristics. AB - The 16S-rRNA gene of Bartonella bacilliformis was amplified using the polymerase chain reaction (PCR). The amplification product was sequenced using a linear-PCR procedure and compared with other published 16S-rRNA sequences. The results of this analysis placed B. bacilliformis in the alpha subgroup of the proteobacteria, and more specifically demonstrated its close phylogenetic relationship to Rochalimaea quintana. This relationship is supported by similarities in the size and mean base composition of the genomes of the two species, and by shared phenotypic characteristics. PMID- 1778433 TI - Molecular cloning and genetic analysis of the rfb region from Shigella flexneri type 6 in Escherichia coli K-12. AB - The rfb gene cluster which determines the biosynthesis of the Shigella flexneri serotype 6 O-antigen specificity has been cloned in pHC79, generating plasmids pPM3115 and pPM3116. These plasmids mediate expression, in Escherichia coli K-12, of lipopolysaccharides (LPS) immunologically similar to the S. flexneri type 6 LPS as judged by SDS-PAGE and Western-immunoblot analysis using S. flexneri type 6 specific antisera. Thus, unlike other S. flexneri serotypes, no additional loci are required for serotype specificity. This expression is independent of E. coli K-12 rfb genes. Southern-hybridization analysis using the 16.2-kb BglII probe from S. flexneri type 6 rfb region detected very little sequence homology in S. flexneri serotypes 1-5, however, some homology was detected with E. coli O2 and O18, but not in E. coli 0101 strains, Salmonella and Vibrio cholerae. PMID- 1778434 TI - Rapid detection and counting of single bacteria in a wide field using a photon counting TV camera. AB - Using Escherichia coli as a model bacterium, we tested a photon-counting method for enumeration of bacteria. This method is based on the principle that microscopic sized luminous particles in a wide field can be directly detected and counted using a photon-counting TV camera without the use of a microscope. E. coli cells were labeled with peroxidase and luminescence induced by adding a luminol-based reaction mixture. The number of luminous spots in the TV images was in good agreement with the number of bacterial colonies grown from labeled cells. The results show that our method provides a rapid and easy microbial counting system for such purposes as clinical diagnosis, microbial analysis in food, and environmental assessment. PMID- 1778435 TI - Ultrastructure of Chlamydia pneumoniae in cell culture. AB - The electron microscopic appearance of Chlamydia pneumoniae elementary bodies with pear-shaped, loose outer membrane has been suggested as one criterion of its classification as a new chlamydial species. The study of the original strain TW 183 in LCL 929 and HL cells and a low-passage isolate of Kajaani-6 isolate in HL cells revealed spherical compact elementary bodies common to other chlamydia. PMID- 1778436 TI - Degradation by Streptomyces viridosporus T7A of plant material grown under elevated CO2 conditions. AB - The biodegradability of plant material derived from wheat grown under different concentrations of atmospheric CO2 was investigated using the lignocarbohydrate solubilising actinomycete, Streptomyces viridosporus. Growth of S. viridosporus and solubilisation of lignocarbohydrate were highest when wheat grown at ambient CO2 concentrations (350 ppm) was used as C-source. Growth of S. viridosporus and solubilisation were reduced when the plant material was derived from wheat grown at 645 ppm CO2. The results suggest that modifications in plant structure occur when wheat is grown under conditions of elevated atmospheric CO2 which make it more resistant to microbial digestion. PMID- 1778437 TI - Comparison of carbohydrate substrate preferences in eight species of bifidobacteria. AB - Eight species of bifidobacteria were tested for their abilities to grow on a range of monosaccharides (glucose, arabinose, xylose, galactose and mannose). In contrast to the other sugars, glucose and galactose were utilized by all species and, in general, specific growth rates were highest on these sugars. Different substrate preferences were observed between species when the bacteria were grown in the presence of all five monosaccharides. For example, glucose and xylose were coutilized by Bifidobacterium longum, whereas glucose repressed uptake of all other sugars in B. bifidum and B. catenulatum. Galactose was the preferred substrate with B. pseudolongum. In B. angulatum, glucose and galactose were utilized simultaneously. B. breve did not grow on arabinose when this sugar provided the sole source of energy. However, glucose and arabinose were preferentially taken up during growth on sugar mixtures. PMID- 1778438 TI - Enterococcus faecalis: specific and non-specific interactions with human polymorphonuclear leukocytes. AB - In previous studies we have demonstrated that the ability of Enterococcus faecalis to adhere to and to be internalized in human urinary tract epithelial cells, Girardi Heart cells and human polymorphonuclear leukocytes (PMNs), was dependent on whether the strain had been isolated from urinary tract infections (UTI) or endocarditis (EN) respectively. These properties were further modified by growth of the organism in human serum. In the present report, using competition assays we show that adhesins containing a D-glucose moiety play a role in mediating the interactions between human PMNs and E. faecalis strains isolated from UTI and grown in brain-heart infusion broth (BHIB). On the other hand, adhesins containing both D-glucose and D-galactose moieties were involved in the interactions between PMNs and serum grown UTI isolates or EN isolates grown in either BHIB or human serum. Moreover, the impairment in the association between both UTI and EN strains after growth in serum appears to be at least partially related to a decrease in enterococcal surface hydrophobicity. PMID- 1778439 TI - Vanadate-resistant mutants of Candida albicans show alterations in phosphate uptake. AB - Phosphate uptake studies in different strains of the dimorphic pathogenic yeast Candida albicans were undertaken to show that this yeast actively transported phosphate with an apparent Km in the range of 90-170 microM. The uptake was pH dependent and derepressible under phosphate starvation. Vanadate-resistant (van) mutants of C. albicans showed a 20-70% reduction in the rate of phosphate uptake in high phosphate medium and was associated with an increased Km and reduced Vmax. The magnitude of derepression under phosphate starvation was different between van mutants. These results demonstrate that van mutants may have developed resistance by modifying the rate of entry of vanadate. PMID- 1778440 TI - Occurrence of poly-D(-)-3-hydroxyalkanoates in the genus Bacillus. AB - A range of Bacillus strains were examined for their ability to accumulate poly-D( )-3-hydroxyalkanoates (poly-HAKs) which are naturally occurring materials that are optically active, biodegradable thermoplastics. The organisms could produce poly-D(-)-3-hydroxybutyrate (poly-HB) up to 50% of cell dry weight. The content of poly-HB in the cells varied with the growth conditions. The addition of propionate or valerate in the culture resulted in a synthesis of poly-D(-)-3 hydroxyvalerate (poly-HV). All the strains tested had the ability to synthesize the co-polyester poly-HB-co-HV. PMID- 1778441 TI - Structural similarity and distribution of small cryptic plasmids of Lactobacillus curvatus and L. sake. AB - Plasmid profiles of strains of Lactobacillus curvatus and L. sake isolated from meat or sauerkraut were analysed to investigate plasmid homology and distribution in relation to the ecology of these organisms in fermenting foods. A hybridisation probe was constructed by cloning of pLc2, a cryptic, 2.6-kbp plasmid from L. curvatus LTH683, into the Escherichia coli plasmid pRV50. In Southern hybridisations with the digoxygenine labeled pLc2 probe, pLc2-related small plasmids were frequently detected in meat-borne strains of L. casei subsp. pseudoplantarum, L. curvatus, L. sake, L. alimentarius, L. farciminis and L. halotolerans and in L. curvatus and L. sake isolated from sauerkraut. Among 27 Lactobacillus type strains originally isolated from habitats other than meat this type of homology was detected only with plasmids of L. buchneri and L. mali. Restriction-enzyme mapping of six small cryptic plasmids from L. curvatus and L. sake revealed strong structural homology but no similarity to previously characterized plasmids of lactobacilli. The presence of a variable region in addition to a conserved one and the occurrence of deletions during cloning of pLc2 suggest that vectors derived from these plasmids are likely to be structurally unstable. PMID- 1778442 TI - Relatedness of penicillin-binding proteins from various Listeria species. AB - The heterogeneity of penicillin-binding proteins (PBPs) of five Listeria species was investigated. Similarities in the overall PBP pattern were found between those of L. welshimeri and L. innocua, and between L. ivanovii and L. seeligeri, and all were distinct from the PBPs of L. monocytogenes. In all species, however, the primary target for beta-lactam antibiotics, as identified in L. monocytogenes recently, appeared highly conserved. In addition, the low-Mr PBP 5 was biochemically very similar in all strains and contained identical binding properties to beta-lactam compounds, suggesting that this protein may play an important role. All other PBPs varied considerably in their penicilloyl-peptide pattern, indicating differences in their amino acid sequences. PMID- 1778443 TI - An analysis of the extracellular xylanases and cellulases of Butyrivibrio fibrisolvens H17c. AB - The extracellular xylanase and cellulase components of Butyrivibrio fibrisolvens H17c were investigated. Two major peaks of enzyme activity were eluted by hydroxylapatite chromatography and designated complex A (CA), having cellulase activity, and complex B (CB) having predominantly xylanase activity but with some activity on carboxymethyl cellulose (CMC). CB was further purified on a DE-52 column and subjected to gel filtration. The xylanase and CMCase activities eluted in a single peak with an apparent molecular mass greater than thyroglobulin (Mr 669,000). CMC xymograms of polyacrylamide gels electrophoresed under non denaturing conditions indicated the presence of five bands with CMCase activity from CA and eight from CB. Xylan xymograms under the same conditions indicated the presence of four bands of activity in CB. Under mild denaturing conditions the xylanase activity in CB was found in 11 bands with molecular mass ranging from 45 to 180 and the CMCase activity in three bands with molecular mass ranging from 45 kDa to 60 kDa. This indicates that CB exists as a multi-subunit protein aggregate of xylanases, some of which also have cellulase activity. PMID- 1778444 TI - Environmental signals induce major changes in virulence of Shigella spp. AB - Growth conditions play a major role in expression of virulence by Shigella spp. both in vitro (adherence and internalization in eukaryotic host cells) and in vivo (keratoconjunctivitis). Optimized expression of virulence required anaerobic growth to log phase in particular media such as brain heart infusion broth. Kinetic studies of guinea pig eye infections showed that as few as 2 x 10(5) S. dysenteriae CG097 or S. flexneri M90T, grown under these optimized conditions, produced keratoconjunctivitis in 15 h. In vitro studies demonstrated that adherence to and invasion of Henle 407 cells, at 37 degrees C, by organisms grown under these optimized conditions, were significantly greater than when organisms were grown aerobically under the same conditions. PMID- 1778445 TI - The attachments of children in foster care. AB - Subjects for this research were 52 foster children (mean ages 7 years, 11 months) and their natural and foster parents. Case history files provided information concerning reasons for placing the children in foster care. Foster parents completed the Parent/Child Reunion Inventory (Marcus, 1988) measuring the "quality of reunion behavior" following separation. Foster mothers also completed the Child Behavior Checklist (Achenbach & Edelbrock, 1983), and measures of adult empathy were collected from both foster parents. Foster care workers rated the quality and intensity of attachment between the child and all parents. Finally, foster children were interviewed concerning their social supports, perception of affection from adults, and the quality of their relationships with adults and friends. Results showed that behavior and school achievement problems were predictable from measures of the quality of attachment with parents. The mean number of behavior problems of foster children were found to be midway between clinical and nonclinical norm groups. Children's perceptions of friends' behavior and degree of control over friends were related to their adjustment. Case history variables were also related to behavior problems and attachment. PMID- 1778446 TI - Making it on the streets in Bogota: a psychosocial study of street youth. AB - In this study, we investigated the perceptions of the life situations, experiences, psychosocial characteristics, and environments of 94 street youth in Bogota, Columbia. We outlined the implications of our results for developmental theory, psychosocial competence theory, future research, public policy formation, program development, and direct intervention. PMID- 1778447 TI - A developmental comparison of the effectiveness of encoding tasks. AB - In Experiment 1, the free-recall performance of young children, college students, and older adults was examined. Subjects encoded words by simply learning them, by studying them in either base or elaborate sentence frames, or by constructing sentences. Overall recall was better for the college students than for the children or for the older adults, and the college students recalled best in the simple learning condition. The young children recalled best in the sentence construction condition; recall by older adults did not vary as a function of the encoding tasks. In Experiment 2, college students and older adults recalled a categorized list, encoding the words by simply learning them, by studying them in elaborate sentence frames, or by completing word fragments. For both age groups, simple learning produced the highest level of recall. These results suggest that organization provides the most effective encoding system and that older adults may need a more obvious basis for organization than do younger adults. Younger and older adults recalled equally well only when organization was discouraged by conceptual processing. PMID- 1778448 TI - [Cloning of genes degrading 3-chlorobenzoate from Pseudomonas putida strain 87]. AB - The ability of Pseudomonas putida strain 87 to catabolize 3-chlorobenzoate was shown to be mediated by genes of pBS109 plasmid. The plasmid may be transferred by conjugation into P. aeruginosa PAO2175. It seems possible that the pBS109 plasmid codes for pyrocatechase II specific for halogenated catechol, but not catechol. The genes specifying utilization of 3-chlorobenzoate from pBS109 plasmid were cloned in the 5.5 kb BgIII fragment by using broad-host cloning system. The resulting pBS110 plasmid was transferred into P. putida, which results in utilization of 3-chlorobenzoate by transconjugants. PMID- 1778449 TI - [A replication enhancer of viral origin increases the mitotic stability of yeast transformants]. AB - It is shown in this paper that a DNA fragment of Hepatitis B virus possessing structural features of yeast replication enhancer increases the mitotic stability of yeast transformants containing hybrid plasmids of episomal and replicative types. The mitotic stability of transformants with plasmid of the replicative type and with the replication enhancer increases only in [cir+] cells. Comparison of primary sequences of HBV DNA of different subtypes revealed that only DNA has unique structural features of the yeast enhancer of replication. PMID- 1778450 TI - [Temperature control of the crossing-over frequency in Drosophila melanogaster. Effect of infra- and super-optimal shock temperatures in early ontogenesis on the recombination frequency]. AB - Effect of temperature shock treatments (0 and 37 degrees C) in early ontogenesis on recombination frequency was studied in two strains of Drosophila X1 and X2. Recombination frequency under treatment with temperature of 0 degrees C and 37 degrees C (shock treatment), as well as at 14 degrees C and 29 degrees C nonshock treatment was found to be dependent on strain genotype, the chromosomal segments under consideration, developmental stage and the age of individuals analysed. Shock treatments usually increase recombination frequency, whereas nonshock treatments lead to unstable and variable recombination frequencies. A concept of ontogenic homeostasis of recombination has been introduced. It is assumed that the effect of temperature treatments on recombination frequency is indirect--i.e. physiologically mediated. PMID- 1778451 TI - [Adaptability of experimental populations of Drosophila melanogaster in directed and stabilizing selection]. AB - Stabilizing selection for a set of morphometric wing traits was combined with directional selection for increased expression of radius incompletus (ri) mutation of Drosophila melanogaster. Three experimental regimens were used: directional and stabilizing selection (stabilized lines); directional selection (unstabilized lines); no selection (control lines). The dynamics of two fitness associated parameters (coefficient of fluctuating asymmetry and population size) was registered during the experiment. At the end of experiment, selection competitive ability test was carried out. The competitive indices did not significantly differ under various treatments, while fluctuating asymmetry was significantly lower in stabilized than in unstabilized lines. Average population size was greater in stabilized lines as compared to the unstabilized ones. The possible causes for these differences are discussed. PMID- 1778452 TI - [Ontogenesis of animals from the position of absence of self-maintaining synthesis of regulatory proteins]. AB - The starting point of this paper is that there is no self-maintenance of most tissue-specific regulatory proteins. There in only one cycle within regulatory genes hierarchy--"germ line" cycle ensuring the next generation ontogeny. The consequences of this are stage-specificity of gene expression and organism ageing. To explain the existence of long-living differentiated cells, we assume that certain genes cause specific repression of mRNAs encoding regulatory proteins, thereby stabilizing the mRNAs. On the contrary, the mRNAs encoding regulatory proteins necessary for proliferation are to be translated due to growth factors. If one of the genes encoding such mRNAs acquires a foreign (viral, for example) promoter, the cell will divide infinitely; this can explain a number of nuclear proto-oncogenes properties. From this view-point, cell proliferation and differentiation, ontogeny and regeneration are considered. PMID- 1778453 TI - [Trigger approach to proliferation, aging, and immortalization of animal cells]. AB - It is proposed that the expression regulation system of a nuclear protooncogene behaves as a trigger, its mRNA stability depending on growth factors. If cells can proliferate, the system tends towards one of stable stationary states. Since transcription does not take place during mitosis, the amount of protooncogene products is rapidly decreased (they are extremely unstable). When mitosis terminates, the system can tend towards either the former state (i.e. it recycles) or another stable stationary state. The system can not pass from the latter state to the former one, if even growth factors are added, i.e. such a cell is terminally differentiated. A cell population should have a limited doubling potential. If a nuclear protooncogene acquires a foreign promoter, then the system will have a single stable stationary state; such cells are unable to become terminally differentiated. If the gene loses mRNA-destabilizing sequences, then the terminal differentiation probability will become far less than formerly. Mutations of genes for proteins digesting specifically the protooncogene mRNAs should lead to the same effect. Any of the events should cause cell immortalization. PMID- 1778454 TI - [Features of adrenal gland and gonadal reactions in mice with a genetic predisposition to dominance under zoo-social stress]. AB - Intensity and duration of endocrine responses of adrenals and gonads in QT, CBA/Lac male mice and heir first generation reciprocal hybrids (F1) mice, social stress were studied. PT males had higher level of corticosterone in 1 h after stress, the adrenals and gonads reactions being some hrs shorter, as compared with CBA/Lac mice. No differences were observed in dynamics among reciprocal hybrids. They inherited not only high capacity to dominance in micropopulations but also reactions of adrenal activation and gonadal inhibition. Similar results were obtained, when these features were studied in dominant and subordinate males of PT strain mice. PMID- 1778455 TI - [An attempt to locate the gene for congenital cataracts using linkage analysis]. AB - Analysis of linkage between the gene of autosomal dominant congenital cataract and 10 polymorphic loci localized in 1, 2, 3, 4, 6, 13, 16 chromosomes was performed. Some loci were only informative for this purpose: Mucin located in 1q21, NH24 located in the 2-nd chromosome and Pi located in 1q21 32.17. No linkage was observed for the cataract gene and the loci located in chromosomes 1 and 2. The maximum estimate of likelihood is approx. 0.2 for the cataract gene and the Pi locus located in 14q32.1, though the value of the maximal lod score was only, 0.732. PMID- 1778456 TI - [Automated information-diagnostic system for hereditary diseases in childhood]. AB - This article describes computer-based information-and-diagnostic system dealing with child hereditary diseases which makes in possible to organize automated consultative service on a wide range of monogene and chromosome syndromes. The system is oriented for sorting out a narrow differential-and-diagnostic row from 1200 of genetically determined diseases at the stage of pre-laboratory child examination. The choice of diagnoses in the system is based on the analysis of the likeness of phenotypical manifestation of the syndromes described in literature with the case under analysis. The system envisages information exchange with a physician in a dialogue using the natural language. The system is based on IBM-370 computer and can be operated from remote video device in the data TV transmitting mode. PMID- 1778457 TI - [Manifestation of antimutagenic activity of "dark" repair under alternative levels of aeration of UV-irradiated bacteria]. AB - The cease of aeration of UV-irradiated bacteria incubated in glucose-salt medium does not affect antimutagenic activity of excision repair in Escherichia coli cells but strongly inhibits that in Bacillus subtilis cells. It has been suggested that these differences are connected with various possibilities for energy (ATP) production in facultative anaerobe, which is E. coli, and obligate anaerobe, Bac. subtilis. The absence of noticeable influence of the aerobiosis--- anaerobiosis shift on the kinetics of disappearance of potential mutations in E. coli cells is interpreted in terms of existence of a mechanism regulating the expenditure of cell energy reserve upon repair process. It is suggested that the low rate of disappearance of potential mutations observed in post-irradiation conditions favourable for protein synthesis is a consequence of limited supply of energy to repair process at some sites of cellular DNA, due to great expense of energy for protein synthesis. PMID- 1778458 TI - [Genetic control of phenoloxidase in the imago of Drosophila melanogaster]. AB - The A1 component of Drosophila melanogaster phenol oxidase is controlled by an independent structural gene which has been located by the method of recombination mapping on the second chromosome at 67.3. The Dox-A1 is the only one from the group of genes coding for phenol oxidase in Drosophila which is expressed at the imago stage. The activity of phenol oxidase depends on the level of gene Dox-A1 expression and also on the presence in haemolymph of proenzyme activators. Males have a minimum level of phenol oxidase activity, which possibly protects them from mechanical damages of cuticle and toxic effects. Females are characterized by a higher level of A1-phenol oxidase activity than males. This may be caused by their reproduction function. PMID- 1778459 TI - [Ecdysone-dependent changes in the activity of ontogenetic puffs in the salivary glands of Drosophila cultivated in vitro as regards the effect of heterosis and selection of adaptively significant characters]. AB - Regression of 4 intermolt and induction of 14 early ecdysone puffs in two inbred stocks of Drosophila with high (HA) and low (LA) activity and hybrid F1 HA x LA were studied. Experiments were performed in vitro with ecdysone-containing media. Differences in developmental rate and fitness of stocks HA, LA and their hybrid were shown to correlate with the rate of change in polythene chromosomes puffing activity. Adaptive heterosis and ontogenetic homeostasis mechanisms are under discussion in connection with the results obtained. PMID- 1778460 TI - [Inversion polymorphism in populations of Drosophila lummei, Hackman]. AB - Four population inversions have been revealed in the chromosomes set of Drosophila lummei, Hackman, two of them being found for the first time. The new inversions (5S and 5R) are only typical of individuals from the Finnish population. The lines analysed are heterogeneous for inversions 4R and 4S. Individuals with the inversion 4R outnumber those with the 4S. In the USSR we found no predominance of these inversions in the D. lummei populations. The breaking points of the new inversions (5S and 5R) were located, and the boundaries of earlier described inversions in chromosome 4 were specified. PMID- 1778461 TI - [Non-random distribution of spontaneous and high temperature-induced recessive lethal mutations in the X-chromosome of Drosophila]. AB - Frequency and localization of spontaneous and induced by high temperature (37 degrees C) recessive lethal mutations in X-chromosome of females belonging to the 1(1) ts 403 strain defective in synthesis of heat-shock proteins (HSP) were studied. No differences in frequencies of both spontaneous and induced lethals between 1(1) ts 403 and control strain were found, thus implying that the disturbances in HSP synthesis have no effect on this process in oocytes of Drosophila melanogaster females. Surprisingly, distribution of spontaneous and induced lethals along the X-chromosome of 1(1) ts 403 strain appeared to be non random: they primarily are located in its distal portion (1-44 cM of genetic map or in I-II sections of the Bridges cytogenetic map). This correlates with non random distribution of mobile elements in the X-chromosome of D. melanogaster (Leibovich, 1990). PMID- 1778462 TI - [Intracranial allometry and craniologic changes during domestication of silver foxes]. AB - Skull proportions and pattern of intracranial allometry in farm foxes of bred domesticated populations are compared. Changes in skull measurements and bivariate allometry are observed in domesticated males, which in this respect become closer to domesticated females. The changes in the allometry pattern in the domesticated population points to deep modifications of regulatory ontogenetic processes which underlie the allometric growth. However, morphological changes in domesticated foxes cannot be only accounted for by allometry. PMID- 1778463 TI - [Empirical estimation of recurrence risks in multifactorial diseases with variable age-at-onset: conditional probability approach]. AB - Conditional probability approach in estimation of recurrence risks considered in the report is naturally extended to the case of diseases with variable age-at onset which are divided into many age-at-onset incompatible classes, the distribution of families for classes of affected and normal siblings being polynomial, modified with regard both for classes by age manifestation and for age of relatives at the moment of observation. This case is realised within the framework of the so called "life-table" approach of general use in demography. It is emphasized that the estimate of "accumulated morbidity" obtained within this framework--as a resulting estimate of "forthcoming risk" for individuals which are at premanifestational age--is the "a posteriori" probability for relatives to be affected by the disease. It is indicated that conditional probability approach, being free of any biological models of the disease origin, is not free of ascertainment models: different kinds of stratifications of the patients for the features related to their ascertainment as probands (age-at-onset, age by the time of observation, sex, birth order, etc.) can naturally generate inconsistency of the ascertainment probability pi both within and among the families, violating the independence of the ascertainment of patients as probands. In this connection, the maximum likelihood equations are given for estimation of the ascertainment probabilities of different incompatible groups of patients as probands and the necessity to account for possible differences in pi-s is pointed out. PMID- 1778464 TI - [Serologic polymorphism of the HLA Class 2 antigens in the Russian population]. AB - Two hundred and thirty Russian Moscovities (108 healthy individuals and 122 cadaver kidney donors) were typed for antigens HLA-DR1-DRw10, HLA-DRw52-DRw53, and HLA-DQw1 and DQw3. HLA-DR1, 2, 3, 4, 5 and 7 were investigated in all individuals, the other having been only studied in portions of the material. The HLA class 2 antigens' polymorphism in Russian population has been shown to have features common to all Caucasians. Most widely distributed antigen is DR2 (phenotype frequency is 36%). Antigens DRw8, DR9 and DRw10 are rare. DR allele distribution demonstrated perfect fits to Hardy--Weinberg expectations. Antigens DR5 and DR4 are considered most difficult to define at early stage of the study. PMID- 1778465 TI - [Sequences homologous to the suffix from the Drosophila melanogaster genome in the DNA of other organisms]. AB - Sequences homologous to the suffix repeat involved in 3'maturation of many Drosophila melanogaster genes have been searched in various organisms by molecular hybridization technique. Several species from evolutionary close and distant to Drosophila melanogaster taxons have been found to contain homology with the suffix in their genomes. PMID- 1778467 TI - "Portraying" of plant genomes using polymerase chain reaction amplification of ribosomal 5S genes. AB - Nontranscribed spacers of plant genes coding for ribosomal 5S RNA were amplified using the polymerase chain reaction. Primers were synthesized that were complementary to 3' (direct) and 5' (reverse) ends of the coding region and that are universal for higher plants. The patterns of polymerase chain reaction products are species and, sometimes, variety specific. The use of this approach for identification of barley 5S genes in chromosome-addition lines of wheat is discussed. This principle can be applied for the "portraying" of other tandem repetitive genes containing divergent regions. PMID- 1778466 TI - A centromeric satellite DNA in the European plethodontid salamanders (Amphibia, Urodela). AB - A highly repeated satellite DNA (Hy500) located in the centromeric heterochromatin of the European plethodontid salamander Speleomantes (formerly Hydromantes) was studied. The Hy500 family represents about 1% of the Speleomantes supramontis genome and has a major repeating unit of about 500 base pairs, which may have evolved from the progressive amplification of shorter sequences. This centromeric satellite is conserved in all the Speleomantes species, which nevertheless show distinct patterns of chromosomal distribution, which are of relevance as to their phylogenetic relationships. PMID- 1778468 TI - No character displacement for reproductive isolation between Drosophila bipectinata and Drosophila malerkotliana. AB - To test whether character displacement for reproductive isolation between Drosophila bipectinata and Drosophila malerkotliana exists, the degree of sexual isolation was measured between their sympatric and allopatric populations. Although the isolation indices vary in different crosses, the average isolation index for sympatric populations is very close to that for allopatric populations. This shows no difference in the degree of sexual isolation between sympatric and allopatric populations of D. bipectinata and D. malerkotliana. Thus there is no evidence for the existence of character displacement for sexual isolation between these two closely related sympatric species. PMID- 1778469 TI - The desynaptic mutant of maize as a combined defect of synaptonemal complex and chiasma maintenance. AB - The phenotype of the desynaptic (dy) mutant of maize in microsporocytes at meiotic prophase was compared with normal microsporocytes of a closely related strain and with microsporocytes of a maize inbred line (KYS) assumed to be normal. Strikingly more univalents and open arms of bivalents were found in the mutant cells than in normal cells at diakinesis, and where there was heterozygosity for a distal knob (heterochromatic region), separation was usually equational, indicating the occurrence of normal crossing-over followed by failure of chiasma maintenance in the mutant. Differences found in the mutant by electron microscopy were a statistically significant wider dimension of the synaptonemal complex central region and also less twisting of synapsed configurations at pachytene. It is suggested that these are side-effect symptoms of a defect in the synaptonemal complex (or associated substance), which is expressed later as sporadic loss of chiasma maintenance. PMID- 1778470 TI - Presence of a centromeric filament during meiosis. AB - Spermatocytes at meiotic metaphase I and anaphase I have a characteristic centromeric filament in a variety of vertebrate organisms. This centromeric filament was first demonstrated on mouse spermatocytes and its presence is now extended to spermatocytes from the human, rat, golden hamster, bull, and chicken. The visualization of this filament was possible through the use of a novel silver staining technique, which allows a high contrast between the filament and the centromeric chromatin. In the species cited, the centromeric filament shares an intense staining, a short (0.2-0.6 micron) length, a curved and branched shape, and location inside the centromeric chromatin of seemingly every homologue of the complement. The similarity of staining reactivity and the observation of transitional structures during first meiotic prophase strongly suggest that the centromeric filament is a remnant of a lateral element of the synaptonemal complex, which stays specifically at both centromeric regions of each bivalent. This filament is not found at the second meiotic division or at the centromeres of mitotic chromosomes. It is assumed that this centromeric filament joins the two sister chromatids of each homologue at the centromere and thus ensures the proper coorientation of sister kinetochores at metaphase I. Further testable assumptions on the functions of this filament are presented. PMID- 1778471 TI - Variability of C-banding patterns in Japanese quail chromosomes. AB - Observations were made of the C-banding patterns in several cells from 182 Japanese quail embryos to detect presence of stable variants. Each of the eight largest autosomes contains a C-band at the centromeric region. The short arm of autosome 8 is C-band positive, as is the entire W chromosome. The Z chromosome consistently contains an interstitial C-band in the long arm and a less prominent one in the short arm. Distinct variants of chromosome 4 and the Z chromosome were observed. In the Z chromosome a C-band at the terminal region of the short arm was markedly elongated in some embryos. Likewise, the short arm of chromosome 4 was much more prominent in one or both of the homologues in some embryos. Most of the microchromosomes contain a prominent C-band. The heteromorphisms are useful chromosome markers to detect the origins of heteroploidy in early embryos. PMID- 1778472 TI - Nerve cells of Drosophila Notch mutant are differentiated inside amphibian brain: a new approach for the analysis of genetic control of nerve cell differentiation. AB - Fragments of the neural primordium of a new Notch mutant of Drosophila melanogaster produced in our laboratory were transplanted into the neural tube of embryos of 4 amphibian species (caudate and ecaudate) immediately after completion of neurulation. The grafts were identified by using a light microscope, scanning electron miscroscope, and in situ hybridization with mobile genetic elements of Drosophila and fluorescent dyes as markers. As has been shown, Drosophila nerve cells survive and differentiate inside the neural tube of amphibian embryos. The grafts increase in size by twentyfold and the cell proliferation zones are retained during the period of six months. Differentiated cells of the graft formed axon-dendritic contacts with recipient cells and penetrated into the organisms' brain structures. The effect of Drosophila transplants proved to be different for caudate and ecaudate amphibians. The presence of the graft accelerated the development of Xenopus laevis and it also affected their behavior. This approach can be very useful for the study of genetic basis of development and behavior. PMID- 1778474 TI - Allelic variants of rearranged immunoglobulin heavy and light chain genes in hybridoma PTF-02 and parent myeloma. AB - The hybridoma PTF-02 secretes an antibody against pig transferrin. Rearranged genes for heavy and light immunoglobulin chains have been studied in the genomes of this hybridoma and in the parent myeloma P3-X63.Ag8.653. The hybridoma was shown to contain three rearranged allelic variants of the heavy chain gene's locus. The gene H2, responsible for synthesis of the heavy chain of the antibody to transferrin, was transmitted in the hybridoma cell from a lymphocyte. Two other genes (H1 and H3) were found both in the hybridoma and parent myeloma genomes. The gene H1 was identified in MOPC21 myeloma, which is a precursor of the X63.Ag8 descendent line. Rearranged k genes were also identified both in the hybridoma and parent myeloma. A functional (K2) gene and a fetal (F) gene appeared in the hybridoma genome from an antigen-stimulated normal lymphocyte. The fetal gene was lost in the course of continuous cultivation of the hybridoma PTF-02 cell line. The gene K1 was transmitted from the myeloma used for fusion. In such a way, the pedigree of rearranged heavy and light chain genes in the hybridoma PTF-02 was established. The results obtained in this work may be relevant to many hybridomas whose immortalizing fusion partner is a MOPC21 derivative, and allow one to identify and isolate functional variable genes to create recombinant constructions. PMID- 1778473 TI - Structure comparison and evolutionary relations between elongation factors EF-Tu (EF-1 alpha) and SUP 2 proteins. AB - On the basis of high homology and structural similarity, three genes, SUP2 Saccharomyces cerevisiae, SUP2 Pichia pinus and GST1 Homo sapiens, might be considered as members of one family named SUP2. Comparison of the primary structure of SUP2 proteins and elongation factors EF-Tu(EF-1 alpha) from 19 different species was performed. It was found that SUP2 proteins bear more homology to eukaryotic elongation factor than to procaryotic EF-Tu, though the degree of sequence conservation in SUP2 proteins is smaller than in EF-1 alpha factors. The extensive phylogenetic analysis of SUP2 and EF-Tu(EF-1 alpha) genes was performed by means of 3 methods, 2 phenetic and one cladystic (maximal parsimony). The data support the close relation of SUP2 genes to other elongation factor genes. PMID- 1778475 TI - Reactive oligonucleotide derivatives as gene-targeted biologically active compounds and affinity probes. AB - Development of efficient methods for synthesis of oligonucleotides and oligonucleotide analogs has opened up the possibility of designing a broad spectrum of affinity reagents for specific modification of nucleic acids and proteins. These affinity reagents are used for investigation of the topology of ribosomes and nucleic acid polymerases. Oligonucleotides and their analogs are already used for suppression of specific gene expression and for elucidation of the physiological role of their products. Oligonucleotide derivatives appear to offer considerable promise as potential gene-targeted drugs such as antivirals and specific inhibitors of oncogene expression. PMID- 1778476 TI - Chromomeric organization of polytene chromosomes. AB - This is a review summarizing work carried out at the Laboratory of Molecular Cytogenetics in recent years. Problems of genetic organization of bands, interbands and puffs as well as intercalary heterochromatin and position effect variegation are discussed from the point of view of the dynamic model of polytene chromosome organization. PMID- 1778477 TI - The role of balancing selection and overdominance in maintaining allozyme polymorphism. AB - Three approaches to the estimation of the role of balancing selection in maintaining allozyme polymorphism are considered: 1) Analysis of the stationary distributions of allelic frequencies in a native subdivided population; 2) Comparison of the genotypic distributions at the early and late developmental stages in successive generations of the same population; 3) Analysis of the 'joint' variability of monogenic and polygenic traits. The conclusion is drawn that allozyme polymorphism must not be regarded as a transient phase of molecular evolution but as its stationary phase. The mechanisms responsible for supporting such stability are discussed. PMID- 1778478 TI - Practice innovations and research: reconciling the chicken and the egg. PMID- 1778479 TI - Removing barriers to the empowerment of the elderly in health programs. PMID- 1778480 TI - One law does not make a right. PMID- 1778481 TI - Participation of older adults in health programs and research: a critical review of the literature. AB - This collection of five papers evaluates the participation of older adults in clinical trials, health promotion/disease prevention initiatives, and health programs designed to maintain or improve the functioning of chronically ill older adults. Understanding the willingness or unwillingness of older adults to participate in these programs is critical to the development and implementation of health programs and policies for this population. In this introductory paper we briefly review illustrative literature to provide both an overview of the participation of older adults in health programs as well as background information relevant to the symposium papers. PMID- 1778482 TI - Participation and adherence among older men and women recruited to the Beta Carotene and Retinol Efficacy trial (CARET). AB - We evaluated as functions of age and gender participation and adherence rates in older adults recruited to pilot studies for CARET, a multicenter chemoprevention trial. Eligible were men and women aged 50-69 who were current or recent former smokers, and men aged 45-74 with occupational exposure to asbestos. We found negligible differences by age in response to recruitment mailings, drop out during the enrollment process and after randomization, and adherence to taking the study capsules. Men had numerically lower drop-out and higher adherence rates than women, but differences were not statistically significant. These results should encourage researchers to recruit older men and women (at least up to age 69) to clinical trials. PMID- 1778483 TI - Factors associated with participation in a senior health promotion program. AB - The health status and life-style characteristics of participants in a senior health promotion program were compared with those of nonparticipants from the same HMO enrollee population. Nonparticipation was associated with lower income, less education, and lower involvement in community organizations. Although nonparticipants smoked more and evaluated their health less favorably than did participants, other risky behaviors and health status indicators differed little between the groups. PMID- 1778484 TI - Participation of higher users in a randomized trial of Medicare reimbursement for preventive services. AB - In a study of older enrollees in an HMO, we found that seniors who are higher users of health care services are willing to participate in health promotion programs. Although people aged 85 or older and those with chronic diseases are slightly more reluctant to participate, they are willing to make additional visits for health promotion purposes. Close proximity to the clinic and support from their family physician are important correlates of participation. PMID- 1778485 TI - Factors associated with participation in a randomized trial of adult day health care. PMID- 1778486 TI - A new myth about families of older people? AB - Are gerontologists creating a new myth about families by emphasizing individual autonomy as independence without family interdependence, by advocating advance directives instead of supporting a rebuttable presumption of family surrogates, and following the lead of the U.S. Supreme Court in the Cruzan case (Cruzan v. Director, 1990), by ignoring intergenerational interdependencies in surrogate decision making? This paper argues that another antifamily trend is developing despite empirical evidence showing that elderly persons themselves prefer family members to represent them in surrogate decision making. Research and public policy suggestions are offered for protecting the elderly's preferences. PMID- 1778487 TI - Health care decision making by the elderly: I get by with a little help from my family. AB - Shared decision making about placement and medical interventions can be empowering to the older person involved, relieve burdens on the older person and family members, and facilitate better surrogate decision making later. Potential dangers of the shared process include coercion, conflicts of interest, and disagreements between family members. New legal concepts, similar to those governing property, could help our legal system better accommodate the realities of shared decision making. PMID- 1778488 TI - Ethical dimensions of intergenerational reciprocity: implications for practice. AB - This paper reviews the moral and ethical context of family relationships and caregiver stress, with an emphasis on the implications for professional interventions. Three views of filial responsibility are presented: parental reverence, a debt of gratitude, and caregiving as an expression of friendship and love. Case studies are presented to illustrate how an exploration of ethically defensible limits to caregiving might proceed. PMID- 1778489 TI - Ethical dimensions of quality of life in aging: autonomy vs. collectivism in the United States and Canada. AB - Ethical concepts lie at the core of how quality of life in aging is defined and enhanced. Although recent American attention has been largely focused on autonomy as an important value for quality of life in old age, there is real danger in emphasizing personal independence at the expense of community or collectivism. This conceptual analysis compares and contrasts these value orientations in the U.S. and Canada and examines their relationship to the concept of quality of life in aging. It also explores implications of the analysis for expanding our understanding of the importance of value dimensions in comparative gerontology, and suggests ways of integrating individualistic and collectivistic ideals in gerontological policies and programs. PMID- 1778490 TI - Intergenerational transfers: a question of perspective. AB - Informal intergenerational transfers have traditionally been examined from the perspective of the older generation; more recent studies have proceeded from the perspective of adult children. Drawing upon principles of formal demography, we establish the mathematical relationship between the two generations' perspectives. We then consider the importance of generational perspective with regard to prevalence estimates of intrafamily transfers. Transfers examined include coresidence, household and financial assistance, and personal caregiving. Results have implications for projection of future trends in intrafamily transfers and for data collection. PMID- 1778491 TI - Patient characteristics and outcomes in institutional and community long-term care. AB - This paper examines the three-way relationships among patient characteristics, type of care (admission to a nursing home or community setting), and 6-month outcomes of 352 long-term care patients. The study found that patient characteristics influenced the type of care received and that substantial portions of the variance in the outcomes were attributable to initial differences among patients in the two types of care. Controlling for the effect of selective admission, type of care had no significant impact on patients' ADL scores, mobility scores, or disposition after 6 months in the long-term care setting. PMID- 1778492 TI - Women at risk: predictors of financial stress for retired women workers. AB - Research on women workers tends to neglect older workers, and much of the literature on retirement has focused on male experiences. This analysis uses data from the 1982 New Beneficiary Survey to examine financial stress in retirement for a sample of highly committed women workers. Separate regressions are done for married and unmarried women, and particular attention is paid to the impact of gender-segregated jobs. Results suggest the relative importance of work history and sociodemographic variables as predictors of financial stress in early retirement. PMID- 1778493 TI - Travel behavior of nursing home residents perceived as wanderers and nonwanderers. AB - A video-based observational methodology was used to assess the travel behaviors of 40 nursing home residents, 24 of whom were identified by nursing staff as wanderers. Travel was monitored continuously for 30 days, resulting in the recording of over 5,000 unassisted travel events. Four basic travel patterns were observed: direct travel (86.8%), lapping (11.6%), random travel (.9%), and pacing (.7%). Travel efficiency (percentage of direct travel) was significantly related to cognitive status (r = .56), with inefficient travel most prevalent in severely demented participants. PMID- 1778494 TI - Old age and historical examples of the miser. AB - Older people have historically been characterized as avaricious and miserly. A review of Western art and literature reveals many examples of this stereotypical view of aging. Historical reasons for characterizing older people as misers, such as their need to control wealth, intergenerational conflict, and lack of social support programs, are described. Industrialization, Social Security, and other factors have led to a decline in the use of these stereotyped images in modern times. PMID- 1778495 TI - Twenty years of gerontological education: a report on the experience of one program. AB - The Center for Studies in Aging at the University of North Texas has been in existence for over 20 years. Data were collected from 339 of the 493 students who completed its program between 1967 and 1987. Data suggest that: levels of both initial employment and retention in the field of aging are high; gender differences in salaries exist among program concentrations and year of completion; and former students report high levels of involvement in collateral activities. PMID- 1778496 TI - TOPS: a consumer approach to Alzheimer's respite programs. AB - Time Off Promotes Strength (TOPS), a program for caregivers of Alzheimer's victims, provides in-home and day program services. Through application of a service/training model adapted from the Global Deterioration Scale (Reisberg, 1983), the TOPS program maintains a high quality of services with a limited but highly trained professional staff. Caregiver independence and autonomy are emphasized, as is a flexible system that accommodates the ever-changing needs of both caregivers and care recipients. PMID- 1778498 TI - Teaching gerontological content to schoolchildren in Israel as preparation for adult life. AB - An Israeli public school made gerontological content and experiences available to pupils aged 13-14. The learning process included library research, interviewing older residents in their homes, friendly visiting to a nearby home for the aged, formal lectures, role-playing before video cameras operated by classmates, and homework assignments. Children who participated were reported to have improved relations with their own grandparents. The school received public recognition for its pedagogic pioneering, and "town-gown relations" between municipal officials and the University were enhanced. PMID- 1778497 TI - A model community education program on depression and suicide in later life. AB - This paper describes the development and evaluation of a 3-hour multimedia community education program on depression and suicide in later life. Designed for families, older adults, and service providers, the program provides information and teaches skills needed to recognize and respond to depression and suicidal behavior in the elderly. Compared with a control group, program participants had significant gains in knowledge and in their intent to take appropriate action in support of a depressed person. PMID- 1778499 TI - The patient chose to die: why? AB - The elderly patient's choice to die may only appear to be independent of the family's choices. Behind the patient's choice often lie implicit interpersonal as well as overt personal reasons. These must be understood in order to provide optimal care for the patient and family. Case examples of undeliberate and deliberate clarification are offered. PMID- 1778500 TI - Hydrogen peroxide decreases effective refractory period in the isolated heart. AB - Although previous investigations have concluded that reactive oxygen metabolites contribute to reperfusion arrhythmias, the experimental models employed also had a significant amount of tissue injury, which may have contributed to the observed electrophysiologic effects. We studied whether exposure of the intact heart to a reactive oxygen metabolite at doses that are not associated with histologic evidence of cell necrosis would alter myocardial refractoriness, suggesting that subtle and reversible oxidative stress could alter myocardial electrophysiologic properties and perhaps contribute to ventricular arrhythmias. Isolated rabbit hearts were perfused for 30 min with low doses of hydrogen peroxide (H2O2), either 10(-5), 5 x 10(-6), or 10(-6)-M H2O2 versus vehicle alone; followed by a 30-min washout period without H2O2. Infusion of H2O2 for 30 min decreased ventricular epicardial effective refractory period (ERP) in a dose-dependent manner compared to saline controls (delta ERP). The delta ERP versus time curves during the last 10 min of H2O2 infusion were different (p less than 0.01) for each of the three H2O2 doses. Creatine phosphokinase and reversible oxidized glutathione release occurred during 10(-5)-M H2O2 infusion, but not with lower H2O2 doses. Exposure of the intact heart to low concentrations of H2O2, in a range that caused subtle oxidative injury, decreased ventricular ERP in a dose dependent manner. Thus, H2O2 generation could contribute to ventricular arrhythmias, even in settings of sublethal and potentially reversible oxidative injury. PMID- 1778501 TI - Does hydrogen peroxide exist "free" in biological systems? AB - Hydrogen peroxide (H2O2) can diffuse far from the site of production to intracellular locations where biological effects may be greater. The diffusion range is extended by H2O2 carriers formed spontaneously by hydrogen bonding with monomeric and polymeric compounds, including amino and dicarboxylic acids, peptides, proteins, nucleic acid bases, and nucleosides. Hydrogen peroxide adducts (HPAs) are readily synthesized, e.g., crystalline histidine (His)-H2O2 adducts. An equilibrium exists between an adduct-forming compound and H2O2. The detection and relative stabilities of HPAs are measured by the degree of decomposition of H2O2 as influenced by test compounds in buffered solution competing with glucose or fructose for H2O2. The HPAs delay decomposition of H2O2 up to several hundredfold. The overall charge on an HPA, i.e., its ability to penetrate cell membranes, influences the cytotoxic and clastogenic effects of H2O2. Growth inhibition of Salmonella typhimurium LT2 by H2O2 is enhanced by neutral HPAs but decreased by anionic HPAs. Addition of catalase 1, 10, or 30 min after inoculation of S. typhimurium LT2 reduces or nearly eliminates partial growth inhibition by H2O2, but a neutral HPA, especially His-H2O2, transported H2O2 into the cells within 1 min, and in about 10 min completely inhibited growth. The stability of HPAs decreases with increasing pH or increasing temperature, while added Fe(II) in the presence and absence of EDTA accelerates H2O2 and HPA decomposition. Calculations indicate H2O2 hydrogen bonds with nucleic acid-base pairs with no apparent bond strain and energy stabilization comparable to normal hydrogen bonding. PMID- 1778502 TI - Elaboration of cellular DNA breaks by hydroperoxides. AB - Cellular damage produced by ionizing radiation and peroxides, hydrogen peroxide (HOOH) and the organic peroxides tert-butyl (tBuOOH) or cumene hydroperoxide (CuOOH) were compared. DNA breaks, toxicity, malondialdehyde production, and the rate of peroxide disappearance were measured in a human adenocarcinoma cell line (A549). The alkaline and neutral filter elution assays were used to quantitate the kinetics of single and double strand break formation and repair (SSB and DSB), respectively. Peroxides, at 0.01-1.0 mM, produce multiphasic dose response curves for both toxicity and DNA SSBs. Radiation, 1-6 Gy, produced a shouldered survival curve, and both DNA SSB and DSBs produced in cells x-rayed on ice were nearly linear with dose. The peroxides produced more SSBs than radiation at equitoxic doses. X-ray induced DNA single strand breaks were rejoined rapidly by cells at 37 degrees C with approximately 80% of initial damage repaired in 20 min. Peroxide induced SSBs were maximal after 15 min at 37 degrees C. Rejoining proceeded thereafter, but at a rate less than for x-ray induced strand breaks. Significant DNA DSBs could not be achieved by peroxides even at concentrations 50 fold higher than required to produce SSBs. HOOH treatment of DNA on filters following cell lysis and proteolysis produced SSBs. CuOOH and tBuOOH produced no SSBs in lysed cell DNA. None of the peroxides produced DSBs when incubated with lysed cell DNA. Malondialdehyde was released from cells incubated with organic hydroperoxides, but not HOOH, nor up to 40 Gy of x-rays. HOOH was metabolized three times faster than the organic peroxides. The overall results demonstrate the necessity for a metabolically active cell environment to elaborate maximal DNA strand breaks and cell death at hydroperoxide concentrations of 10(-4) or greater, but prevent strand breaks and stimulate cell growth at 10(-5) M. PMID- 1778503 TI - Immunoquantitation of rat erythrocyte superoxide dismutase: its use in copper deficiency. AB - Two immunoassays have been developed for the determination of rat erythrocyte dismutase (Cu,Zn-SOD). An enzyme-linked immunosorbent assay (ELISA) was very sensitive down to 4 ng/ml with a coefficient of variation (CV) of 18% while the single radial immunodiffusion assay (SRID) permitted an adequate detection level (5 micrograms/ml) with far better accuracy (CV = 4.2%). The latter was thus selected for the determination of Cu,Zn-SOD in the red blood cells of normal and copper-depleted rats. The average value of Cu,Zn-SOD in normal adult rat erythrocytes was 1142 +/- 120 ng/mg hemoglobin. When compared to activity measurements, good correlation was obtained between enzyme content and enzyme activity (r = 0.803, P less than .001). In an experimental copper deficiency followed by supplementation, good correlation was observed in the course of depletion (r = 0.848, P less than .001) and repletion (r = 0.896, P less than .001). During depletion, the loss of enzyme activity was mainly related to a loss of enzyme. However, enzymatically inactive protein was formed which would be activated when copper was added. These results indicate the importance of a combined use of Cu,Zn-SOD immunoquantitation and activity measurements to enable a better understanding of changes occurring with respect to enzyme activity. PMID- 1778504 TI - Free radical-induced liver injury. I. Effects of dietary vitamin E deficiency on triacylglycerol level and its fatty acid profile in rat liver. AB - Effects of dietary vitamin E deficiency on the fatty acid compositions of total lipids and phospholipids were studied in several tissues of rats fed a vitamin E deficient diet for 4, 6, and 9 months. No significant differences were observed between the vitamin E deficiency and controls except in the fatty acid profiles of liver total lipids. Triacylglycerol (TAG) accumulation was found in the liver of rats fed a vitamin E-deficient diet. The levels of TAG-palmitate and -oleate increased particularly in the liver from such animals. The fatty acid compositions of hepatic phospholipids were not affected by the diet. Increased TAG observed in the liver of rats fed a vitamin E-deficient diet was restored to normal when the diet was supplemented with 20 mg alpha-tocopheryl acetate/kg diet. These findings indicate that dietary vitamin E deficiency causes TAG accumulation in the liver and that the antioxidant, vitamin E, is capable of preventing free radical-induced liver injury. PMID- 1778505 TI - Association of antioxidant systems in the protection of human fibroblasts against oxygen derived free radicals. AB - The protection of human diploid fibroblasts against high oxygen tension was investigated using various combinations of the three major antioxidant enzymes: superoxide dismutase, catalase and glutathione peroxidase. alpha-Tocopherol, a well-known hydrophobic antioxidant, was also tested in combination with the different enzymes. Microinjection of solutions containing different combinations of the three enzymes was compared with the injection of each single enzyme. We observed that the protections given by catalase or superoxide dismutase on the one hand, and by glutathione peroxidase on the other hand, were additive. Surprisingly, the combinations of catalase and superoxide dismutase were less effective than catalase alone and was even toxic at low SOD concentrations. Addition of alpha-tocopherol following the injection of any of the three enzymes was highly beneficial, but the strongest synergistic effect was obtained with glutathione peroxidase. These results stress the importance of membrane protection by alpha-tocopherol and indirectly by glutathione peroxidase. They also showed that any injection leading to the decrease in the O2.- or H2O2 concentration combined with one of these two protectors is very beneficial for the cells probably by decreasing the OH concentration. This is also proven by the very good protective effect obtained with desferrioxamine. PMID- 1778506 TI - Phospholipid hydroperoxide glutathione peroxidase is a selenoenzyme distinct from the classical glutathione peroxidase as evident from cDNA and amino acid sequencing. AB - The primary structure of phospholipid hydroperoxide glutathione peroxidase (PHGPx) was partially elucidated by sequencing peptides obtained by cyanogen bromide cleavage and tryptic digestion and by isolating and sequencing corresponding cDNA fragments covering about 75% of the total sequence. Based on these data PHGPx can be rated as a selenoprotein homologous, but poorly related to classical glutathione peroxidase (GPx). Peptide loops constituting the active site in GPx are, however, strongly conserved in PHGPx. This suggests that the mechanism of action involving an oxidation/reduction cycle of a selenocysteine residue is essentially identical in PHGPx and GPx. PMID- 1778507 TI - A water-soluble quaternary ammonium analog of alpha-tocopherol, that scavenges lipoperoxyl, superoxyl and hydroxyl radicals. AB - The new water-soluble ammonium-analog of alpha-tocopherol (vitamin E) (compound 1: 3,4-dihydro-6-hydroxy-N,N, N-2,5,7,8-heptamethyl-2H-1-benzopyran-2 ethanaminium 4-methylbenzenesulfonate) and its tertiary amine derivative (compound 2: 3,4-dihydro-2-(2-dimethylaminoethyl)-2,5,7,8-tetramethyl-2H-1 benzopyran -6-ol hydrochloride) were investigated as scavengers of oxygen-derived free radicals. Compounds 1 and 2 were at least 40 times more potent inhibitors of Fe-driven heart microsomal lipid peroxidation than Trolox. While the alpha tocopherol analogs had the same potency as scavengers of xanthine/xanthine oxidase-generated superoxyl radicals, the thiol compounds D,L-penicillamine and N 2-mercaptopropionyl glycine reacted at a much slower rate. The O-acetyl derivatives of compounds 1 and 2 were not scavengers of superoxyl radicals. Considerable differences between the alpha-tocopherol analogs were observed in their competition with 2-deoxyribose for hydroxyl radicals (OH.). Compound 2 was equipotent with Trolox and thiourea, whereas the reactivity of these substances was diminished by more than 30% as compared to compound 1. Although showing lower reactivity, the O-acetyl derivatives of compounds 1 and 2 were active nevertheless as OH.-scavengers. The previously reported high potency of compound 1 in reducing infarct size during myocardial ischemia/reperfusion appears to be due to its radical-scavenging properties, likely to be enhanced by its previously described cardioselectivity. PMID- 1778508 TI - Effect of additives on the inactivation of lysozyme mediated by free radicals produced in the thermolysis of 2,2'-azo-bis-(2-amidinopropane). AB - The inactivation of lysozyme caused by the radicals produced by thermolysis of 2,2'-azo-bis-2-amidinopropane can be prevented by the addition of different compounds that can react with the damaging free radicals. Compounds of high reactivity (propyl gallate, Trolox, cysteine, albumin, ascorbate, and NADH) afford almost total protection until their consumption, resulting in well-defined induction times. The number of radicals trapped by each additive molecule consumed ranges from 3 (propyl gallate) to 0.12 (cysteine). This last value is indicative of chain oxidation of the inhibitor. Uric acid is able to trap nearly 2.2 radicals per added molecule, but even at large (200 microM) concentrations, a residual inactivation of the enzyme is observed, which may be caused by urate derived radicals. Compounds of lower reactivity (tryptophan, Tempol, hydroquinone, desferrioxamine, diethylhydroxylamine, methionine, histidine, NAD+ and tyrosine) only partially decrease the lysozyme inactivation rates. For these compounds, we calculated the concentration necessary to reduce the enzyme inactivation rate to one half of that observed in the absence of additives. These concentrations range from 9 microM (tryptophan and Tempol) to 5 mM (NAD+). PMID- 1778509 TI - Embryo loss, blastomere development and chromosome constitution after human chorionic gonadotropin-induced ovulation in mice and rats with regular cycles. AB - A dose of 7 IU human chorionic gonadotropin (hCG) given 14 h before the expected LH peak on proestrus significantly increased embryonic mortality in Swiss random bred female mice to 55% of the number of corpora lutea. The use of luteinizing hormone-releasing hormone in a similar injection protocol did not induce embryonic death. The effect found in Swiss random-bred mice resembles that of a dose of 20 IU hCG in the rat. Afternoon-day-4 mouse embryos contained 39.1 +/- 12.6 nuclei after hCG-induced ovulation compared to 46.2 +/- 16.6 nuclei after spontaneous ovulation. For early-day-5 embryos of the rat, these figures were 34.2 +/- 10.1 and 31.7 +/- 8.4, respectively (mating was early on day 1). Numerical chromosome errors were estimated in secondary oocytes of the mouse and early-day-5 embryos of the rat. Compared with data from the literature, hCG seems to induce some extra meiotic nondisjunction in the rat only. Combining all genetic and physiological data, the loss of fecundity after hCG-induced ovulation is a maternal effect. PMID- 1778510 TI - Evaluation of fetal sonographic measurements in the first trimester by transvaginal sonography. AB - To assess the reliability of early biometric measurements in pregnancy, transvaginal sonography was performed in 92 pregnancies in the first trimester in a cross-sectional fashion. Measurements included crown-to-rump length (CRL), biparietal diameter (BPD), head and abdominal circumference (HC and AC), and femur length (FL). Stepwise regression analysis of the gestational age was performed. CRL maintained the highest correlation with gestational age (r = 0.99, p less than 0.001). BPD, HC, AC also correlated well. FL showed a less strong correlation with gestational age (r = 0.76, p less than 0.001). CRL remains the standard for early sonography measurements. PMID- 1778511 TI - Embryonic heart rates: development in early first trimester and clinical evaluation. AB - One hundred and forty-three women in the early first trimester of gestation were examined 364 times using transvaginal sonography, and the development of embryonic heart rate was studied. In each case gestational age was revised retrospectively by either recorded basal body temperature or ultrasound crown rump length dating between 9 and 10 weeks. Embryonic cardiac activity could be detected as early as 37 days of gestation. In 133 continuing pregnancies, embryonic heart rate rose from an average of 97.7 beats per min at 36-38 days to 174.7 beats per min at 60-62 days. A significant correlation was seen between gestational age and embryonic heart rate (p less than 0.001). The regression equation for heart rate was as follows: heart rate = 3.850 x gestational age (days) -54.64 (r = 0.908, n = 347), in short, embryonic heart rate continued to rise about 4 beats per min every day until 8 weeks of gestation. In this series, 10 pregnancies resulted in spontaneous abortion in the first trimester, and all of them showed relative bradycardia. Embryonic heart rate measurements in 8 of them were below the 95% prediction intervals for normal heart rate plotted against gestational age. This study suggests that embryonic heart rate measurement by ultrasound may be a new method for dating early first trimester, and that first trimester bradycardia may be associated with a poor prognosis for the pregnancy. PMID- 1778512 TI - Red cell deformability alterations in normal late pregnancy: possible role of plasma components. AB - Red cell deformability of 30 nonpregnant volunteers and 20 normal pregnant women in the 3rd trimester was assessed by determination of filterability of red cells suspended either in autologous plasma or in buffer by St. George's filtrometer method. Total red cell deformability was decreased in normal pregnancy [transit time (Tc) = 7.79 +/- 0.86 vs. 6.99 +/- 0.65, p less than 0.01] as compared to nonpregnant women when erythrocytes were studied in buffer suspensions, while the number of profoundly rigid red cells was lower in pregnant patients [clogging particles (CP) = 0.864 +/- 0.225 vs. 1.103 +/- 0.246, p less than 0.01]. Total red cell deformability was no longer reduced in pregnant women when erythrocytes were suspended in autologous plasma (Tc = 7.25 +/- 0.66 vs. 7.13 +/- 0.69, p = NS) while the number of rigid erythrocytes was still lower (CP = 0.802 +/- 0.157 vs. 1.055 +/- 0.210, p less than 0.01). Our data suggest that by the end of normal pregnancy, red cell deformability decreases with a consequent accelerated turnover and a fast elimination of very poorly deformable erythrocytes; plasma alterations in late pregnancy partly counteract the intrinsic loss of deformability of red blood cells. PMID- 1778514 TI - Association between umbilical artery cord pH, five-minute Apgar scores and neonatal outcome. AB - A prospective study was conducted of 270 intrapartum patients admitted in labor to investigate the independent and combined relationships between umbilical arterial cord pH and Apgar scores and neonatal outcome. The results revealed that when assessed independently, a low 5-min Apgar score (less than 7) was associated with both NICU admission and neonatal sepsis. When categorized by both cord pH and 5-min Apgar, the majority of patients (75.9%) had both parameters normal, 20.7% had an abnormal pH (less than 7.20) and normal Apgar (greater than or equal to 7) and few patients had either both normal or an abnormal Apgar given a normal pH. Given a normal 5-min Apgar score, additional information about the cord pH did not enhance the predictability for either NICU admission or neonatal sepsis. Neonates with both an abnormal pH and 5-min Apgar had the highest incidence of NICU admission. For all neonates, the presence of meconium greatly increased the likelihood of being admitted to the NICU. PMID- 1778513 TI - A prospective study on the perinatal outcome in Mozambican pregnant women with preterm rupture of membranes using two different methods of clinical management. AB - Antenatal care of women with preterm rupture of membranes is controversial, particularly in countries with high prevalence figures for sexually transmitted diseases and other genital infections. In order to assess the value of conservative and active management routines, 92 women with singleton pregnancies and gestational lengths between 27 and 34 weeks were adopted into the two respective groups. The first group comprised 40 cases who were treated conservatively and the second comprised 52 cases who were treated actively with induction. The first group received amoxicillin (100 mg) and metronidazole (500 mg), both drugs given three times daily. All patients were also routinely treated with an antimalarial dose of chloroquine. The second group was not given any pharmaceutical treatment, and labor was induced 3-24 h after membrane rupture. The two groups differed significantly regarding birth weight, the average birth weights being 2,168 and 1,780 g in the first and second groups, respectively (p less than 0.05). While the intrauterine mortality was approximately the same in both groups, the neonatal mortality differed significantly (2.6 vs. 19.2%; p less than 0.05). It is concluded that an expectant attitude, rather than an active and induction-oriented one, is most favorable in cases with preterm rupture of membranes, also in settings in which prevalence figures of sexually transmitted diseases and other genital infections are high. PMID- 1778515 TI - Evaluation of the functional status of the fallopian tubes in unexplained infertility with radionuclide hysterosalpingography. AB - The functional status of the Fallopian tubes in patients with unexplained infertility (UI) was evaluated with radionuclide hysterosalpinography (RN-HSG). The rate of bilateral tubal occlusion with RN-HSG in women with UI (3/18 = 16.7%) was considerably higher than in a group of fertile and male-infertile women (0/28 = 0%), implying that a number of cases with UI might be associated with functional rather than anatomical tubal defects. RN-HSG is a simple, innocuous and potentially useful method for assessing functional tubal occlusion, and it might give a better understanding of the functional status of the tubes in UI. PMID- 1778516 TI - Immunohistochemical evidence of estrogen and progesterone receptors in the female lower urinary tract and comparison with the vagina. AB - Tissue biopsies from the lower urinary tract and the vagina were obtained from 51 and 45 women, respectively, during incontinence surgery or other gynecological operation procedures in order to calculate hormone receptor content. We compared the results between premenopausal, postmenopausal patients with and those without hormonal treatment. Utilizing the enzyme immunohistochemical assay we were able to demonstrate nuclear estrogen and progesterone receptors in the smooth muscle of the trigone and the posterior part of the bladder neck. But only in about 50% of the patients receptor proteins were detected in the frozen thin sections of these tissues. Biopsies from the anterior part of the bladder neck and the bladder vault were never receptor positive. In the vagina the rate of receptor positive tissues was about 80%; in comparison, a smaller number of patients had receptor-positive cells in the bladder. From 29 patients we obtained specimens from the trigone and the vagina as well. The correlation of receptor-positive and -negative tissues of both organs was only 66%. Thus tissue biopsies obtained from the vagina only are not sufficient to discuss the probability of hormonal influence of the lower urinary tract. PMID- 1778517 TI - Immunohistochemical reactivity of antikeratan sulfate monoclonal antibody 5D4 to various conditions of human endometrial tissues and its application as a useful marker for identifying endometrial epithelia. AB - Immunohistochemical staining was performed on normal, endometriotic, neoplastic endometrial tissues and various epithelial tissues of other organs using a monoclonal antibody, 5D4, which was raised originally against skeletal and corneal keratan sulfate. The results showed that this antibody exhibited strong and consistent reactivity to glandular epithelia found in normal and endometriotic tissues. In endometrial carcinomas, moderate reactivity was noted in well- to moderately differentiated adenocarcinoma. Other epithelial tissues examined showed almost no or faint reactivities. These results suggested that 5D4 would be a useful tool for identifying the endometrial glandular epithelia in histochemical studies. PMID- 1778518 TI - Continuous bromocriptine treatment of empty sella syndrome aggravating pregnancy. A case report. AB - Pregnancy, aggravated by hyperprolactinaemic empty sella syndrome, is a risky and rare event. A case with such complication and continuous bromocriptine treatment during the whole gestation is presented. Neither fetal abnormalities nor deterioration of maternal pituitary pathology or the course of gestation are observed. PMID- 1778519 TI - Massive ovarian serous cystadenoma with uneventful postoperative recovery. AB - Removal of a massive ovarian cyst may be followed by life-threatening complications. We report the case of serous cystadenoma occupying most of the abdominal cavity, associated with uneventful postoperative course. PMID- 1778520 TI - Uterine myoma causing uremia in a 15-year-old girl. AB - Uterine myoma leading to uremia in young women below 16 years of age is an extremely rare condition. On reviewing the literature we have not been able to find any case similar to the one described below. PMID- 1778521 TI - Chemical and biochemical aspects of polyether-ionophore antibiotic biosynthesis. PMID- 1778522 TI - [The morphological results of the use of a pulsed krypton fluoride excimer laser for enamel conditioning]. AB - Although there have been many advances in the field of acid etching, major problems still present. For the most part, these are the unpredictability of the effects of etching, the lack of control of the depth of etching over the long term, and the development of enamel fractures occurring on debonding. The aim of this study was to investigate the morphological effects of enamel conditioning using a pulsed krypton fluoride excimer laser (wavelength 248 nm). Scanning electron microscopic examination revealed a surface similar to that produced by peripheral etching; no signs of thermal damage were to be seen. The requirements that have to be met by a modern laser considered as a possible alternative to conventional acid etching, are discussed. PMID- 1778523 TI - [In-vitro research on the thermal debonding of ceramic brackets]. AB - The mechanical debonding of ceramic brackets using special instruments involves the use of a degree of force that is damaging to the enamel. For this reason, the authors have developed the Ceramic Debonding Unit for the thermal debonding of ceramic brackets. The unit reduces the force necessary for debonding, without overheating the tooth. The present article explains the principle of the unit. The influence on the temperature increase in the pulpa of the mechanical torque applied during debonding, and the time taken for debonding was investigated in extracted teeth (lower central incisors). Tests on ceramic brackets made by various manufacturers showed that safe debonding is possible if the debonding time does not exceed 3 seconds at a torque of 100 Nnm. The temperature increase in the pulpa will not exceed 5 degrees C when the Ceramic Debonding Unit is used under these conditions, so that harmful overheating of healthy teeth does not occur. PMID- 1778524 TI - [The effect of adhesive agents on the bonding strength of ceramic-composite. An in-vitro comparative study with 6 "porcelain primers" and a control group]. AB - Orthodontic brackets were bonded to a total of 240 Biodent porcelain surfaces pretreated with a number of different porcelain primers. In a control group, 40 surfaces were pumiced, etched, rinsed and dried, and then bonded to similar brackets without the use of a primer. The test objects of group 1 (n = 140) and those of group 2 (n = 40) were tested for bond shearing strength in a material testing machine (Zwick 1441) after prior incubation in a corrosive fluid at a pH of 2.3 and a temperature of 37 degrees C for 24 hours and 21 days, respectively. The fracture sites were inspected and analysed. Incubation in corrosive fluid reduces the strength of the porcelain-composite bonding, the shearing strength and the number of fractures in the bonding decreasing. Damage to the porcelain was seen to occur after the use of Lee-Ortho-Prime and Bond-Por primers. All the primers tested can be used, although a bond shearing strength of less than 2 N/mm2 is at the lower limit of what can be accepted under the usual conditions of daily practice. PMID- 1778525 TI - [Integrated and frequency spectra of the electromyograms in patients with temporomandibular symptoms]. AB - With the aid of bipolar surface electrodes, the electromyographic activity of the anterior temporal and the superficial masseter muscles were recorded bilaterally and evaluated by counting the integrated potentials and mean power frequency using Fourier's analysis. A comparison between 17 patients with myofacial pain dysfunction (average age 21.3 years) and a group of 20 controls (average age 20.5 years) revealed a significantly greater activity in patients with pain syndrome, while no significant inter-group difference in mean power frequency was seen. The differences in the level of activity between the right and left sides in the control group were significantly smaller than in patients with pain dysfunction. An investigation of measures aimed at reducing the right/left asymmetry in a further 14 patients with pain dysfunction revealed the practice of "maximum occlusion with feedback" to be the most effective measure. PMID- 1778526 TI - [Longitudinal changes in the acoustic temporomandibular symptoms due to different procedures of orthognathic surgery]. AB - A longitudinal study of TMJ sounds prior to and after combined orthodontic orthognathic surgical procedures was carried out. The relative frequency of such sounds two days prior to operation (T0) and three months (T1), eight months (T2), 14.5 months (T3), and 25.5 months (T4) postoperatively remained--treatment independently--largely unchanged. Chances in frequency between T0 and T4 showed only a nonsignificant tendency to differ in comparison with changes seen after orthodontic treatment (A) only. An analysis of individual changes revealed that after Le Fort I osteotomy (B) and bimaxillary procedures/posterior mandibular repositioning (D), no change in the preoperative sounds is to be expected. In contrast, following mandibular advancement (C) TMJ sounds first disappeared, in particular in the period immediately following operation (T0-T1), but also subsequently reappeared. The difference vis-a-vis group B (Le Fort I osteotomies) was statistically significant (group B vs. group C: p less than or equal to 0.01. PMID- 1778527 TI - [The development of dysgnathia from the primary dentition to the mixed dentition]. AB - We investigated the fully developed deciduous dentition in 408 children, and re examined the situation four years later. The nature of the milk teeth (spaced, unspaced, crowded) has a considerable influence on subsequent development. Orthodontic treatment of the mixed dentition is most likely (76,7%) if there has been crowding of the milk teeth. Frontal crowding, distal occlusion, increased overjet, lateral cross-bite and prognathism of the lower jaw are most frequently retained in the mixed dentition. However, individual development follows this trend to a varying degree. On the basis of the situation in the primary dentition it is not possible to make a definitive prediction of the vertical relationships of the upper and lower front teeth in the permanent dentition. PMID- 1778528 TI - [The significance of the fissurae petrotympanica, petrosquamosa and tympanosquamosa for disk displacements in the temporomandibular joint]. AB - The correlation between disc displacements in the temporomandibular joint and the petrotympanic, petrosquamous and tympanosquamous fissures was investigated in 38 corpses. Only 12 joints had no ossification of the fissures, while 26 joints were partially ossified. With one exception, none of the joints with non-ossified fissures revealed disc displacement. In contrast, all the joints with ossified fissures revealed disc displacement. Women proved to have more displaced discs than men. On the basis of the findings, a model of the etiology of disc displacement is discussed. PMID- 1778529 TI - [The trend to natural cure procedures--the psychosocial background]. AB - There is a present trend towards so-called alternative methods in medicine and dentistry, which is increasing despite the undeniable successes of established "scientific" medicine. The neglect of psychological and psychosomatic aspects of diseases by established medicine since the second half of the last century is identified as one of the major causes of this development. PMID- 1778530 TI - [Mummies: the living dead. 1: squatting mummies--bundled mummies]. PMID- 1778531 TI - [Human Parvovirus B19--really only fifth disease? Unusual disease course in children and adolescents]. AB - The human parvovirus B19 agent causes infectious erythema (fifth disease). However, a wide range of other pathological manifestations may also be seen: atypical exanthema, ARD (also obstructive forms, e.g. bronchiolitis), acute gastroenteritis, chronic anemia or aplastic crises (in constitutional or malignant hematological diseases or immunological deficiency), arthralgia/arthritis (e.g. rheumatoid arthritis, jcA), diseases of the central nervous systems (e.g. febrile convulsions in young children), lymphadenopathies (e.g. lymphadenitis mesenterialis or pseudoappendicitis); prenatal infection can lead to fetal death (not malformations!). Infection occurring concomitantly with vaccination may suggest complications of the latter. To clarify the true etiological situation, modern laboratory investigations are then required. Vaccination against parvovirus B19 (initially indicated in the case of non-immune girls and women wanting children) is a desirable future development. PMID- 1778532 TI - [Appendicitis in early childhood]. AB - Between 1982 and 1987 550 appendectomies in children under sixteen years of age were carried out in our surgical department. Only 21 patients were children under 4 years of age, accounting for 4% of all patients. The perforation rate however, was 44% in contrast to 12% in older children. One reason is the more difficult, und therefore often delayed, diagnosis. The mean duration of symptoms of appendicitis in young children was 3.4 days. In the special case of perforated appendicitis the mean duration of symptoms was 132 hours, as compared with 42 hours in children without perforation. Clinical examination is decisive for the diagnosis. Fever and vomiting are non-specific symptoms, but frequently present. Some 81% of the patients had leukocytosis over 15,000. If there are any doubts about the indication for appendectomy, x-ray examination should be carried out as a further useful diagnostic procedure. PMID- 1778533 TI - [Chronic fascioliasis with destructive cholangitis]. AB - A 56-year-old Greek working in an electroplating shop, in Germany since 1965, had experienced abdominal pain with weight loss for about 16 years. He had received treatment for a variety of diagnoses. With the aid of ERC and aspired bile, the diagnosis of chronic fascioliasis was finally established. PMID- 1778534 TI - [Treatment of acute episodes of atopic dermatitis. Double-blind comparative study with 0.05% halometasone cream versus 0.25% prednicarbate cream]. AB - In a double-blind, randomized multicenter study in patients with acute episodes of atopic dermatitis, the efficacy and tolerance of 0.5% halometasone (Sicorten) cream were compared with those of 0.25% prednicarbate cream. A total of 165 patients (88 men, 77 women) were admitted to the study. The halometasone group contained 9% more cases with severe disease than did the prednicarbate group. Two daily nonocclusive applications were permitted, and treatment lasted 14 days. No difference in the onset of the effect was observed between the two groups. With respect to clinical efficacy, higher healing rates were found in the halometasone group: 50.6% versus 34.5% in the patients as a whole, and 39.5% vs. 16.2% in the subgroup of clinically severe cases. Applying stratification, a statistical difference was found in the clinically severe cases. Both creams were well tolerated; undesired side effects were observed neither with halometasone cream nor with prednicarbate cream. Cosmetic acceptance was assessed as very good by 50.6% of patients treated with halometasone cream, and 46.0% of patients treated with prednicarbate cream. Summarizing, it may be noted that halometasone cream is more effective than prednicarbate cream, and is equally well tolerated. PMID- 1778535 TI - Metabolism of digoxin, digoxigenin digitoxosides and digoxigenin in human hepatocytes and liver microsomes. AB - In vitro metabolism of digoxin and its cleavage-related compounds was investigated using hepatocytes in primary culture and microsomal fractions both isolated from human livers. On these models, digoxin (DG3) and digoxigenin bisdigitoxoside (DG2) were not shown to be significantly metabolized in vitro in man. Therefore, it appeared that the stepwise cleavage of DG3 and DG2 sugars was not cytochrome P450 dependent. This enzymatic system probably plays a minor role in humans for this particular reaction. However, digoxigenin monodigitoxoside (DG1) and digoxigenin (DG0) which are known to be formed after intra-gastric hydrolysis of DG3, were extensively converted to polar compounds (mainly glucuronides). In addition, using human liver microsomes, a wide variability in UDP-glucuronyl transferase (UDPGT) activities responsible for DG1 glucuronidation was demonstrated. These results suggest that two main factors may contribute to the overall interindividual variability of digoxin biotransformation: 1), the individual intra-gastric pH which influences the sugar cleavage leading to DG1 and DG0; ii), a variability in the level of the hepatic UDPGT specific for digitalis compounds conjugation. PMID- 1778536 TI - In vivo effects of macrolides on thyroid hormone serum levels and on hepatic type 1 5'-deiodinase in rat. A comparative study with amiodarone, phenobarbital and propranolol. AB - Very often, an impact on the intracellular metabolism of iodothyronines and more precisely on microsomal deiodinases is evoked to explain thyroid hormone (TH) serum level alterations occurring with numerous drugs. Among them, three at least are also known to interfere with other hepatic microsomal enzymes, amiodarone (AMI), phenobarbital (PHE) and propranolol (PRO). Starting from this statement, we have examined the effects of 5 macrolides on TH serum level and on hepatic 5' type 1 deiodinase (5'DI) in vivo in rat. Rats were treated orally for eight days either with 200 mg/kg macrolides--erythromycine (ERY), troleandomycine (TRO), josamycine (JOS), midecamycine (MID) and spiramycine (SPI)--, or with AMI (45 mg/kg), PHE (50 mg/kg) or PRO (20 mg/kg), these 3 latter drugs for comparative purpose. Total T4, T3 and rT3 were determined by RIA. Hepatic 5'DI was evaluated by measuring released radioactive iodide from a reverse T3 monolabelled with 125I used substrate. Compared to control group, ERY and TRO decreased T4 (respectively by 28 and 16%) and from these two, only TRO decreased T3 (23%). With JOS, the only major modification was an increment of T3 (26%). AMI gave a typical alteration with a high T4 (130%), a low T3 (26%) and a high rT3 (376%). 5'DI was statistically inhibited by AMI (85%), JOS (49%), TRO (43%) and ERY (35%). The other drugs showed no significant effect. So, three macrolides have both altered TH serum level and 5'DI, findings which have never been reported before. The precise mechanism of this action remains unknown and the resulting effect, being far from the one observed with AMI, tends to demonstrate, for macrolides, an absence of correlation between the extent of 5'DI inhibition and TH serum profile. Besides, comparative analysis of the results observed with macrolides, AMI, PHE and PRO argues against any relationship between 5'DI and cytochrome-P450 monooxygenases. PMID- 1778537 TI - Pharmacokinetics of methohexital during cardiovascular surgery with cardiopulmonary bypass. AB - The pharmacokinetics of methohexital after intravenous bolus administration was studied during cardiovascular surgery with cardiopulmonary bypass. The effect of body temperature (normothermia and hypothermia) during cardiopulmonary bypass on methohexital pharmacokinetics was investigated. The pharmacokinetic data obtained were compared with those from vascular surgery without cardiopulmonary bypass. A marked decrease in plasma methohexital concentrations and therefore in area under curve and a significant increase in clearance and in volume of distribution were observed in the cardiopulmonary bypass groups compared to the vascular surgery group without cardiopulmonary bypass. However, the elimination half-life and the mean residence time were similar in the 2 groups. Furthermore, the study shows that body temperature during cardiopulmonary bypass does not influence methohexital pharmacokinetics. PMID- 1778538 TI - A comparative pharmacokinetic and pharmacodynamic study of conventional and sustained-release preparations of acebutolol in healthy volunteers. AB - Pharmacokinetics and the degree of beta-blockade of sustained release (SR) acebutolol (500 mg/day) and conventional acebutolol (200 mg tid) were examined after the first oral dose and after 10 days of treatment in ten healthy volunteers. After the first dose, acebutolol Cmax did not significantly differ between the two formulations; however, on day 10 acebutolol Cmax was significantly higher after SR formulation. Cmax of diacetolol, the major metabolite, did not differ between SR and conventional acebutolol neither on day 1 nor on day 10. The dose-corrected relative bio-availability of acebutolol was not different from 100% on day 1 and day 10; however the dose-corrected diacetolol AUC, SR/conventional ratio, was significantly lower than 100% on days 1 and 10. Both acebutolol preparations exerted a significant reduction in exercise tachycardia over 24 h on day 1 and day 10; however, conventional acebutolol exhibited a greater reduction 24 h after the first dose. Exercise induced increase in systolic blood pressure was similarly inhibited by both treatments except for 24 h after the first dose when systolic blood pressure was significantly higher with SR than with conventional acebutolol. The percent reduction in heart rate during exercise was linearly correlated with log acebutolol plasma concentrations for each treatment regimen. These results suggest that beta-blockade exerted by SR acebutolol in healthy volunteers is equivalent to that of conventional acebutolol. PMID- 1778539 TI - Steady-state population pharmacokinetics of sustained release theophylline in adult asthmatic patients. AB - The steady-state population pharmacokinetics of theophylline were studied in 52 asthmatic adult patients who received sustained-release theophylline as armophylline or euphylline. A total of 92 steady-state plasma theophylline concentration-dosage pairs were analyzed using a nonlinear mixed effects model. The pharmacokinetic model used was a one-compartment open model with single path Michaelis-Menten elimination. Dosage was adjusted to body weight. The effects of age, gender, alcohol consumption, cigarette smoking, dosage form, concurrent treatment with beta-agonists or steroids, outpatient dosing, and plasma caffeine concentration on maximum elimination rate (Vm) and Michaelis constant for theophylline metabolism (Km) were investigated. Hypothesis testing produced a final model in which Km = 0.42 (mg/l), and Vm (mg/kg per day) was based on cigarette smoking and dosage form, with Vm = 7.54 + 2.01 (smoking) + 1.08 (euphylline). Estimated coefficients of variation for interindividual variability in Km and Vm were 162.6% and 48.1%, respectively. Residual variability in dosage rates was estimated as 0.90 mg/kg per day. The identification of factors influencing theophylline disposition should prove useful for the a priori design of theophylline dosage regimens and monitoring of drug levels during therapy. PMID- 1778540 TI - Kinetics of allopurinol and its metabolite oxypurinol after oral administration of allopurinol alone or associated with benzbromarone in man. Simultaneous assay of hypoxanthine and xanthine by gas chromatography-mass spectrometry. AB - Allopurinol, oxypurinol, hypoxanthine and xanthine were assayed simultaneously using a highly specific method combining gas chromatography and mass spectrometry. Two hypo-uricaemic prescriptions were compared: i) 300 mg of allopurinol (AL); and ii) 100 mg of allopurinol plus 20 mg of benzbromarone (AL + BZB). When administered acutely, their effects on blood uric acid levels were similar. Analysis of the pharmacokinetic parameters of allopurinol and its metabolite after each treatment showed dose-linearity for the metabolite but not for the drug itself. The area under the concentration time curve for allopurinol was 40.3 +/- 9.3 mumol l-1 h after AL, against 8.4 +/- 3.9 mumol-1 h after AL + BZB, while for oxypurinol it was 948.0 +/- 125.4 mumol l-1 h after AL and 285.2 +/- 77.9 mumol l-1 h after AL + BZB. The difference in dosage form may partly account for this difference, but the benzbromarone also seems to be involved. Its role on the blood uric acid lowering action of the drug association is complex. Although benzbromarone appreciably favors the elimination of oxypurinol, which should result in a weakening of its hypo-uricaemic action, this is offset by enhanced elimination of hypoxanthine and xanthine. Renal clearance of xanthine was significantly increased under AL + BZB (173.1 +/- 65.6 ml/min against 112.2 +/- 32.9 ml/min after AL). Similarly, blood xanthine levels were proportionately higher in the presence of benzbromarone. The action of the two agents may thus be synergistic and not antagonistic, a pharmacological justification for the therapeutic use of this drug association. PMID- 1778541 TI - Dose-response effects of atropine in human volunteers. PMID- 1778542 TI - Protection against ischaemic ventricular fibrillation by blocking agents of myocardial cell calcium influx. Electrophysiological study in the pig in situ heart. PMID- 1778543 TI - Lesioning the substantia nigra reduces striatal infarct volume following focal ischemia in rats. PMID- 1778544 TI - A physician's view of managed care. PMID- 1778545 TI - Can managed care control costs? PMID- 1778546 TI - New systems to manage mental health care. PMID- 1778547 TI - Managing the physician: rules versus incentives. PMID- 1778548 TI - Employers and managed care: what are the early returns? PMID- 1778549 TI - The impact of state laws on managed care. PMID- 1778550 TI - The health insurance industry in the year 2001: one scenario. PMID- 1778551 TI - Insurance reform: industry, heal thyself! PMID- 1778552 TI - Change and growth in managed care. PMID- 1778553 TI - A labor leader's view of insurance reform. PMID- 1778554 TI - The promise of managed care: an insurer's perspective. PMID- 1778555 TI - HMOs and managed care. PMID- 1778556 TI - HMO managers' views on financial incentives and quality. PMID- 1778557 TI - How competitive is competitive bidding? PMID- 1778558 TI - Health spending through 2030: three scenarios. PMID- 1778559 TI - Comparing urban and rural physicians. PMID- 1778560 TI - Patients evaluate their hospital care: a national survey. PMID- 1778561 TI - The consumer movement takes hold in medical care. PMID- 1778562 TI - Is health professions education part of the solution? PMID- 1778563 TI - Policy analysis or polemic on Oregon's rationing plan? PMID- 1778564 TI - Give Oregon a chance. PMID- 1778565 TI - Efficiency and health services. PMID- 1778566 TI - Diversity and transition in health insurance plans. PMID- 1778567 TI - Tracing the cycle of health insurance. PMID- 1778568 TI - Coordinated care and public programs. PMID- 1778569 TI - National health insurance revisited. PMID- 1778570 TI - State responses to HMO failures. PMID- 1778571 TI - Managing a pluralist health system. PMID- 1778572 TI - Resection for achalasia of the esophagus. AB - One hundred and twenty-two patients with advanced mega-esophagus managed by esophagectomy without thoracotomy and cervical gastroplasty were evaluated. Sixty nine patients were followed up for periods of 6 months to 16 years. Clinical assessment included X-ray studies and endoscopy of the cervical esophagus and mobilized stomach. The most common postoperative complications were pleural effusion (22.1%) and cervical fistula (8.2%). Mortality was 4.18%. Regurgitation was the most frequent complaint in the late follow-up, followed by heartburn. Both symptoms were related to esophagitis and diffuse gastritis. Diarrhea and dumping also occurred due to vagotomy and pyloromyotomy performed at the same time as esophagectomy. The endoscopic study demonstrated esophagitis in 25.5% of the patients, and diffuse erosive gastritis in 12.7%. The symptoms and late complications were handled by clinical measures and careful endoscopic follow-up. Gastroplasty was considered a good procedure for replacing the esophagus, solving the serious problem of dysphagia and for providing nutritional improvement for the patient. PMID- 1778573 TI - Results of surgical treatment of achalasia of the esophagus. AB - Surgical treatment of patients with achalasia of the esophagus results in dramatic and permanent relief in almost 90% of the patients. The abdominal approach seems to produce more reflux than the thoracic route. There is evidence that extending myotomy more than 10 mm onto the stomach increases reflux. The length of the hypertensive gastroesophageal sphincter is almost 4 cms and an anterior esophagomyotomy of 5 to 6 cms is long enough in these patients. Extending the section 7 to 10 cms proximally would seem to be unnecessary and may provoke more reflux. The mortality rate of the surgical procedure is very low- less than 0.2%. Postoperative complications can occur in almost 4% of them, esophageal leakage being the most dangerous. The most frequent late complication is gastroesophageal reflux, which can occur symptomatically in 10% of the cases and by objective studies in almost 20% of the patients. The addition of antireflux surgery is controversial. If performed, it must be ensured that no obstruction can occur; esophageal emptying in an aperistalsic esophagus can be seriously delayed. Comparative studies suggest that the addition of antireflux surgery gives better results than myotomy alone. Surgeons performing this operative technique should be specialized digestive tract surgeons and familiar with manometric studies. PMID- 1778574 TI - Clinical aspects and manometric criteria in achalasia. AB - Achalasia is the best known primary motility disorder of the esophagus. Dysphagia is the main symptom, intermittent at the beginning, but becoming more marked with evolution. Although some peculiarities are noted, they are not sufficiently characteristic to establish the diagnosis. Chest pain is often associated with dysphagia and may be the prominent complaint in the early stage of the disease. Dynamic investigations, mainly esophageal manometry, are needed for the diagnosis and follow-up after treatment. Three findings are commonly recorded: increase in lower esophageal sphincter pressure, lack of relaxation and absence of peristalsis, the latter being indispensable for the diagnosis of achalasia. On the basis of manometric findings, achalasia is easily differentiated from other primary motility disorders, i.e. diffuse esophageal spasm, nutcracker esophagus, but non-specific esophageal motility disorders are frequent. Manometry is also an objective method of assessing the effectiveness of treatment--i.e. surgical myotomy or balloon dilatation--of the lower esophageal sphincter. PMID- 1778575 TI - Surgical management of failed esophagomyotomy (Heller's operation). AB - An analysis of the causes of failure of Heller's operation is necessary in order to arrive at appropriate treatment. We retrospectively studied 100 reoperations for failed esophagomyotomy. Usually, a repeat myotomy was performed via an abdominal approach if the initial Heller's operation proved a failure, or via a thoracic approach if extensive motor disorders were discovered at manometry. Until 1978, esophagogastric resections were performed for severe esophageal injuries due to reflux after Heller's operation, but since then, duodenal diversion has obviated the need for resection. Antrectomy with Roux-en-Y gastrojejunostomy and vagotomy might be performed via an abdominal approach because the latter, always mandatory, is feasible through a transdiaphragmatic approach. Esophageal resection was reserved for major esophageal asystole, some cases of sclerosis, and carcinomas occurring or discovered after Heller's operation. PMID- 1778576 TI - Non-surgical treatment of achalasia. AB - The present-day treatment of achalasia is palliative and is aimed at reducing the lower esophageal sphincter pressure. Drug therapy with nitrates and nifedipine is beneficial for short-term relief in patients with relatively mild symptoms or as a temporary measure before a more definitive form of therapy. Balloon dilatation is the traditional non-surgical treatment of achalasia. Balloon dilatation is a safe procedure that can be used even when the esophagus is widened and tortuous, or when the patient is cachectic. The method of balloon dilatation used by the authors is described in detail. The immediate and late clinical, manometric and radiographic results of such dilatation are excellent and compare favorably with those of surgery. With balloon dilatation improvement is immediate, complications are rare and the risks are low. Morbidity and costs and the occurrence of stenosing reflux are considerably less than after surgical cardiomyotomy. Balloon dilatation is considered the treatment of choice for most patients with achalasia. PMID- 1778577 TI - Esophagomyotomy by the thoracic approach for esophageal achalasia. PMID- 1778578 TI - Comparison of forceful dilatation and esophagomyotomy in patients with achalasia of the esophagus. AB - In the present paper we have reviewed the results of forceful dilatation as compared with surgical esophagomyotomy in patients with achalasia. The review of 4 retrospective and uncontrolled studies revealed that in all, surgery produced a more effective late result than dilatation, with minimal side effects and very low or no mortality. In the only prospective randomized study comparing both treatments by the same group, good late results were seen after surgery in 95% of the cases, as compared with 65% after dilatation (p less than 0.001). The resting gastroesophageal sphincter pressure was predictive of the quality of the late results. Reflux occurred in 8% of the dilated and in 19% of the operated group as measured by standard acid reflux test. The old, classical concept that dilatation is the first choice and preferable method of treatment for patients with achalasia should be reviewed, and the idea that surgery should be reserved only for patients in whom dilatation has failed should be abandoned. We propose that surgical treatment should be the initial choice in the majority of patients with achalasia of the esophagus. PMID- 1778579 TI - Gastro-esophageal reflux following myotomy for achalasia. AB - Evidence is not available for a surgeon to be certain that one form of procedure is better than another in preventing reflux after myotomy of the lower esophageal sphincter in patients with achalasia. Therefore, each surgeon should choose the procedure and approach which he performs most competently. Well respected authorities in this field continue to advocate the performance of an antireflux procedure, or advocate that it is unnecessary to use a routine antireflux procedure. It is the author's own practice to add an antireflux procedure in the form of a partial fundoplication, in all patients having a myotomy of the lower esophageal sphincter. Sometimes there are factors which dictate one or other of the thoracic or abdominal approach, e.g. previous surgery, very obese patient, etc. When no such factors are present I favor the abdominal approach in the belief that an abdominal incision provides less morbidity than a thoracic incision. PMID- 1778580 TI - Achalasia of the esophagus in childhood. Surgical treatment in 35 cases, with special reference to familial cases and glucocorticoid deficiency association. AB - Achalasia of the esophagus is a relatively rare problem in children, but it may be the cause of severe lung disease, growth retardation and respiratory death in young infants. Surgical esophago-cardio-myotomy remains the treatment of choice, and this article details 25 years of experience with 35 children with achalasia of the esophagus and their late post-operative follow-up. The occurrence of achalasia in the first six months of life, the existence of a familial factor, the prevalent possible association with genetic diseases (familial dysautonomia, glucocorticoid insufficiency, Rozycki syndrome) suggest that achalasia in childhood may in certain cases represent a congenital problem, somewhat different from the adult form, which is considered to be an acquired disease. PMID- 1778581 TI - Esophageal carcinoma and achalasia: prevalence, incidence and results of treatment. AB - Between 1980 and 1988, we treated 1,521 patients with squamous cell carcinoma of the esophagus and 336 patients with adenocarcinoma of the gastric cardia. Between 1967 and 1988, 244 patients with esophageal achalasia were also observed. Among 1,857 patients with cancer, achalasia was present in 21 cases (1.1%). In 18 patients the mean and median interval between the diagnosis of achalasia and cancer was 11.5 and 8 years, respectively. In 3 cases achalasia was detected during the work-up for esophageal cancer. The previous treatment for achalasia administered elsewhere was as follows: balloon dilatation in 6 cases, myotomy and Nissen repair in 2, and distal esophageal resection in 1. Thirteen patients (61.9%) underwent resection, resulting in 1 postoperative death, and a mean and median survival of 23.3 and 13 months, respectively. Push intubation was performed in 4 cases, chemotherapy in 2, a by-pass procedure in 1, endoscopic Nd:YAG laser in 1, while 1 further patient did not receive any treatment for the carcinoma, but only balloon dilatation of the LES. The mean follow-up of the 244 patients with primary esophageal achalasia was 44.6 months (range 1-108), and only 1 patient developed an esophageal cancer, giving an incidence of 18.6 cases per 100,000 per year. CONCLUSIONS: in our experience, achalasia is present in a minority of patients with esophageal cancer, and larger prospective controlled trials are needed to assess the true incidence of malignant degeneration in the achalasic patient. PMID- 1778582 TI - Gastric adenocarcinoma in the gastric stump after partial gastrectomy. AB - Carcinomas of the gastric stump are divided into two types. In the main group of patients (n = 18), carcinoma developed after resection for benign ulcer disease, and in the second group (n = 4) after resection for early gastric carcinoma. In the first group, the mean age of the patients was 63, and the male-to-female ratio of 17:1. The mean interval between the primary operation and the diagnosis of cancer was 27 years. Biopsies were positive in 16 out of 18 patients. The resectability rate was 72%, resection being performed with curative intent in 50%. Total gastrectomy was performed in 50% of the cases. There were no postoperative deaths. The 5-year survival rate was 33% for all patients and 50% after tumoral resection. Early detection was achieved by means of an endoscopic survey of the gastric stump. A comparison between gastric stump carcinomas and other gastric carcinomas in our series fails to reveal any major differences. Gastric stump carcinoma is not specific. In the second group, the mean age of the patients was 72.5 and the sex ratio 1:1. The mean interval between the two operations was 5 years. The resectability rate was 100%, and all the patients survived with follow-up ranging from 2 to 10 years. The second lesion could be considered a metachronous cancer, but it may have been present and overlooked at the time of the initial gastrectomy. Differentiating between synchronous and metachronous lesions is quite difficult. PMID- 1778583 TI - Gastric secretory investigation of recurrent ulcer after surgery for duodenal ulcer. AB - The results of gastric secretory studies in 192 cases of recurrent ulcer after surgery for duodenal ulcer were analyzed and compared with the secretory data collected in a control group of 74 duodenal ulcer patients who had undergone various forms of gastric surgery, but who did not develop a recurrent ulcer (controls). The patients studied comprised 46 cases of recurrent ulcer after partial gastrectomy, 10 cases of recurrent ulcer after partial gastrectomy and bilateral truncal vagotomy, 56 cases of recurrent ulcer after truncal vagotomy and drainage, 52 cases of recurrent ulcer after highly selective vagotomy, and finally 28 cases in which the recurrent ulcer led to the diagnosis of the Zollinger-Ellison syndrome. The entire study was based upon an analysis of the basal acid output, the response to maximal stimulation by pentagastrin or by histalog and by insulin in the case of previous vagotomy, and finally on an assessment of basal serum gastrin. The analysis has suggested minimal secretory levels with discriminative values useful for the postoperative diagnosis of recurrent ulcer and for an assessment of the completeness of vagotomy (ratio PAO Insulin/PAO pentagastrin or histalog). Moreover, an analysis of various elements of the sequential basal pentagastrin-insulin test permitted us to approach the pathophysiological mechanism responsible for ulcer recurrence, and to identify suitable criteria for selection of the best treatment. PMID- 1778584 TI - Total duodenal diversion in patients with previous gastric surgery. AB - Total duodenal diversion (TDD) was performed in 19 patients with severe post gastric surgery symptoms. Previous operations were truncal vagotomy associated with pyloroplasty or antrectomy (n = 6), proximal esophagogastrectomy (n = 8) or total gastrectomy (n = 5). Technical adjustments to the standard procedure (truncal vagotomy, antrectomy and gastrojejunal anastomosis using a 70 cm Roux-en Y loop) were required. There were no postoperative deaths, no anastomotic leakage or anastomotic ulceration. The main symptoms were eliminated, and endoscopic gastritis and esophagitis healed in all patients. Heartburn and bilious vomiting ceased in all patients, but in five out of 14 patients with a residual stomach some symptoms persisted. TDD proved a safe and effective treatment of disabling symptoms following gastric surgery. PMID- 1778585 TI - Gonadal dysfunction and changes in sex hormones in postnecrotic cirrhotic men: a matched study with alcoholic cirrhotic men. AB - To investigate the gonadal dysfunction and changes in sex hormones in male patients with postnecrotic cirrhosis, and to compare them with those in alcoholic cirrhotic men, three age-matched groups of men (hepatitis B virus-related postnecrotic cirrhosis 27, alcoholic cirrhosis 21, normal controls 30) were studied. Twelve of the 21 (57%) alcoholic cirrhotics and 16 of the 27 (59%) postnecrotic cirrhotics had a history of impotence. Both alcoholic and postnecrotic cirrhotic patients had significantly lower basal testosterone, but higher estradiol and prolactin levels than the control group (p less than 0.05). However, no differences were noted between the two cirrhotic groups. The degree of reduced testosterone and increased prolactin levels correlated with the severity of the cirrhosis. Despite the low testosterone concentration, basal levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) were not increased in the cirrhotic patients. All the three groups studied had normal FSH and LH responses to the stimulation of exogenous gonadotropin releasing hormone. On the basis of these results, we conclude that: (1) impotence and low testosterone level are not infrequent findings in men with hepatitis B virus related postnecrotic cirrhosis, especially in those with decompensated liver function. (2) The liver disease per se is important for the development of male sexual dysfunction. (3) The derangement of hypothalamic-pituitary function may play a role in the sexual dysfunction and changes in sex hormones in male patients with cirrhosis. PMID- 1778586 TI - Gastric hyperplastic changes and thymidine uptake after partial gastrectomy in rats. AB - Foveolar hyperplastic changes have been recently considered to be the most distinctive histological findings following partial gastrectomy, and their relationship to bile reflux has been proven. The present study was undertaken in order to determine whether an increase in 3H-thymidine uptake, which is an expression of increased gastric mucosal proliferative activity, might correspond to these hyperplastic changes. Histology and thymidine uptake values were assessed and compared in nineteen rats operated upon either with a Polya gastrectomy (11) or with a Roux-en-Y biliary diversion (8). Thymidine uptake values and the extent of gastric hyperplastic changes were greater in the Polya than in the Roux-en-Y group. Moreover, a significant correlation was found between thymidine uptake values and the extent of hyperplastic changes. Therefore, the relationship between hyperplastic changes and increased mucosal proliferative activity post-gastrectomy would seem to have been proven. Since bile acids have been shown to be able to stimulate cell proliferation in ileal and colonic mucosa, a role for bile reflux in the increased cell proliferation activity in the gastric stump can be hypothesized. PMID- 1778587 TI - Autoantibody specific for transfer ribonucleic acid (tRNA) in patients with autoimmune chronic active hepatitis and primary biliary cirrhosis. AB - Autoantibody reactive with tRNA was identified by immunoprecipitation of Hela cell extract. Four out of 56 sera from patients with autoimmune chronic active hepatitis (CAH), and four out of 35 sera from patients with primary biliary cirrhosis (PBC) contained antibody directed against gel-purified tRNA in Hela cell extract, but no sera obtained from CAH type B, CAH non-A, non-B, or healthy volunteers did. Further studies on these eight anti-tRNA sera disclosed that 6 of the 8 sera that immunoprecipitated tRNA from Hela cell extract, reacted with purified tRNA, but reacted with neither 5sRNA nor ribosomal RNA species. After proteinase and deoxyribonuclease digestion of Hela cell extract, the epitope for these 6 sera was conserved, and the antigen was sensitive to ribonuclease (anti tRNA serum). Purified Hela cell DNA digested with Eco RI or Hind III (denatured or non-denatured) could not be immunoprecipitated by these sera. In a patient with autoimmune CAH, the anti-tRNA antibody was weakly positive at week 2 and disappeared 2 months after steroid therapy started, "in parallel" with disappearance of anti-nuclear antibody. In the other 2 sera, the antigen was sensitive to proteinase. PMID- 1778588 TI - Abdominal sepsis following liver resection in the rat. AB - A standardized 2/3 liver resection was performed in the rat. One and seven days following liver resection, gram-negative sepsis was induced by cecal ligation and puncture (CLP). Mortality significantly increased following CLP one day after hepatectomy, but no difference was to be seen after seven days as compared with sham operated animals. Clearance of radiolabeled heat-killed 125I E. coli injected intravenously was significantly decreased one day following liver resection, but not after seven days. The capability of bacterial clearance and survival correlated well with the increase in weight of the liver remnant following liver resection, as did organ uptake of radiolabeled bacteria within the liver, spleen and lungs, as a measure of reticuloendothelial system function. Splenic and pulmonary uptake initially increased following liver resection, but normalized within seven days. In conclusion, the present study shows that the liver is responsible for most of the reticuloendothelial system function and that a major liver resection increases the risk of fatal outcome before regeneration of the liver remnant has occurred, despite normal function of the residual liver tissue. PMID- 1778589 TI - Villous tumors of the duodenum. Presentation of five cases. AB - Five cases of villous tumors of the duodenum are reported. These tumors have a predilection for the periampullary region and tend to present with jaundice or obstruction of the duodenal lumen. In four of these patients, malignant transformation was seen. Endoscopy and biopsy play a major role in attempting to obtain an accurate preoperative diagnosis. Unfortunately, the diagnosis of malignant degeneration is frequently missed, even when multiple biopsies are taken. For this reason villous tumors should always be resected, and the strategy of treatment must depend on pre-, intra- and postoperative histological evaluation, location in the duodenum and intra-operative findings. PMID- 1778590 TI - Simultaneous superficial squamous cell carcinoma of the esophagus and early gastric adenocarcinoma. AB - Although cases of simultaneous invasive cancer of the esophagus and primary gastric cancer have been reported sporadically, the incidence of the association of superficial esophageal cancer and early gastric cancer is extremely low. In this paper we report on two cases of the rare combination of superficial squamous cell cancer of the esophagus and simultaneous early adenocarcinoma of the stomach. A total of 18 such cases in the literature are reviewed and discussed with respect to surgical procedure and the choice of alimentary tract for the reconstruction of the esophagus. PMID- 1778591 TI - Splenic vein thrombosis. Diagnosed with Doppler ultrasonography. AB - The case of a 31-year-old pregnant woman with an isolated splenic vein thrombosis, diagnosed with Doppler ultrasonography is presented. Routine ultrasound examination in the fourth month of the pregnancy revealed massive splenomegaly of unknown origin. Doppler ultrasonography subsequently revealed splenic venous thrombosis with absence of blood flow. Noteworthy gastric varices were present at the endoscopic examination. On splenectomy, a spleen weighing 2,600 was removed, and numerous venous collaterals were found in the perigastric region. The postoperative course was satisfactory, pregnancy evolved normally, and a healthy female baby was delivered at term. The patient remained in excellent health with normal clinical and laboratory data. PMID- 1778592 TI - The effect of the frequency of subcutaneous insulin-like growth factor-1 administration on weight gain in growth hormone deficient mice. AB - To ascertain the frequency of subcutaneous IGF-1 administration necessary to promote growth we examined the weight gain of male homozygous lit/lit mice in response to either sc. IGF-1 or bovine GH administration. Lit/lit mice showed a dose dependent response to treatment with GH. Bovine GH induced a response in body weight gain within 3 days of the start of treatment. Following a single subcutaneous injection of IGF-1, plasma IGF-1 levels were elevated for 4-6 hours. Three treatment schedules for IGF-1 were used (once daily, twice daily and four times daily), each employing the same total daily dose of IGF-1 (30 micrograms). With IGF-1 treatment, a significant effect on body weight gain was obtained when administered four times daily. The growth rate with IGF-1 treatment 6 hourly was similar to that observed following treatment with bGH (10 micrograms sc daily). Twelve hourly IGF-1 administration only had a significant effect on body weight gain when weight was measured in the evening. Lit/lit mice treated once daily with 30 micrograms IGF-1 had no weight gain response and became severely hypoglycaemic. Frequent subcutaneous IGF-1 administration is one approach to growth enhancement in GH deficiency; higher doses administered less frequently do not promote growth and may cause hypoglycaemia. PMID- 1778593 TI - Effect of dietary level of protein on the metabolism of mouse liver nuclear proteins. AB - The effect of protein depletion and refeeding on the metabolism of mouse liver nuclear proteins was studied. Five days protein depletion caused a 35% decrease in total nuclear protein. A fast recovery of the lost proteins, except histones, was induced when depleted mice were refed with a normal diet. Depletion caused a decrease in total nuclear protein synthesis, whereas refeeding quickly restored its normal value. The rates of total nuclear protein breakdown were estimated either as the difference between synthesis and protein gain or from the decay of radioactivity in protein labeled by the administration of both sodium [14C]bicarbonate and [35S]methionine. By these procedures, it was found that refeeding caused a slowdown in total nuclear protein breakdown. Hence, the recovery of the protein content observed during refeeding is due to both a restoration of synthesis and a decrease of breakdown. The [14C]bicarbonate procedure did not permit to obtain a high efficiency of label and, therefore, it was unsatisfactory for the measurement of the breakdown of fractionated nuclear proteins. A labeling procedure using [35S]methionine was designed for adequate measures of the decay of radioactivity in these proteins. This allows us to find that a slow down in breakdown affects similarly during refeeding to histones, to non histones, and to a fraction which contains ribonucleoproteins and soluble proteins. PMID- 1778594 TI - Metabolic adaptations to nitrogen excess in late gestation in rat. AB - Pregnant rats of 19th and 21st days were given an acute nitrogen overload produced by an infusion of either 0.2 M ammonium acetate or 0.2 M glutamine. Metabolic adaptations to nitrogen excess were studied measuring--in fetomaternal unit--non-protein nitrogen content and the activities of enzymes related with ammonia metabolism. Maternal and fetal plasma urea levels were increased by ammonium acetate treatment. Glutamine overload increased more the amino acid content in the mothers than in conceptus. As response to ammonium acetate treatment, glutamate dehydrogenase activity in liver was more sensitive in pregnant than in nonpregnant rats, suggesting more nitrogen incorporation into amino acids in pregnancy. Regarding glutamine synthetase activity, both treatments had an opposite effect except in kidney. The adenylate deaminase activity of pregnant rats was inhibited similarly to nonpregnant rats by nitrogen overloads, but stronger after glutamine infusion. Placenta and fetal metabolism were adjusted, as the dams, to lack of ammonia production by nitrogen overloads and to glutamine synthesis by ammonium acetate infusion. PMID- 1778595 TI - Dissociated response of thyrotropin and prolactin to dopamine receptor blockade with domperidone in hypothyroid subjects. AB - To investigate the hypothesis of an altered hypothalamic dopaminergic activity in primary hypothyroidism, eight patients with hypothyroidism and seven normal subjects, all female, were studied. All of them were submitted to two tests: TRH stimulation and after the administration of dopamine receptor-blocking drug, Domperidone. The hypothyroid patients with basal TSH values less than or equal to 60 mU/L (4 cases--group 1) had lower PRL levels than the remaining 4 subjects with TSH greater than 60 mU/L (group 2) (p less than 0.001), despite all patients presenting the PRL levels within the normal range. A significant increase occurred for both TSH and PRL after the administration of TRH and Domperidone in normal as well as in the hypothyroid subjects, except for TSH in group 1 after the administration of Domperidone. The area under the curve for PRL response to THR was not different between the normal subjects and both hypothyroid groups, while that under the curve for TSH was greater in the hypothyroidism as a whole than in the normal subjects (p = 0.006) and between the hypothyroid groups, being greater in group 2 than in 1 (p less than 0.009). In relation to Domperidone, the area under the curve for TSH was significantly higher in group 2 when compared to the normal controls (p less than 0.001), while for PRL it was not different between hypothyroid groups in relation to normal controls and when groups I and II were compared. These results suggest that the hypothalamic dopamine activity is not altered in primary hypothyroidism and favor the small relevance of dopamine on the control of TSH secretion. PMID- 1778597 TI - Daily profiles of aldosterone levels during normal, high and low sodium intake in patients with essential hypertension. AB - The episodic secretion of aldosterone depends on the dietary sodium intake, alterations in posture and follows ACTH circadian rhythm. Aldosterone daily profiles have been studied in 23 supine essential hypertensive patients on normal sodium intake. Secretory pulses at a frequency of two to five pulses per 12 hr have occurred, independent of PRA levels. Among 13 patients with normal PRA two lost pulsatility when sodium was loaded (10 g/24 hr) and the same happened with two others on sodium restricted diet (2 g/24 hr). These results suggest a profound effect of dietary sodium intake on the pulsatile pattern of aldosterone secretion, particularly in normal PRA essential hypertension. PMID- 1778596 TI - Activation of blood coagulation and fibrinolysis in Graves' disease. AB - We studied blood coagulation and fibrinolysis activities in hyperthyroidism before and after methimazole or 131I. Fibrinopeptide A and B beta 15-42, in vivo indicators of thrombin and plasmin activity, were measured by RIA, while fibrinogen by the Clauss method. We studied 50 patients, affected by toxic diffuse goiter. We evaluated 21 of them before and after treatment. Fibrinogen, fibrinopeptide A, and B beta 15-42 were higher in patients than in controls (p less than 0.0001). There was no difference in fibrinopeptide A nor in B beta 15 42 before or after treatment. In euthyroidism fibrinogen returned to normal values. Inflammation of the thyroid gland secondary to autoimmunity may activate blood coagulation by release of tissue factor. High fibrinogen before treatment may be explained as an aspecific response. Since it persists in euthyroidism, autoimmunity could account for high fibrinopeptide A and B beta 15-42 aftertreatment. PMID- 1778598 TI - Acid phosphatase activity in human uterine fluid in relation to infertility. AB - In the luminal fluid of parous women the acid phosphatase activity was found to be very low and remained virtually unchanged throughout the cycle (10.60 to 18.14 mgp/hr/100 ml). In the infertiles, the activity was generally high with a maximum of 54.37 mgp/hr/100 ml at late follicular phase. It was argued that increased enzyme level in infertiles could have adversely affected the sperm capacitation power as well as the implantation of the fertilized ovum. PMID- 1778599 TI - Combination of microdialysis and Glucosensor permits continuous (on line) s.c. glucose monitoring in a patient operated device: I. In vitro evaluation. AB - A device for continuous glucose monitoring in fluids was obtained by combining the microdialysis technique with a measuring flow chamber of the "Glucosensor Unitec Ulm" using the GOD method for determining amperometrically blood glucose profiles. The in vitro experiments demonstrate that the relative recovery of glucose by this device is inversely related to the flow rate of the microdialysis perfusion fluid, which, in turn, is inversely related to the response time of the device. The glucose signal increases linearly with the area of the microdialysis working membrane (r = 0.98), and with the glucose concentrations of the standard solutions (r greater than 0.95). The variation coefficient for repeated measurements is below 8%. The accuracy of the device as demonstrated by mean measuring deviation ranges between 1 and 3.8%. PMID- 1778600 TI - Mitotane administration: an unusual cause of hypercholesterolemia. PMID- 1778601 TI - Endothelin induces DNA polymerase alpha activity in ovaries of hypophysectomized estrogen-treated immature rats. PMID- 1778602 TI - The determination of immunoreactive beta-endorphin concentration in the human fetal and neonatal thymus. PMID- 1778603 TI - DNA polymorphisms of the apolipoprotein AI/CIII/AIV gene cluster influence plasma cholesterol and triglyceride levels in the Mayans of the Yucatan Peninsula, Mexico. AB - The purpose of this work was to examine the influence of apolipoprotein gene variation on plasma lipid levels in a population of Mayan Indians of the Yucatan Peninsula, Mexico. Four restriction enzymes: XmnI, PstI, SstI, and PvuII, were used to detect restriction fragment length polymorphisms (RFLP) within the region of the apolipoprotein AI/CIII/AIV gene cluster. The frequencies of these polymorphisms in this Mayan population were similar to those reported for other Amerindian populations, but differed widely from those reported for Caucasian populations. The XmnI and SstI RFLPs were informative for association studies in this population, and we analyzed their influence on the quantitative variation of plasma cholesterol and triglycerides. Using a nonparametric analysis of variance, it is shown that the presence of the XmnI restriction site had a significant effect in lowering plasma cholesterol, whereas the presence of the restriction site for SstI had a significant effect in raising plasma triglycerides. Consequently, genetic indicators of both low and high risk for lipid-related diseases, such as atherosclerosis and coronary heart disease, seem to be present within the same gene region in this Mayan population. PMID- 1778604 TI - The Lewis blood group system among Chinese in Taiwan. AB - The nonsecretor gene se is absent (or very rare) among Chinese in Taiwan and the previously reported Le(a+b-) phenotype in this population is in fact Le(a+b+) as proven by the presence of small amounts of Leb antigen on red blood cells. Salivary ABH substances in this phenotype are usually (although not always) markedly reduced. The Chinese Le(a+b+) phenotype is postulated to be the result of a weak secretor gene Se omega. Although the Le(a+b+) phenotype is very rare in Caucasians, it has a frequency of 25% in Chinese. All Le(a-b-) Chinese are ABH secretors and have varying amounts of Lea and/or Leb substances in saliva. PMID- 1778605 TI - D-- and Dc- gene complexes in the coloureds and blacks of Natal and the eastern Cape and blood group phenotype and gene frequency studies in the Natal coloured population. AB - Following the detection of apparent exclusions in the Rh system in two Coloured (mixed race) families during paternity testing, a rare D-- gene complex was identified in one family and two examples of an unusual gene complex producing weak e and very weak or non-demonstrable f antigen in the other. The latter, which almost certainly belong to the heterogeneous collection known as Dc-, were found when the Rh phenotypes expected to give f+, instead gave f- or f+W (weak positive) results and those expected to give f-, gave f+W results. Blood group phenotype and gene frequency studies showed that the Natal Coloured population contains a mixture of approximately 40% Black, 30% White and 30% Indian (Asian) genes. The phenotypes A1 high H, B high H, B low H, K+ and Kp(a+) associated with Caucasoids and the phenotypes Abantu, Dantu+, hrS- (Rh: -18,-19), hrB- (Rh: -31, 34) and Fy(a-b-) associated with Negroids were all represented. The DCe/Dc- frequency was 6.9% and the DcE/Dc- frequency 2.6%. PMID- 1778606 TI - Genetic polymorphism of alpha-2-HS-glycoprotein in a Spanish population. AB - The genetic polymorphism of alpha-2-HS-glycoprotein (AHSG) was analyzed in 489 unrelated individuals living in Madrid (central Spain), by isoelectric focusing in miniaturized polyacrylamide gels followed by immunoblotting. The allele frequencies were estimated to be 0.7147 and 0.2771 for AHSG*1 and AHSG*2, respectively. In addition to the common alleles, 3 rare variants (AHSG*3, AHSG*10 and AHSG*11) have been found in this study. PMID- 1778607 TI - Linkage disequilibrium and linkage information from one-child families. AB - In linkage analysis a single-child family is usually considered to be completely uninformative. This article shows that such a family can provide information on linkage disequilibrium, even if it provides no information on linkage equilibrium. A transition matrix consisting of the recombination fraction and the phase proportion is proposed to study the genetic transmission from a pair of parents to their single child. The information about linkage for a single-child family is shown to be confounded by the phase proportion. This explains why such a family used to be considered uninformative under the assumption of linkage equilibrium. By reparametrizing the recombination fraction and the phase proportion into one parameter, it is demonstrated that extracting information on linkage disequilibrium is feasible. The study of power of the testing method proposed here is carried out by simulation. PMID- 1778608 TI - HLA phenotype and haplotype frequencies in the Cantabria (middle north Spain) population. AB - The gene and haplotype frequencies of the HLA-A and -B locus antigens were determined in 502 unrelated individuals from Cantabria (middle North Spain). Our results were compared with those reported for other European and Spanish populations. The haplotypes with significant linkage disequilibrium were also analyzed in various Spanish population samples in order to establish possible relationships with geographic situation and historical events. PMID- 1778609 TI - The C5 isozyme of serum cholinesterase and adult weight. AB - The relationship between the CHE2 locus of serum cholinesterase (BChE) and adult human weight was studied in a sample of 225 CHE2 C5+ individuals and 225 CHE2 C5- controls matched for sex, height, age and race. With respect to the intensity of the C5 band staining (scored 1-6), 113 individuals had faint C5 bands (scores 1 3) and 112 intense C5 bands (scores 4-6). The individuals with intense CHE2 C5+ phenotype showed a significantly lower mean adult weight (64.66 +/- 0.73 kg) when compared to their controls (70.59 +/- 0.97 kg) and a significant reduction in weight variance (59.81 and 105.18, respectively). Individuals with faint C5 bands, although showing a negative correlation between weight and C5 band intensity, did not differ from their controls in mean weight. PMID- 1778611 TI - Haptoglobin phenotypes in diabetes mellitus and diabetic retinopathy. AB - An analysis of haptoglobin (HP) phenotypes in 81 cases of diabetes mellitus (DM) without retinopathy and 122 cases with diabetic retinopathy (DR) were studied in relation to 180 normal and healthy controls matched for age and sex. A significant decrease in HP 2-1 frequency was found, suggesting protection for heterozygotes in both DM and DR (with a relative risk of about 0.31). As an acute phase reactant HP may be functionally involved in the etiology of DM and DR, which are associated with immunologic and inflammatory processes, respectively. No significant differences were found with respect to sex, age at onset, duration of DR, types of DM and DR, and family history. PMID- 1778610 TI - Alpha-1-antitrypsin (PI) polymorphism in France, with special regard to the PI*Z allele. AB - Alpha-1-antitrypsin (PI) phenotypes were studied in a sample of more than 5,000 individuals from cities throughout France. Special interest was paid to the PI*Z allele whose average frequency, based on the present work plus results from the literature, was 0.0130. This figure was used to estimate the number of PI Z homozygotes in France. In accordance with previous studies, the frequency of the PI*S allele was found to increase towards the southern parts of France. PMID- 1778612 TI - Recovery of human immunodeficiency virus from asymptomatic prostitutes from Tamil Nadu. AB - Peripheral blood mononuclear cells (PBMC) from 13 asymptomatic healthy human immunodeficiency virus type-1 (HIV-1) antibody positive prostitutes from Tamil Nadu, southern India, were cocultivated with phytohemagglutinin stimulated PBMC from HIV antibody negative donors for HIV isolation. In addition, plasma samples from two antibody positive prostitutes with HIV antigenemia were processed for virus isolation. The presence of virus in the cultures was monitored by (i) assay for virus particle associated reverse transcriptase (RT) activity, (ii) HIV antigen enzyme immunoassay, and (iii) indirect immunofluorescence test to detect expression of HIV specific core antigens p-24 and p-17 in infected cells using monoclonal antibodies to these antigens. The virus was isolated from PBMC from 2 prostitutes (86-4 and 86-5) and from plasma of one prostitute (86-20). These isolates have been characterised as HIV type-1 by dot blot hybridization using HIV-1 and HIV-2 proviral DNA probes. PMID- 1778613 TI - Prevalence of hepatitis B surface antigen & its subtypes in high risk group subjects & voluntary blood donors in Bombay. AB - HBsAg positive subjects belonging to high risk groups and voluntary blood donors were analysed for prevalence of HBsAg among various groups of subjects for ascertaining the carrier status among the voluntary blood donors, HBsAg subtype distribution, and association of HBsAg with blood groups and caste or religion. The prevalence of HBsAg varied from 2.02 per cent in voluntary blood donors to 58.38 per cent in patients of acute viral hepatitis. 70.5 per cent subjects had subtype 'ay' while 23.9 per cent of the subjects had subtype 'ad'. We also found compound 'ady' subtype in 5.6 per cent of our subjects. HBsAg/adr, a subtype not usually prevalent in India, was found in 30 of the 90 'ad' sera. Co-occurrence of HBsAg and anti-HBs was noted in 9 subjects. Homotypic anti-HBs was found to occur together mainly in voluntary blood donors, while heterotypic anti-HBs was found to occur together mainly multi-transfused patients. There was no significant correlation between HBsAg and blood group antigens and a relatively higher incidence of HBsAg among the Jain community was observed. PMID- 1778615 TI - Induction of L-asparaginase synthesis in Vibrio proteus. AB - Studies on L-asparaginase synthesis in V. proteus showed increased synthesis in cultures grown under conditions of moderate aeration (P less than 0.005) after oxygen had been used up from the medium. Addition of sodium lactate to the medium at a concentration of 80 mu mole/ml, stimulated L-asparaginase synthesis (2.2 times over control) in moderately-aerated cultures (P less than 0.001). The substrate L-asparagine induced enzyme synthesis when growth conditions were made anaerobic or lactate was incorporated into the medium (3.8 times increased enzyme synthesis over control). PMID- 1778614 TI - ELISA for detection of heat stable enterotoxin producing Escherichia coli strains. AB - Among 557 strains of Esch. coli isolated from patients with acute diarrhoea, 392 (70.4%) isolates demonstrated ST production by ELISA. Predominant ST producing serogroups were 020 (45), 078 (40), 0128 (21), 061 (19), 0149 (9), 04, 055, 0106 and 0114 (8 each). The inhibition ELISA range was between 10.5 and 40.5 per cent. Visual difference between a negative and a positive ELISA test was distinct. A comparison of ELISA with classical suckling mouse assay for 100 strains showed 88 and 80 positive strains respectively for ST. ELISA proved a more specific, rapid and sensitive assay which may be useful for screening large number of isolates in epidemiological studies. PMID- 1778616 TI - Enterotoxigenic Klebsiella pneumoniae in acute childhood diarrhoea. AB - K. pneumoniae strains recovered as pure or predominant isolate from stool specimens of 50 children below three years of age, presenting with acute watery diarrhoea, were studied for heat-labile enterotoxin production. Twenty three (46%) of the 50 crude toxin concentrates showed positivity in rabbit ileal loops and skin permeability tests. Antigenically 17 (34%) and 20 (40%) of the toxin extracts reacted with immuno-purified anti H-LT antibody in latex particle agglutination and immuno-dot blot assays respectively. Polyacrylamide-gel electrophoresis, Western-blotting and enzyme-immunoassay revealed heat-labile enterotoxin and its subunits in 19 (68%) of 28 extracts tested. In 5 of 10 strains tested the toxigenicity could be transferred to recipient Escherichia coli J-35 in plasmid transfer experiments. Klebsiella induced enterotoxigenic diarrhoea and produced a heat-labile toxin which seems to be biologically, antigenically and possibly genetically related to the heat-labile toxin of the cholera-coli family. PMID- 1778617 TI - An operational study on implementation of oral rehydration therapy in a rural community of West Bengal, India. AB - An operational study of a 3-tier strategy for implementation of oral rehydration therapy (ORT) was conducted in a block of West Bengal with 216,825 population through the existing health services facilities. All the grassroot level, health workers including their supervisors at various levels were trained regarding the management of patients of diarrhoea with mild to moderate degree of dehydration, by ORT. Another block in the same district with similar demographic features where this intervention was not provided served as control. After 22 months of observation, it was evident that despite adequate training, the performance of Community Health Guides (CHGs) and Anganwadi Workers (AWWs) was not encouraging because of the low utilization of both home available fluids (32.0%) and oral rehydration solution (18.0%) in the study area. Similarly, diarrhoea associated mortality could not be reduced significantly. Lack of motivation and failure to maintain sustained level of skill by the CHGs and AWWs constitute the major bottlenecks for the successful implementation of the programme at the community level. PMID- 1778618 TI - Lipid peroxidation in acute falciparum malaria. AB - Lipid peroxidation was assessed by measuring malondialdehyde (MDA) in 30 patients with falciparum malaria and 20 controls (10 healthy adults and 10 patients of vivax malaria). Mean serum MDA was 0.96 +/- 0.38 nmol/ml, 1.1 +/- 0.17 nmol/ml and 2.9 +/- 1.1 nmol/ml in healthy controls, disease controls and falciparum malaria patients, respectively. Levels were significantly high (P less than 0.001) in patients with falciparum malaria. Higher values were associated with more number of complications and deaths. PMID- 1778619 TI - Monoclonal antibodies which inhibit in vitro cytotoxicity of axenic Entamoeba histolytica. AB - A panel of 12 independent hybridoma cell lines secreting monoclonal antibodies to axenic E. histolytica (HM1) have been developed. A hybridoma cell line P4 C4 P2 F8 C8 (clone C8) produced monoclonal antibodies (MoAb C8) of IgG1 isotype which recognised a 29 KD surface associated antigen of amoebic trophozoites in Western immunoblot. Immunofluorescent probing with MoAb C8 employing live and acetone fixed amoebic trophozoites indicated 29 KD molecule on the surface plasma membrane of E. histolytica trophozoites. The MoAb C8 also agglutinated the live amoebic trophozoites. Pretreatment of amoebic trophozoites with anti 29 KD monoclonal antibody significantly (P less than 0.01) inhibited in vitro cytotoxicity of amoebic trophozoites to the cultured baby hamster kidney (BHK-21) cells. MoAb recognised a 29 KD molecule of E. histolytica trophozoites which mediated cytotoxic potentials of the parasite. The absence or variable degree of expression of cytotoxic 29 KD molecule may possibly serve as a marker to differentiate virulent/avirulent populations or strains of E. histolytica. PMID- 1778620 TI - Production & formulation of Bacillus thuringiensis var. israelensis & B. sphaericus 1593. AB - Three fermentation media each for bulk growth of B. thuringiensis var. israelensis and B. sphaericus 1593 were formulated using defatted groundnut cake (Arachis hypogea) as the first nitrogen source and gram flour (Cicer arientinum), soy bean (Glycine max) and defatted milk powder as the second nitrogen source. Medium containing gram flour showed highest toxicity (14.45 micrograms/l) in case of B. thuringiensis var. israelensis whereas medium containing milk powder was found to be highly toxic with B. sphaericus 1593 (51.39 micrograms/l). Sustained release floating pellet formulations of B. thuringiensis var. israelensis and B. sphaericus 1593 exhibited toxicity of 77 per cent and above for 42 days at a dose of 500 micrograms/l for 4th instar larvae of Culex pipiens quinquefasciatus Say. PMID- 1778621 TI - Larvicidal efficacy of Quassin against Culex quinquefasciatus. AB - Crushed aqueous extracts of leaf, wood, bark and flowers of Quassia amara showed antilarval activity against C quinquefasciatus. Quassin has been identified to be the antilarval principle present in this plant and was effective against mosquito larvae at a concentration of 6 ppm. Quassin was present to the extent of 0.1 to 0.14 per cent (average 0.12%) on a dry weight basis in wood of Q. amara. This compound is an unsaturated lactone and it gave a positive response to the Legal test, characteristic of unsaturated lactones. Quassin lost its antilarval activity on treatment with strong alkalies. Quassin was over five times as active as carbaryl, a synthetic antilarval agent. PMID- 1778622 TI - Host preference pattern of phlebotomine sandflies of Bikaner city. AB - Host preference pattern of phlebotomine sandflies was ascertained using the precipitin test. Engorged sandflies from endemic localities revealed that out of 126 blood meals 88.8 per cent were human blood, 7.3 per cent bovine blood and 3.9 per cent mixed for both human and bovine. Four of five Sergentomyia babu were positive for human blood and the remaining one for bovine. Two S. baghdadis collected had only human blood, of two S. punjabensis collected, one had human blood. Mixed human and bovine blood meal was detected in the other one. Phlebotomus papatasi appears to be the most common vector of leishmaniasis and another important observation was the repeated feeding by sandflies within a short period and anthropophilic nature of Sergentomyia species. PMID- 1778623 TI - The effects on the dental pulp of a composite resin and two dentine bonding agents and associated bacterial microleakage. AB - The pulpal reaction associated with a composite resin alone and composite resin used in conjunction with two dentine bonding agents was studied. Class V cavities were prepared on the labial surfaces of the canine teeth of 18 male ferrets. After acid etching of the enamel margins, the cavities were restored with either a composite resin alone or in combination with one of two dentine bonding agents, Scotchbond and Gluma. One cavity in each animal was filled with Kalzinol as a control. The animals were killed after 7, 14 and 28 days. After histological processing, the pulpal changes were assessed qualitatively and quantitatively according to standard criteria. There were variations in the pulpal response at all time intervals. The responses to the two dentine bonding agents were similar to those found with composite resin alone. No pulpal inflammation was observed in the control teeth. Gram-positive micro-organisms were identified at the interface of restoration and cavity wall, or within the dentinal tubules in virtually all cases in which pulpal inflammation was observed. PMID- 1778624 TI - The antimicrobial effect of calcium hydroxide as a short-term intracanal dressing. AB - The antibacterial effect of calcium hydroxide as a short-term intracanal dressing was clinically evaluated by applying the medicament for 10 minutes or 7 days in root canals of teeth with periapical lesions. The results showed that the 7-day dressing efficiently eliminated bacteria which survived biomechanical instrumentation of the canal, while the 10-minute application was ineffective. PMID- 1778625 TI - The effect of pulp capping and pulpotomy on hard tissue bridges of contaminated pulps. AB - The pulp and dentine of permanent incisors in 13 young monkeys were exposed by grinding. The pulpal perforations were treated by partial pulpotomy with a tungsten carbide fissure bur after exposure for 4, 48, or 168 hours in nine animals, and by direct pulp capping after exposure for 4 or 48 hours in the remaining four animals. After haemostasis, the pulpal wounds were covered with calcium hydroxide (Dycal), followed by conventional amalgam (Revalloy). Initial and subsequent formation of hard tissue bridges over the wounds was studied by conventional histology after 1-6 months. Screening showed three categories of initial bridging development, differing in nature and rate of formation. A significant difference in the distribution of the two main categories was found between the two methods of treatment (P less than 0.02). A similar difference was observed when partial pulpotomy was performed after 168 hours compared with that performed after 4 hours (P = 0.055). No relationship was found between the initial bridging category and the eventual development of complete dentine bridges. PMID- 1778626 TI - Perspectives on periradicular healing using Sealapex: a case report. AB - The use of the calcium hydroxide-containing root canal sealer, Sealapex, has been questioned regarding its predisposition to solubility and subsequent effect on the root canal seal and periradicular healing. This case report demonstrates, radiographically, dissolution of excess sealer in the periradicular tissues with subsequent osseous repair which was similar to healing in periradicular tissues where there was no extruded sealer. PMID- 1778627 TI - Pulpal response to two semihydrous glass ionomer luting cements. AB - This study compared the pulpal responses to two innovative semihydrous glass ionomer luting cements (STA and ZIN) with those previously obtained for a conventional anhydrous glass ionomer luting cement, Aquacem. ZIN contained zinc oxide in the formulation. The study was conducted according to the BSI (1989) recommendations for testing restorative materials in vivo. ZIN was associated with minimal pulpal changes and microbial microleakage, and differed little from the control material, Kalzinol. The pulpal response to STA was similar to that observed for Aquacem, but was associated with less microbial microleakage. The statistical model demonstrated a significant association between bacterial presence within the experimental cavity and pulpal inflammation. The closer that bacteria were to the pulp, the more severe was the ensuing inflammation. PMID- 1778628 TI - Pharmacokinetics and pharmacodynamics of continuous intravenous infusion. PMID- 1778629 TI - Rationale and technique for continuous infusions in anesthesia. PMID- 1778630 TI - Technology for continuous infusion in anesthesia. PMID- 1778631 TI - Intravenous anesthetic drugs: infusion pharmacology. PMID- 1778632 TI - Intravenous anesthetic drugs: infusion regimens. PMID- 1778633 TI - Status and progress of hospital information systems (HIS). AB - Expectations for hospital information systems (HIS) have yet to be realized. Requirements have been defined by the International Medical Informatics Association, health care futurists, and others. With a volatile marketplace and evolving technologies, computerization has been a non-trivial task. However, recent advances in architecture and communication standards promise to make networking possible. In addition, the development of professional workstations and of computer-based patient records linked to new tools and applications can transform health care. For HIS to realize these expectations, however, technology assessment and outcome analysis must play critical roles. PMID- 1778634 TI - A brief historical overview of hospital information system (HIS) evolution in the United States. AB - This paper describes the evolution of hospital information systems (HIS) in the United States of America from 1950 to the present and defines HIS within the context of a medical information system. After a concise review of HIS administrative functions, the paper focuses on HIS clinical functions, including the following: computer-based patient records; data entry and retrieval; text processing; data and system protection; networks; clinical subsystems (nursing and medical subspecialties); clinical decision support and quality assurance; and research databases. The paper surveys early examples of HIS and makes projections for HIS in the 1990s. PMID- 1778635 TI - An integrated information system for the intervention and prevention of AIDS. AB - The epidemic of acquired immune deficiency syndrome (AIDS) and its causative agent, the human immunodeficiency virus (HIV), are serious and spreading. In response to the epidemic, a variety of intervention and prevention programs have been instituted. In such AIDS intervention and prevention (AIP) activities, the role played by information systems becomes more and more important. The applications of information systems technology in AIP mostly seem to fall within a spectrum of databases, decision support systems and expert systems. This paper describes the implementation of an information system in a regional AIDS intervention and prevention program. In this integrative information system, the database is integrated with both decision support systems and expert systems, and decision support systems are integrated with expert systems. The implementation results of the system present evidence of the usefulness of the system in AIDS intervention and prevention. PMID- 1778636 TI - Computer-based evaluation of antibiotic therapy predictions. AB - Planning antibiotic treatment according to the given data on patients and results of microbiological examinations are important decision-making goals for physicians. One approach using a computer in medical education to improve the teaching process in this respect is described in this paper. On the basis of data about real patients and the optimal antibiotic treatment validated by the antibiotic center of the Faculty Hospital II, we can evaluate the student's abilities to predict correct antibiotic treatment. The general program written for this task and the method of evaluating the student's predictive skills are described. PMID- 1778637 TI - Bubble number saturation curve and asymptotics of hypobaric and hyperbaric exposures. AB - Within bubble number limits of the varying permeability and reduced gradient bubble models, it is shown that a linear form of the saturation curve for hyperbaric exposures and a nearly constant decompression ratio for hypobaric exposures are simultaneously recovered from the phase volume constraint. Both limits are maintained within a single bubble number saturation curve. A bubble term, varying exponentially with inverse pressure, provides closure. Two constants describe the saturation curve, both linked to seed numbers. Limits of other decompression models are also discussed and contrasted for completeness. It is suggested that the bubble number saturation curve thus provides a consistent link between hypobaric and hyperbaric data, a link not established by earlier decompression models. PMID- 1778638 TI - Kinetic description of the activation of the delayed potassium current of the land snail Zachrysia guanensis in terms of the Hodgkin-Huxley formalism. AB - A description of the activation phase of the land snail Zachrysia guanensis delayed potassium current (IK) is presented. It was found that IK activation kinetics may be congruent with the Hodgkin-Huxley scheme if one assumes that the proportion of n particles at the beginning of the pulse is not zero. In this case IK activation may be treated as carried by a homogeneous channel population, which may be relevant in view of the reported heterogeneity of the inactivation phase of this current. PMID- 1778639 TI - Rao's polynomial growth curve model for unequal-time intervals: a menu-driven GAUSS program. AB - For lack of alternatives, longitudinal data are often analyzed with cross sectional statistical methods, for instance, t-tests, ANOVA and ordinary least squares regression. Appropriate statistical software has been generally unavailable to investigators using serial records to study growth and development or treatment effects. In an earlier paper (Schneiderman and Kowalski, Am. J. Phys. Anthropol., 67 (1985) 323-333.) we described a suitable method, Rao's polynomial growth curve model (Rao, Biometrika, 46 (1959) 49-58), and provided an SAS computer program for the analysis of a single sample of complete longitudinal data. This method included the computation of an average polynomial growth curve, its 95% confidence band, its coefficients and corresponding confidence intervals. The present paper extends this method to accommodate a sample with observations made at unequal time-intervals. Significant improvements in the accessibility, operation and user-friendliness of the program have been made, facilitated by recent advances in microcomputer technology. This stand-alone GAUSS program (no compiler necessary) runs on PC-compatibles and is available at a nominal cost. In this report we provide an overview of the statistical model, the general structure of the program, and give an example in which a developmental variable (human upper incisor angulation) is analyzed. Ease of installation and use, speed of execution and color graphic displays of growth curves and confidence bands, and most importantly, suitability to longitudinal data, make this method/program a potentially valuable tool for those interested in growth, development, and treatment effects in humans and other species. Some areas in which this method will have immediate applications are orthodontics, maxillofacial surgery and pediatrics. PMID- 1778640 TI - Some observations on the development of a 'scoring system' in an expert system for prediction of ovulation. AB - As part of the construction of an expert system for the diagnosis of infertility we have developed a scoring system for the identification of conditions which can interfere with ovulation. The scores were obtained from a group of clinicians, and the arithmetic means of these scores were used in the actual system. Correlation between the scores obtained from individual clinicians was very poor (r = 0.345 +/- 0.134). Correlation improved when groups of clinicians were compared. Thus scores derived from a group of clinicians will reflect more reliably the 'general medical opinion'. Scores derived from the opinion of clinicians should be regarded with caution until probabilities or weighting factors derived from real clinical data become available. PMID- 1778641 TI - Classification of postoperative cardiac patients: comparative evaluation of four algorithms. AB - Four classification algorithms based on Bayes' rule for minimum error are compared by evaluating their ability to recognize high- and normal-risk cardio surgical patients. These algorithms differ in the modelling of the probability density function (pdf) for each class and include: (a) two parametric algorithms based on the assumption of normal pdf; (b) two non-parametric algorithms using Parzen multidimensional approximation of pdf with normal kernels. In each case, classes with both equal and different covariance matrices were considered. A set of 200 patients in the 6 h immediately following cardiac surgery has been used to test the performance of the algorithms. For each patient the three measured variables most effective in representing the difference between the two classes were considered. We found that the two algorithms which explicitly incorporate the information on the different sample covariance between the physiological variables existing in the two classes generally provide better recognition of high- and normal-risk patients. Of these two algorithms the parametric one appears extremely attractive for practical applications, since it exhibits slightly better performance in spite of its great simplicity. PMID- 1778642 TI - Evolution of the concentration field of an antibiotic during an injection. AB - A complete mathematical model is presented which describes a substrate injection into a capillary and its diffusion in tissues. Numerical methods are implemented and compared, simplification is discussed and the results' behaviour is studied. A new experimental technique yields curves which are compared to the numerical solutions of the model and used for estimating diffusion and permeability coefficients. Furthermore it is proved that the physiological Krogh model is valid and can be used as a tool by physicians and biologists. PMID- 1778643 TI - Formula predicting survival in patients with acute myelogenous leukemia. AB - A microcomputer program in BASIC for predicting the survival probability after diagnosis of acute myelogenous leukemia in patients is designed. Formulas used in this program are derived from the data published by Feigl and Zelen. A mathematical model and a computer program previously published by the author are employed in this study. Analysis of the computer-assisted predicted and the Feigl and Zelen's reported data has shown that the program is fairly accurate and reliable with close agreement in expressing survival probability as a function of white cell count and time after diagnosis. PMID- 1778644 TI - Selected questions of topical interest in human bioclimatology. AB - This paper deals with the different effects of climate, and the likely impact of climatic change, on the human being, his health and well-being. Those effects follow from consideration of the human energy budget and air pollution, including photooxidants and radiation, the latter especially in the UV-range. The development of tools to produce bioclimate maps, i.e. maps expressed in physiologically significant terms, in different scales up to the high resolution necessary for the microscale urban climate, will be discussed. The most important questions in bioclimate research and its application will be considered. PMID- 1778645 TI - The human climate of tropical cities: an overview. AB - A review of physioclimatic maps at global, regional, and local scales is made of the tropical environment. At the global scale the highest heat load is located seasonally in arid subtropical cities. High sultry conditions (heat and humidity) prevail during the whole year in equatorial cities. In most inner areas of the tropics, urban areas with wet/dry seasons and days are seasonally hot or sultry while nights may be cool or tolerably warm. In some mountain tropical climates (altitudes between 1600 and 1900 m above sea-level) the stress due to either heat or cold is minimal. From the point of view of human comfort the bioclimate in these cities would approach the ideal (in the shade). One has to keep in mind, however, that even in these climates for a person walking on a street at noon, comfort is reduced drastically by the high radiation levels. PMID- 1778646 TI - The bioclimate in temperate and northern cities. AB - Climate is a basic component of the human environment. Developments in building design and indoor climate control have contributed greatly to improving human health and comfort. By contrast, the possibilities for improving urban climatic conditions by deliberate planning have been poorly exploited. The structure and processes of the urban atmosphere in extratropical regions are briefly described. The impact of certain selected urban climates on human health is summarized. The need for relevant bioclimatological "design tools" for applications in urban planning is stressed, followed by a brief review of some recent work on human thermal comfort. It is argued that the modification of present day comfort criteria to reflect human adaptation to climate may be important for further improvements of indoor climate, as well as for deducing the emissions of air pollutants and greenhouse gases. PMID- 1778648 TI - Biometeorology and animal protein production: the case of arid lands. AB - To meet the food demands of the ever-increasing world population, man's only major future land bank is the arid lands. However, their exploitation has been limited and constitutes a major challenge to many scientific disciplines. Under the present conditions of hunger and/or malnutrition, a large-scale expansion in food production is not to be expected. Hence, it is imperative that in any development programme for arid lands, malnutrition, in general, and a deficiency of animal proteins, in particular, should be considered. Major advancements have been made, but much remains to be learned and implemented. Improvement of native farm animals should be the first step in increasing the availability of animal proteins. This may be achieved by an educational programme to enhance management, housing, food intake, etc. Then a breeding programme selecting for high productivity can be pursued. After eliciting the maximum return from the present livestock, attention should be directed to domesticating wild ungulates and/or introducing highly productive temperature-zone breeds for upgrading the local animals. Additionally, new potential and unconventional sources of animal proteins must be explored. Aquaculture, in particular, has the potential of producing large quantities of lower-cost protein-rich food. Available evidence in arid regions of the developed countries, i.e. USA and Australia, promises favourable results in our efforts toward increasing the production of animal protein. By innovative methods and long-term planning, such successes can be adapted and transferred to other regions of the world, with the aim of gradually lessening the present state of malnutrition and hunger. PMID- 1778647 TI - Neuroendocrine effects of light. AB - The light/dark cycle to which animals, and possibly humans, are exposed has a major impact on their physiology. The mechanisms whereby specific tissues respond to the light/dark cycle involve the pineal hormone melatonin. The pineal gland, an end organ of the visual system in mammals, produces the hormone melatonin only at night, at which time it is released into the blood. The duration of elevated nightly melatonin provides every tissue with information about the time of day and time of year (in animals that are kept under naturally changing photoperiods). Besides its release in a circadian mode, melatonin is also discharged in a pulsatile manner; the physiological significance, if any, of pulsatile melatonin release remains unknown. The exposure of animals including man to light at night rapidly depresses pineal melatonin synthesis and, therefore, blood melatonin levels drop precipitously. The brightness of light at night required to depress melatonin production is highly species specific. In general, the pineal gland of nocturnally active mammals, which possess rod dominated retinas, is more sensitive to inhibition by light than is the pineal gland of diurnally active animals (with cone-dominated retinas). Because of the ability of the light/dark cycle to determine melatonin production, the photoperiod is capable of influencing the function of a variety of endocrine and non-endocrine organs. Indeed, melatonin is a ubiquitously acting pineal hormone with its effects on the neuroendocrine system having been most thoroughly investigated. Thus, in nonhuman photoperiodic mammals melatonin regulates seasonal reproduction; in humans also, the indole has been implicated in the control of reproductive physiology. PMID- 1778649 TI - The evolution of sweat glands. AB - Mammals have two kinds of sweat glands, apocrine and eccrine, which provide for thermal cooling. In this paper we describe the distribution and characteristics of these glands in selected mammals, especially primates, and reject the suggested development of the eccrine gland from the apocrine gland during the Tertiary geological period. The evidence strongly suggests that the two glands, depending on the presence or absence of fur, have equal and similar functions among mammals; apocrine glands are not primitive. However, there is a unique and remarkable thermal eccrine system in humans; we suggest that this system evolved in concert with bipedalism and a smooth hairless skin. PMID- 1778650 TI - Pulmonary vascular remodelling in a high-altitude Aymara Indian. AB - A histological study of the pulmonary vasculature in a young male high-altitude Aymara Indian revealed four aspects of interest. There was muscularization of the terminal portion of the pulmonary arterial tree to involve pulmonary arterioles as small as 15 microns in diameter, thus forming a basis for the slightly increased pulmonary vascular resistance of native highlanders. Intimal longitudinal muscle was found in pulmonary arteries and arterioles and though to be due to chronic alveolar hypoxia. Inner muscular tubes similar to those found in chronic obstructive lung disease were present. Pulmonary veins and venules also showed intimal muscularization suggesting that alveolar hypoxia affects vascular smooth muscle cells per se irrespective of their situation. The nature of the remodelling in a pulmonary blood vessel depends on a combination of hypoxia and haemodynamics. PMID- 1778651 TI - Seasonal influence on the reproductive performance of swine in the humid zone of Ghana. AB - Relationships between month and climatic factors (ambient temperature, relative humidity, RH, and rainfall) with litter size, conception rate, days from weaning to conception and mortalities at birth and preweaning were studied in large white pigs under research station (RS) and commercial farm (CF) conditions. In RS and CF 868 and 572 farrowing records, respectively, were involved. Litter size was almost evenly distributed in all months of the year, at both farms, despite significant (P less than 0.05) negative but low correlations between litter size and maximum (r = -0.272, RS) and minimum (r = -0.233, CF) temperatures in the month after conception. There were no significant differences in conception rate between months. However under RS conditions there were significant (P less than 0.05) correlations between minimum temperature and conception rate in the months prior to (r = -0.362) and at conception (r = -0.221). Days from weaning to conception were bimodally distributed with peak values occurring between January and June and October and December. Significant mortality at birth (P less than 0.05) and preweaning was generally highest in the cold rainy months of May to October. However, only under CF conditions were there significant correlations between minimum temperature in the month of birth and percentage mortalities at birth (r = -0.217) and preweaning (r = -0.250). Rainfall and RH had no significant (P greater than 0.05) correlation with birth and preweaning mortalities. PMID- 1778652 TI - Effects of physical training on pulmonary arterial pressure during exercise under hypobaric hypoxia in rats. AB - In this investigation, we assessed the effects of physical training on exercise induced systemic and pulmonary hemodynamic changes under hypobaric hypoxia in catheter-implanted rats. We made continuous measurements of pulmonary and systemic arterial pressures during progressive treadmill exercises under hypobaric hypoxia (equivalent to altitudes of 2500 and 5500 m) in 46 control and 41 trained rats. Trained rats were exercised on two running schedules: 4 weeks (4 trained) and 6 weeks (6-trained). Both these groups of trained rats were exercised for the same length of running time each day. The increase in resting mean pulmonary arterial pressure (Ppa) with increasing equivalent altitude was lower in the two trained groups than in the control group. The increase in Ppa with progressive intensity of exercise was lower in the 6-trained than in the 4 trained and control groups at 610 and 2500 m. The 6-trained rats showed higher pH, Pa CO2 and O2 saturation in their blood than did the control group, whereas the Pa O2 was less. Lung tissue cyclic AMP concentration at rest was higher in the 6-trained than in the control group. Finally, it may be noted that exercise induced lung tissue vasodilator responses seem to be enhanced in well-trained rats under both normobaric normoxia and hypobaric hypoxia. This study indicates that exercise training may be useful in preventing pulmonary hypertension resulting from both hypoxia and exercise. PMID- 1778653 TI - Effect of different seasons on concentration of plasma luteinizing hormone and seminal quality vis-a-vis freezability of buffalo bulls (Bubalus bubalis). AB - Seasonal variations in semen quality, freezability and plasma luteinizing hormone (LH) levels were studied between summer and spring. Semen volume, density and initial sperm motility did not differ significantly between different seasons. Plasma LH decreased between summer and spring but the differences were, however, not significant. Pre-freezing motility did not differ significantly but post freezing motility varied significantly (P less than 0.01) between seasons. Post freezing motility was lowest during summer and highest during winter. It can be concluded that summer spermatozoa may be fragile and cannot withstand freezing stress. To increase reproductive efficiency in buffalo during summer, semen should be frozen during winter and spring and used during hot weather conditions. Seasonal variations in plasma LH levels were insignificant. PMID- 1778654 TI - Population of goats related to climate in western India: an ecological assessment. AB - Western India experiences arid to dry subhumid ecoclimate. Aridity increases from east to west to the Great Indian Desert or Thar Desert. The desert economy is animal based and goats are the most common livestock; density of goats increases with increase in aridity. There are large morphological variations in goats warranting the recognition of population differences throughout the region. The present investigations were therefore undertaken to see whether there are population differences and, if so, to establish the populations on a sound ecological basis. Eleven physical measurements of the animals were made in the fields of western India in a total of 518 animals (255 adults). Five populations were initially segregated by means of a scatter diagram. Population differences were confirmed by mathematical treatments using analysis of variance (one-way and two-way) and Students-Newman-Keuls test, which yields a critical comparison among means. Discriminant analysis was used to determine whether the goat populations differed significantly between the five climo-edaphic-vegetational zones. Each population was designated according to the locality having the greatest density as: POP1Ku, POP2Sa, POP3Jh, POP4Ga, POP5Pa. The five populations occurring in distinct climo-edaphic-vegetational zones or ecological niches in western India may be referred to as ecotypes. PMID- 1778655 TI - Immunohistochemical study of temporal variations in cytochrome P-450 isozymes in rat testis and their modifications by the inductive effects of cadinenes. AB - Temporal variations in cytochrome P-450 isozymes of rat testis, PB-P-450 (forms of cytochrome P-450 strongly induced by phenobarbital) and MC-P-448 (forms of cytochrome P-450 strongly induced by 3-methylcholanthrene), were investigated immunohistochemically by the avidin-biotin-complex method using specific antibodies against PB-P-450 and MC-P-448 isozymes. Immunoreactivity to both PB-P 450 and MC-P-448 isozymes was observed in Leydig cells. The number of PB-P-450 positive Leydig cells was found to undergo significant time-of-day variation with a peak time of 0000 hours (light phase from 0800 to 2000 hours). Injection of cadinenes (300 mg/kg per day intraperitoneally at 48 and 96 h before sacrifice) induced PB-P-450 isozyme but did not induce MC-P-448 isozyme. The induction of PB P-450 isozyme by cadinenes was time dependent, and the early dark phase (2000 and 0000 hours) was most sensitive. These results suggest that temporal variation of cytochrome P-450 isozymes is one of the important physiological variations in detoxification and activation of various xenobiotics and chemicals in the testis. PMID- 1778656 TI - The involvement of the sympathetic nervous system in meal-induced thermogenesis in mice. AB - The acute effect of food intake on the activity of the sympathetic nervous system (SNS) in both heart and brown adipose tissue (BAT) was investigated in mice. Upon delivery to the laboratory mice were housed singly and divided into two groups. Half the mice were accustomed to eat their daily food ration in two meals whereas the other half were given continuous access to food. SNS activity in both heart and BAT was estimated by measuring the accumulation of dopamine (DA) after having blocked the transformation of dopamine into noradrenaline (NA) with 1-cyclohexyl 2-mercapto-imidazole (CHMI). CHMI inhibits the enzyme dopamine beta-hydroxylase. On the day SNS activity was assessed, continuously fed (CF) or meal-fed (MF) mice were injected with either saline or CHMI one hour before being killed. In order to assess the anticipatory effects of being fed, a group of mice already accustomed to the meal-feeding schedule were not allowed to eat after the injections. Additional CF and MF mice were killed without being injected in order to determine the basal levels of both DA and NA. The results show that the accumulation of DA in both heart and BAT was higher in MF than CF mice regardless of whether MF mice were or were not fed after the injection of CHMI. It therefore appears that the intake of food may increase SNS activity in various tissues in mice, and that such a response may be largely of cephalic origin. PMID- 1778657 TI - Energy expenditure in early infancy and later body fatness. AB - Total energy expenditure was measured in a cohort of 33 normal, full term infants at 12 weeks of age using the doubly labelled water technique. These data were related to Quetelet's index and the sum of the triceps and subscapular skinfold measurements at 9 months and 2 years of age. Correlation coefficients were used to determine the relationship between total energy expenditure and later indices of body composition. Total energy expenditure was expressed as kcal/kg per day; kcal/kg0.5 per day (in order to negate the effect of body weight) and kcal/kg fat free mass per day (in order to take into account body composition). Using this approach there was no relationship between the level of total energy expenditure at 12 weeks of age and later indices of body fatness. The highest correlation coefficient being 0.09 (n = 33, P greater than 0.10). These findings are contrary to recent reports that a reduced total energy expenditure is related to the development of obesity in certain selected groups of individuals. PMID- 1778658 TI - Adipose tissue distribution changes during rapid weight loss in obese adults. AB - Changes in adipose tissue distribution as defined by the waist-to-hip ratio (WHR), were evaluated in 16 android, obese subjects (seven male and nine female) given a very low energy ketogenic diet of 1.72 MJ (411 kcal) for 4 weeks. Total weight loss was significantly greater for the males (11.2 +/- 2.5 kg) compared to females (8.3 +/- 0.8 kg); the relative weight loss however, was similar (9.9 vs 9.3 percent). Female and male losses in percent body fat and lean body mass were not significantly different. For both groups, significant (P less than 0.01) changes in waist and hip circumferences were observed; however, no significant changes were observed in WHR. These results indicate that in obese android male and female subjects, adipose tissue distribution as measured by WHR, does not change in response to rapid weight loss. PMID- 1778659 TI - Toward an empirically derived typology of obese persons. AB - The MMPI, medical, anthropomorphic, and laboratory evaluations were completed by 260 obese patients (211 females, 49 males) at a New York hospital. Biological and psychological variables were separately subjected to principal components analyses. Fifteen biological and five psychological components were extracted. A three-cluster solution was selected from a K-means clustering on biological components, replicated via Ward's method, and validated via a discriminant analysis on psychological components. Cluster 1, 'android obesity', contained 75 percent of the males and was characterized by 'masculine phenotypy', 'poor conditioning' and 'adverse serum lipids', and less 'feminine' responding on the MMPI. Cluster 2, 'gynoid obesity', was low on components measuring physical stress and masculine phenotypy, was 95 percent female, moderately obese compared to clusters 1 and 3, and had a relatively healthy profile. Cluster 3 had elevations on overall fatness and physiological and psychological stress, and low scores on a 'healthy blood synthesis' component. This cluster, labeled 'morbidly obese', was the most obese and had profiles suggesting adverse effects of obesity. PMID- 1778661 TI - Commingling analysis of generalized body mass and composition measures: the Quebec Family Study. AB - Human body mass and composition are heterogeneous phenotypes resulting from the combined effects of genes, environmental factors, and their interactions. In order to gain an understanding of the individual genetic determinants leading to obesity, we have initiated a systematic analysis of several measures of fatness and its phenotypes including: the body mass index (wt/ht2), fat mass, fat-free (lean) mass, the ratio of fat mass over fat-free mass, percent body fat, and a fat mass index (fat mass/ht). In this report, we examine the distributions of these age and sex adjusted variables in a large family study from Quebec in terms of evidence for commingling and skewness, and evaluate the inter-relationships among the measures. Fat mass, fat-free mass and the fat mass index conceptually represent primary variables in that they are quantitative measures of relevant components of total body weight; the hypothesis of a single distribution was inferred for each of these primary measures, with significant residual skewness except for fat mass. In general, offspring (8-26 years old) distributions were more positively skewed than parent (30-60 years old) distributions. The remaining variables (body mass index, fat mass to fat-free mass ratio, and percent body fat) are indexes combining information on fat and fat-free mass into single measures. Although offspring data were consistent with a single skewed distribution, commingling was found in the parents in each case. The prominent heterogeneity between generations suggests that there may be significant developmental (genetic or environmental) effects in the transition during growing years to adult pattern phenotypes, particularly for the complex indicators of body composition. PMID- 1778660 TI - Effect of anatomical site on insulin action and insulin receptor phosphorylation in isolated rat adipocytes. AB - The effects of insulin were evaluated on adipocytes isolated from three different anatomical sites in male, Sprague-Dawley rats: epididymal (EPI), retroperitoneal (RP), and dorsal subcutaneous (SC). The results indicated that maximal insulin stimulated glucose transport was significantly lower (P less than 0.001) in cells from the SC region as compared to EPI and RP cells. In addition, the ED50 value for SC cells (259 +/- 34 pmol/l) was significantly higher than for EPI (66 +/- 5 pM) or RP adipocytes (111 +/- 32 pmol/l). Insulin inhibition of catecholamine induced lipolysis was also significantly greater (P less than 0.001) in EPI cells as compared to RP or SC adipocytes, and that was true when expressed in absolute or relative terms. The decrease in the ability of insulin to either stimulate glucose transport or inhibit catecholamine induced lipolysis in SC cells was associated with a decrease in insulin receptor autophosphorylation and receptor tyrosine kinase activity. These data show that insulin action on isolated adipocytes varies as a function of anatomical site, and that these changes are associated with variations in insulin receptor autophosphorylation and insulin receptor tyrosine kinase activity. PMID- 1778662 TI - Weight loss and body fat distribution: a feasibility study using computed tomography. AB - Computerized tomography (CT) was used to assess the effect of a loss of body weight (18.8 kg) on the size of five fat depots in 11 obese postmenopausal women: the abdominal subcutaneous and visceral depots, the pelvic subcutaneous and intrapelvic depots, and the thigh subcutaneous depot. The mean decrease in total body fat was 34 percent, with comparable decreases in total abdominal fat (33 percent) and total pelvic fat (32 percent). In the abdomen, visceral fat was reduced by 35 percent and subcutaneous fat by 33 percent. In the pelvic region, intrapelvic fat decreased by 51 percent and subcutaneous fat by 25 percent. The decrease in the size of the abdominal visceral fat depot was highly correlated with fat loss during treatment (r = 0.68). By contrast, the decrease in the size of the subcutaneous abdominal fat depot correlated less highly with fat loss. These preliminary findings suggest that obese postmenopausal women with large visceral fat depots will decrease the size of their visceral fat depots by weight reduction. This is good news since the adverse health effects of obesity are believed to be associated with visceral fat. PMID- 1778663 TI - Italian Consensus Conference--overweight, obesity and health. AB - On 5 and 6 April 1991, at the National Research Council (CNR) in Rome, a Consensus Conference on the relationship between overweight, obesity and health was held. The conference was sponsored by FATMA (Applied Project on Disease Factors of the CNR) and UICO (Italian Society for the Study of Obesity) with the purpose of establishing guidelines for health employees. The development of the conference followed the methodology set down by OMAR to obtain a rational and significant consensus on the answers to six basic questions prepared by the planning committee. The questions were the pivotal point of the conference and were brought to the attention of all the attendees and widely diffused among the medical community; they were proposed with the aim of giving an exhaustive definition of obesity, to investigate its relationship with mortality and morbidity, to highlight its social characterization, to indicate methods of evaluation and recommendations for weight loss, to select groups at risk, and to focus general guidelines for research. After the presentation of the state of the art on 18 topics by experts in the field, the 22 members of the consensus panel, impartial experts from a vast area of the scientific community, discussed a draft document representing the answers to the questions, which was subsequently submitted to the 307 attendees, discussed and then approved. This paper is the definitive document of the Consensus Conference. The introduction explains the reasons which led to the decision to promote the conference six years after the one held in the United States. The methodology is then set out. The questions are answered in the form of recommendations and backed up by data and scientific evidence from the literature. PMID- 1778664 TI - Effect of testosterone on abdominal adipose tissue in men. AB - Recent studies in men have shown that abdominal fat increases with age and decreasing testosterone concentrations. Furthermore, in cell culture, testosterone expresses an increased lipolytic potential and depresses lipoprotein lipase activity (LPL) in adipose cells. These metabolic characteristics are found in abdominal adipose tissue in young men. In order to see whether abdominal fat masses in moderately obese middle-aged men might be diminished by testosterone, this hormone was given either as a single injection (500 mg) or in moderate doses (40 mg X 4) for 6 weeks in an oral preparation, bypassing the liver. When measured 1 week after the single dose, abdominal LPL tended to decrease. After 6 weeks a dramatic decrease of abdominal LPL was found, as well as an increase in the lipolytic responsiveness to norepinephrine, both changes confined solely to the abdominal, and not femoral adipose tissue regions. The waist/hip circumference decreased in 9 out of the 11 examined men. No untoward effects were seen in behavioural variables, blood pressure, triglyceride or cholesterol values, and liver function tests. These preliminary results suggest that administration of testosterone in moderate doses to middle-aged men lead to adaptations of the metabolism of adipose tissue expected to be followed by a diminution of this mass. PMID- 1778665 TI - Epidermal growth factor in human tear fluid: a minireview. AB - This minireview deals with the presence of epidermal growth factor (EGF) in human tear fluid. It explains the occurrence of EGF in tear fluid, the origin of EGF and its dependency on tear fluid dynamics. The alterations in tear fluid EGF concentrations that occur during diseases of the ocular surface are described and discussed in the context of the current knowledge about the interaction between EGF and EGF receptors. The possible clinical implications of topical treatment with EGF are considered. PMID- 1778666 TI - Tear plasminogen activators--indicators of epithelial cell destruction. The effect of scraping, n-heptanol debridement, and alkali burn of the cornea on the plasminogen activator activity of rabbit tears. AB - Plasminogen activator (uPA) activities were determined in the tears of rabbits following mechanical (scraping) or chemical (n-heptanol) debridement and alkali burn of the central part of the corneal epithelium. All three types of injury enhanced the plasminogen activator activities in the tears. The increase in uPA activity was highest in alkali burn, lowest for n-heptanol debridement. Scraping yielded an intermediate increase in uPA activity. The maximum value in activator activity was reached at 5 hours for mechanical injury and at 24 hours for chemical injuries. uPA activity values returned to the normal range by the time of re-epithelialization for mechanical scraping and 1-3 days following re epithelialization for heptanol debridement and alkali burn. A trend was observed between uPA activity level and the size of the wound but the correlation was not pronounced (R = 0.538). PMID- 1778667 TI - The viscosity of human tears. AB - Blinking involves high rates of shear within the tear film, requiring a low tear viscosity to avoid damage to epithelial surfaces. Conversely, in the open eye, a higher viscosity is desirable to resist drainage and film break-up. Samples of human tears were collected with moderate stimulation from 5 adult males, 3 with normal and 2 with marginally-dry eyes. The apparent viscosity at 22 degrees C was found using a Couette-type rheometer over the range of shear rate 2-160 sec-1. Marked shear-thinning was apparent in all samples, with little apparent difference between normal and dry-eye tears. Although a power-law equation could be fitted over part of the range, analyses according to either the Casson plastic model as used for rabbit tears (with a low yield-point indicative of some very loose initial gel-like structure) or the Steiger-Ory model (a true pseudoplastic model with no initial yield point) were inconclusive over the range of shear rate studied. The descriptive model of Cross gave zero-shear viscosity values of 4.4, 7.1 and 8.3 mPa.sec for normal tears, and 27.1 and 31.1 mPa.sec for dry-eye tears; the corresponding time constants were 0.13, 0.27 and 0.38 sec for normal tears, and 2.7 and 2.9 sec for dry-eye tears. These time-constants can be considered as an approximate relaxation time, indicating the time taken for the tear film to stabilise after a blink. PMID- 1778668 TI - Determination of basal tear turnover in insulin-dependent diabetes mellitus patients by fluorophotometry. AB - The tear turnover was determined by fluorophotometry in 25 insulin-dependent diabetes mellitus (IDDM) patients without retinopathy and 29 IDDM patients with (pre-)proliferative retinopathy. The results were compared with those in 34 healthy controls, to investigate the lacrimal gland function in diabetic patients. The tear turnover was calculated from the decay of the relative tear fluorescein concentration values measured after instillation of one microliters of fluorescein. The tear turnover values in both patient groups did not correlate significantly with age or diabetes duration (linear correlation coefficients: r less than 0.3). The tear turnover values in patients both without retinoplathy and with (pre-)proliferative retinopathy did not differ significantly from those in healthy controls (mean +/- SD in %/min: 13.7 +/- 4.5, 14.7 +/- 5.8 and 15.5 +/ 5.1, respectively; P greater than 0.16). The tear turnover was significantly decreased in eyes having a BUT shorter than 10 seconds compared with eyes having a BUT longer than 10 seconds (P less than 0.05). The tear turnover values correlated significantly with the HbA1c and Schirmer-test values in patients with (pre-)proliferative retinopathy (r = 0.7 and r = 0.4, respectively; P less than 0.02) and with the blood glucose values in patients without retinopathy (r = 0.41, P = 0.04). Since the tear turnover was not significantly decreased in IDDM patients in comparison with healthy controls the corneal disorders which are more frequently seen in these patients than in a healthy population may not be attributed to a decrease in tear production. PMID- 1778669 TI - Clinical profiles of non dry eye patients and correlations with tear protein levels. AB - An accurate clinical description of the normal patient must be established before the dry eye patient can be accurately profiled. The current study was designed to (a) determine normal values for, and to seek correlations between, clinical tests used for the evaluation of non dry eye patients' tear film and ocular surface, and (b) compare clinical findings with previously reported levels of non stimulated and stimulated tear proteins for the same group. Thirty non-contact lens wearing patients (age range 20-64 years) were determined to be free of dry eye based on the results of a series of clinical tests. McMonnie's dry eye questionnaire was used as an initial screening step. Clinical tests included lacrimation kinetics (using sealed, calibrated filter paper strips), non-invasive tear break-up time (NIBUT) measurement by Xeroscope, biomicroscopic evaluation of the anterior segment, assessment of tear prism height and regularity, and fluorescein and Rose Bengal staining. No significant correlations were found between age, questionnaire score, lacrimation kinetics final tear secretion rate or NIBUT. However, NIBUT results did vary by gender. Mean NIBUT for females was 46.3 +/- 16.6 (standard deviation) seconds and for males 59.3 +/- 2.1 seconds. some significant correlations were found between clinical test results and levels of non-stimulated and stimulated tear proteins. Overall, the results indicate that this battery of clinical tests will be appropriate for distinguishing between normal and dry eye patients. Combined with tear protein assay, this clinical approach may improve our current understanding of the different types of dry eye. PMID- 1778670 TI - Tear ferning and other lacrimal tests in normal persons of different ages. AB - We investigated in normal persons of different ages ranging from 4 months to 85 years the frequency of different ferning types as well as the results of the Schirmer I test, break-up time and tear protein profile. With increasing age, ferning types of higher degree were significantly more frequent. Furthermore, a correlation was found between the ferning test and low Schirmer test values (p less than 0.05) as well as break-up time (p less than 0.1). No correlation exists between ferning the test and tear protein pattern. These results indicate that tear ferning is independent from single tear proteins but in correlation with secreted watery volume and plays some role in tear film stability. Furthermore, these normal values of ferning and protein pattern can be used as references for different ages. PMID- 1778671 TI - Use of ultrasound diagnostics in lacrimal sac diseases. AB - Ultrasonographic examinations of the lacrimal drainage system demonstrated that the Ultrascan System IV apparatus used was not able to represent the normal-size lacrimal canaliculi, the common canaliculus, the lower part of the nasolacrimal duct and the lacrimal ostium. It can be used routinely, however, in the diagnostics of diseases of the lacrimal sac and its surrounding tissue, for surgical indication and in order to examine the postoperative condition, in most cases without other expensive diagnostic methods. The advantages over dacryocystography are that it is simple, quick, and inexpensive, it can be used post-operatively immediately, the patient is not exposed to radiation, it can be used without any contrast medium, and it is useful when the common canaliculus is occluded. PMID- 1778672 TI - Primary Sjogren's syndrome from the viewpoint of an internal physician. AB - The characteristics of primary Sjogren's syndrome are described on the basis of the follow-up of 65 patients with extraglandular symptoms at the onset and during the disease. The mean age of the patients at onset was 41.8 years and at the time of definite diagnosis was 45.8 years. Articular (32 cases), lacrimal (30 cases) and salivary (30 cases) manifestations were the most frequent initial symptoms. In only 22 of the 65 patients could Sjogren's syndrome be diagnosed at the onset. In most cases, the articular symptoms observed observed in 56 patients during the course corresponded to true polyarthritis, as verified by joint scintigraphy. Most frequently the wrists and ankles were affected. Chronic atrophic gastritis was found in 35 patients. In the young patients (13 cases), both the antrum and the corpus were affected more frequently than in the controls. In middle-aged patients (21 cases), atrophy of the antrum, and in the elderly (10 cases) atrophy of the corpus was more frequent than in the controls. All three types of chronic atrophic gastritis occurred in the disease. The decreased gastric acid secretion was characteristic of types A and AB gastritis, but the hypergastrinaemia only of type A. It was verified that chronic duodenitis and jejunitis occur in the disease. The pancreatic lesions were mild. Renal involvement was detected in 15 patients, vascular symptoms in 22 and lower-airway changes in 21. The variety of the different symptoms proved that primary Sjogren's syndrome can involve many organs. PMID- 1778673 TI - Videodocumentation in digital dacryocystography. AB - The digital dacryocystography proved to be the optimum method of X-ray diagnostics in obstructions of the lacrimal pathways. The examination was performed with a computer controlled X-ray unit with a C-arc coupled to an image intensifier tv-system. In the study the advantages of this technique were combined with the advantages of modern videotechnique. A nonionic water soluble contrast medium was used. The bilateral contrast medium filling process was registrated and the findings were recorded on videotape concurrently. The videocassettes, marked with the data of the patients and the date of examination, are stored in a video-tape library. This provides an always repeatable diagnostic documentation and it is also an excellent base for scientific analyses. The technique and the results of the examinations, performed with 18 patients, are described. PMID- 1778674 TI - Anatomical analysis of the human lacrimal drainage pathway under an operating microscope. AB - Mesoscopic structures of the lacrimal drainage pathway were observed under an operating microscope in six cases of 5 adult cadavers. In all these cases the upper and lower canaliculi fused to form the common canaliculus. Two cases with a large common canaliculus showed large projections of mucosa which reduced the inner space of the common canaliculus. The remaining 4 cases with a small common canaliculus did not show any projections. These findings indicate that the human lacrimal system can function physiologically through a small narrow space of the common canaliculus. PMID- 1778675 TI - Acute changes in microvascular blood flow distribution in the myocardium of the rat during partial occlusion of the right coronary artery; effects of dihydroergotamine. AB - Changes in blood flow during restricted right coronary perfusion were studied in anesthetized rats. By use of a carotid-coronary shunt system, coronary perfusion pressure could be reduced to 40 mm Hg, leading to a fall in flow from 0.9 ml/min to 0.3 ml/min. The perfusion pattern within the flow-restricted area was determined by labelling the blood plasma with fluoresceinisothiocyanate (FITC) globulin (demonstration of the entire vascular system) and lissamine-rhodamine B200 (RB200) globulin (demonstration of actually perfused myocardial capillaries). In histological sections, arterial ramifications were evaluated with respect to the arrival of RB200 in their branches. Large filling defects were observed when flow was obstructed. After 10s labelling, in ramifications with a feeding artery larger than 15 microns in diameter, 10.5% of the vessels displayed dye in only one of the branches, and 13.5% in neither of the two branches. For smaller ramifications (less than 8 microns), these values amounted to 17.5% and 41.5%, respectively. A similar pattern was observed after vascular labelling for 60 s. When dihydroergotamine (2.0 micrograms/kg i.v.) was applied one minute after onset of occlusion, the perfusion inhomogeneity was significantly reduced (labelling in one branch and in none of the two, respectively: greater than 15 microns: 60% and 10.0%; less than 8 microns: 13.5%, and 26%). It can therefore be concluded that dihydroergotamine reduces hypoperfusion-induced inhomogeneity in myocardial blood flow. PMID- 1778676 TI - Arteriolar and venular reactivity to superfusate pO2 in tissues with different metabolic capacity. A study in skeletal muscle and mesentery of the rat. AB - In skeletal muscle (extensor hallucis proprius) and mesentery of anesthetised (pentobarbital 30 mg/kg) female rats (200 g) we have compared reactivity to O2 of arterioles and venules with their response to a vasoconstrictor (epinephrine 5.5 x 10(-7) M) and a vasodilator (adenosine 10(-4) M). Muscle arterioles fully constricted with O2 and epinephrine and dilated with adenosine (22%). Muscle venules did not respond to changes in superfusate pO2, constricted 18% with epinephrine and dilated 10% with adenosine. In the mesentery changes in superfusate pO2 had no effect on diameters of arterioles or venules but epinephrine fully constricted arterioles and constricted venules by 19%, while adenosine dilated arterioles (6%) but not venules. When we set arteriolar and venular diameters during adenosine superfusion at 100%, muscle arterioles appeared to operate at 63% and mesenterial arterioles at 84% of maximal diameter at normal tissue pO2. For venules these percentages were 91 and 97%, respectively. Arterioles and venules in muscle thus have higher tone and muscle arterioles are greatly sensitive to changes in tissue pO2 while in our preparation mesenterial arterioles are not. PMID- 1778677 TI - Spatial distribution of red blood cells in individual skeletal muscle capillaries during extreme hemodilution. AB - The effect of extreme hemodilution on single capillary red blood cell (RBC) distribution and microcirculatory hemodynamic parameters was studied in the resting rabbit tenuissimus muscle. Systematic hematocrit was progressively reduced to 26 +/- 3% of control by isovolemic hemodilution with a 6% dextran solution (70,000 MW). Heart rate and mean arterial pressure were monitored and noted to be constant throughout the procedure to ensure isovolemic exchange. Hemodilution induced an increase in the median spatial distance between RBCs within a capillary segment and a broadening of the range. Comparison of histograms constructed from normalized RBC spacing data relative to the median at each dilution level showed no statistical deviation from control, suggesting that spatial RBC distribution during capillary transit is independent of hematocrit reduction. Thus progressive hemodilution, while reducing capillary hematocrit and increasing the median spacing, did not alter the relative spatial distribution of RBCs within a vessel. The hemodynamic parameters analyzed were capillary hematocrit (HCTc), RBC flux (RBCf), and RBC velocity (VRBC). The reduction of the systemic hematocrit (HCTs) was not followed by a proportional fall in HCTc, implying a Hctc regulation. RBCf was maintained by an overall increase in VRBC which reached 101 +/- 61% of the control level at an average HCTs of 11 +/- 1.4%. The relative pattern of RBC spacing remained fixed, despite the change in cell number and modification of velocity. During extreme hemodilution, the potential supply of oxygen to the tissue remained constant and the pattern of RBC delivery pass the tissue was unchanged. PMID- 1778678 TI - A new preparation of rat extensor digitorum longus muscle for intravital investigation of the microcirculation. AB - The extensor digitorum longus (EDL) muscle is a fast contracting muscle with 60% of Type IIB fibres at the surface. We developed a surgical procedure for exposing this surface from which the microcirculation can be visualized via intravital microscopy. From video recorded microscopic images we determined that microvascular perfusion at the surface is fairly stable for at least 5 hours. Among 7 anaesthetized rats (male Wistar), the density of perfused capillaries decreased at a rate of 4% per hr. The average velocity of red cells in perfused capillaries remained constant at 0.14 mm/s. In order to demonstrate the usefulness of the preparation we report 2 sample experiments involving muscle contraction and aging. The major advantages of EDL preparation are (1) absence of mechanical manipulation of the muscle during exposure, (2) no requirement for surface superfusion following exposure, and (3) independence of the visibility of the microcirculation from rat size and age. PMID- 1778679 TI - The effects of long-term hypoxia on epicardium and myocardium in developing chick embryo hearts. AB - The consequences of long-term O2 deprivation on heart development were analyzed morphometrically and ultrastructurally, utilizing the hearts of chicken embryos developed under hypoxia from the 3rd to the 18th incubation day. The results indicate that embryos kept under low O2 blood tension do not show disturbances in heart morphohistogenesis, but are characterized by a thicker epicardium and a thinner myocardium than the controls; moreover, both the number and calibre of the heart microvessels are increased. The thickening of the epicardium is due to hyperplasia of the mesothelial cells, increment in calibre of the submesothelial vessels, and to conspicuous perivascular infiltration of blood-derived cells. The thinning of the cardiac muscle seems to be dependent on myocardiocyte hypotrophy and myofibril reduction. The increase in the volume density of myocardium vessels, due to their dilatation and proliferation, may be considered expression of a vascular adaptive reaction to low oxygen tissue concentration. PMID- 1778680 TI - A preliminary study of the effects of cardiac procedures on cognitive performance. AB - The effects of three commonly performed cardiac procedures on cognitive performance were evaluated in patients undergoing coronary artery bypass graft (CABG) surgery (N = 20), percutaneous transluminal coronary angioplasty (PTCA) procedure (N = 8), or cardiac valve repair (N = 11). Patients completed a neuropsychological test battery on the day prior to their surgery and at discharge. Results showed that valve and CABG patients exhibited declines in performance on the Digit Symbol subtest, while PTCA patients did not change. Reaction time performance improved for the PTCA patients but declined significantly for valve patients. These results suggest that common cardiac procedures may have measurable effects on cognitive performance, as assessed by a relatively brief test battery. PMID- 1778681 TI - Life events and irrational attitudes in patients with rheumatoid arthritis: relations to pain, disability and general health condition. AB - Previous research on the effects of life events on maladaptation suggest they should be related to disease impacts in rheumatoid arthritis (RA). From the concept of Rational-Emotive-Therapy the hypothesis was derived that irrational attitudes-in a similar way-are associated with disease related impairment. Subjects were 128 patients with definite RA from a specialized treatment center. When disease activity was controlled, positive change was associated with less disability, negative change was related to general symptoms. Relations between life events and three pain measures could not be established. Irrational attitudes shared significant common variance with three pain-measures (attributes, recent intensity, avoidance), with physical abilities, and with general health condition. The results were discussed with respect to literature and to clinical practice. PMID- 1778682 TI - Life events, abdominal pain and depression in peptic ulcer and depressive disorder. AB - Three patients with documented peptic ulcer and four patients with depressive disorder were followed every month for 10 to 14 months. A life events inventory, clinical ratings of depressive mood and ulcer symptoms, and analysis of the urinary excretion of cortisol and melatonin were used on every occasion. Although the number of patients was small a few tentative findings were made. First of all, associations between life events and depressive mood seemed to be "delayed" more often in the ulcer patients than in the depression patients. Secondly, there were individual associations between cortisol excretion and life events or between cortisol excretion and ulcer symptoms, but these associations seemed to form individual patterns. Two of the ulcer patients who had correlations in the expected directions showed a personality profile close to the one expected from classical literature, whereas the third patient who showed no correlations showed alexithymic traits. PMID- 1778683 TI - Progressive muscle relaxation and restricted environmental stimulation therapy for chronic tension headache: a pilot study. AB - Thirty-one patients suffering from chronic tension headache participated in one of four procedures, each of which comprised two one-and-one-half hour sessions per week for 4 weeks. The conditions were: Chamber/Control (both weekly sessions lying on a bed in a dimly-lit room), and three active treatment procedures: Chamber/Tank, one session as above, the other floating in a dark, silent REST tank; Chamber/Relaxation, one as above, one doing progressive muscle relaxation exercises; and Tank/Relaxation, one session floating and one doing progressive muscle relaxation. By 6 months after the end of treatment, complete data had been obtained from 20 subjects. There was a significant overall decrease in headache reports; the active treatment groups collapsed improved significantly more than the control group. At the 6-month followup, the treatment groups showed continuing improvement (57% over end of treatment for the Tank-Relaxation group and a mean of 25% for the other two), whereas the control group had deteriorated by 34% since end of treatment. Clinical improvements were comparable to those of more time- and effort-consuming relaxation therapies, and confirm the usefulness of REST as a long-lasting and versatile treatment in behavioral health. PMID- 1778684 TI - Changes in mode of control and self-control for post myocardial infarction patients evidencing Type A behavior: the effects of a cognitive/behavioral intervention and/or cardiac counseling. AB - A control model of psychological health was utilized to assess the effects of a cognitive/behavioral intervention and/or cardiac counseling with post myocardial infarction patients evidencing Type A behavior. A previously developed four quadrant control inventory measuring perceived mode of control and perceived self control was given to groups in two sections of the Recurrent Coronary Prevention Project. The experimental group (coronary counseling plus cognitive/behavioral intervention) was tested after one year (E1) and two years (E2) of treatment. The cardiac counseling group was assessed only after two years (C2). As hypothesized, the cognitive/behavioral treatment section at E2 had a significantly higher overall satisfaction level and congruence between real and ideal self on each of the four quadrants than at E1, and than the cardiac counseling only (C2). Further, on each of the four quadrants, E2 had a psychologically healthier mode of control profile than the cardiac counseling only (C2); and a healthier profile on both the positive assertive and positive yielding mode of control than at E1. Finally, E2's self-control score was significantly higher than C2's. Comments on future directions in measuring perceived control, and on the relationship of control and Type A behavior are offered. PMID- 1778685 TI - Gender differences and geographical differences in content from dreams elicited by a television announcement. AB - We studied 108 male and 110 female dreams that had been collected in response to a television announcement. We did not find a number of gender differences that had been previously reported. We found no difference between men's and women's dreams in the amount of aggression, friendliness, sexuality, male characters, weapons, or clothes. However, women's dreams still contained a higher number of family members, babies, children, and indoor settings than did men. We also looked at geographic differences, finding that while patterns of aggression did not distinguish men from women, they did distinguish residents of different areas. In dreams in which the dreamer was either the aggressor or victim, dreamers from the East coast were more likely to be the aggressor than those from the Midwest and West coast. PMID- 1778686 TI - A prevalence study of bestiality (zoophilia) in psychiatric in-patients, medical in-patients, and psychiatric staff. AB - The prevalence of bestiality (both actual sexual contacts and sexual fantasy) was investigated in an experimental group (psychiatric in-patients) and two control populations (medical in-patients and psychiatric staff). Psychiatric patients were found to have a statistically significant higher prevalence rate (55%) of bestiality than the control groups (10% and 15% respectively). Implications of these findings are discussed. It is recommended that due to the obvious prevalence of this condition, questions exploring this previously ignored topic should be routinely included in the psychiatric interview. PMID- 1778687 TI - The attitude of patients at risk for infective endocarditis toward dental treatment. AB - This study deals with four major characteristics that directly affect motivation and attitude of patients at risk for infective endocarditis (IE) toward oro dental health. Dental anxiety, self image, recognized importance of oro-dental care, and active coping were self-assessed by 25 patients at risk for IE and by a matched control group. The study group demonstrated less dental anxiety, lower self image and higher levels of recognized importance of oro-dental care than the controls, while active coping did not differ between the two groups. A review of the relevant literature is also presented. PMID- 1778688 TI - Comparison between the psychopathological profile of dental anxiety patients and an average dental population. AB - The psychological characteristics of 38 patients with extreme dental fear were compared with those of an age and sex matched control group chosen from the average population visiting the dental clinic. The results were assessed by means of the Kleinknecht Dental Anxiety test, the Brief Symptom Inventory and Spielberger Anxiety State questionnaires. The majority of the dental fear patients were women, the male/female ration being 0.29. In the sample group, the dental anxiety manifested as a state and not as a trait: the anxiety state mean score of the dental phobic group was significantly higher than that of the controls (p less than 0.05), while the mean score for anxiety trait did not differ. Profound psychopathological distress other than anxiety was present only among the phobic males. PMID- 1778689 TI - Psychosomatic medicine in Czechoslovakia: history, present state and perspectives. AB - The history and present state of psychosomatic medicine in Czechoslovakia are described in detail. At the present time, a concept of Z.J. Lipowski is spreading. Since the formation of the Section for Study of Psychosomatic Medicine, a part of the Czech Psychiatric Association in 1975, several teams of physicians and clinical psychologists have started work in various fields of psychosomatic medicine. Some inpatient and outpatient psychosomatic wards and units were opened. Pre- and postgraduate training in psychosomatics and behavioral medicine have started. Future developments of psychosomatic health care in Czechoslovakia will require the integration of the psychosomatic approach and the bio-psychosocial model of disease into primary health care and other bio medical disciplines. Psychosocial theory must be incorporated into prevention, diagnosis, treatment and rehabilitation of all diseases using the method of liaison psychiatry, along with the further institutionalization of psychosomatic care. PMID- 1778690 TI - Can stress be measured with an anxiety questionnaire? AB - The general problem of stress assessment and the role of anxiety state is considered using a widely accepted theoretical model of stress. The need for clear conceptualizations of stress production and stress response factors is indicated, to avoid confusion between measurements taken from instruments assessing anxiety state and emotional stress response. PMID- 1778691 TI - Spontaneous remission of depression after attempted suicide by hanging: a case report and literature review. AB - This is a case report of a spontaneous remission of depression after an attempted suicide by hanging. The patient suffered from cardiopulmonary arrest and anoxic encephalopathy, but recovered without apparent neurologic sequelae. The authors review the literature and explore the possible effects of hypoxia and hypercapnea on the locus ceruleus and the limbic system which could contribute to the patient's remission of symptoms. Also discussed are the psychosocial factors affecting patients' moods after a suicide attempt. PMID- 1778692 TI - The work of the National Perinatal Epidemiology Unit. One example of technology assessment in perinatal care. AB - This article describes one approach to assessing the effects of perinatal care- that adopted by the National Perinatal Epidemiology Unit in Oxford, England. The unit's research has been based primarily on a combination of simple, descriptive analyses of observational data and statistically robust analyses of evidence derived from randomized controlled trials. PMID- 1778693 TI - Preventing and managing prematurity. AB - In the past decade the prevention and management of prematurity have begun to be addressed with more appropriate designs. A few strategies--very few--can now be recommended. A few, some widely implemented, can be abandoned. The risks and benefits of most interventions still require clarification. PMID- 1778694 TI - Support in pregnancy. AB - Both observational studies and nonrandomized controlled trials have found the presence of support during pregnancy to be associated with superior outcomes in terms of preventing abortion, extending the length of gestation, and reducing interventions in labor. However, randomized controlled trials of supportive interventions in pregnancy have not demonstrated any physical benefits from the interventions. It is also unlikely there are any significant adverse effects. Psychological benefits do appear to result from supportive interventions, including better enjoyment of the pregnancy and better postnatal status. PMID- 1778695 TI - Assisted conception. Health services and evaluation. AB - Comparison of assisted conception in Australia, the United Kingdom, and the United States indicates that further rapid growth in services is likely in many countries. Better data on pregnancy rates and the outcome of pregnancy, as well as standardized reporting of national results, are needed to monitor the effectiveness of treatment. PMID- 1778696 TI - Assessment of midwifery routines. Toward a north/south collaborative effort. AB - Cooperation in midwifery research between Zambia and Sweden is ongoing. Joint studies on gastric suctioning and maternity routines are used as examples, and breastfeeding is discussed from a global perspective. The midwife, who also interprets responses from mothers, is an important member of an assessment team. Cooperation over cultural boundaries is feasible and mutually rewarding. PMID- 1778697 TI - Prenatal diagnosis, prenatal screening, and the rise of the tentative pregnancy. AB - More and more medical technologies are becoming available for the early detection of congenital abnormalities, such as amniocentesis, chorionic villus sampling, and ultrasound scanning. Recent research has shown that maternal serum can provide a wealth of information on the unborn fetus and that the testing method lends itself to mass screening. Although screening will prevent a great deal of grief, such developments also lead to extreme medicalization of pregnancy. However, owing to the fact that people show a strong desire to avert every possible approaching calamity, the "tentative pregnancy" seems to be unavoidable. PMID- 1778698 TI - Maternity patients' advocates in the 1990s. Changing debates and new debaters. AB - Beginning in the 1960s, the maternity patients' movement in the United States was joined by lay, medical, and political critics who protested the escalating cost, poor and inequitable distribution, and over-specialization of medical care. During the 1970s some goals of the maternity patients' movement were met, including fathers' attendance at birth, care in low intervention birth centers, and keeping the newborn baby with the parents immediately after delivery. At the same time, however, perinatal care became ever more based on new technology, tests, and procedures, some of which were promoted by doctor-developers in continuing education courses and in expert witness testimony at malpractice trials. Primary obstetric units closed while urban and suburban centers advertised new services to people who could pay. In the 1990s the maternity patients' advocates have most of the same complaints as in 1970, as well as many new ones. PMID- 1778699 TI - Health care and medical technology in Nigeria. An appraisal. AB - The objective of the study was to ascertain the extent of utilization of medical technologies (defined as equipment) used in various health care institutions in Nigeria. The study also investigated the factors accounting for use of and under- and nonutilization of this equipment. Sixteen major and minor health care institutions were surveyed. The outcomes of the study indicate that not less than a third of the equipment was out of order at the time of the study. A number of factors are responsible for nonutilization of this equipment. They include lack of infrastructural facilities such as piped water, storage, and power supply; poor handling by badly trained staff; and the low priority that is accorded to maintenance. The study leads to the important conclusion that the local culture is unable to sustain the technologies that are procured. PMID- 1778700 TI - Medical technology transfer in major Chinese medical schools. AB - This paper examines how the decision-making process and its consequences affect medical technology transfer in major Chinese medical schools. Data are from a 1987 survey of 13 key medical universities, directly supervised by the Ministry of Public Health in the People's Republic of China. This paper limits itself to four types of laboratory equipment--electron microscopes, UV/VIS spectrophotometers, high-performance liquid chromatographs, and polygraphs. Decisions on the transfer of medical technology have been more decentralized in China since the economic reform in 1978. The major reason for schools to import these four types of equipment is their dissatisfaction with the quality of domestic products. Chinese medical schools depend heavily on the information provided at medical equipment exhibits and their neighboring schools. Their decisions to acquire the equipment are based more on the quality and service available than on the prices. Chinese medical schools face serious infrastructure problems in acquiring and maintaining these pieces of equipment. A number of suggestions are made for improving the efficiency of medical technology transfer in China. PMID- 1778701 TI - Economic analysis alongside clinical trials. Revisiting the methodological issues. AB - Controlled clinical trials are recognized as the best source of data on the efficacy of health care interventions and technologies. Because economic evaluation is dependent on the quality of the underlying medical evidence, clinical trials have increasingly been viewed as a natural vehicle for economic analysis. However, the closer integration of economic and clinical research raises many methodological issues. This paper discusses these issues in trial design, collection of resource use data, collection of outcome data, and interpretation and extrapolation of results. Some guidelines are suggested for economic analysts wishing to undertake evaluations alongside clinical trials. PMID- 1778702 TI - Diffusion of in-vitro fertilization in The Netherlands and England. An exploratory study. AB - In-vitro fertilization (IVF) is a relatively recent approach to overcoming human fertility problems. This study explored factors in the diffusion of IVF in England and in the Netherlands. Many factors were common to the two countries. Governments in both countries have been passive, apparently wishing to avoid entering a controversial field. Technology assessment has played little part in the diffusion process in these two countries. PMID- 1778703 TI - Effects and costs of in-vitro fertilization. Again, let's be honest. AB - The decision whether to enhance diffusion and to reimburse for the fertility treatment in-vitro fertilization (IVF) was postponed in the Netherlands until the results of a cost-effectiveness analysis were known. IVF appeared to be as cost effective as its most important alternative, tubal surgery. But policy decisions still were not straightforward, obscuring important social and ethical issues. PMID- 1778704 TI - Economic evaluation of trends in cancer therapy. Marginal or average costs? AB - Evaluating the use of resources as well as outcomes in cancer therapy is increasingly becoming recognized by both clinicians and others as a legitimate and indeed even desirable activity. While this trend is to be welcomed if it facilitates the efficient use of resources for cancer care, there are dangers in applying estimates of unit costs, in particular average costs to the evaluation of trends in practice in cancer therapies. This article examines the use of appropriate measures of average and marginal cost in the economic evaluation of developments in cancer therapy, taking illustrations from radiotherapy and chemotherapy. PMID- 1778705 TI - Costs of breast cancer and the cost-effectiveness of breast cancer screening. AB - Breast cancer is the second leading cause of death by cancer among women in the United States. The total cost of illness for breast cancer has been estimated to be $3.8 billion, of which $1.8 billion represents medical care costs. It has been estimated that breast cancer detected early is considerably less expensive than when the tumor is discovered at a later stage. Mass screening using mammography can improve early detection by as much as 15-35%. Cost-effectiveness studies have estimated that the costs of breast cancer screening range between $13,200 and $28,000 per year of life saved. The cost-effectiveness of breast cancer screening in the 40-49-year-old age group is controversial. Mass screening for breast cancer will probably increase total health care costs, but when all economic costs are included, screening appears to be more cost-effective than not screening. PMID- 1778706 TI - The cost-effectiveness of breast cancer screening. PMID- 1778707 TI - Report from the U.S. Agency for Health Care Policy and Research (AHCPR). Electroencephalographic (EEG) video monitoring. PMID- 1778708 TI - Report from the Canadian Coordinating Office for Health Technology Assessment (CCOHTA). Reuse of single-use cardiac catheters. PMID- 1778709 TI - Reports from the Conseil D'evaluation des Technologies de la Sante du Quebec. Screening for breast cancer in Quebec: estimates of health effects and costs. PMID- 1778710 TI - Reports from the Conseil d'evaluation des Technologies de la Sante du Quebec. Hemodialyzer reuse: considerations of safety and cost. PMID- 1778711 TI - Report from the Health Council of The Netherlands. Report on cholesterol. PMID- 1778712 TI - Consensus statement from the U.S. National Institutes of Health (NIH). Intravenous immunoglobulin: prevention and treatment of disease. PMID- 1778713 TI - Report from the U.S. Office of Technology Assessment (OTA). Adolescent health. PMID- 1778714 TI - Report of a Joint Working Conference on Medical Informatics. Assessment of medical informatics technology. PMID- 1778715 TI - Cost-effectiveness of extracorporeal shock wave lithotripsy. PMID- 1778716 TI - Comment on "Dealing with discounting". PMID- 1778717 TI - Surgical treatment of carcinoma of the esophagogastric junction. AB - Forty-seven patients with carcinomas of the esophagogastric junction were operated. In acquiring complete dissection of lymph nodes located at the splenic hilus and along the splenic artery, splenectomy with or without caudal hemipancreatectomy was performed in 29 of 47 patients. To avoid leaving carcinoma cells behind in the remaining esophagus margin of resection, 20 patients underwent left thoracophrenicolaparotomy and 14 patients received blunt dissection of the intrathoracic esophagus. Five-year survival of 55.6% was observed in curative groups of the present study. No operative mortality was present. PMID- 1778718 TI - Gastric bleeding after endoscopic injection sclerotherapy for esophageal varices may be fatal. AB - Among 457 Japanese cirrhotic patients with esophageal varices, 28 (6%) bled from the upper gastrointestinal tract after the initial session of endoscopic injection sclerotherapy (EIS); 13 bled during the course of repeated EIS and 15 bled mainly from gastric lesions after eradication of the varices. Of these 28 patients, bleeding from gastritis occurred in 13 (46%), from esophageal varices in 10 (36%), from gastric varices in 4 (14%) and from gastric ulcer in one (4%). Six of 13 patients with gastritis-related bleeding and 3 of 4 patients with gastric variceal bleeding died of uncontrollable hemorrhage complicated liver failure, while 9 of 10 patients with esophageal variceal bleeding were controlled and reinjection was feasible. Ten (36%) of the 28 patients, with Child's grade B or C and severe ascites, died, mainly following bleeding from gastric lesions. This study shows that bleeding from gastric lesions after EIS can be uncontrollable and fatal in patients with poor liver function. PMID- 1778719 TI - Extracapsular lymphnode metastases in the staging and prognosis of gastric cancer. AB - The aim of this study was to evaluate the influence of the degree of nodal involvement (extracapsular vs intracapsular) on survival of 121 patients radically resected for gastric adenocarcinoma with nodal metastases at the Department of Clinica Chirurgica I of "La Sapienza" University of Rome. Patients with extracapsular nodal metastases had a worse 10-year survival rate than those with intracapsular nodal involvement (7.9% vs 22.4%). A better prognosis among patients with intracapsular node metastases was observed in each p-TN subgroup. In the multifactorial analysis (3-way ANOVA) survival was correlated with the depth of invasion of the gastric wall and the degree of lymphnode involvement (p less than 0.01) but not with the level of nodal involvement (N1 vs N2). Our results suggest that the degree of nodal involvement is an important independent prognostic factor that should be considered in the current staging system for curative resection in gastric carcinoma. PMID- 1778721 TI - Long term peritoneal nutrition in dogs, both normal and after intestinal resection. AB - We carried out total and prolonged peritoneal nutrition (PN) in a group of healthy dogs and in another group that had previously undergone an 80% resection of the small intestine. A third group of animals underwent the same operation but did not receive intraperitoneal nutrition, as they formed the control group. A nutritive mixture was used, composed of glucose fat emulsion, aminoacids, ions, trace elements, insulin and vitamins. The caloric rate was 45 kcal/kg/day. Peritoneal nutrition lasted 30 days. Periodical clinical controls were made for biochemical, hematological, microbiological and histopathological analyses. We found two episodes of peritonitis out of a total of 19 dogs subjected to PN. Hyper- and hypoglycemia occurred in the animals with PN and that had not undergone intestinal resection there were also increases in triglyceride, free fatty acid and cholesterol levels as well as a reduction of albumin. We observed a greater decrease in albumin and urea nitrogen and a greater weight loss in the animals underwent intestinal resection. The quantity absorbed was greater than 95% of the volume infused over the four week period. In all the animals subjected to PN we found hyperplasia and phagocytic phenomena in the peritoneal mesothelium cells after 30 days of peritoneal nutrition, symptoms which disappeared one month after this kind of nutrition was stopped. PMID- 1778720 TI - Surgical treatment of advanced gastric cancer with metastasis in para-aortic lymph node. AB - We have studied the incidence and prognosis of N4 node (para-aortic lymph node) metastases in gastric cancer in 434 patients who had been referred to our department for surgical treatment during the period between 1978 and 1988. N4 nodal involvement was found in 76 (17.5%) of 434 patients who had received a laparotomy with resection, and in 42 (10.5%) of 400 patients who had "curative" resection. When the surgeon assessed that the patients had metastasis in para aortic lymph nodes, the para-aortic lymph nodes lying above and below the left renal vein were completely removed (R4 gastrectomy). During this period, 42 patients with N4 nodal involvement underwent "curative" resection by R4 gastrectomy. Their treatment results were compared with those of 32 patients who underwent subtotal or total gastrectomy (R2 or R3 gastrectomy) without resection of metastases of para-aortic lymph nodes ("palliative" resection). The operating time and the operative mortality rate were similar in both groups (R4 vs R2 or R3 gastrectomy). The patients who had undergone "curative" resection (R4 gastrectomy) had a significantly higher five-year survival rate than those who had received "palliative" resection. The R4 gastrectomy is a rational and useful surgical procedure for treating patients with N4 nodal involvement. PMID- 1778722 TI - Detrusor-rectal neck dyssynergia syndrome. A new syndrome with report of nine cases. AB - Nine patients with detrusor-rectal neck dyssynergia syndrome are presented. Six were females and three were males. The complaint was constipation and straining at stool in all the patients and fecal soiling in four. Eight subjects with normal rectal functions acted as controls. Investigative results have shown that frequency and weight of stools are within normal range. Rectal neck pressure at rest was lower than the normal values (average 16.2 mmHg), while on voluntary squeeze it was normal (average 146.2 mmHg). The rectal pressure recorded normal values (20.6 mmHg). The recto-inhibitory reflex showed internal sphincter contraction on rectal distension; rectal neck pressure registered an average of 82 mmHg and rectal pressure 68 mmHg. Excessive straining at stool is due to failure of the rectal neck to open on rectal distension as a result of internal sphincter contraction. Fecal soiling could be due to the low pressure zone in the rectal neck at rest. Myectomy effected improvement in strainodynia and prevented internal sphincter contraction on rectal distension. Fecal soiling however did not improve after the operation. Myectomy specimens did not show histologic abnormalities. PMID- 1778723 TI - Effect of surgical stress on glucose-stimulated insulin release from isolated perfused rat pancreas. AB - To investigate the effect of surgical stress on the endocrine pancreas, we evaluated the changes in glucose-stimulated insulin release from the isolated perfused pancreas 4 and 7 days after laparotomy. Four days after laparotomy, insulin response to a glucose load was poor, and integrated insulin release was significantly less in the first and third phase of stimulation than in the normal rats. At 7 days, however, insulin response to a glucose load was augmented, and the integrated insulin release was significantly increased in all the phases of stimulation. These results indicate that in the early phase after surgical stress there is an impaired insulin response to a glucose load and that in the recovery stage after surgery, there is an augmented insulin response to a glucose load. PMID- 1778724 TI - Use of semiocclusive, transparent film dressings for surgical wound protection: experience in 3637 cases. AB - During an eight-year period, the author used a semiocclusive, transparent film surgical dressing as a protective cover for 3637 surgical incisions. The wet environment facilitated healing, and no patient exhibited any symptoms of wound infection. Compared with traditional methods, the semiocclusive dressing resulted in faster wound healing, decreased pain, and less scarring. It also permitted visual assessment of wound healing, as well as promoting patient mobility and hygiene. PMID- 1778725 TI - Endotoxemia is masked in fungal infection due to enhanced endotoxin clearance by beta-glucan. AB - Employing a novel turbidimetric assay, the amount of endotoxin and beta-glucan in plasma was monitored in postoperative patients suffering from both bacterial and fungal infections. The patients, whose beta-glucan level was markedly elevated, were always negative for endotoxin, suggesting a possible role of beta-glucan in the clearance of circulating endotoxin. In order to test the above hypothesis, effects of beta-glucan (carboxy methylated curdlan or lentinan) on endotoxin clearance were studied in rabbits. beta-glucan (4 micrograms/kg or 40 micrograms/kg) was intravenously administered to rabbits which received 4 micrograms/kg endotoxin injection, simultaneously or 120 min before the injection. Either of the beta-glucans increased the endotoxin clearance in a dose dependent manner, and the preinjection of beta-glucan was more effective than the coinjection. The increased amount of plasma beta-glucan results in the unexpectedly low level of plasma endotoxin, which may be removed by the reticuloendothelial system activated by beta-glucan, in cases with both bacterial and fungal infections. Thus, it is important to recognize that endotoxemia may be masked by the coexisting fungal infection. PMID- 1778726 TI - Value of ultrasound in persistent flank pain. AB - Urinary tract stones were present in 41 patients out of 54 who presented with recurrent or persistent flank pain. Ultrasound showed pelvicaliceal dilatation in 95.1% of these patients. Ultrasound is a safe, quick, reliable and cost effective diagnostic tool in such cases. Intravenous urography should be reserved for cases which need surgical intervention. PMID- 1778727 TI - Immunoglobulin transport in B cell development. PMID- 1778728 TI - The male germ cell protective barrier along phylogenesis. PMID- 1778729 TI - The cytoskeletal system of nucleated erythrocytes. PMID- 1778730 TI - Structure of the mouse egg extracellular coat, the zona pellucida. PMID- 1778731 TI - Isis current bibliography of the history of science and its cultural influences. 1991. PMID- 1778732 TI - Still more on ear cropping. PMID- 1778733 TI - Bovine somatotropin given okay by OTA report. PMID- 1778734 TI - FSIS begins sampling for antibiotics, sulfonamides. PMID- 1778735 TI - Comparison of bovine spongiform encephalopathy risk factors in the United States and Great Britain. PMID- 1778736 TI - Veterinary medicine in the Big Apple. PMID- 1778737 TI - Conflicting definitions of confounding and their ramifications for veterinary epidemiologic research: collapsibility vs comparability. PMID- 1778739 TI - To disclose or not to disclose, that is the question. PMID- 1778738 TI - ECG of the month. PMID- 1778740 TI - Risk factors associated with transmissible gastroenteritis in swine. AB - Commercial production data base records from 2 Illinois farms, on which epizootic or enzootic transmissible gastroenteritis (TGE) was experienced, were accessed for an epidemiologic study. Risk factors investigated were sow parity, source of sows, location of farrowing crates, and breeding practices. At farm 1, an epizootic was experienced; at farm 2, an epizootic of TGE followed by enzootic TGE was experienced. Initially, crude risk ratios were calculated for these risk factors, and the crude risk ratios were subsequently adjusted for confounders and interactions, using multiple logistic regression techniques. After adjustment, parity-3 sows were 2.3 times more likely to have litters with TGE than were sows of all other parities on farm 1, and parity-1 sows were 2.6 times more likely to have litters that experienced TGE than were sows of all other parities on farm 2. A single boar on each farm was linked to increased likelihood of a sow's litter contracting epizootic TGE on each farm. Enzootic TGE was maintained by the periodic influx of outside-source gilts on farm 2; these gilts were 2.2 times more likely to have litters with TGE than were sows derived from farm 2. Sows housed in farrowing crates located under the cold air inlet of farm 2 were 1.7 times as likely as sows located in other rows to have litters with enzootic TGE. PMID- 1778741 TI - Tumor necrosis factor activity in serum from neonatal foals with presumed septicemia. AB - A study was performed to determine prevalence of tumor necrosis factor (TNF) activity in serum of equine neonates with presumed sepsis and to determine correlation between serum TNF activity and severity and outcome of disease. Twenty foals less than 21 days old were considered suitable for inclusion in this study by satisfying clinical and laboratory criteria suggestive of septicemia. At admission, blood samples were collected from all foals for determination of serum TNF activity, then clinical course and outcome of disease were recorded. Thirty one clinically normal foals less than 21 days old served as controls for serum TNF activity. Serum TNF activity was estimated by use of an in vitro cytotoxicity bioassay and WEHI 164 clone-13 murine fibrosarcoma cells. Of the 20 foals with presumed sepsis, 5 had high serum TNF activity. Mean heart rate (P less than 0.005), mucosal petechial hemorrhages (P = 0.06), and death rate (P = 0.06) were greater in the group of foals with high serum TNF activity. These foals also had a lower mean neutrophil count (P less than 0.001), greater band-to-segmented neutrophil ratio (P less than 0.0001), and more prevalent neutrophil toxic changes (P = 0.07) than did foals without serum TNF activity (P = 0.02). Joint swelling was more prevalent in foals without serum TNF activity. Results of the study indicate that serum TNF activity is correlated with clinical criteria of sepsis in equine neonates. An association was apparent between disease severity and serum TNF activity in this group of foals with presumed septicemia. PMID- 1778742 TI - Biomechanical evaluation of acrylic external skeletal fixation in dogs and cats. AB - Acrylic external skeletal fixators (ESF) were compared with Kirschner ESF in biomechanical tests. A 2-cm unilateral acrylic ESF was found to be superior to medium Kirschner ESF in compression and shear loads. Acrylic ESF performed as well as Kirschner ESF in torsion loads. Acrylic ESF were used on 11 dogs and cats for repair of long bone fractures, for arthrodesis, or for immobilization of joints following ligament or tendon surgery. There were no complications associated with the use of acrylic ESF. Acrylic ESF offers the advantage of reduced cost, improved versatility, and simplified application technique when compared with Kirschner ESF. PMID- 1778743 TI - Use of the triiodothyronine suppression test for diagnosis of hyperthyroidism in ill cats that have serum concentration of iodothyronines within normal range. AB - Administration of triiodothyronine (liothyronine, 15 micrograms, q 8 h, for 6 treatments) caused marked decrease in serum concentration of thyroxine (T4) and estimates of free T4 (fT4) concentration in clinically normal cats. A prospective clinical study was done to evaluate the use of this suppression test for diagnosis of hyperthyroidism in cats with clinical signs suggestive of the disease, but lacking high serum concentration of iodothyronines. Twenty-three cats were confirmed as hyperthyroid on the basis of histologic changes in the thyroid gland or clinical improvement in response to administration of methimazole. Mean +/- SD serum concentration of T4 (34.3 +/- 12.7 to 31.3 +/- 11.5 nmol/L) and estimate of fT4 concentration (26.6 +/- 6.4 to 25.6 +/- 6.9 pmol/L) did not change after administration of liothyronine to these cats. Twenty three cats were classified as nonhyperthyroid by histologic confirmation of other disease, abnormal results of other diagnostic tests that strongly supported primary disease other than hyperthyroidism, or spontaneous remission of weight loss without treatment. Mean +/- SD serum concentration of T4 (27.9 +/- 10.3 to 11.7 +/- 6.4 nmol/L) and estimate of fT4 concentration (21.7 +/- 5.4 to 10.4 +/- 4.4 pmol/L) decreased significantly (P less than 0.001) in response to administration of liothyronine. Discriminant analysis was used to identify variables from iodothyronine assays (eg, absolute concentration of T4 or absolute estimate of fT4 concentration, or changes of T4 or fT4 concentration) that provided the best diagnostic sensitivity and specificity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778744 TI - Acute tularemia in three domestic cats. AB - Acute Francisella tularensis infection in 3 domestic cats was presumptively diagnosed on the basis of clinical signs and lesions and confirmed by culturing or immunofluorescent demonstration of the organism. Clinical findings include marked signs of depression, oral/lingual ulceration, regional or generalized lymphadenomegaly, hepatosplenomegaly, panleukopenia with severe toxic change of neutrophils, and hyperbilirubinemia with bilirubinuria. Lesions found at necropsy included icterus, oropharyngeal and lingual ulceration, multiple foci of necrosis in lymph nodes, spleen, liver, and lung, and severe segmental or diffuse enterocolitis. Results of serologic testing for F tularensis was positive in only 1 of the 3 cats. The organism was cultured aerobically from several tissues, including aspirated bone marrow obtained before death in 1 cat. Results of an indirect fluorescent antibody test, performed on fresh and formalin-fixed tissues of all cats, were positive. Because of the severe clinical course, opportunity to evaluate therapeutic regimens was not possible. Until now, confirmed diagnosis of feline tularemia only has been made retrospectively, in instances when cats were suspected to have transmitted infection to human beings in whom the primary diagnosis was made. The findings in this report provide a basis for presumptive diagnosis that will help to minimize public health risk associated with this potentially fatal zoonotic disease. PMID- 1778745 TI - Extradural spinal liposarcoma in a dog. AB - An 8-year-old female Doberman Pinscher was examined because of progressive, asymmetric, ambulatory caudal paraparesis. Myelography revealed extradural left ventrolateral spinal cord compression over the first and second lumbar vertebral bodies. A left hemilaminectomy, extending from the thirteenth thoracic to the second lumbar vertebrae, was done, and an extradural mass was removed. The tumor was identified histologically as myxoid liposarcoma. The dog's neurologic function improved gradually after surgery; however, at 7 months after surgery, hind limb neurologic function deteriorated rapidly over a 5-week period, presumably because of local recurrence of the tumor. The dog was euthanatized; necropsy was not permitted. PMID- 1778746 TI - Idiopathic, duodenogastric intussusception in an adult dog. AB - An adult Basset Hound was examined because of acute vomiting, signs of depression, dehydration, and signs of abdominal pain. Radiography revealed a soft tissue dense mass in the stomach. At exploratory laparotomy, 75% of the stomach was black, and the pylorus, proximal portion of the duodenum, and pancreas were found inverted into the stomach. The dog was euthanatized. PMID- 1778747 TI - Intestinal strangulation caused by intra-abdominal lipomas in a dog. AB - Pedunculated, intra-abdominal lipomas caused intestinal strangulation in a Doberman Pinscher. The dog was treated surgically to remove the lipomas and the devitalized intestine but died soon after surgery. Histologic evaluation confirmed the diagnosis of lipoma. PMID- 1778748 TI - Mesenteric tears of the descending (small) colon as a postpartum complication in two mares. AB - Segmental ischemic necrosis of the descending colon associated with discrete tears of the mesocolon were diagnosed in 2 mares following foaling. After foaling, both mares had a slow onset of signs of abdominal pain and gradual deterioration of clinical status. Increases in peritoneal fluid total protein concentration and WBC count and a palpable impaction of the descending colon on examination per rectum were useful diagnostic aids. Surgical intervention was successful in one mare, but not in the other. PMID- 1778749 TI - Septic tenosynovitis in horses: 25 cases (1983-1989). AB - The medical records of 25 horses with septic tenosynovitis treated over 7 years (1983 to 1989) were reviewed to determine clinical features of the disease and response to treatment. The median age of horses with septic tenosynovitis was 5 years (range, 1 month to 21 years). Fourteen fore limbs and 11 hind limbs were affected. Sepsis was located in the sheath of the digital flexor tendons of 22 horses. Sepsis was located in the sheath of the extensor carpi radialis tendon (1 horse), sheath of the long digital extensor tendon (1 horse), or sheath of the common digital extensor tendon (1 horse) in the remaining horses. Nine horses received only medical treatment, using a combination of broad-spectrum parenterally administered antimicrobial drugs (8 of 9 horses), nonsteroidal anti inflammatory drugs (8 of 9 horses), or irrigation of the wound (4 of 9 horses). Fourteen horses were treated surgically with either transection of the palmar/plantar annular ligament of the metacarpo/metatarsophalangeal joint (5 of 14 horses), lavage of the sheath after insertion of drains into the sheath (7 of 14 horses), or both (2 of 14 horses). All horses treated surgically were concurrently treated parenterally with broad-spectrum antimicrobial drugs and nonsteroidal anti-inflammatory drugs. Two horses with septic tenosynovitis were not treated and were euthanatized at the owners' request. Five horses were euthanatized before discharge from the hospital. Two horses (both treated medically) were lost to follow-up. Follow-up information was obtained for 18 horses, 6 to 55 months after discharge from the hospital.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778750 TI - Clinical and pathologic features of prostatic adenocarcinoma in sexually intact and castrated dogs: 31 cases (1970-1987). AB - The medical records of 31 dogs diagnosed with prostatic carcinoma at the teaching hospital between January 1970 and October 1987 were reviewed to determine whether gender status had an effect on the clinical features or biologic behavior of the disease. The only significant difference between sexually intact and castrated dogs was increased prevalence of pulmonary metastasis in castrated dogs. PMID- 1778751 TI - Potential clinical benefits of dietary supplementation with marine-life oil. PMID- 1778752 TI - What is your diagnosis? Severe hepatomegaly. PMID- 1778753 TI - The need for epidemiological studies of the medical exposures of Japanese patients to the carcinogen ethyl carbamate (urethane) from 1950 to 1975. PMID- 1778755 TI - Inhibition of azoxymethane-induced colon carcinogenesis in rat by green tea polyphenol fraction. AB - The effect of green tea polyphenol fraction (GTP) on azoxymethane(AOM)-induced colon carcinogenesis was investigated in male Fischer rats. The rats were given AOM (7.4 mg/kg body weight) s.c. once a week for 10 weeks. A week after the treatment, they were divided into three groups: AOM-control (26 rats), AOM-GTP1 (26 rats) and AOM-GTP2 (25 rats). AOM-GTP1 and AOM-GTP2 groups respectively received 0.01 and 0.1% GTP in drinking water from week 11 to 26. AOM-control group received tap water throughout this experiment. Autopsy on week 26 showed that tumor incidence and average numbers of tumors per rat in the AOM-GTP1 and AOM-GTP2 groups were significantly lower than those of the AOM-control group: 38.1% and 47.6% versus 77.3%; 0.6 and 0.7 versus 1.5. Thus, it was concluded that GTP inhibited the development of AOM-induced colon carcinogenesis. The inhibition by GTP did not show significant dose dependence. PMID- 1778754 TI - P450 and human cancer. AB - Most of the chemical carcinogens in our environment are activated mainly by a restricted number of cytochrome P450 species, P450 1A1, 1A2, 2E1, and 3A. This metabolic activation of procarcinogens is a crucial part of the initial host response to the environmental exposure, since most chemical carcinogens do not show any carcinogenicity by themselves. Inter-individual variability in the metabolic activity may thus be a key host factor to explain the differences in susceptibility to chemical carcinogenesis among individuals. Recent studies on P450s in cancer etiology have provided some valuable insights into this problem. PMID- 1778756 TI - Flow cytometric measurements of somatic cell mutations in Thorotrast patients. AB - Exposure to ionizing radiation has long been well-recognized as a risk factor for cancer development. Since ionizing radiation can induce mutations, an accurate way of measuring somatic mutation frequencies could be a useful tool for evaluating cancer risks. In the present study, we have examined in vivo somatic mutation frequencies at the erythrocyte glycophorin A (GPA) and T-cell receptor (TCR) loci in 18 Thorotrast patients who have been continuously irradiated with alpha-particles emitted from the internal deposition of thorium dioxide and who thus have increased risks of certain malignant tumors. When compared with controls, the results showed a significantly higher frequency of mutants at the lymphocyte TCR loci but not at the erythrocyte GPA loci in the Thorotrast patients. The discrepancy between the results of the two assays is discussed. PMID- 1778757 TI - A possible error in the interpretation of gastric carcinoma. AB - Isolated clusters of pyloric cells having homogeneous, eosinophilic (i.e., "glassy") cytoplasm were present in 6 (18.2%) of 33 consecutive gastrectomy specimens. Clusters with "glassy" cells displayed either a glandular arrangement or appeared as cohesive clusters. Cohesive clusters could be misinterpreted as signet-ring cell adenocarcinoma. However, remnants of the apical mucous secretion from the "ordinary" pyloric cells, the nuclei usually near the free border of the cells, as well as the negative reaction in the "glassy" cytoplasm for neutral and acid mucins, helped to differentiate them from signet-ring adenocarcinoma cells. PMID- 1778759 TI - Cancer incidence in Hawaiian Japanese: migrants from Okinawa compared with those from other prefectures. AB - Japanese men in Hawaii whose ancestral roots were in Okinawa were compared to Japanese migrants from all other prefectures. The Okinawan migrants have acquired fewer cancers than men from other prefectures (P = 0.12). No one primary site accounts for this difference. Stomach cancer rates showed the largest difference between the two migrant groups. This replicates the experience of Okinawans and non-Okinawans in Japan itself. Lymphosarcoma mortality rates are much higher in Okinawa than in all Japan, but this difference is not reproduced in Hawaiian migrants. This could be explained by a post migrational decrease in HTLV-I related acute T-cell lymphoma/leukemia. Cancer of the mouth, pharynx and esophagus has decreased in all Japanese migrants, but the decrease is much greater among Okinawan migrants, suggesting they have escaped exposure to risk factors peculiar to the Okinawan environment. Colon cancer is more common in migrant Japanese than in U.S. whites. The dramatic increase in the frequency of this tumor affects Okinawan and non-Okinawan migrants to an equal degree. PMID- 1778758 TI - Second primary cancers following colon and rectal cancer in Osaka, Japan. AB - The frequencies of second primary cancers following colon and rectal cancers were estimated using the Osaka Cancer Registry's population-based data for Osaka, Japan. A series of 7,312 colon and 6,923 rectal cancer cases newly diagnosed in the period of 1966-1986 were followed up until the end of 1986. The average follow-up period was 3.6 years for colon cancer and 3.7 years for rectal cancer. Significantly elevated risks of second primary cancers following colon cancer were observed for cancers of the rectum (O/E = 2.0; 95% confidence interval (CI) = 1.1-3.4 among males, O/E = 4.3; 95% CI = 2.4-7.2 among females), corpus uteri (O/E = 8.2; 95% CI = 3.3-16.9), ovary (O/E = 4.3; 95% CI = 1.0-5.0), and female thyroid gland (O/E = 4.7; 95% CI = 1.7-8.8). These findings were more notable among right-sided colon cancer patients than left-sided colon cancer patients. The elevated risks of second primary cancers were particularly evident among patients younger than 50 years of age at the time of diagnosis of the initial cancer (colon cancer: O/E = 3.1 among males, 3.4 among females, rectal cancer: O/E = 1.7 among males, 1.3 among females). These findings suggest that younger colorectal cancer patients should undergo more careful checkups throughout their lives. PMID- 1778760 TI - Renal pelvic carcinoma which shows metastatic potential to distant organs, induced by N-butyl-N-(4-hydroxybutyl)nitrosamine in NON/Shi mice. AB - Renal pelvic carcinoma was induced in mice by giving N-butyl-N-(4 hydroxybutyl)nitrosamine (BBN). Initially, differences in renal pelvic carcinogenesis by BBN were examined in three male mouse strains: NON/Shi, which demonstrate spontaneous hydronephrosis with incidences of 10-30%, and DS/Shi and B6C3F1, which do not exhibit hydronephrosis. When mice of these strains were given 0.05% BBN in the drinking water for 12 weeks followed by water without BBN for 8 weeks, renal pelvic carcinoma morphologically similar to human carcinomas developed in 8 of 23 NON/Shi mice (35%). Metastasis to the lung was found in one of them (13%). B6C3F1 and DS/Shi mice had no pelvic tumors, but the response to urinary bladder carcinogenesis in NON/Shi mice was nearly equal to that in DS/Shi and B6C3F1 mice. These results suggest that renal pelvic carcinogenesis is related to the presence of stagnant urine containing carcinogen in the renal pelvis. In a second experiment, we examined renal pelvic carcinogenesis in NON/Shi mice given BBN for 4 weeks followed by water without BBN for 32 weeks. The incidence of renal pelvic carcinoma (28%) was similar to that in the first experiment, but the incidence of metastasis was markedly elevated to 60%. These results indicate that BBN treatment can induce renal pelvic carcinoma which often metastasizes to the lung in NON/Shi mice. PMID- 1778761 TI - Synergistic enhancement of glutathione S-transferase placental form-positive hepatic foci development in diethylnitrosamine-treated rats by combined administration of five heterocyclic amines at low doses. AB - Potential synergism among 5 heterocyclic amines at low doses in the induction of glutathione S-transferase placental form (GST-P)-positive liver cell foci was examined in an 8-week experiment using male rats initially given diethylnitrosamine (200 mg/kg, ip). The heterocyclic amines applied were 3-amino 1-methyl-5H-pyrido[4,3-b]indole (500 ppm), 2-amino-6-methyldipyrido[1,2-a:3',2' d]-imidazole (500 ppm), 2-amino-3-methyl-9H-pyrido[2,3-b]indole (800 ppm), 2 amino-9H-pyrido[2,3-b]indole (800 ppm), and 2-amino-1-methyl-6-phenylimidazo[4,5 b]pyridine (PhIP, 400 ppm). Separate groups received each chemical at the dose used in earlier carcinogenicity assays (above doses), at 1/5 or 1/25 of these, or all 5 chemicals together, each at the 1/5 or 1/25 levels. The numbers and areas of GST-P-positive foci were significantly increased with all chemicals, except for PhIP, at the highest dose, the results being consistent with the reported liver carcinogenicity. In the combined treatment at the 1/5 dose levels, synergistic enhancement occurred; the numbers and areas of foci were significantly increased above the sums of individual data. However, this was not the case for the 1/25 dose groups. Although the synergism between pyrolysis products in liver carcinogenesis depended on the dose and combination of chemicals, the findings, together with those from a previous experiment using 5 different heterocyclic amines, are of particular significance since several heterocyclic amines might be simultaneously generated during cooking of foodstuffs. PMID- 1778762 TI - Possible application to medium-term organ bioassays for renal carcinogenesis modifiers in rats treated with N-ethyl-N-hydroxyethylnitrosamine and unilateral nephrectomy. AB - The effects of the renal tumor promoters; beta-cyclodextrin (beta-C), DL-serine (DL-S), basic lead acetate (LA), trisodium nitrilotriacetate monohydrate (NTA) and potassium bromate (KB), and diethylene glycol (DEG) as a negative control, on early stage of renal carcinogenesis were investigated in unilaterally nephrectomized male Wistar rats after N-ethyl-N-hydroxyethylnitrosamine (EHEN) administration. Wistar male rats were fed 1000 ppm EHEN diet for 2 weeks and the left kidney was removed at week 3, then the animals were divided into 7 groups of 15 rats each. These groups received the following treatments: 1000 ppm LA, 10000 ppm NTA or 500 ppm KB diet for 18 weeks from week 3; 45 mg/100 g body wt./day of beta-C injected sc for 7 days; 100 mg/100 g body wt. of DL-S injected sc biweekly for 6 weeks; 5% DEG in drinking water as a negative control for two days. Five rats in each group were killed at weeks 8, 12 and 20 and their kidneys were examined histologically. At week 20, the average numbers of adenomatous hyperplasias seen as preneoplastic lesions in the beta-C, DL-S, LA, NTA or KB groups were significantly higher than those in the DEG or control groups. Thus within a relatively short period of 20 weeks, promoting effects of chemicals can be detected as a significant increase of adenomatous hyperplasias in this model. PMID- 1778763 TI - Rapid induction of endometrial carcinoma in ICR mice treated with N-methyl-N nitrosourea and 17 beta-estradiol. AB - The present study was undertaken to develop an animal model for endometrial neoplasms. A total of 107 female ICR mice, 10 weeks of age, were used and treated as follows: Group 1 (31 mice) was given intravaginal instillation of N-methyl-N nitrosourea (MNU) solution (1 mg/100 g body wt.) once a week for three weeks and then fed diet containing 5 ppm 17 beta-estradiol (E2) for 20 weeks, starting one week after the last exposure to MNU. Group 2 (30 mice) was given MNU alone. Group 3 (31 mice) was given E2 diet alone. Group 4 (15 mice) was fed the basal diet alone and served as the untreated control. At the termination of the experiment (week 23), all surviving mice were killed. Histopathological examination revealed that adenocarcinomas in the uterine corpus developed in mice of Groups 1-3, with a high incidence of endometrial hyperplasia. The incidence of endometrial carcinomas in Group 1 (15/31, 48%) was significantly higher than in Group 2 (2/29, 7%, P less than 0.001) or Group 3 (7/31, 23%, P less than 0.01). In the uterine cervix, small numbers of squamous cell carcinomas and pre-neoplastic lesions (dysplasias and hyperplasias) were also present in mice of Groups 1-3. In Groups 1 and 3, an increased E2/progesterone (P) ratio was observed. Thus, the results indicated that this medium-term model for endometrial neoplasms is useful for studying the pathogenesis of endometrial cancer and that an increased E2/P ratio is an important factor for the development of endometrial adenocarcinoma. PMID- 1778764 TI - Enhancing potential of 6 different carcinogens on multi-organ tumorigenesis after initial treatment with N-methyl-N-nitrosourea in rats. AB - The advantages of applying a whole-body concept to the assessment of carcinogenic potential of compounds in a two-stage model after initiation by N-methyl-N nitrosourea (MNU) were investigated. Male, 6-week-old F344 rats were injected with MNU (20 mg/kg, i.p.) twice a week for 4 weeks and they then received 3,2' dimethyl-4-aminobiphenyl (DMAB) (50 mg/kg, s.c., once a week), N,N' dibutylnitrosamine (DBN) (0.05%, in drinking water), N-bis(2 hydroxypropyl)nitrosamine (DHPN) (0.1%, in drinking water), diethylstilbestrol (DES) (2.5 ppm, in diet), sodium o-phenylphenate (S.OPP) (2%, in diet) or captafol (0.15%, in diet) for 20 weeks. All six carcinogens enhanced the incidences of preneoplastic and neoplastic lesions in their respective target organs: liver, pancreas, small intestine and urinary bladder with DMAB; liver, esophagus, forestomach and urinary bladder with DBN; thyroid, lung, liver, esophagus, forestomach, small intestine and urinary bladder with DHPN; liver and forestomach with DES; and thyroid, forestomach, kidney and urinary bladder with S.OPP; liver and forestomach with captafol. The results suggested that prior treatment with MNU sensitized the tissues to the organotropic carcinogenic potential of chemicals given thereafter for as short a period as 20 weeks. Thus, this system could be utilized as a whole-body medium-term bioassay system for the screening of environmental carcinogens, bridging the gap between in vitro mutagenicity and long-term carcinogenicity tests. PMID- 1778765 TI - Genetic alteration of p53 in some patients with adult T-cell leukemia. AB - Abnormalities of p53 mRNA in adult T-cell leukemia (ATL) were analyzed using reverse transcription-polymerase chain reaction-single strand conformation polymorphism analysis. Mutations were present in two of 12 ATL patients studied, but not in 3 cell lines immortalized by human T cell leukemia virus type 1 (HTLV 1) infection in vitro. Direct sequencing analysis of the p53 gene from these two patients revealed missense point mutations at codon 153 (arginine to histidine) or codon 220 (cysteine to tyrosine), respectively. Immunohistochemical analysis revealed the elevated expression of p53 proteins in ATL cells from a patient carrying the mutated p53 gene at codon 158. Neither gross rearrangement of p53 gene nor abnormal size of mRNA for the gene was demonstrated by Southern or Northern blot analyses. Thus, there is a mutated p53 in some patients with ATL. The involvement of abnormalities in some suppressor oncogenes may play a role in the development of ATL. PMID- 1778766 TI - Aberrant elevation of tyrosine-specific phosphorylation in human gastric cancer cells. AB - Phosphotyrosine-containing proteins in various human cancer cell lines were studied by immunoblotting with anti-phosphotyrosine antibody. Of 29 cell lines derived from oral epidermoid cancer, esophageal cancer, gastric cancer, colon cancer, pancreatic cancer, hepatocellular carcinoma and malignant melanoma, 3 of the 6 gastric cancer cells showed aberrant elevation of tyrosine-specific phosphorylation. On the other hand, both esophageal cancer cells and colon cancer cells, which were reported to have amplified epidermal growth factor receptor and activated p60v-src kinase, respectively, showed no apparent elevation of tyrosine specific phosphorylation, and their profiles of phosphorylation were similar to that of normal human fibroblasts. Two gastric cancer cells, NUGC-4 and MKN-45, showed similar profiles of phosphorylation but their responses to growth factors differed from each other. Tyrosine phosphorylation in NUGC-4 was strongly activated by treatment with epidermal growth factor and quickly reduced by the acid treatment which is effective in removing growth factors from cellular surface receptors. On the contrary, phosphorylation in MKN-45 did not respond to either growth factor or acid treatment. These results suggest that NUGC-4 and MKN 45 have tyrosine kinases which are activated by different mechanisms but share similar substrates. PMID- 1778767 TI - Estrogen receptor levels and tumor growth in a series of pituitary clonal cell lines in rats. AB - Four kinds of in vitro clonal pituitary tumor cell lines named MtT/Se, MtT/SM, MtT/S and MtT/E, each of which shows different sensitivity to estrogen on proliferation, were inoculated into fat pad of ovariectomized rats and estrogen loaded ovariectomized rats at 10(5) and 10(6) cells/site. They formed tumor with average latency ranging from 30 to 71 in ovariectomized rats and 13 to 63 days in estrogenized rats inoculated with 10(6) cells. MtT/Se was highly sensitive to estrogen for growth, and MtT/SM also grew well in estrogenized rats. With MtT/S and MtT/E, there was no significant shortening of average tumor latency in estrogenized rats. In vivo, the cytosolic estrogen receptor (ER) levels of MtT/Se, SM, S and E were measured to be 452 +/- 66, 370 +/- 115, 260 +/- 16 and 83 +/- 8 fmol/mg protein, respectively. In vitro, however, the lowest ER level was noted in MtT/Se. Histologically, all four tumors grown in rats were composed of homogeneous round cells, and MtT/Se contained particularly large nucleated cells. In MtT/E, the cells appeared to be changing into fibromatous cells. Three cell lines except MtT/E maintained the function of hormonal secretion in vivo as well as in vitro. Serum GH level was increased in rats with MtT/Se and MtT/S. Increased levels of both prolactin and growth hormone were measured in sera of rats with MtT/SM. Increases of hormones as well as tumor sizes were promoted by the estrogen. PMID- 1778768 TI - Effects of the tumor inhibitor IKP-104, a 4(1H)-pyridinone derivative, on cytoskeletal microtubules of cultured tumor cells. AB - The effects of IKP-104, a 4(1H)-pyridinone derivative, on the mitotic profile and cytoskeletal microtubule dynamics of cultured B16 melanoma cells were examined in order to investigate the mechanism of its antitumor activity. The exposure to IKP 104 caused accumulation of cells in abnormal metaphase with chromosomes scattered within the cytoplasm and induced polyploid and multinucleate cells as detected by differential staining microscopy with brilliant blue R and safranin O. An immunofluorescence study with monoclonal anti-alpha-tubulin antibody revealed that IKP-104 diminished cytoskeletal microtubules of both interphase and mitotic cells, resulting in induction of a few fragments resembling "microtubular bundles" induced by vinblastine (VLB). These results indicated that IKP-104 arrests cells in the mitotic phase by inhibition of polymerization and induction of depolymerization of cytoskeletal microtubules, similarly to VLB. PMID- 1778769 TI - Pioneers of cancer research in Japan. PMID- 1778770 TI - 4-Nitroquinoline 1-oxide. PMID- 1778771 TI - Carcinogenicity of antioxidants. PMID- 1778772 TI - The first family of oncogenes: appreciation of a Japanese contribution. PMID- 1778773 TI - IL-6: a multifunctional regulator of immunity and inflammation. PMID- 1778774 TI - Oxygen radicals and 8-hydroxyguanine in DNA. PMID- 1778775 TI - Presidents of the Japanese Cancer Association for five decades since its establishment. PMID- 1778777 TI - Comprehensive studies on HTLV-1/ATL in Japan. PMID- 1778776 TI - A single GST-P positive hepatocyte induced by a hepatocarcinogen. PMID- 1778778 TI - SSCP (single strand conformation polymorphism) analysis of PCR fragments. PMID- 1778779 TI - Krev-1: the first transformation suppressor gene isolated by expression cloning. PMID- 1778780 TI - Alisamycin, a new antibiotic of the manumycin group. I. Taxonomy, production, isolation and biological activity. AB - Alisamycin is a new member of the manumycin group of antibiotics produced by Streptomyces sp. HIL Y-88,31582, which taxonomically appears to be Streptomyces actuosus. Alisamycin is active against Gram-positive bacteria and fungi, and has a weak antitumour activity. PMID- 1778781 TI - Isolation and structural elucidation of new 18-membered macrolide antibiotics, viranamycins A and B. AB - Two cytotoxic antibiotics, designated viranamycins A and B, were isolated from the culture broth of Streptomyces sp. CH41. Their structures were elucidated as new 18-membered macrolides related to virustomycin A and concanamycin A from NMR spectral analysis. Viranamycins A and B inhibited the growth of P388 mouse leukemia and KB human squamous-cell-carcinoma cells. PMID- 1778782 TI - Dynemicins, new antibiotics with the 1,5-diyn-3-ene and anthraquinone subunit. I. Production, isolation and physico-chemical properties. AB - Dynemicin A, a novel antibiotic containing the bicyclo[7.3.1]-1,5-diyn-3-ene and 1,4,6-trihydroxyanthraquinone functionalities, was isolated from the culture broth of Micromonospora chersina sp. nov. M956-1. The antibiotic exhibited potent in vitro antibacterial and cytotoxic activity, and in in vivo, it cured mice from lethal Staphylococcus aureus infection and prolonged survival time of mice inoculated with murine tumors. Three satellite components, dynemicins L, M and N, were also isolated from the culture broth and chemically characterized. PMID- 1778783 TI - Dynemicins, new antibiotics with the 1,5-diyn-3-ene and anthraquinone subunit. II. Antitumor activity of dynemicin A and its triacetyl derivative. AB - Dynemicin A showed extremely potent in vitro cytotoxicity against a variety of murine and human tumor cells. In the experimental animal tumor models implanted ip with P388, L1210 leukemias and B16 melanoma cells, dynemicin A administered ip significantly prolonged life-span of tumor-bearing mice with the wide range of activity. This antibiotic administered iv was also active against iv implanted P388 and L1210 leukemias. In the macromolecule biosynthesis of B16 melanoma cells, dynemicin A inhibited DNA synthesis specifically. The triacetyl derivative exhibited similar in vitro and in vivo antitumor activities to those of the parent antibiotic. PMID- 1778784 TI - Dunaimycins, a new complex of spiroketal 24-membered macrolides with immunosuppressive activity. I. Taxonomy of the producing organisms, fermentation and antimicrobial activity. AB - The dunaimycins are a new complex of spiroketal 24-membered macrolides discovered in the fermentation broth of two actinomycetes. Based on taxonomic studies these two cultures, which were isolated from soil, were identified as Streptomyces diastatochromogenes strains AB 1691Q-321 and AB 1711J-452. The dunaimycins possess both immunosuppressive and antimicrobial activity. PMID- 1778785 TI - Dunaimycins, a new complex of spiroketal 24-membered macrolides with immunosuppressive activity. II. Isolation and elucidation of structures. AB - A novel complex of antifungal and immunosuppressant compounds has been isolated from the fermentation broth and mycelia of two strains of Streptomyces diastatochromogenes. The structures of eight related components were determined employing 1D and 2D homonuclear and the heteronuclear NMR spectroscopy and mass spectrometry. These structures represent the first reported spiroketal 24 membered macrolide natural products related to the common 26-membered oligomycins. PMID- 1778786 TI - Endothelin-binding inhibitors, BE-18257A and BE-18257B. I. Taxonomy, fermentation, isolation and characterization. AB - Two endothelin (ET)-binding inhibitors, BE-18257A and BE-18257B, which antagonized 125I-ET-1 binding to a porcine aortic smooth muscle membrane, were isolated from the mycelium of a strain of Streptomyces misakiensis. These binding inhibitors were extracted with methanol from mycelium and purified by HPLC. PMID- 1778787 TI - Endothelin-binding inhibitors, BE-18257A and BE-18257B II. Structure determination. AB - The structures of novel endothelin-binding inhibitors, BE-18257A and BE-18257B, were elucidated by spectral analyses and chemical studies. Both inhibitors were found to have a cyclic pentapeptide structure containing three D-form amino acid residues, namely, the structures of BE-18257A and BE-18257B were elucidated to be cyclo(-D-Glu-L-Ala-D-Val-L-Leu-D-Trp-) and cyclo(-D-Glu-L-Ala-allo-D-Ile-L-Leu-D Trp-), respectively. PMID- 1778788 TI - A new alkaloid antibiotic tetrazomine. Structure determination. AB - A new alkaloid antibiotic tetrazomine was isolated from the culture broth of Saccharothrix mutabilis subsp. chichijimaensis subsp. nov., and its structure was determined to be I by means of spectroscopic measurements. It has an unusual structure which consists of six rings, including piperidine, piperazine, oxazole, and pyrrolidine rings. PMID- 1778789 TI - Studies on condensed-heterocyclic azolium cephalosporins. I. Synthesis and antibacterial activity of 7 beta-[2-(2-aminothiazol-4-yl)-2(Z)- alkoxyiminoacetamido]-3-(imidazo[1,2-a]pyridinium-1-yl)methyl-3- cephem-4 carboxylates. AB - In our study of the structure-activity relationships of cephalosporins bearing quaternary ammonium groups at the 3 position, we postulated that delocalization of the azolium positive charge would lead to an expanded antibacterial spectrum and increased activity. Since quaternization of condensed-heterocyclic compounds such as imidazo[1,2-a]pyridine gives positive charge delocalization, 7 beta-[2-(2 aminothiazol-4-yl)-2(Z)-alkoxyiminoacetamido] cephalosporin derivatives (1-53) bearing various (imidazo[1,2-a]pyridinium-1-yl)methyl moieties at the 3 position were prepared and their antibacterial activity was determined. As expected, these cephalosporins exhibited potent activity against both Gram-positive and Gram negative bacteria including Pseudomonas aeruginosa. These results imply that imidazo[1,2-a]pyridine is a quite useful substituent for improving antibacterial activity and spectrum. The structure-activity studies revealed that a favorable substituent on the imidazo[1,2-a]pyridine is the cyano radical at the 6 position of the ring, and ethoxyimino or 1-carboxy-1-methylethoxyimino groups are suitable for the alkoxyimino substituent. Among the cephalosporins tested, 7 beta-[2-(2 aminothiazol-4-yl)-2(Z)- ethoxyiminoacetamido]-3-(6-cyanoimidazo[1,2-a]pyridinium -1-yl)methyl-3-cephem-4-carboxylate (45) and 7 beta-[2-(2-aminothiazol-4-yl)-2(Z) (1- carboxy-1-methylethoxyiminoacetamido]-3-(6-cyanoimidazo[1,2- a] pyridinium-1 yl)methyl-3-cephem-4-carboxylate (49) showed good antibacterial activity. PMID- 1778790 TI - Studies on condensed-heterocyclic azolium cephalosporins. II. Synthesis and antibacterial activity of 7 beta-[2-(2-aminothiazol-4-yl)-2(Z) alkoxyiminoacetamido]-3-(condensed- heterocyclic azolium)methyl-3-cephem-4 carboxylates. AB - From our series of 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)-alkoxyiminoacetamido]ceph alosporins containing imidazo[1,5-a]pyridinium, imidazo[1,2-b]pyridazinium, imidazo[1,2-a]pyrimidinium, imidazo[1,2 c]pyrimidinium, and pyrazolo[1,5-a]pyridinium methyl groups at the 3 position. Among the cephalosporins tested, 7 beta-[2-(2-aminothiazol-4-yl)-2(Z) methoxyiminoacetamido]-3- (imidazo[1,5-a]pyridinium-2-yl) (1), (imidazo[1,2 b]pyridazinium-1-yl) (2), and (pyrazolo[1,5-a]-pyridinium-1-yl) (3)methyl-3 cephem-4-carboxylates showed potent antibacterial activity and broad antibacterial spectrum. The antibacterial activity of these cephalosporins (1 approximately 3) was superior to that of ceftazidime (CAZ). These results imply that the delocalization of the positive charge of the imidazo[1,5-a]pyridinium, pyrazolo[1,5-a]pyridinium and imidazo[1,2-b]pyridazinium groups leads to an expanded antibacterial spectrum and increased activity and that these condensed heterocyclic compounds as well as imidazo[1,2-a]pyridine are effective moieties for improving antibacterial activity and spectrum. PMID- 1778791 TI - All eight possible mono-beta-D-glucosides of validoxylamine A. I. Preparation and structure determination. AB - Validamycin A is the major and most active compound among the validamycin complex. Since the site of beta-glucosidic attachment to validoxylamine A (1) was expected to affect the activity against the pathogenic fungus, Rhizoctonia solani, all eight possible mono-beta-D-glucosides of 1 were prepared. 2-O-, 4-O-, 4'-O-, and 7'-O-beta-D-glucopyranosylvalidoxylamine A (2, 4, 6 and 9, respectively) were prepared by microbial beta-glycosylation of 1 with strains of Rhodotorula sp. 7-O- and 6'-O-beta-D-glucopyranosylvalidoxylamine A (5a and 8a, respectively) were prepared semisynthetically through microbial formation of 7-O beta-D-glucopyranosylvalidamine (10), oxidation of the primary amine of 10 to a ketone, and coupling of the ketone derivative with valienamine, and through microbial formation of 6-O-beta-D-glucopyranosylvalienamine (11), and coupling of 11 with (2R)-(2,4/3,5)-2,3,4-trihydroxy-5-hydroxymethylcyclohexanone (12), respectively. 3-O- and 5'-O-beta-D-glucopyranosylvalidoxylamine A (3a and 7a, respectively) were chemically synthesized. PMID- 1778792 TI - All eight possible mono-beta-D-glucosides of validoxylamine A. II. Biological activities. AB - The biological activities of all eight possible mono-beta-D-glucosides of validoxylamine A against Rhizoctonia solani were studied. The attachment of the D glucosyl residue to validoxylamine A generally diminished the inhibitory activity against trehalase. The introduction of the D-glucosyl residue at the C-3 position did not cause serious loss in activity, while substitution at the C-6' position caused complete loss in trehalase inhibitory activity. Of the eight beta-D glucosides, 4-O-beta-D-glucopyranosylvalidoxylamine A (4-O-beta-Glc-VA), 3-O-beta Glc-VA and 5'-O-beta-Glc-VA exhibited very strong activity against R. solani in the "dendroid-test method". The antagonistic activity of sugars (1 mM) against validoxylamine A and 4-O-beta-Glc-VA was examined using the "dendroid-test method". The inhibitory effect of validoxylamine A on hyphal extension was not antagonized by any sugars tested, whereas that of 4-O-beta-Glc-VA was antagonized by beta-1,3- and beta-1,4-glucooligosaccharides. Of 2-O-, 3-O-, 4-O- and 7-O-beta Glc-VAs, 7-O-beta-Glc-VA exhibiting the lowest activity was not antagonized by any beta-glucooligosaccharides tested. The inhibitory effect of 3-O- and 4-O-beta Glc-VAs was antagonized by most beta-glucooligosaccharides. The uptake of 4-O beta-Glc-VA into the mycelia was inhibited by laminaribiose and cellobiose but not by maltose. PMID- 1778793 TI - Studies on cephalosporin antibiotics. IV. Synthesis, antibacterial activity and oral absorption of new 3-(2-substituted-vinylthio)-7 beta-[(Z)-2-(2-aminothiazol 4-yl)-2- (carboxymethoxyimino)acetamido]cephalosporins. AB - A series of new 7 beta-[(Z)-2-(2-aminothiazol-4-yl)-2-(carboxymethoxyimino)ace tamido] cephalosporins (1) having various substituted-vinylthio groups at the C-3 position of the cephen nucleus was synthesized and evaluated for antibacterial activity and oral absorption in rats in comparison with cefixime. Of these, the cephalosporins (1a and 1c) with a lower alkoxycarbonylvinylthio group (Z-form) at the C-3 position showed a potent antibacterial activity against Gram-negative bacteria, improved activity against Staphylococcus aureus as well as good oral absorption in rats. The structure-activity relationships of 1 are also presented. PMID- 1778794 TI - Hexaene H-85, a hexaene macrolide complex. PMID- 1778796 TI - New polyenic antibiotics active against gram-positive and gram-negative bacteria. V. Mode of action of enacyloxin IIa. PMID- 1778795 TI - Antifungal activity of SL-1, a beta-nitrostyrene type pigment and its synthetic congeners. PMID- 1778797 TI - cis-2-amino-1-hydroxycyclobutane-1-acetic acid, a herbicidal antimetabolite produced by Streptomyces rochei A13018. PMID- 1778798 TI - Enopeptin A, a novel depsipeptide antibiotic with anti-bacteriophage activity. PMID- 1778799 TI - Thielocins A1 alpha and A1 beta, novel phospholipase A2 inhibitors from ascomycetes. PMID- 1778800 TI - Stimulation of mammalian cell proliferation by lavanducyanin. PMID- 1778801 TI - William Garfield Kammlade, 1892-1988: a brief biography. PMID- 1778802 TI - Comparison of real-time ultrasound and other live measures to carcass measures as predictors of beef cow energy stores. AB - Thirty-nine mature cows were divided into three condition groups on the basis of their subcutaneous fat thickness as determined by real-time ultrasound. A representative animal from each group was measured and slaughtered. The remaining cows with each group were stratified evenly into two groups with one group fed to gain weight and the other to lose weight. Several ultrasound and other live measures were taken every 4 wk and two animals per subgroup were randomly slaughtered. Carcass data were collected and one side of each carcass was boned, ground, mixed, and subsampled for fat and protein determination. Four regression equations were generated to predict percentage of fat (FAT), percentage of protein (PROT), total fat (TOTFAT), total protein (TOTPROT), total calories (CAL), CAL per live weight (CAL/WT), yield grade (YG), and marbling (MARB). The first equation used all live measures (SUB), the second equation used only objective live measures (OBJ), the third equation incorporated traditional live measures (EAS), and the fourth equation used only carcass data (CAR). Adjusted R squares of the most appropriate equation using the SUB, OBJ, EAS, and CAR measurements were .82, .73, .82, and .82 for FAT; .82, .57, .61, and .66 for PROT; .89, .87, .86, and .85 for TOTFAT; .95, .95, .93, and .74 for TOTPROT; .93, .92, .91, and .90 for CAL; .83, .78, .83, and .82 for CAL/WT; .86, .86, .78, and .93 for YG; and .75, .70, .74, and .74 for MARB, respectively. It seems that condition score or ultrasound with other objective live measures is as accurate in predicting cow composition as carcass measures. PMID- 1778803 TI - Effects of genotype and mating weight on ovulation rate, litter size, and uterine efficiency of Coopworth, Polypay, and crossbred ewes. AB - Six genotypes were produced by mating Coopworth (C), Polypay (P), and Suffolk (S) rams to Coopworth-type and Polypay ewes. In 1989, BW and ovulation rate (OR) were recorded for 188 naturally ovulating 5- and 6-yr-old ewes representing all six genotypes, and litter size (LS) was recorded for 174 ewes (93%) lambing to the ovulation observed by laparoscopy. Overall OR and LS averaged 1.85 and 1.71, respectively. Mean OR and LS did not differ (P greater than .40) among daughters of the various sire breeds; however, daughters of Polypay dams exhibited both higher OR (P less than .05) and LS (P less than .01) than daughters of Coopworth type ewes. Heterosis estimates for OR and LS were 6 and 7%, respectively. Overall uterine efficiency (UE) of ewes conceiving to twin ovulations was .83. Polypay derived ewes exhibited higher UE than other genotypes (P less than .05). Premating BW had significant but small effects on both OR and LS. Overall estimates of OR and LS response to a 10% increase in BW were 5 and 3%, respectively. Only Polypay-sired ewes showed a significant relationship between BW and reproductive performance; the estimated responses to a 10% BW increase were 9% for OR and 6% for LS. Variation in BW had no effect on UE of ewes conceiving to twin ovulations (P greater than .50). PMID- 1778804 TI - Effects of differential ewe condition at mating and early postmating nutrition on embryo survival. AB - Ewes in two trials were given either a high (H) or a low (L) level of premating nutrition for 19 wk followed by 6 wk of either H or L postmating nutrition to examine effects on reproductive performance. Trial 1 ewes were 5- to 8-yr-old Polypays and Trial 2 ewes were 3-yr-old Polypay and Coopworth x Polypay crosses. Ewes given L nutrition premating were either immunized with androstenedione-7 carboxyethylthioether:human serum albumin (also known as ovandrotone or Fecundin) in (diethylamino)ethyl-dextran adjuvant (Trial 1) or flushed for 3 wk premating (Trials 1 and 2) to enhance ovulation rates. All ewes were synchronized for mating in both trials. Trial 1 premating treatments created a difference of 10 kg in BW and 1.1 in condition score units between H and L ewes preflushing; flushing halved the BW difference. Ovulation rates averaged 2.58 and were similar for H, L flushed, and L-immunized (LI) ewes; however, both conception rate and litter size were lowest for immunized ewes. Among both twin and triple-ovulating ewes, highest mean litter size was produced by H ewes, followed in order by L and LI ewes. High postmating nutrition increased BW by 6 kg vs slight weight loss in L ewes, but postmating treatments did not affect litter size of either twin or triple ovulators. The H and L premating groups of Trial 2 differed by 18 kg and 2.2 condition score units preflushing. The H ewes exhibited higher ovulation rates (overall mean = 2.63) but lower conception than the L ewes to synchronized estrus. Litter size averaged 2.15 for H ewes vs 1.82 for L ewes. Among both twin and triple ovulators, L ewes produced fewer lambs than H ewes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778805 TI - Evaluation of methods of providing supplemental heat to newborn pigs during and after farrowing. AB - Two experiments were conducted to evaluate systems of providing supplemental heat to newborn pigs during and after farrowing. In Exp. 1, 35 sows were randomly allotted to farrowing crates with two supplemental heat treatments: 1) two lateral 250-watt heat lamps; and 2) two lateral heat lamps, plus a 250-watt heat lamp behind the sow during farrowing. In Exp. 2, 72 sows were randomly assigned to farrowing crates with four supplemental heat treatments: 1) one lateral 250 watt heater; 2) one lateral heater plus a 250-watt heater behind the sow during farrowing; 3) a hover with 100-watt light bulb; and 4) a hover with light bulb plus heater behind the sow during farrowing. The average farrowing house temperature was 18.9 degrees C in Exp. 1 and 21.6 degrees C in Exp. 2. Results showed no significant treatment effects on preweaning pig survival or growth rates in either experiment. Thus, providing a heat lamp at the rear of the sow during parturition was not beneficial and would increase operating costs. Hovers have a higher initial cost than conventional heat lamps or heaters, but they would have a much lower operating cost. Hovers may offer swine producers a way of reducing energy costs without affecting preweaning pig survival and performance. PMID- 1778806 TI - Variance and covariance estimates for weaning weight of Senepol cattle. AB - Variance and covariance components were estimated for weaning weight from Senepol field data for use in the reduced animal model for a maternally influenced trait. The 4,634 weaning records were used to evaluate 113 sires and 1,406 dams on the island of St. Croix. Estimates of direct additive genetic variance (sigma 2A), maternal additive genetic variance (sigma 2M), covariance between direct and maternal additive genetic effects (sigma AM), permanent maternal environmental variance (sigma 2PE), and residual variance (sigma 2 epsilon) were calculated by equating variances estimated from a sire-dam model and a sire-maternal grandsire model, with and without the inverse of the numerator relationship matrix (A-1), to their expectations. Estimates were sigma 2A, 139.05 and 138.14 kg2; sigma 2M, 307.04 and 288.90 kg2; sigma AM, -117.57 and -103.76 kg2; sigma 2PE, -258.35 and 243.40 kg2; and sigma 2 epsilon, 588.18 and 577.72 kg2 with and without A-1, respectively. Heritability estimates for direct additive (h2A) were .211 and .210 with and without A-1, respectively. Heritability estimates for maternal additive (h2M) were .47 and .44 with and without A-1, respectively. Correlations between direct and maternal (IAM) effects were -.57 and -.52 with and without A-1, respectively. PMID- 1778807 TI - Genetic parameters for calving ease and survival at birth in Angus field data. AB - Calving performance records from the American Angus Herd Improvement Registry files were used to estimate variance components for calving ease and survival to 24 h. Genetic parameters for direct and maternal effects were estimated by using a sire-maternal grandsire model. Data included two independent samples of 19 and 34 herds with complete calving information. Maternal variance for calving ease was much larger than the variance for the direct effect of the sire. Maternal heritability for calving ease was .27 and .20 in the two samples of herds, respectively. Heritabilities for direct effects were .21 and .07. The genetic correlations between direct and maternal effects were -.93 and -.80. There was little genetic variation in survival at birth. Parameter estimates were within the allowable parameter space in the sample of 19 herds. Heritability for the direct effect of the sire on survival was .04. Maternal heritability was .09, and the direct-maternal correlation was -.85. PMID- 1778808 TI - Prediction of breeding values for twinning rate and ovulation rate with a multiple trait, repeated records animal model. AB - A genetic correlation near unity between ovulation rate in heifers and later twinning frequency led to consideration of using measures of ovulation rate in heifers for each estrous cycle, beginning at puberty, to increase accuracy of selection for twinning rate. An initial evaluation with a multiple trait animal model for predicting breeding values included six genetic groups: 1) selected Scandinavian bulls, 2) transfers from other populations at the Research Center to a twinning project, 3) early-purchased Holsteins, 4) late-purchased Holsteins, 5) early purchases-other breeds, and 6) late purchases-other breeds. For ovulation and twin measures, heritabilities of .100 and .070 and repeatabilities of .120 and .092 were assumed. Assumed phenotypic correlation between ovulation and twin measures of .08 was accounted for by genetic correlation of .89 and permanent environmental correlation of .19. The number of animals evaluated was 1,745; 6,912 estrous cycles were measured for ovulation rate on 840 heifers and 1,929 parturitions were observed for occurrence of twinning on 851 cows, of which 346 had ovulation rate measured as heifers. The remaining 400 animals were foundation animals that created relationships among those with records or were sires of animals with records. The Scandinavian genetic group effect was substantially greater than that of the others. Joint evaluations were compared to evaluations using only twinning measures. For animals with twin evaluations based only on parents but with ovulation rates measured, the multiple trait evaluation increased accuracy of evaluation from .62 (twin information only) to .81.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778809 TI - Selection for immune response in goats: the antibody response to diphtheria toxoid after 12 years of selection. AB - A herd of Norwegian dairy goats was subject to selection for high and low antibody response to diphtheria toxoid for 12 yr, or approximately 5.5 generations because sires were used for one mating season, whereas dams were used several years. The herd comprised approximately 100 milking goats. Only sires were tested and selected, five to seven sires were used in each line each year, and the percentage of male kids used for breeding varied between 15 and 50%. The mean phenotypic values of the lines diverged until the 4th yr, but the lines did not diverge any further. The means of both lines decreased during the experimental period. The restricted maximum likelihood (REML) estimate of the heritability of the trait in the base population was .19, whereas the realized heritability approached zero in the last six cycles of selection. Using the REML estimate of heritability in an individual animal model, the mean breeding values (BLUP) of the lines were significantly different. The difference in mean BLUP values between the lines increased throughout the study. Yet, this increase was only 40% from the 2nd to the 12th yr. No effect of a major gene was observed in a test based on individual BLUP. PMID- 1778810 TI - Comparison of crossbred cows containing various proportions of Brahman in spring- or fall-calving systems: IV. Effects of genotype x environment interaction on lifetime productivity of young cows. AB - Lifetime productivity of young (2 to 6-yr-old) crossbred cows containing various proportions (0, 1/4, or 1/2) of Braham breeding was evaluated using 188 spring calving and 154 fall-calving cows. Cows were mated to Limousin sires to produce 1983 through 1986 calf crops. The 1987 calf crops were produced using Limousin and Salers sires. Significant (P less than .10) genotype (crossbred cow group) x environment (season of calving) interactions were found for age at first calf and lifetime calving percentage and mature cow weight. Within the spring calving group, no differences were found between crossbred groups for age at first calf or lifetime calving percentage. However, within the fall-calving group, 0 and 1/2 Braham cows from Angus dams calved earlier than did those from Hereford dams. Age at first calf also tended to increase as proportion of Brahman increased in the fall-calving group. Within the fall-calving group, lifetime calving percentage for 0 and 1/2 Brahman cows from Hereford dams was lower than for those from Angus dams. The opposite was true for the 1/4 Braham crosses. In general, as the proportion of Brahman breeding increased, productivity, measured as weight per calf or weight weaned per year, increased; however, age at first calving increased also as proportion of Brahman increased. All spring-calving groups calved earlier in life (P less than .05) than their respective fall-calving counterparts and with the exception of the 0 Brahman groups, which were similar, spring-calving groups produced a higher (P less than .05) percentage of calves than did the fall groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778811 TI - Genetic variation in composite and parental populations: expectations for levels of dominance and gene frequency. AB - Usefulness of multibreed composites depends on: 1) adaptation of the average breed effects combined, 2) amount of initial heterosis retained, and 3) the rate of further improvement from selection. Potential improvement could be increased, relative to parental stocks, by retained heterosis in reproductive rate and by any increase in additive genetic variation in the composite. A single-locus, two allele model with additive plus dominant gene effects was used to clarify expected changes from varying: 1) degree of dominance (d) from none to over dominance, 2) variance among parental lines in frequency of a dominant allele (Vq), and 3) mean gene frequency in the composite (qc). Simulation for a three breed composite (1/2, 1/4, 1/4) showed that expected heterosis retained in the composite is proportional to d and Vq and is highest for any d and Vq when qc is intermediate. Percentage of change of the composite from parental mean in additive genetic variance (delta Vac,%) increases most with parental diversity (Vq) when d = 0 but changes with higher d from positive when q is less than .5 to negative when q is greater than .5. Therefore, the expected association of delta Vac with level of heterosis retained (delta H,%) is always smaller for higher d and changes from positive when qc less than .5 to negative for the more likely higher equilibrium values of qc. Thus, greater selection intensity (from a higher reproductive rate) in composites than in parent stocks may not be accompanied by increased genetic variability and change in response per unit of selection applied may be limited. PMID- 1778812 TI - Genetic and environmental effects on growth to 1 year and viability of lambs from a crossbreeding study of D'man and Sardi breeds. AB - Genetic effects were estimated for growth to 1 yr and viability to 90 d of 882 lambs from a diallel cross of Sardi (S), D'man (D), and D'man x Sardi (DS) male and female parents. Sardi direct genetic effects were significantly higher than those of D'man for weights at birth and up to 2 mo, but the difference decreased thereafter and was in favor of D'Man at 6 mo. Sardi maternal ability was better than that of D'man for weights at all ages. Estimates of individual heterosis were small and negative for weight at birth, weight at 1 mo, and lamb viability and positive for other body weights; the estimate was significant for 12-mo weight. Estimates of maternal heterosis were small and did not approach significance for any trait. Epistatic recombination effects were generally small, but negative for all traits and significantly so for viability to 30 d. In general, the results, combined with those on reproduction and total lamb production of ewes of these groups, reported elsewhere, indicate that a population produced by inter se mating of animals 50% D, 50% S breeding is expected to have higher total lamb production than either purebred. PMID- 1778813 TI - Bulls show no preference for a heifer in estrus in preference tests. AB - The objective of this experiment was to determine whether sexually experienced bulls would demonstrate a preference (using primarily olfaction) between a heifer in estrus and a heifer in diestrus (luteal phase) when physical contact was denied. In Exp. 1, a heifer in estrus and a heifer in diestrus (n = 18 pairs) were individually enclosed in opposite ends of a pen. During each period (n = 18), three bulls were individually introduced into the pen and allowed 5 min to demonstrate preference between the heifer in estrus and the heifer in diestrus. The total time that a bull spent within 2.5 m of either heifer was used to evaluate his preference. The total time that bulls spent adjacent to the heifer in estrus was not greater (P greater than .05) than the total time that bulls spent adjacent to the heifer in diestrus. In Exp. 2, five bulls were used and were evaluated using the same method as in Exp. 1. In addition, the number of flehmen reactions were recorded for each bull. Six heifers were ovariectomized and each heifer was induced into estrus with one of three doses of estradiol 17 beta (5, 10, and 20 mg) over the 5-wk treatment period. Estradiol 17 beta-treated heifers were always paired with a non-estradiol-treated (control) heifer. The goal of Exp. 2 was to determine whether heifers treated with pharmacological doses of estradiol 17 beta would be preferentially selected from non-estradiol treated (control) heifers by bulls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778814 TI - Evaluation of recombinant porcine somatotropin on growth performance, carcass characteristics, meat quality, and muscle biochemical properties of Belgian Landrace pigs. AB - The dose related effects of recombinant porcine somatotropin (rpST) on growth, carcass characteristics, muscle properties, and meat quality were investigated in lean Belgian Landrace finishing pigs. Ninety-six pigs (48 barrows and 48 gilts) were injected daily with either vehicle, 1.5, 3, or 6 mg of rpST from 60 to 97.5 kg live weight. Each treatment group consisted of six pens of four pigs each (two of each sex). Pigs were given ad libitum access to a high-protein (20.4% CP) cereal-based diet. Administration of rpST increased (P less than .05) growth rate (16.3 to 25.4%) and improved (P less than .05) feed efficiency (16.9 to 29.4%). Feed consumption was reduced (12%; P less than .05) only in the 6 mg of rpST group. Liver, kidney, and heart weights were increased (P less than .05) in the 3 and 6 mg of rpST groups. Although the Belgian Landrace pigs are bred for superior carcass quality, rpST further improved (P less than .05) carcass composition at all dose levels as evidenced by a reduction (10 to 50%) in a number of subcutaneous fat depth measurements, an increase (10 to 20%) in longissimus muscle area, and an improvement in the lean cut:fat cut ratio. Rate of pH decline in the gluteus and longissimus muscles was similar, but rapid, in all groups (pH after 30 min = 5.74 to 5.94); the ultimate (24 or 72 h) pH was .15 to .2 pH units higher (P less than .05) in the pigs that received the 3 and 6 mg of rpST doses.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778815 TI - Influence of dietary protein and recombinant porcine somatotropin administration in young pigs: II. Accretion rates of protein, collagen, and fat. AB - The present study was conducted to determine the effects of different dietary protein levels and recombinant porcine somatotropin (rpST) administration on deposition rates of protein, fat, water, ash, and collagen in pigs. Ten groups of six barrows (30 kg BW) were restrictively fed (80% of ad libitum) one of five diets containing 11, 15, 19, 23, or 27% CP. Diets were isoenergetic and all contained equivalent amounts of lysine. Thirty barrows were treated daily with rpST (100 micrograms/kg) by i.m. injection; remaining pigs were treated with diluent for 42 d. At all levels of dietary protein intake, carcass and empty body accretion rates of protein, water, and ash were greater in rpST-treated pigs than in respective controls. The magnitude of change elicited by rpST was lowest in pigs consuming 11% CP. Administration of rpST resulted in a 34% decrease in the accretion rate of fat; increasing protein intake resulted in a linear decrease in fat accretion in control and rpST-treated pigs. Accretion rates of protein, water, ash, and fat were increased in viscera of rpST-treated pigs compared with respective controls; rates of visceral protein and water accretion were increased as dietary protein was increased, whereas deposition of fat was decreased in control and rpST-treated pigs. Administration of rpST resulted in an overall 66% increase in the utilization efficiency of dietary protein for empty body protein deposition. Protein intake had minimal effect on the concentration of collagen in the carcass; however, rpST treatment increased concentrations of total and soluble collagen by 30 and 33%, respectively. Recombinant pST had little influence on collagen crosslinking or maturation. Deposition rate of carcass collagen was increased 63% in rpST-treated pigs compared with respective controls. PMID- 1778816 TI - Bovine lipoprotein and apolipoprotein profiles as influenced by sex and growth. AB - Three (intact) Angus males and females that were half-sibs and born within 21 d of each other were selected for this study. Each animal was bled periodically from birth to slaughter (18 mo) to determine the qualitative composition of plasma lipoproteins and apolipoproteins during its growth and development. Major components observed were: 1) very low-density (VLDL), 2) low-density (LDL), and 3) high-density lipoproteins (HDL). Individual amounts of triglycerides, cholesterol, and proteins for the VLDL were not different (P greater than .05) between sexes at any time during growth and development. At 1 yr of age and 15 mo of age, females had significantly larger (143.4 and 93.5 mg/dl) amounts of protein in the HDL than males (67.0 and 93.5 mg/dl), respectively. Within the male group, the LDL triglyceride concentration of calves was significantly (P less than .05) higher (7.4 mg/dl) than at all other bleeding times. Within the female group, cholesterol values for the VLDL were significantly (P less than .05) larger as calves and weanlings (16.5 and 21.7 mg/dl respectively) than for other bleeding periods. At all stages of growth and development, the HDL apoprotein profiles showed a distinct band with a weight of about 28,000 Da, which represented apolipoprotein-A-I. During the suckling stage, pooling of LDL fractions provided two components on the acrylamide gel (7.5 to 20%), apolipoprotein-B and a low molecular weight band. At 12 and 15 mo, no low molecular weight band was present in the pooled LDL fraction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778817 TI - Finishing lamb performance responses to bovine and porcine somatotropins administered by Alzet pumps. AB - Daily injection of ovine and bovine somatotropin (oST and bST, respectively) has been shown to improve performance and carcass quality of finishing lambs. To evaluate responses to continuously released bST and porcine ST (pST), which have 99 and 91% sequence homology with oST, respectively, finishing lambs were implanted with 2-wk Alzet pumps containing bST or pST, which was released at rates of 2 or 4 mg/d. Six-week growth rate and feed efficiency responses to bST were greater than those to pST (P less than .05). Overall feed efficiency was improved 15% and growth rate was increased 16% in lambs treated with 4 mg/d of bST compared with control lambs and neither trait was affected in pST-treated lambs. Performance responses were reflected by changes in circulating glucose, blood urea nitrogen, and insulin-like growth factor I (IGF-I) concentrations. Scatchard analysis of sera with relative binding of greater than 30% revealed that average binding capacities and affinities of pST-treated lambs were 7.0 mg/liter and 6.0 x 10(9) liters/mol, respectively, and of bST-treated lambs were .8 mg/liter and 1.3 x 10(9) liters/mol, respectively. In addition, lambs with high-capacity pST antibodies had lower 6-wk IGF-I concentrations than those of controls, suggesting that these antibodies may have been attenuating responsiveness to pST. It is concluded that continuously released bST, but not pST, improves performance of finishing lambs. PMID- 1778818 TI - Sensory and processing properties of cured semimembranosus muscle from stress susceptible pigs treated with porcine somatotropin. AB - Forty-eight Yorkshire cross pigs of three stress susceptibility classes (stress positive, stress-carrier, and stress negative) were injected daily with porcine somatotropin (pST; 4 mg/d) or placebo. Each pig was injected in the neck once daily until taken off test, starting when the pigs weighed 59 kg. Porcine somatotropin treatment was terminated at weekly intervals as individual pigs reached 109 kg, but animals continued to be fed for six additional days to allow for required withdrawal time. The effect of pST and stress classification on the sensory, physical, chemical, and processing characteristics of cured semimembranosus (SM) muscle was evaluated. Treatment of animals with pST had no effect on the sensory scores, lipid and protein content, cooking yields, or color values of SM muscle slices. Semimembranosus muscles from stress-positive animals, however, had reduced sensory scores for texture, flavor, and overall palatability. Semimembranosus muscles from stress-positive pigs also had smaller cooking yields and greater Hunter a and b values of processed slices. The greater Hunter a and b values suggested that the color of these slices were redder and yellower than the color of SM muscle slices from negative and carrier animals. Semimembranosus muscles from stress-susceptible animals also had a significantly lower lipid content. Treatment of animals with pST did not significantly alter sensory, chemical, or processing characteristics of SM muscle slices from these animals. PMID- 1778819 TI - Influence of rapeseed meal, whole rapeseed, and soybean meal on fatty acid composition and cholesterol content of muscle and adipose tissue from ram lambs. AB - Twenty-four Suffolk x Hampshire ram lambs (average 46 kg) were assigned to one of three diets containing rapeseed meal (RM), soybean meal (SBM), or whole rapeseed soybean meal (RSSBM) as the protein source. Diets contained 75% roughage, 14% CP and 2.0 Mcal of ME/kg and lambs were allowed ad libitum access to diets for 35 d. Lipid composition of the longissimus, semimembranosus, and triceps brachii muscles and their corresponding s.c. adipose tissue was determined by gas-liquid chromatography (GLC). The total lipid content in either muscle or subcutaneous fat was not different (P greater than .01) by diet. In lean tissue, palmitic and palmitoleic acids were higher and stearic acid was lower (P less than .01) in rams fed RM than in rams fed RSSBM or SBM, regardless of anatomical location. In the s.c. adipose tissue, the amounts of myristoleic, pentadecylic, and palmitoleic acids were lower and the amount of stearic acid was higher (P less than .01) in rams fed RSSM than in those fed RM or SBM, regardless of anatomical location. The semimembranosus and triceps brachii muscles from all treatments contained 12 to 19% more polyunsaturated fatty acids (PUFA) than the longissimus muscle. The cholesterol content of the three muscles was highest in SBM-fed lambs, lowest in RM-fed lambs, and intermediate in RSSBM-fed lambs. These results demonstrate that dietary treatments of the types used in the present study elicit changes in fatty acid composition of both adipose and muscle tissue without affecting the quantity of total lipid.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778820 TI - Interrelationship between hypersensitivity to soybean proteins and growth performance in early-weaned pigs. AB - The objective of this growth trial was to determine the interrelationship between immunological criteria, gut morphology, and performance of starter pigs fed soybean proteins processed by different methods. One hundred twenty-five pigs were orally infused with 6 g/d of either dried skim milk, soybean meal (48% CP), soy protein concentrate, extruded soy protein concentrate, or experimental soy protein concentrate from 7 to 11 d of age and then fed a diet containing the same protein sources from weaning (d 21) to 35 d of age. All pigs were fed a corn soybean meal diet containing 10% dried whey, 1.25% lysine, and 3% soybean oil for the remaining 21 d of the experiment. Xylose absorption and anti-soy immunoglobulin G (IgG) titers were measured on d 6 postweaning, and skin-fold thickness after intradermal injection of protein extracts was measured on d 7 postweaning. A total of 25 pigs (five pigs/treatment) was euthanatized on d 7 postweaning. Villus height and crypt depth from duodenum samples were measured. These measurements were obtained to elucidate a relationship between the hypersensitivity responses to soybean products and growth performance of baby pigs. Pigs fed diets containing soybean meal had a lower (P less than .05) rate of gain (d 0 to 14) and villus height, higher (P less than .01) serum anti-soy IgG titers, and increased skin-fold thickness (d 6 and 7 postweaning) after intradermal injection compared with those fed dried skim milk. Pigs fed other soy proteins also had lower ADG from d 0 to 14 postweaning; however, pigs fed moist extruded soy protein concentrate tended (P less than .09) to have higher ADG and improved feed utilization when compared with pigs fed soybean meal (d 0 to 14).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778821 TI - Effects of dietary cadmium chloride throughout gestation on blood and tissue metabolites of primigravid and neonatal dairy cattle. AB - Thirty-six postpubertal Holstein heifers were allocated to three groups and fed the same diet, which differed only in the concentration of Cd: control group (.25 ppm of Cd), low-Cd group (1 ppm of Cd), and high-Cd group (5 ppm of Cd). Cadmium was supplemented to the low-Cd and high-Cd groups using CdCl2. Liver, kidney cortex, and abdominal muscle were biopsied for mineral analysis from one-half of the heifers of each group before Cd supplementation and again from the same animals within 5 d after parturition, 394 d later. Blood, liver, and muscle were collected from each calf within 5 h after birth. In the dam, 5 ppm of dietary Cd caused a 62-, 27-, and 4-fold increase in Cd of the kidney, liver, and muscle, respectively; kidney Zn and Fe increased (76%) and decreased (33%), respectively, whereas the serum Cu was reduced (31%). Liver Cu was reduced to 40 and 17% by dietary Cd of 1 and 5 ppm, respectively, in the dams. Calves from dams consuming 5 ppm of Cd had a 29 and 43% reduction in liver Cu and Zn, respectively. In these same calves, packed cell volume, hemoglobin concentration, and serum Cu were decreased by 17, 18, and 25%, respectively, whereas serum Zn was increased (55%). Serum sodium and potassium were reduced by 4 and 13%, respectively, and blood urea nitrogen was increased by 63% in calves from dams consuming 5 ppm of Cd. Feeding primigravid dairy cattle up to 5 ppm of Cd as CdCl2 throughout gestation did not influence the concentration of Cd in the neonate but caused reductions in liver Cu and Zn; teratogenesis was not apparent. PMID- 1778822 TI - Effects of long-term dietary cadmium chloride on tissue, milk, and urine mineral concentrations of lactating dairy cows. AB - The effects of long-term consumption of 1 and 5 ppm of Cd on Cd, Cu, Fe, and Zn concentrations in milk and a variety of tissues of first-lactation dairy cows was investigated. Thirty-six Holstein heifers were allocated to three groups and fed similar diets differing only in the concentration of Cd (.25, 1, and 5 ppm) for a 394-d period before calving. One- and 5-ppm Cd concentrations were achieved using CdCl2. Liver, kidney cortex, and muscle were biopsied from one-half of the heifers of each group before Cd supplementation and again from the same heifers within 5 d after parturition. Colostrum and milk were sampled throughout the 150 d of lactation. Urine was sampled after an average of 450 d of Cd exposure. At slaughter (after an average of 554 d), 11 tissues were sampled from 12 cows representing all treatment groups. During the first 394 d, Cd accumulated in kidney and liver with increasing dietary concentrations of Cd but did not further increase by 554 d. However, by 554 d Cd had also accumulated in the adrenal glands, ovaries, spleen, and uteri of cows consuming 5 ppm of Cd. Dietary Cd did not influence the concentration of Cd, Cu, Fe, or Zn in colostrum or milk. However, urine pH, Zn, and K were lower in cows consuming 5 ppm of Cd. Liver Cu was reduced by 1 and 5 ppm of Cd at both 394 and 554 d.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778823 TI - Effects of calcium soaps of fatty acids on postpartum reproductive function in beef cows. AB - Twelve multiparous Simmental cows (584 kg) were used to determine the influence of calcium soaps of fatty acids (CSFA) incorporated in a range supplement on postpartum reproductive characteristics. Cows were assigned randomly to receive a control [C; containing grain sorghum (GS) and soybean meal (SBM)] or CSFA-based (containing Megalac [a source of CSFA], GS, and SBM) supplement. Supplements plus prairie hay were individually fed. Diets were isonitrogenous and met the NEm requirement for heavy-milking beef cows in early lactation. Supplement feeding and daily blood collection began at parturition. Calves were removed permanently from cows at 25 +/- 2 d postpartum. Duration of first postpartum estrous cycles was determined by both visual observations and changes in concentrations of progesterone in serum. Concentrations of LH in serum (15-min intervals for 6 h) were determined 12 h before and 48 and 96 h after calf removal. Concentrations of progesterone and estradiol-17 beta in serum were determined daily. Cows receiving CSFA had higher (P = .06) mean concentrations of LH than those receiving C (1.47 vs 1.12 +/- .13 ng/ml). Concentrations of estradiol-17 beta were lower (P less than .02) and serum progesterone were higher (P less than .02) between d 6 and 8 of the induced cycle in CSFA-fed cows. Plasma cholesterol was greater (P less than .01) in cows fed CSFA although plasma triglyceride concentrations were similar between treatments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778824 TI - Gonadotropin concentrations, follicular development, and luteal function in pituitary stalk-transfected ewes treated with bovine follicular fluid. AB - Two experiments, each arranged as a 2 x 2 factorial, were conducted in ewes to examine direct effects of bovine follicular fluid (bFF) on follicular development and luteal function and to further characterize follicular development and luteal function after pituitary stalk transection (SS). In Exp. 1, ewes were sham operated or SS on d 6 of an estrous cycle and received 5 ml of saline or bFF three times daily on d 5 through 11 of the same cycle. In Exp. 2, all ewes were SS on d 6 of an estrous cycle and treated with saline or bFF three times daily on d 5 through 11 and with ovine FSH (60 micrograms; NIADDK-oFSH-16) or saline (1.2 ml) from d 7 to 11. In Exp. 2, ewes were ovariectomized on d 11 to assess effects of treatments on follicular development and luteal function. In both experiments, concentrations (ng/ml) of FSH on d 7 were suppressed (P less than or equal to .005) by bFF compared with saline (.50 +/- .17 vs 1.63 +/- .15) and remained suppressed (P less than or equal to .005) through d 11 (.46 +/- .12 vs 1.54 +/- .12). Replacement therapy (oFSH) restored concentrations of FSH. Concentrations of LH were not affected by bFF but were elevated (P less than or equal to .05) 1 d after SS (d 7; .88 +/- .09 vs .56 +/- .09) and remained elevated (P less than or equal to .05; 1.31 +/- .20 vs .65 +/- .11) from d 6 through 11. Concentrations of progesterone were unaffected by SS.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778825 TI - Enclomiphene does not alter the postpartum interval of suckled beef cows. AB - The objective of this study was to determine whether an antiestrogen (enclomiphene) would shorten the interval to first estrus and conception in postpartum beef cows. Sixty postpartum Angus beef cows were stratified by age, body condition, and calving date and were randomly assigned to one of two treatment groups. Group 1 cows (n = 24) received three silastic implants, each containing 150 mg of enclomiphene, on d 20 postpartum. Implants were removed on d 30 postpartum. Group 2 cows (n = 28), received empty implants and served as controls. Cows were artificially inseminated at first detected estrus. Estrus detection and ovulation were further verified by increased serum progesterone. Concentrations and pulse frequencies of LH were determined from blood samples collected at 15-min intervals for 6 h on d 20, 25, 30, and 40 postpartum. Hypothalami and pituitaries were collected from four cows in each treatment group on d 30 postpartum and analyzed for concentrations of estradiol receptors. Concentrations of total and unoccupied hypothalamic and pituitary estradiol receptors were reduced by enclomiphene. Neither concentrations nor pulse frequencies of LH differed significantly between treatment groups on any of the 4 d. Days to first estrus did not differ (P greater than .05) between enclomiphene treated (57 +/- 6; n = 24) and control (56 +/- 4; n = 28) cows. Days to conception did not differ between treated (81 +/- 9) and control (79 +/- 8) cows. The dose of enclomiphene used in this study reduced hypothalamic and pituitary estrogen receptors but did not alter secretion of LH or days to first estrus in the postpartum beef cow. PMID- 1778826 TI - Influence of dietary forage and energy intake on metabolism and acyl-CoA synthetase activity in bovine ruminal epithelial tissue. AB - Twenty calves (7 mo old) were blocked by breed, sex, and weight into five groups of four calves and randomly assigned to either a 90% forage (alfalfa) or a 90% grain (50% sorghum and 50% wheat) diet fed at one (1M) or two (2M) times NEm for 140 d. Samples of ruminal epithelial tissue were collected from the anterior ventral sac, and papillae were cut free by hand and used for in vitro incubations and acyl-CoA synthetase assays. Substrates were acetate (90 mM), propionate (60 mM), butyrate (30 mM), and glucose (20 mM). Net productions of beta hydroxybutyrate and acetoacetate from acetate were greater (P less than .01) with the 2M feeding; however, 14CO2 production from acetate was greater (P less than .05) with the grain diet. Net production of lactate (P = .09) and pyruvate (P less than .01) from propionate increased with the 2M feeding, whereas net lactate production from glucose decreased (P less than .01). Uptakes of VFA were similar with 1M and 2M feeding and were about 10-fold greater than uptakes of glucose. Production of 14CO2 from propionate was two- to fivefold greater than from acetate, butyrate, or glucose. Oxygen consumption was greater (P less than .01) with 2M feeding and unaffected by substrate. Activities of butyryl-CoA synthetase (nmol.mg of tissue-1.h-1) were greater (P less than .05) for animals consuming the forage diets. Addition of butyrate inhibited acetyl- and propionyl-CoA synthetase activity by 63 and 92%, respectively for all dietary treatments. Overall, metabolism of ruminal epithelial tissue tended to increase with the 2M feeding. Influence of dietary forage content on metabolism and activity of acyl CoA synthetases was minimal, but the high-forage diet caused slight increases. PMID- 1778828 TI - Feed intake, rectal temperature, and serum mineral concentrations of feedlot cattle fed zinc oxide or zinc methionine and challenged with infectious bovine rhinotracheitis virus. AB - Three experiments were conducted using feedlot steers in a randomized block design to determine the effect of zinc methionine (ZnMet) and zinc oxide (Exp. 3) on feed intake (DMI), rectal temperature, and serum mineral concentrations of feedlot cattle challenged with infectious bovine rhinotracheitis virus (IBRV). All the steers used were seronegative to IBRV. Steers were adapted for 7 d to their respective diets and challenged with 3.7 x 10(5) plaque forming units of IRBV on d 0 of each experiment. Live BW, rectal temperature, and individual daily DMI were recorded for 14 d. Blood samples were taken on d 0, 7, and 14. In Exp. 1, daily DMI of the control steers (Zn = 31 ppm) decreased 50% compared with 15% in the ZnMet (Zn = 90 ppm) steers 3 d after IBRV challenge. By d 6, the ZnMet steers had regained their pretrial mean daily DMI, but the control steers took 11 d. The ZnMet steers had lower (P less than .05) mean rectal temperature than the control steers on d 7 and 12. In Exp. 2, the control (Zn = 35 ppm) steers had lower (P less than .05) daily DMI on d 8 to 12 than the ZnMet (Zn = 89 ppm) steers. In Exp. 3, the mean decrease in daily DMI tended to be more rapid in the ZnO steers than in the control and ZnMet steers. All steers had the lowest daily DMI on d 5 and 6, coinciding with the highest rectal temperature. Serum Zn, P, and Mg concentrations decreased and serum Cu increased in all steers after infection. These data suggest that dietary Zn enhanced the recovery rate of IBRV stressed cattle. PMID- 1778827 TI - Influence of supplementation method on forage use and grazing behavior by beef cattle grazing bluestem range. AB - Two 25-d trials (late summer and early winter) were conducted to determine the influence of supplementation method on forage use and grazing behavior. Fifteen ruminally and 12 esophageally fistulated steers (316 and 400 kg, respectively) were blocked by weight and assigned randomly to one of three treatments: 1) self feeding supplement (via Calan gates) with salt as a limiting agent; 2) daily hand feeding supplement plus salt; and 3) daily hand-feeding supplement without salt. Supplement intake was restricted to .95 kg.steer-1.d-1 with .23 and .40 kg of salt.steer-1.d-1 during summer and winter, respectively. Neither season nor supplementation method affected forage (1.64% of BW) or total (1.89% of BW) OM intake (P greater than .10). Total OM digestibility was greater (P less than .05) in the summer, in salt-supplemented steers, and when steers were self-fed supplement. Digestibility of NDF was greater (P less than .05) in the summer than in early winter, but did not differ among treatments (P greater than .10). Fluid dilution rate was greater (P less than .05) for salt-fed and self-fed steers during the summer but similar among treatments (P greater than .10) during the winter. Total VFA concentrations did not differ among treatments during summer, but were slightly greater (P = .07) in hand-fed steers during the winter. Steers fed supplements containing salt consistently displayed lower (P less than .01) acetate:propionate ratios, and self-fed steers had lower (P less than .01) acetate:propionate ratios during the summer. Ruminal ammonia concentrations did not differ (P greater than .10) among treatments and between periods.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778829 TI - Techniques for evaluation and quantification of pig reproductive, ingestive, and social behaviors. AB - A literature survey was conducted to find papers that reported pig behavior during the period 1987 to June 1990. A total of 171 papers reporting measures of pig behavior was identified. Investigators used either descriptions of behavior or they quantified behavior. Behavior was quantified by recording frequency, durations, sequences, or bouts of behavior. Sexual behavior was often recorded as an all-or-none event (e.g., they were bred or not). Feeding behavior was studied by either weighing feeders often or by operant techniques. Operant feeding devices were commonly used to study pig feeding and drinking behaviors. Social behavior was studied either as interactions among established groups or when pigs fought after grouping. In either case, behavioral frequencies or durations were often reported. A large number of papers documented studies of maternal-neonatal interactions, teat orders, and animal care issues. Only a few studies reported mechanisms controlling pig behavior. Because few studies investigated behavior genetics or physiological mechanisms controlling pig behavior, these areas of investigation hold great opportunity for future improvements in pork production. PMID- 1778830 TI - Behavioral methods to answer questions about sheep. AB - Animal behavior has been defined as the interaction of an animal with its environment. During this interaction the animal must make decisions, based on its evaluation of the environment and its needs, of whether or not the environment is adequate or appropriate for specific behaviors. The environment includes both physical and biotic components, so sheep adjust their behavior in response to such diverse characteristics as the thermal conditions of their environment, the flora present, or the characteristics of other sheep. Although an animal's subjective experiences may not lend themselves to direct evaluation, we may be able to address these questions indirectly by using behavior as an indicator of the animal's decisions. This paper reviews research on the use of space, maternal and neonatal recognition, sexual behavior, and aversiveness. The majority of methods involve preference or acceptance tests. Assumptions, which often affect how tests are conducted and results interpreted, should be made only after the alternatives are carefully considered. PMID- 1778831 TI - Investigating equine ingestive, maternal, and sexual behavior in the field and in the laboratory. AB - Some of the techniques that may be used to study social, reproductive, and ingestive behavior in horses are described in this paper. One of the aspects of equine social behavior is the dominance hierarchy or patterns of agonistic behavior. Paired or group feeding from a single food source may be used to determine dominance hierarchies quickly. Focal animal studies of undisturbed groups of horses may also be used; this method takes longer, but may reveal affiliative as well as agonistic relationships among the horses. Reproductive behavior includes flehmen, the functional significance of which can be determined using combinations of field observations of harem groups and laboratory studies of stallions exposed to female urine or feces in the absence of the donor mare. Ingestive behavior may include food, salt, or water intake. Direct and indirect measurements of intake can be made and used to answer questions regarding the ability of horses to control their energy intake when the diet is diluted, the effect of feral equids on the ecology of an area, and the abilities of horses to compensate for dehydration and hypovolemia. PMID- 1778832 TI - Animal welfare: concepts and measurement. AB - The term "welfare" refers to the state of an individual in relation to its environment, and this can be measured. Both failure to cope with the environment and difficulty in coping are indicators of poor welfare. Suffering and poor welfare often occur together, but welfare can be poor without suffering and welfare should not be defined solely in terms of subjective experiences. The situations that result in poor welfare are reviewed in this study with special reference to those in which an individual lacks control over interactions with its environment. The indicators of poor welfare include the following: reduced life expectancy, impaired growth, impaired reproduction, body damage, disease, immunosuppression, adrenal activity, behavior anomalies, and self-narcotization. The uses of measures of responsiveness, stereotypies, and animal preferences in welfare assessment are discussed. The need to make direct measurement of poor welfare as well as to use sophisticated studies of animal preferences is emphasized. PMID- 1778833 TI - Husbandry of animals on land and in water: similarities and differences. AB - The husbandry of aquatic animals originated in China in approximately 1,100 B.C., thousands of years after the beginning of animal agriculture. The practice did not reach Europe until the Middle Ages. Aquaculture apparently was not very important in Western Europe. The early immigrants from that region did not include fish with the other food animals that they brought with them to the New World. The practice of aquaculture finally came to the United States in the mid nineteenth century, where it was used for the production of trout for stocking coldwater ponds and streams for sport fishing. Later, cultural practices were extended to warmwater species such as the largemouth black bass and the channel catfish. Thus, aquaculture in the United States was derived from recreational fishing rather than from food production, and from fisheries management rather than from animal science. There are important differences in the hydrosphere and atmosphere as cultural environments. Differences in composition, density, response to physical force, latent heat of fusion, specific heat, transparency, viscosity, and erosiveness of air and water result in different problems for land animal and aquatic animal culturists. Aquaculturists work primarily with "cold blooded" ("lower") animals, whereas agriculturists work with "warm-blooded" ("higher") animals. In comparison with warm-blooded land animals, cold-blooded aquatic animals are less independent of changes in their environment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778834 TI - Aquacultural production systems. AB - The wide range of species reared, species requirements, water resources, and regional preferences create the need for a wide variety of aquaculture production systems. Factors such as the interaction between water temperature and water quality and the feeding, growth, and survival of aquatic species cause the design of aquatic production systems to be much more location-specific and site-specific than the designs of systems for terrestrial animal agriculture. Economic and regulatory pressures are continuing to change the characteristics of aquatic production systems. PMID- 1778835 TI - Nutrition of aquaculture species. AB - Dietary requirements for amino acids and fatty acids have been reported for channel catfish (Ictalurus punctatus), salmonids (Oncorhynchus spp.), common carp (Cyprinus carpio), tilapias (Oreochromis spp.), and eel (Anguilla japonicus). Most of the vitamin and mineral requirements are available for channel catfish and salmonids, and some are available for common carp, tilapia, eel, and other finfish and crustaceans. From this available information, cost-effective feeds can be formulated for the major commercial aquaculture species. Major differences in nutrient requirements between fish and mammals or birds are as follows: fish have a lower digestible energy:protein ratio (8 to 10 kcal of DE/g of CP for fish vs 15 to 20 kcal of DE/g of CP for livestock); fish require n-3 fatty acids and land animals require n-6; fish can absorb minerals from the water, which negates the need for some minerals in the diet; and fish have limited ability to synthesize vitamin C and must depend on a dietary source. Areas for further research include 1) refinement of nutrient requirements of the major culture species considering effects of fish size, temperature, and management; 2) nutrient requirements of crustaceans; 3) effects of nutrition on fish health and product quality; and 4) feeding technology. PMID- 1778836 TI - Aquaculture disease and health management. AB - Disease problems constitute the largest single cause of economic losses in aquaculture. In 1988, channel catfish producers lost over 100 million fish worth nearly $11 million. Estimates for 1989 predict even higher losses. The trout industry reported 1988 losses of over 20 million fish worth over $2.5 million. No data are available on losses sustained by producers of shellfish. Bacterial infections constitute the most important source of disease problems in all the various types of production. Gram-negative bacteria cause epizootics in nearly all cultured species. Fungal diseases constitute the second most important source of losses, especially in the culture of crustaceans and salmon. External protozoan parasites are responsible for the loss of large numbers of fry and fingerling fin fishes and are a cause of epizootics among young shellfish. The number of therapeutants approved by the Food and Drug Administration is limited. Research to support the registration of promising therapeutic agents is urgently needed. PMID- 1778837 TI - Aquaculture product quality issues: market position opportunities under mandatory seafood inspection regulations. AB - Impending legislation for a mandatory seafood inspection program will be important in shaping the consumer's perception and expectation of quality in seafood products. Because aquacultured species are produced in controlled environments, fed special diets, and processed under optimum conditions, they possess unique product characteristics. The perception by the consumer that these products could be safer, fresher, more wholesome, and better tasting may lead to a competitive marketing position relative to captured products. PMID- 1778838 TI - Genetics and reproduction in fish culture. AB - Fish genetics has made major strides during the past 20 yr due both to improvements in the ability of fish culturists to manage reproduction and to deliberate experimentation and application. The general finding has been that the quantitative genetics of fish differ little from those of other animals and that the applications of animal improvement techniques are similar for fish and other animals. In addition, a number of novel techniques, such as ploidy manipulation and sex reversal, are relatively easy to achieve with a number of fish species. As a result, some very specialized approaches to research have been possible, and applications to fish production seem to be limited only to the imagination of the breeder. However, only limited application has occurred over a major portion of the industry, and genetic improvement of stocks has been achieved in very few instances. The reason for this apparent dichotomy between opportunity and reality seems to be related to the industry's lack of emphasis on genetic improvement. PMID- 1778839 TI - Aquaculture: opportunities for the nineties. AB - The aquacultural industry in the United States has expanded at a rapid rate since 1980. This expansion has been driven by increased demand for fisheries products, a leveling off of commercial landings, and the ability of the industry to produce a competitively priced, high-quality product. As the demand for fisheries products increases during the next 10 yr, aquacultural production will play an increasingly important role in meeting the global demand for fisheries products. World aquacultural production reached over 13 million tons in 1987. Aquacultural production in the United States reached an all-time high of 292,457 t in 1988. Opportunities for continued expansion of the industry are good. The industry must continue to develop sound marketing strategies and continue to improve production efficiency. Additionally, a number of important economic, geophysical, social, and political factors will affect the development of the industry. PMID- 1778840 TI - Problems and possibilities into the next decade involving beef cattle breeding research in the southern region: experiment station herds. AB - Opinions on expected support of animal breeding and genetics research into the next decade were requested from heads of Departments of Animal Science and directors of agricultural experiment stations in the Southern Region and from directors of agricultural experiment stations outside the Southern Region. A majority of administrators in all three groups expect a reduction in assignment of state appropriated funds for beef cattle breeding research compared with total support available. Cattle numbers and land areas assigned to breeding and genetics research may be more limited in the future. Directors of agricultural experiment stations expect animal breeding scientists to work more closely with scientists in biotechnology and to become more involved in multidisciplinary research to reduce the costs associated with maintaining large herds of cattle. Departments of Animal Science do not expect to reduce significantly the number of animal breeding positions, but they may reassign some that come open to balance departmental opportunities. Animal breeding scientists will be needed to educate graduate students, teach classes, and handle research responsibilities as in the past. PMID- 1778841 TI - Problems and possibilities into the next decade involving beef cattle breeding research in the southern region: purebred field data banks. AB - Beef cattle field records can provide data to generate important research information. The challenge in using field data for animal breeding studies involves proper editing to remove erroneous records and formulating proper models to account for fixed effects and to estimate or predict effects of interest free of bias and(or) with minimum estimation error. Use of field data for testing hypotheses is limited due to the lack of control and knowledge of the conditions under which the data were collected. Therefore, designed studies and field data should be used together to answer important questions. Some of the possible projects that can use field records are the estimation of genetic and environmental relationships among economically important traits, defining environments over which genotype x environment interactions and heterogenous heritabilities are most likely to occur, and pinpointing important fixed effects that must be accounted or adjusted for in genetic prediction models. The goal of research involving field data has been and will continue to be to provide information to improve genetic prediction models and procedures and to provide producers with genetic values with which to make informed selection decisions with a high degree of confidence. PMID- 1778842 TI - Problems and possibilities into the next decade involving beef cattle breeding research in the southern region: cooperator herds. AB - When resources are limited, use of cattle owned and maintained by cooperators to conduct beef cattle breeding research in the Southern Region can be a feasible alternative to the traditional policy of using experiment station cattle. Former students, former experiment station employees, extension personnel, institutional personnel, or tribal personnel can serve as suitable cooperators or can aid in locating potential cooperators. Several problems can be associated with cooperative work; however, the two most obvious are 1) only a limited number of researchable questions can be addressed and 2) complete experimental control over the cattle is seldom achieved. The procedure has the primary advantage that in most cases all or at least the greatest portion of the expense of owning and maintaining the cow herd is borne by the cooperator. PMID- 1778843 TI - Streptococcal ecovars associated with different animal species: epidemiological significance of serogroups and biotypes. PMID- 1778844 TI - Bacteriological studies on Iraqi milk products. AB - Samples from different types of domestic milk products including cheese, kishfa and gaymer were assessed for bacteriological quality over a 4-month period. A total of 400 samples were randomly selected across Mosul city and tested for faecal coliform counts, enteropathogenic Escherichia coli (EPEC) and enterotoxigenic E. coli (ETEC). Faecal coliforms were present at levels greater than 10(2) cfu/g in 72.5% and less than 10(2) cfu/g in 27.5% of samples. Of the 430 E. coli strains isolated from the 400 samples of milk products, 138 were serotypes of EPEC. These were found in 81 (40.5%) samples of cheese, 35 (23.8%) of kishfa and 22 (29.7%) of gaymer. During this period, 26 strains of ETEC were also isolated, all of which demonstrated heat-labile or heat-stable toxins. The high proportion of strains of three groups of E. coli showing resistance to antibiotics is discussed in relation to widespread use of antibiotics and the possible public health implication. PMID- 1778845 TI - Glucose and lactate catabolism by bacteria of the pig large intestine and sheep rumen as assessed by 13C nuclear magnetic resonance. AB - The fermentation of [1-13C] glucose and [3-13C]lactate by bacteria isolated from sheep rumen and pig large intestine was compared by the nuclear magnetic resonance (NMR) technique. Washed cell suspensions were incubated directly in the NMR spectrometer and spectra were recorded every 10 min after injection of the labelled substrates. The results showed large differences in the fermentation patterns between rumen and hindgut bacteria. The latter pattern indicated a greater ability for formation and fermentation of lactate than that of the rumen. Moreover, with both substrates the amount of propionate formed via the acrylate pathway was always greater with hindgut than with rumen bacteria, 50% and 20% of the total, respectively. PMID- 1778846 TI - Decreased biocide susceptibility of adherent Legionella pneumophila. AB - In a study of the in vitro effectiveness of biocides against Legionella pneumophila, some aspects of the cooling tower environment were replicated in the laboratory, paying particular attention to water hardness and pH. Pieces of Douglas fir and polyvinyl chloride were colonized in a recirculating system and the comparative efficacy of two biocides (Bronopol and Kathon) against the sessile and planktonic populations was examined. While the biocides were relatively effective against the planktonic L. pneumophila population over a short period of time (minimum 9-12 h), substantially longer periods of time (maximum greater than 48 h) were required to reduce the number of cultivable bacteria to below detectable levels in the adherent population. The results indicate that failure to monitor the sessile population of L. pneumophila in laboratory studies of biocides may result in the use of incorrect dosages and/or contact times in field trials with apparently reduced in situ efficacy. PMID- 1778847 TI - Fungal infection in neonates. PMID- 1778848 TI - BSAC spring meeting, March 1991: pathogenic mechanisms in lung disease. PMID- 1778849 TI - The control of class I beta-lactamase expression in Enterobacteriaceae and Pseudomonas aeruginosa. PMID- 1778850 TI - Molecular evolution of tetracycline-resistance plasmids carrying TetM found in Neisseria gonorrhoeae from different countries. AB - High level tetracycline resistant strains of Neisseria gonorrhoeae (TRNG) have been shown to carry a 40.6 kb (25.2 MDa) conjugative plasmid with a Class M tetracycline resistance determinant. Restriction endonuclease analysis mapping showed that there were at least two different TRNG plasmid types which were found in geographically distinct locations. The physical maps of these two plasmids were compared to a gonococcal conjugative plasmid which did not encode tetracycline resistance. The plasmid type which is endemic in the Netherlands was found to be closely related to the gonococcal conjugative plasmid, which supports the established hypothesis that the 40.6 kb plasmid has evolved by transposition of the TetM determinant into the conjugative plasmid. The plasmid found in the United States has either evolved by substantial divergent evolution or it results from a different transposition event. In the UK there have been isolations of TRNGs carrying either of the two plasmid types reflecting a flow of people both across the Atlantic and in Europe. It is possible that further TetM-containing plasmids will be found in N. gonorrhoeae paralleling the family of TEM beta lactamase encoding plasmids already described. PMID- 1778851 TI - Role of OmpD2 and chromosomal beta-lactamase in carbapenem resistance in clinical isolates of Pseudomonas aeruginosa. AB - Imipenem-resistant clinical isolates of Pseudomonas aeruginosa were divided into two categories: (i) isolates that were moderately resistant to imipenem (MIC 6.25 mg/L) that produced trace amounts of protein D2 detected with immunoblotting using anti-protein D2 antibody, but not when stained with Coomassie blue and had inducible class 1 beta-lactamase expression; (ii) isolates that were highly resistant to several beta-lactams, including meropenem, with no protein D2 by staining or immunoblotting and had stably derepressed beta-lactamase. Laboratory strains were isolated and analyzed: (i) mutants lacking protein D2, or (ii) lacking protein D2 and producing stably derepressed beta-lactamase with carbapenem resistance similar to the clinical isolates. (iii) mutants producing undetectable beta-lactamase which were four-fold more susceptible to imipenem than the mutant producing stably derepressed beta-lactamase or the strain with inducible beta-lactamase. These data suggests that beta-lactamase and outer membrane permeability govern meropenem-resistance in P. aeruginosa. PMID- 1778852 TI - beta-Lactamase expression and outer membrane protein changes in cefpirome resistant and ceftazidime-resistant gram-negative bacteria. AB - Twenty-five strains of Enterobacteriaceae (five each of Enterobacter cloacae, Citrobacter freundii, Serratia marcescens, Morganella morganii, and Providencia stuartii) and five strains of Pseudomonas aeruginosa were exposed to various concentrations of cefpirome or ceftazidime in agar. Mutants with a greater than four-fold increase in the MIC were examined for changes in beta-lactamase expression and outer membrane protein (OMP) profile. Both agents selected mutants with decreased susceptibility to the selecting antibiotic and other beta-lactams at a frequency of 10(-7)-10(-8). The MICs of all beta-lactams were higher for the resistant mutants of E. cloacae and P. aeruginosa than for the other species. Both agents selected mutants expressing derepressed class I beta-lactamase, but this was more common with ceftazidime. Only a few mutants of P. aeruginosa and E. cloacae had an MIC of cefpirome that was above the recommended breakpoint concentration. Some mutant strains of Enterobacteriaceae lacked an OMP of molecular size similar to OmpF, but the MIC of cefpirome was below the breakpoint concentration for all these strains. PMID- 1778853 TI - Physiological effects of metronidazole on Clostridium pasteurianum. AB - The physiological effects of metronidazole on the growth, viability, fermentation end-product production and cellular morphology of Clostridium pasteurianum cells growing logarithmically were studied. Metronidazole (a 5-nitroimidazole) was found to be the most potent of the nitroimidazole compounds tested against C. pasteurianum. It inhibited the growth rate of C. pasteurianum cultures by varying degrees over a range of drug concentrations (2.5-10 mg/L). Metronidazole had an immediate bactericidal effect at a concentration of 10 mg/L, killing 99.9% of cells within 5 min of drug addition. The same concentration caused an immediate cessation of fermentation end-product (acetate and butyrate) production in these cultures. These observations may be relevant to a proposed cell lysing mechanism which may form an additional mode of action of this important antibiotic. PMID- 1778854 TI - In-vitro activity and beta-lactamase stability of SR 44337, a new long acting cephalosporin. AB - The in-vitro activity of SR 44337 was compared with that of other broad-spectrum parenteral cephalosporins, plus imipenem and co-amoxiclav. SR 44337 showed good activity against the Enterobacteriaceae, with MIC90s of less than 0.5 mg/L against all species tested, with the exception of Citrobacter spp. (MIC90 2 mg/L) and Serratia spp. (MIC90 4 mg/L). Of the agents tested, only ceftriaxone showed consistently greater activity against this family of organisms. SR 44337 had higher activity than ceftriaxone against Acinetobacter spp. and Pseudomonas aeruginosa, and was the most active agent tested against Neisseria meningitidis (MIC90 0.004 mg/L). All strains of N. gonorrhoeae, Haemophilus influenzae and the streptococci (excluding the enterococci) were susceptible to less than or equal to 0.25 mg/L of SR 44337, which was also the most active cephalosporin tested against Staphylococcus aureus. SR 44337 was stable to hydrolysis by the TEM-1, SHV-1 and P99 beta-lactamases, and was more stable than ceftriaxone to the K-1 beta-lactamase. PMID- 1778855 TI - The in-vitro activity of cefdinir (FK482), a new oral cephalosporin. AB - The in-vitro activity of cefdinir (FK482), an orally absorbed aminothiazolyl cephalosporin, was compared with that of cefuroxime, cefixime, cephalexin, cefaclor and co-amoxiclav. Cefdinir was highly active against Staphylococcus aureus, inhibiting 90% of strains at 0.03 mg/L. The respiratory pathogens Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis were also susceptible (MIC90 less than or equal to 1 mg/L). The common members of the Enterobacteriaceae were susceptible (MIC90 less than or equal to 1 mg/L), but those possessing chromosomal beta-lactamases were more resistant. Cefdinir appeared highly stable to the TEM-1 and SHV-1 beta-lactamases with only relatively minor degrees of hydrolysis being seen with TEM-3, -5 and -9. PMID- 1778856 TI - Antimicrobial susceptibility of Streptococcus pneumoniae, Haemophilus influenzae and Moraxella (Branhamella) catarrhalis isolated in the UK from sputa. AB - Four hundred and thirty-one Streptococcus pneumoniae, 1272 Haemophilus influenzae and 305 Moraxella (Branhamella) catarrhalis were isolated from sputa and identified in 28 UK laboratories during a ten week period in 1990. Disc diffusion susceptibility testing was performed in each centre using identical methods. Species-specific susceptibility breakpoints applied to data for six antimicrobial agents were determined from the distribution of isolates according to zone diameters of inhibition measured in participating laboratories and were correlated with minimum inhibitory concentration data obtained with 302 isolates sent to the coordinating centre. Inter-laboratory reproducibility was estimated by comparing peripheral and coordinating centre results for these 302 isolates and by distributing five reference strains to all laboratories for testing. Reduced susceptibility to ampicillin and amoxycillin-clavulanate was detected in less than 3% of S. pneumoniae, but 8.1% were resistant to tetracycline and 6.5% to erythromycin. Resistance to ampicillin due to production of beta-lactamase occurred in 9.4% of H. influenzae; another 5.2% were resistant to ampicillin and amoxycillin-clavulanate but were beta-lactamase-negative. 4.5% were resistant to tetracycline and most (86.6%) had MICs greater than or equal to 1 mg/L of erythromycin. Zone diameters around ampicillin discs were greater than or equal to 10 mm smaller than those around amoxycillin-clavulanate discs for 241 (79%) of M. catarrhalis. Although only 193/241 had been reported to be beta-lactamase positive by participating laboratories, data obtained at the coordinating centre confirmed that greater than or equal to 10 mm and less than or equal to 3 mm zone size differences correlated with beta-lactamase-positive and -negative isolates respectively. No M. catarrhalis were resistant to amoxycillin-clavulanate and less than 4% were resistant to either tetracycline or erythromycin. The prevalence of resistance to cefaclor was highest among H. influenzae (5.2%) and lowest among S. pneumoniae (0.9%). Only seven of 2008 isolates (two to three per species) were resistant to cefixime. The data suggest that the prevalence of resistance to ampicillin, tetracycline and erythromycin must be taken into consideration when treating respiratory infections. PMID- 1778857 TI - Experimental studies on the nephrotoxicity of amphotericin B in rats. AB - The renal effects of amphotericin B alone and in combination with cyclosporin A, tobramycin, fosfomycin, D-glucaro-1,5-lactam and verapamil were studied in rats. The parameters for nephrotoxicity were urinary loss of tubular cells and malate dehydrogenase, as well as creatinine clearance. Repeated intraperitoneal injections of amphotericin B led to an increase of urinary tubular cell elimination and malate-dehydrogenase. After co-administration of amphotericin B and cyclosporin A, the urinary loss of tubular cells increased and creatinine clearance was reduced. A combination of amphotericin B and tobramycin reduced tubular cell elimination but the creatinine clearance improved. When verapamil was combined with amphotericin B, endogenous creatinine clearance increased, though the loss of tubular cells was elevated. Furthermore, fosfomycin reduced the loss of tubular cells and improved renal functional parameters in combination with amphotericin B. In addition, D-glucaro-1,5-lactam was found to reduce the urinary loss of tubular cells induced by amphotericin B. PMID- 1778858 TI - Concentration of metronidazole in cervical mucus and serum after single and repeated oral doses. AB - The disposition of metronidazole in cervical mucus and serum after single and repeated oral doses (400 mg) was investigated in six healthy female subjects. Metronidazole reached higher concentrations in serum than cervical mucus after both single and repeated oral doses. Metronidazole concentrations in both cervical mucus and serum were high enough to be trichomonicidal and bactericidal. After oral administration, metronidazole concentrations in cervical mucus are due to diffusion rather than ion trapping. PMID- 1778859 TI - Relationship between cefpirome clearance, serum creatinine, weight and age in patients treated for infection. AB - Cefpirome serum concentrations were measured by microbiological assay in 30 patients after five to nine days of treatment with 1 or 2 g bd for moderate to severe infection of presumed bacterial origin. Patients with serum creatinine (SCr) greater than 220 mumol/L were excluded. The age of patients ranged from 34 86 years. Creatinine clearance (Clcr) was calculated from age, sex, weight and SCr. The range of SCr was 63-220 mumol/L and the range of Clcr was 18-169 mL/min. The correlation coefficient with cefpirome clearance was 0.464 for SCr and 0.747 for Clcr. More than half of the patients with Clcr less than 50 mL/min had SCr within the normal range of 70-150 mumol/L. Mean cefpirome clearance in patients with Clcr 18-50 mL/min was 42.7 mL/min, which is very similar to the figure of 43.5 mL/min reported in a single dose volunteer study in patients with renal failure. Mean cefpirome clearance in patients with Clcr greater than 80 mL/min was 107.6 mL/min. In conclusion, these data on cefpirome clearance obtained after multiple dose treatment of patients with presumed bacterial infection are consistent with data previously obtained from single dose volunteer studies and support the currently recommended dose regimens. Clinicians should take account of age, weight and sex when estimating renal function from SCr. PMID- 1778860 TI - Treatment of chlamydial conjunctivitis in newborns and adults with erythromycin and roxithromycin. AB - A randomized single-blind study of the effects of erythromycin and roxithromycin on chlamydial conjunctivitis was performed on a group of patients, comprising 28 newborns and 27 adults. Treatment used was either 200 mg of erythromycin ethylsuccinate or 50 mg of roxithromycin daily, divided into two doses for the neonatal group or for the adult group, 1000 mg of erythromycin stearate or 300 mg of roxithromycin daily divided into two doses. All patients were treated for ten days. Clinically nine of the neonates and 13 of the adults had unilateral conjunctivitis, whilst the remaining cases were bilateral. At follow-up one month after commencing therapy, all but one (erythromycin-treated) of the 28 neonates and three (two of whom were erythromycin-treated) of the 27 adults were cured. However, 16 (nine neonates and seven adults) were culture-positive for Chlamydia trachomatis in samples from eye and/or nasopharynx. The culture-positive group comprised ten cases (four neonates and six adults) who had been treated with erythromycin and six (five neonates and one adult) with roxithromycin. No major side effects of the therapy were seen. The study indicates that there was no difference in the clinical cure rate for the two drugs either in neonates or in adults. However, the isolation rate of chlamydiae in the adult group differed, with 12 (92%) of the 13 roxithromycin-treated cases becoming culture-negative, whilst this was true for only eight (57%) of the 14 erythromycin-treated cases (P less than 0.007). PMID- 1778861 TI - Susceptibility testing of urinary tract pathogens to norfloxacin. PMID- 1778862 TI - In-vitro susceptibility of Rhodococcus equi to 27 antibiotics. PMID- 1778863 TI - Intraperitoneal penetration of meropenem. PMID- 1778864 TI - Pharmacokinetic evidence of imipenem efficacy in the treatment of Klebsiella pneumoniae nosocomial meningitis. PMID- 1778865 TI - Development of spontaneous resistance to ciprofloxacin in a strain of Campylobacter jejuni. PMID- 1778866 TI - Development of quinolone resistance and multiple antibiotic resistance in Salmonella bovismorbificans in a pancreatic abscess. PMID- 1778868 TI - ARTs versus ASTs: where are we going? PMID- 1778867 TI - A randomized trial of ciprofloxacin plus azlocillin versus netilmicin plus azlocillin for the empirical treatment of fever in neutropenic patients. PMID- 1778869 TI - Role of the quinolones in the treatment of legionellosis. PMID- 1778870 TI - Selection and characterization of cefepime-resistant gram-negative bacteria. AB - The NCTC type strains and four clinical isolates of Enterobacter cloacae, Citrobacter freundii, Serratia marcescens, Morganella morganii, Providencia stuartii and Pseudomonas aeruginosa were exposed, in agar, to cefepime at 3, 5, and 10 x MIC and a breakpoint concentration of 16 mg/L. Mutants were selected at a frequency of approximately 10(-8) that had decreased susceptibility to cefepime and cefpirome, and species-dependent resistance to other beta-lactams. Any putative mutant with a greater than four-fold increase in the MIC was examined to determine its beta-lactamase expression and outer membrane protein (Omp) profile. Mutant strains of P. stuartii and M. morganii lacked an Omp of molecular mass similar to that of OmpF, and were cross-resistant to nalidixic acid. Mutant strains of E. cloacae had derepressed class I beta-lactamase production and lacked an Omp corresponding to OmpF, suggesting that in this species both parameters are necessary for decreased susceptibility. Derepressed beta lactamases purified from mutant strains of E. cloacae, C. freundii and P. stuartii was able to hydrolyse cefepime, but not as quickly as TEM-10. PMID- 1778871 TI - Dextran sulphate reduces diphenylhexatriene anisotropy in human peripheral blood lymphocytes: impact on plasma membrane fluidity and HIV-cytopathogenicity. AB - Cytopathogenicity of HIV and other enveloped viruses is reduced by membrane fluidizing agents and by dextran sulphate (DS). To investigate whether DS exerts its antiviral action via plasma membrane fluidization of host cells, we performed anisotropy measurements on human peripheral blood lymphocytes (PBL) using the fluorescent marker diphenylhexatriene. Anisotropy was decreased in DS-exposed PBL indicating increased fluidity in the hydrophobic membrane interior. PMID- 1778872 TI - Screening tests for the detection of methicillin resistance in Staphylococcus epidermidis. AB - Methods to detect resistance to methicillin in Staphylococcus epidermidis were studied in order to find a rapid screening test suitable for routine use. One hundred and forty-nine clinical isolates, 16 isolates from skin of healthy people and two reference strains were studied. Hypersecretion of beta-lactamase as a cause of methicillin resistance was eliminated in the strains studied. Tube and microtitre breakpoint, agar breakpoint and disc diffusion methods were compared. The breakpoint for methicillin resistance used was 16 mg/L in broth and 10 mg/L in agar. The discs used contained 1 and 5 micrograms oxacillin and 5 and 10 micrograms methicillin. Turbidimetric measurements in broth during incubation were carried out using the Bioscreen analysing system. The skin strains were founf to be susceptible in all tests. Using an inoculum of 10(7) cfu/mL 111/149 clinical isolates were classified as resistant after incubation for 24 h at 35 degrees C using the tube and microtitre breakpoint tests, incubation for 72 h did not increase this rate. When an inoculum of 10(5) cfu/mL was used 73% of these strains were identified within 24 h and all within 72 h with the tube breakpoint test. Using the microtitre breakpoint test, with an inoculum of 10(5) cfu/mL or lower, all resistant strains were not detected within 48 h. All agar breakpoint tests required 48 h incubation for reliable results. Only the 1 microgram oxacillin disc always separated strains found to be resistant or susceptible in the tube breakpoint test. The zone of inhibition was clearly readable after 16 h of incubation at 35 degrees C. PMID- 1778874 TI - The effect of combinations of cefotiam and other antibiotics on methicillin resistant Staphylococcus aureus in vitro. AB - The in-vitro activities of cefmetazole, flomoxef, imipenem, vancomycin and enramycin alone and in combination with cefotiam against eighteen clinically isolated methicillin-resistant Staphylococcus aureus was investigated. Cefotiam, cefmetazole, flomoxef and imipenem inhibited the growth of clinical isolates at concentrations ranging from 100 to 1600, 6.25 to 400, 6.25 to 400 and 0.78 to 200 mg/L, respectively. Synergic effects were observed with combinations of cefotiam and cefmetazole, flomoxef or imipenem against more than 70% of the strains. The fractional inhibitory concentration (FIC) index values were less than 0.1. Vancomycin and enramycin alone inhibited the growth of all strains at concentrations ranging from 0.39 to 1.56 mg/L and 0.2 to 0.78 mg/L, respectively. Moreover, vancomycin and enramycin in combination with cefotiam showed synergy against strains in which no synergic effects were observed when cefotiam was combined with other beta-lactam agents. About 50% of the strains tested were inhibited synergically by cefmetazole, flomoxef or imipenem, at clinically relevant concentrations in combination with 0.78 mg/L of cefotiam. The effects of vancomycin or enramycin in combination with cefotiam on the growth of a homogeneous resistant clone, which was derived from one of the clinical isolates, TS-65, was also studied. Regrowth in the presence of vancomycin or enramycin alone was suppressed when cefotiam was added. PMID- 1778873 TI - Bactericidal activity of ceftizoxime, cefotetan, and clindamycin against cefoxitin-resistant strains of the Bacteroides fragilis group. AB - The bactericidal activity of ceftizoxime, cefotetan, and clindamycin at 0.5 x MIC, 1 x MIC, and 4 x MIC was determined by killing kinetic studies for 12 cefoxitin-resistant strains of the Bacteroides fragilis group. Ceftizoxime and clindamycin had greater bactericidal activity than cefotetan. The degree of bactericidal activity of each compound increased as the concentration increased from subinhibitory (0.5 x MIC) to suprainhibitory concentrations (4 x MIC). Comparison of the bactericidal activity at the MIC of the test agents with the MIC showed greater killing of susceptible strains than the resistant strains. Interestingly, ceftizoxime was more active than clindamycin, or cefotetan, against strains with high cefoxitin MIC values. PMID- 1778875 TI - Effect of antimicrobial agents on the uptake of ofloxacin and its optically active isomer (-)-ofloxacin by human polymorphonuclear leucocytes. AB - The effect of several antimicrobial agents, active against Gram-positive cocci, anaerobes or fungi on the intracellular penetration of ofloxacin and its optically active isomer (-)-ofloxacin into human polymorphonuclear leucocytes (PMNs) was studied. In the presence of therapeutic extracellular concentrations of these drugs, both ofloxacin and (-)-ofloxacin reached high intracellular concentrations (cellular to extracellular ratio (C/E greater than 3). Ofloxacin and (-)-ofloxacin uptake by PMNs was higher when cells were stimulated with opsonized zymosan (C/E greater than 5). It is concluded that none of the antimicrobial agents studied significantly affected the uptake of both quinolones by human PMNs. PMID- 1778876 TI - Correlation of in-vitro parameters of antimicrobial activity with prophylactic efficacy in an intradermal model of Staphylococcus aureus infection. AB - Cephalosporins differ in their ability to prevent staphylococcal wound infection. Although the reasons for the observed differences are not fully understood, the susceptibility of cephalosporins to hydrolysis by staphylococcal beta-lactamase has been correlated with failures of prophylaxis. To investigate the effect of beta-lactamase stability and other in-vitro parameters of the bacterial antimicrobial interaction on the efficacy of antimicrobial prophylaxis, two beta lactamase-stable agents, cefuroxime and cefmetazole were compared to cefazolin and cefamandole in an in-vivo model of intradermal infection employing four strains of Staphylococcus aureus. Following intraperitoneal administration of a single dose of cephalosporin or placebo, guinea pigs were inoculated at multiple intradermal sites with 2 x 10(7) cfu of a strain of staphylococcus. For three strains, the area of induration at 24 h following inoculation was significantly smaller in guinea pigs receiving prophylaxis with cephalosporins versus placebo; no cephalosporin was effective against the fourth strain. Differences were also noted among the cephalosporins; prophylaxis with cefuroxime and cefmetazole resulted in smaller lesions than seen in animals given cefazolin or cefamandole. Poor correlation was noted between results of the in-vivo model and in-vitro determinants of the bacterial-antimicrobial interaction which were MIC values, time-kill curves, and the rates of beta-lactamase-mediated cephalosporin hydrolysis by the different strains. The model demonstrated unexplained failures of prophylaxis and unexpected differences in efficacy of various cephalosporins as has been described before. This study highlights the need for an improved animal model of surgical antimicrobial prophylaxis and the identification of in vitro determinants that predict in-vivo prophylactic efficacy more accurately. PMID- 1778877 TI - Increased dosing requirements for amikacin in burned children. AB - Pharmacokinetic analysis was performed on 38 thermally injured children ranging from 3 months to 18 years of age with per cent total body surface area burns (%TBSA) of 17-87%. All patients needed increased dosing requirements for amikacin to maintain therapeutic serum levels. There was a wide variation in the volumes of distribution and an inverse relationship with age, i.e., the volume of distribution tended to be lower in the older children. The results indicate the manufacturer's recommended dose will result in subtherapeutic serum levels and we recommended initial doses of at least 10 mg/kg administered every 6 h. Dosage adjustments using individualized pharmacokinetics should then be performed within 24 h of initiation of therapy. The study documents the importance of dosage individualization for amikacin in the burned child. PMID- 1778878 TI - A prospective randomized study comparing once- versus twice-daily amikacin dosing in critically ill adult and paediatric patients. AB - Three hundred and forty eight critically-ill patients with a documented Gram negative infection were randomized to receive amikacin once- (od) or twice-daily (bd). The amikacin was given by slow intravenous injection in a daily dose of 20 mg/kg in patients under the age of one year (paediatric group) and 15 mg/kg in patients over the age of one year (adult group). Paediatric and adult patients on the od regimen received a loading dose of 25 and 20 mg/kg respectively. The dosages were subsequently adjusted to achieve desirable blood levels. Patients received other antibiotics as clinically indicated. Forty-eight patients were withdrawn from the study due to death or azotaemia occurring in the first 72 h. One hundred and fifty five patients (76 paediatric) received an od dose and 145 (65 paediatric) received a bd dose. The clinical cure rate was 83% in the od group compared to 66% in the bd group (P = 0.001). The bacteriological cure rate was 81% in the od group compared to 58% in the bd group (P = 0.005). In the paediatric sub-group the cure rate was higher with the od regimen (P = 0.002) but this difference was not statistically significant in the adult patients (P = 0.1). The serum creatinine rose in 35% of patients in the bd group compared to 21% in the od group (P = 0.05). Although audiometry was not performed there was no clinical evidence of ototoxicity in any of the patients. In conclusion od amikacin dosing resulted in a higher cure and less nephrotoxicity than conventional bd dosing. PMID- 1778879 TI - Three-day treatment of typhoid fever with two different doses of ceftriaxone, compared to 14-day therapy with chloramphenicol: a randomized trial. AB - Fifty-nine adult Filipino patients suffering from typhoid fever documented by blood culture were randomly allocated to one of three different drug regimens. Nineteen patients received 3 g ceftriaxone iv once daily for three days. Twenty patients received 4 g ceftriaxone iv once daily for three days and 20 patients received oral chloramphenicol 3 g daily in divided doses for two days followed by 2 g daily for 12 days. Eighteen patients were cured (95%) with 3 g of ceftriaxone for three days. All patients receiving 4 g ceftriaxone per day for three days or chloramphenicol for 14 days were cured. In the ceftriaxone groups two patients developed typhoid fever 30 and 45 days respectively after completion of treatment and one further patient had evidence of reinfection. Three patients relapsed within 15 to 17 days in the chloramphenicol group. Fever subsided in most patients between six and eight days, with three patients having a prolonged and moderate fever for 11 days in the ceftriaxone groups. This study suggests that a short treatment of three days of typhoid fever with ceftriaxone (3 or 4 g once daily) is adequate and not hazardous as far as relapses are concerned. PMID- 1778880 TI - MIC determination by the E test. PMID- 1778881 TI - Recognition of a new Branhamella catarrhalis beta-lactamase--BRO-3. PMID- 1778882 TI - The automated in-vitro assessment of beta-lactamase inhibitors. PMID- 1778883 TI - Enterobacter cloacae with clavulanic acid dependent variants. PMID- 1778885 TI - Liposomal amphotericin B (AmBisome) in the treatment of systemic fungal infection. A symposium. Stratford-on-Avon, UK, March 1991. PMID- 1778884 TI - Zidovudine resistance in clinically significant bacterial isolates from AIDS patients. PMID- 1778886 TI - Epidemiology and pathogenesis of systemic fungal infections in the immunocompromised host. AB - The epidemiology and pathogenesis of invasive candidosis and aspergillosis, cryptococcal meningitis, mucormycosis and disseminated histoplasmosis are reviewed. Particular areas of growth of knowledge that are emphasized are the epidemiology of candidosis and aspergillosis, putative virulence factors in aspergillosis and the pathogenesis of cryptococcosis. PMID- 1778887 TI - Experience with liposomal amphotericin B (AmBisome) in cryptococcal meningitis in AIDS. AB - Three patients with AIDS who had cryptococcal meningitis were treated with liposomal amphotericin B after unsuccessful treatment with fluconazole and conventional amphotericin B. One patient responded but relapsed nine weeks later; he responded to a second course of treatment but again relapsed and subsequently died. Another patient deteriorated despite an improvement in cryptococcal antigen titres. The third patient was found to have culture negative CSF and treatment was therefore stopped. None of the patients suffered any adverse effects and renal function improved in all after conventional amphotericin was stopped and liposomal amphotericin B commenced. PMID- 1778888 TI - Liposomal amphotericin B in the treatment of visceral leishmaniasis. AB - A case of visceral leishmaniasis unresponsive to several course of treatment with standard drugs, was successfully cured by a 21 day course (50 mg/day) of liposomal amphotericin B (AmBisome, Vestar Inc.). The efficacy of the AmBisome formulation is supported by experimental studies on Leishmania donovani infected BALB/c mice where ED50 values of AmBisome and conventional amphotericin B were 0.15-0.25 and 0.95-4.9 mg/kg, respectively. A lack of toxicity of the AmBisome formulation was noted in both studies. PMID- 1778889 TI - Overview of the treatment of disseminated fungal infections. AB - Disseminated fungal infections are significant causes of mortality and morbidity in the immunocompromised patient. There is now an increasing array of drugs available for their treatment. While amphotericin B is still the main choice for many of these infections the imidazole and triazole drugs have specific roles to play in the management of these patients. However, there remain a number of important problems, particularly the treatment of the patients with continuing immunosuppression and the emergence of antifungal drug resistance. There are also too few comparative studies of drugs within the increasing number of antifungal agents which would provide a reliable basis for choice. PMID- 1778890 TI - Amphotericin B: an introduction. AB - Amphotericin B has a broad spectrum of action that includes most of the major fungal pathogens of man. This drug binds to the membrane sterols of fungal cells, causing impairment of their barrier function and loss of cell constituents. Metabolic disruption and cell death are consequent upon membrane alterations. Investigations of the sterol content of mutant strains of Candida albicans and Cryptococcus neoformans has demonstrated that resistance is often associated with alterations in membrane sterol composition. Treatment failure due to the development of amphotericin B resistance is an uncommon problem. It has tended to occur in patients receiving treatment with cytotoxic drugs. Interactions between amphotericin B and a number of other antimicrobial drugs have been observed in tests in vitro and in vivo. However, apart from one report that the combination with flucytosine is superior to amphotericin B on its own in the treatment of cryptococcal meningitis, there have been no controlled trials to support the use of drug combinations in human infections. PMID- 1778891 TI - Overview of liposomes. AB - Many of the problems associated with conventional drug therapy may be circumvented by the use of delivery systems which, in a variety of ways, will optimize drug action. Among the systems being investigated, liposomes hold considerable promise. Versatility in both the structural characteristics of liposomes and their ability to accommodate a wide range of drugs has contributed to the design of appropriate formulations with optimal pharmacological actions. Areas in which such formulations have been already applied successfully experimentally or clinically, include cancer chemotherapy, antimicrobial therapy and vaccines. PMID- 1778892 TI - Pharmacology and toxicology of a liposomal formulation of amphotericin B (AmBisome) in rodents. AB - AmBisome is a lyophilized preparation of liposomal amphotericin B. The acute intravenous toxicity of AmBisome was evaluated in mice and rats, and the LD50S were found to be greater than 175 and 50 mg/kg, respectively. The corresponding LD50S for conventional amphotericin B were approximately 2.3 and 1.6 mg/kg for mice and rats, respectively. The multiple dose toxicity test confirmed that AmBisome was well tolerated by both species. There were no deaths observed among mice receiving 25 or 50 mg/kg AmBisome for 14 days, and only two deaths among mice receiving 75 mg/kg AmBisome. One rat died in the group receiving 25 mg/kg AmBisome for 30 days. However, five of ten and nine of ten rats died in the groups treated with 50 and 75 mg/kg AmBisome, respectively. Hepatotoxicity was evident by elevation in serum liver enzyme levels for these groups. Initial pharmacokinetic evaluations demonstrated that peak plasma concentrations of 87 and 118 mg/kg, respectively, were attained in mice and rats after injection with 5 mg/kg AmBisome. Terminal plasma half-lives of 3.36 and 7.56 h were calculated for mice and rats, respectively. Tissue accumulations of amphotericin B resulting from multiple dose intravenous administration of either conventional amphotericin B or AmBisome were determined. At equivalent doses of 1 mg/kg, AmBisome treatment resulted in higher liver and spleen uptake of drug, but lower kidney and lung uptake than amphotericin B. At 5 mg/kg, AmBisome treatment resulted in concentrations of drug in the kidney and lungs that were comparable to corresponding tissue levels observed in the group treated with 1 mg/kg conventional amphotericin B.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778893 TI - Treatment of murine candidosis and cryptococcosis with a unilamellar liposomal amphotericin B formulation (AmBisome). AB - This investigation examined the therapeutic efficacy of AmBisome, a unilamellar (55-75 nm) liposome amphotericin B preparation with a murine LD50 by the intravenous route of greater than 175 mg/kg amphotericin B. Both fungal burden and survival were used to evaluate the drug's efficacy against murine candidosis and cryptococcosis. Single and multiple dose intravenous treatment with AmBisome (2.5, 5.0 and 10.0 mg/kg) reduced the colony forming units/mg kidney in candida infected mice by 99% and improved survival by at least 40% relative to untreated control mice. Repeated intravenous dosing of candida-infected mice with equivalent amounts (0.75 mg/kg) of conventional amphotericin B (Fungizone) or AmBisome showed comparable reduction of yeasts in the kidneys. When mice were infected systemically with Cryptococcus neoformans, all but one of the 30 mice given AmBisome (5.0, 7.5 or 10.0 mg/kg) survived until the experiment was terminated 35 days after infection. Liver and spleen cultures from AmBisome treated mice were negative for fungal growth. All the mice given conventional amphotericin B intraperitoneally at 4.5 mg/kg survived and cleared the infection from the livers although some of the mice had infected spleens. The percentage of cultured brains free of cryptococcus was 89% following treatment with 10.0 mg/kg AmBisome, and 80% with 4.5 mg/kg conventional drug. These preclinical studies of systemic candidosis and cryptococcosis demonstrate comparable efficacy of AmBisome and conventional amphotericin B at low doses and improved efficacy with AmBisome at doses higher than can be safely administered of the conventional drug. PMID- 1778894 TI - Efficacy of amphotericin B encapsulated in liposomes (AmBisome) in the treatment of invasive fungal infections in immunocompromised patients. AB - One hundred and twenty-six patients were treated for 137 episodes of fungal infection with liposomal amphotericin B (AmBisome) at 43 investigational centres. Among the patients were 72 with malignancies, 17 organ transplant recipients, 20 patients with immunological disorders and 17 others. AmBisome treatment was instituted after toxicity from previous amphotericin B treatment in 49 cases, nephrotoxicity or renal insufficiency in 40 and failure of previous antifungal treatment in 41. One hundred and eight episodes were clinically evaluable; among these 52 were caused by Candida spp. and 34 by Aspergillus spp. Ninety-nine patients were treated for at least eight days with a maximum dose of 0.7-5 mg/kg/day. Among 64 cases with proven invasive fungal infection 58% were cured. Fungi were eradicated in 35 of 54 (65%) mycologically evaluable cases. The cumulative dose was 3.2 +/- 3.2 (mean +/- S.D.) in cases where fungi were eradicated in comparison with 3.3 +/- 2.3 g in cases where fungi persisted. The eradication rate was 83% for Candida spp. compared with 41% for Aspergillus spp. (P less than 0.01). Among 24 cases with presumptive invasive fungal infections 14 (58%) were cured. Candida spp. were eradicated in seven of ten of these cases. Among 11 cases with superficial fungal infections eight were cured and three improved. Candida spp. were eradicated in four of five patients. It is concluded that AmBisome is an effective antifungal agent in a majority of patients with invasive or superficial fungal infections. PMID- 1778895 TI - Liposomal amphotericin B (AmBisome): safety data from a phase II/III clinical trial. AB - AmBisome is a commercially available preparation of amphotericin B incorporated in small unilamellar liposomes. The analysis of safety data provided in a multicentre compassionate phase II/III study evaluating 133 episodes of therapy with AmBisome in patients with severe underlying disease is very encouraging. Rapid (30-60 min) administration of a high daily dose of AmBisome is feasible without the well known side effects observed with the conventional formulation of amphotericin B (Fungizone). Although eleven of 71 patients with initially normal serum creatinine concentrations showed increased values after AmBisome therapy, 17 patients among 50 with initially high creatinine concentrations recovered normal renal function during AmBisome treatment. Hypokalaemia was observed in 24 episodes of treatment (18%). Increases in serum glutamyl oxaloacetic transaminase and alkaline phosphatase were also quite common in this selected population with severe underlying disease and the contribution of AmBisome to these changes is difficult to establish. AmBisome appears a safe alternative to conventional amphotericin B, and its efficacy should be further investigated. PMID- 1778896 TI - Liposomal amphotericin B (AmBisome) in the treatment of fungal infections in neutropenic patients. AB - The use of high-dose chemotherapy and the subsequent prolonged neutropenia in patients with haematological diseases has resulted in an increased incidence of fungal infections. The diagnosis and treatment of these infections in neutropenic patients pose major therapeutic problems. The only drug with proven efficacy in the treatment of deep-seated fungal infections, including invasive aspergillosis, is amphotericin B. Unfortunately, this drug has adverse side effects, most importantly dose-dependent nephrotoxicity; furthermore, some patients fail to show a response to amphotericin B. We have treated 20 patients undergoing myeloablative chemotherapy and/or bone marrow transplantation for haematological diseases with liposomal amphotericin (AmBisome) for proven or suspected aspergillosis. Eighteen patients had diffuse interstitial pneumonitis and two patients had suspected fungal liver abscesses. Five patients had mycologically proven fungal infection and of these, three patients (60%) showed a complete response to liposomal amphotericin. Eleven patients received liposomal amphotericin because of the failure of conventional amphotericin B to eradicate proven or suspected fungal infection. Five of these 11 patients (45%) showed a complete clinical response to liposomal amphotericin. Eight patients received liposomal amphotericin because of pre-existing renal impairment or nephrotoxicity caused by conventional amphotericin B. Four of these patients (50%) showed a response to liposomal amphotericin. Recovery from probable fungal infection in this group of patients occurred when there was complete remission of underlying disease and recovery of neutrophil counts, when they were concurrently treated with liposomal amphotericin. PMID- 1778897 TI - Effect of feeding and fasting on excess postexercise oxygen consumption. AB - This study was undertaken to determine the effect of fasting on the magnitude and time course of the excess postexercise O2 consumption (EPOC). Six lean untrained subjects were studied in the fasted state for 7 h after a previous strenuous exercise bout (80 min at 75% of maximal O2 uptake) and in a control experiment. The results were compared with identical control and exercise experiments where the subjects were fed a 4.5-MJ test meal after 2 h of rest. EPOC was calculated as the difference in O2 uptake between the corresponding control and exercise experiments. The total EPOC (0-7 h postexercise) was 20.9 +/- 4.5 (fasting) and 21.1 +/- 3.6 liters (food, NS). A significant prolonged EPOC component was observed in the fasted and in the fed state. The thermic effect of food (TEF) was calculated from O2 consumption and respiratory exchange ratio as the difference in energy expenditure between the corresponding food and fasting experiments. The total TEF (0-5 h postprandial) was 321 +/- 32.0 (control) and 280 +/- 37.7 kJ/5 h (exercise, NS). It is concluded that the prolonged component of EPOC is present in the fasting state. Furthermore, no major interaction effects between food intake and exercise on the postexercise O2 consumption could be detected. PMID- 1778898 TI - Linear and nonlinear characteristics of oxygen uptake kinetics during heavy exercise. AB - We assessed the linearity of oxygen uptake (VO2) kinetics for several work intensities in four trained cyclists. VO2 was measured breath by breath during transitions from 33 W (baseline) to work rates requiring 38, 54, 85, and 100% of maximal aerobic capacity (VO2max). Each subject repeated each work rate four times over 8 test days. In every case, three phases (phases 1, 2, and 3) of the VO2 response could be identified. VO2 during phase 2 was fit by one of two models: model 1, a double exponential where both terms begin together close to the start of phase 2, and model 2, a double exponential where each of the exponential terms begins independently with separate time delays. VO2 rose linearly for the two lower work rates (slope 11 ml.min-1 W-1) but increased to a greater asymptote for the two heavier work rates. In all four subjects, for the two lighter work rates the double-exponential regression reduced to a single value for the time constant (average across subjects 16.1 +/- 7.7 s), indicating a truly monoexponential response. In addition, one of the responses to the heaviest work rate was monoexponential. For the remaining seven biexponential responses to the two heaviest work rates, model 2 produced a significantly better fit to the responses (P less than 0.05), with a mean time delay for the slow component of 105 +/- 46 s.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778899 TI - Temperature regulation during acute heat loads in rats after short-term heat exposure. AB - Eleven rats were kept at an ambient temperature of 33.5 degrees C (HC) for 4-5 consecutive days, 9 additional rats were subjected to 33.5 degrees C for approximately 5 h daily (HI) for the same period, and 12 controls (Cn) were kept at 24 degrees C. After the exposure, the rats were placed in a direct calorimeter, where the wall temperature was set at 24 degrees C, and subjected to direct internal heating (6.2 W.kg-1, 30 min) through an intraperitoneal electric heater. After the first heat load and when thermal equilibrium had been attained again, the rats were subjected to indirect external warming by raising the jacket water temperature surrounding the calorimeter from 24.0 to 38.8 degrees C in 90 min. Hypothalamic (Thy) and colonic temperatures (Tco), evaporative and nonevaporative heat loss, and metabolic heat production (M) before the acute heat loads did not differ among the groups. During heat loads, the latent times for the onsets of the rises in tail skin temperature and evaporation were significantly longer, and Thy and Tco at the start of increases in heat losses tended to be higher, in the HC than in the Cn. M significantly decreased in all groups, but the magnitude and duration of reduction in M were significantly greater in the HC than in the Cn. There were no differences between the thermoregulatory responses to heat loads of the HI and Cn. These results suggest that in HC the threshold core temperature for heat loss response and the upper critical temperature have already shifted to a higher level and that HC respond to heat stress more strongly with the reduction of M than Cn. Short-term intermittent heat exposure had little effect on the thermoregulatory mechanisms in rats. PMID- 1778900 TI - Skeletal muscle changes after endurance training at high altitude. AB - The effects of endurance training on the skeletal muscle of rats have been studied at sea level and simulated high altitude (4,000 m). Male Wistar rats were randomly assigned to one of four groups: exercise at sea level, exercise at simulated high altitude, sedentary at sea level, and sedentary at high altitude (n = 8 in each group). Training consisted of swimming for 1 h/day in water at 36 degrees C for 14 wk. Training and exposure to a high-altitude environment produced a decrease in body weight (P less than 0.001). There was a significant linear correlation between muscle mass and body weight in the animals of all groups (r = 0.89, P less than 0.001). High-altitude training enhanced the percentage of type IIa fibers in the extensor digitorum longus muscle (EDL, P less than 0.05) and deep portions of the plantaris muscle (dPLA, P less than 0.01). High-altitude training also increased the percentage of type IIab fibers in fast-twitch muscles. These muscles showed marked metabolic adaptations: training increased the activity levels of enzymes involved in the citric acid cycle (citrate synthase, CS) and the beta-oxidation of fatty acids (3 hydroxyacyl CoA dehydrogenase, HAD). This increase occurred mainly at high altitude (36 and 31% for HAD in EDL and PLA muscles; 24 and 31% for CS in EDL and PLA muscles). Training increased the activity of enzymes involved in glucose phosphorylation (hexokinase). High-altitude training decreased lactate dehydrogenase activity. Endurance training performed at high altitude and sea level increased the isozyme 1-to-total lactate dehydrogenase activity ratio to the same extent.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778901 TI - Voluntary activation of human quadriceps during and after isokinetic exercise. AB - The extent of voluntary activation in fresh and fatigued quadriceps muscles was investigated during isometric and isokinetic voluntary contractions at 20 and 150 degrees/s in 23 normal human subjects. The muscles were fatigued by a total of 4 min of maximal knee extension at an angular velocity of 85 degrees/s. Voluntary activation was determined by the superimposition of tetanic electrical stimulation at 100 Hz for 250 ms, initiated at a constant knee angle. The relationship between voluntary and stimulated force was similar to that found with the established twitch superimposition technique used on isometric contractions. In fresh muscle all the subjects showed full voluntary activation during isometric contractions. Some activation failure was seen in five subjects at 20 degrees/s [2.0 +/- 0.9 degrees (SE)] and in two subjects at 150 degrees/s (0.7 +/- 0.5). After fatigue all subjects showed some activation failure at 0 and 20 degrees/s (36.4 +/- 3.1 and 28.8 +/- 4.1 degrees, respectively), but only two showed any at 150 degrees/s (1.4 +/- 5.7). We conclude that brief high-intensity dynamic exercise can cause a considerable failure of voluntary activation. This failure was most marked during isometric and the lower-velocity isokinetic contractions. Thus a failure of voluntary activation may have greater functional significance than previous studies of isometric contractions have indicated. PMID- 1778902 TI - Hopping frequency in humans: a test of how springs set stride frequency in bouncing gaits. AB - The storage and recovery of elastic energy in muscle-tendon springs is important in running, hopping, trotting, and galloping. We hypothesized that animals select the stride frequency at which they behave most like simple spring-mass systems. If higher or lower frequencies are used, they will not behave like simple spring mass systems, and the storage and recovery of elastic energy will be reduced. We tested the hypothesis by having humans hop forward on a treadmill over a range of speeds and hop in place over a range of frequencies. The body was modeled as a simple spring-mass system, and the properties of the spring were measured by use of a force platform. Our subjects used nearly the same frequency (the "preferred frequency," 2.2 hops/s) when they hopped forward on a treadmill and when they hopped in place. At this frequency, the body behaved like a simple spring-mass system. Contrary to our predictions, it also behaved like a simple spring-mass system when the subjects hopped at higher frequencies, up to the maximum they could achieve. However, at the higher frequencies, the time available to apply force to the ground (the ground contact time) was shorter, perhaps resulting in a higher cost of generating muscular force. At frequencies below the preferred frequency, as predicted by the hypothesis, the body did not behave in a springlike manner, and it appeared likely that the storage and recovery of elastic energy was reduced. The combination of springlike behavior and a long ground contact time at the preferred frequency should minimize the cost of generating muscular force. PMID- 1778903 TI - Rostral pontile mechanisms regulate durations of expiratory phases. AB - Neural expiration can be divided into two phases. Phase I corresponds to the period of laryngeal adduction, whereas many spinal nerves reach peak discharge in phase II. The present studies evaluated the hypothesis that rostral pontile mechanisms contribute to determining the time of onset of spinal motoneuronal activities in phase II. In decerebrate and paralyzed cats, efferent activities were recorded from the phrenic nerve and from single fibers of the branch of the intercostal nerve innervating the triangularis sterni muscle. These activities were recorded in eupnea and apneusis; the latter was produced by cooling the rostral pons by a fork thermode. In eupnea, there was a delay between the rapid decline of phrenic discharge from peak levels and the commencement of activities of motoneurons of the triangularis sterni. This delay was significantly reduced in apneusis. Peak discharge frequencies of triangularis sterni motoneurons were the same in eupnea and apneusis. We conclude that rostral pontile mechanisms contribute significantly to defining the phases of neural expiration. PMID- 1778904 TI - Physiological consequences of intermittent exercise during compensable and uncompensable heat stress. AB - Time-weighted averaging is a traditional method used in heat stress analyses to approximate, in terms of a single continuous level of heat production, the rate of heat production from complex intermittent exercise patterns. Physiological responses during intermittent and continuous exercise were studied in four subjects exposed to heat stress in which evaporation was either free or severely restricted. Intermittent work consisted of repeated 10-min exercise-rest patterns. Continuous work was at the time-weighted average of intermittent exercise: 3.3 mets. When heat stress was uncompensable, intermittent work induced more physiological strain than continuous work: endurance time was 14 min less (P less than 0.05); core temperature at 60 min was 0.40 degrees C higher (P less than 0.05); and, after 30 min of exposure, the rate of core temperature rise was 33% greater. The difference in the rate of heat storage was not satisfactorily explained by a discrepancy in the average rate of heat production or in the calculated rate of surface heat loss. Alternatively, the results may be partially explained by interruptions in the usual rate of heat transport via the cutaneous circulation. These interruptions may be caused by nonthermal factors associated with postural and work load transitions. Although the mechanisms are not totally understood, it is clear that application of the time-weighted averaging method can lead to erroneous overprediction of endurance time and should be applied with discretion. PMID- 1778905 TI - Epithelium modulates the potency of vasoactive intestinal peptide in the guinea pig. AB - The purpose of the study was to evaluate the importance of the epithelium in determining the potency of exogenous vasoactive intestinal peptide (VIP) in inhibiting responses of isolated guinea pig trachea to vagal stimulation. Isolated innervated tracheal preparations (n = 56) were mounted in glass organ baths in Krebs-Henseleit (K-H) solution at 37 degrees C and gassed with 95% O2-5% CO2. The inside of the trachea was separately perfused with K-H solution at 1 ml/min. The vagal nerve trunks were stimulated (20 V, 1-ms pulses, 10-s trains) at low (0.5 Hz) and high frequency (15 Hz) alternately, and the contractile responses were measured as increases in intratracheal pressures. VIP (10(-8)-10( 7) M) inhibited responses to both high- and low-frequency stimulation. VIP was more potent in inhibiting contractions when administered to the outside than the inside surface of the trachea, and disruptionon of the epithelium abolished this difference. The endopeptidase inhibitors phosphoramidon and thiorphan (5 x 10(-6) M) potentiated the action of VIP. These data indicate that the epithelium reduces the efficacy of VIP. We suggest that the epithelium is a site of degradation of VIP by endopeptidase and may also be a diffusion barrier. PMID- 1778906 TI - Segmental barrier properties of the pulmonary microvascular bed. AB - We determined liquid flux across single pulmonary microvessels of dog, ferret, and rat by our split-drop technique (J. Appl. Physiol. 64: 2562-2567, 1988). Data are reported from 58 lungs excised under halothane or pentobarbital sodium anesthesia and then blood perfused. We stopped blood flow at known vascular pressures and then micropunctured microvessels to inject oil, which we split with albumin solution. From measurements of vessel diameter and split oil drop length, we calculated Jv, the liquid transport rate per unit surface area [x 10(-6) ml/(cm2.s)]. At constant vascular pressure, Jv was not significantly different after different periods of oil-endothelium contact and at different sites within a single vessel. From measurements of Jv at different vascular pressures, we determined Lp, the hydraulic conductivity [x 10(-7) ml/(cm2.s.cmH2O)], and Pzf, the zero filtration pressure. From determinations of Pzf at different albumin concentrations, we quantified sigma alb, the albumin reflection coefficient. Lp and Pzf did not differ among venules of the same lung. However, in venules, Lp was 40% higher and sigma alb 25% lower than in arterioles (P less than 0.01). We conclude that 1) micropuncture procedures incidental to our split-drop technique do not progressively deteriorate the experimental microvessel and 2) in lung, permeability is higher in venules than in arterioles. PMID- 1778907 TI - Longitudinal distribution of pulmonary vascular pressures as a function of postnatal age in rabbits. AB - The major purpose of this study was to determine whether the longitudinal distribution of pulmonary vascular pressures changes with postnatal age in rabbits. Using the direct micropuncture technique, we measured pressures in 20- to 80-microns-diam arterioles and venules in isolated lungs of rabbits of different postnatal ages. To determine the contribution of vasomotor tone, we added the vasodilator papaverine to the perfusate of some lungs of each age group. We compared vascular pressures measured at blood flow rates chosen to approximate in vivo cardiac outputs. In untreated lungs, the resistance across 20 to 80-microns-diam microvessels decreased from 12- to 72-h-old (0.022 +/- 0.009 cmH2O.min.kg.ml-1) to 5- to 15-day-old rabbits (0.008 +/- 0.007 cmH2O.min.kg.ml 1) and remained at this lower level in adults (0.013 +/- 0.008 cmH2O.min.kg.ml 1). In contrast, in papaverine-treated lungs, the resistance across 20- to 80 microns-diam microvessels did not change between 12- to 72-h-old (0.007 +/- 0.005 cmH2O.min.kg.ml-1) and 5- to 15-day-old rabbits (0.005 +/- 0.002 cmH2O.min.kg.ml 1) but increased between 5- to 15-day-old and adult rabbits (0.014 +/- 0.007 cmH2O.min.kg.ml-1). Thus vasomotor tone contributed to the postnatal change in the distribution of vascular pressures across lungs of rabbits. PMID- 1778908 TI - Intra- and extracellular pH of the brain in vivo studied by 31P-NMR during hyper- and hypocapnia. AB - Studies were performed to determine the pH relationships among the extracellular, intracellular, and arterial blood compartments in the brain in vivo. Resolution of the extracellular monophosphate resonance peak from the intracellular peak in 31P nuclear magnetic resonance (NMR) spectra of sheep brain with the calvarium intact enabled pH measurement in these respective compartments. Sheep were then subjected to both hyper- and hypoventilation, which resulted in a wide range of arterial PCO2 and pH values. Linear regression analysis of pH in these compartments yielded slopes of 0.56 +/- 0.05 for extracellular pH (pHe) vs. arterial pH, 0.43 +/- 0.078 for intracellular pH (pHi) vs. pHe, and 0.23 +/- 0.056 for pHi vs. arterial pH. These data indicate that CO2 buffering capacity is different and decreases from the intracellular to extracellular to arterial blood compartments. Separation of the extracellular space from the vascular space may be a function of the blood-brain barrier, which contributes to the buffering capability of the extracellular compartment. A marked decrease in the pH gradient between the extracellular and intracellular space occurs during hypercarbia and may influence mechanisms of central respiratory control. PMID- 1778909 TI - Original waveform of lung sound crackles: a case study of the effect of high-pass filtration. AB - In lung sound research, low-frequency noise usually disturbs the sound signal being recorded. Some researchers therefore use high-pass filtration before the final analysis. In this study, the effect of digital and analog high-pass filtration on the morphology of the lung sound crackles is evaluated. The original nonprefiltered crackle waveform is presented, and the effect of the high pass filtration on the crackle waveform characteristics is elucidated in one patient with silicoasbestosis. PMID- 1778910 TI - Elevated rectal temperature produced by all-night bright light is reversed by melatonin infusion in men. AB - Early morning rectal body temperature is lowest when melatonin levels are highest in humans. Although pharmacological doses of melatonin are hypothermic in humans, the relationship between endogenous melatonin and temperature level has not been investigated. We measured rectal body temperature in nine normal men whose melatonin levels were suppressed by all-night sleep deprivation in bright light and compared values with those seen in sleep in the dark, sleep deprivation in dim light (to control for the stimulatory effect of wakefulness on temperature), and sleep deprivation in bright light with an infusion of exogenous melatonin that replicated endogenous levels. Minimum rectal temperature, calculated from smoothed temperature data from 2300 to 0515 h, was greater in bright-light sleep deprivation, resulting in suppression of melatonin, than in conditions of sleep deprivation in dim light or sleep in the dark. An exogenous melatonin infusion in bright light returned the minimum temperature to that seen in dim-light sleep deprivation. A nonsignificant elevation in mean and minimum temperature was noted in all conditions of sleep deprivation relative to sleep. We conclude that melatonin secretion contributes to the lowering of core body temperature seen in the early morning in humans. PMID- 1778911 TI - Effects of bronchoconstriction and external resistive loading on the sensation of dyspnea. AB - To determine whether the intensity of dyspnea at a given level of respiratory motor output differs between bronchoconstriction and the presence of an external resistance, we compared the sensation of difficulty in breathing during isocapnic voluntary hyperventilation in six normal subjects. An external resistance of 1.9 cmH2O.1-1.s was applied during both inspiration and expiration. To induce bronchoconstriction, histamine aerosol (5 mg/ml) was inhaled until airway resistance (Raw) increased to a level approximately equal to the subject's control Raw plus the added external resistance. To clarify the role of vagal afferents on the genesis of dyspnea during both forms of obstruction to airflow, the effect of airway anesthesia by lidocaine aerosol inhalation was also examined after histamine and during external resistive loading. The sensation of difficulty in breathing was rated at 30-s intervals on a visual analog scale during isocapnic voluntary hyperpnea, in which the subjects were asked to copy an oscilloscope volume trace obtained previously during progressive hypercapnia. Histamine inhalation significantly increased the intensity of the dyspneic sensation over the equivalent external resistive load at the same levels of ventilation and occlusion pressure during voluntary hyperpnea. Inhaled lidocaine decreased the sensation of dyspnea during bronchoconstriction with no change in Raw, but it did not significantly change the sensation during external resistive loading. These results suggest that afferent vagal activity plays a role in the genesis of dyspnea during bronchoconstriction. PMID- 1778912 TI - Relationship among cardiac output, shunt, and inspired O2 concentration. AB - In comparing gas exchange responses of the methacholine- (MCh) challenged mongrel dog with leukotriene receptor blockers and placebo at different inspiratory O2 fractions (FIO2), we previously noted systematically different values of cardiac output as a function of drug administration and/or FIO2. This confounds identification of the effects of FIO2 and/or drugs on gas exchange, because shunt is well known to vary directly with cardiac output when other factors are equal. Accordingly, in six dogs we examined the dependence of combined shunt and low ventilation-perfusion (VA/Q) blood flow ("shunt") on cardiac output in the MCh challenged mongrel dog. Two dogs breathed 100% O2, another two breathed room air, and the final pair breathed 12% O2 while cardiac output was altered several times by sequentially opening and closing arteriovenous fistulas every 10 min for approximately 90 min after a standard MCh challenge. On 100% O2, shunt increased by 11.0% of the cardiac output per 1-l/min increase in cardiac output. On room air, the value was 7.4%. With 12% O2 breathing shunt rose by only 2.2% per 1 l/min rise in blood flow. This FIO2 -dependent behavior of the shunt-cardiac output relationship was highly reproducible, both within and between animals. It suggests that the increase in shunt with cardiac output depends more on vascular tone of noninjured areas than on tone of the low VA/Q regions (which are hypoxic at all FIO2 values). PMID- 1778913 TI - Dynamic ventilatory responses to CO2 in the awake lamb: role of the carotid chemoreceptors. AB - In awake lambs we investigated the role of the peripheral chemoreceptors in producing dynamic ventilatory (VE) responses to CO2. The immediate VE response, within 15 s, to transient CO2 inhalation was studied in two groups: 1) five lambs before carotid denervation and 2) the same lambs after carotid denervation. The time course of VE responses during the first 60 s after a step change to 8% inspired CO2 was also studied in lambs after carotid denervation and in a group of six carotid body-intact lambs 10-11 days of age. Acute CO2 responses were assessed using step changes to various concentrations of CO2 + air and CO2 + O2, while VE was recorded breath by breath. Intact lambs exhibited a brisk VE response to step changes in CO2, beginning after 3-5 s. Hyperoxia altered but did not suppress the dynamic VE CO2 response when the carotid chemoreceptors were intact. Carotid denervation markedly reduced the VE response during the first 25 s after a CO2 step change, revealing the time delay required for the central chemoreceptors to produce an effective VE response. The residual VE response remaining after CD was thought to be mediated by the remaining aortic body chemoreceptors and was eliminated by adding O2 to the CO2 challenges. However, after carotid denervation, even with CO2 + hyperoxia, the onset of a small tidal volume response was apparent by 10-12 s.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778914 TI - Chronic exercise and its hemodynamic influences on resting blood pressure of hypertensive rats. AB - Studies with male spontaneously hypertensive rats (SHR) were initiated to determine the hemodynamic relationships associated with the lower resting caudal artery systolic blood pressure (SBP) of endurance-trained SHR populations. After assignment into nontrained (NT, n = 38) and trained (T, n = 38) groups, the T animals were exercised 5 times/wk on a motor-driven treadmill for 12-16 wk at a moderate intensity that ranged from 40 to 70% of their maximum O2 consumption capacity (VO2max). SBP, VO2max, and treadmill run time were determined before the experimental period began and before the animals were instrumented for hemodynamic measurements. At the end of the study, the T rats exhibited significantly lower SBP (NT = 210 +/- 3, T = 200 +/- 3 mmHg) and significantly higher VO2max (NT = 75 +/- 2, T = 83 +/- 2 ml.min-1.kg-1) and run durations (NT = 11.4 +/- 0.4, T = 14.5 +/- 0.3 min). When the animals were anesthetized for insertion of catheters and microprobes for blood pressure and cardiac output (thermodilution) measurements, the T rats had lower values for body mass, heart rate, mean blood pressure, cardiac output, and cardiac index than the NT rats; however, only the body mass and heart rate differences were statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778915 TI - Anomalous hypoxic acidification of medullary ventral surface. AB - In castrated male goats, two flexible catheters, one open ended for reference and the other ending in a 1-mm-diam glass bulb pH electrode, were advanced ventrally through a left posterior fossa craniotomy into the subarachnoid space between the 9th and 10th cranial nerve roots, passing medially into cerebrospinal fluid (CSF) over the medullary ventral surface (MVS). They were anchored to dura and fascia, tunneled under the scalp, and terminated in connectors on the left horn. After several days for recovery, while the animals were awake, the effects of CO2 and hypoxia on pH of the film of CSF between the pia and arachnoid (pHMVS) were recorded along with end-tidal PCO2 and PO2 (mass spectrometer), ventilation (pneumotachometer) through a permanent tracheostomy, and, when possible, ear arterial O2 saturation (SaO2). High PCO2 acidified MVS as expected: delta pH MVS/delta log PCO2. = -0.64 +/- 0.14, producing a ventilatory response slope delta VI/delta pHMVS = 372 l/min. Hypoxia resulted in acid shifts even when PCO2 was allowed to fall. The development of hypoxic acidosis was related to the location of pH electrodes determined at necropsy. In isocapnic hypoxia, pH over putative chemoreceptor surfaces fell in proportion to desaturation: delta pHMVS = 0.0033(SaO2)-0.34, r = 0.80, Sy.x = 0.025. With uncontrolled arterial PCO2, similar acidosis occurred when SaO2 fell below 85-90%: delta pHMVS = 0.0039(SaO2) 0.34, r = 0.88, Sy.x = 0.032. With constant hypoxia, pH fell (tau = 3.7 +/- 2.2 min) to a plateau after 10-20 min and showed rapid recovery (tau = 2.0 +/- 1.3 min).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778916 TI - Polycythemia and vascular remodeling in chronic hypoxic pulmonary hypertension in guinea pigs. AB - Chronic hypoxia increases pulmonary arterial pressure (PAP) as a result of vasoconstriction, polycythemia, and vascular remodeling with medial thickening. To determine whether preventing the polycythemia with repeated bleeding would diminish the pulmonary hypertension and remodeling, we compared hemodynamic and histological profiles in hypoxic bled (HB, n = 6) and hypoxic polycythemic guinea pigs (H, n = 6). After 10 days in hypoxia (10% O2), PAP was increased from 10 +/- 1 (SE) mmHg in room air controls (RA, n = 5) to 20 +/- 1 mmHg in H (P less than 0.05) but was lower in HB (15 +/- 1 mmHg, P less than 0.05 vs. H). Cardiac output and pulmonary artery vasoreactivity did not differ among groups. Total pulmonary vascular resistance increased from 0.072 +/- 0.011 mmHg.ml-1.min in RA to 0.131 mmHg.ml-1.min in H but was significantly lower in HB (0.109 +/- 0.006 mmHg.ml 1.min). Hematocrit increased with hypoxia (57 +/- 3% in H vs. 42 +/- 1% in RA, P less than 0.05), and bleeding prevented the increase (46 +/- 4% in HB, P less than 0.05 vs. H only). The proportion of thick-walled peripheral pulmonary vessels (53.2 +/- 2.9% in HB and 50.6 +/- 4.8% in H vs. 31.6 +/- 2.6% in RA, P less than 0.05) and the percent medial thickness of pulmonary arteries adjacent to alveolar ducts (7.2 +/- 0.6% in HB and 7.0 +/- 0.4% in H vs. 5.2 +/- 0.4% in RA, P less than 0.05) increased to a similar degree in both hypoxic groups. A similar tendency was present in larger bronchiolar vessels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778917 TI - Forearm vascular resistance increases during static exercise in heart transplant recipients. AB - In heart transplant recipients but not in normal humans, total peripheral vascular resistance increases during static exercise. To determine whether this augmented vasoconstriction limits the vasodilation normally seen in the nonexercising forearm, we measured arterial pressure, heart rate, and forearm blood flow during 30% maximal static handgrip in 9 heart transplant recipients and 10 control subjects. Handgrip evoked comparable increases in mean arterial pressure in the transplant recipients and control subjects (+19 +/- 2 vs. +20 +/- 2 mmHg). Heart rates increased by 14 +/- 3 beats/min in the control subjects but did not change in the transplant recipients. Directionally opposite patterns of forearm vascular resistance were observed in the two groups. In the control subjects, forearm resistance fell during handgrip (-8.8 +/- 1.9 units, P less than 0.05). In contrast, in the transplant recipients, forearm resistance rose during this intervention (+9.0 +/- 2.9 units, P less than 0.05). Thus the vasodilation that normally occurs in the nonexercising forearm during static handgrip is reversed in heart transplant recipients. Vasoconstriction in the forearm contributes to the increase in total peripheral resistance that occurs during static exercise in these individuals. PMID- 1778918 TI - Pulmonary hemodynamic reaction to foreign blood in goats and rabbits. AB - We have found that the goat is extraordinarily sensitive to very small quantities of rabbit or rat blood. As little as 0.004 ml/kg induces transient pulmonary hypertension [maximal rise in pulmonary arterial pressure 32 +/- 10 (SD) cmH2O] in goats. We hypothesized that this reaction may be related to the presence of the resident population of intravascular macrophages that reside in the pulmonary capillaries of goats. If that is so, then rabbits or rats, which have few or no intravascular macrophages, should not be reactive to foreign blood. We compared pulmonary hemodynamics and changes in blood thromboxane B2 concentrations among goats, rabbits, and rats in response to graded doses of foreign blood. The pulmonary reaction to foreign blood was much greater in goats than in rabbits or rats, even though we injected up to 10- or 60-fold larger amounts into the latter species. In goats the pulmonary vascular pressure response to rabbit blood was dose dependent in goats and correlated well with changes in systemic arterial thromboxane B2 concentrations [change in pulmonary arterial pressure = 0.07 (thromboxane B2) + 8.3, r = 0.79]. We also tested the prostaglandin H2 endoperoxide analogue (U-46619) and found that the goats are somewhat more reactive than rabbits. We conclude that the pulmonary hemodynamic reaction to foreign blood is consistent with the concept that the foreign erythrocytes are reacting with the pulmonary intravascular macrophages in goats. The lower reactivity of the rabbit pulmonary circulation to thromboxane may also have a role. PMID- 1778919 TI - Regional deposition of 3.6-micron particles and lung function in asthmatic subjects. AB - In a group of moderately severe asthmatic subjects, regional deposition of 3.6 microns (aerodynamic diameter) monodispersed Teflon particles labeled with 111In was studied twice. The particles were inhaled with maximally deep inhalation at 0.5 l/s. Lung retention was measured at 0, 6, 24, and 48 h by use of a profile scanner equipped with two 13 x 5-cm NaI crystals. The retentions at 24 (Ret24) and 48 h were highly correlated (r = 0.96 with a slope of the regression line close to 1). There was a poor correlation between retention at 6 h and Ret24 (r = 0.54). The Ret24 values at the two exposures were well correlated (r = 0.86). There were significant correlations between airway resistance as well as single breath nitrogen test phase III and Ret24 (r = 0.70 and 0.67, respectively). The correlation between single-breath nitrogen test phase III and Ret24 persisted also when only subjects within a narrow interval of airway resistance were included. The study indicates that regional deposition can be studied by measurements of Ret24 in subjects with moderately severe asthma and that it is dependent on changes in both large and small airways. PMID- 1778920 TI - Dysfunction of M2-muscarinic receptors in pulmonary parasympathetic nerves after antigen challenge. AB - The effect of antigen challenge on the function of neuronal M2-muscarinic autoreceptors in the lungs was studied in anesthetized guinea pigs. Guinea pigs were injected intraperitoneally with saline (control group) or ovalbumin (10 mg/kg) on days 1, 3, and 5. One group of sensitized animals was challenged on days 20-25 with aerosolized ovalbumin for 5 min/day (challenged group), while another group of the sensitized animals was not challenged (sensitized group). On day 26 the animals were anesthetized, paralyzed, tracheostomized, and artificially ventilated. Pulmonary inflation pressure (Ppi), tidal volume, blood pressure, and heart rate were recorded. Both vagus nerves were cut, and electrical stimulation of the distal portions caused bronchoconstriction (measured as an increase in Ppi) and bradycardia. In the control group, pilocarpine (1-100 micrograms/kg iv) attenuated vagally induced bronchoconstriction by stimulating inhibitory M2-muscarinic receptors on parasympathetic nerves in the lungs. Conversely, blockade of these receptors with the antagonist gallamine (0.1-10 mg/kg iv) produced a marked potentiation of vagally induced bronchoconstriction. These results confirm previous findings. In the challenged guinea pigs, pilocarpine did not inhibit vagally induced bronchoconstriction. Furthermore, gallamine did not potentiate vagally induced bronchoconstriction to the same degree as in the controls. In the group of animals that was sensitized but not challenged, the potentiation of vagally induced bronchoconstriction by gallamine was identical to the controls. There was no increase in baseline Ppi in the sensitized or challenged animals compared with the controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778922 TI - Mandible position and activation of submental and masseter muscles during sleep. AB - Movement of the mandible could influence pharyngeal airway caliber because the mandible is attached to the tongue and to muscles that insert on the hyoid bone. In normal subjects and patients with obstructive sleep apnea (OSA) we measured jaw position during sleep with strain gauges, as well as masseter and submental electromyograms, airflow, esophageal pressure, oximetry, electroencephalograms, and electrooculograms. Jaws of patients with OSA were open more than those of normal subjects at end expiration and opened further at end inspiration, particularly at the termination of apneas when the masseter and submental muscles contracted. Masseter activation occurred only in patients with OSA and in a pattern similar to that of submental muscles. Jaw opening at end expiration could narrow the upper airway, whereas opening at end inspiration could reflect efforts to expand the airway with tracheal tug and with submental muscle activation and efforts to open the mouth to allow mouth breathing. Masseter contraction does not close the jaw but may serve to stabilize it. PMID- 1778921 TI - Role of phospholipid lining on respiratory mucus clearance by cough. AB - Phospholipid lining, present at the respiratory mucus-mucosa interface, may have an important role in the protective function of the airways by its abhesive properties and may also facilitate mucus transport. To mimic respiratory mucus mucosa interface, monolayers of three different forms of phosphatidylglycerol (PG) have been deposited on glass slides by the Langmuir-Blodgett technique. Mucus adhesion and clearance by cough of mucus on these PG-coated or noncoated surfaces have been analyzed and compared, using frog respiratory mucus as "normal" mucus. Among the three PG types studied, the phosphatidylglycerol distearoyl, which is the phospholipid with the longest saturated fatty acid chain, was found to significantly improve the mucus cough clearance by decreasing the mucus work of adhesion compared with the noncoated surfaces. On the other hand, phosphatidylglycerol dipalmitoyl did not improve mucus cough clearance although it decreased mucus adhesion, and phosphatidylglycerol dioleyl did not improve either mucus cough clearance or mucus adhesion. PMID- 1778923 TI - Role of caudal ventrolateral medulla in reflex and central control of airway caliber. AB - We investigated the role played by the caudal ventrolateral (CVL) medulla in the reflex and central neural control of airway caliber in chloralose-anesthetized dogs. Changes in total lung resistance were evoked by four different stimuli. These changes were compared before and after bilateral injection of either ibotenic acid (75 nl; 100 mM) or cobalt chloride (75 nl; 50 mM) into the CVL medulla. The four stimuli used to change lung resistance were static muscular contraction, electrical stimulation of thin fiber afferents in the sciatic nerve, electrical stimulation of the posterior diencephalon, and hypoxia. The first three stimuli have been shown to decrease total lung resistance, whereas the latter stimulus has been shown to increase resistance. We found that injection of both ibotenic acid, which destroys cell bodies but not fibers of passage, and cobalt, which prevents synaptic transmission, either abolished or greatly attenuated the decrease in total lung resistance evoked by static contraction, by sciatic nerve stimulation, and by posterior diencephalic stimulation. We also found that injection of ibotenic acid and cobalt attenuated the reflex increase in lung resistance evoked by hypoxia. In control experiments, we found that bilateral injection of ibotenic acid into the dorsal medulla had no effect on the changes in total lung resistance evoked by these four stimuli. We conclude that the CVL medulla plays an important role in the reflex and central control of airway caliber. PMID- 1778924 TI - Influence of nasal airflow temperature and pressure on alae nasi electrical activity. AB - The influence of nasal airflow, temperature, and pressure on upper airway muscle electromyogram (EMG) was studied during steady-state exercise in five normal subjects. Alae nasi (AN) and genioglossus EMG activity was recorded together with nasal and oral airflows and pressures measured simultaneously by use of a partitioned face mask. At constant ventilations between 30 and 50 l/min, peak inspiratory AN activity during nasal breathing (7.2 +/- 1.4 arbitrary units) was greater than that during oral breathing (1.0 +/- 0.3 arbitrary units; P less than 0.005). In addition, the onset of AN EMG activity preceded inspiratory flow by 0.38 +/- 0.03 s during nasal breathing but by only 0.17 +/- 0.04 s during oral breathing (P less than 0.04). When the subject changed from nasal to oral breathing, both these differences were apparent on the first breath. However, peak AN activity during nasal breathing was uninfluenced by inspiration of hot saturated air (greater than 40 degrees C), by external inspiratory nasal resistance, or by changes in the expiratory route. The genioglossus activity did not differ between nasal and oral breathing (n = 2). Our findings do not support reflex control of AN activity sensitive to nasal flow, temperature, or surface pressure. We propose a centrally controlled feedforward modulation of phasic inspiratory AN activity linked with the tonic drive to the muscles determining upper airway breathing route. PMID- 1778925 TI - Performance and metabolic responses to a high caffeine dose during prolonged exercise. AB - The present study examined whether a high caffeine dose improved running and cycling performance and altered substrate metabolism in well-trained runners. Seven trained competitive runners [maximal O2 uptake (VO2max) 72.6 +/- 1.5 ml.kg 1.min-1] completed four randomized and double-blind exercise trials at approximately 85% VO2max; two trials running to exhaustion and two trials cycling to exhaustion. Subjects ingested either placebo (PL, 9 mg/kg dextrose) or caffeine (CAF, 9 mg/kg) 1 h before exercise. Endurance times were increased (P less than 0.05) after CAF ingestion during running (PL 49.2 +/- 7.2 min, CAF 71.0 +/- 11.0 min) and cycling (PL 39.2 +/- 6.5 min, CAF 59.3 +/- 9.9 min). Plasma epinephrine concentration [EPI] was increased (P less than 0.05) with CAF before running (0.22 +/- 0.02 vs. 0.44 +/- 0.08 nM) and cycling (0.31 +/- 0.06 vs. 0.45 +/- 0.06 nM). CAF ingestion also increased [EPI] (P less than 0.05) during exercise; PL and CAF values at 15 min were 1.23 +/- 0.13 and 2.51 +/- 0.33 nM for running and 1.24 +/- 0.24 and 2.53 +/- 0.32 nM for cycling. Similar results were obtained at exhaustion. Plasma norepinephrine was unaffected by CAF at rest and during exercise. CAF ingestion also had no effect on respiratory exchange ratio or plasma free fatty acid data at rest or during exercise. Plasma glycerol was elevated (P less than 0.05) by CAF before exercise and at 15 min and exhaustion during running but only at exhaustion during cycling. Urinary [CAF] increased to 8.7 +/- 1.2 and 10.0 +/- 0.8 micrograms/ml after the running and cycling trials.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778926 TI - Sodium salicylate centrally augments ventilation through cholinergic mechanisms. AB - Several different stimuli, including hydrogen ions, may exert their effect on central ventilatory control through cholinergic mechanisms. Salicylates are known to be central respiratory stimulants. Therefore this study explored whether the ventilatory effect of sodium salicylate (SAL) is through cholinergic mechanisms. Ventriculocisternal perfusion was used in spontaneously breathing anesthetized (pentobarbital sodium, 30 mg/kg) mongrel dogs to study the effects of SAL (50 mM), atropine (ATR, 4.8 mM), and SAL-ATR on ventilation. After 15 min of perfusion with mock cerebrospinal fluid, each test agent was perfused for 15 min at a rate of 1 ml/min. Cardiovascular and ventilatory parameters were monitored. Values at 15 min of test agent perfusion were compared with values at 15 min of mock cerebrospinal fluid perfusion, with each animal used as its own control. Body temperature was kept between 37.5 and 39.0 degrees C. Perfusion with SAL increased minute ventilation (VE) by 54% (P less than 0.005) and respiratory frequency by 50% (P less than 0.005). Tidal volume was not changed, but mean inspiratory flow rate increased (P less than 0.05). Perfusion with ATR decreased VE by 22% (P less than 0.1), and perfusion with SAL-ATR decreased VE by 20% (P = 0.01). No significant cardiovascular changes were noted in any group. We conclude that SAL increases VE centrally, primarily by increasing respiratory frequency. Because ATR blocked this effect, cholinergic mechanisms are probably involved in the salicylates' central stimulation of ventilation. PMID- 1778927 TI - Rate of rise of intrapulmonary CO2 drives breathing frequency in garter snakes. AB - Garter snakes increase ventilation in response to elevated venous PCO2 without a concomitant rise in arterial PCO2 (Furilla et al. Respir. Physiol. 83: 47-60, 1991). Elevating venous PCO2 will increase the PCO2 gradient between pulmonary arterial blood and intrapulmonary gas during inspiration, leading to a greater rate of rise of intrapulmonary CO2 after inspiration. Because the lung contains CO2-sensitive receptors, I assessed the effect of the rate of rise of intrapulmonary CO2 on ventilation in unidirectionally ventilated snakes. CO2 concentration was altered using a digital gas mixer connected to a personal computer. Breathing frequency was highly correlated with the rate of rise intrapulmonary CO2 but only slightly affected by peak intrapulmonary CO2. On the other hand, tidal volume was more closely related to peak intrapulmonary CO2 than to the rate of rise of CO2. Bilateral pulmonary or cervical vagotomy nearly eliminated the ventilatory response associated with altered CO2 rise times but had little influence on the tidal volume response to the rate of rise of CO2. The mechanism whereby breathing frequency is controlled by the rate of rise of intrapulmonary CO2 is likely to originate with intrapulmonary chemoreceptors and may be important in the control of breathing during exercise. PMID- 1778928 TI - Muscle shortening increases sensitivity of fatigue to severe hypoxia in canine diaphragm. AB - The effects of inspired O2 on diaphragm tension development during fatigue were assessed using isovelocity (n = 6) and isometric (n = 6) muscle contractions performed during a series of exposures to moderate hypoxia [fraction of inspired O2 (FIO2) = 0.13], hyperoxia (FIO2 = 1), and severe hypoxia (FIO2 = 0.09). Muscle strips were created in situ from the canine diaphragm, attached to a linear ergometer, and electrically stimulated (30 Hz) to contract (contraction = 1.5 s/relaxation = 2 s) from optimal muscle length (Lo = 8.9 cm). Isovelocity contractions shortened to 0.70 Lo, resulting in a mean power output of 210 mW/cm2. Fatigue trials of 35 min duration were performed while inspired O2 was sequentially changed between the experimental mixtures and normoxia (FIO2 = 0.21) for 5-min periods. In this series, severe hypoxia consistently decreased isovelocity tension development by an average of 0.1 kg/cm2 (P less than 0.05), which was followed by a recovery of tension (P less than 0.05) on return to normoxia. These responses were not consistently observed in isometric trials. Neither isovelocity nor isometric tension development was influenced by moderate hypoxia or hyperoxia. These results demonstrate that the in situ diaphragm is relatively insensitive to rapid changes in O2 supply over a broad range and that the tension development of the shortening diaphragm appears to be more susceptible to severe hypoxia during fatigue. This may reflect a difference in either the metabolic or blood flow characteristics of shortening contractions of the diaphragm. PMID- 1778929 TI - Nasal and oral airway pressure-flow relationships. AB - We examined the inspiratory and expiratory pressure-flow relationships of both the oral and nasal airways before and after exercise in normal upright subjects. With the use of a partitioned facemask, nasal resistance was measured using posterior rhinomanometry, and oral resistance was measured by recording transoral pressure during oral breathing. Both the nasal and oral pressure-flow relationships for inspiration and expiration were curvilinear and were well described by a power function of the form delta P = aVb (where P is pressure, V is flow, a and b are constants) (r2 = 0.96 +/- 0.01). The exponent b describes the curvilinearity of the pressure-flow curve and can be used to infer the flow regimen. At rest, the inspiratory nasal and oral curves suggested a similar degree of turbulence (b = 1.77 +/- 0.06 and 1.83 +/- 0.04, respectively). However, inspiratory flow regimens were inferred to be more turbulent than those during expiration both before and after exercise. After exercise, decreases in inspiratory nasal resistance at low flows were associated with a change in flow regimen from fully turbulent to orifice flow over the entire flow range. Thus the application of a power function to nasal and oral pressure-flow data permits representation of the whole relationship and allows insight into the nature of the flow regimens. PMID- 1778930 TI - Fictive cough in the cat. AB - Experiments were performed to determine whether cough could be elicited in paralyzed cats ventilated on a respiratory cycle-triggered pump. Midcollicular decerebrate cats were paralyzed and artificially ventilated on a phrenic triggered pump. Phrenic and cranial iliohypogastric nerve efferent activities were recorded. Cough was elicited by electrical stimulation of the superior laryngeal nerve (SLN) or probing the intrathoracic trachea. Fictive coughs induced by electrical stimulation of the SLN or mechanical stimulation of the intrathoracic trachea consisted of large-amplitude bursts in phrenic discharge immediately followed by large bursts in cranial iliohypogastric discharge. During fictive cough, phrenic postinspiratory discharge was reduced relative to control cycles. Codeine (0.03-1 mg/kg iv) decreased both SLN- and probe-induced fictive cough. I conclude that fictive cough can be produced in paralyzed cats ventilated on a phrenic-triggered pump. Furthermore, fictive cough can be produced in the absence of afferent feedback associated with active expiration. PMID- 1778931 TI - Effect of fatigue on maximal power output at different contraction velocities in humans. AB - The effect of fatigue as a result of a standard submaximal dynamic exercise on maximal short-term power output generated at different contraction velocities was studied in humans. Six subjects performed 25-s maximal efforts on an isokinetic cycle ergometer at five different pedaling rates (60, 75, 90, 105, and 120 rpm). Measurements of maximal power output were made under control conditions [after 6 min of cycling at 30% maximal O2 uptake (VO2max)] and after fatiguing exercise that consisted of 6 min of cycling at 90% VO2max with a pedaling rate of 90 rpm. Compared with control values, maximal peak power measured after fatiguing exercise was significantly reduced by 23 +/- 19, 28 +/- 11, and 25 +/- 11% at pedaling rates of 90, 105, and 120 rpm, respectively. Reductions in maximum peak power of 11 +/- 8 and 14 +/- 8% at 60 and 75 rpm, respectively, were not significant. The rate of decline in peak power during the 25-s control measurement was least at 60 rpm (5.1 +/- 2.3 W/s) and greatest at 120 rpm (26.3 +/- 13.9 W/s). After fatiguing exercise, the rate of decline in peak power at pedaling rates of 105 and 120 rpm decreased significantly from 21.5 +/- 9.0 and 26.3 +/- 13.9 W/s to 10.0 +/- 7.3 and 13.3 +/- 6.9 W/s, respectively. These experiments indicate that fatigue induced by submaximal dynamic exercise results in a velocity-dependent effect on muscle power. It is suggested that the reduced maximal power at the higher velocities was due to a selective effect of fatigue on the faster fatigue-sensitive fibers of the active muscle mass. PMID- 1778932 TI - Interactions of tumor necrosis factor and granulocytes with pulmonary vascular resistance. AB - We studied the effects of endotoxin and tumor necrosis factor (TNF-alpha) on hypoxic pulmonary vasoconstriction (HPV) in 12 isolated perfused canine lung lobes. Group 1 lobes were perfused with whole blood, and group 2 lobes were perfused with granulocyte-depleted blood. All lobes were sequentially ventilated with control (35% O2) and hypoxic (3% O2) gas mixtures before and after receiving TNF-alpha. After TNF-alpha, group 2 lost HPV but group 1 retained HPV. After TNF alpha, total pulmonary vascular resistance decreased in group 2 from 0.085 +/- 0.013 to 0.049 +/- 0.016 cmH2O.ml-1.min (P less than 0.05). We conclude that TNF alpha acts as a pulmonary vascular vasodilator. In lobes perfused with whole blood, HPV is paradoxically preserved. We speculate that in the presence of cells rich in TNF-alpha receptors, i.e., granulocytes, the circulating levels of TNF alpha are depressed and full expression of its vascular effects is blunted. PMID- 1778933 TI - Responses of baboons to prolonged hyperoxia: physiology and qualitative pathology. AB - Cardiopulmonary responses to prolonged hyperoxia and their relationships to the development of lung pathology have not been fully characterized in primates. In this study, circulatory hemodynamics and pulmonary function, vascular permeability, and leukocyte sequestration were measured in male baboons after 100% O2 exposure and related to ultrastructural changes of lung injury by electron microscopy. Three groups of animals were exposed to 100% O2 in an exposure cage for 40, 66, and 80 h, respectively. A fourth group of animals was exposed in a cage for 80 h and then anesthetized and ventilated with 100% O2 for additional time. These animals were exposed for a total duration of 110 h or until death from the injury. Physiological responses to hyperoxia were characterized by decreases in total lung capacity and inspiratory capacity at 80 and 110 h. A significant increase in pulmonary leukocyte accumulation was noted by 80 h. Extravascular lung water and permeability surface-area product increased at 80 and 110 h. Cardiac output and stroke volume also decreased, and systemic vascular resistance increased after 80 and 110 h of hyperoxia. Histopathological changes were present in the lungs of all but the 40-h exposure group. Animals exposed for 66 h showed endothelial injury and neutrophil accumulation. By 80 h, animals showed endothelial cell destruction, interstitial edema, and type I cell injury. At 110 h, animals showed substantial destruction of endothelial and type I epithelial cells, exposure of alveolar basement membrane, congestion of capillaries, and substantial interstitial edema. The data indicate that histological changes by electron microscopy precede physiological responses to hyperoxic pulmonary injury in baboons by as much as 14 h and that the physiological responses to early hyperoxic injury are relatively insensitive to the pathological injury. PMID- 1778934 TI - Shifts in rat plantaris motor unit characteristics with aging and compensatory overload. AB - Contractile characteristics of single motor units from plantaris muscles of young (6 mo), middle-aged (14 mo), and older (20 mo) rats were examined. Some of the muscles were subjected to a short-term (30 days) compensatory overload. After overload, the absolute increase in muscle weight was less for the 20-mo-old rats (38%) than the other groups (62%). However, when muscle weight per unit body weight was examined, the ratio was increased to a similar extent for all age groups. Aging was associated with an increase in slow (6 mo, 12.5%; 14 mo, 17.7%; 20 mo, 30.2%) and transitional (6 mo, 2.5%; 14 mo, 15.2%; 20 mo, 12.7%) motor unit proportions. This increase initially occurred at the expense of fast fatigable motor units (6 mo, 36.3%; 14 mo, 13.9%; 20 mo, 20.7%) and then fast intermediate units (6 mo, 40%; 14 mo, 39.2%; 20 mo, 26.7%). In addition, the maximal tension of individual motor units tended to increase with age. In younger rats compensatory overload produced changes in the motor unit profile similar to those that occurred with aging. In contrast, overload of the plantaris from 20-mo old rats resulted in an increase in the force contribution from fast motor units. These results demonstrate that aging is accompanied by a gradual reorganization of the skeletal muscle motor unit pool, such that there is a loss of fast motor units and an increase in the proportion of slow motor units. While compensatory overload initially appears to mimic the aging effect, in older animals it may delay or reverse some of the age-related changes. PMID- 1778935 TI - Alveolar septal folding and lung inflation history. AB - On the basis of microscopic appearance of excised lungs, it has been thought that alveolar septa may fold and unfold during deflation and inflation. We suspected that this appearance might depend heavily on the inflation history of the lung preparation. We therefore studied, by light and electron microscopy, dog, rabbit, and rat lungs fixed over a range of inflation pressures and after a variety of inflation histories. Septal folding, as suggested by the configurations of the air spaces, by the placement of the fine and coarse connective tissue elements, and by the pattern of infolding of alveolar epithelium, was readily seen with some inflation protocols but was absent with others. Pressure at fixation was not as important as events before fixation; deflation to 3 cmH2O did not induce folding, and inflation to 16 cmH2O did not undo the folds. This range corresponds with concepts of critical opening and closing pressures. We suggest that folds form de novo during experimental preparation; one need not postulate that septal folding was present in vivo. PMID- 1778936 TI - Thirst and salt appetite in horses treated with furosemide. AB - When a preliminary experiment in sodium-replete ponies revealed an increase, but not a significant increase, in salt consumption after furosemide treatment, the experiment was repeated using sodium-deficient horses in which aldosterone levels might be expected to be elevated to test the hypothesis that a background of aldosterone is necessary for salt appetite. Ten Standardbred mares were injected intravenously with furosemide or an equivalent volume of 0.9% sodium chloride as a control to test the effect of furosemide on their salt appetite and blood constituents. Sodium intake and sodium loss in urine, as well as water intake and urine output, were measured and compared to determine accuracy of compensation for natriuresis and diuresis. Plasma protein and packed cell volume showed significant increases in response to furosemide treatment (F = 29.31, P less than 0.001 and F = 11.20, P less than 0.001, respectively). There were no significant changes in plasma sodium concentration or osmolality in response to the treatment (P greater than 0.05). The furosemide-treated horses consumed 126 +/- 14.8 g salt, significantly more than when they were given the control injection (94.5 +/ 9.8 g; t = 2.22, P = 0.05). In response to furosemide, horses lost 962 +/- 79.7 and consumed 2,170 +/- 5 meq sodium; however, compared with control, they lost 955 meq more sodium and ingested only 570 meq more sodium, so they were undercompensating for natriuresis. The furosemide-treated horses drank 9.6 +/- 0.8 kg of water, significantly more than when they received the control injection (6.4 +/- 0.8 kg; t = 6.9, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778937 TI - Effects of fitness, fatness, and age on men's responses to whole body cooling in air. AB - Simple and multiple regression analyses were used to assess the influence of 12 white men's fitness (aerobic capacity 44-58 ml O2.min-1.kg fat-free mass-1), fatness (mean skin-fold thickness 5-20 mm, body fat content 15-36%), and age (26 52 yr) on their thermal, metabolic, cardiovascular, and subjective responses to 2 h of whole body cooling, nude, in air at 10 degrees C. Fitter men had slower heart rates, and fatter men had higher blood pressures. Fitness had no effect (P greater than 0.39) on any measured response to cold. Fatness was associated (P less than 0.01) with reduced heat loss, heat production, and mean skin temperature; unchanged heat debt; and increased tissue insulation. Age had the opposite effects. When the confounding effects of fatness were held constant by multiple regression, older men responded to cold as though they were 1 mm of skinfold thickness leaner for each 3-4 yr of age. We conclude that aging, even between the relatively youthful ages of 26 and 52 yr, is accompanied by a progressive weakening of the vasoconstrictor response to cold. PMID- 1778938 TI - Frequency domain analysis of ventilation and gas exchange kinetics in hypoxic exercise. AB - The kinetics of O2 up-take (VO2), CO2 output (VCO2), ventilation (VE), and heart rate (HR) were studied during exercise in normoxia and hypoxia [inspired O2 fraction (FIO2) 0.14]. Eight male subjects each completed 6 on- and off-step transitions in work rate (WR) from low (25 W) to moderate (100-125 W) levels and a pseudorandom binary sequence (PRBS) exercise test in which WR was varied between the same WRs. Breath-by-breath data were linearly interpolated to yield 1 s values. After the first PRBS cycle had been omitted as a warm-up, five cycles were ensemble-averaged before frequency domain analysis by standard Fourier methods. The step data were fit by a two-component (three for HR) exponential model to estimate kinetic parameters. In the steady state of low and moderate WRs, each value of VO2, VCO2, VE, and HR was significantly greater during hypoxic than normoxic exercise (P less than 0.05) with the exception of VCO2 (low WR). Hypoxia slowed the kinetics of VO2 and HR in on- and off-step transitions and speeded up the kinetics of VCO2 and VE in the on-transition and of VE in the off transition. Frequency domain analysis confined to the range of 0.003-0.019 Hz for the PRBS tests indicated reductions in amplitude and greater phase shifts in the hypoxic tests for VO2 and HR at specific frequencies, whereas amplitude tended to be greater with little change in phase shift for VCO2 and VE during hypoxic tests.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778939 TI - Effect of exercise training on insulin sensitivity and glucose metabolism in lean, obese, and diabetic men. AB - To clarify the impact of vigorous physical training on in vivo insulin action and glucose metabolism independent of the intervening effects of concomitant changes in body weight and composition and residual effects of an acute exercise session, 10 lean, 10 obese, and 6 diet-controlled type II diabetic men trained for 12 wk on a cycle ergometer 4 h/wk at approximately 70% of maximal O2 uptake (VO2max) while body composition and weight were maintained by refeeding the energy expended in each training session. Before and 4-5 days after the last training session, euglycemic hyperinsulinemic (40 mU.m2.min-1) clamps were performed at a plasma glucose of 90 mg/dl, combined with indirect calorimetry. Total insulin stimulated glucose disposal (M) was corrected for residual hepatic glucose output. Body weight, fat, and fat-free mass (FFM) did not change with training, but cardiorespiratory fitness increased by 27% in all groups. Before and after training, M was lower for the obese (5.33 +/- 0.39 mg.kg FFM-1.min-1 pretraining; 5.33 +/- 0.46 posttraining) than for the lean men (9.07 +/- 0.49 and 8.91 +/- 0.60 mg.kg FFM-1.min-1 for pretraining and posttraining, respectively) and lower for the diabetic (3.86 +/- 0.44 and 3.49 +/- 0.21) than for the obese men (P less than 0.001). Insulin sensitivity was not significantly altered by training in any group, but basal hepatic glucose production was reduced by 22% in the diabetic men. Thus, when intervening effects of the last exercise bout or body composition changes were controlled, exercise training per se leading to increased cardiorespiratory fitness had no independent impact on insulin action and did not improve the insulin resistance in obese or diabetic men. PMID- 1778940 TI - Detection of interleukin 1 alpha and 1 beta in rabbit tissues during endotoxemia using sensitive radioimmunoassays. AB - Interleukin 1 (IL-1) is a primary mediator of a wide variety of immunologic and inflammatory responses, including reactions to microbial infections. To study this cytokine in an animal model, we have developed specific and sensitive radioimmunoassays for the quantitation of rabbit IL-1 alpha and IL-1 beta. The sensitivity (limit of detection at 95% confidence level) of our assay for IL-1 alpha and 1 beta was 20-40 and 40-80 pg/ml, respectively. Recovery of IL-1 from tissues ranged from 75 to 107%, with a mean of 95% for IL-1 alpha and 89% (range 19-98) for IL-1 beta. We employed these assays in in vivo and in vitro studies. In an in vivo model, we measured the amount of rabbit IL-1 alpha and 1 beta protein present in brain, kidney, liver, lung, muscle, and spleen at various times after the injection of endotoxin. IL-1 was found in all tissues studied but largely in the spleen; IL-1 levels were transient, reaching peak levels by 4 h after injection of endotoxin and rapidly decreasing to low levels by 24 h. In similar in vitro studies, IL-1 alpha levels reached peak elevation 6 h after addition of endotoxin, whereas IL-1 beta was maximal at 24 h. IL-1 alpha was detected in all tissues; IL-1 beta was observed primarily in lung, kidney, and spleen. These studies establish the presence of IL-1 in various tissues during endotoxemia. PMID- 1778941 TI - Whole body and muscle respiratory capacity with dobutamine and hindlimb suspension. AB - The effects of repeated injections of dobutamine, a synthetic catecholamine, were studied in control and tail-suspended rats to determine whether this drug could improve the metabolic response to unweighting. Dobutamine prevented the decrease in maximal oxygen uptake (VO2max) induced by hindlimb suspension. Furthermore, VO2max was 12% greater in dobutamine-treated animals than in saline-treated control animals. Soleus muscle weight and mean fiber cross-sectional area were decreased by 60 and 75%, respectively, in saline- and dobutamine-treated suspended rats. Total capillary length was unaffected by unweighting and increased 21% in all animals receiving dobutamine. The drug prevented the increase in total mitochondrial volume density (+30%) induced by unweighting but did not change total mitochondrial volume. Our results suggest that 1) dobutamine is useful to prevent the decrease of total aerobic capacity during hindlimb suspension, 2) dobutamine increases VO2max in control rats, and 3) total capillary length in soleus muscle is increased by the drug in all groups, although no beneficial effects on mitochondria can be detected. PMID- 1778942 TI - Partitioning of respiratory mechanics in mechanically ventilated patients. AB - In ten mechanically ventilated patients, six with chronic obstructive pulmonary disease (COPD) and four with pulmonary edema, we have partitioned the total respiratory system mechanics into the lung (l) and chest wall (w) mechanics using the esophageal balloon technique together with the airway occlusion technique during constant-flow inflation (J. Appl. Physiol. 58: 1840-1848, 1985). Intrinsic positive end-expiratory pressure (PEEPi) was present in eight patients (range 1.1 9.8 cmH2O) and was due mainly to PEEPi,L (80%), with a minor contribution from PEEPi,w (20%), on the average. The increase in respiratory elastance and resistance was determined mainly by abnormalities in lung elastance and resistance. Chest wall elastance was slightly abnormal (7.3 +/- 2.2 cmH2O/l), and chest wall resistance contributed only 10%, on the average, to the total. The work performed by the ventilator to inflate the lung (WL) averaged 2.04 +/- 0.59 and 1.25 +/- 0.21 J/l in COPD and pulmonary edema patients, respectively, whereas Ww was approximately 0.4 J/l in both groups, i.e., close to normal values. We conclude that, in mechanically ventilated patients, abnormalities in total respiratory system mechanics essentially reflect alterations in lung mechanics. However, abnormalities in chest wall mechanics can be relevant in some COPD patients with a high degree of pulmonary hyperinflation. PMID- 1778943 TI - Heat stress and thermal dehydration: lactacidemia and plasma volume regulation. AB - This investigation was undertaken to study heat stress and dehydration effects on 1) plasma lactic acid (LA) concentration and 2) plasma LA effect on plasma volume conservation during thermal dehydration. Experiments were performed on conscious nonacclimated and heat-acclimated laboratory rats subjected to various levels of heat stress and/or dehydration (37-42 degrees C with and without drinking water). During the exposures, rectal temperature (Tre), plasma LA pyruvic acids, and hematocrit were measured. From these data, excess LA, indicative of anaerobic metabolism, was calculated. In separate experiments, transvascular protein efflux (half time of Evans blue-labeled albumin) was measured before and after plasma LA elevation, either by LA infusion or thermal dehydration. The results show that elevation of plasma LA was associated with a rise in Tre, with accelerated elevation within a Tre range of 41-42 degrees C. LA concentrations were similar for the same Tre in all experimental groups. In nonacclimated rats, this rise was accompanied by a significant rise in excess LA. In acclimated rats, only a minor rise in excess LA was observed. A positive correlation was found between plasma LA elevation and the increase in plasma protein efflux. It is concluded that there is a temperature threshold for the rise in plasma LA. In nonacclimated rats, local hypoxia may contribute to this rise. The data also suggest that, in nonacclimated rats, lactacidemia accelerates plasma protein and fluid loss, leading to circulatory failure during acute thermal dehydration. PMID- 1778944 TI - Respiratory responses induced by the activation of somatic nociceptive afferents in humans. AB - To further investigate the role of somatic nociceptive afferents in the neural control of breathing, we studied the respiratory effects of their activation by means of either electrical stimulation or ischemic pain in 14 healthy volunteers. Painful electrical cutaneous stimulation increased respiratory frequency (f), mean inspiratory flow (VT/TI), and rate of rise (XP/TI) of integrated electromyographic activity of diaphragm (IEMGdi). Painful muscular electrical stimulation caused similar but larger changes accompanied by increases in tidal volume (VT), peak XP of IEMGdi, and ventilation (VE); it also entrained respiratory rhythm. Ischemic pain, which was characterized by a progressively increasing intensity, caused augmentation in respiratory activity that displayed an increasing trend: VE, f, VT, XP, VT/TI, and XP/TI increased. In the light of available literature, it seems conceivable to suggest that respiratory responses to painful electrical stimulation are mediated through the activation of cutaneous (A delta) and muscular (group III) fine-myelinated afferents, and responses to ischemic pain are mediated by the activation of both fine myelinated (group III) and unmyelinated (group IV) muscular afferents. The input conveyed by these afferents may constitute an effective stimulus to respiration in humans. PMID- 1778945 TI - Relative contribution of gravity to pulmonary perfusion heterogeneity. AB - We designed a series of experiments and analyses to quantify the contribution of gravity to pulmonary perfusion heterogeneity. Regional pulmonary perfusion was measured in five anesthetized and ventilated dogs in both supine and prone positions by use of radiolabeled microspheres injected during apnea at functional residual capacity. Measurements of flow were repeated in each position, and the sequence of positions was prospectively designed to nullify any effect of order. The lungs of each animal were excised, perfused with saline until clear, dried at an inflation pressure of 25 cmH2O, and cut into 1.9-cm3 pieces. Each piece was weighed and the radioactivity determined in a scintillation counter. Measurement errors were minimized by excluding lung pieces that had greater than 25% airway and weighed less than 10 mg or greater than 60 mg. Weight-normalized flows in each position and repetition were determined for each lung piece. An analysis of variance model was used to identify the percentage of variation in regional flow that was due to position (supine vs. prone), to random error and time (measurement and repetition), and to structure, where structure was defined as the component of flow that remained constant across position and replication. The contributions of position, error/time, and structure to the total variability of flow across the five dogs were 7.8 +/- 0.6, 8.4 +/- 8.3, and 83.8 +/- 8.4%, (SD), respectively. Because the contribution of position represents the additive effect of gravity between two opposite positions, the contribution of gravity to perfusion heterogeneity in one position may be as little as 4%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778946 TI - Regional differences in the sweating responses of older and younger men. AB - Ten older (60-71 yr) and nine younger (20-25 yr) active healthy men were exposed to passive heating [by placing the lower legs and feet in a 43 degrees C water bath for 60 min while sitting in a warm (35 degrees C, 45% relative humidity) chamber] in summer and winter. The increase in rectal temperature (Tre) was significantly (P less than 0.05) greater, and mean skin temperature and forearm blood flow were lower, for the older men in both seasons. Total sweating rate was lower in the older men, but significantly (P less than 0.05) so only in the summer. The Tre threshold for sweating was unaffected by either age or site (back vs. thigh). The local sweating rate (msw) on the thigh was significantly lower (P less than 0.05) for the older men throughout the exposure, whereas there were no significant age-related differences for the average or peak values of back msw, although lesser sweating on the back occurred during the first 30 min of exposure. The decreased msw on the thigh was due to a lower sweat output per heat activated sweat gland rather than from recruitment of fewer glands. It was concluded that regional differences exist in the age-related decrement in sweat gland function. Furthermore, these findings suggest that aging leads to a decreased ability to maintain body temperature with passive heating of the extremities, which may be attributed in part to decreased regional sweat gland function. PMID- 1778947 TI - Nasal glandular secretory response to cholinergic stimulation in humans and guinea pigs. AB - A guinea pig model of nasal secretory responses was developed to assess the contributions of vascular permeability and glandular secretion responsible for the production of cholinergically stimulated nasal secretions. The nasal secretory responses to provocation with saline, methacholine, and atropine on the ipsilateral (challenged) side and contralateral (reflex) side were analyzed by measurement of total protein (Lowry method), guinea pig albumin (enzyme-linked immunosorbent assay), 125I-labeled bovine serum albumin after intravenous injection, and alkaline phosphatase enzyme activity in nasal fluid. Alkaline phosphatase was found to be localized to submucosal glands by zymography. Topical methacholine challenge increased the secretion of total protein, alkaline phosphatase activity, and albumin on the ipsilateral challenged side, whereas the percentage of total protein represented by albumin was not increased. This response was totally prevented by atropine pretreatment. Serial provocation with methacholine resulted in progressively reduced amounts of both the total protein and alkaline phosphatase in secretions. The observation that repeated challenges produced progressively smaller responses was also examined employing human nasal provocation. Repeating methacholine (25 mg) challenges four times at 10-min intervals in six human volunteers revealed that the initial challenge produced the largest response as reflected in total protein, albumin, lysozyme, lactoferrin, immunoglobulin (Ig) G, IgA, and secretory IgA secretion. When the constituents in secretions were analyzed in relationship to the total protein, the two vascular proteins, IgG and albumin, demonstrated the greatest decrements with repeated methacholine challenges. The glandular proteins, lactoferrin, lysozyme, and secretory IgA, either remained constant or increased in their relative proportion to total protein. Thus, cholinergic stimulation causes glandular secretion from both the guinea pig and human nasal mucosa.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778948 TI - Transcapillary fluid shifts in tissues of the head and neck during and after simulated microgravity. AB - To understand the mechanism, magnitude, and time course of facial puffiness that occurs in microgravity, seven male subjects were tilted 6 degrees head-down for 8 h, and all four Starling transcapillary pressures were directly measured before, during, and after tilt. Head-down tilt (HDT) caused facial edema and a significant elevation of microvascular pressures measured in the lower lip: capillary pressures increased from 27.7 +/- 1.5 mmHg (mean +/- SE) pre-HDT to 33.9 +/- 1.7 mmHg by the end of tilt. Subcutaneous and intramuscular interstitial fluid pressures in the neck also increased as a result of HDT, whereas interstitial fluid colloid osmotic pressures remained unchanged. Plasma colloid osmotic pressure dropped significantly by 4 h of HDT (21.5 +/- 1.5 mmHg pre-HDT to 18.2 +/- 1.9 mmHg), suggesting a transition from fluid filtration to absorption in capillary beds between the heart and feet during HDT. After 4 h of seated recovery from HDT, microvascular pressures in the lip (capillary and venule pressures) remained significantly elevated by 5-8 mmHg above baseline values. During HDT, urine output was 126.5 ml/h compared with 46.7 ml/h during the control baseline period. These results suggest that facial edema resulting from HDT is caused primarily by elevated capillary pressures and decreased plasma colloid osmotic pressures. The negativity of interstitial fluid pressures above heart level also has implications for maintenance of tissue fluid balance in upright posture. PMID- 1778949 TI - Control of internal temperature threshold for active cutaneous vasodilation by dynamic exercise. AB - Exercise induces shifts in the internal temperature threshold at which cutaneous vasodilation begins. To find whether this shift is accomplished through the vasoconstrictor system or the cutaneous active vasodilator system, two forearm sites (0.64 cm2) in each of 11 subjects were iontophoretically treated with bretylium tosylate to locally block adrenergic vasoconstrictor control. Skin blood flow was monitored by laser-Doppler flowmetry (LDF) at those sites and at two adjacent untreated sites. Mean arterial pressure (MAP) was measured noninvasively. Cutaneous vascular conductance was calculated as LDF/MAP. Forearm sweat rate was also measured in seven of the subjects by dew point hygrometry. Whole body skin temperature was raised to 38 degrees C, and supine bicycle ergometer exercise was then performed for 7-10 min. The internal temperature at which cutaneous vasodilation began was recorded for all sites, as was the temperature at which sweating began. The same subjects also participated in studies of heat stress without exercise to obtain vasodilator and sudomotor thresholds from rest. The internal temperature thresholds for cutaneous vasodilation were higher during exercise at both bretylium-treated (36.95 +/- 0.07 degrees C rest, 37.20 +/- 0.04 degrees C exercise, P less than 0.05) and untreated sites (36.95 +/- 0.06 degrees C rest, 37.23 +/- 0.05 degrees C exercise, P less than 0.05). The thresholds for cutaneous vasodilation during rest or during exercise were not statistically different between untreated and bretylium-treated sites (P greater than 0.05). The threshold for the onset of sweating was not affected by exercise (P greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778950 TI - Hyaluronan in human skeletal muscle of lower extremity: concentration, distribution, and effect of exercise. AB - The concentration and localization of hyaluronan (HYA) were determined in biopsy specimens from resting human quadriceps femoris and anterior tibial muscles. The influence of physical exercise on HYA concentrations in the quadriceps femoris muscle and in blood was also evaluated. A sensitive radioassay was used for the quantification of HYA. The distribution of the glycosaminoglycan was demonstrated using a histochemical method that involved microwave-aided fixation and an HYA binding protein. At rest, the muscle HYA concentration was 34.9 +/- 23.6 (SD) micrograms/g muscle wet wt with a large interindividual variation. Exercise had no significant effect on the muscle HYA concentration. The serum HYA concentration increased from 35.9 +/- 22.7 to 53.4 +/- 57.1 micrograms/l during exercise, but 30 min after the exercise the HYA concentration was significantly lower (19.1 +/- 6.3 micrograms/l) than the initial preexercise value. In resting skeletal muscles of the lower extremity, HYA was heterogeneously distributed in the perimysium and endomysium. Perivascular and perineural connective tissues were distinctly HYA positive. PMID- 1778951 TI - Effects of upper airway pressure on abdominal muscle activity in conscious dogs. AB - We have examined arousal and abdominal muscle electromyogram (EMGabd) responses to upper airway pressure stimuli during physiological sleep in four dogs with permanent side-hole tracheal stomata. The dogs were trained to sleep with a tightly fitting snout mask, hermetically sealed in place, while breathing through a cuffed endotracheal tube inserted through the tracheostomy. Sleep stage was determined by behavioral and electroencephalographic criteria. EMGabd activity was measured using bipolar fine-wire electrodes inserted into the abdominal muscle layers. Static increases or decreases in upper airway pressure (+/- 6 cmH2O), when applied at the snout mask or larynx (upper trachea), caused an immediate decrease in EMGabd on the first two to three breaths; EMGabd usually returned to control levels within the 1-min test interval. In contrast, oscillatory pressure waves at 30 Hz and +/- 3 cmH2O amplitude (or -2 to -8 cmH2O amplitude) produced an immediate and sustained reduction in IMGabd in all sleep states. Inhibition of EMGabd could be maintained over many minutes when the oscillatory pressure stimulus was pulsed by using a cycle of 0.5 s on and 0.5 s off. Oscillatory upper airway pressures were also found to be powerful arousal promoting stimuli, producing arousal in 94% of tests in drowsiness and 66% of tests in slowwave sleep. The results demonstrate the presence of breath-by-breath upper airway control of abdominal muscle activity. PMID- 1778952 TI - Effects of cycle exercise on intestinal absorption in humans. AB - Intestinal absorption was measured in six trained male cyclists during rest, exercise, and recovery periods with the segmental perfusion technique. Each subject passed a multilumen tube into the duodenojejunum. The experiments consisted of 1) a sequence of 1-h bouts of cycling exercise at 30, 50, and 70% maximal O2 uptake (Vo2max) separated by 1-h rest periods or 2) a 90-min bout at 70% VO2max. The cycling was performed on a constant-load Velodyne trainer. Absorption of water and a 6% carbohydrate-electrolyte (2% glucose, 6% sucrose, 20 meq Na+, 2.6 meq K+) solution (both perfused at 15 ml/min) were compared. The effects of perfusing an isotonic electrolyte solution during mild (30% VO2max) exercise were also studied. Fluid was sampled every 10 min from ports 10 and 50 cm distal to the infusion site. Water flux was determined by differences in polyethylene glycol concentration across the 40-cm test segment. Results showed 1) no difference in water or electrolyte absorption rates among rest, exercise, and recovery periods; 2) no difference in absorption rates among the three exercise intensities or different exercise durations; and 3) significantly greater fluid absorption rates from the carbohydrate-electrolyte (CE) solution than from water. Water flux during rest, exercise, and recovery was about sixfold greater from the CE solution than from the isotonic solution without carbohydrate. We conclude that 1) exercise has no effect on water or solute absorption in the duodenojejunum, 2) fluid absorption occurs significantly faster from a CE solution than from water, and 3) fluid absorption is increased sixfold by addition of carbohydrate to an electrolyte solution. PMID- 1778953 TI - Quantification of conservative endurance times in thermally insulated cold stressed digits. AB - The estimation of endurance times of the digits exposed to cold weather is performed by an analytical, one-dimensional cylindrical model. Blood perfusion effects are lumped into a volumetric heat-generation term. Cold-induced vasodilatation (CIVD) effects are not included in the present analysis. Endurance times, defined by a drop in cylinder tip temperature to 5 degrees C, were evaluated. Parameters included in this evaluation were 1) environmental temperatures, 2) thermal insulation applied on the cylinder, 3) length of the cylinder, and 4) diameter of the cylinder. It was found that the lower the ambient temperature, the longer the finger, and the smaller its diameter, then the shorter the endurance time for the same thermal insulation. Results of the model were compared with measured data for a subject not exhibiting CIVD response to cold stress. Conformity of results calculated for an adjusted value of the volumetric heat-generation term and measured data was very good, with a maximum deviation of less than 10% at only one particular point in time. This model facilitates the conservative estimation of lower bounds to thermally insulated fingers and toes exposed to cold stress. PMID- 1778954 TI - Kinetic measurements of gas exchange in the intact pulmonary microcirculation. AB - The kinetics of gas exchange are monitored in an isolated perfused lung preparation contained within a plethysmograph. The lungs are perfused with buffer, and there is no gas exchange until a 2.0-ml bolus of reactant is injected into the perfusion system. Subsequent gas exchange produces a pressure transient that is related to the corresponding volume of exchanged gas. The observed rate of volume change is the result of two separate processes: 1) the rate of gas exchange during transit through the capillary bed and 2) the distribution of vascular transit times between the point of injection and the capillary bed. The latter is assessed by a control injection containing a dissolved inert gas that is liberated in the alveoli as the bolus enters the capillary bed. Analysis of the experimental curves permits the separation of these two processes. A model of exchange kinetics indicates that this method has the capability of measuring kinetic events occurring during gas exchange in the microcirculation under physiological conditions. PMID- 1778955 TI - Permeability-surface area product and reflection coefficient of the parietal pleura in dogs. AB - The parameters describing the permeability of the parietal pleura to liquid and total plasma proteins were measured in five anesthetized adult dogs. Small areas of parietal pleura (approximately 1 cm2) and the underlying endothoracic fascia were exposed through resection of the skin and the intercostal muscles. The portion of the thorax containing the pleural windows was removed from the chest and fixed over a bath of whole autologous plasma, the inner parietal pleural surface facing the bath. Small hemispheric Perspex capsules (surface area 0.28 cm2) connected to a pressure manometer were glued to the pleural windows; a subatmospheric pressure was set into the capsule chamber to create step hydraulic transpleural pressure gradients (delta P) ranging from 5 to 60 cmH2O. Transpleural liquid flows (Jv) and protein concentration of the capsular filtrate (Cfilt) and of the plasma bath were measured at each delta P. The transpleural protein flux (Js) at each delta P was calculated by multiplying Jv by the corresponding Cfilt. The hydraulic conductivity (Lp) of the parietal pleura was obtained from the slope of the Jv vs. delta P linear regression. The average Lp from 14 capsules was 9.06 +/- 4.06 (SD) microliters.h-1.cmH2O-1.cm-2. The mathematical treatment of the Js vs. Jv relationship allowed calculation of the unique Peclet number at the maximal diffusional protein flux and a corresponding osmotic permeability coefficient for plasma protein of 1 x 10(-5) +/- 0.97 x 10( 5) cm/s. The reflection coefficient calculated from the slope of the linear phase of the Js vs. Jv relationship was 0.11 +/- 0.05.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778957 TI - Hardiness and social support as predictors of psychological discomfort in mothers of children with autism. AB - Mothers of 60 children with autism participated in this study to measure the effects of social support and hardiness on the women's responses to the stressful demands of raising a child with a disability. MANOVA analysis indicated a significant main effect for hardiness, Wilks' lambda = .859, approx. F(2, 55) = 4.494, p less than .02. There were no main effects for social support, or for the interaction of social support and hardiness. In regression analyses, the best combination of predictors of depressive symptoms were the Commitment dimension on the Hardiness Questionnaire and the total score on the Interpersonal Support Evaluation List social support inventory, mult. R = .783, p less than .001. The best predictor of somatic complaints was total Hardiness score, mult. R = .698, p less than .01. There was a significant correlation between hardiness and perceived social support, r(57) = -.67, p less than .001. Results are discussed in terms of the relationship between perceived social support and hardiness and the potential buffering effect of these dimensions. PMID- 1778956 TI - Rett syndrome: a review of current knowledge. AB - Rett syndrome was first described in 1966 by Andreas Rett. To date, this syndrome has been reported only to afflict females. The disorder is characterized by a progressive loss of cognitive and motor skills as well as the development of stereotypic hand movements, occurring after an apparently normal 6 to 18 months of development. Although Rett syndrome is thought to afflict as many as 10,000 girls in the United States, fewer than 1,200 have been identified thus far. A lack of awareness of this disorder is thought to play a critical role in the failure to differentially diagnose this syndrome. The present article presents a review of our current knowledge concerning this disorder. Information is provided related to the clinical manifestations, etiology, prevalence, pathogenesis, and treatment of the Rett syndrome. PMID- 1778958 TI - A comparison and evaluation of three commonly used autism scales. AB - Reliability and validity of three commonly used autism scales, the Autism Behavior Checklist (Krug, Arick, & Almond, 1980), the Real Life Rating Scale (Freeman, Ritvo, Yokota, & Ritvo, 1986), and the Childhood Autism Rating Scale (Schopler, Reichler, & Renner, 1988), were investigated. Data analyses were based on completed protocols for 24 children or adolescents who met DSM-III-R criteria for pervasive developmental disorders. First, to replicate previous findings, interrater reliability of each of the two direct observational scales was assessed. Second, correlations between pairs of the three scales were calculated. Third, diagnostic classifications based on autism scale cutoff scores were compared to classifications based on DSM-III-R criteria. Fourth, relationships between autism scale scores and adaptive behavior scores were investigated. Results and implications for the use of these scales in the assessment of autistic behaviors are discussed. PMID- 1778959 TI - Analog language teaching versus natural language teaching: generalization and retention of language learning for adults with autism and mental retardation. AB - Examined the effects of two instructional methods on language generalization and long-term retention in 23 adults with autism and severe to profound mental retardation. Analog language teaching employed discrete trials in a controlled setting concentrating on discrimination and identification of materials. Natural language teaching emphasized instruction through interactions that occurred incidentally to training students in the use of materials to perform functional tasks. Assessments were conducted under conditions favoring analog teaching to assure against partiality toward natural language teaching. Under such disadvantageous conditions, the methods of natural language teaching would be supported by results showing either no difference or an advantage in their favor. Both techniques increased initial and long-term generalization though the results suggest no relative superiority for either method under these assessment conditions. A significant interaction was found between prior functioning level and sequence of instruction. Because natural language teaching has many strengths, few drawbacks, and produces equal generalization and retention under disadvantageous conditions, it is strongly supported as preferable for people with autism and mental retardation. PMID- 1778960 TI - Abnormal visual event-related potentials of autistic children. AB - This study compared the visual ERPs and concurrently measured fixation times of autistic children with those of normal children and two psychiatric control groups (so-called "externalizers" and "internalizers"). Autistic children had, in contrast with normal control groups, smaller P3 waves (occipital maximum) to visual target stimuli but did not differ in this respect from the two psychiatric control groups. When the autistic group was split into "good" and "bad" performers, the latter group had significantly smaller amplitudes than the former. No difference was found between the groups in electrophysiological reactivity to the first, novel stimulus of a habituation series. However, an unexpected change in stimulus location induced an increased Fz N400 in the normal group but not in the autistic group or the two psychiatric control groups. In addition, in a non-task-relevant habituation condition, the autistic group fixated complex visual stimuli for shorter times and had smaller occipital P3 waves than the control groups. Analysis of covariance showed that the smaller P3s could not be explained by the shorter fixation times. In none of the ERP parameters were there differences in habituation rate between the controls and the autistic children. PMID- 1778961 TI - Sexual attitudes and knowledge of high-functioning adolescents and adults with autism. AB - Interviewed 21 high-functioning adults with autism and 20 mildly to moderately mentally retarded adults without autism about sexuality and dating. Sexual knowledge and interest were assessed by a sexuality vocabulary checklist and a multiple-choice questionnaire. Group differences were found in experience, with more sexual experiences among the mentally retarded adults, but not in knowledge or interest. In both groups IQ was positively correlated with knowledge scores and males had significantly greater interest in sexuality than females. Implications of sex and group differences are discussed. PMID- 1778962 TI - Sequential and simultaneous processing abilities of high-functioning autistic and language-impaired children. AB - Investigated the Sequential and Simultaneous processing distinctions of high functioning autistic children and children with a developmental receptive language disorder (DRLD). Twenty autistic subjects and 20 DRLD subjects were matched on age and gender, and compared to each other on their Sequential and Simultaneous processing abilities utilizing the K-ABC and selected subtests of the WISC-R. Results showed that both groups manifested a relative sequential processing deficit. However, the groups did not differ significantly on their overall sequential and simultaneous processing capabilities relative to their degree of language impairment. The application of the sequential and simultaneous processing model to the WISC-R provided consistent convergent and discriminant validation for the assessment of these processes with the WISC-R. PMID- 1778963 TI - Changing patterns of intellectual strengths and weaknesses in males with fragile X syndrome. AB - Examined the changing profiles of intelligence in males with fragile X syndrome as these individuals increased in chronological age. Using a psychometric instrument designed to measure styles of information processing, 21 males aged 4 to 27 years were examined cross-sectionally in sequential processing, simultaneous processing, and achievement. The age of the subject was associated with age-equivalent levels of both simultaneous processing and achievement, but fragile X males did not show higher levels of sequential processing with increasing chronological age. Compared to younger fragile X males, the older subjects were more delayed in sequential processing skills relative to their in other areas. A smaller longitudinal study confirmed the presence of a plateau in sequential processing among those subjects tested two times after the age of 10 years. Implications are discussed for diagnosis, intervention, and the matching of subject groups in mental retardation research. PMID- 1778964 TI - Catatonia in autistic disorder: a sign of comorbidity or variable expression? AB - Catatonia, once solely attributed to schizophrenia, is now thought to be associated with many disorders. Autistic disorder shares some symptoms with catatonia, namely, mutism, echopraxia/echolalia, and sterotypes. Catatonia in autism may therefore be a variant of the autistic condition. However, organic deficits and psychiatric disorders, such as bipolar disorder, have also been deficits and psychiatric disorders, such as bipolar disorder, have also been linked with the manifestation of catatonia. Individuals with autism presenting with these comorbid conditions may therefore be at increased risk for catatonia. Little is written of the association of autism and catatonia to clarify the possibility of catatonia as a variant or a sign of a comorbid condition. The authors discuss three autistic patients and suggest specific etiologies for the symptoms of catatonia which presented in these cases. The therapeutic and diagnostic importance of comorbid disorders in autism is stressed. PMID- 1778965 TI - A closer look at the Autism Behavior Checklist: discriminant validity and factor structure. AB - The psychometric properties of the Autism Behavior Checklist (ABC; Krug, Arick, & Almond, 1980a, 1980b), a 57-item screening checklist for autism was investigated. Professional Informants completed the ABC on 67 autistic and 56 mentally retarded and learning-disabled children. The autistic children were the total population of autistic children aged 6-15 in two circumscribed suburban and rural regions. Using the total score, the ABC accurately discriminated 91% of the children, with 87% of the autistic and 96% of the nonautistic group correctly classified. Moreover, the accuracy of classification was virtually identical when only the more heavily weighted checklist items were used. A 3-factor model accounted for 32% of the total variance in the checklist. Seventeen items loaded .4 or more on Factor 1, 12 items loaded on Factor 2, and 10 items loaded on Factor 3. The present results fail to provide empirical support for a single unidimensional scale for autism. Also, there is little support for subdividing the checklist into five subscales based on symptom areas. PMID- 1778966 TI - Brief report: signal detection analysis of items from the Autism Behavior Checklist. PMID- 1778968 TI - Re: "Family characteristics of autistic children: a further report". PMID- 1778967 TI - Brief report: cognitive and adaptive functioning in 28 girls with Rett syndrome. PMID- 1778969 TI - Autism as a result of a dysfunctional hierarchy of the senses: treatment of autism by Van Soest therapy. PMID- 1778970 TI - Suppression of ethanolamine-containing glycerophospholipid synthesis in HL-60 cells during retinoic acid-induced differentiation. AB - Synthesis and degradation of glycerophospholipids in HL-60 cells and retinoic acid (RA)-treated HL-60 cells were examined. The synthesis of each subclass of ethanolamine-containing glycerophospholipids was extremely suppressed in RA treated HL-60 cells, while that of other glycerophospholipids was not seriously affected. A pulse-chase experiment revealed that about 88% of 1,2-diacyl and 28% of 1-alkenyl-2-acyl glycerophosphoethanolamine were degraded during 4 days in RA treated HL-60 cells. These characteristics of metabolism observed in RA-treated HL-60 cells might be responsible for the change of subclass composition of ethanolamine-containing glycerophospholipids in HL-60 cells during differentiation to granulocytes. PMID- 1778971 TI - Crystallization and preliminary X-ray studies on Sulfolobus acidocaldarius ferredoxin. AB - Ferredoxin from a thermoacidophilic archaebacterium, Sulfolobus acidocaldarius, has been crystallized. The space group is P4(3)2(1)2 or P4(1)2(1)2 and the cell dimensions are a = b = 50.12 A and c = 69.52 A. The Vm value is calculated to be 1.88 A3/Da, assuming one molecule per asymmetric unit. The crystal diffracts X rays beyond 2.0 A resolution. PMID- 1778972 TI - Polar glycosphingolipids in insect: chemical structures of glycosphingolipid series containing 2'-aminoethylphosphoryl-(----6)-N-acetylglucosamine as a polar group from larvae of the green-bottle fly, Lucilia caesar. AB - A series of glycosphingolipids containing 2'-aminoethylphosphoryl(----6)-N acetylglucosamine as a polar group has been demonstrated in larvae of the green bottle fly, Lucilia caesar. The thin-layer chromatographic pattern of the total polar glycolipid revealed the presence of more than eight components, of which five major components were purified by the use of successive column chromatography on QAE- and DEAE-Sephadex and silicic acid (Iatrobeads). From structural studies including compositional sugar analysis, hydrogen fluoride degradation, proton magnetic resonance spectroscopy, methylation analysis, and fast atom bombardment mass spectrometry, their structures were deduced to be as follows: 2'-aminoethylphosphoryl----6GlcNAc beta 1-3Man beta 1-4Glc beta 1-Cer, GalNAc beta 1-4(2'-aminoethylphosphoryl----6)GlcNAc beta 1-3Man beta 1-4Glc beta 1-Cer, GalNAc alpha 1-4GalNAc beta 1-4(2'-aminoethylphosphoryl----6)GlcNAc beta 1 3Man beta 1-4Glc beta 1-Cer, Gal beta 1-3GalNAc alpha 1-4GalNAc-beta 1-4(2' aminoethylphosphoryl----6)GlcNAc beta 1-3Man beta 1-4Glc beta 1-Cer, and GlcNAc beta 1-3Gal-beta 1-3GalNAc alpha 1-4GalNAc beta 1-4 (2'-aminoethylphosphoryl--- 6)GlcNAc beta 1-3Man beta 1-4Glc-beta 1-Cer. The main molecular species of the ceramide moiety was arachidinyltetradecasphingenine in all of the major glycolipids. PMID- 1778973 TI - Detection of one attomole of [Arg8]-vasopressin by novel noncompetitive enzyme immunoassay (hetero-two-site complex transfer enzyme immunoassay). AB - One attomole of [Arg8]-vasopressin (AVP) was detected by a novel noncompetitive enzyme immunoassay (hetero-two-site complex transfer enzyme immunoassay). AVP was indirectly biotinylated using N-hydroxysuccinimidobiotin and trapped onto an anti AVP IgG-coated polystyrene ball. After washing, biotinylated AVP was eluted from the polystyrene ball with HCl and was reacted with 2,4-dinitrophenyl-fluorescein disulfide-bovine serum albumin-rabbit anti-AVP IgG conjugate. The complex formed was trapped on [anti-2,4-dinitrophenyl group] IgG-coated polystyrene balls and, after washing, reacted with avidin-beta-D-galactosidase conjugate. The polystyrene balls were washed, and the complex of the three components was eluted with 2,4-dinitrophenyl-L-lysine and transferred to anti-fluorescein IgG-coated polystyrene balls. After washing, the complex was released from the polystyrene balls by reduction with 2-mercaptoethylamine and transferred to [anti-rabbit IgG] IgG-coated polystyrene balls. beta-D-Galactosidase activity bound to the last polystyrene balls was assayed by fluorometry. The detection limit of AVP was 1.1 fg (1 amol)/tube. Interference by proteins in biological fluids was eliminated by separation of peptides from proteins using a molecular sieve. The principle of the present method may be applicable to the measurement of haptens, including peptides, that can be derivatized so as to be bound simultaneously by both anti hapten antibody and avidin molecules. PMID- 1778974 TI - High-affinity binding of cytochalasin B to the B-end of F-actin loses its inhibitory effect on subunit exchange when the bound nucleotide is ADP. AB - We investigated the mode of binding of cytochalasin B (CB) to F-actin in an ADP solution with and without inorganic phosphate (Pi). In the presence of Pi (20 mM), a filament of F-actin had a single high-affinity CB binding site (Kd = 1.4 nM), just like in the case of an ATP-solution [Kd = 5.0 nM: Suzuki, N. & Mihashi, K. (1991) J. Biochem. 109, 19-23]. But in the absence of Pi, there were two low affinity (Kd = 200 nM) CB binding sites as well as one high-affinity site (Kd = 1.6 nM). We determined the concentration of CB necessary for half-maximal inhibition of growth or shortening of F-actin (Ki) using of pyrene-labeled actin. We obtained Ki = 80 nM for growth and Ki = 800 nM for shortening in the presence of ATP. The addition of Pi to the ATP-solution reduced Ki for growth to 9 nM. We propose a model explaining these results. In the model, high-affinity CB binding to the terminal subunit dimer can inhibit subunit exchange at the B-end only when the terminal subunits bind ATP or ADP.Pi. When the terminal subunits bind ADP, additional low-affinity CB bindings to the terminal subunits are needed to inhibit the subunit exchange. PMID- 1778975 TI - Purification and characterization of a new NAD(+)-dependent enzyme, L-tartrate decarboxylase, from Pseudomonas sp. group Ve-2. AB - A new enzyme, L-tartrate decarboxylase, was found in cells of Pseudomonas sp. group Ve-2. The enzyme was purified to homogeneity and characterized. The enzyme requires K+, Mg2+, and NAD+ for L-tartrate decarboxylation. The dependence of the enzymatic decarboxylation on NAD+ suggests that the decarboxylation involves redox reactions of the substrate. The enzyme catalyzes NAD(+)-linked oxidative decarboxylation of D-malate as well. The enzyme is composed of four subunits with identical molecular weight (Mr 40,000). The apparent Michaelis constants for L tartrate and NAD+ are 1.1 mM, respectively. The cofactor requirements and the physical properties of the enzyme were similar to those of L-tartrate dehydrogenase-D-malate dehydrogenase from Rhodopseudomonas sphaeroides, and tartrate dehydrogenase from P. putida. PMID- 1778976 TI - Characterization of the lateral interaction between human erythrocyte spectrin subunits. AB - A technique in which the subunits of human erythrocyte spectrin were immobilized on a nitrocellulose membrane was developed to study which domains of the subunit are able to bind to the counterpart subunit. The limited tryptic digestion of the isolated alpha and beta subunits of human erythrocyte spectrin produced eight fragments in the alpha subunits and nine fragments in the beta subunit. Four fragments of the beta (80, 60, 44, and 18 kDa) and two of the alpha (82 and 33 kDa) bound to alpha and beta subunits which were immobilized on nitrocellulose membrane strips, respectively. The binding affinities of all the fragments to the subunits, however, were remarkably lower than that of the mother proteins. The titration of fluorescence anisotropy of N-(1-anilinonaphthyl-4)maleimide which was covalently attached to the subunit by the trypsin-digested fraction of the counterpart subunit also indicate weak binding of the fragments even in solution. These findings suggest that the high-affinity binding of the alpha subunit to the beta subunit to form spectrin alpha beta dimer occurs only when the binding domains are arrayed along the polypeptide chains at the appropriate positions on the subunits. PMID- 1778977 TI - Genetic polymorphisms in the 5'-flanking region change transcriptional regulation of the human cytochrome P450IIE1 gene. AB - We identified genetic polymorphisms in the 5'-flanking region of the human cytochrome P450IIE1 gene and investigated the effect of these polymorphisms on the transcriptional regulation of the gene. PCR direct sequencing of the two homozygous alleles [types A (c1/c1) and C (c2/c2)] revealed the existence of several point mutations in the distal 5'-flanking region of the gene, but no differences in the proximal promoter region. The DNA segment (-1372 to -960) placed upstream of SV40 promoter and the chloramphenicol acetyltransferase (CAT) gene enhanced the expression of the gene, and the enhancement of expression by type C DNA was about 10 times that by its type A counterpart. DNase I footprinting analysis showed at least one protected region in which one of the polymorphic loci (RsaI polymorphism) was located. The DNase I sensitivities and protection profiles of the two genotypes were different. The protected region had high homology to the consensus sequence of the binding region of liver specific transcription factor HNF1 (LF-B1), and this was confirmed by gel retardation assay. These results indicate that genetic polymorphisms in the 5'-flanking region of the human P450IIE1 gene affect its binding of trans-acting factor and change its transcriptional regulation. This may lead to inter-individual differences of microsomal drug oxidation activity. PMID- 1778978 TI - Immuno-affinity purification and characterization of the alpha subunits of G0 type G proteins from various bovine tissues. AB - Polyclonal antibodies to the alpha subunits of G0 type G proteins (G0 alpha) were coupled to agarose gel and used to isolate G0 alpha from solubilized membranes of various bovine tissues. The cholate extract of membranes was applied to the anti G0 alpha-agarose gel column. The column was washed extensively, then bound proteins were eluted at a neutral pH using a commercial ActiSep Elution Medium. The proteins in the eluate displayed a single band of 39 kDa on SDS polyacrylamide gel electrophoresis. They bound to GTP gamma S and were ADP ribosylated by pertussis toxin. The yield of the immunoreactive G0 alpha from the extract was about 40%. Isoelectric focusing, immunoassay and peptide mapping analysis of the G0 alpha-like proteins purified from the heart and adrenal medulla indicated that these proteins were very similar to the alpha subunit of a minor subtype of G0 in the brain which was previously referred to as G0 * alpha. PMID- 1778979 TI - The amino acid sequence of the 9 kDa polypeptide and partial amino acid sequence of the 20 kDa polypeptide of mitochondrial NADH:ubiquinone oxidoreductase. AB - Mitochondrial NADH:ubiquinone oxidoreductase (complex I) is the most complicated enzyme in the respiratory chain and is composed of at least 26 distinct polypeptides. Two hydrophilic subfractions of bovine heart complex I were systematically resolved into individual polypeptides by chromatography. Three polypeptides (51, 24, and 9 kDa) were isolated from the flavoprotein fraction (FP) of complex I, and the complete amino acid sequence of the 9 kDa polypeptide was determined. The 9 kDa polypeptide is composed of 75 amino acids with a molecular weight of 8,437. This protein exhibits no obvious sequence similarity to other proteins. The iron-sulfur protein fraction (IP) of complex I was separated into eight polypeptides, 75, 49, 30, 20, 18, 15, 13 kDa-A, and 13 kDa B. The 20 kDa polypeptide was recognized as a novel component of IP for the first time. The N-terminal and several peptide sequences of the 20 kDa polypeptide were determined. Comparison of the sequences revealed significant sequence similarities of the 20 kDa polypeptide to the psbG gene products encoded in the chloroplast genome. The conserved sequence in these proteins was also found in the small subunit of the nickel-containing hydrogenases. These results suggest that complex I is related to other redox enzyme complexes. PMID- 1778980 TI - Temperature and solvent effects on reaction centers from Chloroflexus aurantiacus and Chromatium tepidum. AB - Temperature and solvent effects on reaction center structures were examined in two thermophilic photosynthetic bacteria, Chloroflexus aurantiacus and Chromatium tepidum, in order to gain insight into the interactions among the reaction center proteins and pigment systems. Thermal stability of the reaction centers was found to be proportional to the optimum growth temperature. Circular dichroism (CD) spectra in the 250-300 nm region indicated that thermal denaturation destroyed tertiary structures (helix-to-helix interactions or amino acid residue conformation) in the native reaction center, keeping helical structures intact. Absorption and circular dichroism spectral changes showed that alcohol denatured the so-called special pair and the accessory BChl a independently. The alcohol denaturation further indicates that the coordination between BChl a and amino acid residue in the protein is one of the important interactions maintaining the pigment organization of the reaction centers. PMID- 1778981 TI - Isolation and structural studies of human milk oligosaccharides that are reactive with a monoclonal antibody MSW 113. AB - We have determined the structures of six oligosaccharides isolated from human milk using a monoclonal antibody, MSW 113. The isolation involved affinity chromatography on a column of the immobilized monoclonal antibody and high performance liquid chromatography. From the results of 500 and 600 mHz 1H NMR spectroscopy and fast atom bombardment-mass spectrometry their structures were deduced to be: [formula; see text] Two of these oligosaccharides, numbers 4 and 5, have not previously been described. All of them bound to MSW 113, but their reactivities are weaker than those of sialyl-Le(a) oligosaccharides. The results indicate that MSW 113 reacts with oligosaccharides with the mono- and disialyl Le(a), and other sialyl type 1 structures. PMID- 1778982 TI - Substrate-selective activation of histidine-modified porcine pancreatic alpha amylase by chloride ion. AB - Porcine pancreatic alpha-amylase (1,4-alpha-D-glucan glucanohydrolase) [EC 3.2.1.1] has both amylase activity (hydrolysis of alpha-1,4-D-glucoside bond of starch) and maltosidase activity (hydrolysis of p-nitrophenyl-alpha-D-maltoside to p-nitrophenol and maltose). By the modification of histidine residues of porcine pancreatic alpha-amylase with diethylpyrocarbonate (DEP), both amylase and maltosidase activities were decreased in the absence of chloride ion. In the presence of chloride ion, however, maltosidase activity of the modified enzyme was increased to more than 260% of that of the native enzyme, whereas amylase activity was decreased to less than 15% of the native enzyme. Since the chloride ion binding site is part of the active site loop [Buisson et al. (1987) Food Hydrocolloids 1,399-406 and Buisson et al. (1987) EMBO J. 6, 3909-3916], the special arrangements of both catalytic and modified histidine residues induced by the chloride ion binding would enhance only the maltosidase activity of the histidine-modified enzyme. PMID- 1778983 TI - Characterization of Rarobacter faecitabidus protease I, a yeast-lytic serine protease having mannose-binding activity. AB - Rarobacter faecitabidus protease I, a yeast-lytic serine protease, was characterized in order to elucidate the mechanism of lysis of yeast cells by this enzyme. The N-terminal amino acid sequence of the enzyme was found to be homologous to those of Lysobacter enzymogenes alpha-lytic protease and Streptomyces griseus proteases A and B around the catalytic His residue, showing that it is a mammalian type serine protease. In a study of its substrate specificity, it preferentially hydrolyzed the ester of alanine among amino acid p nitrophenylesters. It also efficiently hydrolyzed succinyl Ala-Pro-Ala p nitroanilide, the specific synthetic substrate for pancreatic elastase. With oxidized insulin B-chain, it hydrolyzed almost exclusively the peptide bond between valine 18 and cysteic acid 19 in the early step of the reaction, and thereafter it partially hydrolyzed Val12-Glu13, Ala14-Leu15, and Leu15-Tyr16. These results indicate that Rarobacter protease I is elastase-like in its substrate specificity, preferentially hydrolyzing the peptide bond of aliphatic amino acids. Its affinity for yeast cells was also investigated, and while Rarobacter protease I was adsorbed by yeast cells, pancreatic elastase was not. This difference was thought to account for the failure of pancreatic elastase to lyse yeast cells, even though its specificity is similar to that of the yeast lytic enzyme. Rarobacter protease I was adsorbed by a mannose-agarose column and specifically eluted from the column with a buffer containing D-mannose or D glucose. These monosaccharides also inhibited its yeast-lytic activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1778984 TI - Novel plasmid vectors for gene cloning in Pseudomonas. AB - Novel host-vector systems have been developed for gene cloning in the metabolically versatile bacterial genus Pseudomonas. We found that a new Pseudomonas strain, Pseudomonas flavida IF-4, isolated from soil, carried two small cryptic plasmids, named pNI10 and pNI20. They were multi-copy, but not self transmissible, and the genome size was 3.7 kb for pNI10 and 2.9 kb for pNI20. Several types of cloning vectors containing a kanamycin or streptomycin resistance (Kmr or Smr) gene were constructed from pNI10 and pNI20. These plasmid vectors were efficiently transformed into several strains of Pseudomonas at a frequency up to 4 x 10(5) transformants per 1 microgram plasmid DNA by the usual competent cell method. The vectors derived from pNI10 replicated not only in Pseudomonas but also in some other Gram-negative enteric bacteria such as Escherichia coli, Enterobacter aerogenes, and Proteus mirabilis. PMID- 1778985 TI - Subunit composition of Photosystem I complex that catalyzes light-dependent transfer of electrons from plastocyanin to ferredoxin. AB - The PSI core complex prepared from cucumber cotyledons, which contains 80 chlorophylls per reaction center (P700) and eight polypeptides with apparent molecular masses of 65/63, 20, 19.5, 18.5, 17.5, 7.6, and 5.8 kDa, has been shown to catalyze the light-dependent transfer of electrons from plastocyanin to ferredoxin. The "native" PSI complex, which contains more than fifteen polypeptides and 120 chlorophylls per P700, did not show higher activity. Any attempt to deplete subunit(s) of the core complex decreased its activity. These results suggest that in addition to light-harvesting chlorophyll a/b protein complexes, several genes of psaA-psaK, which have been proposed as components of PSI complex, are not involved in the activity of PSI complex. It was also found that the amount of 18.5-kDa polypeptide in the PSI complex affects the activity: when this polypeptide was largely depleted, the complex was almost inactive. The inactivation was due to inhibition of electron transfer from plastocyanin to photooxidized P700. Chemical cross-linking and N-terminal amino acid sequencing experiments indicated that the 18.5-kDa polypeptide is the plastocyanin-docking protein and the psaF gene product. The function of the psaF gene product was discussed. PMID- 1778986 TI - Synthesis of human big endothelin-1 by sequence-specific proteolysis of a fusion protein in Escherichia coli. AB - Three DNA constructs, pETB-40, 41, and 42, encoding human big endothelin-1 (ET-1) preceded by the specific recognition sequence (Ile-Glu-Gly-Arg) for the activated blood coagulation factor Xa (FXa), fused in frame to the N-terminal portion of beta Gal, were expressed in Escherichia coli. The fusion proteins, pETB-40P, 41P, or 42P, consisted of the 55-, 51-, or 42-aa N-terminal peptide of beta Gal and the 38-aa of big ET-1, and had 1, 0, or 0 Cys residues and 5, 5, or 1 Arg residues in the N-terminal peptide of beta Gal, respectively. Enzymatic cleavage of the purified fusion proteins by FXa or trypsin allowed the recovery of authentic human big ET-1. The rates of conversion of pETB-40P, 41P, and 42P to big ET-1 by FXa digestion were 5.6, 11.2, and 30.0%, respectively. pETB-40P with a deletion of one Cys residue and four Arg residues in the N-terminal part was a better substrate than the other two for FXa or trypsin in the production of big ET-1. PMID- 1778987 TI - Fusion and fragmentation of phospholipid vesicles by apohemoglobin at low pH. AB - Human apohemoglobin in acidic media was found to induce fusion of phosphatidylcholine/phosphatidylserine (1:1) vesicles at low protein concentration but to fragment the same vesicles to form micellar complex at high protein concentration. The fusion was demonstrated by size increase, vesicle content mixing, lipid mixing, and electron microscopy. The micellization of phospholipid vesicles was observed by light scattering, gel filtration, and electron microscopy. The hydrophobic labeling of the apohemoglobin/vesicle complex followed by CNBr cleavage of apohemoglobin showed that an N-terminal segment of the beta subunit with a molecular weight of approximately 6,000 seems to be mainly involved in the fusion process, but the whole sequences of both alpha and beta chains participate in the micellization process. PMID- 1778988 TI - Hamster cytochrome P-450 IA gene family, P-450IA1 and P-450IA2 in lung and liver: cDNA cloning and sequence analysis. AB - Two cDNA clones, 2C19 and 4C1, were isolated from a lung cDNA library of 3 methylcholanthrene (MC)-treated hamster by using rat P-450c cDNA as a probe. The cDNA determined from 2C19 and 4C1 was 2,916 bp long and contained an entire coding region for 524 amino acids with a molecular weight of 59,408. The deduced amino acid sequence showed a 85% identity with that of rat P-450c indicating 2C19 and 4C1 encode the hamster P-450IA1 protein. Another cDNA clone, designated H28, was isolated from a MC-induced hamster liver cDNA library by using the hamster lung 2C19 or 4C1 cDNA clone as a probe. H28 was 1,876 bp long and encoded a polypeptide of 513 amino acids with a molecular weight of 58,079. The N-terminal 20 residues deduced from nucleotide sequence of H28 were identical to those determined by sequence analysis of purified hamster hepatic P-450MCI. The high similarity of the nucleotide and deduced amino acid sequences between H28 and P 450IA2 of other species indicated that H28 encoded a P-450 protein which belongs to the P-450IA2 family. Northern blot analysis revealed that the mRNAs for hamster P-450IA1 and IA2 were about 2.9 and 1.9 kb long, respectively. Hamster P 450IA1 mRNA was induced to the same level in lungs as in livers by MC treatment, whereas hamster P-450IA2 mRNA was induced and expressed only in hamster liver. PMID- 1778989 TI - Identification of full-sized forms of salivary (S-type) cystatins (cystatin SN, cystatin SA, cystatin S, and two phosphorylated forms of cystatin S) in human whole saliva and determination of phosphorylation sites of cystatin S. AB - Our recent work on the gene structures for human salivary (S-type) cystatins [Saitoh, E. et al. (1987) Gene 61, 329-338] has suggested that the structures of cystatins which we determined previously at the protein level lack N-terminal peptide portions of the full-sized intact forms. In the present study, attempts were made to isolate full-sized S-type cystatins by introducing methanol fractionation into the purification steps to suppress the enzymatic activity present in saliva. Full-sized cystatin SN and two phosphorylated forms of full sized cystatin S were thus isolated. Analysis of one fraction indicated that this was a mixture of full-sized cystatin SA and non-phosphorylated cystatin S. The phosphorylation sites of cystatin S were determined to be Ser-Ser-Ser1(P)-Lys-Glu Glu- for monophosphorylated cystatin S and Ser1(P)-Ser-Ser3(P)-Lys-Glu-Glu- for diphosphorylated cystatin S. Immunoblotting analysis with anti-cystatin S antiserum revealed that tears and seminal plasma also contained S-type cystatins, but diphosphorylated cystatin S was detected neither in tears nor in seminal plasma and no cystatin SN was found in seminal plasma. These data indicate that S type cystatins are secreted into the oral cavity without significant degradation in salivary glands or ducts and that they are expressed tissue specifically. PMID- 1778990 TI - Phosphorylation of type II (beta) protein kinase C by casein kinase II. AB - Rat brain type II (beta) protein kinase C (PKC) was phosphorylated by rat lung casein kinase II (CK-II). Neither type I (gamma) nor type III (alpha) PKC was significantly phosphorylated by CK-II. CK-II incorporated 0.2-0.3 mol of phosphate into 1 mol of type II PKC. This phosphate was located at the single seryl residue (Ser-11) in the V1-variable region of the regulatory domain of the PKC molecule. A glutamic acid cluster was located at the carboxyl-terminal side of Ser-11, showing the consensus sequence for phosphorylation by CK-II. The velocity of this phosphorylation was enhanced by the addition of Ca2+, diolein, and phosphatidylserine, which are all required for the activation of PKC. Phosphorylation of casein or synthetic oligopeptides by CK-II was not affected by Ca2+, diolein, or phosphatidylserine. Available evidence suggests that CK-II phosphorylates preferentially the activated form of type II PKC. It remains unknown, however, whether this reaction has a physiological significance. PMID- 1778991 TI - Three types of mouse peptidylarginine deiminase: characterization and tissue distribution. AB - Three types of mouse peptidylarginine deiminase were separated by DEAE-Sephacel ion-exchange column chromatography, and we propose designating them peptidylarginine deiminase type I, II, and III according to the order of elution. The type II enzyme was widely distributed in various tissues including the skeletal muscle, whereas the type I enzyme was localized in the epidermis and uterus, and the type III enzyme was detected in the epidermis and hair follicles. These enzymes were distinguished by their molecular weights and substrate specificity. The molecular weights were estimated to be approximately 54,000 (type I) and 100,000 (type II and III) by Sephacryl S-200 gel filtration column chromatography. On SDS-PAGE the type II and III enzymes gave Mr = 81,000 and Mr = 76,000, respectively. Among the substrates tested, the type I enzyme showed highest activity toward BZ-L-Arg-NH2, type II toward BZ-L-Arg-O-Et, and type III toward protamine. Western blot analysis showed that antibodies against the type II enzyme were immuno-crossreactive to the type III enzyme. PMID- 1778992 TI - Identification of a specific protein factor defective in group A xeroderma pigmentosum cells. AB - A protein factor which corrects the defect in xeroderma pigmentosum cells belonging to complementation group A (XP-A cells) was detected in a cell extract prepared from calf thymus. The activity of this factor was measured as the amount of unscheduled DNA synthesis (UDS) reappearing in UV-irradiated XP-A cells after microinjection of the extract. The native molecular mass of this factor was estimated to be 80 kDa by gel-filtration and 25 kDa by glycerol gradient centrifugation. The activity was, however, recovered at a position corresponding to 43 kDa after renaturation on an SDS-PAGE gel. The isoelectric point was determined to be approximately 7.5 by measuring the activity after renaturation on an IEF gel. These values were obtained with a partially purified sample. A spot corresponding to these values was detected on two-dimensional gel electrophoresis with a highly purified sample recovered from an SDS-PAGE gel. The purified protein stimulated UDS specifically in the XP-A cells and endowed the cells with a normal level of UV-resistance. The XP-A cells injected with the factor also showed a normal level of UDS after treatment with either 4HAQO or psoralen plus UV-A. This factor (XP-A complementing factor; XP-ACF) may be involved in the repair of DNA damage induced by various agents. PMID- 1778995 TI - Effects of lipoproteins on protein/platelet interaction on polymers. PMID- 1778994 TI - Steroid hormone specifically binds to rat kidney plasma membrane. AB - A high-affinity and low-capacity corticosterone specific binding was detected in the purified plasma membrane preparation from rat kidney using an in vitro steroid hormone binding assay. The specific-bound hormone was efficiently distinguished from the irreversible-bound hormone with 10 microM corticosterone. Under standardized conditions of pH 7.4 at 2 degrees C and 30 min incubation time, the binding was saturable and showed Kd = 13 +/- 3 nM and Bmax = 616 +/- 34 fmol/mg of protein. Competitive binding studies with analogue steroids indicated that corticosterone binding to kidney plasma membrane is hormone-specific. Results indicated that the possible nongenomic effects of steroids could be mediated by their interaction with plasma membrane. PMID- 1778993 TI - Dehydrogenase activation by Ca2+ in cells and tissues. AB - The activation of intramitochondrial dehydrogenases by Ca2+ provides a link between the intensity of work performance by a tissue and the activity of pyruvate dehydrogenase and the tricarboxylate cycle, and hence the rate of ATP production by the mitochondria. Several aspects of this model of the control of oxidative phosphorylation are examined in this article, with particular emphasis on mitochondrial functioning in situ in cardiac myocytes and in the intact heart. Recent use of the fluorescent Ca2+ chelating agents indo-1 and fura-2 has allowed a more quantitative description of the dependence of dehydrogenase activity upon concentration of free intramitochondrial Ca2+, in experiments with isolated mitochondria. Further, a novel technique developed by Miyata et al. has allowed description of free intramitochondrial Ca2+ within a single cardiac myocyte, and the conclusion that this parameter changes in response to electrical excitation of the cell over a range which would be expected to give substantial modulation of dehydrogenase activity. PMID- 1778997 TI - Mast cells and tissue reaction to intraperitoneally implanted polymer capsules. AB - The inflammatory reaction to implanted biomaterials often compromises the clinical usefulness of implantable devices. Dexamethasone, an anti-inflammatory agent, acts on macrophages to decrease production of inflammatory mediators, and on mast cells to prevent degranulation. Systemic administration of dexamethasone (dms) in rats decreases the tissue reaction to intraperitoneally implanted vinyl chloride-acrylic copolymer capsules. Local release of even smaller amounts of dms from a polymeric substrate placed inside an acrylic copolymer capsule may control the tissue reaction while avoiding the undesirable side effects of systemic treatment. Such a system also allows investigation of the local effect of soluble molecules on tissue-material interactions without altering the surface properties of the implant or adding the effect of a releasing material. In the present study, we investigated the effect of dms released from ethylene vinyl acetate (EVAc) rods placed in acrylic copolymer capsules and implanted in the peritoneal cavity of rats. In vitro the release of dms from EVAc rods was quasilinear for 5 weeks. When implanted intraperitoneally into rats, polymer capsules containing EVAc/dms rods generated a tissue reaction that was significantly thinner and featured fewer fibroblast and collagen layers than that around capsules containing pure EVAc rods at all time points studied. The tissue reaction layer was also thinner than that previously described in rats treated systemically with dms. The trabeculae of implants with dms-loaded EVAc rods contained significantly more intact mast cells than implants with EVAc alone, suggesting that degranulation of mast cells is involved in the tissue reaction to intraperitoneal polymer implants. PMID- 1778996 TI - Effect of hydrophilic soft segment side chains on the surface properties and blood compatibility of segmented poly(urethaneureas). AB - Segmented poly(urethaneureas) with hydrophilic side chains were prepared from poly(tetramethylene oxide) (PTMO), 4,4'-diphenylmethane diisocyanate (MDI), ethylene diamine (ED) and a diol with a long hydrophilic side chain comprised of an ethylene oxide-proplene oxide copolymer. The end groups of the hydrophilic chains were either sodium sulfonate or methoxy groups. The state of microphase separation showed a small dependence on the fraction of long-chain hydrophilic diol. Surface analysis by means of static underwater contact angle and dynamic contact angle measurements revealed that the graft chains were at the aqueous interface in the hydrated state. An ex vivo A-V shunt experiment revealed that a more thrombogenic blood-material response was correlated with an increase in the concentration of polymeric hydrophilic side chain incorporation. The polyurethane containing a long chain diol with methoxy end groups exhibited a higher level of thrombogenicity than the similar polymers possessing a sulfonate terminated side chain. PMID- 1778998 TI - The in vitro effects of metal cations on eukaryotic cell metabolism. AB - The in vitro cytotoxicity of nine metal cations common in dental casting alloys was evaluated using Balb/c 3T3 fibroblasts and four toxicity parameters: total protein production, 3H-leucine incorporation, 3H-thymidine incorporation, and MTT formazan production. Concentrations causing 50% toxicity compared to controls (TC50's) and reversibility of these effects were determined. The range of potency of the metal cations was 2-3 orders of magnitude, with Cd2+ showing the greatest potency and In3+ showing the least. Potency did not correlate with atomic weight for these metals. For each metal cation, the TC50's of the various toxicity parameters were similar in most cases. However, several cations (Cu2+, Ga3+) showed greater potency with 3H-thymidine incorporation. Reversibility of the toxic effects was observed for all cations; the effects generally became irreversible at concentrations in the range of the TC50 value for each cation. Several stimulatory effects were seen. Small but statistically significant stimulations were observed after 24 h of metal exposure for Ag1+, Au4+, Cu2+, Ga3+, and Ni2+. Residual stimulations 24 h after removal of the metal cations were observed for Au4+, Cd2+, Ni2+, and Zn2+. Stimulations always occurred at concentrations below the TC50 concentrations. This study should be useful in evaluating the potential cytotoxic effects of metal cations released from dental alloys. PMID- 1778999 TI - Evaluation of polyphosphates and polyphosphonates as degradable biomaterials. AB - A series of polymers, bisphenol A-based poly(phosphoesters), were evaluated as degradable biomaterials. Degradation was observed for the four polymers studied under both in vitro and in vivo conditions. The rate of degradation was affected by polymer side-chain structure and correlated with the swelling behavior. The ethyl side-chain polymers absorbed more water than their phenyl counterparts. Among the sterilization methods, UV irradiation followed by antibiotic treatment was the most suitable, as steam autoclave and ethylene oxide treatments altered the properties of several of the poly (phosphoesters). Tissue response to the poly(phosphoesters) in rabbits was characterized by minor encapsulation and slight or no lymphocyte, giant cell, or macrophage activity. No evidence of edema or necrosis was found. The elastic moduli of these materials varied from 488 MPa for poly(bisphenol A-ethylphosphate) (BPA/EOP) to 627 MPa for the more rigid poly(bisphenol A-phenylphosphonate) (BPA/PP). The ultimate strength, modulus, and energy to failure of BPA/PP were lower than those of similarly compression molded high-molecular-weight poly(L-lactic acid) (PLLA). PMID- 1779000 TI - Synthesis and bioactivity of copolymers with fragments of heparin. AB - A new type of biocompatible copolymer comprising small fragments of heparin, (octa- to dodecasaccharides) copolymerized with a synthetic monomeric component, viz. acrylamide, has been prepared. The heparin fragments are produced by enzymatic or chemical means and are copolymerized, directly or after suitable derivatization, with acrylamide as the major polymerizable component. The polymeric material incorporates the heparin segments as pendant moieties such that their essential functional groups and structural features for specific binding with the selective serine protease coagulation factor inhibitor antithrombin III are preserved. An important feature of this copolymer is its biocompatibility which relates specifically to its antithrombotic and antithrombogenic activity derived from those of heparin fragments. The biological activity of heparin fragments and copolymers thereof are determined in terms of APTT and anti-Xa activity, their antithrombotic potential being expressed as a ratio of anti-Xa activity to APTT. The copolymers reported have biological activities similar to equivalent amounts of respective heparin fragments, and show higher antithrombotic activity compared to intact heparin or commercially available low-molecular-weight heparin (4,000-6,000 Da). PMID- 1779001 TI - Peripheral lymphocyte membrane fluidity after thermal injury. AB - Serum cortisol levels are increased in patients after thermal injury. Lymphocyte function is altered in these patients, which renders them susceptible to infections. Elevated cortisol levels may contribute to this compromised state. In this study, we have demonstrated that cortisol directly affects lymphocyte membrane fluidity as measured by the polarization of fluorescence from the membrane-associated probe diphenylhexatriene in peripheral blood lymphocytes. Membrane fluidity increased in vitro with short- or long-term cortisol exposure. However, membranes of control peripheral blood lymphocytes that were previously exposed to cortisol became resistant to the fluidizing effect of cortisol, which implies membrane adaptation to long-term cortisol exposure. Cortisol effects were similar to those associated with ethanol, a known membrane-fluidizing agent, in peripheral blood lymphocytes and cytotoxic T lymphocytes. Membrane fluidity was compared in peripheral blood lymphocytes from thermally injured patients and peripheral blood lymphocytes from normal (control) subjects. Peripheral blood lymphocyte membrane fluidity increased in major thermal injury. Our data suggest that cortisol affects lymphocyte membrane fluidity in vitro in a manner similar to the membrane fluidity alterations that are observed in vivo after thermal injury. These observations reflect a direct membrane effect of cortisol, which may explain, in part, the cellular dysfunction and immunologic suppression that is observed after thermal injury. PMID- 1779002 TI - Energy balance studies and plasma catecholamine values for patients with healed burns. AB - We report heat balance studies and plasma catecholamine values for 49 children and young adults with healed burn wounds (age range 0.6 to 31 years and burn range 1% to 82% body surface area burned; mean 41%). All measurements were made during the week of discharge. Heat production for patients with healed burns was not significantly different from predicted normal values. However, compartmented heat loss demonstrated a persistent increment in evaporative heat loss that was secondary to continued elevation of cutaneous water vapor loss immediately after wound closure. A reciprocal decrement in dry heat loss was demonstrated (as a result of a cooler average surface temperature, 0.84 degree C cooler than the average integrated skin temperature of five normal volunteers who were studied in our unit under similar environmental conditions). Mean values for plasma catecholamines were in the normal range: epinephrine = 56 +/- 37 pg/ml, norepinephrine = 385 +/- 220 pg/ml, and dopamine = 34 +/- 29 pg/ml. In conclusion, patients with freshly healed burn wounds have normal rates of heat production; however, there is a residual increment in transcutaneous water vapor loss, which produces surface cooling and decreased average surface temperature, which in turn lowers dry heat loss by an approximately equivalent amount. PMID- 1779003 TI - Influence of burn size on the incidence of contamination of burn wounds by fecal organisms. AB - Ischemia and reperfusion injury of the gut mucosa after severe injury have been shown to allow endogenous gastrointestinal tract microorganisms to pass into systemic areas (bacterial translocation); this has been hypothesized as a source of burn-wound contamination. To study this phenomenon, 53 pediatric patients with burns underwent routine fecal culture at the time of admission. These cultures were compared with wound cultures that were obtained at the time of admission and throughout their hospitalization. Patients were grouped according to burn size: Small (1% to 20% total body surface area burned), Moderate (21% to 50%), and Severe (greater than 50%). The incidence of corresponding isolates was determined for each group and compared by analysis of variance. No difference in the frequency of corresponding isolates could be demonstrated between the Small (4.0%) and Moderate (7.7%) groups, whereas the Severe group (53.3%) demonstrated a significantly larger incidence of corresponding isolates (p less than 0.0001). Translocation of gut flora after severe burn injury may account for some instances of burn-wound contamination. PMID- 1779004 TI - The protection against and treatment of a liquid propane freeze injury: an experimental model. AB - Liquid propane causes a severe, deep thermal injury in unprotected tissue. Delayed surgical intervention, as for thermal burns, has been the gold standard of treatment. An animal model of liquid-propane injury was devised to document injury, to demonstrate a better method of protection, and to define an appropriate management protocol. Twenty-eight rats were classified into four groups: unprotected tissue (n = 8), skin covered with wool (n = 8), skin covered with Neoprene (Wm. H. Horn & Brothers Inc., Philadelphia, Pa.) (n = 8), and skin covered with wool plus Neoprene (n = 4). Each group was subdivided into two exposure times: 6 seconds and 30 seconds. The mean temperatures +/- standard error of the mean of the various tissue levels initially and at 6 and 30 seconds of exposure were determined. Histologic examination demonstrated that full thickness tissue necrosis occurred in unprotected and wool-covered tissue. Areas that were covered with Neoprene showed intact skin and subcutaneous tissue with underlying muscle necrosis. Examination of the tissue that was covered with wool plus Neoprene showed no histologic damage. There was no sign of tissue regeneration at the wound periphery, and there was no histologic difference in any group, whether the examination took place at 1 or 5 days after injury. This study demonstrated that the best form of protection appears to be a wool glove liner covered with a Neoprene glove. The histologic evidence suggests that a liquid-propane injury to unprotected tissue should be managed aggressively with early excision and grafting. PMID- 1779005 TI - The role of gentamicin iontophoresis in the treatment of burned ears. AB - Ear cartilage heals slowly, and limited vascularity in cartilage precludes use of systemic antibiotics. Iontophoresis electrically induces drugs in solution to migrate into target tissues. Fifteen patients were randomized to receive gentamicin iontophoresis (n = 7) plus dressing changes every 6 hours and cleaning or routine care alone (n = 8) for treatment of ear burns. There were no differences between the groups in incidence of chondritis (43% vs 50%) or cartilage loss (11% vs 16%). However, gentamicin-resistant organisms developed in 29% of the patients who received iontophoresis, but in none of the patients in the control group (p less than 0.05). To identify the etiology of the resistant organisms, 10 New Zealand white rabbits receive 7 cm2 contact burns to each ear. Gentamicin iontophoresis was performed on one ear, and the other ear served as the control. Serum gentamicin levels were always subtherapeutic. Additionally, gentamicin tissue levels in both the treated and control ears were subtherapeutic. Gentamicin iontophoresis appears to offer no additional salutary effects beyond those that are provided by routine care and may encourage the development of antibiotic resistance. PMID- 1779006 TI - Reduced fluid volume requirement for resuscitation of third-degree burns with high-dose vitamin C. AB - The effects of high-dose vitamin C therapy (170 mg, 340 mg, and 680 mg/kg/day) were evaluated in 70% body surface area third-degree burns in guinea pigs that were resuscitated with 1 ml/kg/%burn Ringer's lactate solution. The water content measurements of the burned skin at 24 hours after burn injury in the vitamin C treated groups were significantly lower than those of the control group (1 ml/kg/%burn) and those of the standard resuscitation group (4 ml/kg/%burn). The cardiac outputs in the group that received 340 mg vitamin C were significantly higher than those of the control group but not significantly different than those of the standard therapy group at 2 hours after burn injury and thereafter. In comparison with the regimen of 340 mg vitamin C, the regimen of 680 mg vitamin C was no more beneficial, and the regimen of 170 mg was less effective. With administration of adjuvant high-dose vitamin C, we were able to reduce the total 24-hour resuscitation volume from 4 ml/kg/%burn to 1 ml/kg/%burn, while a comparable cardiac output was maintained. PMID- 1779007 TI - Cultured epithelial autografts: three years of clinical experience with eighteen patients. AB - Eighteen patients with major burns (mean total body surface area burned was 49% and mean total body surface area with full-thickness burns was 38%) had cultured epithelial autografts applied to 2% to 35% of the body surface area. In six patients successful "take" of greater than 65% occurred, and in 12 patients less than 40% "take" occurred. Most wounds underwent early excision to subcutaneous fat or fascia, and the wounds of 16 patients had been treated previously with homograft. Cultured epithelial autografts were covered with either single or multilayered dressings. Perioperative wound cultures showed that all patients had microorganisms, and appropriate perioperative antibiotic coverage of Staphylococcus epidermidis and Pseudomonas aeruginosa was noted less frequently in the poor take group, which may have influenced subsequent cultured epithelial allograft take. Adherence and stability of cultured epithelial allografts lag behind adherence and stability of meshed split-thickness autograft. The anterior trunk and thighs are the best recipient sites. The number of autograft harvests that were required to close wounds and the length of hospital stay were not significantly decreased by the use of cultured epithelial allografts as compared with comparable full-thickness burns that were treated previously without cultured epithelial allografts. Presently, grafting with cultured epithelial allografts is an adjunct but not an alternative to conventional burn-wound coverage with split-thickness autograft, because engraftment is inconsistent. PMID- 1779008 TI - Lack of long-term durability of cultured keratinocyte burn-wound coverage: a case report. AB - Cultured epithelial autografts have been advocated for permanent closure of skin surfaces after massive thermal injuries. A 10-year-old boy sustained a nearly 100% total body surface area burn (98% full-thickness) in an explosion accident. Cultured epithelial autograft was used to cover 70% of the total body surface area on postburn day 26. In spite of early success of coverage, 60% of cultured epithelial autograft areas blistered and sloughed over the ensuing weeks. Electron microscopic examination of a biopsy specimen of the healed cultured epithelial autograft (80 days after placement) revealed a lack of dermal attachments of the anchoring fibrils. Additionally, blister fluid that was taken from the bullae of the cultured epithelial autograft revealed levels of 18 ng/ml thromboxane and 24 ng/ml prostaglandin E2. These levels are significantly higher than those seen in acute burn blister fluid and indicate an ongoing inflammatory process. Cultured keratinocytes, although they provide early wound closure, may not provide adequate long-term coverage for patients with massive burns. PMID- 1779009 TI - Burn size estimate reliability: a study. AB - A study was undertaken to assess any differences between physicians' and nurses' estimates of burn size from drawings of 10 hypothetical patients with burns. Patient drawings were sent to the 199 burn facilities that are listed in the American Burn Association's Burn Care Resources in North America 1989-1990. The mailings were randomized between physicians and nurses. In order to have an even distribution, the cover letter asked the individual who received the forms to fill them out himself or herself rather than to pass them on to someone else. Forty-one nurses and 16 doctors (29%) returned the completed forms. The length of experience in burn care for the nurses averaged 9.3 years (range, 2 to 20 years), and the length of experience in burn care for the physicians averaged 14.7 years (range, 1 to 30 years [p = 0.01]). There were significant differences in the estimate of mean burn size between the physicians and nurses for only the two smallest drawings; in these cases, size may have been hard to translate from the patient to the drawing. There were four smaller burn charts (less than 20% body surface area), and in two (50%) of these, there were significant differences in the estimation of the burn size. For the six larger burn charts (greater than 20% body surface area), there were no differences in the size estimates. With regression analysis, no trend was noted that correlated the size estimates with the length of experience in burn care for either the physicians or the nurses. Additionally, the participants were asked to indicate which method of estimating burn size was used in their units. Thirty-five percent use the Rule of Nines, 33% use the Lund & Browder chart, 5.3% use Berkow's method, 3% use other methods, and 1.75% use a combination of the Lund & Browder chart and the Rule of Nines. Twenty one percent failed to indicate any preferred method. Estimates of burn sizes with the use of standardized burn forms were consistently the same whether estimates were made by physicians or nurses. Sixty-eight percent of the respondents used the Rule of Nines or the Lund & Browder chart to estimate burn size, but 21% of the respondents failed to answer the question about which method is used in their units. In conclusion, there appears to be little variance in estimation of burn size as made by experienced burn nurses and physicians, and use of these estimates in a centralized data bank should be reliable. PMID- 1779010 TI - Do trauma scores accurately predict outcomes for patients with burns? AB - A highly refined quality assurance program relies on accurate outcome evaluations and the identification of patients who are truly worthy of peer review. In our hospital, the Glasgow Coma Score, the Trauma Score, and the Injury Severity Score are used to monitor patients with burns. A retrospective review of 511 admitted patients with burns was performed to determine whether the existing monitors (Trauma Score, Glasgow Coma Score, Injury Severity Score) or the use of the Baux Score, the Edlich Burn Score, and the Zawacki Score would provide a more precise monitoring system. Logistic regression techniques demonstrated that the Baux Score, the Edlich Burn Score, and the Zawacki Score were highly correlated with patient outcome (p less than 0.001). Linear regression techniques demonstrated that only the Baux Score, the Edlich Burn Score, and the Zawacki Score were correlated with length of stay (p less than 0.01). On the basis of this retrospective review, the Baux Score, the Edlich Burn Score, and the Zawacki Score more accurately predicted outcomes for patients with burns than did the Trauma Score, the Injury Severity Score, and the Glasgow Coma Score; these scores can thus provide the most valuable information for quality assurance activities. PMID- 1779011 TI - The Baltimore Sepsis Scale: measurement of sepsis in patients with burns using a new scoring system. AB - A new sepsis scale has been developed, and it consists of 13 parameters, each of which is measured daily on a variable point scale. In 41 patients with major burns the Baltimore Sepsis scale correlated well with death or survival, with occurrence of septicemia, and with the level of serum interleukin-6. It did not correlate well with the level of plasma endotoxin or with the type of organism that was grown in blood cultures (gram-positive or gram-negative). We propose that the Baltimore Sepsis Scale would be an accurate and easy scale to use for the measurement of interventions that are aimed at improving the septic state. PMID- 1779012 TI - Quantitative threshold changes in cutaneous sensation of patients with burns. AB - Decreased cutaneous sensation is common after burn injury. This study was designed to quantitate threshold sensory loss with the use of a microcomputer based sensory testing device that generated precisely controlled stimuli. Threshold evaluations of two-point discrimination, pinprick, warming, touch, and vibration were performed on patients with burns (n = 16) and on control subjects (n = 42). All threshold measures in patients with burns were elevated above those for control subjects; threshold measures that reached statistical significance were two-point discrimination, warming, touch, and vibration. Unburned sites on patients with burns had higher thresholds than sites on control subjects, though only vibration was significant. A significant correlation was found between the magnitude of touch and vibration thresholds in control subjects, but there was no similar correlation found in patients with burns. When controls for age were applied, touch and vibration thresholds remained significantly elevated above control levels, and decreases in significance for two-point discrimination and warming were noted. It was concluded that sensory function is reduced in patients with burns. Alternative mechanisms that may have caused the sensory changes were discussed. PMID- 1779013 TI - A prospective safety study of femoral vein versus nonfemoral vein catheterization in patients with burns. AB - A prospective study was undertaken to determine the safety of femoral vein catheterization in patients with burns. Forty-two patients had a total of 275 catheterizations and were divided into two groups: group 1, femoral vein catheterization = 80 catheters and group 2, nonfemoral vein catheterization = 195 catheters (180 subclavian, 8 internal jugular, and 7 supraclavicular). All catheters were changed to new sites every 48 hours, and dressings were changed every 24 hours. Bacteriologic surveillance was accomplished by submitting the tip and subcutaneous segment of the catheter for semiquantitative cultures. Skin exit site cultures were obtained, and blood was drawn through the catheters for fungal isolator cultures before removal. Catheter colonization was defined as greater than or equal to 5 colony-forming units on either the subcutaneous segment or the catheter tip. Catheter-related sepsis was diagnosed when the same organism was recovered from the fungal isolator bottle and either part of the catheter and when there was no other identifiable source of sepsis. The rate of occurrence of colonized catheters was 7.5% (6 of 80) in the femoral vein catheterization group and 13.8% (27 of 195) in the nonfemoral vein catheterization group. Catheter related sepsis occurred in 2.5% (2 of 80) of femoral and 1% (2 of 195) of nonfemoral catheters. None of these differences are statistically significant. There were no noninfectious complications from femoral vein catheterization. Two subclavian catheters had to be repositioned. This study suggests that central venous access in patients with burns can be safely employed with the use of the femoral vein. PMID- 1779014 TI - Treatment of toxic epidermal necrolysis by burn units: another market or another threat? AB - A survey of burn care facilities in the United States has provided information regarding the treatment of toxic epidermal necrolysis and related diseases in burn units. The survey suggests that a disproportionate share (12% to 15%) of the projected number of cases of toxic epidermal necrolysis that occur annually are being transferred to the 2% of United States hospitals that have burn units. Because of the potential for a complex hospital course and extended length of stay, treatment of these patients in a prospective payment system poses a significant fiscal threat to hospitals with burn units. PMID- 1779015 TI - Data collection in airway injury: a need to identify prolonged symptoms after exposure. PMID- 1779016 TI - Diabetic gastroparesis: a review. PMID- 1779017 TI - Evaluation of the tourniquet test as a predictor of diabetic retinopathy. AB - Medical practitioners often have difficulty in assessing the presence or severity of diabetic retinopathy. The tourniquet test is a method of assessing diabetic capillary fragility that has been felt to reliably correlate with background and proliferative diabetic retinopathy. We studied 100 consecutive diabetic patients and 50 age-matched controls in a masked fashion, using fundus photographs and fluorescein angiography to correlate the amount of capillary fragility with the presence and severity of background and proliferative diabetic retinopathy. Although the severity of diabetic capillary fragility did correlate with the presence and severity of diabetic retinopathy (p less than 0.001), this test was not as good an indicator of diabetic retinopathy as were other risk factors such as duration of diabetes (p much less than 0.001). The tourniquet test is unreliable in predicting the presence or severity of diabetic retinopathy because of its high false negative response rate. PMID- 1779018 TI - Discordant effects of the aldose reductase inhibitor, sorbinil, on vascular structure and function in chronically diabetic and galactosemic rats. AB - Effects of sorbinil, an aldose reductase inhibitor, were examined on renal glomerular structure, urinary albumin and IgG excretion, and vascular albumin permeation in eyes and aorta of 8-month diabetic, galactose-fed, and age-matched control rats. Sorbinil was added to the diet of one-half of the rats in each group at the time of induction of diabetes and galactosemia. Weight gain was impaired in diabetic and galactose-fed rats versus controls and was improved slightly in corresponding sorbinil-treated groups. Plasma glucose and glycosylated hemoglobin levels, food consumption, and 24-hr urine volume were increased in diabetic rats and were unaffected by sorbinil treatment. Food consumption and glycosylated hemoglobin levels were increased in galactose-fed rats, although the increases were smaller than in diabetic rats; glycosylated hemoglobin levels were decreased by sorbinil. Diabetes- and galactosemia-induced increases in albumin permeation in eyes and aorta were prevented by sorbinil. Urinary excretion of albumin and IgG was increased by diabetes and decreased by sorbinil, although differences between the two diabetic groups were not statistically significant for albumin. Galactosemia was associated with an increase in urinary albumin and IgG excretion that did not reach statistical significance. Glomerular capillary basement membrane width (GBMW) was increased in diabetic versus age-matched control rats but was unaffected by galactose feeding. GBMW was increased in controls fed sorbinil and glomerular capillary basement membrane thickening in diabetic rats was not prevented by sorbinil. The fractional volume of the glomerulus occupied by mesangium (Vvmes) was increased in diabetic and galactose fed rats versus age-matched controls, and was unaffected by sorbinil.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779019 TI - Factors associated with diabetic microangiopathy: a study of 157 type I (insulin dependent) diabetic patients. AB - The relation between poor glycemic control and the development of diabetic microangiopathy has long been recognized. However hyperglycemia alone cannot account for the striking heterogeneity of diabetic patients regarding the presence or absence of microangiopathic lesions. This study was therefore designed to determine the prevalence of retinopathy, nephropathy, and neuropathy, and to identify the factors respectively associated with these lesions. In 157 patients with type I (insulin-dependent) diabetes, the following parameters were recorded: sex, age, duration of diabetes, body mass index, fasting plasma glucose, HbA1c, blood pressure, antihypertensive treatment, tobacco consumption, urinary albumin excretion, plasma creatinine, and presence of retinopathy and neuropathy. One-half of these patients had retinopathy, 32% neuropathy, and 29% nephropathy. Patients with nephropathy exhibited concomitantly high prevalences of retinopathy (69%) and neuropathy (49%). Among patients with retinopathy, 39% had nephropathy; 79% of those with neuropathy had concomitant retinopathy. For each microangiopathic localization, patients with the disease had significantly higher values (p less than 0.05) than those without for duration of diabetes, prevalence of hypertension, and systolic blood pressure. Stepwise logistic regression analysis showed that the following were independent predictive factors of each localization: for nephropathy, systolic blood pressure; for retinopathy, duration of diabetes; and for neuropathy, duration of diabetes, age, and HbA1c. PMID- 1779020 TI - Effect of steroid-therapy on insulin sensitivity in insulin-dependent diabetic patients after kidney transplantation. AB - Little information is available on glucose and energy metabolism in insulin dependent diabetes mellitus (IDDM) patients receiving immunosuppression after kidney transplantation. We therefore measured insulin sensitivity (euglycemic insulin clamp in combination with indirect calorimetry and infusion of tritiated glucose) in (a) eight steroid-treated IDDM patients after kidney transplantation, (b) ten IDDM patients without nephropathy, (c) ten nondiabetic patients after kidney transplantation, and (d) ten healthy control subjects. Hepatic glucose production was enhanced in both steroid-treated transplanted IDDM patients [4.8 +/- 0.6 mg/kg lean body mass (LBM).min] and IDDM patients without complications (3.8 +/- 0.2 mg/kg LBM.min) compared with nondiabetic renal graft recipients and with healthy controls (2.8 +/- 0.2 and 2.7 +/- 0.1 mg/kg LBM.min; p less than 0.01). Insulin-stimulated glucose disposal was reduced in transplanted and non transplanted IDDM patients and nondiabetic transplanted patients versus healthy controls (6.6 +/- 0.8, 5.7 +/- 0.7, and 7.5 +/- 0.6 versus 9.3 +/- 0.6 mg/kg LBM.min; p less than 0.05). This reduction was mainly due to an impairment in nonoxidative glucose metabolism, i.e., glycogen synthesis (3.1 +/- 0.6, 2.7 +/- 0.4, and 3.3 +/- 0.5 versus 5.0 +/- 0.5 mg/kg LBM.min; p less than 0.05 versus healthy controls). It is concluded that IDDM patients without nephropathy show both hepatic and peripheral insulin resistance. In IDDM patients a further increase of insulin resistance caused by treatment with corticosteroids can be corrected by increased insulin doses. However, nondiabetic steroid-treated renal graft recipients show insulin resistance comparable to IDDM patients. PMID- 1779021 TI - A case of painful progressive peripheral neuropathy after successful pancreas transplantation. AB - A 30-year-old female with diabetes type 1 of 26 years underwent simultaneous pancreas and kidney transplantation. In spite of good function of both organs she developed a pseudotabetic polyneuropathy of a diabetic type. PMID- 1779022 TI - Rapid development of extensive macrovascular calcifications in a type I diabetic patient. AB - This is a case report of a 35-year-old woman with a 15-year history of type I diabetes mellitus, who developed extensive macrovascular calcifications of the abdominal aorta and all its tributaries within 7 months of developing renal insufficiency. The patient was maintained on hemodialysis and peritoneal dialysis for a total of 3 months, then underwent combined cadaveric renal and pancreatic islet transplantation. Although some vascular calcifications are known to occur in elderly patients and in patients with long-standing uremia, it was the rapidity and extent of development of these lesions in this young woman that is astonishing. PMID- 1779023 TI - Slowness of information processing after traumatic head injury. AB - One of the main aftereffects of traumatic head injury is slowness of information processing. In the present study, it was hypothesized that an important causal mechanism is a problem in the activation of information stored in memory; this is thought to be due to a reduced redundancy of these representations. An experimental drawing task was employed in which the degree of familiarity and motor complexity of the items was varied. It was expected that increasing the novelty of a task would be more detrimental for the patients than increasing motor complexity. Ten head-injured patients and 10 matched control subjects participated. Task execution was recorded on-line on a graphic digitizer. The results were in accordance with the hypothesis: That is, novelty but not motor complexity had a crucial influence on the speed of information processing. The implications of the results for therapy are discussed. PMID- 1779024 TI - Possible sex differences in the developing human fetal brain. AB - Left-right regional volumetric asymmetries in five telencephalic regions were studied in the developing human fetal brain. Complete series of coronal sections of 21 fetal brains were digitized and regional volumes were integrated. Five regional indices of asymmetry and two overall indices of asymmetry were calculated and compared across the fetal sample. The two most asymmetrical regions in the developing fetal brain were region 1, roughly equivalent to prefrontal cortex, and region 5, which includes striate and extrastriate cortices. Region 5 also manifested a statistically significant sex difference (p less than .02) in the degree of volumetric asymmetry. It appears that striate extrastriate cortices are far more asymmetrical in male brains than in their female counterparts (M = 33%; F = 13%). Overall indices of asymmetry indicated that, on the average, volumetric asymmetries in the male brain favor the right hemisphere. In contrast, the human fetal female is likely to have two hemispheres of the same size or a left hemisphere that is slightly larger than its right counterpart. We believe that these results support the hypothesis that testosterone in utero may lead to a more rapid growth of the right hemisphere or, alternatively, retard the growth of the left hemisphere. PMID- 1779025 TI - Subjective ordering and working memory in alcoholic Korsakoff patients. AB - Frontal-lobe dysfunction of alcoholic Korsakoff patients was studied by presenting four tasks requiring short-term retention, as well as different degrees and types of control. Digit span forward was considered a measure of passive short-term retention; missing scan measures memory search and comparison, in addition to retention; and two subjective ordering tasks measure active generation of responses in addition to the processes in the other two tasks. The results showed no evidence of reduced performance for any of these tasks, when compared with performance of control subjects. The hypothesis that Korsakoff patients have a frontal-lobe dysfunction in addition to their amnesia needs some qualification because of these results: Frontal-lobe function specific to the ordering of verbal responses seems to be intact in Korsakoff patients. PMID- 1779026 TI - Asymmetry of recall in depression. AB - We compared the verbal (auditory/semantic) and nonverbal (visual/configurational) recall of carefully defined depressed patients with a demographically matched control group of normal volunteers. Whereas controls were split as to whether their nonverbal recall exceeded or was inferior to their verbal recall, 89% of depressed patients demonstrated an asymmetry characterized by poorer nonverbal than verbal recall. Depressive subgroups (determined by clinical and psychoendocrine criteria) differed from controls, but not from each other, in demonstrating this asymmetry of recall. In contrast, depressed patients did not individually demonstrate an asymmetry between verbal and nonverbal recognition that differed from controls. PMID- 1779027 TI - Cued recall and early identification of dementia. AB - The early detection of dementia carries implications for clinical management for patients and their families and is of utmost concern if an effective pharmacological treatment is to be found. The utility of an enhanced cued recall paradigm for predicting dementia in a group of elderly subjects was examined. Forty-five subjects referred for clinical evaluation who did not meet the criteria for dementia at initial assessment were reassessed 12-18 months later. Eighteen of these subjects were diagnosed as having possible or probable Alzheimer Disease at reassessment and the diagnostic status of 27 remained unchanged. At initial assessment the 'change' group performed more poorly than the 'no change' group on measures of retrieval, acquisition and retention derived from the cued recall procedure. As would be expected, the performance of the 'no change' group remained stable over time whereas the performance of the 'change' group deteriorated, resembling the performance of a group of subjects with mild possible or probable Alzheimer disease. When the sensitivity and specificity of the memory variables were examined, the retrieval measure (i.e., free recall) appeared most useful as an early predictor of dementia. Continued longitudinal evaluations of subjects with questionable dementia are needed to address more fully the natural history of early memory changes associated with dementia. PMID- 1779028 TI - Long-term retention of implicitly acquired learning in patients with Alzheimer's disease. AB - This study examined retention of procedural learning, using the serial reaction time (SRT) task, over a 1- or 2-week delay in Alzheimer's disease (AD) patients and elderly control (EC) subjects. The SRT task is a four-choice reaction-time task consisting of blocks of 100 trials. A 10-item repeating sequence was embedded in the first four blocks of trials in session one and the first two blocks of session two. Sequence-specific learning was assessed in session one by comparing reaction time (RT) in the fourth block with a repeating sequence to a fifth block in session one in which the stimuli were randomly arranged. After excluding subjects with deficient session one learning, there were eight AD patients and 14 EC subjects who showed robust sequence-specific learning in session one. In these subjects, retention of sequence-specific learning over the 1- to 2-week delay was examined. The AD patients and EC subjects showed an equivalent change in RT across sessions, and all the AD patients lacked any declarative knowledge of the repeating sequence within the task. Individually, two of the eight AD patients appeared to deviate substantially from the others and from the EC subjects in their excess slowing of RT across sessions. Since six AD patients did show retention similar to the EC subjects, it is concluded that at least some AD patients show normal retention of implicitly acquired knowledge over a long delay. Preserved retention in some of the AD patients implies that it is mediated by brain structures that are not affected by the Alzheimer neuropathological process. PMID- 1779029 TI - Impaired efficiency in female alcoholics' neuropsychological performance. AB - Forty-eight female detoxified alcoholics and 36 female nonalcoholic controls were administered a short computerized neuropsychological test battery; accuracy and speed were assessed for each item. The accuracy and speed scores were used to create summary efficiency ratios (accuracy/speed) for each test. Alcoholics had significantly lower efficiency ratios than controls on each of the tests, and this deficit was maintained across instructional conditions (emphasizing speed, accuracy, or speed and accuracy equally) and level of task difficulty. In addition, alcoholics and controls manifested similar types of relationships between response speed and correctness of the response, with these relationships varying as a function of type of task. The results of this study illustrate the benefits of including speed of response as a performance variable, and provide further support for the use of efficiency as a measure sensitive to alcoholic neuropsychological impairment. PMID- 1779030 TI - Wisconsin Card Sorting Test performance as a measure of frontal lobe damage. AB - We examined the sensitivity and specificity of the Wisconsin Card Sorting Test (WCST) as a measure of frontal lobe damage in 91 subjects with stable focal brain lesions. Anatomical information about the location and extent of brain damage was obtained from MR and CT transparencies. No significant differences in WCST performance were found between subjects with frontal vs. nonfrontal damage. Some subjects with extensive frontal lobe damage performed well on the WCST, and some subjects with damage outside of the frontal lobes failed. The optimal cutoff scores for discriminating frontal from nonfrontal subjects correctly classified only 62% of the subjects. Further analysis of WCST performances associated with damage to various subregions of the frontal lobes also failed to reveal any reliable relationships. These findings indicate that performance on the WCST cannot be interpreted in isolation as an index of frontal lobe damage. PMID- 1779031 TI - Differences between multi-infarct dementia and Alzheimer's disease on unstructured neuropsychological tasks. AB - Although patients with multi-infarct dementia (MID) may have greater spontaneity than those with dementia of the Alzheimer's type (DAT), conventional neuropsychological tests often fail to distinguish between these two dementias. We studied 18 patients with MID and compared them to 18 comparably demented patients with DAT and 18 normal elderly controls on conventional structured tests and two unstructured tasks, a 3-minute verbal description of the Cookie Theft Picture and the Lezak Tinker Toy Test. On the structured tests, the only significant difference between the two dementia groups was worse performance by the DAT patients on several memory measures. On the unstructured tasks, the MID group had significantly fewer words/minute and constructional assemblages. These results suggest that unstructured tasks help distinguish patients with MID from those with DAT, and that MID patients have decreased spontaneous behavior and initiation, possibly reflecting frontal-subcortical pathology and compromised executive abilities. PMID- 1779032 TI - Development and validation of a model for estimating premorbid verbal intelligence in the elderly. AB - In a preliminary effort to improve the early diagnosis of dementia, we developed a regression-based method for estimating premorbid intelligence measured by the ability to read irregular words from the American version of the Nelson Adult Reading Test (AMNART). Using errors on the AMNART and years of education, a model for predicting current verbal intelligence (VIQ) was developed in a sample of nondemented elderly. Double cross validation showed that the model had high accuracy and stability in estimating current VIQ in nondemented subjects. The model was then used to estimate premorbid VIQ in mildly demented subjects. Estimated premorbid IQ exceeded current IQ by at least 10 points and did not differ from that of nondemented subjects. Less than 10% of nondemented elderly had discrepancies that were as large. If intellectual decline predicts future functional loss and can be reliably measured using cross-sectional data, the requirement of functional impairment may be an unnecessary barrier to the early diagnosis of dementia. PMID- 1779033 TI - Obstructive sleep apnea syndrome: pathogenesis of neuropsychological deficits. AB - Neuropsychological deficits have been documented in patients with obstructive sleep apnea syndrome (OSAS). Both nocturnal hypoxemia and impairement of daytime vigilance have been suggested as the pathogenesis of these deficits, yet it remains difficult to find good correlations between cognitive deficits and either of these physiological parameters. In the present study, 10 normal controls were compared to 10 moderately and 10 severely apneic patients, all recorded in a sleep laboratory for two consecutive nights, with a vigilance and neuropsychological assessment made during the intervening day. Relative to the controls, moderate and severe OSAS showed differences in many cognitive functions, although the severely affected showed the greater differences. Moreover, severe apneics were also worse than moderate apneics on tests that were found to be normal in the latter group. This suggests a discontinuity in the appearance of neuropsychological deficits as OSAS progresses. Further analyses revealed that reductions in general intellectual measures, as well as in executive and psychomotor tasks were all attributable to the severity of hypoxemia, while other attention and memory deficits were related to vigiance impairment. Therefore, both vigilance impairment and nocturnal hypoxemia may differentially contribute to the cognitive dysfunctions found in OSAS. PMID- 1779034 TI - Differential effects of unilateral temporal lobectomy on visuospatial memory and attention. AB - We investigated free recall of visuospatial arrays in a free-field format in epileptic patients following unilateral temporal lobectomy (TL) (left = 15, right = 17). TL patients exhibited leftward deviation in right hemispace, but more variable response in left hemispace, a pattern that has been observed in healthy adults. This finding is postulated to result from combined preferential right cerebral activation and a tendency to err toward peri-personal space. Temporal lobectomy affected overall leftward deviation by initially shifting deviation more toward the side of lesion. The initial directional shift in immediate memory dissipated over time suggesting that these subtle attentional shifts may be compensated by learning. Consistent with differential cerebral hemispheric mechanisms, absolute vertical errors were greater in right than left TL patients, and absolute horizontal errors were worse in right hemispace. PMID- 1779035 TI - Reaction times and visuospatial processing in Parkinson's disease. AB - Three motor reaction time tasks which differed in visuospatial complexity but not in motor demands were completed by a group of Parkinson's disease patients and a group of matched control subjects. Response initiation times increased with visuospatial difficulty, whereas movement times remained within a similar range. The two groups differed in response initiation and movement execution times across all reaction time conditions. However, there was no disproportionate increase in response initiation times between an initial nonspatial condition and more complex visuospatial conditions in Parkinson disease patients, and the patients did not make more errors than control subjects. The results do not give support to the hypothesis of a generalised visuospatial deficit in Parkinson's disease. PMID- 1779036 TI - Comparative pathological study of hepatic changes induced by Fasciola gigantica and Gigantocotyle explanatum in Javanese thin-tailed sheep. AB - Pathological changes in the liver induced by Fasciola gigantica and Gigantocotyle explanatum were readily distinguishable from each other. Lesions associated with the migration of immature flukes through the parenchyma were a prominent feature of infection with Fasciola gigantica, whereas lesions induced by Gigantocotyle explanatum were confined to the large bile ducts. The size of the hepatic lesions increased during the course of infection with Fasciola gigantica and was associated with the formation of progressively larger areas of scar tissue in the parenchymal migration tracts as the flukes grew. This was also as a result of the progressively increasing cellular infiltration, proliferation of bile ductules and fibrosis which occurred in adjacent portal triads and interlobular septa. The absence of signs of migration through the hepatic parenchyma by Gigantocotyle explanatum, was regarded as evidence that these flukes gain entry to the bile ducts from the intestine via the common bile duct. In bile ducts infected with Fasciola gigantica there was more extensive desquamation of the epithelium, more intense mucosal infiltration with lymphoid cells and fewer eosinophils, less severe glandular hyperplasia, more free blood in the lumen and a thicker duct wall than in bile ducts infected with Gigantocotyle explanatum. PMID- 1779037 TI - Immune responses of lambs experimentally infected with bovine respiratory syncytial virus and Pasteurella haemolytica. AB - The immune responses of lambs experimentally infected with bovine respiratory syncytial virus (RSV) and Pasteurella haemolytica were compared with lambs infected with bovine RSV or Pasteurella haemolytica alone. Superinfection with P. haemolytica aggravated the reduction in the number of CD5+, CD4+ and LCA p220+ (B) lymphocytes caused by bovine RSV, but it had no effect on the neutralizing antibodies against P. haemolytica cytotoxin. Serum samples obtained from lambs experimentally infected with bovine RSV and P. haemolytica had significantly lower amounts of neutralizing antibodies to bovine RSV than those obtained from lambs infected with bovine RSV alone. PMID- 1779038 TI - Tyzzer's disease (Bacillus piliformis) in Australian marsupials. AB - Tyzzer's disease (Bacillus piliformis infection) was diagnosed in nine marsupials (six possums, a koala, a wombat and a dasyurid). All but two of the possums were captive. Five of the seven marsupials, for which ages were recorded, were juvenile. Affected marsupials were either found dead or were showing non-specific illness for up to two days before death. Affected livers and hearts showed gross haemorrhage and scattered areas of white discolouration. Microscopically, areas of coagulative necrosis were often associated with neutrophilic infiltrates. Intracellular, slender, faintly basophilic rods were occasionally detected in HE stained sections. Rods were shown by silver staining techniques to be associated with the lesions in all affected animals. These rods showed a beaded appearance when stained with methenamine silver and were consistently in packets within cells, on the peripheries of lesions and scattered sparsely and irregularly within the central necrotic regions. PMID- 1779039 TI - Caprine peripheral neuroblastomas: structural and ultrastructural features, intermediate filaments profile and neuro-endocrine characterization. AB - In this report the morphological and immunohistochemical features with respect to intermediate filament proteins and the neuroendocrine nature of bilateral neuroblastomas possibly originating from the adrenal medulla in a goat kid are presented. Histologically, the tumours were composed of small, round, blue cells organized in highly cellular nests and sheets separated by fibrovascular septa. Isolated cells mimicking the morphological features of neurones were observed in both tumours. Ultrastructurally, dense-core neurosecretory granules, about 100 nm in diameter, and irregularly organized neurotubular networks were seen. The small tumour cells were only labelled by vimentin, while the neurone-like cells were labelled by both neurone-specific enolase and synaptophysin. The lack of staining of the tumour cells by the neurofilament proteins antiserum, which was also observed in a human neuroblastoma (used as positive control) has been previously reported and is probably the result of the tissue processing and/or the poor differentiation stage of the tumours. The vimentin labelling of tumour cells could be explained by the poor differentiation stage of the tumours, since vimentin is the only intermediate filament protein in presumptive neuroblasts, being replaced by neurofilament proteins in later stages of neurogenesis. PMID- 1779040 TI - Atypical cilia in the tracheal epithelium of healthy horses. AB - Specimens of the tracheal epithelium were obtained from two sites in nine healthy horses by a fibre optic endoscope. Electron microscopic examination of 53,550 cilia revealed that 5.2 per cent of cilia were atypical. Nine hundred and seventeen (1.7 per cent) were compound, 78 (0.15 per cent) were swollen, 27 (0.05 per cent) were intracytoplasmic and 171 (3.35 per cent) had microtubular defects. These microtubular defects (159 peripheral and 12 central) were found in 5103 cross-sectioned cilia. PMID- 1779041 TI - Immune responses of the ovine lymph node to Chlamydia psittaci. A cellular study of popliteal efferent lymph. AB - The popliteal efferent lymphatics were cannulated in sheep of two categories, seronegative or immune to Chlamydia psittaci. Following subcutaneous injection of live C. psittaci or control material into the draining area of the popliteal node, sequential samples of efferent lymph were collected and analysed. Both categories of sheep responded to C. psittaci with increased outputs of lymphocytes and blast cells. Numbers of blast cells rose both absolutely and as a proportion of the total. Plasmablasts increased in number only in seronegative sheep. Outputs of total T cells (CD5+), helper T cells (CD4+), cytotoxic/suppressor T cells (CD8+) and non-helper, non-suppressor T cells (T19) were maximal 4 and 7 days after challenge in immune and seronegative sheep, respectively. Proportionally, CD4+ T cells declined, CD8+ T cells increased and T19 cells were unaltered with time after infection. Chlamydial antigens could not be demonstrated in the cells of efferent lymph by an immunoperoxidase method. The results of this preliminary study show that both T and B cell responses are involved in immunity to C. psittaci. PMID- 1779042 TI - Hepatic and pulmonary pathology of experimental Fascioloides magna infection in guinea pigs. AB - The guinea pig was used to study the pathology of Fascioloides magna, an important pathogen for sheep. Although flukes migrated freely through various tissues in infected guinea pigs, the most serious lesions occurred in the liver and lungs. The sequential development of lesions indicated that flukes first invaded the quadrate lobe of the liver and subsequently migrated to other liver lobes and tissues. Six weeks post-infection, there was a marked drop in the recovery of flukes from the liver along with a dramatic increase in pulmonary involvement. Much of the hepatic and pulmonary pathology in infected animals was secondary to extensive vascular lesions caused by migrating flukes. In the liver, vascular lesions predominantly involved the portal and hepatic veins. Thrombophlebitis and locally extensive necrosis, resembling infarction, were observed. Vascular lesions in the lungs occurred in the pulmonary arteries leading to thrombosis and haemorrhagic infarction. Discovery of a fluke in a pulmonary artery, along with the pattern of hepatic and pulmonary lesions, suggested that flukes probably used the cardiovascular system as a pathway for dissemination. Death in fluke-infested guinea pigs was most often associated with severe pulmonary lesions. The nature and distribution of fluke-induced lesions observed in this study demonstrate that the guinea pig is a suitable animal model for Fascioloides magna infection in sheep. PMID- 1779043 TI - Scanning electron microscopy of ovine endothelial cells in vitro exposed to tunicamycin. AB - The endothelium of isolated ovine aorta was severely damaged when exposed to tunicamycin. This observation supports the hypothesis that endothelial injury is the basis of the neural lesions induced by this toxin in livestock. PMID- 1779044 TI - A retrospective study of the incidence of bovine neoplasms in Iran. AB - One hundred and forty cases of bovine neoplasia were diagnosed out of a total of 1980 referred cattle cases examined during a 25-year period (1964-1989). The frequency of different types of tumour and their anatomical distribution are discussed. PMID- 1779045 TI - The behavior of selected microorganisms during the manufacture of high moisture Jack cheeses from ultrafiltered milk. AB - Whole milk was pasteurized and concentrated two times by ultrafiltration. Starter cultures, Lactococcus lactis ssp. cremoris and Lactococcus lactis ssp. lactis, were propagated in either reconstituted skim milk, two times UF retentate, or UF permeate, or a direct vat system was used for the starter culture. The cheese milk was simultaneously inoculated with starter culture and Pseudomonas fragi 4973, Staphylococcus aureus 196E, and Salmonella typhimurium var. Hillfarm. Control whole milk, UF control milk, inoculated whole milk, and inoculated UF milk were made into Monterey Jack cheese using traditional procedures. The process of cheese manufacture was followed by determination of pH, titratable acidity, and microbial population levels. The cheeses were stored for 6 mo and analyzed every month for percentage solids and microbial population levels. Generally, numbers of contaminant microbes increased at a similar rate during manufacture in all cheeses. During the 6-mo ripening period, bacterial starter culture population levels remained high, psychrotrophs declined slowly, Staphylococcus levels remained stable, and Salmonella populations decreased. No Staphylococcus enterotoxin was detected by reverse passive latex agglutination assay. PMID- 1779046 TI - Quantitative determination of complex carbohydrates in bovine milk and in milk based infant formulas. AB - Quantitative determination of all structural families of complex carbohydrate micronutrients was performed on bovine milk samples, milk-based infant formulas, and whey-based manufacturing raw materials. Differences found between formulas depended mainly on their whey: casein ratios. A solvent separation procedure was required for quantitative estimation of the gangliosides and neutral glycolipids within the fat fraction. All infant formulas except one contained slightly more gangliosides than bovine milk. Complex carbohydrates were consistently higher in the nonfat fraction. By gel permeation chromatography, an oligosaccharide subfraction was separated from a glycopeptide one. Oligosaccharide content of infant formulas increased as a function of the whey:casein ratio, and glycopeptides were found only in formulas made with whey components. Neuraminic acids from infant formulas were associated primarily with the glycoprotein fraction, except in hydrolysate-based preparations in which "precipitable" glycoproteins were converted into "soluble" glycopeptides by trypsin treatment. Because whey-based raw materials are very rich in all bovine milk glycoconjugates and oligosaccharides their increased use will result in high contents of these micronutrients in modern formulas. PMID- 1779047 TI - Three-dimensional molecular modeling of bovine caseins: kappa-casein. AB - Three-dimensional structures derived from X-ray crystallography are extremely important in elucidating relationships between structure and function for many proteins. However, not all proteins can be crystallized. The caseins of bovine milk are one class of noncrystallizable proteins. The complete primary and partial secondary structures of these proteins are known, but homologous proteins with known crystallographic structure are not available. In this report, sequence based predictions of secondary structure were made and adjusted to conform with global secondary structures derived from Fourier transform infrared spectroscopy. With this information, a three-dimensional structure for kappa-casein was constructed using molecular modeling computer programs. The constructed model contains two unstranded beta-sheets; both are predominantly hydrophobic and capable of forming quaternary structural interaction sites with alpha s1-casein. This unrefined structure is in good agreement with much of the biochemical information available for kappa-casein. PMID- 1779048 TI - Three-dimensional molecular modeling of bovine caseins: alpha s1-casein. AB - Structures derived from X-ray crystallography are extremely important in elucidating functional relationships for many proteins. However, the caseins of bovine milk are one class of noncrystallizable proteins. The complete primary and partial secondary structures of these proteins are known, but homologous proteins of known crystallographic structure cannot be found. Therefore, sequence-based predictions of secondary structure were made and adjusted to conform with global secondary structures determined by Raman spectroscopy. With this information, a three-dimensional structure for alpha s1-casein was constructed using molecular modeling programs. The predicted structure of alpha s1-casein contains a hydrophobic and a hydrophilic domain, which are connected by a segment of alpha helix. This unrefined structure shows good agreement with global biochemical and chemical information concerning alpha s1-caseins A, B, and C. PMID- 1779049 TI - Factors affecting insulin-like growth factor-I concentration in bovine milk. AB - To establish the naturally occurring range of insulin-like growth factor-I concentrations in bovine milk, samples from individual cows (n = 409) managed on five Missouri dairy herds were assayed. Parity, stage of lactation, and farm affected milk insulin-like growth factor-I concentration. Milk insulin-like growth factor-I concentration was higher in early lactation than mid and late lactation with concentrations in multiparous cows exceeding those in primiparous cows. Insulin-like growth factor-I concentration was negatively correlated to milk production the day of sample collection (r = -.15) and not correlated to predicted 305-d milk yields. Unprocessed bulk tank milk samples (n = 100) from a commercial processing plant had a mean concentration of insulin-like growth factor-I in milk of 4.32 ng/ml with a range of 1.27 to 8.10 ng/ml. This distribution was similar to the range detected in samples from individual cows, but values were lower than those reported for human milk. Concentration of insulin-like growth factor-I in milk was not altered by pasteurization (at 79 degrees C for 45 s). However, insulin-like growth factor-I was undetectable in milk heated to temperatures (121 degrees C for 5 min) required for infant formula preparation or in commercially available infant formula. These data indicated that insulin-like growth factor-I is a normal but quantitatively variable component of bovine milk that is not destroyed by pasteurization but is undetectable in infant formula. Concentration of insulin-like growth factor-I in bovine milk is lower than concentrations reported for human milk yet similar to those reported for human saliva.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779050 TI - Enzyme-linked immunosorbent assays for bovine alpha-lactalbumin and beta lactoglobulin in serum and tissue culture media. AB - Enzyme-linked immunosorbent assays for bovine alpha-lactalbumin and beta lactoglobulin have been developed for measurements of serum and tissue culture samples. Either alpha-lactalbumin or beta-lactoglobulin antiserum was coated on ELISA plates. Biotinylated proteins were used in competition with unknown amount of proteins in samples. After unbound proteins were washed off, ExtrAvidin peroxidase and tetramethylbenzidine were then used as a detection system. Crossreactivity of caseins or bovine serum albumin was less than .0001% in either alpha-lactalbumin or beta-lactoglobulin ELISA. Parallel curves from serial dilutions were obtained in serum and media samples. The additivity of alpha lactalbumin and beta-lactoglobulin ELISA was validated in either serum or medium samples. The intraassay and interassay coefficients of variation for alpha lactalbumin and beta-lactoglobulin ELISA were below 10% over 51 and 47 assays. The ELISA are useful in mammary gland biology studies for measuring milk whey protein in serum or culture media. PMID- 1779051 TI - Serum concentrations of the milk proteins alpha-lactalbumin and beta lactoglobulin in pregnancy and lactation: correlations with milk and fat yields in dairy cattle. AB - Serum concentrations of alpha-lactalbumin and beta-lactoglobulin in first pregnancy, parturition, lactation, involution, and second parturition in 37 Holstein cattle were determined and used as an index of mammary status and in predicting milk yield. During first pregnancy, serum alpha-lactalbumin increased in the last 3 mo and reached a peak at parturition (approximately 1100 ng/ml). Changes in alpha-lactalbumin could not be described by a simple exponential equation, whereas changes in serum beta-lactoglobulin were described by a single exponential from second trimester until 4 wk prepartum and reached a peak at parturition (approximately 460 ng/ml). By 2 wk after parturition, alpha lactalbumin had dropped to approximately 140 ng/ml, and beta-lactoglobulin dropped to approximately 25 ng/ml. In late lactation, alpha-lactalbumin was approximately 70 ng/ml and beta-lactoglobulin approximately 20 ng/ml. Short-term elevations were found after cessation of milking in both alpha-lactalbumin and beta-lactoglobulin in serum. The concentrations of alpha-lactalbumin and beta lactoglobulin at second parturition were similar to those at first parturition with no differences found between parity. Both alpha-lactalbumin and beta lactoglobulin in serum were functionally associated with mammary growth and development. In heifers late in pregnancy, both serum concentrations of alpha lactalbumin and beta-lactoglobulin were positively correlated with mature equivalent milk and fat yields in the subsequent lactation. Serum beta lactoglobulin concentrations at 16 wk prepartum in heifers were highly correlated with the sum of first and second lactation milk (r = .60) and fat (r = .60) yields. The potential value of using serum beta-lactoglobulin as an index for prescreening of heifers for lactation potential is discussed. PMID- 1779052 TI - Binding of mouse and rabbit iron-59 transferrins to lactating mouse mammary epithelial cells. AB - The binding of mouse and rabbit transferrins to lactating mouse mammary epithelial cells was tested in a 59Fe-protein-binding assay. The homologous and heterologous binding was slow during the first 30 min, after which the uptake steadily increased. In ligand concentration-dependent saturation studies, the heterologous rabbit protein showed a high degree of binding and required approximately 9.7 ng of ligand to saturate approximately 2 x 10(6) cells. The homologous mouse protein demonstrated a low degree of binding and failed to demonstrate saturation at the above ligand concentration. Scatchard plot for homologous binding data was nonlinear and implied a low (1.08 x 10(-10) M) and a high (1.82 x 10(-9) M) affinity interaction mechanism. However, the plot for heterologous binding was linear and characterized by one high affinity (1.0 x 10( 9) M) binding interaction. A total of 11,000 and 19,600 binding sites per cell were estimated for mouse and rabbit proteins, respectively. These data suggest a binding crossreactivity between mouse and rabbit transferrins. A high affinity binding mechanism seems to be conserved in proteins from both species; however, an additional low affinity binding was present only in the homologous system. PMID- 1779053 TI - Comparison of probiotic and antibiotic intramammary therapy of cattle with elevated somatic cell counts. AB - The effects of treating subclinical mastitis with intramammary infusions of either a Lactobacillus or an antibiotic preparation on intramammary infection cure rate and on milk SCC were compared. Cows with two consecutive monthly DHIA composite SCC greater than 300,000 cells/ml (5.4771 log10/ml) were defined as high SCC cows. Twenty-six subclinical cows were randomly assigned to one of two treatments. Quarter foremilk samples were obtained from all quarters at d 0, 7, and 14 following infusion to determine the microbiological status and SCC. Composite milk SCC were determined monthly by DHIA and at d 0, 7, and 14 of the study. Coagulase-negative staphylococci were the predominantly isolated pathogens. Treatment of cows with Lactobacillus cured 21.7% of infected quarters, whereas 73.7% of infections treated with antibiotic were eliminated. Treatment of quarters with antibiotic did not reduce quarter SCC unless infected quarters were cured. Intramammary infusion of quarters with Lactobacillus increased quarter SCC, mainly because of an increase in SCC of initially uninfected, low SCC quarters. Monthly composite SCC were similar between treatments. The results indicate that administering Lactobacillus or antibiotic treatment to all quarters based on elevated composite SCC should not be adopted. Lactobacillus treatment increased SCC with no effect on infection rate. PMID- 1779054 TI - Effect of milking without pulsation on teat duct colonization with Streptococcus agalactiae and penetrability to endotoxin. AB - Forty quarters of 10 cows were milked for a 9-d period with one of four treatments: 1) no liner pulsation, 2) conventional milking, 3) no pulsation for 4 d followed by conventional milking for 5 d, and 4) conventional milking for 4 d followed by milking without pulsation for 5 d. All teat orifices were inoculated with approximately .5 million cfu of Streptococcus agalactiae and Streptococcus dysgalactiae on d 1 and 5. Recoveries of Strep. agalactiae from the teat end were increased for teats milked without pulsation. Recoveries of Strep. dysgalactiae were lower than those of Strep. agalactiae and not increased by milking without pulsation. In a second experiment, teats of 20 cows were milked for a 15-d period with or without liner pulsation. For 10 successive milkings, all teats were inoculated with 1.0 micrograms of Escherichia coli endotoxin either immediately or 2.5 h after each milking. The frequency of endotoxin penetration, measured by the Wisconsin Mastitis Test, in pulsated quarters and in nonpulsated quarters was similar. For quarters milked without pulsation but not for pulsated quarters, inoculation of endotoxin immediately after milking led to greater incidence of teat duct penetration than for inoculation 2.5 h after milking. PMID- 1779055 TI - Regulation of in vitro metabolism of palmitate by carnitine and propionate in liver from dairy cows. AB - Regulation of in vitro palmitate metabolism by carnitine and propionate was investigated in liver obtained by biopsy from fasted nonlactating cows and from cows during early lactation. Liver slices from nonlactating cows during a 7-d fast esterified less palmitate than those from the same cows before fasting. Carnitine added in vitro increased hepatic oxidation and decreased esterification of palmitate in fed cows, but effects of carnitine were less during fasting. Propionate added in vitro decreased oxidation of palmitate; the effect was greater during fasting. In liver slices from cows during early lactation, carnitine increased oxidation and total utilization of palmitate and decreased palmitate esterification. Addition of tetradecylglycidic acid, an inhibitor of carnitine palmitoyltransferase I, prevented the carnitine-induced changes in palmitate metabolism. Substantial carnitine-independent oxidation of palmitate was observed in the presence of tetradecylglycidic acid. Tetradecylglycidic acid decreased esterification of palmitate to triglycerides but increased esterification to diglycerides. Effects of tetradecylglycidic acid and either propionate or pyruvate on palmitate oxidation were additive, indicating that propionate and pyruvate affect palmitate oxidation at sites other than carnitine palmitoyltransferase I. No interactions were detected between carnitine and propionate, but both compounds were potent regulators of palmitate metabolism in liver slices from cows during early lactation. PMID- 1779056 TI - Ruminal synthesis, biohydrogenation, and digestibility of fatty acids by dairy cows. AB - Ruminal synthesis and biohydrogenation of fatty acids in dairy cows were determined by sampling duodenal digesta through T-cannulas. Fatty acid digestibility in the total tract also was measured. Five diets (concentrate:alfalfa hay:alfalfa haylage:corn silage, 2:1:1:1, DM) in a 5 x 5 Latin square contained either no added fat; 3 or 6% added calcium soap; or 3 or 6% animal-vegetable blend fat. Seventy percent of dietary fatty acids were recovered at the duodenum, and 106 g/d were synthesized in the rumen regardless of diets. Fatty acids synthesized in greatest amounts were odd or branched chains, whereas more than 90% of the fatty acids shorter than 14 carbons disappeared. Fatty acids in calcium soap were biohydrogenated 57% and in animal vegetable blend 87%. Fatty acids in calcium soap were more digestible (80.0 vs. 75.7%) than those in the blended fat due to greater unsaturation in the small intestine. Ruminal microorganisms selectively synthesized fatty acids. PMID- 1779057 TI - Synthesis and biohydrogenation of fatty acids by ruminal microorganisms in vitro. AB - Ruminal degradation, synthesis, and biohydrogenation of fatty acids were examined in vitro. Diets were incubated with ruminal contents, and changes of fatty acids were measured. Two fat supplements, a calcium soap and an animal-vegetable blend, were included in diets at various levels. Addition to diets of acetate and isoacids (collective term for certain short-chain acids) also were tested for effects on fatty acid synthesis. Overall, 6.6 mg of fatty acids/g of fat-free diet were synthesized during 24-h incubation regardless of supplementations. Fatty acids synthesized in greatest amounts were odd-numbered or branched chains, whereas chains of 16 and 18 carbons changed little, and chains shorter than 14 carbons decreased. Degradation of [1-14C]palmitic acid was negligible, as determined by recovery of the label in CO2 (.03%) and acetate (1.09%) after 4-h incubation with rumen contents. Biohydrogenation of fatty acids averaged 47% in diets containing calcium soap and 71% with animal-vegetable blend. Synthesis and biohydrogenation were similar to those measured previously in vivo, showing that in vitro measurements reliably predicted metabolism of fatty acids in vivo. PMID- 1779058 TI - Feeding heat-treated full fat soybeans to cows in early lactation. AB - Forty-six multiparous Holstein cows were fed one of three total mixed diets from 15 to 119 d postpartum with alfalfa silage as the only forage. Each diet contained 50% forage and 50% concentrate on a DM basis. Diets were formulated to be isonitrogenous by replacing corn and solvent soybean meal with raw soybeans or heat-treated soybeans. The proportion of protein supplement in the diet on a DM basis was 10% soybean meal, 13% raw soybeans, or 13% heat-treated soybeans. The soybeans were heat-treated to maximize the amount of available lysine passing to the small intestine. The soybean meal diet was fed to all cows during wk 1 and 2 postpartum for covariate adjustment of DMI and milk production. Intake of DM was similar across treatments. Feeding heat-treated soybeans supported more milk (4.5 kg/d), 3.5% FCM (4.0 kg/d), and milk protein (.09 kg/d) than soybean meal or raw soybeans. Milk fat percentage was not altered by treatments. However, milk protein percentage was depressed in cows fed heat-treated soybeans compared with soybean meal (2.85 vs. 2.99%, respectively). Milk production response of cows fed properly heat-treated soybeans compared with soybean meal with alfalfa silage as the sole forage is thought to be related primarily to improved supply of undegraded intake protein. PMID- 1779059 TI - Effects of dietary fat and protein on fatty acid flow to the duodenum and in milk produced by dairy cows. AB - Four Holstein cows fitted with ruminal and duodenal cannulas were used in a 4 x 4 Latin square with treatments in a 2 x 2 factorial arrangement. Treatments were 1) soybean meal, no fat; 2) fish meal, no fat; 3) soybean meal, fat; and 4) fish meal, fat. Cows were fed for ad libitum intake a diet of alfalfa haylage, corn silage, and concentrate (30:20:50) on a DM basis. Intake of gross energy (105 Mcal/d) was not altered by treatment comparisons. However, feeding fat decreased energy digested in the rumen (15 vs. 24%) and increased energy digested postruminally (55 vs. 43%) but resulted in similar amounts of energy (72 Mcal/d) digested in the total tract. The flow of C14:0, C16:0, C18:0, C18:1, C18:2, C18:3, and total fatty acids to the duodenum was increased by feeding fat. The average flow of C14:0, total C18, and total fatty acids to the duodenum was greater than their intake for all treatments, suggesting de novo synthesis of fatty acids by ruminal microbes. Biohydrogenation of unsaturated C18 was decreased 70, 67, 59, and 51% for treatments 1 to 4, respectively, by feeding fat and fish meal. Digestibility of total fatty acids entering the small intestine (78%) was not altered by treatment comparisons; however, feeding fat altered digestibility of individual fatty acids. The proportion of C16:0 and C18:1 was increased, and the proportion of C6:0, C8:0, C10:0, C12:0, and C14:0 was decreased in milk fat produced by cows fed fat. PMID- 1779060 TI - Some blood minerals and hormones in cows fed variable mineral levels and ionic balance. AB - Eighty multiparous Holstein cows were assigned to eight treatments in a 2 x 2 x 2 factorial design to examine changes in serum parathyroid hormone, calcitonin, Ca, P, Mg, K, and Cl under two levels of dietary Ca and P with two anion-cation balances. Factor levels were low and high Ca (51 vs. 115 g/d), P (38 vs. 52 g/d), and cationic:anionic balance (23 vs. -8 meq). Cows were offered a TMR and an experimental mineral supplement to adjust mineral and anion-cation levels. Caudal vein blood samples were collected every 2 d from d -10 to +10 from calving. Serum K was lower for low Ca and high P compared with high Ca and low P treatments. Neither hormones nor the minerals examined in serum showed treatment effects. Cows of higher parity consumed less supplement and had lower serum Ca and P. All serum variables except calcitonin showed day to day variations. Both Ca and P decreased around parturition, whereas parathyroid hormone and Mg increased. Anionic diets did not differ from cationic diets regarding serum parathyroid hormone, calcitonin, Ca, P, Mg, K, Cl, or Na. PMID- 1779062 TI - Blood hemoglobin, plasma iron, and tissue iron in dams in late gestation, at calving, and in veal calves at delivery and later. AB - The effect of 100 ppm of Fe in milk replacer on some hematological and tissue Fe variables was studied during the first 7 wk of the fattening period in two groups of eight calves with low or high initial blood hemoglobin concentrations. Hemoglobin concentration in calves with initially low hemoglobin increased. It decreased in those with initially high hemoglobin, but the difference remained over the experimental period. Higher mean liver Fe concentration, in some cases extremely high, and lower mean total Fe-binding capacity were found throughout the experiment in the group with the initial high hemoglobin. Of all variables, only low muscle Fe concentrations were correlated linearly with plasma Fe. In another experiment, the relationship of some hematological and tissue Fe variables during late gestation (about 10 d prepartum), at calving in dams, and at delivery in calves was investigated. The calves showed markedly higher liver Fe concentrations at delivery than their dams just before delivery, but these liver Fe concentrations were not correlated between dam and calf. The hematological and tissue Fe variables showed a weak correlation between dams and calves during late gestation or at delivery. However, dams as well as calves were Fe-sufficient. PMID- 1779061 TI - Effects of copper status on neutrophil function, superoxide dismutase, and copper distribution in steers. AB - Twelve Holstein steers in a completely randomized block design were fed either a basal diet (concentrate:silage or hay at a DM ratio of 35:65) plus Cu sulfate at 20 ppm of Cu (Cu-supplemented diet) or a basal diet plus ammonium molybdate to obtain 10 ppm of Mo (Cu-depleting diet) on a DM basis in the whole diet for 8 mo. Supplemental Mo was utilized in the Cu-depleting diet to develop a Cu-deficient group. Molybdenum slowly accumulated in the liver in the group fed the Cu depleting diet. Copper concentrations in the liver and polymorphonuclear neutrophils decreased in the Cu-deficient group compared with the Cu-sufficient group. Plasma Cu concentration did not change during the trial for the Cu sufficient group. In the Cu-deficient group, plasma Cu concentrations increased during the first 3 mo of the trial, then declined, and remained unchanged for the last 5 mo. Superoxide dismutase activities in red blood cells, polymorphonuclear neutrophils, and whole blood decreased in the Cu-deficient group. Phagocytic capacity was not affected by Cu status, but killing capacity was decreased by low Cu status in the Cu-deficient group by the end of the trial. Glutathione peroxidase activity was unaffected by Cu status. Clinical symptoms of Cu deficiency were not observed in this trial; there was no evidence of blood hemoglobin or BW gain difference between the two groups. In this study, Cu status affected its distribution in the tissues and related enzyme activities as well as bactericidal function of neutrophils. PMID- 1779063 TI - Lactation response and body composition of cows receiving somatotropin and three ratios of forage to concentrate. AB - Ninety multiparous Holstein cows were used to determine the effect of ration energy density and bST on lactation performance and whole body chemical composition. Seventy-eight cows, averaging 43.6 d postpartum, were assigned for 168 d to TMR with forage: concentrate ratios of 40:60, 50:50, and 60:40 (DM basis). Half of the cows on each ration received subcutaneously either 0 or 640 mg bST/28 d. Whole body chemical composition was determined by comparative slaughter in 12 cows (means = 35.9 d postpartum) prior to initiation of treatment and in 35 cows after either 84 or 168 d of treatment. Net energy intake was greater for 40:60 and 50:50 than for 60:40. Milk fat percentage was reduced in cows fed 40:60. Ration did not affect milk, 3.5% FCM, and DMI. There were no differences among rations for total body fat, protein, water, and calories. The bST increased milk and 3.5% FCM but had no effect on DM and net energy intakes. Yield of 3.5% FCM by cows receiving bST and fed 40:60 was 1.9 kg/d more and for 50:50 it was 2.7 kg/d more than for those fed 60:40. Administration of bST reduced total body fat and calories but did not affect protein and water. Partitioning of calories to milk at the expense of fat deposition is the primary mechanism for the galactopoietic action of bST. PMID- 1779064 TI - Body composition of dairy cows according to lactation stage, somatotropin treatment, and concentrate supplementation. AB - Body weight, condition score, deuteriated water dilution space, estimated body lipids and proteins, and calculated energy and protein balances were determined in 24 multiparous Holstein cows at wk 1, 7, 20, and 39 after parturition. Cows received two levels of energy concentrate (high and low groups) from wk 3. The objective was to estimate changes in body composition as affected by stage of lactation, concentrate level, and bST administration or placebo from wk 9 in a 2 x 2 factorial design. Cows from high and low energy groups lost 25 and 35 kg of body lipids and 3.3 and .5 kg of body proteins, respectively, during the first 7 wk of lactation. During the end of the winter period (wk 8 to 20), control and bST-injected cows lost 8.5 and 21.1 kg of body lipids, respectively. During the grazing period (wk 20 to 39), bST-injected cows gained more BW (34 kg), water (36 kg), and estimated proteins (5.8 kg) and lost more condition score (-.2 units) and estimated lipids (-11.5 kg) than controls. Using data from control periods, it was calculated that 1 unit change in body condition score corresponded to changes of 35 to 44 kg in BW (corrected for estimated gut content variation), 21 to 29 kg in body lipids, and 200 to 300 Mcal in body energy. One kilogram of corrected BW change corresponded to a change of 4.3 or 5.5 to 5.9 Mcal in body energy when calculated from cumulative energy balances or body components, respectively. PMID- 1779065 TI - Effects of somatotropin and duodenal infusion of amino acids on nutrient passage to duodenum and performance of dairy cows. AB - Four multiparous Holstein cows were used in a 4 x 4 Latin square to investigate the effects of bST and postruminal infusion of lysine and methionine on ruminal fermentation, flow of nutrients to the small intestine, and animal performance. The treatments were 1) control; 2) control plus 24 g of lysine and 8 g of methionine/d; 3) control plus 25 mg of bST/d; and 4) control plus 25 mg of bST/d plus 24 g of lysine and 8 g of methionine/d. Intakes of DM, OM, CP, starch, NDF, and ADF were similar among treatments. Ruminal characteristics, flow of nutrients to the small intestine, and total tract apparent digestibilities of nutrients were not affected by injection of bST or postruminal infusion of lysine and methionine in this short-term experiment. Milk production, 4% FCM, milk fat percentage and yield, and production of milk CP were increased by administering bST. Postruminal infusion of lysine and methionine did not affect milk production or composition. PMID- 1779066 TI - Effects of copper sources and dietary cation-anion balance on copper availability and acid-base status in dairy calves. AB - Twenty-four Holstein and Jersey calves (14 Holstein), 4 to 11 d of age, were assigned randomly to six treatments in a 2 x 3 factorial arrangement to examine the effects of Cu sources and dietary cation-anion balance on Cu availability and acid-base balance. Treatments were cationic basal diet (20 meq of dietary cation anion balance on a DM basis), cationic basal diet supplemented with CuO, cationic basal diet supplemented with CuSO4, anionic basal diet (-10 meq), anionic basal diet supplemented with CuO, and anionic basal diet supplemented with CuSO4. Copper sources did not show any effect on growth of calves. The cationic diet increased calf growth compared with the anionic diet at wk 12 of the experiment. Blood pH was increased by the cationic diet in comparison with the anionic diet at wk 8 and 12. Blood pH also was increased by CuSO4 compared with CuO treatment in the early period of the treatment. Blood bicarbonate concentration was decreased by CuO and the anionic diet. Interactions between Cu sources and cation anion balance were found for blood pH and bicarbonate concentration. Liver Cu concentration was increased by CuSO4 but not by CuO supplementation compared with control. Therefore, CuSO4 was found to be highly available, whereas CuO was a very poorly available source of Cu for young calves. PMID- 1779067 TI - Multitrait animal model with genetic groups. AB - Genetic groups of unknown parents are extended to the multitrait animal model. Computationally feasible mixed model equations are obtained. A strategy to include genetic groups for missing data is proposed. Canonical and triangular transformations can be applied to the multitrait animal model with groups if the transformations can be applied to the same model without groups. Formulations for REML estimation with groups are derived, and the results are almost as feasible as REML estimation without groups. A numerical example is given to illustrate computations of REML formulations. PMID- 1779068 TI - Threshold models applied to Holstein conformation traits. AB - Threshold animal models were applied to five conformation traits of Canadian Holsteins. The estimated breeding values for sires from the threshold model allowed the calculation of predicted percentages of daughters in the desirable categories. Results were compared with those from a linear animal model in terms of their ability to predict future percentages of daughters in the desirable categories using an independent set of data. There was no advantage in a threshold model compared with a conventional linear animal model in its ability to predict future daughter performance. This was likely due to the 18 categories used in the classification of major type traits in Canada and the nearly normal distribution of observations across categories. PMID- 1779069 TI - Effect of season, genetic line, and sire on growth concentrations of somatotropin in serum of Holstein cows in early lactation. AB - To determine the effect of selection for milk yield on somatotropin concentrations, blood samples were collected from 128 Holstein cows whose sires had either high or average predicted differences for milk. The phenotypic difference in milk yield between the high and average yielding groups was 1726 kg on a 305-d mature equivalent basis. At 37 +/- 7 d postpartum, four blood samples were taken from each cow at 1-h intervals beginning at 0800 h. The statistical model contained genetic line, sires within line, and season as whole-plot effects and time of sampling as a subplot effect. The concentration of growth hormone was significantly higher in the high yielding group (1.89) than in the average yielding group (1.49). Cows sampled in summer had the highest concentrations of growth hormone, whereas cows sampled in spring had the lowest concentrations. Sires did not significantly influence the somatotropin concentration of their progeny. In a second analysis with seven extreme outliers (peak values) deleted, the variation of somatotropin concentrations in the cows was significantly accounted for by their sires. Repeatability of somatotropin concentration was .49 within cows. PMID- 1779070 TI - Direct response in yield and correlated response in components accompanying selection for milk yield in Jerseys. AB - In 1967, the Jersey herd at the Dairy Experiment Station, Lewisburg, TN was divided into two groups on the basis of ancestry, type, and breeding value for milk as part of a project to determine effects of single trait selection for high milk yield on yield and correlated traits. Control group was mated randomly to 20 unproven young sires selected randomly from those available from breeding studs in 1967. Selection group was mated to sires selected solely on the basis of their high transmitting ability for milk. Selection sires were selected at intervals and used for 4 yr. By the end of the project (1984), lactation information was available on 672 daughters (520 selection and 152 control) of 37 bulls (17 selection and 20 control). Differences in breeding values for milk, fat, and fat test as calculated from the PTA reported in the July 1989 USDA genetic evaluations and differences in first lactation mature equivalent production of milk, fat, fat test, and 4% FCM were examined. Linear mixed models were used for all analyses and contained the fixed effects group, generation within group, and year. Sires were random, nested within group, and used to test for group differences. Groups differed for all traits. Selection was superior to control in breeding value for milk and fat (828 and 31 kg) and for production of milk, fat, and 4% FCM (1066, 42, and 1061 kg). Control was superior to selection in breeding value and production fat test (.15 and .12%). Group differences existed within generation class for all yield traits but not for fat percentage. Realized response closely matched or exceeded expected response as estimated from pedigree information. PMID- 1779071 TI - Evaluation of decoquinate or lasalocid against coccidiosis from natural exposure in neonatal dairy calves. AB - Forty-one Holstein and Brown Swiss calves were raised as herd replacements under conditions in which they were allowed natural exposure to sporulated coccidial oocysts at a very early age. Two compounds previously shown to have anticoccidial efficacies, decoquinate and lasalocid, were used for this study. Calves were assigned randomly at birth to one of the treatments: decoquinate (approximately .5 mg/kg of BW) or lasalocid (approximately 1.0 mg/kg of BW) or to remain as unmedicated controls through 16 or 24 wk of age. Counts of fecal oocysts were reduced in the calves fed decoquinate for wk 4 to 8 and for both treated groups for wk 9 to 24. Calves fed decoquinate had increased BW, heart girth, and height at withers during wk 5 to 8. Both treated groups had higher gains than untreated calves during wk 12 to 16 with the decoquinate group larger than the lasalocid group. Feeding an anticoccidial compound to newborn calves reduced severity of coccidiosis when early natural exposure occurred. PMID- 1779072 TI - The composition of milk fat. AB - Bovine milk contains about 3.5 to 5% total lipid, existing as emulsified globules 2 to 4 microns in diameter and coated with a membrane derived from the secreting cell. In homogenized milk, the coat is mostly casein. About 98% or more of the lipid is triacylglycerol, which is found in the globule. Phospholipids are about .5 to 1% of total lipids, and sterols are .2 to .5%. These are mostly located in the globule membrane. Cholesterol is the major sterol at 10 to 20 mg/dl. Data are presented on the membrane and the emulsion. Bovine milk contains substantial quantities of C4:0 to C10:0, about 2% each of C18:2 and trans-C18:1, and almost no other long-chain polyunsaturated fatty acids. The fatty acid composition is not altered by ordinary changes in diet. The triacylglycerol structure is unique, with much of the C4:0 to C10:0 at sn-3. The effects of milk cholesterol and fatty acids on human blood cholesterol levels and nonnutritive roles of some microlipids are discussed. PMID- 1779073 TI - Effect of feed on the composition of milk fat. AB - Researchers attending the Wisconsin Milk Board 1988 Milk Fat Roundtable indicated that the ideal nutritional milk fat would contain 10% polyunsaturated fatty acids, 8% saturated fatty acids, and 82% monounsaturated fatty acids. This cannot be accomplished by modifying diets of lactating cows. Monounsaturated fatty acid (C18:1) content can be increased by 50 to 80% and may approach 50% of milk fatty acids by feeding lipids rich in 18-carbon fatty acids. Because of ruminal hydrogenation and intestinal and mammary desaturase activity, degree of unsaturation of dietary 18-carbon fatty acids is not critical in influencing milk fat C18:1. Feeding low roughage diets increases the proportion of C18:1 in milk fat, and effects of feeding low roughage diets and lipid may be additive. Palmitic acid (C16:0) content of milk fat can be reduced by 20 to 40% unless the supplemented lipid is rich in C16:0. Milk fat alteration is dependent on the level of lipid supplementation. Limited evidence indicates frequency of lipid feeding and physical form of oil (free oil vs. oilseed), and heat treatment of oilseeds has relatively little influence on modification of milk fat. Significant changes in milk fat composition can be achieved on farm via nutritional modifications. PMID- 1779074 TI - The potential for genetic change in milk fat composition. AB - Effecting genetic improvement requires genetic variation, a mechanism of selection, and an economic incentive for the improvement. Limited data suggest that there is within-breed genetic variation in milk fat composition, but accurate estimates are lacking. There is some evidence for modest differences among breeds. Substantial differences exist among species, indicating that substantial genetic change in fat composition is biologically possible. The economic incentives for genetic change are not clear. Changes in fat composition that would improve the quality of one milk product would often be detrimental to other products. Such changes would best work where subpopulations produced milk for specific end products. Such division of the industry would be difficult to organize and might impede existing improvement programs. Changes in fat composition that increased consumer acceptance of milk products, such as reduced saturated fat concentration, might increase the market for milk products. However, only large changes in composition are likely to affect consumer acceptance; thus, the gradual changes of conventional genetic improvement would produce little or no return to the breeder. Genetic changes that reduced processing costs or increased product value might have low to moderate economic value, inducing slow rates of change. Production of transgenic animals might provide a route for genetic alteration of fat composition in the future. Such improvement would most likely be cost effective in a subdivided production industry in which milk from cows of a particular genotype can be directed to a particular milk product. It is concluded that although alteration of fat composition could be achieved, it is unlikely to be an important component of genetic improvement of dairy cattle. PMID- 1779075 TI - Linen in the hospital bed: effects on patients' well-being. AB - The aim of the study was to determine if using linen in hospital beds affects patients' well-being. An experimental group consisting of 52 patients (mean age: 64.4 years) at a medical ward used linen in the bottom sheet, the protective sheet, the pillow-case and the patient gown for 4 weeks. A control group consisting of 40 patients (mean age: 67.5 years) at the same ward was observed for 4 weeks using the conventional material (cotton, cotton/polyester). Marginal positive effects on patients' well-being were noted when linen was used. It was discussed that the relative importance of the bed material to patients' well being may be low, compared to medical treatment, nursing, etc. Given the high cost of linen, about 15 times more than the conventional material, it was suggested that the health care system should refrain from large-scale use of linen in hospital beds. PMID- 1779076 TI - How well do nurses care for their own? PMID- 1779077 TI - An analysis of caring: attributions, contributions and resolutions. AB - This paper presents a study of the particular dynamics within hospitals that act as counterproductive forces to caring. To this end, the insights revealed by Isabel Menzies Lyth, following her observations of a large London teaching hospital, will be explored. She argues that hospitals are environments conducive to the erection of primitive social defence systems that generate internal conflict and persecution anxiety within its staff. These social defence systems, in turn, militate against efforts directed towards caring. This results in feelings of guilt, depression and dependency that rapidly establish a negative cycle of affects. Such negative affections, once set in train, are difficult to terminate and transform into a positive cycle of affections. Following this analysis, it will be argued that the hospital environment is unequal to the task of caring for the caregivers because it is permeated with ontological, spiritual and moral anxiety, all of which act as serious impediments to the caring enterprise. PMID- 1779078 TI - Two portraits of caring: a comparison of the artists, Leininger and Watson. AB - Two nursing leaders, Madeleine Leininger and Jean Watson, have devoted their careers to studying and evolving the meaning of caring. The theme of caring as presented by each theorist was explored along with their views of the nature of nursing, use of theory development strategies, and their individual contributions to the development of nursing knowledge. Both identify nursing as a humanistic science, with the concept of caring being the central unifying domain of nursing. Consistent with their belief that the humanistic sciences require a different research methodology to study that which is uniquely human, both have utilized qualitative research methodologies in their study of care. The evolution of each theorist perspective of care reflects their own background and experiences. Each theorist, therefore, has painted a different portrait of caring, demonstrating a differing emphasis on philosophical, cultural and empirical concerns. For Leininger, caring must be placed in a cultural context since caring patterns can differ transculturally. Watson has focused on the philosophic (existential- phenomenological) and spiritual basis of caring and sees caring as the ethical and moral ideal of nursing. Both Leininger and Watson have demonstrated their artistry in their individual portraits of caring and in their contributions to the development of nursing knowledge. PMID- 1779079 TI - Nursing: just a job? Do statistics tell us what we think? AB - This study considers the value of classifying attitudinal statements given by nurses in a questionnaire by the statistical procedure of latent class analysis. It demonstrates with the use of qualitative data derived from in-depth interviews how precarious are the groups derived from statistical analysis. However, it is argued that the apparent discrepancies between responses 'objectively' derived by a statistical approach and those 'subjectively' declared by respondents may focus on different levels of meaning and may well provide a useful resource. Most importantly, it is stressed that a dynamic model is needed which recognizes change and the consequences of change. PMID- 1779081 TI - Being friendly and informal: reflected in nurses', terminally ill patients' and relatives' conversations at home. AB - The aspect of the study discussed is part of the analysis of audio-recorded, naturally occurring conversations between symptom control team (SCT) nurses, terminally ill cancer patients and their relatives in their own homes over a 3 month period. Using an ethnographic, extended case-study approach, four 'role formats' were identified as consistently used by the SCT nurses to carry out their work through conversation, one of them being 'friendly and informal'. The SCT nurses explicitly made it known to patients and their relatives that they intended to be 'friendly and informal'. How such a claim was translated into practice, both non-conversationally and through conversation, is the focus of this paper. Being 'friends' and being 'friendly and informal' with patients and clients is frequently advocated in medical and nursing literature, but how this is achieved in practice and the responses of patients seems unstudied. Therefore, the analysis discussed in this paper opens up for critical reflection an unquestioned, taken-for-granted aspect of practice where it is demonstrated how 'friendliness and informality' are conveyed through chatting and how it differs from 'formal' conversations. PMID- 1779080 TI - Needs and anxiety levels in relatives of intensive care unit patients. AB - The purpose of this study was to explore the perceived needs and anxiety levels of adult family members of intensive care unit (ICU) patients. The study was conducted over a 3-month period, on a convenience sample of 166 subjects selected from the total adult population of family members visiting an ICU patient in three Sudbury hospitals. Data were gathered using a self-report questionnaire, the Critical Care Family Needs Inventory (CCFNI) and Spielberger's State Trait Anxiety Inventory (STAI). Interviews were conducted in French or English according to the subject's preference. The major variables examined were: family needs; state and trait anxiety; on-site sources of worry; spiritual needs; level of knowledge of ICU from past experience or pre-surgery education; sociodemographic data. The Situational Anxiety Scale yielded a mean score of 45.24 and the Trait Anxiety Scale a mean score of 37.3. Inferential statistics demonstrated that family needs and situational anxiety were significantly related (P less than 0.0002). Furthermore, worries, trait anxiety, age and family needs explained 38% of the variation of situational anxiety. As well, spiritual needs and situational anxiety explained 33% of the variation of family needs. PMID- 1779082 TI - Patients' experiences following cranial radiotherapy: a study of the somnolence syndrome. AB - The aim of this study was to establish whether somnolence syndrome existed in adults by exploring their experiences after receiving cranial radiotherapy. Somnolence syndrome is described as excessive sleep, drowsiness, lethargy and anorexia and was found to occur in these patients. A description of the phenomenon was drawn from triangulation of the data. For 6 weeks following radiotherapy, the participants completed a diary consisting of two elements, a quantitative visual analogue scale and an open diary. This was followed by a qualitative semi-structured interview. Patients experienced sleepiness which they described as 'exhausted doing nothing' and that any activity was a 'struggle'. Some individuals described sensory changes, deafness and an increase in leg and arm weakness. These experiences presented a series of unexpected changes in their health which resulted in fear of treatment failure and disease recurrence. The study suggests that more information should be provided for patients on the side effects that occur after radiotherapy has finished. Somnolence syndrome presented for the participants an experience which is not adequately described in previous literature. The nurse has an important role in providing information to prepare patients for their experience and more knowledge about this phenomenon is required for these patients to be informed adequately. PMID- 1779083 TI - Ethical conflicts in placebo treatment. AB - In this paper the pros and cons of using placebo are discussed from the point of view of ethical theories and principles. The effects of placebo are exemplified by findings from previous studies, and an authentic case serves to illustrate ethical dilemmas arising both for the caregiver and the patient in conjunction with the use of placebo. Placebo treatment is discussed from deontological and utilitarianist points of view, and violation of the ethical principles, beneficence, non-maleficence, justice, autonomy and truth-telling, are considered. PMID- 1779084 TI - A double-blind clinical trial to compare the efficacy of an active based cream F14001 against a placebo non-active based cream for the treatment of pressure ulcers in a population of elderly subjects. AB - A double-blind clinical trial was conducted to compare the efficacy of an active based cream against a placebo non-active based cream in the healing of superficial pressure ulcers in a population of geriatric hospital patients and residents in community nursing homes. The active group showed a small significant beneficial effect at week four. The overall results of the trial also demonstrated a significant improvement in ulcer size over the duration of the trial period in both active and placebo groups. PMID- 1779085 TI - Reality basis for teaching psychomotor skills in a tertiary nursing curriculum. AB - This paper, written whilst the authors were working at Curtin University, Western Australia, describes a process of determining the psychomotor skills to be taught in an undergraduate nursing programme. It outlines how consultation with clinical agencies enhanced the planning of the skills component within the new nursing curriculum and details the outcomes in terms of faculty development and curriculum design. PMID- 1779086 TI - Conflicting paradigms of health visiting: a continuing debate for professional practice. AB - The interpretation of health visiting practice has formed the focus of a professional debate amongst practitioners and those involved in health visiting education for many years. More recently, changes in nurse education, government legislation and general anxiety about the future of health visiting have added to the intensity of the debate. In re-examining the conceptual origins of health visiting, this paper proposes one possible explanation for this phenomenon in which the author describes four conflicting paradigms of practice. The author argues that it is the tendency of practitioners to adopt one specific paradigm of practice which has contributed to the continuing debate and current professional uncertainty experienced by health visitors. The authors goes on to suggest a conceptual framework for practice developed from an epistemology of practice grounded in reflection in practice and the principles of health visiting. It is argued that this approach to practice allows practitioners to reconsider their practice in terms of the values and beliefs underpinning health visiting rather than identified tasks and client groups. It may also provide practitioners with the opportunity of developing and adapting strategies to meet current health needs rather than the traditions of practice. PMID- 1779087 TI - Factors which contribute to fatigue associated with rheumatoid arthritis. AB - The purpose of this research was to identify the factors which people with rheumatoid arthritis (RA) believed contributed to their fatigue. A second purpose was to examine the relationships among identified factors and the sensation of fatigue. One hundred people with RA were asked to identify verbally factors which they believed contributed to their fatigue. The three most frequently identified factors included RA disease activity, disturbed sleep and increased physical effort. These factors were operationalized and measured as joint pain using the Modified McGill Pain Inventory, fragmented sleep through overnight electroencephalographic (EEG) sleep studies, and reduced physical ability using walking time and grip strength measures. Fifteen of the original subjects with RA and 12 age and gender matched control subjects completed the second phase of the research. Five of the RA subjects were experiencing a disease flare while the remaining 10 were either in remission or their disease was midly active. Those subjects in flare had significantly (P less than 0.01) more joint pain, significantly (P less than 0.05) more fragmented sleep, and significantly reduced functional capacity as measured through walking time (P less than 0.05) and grip strength (P less than 0.05) when compared to non-flare and control subjects. Fatigue levels of the subjects in flare were positively correlated with joint pain (r = 0.62), fragmented sleep (r = 0.42) and grip strength of the right hand (r = 0.52) and left hand (r = 0.88). Fatigue levels of non-flare and control subjects were negatively correlated with the majority of measured variables.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779088 TI - Changes initiated by a nursing supervision programme: an analysis based on log linear models. AB - The paper discusses the effects of a nursing supervision programme on nursing practices, more specifically on how nurses take their patients' needs into account. The analysis is based on the need theory by Yura and Walsh and examines the changes initiated by the programme on the basis of the subjects' own experiences. The study was carried out in three Finnish public health care organizations. A total of 26 specially trained nurses took part in the supervision programme. The data were collected by a questionnaire immediately before and after the programme and, in order to evaluate long-term effects, 1 year later. Log-linear models were the main method of analysis. The results indicate that the programme had some very favourable effects. According to the nurses involved, their freedom of action and willingness to act, as well as nursing activity itself, had greatly improved. The change was most noticeable in the case of willingness to act. The nurses also felt that the programme had helped them to understand better the relationship between these three components. The results provide some useful clues with regard to the effects of nursing routines and the organization's nursing culture on the nurse's job and her activity. PMID- 1779089 TI - Nurses' opinions of the introduction of computer-assisted learning for use in patient education. AB - Computers have only recently begun to find a place in the everyday work of health care staff. The use of computer-assisted learning (CAL) in patient education is in its infancy. However, the medium appears to offer several advantages to patients. The successful integration of the medium into clinical practice requires the acceptance and support of staff members. Little research exists to date which examines staff responses to the introduction of CAL into their workplace. This small study (n = 14) aims to explore the reactions of staff to the introduction of an experimental CAL package for use in the education of renal patients on continuous ambulatory peritoneal dialysis (CAPD). The opinions of staff members to CAL are probed and their views ascertained regarding the usefulness of CAL to both staff and patients. Results suggest that, despite their initial reservations about CAL, staff were generally positive about the medium. PMID- 1779090 TI - South African nurses' opinions of different organizations: policy implications. AB - There has been considerable debate in South Africa as to what type of organization would best represent the interests of nurses and facilitate their contribution to the achievement of changes in health care. This paper reports their background to and findings of the opinions of nurses in South Africa of different organizations, namely a professional nursing association, a health worker organization and a trade union. The results of the survey show that the South African Nursing Association has performed reasonably in meeting nurses' professional needs, but poorly in meeting their socio-economic needs. There is dissatisfaction with some of the Association's policies, widespread ignorance about trade unions and health worker organizations and resistance to strike action. The policy implications of the findings for the future organization of nurses in South Africa are explored. PMID- 1779091 TI - Biotinylation of denatured double-stranded DNA after transamination of cytidines: molecular biology applications. AB - Transamination at 100 degrees C of cytosines in denatured double-strand DNA is a rapid and reliable method to obtain DNA molecules containing N4 aminoethylcytosine (4aeC), which can be quantitatively conjugated to biotinyl-N hydroxysuccinimide ester (BHS) at 37 degrees C, yielding chemically labelled probes for molecular hybridization. The adopted transamination reaction temperature allows for a ten-fold reduction of the time required for labelling at 42 degrees C, and probes obtained by this procedure are equally effective for general use in molecular biology. Dot-blots with 1-5 pg of target lambda DNA were detected by streptavidin-acid phosphatase complex after hybridization with its homologous sequences. Chemically biotinylated mouse satellite DNA has been used in combination with avidin-horseradish peroxidase to detect metaphase and interphase centromeres via in situ hybridization. Moreover probes labelled with differentially spaced linker arms were prepared by this method. PMID- 1779092 TI - A western blotting procedure for detection of metallothionein. AB - A method to detect metallothionein (MT) by Western blotting technique is described. Cadmium-containing rat MT-I and -II were subjected to sodium dodecylsulfate/polyacrylamide gel electrophoresis (SDS-PAGE) without prior reduction by 2-mercaptoethanol (2-ME), because prior reduction of MTs by 2-ME resulted in diffused bands. After SDS-PAGE, MTs in the gel were reduced by incubating in buffer containing 2-ME, and then electrophoretically transferred to a polyvinylidene fluoride membrane. Non-reduced MTs were not found to be immobilized on the membrane. Prior to electrophoresis the zinc, in zinc containing MT samples, must be replaced with cadmium by addition of excess cadmium chloride. MTs immobilized on the membrane were detected by two methods, (1) binding of radioactive cadmium and (2) immunochemical staining using protein A/colloidal gold conjugate, the detection limits of which were 0.4 and 0.06-0.16 micrograms, respectively. PMID- 1779093 TI - A continuous spectrophotometric method for monitoring phospholipase D-catalyzed reactions of physiological substrates. AB - A continuous spectrophotometric method for monitoring phospholipase D-catalyzed hydrolysis of long acyl chain phosphatidylcholines has been formulated at pH 8.0 in a mixed detergent system using the coupling enzymes choline oxidase and peroxidase. Standard curves for phosphatidylcholine determination in both end point and rate modes are presented and applied to the estimation of that phospholipid in a solubilized human erythrocyte membrane sample. In rate mode the method is suitable for kinetic study of phospholipase D with physiological substrates in micellar form. PMID- 1779094 TI - Automatic method for quantitation of mercury in blood, plasma and urine. AB - Here we report our experience of quantification of mercury in blood, plasma and urine by using modifications of a procedure for cold vapour atomic absorption. We have tried: (1) modifications of the instrumentation including the tower, the cell and apparatus for measurement; (2) to increase the volume of sample, avoiding problems caused by foaming and background to arrive at a reliable method with low detection limit. Blood and plasma samples were digested overnight in a mixture of nitric acid and perchloric acid (1:5). Recovery of known additions of mercury was close to 100%. Coefficients of variation (CV) within runs and between runs was for B-Hg 4.7 and 9.5, respectively at 20 nmol/l, and for U-Hg 1.8 and 5.2, respectively at 57 nmol/l. The same detection limit of 5 nmol/l was obtained with blood, plasma and urine. This is in the lower range of non-occupationally exposed normal subjects. The results, including those obtained in sample exchange with other laboratories and with reference materials, indicate that the accuracy of this method for quantification of mercury is good. PMID- 1779095 TI - Fluorimetric quantification of cell death in monolayer cultures and cell suspensions. AB - A fluorimetric assay using ethidium bromide (EB) was employed to quantify cell death in monolayer cell cultures (MA-104 cells) in situ and isolated cell suspensions (isolated colonic cells and Leishmania). Fluorescence of EB stained cells was measured with a photometer coupled to an inverted microscope for cell monolayers or in a spectrofluorometer for cell suspensions. Dead cells stained with trypan blue were fluorescent with EB in all preparations studied, but the latter gave an unequivocal signal. Staining with EB and fluorescein diacetate was mutually exclusive. The relationship between the number of EB fluorescent cells and the intensity of fluorescence measured in the microphotometer was linear for a large range of cell numbers (1-14000) from different types of preparations. Applicability of the method for measuring living and dead cells in two different time scales (minutes and hours) is shown using MA-104 cell monolayers infected with rotavirus and Leishmania suspensions treated with amphotericin B. The method is fast, simple, sensitive and reliable, enabling quantification of living and dead cells in monolayers and suspensions. PMID- 1779096 TI - A spectrophotometric assay for lipase activity utilizing immobilized triacylglycerols. AB - New substrates for the determination of lipase activity have been developed. Triacylglycerols were immobilized by adsorption on an appropriate carrier or adsorbent yielding a lipase substrate in a powder form. The adsorbed triacylglycerols were easily hydrolyzed by lipases present in a reaction mixture. The released fatty acids were extracted with benzene and converted to the corresponding Cu (II) salts (copper soaps) which were measured spectrophotometrically. PMID- 1779097 TI - Fast titration experiments using heat conduction microcalorimeters. AB - Thermopile heat conduction calorimeters normally have high time constants. Multistep titration experiments involving fast processes may then require several hours to perform. It is demonstrated that such experiments can be conducted about 10 times faster, without loss of accuracy, by use of a "dynamic correction method". For a new small vessel thermopile conduction calorimeter, injections can be made at 1.5-min intervals. PMID- 1779098 TI - 13C-NMR studies of membrane lipid-protein interactions upon protein heat denaturation. AB - Spinach chloroplast membranes were studied by natural abundance carbon-13 nuclear magnetic resonance (13C-NMR) spectroscopy in their normal state and after heat denaturation of membrane proteins. The membrane proteins were denatured by raising the temperature of the sample to 67 degrees C for 5 minutes [YashRoy, R.C. (1991) J. Biochem. Biophys. Methods 22, 55-59]. Line-broadening of 13C-NMR resonances arising from the 1st (carbonyl), 7th, 9th and 12th carbon atom of fatty-acyl chains with reference to the carbonyl (C-1) group shows increased immobilization of lipid fatty-acyl chains at these locations, obviously caused by changes in interactions between membrane lipids and proteins upon heat denaturation of membrane proteins. PMID- 1779099 TI - [Reversibility of visual field defects in primary open-angle glaucoma]. AB - The course of the glaucomatous visual field seems to be best followed by computerized perimetry which allows threshold evaluation in a great number of locations and statistical analysis of the results. To determine the visual field defect reversibility, 16 patients (27 eyes) affected by uncontrolled open-angle glaucoma underwent visual field analysis before and after prescription of a new medical therapy. To avoid the "learning effect" and to decrease the influence of the heterogeneous component of long-term fluctuation, the visual field examination was repeated within 48 hours whenever a change in sensitivity was detected. In addition a total of 10 normal eyes in 10 patients were tested as a control group. A statistically significant threshold improvement was demonstrable after one week of therapy in 31.7% of the eyes. PMID- 1779100 TI - [Comparative study of 2 types of bifocal implants by measurement of visual acuity and contrast sensitivity]. AB - Evaluation of multifocal IOLs suggests the possibility of two retinal images, one for near and one for distant vision. But the optic principles of multifocal IOLs created overlying images and incident light division. We performed this study to evaluate visual acuity and contrast sensitivity for two types of bifocal IOLs (3M bifocal and IOLAB bifocal IOL) and for a control group of monofocal IOL testing in different levels of luminance simulating the normal environmental conditions of the patient's experience. The results showed a visual functional loss especially at the low luminance level for the 3M bifocal group and at bright luminance for the IOLAB bifocal group, which was previously unknown with and consequences for the indications and exclusions of this kind of IOL. PMID- 1779101 TI - [Surgical treatment of non-traumatic retinal detachment in children under 15 years of age]. AB - Etiological and clinical features of 151 retinal detachments in childhood are studied and discussed. Results of surgical management of 92 of them, after at least a 6 month follow-up, especially after ablation of silicon oil when used temporarily, are described. Clinical aspects of the contralateral eyes and their prophylactic treatment is also studied. Though surgical techniques have done great strides, prognosis of retinal detachment in childhood is still desperately poor. Proliferative vitreo-retinopathy, frequent, early and very progressive, is the leading complication and cause of failure in surgical of these retinal detachment. In this series of 151 retinal detachments, only 38% have achieved long term retinal reattachment because of it. If high grade (C-D) proliferative vitreo-retinopathy is associated 14.5% only achieved long term reattachment though 86% it when proliferative vitreo-retinopathy was moderate or absent. It is for this reason that we wish to emphasize the need to inform practitioners and "at risk" families. Strict and systematic follow-up of the "at risk eye" is essential. The most complete surgery at the outset seems to be the best way of managing high-grade proliferative vitreo-retinopathy associated with retinal detachments. PMID- 1779102 TI - [Surgical treatment of traumatic retinal detachment in children under 15 years of age]. AB - The clinical features and results of surgical management of 68 out of a series of 101 cases of traumatic retinal detachment in childhood are described and analysed. Follow-up, in particular after the removal of silicon oil used temporarily, was always been longer than six months. Cases were divided into three groups: contusions, ocular injuries without foreign body and with foreign body. Cases of retinal detachment related to traumatic aphakia, severe myopia and associated with proliferative vitreo-retinopathy were also studied. The prognosis of retinal detachment in childhood, the main characteristics of which are late diagnosis and the early and rapid growth of proliferative vitreo-retinopathy appears to be worse in this series than usually published figures. Proliferative vitreo-retinopathy is the leading cause of surgical failure. The long term retinal reattachment rate did not exceed fifty per cent and the functional success rate was only thirty-three per cent. It is for this reason that the authors wish to emphasize the need for the provision of information to families and to ophthalmologists responsible for the management of these "high risk eyes". It is felt that the most complete surgery possible should be performed at the outset when proliferative vitreo-retinopathy exists. PMID- 1779103 TI - [Treatment of dry eye syndrome with lacrimal gel: a randomized multicenter study]. AB - The appearance on the French market of a carbomer tear substitute, Gel-Larmes, an original galenic form, constitutes a real therapeutic progress in the treatment of dry eye syndrome. An open randomized multicentric trial was conducted comparing the tolerance and efficacy of Gel-Larmes with those of eye drops containing chondroitin sulphate. The statistical analysis evidences an inferior average number of daily instillations for Gel-Larmes, its better efficacy on the symptoms as well as on the objective criteria: biomicroscopic examination, break up time, rose Bengal test. The tolerance of the product is excellent and 81% of the patients express their wish to pursue Gel-Larmes versus 54% for the reference product. PMID- 1779104 TI - [Familial coexistence of the association: Fabry's syndrome and congenital ptosis]. AB - The authors undertook a clinical and genetic study in a large family with the aim of identifying the mode of inheritance of Fabry syndrome and congenital ptosis. These two types of pathology were present to varying extents. The family pedigree consisted of 95 individuals, spanning 5 generations. Three individuals (males) were found to have Fabry syndrome and 14 (males and females) congenital ptosis. The patients with Fabry syndrome also had congenital ptosis. According to these results, Fabry syndrome is inherited by an X-linked recessive mode and congenital ptosis by an autosomal dominant mode. PMID- 1779105 TI - [Anaerobic ocular infections]. PMID- 1779106 TI - [Unilateral paralysis of the levator muscles]. AB - Double elevator palsy is rare clinical disorder of ocular motility characterised by a unilateral palsy of the superior rectus and inferior oblique with a resultant inability or reduced ability to elevate the affected eye on abduction as well as on adduction. The term double elevator palsy has been used to describe clinical cases that certainly do not have the features of the true paralysis. It is useful to distinguish between: true double elevator palsy characterised by hypotropia of the paretic eye in primary gaze, by a limitation of elevation in abduction and in adduction, by a negative forced duction test and by presence of Bell phenomenon; the clinical form in which prolonged hypotropia has produced a contracture of the ipsilateral antagonist; isolated inferior restriction combined with limitation of elevation and normal elevator muscle function. The clinical case reported is that of a patient suffering from a right double elevator paralysis, probably congenital, corresponding to Type 1 of White's classification. PMID- 1779107 TI - [Mucoepidermoid carcinoma of the conjunctiva with intraocular invasion. Apropos of a case]. AB - One case of mucoepidermoid carcinoma of the conjunctiva with intraocular invasion is described. Review of literature retrieve 15 cases of conjunctival localisation of mucoepidermoid carcinoma. These tumors appear to be locally aggressive, they all invade the intraocular or intraorbital structures. They require always a radical surgery with wide excision. Histopathologically, histochemical stains for glycoproteins confirm the diagnosis with admixture of squamous and mucus secreting cells. PMID- 1779108 TI - [Treatment of herpetic keratitis]. PMID- 1779109 TI - [Retino-vitreous hemorrhage in hemoglobinopathies]. AB - During 15 months all the patients with retinal or vitreous hemorrhages diagnosed in departments of ophthalmology or internal medicine in Bamako (Mali) were submitted to an aetiological assessment. Only patients with hemorrhages caused by a general aetiology were included in the study. 64 cases were selected according to these criteria. Hemoglobinopathies were involved in 14.1% of cases, high blood pressure in 31.8%, diabetes mellitus in 10.9% and miscellaneous causes in 15.6%. In 26.6% of cases an association between several of these aetiologies was observed. SC hemoglobin was the most frequent and the most serious. AS and AC traits were involved in 2 retinal hemorrhages' cases. AS and AC traits' responsibility in ocular hemorrhages associated with diabetes mellitus or high blood pressure was doubtful. A frequent association of sickle cell trait and high blood pressure was noticed. One case of Eales syndrome is reported during a diabetes mellitus-AS trait. All the patients were submitted to a treatment by pentoxifylline. Moreover 5 patients were treated by a laser coagulation and 2 patients by cryoapplication. The interest of the hemoglobin electrophoresis for the aetiologic assessment of retinal and vitreous hemorrhages is stressed. PMID- 1779110 TI - [Oncologic and functional results of 57 malignant melanoma of the uvea treated by curietherapy]. AB - Fifty-seven uveal malignant melanomas (T2: 36.8%; T3: 49.1%) were treated between 1983 and 1989 with Cobalt 60 or/and Ruthenium 106 Rhodium 106 plaques. The mean follow-up was 32 months (from 6 to 69 months). A diminution of tumor size was observed in 88% of the cases, either rapid and marked (57%), or slower and more moderate (31%). A multivariate study showed the radiation dose administered to the tumor edge to be the most significant parameter associated with the tumor control. Seven patients developed metastases, and the probability of survival at 60 months was 83.3%. This probability was identical to that of 59 comparable patients treated, some years before, by enucleation. The most frequent complications were radiation retinopathy (28.1%) and retinal detachment (15.8%). The treated eye was retained in 86% of cases. In 57% of treated eyes, vision remained better or equal to 0.1. The predictive parameters of vision impairment after treatment seemed to be tumor size, tumor site near the macula and the optic nerve, and the radiation dose to the tumor base. The use of Ruthenium 106 Rhodium 106 appeared to be advantageous in controlling the disease as well as in reducing the incidence of complications. PMID- 1779111 TI - [Preventive treatment of retinal detachment of the contralateral eye. Results of 5 years follow-up of 109 eyes]. AB - In 1987, we presented a study of 141 eyes treated prophylactically following retinal detachment in the fellow eye. A hundred and nine of these patients are reviewed with a minimum follow-up of five years. Only the evolution was studied, whether a peripheral retinal lesion was present or not at the time of prophylactic treatment. The examiner noted if new lesions had occurred, or if lesions present at the time of the first examination had developed: lattice degeneration or snail track developing into a retinal tear, hole or tear causing a retinal detachment, contained or not by laser treatment. Our study contained sixty two myopes. Fifty eyes had visible, dangerous lesions, and fifty nine a normal retina. Forty five circular barrages with four anterior radial rows returning to the ora serrata were performed, and sixty four barrages with tight anterior grids and a localised barrage of visible lesions. The results were judged on one criterion only: retinal detachment requiring emergency surgery. Only one retinal detachment occurred behind the barrage, caused by proliferative vitreoretinopathy due to multiple tears, and surgical results were good. Eight tears appeared in front of the barrage, five of these in healthy retina. Two very posterior tears behind the barrage were blocked with no problem by laser treatment. Four localised detachments occurred in front of the barrage, three of these without anterior grid treatment. The advantage of this is undeniable since out of sixty three cases treated in this way, only three tears were seen to be blocked by the laser shots, and one anterior localised detachment where the anterior grid was insufficient.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779112 TI - [Ocular pathologies related to carotid artery stenoses and occlusions]. PMID- 1779113 TI - [Microanalysis in ophthalmology]. PMID- 1779114 TI - [Development of vision in infants]. PMID- 1779115 TI - [Accuracy and reproducibility of Nidek's photokeratoanalyser]. AB - We studied the accuracy and reproducibility of the keratoscope PKS 1,000 and keratoanalyser PKA 1,000 (Nidek laboratory). When calibrated steel balls are studied without any precaution, the system is unreliable. The photokeratoscope and the keratoanalyser provide good results only if they are used with care. To use the system, we propose the following schedule. Firstly, take a photograph of a steel ball, then set this picture under the video camera and vary the illumination until the accuracy remains unchanged during repeated calibration. With homogenous and constant illumination, the accuracy is about 0.5 diopter. PMID- 1779116 TI - [Evaluation of the refraction factor using the theoretical formula for calculating the intraocular lens power]. AB - The refraction factor was evaluated by using the theoretical formula for intraocular lens power calculation. This evaluation was made for several combinations of lens position, postoperative refraction, corneal power, axial length and lens design. The calculated values range from 1.19 to 1.51. Refraction factor was found to increase with posterior position of the lens, corneal power and algebraic increase of postoperative refraction. Position of the lens is the most important factor. The following values can be used practically: 1.25 for anterior chamber lenses and meniscal lenses; 1.33 for posterior chamber plano convex lenses; 1.50 for posterior chamber biconvex lenses. PMID- 1779117 TI - [Preventive treatment using laser of age-related macular degeneration of the contralateral eye after age-related macular degeneration of the first eye]. AB - Since 1982, and with informed patient consent, we have photocoagulated confluent drusen and limited serous pigment epithelium detachment (SPED) in the fellow eye of ten patients suffering from advanced, disciform type, age-related macula degeneration (ARMD). This treatment was only carried out on appearance of metamorphopsia. Photocoagulation was performed with either the green ray of the argon laser, or the yellow ray of a dye laser. Spots of about 200 microns were placed in a grid-like fashion among the drusen. No complications were observed due to the treatment. The follow-up period on these ten patients, eight women and two men, mean age 77 years, was two to eight years, and the three patients have died. The drusen disappeared completely in three patients and partially in one. The functional results seemed favorable in three cases. In one case of confluent drusen associated with SPED and serous retinal detachment, vision improved remarkably from 0.3 to 0.5 with a Parinaud 2, with a follow-up of five years. In another case, the improvement was from 0.4 to 0.7 but the patient died after only a few months. In another case, vision has been stable for five years. The vision of the seven remaining patients deteriorated; three cases showed central areolar sclerosis, and one case a localised new vessel with vision less than 0.1. In three cases vision dropped to 0.2 and Parinaud 6, but they have been stable for at least four years (eight years for one patient).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779118 TI - [Penetration of cefixime in the anterior chamber of the human eye]. AB - Penetration of cefixime in aqueous humor was investigated in 21 patients about to undergo elective cataract extraction. All subjects received a 400 mg oral dose. Aqueous humor was collected within 4, 6, 10 or 15 hours after the administration. Cefixime was measured by liquid chromatography. The concentration of cefixime in aqueous humor was below 0.05 mg/l in 17 patients. The highest level reached was 0.16 mg/l. In spite of lower minimal inhibitory concentrations than first generation oral cefalosporins, cefixime per os cannot be proposed for the treatment of postoperative ocular infections. PMID- 1779119 TI - [Ocular anomalies in Alagille's syndrome]. AB - The authors examine a family, in which two brothers were affected by a severe expression of arteriohepatic dysplasia (ADH, Alagille syndrome), an autosomal dominant disorder associated with intrahepatic cholestasis, characteristic facial appearance, congenital embryotoxon. One of these two cases presented a keratoconus and both had retinal pigmentary degeneration with pigment clumping. The father showed a benign expression of ADH, including the characteristic facial appearance and posterior embryotoxon. Another brother presented only retinal pigmentary abnormalities and a bilateral arcus senilis-like corneal opacity, without any other clinical sign of ADH. The presence of posterior embryotoxon in all the cases of Alagille syndrome confirms that this sign is a hallmark of ADH, also in its benign expression. PMID- 1779120 TI - [Penetrating keratoplasty: the in situ corneal procurement]. AB - The authors hereby present an enucleation-free harvesting technique that allows in good security conditions harvesting of donors corneas with or without scleral rim. It also permits the ad integrum tegumentary reconstruction imposed by the legislation on organ transplantation. This results in a better acceptance on behalf of the donor families, France-Transplant harvesting team and morgue staff members. They believe that this technique must supplant enucleation. PMID- 1779121 TI - [Tumors of the eyelids]. PMID- 1779122 TI - [Dyschromatopsias and pictorial art]. AB - The influence of color vision defects on pictorial art was studied using three methods. 1) From a theoretical standpoint, the possibilities of choice of the color-blind painter are determined by the nature of his color perception. Characteristic errors result from the fact that he has to choose between many hues which are different to a normal individual but which all look the same to him. 2) Evaluation of the clinical cases of painters with dyschromatopsias has shown evidence of the following: a) the color-blind painter makes mistakes according to the type of color defect; b) if the color-blind painter makes several copies of the same model, he makes different mistakes at each attempt; c) when several color-blind painters make copies of the same model, they also make different mistakes, even when they suffer from the same type of color vision defect. Preferences for some colored patterns were studied by means of a forced choice procedure and choices of color-blind individuals were often characteristic of their dyschromatopsia. Recent clinical case of acquired dyschromatopsia reported in the literature are discussed, as is a personal case of a painter suffering from tapeto-retinal degeneration. This was a severe dyschromatopsia with a neutral zone in purple (so-called scotpic axis, by Verriest's terminology). The painting of this artist tended to be monochromatic, mainly in green and green-blue colors. 3) Recent studies in art history have shown that only the romantic etcher Meryon was definitively color deficient. The more dubious cases of the Polish painter Grottger and of Eugene Carriere are discussed and conclusions are negative. Among acquired dyschromatopsias, there have been many recent papers devoted to cataract dyschromatopsias, concerning the cases of Rouault, Monet and Mary Cassatt. The hypothesis of a degree of chromatopsia or dyschromatopsia of toxic origin in the case of Van Gogh is also assessed. In conclusion, the problem of the relations between congenital or acquired dyschromatopsias and pictorial art seems very complex and great care is required when making deductions and advancing hypotheses. PMID- 1779123 TI - The effect of certain intrinsic and extrinsic variables on the acute toxicity of selected organophosphorus insecticides to the mummichog, Fundulus heteroclitus. AB - The acute toxicity of two organophosphorus (OP) insecticides, azinphosmethyl and acephate, was evaluated in the mummichog, Fundulus heteroclitus. In addition, the effects of certain intrinsic (sex) and extrinsic (salinity and multiple toxicant interraction) variables on the toxic response were also investigated. Azinphosmethyl was by far the most toxic of the two OP insecticides with a 96h LC50 approximately 100,000 x lower than that for acephate. Slight sex differences were observed in the sensitivity of mummichogs to each of the OP insecticides with male fish being marginally more sensitive. Significant effects of low salinity stress were observed only with acephate exposure and, in this case, low salinity appeared to be slightly protective. In general, all of the insecticide mixtures (azinphosmethyl/endosulfan, azinphosmethyl/fenvalerate and acephate/fenvalerate) tested exhibited simple additive toxicity. PMID- 1779124 TI - Biochemical studies on the terrestrial snail, Eubania vermiculata (Muller) treated with some pesticides. AB - The in vivo effects of methomyl, thiodicarb and metaldehyde on total soluble proteins, total lipids and glycogen content, in addition, the activity of glutamic oxaloacetic transaminase, (GOT), (GPT) glutamic pyruvic transaminase and catalase (CAT) enzymes of terrestrial E. vermiculata snails was studied. The experimental snails were treated with low concentration of 0.2% brain bait w/w of the pesticides for a period of 1,3,5,7 and 10 days. The results showed that methomyl and thiodicarb lead to significant reduction in total soluble proteins, lipids, and glycogen content, while significant increases in the activity of all enzymes tested were noted. Metaldehyde treatment showed no significant effect on total soluble proteins, lipids and GOT level, whereas a significant increase in GPT and CAT enzymes was observed. Also, metaldehyde resulted a significant reduction in glycogen content of snails. PMID- 1779125 TI - Physicochemical characterization of industrial effluents and their effect on fish survival. AB - Water samples taken from selected industrial drainages and receiving streams in and around Islamabad, Pakistan, during the summers of 1987 to 1990 showed disturbances in pH and low oxygen levels. Selected metals (Fe, Pb, Zn, Cd, Cu, Ni, Hg) were higher in all effluents than in receiving waters. Static bioassays of the undiluted industrial effluents from three sites caused 100% mortality in carp during the first 24 hrs. Fishes also suffered 30 to 60% mortality when exposed to other undiluted industrial effluents and some mortality when industrial effluents were diluted by 50%. PMID- 1779126 TI - Structural deformation of the preterm trachea during acute distention and collapse. AB - The compliant airways of the premature neonate undergo episodic distention and collapse in response to changes in transmural pressure such as occur during spontaneous breathing, mechanical ventilation, and various therapeutic maneuvers. To identify and quantitate the effects of distending and collapsing transmural pressures on the structure of immature airways, tracheal segments from fetal rabbits, fixed at 0, +30, and -30 cm H2O transmural pressure, were examined using histologic and morphometric techniques. In comparison to control sections fixed at 0 cm H2O transmural pressure, application of distending pressures led to evagination of the posterior tracheal wall and significantly increased (P less than 0.05) cross-sectional area, antero-posterior diameter, circumference and muscle length, and decreased muscle thickness. Collapsed tracheal segments (-30 cm H2O) demonstrated invagination of the posterior wall and significantly (P less than 0.05) lower cross-sectional area, and antero-posterior diameter compared to the control segments; all the other parameters remained relatively unchanged. These data demonstrate extreme changes in tracheal geometry in response to the acute application of transmural pressure. From a methodological perspective, these observations suggest that fixation pressures may present significant artifact in histological analyses. Functionally, the noted deformation may lead to alterations in anatomic dead space and airway resistance, and mechanical function of the airways; all of which may compromise respiratory status in ventilated premature infant. PMID- 1779127 TI - Contragestational action of hyperthermia on rat pregnancy. Effect on ornithine decarboxylase. AB - In the rat, there are marked changes in ornithine decarboxylase activity in the fetuses and reproductive tissues during gestation. Exposure of pregnant rats to moderate hyperthermia (40 degrees C, 60 min) produced a marked decrease (about 80%) of ornithine decarboxylase activity in fetuses, uterus and ovaries, while this change was more moderate in placenta (about 20%). This effect was observed in different stages of pregnancy. Ornithine decarboxylase activity was returned to control values within a few hours after the end of the hyperthermic treatment. Hyperthermia produced marked contragestational effects if given sequentially on days 8, 9 and 10 of gestation, but only a decrease in the weight of viable fetuses was observed when given on days 11, 12 and 13. These results indicate that part of the harmful effects produced by hyperthermia on pregnant rats may be mediated by the sustained fall of ornithine decarboxylase activity during critical periods of gestation. PMID- 1779129 TI - The interaction of the upper airway and thermo-metabolism on respiratory rhythm during non-REM sleep in the developing lamb. AB - This study investigates the role of metabolic rate and of vagal airway mechanisms in sustaining rhythmic breathing in the developing lamb. Fifteen lambs were prepared, at 2 days of age under fluothane anaesthesia, for sequential studies at 4, 14, 30, 45, and 55 days of age. At each age they were maintained at an ambient temperature of 5, 10, 15, 20, 25 and 30 degrees C for at least one hour before measurements were made during N-REM sleep. In 6 lambs at 4 days and in all lambs at older ages the upper airway was by-passed (by opening a tracheal window) for 10-15 minutes at each ambient temperature. Oxygen consumption was unaffected by upper airway by-pass and there were no consistent changes in mean breathing frequency or amplitude, with the exception of shifts to panting at warm ambient temperatures. Breathing pattern was unaffected by upper airway by-pass in lambs at 4 days of age, but at older ages loss of regularity of breathing frequently occurred (up to 47% of 30 days-old lambs at 25 degrees C). This was related to the fall in oxygen consumption with age and to basal values at thermoneutrality, and coincided with lower respiratory rates and increased use of expiratory laryngeal braking. Periodic breathing (and apnea) of a fixed cycle length (9.3 +/ 0.36 s) was a common feature (62%) of the observed breathing dysrhythmia. In young lambs high metabolic rate sustained high frequency rhythmic breathing which was unaffected by upper airway by-pass.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779128 TI - Thermoregulation and the control of breathing during non-REM sleep in the developing lamb. AB - This study investigates how metabolic rate, as required for thermoregulation, interacts with breathing control during development of the lamb. Fifteen lambs were studied sequentially at 4, 14, 30, 45 and 55 days of age. During each study they were maintained at ambient temperatures of 5, 10, 15, 20, 25 and 30 degrees C for at least 1 h before measurements were made during N-REM sleep. Basal oxygen consumption fell from 16.1 +/- 0.72 (+/- SEM) to 10.1 +/- 0.47 ml/min per kg between 4 and 55 days of age, while breathing frequencies fell from 52.3 +/- 4.4 to 32.4 +/- 1.6 breaths/min over this period. Ventilation increased as oxygen consumption increased on cooling below thermoneutrality. In 4 days-old lambs this was achieved by an increase in breath amplitude, whilst in older lambs breathing frequency also rose. As breathing frequency fell there was a greater incidence of expiratory laryngeal braking at thermoneutrality associated with lengthened expiratory time. The ambient temperature at which these effects occurred, together with panting thresholds, progressively changed with age as the upper and lower critical temperatures fell and the thermoneutral range widened during development. It is concluded that metabolic rate provides a powerful stimulus to breathing in infant lambs. As the metabolic stimulus decreases with age, basal breathing frequency falls and expiratory laryngeal braking becomes important not only to protect lung volume, but also, through airway mechanosensory reflexes, in regulating breath time. This interaction is also particularly apparent as the metabolic and respiratory requirements alter to meet changes in ambient conditions. PMID- 1779130 TI - Effects of acute asphyxia on brain energy metabolism in fetal guinea pigs near term. AB - In a previous study we suggested that--unlike other forms of asphyxia--acute asphyxia caused by arrest of uterine blood flow is accompanied by a fall in oxygen delivery to the fetal brain (Jensen et al., 1987). This may change cerebral energy metabolism by causing an increase in the glycolytic rate. To test this hypothesis we studied the time course of the changes in the levels of high energy phosphates and glycolytic intermediates in the cerebral cortex of unanaesthetized fetal guinea pigs near term before and after 2 and 4 min of acute asphyxia. During asphyxia there was a progressive fall of adenosine triphosphate, creatine-phosphate, glucose and fructose-1,6-diphosphate concentrations, whereas adenosine diphosphate, adenosine monophosphate and lactate concentrations increased. Pyruvate concentrations did not change. We conclude that fetal cerebral energy metabolism becomes increasingly anaerobic during acute asphyxia caused by arrest of uterine blood flow, because oxygen delivery to the fetal brain falls. PMID- 1779131 TI - [Morphological changes in the human cerebral cortex in dementia]. AB - Many diseases of the brain leading to impairment of intellectual capacities are associated with morphological changes in the anteromedial portions of the temporal lobe. Among these are Alzheimer's disease, Parkinson's disease and the syndrome of dementia with argyrophilic grains. The hallmarks of Alzheimer's disease are intraneuronal neurofibrillary changes and extracellular amyloid deposits. The neurofibrillary changes consist of neurofibrillary tangles, neuritic plaques and neuropil threads. The distribution pattern of neurofibrillary changes differs from the distribution of amyloid deposits. The neurofibrillary changes exhibit a distinct but varying distribution pattern in different areas of the cerebral cortex. In fully developed Alzheimer's disease, both the hippocampal formation and isocortical association areas are severely involved while the brunt of the pathology is found in the entorhinal region. The entorhinal region receives information from various isocortical association areas and limbic circuits and projects to the hippocampal formation via the perforant path. This fibre tract is mainly generated by projection neurons within the superficial entorhinal cell layer. In Alzheimer's disease virtually all projection neurons within this layer are destroyed by neurofibrillary tangles. In cases of Parkinson's disease with progressive cognitive decline the neurofibrillary changes are confined to the outer cellular layer of the entorhinal region. In cases of "dementia with argyrophilic grains" the argyrophilic grains are predominantly encountered in the hippocampal formation and in the outer layers of the entorhinal region.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779132 TI - Quantitative histological studies of the optic tectum in six species of Notropis and Cyprinella (Cyprinidae, Teleostei). AB - Significant differences in stratification and size of the visual layers of the optic tectum were found between three clear-water minnows (Notropis amabilis, N. boops, Cyprinella venustas) and three turbid-water minnows (N. atherinoides, N. bairdi, and C. lutrensis). Correlations among a variety of neural structures suggested the importance of stratum marginale (SM), stratum opticum (SO), and stratum fibrosum et griseum superficiale (SFGS), stratum griseum centrale (SGC) and stratum periventriculare (SPV) in vision, of stratum album centrale (SAC) and SGC for olfaction, and of SPV for the processing of acoustico-lateral information. PMID- 1779133 TI - [Cholinesterase activity in the human striatum with special consideration of the terminal islands]. AB - The distribution pattern of cholinesterase activity in the basal forebrain region was examined in five human brains without any history of neurologic or psychiatric disorders. Complete sets of serial sections allowed a three dimensional reconstruction of this region. The intensity grading and the distribution pattern of the specific and non-specific cholinesterase activity was depicted diagramatically. The distribution pattern of cholinesterase activity in the supracommissural striatum demonstrated the well-known striosomal configuration, particularly in the head of the caudate nucleus. Within this nucleus caudatus the striosomes appeared connected with a subventricular zone of low acetylcholinesterase-activity. Bands of very high activity could be demonstrated from the dorsolateral and ventral areas of the caudate nucleus to the lateral border of the putamen and the commissural and subcommissural division of the ventral striatum. The distribution pattern of cholinesterase activity in the subcommissural region showed very close correlation to the cytomorphological subdivisions of the striatum as defined by Brockhaus (1942). In addition to his topographic description it was possible to define the tuberculum olfactorium and several subdivisions of the interstitial nucleus of the stria terminalis. The inhibition of non-specific esterase activity by ISO-OMPA in the globus pallidus allowed distinction between striatal and pallidal components. Three-dimensional reconstructions of the terminal islands revealed several types, which were named according to their topography as insulae substriatales, -subventriculares, olfactoriae, -magnae, and -interstitiales. Characteristically, the core of these islands consisted of clusters of tightly packed, extremely high acetylcholinesterase-positive cells. Cholinesterase activity of the surrounding rim region ranged from negative to strongly positive depending on the position and type of the island. The findings suggest that the islands represent derivatives of the fundus striati region as defined by Brockhaus and are connected to the dorsal striatum by means of cellular bridges. PMID- 1779134 TI - Distribution of cholinergic pallidal neurons in the squirrel monkey (Saimiri sciureus) based upon choline acetyltransferase. AB - The distribution of cells immunoreactive to choline acetyltransferase (ChAT-IR) in, and around the globus pallidus were studied in the squirrel monkey. Intrinsic pallidal ChAT-IR neurons in the globus pallidus were most numerous in ventrocaudal regions of the lateral pallidal segment (LPS) and in the oral pole of the medial pallidal segment (MPS). Smaller numbers of ChAT-positive cells were seen in portions of the medullary laminae of the pallidum. Computer measurements of somal areas of ChAT-IR cells in the globus pallidus, substantia innominata and putamen were made. Morphological features and somal areas of ChAT-IR cells in the globus pallidus and in the Ch4 group of the substantia innominata were strikingly similar. Cholinergic pallidal neurons appear to be part of the Ch4 cell group and have similar widespread cortical projections. The smaller cholinergic neurons in the striatum are considered to be intrinsic neurons which primarily act upon spiny striatal projection neurons. The possible local interaction of pallidal cholinergic neurons upon GABAergic neurons is unknown. PMID- 1779135 TI - Different types of synaptic triads in the monkey dorsal lateral geniculate nucleus. AB - Characteristic synaptic complexes, the triadic synapses, were investigated in long series of sections of parvicellular and magnocellular laminae of the monkey lateral geniculate nucleus. Electron microscopic observations revealed the presence of different triadic types, the intercalated element being in all cases a presynaptic dendrite or soma of an interneuron (I-cell), and the output component being constantly a dendrite or soma of a geniculocortical projection or principal neuron (P-cell). The axonal input to the triads, however, was found to be of three different types: (1) the majority were retinal axon terminals; (2) a smaller fraction were the axonal endings of corticogeniculate fibers, always connected to thin, distal P-cell dendrites; (3) others were terminals with pleomorphic or flattened, small synaptic vesicles, probably belonging to axons of I-cells and/or of thalamic reticular nucleus origin. It was observed also that the retinal terminals established multiple synaptic contacts with both P-cell and I-cell dendrites. Essentially, two types of triadic arrangements with retinal input were recognized: the "simple" unit, frequent in parvicellular laminae, in which the retinal axon was accompanied by only 1-2 presynaptic dendrites; and the "complex" unit, found mostly in the magnocellular laminae, characterized by the presence of up to eight presynaptic dendrites. In the glomerular "complex" units, "closely packed" classical triads, with the three synaptic junctions localized close to each other, coexisted with triads "at a distance" where the synapses were distributed relatively far from each other. The coupling by presynaptic dendrites of "closely-packed" and "at a distance" triads resulted in the formation of multiple triadic arrangements. Since cortical and inhibitory triads were never seen to be involved in multiple triadic complexes, the latter appeared exclusively retinal in nature. The possible functional significance of multiple triads in "ON-gating" operation is briefly discussed. PMID- 1779136 TI - Comparative study of the glial fibrillary acidic protein (GFAP) in toad, kitten and cat sensory ganglia. AB - The peroxidase-antiperoxidase (PAP) method was used on paraffin embedded tissue to demonstrate the presence of the glial fibrillary acidic protein (GFAP) in sensory ganglia of kittens, cats and toads. Special attention was paid to the influence of fixation. It appeared that the final immunostaining of GFAP depends on the fixative and on the species used. GFAP was found in cat sensory ganglia at birth and at all subsequent stages studied. The satellite cells from toad sensory ganglia were also positive, although they displayed a weaker immunoreactivity. The amphibian material showed a clear sensitivity to the fixative used. PMID- 1779137 TI - Finite-element analysis of oxygen transport in the systemic capillaries. AB - A mathematical model is formulated for the transport of O2 in the systemic capillaries and surrounding tissue. The model takes into account molecular diffusion, the convective effect of the blood, the nonlinear effects of oxyhaemoglobin, and the consumption of O2 in the metabolic process. A finite element formulation for solving the equations governing the mass transfer in the capillary is described. A fixed-point iterative technique is used to deal with the nonlinearities in the model. The concentration of O2 is found to decrease from the axis of the capillary to the periphery of the tissue. It is shown that, owing to the nonlinear effects of oxyhaemoglobin, the partial pressure of oxygen (PO2) in the capillary and tissue increases. It is also shown that the tissue PO2 increases as (i) the arterial blood PO2 increases, (ii) the Peclet number increases, and (iii) the diffusive flux of O2 from the capillary decreases. PMID- 1779138 TI - A mathematical model for the rate of oxygenation of blood in pulmonary capillaries using nth-order one-step kinetics of oxygen uptake by haemoglobin. AB - A mathematical model is described for the process of gas exchange in pulmonary capillaries by taking into account the transport mechanisms of molecular diffusion, convection, and the facilitated diffusion due to haemoglobin. The nth order one-step kinetics of oxygen uptake by haemoglobin has been incorporated. The rate k at which blood becomes oxygenated is determined by setting up an appropriate eigenvalue problem. This method eventually leads to a transcendental equation in k. A multiprecision technique due to Verma and Sharan (1980) is employed to obtain a physically acceptable solution. It is shown that, at equilibrium, the saturation of haemoglobin with oxygen computed from the analysis is fairly close to the data of Severinghaus (1966). It was found that 97.15% of the total haemoglobin combined with oxygen. The blood is oxygenated well before it leaves the pulmonary capillary. The dissolved oxygen takes longer to achieve equilibration whereas the carbon dioxide traverses a comparatively smaller distance in the capillary. PMID- 1779139 TI - A note on the reconstruction of ellipsoids from the X-ray transform. AB - This paper is concerned with the problem of locating a solid tumour in X-ray tomography. Given that the unknown tumour is ellipsoidal and of uniform density, it is shown that the location, orientation, principal axes of the tumour are uniquely determined from six radiographs. PMID- 1779140 TI - The population dynamics of nematode infections of ruminants: periodic perturbations as a model for management. AB - We propose and analyse a model for the dynamics of directly transmitted nematode infections of ruminants which allows for the long-term effects of the annual removal of hosts. The model is a simple continuous-time formulation which captures the principal features of parasite transmission and the acquisition of immunity to infection by the host. Analysis of the simplest version of the model, which assumes a constant host population through time, indicates that its equilibrium is locally stable for feasible biological parameters. The regular removal of hosts involved in most management strategies is modelled in terms of periodic perturbations. The analysis indicates that the periodic removal of parasitized hosts corresponds effectively to a reduction in the basic reproductive rate of infection. We also demonstrate that the system exhibits a dramatic peak in parasite numbers during each grazing season at its dynamic equilibrium. This phenomenon (which is characteristically observed in real systems) is discussed in terms of the balance between acquired immunity and periodic perturbations of the parasite population. PMID- 1779142 TI - An author's view: living with rejection. PMID- 1779141 TI - Relaxation distribution function of intracellular dielectric zones as an indicator of tumorous transition of living cells. AB - The response decay data of living cells subject to electric polarization is associated with their relaxation distribution function (RDF) and can be determined using the inverse Laplace transform method. A new polynomial, involving a series of associated Laguerre polynomials, has been used as the approximating function for evaluating the RDF, with the advantage of avoiding the usual arbitrary trial values of a particular parameter in the numerical computations. Some numerical examples are given, followed by an application to cervical tissue. It is found that the average relaxation time and the peak amplitude of the RDF exhibit higher values for tumorous cells than normal cells and might be used as parameters to differentiate them and their associated tissues. PMID- 1779143 TI - An editor's view: living with deadlines. PMID- 1779144 TI - Surgical management of basal joint disease of the thumb. PMID- 1779145 TI - Raynaud's phenomenon of occupational origin. PMID- 1779146 TI - Cold-induced arterial spasm after digital amputation. AB - The incidence and intensity of cold-induced digital vasospasm was investigated in 18 patients with digital amputation injuries. Nine patients had undergone replantation surgery, while in the remaining nine cases the injury had been treated by stump revision and closure. The vascularity of the injured digits and of uninjured fingers in both hands, was studied. The results confirm that cold induced vasospasm is no more conspicuous in replanted fingers than in amputation stumps. Pathological vascular reactions to cold were also common in uninjured fingers in both hands. PMID- 1779147 TI - Digital periarterial sympathectomy for ischaemic digital pain and ulcers. AB - Digital periarterial sympathectomy was performed on 11 digits in three patients with chronic digital ischaemia which was a manifestation of either Raynaud's disease, C.R.E.S.T. syndrome or traumatic ulnar artery thrombosis. Before operation, all patients had pain in the affected fingers and five digits had ulcers, two of which were infected. Using the operating microscope, the adventitia was stripped circumferentially over the distal 2 cm. of the common digital arteries, the bifurcation and the proximal 1 cm. of the proper digital arteries distal to the bifurcation. The same procedure was repeated, at the wrist level, for the ulnar artery and/or the radial artery and its dorsal branch. Follow-up ranged from three to 16 months. After two weeks, all patients reported relief of pain and the ulcers were progressively healing. By three months, all ulcers had healed. PMID- 1779148 TI - Effect of perivascular sympathectomy on distal adrenergic innervation in the hands of monkeys. AB - Perivascular sympathectomy has been thought to cause distal adrenergic denervation. We performed perivascular sympathectomy for a distance of 1 cm. on two common digital arteries in the right hands of two anaesthetised Macaca arctoides monkeys. Four days later, samples were taken for glyoxylic acid-induced fluorescence examination of the operated and opposite control hand. The distal adrenergic nerves were morphologically normal in appearance after the perivascular sympathectomy. The operation should perhaps be called adventitectomy rather than perivascular sympathectomy and its positive effects may be due to the loss of adventitial support for the vasospastic arteries rather than adrenergic denervation. PMID- 1779149 TI - Replantation of the completely avulsed thumb using long arterial and venous grafts. AB - Long arterial and venous grafts (10-15 cm. in length) were used in the replantation of thumbs amputated by avulsion. All replanted parts survived and thrombosis requiring anastomotic revision did not occur in any of the cases. Based upon a consideration of different factors that may lead to the formation of thrombus in reconstructed vessels, a method is recommended for routine use in replantation of the thumb, with specific reference to avulsion injuries. PMID- 1779150 TI - Transmetacarpal replantation of the right hand onto the left. PMID- 1779151 TI - Free lateral arm osteocutaneous neurosensory flap for thumb reconstruction. AB - Three cases are described to illustrate the use of the lateral arm osteocutaneous neurosensory flap in thumb reconstruction. The merits of such a method and its place in the repertoire of techniques for this problem are discussed. PMID- 1779152 TI - Dorsal metacarpal reverse flaps. Anatomical basis and clinical application. AB - The presence of distal intermetacarpal anastomoses between dorsal and palmar vascular networks makes it possible to raise distally-based cutaneous island flaps oriented along the axis of the dorsal metacarpal arteries. These flaps receive a reverse-flow vascularisation. Distal intermetacarpal anastomoses were found consistently in 35 hands from adult cadavers. The exact location of these anastomoses varied with the course of the dorsal metacarpal artery. Thus, island flaps can be raised consistently from the dorsal aspect of the hand and rotated around a distal intermetacarpal pivot. These flaps are suitable for covering the dorsal aspect of the proximal phalanx and the proximal interphalangeal joint. PMID- 1779153 TI - Vascularised bone transfer for defects and pseudarthroses of forearm bones. AB - During a five-year period, 15 patients with defects or pseudarthroses of the forearm bones were operated on. All had previously undergone one to six conventional operations. A vascularised fibular graft was used in ten cases, a radial graft in three cases and a humeral graft in two cases. Bone graft viability and healing were assessed clinically and patients have been observed for seven months to five years. 14 patients have finished treatment: 13 were cured and only two repeat osteosyntheses were required. In one case there was resorption of the central part of the fibular graft. Primary bony union was achieved in three to six months. Care must be taken in precise pre-operative assessment of the state of the forearm arteries. We advocate wider usage of vascularised radial and humeral grafts. PMID- 1779154 TI - Arteriographic findings in radial and ulnar deficiencies. AB - The arterial pattern in 13 cases of radial deficiency and six cases of ulnar deficiency was studied by arteriography. The radial artery was absent or hypoplastic in 84.6% of cases of radial deficiency and in 50% of cases of ulnar deficiency. A persistent median artery was seen in 76.9% of cases of radial deficiency and in 16.7% of cases of ulnar deficiency. In 12 hands, the deep palmar arch was small or absent, depending upon the degree of radial arterial dysplasia. The digital artery to the deficient digits was missing in some cases. The persistence of an embryonic vascular pattern in cases of radial deficiency and ulnar deficiency with dysplasia of the ulna suggests that the teratogenic injury may have been simultaneous, whereas ulnar deficiency without dysplasia of the ulna was not associated with arterial abnormalities in the forearm. PMID- 1779155 TI - The management of the complete ring avulsion injury. AB - The complete ring avulsion injury presents a difficult choice between microvascular repair and further amputation. The former is technically difficult and the latter leaves an undesirable result. We describe an alternative method whereby a thinned groin flap is applied to volar surface and sides of the finger and a full-thickness skin graft covers the dorsum. This provides good quality cover to the volar aspect and avoids bulk on the dorsum. PMID- 1779156 TI - Neurophysiological assessment of the early phases of carpal tunnel syndrome with the inching technique before and during operation. AB - In 14 patients with early carpal tunnel syndrome, the diagnostic sensitivity of the measurement of the segmental sensory nerve conduction velocity at 1 cm. steps ("inching") was compared with the distal sensory latency and the pre-operative wrist-digit and wrist-palm S.C.V. and with similar measurements made at operation immediately after surgical decompression of the nerve. Before operation, distal sensory latency and wrist-digit S.C.V. were normal in all cases, while wrist-palm S.C.V. was pathological in five patients and inching in all 14 patients. Moreover, inching allowed us to determine the site of the slowing across the carpal tunnel, this being between 1-2 cm. from the distal wrist crease in 57% and between 2-3 cm. in 21% of cases. Focal slowing disappeared immediately after decompression in five patients, as is evident from the intra-operative recordings. Inching is, therefore, the most sensitive diagnostic method in early carpal tunnel syndrome. PMID- 1779157 TI - The function of the abductor pollicis longus muscle as a joint stabiliser. AB - The abductor pollicis longus and extensor carpi ulnaris muscles function as a dynamic collateral ligament of the wrist. There are indications of a comparable situation over the carpo-metacarpal joint of the thumb. From experiments with tendon movements, we found that in passive motions of the thumb only the tendons of the superficial division show an excursion, regardless of the position of the wrist joint. However, in motions of the wrist joint the tendons show an identical excursion over an equal distance. These are small in pronation and supination but much larger in the mid-position between them. On some movements of the thumb and the wrist, no tendon excursions can be measured. There are strong indications that the deep division, particularly, has a stabilising function on the basal joint of the thumb. PMID- 1779158 TI - First metacarpal osteotomy for carpo-metacarpal osteoarthritis. AB - The results of basal osteotomy of the first metacarpal in the treatment of carpo metacarpal osteoarthritis have been analysed from two small studies, one retrospective and one prospective. Assessment included clinical examination, standardised radiography and computerised pinch-grip analysis. Surgery reduces the subluxation at the first metacarpal base and provides good pain relief and restoration of function in the majority of cases. It is concluded that this relatively simple technique produces very good results without reducing power grip. PMID- 1779159 TI - Long-term follow-up of the cemented Caffiniere prosthesis for trapezio-metacarpal arthroplasty. AB - 20 patients with 22 Caffiniere prostheses in the trapezio-metacarpal joint were evaluated at a median of nine years after operation. The indication was degenerative osteoarthrosis in 20 cases and rheumatoid arthritis in two cases. We found 18 of the 22 (82%) original prostheses still in place, with satisfactory pain relief and good function. Three hands had been revised due to aseptic loosening, with replacement of two cups and one total prosthesis. Two of the revised prostheses were functioning well 6 1/2 and 10 years after the revision. We conclude that function does not deteriorate within the first nine years, that late loosening is not a significant problem with this prosthesis and that, if aseptic loosening occurs, it is possible to obtain good results by replacing the loose component. PMID- 1779160 TI - Human fight-bite injuries of the hand. A study of 100 cases within 18 months. AB - 100 consecutive patients whose finger had been bitten by another person, or who had cut it on a tooth in a fight, have been studied. 82 healed completely but 18 eventually needed amputation. Early and thorough debridement is required, plus a suitable mixture of antibiotics. Once infection is established in bone or tendon sheath, amputation is often needed, but most infected joints can be saved. PMID- 1779161 TI - Drivers' elbow: a cause of ulnar neuropathy. AB - The ulnar nerve is vulnerable to compression and vibration injury in drivers who have the shoulder abducted and elbow flexed with the arm lying against the lower edge of the window. Three cases of ulnar neuropathy at the elbow are described in vehicle drivers. PMID- 1779162 TI - Ulnar nerve palsy following fractures of the distal radius: clinical and anatomical studies. AB - We report three cases of progressive ulnar nerve palsy following fractures of the distal radius. One was an open injury and one involved dorsal displacement of the nerve through a dislocated distal radio-ulnar joint. All were associated with dense scar tissue formation around the nerve. Early surgical decompression was successful in all cases. An anatomical study indicated that the relative immunity of the nerve to injury in this region may be due to its greater excursion and mobility compared with the median nerve. PMID- 1779163 TI - Distraction lengthening of the forearm. AB - Seven patients aged six to 25 underwent progressive distraction lengthening of the forearm. Five had lengthening of the ulna and two of the radius. Four cases had multiple exostoses, two had post-traumatic distal epiphyseal arrests and one had dyschondrosteosis. Two methods were used: the Wagner technique of diaphyseal distraction and bone grafting, or diaphyseal corticotomy and callus distraction without bone grafting. The average lengthening achieved was 3 cm. Review after one to three year's follow-up showed satisfactory improvement in appearance and function in all cases, with minimal complications. PMID- 1779164 TI - Contracture of the proximal interphalangeal joint in Dupuytren's disease. AB - The correction of fixed flexion deformity at the P.I.P. joint in Dupuytren's disease is often difficult. This paper reports an anatomical study of this joint in fingers amputated because of this condition. all the joints would extend fully after release of the accessory collateral ligaments and volar plate. Lateral and dorsal structures showed severe secondary damage and it is suggested that these changes may explain the poor results of corrective surgery to this joint in Dupuytren's disease. PMID- 1779165 TI - Surgical treatment of fixed flexion contractures in the hands of institutionalised patients. AB - Three severely demented elderly patients had fixed flexion contractures of all fingers of one or both hands. This caused an unpleasant problem of hygiene and of nail ingrowth into the palm. A surgical solution to this problem is described, with good results. PMID- 1779166 TI - Extensor tendon rupture due to osteoarthritis of the distal radio-ulnar joint. AB - Five cases of closed rupture of the finger extensor tendon due to osteoarthritis of the distal radioulnar joint were studied. Difficulty in extension began at the little finger and extended to the ring and long fingers. Pain and swelling in the dorsal aspect of the wrist preceded the tendon rupture. Osteoarthritic changes at the distal radio-ulnar joint were more severe than those at the radio-carpal and intercarpal joints. The distal end of the ulna showed the plus variant, as well as dorsal dislocation or subluxation. All patients underwent a tendon graft or tendon transfer, with excision of the distal ulna. The tendon rupture was thought to be caused mainly by friction between the displaced distal end of the ulna and osteophytes of the distal radio-ulnar joint. PMID- 1779167 TI - Rolando's fracture. AB - The relationship between methods of treatment, quality of reduction and the occurrence of late disability and osteo-arthritic changes was studied in 17 Rolando's fractures. Three were undisplaced, 14 were displaced: of these excellent reduction was achieved in five of 11 treated by open reduction and in none of the three treated by percutaneous K wire fixation. After a median interval of 5.8 years, six of 16 reviewed patients had minor symptoms, while nine had no symptoms. Radiographic examination of 11 patients showed signs of osteoarthritis in six. We did not establish a relationship between the quality of reduction and the occurrence of late symptoms and osteoarthritis. PMID- 1779168 TI - Locked finger due to foreign body in the flexor sheath. AB - A patient is described in whom a wooden splinter penetrated the finger and impaled the flexor tendons. It was pulled out but part remained inside and the finger could not be moved until an operation was performed and the remaining part of the splinter removed. PMID- 1779169 TI - Intra-tendinous chondroma of a flexor tendon. AB - A case of intratendinous chondroma of a finger flexor tendon is described. To our knowledge, such a location has never been reported before. PMID- 1779170 TI - New inventions. Splintage of the hand during operation. December 25, 1948. PMID- 1779171 TI - Subcutaneous release of trigger thumb and fingers in 210 fingers. PMID- 1779172 TI - Simultaneous dislocation of both interphalangeal joints of the finger. PMID- 1779173 TI - Epitope- and antigen-specific cancer vaccines. AB - Anti-idiotypic antibodies (Ab2) that functionally mimic epitopes associated with human cancer cells are the most specific cancer vaccines currently available. Ab2 can induce specific humoral anti-tumor immunity in cancer patients. However, the potential of Ab2 for inducing cellular immunity in cancer patients still requires demonstration. Clonotypic antibodies directed against the combining site for tumor Ag on human T-cell clones may provide highly effective reagents for inducing protective T-cell immunity against human cancer. A new generation of cancer vaccines, molecularly cloned tumor-associated antigens (Ag), has recently been developed. Recombinant Ag have been successfully expressed in vectors allowing large scale production of Ag for immunization of cancer patients. Recombinant tumor Ag was shown to induce specific and protective immunity in experimental animals. In contrast to Ab2, which may mimic a single cancer associated epitope, recombinant Ag express multiple epitopes that are potentially immunogenic. Ag vaccines, therefore, may be more effective in arresting tumor growth than single epitope (Ab2) vaccines because tumor destruction by antibodies is dependent on antibody density on tumor cell surfaces. In light of the important roles that both B and T cells play in the control of tumor growth, the demonstration of induction of specific B and T cell-immunity by recombinant tumor Ag and Ab2 in experimental animals is encouraging. Ultimately, the immunomodulatory role of both types of vaccines has to be compared in cancer patients who are immunologically tolerant to many Ag/epitopes expressed by their growing tumors. The development of both Ab2 and recombinant Ag for single antigenic systems provides the first step towards this goal. PMID- 1779175 TI - Role of gangliosides in active immunotherapy with melanoma vaccine. AB - Among various tumor associated cell surface antigens, gangliosides, the glycosphingolipids that contain sialic acids, offer a variety of epitopes, some of which are preferentially expressed on melanoma cells. These surface components of the bilayered lipid membrane of tumor cells are the targets of active immunotherapy with melanoma vaccine. Purified gangliosides in aqueous solution form micelles and, at high density, form lactones. Their antigenic expression (physical conformation and orientation) on the cell surface is governed by the nature of the sphingosine and the fatty acids they contain. Evidence is accruing to show that the nature of the fatty acid moiety of gangliosides differs in normal and neoplastic cells. Gangliosides per se are not immunogenic and require extrinsic adjuvanticity. Preparation of a melanoma cell vaccine for active immunotherapy requires an understanding of the ganglioside profile of melanoma, the ganglioside-associated heterogeneity of melanoma, and the role of shed melanoma gangliosides in the immunosuppression of cell mediated and humoral immunity. In addition, the role of some of the anti-ganglioside antibodies in the elimination of shed gangliosides, the cytotoxic killing of tumor cells, as well as in the down-regulation of lymphocyte functions must be considered in the formulation of vaccine. Different strategies for augmenting the immunogenicity of melanoma associated gangliosides with melanoma vaccine are evaluated. PMID- 1779174 TI - Anti-idiotype monoclonal antibodies as vaccines for human cancer. AB - The anti-idiotype therapy approach has been tested and has shown to be effective in several animal models including the L1210/GZL tumor system in DBA/2 mice. Very recently, anti-idiotype antibodies (Ab2) have also been used in human trials. In this review, the generation and characterization of Ab2s which can be used as potential vaccine candidates for two human tumor systems--leukemia/lymphona and gastrointestinal carcinoma have been discussed. We have generated syngeneic monoclonal idiotypic cascades for two different human tumor-associated antigens (TAA) gp37 and carcinoembryonic antigen (CEA). In both cascades we have produced TAA mimicking monoclonal Ab2s and monoclonal anti-anti-idiotypes (Ab3) which bind to the original TAA. Modulation of immune responses in cancer patients by Ab2 immunization will be an important consideration in future studies. PMID- 1779176 TI - Attempts to optimize active specific immunotherapy for melanoma. AB - During the past 5 years, we have been conducting clinical trials with a therapeutic melanoma vaccine (melanoma "theraccine"). Mechanical lysates of two melanoma cell lines chosen for their complementary characteristics were combined with the adjuvant DETOX and injected subcutaneously on weeks 1, 2, 3, 4 and 6 for one or two courses, and then monthly in patients with objective clinical responses. Of 109 patients, 22 (20%) have had objective clinical regression of tumor masses, with 5% complete responses. Ten patients have lived more than a year. Eight of the 10 are still alive, five of whom have lived more than 3 years. It was not necessary to achieve complete remissions to cause an increase in survival, and most of the long-surviving patients have one or more (stable) residual nodules. The pace of the disease process has clearly been slowed in those individuals. A rise in the level of cytotoxic T lymphocyte precursors in the blood (pCTL) has correlated with clinical response. Only one patient without such a rise in pCTL has had a response, and assays in that patient were considered unreliable. Both CD4+ and CD8+ CTL have been cloned from the blood of immunized patients. Both types of CTL killed a number of melanoma cell lines, but not other types of tumor or normal cells (lymphoblasts and melanocytes). CD8+ CTL have not been restricted to killing the autologous melanoma. MHC restriction by the HLA-A2 locus was identified. CD4+ CTL were not restricted only by Class II HLA antigens. Many CD4+ clones killed HLA Class II-negative melanomas, and we were able to block cytotoxicity of a particular clone with either anti-HLA Class I or anti-Class II MHC monoclonal antibodies, or both. An association of clinical response to the theraccine with certain HLA phenotypes, notably HLA-C3, -A2 (and the cross-reactive HLA-A28), B12 (and the related alleles (HLA-B44 and -B45) and perhaps DR4, particularly when combinations of those alleles were present, was suggested by our analysis of 70 patients. It is possible that this simply indicates the sharing of MHC antigens between the immunizing melanomas and the patient's melanoma. However, these MHC molecules may be important in their own right in presenting melanoma-associated antigens in CTL in vivo. Subtractive hybridization of mRNA from lung squamous carcinoma cells from cDNA of the M-1 melanoma cell line has yielded several DNA sequences unique to melanoma. Those are now being analyzed for possible immunogenicity, with cytotoxicity by CTL from immunized patients as the major criterion.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1779177 TI - An interactive computer simulator of the circulation for knowledge acquisition in cardio-anesthesia. AB - Knowledge-based decision support systems for use in cardio-anesthesia can provide online support to the anesthesiologist by generating intelligent alarms. However, the acquisition and validation of a consistent knowledge base for this application bears problems related to the transfer of clinical experiences into a rule system. An interactive simulator of the human circulation is presented that supports the process of knowledge acquisition and testing. The simulator can be controlled in realtime by an anesthesiologist during the simulation run thus providing a basis for interdisciplinary discussion of routine as well as critical situations. The output data can be transferred to a knowledge-based system for test purposes. The simulator is currently being used for the development of the Anesthesia Expert Assist System AES-2. With regard to the special application a model of the heart-function was integrated which enables the simulation of heart insufficiency. Simulation runs under various conditions are presented and discussed. The simulator was implemented on an ATARI ST personal computer. PMID- 1779178 TI - Connection of electronic medical devices in ICU according to the standard 'MIB'. AB - In the daily routine of an SICU, particularly in cardiac surgery, the nurses are to an increasing extent confronted with problems of connecting and using medical instruments as well as with documentation of the data of these instruments. An increasing number of user errors is to be expected. Use of advanced computer technology can help avoid such errors. In this paper the system 'ALODIN' is presented which is developed in our institutions according to the IEEE standard 'Medical Information Bus' (MIB). ALODIN-I will be part of a CCCS (computerized critical care system) which is installed in the clinic for cardiovascular surgery at Medical School Hannover. PMID- 1779179 TI - Human factors and computerisation in intensive care units: a review. AB - Current literature on the computerisation of Intensive Care Units indicates that many human factor considerations are relevant to the design and introduction of computer systems and to the evaluation of such systems within this environment. This paper aims to review and summarise essential points from the literature. PMID- 1779180 TI - Evaluation of a single-room, dedicated mass spectrometer. AB - A single-room dedicated mass spectrometer can be used to measure carbon dioxide, halogenated anesthetic agents, nitrous oxide, nitrogen, and oxygen. This device challenges the multiplexed mass spectrometer, a current standard in measurement. This study compared the single-room dedicated mass spectrometer with a conventional mass spectrometer that is normally used in a multiplexed setting. In this study, a single-room dedicated Ohmeda 6000 Mini-Mass Spectrometer and the Perkin-Elmer MGA-1100 mass spectrometer were calibrated with the same reference gases and both devices sampled various concentrations of dry gases. Regression lines and intercepts were plotted and showed excellent correlation between the two devices. The intraclass correlation test of Lee, Koh, and Ong, showed the devices to be equivalent with regard to the ability to determine various gas concentrations. Various advantages of a single-room dedicated mass spectrometer are discussed. PMID- 1779181 TI - Monitoring of coagulation status using thrombelastography during paediatric open heart surgery. AB - Thrombelastography (TEG) has proved useful in identifying coagulopathies (via assessment of clot elasticity properties) during hepatic surgery, but its role in cardiac surgery has as yet not been defined. Twenty-two children [11M, 11F, mean age (range) 4.9 (0.1-16) years] undergoing open heart surgery were investigated [1] preoperatively, [2] 15 min post protamine, [3] 2 h and [4] 24 h postoperatively using TEG. Comparisons were made between pre- and postoperative measurements and haematological indices. The values obtained from the TEG were: R phase (indicative of thrombokinase and thrombin formation disorders), K phase (indicative of fibrinogenesis) and MA phase (providing information on clot stability and platelet function). The patients were divided into two groups based upon 24 h blood loss; Group 1 - blood loss less than 0.7 ml/kg/h and Group 2 - blood loss greater than 0.7 ml/kg/h. In Group 2 there was a highly significant correlation between post-protamine MA phase and platelet number (r = 0.93, p less than 0.001) but there was no correlation in Group 1 (p greater than 0.1). Furthermore, in Group 2 elevated postoperative blood loss was associated with a prolonged K phase (mean [SD] 12.0 [6.0] versus 6.3 [2.1] min, p less than 0.05) and diminished MA phase (37 [12.5] versus 56 [4.9] mm, p less than 0.01) relative to preoperative values. In Group 1, K and MA phase did not alter significantly (p greater than 0.5 and p greater than 0.2, respectively). TEG predicted with 100% (8/8) accuracy increased post-operative bleeding. The specificity of TEG prediction of future bleeding was 73% [8/11]. Alterations in TEG parameters merit further evaluation as markers of postoperative haemorrhage. PMID- 1779182 TI - INFORM: integrated support for decisions and activities in intensive care. AB - Many medical decision support systems that have been developed in the past have failed to enter routine clinical practice. Often this is because the developers have failed to analyse in sufficient detail the precise user requirements, because they have produced a system which takes too narrow a view of the patient, or because the decision support facilities have not been sufficiently well integrated into the routine clinical data handling activities. In this paper we discuss how the AIM-INFORM project is setting out to deal with these issues, in the context of the provision of decision support in the intensive care unit. PMID- 1779183 TI - Computer-aided self-observation psychological stressors in an ICU. AB - We have developed a procedure for a computer-aided self-observation method in stressful situations. Staff members of an ICU recorded their experiences on a computer placed in the ICU, immediately after having experienced a stressful event. The computer asked for and stored psychologically relevant information about cognitive, affective and behavioural aspects. An external stress memory of an ICU was established, allowing a personal/institution-orientated stress diagnosis to be made on the basis of 192 episodes. Sixteen nurses in an intensive care unit in a Swiss hospital used this methodology for 12 weeks. One hundred and ninety-two stressful events were recorded (12 episodes per person), forming a good sample of the stressful episodes for the unit. To the same 16 nurses and 31 nurses at the same hospital (N total = 47) the Nursing Stress Scale was administered. The results from both groups showed that problems dealing with death and work load were predominant. Nurse characteristics such as levels of training (unskilled, skilled) and experience (number of years working as a nurse) were analysed by different statistical procedures and related to their stress experience. PMID- 1779184 TI - Physiological profiles and therapeutic goals--graphical aids support quick orientation in intensive care. AB - Although present-day technical facilities and modern patient monitoring produce an overwhelming number of measured parameters in intensive care medicine, there is a great need to develop decision aids to enable ICU personnel to become quickly orientated in the pathophysiological state of the patients under their care. One possible way for the representation of a multidimensional pattern of physiological values is the graphical display of a physiological profile of a patient's state. A combination of this display and the concept of 'therapeutic goals' is well suited for reducing the complexity of the computer output and for aiding in the necessary decisions in a twofold manner: substantial deviations of a single parameter are instantly visible and may be checked for their causes, the physician obtains an impression of the most serious deviations from the intended therapeutic goal for his patient. So she/he can act to support the patient in achieving the most likely course for recovery. PMID- 1779185 TI - A data model for intensive care. AB - The paper describes a model of clinical management data in a typical general intensive care unit, intended as a generic database specification for advanced intensive care computer systems. The data model was developed as part of the INFORM project. The INFORM project is summarised and the relevance of the data model to the objectives of the project are discussed. An object oriented extension to the entity relationship diagram methodology is presented. The methodology is illustrated with reference to some specific aspects of the data model including: the principle clinical entities; classification of patient state related data and the homogeneous patient group system. It is suggested that such a model will contribute to the better understanding of the data in the system, to the better design of future intensive care computer systems and to the setting of standards for medical data. PMID- 1779186 TI - CINA: a software to Compose INfusion sheets for i.v. Anesthetic drugs. AB - CINA is a software which uses LOTUS 1-2-3 commands and macros and it runs on an IBM PC. It contains an extensive database of three sections. Section 1 includes a list of several models of commercialized infusion devices. Section 2 presents the available IV packagings for a list of IV drugs. Section 3 contains the record of IV standard infusion regimens for each drug. Any other new infusion device, drug, or standard infusion regimen can be added or modified. The software verifies the compatibility of the prescribed infusion device according to the available drug packaging contained in the database. Moreover, it converts the infusion steps into the flow-rate units of the selected infusion device according to the patient's weight and the chosen drug concentration. Finally, the software allows the storage of all the information on a disk file or outputting on a printer. PMID- 1779187 TI - Difficulty many workers have had in interfacing their computers with monitor ports and other equipment. PMID- 1779188 TI - From the Departments of Internal Medicine and Pathology. LSU Medical Center, Shreveport. Benign gastric ulcer and H pylori infection. PMID- 1779189 TI - Liquid crystal contact thermography and its role in evaluating sensory disorders of primary neurological origin as revealed by intraneural microstimulation: a review. AB - Significant neurological research using liquid crystal thermography (LCT) has been performed; however, its acceptance as a practical and useful modality has been slow. Reviewing the method together with some of the most current research should help clarify its role and reveal its potential. This paper defines thermography, describes how infrared patterns are recorded, and reviews determinants of skin temperature, proposed mechanisms of thermal control, normal thermographic patterns, and the role of intraneural microstimulation (INMS) and LCT in evaluating unmyelinated C fibers in sensory disorders of primary neurological origin. The conclusion is that the anatomical and physiological basis for temperature changes in some sensory disorders of primary neurological origin have been established. LCT emerges as a relatively inexpensive, noninvasive, nonionizing technique that may provide insights on the status of unmyelinated systems plus documentation of subjective sensory symptoms. PMID- 1779190 TI - Vibrio vulnificus peritonitis. A unique case. AB - Louisiana is justifiably famous for the seafood harvested from its coastal waters. Unfortunately, undesirables accompany this harvest. The author presents a case of peritonitis due to vibrio vulnificus which followed ingestion of raw oysters. PMID- 1779191 TI - Stemming the tide of health care costs. AB - The government and third party carriers have concentrated their cost containment efforts in the wrong areas: reducing physician payments and restricting patients' access to care, while increasing bureaucratic administrative costs at all levels. There has been no net benefit from this cost containment effort. Shifting income from one group to another is not the solution. For those economists who require proof of this assertion, a study for validation is recommended. For one year a single state could be chosen to implement these recommendations: rapid reimbursement to avoid costly appeals; no utilization review or second opinions; no precertification; notification of patients before a procedure of the reimbursement amount; providing a percentage share of any insurance company savings resulting from physician review of itemized hospital bills; enacting meaningful tort reform to affect that 17% of physicians' costs and countless "defensive" lab and hospital expense; publishing comparative costs of common procedures by hospitals; and publishing comparative prices for common drugs by pharmacies. My hypothesis is that the costs of health care will be reduced below other states, while saving enormous "managed care" administrative costs. Dramatically reducing the huge noncaregiving costs of medicine, which make up at least 30% to 40% of the health care dollar, would enable all the uninsured and uninsurables to have the excellent, readily accessible health care they need at no increase over current expenditures. "Cost shifting" in all its many forms could be eliminated. We simply must cause a proper allocation of funds through appropriate regulation of insurance companies and their excessive administrative charges, meaningful tort reform, and the education of our physicians and the public in cost efficient, high-quality medical care.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779192 TI - ECG of the month. Primum non nocere! Ventricular premature impulses. PMID- 1779194 TI - Aesthetic plastic surgery. Current practices. PMID- 1779193 TI - Keloids. AB - Keloids are a benign proliferative growth of dermal collagen usually resulting from an excessive tissue response to skin trauma in predisposed individuals. Herein is a review of the history, epidemiology, clinical evaluation, histopathology, immunological theories of progression, and treatment of keloids. PMID- 1779195 TI - Basic techniques of face lifts. PMID- 1779196 TI - Rhinoplasty. AB - The nose is one of a person's most noticeable features, a feature with which he or she personally identifies and by which he or she may be known and recognized by others. When there is a facial disharmony by virtue of this important feature being relatively unflattering, disproportionate, disfiguring, or dysfunctional, then surgical change can make an important contribution physically, functionally, psychologically, and socially. Rhinoplasty involves a considerable normal concern on the part of the patient and presents a very significant professional challenge to the surgeon. Both the patient and the surgeon are likely to receive a great deal of personal satisfaction from surgery well done. PMID- 1779197 TI - Blepharoplasty. PMID- 1779198 TI - Lasers in plastic surgery: an expanding frontier. PMID- 1779199 TI - Correction of ear deformities. AB - Both traumatic and congenital ear deformities are immensely variable in their presentation and in the surgical problems that they present. However, many of the surgical techniques and principles are applicable to both. PMID- 1779200 TI - Scar revision and dermabrasion. PMID- 1779201 TI - Breast reconstruction following mastectomy: an update. AB - Breast reconstruction today is a realistic and vital part of total breast cancer treatment. All physicians should be well informed on current methods of reconstruction so that they can present the facts to their patients in an encouraging, yet realistic manner. Recent developments in breast reconstruction after mastectomy have included the increase utilization of immediate breast reconstruction at the time of mastectomy, the improvement and refinement of the TRAM flap, the increased use of the "free" flap transfer of the TRAM flap which increases blood supply to the flap, texturing of implants which appears to increase their stability on the chest wall and reduce the incidence of capsular contracture or firmness, and the introduction of the newer autogenous tissue methods including the LTTF, gluteal, and latissimus dorsi flaps. Plastic surgeons are charged with the task of becoming proficient in breast reconstruction procedures in order to offer the mastectomy patient a safe, realistic facsimile breast that will be trouble free. Fortunately, there are several good options for restoring the breast after mastectomy. The method of reconstruction should be chosen by matching the desires of informed patients with the indications and contraindications in each case. In general, silicone reconstruction is expedient and satisfactory in most patients. However, it cannot compete with autogenous tissue transfer for severe chest wall defects, covering irradiated areas, creating a large, ptotic breast, or providing a natural appearing, soft breast mount. PMID- 1779202 TI - Breast augmentation: a current controversy. AB - Breast augmentation remains a popular aesthetic procedure. Even with the current negative publicity, breast augmentation continues to be a widely accepted procedure. The materials that make up the breast implants have been in use for over 20 years with only minimal complications. Scar contractures continue to be the major complication with this surgery. A causal relationship between silicone breast implants, neoplasms of the breasts, or autoimmune diseases have not been demonstrated in experimental studies on humans. Scientific data presented to the FDA will determine if silicone-containing products will continue to be used for implantation. There is enough concern among some physicians and patients that many are now turning to saline implants. Some of the patients do not entertain the idea of saline implants because of the incidence of deflation and reoperation. Silicone may not be the perfect implantable substance, but no other material has been manufactured to replace this implant in the last 20 years. Until a better material is produced, silicone is the breast implant of choice. PMID- 1779203 TI - Breast reconstruction with free flaps. PMID- 1779204 TI - Recent advances in the treatment of hypertrophy and ptosis of the breast. AB - Changing fashions and popular demand are forcing us to adapt higher standards in breast surgery. The surgical techniques for breast reduction and mastopexy and the complications has been presented. PMID- 1779205 TI - Abdominal lipectomy as an office procedure. AB - Because of the increasing cost of hospitalization, many plastic surgeons have tried to make cosmetic surgery more affordable by performing procedures in the office operating room under local anesthesia and sedation. Standard abdominal lipectomy has classically been considered a procedure to be carried out in the hospital under general anesthesia. Following is the author's technique for performing the procedure under local anesthesia in the office setting. PMID- 1779206 TI - Body contouring: refined diagnosis and technique. PMID- 1779207 TI - The theoretical tenability of the doctrine of double effect. AB - The doctrine of double effect shows that for which the moral agent is responsible, by explicating the relationship between the act directly intended and the consequences of that act. I contend that this doctrine is necessary not only for natural law absolutism, but also for Donagan's Kantianism and for Quinn's revised construal of the doctrine, and even for consequentialism, as bioethical implications of the doctrine make clear. For those who do not accept this necessity, I contend that it is necessary metatheoretically, in order to deal with those moral agents with irreconcilably different notions of the morally good. PMID- 1779208 TI - Who is entitled to double effect? AB - The doctrine of double effect continues to be an important tool in bioethical casuistry. Its role within the Catholic moral tradition continues, and there is considerable interest in it by contemporary moral philosophers. But problems of justification and correct application remain. I argue that if the traditional Catholic conviction that there are exceptionless norms prohibiting inflicting some kinds of harms on people is correct, then double effect is justified and necessary. The objection that double effect is superfluous is a rejection of that normative conviction, not a refutation of double effect itself. This justification suggests the correct way of applying double effect to controversial cases. But versions of double effect which dispense with the absolutism of the Catholic tradition lack justification and fall to the objection that double effect is an unnecessary complication. PMID- 1779209 TI - Moral absolutism and the double-effect exception: reflections on Joseph Boyle's Who is entitled to double effect? AB - Joseph Boyle raises important questions about the place of the double-effect exception in absolutist moral theories. His own absolutist theory (held by many, but not all, Catholic moralists), which derives from the principles that fundamental human goods may not be intentionally violated, cannot dispense with such exceptions, although he rightly rejects some widely held views about what they are. By contrast, Kantian absolutist theory, which derives from the principle that lawful freedom must not be violated, has a corollary--that it is a duty, where possible, to coerce those who try to violate lawful freedom--which makes superfluous many of the double-effect exceptions Boyle allows. Other implications of the two theories are contrasted. Inter alia, it is argued that, in Boyle's theory, that a violation of a fundamental human good can be viewed as a cost proportionate to a benefit obtained, cannot yield a double-effect exception to the prohibition of intentionally violating that good, because paying a cost cannot be unintentional. PMID- 1779210 TI - Four versions of double effect. AB - Recent discussions of the doctrine of double effect have contained improved versions of the doctrine not subject to some of the difficulties of earlier versions. There is no longer one doctrine of double effect. This essay evaluates four versions of the doctrine: two formulations of the traditional Catholic doctrine, Joseph Boyle's revision of that doctrine, and Warren Quinn's version of the doctrine. I conclude that all of these versions are flawed. PMID- 1779211 TI - Conceptions of morality and the doctrine of double effect. AB - Whether one should accept a principle like DDE cannot be settled independent of one's more general moral theory. In this, I take it, I agree with Professor Boyle, though I do not think he has shown that DDE has a role only in his particular form of absolutism. Still, since his theory does require DDE, an important question is what the alternatives are--whether we must choose between this absolutism and either utilitarianism or intuitionism. A form of contractualism, the requirements of which derive to a large extent from institutionally or conventionally established rights, is sketched here as an attractive alternative. It does not lead, so far as I can see, to DDE. PMID- 1779212 TI - The doctrine of double effect: reflections on theoretical and practical issues. AB - The Doctrine of Double Effect and the Principle of Do No Harm raise important theoretical and practical issues, some of which are discussed by Boyle, Donagan, and Quinn. I argue that neither principle is correct, and some revisionist, and probably nonabsolutist, analysis of constraints on action and omission is necessary. In making these points, I examine several approaches to deflection of threat cases, discuss an argument for the permissibility of voluntary euthanasia, and present arguments relevant to medical contexts which justify intentionally harming some to aid others, with and without the consent of those harmed. PMID- 1779213 TI - In vitro intracanal temperatures produced by low- and high-temperature thermoplasticized injectable Gutta-percha. AB - An in vitro computerized temperature measurement system was developed to measure intracanal temperatures produced by different heated gutta-percha obturation techniques. The temperatures produced by low- and high-temperature thermoplasticized injectable gutta-percha systems were recorded and compared in this investigation. The mean intrachamber temperature of the Obtura syringe was 178.68 degrees C. The mean temperature of the Ultrafil heater was 93.06 degrees C. The mean temperature of the extruded gutta-percha was 137.81 degrees C from the Obtura syringe and 62.88 degrees C from the Ultrafil cannule. The intracanal temperature of the gutta-percha recorded for both systems showed that the gutta percha cools rapidly after injection into the canal. PMID- 1779214 TI - Halothane and eucalyptol as alternatives to chloroform for softening gutta percha. AB - Because chloroform was identified as a potential carcinogen by the Food and Drug Administration, interest has been revived to identify an alternative solvent to soften gutta-percha for removal from obturated root canals. This study compared the effectiveness of halothane, eucalyptol, and chloroform in softening gutta percha in simulated root canals. One milliliter of a solvent was placed into a small glass funnel whose stem was obturated with a 30-mm column of gutta-percha. After 30 s, softening was evaluated for each solvent by recording the time required to reach a depth of 10 mm by hand filing with a #100 Hedstrom file. The depth of penetration of a #40 finger plugger under constant weight for 15 min was also determined for each solvent. By using a one-way analysis of variance and Scheffe's test, all comparisons were not significant except for the depth of penetration with constant weight between chloroform and halothane (p less than 0.05). The results indicate that halothane and eucalyptol are suitable alternatives to chloroform as gutta-percha softening solvents. PMID- 1779215 TI - Endodontic retreatment in small and large curved canals. AB - This study used a special jig system, photography, and a sonic digitizer to evaluate the change in canal size and location after retreatment in 20 teeth with small or large curved canals (greater than 23 degrees). During initial instrumentation, small canals enlarged twice as much as large canals in the coronal and middle areas. During retreatment, small and large canals showed 30 to 85% enlargement compared with that of the initial instrumentation. There was a trend, primarily during retreatment, for small canals to deviate more than large canals away from the original canal location. PMID- 1779216 TI - Copper-zinc superoxide dismutase activity in normal and inflamed human dental pulp tissue. AB - Information regarding the presence of the free radical scavenging (inactivating, dismutating) enzyme superoxide dismutase in human dental pulp was sought. Free radicals, such as the superoxide anion radical (O2-) and the hydroxyl anion radical (OH.), are powerful biological oxidants produced by phagocytes during the normal tissue response to injury and infection. Also produced is hydrogen peroxide (H2O2), an aggressive oxygen species formed by the reaction of superoxide with itself, i.e., a dismutation in which one molecule of O2- is oxidized by the other. These three reactive oxygen intermediates serve as part of the normal host biological defense mechanism for the inactivation of microorganisms and the breakdown of their toxic products. Both normal and inflamed dental pulps were assayed for the presence of this enzyme. Superoxide dismutase activity was identified in the normal pulpal tissues. There was a slight decrease in activity with age. In the inflamed pulpal tissues, enzyme activity was markedly and significantly increased in comparison to that in the normal tissues. These observations indicate that human dental pulp possesses an endogenous defense mechanism designed to protect the tissue components (cells and matrix) from the toxic effects of the reactive oxygen intermediates. In this regard, the inflammatory response of this specialized and somewhat isolated (compartmentalized) tissue is not unlike that seen in other connective tissues. PMID- 1779217 TI - Torsional and metallurgical properties of rotary endodontic instruments. 2. Stainless steel Gates Glidden drills. AB - A laboratory study was performed on stainless steel Gates Glidden drills to determine their torsional and metallurgical properties. Samples of #1 to #6 drills from the two manufacturers that distribute these instruments in the United States were tested in incremental and continuous clockwise torsional loading by using a digital torque meter. The values of mean torque at fracture obtained with these tests generally showed no statistically significant differences for the same drill size and a given manufacturer. However, it was not possible to completely evaluate drill sizes #5 and #6 because the torsional moments developed during testing exceeded the capacity of the test instrument. Scanning electron microscope examination confirmed the occurrence of ductile torsional fracture processes, which were evident from visual observation of the instruments after fracture. This study is part of a continuing investigation to establish standards for all rotary endodontic instruments. PMID- 1779218 TI - Human saliva coronal microleakage in obturated root canals: an in vitro study. AB - This study assessed salivary penetration through obturated root canals as related to time by using two methods of analysis--histological examination and dye penetrations. A total of 160 human maxillary anterior teeth were instrumented to size 60 Hedstrom file. Ten of the teeth were not obturated; 150 teeth were obturated by lateral condensation of gutta-percha and Roth's root canal sealer. Fifty of these teeth received intermediate restorative material temporaries to a thickness of approximately 3 mm. All teeth were immersed in 50 ml of whole human saliva and kept at 37 degrees C and 100% humidity. The saliva was changed daily. At 2, 7, 14, 28, and 90 days, 32 teeth were removed from the saliva. Of these, two were unobturated and were examined for bacterial penetration by culturing of the apical one-third. Ten teeth without temporaries were immersed in Pelikan ink for 2 days to demonstrate the extent of salivary penetration. These teeth were decalcified and cleared to allow direct measurement of dye penetration. Decalcified serial 7-microns-thick sections were prepared from the remaining 20 teeth, 10 with and 10 without intermediate restorative material temporaries. The sections were stained with hematoxylin and eosin stain and Brown and Hopps stain. Saliva penetration assessed in histological sections was significantly less than was visualized with dye analysis. Salivary penetration at 3 months was significantly greater than at the four earlier study periods. This amount of salivary penetration was considered to be clinically significant. The results strongly suggest retreatment of obturated root canals that have been exposed to the oral cavity for at least 3 months. PMID- 1779219 TI - Failure of endodontically treated teeth: classification and evaluation. AB - All endodontically treated teeth that were extracted over a 1-yr period in a busy group practice were evaluated for cause of failure. The 116 teeth collected were classified into major failure categories of prosthetic, periodontic, and endodontic origin. Of the teeth, 59.4% were prosthetic failures which were due primarily to crown fracture. Teeth that had been crowned had greater longevity than uncrowned teeth. Periodontal failures constituted 32% of the study. Only 8.6% of the failures were due to endodontic causes, but these failures became evident more quickly than those in the other categories. A classification of failures is presented, and the results are analyzed. PMID- 1779220 TI - A clinical comparison of treatments for endemic dental fluorosis. AB - A case report is presented describing the treatment for endemic dental fluorosis. Six maxillary anterior teeth were treated, three with an acid-bleach combination technique and three with an acid technique. No clinical differences was noted in treatment time or esthetic results. PMID- 1779221 TI - Lack of corrosion of stainless steel instruments in vivo by scanning electron microscope and microprobe analysis. AB - Two clinical cases are presented which show no corrosion of broken stainless steel endodontic instruments. Corrosion of a silver endodontic filling cone is demonstrated. PMID- 1779222 TI - Zebra hunt. Arteriovenous malformations. PMID- 1779223 TI - Developmental study of afferented and deafferented bee antennal lobes. AB - The role of antennal sensory projections on the ontogeny of the bee antennal lobe was analyzed using both light and transmission electron microscopy. Normal and deafferented developing antennal lobes were examined. The results obtained show that (1) initiation of synaptogenesis in the antennal lobe is independent of the arrival of sensory inputs; (2) sensory inputs are necessary for setting up the glomerular antennal lobe organization; (3) regressive events, such as the reduction of synapse density, occur during the development of the antennal lobe; and (4) glomeruli formation appears as related to glia development. PMID- 1779224 TI - Migration patterns of sympathetic preganglionic neurons in embryonic rat spinal cord. AB - The displacement of immature neurons from their place of origin in the germinal epithelium toward their adult positions in the nervous system appears to involve migratory pathways or guides. While the importance of radial glial fibers in this process has long been recognized, data from recent investigations have suggested that other mechanisms might also play a role in directing the movement of young neurons. We have labeled autonomic preganglionic cells by microinjections of horseradish peroxidase (HRP) into the sympathetic chain ganglia of embryonic rats in order to study the migration and differentiation of these spinal cord neurons. Our results, in conjunction with previous observations, suggest that the migration pattern of preganglionic neurons can be divided into three distinct phases. In the first phase, the autonomic motor neurons arise in the ventral ventricular zone and migrate radially into the ventral horn of the developing spinal cord, where, together with somatic motor neurons, they form a single, primitive motor column (Phelps P. E., Barber R. P., and Vaughn J. E. (1991). J. Comp. Neurol. 307:77-86). During the second phase, the autonomic motor neurons separate from the somatic motor neurons and are displaced dorsally toward the intermediate spinal cord. When the preganglionic neurons reach the intermediolateral (IML) region, they become progressively more multipolar, and many of them undergo a change in alignment, from a dorsoventral to a mediolateral orientation. In the third phase of autonomic motor neuron development, some of these cells are displaced medially, and occupy sites between the IML and central canal. The primary and tertiary movements of the preganglionic neurons are in alignment with radial glial processes in the embryonic spinal cord, an arrangement that is consistent with a hypothesis that glial elements might guide autonomic motor neurons during these periods of development. In contrast, during the second phase, the dorsal translocation of preganglionic neurons occurs in an orientation perpendicular to radial glial fibers, indicating that glial elements are not involved in the secondary migration of these cells. The results of previous investigations have provided evidence that, in addition to glial processes, axonal pathways might provide a substrate for neuronal migration. Logically, therefore, it is possible that the secondary dorsolateral translocation of autonomic preganglionic neurons could be directed along early forming circumferential axons of spinal association interneurons, and this hypothesis is supported by the fact that such fibers are appropriately arrayed in both developmental time and space to guide this movement. PMID- 1779225 TI - Co-cultures of inferior olive and cerebellum: electrophysiological evidence for multiple innervation of Purkinje cells by olivary axons. AB - Slices of inferior olive (IO) and cerebellum were co-cultured for several weeks by means of the roller tube technique. Recordings were carried out intracellularly from Purkinje cells (PCs) which were identified morphologically by intracellular injection of the fluorescent dye Lucifer yellow, or by immunohistochemical stainings with antibodies raised against the 28 kD Ca(2+) binding protein calbindin. Following stimulation of olivary tissue, an all-or none full complex spike response was recorded in some PCs consisting of a fast rising spike followed by a depolarizing potential. In other PCs, graded stimulation of the olivary explant induced synaptic potentials which were characterized by step-wise variation in their amplitude and resembled the ones occurring spontaneously. In contrast, only smoothly graded synaptic potentials were observed in cerebellar mono-cultures. These results indicate that some of the PCs in olivo-cerebellar co-cultures are innervated by several olivary neurons. PMID- 1779227 TI - The effect of some platinum compounds on the activity of the CTP synthetase of Ehrlich ascites tumor cells: in vitro and in vivo studies. AB - The present work investigates the effect of cis-DDP (DDP, diamminedichloroplatinum(II)), trans-DDP, SPC (spermine platinum(II) complex), and K2PtCl4 on the activity of the CTP synthetase in the cytosol of Ehrlich ascites tumor cells. To study their in vitro effect, the platinum compounds were supplemented to the incubation mixture for the enzyme assay. A concentration dependent inhibition of the CTP synthetase was found which was strongest in the case of trans-DDP. When ascites cells collected from mice, pretreated in vivo with platinum compounds, were used, the enzyme assay showed that the inhibition is strongest in the case of cis-DDP and K2PtCl4 (about 90% inhibition). This distinct inhibitory effect of the platinum compounds in the present experiments may be explained with the metabolic conversions of the compounds in the organism to their more active forms and/or with the inhibition of the protein biosynthesis under their influence because the lifetime of the CTP synthetase is short. This last assertion is proved in this work by control experiments with the antibiotic cycloheximide, which is an inhibitor of the protein biosynthesis. PMID- 1779226 TI - Sexually dimorphic, androgen sensitive, enkephalinergic afferents to a lumbar motor nucleus of rats. AB - In male rats, methionine-enkephalin immunoreactivity (enkephalin-ir) has been observed in the dorsal lateral nucleus (DLN), a longitudinal pool of motoneurons in the lumbar spinal cord. Within the DLN a mediodorsal crescent of intense enkephalin-ir staining surrounds the motoneurons innervating the ischiocavernosus muscle of the penis, which suggests a function of the enkephalinergic afferents in male copulatory activities. The present study attempted to determine the roles of gender and adult exposure to androgen in shaping the striking subnuclear distribution of enkephalin-ir. Transverse sections through L5-6 were obtained from mature male and female rats that were gonadally intact, gonadectomized, or gonadectomized and treated with testosterone, as well as from male rats genetically deficient in androgen receptors (Tfm). The sections were incubated with primary antiserum raised against methionine enkephalin and bound antibodies were visualized using the avidin-biotin-peroxidase technique. A microphotometer was used to compare the staining density in laminae I-II of the dorsal horn, ventral grey matter, and the DLN. In all groups the DLN stained more darkly than the ventral grey, demonstrating the presence of enkephalin-ir in the DLN regardless of gender or exposure to androgen. However, the mediodorsal crescent of dense staining in the DLN was obvious only in gonadally intact males, while the entire DLN stained darkly in both sexes of gonadectomized rats treated with androgen. Therefore, the preferential distribution of enkephalin-ir in the mediodorsal crescent of the DLN is sexually dimorphic though the overall content of enkephalin-ir within the DLN responds to androgen. PMID- 1779228 TI - Some dicopper complexes of benzimidazole-containing ligands. AB - Dicopper complexes of the following benzimidazole-containing ligands have been studied as possible models for the active site of hemocyanin: EDTB (N,N,N',N' tetrakis-(2-benzimidazolylmethyl)-1,2-ethanediamine), EGTB (1,1,10,10-tetrakis-(2 benzimidazolylmethyl)-1,10-diaza-4,7- dioxadecane), and MEGTB (1,1,10,10-tetrakis (1-methylbenzimidazol-2-y lmethyl)-1,10-diaza-4,7-dioxadecane). The initial oxygenation product of Cu2(EDTB)(ClO4)2 in Me2SO gives optical absorption maxima at 315 nm (epsilon = 3750 M-1 cm-1) and 690 nm (epsilon = 100 M-1 cm-1). The fluorescence emission intensities of Cu2(EDTB)(ClO4)2 at 400 and 700 nm (excitation at 350 nm) decreases rapidly on exposure to air. This suggests oxidation of Cu2(I) to Cu2(II). The x-ray absorption edge spectra suggest that both coppers in the oxygenation product, analyzed as Cu2(EDTB)(ClO4)2(O).3H2O, are Cu(II). From spectrophotometric titration of Cu2(MEGTB)Cl4 with azide, formation constant of the Cu2(MEGTB)N3Cl3 complex has been obtained. Data from cyclic voltammetry experiments suggest that in the presence of azide, Cu(II)(N3)Cu(II) species is present. PMID- 1779229 TI - Reaction of the octahedral antitumor complex trans-RuCl2 (DMSO)4 with 2'deoxyguanosine. AB - The reaction of the antitumor octahedral complex trans-RuCl2(DMSO)4 with 2'deoxyguanosine leads to the reversible formation of two diastereoisomeric monoadducts and one biadduct. This shows that it is possible to accommodate two purine bases in a cis configuration in an octahedral transition metal complex which exhibits antiblastic activity. All the product compounds are characterized by a guanine moiety coordination via the N7 atom. A marked decrease (about two pK units) is observed for the N1H pKa of the coordinated guanine moieties. The reversibility of the monodentate binding could explain the low toxicity of the ruthenium(II) complexes. PMID- 1779230 TI - Mossbauer spectroscopic studies of iron in Pseudomonas aeruginosa. AB - The present Mossbauer spectroscopic studies of isolated bacterioferritin and whole cells of Pseudomonas aeruginosa have shown that the iron core of bacterioferritin is not altered on isolation. These studies have also shown that the bacterioferritin core is typically 85% oxidized within the cell and may contain a significant proportion of its iron as small clusters during the early stage of the stationary phase of cell growth. PMID- 1779231 TI - Hepatic membranolytic stability alteration by metalloporphins in rats. AB - The mothers of experimental neonates were administered excess bilirubin for a month, and the neonates were suffering from hyperbilirubinemia. The studies were conducted on the effect of excess bilirubin and metalloporphyrins on plasma membrane and mitochondrial membrane. We have isolated, separated, and estimated phospholipids, and also assayed the activity of phospholipase A2 from whole liver and mitochondrial and microsomal fractions. Excess of bilirubin administration decreased the total phospholipid level and inhibited the phospholipase A2 activity. Cr-PP (chromium protoporphyrin) induces the phospholipase A2 activity which is inhibited by simultaneous bilirubin administration. However, Zn-PP (zinc protoporphyrin) and Mn-PP (manganese protoporphyrin) showed a reverse pattern. PMID- 1779232 TI - EEG spectral analysis and topographic mapping in Wilson's disease. AB - Computerized EEG spectral analysis and topographic mapping were performed on 14 patients with Wilson's disease (WD) and 10 normal subjects of comparable ages. The predominant EEG changes in WD were diffuse but uneven topographic abnormalities with a decrease in alpha activity, an increase in theta and delta activities, and a low voltage background mainly in the alpha frequency band. Eleven patients (80%) had at least one of the above EEG changes. Furthermore, topographic mapping provided more clearly defined foci of slowing and epileptiform activity. Patients with cerebral white matter involvement, akinetic rigid syndrome, dystonia, or psychiatric symptoms tended to have more abnormal EEGs. It is concluded that EEG changes in WD are common and the quantitative EEG analysis can increase the likelihood of detecting mild or even subtle EEG abnormalities in individual patients as well as in the patient group. PMID- 1779233 TI - A family of familial hypercholesterolemia with cerebral infarction and without coronary heart disease. An unusual case with corneal opacity, polyneuropathy and carpal tunnel syndrome in the family: therapy with probucol and tocopherol nicotinate. AB - A study is presented of a 48-year-old female patient and her three siblings with familial hypercholesterolemia. The family members had episodes of cerebral infarction and apparently had atherosclerosis of the internal carotid artery, but no coronary heart disease due to their almost normal level of cholesterol. The laboratory studies of the family members revealed the elevations of serum lipid peroxides, serum lipoprotein(a), leukotriene C4 in blood, the thromboxane B2/6 keto-prostaglandin F1 alpha ratio in plasma and serum hydroxyl radical. Therefore, it is suspected that these factors accelerating atherosclerotic process caused the cerebral infarction. The patient demonstrated corneal opacities, palpebral xanthomas, thickened Achilles tendons, polyneuropathy and the carpal tunnel syndrome. Laboratory studies revealed an elevation in the OKT4/8 ratio, monocyte dysfunction with respect to phagocytosis and chemotaxis, and the presence of the 46XX/45XO mosaic chromosome. Lipid deposits were observed in the Achilles tendon, the transverse carpal ligament, the Schwann's cells and axons of the sural nerve, and in the keratocytes and stroma of the cornea. Following the administration of tocopherol nicotinate and probucol, the patient's serum lipid peroxide normalized and there was improvement in her palpebral xanthomas, thickening of the Achilles tendons and polyneuropathy. We conclude that the lipid deposits in this patient were due to the abnormal oxidative metabolism of low-density lipoprotein and a disturbance of the scavenger pathway due to the monocyte dysfunction. PMID- 1779234 TI - Cerebral angio- and neuro-Behcet's syndrome: neuroradiological and pathological study of one case. AB - Cerebral angio-Behcet's syndrome is extremely rare and pathological studies are scarce. We describe a 63-year-old man who developed left homonymous hemianopsia and hemiparesis 16 years after the onset of cardinal symptoms of Behcet's syndrome. CT, MRI and PET studies disclosed cerebral lesion with reduced neuronal metabolism in the right hemisphere, which was resolved by glucocorticoid therapy. Cerebral angiography showed no filling of the right Rolandic, anterior and posterior parietal and angular arteries. The postmortem study revealed: (a) occlusive panarteritis of some medium-sized pial branches of the right middle cerebral artery, considered as angio-Behcet's pathology, and small infarctions due to the vascular occlusion; (b) patchy or confluent demyelinated foci with perivascular lymphocytic infiltration in the bilateral brain basis, predominantly in the right retro- and sublenticular structures, being equivalent to neuro Behcet's pathology. Cerebral angio- and neuro-Behcet's syndromes could have occurred and progressed concomitantly, which suggests a close relationship between the two subclassified processes. PMID- 1779235 TI - The role of magnetic stimulation in the diagnosis of multiple sclerosis. AB - Magnetic stimulation was used to measure motor conduction time (MCT) between head and neck, and head and lumbar region, as well as amplitude of the motor evoked potential (MEP) in normal subjects and patients with multiple sclerosis (MS). Patients with definite MS had significantly longer MCTs and smaller amplitude MEPs than normal subjects when recording from arm and leg muscles. In a comparison with visual evoked potential (VEP) recordings, head to neck MCTs were abnormal less often than VEPs, and VEPs detected more silent lesions. Recording from leg as well as arm muscles significantly increased the yield of abnormal MCT measurements. The detection of silent lesions in the patients with definite MS was improved, but there was no improvement in the non-definite cases. Amplitude measurements provided very little extra diagnostic information over MCT measurements alone and did not improve the detection of silent lesions. Interside MCT differences yielded extra abnormalities when recording from the arms but not the legs. Interside MCT abnormalities increased the detection of silent lesions in both the definite and non-definite categories. It was concluded that the majority of useful diagnostic information in patients with MS should be obtainable from bilateral MCT (head to neck) measurements, together with estimation of interside MCT differences. However, VEP recording is a better diagnostic test for MS than MEP recording as more silent lesions are detected. This may be because MCT abnormalities tend to reflect the degree of pyramidal disability. PMID- 1779236 TI - The role of magnetic stimulation as a quantifier of motor disability in patients with multiple sclerosis. AB - Magnetic stimulation was used to measure motor conduction time (MCT) between head and neck in a prospective longitudinal study of patients with multiple sclerosis (MS) and normal subjects. MCT measurements showed a high degree of reproducibility in normal subjects and patients with stable MS. In patients with definite MS, there was significant positive correlation between MCT and motor disability. In patients treated with steroids for relapse of MS, there was significant shortening of MCT following treatment in those who clinically improved, but not in those who were clinically unchanged. In a smaller group of patients followed for 3 months, MCT changes tended to mirror the clinical pattern. Magnetic stimulation should prove a useful tool for the quantification of motor disability, and monitoring the response to new treatments in MS. PMID- 1779237 TI - Long term follow-up of multiple sclerosis by standardized, non-contrast-enhanced magnetic resonance imaging. AB - The usefulness of non-contrast-enhanced, standardized magnetic resonance imaging for the longterm follow-up of MS patients was evaluated in a retrospective study in 36 patients with clinically definite MS. All had remitting-relapsing diseases courses. Sixteen patients remained clinically stable during follow-up. Mean duration of follow-up was 22 months (SD: 11). A mean number of 3 MRI examinations was performed in each of the patients (SD: 1). Subclinical evolution was detected in 56% of the stable patients, indicating that clinical data alone are insufficient to assess disease activity. The relapsing patients showed significantly more and larger changes on MRI than stable patients (P less than 0.001), indicating that MRI is well suited as a follow-up parameter in conjunction with clinical data. The time courses of these quantitative changes and of the qualitative changes of putative MS lesions on MRI are discussed. It is concluded that MRI is a good indicator of global disease activity in multiple sclerosis patients, which makes MRI very useful for the evaluation of therapeutic trials. PMID- 1779238 TI - Leukoencephalopathy in HTLV-I-associated myelopathy/tropical spastic paraparesis: MRI analysis and a two year follow-up study after corticosteroid therapy. AB - Magnetic resonance imaging (MRI) of the brain was studied in 35 patients with HTLV-I-associated myelopathy (HAM)/tropical spastic paraparesis (TSP), 19 HTLV-I seropositive carriers without HAM/TSP (non-HAM/TSP carriers), 18 patients with HTLV-I seronegative spastic spinal paraparesis (SSP), and 82 HTLV-I seronegative controls with other neurological disorders. The incidence of white matter lesions was significantly higher in HAM/TSP (66%) than in the controls (23%) and SSP (11%). HAM/TSP exceeded non-HAM/TSP carriers significantly in the incidence of multiple white matter lesions (37% vs 10%). HAM/TSP affected the deep and subcortical cerebral white matter multifocally, sparing the periventricular regions. None of the lesions were enhanced by gadolinium-DTPA. HAM/TSP patients with the white matter lesions had both a longer duration of disease and a greater disability than did those without lesions. The white matter lesions gradually increased in number, as the disability status became worse, in spite of the high dose corticosteroid treatment. All these observations suggest that the MRI abnormalities of the HAM/TSP brain may reflect the chronic perivascular inflammation with progressive gliosis (chronic disseminated encephalomyelitis). We propose that brain MRI can be successfully utilized as a reliable and non invasive measure for following the disease progression in HAM/TSP. PMID- 1779239 TI - Cortical serotonin-S2 receptor binding in Lewy body dementia, Alzheimer's and Parkinson's diseases. AB - The binding of the selective 5-HT2 antagonist [3H]ketanserin has been investigated in the temporal cortex of patients with Alzheimer's disease (SDAT), Parkinson's disease (PD), senile dementia of Lewy body type (SDLT) and neuropathologically normal subjects (control). 5-HT2 binding was reduced in SDAT, PD with dementia and SDLT. SDAT showed a 5-HT2 receptor deficit across most of the cortical layers. A significant decrease in 5-HT2 binding in the deep cortical layers was found in those SDLT cases without hallucinations. SDLT cases with hallucinations only showed a deficit in one upper layer. There was a significant difference in cortical layers III and V between SDLT without hallucinations and SDLT with hallucinations. The results confirm an abnormality of serotonin binding in various forms of dementia and suggest that preservation of 5-HT2 receptor in the temporal cortex may differentiate hallucinating from non-hallucinating cases of SDLT. PMID- 1779240 TI - Vacuolar myositis with expression of both MHC class I and class II antigens on skeletal muscle fibers. AB - We describe here a 10-year-old patient with high levels of serum IgE and inflammatory myopathy whose muscle fibers exhibit excessive autophagy. Previous studies have demonstrated surface expression of class I MHC antigens on muscle fibers from patients with inflammatory myopathy. The muscle fibers of this patients showed marked expression of both class I and class II MHC antigens. The reaction products were demonstrated not only on sarcolemma but also in and around some vacuoles. Both CD4-positive and CD8-positive T-lymphocytes were noted in inflammatory exudates surrounding these fibers but B-lymphocytes were rare. We hypothesize that myocyte expression of both class I and class II antigens may play a role in the pathogenesis of this new type of inflammatory myopathy. PMID- 1779241 TI - Skeletal muscle regeneration in young rats is dependent on growth hormone. AB - Skeletal muscle fibres have a well known ability to regenerate after different kinds of injury. This study was undertaken to establish if regenerating skeletal muscle is dependent on growth hormone (GH) in the same manner as normal, growing skeletal muscle in young rats. Muscle regeneration was achieved by injection of notexin into the soleus muscle. Initial necrosis, which included all muscle fibres, was followed by a rapid and uniform regeneration throughout the muscle. Cell proliferation was estimated by scintillation counting and autoradiography of incorporated [3H]thymidine, injected intravenously 1 h before killing, 7 or 27 days after the initiation of regeneration. GH deficiency was accomplished by hypophysectomy 4 days before the [3H]thymidine injection. Cell proliferation was diminished in both regenerating and normal muscle of the hypophysectomized rats compared to control and GH-substituted rats. After 7 days of regeneration the reduction of cell proliferation seen in hypophysectomized rats was less pronounced in the regenerating than in the normal muscle. These findings demonstrate that GH plays an important role for muscle regeneration in young rats, although other substances appear to be of greater importance during the early stages of regeneration. PMID- 1779242 TI - Hormonal changes in headache patients. AB - Seventy-three patients with headache underwent serum and cerebrospinal fluid (CSF) radioimmunoassays of follicle-stimulating hormone (FSH), luteinizing hormone (LH), cortisol and prolactin. Serum FSH showed significant increases in all headache patients while serum LH increased only in females. Such a rise of serum FSH and LH is attributed to disturbances of the sleep-wake cycle. On the other hand, serum cortisol was significantly decreased in the male headache patients, probably due to altered circadian rhythm. Serum prolactin remained within normal limits. CSF prolactin, FSH and LH showed detectable levels in all headache sufferers compared to undetectable levels in control subjects, while CSF cortisol was significantly reduced. PMID- 1779243 TI - Effect of intraventricular injection of an anti-Purkinje cell antibody (anti-Yo) in a guinea pig model. AB - Female guinea pigs had intraventricular injections of either IgG from a patient with paraneoplastic cerebellar degeneration (PCD) and anti-Purkinje cell antibodies (anti-Yo IgG) or control IgG. In animals that received a single injection of control or anti-Yo IgG and were killed at different time intervals, IgG immunoreactivity was present in the cytoplasm of Purkinje cells at 2 h and persisted at 24 h. In guinea pigs injected for 15 days with control or anti-Yo IgG and sacrificed 24 h after the last injection, IgG was detected into the Purkinje cells in both groups, whereas animals killed 7 and 30 days after the last injection had no staining for IgG in the Purkinje cells. Clinical or pathologic evidence of cerebellar involvement was not seen in any of the animals. This study suggests that anti-Yo antibody alone may not be the cause of the Purkinje cell loss in PCD. PMID- 1779244 TI - No transketolase abnormalities in Wernicke-Korsakoff patients. AB - Transketolase isoenzyme patterns of Wernicke-Korsakoff patients, relatives, alcoholics and controls, obtained by isoelectric focusing of purified erythrocyte transketolase, were all identical. After a series of investigations published by several authors little evidence remains to support the hypothesis of an inborn transketolase abnormality in Wernicke-Korsakoff patients. PMID- 1779245 TI - Antibody in the CSF of patients with multiple system atrophy reacts specifically with rat locus ceruleus. AB - Idiopathic chronic autonomic dysfunction may occur as pure autonomic failure (PAF) or in association with multiple system atrophy (MSA). CSF immunoreactivity to rat locus ceruleus occurred in a significantly greater number of samples from MSA patients compared to control subjects or patients with PAF. Other brain regions infrequently showed immunoreactivity. These findings suggest that degeneration in MSA may release antigen(s) that induce antibodies against locus ceruleus neurons. Further studies are required to determine whether immune abnormalities play a pathogenetic role in MSA. Lack of CSF immunoreactivity in PAF is consistent with primarily peripheral involvement. PMID- 1779246 TI - The shadow of movement. AB - Movement is preceded, accompanied and followed by reactions which give to the primary action its correct execution and ensure that the body's axis, together with the limbs, maintains the right balance. If these reactions are interfered with, incoordination of movement, lack of balance, hypertonia or dystonia may all appear. In the case of dystonia, postural mechanisms tend to become dominant and take over from the kinetic component of movement. In the upper limbs, the dystonic posture follows patterns analogous to those used by monkeys for postural purposes. Thus, while the initial mechanisms of movement represent highly sophisticated processes thoroughly adapted to living in an upright state, the reactions that go with the movement are more primitive and probably have a less helpful role. PMID- 1779247 TI - Cervical intramedullary cavernous angioma with MRI-proven haemorrhages. AB - Two contrasting cases of cervical intramedullary cavernous angioma in young female patients are reported. One patient had a 3-year course of step-wise progressive tetraparesis; at each of the five events intramedullary bleeding from a cryptic vascular malformation at C6-7 level was diagnosed by MRI. The other patient presented with one episode which led to MRI diagnosis of a vascular malformation at the C2 level. Both patients eventually underwent complete surgical excision of the angioma with subsequent steady improvement of the neurological deficit. PMID- 1779248 TI - Auditory middle-latency responses in patients with localized and non-localized lesions of the central nervous system. AB - Auditory middle-latency responses were recorded in 45 neurological patients. In 4 patients with localized lesions in the thalamus, or subcortical white matter, the component Na was attenuated or delayed at T3, Cz and T4, exclusively on stimulation of the ear contralateral to the lesion. In 5 patients with temporal lobe lesions with receptive aphasia, the amplitude of component Pa was decreased on the lesion side (T3), regardless of the side of stimulation. These findings suggest that Na is generated from a subcortical structure and Pa is generated from the temporal cortex. In 25 patients with diffuse CNS lesions, V-Na interpeak latency was prolonged in 2 cases. PMID- 1779249 TI - The natural history and results of surgery in 50 cases of syringomyelia. AB - In recent years, new neuroimaging techniques have revived interest in syringomyelia with respect to indications and results of surgery. Fifty patients, 36 of whom underwent surgery, have been reviewed. All patients but 3 underwent a new clinical assessment and 33 of them were also neurophysiologically investigated. In approximately one-third of the non-surgically treated patients the clinical course was benign. In 26 of the surgically treated patients an improvement was noted at the short-term assessment both for spasticity and pain, but in most of them it was not maintained in the medium term. Therefore, an accurate selection of the patients to be treated surgically is strongly recommended, particularly when the natural history of the disease is considered. Decompression of the posterior fossa seems to give the best results, yet no curative surgical treatment has been devised to date. PMID- 1779250 TI - Two cases of cerebral toxoplasmosis in AIDS patients mimicking HIV-related dementia. AB - Two unusual cases of cerebral toxoplasmosis in AIDS patients are presented. Two homosexual males aged 33 and 52 years in CDC stage IV C1 complained of memory loss during the past 6 months, as well as weight loss and mild fever. They showed severe intellectual deterioration and discrete basal ganglia dysfunction. Motor performance and cognitive function as well as the conventional EEG findings were grossly abnormal. MRI was normal in the younger patient but showed signal intensive zones in the basal ganglia and cortical atrophy in the older one. CSF and serological antibody tests were normal; immunological function was severely impaired. The patients were diagnosed as late "HIV-related dementia". Both deteriorated rapidly and died within a few weeks. Neuropathological examination revealed histologically severe Toxoplasma gondii encephalitis, involving the basal ganglia in particular. It is concluded that in AIDS patients with a severely impaired immune status cerebral opportunistic infection may present as dementia with mild basal ganglia impairment in the absence of other focal neurological signs or the characteristic radiological findings. PMID- 1779251 TI - Tolerance for light and sound of patients with persistent post-concussional symptoms 6 months after mild head injury. AB - Patients with post-concussional symptoms (PCS) about 6 months after a mild head injury (MHI) were examined for tolerance of light and sound in comparison with concussed patients without PCS and non-concussed healthy controls. MHI patients with PCS were individually matched with subjects from the two control groups for the time elapsed from the injury, and for age and sex. Using a computerized rating technique, we assessed both the maximal and submaximal levels of lowered tolerance for light and sound over a wide range of stimuli. We found that the MHI patients with PCS 6 months after the trauma (n = 11) tolerated significantly less well stimuli of intensities of 71 dB and 500 lx than MHI patients without PCS (n = 11) and non-concussed controls (n = 11). There were no significant differences in tolerance for light and sound between MHI patients without PCS and the non injured controls. Decreased tolerance for light and sound may contribute to the persistence of symptoms up to 6 months after a mild head injury. The psychophysical method provides an objective measure for the evaluation of the late persistent post-concussional syndrome. PMID- 1779252 TI - Acute motor neuropathy with antibodies to GM1 ganglioside. AB - We describe a 52-year-old man who had an acute-onset purely motor neuropathy fulfilling the diagnostic criteria for the Guillain-Barre syndrome, in whom virtually complete spontaneous recovery occurred by 1 year, and in whom high titres of polyclonal serum antibody to GM1, GD1b, asialo-GM1 and lacto-N-tetraose were detected. The titre of IgM antibody to GM1 fell during the course of the disease with a concomitant rise in the IgG titre. This case adds to the widening spectrum of disease associated with anti-GM1 antibodies and provides further evidence for a relationship between anti-GM1 antibodies and motor system disease. PMID- 1779253 TI - Topical 0.025% capsaicin in chronic post-herpetic neuralgia: efficacy, predictors of response and long-term course. AB - In order to evaluate the efficacy, time-course of action and predictors of response to topical capsaicin, 39 patients with chronic post-herpetic neuralgia (PHN), median duration 24 months, were treated with 0.025% capsaicin cream for 8 weeks. During therapy the patients rated their pain on a visual analogue scale (VAS) and a verbal outcome scale. A follow-up investigation was performed 10-12 months after study onset on the patients who had improved. Nineteen patients (48.7%) substantially improved after the 8-week trial; 5 (12.8%) discontinued therapy due to side-effects such as intolerable capsaicin-induced burning sensations (4) or mastitis (1); 15 (38.5%) reported no benefit. The decrease in VAS ratings was significant after 2 weeks of continuous application. Of the responders 72.2% were still improved at the follow-up; only one-third of them had continued application irregularly. Treatment effect was not dependent on patient's age, duration or localization of PHN (trigeminal involvement was excluded), sensory disturbance or pain character. Treatment response was not correlated with the incidence, time-course or severity of capsaicin-induced burning. If confirmed in controlled trials, the long-term results of this open, non-randomized study might indicate that the analgesic effect of capsaicin in PHN is mediated by both interference with neuropeptide metabolism and morphological changes (perhaps degeneration) of nociceptive afferents. PMID- 1779254 TI - Peduncular hallucinations. AB - Peduncular hallucinations usually present as visual disorders and are often genuine hallucinations associated with thalamic and/or mesencephalic lesions. In this case report we describe the clinical findings in a patient with hallucinations. Magnetic resonance imaging demonstrated bilateral ischaemic lesions in the thalamus and in the mesencephalon. The pathogenesis of hallucinations in these disorders is discussed in the light of the findings provided by imaging techniques. PMID- 1779255 TI - Antibacterial activity of ceftibuten, a new oral third generation cephalosporin. AB - Ceftibuten, a new oral third generation cephalosporin, was found to be the most active beta-lactam drug tested against members of the Enterobacteriaceae, inhibiting most strains at less than 4 micrograms/ml. All isolates of Branhamella catarrhalis, Haemophilus influenzae, and Neisseria spp. were highly susceptible to ceftibuten. Penicillin-sensitive pneumococci and pathogenic beta-hemolitic streptococci were also killed by ceftibuten. The antibacterial activity of this new drug, which results in rapid lysis of susceptible cells, was not significantly affected by serum, pH, inoculum size, media composition and growth conditions. Ceftibuten is characterized by a remarkable resistance to inactivation by most beta-lactamases synthetized by common gram-positive and gram negative pathogens. The potent in vitro activity of ceftibuten in conjunction with its favorable pharmacokinetic profile render this new molecule an attractive candidate for the treatment of respiratory and urinary tract infections sustained by susceptible pathogens. PMID- 1779256 TI - Combination therapy of trypanosomiasis using diminazene and non-steroidal anti inflammatory drugs. AB - The susceptibility of established Trypanosoma brucei (8/18 strain) infection in mice and rabbits to low doses of diminazene (Berenil) in combination therapy with non-steroidal anti-inflammatory drugs (NSAIDs) has been evaluated using piroxicam (Feldene) and pirprofen (Rengasil) as examples of the NSAID. The results show that low doses of diminazene combined with piroxicam cured experimentally infected mice and rabbits with T. brucei. On the other hand, diminazene in combination with pirprofen did not offer any activity against the course of the infection. Mice treated with low doses of diminazene combined with pirprofen did not show reduced parasitemia and died within 3-4 days post infection. The study shows that low doses of diminazene at rates of 2 mg/kg and 1 mg/kg, when combined with piroxicam at a dosage rate of 0.6 mg/kg, can effect permanent cure in experimentally infected mice and rabbits with T. brucei. PMID- 1779257 TI - In vitro and ex vivo effects of recent and new macrolide antibiotics on chemotaxis of human polymorphonuclear leukocytes. AB - The effects of five macrolide antibiotics: erythromycin, josamycin, miokamycin, roxithromycin and rokitamycin, on human polymorphonuclear leukocyte (PMN) chemotaxis was studied in vitro and ex vivo. At therapeutic concentrations none of the antibiotics tested affected in vitro PMN chemotaxis. In vitro, erythromycin, josamycin, miokamycin, roxithromycin and rokitamycin decreased PMN chemotaxis significantly only at the concentration of 10 mg/l, which is not usually reached in vivo. Ex vivo studies after the ingestion of therapeutic doses of erythromycin, josamycin, miokamycin and roxithromycin by five volunteers showed a significant effect on PMN chemotaxis. However, further studies are needed to confirm and better evaluate the clinical significance of recent and novel macrolides on PMN chemotaxis. PMID- 1779258 TI - Impact of rokitamycin, a new 16-membered macrolide, on serum theophylline. AB - Side effects have been observed when 14-membered macrolides, erythromycin and troleandromycin, have been prescribed concurrently in patients receiving therapeutic doses of theophylline. Rokitamycin is a new 16-membered macrolide antibiotic. We have evaluated its effect on theophylline serum concentrations in 12 adult patients suffering from chronic obstructive pulmonary disease. Initially, six patients were treated for four consecutive days with theophylline as sustained-release formulation in the amount of 600 mg daily; six other patients received for four consecutive days a short term intravenous infusion of 240 mg aminophylline, given over a period of 30 min twice daily. On the last day, blood samples were taken for theophylline determination. Theophylline concentrations were measured serially for 12 hours after oral formulation and 4 hours after aminophylline by enzyme immunoassay technique. Subsequently, while theophylline and aminophylline treatments were continued at the same dosage, each patient received in addition rokitamycin tablets, 400 mg every 12 hours. After seven days of this combined medication, the serial assays of serum theophylline were repeated at the same time intervals as before. Concomitant administration of therapeutic doses of rokitamycin did not affect significantly the steady-state pharmacokinetics of oral theophylline and did not alter the (pseudo-) steady state pharmacokinetics of intravenous aminophylline, showing that the two drugs may be coadministered without any theophylline dose adjustment. PMID- 1779259 TI - Cefaclor in the treatment of infective exacerbations of chronic bronchitis in cigarette smokers. AB - There is a direct correlation between number of cigarettes smoked and the incidence of lower respiratory tract infection in humans. In studies with smokers suffering from exacerbations of chronic bronchitis, the most common bacterial pathogens found were Haemophilus influenzae, Streptococcus pneumoniae, Staphylococcus aureus and Branhamella catarrhalis. Antibiotics should be effective against such possible pathogens. Cefaclor has demonstrated in vitro activity against all these pathogens. We designed the present study to evaluate the efficacy and safety of cefaclor in the treatment of acute exacerbations of chronic bronchitis in cigarette smokers. A total of 106 patients were enrolled in the study. H. influenzae was the most common bacterial species isolated in the sputum (in 23.6% of the total sample), followed by S. pneumoniae (18.9%), S. aureus (17.0%), K. pneumoniae (7.5%) and B. catarrhalis (5.7%), while mixed forms were present in 22.6% of cases and other pathogens in 4.7%. Cefaclor (500 mg) was given orally every 8h for 7 to 16 days (mean 10.73 +/- 2.11). Analysis of clinical response data indicates that 75.5% of patients were cured and 17.0% improved. This finding is important because it demonstrates that cefaclor's spectrum of activity encompasses all the most likely pathogens encountered in smokers. Because of its excellent response rate, cefaclor is of particular value in the treatment of lower respiratory tract infections in cigarette smokers. PMID- 1779260 TI - The efficacy of mezlocillin-amikacin combination in febrile neutropenic children with oncologic disease. AB - The efficacy of mexlocillin-amikacin combination as empirical therapy for febrile neutropenic patients was studied in 30 children (21 males, 9 females) with various oncologic diseases aged 1-15 years (mean age 7.3 +/- 4.4) in the Istanbul Medical School, Oncologic Disease Research and Treatment Center, and Department of Pediatric Hematology-Oncology between January 1 and May 31, 1988. The response rate was 76.6%. Profound persistent granulocytopenia (fewer than 100 ml) was present in 70% of the patients. In 63.3% of patients, the infections were microbiologically documented (60%) Gram(+) and 40% Gram(-). The combination was well tolerated with hepatic and/or renal disturbances in 8 cases (26.6%). We conclude that mezlocillin-amikacin is an effective empirical combination in the initial treatment of infections in febrile neutropenic children with various oncologic diseases. PMID- 1779261 TI - Effect of (dl)-5-methyltetrahydrofolate on acute non-lymphocytic leukemia cells in primary culture. AB - High doses of (dl)-5-methyltetrahydrofolate (mTHF) cause strong inhibition of growth of leukemic cell lines. We studied the effect of mTHF, at concentrations ranging from 10(-3) M to 10(-4) M, on peripheral leukemic cells obtained from 15 acute non-lymphocytic leukemia (ANLL) patients, by [3H]-thydimidine uptake inhibition. Unlike leukemic cell lines, mTHF exerts a variable effect on ANLL cells in primary culture. While about 33% of cases are strongly inhibited, 55% are only slightly affected, showing a reduction in growth comparable to normal cell populations tested (unstimulated and PHA-stimulated lymphocytes, day 7 and day 14 colony forming units-granulocyte/monocyte (CFU-GM), normal blast colonies). In a minority of cases we observed stimulation of growth. This study reflects the metabolic variability of single-case leukemic cell populations, possibly in relationship to folate transport and accumulation. PMID- 1779262 TI - No evidence of enterohepatic circulation of doxorubicin in a patient with transitory biliary obstruction due to lymphoblastic lymphoma. AB - Doxorubicin (DOX) and doxorubicinol (DOXOL) were analyzed by high performance liquid chromatography in serum, bile and urine in a lymphoma patient with tumor induced biliary obstruction. The patient had an indwelling T-tube and was given DOX containing combination chemotherapy. The bile was collected via the T-tube and given orally (together with beer) to the patient four times daily. New samples were obtained three weeks later when normal bile flow was re-established. The serum and bile concentration curves for DOX and DOXOL show great similarity between the first and second chemotherapy course, respectively. This finding strongly argues against an enterohepatic circulation of DOX or DOXOL of clinical importance in man. PMID- 1779263 TI - Endometrial carcinoma in tamoxifen-treated breast cancer patients. AB - Tamoxifen is an important agent for the treatment of breast cancer. Occasionally the drug, which is an antiestrogen, has agonistic estrogenic activity. The authors describe three new cases of endometrial carcinoma developing in breast cancer patients taking tamoxifen and stress the necessity of carefully monitoring the uterine cavity under tamoxifen treatment. PMID- 1779264 TI - [Auditory brainstem response in the anterior inferior cerebellar artery insufficiency]. AB - The purpose of this study was to determine the effects of vascular occlusion on the cochlear blood flow and auditory brainstem response (ABR) in the cat basilar artery system. Any occlusion in the basilar, anterior inferior cerebellar, or internal auditory arteries had chances of decreasing the cochlear blood flow, in which case the extent of the depression of the waves I and II of ABR was proportional to the blood flow decrease. This results suggests attention should be payed to the ischemic cochlear involvement in evaluation of the brainstem pathology using ABR. PMID- 1779265 TI - [Isolated medial orbital wall fracture and late fronto-ethmoidal mucocele]. AB - Twenty-one cases of isolated medial orbital wall fractures were reported and CT findings by coronal planes were evaluated as to the effects of fractures upon the ethmoidal cells and nasal meati. Three coronal planes, which respectively contain such structures as Agger nasi, Pars membranacea and superior meatus, were selected for the study. The extent of fracture was evaluated by dividing the medial wall into three equal portions, i.e., superior, middle and inferior. The prolapsed volume was evaluated in three classes of occupying 1/3, 2/3 and 3/3 of the ethmoid. The presence of soft tissue density was recorded at the three surfaces, upper, medial and lower, around the prolapsed orbital content. The extent of the fracture was most often seen in such cases as involving all the three divisions in 41.3%. The prolapsed volume occupying 1/3 was seen in 28, 6%, and 2/3 in 23.8%. The presence of soft tissue density was seen in 38.1% of upper surface, in 36.5% of medial, and 11.1% of lower. Summarizing the total effects of the fractures, the coronal plane containing Pars membranacea was most severely damaged followed by the plane of the superior meatus. Two rare cases of fronto ethmoidal mucoceles, caused by the traumas of 23 and 14 years before respectively, were also included and reported. The ophthalmological prognosis was favorable in 90.5% of cases by observations extending more than 6 months. Five cases were surgically treated including two cases of mucoceles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779266 TI - [Glycoconjugates in the chinchilla tubotympanum: a lectin histochemical study]. AB - Glycoconjugates are essential for normal functioning of the mucociliary defence system of the tubotympanum. Recently, terminal glycosylation sequences of glycoconjugates have been recognized for their role in mediating biological recognition, such as serving as a receptor for bacterial adherence. In this study, neuraminidase and 6 different lectins: Wheat germ agglutinin (WGA), Limax flavus agglutinin (LFA), Sambucus nigra agglutinin (SNA), Peanut agglutinin (PNA), Ricinus communis agglutinin-I (RCA-I), and Concanavalin A (Con A), were used to characterize histochemically the carbohydrate structures of glycoconjugates of the chinchilla tubotympanum. WGA, LFA, SNA, and RCA-I strongly labeled epithelial goblet cells, glandular mucous cells, cell surfaces, and mucous blanket. PNA weakly labeled only a small number of epithelial goblet cells and glandular mucous cells, and did not label cell surfaces. After neuraminidase treatment, PNA labeled large number of these secretory cells and cell surfaces. Con A predominantly labeled glandular serous cells, epithelial dark granulated cells, and cell surfaces, and also labeled dark cores of mucinous granules. These results revealed that: sialomucin are produced from glandular mucous cells and epithelial goblet cells and are present on cell surfaces and within the mucous blanket; their terminal trisaccharide linkage appears to be the sequence Neu5Ac (alpha 2-6) Gal (beta 1-3) GalNAc and serum type glycoproteins are produced from glandular serous cells and dark cores of mucinous granules. PMID- 1779267 TI - [Influence of anesthesia on auditory evoked response]. AB - Auditory brainstem response (ABR) and auditory middle latency response (MLR) in 128 patients were recorded during the surgical operation which was performed under the various anesthetic methods and conditions. The relation between the anesthetic methods and the characteristics of the auditory evoked responses was investigated. From the results, the anesthesia could be classified into following three types: type A such as enflurane-nitrous oxide-oxygen and halothane-nitrous oxide-oxygen anesthesia by which both ABR and MLR were affected, type B such as thiamylal and diazepam anesthesia by which only MLR was affected, and type C such as neuroleptanesthesia (NLA), high dose fentanyl, ketamine, althesin, spinal and epidural anesthesia, by which both ABR and MLR were not affected. Therefore, when ABR and MLR are recorded as a monitor of the eighth nerve surgery, NLA would be the most adequate and available method. On the other hand, it was proved that ABR and MLR were markedly affected by the decrease of body temperature. Therefore, the decrease of body temperature should be taken into consideration when the auditory evoked response of comatose patients was monitored. PMID- 1779268 TI - [Mechanisms of development of endolymphatic hydrops following secondary immune response in the endolymphatic sac of guinea pigs]. AB - Previously the author reported the immediate development of endolymphatic hydrops (e. hydrops) following direct challenge of secondary antigen to the endolymphatic sac (ES) in guinea pigs, during the early phases of postchallenge, ranging from 1 to 5 weeks. The present study reports the results of specimens taken up to 10 weeks postchallenge, and correlation of e.hydrops to perilymph in antigen specific antibody levels. From the present results, mechanisms of e.hydrops induced ES immune reaction are suggested as follows. 1) In the early stage of e.hydrops, an acute inflammatory reaction in the ES may produce endolymph by an increased vascular permeability of the inner ear and may impair endolymph absorption from the ES. 2) In the latter stage of e.hydrops, the moderate cellular infiltration in the ES may cause chronic impairment of endolymph absorption in the ES. PMID- 1779269 TI - [Mucosal bridge of the vocal fold]. AB - Mucosal bridge of the vocal fold is a newly recognized laryngeal disease need to be differentiated from the functional voice disorder. A 16-year-old woman with deteriorating hoarseness presented for indirect laryngoscopy and laryngofiberoscopy of just slight swelling of the bilateral vocal folds. Since the laryngeal stroboscopy revealed the decrease of wave formation at the swelling portion, we performed an endolaryngeal microsurgery and discovered a sulcus in a side of the vocal fold and a mucosal bridge in the other side. Resection of the bridge followed by the voice therapy increased the voice range and decreased the hoarseness. This case suggests that the laryngeal stroboscopy and microscopic examination with direct laryngoscopy are the most important for diagnosing the mucosal bridge of the vocal fold. PMID- 1779270 TI - [Study of pyogenic granuloma of the oral cavity]. AB - Pyogenic granuloma is one of the diseases sometimes seen in otorhinolaryngology clinics. The clinical features of this disease are understood to be that the lesion is located in the oral cavity in the majority of cases that its causative agent is usually discovered and that it most likely grows as a malignant tumor. However, the entity of pathological diagnosis has not been established. Thirty one cases of oral pyogenic granuloma, including 16 males and 15 females, are reported in this paper. The granuloma was located most frequently at the tongue, followed, in order, by the gingiva, buccal mucosa, hard palate, lip and oral floor. The period between the patient's first visit to our clinic and the onset of his/her complaint was variable. It was relatively shorter in those cases with the lesion at the gingiva or tongue as compared to other locations. The size of the lesion was smaller than 10 x 10 mm. We classified the pathological features into three patterns; granuloma type, hemangioma type, and intermediate type. Many cases of lesions located at the back of the tongue, buccal mucosa, or hard palate were of the hemangioma type, while many cases of lesions located at the top of the tongue, gingiva, or oral floor were of the granuloma type. We have the impression that pyogenic granuloma could be one of the purulent changes associated with benign oral tumors. PMID- 1779271 TI - [Reconstruction with peroneal free flap after ablation of head and neck cancer]. AB - One-stage reconstruction of head and neck defects following radical surgery was performed for two patients with the peroneal flaps which had the peroneal artery, vein and their branches as a pedicle. These flaps were viable without any post operative complications. The advantages of these flaps are described as follows. (1) The subcutaneous fat is thin, and thus the flap is flexible and not bulky. (2) The diameters of the peroneal artery and vein are relatively large and the pedicle is long. (3) A pretty large size of the flap can be utilized. (4) A relatively long bone can be obtained together with skin at the same time, and the angle of the fibula can be easily changed. (5) Bleeding is little when the flap is taken out. (6) The resection of the tumor and the harvest of the flap can be done at the same time, due to different surgical areas. (7) The skin graft to the donor defect is not necessary, and the defect can be closed at one-stage. (8) The donor site does not stand out. Thus, this method is cosmetically excellent. This procedure has many advantages. Reconstruction with the peroneal flap offers a safe, reliable, and versatile method. PMID- 1779272 TI - [Microvascular architecture of the human tongue carcinoma--a scanning electron microscopic study]. AB - Vascular architecture of tumors in experimental animals has been studied in detail. However, the reports on architecture of the capillaries in human carcinoma in the head and neck regions are few nowadays. In this paper architecture of the blood vessels reproduced by using methacrylate casting medium in human carcinoma of the tongue was studied by scanning electron microscopy. Tortous capillaries and loop-like vessels were observed at the proliferative area of the tumor on the surface of the tongue. There were avascular zones around the vessels of the tumor characterizing irregular proliferation. The vessels of sinusoidal, tapering, distorted and disrupted characters were seen in the muscle layer of the tongue. Ruptured vessels and viable tumor-cells were observed at the areas surrounding necrotic lesions. These findings elucidated combination of various kinds of architectures of vessels in various stages of tumor-growing. Existence of the avascular area suggests that proliferation of tumor-cells proceeds before proliferation of the capillaries. Both avascular and necrotic changes in the structure might reduce the effects of anti-cancer agents. PMID- 1779273 TI - [Dipole tracing method analysis for source of auditory brainstem response (wave V) in two normal hearing subjects]. AB - The location and vector moment of the equivalent current dipoles of ABR (wave V) evoked by unilateral acoustic stimuli were estimated in normal adults with the Dipole Tracing (DT) Method. The ABR's were recorded through 21 electrodes arranged according to the international 10-20 standard. The DT method is based on a realistic head shape with uniform volume conductor and individual differences of the skull were corrected for afterwards. The 3-D dipole locations were plotted on the cross-sectional MRI data of the subject. As a result the dipole of the wave V of auditory brainstem responses was found near the contralateral midbrain. PMID- 1779274 TI - [Localization of sensory neurons in the canine nodose ganglion sending fibers to the laryngeal nerves]. AB - Afferent fibers from the larynx traverse through the superior laryngeal nerve (SLN) and the inferior laryngeal nerve (ILN), and the parent cell bodies of these fibers are located in the nodose ganglion (NG). However, the exact location and form of these neurons in the NG have not been clarified. The aim of this study is to determine the exact location and form of the sensory neurons in the canine NG which send fibers to the laryngeal nerves, using the retrograde tracer technique with wheat germ agglutinin-horseradish peroxidase (WGA-HRP). The cell bodies sending sensory fibers to the internal and external branches of the SLN (SLNI & SLNE) were localized on the rostro-lateral side of the NG, but the cell bodies sending fibers to the ILN were widely distributed. These findings suggest that the location of cells does not reflect differences in the roles of the cells, but is due to the courses of nerve fibers. The cell bodies sending sensory fibers to the SLNI accounted for about 11% of all cells in the NG; about 0.1% of cells sending fibers to the SLNE; and about 0.2% in the ILN. The cell bodies sending sensory fibers to each laryngeal nerve varied in size, from 15 to 60 microns, suggesting differences in the roles of these cells. PMID- 1779275 TI - [Experimental study of local immunochemotherapy of head and neck cancer]. AB - The mechanism of induction of antitumor activity by local administration of recombinant interleukin-2 (rIL-2) combined with cisplatin (CDDP) was investigated in order to establish a method of immunochemotherapy against head and neck cancer. Local administration of rIL-2 had significantly greater inhibitory effects on tumor growth in both Meth A and C26 tumor bearing mice than did systemic administration. The cytotoxic activity of tumor infiltrating lymphocytes (TILs) obtained from C26 tumor bearing mice was studied. Local injection of rIL-2 around the tumor site for 4 days induced augmentation of the cytotoxicity of TILs not only in NK sensitive tumors but also in NK resistant C26 tumors. This phenomenon was not observed in spleen cells. Both negative selection assay and cold target inhibition assay revealed that the effector cells were tumor nonspecific asialoGM1 positive activated NK cells. Additional experiments were performed to determine the effectiveness of combined immunochemotherapy using CDDP and rIL-2 in C26 tumor bearing mice. The intraperitoneal administration of CDDP following the local administration of rIL-2 was more effective in suppressing tumor growth and in promoting well-survival than the use of CDDP or rIL-2 alone. To investigate the mechanism of antitumor activity, the effects of CDDP on the tumor cells and immunological changes were observed in tumor bearing mice. The susceptibility of tumor cells to effector cells was enhanced after in vitro culture with CDDP. In vivo administration of CDDP augmented the cytotoxic activity of effector cells and responsiveness to IL-2 of TIL. These results suggest that local immunochemotherapy using locally administered rIL-2 combined with CDDP may be available as a therapy for head and neck cancers. PMID- 1779276 TI - (Systemic) phototoxicity of drugs and other xenobiotics. AB - Xenobiotics extensively used in drugs, cosmetics, food and agricultural chemicals can produce adverse biological effects. These toxic effects are separated into classes, e.g. hepatotoxicity, genotoxicity and neurotoxicity. Skin allergy, part of immunotoxicity, is also a subdivision of toxicology. When light is an essential condition for toxicity, the xenobiotic is called phototoxic. Thus it fits into the logic of toxicology that photoallergic compounds are a subdivision of phototoxic compounds. Phototoxicons as a group do not differ from the group of phototherapeutics with regard to their eventual biological effects. The primary photoreactions, secondary molecular processes, biomolecules involved and cellular and tissue damage are similar. The difference between the two groups is in the appreciation of the photobiological effects: adverse vs. desired. The aim of research is to determine the part of the molecular structure which makes a given compound phototoxic. With that knowledge the structure of the phototoxicon can be changed. This can result in a derivative which still has the desired properties of the parent compound, but is no longer phototoxic. This aim can be reached by combining data from both in vitro and in vivo research. The variety and number of phototoxic compounds is large. This, together with the limited research effort devoted to this subject so far, means that for most phototoxic xenobiotics a relationship between structure and in vivo photoreactivity is not available. In this review, emphasis is placed on xenobiotics whose in vitro and in vivo photochemistry have been studied. Furthermore, possible phototoxic effects which do not concern the skin but involve inner organs (systemic effects) are considered. References in this review mostly concern investigations over the last 10 years. For older literature or for additional information, references to other reviews are given. Important groups of phototoxic xenobiotics not dealt with in this article were already sufficiently covered in the reviews referred to. PMID- 1779277 TI - Molecular mechanism of drug photosensitization. Part 3. Photohemolysis sensitized by diflunisal. AB - The lysis of red blood cells photosensitized by diflunisal (DFN) was investigated. Photohemolysis is inhibited by butylated hydroxyanisole and reduced glutathione, but is unaffected by mannitol and enhanced by sodium azide; the presence of oxygen markedly reduces the lysis which is accelerated in anaerobic conditions. These results contrast with those expected for a photodynamic mechanism. High lytic activity is observed for pre-irradiated solutions, mainly under anaerobic conditions. Direct irradiation of DFN in buffer solution at pH 7.4 leads to the formation, under anaerobic conditions, of compound 2'-(2''',4''' difluoro-3''-carboxy-[1'',1'''-biphenyl]-4''-oxy)-4'- fluoro-4-hydroxy-[1,1' biphenyl]-3-carboxylic acid (PhP), whereas under aerobic conditions formation of PhP is accompanied by unidentified photo-oxidation products; only compound PhP displays strong lytic activity. The overall results for DFN-photosensitized hemolysis suggest a mechanism involving a concerted action of free radicals, superoxide anion, singlet oxygen and sensitizer photoproducts. PMID- 1779278 TI - Laser picosecond microspectrofluorometry of haematoporphyrin in cells and liposomes. AB - The results of a laser picosecond microspectrofluorometric study of the spectral and kinetic characteristics of haematoporphyrin (Hp) fluorescence at various sites in cultured SPEV cells and phosphatidylcholine liposomes are presented. The computer-controlled detection system is based on the single-photon counting method with picosecond time resolution. In aqueous medium, the Hp fluorescence spectrum is characterized by two bands at 615 and 675 nm. In living cells and liposomes, Hp fluorescence is red shifted to 630 and 690 nm. In addition a new band at 665 nm is detected. The dependence of this band on the incubation time and Hp concentration was investigated. The fluorescence decay kinetics of Hp in a culture medium, liposome and a cell nuclear membrane were measured. Possible Hp aggregate formation in the lipid bilayer and its implications are discussed. PMID- 1779279 TI - Continuous cell lines from the tick Hyalomma anatolicum anatolicum. AB - The establishment of 5 continuous cell lines from embryonic tissues of the tick Hyalomma anatolicum anatolicum is reported. Each line comprises 2 or more cell types; they are maintained at 28 C and 32 C in L-15/H-Lac medium with 20% fetal calf serum, and have been cryopreserved successfully. Sustained and consistent growth was achieved only after 12-41 mo in culture. PMID- 1779280 TI - Gastric nematodes of the Paraguayan caiman, Caiman yacare (Alligatoridae). AB - Examination of the stomach contents of 115 Caiman yacare Daudin, 1802, from Paraguay revealed the presence of the nematodes Brevimulticaecum baylisi (Travassos, 1933), Brevimulticaecum stekhoveni (Baylis, 1947), Contracaecum sp. of Railliet and Henry, 1912, Dujardinascaris paulista (Travassos, 1933), Eustrongylides sp. of Jagerskiold, 1909, Micropleura vazi Travassos, 1933, and Ortleppascaris alata (Baylis, 1947). Nematode prevalence was 28%; greatest species prevalence (14%) was found for B. baylisi. Greatest mean intensity, 25.4, was for Contracaecum sp. All occurrences are new host and distribution records. PMID- 1779281 TI - Production and partial characterization of monoclonal antibodies specific for the gamonts of Eimeria tenella. AB - Thirteen hybridomas secreting monoclonal antibodies (Mabs) specific for the sexual stages (gamonts) of Eimeria tenella were produced by fusing spleen cells of gamont-immunized RBF/Dn mice with FOX-NY myeloma cells. A Mab subisotype profile revealed 1 IgG2a and 12 IgG1. All Mabs demonstrated a similar binding pattern when incubated with parasitic gamonts as determined by the indirect fluorescent antibody test. Ascitic fluid containing Mab (GD9 (IgG1) was produced and used to immunize chicks passively per os. There was a 34% decrease (P less than 0.05) in oocyst output from immunized chicks when compared to control chicks. Passively immunized chicks also had reduced cecal lesion scores when compared to control chicks. These results suggest that Mab GD9 partially inhibited the fertilization process of E. tenella. PMID- 1779282 TI - New host and locality records of coccidia (Apicomplexa: Eimeriidae) from rodents in the southwestern and western United States. AB - One hundred forty-seven murid and heteromyid rodents were collected from various sites in the southwestern and western United States (Arizona, Colorado, New Mexico, Texas, and Utah) and Baja California Norte, Mexico, and their feces were examined for coccidial parasites. Of these, 53 (36%) were infected with at least 1 coccidian; 45 of 53 (85%) of the infected rodents harbored only 1 species of coccidian. Infected rodents included: 10 of 22 (45%) Neotoma albigula, 3 of 11 (27%) Neotoma floridana, 2 of 14 (14%) Neotoma lepida, 15 of 29 (52%) Neotoma micropus, 5 of 8 (63%) Peromyscus crinitis, 6 of 6 (100%) Peromyscus difficilis, 1 of 2 (50%) Peromyscus eremicus, 9 of 34 (26%) Sigmodon hispidis, and 2 of 3 (67%) Sigmodon ochrognathus; 4 Neotoma cinerea, 3 Neotoma devia, 3 Neotoma mexicana, 1 Peromyscus maniculatus, 1 Onychomys leucogaster, 1 Onychomys torridus, 3 Chaetodipus fallax, and 2 Chaetodipus penicillatus were negative. Although no new species was found, the following coccidians were identified from infected rodents: Eimeria albigulae from N. albigula, N. floridana, and N. micropus, Eimeria antonellii from N. albigula and N. micropus, Eimeria ladronensis from N. albigula, N. floridana, N. lepida, and N. micropus, Eimeria arizonensis and Eimeria lachrymalis from P. crinitis and P. difficilis, Eimeria lachrymalis from P. eremicus, Eimeria tuskeegensis from S. ochrognathus, and Eimeria roperi, Eimeria sigmodontis, Eimeria tuskeegensis, Eimeria webbae, and an unidentified species of Eimeria from S. hispidis. This report documents 12 new host and several distributional records for Eimeria species from murid rodents in Arizona, Texas, and Utah. PMID- 1779283 TI - Influence of collection methods on the occurrence of alimentary canal helminth parasites in fish. AB - The effect of collecting trauma on the metazoan parasites in the alimentary canal of French grunts, Haemulon flavolineatum (Desmarest) (Perciformes: Haemulidae), was evaluated by comparing the number and species of parasites in 10-fish lots that were identical except for collecting technique. Collecting techniques included speared (dead), speared through the caudal peduncle (live), trapped, dipnetted at night, and ostracitoxin exposed. Dead, trapped, and toxin-stressed fish had no alimentary canal parasites, whereas speared-live and night-dipnetted fish had comparable numbers of parasites. Fish collected by using apparently traumatic techniques quickly expelled their alimentary canal metazoan parasites. Our results cast doubt on the reliability of traditional fish parasite surveys, studies on population dynamics of fish parasites, and experiments that employ these traumatic collecting methods. PMID- 1779284 TI - Presidential address. Peregrinations of a parasitologist. PMID- 1779285 TI - Introduction of Marilyn E. Scott as the Henry Baldwin Ward medalist for 1991. PMID- 1779286 TI - Acceptance of the Henry Baldwin Ward Medal. PMID- 1779287 TI - Presentation of the Bueding-von Brand award to Donald Fairbairn. PMID- 1779288 TI - Microsporidiosis in the acquired immunodeficiency syndrome. PMID- 1779289 TI - Morphological adaptations of intestinal helminths. AB - Nematodes, trematodes, cestodes, and acanthocephalans each have become adapted in different ways to the microenvironment of the vertebrate intestine. Life in this specialized habitat affords parasites a reliable source of nutrients, a relatively homeostatic environment, and protection from predators but, in exchange for these advantages, presents the special challenges of exposure to digestive enzymes, normal peristalsis, and host immune response to infection. Logically, the surface of the parasite should be the first part of the organism to encounter such challenges, and, for this reason, any response or reaction by the parasite is expected to be manifested at the parasite-host interface. Morphological adaptations of intestinal helminths to their microenvironment include modification of the tegumental surface that affords protection and increases absorptive surface area, development of specialized attachment organs, and, in some cases, complete loss of their own internal digestive system. Representative examples of such adaptations by helminths are described and discussed in terms of the parasite's nutritional requirements, site selection, and host specificity, and the possibility is suggested that some helminths may have adapted in ways that exploit host defensive mechanisms for their own benefit. PMID- 1779290 TI - Water balance and its relation to fermentation acid production in the intestinal parasites Hymenolepis diminuta (Cestoda) and Moniliformis moniliformis (Acanthocephala). AB - Water balance and its relation to carbohydrate metabolism was examined in Hymenolepis diminuta in parallel with the putative osmoconformer Moniliformis moniliformis. Worms were removed from rat intestines, weighed, and incubated (37 C) 1 hr in rat serum and various salines, some with mannitol to vary osmotic concentration from 150 to 400 mOsm/L. Worms were removed at 15-min intervals, weighed, and returned to the test solution. Rat serum and a Ringer's saline (pH 7.4 and 300 mOsm/L) with or without 5 mM glucose were isotonic to M. moniliformis, which behaved like an osmometer, shrinking, or swelling in proportion to external osmotic changes. Hymenolepis diminuta rapidly lost 20-25% wet weight in these solutions and regained lost water when 5 mM glucose was added to the saline. Tapeworms maintained constant body weight between 210 and 335 mOsm/L, but they rapidly gained or lost water outside of this range. Glucose metabolism and uptake of [3H]glucose from the medium increased progressively between 210 and 310 mOsm/L, whereas uptake rates of [3H]leucine, 22Na+, and 36Cl- were not affected. Unbuffered saline (initial pH 6.5 and 300 mOsm/L) had a lower pH (5.0) and higher osmolality (307 mOsm/L) after a 1-hr incubation with tapeworms. Such saline was less hypertonic than unconditioned saline to freshly obtained worms. A Ringer's saline (300 mOsm/L) containing 50 mM acetate- was also hypertonic (greater than 20% weight loss) to tapeworms at pH 7.4, but it was hypotonic (greater than 20% weight gain) at pH 5.0. Isotonicity at 300 mOsm/L was achieved with pH 5.0 and 20 mM acetate-, the approximate pH and fermentation acid concentration in an infected rat intestine. Rats infected with tapeworms (12 days old) were fasted for 2 days. Starved worms were smaller but had the same percentage of body water and internal osmolality as controls. These results show that H. diminuta can regulate its body water content and that water balance is closely related to the fermentation acid concentration and pH of the bathing medium. PMID- 1779291 TI - Genetic variation and host-parasite relations: Nematospiroides dubius in mice. AB - Our work deals with aspects of the genetics and immunology of host-parasite relationships as they influence the development of protective immunity and the phenomenon of coevolution. The aim is to understand parasitism through analyses of host specificity. In earlier studies we examined the inheritance of resistances in mice to infections with Nematospiroides dubius (=Heligmosomoides polygyrus) and established the predominant role played by antibodies in protective immunity. Here we report information concerning the selection of lines of N. dubius that differ in their ability to survive antagonistic immunological reactions from mice. Challenge infections with groups of these mice, immunized and protected by previous repeated infections, show that worms selected to survive the immunity that kills other worms do so by inhibiting the effectiveness of the cellular rather than humoral elements of protective immunity. PMID- 1779292 TI - Phylogenetic analysis of Alloglossidium Simer, 1929 (Digenea: Plagiorchiiformes: Macroderoididae) with discussion of the origin of truncated life cycle patterns in the genus. AB - Alloglossidium comprises 9 species of North American plagiorchiiform digeneans using ictalurid catfish, freshwater crustacea, and hirudinid leeches as definitive hosts. Two hypotheses about the evolution of this array of definitive hosts were examined using phylogenetic systematic analysis. Two most parsimonious trees, based on 15 homologous series derived from morphological data, each indicated the 2 species utilizing ictalurid catfish definitive hosts are basal members of the group, whereas the 2 species using freshwater crayfish definitive hosts and the 5 utilizing leech definitive hosts each comprise relatively derived monophyletic sister groups. The results suggest that species using crustaceans as definitive hosts are derived by life cycle truncation, whereas those using leeches as definitive hosts appear to be derived through a switch from crustaceans to leeches. PMID- 1779293 TI - Pauciconfibula subsolana n. sp. (Monogenea: Microcotylidae) from Morone americana (Perciformes: Percichthyidae) collected in fresh water in New Brunswick, Canada. AB - Pauciconfibula subsolana n. sp. (Monogenea: Microcotylidae) is proposed for parasites found on the inner surface of the operculum of Morone americana collected in the freshwater reaches of the Saint John River, near Mactaquac, New Brunswick. Pauciconfibula subsolana is differentiated from other species in the genus by the 2 posterolateral clamp sclerites, each of which is composed of 2 distinct sections, and by the absence of appendages on the eggs. An amended generic diagnosis is provided for Pauciconfibula. Pseudoaspinatrium Mamaev, 1986, is considered a junior synonym of Pauciconfibula Dillon and Hargis, 1965, and the species previously assigned to Pseudoaspinatrium are transferred to Pauciconfibula as Pauciconfibula euzeti (Ktari, 1971) n. comb., Pauciconfibula gallieni (Euzet and Ktari, 1971) n. comb., and Pauciconfibula pogoniae (MacCallum, 1913) n. comb. PMID- 1779294 TI - Carettacola hawaiiensis n. sp. (Trematoda: Spirorchidae) from the green turtle, Chelonia mydas, in Hawaii. AB - Carettacola hawaiiensis n. sp. (Trematoda: Spirorchidae) is described from the hepatic vessels of the green turtle, Chelonia mydas (L.), in Hawaii. The new species differs from any previously described species of Carettacola in size, placement of vitellaria, and shape and placement of Laurer's canal. The genus Haemoxenicon Martin and Bamberger, 1952, becomes a synonym of Carettacola Manter and Larson, 1950. Haemoxenicon stunkardi Martin and Bamberger, 1952, is transferred to the genus Carettacola Manter and Larson, 1950, and becomes Carettacola stunkardi n. comb. An emended generic diagnosis for Carettacola is given along with a key to the species. PMID- 1779295 TI - A new species of coccidian (Apicomplexa: Eimeriidae) from the prairie racerunner, Cnemidophorus sexlineatus viridis (Sauria: Teiidae), in Arkansas. AB - Feces from 26 prairie racerunners, Cnemidophorus sexlineatus viridis Lowe, 1966, from Arkansas, were examined for coccidian parasites. One of these was found to be infected with oocysts of an undescribed eimerian, which is described herein as new. Sporulated oocysts of Eimeria sexlineatus n. sp. were cylindrical, 30.4 x 17.1 (28-32 x 16-19) microns, with a shape index (length/width) of 1.8 (1.6-2.0). A micropyle and oocyst residuum were absent but 1 (to several) polar granule(s) was present. Sporocysts were ellipsoidal, 10.7 x 8.5 (9.6-11.2 x 8.0-8.8) microns, with a shape index of 1.3 (1.2-1.4). A sporocyst residuum was present but Stieda, substieda, and parastieda bodies were absent. Sporozoites were elongate, 13.2 x 2.7 microns (12.0-14.4 x 2.4-3.2) in situ, containing a single, spherical posterior refractile body. Oocysts and endogenous developmental stages were found within the gall bladder epithelium of the infected lizard. This represents the first time a coccidian has been reported from a North American whiptail lizard. PMID- 1779296 TI - Evaluation of gill nets, fyke nets, and mark-recapture methods to estimate the number of Hirudinea and Crustacea on fish. AB - Twenty species of fishes (n = 20,759) were collected from Dauphin Lake, Manitoba, Canada, to determine the types and numbers of ectoparasites they harbored. Counts of ectoparasites on fishes collected with different gear were compared to evaluate different methods of collection and to estimate rates of recruitment of ectoparasites by fishes. Ectoparasites were found on 11 species of fishes and the majority of these were parasitic leeches (Myzobdella moorei, Cystobranchus verilli, and Placobdella montifera) and parasitic Crustacea (Argulus appendiculosus and Lernaea cyprinacea). Some fishes also were infested by neascus type metacercariae (blackspot) or had tumors (lymphocystis). The prevalence of ectoparasites was correlated with the abundance, feeding habits, and spatial distribution of fish species. Argulus appendiculosus and blackspot were more prevalent on benthic fishes, whereas M. moorei and tumors were more prevalent on limnetic fishes. Mark-recapture records showed that fishes occupying shallow (less than or equal to 1.5 m) water had a higher prevalence of infestation and 28 of 29 infected fishes caught by gill nets were captured in shallow water. Placobdella montifera was the only ectoparasite found on fishes from deep (1.5 3.5 m) water and the only species that was acquired by fishes previously released with no ectoparasite (2 of 239 fishes). The littoral zone (less than or equal to 1.5 m) comprises only 14% of the surface area and 3% of the volume of Dauphin Lake, yet 72% of all gill-netted fishes harboring ectoparasites were collected there. Intensities of ectoparasites estimated from gill net and pound net samples were similar, but prevalence of ectoparasites estimated from samples obtained with gill nets was lower. PMID- 1779297 TI - The localization of allergens of Paragonimus westermani by pleural exudates from patients. AB - The allergens of the lung fluke Paragonimus westermani were localized by indirect immunostaining in adult fluke sections using pleural exudates from 3 patients with P. westermani. Immunostaining performed by using pleural exudate with the highest level of specific IgE revealed that the P. westermani major allergen (or allergens) was located in the gut epithelium and luminal contents and that minor allergens were in the tegument and parenchyma. The antigens recognized by specific IgG were located at various sites including those recognized by specific IgE. Paragonimus westermani-specific IgE cross-reacted with only the gut of 2 other Paragonimus species, Paragonimus miyazakii and Paragonimus ohirai. The major allergen in the gut also was recognized by the other 2 pleural exudates. These results indicate that the substance present in and secreted from the gut is not only a major allergen but is also a common allergen among Paragonimus species. PMID- 1779298 TI - Effect of host sex and litter on the population dynamics of Echinococcus granulosus in dogs. AB - Twenty-one Beagle dogs consisting of 10 males and 11 females and belonging to 3 litters were infected with 60,000 E. granulosus protoscolices each. They were killed on day 40, the parasites from their intestines recovered, and the number of worms, average number of proglottides per worm, average length per worm, percentage of worms with a uterine cavity, and percentage of egg-bearing worms were determined for each dog and analyzed per sex and litter. On average, the dogs had 1,253 +/- 339 worms (means +/- standard error) with 2.42 +/- 0.1 proglottides, were 1.59 +/- 0.07 mm long, and 25.6 +/- 4.8% of the worms presented a uterine cavity and 1.2 +/- 0.6% bore eggs. The number of worms exhibited a bimodal distribution with 19 dogs having less than or equal to 2,565 worms and 2 greater than or equal to 5,520 worms. Average number of proglottides also showed a bimodal distribution with 7 dogs having less than or equal to 2.1 proglottides per worm and 14 dogs having greater than or equal to 2.4 proglottides per worm. The parasites were significantly more numerous in females than in the males (1,964 +/- 573 vs. 681 +/- 202), had more proglottides (2.67 +/ 0.08 vs. 2.15 +/- 0.16), and were longer (1.72 +/- 0.07 vs. 1.44 +/- 0.11 mm). The percentages of parasites with a uterine cavity (27.8 +/- 5.9 vs. 23.2 +/- 8.1) or bearing eggs (1.0 +/- 0.5 vs. 1.5 +/- 1.8) were comparable in females and males.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779299 TI - A comparison of behavioral alterations in the brown cockroach, Periplaneta brunnea, and the American cockroach, Periplaneta americana, infected with the acanthocephalan, Moniliformis moniliformis. AB - We examined behavioral alterations in the brown cockroach, Periplaneta brunnea, infected with the acanthocephalan, Moniliformis moniliformis. The responses of infected and uninfected P. brunnea to light, substrate choice, and activity were compared. Infected brown cockroaches spent more time on white horizontal substrates under red and white light. Infected brown cockroaches also had a shorter freeze time than uninfected cockroaches after being presented with a light source. There was no difference in photophilia or activity of infected and uninfected brown cockroaches. These behavioral alterations in brown cockroaches were compared to those in Periplaneta americana, the American cockroach, infected with the same parasite. American and brown cockroaches differed in some responses to substrate, phototaxis, and activity. PMID- 1779300 TI - Spatial and temporal dispersion of immature Ixodes dammini on Peromyscus leucopus in northwestern Illinois. AB - Infestation by immature Ixodes dammini and infection by Borrelia burgdorferi of the white-footed mouse Peromyscus leucopus were studied in Castle Rock State Park in northwestern Illinois during June-October 1990. Prevalence and intensity of infestation of larvae on mice were highest in August with a smaller peak in early June. The distribution of larvae on mice was highly aggregated during each of the sampling periods. Aggregation appears to be the result of a series of nonrandom successful attachments by single larvae, rather than of simultaneous attachment by clumps of larvae. Infection rate of mice by B. burgdorferi averaged 21.4% with a peak of 28.6% in August. A comparison of the numbers of attached immature ticks collected from mice and of questing ticks collected through dragging indicated that the larvae-to-nymph ratio was higher on mice than on drags. Given the low total numbers of nymphs collected from mice, this suggests a potential role for other hosts of I. dammini nymphs in northwestern Illinois. PMID- 1779301 TI - Metabolic labeling of Dirofilaria immitis third- and fourth-stage larvae and their excretory-secretory products. AB - Infective third-stage larvae of Dirofilaria immitis were collected from Aedes aegypti and cultured in vitro to the fourth stage. Larval proteins were labeled metabolically using [35S]cysteine and methionine in different media and for different lengths of time. Labeled proteins in the excretory-secretory component and the larval homogenates were evaluated by sodium dodecyl sulfate polyacrylamide gel electrophoresis under reducing and nonreducing conditions and by 2-dimensional gel electrophoresis. Numerous proteins ranging from 14 to greater than 200 kDa were identified from both the excretory-secretory components and the larval homogenates. Both fractions demonstrated shared and unique proteins. Using timed labeling, age- and stage-specific proteins were identified; at least 2 proteins of approximately 20.5 and 22 kDa were associated in time with the molt from the third to fourth stage. Two proteins of the same molecular weight were specifically recognized by immune dog sera, but not by sera of their infected nonimmune cohorts. PMID- 1779302 TI - In vitro encystation of Giardia lamblia: large-scale production of in vitro cysts and strain and clone differences in encystation efficiency. AB - A method for obtaining large numbers of Giardia lamblia cysts in vitro was developed based on modification of earlier methods of in vitro encystation. Maximal numbers of cysts were obtained by growing trophozoites to confluence in TYI-S-33 growth medium containing 0.5 mg/ml of bovine bile, followed by incubation in medium containing 10 mg/ml of bovine bile, at pH 7.8 for 96 h at 37 C. Up to 4 x 10(5) cysts were obtained per milliliter of encystation medium. Cysts thus obtained were similar in structure to those in vivo, were resistant to hypotonic lysis, and reacted with a cyst-specific monoclonal antibody. Further modification of this method by returning the trophozoites to growth medium after 24 hr of exposure to encystation medium resulted in production of cysts that were shown to be viable by fluorogenic dye staining and ability to excyst. This method was scaled up using roller bottles, which resulted in production of up to 1.6 x 10(8) cysts per roller bottle. In addition, of 4 strains tested, the LT strain yielded the highest number of cysts. Of 4 clones of the WB strain, clone A consistently produced the largest number of cysts. PMID- 1779303 TI - Pathogenesis of acute experimental amebic liver abscess in hamsters. AB - The hypothesis was tested that tissue necrosis in acute experimental amebic liver abscess in hamsters is not caused directly by the parasite but rather, indirectly, by the destruction of closely surrounding leukocytes that release their lysosomal enzymes and damage neighboring liver cells. Axenically grown trophozoites of Entamoeba histolytica strain HM-1 were injected intraportally into normal, hypocomplementemic, and leukopenic hamsters, and the lesions were studied histologically 2, 5, 10, and 24 hr after injection. Hypocomplementemia (less than 5% of normal CH50) and leukopenia (less than 1,000 leukocytes/ml) were achieved and sustained for up to 72 hr with repeated intraperitoneal injections of goat anti-hamster C3 and anti-hamster leukocyte antibodies, respectively. Decrease or absence of polymorphonuclear leukocytes in the vicinity of intrahepatic amebas effectively blocked deleterious effects of the parasites on surrounding hepatocytes. We conclude that in acute experimental amebic liver abscess the direct effect of the parasites on hepatocytes and their stroma is not responsible for tissue necrosis, but rather it is due to their indirect action through the destruction of inflammatory cells. PMID- 1779304 TI - Simultaneous purification of merozoites and schizonts of Eimeria tenella (Apicomplexa) by Percoll flotation and assessment of cell viability with a double fluorescent dye assay. AB - The asynchronous development of Eimeria tenella in orally infected chickens makes it possible to purify second generation merozoites (meros) and shizonts from a single mucosal homogenate. After centrifugation in 30% Percoll in phosphate buffered saline (Percoll-PBS), debris, villi, and schizonts float, whereas meros and erythrocytes are pelleted. Erythrocytes are lysed by a mild hypotonic shock; meros are filtered through a cotton wool plug and collected by centrifugation. The 30% Percoll-PBS supernatant fraction is diluted to 25% Percoll-PBS and centrifuged to sediment mature schizonts. By repeated slow-speed centrifugation, schizonts are separated from nuclei and small-sized debris. In less than 3 hr, 8.8 +/- 2.3 x 10(8) meros and 7.2 +/- 3.9 x 10(6) schizonts are collected from 10 infected chickens. Contamination with host material is 2% for meros but variable for schizonts. For the assessment of cell viability, ethidium bromide (EB) and acridine orange (AO) have been used as markers for dead and living cells, respectively, in a single step method. More than 95% of the schizonts and meros accumulate AO and no EB, whereas lysed erythrocytes and all cells hosting a schizont are permeable to EB. After incubation of meros and schizonts in synthetic media with [5,6- 3H]uracil, label accumulates in the perchloric acid soluble and -insoluble fractions, indicating transport, salvage, and incorporation of the pyrimidine precursor in nucleic acids. If stored on ice, meros and schizonts retain metabolic activity for at least 5 hr, but metabolism declines rapidly during incubation at 41 C. PMID- 1779305 TI - Development of an in vitro microtest to assess drug susceptibility of Babesia bovis and Babesia bigemina. AB - Continuous cultivation of the bovine hemoparasites Babesia bovis and Babesia bigemina was developed as an in vitro microtest to assess parasite susceptibility to babesicidal compounds. Reproducibility of parasite multiplication rates was independent of culture size, making it possible to use a microscale of 100 microliters for each test sample. Inhibitory concentrations (IC50s) of a commonly used babesicide, quinuronium sulfate, evaluated by this in vitro method were found to be 5 x 10(-8) g/ml for B. bovis and 2 x 10(-9) g/ml for B. bigemina. PMID- 1779306 TI - A molecular modeling approach to in vivo efficacy of triclabendazole. AB - The structural and electronic features of a narrow-spectrum benzimidazole anthelmintic triclabendazole (TCZ, 6-chloro-5-[2,3-dichlorophenoxy]-2-methylthio benzimidazole) and its 2 main metabolites triclabendazole sulfoxide (TCZ sulfoxide, 6-chloro-5-[2,3-dichlorophenoxyl]-2-methylsulfonyl-benzimidazole) and triclabendazole sulfone (TCZ sulfone, 6-chloro-5-[2,3-dichlorophenoxy]-2 methylsulfonyl-benzimidazole) have been determined using a combination of quantum mechanics, molecular graphics, and molecular modeling techniques. Using conformational analyses and quantum mechanics, 2 important differences were found between TCZ sulfoxide, the purported active species, and the broad-spectrum benzimidazole anthelmintics. The first distinguishing feature is the shape of the molecule; the substituent at the 2 position of TCZ sulfoxide is nonplanar. All other broad-spectrum benzimidazole anthelmintics, regardless of substituent at the 2 position (methyl carbamate or thiazolyl group), are flat. The second distinguishing feature is the net atomic charge on the substituent at the 2 position of TCZ sulfoxide; it is an order of magnitude larger than the net atomic charges on the other anthelmintics. Thus the nonplanar shape of the methysulfinyl group at the 2 position of TCZ sulfoxide is different (as is its net charge), suggesting that this may be the origin of its narrow spectrum of activity. PMID- 1779307 TI - Evidence for a role of volatile amines in the development of neonatal hypergastrinemia. AB - We investigated the presence of volatile aliphatic amines by fluorescamine and gas chromatographic-head space analysis in human breast milk and amniotic fluid to assess their role in neonatal hypergastrinemia. These volatile nitrogenous amino acid metabolites have been previously demonstrated to stimulate gastrin release in in vivo and in vitro laboratory preparations. In the present study we demonstrated that these gastrin-stimulatory volatile amines were present in significant concentrations in breast milk during the first several weeks after parturition and in amniotic fluid. The individual amines that were identified in both human milk and amniotic fluid samples were methylamine, dimethylamine, ethylamine, trimethylamine, propylamine, isobutylamine, and butylamine. This study provides indirect evidence to support the possibility that the hypergastrinemia measured in the fetus/neonate during the period immediately before and after birth may be attributable, in part, to the ingestion of fluid containing high concentrations of gastrin-stimulating amines. PMID- 1779308 TI - Determining esophageal length from crown-rump length. AB - Since esophageal length varies linearly with height, intraluminal pH monitoring can be performed at a position within the esophagus that is determined by an equation. Alternatively, pH probes can be positioned under fluoroscopic guidance, though no radiographic landmarks indicate the position that is 87% of esophageal length (where the monitoring is usually accomplished). Our aims were to determine whether a relationship might exist between crown-rump length and esophageal length, for use in patients in whom height is difficult or inappropriate to measure, and to determine whether the mid-right atrium can be used as a radiographic landmark in fluoroscopic pH probe placement. Height, crown-rump length, and distance from the suprasternal notch to the left anterior superior iliac spine were measured in 65 consecutive children undergoing 24-h pH monitoring. As the pH probe was inserted under fluoroscopy, distances from the nose to diaphragm and mid-right atrium were determined. Equations were derived by simple linear regression to describe the relationships between each of the body measurements and esophageal length. There is excellent correlation between crown rump length and the distances from the nose to diaphragm and to mid-right atrium. The mid-right atrium corresponds to 87% of the nose to diaphragm distance in many patients. PMID- 1779309 TI - The intestinal absorption of 3-O-methyl-D-glucose in methotrexate-treated rats: an in vivo study of small bowel function. AB - The in vivo absorption of 3-O-methyl-D-glucose (3MG) as a marker of intestinal function has not been studied in an animal model. We evaluated the use of 3MG as a marker of intestinal absorption when given enterally to rats recovering from small bowel mucosal injury induced by methotrexate (MTX). Radiolabeled 3MG was administered into the duodenum of control (CON) and MTX-treated rats and blood samples were obtained at specified intervals. Mucosal permeability was also assessed using radiolabeled mannitol and polyethylene glycol 900 (PEG). Concentration time points were plotted, and area under the curve was calculated as an approximation of absorbed dose. Mucosal weight, maltase activity, and protein content were determined on mucosal scrapings. During the acute phase (day 5), 3MG absorption and maltase-specific activity were significantly decreased in the MTX group when compared to the CON group (p less than 0.001). The MTX group showed a trend toward greater permeability to mannitol when compared to the CON group; however, this was not statistically significant. Mucosal permeability to PEG was similar in both groups. During a later stage in the recovery process (day 12), the area under the curve calculations for 3MG absorption were the same for both CON and MTX animals, with maltase activity in the MTX group recovering to control values. Changes in 3MG absorption paralleled total maltase activities following severe injury. These results suggest that the combined active and passive transport of 3MG in vivo could be of use as a marker of intestinal absorption in states where the small intestine has sustained major damage resulting in compromised absorption as well as brush border digestion. PMID- 1779310 TI - Calcium metabolism in children during long-term total parenteral nutrition: the influence of calcium, phosphorus, and vitamin D intakes. AB - Hypercalciuria and bone disease are frequently associated with total parenteral nutrition (TPN) in children and adults. The aim of this study was to assess the influence of calcium, phosphorus, and vitamin D intakes on hypercalciuria. We observed seven children aged 4-13 years receiving home cyclic TPN for 4 consecutive years. Calcium and phosphorus intakes, constant during the 1st year, were reduced during the last 3 years to 50 and 30% of the initial intakes, and vitamin D was stopped during the 3rd and the 4th years. All children had hypercalciuria and one of them had acute painful osteopenia and nephrocalcinosis at the beginning of the study. Hypercalciuria was corrected and painful bone disease did not occur during the three following years, with TPN daily intakes of calcium, 0.35 mmol/kg, and phosphorus, 0.70 mmol/kg. Cessation of vitamin D administration during 48 months led to no further decrease in calciuria nor to the occurrence of clinical or biological signs of vitamin D deficiency. However, we hypothesize that excessive vitamin D intake may have facilitated the occurrence of the TPN-related bone disease in one patient and should be avoided. The possible role of parenteral aluminum loading is also discussed. PMID- 1779311 TI - The effect of glucocorticosteroids on serum, liver, and lung vitamin A and retinyl ester concentrations. AB - Vitamin A and its active metabolites are important factors in promoting normal respiratory epithelial differentiation and growth. Glucocorticoids, often used to treat chronic lung diseases in infancy and childhood, are known to increase serum retinol concentrations. To determine the effects of exogenous steroids on serum retinol and retinol-binding protein concentrations (as well as on liver and lung total vitamin A, retinol, and retinyl ester concentrations), 32 weanling Sprague Dawley rats were divided into four equal experimental groups. Eight animals were vitamin A sufficient and received 7 days of intraperitoneal dexamethasone at 0.5 mg/kg/day (group SD), 8 were vitamin A sufficient and received placebo (group SP), 8 were made vitamin A deficient and subsequently received dexamethasone (group DD), and 8 were vitamin A deficient and received placebo (group DP). Dexamethasone increased serum retinol concentrations in the SD group (2.27 +/- 0.20 mumol/L) when compared with control (SP, 1.64 +/- 0.46 mumol/L, p less than 0.001) as well as with pretreatment baseline values (1.21 +/- 0.23 mumol/L, p less than 0.001). Lung total vitamin A, retinol, and individual retinyl esters were depleted by 56 +/- 19% in the SD group, whereas liver values were depleted by 36 +/- 23%. In the vitamin A-sufficient groups the relative percentages of four major retinyl esters (palmitate, stearate, oleate, and linoleate) did not change in either tissue after steroid exposure. The vitamin A-deficient groups had no detectable tissue vitamin A, and dexamethasone did not increase serum retinol concentrations in the DD group. Serum retinol-binding protein concentrations were significantly higher in both steroid-treated groups when compared with control.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779312 TI - Nutritional rehabilitation increases resting energy expenditure without affecting protein turnover in patients with cystic fibrosis. AB - The effect of nutritional rehabilitation on several nutritional parameters was studied in eight malnourished patients with cystic fibrosis during the first year after gastrostomy tube insertion. Body composition was studied by fat skinfold measurements and by total body potassium count, resting energy expenditure (REE) by indirect calorimeter, and protein turnover by a single dose administration of [15N]glycine. Weight gain was accompanied by a significant increase in the various body compartments: weight 41.4 +/- 7.5 to 46.1 +/- 8.4 kg (p less than 0.0002), fat body mass 5.6 +/- 2.8 to 7.7 +/- 3.4 kg (p less than 0.005) and fat free body mass (FFBM) 35.7 +/- 6.3 to 38.3 +/- 6.9 kg (p less than 0.0003). REE increased significantly per kg of body weight as well as per kg of FFBM. No significant differences were found in protein turnover during refeeding nor in pulmonary function. We conclude that nutritional support restores body composition, but is accompanied by an increase in energy expenditure. This increase could not be attributed to increased protein turnover. PMID- 1779313 TI - Heart rates of breast-fed and formula-fed infants. AB - Heart rates of 46 breast-fed and formula-fed infants were monitored continuously for approximately 18 h at 1 or 4 months of age. Heart rate differed significantly by age (1 month greater than 4 months; p less than 0.001) and feeding mode (breast-fed less than formula-fed; p less than 0.001). Approximately 58% of the variability in heart rate could be attributed to feeding mode, sex, and age. Heart rate was correlated significantly with energy intake (r = 0.60; p less than 0.001), but not sleeping metabolic rate or total daily energy expenditure. Energy intake accounted for none of the variability in heart rate beyond that explained by feeding mode, sex, and age. PMID- 1779314 TI - Comparison of glucose/electrolyte and maltodextrin/glycine/glycyl glycine/electrolyte oral rehydration solutions in acute diarrhea in children. AB - Male children (N = 101) 6-35 months of age presenting with acute watery diarrhea for less than 48 h at home before hospitalization were admitted into a randomized, double-blind clinical trial. Fifty-one children were treated with standard oral rehydration solution (ORS) (World Health Organization [WHO] formulation containing citrate) and 50 were treated with an improved ORS formulation (containing, in addition to the standard formula, 20 g maltodextrin instead of glucose, and 4 g glycine and 4 g glycyl-glycine). None were given antibiotics. No i.v. infusions were given. Rotavirus was detected by enzyme linked immunosorbent assay in stools of 43 children. Clinical characteristics of children in the two treatment groups were comparable. Improved ORS did not produce significant reduction in the volume of diarrhea stools. Children given improved ORS had greater weight gain than that observed in children treated with standard ORS, but the differences were not statistically significant except at the end of the first 24 h. Among children with rotavirus diarrhea, no significant differences were observed between the 23 children who received improved ORS and the 20 who received standard ORS. PMID- 1779315 TI - Infectious gastroenteritis does not act as a triggering mechanism for the synthesis of serum IgG antibody to beta-lactoglobulin. AB - beta-Lactoglobulin (BLG)-specific serum IgG antibody was measured by enzyme linked immunosorbent assay in 1,392 serum samples from newborn to 5-year-old Ecuadorian children enrolled into a representative nutrition and health survey. At a 1:100 serum dilution, 62% of the children showed specific antibody (blank corrected optical density greater than or equal to 0.1). This prevalence did not change with increasing age. More specifically, we did not observe a prevalence or titer increase of BLG-specific antibody in age groups where the majority of these Ecuadorian children experienced infection with rotavirus (8-24-month age groups) and enterotoxigenic Escherichia coli (8-12-month age group). In addition, BLG specific antibody did not differ between children who did or did not experience an episode of diarrhea 15 days before blood sampling. We observed a small but statistically significant difference in BLG-specific antibody between subsamples of Ecuadorian children regularly or only occasionally ingesting milk. Titers were higher in the group consuming more milk. PMID- 1779316 TI - Persistent diarrhea: total gut transit time and its relationship with nutrient absorption and clinical response. AB - The study was undertaken to better understand the role of total gut transit time (TGTT) on the absorption of nutrients in patients with persistent diarrhea. Twenty-six boys aged 3-18 months with persistent diarrhea and 25 age-matched healthy controls were studied. Their TGTT was measured with charcoal markers during their treatment with a diet made up with rice powder soya oil, glucose, and egg white. Coefficients of absorption of nutrients were estimated in a 72-h balance study. The median TGTTs in patients and controls were 5 and 11.6 h, respectively. Among the patients, the TGT correlated significantly with absorption of total energy (p less than 0.01), absorption of fat (p less than 0.01), stool frequency (p less than 0.01), and stool weight during the 1st 24 h (p less than 0.01). Coefficients of absorption of energy, fat, and carbohydrate were significantly different among the patients above or below the median transit time (5 h). None of these relationships was present among the healthy controls. The TGTT was negatively associated with the duration of clinical recovery. The results of this study suggested that intestinal transit time is an important factor for absorption of nutrients that may influence clinical recovery in patients with persistent diarrhea. PMID- 1779317 TI - Congenital diabetes mellitus and fatal secretory diarrhea in two infants. AB - Two unrelated male infants presented with brittle insulin-dependent diabetes mellitus in the first days of life. Subsequently they each developed severe secretory diarrhea, with stool volumes of more than 100 ml/kg/day. Extensive biochemical and serological investigation failed to reveal the etiology of the diarrhea. The infants, cared for at different institutions, underwent therapeutic trials of various agents including loperamide, cholestyramine, prednisone, indomethacin, and somatostatin analogue, without response. Both infants succumbed to septicemia and malnutrition related to diarrhea and poor control of glycemia. At autopsy, both were found to have absence of islets of Langerhans in the pancreas, and diffuse dysplastic changes in small and large intestinal mucosae. In particular, the entire alimentary tract in each case was lined by epithelia most typical of foregut mucosa: secretory-type glands, absent crypts of Lieberkuhn, and absent villi. These cases are contrasted with previously-reported infants with congenital diabetes mellitus, and the possible interrelation of these two highly unusual findings, congenital diabetes mellitus and diffuse intestinal dysplasia, is examined. PMID- 1779318 TI - Button gastrostomy obstructing the ileocecal valve removed by colonoscopic retrieval. AB - A 16-year-old male with profound developmental disability acutely developed retching, irritability, and abdominal distension. He had undergone a fundoplication and placement of a feeding gastrostomy 6 months earlier. A button gastrostomy tube was subsequently placed, but was noted to be missing from the stoma when the patient was awakened by his mother one morning. Within 48 hours he developed signs of abdominal obstruction. Abdominal radiography confirmed the presence of the gastrostomy button at the ileocecal valve. After a trial of decompression and medical management failed, the button was successfully removed endoscopically, resulting in prompt resolution of the obstruction. Gastrostomy buttons are a newer alternative to conventional catheters, but can become dislodged and migrate, as illustrated by this case. Refinements in the outer wing design may be needed. PMID- 1779319 TI - Hypersensitivity reaction in an infant fed hydrolyzed lactalbumin. PMID- 1779320 TI - Translocation of bacteria from gut lumen to mesenteric lymph nodes--and beyond? PMID- 1779321 TI - Serafeddin Sabuncuoglu, the author of the earliest pediatric surgical atlas: Cerrahiye-i Ilhaniye. AB - The author of one of the earliest surgical books was Serafeddin Sabuncuoglu, who was born in one of the ancient cities of Central Anatolia. In 1465, he wrote a surgical book in Turkish. The aim of this study was to investigate the details of this book and compare it with the old classics. It was observed that the book of Sabuncuoglu did not contain only pictures or miniatures of pediatric surgical procedures, but there were many important and major new contributions to the surgical literature originally described by Sabuncuoglu himself. He based his contributions and techniques on formerly designed and described procedures, moreover, developing and nourishing pediatric surgical culture of that era. Thus a combination of Greek, Roman, Arabic, and Turkish pediatric surgery combined extraordinarily and influenced the development of European pediatric surgery. PMID- 1779322 TI - Felix Wurtz: surgeon and pediatrician. AB - Felix Wurtz, a surgeon in Basel and Zurich, wrote a book on pediatrics, The Childrens Book, which was first published (after his death) in 1612. It is the first known book in western Europe to deal with pediatrics and surgery. The book discusses issues dealing with the care of children, also addressing problems in pediatric surgery, primarily congenital and acquired orthopedic malformations. The book, and the contribution of its writer to pediatric surgery, are reviewed. The accuracy of the first English language translation is also evaluated. PMID- 1779323 TI - Adjuvant effects of beta-adrenergic drugs on indomethacin treatment of newborn canine endotoxic shock. AB - Newborns are susceptible to gram-negative sepsis/septic shock, but there is no established method of its treatment. This study was performed to evaluate the adjuvant effects of dopamine and dobutamine in the indomethacin treatment of newborn endotoxic shock. Endotoxic shock was induced in newborn dogs (2 to 10 days old; 300 to 800 g) by Escherichia coli lipopolysaccharide (LPS; 1.5 mg/kg, intravenously [IV]). Indomethacin (1.5 mg/kg, IV) was injected 5 minutes after LPS injection. Dopamine (5 micrograms/kg/min) or dobutamine (5 micrograms/mg/min) infusion started 5 minutes after LPS injection immediately following indomethacin injection. Hemodynamic parameters were monitored serially for 120 minutes. LPS induced bradycardia and hypotension, decreased the cardiac output and cardiac performance, and increased the total vascular resistance. When dopamine, dobutamine, or indomethacin were used alone, they attenuated the hemodynamic deterioration by LPS. Dopamine infusion following indomethacin administration improved the hemodynamics further, although dobutamine infusion did not. Therefore, we conclude that the adjuvant therapy of dopamine in the indomethacin treatment of newborn endotoxic shock is beneficial. PMID- 1779324 TI - Early prediction of outcome following head injury in children: an assessment of the value of Glasgow Coma Scale score trend and abnormal plantar and pupillary light reflexes. AB - A retrospective study of 95 children less than 15 years of age with significant head injury was made to assess the value of Glasgow Coma Scale (GCS) score trend and plantar and pupillary light reflexes during the first 24 hours after injury, in predicting eventual outcome. GCS score trend or reflexes used alone were significantly correlated to outcome. There was also a statistically significant correlation when these parameters in combination were related to outcome. However, the clinical value of the combined use of GCS score trend and reflexes was only slightly greater than the use of GCS score trend alone. PMID- 1779325 TI - Peripheral vascular injuries in children. AB - We report 94 arterial injuries in 91 children treated at the Department of Thoracic and Cardiovascular Surgery, Medical School of Dicle University, between 1978 and 1988. The average age was 10.3 (range, 3 to 14) years. Stab wounds were seen in 37 patients (40%). Gunshot wounds were seen in 21 patients (23%), and two cases were caused by iatrogenesis. Vein damage was present in 39 patients (44.4%), and nerve loss was observed in 20 patients (21.2%). Twenty-one cases (23.3%) were associated with fractures. Diagnosis of arterial injury was made by clinical findings. Arteriography was used in 15 patients (16.5%) as the diagnostic method. The surgical interventions performed for arterial repair in our series were end-to-end anastomosis in 61 (64.5%), interposition of autogenous reversed saphenous vein grafts in 22 (23.4%), lateral suture in 8 (8.3%), and ligation in 3 (3.9%) patients. Four patients (5.3%) underwent limb amputation. PMID- 1779326 TI - Management of nutritional and infectious complications of postoperative chylothorax in children. AB - Postoperative chylothorax may occur following any intrathoracic surgical procedure in children. From January 1979 through February 1987, 18 children aged 1 month to 9 years had chylothorax listed among their discharge diagnoses. Initial therapy for all patients consisted of chest tube placement for pleural space drainage and nutritional support with either enteral formulas enriched with medium-chain triglycerides or total parenteral nutrition. Both total parenteral nutrition and medium-chain triglyceride-enriched enteral regimens provided adequate nutritional support in these children. Five of the 18 experienced lymphopenia secondary to chylous lymphocyte loss. Infections were diagnosed in 5 patients during hospitalization; one was a fatal viral pneumonitis. No correlation between infectious complications and lymphocyte count could be demonstrated. PMID- 1779328 TI - Torsion of uterine adnexa in neonates and children: a report of 20 cases. AB - Twenty children under the age of 14 years with torsion of the uterine adnexa are discussed. Of the 14 postnatal cases, 8 were associated with additional ovarian pathology whereas in 6 cases the torsion was of normal uterine adnexa. Six additional cases had antenatal torsion with "pseudocyst" formation. All 14 postnatal cases presented as acute abdominal emergency requiring immediate surgery. Only 6 of the 14 had been correctly diagnosed preoperatively, the rest being mostly diagnosed as acute appendicitis. Sonographic studies can improve the preoperative diagnosis. Hemorrhagic necrosis of the adnexa (secondary to the torsion) was found in all cases except one, and necessitated adnexal resection. In only one case preservation of the adnexa was possible. Fixation of the contralateral ovary is recommended in cases of torsion of normal uterine adnexa. All six cases of antenatal torsion were diagnosed by routine ultrasonography during pregnancy between the 29th and 40th week of gestation. The "fluid-fluid" level sign is characteristic of this lesion. These neonates were born in no acute distress and were found to be completely asymptomatic. Hence, they did not require urgent surgery and underwent operation electively at the age of 2 weeks. Resection of the pseudocyst with fixation of the contralateral ovary is the treatment of choice in these cases. PMID- 1779327 TI - Gastrointestinal protein loss in children recovering from burns. AB - Qualitative gastrointestinal protein loss was evaluated in 10 children with second- and/or third-degree burns covering 10% or more of their body surface area (BSA) by using fecal alpha-1-antitrypsin (FA-1-AT) as a marker. Patients were subdivided according to the extent of the burned area: group I (5 patients) had burns covering less than 20% of BSA; group II (5 patients) had burns covering more than 20% of BSA (mean, 37.2% = 24.9%). Results were compared with those of 12 healthy normal controls. Mean maximal FA-1-AT excretion in group II patients (2.71 +/- 1.35 mg/g) was significantly greater than that found in group I children (0.43 +/- 0.26 mg/g; P = .006) and in the controls (0.62 +/- 0.25 mg/g; P = .004). The mean maximal FA-1-AT excretion positively correlated to the percent of BSA covered with burns (r = 0.83). Although the mean septic score (SS) of group I patients (7 +/- 2.9) was significantly greater than that calculated for group II children (3 +/- 2.45; P = .047), only 2 patients in group II had positive microbiological cultures. Patients in both groups had received more than the recommended enteral caloric and protein allowance during the 96 hours prior to the maximal FA-1-AT measurements. Within this range, no correlation was found between the amount of FA-1-AT and the number of calories per kilogram protein consumed. By using the method of FA-1-AT quantification, this study provides the first report on postburn intestinal protein loss in children. PMID- 1779329 TI - Uterus didelphys with an obstructed hemivagina and ipsilateral renal agenesis: a rare cause of acute abdomen in pubertal girls. AB - The unique clinical syndrome of uterus didelhphys with an obstructed hemivagina and ipsilateral renal agenesis, presenting as acute abdomen in three pubertal girls, is reported. Accurate preoperative diagnosis and appropriate treatment will offer relief of symptoms and decrease morbidity and unnecessary procedures. PMID- 1779330 TI - Complications of endorectal pull-through for Hirschsprung's disease. AB - In 10 years, 57 infants with Hirschsprung's disease underwent endorectal pull through (ERPT). Postoperatively, 3 patients died. Of the 44 survivors with an intact endorectal anastomosis aged more than 3 years, 23 (52%) had an excellent result, and of the 28 children more than 5 years old, 23 (82%) had a satisfactory result. Of the 53 known survivors of all ages, 18% suffered from diarrhea with intermittent incontinence and 5 (9.4%) had undergone a Duhamel procedure within 4 years of ERPT. PMID- 1779331 TI - Technical improvement for anorectal manometry in newborns. AB - A modification of the anorectal manometric technique has been devised to improve its accuracy in 31 low-weight newborn and premature infants. The characteristics of the probes used allowed long recording sessions without any sedation of patients. The pressure records fit well the classically accepted requisites. All recordings showed spontaneous fluctuating waves and increased mean pressure in the aboral direction. The anorectal reflex was observed in all cases. Clear reflex waves were recorded in the most caudal third of the anal canal. In this zone the recording showed more distinct features with respect to fluctuation and relaxation waves than those located in more proximal parts. The validity of this technique is unquestionable from the view of the reliability of the recordings independent of the weight, gestational age, and birth age of the infants. PMID- 1779332 TI - Gracilis muscle transposition for anal incontinence in children: long-term follow up. AB - We report a series of 7 patients, aged 6.5 to 19 years (mean, 12.9), who have been treated for uncontrollable fecal incontinence since 1976: 5 had imperforate anus and multiple subsequent operative procedures, 1 had a low myelomeningocele with bi-sphincteric incontinence, and 1 had a traumatic destruction of the sphincter apparatus. A modified Pickrell procedure was performed, with the gracilis muscle transposed subcutaneously, without constructing a pulley through the median raphe as originally described. All patients were evaluated by anorectal manometry preoperatively and post-operatively. They were followed-up for a period of 0.5 to 12.5 years (mean, 4.4). All patients were continent at follow-up, with a normal defecation pattern and no enemas required. None of the patients had evidence of fibrosis of the muscle or anal canal, and tension in the transposed muscle was maintained. Voluntary contractions remain efficient in all cases. Age was thought to be an important factor: personal motivation and compliance with physiotherapy, essential for a good outcome, is unlikely to be present in the younger child. We conclude that the gracilis sling procedure is an excellent long-term alternative for total fecal incontinence when time and other therapeutic measures have failed. PMID- 1779333 TI - Chemoimmunotherapy in conjunction with surgery: strategies for management of murine neuroblastoma. AB - The combination of biological response modifiers with cytotoxic drugs has proven to be synergistic in several tumor systems. Recombinant human tumor necrosis factor (rhTNF) has been shown to enhance the antitumor efficacy of etoposide (VP 16) in the treatment of C1300 murine neuroblastoma. However, after completion of therapy, tumor growth resumes and results in subsequent death. In an effort to assess the impact of combining surgery with rhTNF/VP-16 therapy, A/J mice bearing the C1300 murine neuroblastoma were treated within adjuvant or neoadjuvant protocols. Adjuvant-treated animals had a longer interval to disease recurrence (P = .01) and smaller average recurrent tumor volumes postexcision (P less than .05) compared with surgical controls. Histological evidence of tumor recurrence and liver metastases was seen in both adjuvant-treated and surgical control animals. Neoadjuvant-treated animals had a longer interval to disease recurrence (P = .03) and smaller average recurrent tumor volumes up to 14 days postexcision (P less than .02) compared with surgical controls. In addition, 30% of the neoadjuvant-treated animals had no microscopic evidence of disease recurrence, and only 14% had histological evidence of liver metastases. The surgical controls in the neoadjuvant experiment all had histological evidence of disease recurrence and liver metastases. Thus, the combination of surgery and rhTNF/VP-16 in the adjuvant or neoadjuvant setting appears to significantly delay the progression of C1300 murine neuroblastoma. Furthermore, administering chemoimmunotherapy prior to surgical excision in a neoadjuvant manner appears to be most beneficial as regards prevention of local disease recurrence and distant metastases. PMID- 1779335 TI - The role of surgery in American Burkitt's lymphoma in children. AB - The records of 28 children with the pathological diagnosis of American Burkitt's lymphoma were reviewed. Twenty-three of these children (82%) presented with primary abdominal tumors and 5 with disease located in the head and neck. Twelve required an emergency operation for either intestinal obstruction (3), intussusception (5), or appendicitis (4); the others underwent an elective exploration for tissue diagnosis. Ten patients had disease localized to one particular site. Seven of these 10 children underwent complete resection of the tumor including a right colectomy (4), small bowel segmental resection (1), tonsillectomy (1), and appendectomy (1). Eight children had a subtotal resection of the tumor (less than 90% of tumor burden) and the rest underwent incisional biopsies. Following the diagnosis, all patients received chemotherapy; 8 (29%) also were treated concurrently with radiation therapy. Nineteen patients (70%) remain long-term survivors with a mean survival time of 3.6 years. Eight patients died of either recurrent disease (6) or sepsis secondary to their chemotherapy, with a mean survival time of 6 months. Sixteen patients (57%) developed complications during their hospitalization that required surgical consultation or intervention (acute renal failure [9], pleural effusion [2], intestinal obstruction [5], gastric outlet obstruction [1], and wound infection [1]). No subsequent treatment of these complications resulted in mortality or morbidity. The significant positive determinant for survival was the initial absence of either bone marrow or central nervous system involvement (P less than .05). In those children who had complete resection of their tumor, survival time was greater than 3.7 years.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779334 TI - Urinary dopamine/noradrenaline and dopamine/vanillylmandelic acid ratios as a reflection of different biology of adrenergic clones in children's neuroblastic tumors. AB - The results of calculations of urinary dopamine/noradrenaline (DA/NAd) and dopamine/vanillylmandelic acid (DA/VMA) ratios in 54 untreated children with neuroblastic tumors are reported. Thirteen patients were in the prognostically favorable group (stages I, II, and IV-S and ganglioneuroma [GN]), and 41 had advanced neuroblastoma (stage III and IV). Among patients with ganglioneuroma and favorable neuroblastoma (n = 13), of whom all were survivors, the urinary DA/NAd and DA/VMA ratios exceeded 1.8 in only 2 cases of stage IV-S and stage I, respectively. In the advanced neuroblastoma group, the DA/NAd and DA/VMA ratios exhibited a wide range of values, but among the stage III and IV survivors (n = 10), DA/NAd ratios greater than 1.8 were noted in only 3 patients. The DA/VMA ratio was not greater than 1.8 in those 3 patients. The mean DA/NAd and DA/VMA proportions in the population comprising all survivors were 1.8 +/- 2.7 (mean +/- SD) and 1.1 +/- 0.4, respectively. The same computations carried out in patients who died showed higher values, ie, the mean DA/NAd and DA/VMA ratios were 5.2 +/- 6.3 and 5.6 +/- 10.5, respectively, showing the difference in DA/NAd and DA/VMA ratios between prognostically favorable and unfavorable groups. Of 23 survivors, only 4 had DA/NAd ratios greater than 1.8 (17%), while 24 of 31 children who died (77%) had DA/NAd ratios was greater than 1.8. The reported results suggest dissimilarity in the catecholamine metabolism of adrenergic clones with respect to the stage of advancement of neoplastic disease. PMID- 1779336 TI - Microlymphography of spontaneous lymph vessel anastomosis in small bowel transplantation in the rat. AB - Following small bowel transplantation, new lymph vessel anastomoses form spontaneously. Surgical anastomoses of the lymphatic vessels are unnecessary. The formation occurs in three stages. To the second postoperative day, lymph stays within the lymphatic vessels of the transplant. Following the fourth postoperative day, lymph flows within preexistent adventitial lymphatic vessels along the transplanted mesenteric artery to the arterial anastomosis at the aorta and stops there. From the sixth postoperative day on, lymph crosses the arterial anastomosis for the first time and flows along the recipient's aorta. To the eighth postoperative day a new lymph anastomosis is formed between the adventitia of the aorta and the neighbouring major lymphatic vessels. In the experiments presented here, these are represented by the vasa lymphatica testicularia sinistra of the recipient. Thus, the new anastomosis between lymphatic vessels is complete on the eight postoperative day. These new vessels gradually dilate with time. PMID- 1779337 TI - The human tail and spinal dysraphism. AB - Recent publications have endeavoured to differentiate between the true, or vestigial tail, and the pseudotail by clinical and pathological examination, and have indicated the benign nature of the true tail. The true tail arises from the most distal remnant of the embryonic tail, contains adipose, connective, muscle, and nerve tissue, and is covered by skin. Pseudotails represent a variety of lesions having in common a lumbosacral protrusion and a superficial resemblance to vestigial tails. A review of the case reports indicates spina bifida to be the most frequent coexisting anomaly with both. A review of occult spinal dysraphism shows it to be associated with cutaneous signs in more than 50% of instances. Three cases of spinal dysraphism with tail-like cutaneous structures are described and their radiological, operative, and pathological findings presented. The classification of each of the appendages into true tail or pseudotail remains obscure. Although the finding of these three tails was the subject of much curiosity, surgical treatment was clearly designed to adequately deal with the associated dysraphic state. The presence of a tail-like appendage in the lumbosacral region should alert the clinician to the possibility of underlying spinal dysraphism. Preoperative assessment must include a complete neurological history and examination as well as computed tomographic or magnetic resonance imaging. PMID- 1779338 TI - The area under pH curve: a single-figure parameter representative of esophageal acid exposure. PMID- 1779339 TI - Simultaneous occurrence of congenital partial pericardial defect and posterolateral diaphragmatic hernia. PMID- 1779340 TI - Surgical proposition for the treatment of omphalocele. PMID- 1779341 TI - Huge swelling over the tip of tongue. PMID- 1779342 TI - Pain relief in infants after major surgery: a descriptive study. PMID- 1779343 TI - Introduction to perinatal audit. PMID- 1779344 TI - Perinatal audit and control of infant mortality in the German Democratic Republic (East Germany). PMID- 1779345 TI - Clinical significance of Doppler velocimetry in the prediction of outcome in high risk pregnancies. PMID- 1779346 TI - Should perinatal audit be internally generated or externally moderated? PMID- 1779347 TI - Consensus statements round table "fetal and neonatal distress". PMID- 1779348 TI - The role of electronic fetal monitoring in labour. PMID- 1779350 TI - Fetal behaviour and biophysics as observed by ultrasound. PMID- 1779349 TI - Fetal oxygenation and acid base balance during pregnancy. PMID- 1779351 TI - Neonatal stress or distress. PMID- 1779352 TI - Regionalization of perinatal care. PMID- 1779353 TI - A contactless cardiorespiratory monitoring system. PMID- 1779354 TI - New frontiers in prenatal prevention of respiratory distress syndrome. PMID- 1779355 TI - New ventilatory techniques in the treatment of newborn infants. PMID- 1779356 TI - The dilemmas of surfactant replacement. PMID- 1779357 TI - Follow up of the newborns with respiratory problems. PMID- 1779358 TI - Multiple pregnancy and very early preterm births in a referral center. PMID- 1779359 TI - Cardiac septation revisited: the developing conduction system as a "reference structure". PMID- 1779360 TI - The disposition of the conduction tissues in congenitally malformed hearts with reference to their embryological development. PMID- 1779361 TI - The morphology of atrioventricular septal defects: a clue to controversies concerning development. PMID- 1779362 TI - Developmental morphology of atrio-ventricular cushions and atrioventricular septal structures. A clue to understanding atrio-ventricular septal defects. PMID- 1779363 TI - Twin pregnancies and mode of delivery-too many cesarean sections? PMID- 1779364 TI - Twin pregnancies after medically assisted reproduction: epidemiology, comparative perinatal morbidity and mortality. PMID- 1779365 TI - Zygosity determination at birth: a plea to the obstetrician. PMID- 1779366 TI - The consequences to the family of triplets or more. PMID- 1779367 TI - Perinatal bereavement after the loss of one twin. PMID- 1779368 TI - Neonatal complications specific to twin (multiple) births (twins transfusion syndrome, intrauterine death of cotwin). PMID- 1779369 TI - The natural history of vertically acquired HIV infection. The European Collaborative Study. PMID- 1779370 TI - Therapy of neonatal and pediatric HIV infection. PMID- 1779371 TI - Ethical issues in perinatal care and research. The process of decision-marking in reproductive medicine. PMID- 1779372 TI - Prenatal prediction of renal function in fetal obstructive uropathies. PMID- 1779373 TI - Fetal Doppler studies in normal and complicated pregnancies. PMID- 1779374 TI - Brain development--normal and abnormal. PMID- 1779375 TI - Transvaginal color Doppler studies in pregnancy. PMID- 1779376 TI - Doppler ultrasound examination as a clinical diagnostic test in obstetrics. PMID- 1779377 TI - Applications of Doppler ultrasound in neonatal medicine. PMID- 1779379 TI - Management of the extreme premature delivery. AB - Generally speaking the answer, how early is too early, can't be exactly answered. For practical reasons it seems advisable to draw that line about 25 completed weeks of gestation but of course it is desirable to make individual decisions in each case when time and experience allows that. If possible, mothers with threatening very premature delivery should be transported to a stage 3 hospital. When one is prepaired to make maximal efforts for the survival of the infant, modern supervision of the fetus should be applied. In uncomplicated cases of idiopatic premature labour vaginal delivery should be allowed. Due to the fragility of the immature fetus any kind of birth trauma should be minimized. Caesarean section might be used on liberal indications and cases with beginning acidosis should be promptly delivered in the most suitable way. When complicated by breech presentation the delivery seems to be best performed by the abdominal route. I like to emphasize that to me, the most important item concerning the management of the very preterm birth is the correct dating of the pregnancy. Without reliable data one can hardly make any proper decisions on how early is too early and solve the problems connected to that question. In my opinion the emergency weight estimation with ultrasound is not satisfactory, only the knowledge of the length of the pregnancy allows you to do so. PMID- 1779378 TI - How small is too small or how early is too early? Epidemiology. PMID- 1779380 TI - Neonatal management of extremely low birth weight (ELBW) infants. How to improve it? PMID- 1779381 TI - Developmental risks and outcome of very low birth weight infants. PMID- 1779382 TI - Introduction to studies within the EC Working Group 'Fetal Electro- and Phonocardiography'. PMID- 1779383 TI - Quantification of intrapartum asphyxia. PMID- 1779384 TI - A system for acquisition and storage of intra partum fetal ECG. PMID- 1779385 TI - Clinical experience with the STAN-PC--optical disc. PMID- 1779386 TI - Prenatal diagnosis today. PMID- 1779387 TI - ECG analysis during labour--presentation of initial results of the EC Multicentre Project. Model for data analysis with a case study. PMID- 1779388 TI - Oxygen availability determines oxygen consumption of fetal skeletal muscle cells in monolayer culture preliminary report. PMID- 1779389 TI - Acute ventilation-dependent expression of surfactant-associated proteins in preterm rabbit neonates. PMID- 1779390 TI - Effect of hyperglycemia on sorbitol and myo-inositol content of cultured rat conceptus: prevention of dysmorphogenesis with aldose reductase inhibitors and myo-inositol. PMID- 1779391 TI - Hypercoagulability of blood in newborn infants: role of neonatal red cell membrane oxidation and prenatal care. PMID- 1779392 TI - A trial of vitamin A supplementation for the prevention of intraventricular hemorrhage in very low birth weight neonates. PMID- 1779393 TI - Endocrinological oxytocic bioactivity of human fetal thymus and influence on glucose and lipide metabolism. PMID- 1779394 TI - Economic impact of porcine surfactant replacement (Curosurf) for severe neonatal respiratory distress syndrome. PMID- 1779395 TI - Glucocorticoid and estradiol receptors in human fetal lung. PMID- 1779396 TI - The non-invasive methods of prenatal diagnosis: the role of ultrasonography and MRI. PMID- 1779397 TI - Ultrasound and genetic counselling in the prenatal diagnosis of fetal malformations. PMID- 1779398 TI - Reproductive counselling: the perinatologist's view. PMID- 1779399 TI - Postnatal adaptation in thermoregulation. PMID- 1779400 TI - Adaptation of cardiorespiratory control in neonates. PMID- 1779401 TI - Neonatal adaptation of fluid balance. PMID- 1779402 TI - "Neonatal adaptation of energy and protein metabolism". AB - During the last decade, the development of "bedside" investigative methods, including indirect calorimetry, nutritional balance and stable isotope techniques, have given a new insight into energy and protein metabolism in the neonates. Neonates and premature infants especially, create an unusual opportunity to study the metabolic adaptation to extrauterine life because their physical environment can be controlled, their energy intake and energy expenditure can be measured and the link between their protein metabolism and the energetics of their postnatal growth can be assessed with accuracy. Thus, relatively abstract physiological concepts such as the postnatal timecourse of heat production, energy cost of growth, energy cost of physical activity, thermogenic effect of feeding, efficiency of protein gain, metabolic cost of protein gain and protein turnover have been quantified. These results show that energy expenditure and heat production rates increase postnatally from average values of 40 kcal/kgxday during the first week to 60 kcal/kgxday in the third week. This increase parellels nutritional intakes as well as the rate of weight gain. The thermogenic effect of feeding and the physical activity are relatively low and account only for an average of 5% each of the total heat production. The cost of protein turnover is the highest energy demanding process. The fact that nitrogen balance becomes positive within 72 hours after birth places the newborn in a transitional situation of dissociated balance between energy and protein metabolism: dry body mass and fat decrease while there is a gain in protein and increase in supine length. This particular situation ends during the second postnatal week and soon thereafter the rate of weight gain matches the statural growth. The goals of the following review are to summarize recent data on the physiological aspects of energy and protein metabolism directly related to the extrauterine adaptation, to describe experimental approaches which recently were adapted to the newborns in order to get "bedside results" and to discuss how far these results can help everyday's neonatal practice. PMID- 1779403 TI - A simple method for the simulation of unbound serum disopyramide concentration in patients. AB - There were remarkable differences in the serum total and unbound concentrations of disopyramide (DP) and mono-N-dealkyldisopyramide (MND), the major metabolite of DP, among patients with arrhythmias. Serum levels of alpha 1-acid glycoprotein (AAG) also varied among the same patients. To predict the unbound DP concentrations, we have obtained the serum concentration-time curves of unbound DP in these patients by means of total DP concentration, DP pharmacokinetic parameters, AAG levels and dissociation constants of DP and MND at specific AAG binding sites. In patients with normal AAG levels, the theoretical values of unbound DP were in good agreement with the measured concentrations. On the other hand, in patients with high AAG levels, the theoretical values could be obtained by correcting the calculated values using both AAG levels of each patient and the equation correlating the unbound DP fraction to AAG concentrations. These findings indicate that patient AAG levels can provide valuable information permitting the rapid estimation of unbound DP concentrations, the pharmacologically active fraction, and the development of effective DP dosage regimens. PMID- 1779404 TI - Participation of monocarboxylic anion and bicarbonate exchange system for the transport of acetic acid and monocarboxylic acid drugs in the small intestinal brush-border membrane vesicles. AB - A participation of bicarbonate exchange system for the transport of acetic acid and the related monocarboxylic acid drugs in the intestinal brush-border membrane vesicles (BBMVs) was investigated. The uptake of [3H]acetic acid at 37 degrees C by BBMVs was markedly stimulated and showed a clear overshoot phenomenon in the presence of outward-directed bicarbonate gradient (pHin = 7.5, [KHCO3]in or [NaHCO3]in = 100 mM; pHout = 7.5, [K-gluconate]out or [Na-gluconate]out = 100 mM). This uptake process was saturable (Kt = 50.4 +/- 4.96 mM and Jmax = 11.6 +/- 0.61 nmol/mg protein/10 s) and was inhibited by DIDS (4,4-diisothiocyano-2,2' disulfonic acid stilbene disodium salt) and furosemide, anion exchange inhibitors, and by many monocarboxylates. The initial uptake of [3H]acetic acid was competitively inhibited by salicylic acid, suggesting the common transport between acetic acid and salicylic acid. At lower extravesicular pHs and in the presence of outward-directed bicarbonate gradient (pHin = 7.5 [KHCO3]in = 100 mM; pHout = 6.0 or 5.0, [K-gluconate]out = 100 mM) where membrane potential was clamped to zero by K(+)-valinomycin, the uptake of [3H]acetic acid showed an overshoot phenomenon, whereas the uptake was significantly decreased in the presence of carbonyl cyanide p-trifluoromethoxyphenylhydrazone, a protonophore. It was concluded, therefore, that there are one or two mechanisms for the carrier mediated transport of acetic acid and monocarboxylates related to bicarbonate exchange systems in rabbit intestinal BBMVs: 1) proton gradient independent and bicarbonate exchange system; 2) proton gradient dependent and bicarbonate exchange system. PMID- 1779406 TI - Antitumor activity of polymorphonuclear leukocytes activated by a beta-1,3-D glucan. AB - The antitumor activity of mouse polymorphonuclear leukocyte (PMN) treated with a beta-1,3-D-glucan from Alcaligenes faecalis var. myxogenes IFO 13140 (TAK-N) and its carboxymethylated derivative (CM-TAK) was investigated in vitro and in vivo. ICR mouse PMN showed strong cytotoxicity against sarcoma 180 cells and inhibition of the growth of the tumor cells in vitro in the presence of TAK-N but not in the presence of CM-TAK. Since the cytotoxicity induced by TAK-N was almost completely inhibited by catalase, it seems to be mediated by H2O2 production by PMN. On the other hand, TAK-N induced no cytotoxicity in macrophages and neither did CM-TAK in PMN or in macrophage. Intraperitoneal injection of TAK-N into ICR mice induced a large number of PMN and macrophages in the peritoneal cavity. The peritoneal exudate PMN which were harvested at 10 to 72 h after TAK-N injection showed cytotoxicity against sarcoma 180 cells, but the peritoneal exudate macrophages did not. Treatment of sarcoma 180 ascites tumor-bearing ICR mice with TAK-N at a dose of 100 mg/kg prolonged significantly the survival time over that of the control. These results indicate that TAK-N induces PMN cytotoxicity against sarcoma 180 cells not only in vitro but also in vivo. The antitumor effect of TAK N on sarcoma 180 ascites tumor seems to be derived from PMN stimulated with TAK N. PMID- 1779405 TI - Comparative study of certain antibiotics on epileptogenic property, including (1Rpi, 5S, 6S)-2-[(6,7-dihydro-5H-pyrazolo[1,2-a][1,2,4]triazolium-6-yl)] thio-6 [(R)-1-hydroxyethyl]-1-methyl-carbapenem-3-carboxylate (LJC10627), a carbapenem antibiotic with broad antimicrobial spectrum. AB - The epileptogenic effects of (1R, 5S, 6S)-2-[(6,7-dihydro-5H-pyrazolo[1,2 a][1,2,4]triazolium-6- yl)]thio-6-[(R)-1-hydroxyethyl]-1-methyl-carbapenem-3 carboxylate (LJC10627), a new derivative of carbapenem were studied in comparison with those of imipenem (imipenem/cilastatin), cefazolin and penicillin G. In intraventricular injection in rats, LJC10627 caused no epileptogenic activity at a dose of 32 micrograms. In contrast, imipenem, cefazolin and penicillin G showed dose-related seizure signs, continuous rhythmic spikes or high voltage spike-wave complexes and convulsive behaviors at doses higher than 10 micrograms. After intravenous injection of LJC10627, no epileptogenic signs on the electroencephalogram (EEGs) or in behavioral symptoms were observed, even at a dose of 500 mg/kg in rats and 300 mg/kg in rabbits, respectively. By contrast, imipenem/cilastatin provoked severe seizure patterns characterized by high voltage spikes-wave complex and convulsive behavior, both in rats and rabbits, using the same doses of LJC10627. Cefazolin and penicillin G also induced obvious epileptogenic signs in both rats and rabbits after intravenous injection. From these results, it was concluded that LJC10627, unlike imipenem (imipenem/cilastatin) and cefazolin, dose not elicit epileptogenic activity, and may therefore be safely used for clinical purpose. PMID- 1779407 TI - Regulation of epidermal growth factor receptors in rat gastric mucosa: effect of gastric ulceration. AB - The effect of experimental ulcers on the binding of human epidermal growth factor (hEGF), beta-urogastrone, to plasma membranes isolated from rat gastric mucosa was studied in order to develop hEGF as an anti-ulcer drug. The binding of [125I]hEGF to the gastric plasma membranes was significantly decreased 1 h after treatment with aspirin (300 mg/kg) and after 12 h of water-immersion stress. However, the number of EGF binding sites was increased 12 h after aspirin administration. There was little change in the binding of [125I]insulin to the gastric plasma membranes in response to water-immersion stress. These results indicate that changes in EGF binding to its receptors occur on plasma membranes of the rat gastric mucosa during ulcer. PMID- 1779408 TI - Metabolic fate of a new anti-ulcer drug (+)-(1R,4aS,10aR)- 1,2,3,4,4a,9,10,10a octahydro-1,4a-dimethyl-7-(1- methylethyl)-6-sulfo-1-phenanthrenecarboxylic acid 6-sodium salt pentahydrate (TA-2711). I. Disposition, metabolism and protein binding in rats and dogs. AB - Metabolic fate of (+)-(1R,4aS,10aR)-1,2,3,4,4a,9,10,10a-octahydro-1,4a- dimethyl 7-(1-methyl-ethyl)-6-sulfo-1-phenanthrenecarboxylic acid 6-sodium salt pentahydrate (TA-2711), a new anti-ulcer drug, was studied in animals using 14C TA-2711. The absorption was estimated to be 3.4-7.0% of dose in rats. The plasma radioactivity after oral dosing peaked at 5-6 h in rats and at 2 h in dogs, and their elimination half lives (beta) were about 120-130 h. After oral or intravenous administration of TA-2711 to rats, the concentrations of radioactivity in most of the tissues were much lower than that in the plasma, indicating the low transfer of TA-2711 into the tissues from the plasma. In whole body autoradiograms of rats, most of the radioactivity given orally was localized in the gastrointestinal tract. Almost all the radioactivity given orally was excreted to the feces while the urinary excretion was extremely low. The sole and slight metabolite, glucuronide of TA-2711, was detected only in the urine of rats and dogs after oral dosing. During the consecutive oral dosing once a day for 21 d to rats, the plasma levels attained the steady state after administration of drug 7-10 more times. After the final dosing, the patterns of disappearance of radioactivity in the plasma were similar to those in the tissues, and the tissue/plasma ratios of the concentrations were similar to those after single dosing, suggesting no accumulation in rat tissues. More than 96% and about 85% of TA-2711 was bound in vitro to human and rat serum proteins, mainly albumin, respectively. No radioactivity was found in fetus and milk of rats given oral administration. PMID- 1779409 TI - Metabolic fate of a new anti-ulcer drug (+)-(1R,4aS,10aR)-1,2,3,4,4a,9,10,10a- octahydro-1,4a-dimethyl-7-(1-methylethyl)-6-sulfo-1- phenanthrenecarboxylic acid 6-sodium salt pentahydrate (TA-2711). II. Distribution in the rat stomach. AB - The distribution of (+)-(1R,4aS,10aR)-1,2,3,4,4a,9,10,10a-octahydro-1,4a- dimethyl-7-(1-methylethyl)-6-sulfo-1-phenanthrenecarboxylic acid 6-sodium salt pentahydrate (TA-2711) in stomach was studied after oral administration of 14C-TA 2711 (100 mg/kg) to rats. At 6 h after dosing, most of the radioactivity was found in the lower intestine, caecum and large intestine. However, the radioactivity in the stomach was higher than that in the upper and middle small intestine. The concentration of the radioactivity in the glandular stomach was about 1.5 mg eq. TA-2711/g at 30 min after administration. Thereafter, it decreased gradually to about 60 micrograms eq. TA-2711/g at 6 h after dosing. In the radioluminograms of 6 and 24 h after dosing, most of the radioactivity was observed on the surface of gastric mucosa. After administration to rats with gastric ulcer induced by acetic acid, higher radioactivity was observed in the ulcerated tissues of the stomach than in the nonulcerated control tissues. In the stomach damaged by ethanol, the concentrations of radioactivity in lesion parts were also higher than those in non-lesion parts. In the microautoradiograms of gastric mucosa damaged by ethanol, the developed silver grains were densely distributed in necrotic tissues. PMID- 1779410 TI - In vivo testing of a biostable polyurethane. AB - At present all the commercially available "medical grade" urethane elastomers exhibit a phenomenon known as environmental stress cracking (ESC). This phenomenon is characterized by surface microcracking when the elastomer is elongated while in vivo. The degree of strain that is required to initiate microcracking varies from composition to composition. It has been found that harder compounds generally tend to have a higher strain threshold than corresponding softer ones. We theorized that this degradation occurs when certain enzymes (present only in vivo) attack and break down the ether linkages that link the polymer molecules together. Those elastomers that contain more ether linkages (such as the softer compositions) appear to microcrack more easily than elastomers with fewer ether linkages (such as the harder ones). The molecular composition of ChronoFlex urethane has been chosen so that the finished elastomer will be free of ether linkages; thus, it is expected to be immune from environmental stress cracking. PMID- 1779411 TI - Photochemical coatings for the prevention of bacterial colonization. AB - Biomaterials are being used with increasing frequency for tissue substitution. Implantable, prosthetic devices are instrumental in the saving of patients' lives and enhancing the quality of life for many others. However, the greatest barrier to expanding the use of biomedical devices is the high probability of bacterial adherence and proliferation, causing very difficult and often untreatable medical device centered infections. The difficulty in treating such infections results in great danger to the patient, and usually retrieval of the device with considerable pain and suffering. Clearly, development of processes that make biomedical devices resistant to bacterial adherence and colonization would have widespread application in the field of biomedical technology. A photochemical surface modification process is being investigated as a generic means of applying antimicrobial coatings to biomedical devices. The photochemical process results in covalent immobilization of coatings to all classes of medical device polymers. A discussion of the photochemical surface modification process and preliminary results demonstrating the success of photochemical coatings in formulating microbial-resistant surfaces are presented in this paper. PMID- 1779412 TI - Hydrogel grafted surfaces: protein interaction and platelet adhesion. AB - The blood compatibility of an artificial polymeric implant largely depends on the physicochemical nature of the polymer substrate. In the present study our aim is to develop an understanding of polymer surfaces having similar surface free energy, but different chemical characteristics. We attempted to graft hydrogels onto a silastic polyurethane (Angioflex) material and optimised the surface free energy to about 35.0 ergs/cm2. We compared the protein adsorption and platelet and lymphocyte adhesion on these surfaces. It is observed that there is a relative change in behavior because of the difference in chemical nature. PMID- 1779413 TI - Assessing the validity of the Plutchik Suicide Risk Scale. AB - One of the newer scales of suicide risk devised by Plutchik and colleagues was tested to see if it could discriminate between levels of suicide ideation and suicide attempts. A sample of 80 subjects were placed into various categories of suicide risk on the basis of a psychiatric examination. Results showed that the full scale did not adequately discriminate among groups. An explantation of the results has been proposed and a design to test this suggestion described. PMID- 1779414 TI - Sleep EEG and nocturnal secretion of testosterone and cortisol in patients with major endogenous depression during acute phase and after remission. AB - Sleep EEG and the nocturnal secretion of cortisol and testosterone in 12 male patients (mean age 46.4 +/- 11.26 years) with major endogenous depression were investigated concomitantly during acute depression, before treatment and after recovery and drug cessation. Testosterone concentration increased after remission, while cortisol secretion decreased. Sleep EEG disturbances remained unchanged in remitted patients. The data suggest that a blunted testosterone and an elevated cortisol secretion are state markers of acute depression, which normalize independently from sleep structure. An interaction between the hypothalamic-pituitary-gonadal axis and the limbic-hypothalamic-pituitary adrenocortical axis appears likely. PMID- 1779415 TI - Tyramine conjugation test distinguishes unipolar from bipolar depressed patients and controls. AB - Tyramine sulphate conjugation following oral tyramine administration (the tyramine test) has previously been found to distinguish endogenous unipolar from neurotic depression and appears to be a trait marker. In this study, the test was used in 24 unipolar depressed patients compared with similar sized matched groups of bipolar depressed patients and normal controls. Most of the depressed patients in each group showed endogenous features. The study found that whereas tyramine sulphate conjugation was significantly impaired in unipolar patients, values in the bipolars were similar to those of controls. These results provide further evidence for the biological difference between unipolar and bipolar depression. PMID- 1779416 TI - Subjective social support and depressive symptoms in major depression: separate phenomena or epiphenomena. AB - One hundred and twenty-five middle-aged and elderly adults suffering from a major depressive episode were evaluated during the index episode and at six and twelve month follow-up. Subjective (emotional) social support and depressive symptoms (CES-D) were evaluated during each interview. Contigency table and correlation analyses reveal that subjective support and depressive symptoms are interrelated but separate constructs. PMID- 1779417 TI - Odor-modulated upwind flight of the sphinx moth, Manduca sexta L. AB - 1. Male and female Manduca sexta flew upwind in response to the odor of female sex-pheromone gland extract or fresh tobacco leaf respectively, and generated very similar zigzagging tracks along the odor plume. 2. After loss of odor during flight, males and females alike: (1) first flew slower and steered their flight more across the wind, then (2) stopped moving upwind, and finally (3) regressed downwind. 3. Males flying upwind in a pheromone plume in wind of different velocities maintained their ground speed near a relatively constant 'preferred' value by increasing their air speed as the velocity of the wind increased, and also maintained the average angle of their resultant flight tracks with respect to the wind at a preferred value by steering a course more precisely due upwind. 4. The inter-turn duration and turn rate, two measures of the temporal aspects of the flight track, were maintained, on average, with remarkable consistency across all wind velocities and in both sexes. The inter-turn durations also decreased significantly as moths approached the odor source, suggesting modulation of the temporal pattern of turning by some feature of the odor plume. This temporal regularity of turning appears to be one of the most stereotyped features of odor modulated flight in M. sexta. PMID- 1779418 TI - A visually evoked escape response of the housefly. AB - Flies (Musca domestica) avoid danger by initiating a rapid jump followed by flight. To identify the visual cues that trigger the escape response in the housefly, we measured the timing and probability of escapes when the fly was presented with a variety of visual stimuli created by moving targets toward it. Our results show that an escape response is triggered by an approaching dark disk, but not by a receding dark disk. On the other hand, a bright disk elicits escape only when it recedes. A disk with black and white rings is less effective at eliciting escape than is a dark solid disk of the same size. This indicates that the darkening contrast produced by an approaching stimulus is a more crucial parameter than expansion cues contained in the optical flow. Escape is also triggered by a horizontally moving dark edge, but not by a moving bright edge or by a grating. An examination of several visual parameters reveals that the darkening contrast, measured from the onset of stimulation to the start of escape is nearly constant for a variety of stimuli that trigger escape reliably. Thus darkening contrast, coupled with motion may be crucial in eliciting the visually evoked escape response. Other visual parameters such as time-to-contact or target angular velocity seem to be relatively unimportant to the timing of escapes. PMID- 1779419 TI - The morphological basis of intracellular measurements in the cockroach tactile spine neuron. AB - The femoral tactile spine of the cockroach (Periplaneta americana) contains a single sensory neuron, which adapts rapidly and completely to step deformations of the spine. Techniques for stable intracellular recording from the tactile spine neuron have recently been established, allowing electrophysiological investigation of mechanotransduction and adaptation in this sensory neuron. However, intracellular recordings from the neuron produce a wide range of action potential heights and thresholds, raising the possibility that some penetrations are in adjacent, but closely coupled supporting glial cells. This problem is exacerbated because the cell cannot be visualized during penetration. Systematic measurements of action potential heights and thresholds were made in tactile spine cells, together with identification of some penetrated cells by intracellular injection of Lucifer Yellow. All stained cells were clearly sensory neurons, although their action potential amplitudes varied from 9 mV to 80 mV. Smaller action potentials were broader than larger action potentials, and the changes in height and shape could be explained by a simple cable conduction model using measured morphological and electrical parameters. The model could also account for the observed relationship between action potential height and threshold. These results indicate that reliable recording from the tactile spine neuron is possible, but that variability in the positions of the penetration or the spike initiating zone cause an apparently wide range of electrophysiological measurements. PMID- 1779420 TI - Electric organ discharge frequency and plasma sex steroid levels during gonadal recrudescence in a natural population of the weakly electric fish Sternopygus macrurus. AB - 1. Sternopygus macrurus were collected in Venezuela during the period of gonadal recrudescence in early or late dry season. Electric organ discharge (EOD) frequencies were recorded, blood samples were taken for analysis of steroid titers, and gonads were taken for determination of reproductive condition. 2. Mean EOD frequencies were significantly lower in males than in females in all samples. EOD frequency was inversely correlated with body length in males in late, but not early, dry season, and these parameters were never correlated in females. 3. Plasma levels of testosterone (T) and 11-ketotestosterone (11-KT), but not estradiol-17 beta (E2), were inversely correlated with EOD frequency in males. No 11-KT was observed in plasma of females, and plasma levels of T and E2 in females were comparable to those of males. Neither T nor E2 were correlated with EOD frequency in females. 4. Testes collected in late dry season were more mature than those from early dry season; androgen levels and EOD frequency were correlated with testicular maturity. Ovaries collected in early dry season were immature, while those from late dry season were more mature. There was no relationship between EOD frequency and stage of ovarian development. 5. These results suggest that plasma androgens modulate EOD frequency in males during the reproductive season and that plasma E2 has little relationship to EOD frequency in either sex. PMID- 1779421 TI - Differential reproductive response to short photoperiod in deer mice: role of melatonin. AB - Inhibitory photoperiod differentially effects reproduction in deer mice (Peromyscus maniculatus nebrascensis). Pituitary-testicular function is arrested in about one-third of short-day exposed males (reproductively responsive mice), while an equal number remain fertile (reproductively nonresponsive mice). Both phenotypes are found in natural populations and their disparate reproductive responses have a genetic basis. To assess whether this difference is attributable to a prepineal/pineal or post-pineal mechanism, we compared spermatogenic responses of known and unknown phenotype to exogenous melatonin. Melatonin significantly reduced mean sperm number in long-day housed mice of unknown phenotype. But, individual responses ranged from azoospermia to normal spermatogenesis, and this range was not significantly different from that previously recorded for short-day exposed mice. Reproductively nonresponsive males were unaffected by melatonin administration when housed under long or short daylength. In contrast, melatonin significantly suppressed sperm production in reproductively responsive males housed under long photoperiod, but had no additional suppressive effect in short-day housed mice with regressed testes. These data demonstrate that melatonin is only effective in eliciting testicular regression in reproductively responsive males. Taken together, these results suggest that differential testicular response to photoperiod are caused by a post pineal mechanism. PMID- 1779422 TI - Ultrasonic startle behavior in bushcrickets (Orthoptera; Tettigoniidae). AB - 1. In the present work, we show that in flight, bushcrickets not previously known to respond to ultrasound alter their flight course in response to ultrasonic stimuli. Such stimuli elicit in flying Neoconocephalus ensiger an extension of the front and middle legs along the body and a rapid closure of all 4 wings (Fig. 1). This is a short latency acoustic startle response to ultrasound, consistent with acoustic startle responses of other insects. 2. The percentage of trials on which acoustic startle responses were elicited was maximum (90%) for sound frequencies ranging from 25 to at least 60 kHz. No acoustic startle response was observed at frequencies of 5 or 10 kHz (Fig. 2). The threshold for the response was roughly 76 dB between 25 to 60 kHz (Fig. 2) and the behavioral latency was 45 ms (Fig. 3). Recordings from flight muscles show that they cease discharging during the acoustic startle response (Fig. 4). 3. The characteristics of the acoustic startle response match those of an auditory interneuron called the T neuron. The frequency sensitivity of this neuron is greatest for sound frequencies ranging from 13 to 60 kHz (Fig. 6). Moreover, we found that the neuron produces many more spikes to ultrasound (30 kHz) of increasing intensities than to a conspecific communication sound, whose dominant frequency is 14 kHz (Fig. 7). PMID- 1779423 TI - Treatment of canine appendicular osteosarcoma using cobalt 60 radiation and intraarterial cisplatin. AB - Twelve dogs with appendicular osteosarcoma were treated with 24-40 Gy of cobalt 60 radiation and two doses of intraarterial cisplatin. Improvement in limb function occurred in four dogs, and three dogs, which had only mild initial lameness, had no worsening of their lameness post-treatment. In nine dogs in which local control was evaluable, eight had local failure, with the median (95% CI) duration of local control being 5.9 (4.6, 6.7) months. Two dogs had metastatic disease before therapy, and an additional nine dogs had metastatic disease at a median time of 6.4 months. Pathologic fracture was present in four dogs; two fractures occurred before treatment and two were documented at the time of tumor recurrence. Median (95% CI) survival time for all 12 dogs was 4.9 (3.4, 6.8) months. Excluding the two dogs with preexisting metastatic disease, median survival time was 6.7 months. Three dogs survived longer than 1 year. This mode of therapy was well tolerated and may be considered an alternative to amputation or limb-sparing surgical procedures in selected dogs with appendicular osteosarcoma. PMID- 1779424 TI - Intrahepatic postsinusoidal venous obstruction in a dog. AB - Intrahepatic postsinusoidal obstruction, similar to congenital Budd-Chiari syndrome in human patients, was diagnosed in a young Basenji dog. Sonographic, radiographic, and manometric studies were used in antemortem localization of this unusual functional lesion, that was believed to be congenital. PMID- 1779425 TI - Permanent transvenous pacemaker implantation in forty dogs. AB - Permanent transvenous cardiac pacemakers were implanted in 40 dogs. Electrocardiographic diagnoses included persistent atrial standstill (3 dogs), sick sinus syndrome (8 dogs), and high-grade second-degree or third-degree atrioventricular (AV) block (29 dogs). Thirteen dogs were alive and well 4 to 42 months after pacemaker implantation (mean, 16.9 months). The mean and median survival times of the 26 dogs that died or were euthanatized during the study were 17.9 months and 13 months, respectively. Most of these dogs succumbed to problems unrelated to the arrhythmia and pacemaker implant. One dog was lost to follow-up. Complications associated with permanent transvenous pacemaker implantation included lead dislodgement, infection, hematoma formation, skeletal muscle stimulation, ventricular arrhythmia, migration of the pulse generator, and skin erosion. Lead dislodgement was the most common complication, occurring in 7 of 9 dogs paced using untined electrode leads and in 6 of 30 dogs paced using tined leads. Lead dislodgement did not occur in the only dog paced using an actively fixed endocardial lead. It was concluded that permanent transvenous cardiac pacing is a feasible, less traumatic alternative to epimyocardial pacing in dogs, but that successful use of this technique requires careful implantation technique and anticipation of the potential complications. PMID- 1779426 TI - Measurements of the accuracy of clinical diagnoses of equine neurologic disease. AB - Parameters for the accuracy of clinical diagnosis of neurologic diseases in the horse were determined from 210 horses in which a definitive pathologic diagnosis was confirmed. The overall efficiency of diagnosis for all diseases was 0.95 although the validity varied from 0.79 to 1.00, the sensitivity varied from 0.73 to 0.95, and the specificity varied from 0.88 to 1.00 for individual disease categories. Equine protozoal myeloencephalitis was overdiagnosed, whereas Eastern equine encephalomyelitis, equine degenerative myeloencephalopathy, and traumatic neurologic disease were underdiagnosed. The use of such measurements of accuracy of diagnosis parameters in clinical practice will allow new diagnostic techniques to be objectively evaluated, resulting in greater efficiency of diagnosis and therapy. PMID- 1779427 TI - Factors associated with failure of passive transfer of colostral antibodies in Standardbred foals. AB - The records of 361 Standardbred mares and their 1986 or 1987 foals were evaluated to identify factors associated with failure of passive transfer (FPT) of colostral antibodies in equine neonates. Sixty-five foals (18%) were classified as FPT based on a serum immunoglobulin concentration of less than 400 mg/dl at 24 to 36 hours of age, determined by the glutaraldehyde coagulation test. The potential association of mare- and foal-related factors with FPT were assessed by reviewing a series of multiple logistic regression models. The season in which the mare foaled and foal exam score, a subjective assessment of foal vigor, maturity, and general health, were the primary factors associated with the development of FPT. Foals with FPT were more likely (odds ratio = 3.50; 95% confidence interval = 1.81-6.68) than normal foals to require medical therapy during the first 3 months after parturition. PMID- 1779429 TI - Clinical assessment of renal tubular function through determination of electrolyte and creatinine concentrations. PMID- 1779428 TI - Persistent experimental Salmonella dublin intramammary infection in dairy cows. AB - Experimental intramammary infections were induced in five post-parturient Holstein cows by inoculation of low numbers (5000 colony forming units) of virulent Salmonella dublin via the teat canal of mammary gland quarters. Rectal temperature, pulse and respiratory rates, milk yield, and milk quality as assessed by the California Mastitis Test (CMT) and somatic cell counts (SCC) were recorded every 12 hours at milking. Bacteriologic cultures of foremilk quarter samples and feces were obtained daily, as were complete blood counts. ELISA titers for IgG and IgM recognizing S. dublin lipopolysaccharide (LPS) were obtained weekly on serum and quarter milk samples. All cows excreted S. dublin intermittently from infected quarters, but no changes were detected in rectal temperature, appearance of the mammary gland or secretions, CBC, milk yield, and pulse and respiratory rates. Somatic cell counts were modestly increased in infected quarters as compared with uninfected quarters (P = .015, paired t test); however, CMT scores after infection remained low, and were not significantly different from pre-infection scores (P greater than .10, sign test). After infection, administration of dexamethasone resulted in signs of clinical mastitis and increased excretion of S. dublin from mammary quarters (P = .0004, paired t test). One cow had necrotizing mastitis and S. dublin septicemia and was euthanatized. In the four surviving cows, clinical improvement was observed after systemic gentamicin therapy and intramammary infusion with polymyxin B, but all cows continued to excrete S. dublin intermittently from one or more quarters and occasionally from feces for the remaining period of observation. All infected cows demonstrated a rise in IgG and IgM ELISA titers recognizing S. dublin LPS in serum and milk. At necropsy (13-25 weeks postinfection), S. dublin was recovered only from the mammary tissue or supramammary lymph nodes in three of four cows. In one cow, mammary gland and lymph-node samples were negative for S. dublin despite positive milk cultures. In all cows, histopathologic examination revealed multifocal areas of chronic active mastitis. These lesions were similar to histopathologic findings from mammary gland carriers with naturally acquired S. dublin infection. PMID- 1779430 TI - Random walking. PMID- 1779431 TI - Template-directed extension of a guanosine 5'-phosphate covalently attached to an oligodeoxycytidylate template. AB - We have prepared molecules in which a guanosine 5'-phosphate (pG) residue is attached to the 3' terminus of a decadeoxycytidylate (pdC)10 template via diamine linkers H2N(CH2)nNH2, n = 4-7. The pG residue acts as a primer and is extended very efficiently by incubation with activated pG derivatives to give products containing 6-9 G residues in greater than 80% yield. The detailed nature of the product distribution is discussed. PMID- 1779432 TI - The alpha A-crystallin gene: conserved features of the 5'-flanking regions in human, mouse, and chicken. AB - Approximately 2 kb of 5'-flanking sequences of the lens-specific alpha A crystallin genes from human and mouse are presented and compared with similar regions of the chicken gene. A repetitive element was found approximately 1 kb upstream from the coding sequences of the alpha A-crystallin gene in all three species (Alu in human, B2 in mouse, and CR1 in chicken), suggesting that they may have an important functional or structural role. Despite the ability of alpha A crystallin promoters to function across species, dot matrix analyses show only limited similarity among the 600 bp 5' to the structural genes of these three species. The human 5'-flanking sequence is more similar to that of the mouse and chicken than the mouse and chicken are to each other. Numerous short sequences (8 13 bp) are common to all three genes but are distributed differently in each species. The locations and conservation of these sequence motifs suggest functional roles, possibly as cis-regulatory elements of transcription. One motif is similar to the alpha A-CRYBP1 binding site implicated earlier in the transcriptional regulation of the mouse alpha A-crystallin gene, and other motifs correspond to sites previously mapped by methylation interference studies in the mouse alpha A-crystallin promoter. The modular arrangement of conserved sequence motifs is consistent with evolutionary changes occurring at the level of gene regulation. PMID- 1779433 TI - The adult alpha-globin locus of Old World monkeys: an abrupt breakdown of sequence similarity to human is defined by an Alu family repeat insertion site. AB - The haploid genomes of all known primates have two or more adult alpha-globin genes contained within tandemly arranged duplication units. Although the tandem duplication event generating these alpha-globin loci is believed to occur prior to the divergence of primates, a number of length polymorphisms exist within the loci among different primate species. In order to understand the molecular basis of these length polymorphisms, we have cloned and determined the nucleotide sequence of a major portion of the rhesus monkey adult alpha-globin locus. Sequence comparison to human suggests that the length difference between the adult alpha-globin loci of human and Old World monkey is the result of one or more DNA recombination processes, all of which appeared to be related to the transposition of Alu family repeats. First, the finding of a monomeric Alu family repeat at the junction between nonhomology block I and homology block Y of the alpha 2 gene-containing unit in rhesus macaque suggests that the dimeric Alu family repeat, Alu 3, at the orthologous position in human was generated by insertion of a monomeric Alu family repeat into the 3' end of another preexisting Alu family repeat. Second, two Alu family repeats, Alu 1 and Alu 2, exist in human at the 3' end of each of the two X homology blocks, respectively. However, this pair of paralogous Alu family repeats is absent at the corresponding positions in rhesus macaques. This raises interesting questions regarding the evolutionary origin of Alu 1 and Alu 2. Finally, DNA sequences immediately downstream from the insertion site of Alu 2 are completely different between human and rhesus macaque.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779435 TI - The branching order of mammals: phylogenetic trees inferred from nuclear and mitochondrial molecular data. AB - In order to clarify some controversial phylogenies such as those regarding the triplet of human, rodent, and cow and the evolutionary position of Lagomorpha with respect to other mammals, we have analyzed both nuclear and mitochondrial genes using the stationary Markov model developed in our laboratory. We found that the two sets of genes give different results. In particular the mitochondrial tree showed rabbit linked first to rodents and the rabbit-rodents branch linked to artiodactyls with human as the outgroup. The most favorite nuclear tree showed human linked first to artiodactyls and the human-artiodactyls branch linked to rabbit with rodents as the outgroup. The obvious questions, (1) which tree is the correct one, or (2) both trees can be incorrect, and (3) how can we explain such an evolutionary pattern, are discussed on the basis of our limited knowledge of factors that influence the clocklike behavior of biological macromolecules. PMID- 1779434 TI - Molecular phylogenetic analysis of actin genic regions from Achlya bisexualis (Oomycota) and Costaria costata (Chromophyta). AB - Actin genic regions were isolated and characterized from the heterokont flagellated protists, Achlya bisexualis (Oomycota) and Costaria costata (Chromophyta). Restriction enzyme and cloning experiments suggested that the genes are present in a single copy and sequence determinations revealed the existence of two introns in the C. costata actin genic region. Phylogenetic analyses of actin genic regions using distance matrix and maximum parsimony methods confirmed the close evolutionary relationship of A. bisexualis and C. costata suggested by ribosomal DNA (rDNA) sequence comparisons and reproductive cell ultrastructure. The higher fungi, green plants, and animals were seen as monophyletic groups; however, a precise order of branching for these assemblages could not be determined. Phylogentic frameworks inferred from comparisons of rRNAs were used to assess rates of evolution in actin genic regions of diverse eukaryotes. Actin genic regions had nonuniform rates of nucleotide substitution in different lineages. Comparison of rates of actin and rDNA sequence divergence indicated that actin genic regions evolve 2.0 and 5.3 times faster in higher fungi and flowering plants, respectively, than their rDNA sequences. Conversely, animal actins evolve at approximately one-fifth the rate of their rDNA sequences. PMID- 1779436 TI - The complete nucleotide sequence of the mitochondrial DNA of the fin whale, Balaenoptera physalus. AB - The composition of the mitochondrial DNA (mtDNA) of the fin whale, Balaenoptera physalus, was determined. The length of the molecule is 16,398 bp, and its organization conforms with that of other mammals. The general similarity between the mtDNA of the fin whale and the cow is greater than the similarity between the fin whale and other species (human, mouse, rat) in which the composition of the entire molecule has been described. The D-loop region of the mtDNA of the fin whale is 81% identical to the D-loop of dolphin DNA, and the central portion of the D-loop is similar to the bovine D-loop. The accumulation of transversions and gaps in the 12S and 16S rRNA genes was assessed by comparing the fin whale, cow, and human. The sequence difference between human and the whale and human and the cow was at the same level, indicating that the rate of evolution of the mtDNA rRNA genes is about the same in artiodactyls and cetaceans. In the 12S rRNA gene an accumulation rate of 0.05% per million years places the separation of cetaceans and artiodactyls at about 55 million years ago. The corresponding figure for human and either the whale or the cow is about 80 million years. In the 16S rRNA gene a 0.08% accumulation rate of transversions and gaps per million years yields concurring figures. A comparison between the cytochrome b gene of the fin whale and cytochrome b sequences in the literature, including dolphin (Stenella) sequences, identified the cetaceans as monophyletic and the artiodactyls as their closest relatives. The comparison between the cytochrome b sequences of the fin whale and Stenella showed that differences in codon positions one or two were frequently associated with a change in another codon position. PMID- 1779437 TI - [An investigation of radiation exposure on pediatric patients and doctors during cardiac catheterization and cineangiography]. AB - Cardiac catheterization and cineangiography are invasive diagnostic radiological examinations which exposure the patient to a relatively high radiation dose, the largest radiation dose of any diagnostic examination. Sixty-one infants and children, aged 28 days to 15 years, were randomly selected into this study to assess such questions regarding cardiac catheterization in children as; (1) How much the pediatric patient's and doctor's radiation exposure is during a routine cardiac catheterization and cineangiography? (2) What difference are there in exposure to various areas of the body? (3) How much radiation exposure is related to cineangiography compared with fluoroscopy? (4) How much radiation exposure may be reduced by lead apron worn by doctors? Thermoluminescent dosimeters containing 80 mg of CaSO4: Dy were applied to the body for the measurement of radiation exposure during cardiac catheterization. In hemodynamic assessment of catheterization (mean time 6 +/- 5 min), dosimeters were placed on various areas of the patient's skin and unexposed dosimeters were attached to mid sternum and right lateral chest during cineangiography (mean time 11 +/- 5 sec). Average skin doses over the patients' organs during catheterization and cineangiography were: eye 51 mu Gy, thyroid 746 mu Gy, sternum 5,102 mu Gy, right lateral chest 10,098 mu Gy, umbilicus 123 mu Gy and gonad 24 mu Gy. The radiation exposure during cineangiography at sternum and right lateral chest contributed to 61% and 70% of total exposure.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779438 TI - The in vitro and in vivo cytotoxicity of menadione (vitamin K3) against rat transplantable hepatoma induced by 3'-methyl-4-dimethyl-aminoazobenzene. AB - Menadione (vitamin K3, 2-methyl-1,4-naphthoquinone) is a synthetic derivative of napthoquinone. Its ability to inhibit cell growth in a wide variety of and human tumor cell types, and in rat hepatocytes has been recognized. Using a rat transplantable hepatoma model, we have evaluated the cytotoxic activity of menadione in hepatoma cells. Tumor cells in culture were sensitive to menadione treatment. The ID50 of drug is 3.4 microM as shown by a colorimetric MTT (3-(4,5 dimethythiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay. Tumor-bearing rats were randomized into the treatment (n = 16) and control (n = 15) groups. Rats in the treatment group received intraperitoneal injection of menadione (10 mg/2 ml) once a week for four times; the control group received 2 ml water instead. None of the control rats survived after the 17th day following the start of treatment, while 5 out of the 16 treated rats responded well and survived long-term (greater than 60 days). Medadione was shown to inhibit actively the growth of hepatoma cells in vitro as well as in vivo. PMID- 1779439 TI - [Sensorineural hearing loss in chronic otitis media]. AB - In individuals with chronic otitis media-(COM), mixed hearing impairments are common, but it is unclear whether the raised bone conduction thresholds are a reflection of the pathologic process affecting the middle ear resulting in conductive defect. Charts of 65 patients with unilateral chronic otitis media were reviewed. These were three groups: 1) simple COM 2) COM with granulation, 3) COM with cholesteatoma. In them, the amount of sensorineural hearing loss in the third group was 20.3 dB, which was greater than the other two groups for pure tone average. The amount of air conduction hearing loss was 66.8 dB, also the highest. In addition, the amount of sensorineural hearing loss was greater than that of normal contralateral ears in all of three groups. These findings suggest that more severe middle ear disease may result in sensorineural hearing loss. Raised bone conduction thresholds in chronic otitis media are considerably more likely to reflect the Carhart effect, rather than disease damage to the inner ear. However, for the majority of subjects, the amount of sensorineural hearing loss was judged not to be clinically significant. PMID- 1779440 TI - Aqueous acupuncture for postoperative pain--a matched controlled trial. AB - The analgesic effects of acupuncture are well-documented. Aqueous acupuncture, or point injection, is a conveniently modified modern acupuncture method. This matched controlled trial was carried out to evaluate the effects of aqueous acupuncture in postoperative pain control. A total of 12 patients were selected as age-, sex- and operative-style-matched controls. In treating group, 2 to 5 ml of 20% glucose solution was injected into Ho-Ku (LI 4) and Yang-Ling-Chuan (GB 34) when patients had regained conciousness from operation anesthesia. The pain intensity were recorded as score system included verbal, sleep disturbance and use of narcotics. In comparisons with the control group, the intensity of postoperative pain, and the amounts and frequency of narcotics used were significantly lower in the study group, especially for the first 12 postoperative hours. Aqueous acupuncture is a convenient and effective procedure in postoperative pain control. PMID- 1779441 TI - [Stress distribution of prefabricated screw posts. Part I: Post size]. AB - A commonly used prefabricated screw post was analysed for its various lengths and diameters. When endodontic dowels were installed in standardized models, direct comparisons of stress distributing properties were analysed through photoelastic stress analysis. According to the analysis, installation of the post produced severe lateral stress. At shorter lengths, these stress concentrations were much more severe. However, increasing the diameter of the dowel may reduce the stress slightly. Under load conditions, the stress-producing characteristics of the dowel increased with shorter lengths and smaller diameters. It seems that increasing the surface area of insertion with the dentin improves the distribution of the load caused by the insertion of the post. PMID- 1779442 TI - [Repair method and healing of skeletal muscle injury]. AB - This study used m.anterior tibialis of rabbits to document recovery after laceration and repair after a healing period of 12 weeks. Postoperation care were divided into three groups: cast immobilization one or four weeks, and free activity. There were three different methods used to repair muscles including simple suture with Dexon 2-0, modified Kessler with 1/4 width of mersiline 5-0 and simple suture with tendon graft. Physiologic recovery including tension force and muscle contracture length had been tested. Histologic recovery including H & E and ATPase stains had been examined. The recovery of tension force was influenced by immobilization time, not by suture method. The best recovery of tension force was resulted from postoperation care with free activity. The result of shortening length of muscle was according to different suture methods and had no relation with immobilization time. Modified Kessler suture resulted in the best muscle contracture length. The method of modified Kessler suture without immobilization was recommended for management of lacerated muscle. PMID- 1779443 TI - Technetium-99m methylene diphosphonate scintigraphy of relapsing polychondritis. AB - Relapsing polychondritis is a progressive multisystem disorder that predominantly affects cartilage, producing an inflammatory reaction. The scintigraphic findings of technetium-99m methylene diphosphonate (Tc-99m MDP) bone scan is a case of relapsing polychondritis are described and discussed. PMID- 1779444 TI - Lung cancer: past, present, and future. AB - The epidemiology of lung cancer in industrialized nations during the 20th century is a fascinating phenomenon. It is predicted that 161,000 new cases of lung cancer will be diagnosed in the United States in 1991. Lung cancer will cause 143,000 deaths in the United States in 1991, and it has surpassed breast cancer as the leading cause of cancer-related deaths in women. The 5-year survival for patients with lung cancer has not changed significantly over the past several decades and is approximately 13%. The current attack on lung cancer is aimed at earlier detection, better understanding of its biology, or effective therapy, and prevention, the last of which is the key to controlling this disease. Medical historians of the future will surely be both amused by and disappointed in our efforts of the past five decades. Despite our knowledge of the most important causative factor in the development of lung cancer, our efforts to control this deadly epidemic have been paltry at best. PMID- 1779445 TI - Clinical manifestations of carcinoma of the lung. AB - In 1991 lung cancer will account for 30% of all cancer deaths in this country, or more than 140,000 deaths. One reason for this high mortality rate is our inability to diagnose carcinoma of the lung at an early stage. Carcinoma of the lung is associated with numerous systemic effects. Because many of these are subtle in their clinical presentation, they may be overlooked until more obvious signs of malignancy are present. By this time, the tumor may be no longer amenable to surgical resection, and the chance for cure is lost. The article reviews the clinical manifestations of carcinoma of the lung that may alert the clinician to its presence and perhaps allow earlier diagnosis and prolonged survival. PMID- 1779446 TI - The radiologic staging of lung cancer. AB - The radiographic evaluation and staging of bronchogenic carcinoma remains one of the greatest challenges to the thoracic radiologist and one of his or her most important responsibilities. With lung cancer now the most common malignant tumor in both men and women, there will be a continued need for radiologists to guide clinicians to the appropriate diagnostic and staging procedures, to help plan curative surgery, and to assess the response to therapy or progression of disease. The article reviews the radiographic approach to lung cancer diagnosis and staging with an emphasis on the use of computed tomography and magnetic resonance imaging for the evaluation of the primary tumor and mediastinal and hilar lymph node metastases. PMID- 1779447 TI - Interventional procedures used for diagnosing and treating lung cancer. AB - In recent years interventional radiology has played an increasingly important role in the diagnosis and treatment of lung cancer. Useful interventional procedures include biopsy techniques, direct infusion of chemotherapeutic agents into neoplasms, and a number of palliative procedures. The article reviews the indications, contraindications, techniques, and complications of these procedures with emphasis on some of the newer procedures. PMID- 1779448 TI - The functional significance of calcification of coronary arteries as detected on CT. AB - We evaluated the coronary arteries on computed tomography (CT) scans of the chest and on coronary angiograms of 27 patients who underwent both studies. We related the presence or absence of coronary artery calcification on CT to percentage stenosis on angiogram. For the left anterior descending artery (LAD), the likelihood of calcification rose proportionately with degree of stenosis; this was less true for the circumflex, and not true for the right coronary artery (RCA). The sensitivity of CT in detecting coronary artery calcification in patients with angiographic criteria of significant coronary artery disease (CAD) was 78% for the LAD, 63% for the circumflex, and 16% for the RCA. Specificities were 78%, 80%, and 100%, and positive predictive values were 88%, 83%, and 100%. The high positive predictive values suggest that coronary artery calcification diagnosed by chest CT has a high correlation with clinically significant CAD. Therefore, when we detect such calcification in a patient without documented heart disease, we suggest that a cardiac workup is indicated. PMID- 1779449 TI - Computed tomography differentiation between cystic bronchiectasis and bullae. AB - Bronchiectatic lung cysts are larger on inspiration than on expiration. Bullae do not change in size during the different phases of respiration. By adding expiratory CT scans when cystic lung lesions are found, it is possible to distinguish bronchiectatic cysts from bullae. PMID- 1779450 TI - Adult cystic mediastinal lymphangioma simulating a thymic cyst. AB - We report a patient with mediastinal lymphangioma, with plain film and computed tomographic findings that suggested the diagnosis of thymic cyst. The differential diagnosis and magnetic resonance imaging of mediastinal lymphangioma are discussed. PMID- 1779451 TI - [Electrolyte abnormality and renal insufficiency in malignant lymphoma; clinical and pathological analysis in 123 cases]. AB - The clinical studies about the electrolyte abnormality (EA) in patients with malignant lymphoma (ML) are rarely reported. We analyzed the EA and renal insufficiency in 123 patients with ML between June. 1976 and Jan. 1989; 8 patients with Hodgkin's disease, and 115 patients with non-Hodgkin's lymphoma (NHL). Before treatment, the incidence of the EA was 24.2% and hypercalcemia, hypocalcemia, and hyperkalemia were predominant. After treatment it became to 74.7% and the number of hyponatremia and hypokalemia increased. The incidence of proteinuria and renal insufficiency (serum creatinine above 1.5 mg/dl), were 7.3% and 2.4% before treatment, and became to 26.8% and 26.8% after treatment, respectively. There was a significant difference between two groups with and without the EA before treatment as for serum lactate dehydrogenase (LDH) levels (p less than 0.01), clinical stages (p less than 0.05) and the incidence of bone marrow involvement (p less than 0.01). In 34 autopsied cases, 3 cases showed massive renal involvement and about a half of cases showed various renal changes. The EA before treatment was caused by extrarenal factors, because the incidence of proteinuria and renal insufficiency were almost same to healthy controls. And renal factors play an important role on the E.A after treatment. Above results suggest that the EA before treatment indicates the progress of malignant lymphoma and the EA after treatment means not only the progress of the disease but also therapy-related renal damages. PMID- 1779452 TI - [Evaluation of clinical usefulness of a rapid quantitative measurement of D dimer (cross-linked fibrin degradation products)]. AB - In order to evaluate precisely the fibrinolytic states in clinical disorders, plasma levels of D dimer (cross-linked fibrin degradation products) were measured by a newly developed, rapid quantitative method based on the latex photometric immunoassay in patients with hematological malignancies, diabetes mellitus, collagen disease, liver disease, thrombotic disease and disseminated intravascular coagulation (DIC). Plasma levels of D dimer were elevated in a variety of diseases, especially in DIC. Patients with hematological malignancies, liver disease and thrombotic disease also had relatively high levels of D dimer. On the whole, D dimer values were positively correlated with plasmin-alpha 2 plasmin inhibitor complex and thrombin-antithrombin III complex. In addition, plasma D dimer was measured during fibrinolytic therapy with urokinase or tissue type plasminogen activator; its elevation was detected in some patients. These findings indicate that accelerated fibrinolysis is frequently observed in a variety of diseases, and that a rapid quantitative measurement of D dimer would be valuable for the precise assessment of fibrinolysis in these disease states. PMID- 1779453 TI - [Elevated Clq-bearing immune complexes in hemophiliacs with viral infections]. AB - One hundred hemophilia A and 30 hemophilia B patients who had been treated with non-heated and heated factor VIII or prothrombin complex concentrates were examined by immunological tests including Clq-bearing immune complexes assay. Antibodies to human immunodeficiency virus type 1 (HIV-1), hepatitis B virus (HBV), hepatitis C virus (HCV) and human parvovirus B19 (B19) were analyzed by Western blotting, enzyme immunoassay, passive hemagglutination or radio immunoassay. Clq-bearing immune complexes were assayed by a monoclonal anti-Clq ELISA system (Immunomedics). Seropositivity to HIV-1, HBV, HCV, and B19 was 56.9%, 87.7%, 79.2% and 100% respectively. Clq-bearing immune complexes were positive in 109 of the 130 patients (83.8%). The positivity and the levels were extremely higher than those in normal individuals. Clq-bearing immune complex levels in patient positive for HIV-1, HCV, or HBV were higher than those in the negative group (HIV: P less than 0.001, HCV: P less than 0.005, HBV: P less than 0.05). When the patients were divided into four groups according to seropositivity to HIV-1 and/or HCV, Clq-bearing immune complex levels were the highest in the group positive for both antibodies, and the lowest in the group negative for both antibodies. These results suggested that each viral infection influences the formation of immune complexes and repeated viral infection increased the level of Clq-bearing immune complexes in these patients. PMID- 1779454 TI - [Polycythemia vera with der(15) and der(20) associated with remarkable neutrophilia]. AB - An autopsy case of polycythemia vera with der(15) and der(20) associated with remarkable neutrophilia was reported. A 87-year-old man was diagnosed as polycythemia vera in August 1987. The red blood cell count was 621 x 10(4)/microliters, Ht 58.5% and the white blood cell count 45,400/microliters with 92% neutrophils. The splenomegaly, increased red blood cell volume and the low erythropoietin level were present. The arterial SaO2 value was above 92%. The chromosome analysis of bone marrow cells revealed 46, XY, -15, -20, +der(15)t(15;?)(q13-15;?), +der(20)t(20;?)(q11;?). The breakpoint in No. 20 was in q11. The remarkable leukocytosis with relative and absolute neutrophilia were observed. Particularly late in the clinical course the white blood cell count was 92,900/microliters with 99% neutrophils. The Ph1 chromosome was negative and the bcr rearrangement was not detected. He died of bronchopneumonia in January 1989. At the autopsy findings neither the marrow fibrosis nor the extramedullary leukemic cell infiltration was noticed. PMID- 1779455 TI - [Burkitt's lymphoma with monoclonal pattern (IgG, kappa type) of cytoplasmic immunoglobulin--clinical report and review of Japanese literature]. AB - A 52-year-old male was admitted to the hospital because of abdominal mass. Bone marrow examination revealed 26% blasts, which morphology was L3 in FAB criteria. Abdominal tumor was resected and histologic feature of the tumor was malignant lymphoma, small non-cleaved cell, Burkitt's. Lymphoma cells from the resected tumor were cultured and a cell line was established. Cytological studies of the original tumor cells and the cell line revealed that the lymphoma was negative both for EBNA and EBV DNA, and possessed t(8;14) (q24;q32) in chromosome analysis. Surface antigens were positive for HLA-DR, CD19 and CD20, but negative for CD10. The lymphoma also expressed a monoclonal pattern (IgG, kappa type) both of surface immunoglobulin and cytoplasmic immunoglobulin. Thus, the lymphoma was originated from mature B-lymphocyte. We analysed clinicopathological findings of 216 patients who were reported as Burkitt's lymphoma in Japan. Of 35 cases examined for cell EBNA, 7 (20%) were positive for EBNA. Of 86 cases tested for surface immunoglobulin of tumor cells, 67 expressed IgM alone and 10 IgG alone on tumor cells. Cytoplasmic immunoglobulin of tumor cells was positive in 61% of patients. Of 11 cases positive for cytoplasmic immunoglobulin, IgM was detected in 8 patients and IgG only in our patient. PMID- 1779456 TI - [Pharmacokinetics of BHAC, VP-16 and Ara-C derived from BHAC in a hemodialysed patient with AMMoL]. AB - Although recently the occurrence of a malignant neoplasma as a complication of uremia is becoming more frequently, pharmacokinetics of antitumor agents are not precisely studied in patients with impaired renal function. In this report we investigated pharmacokinetics of enositabine (BHAC), arabinosylcytosine (Ara-C) and etoposide (VP-16) in a patient on maintenance hemodialysis who suffered from acute myelomonocytic leukemia and treated by BHAC-EV regimen. Pharmacokinetic parameters of BHAC in uremia were not different from that in patients with normal renal function, and hemodialysis did not affect on the plasma level of BHAC. No significant accumulation of Ara-C was seen in uremia, but there remained the possibility that Ara-C could be removed by hemodialysis. So BHAC was able to be used in uremic patients safely. Since VP-16 was proved to be not a hemodialyzable but an accumulative substance and prolongation of plasma half life was prompt in uremia, VP-16 should be administered to uremic patients very cautiously. From these results BHAC-EV regimen was presumed to be a safely, well tolerated and beneficial regimen in uremic patients. PMID- 1779457 TI - [Thrombotic thrombocytopenic pupura (TTP)--remission following treatment with high-dose immunoglobulin]. AB - A 60-year-old man was admitted to our hospital because of fever, hemorrhagic tendency, anemia and neurological abnormality. A blood count revealed that the hemoglobin was 6.8 g/dl, the reticulocyte was 17.3 percent with 2 erythroblasts per 100 white cells, the white cell count was 7,100/microliters and the platelet count was 0.8 x 10(4)/microliters. Peripheral blood smear demonstrated marked fragmentation of red cells. Bone marrow examination disclosed the marked erythroid hyperplasia. Although the bleeding time was prolonged (14 minutes 30 seconds), the other hemostatic data were within normal limits. The serum bilirubin level was 1.57 mg/dl; LDH level, 1,437 U/l; creatinine level, 0.92 mg/dl; BUN level 14.7 mg/dl. Haptoglobin was below 10 mg/dl. Results of immunological tests were all negative except the result of PAIgG (576.6 ng/10(7) cells). The urinalysis showed proteinuria, microhematuria and trace granular and hyaline casts. A diagnosis of thrombotic thrombocytopenic purpura was made. The patient was initially treated with prednisolone (60 mg), aspirin (1,000 mg), dipyridamole (150 mg), gabexate mesilate (1.5 g), sodium oxagrel (80 mg) daily with little response. The thirty days after admission, infusion of gamma globulin (20 g, daily) was given for 3 days. The clinical state and laboratory findings became dramatically improved shortly after the administration of gamma globulin and the laboratory data came to be normalized after 1 month. After ten months of this treatment, the patient is remained asymptomatic and the hematological data are within normal range without using any drug. A trial seems justified to confirm the value of this mode of therapy. PMID- 1779458 TI - [Orthostatic purpura: report of two cases]. AB - Two patients with orthostatic purpura were reported. Case 1: A 47-year-old man was admitted to our institution because of multiple purpuric eruptions over the legs after the long periods of sitting or standing. Bleeding time was 4.0 min. Platelet aggregation induced by ADP was disaggregated and no aggregation was observed when induced by collagen and epinephrine. He was diagnosed as having release abnormality of the platelets caused by glutathione administered for treatment of liver damage for several years. Purpura, however, appeared even though platelet function became normal after discontinuing glutathione. Purpura proved to be induced by the long periods of sitting or standing. Case 2: A 37 year-old woman was admitted to our hospital because of purpuric eruptions over the legs for three years. Bleeding time was 2.0 min. Platelet aggregation induced by ADP, epinephrine, collagen and ristocetin was normal. Purpura was caused by long periods of standing without movement. Wearing elastic pantyhose showed reduced appearance of the purpura. Biopsy specimens from both patients revealed no abnormal findings. Both patients had no abnormal results in coagulation studies. Purpura seemed to be caused by the increased capillary pressure after the prolonged periods of standing. No case report concerning orthostatic purpura or mechanical purpura has been published. PMID- 1779459 TI - [Changes in the megakaryocyte-platelet system in chronic neutrophilic leukemia]. AB - Platelet functions and morphological changes of megakaryocytes were investigated in three cases with chronic neutrophilic leukemia (CNL). The bleeding time was prolonged, the ADP, collagen, epinephrine-induced aggregation of platelets decreased in one case. The adhesiveness, epinephrine-induced aggregation and adenine nucleotide content of platelets decreased in one other case. Megakaryocyte size in CNL was larger than in CML and this difference of the megakaryocyte sizes was related to DNA content distribution of the megakaryocytes. Atypical megakaryocytes were apparently found in one case. The present study suggests that CNL is a stem cell disorder. PMID- 1779460 TI - [Intermittent administration of natural interferon-alpha for over 5 years induced complete suppression of Philadelphia chromosome in a patient with myelogenous leukemia]. AB - A 60-year-old woman was admitted to our hospital because of gastric ulcer, anemia, and leukocytosis in November 1984. Blood cell counts on admission were as follows: RBC 407 x 10(4)/microliters, Hb 9.8 g/dl, WBC 33,000/microliters (baso 8%, eo 7%, myelo 11%, meta 2%, stab 4%, seg 54%), Plt 93.7 x 10(4)/microliters. Bone marrow showed hypercellular and myeloid hyperplasia. She was diagnosed as Ph1-chromosome positive chronic myelogenous leukemia. She received natural interferon-alpha at the dosage of 600 x 10(4) IU daily for 22 days from January 14, 1985. After March 1985, she has been given intermittent administration of interferon once in 10 to 20 days, and maintained normal blood cell counts. Cytogenetic improvement was seen on 35 months after the start of IFN and complete suppression of Ph1 chromosome was observed at July 1990 (66 months after). PMID- 1779461 TI - [Histopathologic diagnosis of bone marrow in leukemia and related disorders]. AB - Histopathologic diagnosis of the bone marrow in leukemia is usually a supplementary method to the cytological in acute and chronic leukemia. However, for patients with MDS and MPD and with dry tap bone marrow biopsy is very important. Important morphological findings and useful immunohistochemical methods for differentiation and characterization of leukemia are reported and the usefulness of sequential examination of bone marrow in leukemia during and after chemotherapy is emphasized. In addition to leukemia, histological features and differential points of myelodysplastic syndrome (MDS) and myeloproliferative disorders (MPD) are mentioned. The proliferating megakaryocytes differed in size and shape between MDS and MPD. The difference in proliferating rate of the cells examined by PCNA was also useful to differentiate the two disorders histologically. PMID- 1779462 TI - [The significance of cytogenetic analysis in the diagnosis of leukemia]. AB - The results of a comprehensive study on 1,000 patients who had been cytogenetically diagnosed to have leukemia in our department since 1962 are reported, and the value of cytogenetic diagnosis for leukemia emphasized. In our series, we detected patients with FAB L1 and L2 showing an abnormality rate of 60 and 66%, respectively. They included 20% with Ph1 positive ALL. In FAB L3, we found t(8;14) in 5 of the 6 patients. The FAB M1 group showed the lowest abnormality rate (50%). Forty percent of the M2 patients exhibited t(8;21), 60% of which also showed loss of sex chromosome of either X or Y. Seventy-eight percent of the M3 patients presented t(15;17) (two patients with no detectable t(15;17) showed rearrangements of retinoic acid receptor alpha gene). Inversion of chromosome 16 was found in 10% of the patients with FAB M4. Patients with M6 exhibited relatively complex chromosomes aberrations. RAEB patients showed more frequent and complex type of chromosome aberrations than PARA patients. Cytogenetic and molecular-biological analyses provided valuable information on the pathophysiology of leukemia and suggested the possible localization of novel oncogene(s). PMID- 1779463 TI - [Gene analysis in human hematopoietic malignancies]. AB - We analyzed the T-cell receptors and immunoglobulin genes in 140 cases of hematopoietic malignancies, including ALL/LBL, malignant lymphomas, AILDs, Hodgkin's disease, ATL and CLL. In many cases, the findings obtained by immunoassociated gene analysis were in parallel to the phenotypic findings. Gene analysis is useful to determine the clonality and the lineage of malignant cells. However, 10-30% cases appeared bigenotype. In some cases, oligoclonalities were recognized. The relationship to the prognosis in these cases was discussed. The development of gamma delta- and alpha beta-cells on T-cell ontogeny was elucidated. Some T-cell leukemic lines were found to be pre-alpha beta T-cells with some consensus characteristics. We also analyzed the V beta family of 15 alpha beta T-cell leukemia cell lines using six V beta cDNA probes. This approach may be useful to determine the clonality of T-cell malignancies. The method of using a PCR system on immunoassociated genes has been described. The PCR method, using the super variable region as a tumor specific fragment, is valuable in the detection of the residual cells of lymphoma and leukemia at a concentration of 1/10(5) cells. PMID- 1779464 TI - [New trends in the treatment of leukemia]. AB - More than 50% cure can be obtained with allogeneic bone marrow transplantation (BMT) when patients are transplanted in first remission of AML and ALL or chronic phase of CML. On the other hand, considerable progress has been made recently in treating acute leukemia with chemotherapy. Recent studies of intensive chemotherapy in adults with AML report approximately 40-50% 3-year disease-free survival (DFS). Accordingly, several prospective randomized clinical trials have been conducted on the use of BMT versus intensive chemotherapy in the treatment of AML. Significant differences in DFS were found only in a few studies though the results of BMT appear to be comparable or superior to chemotherapy. Therefore, the overall advantage of BMT in first remission AML is smaller than expected. We should know not whether to transplant or to perform chemotherapy, but rather whether to transplant in first remission or to perform chemotherapy first and reserve transplantation as salvage therapy. Recently acute promyelocytic leukemia has been successfully treated with differentiation therapy using all-trans retinoic acid. Low-dose aclarubicin has also been reported to be effective as differentiation therapy in some patients with myelodysplastic syndrome and atypical AML. With the advance of molecular biology of cytokines, several of them are now available for clinical use. G-CSF, GM-CSF and M-CSF are potent stimulators for the granulocyte-macrophage production; they are very effective for accelerating hematologic recovery after chemotherapy-induced myelosuppression or BMT. Interferon-alpha (IFN-alpha) has been used in the several studies. Furthermore, Ph chromosome positivity can be reduced with long term administration of IFN-alpha; Ph-positive clone can be undetectable in some patients. Thus, IFN-alpha will be the choice of treatment for CML even if BMT is planned. PMID- 1779465 TI - [Diabetes mellitus and molecular biology]. AB - There are two approaches to identify diabetes-susceptibility genes. One approach is to isolate and characterize genes expressed in the beta-cell and in insulin target tissues whose mutation or altered expression may contribute to the development of diabetes mellitus. Another approach is to clone a diabetes susceptibility gene by a reverse genetic strategy. The first step for this strategy is to identify a DNA polymorphism that is linked to the disease locus. Using the strategy of the first approach, several candidate genes were examined. Among these genes, the mutation of insulin genes and insulin receptor genes was found in the patient with diabetes. By cDNA cloning or PCR-direct sequencing methods, we identified several mutations in the insulin receptor genes of four insulin-resistant diabetic patients. At least two mutants of insulin receptor genes were expressed in Chinese hamster ovary cells and these mutated receptors showed impaired ability to transduce insulin action in these cultured cells. The expression of these mutant genes in animals such as transgenic mice will be indispensable to establish the relationship between the gene mutation and the abnormality found in the patient. Using the strategy of the second approach, Bell et al. recently reported that the gene responsible for MODY (maturity-onset diabetes of the young) is tightly linked to the adenosine deaminase gene on chromosome 20q. However, this strategy will not be applicable for identification of diabetes-susceptibility genes of NIDDM, since this disorder is likely to be genetically heterogenous, with mutations in several different genes able to cause hyperglycemia, and this heterogeneity could confound the linkage analysis. PMID- 1779466 TI - [Molecular biology and laboratory diagnosis of hypothalamic-pituitary-thyroid axis]. AB - Recent developments in molecular biology have brought dramatic changes in laboratory medicine. Applications of molecular biology techniques have made it possible to make etiological diagnosis and produce recombinant proteins for reagents. Laboratory investigations of molecular biology in the hypothalamic pituitary-thyroid axis include TRH gene, TRH effect, TSH gene, TSH receptor and its autoantibodies, thyroid peroxidase and thyroglobulin and their autoantibodies, thyroxine (T4) binding protein genes, deiodination of T4, thyroid hormone receptor, oncogenes of thyroid etc. The following developments are reviewed. 1) Human TSH (hTSH) beta gene and its abnormality: Two types of mutations of hTSH beta gene have been found in patients with hereditary isolated TSH deficiency. DNA diagnosis and genetic counseling are now being performed. 2) Structure and function of TSH receptor: The primary structure of hTSH receptor was identified from its gene. Relationships between its structure and function have been investigated using site specific mutagenesis and synthetic short peptides. 3) Thyroid hormone receptor gene and its abnormality: The thyroid hormone receptor gene has been successfully cloned. Several mutations of the gene have been demonstrated in patients with thyroid hormone resistance. 4) Application of recombinant hTSH (r-hTSH):r-hTSH has been produced in CHO cells. Immunological and biological properties of r-hTSH are similar to those of authentic pituitary hTSH. Clinical application of r-hTSH is now in progress. PMID- 1779467 TI - [The detection of minimal residual disease in leukemia by in vitro DNA amplification]. AB - In vitro amplification of genomic or cDNA sequences by polymerase chain reaction (PCR) is one of the most powerful tools in recent molecular biology. More than 10(5) copies of DNA sequence ranging from 50 bp to 7 kb can be synthesized in a couple of hours. Ever since its development, PCR has attracted much attention because this strategy would allow the detection of minimal residual disease (MRD) at a very low level. The first successful application of this ultra-sensitive technique was the detection of residual tumor cells carrying a 14;18 translocation in follicular lymphoma. The abnormal transcripts caused by 9;22 translocation in chronic myelocytic leukemia (CML) was also exploited for the amplification to detect the MRD. These techniques have successfully shown the detection of one leukemic cell in 100,000 normal cells. Besides leukemic specific sequences caused by chromosome and gene translocations, unique sequences caused by rearrangements in IgH or TCR gamma, delta chain genes have been used as clonal markers for tumor cells. By targetting these sequences for PCR amplification, almost all ALL patients can be analyzed for MRD. The successive measurement of MRD might contribute to improvement of treatments for leukemic patients. PMID- 1779468 TI - [Expression and detection of platelet specific genes in human megakaryocytic cells]. AB - The expression and biological function of interleukin-6(IL-6), and its receptor mRNA, were studied in a human megakaryocytic cell line (CMK). IL-6 possessed stimulatory effects on the DNA synthesis as well as colony formation of CMK cells. The IL-6 receptor mRNA could be detected by the method of reverse transcriptase polymerase chain reaction (RT-PCR) but not Northern blotting. On the contrary, IL-6 mRNA was detected by the method of RT-PCR, and its expression induced by the addition of 12-O-tetradecanoylphorbol-13-acetate (TPA) could be clearly shown by Northern blotting. These findings indicate that IL-6 and its receptor mRNA should be analyzed by both methods, and the growth and differentiation of CMK cells may be controlled by an IL-6 autocrine loop. Next, the expression and biological role of low molecular GTP-binding proteins (smg p21A and -B) mRNAs were examined in CMK cells. Both the smg p21A and -B mRNAs were detected in CMK cells using Northern blotting, and their levels were markedly elevated by TPA treatment. The mRNA level of glycoprotein IIb, a typical marker of the megakaryocytes, was increased by TPA, but the time course of the increase in the smg p21 mRNA levels was more rapid that that in the GPIIb mRNA level. These findings suggest that smg p21s play an important role during the TPA induced differentiation of CMK cells. PMID- 1779469 TI - [Detection of methicillin-resistant Staphylococcus aureus by polymerase chain reaction]. AB - The low-affinity penicillin-binding protein (PBP 2') is associated with methicillin-resistance of Staphylococcus aureus and its structural gene (mecA) not present in methicillin-susceptible S. aureus could be detected by the polymerase chain reaction (PCR) method, in which a 533 bp region of mecA was amplified and detected by agarose gel electrophoresis. Survey for the mecA gene in 210 clinical isolates of S. aureus revealed that, while there was a gross correlation between the presence of the mecA gene and the resistance level to beta-lactams, three strains of mecA (+) tested showed beta-lactam susceptibility similar to those of mecA (-) strains. These three strains did not produce a detectable amount of PBP 2' constitutively nor inducibly, which was the cause of their high susceptibility to beta-lactams. One of them yielded a typical methicillin-resistant variant at a low frequency with a concomitant recovery of PBP 2' production when the bacterial cells of high density were spread onto an agar plate containing 10 micrograms/ml of oxacillin. These findings suggested that typical methicillin resistant S. aureus occurred during chemotherapy with beta-lactam antibiotics even when resistant strains could not be detected by the susceptibility test and thus all mecA (+) strains including those with high susceptibility should be precisely detected. PMID- 1779470 TI - [Molecular analysis of an African family with sickle cell disease and alpha thalassemia-2]. AB - An etiological examination was performed on the DNA of a 13-year-old Zairean girl, who had some abnormalities in hematological and red cell morphological examinations and was homozygote for an abnormal Hb like HbS. DNA was amplified by the PCR method to obtain 1.7 kb size DNA containing the 5' region of the beta globin gene. The amplified DNA was digested with Eco 81 I and electrophoresis of the digest revealed the absence of its active site, which is on codons beta 5-7 (CCTGAGGAG) of the normal DNA. Sequencing of the cloned DNA by the dideoxy method confirmed that the codon beta 6 (GAG, Glu) mutated to a new codon GTG (Val) which is the beta S globin gene producing abnormal HbS. The haplotype of the chromosome having beta S gene was --+---++, which is the most common type in Zaire area. On the other hand, when the genomic DNA was digested with Bgl II or Bam HI and hybridized to an alpha probe, a fragment (16 kb/Bgl II or 10.5 kb/Bam HI) in addition to the normal ones (12.5 and 7.5 kb/Bgl II or 14 kb/Bam HI) was observed. This resulted from the deletion of 3.7 kb from the alpha gene arrangement, which led to alpha-thalassemia-2 (genotype: alpha 3.7-/alpha alpha). A family study demonstrated that her parents were heterozygote for HbS and her father had alpha-thalassemia-2. PMID- 1779471 TI - [Detection of autoantibody to mitotic spindle associated antigen (MSA) in sera from patients with positive mycoplasma pneumoniae particle agglutination (PA) test]. AB - Autoantibody to mitotic spindle associated antigen (MSA) was examined in sera from patients with positive mycoplasma pneumoniae particle agglutination (PA) test along with various autoimmune diseases and healthy subjects by means of indirect immunofluorescence (IF) using HEp-2 cells as substrates. Anti-MSA antibody was identified in 9 patients sera including 7 out of 180 sera with positive mycoplasma pneumoniae PA test, one with systemic lupus erythematosus (SLE) and one with scleroderma (PSS) respectively. Five of 9 sera with positive anti-MSA antibody contained anti-nuclear antibody (ANA) including 4 with speckled staining ANA and one with homogeneous + nucleolar staining ANA. Two collagen diseases sera positive for anti-MSA antibody showed negative mycoplasma pneumoniae PA test. In addition, there was no correlation between the presence of anti-MSA antibody and the titers of mycoplasma pneumoniae PA test. Our results indicated that anti-MSA antibody was not limited to such connective tissue diseases as previously described by other workers. It would be speculated that mycoplasma pneumoniae infection might induce anti-MSA antibody production. PMID- 1779472 TI - [Qualitative and quantitative evaluation of CFU-E colonies in myelodysplastic syndromes]. AB - Hemoglobin (Hb) synthesis in colony-forming-unit erythroid (CFU-E) colonies from the bone marrow of 10 normal subjects and 6 patients with myelodysplastic syndromes (MDS) was studied using microcytofluorometry. Hb content was determined utilizing a photochemical reaction in which the intracellular Hb is converted into fluorescent porphyrin. Briefly, the CFU-E in plasma clots was assayed according to Tepperman's method. Bone-marrow mononuclear cells were then dispensed onto petri dishes containing the plasma clots. The cells in plasma clots were cultured for seven days and then air-dried. The samples were then fixed with pure methanol. Thereafter, the dishes were exposed to ultraviolet light (lambda = 405 nm) in the presence of an SH-donor (0.2 M mercaptoethylamine hydrochloride). The intensity of porphyrin fluorescence was measured using a microcytofluorometer. When the photochemical reaction was carried out for 50 min, the intensity of fluorescence was found to be proportional to the mean corpuscular Hb (MCH) level, suggesting that the intracellular Hb level can be determined as a function of the intensity of this fluorescence. The number of CFU E colonies in MDS patients was smaller than that in normal subjects. In addition, intracolony Hb level was markedly lower in the MDS cases than in normal subjects. Our findings suggest that the maturation process of CFU-E is impaired in MDS patients. PMID- 1779473 TI - [Seropositivity of anti-HTLV-II antibodies in patients with HTLV-I-associated myelopathy and adult T-cell leukemia]. AB - Dr Kira et al. (Lancet 1991, 338: 64-65) stress the high incidence of the co infection with HTLV-I and HTLV-II in the HTLV-I associated myelopathy or tropical spastic paraparesis (HAM/TSP) detected by a polymerase chain reaction (PCR). They showed that 67% of HAM/TSP patients and 6% of healthy carriers had the co infection. They suggested the co-infection might be important for the development of the myelopathy. Recently, we have analyzed the seropositivity of antibodies to HTLV-I and II in Adult T-cell Leukemia (ATL), HAM/TSP and carriers in Japan using SELECT-HTLV (IAF Biochem International Inc., Montreal, Canada). This system was a solid phase enzyme immunoassay utilizing synthetic peptides to differentiate between antibodies to type I and II. We examined 101 samples (31 ATL patients, 20 HAM/TSP and 50 carriers) which were all positive with the particle agglutination (PA, Fujirebio, Tokyo) and ELISA (Eisai, Tokyo). All samples were negative with HTLV-II and positive with HTLV-I. The results of our serological survey suggested that HTLV-II did not associate with the etiology of ATL and HAM/TSP in Japan. PMID- 1779474 TI - [An autopsy case of neoplastic angioendotheliosis mainly affecting the lung and presenting with atypical cells in peripheral blood]. AB - Neoplastic angioendotheliosis (NAE) is a rare condition characterized by proliferation of atypical cells in small vessels of various organs. In the past, atypical cells seen in this condition were considered to originate from vascular endothelial cells. However, recent immunohistochemical studies have established that the tumor cells in this condition mainly originate from B-lymphocytes. NAE is likely to affect the central nervous system and skin. Cases of NAE with a primary lesion in the pulmonary vessels are rare. One such rare case of NAE was recently encountered by us. The patient was a 77-year-old woman who was admitted to our department because of fever and interstitial shadow in both lungs. After admission, fever did not subside, and the pulmonary shadow became more marked. Laboratory tests upon admission disclosed elevated LDH. Of isozymes, LDH2 and LDH3 were high. Anemia and thrombocytopenia gradually became aggravated, and atypical cells with large basophilic cell body and irregularly shaped nucleus subsequently appeared in peripheral blood. Thereafter, the patient's general condition worsened rapidly and she died about 5 months after admission. Post mortem examination revealed pleomorphic atypical cells filling the lumen of small vessels in various regions of the body. This finding was particularly marked in pulmonary vessels. With various immunohistochemical stains, these cells were identified as cells of B-lymphocyte origin. PMID- 1779475 TI - [A report on the hygienic status of sacred "temizu" water in shrines]. AB - The quality of the sacred "temizu" water in shrines in Kyoto was surveyed. It was found that the sources of "temizu" were the municipal water supply or domestic wells and that the "temizu" was usually used for washing the hands and mouth, while in certain shrines it was drunk as well. Of 50 visitors responding to questions, 26 persons said that they drank "temizu". In some shrines using the municipal water supply as "temizu", the free residual chlorine concentration was lower than that in the municipal water supply itself. Contamination of "temizu" by Escherichia coli or Aeromonas hydrophila was observed in some shrines. PMID- 1779476 TI - [Assessment of cadmium and lead released from cigarette smoke]. AB - Cigarette smoke, which contains many harmful compounds, affects not only the smoker's health but also indoor air quality. To evaluate indoor air contamination by cadmium (Cd) and lead (Pb), we measured Cd and Pb contained in the mainstream and sidestream smoke exhaled by experimental smoking of Japanese cigarettes and also determined urinary and blood Cd and Pb levels in smokers and non-smokers and air Cd and Pb levels in smoky environments. 1. One cigarette of each of 7 Japanese brands contained about 1 microgram each of Cd and Pb, of which about 50 ng each was released to the mainstream and 250 ng of Cd and 50 ng of Pb to the sidestream by smoking. 2. The blood Cd level in the smokers was significantly higher than that in the non-smokers. The urinary Cd level in the smokers was slightly higher than that in the non-smokers. The blood Cd level was related to the number of cigarettes smoked daily. Blood and urinary Pb levels did not differ between the smokers and non-smokers, but the blood Pb level was also related to the number of cigarettes smoked daily. 3. The air Cd levels in smoky places such as the smoking car of the special express train, an office, and a pachinko parlor were markedly higher than that in outdoor air. The air Cd concentration was well correlated with the environmental tobacco smoke concentration. On the other hand, the air Pb level was slightly higher in the above smoky places than outdoors. The mean air Pb concentration was not correlated with the environmental tobacco smoke concentration but was higher at higher environmental tobacco smoke concentration in each place. PMID- 1779477 TI - Pilot study on smoking prevention in Japanese adolescents. PMID- 1779478 TI - Mortality in medicolegal deaths in Hyogo Prefecture (1986-88). AB - Only three medical examiner offices are undertaking inquests on medicolegal deaths and no coroner system exists in Japan. Medical practitioners are also entrusted to hold such inquests. Certificates filed by the medical examiners of Hyogo Prefecture were compared with those filed by medical practitioners. Medical examiners certified deaths as "heart failure" only when no pathological changes were found after an autopsy. Of 2,622 deaths caused by diseases, 1,707 were certified as "heart failure" by medical practitioners without performing an autopsy. The term "heart failure" seems likely to be misused for deaths of which causes are unknown. Although the age-adjusted mortality rate for "heart disease" in Japan (98.7 per 100,000 population) showed a higher rate than for "cerebrovascular disease" (84.2), it included 53.9 for "heart failure". The misuse of the term "heart failure" seems to have introduced serious bias into the recent mortality statistics of Japan. This inaccuracy is due to ignorance about the importance of mortality statistics and ICD. Improvement in the reliability of mortality statistics is necessary for disease prevention projects through clinical medicine and public health means. PMID- 1779479 TI - [Systems analytical investigation of the effect of countermeasures against the AIDS epidemic among homosexuals]. AB - In Japan, the AIDS (Acquired Immunodeficiency Syndrome) epidemic among haemophiliacs has been the most urgent issue, because of the large number of haemophiliacs with AIDS. However, after governmental approval of the production of heated coagulating agents in 1985 and 1986, the prime object of prevention against the AIDS epidemic shifted from transmission through coagulation agents to that through sexual contacts. In order to investigate the most appropriate countermeasures against the AIDS epidemic among homosexuals in Japan, the numbers of HIV (Human Immunodeficiency Virus)-infected cases and AIDS cases in the future were estimated, and changes of the future numbers of HIV-infected persons and AIDS cases by behavior of homosexuals were compared using a systems analytical method. The methods of estimation and comparison are similar to those of R. M. Anderson and others, using numerical analysis of a mathematical model consisting of differential equations. They assumed a closed homosexual group whose members seldom have contact with members of other homosexual groups, but we assumed an open homosexual group whose members are being infected by other groups, because this assumption was more appropriate to the situation of homosexual society in Japan. The results showed that the prevalence number of HIV-infected cases would be about 1,800, that the prevalence number of AIDS cases would be about 100 among 100,000 homosexuals at 20 years after the beginning of the AIDS epidemic, and that the most effective countermeasure was reducing the frequency of sexual contacts among members or taking prophylactic measures during sexual contacts. These prevalence numbers of HIV-infected cases and AIDS cases would be reduced to between 1/4 and 1/2 of the above-mentioned calculated values by promotion of that countermeasure. PMID- 1779480 TI - [The effect of storage on serum fatty acids]. AB - To investigate the effect of storage on serum fatty acids, we examined the composition of serum fatty acids in samples from healthy men stored at different temperatures for various periods of time. The following experimental storage conditions were studied: 1) 4 degrees C for three weeks, 2) -20 degrees C for 12 months and 3) -80 degrees C for 24 months. The fatty acid composition did not change after two-week storage at 4 degrees C. At -20 degrees C, there was a decline in the content of docosapentaenoic acid (22: 5, omega 3) after one month, and docosahexaenoic acid (22: 6, omega 3) after three months. However, omega 3 polyunsaturated fatty acid as a whole did not show a significant change. At -80 degrees C, there was a decline of docosapentaenoic acid after three months, arachidonic acid (20: 4, omega 6) after 12 months, and linoleic acid (18: 2, omega 6) after 24 months. As a whole, omega 3-polyunsaturated fatty acids did not change. Omega 6-Polyunsaturated fatty acids significantly declined 5% after 24 months. Therefore, it is recommended that serum fatty acids be measured within two weeks at 4 degrees C, within a few months at -20 degrees C and within one year at -80 degrees C to estimate the composition of the major fatty acids. PMID- 1779481 TI - [Clinical and epidemiological study on osteofluorosis]. AB - The clinical manifestations of osteofluorosis in subjects exposed to high levels of fluoride in air or drinking water for longer than 10 years were observed. In particular, the relationship among the findings observed in X-ray pictures of bone and the extent of fluoride exposure, and the concentrations of fluoride in serum, urine and the environment were studied. Interpretation of the film was carried out by orthopedic surgeons by means of blind tests. When sclerotic changes of bone at more than two locations were observed, the subject was diagnosed as having possible osteofluorosis. From these studies, the following conclusions were obtained. 1) Of the 63 subjects exposed to airborne fluoride (average concentration: 0.88 +/- 0.74mg/m3; max.: 2.9mg/m3) for longer than 10 years, four possible cases of osteofluorosis were found. However, there were no patients presenting typical osteofluorosis. The average fluoride concentrations in serum and urine of the exposed group were 0.055 +/- 0.045ppm and 2.99 +/- 2.20ppm, respectively. The values were almost twice as high as those found in the control group (47 subjects). 2) Of the 95 residents in areas where the concentration of fluoride in drinking water was high (area A: 1.0-3.2 ppm and area B: 2.0-13 ppm), 19 subjects were diagnosed as possible cases of osteofluorosis and one case of definite osteofluorosis (corresponding to the second phase of the Roholm's classification) was found. In the latter case, the subject had drunk highly contaminated (12ppm) water for 26 years; a high serum fluoride concentrations (0.427ppm) and high levels of ALP and osteocalcin were found. This is one of the rare cases of osteofluorosis in Japan; only a few cases have been reported in the past. 3) As primary signs of changes in bone due to osteofluorosis, as seen in X-ray pictures, osteophytes of the lumbar vertebrae, ossification of the pelvic obturator membrane and ligaments and ossification of the interosseous membranes of forearms and lower legs are emphasized. PMID- 1779482 TI - [Relations of serum apolipoprotein A-I, A-II and B levels to smoking, drinking and body mass]. AB - To examine whether the serum apolipoprotein A-I level (Apo A-I), serum apolipoprotein A-II level (Apo A-II) and serum apolipoprotein B level (Apo B) are related to cigarette-smoking habits, drinking frequency and body mass index (BMI) independent of serum lipoprotein cholesterol levels (HDLC, LDLC or VLDLC), we statistically analyzed the data on Apo A-I, Apo A-II, Apo B, HDLC, LDLC and VLDLC and the life style data obtained from health examinations of 256 male residents aged 40 to 49 mostly randomly selected from two Japanese areas, Ninohe, Iwate and Ishikawa, Okinawa. The results were as follows: (1) HDLC was strongly positively correlated with Apo A-I and Apo A-II, while Apo B was strongly correlated with LDLC and VLDLC. (2) According to univariate analyses, Apo A-I, Apo A-II, Apo B, HDLC, LDLC and VLDLC were not associated with smoking. On the other hand, drinking frequency was positively associated with Apo A-I, Apo A-II and HDLC. Apo A-I and HDLC were negatively correlated with BMI, whereas Apo B, LDLC and VLDLC were positively correlated with BMI. (3) According to the results of multi dimensional analyses of covariance, Apo A-II was positively correlated with drinking frequency independent of Apo A-I and HDLC, especially among the individuals with increased HDLC. The same multivariate analysis showed that Apo B was positively associated with smoking independent of LDLC and VLDLC among the individuals without increased VLDLC. From these results, we conclude that Apo A II may be effective as a biological marker for alcohol drinking independent of Apo A-I and HDLC, while cigarette smoking may affect Apo B through a certain direct mechanical effect. (4) Increased HDLC in obese individuals (BMI greater than or equal to 27) or non-drinkers was associated with remarkably increased Apo A-I, while decreased HDLC in thin individuals (BMI less than 21) was associated with remarkably decreased Apo A-II. PMID- 1779483 TI - Proceedings of the 64th annual meeting of Japan Association of Industrial Health. PMID- 1779484 TI - Epidemiology of glaucoma in Japan--a nationwide glaucoma survey. AB - A population-based, collaborative glaucoma survey was conducted in seven regions throughout Japan, during the years of 1988 and 1989. The total number of subjects examined was 8,126 out of 16,078 residents aged 40 years or older, representing a participation rate of 50.54%. There were no significant differences in background factors between participants and randomly sampled nonparticipants. A mainstay of the screening consisted of tonometry and fundus photography with nonmydriatic camera, followed by automatic perimetry as a recall examination. Overall prevalences obtained were primary open-angle glaucoma (POAG) 0.58%, low-tension glaucoma (LTG) 2.04%, primary angle closure glaucoma (PACG) 0.34%, other types of glaucomas 0.60%, and ocular hypertension (OH) 1.37% at the time of screening. The very high prevalence of LTG and extremely low prevalence of OH in the Japanese might reflect a racial peculiarity in the age-specific trend of the intraocular pressure. The prevalence of PACG was found much higher in Japanese than in Caucasians, with a predilection for women. Racial peculiarities as revealed in this study were discussed, with particular reference to the refractive status in the Japanese that showed progressive decrease in myopia with age. PMID- 1779486 TI - Age-related changes of microfibrils in the cornea and trabecular meshwork of the human eye. AB - Microfibrils in the connective tissue can be subdivided into two classes, elastin associated and elastin-independent microfibrils. The distribution of microfibrils of both classes were studied in the anterior segment of the human ocular tissues, with a view to examine age-related morphological changes. In the trabecular meshwork of infants, the tubular structure of microfibrils was identified and the fibrils were associated with elastin, forming a typical elastic fiber. This was confirmed by the tannic acid-uranyl acetate staining which reacts specifically with elastin. In the cornea, microfibrils were detected in the deep stroma of the infant. They were not associated with elastin (elastin-independent microfibrils). In the glaucomatous eye of a 7-year-old boy, microfibrils were indistinct in the trabecular meshwork. In the corneal stroma of the same eye, microfibrils were observed, but the occurrence was rarer than in the nonglaucomatous infants examined in this study. In the trabecular meshwork of aged persons, no tubular or fibrillar structure was seen around the elastin. Microfibrils were not observed in the cornea. The morphological features and occurrence of microfibrils change with age in the anterior segment of the human eye. Thus microfibrils can be a good indicator for the age-related changes in these tissues. PMID- 1779485 TI - Effects of topical application of UF-021, a novel prostaglandin derivative, on aqueous humor dynamics in normal human eyes. AB - The mechanism underlying the intraocular pressure (IOP) lowering effect of a prostaglandin-related compound, isopropyl 20-ethyl-9 alpha,11 alpha-dihydroxy-15 keto-cis-delta 5-prostanoate (UF-021), and its possible adverse effects in long term use were studied in normal human eyes. A single instillation of 0.12% UF-021 significantly lowered IOP without affecting aqueous flow rate, tonographic C value or episcleral venous pressure. Protein concentration in the anterior chamber and corneal endothelial permeability to fluorescein remained unaffected. It was suggested that UF-021 lowers IOP mainly by increasing uveoscleral outflow. Twice daily application of 0.12% UF-021 for 4 weeks caused no significant changes in aqueous protein concentration, aqueous flow rate or corneal endothelial permeability. Neither single nor long-term use of topical UF-021 induced irritative responses in the outer segment of the eye. The present study suggests that UF-021 has potential as a safe and effective ocular hypotensive drug with a mechanism of action different from other drugs currently available for the treatment of glaucoma. PMID- 1779487 TI - Role of rectus muscle enlargement in clinical profile of dysthyroid ophthalmopathy. AB - Using logistic regression analysis, a correlation between enlargement patterns of the 4 rectus muscles and the occurrence of a variety of dysthyroid ophthalmopathy associated ocular symptoms were analyzed in 698 eyes of 349 patients with this disorder. The condition of each rectus muscle was evaluated by computed tomography, and the various ocular symptoms were classified according to the Inoue classification system. The enlargement pattern, particularly when involving the inferior and medial recti, was found to have a strong statistical correlation with the occurrence of individual ocular symptoms. Additionally, the probabilities of the occurrence of most of the ocular symptoms were generally greater in those eyes with 2-, 3- or 4-muscle enlargement patterns than in those eyes with one or no enlarged rectus muscle. PMID- 1779488 TI - Changes in photically evoked blink reflex during sleep and wakefulness. AB - The effects of the state of arousal on photically evoked blink reflex were studied. Eyelid potential (ELP), the averaged electromyographic activity of the orbicularis oculi muscle, was used to define the onset latency and intensity of the reflex. ELP was maximum with the shortest latency when the subjects were awake and doing mental arithmetic. ELP amplitude gradually decreased and the latency lengthened with the advance in non-rapid eye movement (non-REM) sleep stages. In the REM stage, ELP was augmented and resembled that when awake. ELP is useful as an objective sign of the photically evoked blink reflex, which closely reflects cortical activities and brain stem function. PMID- 1779489 TI - Comparison of changes in vascular resistance between choroid and other organs following ligation of carotid artery. AB - The changes in the choroidal vascular resistance after carotid artery ligation were compared with those in the cerebrum and the inferior rectus muscle by evaluating the changes in the blood flow by the hydrogen clearance method. Ligation of the carotid artery produced little change in the ipsilateral cerebral blood flow, but decreased the choroidal blood flow by 16-24% and the blood flow of the inferior rectus muscle by 34-40%. Although the reduction in the arterial pressure in these organs was the same, the responses of the blood flows to the changes in the arterial pressure were different. This suggests that autoregulatory capability varies from organ to organ. It is important to study the pathogenesis of carotid artery occlusion giving special consideration to these differences among the autoregulatory capabilities of various organs. PMID- 1779491 TI - Case of conjunctival liposarcoma. AB - A case of primary conjunctival liposarcoma was reported. The patient was a 62 year-old woman who complained of swelling of the left bulbar conjunctiva. As the swelling lesion did not respond to treatment and had gradually enlarged, surgical excision was performed 18 months after her first visit. The tumor was bean-sized and was located subconjunctivally without connecting orbital tissues. Histopathological examination of the specimen revealed numerous neoplastic cells containing stellate and hyperchromatic nucleus. The cytoplasm of these cells contained vacuoles resembling lipid droplets. Signet-ring type cells were also observed. These cells were considered to be lipoblasts. The stroma was myxomatous and thin-walled vessels were observed. The present tumor was confirmed by histopathological study as myxoid liposarcoma and considered to be of bulbar conjunctiva origin. The patient showed no sign of recurrence during 16 months of follow-up. PMID- 1779490 TI - Influence of lens cortex on postoperative inflammation and cellular deposits on surface of intraocular lenses in rabbit eye. AB - An animal model was used to evaluate the influence of residual lens cortex on postoperative inflammation and cellular deposits on intraocular lenses (IOLs). Eighteen New Zealand white rabbits underwent bilateral endocapsular phacoemulsification with placement of a one-piece polymethylmethacrylate (PMMA) IOL in the capsular bag. A predetermined amount (15 mg, 30 mg or 60 mg) of homogenized lens cortex was injected into the anterior chamber of one of the eyes of each rabbit after bilateral IOL implantation. The contralateral eye served as the control. The animals underwent slit-lamp examination postoperatively, and the anterior segment of each eye was examined by gross and light microscopy. On slit lamp examination, the eyes which had received a 60-mg injection of cortex showed a significantly higher amount of posterior synechiae than their contralateral, control eyes. After 2 weeks of observation, the rabbits were sacrificed, the eyes were enucleated, and the IOLs were removed and examined by light microscopy and scanning electron microscopy (SEM). The number of cellular deposits on the IOLs removed from the eyes receiving a 30-mg injection of cortex was significantly larger than that found in their contralateral, control eyes (P less than 0.05), but the eyes in the 60-mg and 15-mg injection groups showed no significant difference between control eyes and IOL eyes in the number of cellular deposits on explanted IOLs. Observation by SEM determined that the filopodia on the epithelioid cells found on the IOLs removed from the eyes in the 60-mg injection group showed an increased number and length compared to their controls. The epithelioid cells on the IOLs of the 30-mg injection group showed an increased number of filopodia compared to their controls. PMID- 1779492 TI - Electron microscopic study of distribution of proteoglycans in bovine cornea and sclera. AB - To study differences in the distribution of proteoglycans and their relationships to collagen fibrils in the cornea and sclera, bovine cornea and sclera were examined histochemically using the ruthenium red (RR) staining method. RR positive granules (30 nm in diameter) were present in association with fine filamentous materials (3 nm in diameter and 30-100 nm in length) in the interfascicular spaces of collagen bundles in both the corneal stroma and sclera. The amount of these materials was smaller in the sclera than in the cornea. The characteristic band-like arrangement of RR-positive granules connected by filamentous materials at intervals of 80-100 nm was found only in the cornea. In enzyme digestion experiments, tissue sections were treated by chondroitinase ABC, AC, and keratanase before RR staining. The RR-positive granules and their associated filamentous materials were darkly stained after chondroitinase AC or keratanase digestion, but displayed markedly lighter staining after chondroitinase ABC digestion. These results indicate that RR-positive granules and filamentous materials contain dermatan sulfate proteoglycan. PMID- 1779494 TI - [The report of clinical statistical studies on registered bladder cancer patients in Japan 1982-1987. Japanese Urological Association, Committee on General Rule for Studies on Bladder Cancer]. PMID- 1779495 TI - [Overexpression of c-myc, c-fos and Harvey ras oncogenes in renal cancers- analysis at the messenger RNA levels]. AB - The accumulating data have shown that a single or certain combinations of proto oncogenes are genetically altered and acquire oncogenic activities in certain tumor types, through a point mutation and/or overexpression. In the present study, Northern blotting analysis was applied to clinical samples of renal cell carcinomas (RCC) to elucidate expression levels of the c-myc, c-fos and Harvey ras genes in this tumor form. In 11 cases of 23 tumors examined (48%) was shown more than 3-fold expression level of the c-myc gene compared with the matching normal RNA, the c-fos gene in 6 cases (26%), and the Harvey ras gene in one case (4%) showing the concomitant overexpression of two other genes. Overexpression of both the c-myc and c-fos genes was detected in 5 cases (22%). Although the distinct correlation between overexpressions of any genes and the clinical background was not induced, it is considered that these aberrations of proto oncogenes are involved in oncogenesis of a certain subgroup of RCC. PMID- 1779493 TI - A case of acute myelomonocytic leukemia with subconjunctival tumor. AB - A subconjunctival tumor in a 29-year-old woman with acute myelomonocytic leukemia was reported. The tumor was located in the bulbar conjunctiva of her left eye, with vasodilatation and slight elevation. The pathological examination of the tumor revealed infiltration by myelomonocytic leukemia cells. The patient developed numerous skin tumors simultaneously with the conjunctival tumor and died two months thereafter despite intensive reinduction chemotherapy. The clinical course of the patient suggested that subconjunctival tumor is a clinically important sign of acute relapse in myelomonocytic leukemia. PMID- 1779496 TI - [Clinical significance and usefulness of measuring nocturnal penile tumescence in children]. AB - Nocturnal penile tumescence (NPT) is a physiological phenomena that is recognized in almost all normal males. This paper presents a study of NPT and the relation of this phenomenon to age, sexual maturation and physical growth in children. In 30 subjects, ranging from 3 to 18 years old, NPT was measured continuously throughout the night. The following results were obtained: 1. The frequency of NPT had a tendency to increase with age with a maximum frequency at 13 or 14 years of age, although the frequency ranged widely. 2. The maximum increase in penile circumference was below 10 mm in all cases below 10 years of age but was greater in children over 12 years old. 3. Tumescence time and percent tumescence time [tumescence time (min.)/sleep period time (min.)] x 100) was greater in children of over 12 years of age. Percent tumescence time showed a positive correlation with serum LH. Percent tumescence time was clearly higher in children with LH pulse, which indicates the onset of puberty, than in those without it. 4. These results suggest that NPT measurement in children can predict the onset of puberty, when coupled with endocrinological findings. PMID- 1779497 TI - [Pharmacologic characteristics of human neurogenic bladder: response to KCl, carbachol, ATP and CaCl2]. AB - Pharmacologic characteristics of the human neurogenic bladder to KCl, carbachol, ATP and CaCl2 was investigated in vitro in comparison with the control bladder. Patients with neurogenic bladder underwent augmentation enterocystoplasty because of low bladder compliance or uninhibited contraction which resulted in urinary incontinence and/or vesicoureteral reflux. 1. There was no difference in the contractile strength to KCl between the neurogenic bladder and the control. 2. The contractility (both contractile strength and the value of ED50) to carbachol was than in the control. 3. The contractile strength of the neurogenic bladder to ATP showed greater efficacy than that of the control bladder. 4. The contractility of the neurogenic bladder (contractile strength and the value of ED50) to CaCl2 was significantly greater than that of the control. 5. In the neurogenic bladder there was no correlation between pharmacological responsiveness and the clinical parameters including the data of cystometry. In conclusion, the human neurogenic bladder demonstrated supersensitive responses to carbachol, ATP and CaCl2. PMID- 1779498 TI - [Bone mineral densitometry by dual photon absorptiometry in patients with urolithiasis--on the possibility of the differential diagnosis of idiopathic hypercalciuria]. AB - Bone mineral density (BMD) of the 3rd lumbar spine was measured by dual photon absorptiometry (DPA) in 8 patients with primary hyperparathyroidism (PHP) and 39 patients with idiopathic urolithiasis (IU). Of the patients, 15 were classified into idiopathic hypercalciuria (IH) which were further classified into 2 types of IH--renal hypercalciuria (RH) and absorptive hypercalciuria (AH)--by Ca restriction and load test. BMD of the IH patients tended to be lower than patients with normocalciuria, but significantly higher than the PHP patients. BMD of the RH patients was significantly lower than the AH patients. In conclusion, DPA may be a simple method for classifying the types of idiopathic hypercalciuria. PMID- 1779499 TI - [True hermaphrodite with ipsilateral vas deferens and intrascrotal ovary]. AB - A 15-year-old, legally male patient came to our department with chief complaint of gynecomastia. Serum testosterone was at a low level of 1.6 ng/ml, and prolactin a high level of 23 ng/ml. Blood type was a mixed type of both type A and type B, and a chromosomal analysis with peripheral blood lymphocytes demonstrated a mosaic of 46, XX/46, XY. During the follow-up, he complained a painful swelling in his right scrotum, and received an emergent surgery. A large amount of blood was noted in the right scrotum. Unicorn uterus, Fallopian tube and finbriae were observed, and a thumb-sized gonad with hemorrhage and fissure was also seen in the upper part of the scrotum. The right gonad was an ovary and no testicular tissue was confirmed in the right scrotum, whereas the right vas deferens was noted. The left testis was accompanied by an induration on its upper pole which was histologically found to be ovarian tissue. The patient was diagnosed as a true hermaphroditism with 46, XX/46, XY chimera that had an ovary with inguinal uterus hernia and an unusual vas deferens in the right scrotum and an ovotestis in the left. It was considered that an adequate amount of testosterone secreted from the left testis during the early embryonal period might have affected the descent of the right ovary into the scrotum and on the development of the right vas deferens. PMID- 1779500 TI - [Results of Kock pouch construction fully utilizing an auto-suture instrument]. AB - From March 1987 to the end of February 1991, we performed Koch pouch construction as a urinary diversion on 20 patients who had undergone radical cystectomy due to bladder cancer. The operation was done according to the method of Skinner et al. We fully utilized an auto-suture instrument to ensure safe and stable suturing of the ileum and to shorten the operating time. It was of great concern that the staples placed at several portions might cause stone formation or aggravate infection. However, stone formation was observed only in one patient (5%) at the tip of a nipple valve in which a staple became the nucleus of the stone. Staples are usually not regarded as an obstacle as they are usually covered by the mucous membrane. In all patients, the maximum capacity of the pouch was more than 500 ml, intra-pouch pressure was kept low even when the pouch was inflated up to the maximum capacity, and reflux of urine into the upper urinary tract was not observed. As for complications, there was a slight degree of obstructive uropathy in 4 patients (20%), difficulty in catheter insertion was noted in 3 patients (15%), and stress incontinence-like urinary leakage was present in one patient when the capacity exceeded 500 ml. However, there were no complications which necessitated reoperation. In terms of blood chemistry, although there was a tendency towards a slight increase in BUN or hyperchloremia, no specific treatment was necessary as far as the kidney function was normal.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779501 TI - [Experimental study on intraoperative autotransfusion during urological operation]. AB - The value of autotransfusion is widely recognized in the surgical community and may be of increasing importance in prevention of acquired immunodeficiency syndrome and hepatitis. The concern of possible contamination of the blood with urine, bacteria in urine or viable tumor cells has limited the wide use of intraoperative autotransfusion (IAT) in urological operation. There have been no experimental reports about protection of the blood from such contamination. To investigate separation of the blood from a contaminated mixture by using an autotransfusion machine, Haemonetic Cell Saver, a study composed of three experiments was performed. First, 200 ml of blood was mixed 200 ml of urine, and thereafter, the mixture was processed by the machine and the concentration erythrocytes were collected in a bag. Biochemical analysis of the collected erythrocyte solution (CES) was performed. Second, 200 ml of blood was mixed with 200 ml of urine that was adjusted to contain each 10(7)/ml of four bacterial strains. The bacteriological study of the CES was performed. Third, 200 ml of blood was mixed with 200 ml of urine that was adjusted to contain 10(7) cancer cells. Two cell lines, KK47 originated from human bladder cancer and ACHN originated from human renal cell carcinoma was used. The cytological study of the CES was performed. The results of these experiments were: Urine constituents were completely removed from the mixture. However, all strains of bacteria could not be separated, although the number of bacteria decreased. Cancer cells were found in the CES. In conclusion IAT should be done at urological operation in selected patients that have sterile urine and do not have tumor cells in the operation field. PMID- 1779502 TI - [A case of acquired cystic disease of bilateral kidneys with renal cell carcinoma following long-term hemodialysis]. AB - We report a case of bilateral renal cell carcinoma which developed during about 14 years of hemodialysis. The patient of male was a 39-year-old with a chief complaint of macrohematuria 14 years prior to dialysis therapy. Computed tomography revealed multiple cystic changes of bilateral kidneys and a high density area in the right kidney. He was admitted to our department in April 1988. He was suspected of renal cell carcinoma of the right kidney and underwent transperitoneal radical nephrectomy on the right kidney. The left kidney was also resected simultaneously in part because it failed to function and in part because the long-term hemodialyzed patients are considered to have a complication of renal cell carcinoma at a high frequency. Pathological diagnosis was bilateral acquired cystic disease of the kidney (ACDK) with renal cell carcinoma. The kidney develops multiple cystic changes following long-term hemodialysis, which forms a high risk for development of renal cell carcinoma. This is a case of bilateral renal cell carcinoma which occurred after long-term hemodialysis, was reported with discussion and reference to the literature. PMID- 1779504 TI - [Cerebral hemodynamics and mental status of patients with myocardial infarction at the stages of rehabilitation treatment during early physical training]. PMID- 1779503 TI - [A case of mesothelioma of perinephric space origin]. AB - Cystic mesothelioma of perinephric retroperitoneum origin are very uncommon tumors and considered potentially malignant. We report one such case and discuss the clinical and pathological findings. A 70-year-old man was seen with complaint of discomfort in the right flank and hospitalized in May 1989. Computerized tomography revealed multiple cystic masses in the right retroperitoneal space which appeared to be infiltrating the kidney and the iliopsoas muscles. Magnetic resonance imaging showed deformation of the right kidney with many impressions in the parenchyma. The cystic lesions and the right kidney were extirpated on June 2, 1989. Grossly the specimen was 16 x 10 x 8 cm in size and 630 g in weight. The multiple cysts surrounding the kidney were each approximately 10 mm in diameter and had thin outer walls. The cyst fluid was clear and serous. The kidney had not been infiltrated but had only external impressions caused by the cystic lesions. Microscopically, the cysts were lined by a single layer of cuboidal cells accompanied by some hobnail-shaped cells, and no evidence of malignancy was found. The epithelium was focally positive for periodate acid Schiff and slightly positive for Alcian blue. It was strongly positive for cytokeratin and vimentin, and slightly positive for EMA but negative for lectins. The diagnosis was diffused benign multicystic mesothelioma. However, CT taken four months after the operation revealed local recurrence and radiotherapy (40 Gy) was instituted. Since the cystic mass tended to grow in size thereafter, the lesion appeared to be malignant clinically. We consider this is the first case of cystic mesothelioma of perinephric retroperitoneum origin reported in Japan. PMID- 1779506 TI - [Prevention of complications during conducting the exercise test]. PMID- 1779505 TI - [Psychological personality type as a risk factor in the pathogenesis of ischemic heart disease]. PMID- 1779507 TI - [Adaptability of patients to freely selected and forced physical exercise after myocardial infarction]. AB - In 45 patients with myocardial infarction in the rehabilitative period in health resort centers, bicycle ergometric tests with forced routine continuously gradually increasing exercise or without forced graded exercise in accordance with the "free option" motor motivation test were performed at the beginning and at the end of treatment. The work performed at the beginning and at the end of treatment. The work performed with free option is characterized by substantial differences in its volume, duration, intensity, and rate. Free option exercise is submaximal, close to tolerant, but simultaneously shows lower values in heart rates, systolic blood pressure, "double product" and cost-effective index. The free option exercise test is a more sensitive indicator of alterations in the status of a patient with myocardial infarction during health resort rehabilitation. PMID- 1779508 TI - [Selection of optimal training exercise and training schedule for patients with ischemic heart disease at the early periods after aortocoronary bypass]. AB - The study was undertaken to examine 70 patients with coronary heart disease who had undergone aortocoronary bypass. Spirobicycle ergometric testing was performed in all patients in the early postoperative period, coupled with recording hemodynamic parameters, such as cardiac and stroke indices, heart rate, and Q-Z interval, by employing tetrapolar rheoplethysmography. According to the results of threshold exercise, the patients were divided into three groups: those having threshold exercise intensities of 100, 75, and 50 W, respectively. The purpose of the study was to choose the optimal training pulse and training exercise in the early postoperative period of rehabilitation. Using various procedures for determining the training pulse from the threshold of anaerobic exchange, from 70% maximal oxygen uptake and from hemodynamic findings demonstrated that hemodynamic monitoring is the most informative tool since in the early postoperative periods of aortocoronary bypass, the results of threshold exercise are largely determined by the myocardial contractility that is associated with the overall body dysadaptation and, accordingly, the cardiopulmonary system and with the impact of the surgery itself involving extracorporeal circulation. PMID- 1779509 TI - [Risk factors of ischemic heart disease and arteriosclerosis among the population of Tallinn: their relation to age, sex and ethnic origin (a population study)]. AB - A random sample of males aged 30-54, females aged 30-54, and schoolchildren aged 10-14 years who live in Tallinn underwent a cross-sectional epidemiological study. A total of 4149 individuals were examined. The adults and children showed different atherogenic changes in lipid parameters, the former displayed high blood pressures, whereas the Estonian children had higher levels of total cholesterol, triglycerides, and diastolic blood pressure. The Estonian males had more pronounced atherogenic shifts of lipid parameters, low levels of high density lipoprotein cholesterol, while the Russians smoked more cigarettes. The Russian females had higher blood pressures and body weight index than the Estonian ones. Multiple regression analysis demonstrated that body weight was the most common correlate of blood pressure and lipid levels both for children and adults. PMID- 1779510 TI - [Disorders of glucose tolerance and ischemic heart disease]. AB - The incidence of impaired glucose tolerance, the relation of blood glucose levels to the prevalence of risk factors for coronary heart disease (CHD) and to myocardial infarction morbidity and mortality were studied over 15 years among males aged 45-59 years, excluding patients with diabetes mellitus. The data analysis was made in quintils of glucose levels. Impaired glucose tolerance was detected in 20.6% of the males. In the fifth versus the first quintil, there was an increase in the prevalence of systolic and diastolic arterial hypertension (p less than 0.001), obesity (p less than 0.001), low physical activity and hypercholesterolemia (p less than 0.05). As compared with the first, the fifth quintil showed higher total mortality rates and higher myocardial infarction morbidity and cardiovascular disease and CHD morbidity rates. But for age, and major risk factors, the risk for CHD, total and cardiovascular mortality increase at low and high blood glucose concentrations. PMID- 1779511 TI - [Effect of biguanide derivatives on the indicators of lipid metabolism and the functional state of blood mononuclear cells in patients with insulin-dependent diabetes mellitus]. AB - The paper provides the biochemical and immunological findings from 287 patients with Type I diabetes mellitus with regard to the pattern of their management. It has been shown that the patients treated with non-physiological large-dose insulin more frequently display clinical signs of atherosclerosis profound changes in the serum lipid profile and some immunological parameters. It is concluded that chronic insulin overdosage may play a role in the mechanisms of atherosclerosis development. It is indicated that the use of biguanidine derivatives in the treatment of patients with Type I diabetes mellitus concurrent with insulin overdosage leads to correction of most unfavorable changes in biochemical and immunological parameters. PMID- 1779512 TI - [Central and pulmonary hemodynamics in patients with various forms of ischemic heart disease]. AB - Two-dimensional and Doppler echocardiographies were used to examine right cardiac and pulmonary hemodynamics in patients with various types of coronary heart disease (CHD). All the patients were divided into 3 morphofunctional groups of CHD according to the left ventricular volume/mass index. They all were found to exhibit decreased left cardiac contractility and pump function, parallel with moderately elevated pulmonary pressure and right cardiac compensatory hyperfunction, which was largely evident in hypertrophic morphofunctional CHD. The degree of pulmonary hypertension was related to the severity of left ventricular pump dysfunction, but to its disturbed contractility in the dilated type. PMID- 1779513 TI - [Screening of single doses of the main antihypertensive drugs at rest and during various exercise tests in patients with hypertension]. AB - The single doses of three reference antihypertensive drugs: corinfar (20 mg), anapriline (80 mg), and hypothiazide (50 mg) were screened on day 5 of drug administration at rest and during paired isometric and dynamic exercises in comparison to placebo. There was a significant decrease in blood pressures: systolic (SBP), diastolic (DBP), and mean (MBP) (p less than 0.01-0.001) at rest and during isometric and dynamic exercises after single doses of corinfar and hypothiazide versus placebo. A single dose of anapriline resulted in a significant reduction in SBP and MBP at rest and during dynamic exercise (p less than 0.05-0.001), in DBP at rest (p less than 0.05) and in an insignificant decrease in SBP, DBP, and MBP during isometric exercise and DBP during dynamic exercise. The agents were graded in terms of the effect of placebo from the mean group and individual hypotensive effects (by each blood pressure parameter). The resting dynamic exercise failed to yield some new evidence for determining the efficacy of corinfar and hypothiazide, whereas it was informative for anapriline with regard to SBP. With respect to SBP, DBP, and MBP, isometric exercise was informative for hypothiazide. PMID- 1779514 TI - [A rheographic method of determining the duration of the diastolic phases]. AB - Difference thoracic rheography (recording the curve of a signal by subtracting a differential rheogram of the symmetrical portions of chest halves) was used to develop a procedure to define diastole phases, which established periods of relaxation, rapid and slow left ventricular filling, the duration of a systole of the left and right atria, and the time of rapid left ventricular filling velocity peak. The testing of the procedure in 25 healthy males showed that difference thoracic rheogram may be recorded both at rest and movements of a patient during a graded isometric leg loading, which is particularly important to make a comprehensive assessment of the diastolic function of the heart. PMID- 1779515 TI - [Problem of the optimal management of the polyclinical stage of rehabilitation of patients with chronic bronchitis after myocardial infarction]. PMID- 1779516 TI - [Effect of nitroglycerin on the chronocardiodynamics and cardiac kinetics of the right-ventricular anterior wall studied by the radiokinetocardiography]. PMID- 1779517 TI - [Provocation of supraventricular arrhythmia in the diagnosis of sick sinus syndrome]. AB - The diagnostic value of routine evaluations of sinus function and of analysis of sinus pause lengths were compared in 31 patients with a brady- and tachycardia types of the sick sinus syndrome after abolishing the tachyarrhythmic paroxysms provoked during an electrophysiological study. The study was performed by transesophageal electric stimulation. The sensitivity of the two modes of diagnosing the sick sinus syndrome was comparable: 55.5-65.2% for the former and 47.7-69.6% for the latter mode. Their concomitant application increases the diagnostic value of electrophysiological studies in patients with suspected brady and tachycardia types of the sick sinus syndrome by more than 17%. PMID- 1779519 TI - [Use of Doppler ultrasonography of the carotid arteries in patients with risk factors of coronary disease during ambulatory examination]. PMID- 1779520 TI - [Prevalence of disorders of cardiac rhythm and conduction among autochthonous Mongolian population living in the mid-altitude regions]. PMID- 1779518 TI - [Electric alternation of the heart in myocardial abscesses]. PMID- 1779521 TI - [Bioelectrical mechanism of the anti-arrhythmia effect of a synthetic acetylcholine analog EDIHYP]. AB - The synthetic acetylcholine analogue ethyl-3-(2,2-dimethyl-2-ethyl-hydrazinium) propionic iodide (EDIHYP) exerts a powerful antiarrhythmic action in cardiac ischemic, reperfusion, and adrenergic lesions, as well as in infarction and postinfarction cardiosclerosis, as evidenced by animal experiments. The study was undertaken to examine the electrophysiological mechanism of EDIHYP s action on isolated rat heart cardiomyocytes. It was shown that the agent substantially reduced the resting potential, as well as action potential amplitude and duration in total ischemia and resultant reperfusion. The antiarrhythmic changes provided a multiple decrease in the duration of ventricular tachycardia and cardiac fibrillation in reperfusion. Thus, the fact that EDIHYP has a direct action on the bioelectrical activity of cardiomyocytes may play an important role in its antiarrhythmic effect in the whole body. PMID- 1779522 TI - [Effect of vasorenal hypertension and neodicoumarin on the rheological properties of erythrocytes and the balance of blood electrolytes, heart and abdominal aorta wall in rats]. AB - It has been shown that with vasorenal hypertension, erythrocyte suspension viscosity coefficient increases, the abdominal aorta transmural potential difference decreases with lower levels of Na+, K+, Ca2+, and Mg2+ in plasma, cardiac and abdominal aorta tissue and higher red blood cell Na+ levels. Neodicumarinum, 3 mg/kg, modified Na+ and K+ imbalance in the red blood cell plasma-abdominal aorta wall system, which had been caused by vasorenal hypertension. At the same time the changes in Ca2+ and Mg2+ levels in the abdominal aorta and heart tissue, as well as the value of red blood cell suspension viscosity coefficient were demonstrated to be effectively abolished with neodicumarinum in a dose of 30 mg/kg. PMID- 1779523 TI - [Limitation of the cardiac depressive effect caused by various forms of staphylococcal infection by using dalargin, a synthetic analog of endogenous opioids]. AB - Male Wistar rats were used to examine the cardiodepressive action of experimentally induced generalized infection and bacterial shock and the ability of the synthetic opioid dalargin to enhance resistance the damaging effect of bacterial intoxication. The cardiac performance of the infected rats was studied in a model of an isolated perfused heart with the working left ventricle. In the rats, generalized Staphylococcus infection was ascertained to result in a dose dependent inhibition of heart performance at all study stages, showing the peak of cardiodepressive action on days 3 of postinfection. The experimental animals given dalagin displayed a high infection resistance, as manifested predominantly by prevented profound cardiac disorders due to systemic administration of dalargin or by a positive inotropic effect of the drug supplemented to perfusate, the effect being particularly pronounced in bacterial shock or in early generalized infection. PMID- 1779524 TI - [Arteriosclerosis and the adipose tissue: the cause-effect interrelations]. PMID- 1779525 TI - [Apolipoprotein E as a risk factor of coronary arteriosclerosis]. PMID- 1779526 TI - [Various problems of classification of ischemic heart disease and the formulation of its diagnosis]. PMID- 1779527 TI - [Diagnostic significance of clinico-hemodynamic indicators in macrofocal myocardial infarction in relation to the pattern of its course complicated by acute heart failure]. PMID- 1779528 TI - [Past, present and future in the teaching of hypertension]. PMID- 1779529 TI - [Diuretics: their place in antihypertensive therapy]. PMID- 1779530 TI - [Perfection of the method of selective proximal vagotomy and improvement of late term results of the surgical treatment of duodenal ulcer]. AB - In the period from 1985 to Sept. 1990 operations were conducted on 288 patients with duodenal ulcer; 165 of these patients (group I) were treated by selective proximal vagotomy (SPV) by the old method--without extensive mobilization of the cardia, esophagus, and fundus of the stomach; draining operations were used in 97% of patients. A perfected operative method was applied in 123 patients (group II)--besides extensive dissection of the zone of the esophagogastric junction all of them underwent circular esophagomyotomy 2 cm above the cardia and modified fundoplication. The indications for draining operations were limited (51.2% of patients). The results studied in 2.3 patients in follow-up periods of 6 months to 5 years confirmed the advantages of the perfected method of SPV: the number of recurrent ulcers reduced from 11.8% to 1.7%, that of the dumping syndrome from 9.2% to 4.5%, and the incidence of diarrhea from 7.8% to 3.3%. In groups I and II the results were excellent and good in 66.7% and 88.3% of patients, satisfactory in 21.6% and 10.0% of patients, and poor in 11.8% and 1.7% of cases, respectively. Perfection of the SPV method is directly reflected in its results which must be studied in follow-up periods of over 5-10 years for the evaluation to be more objective. PMID- 1779531 TI - [Reply to the letter of A. V. Fedorov (Khirurgiia, 1990, No. 9, p.119)]. PMID- 1779532 TI - [Errors and hazards in the surgical treatment of hepatic echinococcosis]. AB - The article analyses the results of operative treatment of 455 patients for hydatid disease of the abdominal organs, in particular the errors and hazards of surgical management of hydatid disease of the liver. Difficulties occur in the differential diagnosis in suppuration of hydatid cysts which had not been operated on, as well as in residual cavities in patients who had undergone surgery for this disease. The authors dwell on the diagnostic algorithm and the surgical tactics depending on the size and location of the hydatid cysts. Some problems of the operative techniques and intraoperative measures for the prevention of recurrences in complicated forms of hepatic hydatid disease are discussed. The suggested diagnostic algorithm and the surgical tactics allowed the authors to reduce diagnostic errors in this pathological condition to 3.5% and surgical mortality rates to 3.07%. PMID- 1779533 TI - [Erroneous laparotomy in emergency surgery]. AB - The authors studied the data concerning 101 patients who had undergone erroneous laparotomy for suspected acute surgical disease; these accounted for 0.4% of all the patients who were operated on for emergency indications in the same period. Eleven patients died. The operation was undertaken for an erroneous diagnosis of acute appendicitis (32 patients), acute cholecystitis (18), perforating gastric ulcer (15), peritonitis of unknown etiology (14), acute intestinal obstruction (5), strangulated hernia (3), destructive pancreatitis (3), tumor of the large intestine complicated by obstruction (3), abdominal abscess (2), thrombosis of the mesenteric vessels (1), ovarian apoplexy (1), closed abdominal trauma with injury to the viscera (4 patients). Diseases simulating the clinical picture of "acute abdomen" but not requiring an emergency operation were as follows: female reproductive (20 patients), pancreatic (11), renal diseases (11), hepatitis, cirrhosis of the liver (10), cardiovascular (9), pulmonary diseases (5), mesoadenitis (5), Crohn's disease (3), chronic colitis (3), carcinomatosis of the peritoneum (3), herpes zoster (3), and other diseases and injuries (20 patients). The main causes of the diagnostic and tactical errors were objective difficulties in the differential diagnosis due to similar symptomatology, as well as errors in the examination of the patient and haste in making a decision to make an operation. PMID- 1779534 TI - [A method of arresting bleeding from penetrating duodenal ulcer]. AB - In operations for bleeding ulcers a situation often occurs in which the surgeon has to restrict the operation to a small intervention. The danger of a recurrent hemorrhage is the main shortcoming of the existing palliative operations. Excision of the ulcer and subsequent closure of the defect is the only measure after which the bleeding will not recur. However, in penetrating ulcers of the posterior wall or its adjacent areas, this operation cannot be carried out practically. At the same time, it is just these ulcer that are the most common sources of bleeding. The author suggests the following method for such cases: without performing anterior gastroduodenotomy, the upper and lateral borders of the ulcer are excised, the bleeding vessel is ligated, and the separated duodenal wall is sutured to the inferior border of the ulcer and peritotration is conducted. The suggested method makes it possible to exclude the ulcer from the gastrointestinal lumen, which ensures reliable hemostasis. Good results were produced in 3 cases in which the method was applied. A description of the method had not been encountered in the available literature. PMID- 1779535 TI - [Plastic surgery of the choledochus using full autologous vein transplant]. PMID- 1779536 TI - [Acute pyelonephritis and calculous cholecystitis in a patient with complete situs inversus viscerum]. PMID- 1779537 TI - [Successful surgical treatment of a patient with pancreatic-bronchial fistula]. PMID- 1779538 TI - [Foreign body in the common bile duct]. PMID- 1779540 TI - [Cyst of the hepaticocholedochus]. PMID- 1779539 TI - [New possibilities of the antibiotic use in the treatment of patients with acute cholecystitis]. AB - The authors studied the efficacy of directed transport of antibiotics in autologous blood shadows in the complex treatment of 73 patients with acute cholecystitis (the main group) in comparison with the traditional nonoperative treatment of 67 patients with the same disease (the control group). The directed transport of antibiotics in autologous blood shadows makes it possible to arrest adequately the clinico-laboratory manifestations of acute cholecystitis, thus preventing the development of infectious complications of the disease, shorten by 4.5 times the terms for arresting the clinico-laboratory manifestations of acute cholecystitis, and to optimize planned operative treatment. The suggested method increases the quality and the economy of management of surgical patients. PMID- 1779541 TI - [Use of prolonged peridural block in reconstructive-restorative surgery of the esophagus]. PMID- 1779542 TI - [Diagnosis and surgical treatment of rectal incontinence]. PMID- 1779543 TI - [Correction of cellular and humoral defense reactions in the surgical treatment of acute cholecystitis]. AB - Complex study of cellular and humoral defense reactions in patients with acute cholecystitis revealed a decrease in their level, decelerated change of the neutrophil phase to the mononuclear phase, and increased metabolic phagocyte activity in the focus of affection. In the postoperative period the indices of cellular and humoral nonspecific reactions of the blood reduced still more, the level of leukocyte viability and the micro- and macrophage functional activity in the focus of affection remained diminished. The use of extracorporeal prognostic immunostimulation in combination with plasmapheresis corrects the immunodepression within a short time but fails to change the local defence reactions. Transposition of the extracorporeally stimulated auto-immunocytes to the inflammatory focus ensures a high level of local defense reactions and promotes readaptation of the immune system as a whole. PMID- 1779544 TI - [Cholelithiasis in congenital cysts of the hepatic ducts]. AB - The article describes two cases (0.04%) of congenital cystic cholangiectasia complicated by cholelithiasis, which was revealed among 4,800 patients who underwent operation on the biliary tract. The disease was recognized during surgical intervention, retrograde cholangiopancreatography, and computed tomography. The authors carried out hepatoenterostomy with the use of a loop of the small intestine excluded after Roux and formation of choledochoduodenal anastomosis. Biliodigestive anastomoses create good conditions for the passage of bile and concrements from the ducts. PMID- 1779545 TI - [Reparative and reconstructive surgery of the bile ducts]. AB - Fifty-three restorative and 61 reconstructive operations were carried out in 108 patients, 12 of them for the first time and 102 for the second time. The most frequent reasons for the operation were cicatricial strictures of the duct after an iatrogenic injury. The highest reliability of the intervention is attained by exact establishment of the diagnosis, timely intervention, approximation of the walls of the organs which are sutured, and adequate drainage. PMID- 1779546 TI - [Duodenoscopic interventions on the terminal part of the choledochus]. AB - The results of various methods of duodenoscopic interventions on the terminal choledochus in 261 patients with papilla stenosis and choledocholithiasis were analysed. Endoscopic papillosphincterotomy by the cannulation method was performed in 107 patients, endoscopic papillosphincterotomy with preincision of the major duodenal papilla in 31, and endoscopic suprapapillary choledochoduodenostomy in 123 patients. The performance of various methods of duodenoscopic interventions according to indications made it possible to increase the possibility of conducting the operation to 98% and its efficacy to 95%. Complications after duodenoscopic interventions occurred in 10% of cases with 1.2% lethality. The late results of duodenoscopic interventions were good in 85.5% of cases irrespective of the mode of the operation. PMID- 1779547 TI - [Characteristics of manifestations of calculous cholecystitis in men]. AB - Analysis of the features of calculous cholecystitis in 522 females and 106 males showed that acute cholecystitis takes a course which is more severe and acute in males than in females. Its gangrenous forms were encountered more often in males, which was an indication for more frequent emergency operations. In males the process was complicated by obstructive jaundice more frequently. In females acute cholecystitis was attended more frequently by peritonitis and was often combined with pancreatitis. Chronic cholecystitis also had some distinguishing features. Chronic indurative pancreatitis and hydrops of the gallbladder were encountered more often in females. The mortality in the abnormality was higher among males. PMID- 1779548 TI - [Clinical-experimental bases of the use of antioxidants in the treatment of mechanical jaundice]. AB - The results of clinical (200 patients) and experimental (30 dogs) studies reported by the authors show that lipid peroxidation in obstructive jaundice plays an essential role in hepatic functional and morphological abnormalities. Current examination methods were used which confirmed the well-known pathophysiological abnormalities in the body of patients with obstructive jaundice leading to marked hypoxia of hepatocytes and proved that lipid peroxidation is significantly intensified in a liver affected by subhepatic cholestasis. The authors suggest their own conception of the pathophysiological and biochemical shifts in the organism of a patient with obstructive jaundice which are capable of causing stimulation of lipid peroxidation and accumulation of highly toxic products of this process in the body. A scheme of prevention and treatment of hepatic insufficiency is suggested for practical surgery by antioxidants of direct and mediated action which were selected from a series of drugs currently in use. PMID- 1779550 TI - [Diagnosis and treatment of benign tumors of the gallbladder]. AB - The article generalizes experience in the treatment of 226 patients with benign tumors and preneoplastic diseases of the gallbladder, who underwent cholecystectomy. The increased number of patients with the disease is noted, they accounted for 12.77% of all patients who were operated on for gallbladder diseases. Females 40 to 60 years of age have the disease most frequently. In most cases (n = 190) it is seen with calculi. In the absence of concomitant pathological conditions it is generally asymptomatic. The diagnosis is based on instrumental examination. Ultrasonic examination in combination with cholecystography is preferable. Operation is the recommended method of treatment. PMID- 1779549 TI - [Gallstone ileus in cholecystoduodenal fistula]. AB - Operations were performed on 15 patients with obturation gallstone ileus, 8 of them had a cholecystoduodenal fistula and the authors analysed their case records. It is most difficult to establish the diagnosis of the subacute form of the disease which is caused by slow movement of the stone in the intestine, which conceals the clinical picture and leads to delay of operation. The operation of choice is resection of the small intestine together with the stone or enterotomy with obligatory evacuation of contents from the proximal parts of the intestine. The mortality in the group of patients operated on later than on day 4 after the onset of the disease is very high and, according to our data, it is 100%. An obligatory condition of the operation is evacuation of the contents from the intestine in order to reduce intoxication and prevent endotoxic shock. PMID- 1779551 TI - [Acute cholecystogenic suppurative cholangitis]. AB - The authors discuss the results of clinical, instrumental, and microbiological examinations of 240 patients suffering from purulent cholangitis in acute cholecystitis. Choledocholithiasis was the main cause of the development of purulent cholangitis in 90.8% of patients. A classification of cholangitis and the clinical signs of the disease are dwelt upon. Endoscopic decompression of the biliary tract in the preoperative period is an obligatory condition for performing laparotomic operation. A complex of detoxification measures and general and local (prolonged flow dialysis of the biliary tract) antibacterial therapy are indicated in the postoperative period. All the measures led to decrease of mortality rates in cholecystogenic purulent cholangitis from 19.5 to 6.2%. PMID- 1779552 TI - [Gallstone ileus]. AB - The authors discuss 25 patients with gallstone ileus, which is a quite frequently encountered complication of cholelithiasis and is recorded in 0.64% of patient who underwent operation for calculous cholecystitis. The diagnosis and treatment of this complication have some specific features whose knowledge is extremely important in rendering emergency surgical care. Better results can be achieved by a timely and adequate diagnosis, individual choice of the operative method, and subsequent follow-up of the patients who were operated on. Regular medical examination and planned preventive treatment of patients with cholelithiasis are the main trends in the prophylaxis of this disease. Postoperative mortality was 24%. PMID- 1779553 TI - [Diagnosis and treatment of acute pancreatitis]. AB - From study of 549 patients with various forms of acute pancreatitis (AP) the authors conclude that membrane disorders occur in these patients, in which case membrane modulators, products of lipid peroxidation (PLO) among others, play an inducing role. In addition to the routine clinical data, of great significance for the diagnosis of AP are laboratory findings on lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, endogenous enzymes, transamidinase, concentrations of free kinins, blood coagulative system, study of free radical oxidation of lipids, beta-lipoprotein levels, etc. The authors recommend a wider use of fatty emulsions with heparin and intraarterial infusion of agents in the generally accepted complex of therapeutic measures. Operative treatment is usually indicated in approximately 20% of cases. PMID- 1779554 TI - [Draining surgery of the main biliary tract in the surgical treatment of chronic and acute pancreatitis]. AB - The authors studied the site of draining operations on the biliary tract in 160 patients with biliary pancreatitis. Among 64 patients with chronic pancreatitis 41 (64.1%) were subjected to various draining operations on the biliary system, one patient died. In a group of 96 patients with acute biliary cholecystitis 47 (48.8%) underwent internal drainage of the biliary tract and 49 (51.1%) patients were treated by external drainage. Four patients died. The late-term results were studied in 25 patients of each group: in group 1 the results were good in 22, satisfactory in 2, and poor in 1 patient; in group 2 the respective results were encountered in 19, 4, and 2 patients. The authors claim that various draining operations on the common bile duct are conductive to improvement of the immediate and late-term results of treatment of various forms of biliary pancreatitis. PMID- 1779555 TI - [Pancreatitis associated with diseases of the stomach, duodenum and biliary tract]. AB - The authors studied experience with simultaneous operations in 39 patients with coexisting diseases of the stomach, duodenum, biliary tract, and pancreas. A total of 31 operations were carried out in 14 patients with various forms of acute pancreatitis and 54 in 25 patients with chronic pancreatitis. One patient died in the immediate postoperative period from destructive postoperative pancreatitis. Simultaneous operations can be conducted under conditions of modern anesthesiological and intensive care without increasing mortality rates, which contributes to improvement of the immediate and late results of treatment of patients with concomitant digestive diseases. PMID- 1779556 TI - [Clinico-morphological signs of different forms of destructive pancreatitis]. AB - Clinicomorphological comparisons in 434 cases of destructive pancreatitis showed that macroscopic signs of destruction develop in the first 12 hours from the onset of the attack. The elaborated criteria make it possible to evaluate the main morphological components of destructive pancreatitis--pancreonecrosis proper, parapancreatitis, peritonitis, and "polyvisceritis" and to use therapeutic measures on an individual basis. PMID- 1779558 TI - [Lasers and plasma scalpel in the surgery of hepatic echinococcosis]. AB - A plasma surgical device and a CO2-laser device were used in operative treatment of 46 patients with hydatid disease of the liver; in 25 in the patients these measures were combined with exposure to low-energy helium-neon laser radiation. The patients' condition improved more rapidly, the frequency of postoperative complications reduced, the term of postoperative hospital stay of the patients decreased. The fibrous capsule was studied morphologically before and after manipulations with the laser and plasma scalpel. PMID- 1779557 TI - [Surgical tactics in associated echinococcosis of the liver and lung]. AB - Over 10 years operations were conducted in 28 patients with hydatid disease with concurrent involvement of the liver and lungs, which accounted for 5.76% of all patients with hydatid disease of the thoracic and abdominal organs. The following variants were encountered: uncomplicated echinococcosis of the right lung and right hepatic lobe (13 patients); uncomplicated echinococcosis of the left lung and liver (3); suppurative hydatid cyst of the liver with rupture into the pleural cavity and the development of pyothorax (9); rupture of a hepatic hydatid cyst into the bronchial tree of the right lung with the development of a cysto bronchial fistula (3 patients). In the group of 28 patients with concurrent involvement of the liver and lung 18 were operated on through a thoraco-phreno laparotomic approach, 9 through a transpleural approach, and one patient underwent a two-stage operation. The success of the treatment is determined by early recognition of the concurrent echinococcosis and the choice of the optimal surgical tactics. One-stage echinococcotomy from the liver and lung is the operation of choice in concurrent affection of the liver and right lung. PMID- 1779559 TI - [Surgical treatment of hepatic echinococcosis using carbon dioxide laser]. AB - The results of using the laser scalpel in surgery for echinococcosis of the liver in 68 patients are discussed. It was established that carbon dioxide laser induces coagulation of small blood vessels and intrahepatic bile ducts and thus prevents postoperative complications like bleeding and escape of bile, destroys live protoscoleces, and has a harmful effect on the microflora. This creates favourable conditions for shortening the period of treatment for patients with echinococcosis. PMID- 1779560 TI - [Treatment of different variants of the mixed form of portal hypertension]. AB - Among 425 patients who were under observation for portal hypertension 72 (16.9%) had its mixed form. Thrombosis of the portal vein in liver cirrhosis occurred in 6 patients. Marked hepatic fibrosis caused by obstruction of the portal vein was encountered in 14 patients. Compression of the hepatic segment of the inferior vena cava was found in 44 patients with cirrhosis of the liver. Nutmeg cirrhosis developed in 8 patients in prolonged disorder of venous flow from the liver. Coexistence of pre- and intrahepatic forms of portal hypertension occurred in the first two situations and coexistence of intra- and suprahepatic forms in the second two. The variety of mixed forms of portal hypertension should be borne in mind in choosing the method of operative treatment and defining its prognosis. PMID- 1779561 TI - [Long-term results of the embolization of the hepatic and splenic arteries in liver cirrhosis]. AB - The authors studied the long-term results of portal hypertension correction in patients with far-advanced stages of cirrhosis of the liver. Embolization of the hepatic and/or splenic arteries was performed in 231 patients (147 males and 84 females) aged from 17 to 70 years. Sixty-seven patients are alive at present, the average duration of the follow-up period is 57.9 +/- 19.8 months. Four patients were not followed up; 160 patients died, 18 (7.8%) of them within 30 days after an endovascular manipulation. The mean survival of patients who were discharged from the clinic was 21.1 +/- 17.4 months. Survival was higher among patients treated by successive embolization of the hepatic and splenic arteries than in those treated by occlusion of one of these vessels. Comparative analysis showed that embolization of arteries of the hepatolienal zone prolongs the life of patients with complicated forms of portal hypertension in cirrhosis of the liver. PMID- 1779562 TI - [State of the liver in patients with obesity at distant periods after formation of a "small stomach"]. AB - Histological study of biopsy specimens taken from the liver of 96 patients during operation for formation of a "small stomach" revealed fatty dystrophy of the liver in 93 patients (96.9%) which was attended by marked inflammatory and fibrous changes in 68 (70.8%) of them and by disturbed lobar structure of the liver (cirrhosis) in 2 patients (2.1%). Biochemical blood tests failed to show the pattern of the pathological changes before the operation. Study of the hepatobiliary system with methionine-75Se was the only method by which protein and pigment metabolism in the liver could be appraised. Examination of patients during 3 postoperative years showed a positive dynamics of changes in biochemical blood tests and improved protein metabolism in the hepatocytes according to the results of scanning of the liver with methionine-75Se. Thirteen repeated studies of the hepatic tissue collected from patients in different periods after operation for the formation of a "small stomach" showed a significant diminution of fatty dystrophy and inflammation of the parenchyma. The level of portal tract inflammation and portal fibrosis did not change. The findings suggest that there is an improved functional and morphological condition of the liver in weight loss caused by operation for the formation of a "small stomach", which allows this type of surgical intervention to be recommended for the treatment of patients with alimentary-constitutional obesity and initially diminished compensatory capacities of the liver. PMID- 1779563 TI - [Decompression of the biliary tract in acute cholangitis]. AB - Analysis of the results of treatment of 152 patients with acute cholangitis of benign origin made it possible to substantiate two-stage therapeutic tactics consisting in instrumental decompression at the peak to the disease and a corrective intervention conducted after removal of the clinical manifestations of ascending biliary infection and cholemic intoxication. The two-stage method of treatment of acute cholangitis allowed the frequency of purulent complications of hepatic insufficiency to be reduced and the postoperative mortality to be lowered six fold. PMID- 1779564 TI - [Surgical risk: some problems and methods of analysis]. AB - A decision made by a surgeon in a risk situation differs basically from his action under condition of a necessity (extreme necessity). If the former situation is characterized by the existence of an alternative and a choice (the possibility of avoiding the infliction of harm to the patient), in the latter situation of extreme necessity (when there is no choice), in contrast, such a possibility is absent--the harm is inevitable. The property of the risk--the discrepancy between the objectively existing risk situation and its subjective evaluation--compels the surgeons to evaluate it mainly on the basis of their own experience--on the level of opinion. At present attempts are made to determine the value of the operative risk in the form of a matrix, estimation expressions, "tree of decisions", score counting and mathematical-statistical methods. An effective, sufficiently simple classification of operative risk criteria may promote the solution of an adequate scientific evaluation of the degree of the operative risk. The problem of the operative risk may be solved only on the basis of an interdisciplinary approach. PMID- 1779565 TI - [Anesthesia and the cardiovascular system]. PMID- 1779566 TI - [Temporary mechanical circulatory assist: pumps with continuous or phasic blood flow]. PMID- 1779567 TI - [Anesthesiologic problems of heart-(lung-)transplantation]. PMID- 1779568 TI - [Anesthesia considerations in heart valve diseases (including valve reconstruction and replacement)]. PMID- 1779569 TI - [Anesthetics and coronary circulation]. PMID- 1779570 TI - [Hemodynamics of congenital heart defects]. PMID- 1779571 TI - [Anesthesiologic aspects of the correction of congenital heart defects in newborn and young infants]. PMID- 1779572 TI - [Myocardial protection and reperfusion injury]. PMID- 1779573 TI - [Extracorporeal circulation. Monitoring and protection of brain function]. PMID- 1779574 TI - [Extracorporeal circulation. Management of heparinization, mechanical ventilation and acid-base status]. PMID- 1779575 TI - [Anesthesiologic aspects of aneurysms of the thoracic aorta]. PMID- 1779576 TI - [Monitoring and anesthesia problems in carotid surgery]. PMID- 1779577 TI - [Anesthesia and the cardiovascular system. Perioperative anti-arrhythmic therapy and pacemaker management]. PMID- 1779578 TI - [Anesthesia and the cardiovascular system. Status and future of hemodynamic monitoring]. PMID- 1779579 TI - [Anesthesiologic considerations in patients after heart transplantation]. PMID- 1779580 TI - [Volatile anesthetics in coronary disease]. PMID- 1779581 TI - [Coronary disease and arterial hypertension. Preoperative risk estimation and pretreatment]. PMID- 1779582 TI - [Anesthesia considerations in patients with coronary disease and hypertension]. PMID- 1779583 TI - [Anesthesia considerations in heart surgery]. PMID- 1779584 TI - [Preoperative risk estimation and drug therapy in chronic heart insufficiency]. PMID- 1779585 TI - [Anesthesia and perioperative drug therapy considerations in myocardial insufficiency]. PMID- 1779586 TI - [Anesthesiologic and therapeutic considerations in right heart insufficiency]. PMID- 1779587 TI - [Home nursing care (V). Enteral feeding]. PMID- 1779588 TI - [Home nursing care (V). Ostomy care]. PMID- 1779589 TI - [Home nursing care (V). Home care for mental disorders]. PMID- 1779590 TI - [Strategy for high technology home care]. PMID- 1779591 TI - [Home health care in general hospitals]. PMID- 1779592 TI - [Specialization in nursing and professional control]. PMID- 1779593 TI - [Are we using too much betadine?]. PMID- 1779594 TI - [Case study of a patient with Parkinson's disease]. PMID- 1779595 TI - [Home nursing care (V). Home care for the terminal]. PMID- 1779596 TI - [A four year study of the personal and interpersonal value systems of freshman nursing students at Yonsei University]. AB - The purpose of this study was to determine the values of freshman nursing students and to determine changes each year over the four years of the study and to provide base data for curriculum and student guidance. The sample consisted of the freshman students who entered college of nursing from 1988 through 1991. The total sample was 358 students and data were collected during March of each of the four years. The data were analyzed using t-test, ANOVA and Pearson Correlation to examine the relationship between the subcategories of values and Duncan multiple range test to examine the relationship between the scores for each year and the demographic data. The instrument used in this study was the Survey of Personal Values and Interpersonal Values modified by UngYun Hwang and KyungHae Lee in accordance with L.V. Gordon's instrument. This tool provides scores on practical mindedness, achievement, variety, decisiveness, orderliness, goal orientation, support, conformity, recognition, independence, benevolence and leadership. The results of the study were as follows: 1. The nursing freshman students surveyed had the highest score for goal orientation (21.44) and the lowest for variety (17.13) on the SPV (Survey of Personal Values) and the highest score for benevolence (21.19) and lowest for leadership (17.00) on the SIV (Survey of Interpersonal Values). In accordance with the standardized scores for Gordon's SPV for other woman college students, the students in the study were between the 78%ile-97%ile and were in the 72%ile-97%ile for the SIV. 2. When t-test scores were compared, no significant variation was found between the years for each of the values (P less than .05). 3. A significant variation was found on variety, between 1989 and 1991 (P less than .05), and between 1988 and 1991. The highest score was in 1991 in both comparisons. Supporting was also higher for 1991 than for 1988 (P less than .05). 4. Religion and occupation of father did not show any significant differences (P less than .05). There was no significant difference in values according to the student's religion or the occupation of their father. Students born in the metropolitan area had a higher score on variety than those from the rural area and vice versa on regularity (P less than .05). The results of this study show that there is a higher score on values for Y University freshman than shown for freshmen in other universities reported from other research. To keep or promote values, it is very important that there be a systematic strategy of education and special educational programs. PMID- 1779597 TI - [A study for womanhood and caring]. AB - This study is to explore the womanhood and caring. To explore the meaning of caring for nursing, it is necessary to identify the terms of the relationship between caring and womanhood as these bonds have been formed over the last century. Historically, nurses were expected to act out of on obligation to care, taking on Caring more as an identity than as work, and expressing altruism without, thought of autonomy either at the bedside of in their profession. Not only did the role of nursing evolve from the mother's role in the family, but the family itself served as a modal for care in the hospital. Thus, Nurses, like others who perform what is defined as "womens'work" in own society, have had to content with what appears as a dichotomy between the duty to Care for others and the right to control their own activities in the name of caring. Nursing was to be, therefore, a woman's duty, not the job. Obligations and love, not the need of work, were to bind the Nurses bo her patient. Caring was to be an unpaid labour of Love Gender studies suggests a basis for caring the stresses individual discretion and values, acknowledging that the Nurses'right to Care should be given equal consideration with the physician's right to Cure. Nursing continues to struggle with the basis, and the value of caring. But the dilemma of nursing is too tied to society's broader problems of gender and class. Nurses will have both to create a new political understanding for the basis of caring and to find ways to gain the power to implement it.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779598 TI - [The trends and issues of Korean nursing education through a historical perspective]. PMID- 1779600 TI - Multiple organ failure (MOF) after intestinal operations--a clinical and statistical study of the past 5 years. AB - Multiple Organ Failure that occurred in 35 cases out of a total of 1498 cases after intestinal surgery were studied by an analysis of the clinical and statistical data from the past 5 years (1984-1988). 1. The incidence of MOF after intestinal surgery was 2.3%. 2. Twenty-eight of MOF resulted from severe infections. 3. The incidence of infection was highest after esophageal operations. 4. Hepatic failure was the most common type of primary organ failure and renal failure was the second most common. 5. The prognosis for MOF was very poor with a survival rate of 8.7%. PMID- 1779599 TI - Arachidonate metabolism in bovine gallbladder mucosa. AB - Incubation of [1-14C] arachidonicacid (AA) with homogenates of bovine gallbladder mucosa in the presence or absence of reduced glutathione (GSH) generated large amounts of products that cochromatographed with PGE2 and 6-keto-PGF1 alpha and small amounts of products comigrating with PGF2 alpha, TxB2 and PGD2. In the presence of GSH PGE2-like material was predominantly produced while in the absence of GSH 6-keto-PGF1 alpha-like material was a major product. Identification of PGE2 was performed by its chemical conversion with NaBH4 or KOH treatments and by gas chromatography-mass spectrometry. Identification of 6-keto PGF1 alpha was confirmed by gas chromatography-mass spectrometry. Gallbladder muscle produced predominantly 6-keto-PGF1 alpha in the presence or absence of GSH. The total amount of cyclooxygenase products was approximately 2 times higher in the mucosa than in the muscle. These results indicate that bovine gallbladder mucosa contains higher levels of fatty acid cyclooxygenase, and PGE2 isomerase and PGI2 synthetase in a proportion different from that in the muscle. PMID- 1779601 TI - Reoperation for acquired valvular heart disease--operative method and surgical results. AB - Between January, 1982 and December, 1989, 102 reoperations (repeat median sternotomy) in 101 patients with valvular heart disease were performed at Kurume University Hospital. In these operations, the heart was not mobilized from the pericardium to prevent tearing the heart or great vessels. All operative procedures were performed through the pericardium which adhered tightly to the heart. Adequate left ventricular hypothermic protection was obtained without total dissection of the heart by cold crystalloid cardioplegic solution and topical cooling which was accomplished by filling the left pleural space with cold saline during the operation. As to the surgical results, the early mortality rate was 4.0%, and the late mortality rate was 5.2%. The causes of death were not related to the operative procedures or perioperative myocardial protection. There was no significant difference in the early mortality rate between the reoperations and the initial operations. These results suggest that reoperation for valvular heart disease should be performed before the hemodynamic condition of the patient deteriorates. PMID- 1779602 TI - An evaluation of long-term results over 10 years after intracardiac repair of tetralogy of Fallot. AB - A follow-up study was conducted of 166 patients who had survived for more than 10 years after total correction of tetralogy of Fallot. The total number of patients in NYHA class I was 141 (85%); the other 25 patients had been medically treated or had followed a prudent life style. The factors which caused postoperative symptoms were residual lesions and ventricular arrhythmia. Ultrasonic echocardiography showed that among 72 patients with transannular patch, 68 (95%) showed moderate or severe pulmonary incompetence. There was a correlation of gamma = 0.43 between the severity of pulmonary incompetence and cardiothoracic ratio in the 48 patients without any residual lesions, while two cases with severe pulmonary incompetence showed obvious right ventricular failure. Ambulatory ECG monitoring was employed to study 53 patients. As a result, 21 patients were found to present solitary moderate or severe pulmonary incompetence, while premature ventricular contraction of Lown's grade 4A was seen in nine patients (42.9%). In conclusion, it is considered essential to carefully follow up patients after intracardiac repair of tetralogy of Fallot, especially those with severe pulmonary incompetence. PMID- 1779603 TI - Comparative vascular anatomy of the hip of the miniature dog and of the normal size mongrel. AB - In order to investigate the aetiology of Perthes' disease in the dog the author has conducted a comparative anatomical study of the vascular system of the femoral heads in miniature dogs and in normal-size mongrels. The study was made in five three-months old miniature dogs and five age-matched normal-size mongrels, in which the epiphyseal plate of the femoral head was still open. The most distinct difference between the two species was in the channel of the superior retinacular vessels. In miniature dogs, these vessels go through the shallow neck and appear as a "suspended bridge". In normal-size mongrels they go through the deep fossa of the femoral neck and appear to be very rigidly stable. Although foveolar vessels in the round ligament were present in both species, no vessels were found in either species reaching the epiphysis by penetrating the articular cartilage at this stage of development. PMID- 1779604 TI - Clinical analysis of traumatic subarachnoid hemorrhage. AB - Traumatic subarachnoid hemorrhage (TSAH) is regarded as a poor prognostic factor of primary brain stem injury. The aim of the present study is to describe the results of a clinical analysis of 15 patients with TSAH who were hospitalized between March, 1987 and April, 1990. They were classified into three groups on the basis of the initial level of consciousness evaluated by Glasgow Coma Scale (GCS) scores. Fourteen patients had TSAH in the sylvian fissures, while in five the location was the cortical sulci. Four patients had TSAH in the ambient and quadrigeminal cisterns, and another four patients had TSAH in the prepontine and interpeduncular cisterns. TSAH localized to the suprasellar cistern was found in three patients, and five patients were found to have TSAH only in the sylvian fissures. Other accompanying intracranial lesions were as follows: acute subdural hematoma in five patients. Intracerebral hematoma in four and cerebral contusion in three. Three patients, one in the severest group and two in the severe group, had fatal outcomes. The cause of death was more closely associated with the accompanying intracranial lesion than the TSAH. One patient had a fair outcome, and 11 patients had a favorable outcome. In the present study, the outcome was generally good in the patients who had TSAH in a confined area, such as the sylvian fissures or cortical sulci. PMID- 1779605 TI - Long-term results of immunochemotherapy for advanced ovarian cancer. AB - Fifty-one patients with stage III and IV ovarian adenocarcinoma underwent initial cytoreductive surgery at Kurume University Hospital between January 1982 and October 1985. They were assigned postoperatively by randomized trials to immunochemotherapy or chemotherapy alone. Of all 51 patients, long-term results of immunochemotherapy for 43 patients were evaluated versus radicality of initial cytoreductive surgery. As a result, the group of patients treated with immunochemotherapy tended to have a better prognosis than the group of patients treated with chemotherapy alone, whereas no statistical difference was observed between the two groups. Moreover, no significant difference was observed in the monitoring of OKT 4/8 ratio between the two groups. However, immunochemotherapy produced a favorable prognosis in the patients with residual disease of greater than 2 cm in diameter at initial surgery. In conclusion, these data suggested that immunochemotherapy may have some impact on survival of patients with ovarian adenocarcinoma. PMID- 1779606 TI - Early gastric cancer following gastrojejunostomy without gastrectomy. AB - Two rare cases involving distal gastrectomies for gastric cancer after an earlier gastrojejunostomies without gastrectomy for duodenal or gastric stricture due to a duodenal or pre-pyloric ulcer are reported. The time interval between the initial gastrojejunostomy and the resection of the distal stomach with gastrojejunal stoma were 17 and 36 years. One patient underwent reconstruction by Billroth II and the other by Roux-en-Y end-to-side gastrojejunostomies, both retrocolically without any peri or postoperative complications. The histological classification was confirmed for both as type IIc mucosal early gastric cancer. Only 6 other primary early gastric cancers following gastrojejunostomies without gastrectomy have been reported in the Japanese literature. PMID- 1779607 TI - Early mucosal gastric cancer with extra-perigastric (n2) lymph node metastasis. AB - During the 10 years from 1977 to 1986, a total of 314 cases of early gastric cancer were resected. Of these, 43 (14%) had lymph node metastases, with 6 cases of mucosal (m-) cancer and 37 of submucosal (sm-) cancer. Among the patients with positive lymph node metastases, 37 (86%) had metastases in the Group 1 regional lymph nodes. Eight patients had metastases in the Group 2 lymph nodes, and these involved 2 cases of m-cancer and 6 of sm-cancer. Lymph node metastasis is generally believed to occur in only about 3% of m-cancer, and then mainly in the Group 1 lymph nodes. Here, 2 rare cases of early gastric m-cancer with positive extra-gastric lymph node metastasis are reviewed in detail, with special attention to the surgical management. PMID- 1779608 TI - A sequential immunosuppressive treatment with mizoribin (Bredinin) plus cyclosporin A on the subrenal capsule assay. AB - To minimize immunological interferences on the subrenal capsule (SRC) assay, a new immunosuppressor, mizoribin (MZB: Bredinin) alone or combined with cyclosporin A (ScA) was evaluated by an experimental SRC assay system using a rat ovarian cancer tissue. Daily applications of MZB (200 mg/kg) for 7 days following the xenograft of cancer tissue were insufficient to suppress immunological reactions of the recipient mice, and all the grafted cancer tissues were rejected. Although CsA monotreatment (60 mg/kg of CsA given daily for 7 days) successfully suppressed the host immune reaction, enhanced toxicities of CsA in combination with anticancer agents caused high lethal rate of host mice during the experimental chemotherapy. Sequential use of CsA on day 0 to day 2 followed by MZB on day 3, 5 and 7 brought the most favorable results with minimal host reactions and toxicities. An anticancer screening test using the modified SRCA accurately reflected the results of experimental chemotherapy against the rat ovarian cancer. The immunosuppressive treatment which minimizes immunological interferences with SRC assay chemoscreening test. PMID- 1779609 TI - Anomalous origin of the right coronary artery associated with congenital bicuspid aortic valve. AB - Anomalous origin of the right coronary artery is an infrequent anomaly. A case with anomalous origin of the right coronary artery from the ascending aorta above the left sinus of Valsalva is described. This patient was also found to have a bicuspid aortic valve. The aortic valve was markedly calcified and stenotic. The aortic valve was replaced with a St. Jude Medical prosthesis. PMID- 1779610 TI - Stable isotope dilution analysis of N-acetylaspartic acid in CSF, blood, urine and amniotic fluid: accurate postnatal diagnosis and the potential for prenatal diagnosis of Canavan disease. AB - A sensitive and selective analytical technique is described for the determination of N-acetylaspartic acid in body fluids using stable isotope dilution in combination with positive chemical ionization mass spectrometry with selected ion monitoring. Control mean and ranges have been established: in urine 19.5 and 6.6 35.4 mumol/mmol creat.; in plasma 0.44 and 0.17-0.81 mumol/L; in cerebrospinal fluid 1.51 and 0.25-2.83 mumol/L; and in amniotic fluid 1.27 and 0.30-2.55 mumol/L. In a patient with Canavan disease, N-acetylaspartic acid concentration was elevated 80-fold in urine and 20-fold in plasma compared to the control means. A subsequent pregnancy of the mother was monitored and the N acetylaspartic acid concentration in the amniotic fluid was within the control range and a healthy child was born. PMID- 1779611 TI - Rapid diagnosis of medium-chain acyl CoA dehydrogenase deficiency by measurement of cis-4-decenoic acid in plasma. AB - Plasma concentrations of octanoate and cis-4-decenoate were measured by gas chromatography-mass spectrometry in children with deficiencies of medium-chain acyl-CoA dehydrogenase (MCAD), long-chain 3-hydroxyacyl-CoA dehydrogenase (3LHAD) and multiple acyl-CoA dehydrogenase (MAD) deficiency. Children receiving medium- and long-chain lipid supplements were also studied. Octanoate was elevated in all but one of the children with MCAD deficiency, in MAD deficiency and in children receiving medium-chain triglyceride supplementation. Cis-4-decenoate was only elevated in MCAD and MAD deficiency. It is concluded that measurement of plasma cis-4-decenoate provides a sensitive and specific test for defects of medium chain acyl CoA dehydrogenase. PMID- 1779612 TI - Organic acids in aqueous humour and plasma: post mortem study in infants and diagnosis of enzymopathies. AB - Organic acids have been determined in aqueous humour and plasma by gas chromatography-mass spectrometry in 38 cases of infant death and 4 cases of inherited metabolic disease: one had a complex fatty-acid oxidation disorder with a large urinary excretion of adipic acid, the others had a disorder of propionate catabolism with a large urinary excretion of methylmalonic acid. In each case we found in aqueous humour the abnormal metabolite present in urine. Thus aqueous humour could be a suitable material for retrospective diagnosis of inherited metabolic diseases at autopsy in sudden infant death syndrome. PMID- 1779613 TI - Long-chain 3-hydroxyacyl-CoA dehydrogenase deficiency. PMID- 1779614 TI - Pristanic acid does not accumulate in peroxisomal acyl-CoA oxidase deficiency: evidence for a distinct peroxisomal pristanyl-CoA oxidase. AB - The concentration of pristanic acid was measured in plasma from a patient with an isolated peroxisomal very long chain fatty acid (VLCFA) acyl-CoA oxidase deficiency, a defect in peroxisomal beta-oxidation resulting in accumulation of VLCFA in plasma and tissues. Although peroxisomes are believed to be involved in pristanic acid beta-oxidation, the pristanic acid level in the patient's plasma was within the control range. This finding provides evidence for the existence of a pristanyl-CoA oxidase distinct from the specific trihydroxycholestanoyl-CoA and VLCFA acyl-CoA oxidases. PMID- 1779615 TI - N-acetylglutamate synthetase deficiency: clinical and laboratory observations. AB - Two male siblings presented in the first 6 weeks of life with emesis, diarrhoea, metabolic acidosis and lethargy. A male sibling had previously died at 14 months of age from liver failure of unknown aetiology. Both of the current cases had mild hyperammonaemia with normal orotic acid, organic acid and argininosuccinic acid levels. Citrulline and arginine levels were normal or mildly decreased. One of the brothers was biopsied and had no detectable N-acetylglutamate synthetase activity and normal values for other enzymes of the urea cycle in liver. Treatment with a low-protein diet and sodium benzoate/sodium phenylacetate resulted in near normal blood ammonia levels, except during viral illness. Subsequent neurological development has been normal to mildly delayed. These patients differ from those previously described with N-acetylglutamate synthetase deficiency in that their presentation and subsequent course were relatively benign. PMID- 1779617 TI - Fifteen years' experience with 212 hyperammonaemic cases at a metabolic unit. PMID- 1779616 TI - Possible deleterious effect of L-carnitine supplementation in a patient with mild multiple acyl-CoA dehydrogenation deficiency (ethylmalonic-adipic aciduria). AB - A patient with riboflavin-responsive mild multiple acyl-CoA dehydrogenation deficiency of the ethylmalonic--adipic aciduria type experienced a recurrence of spontaneous hypoglycaemic episodes whilst being given supplementary L-carnitine. This phenomenon is explicable in terms of the known biochemical features of this condition and suggests caution in the carnitine supplementation of patients with defective oxidation of medium- or short-chain fatty acyl-CoA esters. This patient excreted excessive phenylpropionylglycine after an oral phenylpropionic acid load. Thus the phenylpropionic acid loading test is not completely specific for primary medium-chain acyl-CoA dehydrogenase deficiency as has been supposed. PMID- 1779618 TI - Uptake and metabolism of radiolabelled GM1-ganglioside in skin fibroblasts from controls and patients with GM1-gangliosidosis. AB - The uptake and metabolism of [3-3H-sphingosine]GM1-ganglioside was measured in cultured skin fibroblasts from controls and patients with infantile, juvenile and adult GM1-gangliosidosis. When dissolved in medium with phosphatidylserine, GM1 ganglioside was efficiently taken up by cultured skin fibroblasts and transferred into lysosomes. A linear increase in GM1-ganglioside endocytosis was shown with phosphatidylserine concentrations of up to 40 micrograms/ml. A pulse-chase study revealed that [3H]GM1-ganglioside was metabolized to GM2-ganglioside, GM3 ganglioside, ceramide dihexoside, ceramide monohexoside, ceramide and sphingosine. Sphingosine was recycled to sphingomyelin. In a 20-h pulse study, cell lines from patients with GM1-gangliosidosis of infantile, juvenile and adult types hydrolysed 2-5%, 20-44% and 54-58% of the total endocytosed GM1-ganglioside respectively. These values were lower than in control cells (64.17 +/- 5.43% (n = 10]. The hydrolysis rates of exogenous [3H]GM1-ganglioside in cultured fibroblasts from patients with various types of GM1-gangliosidosis closely reflected the clinical severity. PMID- 1779619 TI - A comparative study of sialyloligosaccharides isolated from sialidosis and galactosialidosis urine. AB - Sialic acid-containing carbohydrates were isolated from sialidosis urine by a combination of gel-filtration on Bio-Gel P-6 and medium-pressure anion-exchange chromatography on Mono Q. The Mono Q fractions were subjected to 500-MHz 1H-NMR spectroscopy, sugar analysis and analytical HPLC on Lichrosorb-NH2. These methods indicated the presence of various N-acetyllactosamine type sialyloligosaccharides differing from each other in branching pattern and sialic acid linkage types. Among the structures were fully and partially sialylated mono-, di-, tri- and tetra-antennary compounds. A comparison with the results from galactosialidosis urine indicated that essentially the same carbohydrates were present in both urines, but that the relative amounts of the various sialyloligosaccharides differ to some extent. Sialidosis urinary oligosaccharides contained relatively more alpha 2-6 linked sialic acid than oligosaccharides from galactosialidosis urine. It could be concluded that the additional beta-galactosidase deficiency in galactosialidosis did not influence the nature of the excreted material and that the sialidase deficiency determined completely the defective catabolism of glycoproteins in both sialidosis and galactosialidosis. PMID- 1779620 TI - Content of phenylalanine, tyrosine and their metabolites in CSF in phenylketonuria. AB - By using ion-exchange chromatography and gas chromatography coupled with mass spectrometry, the content of phenylalanine, tyrosine and their metabolites typical of phenylketonuria (PKU) was determined in the cerebrospinal fluid (CSF) of 8 untreated children with classical PKU and 9 controls. At the same time, plasma and urine were analysed. In PKU the content of phenylalanine is increased on average 23 times in plasma and CSF. The content of phenylalanine and tyrosine in CSF is about 4 times less as compared with plasma. The phenylalanine-to tyrosine ratio is approximately the same for these fluids both in control and in PKU. This indicates that the transport of phenylalanine and tyrosine through the blood-brain barrier is not disturbed in PKU. Phenylpyruvate and 4 hydroxyphenylpyruvate are either not detected or present in very low concentrations in the CSF of children with PKU; their derivatives, phenyllactate and 4-hydroxyphenyllactate, are present in relatively higher concentrations. This indicates increased metabolic conversion in brain tissues. PMID- 1779621 TI - Agoraphobia in phenylketonuria. AB - We describe agoraphobia as a complication of phenylketonuria (PKU) in young adults. The five patients have classic PKU and received phenylalanine-restricted diet only in childhood. Only one has normal intelligence. All but one were also depressed. All were anxious. Three of the five had initiated the phenylalanine restricted diet after 3 months of age. Two returned to the phenylalanine restricted diet with dramatic reduction of symptoms. The frequency of manifestations of agoraphobia was also examined in 50 young women with PKU enrolled in a longitudinal study of psychosocial factors in maternal PKU, 47 of their acquaintances and 49 women with diabetes. All were administered a test of agoraphobic-avoidant behaviour. The women with PKU appeared to be more prone to social withdrawal and fear of leaving home. Twenty per cent were within the agoraphobia range of the Mobility Inventory. Those still on diet and those with non-PKU hyperphenylalaninaemia reported less avoidant behaviour than those who had terminated the diet in childhood. These results suggest that young adults with PKU are at risk for agoraphobia but that return to the phenylalanine restricted diet may be an effective treatment. PMID- 1779622 TI - Chronic inflammatory bowel disease in glycogen storage disease type 1B. AB - Two children with glycogen storage disease type 1B developed chronic inflammatory bowel disease. The first, a 7-year-old boy, had ileitis and later developed perianal disease. The second developed colitis by the age of 9 years; in both the features were consistent with Crohn disease. The children had neutropenia and neutrophil mobility defects characteristic of GSD-1B. It is suggested that these neutrophil abnormalities are important in the pathogenesis of the bowel inflammation. PMID- 1779623 TI - Abnormal mRNA and inactive polypeptide in a patient with prolidase deficiency. PMID- 1779624 TI - Tyrosinaemia type III: immunochemical studies on 4-hydroxyphenylpyruvic acid dioxygenase and molecular cloning of cDNA for the enzyme. PMID- 1779625 TI - A four-nucleotide insertion at the E1 alpha gene in a patient with pyruvate dehydrogenase deficiency. PMID- 1779626 TI - Molecular analysis of mucopolysaccharidosis type VII. PMID- 1779627 TI - A new type of mitochondrial DNA deletion in patients with encephalomyopathy. PMID- 1779628 TI - Characterization and purification of human beta-galactosidase overexpressed in recombinant baculovirus-infected Spodoptera frugiperda cells. PMID- 1779629 TI - Molecular study of Duchenne and Becker muscular dystrophies in Japanese. PMID- 1779630 TI - A simple and sensitive method for the determination of pterins in cerebrospinal fluid. Clinical usefulness for management of tetrahydrobiopterin deficiency. PMID- 1779631 TI - Peliosis hepatis with type I glycogen storage disease. PMID- 1779632 TI - A difficult diagnosis of lysinuric protein intolerance: association with glucose 6-phosphate dehydrogenase deficiency. PMID- 1779633 TI - Non-ketotic hyperglycinaemia: a therapeutic approach. PMID- 1779634 TI - Valproate-induced lethal hyperammonaemic coma in a carrier of ornithine carbamoyltransferase deficiency. PMID- 1779635 TI - Isolated 3-methylcrotonyl-CoA carboxylase deficiency in a 16-month-old child. PMID- 1779636 TI - Erythematous skin lesions and partial deficiency of 3-methylcrotonyl-CoA carboxylase in peripheral lymphocytes in a patient with propionic acidaemia. PMID- 1779637 TI - Medium-chain triglycerides: a pitfall in the assay of organic acids in cerebrospinal fluid. PMID- 1779638 TI - Ornithine carbamoyltransferase deficiency with subnormal enzyme activity. PMID- 1779639 TI - Attempt at treatment with tetrahydrobiopterin in combined deficiency of xanthine oxidase and sulphite oxidase. PMID- 1779641 TI - Type II hyperprolinaemia with renal involvement. PMID- 1779640 TI - A case of 6-pyruvoyl-tetrahydropterin synthase deficiency after screening 1,500,000 newborns in Greece. PMID- 1779642 TI - Erythrocyte nucleotide variations in hypoxanthine phosphoribosyltransferase deficiency. PMID- 1779643 TI - Adipic aciduria, a dietary artefact. PMID- 1779644 TI - Recurrent abortion and amino-acid abnormalities. PMID- 1779646 TI - Dyggve-Melchior-Clausen syndrome with increased pipecolic acid in plasma and urine. AB - A child with the Dyggve-Melchior-Clausen syndrome associated with elevated pipecolic acid levels in plasma and urine is described. Other studies of peroxisomal function, including phytanic acid, very long-chain fatty acids, and plasmalogen synthesis, were normal. This disorder may represent an incompletely characterized defect in peroxisomal metabolism. PMID- 1779645 TI - Liver pathology and immunocytochemistry in congenital peroxisomal diseases: a review. AB - Diagnostic and pathogenetic investigations of peroxisomal disorders should include the study of the macroscopic and microscopic pathology of the liver, in addition to careful clinical observations, skeletal X-ray and brain CT scan, assays of very long-chain fatty acids and bile acid intermediates, and selected enzyme activities. This review of the literature also contains novel observations about the following syndromes: cerebro-hepato-renal (Zellweger) syndrome, X linked and neonatal adrenoleukodystrophies (ALD, NALD), NALD-like syndromes, infantile phytanic acid storage, classical Refsum disease, rhizomelic and other forms of chondrodysplasia punctata (XD, XR, AR), hyperpipecolic acidaemia, primary hyperoxaluria I, pseudo-Zellweger and Zellweger-like syndromes, and single enzyme deficiencies. Microscopic data include catalase staining and morphometry of peroxisomes, immunolocalization of beta-oxidation enzymes, detection of trilamellar, polarizing inclusions in PAS-positive macrophages, fibrosis and iron storage. Peroxisomal enlargement appears to be related to functional deficit in beta-oxidation disorders as well as in rhizomelic chondrodysplasia punctata. Because normal peroxisomal localization of active beta oxidation enzymes can accompany a C26 beta-oxidation deficit, other mechanisms such as impaired transport of metabolites should be investigated. 'Ghost'-like organelles are shown in the liver of an infantile Refsum patient and in an NALD like case; immuno-gold labelling of membrane proteins did not reveal ghosts in Zellweger livers. PMID- 1779647 TI - Bony changes of PKU neonates unrelated to phenylalanine levels. AB - In 1962 bone abnormalities were described radiographically in phenylketonuria patients. Later, observations were made on PKU infants during the neonatal period, which allowed differentiation between inherited alterations in bone development from those changes due to dietary restriction. Similar changes have been described in other aminoacidurias. Wrist radiographs and serum phenylalanine levels were obtained on 73 patients first seen between 1965 and 1990. All radiographs were taken on the day of referral, when the patient was between 6 and 57 days old. Forty-nine patients were less than 28 days old. Bone abnormalities were present in 56 of 73 (77%) of the children, as compared to 0 of 16 in a control group. The presence or absence of bone abnormality is unrelated to serum phenylalanine level, and to the age of the children at referral. This finding suggests that the cause of these mesodermal changes is not a deviation of a single amino acid in the infant, but that they are caused by an intrauterine amino acid imbalance. PMID- 1779648 TI - Genetic expression of Menkes disease in cultured astrocytes of the macular mouse. AB - The copper concentration was investigated in the cultured astrocytes from macular mice, an animal model of Menkes disease. An excessive amount of copper was accumulated in the astrocytes as copper-metallothionein. These results show that the underlying genetic defect of the macular mouse is expressed in the astrocytes. A similar situation may exist in Menkes disease and cause a failure of copper transport to neurones. PMID- 1779650 TI - Familial combined hyperlipidaemia: use of stable isotopes to demonstrate overproduction of very low-density lipoprotein apolipoprotein B by the liver. AB - We have assessed very low-density lipoprotein apolipoprotein B production, using [15N]glycine as an endogenous marker in a 9-hour primed constant infusion protocol, in four adult male subjects with familial combined hyperlipidaemia and in four normolipidaemic adult male controls. The mean very low-density lipoprotein apolipoprotein B absolute synthetic rate was significantly greater in the familial combined hyperlipidaemic subjects than in control subjects (26.31 +/ 8.37 vs 9.36 +/- 4.07 mg/kg per 24 h, p less than 0.05). These results confirm findings using exogenous radioisotope labelling techniques that very low-density lipoprotein apolipoprotein B production is significantly increased in most patients with familial combined hyperlipidaemia. A modified 9-hour protocol can be safely done repeatedly and in children and pregnant women. PMID- 1779651 TI - Worldwide survey of neonatal screening for biotinidase deficiency. AB - Neonatal screening for biotinidase deficiency has been conducted in 14 countries since 1984. To 31 December 1990, 8,532,617 newborns were screened. One hundred and forty-two infants with biotinidase deficiency were identified; 76 infants with profound deficiency (less than 10% of mean normal serum activity) and 66 infants with partial deficiency (10-30% of mean normal activity). The estimated incidence of profound biotinidase deficiency is 1:112,271 (1:85,000 to 1:145,000; 95% confidence limits) and the incidence of partial deficiency is 1:129,282 (1:112,700 to 1:177,000). The incidence of combined profound and partial deficiency is 1:60,089 newborns (1:49,500 to 1:73,100). The estimated frequency of the allele for biotinidase deficiency is 0.004 and an estimated 1 in 123 individuals is heterozygous for the disorder. PMID- 1779649 TI - Low beta-glucuronidase activity in a healthy member of a family with mucopolysaccharidosis VII. AB - A phenotypically normal mother of a mucopolysaccharidosis VII child, is reported with an unusually low beta-glucuronidase activity. Low enzyme activity was systemic (6-10% of controls) and residual beta-glucuronidase in leukocytes had an apparently normal Km value. [35S]sulphate incorporation and chase assays in fibroblasts gave values similar to control cells. A normal excretion pattern of glycosaminoglycan was found in this woman's urine. Low enzymatic activity can be related to a non-pathological 'pseudodeficiency' allele for beta-glucuronidase; this woman appears to be an apparent compound heterozygote for this allele and mucopolysaccharidosis VII. Her next pregnancy was monitored by chorionic villus sampling and a heterozygous fetus was suspected. These studies stress the need for complete enzyme investigations of obligate carriers for mucopolysaccharidoses in order to prevent difficulties at prenatal analysis. PMID- 1779652 TI - Neonatal screening for biotinidase deficiency in east-Hungary. AB - There are two types of multiple carboxylase deficiency, the neonatal form with holocarboxylase synthetase defect and the late-onset form with biotinidase deficiency. We report our preliminary experiences in screening for biotinidase deficiency. In total 43,493 infants were screened for the deficiency of the enzyme biotinidase; 0.14% false positive results that necessitated requests for second blood samples and two newborns with a biotinidase defect were identified during our pilot study. The definitive diagnosis required the demonstration of enzyme deficiency in serum. Both of the patients have residual biotinidase activity: 3.59% and 7.55%. These two newborns with biotinidase deficiency are treated with daily supplementation of free biotin. According to our preliminary results biotinidase deficiency satisfies all the criteria for incorporation into the national newborn mass screening. PMID- 1779653 TI - Prenatal diagnosis of molybdenum cofactor deficiency by assay of sulphite oxidase activity in chorionic villus samples. AB - Molybdenum cofactor deficiency is characterized by the absence of sulphite oxidase, xanthine dehydrogenase and aldehyde oxidase, the three known enzymes in man that require the cofactor for their activity. Prenatal diagnosis of the deficiency may be performed by assay of sulphite oxidase activity in cultured amniocytes. However, the activity in amniocytes is low and large numbers of cells are required for reliable assessment. We show that sulphite oxidase is present at high levels in chorionic villi obtained at 10-14 weeks gestation and can be assayed directly in the biopsy sample without cell culture. This assay has been applied to two pregnancies at risk for molybdenum cofactor deficiency with successful diagnoses of an unaffected and an affected fetus. PMID- 1779655 TI - Use of a fluorogenic substrate, 6-hexadecanoylamino-4-methylumbelliferyl-beta-D galactopyranoside, in the diagnosis of Krabbe disease. PMID- 1779654 TI - Urinary thiosulphate/creatinine concentration ratio in hospitalized children. PMID- 1779656 TI - Sialuria: a follow-up report. PMID- 1779657 TI - Characterization of iodine derivatives of aflatoxin B1 and G1 by thermospray mass spectrometry. AB - Thermospray mass spectrometry (TSMS) was used to identify the derivatives formed when iodine is reacted with aflatoxins B1 and G1 at approximately 70 degrees C to enhance fluorescence. It was found that stable derivatives were formed by addition of an iodine atom and a methoxy group across the double bond located on the furan ring of the aflatoxin B1 and G1 molecules. TSMS and TSMS/MS daughter spectra of the reaction products of aflatoxin B1 and G1 with iodine provide evidence of the addition of each moiety to produce the iodo-methoxy derivative. The addition of an iodine atom to one carbon and a methoxy group to the other carbon of the furan ring provided molecular weights of 470 and 486 for the products of aflatoxin B1 and G1, respectively. PMID- 1779658 TI - Morphine and etorphine: XIV. Detection by ELISA in equine urine. AB - We have raised antibodies to morphine and etorphine and developed one-step enzyme linked immunosorbent assays (ELISA) for these drugs as part of a panel of post race tests for drugs in racing horses. These tests are simple, can be completed in 2 h, and can be read by visual inspection. The morphine ELISA has an I50 for morphine of about 1.5 ng/mL, while the etorphine ELISA has an I50 for etorphine of 250 pg/mL. Cross-reactivity studies show that the antimorphine antibody cross reacts well with levorphanol, hydromorphone, and oxycodone, while the anti etorphine antibody showed no cross-reactivity with buprenorphine, diprenorphine, oxymorphone, morphine, or thebaine. The morphine test readily detected parent morphine or its metabolites in equine urine for at least 8 h after administration of 50 mg/horse, while a 0.1 micrograms/kg dose of etorphine was detectable for up to 48 h post dosing. For each test the background activity in post-race urines was equal to or less than the I50 for the standard curves, making them useful equine forensic tests. Each of these tests has detected "positives" in post race urine samples and as such these tests are capable of substantially improving the speed and efficacy of both pre-race and post-race testing for morphine, etorphine, and their congeners in racing horses. PMID- 1779659 TI - Simultaneous HPLC analysis of the hypnotic benzodiazepines nitrazepam, estazolam, flunitrazepam, and triazolam in plasma. AB - A new analytical methodology was developed for simultaneous high-performance liquid chromatographic quantitation of nitrazepam, estazolam, flunitrazepam, and triazolam in plasma. After addition of the internal standard nor-prazepam, biological samples and calibration standards were extracted at basic pH into diethyl ether-methylene chloride (2:1, v/v). The reconstituted extract was separated on a reversed-phase Nova Pak C18 column with acidic buffer (6mM) acetonitrile-methanol (64:23:13, v/v) as mobile phase. The detection was performed at 242 nm. Within-run and day-to-day precision values were about 2-8%. The method is thus sensitive and reproducible for use in clinical and experimental toxicokinetic studies. PMID- 1779660 TI - Evaluation of the Abbott ADx Amphetamine/Methamphetamine II abused drug assay: comparison to TDx, EMIT, and GC/MS methods. AB - Although the legitimate clinical use of amphetamine and amphetamine congeners is declining, the illicit use of these drugs remains high. There is a need for a rapid and conclusive method for detecting these compounds in routine urine drug testing, drug screening in drug rehabilitation centers, and as an aid in the diagnosis and treatment of potential overdoses. The Abbott ADx Amphetamine/Methamphetamine II assay (A/M II), a fluorescence polarization Immunoassay (FPIA), was compared to the Abbott TDx Amphetamine/Methamphetamine II assay (FPIA), the Syva enzyme-multiplied immunoassay technique (EMIT) and a gas chromatograph/mass spectrometry (GC/MS) method. Precision of the A/M II assay was evaluated on the ADx analyzer over a 14-day period in each of three modes of operation (batch, combination, and panel) and was based on within-run and between run coefficients of variation (CVs). Within-run CVs for all three controls (low [L], medium [M], and high [H]) ranged from 0.40% to 10.60% and between run CVs ranged from 3.96% to 7.92%. Data indicated that the calibration curve was stable for 16 days. Each of the six calibrators and three controls were within 10% of their labeled concentrations when analyzed by GC/MS. Fifty routine clinical specimens from our laboratory and 74 specimens screened as positive for amphetamine or related compounds from a rehabilitation center were screened by ADx, TDx, and EMIT. Any specimen yielding a positive result by any of these three methods was confirmed by GC/MS. In-house controls, as well as clinical samples, which contained both amphetamine and methamphetamine in the same sample produced results greater than two times the expected response on the ADx and TDx.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779661 TI - The effect of breath alcohol simulator solution volume on measurement results. AB - Breath alcohol simulator devices (simulators) containing alcohol and water solutions are used to calibrate and test breath-testing instruments. The manufacturers of simulators design them to contain 500 mL of solution. This study evaluated the variability observed among three different groups of data: one group (experimental) in which the solution volume varied from 400 mL to 600 mL, one group (control) in which the simulator volume remained constant at 500 mL for each aliquot, and finally one group consisting of field simulator measurements collected over time. The infrared breath test instrument employed was a BAC Verifier Datamaster. A one-way analysis of variance and the Cochran's C for equal variances were applied to the data. The results indicated that when the solution volume remained at 500 mL, there was nearly as much or greater within-run variability as when the volumes were varied from 400 mL to 600 mL. Both the experimental and control groups showed statistical significance for the one-way ANOVA and were considered within-run measurements. The high within-run instrumental precision (CV approx. 1%) probably accounts for these results. The field data, considered between-day measurements, had larger within-group variability and resulted in a nonsignificant ANOVA. Small variations from the 500 mL volume in a simulator do not result in a statistically significant difference where between-day measurements are evaluated. PMID- 1779662 TI - Surreptitious lead exposure from an Asian Indian medication. AB - A case of lead exposure resulting from the ingestion of a lead-containing medication is reported. The ingestion was detected during routine biological monitoring for lead exposure conducted on all workers of a lead-acid battery plant where the subject was employed. A case history, including the results of periodic blood lead, hemoglobin, and protoporphyrin analysis, and analysis of the medication, is provided. The discussion reviews the problem of leaded medications and emphasizes the need to carefully pursue suspected instances of outside exposure in lead workers as well as in the general public. PMID- 1779663 TI - Methomyl in the blood of a pilot who crashed during aerial spraying. AB - An aerial-spray pilot died when his aircraft crashed while he was spraying methomyl. We measured the pesticide in his blood by gas chromatography with flame photometric detection and confirmed the results by mass spectrometry with direct liquid injection through a liquid chromatography interface. The whole blood methomyl concentration was 570 ng/mL. PMID- 1779664 TI - A fatal copper sulfate poisoning. AB - An 11-year-old female died within hours of accidentally ingesting a solution of copper sulfate. A postmortem blood sample was found to contain 66 micrograms/mL copper. The initial qualitative identification of this poison in the body organs and fluids was by means of SEM-microprobe analysis (SEM-MPA) and X-ray fluorescence (XRF). The samples were quantified by atomic absorption spectrometry. PMID- 1779665 TI - Statistical evaluation and reporting of blood alcohol/breath ratio distribution data. PMID- 1779666 TI - Sensitive, selective, and rapid procedure for the quantitation of ecgonine methyl ester in urine. PMID- 1779667 TI - Concerning breath alcohol measurements during absorption and elimination. PMID- 1779668 TI - The frog and the future. PMID- 1779669 TI - Stress among emergency services personnel: progress and problems. PMID- 1779670 TI - The cardiovascular perfusionist as a model for the successful technologist in high stress situations. AB - This study investigates the psychological profiles of highly stressed medical technologists. One hundred and four individuals representing a cross-section of the United States who function as operators of heart-lung machines during open heart surgery (perfusionists) were studied using both internal and external models based on the works of Eric Berne and Karen Horney. Daily exposure to life and death responsibilities combined with the constant pressures of maintaining current technical skills can make the profession selected for this study representative of high technology professions that require a great deal of coping. Results of this study indicate that there is a balanced psychological profile in successful technologists functioning in long-term, high-stressed occupations. Female perfusionists appear to be more aggressive and critical than their male counterparts. This is seen as an attempt by female perfusionists to compensate for what has historically been a male dominanted, highly technical and high-stressed occupation. Generalizations for candidate selections to high stressed occupations could be made as well as projections of foundations for possible progressive disillusionment (burn out). PMID- 1779672 TI - Laboratory-based evaluation of the protection provided against cold water by two helicopter passenger suits. AB - The thermal protection provided by two helicopter passenger immersion suits was evaluated. Suit A was a standard 'dry' suit and suit B was a 'dry' suit with inherent insulation provided by inflation of the outer shell of the suit. During four hour immersions in water at 4 degrees C with simulated rain, wind and waves, suit B provided significantly (p less than 0.01) better protection against the long-term effects of immersion than suit A. The skin and core temperature of subjects fell at slower rates over the immersion period when they wore suit B, they shivered less, had lower heart rates and were more comfortable in this suit. The problems of testing and selecting appropriate immersion suits are discussed and it is concluded that tests of immersion suits should be as realistic as possible and, when this is so, 'dry' suits with inherent insulation which is unaffected by leakage are likely to perform better in cold water than those without such insulation. PMID- 1779673 TI - Cervical cytology screening convenient for the workforce. AB - The study describes the demographic details and smear results of women attending a Well Woman Clinic in an Occupational Health setting over a two year period. The clinic is located close to the place of work, run during working hours, and operated by a doctor and nurse. Charging fees acceptable to women attending or their employers, the service has made a modest profit and offers scope for increasing the income against fixed costs. The age range attending is older than commonly found at screening clinics. The abnormal smear detection rate, 115 per 1000 is high while the proportion of inadequate results at 50 per 1000 compares favourably with other clinics. In an area with 13 per cent Asian population, only 5 per cent of attenders were Asian but of these one fifth had abnormal smears. A cervical cytology screening facility timed and located for the convenience of the working woman is found to attract a group of women in the older age range who have a high abnormal smear rate, and those who fail to attend elsewhere. PMID- 1779671 TI - Psychological responses to thermal stress in a glass bangle factory. AB - Behavioural studies were conducted on a random sample of 38 glass bangle workers engaged in various occupations and exposed to high ambient temperature (38.2 +/- 3.4 degrees C) and radiant heat (46.2 +/- 5.1 degrees C) during their work in the glass bangle industries at Firozabad, India. Twenty-two control subjects of similar age and socio-economic status unexposed to heat during their work were also studied for comparison. The digit span test, digit symbol test, Bourdon Wiersma vigilance test, flicker fusion test and Maudsley personality inventory (MPI) were used to assess the behavioural changes induced by the existing heat stress. The mean scores of immediate memory were much lower in the exposed population than in the controls thereby indicating impairment of immediate memory in the study group. The visuo-motor coordination and vigilance were also significantly affected. Visual perception showed a downward trend among the glass bangle workers, although the MPI test indicated no personality changes. PMID- 1779674 TI - Managing psychological trauma in the police service: from the Bradford fire to the Hillsborough crush disaster. AB - Particularly since the Bradford football stadium fire of May 1985, the UK Police Service has been developing increasingly sophisticated procedures for managing post-traumatic stress reactions in its officers. Coupled with the growth of dedicated occupational health units within the Police Service, this suggests that physicians working within police forces will have an increasingly important role to play in the management of such problems. A brief account is given of the confidential screening and counselling service for police officers that was instituted after the Bradford fire, and a corresponding description is given of the more elaborate procedures implemented after the Hillsborough football stadium crush disaster of April 1989. In conclusion, the possible scope for preventive management of Post-traumatic stress disorder (PTSD) is highlighted. PMID- 1779675 TI - Occupational health management of police officers involved in the Piper Alpha disaster. AB - The Occupational Health Management of Police Officers involved in the Piper Alpha Incident is described with reference to the factors likely to cause either physical or psychological distress and the measures taken to overcome these. Once the enormity of the Piper Alpha Disaster became apparent with the realization that the recovery of the bodies would extend over a period of months, the problems of maintaining the physical and mental health of the Police Officers involved assumed prime importance. PMID- 1779677 TI - Economic indicators and involvement of health professionals at worksite health services in a developing country. AB - Identification of accurate source lists for workplace health service research is problematic. Using the national list of health professionals registered to dispense medicines at 981 worksites in South Africa, a third of questionnaires were undelivered. A 33 per cent response rate was obtained to delivered questionnaires. Non-responders appeared to lack the information required. Although the number of employees at a worksite may influence sickness absenteeism, it does not appear to affect the absolute cost per employee nor the relative expenditure on different categories of costs incurred by worksite health services. Expenditure on staff and consumables accounts for nearly 80 per cent of worksite health service costs, regardless of workforce size. In 1988, the average cost of registered workforce health services at which medicines were dispensed and information was available, was R125 (35 pounds) per employee per year. Establishing standards and applying them to intra and inter industrial economic evaluation of workforce health services using sickness absenteeism and percentage breakdown of costs appears feasible in South African industries with both large and small workforces, provided that health professionals have access to adequate management information systems. PMID- 1779676 TI - Effect of physiotherapy on sickness absence in industry: a comparative study. AB - A cross-sectional comparative study was carried out in two chemical manufacturing plants in order to ascertain the effect of an occupational physiotherapy service on absence attributed to sickness. There was no overall effect on total sickness absence rates in this study, but a possible reduction in short-term sickness absence was noted. Changes in management attitudes to absence attributed to sickness at the comparison site caused a significant reduction in short-term absences. It is concluded that physiotherapy in an occupational setting has little effect on sickness absence compared to management attitudes, but the unquantifiable benefits, such as increased employee mobility, better industrial relations and employee morale may be significant benefits, worthy of further study. PMID- 1779678 TI - Absence and labour turnover in a foundry attributable to respiratory disease. AB - A survey of foundry workers was undertaken to assess the effect of respiratory disease on both absence in the year prior to the survey and labour turnover since a cross-sectional study of respiratory morbidity five years previously. The presence of a wheeze, but not an objective disturbance of airway function, was predictive of absence. Those with respiratory illness, detected in the survey five years previously, were no more likely to have left the foundry than those without such illness. Limited job opportunities may discourage moulders with respiratory disease from leaving the foundry. Absence was not related to cigarette smoking, the presence of bronchial hyperreactivity, or a positive skin test to common allergens. In view of the small number of subjects in this study, studies of larger work populations should be undertaken to further assess the effect of subjective and objective indices of respiratory morbidity on absence and labour turnover. PMID- 1779679 TI - Attitude of GPs to occupational health services. PMID- 1779680 TI - Research on human populations: national and international ethical guidelines. PMID- 1779682 TI - Epidemiology, ethics and 'health for all'. PMID- 1779681 TI - Research on human populations: national and international ethical guidelines. PMID- 1779683 TI - The responsibilities of epidemiologists. PMID- 1779684 TI - Epidemiology and ethics. PMID- 1779685 TI - Issues in preparing ethical guidelines for epidemiological studies. PMID- 1779686 TI - Ethical principles for the conduct of human subject research: population-based research and ethics. PMID- 1779687 TI - Epidemiology and ethics: the people's perspective. PMID- 1779688 TI - Informed consent: some challenges to the universal validity of the Western model. PMID- 1779689 TI - Existing international ethical guidelines for human subjects research: some open questions. PMID- 1779690 TI - The American, British and Dutch responses to unlinked anonymous HIV seroprevalence studies: an international comparison. PMID- 1779691 TI - Children in HIV/AIDS clinical trials: still vulnerable after all these years. PMID- 1779692 TI - Confidentiality: the protection of personal data in epidemiological and clinical research trials. PMID- 1779693 TI - Case studies of expedited review: AZT and L-dopa. PMID- 1779694 TI - International guidelines for ethical review of epidemiological studies. PMID- 1779695 TI - U.S. Public Health Service (PHS) consultation on international collaborative human immunodeficiency virus (HIV) research. PMID- 1779696 TI - Recent developments in abortion law. PMID- 1779697 TI - "They will put it together/and take it apart": fiction and informed consent. PMID- 1779698 TI - Cellular differentiation and the microcompartmentation of glycolysis. AB - In this paper, the main features of the cellular activities of the glycolytic enzymes during growth and tissue differentiation are summarized, and correlated with the occurrence of multiple forms of these enzymes, and with their degree of interaction with subcellular structure. The substantial evidence for micro organization of the glycolytic sequence is described, as well as its significant contribution to the diverse physiological situations encountered during development. Based on this evidence, a modular, biphasic model of glycolytic activity has been developed, with associated features of microcompartmentation and segmentation. Evidence has been provided that these phenomena play important roles in meeting the special needs of emerging cell types during early ontogeny, as well as offering the potential for increased flexibility and control of glycolysis in specialized physiological situations in the adult organism. PMID- 1779699 TI - Light and electron microscopic features of peripheral ganglion cells cultured from young and aged Wistar rats. AB - Neurons of the dorsal root ganglion (DRG) and sympathetic superior cervical ganglion (SCG) were cultured as explants from young adult (3 months old) and aged (28 months old) Wistar rats. Both aged DRG and SCG neurons showed delayed neurite outgrowth compared to young adult neurons. Young and some aged cultured neurons had an ultrastructure similar to that found in normal uncultured cells, but most of the aged cultured neurons displayed a heavy accumulation of homogenous lipid like inclusions in addition to classic age pigments. Occasionally, large neurofilament aggregates were seen in aged DRG neurons. They were sometimes localized perinuclearly, resembling neurofibrillary tangles. The results show that even very old peripheral neurons survive in culture. As aged cultured neurons show degenerative changes not observed in young adult neurons, it is suggested that cultured peripheral neurons of different ages could provide useful means for neuronal aging studies. PMID- 1779700 TI - Agonist-induced Ca2+ mobilization in the rat submandibular gland during aging and subsequent to chronic propranolol treatment. AB - The effects of age and chronic propranolol treatment on the agonist-induced rise in intracellular free Ca2+ ([Ca2+]i), an index for the coupling of receptor second messenger generation, was studied using a dispersed rat submandibular gland preparation. Muscarinic stimulation (10 microns carbachol) caused a rapid (T1/2 less than 2 s) and dramatic (approximately 4.5-fold) rise in [Ca2+]i followed by a lower sustained increase (approximately 3-fold) in [Ca2+]i as measured directly with the Ca(2+)-sensitive fluorescent probe, fura-2. The magnitude and the rate of increase of the initial rise in [Ca2+]i and the level of the sustained increase in [Ca2+]i were not different between 2- an 21-month old rats. Stimulation in a Ca(2+)-free medium reduced the initial agonist-induced increase in [Ca2+]i by approximately 35-40%, while the sustained increase was abolished by the removal of extracellular Ca2+ from cells in both young and old rats. Chronic treatment for 30 days with 20 mg/kg propranolol, a beta-adrenergic antagonist, did not significantly alter the ability of dispersed submandibular cells in old rats to mobilize Ca2+ during agonist stimulation or influence the in vivo stimulated gland output. These results suggest that the agonist-induced rise in [Ca2+]i is not altered by aging or by chronic treatment of aged rats with propranolol and, therefore, receptor-second messenger coupling remains intact. PMID- 1779701 TI - Aging as a multi-step process characterized by a lowering of entropy production leading the cell to a sequence of defined stages. AB - The principles of the thermodynamics of irreversible processes which occur in biological cells considered as open systems, have been reviewed and applied in order to describe a possible evolution of cells during aging. The main feature of such an approach is that cells operating in a steady state, optimize their free energy production by lowering their entropy production which is kept to a minimum. Instabilities can however occur which can lead the cell from one steady state to another characterized by a lower production of entropy. Concomitantly, the level of errors or entropy of the system will increase. The process will continue and the cell will go from one state to another until a critical level is attained where the cell can not cope any more with keeping its organization and will die. The effect of stresses and mitosis have been also considered in this model. Such an approach stresses that cells can only subsist as a whole in certain states which are the result of the genetic constitution but also of the optimalization of cellular functions given their requirement in energy and the fluctuations from the environmental changes. In this respect, it reconciles both programmed and stochastic theories of aging. PMID- 1779702 TI - The craniofacial proportions and laryngeal position in monkeys and man of different ages (a morphometric study based on CT-scans and radiographs). AB - Using CT-scans and radiographs, sagittal planes through the head and neck of men and monkeys at different ages were analyzed morphometrically for their craniofacial proportions and laryngeal position. In monkeys, a continuous prognathic growth of the splanchnocranium was found within the first 3 years. The neurocranial growth, however, was markedly reduced. The larynx of monkeys showed only a slight descensus with age. In contrast to this, the growth of the splanchnocranium in man did not change the craniofacial proportions significantly. The larynx, however, descended markedly within the first two years of life. In adults, the final position of the larynx was nearly 3 vertebral bodies further caudally than in the newborn. The differences in the postnatal position of the larynx, which is essential for the development of speech, are explained by differences in the growth pattern of human and monkey skulls. PMID- 1779703 TI - Age related changes in the lipoprotein substrates for the esterification of plasma cholesterol in rats. AB - The activity of the enzyme lecithin:cholesterol acyltransferase (LCAT) and the properties of its lipoprotein substrates have been investigated in 6- and 19 month-old Fischer-344 rats. These studies were carried out to determine the nature of the relationship between the observed hypercholesterolemia and the age related decrease in the fractional rate of lipoprotein cholesterol esterification. The distribution of LCAT activity of plasma fractions was determined following gel chromatography and ultracentrifugation respectively. LCAT activity was found to be associated with the high density lipoprotein (HDL) fraction when rat plasma was passed through a Bio-Gel A-5 M column. Upon density gradient ultracentrifugation for 24 h it was found associated with HDL fraction; d = 1.125-1.21 g/ml. However, following prolonged ultracentrifugation (40 h), the majority of the LCAT activity was displaced into the lipoprotein-free infranatant (d greater than 1.225 g/ml). The dissociation of LCAT from its complex with HDL occurred to a smaller extent in aged rat plasma than in young rat plasma. Substrate specificity studies indicated that HDL was a considerably better substrate for LCAT than very low density lipoproteins (VLDL) in both young and aged rats. In addition, HDL from young rats was a better substrate for LCAT than the HDL from aged rats. Incubation experiments followed by the isolation of lipoproteins and the subsequent analyses of their cholesterol contents revealed that the age-related hypercholesterolemia was mainly due to an increase in the cholesterol carried by lipoprotein fractions d = 1.025 -1.07 g/ml (LDL + HDL1). These and other low density lipoproteins (d less than 1.025 g/ml) were poor substrates for LCAT. However, these lipoproteins could provide free cholesterol for esterification by first transferring it to HDL (d = 1.07-1.21). The HDL isolated from the plasma of aged rats was enriched with apolipoprotein (apo) E and these lipoprotein particles were found to be inferior substrates for LCAT. These data suggest that the decreased fractional rate of esterification observed in aged rats is due to the slower utilization of the HDL lipid substrate pool by the enzyme LCAT as a result of the accumulation of unfavorable substrates (compositionally altered HDL particles) for the LCAT reaction. PMID- 1779704 TI - Oxidized ascorbic acid and reaction products between ascorbic and amino acids might constitute part of age pigments. AB - Fluorescence and non-enzymatic browning were observed in reactions between ascorbic acid (AH2) and amino acids (AA) as well as in reactions involving AH2 autoxidation and/or polymerization in the presence of trace amounts of adventitious iron (less than or equal to 10 microM). These reaction products exhibited fluorescent spectra (400-490 nm) akin to those of extracts from lipofuscin-rich tissues. Lengthy incubation of AH2 at 37 degrees C in phosphate buffer (pH 7.0) caused a concentration- and time-dependent increase in absorbance at 412 nm, paralleling increase in 377/440 nm fluorescence, due to formation of autoxidation/polymerization products. The fluorescences of these substances were increased by acidity and quenched at alkaline conditions but restored by neutralization. The reactions between AH2 (0.1-2.0 mM) and a number of AA (1.0 4.0 mM) were also found to result in products with blue fluorescence. Following TBA test, the AH2 autoxidation/polymerization products and AH2/AA reaction products showed only moderate and slight absorbance at 535 nm, respectively, indicating a little or minute formation of aldehydes with MDA-like reactivity. The findings in this study, nevertheless, suggest possible misinterpretations of results in previous studies dealing with AH2-dependent, oxygen free radical induced, 'lipofuscin-related fluorescence'. Thus, similar to nonenzymatic glycosylation (Maillard) reactions, AH2 autoxidation as well as reactions between AH2 and AA may result in 'lipofuscin-like material', as judged from their fluorescence spectral patterns. PMID- 1779705 TI - Ion-pair high-performance liquid chromatography of bile salt conjugates: application to pig bile. AB - The high-performance liquid chromatographic separation and quantitation of conjugated bile salts from pig bile is reported. Synthetic standards and bile samples were chromatographed on a C18 reversed phase column using acetonitrile/water/tetrabutyl ammonium phosphate as an isocratic mobile phase at a flow rate of 1 mL/min. Detection of the ion-pairs was at 214 nm. The method permits efficient separation of all conjugated pig biliary bile salts without prior modification or treatment of the samples. Analysis of 12 pig biles showed that 85% of the bile salts are conjugated to glycine. The three main conjugated bile salts were glyco-3 alpha,6 alpha,7 alpha-trihydroxy-5 beta-cholanoic acid (GHC), glyco-3 alpha,7 alpha-dihydroxy-5 beta-cholanoic acid (GCDC), and glyco-3 alpha,6 alpha-dihydroxy-5 beta-cholanoic acid (GHDC). Glyco-3 alpha-hydroxy-6-oxo 5 beta-cholanoic acid (G3 alpha 6oxo), tauro-3 alpha,7 alpha-dihydroxy-5 beta cholanoic acid (TCDC), tauro-3 alpha,6 alpha,7 alpha-trihydroxy-5 beta-cholanoic acid (THC), and tauro-3 alpha,6 alpha-dihydroxy-5 beta-cholanoic acid (THDC) were found to contribute each for 4 to 5% to the total. An excellent correlation was found between the sum of conjugated bile salts quantitated by high-performance liquid chromatography (HPLC) and values obtained by conventional enzymatic assay. Simplicity, efficiency and relative rapidity of the method render it suitable for routine analyses. PMID- 1779706 TI - Sterol biosynthesis inhibitors: their current status and modes of action. AB - The mechanism of each of the reactions in the post-squalene segment of the fungal and higher plant sterol biosynthetic pathway is outlined. The inhibitors of the enzymes catalyzing the reactions are described and how inhibition is brought about is explained in the areas where it is known. PMID- 1779707 TI - Involvement of heme components in sterol metabolism of Saccharomyces cerevisiae. AB - There is an intimate association between sterol biosynthesis in yeast and aerobicity. Besides the requirement for molecular oxygen for the epoxidation of squalene, cytochrome hemoproteins are involved in demethylation and desaturation steps. Regulatory effects of hemes on sterol formation have been demonstrated using specifically defective mutants of yeast. Heme competency participates in a mechanism whereby wild-type cells are prevented from taking exogenous sterols from the growth media. The multiple interactions of hemes and sterols appear to be associated with the variously defined functions for sterols in the yeast cells. PMID- 1779708 TI - Metabolism of plant sterols by nematodes. AB - Parasitic nematodes do not biosynthesize sterols de novo and therefore possess a nutritional requirement for sterol, which must be obtained from their hosts. Consequently, the metabolism of phytosterols by plant-parasitic nematodes is an important process with potential for selective exploitation. The sterol compositions of several species of plant-parasitic nematodes were determined by capillary gas chromatography-mass spectrometry and compared with the sterol compositions of their hosts. Saturation of the phytosterol nucleus was the major metabolic transformation performed by the root-knot nematodes Meloidogyne arenaria and M. incognita and the corn root lesion nematode, Pratylenchus agilis. In addition to saturation, the corn cyst nematode, Heterodera zeae, dealkylated its host sterols at C-24. Because free-living nematodes can be cultured in sterol defined artificial medium, they have been successfully used as model organisms for investigation of sterol metabolism in plant-parasitic nematodes. Major pathways of phytosterol metabolism in Caenorhabditis elegans, Turbatrix aceti and Panagrellus redivivus included C-24 dealkylation and 4 alpha-methylation (a pathway unique to nematodes). C. elegans and T. aceti introduced double bonds at C-7, and T. aceti and P. redivivus saturated the sterol nucleus similarly to the plant-parasitic species examined. Several azasteroids and long-chain dimethylalkylamines inhibited growth and development of C. elegans and also the delta 24-sterol reductase enzyme system involved in the nematode C-24 dealkylation pathway. PMID- 1779709 TI - Cloning and disruption of the yeast C-8 sterol isomerase gene. AB - The yeast ERG2 gene codes for the C-8 sterol isomerase, an enzyme required for the isomerization of the delta 8 double bond to the delta 7 position in ergosterol biosynthesis. The ERG2 gene was cloned by complementation of a C-8 sterol isomerase mutant strain (erg2). The complementing region of DNA required to restore ergosterol synthesis to erg2 was limited to a 1.0 kb StuI-BglII fragment. In order to determine whether the ERG2 gene was essential for yeast viability, a LEU2 gene was inserted into the NdeI site (made blunt) of this 1.0 kb fragment. Transformation of a wild type diploid strain with the ERG2 substituted DNA resulted in the generation of viable haploids containing the erg2 null allele (erg2-4::Leu2). These results suggest that the C-8 sterol isomerase activity is not essential for yeast cell viability. This disruption represents the second ergosterol biosynthetic gene in the distal portion of the pathway to be disrupted without adversely affecting cell viability. PMID- 1779710 TI - Sterol pathway in yeast. Identification and properties of mutant strains defective in mevalonate diphosphate decarboxylase and farnesyl diphosphate synthetase. AB - Yeast mutant strains auxotrophic for ergosterol and blocked in mevalonate diphosphate decarboxylase (erg19) and farnesyl diphosphate (FPP) synthetase (erg20) were isolated. The main feature of the mutants blocked in FPP synthetase is their ability to excrete prenyl alcohols, such as geraniol and farnesol. The isolation of the functional ERG20 gene allowed us to show that farnesyl diphosphate synthetase could be a rate limiting enzyme in ergosterol biosynthesis in yeast. PMID- 1779711 TI - A biliary protein identified by immunoblotting stimulates proliferation of peripheral blood T lymphocytes in primary biliary cirrhosis. AB - The source of activation of T lymphocytes in primary biliary cirrhosis (PBC) is undefined. Hence, T-cell-mediated reactivity against a biliary tract antigenic protein from human bile was studied. The bile protein was fractionated by 30-50% saturated ammonium sulphate and gel-chromatography, and analysed by SDS-PAGE and Western immunoblotting using rabbit antisera to the bile protein. The antisera reacted specifically with human bile duct epithelium. Western blotting of bile proteins showed two major bands, the B1 and B2 antigens. B1 stained for sialoglycoprotein but not lipid, but B2 was negative for both. Cell-mediated reactivity was tested by proliferation of peripheral lymphocytes against B1. Taking the upper limit of the normal range for stimulation indices (S.I.) as less than 1.89 (= mean + 2 SD), a mitogenic response was detected in 14 of 16 patients with PBC (S.I.: 11.7 to 2.3), and in 4 of 15 patients with chronic active hepatitis, but in none of 12 patients with drug-induced intrahepatic cholestasis or obstructive jaundice. The B2 protein was non-stimulatory. Lymphocyte proliferation to B1 in PBC was confined to T cell fractions of peripheral blood leucocytes. There was no cross-antigenicity between B1 and the M2 antigens, according to Western blotting using the rabbit antisera and PBC sera with anti-M2 reactivity. Thus, the B1 biliary protein is a possible source of T cell activation in PBC and hence could be an immunological co-factor in the pathogenesis of this disease. PMID- 1779712 TI - Bacteremia in patients with cirrhosis of the liver. AB - Infections are frequent in patients with liver cirrhosis, as their defenses against infectious agents are altered. But bacteremia occurring in cirrhotic patients has seldom been reported in the literature. From 1981 to 1986, we collected 197 cases with 228 episodes of bacteremia for this retrospective study. The incidence of bacteremia in cirrhotic patients was 8.8%; no significant difference was noted between cirrhotic patients with variant etiologies of HBV(+), HBV(-) and alcohol. But the incidence increased with the severity of the disease (1%, 4.8%, 17.1% in Child's A, B, C groups, respectively). Gram-negative bacteria were the predominant microorganisms of bacteremia (75.6%). Among them, Escherichia coli, Klebsiella pneumoniae and Aeromonas hydrophilia were the three most commonly detected microorganisms. Gram-positive bacterias were detected in 21.2% of patients with bacteremia, with predominance of the Streptococcus group and Staphylococcus aureus. In about 26.3% of cases the infectious sources were the same by bacteria cultures as from blood. The most common sources were spontaneous bacterial peritonitis, urinary tract infection, pneumonia and biliary tree infection. In cirrhotic patients with and without bacteremia, the mortality rate increased significantly in the bacteremia group (54.8% vs 23.2%, P less than 0.05). By Child's classification, the mortality of patients with classes B and C increased significantly after onset of bacteremia. There was no significant difference in mortality between bacteremic patients in the HBV(+), HBV(-) and alcohol groups. In conclusion, bacteremia is a severe complication of liver cirrhosis and a sign of a poor prognosis. PMID- 1779713 TI - Second evaluation of HEPAR, an expert system for the diagnosis of disorders of the liver and biliary tract. AB - HEPAR is an expert system which can be used as a supportive tool in the diagnosis of disorders of the liver and biliary tract. When consulted for a particular patient, the system assesses the patient's disorder in two stages. In the first stage, data of medical history, physical examination and routine laboratory tests are used to determine whether the disorder is hepatocellular or biliary obstructive, and whether benign or malignant features are present. In the second stage, the system produces a differential diagnosis out of a set of 80 disease categories, using the conclusions of the first stage of the assessment and the results of a restricted number of supplementary investigations, i.e. serological tests and ultrasonography. The conclusions of the two stages are ordered by the amount of evidence computed by HEPAR. The system is not yet suitable for clinical use. The system has been evaluated using data of 181 patients selected from a population of 214 consecutively admitted patients with jaundice. The patients were classified by the system as having a hepatocellular or biliary obstructive, and a benign or malignant disorder in 96% and 100% of the cases, respectively. When comparing the conclusions with strongest evidence with the final clinical diagnoses, the patients were classified correctly in 86% and 83% of the classified cases, respectively. A differential diagnosis was produced in 87% of the patients. A correspondence between the diagnosis with strongest evidence and the final clinical diagnosis was found in 78% of the classified patients. PMID- 1779714 TI - Streaming liver. VIII: Cell production rates following partial hepatectomy. AB - Twenty-four young, female, random-bred rats weighing 250 g were partially hepatectomized and killed in groups of four animals at the following times: 1 h and 1, 2, 3, 7 and 14 days. One hour before killing, each rat was injected i.p. with 0.5 microCi [3H]-thymidine, specific activity 5 Ci/mmol/g body weight. Livers were processed histologically and dipped into liquid emulsion for autoradiography. Twenty-four hours after partial hepatectomy, hepatocyte and littoral labelling indices rose, reaching on the third day respective peak values of 3.7%, and 15.4%, whereupon they declined, remaining slightly above pre treatment level. Labelling indices served for cell production estimates. On day 3 the hepatocyte labelling index rose 26-fold. At the same time hepatocytes doubled their ploidy, indicating that half of the observed L.I. increase was directed to DNA accumulation and not to cell division. The hepatocyte production rate therefore increased 13-fold (or 1300%). The acinus diameter increased 15%, and cell density declined 5%, so that the acinus capacity to retain cells increased only 5%. Since the acinus did not enlarge proportionally to cell production, it is concluded that 95% of newly formed cells were eliminated. Partial hepatectomy thus triggers two processes: an acute process lasting about a week marked by massive and rapid cell turnover during which most newly formed cells are eliminated; and a second, more protracted process which serves for liver mass restoration. It is proposed that partial hepatectomy induces an acute shortage of a hitherto unknown metabolite that is produced by newly formed cells immediately after hepatectomy. PMID- 1779715 TI - IgM anti-preS2 monitoring during combined corticosteroid/interferon-alpha 2b therapy in chronic hepatitis B. AB - The biological significance of antibody reactivities towards the preS2 gene encoded proteins of HBV is not yet well known. We investigated the pretreatment IgM anti-preS2 (1-55) ad reactivity in 22 Chinese and 11 Swedish patients with active HBV disease. Significantly enhanced IgM anti-preS2 levels (titers greater than 1/1000) were observed in 48% (16/33) of these patients. The OD405 values for sera from patients with indolent HBsAg carriership were within the range of that obtained for "normal" control-sera when tested at dilutions from 1/1000 to 1/128,000. Five Chinese patients were treated with a short course of corticosteroids, followed by alpha-interferon 2b (IFN-alpha 2b) treatment for 16 weeks. The IgM anti-preS2 response was consecutively monitored during treatment. A beneficial effect on the outcome of the combined treatment was associated with rising titers of IgM anti-preS2 during the prednisolone cycle. The IgM anti-preS2 levels fell dramatically upon steroid withdrawal and were followed by a second peak response of IgM anti-preS2 reactivity during the IFN-alpha 2b treatment. No sustained loss of HBV-DNA or DNA polymerase with concomitant HBe/anti-HBe seroconversion was observed in treated patients, who lacked detectable pretreatment levels of IgM anti-preS2 in circulation. PMID- 1779716 TI - Magnetization prepared rapid gradient-echo (MP-RAGE) MR imaging of the liver: comparison with spin-echo imaging. AB - We have implemented an MR technique that employs a rapid gradient echo sequence, preceded by magnetization preparation pulses to provide T1- and T2-weighted tissue contrast. With this technique, which can be identified as a member of a new family of pulse sequences, generically named Magnetization Prepared RApid Gradient Echo (MP-RAGE), very short repetition times are used, allowing acquisition times of less than one second and images virtually free of motion induced artifacts during quiet respiration. Fifteen patients with known liver lesions (metastases, hemangiomas, and cysts) were examined using T1- and T2 weighted 2-dimensional MP-RAGE sequences, and the images were compared with conventional T1- and multi-echo T2-weighted spin-echo (SE) sequences. Signal difference-to-noise ratios (SD/Ns) of the lesions were calculated for all pulse sequences using corresponding axial images and were normalized for voxel volume. The mean normalized SD/Ns of the MP-RAGE sequences were generally comparable to those for the SE sequences. In addition, there were no noticeable respiratory artifacts on the MP-RAGE images whereas these were clearly present on the T2 weighted SE images and to a lesser degree on the T1-weighted SE images. It is concluded that the MP-RAGE technique could become an important method for evaluating the liver for focal disease. PMID- 1779717 TI - Halfscan: clinical applications in MR imaging. AB - A series of phantom experiments was performed to evaluate the effects of half Fourier scanning, also known as Halfscan, on signal-to-noise and in-plane resolution. Resolution was not demonstrably effected with the available phantoms and signal-to-noise was seen to vary as the square root of time independent of the implementation of Halfscan. Evaluation of the Halfscan technique was made using data from 240 patients. The technique was found to "salvage" examination in an estimated 70% of uncooperative patients where motion artifact or other patient concerns would have precluded clinically useful studies. Halfscan was also combined with other techniques such as increased number of signal acquisitions, prolonged repetition times and three-dimensional Fourier transform technique. PMID- 1779718 TI - MRI of female uterine and juxta-uterine masses: clinical application in 25 patients. AB - The clinical utility of magnetic resonance imaging (MRI) in the diagnosis of gynecologic masses was evaluated in 25 patients. In each patient the final pathologic diagnosis was semiquantitatively correlated with the diagnostic impressions from pelvic examination, ultrasound and MRI. There were 9 uterine, 11 ovarian and 5 nonovarian pelvic masses. Pelvic examination correlation with final diagnosis was 26%, consistent with the literature. Ultrasound fared surprisingly poorly, with only 44% correlation. MRI showed an 87% correlation with the final diagnosis. MRI was able to accurately identify masses, discriminate adnexal masses from fluid-filled bowel, identify dermoids, and in one case obviated surgery in a pregnant patient. MRI provided significant clinical management information with greater accuracy than did ultrasound or pelvic examination. PMID- 1779719 TI - An extended-length coil design for peripheral MR angiography. AB - Magnetic resonance angiography of the peripheral vascular system has been hampered by the limited view provided by available imaging coils. We have constructed an extended-length, split-saddle design radiofrequency (rf) coil for peripheral angiography. The two coil halves are inductively coupled, to each other and to the rf source. Details regarding the construction of the coil and comparison of the performance with the knee coil are described here. This coil provides the benefit of a larger field of view but with image quality comparable to that of a commercial knee coil. PMID- 1779720 TI - MRI of the normal hippocampus. AB - Before it is possible to use MR imaging to investigate changes in the hippocampus in disease processes such as epilepsy and memory disorders, it is imperative that normal variations are defined. Using specific anatomic locations, we evaluated the hippocampi of 29 normal volunteers with coronal MR studies. Mild variations occur with regard to hippocampal size and shape, and hippocampal fissure visualization. Hippocampal signal intensity is isointense to cortical gray matter. Recognition of normally occurring variations should help prevent over interpretation of hippocampal changes in pathologic disorders. PMID- 1779721 TI - MRI of the temporal lobe: normal variations, with special reference toward epilepsy. AB - Recent investigations of epilepsy, Alzheimer's disease, amnesia, and schizophrenia have used magnetic resonance imaging (MRI) to evaluate changes in temporal lobe structures. Normal variations in these structures need to be defined before one can use these structures to describe abnormal conditions. Twenty-nine normal volunteers were studied by coronal MRI. Frequent findings include notching of the uncus by the tentorium or adjacent vessels (22/29) and asymmetry of the temporal horns (20/29). This finding of uncal notching strengthens the evidence against "incisural sclerosis" as the basis for hippocampal sclerosis. Temporal horn dilatation occurred in four. However, mild asymmetry of the temporal horn was seen frequently at its anterior tip (16/29) and may be related to head rotation. Asymmetry of the choroidal fissure was never marked. Mild asymmetry was common at the hippocampal head (pes). Mild enlargement of the right temporal lobe by visual inspection is not uncommon. Subtle asymmetry of the white matter between the hippocampus and the collateral sulcus occurred in six. The collateral sulcus does not always point to the temporal horn. The occipitotemporal sulcus may point to the temporal horn. Asymmetric uncal protrusion (0/29) and Sylvian fissure dilatation (4/29) occur rarely. PMID- 1779722 TI - FID-acquired-echos (FAcE): a short echo time imaging method for flow artefact suppression. AB - The FID-Acquired-Echo sequence (FAcE) is a magnetic resonance imaging technique using fractional-echo acquisitions, with sequential separate sampling of the right and left k-space half planes. It reduces the minimal echo times by about a factor of two, compared to conventional full-(gradient)-echo sampling schemes. With this sequence, implemented on a commercial 1.5 Tesla whole body system, high resolution images are acquired with typical echo times between 3 and 4.5 msec. Using short echo times the signal dephasing caused by velocity and higher order spin motion is reduced. Further, due to the modified sampling scheme, the sequence exhibits, for triggered studies, partially a compensation of motion induced phase shifts in the frequency-encoding direction. Thus, the sequence offers an alternative means for the reduction of motion-induced image artefacts to the use of flow compensating gradients, which usually makes a sequence more sensitive to higher order motion and introduces further eddy currents. Besides potential application for imaging of nuclei and tissues with short T2 relaxation times, and non-ECG-triggered in-flow angiography, the main application seems to be triggered-phase contrast imaging with focus on quantitation of blood flow. Its usefulness is largest in cases with irregular flow patterns, where considerable in-plane flow occurs. PMID- 1779723 TI - In vivo non-invasive studies on the human lens. AB - Progress in biophysical technology now permits us to monitor aging and precataractous changes in the human ocular lens in vivo as well as in vitro. We are employing two noninvasive techniques to measure changes in lens fluorescence and in one lens water compartment (T2) utilizing Scheimpflug lens fluorescence densitography and magnetic resonance imaging. These studies demonstrate age related changes in the normal lens as reflected by enhanced fluorescence and longer T2 values. Precataractous changes can also be detected with this approach. PMID- 1779724 TI - Magnetic resonance imaging of burn injury in rats. AB - In-vivo magnetic resonance imaging (MRI) studies have been performed to follow pathological changes induced by 3-sec and 10-second burns on eleven rat tails. T1 weighted, T2-weighted, density-weighted, and water-suppressed images were acquired immediately after and four days following thermal injury. MRI results were correlated with histology. For 3-sec burns, both edema and lipids contributed significantly to the hyperintensity seen on MRI at the site of injury. For 10-sec burns, edema was the major contributor to hyperintensity. Quantitative comparisons indicated the intensity and spatial extent of the edema signal to be most indicative of the degree of injury. MRI also demonstrated potential in determining coagulation necrosis and lipid accumulation at burn sites. These studies indicate the potential of MRI in diagnosing and monitoring burn injuries and therapies. PMID- 1779725 TI - Estimation of myocardial perfusion using deuterium nuclear magnetic resonance. AB - A technique to estimate regional and/or global myocardial perfusion in-vivo was developed using deuterium nuclear magnetic resonance measurement of perdeuterated saline washout from the myocardium of 9 dogs. Washout data were fitted to a one component plus baseline Kety-Schmidt exponential model. To assess the ability of this technique to reliably measure changes in perfusion during change in myocardial workload, norepinephrine (1 microgram/kg/min) was infused and hypoxia was induced (by increasing the inspired ratio of N2/O2 to obtain a PAO2 of 20-30 mmHg) in separate interventions. Myocardial work, as determined by heart rate X systolic blood pressure, increased during both interventions. To support this increased workload, myocardial perfusion increased during both physiological interventions. These data indicate that myocardial perfusion can now be reliably estimated with a non-radioactive, non-toxic (in the concentrations used) tracer, perdeuterated saline. The technique can be used for repeated real-time measurements of perfusion during sequential physiological interventions. PMID- 1779726 TI - Mn[III] uroporphyrin I: a novel metalloporphyrin contrast agent for magnetic resonance imaging. AB - We have used an intracranial 9L rat brain tumor model to determine whether a novel metalloporphyrin, Mn[III] uroporphyrin I (MnUROP-I), could function as an intravenous MRI contrast agent for brain tumors. In several experiments, 24 male Fischer 344 rats were inoculated intracranially with 9L brain tumor cells. On day 15 postinoculation, animals were anesthetized and the femoral vein exposed. Prior to the intravenous injection of the contrast agent, a precontrast scan (1 Tesla in a standard head coil) was performed. Thirty min after injection of the contrast agent, a postcontrast scan was performed. Although there was only a suggestion of abnormality on the precontrast scans, the presence of tumor was visibility enhanced in the postcontrast scans. In 3 animals scanned at 24 hr postinjection, persistent tumor enhancement was demonstrated. Measured tumor sizes on the MRI scans were consistent with sizes measured at autopsy and histologically. These results demonstrate that MnUROP-I is an effective MRI contrast agent for the detection of an intracranial brain tumor in the rat model. PMID- 1779727 TI - Enteric MRI contrast agents: comparative study of five potential agents in humans. AB - We compared the effectiveness of 1 mM Geritol, 12% corn oil emulsion, Kaolin pectin, single contrast oral barium sulfate, and effervescent granules as enteric magnetic resonance imaging (MRI) contrast agents. Five volunteers were recruited. Each volunteer ingested for examinations, separated by at least one week, either 500 ml of each of the liquid preparations or two packets of the CO2 granules (producing 400 ml of CO2 per packet). Abdominal MR images were then obtained using a 1.5 T Magnetom imager and SE 550/22, SE 2000/45/90 and FISP 40/18/40 degrees pulse sequences. The oil emulsions were best tolerated. Barium sulfate caused the greatest amount of nausea, followed by Geritol and Kaolin-pectin. With FISP 40/18/40 degrees, 60%-80% of the small bowel was well delineated using oil emulsion, Kaolin-pectin, or barium sulfate. We conclude that oil emulsion was by far the best enteric MR contrast agent in our study. Good delineation of the small bowel and pancreas can be achieved using oil emulsion and gradient echo pulse sequences. The lack of side-effects and the excellent taste make it highly acceptable to human subjects. PMID- 1779728 TI - An analysis of the intrinsic resonance offset dependence of magnetization generated by stimulated echo pulse sequences for noncoupled spins. AB - It is demonstrated that the basic radiofrequency pulse train used to generate stimulated echoes (90x-tau TE-90x-tau TM-90x-tau TE-Acq.) is in general characterized by strong amplitude and phase modulations of the transverse magnetization as a function of the resonance offset. Two dephasing techniques which eliminate the modulations are investigated both theoretically and experimentally, and a simple formula is derived for calculating the relative modulation across a spectrum as a function of gradient strength and duration, echo delay, and spectral linewidth. PMID- 1779729 TI - Study of biodistribution of enflurane in rats with in vivo 19F MRI. AB - In vivo 19F magnetic resonance imaging (MRI) of anesthetized rats enabled us to visualize the biodistribution of fluorinated anesthetics and to document the changes in MR signals in the body during the induction and the elimination phase of anesthesia. The authors examined in vivo 19F MRI in rats anesthetized with concentrations of 1.75-2.0% enflurane and demonstrated its in vivo distribution with concomitant 1H and 13C MRI to verify the anatomical correlation. Distinct 19F MR signals were acquired predominantly from the systemic adipose tissue and the liver. Additionally, the temporal changes in the tissue during and after anesthesia were characterized with in vivo 19F MRI in 6.4 min of the acquisition time. The 19F MR signals increased with time after anesthesia; however, the signals from the adipose tissue were apparently stronger than those from the liver. Following the discontinuation of inhalation, the MR signals in the liver decreased far more rapidly than those from the adipose tissue. When the animal woke up and began to move, the MR signals were still visible in the adipose tissue. These results confirmed the fact that enflurane dissolves preferentially in the adipose tissue and remains when the anesthetic effect disappears. Additionally, 19F MR signals of the liver during the elimination phase might reflect the concentration of enflurane in the blood. PMID- 1779730 TI - High resolution NMR imaging: Gd-DTPA labeled enzyme as a probe for permeability studies in polyacrylamide gels. AB - The penetration of horse liver alcohol dehydrogenase (HLAD) molecules into polyacrylamide gel beads, which are used to immobilize the enzyme, was studied. HLAD was labeled with gadolinium diethylene-triamine-pentaacetic acid (Gd-DTPA), using the N-hydroxy-succinimide active ester of DTPA as a chelating agent. The HLAD-(Gd-DTPA)27 has a 3.7-fold larger longitudinal (R1) and a 14-fold larger transversal relaxivity (R2) (at 2.4 T) than the plain Gd-DTPA. A series of dry polyacrylamide gel beads, with total monomer concentration ranging from 5% to 30% were synthesized and swollen in a buffered solution of HLAD-(Gd-DTPA)27. The gel beads were examined with high resolution NMR imaging. The T1- and T2-weighted images revealed that the permeability for the labeled HLAD decreased with increasing total monomer concentration of the gel beads. These imaging results correlate fairly well with the enzymatic reactivities measured for the same range of gel beads but swollen in a solution of non labeled HLAD and NAD+ (nicotinamide adenine dinucleotide). It is concluded that Gd-labeling can be used to monitor the distribution of weakly concentrated, water soluble products in a solid matrix. PMID- 1779731 TI - Sources of error in the quantitative analysis of MRI scans. AB - The increasing use of quantitative analysis of MRI scans in the literature has produced a need to identify potential sources of bias in such analysis procedures. Six sources of bias are demonstrated in this paper. These include bias attributable to partial volume effects, head tilt, plane of view, use of noncontiguous slices, contrast/intensity manipulations, and magnetic inhomogeneities. The magnitude of bias for each source varied according to whether a hemisphere or regions within a hemisphere were measured, with regional effects typically exceeding hemisphere effects. PMID- 1779732 TI - Improvement of 3D acquisition and visualization in MRI. AB - Three-dimensional (3D) visualization techniques are becoming an ever more important aid in the interpretation of tomographic data. Up to now, however, they have not received widespread use in MRI, because both acquisition and visualization techniques have been inadequate. In this paper we describe new 3D acquisition techniques which can acquire up to 128 slices with a resolution of 256 x 256 pixels in from 8 to 20 min. These techniques produce 3D data sets with excellent contrast and few motion artifacts, which are very well suited for 3D visualization techniques. For the visualization we investigate several rendering techniques, describe some improvements and compare their results. We found that there is no single method which renders all objects equally well. We show which shading method is best suited for different objects and why the other methods fail. Our studies suggest that in a 3D view with several objects each object should be rendered with a separate shading method. In so doing, 3D views can be generated which look like the real human anatomy. PMID- 1779733 TI - Bayesian image processing in magnetic resonance imaging. AB - In the past several years, image processing techniques based on Bayesian models have received considerable attention. In our earlier work, we developed a novel Bayesian approach which was primarily aimed at the processing and reconstruction of images in positron emission tomography. In this paper, we describe how the technique has been adopted to process magnetic resonance images in order to reduce noise and artifacts, thereby improving image quality. In this framework, the image is assumed to be a statistical variable whose posterior probability density conditional on the observed image is modeled by the product of the likelihood function of the observed data with a prior density based our prior knowledge. A Gibbs random field incorporating local continuity information and with edge-detection capability is used as the prior model. Based on the formalism of the posterior density, we can compute an estimate of the image using an iterative technique. We have implemented this technique and applied it to phantom and clinical images. Our results indicate that the approach works reasonably well for reducing noise, enhancing edges, and removing ringing artifact. PMID- 1779734 TI - Software and hardware integration of a microprogrammable state machine for NMR imaging. AB - We have integrated a commercially available microprogrammable state machine (Tecmag PULSkit) for use as a magnetic resonance pulse programmer. Providing the capability for active research environment imaging protocols, it features timing resolution of 100 nsec, ten 16-bit loop counters, and individually addressable look-up tables. This integration involved hardware and software integration with a VAX 11/750 at several levels. Hardware: Each of the three gradient channels employs three digital-to-analog converters (DACs). An 8-bit, 4-quadrant, multiplying DAC generates the gradient waveform shape. A 12-bit DAC generates the multiplying DAC scaling voltage, controlling gradient amplitude and sign. A third 12-bit DAC produces a gradient offset (shim) voltage. An eddy current compensation network is present for each gradient channel. Software: The software design philosophy was to create a flexible interface (interactive window environment), while not constraining complex manipulation of the hardware (direct use of the pulse-sequence compiler primitives and microprogramming). The software levels include (a) pulse-sequence microprogramming, (b) pulse-sequence compiler, (c) interactive parameter specification, and (d) canned pulse-sequence microcode library. PMID- 1779735 TI - Short-term exposure to a 1.5 tesla static magnetic... PMID- 1779736 TI - [Control of exposure time of a roentgenodiagnostic unit by the radiation method]. AB - The authors word the main requirements to the measuring channel of an outfit for measuring the time of exposure of a roentgeno-diagnostic unit by the radiation method. Define optimal conditions of radiation filtering within the range of 40 125 kV. The measuring channel permits recording exposures in roentgenography made within the limits of 0.001-5 s. PMID- 1779737 TI - [Measuring the size of an effective focus spot of a computerized x-ray tomograph]. PMID- 1779739 TI - [Current problems of standardization of the requirements of electric safety of medical technology items]. PMID- 1779738 TI - [Analysis of regularities of rhythmic sensomotor activities using a Rhythmotest device]. AB - The paper is concerned with a study into the mechanisms of rhythmic sensorimotor activity (RSMA) using a "Ritmotest" device. The authors demonstrate potentialities of the device in determining the grade of automation of RSMA skill, which is presented as a process of the control conversion from the external feedback to the internal one. The conversion in question is realized with an output of a sensory standard at a given time interval. The "Ritmotest" may also specify the individual characteristics of the sensory standard formation. PMID- 1779740 TI - [Continuity of knowledge in professional training of physicians]. PMID- 1779741 TI - [Present-day medical gas analysis equipment]. AB - The author describes outfits presented at the exhibition "Zdravookhranenie-90", intended for gas analysis and blood gas measurements. Regards the principles of their operation and provides brief technical specifications. PMID- 1779742 TI - [Physical methods of the evaluation of the immune status of man]. AB - The paper reviews the main up-to-date physical methods for assessing humoral and cellular components of immunity. The merits and shortcomings of the methods are described and compared with the routine biochemical and histological assays used for these purposes. Emphasis is laid on the necessity of a wider use of physical approaches and methods in immunology. According to the author's opinion, it holds promise for further studies into intimate mechanisms of immune defense of man. PMID- 1779743 TI - [Physical-technical possibilities of perfecting roentgenographic research]. AB - The authors have classified factors that determine the quality of roentgenographic images and provided evidence for measures aimed at their improvement. It has been shown that it is conversion to an x-ray feeding device fitted out with microprocessor control that will make it possible to upgrade the quality of roentgenographic images and to reduce radiation loads of the patients. PMID- 1779744 TI - [Requirements for design of total prosthesis of the hip joint]. AB - Analysis of the forces acting on the total endoprosthesis of the hip joint and studies carried out for 16 years of the outcomes of 546 operations have demonstrated the position at an angle of 25-40 degrees to the horizontal to be the best variant of establishing the nest of an endoprosthesis. There is a necessity of designing endoprostheses having a cervico-diaphysial angle of 145 150 degrees. PMID- 1779745 TI - [Automatic microcomputer-assisted ophthalmo-tonometer]. PMID- 1779746 TI - [An Elektronika-KVCh device for reflexotherapy]. PMID- 1779747 TI - [Amalgam carrier and a vessel for amalgam]. AB - An amalgam carrier designed by the NPO Medinstrument makes it possible to take amalgam from the vessel, carry it to the carious cavity without any losses and to thicken it in the carious cavity and to regulate the amount of the amalgam introduced. The amalgam carrier in the non-operating condition may be dismantled into parts with a purpose of more adequate sterilization and disinfection. PMID- 1779748 TI - [Expert system of choosing lower limb (thigh) prosthesis and diagnosis of the quality of prosthetics (II)]. AB - The authors review an expert system (ES) of diagnosing the prosthetics quality, elucidate problems of the ES functioning within the framework of the general ES. Special attention is paid to the description of the knowledge and datum surface, to the algorithms of direct and reverse illegible logical data output in taking decisions as to defects of the patient's prosthesis in accordance with the signs observable. The work of the ES is demonstrated with special reference to concrete cases. Analysis is made of the estimates of the sensitivity to the initial data. The ES presents knowledge in depth, being designed in two versions: for practical (individual and mass) prosthetics and training purposes. PMID- 1779749 TI - Pseudomonad replication origins: a paradigm for bacterial origins? AB - Structural features of three analysed bacterial DNA replication origin classes (six enteric origins, three pseudomonad origins, and the Bacillus subtilis origin region) are compared in order to deduce characteristics common to all bacterial origins and characteristics that distinguish the three origin classes. The two Pseudomonas aeruginosa origins are shown to map within 10 kb of each other, and correlations are drawn with four potential origin regions in B. subtilis. The enteric origin class is further distinguished from the other two classes by its genetic organization, the presence of GATC sites, and the role of Dam methylation in enteric initiation. The pseudomonad origin class has the most features that are common to all of these bacterial origins, and hence may be the paradigm bacterial origin class. PMID- 1779750 TI - Structure and function of DnaA and the DnaA-box in eubacteria: evolutionary relationships of bacterial replication origins. AB - DnaA protein (a trans-acting element) and its binding sequence, DnaA-box: (a cis acting element) are two elements essential for the initiation of chromosomal replication in Escherichia coli and other enteric bacteria. Recently these two elements have been found to be conserved in three Gram-positive bacteria (Bacillus subtilis, Micrococcus luteus and Mycoplasma capricolum) as well as in Gram-negative pseudomonads. DnaA protein was also found to be essential in the initiation of the replication of the B. subtilis chromosome, and regions containing multiple repeats of DnaA-box (DnaA-box region) are found to be active as autonomously replicating elements both in B. subtilis and pseudomonads. In this MicroReview we compare first the structures of these DnaA-box regions and their locations on the chromosome and then functional aspects of DnaA protein and DnaA-box regions in the initiation and regulation of chromosomal replication. From these observations we propose evolutionary relationships between replication origins of eubacteria. PMID- 1779751 TI - Regulation of sod genes in Escherichia coli: relevance to superoxide dismutase function. AB - This review is concerned with the effects of environmental perturbations on the expression of the two superoxide dismutase (SOD) genes in Escherichia coli (sodA, MnSOD; sodB, FeSOD). Early studies using SOD activity, showed that MnSOD levels respond to changes in oxygen tension, type of substrate, redox active compounds, iron concentration, the nature of the terminal oxidant, and the redox potential of the medium. FeSOD levels appeared nominally insensitive to these perturbations. More recent molecular genetic studies revealed that sodA expression is subject to regulation by three major regulatory systems: fur (ferric uptake regulation) and arcA arcB (aerobic respiratory control) mediate repression of sodA, while a relatively new system, soxR soxS (superoxide response), mediates activation of sodA expression. By contrast, sodB expression, which is much less studied at this time, appears to be positively activated in trans by fur. A rudimentary gene regulation model is presented which rationalizes past observations, is experimentally testable, and should serve as a guide to future research in this area. PMID- 1779752 TI - Structure and function of pneumolysin, the multifunctional, thiol-activated toxin of Streptococcus pneumoniae. AB - Pneumolysin is a thiol-activated, membrane-damaging, multifunctional toxin and a known virulence factor of Streptococcus pneumoniae. The toxin can interfere with the functioning of both cellular and soluble components of the human immune system which protects against pneumococcal infection. Different amino acids within the toxin which are important in promoting oligomerization of the toxin in membranes and for the generation of functional lesions have been identified by site-directed mutagenesis. Pneumolysin can also activate the classical pathway of complement, and this appears to involve antibody binding (via Fc) by a region of the toxin homologous to C-reactive protein, a human acute-phase protein also capable of classical pathway activation and implicated in host defence against pneumococcal infection. PMID- 1779753 TI - Activation of cholera toxin and Escherichia coli heat-labile enterotoxins by ADP ribosylation factors, a family of 20 kDa guanine nucleotide-binding proteins. AB - Cholera toxin and Escherichia coli heat-labile enterotoxins are responsible, in part, for the symptomatology of cholera and traveller's diarrhoea, respectively. Effects of the toxins result from ADP-ribosylation of regulatory guanine nucleotide-binding (G) proteins; the ADP-ribosylated G protein is stabilized in an activated state, resulting in prolonged effects on its target. Toxin-catalysed ADP-ribosylation is stimulated in vitro by a family of guanine nucleotide-binding proteins, c. 20 kDa, termed ADP-ribosylation factors or ARFs. In the presence of GTP, but not GDP or adenine analogues, ARFs serve as allosteric activators of the toxin. The effects are amplified by certain phospholipids and detergents which promote guanine nucleotide binding. Six different mammalian ARF genes have been identified. They encode highly conserved, ubiquitous proteins of 175 to 181 amino acids, containing consensus domains responsible for guanine nucleotide binding. Differences in amino acid sequences are localized near the amino terminus and in the carboxy half of the protein. Although the physiological functions of ARFs have not been precisely defined, their immunological localization to the Golgi is consistent with a role in the regulated orderly movement of newly synthesized proteins from the endoplasmic reticulum, through the Golgi system to their ultimate destination. PMID- 1779754 TI - Escherichia coli molecular genetic map (1500 kbp): update II. AB - The DNA sequence data for Escherichia coli deposited in the EMBL library (release 27), together with miscellaneous data obtained from several laboratories, have been localized on an updated and corrected version of the restriction map of the chromosome generated by Kohara et al. (1987) and modified by others. This second update adds a further 500 kbp, increasing the amount of the E. coli chromosome sequenced to about one third of the total: 1510 kbp of sequenced DNA is included in the present data base. The accuracy of the map is assessed, and allows us to propose a precise genetic map position for every sequenced gene. The location of rare-cutting sites such as AvrII, NotI and SfiI have also been included in the update in order to combine the data obtained from different sources into one single file. The distribution of palindromic sequences (to which most restriction sites belong) has been studied in coding sequences. There appears to be a significant counter-selection against several such sequences in E. coli coding sequences (but not in other organisms such as Saccharomyces cerevisiae), suggesting the existence of constraints on DNA structure in E. coli, perhaps indicative of a functional role for horizontal gene transfer, preserving coding sequences, in this type of bacteria. PMID- 1779755 TI - Export of infectious particles by Escherichia coli transfected with the RF DNA of Pf1, a virus of Pseudomonas aeruginosa strain K. AB - Pf1 is a filamentous, single-stranded DNA virus that has Pseudomonas aeruginosa (strain K) as host. It is the longest of the filamentous bacterial viruses, and the DNA within it has the most extended conformation known. Pf1 virus cannot infect Escherichia coli (strain MM294) cells, but when these cells are transfected with the double-stranded replicative form of Pf1 DNA (RF DNA, 7.35 kb), they export low levels of infectious particles that create plaques on lawns of P. aeruginosa. Several different structural species, at least two of which are infectious, are exported. One of them, called Epf1, has virtually the same structure as Pf1, but the amount of Epf1 exported by E. coli is 10(4) lower than the amount of Pf1 exported by P. aeruginosa. The results imply that host factors affect not only the efficiency of virus assembly and export, but also the actual structures of the species exported. PMID- 1779756 TI - DNA sequencing and complementation/deletion analysis of the bchA-puf operon region of Rhodobacter sphaeroides: in vivo mapping of the oxygen-regulated puf promoter. AB - Within the photosynthetic gene cluster of Rhodobacter sphaeroides the genes encoding light-harvesting LHI and reaction-centre complexes are transcriptionally linked in the order pufBALMX. The region stretching 1.6 kb upstream of pufB has been examined by DNA sequencing and by complementation/deletion analysis. These studies demonstrate that three open reading frames are located upstream of pufB. One open reading frame, designated bchA, terminates just inside pufQ, which is located proximal to pufB. BchA contains a 37 bp region that functions as the oxygen-regulated promoter for pufQ, and probably for the puf operon as a whole. We also demonstrate that the protein encoded by pufQ appears to play a role in bacteriochlorophyll biosynthesis. PMID- 1779757 TI - Targeting and assembly of an oligomeric bacterial enterotoxoid in the endoplasmic reticulum of Saccharomyces cerevisiae. AB - A hybrid protein consisting of the Escherichia coli lipoprotein signal sequence attached to the mature sequence of the B subunit of heat-labile enterotoxin (Lipo EtxB) was expressed in yeast and E. coli. Analyses of cell lysates from Saccharomyces cerevisiae and E. coli expressing the protein revealed that both organisms were able to assemble Lipo-EtxB into oligomers that were (i) stable in the presence of sodium dodecyl sulphate, (ii) resistant to proteinase K degradation, and (iii) able to bind to GM1-ganglioside receptors. Each of these properties are characteristic of the wild-type B subunit pentamer produced in E. coli. Assembly of Lipo-EtxB was found to be unaffected in a sec18 mutant of S. cerevisiae, which possesses a temperature-sensitive defect in protein transport from the endoplasmic reticulum (ER) to the Golgi apparatus, but was found not to assemble in a sec53 mutant, which causes the misfolding of proteins targeted to the ER. A kar2-1 mutation with a defect in the yeast homologue of BiP caused an 18-fold reduction in Lipo-EtxB assembly at the non-permissive temperature in S. cerevisiae. However, introduction of the wild-type KAR2 gene on a plasmid into the kar2-1 mutant completely suppressed the inhibition of Lipo-EtxB assembly. This provides the first evidence that KAR2 facilitates the assembly of an oligomeric protein in yeast and thus implicates KAR2 as a 'molecular chaperone'. The possible mechanisms of enterotoxoid assembly in E. coli and S. cerevisiae are discussed. PMID- 1779758 TI - The kis and kid genes of the parD maintenance system of plasmid R1 form an operon that is autoregulated at the level of transcription by the co-ordinated action of the Kis and Kid proteins. AB - Stability mediated by the parD system of plasmid R1 is modulated by a killer protein, Kid, and by an antagonist of this function, Kis. Determination of the 5' ends of ParD transcripts, revealed that the genes coding for these proteins are transcribed from a single promoter. Analysis of the 3' end of the ParD RNAs indicated the existence of two transcripts: one of them coding for the Kis and Kid proteins, and the other coding only for Kis. Analysis of the effects of parD+ and kis+ recombinants on the beta-galactosidase levels expressed by different transcriptional and translational parD-lacZ fusions, and on the ParD RNA levels determined by a derepressed parD mutant, indicated that the Kis and Kid proteins repress coordinately the parD system at the transcriptional level. We discuss the relevance of these results in terms of the activities of the Kis and Kid proteins and in the context of the stabilization mediated by parD. PMID- 1779759 TI - Identification of cfxR, an activator gene of autotrophic CO2 fixation in Alcaligenes eutrophus. AB - A regulatory gene, cfxR, involved in the carbon dioxide assimilation of Alcaligenes eutrophus H16 has been characterized through the analysis of mutants. The function of cfxR is required for the expression of two cfx operons that comprise structural genes encoding Calvin cycle enzymes. CfxR (34.8 kDa) corresponds with an open reading frame of 954 bp, with a translational initiation codon 167 bp upstream of the chromosomal cfx operon. The cfx operon and cfxR are transcribed divergently. The N-terminal sequence of CfxR is very similar to those of bacterial regulatory proteins belonging to the LysR family. Heterologous expression of cfxR in Escherichia coli was achieved using the pT7-7 system. Mobility shift experiments demonstrated that CfxR is a DNA-binding protein with a target site upstream of both the chromosomal and the plasmid-encoded cfx operons. PMID- 1779760 TI - The merR regulatory gene in Thiobacillus ferrooxidans is spaced apart from the mer structural genes. AB - Two distinct merR genes, which regulate expression of the mercuric ion resistance gene (mer), of Thiobacillus ferrooxidans strain E-15 have been cloned, sequenced and termed merR1 and merR2. As a result of gene walking around two merR genes, it was found that these two genes were quite close in distance. The nucleotide sequence of the region (5,001 base pairs; PstI-EcoRI fragment) containing the merR genes was determined. Between the two merR genes, there were five potential open reading frames (ORFs). Two of these were identified as merC genes, and the other three as ORFs 1 to 3. ORFs 1 to 3 show significant homology to merA, tnsA from transposon Tn7, and merA, respectively. Both merR genes consist of a 408 bp ORF coding for 135 amino acids. Their gene products, MerR1 and MerR2, differed at three amino acid positions, and shared 56-57% and 32-38% identity with the MerRs from other Gram-negative and Gram-positive bacteria, respectively. Competitive primer extension analysis revealed that both regulatory genes were expressed in the host cells. These merR genes were located more than 6 kb from either end of the mer structural genes (merC-merA). This is the first example of merR being separated from the mer structural genes. The two merC genes, each of which coded for a 140-amino-acid protein, appeared to be functionally active because Escherichia coli cells carrying these merC genes on plasmid vectors showed hypersensitivity to HgCl2. However, ORFs 1 and 3, which were homologous to merA, seemed to be inactive both structurally and enzymatically. The gene arrangement in this region took on a mirror image, with the truncated tnsA as the symmetrical centre. It is suggested that the Tn7-like factor may have participated in gene duplication events of the mer region, and in its chromosomal integration. PMID- 1779761 TI - Escherichia coli rpoA mutation which impairs transcription of positively regulated systems. AB - The rpoA341 (phs) mutation of Escherichia coli results in decreased expression of several positively regulated operons and has been mapped to within or very near the rpoA gene encoding the alpha subunit of RNA polymerase. We have shown that plasmid-directed synthesis of the wild-type alpha subunit can complement the defective phenotypes associated with this mutation consistent with its proposed location within rpoA. This mutation was mapped by marker rescue to within a 182bp region near the 3' end of rpoA and was subsequently transferred to a plasmid by recombination in vivo. DNA sequence analysis revealed that the RpoA341 phenotype was the result of the substitution of lysine 271 by glutamate within the alpha polypeptide. We discuss this result in relation to our current understanding of the functional organization of the alpha subunit. PMID- 1779762 TI - Investigation of the specificity of the interaction between colicin E9 and its immunity protein by site-directed mutagenesis. AB - Comparison of the amino acid sequences of the C-terminal domain of three DNAase type E colicins has identified six candidate specificity determinants for the interaction of these E colicins with their homologous immunity proteins. We have changed these candidate specificity determinants of colicin E9, using site directed mutagenesis, to the corresponding amino-acids of colicin E8. A 'mutant' colicin E9, in which four of the six candidate specificity determinants have been changed, demonstrated colicin activity against Escherichia coli indicator strains which carried either the E8imm or the E9imm genes, indicative of a 'novel' E. colicin. After changing all six of the candidate specificity determinants, the resulting colicin E9 'mutant' exhibited a phenotype very similar to that of colicin E8. PMID- 1779763 TI - Identification of a nifA-like regulatory gene of Azospirillum brasilense Sp7 expressed under conditions of nitrogen fixation and in the presence of air and ammonia. AB - A gene bank of Azospirillum lipoferum Br17 constructed in the vector lambda GEM11 was screened with a Bradyrhizobium japonicum nifA gene probe. A 7.3 kb EcoRI fragment carrying a nifA-like gene was thereby isolated and subsequently used to screen a gene bank of Azospirillum brasilense Sp7 constructed in pUC18. Two EcoRI fragments of 5.6 kb and 3.6 kb covering the nifA-homology region were found. Mutants with Nif- phenotype were obtained by site-directed Tn5 mutagenesis of the 5.6 kb fragment and subsequent recombination into the A. brasilense Sp7 genome. The mutations were clustered into two loci located at each extremity of the fragment. One of these loci corresponded to nifA and the other to nifB. The nucleotide sequence of nifA of A. brasilense Sp7 was determined. Comparison of the deduced amino acid sequences of NifA of A. brasilense Sp7 and NifA of B. japonicum, Rhizobium leguminosarum biovar trifolii and Klebsiella pneumoniae confirmed that it was a nifA-like gene. Construction of a nifA-lacZ fusion and mapping of the RNA transcriptional start site showed that the nifA-like gene was expressed from an unidentified promoter, under conditions of nitrogen fixation and in the presence of oxygen and ammonia. PMID- 1779764 TI - Magnesium transport in Salmonella typhimurium: the influence of new mutations conferring Co2+ resistance on the CorA Mg2+ transport system. AB - The CorA Mg2+ transport system of Salmonella typhimurium mediates both influx and efflux of Mg2+. Mutations at the corA locus (83.5 min) confer resistance to Co2+. Using transposon mutagenesis, three additional Co2+ resistance loci (corB, corC, and corD) were found and mapped to 55, 15, and 3min, respectively, on the S. typhimurium chromosome. No mutations corresponding to the reported corB locus at 95 min in Escherichia coli were obtained. The corB, corC, and corD mutations confer levels of Co2+ resistance intermediate between those of the wild-type and corA mutations. Isogenic strains were constructed containing combinations of transposon insertion mutations in each of the three Co(2+)-resistance loci to assess their influence on the CorA Mg2+ transport system. The Vmax and Km values for 28Mg2+ or for 57Co2+ and 63Ni2+ influx, analogues of Mg2+ transported by the CorA system, were changed less than twofold compared with the wild-type values, regardless of the mutation(s) present. However, while efflux of 28Mg2+ through the CorA system was decreased threefold in strains carrying one or two mutant alleles among corB, corC, or corD, efflux was completely abolished in either a corA or a corBCD strain. Thus, although the corA gene product is necessary and sufficient to mediate Mg2+ influx, Mg2+ efflux requires the presence of a wild type allele of at least one of the corB, corC or corD loci. PMID- 1779765 TI - New approaches in genome analysis by pulsed-field gel electrophoresis: application to the analysis of Pseudomonas species. AB - A general method for the evaluation of macrorestriction fragment patterns is presented and its applicability to the taxonomy of bacteria is demonstrated for 32 Pseudomonas species. Strains were differentiated at the species and subspecies level by genome size and macrorestriction fragment fingerprints of the chromosome that had been separated on pulsed-field gels. The relatedness of bacteria was ascertained from the similarity of AsnI, DraI, SpeI, SspI or XbaI fragment patterns. In general, the dendrograms calculated from the genome fingerprints corresponded with the phylogenetic classification obtained from phenotypic marker or nucleic acid hybridization analysis, but several exceptions were noted. The techniques and algorithms presented herein are generally applicable to the genome analysis of bacteria, lower eukaryotes, and DNA fragments cloned in yeast artificial chromosomes. PMID- 1779766 TI - An amplifiable and deletable chloramphenicol-resistance determinant of Streptomyces lividans 1326 encodes a putative transmembrane protein. AB - A genetically unstable chloramphenicol resistance gene from Streptomyces lividans 1326 was cloned and characterized. This gene and adjacent DNA regions can be lost spontaneously or amplify within variants. Biochemical studies proved that chloramphenicol is not modified by an acetyltransferase or any other enzyme and that ribosomes of the resistant strain are sensitive to chloramphenicol. Sequence data revealed that the resistance gene encodes a hydrophobic protein predicted to have 12 membrane-spanning alpha-helices and a hydropathic profile similar to the membrane of proteins required for the efflux of tetracycline. Variable proportions of the amino acids (about 16-24%) within the presumed chloramphenicol resistant protein are identical to various aligned tetracycline-resistant proteins from Gram-negative and Gram-positive bacteria and to transporters for citrate in Klebsiella pneumonaie and for ferrichrome in Escherichia coli. PMID- 1779767 TI - Mechanism of regulation of the formate-hydrogenlyase pathway by oxygen, nitrate, and pH: definition of the formate regulon. AB - The products of a minimum of 15 genes are required for the synthesis of an active formate-hydrogenlyase (FHL) system in Escherichia coli. All are co-ordinately regulated in response to variations in the oxygen and nitrate concentration and the pH of the culture medium. Formate is obligately required for transcriptional activation of these genes. Analysis of the transcription of one of these genes, hycB linked to the lacZ reporter gene, revealed that oxygen and nitrate repression of transcription could be relieved completely, or partially in the case of nitrate, either by the addition of formate to the medium or by increasing the copy number of the gene encoding the transcriptional activator (fhlA) of this regulon. These studies uncovered a further level of regulation in which the transcription of hycB was reduced in cells grown on glucose. This effect was most clearly seen in aerobically grown cells when formate was added externally. Addition of cAMP overcame this glucose repression, which could be shown to be mediated by the cAMP receptor protein. These results would be consistent with the transport of formate being regulated by catabolite repression. Moreover, the repression of transcription through high pH also could be partially overcome by addition of increasing concentrations of formate to the medium, again being consistent with regulation at the level of formate import and export. Taken together, all these observations indicate that it is the intracellular level of formate that determines the transcription of the genes of the formate regulon by FhlA. This represents a novel positive feedback mechanism in which the activator of a regulon induces its own synthesis in response to increases in the concentration of the catabolic substrate, and this in turn is governed by the relative affinities of FhlA and the three formate dehydrogenase isoenzymes for formate. PMID- 1779768 TI - Regulation of toxA and regA by the Escherichia coli fur gene and identification of a Fur homologue in Pseudomonas aeruginosa PA103 and PA01. AB - A multicopy plasmid containing the Escherichia coli fur gene was introduced into Pseudomonas aeruginosa strain PA103C. This strain contains a toxA-lacZ fusion integrated into its chromosome at the toxA locus. Beta-galactosidase synthesis in this strain is regulated by iron, as is seen for exotoxin A production. Beta galactosidase synthesis and exotoxin A production in PA103C containing multiple copies of E. coli fur was still repressed in low iron conditions. The transcription of regA, a positive regulator of toxA, was also found to be inhibited by multiple copies of the E. coli fur gene. In addition, the ability of PA103C containing multiple copies of E. coli fur to produce protease was greatly reduced relative to PA103C containing a vector control. A polyclonal rabbit serum containing antibodies that recognize E. coli Fur was used to screen whole-cell extracts from Vibrio cholerae, Shigella flexneri, Salmonella typhimurium and Pseudomonas aeruginosa. All strains tested expressed a protein that was specifically recognized by the anti-Fur serum. These results and those described above suggest that Fur structure and function are conserved in a variety of distinct bacterial genera and that at least some of these different genera use this regulatory protein to control genes encoding virulence factors. PMID- 1779769 TI - Three in-frame N-terminally different proteins are produced from the repressor locus of the Streptomyces bacteriophage phi C31. AB - The sequence of the repressor locus, c, of the Streptomyces temperate phage, phi C31, was shown previously to contain an open reading frame encoding a 74 kDa protein. Further analysis of the transcriptional and translational products of the c gene shows a more complex pattern of expression. A nest of three in-frame N terminally different, C-terminally identical proteins of 74, 54 and 42 kDa were found to be expressed from a corresponding nest of transcripts. The repressor proteins were produced in Escherichia coli and the 42 kDa protein was purified, verified by N-terminal sequencing, and used to raise antibody. The antibody cross reacted in Western blots with the 74, 54 and 42 kDa proteins expressed in E. coli and Streptomyces lividans and from Streptomyces coelicolor phi C31 lysogens. Analysis of transcription of the c gene by S1 mapping and primer extension showed that the nest of transcripts encoding the repressor protein were induced after heat treatment of the cts locus (Sinclair and Bibb, 1989; this paper). Correspondingly, all three of the repressor proteins were induced. In addition to a promoter, cp1, which lies upstream of the 74 kDa open reading frame, the c locus contained at least one internal promoter, cp2, which transcribes DNA encoding the 54 and 42 kDa proteins. Transcripts initiating from cp3 were observed in RNA preparations from S. lividans containing the c gene deleted for cp1 and cp2, but gene fusions using DNA which should contain any putative promoting activity from this region transcriptionally fused to the xylE gene showed very low levels of expression of catechol 2,3 dioxygenase in S. lividans. The 74 kDa protein was not necessary for super-infection immunity. Data described here and current knowledge of the nature of other 'dual start' genes suggest a model for the regulation of lysis versus lysogeny in phi C31. PMID- 1779771 TI - Metallobiochemistry. Part B. Metallothionein and related molecules. PMID- 1779770 TI - A protein kinase gene complements the lytic phenotype of Saccharomyces cerevisiae lyt2 mutants. AB - By genetic analysis of a thermosensitive autolytic mutant whose phenotype was complemented by osmotic stabilization with sorbitol, we identified gene LYT2 of Saccharomyces cerevisiae, which is probably involved in cell wall formation. A yeast gene complementing lyt2 strains was cloned and shown to carry an open reading frame coding for a 484-amino-acid protein exhibiting all the characteristic domains of serine/threonine protein kinases and highly homologous to other yeast protein kinases involved in control of the mitotic cycle. Mutants disrupted in the cloned gene also displayed an autolytic phenotype complemented by osmotic stabilization with sorbitol. However, genetic comparison of lyt2 mutants and disruptants of the protein kinase gene revealed that the cloned gene is not the structural gene LYT2 but a suppressor of the lytic phenotype, named gene SLT2, that was mapped to chromosome V. The product of gene SLT2 is the first protein kinase to be described in relation to the yeast cell-wall functions. PMID- 1779772 TI - Detection of metallothionein by western blotting. PMID- 1779773 TI - Toxicological significance of metallothionein. PMID- 1779774 TI - Detection of carboxymethylmetallothionein by sodium dodecyl sulfate polyacrylamide gel electrophoresis. AB - A sensitive method for detecting metallothioneins (MTs) by using silver staining and autoradiography after sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) of carboxymethylated MTs is described. Carboxymethylation of MTs is indispensable because it prevents their aggregation, thereby allowing each of them to appear as a single band using SDS-PAGE. Metallothioneins can be detected with a limit of nanogram levels per lane. This method can be applied to MTs induced in in vitro cultured cells and in in vivo tissues. PMID- 1779775 TI - Radioimmunoassay for metallothionein in body fluids and tissues. PMID- 1779776 TI - Measurement of human metallothionein by enzyme-linked immunosorbent assay. PMID- 1779777 TI - Separation and quantification of isometallothioneins by high-performance liquid chromatography-atomic absorption spectrometry. PMID- 1779778 TI - Detection of metallothioneins by high-performance liquid chromatography inductively coupled plasma emission spectrometry. PMID- 1779779 TI - Electrochemical detection of metallothionein. PMID- 1779780 TI - Purification and quantification of metallothioneins by reversed-phase high performance liquid chromatography. PMID- 1779781 TI - Purification of metallothionein by fast protein liquid chromatography. PMID- 1779782 TI - Purification of human isometallothioneins. PMID- 1779783 TI - Isoelectric focusing of mammalian metallothioneins. PMID- 1779784 TI - Nutritional and physiologic significance of metallothionein. PMID- 1779785 TI - Purification of vertebrate metallothioneins. PMID- 1779786 TI - Purification of invertebrate metallothioneins. AB - Purification procedures that appear to be generally applicable to invertebrate MTs have only recently been developed and are described here. Thus far, few invertebrate MTs have been purified and characterized, although proteins that exhibit similarities to MT have been identified in numerous invertebrate species. A greater understanding of MTs of this group, which comprises most of the animals in the animal kingdom, will provide the basis for increased understanding of the evolution of this ubiquitous protein. Additionally, specific invertebrate species may provide useful models for probing MT function and contribute to a greater understanding of the biological role of MT. PMID- 1779787 TI - Purification of yeast copper-metallothionein. PMID- 1779788 TI - Purification of prokaryotic metallothioneins. PMID- 1779789 TI - Introduction to metallothionein. PMID- 1779790 TI - Role of metallothionein in essential, toxic, and therapeutic metal metabolism in Ehrlich cells. PMID- 1779791 TI - Purification of mammalian metallothionein from recombinant systems. PMID- 1779792 TI - Cadmium-binding peptides from plants. PMID- 1779793 TI - Phytochelatins. PMID- 1779794 TI - Sulfur-containing cadystin-cadmium complexes. PMID- 1779795 TI - Cadystins: small metal-binding peptides. PMID- 1779796 TI - Isolation of metallothionein from ovine and bovine tissues. PMID- 1779797 TI - Detection of metallothionein in brain. PMID- 1779798 TI - Large-scale preparation of metallothionein: biological sources. PMID- 1779799 TI - Cysteine modification of metallothionein. PMID- 1779800 TI - Ligand substitution and sulfhydryl reactivity of metallothionein. PMID- 1779801 TI - Standard isolation procedure for metallothionein. PMID- 1779802 TI - Determination of metals in metallothionein preparations by atomic absorption spectroscopy. PMID- 1779803 TI - Amino acid sequence determination. PMID- 1779804 TI - Differential modification of metallothionein with iodoacetamide. PMID- 1779805 TI - Lysine modification of metallothionein by carbamylation and guanidination. PMID- 1779806 TI - Limited proteolysis of metallothioneins. PMID- 1779807 TI - Criteria of purity for metallothioneins. PMID- 1779809 TI - Copper coordination in metallothionein. PMID- 1779808 TI - Metal removal and substitution in vertebrate and invertebrate metallothioneins. PMID- 1779810 TI - In vitro preparation and characterization of aurothioneins. PMID- 1779811 TI - Isolation of metallothioneins under metal-free conditions. PMID- 1779812 TI - Stability constants and related equilibrium properties of metallothioneins. PMID- 1779813 TI - X-ray structure of metallothionein. PMID- 1779814 TI - Determination of the three-dimensional structure of metallothioneins by nuclear magnetic resonance spectroscopy in solution. PMID- 1779815 TI - Absorption, circular dichroism, and magnetic circular dichroism spectroscopy of metallothionein. PMID- 1779816 TI - Luminescence spectroscopy of metallothioneins. PMID- 1779817 TI - Induction of metallothionein in rats. PMID- 1779818 TI - Induction of metallothionein in primary rat hepatocyte cultures. PMID- 1779819 TI - Determination of metallothionein in biological materials. PMID- 1779820 TI - Metallothionein and zinc metabolism in hepatocytes. PMID- 1779821 TI - Metallothionein and copper metabolism in liver. PMID- 1779822 TI - Biological indicators of cadmium exposure. PMID- 1779823 TI - Assay of extracellular metallothionein. PMID- 1779824 TI - Cadmium-binding peptide complexes from Schizosaccharomyces pombe. PMID- 1779825 TI - Overview of metallothionein. PMID- 1779826 TI - Definitions and nomenclature of metallothioneins. PMID- 1779827 TI - Determination of metallothionein in tissues by cadmium-hemoglobin affinity assay. PMID- 1779828 TI - Immunohistochemical localization of metallothionein. PMID- 1779829 TI - Immunohistochemical detection of metallothionein. PMID- 1779830 TI - Protein-DNA interactions. PMID- 1779831 TI - Purification of sequence-specific binding proteins by DNA affinity chromatography. PMID- 1779832 TI - Gel retardation. PMID- 1779833 TI - DNA bending in protein-DNA complexes. PMID- 1779834 TI - Footprinting protein-DNA complexes in vivo. PMID- 1779836 TI - Kinetic studies on promoter-RNA polymerase complexes. PMID- 1779835 TI - Laser cross-linking of protein-nucleic acid complexes. PMID- 1779837 TI - Using protein affinity chromatography to probe structure of protein machines. PMID- 1779838 TI - Thermodynamic methods for model-independent determination of equilibrium binding isotherms for protein-DNA interactions: spectroscopic approaches to monitor binding. AB - The measurement of equilibrium binding constants for ligand-macromolecule interactions by monitoring a change in some spectral property of the ligand or the macromolecule is a common method used to study these interactions. This is due to the high sensitivity of the spectroscopic methods and general ease in applying these experimental procedures. In addition, binding can be monitored continuously, thus facilitating kinetic measurements. The main problem with these methods results from the fact that the spectroscopic signal is an indirect measure of binding, since the relationship between the change in the spectroscopic signal and the extent of binding is unknown, a priori. A common recourse is to assume a strict proportionality between the signal change and the fractional saturation of the ligand or macromolecule; however, it is often the case that such a direct proportionality does not hold. In this chapter we have reviewed the use of methods to analyze ligand-macromolecule equilibrium titrations that are monitored by indirect spectroscopic techniques. These methods of analysis yield thermodynamically rigorous, model-independent binding isotherms, hence assumptions concerning the relationship between the signal change and the extent of binding are not required. In fact, these methods can also be used to determine quantitatively the relationship between the signal change and the average degree of binding. In addition, the approaches discussed here are general and not limited to spectroscopic signals and therefore can be used with any intensive physicochemical property that reflects binding. PMID- 1779839 TI - Analysis of equilibrium and kinetic measurements to determine thermodynamic origins of stability and specificity and mechanism of formation of site-specific complexes between proteins and helical DNA. AB - The concentration and nature of the electrolyte are key factors determining (1) the equilibrium extent of binding of oligocations or proteins to DNA, (2) the distribution of bound protein between specific and nonspecific sites, and (3) the kinetics of association and dissociation of both specific and nonspecific complexes. Salt concentration may therefore be used to great advantage to probe the thermodynamic basis of stability and specificity of protein-DNA complexes, and the mechanisms of association and dissociation. Cation concentration serves as a thermodynamic probe of the contributions to stability and specificity from neutralization of DNA phosphate charges and/or reduction in phosphate charge density. Cation concentration also serves as a mechanistic probe of the kinetically significant steps in association and dissociation that involve cation uptake. In general, effects of electrolyte concentration on equilibrium constants (quantified by SKobs) and rate constants (quantified by Skobs) are primarily cation effects that result from the cation-exchange character of the interactions of proteins and oligocations with polyanionic DNA. The competitive effects of Mg2+ or polyamines on the equilibria and kinetics of protein-DNA interactions are interpretable in the context of the cation-exchange model. The nature of the anion often has a major effect on the magnitude of the equilibrium constant (Kobs) and rate constant (kobs) of protein-DNA interactions, but a minor effect on SKobs and Skobs, which are dominated by the cation stoichiometry. The order of effects of different anions generally follows the Hofmeister series and presumably reflects the relative extent of preferential accumulation or exclusion of these anions from the relevant surface regions of DNA-binding proteins. The question of which anion is most inert (i.e., neither accumulated nor excluded from the relevant regions of these proteins) remains unanswered. The characteristic effects of temperature on equilibrium constants and rate constants for protein-DNA interactions also serve as diagnostic probes of the thermodynamic origins of stability and specificity and of the mechanism of the interaction, since large changes in thermodynamic and activation heat capacities accompany processes with large changes in the amount of water-accessible nonpolar surface area.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1779840 TI - Use of polyethyleneimine in purification of DNA-binding proteins. PMID- 1779841 TI - DNA contacts probed by modification protection and interference studies. PMID- 1779842 TI - Nuclease activity of 1,10-phenanthroline-copper in study of protein-DNA interactions. PMID- 1779843 TI - Metal requirements for nucleic acid binding proteins. PMID- 1779844 TI - Protein chemical modification as probe of structure-function relationships. PMID- 1779845 TI - Characterization of protein-DNA complexes by affinity cleaving. PMID- 1779846 TI - Identification of amino acid residues at interface of protein-nucleic acid complexes by photochemical cross-linking. PMID- 1779847 TI - Large-scale preparation of DNA fragments for physical studies of protein binding. PMID- 1779848 TI - Use of nonsense suppression to generate altered proteins. AB - The use of suppressed nonsense mutations to generate altered proteins can greatly simplify studies in which a large number of defined mutant proteins are sought. If site-directed mutagenesis is used to generate specific mutations, than for every amber (UAG) mutation constructed, as many as 13 different amino acids can be inserted at the corresponding site in the protein. This allows a rapid screening of many altered proteins for those with interesting properties. Once identified, the interesting substitutions can be regenerated by missense changes, to avoid some of the potential problems of the method. Nonsense suppression has been used to generate more than 3300 amino acid replacements in the E. coli lac repressor, and close to 250 amino acid substitutions in E. coli thymidylate synthase. PMID- 1779849 TI - Random mutagenesis of protein sequences using oligonucleotide cassettes. PMID- 1779850 TI - Identification of amino acid-base pair contacts by genetic methods. PMID- 1779851 TI - Multidimensional nuclear magnetic resonance spectroscopy of DNA-binding proteins. PMID- 1779852 TI - Second-site reversion as means of enhancing DNA-binding affinity. PMID- 1779854 TI - Functional organization of the nucleus: a laboratory guide. PMID- 1779853 TI - Crystallization of protein-DNA complexes. PMID- 1779855 TI - Visualization of DNA sequences in meiotic chromosomes. PMID- 1779856 TI - Meiotic chromosome preparation and protein labeling. PMID- 1779857 TI - The use of monoclonal antibody libraries. PMID- 1779858 TI - Optical sectioning and three-dimensional reconstruction of diploid and polytene nuclei. AB - To build a coherent picture of mitosis and cell fates during blastoderm and through the complex movements of gastrulation, it will be important to localize and follow several markers simultaneously in live specimens, ideally in 3D, using high-resolution, specific, noninjurious staining and observation procedures. The study of early Drosophila development has already profited from the use of fluorescent labeling and low-light-level imaging of live embryos using a CCD camera. Chromosomes in fixed samples have been labeled using DNA-specific dyes, making the pattern of mitotic patches visible. In vivo, 3D microscopy of fluorescently tagged chromosomes, in conjunction with computerized image processing, has permitted the first direct cell lineage analysis in the early Drosophila embryo. Moreover, the techniques adapted to study Drosophila development have been used for analysis of Drosophila chromosome structure, mitosis, and cell cycle, and are general enough to be applied to a myriad of problems in cell biology. "Optical sectioning" has always been used to scrutinize everything from onion roots to frog eggs, focusing up and down through the specimen, with the observer's brain responsible for the image processing. However, the volume of raw data generated by the high-resolution approach detailed above requires the use of sophisticated and adaptable computer systems to analyze and organize the results. Software designed to extract information from these complex images, either automatically or through an interactive approach, will become essential tools for cell and developmental biology. The brain of the experimenter remains the most important component in any image processing system, but the support of technology will be essential. PMID- 1779859 TI - Yeast minichromosomes. PMID- 1779860 TI - DNA sequence localization in metaphase and interphase cells by fluorescence in situ hybridization. PMID- 1779861 TI - Nucleosomes of transcriptionally active chromatin: isolation of template-active nucleosomes by affinity chromatography. PMID- 1779862 TI - Localization of mRNAs by in situ hybridization. PMID- 1779863 TI - Control of class II gene transcription during in vitro nucleosome assembly. PMID- 1779864 TI - In vitro nuclear protein import using permeabilized mammalian cells. PMID- 1779865 TI - Mutations that affect chromosomal proteins in yeast. PMID- 1779866 TI - Mutations that affect nuclear organization in yeast. PMID- 1779867 TI - Concern for the health of babies or paternalistic racial discrimination? PMID- 1779868 TI - The hypertensive disorders of pregnancy: their contribution to maternal mortality. AB - The hypertensive disorders of pregnancy and their complications are the major cause of maternal mortality in the developed world and the third most common cause of maternal mortality in the world. In this paper the extent of the problem is described and factors affecting pre-eclampsia and eclampsia are described. Ways of reducing deaths from these causes are suggested. PMID- 1779869 TI - Variations in breast feeding advice, a telephone survey of community midwives and health visitors. AB - Although 65% of mothers start breast feeding their baby, at six weeks after birth this proportion has dropped to 40%. It is postulated that one of the causes of this decrease might be that women receive conflicting advice from professionals. To examine this hypothesis, a telephone survey was designed to compare a random sample of community midwives (CMs) and a random sample of health visitors (HVs), in regard to the advice they would offer to breast feeding women, and the resources available to help them. On many topics, the advice likely to be offered by the two groups was markedly different. The CMs tended to be more uniform in their advice, which generally followed the Royal College of Midwives' booklet entitled Present Day Practice in Infant Feeding. Both groups recognised the value of lay breast-feeding counsellors, and there was much support for collaboration in the production of a guidance document on breast feeding. PMID- 1779870 TI - A study of the relationship between the delivery to cord clamping interval and the time of cord separation. Oxford Midwives Research Group. AB - A randomised controlled trial of 554 women was carried out to compare the effects of late and early umbilical cord clamping on the time of cord separation. In addition data were collected on maternal and neonatal outcomes. There were no significant differences between the two groups in the duration of cord adherence and neonatal and maternal outcomes. There appeared to be a higher rate of jaundice in the late clamped group which did not reach statistical significance. There was an unexpectedly higher rate of breast feeding at home in the late clamped group which did reach statistical significance. Overall the trial provides no clear evidence for the benefit of early cord clamping (the current policy as part of the active management of the third stage in the UK) on the outcomes considered. PMID- 1779871 TI - Factors affecting the duration of postnatal visits. AB - 24 community midwives recorded details of 783 postnatal visits over a 2 week period. The findings provide a description of postnatal visiting practice in Lothian Region, Scotland. Analysis revealed that 10 factors were significantly associated with the duration of visits. These could be grouped as follows: time consuming procedures (physical examination of the mother or baby, PKU testing), administration-related (the number of other visits that day, the need to liaise with general practitioners or health visitors, whether the mother was already known to the midwife, the time kept waiting at the house), feeding-related (the existence of feeding problems, whether the mother had breast fed previously) and delivery-related (the existence of complications during the delivery). The presence of health, social or emotional problems, or the lack of family/partner support was not associated with longer visits. The implications of these findings are discussed. PMID- 1779872 TI - Midwife/client relationship: midwives' perspectives. AB - This study set out to explore midwives' understanding of the factors which affected the development of a therapeutic relationship with clients. A qualitative approach was adopted for the study to avoid placing predetermined categories upon midwives' perceptions. Because of the qualitative nature of the study in-depth interviews were conducted to allow midwives to explore in depth their perceptions of the research topic. Themes identified within the interview data indicated conflicting needs/interests which in turn seemed to cause dilemmas for the midwives interviewed. It seemed appropriate therefore to take the data analysis one step further by utilising dilemma analysis. Consideration of the situations in which the midwives experienced 'good' or 'poor' relationships revealed a complex picture of the factors affecting relationships with clients. Four main issues were identified: the nature and value of the midwives' role; recognition of authority/autonomy in practising this role; emotional involvement with clients; and maintaining personal integrity. From dilemma analysis of the data it appears that when midwives were successful in managing these issues then the relationship became 'special' and therapeutic for clients. Mismanagement of these issues in contrast led to dilemmas which then inhibited development of meaningful relationships between the midwives and clients. In view of the fact that clients and midwives value this 'special' relationship a case is made for midwives to be prepared educationally to manage effectively issues which are raised in their everyday practice. Only then will the midwife/client relationship become therapeutic. PMID- 1779874 TI - Safest birth attendants. PMID- 1779873 TI - Neonatal intensive care units: visiting policies for grandparents. AB - Most neonatal intensive care units (NICUs) in the UK now permit grandparents and siblings to enter but there has been no systematic evaluation of current policies for visiting. Postal questionnaires were used to obtain data from all qualified nurses/midwives (N = 265) and doctors (N = 63) employed in the seven largest NICUs in Scotland. Subsequently, parents and grandparents of very low birth weight (VLBW) babies were sent questionnaires one month after delivery and one month after the babies' discharge home. 93 families participated. Areas under investigation were sources of support and their perceptions of current visiting policies. Overall professionals found working with grandparents the least liked aspect of their job and there was widespread dissatisfaction with existing policies for grandparents' involvement which were not seen to meet perceived needs. Although most grandparents were tolerant of the restrictions limiting their access, parents were far less satisfied on their behalf. Families and staff alike called for a revision of policies and a much greater voice in decision making for the parents and relatives themselves. PMID- 1779875 TI - Physiological effects of the lipopolysaccharide of Vibrio vulnificus on mice and rats. AB - Vibrio vulnificus is a pathogenic, marine, Gram-negative bacterium which commonly enters and infects humans via open wounds or the ingestion of raw seafood. The lipopolysaccharide (LPS) of V. vulnificus has recently been characterized, but the biological activity of this putative endotoxin is unknown. Three treatment groups were used to test its activity: saline (negative control), the LPS of Salmonella typhimurium (a known endotoxin), and the LPS of V. vulnificus. Whereas, intravenous injections of the S. typhimurium LPS caused mortality in two strains of mice, V. vulnificus LPS was not lethal. However, intraperitoneal injections into rats of both V. vulnificus and S. typhimurium LPS were pyrogenic. Intravenous injections of V. vulnificus LPS in rats caused decreased mean arterial pressure within 10 min which further declined, leading to death in 30 to 60 min. S. typhimurium LPS caused similar responses at the same concentration. The data suggest that the LPS of V. vulnificus may be a factor contributing to the virulence of this organism. PMID- 1779876 TI - Excretion of the Escherichia coli alpha-haemolysin by Serratia marcescens. AB - Serratia marcescens 2170 derivative strains harbouring either the haemolytic plasmid pANN202-312 or pANN202-312R, were able to produce extracellular haemolysin to a greater extent than the corresponding Escherichia coli 5K strains. The haemolysin recovered from S. marcescens cultures supernatants had a molecular weight of 110 kD, and its extracellular production was maximal near the end of the exponential growth phase. The hlyR sequence, which belongs to the haemolytic determinant located in the plasmid pHly152 and enhances haemolysin expression and secretion in E. coli, appeared not to play an equivalent role in S. marcescens. PMID- 1779877 TI - Co2+ and Ni2+ resistance in Saccharomyces cerevisiae associated with a reduction in the accumulation of Mg2+. AB - A mutant strain of Saccharomyces cerevisiae (NR 6), which can be associated with a reduction in the accumulation of Mg2+ has been isolated. This mutant strain displays resistance to both Ni2+ and Co2+, but not, however, towards Cu2+, Cd2+, Mn2+, Zn2+ and Cr2O7(2-). Both Co2+ and Ni2+ uptake by the mutant strain is less than by the wild type (CMR-50). The inhibitory effects of Ni2+ and Co2+ on the growth of both strains NR-6 and CMR-50 can be cancelled by increasing the concentrations of Mg2+ in the medium and to a lower extent by the addition of Ca2+ which results in a decreased uptake of these metals. It therefore appears that the resistant mechanisms of this mutant strain NR-6 is due to a reduction in the uptake of Co2+ and Ni2+ via a Mg2+ transport system. PMID- 1779878 TI - Studies on the antifungal antibiotics: bacillomycin D and bacillomycin D methylester. AB - Bacillomycin D, an antifungal compound of Bacillus subtilis, was produced during the stationary phase of growth when all the glucose of the medium was exhausted and the pH reached about 8. In addition to bacillomycin D, bacillomycin D methylester was characterized by its antifungal properties and its haemolytic activity. PMID- 1779879 TI - A comparative study of the activity of first and second generation cephalosporins and their combinations with beta-lactamase inhibitors against Bacteroides fragilis. AB - The sensitivity of 160 strains of Bacteroides fragilis, 74 beta-lactamase positive and 86 negative, to two first generation and four second generation cephalosporins, alone and in combination with clavulanic acid and sulbactam, was investigated. For the susceptibility test the dilution method in agar was used. The detection of beta-lactamase production by this micro-organism was performed by means of the method using chromogenic cephalosporin of Nitrocefin. In both strains an important improvement in the activity of cephalothin, cephazolin, cefonicid and cefamandole was noted when they were combined with the two inhibitors. In combinations of cefoxitin and cefmetazole, no significant improvement was evident in the values of the parameters studied in the beta lactamase-producing strains; and even in beta-lactamase-negative strains these values showed only a slight increase. PMID- 1779880 TI - The choriocapillaris in spontaneously diabetic rats. AB - During diabetes in rats, the choroid of the eye shows increased permeability to albumin, basement membrane thickening, and decreased anionic charge sites on the abluminal surfaces of the choriocapillary microvessels. In other microvascular beds, permeability differences are correlated with differences in luminal membrane microdomains as indicated by the distribution of luminal membrane anionic charge. To see whether luminal surface charge distribution or other structural features of the choroidal microvasculature become altered during diabetes, we studied spontaneously diabetic and control rats using ultrastructural tracers and morphometric techniques. Rats were injected with horseradish peroxidase and perfused with aldehydes, and then retina-choroid tissue sections were incubated with cationized ferritin, reacted to visualize peroxidase, and prepared for electron microscopic study. The most striking alterations in the diabetic rats were vascular debris and migrating cells resembling vascular cells in the choriocapillaris stroma, suggesting an increase in capillary turnover. In addition, extracellular matrix material was increased, and peroxidase uptake and ferritin binding were low in some vessels of the diabetic rats compared with the controls. Variability was large in the diabetic animals, however, and other vessels remained apparently normal. PMID- 1779881 TI - Morphological response of human endothelial cells subjected to cyclic strain in vitro. AB - Endothelial cells (EC) are subjected to hemodynamic forces in vivo. However, most in vitro studies of EC biology have been performed utilizing stationary culture conditions. To study the morphology and cytoskeletal features of EC under dynamic culture conditions, we utilize a system capable of exerting repetitive strain on cells in culture. Human saphenous vein EC were plated to a subconfluent density in 25-mm wells with a thin flexible bottom and a rat collagen, Type I surface. A 20 kPascals vacuum applied to the bottoms led to a maximum deformation of 24%. EC were exposed to 0.5 sec deformation alternating with 0.5 sec relaxation (60 cycles/min) for 24 hr. EC were fixed with formalin at different time intervals and stained with crystal violet. Actin filaments were stained with rhodamine phalloidin, an F-actin marker, while beta-tubulin and vimentin were visualized by immunofluorescent antibody techniques. Within 15 min after initiation of cyclic strain, actin stress fibers were aligned perpendicular to the force vector. By 12 hr of cyclic strain EC were elongated and oriented in the same direction as the actin filaments. EC elongation and alignment were inhibited by cytochalasin B. Even up to 24 hr of cyclic strain, beta-tubulin and vimentin distributions were unaltered. We propose that cyclic strain of EC in vitro influences cell alignment and elongation by a mechanism dependent on the actin filament system. PMID- 1779882 TI - Extracellular matrix of newly forming vessels--an immunohistochemical study. AB - During wound healing, embryological development, and solid tumor growth, the established vasculature gives rise to large numbers of new blood vessels. This neovascular response occurs at the level of the capillary bed, where endothelial cells divide rapidly, locally remodel the surrounding stroma, and migrate away from existing vessels to form capillary sprouts. In order to examine the environment of these newly forming vessels, actively growing blood vessels in neovascularized rabbit and guinea pig corneas were examined immunohistochemically using antibodies against laminin, type IV collagen, heparan sulfate proteoglycans, entactin, and factor VIII-related antigen. Sequential serial 5 microns sections taken from the unfixed frozen corneas in a plane perpendicular to the direction of vessel growth were stained with these antibodies. It was possible to follow well-defined lumenized vessels out through sequential sections to the point where they became single factor VII-R positive cells in the region of the capillary sprout. Examination of these stained sections has shown the presence of four important basement membrane components--laminin, type IV collagen, heparan sulfate proteoglycan, and entactin--associated with actively migrating and invading capillary sprouts. These results suggest that the extracellular matrix of the actively invading capillary sprouts does not differ qualitatively from that of the established vasculature. PMID- 1779883 TI - A simple, dual tracer method for the measurement of transvascular flux of albumin into the lung. AB - A simple, first-order model of albumin kinetics in the rat lung is presented and validated with a more sophisticated model. The simple model assumes that intravascular concentration of tracer albumin is constant over 30 min after injection and transvascular flux of tracer albumin is unidirectional and proportional to the permeability-surface area product (PS). 125I-albumin is injected initially and 131I-albumin at 20 min. At 30 min the rat is sacrificed and plasma and tissue samples are obtained for gamma counting. Simultaneous equations are set up for the two tracers and solved for PS and plasma volume. The accuracy of this approach is examined with data generated from a more complete model. This model uses the concepts of hydraulic conductivity, solvent drag, reflection coefficients, hydrostatic and osmotic pressures, exclusion volumes, and lymph flow, as well as PS. Based on known PS and clearance rates from the complex model, the simple model estimates tracer albumin leakage rate with less than 5% error over the range of PS encountered in rat studies. PMID- 1779884 TI - Dynamics of leukocyte-endothelium interactions in the splanchnic microcirculation. AB - In vivo dynamics of the interaction between leukocytes and the endothelium following direct activation of the white blood cells (WBCs), apart from possible endothelial cell activation, were studied in arterioles, capillaries, and venules of splanchnic tissue (rabbit omentum). WBCs were isolated using either density gradient or centrifugation techniques, labeled with fluorescent dyes, and exposed to physiological solutions with or without the chemoactivator N-formyl-methionyl leucyl-phenlyalanine (FMLP). WBCs isolated using standard density gradient separation techniques rapidly disappeared from the circulating pool following a bolus injection and were sequestered in lung microvessels. The centrifugation technique produced cells that circulated for at least 60 min. WBCs directly activated with FMLP adhered to venular endothelium but not to arteriolar endothelium, suggesting that differences in hydrodynamics in the arteriolar and venular network or fundamental differences between arteriolar and venular endothelia may explain the lack of leukocyte-endothelium adhesion (LEA) in arterioles. WBCs pretreated with FMLP had significantly longer attachment times than nontreated cells, 13.4 and 2.5 sec respectively, which may be indicative of specific receptor chemistry. Similarities in the LEA attachment-detachment process for splanchnic tissue with that previously reported for lymphoid tissue suggest that a fundamental process of cell to cell interaction may exist in all tissues. PMID- 1779885 TI - The effect of neonatal treatment with capsaicin on focal arteriolar insudation. AB - There is evidence that peptide neurotransmitters (e.g., substance P, neurokinin A, vasoactive intestinal peptide, calcitonin gene-related peptide) from sensory nerves play a part in vasoregulation. We examined the effect of neonatal treatment with capsaicin, a procedure that causes permanent impairment of primary sensory neurons, on a recently described arteriolar response to inflammation, focal arteriolar insudation (FAI). FAI occurs at a distance from the site of injury, in arterioles supplying that area, and is first observed 6 hr after onset of inflammation and maximally at 24 hr; the affected arterioles show dilation, with increased endothelial permeability and occasional smooth muscle cell damage. In our model, inflammation is induced by implanting a sterile plastic disk in the connective tissue superficial to the rat cremaster muscle. When carbon black is injected intravenously 24 hr later, FAI in the cremaster arterioles can be detected on light microscopy as areas of carbon extravasation; and the length of affected segments is morphometrically measured. The capsaicin-pretreated group showed a marked decrease in FAI compared to the controls. Mean FAI in the capsaicin group (12 animals) was 1.8 +/- 2.4 (SD) mm/cremaster compared to 5.6 +/ 5.1 for the control group (12 animals). P less than 0.003. These results provide evidence that this arteriolar response to inflammation is modulated in part by capsaicin-sensitive neurons. PMID- 1779886 TI - Molecular pathogenesis of shigellosis: a review. PMID- 1779887 TI - Experimental study on the relapse of tuberculosis after the termination of antituberculous chemotherapy using immunodeficient nude mice. AB - The effect of cellular immunity induced by tuberculous infection on bacteriological relapse after the termination of antituberculous chemotherapy was studied experimentally using immunodeficient nu/nu mice and immunocompetent dd mice. The efficacy of intensive chemotherapy was excellent even in nu/nu mice; tubercle bacilli in the organs decreased below the detectable limit, but formidable regrowth of bacilli was seen after the termination of chemotherapy. On the other hand, in the case of dd mice that established antituberculous cellular immunity through tuberculous infection, bacteriological relapse was generally very slight. It was concluded that bacteriological relapse was related closely with the established cellular immunity induced by the infected tubercle bacilli. PMID- 1779888 TI - An indirect immunofluorescence method for detection of Mycoplasma hominis in vaginal smears. AB - We developed a novel method for the detection of Mycoplasma hominis from vaginal swabs using an indirect immunofluorescence technique. It is a rapid and simple method that can be finished in only 5 hr and is more sensitive than the usual culture isolation method. The indirect immunofluorescence method was applied to vaginal smears from 193 healthy women and 33.7% gave a positive test. This value was much higher than that (11.4%) obtained from the same specimens by the culture method. When vaginal smears were subjected to Papanicolaou staining after the indirect immunofluorescence method, the specific immunofluorescence of the epithelial cells was located exactly at the sites of granular aggregates stained with Papanicolaou stain. A histological examination by Papanicolaou staining showed that the incidence of inflammation seems to be slightly higher in M. hominis-carriers than in non-carriers. PMID- 1779889 TI - Immune response of mice infected with recombinant vaccinia viruses carrying the HIV gag gene. AB - We examined mouse immune response to 4 kinds of recombinant vaccinia viruses carrying the HIV gag gene, including vac-gag/pol, which produces HIV-like particles with processed gag proteins; vac-gag, which also produces HIV-like particles but with unprocessed gag protein; and vac-gag-pol-fuse and vac-es gag/pol, neither of which produces such particles but releases reverse transcriptase and gag protein, respectively, from infected cells. Although infection of mice with recombinant vaccinia viruses induced production of the anti-p24 antibody in all mice, vac-gag/pol and vac-es-pol induced higher production than the other two recombinants. Increase in [3H]thymidine uptake by splenic lymphocytes following p24 antigen stimulation was most evident in mice infected with vac-gag/pol. Thus, the highest immune reaction, both humoral and cellular, was elicited by vac-gag/pol, indicating that among those tested, this recombinant vaccinia virus is the best candidate for a vaccine that induces anti HIV gag immunity. PMID- 1779890 TI - A sensitive method for detecting the fermentation-inhibition antibody to Mycoplasma pneumoniae. AB - The fermentation-inhibition (FI) test for Mycoplasma pneumoniae was improved by using a combination of guinea pig complement and gamma globulin-depleted horse serum in place of unheated whole horse serum employed in the conventional assay system. As the test antigen for the new FI assay system, M. pneumoniae filtrated through a 3.0 microns membrane filter was used. Owing to the strong augmenting effect of guinea pig complement, the FI activity of rabbit immune serum was increased 32-fold in the new system compared with the conventional system. Furthermore, IgM antibody, which is barely detectable by the conventional system, could easily be titrated by the new system. With this sensitive method, rapid rise of FI titer was clearly demonstrable in most children with acute M. pneumoniae infections, and a prevalence of FI or growth-inhibitory antibody among healthy adults in Japan (82%) was revealed. PMID- 1779891 TI - Interleukin-4 downregulates interleukin-6 production by human alveolar macrophages at protein and mRNA levels. AB - Effects of interleukin-4 (IL-4) on IL-6 production by human alveolar macrophages (AM) obtained by bronchoalveolar lavage from healthy donors was examined at the protein and gene levels. IL-6 production was quantitated by enzyme immunoassay (EIA) and bioassay using the IL-6 dependent murine hybridoma cell line MH60.BSF2. Results showed that when activated with LPS, AM released significantly more biologically active IL-6 than blood monocytes. Human rIL-4 significantly suppressed IL-6 production by AM and monocytes stimulated with LPS. Northern blot analysis revealed that IL-4 reduced the expression of IL-6 mRNA in LPS-stimulated AM and monocytes. The inhibitory effect was most pronounced when IL-4 was added with LPS or within the first 4 hr after LPS to AM or monocytes. The suppressive effect of IL-4 was completely neutralized by pretreatment with anti-IL-4 antibody. IL-4 also showed a suppressive effect on IL-6 production by macrophages generated in vitro by maturation of blood monocytes with granulocyte-macrophage colony stimulating factor (GM-CSF). These observations suggest that IL-4 may play a critical role in in situ regulation of immune responses through suppression of IL-6 production. PMID- 1779892 TI - Immunological properties of Borrelia burgdorferi isolated from the Ixodes ovatus in Shizuoka, Japan. AB - Three strains of spirochetes (IKA1 to 3) were isolated from the midgut of Ixodes ovatus collected in the Ikawa region of the northern part of Shizuoka, Japan. These isolates had eight flagella, and their size and other morphological features were similar to Borrelia burgdorferi. They showed similar motility and reacted with monoclonal antibody (MAb) H9724 against borrelial flagella and with MAb H5332 against the outer surface protein A. These strains showed similar SDS PAGE profiles to that of B. burgdorferi strain B31 and P/Bi isolated in the U.S.A. and Europe, respectively. Immunoblot with Lyme disease patient serum showed positive reactions with the flagella (41 Kilodalton, kDa), protein C (20 to 22 kDa), and outer surface protein A (29 kDa) of the isolates. Immunological properties, morphological characteristics, and epidemiological features revealed that these isolates were B. burgdorferi. PMID- 1779893 TI - Paradoxical effect of Tween 80 between the susceptibility to rifampicin and streptomycin and the susceptibility to ethambutol and sulfadimethoxine in the Mycobacterium avium-Mycobacterium intracellulare complex. AB - The susceptibility to rifampicin and streptomycin of the Mycobacterium avium Mycobacterium intracellulare complex was augmented by the addition of Tween 80 into 7H10 agar medium with OADC, whereas the susceptibility to ethambutol and sulfadimethoxine was either not changed or reduced by the addition of Tween 80. In 7H10 agar medium without OADC, however, susceptibilities to both rifampicin and sulfadimethoxine were reduced by the addition of Tween 80 to the medium. A number of hypotheses are made to explain these phenomena. PMID- 1779894 TI - The remembrance book: a personal discovery of the feelings of those who grieve. PMID- 1779895 TI - An "alternative" project. PMID- 1779896 TI - Midwifery: the dream and the reality. PMID- 1779897 TI - The place of women in the NHS. PMID- 1779898 TI - Mabel Liddiard Memorial Lecture 1991. What do women want? Asking consumers' views. PMID- 1779899 TI - Twinning: supporting midwifery around the world. PMID- 1779900 TI - RCM lobbies politicians on maternity services. PMID- 1779901 TI - Ten point quality plan for midwives in relation to breast-feeding. PMID- 1779902 TI - Matron's Aid Society 1881--Royal College of Midwives 1991: not by ideals alone. PMID- 1779903 TI - The Copyright Act and keeping up to date. PMID- 1779904 TI - [Dimorphism in the fungus Coccidioides immitis Rixford et Gilchrist under the action of saprophytic bacilli]. AB - It is shown that there are specific substances produced and secreted into the environment by saprotrophic bacilli. These inhibit the growth of the coccidioidal fungus in its mycelial form and some cells are converted into the yeast form, which leads to the destruction of the fungi (in natural environment) or, if the conditions allow, to their growth in the yeast form. This phenomenon, existence of a large amount of bacilli antagonistic to Coccidioides immitis, may be one of reasons why the latter has not been isolated so far from the soil in the territory of the USSR. PMID- 1779905 TI - [The action of bacillary inhibitory substances on human-pathogenic, phytopathogenic and saprotrophic fungi]. AB - The study has shown that the growth of many soil fungi is inhibited by the effect of substances which are produced into the environment by some bacilli saprotrophs. Besides, these substances can bring about a dimorphism of the Trichoderma, Blastomyces, Emmonsia, Alternaria and Verticillium fungi from the mycelial form into the yeast form, which results in the death of the fungi. The existence of bacilli capable of producing the inhibitory substances, in the soil in the territory of the USSR may explain, to a certain extent, the absence of the coccidioidomycosis and North American blastomycosis agents pathogenic for people and many animals. PMID- 1779906 TI - [The flotation characteristics of Bacillus cells and spores]. AB - Variations in hydrophobicity of the surface of bacillary cells and their capacity to flotation in the process of batch cultivation have been studied. It is shown that hydrophobicity of the cell surface increases in the course of batch cultivation of Bacillus thuringiensis, B. licheniformis and B. megaterium. Hydrophobicity of spores of the mentioned cultures is considerably higher than that of the vegetative cells. The increase of hydrophobicity of bacillary cells positively correlated with their capacity to flotation. That is why the use of flotation for the age fractionation of bacillary cells is possible: spores are concentrated in the foam while vegetative cells remain in the culture liquid. PMID- 1779907 TI - [A method for selecting Streptomyces spheroides mutants--producers of an exoprotease with fibrinolytic activity]. AB - The paper present a description of a fast method to obtain mutants of Streptomyces spheroides--supersynthetics of exoprotease. The primary culture spores being irradiated by UV-rays, the mutants are formed with presence in the cultural medium of own proteolytic enzyme added from without. The described method is based on the phenomenon of growth suppression in the primary culture spore by high concentrations of the own proteolytic enzyme. It permits selecting producers with high proteolytic activity of fibrinolytic proteases from the small number of mutants grown in these colonies. PMID- 1779908 TI - [The immunochemical characteristics of the lipopolysaccharides of Pseudomonas syringae (pathovars atrofaciens and phaseolicola) and P. holci (serogroup VI)]. AB - Lipopolysaccharides (LPS) of the representatives of strains of serogroup VI Pseudomonas syringae (P. syringae pv. atrofaciens 2399, pv. phaseolicola 120a, 7842 and P. holci 8299) possessing virulence and confinement to the host-plant are characterized by high serological activity in direct and cross reactions of the binary diffusion in agar, immunoelectrophoresis, passive hemagglutination and inhibition of passive hemagglutination. A supernatant and a sediment obtained after ultracentrifugation of LPS preparations possessed O-antigenic activity. O specific polysaccharide (PS) is serologically less active than the LPS preparations. Problems of the intergroup and intragroup serological affinity in connection with the structure of O-specific PS. It is proved that the basic chain of O-specific polysaccharide (D-rhamnane) plays definite (but not a single) part in displaying antigenic properties of the whole LPS macromolecule. PMID- 1779909 TI - [The use of the Soviet detergents dezintegron-O and dezintegron-B for the solubilization of influenza virus glycoproteins]. AB - Native detergents, desintegron-O-and desintegron-B, solubilize hemagglutinins of the influenza virus as intensively, as foreign drugs (mulgophen, zwittergent and sodium sarcozyl) do. This permits recommending desintegrons for quantitative determination of hemagglutinin of the influenza virus in virus-containing materials by means of the reaction of single radial immunodiffusion. Desintegron O and desintegron-B permit extracting enzymatically active neuraminidase from influenza A viruses with 44.6-83.4% yield. PMID- 1779910 TI - Unattainable homeostasis in healing leads to interstitial and vascular intimal fibroses: a unified hypothesis of their pathogenesis. AB - Homeostasis, or the maintenance of constant internal environment in the organism, is disrupted by injury. In this case, pathological defence reactions such as inflammation and healing take place in order to restore it. They succeed if etiological harmful factors are eliminated. In the opposite case, constant injury leads to continuous healing and fibrosis. Both interstitial and vascular intimal fibroses have similar pathogeneses and may be provoked by the same etiological factors. It may be concluded, therefore, that in spite of their apparent differences, both fibroses are only the different expressions of the same process by which injury should be healed and homeostasis restored. Fibrosis itself may become dangerous for the patient, depending on its extent and on the affected organ. In this case, the inhibition of healing reaction by antiangiogenesis may be envisaged as a life-saving measure. PMID- 1779911 TI - The organ of corti, like the retina, should be considered as brain tissue. AB - The retina is considered as a part of brain tissue. The organ of corti, which is as specialized as the retina, is described as placodal in origin. A 14-point comparison--functional, evolutional, structural and biological--has been made between the organ of corti and the retina to justify the consideration of the organ of corti as also a part of brain tissue. PMID- 1779912 TI - Pulsing reverse osmosis as the mechanism underlying fluid exchange. AB - Problems inherent in the existing theories of fluid exchange are discussed. An alternative theory based on the interaction between the pulsing of the capillary pressure and the osmotic gradient between plasma and interstitial fluid is offered. Theoretic values for plasma and interstitial osmolalities are calculated. These are similar to the pressure found in the Bowman's capsule in the kidney. The theory offers a possible explanation for the pulsatile nature of the blood pressure, the formation of oedema and the stasis of fluid exchange in shock. PMID- 1779913 TI - Mechanism of anergy in AIDS and malnutrition. AB - Human immunodeficiency virus, the retrovirus associated with acquired immunodeficiency syndrome, is known to deplete CD4+ helper cells and reduce CD8+ cytotoxic cell activity, resulting in impaired cell-mediated immunity and a 'state of anergy'. This leads to dissemination of micro-organisms that are normally held dormant in the host by the cell-mediated immune system. Malnutrition also leads to depletion of CD4+ helper cells and decreases CD8+ cytotoxic cells leading to impaired cell-mediated immunity and 'state of anergy'. Clinical situation can worsen when the two conditions co-exist. PMID- 1779914 TI - Cytokines. A unifying concept in the pathogenesis of clubbing. AB - Finger clubbing is a striking clinical sign associated with a large variety of diseases and syndromes. Although clubbing is poorly understood, we hypothesise that there is a final common pathway in the pathogenesis of clubbing by which there is increased growth of connective tissue and augmented blood flow mediated or stimulated by cytokines, which are either over-produced or poorly eliminated. PMID- 1779915 TI - The ecologically wrong vaginal lactobacilli. AB - Morphologically different Lactobacilli can be observed in wet smear preparations from the lower female genital tract; this morphological difference seems to correlate with the ability of the bacterium to produce hydrogen peroxide. This discussion will examine the role of the normal bacterial flora in protection of the host against recurrent infections. Further, we will propose a model as to how the potential role of immunological tolerance or 'immunological preference for' the maternal bacterial flora, can give individual differences in disposition for infections. PMID- 1779916 TI - May the alterations in lipid fluidity-mediated platelet hypersensitivity contribute to accelerated aging of platelets in diabetes mellitus? AB - Reduced platelet membrane lipid fluidity occurring in diabetes implies that platelet membrane receptors are more exposed to the external environment. This, in turn, may result in an increased sensitivity of platelets from diabetic humans to platelet aggregating agents. Platelet hypersensitivity (PH) may lead to augmented effects of agonists on the release of amine storage granules from the platelets of diabetic individuals. Aggregating and release-inducing agents decrease platelet density, which is assumed to be relevant to the aging processes. Thus it has become commonly accepted that platelet senescence or aging contributes to platelet density heterogeneity (PDH). Alterations of dynamic parameters of platelet membranes in diabetes may thus underlie the increased rate of aging or senescence of platelets in diabetic subjects. PMID- 1779917 TI - Freedom from wholism in multicellular organisms: a possible role of tumor suppressor genes. AB - Wholism, known as 'homeostasis' in multicellular organisms, is fundamentally expressed in the regulation of cell proliferation and of the metabolism of individual cells. Control mechanisms represent an overriding control of the autonomy of cells in multicellular organisms. Negative regulation by suppressor genes including tumor suppressor genes is essential to maintain homeostasis in these organisms. Without wholistic regulation, the cellular society of multicellular organisms would progress from bad to worse, with eventual destruction of the whole system. The enhancement of division and differentiation of cells transduced by water-soluble factors may be considered as the controlling structure on the tumor suppressor genes. In microevolution, cell killing by the immunosurveillance systems directed at the external environments has been avoided for the 'self' cells in general, since the multicellular organism may not be considered as only a crowd of single cells. PMID- 1779918 TI - Artificial insemination: can appropriate stimulation improve success rates? AB - Studies of other animal species suggest that stimulation during copulation has important effects on the probability of conception. Thus appropriate stimulation during artificial insemination may improve rates of conception. PMID- 1779919 TI - Lineage selection and the capacity to evolve. AB - The capacity of genetic recombination is an unusual adaptive trait since it is based on the capacity to produce evolutionary change rather than on the capacity to produce better performing individuals. The evolution of this character has been considered to be a case of group or species selection. Alternatively, I introduce a new concept, lineage selection, to account for the evolution of this trait. PMID- 1779920 TI - Exploring the role of an endogenous caffeine-like substance in the pathogenesis of schizophrenia. AB - In a previous paper, I have proposed that the deficiency of an endogenous caffeine-like substance is the underlying pathogenic mechanism in schizophrenia (1). In the present paper, my new concept is used to explain many of the clinical, biochemical, radiologic and pharmacologic facts about schizophrenia. PMID- 1779921 TI - Cancer deaths due to all causes, its relationship with vehicle travel in Australia, Japan and European countries. AB - Results of analysis of statistical data gathered and studied over a period from 1968-1989 have led to findings indicating that all cancers have a common cause. A relationship has been studied between the number of deaths due to all types of cancer and road accident deaths in time, by age, sex, and country. Road accident deaths in this paper are considered to be a measure of miles travelled for both males and females. PMID- 1779922 TI - Leukaemia, a close association with vehicle travel. PMID- 1779923 TI - Effects of HA1077, an intracellular calcium antagonist, on neurotransmitter metabolism in rat brain in vivo. AB - The effect of HA1077, an intracellular calcium antagonist, on neurotransmitter metabolism in rat brain was investigated in vivo. After administration of HA1077, at doses of 0.1, 0.3, and 3 mg/kg, 5-hydroxyindoleacetic acid (5-HIAA) levels increased in most regions except midbrain. In the striatum, parallel increases of both serotonin (5-HT) and 5-HIAA levels were observed at 0.3 mg/kg, but only the 5-HT level increased at 0.1 mg/kg. These results suggest that HA1077 may activate the turnover or synthesis of 5-HT. After administration of HA1077 at 0.3, 1, and 3 mg/kg, the dopamine (DA) level was increased in the striatum, but 3,4 dihydroxyphenylacetic acid (DOPAC) and homovanillic acid levels were unchanged. After HA1077 administration at 1 mg/kg, both DA and DOPAC levels increased in the hypothalamus and only DA level increased in the cerebral cortex. By contrast, DOPAC level decreased in the midbrain after HA1077 treatment at 0.1 and 0.3 mg/kg, and in the brainstem at 0.1 and 10 mg/kg. The ratio of [3H]-N methylspiperone accumulation relative to that in the cerebellum did not change after HA1077 treatment at any of the doses employed. Thus, the effects of HA1077 on neurotransmitter metabolism are complex and vary depending on the dosage and sites of the brain. Although the dose-dependent effects of HA1077 on neurotransmitter metabolism are similar to those of calcium entry blockers, HA1077 can facilitate DA synthesis in the hypothalamus and striatum, unlike the calcium entry blockers. PMID- 1779924 TI - Regional changes in intracellular pH determined by neutral red histophotometry and high energy metabolites during cardiac arrest and following resuscitation in the rat. AB - Intracellular pH was determined by neutral red color histophotometry in cerebral tissue from rats subjected to 10 minutes of cardiac arrest and from rats that had recovered for 1 and 6 hours following 8-10 minutes of total cerebral ischemia (TIA). Tissue concentrations of ATP, lactate and glucose were measured corresponding to the pH determinations. As expected, tissue ATP was depleted while tissue lactate was markedly elevated after 10 minutes of ischemia without reflow in the cerebral cortex, striatum and hippocampus. However, both metabolites were near control following 1 and 6 hours of recovery in all three regions. Tissue glucose was not significantly different from control following 1 and 6 hours of reperfusion. During ischemia, the intracellular pH dropped to 6.5 6.7 in all three regions (p less than 0.05). But, since the initial pH of the hippocampus was 7.79 while that of the cerebral cortex and striatum was approximately 7.02, the net drop in pHi the hippocampus was greater than in the other two regions. Following 1 hour of reperfusion, a trend towards tissue alkalosis was observed in the cerebral cortex and striatum. PMID- 1779925 TI - Testosterone effects on ribosomal RNA levels in injured peripheral motor neurons: a preliminary report. AB - We have previously demonstrated that administration of testosterone to hamsters during the early phases of axonal regeneration following facial nerve injury accelerates both the rate of regeneration of the fastest growing population of axons and the return of functional movement. We hypothesized from those studies that testosterone primes the neuronal cell body in such a way as to accelerate the "switch" from a normal to a reparative state. That hypothesis was tested in this study using ribosomal DNA (rDNA) probes in conjunction with in situ hybridization to map the molecular response of the polymerase I system to axotomy, with and without hormone exposure. Adult male hamsters were subjected to right facial nerve severance, with the left side serving as an internal control. Half the animals were administered testosterone propionate via subcutaneous implants. In situ hybridization using a genomic rDNA probe complementary to the 28S rRNA species was accomplished, and levels of rRNA in injured facial neurons assessed both qualitatively and quantitatively. Our initial findings indicate that testosterone markedly upregulates rRNA levels after injury, and support the hypothesis of an acceleration in the metabolic switch to a reparative state. This leads us, in turn, to suggest that this effect of testosterone on the ribosomal system is causally related to the increase in axonal regeneration rate and return of functional movement previously documented in this system. PMID- 1779926 TI - Organelle biogenesis and intracellular lipid transport in eukaryotes. AB - The inter- and intramembrane transport of phospholipids, sphingolipids, and sterols involves the most fundamental processes of membrane biogenesis. Identification of the mechanisms involved in these lipid transport reactions has lagged significantly behind that for intermembrane protein traffic until recently. Application of methods that include fluorescently labeled and spin labeled lipid analogs, new cellular fractionation techniques, topographically specific chemical modification techniques, the identification of organelle specific metabolism, permeabilized cell methodology, and yeast molecular genetics has contributed to revealing a diverse biochemical array of transport processes for lipids. Compelling evidence now exists for ATP-dependent, ATP-independent, vesicle-dependent, and vesicle-independent transport processes that are lipid and membrane specific. ATP-dependent transport processes include the transbilayer movement of phosphatidylserine and phosphatidylethanolamine at the plasma membrane and the transport of phosphatidylserine from its site of synthesis to the mitochondria. ATP-independent processes include the transbilayer movement of virtually all lipids at the endoplasmic reticulum, the movement of phosphatidylserine between the inner and outer mitochondrial membranes, and the transfer of nascent phosphatidylcholine and phosphatidylethanolamine to the plasma membrane. The ATP-independent movement of lipids between organelles is believed to be due to the action of lipid transfer proteins, but this still remains to be proved. Vesicle-based transport mechanisms (which are also inherently ATP dependent) include the transport of nascent cholesterol, sphingomyelin, and glycosphingolipids from the Golgi apparatus to the plasma membrane and the recycling of sphingolipids and selected pools of phosphatidylcholine from the plasma membrane to the cell interior. The vesicles involved in cholesterol transport to the plasma membrane are different from those involved in bulk protein transport to the cell surface. The vesicles involved in recycling sphingomyelin to and from the cell surface are different from those involved in the assembly of newly synthesized sphingolipids into the plasma membrane. The preliminary characterization of these lipid translocation processes suggests divergent rather than unifying mechanisms for lipid transport in organelle assembly. PMID- 1779927 TI - Oxidative stress responses in Escherichia coli and Salmonella typhimurium. AB - Oxidative stress is strongly implicated in a number of diseases, such as rheumatoid arthritis, inflammatory bowel disorders, and atherosclerosis, and its emerging as one of the most important causative agents of mutagenesis, tumorigenesis, and aging. Recent progress on the genetics and molecular biology of the cellular responses to oxidative stress, primarily in Escherichia coli and Salmonella typhimurium, is summarized. Bacteria respond to oxidative stress by invoking two distinct stress responses, the peroxide stimulon and the superoxide stimulon, depending on whether the stress is mediated by peroxides or the superoxide anion. The two stimulons each contain a set of more than 30 genes. The expression of a subset of genes in each stimulon is under the control of a positive regulatory element; these genes constitute the OxyR and SoxRS regulons. The schemes of regulation of the two regulons by their respective regulators are reviewed in detail, and the overlaps of these regulons with other stress responses such as the heat shock and SOS responses are discussed. The products of Oxy-R- and SoxRS-regulated genes, such as catalases and superoxide dismutases, are involved in the prevention of oxidative damage, whereas others, such as endonuclease IV, play a role in the repair of oxidative damage. The potential roles of these and other gene products in the defense against oxidative damage in DNA, proteins, and membranes are discussed in detail. A brief discussion of the similarities and differences between oxidative stress responses in bacteria and eukaryotic organisms concludes this review. PMID- 1779928 TI - Viruses and viruslike particles of eukaryotic algae. AB - Until recently there was little interest or information on viruses and viruslike particles of eukaryotic algae. However, this situation is changing. In the past decade many large double-stranded DNA-containing viruses that infect two culturable, unicellular, eukaryotic green algae have been discovered. These viruses can be produced in large quantities, assayed by plaque formation, and analyzed by standard bacteriophage techniques. The viruses are structurally similar to animal iridoviruses, their genomes are similar to but larger (greater than 300 kbp) than that of poxviruses, and their infection process resembles that of bacteriophages. Some of the viruses have DNAs with low levels of methylated bases, whereas others have DNAs with high concentrations of 5-methylcytosine and N6-methyladenine. Virus-encoded DNA methyltransferases are associated with the methylation and are accompanied by virus-encoded DNA site-specific (restriction) endonucleases. Some of these enzymes have sequence specificities identical to those of known bacterial enzymes, and others have previously unrecognized specificities. A separate rod-shaped RNA-containing algal virus has structural and nucleotide sequence affinities to higher plant viruses. Quite recently, viruses have been associated with rapid changes in marine algal populations. In the next decade we envision the discovery of new algal viruses, clarification of their role in various ecosystems, discovery of commercially useful genes in these viruses, and exploitation of algal virus genetic elements in plant and algal biotechnology. PMID- 1779930 TI - Synthesis of the cell surface during the division cycle of rod-shaped, gram negative bacteria. AB - When the growth of the gram-negative bacterial cell wall is considered in relation to the synthesis of the other components of the cell, a new understanding of the pattern of wall synthesis emerges. Rather than a switch in synthesis between the side wall and pole, there is a partitioning of synthesis such that the volume of the cell increases exponentially and thus perfectly encloses the exponentially increasing cytoplasm. This allows the density of the cell to remain constant during the division cycle. This model is explored at both the cellular and molecular levels to give a unified description of wall synthesis which has the following components: (i) there is no demonstrable turnover of peptidoglycan during cell growth, (ii) the side wall grows by diffuse intercalation, (iii) pole synthesis starts by some mechanism and is preferentially synthesized compared with side wall, and (iv) the combined side wall and pole syntheses enclose the newly synthesized cytoplasm at a constant cell density. The central role of the surface stress model in wall growth is distinguished from, and preferred to, models that propose cell-cycle-specific signals as triggers of changes in the rate of wall synthesis. The actual rate of wall synthesis during the division cycle is neither exponential nor linear, but is close to exponential when compared with protein synthesis during the division cycle. PMID- 1779931 TI - Recombination-dependent concatemeric plasmid replication. AB - The replication of covalently closed circular supercoiled (form I) DNA in prokaryotes is generally controlled at the initiation level by a rate-limiting effector. Once initiated, replication proceeds via one of two possible modes (theta or sigma replication) which do not rely on functions involved in DNA repair and general recombination. Recently, a novel plasmid replication mode, leading to the accumulation of linear multigenome-length plasmid concatemers in both gram-positive and gram-negative bacteria, has been described. Unlike form I DNA replication, an intermediate recombination step is most probably involved in the initiation of concatemeric plasmid DNA replication. On the basis of structural and functional studies, we infer that recombination-dependent plasmid replication shares important features with phage late replication modes and, in several aspects, parallels the synthesis of plasmid concatemers in phage-infected cells. The characterization of the concatemeric plasmid replication mode has allowed new insights into the mechanisms of DNA replication and recombination in prokaryotes. PMID- 1779929 TI - Molecular genetics and pathogenesis of Clostridium perfringens. AB - Clostridium perfringens is the causative agent of a number of human diseases, such as gas gangrene and food poisoning, and many diseases of animals. Recently significant advances have been made in the development of C. perfringens genetics. Studies on bacteriocin plasmids and conjugative R plasmids have led to the cloning and analysis of many C. perfringens genes and the construction of shuttle plasmids. The relationship of antibiotic resistance genes to similar genes from other bacteria has been elucidated. A detailed physical map of the C. perfringens chromosome has been prepared, and numerous genes have been located on that map. Reproducible transformation methods for the introduction of plasmids into C. perfringens have been developed, and several genes coding for the production of extracellular toxins and enzymes have been cloned. Now that it is possible to freely move genetic information back and forth between C. perfringens and Escherichia coli, it will be possible to apply modern molecular methods to studies on the pathogenesis of C. perfringens infections. PMID- 1779934 TI - Effect of aluminum on calcium binding to bovine intestinal calcium-binding protein. AB - Aluminum is known to inhibit vitamin D-dependent intestinal absorption of calcium. To investigate possible mechanisms of action, the effect of aluminum on the binding of calcium to bovine intestinal calcium-binding protein (CaBP) was studied by means of equilibrium dialysis. The results of these studies indicate that aluminum in concentrations up to 80 microM and up to 80 times the ambient calcium concentration did not significantly alter the affinity of CaBP for calcium (Kd = 0.17 microM) nor its molar capacity (2 mol/mol CaBP). PMID- 1779935 TI - Systemic hemodynamic pattern in primary hyperparathyroidism and its changes after parathyroidectomy. AB - Twelve patients (7 men and 5 women) with an average age of 53 years (range 37-69) were hospitalized for renal stones and found to have primary hyperparathyroidism. Five were hypertensive and 7 normotensive. The systemic hemodynamics, plasma renin activity and glomerular filtration rate were evaluated before and at least 6 months after removal of a parathyroid adenoma. After surgery the mean intra arterial blood pressure fell in almost all patients, due to some reduction in the peripheral vascular resistance index with no change in the cardiac index. However, the hemodynamic variations were not uniform in all patients. No change was seen in plasma renin activity and glomerular filtration rate. A positive correlation between the percent change in mean arterial pressure and percent decrease in total serum calcium was found. The results obtained indicate that it is likely that hypercalcemia plays some role both in patients with high and those with normal blood pressure. The systemic hemodynamic changes after parathyroidectomy indicate that the fall in peripheral vascular resistance could have a certain influence. PMID- 1779933 TI - Alpha-toxin of Staphylococcus aureus. AB - Alpha-toxin, the major cytotoxic agent elaborated by Staphylococcus aureus, was the first bacterial exotoxin to be identified as a pore former. The protein is secreted as a single-chain, water-soluble molecule of Mr 33,000. At low concentrations (less than 100 nM), the toxin binds to as yet unidentified, high affinity acceptor sites that have been detected on a variety of cells including rabbit erythrocytes, human platelets, monocytes and endothelial cells. At high concentrations, the toxin additionally binds via nonspecific absorption to lipid bilayers; it can thus damage both cells lacking significant numbers of the acceptor and protein-free artificial lipid bilayers. Membrane damage occurs in both cases after membrane-bound toxin molecules collide via lateral diffusion to form ring-structured hexamers. The latter insert spontaneously into the lipid bilayer to form discrete transmembrane pores of effective diameter 1 to 2 nm. A hypothetical model is advanced in which the pore is lined by amphiphilic beta sheets, one surface of which interacts with lipids whereas the other repels apolar membrane constitutents to force open an aqueous passage. The detrimental effects of alpha-toxin are due not only to the death of susceptible targets, but also to the presence of secondary cellular reactions that can be triggered via Ca2+ influx through the pores. Well-studied phenomena include the stimulation of arachidonic acid metabolism, triggering of granule exocytosis, and contractile dysfunction. Such processes cause profound long-range disturbances such as development of pulmonary edema and promotion of blood coagulation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779936 TI - Plasma insulin-like growth factor-1 and bone formation parameters in predialysis chronic renal failure. AB - Insulin-like growth factor-1 (IGF-1), produced by osteoblasts following parathormone (PTH) stimulation, is a local hormone with autocrine and paracrine functions on bone formation. To evaluate whether circulating IGF-1 is also important in stimulating bone formation, a study was carried out on 28 patients with slowly progressing nondialytic chronic renal failure. 9 patients were treated with 1,25(OH)2D3, while 19 did not receive vitamin D metabolites. In all patients a transiliac bone biopsy for histomorphometric studies was obtained, and the following determinations were made: immunoreactive PTH (iPTH), osteocalcin, alkaline phosphatase, IGF-1, serum calcium, phosphate and creatinine. Serum IGF-1 levels were similar in the two groups of patients, and higher than normal. iPTH and osteocalcin were positively correlated with serum creatinine, osteoblast surface and the eroded surface, but did not correlate with IGF-1. A negative (n.s.) relationship was found between dynamic bone parameters and circulating IGF 1, with the mineral apposition rate reaching a significant level (p less than 0.05). In conclusion, the circulating levels of IGF-1 are not correlated with bone formation parameters, thus apparently showing no role in bone turnover or dependency on bone production of the growth factor. The results may favor the hypothesis of a negative feedback control of circulating IGF-1 by suppressive signals originating from active bone metabolic units. PMID- 1779937 TI - Effect of different doses of aluminium hydroxide on renal deterioration and nutritional state in experimental chronic renal failure. AB - To investigate the effects of aluminium hydroxide (AH), a phosphate binder, on the progress of chronic renal diseases, high doses (9.6 g/kg/day, group ADR-H), moderate doses (2.4 g/kg/day, group ADR-M), and low doses (1.2 g/kg/day, group ADR-L) of the compound, were orally administered for 34 weeks to rats with Adriamycin (ADR)-induced focal glomerular sclerosis. Serum creatinine and blood urea nitrogen were significantly lower in either group ADR-H or ADR-M than in group ADR at week 34. Urinary protein excretion was significantly lower in group ADR-H than in group ADR in all observation periods and was also lower in group ADR-M than in group ADR at weeks 28 and 32. Both glomerular sclerosis and tubular change were significantly less severe in group ADR-H, while tubular change was less marked in group ADR-M than in group ADR. These results revealed that phosphate depletion was induced, and progressive renal failure was ameliorated in proportion to the dosing of AH. On the other hand, body weight was significantly smaller in group ADR-H than in group ADR in more than half of the observation period. In conclusion, a high dose of AH may adversely affect the nutritional state irrespective of having an extremely protective effect on progress of renal dysfunction. Appropriate doses of AH should be used to prevent the renal deterioration. PMID- 1779938 TI - Lithium clearance in patients with chronic renal failure. AB - Lithium clearance (CLi) was studied in the healthy subjects (H) and in patients with chronic renal failure (CRF) with a mean GFR of 36.08 +/- 3.8 ml/min x 1.73 m2 in order to evaluate (1) the variability of CLi measurements; (2) the changes of CLi during the hyperfiltration response to a meat meal (2 g/kg b.w. of protein), and (3) the effects on CLi of different protein intakes. CLi correlated with GFR and with urinary sodium, FeLi correlated with FeNa in H and CRF. The intraindividual standard deviation (IISD) of GRF, CLi and FeLi assessed in triplicate studies in the course of a single experiment averaged 4.70, 7.15 and 10.69% in CRF and 1.77, 4.09 and 4.61% in H. When IISD for GFR, CLi, and FeLi was assessed in triplicate measurements in the course of 3 studies performed at 1 week intervals (day 1, day 8, day 15), it averaged 7.36, 9.21 and 15.72% in CRF and 1.83, 5.08 and 5% in H. During the hyperfiltration response to a meat meal, CLi and FeLi did not change in CRF and increased significantly in H. In 10 patients with CRF who were switched for 3 weeks from a protein intake of 0.85 g/kg to a protein intake of 0.60 g/kg, GFR was significantly (p less than 0.001) reduced by 29%, while CLi was stable. The data indicate that because of its variability, CLi is of little use in experiments designed to study subtle changes in renal Na transport. PMID- 1779932 TI - The biology of Giardia spp. AB - Gardia spp. are flagellated protozoans that parasitize the small intestines of mammals, birds, reptiles, and amphibians. The infectious cysts begin excysting in the acidic environment of the stomach and become trophozoites (the vegetative form). The trophozoites attach to the intestinal mucosa through the suction generated by a ventral disk and cause diarrhea and malabsorption by mechanisms that are not well understood. Giardia spp. have a number of unique features, including a predominantly anaerobic metabolism, complete dependence on salvage of exogenous nucleotides, a limited ability to synthesize and degrade carbohydrates and lipids, and two nuclei that are equal by all criteria that have been tested. The small size and unique sequence of G. lamblia rRNA molecules have led to the proposal that Giardia is the most primitive eukaryotic organism. Three Giardia spp. have been identified by light lamblia, G. muris, and G. agilis, but electron microscopy has allowed further species to be described within the G. lamblia group, some of which have been substantiated by differences in the rDNA. Animal models and human infections have led to the conclusion that intestinal infection is controlled primarily through the humoral immune system (T-cell dependent in the mouse model). A major immunogenic cysteine-rich surface antigen is able to vary in vitro and in vivo in the course of an infection and may provide a means of evading the host immune response or perhaps a means of adapting to different intestinal environments. PMID- 1779939 TI - A method for determining the total magnesium, calcium, sodium and potassium contents of human platelets. AB - Platelet levels of magnesium, calcium, sodium and potassium may provide a better index of intracellular cations or total body ion status than serum, erythrocyte or leukocyte cation concentrations. A method is described for the determination of the total magnesium, calcium, sodium and potassium contents of human platelets. The method involves platelet isolation, repeated washing, lysis and measurement of the ions in the lysate. Magnesium and calcium were determined by atomic absorption spectroscopy and sodium and potassium by flame photometry. Platelet total potassium, magnesium, calcium and sodium were 4.5 +/- 1.5, 2.3 +/- 0.6, 1.8 +/- 0.5, 1.5 +/- 0.6 mumol/1 x 10(8) cells, respectively (means +/- SD). The method is simple, repeatable and accurate. PMID- 1779940 TI - The influence of calmodulin antagonists on calcium transport and uptake in the rat intestine. AB - The effects of calmodulin (CaM) antagonists on calcium transport, tissue retention and the cell-associated calcium space were determined in duodenal segments of intestine and isolated duodenal enterocytes from young male rats. The CaM antagonists trifluoperazine (TFP) and chlorpromazine (CPZ) which were added separately to the media bathing both the mucosal and serosal surfaces of duodenal segments decreased calcium transport and tissue uptake in a dose-related fashion over a concentration range of 0.1-1 mM. Both TFP and CPZ reduced active transport to a greater extent than calcium retention in the duodenal segments. In addition, TFP and CPZ produced a dose-related decrease in the observed intracellular calcium space in duodenal tissue and reduced calcium uptake into isolated enterocytes. The TFP-induced antagonism of calcium transport was greater when TFP was at the mucosal surface than at the serosal surface of the intestinal tissue. Although TFP and CPZ are not entirely specific CaM antagonists at the concentrations used in this study, the results indicate that CaM antagonism by TFP and CPZ decreases active calcium transport and calcium uptake in duodenal segments of rat intestine in a dose-related fashion. Therefore, the present study together with the reports of other investigators suggests that CaM is involved in the mediation of calcium translocation in intestinal tissue in a fashion which is similar to that reported in other biological tissue. PMID- 1779941 TI - Effect of captopril on aldosterone response to potassium infusion in primary aldosteronism. AB - The effect of captopril on the aldosterone response to potassium was studied in 6 patients with idiopathic adrenal hyperplasia (IAH) and in 4 patients with an aldosterone-producing adenoma (APA), who all have suppressed activity of circulating renin-angiotensin system (RAS). Precaptopril, KCl infusion induced a significant increase in aldosterone in both groups. This increment was significantly blunted by captopril in IAH, but not in APA. Decreased potassium stimulated aldosterone secretion after captopril in IAH supports the hypothesis that adrenal RAS plays a role in aldosterone production under potassium stimulation. PMID- 1779942 TI - Effects of glucagon on serum calcium, magnesium and strontium levels in rats. AB - The pharmacological effects of glucagon (0.05 mg/kg b.wt. day) on serum calcium, magnesium and strontium levels were analyzed in order to clarify the response of divalent cations to glucagon administration and its possible relation with calcitonin release stimulation. The results show significant decreases in serum calcium and strontium levels 2 h after glucagon administration, and in daily administration the effect peaks on the 3rd day and returns to baseline values by the 9th day. In contrast, the serum magnesium increases significantly by the 3rd day of daily glucagon administration and continues to increase until the 9th day. Calcitonin administration (90 mU Medical Research Council unit)/100 g b.wt.) significantly reduces the serum calcium, strontium and magnesium levels up to the 3rd day of treatment, just when the glucagon effect is highest. Other additional mechanisms may be involved besides the calcitonin release stimulation, in the response induced in divalent cations--particularly magnesium--by the exogenous administration of glucagon. PMID- 1779943 TI - Effect of potassium chloride on cytosolic calcium of brain synaptosomes of rats with chronic renal failure. AB - Norepinephrine (NE) release from brain synaptosomes is dependent in major part on an adequate rise in cytosolic calcium ([Ca2+]i). A smaller or a greater calcium signal (delta [Ca2+]i) or delta[Ca2+]i/basal [Ca2+]i ratio in response to stimuli may interfere with NE release from brain synaptosomes. In order to further evaluate the mechanism of reduced NE release from brain synaptosomes in chronic renal failure (CRF), we examined the changes in synaptosomal [Ca2+]i in response to KCl in normal, CRF, and normocalcemic, parathyroidectomized (PTX) CRF rats (CRF-PTX) and in CRF rats treated with verapamil (CRF-V). CRF rats displayed significantly (p less than 0.01) higher basal levels of [Ca2+]i and a higher delta[Ca2+]i and delta [Ca2+]i/basal [Ca2+]i ratio than in the other three groups of rats. These parameters were not different among normal, CRF-PTX and CRF-V rats. The data are consistent with the notion that the higher calcium signal and the higher ratio between signal and the basal [Ca2+]i in response to a stimulus in CRF are deleterious to synaptosomal function and are responsible, in part, for the reduced NE release by these structures in CRF. PMID- 1779944 TI - Selecting exposure parameters in developmental neurotoxicity assessments. AB - Numerous factors must be considered in selecting exposure parameters for developmental neurotoxicity investigations. Whether employing a single dose during pregnancy, or continuous exposure from prepregnancy through early postnatal developmental periods, the following primary factors should be addressed: 1) Purpose of the study; 2) pharmacokinetics/pharmacodynamics; 3) biotransformation; 4) genotypic variables; 5) limiting factors, including the availability of test compounds for evaluation; and, 6) several general, miscellaneous factors. Whether a single, large dose of an exogenous agent is more toxic to the developing nervous system than a series of smaller doses depends upon the interaction of the physicochemical, pharmacokinetic, and pharmacodynamic properties of the agent with the genotypic features of the test organism. PMID- 1779945 TI - Auditory deficits and motor dysfunction following iminodipropionitrile administration in the rat. AB - The behavioral effects of 3,3'-iminodipropionitrile (IDPN) were studied using reflex modification of the acoustic startle response and figure-eight maze activity. A number of experiments were conducted with separate groups of adult male Long-Evans hooded rats exposed to saline or 50-500 mg/kg IDPN for 3 consecutive days. Auditory thresholds (reflex modification), motor activity, and grip strength were measured 1 day, and 1, 3, and 9 weeks postdosing. Reflex inhibition was monitored daily, prior to, during, and for 7 days following exposure. Auditory thresholds for 5- and 40-kHz tones were elevated approximately 25 dB and 50 dB, respectively. The onset of this auditory dysfunction in the 200 mg/kg/day group, as demonstrated by a loss of reflex inhibition, was 2 days for the 40-kHz tone and 4 days for the 5-kHz tone. Motor activity was increased up to 400% in the 200-mg/kg group, whereas there was no alteration in hindlimb grip strength. These data demonstrate dosage- and time-dependent alterations in auditory and motor function following IDPN exposure. PMID- 1779946 TI - The relationship of rat brain weight and pituitary weight to postnatal growth after prenatal exposure to methylazoxymethanol. AB - Teratogens can affect body weight in various ways, but the association of brain damage with postnatal growth abnormalities suggests a role for neuroendocrine growth-controlling systems. Growth deficiencies follow methylazoxymethanol (MAM) exposure during the period when the growth hormone releasing factor (GRF) cells of the hypothalamus form, and the pattern of growth of the animals is like that of animals deficient in growth hormone. The present studies were designed to examine the growth, body proportions, brain weight, and pituitary weight of animals treated with 20 mg/kg MAM on the 13th day of gestation, a peak period for production of GRF neurons. Among the offspring, this treatment produced about 25% dwarfs (animals smaller than the smallest control of the same sex). Significantly more females than males were categorized as dwarfs. The weight effect occurred long after birth, as is characteristic of animals and humans with growth hormone deficiency. Analyses of weights over the course of development indicated that prenatal factors, rather than factors operating between birth and weaning, predicted the adult body weight of dwarfs, while both sets of factors were significant in other animals. The growth reduction was symmetrical, as would be expected if the animals were growth hormone deficient, with an 18% reduction in weight reflecting a 6% reduction in bone length. The remaining treated animals were similar to controls in absolute weight, body proportions, and rate of growth. Neither pituitary weight nor brain weight appears to play the key role in determining which animals will exhibit growth deficiency.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779947 TI - Interlaboratory comparison of motor activity experiments: implications for neurotoxicological assessments. AB - Motor activity is an important functional measure used in neurotoxicology. The effects of chemicals on motor activity, however, may depend on variables such as type of measurement apparatus, physical and environmental testing conditions, and many other experimental protocol and organismic variables. Due to the increasing use of motor activity in neurotoxicology, a major question concerns the potential for differences in experimental findings due to variations in sensitivity and reliability between different laboratories and devices used to measure motor activity. This study examined historical data from a number of laboratories that employed different devices and experimental protocols to measure motor activity. Four aspects of the motor activity data were compared: 1) within-laboratory control variability across time; 2) within-laboratory replicability of control data; 3) between-laboratory variability in the effects of chemicals; and 4) between-laboratory comparison of the control rates of habituation. The analyses indicated that there was a relatively restricted range of within-laboratory variability and reliability in control values, and that these ranges were comparable across laboratories. Similar profiles of habituation were also seen across the different laboratories. Moreover, in virtually every case, all laboratories were capable of detecting qualitatively similar changes in motor activity following acute exposure to a variety of chemicals. These data indicate a high degree of comparability in the data generated by the different devices and experimental protocols. PMID- 1779948 TI - Acute and long-term neuronal deficits in the rat olfactory bulb following alcohol exposure during the brain growth spurt. AB - This study demonstrates that there is a relative recovery in the number of olfactory bulb granule cells following an initial alcohol-induced deficit, while the number of mitral cells remains permanently and severely depressed. The importance of pattern of exposure in influencing the severity of alcohol-induced neuronal loss in the olfactory bulb is also demonstrated. Sprague-Dawley rat pups were reared artificially and were administered alcohol over postnatal days (PD) 4 through 9, a period of rapid brain growth comparable to part of the human third trimester. Two groups received a daily alcohol dose of 4.5 g/kg, administered either as a 5.1% or 10.2% solution. A third group received a higher daily alcohol dose of 6.6 g/kg administered continuously as a 2.5% solution. Pups were either sacrificed on PD 10 or were allowed to grow to adulthood and sacrificed on PD 90. The number of mitral cells and granule cells and the area of the subependymal zone were determined from single sections. On PD 10, immediately following the alcohol exposure, both the mitral cells and the granule cells were significantly reduced in number, relative to controls, in both of the groups receiving the concentrated (5.1% and 10.2%) alcohol treatments. On PD 90, however, only the mitral cell number remained significantly reduced in the groups receiving the concentrated solutions, while the number of granule cells no longer differed significantly from that of controls. The group receiving the higher daily dose (6.6 g/kg) in continuous fractions had no significant cell loss at 10 or 90 days of age.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779949 TI - Fetal brain damage in the rat following prenatal exposure to cocaine. AB - The aim of this study was to identify fetal brain damage induced by 1) prenatal cocaine exposure or 2) physical procedures causing temporary constriction or occlusion of the uterine vessels in pregnant rats. Brains were examined from rat fetuses killed 48 hours after the dam was given one or more intraperitoneal doses of cocaine (50-70 mg/kg) on day 16 of gestation. Only brains from fetuses with hemorrhage in the extremities were examined, as this indicated they had undergone a circulatory disturbance. Four of the 10 brains examined showed bilateral necrosis and cavitation in the cerebral cortex. There were also hemorrhage and ectopic outgrowths in the corpus striatum, bilateral cavitation in the brainstem and vacuolization in the lens of the eye. A similar type and distribution of damage was seen in rat fetal brains from dams treated by temporary occlusion of the uterine vessels or direct handling of the pregnant uterus on day 16 of gestation and examined 48 hours later. It is proposed that the procedures act through the common mechanism of constriction/occlusion of the uterine vessels. The damage to the fetuses appears to be due to hemorrhage from the fetal vessels and ischemia. These findings are discussed in relation to cocaine use during human pregnancy. PMID- 1779950 TI - Demonstration of physical dependence following chronic continuous methadone delivery via osmotic minipumps in pregnant rats. AB - The effects of a 14-day (gestation days 7-20) chronic methadone (6.3-9.0 mg/kg/day) infusion via osmotic minipumps were studied on the induction of physical dependence in both pregnant and nonpregnant female rats. Following continued methadone exposure, an acute injection of naloxone (2.0 mg/kg, SC) produced the following symptoms of withdrawal in both pregnant and nonpregnant methadone-exposed rats: increased frequency of head shakes, teeth-chattering and face-rubbing episodes, as well as the induction of burrowing, diarrhea, facial tremor, squeaking and vaginal sniffing. Increased fetal movement in the maternal abdomen was also observed in the pregnant rats. In the saline-exposed pregnant controls, naloxone failed to induce a significant effect. In addition, brain and plasma methadone levels during the various stages of pregnancy (gestation days 8 20) were determined. The methadone levels in plasma were initially variable (gestation days 8-12) but became more constant (approximately 50 ng/ml) from gestation day 14 to 20. Methadone brain levels also followed a similar pattern, except that the brain methadone content was at least 20-fold greater than plasma concentrations at any given time. Thus, relative to the high brain levels, the present data suggest that acute changes in methadone plasma concentration may not be a good index of pharmacological effect. PMID- 1779951 TI - Prenatal exposure to cannabis: a preliminary report of postnatal consequences in school-age children. AB - Aspects of neurobehavioural development were examined in 28 school-age children born to regular cannabis users and 28 control children matched on prenatal drug history. Measures which discriminated between the study groups and on which the children of cannabis users scored more poorly included parental ratings of behaviour problems, visual-perceptual tasks, language comprehension, and distractibility. For a measure of visual memory and a measure of language comprehension, mother's age at the child's birth potentiated the effect of cannabis use to produce lowered scores for children of young, cannabis-using mothers relative to children of young, nonusing mothers. After controlling for the influence of mother's age at delivery, mother's personality and home environment, the relationship between prenatal cannabis exposure and the discriminating variables was no longer statistically significant. Path analysis demonstrated the way in which home environment conditions, particularly high levels of aggression, could magnify effects of prenatal exposure to cannabis on postnatal outcomes. PMID- 1779952 TI - Behavioral effects of exposure to caffeine during gestation, lactation or both. AB - Open-field behavior and latencies of emergence from a darkened chamber to a brightly lit arena were recorded at 1, 2, 4 and 6 months after birth in male and female rats that had been exposed to 26 or 45 mg/kg/day caffeine ingested by dams in their drinking water during gestation, 25 or 35 mg/kg/day during lactation or to the two low or high doses ingested during both gestation and lactation. One or both of the gestational or lactational doses reduced locomotor activity and increased defecation in the open field at all ages for males only. Rearing was decreased for both sexes by 25 mg/kg/day lactational caffeine. Numbers of rats that failed to or took longer than 1 min to emerge into the brightly lit arena were increased by 26 mg/kg/day gestational caffeine. All rats that had been exposed to either dose combination of caffeine during both gestation and lactation showed less locomotor and rearing activity, reduced tendencies to emerge within 1 min and, at 6 months of age only, more defecation in the open field. It was concluded that the effects of gestational and lactational exposure to caffeine were additive in their modification of the developing brain as reflected in decreased motor activity possibly arising from heightened emotional reactivity to the testing situation. Hypersensitivity of males to caffeine exposure during either gestation or lactation separately seemed to diminish when exposure was increased for all rats through experience of the drug during both gestation and lactation. Possible involvement of caffeine-induced increases in adenosine receptors in the type of results obtained was discussed. PMID- 1779953 TI - The effects of chronic postweaning amphetamine on rats exposed to alcohol in utero: weight gain and behavior. AB - Offspring of rats fed alcohol, pair-fed, or fed ad lib control diets during pregnancy were administered a dose of amphetamine (0, 2 or 10 mg/kg) daily from postnatal day 22 (PN22) to PN42. Body weight was measured regularly from PN22 to PN60, and behavior was measured on PN22, PN28, PN36 and PN42. Rats exposed to alcohol in utero weighed less than controls at birth and throughout most of the experiment, despite a significantly accelerated weight gain relative to controls. By PN60, prenatal alcohol-exposed rats weighed the same as pair-fed controls. There were dose-dependent reductions in the rate of weight gain during amphetamine administration. After the daily injections stopped, the high-dose (10 mg/kg) amphetamine groups showed a higher growth rate than the 0-mg/kg and 2 mg/kg groups. There were no interactions between prenatal treatment and dose of amphetamine on body weight gain. Rats exposed to alcohol in utero showed a greater locomotor activation than controls given 2 mg/kg amphetamine. The magnitude of the locomotor activation to this dose of amphetamine decreased equivalently over the four test days for all prenatal treatment groups. Male but not female rats exposed prenatally to alcohol showed an apparent sensitization to 10 mg/kg amphetamine not seen in control rats between PN28 and PN42. There were no group differences in amphetamine-induced stereotypy or SCH-23390-induced catalepsy. The results implied that children with Fetal Alcohol Syndrome who may be treated for attentional dysfunction would show different dose-responses for some behavioral effects of CNS stimulants, but not for growth-retarding "side effects." PMID- 1779954 TI - Low-level cadmium exposure increases one-way avoidance in juvenile rats. AB - Twenty-seven pregnant rats from three genetic lines, Roman High Avoidance (RHA), Roman Low Avoidance (RLA), and Satinder's Heterogeneous Stock (SHS), received daily SC injections of either 0.075 mg/kg CdCl2 (low dose), 0.225 mg/kg CdCl2 (high dose), or an equivalent volume of saline vehicle (control) throughout gestation. Cd-exposed progeny from the RHA genetic line weighed significantly less than RHA control progeny (pd 35-44); however, SHS progeny from the low-dose group weighed significantly more than progeny from any other group (pd 14-44). Unconditioned escape response (UER) level was determined on pd 39. Progeny from the high-dose group required a significantly lower UER level as compared to the low-dose group. Acquisition of conditioned avoidance responses was tested from pd 41 to 44. There were significant differences due to dose for one-way avoidance responses. Cd-related differences in one-way avoidance were restricted to progeny from the SHS genetic line. SHS progeny from the high-dose group demonstrated significantly more one-way responses when compared to the control group. Differences in avoidance responses are discussed in relation to Cd-induced hypernociception. The concentration of Cd in the liver and kidney of dams and progeny was determined by Inductively Coupled Plasma spectroscopy (ICP). There were significant dose-related differences in Cd concentration in maternal tissues. PMID- 1779955 TI - Behavioral risk factor surveillance, 1986-1990. AB - Since 1984, an increasing number of states (including the District of Columbia) have participated in the Behavioral Risk Factor Surveillance System (BRFSS). This report provides state-specific estimates of the prevalence of selected health risk behaviors for the years 1986 through 1990. Apparent trends and progress toward several of the year 2000 national health objectives are discussed, both for the entire adult population (persons ages greater than or equal to 18 years) and selected high-risk demographic subgroups. Now that BRFSS includes 45 states and covers over 90% of the nation's adult population, it can be used both as a measure of state-specific risk factor prevalence and an indicator of national trends. PMID- 1779956 TI - Results of testing for intestinal parasites by state diagnostic laboratories, United States, 1987. AB - We analyzed results of 216,275 stool specimens examined by the state diagnostic laboratories in 1987; parasites were found in 20.1%. Percentages were highest for protozoans: Giardia lamblia (7.2%), Entamoeba coli and Endolimax nana (4.2% each), Blastocystis hominis (2.6%), Entamoeba histolytica (0.9%), and Cryptosporidium species (0.2%). Identifications of Giardia lamblia increased broadly from the 4.0% average found in 1979, with 40 states reporting increases and seven decreases. Most states that identified Giardia in more than 9% of specimens were located around the Great Lakes or in the Northwest. Seasonally, Giardia identifications increased in the summer and fall, especially in northern states. The most identified helminths were nematodes: hookworm (1.5%), Trichuris trichiura (1.2%), and Ascaris lumbricoides (0.8%). Other less commonly identified helminths included Clonorchis and Opisthorchis species (0.6%), Strongyloides stercoralis (0.4%), Hymenolepis nana (0.4%), Enterobius vermicularis (0.4%), and Taenia species (0.1%). Tape tests for Enterobius, reported for 35 states, were positive for 11.4% of 9,597 specimens. Nine states (California, Colorado, Hawaii, Idaho, New Jersey, Oregon, Rhode Island, Washington, Wisconsin) reported hookworms in more than 2% of specimens; none were states traditionally associated with indigenous transmission. Cryptosporidium diagnoses, reported by 25 of 49 states, were recorded for the first time in a national survey and showed no marked regional clustering. The Giardia data revealed changes in rates of identification and in geographic patterns compared with state laboratory data collected a decade earlier (1976-1978). PMID- 1779957 TI - Effect of alanine supply on hepatic protein synthesis in animals maintained on a protein free diet. AB - In contrast to what it is observed during starvation, animals maintained on a protein-free isocaloric diet showed an increase in the rate of hepatic peptide chain elongation as determined by measuring the ribosomal transit time in vivo. The loss of body nitrogen per se is insufficient to generate the signal(s) which arrests hepatic peptide chain elongation. This observation suggests that it is an increase in gluconeogenic demand, and not the negative nitrogen balance, which is implicated in determining reciprocal changes in the rate of protein synthesis. The rate of protein synthesis, as expressed per mg of DNA, does not change in protein deprived animals, while the RNA to DNA ratio decreased. These data also agree with a higher ribosomal efficiency at the elongation step. The animals maintained on a protein-free diet have a decreased hepatic content of protein and an increased concentration of valine, indicating an increased proteolysis. The enhanced rate of polypeptide elongation observed in animals kept on a protein free diet was accompanied by decreases in the state of aggregation of polyribosomes and in the ability of liver extracts to form eIF-2 catalyzed ternary complexes. These observations suggest that the activity of the hepatic initiation factor in vivo may not be rate limiting. The administration of alanine in vivo to animals maintained on a protein-free diet showed a preferential effect in reaggregating polyribosomes. This action was neither accompanied by detectable effects on the rate of eIF-2 catalyzed ternary complexes formation nor by significant changes in the rate of elongation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779958 TI - Variations in the kinetic response of several different phosphate-dependent glutaminase isozymes during acute metabolic acidosis. AB - We describe the kinetic modifications to mitochondrial-membrane-bound phosphate dependent glutaminase in various types of rat tissue brought about by acute metabolic acidosis. The activity response of phosphate-dependent glutaminase to glutamine was sigmoidal, showing positive co-operativity, the Hill coefficients always being higher than 2. The enzyme from acidotic rats showed increased activity at subsaturating concentrations of glutamine in kidney tubules, as might be expected, but not in brain, intestine or liver tissues. Nevertheless, when brain and intestine from control rats were incubated in plasma from acutely acidotic rats enzyme activity increased at 1 mM glutamine in the same way as in kidney cortex. The enzyme from liver tissue remained unaltered. S0.5 and nH values decreased significantly in kidney tubules, enterocytes and brain slices preincubated in plasma from acidotic rats. The sigmoidal curves of phosphate dependent glutaminase shifted to the left without any significant changes in Vmax. The similar response of phosphate-dependent glutaminase to acute acidosis in the kidney, brain and intestine confirms the fact that enzymes from these tissues are kinetically identical and reaffirms the presence of an ammoniagenic factor in plasma, either produced or concentrated in the kidneys of rats with acute acidosis. PMID- 1779959 TI - Effect of benzyl viologen on the phospholipid fatty acid composition and some properties in hepatic microsomal membrane of rats. AB - The effect of benzyl viologen (a stimulator of free radical production in cells) on lipid composition, fluidity and enzymes involved in both polyunsaturated fatty acid biosynthesis and cholesterol metabolism was studied in liver microsomal membrane of adult rats. In viologen-treated animals, a significant decrease in the levels of free cholesterol and cholesteryl esters, accompanied to a decrease at the free cholesterol/phospholipid ratio, were observed. The levels of 3 hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase and acyl-coenzyme A: cholesterol acyltransferase (ACAT) were also lower in viologen-treated rats than in controls. Linoleic and arachidonic acids were both severely lower while docosatetraenoic, docosapentaenoic and docosahexaenoic acids were significantly higher as compared with controls. Furthermore, a decrease in monounsaturated/saturated ratio was found. In addition, the treatment evoked a depression in the fatty acid desaturation complex, with a diminish of delta 9, delta 6 and delta 5 desaturase activities in microsomal membrane. It was concluded that changes in phospholipid microsomal fatty acid and cholesterol content could be directly responsible for changes in membrane fluidity and function, and that extensive yield of docosahexaenoic acid may serve to maintain the physical characteristics of particular domains against oxidative stress caused by benzyl viologen treatment. PMID- 1779960 TI - Human intestine epithelial cell acetyl- and butyrylcholinesterase. AB - The epithelial cells of the human intestine exhibit a cholinesterase activity which is restricted to the apex of the villi. This activity displays a maximum in the colon and a minimum in the jejunum. Contrary to most of the studied vertebrates, the human cells present both acetylcholinesterase and butyrylcholinesterase activities, acetylcholinesterase being predominant in all the intestinal segments: duodenum, jejunum, ileum and colon. Like in the other vertebrates, only globular forms are identified by sucrose gradient centrifugation. However, the simultaneous presence, on the one hand of three globular forms (G1, G2 and G4) and, on the other hand of soluble as well as detergent-soluble molecular species seems to be a particular feature of the human cells. PMID- 1779961 TI - A mechanism for the loss of cytochrome P-450 in primary mouse hepatocytes. AB - This study examined various biochemical parameters such as mitochondria and mitochondrial DNA (mtDNA), total heme and cyto P450 content in fresh hepatocytes and dedifferentiated hepatocytes. These parameters were chosen in order to understand the dramatic decrease in drug metabolism in cultured hepatocytes. The data in this study shows a temporal decrease in cytochrome P450, a total heme and also a decrease in mitochondria. Also, the ratio of mtDNA content to mitochondrial density was found to increase as hepatocytes underwent dedifferentiation. Stereological analysis of cell preparations provided a measure of mitochondrial density per cell area and mtDNA content was assessed by the use of a specific radiolabelled probe. This study demonstrates that a loss of the organelle which is partially responsible for synthesis of heme correlates with a decrease in cytochrome P450. PMID- 1779962 TI - Biochemical and immunological characterization of exometabolites from an Indian strain of Leishmania donovani promastigotes grown in a chemically defined medium. AB - Exometabolites (EXOM) of an Indian strain of Leishmania donovani promastigotes isolated from a chemically defined medium by ultrafiltration consisted of proteins, glycoproteins, lipid and lipophosphopolysaccharide (LPPS). LPPS of Mr 40-28 kDa in SDS-PAGE could be labelled metabolically with [32P]-phosphate and recovered in the aqueous phase of hot-phenol-water extraction of EXOM (PE-Aq) along with a glycoprotein of Mr 150-130 kDa (GP150-130). These two molecules could be eluted from DE-52 column with 200 mM NaCl (D2). The 300 mM NaCl (D3) and 400 mM NaCl (D4) eluates from DE-52 column contained one unsaturated polar lipid component. The LPPS had Rf value of 0.65-0.75 in Thin Layer Chromatography (TLC) using saturated phenol water solvent system. EXOM revealed 15 bands in SDS-PAGE of which proteins of Mr 84, 66, 56, 50 and 29 kDa were prominent. When EXOM were fractionated through Con A-Sepharose column, the fraction eluted with alpha methyl-D-mannoside (Con A-E) had seven bands as revealed by SDS-PAGE of which 25, 16, 13 and 12 kDa glycoproteins were prominent. The antigens present in EXOM can be classified as slower anodic migrating and faster anodic migrating antigens as revealed by immunoelectrophoresis (IEP). The slower anodic migrating antigens, LPPS and GP150-130 recovered in PE-Aq and D2 did not cross-react with kala-azar patients' sera but cross-reacted with homologous anti-promastigote sera. Two faster anodic migrating antigens which could be recovered in organic phase of hot phenol extraction of EXOM (PE-O) and eluted in D3 and D4 and Con A-E, cross reacted with kala-azar patients' sera. The antigens of both the classes were sensitive to periodic acid oxidation. PMID- 1779963 TI - Studies on the agglutinating activity of pancreatic extracts and its relevance to function. AB - Agglutination of washed rabbit erythrocytes caused by pancreatic acinar cell extract was inhibited by glucose, maltose and cellobiose. Process of elimination and purification divulged that the acinar cell enzyme alpha-amylase was responsible for attributing the agglutinin activity. Assay of enzyme and agglutinin activity data of different fractions of re-purified alpha-amylase eluted from HPLC column showed that both the activity resides in the same fraction which suggests that the enzyme binds to the glucosyl residues of the rabbit erythrocytes via the carbohydrate binding/catalytic sites. Similar properties of other glycosidases were also noted. PMID- 1779964 TI - Estrogen receptor variants in clinical breast cancer. AB - We have used the screening techniques of chemical mismatch cleavage, single stranded conformational polymorphism, and gel retardation to discover a number of estrogen receptor RNA variants in clinical breast cancer tissues. We have found basepair insertions, transitions, and deletions as well as alternative splicing, yielding deletions of exon 3, 5, or 7. Using a yeast transactivation assay we have discovered receptors with outlaw function, including both a dominant positive receptor, which is transcriptionally active in the absence of estrogen, and a dominant-negative receptor, which is itself transcriptionally inactive, but prevents the action of normal estrogen receptor. These variants could have clinical significance, helping to explain breast tumor behavior and patient outcome. PMID- 1779965 TI - Multiple components of a complex androgen-dependent enhancer. AB - Sex-limited protein (Slp) is expressed in adult male mice. A 160-basepair fragment 2 kilobases upstream of the gene serves as an androgen-dependent enhancer of chloramphenicol acetyltransferase expression in transient transfection assays in cells with endogenous or cotransfected androgen receptor. One element that is necessary, but not sufficient, for induction is a consensus glucocorticoid (or hormone) response element (HRE). This element binds to the mouse androgen receptor in vitro, but with apparent weak affinity. Induction by the HRE is greatly augmented by an accessory sequence within the 160 basepairs, suggesting that cooperative interactions confer strong response to androgen. Additional elements within the enhancer modulate induction, positively or negatively, and exhibit cell-specific behavior. Of particular interest are two degenerate HREs that are adjacent to the consensus sequence; they show no independent activity, but are functionally significant in conjunction with other elements. The complexity of this enhancer may reflect biological mechanisms that ensure specificity of hormonal response and allow gene expression to respond to changes in hormone concentration. PMID- 1779966 TI - Functional estrogen receptors in osteoblastic cells demonstrated by transfection with a reporter gene containing an estrogen response element. AB - Although a small number of estrogen receptors (ER) were visualized in osteoblastic cells, and estradiol (E2) has some effects on osteoblasts in vitro, the direct action of E2 on osteoblasts has not been fully established. To determine the presence of functional ER in osteoblasts, we transfected cells with a plasmid containing the chloramphenicol acetyl transferase (CAT) reporter gene and the estrogen-responsive element (ERE) from the vitellogenin A2 gene. E2 dependent induction of CAT activity was determined 48 h after transient transfection and subsequent treatment with 10-100 nM 17 beta-E2. 17 beta-E2, but not 17 alpha-E2, dihydrotestosterone, or progesterone, induced CAT activity in a dose-dependent manner (up to 6-fold) in rat calvarial fraction-3, RCT-3, PyMS, and UMR-106 cells as well as in the human osteosarcoma cell line SaOS-2/B-10. In contrast, E2 had no effect on the induction of CAT activity in the preosteoblastic cell lines RCT-1 and TRAB-11, in the rat osteosarcoma cell line ROS 17/2.8, and in the fibroblastic cell lines BALB-c/3T3 and NRK. Over expression of ER using a simian virus-40-based expression vector not only conferred or enhanced E2-dependent induction of CAT in all cell types, but augmented E2-dependent expression of insulin-like growth factor-I and E2 stimulated DNA synthesis in primary calvarial and PyMS osteoblastic cells, respectively. These data show the presence of low levels of functional endogenous ER in some, but not all, osteoblastic cells and suggest that the abundance of ER may be rate limiting in the action of E2 on these cells. PMID- 1779967 TI - A new structural model for the thyrotropin (TSH) receptor, as determined by covalent cross-linking of TSH to the recombinant receptor in intact cells: evidence for a single polypeptide chain. AB - The most widely held model for the human TSH receptor is of holoreceptor of 80 kDa with two subunits of approximately 50 and 30 kDa linked by disulfide bridges, with the former subunit containing the major hormone-binding site. We reexamined this model by covalently cross-linking radiolabeled TSH to the recombinant human TSH receptor stably expressed in Chinese hamster ovary (CHO) cells. When cross linking was performed after the preparation of CHO membranes, analysis of hormone receptor complexes under reducing and nonreducing conditions provided results supporting the two-subunit TSH receptor model. In contrast, however, cross linking of TSH to the TSH receptor in intact CHO cells before membrane preparation revealed, even under reducing conditions, an approximately 100-kDa receptor as well as an approximately 54-kDa hormone-binding subunit. The approximately 100-kDa holoreceptor size is consistent with the size of the TSH receptor, as predicted from its derived amino acid sequence. The proportions of the approximately 100-kDa TSH receptor and the 54-kDa fragment varied in different experiments, suggesting the occurrence of proteolytic cleavage. Cross linking of radiolabeled TSH to intact cells expressing a mutant TSH receptor (TSHR-D1) lacking amino acids 317-366 localized the proteolytic cleavage site to just up-stream of amino acid residue 317. In summary, the present data obtained by cross-linking TSH to recombinant human TSH receptors in intact cells provides evidence that the receptor exists in vivo as an approximately 100-kDa glycoprotein with a single polypeptide chain with intramolecular disulfide bridges.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779968 TI - The bovine chromogranin A gene: structural basis for hormone regulation and generation of biologically active peptides. AB - The structure of the gene encoding bovine chromogranin-A has been determined by characterization of two isolated genomic clones. Chromogranin-A is encoded by eight exons, which organize the coding region into several distinct structural and functional domains. Exons 1-5 represent the highly conserved signal peptide and N-terminal domain, which are separated into regions corresponding to the signal peptide, N-terminal sequence, disulfide-bonded loop, and remainder of the conserved N-terminal domain. Exon 6 represents the variable domain and encodes a region that is identical to the novel chromogranin-A-derived peptide chromostatin. Exon 7 encodes the biologically active peptide pancreastatin as well as most of the conserved C-terminal domain, with the remainder found on exon 8. The mRNA sequence obtained from the gene contains five nucleotide differences from the consensus sequence of four reported bovine chromogranin-A cDNA clones. Two of the differences in the gene result in two amino acid changes in the region encoded by exon 6. The structural organization of the chromogranin-A gene resembles that of the chromogranin-B gene in the exons corresponding to the signal peptide, N-terminal sequence, disulfide loop, and C-terminal sequence.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779969 TI - Hormonal regulation of serine dehydratase gene expression in liver and kidney of the adrenalectomized rat. AB - We have previously demonstrated that glucagon but not dexamethasone could induce serine dehydratase (SDH: EC.4.2.1.13) in liver, and either glucagon or dexamethasone could induce the enzyme in kidney of normal rats. The mechanism(s) of the hormonal regulation of SDH gene expression in liver and kidney was further studied using adrenalectomized rats. Simultaneous administration of glucagon and dexamethasone induced the activity, rate of SDH synthesis, and accumulation of SDH mRNA in both liver and kidney of the rat. The increased SDH activity was reflected by changes in the amount of enzyme protein and in the rate of SDH protein synthesis, both parameters closely paralleling the changes in the levels of SDH mRNA. The rates of transcription of the SDH gene as measured in run-on experiments with isolated nuclei were also increased by the administration of these hormones. These results indicate that the expression of the SDH gene was regulated primarily at the transcriptional level under these conditions. When glucagon or dexamethasone was injected separately into adrenalectomized rats, significant increases in the levels of SDH mRNA and the rate of SDH gene transcription were observed in liver. Although glucagon was more effective than dexamethasone, both hormones were required for the maximal induction of SDH gene transcription in liver. In contrast, dexamethasone alone effectively increased the rate of SDH gene transcription in kidney.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779970 TI - Regulation of start site usage in the leader exons of the rat insulin-like growth factor-I gene by development, fasting, and diabetes. AB - Rat insulin-like growth factor-I (IGF-I) mRNAs with different 5'-untranslated region/prepeptide coding sequences result from transcription initiation in one of two leader exons. While not altering the mature IGF-I coding sequence, these different leaders potentially encode two distinct IGF-I prepeptides, one of 48 amino acids (exon 1) and one of 32 amino acids (exon 2). Within exon 1, transcription initiation is dispersed (i.e. occurs over a approximately 350 basepair region), while within exon 2, it is highly localized. A fourth exon 1 start site, residing only approximately 30 basepairs from its 3' end, is suggested on the basis of RNase protection assays; its use would produce an mRNA encoding a third distinct IGF-I leader peptide of 22 amino acids. We have determined that during postnatal development, and as a result of insulinopenic diabetes and fasting, choice of transcription start sites within exon 1 in the liver is coordinately regulated, i.e. use of all start sites increased during development and decreased in the two catabolic states. Transcription initiation at the single major site within exon 2 was also reduced in diabetes and fasting. Insulin replacement therapy and refeeding restored the levels of all transcripts coordinately. During postnatal development, however, transcripts initiating within exon 2 exhibited a different developmental profile than did exon 1 transcripts, increasing especially at the onset of GH-dependent linear growth. In liver, therefore, negative regulation of exon 1 and exon 2 transcription start site usage occurs in catabolic states, while in development, differential regulation of exon 1 and exon 2 transcription start sites occurs. PMID- 1779971 TI - Transforming DNA sequences present in human prolactin-secreting pituitary tumors. AB - Five human PRL-secreting pituitary tumors were tested for the presence of DNA transforming sequences. After calcium phosphate transfection to NIH-3T3 mouse fibroblast cells, DNA samples derived from two prolactinomas induced foci of morphologically transformed cells which subsequently grew in soft agar. After retransfection of transformant DNA, resulting secondary transformants elicited rapidly growing solid tumors in nude mice. Southern analysis of transformant DNA revealed the integration of Alu-positive human DNA sequences into the mouse fibroblast NIH-3T3 cells, as judged by hybridization to a Blur-8 probe. The Alu signal became increasingly more difficult to detect with the multiple passaging (greater than 20) of transformant cells in culture. Alu polymerase chain reaction (PCR) was, therefore, used to selectively amplify human DNA sequences from the NIH-3T3 rodent background. PCR using a human Alu-specific primer resulted in amplification of an Alu-containing DNA region within these transformants. The transformant DNA did not hybridize to human genomic probes for genes known to evoke focus formation in this assay, including H-ras, K-ras, N-ras, trk, ret, ros, or met. Further identification of the Alu-containing region revealed that it contained sequences from the human hst gene, a member of the fibroblast growth factor family. The presence of human hst was demonstrated by strong hybridization to a 40-mer oligonucleotide probe to the second exon of hst, by amplification of this region with human hst-nested amplimers within the first and second introns, and finally by direct sequencing.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779972 TI - Identification of a dominant negative form of the human estrogen receptor. AB - Experiments were undertaken to characterize mRNAs coding for the estrogen receptor (ER) in the human breast cancer cell line T47D. We report here the isolation of cDNAs corresponding to three isoforms of this receptor in addition to a majority of wild-type clones. Sequence analysis showed that these isoforms are generated through alternative splicing. None of the alternatively spliced isoforms of ER is able to bind to an estrogen-responsive element (ERE) in a gel mobility shift assay in vitro or to activate transcription of a reporter gene containing an ERE in vivo. One isoform, ER delta E3, which harbors a deletion of exon 3 encoding the second zinc finger of the DNA-binding domain, inhibits estrogen-dependent transcription activation in a dominant negative fashion when it is cotransfected with the wild-type ER and reporter plasmid. It also inhibits DNA binding of wild-type ER in a gel mobility shift assay in vitro. Since ER delta E3 is not able to bind to its response element, the observed inhibitory effect probably occurs through protein-protein interactions. This could involve the formation of a heterodimer between mutant and wild-type receptors, competition for a limiting transcription factor, or both. These results may have implications for understanding the loss of estrogen responsiveness that frequently occurs in breast cancer. PMID- 1779973 TI - Inhibition of prolactin gene transcription by transforming growth factor-beta in GH3 cells. AB - Transforming growth factor-beta (TGF beta) is a member of a large family of growth factors, several of which regulate pituitary function. TGF beta has recently been reported to reduce PRL production by GH4 cells. We have examined the effect of TGF beta on PRL gene expression in rat pituitary tumor GH3 cells. TGF beta 1 or TGF beta 2 reduced both basal and Ca(2+)-stimulated PRL mRNA levels. This inhibition was specific, as the mRNA levels for GH, glucose regulated protein 78, and histone-3 were unaffected by TGF beta. Inhibition of PRL gene expression by TGF beta was dose dependent in the range of 0.5-10 ng/ml. TGF beta inhibited run-on PRL gene transcription in nuclei from treated cells to the same extent that it reduced PRL mRNA levels, indicating a transcriptional mechanism of action. However, TGF beta did not affect Pit-1 mRNA levels or run-on transcription of the Pit-1 gene. Thus, TGF beta does not appear to act through modification of Pit-1 gene expression. The PRL promotor contains two regions of homology, with a consensus sequence found in the promoters of other TGF beta inhibited genes. These findings are consistent with other studies that have demonstrated transcriptional repression by TGF beta. The potency and specificity of the effects of TGF beta on PRL gene expression suggest that it may be a physiological regulator of lactotroph function. PMID- 1779974 TI - Expression of the growth hormone gene and the pituitary-specific transcription factor GHF-1 in diabetic rats. AB - Diabetes in the rat is associated with poor growth and decreased GH in the pituitary. In this study we have examined whether this reduction reflects an impairment of GH gene expression. Diabetes was induced by the administration of streptozotocin (7 mg/100 g BW), and 18 days later, GH content, GH mRNA, and GH transcription rate were determined. GH mRNA levels were reduced by more than 80% in the pituitaries of diabetic rats, which had a similarly reduced GH content. The differences observed in transcription fully account for the changes in mRNA concentration, since the transcription rate of the gene was also reduced by a factor of 10 in the diabetic pituitaries. Insulin therapy (3 U/15 days) partially restored these parameters. The expression of the specific transcription factor GHF-1/Pit-1 in diabetic rats was also analyzed. Both GHF-1 mRNA levels and the binding of nuclear proteins to an oligodeoxynucleotide conforming to the GHF-1 proximal binding site in the promoter of the GH gene were normal in the diabetic pituitaries, thus excluding the possibility that decreased availability of this factor could be responsible for the decreased GH transcription. Since diabetes produced an approximately 3-fold reduction of circulating T3, the potential role of thyroid hormones on GH gene expression was also evaluated in thyroidectomized and thyroidectomized diabetic rats. Thyroidectomy decreased GH and GH mRNA to less than 5% of the values found in intact animals, and a single saturating injection of T3 (250 micrograms/100 g BW) resulted in a 8- to 10-fold induction of GH mRNA after 6 h.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779975 TI - Interleukin-1 alpha and tumor necrosis factor-alpha (TNF alpha) inhibit growth and induce TNF messenger RNA in MCF-7 human breast cancer cells. AB - We studied the effects of interleukin-1 alpha (IL-1) and tumor necrosis factor alpha (TNF), alone and in combination, on MCF-7 breast cancer cells to determine whether these cytokines alter cell growth, TNF gene expression, and TNF secretion. We found that IL-1 alone and TNF alone inhibited cell growth in a dose dependent manner. Each cytokine arrested growth in the G0/G1 phase of the cell cycle, with maximum growth inhibition at 1000 U/ml (P less than 0.05) and 100 U/ml (P less than 0.01), respectively. However, the combination of these two cytokines did not result in greater growth inhibition or a greater percentage of cells arrested in the G0/G1 phase of the cell cycle compared with each cytokine alone. We examined the effect of exogenous IL-1 and TNF on TNF gene expression by Northern blot analysis. In the absence of any cytokine, these cells do not express TNF mRNA. Exposure to IL-1 (1000 U/ml) induced TNF mRNA at 3 h; however, mRNA levels diminished thereafter to barely detectable levels by 24 h. Exposure to TNF (1000 U/ml) also induced TNF mRNA at 3 h, but in contrast to IL-1, the level of enhanced expression persisted at these levels through 72 h of exposure. Secretion of TNF by these cells is induced by exogenous TNF, but not by IL-1. IL 1 and TNF in combination do not produce greater inhibition of growth, greater amounts of TNF mRNA at 3 h, or greater secretion of TNF than that produced by TNF alone.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779976 TI - Pit-1 binding sequences permit calcium regulation of human prolactin gene expression. AB - This study examines the regulation of the human PRL (hPRL) gene promoter by intracellular calcium. Deletants of the 5'-flanking region of the hPRL gene and constructs consisting of the thymidine kinase promoter linked to the first or second proximal Pit-1 binding site were fused to the bacterial chloramphenicol acetyl transferase (CAT) reporter gene. With the complete 5-kilobase pair (kbp) hPRL promoter sequence the calcium channel agonist Bay K8644 induced a significant 2-fold increase in CAT reporter gene expression and the antagonist verapamil a 4.5-fold reduction, using GH3 cells cultured in physiological levels of calcium. The transcriptional response to calcium influx was similar with a series of 5'-deleted hPRL-CAT constructs including those that comprised the proximal (up to 740 bp) or distal (-1300- to -1700-bp) sequences alone. When treating cells cultured in low calcium conditions the induction with the hPRL promoter increased to 5-fold on the addition of exogenous calcium and Bay K8644. The pituitary-specific expression of the hPRL gene is conferred by the interaction of the pituitary-specific factor Pit-1 with several binding sites located in the 5'-flanking DNA, of which three are located in the proximal region. This suggested that Pit-1 binding sites may be involved in the calcium response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779977 TI - Characterization and functional properties of the A and B forms of human progesterone receptors synthesized in a baculovirus system. AB - Human progesterone receptors (PR) were overexpressed in Spodoptera frugiperda (Sf9) insect cells using a recombinant baculovirus system. Recombinant viruses were constructed that produced either full-length A (94K) or B (120K) forms of human PR, and each was expressed as a functional protein. Steroid and DNA binding activities were found to be indistinguishable from that of endogenous human PR in T47D breast cancer cells. Moreover, as analyzed by gel-mobility shift, recombinant PR-A and PR-B each bound to specific progesterone response elements in a strictly hormone-dependent manner. Native receptors expressed in Sf9 cells also exhibited structural properties similar to that of endogenous PR. Cytosolic PR (PR-A or PR-B), prepared in low salt buffer, sedimented on density gradients as an 8S oligomeric complex that was converted largely to 4S by treatment with 0.4 M NaCl. Immune isolation of the 8S cytosol PR complex and analysis of protein composition revealed the presence of two specific copurifying proteins of approximately 90K and 70K. The 90-K component was identified immunologically as heat shock protein 90. The 70-K component was not identified but is likely to be the insect equivalent of heat shock protein 70. Immune isolation of PR from Sf9 cells metabolically labeled with [32Pi], revealed that expressed PR was capable of being phosphorylated in insect cells. Hormone addition to Sf9 cells, however, did not stimulate the same increase in PR phosphorylation or upshift in mobility on sodium dodecyl sulfate gels that occurs with endogenous receptors in T47D cells. Thus some, but not all, phosphorylations occur with human PR expressed in Sf9 cells. These phosphorylation data, together with the fact that expressed PR required hormone for DNA binding, indicate that the hormone-dependent phosphorylation step responsible for PR upshifts on sodium dodecyl sulfate polyacrylamide gel electrophoresis is not required for receptor binding to DNA. The baculovirus expression system, therefore, may prove valuable in dissecting the functional role(s) for both hormone-dependent and hormone-independent PR phosphorylation. PMID- 1779978 TI - Isolation and characterization of Opisthorchis viverrini specific DNA probe. AB - An Opisthorchis viverrini specific repetitive DNA fragment was isolated from the O. viverrini genome. The cloned fragment, herein designated pOV-A6, contained tandemly repeated 334 bp O. viverrini DNA and has the potential to be a highly specific and sensitive DNA probe. Radioactively labelled pOV-A6 could detect as little as 25 pg of its own genomic DNA and five purified eggs by dot-blot hybridization. The presence of 50 O. viverrini eggs could be readily detected in samples containing faecal materials. The probe was highly specific for O. viverrini DNA and did not cross hybridize with DNAs prepared from related and unrelated parasites, enteric bacteria and a number of definitive and intermediate hosts. The probe has potential for screening a large number of samples and could be readily applied in epidemiological studies. PMID- 1779979 TI - Overt and latent HIV 1 and HTLV-I infection in cohorts of at high risk individuals in Argentina. AB - We conducted a survey using serology and polymerase chain reaction assays to detect HIV 1 and/or HTLV-I antibodies and viral DNA, respectively, in 113 intravenous drug abusers and in 62 sexually active high risk individuals attending two Drug Addict Centres and a Centre for Venereal Diseases in Buenos Aires, Argentina. At the time of the survey 137 of these subjects were known to be HIV 1 seropositive but none of them was symptomatic. Serological tests for HTLV-I were found to be positive in 38 (21.7%) of the HIV 1 positive individuals, whereas all of the 38 HIV 1 seronegative subjects were also seronegative for HTLV I antibodies. Gene amplification assays carried out in blood sample DNA from the 38 HIV 1/HTLV-I seronegative individuals, revealed HIV 1 DNA in six out of 28 intravenous drug abusers (21.5%). One subject (2.6%) was positive for both HIV 1 and HTLV-I DNA sequences, whereas four (10.5%) showed HTLV-I DNA only. To determine whether these individuals were infected with HTLV-I and/or HTLV-II, DNA samples were also amplified with HTLV-II specific primers and no evidence of HTLV II infection was observed. None of the subjects seroconverted according to conventional serological tests during the 2 year follow-up period. The 10 seronegative subjects belonging to the sexual risk group were negative for both HIV 1 and HTLV-I in polymerase chain reaction assays. We conclude that not only HIV 1, but also HTLV-I is a widely spread infection in intravenous drug abusers and sexually active high risk individuals in Argentina.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1779980 TI - Evaluation of a DNA probe of plasmid origin for the detection of Chlamydia trachomatis in cultures and clinical specimens. AB - This study evaluates five cryptic plasmid-derived DNA probes in a 4-h slot-blot hybridization assay for the detection of Chlamydia trachomatis in cultures and clinical specimens. The probes, consisting of either the entire cloned 7.5 kbp cryptic plasmid pSE8 or one of four Hin dIII/Eco RI fragments measuring 710, 1055, 710, and 500 bp, respectively, were labelled with Photoprobe biotin. The probe was detected using a streptavidin-alkaline phosphatase conjugate followed by addition of BCIP and NBT. The sensitivity of the assay, using 25 ng of probe DNA, ranged from 50 pg (with the entire plasmid as probe) to 5 ng (with the 500 bp fragment as probe). A total of 103 reference strains of Chlamydia trachomatis and other bacteria were tested for reactivity with the probes. All 18 reference strains of C. trachomatis hybridized with the probes. None of the DNA from the heterologous organisms tested was found to hybridize with any of the probes. A total of 174 samples taken from patients visiting the STD clinic at the University Hospital, University of Seville were used in the study. The overall sensitivity of the assay, using the 710 bp biotinylated probe was 94.5% compared to culture while the specificity was 97.5%. Positive and negative predictive values were 96.5% and 97.5%, respectively. It appears that the plasmid-derived probes used in this study could serve as useful tools for the rapid and specific detection of Chlamydia trachomatis in cell cultures and clinical specimens. PMID- 1779981 TI - A nested PCR followed by magnetic separation of amplified fragments for detection of Escherichia coli Shiga-like toxin genes. AB - The Shiga-like toxin (SLT) I and II genes in cytotoxic Escherichia coli strains were detected using a polymerase chain reaction (PCR) procedure. Identification and differentiation of SLT I and II was carried out using primers giving PCR generated DNA fragments of different size for the two cytotoxins. A two-step PCR procedure utilizing three primers in a nested configuration for both SLT I and II was combined with magnetic separation to identify the toxin genes in a rapid, specific and sensitive test system designated DIANA (Detection of Immobilized Amplified Nucleic Acid). The first PCR was carried out using standard methods, and the product generated was used as primer in the second PCR. In this procedure one of the primers from the first PCR was used with biotin label, and the second (inner) primer was 32P-labelled. The double-stranded DNA fragments generated containing the two primers, were biotinylated on one 5' end and 32P-labelled on the other 5' end. These fragments were separated from the solution using streptavidin-coated super-paramagnetic microscopic beads. The test could detect and differentiate between SLT I and II in a positive/negative ratio of more than 20. The assay could detect five SLT-positive E. coli organisms in the 5 microliters test sample. The presence of 100-fold more SLT-negative strains in a sample did not adversely affect the test signal. PMID- 1779982 TI - Rapid detection of gene expression. AB - Conventional methods of in situ hybridization are not only complex, laborious and lengthy, tending to produce poor cellular resolution but are also inherently hazardous. We report a new method that overcomes many of these difficulties. Denovo attachment of a non-isotopic ligand, viz. 5-bromo-2'-deoxyuridine (BrdU) to oligonucleotide probes guaranteed the production of labelled probes of 100% specific activity that gave consistent, reproducible results, within hours, in a rapid in situ hybridization (ISH) technique. The method is demonstrated by localization of insulin-like growth factor II (IGF-II) mRNA in human intracranial tumours and foetal brain. Five of 10 meningiomas expressed IGF-II mRNA to an extent of 1% of their tumour cells and two of three pituitary adenomas exhibited a less than 0.2% IGF-II mRNA-positive cell population. IGF-II may be important in the progression and/or maintenance of these tumours. Foetal brain showed no hybridization. The method's simplicity, rapidity and reliability commends its use in a variety of research and diagnostic applications and the BrdU-labelled probes can be used in any hybridization technique. PMID- 1779983 TI - DNA enzyme immunoassay: a rapid and convenient colorimetric method for diagnosis of cystic fibrosis. AB - Genetic analysis of inherited diseases has been greatly facilitated by new approaches, involving genomic DNA amplification by the polymerase chain reaction (PCR), followed by hybridization with wild type-specific or mutation-specific oligonucleotide (MSO) probes. The main advantage of these methods is that they allow easy detection of point mutations starting from minimal amounts of biological materials. These techniques, however, require procedures which are not well suited to large-scale screening or use in routine laboratories. The development of dedicated kits to perform these tests efficiently in clinical laboratories is an important current issue. We developed a new non-radioisotopic assay to reveal specifically DNA-DNA hybrids between amplified DNA and MSO probes, and applied it to the detection of two mutations causing cystic fibrosis. The detection of hybrids is achieved by means of an anti double-stranded DNA antibody, in a format which is designed as a colorimetric assay resembling a common enzymatic immunoassay (EIA). The assay detects the hybridization event, independent of the nucleic acid sequences involved in the formation of the specific hybrids, and can be used with any combination of target DNA and probes. Therefore, this test represents a significant improvement for the clinical use of the polymerase chain reaction in the diagnosis of inherited diseases. PMID- 1779984 TI - Immunological fine structure of the variable and constant regions of a polymorphic malarial surface antigen from Plasmodium falciparum. AB - The 51-kDa merozoite surface antigen MSA2 of Plasmodium falciparum shows considerable strain-dependent polymorphism. Although marked sequence variation occurs in the central region of the molecule, the N and C-terminal sequences are highly conserved. A number of monoclonal antibodies directed against MSA2 have been described which inhibit parasite growth in vitro, but these are all directed against variable regions. In an attempt to raise strain independent antibodies we have prepared peptide-diphtheria toxoid (DT) constructs from 36 N-terminal octapeptides spanning the constant region and extending into the variable region of the FCQ/27 PNG variant staggered by one amino acid at either end. Similarly, we prepared 26 C-terminal octapeptides spanning the C-terminal constant region as well as 10 octapeptides from the variable region of the Indochina I variant MSA2. Most of the peptides elicited antipeptide titres in excess of 1/10(4) when administered to mice as peptide-DT adducts emulsified with Freund's complete adjuvant. Only 3 of the 43 N- and C-terminal constant region peptides elicited antibodies which reacted appropriately on immunofluorescence (IFA) or immunoblotting analysis with the intact MSA2 of both strains studied (FCQ/27 and Indochina I), whereas 3 other peptides from the variable region elicited antibodies reactive with the parent MSA2 only. Peptide constructs eliciting antibodies recognising the intact protein corresponded to elements in the cognate sequence of high antigenicity as predicted by the Jameson and Wolf algorithm. PMID- 1779985 TI - Translational elongation factor 1 alpha (EF-1 alpha) of Onchocerca volvulus. PMID- 1779986 TI - Subcellular distribution of trypanothione reductase in bloodstream and procyclic forms of Trypanosoma brucei. PMID- 1779987 TI - The gene for apocytochrome B of Theileria annulata resides on a small linear extrachromosomal element. PMID- 1779988 TI - Molecular karyotype and chromosomal localization of genes encoding two major surface glycoproteins, gp63 and gp46/M2, hsp70, and beta-tubulin in cloned strains of several Leishmania species. AB - The molecular karyotypes of several Leishmania isolates (Leishmania amazonensis, Leishmania braziliensis, Leishmania guyanensis, Leishmania panamensis, Leishmania donovani, Leishmania major, Leishmania aethiopica, Leishmania tropica, Leishmania enriettii) have been analyzed by clamped homogeneous electric field (CHEF) gel electrophoresis. The chromosomal localization of genes encoding 2 major surface glycoproteins, gp63 and gp46/M2, heat shock protein 70 (hsp70), and beta-tubulin was determined for cloned isolates of 8 of these Leishmania species. The chromosome size class assignment of hsp70 genes was most conserved in that all species contained a single hybridizing DNA band of approximately 1200 kb. The beta-tubulin gene probe hybridized predominantly to large (1600-1750 kb) chromosome-size DNA and to 1-5 additional bands, the number of which depended on the species. The number and size of DNA bands hybridizing to gp63 or gp46/M2 gene probes were not uniformly conserved among species. In contrast to previous reports of gp63 genes being located on a single chromosome, using various CHEF gel conditions we observed a Leishmania major gp63 gene probe hybridizing to at least 2 chromosomal DNA bands in the New World species and in L. tropica. Gp46/M2 genes were located on 1 band in L. donovani, L. major, and L. aethiopica or 2 bands in L. tropica and L. amazonensis, but surprisingly, do not hybridize to any chromosomal DNA of species in the L. braziliensis complex or in L. enriettii. Whenever both genes were present in a species, gp63 and gp46/M2 genes were located on different chromosomal DNA bands. PMID- 1779989 TI - Induction and localization of Plasmodium falciparum stress proteins related to the heat shock protein 70 family. AB - Induction of heat shock-related stress proteins Pfhsp and Pfgrp, similar in sequence to hsp70 (heat shock protein) and grp78 (glucose-regulated protein), respectively, was studied in culture-derived parasite Plasmodium falciparum. Elevation in temperature from 26 degrees C to 37 degrees C and higher caused significant induction of Pfhsp with a moderate effect on the synthesis of Pfgrp also. Synthesis of Pfgrp, however, was not induced by partial glucose deprivation. On the contrary, lack of glucose in the medium resulted in cessation of protein synthesis in the parasites. Other known inducers of grp synthesis in mammalian cells, i.e., calcium ionophore A23187 and inhibitors of glycosylation (tunicamycin, 2-deoxy glucose) were also without any apparent effect on the synthesis of Pfgrp. Heat shock-induced responses were transient in nature: removal of stress caused repression of these responses. The effect of glucose deprivation was only partially reversible with better recovery if parasites were subjected to glucose starvation at 26 degrees C than at 37 degrees C. Northern blot analysis and in vitro translation of mRNA revealed a parallel increase in the levels of mRNA for Pfhsp upon heat shock. Immuno-gold electron microscopy with cultured parasites revealed nuclear location of Pfhsp and primarily cytoplasmic (probably endoplasmic reticulum) location of Pfgrp. These findings suggest that SDEL (carboxy terminal sequence of Pfgrp) might play a similar role in the cellular localization of Pfgrp as does the sequence KDEL in mammalian cells and HDEL in yeast. PMID- 1779990 TI - Further characterisation of the Schistosoma japonicum protein Sj23, a target antigen of an immunodiagnostic monoclonal antibody. AB - Sj23, the 23-kDa target antigen in Schistosoma japonicum adult worms of the hybridoma monoclonal antibody (mAb) I-134, has been identified and cloned from cDNA libraries, mAb I-134 has been successfully used in immunodiagnostic assays to detect S. japonicum infection in Philippine patients. Sequence analysis has shown that Sj23 is the homologue, with 84% amino acid identity, of Sm23, a 23-kDa molecule from S. mansoni worms previously described from our laboratory. The domain structures of Sj23 and Sm23 are strikingly similar to the human membrane proteins ME491, CD37, CD53 and TAPA-1, which may suggest a functional role for the schistosome molecules in cellular proliferation. PMID- 1779991 TI - Organisation and expression of small subunit ribosomal RNA genes encoded by a 35 kilobase circular DNA in Plasmodium falciparum. AB - A restriction map of the 35-kb circular DNA molecule of Plasmodium falciparum showed that a region of about 6 kb, encoding both a large and a small subunit ribosomal RNA gene, has been duplicated in inverted orientation. The complete sequence of one small subunit rRNA gene is presented as well as an analysis of transcripts from erythrocytic stage parasites. Comparative sequence analysis of the rRNA gene and the proposed secondary structure of the rRNA suggest that it is of organellar origin. Intriguingly, while some characteristics of the small subunit rRNA gene are similar to mitochondrial sequences, others are more like those of plastids. The origin of the circular DNA molecule and evolutionary implications of its genetic content are discussed. PMID- 1779992 TI - Studies using a recombinant vaccinia virus expressing the circumsporozoite protein of Plasmodium berghei. AB - A recombinant vaccinia virus was constructed which expressed the circumsporozoite protein of Plasmodium berghei. Four different strains of mice belonging to different haplotypes were immunized with the recombinant virus. The antibody response to the circumsporozoite protein as well as to vaccinia virus varied among the strains, independently of each other. The anti-circumsporozoite protein titers were comparable to that obtained on immunization with irradiated sporozoites. Spleen cells from H2d mice immunized with P. berghei sporozoites showed a significant proliferative response when cultured in vitro with a low multiplicity of the recombinant vaccinia virus. A weak cytotoxic T lymphocyte response specifically targeting the circumsporozoite protein could be identified in spleens of BALB/c (H2d) mice immunized with vaccinia virus when BALB 3T3 cells transformed with a plasmid expressing the circumsporozoite protein under control of the simian virus 40 promoter were used as target cells in the cytotoxic T lymphocyte assay. However, none of the recombinant virus-immunized animals could be protected from a challenge of sporozoites even at the lowest dose of parasite used. PMID- 1779993 TI - Diagnostic potential of IgA coated Candida cells in mucous membrane candidiasis. AB - The significance of in vivo IgA coated yeast cells for the diagnosis of candidiasis of the oral and vaginal mucosal membranes was evaluated by direct immunofluorescence in 70 patients with or without clinical symptoms, shown to be positive for yeast growth in the cultural test. Most of the patients with clinically suspected candidiasis of the mucosal membranes gave positive results by serologic assays in contrast to the majority of symptomless patients. The diagnostic approach proved to be essentially consistent with the clinical signs, persistence of infection, response to antifungal therapy and quantitative cultural data. PMID- 1779995 TI - IMI descriptions of fungi and bacteria No. 1085. Phialophora bubakii. PMID- 1779994 TI - Studies on clinical signs and haematological alterations in pneumonic aspergillosis due to Aspergillus flavus in Japanese quail. AB - Intratracheal inoculation of 2-week old quail chicks with Aspergillus flavus spores resulted in the development of clinical signs within 24 h of infection. These were characterized by dullness, depression, anorexia, accelerated breathing, gasping and prostration leading to death. These signs continued up to 7 days followed by considerable decrease in the intensity of the symptoms as well as number of birds showing clinical signs. Mortality occurred primarily in the first week with a majority of the birds dying from 2-4 days after infection. The overall mortality during a 6-week observation period was 25%. The average body weight of the infected chicks was slightly lower than that of controls; the difference being significant at 2, 3 and 42 days post-infection. There was no appreciable difference in the mean values of haemoglobin, packed cell volume and total erythrocyte count between the infected and control chicks at any stage of infection, but total leucocyte count revealed a significant increase (p less than 0.05) from 3-7 days post-infection. This was due to increase in the percentage of heterophils and decrease in lymphocytes. PMID- 1779996 TI - IMI descriptions of fungi and bacteria No. 1088. Phialophora mutabilis. PMID- 1779997 TI - IMI descriptions of fungi and bacteria No. 1089. Phialophora richardsiae. PMID- 1779998 TI - IMI descriptions of fungi and bacteria No. 1090 Phialophora verrucosa. PMID- 1779999 TI - Occurrence of aflatoxins in parboiled rice in Sri Lanka. AB - In Sri Lanka, rice is the main staple which is mostly processed into parboiled rice. The levels of aflatoxin B1 (AFB1) and aflatoxin G1 (AFG1) in parboiled and raw milled rice collected from major rice producing areas and rice consuming townships were estimated. In almost all the samples of parboiled rice examined, the AFB1 and AFG1 contents were significantly higher than in raw milled rice. The highest AFB1 content was 185 micrograms/kg and AFG1 content 963 micrograms/kg. These samples were collected from a major rice producing/milling district where the mean relative humidity is 78% and mean annual temperature 27 degrees C which is the highest amongst the rice growing areas in Sri Lanka. Raw rice was either free of aflatoxins or when toxins were detected, they occurred in less than 10% of the samples. The frequency of occurrence of surface fungal flora (Aspergillus/Penicillium) and aflatoxin content in market samples was closely related. Brownish or greenish moldly rice samples with fermented odour contained over 1000 micrograms/kg of AFB1. PMID- 1780000 TI - Transformation of sterigmatocystin and O-methylsterigmatocystin by aflatoxigenic and nonaflatoxigenic field isolates of the Aspergillus flavus group. AB - Transformation of sterigmatocystin and O-methylsterigmatocystin (two metabolic aflatoxin precursors) to aflatoxins by aflatoxigenic and nonaflatoxigenic field isolates of Aspergillus flavus was studied. The 24 nonaflatoxigenic isolates investigated failed to transform both precursors. Among the 8 aflatoxin-producing isolated used, 7 transformed both precursors whereas the remaining failed to transform both. According to these results, the usefulness of the measurement of enzymatic activities related to aflatoxin production in understanding the true status of conflictive field isolates is discussed. PMID- 1780001 TI - Inhibition of some mycotoxigenic fungi by iturin A, a peptidolipid produced by Bacillus subtilis. AB - Bacillus subtilis produces peptidolipid compounds of the iturin group that have been shown to have antifungal properties, but not all fungal species are sensitive to these compounds. In this study, the activity of iturin A, produced by B. subtilis strain B-3, was tested. Paper disks impregnated with various concentrations of iturin A were placed on agar plates seeded with conidia of toxigenic species of Fusarium, Gerlacia, Penicillium or Aspergillus. Most isolates were inhibited at iturin A concentrations as low as 4 micrograms/disk. Penicillium italicum, P. viridicatum, A. ochraceus and A. versicolor were most strongly inhibited by the iturin whereas P. citrinum and A. parasiticus were least sensitive to iturin A. PMID- 1780002 TI - Efficacy of seed-based media for the mould-yeast conversion of Blastomyces dermatitidis. AB - The efficacy of 20 seed-based media is reported for the in vitro mould-yeast conversion of Blastomyces dermatitidis, employing pharmamedia agar, peptone glucose agar, glucose agar and water agar as controls. The mould-yeast conversion varied significantly according to the culture medium, fungal strains and incubation period (p less than 0.01). Garden-pea, chick-pea, cow-pea, soybean, peanut, green gram, French bean, lentil, okra and cottonseed converted all of the 7 B. dermatitidis test strains after 5 days of incubation at 37 degrees C. Although the efficacy of many of these seed media was found to be at par with pharmamedia agar - a commercial cottonseed embryo-derived protein, garden-pea seed agar is adopted because of the wider availability and low fat content of this seed. The recommended composition of the medium comprises 2% aqueous seed extract, 2% glucose and pH 6-7. Only nigerseed and sunflower seeds failed to support the conversion of B. dermatitidis. Of the control media, peptone glucose agar, glucose agar and water agar did not support the conversion of 2 of the B. dermatitidis test strains. The mechanism underlying variable mould-yeast conversion of B. dermatitidis on seed-based media is not clearly understood. However, most of the seeds supporting excellent mould-yeast conversion are known for their high protein content. The conversion was apparently not affected by the fat content of the seeds or by incorporation of glucose in the medium. PMID- 1780003 TI - Toxicity of the mycotoxins fumonisins B1 and B2 and Alternaria alternata f. sp. lycopersici toxin (AAL) in cultured mammalian cells. AB - Fumonisins B1 and B2 and AAL toxin are a series of structurally related mycotoxins. Fumonisins B1 and B2, produced by Fusarium moniliforme Sheldon induce toxic hepatitis and hepatomas in rats and leukoencephalomalacia in horses. The cancer-promotion assay which has been used to guide their purification is slow and consumes large amounts of sample. We have examined a series of cultured mammalian cell lines in order to develop a more rapid and sensitive bioassay system, which may be useful for examining structure-activity relationships and the mechanism(s) of action of these toxins. Of 9 rat hepatoma cell lines tested, all except the two most de-differentiated line were sensitive to the three toxins, with a toxic response visible by 48 h. Approximate IC50 values for the most sensitive hepatoma line, H4TG, were 4, 2 and 10 micrograms/ml for fumonisins B1, B2 and AAL toxin, respectively, in 100 microliters cultures. Among 15 cell lines from other sources, only MDCK dog kidney epithelial cells were sensitive (IC50 = 2.5, 2 and 5 micrograms/ml, respectively). Studies in co-cultures of sensitive and insensitive cell lines and in cultures of a sensitive cell line over a range of cell densities indicated that cytotoxicity of fumonisins B1 and B2 does not involve metabolite activation to a derivative stable enough to diffuse to adjacent cells. PMID- 1780004 TI - Metabolic effects of licorice roots (Glycyrrhiza glabra) on lipid distribution pattern, liver and renal functions of albino rats. MS. AB - The biochemical activity of licorice roots was investigated by administrating it to hypercholesterolaemic rats at two different doses. High cholesterol level in the serum and most organs of hypercholesterolaemic rats was accompanied by high levels of triglycerides and total lipids but low one of phospholipids. The hypocholesterolaemic action of licorice roots was accompanied by hypolipaemic action but higher level of phospholipids in the rat serum and most organs. The results showed that while the high cholesterol level in the rat serum has impairing effects on liver and renal functions, the licorice administered to these rats has a counteracting action i.e. it can improve the impaired function of both liver and p4f1ey, It has also a hypoglycaemic action. PMID- 1780005 TI - The biochemical role and hypocholesterolaemic potential of the legume Cassia fistula in hypercholesterolaemic rats. AB - The hypocholesterolaemic effect of Cassia fistula was investigated using hypercholesterolaemic male albino rats. Hypercholesterolaemia was induced by feeding on a mixture of cholesterol plus cholic acid for a 12 weeks period. Hypercholesterolaemia was characterized by significant increase in the average levels of total lipids, total cholesterol, and triglycerides and significant decrease in phospholipids content. Administration of Cassia fistula significantly reduced blood and liver total lipids. Brain, spleen, kidneys and heart followed nearly the same trend but with moderate effect. Blood, liver, kidneys, spleen and heart total cholesterol was significantly reduced, while that of brain was not affected. The level of triglycerides was markedly improved. There was a moderate rise, however, in phospholipids content in all studied organs. That is to say a marked progress in the correction of lipid metabolism occurred. Also, administration of Cassia fistula induced a significant decrease in the high activities of serum GOT, GPT, alkaline and acid phosphatase and the values nearly returned the initial values. Total serum protein, albumin (A), globulin (G), A/G, free amino acids, uric acid and creatinine were also determined and their values were improved and attained nearly the normal values of the control group. PMID- 1780006 TI - Influence of different levels of peanut hull flour on physical and sensory evaluation of low calorie cakes. PMID- 1780007 TI - The correlation between serum total cholesterol and some trace elements in serum, liver and heart of rats fed high cholesterol diet. AB - The work indicates the link between the serum cholesterol, atherosclerosis and certain metal metabolism. 122 adult albino rats were used in this study and classified into 5 groups: Control group, 29 rats fed the stock diet; group I, 32 rats fed the stock diet with 1% cholesterol for 6 weeks; group II, 36 rats fed the stock diet with 1% cholesterol for 8 weeks; group IIIA, 17 rats fed the stock diet and 0.2 ml oil/day orally for 8 weeks and group IIIB, 18 rats fed the stock diet and 0.2 ml oil with cholesterol daily (50 mg cholesterol/1 ml oil) for 8 weeks. The results obtained showed that: 1. A positive correlation was found between serum total cholesterol and serum copper, cadmium and Cd/Zn ratio, whereas a negative correlation occurred between serum total cholesterol and serum Zinc and Zn/Cu ratio. 2. A positive correlation was found between serum total cholesterol and cadmium, Zn/Cu and Cd/Zn ratio in liver. On the other hand, a negative correlation occurred between serum total cholesterol and copper in liver. 3. A positive correlation was found between serum total cholesterol and Zn/Cu ratio in heart which was negative in heart copper, cadmium and Cd/Zn ratio. Histopathological examination of liver sections of animals treated with cholesterol revealed the presence of mild degree of fatty change, while the kidney tissues showed glomerular lesion in the form of obliteration of Bowman's capsule with increased cellularity inside, beside degenerated tubules and interstitial fibrosis. PMID- 1780008 TI - Factors influencing the synthesis of an extracellular proteinase by Enterococcus faecalis subsp. liquefaciens. AB - Studies were conducted on optimum temperature, pH and the requirement for an energy source, amino acids, casein, Zn2+ and Ca2+ during the synthesis of an extracellular acid proteinase by Enterococcus faecalis var. liquefaciens. Synthesis was monitored using cells grown to mid-logarithmic phase and resuspended at high density in fresh growth medium. Proteinase production was optimal at 30 degrees C and pH 7.0. Proteinase synthesis, being energy-dependent, occurred only in glycolysing cells. The synthesis was high when lactose but not glucose was utilized as a source of energy, indicating that phospho-beta galactosidase gene might probably be located directly upstream the proteinase gene on a plasmid. Good induction of proteinase synthesis could be achieved by 0.2-0.5% of either yeast extract or tryptic digested casein, perhaps due to its content of a wide variety of free amino acids. Casein was essential for preventing proteinase autolysis and sustaining the enzyme production. Zn2+ and Ca2+ were required for the formation of an active extracellular proteinase. The synthesis immediately ceased after addition of chloramphenicol or EDTA. EDTA inactivated the preformed proteinase as well. Sodium chloride at a concentration of 6.5% inhibited both proteinase synthesis and glycolysis. PMID- 1780009 TI - [Algorithms, brains, computer. What they know and what not. II]. AB - In order to say something substantial about the fundamental limits of machines (especially of computers) and of human calculations, we must explicate the concept of algorithm. Such an explication is provided by the Turing machine. Thus, problems have been discovered which cannot be solved algorithmically. For other problems there are problem-solving procedures, but no elegant algorithms. That men are fundamentally superior to machines has not been shown as yet. PMID- 1780010 TI - Length of hair cells as a measure of frequency representation in the mammalian inner ear? PMID- 1780011 TI - [Should the practice of cervical endarterectomy of the carotid artery be continued?]. PMID- 1780012 TI - [Carotid endarterectomy. What about it?]. PMID- 1780013 TI - [Carotid endarterectomy. Questions still remaining open]. PMID- 1780014 TI - [Complications and biological risks of neuronal grafts]. AB - Following an experimental stage, considered insufficient by some authors, the first neural grafts on humans were done on Parkinson patients in 1982. Since then, hundreds of patients, mostly with Parkinson disease, have been subjected to grafts. Recently patients suffering from other neurodegenerative diseases or pain of carcinomatous origin have also been grafted. The first results obtained in humans are modest and vary depending on the research groups and methods employed. It must be distinguished between two types of surgery which raise different ethical and scientific problems. First, embryonic neural transplants, in which the effects could be related to a possible actual reinnervation of the striatum. Second, autografts of adrenal medulla, the mechanisms of action of which are still hypothetical. The relative ease of graft technique and their success with the media should not minimize complications and risks. There are three types of known or possible complications: 1 - the complications related to the surgery, 2 the non-specific complications of the graft itself, that are secondary to the host reaction to transplantation, 3 - the specific graft complications related to relationship established between the grafted cells and the host. In the adrenal medulla autograft, the surgery complications are responsible for an important morbidity and mortality. The immunological and infectious (viral) risks are the most worrying in the embryonic transplants. Even though neuronal grafting can be a technique of the future, great caution is necessary, since intracerebral grafting in Parkinson's disease still is in the experimental field. PMID- 1780015 TI - Unilateral MPTP-induced parkinsonism in monkeys. A quantitative autoradiographic study of dopamine D1 and D2 receptors and re-uptake sites. AB - The cynomolgus monkeys received a unilateral intracarotid injection of the neurotoxin N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) in order to induce a chronic model of hemi-parkinsonism. The procedure was well tolerated by the animals. Unilateral injection of MPTP caused rigidity and bradykinesia of the contralateral limbs, but the animals were able to eat and drink without levodopa therapy. During spontaneous motor activity, animals rotated toward the lesioned side whereas systemic apomorphine injection stimulated circling toward the normal non-lesioned side. Twelve weeks after MPTP injection, we found a marked reduction in striatal and nigral [3H]-mazindol binding on the MPTP-injected side which is indicative of a loss in both dopaminergic nerve terminals and cell bodies. The unilateral dopaminergic denervation was associated with an ipsilateral increase in striatal and a reduction in nigral [3H]-spiperone-labelled D2 dopamine receptors; these changes are consistent with the known localization of the D2 receptors on striatal dopaminergic nerve terminals and on nigral dopaminergic cell bodies. In contrast, no changes in [3H]-SCH 23390-labelled D1 dopamine receptors were observed at the level of either the striatum or the substantia nigra. This study describes a well tolerated procedure which induces a clinical and morphological hemi-parkinsonian syndrome. This animal model may be useful in the studies of new antiparkinsonian drugs, for testing the functional efficacy of brain tissue implants and in the understanding of the physiopathogenesis of levodopa-induced dyskinesias. PMID- 1780016 TI - [Subarachnoid hemorrhage of unknown origin. Apropos of 59 cases]. AB - Fifty-nine subarachnoid hemorrhage with normal panangiography were reviewed (1982 1989). The mean age is 50 + 10. The grades at admission are compared following the Hunt and Hess and the World Federation Classification. Fifty cases (Hunt and Hess) or 45 (W.F.N.S.) are grade I or II. Compared with 278 cases of subarachnoid hemorrhage of aneurysmal etiology, 76% were in good grades versus 55% only for the aneurysms. Hypertension was present in 21 cases (35%) and represented a factor of gravity. Hydrocephaly is a rare complication in these cases and only 2 cases were shunted. The repetition of angiographic exploration seems to be unnecessary: all the examens remained negatives. The aspect on C.T. Scan was the same that the subarachnoid hemorrhage of aneurysmal origin. Angiography of 4 pedicles were performed in all cases and in the late 15 cases, external carotid explorations were added for exclusion of dural malformations. Seven suspected cases had had a secondary exploration between 12 days. The other cases were reexamined at 3 months. Three cases deceased from a second hemorrhage without aneurysm at autopsy. These cases confirm that subarachnoid hemorrhage of unknown etiology is of good prognosis. Low grades, rare complications, few rebleeding and good outcome scale are common. Etiology remains hypothetic. PMID- 1780017 TI - [Intraforaminal lumbosacral neurinoma]. AB - Twelve cases of intra-foraminal localization of lumbosacral neurinoma are reported including 9 schwannomas, 2 neurifibromas and 1 melanotic schannoma. According to their extension, they are classified in type II strictly intra foraminal and extra-arachnoidal: N = 6, type I-II, extending into the subarachnoidal space; N = 5, type II-III, extending out of the spine. There were 7 men and 5 women with mean age of 49.5 years and a 5.2 years delay before diagnosis. The most common, though not permanent, symptom was radiculalgia; a generally weak sensorimotor deficit was noticed in 4 cases and hypoesthesia in two cases. Diagnosis was sometimes doubtful using myelography for the oldest cases, but is now made easily with CT scan and M.R.I. Microsurgery allows to dissect out the tumor inside the perineural sheath and to preserve the nervous root in most cases even in extra-arachnoidal forms (N = 8). However, in cases of neurofibromas and of large tumors, the root had to be divided (N = 4) with rather surprisingly no new post-operative deficits. Intra-foraminal localization of lombo-sacral neurinomas is rare but now easily identified; it should be cured surgically with the goal, often reached, of maximum preservation of the nervous root. PMID- 1780018 TI - [Recklinhausen brown tumor of the cervical spine disclosing primary hyperparathyroidism]. AB - The authors report a case of osteitis fibrosa cystica of the cervical spine with spinal cord and root compression. Histological diagnosis was made in the post surgical phase during which acute renal failure and hypercalcemia developed; a parathyroid nodule was found and subsequently excised. PMID- 1780019 TI - [Pseudo-oligodendrogliomatous meningioma. Report of 2 cases and review of the literature]. AB - We report two cases of oligodendroglioma-like meningioma revealed by symptoms of increased intracranial pressure, progressive hemiparesia and partial epileptic seizures. Brain CT-scan or scintigraphy and carotid arteriography were suggestive of a convexity meningioma. One patient had received radiation treatment for scalp tinea capitis 25 years previously. In spite of complete surgical removal, the tumor recurred in both cases respectively 17 years and 18 months later. The two patients were operated again, and one underwent a complementary radiotherapy. Pathologic diagnosis was particularly difficult in the first case where the pattern at conventional histologic technics was that of oligodendroglioma. On the occasion of recurrence, immuno-histochemistry and ultrastructural studies were performed. The tumor was positive for epithelial membrane antigen (E.M.A) and cytokeratin, but was negative for glial fibrillary acidic (G.F.A.) protein, S 100 protein (S 100), neuron-specific enolase (N.S.E.), vimentin, anti-LEU-7 (N.H.K.1), and neurofilaments (N.F.). Electron microscopy showed closely adjacent cells with tonofilaments and numerous desmosomes. These findings permitted to establish the diagnosis of oligodendroglioma-like meningioma instead of oligodendroglioma. In the second case, the histologic pattern was also reminiscent of oligodendroglioma, but presence of few cellular whorls in some part of the tumor permitted the correct diagnosis. The pathogenesis of this atypical form of meningioma, its tendency for recurrence, and usefulness of radiotherapy are discussed and literature is reviewed. PMID- 1780020 TI - [Aneurysm rupture and cocaine addiction]. AB - We describe a new case in which cocaine use was related to stroke and review the literature. Cocaine is increasingly used by drug addicts. The neurological complications are unpredictable. They include generalized or partial epileptic seizures, ischaemic or haemorrhagic cerebral vascular accident. In this case, stroke after intravenous drug injection is associated with rupture of an intra cranial aneurysm. We put the accent on the difficulties to diagnose the cerebral stroke in cocaine abusers. PMID- 1780021 TI - [Thalamocapsular metastasis of muco-epidermoid adenocarcinoma of the parotid gland]. AB - A 58 years woman with muco-epidermitis carcinoma of the left parotid gland treated by parotidectomy and external radiation developed seven years later a left hemianopsia and moria related to thalamo-capsulo-lenticular lesions. Three stereotactic biopsies were performed. Neuropathological examination confirmed a secondary lesion of carcinoma with the same histological features than primary lesion of the parotid. Due to the metastasis location treatment consisted in external radiotherapy guided by stereotactic coordinates. PMID- 1780022 TI - [Lesions of the pineal and tentorial region. Occipito-parietal approach in three quarter prone position with infrasagittal craniotomy]. AB - Surgical treatment of pineal-tentorial region lesions remains a challenge. The difficulty in approaching the pineal region can be verified with the number of operative plans that have been proposed to reach this area: transcallosal, occipital transtentorial, infratentorial supracerebellar approaches and sitting, prone or Concorde positions. This emphasizes the surgeon's dissatisfaction with the surgical techniques described. Recently, a three-quarter prone position with the bone flap placed under the midline has been described (1, 3, 8). We have decided to test this approach that we have slightly modified and we report our results on 13 cases: 2 arachnoid cysts, 3 vascular malformations and 8 tumors (3 brainstem gliomas, 2 dysgerminomas, 1 quadrigeminal plate metastasis and 1 meningioma plus 1 metastasis of the falx). Keeping the table in a horizontal plane, risks of air embolus are eliminated. Using the natural effect of gravity, traction on the occipital lobe is no more necessary and hemianopsia no more occurs. We recommand the parieto-occipital route which is the shortest way to reach epiphysis and falco-tentorial notch. We confirm the results of american colleagues (1, 3, 8, 15) and we advise to use this approach which seems to us the best way to treat pineal-tentorial lesions. PMID- 1780023 TI - Special issue dedicated to Dr. Eugene Roberts. PMID- 1780024 TI - The structural and functional heterogeneity of glutamic acid decarboxylase: a review. AB - Studies of the GABA-synthetic enzyme glutamate decarboxylase (glutamic acid decarboxylase; GAD; E.C.4.1.1.15) began in 1951 with the work of Roberts and his colleagues. Since then, many investigators have demonstrated the structural and functional heterogeneity of brain GAD. At least part of this heterogeneity derives from the existence of two GAD genes. PMID- 1780025 TI - Structure and function of L-glutamate decarboxylase. AB - Membrane bound L-glutamate decarboxylase (GAD) has been solubilized and partially purified from hog brain. The solubilized GAD appears to exist in two forms, alpha and beta, differing in their size and electrophoretic mobility. The alpha form has similar mobility as that of the soluble GAD in 7.5% and 5-25% gradient polyacrylamide gel electrophoresis suggesting that they are similar in size and charge. In addition, gene encoding for mouse brain GAD has been cloned and characterized. Mouse brain GAD cDNA consists of two DNA fragments with 1.6 and 1.0 Kb. The 1.6 and 1.0 Kb fragments contain 1657 and 974 bP, respectively. The significance of multiple forms of GAD is also discussed. PMID- 1780027 TI - Glutamate decarboxylase activity in the substantia nigra and the hippocampus of rats microinjected with inhibitors of the enzyme. AB - Three inhibitors of glutamate decarboxylase (GAD), acting through different mechanisms, as well as pyridoxal phosphate (PLP), were microinjected unilaterally by stereotaxic procedures into the substantia nigra reticulata or the CA1 area of the hippocampus of the rat. The inhibitors used were thiosemicarbazide (TSC), gamma-glutamyl hydrazide and the PLP-glutamyl-hydrazone (PLPGH) formed by the combination of the latter with PLP. No behavioral alterations were observed after the administration of any of the drugs used, in any of the two brain regions studied. When measured in the absence of exogenous PLP, GAD activity in the substantia nigra injected with TSC was diminished by about 35%, and no changes were observed with the other drugs. In the CA1 hippocampal area both TSC and PLPGH inhibited GAD by more than 50%, and this inhibition was not reversed by PLP added in vitro. The results are discussed in terms of the possible explanation for the differences between the drugs used and for the lack of effects of GAD inhibition on the behavior of the animals. PMID- 1780026 TI - Postnatal expression of glutamate decarboxylases in developing rat cerebellum. AB - The recent identification of two genes encoding distinct forms of the GABA synthetic enzyme, glutamate decarboxylase (GAD), raises the possibility that varying expression of the two genes may contribute to the regulation of GABA production in individual neurons. We investigated the postnatal development the two forms of GAD in the rat cerebellum. The mRNA for GAD67, the form which is less dependent on the presence of the cofactor, pyridoxal phosphate (PLP), is present at birth in presumptive Purkinje cells and increases during postnatal development. GAD67 mRNA predominates in the cerebellum. The mRNA for GAD65, which displays marked PLP-dependence for enzyme activity, cannot be detected in cerebellar cortex by in situ hybridization until P7 in Purkinje cells, and later in other GABA neurons. In deep cerebellar nuclei, which mature prenatally, both forms of GAD mRNA can be detected at birth. The amounts of immunoreactice GAD and GAD enzyme activity parallel changes in mRNA levels. We suggest that the delayed appearance of GAD65 is coincident with synapse formation between GABA neurons and their targets during the second postnatal week. GAD67 mRNA may be present prior to synaptogenesis to produce GABA for trophic and metabolic functions. PMID- 1780029 TI - Anoxic block of GABAergic IPSPs. AB - In rat hippocampal slices GABAergic IPSPs are very rapidly suppressed by anoxia (in less than 2 min). Both early (GABAA) and late (GABAB) components are affected. After reoxygenation, the IPSPs recover, but only slowly and not always completely. Iontophoretic applications of GABA or baclofen indicated no major depression of responses during anoxia. It is therefore unlikely that the anoxic suppression of IPSPs is caused by desensitizations of GABA receptors. A more probable explanation is a failure of GABAergic neurons to release GABA from inhibitory nerve terminals. PMID- 1780028 TI - Alterations of GABA metabolism and seizure susceptibility in the substantia nigra of the kindled rat acclimating to changes in osmotic state. AB - Seizure susceptibility and GABA metabolism were altered in the substantia nigra [SN] of adult male Sprague Dawley rats when these animals were acclimating to an altered plasma osmolality. Changes in GABA metabolism were measured in vivo in SN of the freely moving rat. Suitable precautions were taken to avoid any post mortem flux of glutamate to GABA and to correct for the underestimation of GABA build up in SN due to the finite diffusion rate of gamma-vinyl GABA [GVG] after stereotaxic injection of small amounts into one side of the brain. Control experiments provided evidence that changes in osmolality, within a normal physiological range, did not affect significantly gamma-aminobutyric acid transaminase [GABA-T]. Also kindling via the medial septum [MS], in the absence of electrical stimulation did not alter GABA metabolism in SN, thus providing a stable baseline for studies of osmotic effects. Hyperosmolality was associated with a rise in seizure thresholds, with a marked reduction of the rate of GABA synthesis in SN, and with a substantial increase in turnover time of the GABA pool. Hypoosmolality, of a degree known to be associated with mild cerebral edema and swelling localized to astrocytes, markedly reduced seizure threshold, and reduced GABA pool size in SN, but did not alter the rate of GABA synthesis significantly. These results demonstrate by new and independent means the relationship between GABA metabolism in the SN and seizure susceptibility in vivo. PMID- 1780030 TI - (4S)-4-amino-5,6-heptadienoic acid (MDL 72483): a potent anticonvulsant GABA-T inhibitor. AB - (4S)-4-Amino-5,6-heptadienoic acid [S)-gamma-allenyl-GABA; MDL 72483) is a potent inactivator of brain GABA-T in mice; (ED50 (i.p.) = 60 mg.kg-1; ED50 (oral) = 70 mg.kg-1). Its anticonvulsant effects against 3-mercaptopropionic acid (MPA) induced seizures in mice is related to the elevation of whole brain GABA concentrations: The mentioned doses of MDL 72483 which cause a decrease of GABA-T activity by 50%, produce within 5 h after dosing an increase of GABA concentration by about 3 mumol.g-1, and protect 50% of the mice against seizures in this model of presynaptic GABA deficit. When given orally MDL 72483 is about five times more potent than vigabatrin [4R/S)-4-amino-5-hexenoic acid) a known antiepileptic GABA-T inhibitor. Complete protection was achieved with a dose of 150 mg.kg-1. Similar to vigabatrin, MDL 72483 does not protect significantly against metrazol-induced convulsions. However, at a dose of 300 mg.kg-1, the time elapsing between metrazol administration and onset of convulsions was prolonged by a factor of 3.4. Oral administration of MDL 72483 for up to 19 days at a daily dose of 91-96 mg.kg-1 did not produce any obvious behavioral changes in mice, nor was the ED50 of the drug in MPA-seizure tests significantly altered by the pretreatment. These observations indicate that MDL 72483 is a promising drug for the treatment of certain epilepsies. PMID- 1780032 TI - Spontaneous generation of selectable variation in the brain. AB - Selection models of behavior presuppose "selectable variation", diversity in the brain that is stable over time. Diversity can arise spontaneously through the mutual interactions of cell assemblies, which are postulated to align or disalign their neighbors into processing modes conforming to or opposite from their own. These processes are similar to magnetization and crystallization. If aligning and disaligning influences are distributed at random, a state resembling a spin glass can arise, where processing modes are highly varied in space but stable in time. If disalignment occurs regularly at the points of a two-dimensional lattice, and elsewhere the interactions are aligning, a pattern emerges with properties remarkably similar to visual orientation columns. These patterns are maintained dynamically, and emerge statistically without detailed genetic specification. PMID- 1780034 TI - Diazepam binding inhibitor: a novel peptide with multiple functions. Washington, 29-30 November 1990. PMID- 1780033 TI - Living systems are tonically inhibited, autonomous optimizers, and disinhibition coupled to variability generation is their major organizing principle: inhibitory command-control at levels of membrane, genome, metabolism, brain, and society. AB - It is proposed that the major organizing principle in living systems is disinhibition coupled to variability generation. Facile traverse of adaptive functional ranges is made possible by activities of inhibitory (attenuating and/or time-delaying) influences. These maintain barriers to physicochemical perturbations, so that interactions between the external environment and living systems produce transient local changes (signals) that are transduced by a variety of devices at hand to release activities within them. Coupling exists between the driving force (forcing function) and the generation of variability (information-processing capacity) among subunits of particular systems, i.e., there is expansible capacity for processing information in relation to demand. Metaphorically, metabolically generated energy is used to wind the biological springs. Hierarchical nesting of inhibitory command-control is discussed at levels of membrane, metabolism, genomic expression, brain function, and internalization of societal prohibitions (conscience). PMID- 1780031 TI - GABA neurons in seizure disorders: a review of immunocytochemical studies. AB - Immunocytochemical studies have identified alterations in GABA neurons in several models of seizure disorders. However, the changes have varied among different epilepsy models, and these variations presumably reflect the diversity of mechanisms that can lead to seizure disorders. In models of cortical focal epilepsy, there is strong evidence for decreases in the number of GABAergic elements, and the changes closely parallel the time course of seizure development. By contrast, in some genetic models of epilepsy, increases in the number of immunocytochemically-detectable neurons have been observed in selected brain regions. In several models of temporal lobe epilepsy, there presently is little immunocytochemical evidence for alterations of GABA neurons within the hippocampal formation despite physiological demonstrations of decreased GABA mediated inhibition in this region. However, it remains possible that certain types of GABA neurons could be differentially affected in some seizure disorders while other types are preserved. Thus, distinguishing between different classes of GABA neurons and determining their functional roles represent major challenges for future studies of GABA neurons in seizure disorders. PMID- 1780035 TI - Diazepam binding inhibitor peptide: cloning and gene expression. AB - Diazepam binding inhibitor (DBI) is a peptide, initially identified for its ability of displacing the binding of diazepam. The screening of lambda gt 10 cDNA libraries from rat brain with a 47merdeoxyoligonucleotide probe, complementary to a small portion of DBI coding region, allowed the isolation of cDNA clones encoding the entire aminoacid sequence of DBI. This sequence, when compared to that of mouse, human and bovine, revealed that DBI is a well conserved peptide, suggesting a similar function in different species. In order to characterize the function of DBI, studies on the regulation of DBI gene expression were undertaken. The expression of DBI mRNA occurs unevenly in the brain, as well as in peripheral tissues. Moreover, the biosynthesis of DBI is up-regulated in the cerebellum and cerebral cortex of rats made tolerant to diazepam, suggesting that changes in the biosynthesis of DBI might be one of the mechanisms eliciting tolerance to benzodiazepine. In peripheral tissues, the expression of DBI mRNA changes during development. In liver, the content of DBI mRNA was found maximal at postnatal day 1. In contrast, in kidney and heart a linear increase in levels of DBI mRNA was observed from postnatal day 1 to the adult stage, where it reached its maximum level. The tissue specific regulation of DBI mRNA expression, both pharmacologically or developmentally, leads to the hypothesis that DBI might have different functions in different tissues. This would be in line with recent findings that DBI might be also involved in the regulation of an important step of cell metabolism. PMID- 1780036 TI - Human DBI (endozepine): relationship to a homologous membrane associated protein (MA-DBI). AB - Human endozepine, an 86 amino acid polypeptide, was originally isolated from human brain tissue as a putative ligand of the benzodiazepine receptor. Complete amino acid sequencing of the human and bovine proteins revealed significant homology with the partial sequence of diazepam binding inhibitor (DBI), a protein from rat brain. Both endozepine and DBI have been shown to elicit behavioral effects, suggesting that they function as pharmacologically-active ligands of the GABA (gamma-aminobutyric acid) receptor complex. Subsequent cDNA cloning of human and bovine endozepine, rat DBI and human DBI has shown that these proteins are encoded by the same gene. A related cDNA, encoding a transmembrane protein of 533 amino acids with a domain homologous to DBI, has also been cloned from bovine brain. PMID- 1780037 TI - Diazepam binding inhibitor and the endocrine pancreas. AB - Regulation of blood glucose homeostasis is complex. Its major hormonal regulators include insulin, glucagon and somatostatin from the endocrine pancreas. Secretion of these hormones is controlled predominantly by the supply of nutrients in the circulation but also by nerve signals and other peptides. Thus, it is likely that peptides, released from cells of the gut or endocrine pancreas or from peptidergic nerves, affect glucose homeostasis by modulating the secretion of insulin, glucagon and somatostatin. When searching for novel gut peptides with such effects, diazepam binding inhibitor (DBI) was isolated from the porcine small intestine. By immunocytochemistry, DBI has been demonstrated to occur not only in the gut but also in endocrine cells of the pancreatic islets, namely in the somatostatin-producing D-cells in pig and man, and in the glucagon-producing A-cells in rat. Porcine DBI (pDBI; 10(-8)-10(-7) M) has been shown to suppress glucose-stimulated release of insulin from both isolated islets and perfused pancreas of the rat. Furthermore, secretion of insulin stimulated by either the sulfonylurea glibenclamide or the phosphodiesterase inhibitor 3-isobutyl-1 methylxanthine (IBMX), was inhibited by the peptide. In contrast, arginine induced release of insulin was unaffected by pDBI. Moreover, pDBI decreased arginine-induced release of glucagon from the perfused rat pancreas, whereas release of somatostatin was unchanged. Notably, rat DBI, structurally identical with rat acyl-CoA-binding protein, has also been demonstrated to inhibit glucose stimulated release of insulin in the rat, both in vivo and in vitro. Long-term exposure of cultured fetal rat islets to pDBI (10(-8) M) significantly decreased the synthesis of DNA in islet cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780038 TI - Acyl-CoA-binding and transport, an alternative function for diazepam binding inhibitor (DBI), which is identical with acyl-CoA-binding protein. AB - Acyl-CoA binding protein (ACBP) was originally identified as an artifact in a preparation of fatty acid binding protein. The amino acid sequence of ACBP from bovine, rat and human liver is identical to the sequence of diazepam binding inhibitor (DBI) from these species. ACBP and DBI are therefore one and the same protein. The tertiary structure of ACBP in solution has been determined by 2D NMR. ACBP consists of 4 alpha-helixes, covering the sequence from amino acid 2 11, 20-38, 51-62 and 72-85, respectively. The protein is folded so that it forms a boomerang type of structure with helix 1 and 2 arranged antiparallel in the one arm of the boomerang, helix 3 and the non-helical part between helix 2 and 3 form the second arm in the boomerang. Helix 4 is located in an angle behind helix 1 and 2. NMR measurements of chemical shifts, induced by acyl-CoA binding, indicate that the binding site is located in the bottom of the V formed between the two arms of the boomerang. This location of the binding site is confirmed with affinity labelling with radioactive photoreactive acyl-CoA esters. ACBP does not bind free CoA or free fatty and short chain acyl-CoA esters (C2-C8). The affinity increases with increasing length of the acyl chain from C10-C20 and drops again in acyl-CoA esters with 22 and 24 carbon in the acyl chain.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780039 TI - The role of diazepam binding inhibitor in the regulation of steroidogenesis. AB - It has been well established that one factor influencing the rate of side-chain cleavage of cholesterol is the rate of delivery of the substrate, cholesterol, from depots in the cytoplasm to the inner mitochondrial membrane within the organelle. This process of intracellular transport consists of two steps: transport to the mitochondria and transport from outer to inner membrane. Transport to mitochondria requires the cytoskeleton and Ca(2+)-calmodulin but not newly synthesized protein. Transport within the mitochondria requires newly synthesized protein. Both steps are stimulated by the trophic hormones ACTH and LH, in their respective target organs. Since the steroidogenic responses to these hormones are inhibited by cycloheximide, it is proposed that the new protein(s) required for these responses are synthesized in the cytoplasm. Using an assay based on the production of pregnenolone by mitochondria from bovine adrenal cortex, a protein of mol. wt approximately 8200 (temporarily referred to as 8.2 K) was isolated. The protein was purified to homogeneity and found to possess the following properties: (i) 8.2 K accelerated the synthesis of pregnenolone by isolated mitochondria (ii) it promoted entry of cholesterol from the incubation medium into mitochondria (iii) 8.2 K accelerated the transport of cholesterol from outer to inner membrane (iv) it also promoted loading of P-450scc with cholesterol, when either mitoplasts of the inner mitochondrial membranes were incubated with 8.2 K in vitro. Moreover, (v) the synthesis of 8.2 K was increased by ACTH and (vi) the half-life of the protein was less than 2 min.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780040 TI - Cerebrospinal fluid diazepam binding inhibitor in depressed patients and normal controls. AB - Diazepam binding inhibitor (DBI) is a neuromodulatory peptide for gamma aminobutyric acid (GABA) neurotransmission. Levels of DBI in cerebrospinal fluid (CSF) were found to be elevated in depressed patients, when compared to age- and sex-matched normal controls. Levels of the peptide, corticotropin-releasing hormone (CRH), in CSF have been found to be elevated in depressed patients. Significant positive correlations between levels of DBI and CRH in the CSF of depressed patients and normal controls were found. These data suggest the possibility that DBI may have a role in coordinating responses to stress in humans, in addition to its possible role in the pathophysiology of depression. PMID- 1780041 TI - Mechanism of the blocking action of beta-eudesmol on the nicotinic acetylcholine receptor channel in mouse skeletal muscles. AB - beta-Eudesmol, an uncharged alcohol contained in Atractylodes lancea, blocks the neuromuscular junction. Atractylodes lancea is prescribed in a traditional Chinese medicine and plays a main role for "alleviation of pain in skeletal muscle". By using the cell-attached patch-clamp or conventional intracellular technique, the site of action of beta-eudesmol on the nicotinic acetylcholine (ACh) receptor (nAChR) channel in skeletal muscle of the adult mouse, was investigated and compared with that of different types of blockers of the nicotinic ACh receptor channel (bupivacaine, chlorpromazine and phencyclidine). beta-Eudesmol (200 microM) depressed completely the nerve-evoked twitch tension and reduced the amplitude and quantal size of endplate potentials but did not alter either the quantal content, resting membrane potential or action potential. beta-Eudesmol (100-200 microM) decreased the amplitude of ACh potentials and accelerated the slow decay of depolarization, induced by the continuous application of ACh. beta-Eudesmol (40 microM) and phencyclidine (10 microM) decreased both the open time and opening frequency, without affecting the single channel conductance. Bupivacaine (10 microM) decreased only the open time. Chlorpromazine (10 microM) decreased only the opening frequency. These results indicate that the blocking effect of beta-eudesmol on nerve-evoked contraction, was due to blockade of nicotinic ACh receptor channels at the neuromuscular junction. Like phencyclidine, beta-eudesmol blocked the nicotinic ACh receptor channel in both the open and closed conformations, and accelerated the desensitization of the nicotinic ACh receptor. PMID- 1780042 TI - Neurochemically dissimilar anxiolytic drugs have common effects on hippocampal rhythmic slow activity. AB - Previous experiments have shown that anxiolytic drugs reduce the frequency of hippocampal rhythmic slow activity, induced by high frequency stimulation of the reticular formation and flatten the function relating threshold septal stimulation to the frequency of driven rhythmic slow activity. All of the drugs involved are known to augment GABAergic transmission. The present experiments investigated the effects of the novel anxiolytic compound buspirone which, unlike conventional anxiolytics, does not interact with GABA, yet is a clinically effective anxiolytic. Buspirone (0.156-40 mg/kg, i.p.) was found to reduce the frequency of reticular-elicited rhythmic slow activity, in a similar manner to chlordiazepoxide (0.019-20 mg/kg, i.p.). Buspirone did not change the linearity of the voltage-frequency function. Buspirone (10 mg/kg, i.p.) also altered the threshold for septal driving of rhythmic slow activity, in a similar manner to classical anxiolytics. The combination of chlordiazepoxide (5 mg/kg, i.p.) with corticosterone (0.2 mg, s.c.) removed the minor differences between buspirone and chlordiazepoxide in both the septal and reticular tests. These results show that buspirone altered the control of rhythmic slow activity in the hippocampus, in a manner which appeared functionally equivalent to other anxiolytics but which depends on mechanisms which are likely to be neurally and pharmacologically distinct from those of other anxiolytic drugs. PMID- 1780043 TI - Chronic inhibition of enkephalinase induces changes in the antinociceptive and locomotor effects of the enkephalinase inhibitor acetorphan in rats. AB - The enkephalinase inhibitor thiorphan was infused intracerebroventricularly in rats during 14 days (25 micrograms/5 microliters/hr), inducing an average inhibition of cerebral enkephalinase of about 65%. Animals were tested during the infusion for their response to acetorphan, a parenterally active derivative of thiorphan. When administered intravenously on day 8 of the infusion, acetorphan (5 mg/kg) significantly increased locomotion in chronic saline-infused rats but not in animals receiving thiorphan. Furthermore, when injected at the same dose on day 10, acetorphan did not modify the latency to jump, in the hot plate test, in thiorphan-treated rats, whereas it elicited a significant analgesia in chronic saline-treated controls. These data show that the effects induced by the administration of an enkephalinase inhibitor were diminished after a period of chronic inhibition of the enzyme, suggesting the development of tolerance. PMID- 1780044 TI - 8-Phenyltheophylline reverses the antinociceptive action of morphine in the periaqueductal gray. AB - Morphine was injected into the periaqueductal gray region of the rat and 8 phenyltheophylline, an adenosine receptor antagonist, was injected intrathecally 15 or 30 min later, to determine whether supraspinally-administered morphine activated descending mechanisms to release adenosine (or a nucleotide which is metabolized to adenosine) from the spinal cord. 8-Phenyltheophylline (10 micrograms) reversed the antinociceptive action of morphine in the hot plate but not the tail-flick test. A combination of methysergide/phentolamine (15 micrograms each) reversed the action of morphine in both tests. 8 Phenyltheophylline retained the ability to reverse the action of morphine in the hot plate test in rats pretreated with 6-hydroxydopamine (to induce degeneration of descending noradrenergic pathways) but reversal was no longer observed in rats pretreated with 5,7-dihydroxytryptamine (after pretreatment with desipramine, to induce degeneration of descending serotonergic pathways). These results indicate that a component of the supraspinal antinociceptive action of morphine is due to release of adenosine or nucleotide, within the spinal cord and this release is dependent on intact serotonergic pathways. PMID- 1780045 TI - Intra-nigral infusion of Cu-free superoxide dismutase prevents paraquat-induced behavioural stimulation and ECoG epileptogenic discharges in rats. AB - In adult rats, with cannulae chronically implanted by a stereotactic instrument into the substantia nigra (pars compacta), the electrocortical (ECoG) and behavioural effects elicited by intranigral infusion of paraquat and the prevention of these effects by prior administration into the same site of different types of superoxide dismutase, were studied. Paraquat (50 micrograms) produced an intense pattern of behavioural stimulation, contralateral circling and repetitive discharges of high voltage ECoG spikes. The effects of paraquat were abolished in all of the animals pretreated into the same site with copper free superoxide dismutase. Pretreatment with native Cu, Zn-superoxide dismutase prolonged significantly the latency of onset but did not prevent the behavioural stimulation and ECoG spikes evoked by paraquat. On the contrary, pretreatment with albumin or saline did not confer any protection against the neurotoxicological changes induced by paraquat. In conclusion, the present experiments showed that motor, ECoG and lethal effects of paraquat were completely prevented by Cu-free superoxide dismutase, suggesting that the central effects of this herbicide are in some way related to the release in the brain of copper and/or other transition metal ions. PMID- 1780047 TI - C2 rotation and spinous process deviation in migraine: cause or effect or coincidence? AB - Previous reports have shown an association between the side of C2 spinous process deviation or asymmetrical prominence, or vertebral rotation, and the side of the headache in unilateral migraine. However, this study has found that such C2 appearances were present as frequently in the controls as in the migraine patients, and that there was no association between the side of the anomaly and the lateralisation of the headache. The results were comparable for the different sub-groups of migraine. PMID- 1780046 TI - Spinal cord tumors: gadolinium-DTPA-enhanced MR imaging. AB - To assess the utility of gadolinium-DTPA (Gd) and of MR imaging in the evaluation of spinal cord tumors, ten consecutive patients were prospectively evaluated. T1 proton density-, and T2-weighted images were obtained in sagittal or axial planes. T1-weighted images were obtained before and after intravenous administration. Five tumors were within the cervical spinal cord; 3 neoplasms were within the thoracic cord; 1 neoplasm extended from the cervical to the thoracic cord and 1 neoplasm extended from the cervical cord to the conus medullaris. Four tumors were ependymomas; 3 were astrocytomas; 1 was an hemangioblastoma, and 1 was a metastatic malignant peripheral nerve sheath tumor. The remaining patient died prior to spinal surgery and no autopsy was obtained. Of the precontrast sequences, tumors were best evaluated using T1-weighted images. Abnormal findings included cord widening, presence of a tumor mass, intratumoral or other associated cyst(s), and hemorrhage. Nevertheless, T1 weighted images obtained following the administration of GD were superior relative to all other pre- and post-contrast sequences for defining tumor margins, characterizing cyst(s) and delineating tumor masses. Based primarily on their appearance on post-contrast T1-weighted images, tumor-associated cysts could be subcategorized into 3 types: intratumoral cysts (found within the contrast-enhancing soft tissue mass); nonenhancing extratumoral cysts (found eitherrostral or caudal to the enhancing tumor mass); and enhancing extratumoral cysts (having an enhancing wall or containing an enhancing nodule).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780048 TI - Pattern recognition in magnetic resonance imaging of white matter disorders in children and young adults. AB - Magnetic resonance imaging (MRI) is considered to be a highly sensitive modality for visualizing white matter abnormalities. Estimations of its specificity are far less positive. However, diagnostic specificity depends upon both the inherent qualities of MRI and on the quality of image interpretation. Systematic and detailed analysis of many image elements, and substantial prior experience improve the quality of image interpretation and thus improve diagnostic specificity. The present study has been set up to develop a pattern recognition system which combines sensitivity and specificity, systematic analysis of image elements and prior experience. This pattern recognition is based on the data of 277 patients with white matter disorders referred for MRI. The information was stored in a data base and computer analyzed. Twenty-two MRI patterns were discerned in as many disease categories. The frequency of occurrence of each MRI abnormality was assessed per disease category to establish the pattern of abnormalities characteristic for each separate disease category. The pattern recognition program was also written so that: (a) when fed data about MRI abnormalities observed in a new case, the computer produces a differential diagnosis with probabilities and 95% confidence intervals for each differential diagnosis; (b) specific data on the MRI findings of new cases could be added to the data base to improve the experience and accuracy of the program. This program for pattern recognition of abnormalities in the MR images of white matter disorders enhances the specificity of image interpretation and provides a wonderful aid for teaching purposes. PMID- 1780049 TI - CT scan changes in multiple sclerosis among Malaysian patients. AB - A study of 12 patients with clinically definite multiple sclerosis (CDMS) using high dose infusion CT showed overall abnormality of 75% with an average of 2.5 lesions per patient. 75% of the patients showed abnormality of the cerebrum, mostly asymptomatic. The main changes were ventricular dilatation and asymmetry, isolated or generalized cerebral atrophy, areas of low attenuation mainly in the deeper parts of the cerebrum and the peri-ventricular area. 25% of the patients showed changes in the brainstem and none was seen in the cerebellum. The abnormality was more florid in patients with clinically disseminated forms of the disease. The study demonstrated that asymptomatic cerebral involvement is common among Asian patients with MS and CT is a useful tool in the overall assessment and diagnosis of Asian MS patients. PMID- 1780050 TI - The characteristics of cerebral meningiomas and surrounding tissues on dynamic CT. AB - Dynamic CT was utilized to evaluate 11 patients with histologically benign meningiomas. While it was found that all demonstrated macroscopic neovascularity, subtle differences in the dynamic perfusion curves were identified both between different meningiomas and from region to region within the same tumor. Other than basic anatomic differences, these changes may reflect intratumoral ischemia and hypothetically herald cystic/necrotic alteration within the neoplasm. The dynamic calculations over the surrounding brain showed areas of gross hyper- and hypoperfused cerebral cortex, and hypoperfused white matter in regions of peritumoral edema. These latter findings are of uncertain clinical importance. The dynamic examination also confirmed cases of dural venous sinus invasion and calvarial permeation by tumor. In addition, the dynamic series showed macroscopic neovascularity in one case with a completely negative selective cerebral arteriogram. It is felt that certain cases which have previously been evaluated by static CT may benefit from further study utilizing the dynamic method. PMID- 1780051 TI - Development of a ceiling-suspended angiographic unit for interventional neuroradiology. AB - A new neuroangiographic unit was developed with a ceiling-suspended gantry, capable of rotation (110 degrees) and craniocaudal angulation (+/- 45 degrees) along the body axis. The gantry could also be rotated 225 degrees at the ceiling suspension axis and sidetracked away from the angiographic table in case of emergency. Two sets of a twin-focus X-ray tube and a 12-inch image intensifier (II) were mounted on the gantry in the isocentric and cross-firing positions. High resolution 1024 x 1024 matrix digital radiography was obtained with a speed of 30 frames/s, while conventional film-screen radiography was obtained at 4 films/s. Rapid film changers were installed and interchangeable with the IIs. The lateral II and X-ray tube could be positioned from either side of the patient. There was no angulated position of the lateral imaging system during angulated anteroposterior or Towne projection of the frontal imaging system. Automatic repositioning of the gantry was possible to the preset position. Stereoscopic, magnification and stereoscopic magnification radiography could be obtained easily in monoplane or biplane mode. Switching from fluoroscopy to radiography and vice versa was possible rapidly and easily. Neuroangiographic as well as interventional procedures were performed expeditiously with lower complication rates. Suspending the gantry from the ceiling made more space available on the floor for the anesthesiologists. PMID- 1780052 TI - Traumatic aneurysm of superficial temporal artery. CT demonstration. AB - A case of traumatic pseudo-aneurysm of the superficial temporal artery documented on Computed tomography (CT) and angiography is described in a 55-years-old female, who was treated by surgical excision. Computed tomographic appearance of this lesion is illustrated. This represents, to our knowledge, the first CT demonstration of traumatic aneurysm of superficial temporal artery within a large subgaleal haematoma. PMID- 1780053 TI - The posterior inferior cerebellar artery originating from the internal carotid artery, associated with multiple aneurysms. AB - We report the rare case of ipsilateral posterior inferior cerebellar artery originating from the carotid artery, and associated with multiple concurrent aneurysms. This is the 23rd reported case of carotid-cerebellar anastomosis and the first case with three concurrent aneurysms reported in the literature. Of the 23 cases, 6 had single aneurysms, 2 had double aneurysms and the present case had triple aneurysms. PMID- 1780054 TI - Percutaneous discectomy using Onik's method: 3 years' experience. AB - A total of 234 patients treated by percutaneous discectomy at 237 levels and followed-up between 11 months and 3 years 4 months showed an overall success rate of about 75%. In a subgroup of 112 of these patients rechecked for a second time, the clinical results remain consistently good even 24 months after surgery. In a special group of 28 patients who complained only of low back pain, percutaneous discectomy achieved a success rate of 85.7%. Complications consisted of one disc infection which cleared without clinical or radiological sequelae (0.26%). PMID- 1780055 TI - Magnetic resonance imaging of limbic encephalitis. AB - In two patients with limbic encephalitis serial magnetic resonance (MR) imaging showed evolution of abnormal high-signal intensity in both hippocampal formations on T2-weighted images. PMID- 1780056 TI - Reversible MRI and CT findings in uremic encephalopathy. AB - In this 35-year-old woman with chronic glomerulonephritis and uremic encephalopathy, the basal ganglia bilaterally, internal capsules and periventricular white matter showed hypodensity on CT, low signal intensity on T1 weighted MRI and high signal intensity on T2-weighted MRI. Following a series of dialyses, her clinical symptoms and blood chemistry improved. The CT and MRI returned to normal. These reversible abnormalities may be caused by reversible ischemic change, but disorders of cerebral metabolism and uremic toxins may contribute. PMID- 1780057 TI - MRI in the diagnosis of heterotopic gray matter. Report of three cases first discovered in adulthood. PMID- 1780058 TI - Haemorrhage in intradiploic haemangioma mimicking extradural haematoma. AB - Traumatic haemorrhage in a previously occult intradiploic haemangioma in an elderly lady resulted in clinical and computer tomographic (CT) appearances mimicking an extradural haematoma. Literature relevant to this rare situation is briefly discussed. PMID- 1780060 TI - Obesity and the U.S. Navy. PMID- 1780059 TI - MRI of post-traumatic lenticular dislocation. PMID- 1780061 TI - Unplanned pregnancy. PMID- 1780062 TI - The medical care of Iraqi enemy prisoners of war. AB - During Operation Desert Storm, Approximately 62,000 enemy prisoners of war (EPWs) were captured by allied forces. Most of these EPWs were taken during the ground war and the weeks following. Over 20,000 of these were interned at East Camp, which was located approximately 125 miles south of the Kuwaiti border. The 300th Field Hospital was tasked to provide inpatient and outpatient care to the EPWs. This paper summarizes the experience, analyzing the diseases encountered, the types of medicines needed, and the unique problems of treating non-English speaking EPWs. From January 27 to February 23, 1991, approximately 308 patients were treated. From the beginning of the ground war on February 24, through March 30, approximately 8,979 patients were treated. The most common condition seen was dental disease (24.0%). Other commonly treated conditions were upper respiratory infection (12.4%), headache (11.7%), and urinary tract infections (9.6%). The unique problems of language barriers and security requirements increased the difficulty and the time required to conduct sick call for Iraqi EPWs. PMID- 1780063 TI - Non-surgical medical care of enemy prisoners of war during Operation Desert Storm. AB - The large numbers of prisoners taken during Operation Desert Storm strained available medical resources. The experiences and difficulties of the 300th Field Hospital in providing medical care to approximately 20,000 enemy prisoners of war is discussed. PMID- 1780064 TI - Blast injury of the ear. AB - The course of middle ear injuries secondary to blast effect was evaluated in 147 soldier-patients (210 ears) during the years 1967-1986. All perforations were in the pars tensa of the tympanic membrane. Ossicular chain interruption (11 ears) was associated mainly with dislocation of the incudo-stapedial joint. Mixed-type hearing loss was most prevalent (37%). Spontaneous closure occurred in 155 ears (73.8%), most of them (65.5%) within a 3-month period. Seven ears (3.3%) developed simple chronic suppurative otitis media; in 10 (4.8%), an invasive cholesteatoma developed, and in 6 others (2.8%), epithelial pearls were encountered behind an intact eardrum. Thirty-two patients were treated by immediate patching of the perforated drum, with an 84% rate of spontaneous closure; no cholesteatoma developed among this group, emphasizing the need for immediate patching. Tympanoplasty is recommended 1 year following the injury, and a 4-year follow-up period for detection of late complications is also recommended. PMID- 1780065 TI - Burn dressings: a critical indicator for patient care classification in burn units. AB - Nursing services consume approximately 60% of a hospital personnel budget, requiring justification for staffing levels and manpower expenses. The lack of an adequate level of nursing care affects the operation of the entire health care team. The purpose of this descriptive study is to establish the mean tasking time to apply burn dressings. The number of nursing staff required to complete a burn dressing application is dependent on the location of injury and the ability of the patient to cooperate. Establishing the essential mean tasking time for routine post-operative dressing assists in the production of accurate reporting of nursing manpower requirements. PMID- 1780066 TI - Decentralization of a budget to head nurses in long-term care. PMID- 1780067 TI - Quality improvement in nursing: implementation of a comprehensive program using cost-effective automation. PMID- 1780068 TI - Etiological characteristics of abusive husbands. AB - This study compared abusive husbands with nonabusive, marital discordant husbands using six measures to ascertain certain etiological characteristics of abusers. Both groups completed the Jenkins Activity Survey for measuring type A behavior, the Short Michigan Alcoholism Screening Test, the Index of Self-Esteem, the Spence-Helmrich Attitudes Toward Women Scale, the Index of Marital Satisfaction, and a simple rating scale to access their perceptions of their wives' physical attractiveness. As predicted, abusers evidence significantly higher type A behaviors, higher problem drinking behaviors, more rigid attitudes toward women, lower marital satisfaction, and rated their wives as less attractive than did nonabusers. Inconsistent with the literature, however, no significant differences were discovered between the self-esteem of abusers and nonabusers. PMID- 1780069 TI - Screening for Chlamydia trachomatis by the direct fluorescent antibody test in female Navy recruits. AB - Female Navy recruits at risk for sexually transmitted diseases were screened for Chlamydia trachomatis. The screening method was the direct fluorescent antibody (FA) test. The patients represented all areas of the U.S. Average age was 20.4 years. Patients listed past gynecological infections and current symptoms. The clinical findings of the provider at examination and the results of the direct FA test were correlated. There does not appear to be a reliable office method to predict which patients will have positive FA for Chlamydia. The direct FA test is a good tool to predict infection and institute treatment in high-risk patients. PMID- 1780070 TI - Molecular analysis and chorionic villus sampling (CVS): opportunities for rapid prenatal diagnosis in the military. AB - Prior to recent advances in the field of molecular biology, prenatal diagnosis of hemoglobinopathies was accomplished by direct analysis of the gene product(s) in samples obtained by fetoscopy or, more recently, percutaneous umbilical blood sampling. The use of the polymerase chain reaction enables quicker diagnosis than with indirect or cumbersome Southern blot techniques. This case, reporting a couple at risk for fetal sickle cell disease, is a model for rapid prenatal diagnosis and demonstrates the capabilities which exist in the military health care referral system. Within 24 hours of a couple's presentation for consultation and accomplishment of chorionic villus sampling (CVS), preliminary results of both cytogenetic and sickle cell status of an at-risk fetus were determined. Final analysis was accomplished by 48 hours. The combination of early referral, early sampling by CVS, and application of advances in DNA laboratory technologies offers tremendous improvements for care heretofore unavailable as a complete "package" in the military. The implications and limitations for prenatal testing for single gene disorders within the military medical health care system will be discussed. PMID- 1780071 TI - Analgesic concerns in glucose-6-phosphate dehydrogenase-deficient dental patients: myth or reality? AB - Certain military dental records contain medical advisory sheets warning that the patients have deficiencies of the enzyme glucose-6-phosphate dehydrogenase and warn that certain medications, including many commonly used analgesics, should not be given, or should be given only with extreme caution, in those patients. A review of the literature does not support that advisory and there is little evidence to suggest that short-term therapeutic administration of these essential medications will pose a threat of hemolytic reaction in dental patients. There are no reported cases found of such a reaction in the dental literature, and this survey of 19 military patients failed to identify even one case that had problems. From a dental treatment standpoint, the concern over short-term medication regimens in these patients following dental surgery or treatment is unsubstantiated. There appears to be little rationale for the dental records of these patients to contain medical precautionary sheets. PMID- 1780072 TI - Malaria as a military factor in Southeast Asia. AB - Malaria remains a major cause of military casualties in Southeast Asia. The numerous conflicts in the region have been greatly affected by malaria. Besides guerrilla warfare, refugees and other civilian movements across international borders contribute heavily to the continuing problem of multiple drug-resistant malaria. Drug resistance is an increasing problem with few available prophylactic options. The malaria threat to any potential deployment of United States military forces remains unsolved. PMID- 1780073 TI - Spondylolysis and spondylolisthesis in military parachutists. AB - This paper reports on three cases of symptomatic low back pain in three paratroopers in association with bilateral L5 spondylolysis and L5 on S1 spondylolisthesis. The controversy regarding the etiology of this lesion as well as the problems of establishing causality when associated with parachuting injuries are discussed. These cases raise the issue of whether routine lumbar spine roentgenography should be performed as part of the pre-course medical screening prior to an individual undertaking basic parachutist training, and stress the need for further study of the relevance of these lesions in military parachuting. PMID- 1780075 TI - Health promotions. PMID- 1780074 TI - Coombs-positive hemolytic anemia in Hodgkin's disease: case presentation and review of the literature. AB - Immune hemolytic anemias are a diverse group of disorders that have in common the presence of red cell autoantibodies, which result in a shortened red cell span. Its etiology is diverse. Of the lymphoproliferative disorders implicated, chronic lymphocytic leukemias and non-Hodgkin's lymphomas are the most common. Hodgkin's disease was first associated with immune hemolytic anemias in 1967. Here we report the case of a patient diagnosed with Hodgkin's disease, who developed an immune hemolytic anemia, and its management and outcome. The literature is reviewed as well. PMID- 1780076 TI - Observations about battle fatigue: its occurrence and absence. PMID- 1780077 TI - [Treatment of unstable angina with dipyridamole combined with low doses of aspirin. A multicenter pilot double-blind controlled study]. AB - In order to assess the usefulness of a combination of low-dose aspirin (25 mg b.i.d.) with dipyridamole (200 mg b.i.d.) in the prevention of major coronary events in patients with acute unstable angina, we performed a prospective, double blind, placebo-controlled study involving 88 consecutive patients admitted to three Hospital Departments of Cardiology. The patients entered the study as soon as possible after hospital admission, and were treated and followed up to one year. There was no appreciable difference in side effects and adverse reactions between the treatment and control group. The incidence of cardiac death and/or nonfatal myocardial infarction during the whole period of observation was 14% (6/44) in the treatment group and 25% (11/44) in the placebo group by "intention to-treat" analysis; 16% (4/25) and 32% (10/31), respectively, by "drug-efficacy" analysis (p = 0.21 by Fisher's exact test, non significant difference). However, when considering the only events occurred in the first month (2/44 in the treatment group and 9/44 in the placebo group, amounting to 4.5 and 20 percent, respectively), the combination of dipyridamole with low-dose aspirin reached a statistically significant protective effect (p = 0.04). The results of this pilot study provide strong evidence for a beneficial effect of the regimen tested in patients with acute unstable angina, at least in the first weeks of treatment, while at the same time suggesting a safe alternative for patients with contraindications to higher doses of aspirin. PMID- 1780078 TI - [Evaluation of anti-thrombophilic properties of heparan sulfate in venous vascular pathology. A controlled clinical study versus active reference]. AB - Forty adult patients (31 females and 9 males), mean age 48.41 years with chronic venous insufficiency of the lower limbs due to a variety of etiopathogenesis, were randomly divided into two groups of twenty subjects and treated with heparan sulphate and sulodexide. The experimental clinical protocol was formulated using a single blind model. The following dosages were used: a tablet of heparan sulphate in the morning and evening (200 mg/die), and one capsule of sulodexide in the morning and evening (500 ULS/die); treatment lasted 60 days. The aim of the study was to compare the two compounds in terms of efficacy and tolerability. The clinical effect of the two drugs was substantially similar: in particular the symptoms of itch, edema, spontaneous pain and nocturnal cramp responded significantly to (p less than 0.01) to both forms of treatment. The response of fibrin degradation products to heparan sulphate treatment was more positive and differed significantly from that obtained using sulodexide (p less than 0.001). Other parameters, namely erythrocytic filtration and blood viscosity, responded significantly to heparan sulphate treatment in comparison to sulodexide (p less than 0.001). Other blood coagulation and hemorheological parameters and Doppler response showed no change using either drug. With regard to side effects, five cases of digestive intolerance were observed using heparan sulphate and two with sulodexide. Two patients failed to complete heparan sulphate treatment, and one sulodexide treatment. In conclusion, heparan sulphate showed a marked pro fibrinolytic and prohemorheological effect compared to the reference drug. PMID- 1780080 TI - [Composite bypass using endarterectomized autologous superficial femoral artery. A valid concept in the extension of lower limb salvage surgery]. AB - Saphenous vein is nowadays the material of choice performing on femoro-distal revascularisation; when this is not available, it is important to use a material which gives the closest approximation of an ideal conduit and for same time an easy handling during the execution of the anastomosis. Although vein's degenerative alterations are very rare, it has now been shown that there is widespread destruction of the endothelium among infrainguinal vein grafting, producing a relatively thrombogenic surface. These factors may contribute to the initial failure rate of these bypasses. For this reason we suggest to employ a segment of thromboendarterectomized SFA (superficial femoral artery) as a distal part of a composite bypass. Twenty-four composite bypasses were performed using three different methods over a total of 123 femoro-distal revascularizations. Eighteen months follow-up showed more than 50% and more than 75% patency rate comparing type B (graft or thromboendarterectomized SFA + autogenous saphenous vein) and type C (thromboendarterectomyied SFA + graft). We believe, waiting for a wider follow-up, that this technique could be a valid alternative to a femoro distal revascularization when saphenous vein is not available. PMID- 1780079 TI - [Vascular reactivity related to postural changes in diabetics]. AB - Resting skin flow (RF) and the venoarteriolar response (VAR) were studied in 40 patients with diabetic microangiopathy and neuropathy, in 40 diabetes with microangiopathy and in 30 normal subjects using laser-Doppler flowmetry. In patients with microangiopathy and neuropathy RF was increased and the VAR was impaired to a greater extent than in patients without neuropathy. We evaluated the microangiopathy index (VAR/RF) that was lower in diabetics without neuropathy and even lower in those with neuropathy than in normals We also evaluated the VAR with different postural changes. PMID- 1780082 TI - [Subrenal coarctation of the aorta. Presentation of a clinical case]. AB - Coarctation of abdominal aorta constitutes a rare group of vascular abnormalities, including segmental stenoses and extended hypoplasia below the restriction. Usually hypertension is the only clinical evidence. The natural history of the surgically untreated disease foresees a decline of life expectancy; while surgical operation permit an almost complete "restitutio ad integrum". The Authors report a case of coarctation of the abdominal aorta come to their observation whose particularly was determined by the absence of high blood pressure, the aortic stenoses being located under the renal arteries. PMID- 1780081 TI - [Unstable angina in a patient with single coronary artery]. AB - Single coronary artery is a rare anomaly with or without other cardiac diseases and uncertain prognostic importance. It may be related with sudden death. We report a case of 64 years old man with single coronary artery and unstable angina, successful treated with medical therapy, for long time (six years). PMID- 1780083 TI - [AIDS in Italy]. PMID- 1780084 TI - [Lactoferrin]. AB - Lactoferrin is a protein present in many fluids of the human organism and in the secondary granules of polymorphonuclear cells (PMN). In the blood stream lactoferrin favours the segregation of PMN by mediating and amplifying the immune response, and realizes a negative feedback control on the Colony Forming Unit Granulocyte/Macrophage (CFU-GM) proliferation. At intestinal level it promotes iron absorption and prevents bacterial overgrowth. The antibacterial effect of lactoferrin is used clinically to prevent bacterial infections in neutropenic patients submitted to chemotherapy for leukemic diseases type M1, M2, M4 and M5, according to FAB criteria. In patients affected by chronic pancreatitis the lactoferrin concentration, in duodenal juice, is found to be significantly higher than in normal subjects. This finding suggests a pathogenetic role of the protein in chronic pancreatitis. PMID- 1780085 TI - [Prognostic significance of hypereosinophilia in surgically treated breast carcinoma. Our experience]. AB - Several Authors have published that hypereosinophilia is often related to solid carcinoma and mostly to mucin secreting epithelium carcinoma. Such hypereosinophilia has been considered a negative prognostic symptom. In this trial we have studied our out-patients affected by breast cancer who showed hypereosinophilia during their post-surgical follow-up or therapy. Such hypereosinophilia was not related to any symptom of progression of neoplasia. We thus suppose that hypereosinophilia associated with breast cancer is probably not related to the development of neoplastic tissue. PMID- 1780086 TI - [Carcinoembryonic antigen (CEA) and mucinous-like tumor associated antigen (MAC). Statistic correlation in advanced breast carcinoma]. AB - In this study we have determined the plasmatic values of carcinoembryonic antigen (CEA) and mucinous like tumor associated antigen (MCA) in 20 women with metastatic breast cancer. CEA and MCA were determined by enzyme immunoassay technique. The results were analyzed by test r for the statement of statistical correlation. Since r was inferior to p 5% (r = 0.3255; p = 0.4438) the 2 parameters are not correlated and their biological expression must be considered independent. PMID- 1780087 TI - [Focus. An expert system for the clinical diagnosis of the location of acute neurologic events]. AB - Focus is an expert system developed to diagnose, by the findings on neurological examination, the anatomic location of an acute neurologic event. The inference engine uses a forward tracking algorithm and a rule based data base that includes associations of neurological signs with specific anatomic areas. Focus is linked to a data base in which all personal cases and final diagnoses confirmed by laboratory studies are stored. This makes it possible to assess the validity of the system's diagnoses and use personal cases as additional example to the revision of the rules. The program is easy to use and runs on MS-DOS microcomputer. Furthermore the diagnostic rules are accessible so Focus may furnish an interactive teaching device. PMID- 1780088 TI - [Infarction of the anterior choroidal territory. Clinical and tomodensitometric study of 11 cases]. AB - Clinical features of anterior choroidal artery (ACA) territory infarct are hemiplegia, hemi-anaesthesia and homonymous hemianopia. However this syndrome in its complete form is of rare occurrence, since one or more signs or symptoms may be lacking. The Authors describe 11 patients with CT-documented infarctions in the (ACA) territory in order to establish clinical-CT correlations and possible risk factors. Among the investigated risk factors arterial hypertension is the most frequent in these patients. This finding, and the small size of the ischemic lesions make the ACA territory infarctions similar to Lacunar Infarcts. The Authors, emphasize that, as in lacunar infarcts, a thromboembolic mechanism cannot always be ruled out in ACA infarctions. Therefore a cause other than arterial hypertension should be considered in each patient for a better management of this type of infarcts. PMID- 1780089 TI - [The diabetic foot]. AB - The rise in the mean age and the increase in diabetes have frawn the surgeon's attention to gangrene of the lower limb which requires a multidisciplinary approach (doctor, surgeon, prosthesis specialist). Contrary to the concept of high thigh amputation, the possibility of carrying out a lumbar sympathectomy has encouraged the idea of a more distal amputation with conservation of physiological joints and an early recovery of function thus enabling patients who would otherwise have been condemned to permanent invalidity to return to social life. PMID- 1780090 TI - [Indications and methods of treatment with sulfonylureas in NIDDM patients]. AB - Metabolic corrections induced by SU therapy can be assessed by daily glycemic changes which reflect all metabolic events taking place during the 24-hour period. Varying responses to treatment reveal different degrees of metabolic reserve. In order to be meaningful the SU sensitivity test must be compared to the daily glycemic profile. Sensitivity test responses were first compared to similar alterations following treatment; and secondly, the correlation was determined between the sensitivity test and the daily percentage of glycemic decrement induced by therapy. The high significance of these comparisons confirmed that the SU sensitivity test is a reliable index of response to treatment and this has also influenced treatment methods. When studying the modes of action of the SU sensitivity test we took into account insulin incretion and sensitivity tests to exogenous insulin to determine the level of receptor activity. Even during acute treatment, SU action is mediated by insulin incretion, whereas SU activity is not related to changes in the receptor system induced by exogenous insulin stimulation. PMID- 1780091 TI - [Prevalence of reactions to drugs in 251 patients with urticaria-angioedema syndrome]. AB - We studied 251 outpatients affected by chronic and acute urticaria-angioedema syndrome, triggered or exacerbated by drugs, to evaluate the prevalence of adverse reactions to each pharmacological group. Among these patients, 134 (53.4%) presented one or more adverse reactions to a single drug: 100 (74.7%) reacted to NSAIDs, 33 (24.7%) to antibiotics and 1 to B vitamin complex. The remaining 117 patients (46.6%) presented adverse reactions to more than one drug. Considering the patients all together, 123 (49%) had adverse reactions to ASA, 116 (46.2%) to pyrazones, 65 (25.9%) to antibiotics, 26 (10.3%) to NSAIDs different from ASA and pyrazones. In our experience, according to other reports, there is a greater frequency of drug reactions to NSAIDs vs other drugs. ASA is the more frequently involved drug. PMID- 1780092 TI - [Clinical study of the efficacy of and tolerance to nimesulide in suppository formulation in pain-inflammatory pathologies of the ear, nose, and throat]. AB - The efficacy and tolerability of a new pharmaceutical form of the non-steroid anti-inflammatory drug. Nimesulide have been studied in a double blind study compared with flurbiprofen, in 98 patients aged between 18 and 75 suffering from pain-inflammatory pathologies of ENT nature. Both drugs, administered in a dose of one suppository twice a day for 7 days, showed marked anti-inflammatory, analgesic and antipyretic activity and produced a significant, progressive improvement in the typical symptoms of the inflammatory state up to their complete remission. Nimesulide evidenced greater speed and duration of therapeutic action. Assessment on the effectiveness and tolerability as expressed separately by the physician and patient were positive in almost all cases of both treatments. PMID- 1780093 TI - [Pharmacokinetics of defibrotide in uremic patients undergoing hemodialysis]. AB - Defibrotide pharmacokinetics were studied in 6 voluntary healthy subjects and in 10 uremic patients undergoing dialysis during which (instead of heparin) defibrotide was administered to prevent fibrino-formation in the circuit. Blood concentrations of the drug were assessed (expressed with reference to the residual glycidic deoxyribose) during a standard dialysis using defibrotide, 3.5, 15, 30, 45, 60 and 90 minutes after the defibrotide bolus (200 mg) had been injected into the arterial channel. The half-lives of the alpha and beta plasmatic phases were found to be equal at 3.79 and 41.4 min in dialysed subjects and at 1.13 and 16.54 in healthy volunteers. These results indicate that in uremic patients undergoing dialysis at intervals using defibrotide, a longer time is required to eliminate the drug from the circulation. This variation does not however appear to be significant in terms of the therapeutic use of the drug during dialysis. PMID- 1780094 TI - [Evaluation of the effectiveness of monotherapy in the treatment of epilepsy]. AB - On 44 patients undergoing monotherapy, with total plasma levels of drug therapeutic range, 33 had a reduction of the frequency of seizures, while the remaining 11 were unmodified. There was 90% improvement in Primary Generalized seizures, 73% in Secondary Generalized and 62% in Partial Complex; 27% of PC, 16% of PG and 16% of SG shifted to polytherapy. Considering that monotherapy can be better managed and is less toxic, we can recommend it as first choice treatment in newcomers, as a maintenance therapy, and as treatment of choice for the gradual elimination of therapy. PMID- 1780095 TI - [Obesity among patients admitted to a medical department at the Terni Hospital]. AB - The Authors report the results of a study intended to asses the prevalence of obesity in Terni's medical department. Body mass index (BMI) was used as a measure of obesity: it can easily be calculated from weight and height (W/H2) for any individual. A sample of 1195 patients (569 males and 626 females) was studied; obesity was found in 30% of the females and in 10% of the males. PMID- 1780096 TI - [Sweet's syndrome (acute febrile neutrophilic dermatosis) associated with Sjogren's syndrome. A clinical case]. AB - A case of Sweet syndrome associated with Sjogren syndrome is reported. After a review of the literature, the clinical and pathologic patterns of the disorder are described. The possible underlying or associated diseases, and the problems on diagnosis and prognosis are discussed. In spite of the several etio pathogenetic problems still unsolved, the syndrome can be considered as a primary, immuno-mediate disorder. PMID- 1780097 TI - [Syndrome of the aortic arch and rheumatic polymyalgia. Description of a case]. AB - The paper reports a recently observed case of a 76-year-old man suffering from claudication of the upper limbs, undetectable brachial pressure and bilateral absence of radial, brachial and axillary pulses. During the previous two years the patient had complained of symptoms reminiscent of polymyalgia rheumatica. On admission to hospital, he also presented elevated ESR without temporal arteritic symptoms or involvement of other arterial districts, excluding the main supra aortic branches, and without ocular signs. Arteriography showed the typical radiological findings of arteritis with bilateral occlusion of the subclavian arteries. Steroid therapy, which was commenced without previous histological biopsy, resulted in a clear subjective and objective improvement in the patient's condition. Following a review of the literature, the A. focus on the incidence of extra-temporal localisations of arteritis associated with polymyalgia rheumatica and on other related problems. They emphasise the importance of beginning steroid therapy as early as possible. PMID- 1780098 TI - [Neurovascular syndrome of the arm caused by acquired luxation of the sternoclavicular articulation]. AB - The Authors report on a case of neurovascular syndrome of the upper extremity caused by acquired luxation of the sternoclavicular articulation. The patient was treated by simple scalenotomy with a favourable long-term result. PMID- 1780099 TI - [Adrenocortical carcinoma and its treatment with mitotane. Description of a case]. AB - Adrenocortical carcinoma is a rare tumor with a poor prognosis. The clinical features and rational bases of pharmacologic therapy of adrenocortical carcinoma are discussed in the light of the case of a patient with a bulky, inoperable tumor whose treatment with mitotane was followed by a dramatic regression though several, important side effects. PMID- 1780100 TI - Changes in education. PMID- 1780101 TI - Clinical presentation and final diagnosis of patients referred to a temporomandibular joint clinic. AB - The clinical presentation and final diagnosis of 182 consecutive patients referred to the Temporomandibular Joint Clinic at the University of Otago School of Dentistry over a 12-month period were reviewed. The definitive diagnosis utilised a classification based upon accepted pathological concepts. Thirty-six percent of patients had internal derangement of the TMJ, 33 percent had joint overload, 12 percent had an acute muscle disorder, 12 percent had degenerative joint disease, and 7 percent had other conditions including ENT disorders and pulpitis. Only six percent of patients underwent treatment involving occlusal modification or TMJ surgery. The remainder received a variety of conservative treatments confirming the widely held view that the majority of patients with a TMJ disorder can be managed with a variety of reversible therapeutic methods. PMID- 1780102 TI - Dental status and treatment needs of a New Zealand institutionalised elderly population. AB - A survey of 359 elderly residents of rest homes and geriatric hospitals in the Manawatu and Horowhenua districts showed that approximately two-thirds were aged 80 or over, and 19.5 percent were dentate, with a mean 13.3 teeth per dentate subject. A mean of 4.6 teeth per dentate subject had caries of either the crown or root, or both. Older males had substantially higher extraction requirements than other subjects. The periodontal needs of the sample were generally low and dominated by the need for calculus removal. PMID- 1780103 TI - Craniofacial pain and dysfunction: an update. PMID- 1780104 TI - Allies in dental health. AB - Groups and individuals within the community, for a variety of reasons, have difficulty in attaining and maintaining oral health and in obtaining needed oral health care. Dentists themselves have limited opportunities for reaching these people. There are, however, occupational groups in frequent contact with them, able to influence their oral health positively and to facilitate the obtaining of treatment. Better liaison with these groups, and utilisation of their networks, will be an effective means of oral health promotion. PMID- 1780105 TI - Hip fractures. PMID- 1780106 TI - AIDS newsletter. PMID- 1780107 TI - Perfusion scintigraphy and evaluation of myocardial viability. PMID- 1780108 TI - Differentiation of regional perfusion and fatty acid uptake in zones of myocardial injury. AB - The relative myocardial distribution of 201Tl and modified fatty acid (123I labelled 3-methyl-p-[iodo]-phenyl pentadecanoic acid, MFA) was determined in eight patients with unstable angina (UA) and six patients with acute myocardial infarction treated with reperfusion therapy within 4.1 h (MI). The results of radionuclide imaging were correlated with coronary angiography and quantitative left ventriculography performed within 10 days of the radionuclide procedures. Zones of injury were identified as areas with diminished 201Tl uptake distal to sites of coronary narrowing. A nearly parallel reduction in regional fatty acid concentration was observed in these areas. Comparison of the regional distributions of the two agents revealed subtle differences in their distributions in the ischaemic zones. Three patterns were recognized: (a) MFA uptake greater than Tl (MFA greater than Tl), (b) matched decrease of MFA and Tl (MFA = Tl), (c) MFA uptake less than Tl (MFA less than Tl). Seven of eight patients with UA had normokinesis or hypokinesis on quantitative left ventriculography. Five of the seven showed the MFA greater than Tl pattern, while one had the MFA less than Tl pattern and one had the MFA = Tl pattern. The eighth patient with UA had akinesis and the MFA = Tl pattern. All six patients with acute infarction had akinesis on ventriculography. One of these patients had the MFA greater than Tl pattern, two had the MFA = Tl pattern and three had the MFA less than Tl pattern. These results suggest that fatty acid and thallium have grossly similar distributions in areas of acute myocardial ischaemia. On careful inspection, zones of slight relative excess fatty acid concentration are observed more often in areas of acute ischaemia with normal wall motion. PMID- 1780109 TI - Gated 99Tcm-MIBI myocardial function imaging. AB - The introduction of the 99Tcm isonitrile perfusion agents has provided improved myocardial image quality with conventional imaging equipment allowing improved edge definition on gating. We evaluated left ventricular wall motion in 46 patients using gated 99Tcm-2-methoxy-2-methyl-isopropyl-1-isonitrile (MIBI) scintigraphy. Using a method of myocardial profiles in four axes, global and regional fractional shortening (FS) were assessed. A good correlation was found between FS in the left anterior oblique (LAO) 40 degrees projection and ejection fraction (EF) on gated radionuclide ventriculography (r = 0.81, P less than 0.001). This was improved by using FS in two planes, LAO 40 degrees and anterior (r = 0.88, P less than 0.001). There was also a good correlation between FS in two planes and EF on cine-angiography (r = 0.72, P less than 0.001). There was good intra- and interobserver agreement with the studies. Assessment of myocardial function using gated MIBI imaging and myocardial profiles provides useful additional information to the perfusion scan, thus enhancing the diagnostic usefulness of the agent. PMID- 1780110 TI - Radiation dose rates from paediatric patients undergoing 99Tcm investigations. AB - Infants or children undergoing nuclear medicine investigations may subsequently come into close contact with nurses or parents responsible for their care. In order to estimate the radiation dose to these individuals, and to formulate appropriate recommendations, dose rates were measured at distances of 0.1, 0.5 and 1.0 m from 148 paediatric patients who had undergone one of 12 99Tcm studies. The maximum dose rates of 70, 14 and 5 microSv h-1 at these distances were not greater than the corresponding maximum values found in an earlier study of adult patients. However, the maximum dose rates per unit activity of 0.5, 0.2 and 0.1 microSv h-1 MBq-1 were greater than the corresponding maximum 99Tcm adult values, consistent with a general increase of dose rate per unit activity with decrease of body weight observed in the paediatric measurements. A parent caring for and feeding a young infant is most unlikely to receive a dose equivalent of 1 mSv, and a nurse attending to one young radioactive patient is most unlikely to receive a dose equivalent in a working day of 60 microSv. The data obtained should allow radiation doses to be estimated and appropriate recommendations to be formulated for other circumstances, including any future legislative changes in dose limits or derived levels. PMID- 1780111 TI - 99Tcm-exametazime-labelled leucocytes: effect of volume and concentration of exametazime on labelling efficiency, and clinical protocol for high efficiency multi-dose radiolabelling. AB - We have investigated the effect of volume and concentration of exametazime on the labelling efficiency of 99Tcm-exametazime-labelled leucocytes. The first study examined the effect of varying the volume of exametazine solution whilst the concentration remained constant. A vial of Ceretec (Amersham Ltd plc) was reconstituted with sodium chloride injection BP. Aliquots of 0.25-2.0 ml were removed, added to sodium pertechnetate injection BP and incubated with 2 x 10(7) 5 x 10(7) leucocytes from 25 ml blood. The labelling efficiency decreased from 65 +/- 10% S.D. (0.25 ml) to 45 +/- 8% (2.0 ml) (n = 4). In a second study different concentrations of exametazime solution were used whilst the volume remained constant. A vial of Ceretec was reconstituted with sodium chloride injection BP. Aliquots of 25-200 micrograms were removed, made up to a fixed volume of 0.6 ml, added to pertechnetate and incubated with the plug of leucocytes as before. The labelling efficiency decreased as the concentration of ligand decreased. Thus for 200 micrograms/0.6 ml the labelling efficiency was 64 +/- 5% and for 25 micrograms/0.6 ml the labelling efficiency was 43 +/- 18% (n = 4). Clinical studies were performed using 50 ml blood from patients with a wide range of inflammatory disorders including inflammatory bowel disease, abdominal abscess and vasculitis. The concentration of ligand used was 83 micrograms/0.25 ml. The labelling efficiency was found to be 82 +/- 7% (n = 36). PMID- 1780112 TI - The use of 99Tcm-HSA dynamic vascular examination in the staging and therapy monitoring of reflex sympathetic dystrophy. AB - Evaluation of the local haemodynamic changes was performed in 93 patients with untreated reflex sympathetic dystrophy, based upon a simple dynamic vascular examination technique, using 99Tcm-HSA. According to the disease stage, opposite observations were made: in stage I (n = 72) an increase in both blood flow and blood volume was found, in stage II (n = 21) in contrast, both blood flow and blood volume decreased. These findings show that reflex sympathetic dystrophy can be staged according to haemodynamic changes. It is obvious, moreover, that a careful haemodynamic staging is most important for the choice of the right vasoactive treatment; e.g. calcitonin (vasoconstrictive) versus guanethidine (vasodilating). PMID- 1780113 TI - Reproducibility of renal blood flow estimation in the miniature pig using 99Tcm DTPA: introducing semiautomatic processing. AB - This study examines the reproducibility of renal blood flow measurement (RBF) in nine miniature pigs using 99Tcm-DTPA renography, and introduces a new algorithm useful in data processing. Renal blood flow can be estimated using three arterial regions of interest (ROI), the left ventricle (LV), the right lung (RL) and the aorta. Using the LV ROI, left kidney RBF was 9.08 (S.D. 1.69) and right RBF was 10.87 (S.D. 2.26). Reproducibility was assessed by performing renograms on successive days in nine pigs and was found to be best for LV [S.D. of change 0.32 for the left kidney (LK) and 0.74 for the right kidney (RK)] followed by RL (0.77 for LK and 0.75 for RK) and worst for aorta (1.47 for LK and 1.78 for RK). PMID- 1780114 TI - Use of 111In-labelling to follow tissue distribution of Candida albicans in mice. AB - Two strains of Candida albicans, a wild type and a derived mutant, were labelled with 111Inoxine. Labelled cells were injected into mice and tissue distribution patterns were determined from 0.5 to 48 h. During the first 4-h post-injection phase, remarkable differences in tissue distribution were observed between the two strains. Radiolabelling of C. albicans with 111Inoxine is shown to be a much more reliable method for determining early tissue distribution patterns in infected animal models than culturing the infected tissue. PMID- 1780115 TI - Maternal hydrops syndrome: a review. AB - The maternal hydrops syndrome (Ballantyne syndrome, mirror syndrome, pseudotoxemia, triple edema) is a preeclampsia-like disease observed in some pregnancies with severe fetal and/or placental hydrops. We describe three pregnancies with severe immunological fetal-placental hydrops resulting in fetal death, in spite of intrauterine transfusions. The mothers suffered severe hydrops syndrome, one of which was complicated by an eclamptic convulsion. All three women had anemia, low hematocrit, and elevated plasma uric acid levels. It is suggested that low hematocrit is an important pathophysiological feature in maternal hydrops syndrome. PMID- 1780116 TI - Cumulative subject index, 1987-1991. Volumes 42-46, inclusive. PMID- 1780117 TI - Measurements of the auricle in the human fetus. AB - The auricular length, auricular base length and auricular width were measured in 94 human fetuses with crown-rump (CR) lengths ranging from 49 mm (approximately 11 weeks of gestational age) to 250 mm (approximately 31 weeks of gestational age). The three measurement values showed linear increases as the CR length increased, suggesting that they are useful parameters to indicate intrauterine growth. The measurement values also suggested that the mandibular and hyoid derivatives did not grow independently, but did grow with maintaining a certain relationship. PMID- 1780118 TI - Application of bromodeoxyuridine immunohistochemistry to the rat temporomandibular joint. AB - To detect S-phase cells in the decalcified paraffin-embedded temporomandibular joint (TMJ) tissues of the rat, bromodeoxyuridine (BrdUrd) immunohistochemistry was performed. Percardiac perfusion of 10% EDTA-2Na Tris buffer accelerated the decalcification. The use of the monoclonal antibody to BrdUrd enabled the visualization of the distribution of S-phase cells. This method is practical in studying cell kinetics and the specific proliferation mode of the TMJ. PMID- 1780119 TI - Considerations on the morphology and terminology of the organs. AB - In anatomy, the morphological features of organs are captured in a variety of ways, and this allows wide interpretations of the terminology for organs. However, the present terminology is considered to include terms that require re evaluation for appropriate ranking of organs. Organs should be understood in a proper perspective of their anatomical hierarchy and architectural characteristics. I consider that organs should be classified morphologically by the terminology of "organelle" on the cytological level, "sub-organ" on the histological level, "organ" on the macroscopic anatomical level, and "organ system", which may also be expressed as "apparatus" or "organa", on the level of systematic anatomy. I strongly demand that N.A.V.-N.H. (1983) acknowledge this hierarchial order and adopt the general term "organum". PMID- 1780120 TI - Pepsinogen granules in the esophageal epithelium of the rock snake. AB - We demonstrated a large number of pepsinogen granules in the esophageal pseudostratified ciliated epithelium of the rock snake. 1. The snake esophagus is covered with a pseudostratified ciliated epithelium. 2. This epithelium develop mostly in the upper portion of the esophagus. 3. Long supranuclear portions of the same cells are strongly PAS-positive and contain pepsinogen granules. Those cells possess cilia. 4. The strongly PAS-positive cells and pepsinogen granules decrease or are lost in the middle and lower portions of the esophagus. 5. Glands are distributed in the lamina propria mucosae of the esophagus of the Japanese lizard and gecko. Those in humans and the bird are compound tubular glands and those of the Japanese lizard and gecko are bottle-shaped. The pepsinogen granules of these glands are secreted into the excretory ducts and then discharged into the esophageal lumen. 6. However, the same granules of the snake are contained in the supranuclear portion of the epithelium and are secreted directly into the esophageal lumen. 7. The mode of pepsinogen granule secretion of the esophagus is most simple in the snake. PMID- 1780121 TI - Aging of bone density in the second metacarpal. AB - Bone weight, bone and cortical areas, and apparent and true bone densities (W/BV and W/CV) were measured on the second metacarpals of 114 male and 114 female Japanese, aged 30 to 98 years. Measurements were taken from midshaft cross sections 2 mm thick, using an electron balance and an image analyzing system. The mean values of these variables were greater in men than in women at all ages. Bone area stayed almost unchanged regardless of age. Bone weight and cortical area decreased linearly with advancing age. The respective rates of decrease per decade observed for the these variables were 3.1% and 2.9% in men and 5.5% and 4.8% in women. Apparent bone density decreased gradually with age after the fourth decade in women. While, in men, it stayed almost unchanged or increased slightly until the fifth decade and then, decreased gradually with age. The rate of decrease per decade was accelerated after the fifth decade in women and after the sixth in men, being 10.3% and 8.1% in each gender, respectively. The mean loss of bone was about twice as great in women as in men. In women, significant differences (p less than 0.01) were found in these variables after the seventh decade compared with the preceding age group. However, true bone density (W/CV) stayed almost unchanged regardless of age, being about 2.0 in men and about 1.9 in women. Osteoporosis could be primarily a manifestation of normal aging, including the postmenopausal estrogen deficiency in women, regardless of gender or race. PMID- 1780122 TI - The tick-borne rickettsia Cowdria ruminantium has a Chlamydia-like developmental cycle. AB - The development of the tick-borne rickettsial pathogen Cowdria ruminantium (S stock) was studied in bovine umbilical endothelial (BUE) cell cultures and in goat choroid plexus, by light- and electron microscopy. Cowdria divided by binary fission within intracytoplasmic vacuoles resulting in large colonies of reticulate bodies. After three to four days in culture, reticulate bodies developed into smaller intermediate bodies characterized by an electron-dense core. Shortly before disruption of the host cells, intermediate bodies condensed further into electron-dense elementary bodies, which were released into the culture medium. Elementary bodies invade other endothelial cells thus initiating a new infectious cycle which lasts between 5 and 6 days. In the infected goat choroid plexus similar reticulate and intermediate bodies were identified within vacuoles of capillary endothelial cells. However, extracellular elementary bodies were not detected. Another stock of Cowdria (W) showed an identical developmental cycle as that of the S stock. The W isolate was also pathogenic for mice, making it possible to test the infectivity of reticulate and elementary bodies in these animals. Reticulate bodies appeared to be less infective than elementary bodies. The developmental cycle of Cowdria resembles the cycle known to occur in Chlamydia. Moreover, Cowdria has other similarities with Chlamydia. It has a Gram negative envelope, it does not store iodine-stainable carbohydrates and may lack peptidoglycan as does Chlamydia. It is concluded, that Cowdria and Chlamydia are to a certain extent related, confirming a recent report that both organisms have certain antigenic determinants in common. Since Cowdria is also related to Ehrlichia it may well be that Cowdria takes an intermediate position between Chlamydia and Ehrlichia. The phylogenetic relationship between Cowdria and Chlamydia and also with Ehrlichia should be further elucidated by molecular analysis using 16S ribosomal DNA sequences. PMID- 1780123 TI - Treatment of Cyprinus carpio L. and Clarias gariepinus (Burchell) embryos with formalin and malachite green: effect of concentration and length of treatment on their survival. AB - Malachite green and formalin were investigated as prophylactic dip treatments for developing embryos of Cyprinus carpio and Clarias gariepinus. Based on the findings, recommendations are made on the respective concentrations to be used and exposure periods to be followed for both formalin and malachite green for both fish species. PMID- 1780124 TI - Investigations into the effects of concentration and duration of exposure to formalin and malachite green on the survival of the larvae and juveniles of the common carp Cyprinus carpio L. and the sharptooth catfish Clarias gariepinus (Burchell). AB - Prophylactic dip treatments using formalin and malachite green were applied to 4 day old larvae and 12- and 20-day old juveniles of the European common carp, Cyprinus carpio and the African sharptooth catfish, Clarias gariepinus. Treatments consisted of 100 mg/l malachite green for exposure periods of 10, 30 or 90 s and 200 mg/l formalin, administered for 30, 60 or 90 min. Larvae and juveniles of C. gariepinus could be treated with 100 mg/l malachite green for 10 s, or with 200 mg/l formalin for 30 min, with minimum mortalities. Both chemicals affected the survival of the C. gariepinus juveniles, especially the 90 min exposure to formalin. Juveniles of both species were extremely sensitive to 100 mg/l malachite green concentrations. PMID- 1780125 TI - Parasites of domestic and wild animals in South Africa. XXVIII. Helminth and arthropod parasites of Angora goats and kids in Valley Bushveld. AB - Two adult Angora goats were slaughtered each month for 24 consecutive months on a farm in Valley Bushveld in the eastern Cape Province. On the same farm 2 Angora goat kids were slaughtered each month for 2 consecutive years from the time they were 1 week old until they reached 12 months of age. All these goats were processed for the recovery of helminth and arthropod parasites. Fourteen nematode species, 2 nematode genera and 1 cestode species were recovered. Worm burdens were generally low in the adult goats. Nematode burdens increased erratically in the kids reaching the greatest numbers when they were 1 year old. The tapeworm, Moniezia expansa, was present in kids at 3 or 4 months of age and had usually disappeared by the time they reached 7 months of age. PMID- 1780127 TI - Parasites of South African wildlife. XI. Description of a new race of Cooperia rotundispiculum Gibbons & Khalil, 1980. AB - During surveys of the helminths of South African wildlife, a Cooperia sp. that closely resembles Cooperia rotundispiculum Gibbons & Khalil, 1980, was recovered from several antelope species. This nematode has spicules 0,140-0,248 mm long and has 18-20 longitudinal cuticular ridges, whereas typical C. rotundispiculum has spicules 0,179-0,226 mm long and has 14 ridges. In view of the few differences between the 2 helminths, the Cooperia sp. is described here as a race of C. rotundispiculum. PMID- 1780126 TI - Parasites of domestic and wild animals in South Africa. XXIX. Ixodid ticks on hares in the Cape Province and on hares and red rock rabbits in the Orange Free State. AB - One hundred and seventeen scrub hares, Lepus saxatilis, were examined for ixodid ticks in various regions of the Cape Province. They were infested with 18 tick species and the seasonal abundances of the immature stages of Amblyomma hebraeum, Amblyomma marmoreum, Hyalomma marginatum rufipes, Rhipicephalus appendiculatus and Rhipicephalus glabroscutatum and all stages of Rhipicephalus oculatus and the adults of a Rhipicephalus sp. (near R. oculatus) were determined. Seventy-two scrub hares on 3 farms in the Orange Free State harboured 10 ixodid tick species and the seasonal abundances of the immature stages of H. marginatum rufipes and Hyalomma truncatum and all stages of Rhipicephalus punctatus were determined. Thirty Cape hares, Lepus capensis, examined in the northern Cape Province harboured 5 tick species and the seasonal abundances of the immature stages of H. marginatum rufipes and H. truncatum were determined. Thirty-four Cape hares examined in the south-western Orange Free State carried 6 tick species and the seasonal abundance of immature H. marginatum rufipes was determined on these animals. Twenty-eight Smith's red rock rabbits examined on 2 farms in the south western Orange Free State were infested with 7 tick species. PMID- 1780128 TI - Parasites of South African wildlife. XII. Helminths of Nyala, Tragelaphus angasii, in Natal. AB - The helminths of 77 nyala, Tragelaphus angasii, from 4 game reserves in Natal, were collected, counted and identified. Ten nematode species and 4 nematode genera, a trematode species and paramphistomes, and 2 cestode genera were recovered from the antelope. Of these, a Cooperia rotundispiculum race, Gaigeria pachyscelis, a Gongylonema sp., Haemonchus vegliai, Impalaia tuberculata, an Oesophagostomum sp., a Setaria sp., Trichostrongylus deflexus, Trichostrongylus falculatus, the larval stage of a Taenia sp., a Thysaniezia sp. and Schistosoma mattheei are new parasite records for this host. Individual nematode helminth burdens varied from 3 to 13 493 and the total mean nematode burden was 700. The mean burdens of nyala from Mkuzi were the largest and those from animals from the Umfolozi Game Reserve and the False Bay Park the smallest. Ostertagia harrisi was the most prevalent nematode, and it was also the most numerous in nyala from Umfolozi, Mkuzi and False Bay. A race of Cooperia rotundispiculum was the most numerous in nyala from Ndumu. No clear-cut trends in the seasonal abundance could be discerned for any of the worm species recovered in this study. PMID- 1780129 TI - Ixodid ticks and lice infesting red duikers and bushpigs in north-eastern Natal. AB - Eighteen red duikers, Cephalophus natalensis, from the Charters Creek Nature Reserve and 2 from Fanies Island Nature Reserve were processed for arthropod parasite recovery. They harboured 8 species of ixodid ticks and 2 lice species. All were infested with Haemaphysalis parmata and the nymphs of Rhipicephalus muehlensi. Two bushpigs, Potamochoerus porcus, from the Ndumu Nature Reserve, 5 from the Eastern Shores Nature Reserve and 1 from Cape Vidal were examined for ectoparasites. They were infested with 8 ixodid tick species, of which Rhipicephalus maculatus was the most abundant, and with 1 louse species. PMID- 1780130 TI - Overberg Research Projects. XI. First stage larval reduction test to assess anthelmintic efficacy ante mortem in sheep. AB - Two field trials, one with suckling Merino ewe lambs and the other with yearling Dohne Merino rams, are described. In these the anthelmintic efficacy of febantel (a benzimidazole), ivermectin, levamisole and morantel are compared, using the 1st stage larval reduction test. The mean natural log (+1 for zero values) of the post treatment larval counts of the treated groups was compared with that of the untreated controls and the percentage reduction used to assess anthelmintic efficacy. Febantel was only 87.4% effective against Teladorsagia in suckling lambs but the other anthelmintics were more than 99% effective against this genus. Efficacy against Haemonchus and Trichostrongylus ranged from 93.2%-100% for all 4 compounds. In the rams all compounds were 100% effective against Trichostrongylus, with the exception of morantel which was only 87.5% effective. None of the compounds were effective against Teladorsagia, particularly morantel, animals treated with which having more larvae than the controls. The interpretation of anthelmintic efficacy; the advantages of the first stage larval reduction test, compared with the faecal egg count reduction test; and the importance of incubating cultures at 30 degrees C for 24 h, in order to harvest first stage larvae, are discussed. PMID- 1780131 TI - Cardiomyopathy of ruminants induced by the litter of poultry fed on rations containing the ionophore antibiotic, maduramicin. I. Epidemiology, clinical signs and clinical pathology. AB - The epidemiological, clinical and clinical pathological findings in 20 cattle and 4 sheep from 15 outbreaks of poultry litter toxicity in South Africa over the past 6 years are documented. In 6 outbreaks, the litter emanated from batteries where maduramicin had been incorporated into rations of broilers. According to circumstantial evidence the litter involved in the 9 other outbreaks was also derived from broilers which had been fed on rations containing an ionophore. The litter was fed ad libitum to the affected stock or constituted 30-80% by volume of their rations. The principal sign manifested was sudden mortality of up to 70% of the herd or flock, usually within 20-40 days of commencement of feeding of poultry litter. A few cattle developed signs of congestive heart failure, and stiffness was commonly seen in sheep. In a dosing trial with poultry litter involving 1 steer and 6 sheep, the steer and a sheep died suddenly and a second sheep was destroyed in extremis. Tachycardia and/or cardiac arrythmia were recorded in 5 sheep, and the activity of aspartate transaminase (AST) and/or lactate dehydrogenase (LD) in the sera of 4 was elevated. Since the cardiac lesions in field cases were similar to those of ionophore poisoning and broiler rations containing maduramicin was a common factor in several outbreaks, toxic litter from some of these outbreaks were tested for the presence of this compound. Analysis by high performance liquid chromatography of litter from 2 specimens of outbreaks revealed that they contained 2.5 ppm and 6.1 ppm maduramicin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780132 TI - Perinatal mortality in lambs of ewes exposed to cultures of Diplodia maydis (= Stenocarpella maydis) during gestation. AB - During 1987 when cob rot was rife, perinatal losses were reported in flocks and herds that had been exposed to diplodiosis. The affected lambs or calves were either stillborn or died soon after birth. Dosing trials at the Onderstepoort Veterinary Research Institute involving 82 ewes revealed that 66% of the offspring of dams exposed to cultures of Diplodia maydis (= Stenocarpella maydis) in the second trimester of pregnancy and 87% of lambs of ewes exposed in the third trimester were born dead or died soon afterwards. A status spongiosus similar to that of the field cases was present in the white matter of the brains of all the affected lambs. The lambs of ewes that had shown nervous signs and those of ewes that had not shown such signs were equally affected. The experiments also clearly demonstrated that foetuses were much more susceptible to diplodiosis than the adults, e.g. in the third trimester 87% of the lambs were affected compared to only 44% of the dams. No perinatal mortalities were recorded in the group exposed to the culture in the first trimester. Ewes developed significant resistance to intoxication after initial exposure to the culture and both the length of gestation and birth mass of the affected lambs were less than those of their untreated counterparts. PMID- 1780133 TI - Spread in South Africa of the Oriental latrine fly Chrysomya megacephala. (Fabricius) (Diptera: Calliphoridae), an introduced species closely resembling Chrysomya bezziana Villeneuve. AB - Chrysomya megacephala, also known as the Oriental latrine fly, is indigenous to south-east Asia. During the 1970's it successfully invaded Africa and South America, and more recently during the 1980's also established itself in the United States of America. Although the first specimens from South Africa were collected from the south-western Cape Province in 1978, no published data appears to exist on its subsequent spread or status in southern Africa. During May 1991 a specimen of C. megacephala was incidentally captured near Beaufort West, Cape Province, South Africa, which prompted re-examination of blow-flies captured in the Kruger National Park during 1984. In this way it was found that C. megacephala was already well established in the south-eastern Transvaal by mid 1984. Adult C. megacephala can easily be confused with C. bezziana and medical/veterinary entomologists and veterinarians should take note of the existence of this species and the fact that it is probably widespread throughout southern Africa at this state. PMID- 1780134 TI - [Surgical treatment of congenital hip dislocation in adults]. AB - In the article is summarized the experience of treatment of adult patients with congenital dislocation of the femur. In clinic there has been applied not widely practised access by means of inter--of supratrochanteric osteotomy. After that the proximal fragment of the femur is diverted outwardly and the capsule is opened on the medial side. In this way the blood supply of the head and neck of the femur is maximally spared. During 12 years there have been operated 67 patients aged 15-50 years. Dynamic observation of patients indicated absence of such grave complication as the aseptic necrosis of the head of the femur that is the principal confirmation of low-traumatic character of the operation. PMID- 1780135 TI - [Explosion injuries of the hand in children]. PMID- 1780136 TI - [Results of the treatment of patients with post-traumatic osteomyelitis]. AB - The author cites the nearest and remote (up to 13 years) results of treatment of 152 patients with posttraumatic osteomyelitis of the bones of crus and femur. On the basis of analysis of clinical data there are recommended the terms (3-6 months) of radical-restorative operations in patients with osteomyelitis and is drawn attention to the considerable frequency of the joint contractures. PMID- 1780137 TI - [Surgical treatment of total forms of chronic osteomyelitis of the femur in children]. AB - In the article is described a new method of treatment of chronic hematogenic osteomyelitis of femur in children in case of its total affection. The essence of the method consists in making a longitudinal groove along the whole length of a bone by means of chisels and milling cutters till the medullar canal is reached and removal of pus, sequesters, pathologic granulations and zones of excessive osteosclerosis. The cavity after bathing is subjected to ultrasound cavitation; fibrinous film and gauze plastrons, impregnated with hemostatic sponge, are placed in it with the proximal and distal ends connection to the tubular drainage in order to ensure permanent lavage of cavity with antiseptic solution and active vacuum aspiration of its content with the subsequent application of sutures on the wound, tight bandaging of a limb and its immobilization. 6 patients have been subjected to treatment by this method with good outcomes in all cases. The results have been followed through 2.5-8 years. PMID- 1780138 TI - [Significance of roentgenologic indications of osteogenesis in the choice of tactics in distraction osteosynthesis using G. A. Ilizarov's method in rigid pseudarthrosis]. AB - On the basis of 274 observations the authors stated the conception of staged roentgenologic course of the osseous tissue regeneration in case of close distraction of rigid false joints according to G. A. Ilizarov. In line with visual appraisal of roentgenograms there were used roentgenometry and densitometry. There are described in details the stages of reparative regeneration and in accordance with them are given the tactical recommendation as to the selection of the distraction rate and its duration, the terms of loading and immobilization of fractures by means of perosseous apparatus. The tactics of the patient control with regard to the peculiarities of osteogenesis in the process of distraction allowed to decrease the number of failures in treatment of false joints by 2 times. PMID- 1780139 TI - [Use of technical means in the rehabilitation process of patients with movement disorders]. AB - On the basis of many years' work experience of ambulatory center of industrial rehabilitation the author proposed the set of technical means necessary for restorative treatment of patients with locomotor disturbances. There are proposed constructions, developed in the center and approved in the process of rehabilitation of patients with segmentary disturbances of locomotory functions. PMID- 1780140 TI - [Orthopedic devices for footwear in flatness of the anterior part of the foot]. AB - The work is dedicated to the problem of orthopedic supply of patients with flatness of the anterior part of foot. There is proposed a number of footwear orthopedic devices made of foam rubber. There is described the technology of their production with application of modern polymeric materials. There has been studied prosthetics of 50 patients with flatness of foot and revealed the positive result of application of footwear orthopedic devices made of foam rubber. PMID- 1780141 TI - [Appraisal of outcomes of the treatment of equinus-cavus-varus deformities of the foot in adults]. AB - There is presented the experience of treatment of 81 patients with equinus-cavus varus deformation of 102 feet of different etiology by means of closed application of Volkov-Oganesyan-Povarov's hinged-distraction apparatus to restore the form and function of foot and talocrural articulation. For impartial assessment of the outcomes of treatment there has been developed and applied the scheme of multimark grading system of clinico-functional state of feet. The grade of the foot form and function restoration is appraised by 15 indices in comparison with the same in normal state. The sum of marks equals to 100 in case of optimum outcome. In accordance with the developed scheme there have been appraised 54 feet with the sum of marks obtained from 45 to 91 and their statistic reliability. The proposed scheme allows to make an impartial assessment of the outcomes of treatment of the equinus-cavus-varus deformation of feet and can be applied in practical institutions. PMID- 1780142 TI - [Case of adhesion of the cervical vertebrae]. PMID- 1780143 TI - [Treatment of fractures of the proximal end of the femur in middle aged and aged persons]. PMID- 1780144 TI - [Single-stage and dosed compression of the pelvic ring in rupture of the pubic symphysis]. PMID- 1780145 TI - [Treatment of non-consolidated fractures and pseudarthrosis of the femoral diaphysis by means of a functional plaster cast]. PMID- 1780146 TI - [Experience in the treatment of open fractures of shin bones by means of bitemporal ultra-high frequency electric field and transcerebral electrophoresis]. PMID- 1780147 TI - [Dynamic compression osteosynthesis in fractures and pseudarthrosis of the femoral neck]. PMID- 1780148 TI - [Reconstruction of the proximal end of the femur in pseudarthrosis of the femoral neck and its varus deformation]. PMID- 1780149 TI - [Restoration of damaged ligaments of the knee joint]. PMID- 1780150 TI - [Forms of post-traumatic knee joint instability]. AB - The authors have proposed an addition to the clinical classification of posttraumatic instability of the knee joint, based upon the complex clinico physiologic evaluation of functional state of a joint as a single system. According to the degree of expression of morpho-functional changes there have been singled out compensated, subcompensated and decompensated forms of posttraumatic instability. Singling out of the given forms orients the physician in selection of tactics of carrying out of pre- and postoperative periods, helps a surgeon to solve the problem of optimal plan of operative treatment. PMID- 1780151 TI - [A device made of shaped metal alloy for distraction osteosynthesis of fragments of the pelvis]. PMID- 1780152 TI - [Closed osteosynthesis by threaded rods in fractures of the femoral neck]. PMID- 1780154 TI - [Reply to A. P. Kuz'minykh and O. I. Shtanakov in regard to the article, "To our opponents"]. PMID- 1780153 TI - [Effectiveness of medico-social rehabilitation of patients with defects and pseudarthrosis of the lower limb bones]. PMID- 1780155 TI - [Regarding the article by N. I. Kulish and V. A. Tan'kut, "Hyperplastic Coxarthrosis"]. PMID- 1780156 TI - [First professor of the Chair of Orthopedics]. PMID- 1780157 TI - [Role of non-steroidal anti-inflammatory agents in complex treatment of coxarthrosis (review of the literature)]. PMID- 1780158 TI - [Our experience in the surgical treatment of inveterate lesions of cruciate ligaments of the knee joint]. AB - On the basis of examination of 58 patients with inveterate damages of bursal and ligamentous apparatus of the knee joint there has been revealed a number of mistakes in diagnosis and treatment on the preceding stages that resulted in considerable secondary changes in articulation and unjustified loss of working ability. All patients were subjected to plasty of ligamentous apparatus by means of a cold-preserved allotendon. As the result of careful preparation of a patient for operation and application of complex restorative treatment, including general radon baths, during post-operative period, there have been obtained positive results of treatment in predominant majority of cases (87.9%). The difficulties of rehabilitation are caused mainly by late coming of the patients. PMID- 1780160 TI - Surgical preapproval program ends. PMID- 1780159 TI - RBRVS/visit codes due in January. PMID- 1780161 TI - Now is the time to review your collections policy. The Health Care Group. PMID- 1780162 TI - Reflections on an election. PMID- 1780163 TI - Hyperventilation in children with dengue hemorrhagic fever (DHF). AB - Many studies of Dengue Hemorrhagic Fever (DHF) have been done but only a few revealed the respiratory status. Respiratory problems arise because of plasma leakage through the damaged capillaries, causing lung edema and in turn result in hypoxemia. This later on will be compensated by a hyperventilation state. During a 6-month-period (May to September 1988), two aspects were studied in 85 patients hospitalized with DHF. First, the ventilatory pattern and second, the result of giving oxygen support in improving the respiratory disturbance, in this case alveolar hyperventilation. The incidence of alveolar hyperventilation in DHF grade II (DHF II) and Dengue Shock Syndrome (DSS) differed significantly. Hypoxemia occurred in DHF II and DSS with no significant differences. The difference of the incidence of metabolic acidosis in DHF II and DSS were significant. In DHF II patients having had hyperventilation state, oxygen therapy decreased respiration rate significantly and increased the PaCO2 though not significantly. PMID- 1780164 TI - A study of aplastic anemia at the Department of Child Health, School of Medicine University of North Sumatera/Dr. Pirngadi Hospital, Medan. AB - A study of aplastic anemia in children in a period of June 1980 to June 1989 was done to evaluate the pattern of aplastic anemia in children. The cases consisted of 55 children, 30 males (54.55%) and 25 females (45.45%). Most of the patients (47.27%) were found in the age group of 10 to 15 years. The complaints were paleness (90.91%), fever (56.45%) and bleeding (52.72%). The hemoglobin concentration was 4.25 +/- 1.17 g/dl (mean +/- SD), and the thrombocytopenia was generally severe. Prednisone or combination of prednisone and oxymethalone was given in addition to blood transfusions, antibiotics and vitamins. The outcome was difficult to evaluate because of the irregularity of treatments. Of the 55 children, 9 (18.02%) contracted leukemia after 1-5 months. PMID- 1780165 TI - The pattern of thalassemia in children at the Department of Child Health, School of Medicine University of North Sumatera/Dr. Pirngadi Hospital, Medan. AB - A study of the characteristics of childhood thalassemia was conducted at the Sub Department of Pediatric Hematology, Dr. Pirngadi Hospital from June 1979 to May 1989. There were 131 cases, consisting of 75 (57.25%) boys and 56 (42.75%) girls with an average of 12 admission every year. The predominant age group was 0-2 years, and the youngest was 3 months old. Javanese ethnic group appeared predominant in 36 (63.15%) cases. Clinical symptoms of anemia were found in 112 (85.49%), hepatomegaly in 91 (69.46%), hepatosplenomegaly in 84 (64.12%), without enlargement of organ in 17 (12.97%), and icterus in 6 (4.58%). Hb-Electrophoresis was done in 42 cases, revealing 26 (61.90%) with thalassemia major, 15 (35.71%) Hb E thalassemia, and 1 (2.20%) Hb H thalassemia. Hb value at the first admission in 65 (49.62%) was less than 5 g/dl, in 63 (48.09%) it was 5-10 g/dl and in 3 (2.29%) more than 10 g/dl. PMID- 1780166 TI - Acute non lymphoblastic leukemia in the Department of Child Health School of Medicine, University of North Sumatera/Dr. Pirngadi Hospital Medan (1983-1988), a preliminary study. AB - A retrospective study on Acute Non Lymphoblastic Leukemia (ANLL) was conducted at the Sub Division of Pediatric Hematology, School of Medicine, University of North Sumatera/Dr. Pirngadi Hospital Medan, in a period of 5 years (1983-1988). There were 18 cases consisted of 14 (77.78%) males and 4 (22.22%) females with the age group of 0-2 years: 6 (30%), 2-8 years: 9 (50%), 8-15 years: 3 (30%). By the FAB classification, they were of FAB M-1: 1 (5.55%). FAB M-2: 1 (5.55%), FAB M-3: 1 (5.55%), FAB M-4: 2 (11.12%) and FAB M-6: 13 (72.23%). Only 7 (38.88%) were treated with cytostatics while the others received only supportive therapy. The result of cytostatic treatment was unsatisfactory: 4 (57.14%) died within the first 2 months of treatment, 3 (42.86%) discontinued their cytostatics treatment. PMID- 1780167 TI - Bronchopneumonia with measles in infants and children at the Department of Child Health School of Medicine, University of North Sumatera/Dr. Pirngadi Hospital Medan (January 1985-December 1989). AB - A retrospective study was done on patients with bronchopneumonia hospitalized at the Dr. Pirngadi Hospital, Medan/School of Medicine, University of North Sumatera, during January 1985 through December 1989. The purpose of this study is to assess the morbidity and mortality of bronchopneumonia with measles and the nutritional status of the patients. Out of the 14.082 patients admitted, 1310 children suffered from bronchopneumonia (10.7%). Ninetynine of them were also with measles (7.6%). Most of the patients with bronchopneumonia without measles were in the age group 0-1 year (58.7%). The mortality was 24.8% and the highest mortality rate was in the age group of 4-5 years (34.6%). Most of the patients with bronchopneumonia and measles were in the age group of 1-2 years (30.3%). The mortality rate of bronchopneumonia with measles was 22.2% and the highest mortality rate was in the age group of 3-4 years (35.7%). Bronchopneumonia with or without measles occurred more in malnourished patients rather than in well nourished cases. All of the patients who had bronchopneumonia with measles in the present study had never been immunized against measles. PMID- 1780168 TI - The predictive value of Phadiatop Paediatric in the determination of atopy in allergic diseases in children. AB - We obtained 28 patients with asthma bronchiale in this study. The presumptive diagnosis of allergy was made on the basis of history and physical examination. The positive result of the skin test to inhalant extracts and positive history of inhalant allergy add a confirmatory evidence in the diagnosis of inhalant allergy. The diagnosis of food allergy was judged by positive result in the provocation test. This study provided 15 patients with food allergy and 13 patients with food and inhalant allergy. House dust and mites were the most prevalent positive result in the skin test. While in the provocation test, egg and milk were found as the most prevalent food causing symptoms of allergy. The skin test predicted the atopy with an efficiency of 53.5%, while Phadiatop Paediatric predicted the atopy with an efficiency of 82.1%. We concluded, as a screening procedure in allergy, the Phadiatop Paediatric is better than the skin test. Nevertheless the skin test has its superiority in the development of logical environmental controls and as a guide to immunotherapy in inhalant allergy. PMID- 1780169 TI - Differential targeting of dense granule proteins in the parasitophorous vacuole of Toxoplasma gondii. AB - The biosynthesis and fate of 4 different dense granule proteins of Toxoplasma gondii were studied with 3 monoclonal antibodies raised against tachyzoites and 1 polyclonal antibody raised against a recombinant protein. These proteins have the following molecular weights: 27 kDa (GRA 1), 28 kDa (GRA 2), 30 kDa (GRA 3) and 40 kDa (GRA 4). All four proteins were found in dense granules by immunoelectron microscopy; in T. gondii-infected cells, they were found in the vacuolar network but, in addition, GRA 3 was also detected on the parasitophorous vacuole membrane. Therefore, dense granule contents undergo differential targeting when exocytosed in the parasitophorous vacuole. Metabolic labelling and immunoprecipitation showed that GRA 2 and GRA 3 were processed from lower molecular weight precursors, and that GRA 2 and GRA 4 incorporated [3H] glucosamine and are thus likely to be glycosylated. PMID- 1780170 TI - An ELISA for the detection of pentastomid infections in the rat. AB - A specific enzyme-linked immunosorbent assay, based on a 48 kDa metallo proteinase isolated from the frontal glands of a porocephalid pentastomid (Porocephalus crotali) in rat intermediate hosts, is described. SDS-PAGE analysis of whole nymphal homogenate, followed by Western blotting and probing with immune rat serum, revealed that only 2 protein bands label consistently; these are the 48 kDa metallo-proteinase and a 150 kDa metallo-proteinase from the body fluid, but only the former labels strongly. Furthermore this response is detected earlier and persists much longer. These characteristics uniquely qualify the 48 kDa metallo-proteinase as a diagnostic antigen. We review the literature concerning the related porocephalid Linguatula serrata from the nasal cavities of domestic dogs, which can zoonotically infect man principally through the ingestion of eggs. We conclude that the high prevalences in dogs in certain areas, most notably the Middle East, must inevitably signal significant human infections. Our ELISA can be readily adapted for the serodiagnosis of linguatulosis and this should establish whether our prediction is true. PMID- 1780172 TI - Thermal preferences of resistant and susceptible strains of Biomphalaria glabrata (Gastropoda) exposed to Schistosoma mansoni (Trematoda). AB - The thermal preferences of two strains of the snail Biomphalaria glabrata, one resistant to, and one susceptible to, the parasite Schistosoma mansoni were determined in an aquatic thermal gradient. Snails were tested without exposure to the parasite, and 2 h and 5 weeks after exposure to trematode miracidia. The mean temperature selected by susceptible strain snails 2 h post-exposure tended to be lower than that of unexposed controls, although this was not statistically significant. In this strain, at 5 weeks post-exposure, the preferred temperature dropped by 1.9 +/- 0.5 degree C. The resistant strain displayed a significant drop of 1.8 +/- 0.6 degree C 2 h post-exposure. These results are consistent with the hypothesis that a drop in mean temperatures selected by snails is due to altered levels of endogenous cytokines such as IL-1 or TNF in association with parasite activation of the snail internal defense system. PMID- 1780171 TI - Comparison of different chemotherapy strategies against Schistosoma mansoni in Machakos District, Kenya: effects on human infection and morbidity. AB - A comparison was made of the long-term impact of different methods of administration of chemotherapy (oxamniquine, 30 mg/kg in divided doses; or praziquantel, 40 mg/kg) on prevalence and intensity of Schistosoma mansoni infection in four areas in Kangundo Location, Machakos District, Kenya. In Area A, treatment was offered in October 1983 and again in April 1985 to all infected individuals. In Area H, treatment was offered in April 1985 to individuals excreting greater than or equal to 100 eggs per gram (epg) of faeces. In Area S, treatment was offered in April 1985 to all infected school children, within the framework of the primary schools. In the witness area, Area W, treatment was given in April 1985, for ethical reasons, to a small number of individuals excreting greater than or equal to 800 epg. Prevalence and intensities of infection were subsequently monitored at yearly intervals for three complete post treatment years. In the Area S schools, clinical examination was also carried out at yearly intervals. Treatment of all infected individuals on two occasions (Area A) was the most effective and long-lasting way of reducing prevalence and intensity of infection. In this area, however, some earlier interventions had been carried out and pre-treatment intensities were lower than in the other areas. Treatment only of infected schoolchildren (Area S) also had a marked and prolonged effect, comparable to or better than treatment of individuals with heavy infections (Area H). Treatment of infected schoolchildren also caused a persistent reduction in the prevalence of hepatomegaly, and there was suggestive evidence from intensities of infection in community stool surveys (but not from incidence rates) of an effect on transmission. In all study areas, reinfection was most rapid and most intense among children. These findings are discussed in the light of theoretical considerations and of results from other studies, both on schistosomiasis and on intestinal helminths. We conclude that, in areas of low morbidity such as Kangundo, chemotherapy of schoolchildren only, at intervals of up to 3 years, is a satisfactory way of producing a long-term reduction in both intensity of infection and morbidity. PMID- 1780173 TI - Heterogeneities in water contact patterns and the epidemiology of Schistosoma haematobium. AB - Variations in the amount of water contact made by individuals and in the amount of water contact made at different sites may have significant impacts on patterns of human schistosome infection. Previous studies have reported variations in the rate of water contact and differences in the sites used between age/sex classes, but there is limited information on variations in individual water contact behaviour. In this paper we report and analyse observations of essentially all water contacts made over a two week period by all individuals in a rural community in eastern Zimbabwe. The mean rate of water contact was 0.43 contacts/person/day. These data were over-dispersed, ranging from zero to 3.3 contacts/person/day; 90% of contacts were made by only 37% of the population. Contact rates were related to age (highest in 8 to 10-year-olds) but not sex, with substantial variation unaccounted for by these variables. Age and sex classes differed in types of water-related activities and the time of day of contact. A greater diversity of sites was used by children than by adults and by males than by females. Individual contact rates were correlated with intensities of infection, although the risk of infection per contact was estimated to be highest in 2 to 4-year-old children and higher for males than females. Five contact sites were used during the study period, with more than 50% of contacts occurring at just 2 sites. Different age and sex classes used different sites and there were additional site-related differences in types of activity and the time of day of use. The implications of these water contact patterns for schistosome epidemiology are discussed. In particular the results provide strong quantitative support for control programmes aimed at heavily used sites (e.g. focal mollusciciding) or at the minority of individuals making most water contacts (e.g. targeted chemotherapy). PMID- 1780174 TI - The occurrence of schistosomin, an antagonist of female gonadotropic hormones, is a general phenomenon in haemolymph of schistosome-infected freshwater snails. AB - In haemolymph of Lymnaea stagnalis, parasitized with the digenetic trematode parasite Trichobilharzia ocellata, a neuropeptide (schistosomin) occurs which antagonizes female gonadotropic hormones, e.g. calfluxin (CaFl). By means of an ultracytochemical hormone-assay, the CaFl assay, it was demonstrated that the occurrence of schistosomin is a general phenomenon in schistosome-infected freshwater snails. Haemolymph of the schistosomiasis-transmitting snail species Biomphalaria glabrata and B. pfeifferi, parasitized with Schistosoma mansoni, also appeared to contain an antagonizing factor, i.e. schistosomin. In contrast, in haemolymph of L. stagnalis parasitized with Diplostomum spathaceum (Diplostomatidae) no schistosomin could be found. This suggests that schistosomin may only occur in snails infected with parasites belonging to the Schistosomatidae. The effect of schistosomin is rather specific. Haemolymph of B. glabrata parasitized with S. mansoni had not the capacity to inhibit the response to CaFl in the target organs for CaFl, the albumen glands of L. stagnalis and Bulinus truncatus. The same holds true for haemolymph of infected L. stagnalis: it did not inhibit the CaFl response in glands of B. glabrata and B. truncatus and even not in those of a related species (L. ovata). Schistosomins in haemolymph of infected B. glabrata and B. pfeifferi, on the other hand, seem more related. Both appeared to inhibit the hormone response in glands of the two Biomphalaria species studied. The results indicate that schistosomin in haemolymph of schistosome-infected pulmonate snails, although functionally related, may differ structurally. PMID- 1780175 TI - The effects of genetic exchange on variable antigen expression in Trypanosoma brucei. AB - The inheritance of variant surface antigens in Trypanosoma brucei has been determined by identifying variable antigen types (VATs) in each of two cloned parental stocks and then examining the presence and abundance of these VATs in hybrid progeny produced when these stocks undergo genetic exchange during co transmission through tsetse flies. Nine VATs have been identified from the repertoire of the parental stock STIB 247L and 5 VATs have been identified from the parental stock STIB 386AA; the identified VATs were exclusive to each stock. Their inheritance was elucidated using two assays. In the first, repertoire antisera (RAS) containing antibody specificities to many different VATs were raised in rabbits to the 2 parental stocks and 6 progeny clones. The presence of VAT-specific antibodies in these RAS was then determined by antibody-dependent complement-mediated lysis. In the second assay, the 2 parental stocks and 4 hybrid progeny clones were each independently transmitted through tsetse flies and VATs observed using VAT-specific antisera in indirect immunofluorescence of metacyclic trypanosomes and in bloodstream forms of fly-bitten mice. The results from both assays showed that (1) both metacyclic- and bloodstream-VATs were inherited into the progeny, (2) each hybrid progeny clone contained some VATs from both parents, (3) hybrids did not express all the VATs from either parent, (4) there was little apparent pattern as to which VATs had been inherited and which had not and (5) the VAT repertoires of the hybrid progeny appeared to be larger than those of the parents. In addition, two results indicated that control of VAT expression remains unaltered after genetic exchange.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780176 TI - A major Litomosoides carinii microfilarial sheath glycoprotein (gp22): amino terminal sequence and immunological studies with corresponding synthetic peptides. AB - The major glycoprotein of the sheath of Litomosoides carinii microfilariae (gp22) was analysed for its amino acid and amino sugar composition. It is rich in proline, glutamine/glutamic acid and glycine and contains (N acetyl)galactosamine. The N-terminal amino acid sequence was determined up to position 37. It consists of a group of 6 repeats of the pentapeptide sequence methionine-glycine-proline-glutamine-proline with two minor modifications in repeats 3-6, while the first two repeats follow the general pattern more loosely. Identical N-terminal amino acid sequences were found in at least two other sheath polypeptides (33 kDa, 39 kDa). Antisera prepared against 3 overlapping synthetic peptides corresponding to the amino terminus of gp22 recognized different epitopes. They all reacted with identical patterns of sheath polypeptides. The antisera failed to recognize antigens of 4th-stage larvae of L. carinii. In contrast, cross-reacting epitopes were detected in other parasite stages. Antisera reacted with material surrounding embryos and microfilariae in the uterus of females, and caused patchy fluorescence on the sheath of blood-derived and in vitro-released microfilariae. PMID- 1780178 TI - The effect of the protein content of CBA/Ca mouse diet on the population dynamics of Trichuris muris (Nematoda) in primary infection. AB - The relationship between host dietary protein and intestinal helminth population biology during primary infection was studied using a mouse-T. muris experimental model. Uninfected CBA/Ca mice fed either a 4% (by mass) or 16% protein diet grew at a similar rate, but both suffered significant growth retardation when infected with T. muris. T. muris initial establishment and fecundity were unaffected by dietary protein content, but were significantly influenced by infection dose, declining at the higher level of infection. Dietary protein deficiency increased parasite survival at high infection levels. Heavily infected hosts fed the 16% protein diet were found to expel almost the whole of their infections around day 21 p.i. By contrast, this response appeared defective in hosts fed the lower 4% protein diet, resulting in the establishment and survival of large, chronic and patent infections. Mean faecal egg output per mouse increased with infection dose in animals fed a low protein diet, but was low and unrelated to infection exposure in hosts fed the 16% protein diet. It is concluded that low protein levels in diet, via alterations in host resistance, may have an important influence on the transmission of T. muris. PMID- 1780177 TI - Effects of Plagiorhynchus cylindraceus (Acanthocephala) on the energy metabolism of adult starlings, Sturnus vulgaris. AB - Although the relationship between intestinal parasitism, the ingestion and use of energy, and host survival is expected, little work has been done to outline the effect of such organisms upon their host's nutritional requirements in an ecological context. This study is the first to demonstrate that an intestinal helminth previously reported to be of little or no histopathological consequence, Plagiorhynchus cylindraceus, has a significant detrimental impact upon the flow of food energy through a definitive host, the European starling, Sturnus vulgaris. Within both male and female adult European starlings reductions in standard metabolic rates occurred as the result of initial infection, indicating that the host's basal metabolism/thermal regulatory abilities were altered. Moreover, initially infected male starlings, but not females, had an increased consumption and excretion of energy and maintained lower average daily body weights versus controls when temperature stressed. These results appear to be due to either a parasite-mediated alteration in host activity and/or to the disruption of host-digestive abilities. Additionally, these data indicate that, overall, male and female S. vulgaris respond differently to infection and that intestinal helminths normally thought to be of little or no pathological consequence to the host are factors that should be addressed in future studies regarding animal energetics, ecology, and behaviour. PMID- 1780179 TI - Ultrastructural changes associated with exsheathment of infective juveniles of Haemonchus contortus. AB - Ultrastructural changes associated with exsheathment of the infective juveniles of Haemonchus contortus are described. Hyaline ring formation occurs associated with annulations 10 and 20 and consists of the dissolution of the basal zone and the inner electron-dense layer resulting in the rupture of the sheath. These changes are consistent with the action of a protease-exsheathing enzyme. There is a significant reduction associated with exsheathment in the size of the excretory cells and the number of excretory granules contained within them. No changes in the oesophagus were observed associated with exsheathment. These, and the observations of earlier workers, suggest that it is the excretory cells and not the oesophagus which are the source of exsheathing fluid during exsheathment. PMID- 1780180 TI - Heligmosomoides polygyrus (Nematoda): susceptible and resistant strains of mice are indistinguishable following natural infection. AB - BALB/c mice were characterized as more resistant to infection with Heligmosomoides polygyrus (Nematoda) than C57BL/6 mice based on lower establishment and survival during a primary infection and stronger protection induced by an immunizing regime. It was hypothesized, therefore, that C57BL/6 mice would be more heavily infected than BALB/c mice when they lived together as a single population in a large indoor arena where transmission occurred through contact between the mice and damp peat trays where parasite eggs developed into larvae. Fifty female mice (including 5 infected mice) of each strain were placed in a 3.2 x 0.8 m arena. Net egg production and numbers of larvae acquired by sentinel mice of each strain were monitored every two weeks. The experiment was replicated twice. The results did not support the hypothesis. No difference was detected between strains of mice in the number of larvae acquired by sentinel mice during 24 h exposure periods, or in the numbers of worms present after 12 or 23 weeks. Net egg production was also comparable between strains. A hypothesis that the unexpected similarity of infection in the two strains was related to differences in rates of contact with the peat trays was not supported by preliminary data on mouse behaviour that revealed equal frequency of contact with peat trays between strains. A second hypothesis that continuous exposure to larvae led to similar infection levels in the two strains (in contrast to the controlled characterization experiments) was also unsupported. Mice were infected weekly with 10, 50 or 100 larvae for 5 or 10 weeks. Net egg production and numbers of worms were consistently higher in C57BL/6 than BALB/c mice. At this time it is not clear why infection in the two strains was virtually identical in the large arenas but clearly distinct in all controlled infection experiments. PMID- 1780181 TI - Can the nematode Capillaria hepatica regulate abundance in wild house mice? Results of enclosure experiments in southeastern Australia. AB - The hypothesis that a liver-inhabiting nematode, Capillaria hepatica, can regulate abundance of the house mouse (Mus domesticus) was tested in enclosures, in southeastern Australia. Changes in mouse abundance, and the relationship between mortality and host abundance were compared in three treatment and three control populations. Any effect of C. hepatica on mouse abundance was masked by an unknown regulating factor(s). This factor(s) caused density-dependent mortality in the control and treatment populations and, together with strong seasonal trends in parasite transmission, confounded our test of the ability of C. hepatica to regulate the abundance of house mice. The seasonal trends in transmission have important implications for the potential of this parasite as a biological control agent and for models of the interaction of C. hepatica and mouse populations. Transmission of C. hepatica apparently occurred throughout the 18 month study, further supporting its potential as a biological agent in the control of mouse plagues in this region. PMID- 1780183 TI - Behavioural responses of the cercariae of Cryptocotyle lingua (Digenea: Heterophyidae) to computer-controlled shadow sequences. AB - The cercariae of Cryptocotyle lingua have a brief but active life during which they do not feed. In order to maximize the probability of infection they must respond to a variety of host-related stimuli yet conserve their finite energy reserves by minimizing unnecessary muscular activity. In laboratory experiments, simulated shadows representing the passage of a fish host were found to increase population activity levels. Evidence was also found for a relationship between shadow duration and the duration of subsequent bursts of swimming activity. Adaptation to continuous shadowing was recorded, its onset and magnitude being dependent on both the frequency and duration of shadows delivered. As cercariae aged they became less responsive to shadow stimuli, especially those of short duration. PMID- 1780182 TI - Comparison of isolates and species of Toxocara and Toxascaris by biosynthetic labelling of somatic and ES proteins from infective larvae. AB - Infective-stage larvae of three different isolates of Toxocara canis were intrinsically ([35S]methionine) labelled in culture, to determine the presence of similarities or differences in the somatic and ES antigens expressed between larvae derived from different hosts and different geographical regions. Two other closely related ascaridids, Toxascaris leonina which infects cats and dogs, and Toxocara vitulorum (Neoascaris vitulorum) which infects cattle, were also compared to T. canis larvae by this method. Overall comparisons were made by 1- and 2-dimensional electrophoresis, while immunological cross-reactivities between the different species were analysed by radio-immunoprecipitation. Our results show that extensive physicochemical characteristics are shared between T. canis isolates, both from different hosts and different geographical locations. A substantial overlap was revealed when T. canis and T. vitulorum antigens were compared, whereas Toxascaris was found to produce a distinct antigen profile: this result was independent of whether methionine- or Iodogen-labelled products were being considered. Antigen recognition by polyclonal antibodies raised to all three species and to the cat ascaridid Toxocara cati, revealed considerable cross reactivities. The cross-reactions were especially prominent between the Toxocara species, a fact further substantiated when reactivity of T. canis ES-specific monoclonal antibodies were tested against T. leonina and T. vitulorum antigens. The ES antigens of T. leonina were not recognized by the T. canis monoclonals, whereas the majority of these antibodies precipitated antigens of T. vitulorum. One which did not react with T. vitulorum was monoclonal antibody Tcn 2, indicating its species-specific reactivity and therefore its potential for the specific diagnosis of human toxocariasis. PMID- 1780184 TI - In ovo cultivation of Microphallus primas (Trematoda: Microphallidae) metacercariae to ovigerous adults and the establishment of the life-cycle in the laboratory. AB - This investigation reports for the first time the establishment of a trematode life-cycle in the laboratory using in ovo cultivation of the adult stage. Microphallus primas metacercarial cysts were removed from Carcinus maenas crabs and chemically excysted. Using a modification of the technique developed by Fried (1962) the released metacercariae were grown in fertile hen's eggs to ovigerous adult flukes. These were removed from the under surface of the chorio-allantoic membrane of chick embryos 5 days post-infection and the fluke eggs recovered were used to infect laboratory-reared Hydrobia ulvae snails. When challenged against parasite-free crabs the cercariae released from the experimentally infected snails gave rise to metacercarial cysts that were again identified as M. primas. PMID- 1780185 TI - An autopsy study of pulmonary thromboembolism in Hong Kong Chinese. AB - A retrospective study of autopsied material in the last 15 yrs is documented an increasing incidence of pulmonary thromboembolism (PTE) in Hong Kong Chinese. The incidence of significant PTE increased from 0.58% in the first 5 yr period to 2.08% in recent years. The topographic features and characteristics of these PTE patients are analysed and the factors contributing to the changes are discussed. PMID- 1780186 TI - An analysis of donor blood wastage due to outdating in a large teaching hospital. AB - We analyzed the pattern and rate of donor blood outdating in our hospital from 1986 to 1990. We found that there was a sharp drop in blood outdating since the implementation of the Type and Screen crossmatch protocol. The outdating rate was reduced from 11.5% to 1.3% for whole blood and from 4.9% to 0.4% for red cells. In absolute numbers, wastage of blood due to outdating was cut from 2,570 units in 1986-87 (a 2 yr period before Type and Screen) to only 227 units in 1988-89 (a 2 yr period after Type and Screen). We also found that the outdating rate varied among different blood groups (group 0 less than A = B less than AB), and the outdating of whole blood was consistently more than red cells throughout the study period. The results of our utilization review were conveyed to local hospitals and the blood supplier in an effort to preserved donor blood. PMID- 1780187 TI - The role of apoptosis in the development of renal cortical tubular atrophy associated with healed experimental renal papillary necrosis. AB - An animal model of chronic analgesic nephropathy, in which renal papillary necrosis was induced by the administration of a single injection of bromoethylamine 2-hydrobromide in male Sprague-Dawley rats, was used to investigate the pathogenesis of the atrophy of tubules that leads to cortical atrophy or 'scarring' in analgesic nephropathy. One of the major objectives was documentation of the participation of apoptosis, a distinctive mode of cell death, in the process of cortical tubular atrophy. Control and treated groups of animals were studied at 2 wks, and at subsequent monthly intervals up to 4 mths. At each time, light microscopy and ultrastructure were used to relate changes in cellular pathology to alterations in renal mass. Apoptosis was quantitated in paraffin sections, and autoradiographic identification of cells showing tritiated thymidine uptake was used as an indication of cell proliferation. In animals with total renal papillary necrosis (RPN), focal or diffuse cortical atrophy developed, the extent of which appeared to be proportional to the extent of the RPN. Renal mass was reduced only in those kidneys that developed extensive, diffuse lesions. Compensatory renal growth occurred in the areas of healthy tissue adjacent to the foci of atrophy, with both cellular hyperplasia and hypertrophy playing roles in its development. One of the prominent cellular events was the appearance of apoptotic cells and bodies, with invading intraepithelial macrophages involved in their phagocytosis and degradation. We propose that this form of cell death plays an important role in the pathogenesis of cortical atrophy. Current descriptions of the cortical lesions that occur in analgesic nephropathy refer to the changes as 'scars'. Although the focal lesions have a macroscopic appearance that resembles scars, the results of the present study indicate that usage of this terminology may be misleading, since scarring is often described after severe tissue injury or necrosis, which was not identified in the present study. PMID- 1780188 TI - Pyocin typing of Pseudomonas aeruginosa isolates from children with cystic fibrosis. AB - Pyocin typing and serotyping of 433 strains of Pseudomonas aeruginosa from children with cystic fibrosis (CF) showed that pyocin type 9 was predominant, particularly in association with polyagglutinating serotype. The common pyocin groups, 1, 5 and 10, made up only 20% of these isolates in contrast to reported rates of up to 89% in other studies using non-CF strains. No strains of pyocin type 3 were found. Polyagglutinating strains made up 72% of strains from patients colonized with P. aeruginosa for more than 12 mths. Pyocin type 9 was associated with 93% of polyagglutinating strains. The parallel between pyocin type 9 and polyagglutinating serotype suggests that these may both be characteristics acquired by P. aeruginosa colonizing patients with CF. Because of confounding between duration of colonization and exposure to cross-infection, this study does not allow definition of the role of cross-infection in determining the characteristics of these strains in most patients. In siblings, however, evidence supports a role for cross-infection either between siblings or from a common source. In 6 pairs of siblings studied, each pair had at least 1 pyocin group in common concurrently, either at entry to the study or after an interval of several months. Identical and unusual pyocin groups were recognized in samples obtained on the same day from pairs of siblings. More studies are needed to compare results of pyocin typing with methods such as genome fingerprinting to characterize these strains and determine whether the observed distribution of pyocin groups in CF isolates is related to cross-infection or whether the combination of pyocin type 9 with polyagglutinating serotype is a characteristic of CF strains. PMID- 1780189 TI - Successive Salmonella give and Salmonella typhi infections, laboratory-acquired. AB - A case of laboratory-acquired typhoid fever is described. The case was complicated by a self-limiting Salmonella give gastroenteritis which may also have been laboratory-acquired and which occurred during the incubation period of the Salmonella typhi infection. The symptoms of typhoid were not sufficiently severe for the patient to seek medical attention and she was recovering from the infection when the typhoid bacillus was isolated from her stools. The mode of transmission of the S. typhi was presumed to be a laboratory infection from an unknown source. Although there was no obvious breakdown in safe laboratory techniques, the infecting dose of S. typhi is known to be small and the dangers of handling specimens which may contain this bacterium are emphasized. PMID- 1780190 TI - Molecular genetics and cytogenetics--a glossary and list of abbreviations. AB - A glossary of terms commonly used in molecular genetics and cytogenetics has been prepared to assist pathologists. The emphasis is on clinically relevant examples. PMID- 1780191 TI - Fulminant tuberculous bronchopneumonia in a young Hong Kong Chinese woman. AB - A 24-yr-old, previously healthy Chinese woman presented with symptoms of acute bronchopneumonia which led to acute respiratory failure and death 6 days after admission to hospital despite intensive antibiotic treatment. Autopsy showed acute tuberculous bronchopneumonia of the acinar type. This is a rare presentation and outcome of tuberculous infection in Hong Kong, where 124 cases per 100,000 population were notified in 1988, and indicates that tuberculosis can mimic acute bronchopneumonia and should be considered in cases so presenting, particularly when there is no growth on routine culture and no response to conventional antibiotics. Acute respiratory failure developing in such cases can cause a delay in the diagnosis of tuberculosis. PMID- 1780192 TI - Membranous nephropathy associated with spinal schwannoma. AB - Clinical cure was effected in a patient with biopsy-proven membranous nephropathy associated with spinal schwannoma. The renal manifestation of nephrotic syndrome antedated the clinical presentation of the spinal tumor. The proteinuria and edema subsided 4 mths after the complete resection of the intradural component and partial removal of the extradural component of the schwannoma. Careful workup in patients with membranous nephropathy should include not only malignant but also benign tumors. PMID- 1780193 TI - Spontaneous improvement in Fanconi's anemia. PMID- 1780194 TI - Cryptococcal epididymo-orchitis complicating steroid therapy for relapsing polychondritis. AB - Disseminated cryptococcosis is a known complication of steroid therapy. Infection within the genito-urinary tract is usually assumed to be part of generalized cryptococcosis complicating a primary pulmonary focus. A case of isolated testicular cryptococcal orchitis complicating steroid therapy for relapsing polychondritis is presented. To the authors' knowledge isolated cryptococcal orchitis has not been previously described. PMID- 1780195 TI - A comprehensive microcomputer network program for histopathology. AB - For a small hospital with a limited budget, a stand-alone histopathology microcomputer network may be more valuable to the pathologist than one running off the hospital's main computer. In return for sacrificing the limited benefit of screen reading of pathology reports in the wards, one receives the great advantage of more rapid retrieval of disease data. Commercial relational database programs for microcomputers can now achieve nearly all the power of a minicomputer program, with more versatility. Using an application developed on such software, we now have 30,000 pathology reports entered, from which we can retrieve a list of pathology numbers, with patients' names, age, sex, disease, and site, for any diagnosis in 3-5 seconds. The application includes full biopsy reports for doctors and wards, autopsy final diagnoses, computer-assisted Snomed coding, outside consultations, literature abstracts, daybook printing, workload statistics and billing codes and charges, and a cytology module has been added for another hospital. Moreover, the interested pathologist can easily make his own alterations to menus, entry screens, fields, and screen listing or printout formats. PMID- 1780196 TI - An improved method of alkaline phosphatase--antialkaline phosphatase immunophenotyping using microwave irradiation. AB - The application of microwave irradiation from a domestic microwave oven to the alkaline phosphatase-antialkaline phosphatase immunophenotyping has resulted in substantial time saving of the procedure. This has been achieved without compromising the quality of the final preparation. It can be carried out on peripheral blood smears, bone marrow smears and cytocentrifuge preparations on fresh slides, slides that have been stored at -20 degrees C wrapped in aluminium foil and unfixed smears left at room temperature for up to 8 days. PMID- 1780197 TI - Microwave fixation and rapid processing in a large throughput histopathology laboratory. AB - Technical details of a method of microwave fixation and rapid processing are described. Fresh biopsy specimens are sampled and trimmed into 2 mm thick blocks and irradiated to a temperature of 68 degrees C. They are then processed through cycles of absolute alcohol (75 min), xylene (50 min) and wax (50 min). It is possible, in this manner, to run several 'short' cycles of about 3 hrs each during the working day so that stained sections are available on the same day as receipt of the specimens. Endoscopic biopsies are processed through a shorter cycle comprising 30 min of absolute alcohol (4 changes), 20 min of xylene (3 changes) and 20 min of wax (2 changes). For convenience we also employ an overnight cycle whereby microwave-fixed blocks are processed through several changes of absolute alcohol, xylene and wax without the use of formalin. This method of processing not only removes the use of noxious and potentially toxic formalin but also allows rapid preparation of good quality diagnostic sections with superior antigen preservation compared to formaldehyde fixation. PMID- 1780198 TI - "Age-related glomerular sclerosis: baseline values in Hong Kong". PMID- 1780199 TI - The visual perception of smoothly curved surfaces from minimal apparent motion sequences. AB - A series of four experiments was designed to investigate the minimal amounts of information required to perceive the structure of a smoothly curved surface from its pattern of projected motion. In Experiments 1 and 2, observers estimated the amplitudes of sinusoidally corrugated surfaces relative to their periods. Observers' judgments varied linearly with the depicted surface amplitudes, but the amount of perceived relative depth was systematically overestimated by approximately 30%. The observers' amplitude judgments were also influenced to a lesser extent by the amount of rotary displacement of a surface at each frame transition, and by increasing the length of the apparent motion sequences from two to eight frames. The latter effect of sequence length was quite small, however, accounting for less than 3% of the variance in the observers' judgments. Experiments 3 and 4 examined observers' discrimination thresholds for sinusoidally corrugated surfaces of variable amplitude and for ellipsoid surfaces of variable eccentricity. The results revealed that observers could reliably detect differences of surface structure as small as 5%. The length of the apparent motion sequences had no detectable effect on these tasks, although there were significant effects of angular displacement and surface orientation. These results are considered with respect to the analysis of affine structure from motion proposed by Todd and Bressan (1990). PMID- 1780200 TI - Integrating speech information across talkers, gender, and sensory modality: female faces and male voices in the McGurk effect. AB - Studies of the McGurk effect have shown that when discrepant phonetic information is delivered to the auditory and visual modalities, the information is combined into a new percept not originally presented to either modality. In typical experiments, the auditory and visual speech signals are generated by the same talker. The present experiment examined whether a discrepancy in the gender of the talker between the auditory and visual signals would influence the magnitude of the McGurk effect. A male talker's voice was dubbed onto a videotape containing a female talker's face, and vice versa. The gender-incongruent videotapes were compared with gender-congruent videotapes, in which a male talker's voice was dubbed onto a male face and a female talker's voice was dubbed onto a female face. Even though there was a clear incompatibility in talker characteristics between the auditory and visual signals on the incongruent videotapes, the resulting magnitude of the McGurk effect was not significantly different for the incongruent as opposed to the congruent videotapes. The results indicate that the mechanism for integrating speech information from the auditory and the visual modalities is not disrupted by a gender incompatibility even when it is perceptually apparent. The findings are compatible with the theoretical notion that information about voice characteristics of the talker is extracted and used to normalize the speech signal at an early stage of phonetic processing, prior to the integration of the auditory and the visual information. PMID- 1780202 TI - Geometrical illusions in solid objects under ordinary viewing conditions. AB - The Muller-Lyer and Ponzo illusions were obtained under free binocular viewing of three-dimensional objects, and the function relating magnitude of illusion to fin angle, characteristic of converging-line versions of the Muller-Lyer pattern, was closely paralleled by volumetric (three-cone), line-free objects (but not with an erect, planar "walk-through" construction and moving observers). Illusions cannot be dismissed as artifacts of static, impoverished viewing, therefore, but must be explained within any general theory of perception. Perspective explanations have difficulties with such three-dimensional manifestations, and seem completely inapplicable to our further finding that approximately the same amount of illusion occurred in objects and patterns with no oblique lines or edges. Confusion or averaging theories, not themselves tested here, remain unthreatened by these data. PMID- 1780201 TI - Movement and focused attention: a failure to replicate. AB - Our original goal was to explore the nature of the grouping-by-movement phenomenon reported by Driver and Baylis (1989). In their studies, distractors that moved in common with a centrally located target had a larger influence on focused-attention performance than did more proximate but stationary distractors. These results seemed particularly important since they suggested, contrary to the predictions of space-based models of attention, that attention could be allocated to noncontiguous regions of the visual field. Their results also suggested mandatory processing of stimuli with common motion. Unfortunately, we were unable to replicate this grouping-by-movement effect. In the conditions of Experiment 1 in which we replicated Driver and Baylis's methodology, stationary distractors produced a larger response-compatibility effect than did the more distant distractors that moved in common with the target. In Experiment 2, we redundantly coded the centrally located target and the far distractors with common movement and color. However, the results were identical to those obtained in Experiment 1. The stationary near distractors that appeared in a different color from the target and the far distractors produced the largest response-compatibility effect. In a final experiment, we attempted to compensate for the reduced acuity of the moving distractors by adjusting their size by a cortical magnification factor. However, even with this manipulation, we found a larger response compatibility effect for the stationary near distractors than for the moving distant distractors. Our results suggest that subjects are capable of selectively processing a target item that moves in common with distractors. PMID- 1780203 TI - Is subitizing a unique numerical ability? AB - Two models that predict the relation between mean enumeration time and numerosity in a speeded enumeration experiment are tested. The first is a bilinear two process model, and the second is a log-linear single-process model. Previously, support for the bilinear model has provided evidence for the existence of a unique numerical ability called "subitizing." Both models are shown to yield close approximations to the empirical data, but at the same time to consistently violate the robust shape of these data. Two fundamental discrepancies exist: (1) Enumeration of single-element displays is unpredictably fast, both in the data reported here and elsewhere, and (2) the response-time function for multiple elements is continuously convex upward, with a significant log-quadratic component. The findings support the contention that enumeration is a capacity limited process, but not statistically reliable change in processing character, that is, from subitizing to some other process, is evident in enumeration of displays of up to six elements. PMID- 1780204 TI - Duration discrimination of filled and empty auditory intervals: cognitive and perceptual factors. AB - Adult subjects were presented with two auditory stimuli per trial, and their task was to decide which of the two was longer in duration. An adaptive psychophysical procedure was used. In Experiments 1, 2, and 4, the base duration was 50 msec, whereas in Experiment 3, the base duration was 1 sec. In Experiments 1, 2, and 4, it was found that filled intervals (continuous tones) were discriminated more accurately than empty intervals (with onset and offset marked by clicks). It was concluded that this difference was perceptual rather than cognitive in nature, since performance on filled and empty intervals was not affected by increasing cognitive load in a dual-task procedure (Experiment 2) but was affected by backward masking (Experiment 4). In contrast, the results of Experiment 3 showed that duration discrimination of filled auditory intervals of longer duration was cognitively influenced, since performance was impaired by increasing cognitive load. Implications for notions of perceptual processing and timing mechanism underlying differences in duration discrimination with filled and empty intervals are discussed. PMID- 1780205 TI - The effect of ingested alcohol on fusion latency at various viewing distances. AB - Although diplopia is a frequently reported symptom of severe alcohol intoxication, there have been few past attempts to describe in any systematic fashion the specific impact of alcohol on fusion. In the present experiment, fusion latency was assessed for 8 male emmetropes. At the beginning of the alcohol condition, they consumed a drink containing 1.4 ml/kg of 95% ethanol, plus diluent. For the placebo condition, the drink consisted only of diluent. In each condition, fusion latency (the time required to fuse a binocularly visible target) was recorded for targets requiring a magnitude of vergence that varied from +10 through -2 meter angles, in 1-meter-angle steps. It was found that the far point of fusion approached the observer as a direct function of intoxication level. Furthermore, fusion latency increased for optically far and near targets as a systematic function of intoxication, with no effect of alcohol on intermediate targets. The results were consistent with previous findings of alcohol-induced narrowing of vergence range, suggesting that alcohol causes the farthest and nearest distances at which fusion latency is affected to approach an intermediate value. Measurable effects on fusion latency were observed with blood alcohol levels as low as 0.05%-0.06%, considerably below the legal limit for operating a motor vehicle in most states. PMID- 1780206 TI - Bias produced by fast guessing in distribution-based tests of race models. AB - A comparison involving cumulative probability distributions of reaction time (RT) has been used to test race models of the redundancy gain observed in certain divided-attention paradigms. It has been pointed out, however, that the presence of fast guesses would interfere with this test, biasing it to accept race models. The present paper reports simulations carried out to determine the size of the bias introduced by fast guesses. In absolute terms, this bias can be quite large- exceeding 175 msec in some conditions. Simulations indicate that the bias increases with the percentage of fast guesses and with the latency difference between the lower tails of guess and nonguess RT distributions. Discarding and rerunning errors reduces bias somewhat, but a more elaborate "kill-the-twin" procedure reduces it much more. PMID- 1780207 TI - Naming versus matching in color constancy. AB - In this paper, a replication of the color-constancy study of Arend and Reeves (1986) is reported, and an alternative method is presented that can be used for the study of higher order aspects of color constancy, such as memory, familiarity, and perceptual organization. Besides a simultaneous presentation of standard and test illuminants, we also carried out an experiment in which the illuminants were presented successively. The results were similar to Arend and Reeves's; however, in the object-matching condition of the successive experiment, we found an overestimation, instead of an underestimation, of the illuminant component. Because the results of matching experiments are difficult to interpret, mainly due to their sensitivity to instruction effects, we introduced another type of color-constancy task. In this task, subjects simply named the color of a simulated patch. It was found that, by applying such a task, a reliable measure of the degree of identification of object color can be obtained. PMID- 1780208 TI - Time and duration: a persistent illusion. PMID- 1780209 TI - Supporters and survivors: the people without AIDS. AB - Over the past 10 years the AIDS crisis has produced a large volume of writing. Much of this is documentary. Dozens of studies of AIDS from various clinical and political perspectives have been complemented by just as many published diaries, autobiographies, novels, plays, and poems. A few of these works have risen to the surface not only as extraordinarily valuable testimonies to the changes AIDS has wrought in individual and collective life but also as first-rate literary works, worth reading because beyond their immediate purposes they articulate with extraordinary lucidity and compassion some deep truths about the human--and the modern--condition. Paul Monette's Borrowed Time is among the most distinctive of those. It speaks not only for the community of people with AIDS and those who support them but for a generation. PMID- 1780210 TI - Dr. Martin Arrowsmith: scientist and medical hero. PMID- 1780211 TI - The development of modern neurological thinking in the 1860s. PMID- 1780212 TI - Some thoughts about aging from a nineteenth-century Connecticut Yankee. PMID- 1780214 TI - The empirical basis for the discovery of new therapies. PMID- 1780213 TI - Eugenics and the "new genetics". PMID- 1780215 TI - Two perspectives: on Rene Dubos, and on antibiotic actions. PMID- 1780216 TI - Priorities in the application of genetic principles to the human condition: a dissident view. PMID- 1780217 TI - Canine pain syndrome is a model for the study of Kawasaki disease. PMID- 1780218 TI - The immunological self: a centenary perspective. PMID- 1780219 TI - Of chairs and stools: or, what's academic about academic medicine? PMID- 1780220 TI - Does history of medicine teach useful lessons? PMID- 1780221 TI - Orthoses of ventilative plastics. AB - Plastics are extensively used as a material for orthoses. However, one remaining problem is the ventilation of the orthosis. This is a real problem in countries such as Japan, where it is hot and humid especially in summer. The authors have invented a new orthosis "POROPLAST", which is made of mesh plastic sheets, combined in a cross-like weave. These orthoses provide good ventilation and are very comfortable to wear. They have been fitted to seventy-four cases with satisfactory results. PMID- 1780222 TI - A clinical evaluation of stumps in lower limb amputees. AB - A study was carried out on 93 consecutive unilateral below-knee (BK) and 62 above knee (AK) amputees. The dimensions of the amputation stumps were measured and the general condition and contralateral limb assessed at the time of prosthetic fitting. After one postoperative year, follow-up information for 124 (89%) of the surviving patients was obtained by personal contact. The observations were based on the standard formula for stump classification constructed by the International Society for Prosthetics and Orthotics. The 93 BK stumps had a mean length of 16.0 cm and the 62 AK stumps a mean length of 28.0 cm. The scar on the stump was adherent in 13% of BK and 2% of AK stumps. The scar was deeply wrinkled in 7% of BK stumps and 10% of AK stumps. The scar on the stump was most frequently adherent or deeply wrinkled in trauma patients (33%). The skin was undamaged in 93% of all the patients at the first visit and in 94% at the time of follow-up. The mobility of the stump in the proximal joint was limited at the time of prosthetic fitting in 15% of cases. Phantom pain was reported by 59% and stump pain by 5% of patients at this time. Although the phantom pain was mild in most cases, it was usually still present after one year, and 53% of the surviving patients suffered from phantom pain. At the first visit, 20% of patients had problems in their contralateral leg. During the first postoperative year, 6 contralateral BK amputations were performed in the BK group and one contralateral AK amputation in the AK group. Thus, along with examination of the stump, attention must be paid to the contralateral limb with a view to preserving it. The study supports the usefulness of the standard form and classification of amputation stumps. PMID- 1780223 TI - Lower limb intersegmental forces for below-knee amputee children during standing. AB - The purpose of this investigation was to compare intersegmental knee and hip forces for below-knee amputee (BKA) and able-bodied children during standing. Three unilateral BKA children and 10 able-bodied children (7-9 years) were tested on four separate occasions at six month intervals. Three trials of external force and spatial data during standing were collected from each subject for each session. These data were utilised to determine the intersegmental forces at the knees and hips of the children using a static force analysis. Results indicated that in some instances the intersegmental forces for the BKA children were significantly greater than those of the able-bodied children and in other instances significantly lower (p less than 0.05). In all cases, however, the values were substantially less than corresponding values for walking and running. The effects of the forces upon spatial orientations indicated significant differences between the two groups of children. The frontal plane prosthetic knee angle, the sagittal plane prosthetic and non-prosthetic knee angles, and the sagittal plane trunk angle were all greater for the BKA children when compared to able-bodied children. These differences may be the result of the anatomical structure of the amputee and/or the construction of the prosthesis. PMID- 1780224 TI - Physiological considerations in seating. AB - Physiological changes occur with change of posture. Seating imposes significant effect on the cardiovascular, respiratory, abdominal, renal and neurological systems. The presence of severe skeletal deformities can significantly alter the physiological responses of the individual to changes in posture. In the case of severe kyphoscoliosis profound haemodynamic changes may occur. Lung perfusion has been shown to be posture dependent and the imposition of a specific seated position may have profound effects. This may compound existing lung problems for example bronchiectasis, which is not uncommon in these individuals, leading to hypoventilation. Abdominal compression which can occur with the patient in a flexed position can exacerbate a hiatus hernia, which can be both uncomfortable for the patient and may lead to feeding difficulties. The flexion at the hips of the lower limbs may also lead to problems of renal drainage especially where there is a catheter or other drainage appliance. Seating significantly affects many neurological reflexes. For example the presence of an extensor pattern can be helped by the adoption of a flexed position. The presence of pain can also influence the neurological response to a specific position. Those providing seating systems must consider the physiological effects that occur and compromise between these and the other requirements. PMID- 1780225 TI - The causes of developmental deformity and their implication for seating. AB - This article attempts to touch upon several different aspects of developmental deformity. It is intended to show that the position in which children are placed and the time these postures are maintained are important in preventing fixed and structural deformity. These are considered to be the prime causes of deformity. Whilst surgery is often necessary, it should be seen as complementary to an early postural regime, one part of which is the position in which a child sits. PMID- 1780226 TI - Pressure management. AB - The prevention or minimisation of the occurrence of pressure sores is an important consideration in the rehabilitation of physically disabled people, especially for the wheelchair user with a spinal cord injury. Although there is little definitive information on the cause of pressure sores, several intrinsic and extrinsic factors have been highlighted. Probably the most significant causative factor is the application of force to the skin surface. The relationship between the magnitude of pressure and its duration; the temperature and humidity at the interface; and the physiological effects that this has on the microcirculation and lymphatic drainage are discussed in this article. It is suggested that a rationale for the prevention of pressure sores includes the limitation of the duration of pressure applied to the skin surface and the reduction of the peak pressures particularly at vulnerable sites. In this context the design criteria for a clinical interface pressure measurement system, and the uses and limitations of the commercially available options, are considered. The development of a structured programme of wheelchair and support surface provision, assessment and follow-up is required. PMID- 1780227 TI - Evaluation of cushions using dynamic pressure measurement. AB - Reduction of pressures generated in the tissues overlying the ischial tuberosities is an important measure for predicting a cushion's effectiveness. In particular, the pressure-time relationship is significant in the prevention of pressure sores. In this study a dynamic pressure monitoring system was used to obtain pressure-time profiles for 25 spinal cord injured subjects. Each subject tested three types of cushion (Foam, Gel (Aberdeen) and Roho) for periods of two hours each during which routine activities were performed. Results obtained were broadly comparable with previous studies. Average pressures were: Foam 87.6mmHg (11.6kPa); Gel 68.6mmHg (9kPa) and Roho 54.6mmHg (6.7kPa). Pressure-time histograms are presented for three subjects for each cushion. These show inter subject variability on the same cushion as well as intra-subject variability on different cushions. Therefore individual patient assessment is important in providing the most appropriate cushion. Dynamic pressure monitoring allows the pattern of pressure variation to be determined and hence the potential effectiveness of the cushion. PMID- 1780228 TI - The New Jersey Board of Nursing advanced nursing practice: advisory opinion. PMID- 1780229 TI - NJSNA position statement on temporary reassignment. PMID- 1780230 TI - Oxytocics for augmentation and induction of labor. PMID- 1780232 TI - Nursing: the practice of caring. PMID- 1780231 TI - A special wish. PMID- 1780233 TI - The nature of nursing. A definition and its implications for practice, research, and education. Reflections after 25 years. PMID- 1780234 TI - Peace and power. A handbook of feminist process. PMID- 1780235 TI - Serum immunoreactive erythropoietin level: a new parameter for monitoring transfusion management of thalassaemia. AB - Serum immunoreactive erythropoietin (EPO) was measured sequentially in 8 patients with thalassaemia major. The EPO levels were distinctly increased before transfusion; they did not significantly change just after transfusion, but subsequently decreased. Pretransfusion EPO levels were similar to those observed in patients with non renal non inflammatory anaemias of the same severity. Our results show that production of EPO is appropriately increased in thalassaemia major and confirm that stimulation of endogenous erythropoiesis is not completely suppressed by the hypertransfusion regimen commonly used in this disease. As hyperstimulated ineffective erythropoiesis may lead to invalidating complications, we suggest that serum EPO measurements, which are now easily and reliably performed, should be used in monitoring the therapy of thalassaemia major. PMID- 1780236 TI - Association of autoimmune thrombocytopenic purpura (AITP), Graves' disease and ovarian carcinoma. AB - We report here the case of a patient suffering sequentially from autoimmune thrombocytopenic purpura (AITP), Grave's disease and an ovarian carcinoma. An autoimmune mechanism was indicated by the presence of platelet associated immunoglobulins and the detection of antithyroid microsomal antibodies. However, the exact mechanism associating these autoimmune manifestations with the ovarian tumour remains unexplained. Specific therapy for hyperthyroid led to a moderate increase of the platelet count. But complete remission of AITP now lasting for more than eight years was only obtained by ablation of the ovarian tumour. PMID- 1780237 TI - Cunninghamella bertholletiae: an uncommon agent of opportunistic fungal infection. Case report and review. AB - Cunninghamella bertholletiae is a fungus of the Zygomycetes class, Mucorales order. Only very few cases of disseminated infection have been reported. We observed a new case in a 19 years old man with severe aplastic anemia, due to pulmonary primoinfection and hematologic dissemination. This aplastic anemia failed to respond first to an antithymocyte globulin and steroid treatment and then to cyclosporine A. Deferoxamine was infused weekly to prevent iron overload. During a second antithymocyte globulin and steroid treatment, the patient developed bilateral pneumonia. Culture of the broncho-alveolar washing fluid established the diagnosis by isolation of C. bertholletiae. Despite amphotericin B and 5-fluorocytosine intravenous therapy, the patient died of disseminated infection six days after diagnosis, which was confirmed by necropsy. Underlying conditions, diagnosis and treatment are discussed, together with a review of the literature. PMID- 1780238 TI - Platelet cytotoxicity against parasites. AB - Platelets are not restricted to hemostasis and thrombosis since they are involved in defence mechanisms especially in parasitic diseases. They express cytotoxic functions in vitro and in vivo against extra-cellular and intra-cellular parasites. The toxic process is mediated either by specific antibodies or directly by the parasite itself. As some metabolic pathways seem to be implicated both in hemostasis and in parasiticidal activity, primary hemostasis and cytotoxicity may be considered as specialized inflammatory responses. PMID- 1780239 TI - [The early diagnosis of Perthes disease: the value of bone scintigraphy and magnetic resonance imaging in comparison with x-ray findings]. AB - The value of conventional radiology, bone scintigraphy and magnetic resonance imaging (MRI) in the early diagnosis of Legg-Calve-Perthes disease (LCPD) was assessed. The initial results were compared with the clinical and radiological findings of long-term follow-up in 43 children. Radiological and scintigraphic examination resulted in a relatively high number of equivocal findings (16% and 10%, respectively). MRI findings were less equivocal (3%). Depending on whether such findings were classified as normal or as pathological, the diagnostic accuracy ranged as follows: radiography 88-93%, bone scintigraphy 88-91%, and MRI 97-99%. Therefore, MRI by itself seems to be sufficient to detect or exclude LCPD. The results of this study and the radiation exposure associated with radiography and scintigraphy raise the question whether MRI should be the diagnostic method of choice in patients with suspected LCPD. PMID- 1780240 TI - [Bone marrow changes in patients with thyroid carcinoma]. AB - In 62 patients with thyroid carcinoma 79 MRI bone marrow examinations and 48 bone marrow scintigraphies were recorded before or following radioiodine therapy, to study the extent of bone marrow expansion. The results of both methods were the same. In 34/79 investigations normal findings were seen, in 18 the bone marrow expanded to the middle third and in 26 to the distal third of the femur. One patient showed bone marrow expansion to the tibia. These results were compared with the following data: histology of tumor, TNM-staging, time passed since thyroidectomy, accumulated doses of radioiodine therapy, results of 131I scintigraphy, hematological changes, thyroglobulin level, age and sex. No significant correlations were found between these and the bone marrow imaging results. Bone marrow changes in patients before radioiodine therapy were similar to those in patients treated with up to 48 GBq 131I. Blind biopsy of the posterior iliac crest in five patients showed slightly pathological reactive changes. In only 2/17 follow-up studies an increase of bone marrow expansion was seen. In 8 patients localized findings indicating malignant infiltration were observed. In 4/8 patients metastases of thyroid carcinoma were known or confirmed by pathological radioiodine uptake and in 2/8 metastatic involvement was assumed because of an increased thyroglobulin level. PMID- 1780241 TI - [Retrosternal lymph node metastases in breast cancer: lymphoscintigraphy and magnetic resonance tomography]. AB - In 21 patients with breast cancer (pT1-4, N0, M0) internal mammary lymphoscintigraphy and magnetic resonance imaging (MRI) were performed to evaluate retrosternal lymph node metastases. In 6 patients normal findings of lymphoscintigraphy were confirmed by MRI. In the 15 patients with focal defects seen by lymphoscintigraphy no lymph nodes were found by MRI in 5 in the corresponding area, 5 showed normal-sized lymph nodes (less than 1 cm) and 5 enlarged lymph nodes indicating metastatic infiltration. In addition to internal mammary lymphoscintigraphy MRI may offer the possibility to improve TNM staging in patients with breast cancer. PMID- 1780242 TI - [The determination of left ventricular flow rates using single-probe radiocardiography in the steady-state distribution phase]. AB - A new procedure of extracting data from measurements by single-probe radionuclide ventriculography is presented which reduces the phase differences during summation of single-beat actions and permits the use of a greater number of single actions for summation. Sum curves so determined are better suited for measurements of ejection fractions, compliance and ventricular blood flow rates. PMID- 1780243 TI - Evaluation of diagnostic reliability of radionuclide phlebography using 99mTc-MAA to detect deep venous thrombosis; its role in establishing indications for inferior vena cava filter implantation. AB - Radionuclide phlebography (RNP) of the lower extremities and pelvis was performed using 99mTc-MAA in 40 patients with pulmonary thromboembolism. Deep venous thrombosis (DVT) was found in all patients, more frequently in the right calf and in the left iliac veins in 20 patients (55%). RNP and contrast phlebography (CP) were performed in 18 patients and confirmed the presence of DVT in all cases. The greatest specificity of RNP was obtained in the left (92.4%) and in the right pelvis (80%). In 12 of 18 patients in whom a cava filter was implanted, specificity of RNP was 100% for the left thigh and 91.7% for other localizations. In establishing indications for cava filter implantation, RNP should be performed prior to CP and bilaterally, but in case of non-indicated CP, RNP findings should be sufficient. PMID- 1780244 TI - The role of the interaction between Fe(III) and cell surface in the accumulation of 67Ga by tumor cells. AB - The study of the interaction between complexed iron and tumor cells in the presence of 67Ga-citrate indicates that a phenomenon of iron-binding related to the thermodynamic constant of stability of the iron complex, and a hydrolysis (or anion penetration) of the interaction product determine the uptake of 67Ga. The effects of various parameters such as ionic composition of the medium, nature of the iron complex, time of incubation and number of cells are discussed. PMID- 1780245 TI - N-isopropyl-123I-p-iodoamphetamine uptake mechanism in the lung--is it dependent on pH, lipophilicity or pKa? AB - The uptake and binding mechanism of biogenic amines in the lungs has been studied extensively with no conclusive results. The competition between N-isopropyl-123I p-iodo amphetamines (123I-IMP) and propranolol and 123I-IMP and ketamine, in the lungs suggest that the pKa value of the biogenic amines has a significant role to play in the mechanism of uptake and retention of biogenic amines in the lungs. PMID- 1780246 TI - Nuclear Medicine in Osteology. 7th Nuclear Medicine Workshop Innsbruck--Hannover 1991. PMID- 1780247 TI - Psychosocial dimensions in childcare. PMID- 1780248 TI - Health education in neuro-psychiatric set-up. PMID- 1780249 TI - Nursing and HIV/AIDS: focus on counselling. PMID- 1780250 TI - Home environment and health. PMID- 1780251 TI - Knowledge and perceptions regarding menstruation among adolescent girls: a research study. PMID- 1780252 TI - [Simplification of the "wash technique"]. PMID- 1780253 TI - [The decline of dental caries in France. An analysis of epidemiological data from 1978 to 1990 on 9 and 12-year old children]. PMID- 1780254 TI - Albinism in White Leghorn chickens. AB - The appearance in 1988 of an oculocutaneous albino chick in a Single Comb White Leghorn line suggested a new mutational event. This line was closed in 1949, and has been reproduced each spring since then. Subsequent matings indicated that the mutation occurred at the C pigment locus. A mating of the Wisconsin albino (WIA) to cre/cre (red-eyed white) birds showed the mutation to be incompletely recessive to cre. No segregation was apparent when mated to ca/ca (recessive albinism) birds. These data indicate that the WIA mutation is identical to, or very similar to, the previously described tyrosinase-negative ca mutation at the C locus. PMID- 1780255 TI - Heterozygosity at protein loci in inbred and outbred lines of chickens. AB - Levels of heterozygosity at six polymorphic protein marker loci were determined by electrophoresis in 24 lines of poultry, encompassing 17 White Leghorn inbred lines (WLI) (with inbreeding coefficients, F, ranging from .946 to .988), five Australorp inbred lines (AusI) (with F values ranging from .924 to .961), and two randombred lines (one White Leghorn and one Australorp). Fixation was observed at one locus in WLI lines, and at two loci in the AusI lines. Segregation at the other loci was observed in the inbred lines of the two breeds. Observed heterozygosity in the inbred lines markedly exceeded the expectations under inbreeding theory. In White Leghorns, reproductive fitnesses for heterozygotes were superior to homozygotes in the inbred lines, but not in the control. Consequently, natural selection operating through associative overdominance appears to be responsible for the higher than expected heterozygosities in the inbred lines. PMID- 1780256 TI - Retention of larvicidal activity after feeding cyromazine (Larvadex) for the initial 20 weeks of life of single comb White Leghorn layers. AB - Single Comb White Leghorn pullets were fed cyromazine (Larvadex) continuously at levels of 0, 25, 250, and 1,000 mg/kg diet (ppm) from hatch to 20 wk of age. Fresh manure was bioassayed for toxicity to housefly, Musca domestica, larvae beginning at the 6th wk after removal of cyromazine from the feed, and at weekly intervals thereafter. At 6 wk after removal of the feed additive there was 51.6% fly mortality at 25 ppm, 75.7% at 250 ppm, and 86.5% at 1,000 ppm relative to the 0-ppm control. Fly mortality decreased to less than 10.7% mortality at 13 and 15 wk postremoval for hens grown on 25 ppm and 250 ppm cyromazine, respectively. Hens grown on 1,000 ppm cyromazine produced manure that was still exhibiting more than 50% fly mortality 20 wk after removal of the feed additive. These data demonstrate retention of cyromazine in laying hens for up to 20 wk after feeding the chemical to the birds at 5 to 200 times greater than the maximum recommended rate for the initial 20 wk of life. PMID- 1780257 TI - Variability in preincubation embryo development in domestic fowl. 1. Effects of nest holding time and method of egg storage. AB - Embryos of eggs from Single Comb White Leghorn hens were analyzed to determine whether nest holding time and method of storage had a significant effect on postoviposition embryonic growth prior to incubation. Eggs were collected from 38 to 42-wk-old hens naturally inseminated and housed in floor pens. The experiment had a 2 x 2 factorial arrangement of treatments with two nest holding times and two storage methods. Eggs were collected within 1 h of oviposition, placed on cardboard egg flats, and stored unpacked (Treatment 1), or put on flats, and packed in 30-dozen egg cases (Treatment 2). Eggs in Treatments 3 and 4 were marked within 1 h of oviposition, but remained in the nest for 6 to 7 h. These eggs were separated into unpacked (Treatment 3), and packed (Treatment 4) groups. All eggs were stored at 13.8 C for 4 days. A total of 250 embryos were staged after storage for development using the Eyal-Giladi and Kochav classification. Least square means (LSM) for stage of development were: Treatment 1, 10.76; Treatment 2, 11.52; Treatment 3, 12.41; and Treatment 4, 12.36. For the main effects, nest holding time significantly affected stage of development (P = .0001), but storage method (P = .1140) and nest holding time by storage method interaction (P = .0730) did not. Comparison of LSM of Treatment 1 versus 3 (P = .0001), 2 versus 4 (P = .0152), and 1 versus 2 (P = .0214) were significant, but Treatment 3 versus 4 (P = .8595) was not.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780258 TI - The upper critical ambient temperature in neonatal chicks. AB - Heat production, dry matter, and water loss in the body and yolk sac of neonatal broiler chicks were measured during 24 h exposure to constant temperatures from 30.8 to 38.8 C. Average initial body and yolk sac weights were 41.6 and 4.4 g, respectively. Chicks housed at 30.8 C lost 3.5 g/day and chicks housed at 38.8 C lost 5.7 g/day of total body weight. Between 30.8 and 35.1 C, weight loss of the yolk sac was 1.9 g/day. At 38.8 C, weight loss of the yolk sac was 1.4 g/day. Weight lost from the yolk sac consisted of equal amount of dry matter and water. Water loss from the remainder of the chick's body (the total body without yolk sac) increased from 1.8 to 4.4 g as environmental temperature was raised from 30.8 to 38.8 C. This increase occurred mainly above about 35 C. Chick heat production increased with ambient temperature. Heat production as determined per subsequent 3-h period decreased with increasing duration of exposure from 34.6 to 28.2 kJ/kg per hour (1 kJ = .239 kcal) at 30.8 C and from 44.1 to 35.5 kJ/kg per hour at 38.8 C. The upper critical temperature was derived from regression of heat production on temperature. Results showed that this critical temperature was between 36 and 37 C. PMID- 1780259 TI - A comparison of three continuous and four shuttle anticoccidial programs. AB - Continuous programs of a combination of narasin (40 ppm) and nicarbazin (40 ppm) (NaNi), narasin at levels of 60 and 70 ppm, and a 2 by 2 factorial shuttle design (NaNi or nicarbazin at 125 ppm, each for 27 or 28 days, followed by narasin at 60 or 70 ppm to termination), were compared with unmedicated controls for their anticoccidial efficacy and growth performance in nine broiler trials conducted in seven countries outside the United States. Cecal coccidial lesions were reduced only by treatments that incorporated nicarbazin either at the 40-ppm level in NaNi or at 125 ppm, whereas total intestinal lesion scores were reduced by all the anticoccidial programs tested. At Day 28, the three treatments containing NaNi and the treatment containing narasin at 60 ppm significantly improved weight gain and feed efficiencies over the two treatments containing nicarbazin at 125 ppm and the unmedicated controls. At termination all the anticoccidial programs significantly decreased the mortality rate and improved bird weights and feed efficiencies. Birds on the treatments containing NaNi either in the two shuttle programs or in the continuous program were significantly heavier than those on the two treatments containing nicarbazin at 125 ppm in shuttle programs. PMID- 1780261 TI - The role of intestinal microflora on the prevention of Salmonella colonization in gnotobiotic chickens. AB - The possible role of the intestinal microflora in inhibiting the colonization of Salmonella in the ceca of gnotobiotic chickens was investigated. In the cecal contents of newly hatched (2-day-old) and adult normal (7-mo-old) chickens, a larger number of Escherichia coli and a smaller number of Lactobacillus sp. were noticed in 2-day-old chickens than in adult chickens. Gnotobiotic chickens treated with cecal contents from either newly hatched or adult birds were orally exposed to Salmonella typhimurium, and on the following day S. typhimurium in the ceca were counted. The adult microflora prevented S. typhimurium colonization more strongly than did the microflora of newly hatched chicks. Gnotobiotic chickens treated with E. coli, Lactobacillus sp., or the mixture of both organisms were orally inoculated with S. typhimurium. The mixture of both organisms suppressed S. typhimurium colonization most effectively, followed by E. coli alone and Lactobacillus sp. alone, Escherichia coli may play a role of competitive exclusion only in newly hatched chickens, whereas Lactobacillus sp. may have a partial role in adult chickens. PMID- 1780260 TI - Immunosuppressive effects of Fusarium moniliforme corn cultures in chickens. AB - In the present study, the toxic and immunosuppressive effects of three isolates of Fusarium moniliforme (MRC 826, MRC 1069, and RRC 408) in male White Leghorn chickens were investigated. Chickens were fed diets containing .5, 5.0, or 25% of F. moniliforme corn cultures for 6 wk. About 30% of the chickens fed RRC 408 had leg weakness. Relative weights of bursae of Fabricius were lower in birds fed all doses of MRC 826. Birds fed 5.0 or 25% MRC 1069 had lower relative spleen weights. Thymus weights were lower in birds fed .5 and 5.0% RRC 408, but not in those fed 25%. Immunosuppressive effects were determined by measuring serum levels of primary and secondary agglutinin responses to SRBC and Brucella abortus. Birds fed 5.0 or 25% MRC 826 were immunosuppressed, as shown by low antibody titers to B. abortus in both the primary and secondary responses. Isolate MRC 1069 caused a decrease in secondary response to SRBC at 25% and B. abortus at the 5.0 and 25% of culture material. The RRC 408 isolated reduced the secondary response to SRBC at all doses and response to B. abortus at 5.0 and 25% of culture material. These results appear to be the first report that feed contaminated with F. moniliforme can produce deficiencies in the immune system of chickens. PMID- 1780262 TI - The effects of particle size and origin of calcium carbonate on performance and ossification characteristics in broiler chicks. AB - The following physico-chemical characteristics of various calcium sources, differing in origin and particle size were determined: mineral composition, sieve and image analysis, apparent solubility (AS), surface area (SA), porous volume, specific gravity, and compressibility (C). The AS, SA, and C values were related more to the calcium particle size than to its origin and were higher in ground calcium sources. Calcium retention of seashells treated with phosphoric acid, oyster shells, and limestone using two particle sizes, ground or particulate, was assayed in 98 broiler chicks. Particulate marble was also tested in this experiment. Calcium retention expressed as a percentage of calcium ingestion was decreased when coarse particles of calcium were supplied in lieu of pulverized sources (40 versus 49%). An experiment with a 3 x 3 x 3 factorial arrangement of treatments were tested using 576 broiler chicks. Treatments included three calcium sources (phosphorus-treated shell, oyster shell, and marble), three particle sizes [ground (less than .15 mm), medium (.6 to 1.18 mm) and coarse (greater than 1.18 mm)] and three levels of calcium (.5,.7, and .9%) with ground limestone as a reference. Performance, tibial morphometry, breaking strength variables, and ash content were measured at 4 wk of age. Weight gain and feed conversion were ameliorated with ground particles of calcium. Cortical thickness, length of the tibia, stiffness, stress, and tibia ash were diminished when coarse particles of calcium were incorporated in the diets. Conversely, the origin of the calcium source hardly affected these criteria. Additionally, the incorporation of phosphorus-treated shells was assayed in 112 broiler chicks. Coarse particles decreased calcium retention. Consequently, ultimate stress, the modulus of elasticity, and stress were impaired. It is concluded that differences in utilization of calcium carbonate sources by the broiler chick is primarily a result of particle size rather than origin. Ground particles of calcium (pan to .15 mm) significantly improves performance and tibial ossification characteristics in broiler chicks. PMID- 1780264 TI - Influence of age, sex, and method of rearing on tibia length and mineral deposition in broilers. AB - Two experiments were conducted to determine linear growth and mineral deposition in the tibiae of Vantress x Arbor Acres broilers. In Experiment 1, birds were maintained in battery brooders for 21 days then housed in floor pens from Day 22 to 70. In the second experiment, birds were reared either in battery brooders and grow-out cages or floor pens from Day 1 to 63. Males and females were maintained separately. Birds in both trials were weighted at weekly intervals and three birds of each sex per treatment were euthanatized weekly to obtain tibia samples. Tibiae were cleaned of muscle and connective tissues, dried, extracted with diethyl ether, measured for length in centimeters, weighed, and ashed. Results from both experiments show a curvilinear response for weight gain, bone length, and bone ash weight. In some cases, sex by week or week by rearing interactions (P less than .001) were observed. As expected, males had greater weight gain and bone length than females. In Experiment 2, birds grown in floor pens had greater (P less than .05) bone length, tibia weight, and tibia ash weight than cage reared birds, but percentage tibia ash was not different between the two rearing systems. Tibia growth and mineral deposition were influenced by gender and rearing systems. Bone ash weight data for females in both trials had a response curve that approached a sigmoidal shape. Response curve for males tended to be more quadratic, indicating a significant (P less than .003) week by week by sex interaction. Thus, there was evidence for bone growth differences not only between rearing systems, but also between sexes, the latter not unexpected. PMID- 1780263 TI - Skin tearing in broilers in relation to skin collagen: effect of sex, strain, and diet. AB - The relationship between skin tearing and collagen in broilers was investigated in two trials in which strain and sex, and strain and diet served as factorial arranged variables, respectively. In the first trial, males and females of three strains were examined. Both skin tearing and skin collagen were significantly influenced by strain and sex without any significant strain by sex interaction. Skin collagen, expressed as a fraction of fresh skin protein (N x 6.25) was lower and skin tearing was higher in females than in males, particularly in the most susceptible strain. In the second trial, the effects of supplementary protein or methionine and of a low-density diet were tested in females of two strains that differed in their susceptibility to skin tearing. High dietary protein reduced skin tearing and increased skin collagen. The significant diet by strain interaction resulted from the more pronounced response of the susceptible strain. Neither supplementary methionine nor feeding of low-dietary-density diet significantly affected skin tearing or skin collagen. PMID- 1780265 TI - An improved procedure for intramagnal insemination of the chicken. AB - Intramagnal insemination is a useful technique in the analysis of spermatozoal function. Precise deposition of spermatozoa requires the use of laparotomy. However, hen-day egg production can be adversely affected by such a procedure. The present work demonstrates that postoperative hen-day egg production is affected by choice of anesthetic. Hens anesthetized with a mixture of ketamine and xylazine prior to laparotomy laid 14% fewer eggs (P less than .05) when compared with intact controls. In contrast, the postoperative hen-day egg production of hens anesthetized with xylazine alone was comparable with that of intact controls (P greater than .05). Furthermore, the use of xylazine alone increased the ease of handling sedated hens and decreased recovery time. Therefore, xylazine is recommended for anesthetizing hens prior to laparotomy. PMID- 1780266 TI - The effect of indomethacin on eggshell quality. AB - The objective of the present study was to determine whether indomethacin, an inhibitor of prostaglandin synthesis, could improve shell quality in birds laying a high incidence (greater than 15%) of soft-shelled (SS) and shell-less (SL) eggs and in birds laying exclusively hard-shelled (HS) eggs. Treatments consisted of two injection types, indomethacin or oil (controls), and two injection times, 4 h or 16 h postentrance of the egg into the uterus. Indomethacin delayed oviposition in both HS and SS or SL egg layers, with indomethacin being more effective in delaying oviposition when injected at 16 h as compared with 4 h postentrance of an egg into the uterus. Indomethacin increased shell thickness of the first egg laid following injection in the SS or SL groups but not in the HS groups. Egg weight was not affected by indomethacin injection. It was concluded that indomethacin delayed oviposition and prevented the premature expulsion of some SS or SL eggs. This delay in oviposition resulted in thicker shells of the first egg laid postinjection. PMID- 1780267 TI - Comparison of procedures for collecting semen from ganders and inseminating geese. AB - Experiments were conducted to compare management of ganders and semen collection procedures with respect to semen and sperm yield, and two frequencies of artificial insemination were tested with respect to fertility. Housing ganders in groups, singly, or singly with the introduction of a female just before collection was the rank order of housing system from least to most successful collection of ejaculates. There were no significant differences among types of housing with respect to semen volume, but ejaculates from ganders housed singly had the greatest (P less than .05) spermatozoal concentrations. Ejaculates collected with an artificial vagina were of greater (P less than .05) volume and total spermatozoal yield but not spermatozoal concentration than those collected by aspiration. Interactions between collector and method were observed for spermatozoal traits. Geese inseminated on 2 consecutive days/wk showed greater (P less than .01) fertility than those inseminated once per week. Therefore, collection of semen with an artificial vagina from ganders housed singly, with insemination weekly but on consecutive days, should result in successful reproduction of geese. PMID- 1780268 TI - Analysis of deferent duct morphology in turkeys characterized as low or high semen volume producers. AB - The objective of the present research was to clarify the basis for the difference in performance of turkey toms characterized as low or high semen volume producers. Variables measured included testicular weight, deferent duct semen volume, and deferent duct morphology based upon plastic casts. Three organizational patterns emerged after viewing plastic casts of deferent ducts: helical, serpentine, and randomly folded coil. THe randomly folded coil was the principal pattern in deferent ducts from low and high semen volume producers alike. No difference in patterns was observed between low and high semen volume producers. Differential semen yield was attributed to a greater testicular mass along with a greater storage capacity of the deferent duct in high semen volume producers. However, deferent duct storage capacity appeared to be the predominant factor affecting semen yield. PMID- 1780269 TI - Analysis of poultry fertility data. 2. Comparison of long- and short-term fertility trials. AB - The purpose of the present study was to determine the effect of egg collection interval on interpretation of fertility trial results. Low-fertility (LF) and randombred (RB) Delaware hens were inseminated with spermatozoa from LF or RB Delaware roosters. Three replicate trials were performed for each cross. Eggs were collected for 21 days following insemination. Fertility was analyzed with a log odds model following logit transformation. Separate analyses were performed on data collected throughout the first 7 days and the entire egg collection interval. Duration of fertility over the 21-day interval was analyzed by iterative least squares. Whereas the 21-day egg collection interval afforded detection of differences between males and between females, no differences were observed following analysis of data from the 7-day interval. Differences in reproductive efficiency also were detected when data were analyzed by iterative least squares. Thus, the value of a fertility trial is, in part, determined by the length of the egg collection interval. PMID- 1780270 TI - Research note: effect of electronic treatment of drinking water on growth performance of broiler chickens. AB - Three electronic devices used to treat drinking water were compared with untreated city well water in a broiler growth performance trial. In each treatment feed conversion and BW were measured in 16 replicate pens of 60 female broilers at 29, 42, and 49 days of age. Two of the devices increased dissolved oxygen content of the water and reduced conductivity and microorganism count. One of these reduced broiler mortality (P = .065), decreased pH (P = .062), and increased Fe and Mn concentration in the water. The other increased water temperature, Ti, and Mn but reduced the concentration of Cl, Al, Ca, Cr, Mg, and Sr in the water. Neither the third device, an electrostatic water treatment, nor the other devices affected BW (P = .586) or feed conversion (P = .564) at 49 days of age. No significant treatment differences (P less than or equal to .05) in hematocrit, bursa of Fabricius weight, or tibial ash weight were observed at 21 days of age. PMID- 1780271 TI - Research note: naloxone inhibits drinking in the chick induced by angiotensin II. AB - Subcutaneous injection of Angiotensin II (AII) induces a rapid increase in water intake in the chick. These studies were designed to determine whether this response was mediated through the opioid system. Injection of AII stimulated a rapid increase in water intake. Administration of naloxone, an opioid antagonist, attenuated AII-induced drinking in the chick. These data would indicate that the opioids may be involved in the drinking response elicited by AII. PMID- 1780272 TI - A simple method to fix and extract ATP from rat liver samples. AB - A simple one-step method to fix and extract ATP from rat liver samples is described. The results show that this method is suitable for fixation and extraction of the hepatic ATP content, whereas its simplicity leads to consider it the procedure of choice. PMID- 1780273 TI - A sensitive multienzymatic assay for the measurement of pyruvate, dihydroxyacetone phosphate, oxaloacetate, and acetoacetate in clear extracts from biological samples. AB - A multienzymatic method for the measurement of pyruvate, dihydroxyacetone phosphate, oxaloacetate, and acetoacetate is presented. The determination procedure is considered suitable because it is simple, sensitive, and its advantages could be demonstrated by comparison with the original methods. PMID- 1780274 TI - Subsetting of acetylcholine receptor-reactive antibodies by preparative isoelectric focusing. AB - The antibodies produced against most foreign antigens are composed of a family of immunoglobulins, a family composed of members that are of a number that often reflects the size/complexity of the molecule that stimulates their production. In other words, such responses involve the activation of a "polyclonal" B lymphocyte population. The antibody products of the B cells, although all capable of binding the original antigen, bind at various immunogenic sites (epitopes) on that antigen. Such differences in antigen-binding fine specificity is determined by amino acid residues in the antibody variable region domains found associated with the antigen combining site and tend to have a complimentary biochemistry with the molecule for which they are intended to interact. Furthermore, in addition to amino acid differences that dictate the isotypes and allotypes of antibody molecules, differences in the amino acids that compose the variable regions can produce differences in net charge of particular antibody molecules; thus, families of polyclonal antibodies, all reactive with the same antigen but with different fine specificities, can be separated and, as shown below, purified based on their isoelectric points by preparative isoelectric focusing (pIEF). PMID- 1780275 TI - A simple purification method of squeezed krill for obtaining high levels of hydrolytic enzymes. AB - The raw material originating from freshly caught Antarctic krill (E. superba) was processed by centrifugation and then immediately frozen. This squeezed fluid adjusted to pH 7 was subjected to spontaneous autolysis by storing at different temperatures (20-45 degrees C) and times (10-48 h). The autolyzed material resulted in 3 distinct phases after high speed centrifugation. The intermediate phase (water-phase) was collected and concentrated by membrane filtration. The high-molecular-weight substances (greater than 10,000 Daltons) were further purified by ion-exchange chromatography and eluted by a salt gradient. In this matter a bulk enzymatic material from krill can be efficiently obtained for further purification of different hydrolytic enzymes (peptide hydrolases/carbohydrases). PMID- 1780276 TI - Purification of prephenate dehydratase from Corynebacterium glutamicum by affinity chromatography. AB - Prephenate dehydratase has been purified from the wild type strain Corynebacterium glutamicum by affinity chromatography. Three ligands, L-Trp, L Tyr, and L-Phe have been tested as well as conditions for elution. L-Phe is the most specific ligand: it leads to a purification factor of 11 in one step using step gradients of NaCl in Tris-HCl buffer at pH 7.5. PMID- 1780277 TI - [Study of the dopaminergic system in various neuroendocrine diseases using the sulpiride test]. AB - Altogether 25 patients with acromegaly, 19 patients with prolactinomas, and 6 patients with nonfunctioning hypophyseal tumors (NHT) were investigated. Dopaminergic regulation of PRL, STH, TSH, LH and FSH was investigated with sulpiride (an antagonist of peripheral action) in all the patients. In acromegaly, irrespective of the presence of hyperprolactinemia, one can observe dysfunction of the central dopaminergic system (DAE) and DAE-regulation of adenohypophyseal hormones. Signs of disordered hormonal DAE-regulation are disorder of the normal ejection of PRL and pathological ejection of TSH in response to administration of DA antagonists. The results of investigations revealed both an enhanced tone of the DAE-system and insufficiency of DAE-control of hormonal secretion in patients with different hypophyseal tumors and other neuroendocrine diseases. PMID- 1780278 TI - [ECG changes in patients with type I diabetes mellitus as a function of disease duration]. AB - A study of changes on additionally intensified (I mV-50 mm) ECG of 137 patients with diabetes mellitus without clinical signs of heart involvement with a disease of various duration has shown that time and total amplitude ECG values had no statistically significant differences in several groups (with duration of disease 0-4, 5-9, 10 and more years--1st, 2nd, and 3rd groups, respectively). The results obtained were interpreted as a sign of an increased hemodynamic load of atrial myocardium, resulting from augmenting diabetic dystrophic changes in the myocardium associated with diabetes mellitus progress. PMID- 1780279 TI - [Placental ultrastructure in disturbed antenatal development of fetus and pathogenesis of these disorders in women with different types of diabetes mellitus]. AB - The paper is concerned with analysis of 819 electronograms of placenta in macrosomia, hypotrophy, diabetic phenopathy, and antenatal death of fetuses on the 37th-38th weeks of pregnancy in 39 women with different types of diabetes mellitus. Ultrastructural characterization of placenta was analyzed, as was its hormone-producing function and the infant condition at birth and a degree of maturity of his main functional systems. Discrepancy between morphofunctional criteria of chorionic ultrastructure and a period of gestation were revealed in diabetic women in abnormal antenatal development of a fetus and imperfect adaptive possibilities of an infant in the neonatal period. The results of investigation have shown that disorders of antenatal development, functional incompetence of the systems of fetal self-regulation, and imperfect adaptive possibilities of an infant seem to be associated with discordance of placental development and fetogenesis. The author puts forward a hypothesis that diabetic fetopathy results from dysfunction of the hypothalamo-hypophyseo-adrenal system, and metabolic derangement i fetal self-regulation, caused by trophoblastic morphofunctional pathology and inadequacy of chorionic compensatory reactions in women with diabetes mellitus. PMID- 1780280 TI - [Plasmapheresis in the therapy of insulin-dependent diabetes mellitus detected for the first time]. AB - Heterogeneity of the metabolic syndrome in diabetes mellitus serves as an indication for plasmapheresis in therapy of disease. The effect of plasmapheresis on the indices of carbohydrate, lipid metabolism and immune homeostasis was studied in 30 patients with primary diabetes mellitus. Microstructure of the surface of dried blood serum drops was investigated in parallel with it. The control group included 20 patients who were not given plasmapheresis and 20 healthy subjects. A positive effect of plasmapheresis on the above indices was observed. Its approximate effect on the patients blood serum composition was shown. PMID- 1780281 TI - [Physical factors in the comprehensive therapy of purulent wounds in diabetes mellitus]. AB - Various physical therapeutic methods were used in 256 patients with purulent wounds against a background of diabetes mellitus. Comparative evaluation of various therapeutic methods has shown that the use of physical factors lowers intoxication, stabilizes the blood level of glucose, improves indices of immunological reactivity, promotes a more dynamic course of a wound process, and reduces the time of treatment. Ultrasound cavitation and application of adsorbents to wounds proved to be the most effective physical methods for therapy of purulent wounds in patients with diabetes mellitus. PMID- 1780282 TI - [Role of monoamines in the pathogenesis of various forms of endocrine sterility]. AB - No doubt, the problems of pathogenesis of different types of endocrine sterility are of practical interest. Biogenic amines (dopamine, norepinephrine and serotonin) play a decisive role in the hypothalamic regulation of the sexual cycle, in the regulation of secretion and production of hypothalamic neurohormones. Disorder of the monoaminergic regulation may lie at the basis of reproductive dysfunction. A total of 40 women with hyperprolactinemia, 44 with a hyperandrogenic sterility, 40 with chronic anovulation of obscure genesis, and 20 healthy women of reproductive age (controls) were investigated. The following diagnostic methods were used: echography of the uterus and appendages, x-ray of the cranial bones, laparoscopy, determination of blood levels of FSH, LH, PRL, estradiol, progesterone, testosterone, cortisol in the follicular and luteal phases of the menstrual cycle; determination of urinary levels of dopamine, adrenalin and norepinephrine, and blood levels of serotonin. The results have shown that hyperprolactinemia and hyperandrogenemia are accompanied by disorder of monoaminergic regulation, resulting in the rearrangement of hormonal interrelationships in the neuroendocrine system. PMID- 1780284 TI - [Basic trends and analysis of inventions in the field of clinical endocrinology]. PMID- 1780283 TI - [Relative number of B-lymphocytes in endocrine opthalmopathy in patients with diffuse toxic goiter]. AB - The number of B-lymphocytes was counted in 69 patients with diffuse toxic goiter (DTG) using a new method. The relative number of B-lymphocytes was investigated before therapy, one year and 2 years after it. The patients were divided into 2 groups (48 patients with endocrine ophthalmopathy and 39 patients without it). The investigation has shown that in the patients without endocrine ophthalmopathy the relative number of B-lymphocytes did not differ from control values, whereas in the patients with endocrine ophthalmopathy their number was elevated. These differences suggested an idea of the involvement of B-lymphocytes in the process of endocrine ophthalmopathy, that was confirmed by positive correlation (r = 0.38, p less than 0.001) between the relative number of B-lymphocytes before therapy and a degree of endocrine ophthalmopathy in one year. Thus, the relative number of B-lymphocytes before therapy can serve a marker of an outcome of endocrine ophthalmopathy. PMID- 1780285 TI - [A case of chromaffinoma associated with thymoma and myasthenia]. PMID- 1780286 TI - [Errors in the diagnosis of insuloma]. PMID- 1780287 TI - [Subacute thyroiditis (De Quervain thyroiditis; lecture)]. PMID- 1780288 TI - [Urinary excretion of inorganic iodine in thyroid diseases]. PMID- 1780289 TI - [Clinical variant of the course of diabetes mellitus in a child with the syndrome of empty sella turcica]. PMID- 1780290 TI - [Atypical clinical variants of hypothyrosis]. AB - Timely diagnosis of hypothyrosis was noted in 34% of patients only. Considerable difficulties in the diagnosis of disease were associated with an atypical course of disease in a number of patients. The authors discuss some problems of a clinical picture of hypothyrosis with arterial hypertension, sympatico-adrenal crises, polyserositis, pituitary adenoma, amenorrhea-lactorrhea, premature puberty in boys; they also discuss pathogenesis of sexual advancement of a number of pubertal features in Van Wyk-Grambooh syndrome. Hennes-Ross syndrome was identified as a separate entity. PMID- 1780292 TI - [Current approaches to insulin therapy for insulin-dependent diabetes mellitus]. PMID- 1780291 TI - [The DIDMOAD-syndrome]. PMID- 1780293 TI - [Suppression of development of autoimmune thyroiditis during prolonged stimulation of T-cellular immunity]. AB - The purpose of this experiment was to investigate the suppression of autoimmune thyroiditis in guinea-pigs by prolonged stimulation of T-cellular immunity with T activin, a thymic hormone. The development of experimental autoimmune thyroiditis (EAT) at early stages was shown to be characterized by deficiency of T-cells of helper and suppressor phenotypes, hypersecretion of thyroid hormones and insignificant development of a thyroid autoimmune process. With disease development indices of peripheral blood immunity of guinea-pigs were close to normal, and the frequency and degree of lymphoid infiltration of the gland were increased in parallel with the development of hypofunction of the organ. Immuno correction of developing EAT with injections of T-activin according to our scheme resulted in a prolonged stimulation of T-cellular immunity, prevented sensitization of lymphocytes with thyroid antigens, increased secretion of the thymic hormones in parallel with a decrease in a degree of lymphoid-plasmacytic infiltration from thyroid tissues, indicating suppression of the disease. PMID- 1780294 TI - [Radiation-induced disorders of steroid-metabolizing function of the liver]. AB - A study was made of metabolic derangement of exogenous cortisol in isolated perfused liver of irradiated rats. The animals were exposed to x-radiation at doses of 2, 4, 8, 10 and 12 Gy. A 72 h irradiation was followed by decapitation and perfusion of the liver with cortisol. Cortisol and its metabolites in a perfusion medium were determined by thin-layer chromatography. Irradiation at the doses of 2 and 4 Gy resulted in no noticeable changes of steroid-metabolizing liver function. At the lethal doses of 8, 10 and 12 Gy cortisol absorption by the liver was gradually decreased and accompanied by accumulation in the perfusion medium of excessive amounts (as compared to control) of tetrahydrocortisone, cortisone, and unidentified metabolites that may be associated with disorder of their conversion at subsequent stages of metabolism. A method of selective extraction of varied polarity fractions of hydrocortisone metabolites from a perfusate has also shown that irradiation inhibits transformation of steroids into more polar compounds. PMID- 1780296 TI - [Insulin sensitivity in patients with diabetes mellitus and methods for its assessment]. PMID- 1780295 TI - [Metabolism of thyroid gland cells as affected by prolactin and emotional physical stress]. AB - A study was made of the role of prolactin (PRL) in the regulation of thyroid function in intact animals and in those exposed to stress (swimming was used as physical exercise). A single daily dose of 125 micrograms of PRL per 100 g of body mass was injected subcutaneously in 0.5 ml of saline solution during a week to male rats (control: intact rats; injection of 0.5 ml of saline solution subcutaneously). Redox enzymes; succinate dehydrogenase, lactate dehydrogenase, glucose-6-phosphate dehydrogenase, NAD.H2 and NADP.H2, ATPase and monoamine oxidase, total protein, RNA and glycogen in glandular cells were investigated histochemically 24 h after the last injection of PRL or saline, 30 min., 1, 2, 3, 5 and 7 hours after swimming or right after complete fatigue (in the presence of experimental hyperprolactinemia). A conclusion has been made that one of the most important mechanisms of the adaptive effect of PRL is its ability to suppress thyroid function, thus decreasing the metabolism level, which results in reduction of oxygen consumption and improves body tolerance to stress. PMID- 1780297 TI - [Intravascular blood coagulation in diabetes mellitus]. PMID- 1780298 TI - [Long-term results of therapy of primary hypothyroidism in relation to immune status]. AB - Disorders in the immune status of patients with hypothyroidism (idiopathic and postoperative) produce a negative effect on a course of disease. Periods of decompensation (exacerbation) develop in such patients more frequently than in patients suffering from hypothyroidism with the normally or moderately changed immune status. PMID- 1780299 TI - [Tuberculosis morbidity in high-risk groups of children]. AB - A follow-up of 2052 children has shown that the level of Mycobacterium tuberculosis contamination among the subjects frequently getting ill with ARVD is 1.5-2 times higher than among healthy ones. This parameter was 1.5-2 times higher among pyelonephritis patients than among healthy subjects. Hyperergic tuberculin reactions more often developed in children being in tuberculosis infection foci, including 58.3% from the bacillary environment. A close association of tuberculin hypersensitivity and the action of aggravating factors is often accompanied by immunity derangement. According to our data, even sufficiently adequate BCG vaccination fails to prevent local tuberculosis which develops in 1.9%. PMID- 1780300 TI - [Disability as a result of tuberculosis in newly diagnosed patients]. AB - A combination of factors conducive to disability development due to tuberculosis infection was established in 1004 newly diagnosed cases. Stable loss of their working capacity was promoted by a combination of social and medical factors. Among the social factors, the unfavourable working conditions (70%) were most significant, while among the medical ones, the process progression (44.5%) and serious functional disturbances (61.6%) were predominant. PMID- 1780301 TI - [Proposals by L.B. Shefer and A.D. Dzhunusbekov regarding incentives to promote the final results of antituberculous care]. AB - A variant of encouragement of physicians for the detection of tuberculosis patients and of physicians and patients for efficient treatment is submitted for discussion. The authors' conception, as compared to the previous one, is distinguished by relative simplicity and clearly established arrangements and conditions aimed at the material stimulation and can be applied under conditions of transition to medical care insurance. PMID- 1780302 TI - [On the paper by L.B. Shefer and A.D. Dzhunusbekov "Concept of a system of financial incentives for the final results of antituberculous care"]. PMID- 1780303 TI - [Treatment of immunodeficient conditions caused by viral infection with the Soviet immunomodulator kemantan in patients with pulmonary tuberculosis]. AB - Observation of 219 patients with pulmonary tuberculosis was made to study the effect of acute respiratory viral infection (ARVI) on the course of the disease. The affected were divided into 2 groups: 136 subjects who had ARVI and 83 persons who did not have it during their stay at a hospital. Patients with infiltrative pulmonary tuberculosis, and young and middle-aged men were prevalent in both groups. It was found that ARVI promoted the aggravation of a specific process in the lungs in 19.1 per cent of the patients. Keeping in mind a large proportion of aggravations and low immunologic indices as a consequence of ARVI, 14 patients were put on kemantan. Study of the immune status of the patients who had ARVI and received kemantan demonstrated a significant increase in the formation of blasts and the concentration of T cells whose functional activity tended to rise. At the same time the above-mentioned indices remained intact or tended to drop in patients receiving no kemantan. The Soviet immunomodulator kemantan is recommended for a combined treatment of the pulmonary tuberculosis patients who had intercurrent viral infection to stimulate cellular immune defences and prevent an aggravation of the specific process. PMID- 1780304 TI - [Effect of low-energy laser irradiation of bronchial mucosa on systemic and local immunity in patients with chronic bronchitis]. AB - The effectiveness of endobronchial low-energy laser therapy was studied in 28 patients with chronic nonobstructive bronchitis concurrent with thinning of bronchial mucosa. The course of treatment made it possible to obtain positive dynamics of most parameters of immunologic reactivity in CNB patients. Systemic immunity parameters, except for the NST and concentration of circulating immune complexes, underwent essential normalization. Marked positive changes were found in the parameters characterizing functional activity of alveolar macrophages: there was a 2.5-fold increase in adhesive properties and over 1.3-fold increase in the percentage of phagocytes. The level of secretory IgA rose significantly (by 3.5 times). Hence, a manifested therapeutic effect of this therapeutic method is mainly associated with its immune-stimulating action. PMID- 1780305 TI - [Immunomodulation in patients with cavernous kidney tuberculosis using piperazine adipinate and amniocene]. AB - Findings of a complex immunologic examination of 138 patients with active cavernous tuberculosis of the kidneys concurrent with secondary immunodeficiency are presented. Biostimulators and immunomodulating drugs were administered as conservative treatment in this case. Changes in cellular and humoral immunity indices as well as those of the mononuclear-phagocyte system before and after treatment were traced in the groups of patients receiving biogenic stimulators (such, as aloe extract, vitreous body, plasmol, Fibs) and immunoregulating drugs (like piperazine adipinate and injected amniocene). It was found that the biogenic stimulators fail to have a pronounced effect on the immunologic indices. The inclusion of piperazine adipinate and injected amniocene into a complex of antibiotic and chemotherapy brings about a significant improvement of the cellular immunity indices and the mononuclear-phagocyte system function which are inhibited to a greater extent in patients with active destructive nephrophthisis. A recommended use of piperazine adipinate and amniocene as adjuncts to a complex treatment has been proved in patients of this category by means of clinicoimmunologic correlations. PMID- 1780306 TI - [Intolerance to antituberculous drugs and methods of its elimination]. AB - The frequency of adverse reactions to antituberculous drugs was 33.6%, according to the materials of mass screening of Group I contingents of the dispensary record (259 patients) at various levels of treatment (hospital, polyclinic, sanatorium). At the polyclinic level which in all cases was nearly used after hospital, the frequency of adverse reactions was half as much as at the hospital level which was due to the use of the intermittent method and, in most cases, at least 2 drugs. The abolishing action of sodium thiosulphate, splenin, hyperbaric oxygenation and their various combinations was found to be higher than that of antihistaminics used in allergic reactions, hemodez or a 5% glucose solution applied in toxic reactions. Hemosorption and hyperbaric oxygenation are more effective for the alleviation of adverse reactions than splenin and sodium thiosulphate. Toxic reactions are better arrested by hemosorption and sodium thiosulphate, while the allergic reactions by hyperbaric in combination with splenin, sodium thiosulphate or hemosorption. PMID- 1780307 TI - [A thermo-nasal test for detecting allergy to antitubercular drugs]. AB - A diagnostic test has been suggested for the detection of the allergic-type adverse reaction to antituberculosis drugs. The drug-allergen is applied to the nasal mucosa and the temperature reaction of the alla nasi tissues is measured with the help of a mesomorphic thermoindicative film. PMID- 1780308 TI - [Osteochondral alloplasty of the humeral head in tuberculous omarthritis]. AB - Techniques of the radical surgical treatment of tuberculosis of the shoulder joint with partial of subtotal osteochondral alloplasty are discussed, which was used in surgical treatment of 22 patients between the ages of 29 and 58 years. All patients had active tuberculous omarthritis that was accompanied in 9 cases by partial and in 13 by subtotal destruction of the humeral head. The results of treatment were followed up in 21 patients in terms varying from several months to 6 years. The tuberculous process alleviated in all patients with reconstruction of the destructed head anatomical structure and shoulder joint mobility was restored. PMID- 1780309 TI - [Local enzyme therapy of an open cavern]. AB - The results of local application of the immobilized proteolytic enzyme immunozymase (USSR) for the open treatment of a cavern in 30 cases are presented. Prolonged continuous proteolysis (for about 100 hours) of the caseous-necrotic content in an open cavern with the help of the enzyme reduces the term of full cleansing of an open cavern to 7-12 days. This provides for earlier plastic intervention, in most of the cases under discussion, aimed at removing the remaining cleansed cavity, thus reducing hospital stay of patients from 6-8 to 2 4 months. PMID- 1780310 TI - [Pulmonary tuberculosis in patients with alcoholism and psychological diseases]. PMID- 1780311 TI - [Detection of gastrointestinal diseases in patients with pulmonary tuberculosis by automated screening]. PMID- 1780312 TI - [Organization of antituberculosis care under the new economic conditions]. AB - The organizational forms of antituberculosis care now applied fail to promote the achievement of better final results at minimal expenses of material and personnel resources. New principles of financing of the antituberculosis service are required as well as the assessment criteria of its activity and changes in the antituberculosis aid tactics. The principle of separate financing of long-term tuberculosis-related programs opens perspectives for the improvement of the organizational forms of antituberculosis aid. It is required that the preventive antituberculosis measures exercised among the whole population be conducted in groups of population subjected to a high risk of tuberculosis infection. PMID- 1780313 TI - [Mechanisms of development of antiproteolytic deficiency in tuberculosis and in nonspecific lung diseases]. AB - In the course of 3 series of experiments on CBA mice intravenously infected with tuberculosis and the use of bronchoalveolar washings (BAW) as a test material, it was revealed that the period of developed tuberculosis is accompanied by a simultaneous rise in antitryptic activity (ATA) and that of neutrophilic elastase (NE). The treatment of the affected animals with alpha-tocopherol, a liposoluble antioxidant, failed to prevent the loss of antielastase activity in pulmonary antiproteinases. In vitro incubation of BAW with 0.01M of ascorbic acid water soluble antioxidant completely recovered the antielastase activity in pulmonary antiproteinases and provided a three-fold increase of their ATA. As a result of clinical experience gained in the management of 30 patients with different types of chronic pulmonary pathology, ATA, NE and NE complexes with alpha 1-proteinase inhibitor were defined both in blood serum and in BAW. Concentration of these complexes and the NE indices in BAW were seen to be directly related to the content of neutrophils. In blood serum, a direct correlation of the above complexes with NE and a reverse one with ATA were traced. It is concluded that in the development of antiproteolytic deficiency in patients with tuberculosis and other types of chronic pulmonary pathology, an oxidizing inactivation of antiproteinases and their consumption during conjugation with the surplus of proteolytic enzymes have an important role to play. PMID- 1780314 TI - [Immunologic reactivity in patients with disseminated pulmonary tuberculosis with polysensitization]. AB - Study of immunologic reactivity in patients with disseminated pulmonary tuberculosis has demonstrated that 80% of patients have sensitization to Mycobacterium tuberculosis antigens, in addition to that to bacterial flora (Streptococcus, Staphylococcus, Pneumococcus). The degree of immunity system damage depends on the character of the course and dissemination of the pathologic process. Three degrees of immunity system damage were distinguished: sharply manifested degree with suppression of all types of cellular immune response and activation of humoral immunity, which is seen in patients with bilateral caseous pneumonia and military pulmonary tuberculosis; manifested degree with suppression of cellular immunity, natural organism's resistance and moderate decrease of humoral immunity typical of subacute disseminated pulmonary tuberculosis; moderate degree with mild changes in cellular and humoral immune response and natural organism's resistance and high sensitization in the lymphocyte blast transformation reaction with specific antigen, which occurs in chronic disseminated pulmonary tuberculosis. PMID- 1780315 TI - [Correlation of local immune system indices of patients with tuberculous and serous meningitis]. AB - The method of discrete-dynamic analysis was used for studying the immunity system state in 60 patients with tuberculous meningitis (TM) of various degree of severity and in 35 patients with serous meningitis of nontuberculous etiology (SMNE). A significant difference was established of the correlation between parameters in the combinations comprising lymphocytes immune to Mycobacterium tuberculosis which enables TM and SMNE differentiation. TM was characterized by a sharp increase in the number of correlations (intensity) in the parameters as compared with SMNE. Intensity significantly declines in the fatal outcome of TM as compared with this parameter in the survived patients. In SMNE local immunity state normalizes (intensity decline) in 1.5-2 months, in TM of moderate severity in 3 months and in a serious course (during the follow-up) intensity does not decline. PMID- 1780316 TI - [Protein spectrum of mycobacteria in relation to their taxonomy and resistance to antitubercular drugs]. AB - Study of the protein spectra of the mycobacteria of a different taxonomic belonging and isoniazid, streptomycin- and rifampicin-resistant strains has shown typical differences of the protein complexes of the studied strains. PMID- 1780318 TI - [Physiotherapeutic methods in the complex treatment of patients with pulmonary tuberculosis]. PMID- 1780317 TI - [Ca(2+)-dependent regulation of T-lymphocytes in experimental tuberculosis]. AB - Ca(2+)-exchange kinetics and the content of membrane and cytoplasm fractions of calmodulin in the splenic T-lymphocytes of guinea pigs with experimental tuberculosis were studied. A tuberculous process was accompanied by the changes in the Ca2+ exchange kinetics in the form of T-lymphocyte oversaturation with Ca2+ ions which in the end leads to an inhibition of the functional status of the immunity T system. PPD, a specific allergen, brought the capacity of T lymphocytes down in relation to the cellular Ca2+ exchange, presumably causing the normalization of the immune response. PMID- 1780319 TI - [AIDS in patients with tuberculosis]. PMID- 1780320 TI - [Medical rehabilitation of patients with osteoarticular tuberculosis in a sanatorium]. PMID- 1780321 TI - [Risk factors in the development of fibro-cavernous pulmonary tuberculosis and its outcomes]. AB - A number of social and clinical factors has been revealed which contribute to the development of fibrocavernous pulmonary tuberculosis in patients under the present conditions (alcoholism in 56%, inadequate treatment 52%, serious concurrent diseases 48.2%, unsatisfactory material and living conditions 51.1%). The decisive role in the development of this form of tuberculosis in subjects aged over 50 years was played by serious concurrent diseases and in younger subjects by sociomedical factors: previous staying in labour-reformatory establishments (70%) and alcoholism and narcomania (90%). PMID- 1780322 TI - Pancreatic procolipase activation peptide-enterostatin-inhibits pancreatic enzyme secretion in the pig. AB - Pancreatic procolipase, a protein cofactor for lipase, is activated by trypsin, with a simultaneous formation of colipase and a pentapeptide with the sequence Val-Pro-Asp-Pro-Arg (VPDPR). This peptide was found to significantly inhibit pancreatic protein secretion after intraduodenal infusion in pigs (2 mg/kg/h). The inhibition, amounting to 60%, occurred under base-line conditions as well as after stimulation with cholecystokinin (CCK)/secretin (1 U of each peptide/h/kg body wt). In contrast, intravenous infusion of VPDPR (0.2 mg/h/kg) did not affect pancreatic secretion. There was no significant change in the plasma levels of pancreatic polypeptide, insulin, glucagon, or glucose following intraduodenal infusion of VPDPR. It is concluded that the procolipase activation peptide might have an inhibitory function in pancreatic enzyme secretion mediated indirectly through a gut action. Therefore, the lipolytic enzymes of pancreas may also take part in the feed-back regulation of the pancreatic function. We suggest the name enterostatin for this novel regulatory peptide. PMID- 1780323 TI - Inhibitory effects of a calcium antagonist on ornithine decarboxylase induction in pancreatic cancer cell lines. AB - The calcium channel blocker verapamil has been previously shown to augment the chemosensitivity of pancreatic adenocarcinoma cell lines to doxorubicin by mechanisms other than changes in the intracellular accumulation, retention, or metabolism of doxorubicin. Because of our interest in polyamine biosynthesis and metabolism and the known involvement of calcium in the induction of ornithine decarboxylase (ODC) by serum refeeding of cultured cells, the effects of verapamil on the serum-stimulated ODC activity in two hamster pancreatic adenocarcinoma cell lines were examined. In plateau phase well-differentiated (WD) PaCa and poorly differentiated (PD) PaCa cells, a dose-dependent inhibition of the 4-h serum induction of ODC was seen at concentrations of 1, 5, and 10 microM verapamil. At the higher concentrations of verapamil, the inhibition of ODC induction was comparable to that achieved with 5 mM alpha difluoromethylornithine (DFMO, a specific enzyme inhibitor of ODC) and greater than that seen with 2 mM EGTA plus calcium-depleted serum. Log phase PD PaCa cells, included for comparison, showed less ODC induction with serum and lesser degrees of inhibition of the response to serum refeeding with verapamil, DFMO, and calcium depletion. No direct inhibition of the ODC enzyme was found when verapamil was added at the time the activity was measured. Based on our present data, a possible influence of intracellular calcium pools in the verapamil effect on ODC activity is unclear. Nevertheless, the present findings suggest that verapamil's effects on cytotoxicity may be mediated (at least in part) by inhibition of the serum-mediated induction of ODC. PMID- 1780324 TI - Prolonged maximal stimulation of insulin secretion in healthy subjects does not provoke preferential release of proinsulin. AB - Release of immature secretory granules rich in incompletely processed proinsulin has been proposed to explain the relative hyperproinsulinemia in type 2 diabetic and insulinoma patients because of a constant secretory drive resulting from hyperglycemia and autonomous secretion, respectively. To test this hypothesis, insulin secretion was stimulated by a combination of hyperglycemia (11 mmol/L clamp), intravenous (i.v.) tolbutamide (1 g), and i.v. glucagon (initial bolus 10 micrograms/kg body weight, maintenance infusion 2 micrograms/kg body weight per hour) for 3 h. Circulating IR-insulin and IR-C-peptide concentrations increased 89-fold and 14-fold over basal values, respectively, but IR-proinsulin concentrations increased only ninefold over basal values. Estimation of the amount of insulin secreted (based on deconvolution analysis of plasma C-peptide values) showed that approximately 76 +/- 21 U were secreted during the stimulation period. This amount is a significant proportion of pancreatic insulin content in normal humans. In molar terms, IR-proinsulin (integrated incremental response multiplied by metabolic clearance rate of proinsulin) relative to IR-C peptide (= insulin) secretion (deconvolution analysis) was estimated to be equal or even lower than the known proportion in islets (0.22 +/- 0.05%). Thus, using a near-maximal stimulation of insulin secretion maintained long enough to cause release of amounts of insulin approaching the estimated pancreatic content, no preferential release of proinsulin was observed in normal humans. Therefore, the hyperproinsulinemia of type 2 diabetes and in insulinoma patients may be caused by additional defects in the proinsulin to insulin conversion process. PMID- 1780325 TI - Effect of nerve blockade on pulsatile insulin and glucagon secretion in vitro. AB - We recently reported that the secretion of insulin and glucagon by isolated murine islets is pulsatile and suggested that the pacemaker controlling these hormone oscillations is present in the islet. In the present study, we tested the hypothesis of an intrinsic islet neural controlling mechanism for the observed hormone pulsatility. Nerve blockade was attempted by infusion of tetrodotoxin (TTX) on a background of combined adrenergic and cholinergic blockade with atropine, propranolol, and phentolamine, (ATX). Because TTX acts by blocking Na+ channels, we also studied the effects of other cationic channel manipulations on the amplitude and frequency of the oscillations. The normal frequency and amplitude of glucagon and insulin oscillations were not affected by ATX. In contrast, TTX infusion increased the amplitude of insulin (198.6 +/- 20.9 vs. 507.2 +/- 62.8 pg/min, p less than 0.05, n = 4) and shortened the period from 5.03 +/- 0.26 to 3.33 +/- 0.0 min without affecting glucagon cycles. Whereas the Ca2+ ionophore A23187 had no effect on either hormone oscillation, the ATP sensitive K+ channel blocker glyburide only increased the amplitude of insulin and decreased the amplitude of glucagon, without altering the frequencies. These data suggest that an intrinsic autonomously functioning islet nervous system is the pacemaker for the insulin oscillations and that the control of glucagon cycles differs from that of insulin. PMID- 1780326 TI - Further morphological and biochemical observations on early low dose streptozocin diabetes in mice. AB - Conflicting published data regarding the role of macrophages and other cell types during the early stages of diabetes mellitus led us to further study this problem. To this end we diabetized mice, using low doses of streptozocin (STZ), 40 mg/kg body wt/day/5 days, and processed their pancreatic tissue for immunocytochemistry and ultrastructural observations; immunohistochemistry was performed on days 5 and 18 after the first STZ injection, and islets were observed ultrastructurally on days 5, 9, 10, and 18. Animals were tested for fasting serum glucose, and isolated islets were assayed for insulin secretion capacity. Immunohistology demonstrated that expression of major histocompatability complex class 2 antigens is strongly induced by multiple, low dose STZ treatments prior to impaired insulin release, and that different types of cells within the islet are capable of expressing Ia molecules. Ultrastructurally we found (a) a small number of macrophages (most probably resident monocytes/macrophages) containing B-cell debris, that were located close to either damaged or intact B cells; (b) a large number of recruited macrophages in a vascular or perivascular position; and (c) macrophages recognizable in the exocrine portion, close to the islets, occasionally containing exocrine cell debris. This led us to believe that recruited macrophages play an important role in the early islet-infiltrating stage. PMID- 1780327 TI - Effect of octreotide, a long-acting somatostatin analogue, on plasma amino acid uptake by the pancreas. AB - Octreotide (SMS 201-995) is a long-acting somatostatin analogue that inhibits exocrine pancreatic secretion and that has been proposed for treatment of various pancreatic disorders. To gain more information about the mechanism by which octreotide inhibits pancreatic enzyme secretion, we studied the effect of this compound on plasma amino acid uptake by the pancreas in six healthy volunteers aged 22-29 years. Pancreatic amino acid uptake was assessed by measuring plasma amino acid concentration before and during pancreatic enzyme synthesis stimulation with cerulein (50 ng/kg/h). The infusion of cerulein caused a significant decrease (p less than 0.001) in plasma amino acid concentration. The subcutaneous injection of octreotide at dosages of 12.5, 25, and 50 micrograms prevented this decrease in a dose-dependent manner. The decrease in amino acid concentration reached a maximum of 19.4 +/- 2.4% during cerulein infusion and a maximum of 10.7 +/- 2.5, 6.8 +/- 1.2, and 2.9 +/- 1.2% (means +/- SD) when cerulein was preceded by injection of octreotide at 12.5, 25, and 50 mg, respectively. These results indicate that octreotide is able to inhibit the plasma amino acid uptake by pancreatic acinar cells and, consequently, synthesis of pancreatic enzymes. Clinically, this effect could be useful in treatment of pathologic conditions of the pancreas in which it is desirable to suppress acinar cell activity and avoid accumulation of enzymes in acinar cells. PMID- 1780328 TI - Route of access of secretin into rabbit duodenal lumen during acid perfusion. AB - The route of entry of immunoreactive secretin into the duodenal lumen during acid perfusion is unknown. Possible sites include paracellular diffusion from the extracellular space, transapical secretion from S cells, or leaching from cells damaged by the perfusate. Antisecretin in the extracellular space and interstitium should reduce access due to paracellular diffusion from the interstitium without significantly affecting secretion or leaching. We therefore studied the effect of intravenous antisecretin antibody on luminal secretin output. Two groups of rabbits received either intravenous normal rabbit serum (controls) or antisecretin antibody, before perfusing a closed segment of duodenum with hydrochloric acid. Preliminary experiments established that duodenal perfusion with HCl concentrations below 0.025N produced no apparent mucosal damage on electron microscopy. HCl concentrations above this significantly damaged the mucosa. In the control group, perfusion with 0.01N, 0.0125N, and 0.025N hydrochloric acid resulted in a dose-dependent increase in secretin in the perfusate. Secretin output was markedly reduced in the group injected with secretin antibody. Antisecretin antibody significantly reduced bile flow at all levels of HCl concentration in the duodenal perfusate. These data suggest that luminal secretin is probably derived from the interstitium and travels to the lumen across narrow paracellular channels. PMID- 1780329 TI - Index of the protein sequences added in 1990 to the Protein Sequence Database of the International Association of Protein Sequence Databanks. Volume 4, Numbers 3 5, 1991. PMID- 1780330 TI - Morphogenesis of the brain and craniofacial complex in trisomy 16 mice. PMID- 1780332 TI - Neuro-cutaneous interactions in embryonic development: implications for medical dermatoglyphics. PMID- 1780331 TI - Chondroitin sulfate proteoglycans: do they play a role during cardiac morphogenesis? PMID- 1780333 TI - Enhanced resistance effect of piracetam upon hypoxia-induced impaired retention of fixed-interval responding in rats. AB - Rats were trained on a fixed-interval schedule of 60 s (FI 60). After stabilization of performance, rats were chronically submitted to hypoxic treatment (3.5% O2, 10 min) once a day, immediately after the daily FI 60 session. Hypoxia disturbed the retention of FI responding. It was mainly characterized by a decrease in response rate and in pause duration, and by changes in the temporal distribution of responses. Animals receiving piracetam (100 mg/kg, IP) 30 min before each FI session followed by hypoxia were significantly less affected than saline-treated animals. Results are discussed with reference to the effects of hypoxia and piracetam on nonspecific factors and on memory function. It is suggested that the effects of piracetam are due to alleviation of hypoxia-induced memory retrieval deficit rather than to a protection against hypoxic brain cell injury. PMID- 1780334 TI - Effects of nicotine, caffeine, and their combination on locomotor activity in rats. AB - The interactive effect of caffeine and nicotine on spontaneous locomotor activity in a tunnel maze was determined in nicotine-naive and nicotine-tolerant rats. Rats were daily injected subcutaneously for 12 days with nicotine (0.4 mg/kg) to induce nicotine tolerance. Nicotine-naive rats were injected with saline. During the next two days, they were exposed to a tunnel maze for two 6-min trials. On the third day, locomotor activity was measured (30-min trial) in the tunnel maze 15 minutes after subcutaneous injection of saline, nicotine (0.2 mg/kg), caffeine (8 mg/kg), or nicotine (0.2 mg/kg) and caffeine (8 mg/kg) in combination. Acute exposure to nicotine decreased locomotor activity in nicotine-naive rats. This decrease was antagonized by simultaneous injection of caffeine. Chronic nicotine exposure induced the development of tolerance to the acute behavioral depressive effects of nicotine. In nicotine-tolerant rats, caffeine and nicotine in combination significantly increased locomotor activity above saline level, whereas given alone they had no significant stimulant effect. Neither chronic nicotine treatment nor acute drug treatments affected exploratory efficiency of rats. PMID- 1780335 TI - Nicotine yield as determinant of smoke exposure indicators and puffing behavior. AB - Relationships between machine smoking nicotine yield and different smoke exposure indicators were investigated in a cross-sectional study. For each of the four yield classes H (1.0-1.2 mg), M (0.7-0.9 mg), L (0.4-0.6 mg) and U (0.1-0.3 mg) 18 male and 18 female subjects were recruited. The experimental design (2 x 2) included smoking with lip contact or with a flowmeter holder, natural smoking of one cigarette or forced smoking (30 puffs). The analysis of presmoking measures revealed for plasma nicotine H greater than L, U; M greater than U, for plasma cotinine H, M greater than U, and no differences for respiratory CO. Pre- to postsmoking boosts of CO and nicotine increased with yield, but the differences were smaller than those in yield. This partial compensation can be attributed to puffing behavior as revealed by the differences between yield classes with respect to flowmeter measures (puff volume, flow parameters, number of puffs). Contact condition hardly influenced the results. Forced puffing revealed down regulation mechanisms in smoke absorption and, less pronounced, in puffing behavior. Cardiovascular and subjective effects were widely independent of yield. Plasma cotinine appeared as the best smoke exposure indicator, due both to its high retest reliability and its relationship to nicotine yield. PMID- 1780336 TI - Modulation by peripheral serotonin of the threshold for sexual reflexes in female rats. AB - Using immunohistochemical techniques, a large number of serotonergic paracrine cells were identified in the urethral mucosa of the female rat. The functional significance of these cells was investigated. A model for the study of sexual climax in the anesthetized, acutely spinalized female rat was used. In this model, distension of the urethra with saline elicits a stereotyped coordinated genital response which closely resembles the neuromuscular concomitants of sexual climax. Addition of serotonin to the urethral perfusate (10(-4)-10(-7) M) caused a dose-dependent decrease in the mechanical threshold necessary to elicit the climax-like response. This effect was blocked by a specific 5-HT3 receptor antagonist. The physiological implications of these findings are discussed. PMID- 1780337 TI - Influence of anticholinesterase on distribution of ventilation and gas exchange. AB - This project was designed to titrate the influence of pyridostigmine injected intraarterially on pulmonary resistance and gas exchange in pigs and dogs. Pyridostigmine at 1 mg/kg reduced red blood cell cholinesterase activity 28-35% that was not significantly reduced further with doses up to 9 mg/kg. Plasma cholinesterase was reduced by 80% in the dog and 40% in the pig with 1 mg/kg of pyridostigmine and with 3 mg/kg it was reduced to 40% in the pig and 10% in the dog. Higher doses had no further significant effect. Breathing resistance (cm H2O/l/s) in the pig was doubled as a linear function with 9 mg/kg pyridostigmine. In the dog, breathing resistance went to a maximum of 8 cm H2O/l/s from a control value of 1 cm H2O/l/s with 3 mg/kg of pyridostigmine but did not go higher with doses up to 9 mg/kg. PaO2 was reduced by approximately 20% in the pig and 15% in the dog with pyridostigmine doses of 6-9 mg/kg. These experiments indicate that significant alterations in pulmonary function do not occur until acute dosages in the range of 3-6 mg/kg are reached. Furthermore, acute administration of large doses of pyridostigmine results in salivation and gastrointestinal stimulation well in advance of any impairment of respiratory function. PMID- 1780338 TI - Forebrain noradrenaline concentration following weakly reinforced training. AB - Day-old chicks trained on a single-trial discriminated passive avoidance task using a concentrated taste aversant, methyl anthranilate, have been shown to exhibit three stages of memory processing; short-, intermediate-, and long-term memory. If the aversant is diluted to 20% v/v methyl anthranilate in absolute ethanol, only the short-term and some of the intermediate stage are observed. In this study we investigated the whole forebrain levels of noradrenaline in response to differing intensities of the training experience. The results show a profound difference in the level of whole forebrain NA at all training-sacrifice intervals for the trained as compared to the untrained controls, except at 15- and 20-minute posttraining, when a substantial reduction in the level of NA was achieved under all training conditions. Furthermore, subjects which received treatments which resulted in the emergence of behavioural evidence of long-term memory tended to have higher levels of whole-forebrain NA at 30 minutes after initial training. This is the time when we have postulated that triggering of protein synthesis associated with long-term memory formation takes place. PMID- 1780339 TI - Smoking behavior in low-yield cigarette smokers and switchers in the natural environment. AB - Urinary cotinine and puffing parameters were studied in 36 smoking students. Three smoking groups, formed according to the tar content of their preferred cigarette, were compared. Eighteen students had always smoked low-yield, 10 medium-yield and 8 were switchers from medium- to low-yield cigarettes. The subjects smoked their preferred brand (the first week), low-yield cigarettes (the second week) and medium-yield cigarettes (the third week). Day urine samples were collected for cotinine analysis during the two last days of the test weeks. Puffing indices were reported on the last day of every test week with a portable microcomputer assisted analyzer with flowhead cigarette holder. Urinary cotinine concentrations were rather constant within the groups, but lower among the low yield cigarette smokers as compared to the switchers (p less than 0.05). Also the female smokers had lower cotinine concentrations than the male smokers (p less than 0.05). The compensatory behavior seen in every smoking group while they were smoking low-yield cigarettes was based on up-regulation in single puff volume, puff duration and total smoking time when compared to values with medium-yield cigarettes. The correlation between cotinine concentration and diurnal puff volume (1/day) was poor. It is concluded that the benefit possibly gained with low-yield cigarettes is not long lasting. PMID- 1780340 TI - Failure of naltrexone to affect the pleasantness or intake of food. AB - Two separate studies were conducted to investigate the effects of oral naltrexone on the pleasantness ratings of foods and food intake. In both studies, normal weight, nondieting males rated hunger, fullness, mood and the pleasantness of the taste of a variety of foods before and after double-blind administration of 50 mg of naltrexone or placebo. All subjects received a test meal, in a counterbalanced, repeated measures design. In the first study, 12 subjects were given a self-selection test meal after overnight deprivation. In the second study 14 subjects were given an ice cream test meal with no deprivation. In both experiments the pleasantness of the taste of the foods, sensory-specific satiety, hunger ratings and overall energy intake were not differentially influenced by naltrexone administration. In Experiment 2, intake of the ice cream was greater after active drug administration because subjects who received active drug on the first session ate less ice cream in the placebo session. In conclusion, in the short term, naltrexone had no impact on hunger, sensory-specific satiety or food intake. PMID- 1780341 TI - Effects of prenatal diphenhydramine exposure on dopaminergic function in adult rats. AB - Female pregnant rats were treated with 20.0 mg/kg diphenhydramine (DPH) or the same volume of saline solution (NaCl 0.9%), SC, daily during pregnancy. As adults, male pups were tested for stereotyped behavior in response to apomorphine (1 mg/kg, SC) administration. No differences between DPH-exposed and control rats were evident. In another group of rats, dopamine (DA) and homovanillic acid (HVA) levels were quantified in striatal samples. DA levels were equivalent, but increased levels of HVA were observed. Based upon these data we suggest that prenatal exposure to DPH, a histamine (H1) receptor antagonist, reduces presynaptic dopaminergic mechanisms without altering postsynaptic dopaminergic function in adulthood. PMID- 1780342 TI - Effects of acute and chronic morphine on food intake in rats: modulation by oxytocin and vasopressin. AB - The effects of acute and chronic morphine administration and the interaction with oxytocin and vasopressin on food intake response were investigated at various intervals during a 24-h schedule in rats. Acute morphine (5 mg/kg, IP) produced a generalized hyperphagic effect in both light (0-6 h) and dark (6-24 h) phases, the most marked effects being at 0-1 h, 1-3 h and 6-24 h. Chronic morphine (7 days) in an escalating dose schedule (5-35 mg/kg/day) produced (a) an enhancement of the hyperphagic effect in the light phase and (b) an attenuation of the food intake response during the dark phase. Neither oxytocin nor vasopressin had any significant influence on food intake, per se, after either acute or chronic administrations. However, both OXY and AVP reduced the hyperphagic response to acute morphine throughout the 24-h observation period. Further, on chronic administration, both neurohypophyseal peptides blocked the enhancements of morphine-induced hyperphagia (reverse tolerance) during light phase, whereas only vasopressin was effective in attenuating the reduction of hyperphagia (tolerance) during dark phase. These results are discussed in light of complex opiate oxytocin/vasopressin interactions in the regulation of food intake. PMID- 1780343 TI - Role of adenosine in sleep and temperature regulation in the preoptic area of rats. AB - We have examined the effects on sleep and brain temperature of bilateral microinjections of adenosine and adenosine analogs to the preoptic area (PO) of rats. Administration of adenosine (12.5 nmoles), a nonselective adenosine A1/A2 receptor agonist NECA (N-ethyl-carboxamido-adenosine, 1.0 nmole), and the selective adenosine A1 receptor agonist CPA (cyclopentyladenosine, 0.25, 0.5 nmoles) increased total sleep primarily through an enhancement in deep slow-wave sleep (SWS2), while adenosine also increased REM sleep. Administration of 12.5 nmoles adenosine and 0.25 nmoles CPA did not affect brain temperature, while 1.0 nmole NECA and 0.5 nmoles CPA caused a transient and prolonged hypothermia, respectively. Administration of the selective adenosine A2 receptor agonist CV 1808 (2-phenylaminoadenosine, 5, 10 nmoles) had no effect on sleep or brain temperature. The present results demonstrate a site for the central hypnotic action of adenosine, and a functional role for adenosine A1 receptors in the hypothalamus. PMID- 1780344 TI - Cocaine self-administration in pigeons. AB - Pigeons with chronic indwelling intravenous catheters responded under a multiple schedule of food and cocaine presentation. In one component, responding was maintained by food presentation under a fixed-ratio (FR 50) schedule, whereas in the other component, responding was maintained under the same schedule by IV infusions of cocaine (0.03 or 0.1 mg/kg/injection). A 30-s timeout followed each cocaine infusion. Components alternated after 3 presentations of either food or cocaine, and each session was terminated after 18 cocaine infusions or 2 h, whichever occurred first. In general, under baseline conditions, the response rate was higher in the food component than in the drug component. Under control conditions where saline was substituted for cocaine, the response rate gradually decreased across sessions, while food-maintained responding was generally unaffected. Substituting doses lower or higher than the training dose decreased the rate of cocaine-maintained responding. Food-maintained responding only decreased at higher doses of cocaine. When blackout periods were substituted for the food component (Experiment 2), the response rate in the cocaine component decreased and then stabilized at levels well above zero. Saline substitution on this baseline produced a further decrease in the rate of FR responding. In Experiment 3, the effects of pretreatment with haloperidol (0.056 or 0.1 mg/kg) on both food- and cocaine-maintained responding were examined using a multiple schedule similar to that used in Experiment 1. Each dose was given for a period of 7-10 days. In general, haloperidol dose-dependently decreased both the overall rate of cocaine-maintained responding and the percent of available reinforcers obtained, while having little or no effect on food-maintained responding. This research indicates that cocaine can serve as a reinforcing stimulus for maintaining self-administration behavior in pigeons, and that this behavior is sensitive to antagonism by haloperidol. PMID- 1780345 TI - Conditioned tolerance to the anorectic and corticosterone-elevating effects of nicotine. AB - We have shown that tolerance to the behavioral effects of nicotine is partially dependent on conditioned environmental cues that predict drug delivery. The present research extends this finding to physiological effects of nicotine by assessing both the appetite-suppressing and adrenocortical-activating effects of nicotine, as measured by plasma corticosterone (CORT). In the first study, male rats on a 22-h food deprivation schedule were injected daily with 0.33 or 0.66 mg/kg (free base) of nicotine bitartrate or saline in a distinctive environment and tested for milk intake. Nicotine initially suppressed milk intake and tolerance developed over 10 days. Changing cues associated with drug administration partially reversed tolerance since injection of nicotine in a new environment reduced milk intake of tolerant animals. Similarly, animals who repeatedly received nicotine in one environment exhibited CORT levels lower than rats injected for the first time, and this tolerance also was partially reversed when administration occurred in the new environment. The second experiment indicated that the increased CORT of Experiment 1 was not a stress response associated with injecting animals in a different environment. These results indicate that tolerance to both behavioral and neuroendocrine effects of nicotine is influenced by conditioning. PMID- 1780347 TI - Antidepressants reverse the inhibition of shock-induced aggression elicited by a prior inescapable shock. AB - Animals were exposed to long-duration inescapable shock (IS) and six days later submitted in pairs to a foot-shock session in order to induce shock-elicited aggression (SIF). Shocked rats subsequently displayed a lower aggressive response as compared to unshocked animals. This reduction was prevented by repeated treatment with different antidepressant drugs administered either prior or following IS exposure. In addition, rats chronically administered with antidepressant drugs before the IS showed less inactivity during the application of the uncontrollable aversive event. These data indicate that persistent administration with these pharmacological compounds prevent the induction and impede the further expression of the reduced aggressive response induced by a previous IS. PMID- 1780346 TI - The effect of ofloxacin on pentobarbital-induced sleep in mice. AB - There have been several reports that insomnia occurs in some patients who receive ofloxacin. Since almost no experimental data on ofloxacin-induced insomnia were available, this study was conducted for the evaluation of ofloxacin effects on sleep parameters in mice. In Experiment 1, mice were pretreated with ofloxacin (20 or 40 mg/kg IP) or saline 15 minutes before sodium pentobarbital (35 mg/kg IP). Experiment 2 was carried out in two days. On the first day mice were treated twice, in the morning and in the evening, with ofloxacin (20 or 80 mg/kg IP) or saline. On the second morning, mice were pretreated with the same doses of ofloxacin or saline 15 minutes before sodium pentobarbital (35 mg/kg IP). Sleep latency and sleeping time were recorded in each experiment. Results showed that ofloxacin had no apparent effect on sleep latency, but caused a shortening in sleeping time. However, this effect was significant only in the 40 and 80 mg/kg ofloxacin-treated groups. PMID- 1780348 TI - Roman strains as a psychogenetic model for the study of working memory: behavioral and biochemical data. AB - Performances of male rats of the Roman High- (RHA), Roman Control- (RCA) and Roman Low- (RLA) Avoidance strains were compared in two working memory tests, a spatial one, the radial maze, and a nonspatial one, an object recognition test. The same rats were subjected to measures of emotional reactivity and of different forms of motor activity and finally to measures of cholinergic and aminergic activities in the hippocampus, frontal cortex and striatum. Compared to RHA, RLA performed better in the two working memory tests, displayed "anxiety" and had also lower levels of exploratory locomotor activity. Hippocampal ChAT activity was higher in RLA than in RHA. Levels of DA and DOPAC in the striatum were higher in RLA compared to RHA, whereas in the frontal cortex they were lower. For most of these measures, RCA were intermediate between RLA and RHA. These results confirm and extend the finding that the Roman strains are not only a genetic model for two-way avoidance conditioning but also for working memory. PMID- 1780349 TI - (-)threo-chlorocitric acid decreases sham feeding of sucrose in rats. AB - The contribution of changes in rate of gastric emptying to the anorectic effect of (-)-threo-chlorocitric acid (chlorocitrate) was assessed by examining the effect of this drug in sham feeding rats, a preparation where gastric distention does not occur. Gavage administration of chlorocitrate (100-400 mg.kg-1) decreased sham and real feeding of 20% sucrose in a dose-related manner. In sham feeding rats, the minimal effective dose was 200 mg.kg-1. The anorectic effect was evident at 60 min after 200 mg.kg-1 and 30 min after 400 mg.kg-1. In real feeding rats, the minimal effective dose was 100 mg.kg-1 and for all doses tested the effect was apparent at the 15-min time point. In a second experiment, the effect of chlorocitrate (100-400 mg.kg-1) on gastric emptying of 20% sucrose was examined. Chlorocitrate (200 and 400 mg.kg-1) had a modest but significant inhibitory effect on gastric emptying; however, the effect was not dose-related. Inasmuch as chlorocitrate decreased sham feeding, its anorectic effect cannot be solely attributed to inhibition of gastric emptying. However, because chlorocitrate was more potent in the real-feeding condition relative to sham feeding, and the time course of the response in the two feeding conditions was different, part of chlorocitrate's anorectic effect may depend on postingestive cues such as gastric distention. PMID- 1780350 TI - Effect of naltrexone upon self-injurious behavior, learning and activity: a case study. AB - Naltrexone significantly attenuated self-injurious behavior in a 20-year-old mildly retarded autistic male patient. The patient was videotaped daily and behavior was evaluated with a time-sampling procedure. Behavioral ratings of SIB frequency, SIB severity, and activity were collected automatically with a computerized system. Learning and memory were tested on a weekly basis with a modification of a paired associate learning test (PALT). Treatment with naltrexone resulted in (a) attenuation of SIB in the unstructured setting and (b) improvements in learning and memory without influencing activity levels. PMID- 1780351 TI - ICS 205-930 and feeding responses to amino acid imbalance: a peripheral effect? AB - Serotonin3 (5-HT3) receptor antagonists (ICS 205-930 and MDL 72222) have been shown to block or ameliorate the anorectic response of the rat to amino acid imbalanced (IMB) diets. Two experiments were conducted to determine whether the effects of these antagonists are mediated through central or peripheral 5-HT3 receptors. In Experiment One, ICS 205-930 (ICS) was injected centrally, into either the lateral ventricle (doses: 0.3 pmol to 10 nmol), or the cisterna magna (62 nmol). The intake of rats fed an isoleucine IMB diet was not affected by these injections. In Experiment Two, rats received an IP injection of either saline, ICS, or a quaternized derivative of ICS (Q-ICS) that should not cross the blood-brain barrier. Both ICS- and Q-ICS-injected rats ate significantly more (p less than 0.05) IMB diet than saline-injected rats. Intake of IMB diet was not different (p greater than 0.4) between ICS and Q-ICS groups. From these results, it appears that ICS restores intake of IMB through a peripheral component. PMID- 1780352 TI - Effects of single and repeated marijuana smoke exposure on fetal EEG. AB - The effect of single and repeated marijuana smoke exposure on fetal EEG was investigated in the chronic fetal lamb model using power spectral analysis. Maternal inhalation of marijuana smoke (n = 9) resulted in a significant reduction in total power and power distribution in the delta (1-4 Hz) band, and an increase in power distribution in the faster frequencies in the first h after smoke inhalation. These EEG changes were not observed following maternal inhalation of placebo smoke (n = 5), nor in animals with 3-5 prior exposures to marijuana smoke (n = 5). These results suggest that the effects of marijuana smoke exposure on fetal EEG is short-lived and tolerance develops rapidly with repeated exposure. PMID- 1780353 TI - Phthalocyanine-induced photodynamic changes of cytoplasmic free calcium in Chinese hamster cells. AB - Exposure to light of Chinese hamster cells preloaded with chloroaluminum phthalocyanine causes an immediate increase of cytoplasmic free calcium, [Ca2+], from about 0.2 microM to 1 microM within 5 min after illumination. This increase was dose-dependent within the biological dose range, reaching a plateau at a dose that kills 99.5% of the cells. Fluoride addition prior to light exposure protected against cell killing and reduced the increase of [Ca2+]i. These findings raise the possibility that changes in [Ca2+]i after photodynamic treatment may be relevant to cell killing and/or other biological responses of the cells, e.g. release of eicosanoids. PMID- 1780354 TI - Demonstration that phosphorescent 6-bromo-2-naphthyl sulfate can be used to probe heme accessibility in heme proteins. AB - The phosphorescence properties of 6-bromo-2-naphthyl sulfate (BNS) in aqueous solution were studied. The phosphorescence lifetime is several hundred microseconds and is self-quenched. Although a fluorescent photoproduct is formed from BNS, it does not interfere with the decay properties of triplet-state BNS and its utility as a probe of the accessibility of the heme group in heme proteins. Quenching of BNS phosphorescence does not occur for the non-heme protein lysozyme and apomyoglobin but occurs by a dynamic mechanism with a quenching constant of 1-2 x 10(9) M-1 s-1 for cytochrome c and myoglobin and with a quenching constant of 6.2 x 10(9) M-1 s-1 for protoporphyrin IX. The phosphorescence of an inclusion complex of 1-bromonaphthalene and beta cyclodextrin is not quenched by heme-containing proteins. The temperature and viscosity dependencies of the rate with which BNS phosphorescence is quenched by microperoxidase-11 are consistent with unit quenching efficiency. These results indicate that quenching of BNS phosphorescence occurs only upon contact with the quencher, and the quenching constant can be used to assess the degree of accessibility of the heme group. PMID- 1780355 TI - Comparative photoactivity of tin and zinc porphyrin inhibitors of heme oxygenase: pronounced photolability of the zinc compounds. AB - Metalloporphyrin inhibitors of heme oxygenase may also have photosensitizing properties in vivo. To assess photoactivity in serum, the relative ability to mediate photooxidation of tryptophan or other oxidizable targets, presumably by singlet oxygen production, was measured for tin mesoporphyrin, zinc mesoporphyrin, and zinc deuteroporphyrin bisglycol in aqueous solution and when bound to human serum albumin. While tin mesoporphyrin sensitized at the greatest initial rate in aqueous solution, the zinc compounds sensitized at a greater initial rate in detergent micelles or when bound to albumin. There was minimal alteration of the tin mesoporphyrin during the time course of illumination in the Soret or visible absorption regions. The zinc compounds, however, proved to be extremely photolabile and were extensively destroyed by light; the photooxidized forms were found to be ineffective as inhibitors of heme oxygenase. PMID- 1780356 TI - Sites and efficacy of photodamage by tin etiopurpurin in vitro using different delivery systems. AB - Photosensitization by tin etiopurpurin (SnET2) was determined in cell culture using sensitizer dissolved in ethanol or solubilized via three different delivery systems: Cremophor EL, gamma-cyclodextrin or Molecusol (a more water-soluble cyclodextrin derivative). Sensitizer uptake was substantially more efficient when the delivery systems were employed, in terms of intracellular level needed to lethally photosensitize cells. We observed photodamage at both membrane and mitochondrial loci, but the former was better correlated with loss of viability. PMID- 1780357 TI - DNA breaks caused by monochromatic 365 nm ultraviolet-A radiation or hydrogen peroxide and their repair in human epithelioid and xeroderma pigmentosum cells. AB - The induction and repair of DNA single-strand breaks (SSB) assayed by alkaline filter elution was compared in human epithelioid P3 and xeroderma pigmentosum (XP) cells exposed to monochromatic 365-nm UV-A radiation and H2O2. Initial yields of SSB were measured with the cells held at 0.5 degrees C during exposure. The yield from exposure to 365-nm radiation was slightly greater in XP than in P3 cells, whereas H2O2 produced more than three times as many SSB in P3 compared with XP cells. o-Phenanthroline (50 mM) markedly inhibited the yields of SSB induced in XP cells by H2O2, but had no effect on those produced by 365-nm UV-A. These results are consistent with the fact that P3 cells, unlike XP cells, have undetectable levels of catalase. The measured production of trace amounts of H2O2 by the actual 365-nm UV-A exposures was not sufficient to account for the numbers of breaks that were observed. Single-strand breaks produced by both agents were completely repaired after 50 min in P3 cells, as were H2O2-induced SSB in XP cells. However, 25% of the 365-nm UV-A-induced SSB in XP cells remained refractory to repair after 60 min. The results show that SSB produced by these two agents are different and that 365 nm radiation produces most SSB in cells by mechanisms other than by production of H2O2. PMID- 1780358 TI - Chronic ultraviolet radiation-induced increase in skin iron and the photoprotective effect of topically applied iron chelators. AB - In the skin of albino hairless mice (Skh:HR-1) there is a basal level of non-heme iron. Chronic exposure of mice to sub-erythemal doses of ultraviolet (UV) B radiation results in an increased skin level of non-heme iron. The iron increase may be the result of a UVB radiation-induced increase in vascular permeability, which we measured in vivo with the dye marker Evans Blue. We also observed greater non-heme iron in sun-exposed vs non-exposed body sites of human skin, suggesting that similar events occur in man. Iron may have a role in skin photodamage by participating in formation of reactive oxygen species. These species have been implicated in skin photodamage. It is known that iron can contribute to oxygen radical production by acting catalytically in the formation of species such as hydroxyl radical. While the basal level of skin iron may be available for catalysis, the elevated iron content of UV-exposed skin increases the potential for iron-catalyzed radical production. Topical application of certain iron chelators to Skh albino hairless mice dramatically delayed the onset of UVB radiation-induced skin photodamage. Non-chelating analogs provided no significant protection. PMID- 1780359 TI - Simultaneous establishment of monoclonal antibodies specific for either cyclobutane pyrimidine dimer or (6-4)photoproduct from the same mouse immunized with ultraviolet-irradiated DNA. AB - Six new monoclonal antibodies (TDM-2, TDM-3, 64M-2, 64M-3, 64M-4 and 64M-5) specific for ultraviolet (UV) induced DNA damage have been established. In the antibody characterization experiments, two TDM antibodies were found to show a dose-dependent binding to UV-irradiated DNA (UV-DNA), decrease of binding to UV DNA after cyclobutane pyrimidine dimer photoreactivation, binding to DNA containing cyclobutane thymine dimers, and unchanged binding to UV-DNA after photoisomerization of (6-4)photoproducts to Dewar photoproducts. These results indicated that the epitope of TDM monoclonal antibodies was the cyclobutane pyrimidine dimer in DNA. On the other hand, four 64M antibodies were found to show a dose-dependent binding to UV-DNA, unchanged binding to UV-DNA after cyclobutane pyrimidine dimer photoreactivation, undetectable binding to DNA containing thymine dimers, and decrease of binding to UV-DNA after photoisomerization of (6-4)photoproducts. These results indicated that the epitope of 64M antibodies was the (6-4)photoproduct in DNA. This is the first report of the simultaneous establishment of monoclonal antibodies against the two different types of photolesions from the same mouse. By using these monoclonal antibodies, we have succeeded in measuring both cyclobutane pyrimidine dimers and (6-4)photoproducts in the DNA from human primary cells irradiated with physiological UV doses. PMID- 1780360 TI - Biochemical changes in hairless mouse skin collagen after chronic exposure to ultraviolet-A radiation. AB - Evidence is mounting that UV-B and UV-A radiation affect skin differently in responses as diverse as erythema and elastosis. We found in this study that collagen metabolism was also differentially affected. Albino hairless mice were irradiated with two UV-A sources: (1) UVASUN 3000 (340-400 nm) for cumulative exposures of 4000 and 8000 J/cm2; (2) a xenon solar simulator filtered to provide full spectrum UV-A (320-400 nm) and long wavelength UV-A (335-400 nm) for cumulative exposures of 3000 and 4000 J/cm2 respectively. Collagen was isolated from other skin proteins by acid extraction, pepsin digestion and salt precipitation. Collagen types I and III were separated by interrupted gel electrophoresis. Ultraviolet-A rendered the collagen highly resistant to pepsin digestion. In age-matched controls only 16-18% of the total collagen remained insoluble, whereas in long wavelength UV-A-irradiated skins the insoluble fraction was as high as 87%. A dose response was noted at 4000 and 8000 J/cm2 as delivered by the UVASUN. Recovery of collagen from the pepsin soluble fraction was low in all UV-A groups and the amount of type III so small that determination of ratios of type III to I collagen was unreliable. These results suggest that chronic UV-A radiation may increase cross-linking of dermal collagen. PMID- 1780361 TI - Age-related changes in the fluorescence of melanin and lipofuscin granules of the retinal pigment epithelium: a time-resolved fluorescence spectroscopy study. AB - The photophysical properties of purified populations of melanin and lipofuscin granules from human retinal pigment epithelium, and their changes with donor age, have been investigated using high-sensitivity time-resolved fluorescence spectroscopy techniques with picosecond gating capabilities. The overall fluorescence intensity of both melanin and lipofuscin granules clearly increased with increasing donor age, the increase being most marked for melanin. In all granule populations the fluorescence decays were multiexponential with subnanosecond and nanosecond decay components. The resultant time-integrated and time-gated spectra also exhibited marked age-variations for each type of granule. Young melanin showed spectral patterns similar to those of bovine melanin, while a yellow-orange fluorescence band appeared in melanin samples from older age groups. Lipofuscin granules exhibited a blue, a yellow and an orange band whose relative amounts were age-related. The results demonstrate the potential of time resolved techniques for discriminating fluorophores in vitro and in situ, and have confirmed results previously obtained using extraction techniques. Furthermore, the ability of this technique to identify and quantify individual fluorophores within granules may provide an important insight into the origin and development of lipofuscin within the retinal pigment epithelium and ultimately into the mechanisms of age-related retinal diseases. PMID- 1780362 TI - Spectroscopic observation of solvent interaction with selected retinal Schiff bases. AB - Iodide salts of several N-retinylidenedialkylamines were prepared and their UV VIS spectra recorded. Their lambda max values increased as the number of hydrogen atoms on the carbons alpha to nitrogen increased. In separate experiments, iodide salts of N-retinylidene-n-butylammonium (1) and N-retinylidene-n butylmethylammonium (2) were prepared, and their excitation energies (delta E) were measured in selected solvents of varying dielectric constant (epsilon). Data from each compound gave a straight line which converged at epsilon = 0. On the other hand, when delta E values of the iodide and bromide of 2 were plotted vs solvent epsilon, parallel rather than convergent lines were obtained. When lambda max values of 1 and 2 were measured in a greater number of solvents, the solvents fell into four main groups. The first group, regular solvents, are rigid, have fixed dipoles, neither donate nor accept H-bonds, and the delta E of 1 and 2 decreases linearly as solvent epsilon increases. This line for 2 is taken as a standard against which other solvents are judged. A second class of solvents that are good H-bond donors like CHCl3, whose dipole moment coincides with the C-H bond axis, is located in an area below the standard line. A third group, nucleophilic solvents like tetrahydrofuran, whose dipole moment is coincident with a strongly nucleophilic oxygen atom are good H-bond acceptors and are found above the standard line. Solvents with unpredictable spectroscopic behavior are classed as anomalous. PMID- 1780363 TI - Ultraweak light emission from rat liver nuclei. AB - An extremely weak native light emission from rat liver nuclei was detected and studied using a highly sensitive single photon counting system. This emission is oxygen dependent and we attribute it to (per) oxidative processes. The effects of deuterium oxide and 1,4-diazabicyclo-[2.2.2] octane on the light emission suggests the possible involvement of singlet oxygen. The kinetic features of the underlying reactions including biphasic response to both oxygen and temperature changes, could be clearly discerned. Further study of this light emission can serve as a useful adjunct to biochemical investigations of oxidative processes which play an important role in mutation, carcinogenesis and aging. PMID- 1780364 TI - Excited-state properties of the alternating polynucleotide poly(dA-dT).poly(dA dT). AB - Measurements of the steady-state fluorescence spectrum and anisotropy, r, of the alternating polynucleotide poly(dA-dT).poly(dA-dT) were carried out in order to characterize its photophysical properties at room temperature. The shape of the fluorescence spectrum depends on the excitation wavelength, namely, the relative fluorescence intensity of the short-wavelength peak decreases for excitation at short wavelengths. When monitoring the emission at short wavelengths, r is 0.18 and independent of the excitation wavelength. When monitoring the emission at long wavelengths, however, r is very low, about 0.03. These results suggest that: (i) the short-wavelength emission stems from thymine; and (ii) the long wavelength emission stems from an excited-state complex (excimer), with the same one being formed regardless of whether thymine or adenine is excited. The corresponding fluorescence spectra have been resolved. The occurrence of transfer of electronic energy is discussed. PMID- 1780365 TI - Subnanosecond single photon timing measurements using a pulsed diode-laser. AB - The convenient and inexpensive use of a pulsed diode-laser (Hamamatsu Photonics PLP-01 660 nm) is demonstrated as a low cost alternative to a standard pulsed laser or gas discharge flash system in a commercial time-correlated single photon counting instrument. Fluorescence lifetimes of compounds of photobiological interest such as phytochrome, chlorophyll a, 1,1'-diethyl-4,4' carbocyanine iodide (DCI/cryptocyanin),5,10,15,20-tetra(p-phenyl) porphyrin and stentorin I are presented using the pulsed diode-laser source. PMID- 1780366 TI - The interaction of pseudohalides with the phospholipid head-group: a nuclear magnetic resonance study. AB - Liposomes have been studied by means of high-field magnetic resonance techniques. The choline N+(CH3)3 group showed two proton resonances for phosphatidylcholine whereas the addition of a charged species to the phospholipid resulted in a single N+(CH3)3 resonance. Upon the addition of either of two linear pseudohalide anions, the two resonances for phosphatidylcholine were further split whereas for the mixture of lipids containing a charged species, the single head-group resonance was now split. The presence of a negative charge on the liposome does not prevent the anion-liposome interaction observed for neutral liposomes. Incorporation of cholesterol into the negatively charged liposomes results in a clear initial splitting of the head-group proton signal in a manner very similar to that for neutral liposomes; this head-group signal is then further split upon anion addition. The small splitting involved suggests a weak pseudohalide liposome interaction whose magnitude depends on the position of the anion in the lyotropic series. The phosphorous NMR signal from the head-group is unaffected by the pseudohalide interaction whereas the carbon signals from the N+(CH3)3 groups are affected, indicating that the initial anion interaction is localized to the region of the choline groups of the liposome. After the initial exposure of the liposome to the anion, however, the splitting decreases with time, indicating that the anions have entered the liposome and interact with both inside and outside head-groups. PMID- 1780367 TI - Exhalation of metallic mercury by acatalasemic, hypocatalasemic and normal mice exposed to metallic mercury vapor. AB - In order to elucidate the amounts of metallic mercury exhaled from mice having different amounts of catalase activity, normal, homozygous hypocatalasemic and acatalasemic mice were exposed to radioactive metallic mercury vapor at three levels of concentrations (0.072, 0.144, and 0.297 mg/m3). The timed and cumulative amounts of metallic mercury exhaled from the mice were used to classify them, in the descending order, as being acatalasemic, hypocatalasemic, and normal at the three environmental mercury concentrations. The statistical differences in the mean values among the acatalasemic, hypocatalasemic, and normal mice were calculated by the use of one-way ANOVA and multiple comparison of the mean values by Tukey's method. The mean values of the timed amounts of exhaled metallic mercury were found to be significantly different (P less than 0.05) among the three kinds of mice several hours after exposure, and those of the cumulative amounts of exhaled metallic mercury were in the descending order of acatalasemic, hypocatalasemic and normal mice, and were significantly different among the three types of mice almost over the entire time course. Thus, negative correlation coefficients were obtained between the logarithms of the catalase activity in the lungs and the blood, and the logarithms of the cumulative amounts of exhaled metallic mercury. PMID- 1780369 TI - [Plasma amitriptyline level and its therapeutic effectiveness in patients with affective disorders]. AB - 57 patients treated with amitriptyline because of depressive syndrome in the course of affective disorder were studied. The drug level in plasma was measured weakly using a gas chromatograph. A non-linear correlation between the amitriptyline level in plasma and the clinical effect of the treatment was substantiated. The range of therapeutic effectiveness was determined between 68.0 and 185.0 ng/ml. PMID- 1780368 TI - The kinetics of chemical reaction of activated nitrosamine with organic substrates. AB - The chemical reaction of tosylated N-nitrosobis (2-hydroxylpropyl) amine with aniline, 1-naphthol, pyridine, and hydroxylamine follows kinetics which can be described in a mixed order rate equation. This nitrosamine, considered an activated nitrosamine with a potential for alkylating a substrate, was seen to alkylate aniline, pyridine, 1-naphthol, and hydroxylamine. The presence of salts in the solution as well as an increase in solution pH increased the rate of reaction of the nitrosamine with substrates. The nitrosamine reacts quickly with water but will not react with solvents such as acetonitrile, dimethylsulfoxide, and methylene chloride. PMID- 1780370 TI - [Social adaptation of patients with bipolar disorder in relation to the problems of alcoholism (pilot studies)]. AB - 89 patients (52 women and 37 men) with bipolar affective disorder was separated on two groups: with alcohol problems (n = 30) and without alcohol problems (n = 59). Both groups were tested using Scale of Adaptation and Activity of Puzynski (SAA III). The bipolar affective illness discriminates patient's social functioning (especially married life and emotional relation to the closest relatives). The bipolar patients with alcohol problems did show worse social adaptation than the other group; it concerns mainly masculine patients. PMID- 1780371 TI - [Personality characteristics in students at risk of alcoholism]. AB - The aim of the study was to establish personality traits differentiating between persons endangered with alcohol habituation and those that did not abuse alcohol. With Engs rating scale 225 men and 73 women in danger of alcohol habituation were found among a group of 1255 students. Significant differences in the adaptation level of the affected group--as compared to the unaffected group--were found using MMPI. The differences concerned mainly the lack of emotional stability, poor self-control, high level of hostility and low tolerance to frustration. PMID- 1780372 TI - [Psychiatric and psychological aspects of anorexia nervosa]. AB - A group of 38 patients treated in the Department of Psychiatry, Medical Academy of Gdansk, from 1972 to 1988, because of anorexia nervosa (0.33% patients treated in the Department) was studied. There was 36 women and 2 men aged 14 to 39 years (average 21 years). Half of the patients finished only secondary school, the others started university education--most of them were still students. Except one, they presented good intellectual abilities; 6 women were married. In 42% cases a conflict situation at school or family was found (adaptational problems, competition at home); in 18% cases problems with acceptance of the role of woman. In 25% cases minimal brain damage symptoms were found in the EEG and psychologic tests. In the rest of the cases neurotic traits were present--the schizophrenic process was not found at all. Frequently the patients did show fearful attitude, difficulties with emotional relation towards other persons, egocentrism; a tendency to use regression, resignation, repression, over intellectualism and conversion as defence mechanisms. The pharmacological and psychotherapeutic treatment did results in clinical improvement (weight gain, mood and sleep normalization, reduced anxiety) in all cases studied. PMID- 1780373 TI - [Cultural factors and schizophrenic symptoms; comparative studies in Malta and in Poland]. AB - A study of 120 cases of schizophrenia in Poland and 80 in Malta. Clinical analysis have showed differences of the symptomatology as well as of the content of the delusions and hallucinations, treatment and prognosis as a result of the cultural, racial and social pathoplastic influences. In comparison with Polish the Maltese schizophrenics had less described and less systematized productive symptoms. PMID- 1780374 TI - [Is homosexuality a deviation?]. PMID- 1780376 TI - [The place of electroconvulsive therapy in the treatment of mental disorders]. PMID- 1780375 TI - [Clinical usefulness of monitoring serum levels of imipramine and desipramine in patients treated for endogenous depression]. AB - Fifteen patients with endogenous unipolar and bipolar depression were treated with imipramine and, if necessary, one of benzodiazepine or neuroleptic. Total serum concentrations of imipramine (IMI) and its active metabolite desipramine (DMI) were measured in steady-state by FPIA method . Severity of depression was assessed using the Hamilton Depression Rating Scale. IMI + DMI serum concentration monitoring appeared to be useful in every case. It helped to arrive more quickly at the optimal dosage, confirmed the suspicion of overdosage or noncompliance. In nonresponders group, it helped with the earlier decision of changing brands of tricyclic antidepressant or it contributed to intensify the diagnostic process which detected the additional pathology. PMID- 1780377 TI - [Effect of delayed-action Mirenil (Polfa) on the hypothalamic function in patients with schizophrenia]. AB - Hormonal tests--TRH, ITT and L-RH--were performed in 10 cases of paranoid schizophrenia before the paranoid deterioration and after--on average--ten months of treatment with fluphenazine depot injection. The drug did show a clear modulating effect on the mechanisms regulating secretion of gonadotrophins and prolactin --it did not effect the secretion of thyrotropin , thyroxine, triiodothyronine, cortisol, growth hormone or insulin . PMID- 1780378 TI - [Psychotherapy and the patient]. PMID- 1780379 TI - [A case of fear of AIDS]. PMID- 1780380 TI - [XYY syndrome from the viewpoint of child psychiatry]. PMID- 1780381 TI - Training general psychiatry residents in child and adolescent psychiatry. AB - The authors describe the nature of current social and economic forces impacting on the education and future practice of general psychiatry residents in child and adolescent psychiatry. They review theoretical and practical reasons for training in child and adolescent psychiatry, analyze the form and content of what is currently taught based on a national survey of general training programs, and suggest guidelines for the training and postgraduate practice of general psychiatrists in evaluating and treating children and adolescents. The authors conclude that while social and economic changes necessitate general psychiatrists' clinical involvement with children and adolescents, insufficient general training may necessitate postgraduate education and supervision. They pose ethical and professional dilemmas for the field in meeting the national shortage of child and adolescent psychiatrists and propose strategies to enhance recruitment into child and adolescent residency training. PMID- 1780382 TI - Research and clinical training in psychiatry: inputs and outputs. AB - The interactive relationship between scientific advance and clinical training is increasingly important and complex in the field of psychiatry. Advances in the biological and behavioral sciences offer an unprecedented wealth of research opportunities in an atmosphere of increasing public and political support for psychiatric research. The continuing diminution of resources for clinical training in psychiatry adds to the complexity of this relationship. By discussing the diverse research opportunities and their impact on clinical training, reviewing science policy issues and support for research over the past several decades, and suggesting strategies for recruitment of psychiatric researchers, this paper highlights psychiatry's need to define new methods for training clinicians who can understand and utilize research findings, as well as create a conduit for recruitment of a new generation of psychiatric investigators. PMID- 1780383 TI - Regulatory influences in residency education. PMID- 1780384 TI - The evolution of psychiatric subspecialties. PMID- 1780385 TI - Certification and recertification. AB - The American Board of Psychiatry and Neurology issues certificates for psychiatrists in general psychiatry, child and adolescent psychiatry, and added qualification in geriatric psychiatry. It will issue a certificate in added qualification in clinical neurophysiology in 1992. An application for a certificate in added qualification in addiction psychiatry is currently under review by the American Board of Medical Specialties. The American Psychiatric Association has requested that the ABPN consider forensic psychiatry for an added qualification. All new subspecialty certificates will have a ten year time limit. Beginning on October 1, 1994, all certificates will be time-limited. Time-limited certificates will lead to the requirement for recertification. Current requirements for certification are reviewed and strategies for planing for recertification are discussed. PMID- 1780386 TI - Psychiatry's future: facing reality. AB - U.S. public and private health care costs, including mental health treatment costs, continue to rise at unacceptably high annual rates of increase. "Basic" health insurance plans presently being developed by both public and private payers, in response to this crisis, will include: (1) severely limited coverage for psychiatric care; and (2) coverage for specific categories of serious mental illness. Psychiatrists must develop cost-effective goals and treatment standards that achieve satisfactory outcomes for these high-priority conditions. Treatment standards must be compatible with economic reality. Psychiatry as a profession (i.e., all psychiatrists) must accept cost-effective treatment responsibility for society's most seriously mentally ill individuals. We need to train psychiatrists who are biologically-, crisis-, and rehabilitation-oriented and who can practice effectively and comfortably within society's treatment expectations and funding constraints. PMID- 1780387 TI - Social and economic influences on psychiatric education: a commentary. AB - This issue of Psychiatric Quarterly is dedicated to psychiatric educators and psychiatric education. The authors contributing to this special publication are committed to the pursuit of excellence in education and in the clinical application of current knowledge. Because psychiatry encounters turbulence at its boundaries and encroachments on its roles in society, the psychiatric educational process struggles to adapt to society's concerns and expectations, while at the same time continuing to emphasize the development of clinical excellence for trainees. PMID- 1780388 TI - Forty year trends in selecting a psychiatric career. AB - Since 1950, between three and ten percent of American medical school graduates selected psychiatric careers. Until 1989, the direction of the ratio of medical school applicants to acceptance was the best predictor for medical school graduates entering psychiatry; a declining ratio predicts more students become psychiatrists. The decrease in number of graduates selecting psychiatry for 1989, 1990 and 1991 suggest new factors may be influencing career decisions. Women continue to select psychiatry in a greater proportion than men. In an attempt to understand the historical context of these trends and suggest implications and actions for the next decade, this paper presents data on the psychiatric career choice of U.S. medical school graduates beginning with the medical school graduates of 1950. PMID- 1780389 TI - The influence of the curriculum in psychiatry residency education. AB - Extraordinary economic forces are influencing graduate medical education in this country. Federal, state, and third party cost containment efforts, managed care, medical student loan indebtedness, and decreasing governmental and industry enthusiasm to support residency training are producing significant external pressures on academic health centers, recruitment into psychiatry, and on the practice of psychiatry. Other pressures on the psychiatry residency curriculum are being generated from the rapid expansion in our scientific knowledge base in clinical psychiatry and the influence of subspecialization. The future psychiatrist will be trained for a life long career in continuing education to accommodate for the explosive scientific contributions to our field. The residency training program will promote the ability to think scientifically, to teach others, to administrate and lead, and to achieve clinical competence in a more rigorous fashion. Regardless of the number and forms of emerging practice settings, it is best to train our residents for flexibility through emphasizing fundamental clinical and scientific excellence. PMID- 1780390 TI - Cortical circumferential profile of SPECT cerebral perfusion in Alzheimer's disease. AB - We developed a semiautomatic method termed "cortical circumferential profiling" for objective analysis of cerebral cortex function in emission tomographic neuroimaging studies. This method treats cortex as a continuous ring near the outer brain edge. A computer algorithm samples the cortex at 60 contiguous, equiangular locations, using 1-cm2 samples. These values are plotted as a function of cortical angle to produce the cortical circumferential profile. This method was used in a study of regional cerebral perfusion in 15 patients with Alzheimer's disease and 8 elderly control subjects using N-isopropyl[I-123] iodoamphetamine. Cortical circumferential profiling decreases variability, examines the entire cortex within slices at preselected levels above the orbital meatal line, and facilitates intrasubject and intersubject comparisons. PMID- 1780391 TI - Topography of the quantitative electroencephalogram in dementia of the Alzheimer type: relation to severity of dementia. AB - Conventional electroencephalographic (EEG) frequency bands and peak frequency were investigated in patients with probable dementia of the Alzheimer type (DAT). Measures of EEG topography and activity were also related to the severity of dementia, as assessed by neuropsychological tests. EEG activity measured in conventional frequency bands proved to be the most sensitive parameter for the quantitative differentiation of DAT, whereas the topography of peak frequency was the better qualitative discriminator between healthy subjects and DAT patients. PMID- 1780392 TI - Changes in glucose metabolism in dementia of the Alzheimer type compared with depression: a preliminary report. AB - We evaluated positron emission tomography (PET) in the differential diagnosis of depression and Alzheimer's disease. The local cerebral metabolic rate for glucose (LCMRGlc) in the parahippocampal gyrus-hippocampus and the dorsolateral prefrontal cortex were determined. The ratio of the LCMRGlc in those two regions was examined in patients with unipolar depression, bipolar depression, and Alzheimer's dementia. An analysis of variance revealed significant overall intergroup differences in values for both hemispheres. Student's t test showed significant differences in LCMRGlc for both unipolar and bipolar depression as compared with Alzheimer's dementia. These data indicate that PET may be useful in the differential diagnosis of dementia vs. depression. PMID- 1780393 TI - Gadolinium-DTPA enhanced gradient echo magnetic resonance scans in first episode of psychosis and chronic schizophrenic patients. AB - Ten male schizophrenic patients underwent Gadolinium-DTPA (Gd-DTPA) enhanced magnetic resonance (MR) imaging to determine the utility of paramagnetic contrast agents in evaluating neuropathology. MR images enhanced by Gd-DTPA demonstrated no defect in the integrity of the blood-brain barrier. PMID- 1780394 TI - Evaluation of a brief psychological treatment for emotional disorders in primary care. AB - A randomized trial in general practice compared: (i) a brief psychological treatment (problem-solving) given by a psychiatrist; (ii) any treatment of the GP's choice, whether psychological or pharmacological. The patients had recent onset emotional disorders of poor prognosis. Patients in the problem-solving group showed significantly greater reductions in symptoms. Problem-solving as given by a psychiatrist was feasible in primary care and acceptable to patients. Problem-solving is now being evaluated as given by general practitioners trained in the method. PMID- 1780395 TI - Demoralization and gender differences in a kibbutz. AB - Gender differences in demoralization (depressive symptoms) were examined in a first-ever true prevalence study conducted in a kibbutz. The unusual organizational arrangements of this commune, where women have achieved higher levels of equality than in most other societies, offered a laboratory-like opportunity to test the psychosocial factors imputed as a partial explanation for the higher rates of demoralization in women. Demoralization was studied using the 27-item scale of the Psychiatric Epidemiology Research Interview (PERI) in all of the adult population of a single kibbutz. The response rate was close to 95%. Univariate and multivariate analyses were conducted to assess the effects of key sociodemographic and kibbutz-related variables on gender differences. The results showed that women had higher mean scores and rates even after these variables were controlled. The female:male demoralization ratio was well within the range of results obtained in non-socialist Israeli urban settings. The paper concludes with a discussion on the tentative relevance of the study results for the interpretation of the 2:1 female-male ratio of depression found in the epidemiological literature. PMID- 1780396 TI - Attributions of common somatic symptoms. AB - Three studies explored the causal attributions of common somatic symptoms. The first two studies established the reliability and validity of a measure of attributional style, the Symptom Interpretation Questionnaire (SIQ). Three dimensions of causal attribution were confirmed: psychological, somatic and normalizing. The third study examined the antecedents and consequences of attributional style in a sample of family medicine patients. Medical and psychiatric history differentially influenced attributional style. Past history and attributional style independently influenced clinical presentations over the subsequent 6 months. Symptom attributional style may contribute to the somatization and psychologization of distress in primary care. PMID- 1780397 TI - The contribution of list length to the absence of the primacy effect in word recall in dementia of the Alzheimer type. AB - It has repeatedly been demonstrated that patients with dementia of the Alzheimer type (DAT) show an absence of the primacy effect when asked to recall a list of items. The results of the present study show that the absence of the primacy effect in DAT patients is related to list length but probably in a way that is qualitatively not specific since it follows the same pattern as in normal ageing. It is also demonstrated that DAT patients differ in learning style. It is suggested that this indicates a reduced capacity to maintain controlled processing. PMID- 1780398 TI - Dimensions of functional social support and psychological symptoms. AB - In the summer following graduation a sample of 125 female college graduates (mean age = 28) completed Cohen & Wills' ISEL (1985) which includes scales measuring four social support functions: belonging (social companionship), appraisal (availability of confidants), tangible (instrumental), and self-esteem support. In the summer and fall subject status on two outcome scales was ascertained: the Psychophysiologic Symptom Scale and the Center for Epidemiologic Studies Depression Scale (CES-D). Reliability of the difference scores suggested that the ISEL scales do not measure entirely different constructs and the ISEL Self-esteem Scale is operationally redundant with the Rosenberg Self-esteem scale and the CES D. Cross-sectional analyses indicated that the ISEL scales were related to symptoms. By contrast, standard longitudinal and prospective MLR analyses indicated that only the Belonging Scale was significantly related to future symptoms. The issues of confounding support with symptoms and the dimensionality of the subscales were discussed. The study suggests that specific functions of support take on greater importance during major life transitions and that any one supportive behaviour often serves multiple functions. PMID- 1780400 TI - The many faces of human ageing: toward a psychological culture of old age. AB - In an effort to distil major findings about the nature of human ageing, seven propositions are presented as a guiding frame of reference. This propositional framework is then used to specify some conditions for a positive culture of old age and to advance one possible model of good psychological ageing. This model focuses on the dynamic interplay between three processes: selection, optimization, and compensation. The model is universal in its basic features, but at the same time emphasizes individual variations in phenotypic manifestation. PMID- 1780399 TI - Prevalence of mental disorders in Sardinia: a community study in an inland mining district. AB - Using standardized interviews 374 subjects randomly selected among people living in two villages in a mining district in Sardinia (Italy), were studied. Of these, 57 subjects (15.2%) were identified as 'cases'. Ten per cent of the sample was affected by a depressive syndrome and 4% by an anxiety disorder. Females were significantly more at risk for anxiety disorders, while a trend towards a major risk for depression emerged among middle-aged and elderly people. Of the sample 9.8% were taking benzodiazepines, with a significant over representation of females. Depressed subjects took benzodiazepines more frequently than anxious subjects, while the use of antidepressants was negligible. PMID- 1780401 TI - Long-latency auditory event-related potentials in schizophrenia and in bipolar and unipolar affective disorder. AB - Long-latency auditory event-related potentials were examined in 96 subjects with schizophrenia, 99 with bipolar affective disorder and 48 with major depressive (unipolar) disorder, and compared with 32 in-patient and 213 normal controls. The latency of the P3 component was significantly greater in the schizophrenic and bipolar subjects compared to other groups. The difference was stable with respect to clinical state at the time of testing and was not due to age differences or the effect of psychotropic medications. The results support the clinical distinction between bipolar and unipolar affective disorders, but also show that P3 change is not specific to schizophrenia and found in bipolar but not unipolar affective disorder. PMID- 1780402 TI - Dysphoric mood and symptomatology in schizophrenia. AB - The relationships between depression, anxiety and positive and negative symptoms of schizophrenia were examined in a study of 95 schizophrenic patients who were receiving out-patient care. Various measures of depression and anxiety showed a pattern of interrelationships which suggested that they were measuring a general state of dysphoria rather than separate dimensions of anxiety and depression. Dysphoria was found to be more reliably related to level of positive symptomatology than to negative symptoms. PMID- 1780403 TI - Psychiatric, neurological and medical aspects of misidentification syndromes: a review of 260 cases. AB - Two hundred and sixty case reports of misidentification syndromes were evaluated. One hundred and seventy-four patients had a Capgras syndrome misidentifying other persons, 18 a Fregoli syndrome, 11 intermetamorphosis, 17 reduplicative paramnesia and the rest had other forms or combinations of mistaken identification. Schizophrenia (127 cases), mostly of paranoid type, affective disorder (29), and organic mental syndromes including dementia (46) were the most common diagnoses in patients who misidentified others or themselves. The patients with reduplicative paramnesia more frequently suffered from head trauma or cerebral infarction and showed more features of right hemisphere lesions on neuropsychological testing or CT scan than the patients with other misidentification syndromes. Forty-one case-reports implicated underlying medical conditions. Forty-six of the patients were reported to show violent behaviour. The misidentification of persons can be a manifestation of any organic or functional psychosis, but the misidentification of place is frequently associated with neurological diseases, predominantly of the right hemisphere. Misidentification syndromes show a great degree of overlap and do not represent distinctive syndromes nor can they be regarded as an expression of a particular disorder. These patients deserve special diagnostic and therapeutic attention because of the possible underlying disorders and their potentially dangerous behaviour. PMID- 1780404 TI - Cognitive impairment and dementia in Parkinson's disease: a controlled study. AB - The performance of 47 patients with Parkinson's disease on a battery of tests of cognition, motor function, disability and mood was compared with the performance of 47 healthy control subjects who were matched to the patients on the basis of age, sex and pre-morbid IQ. An increased prevalence of impairment over a range of cognitive functions was observed in the Parkinson's disease patients as compared with their matched controls. The differences between the Parkinson's disease patients and controls could not be accounted for by factors such as depressed mood, effects of medication or motor impairment. Our findings are discussed in relation to the methodology of previous studies in this area and to the need for a comprehensive clinico-pathological longitudinal study. PMID- 1780405 TI - The validity of the diagnosis of mild dementia. AB - Five operational methods for clinical diagnosis of mild dementia were compared to find out their diagnostic concordance when applied to a single group of seventy five subjects. The clinical validity of the diagnoses was assessed in terms of their capacity to predict continued cognitive deterioration over three years after diagnosis and their capacity to reject the diagnostic influence of 'non dementia' factors (that is, the cognitive consequences of depression, poor intellect, limited education and non-neurological physical illness). By all criteria of clinical validity the diagnostic methods for mild dementia performed poorly. Kappas measuring agreement between methods averaged only 0.15 and up to 57% of diagnostic deviance was explained by 'non-dementia' factors. Prediction of continued deterioration was poor, with a false positive rate which was too high for the diagnoses to be clinically usable. By no criterion of validity did the diagnostic methods exceed the performance of a clinician's judgement of the presence of pathological cognitive impairment or diagnosis by a cutpoint on the Mini-Mental State Examination. PMID- 1780406 TI - Is age kinder to the initially more able? A study of eminent scientists and academics. AB - Elderly eminent academics and blue-collar workers were compared with Doctor of Philosophy students and trade apprentices to investigate whether intelligence and memory deteriorate at a slower rate in persons with high ability. The elderly groups showed decline on tests of perceptual-motor speed, visuospatial reasoning, inferential thinking and memory relative to the young subjects. Initial ability determined the level of intellectual performance, such that elderly academics maintained their initial advantage over the elderly blue-collar workers. However, with the exception of the Similarities subtest of the Wechsler Adult Intelligence Scale, the rate of change on tests of memory and intelligence did not differ for the high- and low-ability groups. The hypothesis that high ability is associated with a slower rate of cognitive decline was not supported. PMID- 1780407 TI - Psychophysiological anomalies in children with emotional and conduct disorders. AB - We studied patterns of psychophysiological (skin conductance, heart rate) reactivity to sounds and to situations with varying emotional and alerting connotations in child psychiatric outpatients and in healthy controls. Children with emotional disorders were particularly reactive to situations with aversive components, while conduct disorder subjects showed increased reactivity to pleasant situations and decreased responses to neutral but high-intensity stimulation and to withdrawal of stimulation in silence periods. The results indicate patterns of biological reactivity which may underlie different psychiatric disturbances in children. PMID- 1780408 TI - Talents and preoccupations in idiots-savants. AB - The question was asked whether a diagnosis of autism or a tendency to repetitive behaviour and preoccupation with a restricted area of interest, were crucial features of idiot-savant talents. Answers by caretakers to a questionnaire on these topics revealed that autistic and nonautistic savants resembled each other closely in preoccupation but differed from controls matched for IQ and diagnosis. In addition, the mentally handicapped showed fewer repetitive tendencies than did autistic controls. It is concluded that independent of diagnosis, preoccupations and repetitive behaviour appear to be closely associated with the manifestation of idiot-savant talents. PMID- 1780409 TI - Four-year follow-up of teacher-reported problem behaviours. AB - This study investigated the stability and change in teacher-reported problem behaviours across a four-year period. An epidemiological sample of 811 children aged 4-12 at the initial assessment was assessed twice with the Achenbach Teacher Report Form (TRF). We found medium stability in the level of TRF total problem scores. Highest stability was found for aggressive and other externalizing behaviours. Stability was higher for girls than for boys. Of the girls who could be regarded as disturbed at base line, 50% could still be so regarded four years later, whereas only 23% of the boys could be considered persistently disturbed across the study interval. Girls' scores on the Externalizing syndrome were especially stable. PMID- 1780410 TI - Suicides and suicide attempts in cancer patients. AB - Suicides and suicide attempts in cancer patients were analysed by following all patients treated for cancer in Stockholm County from 1975 to 1985. Among 59,845 patients we identified 144 suicides and 196 suicide attempts during the follow up, which represents a more than two-fold excess mortality from suicide and a moderately increased rate of suicide attempts. Although the absolute number of deaths from suicide in cancer patients is low, the increased risk highlights the problems of coping with severe illness and the need for psychological and social support in cancer care. PMID- 1780411 TI - Does recurrent depression lead to a change in neuroticism? AB - The hypothesis that recurrent or chronic depressive illness produces a long-term change in neuroticism was examined in a sample (N = 34) from a consecutive series of 89 depressed patients admitted to the Maudsley Hospital in 1965/6. The Eysenck Personality Inventory (EPI) was administered at the time of the index illness both when the patients were depressed and on recovery, and then again at follow up 18 years later. The change in the neuroticism (N) score over the 18-year period was compared in good and poor outcome groups defined variously by a global rating of outcome, frequency of episodes, extent of subsequent hospitalization and the presence or absence of subsequent chronicity. The mean N score for the sample as a whole did not change significantly over the 18 years, and no differential change in the N score was observed between any of the good and poor outcome groups. Thus, the hypothesis was not supported. PMID- 1780412 TI - Work stress, family stress and depression in professional and managerial employees. AB - Detailed interviews were conducted with 1523 married professional and managerial employees of a major US corporation to test associations of acute and chronic occupational and domestic stress with DSM-III-R major depression and current depressive symptoms. After controlling for demographic and clinical risk factors, both sources of stress were significantly associated with the two measures of depression. On the other hand, neither the demographic and clinical risk factors, nor several psychosocial characteristics (social support, sense of mastery and organizational commitment) moderated the relationship between stress and depression. PMID- 1780413 TI - Use of recombinant inbred strains to identify quantitative trait loci in psychopharmacology. AB - Unlike simple Mendelian characteristics, individual differences in complex quantitative phenotypes studied in psychopharmacology are generally distributed continuously and are likely to be influenced by many genes. Recombinant inbred (RI) strains are valuable not only for their traditional use of detecting major gene segregation and linkage but also for identifying associations between quantitative traits and quantitative trait loci (QTL) that account for relatively small amounts of variation in phenotypes as well as loci that account for greater amounts of variation. When applied to published data on genetic markers and on amphetamine, alcohol, and morphine responses in BXD RI strains (RI strains developed from the cross between C57BL/6J and DBA/2J progenitor inbred strains), the RI QTL approach identified several significant associations beyond known major gene effects. Together, significant associations explain more than half of the genetic variance for these measures. The RI QTL approach is especially valuable for investigating the QTL underpinnings of genetic correlations among measures. It is recommended that psychopharmacogenetic research focus on the BXD RI strains. The cumulative and integrative nature of such a program of research is the major benefit of the RI QTL association approach for molecular genetic analysis of psychopharmacological processes, their physiological infrastructure, and their interface with other behavioral and biological systems. PMID- 1780414 TI - Blockade of the discriminative stimulus effects of ethanol with 5-HT3 receptor antagonists. AB - The ability of selective 5-HT3 receptor antagonists to block the discriminative stimulus effects of ethanol was investigated in pigeons trained with food reinforcement to discriminate ethanol (1.5 g/kg; IG) from water. The 5-HT3 receptor antagonists that are substituted tropines, ICS 205-930 (0.1-0.56 mg/kg) and MDL 72222 (3.0-17.0 mg/kg), blocked ethanol-appropriate responding, in a dose dependent manner, suggesting that some of the discriminative stimulus effects of ethanol are mediated via the 5-HT3 receptor. The blockade the discriminative stimulus effects of ethanol occurred in the presence of approximately 25-40 mM blood ethanol levels. Furthermore, the ethanol dose-effect function was shifted to the right by increasing doses of MDL 72222, suggesting a surmountable antagonism of the discriminative stimulus effects of ethanol. However, the benzamide zacopride (0.56-1.7 mg/kg), which is also a 5-HT3 receptor antagonist, did not block the discriminative stimulus effects of ethanol. In addition, the dopaminergic antagonist haloperidol and the 5-HT2 receptor antagonist ketanserin also failed to block the ethanol discrimination. The results suggest that 5-HT3 mediated neurotransmission is an important component of ethanol's discriminative stimulus effects, but that the structural characteristics of the selective 5-HT3 receptor antagonists influence their ability to block this action of ethanol.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780415 TI - Pavlovian conditioning between co-administered drugs: elicitation of an apomorphine-induced antiparkinsonian response by scopolamine. AB - Sprague-Dawley rats with unilateral 6-OHDA substantia nigra lesions were given combined scopolamine (0.5 mg/kg IP) and apomorphine (0.05 mg/kg SC) treatments. In this animal model, scopolamine, when administered separately, induces ipsilateral rotation and apomorphine, contralateral rotation. When these drugs are co-administered at 0.5 mg/kg and 0.05 mg/kg dose levels, respectively, animals rotate in the contralateral direction, creating the opportunity for the stimulus effect of scopolamine to become associated with the response effect of apomorphine. In tests with scopolamine (0.5 mg/kg), animals that previously had scopolamine and apomorphine co-administered rotated contralaterally in the test chamber, thereby behaving as if they had received apomorphine. Thus, scopolamine exhibited a functionally acquired conditioned stimulus (CS) property by eliciting the apomorphine response of contralateral rotation as a conditioned response. This acquired CS property was extinguished with separate scopolamine trials and reacquired following one scopolamine-apomorphine co-administration trial. PMID- 1780416 TI - Effect on smoking cessation of silver acetate, nicotine and ordinary chewing gum. Influence of smoking history. AB - In a randomized smoking cessation study 211, 203 and 82 persons were supported with nicotine, silver acetate and ordinary chewing gum, respectively. After 26 weeks there was no overall difference in number of abstainers between treatments. Participants were divided into subsets with low and high weighted packyears consumption (WPY) which modifies tobacco consumption by nicotine content. Abstainer rates in the total population controlled for treatment decreased with increasing WPY (P less than 0.005). In participants with low WPY abstainer rate was higher in the silver acetate group compared to the nicotine (P less than 0.0005) and ordinary (P less than 0.05) chewing gum groups. Nicotine chewing gum was more effective than silver acetate (P less than 0.05) and ordinary (P less than 0.05) chewing gum in smokers with high WPY. Ratings on some inconveniences experienced during earlier attempts to quit smoking influenced the ability to break the habit but had no influence on chewing gum effects. This study indicated that through consideration of smoking history it should be possible to individualize pharmacological support to smokers wanting to quit, with silver acetate chewing gum most effective for smokers with a low WPY and nicotine chewing gum most effective for smokers with a high WPY. PMID- 1780417 TI - Serotonin 5-HT3 antagonists do not alter the discriminative stimulus properties of cocaine. AB - The central nervous system (CNS) of the rat is known to contain serotonin (5-HT) type -3 receptors (5-HT3). Behavioral evidence suggests that 5-HT3 receptors interact with mesolimbic dopamine (DA) systems and that 5-HT3 antagonists can interfere with the hyperlocomotive effects of amphetamine and cocaine and the rewarding and stimulus effects of morphine, nicotine and ethanol. Cocaine, which blocks the reuptake of DA, norepinephrine (NE), and 5-HT in the CNS, also may be an antagonist at 5-HT3 receptors. The purpose of the present study was to determine whether systemic administration of the 5-HT3 antagonists ICS 205930 or MDL 72222 could mimic or block the discriminative stimulus properties of cocaine. Once rats (N = 16) were trained to discriminate cocaine (10 mg/kg) from saline, substitution tests with various doses of cocaine (0.313-10 mg/kg), ICS 205930 (2 24 mg/kg), and MDL 72222 (2-16 mg/kg) were conducted. Cocaine produced a dose related increase in cocaine-appropriate responding while the 5-HT3 antagonists engendered primarily saline-lever responding. Neither ICS 205930 nor MDL 72222 were able to antagonize the stimulus effects of cocaine (5 mg/kg). Response rates were not significantly reduced when the 5-HT3 antagonists were given in combination with cocaine. The results indicate that although 5-HT3 antagonists can inhibit some of the unconditioned behavioral effects of psychomotor stimulants, the discriminative stimulus effects of cocaine remain intact. PMID- 1780418 TI - Alprazolam attenuates metabolic stress-induced neuroendocrine and behavioral effects in humans. AB - The effects of benzodiazepine drugs and the role of their recognition site, the GABAA/benzodiazepine receptor, in acute glucoprivic stress are not known. In the present study, the effects of acute glucoprivation were examined in ten healthy human subjects. Glucoprivation was induced by infusion of the glucose analog, 2 deoxyglucose (2DG), at doses sufficient (50 mg/kg) to competitively inhibit glucose metabolism. In addition, the effects of the triazolobenzodiazepine alprazolam (1.5 mg) on the 2DG-induced stress response was assessed. 2DG produced significant elevations in plasma cortisol (P = 0.0001) and glucose (P = 0.0003) levels. Alprazolam pretreatment attenuated the 2DG-related cortisol elevations (P = 0.05) but did not effect 2DG-induced glucose increases. In addition, 2DG caused significant increases in hunger (P = 0.01) and thirst (P = 0.001), and alprazolam significantly blunted both of these responses. Lastly, 2DG had significant effects on heart rate, diastolic blood pressure and body temperature (P less than 0.05). Alprazolam did not effect these physiologic indices. The significance of these data for the mechanisms involved in acute glucoprivic stress are examined and the implications of the data for the pathophysiology of affective illness and eating disorders are discussed. PMID- 1780419 TI - Electroencephalographic effects of cigarette smoking. AB - The effects of cigarette smoking on the electroencephalogram (EEG) of smokers were examined in a study involving both task and no-task conditions. Non-smoking subjects were employed as controls. In light inhaling smokers, (depth of inhalation inferred from pre- to post-smoking changes in tidal breath carbon monoxide), smoking was found to attenuate EEG activity in the delta, theta, and alpha frequency bands, as well as facilitate behavioral performance. For theta, the attenuation was lateralized over the right frontal cerebral hemisphere. In deep inhaling smokers, smoking produced a symmetrical central midline increase in beta2 magnitude, an EEG effect that in the benzodiazepine literature is associated with anxiety relief. PMID- 1780420 TI - Signs and symptoms from nicotine gum abstinence. AB - This study examined and compared withdrawal signs and symptoms from cessation of 0, 2 and 4 mg nicotine gum. In addition, a comparison was made between nicotine gum versus cigarette withdrawal symptoms. Smokers first underwent cigarette deprivation for 4 days and then were randomly assigned to 0 (N = 16), 2 (N = 25), and 4 (N = 21) mg gum. They were asked to chew the gum for 1 month and then to undergo a 4-day nicotine gum deprivation period. The results showed a number of significant changes occurring after deprivation from 4 mg gum, one change from 2 mg gum, and no changes from 0 mg gum. There were no significant differences in severity of withdrawal among the various doses of nicotine gum. There were more severe symptoms of withdrawal from cigarette as opposed to 4 mg nicotine gum deprivation. PMID- 1780421 TI - Sabeluzole improves social recognition and antagonizes chlordiazepoxide's effect on habituation in the rat. AB - The memory enhancing properties of sabeluzole were evaluated in two experimental paradigms in rats. First, we determined the protective action of sabeluzole against a chlordiazepoxide-induced impairment of habituation. Sabeluzole (5 or 25 mg/kg, SC) was administered 1 h before and chlordiazepoxide (20 mg/kg, SC) immediately after the acquisition session. In the retention session 72 h later, chlordiazepoxide-treated animals displayed higher locomotor and rearing activities and this effect was blocked by pretreatment with sabeluzole. The results suggest that sabeluzole prevented the amnesic effect of chlordiazepoxide. The second paradigm was a social recognition test in which the behaviour toward a familiar or a novel conspecific was investigated. Time spent in social investigation and time spent sniffing of scent traces left on the floor was estimated during exposure of an adult to a juvenile male rat. Sabeluzole (25 mg/kg, SC) was injected into the adults immediately after the first exposure. Reexposure to the same or a novel juvenile was performed 120 min later. In contrast to control, sabeluzole-treated animals showed a significant reduction in social investigation during the second exposure to the same juvenile. Time spent sniffing the floor was significantly decreased in sabeluzole-treated males. Since there was no effect on investigation of a novel juvenile, results suggest that sabeluzole-treated rats are able to remember longer the individual characteristics of juvenile rat obtained through olfactory cues. PMID- 1780422 TI - Haloperidol and nucleus accumbens dopamine depletion suppress lever pressing for food but increase free food consumption in a novel food choice procedure. AB - An important aspect of motivated behavior is that organisms will perform complex instrumental behaviors to gain access to stimuli such as food. In the present study, food-deprived rats were tested in an operant chamber in which the animals had a choice between pressing a lever to obtain a more-preferred food (Bioserve pellets), or free feeding on a less-preferred food (lab chow). Typically, rats pressed the lever to obtain the preferred food pellets, and ate little of the less-preferred food even though it was freely available. Pre-fed rats showed suppression of both lever pressing and feeding. Systemic administration of 0.1 mg/kg haloperidol (HP) led to a dramatic shift in the behavior of these rats, such that the number of lever presses was substantially reduced, but the amount of less-preferred food consumed showed a significant increase. This result occurred if the rats pressed a lever on either a CRF or FR5 schedule. Injection of 3.5-7.0 micrograms HP directly into the nucleus accumbens, or intra-accumbens injections of 6-hydroxy-dopamine, also decreased lever pressing for food and increased feeding on laboratory chow. Thus, interference with brain dopamine suppressed a highly active instrumental response for food, although the behavior of the animal was still directed towards food acquisition and consumption. PMID- 1780423 TI - Effects of smoking cessation on caloric intake and weight gain in an inpatient unit. AB - The present research was designed to assess the amount of weight gain that would occur when male smokers in an inpatient setting were deprived of cigarettes for 10 days, and to evaluate factors that could contribute to that weight gain, such as caloric intake and activity level. Subjects were 17 healthy male smokers who either smoked ad libitum (n = 8) or quit smoking (n = 9) for 10 days after a 3 day smoking baseline. Caloric intake, activity levels, and body weight were assessed daily. Abstainers gained more weight than did smokers and ate more over time. There were no group differences in activity level. An analysis of energy needs versus actual energy intake suggests that caloric intake accounted for a large percentage of the post-cessation weight gain. However, considerable individual variability exists in caloric intake after smoking cessation. In addition, the study found post-cessation increases in caloric intake that were quite similar to those found in studies with females, suggesting that gender may have little to do with overall post-cessation caloric intake. Further research assessing dietary and metabolic changes after smoking cessation in a larger sample of both males and females is needed so that the reasons for and implications of dietary variability can be evaluated. PMID- 1780424 TI - Magnesium-maintained self-administration responding in cocaine-trained rats. AB - Magnesium chloride (MgCl2) produces behavioral effects similar to those of psychomotor stimulants in a variety of behavioral situations. Because MgCl2 appears to have stimulant properties, the ability of MgCl2 to maintain responding in a rat self-administration paradigm was examined in seven experiments under different access and schedule conditions in cocaine-trained rats. These varied from the availability of MgCl2 for a single day's test session subsequent to 1 h availability of cocaine, to the availability of MgCl2 for 10 or 20 days after cocaine availability was totally discontinued. Fixed ratio 1, fixed ratio 5, and progressive ratio 1, 2 and 3 schedules of drug delivery were used. The results demonstrate that MgCl2 may substitute for self-administered cocaine because it maintained responding; it did so dose dependently to maintain a constant level of MgCl2 intake; and it did so over a 10-day period of time both with and without access to cocaine on test days. Responding maintained by MgCl2 when cocaine was no longer available was similar under fixed ratio 1 and 5 schedule conditions. The progressive ratio breakpoints for MgCl2 were significantly higher than those for saline, but significantly lower than those for cocaine. These data indicate that MgCl2 has some reinforcing efficacy in cocaine-trained rats, particularly under fixed ratio 1 and 5 schedules, but has a low abuse potential compared to cocaine. PMID- 1780425 TI - Effects of nicotine gum on repeated administration of the Stroop test. AB - Using a double-blind procedure, 24 non-smoking subjects chewed either 2 mg nicorette gum or a placebo for 20 min, before completing a Stroop test on three occasions. Colour-word reading and simple colour naming times were consistent across repeats, and were unaffected by nicotine. However, the time taken to name the colour of incongruous colour word stimuli declined across trials. This increase in speed across repeats was significantly greater in those subjects who had received nicotine. These data are consistent with previous reports of a decreased Stroop effect following nicotine administration, but are not compatible with a simple model which assumes that nicotine alters the way in which information is filtered by selective attentional mechanisms. The present results can be explained by postulating that nicotine influences either the rate at which colour naming become more automatic, or changes the way in which resources are allocated to non-automatic processes. PMID- 1780426 TI - Involvement of the amygdala in the memory-enhancing effects of clenbuterol. AB - Male Sprague Dawley rats with stria terminalis (ST) or sham lesions were trained in an inhibitory avoidance task, injected immediately post-training with clenbuterol hydrochloride (0.03 mg/kg; IP), and tested for retention 48 h later. Clenbuterol enhanced retention of the sham-lesioned animals but did not affect retention of the ST-lesioned animals. Clenbuterol injected intraamygdally immediately after training also enhanced retention of the inhibitory avoidance task. These results agree with other evidence suggesting the participation of beta-noradrenergic mechanisms in the amygdala in the modulation of memory storage. PMID- 1780427 TI - The Duphar Lecture: on the etiology of alien, nonself attributes of schizophrenic 'voices'. AB - The etiology of schizophrenic hallucinations of 'voices' remains unknown. The following is a discussion of a hypothesis linking these hallucinatory phenomena to a disruption in discourse planning. The relationship between normal imagery and hallucination is discussed. The concept of 'alien intentionality' is introduced, and a theoretical argument is presented which links this phenomenon with the exteriorization of internal images. Statistical data linking discourse planning disruptions and schizophrenic data are reviewed, and a description of the treatment of a hallucinating schizophrenic via a novel type of speech therapy is described. PMID- 1780428 TI - Musical hallucinations: a statistical analysis of 46 cases. AB - Musical hallucinations remain rare, are more common in women, and their onset is often related to ear pathology, particularly deafness. When brain disease is involved, pathology of the right or non-dominant hemisphere seems overrepresented. Psychosis and personality traits play a minimal role in their development. A discriminant function was constructed that correctly predicted the presence of brain disease (89%) and included the following clinical variables: being male, having acute onset musical hallucinations, and absence of deafness, psychiatric disease, and other forms of hallucination. PMID- 1780429 TI - Visual pseudohallucinations: psychotherapy case study of a long-standing perceptual disorder. AB - The case of a woman with severe neurosis, seen in once weekly psychotherapy over a period of 3 years, illustrates many of the characteristics of pseudohallucinations: their relation to personality, to sensory deprivation and isolation, and to developmental factors. It also suggests that there may be more than one type of pseudohallucinatory experience. PMID- 1780430 TI - Lateralized anomalous perceptual experiences in schizophrenia. AB - Four cases of schizophrenia are described, in which subjects reported anomalous perceptual experiences confined to one visual field, in all cases the left visual field. The pattern, content and laterality of such anomalous perceptions point to the presence of right hemisphere dysfunction in schizophrenia. Further evidence to this effect comes from examining the type of anomalous perceptual experiences reported by subjects with focal lesions in either hemisphere. Those with right hemisphere damage but not those with left hemisphere damage report almost identical experiences to those seen in the 4 schizophrenics described here. PMID- 1780431 TI - An overview of the psychopathology of perception: first rank symptoms as a localizing sign in schizophrenia. AB - Schneider considered that first rank symptoms always signify schizophrenia. They appear to have in common permeability of the barrier between the individual and his environment, or a loss of ego boundaries. They may be a manifestation of a specific disturbance which may be caused pathologically by a limbic lesion in the dominant hemisphere. PMID- 1780432 TI - Psychiatric and somatic hospitalisations of different diagnostic groups: a long term follow-up study. AB - Out of 328 cases with different diagnoses, including those without pathological findings at follow-up, the frequency and duration of in-patient treatment in psychiatric and somatic institutions was observed over an average 14-year period. Schizophrenics were more frequently and longer in psychiatric institutions, but they were less frequently and for shorter periods in somatic care compared with all other diagnostic groups. Patients suffering from affective psychosis had comparatively long psychiatric and somatic periods of hospitalisation. Dependents were hospitalised more frequently and longer for psychiatric rather than for medical reasons in somatic institutions. The total psychiatric in-patient treatment time was distinctly shorter for neurotic disorders compared with schizophrenic psychosis or affective psychosis cases. PMID- 1780433 TI - Erotomania--erotic self-reference psychosis in old maids. A long-term follow-up. AB - The concept of erotomania is discussed and the literature surveyed. The aim of the study is to present a long-term personal follow-up evaluation of cases with erotomania-like symptoms. In a material of 1,802 consecutively admitted patients, 6 (0.3%) presented symptoms suggestive of erotomania. They have been personally followed up 2 or 3 times by the authors over a period of 22-35 years. Our sample was characterized by avoidant and/or paranoid premorbid personality traits with difficulties in establishing relationships, and life-long social isolation. However, the overall clinical outcome was not hopeless. Neuroleptics may be of benefit, and our findings indicate the need for psychosocial treatment to increase the life quality in these patients. PMID- 1780434 TI - [Injuries to the superior ankle joint from the viewpoint of accident surgery]. AB - The treatment of bony, osteochondral, and ligamentous injuries of the tibio-talar joint requires precise preoperative planning by radiological investigation. This is essential to a correct understanding of the underlying pathology and will allow a proper classification of the injury, which is the basis of treatment. Conventional radiography using anteroposterior and lateral X-rays with comparative views of the noninjured side and, if necessary, rotated spot views and tomography are of high value especially in osteochondral fractures of the talus. Intraoperative control images in both planes after osteosynthesis are mandatory. For evaluation of the postoperative course and severity of arthrosis formation, the classification system of Bargon has proved its worth. In addition, tomography of the tibio-talar joint in two planes is useful especially in tibial pilon fractures, some malleolar fractures, and peripheral talar fractures. In talar fracture dislocations with concomitant compartment syndrome an emergency CT scan can be helpful to determine the optimal surgical approach. In these cases a 3-D reconstruction also might be of assistance. If there is evidence of partial or total talar necrosis, magnetic resonance imaging can be extremely helpful. However, in most cases implants considerably limit the validity of the image obtained. Ultrasonography offers a noninvasive, reproducible, and very inexpensive alternative and should be performed in cases of chondral osteochondral talar rim avulsions and juvenile osteochondral ligament ruptures. It can also be used as a dynamic method for stress examination in fibular ligament ruptures and soft tissue injuries such as dislocation of the peroneal tendons. The use of Arthrography, stress tenography, and Arthro-CT scan nowadays has become extremely limited. PMID- 1780435 TI - [X-ray diagnosis of ligament lesions of the superior ankle joint]. AB - Nearly 40 years after ankle arthrography was first introduced, the anterior and inversion stress views of the ankle are still widely preferred as a noninvasive method of evaluating ligament injuries in the upper ankle. We consider the stress test, bilaterally performed using a standardized stress apparatus, as a basic examination by which to differentiate between slight and severe sprain. Intensive muscle splinting due to painful swelling can sometimes be treated by injection of local anesthetic. Like many authors, we perform ankle arthrography in cases where there is a significant difference between the clinical findings and the stress test. The technique of ankle arthrography can be readily learned and is extremely accurate in delineating the extent of ligamentous injury produced by moderate or severe ankle sprains. It can be performed in any X-ray department. PMID- 1780436 TI - [Deformities and trauma sequelae of the ankle joint in children and adolescents]. AB - Knowledge of the normal development of the ankle joint is mandatory to understand the mechanism of injuries in children and adolescents. Some fractures (juvenile Tillaux's or two-fragment triplane fracture) occur only within a particular period of growth, which is determined by the degree of epiphyseal fusion. Tarsal coalitions are the deformities seen most frequently. Special radiographic techniques must be applied for the diagnosis. Ball and socket joint, tibiotalar slant and Trevor's disease are rare deformities, each of which is associated with a pathognomonic radiographic pattern. Some typical joint deformities may be seen in patients with neuromuscular disease. This has to be considered when nothing else is found in the clinical history. PMID- 1780437 TI - [Computed tomography of the superior and inferior ankle joint]. AB - Computed tomography of the tibotalar and subtaler joints in standardised planes produces comparable images irrespective of examiners. Traumatic, degenerative or neoplastic lesions of the joint surfaces are shown without superimposition. Intraosseous changes can be localised exactly in relation to the joint. Assessment of possible fractures in children is simplified by simultaneous imaging of soft tissues and bone. Diagnosis of traumatic lesions of ligaments or tendons and dislocation of tendons by bone fragments is possible only on CT images. After injection of air loose intra-articular bodies can be recognised much more satisfactorily with computed tomography than with conventional arthrography. PMID- 1780438 TI - [Magnetic resonance tomography of the ankle joint]. AB - To define the clinical role of MRI of the ankle joint, a total of 88 patients was investigated. In the evaluation of ligamentous injury, MRI was inferior to established imaging methods. By contrast, it provided additional therapy-relevant information in the assessment of hemophilic arthropathy, osteochondritis dissecans, and inflammatory and neoplastic diseases of the ankle joint. In the latter conditions, MRI may make other more conventional methods of examining the ankle joint unnecessary. PMID- 1780439 TI - [Ethical questions in radiology. A survey of patients]. PMID- 1780440 TI - [A hemiplegic syndrome of unclear etiology]. PMID- 1780441 TI - Reversal of indomethacin-induced inhibition of implantation in the mouse by epidermal growth factor. AB - In the mouse, estriol (E3) can induce implantation as a phase I of estrogen action. E3-induced implantation was attenuated by indomethacin(INDO), an inhibitor of prostaglandin (PG) synthesis. The inhibitory effect of INDO was reversed by administration of epidermal growth factor (EGF), and this EGF effect was dose-dependent. These results suggest that one of the functions of estrogen could be to activate the EGF ligand-receptor signalling in the uterus in generating PGs required for initiation of implantation. This is consistent with the results of EGF stimulation of synthesis of PGs in uterine stromal cells in culture. PMID- 1780442 TI - Effect of oxytocin on plasma concentrations of 13,14-dihydro-15-keto prostaglandin F2 alpha during the oestrous cycle and early pregnancy in the goat. AB - The effect of subcutaneous oxytocin on plasma concentrations of 13,14-dihydro-15 keto-prostaglandin (PG) F2 alpha (PGFM) was examined in the goat at various periods during the oestrous cycle and early pregnancy. 100 i.u. oxytocin was administered daily for 4 day, the dose being divided and given at 0900 and 2100 h; PGFM concentrations were assessed after the first treatment of each day. On days 3-6 (oestrus, day 0) PGFM concentrations increased significantly (P less than 0.001) within 15 minutes and both non-pregnant and mated goats exhibited oestrus behaviour by day 7. Significant (P less than 0.01) increases in PGFM were also produced on days 7-10, in both non-pregnant and pregnant goats, but the responses diminished from day 7 to day 10; only one goat (non-pregnant) came into oestrus. There was a marked difference in response between groups, however, during days 12-15. In non-pregnant goats significant (P less than 0.05) increases in PGFM were detected on days 13-15, but in pregnant animals oxytocin was without effect. Similarly, oxytocin did not increase PGFM concentrations on days 17-20 of pregnancy. However, uterine responsiveness reappeared in pregnant goats with significant (P less than 0.01) increases in PGFM on days 24 and 25. PMID- 1780443 TI - Purification of natural killer-like Kurloff cells and arachidonic acid metabolism. AB - Pulmonary and splenic Kurloff cells have been purified from estrogen-treated guinea pig. Enzymatic digestion of lung tissue and mechanical dispersion of cells yielded about 650 x 10(6) viable cells. After centrifugal elutriation and centrifugation on continuous Percoll gradient, a population of high-density (1,100 g/ml) pulmonary Kurloff cells were obtained with high viability (approximately 99%) and purity (approximately 99%). Splenic Kurloff cells have been isolated by disruption of spleen tissue and centrifugation on continuous Percoll gradient. High-density splenic Kurloff cells (150 x 10(6) cells per spleen) were also obtained with high purity (approximately 99%) and viability (approximately 99%). Pulmonary and splenic Kurloff cells were incubated with various concentrations of arachidonic acid (10, 30 and 100 microM) in the absence or presence of 2 microM ionophore A23187. With 10 microM arachidonic acid the relative production of cyclooxygenase products was the following: TxB2 greater than PGE2 approximately PGI2. For an arachidonic acid concentration superior to 10 microM, the profile of release was PGE2 much greater than TxB2 greater than PGI2. Arachidonic acid metabolism through the 5-lipoxygenase pathway was also studied by incubating pulmonary or splenic Kurloff cells with 10 microM arachidonic acid in the absence or presence of 2 microM ionophore A23187, or in some experiments, with 2.5 microM leukotriene A4. Reverse phase HPLC profiles clearly indicated that high-density Kurloff cells did not express 5-lipoxygenase activity. However, these cells showed the ability to convert exogenous leukotriene A4 into leukotriene B4 suggesting the presence of LTA4 hydrolase activity. These data have been confirmed by a sensitive RIA method. This study constitutes the first report on the purification of pulmonary Kurloff cells and on arachidonic acid metabolism by these cells. The possible implications of Kurloff cells in various biological events are discussed. PMID- 1780445 TI - Public sector career structure update. PMID- 1780444 TI - Plasma prostaglandin F2 alpha and reproduction in the female Triturus carnifex (Laur.). AB - Plasma patterns of prostaglandin F2 alpha (PGF2 alpha) and sex hormones (progesterone, androgens and 17 beta-estradiol) have been studied in the female crested newt, Triturus carnifex (Laur.), during the annual sexual cycle. The effects of exogenous PGF2 alpha on sex hormones were determined. In addition, the effects of one week's captivity on plasma PGF2 alpha and sex hormones were reported. PGF2 alpha plasma level peaked in April, was low in summer, and progressively increased during the autumn to peak again in December. The April PGF2 alpha coincided with a 17 beta-estradiol rise, and with a progesterone drop. The autumn PGF2 alpha increase was coupled to a 17 beta-estradiol rise, and therefore it has been tentatively related to ovary and oviduct development. In newts collected in April, moreover, a PGF2 alpha-dependent 17 beta-estradiol synthesis could occur, since PGF2 alpha injection induced a significant 17 beta estradiol plasma increase. These findings led us to suppose that PGF2 alpha intervenes in spring breeding season termination through the induction of a 17 beta-estradiol synthesis as in other amphibian species. PGF2 alpha injection caused a progesterone decrease, probably by inducing corpora lutea lysis. The patterns of plasma sex hormones were consistent with the results reported for the same newt species. PMID- 1780446 TI - Private sector industrial matters. PMID- 1780447 TI - Nurse education--is it limiting us? PMID- 1780448 TI - Violence in the workplace--predictable and preventable. PMID- 1780449 TI - Connections through art. PMID- 1780450 TI - The airing court. PMID- 1780451 TI - Remote area nurses. PMID- 1780452 TI - Psychiatric services. PMID- 1780453 TI - Nursing loses link to Minister. PMID- 1780454 TI - [Interventional radiology of the digestive system]. AB - The authors report on the use of interventional radiology modalities in the treatment of some gastrointestinal diseases (intussusception, stenosis, hemorrhage, etc). The results are compared with literature data relative to both interventional radiology and conventional therapeutic procedures. In our series, hydrostatic reduction of ileocolic intussusception was successful in 60% of cases. Transluminal dilatation with a balloon catheter was attempted in 108 patients with alimentary tract stenosis and was successful in 93. Hemorrhage and ischemia can be treated by means of transcatheter therapy (vasopressin, embolization) and percutaneous angioplasty. Percutaneous gastrostomy appears to be an effective alternative to surgical gastrostomy. Tapeworm infections can be cured by intraduodenal injection of "Gastrografin" (Schering). The success achieved in the different applications is such as to suggest a wider use of interventional radiology procedures, for they offer a more favorable cost/benefit ratio and often yield better results than conventional techniques. PMID- 1780455 TI - [The assessment of pulmonary arterial pressure by pulsed Doppler in patients with obstructive pneumopathy]. AB - The severity of pulmonary arterial hypertension can be assessed by duplex-Doppler echocardiography, a subxiphoid approach and a general-purpose duplex device. Normally, the peak Doppler flow velocity occurs in midsystole and the flow profile is parabolic (bullet-like). In pulmonary arterial hypertension, changes in vascular compliance cause maximal acceleration of blood in early systole, with shortening of pulmonary acceleration time (AcT, or time to peak velocity). In the more severe cases, a midsystolic notching is visible, related to rapid deceleration of blood flow, followed by a brief secondary increase in velocity in the late systole. We studied 19 adult patients with chronic obstructive pulmonary disease with duplex-Doppler examination, with a subxiphoid approach and right heart catheterization. The study was diagnostic in all cases with Doppler recordings of good quality. An relationship was found between AcT and pulmonary mean or systolic arterial pressure at rest. An evident accurate prediction of pulmonary arterial pressure in emphysematous patients is possible by means of pulsed Doppler, also in case of low-level hypertension. We believe this method to be a simple and reliable adjunct to the non-invasive work-up of emphysematous patients and to represent a good alternative to the classical parasternal approach, which is often not feasible in these patients. PMID- 1780456 TI - [Computer-assisted report generation and image transmission in bedside chest x rays in intensive therapy units]. AB - Since a few years ago, in our department the bedside chest X-rays of intensive care patients have been reported by means of a computer program which has also storing function. This computer program is a guideline for the radiologist and is organized in pages having a logical sequence. The program has proved very useful in learning the correct reporting of bedside chest X-rays. The nosographic data of the patients, the ventilatory and the technical data are stored for a better clinico-radiological correlation. The last four reports are displayed on the monitor to better understand the patient's history. The other reports become part of a "historical" archive. Most important is the cooperation with the referring physician: to make the most of it, a system has been implemented which sends the images from the Radiology Department to Intensive Care. The images are filmed with a camera and then digitalized on 1024 x 768 matrix with 16 million colors and 256 gray levels. Each workstation is composed of: AT286 computer with 60-MB hard disk, hardware or the digitalization and compression of images, a high resolution monitor, an intercommunication system, and a modem. It is possible to zoom on the images, but a close-up on the image with the camera is better for improved spatial resolution. The images are stored on the hard disk: each image requires 3M bytes, but it can be compressed down to 25:1 with no detail loss. The images are transmitted via modem in at least 20 seconds/image. More images can be sent out-line. During transmission, it is possible to talk by the intercommunication system, pointing out structures on the monitor or drawing objects on both sides of the system. In our experience, image quality is good. We are therefore considering extending the network to other Departments and making the transmission of images of pathologic specimens possible. The natural evolution of this system is the teleconsult. PMID- 1780457 TI - [The echo-guided fine-needle biopsy of thoracic and abdominal masses]. AB - Five hundred and seventy-two US-guided fine-needle biopsies were performed on 561 patients (1.2 puncture/patient); in two cases only minor complications were observed. The patients were 12 to 86 years old--most of them ranging 40 to 75. In 5.42% of cases FNAB proved inadequate; 1.75% of the diagnoses was questionable, 28.89% was negative, and 63.98% positive. A comparison with histology was possible in 218 cases: 2 false positives and 5 false negatives were observed. The low rate of false-positive findings demonstrates US-guided FNAB to have high positive predictive value. The method had 95% sensitivity, 98.4% specificity and 84.3% accuracy. The high reliability of FNAB depends on the possibility of centering the lesion through the direct US visualization of the needle tip. This characteristic, together with the presence of the cytologist, who immediately evaluates the aspirated material, helps reduce the number of unnecessary biopsies and, consequently, complications. PMID- 1780458 TI - [The radiological pictures of pulmonary tuberculosis in HIV+ patients]. AB - Mycobacterial infections can be found in 10% of AIDS patients. Seventy cases with HIV+ infection were examined: they exhibited clear alterations of the chest and contemporaneous isolation and identification of mycobacteria. Primary tuberculosis is the most frequent manifestation in these patients. Alveolar parenchymal mono/bilateral infiltrates are the radiographic patterns of this pulmonary condition; they usually present without excavation (45.7%). Hilar and/or mediastinal lymph nodes are usually associated, and no pleural effusions. The main problem is the differential diagnosis with pneumocystis carinii pneumonia, especially the form involving lung apices. A correlation has been observed between the blood level of T-lymphocytes and their subsets (CD4 level) and the radiographic patterns of tuberculosis in AIDS patients. In fact, pleural effusion is frequent in patients with CD4 less than 200, while miliary nodules and cavitations are more frequent in the cases with CD4 greater than 200. PMID- 1780459 TI - [Solitary intraductal papilloma of the breast. An echographic study of 12 cases]. AB - Solitary intraductal papillomas (SIP) of the breast are relatively common lesions (incidence: 2-3%) originating from proximal ducts or from retroareolar lactiferous ducts. This work was aimed at evaluating the diagnostic reliability of US in the diagnosis of this condition and at discussing the differential diagnosis with similar focal lesions. Twelve cases of SIP were diagnosed with US among 31 selected female patients (aged 16-35 years) who had been referred for serohematic discharging breast and/or palpable nodules. All cases had surgical confirmation. US patterns typical of SIP were: 1) solid hypoechoic nodules with peripheral anechoic areas (7 cases); 2) small papillary excrescences within a cystic cavity, corresponding to papillary cystadenocarcinoma (4 cases); 3) periareolar overdistended ducts filled with dense material (1 case). Surgery was performed directly in 8 patients with positive cytology while mammography, ductography and fine-needle biopsy were performed in the extant 4 patients with negative or questionable cytologic findings. US combined with cytologic samples allowed the correct diagnosis to be made in 8 of 12 cases (66%): this is noteworthy when considering the low reliability of mammography in young patients and the poor tolerance to ductography in general. US allows the differential diagnosis with other focal lesions and subsequently helps shorten the diagnostic route. PMID- 1780460 TI - [The intraoperative echography of malignant hepatic lesions]. AB - IOU (intraoperative ultrasound) is nowadays an indispensable technique for the surgeon to confirm the information collected from preoperative tests or to gain further information that may modify surgical strategy. A series of 350 patients were studied with IOU: in 67 cases the liver was involved, with 23 malignant lesions. In the latter group, 10 lesions were found which had been missed even at palpation; the size of 9 of them could be correctly assessed, which had been overestimated in 8 cases and underestimated in 1 before surgery. Moreover, in 39.1% of the cases, the information yielded by IOU determined a change in surgical strategy, favoring a more accurate dissection of the lesion. Surgery was modified depending on the recognition of: nonpalpable lesions (5 cases); portal thrombosis (1 case); lesions bigger (2 cases)--smaller (2 cases) than preoperatively diagnosed. Moreover, IOU was a useful tool to guide the surgeon during intervention, by yielding accurate anatomical information on the segment/segments hosting the lesion. PMID- 1780461 TI - [The radiological study of afferent and efferent loop syndromes]. AB - The authors report on the diagnostic role of radiological imaging in the study of the patients who underwent gastric surgery. This kind of intervention is often followed by postoperative complications, so that accurate clinical-instrumental investigations are required. Routine controls both in the immediate postoperative period and during follow-up are useful especially when a neoplastic lesion was the underlying condition leading to surgery. Radiological imaging plays a fundamental role especially in evaluating such postoperative conditions as afferent and efferent loop syndromes. Radiology is thought to be essential to demonstrate the syndrome and to identify the mechanical/functional nature of the factors causing the disease, all of which are essential to an appropriate and safe therapy. Both the duration of follow-up (early and late controls) and the choice of contrast (water-soluble contrast medium or double contrast enema) are very important factors depending on the time of surgery and the clinical indication. PMID- 1780462 TI - [The potentials of computed tomography in the study of mechanical ileus of the small intestine]. AB - Eighteen patients were examined; they were suffering from small bowel obstruction due to adhesions (7 cases), hernia (3 cases), carcinoma (2 cases), metastasis from melanoma (1 case), radiation enteritis (2 cases), intramural hematoma (2 cases), and peritoneal carcinosis (1 case). CT capabilities in showing the site and the cause of obstruction were evaluated. CT was performed after conventional radiology in 13 cases, while in 5 cases it was the first exam and demonstrated the condition as an occasional finding. In all cases i.v. contrast agents were administered. Filling of the intestinal loop by oral contrast agent was never performed since the hypodense fluid present in the distended intestinal loops allowed good evaluation of intestinal walls. CT always showed the level of the obstruction thanks to the presence of the distended loops (phi: 4-8 cm) above the condition and of collapsed loops below. In 8/18 cases (44%) it was possible to show the cause of the obstruction. Those due to neoplasms, herniae and intramural hematomas were correctly diagnosed. On the contrary, it was not possible to identify the cause of the obstructions due to adhesions, radiation enteritis and peritoneal metastases because of the absence, in such cases, of specific parietal alterations. According to our results, CT is suitable in patients suffering from small bowel obstruction because it allows: to always show the site of the obstruction and, in some cases, its cause; to diagnose closed loop obstructions; to obtain a simultaneous staging in neoplastic patients. PMID- 1780463 TI - [Blocked transcolostomy colonography in the identification of anorectal malformations]. AB - The study of anorectal malformations has considerably improved over the last years also thanks to the use of such diagnostic techniques as CT and MR imaging, which allow a better knowledge of perineal region anatomy and the demonstration of the development of sphincteric structures. The most important diagnostic phase for the identification of anorectal malformations consists in the detection of rectal fistulas. The authors report on their experience with barred water-soluble contrast enema in the study of anorectal anomalies. Over 2 years, 23 patients with anorectal malformations (10 males and 13 females) previously submitted to colostomy, were studied with this method. Fistulas were detected in 21 cases; in the extant 2 patients (both females affected with Down syndrome), no fistulas were detected, not even at surgery, which was posterior sagittal anorectoplasty according to Pena-De Vries. In our experience, the most frequent anomalies were recto-bulbo-urethral fistula in males and low recto-vaginal fistula in females. The authors suggest the use of this method as a routine diagnostic examination, because of its proven reliability. PMID- 1780464 TI - [Computed tomography vs. magnetic resonance in the diagnosis of anorectal anomalies]. AB - Anorectal malformations include a variety of anatomical anomalies which are often difficult to assess. Thirty-four patients (age range: 1 month-19 years) were studied over a 4-year period, 14 of them preoperatively and 20 postoperatively. In addition to inverted lateral plain films, a barred Iopamiro enema was performed in 13 of 14 cases by a Foley's catheter via colostomy. Endocolic pressure could thus be increased, which allowed the detection of rectal fistulas in 11 of 13 cases. Preoperative CT was performed in 9 cases, and MRI in 5. Both CT and axial MR scans provided accurate images of sphincteric muscles: they were well developed in 7 patients and poorly developed in 6; in 1 case the muscles were not identified. Sagittal MR scans only demonstrated the distance between blind pouch and perineum. Sagittal MRI also provided images of the spine (1 patient exhibited tethered cord). In the postoperative management, except for severe sacral anomalies, miscentered puborectal muscle and hypoplastic musculature were observed as the most frequent causes of fecal incontinence in patients treated with abdomino-perineal pull-through of the colon. To select the cases who needed reoperation, most frequently secondary PSARP, 17 patients were studied by CT and 7 by MRI; both techniques were employed in 4 cases. In 6 patients good development of sphincteric musculature and neo-anorectum correctly positioned within were observed. In 4 cases the neo-anorectum was correctly positioned, but sphincteric muscles were too hypoplastic to allow good continence; in 10 patients with incontinence, the neo-anorectum was seen outside sphincteric musculature: in 2 cases the latter was well developed (1 patient had had severe surgical damage to levator ani), while in 8 it appeared to be poorly developed. In our experience, postoperative CT allowed a correct evaluation to be made, whereas MRI failed to yield additional information. PMID- 1780465 TI - [The prognostic factors for the radiation treatment of the cerebral metastases from breast carcinoma]. AB - Complex mechanisms of various nature, not only physical, can influence the patterns of metastases. We compared the patients with recurrences to the brain as the only metastatic site from breast cancer with the patients relapsing in the brain and other organs. All cases were staged and treated following professional protocols. When brain metastases were diagnosed, the patients were accurately restaged before being submitted to radiation therapy; the whole brain was irradiated with various total doses and the same fractionation. The patients underwent clinical examination before and after irradiation. Survival analysis was carried out using the product-limit method considering the following periods: total survival, relapse-free survival, elapsed time till the appearance of brain metastases, and survival after radiation therapy. The cases were grouped and compared using Mantel-Cox and Breslow methods according to the following prognostic factors: brain as the first site of recurrence, pausal state, total radiation dose, stage (TNM), T and N. No significant difference in survival was observed between the cases with brain as the first metastasized organ and the others. The patients were grouped according to the extant prognostic factors: longer total and postirradiation survival rates were observed in patients in premenopausal state (Breslow: p = 0.025 and 0.005) and in the cases treated with total radiation doses greater than 40 Gy (Breslow: p = 0.023 and 0.005). T levels seemed to significantly affect all the examined periods--which influences the stage effect. Conversely, N levels seemed to be of no significant value. The menopausal factor may reflect the effects of age, from which it cannot be separated. These results can be useful for treatment planning. PMID- 1780466 TI - [The surgical and radiotherapy treatment of endometrial adenocarcinoma. A retrospective analysis of 128 patients]. AB - From January 1980 through December 1987, 128 endometrial carcinomas were treated with combined irradiation and surgery (101 cases) or with radiotherapy alone (27 patients). Mean follow-up was 5 years (range: 2-9). Actuarial disease-free (DF) survival (according to the Kaplan and Meyer method) was 86% for T1-T2 patients, 50% for T3 cases and 35% for T4. Recurrence rate was 20% (26 patients): 9 had local recurrences, 9 nodal relapses, and 8 distant metastases. Overall side effects were observed in only 7/128 patients (5.4%): they were grade I in 6 cases and grade II in 1. The evaluation of the prognostic factors confirms the importance of: stage (disease-free survival at 5 years: 86% for T1-T2 versus 50 35% for T3-T4); uterus size in stage T1 (DF survival at 5 years: 90% for T1A versus 70% for T1B); grading (DF survival at 5 years: 92, 87, 62% for G1, G2, G3, respectively). Myometrial infiltration seems to have no prognostic value. PMID- 1780467 TI - [The characteristics of a low-melting-point alloy (Lipowitz's metal) for use in radiotherapy]. AB - Lipowitz's metal is widely employed in radiotherapy to create shielding blocks and compensators for X- and gamma-rays. Its effect in modifying radiation beams cannot be evaluated in a simple manner: therefore, in our opinion, an experimental approach to the problem is the most suitable one. Attenuation for Lipowitz's metal and lead was measured in some different geometrical setups, for a 5 MV linac and a 60Co unit. Transmitted fraction vs attenuator thickness curves were obtained. The influence of attenuators on depth-dose curves in a phantom was also evaluated: the results confirm the need to use data obtained in conditions as close as possible to the operative ones, in treatment planning as well as in studying and realizing calculation models. PMID- 1780468 TI - [A technical note on the percutaneous Z stent treatment of a case of postoperative choledochal stenosis]. PMID- 1780469 TI - [Hemophilic arthropathy of the hands]. PMID- 1780470 TI - [Chondroblastoma of the patella. A diagnostic assessment]. PMID- 1780471 TI - [Sacral agenesis. The clinical and radiological aspects in one case]. PMID- 1780472 TI - [An instrumental senological study of 2 cases of intracystic breast carcinoma]. PMID- 1780473 TI - [Primary neoplasms of the myocardium: 2 3-month-old patients studied by magnetic resonance]. PMID- 1780474 TI - [Spontaneous rupture of a splenic artery aneurysm. Its CT diagnosis]. PMID- 1780475 TI - [An aneurysm of the common trunk of the celiac tripod diagnosed with echo Doppler]. PMID- 1780476 TI - [A case of lymphatic dysplasia in Noonan's syndrome]. PMID- 1780477 TI - [Intestinal occlusion due to traumatic hernia of the right diaphragm. A case report]. PMID- 1780478 TI - [Intestinal invagination in Henoch-Schonlein purpura. The diagnostic contribution of echography]. PMID- 1780479 TI - [Mucocele of the appendix: the diagnostic importance of computed tomography. A clinico-radiological case]. PMID- 1780480 TI - [Computed tomography of intraperitoneal retained gauzes]. PMID- 1780481 TI - [An abscess due to a surgical foreign body. Echographic and CT findings]. PMID- 1780482 TI - [A case of a primary neoplasm of the transplanted kidney]. PMID- 1780483 TI - [On the textbook: Imaging Diagnosis--Equipment]. PMID- 1780484 TI - [An epidural spinal abscess as a lethal complication of peridural anesthesia]. AB - We present a 71-year-old male in whom an epidural abscess developed within a short temporal interval after an epidural anesthetic. Due to different locations of the abscess and the site of the epidural puncture, the diagnosis was quite problematic. The initial symptoms consisted of pain in the shoulder-neck region, elevated temperature, and leucocytosis 1 week after the puncture was performed. The further course presented a picture of high spinal paralysis with respiratory insufficiency and massive cardiovascular problems. Magnetic resonance imaging of the cervical spine confirmed the suspected diagnosis of an epidural abscess (Fig. 1). Due to the reduced general condition of the patient, an operation was initially not possible. After the patient's condition had stabilized under antibiotic therapy with penicillin G, vancomycin, and gentamycin, exploration of the abscess area was performed. Histologic studies showed granulomatous tissue resulting from the previous inflammation. During the subsequent course of the disease, the clinical symptoms did not regress significantly. The patient required prolonged mechanical ventilation and died of recurrent bronchopulmonary infections after 5 months of intensive care treatment. The probable pathogenesis of the abscess as well as the diagnostic and therapeutic aspects are discussed in summary. PMID- 1780486 TI - [A simple technique for estimating the level of analgesia in regional anesthesia]. AB - In regional anesthesia the onset of analgesia is usually determined by stimulating the skin with sharp or cold objects: when sensations of sharp pain or cold are lost, all nociceptive afferents are regarded as blocked. Sharp pain and cold are mediated by thin, myelinated axons whereas the majority of nociceptor axons are unmyelinated. In peripheral nerve blocks unmyelinated fibers are blocked first, followed by those mediating sharp pain and cold. In spinal and epidural blocks the levels of anesthesia to sharp pain and cold correspond within 1-2 segments. Although pinprick seems to be a simple test for analgesia, it involves the risk of infection and is disliked by the patient. As the stimulus is spatially discontinuous, coarse testing may simulate analgesia. An ideal stimulus for testing analgesia should be noninvasive, give distinct sensations, not frighten the patient, and allow spatially continuous examination of larger skin areas. A stimulus that meets these conditions is cold applied to the skin by a metal roller (Fig. 1). If the roller is kept at room temperature (20 degrees-24 degrees C), it gives a strong cold sensation when it is slowly rolled (5-10 cm/s) over the warm skin (usually 30 degrees-35 degrees C on the trunk). With this noninvasive device, the levels of anesthesia to cold can be determined rapidly, with high precision, and without frightening the patient. PMID- 1780485 TI - [Knotting of a peridural catheter]. AB - We report a patient who was given continuous epidural anesthesia due to painful contractions during delivery of a child after intrauterine fetal death. Placement of the catheter and repeated reinjections were carried out without problems, however, during withdrawal of the catheter it could only be pulled 1-2 cm until there was enormous resistance. An X-ray film showed knotting of the catheter in the epidural space. Firm pulling finally allowed complete withdrawal of the catheter. Insertion of the catheter too far into the epidural space initially must be considered as a possible cause. As this complication rarely occurs, we consider this case worth reporting. PMID- 1780487 TI - [CSE--the combination of spinal and epidural anesthesia]. AB - The availability of very fine-bore, long spinal needles (28/10 Ga) has stimulated a new wave of interest in the technique of combined spinal-epidural anesthesia. The original double-puncture technique has progressed due to special combination needles to the current spinal-needle-through-epidural-needle technique. The availability of adapted Tuohy needles, special combination sets, and long spinal needles indicates a lack of standardization. An appropriate introduction technique via Tuohy needle allows identification of the anatomic landmarks and contributes to successful anesthesia. The spinal component allows a rapid onset and intense analgesia with appropriate muscle relaxation. The epidural catheter allows the administration of agents into the epidural space as well as optimization and prolongation of analgesia in the postoperative phase. Confirming the position of the epidural catheter introduced after spinal anesthesia has been established remains a matter of concern. PMID- 1780488 TI - [Comments on the paper by R. Schurg et al. Maternal and neonatal plasma concentrations of bupivacaine during peridural anesthesia for cesarean section]. PMID- 1780489 TI - [Epidural blockade for analgesia and treatment of acute pancreatitis]. AB - The effect of a fractional epidural blockade on acute pancreatitis was investigated in a prospective study. PATIENTS AND METHODS. Thoracic (20 patients) or lumbar (six patients) epidural blockade was carried out in 26 patients with severe abdominal conditions comprising sub-ileus in 100%, pancreatic edema indicated by sonography/computer tomography in 57.8%, and necrosis of the pancreas in 34.6%. RESULTS. On average, 3.4 (1-6) injections with single doses of 6-20 ml 0.25% bupivacaine were injected per day. In four patients, morphine (up to 4 mg per 24 h) was added to the local anesthetic. The duration of treatment was between 1 and 15 days. After 10.5% of the injections, the systolic pressure decreased by more than 20%, and after 12.8% of the injections the blood pressure decreased by more than 30%. Hypotension of more than 30% was treated with 0.3 to 0.5 ml theodrenaline (Akrinor) and/or 0.1 to 0.2 mg dihydro-ergotamine (Dihydergot). General analgesics had to be administered in addition on 21.8% of the treatment days and intensive care treatment (artificial ventilation) on 32% of the treatment days. The duration of epidural analgesia varied between 1 and 15 days depending on the intensity of symptoms (pain, ileus). Within 4 days, the enzyme activity of the lipase fell from 8120 to 427 IU, and that of alpha amylase fell from 1401 to 143 IU. In 3 patients laparotomy (for drainage) was performed. An ERCP was carried out in 16 patients. Cardiopulmonary failure necessitated artificial ventilation over a period of 1-15 days in 6 patients; the epidural blockade was continued during the artificial ventilation. Cholecystectomy was carried out as an interval operation in 6 patients. No neurological complications were observed. All patients survived and were discharged from hospital. PMID- 1780490 TI - Cellular and molecular mechanisms of chemically induced renal carcinogenesis. PMID- 1780491 TI - Protective effect of allopurinol and superoxide dismutase in renal isografts in cyclosporin A-treated rats. AB - Acute tubular necrosis (ATN) after renal transplantation is related to the duration of warm and cold ischemia and leads to temporary or permanent impairment of graft function. An increased incidence of ATN has been reported since the introduction of cyclosporin A. Kidney damage resulting from hypothermic storage is generated in part during reperfusion rather than during ischemia itself. Potential mediators of the reperfusion injury are oxygen-derived free radicals. Therefore, the influence of two oxygen radical antagonists, allopurinol and superoxide dismutase, was evaluated in syngeneic rat kidney transplantation with and without concurrent administration of cyclosporin A. At 15 h cold ischemia, 28 day survival increased from 8% (no treatment) to 22% (superoxide dismutase), 33% (superoxide dismutase and allopurinol), and 73% (allopurinol). Cyclosporin A cotreatment (10 mg/kg over 14 days) resulted in survival rates of 0%, 25%, 17%, and 50% for the respective treatment groups. The results of serum creatinine values and morphological evaluation of biopsies paralleled the survival rates. Cyclosporin A nephrotoxicity was evidenced by significant serum creatinine elevations throughout the 28-day period of observation. In conclusion, allopurinol significantly protects syngeneic rat kidney transplants against a critical duration of cold ischemia. Under the conditions of this experiment, allopurinol was clearly superior to superoxide dismutase treatment. Cyclosporin A nephrotoxicity was, however, not ablated by the oxygen radical antagonists employed. PMID- 1780492 TI - Nephrotoxicity of an ellipticine derivative (N2-methyl-9-hydroxyellipticinium acetate) in rat: a defect of urinary concentrating ability. AB - The antitumor drug celiptium (N2-methyl-9-hydroxyellipticinium) is an ellipticine derivative effective in experimental tumors and in man. The major side effect is nephrotoxicity. The impairment of renal function is studied in rats following a single i.v. dose of 20 mg/kg celiptium and a long-term study (day 2 to day 60). A loss of body weight is noted in celiptium-treated animals between day 4 and day 15, and recovery occurs between day 15 and day 60. Histologic study shows cortical lesions characterized by focal necrosis of proximal tubules without any glomerular, interstitial, and vascular alterations on day 8. It is to be noted that any medullary lesions were not shown. A polyuria and a decreased creatinine clearance are reported on day 8. We were interested in a special study of this polyuria. For this study, rats were water deprived between day 6 and day 8 following celiptium administration. The decrease of urinary osmolality is not recovered after dehydration and exogenous vasopressin derivative (dD AVP) does not correct the renal concentration defect. AVP plasma levels increase after dehydration. These results suggest a pitressino-resistant urinary concentrating inability in celiptium-treated rats. PMID- 1780493 TI - Glomerulopressin activity in carbon tetrachloride-induced cirrhosis in male rats. AB - The activity of glomerulopressin, a putative renal vasoregulatory hormone that is synthesized in the liver, was assayed in male rats with carbon tetrachloride induced cirrhosis and the results were compared to glomerulopressin activity in normal-control and pair-fed animals. Glomerulopressin activity in blood samples collected from the hepatic vein of the cirrhotic group was significantly lower than the activity in the normal-control and pair-fed groups. Glomerulopressin activity in the normal-control and the pair-fed groups were not significantly different. The data support the concept that glomerulopressin deficiency in liver disease, such as cirrhosis, may play a role in the genesis of the functional renal failure associated with liver disease. PMID- 1780494 TI - An electron microscopy study of urinary sediment: relationship between myeloid body excretion and gentamicin nephrotoxicity in the rat. AB - We studied renal function, urinary enzymes, urinary sediment, and renal histopathology in Fischer 344 rats that were treated with one dose of mercuric chloride (HgCl2) alone, HgCl2 followed by gentamicin, gentamicin alone, or gentamicin, followed by HgCl2. HgCl2 was administered intraperitoneally at 1 mg/kg body weight. Gentamicin was injected subcutaneously at 40 mg/kg body weight. Renal function was assessed by creatinine clearance. Urinary sediment was examined using transmission electron microscopy; particular attention was given to the numbers by myeloid bodies in the urinary sediment. Renal tissue was assessed using light microscopy for acute tubular necrosis (ATN). In either HgCl2 or saline-treated rats urinary sediment showed no myeloid bodies, and renal morphology was essentially normal. The rats given HgCl2 48 h prior to initiation of gentamicin therapy showed significant decrease of myeloid bodies excretion. This was accompanied by significantly less impairment of renal function, mild renal lesion, and no necrotic tubule cells in urinary sediment. The rats treated with either gentamicin alone or gentamicin followed by HgCl2 developed significant impairment of renal function in association with marked elevation of the urinary enzymes, and variable extent of ATN. In both of these groups, urinary sediment showed a profusion of free myeloid bodies and many necrotic renal tubule cells. The urinary sediment findings, however, did not aid in distinguishing between these two treatment groups. From these data we conclude that (1) a tentative relationship exists between the concentration of the urinary myeloid bodies and severity of gentamicin nephrotoxicity; (2) prior treatment with compound(s) analogous to HgCl2 which could minimize urinary excretion of the myeloid bodies might be useful in the mitigation of gentamicin nephrotoxicity. PMID- 1780495 TI - The effect of aldose reductase inhibition and dietary protein restriction on renal function in experimental diabetes mellitus. AB - The effects of aldose reductase inhibition on renal function in hyperphagic diabetic rats were examined at 3 months. To prevent a high dietary protein intake from influencing renal function, protein intake in the diabetic animals was reduced to that of nondiabetic animals. To determine the influence of renal prostaglandins, clearance studies were performed before and after indomethacin infusion. Experiments were performed in uninephrectomized sorbinil-treated and untreated streptozocin-diabetic and sorbinil-treated and -untreated control rats. Despite normalization of protein intake, the mean value of the insulin clearance (CIn, mL/min/100 g BW) was 83% greater in the untreated diabetic rats when compared to the untreated control rats (1.06 +/- 0.15 vs. 0.58 +/- 0.07; p less than 0.05). In contrast, the mean value of the CIn in the sorbinil-treated diabetic rats was significantly less than that in the untreated diabetic rats and only 38% greater than the mean value in the sorbinil-treated control rats (0.84 +/- 0.17 vs. 0.61 +/- 0.05; p less than 0.05). In a similar fashion, without sorbinil treatment the mean value of renal blood flow (RBF, mL/min/100 g BW) was greater in the diabetic than the control rats (6.58 +/- 2.03 vs. 3.70 +/- 0.68; p less than 0.05); whereas the mean values of RBF in the sorbinil-treated diabetic and control rats were not significantly different (4.75 +/- 0.73 vs. 4.17 +/- 0.64; NS). Indomethacin infusion failed to cause changes in the CIn and RBF in any group of animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780496 TI - Cyclosporin-associated thrombotic microangiopathy: successful retreatment with cyclosporin. AB - This report describes a patient who developed cyclosporin-induced thrombotic microangiopathy in a renal allograft. Cyclosporin-induced thrombotic microangiopathy is considered by many as a contraindication to subsequent therapy with cyclosporin. This case is notable for successful treatment with cyclosporin following resolution of thrombotic microangiopathy in a renal allograft. PMID- 1780498 TI - Comments on predicting EPA's forthcoming CO standards in light of new clinical evidence. PMID- 1780497 TI - Response to Tollefson et al. PMID- 1780499 TI - Comments on incorporating mechanistic data into quantitative risk assessment. PMID- 1780500 TI - Mathematical modeling of reproductive and developmental toxic effects for quantitative risk assessment. AB - A new mathematical dose-response model for reproductive and developmental risk assessment is proposed. The model includes the possibility of an exposure threshold as well as a litter-size effect. Correlation of responses of offspring from the same litter is taken into account through the use of the beta-binomial distribution. Confidence limits for low-dose extrapolation are based on the asymptotic distribution of the likelihood ratio. An empirical comparison of the proposed procedure to that of Rai and Van Ryzin demonstrates the improvement that can be achieved with the new procedure. PMID- 1780502 TI - Estimating the value of avoiding morbidity and mortality from foodborne illnesses. AB - When people consume products violating the Food, Drug, and Cosmetic (FD&C) Act they may experience morbidity or mortality from foodborne illness. Some studies have used survey data to estimate the dollar value of avoiding a few illnesses, but surveys are expensive and the resulting estimates cannot easily be generalized to the wide variety of foodborne illnesses. We develop a method that uses published data to estimate the value of avoiding morbidity and mortality from foodborne illnesses using two metrics--quality-adjusted life-years and dollars. The method first describes the effects of different illnesses on the patient and then converts these descriptions into changes in time spent in different health states with different relative utility weights. We use these estimated changes to compute losses in quality-adjusted life-years. We demonstrate our method and derive estimates for the value of avoiding a future case of botulism, salmonellosis, chronic hepatitis, and bladder cancer. Researchers can use our method to compare the value of avoiding all illnesses caused by violations of the FD&C Act. More importantly, government officials can use our method to quickly and cost-effectively generate morbidity and mortality valuation estimates for any illness for policy purposes. PMID- 1780501 TI - Knowledge and risk perception among nuclear power plant employees. AB - This is a study of knowledge, risk perception, and attitudes among nuclear power plant employees. A total of 236 persons participated, belonging to 10 different professional groups and working at two Swedish power plants. Job-related radiation risks were judged about average as compared to a number of other risks. On the whole, the participants in the study were satisfied with the measures of safety at work, but there were some exceptions to this rule, especially among those hired for temporary jobs through external contractors. The experience of job-related radiation risks was related to the level of knowledge about radiation and its risks: those who knew less experienced larger risks. General level of anxiety did not correlate with risk perception. The latter was accounted for mainly by perceived radiation risks. Job satisfaction was more strongly related to perceived conventional job risks than to nuclear risks. Risk ratings were related to how subjects defined the concept of risk. Those who stressed consequences as part of their risk definition gave higher risk ratings. PMID- 1780503 TI - Modeling benzene pharmacokinetics across three sets of animal data: parametric sensitivity and risk implications. AB - Typically, the uncertainty affecting the parameters of physiologically based pharmacokinetic (PBPK) models is ignored because it is not currently practical to adjust their values using classical parameter estimation techniques. This issue of parametric variability in a physiological model of benzene pharmacokinetics is addressed in this paper. Monte Carlo simulations were used to study the effects on the model output arising from variability in its parameters. The output was classified into two categories, depending on whether the output of the model on a particular run was judged to be generally consistent with published experimental data. Statistical techniques were used to examine sensitivity and interaction in the parameter space. The model was evaluated against the data from three different experiments in order to test for the structural adequacy of the model and the consistency of the experimental results. The regions of the parameter space associated with various inhalation and gavage experiments are distinct, and the model as presently structured cannot adequately represent the outcomes of all experiments. Our results suggest that further effort is required to discern between the structural adequacy of the model and the consistency of the experimental results. The impact of our results on the risk assessment process for benzene is also examined. PMID- 1780504 TI - Planning replacement of natural gas distribution systems under constraints on acceptable risk from explosions. AB - Natural gas distribution systems in the United States were developed primarily in the first half of this century, utilizing materials such as cast iron and then steel. Over time, cast iron and steel pipe sections became weak from corrosion and are subject to failure which in turn can lead to explosions and possible injury and loss of life. Gas utilities maintain system integrity through repair replacement programs where pipe sections are prioritized for replacement in any given year through cost-benefit analysis; however, the total annual amount to be budgeted for replacement is left to engineering judgment. This approach has left some utilities vulnerable to criticism that their current replacement rate on cast iron pipe is not great enough and that public safety is being compromised. This paper addresses the problem situation by formulating a linear programming replacement decision model which augments cost-benefit analysis with explicit constraints on acceptable risk to human life from fire/explosion. The model is illustrated for a hypothetical utility. PMID- 1780505 TI - Perceived risk, stigma, and potential economic impacts of a high-level nuclear waste repository in Nevada. AB - This study investigates the potential impacts of the proposed nuclear waste repository at Yucca Mountain, Nevada, upon tourism, retirement and job-related migration, and business development in Las Vegas and the state. Adverse impacts may be expected to result from perceptions of risk, stigmatization, and socially amplified reactions to "unfortunate events" associated with the repository (major and minor accidents, discoveries of radiation releases, evidence of mismanagement, attempts to sabotage or disrupt the facility, etc.). The conceptual underpinnings of risk perception, stigmatization, and social amplification are discussed and empirical data are presented to demonstrate how nuclear images associated with Las Vegas and the State of Nevada might trigger adverse economic effects. The possibility that intense negative imagery associated with the repository may cause significant harm to Nevada's economy can no longer be ignored by serious attempts to assess the risks and impacts of this unique facility. The behavioral processes described here appear relevant as well to the social impact assessment of any proposed facility that produces, uses, transports, or disposes of hazardous materials. PMID- 1780506 TI - Comments on "perceived risk, stigma, and potential economic impacts of a high level nuclear waste repository in Nevada". PMID- 1780507 TI - [Randomized studies of antiemetic drugs: need for establishing criteria of optimal dose for correct comparison of efficacy]. PMID- 1780508 TI - [Inadequate ADH secretion syndrome associated with acquired immunodeficiency syndrome]. AB - Within the numerous complications of AIDS, we want to point out the appearance of inadequate ADH secretion syndrome (IADHSS) in 9 out of; patients, which constitutes a higher percentage than in the general population. In all cases IADHSS was associated to lung or central nervous system pathology. In one patient, IADHSS preceded the appearance Pneumocystis carinii pneumonitis. Therefore, if hyponatremia is founding AIDS patients, the existence of adrenal pathology or IADHSS should be suspected. PMID- 1780509 TI - [Renal kallikrein in diabetic nephropathy]. AB - Urinary kallikrein (reliable reflexion of its renal excretion) is studied in a large group of diabetic patients with and without nephropathy (again subdivided following Mogensen stages) and in hypertense non-diabetic patients. It is observed that the urinary excretion of kallikrein is independent of the type of diabetes (insulin or non-insulin dependent). There exists a clear difference in the behaviour of this enzyme, in diabetic patients with and without nephropathy, increasing in the former and decreasing in the latter (p less than 0.001). The decrease in urinary kallikrein is parallel to the existence of diabetic nephropathy with arterial hypertension. Urinary kallikrein in hypertense non diabetic patients who are not treated with diuretics (furosemide) has a behaviour as in normal controls, but it is much higher in patients treated with captopril, being this finding of great importance since it can suggest new therapeutic approaches to diabetic nephropathy. PMID- 1780510 TI - [Thyroid dysfunction induced by amiodarone in Catalonia. Prevalence and characteristics]. AB - The purpose of this study was to review the epidemiological aspects and the characteristics of the thyroid disfunction produced by amiodarone in Catalonia, an area with type I endemic goiter. For this purpose, three groups of patients have been studied: 1) 102 patients with prolonged amiodarone treatment, out of whom 6 (5.9%) presented hyperthyroidism, and 2 (1.9%) hypothyroidism. 2) 909 patients with hyperthyroidism of any origin out of which 42 (4.6%) were produced by amiodarone. 3) 203 patients presenting primary hypothyroidism of any origin out of which 11 (3.8%) were induced by amiodarone. Out of the 48 patients with amiodarone induced hyperthyroidism, 16 presented multinodular goiter, 2 toxic thyroid goiter and 7 Graves Basedow disease. Thyroid uptake of 131I was studied in 10 cases being normal or increased in six of them, all with a underlaying thyroid pathology. Out of the 13 patients with amiodarone induced hypothyroidism, 3 presented diffuse goiter; thyroid uptake of 131I was studied in 5 patients, being normal or increased in 4 cases, 2 of which with thyroid pathology. Amiodarone administration very often produces thyroid disfunction, specially hyperthyroidism. These patients with hyperfunctional thyroids usually present underlying thyroid pathologies in which thyroid uptake of 131I are frequently not suppressed as well as in those patients in whide amiodarone induced hypothyroidism. PMID- 1780511 TI - [Study on the activity of acromegaly: evaluation of IGF-I]. AB - The evaluation of acromegaly only with GH levels can be difficult. We have evaluated in 32 acromegalic patients the clinical activity and baseline GH after oral glucose and THR. IGF-I was also evaluated. According GH suppression by glucose, three groups were established. A) minimum GH less than ng/ml, B) minimum GH 2-5 ng/ml and C) GH less than 2 ng/ml. IGF-1 in group A was 8.8 +/- 4.1 U/ml (mean +/- SD) and in group C IGF-I was 1.4 +/- 0.5 U/ml. Group B presented heterogeneous clinic and IGF-I levels. A 4 years clinical and hormonal follow-up could be performed in 20 patients. Those patients who were clinically inactive maintained their GH levels less than 2 ng/ml, with normal IGF-I titers throughout the follow-up period. In summary, IGF-I is very reliable in the evaluation of acromegaly activity and only requires a baseline determination being thus very useful in initial screening. It also determines with great reliability the treatment effectiveness in the evolutive study. PMID- 1780512 TI - [Multiple primary pulmonary carcinomas]. AB - Three cases of multiple simultaneous primary lung carcinomas are presented, in which diagnosis was established by post-surgery pathological exam. In all three cases, chest X-ray showed pulmonary masses suggestive or clinical malignancy, and pre-surgery pathological diagnosis or squamous lung carcinoma. During thoracotomy or in the resected segment, a second lesion we confirmed which made resection necessary being this second lesion classified as lung adenocarcinoma. PMID- 1780513 TI - [Syringomyelia: diagnostic value of magnetic resonance and computed tomography in 5 cases]. AB - We present five cases of Syringomyelia, three of which are associated with Arnold Chiari malformation, establishing a comparison between the diagnostic effectivity of CT scan and Nuclear Magnetic Resonance (NMR). In all five cases the lesion was detected by NMR, but not by CT scan. The advantages of NMR over CT scan were evaluated concluding that NMR is more sensible and should be of first choice in the diagnosis of Syringomyelia, permitting also, a better study of the extension of the cavities as well as its control after surgical treatment. PMID- 1780514 TI - [Digestive manifestations of common variable immunodeficiency]. AB - We present 4 cases of common variable immunodeficiency with main digestive clinical manifestations. In all four cases chronic diarrhea with intestinal malabsorption predominated, as well as the presence lymphoid nodular hyperplasia; in one case Giardia infestation could be identified; one patient also presented chronic pancreatitis, or recurrent aphthous stomatitis and active chronic hepatitis; sideroblastic anemia could be observed in another patient. All patients had favorable evolution during follow-up which lasted at least 14 months in substitutive treatment with immunoglobulins. One of our patients presented an elevated number of suppressor T lymphocytes, with inversion of the T helper/T suppressor ratio which improved with cimetidine treatment. PMID- 1780515 TI - [General pathogenesis of diffuse alveolar-interstitial pulmonary disease]. AB - Diffuse alveolar-interstitial lung disease is a syndrome characterized, amongst others, by a common pathogenic scheme. The different phases of its pathogenesis are reviewed in this work. First of all, the concept of alveolitis is described, indicating its characteristics and general consequences of this lesion. Secondly, the different agents which could lead to the destruction of alveolar and interstitial structures, especially those of macrophagic origin, are reviewed. Next, the different types of granulomas, cells of which they are formed, and their general production mechanism are described. Finally the concept of lung fibrosis are reviewed, studying the different processes which lead to increased collagen in the interstitial tissue, specially chemotaxis and fibroblastic proliferative factors. PMID- 1780516 TI - [Tuberculosis at the present time]. PMID- 1780517 TI - [Parathyroid carcinoma. Diagnostic difficulties and usefulness of fine needle puncture-aspiration]. PMID- 1780518 TI - [Acute renal failure in leptospirosis. Presentation of 2 cases]. PMID- 1780519 TI - [Cutaneous toxicity by ftorafur, hand-foot or palmar-plantar erythrodysesthesia syndrome]. PMID- 1780520 TI - [Leukemoid reaction and thrombocytosis in sarcoidosis]. PMID- 1780521 TI - [Results of an analysis of oncologic metastasis]. PMID- 1780522 TI - [Neutrophil anticytoplasmic antibodies in systemic lupus erythematosus]. PMID- 1780523 TI - [Meningococcal arthritis and pseudogout]. PMID- 1780524 TI - [Hypertransaminasemia caused by intensive exercise]. PMID- 1780525 TI - [Hypolipidemic agents]. PMID- 1780526 TI - [Multicenter study of tuberculosis in clinical autopsies in Andalucia, in the 1973-1988 period]. AB - We revised 6,863 protocols of clinical autopsies in four hospitals of the Andalusian Health Service, from 1973 to 1988, out of which 2,814 were valid, and finding 81 active tuberculosis cases (TBC) (2.87%), in 53 males and 28 females, with mean age of 54.41 years. Milliar forms (44 cases) predominated over non milliar (37), with a premortem diagnosis in 32 cases. TBC was considered as the principal disease in 65.43%, it directed contributed to death in 59.26% of cases, and was associated to other diseases in 79.01% of cases. The most frequent localizations were lung (80.25%), lymph nodes (43.20%) and liver (37.04%). We compared two similar periods of time: 1978-80 and 1986-88, observing an increase in TBC in the latter, 14:22, which can be attributed to HIV infection, since 6 of the 22 cases were associated to this pathology. PMID- 1780527 TI - [Serology against Toxoplasma gondii in pregnant women. Development of prevalence rates in the course of 4 years]. AB - Sera from 1,221 pregnant women were screened for antibodies against Toxoplasma gondii. The prevalence rate of antibodies was 38.9%. We have observed specific IgM antibodies 15 pregnant women (1.2%). The prevalence rate was not increased significantly with the age and number of pregnancies. The seropositivity was reduced significantly in the 4th year studied. The high rate of seronegativity observed in the pregnant women represent a high risk of Toxoplasma infestation. PMID- 1780528 TI - [Clinical and bacteriological aspects of urinary infections associated with male urethral stenosis]. AB - Urinary infections are extremely frequent in male urethral stenosis. We analyse in the present work its real incidence, clinical and microbiological aspects, complications and morbidity, in a group of 175 male patients presenting urethral stenosis evaluated in our hospital during a period of time of 11 year. We point out the high incidence of urinary infections which in our study affected 36% of patients. It was caused in 90% of cases by a single bacteria, 44% of which were due to Escherichia Coli. It had a high morbidity with complications appearing in 42 of the patients presenting urethral stenosis and urinary infection (67%), and requiring surgery in 19 cases. On the other hand, urinary infection is an important etiological factor in the genesis of urinary stenosis, finding a direct post-infection etiology in 19% of the studied stenosis. To conclude the present study, we can deduce that when presented with a case of a male patient affected of urethral stenosis, we must think of a possible infective mechanism, existing also a great probability that his urine is still infected by the causing or other micro-organism. PMID- 1780529 TI - [Syphilis and human immunodeficiency virus infection: diagnostic and therapeutic problems. Presentation of 2 cases and review of the literature]. AB - We here present the clinical cases of two homosexual patients, carriers of human immunodeficiency virus (HIV), who later presented a syphilis infection and who after receiving the usually recommended treatment, suffered a relapse of the infection six months afterwards, with neurologic involvement in one case. The clinical characteristics are discussed as well as the diagnostic and therapeutic problems which syphilis infection presents in HIV infected patients. Serological results are comparable to those of the general population, although face positives have been occasionally reported as well as some abnormally elevated titers. It is possible that neurosyphilis might be more frequent and of earlier appearance in HIV infected patients. Therefore, it might be necessary to carry out a spinal fluid exam, in these type of patients, in order to rule out the existence of an early and/or asymptomatic neurologic affectation and give the appropriate antibiotic treatment. PMID- 1780530 TI - [Empty sella turcica with intrasellar herniation of the optic chiasm]. AB - We here present the case of a patient who starts with a progressive vision loss, observing in the radiologic exam herniation of optic chiasma in a primary empty sella turcica. Based on this case, we have performed a review of this clinical picture and point out the most important aspects in the literature. PMID- 1780532 TI - [New pharmacologic perspectives in the therapy with antisecretory agents: omeprazole]. PMID- 1780531 TI - [Massive hemothorax: an exceptional complication of Rendu-Osler-Weber disease]. AB - Hereditary familial telangiectasis is a vascular dysplasia characterized by a triple syndrome: hereditary character, telangiectasias and hemorrhages. Its association with systemic and/or pulmonary arterio-venous fistulae is frequent and can condition several complications: cerebral abscess, digestive hemorrhages, epistaxis, hemoptysis, hypoxemia, polyglobulia, and rarely the appearance of hemothorax. We describe a patient who was admitted in hospital with a hypovolemic shock secondary to a massive hemothorax; during emergency surgery, which was necessary to perform, a pulmonary A-V fistula was observed in the middle lobe. The studies afterwards performed demonstrated that it was a Rendu-Osler-Weber disease with duodenal, hepatic, and cerebral involvement. PMID- 1780533 TI - [Progressive anemia in a young man]. PMID- 1780534 TI - [The physician in biomedical investigation: what role do we reserve for him?]. PMID- 1780535 TI - [Etoposide (VP16) treatment of Langerhans-cell histiocytosis]. PMID- 1780536 TI - [Sweet's syndrome in the post-chemotherapy granulocytopenic phase of an acute leukemia]. PMID- 1780537 TI - [Efficacy of flumazenil in hypercapnic encephalopathy: preliminary communication]. PMID- 1780538 TI - [Idiopathic isolated hyperphosphaturic hypophosphatemia and presacral kidney: a casual association?]. PMID- 1780539 TI - [Poisoning with a corrosive agent in an elderly patient. Endoscopy and emergency surgical treatment]. PMID- 1780540 TI - [Necrosis of bone marrow in a metastatic carcinoma of the gallbladder]. PMID- 1780541 TI - [Lymphoid follicular hyperplasia and membranous glomerulonephritis]. PMID- 1780542 TI - [Early infection of Lyme's disease in the southern area of Galicia]. PMID- 1780543 TI - [Spherical pneumonia]. PMID- 1780544 TI - [The role of the nurse in the clinical use of IMAP]. AB - A survey was carried out on patients treated with Fluspirilene (IMAP) at the Mental Health Dispensary from January 1, 1987, to January 1, 1988. An analysis is made on the evolution of the patients given this treatment and extrapyramidal reactions observed, the cases hospitalized in spite of the treatment and the criteria of family members regarding the drug. A statistical discussion is made about the results shown in tables about the study carried out. PMID- 1780546 TI - [The grandparents' club. The results of a working period]. AB - A comparative study was made on the members of the Grandparents' Club from La Salud locality, Quivican municipality, in order to assess a host of physical and psychic parameters. The results were positive in relation to smoking, obesity and sedentariness, on the basis of preventive programs put into practice since the implementation of the family doctor plan and the grandparents' clubs. There was evidence of improvement in blood pressure requirements, presence of arthralgia, dyspnea due to efforts, normal walking and a lower mean record in the physical fitness tests. At the end of the period under study, the number of drugs taken by the elderly was lower and, from a psychic point of view the elderly people were more capable, more helpful and in general "better". PMID- 1780545 TI - [The evolution of the eclamptic patient. A 5-year analysis]. AB - A discussion is made of 17 cases of eclamptic pregnant women cared for in the last 5 years at the Provincial Teaching Gynecological- Obstetrical Hospital Justo Legon Padilla. The results of the variables under study and the evolution of the patients with the treatment are provided. PMID- 1780547 TI - [Complications of the deep venous approach in vascular surgery]. AB - Cultures were made of the distal ends of 101 venous catheters removed from the same number of patients recently operated on for vascular disorders, and 7.9 per cent of the cultures were positive. The most frequently found germ was negative coagulase staphylococcus (4.9%). In these patients, 5.9 per cent of hemocultures were positive, the most frequent germ being positive coagulase staphylococcus (1.9%). There was no coincidence between the patients with positive hemocultures and those with positive cultures of the distal ends of the removed venous catheters. There were no infective or non-infective complications. Also, there no reports of early or late infection of the vascular prosthesis implanted on the patients operated on up to now. PMID- 1780548 TI - [Schistosomiasis: the automation of clinico-epidemiological data]. AB - For many communities throughout the world schistosomiasis has been commonplace for many years. A large amount of Cubans periodically arrive in their country from areas where the disease is endemic. A pack of programs was designed for automatically processing clinical-epidemiological data about it. The output tables are presented of 233 Cubans with established diagnosis who were cared for at the Pedro Kouri Tropical Medicine Institute. Nurses play an important role in caring for these diseased by providing assistance, sanitary education and other activities. PMID- 1780549 TI - [An educational model for extramural 2nd-year nursing]. AB - This article describes a distant curricular methodology of the Universidad del Valle Nursing Department. With such a modality over 500 professionals were able to reach the nursing licenciateship degree, without leaving their jobs and working in different cities of the country. The backgrounds offered refer to the programs of the southwestern region in Colombia and the results of the evaluation, which made it possible to provide a new nursing curriculum, more in accordance with the needs both of the community and of the region and the country. Two main factors are emphasized which underly the educational model: learning while rendering services and solving medical care problems of the institution, and at the same time fulfilling the quality level of the learning model for stimulating creativity, critical discussion, facilitating the active work of the learners. Finally, a summary is made of the method used and the results in terms of the model experimentation and implementation in five universities around the country. PMID- 1780550 TI - [Nursing projects for 1991]. PMID- 1780551 TI - [AIDS. Another nursing battle]. PMID- 1780552 TI - [Esophageal manometry: the indications, contraindications, general principles and procedure]. PMID- 1780553 TI - [The historical personality of Florence Nightingale]. PMID- 1780554 TI - [Research in nursing, an aspect to be explored for the development of science and technology]. AB - A bibliographic study was carried out at the Pinar del Rio Medical Science Faculty about the real possibilities of professional nurses in the scientific research field. The goal was to determine if such professionals are able to involve in creative activity. The results are supported by Cuban and foreign bibliography. In the comparative graph, the interrelation of the research process with nursing activities is shown. It is concluded that there is no contradiction between research activities specific to the profession and other types, as well as the research devoted to basic sciences. It proves that this specialty is not limited to the parameters considered by it. PMID- 1780555 TI - Research on teaching in physical education. AB - This article reviews research on teaching in physical education. I first consider research methodology employed in this area and then examine research related to instructional effectiveness, classroom ecology, and cognition and decision making. Conclusions and future directions are then presented that have implications for researchers, teachers, and teacher educators. PMID- 1780556 TI - Silverman's RT-PE review: too simple a summary of a complex field. PMID- 1780557 TI - Research on teaching in physical education: a commentary on Silverman's review. AB - This commentary discussed the need for a clearer definition of teaching. Silverman's RT-PE schema was reviewed, and several concerns were raised. Clark's framework for conceptualizing research methods for teaching was reviewed. And, finally, the Spectrum of Teaching Styles was suggested as a schema for organizing RT-PE content. Silverman's review has enriched our discipline, and he deserves our appreciation. In particular the breadth of his review is noteworthy. This review should be useful to teachers and should serve as a catalyst for further discussion in the research community about this interesting and important discipline. PMID- 1780558 TI - Research on teaching in physical education: questions and comments. PMID- 1780559 TI - The value and future agenda of research on teaching physical education. AB - Research on teaching physical education is important because teaching is central to the school institution. Consistent results have emerged from research on teaching. A moral imperative exists for continued efforts to refine what we know about effective instruction in the gym. In spite of the complex, nondeterministic, and normative nature of teaching, teachers are influenced by research on teaching as they strive to improve their craft. Research on teaching physical education must move in the direction of understanding the representations teachers employ in helping students who are having difficulty mastering subject matter. Studying teachers' methods for helping students learn while mediating students' social and emotional anxieties in a range of physical education contexts will reveal the kind of knowledge that will have practical importance. We will then be able to describe practice that is successful from the perspective of students and those who set standards for education's results. PMID- 1780560 TI - Familial aggregation in physical activity. AB - The purposes of this study were to (a) examine the stability and consistency of the Caltrac accelerometer (Hemokinetics, Madison, WI) and an activity record to assess physical activity in children and adults (Experiment 1), and (b) to determine if there is a relationship between parents and their children in physical activity level (Experiment 2). Thirty 5-9-year-old children and their biological parents wore Caltrac accelerometers for three consecutive days (including one weekend day). At the same time, parents completed a Caltrac Activity Record (CAL REC) for themselves and their child. Dependent variables were counts per day for the Caltrac and minutes of light activity and activity for the CAL REC. Between-day correlations for the Caltrac ranged from r = .73 to .87 for the parents (p less than .001) and from r = .38 (p less than .04) to .79 (p less than .001) for the children. An analysis of variance with repeated measures indicated no significant differences for the Caltrac between days for parents and children. Between-day correlations for CAL REC ranged from r = .67 to .91 (p less than .05) for parents and r = .36 to .72 (p less than .05) for children, and there were no significant differences between days. In Experiment 2, chi 2 analyses were used to examine familial resemblance in physical activity. Using the Caltrac, familial resemblance occurred in 67% (father and child) and 73% (mother and child) of the families. Using the CAL REC, familial aggregation was present in 70% (father and child) and 66% (mother and child) of the families.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780561 TI - A latent growth curve approach to investigating developmental dynamics and correlates of change in children's perceptions of physical competence. AB - In both the physical and academic domains interest has recently grown regarding developmental change in children's perceptions of competence. Recent advances in statistical methodology, such as latent growth modeling, enable the researcher to analyze developmental trends from both an inter- and intraindividual perspective, thus serving to increase our understanding of correlates of change in perceived competence. Using latent growth modeling, the purpose of the present study was to investigate developmental change in children's perceived competence at physical skills, examining maturational factors and chronological age as possible correlates of change. Subjects were male adolescents (N = 94). Data were collected during the child's sixth, eighth, and ninth grade school years. Results revealed a good fit for the hypothesized model, which specified mean level changes in the variables over time and an interrelationship among the latent chronometric common factors. Although a significant relationship existed between maturation and perceived competence, no significant relationship was evident between chronological age and perceived competence. Findings are discussed with particular reference to the utility of latent growth curve models for assessing developmental processes at both the inter- and intraindividual level. PMID- 1780562 TI - Validity and generalizability of social dance performance ratings. AB - The purpose of three related studies was to develop a social dance instrument that had logical validity and generalizable performance ratings. Three social dance experts critiqued the instrument and concluded the items described the characteristics of good social dance performance. Twelve couples from a social dance class were videotaped for 5 min while performing the fox trot. Their performances were evaluated by a different set of coders in each of the three generalizability (G-) studies conducted (Subjects x Coders x Days ANOVA design). Dance performances were held constant across coding occasions so the day facet represents degree of consistency in coding, not stability of subjects' performances. Decision (D-) studies were also conducted for various measurement conditions. Results of the G-studies indicated that coders with several years of experience teaching and evaluating dance had less systematic coder bias and less systematic coder bias for a subset of dancers than coders who had little or no experience evaluating movement of any form. The performance ratings given by novice coders could be generalized for any randomly selected coder evaluating on any given day (G = .79). It was concluded the social dance test was valid and coders could be trained to obtain generalizable performance ratings. PMID- 1780563 TI - The effect of contextual variety on the practice, retention, and transfer of an applied motor skill. AB - Laboratory research in motor learning has consistently demonstrated higher retention and/or transfer when practice occurs under conditions of high contextual variety (e.g., Lee & Magill, 1983; Newell & Shapiro, 1976; Shea & Morgan, 1979;). In the present study, an attempt was made to determine whether a contextual variety effect could be demonstrated in a standard physical education instructional setting. During practice trials on the long and short badminton serves, male and female subjects performed under either blocked (i.e., all trials of one serve followed by all trials of the other) or varied (i.e., alternating trials of long and short serves) conditions. Retention and transfer tests (i.e., using the service area opposite that employed during the practice phase) were administered at the end of the badminton unit. Although little difference was observed in the performance of the two groups during practice, alternating-trial subjects demonstrated significantly higher retention of the short serve and significantly higher transfer of both serves than blocked-trial subjects. The performance of male and female subjects was not differentially influenced by practice structure conditions. It was concluded that a practice schedule that requires performers to change their plan of action from trial to trial may facilitate the retention and transfer of motor skills in applied instructional settings. PMID- 1780564 TI - Effects of submaximal exercise and noise exposure on hearing loss. AB - A recent Scandinavian study reported that persons cycling at moderate intensity for 10 min suffered hearing loss when the exercise was accompanied by noise. The noise consisted of a 1/3 octave band-filtered noise with a 2000 Hz center frequency at 104 dB SPL. In the present study, adults cycled at 50 rev.min-1 against a force that elicited an oxygen cost equal to 70% of VO2max--an intensity frequently recommended in exercise prescriptions--with and without noise administered via headphones. Repeated measures ANOVA with three factors revealed that although a temporary hearing loss occurred following exercise-and-noise, a similar and slightly greater hearing loss occurred following noise-only. Hearing sensitivity was not significantly altered by exercise-only (p greater than .05). In general, hearing loss values were greatest between 3000 and 4000 Hz. In conclusion, temporary hearing loss was driven by noise exposure, not exercise. However, persons who choose to exercise with personal headphones or in a noisy environment should be aware of potential premature hearing loss. PMID- 1780565 TI - The metabolic cost of two ranges of arm position height with and without hand weights during low impact aerobic dance. AB - To determine the energy cost of low impact aerobic dance while varying arm movement height and the use of hand weights, 10 adults volunteered to participate in four choreographed trials. All trials consisted of identical leg movements. Arm movements, however, were performed above shoulder level both with and without 0.9-kg hand weights and below shoulder level both with and without 0.9-kg hand weights. Open circuit spirometry was employed throughout the 10-min videotape guided trials, and heart rate was measured by telemetry. Neither the use of hand weights nor the change in arm position height significantly altered the energy cost of low impact aerobic dance. However, heart rate responses were significantly different. Caution should be observed by aerobics instructors and participants as to the use of heart rate as an indicator of intensity for low impact aerobic dance. PMID- 1780566 TI - Does self-efficacy predict performance in experienced weightlifters? AB - Previous studies that have examined self-efficacy-performance relationships have used novice performers. It is unclear if these findings would generalize to "experienced" performers. Based on Bandura's self-efficacy theory, this study was designed to investigate (a) the effects of false information feedback on self efficacy beliefs and subsequent weightlifting performance, and (b) whether self efficacy or past performance is most related to subsequent weightlifting performance. Experienced weightlifters engaged in six performance sessions, each consisting of a one-repetition-maximum bench press. Male subjects (N = 36) were randomly assigned to one of three treatment groups: accurate performance information, false information that they lifted more than their actual lift, or false information that they lifted less than their actual lift. Before each session, subjects indicated the amount of weight they were 100%, 75%, and 50% confident they could lift. Results replicated existing research findings regarding deception and performance; false positive feedback increased future bench press performance. In addition, results indicated that past weightlifting performance accounted for nearly all of the variance in subsequent performance. This finding is discussed in light of the difficulty in extending the predictions of self-efficacy theory to sport settings where athletes have gained experience by undergoing repeated training trials. PMID- 1780567 TI - Measurement errors in modified pull-ups testing. PMID- 1780568 TI - A field test for upper body strength and endurance. PMID- 1780569 TI - Health and Physical education: the future. PMID- 1780570 TI - Physical education and the public health: some problems. PMID- 1780571 TI - Physical education's role in public health: a response to the forum. PMID- 1780572 TI - When do I call in a biometrician? PMID- 1780573 TI - Pharmacokinetics of ceftazidime in sheep and its penetration into tissue and peritoneal fluids. AB - Serum, tissue and peritoneal fluid concentrations of ceftazidime were studied in ewes after intravenous, intramuscular and subcutaneous administration at 50 mg kg 1 bodyweight. Tissue and peritoneal cages were implanted in the animals studied. After intravenous bolus administration, the mean serum concentration versus time profile was best described by a two-compartment open model. The distribution rate constant (alpha) was 3.5 +/- 1.1 h-1 and the half-life (t 1/2 alpha) 0.22 +/- 0.09 hour. The elimination rate constant (beta) was 0.43 +/- 0.04 h-1 and half life (t 1/2 beta) 1.6 +/- 0.2 hours. The area under the curve was 275.7 +/- 84.0 micrograms.ml-1 h. The volume of distribution as steady state was 356.1 +/- 208.0 ml kg-1. The penetration ratio into tissue fluid was 62.6 +/- 15.1 per cent and into peritoneal fluid 61.1 +/- 16.5 per cent. After intramuscular injection, the elimination half-life was 1.7 +/- 0.2 hours, the area under the curve was 228.7 +/- 43.3 micrograms.ml-1 h. and the elimination rate constant was 0.42 +/- 0.05 h 1. The penetration ratio into tissue fluid was 68.5 +/- 37.3 per cent and into peritoneal fluid 73.3 +/- 34.4 per cent. After subcutaneous injection, the elimination half-life was 1.8 +/- 0.5 hours, the area under the curve was 231.8 +/- 65.6 micrograms.ml-1 h. and the elimination constant was 0.41 +/- 0.10 h-1. The penetration ratio into tissue fluid was 47.2 +/- 3.5 per cent and into peritoneal fluid 58.1 +/- 15.6 per cent.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780574 TI - Surface markers on bovine fetal lymphocytes and immunoglobulin synthesis in a congenital infection related to epizootic bovine abortion. AB - Immunological parameters were studied among 23 late-term bovine fetuses. Epizootic bovine abortion (EBA) disease was induced in fetuses by feeding Ornithodoros coriaceus ticks on pregnant heifers. A spirochaete-like microorganism was detected in the blood of diseased fetuses and in inapparent natural infections in some abattoir-collected fetuses. Fetuses were classified according to stages of disease: EBA diseased (n = 10), EBA infected (n = 7) and normal (n = 6). Using flow cytometry, the presence of surface immunoglobulins (sIg) and peanut agglutinin (PNA) receptors were used to detect B and T lymphocytes, respectively. In peripheral blood of normal fetuses, most lymphocytes were identified as T or B cells, whereas about 20 per cent of lymphocytes in EBA diseased fetuses did not reveal the sIg or PNA receptor markers (null cells). Size and shape analyses by flow cytometry detected a population of enlarged lymphocytes in the EBA diseased fetuses. The numbers of cells bearing determinants reactive with monoclonal antibodies specific for bovine T cells (B26A and B29A) and B cells (TH21A) were considerably less than those expressing the PNA receptor and sIg. These results suggested that the monoclonal antibodies were binding to differentiation antigens which were not consistently expressed on the fetal cells. Radio-immunodiffusion was used to measure bovine IgM, IgG1 and IgG2 in fetal serum. The quantities of immunoglobulins were markedly increased in animals infected with the spirochaete like organism (groups 1 and 2) and were assumed to result from fetal antibody synthesis. PMID- 1780575 TI - Ability of the fungus Pleurotus pulmonarius to immobilise preparasitic nematode larvae. AB - In vitro experiments showed that the oyster mushroom Pleurotus pulmonarius exerts a strong immobilising effect on preinfective larvae of the animal parasitic nematodes Ostertagia ostertagi, Cooperia oncophora, Oesophagostomum quadrispinulatum and Cyathostoma species. Infective stages of the same species seemed less vulnerable to fungal attack, possibly because they are protected by their outer cuticle. PMID- 1780576 TI - Detection of antibodies to mycoplasmas in South American camelids. AB - Indirect haemagglutination tests on sera from 757 South American camelids (alpacas, llamas and vicunas) carried out in the Andean region of Peru, revealed evidence of exposure mainly to Mycoplasma mycoides subspecies mycoides LC. The incidence of detectable antibodies to this mycoplasma in 554 alpacas was 5.0 per cent and in 141 llamas 15.6 per cent. Antibody to Mycoplasma capricolum and the F38 biotype was detected in 0.9 per cent and 0.2 per cent of alpacas, respectively. In a group of 62 vicunas only one reactor to both M m mycoides LC and M capricolum was observed. No reactors to M mycoides subspecies capri or M agalactiae were observed in the flocks examined. Antibodies to mycoplasma were also detected in nine out of 10 goat flocks tested. The incidence of antibodies to M m mycoides LC was 13.8 per cent, 3.8 per cent for M capricolum and 1.8 per cent for the F38 biotype. In a group of 110 sheep, six reactors (5.5 per cent) to M m mycoides LC and one (0.9 per cent) to F38 were observed. The implications of these results are discussed in relation to the involvement of mycoplasmas in existing disease in camelids in Peru. PMID- 1780577 TI - A quantitative measurement of the effect of avian influenza virus on the ability of turkeys to eliminate Pasteurella multocida from the respiratory tract. AB - The effect of avian influenza virus (AIV) infection on the ability of turkeys to eliminate Pasteurella multocida from the respiratory tract was evaluated. Four week-old turkeys were experimentally infected with an apathogenic AIV subtype (H5N2) by the oculonasal route and subsequently superinfected with P multocida (Urbach strain) by the intranasal route three days after infection with AIV. Quantitative clearance of P multocida from the trachea and lung was determined using a pour plate technique on samples collected at intervals after infection. Samples from turkeys which had been infected with AIV were found to yield more P multocida than those from turkeys which had not been infected with AIV. The numbers of P multocida increased in infected birds to a greater extent than in birds which had not been infected with the virus. The present study suggests that AIV infection may contribute to the increased numbers and a decreased clearance of P multocida in turkeys. PMID- 1780578 TI - Disposition of oxfendazole in goats and efficacy compared with sheep. AB - The disposition of intraruminally administered oxfendazole (OFZ) in goats was studied at 5, 10 and 20 mg kg-1. The area under the plasma concentration with time curve (AUC) increased with increasing dose but at a declining rate. AUC was lower after intra-abomasal compared with intraruminal administration. OFZ was less effective against drug resistant Trichostrongylus colubriformis in goats than in sheep but was of similar efficacy against drug resistant Haemonchus contortus in both host species. In the same experiment peak plasma levels of OFZ in goats were about half those in sheep given the same dose. Of 70 goats tested in the field, total rumen bypass occurred in 12 per cent and partial bypass in 67 per cent. Lower systemic availability due to bypass would be expected to reduce further anthelmintic efficacy in goats. From the results of these experiments a dose rate of 10 mg kg-1 is recommended for goats. When given at this rate as a divided dose at 12 hourly intervals over 24 hours, OFZ was significantly more effective than a single dose in reducing egg counts. PMID- 1780579 TI - Cryptosporidium parvum: investigation of sporozoite excystation in vivo and the association of merozoites with intestinal mucus. AB - Enteric cryptosporidiosis was studied in the small intestine of five-day-old sucking mice after infection with 10(6) Cryptosporidium parvum oocysts. It was shown that excystation and the majority of subsequent endogenous stages occurred predominantly in the ileum. During the first three days of infection the number of merozoites collected in ileal washings increased over 100-fold to approximately 10(6) merozoites per mouse on the third day. In contrast to control mice, wash fluid from infected mice contained numerous strands of dislodged mucus. Estimates of mucus in the ileal washings of infected mice were similar to those made in controls until day 4 after infection when they increased and remained high throughout the remainder of the experiment. This study describes a method whereby ileal mucus washings from C parvum infected infant mice could be used as a rich source of merozoites. PMID- 1780580 TI - Transient infections of goats with a novel spotted fever group rickettsia from Zimbabwe. AB - A novel spotted fever group rickettsia has recently been isolated from Amblyomma hebraeum ticks in Zimbabwe. In a survey of 172 goat sera collected throughout Zimbabwe the highest prevalence of antibodies reactive with this rickettsia was in the south of the country, the area where A hebraeum is most commonly found. Nine goats were infected using male and female A hebraeum taken from a tick line shown to be infected with the novel rickettsia. By week 3 after infection, seroconversion occurred in all nine goats but no clinical signs of disease could be detected. A leucocytosis due to a mature neutrophilia one to two weeks after infection was the only abnormality. Rickettsaemia was detected only on day 3 after exposure to infected ticks. Immunosuppression failed to induce recrudescence of the rickettsaemia. PMID- 1780581 TI - Lactating cows become partially refractory to frequent intramammary endotoxin infusions: recovery of milk yield despite a persistently high somatic cell count. AB - Midlactation cows were infused with 10 micrograms endotoxin in the same two homolateral quarters after each of several consecutive milkings to study the effect of prolonged, endotoxin-induced mastitis on lactational performance. The initial infusion induced an acute response with systemic involvement. Inflammation developed in infused quarters, and milk production declined and milk composition was altered in all quarters. Subsequent infusions failed to induce systemic responses. Furthermore, milk yield and composition in uninfused quarters returned to pre-treatment levels despite further infusions. In infused quarters, milk yield, protein percentage and serum albumin concentration showed partial recovery during the endotoxin infusion period. In contrast, decreased lactose concentration, and increased cell count, N-acetyl-beta-D-glucosaminidase and lactoferrin levels persisted throughout the infusion period. After infusions were stopped, all measurements returned to near pretreatment levels. These data demonstrate that systemic, but not local, responses become refractory to multiple intramammary endotoxin infusions, and that multiple infusions have continued but little progressive or permanent, inhibitory effects on lactational performance despite a persistent mammary leucocytosis. PMID- 1780582 TI - Expression of procoagulant activity by equine lung macrophages: stimulation by blood lymphocytes. AB - Increases in procoagulant activities (PCA) in equine lung macrophages were induced by non-adherent blood lymphocytes which were prestimulated with phytohaemagglutinin for 48 to 72 hours or by supernatants harvested from prestimulated blood lymphocyte cultures. However, prestimulated lymphocyte suspensions themselves expressed PCA which was most probably derived from contaminating monocytes. Because non-adherent cells from lymphocyte suspensions may have attached to adherent macrophages, cells within lymphocyte suspensions might have contributed to the PCAs expressed by lymphocyte-stimulated lung macrophages. Stimulation of lung macrophages for 24 hours by supernatants of phytohaemagglutinin-prestimulated blood lymphocytes induced a significantly greater PCA increase than stimulation by phytohaemagglutin alone. Thus, cytokines from lymphocyte cultures might have triggered or enhanced PCA induction. Direct stimulation of lung cell preparations with phytohaemagglutinin for 48 hours resulted in a progressive increase of PCA in only two of five specimens tested. The failure to induce PCA in three specimens could be due to the absence of sufficient numbers of T cells within the adherent lung cell preparations. In conclusion, PCA response of equine lung macrophages might be lymphocyte stimulated in which case PCA might be a useful tool for monitoring the processes of cell-mediated immunity in horses. PMID- 1780583 TI - Intraperitoneal vaccination of pigs to control Mycoplasma hyopneumoniae. AB - In a field trial at a commercial piggery 22 pigs were vaccinated intraperitoneally, at 30 days and 60 days old, with formalin-killed Mycoplasma hyopneumoniae plus adjuvant. Two other groups of the same size, one receiving a ration containing antibiotics, were not vaccinated. The mean enzyme-linked immunosorbent assay (ELISA) ratio of the vaccinated group increased significantly (P less than 0.001) after 30 days, and continued to rise until day 156 of life. In the other two groups the ELISA ratio did not increase significantly until day 115. The vaccinated pigs in the 30-day period after the first vaccination grew significantly (P less than 0.01) more slowly than the controls but between days 60 and 144 they grew significantly faster (P less than 0.05) than the two other groups, thus compensating for their previous, relative loss. At slaughter (at 163 days old), the mean weight was similar in all groups. The mean score for pneumonia at slaughter for the vaccinated, medicated and control groups was 2.6 (+/- 4.3), 9.4 (+/- 14.0) and 10.5 (+/- 12.4), respectively. The proportion of M hyopneumoniae-affected lungs (4.8 per cent) in vaccinated pigs, as judged by immunofluorescence, was significantly less (P less than 0.001) than the control groups (40 per cent). Thus, intraperitoneal vaccination with killed M hyopneumoniae plus adjuvant might control mycoplasmal pneumonia in commercial piggeries. PMID- 1780584 TI - Detection of equine antiplatelet and antineutrophil antibodies by enzyme-linked immunosorbent assay. AB - An enzyme-linked immunosorbent assay (ELISA) was standardised and applied for the detection of antiplatelet and antineutrophil antibodies using a heterologous system consisting of equine platelets or neutrophils and antisera raised in rabbits. The standardised technique consisted of using Immulon type 3 plate, 1 per cent gelatine as a blocking solution, poly-L-lysine buffer as a coating solution, unfixed antigen, 90 microliters test serum, horseradish peroxidase conjugated antibody and o-phenylenediamine dihydrochloride as a substrate. The number of unfixed platelets or neutrophils required for optimum detection of antibodies was 250,000 per well. Unfixed cellular antigens were as good as their extracts and superior to paraformaldehyde-fixed antigens in detecting specific antibodies. Microtitre plates coated with platelet or neutrophil antigens could be stored at 4 degrees and -70 degrees C for four to five weeks without significant loss of antigenicity. The ELISA was very sensitive in that antiplatelet antibody was detected up to a titre of 1:204,800 and antineutrophil antibody to a titre of 1:51,200. Some cross-reactivity (1:1600) was detected in antiplatelet and antineutrophil sera for neutrophil and platelet antigens, respectively. Platelet-associated antibody was also detected in extracts from platelets pretreated with 1:2 and 1:8 dilutions of antiplatelet serum. Standardised ELISA detected antiplatelet antibodies in nine and antineutrophil antibodies in three of 100 isologous equine blood typing sera. PMID- 1780585 TI - Examination of milk samples from experimentally infected heifers by an N-acetyl beta-D-glucosaminidase test and an antigen-capture ELISA. AB - Milk samples collected from normal and experimentally infected quarters of five heifers throughout their first lactation were examined by bacterial culture, milk cell count (MCC), N-acetyl-beta-D-glucosaminidase (NAGase) test and a monoclonal antibody based antigen-capture ELISA. The results were analysed according to the presence (mastitis positive) or absence (mastitis negative) of bacteria on culture, and the numbers of false negative and false positive results of the other three tests defined in relation to this. Similar numbers of false negative results were observed with the MCC (20), NAGase (18) and ELISA (13). False positive results due to the physiological factors present in early lactation were evident in the MCC, prominent in the NAGase test and absent from the ELISA. The major difference in false positive results associated with experimental infection between the three tests was the more rapid return to negative values of the ELISA following resolution of infection, compared with MCC and NAGase. PMID- 1780586 TI - Enhancement of the plasma concentration of albendazole sulphoxide in sheep following coadministration of parenteral netobimin and liver oxidase inhibitors. AB - The effects of methimazole (MTZ), metyrapone (MTP) and quinine (QNE) on the pharmacokinetics and bioavailability of parenterally administered netobimin (NTB) and its major metabolites, albendazole sulphoxide (ABZSO) and albendazole sulphone (ABZSO2), were studied in sheep. NTB trisamine solution was first administered alone at 20 mg kg-1 by subcutaneous injection and then coadministered with either MTZ (1.5 mg kg-1 intramuscularly), MTP (20 mg kg-1 subcutaneously) or QNE (30 mg kg-1 intraruminally) in adult sheep. Blood samples were taken serially over a 120 hour period and plasma was analysed for NTB and its metabolites by high performance liquid chromatography. NTB parent drug showed a similar pharmacokinetic behaviour after all parenteral treatments. Both ABZSO AUCs (P less than 0.01) and Cmax (P less than 0.05) were significantly higher in the presence of MTZ and MTP than with the treatment with NTB alone. In the presence of each of the oxidation inhibitor compounds, the ratio of AUC ABZSO/ABZSO2 was significantly higher than with the NTB alone treatment. It has been demonstrated that the coadministration of substances which alter liver microsomal oxidation resulted in a modified pharmacokinetic pattern for the metabolites of NTB. Both NTB + MTZ and NTB + MTP treatments resulted in an improved pharmacokinetic profile for the anthelmintically active ABZSO metabolite. PMID- 1780587 TI - Stability of canine factor VIII activity and von Willebrand factor antigen concentration in vitro. AB - The in vitro stability of canine factor VIII activity, von Willebrand factor antigen concentration and the ratio of these two factors was studied. Samples were stored for up to 48 hours, either as plasma or as whole blood, at 4 degrees, 20 degrees and 37 degrees C. Factor VIII activity was generally stable in both plasma and whole blood samples for up to 48 hours at 4 degrees or 20 degrees C. The concentration of von Willebrand factor antigen was more stable in samples stored as plasma than whole blood, and for a shorter time than factor VIII activity. Consequently, the stability of the ratio of these two factors was relatively poor in vitro. PMID- 1780588 TI - Inhibition of natural killer activity in porcine mononuclear cells by African swine fever virus. AB - The coincubation at 37 degrees C for 24 hours of swine peripheral blood mononuclear cells with African swine fever virus inhibited in part the natural killer activity shown by cells incubated without the virus. This inhibition depended on the dose of the virus and on the time that cells were incubated with it. When the virus preparation was fractionated by ultracentrifugation, most of the inhibitory activity was found in the sedimented fraction, where viral particles were present; however, the loss of inhibitory activity in respect to the whole virus preparation indicated that some inhibitory activity was present in the supernatant fraction, probably as factors released by infected cells. Most of the inhibitory activity shown by the sedimented fraction was lost when the virus was inactivated by ultraviolet radiation, indicating an active role of virus infectivity in the inhibition. PMID- 1780589 TI - Interaction of Ostertagia and Nematodirus species in sheep and the potential of serum fructosamine determination in monitoring gastrointestinal parasitism. AB - Serum fructosamine concentration falls with an increase in plasma protein turnover. Since this increase is a feature of gastrointestinal parasite infection at all sites, a falling serum fructosamine level may be of general application in the interpretation of parasite-related events. The circulating fructosamine level was investigated in the lamb as an indicator of protein-losing gastroenteropathy associated with two parasites at different sites, Ostertagia circumcincta (abomasum) and Nematodirus spathiger (small intestine). Infection with 10,000 N spathiger infective larvae daily for seven weeks produced only slight clinical signs, and only a small change in serum fructosamine levels. 2500 O circumcincta L3 daily gave no clinical signs in most animals, but serum fructosamine was more strongly affected in this group. Concurrent infection with both organisms caused some degree of diarrhoea in all lambs, and a sustained fall in serum fructosamine, more accentuated than that observed in either of the single infection groups, supporting the value of serum fructosamine determination in monitoring gastrointestinal parasitism. PMID- 1780590 TI - Histopathology of antitrochanteric degeneration in adult female turkeys of four strains of different mature size. AB - The left and right antitrochanters of 80 female turkeys of four strains were examined for histopathological changes at sexual maturity. Ten birds of each strain were fed ad libitum and 10 restricted to achieve 0.6 of the bodyweight of the ad libitum fed birds at 24 weeks old when the birds were photostimulated. Bodyweights at sexual maturity (28 to 31 weeks) for the four strains were 5.4, 6.5, 7.6 and 13.2 kg for restricted and 7.5, 9.0, 11.1 and 17.1 kg for ad libitum fed birds. The prevalence and severity of cartilage change increased with mature size and was lower in restricted turkeys then in turkeys fed ad libitum. The results showed that abnormal cartilage changes forming the basis of clinical disease occur in females. The prevalence and severity of lesions were directly related to bodyweight and were not limited to particular genotypes. Lesions were more severe in the centre of the antitrochanter, possibly because of forces exerted by the trochanter. Concentrations of basophilic cells in the hyaline cartilage were associated with the increased prevalence and severity of lesions in large turkeys and may be of significance in the development of osteochondrotic lesions in the antitrochanter. PMID- 1780591 TI - In vitro and in vivo efficacy of epsiprantel against Echinococcus granulosus. AB - In vitro, epsiprantel at a concentration of 10 micrograms ml-1 caused tegumental damage and death of protoscoleces, juveniles (seven-day-old) and adult (37-day old) Echinococcus granulosus. Degenerative changes and death occurred more rapidly in the older parasites. Similarly, epsiprantel was more effective against adult (28-day-old) than seven-day-old experimental infections of E granulosus in dogs. Oral doses of 2.5, 5 and 7.5 mg kg-1 were greater than 96 per cent, 99.9 per cent and 99.99 per cent active, respectively, against mature worms, whereas in seven-day-old infections doses of 5, 7.5 and 10 mg kg-1 produced greater than 94 per cent, 90 per cent and 99.8 per cent reduction in worm burdens, respectively. No side effects from treatment were seen. PMID- 1780592 TI - Epidermal dexamethasone receptors in dogs with confirmed hyperadrenocorticalism, hypothyroidism or undiagnosed hormonal alopecia. AB - Low capacity, high affinity [3H] dexamethasone binding receptors were identified in cytosolic preparations of the skin (mean number 42.0 +/- 25.2 fmol mg-1 protein, apparent dissociation constant (1 nM +/- 0.23) of clinically normal dogs. No [3H] dexamethasone binding was observed in the skin of nine out of 10 dogs with confirmed spontaneous hyperadrenocorticism or in the skin of three out of six dogs with undiagnosed hormonal alopecia. A reduction was detected in the number of [3H] dexamethasone binding receptors in the skin of one dog with confirmed hypothyroidism. This study provides evidence for the susceptibility of canine glucocorticoid receptors to down regulation by imbalances of endogenous hormones, particularly increased glucocorticoid concentrations. PMID- 1780593 TI - Comparative in vitro activity of three cephalosporins against Staphylococcus aureus isolated from bovine mastitis. AB - This report compares the in vitro activity of three cephalosporins (cephalothin, cefoxitin and ceftriaxone) against 57 Staphylococcus aureus strains isolated from cows with clinical mastitis on the basis of the minimal inhibitory (MIC) and minimal bactericidal concentrations (MBC). The majority of the S aureus strains showed resistance to cefoxitin and ceftriaxone and sensitivity to cephalothin. The highest MICs and MBCs were found for cefoxitin and ceftriaxone. Antimicrobial tolerance (MBC/MIC greater than or equal to 32:1) was observed in relation to cephalothin and ceftriaxone. The data suggest that these cephalosporins may not be effective for the treatment of staphylococcal bovine mastitis. The precise definition of their antimicrobial efficacies requires more detailed in vitro and in vivo studies. PMID- 1780594 TI - Characterisation of complex karyotype changes in two canine bone tumours. AB - Two dogs developed osteosarcomas. In both cases, the cytogenetic analysis revealed the presence of numerically and structurally altered karyotypes. The chromosome ranges were 90 to 99 and 65 to 67, respectively. Centric fusions frequently identified were 1/3, 1/30 and 2/9 in one case, 3/19, 12/18 and 13/17 in the other. PMID- 1780595 TI - Ostertagia ostertagi in neonatal calves: establishment of infection in ruminating and non-ruminating calves. AB - An experiment was carried out to study the role of the ruminal function in the establishment of Ostertagia ostertagi in neonatal calves. Three groups of calves were fed either milk only (groups A and C), or hay and concentrate in addition to milk (group B) from birth. At the time of infection, ruminal function was negligible in groups A and C, whereas it was well developed in group B. Calves of groups A and B were each given 25,000 normal ensheathed infective larvae of O ostertagi and those of group C were given 25,000 infective larvae exsheathed in vitro. Daily faecal egg output and post mortem worm counts 28 days after infection were higher in calves with well developed ruminal function than those having only negligible ruminal function. In the latter group, exsheathed larvae established at a lower rate than did ensheathed larvae. The results suggest that the degree of development of the ruminal function influences the establishment of O ostertagi. PMID- 1780596 TI - The Pariacaca or Tullujuto story: political realism? AB - The first documented description of acute altitude sickness was published by Father Acosta in 1590. Acosta described this sickness when he traveled through a pass across the Andean divide in central Peru near the mountain Pariacaca. Almost all the maps of modern Peru do not name this mountain. We present evidence that mountaineers who have climbed this mountain know it as Tullujuto. This change in name is the reason why physiologists have found it difficult to locate Acosta's route; consequently the altitude where Acosta experienced this sickness could not be determined until recently. Further, we speculate that political pressures in the late 18th century caused the place name of Pariacaca either to be obliterated or else to be changed to Tullujuto. PMID- 1780597 TI - 13CO2 washout kinetics in acute hypercapnia. AB - The redistribution of CO2 and bicarbonate throughout the body following perturbations of normal respiration is not well described. We used tracer techniques to examine CO2-bicarbonate dynamics in an animal model in which acute hypercapnia was induced by hypoventilation. Eleven rabbits were anesthetized, tracheostomized, paralyzed and ventilated. In five animals PaCO2 was kept between 30 and 35 mmHg (control, C) while in six PaCO2 was held between 65 and 70 mmHg (acute hypercapnia, AH). A bolus of [13C]bicarbonate was given intravenously. Breath samples were obtained for 13CO2 by isotope ratio mass spectrometry and CO2 output (VCO2) was measured breath-by-breath for 240 min. There was no difference in the VCO2 between C [5.6 +/- 1.8 (SD) ml/min per kg] and AH (5.3 +/- 0.8). The 13CO2 washout for both C and AH was well fit by the sum of three exponentials. Only the time constant of the third (slowest) exponential was significantly longer in AH (103 +/- 11 min) compared with C (75 +/- 15, P less than 0.01). The mean residence time in AH (82 +/- 9 min) was significantly lower than in C (57 +/ 10, P less than 0.001). The estimated mass of exchangeable CO2 and bicarbonate was significantly greater in AH (443 +/- 37 ml per kg) compared with C (312 +/- 63, P less than 0.005). Compartmental analysis indicated that the increase in CO2 bicarbonate occurred primarily in the slowly exchanging pool. The data suggest that acute hypercapnia may be accompanied by a redistribution of exchangeable CO2 and bicarbonate in the body. PMID- 1780598 TI - Distribution of ventilation and of diffusing capacity to perfusion in the lung. AB - We developed a method for estimating the distribution of ventilation (VA) and of diffusing capacity (G) to perfusion (Q) in the lungs. We used O2, CO2 and CO together with six inert gases of widely differing solubility and assumed that mass transfer efficiency of each gas in a gas exchange unit is limited by both VA/Q and G/Q ratios. The underlying lung model comprised 20 units along both the VA/Q and G/Q axes. Using numerical analysis, we transformed the data into a virtually continuous distribution of Q in the VA/Q-G/Q field. We tested the precision of the numerical procedure by examining the recovery of various artificial distributions, and found that distributions with up to two modes could be recovered with reasonable accuracy. Analytical results from 15 patients with interstitial pneumonia of unknown etiology (IPF) revealed the following features. (1) In an early disease stage, most of the lung was operating in the range of normal VA/Q, without a significant contribution of diffusion limitation. (2) An advanced stage of the disease exhibited a widening of VA/Q distribution and either broad unimodal or bimodal distribution of G/Q, extending to G/Q below 10( 3) ml (STPD)/(ml.Torr) with diffusion-limited O2 exchange. (3) Severe diffusion limitation causing disequilibrium of inert gas across the blood-gas barrier was observed in three (far advanced fibrosis; active interstitial inflammation) out of 15 patients. These findings suggest that inhomogeneity of G/Q does exist and may play an appreciable role in causing impairment of gas exchange in patients with interstitial pneumonia. PMID- 1780599 TI - Viscoelastic properties of rabbit lung during growth. AB - Viscoelasticity of air-filled isolated lungs of 1-120 day old rabbits was studied at a mean transpulmonary pressure (P1) of 0.65 kPa by measuring: (1) their stress relaxation (SR) following step volume changes (delta V) corresponding to 5% of the vital capacity; (2) their resistance (R1) and elastance (E1) during sinusoidal cycling at 11 frequencies (f) ranging from 0.01 to 0.65 Hz. SR data were analyzed by least-square regression using Hildebrandt's logarithmic model (Hildebrandt, J. (1970) J. Appl. Physiol. 28: 365-372): delta P1/delta V = A - B.log(t) where A is an index of elastance, and B/A is a measure of viscoelasticity. Coefficients A and B were also obtained from R1 and E1 according to: R1 = B/9.2 f and E1 = A + 0.25 B + B.log(2 pi f). Elastance corrected for lung weight increased by 40% between day 1 and days 3-7, and decreased thereafter to reach 30% of its initial value in 120 day old rabbits. B/A ratios also demonstrated an initial rise, followed by a progressive decrease. Values of B/A computed from R1 and E1 were similar to those derived from SR data in 1 day old rabbits, but were 20-30% larger in older animals, which indicates the presence of an additional rate-independent dissipation during flow. Total internal dissipation during cycling varied little with frequency; it was largest in 3-7 day old animals where it represented 20% of the stored elastic energy. PMID- 1780600 TI - Abdominal muscle length during respiratory defensive reflexes. AB - The purpose of the present study was to assess the mechanical behavior of an expiratory muscle during defensive reflexes. Transversus abdominis muscle length changes were measured using sonomicrometry in anesthetized dogs. The abdominal muscle lengthened during the inspiratory phase and shortened at a rapid velocity during the expiratory portion of coughs and sneezes. The mean extent of muscle shortening was not different during coughing compared to breathing (P greater than 0.20) but was approximately double in magnitude during sneezing compared to breathing (P less than 0.005). On the other hand, the peak velocity of muscle shortening was approximately 5-fold greater during coughing (P less than 0.002) and 10-fold greater during sneezing (P less than 0.05) than during breathing. During the largest coughs and sneezes in each animal, peak velocity of muscle shortening averaged 77 +/- 9 and 179 +/- 65% of end-inspiratory length per sec, respectively. Muscle end-inspiratory length during coughs and sneezes differed from values during breathing (range +/- 8%), although for the group of animals the mean changes were small (+/- 1%). Despite these changes in end-inspiratory length, the abdominal muscle continued to operate at lengths both above and below its resting length. These results suggest that during defensive reflexes, greater increases occur in the velocity than in the extent of transversus abdominis muscle shortening relative to during breathing. In addition the transversus abdominis muscle appears to play an active respiratory role during defensive reflexes. PMID- 1780601 TI - Laryngeal afferent activity and reflexes in the guinea pig. AB - We have investigated the various sensory modalities represented in the laryngeal nerves of the guinea pig. In addition, we have examined the defensive responses to mechanical stimuli and capsaicin instillation into the laryngeal lumen of the same species. Recording from both the whole superior laryngeal nerve and from single units of the same nerve revealed the presence of afferent activity related (1) to the contraction of laryngeal muscles and/or the 'tracheal tug', (2) to transmural pressure changes, either positive or negative and (3) to mechanical and chemical irritants. The irritant type receptors of this species, when challenged with water solutions, show two distinct patterns of activation: some behave as osmoreceptors, some respond to the lack of chloride ions. Challenges with capsaicin solutions activated one ending with the characteristics of a C fiber receptor that failed to respond to a subsequent trial. This behavior is consistent with the reflex apnea, dependent on an intact laryngeal innervation, induced by capsaicin instillation that was not elicitable on repeating the challenge. Cough to mechanical probing of the supraglottic area depended on an intact SLN, whereas cough elicited from the subglottic area depended on an intact RLN. Cough to mechanical stimulation could not be desensitized by capsaicin. These findings suggest the presence of two independent afferent pathways for defensive responses. PMID- 1780602 TI - Aortic and carotid body chemoreception in prolonged hyperoxia in the cat. AB - Carotid body chemosensory response to hypoxia is attenuated as a result of prolonged normobaric hyperoxia (NH) in the cat. The effect of NH is likely to be due to high cellular PO2 and O2-related free radicals. Accordingly, the effect would be less if O2 delivery to the chemoreceptor tissue could be compromised. The aortic bodies, which appear to have less of a circulatory O2 delivery, as suggested by their vigorous responses to a slight compromise of O2 flow compared with those of the carotid body, could provide a suitable testing material for the hypothesis. We tested the hypothesis by studying both aortic and carotid body chemoreceptors in the same cats (n = 6) which were exposed to nearly 100% O2 for about 60 h. These chemoreceptor organs were also studied in 6 control cats which were maintained in room air at sea-level. The cats were anesthetized and their carotid and aortic chemosensory fibers were identified by the usual procedure, and their responses to hypoxia and hypercapnia and to bolus injections (i.v.) of cyanide and nicotine were measured. In the NH cats, the carotid but not aortic chemosensory responses to hypoxia and cyanide were attenuated and to hypercapnia (both onset and steady state) augmented. The aortic chemoreceptors were stimulated by hypoxia, hypercapnia, cyanide and nicotine both in the NH and the control cats similarly. The results support the hypothesis that it is presumably a higher tissue blood flow and hence a higher concentration of O2-related free radicals which ultimately led to the specific attenuation of O2 chemoreception in the carotid body. PMID- 1780603 TI - Methacholine-induced bronchoconstriction and phrenic motoneuron activity in dogs. AB - To evaluate the effect of changes in bronchomotor tone on the firing pattern of single phrenic motoneurons, efferent activity of both the C5 branch phrenic nerve and a single fiber from the contralateral phrenic nerve were studied in dogs anesthetized (chloralose/urethane) and breathing spontaneously (65% O2). Bronchoconstriction was induced by inhalation of methacholine (MCh) aerosol, which increased total lung resistance, decreased dynamic lung compliance and tidal volume. The rate of rise of phrenic activity was significantly increased by the changes in pulmonary mechanics induced by MCh. Single phrenic motoneurons could be separated into early (EOM) and late (LOM) onset types based on the onset time of firing relative to the beginning of whole phrenic nerve activity. The increased phrenic nerve activity was due primarily to the recruitment of LOMs. The recruitment of LOMs consisted of a shift in the time of onset to an earlier portion in inspiration, a longer firing duration, and an increase in the number of spikes per inspiratory cycle. After bilateral cervical vagotomy, all the responses of phrenic nerve to changes in pulmonary mechanics induced by aerosolized MCh were attenuated. These results suggest that phrenic motoneurons activity is modulated by alterations in pulmonary mechanics via a reflex mediated by the vagus nerve and that LOM play an important part in this response. PMID- 1780604 TI - Temperature effects on ventilation and metabolism in the lizard, Ctenophorus nuchalis. AB - The effect of temperature upon ventilation and metabolism was measured on a breath by breath basis in the lizard Ctenophorus nuchalis. This species displayed a typical reptilian breathing pattern; groups of breaths separated by periods of breath holding. The lengths of the non-ventilatory periods (NVP) decreased as temperature increased. As a result, overall breathing frequency (f) displayed a thermal dependence. Outside the preferred temperature range (27-37 degrees C) f was also affected by changes in the frequency of breathing that occurred during periods of ventilation (f'). On the other hand, tidal volume (VT) was maintained constant at all temperatures except 42 degrees C ('panting' threshold). Thus, due to the thermal dependency of f, ventilation (VE) displayed a significant increase between 18 and 37 degrees C. Metabolism (VO2 and VCO2) also increased within this temperature range. However, as a result of a lower Q10 for ventilation, ventilatory requirement (VE/VO2 and VE/VCO2) decreased. In addition, lung volume (LV) increased with temperature. Examination of the alveolar ventilation-PCO2 relationship revealed that as a result of the increase in LV the level of intrapulmonary CO2 at the end of an NVP was maintained irrespective of temperature. This implies a temperature-independent chemical threshold for the onset of breathing. It is postulated that with temperature the observed increase in LV could offset the increase in metabolism by slowing the rise of intrapulmonary CO2 levels. This would delay the onset of breathing which in turn would lower VE/VCO2 (and VE/VO2) by preventing an effectual hyperventilation. This supports the notion, at least in C. nuchalis, that relative alkalinity is maintained. PMID- 1780605 TI - Starling forces and lymphatic drainage in pleural liquid and protein exchanges. AB - Pleural liquid volume and protein concentration (C) were determined in rabbits 60 min after a 2 ml hydrothorax with various albumin concentrations in Ringer, homologous serum or plasma. The absorption rate of the hydrothorax decreased with the increase in colloid osmotic pressure of the pleural liquid (pi), being 0.56 +/- 0.03, 0.32 +/- 0.02 and 0.17 +/- 0.05 ml/h with Ringer, 1.1 and 3 g% albumin, respectively, and nil with 5% albumin, serum or plasma. C increased with Ringer and 1.1% albumin, did not change with 3% albumin, and decreased with 5% albumin, serum or plasma. The protein content in the pleural liquid increased with Ringer, did not change with 1.1% albumin, and decreased with the other hydrothoraces. These findings indicate that with hydrothoraces of this size: (1) the Starling forces plus the solute-coupled liquid absorption [Agostoni and Zocchi (1990) Respir. Physiol. 81: 19-28] provide most of the pleural liquid absorption when pi is less than or equal to physiological; (2) the lymphatic drainage increases with pi, providing most of the liquid outflow when pi is similar to that of plasma. This increase in lymphatic drainage, however, does not compensate for the effects of the changes in Starling forces produced by the increased pi. PMID- 1780606 TI - Inflammation in the nervous system. Basic mechanisms and immunological concepts. AB - The basic questions in the pathogenesis of inflammation in the nervous system are how inflammatory cells reach the brain, where they recognize their antigen, how the nervous system interacts with local immune regulation in the lesion, and how inflammatory cells induce irreversible tissue damage. These questions have been addressed by studying the pathogenesis of experimental models of encephalomyelitis. The minimal requirement to start brain inflammation is the presence of activated circulating T-cells directed against a brain antigen and of antigen presenting cells in meninges and perivascular spaces of the nervous system. Such a constellation, however, only results in the disease after hypersensitization, i.e. in the presence of very high numbers of circulating autoreactive T-cells. Other local and systemic immunological factors may profoundly lower the threshold for the induction of brain inflammation. They include antigen recognition on cells in the brain parenchyma (microglia, astroglia), local upregulation of MHC antigens and possibly adhesion molecules (by cytokines or as a consequence of brain injury) and the presence of additional humoral immune responses against brain antigens (autoantibodies). Focal production of cytokines by inflammatory cells as well as by resident cells of the brain plays an important role in determining the activity of the inflammatory process and in inducing effector cells and inflammatory mediators, responsible for tissue destruction. Whereas in pure T-cell mediated auto-immune encephalomyelitis these activated effector mechanisms have low selectivity and mainly induce a "bystander" damage of CNS tissue, additional presence of autoantibodies may focus the immune reaction to specific targets, thus inducing, in high sensitivity, very selective tissue destruction. The present experimental data suggest that different immunological pathways may finally lead to quite similar inflammatory demyelinating lesions. Thus, brain lesions in individual multiple sclerosis patients may develop on a quite diverse immunological background. PMID- 1780607 TI - [Myoclonus and epilepsies in children]. AB - The possible associations of myoclonic phenomena, progressive or non progressive encephalopathies and epileptic phenomena are reviewed with special emphasis on childhood. This leads to the following five groups of conditions: (1) myoclonus without encephalopathy and without epilepsy; (2) encephalopathies with non epileptic myoclonus; (3) progressive encephalopathies with myoclonic seizures or epileptic syndromes (Progressive myoclonus epilepsies); (4) epileptic encephalopathies with myoclonic seizures; (5) myoclonic epilepsies. In the first group, which also includes physiological myoclonus, a more thorough description of "benign sleep myoclonus of newborn" and "benign myoclonus of early infancy" is given. Characteristic of group 2 are "Kinsbourne syndrome" and certain types of "Hyperekplexia" which pose interesting differential diagnosis problems with stimulus-sensitive epilepsies. In group 3, the concept of progressive encephalopathies is stressed, meaning that "Progressive Myoclonus Epilepsies" are always in fact progressive encephalopathies presenting with myoclonic types of seizures or epileptic syndromes among other neurologic and psychologic signs and symptoms. Major and rare causes are reviewed. The term major is applied to typical features or to frequency, whereas rare causes include not only those what are rarely seen, but also some myoclonic variants of diseases which usually have different symptoms. The fourth group refers to severe epilepsies, mainly in infancy and childhood, which lead to mental retardation irrespective of their cause. The assumption is that diffuse and persistent epileptic activity may interfere with normal development of the higher cerebral functions. "West syndrome" and "Lennox-Gastaut syndrome" are the more representative examples and may present with myoclonic type of seizures, but they are not dealt with in detail here. Group 5 comprises true myoclonic epilepsies, differentiating syndromes recognized as idiopathic, such as "benign myoclonic epilepsy of infancy" and "juvenile myoclonic epilepsy", from those which are cryptogenic and carry a more cautious prognosis--i.e.: "cryptogenic myoclonic and myoclono astatic epilepsies" and "Severe myoclonic epilepsy of infancy". Finally other epileptic syndromes usually not considered as myoclonic epilepsies, but presenting sometimes myoclonic seizures, are mentioned. PMID- 1780608 TI - [Clinical and genetic analysis of 188 families with spinocerebellar degeneration. Friedreich's disease and P. Marie's hereditary ataxias]. AB - Based on the hereditary ataxias concepts and a large field survey, the authors analyzed 392 cases of spino-cerebellar degeneration belonging to 188 families. Two main clinical groups were identified: 227 cases of Friedreich ataxia and 74 cases of cerebellar hereditary ataxia of P. Marie type. The association in the same patient of peroneal atrophy of Charcot Marie type with Friedreich ataxia (17 cases) or P. Marie cerebellar hereditary ataxia (13 definite cases and 13 probable) was the most striking finding. "Forme fruste", incomplete form or complex form of Friedreich ataxia were present in some families while in some others there was spastic paraplegia or pure Charcot Marie Tooth disease. This clinical heterogeneity in families of spino-cerebellar degeneration is discussed. PMID- 1780609 TI - [Amnesic syndrome caused by limited infarction in the right anterior thalamus]. AB - A case of global and persistent amnesia due to a right polar and anterior thalamic infarction is reported. There was a moderate impairment of attention and categorization ability. The amnesia was primarily anterograde, with partial disturbance of short-term memory and severe deficit of long-term memory for verbal and visuo-spatial materials. A severe increase of pro-active interference was present. Retrograde memory was mildly affected. Two years later, a second infarction in the right thalamo-sub-thalamic territory occurred, increasing the deficits of attention, short-term memory and recall. PMID- 1780610 TI - [Analysis of the PrP gene in a Tunisian family with Creutzfeldt-Jakob disease]. AB - Results of PrP gene analysis in 5 of 9 members from a Jewish Tunisian family with Creutzfeldt-Jakob disease (CJD) showed a mutation at codon 200 involving substitution of lysine (Lys200) for glutamic acid (Glu200). This observation suggests that Lys200 allele probably tracks with CJD in this family and supports the possible genetic basis of the disease in the Mediterranean cluster. A second PrP variant not associated with Lys200 allele involving a short deletion in the coding sequence has also been found in only one subject. PMID- 1780611 TI - [Giant vertebro-basilar aneurysm. Frontal syndrome]. AB - A 72-year-old man presented with an apparent frontal syndrome. He also had bilateral trigeminal neuralgia, a pyramidal syndrome of all 4 limbs, balance disturbances, a horizontal nystagmus when looking to the left and a right velopalatine paralysis. CT scan with contrast showed a hyperdense rounded lesion in the left cerebello-pontine angle. Cerebral angiography showed this to be a large aneurysm of the end of the vertebral arteries. The patient died suddenly. Autopsy confirmed the site and presence of the aneurysm. Balance disturbances, the pyramidal syndrome and velopalatine paralysis could all be explained by brain stem compression and the bilateral nature of the trigeminal neuralgia by compression of the trigemino-thalamic tract. The apparent frontal syndrome, the authors suggest could have resulted from subacute raised intracranial pressure. PMID- 1780612 TI - [Neurologic manifestations in the vertebro-basilar system revealing pregnancy toxemia]. AB - We report a case with focal neurological deficits suggesting vertebro-basilar system ischemia, in the course of pre-eclampsia. An early CT scan showed a large hypodensity throughout the midbrain. Brainstem auditory evoked potentials initially showed an abolition of III and V pikes suggesting brainstem injury. Two days later both neurological examination and brain stem auditory evoked potentials returned to normal. A CT scan performed three weeks after the onset was normal. These findings suggest a vasospasm which may have been due to sympathomimetic agents given two weeks before the onset of toxemia for preterm labor. PMID- 1780613 TI - [Hemichorea in acquired immunodeficiency syndrome. Toxoplasmosis abscess in the striatum]. AB - Three HIV seropositive patients presented with cerebral toxoplasmosis which was treated by anti-infectious agents. After partial improvement, they developed hemichorea related to striatal infectious lesions. In AIDS patients with cerebral toxoplasmosis, autopsy series have reported a high incidence of basal ganglia abscesses, explaining the occurrence of involuntary movements such as hemichorea. PMID- 1780614 TI - Genetically engineered attenuated herpes simplex viruses. AB - Two recombinant herpes simplex viruses, of type 1 background, were constructed with two large deletions and duplicate sets (type 1 and type 2) of the genes coding for glycoproteins D, G, and E. One recombinant (R7020) is thymidine kinase positive, and the other (R7017) is thymidine kinase-negative. Evaluation in rodents indicated that these viruses are genetically stable, capable of establishing latency, protective against severe herpetic diseases, and protective against the establishment of latency. In Aotus monkeys, R7020 replicates at the site of inoculation but does not disseminate in the body. It can reactivate from the latent state but without causing recurrent lesions, even in immunosuppressed monkeys. PMID- 1780615 TI - [Management of triplet and quadruplet pregnancies]. AB - The management of multiple pregnancies is analyzed on the basis of the results in a series of 34 triple pregnancies and 5 quadruple pregnancies. Hypertension of pregnancy occurred in 6 of the patients, a threat of severe premature delivery in 15 patients. Severe cardiovascular complications, related to beta-mimetics, occurred in one case. Delivery was virtually always by Caesarian, with a mean gestational age of 31 weeks and 5 days for the triple pregnancies and 30 weeks and 5 days for the quadruple pregnancies. In 8.4% of cases, the offspring showed severely retarded intrauterine growth. The total mortality rate was 11.7% for the triple pregnancies and 15% for the quadruple pregnancies. Most deaths during the neo-natal period occurred in offspring from 4 pregnancies in which delivery occurred before 28 weeks of amenorrhea. After 28 weeks of amenorrhea, the adjusted total mortality was 4.2% for the triple pregnancies and no offspring of a quadruple pregnancy died. The prevention of the risk of threatened very early premature delivery led us to propose routine hospitalization after 26 weeks of amenorrhea, in order to improve the foetal prognosis in this age group. Carrying out a Caesarian later, after about 34 weeks of amenorrhea for the triple pregnancies and 32 weeks of amenorrhea for the quadruple pregnancies, made it possible to reduce the incidence of delayed intra-uterine growth and in utero foetal death and also made it possible to schedule the date of delivery. Good obstetric-pediatric coordination is also an essential factor in improving the prognosis for these high-risk pregnancies. PMID- 1780616 TI - [Cervical cancer in women aged 35 and under:a new disease?]. PMID- 1780617 TI - [Genital herpes and childbirth]. AB - Neonatal herpes is a serious infection due to the risk of diffusion and damage to the central nervous system. Depending on the author, the incidence of herpetic infection reported ranges from 1/7,500 to 1/1,000,000 neonates. type II herpes virus is responsible for three quarters of infections. The risk or in-utero damage is low, and does not exceed 5 percent of cases. Contamination usually occurs during delivery or during the immediate post-partum period. The clinical forms of neonatal infection consist essentially of diffuse forms, located in the central nervous system, and localized forms in the integuments and the eye. The prognosis for diffused forms and for damage to the central nervous system was particularly serious (two thirds mortality and a high risk of sequelae amongst survivors); but these results involve children who received anti-viral treatment too late. Primary maternal herpetic infection during the month preceding birth is the most serious risk for the neonate due to the high level of virus in the lesions and the absence of neutralizing antibodies. In this situation, the risk of neonate infection appears to be 75 percent. Fortunately, this situation is unusual. Recurrent infection is accompanied by a lower viral titer, viral elimination is rapid and the patient has neutralizing antibodies. The risk of neonatal involvement in the case of recurrence at the time of childbirth is thought to be less than 5 percent. In cases with a history of genital herpes in the mother or her partner, the risk of neonatal contamination is reported to be 1/1,000.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780618 TI - [Induction of labor by prostaglandins]. AB - The synthesis pathways for prostaglandins (PG) are derived from membrane phospholipids via arachidonic acid. The prostaglandins are the most active substances in inducing maturation of the cervix. They include PGF2 alpha which induces contractions of the uterine muscle and PGE2, which is active on the cervical connecting tissue with no effect on the body. The authors recall the role of the prostaglandins in triggering the spontaneous onset of labour, and suggest the use of PGE2 in the artificial induction of labour. PGE2 can be administered by local or systemic route. The authors report their personal experience with cervical maturation in a retrospective study covering a wide range of clinical circumstances. A prospective study in cases of premature rupture of the membranes, already reported, concludes that labour is induced earlier in a population receiving PGE2 than in a control population. The authors then discuss the literature data and stress the possible use of PGF2 alpha. To conclude, if prostaglandin-induced maturation appears to be more effective, it is nonetheless not the ideal method in view of the side effects and concomitant effects on uterine labour and the cervix. This method has the advantage of being usable in difficult cases. PMID- 1780619 TI - [Medical treatment of ectopic pregnancy by methotrexate]. PMID- 1780620 TI - [Invasive fetal medicine: pros and cons]. AB - Many methods of ovular sampling now exist. They give us access to our second patient, the foetus, for the purpose of carrying out diagnoses and prognoses and of beginning treatment. These methods carry a risk for the foetus, and it is therefore to weigh up the indications carefully. In addition, some methods (embryoscopy, foetoscopy, skin and liver biopsies, foetal blood samples) have to be performed by experienced specialists in reference centers. These methods also raise numerous ethical problems, notably in view of the multiple diagnostic possibilities and the relatively limited therapeutic possibilities. PMID- 1780621 TI - [Evolution of ideas in the conservative treatment of breast cancer]. AB - The epoch of the pioneers began in 1929 with Keynes and then Baclesse in Paris. The time of the large studies coincided, in 1960, with the first cobalt treatment instruments (Pierquin-Spitallier-Papillon-Calle). The randomized studies carried out by Veronesi, I.G. Roussy and the NSABP, showed during the 1970s that conservative treatments and mastectomy had the same long-term efficacy in small breast cancers. In 1990, the standard treatment for T1-T2 less than or equal to 3 cm N0-N1 of the breast is tumorectomy curage followed by irradiation. Surgical and X-ray techniques have clearly improved and now give good aesthetic results in most cases. Women are better informed and consult earlier, screening is being developed and 1 out of 2 women, or perhaps even more, now receive conservative treatment. By the year 2000, we will know the identity of the risk factors of local relapse and how to distinguish these as well as when and how to prescribe adjuvant medication. We will doubtless know that most in situ cancers can be treated like T1 cancers. We may know whether conservative treatment can be proposed for tumors measuring 4 cm and more (primary chemotherapy or radiotherapy, mastectomy and immediate reconstruction). Women have changed little between 1960 and 1990, there has been little change in bistouries and cobalt treatment, and yet mastectomy has disappeared from the treatment of small breast cancers. It has thinking that has changed in the past 30 years. Time is gradually having its effects on medical mentalities. PMID- 1780622 TI - [Contribution of cerebral doppler in the evaluation of fetal well being]. AB - Foetal well being is assumed in normally proceeding pregnancies. In pregnancies with a risk of foetal distress, the obstetrician now has the possibility of carrying out foetal cerebral hemodynamic exploration in order to reach a short term prognosis. The brain of the foetus is a hemodynamically privileged site in cases of hypoxic foetal distress; this brain-sparing effect gives rise to Doppler velocimetric signs which are seen in animal and human foetuses. Cerebral resistance, measured in Doppler velocimetry from the resistance index R = (S.D)/S falls at the beginning of the last third of pregnancy, but remains higher than placental resistance. This is due to the considerable development of foetal brain vascularization from this time forward. Inversion of the ratio between the cerebral index (CRI) and the umbilical index (PRI) and a marked reduction of the cerebral index below the normal range demonstrates the brainsparing effect during hypoxic distress. In cases of delayed intra-uterine growth, this signs is linked to a high probability of forthcoming acute foetal distress (AFD). In hypertension of pregnancy, the fall in CRI is closely correlated with a high Caesarian rate due to AFD and a higher morbidity level and neo-natal sequelae. The prognosis for these foetuses therefore depends on their gestational age: it is good after 34 weeks of amenorrhea, but remains doubtful between 28 and 34 weeks of amenorrhea. In these cases, the administration of oxygen to the mother for 20 minutes (FLO2 = 70%, 8 l/min) constitutes a prognostic test. The foetuses whose CRI is corrected have a better prognosis than the others, if the pregnancy continues up to the change in foetal cardiac rhythm.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780623 TI - [The "so called" therapeutic abortion without valid legislative supports in France]. PMID- 1780624 TI - Ethical problems in rhinologic research. PMID- 1780625 TI - Medico-legal aspects in sinus surgery. PMID- 1780626 TI - Legal aspects in nasal fractures. AB - A criminal act is involved in a high percentage of cases of nasal fracture, and exact medical information describing the damages found is mandatory for the criminal court. It is necessary, that the medical information are obtained from the ENT-department, where the patient is treated, as the information obtained from the casualty department has a too low degree of truth in the establishment of the diagnosis. The statement should include information on the treatment given, as linear fractures in good position requiring no treatment may be classified legally as an offence against the person rather than as a bodily harm. X-ray examination of the nose in cases of nasal fracture gives a much too high number of false positive and false negative results to have any legal value, and, having no medical value as well, they should not be taken unless for scientific purposes. PMID- 1780627 TI - CO2 laser anterior turbinectomy in the treatment of non-allergic vasomotor rhinopathia. A prospective study upon 78 patients. AB - Preliminary results obtained in the treatment of non-allergic vasomotor rhinopathia by CO2 laser are presented. A group of 78 subjects, 35 males and 43 females, aged 18-48 years, mean age 27.6 years, were followed: subjective assessment of nasal breathing quality, anterior rhinomanometry, cytologic findings and saccharine test of nasal clearance. The parameters were observed preoperatively and after surgery. A 400 CO2 Surgical Laser Coherent Medical was used (power density, 140 w/cm2). The beam was applied upon the upper medial quadrant of the head of inferior turbinate by a continuous pulse (7-10 sec) through a Carl Zeiss surgical microscope, at a 10x magnification and focal length of 400 mm. The mean preoperative values of the anterior rhinomanometry were 0.669 and 0.851 Pa sec/ccs for inspiration and expiration, respectively. After the surgery, the mean values were even better, i.e. 0.361 Pa sec/ccs for inspiration, and 0.456 Pa sec/ccs for expiration. The morphological and functional conditions of nasal mucosa were also examined. The former was evaluated using cytologic smears of the nasal mucosa layer, and the latter by the saccharine test of nasal clearance. Normal cytologic findings were found preoperatively in 87% of all cases studied. Saccharine test was normal in 67% of cases. After laser surgery, the cytologic findings and saccharine test results were normal in 92% and 89% of cases, respectively. The subjective patients' assessment of nasal patency pointed to obvious success in 41 out 45 subjects treated. PMID- 1780628 TI - Autogenous auricular concha cartilage transplant in corrective rhinoplasty. Practical hints and critical remarks. AB - Numerous materials have been suggested for correction of nasal defects, especially for the saddle nose. We present here our experience with the autogenous cartilage transplant from the auricular concha in our collective of 32 patients. The concha cartilage is used for saddle nose corrections and reconstruction of the alar cartilages. Auricular concha cartilage is an almost ideal transplant material for corrective rhinoplasty because: 1. Harvesting of the material is a low-risk procedure that is not time-consuming and can be performed under local anaesthesia. 2. Concha cartilage is stable enough for support and elastic enough for contouring. 3. It can easily be shaped as desired. 4. Concha cartilage shows little tendency towards dislocation. 5. Resorption is negligible and thus plays no role in connection with these transplants. 6. Rejection or infection rarely occurs. PMID- 1780629 TI - A prospective trial of Merocel packs. AB - A prospective trial, comparing Merocel nasal packs and glove finger packs is reported. No statistically significant difference was found in symptoms of nasal obstruction or discomfort, findings of nasal crusting or adhesions, or postoperative bleeding, between nostrils packed with Merocel packs or those packed with glove fingers. PMID- 1780630 TI - An international comparison of rhinomanometry between Canada and Japan. AB - International discussions concerning rhinomanometry have been held but no numerical comparisons have been reported. In an attempt to make international comparisons between different rhinomanometric results, nasal resistances were measured by active posterior rhinomanometry with a head-out body plethysmograph produced in Canada and by active posterior and anterior methods with a Japanese commercial rhinomanometer, and the results were compared. No significant differences were found between measurements obtained from the two types of equipment. It is believed that this study is the first project of international comparison of rhinomanometry. PMID- 1780631 TI - Optimal sample frequency in computerized rhinomanometry. Development and method. AB - The authors studied the pressure/flow signals generated during active anterior rhinomanometry of 25 subjects, presenting a normal transnasal breathing. By means of a Fourier transformation, the frequency content of these signals was analyzed. This investigation demonstrated clearly that signals with a frequency of more than 50 Hz no longer yield any further information about the transnasal ventilation. PMID- 1780632 TI - Long-term clinical course of hypersensitive rhinitis. AB - Information on the long-term clinical course of hypersensitive rhinitis was collected among 180 patients who had previously participated in an allergological study. The time period between the initial study and the follow-up questionnaire study was about 18.2 years. Of the patients, 72 were men and 108 women, aged 3.6 69.3 years (mean age 28.5 years) at the time of the initial study. Initially, atopic rhinitis had been verified by allergological investigations in 61.7% while 38.3% of the cases had been designated as intrinsic. During the 18-year period symptoms decreased in severity in 37.2% and ceased completely in 27.2%. Total disappearance of symptoms was more frequent in the intrinsic than in the atopic group. PMID- 1780633 TI - Dentigerous cyst of the maxilla and its image diagnosis. AB - Dentigerous cysts may grow unnoticed to such extensive sizes as to occupy a considerable portion of the maxillary sinus. As they enlarge, the bony walls overlying the cysts thin out giving rise to an egg shell sensation upon palpation. Three cases of such extensive dentigerous cysts were experienced since 1987. These three cases were used to illustrate the advantages and disadvantages of the following imaging techniques in the preoperative evaluation of these cysts, conventional radiographs, sonography, CT, and MRI. PMID- 1780634 TI - Treatment of post-traumatic external nasal neuralgia. AB - Pain about the bridge of the nose is often a diagnostic dilemma. There is a small but important recognizable subgroup who may, as a consequence of involvement of the external nasal nerve in nasal injury, exhibit neuralgic pain after a latent interval. Temporary relief by local anaesthesia is diagnostic and cure is possible by division of the anterior ethmoidal nerve. We present a series of six cases to illustrate this rare cause of facial pain. PMID- 1780635 TI - Rhinocerebral mucormycosis with extension to the cavernous sinus. A case report. PMID- 1780636 TI - Studies on the mechanism of simvastatin-induced thyroid hypertrophy and follicular cell adenoma in the rat. AB - Female Sprague-Dawley rats were treated with either simvastatin (a novel competitive inhibitor of HMG CoA reductase) or phenobarbital (positive control) to ascertain the possible relationship between the effects of simvastatin on hepatic metabolism and the thyroid hypertrophy and follicular cell adenomas which it produces in this strain of rat. The test compounds were administered orally at doses of 100 mg/kg (divided doses at 50 mg/kg, b.i.d.). (This dose of simvastatin represents approximately 250 times the human dose.) After 5 weeks of treatment, either simvastatin or phenobarbital produced significant increases (35% and 39% above control, respectively) in serum thyroid stimulating hormone (TSH), a significant increase (39% and 120% above control, respectively) in the systemic clearance of 125I-thyroxine, and slight decreases in serum thyroxine levels. Statistically significant increases in liver and thyroid weights were associated with phenobarbital treatment. With simvastatin, increased liver weights occurred. At the microscopic level, thyroid hypertrophy was observed in all phenobarbital treated rats and to a lesser degree in most simvastatin-treated animals. Simvastatin did not markedly alter liver microsomal enzyme activities with the exception of the anticipated induction of HMG CoA reductase (which increased approximately 4.4-fold). Conversely, phenobarbital produced large increases in liver microsomal enzymes, including glucuronosyl transferase, but did not affect the activity of HMG CoA reductase. Therefore, the increased clearance of thyroxine in simvastatin-treated female rats was not associated with enzyme induction but may have been related to the increase in functional liver mass produced by this compound at this dose.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780637 TI - Inhibition of copper-associated erythrocyte ghost membrane lipid peroxidation by hepatic cytosolic low molecular weight proteins. AB - Male weanling Fischer rats were injected ip once daily with either 12.5 mg/kg body weight cupric chloride or 2 ml/kg body weight saline for up to 70 days. As the hepatic cytosolic copper increased in copper-treated rats, copper bound to proteins of different molecular weights; this was determined by gel filtration chromatography. Hepatic cytosolic copper from rats treated with cupric chloride for 14 days eluted in 3 peaks. These included a 150,000 + dalton peak, a 29,000 dalton peak and an 11,000-12,800 dalton peak. In addition to these peaks, hepatic cytosolic copper from rats treated with cupric chloride for greater than or equal to 28 days also eluted in a 4th, but shorter, 6,000-7,000 dalton peak. Hepatic cytosolic copper from saline-treated rats eluted only in a single 29,000 dalton peak. Experiments using an erythrocyte ghost membrane model of copper-associated lipid peroxidation demonstrated that incubation of membranes with protein-bound copper eluted in the 11,000-12,000 dalton peak was associated with less lipid peroxidation than incubation of membranes with cupric chloride or protein-bound copper eluted in the 150,000+ dalton peak. Experimental results suggest that the ability of copper to catalyze lipid peroxidation is significantly reduced by binding with hepatic cytosolic low molecular weight proteins but not by binding with hepatic cytosolic high molecular weight proteins. PMID- 1780638 TI - Long-term effects of an inotropic phosphodiesterase inhibitor (ICI 153,110) on the rat salivary gland, harderian gland, and intestinal mucosa. AB - The inotropic vasodilator, ICI 153,110, a phosphodiesterase inhibitor intended for the treatment of congestive heart failure, was administered to Alderley Park Wistar-derived rats for periods of up to 182 days. Treatment produced hypertrophy of salivary glands, hyperplasia of intestinal mucosa, and dacryoadenitis of the harderian gland. As the functions of these glandular tissues can be modified by factors which alter cyclic nucleotide metabolism, it is postulated that the glandular alterations produced by ICI 153,110 occurred as a result of phosphodiesterase inhibition. PMID- 1780639 TI - Hyaline glomerulopathy in B6C3F1 mice. AB - Hyaline glomerulopathy is a spontaneous disease of undetermined etiology that occurs sporadically in various strains of aging mice. In our laboratory, this disease was observed with unusual ultrastructural features as an incidental finding in 2 female B6C3F1 mice from 2 carcinogenicity bioassays. Microscopically, renal lesions were characterized by marked diffuse enlargement and prominent hyalinization of the glomeruli, equally affecting both kidneys. Affected glomeruli were PAS positive, but were negative for amyloid by the Congo red method. Immunocytochemical staining revealed weakly positive glomerular deposits with polyclonal anti-mouse IgG-IgM-IgA cocktail. Ultrastructurally, there were characteristic subendothelial osmiophilic deposits composed of loosely packed linear structures in the glomeruli. Lamellae, which appeared as fibrils in perpendicular sections, were relatively uniform, measured 6.1-17.01 nm in diameter, and formed single or double-layered structures. The ultrastructural and immunocytochemical characteristics are suggestive of a spontaneous immune mediated mechanism in a strain of mouse commonly used in toxicology studies. PMID- 1780640 TI - Immunohistochemical and biochemical identification of pepsinogen isozymes in the hamster lungs: induction by polychlorinated biphenyls. AB - Pepsinogens are acid protease enzymes of pepsin usually found in gastric mucosa. In the present study, we demonstrated the presence of pepsinogen isozymes in male Syrian golden hamster lung tissues by a combined immunohistochemical and biochemical approach. Immunohistochemically, using rat pepsinogen 1 antibody, pepsinogen positive cells were observed mainly in the epithelia of the terminal bronchioles. They demonstrated morphological features of Clara cells. The pepsinogen isozyme pattern of lung tissue determined by polyacrylamide gel electrophoresis was similar to that of stomach mucosa. Treatment of hamsters with polychlorinated biphenyls at a dose of 500 mg/kg body weight ip caused a 2.8-fold increase in pepsinogen content (p less than 0.01) as well as increase in numbers of pepsinogen positive cells in the lung. PMID- 1780641 TI - Spongiosis hepatis: chemical induction, pathogenesis, and possible neoplastic fate in a teleost fish model. AB - Spongiosis hepatis (SH), first reported as a distinct lesion associated with certain forms of hepatic neoplasia in rats, has also been induced with chemicals, in a predictable fashion, in small teleost fishes being studied as carcinogenesis research models. The sheepshead minnow (Cyprinodon variegatus), exposed to N nitrosodiethylamine (DENA) in sea water, provided the model for this study. The fish developed SH and presented a spectrum of developmental or progressive stages of the lesion over a 140 week holding period following a 6 week exposure to / 57 mg/L DENA. The origin of SH in the fish model is homologous to that in the rat model, both species having the perisinusoidal cell (stellate cells of Ito) in the space of Disse as the cell of origin. Light (LM) and electron microscopy (EM) studies characterized the different pathogenetic stages of SH in liver of the sheepshead minnow and revealed a possible late transition of SH to putative polymorphic cell neoplasms. The possible preneoplastic or neoplastic nature of SH from its time of origin in chemically exposed fish to time of appearance of associated presumptive neoplasms is discussed. SH may be a bioindicator of exposure to certain chemicals in some vertebrate species, from fishes to mammals. PMID- 1780642 TI - Histomorphologic observations for cynomolgus monkeys after subchronic subcutaneous injection of recombinant human interleukin-4. AB - Recombinant human interleukin-4 (rhuIL-4) is a candidate for the treatment of refractory cancer based on its potential to enhance the function of the immune system. Total daily dosages of 0 (placebo control), 1, 5, or 25 micrograms/kg of rhuIL-4 were given as divided (b.i.d.) subcutaneous dosages to male and female cynomolgus monkeys (5/sex/group) for 1 month followed by a 2-week recovery. Histomorphologic evaluation of 3/sex/group at 1 month revealed vascular lesions, granulocytic hyperplasia, and seminiferous tubular atrophy attributed to treatment with rhuIL-4. Dosage-dependent proliferative and inflammatory vascular lesions with eosinophil infiltration affected principally the arterial tree. After 2 weeks of recovery, these lesions, including chronic endarteritis and chronic and/or obliterative arteritis, occurred with an overall lower incidence, and were not observed for monkeys from the 1.0 micrograms/kg/day group. Granulocytic hyperplasia in bone marrow observed for monkeys from all groups given rhuIL-4 at 1 month was not present after 2 weeks of recovery. Seminiferous tubular atrophy was observed for monkeys from the 5 and 25 micrograms/kg/day groups at 1 month and after 2 weeks of recovery. PMID- 1780643 TI - Liver damaging effect of suramin in normal and carbon-tetrachloride treated rats. AB - Male Fischer 344 (F344) rats were treated with phenobarbital + carbon tetrachloride (CCl4) for 16 weeks to induce liver cirrhosis. Another group of rats received 50 mg/kg iv suramin once a week for 16 weeks. The third group of rats was treated with both phenobarbital + CCl4 and suramin. After 16 weeks of suramin treatment, a massive periportal infiltration composed of macrophages, many of them containing glycosaminoglycans in their cytoplasm, mast cells, and other inflammatory cells were observed. This lesion was added to the liver cirrhosis caused by CCl4 in the group treated with suramin and CCl4. The changes in glycosaminoglycan metabolism caused by suramin did not influence the CCl4 cirrhosis. Since suramin has been reported to be a prototype of a new generation of antitumor compounds, we suggest caution in the use of chronic suramin treatment, especially in patients with livers which are already damaged. PMID- 1780644 TI - Incidence and pathology of spontaneous renal pelvis transitional cell carcinomas in rats. AB - Spontaneous transitional cell carcinoma (TCC) originating from renal pelvis is very rare. Metastasis from this tumor having been reported only once previously. Data from control groups of 17 carcinogenicity studies in Sprague-Dawley and 10 carcinogenicity studies in Fischer 344 (F-344) rats were reviewed and evaluated to determine the incidence and pathology of TCC. Renal pelvis TCC were observed in 1 male and 1 female Sprague-Dawley rat and in 1 male F-344 rat. Metastasis from TCC to the lung was observed in 1 male Sprague-Dawley rat. Detailed histopathological features of this tumor are described and discussed. PMID- 1780645 TI - Peer review in toxicologic pathology: some recommendations. The Society of Toxicologic Pathologists. PMID- 1780646 TI - Society of Toxicologic Pathologists Great Lakes Region Discussion Group. Bones and articular cartilage responses in experimental animals. PMID- 1780647 TI - [Idiopathic hypercalciuria and bones]. PMID- 1780648 TI - [Bone density in idiopathic hypercalciuria in men. Study by dual photon absorptiometry, X-ray computed tomography and histomorphometry]. AB - Lumbar bone mineral density (BMD) of the L3 vertebra was evaluated by double photon absorptiometry or tomodensitometry (TDM) in 55 hypercalciuric individuals in two separate studies. In the first, in a department of nephrology, 29 lithiasis patients were studied by TDM of L3. By this technique, trabecular density was 75 +/- 23% of normal. It was lower in the 17 patients in whom hypercalciuria persisted after calcium restriction (66 +/- 15% of normal and below the "fracture threshold" in 9 cases) than in the 12 patients in whom it disappeared after the prescription of such a diet (88 +/- 26%, below the "fracture threshold" in 3 cases), this difference being significant (p less than 0.01). In another 26 patients, seen in a department of rheumatology, three of whom had osteoporosis with vertebral fracture, density was measured in 21 cases by double photon absorptiometry (mean Z score -1.9 +/- 1.0) and in 5 cases by TDM (mean BMD of L3 69 +/- 21% of normal). Mean iliac trabecular volume, measured in 8 cases only, was 70 +/- 25% of normal and was below the "fracture threshold" in 3 cases. Comparison of the two study groups was not possible because of differences in recruitment and methods of investigation. These two studies nevertheless show the existence of significant vertebral bone rarefaction during hypercalciuria in the young man. Confirmed and quantified in patients in whom the metabolic disturbance was discovered as a result of radiological abnormalities, this quantitative abnormality was also seen in patients in whom hypercalciurie was found because of renal lithiasis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780649 TI - [Study of bone repercussion in 33 cases with anorexia nervosa which 8 with fracture osteoporosis]. AB - A national survey has regrouped 33 cases of anorexia nervosa (AN) with osseous investigations, in particular an absorptiometry of the lumbar spine. 2 groups have been defined: 25 patients without fracture (F-) and 8 patients with osteoporotic fractures (F+), including 5 cases with 12 vertebral fractures and 5 with non vertebral fractures: 31/33 have a low lumbar bone mineral content (BMC). The lumbar BMC of the F+ is significantly lower than the F-: -4.1 +/- 1.6 DS versus -2.2 +/- 1.2 DS (p less than 0.001). 5 F+ patients are under the fracture threshold (FT), (O F-), 2 F+ are on the same level as the FT, and the last F+ has a lumbar BMC 15% above the FT, but an osteoporotic wrist fracture and a very low femoral neck BMC (0.64 g/m2, normal 1.06 +/- 0.15). F+ are older (35.2 year old versus 23.6, p less than 0.001), owing the fact that the duration of the AN (+ 9.2 years, p less than 0.005) and of the amenorrhea (+ 9.8 years, p less than 0.001) are longer, although the AN began at the same age in the 2 groups. The minimum weight, the body mass index, the percentage of loss of weight are similar in the 2 groups. Phosphocalcic biological studies, which show rather high osteocalcinemia and hydroxyprolinuria (hyperremodeling), with rather high serum 1 25 OH vitamin D, do not differ between the 2 groups. Endocrinologic evaluations, with a constant hypooestradiolemia of hypothalamic origin, low somatomedinemia and normal cortisolemia, are not different between the 2 groups.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780650 TI - [Study of mastocytes in 1298 bone biopsies. Relationship between mastocytes and osteoporosis]. AB - The relationship between the bone damage in systemic mastocytosis and reactional mastocytosis is still poorly understood. The purpose of this study was to determine the incidence of excessive mastocytes in a series of bone biopsies and their significance in cases of osteoporosis. The mastocytes were routinely counted in 1,298 successive biopsies stained with May Grumwald Giemsa: 131 biopsies had more than 5 mastocytes/mm2, i.e., 10% of all samples for all diagnoses combined. In 11 patients (13 bone biopsies) with a large excess of mastocytes (more than 15/mm2) and osteoporosis, the biopsies were examined again to look for mastocytic nodules suggesting bone mastocytosis: mastocytic nodules of this type were found in only 4 cases. The mastocyte is an active cell which may play a role in bone metabolism through the intermediary of its mediators. In osteoporosis, the incidence and significance of excessive mastocytes is not yet understood; this excess of mastocytes appears to correspond to reactive mastocytosis rather than systemic mastocytosis. PMID- 1780651 TI - [Bone involvement in primary oxalosis. Study of 20 cases]. AB - The authors report 20 cases of primary oxalosis with bone involvement, late revealed in adults in 19 cases. They have studied the clinical, radiological and histological manifestations of this bone oxalosis. 19 cases had an end stage chronic renal failure, either treated by maintenance hemodialysis, or by renal (or liver-renal) graft. 17 patients complained of bone pain after starting hemodialysis; 3 had vertebral crush fractures, and 1 multiple spontaneous fractures. Diffuse bone sclerosis (with a homogeneous pattern on axial skeleton and a patchy appearance on the peripherical skeleton), bone translucency, subperiosteal phalangeal resorption were the main radiological symptoms. Oxalate crystals surrounded by a giant cells granuloma were always observed on bone biopsy (16 cases). Bone resorption was observed in 9 cases, hyperparathyroidism in 14 cases and osteomalacia in 7 cases. Hyperparathyroidism does'nt explain all the clinical and radiological manifestations (especially bone resorption). Bone resorption as other radiological and clinical manifestations can be found without hyperparathyroidism and can increase despite parathyroidectomy; so, bone resorption seems to be partly due to the granulomatous reaction around oxalate crystals rather than hyperparathyroidism. PMID- 1780652 TI - [Bone histomorphometric study in involuted fractured osteoporosis treated with 1 ethane-1-hydroxybiphosphonate (etidronate) during one year]. AB - The efficacy of the biphosphonate etidronate has recently been demonstrated versus the vertebral fracture rate in fractured involuted osteoporosis in the literature. However, it would appear that the increase in bone mass (measured from the calcium density) may alone account for these results. The authors undertook a histomorphometrie study in 20 patients with a group mean age of 55 years presenting recent vertebral fracture in the context of osteoporosis, in order to assess the cell changes which may affect bone quality. This factor remains the only one which can account for the reduced number of fractures. The patients received treatment with phosphorus (1,500 mg/d) for 3 days followed by etidronate (400 mg/d) for 14 days every 90 days. A permanent daily intake of 50 mg of calcium and 400 IU of vitamin D was also administered. Each patient underwent bone biopsy of the iliac wing before and after one year of treatment (4 cycles). No change in the bone mass or architectural parameters was observed. However, general slowing of the bone remodeling was found, affecting the natality and activity of the osteoforming and osteoresorbing cells. However, this remodeling which is traditionally uncoupled in osteoporosis was once more coupled. This results in a slowing of bone loss, ageing of the bone present and no change in the architecture. Thus, the diphosphonates appear to have a beneficial effect on the quality of bone rather than on its quantity. This represents a novel approach to the treatment of osteoporosis. PMID- 1780653 TI - [In vitro identification of a mononuclear precursor of osteoclast]. AB - Osteoclast is derived from mononuclear hematopoietic stem cells, most likely within the granulocyte-macrophage lineage. The exact differentiation process of osteoclasts precurssors has only been partially uncovered. The authors isolated in vitro, from the medullary bone of hens a mononuclear precursor of the osteoclast. This cell expressed several characteristics of mature and multinucleated osteoclast including the capacity to resorb the extracellular bone matrix. PMID- 1780654 TI - [Bone density in 20 black African young adults of the Bantu race is identical to that in subjects of white race]. AB - Bone mineral content (BMC in g) as well as bone mineral density (BMD in g/cm2) were measured by dual photon absorptiometry in 20 black africans and 20 white individuals of the same age and sex. The BMC of african males, as well as their body mass index (BMI), were significantly less than those of the whites. In contrast, neither BMD nor the ratio of BMC to BMI differed between the two groups. These results suggest that morphotype plays a greater role than the ethnic factor in the determination of bone mass in the young adult. PMID- 1780655 TI - [Bone density and biological markers in a population of 330 women]. AB - A population of 330 non-selected women underwent determination of bone density by means of Bi X absorptiometry of the lumbar spine and femur. The findings showed a negative correlation with the time since the menopause and a positive correlation with the duration of genitally active life and with substitutive hormonal treatment. The determination of the L1 density can replace that of the entire lumbar spine in cases in which osteoarthritis, atheroma or crushing make this determination unreliable. Conclusions cannot yet be based on measurements of the neck of femur. Changes in the biological markers in function of bone density values are difficult to interpret. The measurement of bone density and the assay of biological markers reflect two distinct phenomena, both of which must be taken into consideration in assessing osteoporotic risk. PMID- 1780656 TI - [Vertebral compressions revealing Cushing's syndrome. 3 cases]. AB - The authors report three cases of osteoporotic vertebral fractures in the Cushing Syndrome. This osteoporosis is partially reversible after treatment of the cause. Laboratory findings must comport a cortisonuric and a 17 hydroxycorticosterone cycle. PMID- 1780657 TI - [Magnetic resonance imaging of fluorosis and stress fractures due to fluoride]. AB - Osteocondensation of the spine and stress fractures of the appendicular bones are observed under treatment with sodium fluoride or after long-term drinking of Vichy Saint-Yorre spring water. Five patients with a mean total dose of fluoride intake of 24.7 g (9-66) were studied with MR imaging. Two of them had a diffuse osteocondensation; MRI showed a low signal intensity in the vertebrae on T1 and T2-weighted images. MRI was performed in an asymptomatic patient who was being treated with sodium fluoride for 16 months; it revealed a heterogenous low signal intensity in the pelvis and femoral metaphysis. Two patients experienced stress fractures; MRI demonstrated a linear area of very low signal intensity surrounded by an area of decreased signal intensity on T1-weighted images and high signal intensity on T2-weighted images. MRI of fluorosis shows a non specific low signal intensity linked to a densifying image on the standard radiograph or an area of high technetium-99m intake on bone scan. PMID- 1780658 TI - [Secondary hyperparathyroidism and articular chondrocalcinosis in the aged]. AB - The incidence of articular chondrocalcinosis (ACC) in elderly patients hospitalised in geriatric departments is approximately 30%. Routine studies including a 2 hour calcium/phosphorus balance, parathormone assay and radiological investigations enabled the selection of 73 patients with secondary hyperparathyroidism. ACC was present in 38 of these individuals (52%). They were slightly older (87 +/- 5) than cases of secondary hyperparathyroidism without radiological ACC (84 +/- 8). Among patients with secondary hyperparathyroidism with ACC, there were 90% women and 10% men, while the sex ratio in the department was 77% women and 23% men. Results of calcium/phosphorus balance and parathormone levels were similar, in the presence or absence of ACC. PMID- 1780659 TI - [Femoral osteosarcoma revealing onset of unifocal Paget's disease. Favourable course with 7-year follow-up]. AB - Sarcomatous degeneration is the most serious complication of Paget's disease, and few cases survive beyond 5 years. The authors report a new case, which occurred in a 62-year-old woman, in which calcifying periarthritis of the hip revealed the presence of a sarcoma developed in a context of a single bone case of Paget's disease affecting the upper extremity of the femur. Diagnosis was histological. The prognostic factors of Paget-related sarcomas are reviewed. The most important are the early timing of diagnosis and a site permitting radical surgical exeresis. PMID- 1780660 TI - [A case of severe rarefaction osteopathy associated with tabes dorsalis]. AB - The authors report the case of a 63 years old man who presented 13 years after a diagnosis of a tabes dorsalis, stress fractures of the lower limbs and Charcot's joints (knees). 7 years later, he had multiple stress fractures of the sacrum and pelvis and of the ribs following a minor trauma. Laboratory investigations revealed a major osteoporosis probably related to the neurochirurgical complications of the tabes dorsalis. PMID- 1780661 TI - [Osteoporosis, arachnoid cyst and conus medullaris compression]. AB - The authors report the case of a 75-year-old woman with an osteoporotic vertebral crush fracture of L1, without detectable vertebral necrosis, with signs of conus medullaris compression. The outcome at 2 years was satisfactory with complete recovery of neurological impairment after laminectomy from T12 to L2 and evacuation of a compressive arachnoid cyst overlying L1. This rare case is remarkable because of the presence of an arachnoid cyst. The role of the latter in the pathogenesis and progression of the neurological lesions is discussed. PMID- 1780662 TI - [Parosteal sarcoma of the radius in the course of etretinate therapy]. AB - A parosteal osteosarcoma of the right radius has developed in a patient treated for a long time by etretinate (total dose: 73 g). If brachial ossifications have been reported to etretinate in 2 cases, they were benign tumours; so coincidence is possible in our case. Nevertheless, a relation between the tumour and the treatment cannot be excluded and justify the report of this observation. PMID- 1780663 TI - [Late myopathies located at the spinal muscles: a cause of acquired lumbar kyphosis in adults]. AB - A primary myopathy limited to the spinal muscles and of late onset was suspected in 14 patients with a mean age of 66. These patients had an anterior inflection of the trunk and were unable to rotate the lumbar spine on the pelvis. This incurvation of the trunk, starting at around age 60, was reducible in a horizontal position and increased with tiredness. The CT scan appearance of the spinal muscles of these patients was hypodense and heterogeneous, different from the atrophy found in the elderly with lumbar osteoarthrosis, comparable with the lesions described in primary myopathies. Histologically, lesions of fibro adiposis were major, accompanied by mitochondrial abnormalities. The frequent existence of a family history would be in favour of a genetically transmitted condition. PMID- 1780664 TI - [Role of iatrogenic spondylodiscitis among pyogenic spondylodiscitis. 136 cases observed between 1980 and 1989]. AB - The authors report 136 cases of spondylodiscitis due to ordinary organisms seen between 1980 and 1989 and note the increasing incidence of iatrogenic forms which during the past three years accounted for 50 per cent of cases. 60 per cent of these cases of iatrogenic spondylodiscitis complicated a medical of surgical procedure involving the spine (form by direct inoculation). In 40 per cent of cases, the organism came from a site of infection located at a distance (from by blood-borne spread). The clinical picture in cases of primary spondylodiscitis and of iatrogenic disease by blood-borne spread is essentially similar. That of iatrogenic forms by direct inoculation is different: most often young subjects, virtually exclusive involvement of the lumbar spine, fever and inflammatory syndrome less common. Escherichia coli and Staphylococcus aureus were the organisms most often responsible for primary spondylodiscitis (23 and 21.7 per cent of case respectively). Streptococci were in third position only (15.6 per cent of cases). Staphylococcus aureus remained predominant in iatrogenic spondylodiscitis (34 per cent of cases), while Escherichia coli and streptococci were significantly rarer than in primary forms and there was the appearance of Pseudomonas aeruginosa and Staphylococcus albus. No organism was found in 23 per cent of cases of primary spondylodiscitis. This figure reached 44% of iatrogenic forms by direct inoculation. Because of their increasing incidence, these cases of apparently aseptic spondylodiscitis, frequently complicating a procedure involving the spine, are modifying the picture of infectious spondylodiscitis. No doubt worthy of separate identification, they raise the problem of the significance of the concept of aseptic spondylodiscitis. PMID- 1780665 TI - [Narrow cervical canal and lumbar canal. Frequency of the association, role of hyperostosis]. AB - The authors undertook a retrospective study involving 47 records of patients hospitalised for cervical myelopathy as the main clinical feature (n = 17) or symptomatic narrow lumbar canal (n = 30). Nine of these patients had clinical signs of both cervical myelopathy and of narrow lumbar canal, 10 of the 17 patients with a cervical myelopathy had lumbar stenosis as shown by midline sagittal tomography and/or CT scan, 9 of the 30 patients hospitalised for symptomatic narrow lumbar canal had cervical stenosis as shown by midline sagittal tomography, 13 of these 19 patients with both cervical and lumbar stenosis had enveloping vertebral hyperostosis. PMID- 1780667 TI - [Epidemiological and clinical aspects of gout in equatorial Africa. Apropos of 60 cases followed in the Department of Rheumatology of the Teaching Hospital Center in Brazzaville]. AB - Between December 15, 1988 and November 30, 1990, the application of Rome and New York criteria enabled the diagnosis of 60 cases of gout among patients with arthritis or hyperuricemia seen as out-patients or hospitalised in the Department of Rheumatology of the Brazzavile T.H.G. There were 57 men and 3 women, with a mean age of 51. Gout is the primary form of inflammatory arthropathy in adults in the Congo. Affecting all socio-professional groups, it is diversely associated with obesity, alcoholism, hypertension and diabetes. Initial involvement affects the big toe. Oligo and polyarticular forms predominate because of the absence or delay in specific treatment. This series included 30 per cent of cases of chronic gout. Evidence of renal impairment was found in one third of patients. However, urate lithiasis was absent. Tophi were found preferentially over the elbows. Sickle cell disease was responsible for one case of tophaceous gout. In contrast with the results of studies undertaken before the 1980s, gout is seen to be a common condition in equatorial Africa. PMID- 1780666 TI - [Serum hyaluronic acid and phospholipase A2 in an arthritic population]. AB - Serum hyaluronic acid (HA) and A2 phospholipase (A2PL) activity were measured by radioimmunoassay (Pharmacia) and using a specific phospholipid substrate respectively, as potential markers of osteoarthritic synovitis. With neither age, treatment nor sample time taken into consideration, the concentration of HA (micrograms/ml) was 585 +/- 1,054 in rheumatoid arthritis, 379 +/- 409 in knee osteoarthrosis, 272 +/- 384 in hip osteoarthrosis, 131 +/- 144 in low back pain and 44 +/- 23 in osteoporosis, with no significant difference between the groups. HA was nevertheless found to be significantly higher in knee osteoarthrosis patients than in normal controls, when samples were drawn at the same time of day. Physical exercise (pedalling), as well as 20 hours lying flat and an intra articular injection of corticosteroids did not cause any significant variation in serum HA levels in knee osteoarthrosis patients, in contrast to 20 hours of rest in the controls. A2PL activity was significantly higher in osteoarthrosis patients than in the controls, decreased with rest and corticosteroids and was not dependent upon sample time. PMID- 1780669 TI - [Concentration of non steroidal anti-inflammatory drugs in the articular cartilage in man]. AB - Experimental investigations suggest that NSAIDs may exert a dose-dependent effect on cartilage metabolism. The cartilage concentrations achieved in vivo may thus be useful for in vitro studies. Unfortunately, the concentrations of NSAIDs in human joint cartilage have been scarcely determined. Moreover, the methodologies used were heterogeneous. Guidelines to further studies are therefore proposed. PMID- 1780670 TI - [Severe ankylosing spondylitis with cauda equina syndrome and cervicothoracic myelo-radicular involvement]. PMID- 1780668 TI - [Transitory bone loss during substitution treatment for hypothyroidism. Results of a two year prospective study]. AB - The authors report the results of a prospective study designed to assess changes in vertebral and femoral bone density during the first two years of replacement therapy in 10 patients with hypothyroidism (4 men, 6 women). During the first year, bone density measured by dual photon absorptiometry fell significantly in the lumbar vertebrae (-5.4%), neck of the femur (-7%) and the trochanteric region (-7.3%). This bone loss was accompanied by an early increase in serum osteocalcin levels, urinary calcium/urinary creatinine ratio and in Sex Hormone Binding Globulin. During the second year, there was complete recovery of values of vertebral and trochanteric bone density, while density of the neck of the femur remained significantly lower than initial values. None of the patients showed any evidence of overdose during the period of monitoring of clinical and laboratory (free T4, total and free T3, ultra-sensitive TSH) parameters. This transitory bone loss could be indicative of a state of tissue hyperthyroidism and/or "hypersensitivity" of hypothyroid bone to the action of thyroid hormones. Its influence on the subsequent risk of fracture remains unclear. In the current state of knowledge, measurement of vertebral and femoral bone density appears to be indicated in patients given long term treatment which suppresses TSH, or requiring replacement therapy for severe hypothyroidism. Any demineralisation prior to treatment could justify the temporary prescription of an antiosteoclastic agent. PMID- 1780671 TI - [Contribution of MRI in the evaluation of fasciitis with eosinophilia induced by L-tryptophan. Apropos of 3 new cases]. PMID- 1780672 TI - [Association of melorheostosis and Raynaud's syndrome. Pathogenic aspects]. PMID- 1780673 TI - [Erasmus syndrome and evolutive atheromatosis of great trunks]. PMID- 1780674 TI - [Epiphysiolysis of the upper extremities of the femur in idiopathic panhypopituitarism. Apropos of a case with review of the literature]. AB - A case of a 39 year old male patient with slipped capital femoral epiphysis and idiopathic panhypopituitarism is reported. A review of the literature shows that a slipped epiphysis with hypothalamo-hypophyseal dysfunction, may be observed either in a proportional pituitary dwarfism or in a skeletal disproportion of the eunuchoidal or even of the acromegalic type. This association leads to examine the causal role of the hormonal status. PMID- 1780675 TI - [Hypercalcemia revealing hyperthyroidism in multiple myeloma]. PMID- 1780676 TI - [Shoulder bursitis in juvenile chronic polyarthritis]. PMID- 1780677 TI - [Association of sclerodermatomyositis and humero-scapular retractile capsulitis. A new case]. PMID- 1780678 TI - [Elbow tuberculosis. Apropos of a case]. PMID- 1780679 TI - [Myelodysplastic syndrome complicating the course of multiple myeloma]. PMID- 1780680 TI - [Achilles tendon rupture in 2 adults treated with pefloxacin, one of the cases with bilateral involvement]. PMID- 1780681 TI - [Tomodensitometric development of herniated lumbar disks without surgical treatment. Apropos of 13 cases]. PMID- 1780682 TI - [Evaluation of osteodensitometry]. AB - The progress made in recent years in the field of bone densitometry, particularly concerning dual-energy x-ray absorptiometry, has resulted in the development of reliable techniques of bone mineral density measurement, especially for measurements in the lumbar spine on anteroposterior views and in the forearm. However, technical improvements are still necessary and concern the standardisation of equipment, measurements in the femur, on lateral views of the lumbar spine and on the whole body, and the definition of normal curves. The value of these measurements must be examined in the light of the epidemiological context of osteoporosis and its current and future cost to the community. They must be evaluated in relation to two pathological situations: osteoporosis and osteopenia. Osteoporosis is a disease characterised by the development of fractures due to bone fragility. It is accompanied by a reduction in bone density and other abnormalities of bone architecture and metabolism, without any disturbance of mineralisation. It is responsible for pain, a functional handicap which alters the patient's quality of life. Osteopenia corresponds to an abnormally low bone density. It is accompanied by an increased risk of fractures. Although it remains asymptomatic, therapeutic intervention may nevertheless be justified. The threshold of therapeutic intervention depends on the degree of bone loss, the patient's age, other associated risk factors and the benefit-risk ratio of the drug used. In all forms of vertebral osteoporosis, the essential conditions for the diagnosis are a decreased vertebral bone density and deformation of a vertebral body.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780683 TI - Evaluation of tumor-associated trypsin inhibitor (TATI) in women with benign and malignant gynecological disease. AB - Tumor-associated trypsin inhibitor (TATI) was assayed in healthy subjects and in women with benign and malignant gynecological diseases. Significantly lower levels were found in boys than in healthy adult subjects. No variations in level were evident over the course of a 24 h period. At a cut-off level of 20 micrograms/l elevated concentrations were found in 42%, 11.4% and 19% of women with ovarian, endometrial and cervical neoplasia, respectively. In patients with ovarian tumors TATI level were elevated both in mucinous and serous tumors. TATI does not seem to be useful for diagnosis of uterine tumors, but could have a specific place in the study and management of ovarian tumors, in which serum concentrations can reach levels 100-200 micrograms/l. In the other gynecological diseases maximum levels of 30-40 micrograms/l were observed. PMID- 1780684 TI - Serum levels of tumor-associated trypsin inhibitor (TATI) in benign and malignant gynecological diseases. AB - The behavior of tumor-associated trypsin inhibitor (TATI) as a marker for gynecological cancer was studied in a control population and in patients with different benign and malignant diseases. When a cut-off level of 21.4 micrograms/l was used the specificity was 100% in patients with benign diseases. The sensitivity in patients with malignant tumors was low for cervical and corpus cancer, 13% and 14%, respectively, whereas it was 33% in all the ovarian malignant tumors, reaching 60% in the mucinous type. There was a clear correlation between TATI level and stage. PMID- 1780685 TI - Comparison of tumor-associated trypsin inhibitor (TATI) with CA125 as a marker for diagnosis and monitoring of epithelial ovarian cancer. AB - Preoperative serum levels of CA125 and tumor-associated trypsin inhibitor (TATI) were measured in 220 patients undergoing laparotomy for adnexal masses. Of the 57 patients with epithelial ovarian cancer. 86% had serum CA125 higher than 35 kU/l and 81% higher than 65 kU/l while 51% had serum TATI above 22 micrograms/l. In eight patients with mucinous ovarian malignancies, serum levels of CA125 were above 65 kU/l in 6 cases while serum TATI was above 22 micrograms/l in 4 cases. Of the 163 patients with benign ovarian masses, 41% had serum CA125 levels above 65 kU/l and 17% above 65 kU/l whereas serum TATI was above 22 micrograms/l in 6%. In 11 cancer patients having elevated levels of both CA125 and TATI at diagnosis, the serum concentrations of these antigens were periodically measured during and after treatment. Changes in CA125 and TATI levels correlated with the clinical course in 84% and 37% of the instances, respectively. After the sixth course of chemotherapy, the diagnostic accuracy of the markers in the evaluation of the disease status at second-look laparotomy was 55% for CA125 with a cut-off level of 35 kU/l, 36% for a cut-off level of 65 kU/l, 55% for TATI, and 66% for the combination of CA125 and TATI with cut-off levels of 65 kU/l and 22 micrograms/l. CA125 is the most sensitive marker for epithelial ovarian cancer, but the concomitant measurement of TATI could be of benefit in both differential diagnosis of adnexal masses and monitoring of response of epithelial ovarian cancer to treatment. PMID- 1780686 TI - Evaluation of TATI and other markers in solid tumors. AB - The usefulness of tumor-associated trypsin inhibitor (TATI) in the diagnosis of various solid tumors was compared to other tumor markers occurring in serum and urine (CEA, CA19-9, CA125, CA72-4, CA50, CA15-3, CA72-4, NSE, TPA, AFP, CK-BB and ferritin). TATI was particularly well suited for the diagnosis of tumors of the pancreas, ovary, oesophagus and bladder. For tumors of these organs TATI may be considered the marker of choice. TATI was also a good marker for distinguishing between disease with or without liver metastasis in cancer of the colon and the breast. PMID- 1780687 TI - Serum TATI levels and clinical correlation in tumors of the head and neck. AB - By radioimmunoassay (RIA) we studied tumor-associated trypsin inhibitor (TATI) in 152 serum samples, divided into three groups: 35 healthy subjects, used as controls; 25 individuals with benign pathology of the ear, nose and throat (ENT) region; 92 serial samples obtained from 69 patients with malignant disease of the head and neck. The malignant ENT group were classified in four stages according to the degree of tumor activity. The TATI concentrations (mean +/- SD) were as follows: control group, 16.0 +/- 3.4; benign group, 17.1 +/- 6.7; A0, 14.8 +/- 11.5; A1, 12.1 +/- 3.5; A2, 17.01 +/- 1.4; A3, 43.0 +/- 54.9. PMID- 1780688 TI - Tumor-associated trypsin inhibitor (TATI) in primary esophageal carcinoma. AB - Esophageal carcinoma has a catastrophic clinical course with a very low 5 year survival rate of 5%. A circulating tumor marker with good specificity and sensitivity would be useful in the management strategy of the disease. So far, no tumor marker effective in esophageal carcinoma has been identified. Preliminary reports suggest satisfactory positivity rates of tumor-associated trypsin inhibitor (TATI) in esophageal carcinoma. We measured TATI levels in 71 patients with primary squamous cell esophageal carcinoma as well as in 30 tissue samples from both carcinoma and normal esophageal mucosa. Detectable TATI levels were not found in tumor tissue samples. The marker showed significantly higher serum levels in patients than in controls, with an overall positivity rate of 28%. TATI levels were significantly lower in patients with a high number of tumor-positive lymph nodes. No relationship was found between TATI and several other clinical and pathological parameters. High TATI levels correlated with a lower probability of overall survival as well as in cases without clinical evidence of lymph node metastases. TATI did not show any relationship with CEA, TPA, ferritin or SCC. The results of the present study suggest that TATI shows a satisfactory positivity rate in esophageal carcinoma, and TATI levels are related to local disease spread and prognosis. PMID- 1780689 TI - Tumor-associated trypsin inhibitor (TATI) in patients with colorectal carcinoma. A critical comparison with CEA. AB - We have evaluated the clinical utility of tumor-associated trypsin inhibitor (TATI) in colorectal cancer and compared it with carcinoembryonic antigen (CEA), the classical marker for this disease. We measured the serum levels of these markers in 53 patients with colorectal carcinoma before and after surgery. CEA was found to have greater sensitivity than TATI in this disease. The TATI concentrations did not correlate as well as CEA with the presence or absence of metastasis and with the course of the disease after surgery. The use of TATI together with CEA for detection or follow up of colorectal cancer does not seem to be useful because a significant increase of positivity is not obtained as compared with determination of CEA alone. PMID- 1780690 TI - Tumor-associated trypsin inhibitor (TATI) in pleural effusions. AB - The purpose of this study was to evaluate the usefulness of tumor-associated trypsin inhibitor (TATI) determination in serum and pleural fluid for differential diagnosis of relapsing pleural effusions. The concentrations of TATI were determined in samples of serum and pleural fluid from 51 patients with pleural effusions comprising 20 benign exudates, 5 transudates and 26 malignant effusions. TATI levels overlapped in benign and malignant fluids. This precludes the use of this marker for diagnosis of pleural effusions. For this purpose CEA seems to be the best tumor marker with a sensitivity frequently higher than that of cytology. PMID- 1780691 TI - Biology and function of tumor-associated trypsin inhibitor, TATI. AB - Tumor-associated trypsin inhibitor (TATI) is a 6,000 Daltons peptide, which is synthesized by several tumors and cell lines. TATI is identical to pancreatic secretory trypsin inhibitor (PSTI). This peptide is also produced by the mucosa of the gastrointestinal tract, where it is thought to protect the mucosal cells from proteolytic breakdown. Elevated serum and urine levels of TATI occur in connection with many types of cancer, especially mucinous ovarian cancer. Elevated levels may also occur in nonmalignant diseases, e.g. in pancreatitis, severe infections and tissue destruction. Thus TATI may behave as an acute phase reactant. Tumors producing TATI often express tumor-associated trypsinogen. Elevation of TATI in cancer and pancreatic disease is therefore associated with expression of trypsin, but such a connection has not been demonstrated in inflammatory disease. TATI can inhibit trypsin-mediated degradation of extracellular matrix by tumor cells. Therefore its role may be to control the activation of tumor-associated trypsinogen. TATI has also been shown to possess growth factor activity in vitro, but it is not known whether this is a physiological function. PMID- 1780692 TI - Tumor-associated trypsin inhibitor as a possible marker in male infertility. AB - The concentrations of tumor-associated trypsin inhibitor (TATI) in the seminal plasma of infertile males was studied. The TATI levels in seminal plasma were not correlated with either sperm count or ejaculate volume. High levels were observed in some men with unexplained infertility and high or normal sperm counts, whereas normal levels were observed in males with antisperm antibodies. The concentrations in seminal plasma were stable in the same subjects. These results suggest that TATI may be an important marker of reproductive pathology in men. PMID- 1780694 TI - Tumor-associated trypsin inhibitor (TATI) in benign and malignant gastric disease. AB - We have evaluated the clinical utility of tumor-associated trypsin inhibitor (TATI) as a marker for gastric cancer. For comparison we also studied CEA, CA19 9, CA-50 and TPA. The study comprised 93 patients with cancer and 45 with gastroduodenal ulcers. In 95% of the patients with benign disease the serum TATI concentrations were below 30 micrograms/l. Using this concentration as cut-off level 46% of the cancer patients had elevated levels. These were most common in advanced disease (68% in stage IVB) and patients with anaplastic tumors. Therefore TATI was a useful complement to CEA, which was most often elevated in patients with differentiated tumors. Addition of TATI to the battery of other markers increased the overall sensitivity for cancer from 69% to 80%. PMID- 1780693 TI - Tumor-associated trypsin inhibitor in induced and acquired immunodeficiency. Studies on transplanted and HIV-infected patients. AB - A new tumor marker, tumor-associated trypsin inhibitor (TATI), was studied in 5 patients who received successful kidney or pancreas grafts and in 30 subjects with antibodies against human immunodeficiency virus. Serum TATI concentrations were very high during the four first days after transplantation. Thereafter the serum levels decreased when the peptide was eliminated through the kidney. Consequently, the urine values were very high. The TATI concentrations of HIV positive subjects were compared with serum levels of HIV antigen and antibody, by Western blotting and determination of peripheral T-lymphocyte subpopulations. The occurrence of high concentrations of TATI in some HIV positive subjects and especially in AIDS patients, suggests that TATI could be useful in exploring physiopathological aspects of severe immunodeficiencies even if TATI levels were not correlated with the commonly used markers of the immune system status. The increased levels of TATI in immunological disorders suggests its possible use in assessing the immune response against cancer. PMID- 1780695 TI - Tumor-associated trypsin inhibitor (TATI) in the diagnosis of lung cancer. AB - To evaluate the usefulness of tumor-associated trypsin inhibitor (TATI) as a marker for the diagnosis of lung cancer we determined serum levels of this peptide in 255 patients with lung cancer and in 74 patients with chronic obstructive lung disease. A reference population consisting of 151 healthy volunteers was also studied. TATI concentrations were measured by radioimmunoassay. As a cut-off point we used the 99th percentile of the TATI concentrations in a reference population, which was 32 micrograms/l. TATI does not appear to be a good tumor marker in lung cancer. Its sensitivity is poor in comparison with CEA and TPA. The correlation between TATI levels and stage of the disease and histological type was weak. PMID- 1780696 TI - Tumor-associated trypsin inhibitor (TATI) in bone diseases. AB - The casual observation of high serum levels in (TATI) of tumor associated trypsin inhibitor in patients with osteosarcoma inspired us to evaluate the use of this peptide in the diagnosis of various bone diseases. We determined the serum concentrations of TATI in 35 patients with various bone diseases, i.e. degenerative diseases, bone metastasis and osteosarcomas. The cut off, determined as the 99th percentile of TATI serum levels in healthy volunteers was 32 micrograms/l. TATI has a better sensitivity in osteosarcomas (83%) than in metastatic bone diseases (33%). Its specificity in non-malignant bone diseases was not exceptional (82%). This is probably because TATI may also behave as on acute phase protein, the levels of which can rise in non-malignant diseases and also as a result of a tissue reaction in primary bone tumors. PMID- 1780697 TI - Tumor-associated trypsin inhibitor, TATI, in gastrointestinal cancer and related benign diseases. AB - Tumor-associated trypsin inhibitor (TATI) was assayed in serum of patients with gastroenterological diseases. Of the patients 92 had gastric cancer, 50 colonic cancer, 38 colitis, 36 polyposis of the colon, and 40 gastric ulcer. The cut-off level established on the basis of the mean concentration +3 SD of a reference population comprising 120 subjects was 32 micrograms/l. In gastric cancer TATI had a sensitivity and specificity similar to that of CA19-9, whereas its behavior in colon cancer was less satisfactory. Like other tumor markers TATI may be elevated in patients with inflammatory diseases. In our opinion TATI is a good tumor marker for gastric cancer and it is a useful complement to CEA and CA19-9. PMID- 1780698 TI - Pathophysiology of nocturnal enuresis. PMID- 1780699 TI - Treatment of priapism by injection of adrenaline into the corpora cavernosa penis. AB - Intracavernous papaverine injection has gained widespread acceptance in the treatment of erectile impotence. The opposite problem--priapism--can be treated with the same technique using a vasoconstrictive drug such as adrenaline. We report on eight patients successfully treated for priapism by intracavernous injection of adrenaline. PMID- 1780700 TI - Intravesical BCG therapy in bladder carcinoma. Effect on cytotoxicity, IL-2 production and phenotype of peripheral blood mononuclear cells. AB - The purpose of the study was to examine the effects of intravesical BCG treatment on the cytotoxicity, interleukin-2 (IL-2) production and distribution of the subsets of peripheral blood mononuclear cells (PBMC) in patients with carcinoma in situ of the bladder. Treatments were made in 6 patients during a conventional BCG treatment schedule. Four patients showed a complete response, one a partial response and one had a progressive disease after BCG treatment. Intravesical BCG did not induce significant changes in the cytotoxicity of PBMC. The distribution of NK-cells and T-cells also remained unchanged and so did the lectin induced production of IL-2. The results suggest that the effects of intravesical BCG on the immune system should be studied in lymphocytes isolated from the bladder. PMID- 1780701 TI - Squamous cell carcinoma of the urinary bladder. AB - Thirteen patients with squamous cell carcinoma of the bladder were reviewed. All tumours were muscle invasive at the time of diagnosis. One third of the patients were irradiated, either before cystectomy or as a full course radiotherapy. The 1 year and 5-year survivals were 25 and 17%, respectively. Only cystectomized patients were alive after 5 years. PMID- 1780702 TI - Extraperitoneal perforation of the urinary bladder in association with urothelial cancer in a female. AB - A case of spontaneous perforation of the bladder wall in a 51-year old female with urothelial cancer is reported. The outcome was lethal because of abdominal and thoracic wall phlegmone and septic shock. PMID- 1780703 TI - Perforation of continent caecal reservoir for urine twice in one patient. AB - Perforation of a continent caecal reservoir, presumably during catheterization, occurred twice in a 64-year-old woman, 52 and 59 months after urinary diversion, during hyperglycemic confusion. Acute overdistension of the reservoir, creating high tension in its wall, with resulting weakness, could have been an underlying cause of the perforation. Awareness of this potentially lethal complication in patients with augmented bladder or continent urinary reservoir is necessary. PMID- 1780704 TI - Comparison of excretory urography, angiography, ultrasound and computed tomography for T category staging of renal cell carcinoma. AB - The diagnostic significance of excretory urography, renal angiography, ultrasound and computed tomography for predicting the stage of tumours was evaluated by comparing their results with peroperative and histopathological findings. Thirty nine out of 178 patients operated on for renal cell carcinoma from 1981 to 1988 were subjected to all four diagnostic procedures. The T stage was determined correctly by computed tomography in 80% of the cases, by ultrasound in 74.5%, by renal angiography in 64% and by excretory urography in 56.5%. Excretory urography did not give any significant additional information on the T category compared with the other imaging methods. Angiography is still of value in that it gives preoperative information on the collateral circulation and the number of renal arteries and their location. PMID- 1780705 TI - Eosinophilic renal cell tumours. A study on tumour heterogeneity with special emphasis on oncocytes. AB - Eosinophilic renal tumour cells are found in oncocytomas, granular cell carcinomas, clear cell carcinomas and in a recently defined entity known as "congeners of oncocytomas". Ultrastructural examination of paraffin embedded tumour tissue representing eosinophilic areas in 40 renal cell tumours was performed in order to characterize the different types of eosinophilic cells. The results showed all tumours diagnosed light microscopically as oncocytomas to be composed of cells containing abundant mitochondria. Similar cells were, however, also found in one case of a clear cell carcinoma and in one case diagnosed light microscopically as a "congener". Oncocytes may therefore be found as part of non oncocytomas and there seems to be a gradual transition from oncocytes to other eosinophilic cells of renal cell carcinomas. Preoperative subclassification of renal cell tumours based on small biopsy specimens is thus of limited value. PMID- 1780706 TI - Efficacy and complications of the Nd:YAG laser in partial nephrectomy: experimental study in piglets. AB - Twenty-four partial nephrectomies were performed in 18 piglets using either the combination Nd:YAG laser technique (contact and noncontact) or a steel scalpel. Additional haemostasis was attempted with ligatures. Blood loss, operation time, and number of ligatures were compared in the two treatment groups. Twelve piglets had a two-week follow-up. The mean blood loss with the laser was 72 +/- 10 g and 83 +/- 13 g with the steel scalpel (no significant difference). The resection time until complete haemostasis was 9.8 +/- 0.9 min with the laser and 14.3 +/- 1.3 min with the steel scalpel (p = 0.0076). The number of ligatures needed for complete haemostasis was 2.8 +/- 0.4 with the laser and 7.5 +/- 1.0 with the steel scalpel (p = 0.0051). Three piglets in the steel scalpel group developed urinomas. There were two perirenal abscesses, one in each group. In the steel scalpel group there was one intussusception. In conclusion, it seems that the combination Nd:YAG laser method offers no definitive advantage over the standard technique for partial nephrectomies in the pig. PMID- 1780707 TI - Prognosis in septicemia complicated by acute renal failure requiring dialysis. AB - During a 12-year period 419 patients were admitted because of acute renal failure requiring dialysis. Fifty (12%) had septicemia verified by blood culture. In a retrospective study age, sex, focus of infection, blood culture results, kidney function, mode of dialysis treatment, numbers and durations of complicating organ failures, presence of gastrointestinal bleeding, and secondary complicating events of septicemia were recorded for the purpose of establishing a prognostic index based on clinical criteria. Respiratory failure was present in 34 patients, circulatory failure in 31 patients, failure of coagulation system in 25 patients, and hepatic failure in 10 patients. Overall mortality was 46%. Highest death rates were found during the first days of dialysis. In patients with multiple organ failures, in elderly and in patients suffering from staphylococcus aureus septicemia, a non-significant trend towards higher mortality was found. The mode of dialysis treatment did not influence patient survival. Our intention of establishing a prognostic index based on bedside clinical criteria has not been fulfilled. Even though mortality-rate increases in patients with acute renal failure complicated by failure of one or more vital organs, survival-rate in patients with four or more organ failures was 30%. PMID- 1780708 TI - An animal model to study the effects of diet on risk factors of calcium stone formation. AB - The effects of diet on the formation of calcium oxalate stones were studied in 150-day-old rats by measuring the diuresis, pH, and urinary and blood concentrations of promoting and inhibitory substances. An increase in phosphate (promoting) and magnesium (inhibiting), and a decrease in citrate (inhibiting) and pH were found in the urine of rats fed with a high protein diet. No differences were observed in the plasma concentrations of calcium, magnesium, and phosphate. These results confirm epidemiological and clinical studies in humans that have shown that any diet rich in protein can change the concentrations of these substances in urine. PMID- 1780709 TI - Malignant mesenchymoma of the scrotum. AB - Paratesticular sarcomas are rare, especially the malignant mesenchymoma. To our knowledge only four cases of paratesticular malignant mesenchymoma have been described previously. All were localized to the spermatic cord. We present a case of malignant mesenchymoma in the scrotum free of the spermatic cord. PMID- 1780710 TI - Long term complication of untreated bilateral testicular torsion in the newborn. Case report. AB - Acute bilateral scrotal swelling of the neonate may be caused by a variety of conditions. Bilateral torsion of the testes is an uncommon but important cause of such swelling and must be suspected in all cases. A case of delayed complication of untreated bilateral testicular torsion in the newborn presenting in adolescence is reported and followed by discussion of the literature review. PMID- 1780712 TI - Osteitis pubis after transrectal aspiration biopsy of the prostate. AB - Two patients developed osteitis pubis after transrectal aspiration biopsy of the prostate. We recommend that prophylactic antibiotics should be given before all such procedures. PMID- 1780711 TI - Spermatic cord liposarcoma: ultrasound for diagnosis and follow-up. Case report. AB - A case of spermatic cord liposarcoma is described in a 48-year-old man. Following local excision, the tumour recurred after 3 years, leading to funiculoorchiectomy. The case is presented, the literature reviewed and the role of ultrasound in the diagnosis discussed. PMID- 1780713 TI - An adult man with a rhabdomyosarcoma of the prostate. A case report. PMID- 1780714 TI - Effect of low and ultra low oral doses of acetylsalicylic acid in microvascular surgery. An experimental study in the rabbit. AB - About 10 h after administering acetylsalicylic acid (ASA) orally in doses of 4 mg and 20 micrograms/kg b.w., the central arteries of rabbit ears were subjected to severe vascular trauma (arteriotomy/intimectomy). Bleeding times from the trauma regions at reperfusion were measured and the activities from accumulating 32P labelled homologous platelets recorded until 2 h after reperfusion when patencies were determined. In other studies, the effects of ASA on ex vivo platelet aggregation (aggregometry), thromboxane production, euglobulin clot lysis time and bleeding time following arterial puncture were investigated. Relative to controls, the following parameters were changed: patency was increased, as were the bleeding times following arterial puncture and thromboxane production was reduced. The median values of platelet accumulation were lower, but the changes were not statistically significant. Aggregometry showed decreased rates of platelet aggregability following treatment with ASA 4 mg/kg. PMID- 1780715 TI - Tendon blood flow assessed by laser Doppler flowmetry. AB - Laser Doppler flowmetry was applied to the surface of both achilles tendons in 10 mature albino rats. A prompt decline in flux values by about 60% was noted when the blood supply to the limb was interrupted by clamping the femoral artery. Increased values, indicating a hyperaemic reaction, often followed release of the clamp. Flux values reached a minimum after death, and this was used as a baseline measurement to eliminate Doppler signals generated by factors unrelated to flow. Although readings in two animals had to be omitted for technical reasons, the present study shows that reliable laser Doppler flow readings can be obtained from the surface of a tendon. The response to reversible ischaemia is prompt and reproducible. Laser Doppler flowmetry may offer a new approach to the assessment of tendon blood flow at the microvascular level. PMID- 1780716 TI - Occurrence and evolution of T3 fibroblast nuclei in healing tendons from growing chicks. AB - We applied immunocytochemical techniques including anti-triiodothyronine (T3) serum and microscopic analysis with colloid gold as the developer to identify the specific receptors of thyroid hormones located within the cell nucleus and between the heteroeuchromatin transition zone in 25 chicks. All chicks underwent tenotomy, followed by tenorrhaphy and immobilisation of the leg in plaster. There was a gradual decrease in the number of T3 receptors of collagen-forming fibroblasts as the tendons healed and their capacity to synthetize collagen diminished. PMID- 1780717 TI - Effect of drying on regenerating rat sciatic nerve. AB - To study the effects of drying on regeneration, crush lesions were made on the sciatic nerve of 38 rats and the injured area was then air-dried for various periods of time (0-60 min). The regeneration distance of sensory nerve fibres was measured by the pinch reflex test three or six days later. Regeneration was significantly impaired by drying the nerve for 30 or 60 min, but shorter periods (10 min) also seemed to affect axonal outgrowth. Regeneration distances were increased in nerves that were subjected to drying and then allowed to recover for a week (conditioning interval) before the nerve was crushed. The results show that drying of a peripheral nerve is detrimental to nerve regeneration, and we suggest that nerves should not be exposed to air for more than a few minutes during operation without irrigation. PMID- 1780718 TI - Ultrasonography for the diagnosis of soft tissue conditions in the hand. AB - Six months' experience of ultrasonographic diagnosis of the hand has proved it to be a valuable method for diagnosis of ganglions, tendon ruptures, synovitis, tumours, and the presence of foreign bodies. We are exploring ways of increasing its scope, in the light of the technical innovations that are being made. PMID- 1780719 TI - Deep venous anatomy of the human palm. AB - The anatomy of the deep veins of the human palm was studied in a series of dissections on 12 fresh cadaver specimens after injection of a polymerizing plastic compound into the vascular tree. Using measures of function rather than position in the hand as criteria for the classification of the vessels, six venous types were identified and characterized: arborized, arches, deep axial, web space, perforating, and synovial. PMID- 1780720 TI - Importance of time in assessing arm and hand function after treatment of breast cancer. AB - Ninety-three patients were examined on two occasions at 24-month intervals after surgery and irradiation for breast cancer. Stiffness of the shoulder joint, brachial oedema, pain in the arm, and the patients' subjective assessment of the degree of functional disability were registered. The results indicated that both oedema and stiffness of the shoulder joint are acceptable measures of functional impairment. We conclude, however, that such measurements should not be used as indicators of prognosis, because spontaneous improvement can occur for two years or more after treatment. PMID- 1780721 TI - Decompression of the axillary vein for oedema of the arm caused by axillary dissection and irradiation. AB - Twenty women with brachial oedema after treatment for breast cancer were operated on by a standard technique, with decompression of the axillary vein and division of the irradiated portion of pectoralis major. After a mean follow-up of 32.5 months a significant improvement was noted in 14 of them. In 19 the range of movement of the shoulder had improved. PMID- 1780722 TI - Effect of low power gallium arsenide laser on healing of venous ulcers. AB - The healing of venous ulcers of the leg with and without gallium arsenide laser treatment was studied in 42 patients randomly divided into two groups. One group received standard conservative treatment and gallium arsenide laser, and the other received the same standard treatment and placebo laser treatment. There were no differences in results between the two groups. PMID- 1780723 TI - Bilateral infraorbital block with 0.5% bupivacaine as post-operative analgesia following cheiloplasty in children. AB - Various studies have shown that bupivacaine nerve blocks provide prolonged post operative analgesia. We studied the efficacy of a 0.5% bupivacaine infraorbital nerve block as post-operative analgesia in a random, prospective, double blind manner in children undergoing cleft lip repair. Following the induction of anesthesia with ketamine 2-4 mg/kg im, 60 patients, aged 2-13 years, ASA I and II were equally divided: Group A received 1-1.5 ml bupivacaine, 0.5% with 1:200,000 epinephrine; Group B received 1-1.5 ml saline injected into the vicinity of the infraorbital foramina. In every patient, the surgeon infiltrated the lip with 4-7 ml of 1% lidocaine with 1:100,000 epinephrine for both anesthesia and hemostasis. Post-operative evaluations were completed after 4, 8, and 12 to 24 hours and were based on a visual analogue scale for pain. Similarly, the nurses and the parents also evaluated post-operative discomfort using specific criteria. All the observers were kept unaware of the solutions used for the block. The results showed that Group A was pain free for a mean duration of 19.4 +/- 5.06 (SD) hours in contrast to 11.7 +/- 6.19 hours for Group B, (p less than 0.001). Group A required no other analgesic whereas a total of 17 patients in Group B required analgesic medication starting at four hours post-operatively, (p less than 0.001). Both the nurses and the parents confirmed that those who received infraorbital block were more comfortable than those who did not. One-way analysis of variance indicates that the mean scores for both groups differs significantly at all levels of comparison, (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780724 TI - Craniofacial development in children with unilateral clefts of the lip, alveolus, and palate treated according to four different regimes. I. Maxillary 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 at three different ages regarding maxillary development. Regimes that included primary bone grafting to the alveolus at six months of age resulted in inhibited anterior maxillary growth and reduced maxillary inclination. Regimes that included secondary bone grafting after eruption of the incisors but before the eruption of the canines, resulted in better maxillary development, but were not as good as regimes that omitted bone grafting altogether. PMID- 1780726 TI - Transfer of the temporal muscle for lagophthalmos according to Gillies. AB - For correction of lagophthalmos different methods have been described such as gold weights, palpebral spring and magnets. Using the transposed temporal muscle is superior to implantation of foreign material. We present a method for correction of lagophthalmos that combines static support with dynamic function. During the last eight years we performed transposition of the temporal muscle in 17 patients. The anterior part of the temporal muscle has been transposed. Corneal irritation and epiphora disappeared in all patients, although a complete correction of lagophthalmos could not be achieved in each case. Chewing was not impaired and closure of the eye could be performed independently from chewing. Because of its low morbidity the transfer of the temporal muscle is the procedure of choice for repair of lagophthalmos. PMID- 1780725 TI - Craniofacial and occlusal characteristics in unilateral cleft lip and palate patients from four Scandinavian centres. AB - Craniofacial morphology and dental occlusion were studied at early school age in 15 consecutive patients with unilateral cleft lip and palate from each of four Scandinavian cleft centres. Treatment differed mainly in the techniques of palatal repair. Push-back closure of the palate particularly impaired maxillary development, which resulted in an increased incidence of crossbite and reduced intercanine distance when compared with patients who had been operated on by the von Langenbeck method or in whom the anterior palate had not yet been closed. PMID- 1780727 TI - Benign symmetric lipomatosis of the neck treated by liposuction. Case report. AB - A patient with benign symmetrical lipomatosis of the neck (Madelung's disease) was successfully treated with liposuction rather than classic surgical lipectomy. To our knowledge this is only the second such patient treated in this way. PMID- 1780728 TI - Tissue expansion in functional and aesthetic reconstruction of the trunk and extremities. Case report. AB - To illustrate how the technique of tissue expansion may be adapted for different types of reconstruction, the following cases are described: a 10-year-old girl with a circumferential naevus from shoulder (at the back) and umbilicus (at the front) to the knees; a 3-year-old boy with a severe injury to the left arm; a 36 year-old man with an amputation injury of the left hip; and an 18-year-old girl with scars from a complicated fracture of the left lower leg. In all cases function and/or appearance were considerably improved. PMID- 1780729 TI - Transplantation of cultured autologous epithelium after meningococcal septicaemia in a 4-year-old with 35% skin loss. AB - A 4-year-old girl with scattered full-thickness skin and soft tissue wounds mainly on the extremities and corresponding to roughly 35% of the total body surface area was treated with early excision and transplantation of cultured autologous epidermal grafts. The transplantation was accomplished in one stage, three weeks after admission. The epidermal cells were cultured in Stockholm, Sweden and the time of transportation of the grafts to Reykjavik, Iceland (seven hours) did not seem to affect the quality, as 85% had taken one week after transplantation. The patient healed completely without further transplantation, but a few local skin flaps were needed to cover exposed articular surfaces. The patient was discharged from hospital with stable grafts five weeks after transplantation. PMID- 1780730 TI - Prognosis and risk factors in acute, dialysis-requiring renal failure after open heart surgery. AB - Of 1988 patients who underwent open-heart surgery from 1980 through 1988, 68 (3.4%) developed postoperative acute renal failure requiring dialysis (2.5% of adult and 8.3% of pediatric patients). Isolated aortocoronary bypass grafting was the operation with lowest incidence of this complication (0.6%). Acute renal failure usually appeared during the first 3 postoperative days. It carried a mortality rate of 63%, with half of the deaths occurring during the first few postoperative days, due to low cardiac output and progressive multiple organ failure. Logistic regression analysis in cases of aortic valve replacement demonstrated that significant independent preoperative risk factors for acute renal failure were renal insufficiency (serum creatinine greater than 110 mumol/l in greater than or equal to 2 samples) and increased cardiothoracic index/left ventricular end-diastolic dimension. Data from the literature indicated no time related trend towards reduction of acute renal failure incidence or mortality. Prevention of low cardiac output is of major importance in these respects. Operative intervention before development of advanced disease with left ventricular dilatation and secondary kidney failure is advocated. PMID- 1780731 TI - Surgical treatment of infective aortic valve endocarditis. AB - Fifty-eight adult patients treated with aortic valve replacement for infective endocarditis were retrospectively reviewed. The operation was performed during antibiotic therapy (group I, n = 25) or after completion of such therapy, on average 17 months after diagnosis (group II, n = 33). Preoperatively 68% of group I and 24% of group II were in NYHA class IV. Bacterial aetiology was verified in 78% of all cases. Preoperative embolic complications occurred in six group I and three group II cases, causing hemiplegia in eight. At operation the aortic valve was bicuspid in 29 of the 58 patients. Vegetations and cusp perforation were present in most cases. Bacteria were demonstrated in 11 of the excised specimens. A mechanical valve prosthesis was inserted in all cases. Three patients died, one perioperatively and two during their time in hospital (2 from group I). Low output syndrome was the commonest postoperative complication. During follow-up averaging 66 months, 12 patients died (6 of cardiac causes). Late complications were periprosthetic leakage (2 cases), significant embolism (5), and prosthetic valve endocarditis (4), causing periprosthetic leakage in one case. PMID- 1780732 TI - Pleural and pulmonary complications after bilateral internal mammary artery grafting. AB - The long-term patency of internal mammary artery (IMA) grafts in coronary bypass surgery is superior to that of saphenous vein grafts. To investigate if bilateral IMA grafting increases the complication rate, especially pleural problems, 100 patients with bilateral and 100 with unilateral IMA grafts were retrospectively studied. Preoperatively the groups did not differ in age, previous myocardial infarction, ejection fraction, NYHA classification or previous respiratory disease, but the coronary artery status was poorer in the bilateral IMA group. Postoperative pleural drainage was greater after bilateral IMA grafting (1074 vs. 497 ml, p less than 0.0001). Reoperation was required for bleeding in 10% of the patients with unilateral, and 20% of those with bilateral IMA grafting (p less than 0.05), and more blood was transfused in the latter group (5.9 vs. 4.7 units, p less than 0.01). Pleural effusion at discharge from hospital or 3 months postoperatively, pain in the sternotomy wound, pain on breathing and postoperative use of nitroglycerin did not differ significantly between the groups. Bilateral IMA grafting thus led to more bleeding and reoperations than single IMA grafting, but did not cause excessive pulmonary complications. PMID- 1780733 TI - Early results of mitral valve replacement. AB - Early results of mitral valve replacement were reviewed in 336 unselected patients, 261 without and 75 with concomitant coronary artery bypass grafting (MVR and MVR + CABG groups). Early (less than 30 days) mortality was 7% in the MVR and 16% in the MVR + CABG group, with cardiac failure as the dominant cause. In multivariate analysis, the variables most strongly related to early mortality were congestive heart failure, diabetes and previous cardiac surgery in the MVR group and congestive heart failure in MVR + CABG. In the cases with fatal outcome the incidence of peroperative technical complications was 32% at MVR and 17% at MVR + CABG. The incidence of myocardial injury was 21% and 35% in the respective groups, and the early mortality in these cases was 19% vs 23%. Half of all fatal cases showed signs of peroperative myocardial injury. Multivariate analysis showed factors independently related to myocardial injury to be year of surgery and aortic cross-clamp time in MVR and previous cardiac surgery in MVR + CABG. Operation before cardiac reserves are reduced, optimal peroperative myocardial preservation and avoidance of technical errors should improve results of MVR. PMID- 1780734 TI - Damage to the right coronary artery as a cause of death after aortic valve surgery. AB - During a 6-year period (1983-1988), 1137 patients underwent surgery which included replacement of the aortic valve. There were 73 deaths within 30 days of surgery. A retrospective analysis showed that in four cases the cause of death probably was related to intraoperative damage to the right coronary artery, which in three cases was accidentally obstructed by a suture and in the fourth case was found at autopsy to be occluded by an organized thrombus. None of the four patients died intraoperatively. Death occurred 2 hours to 20 days postoperatively from arrhythmia and/or pump failure caused by myocardial infarction. PMID- 1780735 TI - Automatic stapling devices in the surgical treatment of esophageal diverticula. AB - Experience is presented of 18 patients in whom surgical treatment of esophageal diverticulum included use of an automatic stapling device. Ten diverticula were pharyngoesophageal, three mid-esophageal and five epiphrenic. One-stage diverticulectomy with myotomy was performed in all cases. Postoperative follow-up was 6-66 months. The results were excellent, without early or late complications or recurrence. PMID- 1780736 TI - Veno-venous extracorporeal membrane oxygenation with a heparin-coated system in adult respiratory distress syndrome. AB - Three patients with adult respiratory distress syndrome were treated with veno venous extracorporeal membrane oxygenation, ECMO, using a heparin-coated system for 8, 12 and 34 days, respectively. Despite extracorporeal blood flow of 4-5 l/min, the patients were ventilator-dependent in the initial period of ECMO. Two of the three patients showed bleeding diatheses despite only slightly elevated activated partial thromboplastin time (APTT). Blood platelet count followed a variable course and serum fibrinogen was normal. Acute pulmonary hypertensive crises, fatal systemic infection, recurrent pneumothorax and plasma leakage from the oxygenators were other main complications during ECMO. Two of the three patients survived, and follow-up showed that severely damaged lungs, if supported in the acute phase, can recover sufficiently to permit normal living. PMID- 1780737 TI - Effects of adenosine infusion on the pig heart during normothermic ischemia and reperfusion. AB - Possible enhancement of myocardial protection during ischemia and reperfusion by administration of adenosine was evaluated in a pig heart model. Adenosine (100 micrograms/kg/min) was infused into the aortic root during ischemia in group AI (n = 5) and into the right atrium during reperfusion in group AR (n = 6). Group C (n = 6) served as controls. During cardiopulmonary bypass the hearts were subjected to 30 min of normothermic ischemia and 15 min of reperfusion before weaning. In group AI the stroke work index 30 and 90 min after ischemia and the mean arterial pressure 30 min after ischemia were significantly higher than in group C. These parameters did not differ significantly between groups AR and C. All groups showed decrease in myocardial adenosine triphosphate (ATP) and adenylate charge potential (ACP) during ischemia and partial (ATP) or complete (ACP) restoration after ischemia. Adenosine infusion into the aortic root during ischemia (adenosine cardioplegia) thus resulted in improved postischemic heart function, although biochemical correlates in ATP and ACP were not apparent. PMID- 1780738 TI - High-dose insulin improves the efficacy of dopamine early after cardiac surgery. A study of myocardial performance and oxygen consumption. AB - The influence of dopamine (7 micrograms/kg b.w./min) and of combined high-dose insulin (7 IU/kg) and dopamine on the relationship between haemodynamic performance and myocardial oxygen consumption was studied 4-6 hours after aortocoronary bypass surgery. The ten patients in the 'dopamine' group and the nine in the 'insulin-dopamine' group responded equally to dopamine alone. In a second study period the cardiac output was increased 41.8 +/- 4.7% by insulin dopamine and 25.9 +/- 6.7% by dopamine alone (p less than 0.05). As the heart rate response was similar in both groups, the difference was mainly due to greater response of stroke volume in the insulin-dopamine group. Systemic vascular resistance decreased 27.4 +/- 5.1% in the insulin-dopamine group but was unchanged in the dopamine group (p less than 0.05). Myocardial oxygen consumption increased 70.7 +/- 15.6% in the dopamine group and 78.8 +/- 18.4% in the insulin dopamine group (NS). The addition of high-dose insulin to dopamine thus improved the haemodynamic efficacy of dopamine without further increasing myocardial oxygen expenditure. PMID- 1780739 TI - Duration of cardiopulmonary bypass compared with changes in the plasma protease systems. AB - Forty patients undergoing elective coronary artery bypass grafting were investigated concerning association between duration of cardiopulmonary bypass (CPB) and changes in the plasma protease systems. Spontaneous enzyme activity, proenzymes and functional inhibition capacities in the fibrinolytic, plasma kallikrein-kinin and coagulation systems were measured before, during and after CPB and in the immediate postoperative period. No clear relationship was revealed between changes in the measured variables and the duration of CPB. PMID- 1780740 TI - Tracheal obstruction due to congenital tracheomalacia in a child. Case report. AB - Congenital tracheal obstruction, though not notably uncommon in infancy, is rarely due to isolated tracheomalacia, especially when characterized by complete absence of cartilaginous rings. A 5-year-old boy underwent successful tracheal resection and anastomosis following severe tracheal obstruction due to aplasia of cartilaginous rings. PMID- 1780741 TI - Left atrial rupture following blunt thoracic injury. Case report. AB - A 22-year-old man presented with intermittent tachycardia and left-sided flail chest after an automobile accident. Initially his condition was stable, but 7 hours after the injury cardiac asystole appeared. Cardiopulmonary resuscitation was immediately begun and operation was performed. A rupture of the left atrium was successfully repaired without cardiopulmonary bypass. PMID- 1780742 TI - [The amino acid taurine--physiology and pathophysiology]. AB - In this review, the main aspects of our knowledge of the physiology and pathophysiology of the beta-amino sulfonic acid taurine will be summarized. After shortly considering the chemistry, the occurrence and the metabolism of taurine, the biological functions of taurine in the mammalian organism will be dealt with. With respect to taurine deficiency, this review will be limited to the cat since taurine is an essential nutrient for this species. PMID- 1780743 TI - [Sebastian Fey, Zuben and Erlen (Thurgau), 1791-1825]. AB - Sebastian Fey (1791-1825) was a young veterinarian of the Swiss canton of Thurgau (founded 1803). He had first made an apprenticeship as a country veterinarian, and his educational background was very modest. But his zealousness to come out of the darknesses of empirical veterinary medicine was very strong. With a cantonal scholarship, he managed to spend a year (1813/14) at the Vienna Veterinary School. He was one of the first members of the Swiss Veterinary Association founded 1813, and published a series of papers in the early volumes of its Schweizer Archiv fur Tierheilkunde, on from 1816. He also had two monographs printed in Constance publishing houses. In the second of them, he confirmed and defended the statements of Skellett, a British pioneer of foetotomy in cattle. PMID- 1780744 TI - Clonal remissions in acute nonlymphocytic leukemia: implications for curability. PMID- 1780745 TI - Allogeneic or autologous bone marrow transplantation for intensification of salvage therapy in patients with high-risk advanced acute lymphoblastic leukemia. The AIEOP/GIMEMA Groups. PMID- 1780746 TI - Why more 6-mercaptopurine? PMID- 1780747 TI - Individualized dosages of chemotherapy as a strategy to improve response for acute lymphocytic leukemia. PMID- 1780748 TI - Influence of radiation dose and radiation field size on the induction or treatment of leukemia. PMID- 1780750 TI - High-dose versus intermediate-dose cytarabine combined with mitoxantrone for the treatment of relapsed and refractory acute myeloid leukemia: results of an age adjusted randomized comparison. PMID- 1780749 TI - Effects of treatment regimens on post marrow transplant relapse. PMID- 1780752 TI - "Quality" remissions: a new target of induction therapy in acute leukemia and the next step in developing curative treatment. PMID- 1780753 TI - Reversing clonality in leukemia. PMID- 1780751 TI - To overcome pharmacologic and cytokinetic resistance to cytarabine in the treatment of acute myelogenous leukemia by using recombinant interleukin-3? PMID- 1780754 TI - Effect of dose on the pharmacokinetic and pharmacodynamic effects of cytarabine. AB - In summary, there are compelling laboratory and clinical data indicating that higher doses of ara-C than are currently used in SDaC protocols constitute optimal therapy. The cellular pharmacokinetics of ara-C are optimized at extracellular drug concentrations in the 10 to 15 mumol/L range. At these concentrations, transport rates are no longer rate-limiting, and ara-C phosphorylation capacity is saturated. The prime determinants of ara-C effect then shift to multiple intracellular events including anabolism to nucleotides, catabolism via deamination by Cyd-dCyd deaminase and dCMP deaminase, half-life of ara-CTP, the extent of incorporation into DNA, and the half-life of ara-CMP residues in DNA. It is postulated that at these high doses an additional effect of ara-C occurs on the cell membrane through affects on membrane phospholipid synthesis. This effect may contribute to the brisk cell lysis associated with HiDaC treatment. When administered as repetitive doses of 3 g/m2 over a 1- to 3 hour period, systemic deamination of ara-C gives rise to high plasma concentrations of ara-U. This metabolite has a long plasma half-life and, at least in the mouse, is concentrated in the liver and kidneys. High concentrations in these organs retard the further catabolism of ara-C and thus increase the systemic AUC providing a longer exposure period to the drug. A similar mechanism may obtain in patients treated with HiDaC. The observed decreased clearance of ara-C when administered in gram versus milligram doses and the long-terminal gamma-phase in plasma clearance of the drug associated with HiDaC usage quite probably reflects this effect of ara-U in patients. Additionally, by some as yet unknown mechanism, high concentrations of ara-U cause accumulation of leukemia cells in S-phase, the phase of the cell cycle wherein ara-C is maximally effective. This effect of ara-U may add to the cytokinetic effects initiated by rapid cytoreduction, which summate in the observed enhancement of the proliferative fraction of residual leukemia cells on day 8. The effect of a second course of therapy at this time is thereby enhanced. These dose-related and metabolite-drug interactions that occur when ara-C is given at high doses constitute a means for "self-potentiation" and may thus contribute to its overall therapeutic efficacy. PMID- 1780755 TI - Evaluating new therapy for acute myeloid leukemia. PMID- 1780756 TI - Intensive therapy for adult acute lymphoblastic leukemia. PMID- 1780757 TI - Improved cure rate by very early intensification combined with prolonged maintenance chemotherapy in patients with acute myeloid leukemia: data from the AML Cooperative Group. PMID- 1780758 TI - Double intensive consolidation chemotherapy in adult acute myeloid leukemia. PMID- 1780759 TI - High-dose chemotherapy in adult acute lymphoblastic leukemia. PMID- 1780760 TI - Improving the curability of acute leukemia: pharmacologic approaches. PMID- 1780761 TI - Does more intensive treatment cure more patients with acute myeloid leukemia? The BGMT Group. PMID- 1780762 TI - Does more intensive therapy increase cures in acute leukemia? PMID- 1780763 TI - New agents in the treatment of acute myeloid leukemia. PMID- 1780764 TI - New pharmacologic approaches to treatment of leukemia. PMID- 1780765 TI - A safe approach to treatment of factor IX-deficient patients. Introduction and overview of treatment. PMID- 1780766 TI - Monoclonal antibody-purified factor IX--comparative thrombogenicity to prothrombin complex concentrate. PMID- 1780767 TI - Thrombogenicity associated with factor IX complex concentrates. PMID- 1780768 TI - Preclinical studies of a monoclonal antibody-purified factor IX, Mononine. PMID- 1780769 TI - [Effects of verapamil on the functional state of the liver in ischemic heart disease]. AB - When treated by verapamil, coronary patients responded differently. Hepatic effects can be either protective or toxic depending on the drug dosage and course duration. Verapamil hepatic protection manifests in day dosage 360 mg and the course duration 3 weeks. 600 mg verapamil is toxic irrespective of the course duration. PMID- 1780770 TI - [Secretory activity of endocrine glands in gastroduodenal ulcer during late postoperative period]. AB - The hormonal status of the endocrine glands (the hypophysis, thyroid, adrenals, pancreas, gastrin-producing cells of the stomach, gonads), was evaluated in patients with gastroduodenal ulcer operated (gastric resection, vagotomy) 6, 12 or 36 months before. Hormonal balance was found affected, the gonads underwent gross changes responsible for gonadal depletion in the long-term postoperative period. Recommendations for relevant correction are provided. PMID- 1780771 TI - [Pathogenesis of arterial hypertension in diabetes mellitus]. AB - To investigate pathogenesis of arterial hypertension in diabetes mellitus, the authors measured parameters of central and peripheral hemodynamics, basal renin levels, angiotensin, aldosterone, kallikrein-kinin system. The results were analysed with regard to hypertension type: essential (EH), atherosclerotic (AH) and nephrogenic (NH). Hypokinetic circulation, defected vascular elasticity, activation of renin-angiotensin-aldosterone system and hypoactivity of kallikrein kinin system were characteristic of EH and AH. Most pronounced changes in peripheral hemodynamics and hypoactivity of depressor kallikrein-kinin system were seen in NH. PMID- 1780772 TI - [Ultrasonic diagnosis of malformations during the 1st trimester of pregnancy]. AB - Available are the results of ultrasonic investigations for 11 women with embryonal anomalies in the I pregnancy trimester. Echography was demonstrated to detect gross CNS malformations (anencephaly, exencephaly), lymphangiomas, omphalocele, conjoined twins, acardia of amorphic embryo, etc. Transvaginal sensors proved highly informative. PMID- 1780774 TI - [Ecological disasters and mental health]. PMID- 1780773 TI - [Effects of ecological factors on the state and development of the fetus and newborn]. PMID- 1780775 TI - [Endocrine function of the pancreas after radical surgery in esophageal cancer]. AB - Postoperative levels of insulin and morphological pattern of beta-cells of islets of Langerhans were studied in 27 esophageal cancer patients following one-stage esophageal resection or repair with the gastric pedicle graft and extracavitary cervical shunt. There is a postoperative inhibition of secretory activity of the insulin pancreatic apparatus which recovered on 120 postoperative day. These shifts resulted from dystrophy of the beta-cells. PMID- 1780776 TI - [CO2 lasers in the treatment of breast cancer]. AB - The paper is a review of the experience gained by foreign and Soviet (the Moscow Cancer Research Institute) investigators in using high-energy CO2-laser fo treatment of breast cancer. It is demonstrated that employment of laser scalpel improves operative results, does not induce complications, prolongs survival and recurrence-free period of breast cancer patients. PMID- 1780777 TI - [Indicators of oxygen-dependent metabolism of peripheral blood neutrophils in the differential diagnosis of bacterial and viral infections]. AB - Oxygen-dependent metabolism of peripheral neutrophils was compared for viral hepatitis and acute yersiniosis patients. The metabolism inhibition was seen in both the diseases with lower values for viral hepatitis. Neutrophil function was dependent on the disease gravity. Its recovery went in parallel with other clinical and laboratory signs of convalescence. A luminol-dependent chemiluminescence test is proposed for differential diagnosis of viral hepatitis with jaundices in generalized bacterial infection. PMID- 1780778 TI - [Intravascular microcoagulation: current status of the question]. PMID- 1780779 TI - [Medico-social and economical aspects of the surgical treatment of fractures by polymer and metal-polymer constructions]. PMID- 1780780 TI - [Block-and-module system of training in a medical school: initial results and perspectives]. PMID- 1780781 TI - [Significance of clinical methods in present-day diagnosis]. PMID- 1780782 TI - [Diagnosis of exudative adhesive constrictive pericarditis]. PMID- 1780783 TI - [Evaluation of the effectiveness of drug correction of impaired cognitive activity in chronic cardiac insufficiency]. PMID- 1780784 TI - [Treatment of pulmonary edema with bolus administration of 0.1% nitroglycerin solution]. PMID- 1780785 TI - [Diagnostic and therapeutic tactics in patients with mechanical jaundice of cholelithiasis etiology]. PMID- 1780786 TI - [Characteristics of lipid-hormone relations in the families of probands with early development of myocardial infarction]. AB - 163 subjects from families whose probands developed myocardial infarction under the age of 50 were examined for plasma levels of total cholesterol, HDLP cholesterol, triglycerides, T3, T4, immunoreactive insulin (IRI) and cortisol. Four family groups were selected: probands (58), wives (41), sons (33), daughters (31). Lipid composition was investigated by standard techniques on Technicon AAP, a hormonal spectrum--by RIA using Soviet kits. It was established that alpha cholesterolemia in the families was a common finding. Probands and their families combine reduced plasma T3 levels with high incidence of atherogenic dyslipoproteinemia (ADLPE). Probands and their sons had hyperinsulinemia resultant in more frequent AFLPE while in probands' wives and daughters higher IRI levels brought about opposite results. PMID- 1780787 TI - [Compactotomy--an alternative to amputation in critical ischemia of the limbs]. PMID- 1780788 TI - [Diagnostic errors in oncologic gynecology and ways of their prevention]. PMID- 1780789 TI - [Principles of the treatment of patients with chronic liver diseases]. PMID- 1780790 TI - [Contraception methods and risk of the development of breast cancer]. PMID- 1780791 TI - [Progesterone test in the diagnosis of stenosis of the ureteropelvic segment]. PMID- 1780792 TI - [Nephrolithotomy in coral-like calculi]. PMID- 1780793 TI - [Hypothalamic syndrome with dexamethasone-dependent hypertension and hyperprolactinemia]. PMID- 1780794 TI - [Diagnosis of acute hepatic encephalopathy in patients with viral hepatitis by means of instrumental coagulography]. PMID- 1780795 TI - [Thrombolysis in deep venous thrombosis: critical review]. AB - Thrombolytic treatment of deep vein thrombosis remains controversial. It has never been demonstrated that the late postthrombotic syndrome may be diminished by the faster dissolution of the clots induced by streptokinase or urokinase. On the other hand are the hemorrhagic side effects associated with thrombolysis well described (lethality of 0.6%). Thrombolysis should be performed preferably under controlled conditions of a clinical study. It is indicated only in young patients with symptoms for less than 7 days of a first thrombosis. Initial results from second generation fibrinolytic substances such as rt-PA (alteplase) do not change this view drastically. PMID- 1780796 TI - [Intermittent venous claudication]. AB - Intermittent venous claudication develops mostly in young patients after iliac vein thrombosis and subsides promptly in the recumbent position. Plethysmographic assessment of calf volume during treadmill work permits objective diagnosis of the phenomenon remaining frequently unrecognized. PMID- 1780797 TI - [Practical proposals for overcoming problems with phlebography]. AB - Venography is considered the gold standard in the diagnosis of venous disease. In the everyday practice, however, it is not used according to this attribute. The article scrutinizes the reasons for the discrepancy, emphasizes the possibilities wrongly renounced to and gives advice to a better indication for and execution of venography. Arguments not to use venography regularly to diagnose or exclude deep venous thrombosis, include claims that it would be superfluous, not readily available, invasive and expensive. Such considerations do not take into account that the clinical diagnosis it not better than tossing a coin. Real difficulties may occur in the evaluation of complicated superficial disease and the postthrombotic syndrome. The problems are minimized by using a methodology based on pathophysiologic knowledge and strictly aimed to solve specific therapeutic questions. The article stresses the need for a proper prevenographic work-up and for a technique tailored to the clinical situation of each individual patient. PMID- 1780798 TI - [Indications for and results of ambulatory varices therapy]. AB - The introduction of the stab-incision--phlebectomy (Muller's technique)--has opened a large field for ambulatory surgery. This is specially true when phlebectomy is combined with a saphena-femoral or saphena-popliteal ligature. In a series of 1825 operations including 1592 incompetent saphenous veins 1216 (67%) were performed under local anesthesia. Radical surgery of incompetent short saphenous veins as well as of minor forms of varicose long saphenous veins is feasible in local anesthesia. Regional or general anesthesia (609 operations) are still recommended for stripping procedures in advanced long saphenous varices. In most cases phlebectomy of varices (553) provides a better cosmetic result than sclerotherapy, the latter being the treatment of choice for small veins and telangiectasias. Ambulatory surgery and sclerotherapy are cost-effective and low risk treatments. No deep vent thrombosis or pulmonary embolism was observed in this group, whereas 1 DVT and 2 PE occurred in the 609 operations performed under general anesthesia. PMID- 1780799 TI - [Assessment of the leg veins using duplex ultrasonography]. AB - Duplex scanning, first used for the investigation of arterial diseases, is characterized by the combination of B-Mode ultrasound and spectral analysis or color imaging of PW-Doppler signals. This provides information on both the morphology of the vessel and the corresponding hemodynamics. Compared to the conventional noninvasive techniques in phlebology such as plethysmography and CW Doppler its major advantage is the additional morphologic information. Until now this anatomical information was only available by invasive phlebography. This technique, however, gives only limited informations on hemodynamics. Using an appropriate technique of duplex scanning, the deep veins from the calf to V. cava as well as the superficial veins and the perforators can be examined. In the hand of a skilled investigator deep vein thrombosis can be diagnosed with accuracy. Compared to the gold standard phlebography sensitivity and specificity are high: 96% and 99% resp. The duplex technique is also very reliable in differentiating the diagnosis of deep vein thrombosis: Baker's cysts, hematomas and tumors usually are easily detected by B-scan. Investigation of chronic venous insufficiency is also possible by duplex-scanning. Imaging of the veins and pulsed Doppler analysis allows to determine whether the reflux is in the deep or superficial system. On a more scientific field duplex allows the precise noninvasive determination of hemodynamic parameters. Thus it is possible to measure physiologic venous hemodynamics and to quantify drug effectiveness. Duplex sonography holds a key position in the phlebological diagnostic procedure. This new technique causes no harm to the patient and important information is obtained at relative low costs. PMID- 1780800 TI - [Mapping of superficial veins for vascular replacement using duplex ultrasound]. AB - With regard to surgical vascular reconstruction, we evaluated the saphenous veins of 110 patients as potential substitute vessels by duplex ultrasound. The technique is analogous to the one used for diagnosis of varicose veins. Finally 74 patients underwent a surgical intervention with exploration or removal of veins. The comparison between the 74 operative findings available for analysis and the results of duplex ultrasound showed agreement in 93%. The duplex technique informs not only about the permeability and morphology of the veins but also by direct skin marking about their precise position. In comparison with phlebography, it is in experienced hands at least as reliable, without morbidity and virtually without inconvenience to the patient. In our opinion, the non invasive duplex ultrasound method is quite adequate for the preoperative judgement of veins destined for vessel replacement. PMID- 1780801 TI - [Microangiopathies in chronic venous insufficiency (CVI)]. AB - The degree of cutaneous microangiopathy at the medial ankle correlates with the severity of chronic venous insufficiency, most probably it is the trigger factor for development of trophic skin lesions. Using intravital fluorescence videomicroscopy, microlymphography, transcutaneous oxygen tension measurement and laser Doppler flowmetry, the microangiopathy is characterized by morphological alterations of blood and lymph capillaries and by dynamic changes (decreased transcutaneous oxygen tension reflecting microvascular ischemia, increased skin perfusion). Microangiopathy in patients with chronic venous insufficiency is recognized by the presence of dilated, elongated and tortuous (glomerulus-like) capillaries and by an increase in diameter of the pericapillary space (halo) filled by Na-fluorescein. In severe CVI a reduction of the capillary number can be observed, probably as a result of previous capillary thrombosis. Lymphatic drainage is disturbed and lymph capillaries are obliterated in part. Laser Doppler flowmetry, which detects flux in deeper, non-nutrient skin vessels, shows increased blood flow. However, the postural vasoconstrictive response remains intact and there is little alteration in the spontaneous rhythmic flux waves. In contrast to deeper skin flux transcutaneous oxygen tension is reduced, in keeping with the microangiopathy observed in the superficial nutrient capillaries. These pronounced morphological and dynamic changes explain the development of trophic skin lesions. PMID- 1780802 TI - In memoriam Staffan Magnusson 1933-1990. PMID- 1780803 TI - Effects of acetylsalicylic acid in stroke patients. Evidence of nonresponders in a subpopulation of treated patients. AB - Platelet reactivity (PR) was tested two and 12 hours after acetylsalicylic acid (ASA) intake in 82 stroke patients, aged 59 +/- 14 years (33 female and 49 male). 10% of these patients showed a pathologically enhanced PR at least two hours after intake of 500 mg ASA (= primary ASA-nonresponder (PNR)). Only 10 hours later, a further 26% of these ASA treated patients exhibited a pathological platelet reactivity (greater than 1.25) (= secondary ASA-nonresponder (SNR)). Single ASA dosages of 500 mg or 200 mg were of identical effectiveness. Additional administration of metoclopramide in combination with 100 mg ASA was more effective as compared to a single dosage of 1000 mg ASA. Those who were SNR at onset of ASA therapy remained SNR as well 28 days later. The change from a normal, ASA corrected PR, to pathological PR values before a period of 12 hours ended seemed a sudden and irreversible event that could only be corrected by the next ASA application. PMID- 1780804 TI - Radioimmunoassay for the detection of active-site specific thrombin inhibitors in biological fluids. I. Assay characteristics and quantitation of recombinant hirudin. AB - A sensitive radioimmunoassay (RIA) for the quantitation of recombinant (r) hirudin in biological fluids is described. Taking advantage of the highly specific hirudin-thrombin interaction, a monoclonal antibody to human alpha thrombin was used to capture hirudin-thrombin complexes in a competitive binding assay. Quantitation of r.hirudin in buffer, plasma or urine at concentrations ranging from 0.17 to 20 ng/ml (1.7 x 10(-3) to 2 x 10(-2) antithrombin units/ml) was achieved. In the absence of competing unlabelled r.hirudin the assay also measured alpha-thrombin (from 2 x 10(-4) to 1 x 10(-2) NIH units/ml) in citrated or defibrinated human plasma. A series of peptides corresponding to the carboxyl terminal region of hirudin and with varying anticoagulant activities did not displace 125I-r.hirudin in the RIA described, confirming published data that these hirudin fragments bind to a site distant to the catalytic site of thrombin. The assay was used to test hirudin clearance after bolus i.v. injections of 0.1 mg r.hirudin [Val1-Val2] into human volunteers. The plasma concentrations and elimination kinetics of r.hirudin were in good agreement with published data and a close correlation between hirudin plasma concentration and prolonged clotting time was observed. PMID- 1780805 TI - Radioimmunoassay for the detection of active-site specific thrombin inhibitors in biological fluids. II. Heparin affects the binding of hirudin to alpha-thrombin. AB - A radioimmunoassay for recombinant (r.) hirudin was used to study the effect of heparin and other glycosaminoglycans (GAG's) on interactions between hirudin and thrombin. Binding of 125I-r.hirudin to thrombin in the presence or absence of heparin (and other GAG's) was monitored by immunoprecipitation of thrombin-125I r.hirudin complexes with a monoclonal antibody to human a-thrombin. Heparin and dextran sulfate substantially reduced hirudin binding to thrombin in human plasma. Inhibition by heparin was restored by addition of increasing amounts of antithrombin (AT) to samples containing constant amounts of heparin, thrombin and 125I-r.hirudin and was not neutralized by protamine sulfate. At very low heparin concentrations competitive displacement of 125I-r.hirudin was observed, while in the presence of heparin-AT complexes some 125I-r.hirudin remained bound to thrombin, suggesting that two or more binding sites for hirudin on the thrombin molecule may be occupied simultaneously. PMID- 1780806 TI - Influence of anticoagulants used for blood collection on plasma prothrombin fragment F1 + 2 measurements. AB - The levels of prothrombin fragment F1 + 2 were measured by a double antibody radioimmunoassay in blood samples collected into different anticoagulant solutions. We evaluated healthy males between the ages of 42 and 77, asymptomatic patients with hereditary deficiencies of protein C or protein S, and persons receiving tumor necrosis factor infusions. The results in specimens collected in an anticoagulant containing ACD, EDTA, adenosine, and 25 U/ml of heparin (a) were highly correlated with those collected in an anticoagulant containing a synthetic thrombin inhibitor, EDTA, and aprotinin (b). However, in asymptomatic patients with congenital antithrombin III deficiency, we found that the plasma levels of F1 + 2 in blood collected in anticoagulant (a) were usually substantially higher than those collected in anticoagulant (b). We determined that this phenomenon was not attributable to the venipuncture procedure itself, but rather appears to be due to the action of low concentrations of heparin in the presence of reduced blood levels of antithrombin III. Our data show that the previously documented elevations in plasma F1 + 2 levels in patients with congenital antithrombin III deficiency appear to be caused by the above in vitro anticoagulant effect, and that this population does not exhibit evidence of a prethrombotic state as defined by the F1 + 2 assay. PMID- 1780807 TI - Monoclonal antibodies against human plasma protein C and their uses for immunoaffinity chromatography. AB - Human protein C, isolated by conventional multistep methods, was used for immunization of mice. Monoclonal antibodies were prepared and screening of antibodies to human protein C was achieved using an immunoblotting technique. Five monoclonal anti-protein C antibodies were compared as affinity ligands. Different parameters were studied (adsorption capacity, specificity of adsorption, possibility of desorption under mild conditions) and two antibodies were selected. One antibody allows preparation of highly purified protein C in a single-step procedure from a fraction of plasma containing high levels of coagulation factors whereas the other can be used for preparation of protein C deficient plasma. PMID- 1780808 TI - Characterization of kininogens in human malignant ascites. AB - Ascites from seven patients with advanced cancer were studied to characterize the kininogens. Immunological quantification of low molecular weight kininogen (L kininogen) and high molecular weight kininogen (H-kininogen) by rocket immunoelectrophoresis showed values of 42% and 39%, respectively, compared to control plasma. Release of kinin from the ascites samples was assayed on an isolated rat uterus. The total kinin released from the kininogens was 39% of the value in control plasma, while release selectively from H-kininogen amounted to 25% of plasma. This indicates about 30% of the bradykinin in H-kininogen to be released in vivo in ascites, and points to kinins as possible mediators of the increased vascular permeability causing accumulation of ascites. The function of kininogens as cysteine protease inhibitors (CPIs) was assayed as well, indicating that both L- and H-kininogen function as cysteine protease inhibitors in human ascitic fluid. The proteolytic cleavage of H-kininogen in ascites was studied by polyacrylamide gel electrophoresis and subsequent immunoblotting. H-kininogen was extensively cleaved in ascites compared to control plasma, with large amounts present of a degraded form with Mr of 99 kDa. The bands observed compared well with those described in plasma, and are consistent with contact activation taking place in ascites. PMID- 1780809 TI - Safety of vapour heated prothrombin complex concentrate (PCC) Prothromplex S-TIM 4. AB - The risk of infection after application of vapour heated prothrombin complex concentrate PROTHROMPLEX S-TIM 4 (PCC) 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 other blood products in addition to PCC. Twenty-One patients were eligible to test for the risk of acquiring hepatitis NANB (ALT-levels) and samples from 12 patients were available that could be screened for anti-HCV. Twenty patients qualified for evaluation of the risk of developing hepatitis B, and 67 patients qualified to test for HIV-1-Infection. None of these patients showed any signs of infection. Vapour heating of prothrombin complex concentrate seems to lower the risk of transmitting viral diseases considerably. PMID- 1780810 TI - Fibrinolytic activity in depression and neurosis. PMID- 1780811 TI - [Register index. 1991]. PMID- 1780812 TI - [Health services for physicians--why and how?]. PMID- 1780813 TI - [Our physical activity habits--are they good enough?]. PMID- 1780814 TI - [The Norwegian Antarctic expedition 1989-1990--medical contingency, work and research]. AB - Antarctica is the world's coldest, driest, highest and most windy continent. The ice may reach a thickness of nearly five km, and the greater part of the world's fresh water is bound in this ice cap. The lowest temperature ever measured is -90 degrees C. The weather during this summer expedition was pleasant, and the temperature seldom fell below -30 degrees C. The 35 persons in the land party included two physicians and one nurse. No serious injury or disease occurred. The participants seemed experience an increase in lean body weight and loss of fat during five weeks in tents. Extensive data were collected for medical psychological projects on immunology, adaptation to cold, exhaustion from cold and stress. Some results have been published in separate reports. PMID- 1780815 TI - [Mental disorders among physicians hospitalized in a psychiatric clinic]. AB - 149 physicians were hospitalized in a psychiatric clinic, Modum Bads Nerve Sanatorium, during the period 1958-89. 122 of the physicians were men and 27 were women. The material is selected but is representative of non-psychotic voluntarily hospitalized physicians. More than 1/3 of the physicians had abuse problems, mainly drug abuse. The average age of the physicians was 46, and they had been practising for an average of 17 years at the time of hospitalization. 60% of them worked outside institutions. About 1/3 of them were specialists. PMID- 1780816 TI - [Physicians hospitalized in psychiatric institutions in Norway]. AB - In the period 1985-89, 124 physicians were hospitalized in Norwegian psychiatric institutions. 20-30 physicians are hospitalized every year. The overall rate of admission to psychiatric institutions seems to be relatively higher among other groups of the adult population than among physicians. The physicians suffer from schizophrenia less frequently than others do, and suffer more frequently from affective and other psychoses. Drug abuse is also a typical disorder among hospitalized physicians. 1/4 of the physicians were hospitalized in Modum Bads Nerve Sanatorium, and the author compares the material from this institution with that from the other 33 psychiatric institutions in Norway. PMID- 1780817 TI - [Health services for physicians in Rogaland. A questionnaire study]. AB - In order to investigate the need for a health service for doctors a questionnaire was mailed to all doctors in Rogaland county. 84% of the respondents were in favour of such a service. It is necessary not only to provide a general medical examination but to focus also on work-related and psychosocial factors. PMID- 1780818 TI - [Low-calorie diet, exercise and hypertension. 2 pilot studies using a protein rich low-calorie diet powder (Nutrilett)]. AB - In the first study the physical performance in ten healthy overweight persons was assessed before and after a four week diet period. An exercise treadmill test (Bruce protocol) was used. No significant change in average oxygen uptake was found. Nine overweight men on antihypertensive treatment were put on the same diet, eight of them completed the study. The diet was well tolerated, and most of the men achieved better blood pressure control. In five of them the doses of antihypertensive medication could be reduced. The average weight loss was ten kilos in one group and eight kilos in the other. Since these were pilot studies with small numbers of participants, care should be taken in drawing general conclusions. The results are nevertheless promising, and we discuss the application of this regimen in patients in general practice. PMID- 1780819 TI - [Effect of Arnica D 30 during hard physical exertion. A double-blind randomized trial during the Oslo Marathon 1990]. AB - The effect of Arnica Montana on stiffness, restitution time and cell damage during hard physical exercise was evaluated in a randomized double blind trial during the Oslo Marathon. 36 participants were randomized: one group received Arnica 10(-30) five pills twice daily for five days, starting the day before the event. The other group received placebo pills. Blood tests were carried out before and immediately after finish, and after 48 and 72 hours. Stiffness was evaluated on a visual analogue scale after finish and on the next three days. There was no difference between the groups as regards ALAT, ASAT, GT, LD, creatinine, haptoglobin or magnesium. CK increased in both groups, but to a higher level in the placebo group. The difference was greatest on the second day (p = 0.07). A feeling of stiffness was more pronounced in the placebo group on all four occasions (p = 0.06 and 0.07 on day 2 and 3). There was no indication that Arnica reduced the time of restitution. PMID- 1780820 TI - [Myopia--a disease or a physiological defect?]. AB - Many investigations have been carried out during the last 150 years to detect factors which cause nearsightedness (myopia). A factor that has been awarded particular attention in addition to hereditary factors is the influence of the environment, especially the amount of close work on the refractive state of the eye. The increasing prevalence of myopia among children and young people revealed in some populations has been related to stressing educational systems, which are suspected of enhancing the changes in the growth of the eye leading to myopia. However, the direct etiological relationship between the myopia and prolonged accommodation during the close work has still to be established. The prevalence of myopia in Norway is not known, but relatively high prevalence was found in a recent study among medical students and physicians. At the present time, increasing interest is being shown for keratorefractive surgery to correct myopia. Both radial keratotomy and excimer laser photorefractive keratomileusis have become available in Norway, and a few hundred patients have been operated. The purpose of this article is to elucidate some important aspects in understanding the etiology, development and correction of myopia. PMID- 1780821 TI - [The "Large Foot" association. The size of the foot, height and age at menarche]. AB - A slight negative correlation (r = -0.198) was found between age at menarche and size of shoe in 106 women from a Norwegian organization for persons using shoe sizes larger than 41. The correlation between stature and size of shoe was smaller (r = 0.086). These findings are discussed with respect to normal growth of the foot and body stature. Since pubertal growth of the foot occurs before the pubertal growth spurt, it is unlikely that oestrogen treatment for tall stature will affect foot length to any degree. The authors also discuss psychological and physical problems related to large feet. PMID- 1780822 TI - [Funeral rituals, mourning and mental health]. AB - 11 informants who were mourning relatives or friends who had died during the last five years were interviewed by a priest, who asked about their relationship to the deceased, their participation in funeral rituals and their experience of their own mourning process. The respondents endorsed the following scales: SCL-90 Depression subscale, Intrinsic, Extrinsic and Quest Scales, Doctrinal Orthodoxy Scale, Liberal Belief Scale, Moral Conservatism Index and Humanistic Mortality Scale. Each respondent was evaluated hermeneutically in a pastoral-clinical way, and the whole material was treated statistically. The extrinsic person uses his religion to attain comfort, security, and social acceptance, and it is not deeply integrated in his personality. The extrinsic religious orientation correlated positively with a prolonged mourning process and depression. It can be tentatively concluded that extensive participation in funeral rituals seems to prevent a prolonged mourning process and resulting depression. PMID- 1780823 TI - [J.A. Komensky (Comenius) in the progress of health education]. PMID- 1780825 TI - [Medical assimilation processes in the middle ages. From Gundishapur to Toledo]. AB - The medicine of Ancient Greece has had an important impact on world medicine right up to modern times. One of the most interesting lines of development can be followed from about 1000 years after the death of Hippocrates (377 BC). At that time, Greek medicine and philosophy encountered the rising Islamic culture of the Arab world. It went through phases of reception and assimilation in the Middle East where, in addition to Baghdad, the city of Gundishapur is emphasized as an important centre of translation. Some hundred years later Latin Europe benefited from these Arab translations of medical and philosophical texts from Ancient Greece. After the Spanish city of Toledo had been reconquered from the Arabs, European scholars gathered there to translate the Greco-Arab manuscripts into Latin, the language of the learned in medieval Europe. The author tries to describe this course of events. PMID- 1780824 TI - [Some cholera graveyards in western Norway]. AB - The Norwegian provisional regulations from 1832 for the control of cholera included detailed directions for the burial of cholera victims. How these directions for graveyards were followed up has been studied in the context of the cholera epidemic in Western Norway in 1848-49. In Bergen an ordinary graveyard was used for burying cholera victims at the beginning of the epidemic, while all later burials took place in a graveyard for cholera victims only. 549 victims were buried here. On the island of Sotra the majority of the cholera victims were buried in three cholera graveyards, and further south in the county several small graveyards were planned or laid out. In general, the directions for cholera graveyards were followed. The cholera graveyard in Bergen was levelled over one hundred years ago, while several other cholera graveyards in Western Norway still exist as reminders of the epidemic. PMID- 1780826 TI - [Sick girls in Norwegian art. Some thoughts based on the paintings of Christian Krohg]. AB - In the last two decades of the nineteenth century the motive of a sick girl was painted several times by Nordic artists. The author describes Christian Krohg's naturalistic painting Sick girl from 1880-81, and uses it as a reference for the discussion of the use of this theme in Scandinavian art. PMID- 1780827 TI - [Physicians and leeches--and traces in words]. AB - The article starts with a brief review of the use and abuse of Hirudo medicinalis. For a long time the word leech was a common name in England for the worm and for a physician, and possibly had its origin in the very old Indo European stem leg, which is probably also the stem of our Scandinavian terms laege/lege/lakare. It is commonly known, however, that lege and other similar words used for physicians in Europe, both today and in former times, are of Celtic origin. This arouses one's curiosity. With the help of a wellknown American colleague and a Czech physician with a special knowledge of languages, I traced the source of these words back to the great Indo-European family of languages. All the traces pointed to leg-the stem with numerous ramifications in many old and modern languages. From the beginning, leg seemed to be associated with knowledge and wisdom. Tempted by this finding, I followed traces of history, as indicated in words referring specially to physicians in the different European languages. In this article I discuss the significance of the Celtic language in this connection, since in former times it was one of the main branches of the Indo-European family of languages. The old Greek word logos, with its corresponding verb legein containing the same implication as mentioned above, is also said to have some connection with our profession. PMID- 1780828 TI - [Diagnosis of depression]. PMID- 1780829 TI - [The power of the health system and situation of the individual]. AB - The article discusses the power of the medical profession and the welfare state in relation to individual health and privacy. It is argued that the increasing power of the profession and social welfare entails a threat to the individual as a master of his own health and life. Modern medicine emerged from widespread disrepute in the 19th century into Messianic enthusiasm caused by aweinspiring therapeutic triumphs at the turn of the century. Unreasonable expectations and expansion of the health sector have spawned counterproductive effects which are to some extent detrimental to public health. The definition of health as "complete physical, social and mental wellbeing", and a lack of recognition of suffering as an essential part of human life, are conceived to be totalitarian wolf in the sheep's clothing of welfare. The efficacy of medicine depends on sensible management of the medical profession as a charismatic status. The medical profession has a necessary element of "conspiracy" which is particularly difficult to maintain in the egalitarian culture of Norway. Additional harm is done through extensive misuse of medical authority in dispensing welfare benefits. PMID- 1780830 TI - [On power and feebleness--and the recreative power of love]. PMID- 1780831 TI - [Homeopathy--the past or a part of future medicine?]. AB - The exact mechanism for the effect of homeopathic remedies is still an enigma. Research shows in vitro effects of homeopathy, as well as differences between the effects of simple dilutions and so called homeopathic potencies. Some of the (relevant) publications are widely disputed. More than 100 controlled clinical trials in humans have been published, but the quality of the majority of the studies is not acceptable. However, some good quality studies do show an effect of homeopathic medicine. We therefore recommend further studies and propose a model for study design. No serious side effects have been reported from homeopathic medicine. PMID- 1780832 TI - [Physical activity habits among adults in Nord-Trondelag]. AB - This article describes the physical activity of 61,732 adults in the Norwegian county of Nord-Trondelag. We collected information about physical activity by questionnaire during the Nord-Trondelag Health Survey in 1984-86. Non-attendents are systematically analyzed and discussed. The article also deals with problems of defining physical activity. The frequency of physical activity gives a different measure of physical activity than does intensity and duration. 15% of the women and 14% of the men were totally inactive. If we consider physical activity at a level high enough to have a preventive effect as regards development of disease, for example, we found that 65% did not practise physical activity often enough or with sufficient intensity or duration. The groups of men aged 70-79 years and women aged 60-69 years contained the persons who practised physical activity most often, while the 20-29 age group contained those who practised physical activity with greatest intensity and for the longest time. We used age, sex, education, residential municipality and physically strenuous work as variables explaining inactivity and high activity. All the variables made a significant contribution to the logistic regression, but gave a better persons characterization of highly active than of inactive persons. PMID- 1780833 TI - [Good physicians--how will the students turn out?]. AB - Good medical practice requires the amalgamation of two worlds, the world of medical science and the world of sick people. Medical science has seen unbelievable progress, but criticism from patients has nevertheless increased. There is also an increasing gap between the direction of medical science and sick people's problems. The curriculum needs reforming in most medical schools. But the teachers are probably more important than the curriculum. The teachers, at least a few of them, should serve as role models and influence the students for life. I describe my three role models as an illustration. The medical schools must therefore work along two lines, they must reform the curriculum and make the teachers good role models. PMID- 1780834 TI - [The Rikshospital under glass]. AB - The new national hospital, "Rikshospitalet", is to be built in the northwestern part of Oslo in 1993. It is not only words when the planners talks about humane architecture. The national hospital is a training hospital for Oslo university, and the various consequent functions are arranged according to a logical plan. The most important feature of the hospital is its main "street", an open construction under a glass roof. It will bustle with life, since it will house both public services and outpatient reception. The street delimits different zones, with causal traffic at street level and hospital traffic between the wards and operating theatres and X-ray departments (which are collected in blocks in a central square) on gangways crossing the "street" at higher levels. The wards are formed as pavillions which project from the main building. In this way each ward will be of reasonable size, and the patients will be in close contact with the beautiful surroundings. The hospital will cover about 120,000 square meters, and its estimated capacity is 25,000 in-bed patients and 100,000 outpatient consultations per year. PMID- 1780835 TI - [Medicine, welfare and the narrow path of moral awareness. A statement about social medicine]. PMID- 1780836 TI - [Why change medical education?]. PMID- 1780837 TI - [How hazardous is elective coronary bypass surgery?]. PMID- 1780838 TI - [The extent of private surgical practice in Norway]. PMID- 1780839 TI - [Triazolam for the last time?]. PMID- 1780840 TI - [HIV infection and AIDS]. PMID- 1780841 TI - [Methadone treatment of narcotic addicts--can it be defended?]. PMID- 1780842 TI - [Alcoholics]. PMID- 1780843 TI - HLA-DPB1 oligonucleotide typing of a southwest German Caucasian population. AB - HLA-DP genotyping with sequence-specific oligonucleotides can detected known sequence variations in the polymorphic segments of the DPB1 second exon. Since the allelic polymorphism of the 22 published alleles is based on recombination of sequence motifs from six variable regions, DPB1 typing depends on the reactivity pattern of many different probes rather than from typing with single allele specific probes. By computer simulation, we have previously shown that the minimal set of probes to define the 22 different alleles and most of the heterozygous combinations is 18. Here we describe HLA-DPB1 typing results and allele frequencies in a panel of 200 unrelated Caucasians from Southwest Germany. The result confirmed the power of the new HLA-DPB1 typing method, but we failed to detect three of the previously described alleles in our panel. To accommodate with the observed 19 different alleles, the sequence and hybridization conditions of 17 oligonucleotide probes are given, which are able to differentiate all except two, resolved by group-specific amplification, of the 190 possible heterozygous phenotypes. PMID- 1780844 TI - Characterization of two human monoclonal antibodies recognizing HLA-A30 and HLA A3 + A31, respectively. PMID- 1780845 TI - Genomic cloning and expression of HLA-B37 in the mouse mastocytoma cell line P815 HTR. PMID- 1780846 TI - New DQw1 diversity identified within DRw12 and DRw14 haplotypes. PMID- 1780847 TI - HLA class II haplotypes in Amerindians and in black North and South Americans. PMID- 1780848 TI - Oligotyping of celiac multiplex families with the 11th International Histocompatibility Workshop reagents. AB - Using PCR and SSO probes from the 11th International Histocompatibility Workshop, we oligotyped for HLA-DRB1 gene and DQA1*0501, DQB1*0201 alleles 10 celiac families each with 2 affected children. All families belong to the Italian population except for one, whose mother is originally from Cape Verde island. 8/10 sibling pairs share the DQA1*0501/B1*0201 heterodimer, inherited in cis or in trans arrangement. All the dimer-negative patients were DR4-positive. PMID- 1780849 TI - Asbestos disease-1990-2020: the risks of asbestos risk assessment. PMID- 1780850 TI - Health risk assessment of radiation. PMID- 1780851 TI - Toxic evaluation of chlorinated aromatic hydrocarbons in human environments. PMID- 1780852 TI - Dangerous and cancer-causing properties of products and chemicals in the oil refining and petrochemical industry: Part I. Carcinogenicity of motor fuels: gasoline. AB - Studies in humans and animals have shown that gasoline contains a number of cancer-causing and toxic chemicals such as 1,3-butadiene, benzene, toluene, ethylbenzene, xylenes, isoparaffins, methyltert-butylether, and others. The International Agency for Research on Cancer (IARC) in its Monograph Supplement 7 (1987) concludes that "in the absence of adequate data on humans, it is biologically plausible and prudent to regard agents for which there is sufficient evidence of carcinogenicity in experimental animals as if they present a carcinogenic risk to humans." Epidemiological studies in humans provide important evidence of potential increased risk of leukemia, lymphatic tissue cancers, cancers of the brain, liver, and other organs and tissues. Recently (July, 1990) the American Conference of Governmental Industrial Hygiene (ACGIH) recommended that the TLV-TWA for benzene be reduced from 1 ppm to 0.1 ppm (ACGIH, 1990). The Collegium Ramazzini and others have also recommended that the exposure level for 1,3-Butadiene be reduced from 1,000 ppm to below 0.2 ppm. This recommendation is based on the findings that were presented at the Symposium on Toxicology, Carcinogenesis, and Human Health Aspects of 1,3-Butadiene (Environ. Health Perspec., 1990). Thus, studies on health effects resulting from very low levels of benzene, 1,3-butadiene, and other cancer-causing chemicals--components of gasoline--necessitate that all avoidable exposure to gasoline or gasoline vapors be avoided. PMID- 1780853 TI - An overview of hazardous waste management. PMID- 1780854 TI - Industrialization and emerging environmental health issues: lessons from the Bhopal disaster. PMID- 1780855 TI - Evaluating industrial risks through environmental audits. PMID- 1780856 TI - Indoor pollution by oil heaters and cigarette smoke. PMID- 1780857 TI - Indoor air quality: assessing health impacts and risks. PMID- 1780858 TI - An epidemiological view of asbestos in buildings. PMID- 1780859 TI - Predicting the risk of indoor air pollutants. PMID- 1780860 TI - Personal exposure to 25 volatile organic compounds. EPA's 1987 team study in Los Angeles, California. AB - The US EPA and the California Air Resources Board studied the exposures of 51 residents of Los Angeles, CA to 25 volatile organic chemicals in air and drinking water in February and July of 1987. Participants carried a personal air monitor consisting of a Tenax cartridge and a small sampling pump for two consecutive 12 hour periods. Concurrently, outdoor air samples were collected in the back yards and indoor air samples were collected in the kitchen and living room. Breath samples were collected at the beginning, middle, and end of the 24-hour monitoring period using a vanmounted spirometer employing Tedlar bags followed by collection on Tenax cartridges. All analyses were by GC/MS. Air exchange measurements were made at all homes using the perfluorotracer method. For most chemicals, personal air concentrations were greater than indoor air levels, which were in turn greater than outdoor air concentrations. Breath concentrations were more stable than air exposures and were significantly correlated with previous exposure. Using the air exchange measurements, whole-house source strengths were estimated to range between approximately zero for carbon tetrachloride to 10,000 micrograms/h for para-dichlorobenzene. Ambient concentrations in February were two-three times those in July, perhaps due to strong inversions. PMID- 1780861 TI - Municipal and industrial hazardous waste management: an overview. PMID- 1780862 TI - The export of hazardous waste to the Caribbean basin region. PMID- 1780864 TI - The current status of solid waste management in P.R. China. PMID- 1780863 TI - Waste management in ASEAN countries (Association of Southeast Asian Nations). PMID- 1780865 TI - Management of industrial waste--a European perspective. PMID- 1780866 TI - Risk reduction management for hazardous waste in Japan. PMID- 1780867 TI - Recent advances in risk reduction engineering. PMID- 1780868 TI - General introduction to risk assessment and risk management. PMID- 1780869 TI - Carcinogen risk assessment. PMID- 1780870 TI - UNIDO's approach to industrial pollution prevention. PMID- 1780871 TI - A balanced approach to risk assessment. PMID- 1780872 TI - Global pollution. PMID- 1780873 TI - The U.S. Environmental Protection Agency's risk assessment guidelines: current status and future directions. PMID- 1780874 TI - Managing the risk transition. PMID- 1780875 TI - Multimedia risk assessment for environmental risk management. PMID- 1780876 TI - Legislative approaches for encouraging clean technology. PMID- 1780877 TI - Risk assessment and risk management in Japan. PMID- 1780879 TI - Environmental risk management in The Netherlands. PMID- 1780878 TI - The distribution, cycling, and potential hazards of industrial chemicals in marine environments. PMID- 1780880 TI - Environmental Impact Assessment as a tool for risk management. AB - Environmental Impact Assessment is essentially a process comprising four elements: identification, prediction, evaluation, and monitoring. Properly conducted EIA studies can identify linkages between injurious events and/or activities and their damaging consequences. This aids in making the risk management decision. This paper discusses how EIA can be used as a tool for risk management. Each element of EIA, as well as available risk management options, is discussed. As a case example, the paper reviews EIA guidelines/procedures in Thailand and identify weakness and strength in capabilities to identify the sensitive areas where risk should be effectively controlled. PMID- 1780881 TI - Industrial risk management: case study of selected industries in India. PMID- 1780882 TI - Issues in industrialization, environment and health in developing countries. PMID- 1780883 TI - Research areas in relation to risk management and risk assessment. PMID- 1780884 TI - Risk assessment and risk management in Japan. PMID- 1780885 TI - Analysis of ozonation by-products produced in drinking water treatment. PMID- 1780886 TI - Water legislation in the U.S.: an overview of the Safe Drinking Water Act. AB - Clearly there is a long history of legislative activity related to water quality in the U.S. Each of the recent legislative provisions in the Safe Drinking Water Act and Clean Water Act will put in motion the adoption of an extensive set of regulations. There is virtual assurance that costly regulations will be promulgated and that these regulations will have a disproportionate impact on small systems, and on the institutional mechanisms for managing and operating water and waste water systems. PMID- 1780887 TI - Pulmonary deposition of a coal fly ash aerosol in rats by long-term inhalation. PMID- 1780888 TI - Lung burden of a glass fiber by inhalation. AB - Pulmonary deposition and clearance of deposited particles from lungs are very important factors in order to induce pneumoconioses. In this paper, five Wistar male rats were exposed to glass fiber particles (mass median aerodynamic diameter (MMAD), 2.8 microns) for 6 hrs/day, 5 days/week for 4 weeks. The average exposure concentration was controlled by a continuous fluidized bed with a screw feeder and an overflow pipe at 0.79 mg/m3 during the exposure period. The fibrous particles concentrations in the exposure chamber were monitored by a light scattering method and showed to be constant during the exposure. The rats were sacrificed at 24 hours after the termination of the exposure and then the wet lung weight and the silica concentration in the lungs were measured. The lungs were treated for low temperature ashing (ca. 150 degrees C) by a plasma asher. After ashing, these samples were melted with sodium carbonate in platinum pot for the measurement of the silica content by the absorption spectrophotometry. The maximum content of SiO2 was 45 micrograms in the exposed rats and 20 micrograms in the control. The deposited amount of SiO2 by the exposure to glass fiber was 25 micrograms. The apparent deposition fraction defined as the deposited amount in the lungs to the amount of the inhaled glass fiber during the exposure was 6.8%. There was no significant difference of the apparent deposition fraction at same MMAD between glass fiber in this study and non-fibrous particles. PMID- 1780889 TI - Sharp increasing of death rate from pneumoconiosis with cohort phenomenon in Japan. 1947-1985. PMID- 1780890 TI - Neutral sugar accumulation in lung lavage fluid following ozone exposure--a sensitive indicator of ozone-induced pulmonary damage. PMID- 1780891 TI - Cellular changes induced in rats lungs by inhalation of ceramic fibres. PMID- 1780892 TI - Risk assessment/management and education for medical decision making in Japan. PMID- 1780893 TI - Estimation of interaction between chemical carcinogens and transcriptional activity by nick translation detection in cellular DNA strand breaks in situ. PMID- 1780894 TI - Environmental problems: past, present, and future. PMID- 1780895 TI - The Japan's socio-natural environment for the past 30 years--made an analysis through the filters of mortality rates, alpha-index and delta-curve. PMID- 1780896 TI - Prevention of occupational and environmental lung disorders. PMID- 1780897 TI - Comprehensive assessment of occupational and environmental health problems: an overview--a proposal of macro approach: industrial ecological sciences. PMID- 1780898 TI - Risk assessment on decision making of water supply and wastewater disposal in Guangzhou City. PMID- 1780899 TI - The role of epidemiology in risk assessment. PMID- 1780900 TI - Environmental and occupational hazards in export processing zones in east and south Asia. With special reference to Taiwan, China, and Sri Lanka. PMID- 1780901 TI - Semiconductor industries. PMID- 1780902 TI - Long-term carcinogenicity bioassays on industrial chemicals and man-made mineral fibers, at the Bentivoglio (BT) laboratories of the Bologna Institute of Oncology: premises, programs, and results. AB - After having stressed the need of primary prevention in the strategy for cancer control, the crucial role of the long-term carcinogenicity bioassays in providing scientific support to primary prevention has been focused. The state-of-the-art, the present inadequacies, the necessity of implementation, and the perspectives of the long-term carcinogenicity bioassays have been briefly reviewed. The performed and ongoing programs of carcinogenicity bioassays at the Bentivoglio (BT) Laboratories of the Bologna Institute of Oncology have been presented, together with the currently available results on several compounds of industrial and commercial relevance. PMID- 1780903 TI - Current issues in the epidemiology and toxicology of occupational exposure to lead. PMID- 1780904 TI - Information and management system to reduce chemical risks. PMID- 1780905 TI - Remarks on 15th anniversary of Tokai University School of Medicine. PMID- 1780906 TI - Effects of fura-2 and indo-1 on [Ca++]i in spontaneously beating cultured heart cells. AB - Changes in contractility and intracellular free Ca([Ca++]i) were measured in spontaneously beating cultured heart cells following exposure to indo-1 acetoxymethyl ester (indo-1AM) and fura-2 acetoxymethyl ester (fura-2AM). Although a 10 microM concentration of indo-1AM slightly decreased the beating rate, 5 and 10 microM concentrations of fura-2AM produced arrest of contraction within 10 min. However, contractility returned to normal after washing. With indo 1, the diastolic and peak systolic levels of [Ca++]i were 282 +/- 23 and 1107 +/- 122 nM, respectively, and 84 +/- 8 and 582 +/- 93 nM, respectively, with fura-2. The difference between the indo-1 and fura-2 generated responses are statistically significant (p less than 0.01). These results demonstrate that indo 1 and fura-2 can affect [Ca++]i, but the influence of indo-1 is less than that of fura-2 in the heart cells. PMID- 1780907 TI - An improved method for removal of antithrombin III from post-heparin plasma lipase fractions with a high recovery rate. AB - Affinity chromatography on heparin-Sepharose has been widely used for the purification of post-heparin plasma triglyceride lipases, but this procedure alone yields lipase fractions with a high content of antithrombin III (AT), which also binds to heparin and coelutes with the lipases. A rapid procedure in which this major contaminant is reduced by the use of affinity chromatography on heparin-Sepharose with low affinity for AT and further removal by anti-AT IgG Affi-Gel 10 column chromatography is reported and the results are compared with these of the conventional heparin-Sepharose and Concanavalin A-Sepharose column chromatography two step method. While the AT contamination of hepatic lipase eluate from conventional heparin-Sepharose column chromatography was 92 mg/dl in 100 mg/dl protein, heparin-Sepharose with low affinity for AT yielded samples with 55 mg/dl in 100 mg/dl protein. A second passage on concanavalin A-Sepharose of the sample from conventional heparin-Sepharose reduced the AT content from 92 mg/dl to 42 mg/dl in 100 mg/dl protein, but passage of the sample from heparin Sepharose with low affinity for AT through an anti-AT IgG Affi-Gel 10 column removed almost all of the AT contamination from the lipase sample. This hepatic triglyceride lipase (HTGL) sample had a specific activity 1,963-fold higher than that of post-heparin plasma with a yield of 17% of the starting material, showing an excellent recovery rate compared with similar methods in use. PMID- 1780908 TI - Comparative epidemiology of oral cancer in Brazil and India. AB - A comparison of the risk factors and occurrence of oral cancer in Brazil and India is presented. These two countries have among the highest incidence rates for such cancer in the world. A distinct pattern of risk factors was observed for each country: in India, tobacco chewing was the predominant risk factor: in Brazil, the major risk factor was the combination of tobacco smoking and alcohol consumption. Observations by descriptive epidemiology reveal high age standardized incidence rates of oral cancer along with some distinctive differences associated with age distribution, sex ratios, and trends in each country. The desirability of additional oral cancer prevention research is also emphasized. PMID- 1780909 TI - A case of insulin-secreting tumor successfully treated with diazoxide. AB - A 72-year-old patient was referred to our hospital because of a hypoglycemic crisis possibly due to an insulin secreting-tumor. Although its localization was assumed to be at the head of the pancreas as assessed by transhepatic venography with sampling, no mass lesion was detected by selective angiography, ultrasound, computerized axial tomography, magnetic resonance imaging and 67Ga-citrate scan. The patient was treated with diazoxide, because of poor localization and his age, insulin secretion was improved after both 30 and 60 min in the 75 g oral glucose tolerance test. The total amount of urinary C-peptide excretion decreased from 70.8 to 29.2 mcg/day. Thereafter, no hypoglycemic symptoms were observed during his admission. No side effects except mild liver damage were observed. PMID- 1780910 TI - Functional imaging of cerebral blood volume using simultaneous measurements of dynamic and xenon computerized tomography (CT). AB - This report describes a method for measuring regional cerebral blood volume (r CBV), by simultaneously using dynamic computerized tomography (DCT) and stable Xenon-enhanced CT (Xe CT). Local cerebral blood flow (CBF) was measured using a Xe CT blood sampling method, and mean transit time (MTT) was calculated using DCT after a rapid injection of iodinated contrast material. A functional image of r CBV was obtained from multiplication of CBF and MTT on each pixel using the formula: CBF x MTT = CBV. This calculated value is not suitable to indicate a r CBV which directly reflects cerebral microcirculation. Accordingly, only a comparative estimation of relative r-CBV images is applicable. However, laterality of image and comparison of serial studies are useful in hemodynamic evaluations, especially in ischemic cerebrovascular diseases, because they indicate hemodynamic reserve within the hypoperfused region. PMID- 1780911 TI - Couple therapy with parents whose youngest daughter had a psychotic episode: impairment of a child and marital conflict. AB - An 18-year-old girl developed a withdrawn state with suicidal ideas. The therapist gave 8 sessions of conjoint family therapy, with her parents and two sisters. In the course of conjoint therapy, she became psychotic and some structural features of the disturbed family system seemed to get more rigid. The therapist therefore, changed the therapeutic modality from conjoint therapy to couple therapy with her parents. During the sessions of couple therapy, the therapist tried to help her parents gain an understanding of his or her respective family of origin. The girl, as a result, got through the psychotic state and her condition stabilized. The author discussed the following points: 1) The girl's symptoms were understood to be the result of chronic tension between her parents, and disappeared when her parents became involved with their couple therapy. 2) Each parent transmitted many unresolved issues in the context of his or her original family to their nuclear family. 3) In couple therapy, when the marital conflict is so great, the couple tend to involve the therapist in triangulation. Therefore, it is very important for the therapist to keep himself in a position of distriangulation with the couple. PMID- 1780912 TI - Abscessed leiomyosarcoma of the ileum. AB - A-49-year-old man was admitted because of a lower abdominal mass. During the five days prior to admission, he had noted fever and lower abdominal pain. Palpation of the abdomen revealed a tender mass, 10 cm in diameter, in the suprapubic region. An x-ray revealed an irregular collection of gas, 9 cm in diameter, in the pelvic cavity, which appeared as a mirror image when the patient was upright. Based on the physical finding and the results of a barium enema, abdominal CT, MRI, and small intestine imaging, a diagnosis of leiomyosarcoma of the ileum was made. Excision of the tumor and part of the small intestine was performed. A saccular tumor, 11 x 6 x 5 cm, was found 1.0 m from the cecum and growing out of the wall of the ileum. A large amount of pus was found inside the cavity. The pathological diagnosis was leiomyosarcoma. PMID- 1780913 TI - Interpretation of patho-physiology by laboratory data (4). Cases of hypernutritional fatty liver. AB - Using blood chemistry data from 77 cases of hypernutritional fatty liver diagnosed in our gastroenterological clinic, an automated quantitative interpretation was formulated. The reliability of this interpretation was confirmed in view of the following points: 1) Comparison with the degree of fatty infiltration of the liver seen in biopsy specimens or ultrasonographic findings. 2) The high rate of coincidence, sensitivity and specificity among the results. 3) Localization of almost all the cases of fatty or non-fatty liver into circumscribed areas by the value of standard deviation index (SDI) of glutamic oxaloacetic transaminase (GOT) i.e. aspartate aminotransferase (AST) and cholinesterase (CHE), respectively. 4) Graphic display of data and interpretation of a representative case of acute hepatitis at specified stages, and the comparison of this interpretation with clinical diagnoses and course of the disease. Moreover, two possible mechanisms for the elevation of the CHE level were discussed. PMID- 1780914 TI - O2 uptake and CO2 elimination during mechanical ventilation with high frequency oscillation. AB - This study was intended to elucidate gas exchange in a quasi-steady state during high frequency oscillatory ventilation (HFO) in terms of arterial blood gases, tidal volume(VT) and frequency of oscillation (f). Firstly, experiments were performed on anesthetized, paralyzed and tracheostomized dogs using a piston-type oscillator with a fresh air bias flow. The f values employed in the animal experiments were 10 to 30 Hz, and VT values were 1 to 3 ml/kg of body weight. Changes in PaO2 observed during HFO could be expressed by the equation PaO2 = 125.2-60.3/(VT X f), which closely coincided with the alveolar ventilation equation for O2, i.e., PaO2 = 125-78/, VA, Where P(A-a) O2 and O2 consumption were assumed to be 25 Torr and 90 ml/min, respectively. PaCO2 during HFO deviated from the curve of the alveolar ventilation equation, PaCO2 = constant/, VA at a higher VT x f, and was distributed along the hyperbolic curve of PaCO2 = 1/, VA + 14.7. This suggested that HFO shows a certain limitation in CO2 elimination. Secondly, indicator gas transport through straight tube models for two directions, i.e., wash-in and wash-out, were observed. Wash-in of indicator gases (He, N2 and SF6) in terms of indicator appearance time at the other end of the tube changed as a function of VT x f. The effect of increasing f at a fixed VT on the wash-in was much less than that of increasing VT at a fixed f. The heavier gas (SF6) was washed in faster than the lighter gas (He) although wash-in of each indicator gas was closely related to the function VT x f. Washout in terms of the appearance time of indicators in the opposite direction was, however, strongly dependent on VT, and the effect of increasing f at a fixed VT on wash-out reached a limit beyond a certain f. It was concluded from the present study, that both convective dispersion and augmented diffusion play important roles, although they are not clearly distinguished, as gas transport mechanisms during HFO. The difference between inspiratory and expiratory gas transport modes could be explained by differences in flow profiles, relative important of convective dispersion, and/or time required for gas mixing in the airways. PMID- 1780915 TI - Autogenous meniscus grafts in articular cartilage defects--an experimental study. AB - Many methods have been attempted to repair defects in the articular cartilage involving the subchondral bone, but no satisfactory method has yet been established. We performed an experimental study utilizing autogenous meniscus grafts for defects in the articular cartilage involving the subchondral bone. Sixty-two knees of 31 rabbits were thus treated. Gross and histological examinations were performed in animals sequentially sacrificed after 2 to 24 weeks. In gross examinations, the articular surface was smooth and the degenerative changes were slight although the grafted area appeared as a piece of whitish meniscus in all experimental knees. Histologically, 12 weeks were necessary for complete union in the superficial zone of the junction between the grafted meniscus and the subchondral bone. However, the junction in the deep zone was completely united after two weeks. Degenerative changes, such as fibrillation or ulceration were not noted on the surface of the grafted meniscus. The chondrocytes of the meniscus survived for as long as 24 weeks. The autogenous meniscus graft appears to be a promising alternative for defects in the articular cartilage. PMID- 1780916 TI - Ataxic hemiparesis due to small semioval center infarction--consideration of the neuroanatomical disruptions responsible for ataxic hemiparesis. AB - A 63-year-old man with clinical features of typical ataxic hemiparesis is reported. CT scan and magnetic resonance imaging showed a small infarction in the contralateral semioval center near the parietal cortex. Of note is the previously unreported site of the lesion relative to this syndrome. The neuroanatomical basis for the ataxic hemiparesis syndrome is discussed. PMID- 1780917 TI - Sjogren's syndrome and pregnancy. AB - We analyzed 117 histories of pregnancy obtained from 40 female patients with Sjogren's syndrome (SS) including 13 patients with primary SS and 27 patients with secondary SS. The frequency of spontaneous abortions did not differ in the 40 patients and those with primary SS compared with 129 healthy women. However, both spontaneous abortions and premature deliveries were significantly more frequent in the SS patients with systemic lupus erythematosus (SLE). Anti-SS-A and anti-SS-B antibodies were not associated with the outcomes of pregnancy although spontaneous abortions were more frequent in secondary SS patients with false positive serological tests for syphilis, anti-erythrocyte antibodies, thrombocytopenia or prolonged activated partial thromboplastin time. Neither congenital anomalies nor connective tissue disease was found in the 77 neonates of the patients. We concluded that SS does not influence the outcome of pregnancy except in patients with SLE or those with serological and hematological abnormalities related to lupus anticoagulants or antiphospholipid antibodies. PMID- 1780918 TI - Consultation-liaison psychiatric approach for school-refusal students in Hiratsuka City, Kanagawa Japan. AB - In current school health care programs, it is necessary to check not only the physical condition but also for mental disorders caused by changes of sociocultural, economic or environmental conditions and, in fact, the relative importance of the latter is increasing every year. Taking these changes into consideration, the Kanagawa Prefectural Joint Teacher-Visiting School Doctor Mental Health Committee started various activities aimed at raising the psychiatric ability of school doctors in 1983. In parallel with the activities of the Kanagawa Prefectural committee, the Hiratsuka Medical Society established the Hiratsuka City Joint Teacher-Visiting School Doctor Mental Health Committee in May 1985. In April 1988, as an extention of the activities of the Hiratsuka Committee, a counseling class for non-attending junior high school students was set up. The purpose of this class was, to provide an opportunity for school, families and medical organization to exchange information and to collaborate to provide more effective treatment and education to cope with recent advanced and prolonged cases of school refusal. In addition to Hiratsuka City, Fukuoka is engaged in practical activities under the direction of a joint committee led by the local Medical Society. PMID- 1780919 TI - Effect of cisapride on gastric emptying in diabetic patients without gastrointestinal symptoms. AB - The long-team effects of cisapride on gastric emptying and hormonal interaction in diabetic patients without gastrointestinal symptoms was evaluated. Gastric emptying was determined by the N-acetyl-p-amino-phenol (APAP) method before and after cisapride treatment. Gastric emptying improved significantly, from 5.95 to 8.04 micrograms/ml, after 6 weeks of treatment. Plasma concentrations of immunoreactive insulin (IRI), after 30 and 45 minutes in the gastric emptying test, increased significantly after treatment. It appeared that improvement of gastric emptying after loading with cisapride might be related to improved insulin secretion in diabetic patients without subjective symptoms of gastroparesis. PMID- 1780920 TI - [The pathogenesis of experimental periodontitis in rabbits]. AB - Periodontitis was simulated in rabbits and rats by suturing a ligature to the gingiva. A follow-up of periodontitis development has revealed the characteristic local (edema, formation of pouches, teeth mobility) and systemic (leukocytosis, moderate hypercalcemia, elevated blood alkaline phosphatase activity, increased blood and gingival lysozyme levels) reactions. PMID- 1780921 TI - [The mechanism of the therapeutic effect of periodontal cytomedin on the course of experimental periodontitis]. AB - Periodontitis induction causes a drastic elevation of free-radical lipid peroxidation, of ceruloplasmin level, and a reduction of antioxidant enzyme activities. Blood analysis shows hypercoagulation, appearance of paracoagulation products, reduced fibrinolysis, enhanced proaggregation activity of the periodontium, elevated levels of circulating immune complexes; this may by regarded as adaptation failure manifesting by these reactions. Morphologic examinations show foci of destructive changes. Administration of periodontal cytomedin reduced the level of free-radical oxidation, enhanced the activity of antioxidant enzymes, normalized antiaggregation activity of the periodontium and hemostasis and fibrinolysis parameters, and reduced the level of circulating immune complexes. The inflammatory reaction disappears completely, that is seen from reduced ceruloplasmin level and clinically. Morphologic study shows disappearance of foci of destruction. Thus, cytomedin of periodontal tissues may be regarded as an effective agent for the therapy of experimental periodontitis. PMID- 1780922 TI - [The inductive effect of methyluracil on periodontal bone tissue regeneration]. AB - The possibility of periodontal bone tissue regeneration induction with methyluracil, a nucleic acid precursor, was studied in guinea pig experiments. The author presents the morphologic characterization of periodontitis course under the effect of methyluracil phonophoresis and demonstrates the inductor effect of this agent. PMID- 1780923 TI - [Experimental research on the stresses in roots with a pin "stump" structural element and in the periodontium of the masticatory teeth using a photoelasticity method]. AB - The photoelasticity method, that discloses the physical essence and the mechanism of the emergence of stress fields in the periodontium, was used to study the strained status of the pin 'stump' design-root-periodontium-well system in flat models with a conditioned root shape 6 perpendicular to 6; various methods of cavity preparation were used, and occlusion was exposed to different combined and solitary vertical forces. Analysis of the findings helps define the optimal methods for cavity preparation and the geometry of the pin 'stump' design from the strained deformed status of certain sites. The authors have for the first time developed a method for simulation of contact strain fields and revealed a relationship that can be calculated from simulated designs to natural ones. PMID- 1780924 TI - [The development of the maxillodental system in the fetus and the newborn animal in intrauterine streptococcal infection]. AB - Effects of an intrauterine streptococcal infection induced at different stages of pregnancy on the developing fetus and newborn were studied in non-inbred white rats. The course of denture development was found changed in both fetuses and newborns. A number of functional shifts in the central nervous system and physical status, presenting in the postnatal period, were detected in the experimental animals. PMID- 1780925 TI - [Age-related characteristics and sex differences in the anatomical structure of the incisive canal]. AB - Age- and sex-associated features in the anatomy of the incisor canal were studied in 254 human skulls aged 22 to 70 with orthognathic intact occlusion and in 66 maxillofacial saw cuts with the use of craniometric and statistical methods of investigation. The findings evidenced age- and sex-linked differences in the mean length of the incisor canal and its openings in mature age. The incisor canal is situated near the central incisor root apexes, the mean distance being 7.4 +/- 0.1 mm. The incisor opening is situated on the lower surface of the maxillary palatal process along the median line at a distance of 9.8 +/- 0.2 mm from the point formed by the medial angles of the central incisor crowns, irrespective of the subject's sex. The distance between the incisor opening and the central incisor roots in adults is 3.5 +/- 0.1 mm. PMID- 1780926 TI - [The morphometric characteristics of the masticatory muscle of dogs with an expanded interalveolar space]. AB - The experiment with 24 dogs involved increase of their interalveolar space in the frontal section by 6 mm via fixation of metal crowns on 98 189 teeth. Follow-up of the masticatory muscle adaptation has shown that it ran a wave-like course. The most intensive shifts are observed on days 7-14 of the experiment, this being followed by a gradual recovery of this muscle tinctorial characteristics by the 20th day of the experiment; then the restructuring process stabilizes on a new structural and functional level by days 30-60 of the experiment. Complete morphologic restructuring of the masticatory muscle in response to increase of the interalveolar space takes more than 60 days. If a still more increase of this space is needed (more than 6 mm), it may be started not before 20-30 days after complete restructuring. PMID- 1780927 TI - [Normobaric pulsed hypoxic stimulation in the combined therapy of periodontitis in adolescents]. AB - Hypoxic stimulation was added to local therapy of periodontitis in 26 adolescents with the initial manifestations of this condition. Analysis of the results has shown that hypoxic stimulation enhanced the body adaptive and compensatory potentialities, was conductive to recovery of the disordered oxygen metabolism and normalization of the regional hemodynamics and periodontal microcirculation. PMID- 1780928 TI - [The results of treating exacerbated chronic periodontitis using sorbents]. AB - The authors claim that sorbents effectively discontinue an acute inflammatory process, are conducive to the creation of active drainage in the periodontium and to a reduction of the incidence of complications. They recommend therapy with sorbents for the treatment of exacerbations of chronic periodontitis. PMID- 1780929 TI - [The methods of modern reflexotherapy in the combined treatment of patients with erosive-ulcerative processes of the oral mucosa]. AB - The authors suggest a scheme of multiple-modality treatment of patients with erosive ulcerative processes in the buccal mucosa. This scheme was employed in the treatment of such patients and it was conducive to a sooner epithelialization of erosions and ulcers in the buccal mucosa; its analgesic effect was fairly high. PMID- 1780930 TI - [The characteristics of the phospholipid composition of the pulp in the milk teeth]. AB - Qualitative and quantitative phospholipid composition of porcine deciduous teeth pulp was studied by microthin-layer chromatography. Basing on the differences in the levels of individual phospholipids in the pulp of deciduous and permanent teeth, the authors come to a conclusion on the inadequate structural organization and functional activity of the pulp of deciduous teeth. PMID- 1780931 TI - [The treatment of patients with chronic sialadenitis resulting from salivary outflow disorder]. AB - The author analyzes the results of treatment of 128 patients with chronic sialadenitis by original surgical and conservative organ-preserving methods. Narrowed orifice of the submandibular duct and excessive curves of the parotid duct in the buccinator were surgically corrected. Conservative therapy included electrophoresis of residues of the Saki Lake therapeutic mud, followed by ultrasonic therapy. These pathogenetically based methods proved to be fairly effective. Removal of stenosed sites of the ducts resulted in alleviation of inflammation symptoms in 103 (80.47%) patients and in clinical remission of the condition. PMID- 1780932 TI - [The treatment of fractures of the mandibular condylar processes]. AB - The authors suggest a splint with a supragingival supporting plate, that improves the reliability of orthodontic treatment and widens the range of indications for such treatment. They recommend osteosynthesis involving the use of a brefostem prepared from tubular bones of a 18-35 week fetus; the brefostem well fixes the fragments, stimulates the reparative processes at the site of the fracture, should not be removed after treatment, since it is eventually replaced by bone tissue not differing from the maxillary bone tissue. PMID- 1780933 TI - [Contrast study in injuries to the lacrimal ducts]. AB - Examinations of the lacrimal duct in 55 patients with posttraumatic deformations of the median zone of the face evidence that lacrimal sac and nasolacrimal channel impairments can be diagnosed by dacryocystography in various modifications; the most reliable data may be obtained when the lacrimal duct is filled via a catheter. Etiotrast proved to be the most adequate contrast agent. The developed dacryocystography modifications help plan reconstructive surgery of the lacrimal duct and monitor the efficacy of the surgery. The suggested modifications may be employed in other diseases of the lacrimal duct. PMID- 1780934 TI - [The role of lipid peroxidation in the pathogenesis of periodontitis]. AB - The authors analyze the role of the factors promoting a disruption of the physiologic antioxidant system, such as nervous stress, hypodynamia, bioantioxidant insufficiency, and inadequate pro-oxidant supply, to the development of peroxidation mechanisms of periodontitis initiation. The suggested concept implies that the general etiologic factors responsible for disruption of the physiologic system of lipid peroxidation inhibition create a background low level antioxidant protection of the periodontal tissues. Under such conditions the local factors (dental deposit, plaques, microorganisms) conducive to neutrophil migration to the gingiva and gingival fluid lead to a break out of lipid peroxidation in soft tissues of the periodontium; this break out is induced by free radicals (O2- et al.) that are produced in "respiration explosion" of phagocytizing leukocytes. Regular outbursts of lipid peroxidation represent the trigger mechanism in the development of morphofunctional changes in the periodontium and its vessels, resulting in collagen destruction and bone tissue resorption. The authors emphasize the usefulness of antioxidants in drug prophylaxis of periodontitis. PMID- 1780935 TI - [Postponed osteoplasty of the mandible with revascularized grafts]. AB - Basing on the results of treatment of 5 patients, the authors claim that revascularized transplants from the iliac crest may be employed for osteogenic osteoplasty of mandibular defects combined with coarse cicatricial changes in soft tissues and bone fragment atrophy. The advantages of bone, muscle, and skin transplants are discussed, permitting monitoring of blood supply to the transplanted tissue from the skin status. PMID- 1780936 TI - [Errors in outpatient stomatological practice in the diagnosis and treatment of odontogenic maxillary sinusitis]. AB - Analysis of case histories of patients with odontogenic sinusitis helped single out the typical errors often made by the practitioners when diagnosing and treating this disease. These errors are: untimely diagnosis of the perforation, inadequate examination, erroneous interpretation of the diagnosis. When the maxillary sinus bottom is perforated during removal of a tooth, the physician often erroneously closes this opening. Treatment of sinusitis is often carried out regardless of the disease form and stage. PMID- 1780937 TI - [The histomorphological changes in the mucosa of the edges of the cleft palate and their effect on surgical wound healing]. AB - The study has involved 30 children aged 4 to 6 with cleft lip and palate. Histomorphologic changes of soft tissues on cleft palate edges were detected; these inflammatory dystrophic changes are associated with reduction of the body nonspecific reactivity. PMID- 1780938 TI - [The planning of cosmetic plastic repair of the face and neck]. AB - The author describes a method for layout before cosmetic plasty of the face and neck. Three types of layout are described according to age-associated changes of the female face and neck. Positive effect of this method was achieved in 157 women. PMID- 1780939 TI - [The optimal times for the surgical treatment of children with congenital cleft lip and palate]. AB - Analysis of the remote results of surgical, orthopedic, and orthodontic treatment of children with cheiloschisis has demonstrated that early surgery of the palate results in development of grave maxillodental deformations involving prolonged many-stage orthodontic treatment, not always effective. The authors claim that surgery on the palate is advisable at the age of 5-7 in children with subtotal palatal clefts and at the age of 10-11 in those with total unilateral and bilateral clefts. Before surgery the child is to be provided for with an occlusive palatal plate starting from the first month of his life and should be administered orthodontic treatment, if necessary. PMID- 1780940 TI - [The planning of the design of combined crowns with regard to tooth display during conversation and smiling]. AB - Analysis of the type of teeth crown exposure in talking and smiling, carried out in 798 subjects, has shown that the perigingival third of the crowns is not exposed in the majority of the examinees. This permitted employment of cast combined crowns with wide perigingival metal rims to support the clasp dentures to make them look better when supplying 73 patients with partial removable dentures. PMID- 1780941 TI - [The mathematical modelling of orthodontic designs supported on endosseous implants]. AB - The priority problems in orthodontic treatment of denture total defects, making use of intraosseous implants, are discussed. The study was aimed at estimation of the optimal number of implants and sites of implantation, choice of a rational orthodontic design permitting the distribution of the masticatory load in proportion with the supporting tissue potentialities. The desired effect is achieved via estimation of the mathematical model of the denture design supported by intraosseous implants. PMID- 1780942 TI - [The effect of metal ceramic crowns on the enzymatic activity of the gingival fluid]. AB - Analysis of the enzymic activities of the gingival fluid obtained round the teeth supplied with metal ceramic crowns with the edges situated on different levels as against the gingival sulcus has revealed an elevation of lactate dehydrogenase, acid and alkaline phosphatases, glutamyl transpeptidase and cholinesterase activities in the gingival fluid from sites where the metal ceramic crown edges were hidden under the gingiva. When the crown edges were on the edge of the gingiva the enzymic activities were found unchanged. The mechanisms of the detected shifts are discussed. PMID- 1780943 TI - [The rate of carbohydrate elimination from the oral cavity after the intake of sweets and the effect of different hygienic measures]. AB - The rate of carbohydrate elimination from the oral cavity after eating sweets was studied in 50 children aged 12 and in 10 students. The mean elimination period has made up 30 min. This process is enhanced almost 6-fold by gargling the mouth with 1-2% sodium bicarbonate solution and cleaning the teeth with a toothbrush. PMID- 1780944 TI - [The efficacy of muscle electrostimulation in the combined treatment of children with congenital cleft palate]. AB - The technique of electrostimulation of the soft palate muscles of children with cleft palate is described. Low-frequency electrostimulation courses were carried out before and after surgery in accordance with the degree of decompensation of the palatopharyngeal junction. This method was effectively used in 30 children with cleft palate. The treatment efficacy was assessed by the morphometric and electromyographic methods, that have confirmed that electrostimulation improved the morphology of soft palatal muscles. PMID- 1780945 TI - [The oral status of children and adolescents undergoing treatment at Truskavets]. AB - A total of 579 children, treated at the Truskavets health resort for visceral abnormalities were examined. Caries intensity in children suffering from cholecystitis pas made up 5.1 carious teeth, that in gastritis 4.4 teeth, that in liver diseases 4.1 teeth. The incidence of periodontal diseases has made up 57.5, 71.2, and 45.5%, respectively. The oral cavity was found neglected in the majority of children sent to the health resort. PMID- 1780946 TI - [The efficacy of anticaries measures performed at different times of year]. AB - The efficacy of therapy for uncomplicated caries and of anticaries fluoridation in relation to seasonal fluctuation in caries incidence was studied in 405 children in the town of Derbent. The efficacy of therapy was found the highest if carried out soon after the major wave of caries development. A close relationship was revealed between the efficacy of anticaries fluoridation and the season when this procedure was carried out. Fluor treatment before the principal wave of caries incidence reduced it by 47.05%, whereas in spring this treatment brought about but a 3.84% reduction of caries incidence. PMID- 1780947 TI - [The dental status of middle-aged and elderly persons in different regions of the USSR]. PMID- 1780948 TI - [Disordered susceptibility to abrasion of the deciduous teeth as a risk factor for maxillodental anomalies and periodontal diseases]. PMID- 1780949 TI - [Perestroika in the organization of the academic process in a department of operative dentistry]. PMID- 1780950 TI - [Current methods of treating oral mucosal involvement in hemoblastoses (a review of the literature)]. PMID- 1780951 TI - Genealogy of regulation of human sex and adrenal function, prostaglandin action, snapdragon and petunia flower colors, antibiotics, and nitrogen fixation: functional diversity from two ancestral dehydrogenases. AB - Metabolism of steroid hormones by dehydrogenases is an important mechanism for regulating steroid hormone action. Analysis of recently reported amino acid sequences of 11 beta-hydroxysteroid dehydrogenase, 17 beta-hydroxysteroid dehydrogenase, and 3 alpha, 20 beta-hydroxysteroid dehydrogenase reveals that they are descended from a common ancestor. Unexpectedly, this superfamily of dehydrogenases has other interesting relatives: 15-hydroxyprostaglandin dehydrogenase, proteins found in nitrogen-fixing bacteria, and enzymes important in the synthesis of antibiotics. The novel lineage of these proteins and the actions of flavonoids in regulating gene transcription in nitrogen-fixing bacteria and mammals provide new insights into the evolution of regulation of gene transcription by intercellular signals in multicellular animals. PMID- 1780952 TI - Structure of the adduct of 16 alpha-hydroxyestrone with a primary amine: evidence for the Heyns rearrangement of steroidal D-ring alpha-hydroxyimines. AB - 16 alpha-Hydroxyestrone, a product of estrogen 16 alpha-hydroxylation in humans that is suspected to be implicated in cell transformation, has been found to form stable adducts with nuclear components. The stable covalent adduct formed from 16 alpha-hydroxyestrone with 2-methoxyethylamine via the Heyns rearrangement of the alpha-hydroxyimine was identified as 3-hydroxy-17 beta-(2-methoxyethylamino)estra 1,3,5(10)-trien-16-one. Since the same product was obtained from 16 beta hydroxyestrone with the amine, the alpha-hydroxyenamine is the most likely intermediate of the Heyns rearrangement. The adduct was fairly stable at 37 C in phosphate buffer (pH 7.4)/methanol (1:1 v/v), while the adduct formed from 16 oxoestradiol was disrupted reversely and completely within 6 hours. The evidence suggests that N-(3-hydroxy-16-oxoestra-1,3,5(10-trien-17 beta-yl)amine is the partial structure of the stable adducts formed from D-ring alpha-ketol estrogens with proteins. PMID- 1780953 TI - Regulatory effects of growth hormone, glucocorticoids, and thyroid hormone on the estrogen receptor level in the rat liver. AB - The multihormonal regulation of the estrogen receptor in the liver of female rats was studied under in vivo conditions. The steroid receptor level was assayed by hormone binding and specific mRNA analyzed by solution hybridization using a 35S labeled RNA probe complementary to the ligand-binding domain of the estrogen receptor gene. Serum growth hormone levels were measured and correlated to the effects of glucocorticoid and thyroid hormone administration on the estrogen receptor expression. In animals subjected to adrenalectomy plus thyroidectomy, the estrogen receptor concentration was reduced from 59 fmol/mg cytosol protein to 10 fmol/mg protein (i.e., with 87% relative to control animals). Adrenalectomy or thyroidectomy alone caused a decrease with 14% and 66%, respectively. Substitution with 10 micrograms betamethasone and 1 microgram triiodothyronine daily for 9 days completely restored the receptor content to control levels. Substitution with either hormone alone increased, but only partially restored receptor levels. The effect of betamethasone alone was dose dependent from 10 micrograms/d to 100 micrograms/d. This dose dependence was not seen when the animal simultaneously received 1 microgram of triiodothyronine. Superphysiologic doses of triiodothyronine did not raise estrogen receptor levels above those seen in animals treated with physiologic doses. High doses of triiodothyronine (greater than 20 micrograms/d) decreased serum growth hormone levels. The estrogen receptor mRNA levels in livers from hypophysectomized animals were increased after treatment with growth hormone (2.5-fold), thyroid hormone (two fold), and glucocorticoids (1.5-fold). The results obtained indicate a very complex regulation of liver estrogen receptor.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780954 TI - 17 alpha-substituted analogs of estradiol for the development of fluorescent estrogen receptor ligands. AB - For the successful development of a high-affinity fluorophore-estradiol conjugate, the fluorophore must be attached to the estradiol molecule at a position that interferes least with its binding to the receptor. We have concentrated on 17 alpha substituents as models for fluorophore attachment, based on literature precedent and on our earlier work with small 17 alpha side chains. In this report, we describe syntheses and estrogen receptor binding affinities of 19 analogs of estradiol substituted in the 17 alpha position with larger side chains (of six to 11 carbons), some of which may be synthetically modified to link a fluorophore. These analogs were synthesized either by nucleophilic cleavage of estrone-17 beta-oxirane 3-benzyl ether and subsequent debenzylation (4 to 18), by cross-coupling of alkynes (21 to 24), by alkylation of 17 alpha ethynylestradiol 3,17-bis(tetrahydropyranyl ether) and subsequent acidic hydrolysis (25 to 28), or by reacting estrone either with appropriate aryl/alkynyllithium reagents (29, 30, and 32) or with benzylmagnesium bromide (31). Relative binding affinities of these newly synthesized analogs were determined for estrogen receptor (rat uterus) using a standard competition assay. The results suggest that analogs with reduced mobility and/or more polarizable electron density in the side chain generally bind more strongly to the receptor. The relative affinities of several selected compounds were also determined in the presence of 4% dimethylformamide; some compounds bearing larger, nonpolar 17 alpha substituents showed dramatically improved affinities, while affinities for compounds with shorter nonpolar side chains remained largely unchanged. These binding affinity results should be useful in designing new high-affinity fluorescent ligands for the estrogen receptor. PMID- 1780955 TI - Synthesis of new pentacyclic heterocyclic steroidal analogs, 6-oxabenz[3,4]-D homoestra-1,3,5(10),8,14-pentaen-17a-one and 3a,4,5,13-tetrahydro-3H [2]benzothieno[5,4-d]naphtho-[1,2-b]pyran. PMID- 1780956 TI - The preparation of 2,4-dibromoestra-1,3,5(10),6-tetraene-3,17 beta-diol diacetate. AB - [2,4,6,7-3H4]Estradiol is used for the quantitative determination of estradiol receptors. The synthesis of 2,4-dibromoestra-1,3,5(10),6-tetraene-3,17 beta-diol 3,17-diacetate, the convenient precursor of [2,4,6,7-3H4]estradiol, is described. 6-Alkoxy compounds were also prepared and investigated. PMID- 1780957 TI - Antimicrobial activity of basic cholane derivatives. X. Synthesis of 3 alpha- and 3 beta-amino-5 beta-cholan-24-oic acids. AB - A simple and convenient route to 3 alpha- and 3 beta-amino-5 beta-cholan-24-oic acids was developed via Leuckart-Wallach amination reduction and subsequent acid hydrolysis. Two epimeric formylamino derivatives were produced (alpha and beta), approximately in a 1:1 ratio, as determined by 13C nuclear magnetic resonance spectroscopy. The two isomers were separated by making use of their different solubilities in ethyl ether. The absolute configuration of the two amino acids was assigned by comparison with authentic reference samples. PMID- 1780958 TI - The isolation, structural characterization, and immunosuppressive activity of cyclosporin G (NVa2-cyclosporine) metabolites. AB - Seven cyclosporin G metabolites were isolated by high-performance liquid chromatography from the urine of normal subjects receiving the drug. The structure and purity of the metabolites were assessed by fast atom bombardment/mass spectroscopy, by proton nuclear magnetic resonance (NMR), and by 13C-NMR. The structural modifications of the cyclosporin G metabolites consisted primarily of hydroxylation and demethylation, as is the case for cyclosporin A metabolites. The immunosuppressive activities of the metabolites were tested in three separate in vitro systems: a primary and secondary mixed lymphocyte system, as well as a mitogen stimulated system. In general, the metabolites have immunosuppressive activity of less than 10% of cyclosporin G. The significance of these findings in relation to the therapeutic monitoring of cyclosporin G is discussed. PMID- 1780959 TI - Plasma distribution of cyclosporine within lipoproteins and "in vitro" transfer between very-low-density lipoproteins, low-density lipoproteins, and high-density lipoproteins. AB - Cyclosporine A (CsA) is a very lipophilic, immunosuppressive peptide that is highly bound (greater than 95%) in plasma. Approximately 50% of the drug is bound to lipoproteins and the remainder to erythrocytes. Neither the therapeutic nor the toxic effects of cyclosporine have been correlated with the free drug concentration. It has been proposed that low-density lipoprotein (LDL) delivers CsA to T-lymphocytes via the LDL receptor pathway, where it then produces its therapeutic effects. We have found that our patients chronically treated with cyclosporine carry as much or more CsA in very-low-density lipoprotein (VLDL), intermediate-density lipoprotein (IDL), and high-density lipoprotein (HDL) as they do in LDL. In addition, as previously reported, those patients with high VLDL carried the major portion of CsA in their VLDL subfraction. Moreover, the triglyceride-rich lipoproteins (VLDL and IDL) were found to contain much more CsA per mg of lipid than either HDL or LDL. An acute drug challenge led to the same CsA distribution as that seen in the chronically treated patients. "In vitro" incubations of lipoproteins containing CsA with lipoproteins from untreated individuals demonstrated a different relative affinity of CsA for the various lipoproteins than would be predicted from the plasma distribution: LDL greater than VLDL greater than HDL. We propose that the plasma distribution of CsA is determined by factors other than simple diffusion between the lipoprotein particles. Possible mechanisms would include (a) plasma factors that augment or inhibit CsA transfer or (b) metabolic processing of the lipoproteins that move CsA from one lipoprotein to another. PMID- 1780960 TI - Effect of plasma exchange on flumequine pharmacokinetics: comparison with control kinetics. AB - The effect of plasma exchange (PE) on the pharmacokinetics of flumequine (Apurone) was studied in eight patients receiving a single oral dose of 800 mg. The maximum concentration (38 micrograms/ml) and time to maximum concentration (2.6 h) values were not significantly altered by PE beginning 3 h after administration of flumequine. There was no change in the terminal elimination half-lives (6.6 h), in the steady-state volume of distribution (29 L), or in the apparent plasma clearance (2.5 L/h). By contrast, PE decreased the mean residence time by 30% (14.3 +/- 4.1 h without PE; 9.88 +/- 1.36 h with PE; p less than 0.05). The amount of flumequine extracted by PE (72 mg) was proportional to the plasma concentration at the beginning of the exchange. The elimination half-life during PE (3.15 +/- 1.23 h) decreased by 40%. Renal clearance (0.3 L/h) was not affected. PE only partially modifies the pharmacokinetics of flumequine administered in a single oral dose before PE. PMID- 1780961 TI - Interactions between hydralazine and oral nutrients in humans. AB - To help clarify whether food or enteral nutrients decrease hydralazine relative bioavailability, eight subjects were given oral hydralazine under four nutritional conditions: fasted (F), with a standard breakfast (SB), with a bolus of enteral nutrients (EB), and with a slow infusion of enteral nutrients administered by nasogastric tube (EI). The area under the curve and maximum concentration values were much higher under the fasted and enteral infusion conditions than under the standard breakfast or enteral bolus conditions, indicating that the absorption and/or disposition kinetics of hydralazine may be altered by food. The median (range) values for these parameters were 2,641 (385 4,747) and 87 (4.5-224) for F; 1,189 (202-1,737) and 15 (3.5-33.9) for SB; 999 (227-3,576) and 11 (2.5-50) for EB; and 3,068 (313-4,917) ng/ml/min and 113 (3.6 235) ng/ml for EI. Furthermore, the rate of nutrient administration, but not necessarily the physical form, of the nutrients appears to be a significant factor in determining the magnitude of the food effect. The nutrient interaction should be accounted for in patients receiving hydralazine and enteral nutrition concomitantly. PMID- 1780963 TI - Valproic acid dosages necessary to maintain therapeutic concentrations in children. AB - Steady-state plasma valproic acid (VPA) concentrations were measured in 118 pediatric inpatients taking VPA. There was a significant (p less than 0.0001) inverse correlation between the daily VPA dosage and the VPA dose ratio (concentration/dose or 1/clearance). The VPA dose ratio was significantly lower in patients taking VPA in combination with phenobarbital (p less than 0.01), carbamazepine (p less than 0.05), or multiple other antiepileptic drugs (p less than 0.0001), compared with those on VPA monotherapy. Neither age nor sex had any influence on VPA dose ratios. No significant (p greater than 0.1) correlation was found between VPA doses and concentrations in children on monotherapy. The distribution of VPA dose concentrations suggests that children, especially those on VPA polytherapy, require higher than recommended pediatric VPA maintenance doses (greater than 60 mg/kg/day) to maintain concentrations greater than 50 mg/L. Results also indicate that at higher concentrations (greater than 80 mg/L), increasing doses may produce less than proportional increases in total VPA concentration. PMID- 1780962 TI - Theophylline disposition in adolescents with asthma. AB - Adolescents frequently require medication for acute and chronic illnesses. A proper dosage schedule is needed to achieve efficacy without toxicity during adolescence when there are marked changes in body size and organ function. Theophylline disposition was studied in 70 asthmatic adolescents, ages 8-18 years, to determine if pubertal changes in body size, composition, and organ function are associated with changes in drug disposition. Forty-eight youngsters were studied as outpatients and 22 while hospitalized. Half-life (t1/2) was computed for all patients. Volume of distribution and clearance were determined for inpatients only. Chronological age and anthropometric growth parameters were measured. Lean body mass (LBM) was derived from anthropometric measurements. Half life was significantly correlated with developmental stage (Tanner r = 0.42, age r = 0.33, p less than 0.01), and body size (height r = 0.39, LBM r = 0.33, weight r = 0.33, p less than 0.01). LBM (kg/kg) was significantly correlated with volume of distribution (L/kg) (r = 0.59, p less than 0.01). Best-fits for t1/2 contained two variables: t1/2 = -4.57 + 1.31 (sex) + 0.0687 (height) (r = 0.48) and t1/2 = 3.54 + 1.32 (sex) + 0.0725 (LBM) (r = 0.43). Chronological age alone is not a useful basis for determining medication dosages due to the heterogeneity in rates of development and body size among adolescents. Half-life increases with increasing height or LBM. Although compliance is clearly an important factor in achieving optimal control of symptoms, this study demonstrates that dose adjustment during times of rapid growth during puberty is equally important. PMID- 1780964 TI - Test performance characteristics of the serum phenytoin concentration (SPC): the relationship between SPC and patient response. The Veterans Administration Epilepsy Cooperative Study Group. AB - A retrospective analysis of Veterans Administration (VA) Cooperative Study No. 118 was conducted to examine the relationship between serum phenytoin concentration (SPC) and various measures of patient response in 111 patients on monotherapy, mostly after 12 months of treatment. Using patient response rating scales specifically developed and validated for the VA study, we plotted SPC vs overall composite score as well as vs each of the three component ratings of neurotoxicity, systemic toxicity, and seizure type and frequency. No statistically significant association was noted between SPC and any of the response measures. We also calculated test performance characteristics for using SPC and a therapeutic range of 10-22 micrograms/ml to categorize patient status with regard to overall response, toxicity, and seizure frequency. Test sensitivities (0.13-0.53), specificities (0.62-0.81), and positive predictive values (0.08-0.44) were much lower than desirable. This results in a large proportion of false-positive and false-negative errors associated with the use of SPC as a test. Our retrospective evaluation suggests that the range of SPC values in successfully treated patients is quite broad; the value of the commonly accepted SPC therapeutic range in predicting various measures of patient response is quite limited; and patient response, therefore, should be the ultimate end point in monitoring patients on phenytoin. Prospective studies of the relationship between SPC and response should be conducted. PMID- 1780965 TI - Concentrations of phosphorylated zidovudine (ZDV) in patient leukocytes do not correlate with ZDV dose or plasma concentrations. AB - Zidovudine (ZDV) elicits its antiviral effect through intracellular metabolism to the 5'-triphosphate, which interferes with viral replication. Monitoring of the active metabolites of ZDV in cells could lead to an intracellular therapeutic range. This study was performed to determine whether a radioimmunoassay, previously used for in vitro quantitation of total phosphorylated ZDV inside peripheral blood leukocytes, could be used for similar determinations in patient samples. The relationship between ZDV dose, plasma concentrations, and intracellular metabolite concentrations was also examined. Ten-milliliter blood samples were drawn from each of 13 human immunodeficiency virus-infected patients and were assayed. Intracellular concentrations of phosphorylated ZDV ranged from 0.33 to 3.54 pmol/10(6) cells, similar to those observed in vitro. Phosphorylated ZDV was independent of dose, and did not correlate with plasma concentrations. Intracellular concentration in the patient population as a whole did not change during the 4-h dosing interval, while plasma concentration decayed normally. Later determinations in the same patients gave intracellular values within 31% of earlier values. Intraassay variability was less than 10%. Thus, the method is valid for measurement of phosphorylated ZDV in patient cells. Although individual concentrations showed no clear change during the 3-month study period, intracellular concentrations decreased with increasing length of therapy (up to 3 years) in the population as a whole. This suggests a decreased cellular ability to phosphorylate ZDV after prolonged exposure to drug. The lack of intracellular decay implies a half-life longer than the 1-h half-life of plasma ZDV. These data suggest that smaller doses or longer dosing intervals might maintain intracellular concentrations once steady state is achieved.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780966 TI - Stereospecific high-performance liquid chromatographic assay for the enantiomers of phenylpropanolamine in human plasma. AB - A stereospecific high-performance liquid chromatographic assay for the enantiomers of phenylpropanolamine (PPA) in human plasma has been developed. The method is based on reaction of extracted PPA with the chiral derivatizing agent 2,3,4,6-tetra-O-acetyl-beta-D-glucopyranosyl isothiocyanate to form diastereomeric thiourea derivatives. These thiourea derivatives are stable for at least 24 h, readily separable by reversed-phase chromatography, and amenable to ultraviolet detection at 254 nm. Standard curves for each of the PPA enantiomers are linear over the concentration range 10-250 micrograms/L. Over the approximate range of the standard curve, precision (intra- and interday) ranged from 2.2-7.0% while accuracy ranged from 99.2-107.3%. The method has been shown to be free from interference from endogenous plasma constituents and from a range of drugs containing a primary or secondary amine function. Individual PPA enantiomer plasma concentration-time profiles measured for a subject administered racemic PPA are included to demonstrate the utility of the assay. PMID- 1780967 TI - The analysis of clobazam and its metabolite desmethylclobazam by high-performance liquid chromatography. AB - The analysis of clobazam and its metabolite desmethylclobazam by high-performance liquid chromatography is described. After adding an internal standard 500 microliters of plasma is extracted under basic conditions into dichloroethane. The organic solvent is then evaporated to dryness and the residue reconstituted in 100 microliters of mobile phase prior to injecting an aliquot (30 microliters) onto a Hypersil 5 MOS column, which is eluted with acetonitrile/acetate buffer (pH 5.4) 40:60 vol/vol. The components are separated in approximately 12 min. Using this method, 15 micrograms L-1 of clobazam and 30 micrograms L-1 of desmethylclobazam can be detected. The method is suitable for the therapeutic monitoring of these two drugs in patient samples. PMID- 1780968 TI - Improved high-performance liquid chromatography assay for atenolol in plasma and urine using fluorescence detection. AB - An improved assay for racemic atenolol (AT) concentrations in human plasma and urine is described using a high-performance liquid chromatographic method with fluorescence detection. The method has a sensitivity limit of 0.5 micrograms/L in plasma with acceptable within- and between-run reproducibilities, and demonstrated linearity at concentrations up to 2,000 micrograms/L. A pilot clinical evaluation of the assay was undertaken on 56 trough plasma specimens from 36 outpatients on established AT therapy. Atenolol concentrations in these patients showed large variations at all prescribed doses, including undetectable levels in four patients (revealing unsuspected noncompliance). Because of its sensitivity and applicability to urinary analysis, the method can be used for pharmacokinetic studies and, under certain circumstances, may be valuable in clinical therapeutic drug monitoring. PMID- 1780969 TI - Effect of storage on the plasma concentration of chlorpromazine and six of its metabolites. AB - The concentrations of chlorpromazine (CPZ) and six of its metabolites in patient plasma samples that had been stored for 24 h at -20 degrees C, for 1 week at -20 degrees C, and for 4 weeks at -70 degrees C were compared. The concentrations of CPZ and six of its metabolites in human plasma spiked with known concentrations and stored at -70 degrees C for either 3 or 12 months were also compared. No significant difference was seen in the concentrations after storage under nitrogen and analysis by a high-performance liquid chromatography technique. PMID- 1780970 TI - Light-induced racemization: artifacts in the analysis of the diastereoisomeric pairs of thioridazine 5-sulfoxide in the plasma and urine of patients treated with thioridazine. AB - The ring sulfoxidation of thioridazine (THD), a widely used neuroleptic agent, yields two diastereoisomeric pairs, fast- and slow-eluting (FE and SE) thioridazine 5-sulfoxide (THD 5-SO). Until now, studies in which concentrations of these metabolites were measured in THD-treated patients have revealed no significant differences in their concentrations. Preliminary experiments in our laboratory had shown that sunlight and, to a lesser extent, dim daylight led to racemization and probably also to photolysis of the diastereoisomeric pairs as measured by high-performance liquid chromatography. Similar results were also obtained with direct UV light (UV lamp). In appropriate light-protected conditions, THD, northioridazine, mesoridazine, sulforidazine, and FE and SE THD 5-SO were measured in 11 patients treated with various doses of THD for at least 1 week. Significantly higher concentrations of the FE stereoisomeric pair were found. The concentration ratios THD 5-SO (FE)/THD 5-SO (SE) ranged from 0.89 to 1.75 in plasma and from 1.15 to 2.05 in urine. Because it is known that the ring sulfoxide contributes to the cardiotoxicity of the drug even more potently than the parent compound does, these results justify further studies to determine whether there is stereoselectivity in the cardiotoxicity of THD 5-SO. PMID- 1780971 TI - Clonazepam and 7-aminoclonazepam in human plasma. AB - The purpose of our study was to evaluate the hypothesis that much of the reported variability in the range of concentrations of plasma clonazepam (and also in the range of concentrations of its major metabolite, 7-aminoclonazepam) encountered in pediatric epilepsy patients is due to collection of samples at random times after dosing. High-performance liquid chromatographic analyses were performed on routinely ordered blood samples collected from chronically dosed outpatients during regular clinic visits. Thirty-six samples from 26 different children (age 0.25-19.6 years, mean 6.3 years) were analyzed. Specific dosing and sample collection times were obtained at the time of blood collection; demographic data were obtained from the clinic charts. A portion of the variation for both clonazepam and its major metabolite was accounted for by differences in daily dosage used. However, by accurate recording of dosage, administration times, and sample collection time, we graphically demonstrated that the majority of the variations in measured clonazepam and 7-aminoclonazepam concentrations was due to the time elapsed between the last dose and the time of sample collection. Thus, random sample collection times (especially during the drug distribution phase and following frequent dosing) may account, in part, for the poor correlation between plasma concentrations and reported anticonvulsant or toxic effects. PMID- 1780972 TI - Stability of diltiazem and its metabolites in plasma during storage. AB - Diltiazem (DTZ) is a calcium antagonist widely used in the treatment of angina and related heart diseases. It is extensively metabolized into a host of metabolites, some of which have potent pharmacological activities. Previous work has shown that DTZ and its major metabolite N-desmethyl-DTZ (MA) were unstable and readily decomposed to deacetyl-DTZ (M1) and deacetyl N-desmethyl-DTZ (M2), respectively. This report describes the stability of DTZ and its metabolites in plasma samples stored at -20 and -70 degrees C for different periods up to 12 weeks. The results indicate that in those samples obtained from volunteers who received DTZ, no deterioration of DTZ or MA occurred up to 8 weeks, but considerable deterioration of DTZ to M1 and MA to M2 (p less than 0.01) occurred after 12 weeks. However, in samples prepared by adding DTZ and its metabolites to outdated plasma (spiked plasma), deterioration of DTZ occurred after 4-6 weeks of storage, but there were no concomitant increases in concentrations of M1 or M2. Thus, it appears that decomposition of DTZ and MA was affected by the nature of the plasma materials, but the reason for the differences in analyte stability observed between volunteers' and spiked plasma is not known. Also, it appeared that DTZ and its metabolites in plasma samples stored at -70 degrees C may be more stable than those at -20 degrees C, although further studies are required to substantiate this observation. On the basis of these results, plasma samples obtained from patients or volunteers receiving DTZ should be analyzed within 8 weeks when the samples are stored frozen at -20 degrees C. PMID- 1780973 TI - Hemodialysis clearance of encainide and metabolites. AB - The disposition of encainide and metabolites O-desmethylencainide (ODE) and 3 methyl-ODE (MODE) was evaluated in a 31-year-old hemodialysis patient following a 25 mg oral dose during an interdialytic period and a second 25 mg oral dose 48 h later, 2 h before a hemodialysis procedure. The inter- and intradialytic elimination half-lives were not different for encainide and its metabolites ODE and MODE. The hemodialysis clearance of encainide, MODE, and ODE are all less than 10% of the creatinine clearance of the dialyzer. Thus, hemodialysis does not result in clinically significant removal of encainide or its metabolites. PMID- 1780974 TI - Analysis of low theophylline concentrations using the Abbott TDx. PMID- 1780975 TI - Tropical medicine in central and eastern Europe. PMID- 1780976 TI - Susceptibility of Plasmodium falciparum in vitro to chloroquine, mefloquine, quinine and sulfadoxine/pyrimethamine in Somalia: relationships between the responses to the different drugs. AB - The susceptibilities of Plasmodium falciparum to chloroquine, mefloquine, quinine and sulfadoxine/pyrimethamine were investigated in Mogadishu in 1988, after chloroquine resistance had spread widely in Somalia. Possible correlations of the responses to these drugs were also investigated. Standard World Health Organization in vitro micro-tests were performed. Of 76 isolates tested for chloroquine susceptibility, 58 (76%) were resistant to the drug with mean EC50 and EC99 values of 1.06 x 10(-6) mol/litre and 10.44 x 10(-6) mol/litre of blood, respectively, indicating a high prevalence and degree of resistance. In contrast, all isolates tested were inhibited by mefloquine 3.2 x 10(-6) mol/litre of blood, quinine at 2.56 x (-6) mol/litre of blood-medium mixture, and sulfadoxine/pyrimethamine at 6.0/0.075 x 10(-6) mol/litre of blood-medium mixture, indicating full sensitivity to these 3 drugs. However, a significant positive correlation was found between responses to quinine and chloroquine and between those to quinine and mefloquine; the responses to chloroquine and mefloquine were not correlated. The results may suggest that sites responsible for the correlation are shared between quinine and chloroquine but not essentially between chloroquine and mefloquine. Thus the evolution of chloroquine resistance together with increased use of quinine treatment of P. falciparum may increase the risks of development of quinine resistance, whereas the development of mefloquine resistance would not be triggered by chloroquine resistance. PMID- 1780977 TI - Positive relationship between the response of Plasmodium falciparum to chloroquine and pyronaridine. PMID- 1780978 TI - Genetic diversity of Plasmodium falciparum in a village in eastern Sudan. 1. Diversity of enzymes, 2D-PAGE proteins and antigens. AB - Twenty-nine plasmodium falciparum isolates from patients in Asar village, eastern Sudan, were characterized for variation in 18 different genetically controlled characters, including iso-enzymes, proteins detected by two-dimensional polyacrylamide gel electrophoresis and blood-stage antigens. Considerable allelic diversity in the genes determining these characters was detected. Each isolate contained genetically distinct parasites. Fifteen individuals were infected with more than one parasite genotype. The diversity of parasite types is most probably generated by recombination during mosquito transmission of mixed parasite clones. PMID- 1780979 TI - Genetic diversity of Plasmodium falciparum in a village in eastern Sudan. 2. Drug resistance, molecular karyotypes and the mdr1 genotype of recent isolates. AB - Isolates of Plasmodium falciparum from a Sudanese village have been collected as part of a study of parasite genetic diversity during seasonal malaria epidemics. The sensitivity in vitro to chloroquine, pyrimethamine and mefloquine of these isolates has been determined. To assess the utility of pulse field gel chromosome separations in isolate characterization, 18 samples from individual patients in a single village were studied using this technique. Extensive variation in chromosome size was detected, no 2 isolates having identical molecular karyotypes. No multidrug resistance (mdr) gene amplification polymorphisms were detected in either chloroquine-resistant or chloroquine-sensitive isolates in this sample. PMID- 1780980 TI - The relationship between anthropometric measurements and measurements of iron status and susceptibility to malaria in Gambian children. AB - Anthropometric measurements were made and serum iron and ferritin levels determined in a group of Gambian children at the beginning of the rainy season and these findings were related to the malaria experience of the children during the following malaria transmission season. Susceptibility to malaria was not correlated with prior weight-for-age, height-for-age, weight-for-height or serum albumin, or with serum iron, serum iron binding capacity nor serum ferritin. Thus, our findings do not provide any support for the view that poor nutritional status, as assessed by anthropometric measurements, or iron deficiency protect against malaria infection. Children who developed a clinical attack of malaria accompanied by a high level of parasitaemia tended to have a higher mean weight for-age at the beginning of the rainy season than did children who had a clinical attack accompanied by a low level of parasitaemia, but the difference between groups was not statistically significant. However, they had a significantly higher mean serum ferritin level (P less than 0.01). PMID- 1780981 TI - Isolation and characterization of Leishmania major from Phlebotomus papatasi and military personnel in north Sinai, Egypt. PMID- 1780983 TI - Leishmania tropica in Morocco: infection in dogs. PMID- 1780982 TI - Cutaneous leishmaniasis in south-eastern Paraguay: a study of an endemic area at Limoy. AB - An epidemiological study was performed on leishmaniasis in a newly established community in south-eastern Paraguay. 149 persons, of 172 inhabitants, were thoroughly examined by clinical, parasitological and immunological (leishmanin skin test) examinations. 88 of those examined (59%) were clinically positive for dermal and nasal (mucosal) lesions or dermal scars, while 74 (50%) were positive by the leishmanin test. Of the 88 persons, 66 (75%) were positive for both leishmanial (dermal and nasal) signs and skin test; these subjects were therefore considered to be leishmaniasis patients. Most of the patients (60%) had a single dermal lesion. Among the 66 leishmaniasis patients, serious mucosal (nasal septum) lesions were observed in the 41 subjects: 2 had destruction of the septum, 8 had ulceration and 31 had erythema. In this community the persons with dermal and/or nasal problems had been treated with meglumine antimonate (Glucantime), without any precise diagnosis having been made by parasitological or immunological examination. The socio-economical and socio-medical points of view aspects are discussed. PMID- 1780984 TI - Recovery of Leishmania (Viannia) braziliensis from hepatic aspirates of the black plumed marmoset, Callithrix penicillata. PMID- 1780985 TI - Aconitate hydratase (ACON), an enzyme that distinguishes Leishmania of the subgenus Viannia from other trypanosomatids. PMID- 1780986 TI - Lactation reduces mortality but not parasitaemia during the acute phase of Trypanosoma cruzi infection in mice. PMID- 1780987 TI - Accumulation of brown adipose tissue in patients with Chagas heart disease. AB - Brown adipose tissue (BAT) is an important source of non-shivering thermogenesis. Increased BAT amounts have been reported to occur in association with several diseases, including congestive heart failure. The objective of the present study was to determine whether BAT accumulation occurs in patients with Chagas disease. Histological sections of peri-adrenal tissue obtained at autopsy from 259 patients were examined. Of these patients, 58 had the digestive form of Chagas disease, 50 had the cardiac form without heart failure and 201 had the cardiac form with heart failure. All cases were investigated in terms of nutritional status and classified as malnourished, normotrophic or obese according to the Quetelet index. The results showed no correlation between BAT and the patients' nutritional status, and more BAT accumulation in patients with the cardiac form of Chagas disease compared to patients with the digestive form. Similarly, a history of heart failure was correlated with greater BAT accumulation. On the basis of the present data and of information reported in the literature, we propose that chronic hypoxia may be the cause of BAT accumulation in Chagas disease patients with heart failure. PMID- 1780988 TI - Pentamidine concentrations in plasma, whole blood and cerebrospinal fluid during treatment of Trypanosoma gambiense infection in Cote d'Ivoire. AB - Pentamidine concentrations in plasma, whole blood and cerebrospinal fluid (CSF) were determined in 11 patients with Trypanosoma gambiense infection without involvement of the central nervous system in Cote d'Ivoire. Blood samples were drawn during a 48 h period after the first and last dose of pentamidine dimesylate given as 10 intramuscular injections on alternate days. Maximum plasma concentrations were generally attained within one hour after injection but varied extensively (420-13420 nmol/litre). The median plasma concentration 48 h after the last dose was approximately 5 times higher than that after the first dose. The ratio between whole blood and plasma concentration was approximately 2. Small amounts of the drug were found in the CSF after the last dose. The findings showed inter-individual differences in the pharmacokinetics of pentamidine. The currently recommended daily dose regimen could be questioned, as drug accumulation was pronounced. All patients were cured and the concentrations attained should be considered as parasiticidal. Further studies on the kinetics and distribution after single and multiple doses of pentamidine as well as studies on the possible relationship between adverse effects and plasma concentrations are, however, needed. PMID- 1780989 TI - Trypanosoma brucei brucei: differences in the trypanocidal activity of human plasma and its relationship to the level of high density lipoproteins. AB - Although high density lipoprotein (HDL) particles purified from human serum by ultracentrifugation are known to lyse Trypanosoma brucei brucei, it is unclear whether individual differences in the trypanocidal activity of human serum reflect changes in the concentration of HDL per se. In the present study, trypanolytic activity, whether assessed in vitro or in vivo, was greater with plasma from normal healthy individuals than with plasma from patients with various hepatic diseases and associated low levels of HDL. For all subjects taken as a single group there were highly significant positive correlations between the plasma concentration of apolipoprotein (apo) A-I, the major protein constituent of HDL and trypanolysis in vivo (r = 0.93, n = 10, P less than 0.001) or in vitro (r = 0.77, n = 36, P less than 0.001). Removal of plasma apoB-containing (i.e. non-HDL) lipoproteins by precipitation revealed that the trypanocidal activity was also significantly correlated with HDL-cholesterol and HDL-apoA-II, as well as with HDL-apoA-I, but not with HDL-apoE. Depletion of all or part of plasma apoA-I by non-ultracentrifugal methods abolished or decreased the trypanolytic effect of the plasma. The findings from these experiments, which were designed to avoid alteration in the composition of HDL by ultracentrifugal forces, provide additional support for the proposal that the trypanocidal action of human plasma resides with native HDL particles. PMID- 1780990 TI - Effect of human milk and infant milk formulae on adherence of Giardia intestinalis. AB - Human milk was shown to inhibit adherence of Giardia at concentrations as low as 0.5%. Unsaturated fatty acids were also found to cause significant inhibitory effects on adherence, with ED50 values less than 1 microM for arachidonic, linoleic and palmitic acids. A variety of infant feeding formulae derived from cow's milk and soy bean had suppressive effects on adherence. These observations may explain in part the low prevalence of giardiasis in young infants. PMID- 1780991 TI - Seroprevalence of Toxoplasma gondii in rural India: a preliminary study. PMID- 1780992 TI - Schistosoma japonicum infection among migrant fishermen in the Dongting Lake region of China. AB - An epidemiological survey of Schistosoma japonicum infection was made among 316 persons, fishermen and their family members, in 5 sites of the Dongting Lake region. Their medical history was taken and physical and stool examinations were carried out. The infected persons were divided into 3 groups; 2 were treated with one or 2 doses of praziquantel and one, the control group, was given no treatment. The results showed a high overall prevalence of 41% with an intensity of infection of 34 eggs per gram (epg) in a single stool specimen. The individuals with a history of treatment had a lower prevalence (45/167, 26.9%) than those with no history of treatment (85/149, 57%) (P less than 0.01). The mean intensity of infection of the treated group, 27.8 epg, was also lower than that of the untreated group, 39.1 epg (P less than 0.01). Symptoms within the past 2 weeks were reported by 31% of the individuals surveyed. Individuals excreting eggs had a higher rate of symptoms (56.2%) than those not excreting eggs (13.4%) (P less than 0.01). The proportions of those not excreting eggs in the treated groups were 77.8% and 84.1%, compared with 14.6% in the control group. The survey revealed relatively high endemicity among fishermen and their family members. Treatment and health education of fishermen should be encouraged to control transmission. PMID- 1780993 TI - The epidemiology of schistosomiasis in Burundi and its consequences for control. AB - This paper summarizes the results of a series of studies on the epidemiology, morbidity and transmission of Schistosoma mansoni in Burundi, and discusses their consequences for control. The main endemic area is the Imbo lowland, consisting of the Rusizi plain, the urban focus of Bujumbura, and the shores of lake Tanganyika; a small, new focus was discovered in the highlands, around lake Cohoha. Distribution studies on 5-10% population samples with duplicate 28 mg Kato smears in these 4 foci showed prevalences of 33%, 26%, 17%, 19% and mean (positive) egg loads of 110, 105, 92, 144 eggs/g, respectively. The combined population at risk was estimated to be 400,000 people, the total number of detectable cases 90,000. Prevalences and intensities varied greatly at the subregional, local and even sublocal level. The age- and sex-related prevalences and intensities of infection showed typical peaks in children and adolescents, but remained relatively high in adults in many areas; these patterns varied from one area to another and could be related to ecology and water contact. Morbidity studies showed that, in children as well as in adults, schistosomiasis-related morbidity such as (bloody) diarrhoea, hepatomealy and splenomegaly was apparent mainly in areas with prevalences over 30-40%. The intermediate hosts were Biomphalaria pfeifferi (Imbo), B. sudanica (Tanganyika marshes) and B. stanleyi (Cohoha). Population dynamic studies showed strong seasonal variations, the patterns of which were focal and even erratic in space and time. Snail densities and cercarial infection rates (0.85% overall in B. pfeifferi) were low.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780994 TI - The effect of antimalarial chloroquine therapy and prophylaxis on concurrent infection with Onchocerca volvulus in Ecuador. AB - The effect of chloroquine phosphate on Onchocerca volvulus in vivo was studied in Ecuadorians undergoing treatment for malaria. All persons with a diagnosis of acute malaria and treated with 2500 mg of chloroquine over 3 d showed a 100% reduction of dermal O. volvulus microfilariae 7 d after treatment. However, 28 d after treatment the microfilarial densities returned to their pre-treatment levels and at 35 d they had increased to 121.6% of their pre-treatment values. Treatment did not appear to have any effect on the adult O. volvulus examined histologically in extirpated nodules. Patients treated for acute malaria and subsequently kept on a prophylactic regimen of 500 mg chloroquine weekly showed a reduction of 56.7% from pre-treatment microfilarial density after 27 weeks. Patients who underwent nodulectomy as well as treatment for acute malaria and were given 500 mg of chloroquine prophylactically for 27 weeks showed a reduction in dermal microfilarial density of 93.6%. Symptoms of onchocerciasis were reduced in the latter group of patients, with the elimination of all acute dermatological changes within 6 weeks. Ocular examination of these surgically and chemotherapeutically treated individuals revealed reductions of 94.9% of microfilariae in the anterior chamber, 95.9% of live microfilariae in the cornea, and 95.1% of dead microfilariae in the cornea. There was a reduction of 69.8% in corneal fluffy opacities. No alteration in the visual acuity or in visible lesions in the posterior segment was recorded. The results suggest that a complex interaction between chloroquine and O. volvulus takes place in vivo, which can be beneficial to the patient over a long period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780995 TI - Onchocerciasis in Ecuador: dermal depigmentation, leopard skin' and comparison with treponemal infection. PMID- 1780996 TI - A placebo-controlled double-blind trial for the treatment of bancroftian filariasis with ivermectin or diethylcarbamazine. AB - Therapeutic efficacy and clinical side-effects of ivermectin (single dose of 100 micrograms/kg) and diethylcarbamazine (DEC) (3 mg/kg for one day, then 6 mg/kg daily for 12 d) were evaluated for microfilaricidal effect in Bancroftian filariasis. Seventy-one microfilaraemic consenting adult male patients (greater than or equal to 100 microfilariae (mf)/ml) were randomly assigned to receive ivermectin, DEC or placebo and kept in hospital for 15 d. Those receiving placebo were treated with ivermectin on day 9. Ivermectin (19 'double-blinded' and 22 'unblinded' patients) caused an abrupt reduction in mf count to 1.5% of the pre treatment level 12 h after drug administration and to 0.06% on day 14, with recrudescence to 1.8% after one month and to 9.2% after 3 months. DEC (30 patients) caused a gradual drop in mf count to 1.1% of the pre-treatment level on day 14, which increased to 2.4% after one and 3 months. The total scores of side effects were 77 (1%), 305 (2.1%) and 311.5 (3.0%) for placebo, ivermectin and DEC respectively; the differences between DEC or ivermectin and placebo were statistically significant. Ivermectin produced lower side-reaction scores than DEC and the differences were highly significant at the 95% confidence level. Side effects were mainly headache and body aches in the ivermectin patients, which appeared as early as 4 h after drug administration, resolved within 36 to 48 hours, and were significantly related to mf densities. Side-effects in DEC patients were mainly testicular and epididymal pain and swelling, unrelated to mf densities, which began at day 2 and continued to day 7.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1780997 TI - Anopheles (Cellia) jamesii: a potential natural vector of bancroftian filariasis in Sri Lanka. PMID- 1780998 TI - Detection of serum antibodies in human Hymenolepis infection by enzyme immunoassay. AB - Although hymenolepiasis is the commonest cestode infection of man, there are no data available on the human immune response to this parasite. Thus, in order to determine if infection induces antibodies against Hymenolepis nana antigens, sera from 52 infected children were initially studied on Ouchterlony plates and then by enzyme-linked immunosorbent assay (ELISA), using a crude antigenic extract prepared from scolex and neck regions of adult worms. In addition, sera from persons with cysticercosis, taeniasis and other parasitoses, and normal human sera, were studied. Only one serum from the Hymenolepis group showed precipitin antibodies against H. nana antigen, while several were positive by ELISA. The sensitivity of the ELISA was 84.62% and its specificity was 100%. Very high cross reactivity rates were obtained with taeniasis (70.6%) and cysticercosis (75%) sera. These results show that Hymenolepis infection in man induces a low but detectable humoral immune response. Although not useful for diagnostic purposes, this may be relevant to the serodiagnosis of other tissue cestode infections of man, since antibodies detected in serological tests used for the diagnosis of cysticercosis, and probably hydatidosis, could be induced by H. nana instead of Taenia solium or Echinococcus larvae. PMID- 1780999 TI - Albendazole treatment in human taeniasis. AB - The results are presented of albendazole trials on human taeniasis infections in Honduras, involving 56 of 68 individuals (2% of the inhabitants) found to be infected during surveys conducted in 15 rural communities. Of the 3 methods used for diagnosis of infection, the Kato cellophane thick smear showed 80% reliability, a combination of Kato and 'Scotch' tape perianal swab 88%, and clinical history of proglottid expulsion less than 50%. Individuals were treated with a dose of 400 mg of albendazole per day for 3 d, followed for 5 d to verify tapeworm expulsion, and evaluated again at 60 and 90 d to assess drug efficacy. All 56 treated individuals remained stool-negative after 60 and 90 d; a partial strobila or segments were recovered from 21 of them (37.5%). Of these, Taenia saginata was identified from 4, and T. solium from 15; 2 specimens could not be specifically identified. Based on negative stool examinations and clinical history after 60 and 90 d, albendazole seems to be a well tolerated, very effective drug for treating infections with Taenia spp. However, confirmation of these results is needed due to the difficulty of making a reliable diagnosis of such infections. PMID- 1781000 TI - No association between meningococcal disease and human immunodeficiency virus in adults in Nairobi, Kenya. PMID- 1781001 TI - Low prevalence of hepatitis D (delta) virus infection in a nephrology unit in south India. AB - Fifty-five consecutive patients with end-stage renal disease entering haemodialysis programmes over a two-month period and 48 consecutive recipients of renal allografts during a period of 6 months were investigated for hepatitis B virus (HBV) and hepatitis D virus (delta) infection. HBV markers were present in 25 of the former and 40 of the latter. Of the 65 patients with HBV infection, 12 were not available for delta antibody screening. HBV infection was present for a mean of 2.5 months and 45.3% of those infected had clinical hepatitis; none had fulminant hepatitis. All the patients tested were negative for antidelta antibody. An additional patient on dialysis with delta superinfection and hepatic encephalopathy is also reported. PMID- 1781002 TI - Horizontal or vertical transmission of hepatitis B virus? A serological survey in family members of hepatitis B carriers in Singapore. AB - Hepatitis B serology was performed on 270 family members of 78 hepatitis B carriers and hepatitis B e antigen status determined in those found to be HBsAg positive. The mean age of index patients was 38 years (range 3-74) and that of family members was 28 years (range 1-71). 67 family members (25%) were HBsAg positive. The proportions of family members positive for HBsAg and those negative for HBsAg but positive for anti-HBs and/or anti-HBc were 25% and 20% for children, 10% and 68% for spouses, 36% and 26% for siblings and 29% and 55% for parents. For children of index parents the proportions positive for HBsAg and those negative for HBsAg but positive for anti-HBs and/or anti-HBc were similar whether the index patient was the mother (24% and 24%) or the father (26% and 18%). Our results suggest that horizontal transmission is a significant mode of spread of hepatitis B within the family in Singapore. PMID- 1781003 TI - Effect of duration of diarrhoea and predictive values of stool leucocytes and red blood cells in the isolation of different serogroups or serotypes of Shigella. AB - Diarrhoeal stools from 11,358 patients were microscopically examined for the presence of white and red blood cells (WBC and RBC) and cultured for enteric pathogens. Of the 3895 patients who had Shigella as sole pathogens, 2681 (72.3%) showed the presence of both WBC and RBC and the remainder had only WBC (P less than 0.001). The presence of both WBC and RBC was as good a predictor of shigellosis as the presence of greater than 25 WBC per high power field (hpf) of the microscope with or without RBC. However, the best predictor of shigellosis (positive predictive value 85%, negative predictive value 83%) was the presence of greater than 25 WBC/hpf and the presence of RBC regardless of their number. More patients infected with S. dysenteriae 1, S. flexneri and S. boydii shed both WBC and RBC than those infected with S. sonnei, most of whom shed WBC only (P less than 0.001). A greater number of patients infected with S. dysenteriae 1 shed more WBC and RBC than those infected with S. flexneri (P less than 0.001). The same trend was found when patients infected with S. flexneri were compared with those infected with S. boydii (though the difference was not statistically significant) and when patients infected with S. boydii were compared with patients infected with S. sonnei (P less than 0.001). There was a progressive decline in the isolation rate of Shigella as the duration of dysentery, before stool culture, increased. PMID- 1781004 TI - Diarrhoeal disease in children less than one year of age at a children's hospital in Guangzhou, People's Republic of China. AB - We performed a case-control study of diarrhoea to determine its causes in children less than 1 year old in Guangzhou, People's Republic of China, in April to September 1989. Stools were cultured for Salmonella, Shigella, Campylobacter and vibrios by standard techniques; rotavirus (RV) was identified by polyacrylamide gel electrophoresis; and specific deoxyribonucleic acid probes were used to identify Escherichia coli containing genes coding for Shiga-like toxin I and II, enteropathogenic E. coli adherence factor, and enteroinvasive E. coli (EIEC). E. coli isolates were tested for heat-labile toxin (LT) and heat stable toxin (ST) production and mannose-resistant adherence to HeLa cells. Rotavirus was identified in 13 of 174 children with diarrhoea (cases) and in 2% of 174 age-matched children without diarrhoea (controls), P less than 0.001. C. jejuni was identified in 10% of cases and 2% of controls, P = 0.003. Giardia lamblia was identified in 4 cases, LT and ST enterotoxigenic E. coli (ETEC) in 2, and S. flexneri in 1 case; they were not found in controls. ETEC that produced LT only was isolated from 5 cases and 3 controls, P = 0.721; E. coli that adhered to HeLa cells in a diffuse pattern was isolated from 30 cases and 40 controls, P = 0.229; and E. coli that adhered in an aggregative pattern was isolated from 20 cases and 18 controls, P = 0.863. EIEC was not isolated from cases or controls. Nine cases (5%) developed persistent diarrhoea (greater than 14 d duration). C. jejuni and aggregative E. coli were isolated from different children with persistent diarrhoea.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781005 TI - Randomized treatment of patients with typhoid and paratyphoid fevers using norfloxacin or chloramphenicol. AB - Forty adult patients with Salmonella typhi and S. paratyphi infections were studied in a randomly assigned prospective study to receive norfloxacin (12 drug sensitive and 8 drug-resistant cases) or chloramphenicol (20 cases). No complication occurred in either group and no side effect was noted in the norfloxacin-treated group. The results suggest that a 7 d course of twice daily norfloxacin promises to be an alternative to a 14 d course of chloramphenicol for treating chloramphenicol-sensitive and multidrug-resistant typhoid and paratyphoid fevers. PMID- 1781006 TI - Amoxycillin-clavulanic acid treatment of melioidosis. AB - Melioidosis is a serious infection with high acute mortality, and a high rate of relapse despite protracted antimicrobial treatment. The current recommended conventional oral treatment regimen is a 4-drug combination of high-dose chloramphenicol, doxycycline and trimethoprim-sulphamethoxazole given for between 6 weeks and 6 months. We have evaluated prospectively the use of amoxycillin clavulanic acid, to which Pseudomonas pseudomallei is consistently sensitive in vitro, for the oral maintenance treatment of melioidosis. Amoxycillin-clavulanic acid was used either as sole treatment of localized disease, or as maintenance therapy following either parenteral ceftazidime or the conventional 4-drug regime; 20 patients with localized infections and 26 with septicaemic melioidosis received a median of 7.5 (2-12) weeks treatment. After a mean follow-up period of 6 months (range 1-19), 31 patients (67%) remain free of disease. The drug was well tolerated. Three patients had fatal relapses, one other died suddenly at home, and another died from underlying promyelocytic leukaemia. The remaining 10 relapses were treated successfully. Resistance developed in one case. Amoxycillin clavulanic acid is a safe alternative to the conventional 4-drug antimicrobial combination for the oral treatment of melioidosis. It may be of particular value in children, pregnant women, and in infections with Ps. pseudomallei resistant to the potentially toxic conventional regimen, but the optimum dose and duration of therapy need to be established. PMID- 1781007 TI - Dispersive flight by Triatoma sordida. AB - One hundred and thirty-two male and female Triatoma sordida were marked with fluorescent paint and released at an experimental site on the salt flats of central Argentina, distant from any inhabited dwellings. Flight by these bugs commenced just after sunset, and the bugs were then systematically searched for using portable ultraviolet lights. There was no apparent tendency for the bugs to fly in any particular direction, but those whose flight could be observed directly all seemed to fly in approximately straight lines at a height of 0.5-1 m. Of the 86 bugs that flew from the release point, 16 made trivial flights of less than 5 m, 4 landed at distances of 60-90 m away, while the other bugs were not recovered and appear to have flown further than 100 m. As expected from similar studies with T. infestans, the proportion of bugs initiating flight declined with increasing weight-length ratio, but T. sordida showed a much higher propensity for flight under these conditions than did T. infestans. PMID- 1781008 TI - Which species of Rhodnius is invading houses in Brazil? PMID- 1781009 TI - Hygiene, skin infections and types of water supply in Venda, South Africa. AB - The impact of the installation of a system to supply chlorinated drinking water in Venda, South Africa, on water quality, water use and health status was evaluated by means of questionnaires, examination for skin infections, and microbiological analysis of water samples. Although the water collection journey became shorter in comparison with use of traditional water supplies such as boreholes and unprotected springs, water use per caput showed no increase. The improved water supply showed no contamination with coliforms even after storage. Borehole water exhibited low coliform counts at the source, but after storage a 10- to 15-fold increase took place. Water samples from unprotected springs exhibited high coliform counts, which declined during storage. The prevalence of infectious skin diseases (27.5%) and diarrhoea (3.7%) among pre-schoolchildren showed no correlation with the quality of drinking water or the use of water per caput. Although the prevalence of infectious skin diseases did exhibit a negative correlation with the frequency of washing, no significant health benefit of the improved water supply could be demonstrated in this limited study. PMID- 1781011 TI - Kwashiorkor-marasmus syndrome and nutritional rickets--a bone biopsy study. PMID- 1781010 TI - Complications and outcome of disease in patients admitted to the intensive care unit of a diarrhoeal diseases hospital in Bangladesh. AB - A retrospective analysis of the medical records of 1970 patients admitted to the intensive care unit of the Clinical Research Centre in Dhaka, Bangladesh was made, to identify various complications and outcome. All patients were admitted with a history of diarrhoea. Children under 5 years old comprised 90% of these patients. 75% of these seriously ill patients recovered; 21% died; the remaining 4% were referred to other facilities for specialized treatment or left the hospital against advice. The principal causes of death were recorded as septicaemia (79%) and pneumonia (28%); multiple conditions contributing to the death were present in 90% of patients. None of the 405 deaths could be attributed to dehydration. Severe malnutrition was noted as an associated underlying disorder contributing to the death of 74% of the children. Recognition of these complications or illnesses in seriously ill diarrhoeal patients, and their timely and energetic management, are vital in achieving a low hospital mortality. PMID- 1781012 TI - Hypernatraemic dehydration of infancy. PMID- 1781013 TI - Protecting the health of the traveller. PMID- 1781014 TI - Reinfection of Somali children with Trichuris trichuria. PMID- 1781015 TI - Immunosuppression as a factor promoting drug resistance in malaria. PMID- 1781016 TI - Differentiation between heterozygous carriers and homozygotes for haemoglobin S using a solubility test. PMID- 1781017 TI - Alternative hypothesis for the evolution of chloroquine resistant Plasmodium falciparum in Africa. PMID- 1781019 TI - All good things ... PMID- 1781018 TI - Entamoeba histolytica and airline personnel. PMID- 1781020 TI - SH2 domains: elements that control protein interactions during signal transduction. PMID- 1781021 TI - ASF/SF2: a splice site selector. PMID- 1781022 TI - The Human Genome Project: creating an infrastructure for biology and medicine. AB - The Human Genome Project (HGP) is an international effort to map and sequence the human genome. It combines skills from diverse fields of biological and technological research, thus establishing deeper interactions between scientific disciplines. The combination of these skills should stimulate many advances in both pure and applied fields of research and give rise to new, interdisciplinary training programs. Some critics say that the HGP will damage biomedical research; however, we argue that it will bring new funds to the field and create a large ripple effect by providing new research opportunities through its discoveries. PMID- 1781023 TI - The Human Genome Project: misguided science policy. AB - Genome mapping and sequencing projects are inappropriate and wasteful expenditures of precious research funds. By focusing on the acquisition of nucleotide sequences, the various genome projects emphasize the products of science over the process of science. It is doubtful that much of the resulting information will provide insights into human diseases or fundamental biological processes. The routine nature of genome sequencing makes it ill-suited for training young scientists. Such projects may also hamper the education of future investigators by diverting research support from universities to genome centers and commercial firms. PMID- 1781024 TI - DNA in profile. AB - The double helix structure of DNA is not necessarily straight but rather can be curved at almost every base pair. Thus, each piece of DNA possesses a unique silhouette, as individual as its base sequence. PMID- 1781025 TI - Oxygen transport in extreme environments. AB - Evolution has adopted different strategies to solve the problem of transporting oxygen to respiring tissues, according to needs dictated by the environment. A thermodynamic analysis of haemoglobins of organisms living in extreme polar environments (mammals and fish) provides elegant examples of such adaptations. PMID- 1781026 TI - Transferrin receptor, antigenic variation and the prospect of a trypanosome vaccine. PMID- 1781027 TI - Genetic mapping of manic-depressive illness. PMID- 1781028 TI - Hybridization analyses of arrayed cDNA libraries. PMID- 1781029 TI - Malignant transformation by mutant Rel proteins. AB - A newly described family of transcriptional regulatory proteins, the Rel family, has recently been the subject of much interest. The Rel family includes proteins known to be important in Drosophila development, replication of HIV-1, oncogenesis and general transcriptional control. Nevertheless, there is still much to be learned about their precise mechanism of action, including the process by which the original member of this family, v-Rel, malignantly transforms cells. PMID- 1781030 TI - Octamania: the POU factors in murine development. AB - Much effort has been directed towards the investigation of regulatory processes in the early mouse embryo. Several multigene families of developmental control genes have been identified. The POU family is a group of related transcription factors containing a particular type of bipartite DNA-binding domain. Members of this family show distinct expression patterns during embryonic development. Two members, Oct-4 and Oct-6, are expressed as early as in the preimplantation embryo and thus may regulate early events of murine development. PMID- 1781031 TI - Boundary functions in the control of gene expression. AB - Recent experiments using stably transformed genes in mouse and Drosophila have demonstrated that elimination of euchromatic position effects can be used as a functional assay for domain boundaries. These studies will lead to an analysis of boundary structure, and in addition will provide clues to the mechanism(s) of gene regulation by higher order chromatin packaging. PMID- 1781032 TI - Randomized trial of primary school education against smoking. AB - Since 1974 an anti-smoking campaign consisting of a one-day educational intervention has been carried out in primary schools in Milan by the Italian League against Cancer (Milan Division). All but two of the 165 schools were randomized to evaluate the intervention effect. A total of 8549 children aged 9 10 were allocated to the intervention group and 8897 to the control group. Four years later a self-administered questionnaire was distributed in order to investigate the children's smoking habits. The proportion of smokers was 8.05% and 8.72% (p = 0.23) respectively for the intervention and control groups. It was concluded that sporadic educational intervention carried out during primary school years has little or no impact in preventing cigarette smoking in teenagers. PMID- 1781033 TI - Soybean and ascorbate feeding in experimental carcinogenesis: immunological studies. AB - Soybean and/or sodium ascorbate have been demonstrated to have protective effects against carcinogenicity of the nitrosamine precursors dibutylamine and sodium nitrite in rats. Some immunological aspects of the cellular and humoral compartments of the immune system were investigated in this experimental model. The parameters chosen for the study were the lymphocyte transformation test, migration inhibition test, the demonstration of Fc and Fc plus complement receptors on the lymphocyte surface (EA and EAC rosette-forming test), and the determination of total serum proteins and their fractions. The results indicated that dibutylnitrosamine can be formed in vivo from its precursors dibutylamine and sodium nitrite, and that it affects the immune system of rats which showed an immunosuppressed state present as depressed cellular and humoral immunity. The protective role of soybean and/or ascorbate against carcinogenicity of dibutylamine and sodium nitrite was demonstrated by the absence of tumor formation. These agents were found to be capable of increasing the defense mechanism of rats by enhancing both cellular and humoral immunity in the presence of the carcinogenic nitrosamine precursors dibutylamine and sodium nitrite. PMID- 1781034 TI - Sex comparison of heme pathway in rats bearing hepatic tumors. AB - The present study was undertaken to explore the effect of the presence of hepatic tumors induced by diethylinitrosamine (DENA) on the metabolic heme pathway, and to assess whether these tumors can modify the response of rats to the porphyrinogenic drug hexachlorobenzene (HCB) and whether the above mentioned effects occur to a greater extent in females than males. The results obtained showed that: a) Females were more susceptible to the hepatocarcinogenicity of DENA than males. b) Female normal and DENA treated rats were more susceptible than male rats to the porphyrinogenicity of HCB. c) The presence of hepatic DENA induced tumors could diminish basal hepatic ferrochelatase activity. d) Hepatic tumors could modify the response of animals to a porphyrinogenic drug such as HCB. Thus, both female and male DENA/HBC rats accumulated more porphyrins and showed a lower delta-aminolevulinate synthase and uroporphyrinogen I synthase induction than HCB rats. e) The heme pathway was functional in DENA induced tumors in both male and female rats but they were little affected by HCB. PMID- 1781035 TI - Comparative studies of steroidogenesis inhibitors (econazole, ketoconazole) on human breast cancer MCF-7 cell proliferation by growth experiments, thymidine incorporation and flow cytometric DNA analysis. AB - The effects of aminoglutethimide, econazole and ketoconazole on human breast cancer cells in culture were compared with those of tamoxifen using four methods (growth experiments, thymidine incorporation, monoparameter and bivariate DNA content flow cytometry analysis). Aminoglutethimide (1 nM-10 microM) had no effect on cell proliferation after 8 days of treatment and did not decrease thymidine tritiated incorporation during logarithmic phase. Even at 20 microM, similar results were obtained with flow cytometry. Econazole and ketoconazole (1 nM-1 microM) decreased MCF-7 cell proliferation in a time- and dose-dependent fashion. They also decreased tritiated thymidine incorporation. By using flow cytometry and a monoclonal antibody against bromodeoxyuridine, we showed an accumulation of MCF-7 cells treated by imidazoles derivatives in G0-G1 phase of the cell cycle. PMID- 1781036 TI - Evaluation of the circulating glycoprotein CA549 in mammary cancer and other malignancies. AB - A prospective study was carried out on a recent marker for breast cancer, CA549, a mucine-like acid glycoprotein present in the fat membranes of human milk. Fifty healthy control subjects and 91 with benign conditions, 103 mammary cancer patients and 256 patients with other types of malignancy were studied. For comparison, CEA and CA15-3 were also investigated. The CA549 cutoff was 11 U/ml. In breast cancer the marker was below the cutoff in 9 cases (92.8%); in malignancies other than breast cancer it was above the cutoff in 5 to 50% of patients. In breast cancer it was raised in 83.3% of cases (CA15-3 showed 82.9% and CEA 50%). In breast cancer after radical surgery, CA549 was normal in patients who were in TNM stage I but above the cutoff in 57.1% of those at more advanced stages. The follow-up study is ongoing among these patients. In all the study conditions, CA549 favorably compared to CA15-3 values, with sensitivity and specificity greater than CEA. PMID- 1781037 TI - In vivo effects of multiple cycles of recombinant interleukin-2 (IL2) on peripheral granulocyte-macrophage hematopoietic progenitors circulating in the blood of cancer patients. AB - The numbers of peripheral blood (PB) granulocyte-macrophage colony forming units (CFU-GM) were evaluated in five patients treated with multiple weekly cycles of recombinant interleukin-2 (IL2). A 4.5-12 fold increase in the number of CFU-GM was evident within 8 days after the beginning of the treatment. The maximal increase in the absolute numbers of CFU-GM/ml blood caused by the IL2 treatment, ranged from 14 to 57 times the baseline values and was reached after two or three cycles of IL2. IL2-activated PBMC, added in vitro to the PBMC of a normal donor did not modify the number of CFU-GM present in the donor PBMC. CFU-GM were also recovered from frozen samples of in vivo IL2-activated PBMC. PMID- 1781038 TI - Carboplatin, continuous infusion fluorouracil and mid-cycle high-dose methotrexate as initial treatment in patients with locally advanced head and neck cancer. Hellenic Co-operative Oncology Group Study. AB - Forty-nine patients with locally advanced squamous cell carcinoma of the head and neck (SCCHN) were treated with 3 cycles of induction chemotherapy prior to definitive local treatment (surgery and/or radiation therapy). Chemotherapy consisted of carboplatin 300 mg/m2 on day 1, fluorouracil 1000 mg/m2 daily as a continuous infusion on days 1 to 5 and high-dose methotrexate 1.2 g/m2 with leucovorin rescue on day 14. After completing the induction chemotherapy, 9 patients (18%) achieved a complete remission (CR), 26 (54%) a partial remission (PR), 7 had stable disease and 7 a progression. The response rates increased to 53% CR and 18% PR following locoregional treatment. Survival at 12 months was 61% and its actuarial probability at 24 months 31%. Median time to progression was 14 months. Toxicity from chemotherapy was generally mild. Nausea was observed in 35%, vomiting in 26%, stomatitis in 57%, anemia in 22%, leukopenia in 36%, thrombocytopenia in 26% and diarrhea in 6% of the patients. In conclusion, the combination of carboplatin, 5-day continuous-infusion fluorouracil and mid-cycle high-dose methotrexate is a moderately effective, well tolerated regimen in patients with SCCHN but does not seem superior to the combination of carboplatin and fluorouracil only. PMID- 1781039 TI - Distant metastases in differentiated thyroid cancer: long-term results of radioiodine treatment and statistical analysis of prognostic factors in 214 patients. AB - Long-term results and statistical analysis of prognostic factors in a series of 214 patients with distant metastases from differentiated thyroid cancer (DTC) are reported here. These 214 were part of a total series of 1457 patients with DTC referred to our center from 1967 to 1987. All patients underwent surgery and 131 I therapy and were treated with TSH suppressive doses of thyroid hormones. After a mean follow-up of 7.3 years including clinical, scintigraphic, radiological and laboratory investigations, 24.4% of patients were alive without disease, 36.5% alive with disease, 1.8% dead without disease and 37.3% dead with disease. One of the main factors influencing the survival in our series was 131-I uptake (RIU) by metastatic tissue. No case of complete remission of disease was observed among patients with nonfunctioning metastases. Another important factor was the site of metastases, patients with bone metastases having the worst prognosis. The patient's age at diagnosis represented another important factor for survival; patients over 40 years, particularly those over 60 years had a bad prognosis. A clear interrelation was found among the factors advanced age, nonfunctioning metastases and bone metastases. Patients with these last clinical features were considered to be at high risk and generally had a fatal outcome. Another significant prognostic factor revealed by univariate analysis was the histologic type. Patients with follicular tumor showed a poorer prognosis in comparison to papillary tumor. When multivariate analysis was applied, the factors age at diagnosis, site of metastases and RIU proved to have a significant influence on survival, but not the histologic type. Lastly, the relative rate of males was higher in the group of patients with metastases in comparison to the whole series of DTC patients. Despite this, the factor sex did not influence survival. PMID- 1781040 TI - Liposarcoma in a child: a case report. AB - Liposarcoma is a soft tissue tumor usually observed in adults. Although occasional cases have been reported in childhood, it is virtually unknown in infants and small children. Our experience documents a case of liposarcoma in a 6 year-old girl, an extremely rare occurrence in this age-group. The patient underwent wide local excision followed by chemotherapy. Histologically, the tumor was a myxoid type. Differential diagnosis and problems concerning prognosis and therapy of this tumor in children are discussed. PMID- 1781041 TI - Treatment of advanced colorectal cancer with mitoxantrone, high dose folinic acid and fluorouracil. AB - A new combination chemotherapy including mitoxantrone 10 mg/m2 i.v. on day 1 and 5-fluorouracil 400 mg/m2 i.v. plus folinic acid 200 mg/m2 i.v. on days 1-5 was administered every 28 days to 13 patients with locally advanced or metastatic colon (1 case), ractosigmoid colon (4 cases), or rectum (8 cases) carcinoma. The median number of cycles performed was 3 (range, 1-9). No patient achieved complete or partial remission with this regimen, whereas 5 showed a stable disease lasting 3-8 months. Acute toxicity was mild/moderate in intensity and comparable to that reported with the standard 5-fluorouracil + folinic acid combination. Since we observed no major responses in our 13 consecutive patients, we consider that the overall activity of our regimen, at the doses and schedule utilized, was only moderately effective in advanced colorectal carcinoma. PMID- 1781043 TI - [Physician and clinical research]. PMID- 1781042 TI - A metastatic breast carcinoma presenting as autoimmune hemolytic anemia. AB - The authors describe the case of a 75-year-old female who was hospitalized for anemia of unknown origin. Physical examination revealed a swelling in the right mammary region, where a mastectomy scar was present from surgery for a breast carcinoma. On admission, laboratory tests disclosed anemia (Hb, 8.5 g/dl), with a reticulocyte count of 65,000/mm3 and slightly increased bilirubin. Immunohematologic study revealed the presence of a red cell autoantibody with anti-D specificity in the serum and in the eluate from the patient's erythrocytes. A biopsy of the swelling was performed and histologic examination showed the presence of metastatic cells of breast carcinoma. The patient was given chemotherapy and radiotherapy. At this writing the anemia was absent, the immunohematologic study was negative, the swelling was greatly reduced, and no other metastatic lesions of breast carcinoma were present. PMID- 1781044 TI - [Rationalization profits of radiographic diagnosis with systematic follow-up DBCG (Danish Breast Cancer Cooperative Group) programs. 1]. AB - In the follow-up programme of the DBCG-77 control and treatment protocols for primary operable breast cancer, bone scintigraphy and chest X-ray were performed 6 months after surgery and thereafter yearly until the diagnosis of any recurrence or another cancer. In the present study, the value of the two examinations was examined to the 6th year control. As a result of a low incidence of primary recurrence to the bone (0.6-3.9%) and to the chest (0.0-3.0%) the value was found to be low. About two thirds of the patients with primary chest recurrence addressed themselves with or had at the time of control pulmonary symptoms. About one half of those patients, in whom (during a 12-month period after the scheduled bone scintigraphy) bone metastases were diagnosed by another method, had a normal scheduled bone scintigraphy. False positive changes were not infrequent, especially at the bone scintigraphies. The diagnosis of asymptomatic chest recurrence did not reduce the mortality among stage II patients, among whom the greatest value of the control examination was found. It is concluded, that systematic use of bone scintigraphy and chest X-ray is not justified in a follow up programme for stage I and II breast cancer patients. PMID- 1781045 TI - [A randomized study of tumor resection versus mastectomy in breast cancer. 2. 6 year results of the DBCG-82TM (Danish Breast Cancer Cooperative Group) protocol]. AB - The Danish Breast Cancer Cooperative Group (DBCG) conducted a randomized trial to compare breast conservation with mastectomy in patients suffering from mammary carcinoma. From January 1983 to March 1989 the trial recruited a total of 1,153 women. Of these 905 patients (79%) were randomly assigned to one of two treatment options, whereas 248 patients (21%) refused randomization. Of the randomized patients, 90% received the surgical option to which they had been originally assigned. As regards breast conservation, the tumour was excised with the object of tumour-free margins on gross examination, and radiotherapy was administered subsequently to residual breast tissue. Mastectomy was performed as a modified radical procedure. The axilla was dissected in all instances. Patient and tumour characteristics were similar in the two random groups. 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 group compared with 66% in the mastectomy group. Survival figures were 79% compared with 82%, respectively. Short-term follow-up did not disclose any significant difference between results of breast conservation compared with those of mastectomy. On the other hand, in the non-randomized group the patients undergoing breast conservation had a significantly poorer outcome than the patients treated with mastectomy. PMID- 1781046 TI - [Prognosis after surgical treatment of breast cancer. 3. The low-risk group of the DBCG (Danish Breast Cancer Cooperative Group)]. AB - The two therapeutic protocols of The Danish Breast Cancer Cooperative Group (DBCG) DBCG 77a (1977-1982) and 82a (1982-1990) comprise patients who were classified as low risk patients after operation for cancer of the breast, a total of 7,315 women. Treatment consisted of mastectomy and dissection of the lower and middle axillary levels. The median period of observation for DBCG 77a was 9 1/2 years and for DBCG 82a 3 1/3 years. The curves for recurrence-free survival and survival were found to be congruent in the two protocols. The recurrence-free survival after five years was 70% and 55% after ten years. Survival was 87% after five years and 70% after ten years. Local recurrence developed in 12.7% and 1.1% had distant recurrences simultaneously. Local recurrence was distributed with 60% in the scar or thoracic wall, 33% in the axilla and 7% in the clavicular lymph nodes. Distant recurrence alone developed in 11.4%. The time curves for development of local or distant recurrences were practically congruent. Local recurrence developed in 3.8% of the patients per annum during the first four years and after that in 1.5% per annum. Distant recurrence was found in 3.5% per annum in the first four years and after that in 1.8% per annum. The survival was significantly different after local and distant recurrence. Patients with tumours of grade 1 anaplasia had better prognoses than patient with grade 2 og 3 tumours as regards recurrence-free survival and survival. Multivariate analysis revealed that age under 40 years and anaplasia grad were significant prognostic variables for the parameters: distant recurrence and local recurrence. In addition, the number of lymph nodes in the operation specimen was a prognostic variable for local recurrence. PMID- 1781048 TI - [Narcotics. Classification of drugs according to legislation]. AB - Based on a historical outline, the survey describes the classifications of narcotic drugs according to present international conventions and Danish legislation. The classification of drugs according to the Danish act concerning euphoriant substances is compared to the classifications in Danish medical and pharmaceutical legislation. PMID- 1781047 TI - [Adjuvant endocrine treatment of postmenopausal patients with breast cancer with high risk of recurrence. 5. Results from the DBCG (Danish Breast Cancer Cooperative Group) 77C randomized trial]. AB - The role of antiestrogen treatment of postmenopausal breast cancer patients with high risk of recurrent disease is evaluated in a nationwide, prospective trial conducted by the Danish Breast Cancer Cooperative Group (DBCG). After total mastectomy and postoperative radiotherapy (RT), 840 patients were randomized to treatment with tamoxifen (RT + TAM) for one year, and 824 were randomized to no further therapy (RT). The recurrenceree survival (RFS) after ten years of lifeable analysis is 31% in the RT + TAM treated group, and 28% in the RT group (p = 0.01). Survival is 38% and 34% in the two treatment groups, respectively (p = 0.04). The data were further analyzed with respect to prognostic factors such as age, number of positive nodes, tumour size, and degree of anaplasia. Survival is prolonged in nearly all subgroups of patients treated with RT + TAM. However, the prolongation is only significant in patients with four or more positive nodes, with tumours of less than 5 centimeters or with tumours of anaplasia grade II. Estrogen (ER) and progesterone receptor (PgR) concentrations were measured in tumours from 309 and 219 patients, respectively. Only patients with ER and PgR values above 100 fmol/mg cytosol protein seemed to have a prolongation of survival. In conclusion, a modest survival benefit is achieved with one year of adjuvant tamoxifen treatment. Nevertheless, this is the first example of a systemic treatment approach being able to change the fatal course of breast cancer in postmenopausal patients. By means of endocrine therapy, and in the context of a new randomized trial, the DBCG will try to improve the survival in these patients even further. PMID- 1781049 TI - [Forced expiratory volume in 1 second (FEV1)--a respiratory physiological measurement of considerable prognostic value]. AB - The epidemiologic literature concerning a relationship between a decreased FEV1 and mortality, morbidity and lung cancer was reviewed FEV1 is a very potent predictor of COPD mortality and morbidity, and of lung cancer. Furthermore, FEV1 is a hitherto largely unrecognized potent predictor of general mortality and cardiovascular mortality and morbidity. The consequence of this knowledge should be a more widespread usage of spirometry, both in epidemiologic studies and in daily clinical practice. PMID- 1781050 TI - [Intracavitary irradiation of esophageal cancer]. AB - Intracavitary irradiation (ICI) of esophageal cancer is a technique where the radioactive source is placed in the lumen of the esophagus thereby delivering a high local radiation dose to the tumor. ICI is used as single modality therapy for palliation of dysphagia or as a supplement to external irradiation. Dysphagia is hereby relieved in more than 90% of the patients and it appears that survival is improved. The side effects are dose dependent and consist of esophagitis, esophageal ulceration and benign stricture. Fistulae do not seem to occur with increased frequency after ICI, but an existing fistula is claimed to be a contraindication to ICI. The mortality connected with ICI is considerably lower than with tubulation or laser extirpation. It is concluded that ICI is a promising treatment in esophageal cancer both as palliative and curative treatment in combination with other treatment modalities. PMID- 1781051 TI - [Gitadyl versus ibuprofen in patients with osteoarthrosis. The result of a double blind, randomized cross-over study]. AB - Thirty-five patients suffering from mild to moderate osteoarthrosis were treated with Gitadyl (a herbal medicine containing 110 mg fever few, 90 mg American aspen, and 60 mg milfoil) or ibuprofen (Ibumetin) for three plus three weeks in a double-blind, cross-over trial. The dosages of Gitadyl and ibuprofen were three tablets per day and 1,200 mg, respectively. Both treatments gave the same reductions in subjective symptoms (pain and walking ability). Gastrointestinal side effects were more frequent in patients treated with ibuprofen. It is concluded that Gitadyl is an alternative form of treatment for patients who do not want a conventional drug or who experience gastrointestinal side effects of NSAID even in low dosage. PMID- 1781052 TI - [Neuropsychological sequelae after electric accidents]. AB - No investigations have been found in the literature which document how many individuals develop neuropsychological and neuropsychiatric dysfunctions following electric shock. Three cases are reviewed in this article where patients developed neuropsychological dysfunction after electric accidents. The first case report describes a man who developed an amnestic syndrome followed by personality changes and diffuse anxiety after an electric accident. The two other case reports are comparable to the post-concussional syndrome. The patients had difficulty in concentration, psychosomatic symptoms and anxiety reactions. On the basis of the case reports described here, it is important to emphasize that manifest or discrete neurological, neuropsychological and neuropsychiatric dysfunctions may occur as sequelae of electric shock. It is therefore of significance to submit patients of this type to neurological examination and neuropsychological and personality psychological investigations in order to reveal possible neurological and psychological disturbances. PMID- 1781053 TI - [Ballism in systemic lupus erythematosus]. AB - A case of systemic lupus erythematosus (SLE) with ballism is presented. The movement disorders, as a group, account for approximately 2% of the neurological and psychiatric symptoms of central nervous system (CNS) involvement in SLE, and more than any of the other neuro-psychiatric manifestations they tend to precede the diagnosis of SLE. Ballism and other rare movement disorders are not included in the 1982 revised American Rheumatism Association criteria for SLE. Being aware of the correlation between CNS disease and more severe SLE, one should assess therapeutic intervention critically. PMID- 1781054 TI - [Accumulation and biotransformation of mercury and its relation to selenium after exposure to inorganic mercury and methylmercury]. PMID- 1781055 TI - [Allergy without waiting lists]. PMID- 1781056 TI - [Sclerosis--a short introduction]. PMID- 1781057 TI - [Long-term results of total condylar knee alloplasty by the Insall-Burstein method. A follow-up after 9-11 years]. AB - A total of 118 patients (164 knees) participated in this investigation. These consisted of 23 males (31 knees) and 95 females (113 knees). The average age was 63 years (24-80 years) and the average period of observation was 10 years (9-11 years). The patients were examined clinically and radiographically preoperatively and also 8-12 weeks postoperatively and at intervals of one year thereafter. The Hospital for Special Surgery knee rating scale was employed in the clinical assessment and The Knee Society recognized radiolucency index in the radiographic assessment. At the most recent control examination, 82% of the knees assessed showed excellent or good results, 9% had fair results and 9% poor. The median total score was 84 points (quartiles: 76 and 98). Complete freedom from pain or slight pain were found in 91%. The range of motion was increased by an average of 12 degrees. A considerable improvement in the walking ability was found. A significantly positive correlation was found between the varus positioning of the tibial component and the occurrence of translucent zones. Serious complications occurred in 10% but none proved fatal. PMID- 1781058 TI - [Scalding among children caused by electric kettles. An increasing problem]. AB - The object of this work is briefly to draw attention to a new type of accident as the cause of scalding in children. The increasing use of electric kettles has resulted in an increased number of scalding accidents caused by these kettles. Within a period of six months, eight children under the age of five years were treated in the Department for Burns, Hvidovre Hospital on account of overturned electric kettles, a form of accident which had not previously been observed in this department. All of the children had pulled the cable. Seven out of eight children were admitted to hospital and transplantations proved necessary in three children. PMID- 1781059 TI - [False-positive diagnostic findings in acoustic neurinomas]. AB - In the period from 1976 to 1990 Tos and Thomsen operated on 520 patients with acoustic neuromas using the translabyrinthine approach and five other patients were operated on via middle fossa approach. The diagnostic work up in all patients included: pure tone audiometry, tympanogram with acoustic reflexes, caloric test and brainstem audiometry. Since the late seventies, CT became the radiological investigation of choice to visualize the tumor. The first generation of CT failed to reveal tumors less than 1.5 cm in the extrameatal diameter, and pantopaque cisternography was necessary in some cases. The following generation of CT did not always reveal small intrameatal tumors, and false-negative results were reported. The incidence of false-positive CT findings in our series is calculated to be 0.6%. Three patients were operated on on account of false positive CT. Peroperatively, adhesions in and around the internal porus were found in two cases while no pathology was found in the third case. Postoperatively, anacusis was observed in two cases. This could have been avoided if magnetic resonance imaging (MRI) with gadolinium contrast had been performed. In our opinion, MRI should be considered before a definitive surgical procedure is undertaken. Until MRI becomes more widely available, intravenous contrast enhanced tomography followed by air cisternography is recommended in the diagnosis of small acoustic neuromas. PMID- 1781060 TI - [Urease test for rapid demonstration of Helicobacter pylori in biopsies from the pyloric antrum]. AB - Helicobacter pylori (HP) is an important etiological factor in chronic gastritis and duodenal ulceration. Demonstration of HP by means of culture and histological examination is relatively time-consuming. The object of this investigation was to assess the validity of two rapidly read chemical tests: the buffered urease reagent (BR) and the unbuffered urease reagent (UBR) in demonstration of HP among patients referred for gastroscopy on account of upper abdominal dyspepsia. In 230 sets of biopsies investigated for HP by culture and histology, the following results were obtained by reading of the BR test three hours later at room temperature: Nosographic sensitivity 0.54, nosographic specificity 0.97, PVpos 0.93 and PVneg 0.71. In another material consisting of 57 sets of biopsies, both BR and UBR were performed. Reading of UBR after 15 minutes yielded the following results: Nosographic sensitivity 0.56, nosographic specificity 1.00, PVpos 1.00 and PVneg 0.61. It is concluded that positive results of the urease tests indicate the presence of HP. If the urease tests are negative, supplementary culture and/or histological examination for HP should be performed. UBR is preferable rather than BR. PMID- 1781061 TI - [Familial neurofibromatosis and hypertrophic obstructive cardiomyopathy]. AB - Two brothers both with hypertrophic obstructive cardiomyopathy, one of them also with neurofibromatosis are described. Only a few cases with this combination of diseases have been reported. The possibility of a coincidence or a causal relationship is mentioned. The importance of echocardiography in persons with cardiac murmurs is emphasized even in cases where the electrocardiogram and thoracic x-ray are normal. PMID- 1781062 TI - [Manchincel poisoning complicated by streptococcal pharyngitis and impetigo]. AB - A Danish tourist to Antigua in the West Indies, ate a fruit of Hippomane mancinella and developed acute poisoning with blistering of the oral mucosa and diarrhoea and a streptococcal superinfection. Ignorant tourists and their travel advisers are warned against this potentially deadly apple-tree-like plant and its tempting fruits. PMID- 1781063 TI - [Frequency of cesarean section in Denmark during 1980-1989]. PMID- 1781064 TI - [Medical humanistic research, fields and methods]. AB - Medical research, which attempts to analyse the numerous aspects of human disease which cannot be investigated scientifically, is at present in a phase of clarification. It is argued that the term "medical humanistic research" is a more adequate term for research into the aspects of human disease within a human scientific tradition than e.g. "qualitative research". The fields of research, methods of collecting data and the various theoretical bases and disciplinary roots of the methodological aspects are discussed. New methodological possibilities are mentioned and the weaknesses and sources of error are indicated. Finally, reflections concerning the future prospects of medical humanistic research in the medical profession are made. The problem is not only the current medical scientific research but, on the other hand, the extent to which the continued medical disciplinary development in scientific understanding is desired. Is possible new structured knowledge about human understanding, feelings, volition and desires which are associated intensely with every medical activity to be abandoned? PMID- 1781065 TI - [Research and common sense. Concluding comment on a debate]. PMID- 1781066 TI - [The Mundelstrup story]. PMID- 1781067 TI - [Social status and cardiovascular risk factors in Danish males]. AB - In a prospective investigation of a cohort of 504 men from the population studies in Glostrup, the participants were examined at the ages of 40 and 51 years. On both of these occasions, the social status was investigated together with a series of cardiovascular risk factors. The main hypothesis of the investigation was that the risk of cardiovascular disease was greater the lower the social status. This hypothesis was confirmed as regards the following risk factors at the examination at the age of 51 years: Plasma-fibrinogen (p less than 0.001), low stature (p less than 0.001), smoking (p less than 0.05), physical inactivity during leisure time (p less than 0.01), shift work (p less than 0.05), job strain (p less than 0.05), living alone (p less than 0.01) and a poor social network (p less than 0.05). Two factors showed a significantly opposite association with social status: Type A behaviour (p less than 0.001) and physical inactivity during work (p less than 0.001). In many countries, during the past 10-15 years, a tendency towards an even more marked association between social status and the risk factors for cardiovascular disease has been observed. This tendency was not observed in the present investigation. PMID- 1781068 TI - Measurement of the ultrasonic properties of vascular tissues and blood from 35-65 MHz. AB - A 50 MHz ultrasound backscatter microscope has been built to measure the acoustic properties of vascular tissues and blood over the frequency range from 35-65 MHz. High resolution (45 microns) ultrasound backscatter microscope images of nine femoral and eight common carotid human artery samples were made and compared with corresponding histological sections. Individual tissue layers were selected using these images for quantitative measurement of the frequency dependent backscatter. Backscatter measurements were made in each layer of an artery at two different angles of incidence: along the axis of the artery (axial direction) and at 90 degrees to this measurement radially out from the center of the artery (radial direction). Scattering was found to be higher in elastic arteries (carotid) than in the muscular arteries (femoral). The largest difference was found in the media where the average scatter (measured in the radial direction at 50 MHz) increased from 0.002 sr-1 mm-1 in muscular arteries to 0.4 sr-1 mm-1 in elastic arteries. Large differences in scattering between measurements made in the axial and radial direction were also found. Again, the largest differences were found in the media where scattering (at 50 MHz) in carotid arteries increased from 0.003 sr-1 mm-1 measured in the axial direction to 0.4 sr-1 mm-1 measured in the radial direction. The speed of sound and attenuation in the artery wall of each sample were measured. Speed of sound measurements were found to range between 1579-1628 ms-1. The average attenuation in the artery wall increased from 4 dB mm-1 at 30 MHz to 10 dB mm-1 at 60 mHz. This is higher than the attenuation measured in blood which increased from 1.6 dB mm-1 to 5 dB mm-1 over the same frequency range. The backscatter coefficient for flowing blood was measured for flow velocities up to 36 cms-1. At flow velocities below 18 cms-1 a level of scattering of 0.0005 sr-1 mm-1 (at 50 MHz) was found. An increase in scattering of 1.6 times was measured when the flow velocity was increased to 36 cms-1. All measurements were made at 37 degrees C. The relevance of these results to clinical imaging and image interpretation is discussed. PMID- 1781069 TI - Change in amplitude distributions of Doppler spectrograms recorded below the aortic valve in patients with a valvular aortic stenosis. AB - Amplitude distributions of Doppler spectrograms were characterized in a group of 22 patients having no aortic pressure gradient and another group of 26 patients having a stenotic aortic valve. Specifically, for each patient, the ratios of the mean amplitude in three normalized frequency bands (low, middle and high) to the mean amplitude of the Doppler spectrogram computed in selected portions of the systolic period were considered. Pulsed-wave Doppler spectrograms were recorded by positioning the sample volume in the left ventricular outflow tract, approximately 1 cm below the aortic valve. Statistically significant differences were found between the middle (p = 0.041) and high (p = 0.028) frequency bands of Doppler signals recorded from the two groups of patients. The differences observed are believed to be attributed to blood flow eddies generated below the stenotic aortic heart valve and to changes in blood flow orientation. PMID- 1781070 TI - Flow velocity waveforms in the fetal inferior vena cava during the second half of normal pregnancy. AB - Fetal inferior vena cava (IVC) flow velocity waveform recording was attempted at the entrance into the right atrium in 60 women at 19-22 weeks, 27-30 weeks and 36 39 weeks of gestation. Technically acceptable waveforms were collected in 48 women. A significant increase in time-averaged velocity and a significant decrease in percent reverse flow with advancing gestational age was established. A large standard deviation was observed for various IVC waveform parameters. From preliminary postmortem data it appeared that the inferior venous entrance into the right atrium represents a funnel-like structure composed of the inlet of the IVC, hepatic veins and ductus venosus. It is suggested that waveform recording at the scanning level employed in the present study provides information on gestational age-related changes in venous return to the right atrium rather than changes in the IVC itself. It is proposed that information on IVC flow velocity waveforms should be obtained more distal to the venous entrance into the right atrium. PMID- 1781071 TI - Effect of maternal posture on the umbilical artery flow velocity waveform. AB - The effect of maternal postural changes on the umbilical artery flow velocity waveform, fetal heart rate and maternal blood pressure was studied in 27 normal singleton pregnancies between 23 and 36 weeks of gestation. A statistically significant change in umbilical artery Pulsatility Index (PI) was established for both maternal standing to supine position (rise) and supine to standing position (drop). These PI changes were not related to gestational age. A statistically significant drop in maternal systolic blood pressure was observed from standing to supine position. The rise in umbilical PI resistance when changing from standing to supine position may be caused by the sluice flow mechanism. PMID- 1781072 TI - Sonographic, clinical and genetic aspects of prenatal diagnosis of cystic kidney disease. AB - Cystic kidneys or renal cystic disease is a morphologic description for an etiological heterogeneous group of disorders ranging from solitary cysts to several forms of multicystic and polycystic kidneys. The combination of the examination of the kidneys and liver, clinical data, family history and the presence of associated anomalies is mandatory to obtain a final diagnosis. The use of prenatal ultrasound to monitor pregnancies at risk for autosomal recessive polycystic kidney disease (ARPKD) is limited because a recurrence can be diagnosed early in pregnancy but may not be excluded. For pregnancies at risk for autosomal dominant polycystic kidney disease (ADPKD), a reliable prenatal diagnosis can only be provided by DNA studies after chorionic villus sampling. Cystic kidneys may present as part of different syndromes. An overview is given of the complex differential diagnosis. Dysplastic (multicystic) kidneys often occur unilaterally. In contrast with polycystic kidneys, diseased liver changes are not present in cystic dysplasia and prenatal ultrasound diagnosis is usually possible. PMID- 1781073 TI - An investigation of simulated umbilical artery Doppler waveforms. III. The effect of noise reduction algorithms on the maximum frequency envelope and on the pulsatility index. AB - The effect of two noise reduction algorithms on the accuracy of estimation of the maximum frequency envelope and pulsatility index (PI) of simulated umbilical artery Doppler waveforms was investigated. The algorithms were: first, smoothing of the envelope from unfiltered Doppler spectra using a double window modified trimmed mean (DWMTM) filter and second, speckle and noise reduction of the Doppler spectrum using an image processing method. The test population consisted of waveforms were the degree of beam-vessel misalignment had been varied. The accuracy of estimation of the maximum frequency envelope and the PI was calculated by comparing each set of waveforms with the gold-standard maximum frequency envelope from the ensemble averaged waveform obtained with no misalignment. Speckle reduction gave rise to PI values that were low by approximately 0.1 (3%-4%). When there was no background noise present the improvements in envelope estimation were factors of 1.27 and 1.24, respectively, for the DWMTM method and the spectral filter, whereas the factors were 1.56 and 2.07 when background noise was present. For estimation of PI the DWMTM filter was superior. For no background noise the DWMTM filter gave a factor of 3.36 improvement whereas there was no improvement with the spectral filter. When background noise was present the factors for improvement in PI estimation were 2.39 and 4.16. PMID- 1781074 TI - The ultrasonic properties of gastric cancer tissues obtained with a scanning acoustic microscope system. AB - A newly developed scanning acoustic microscope (SAM) system operating in the frequency range of 100-200 MHz has been employed to measure the attenuation and the sound speed of formalin-fixed specimens of five different types of gastric cancer. Signet-ring cell carcinoma specimens exhibit attenuation constant and sound speed values significantly lower than other types of gastric cancer tissues. Tubular adenocarcinoma specimens exhibit a trend toward higher attenuation and sound speed values as the cell type became differentiated. Our measurements and observations suggest that the ultrasonic properties are influenced by cellular arrangement, intercellular junction and intracellular chemical components. PMID- 1781075 TI - Estimation of transient temperature elevation in lithotripsy and in ultrasonography. AB - Transient solutions of the thermal conductivity equation for the two-dimensional case of an elongated cylindrical focus in the ultrasonic beam were derived and applied for lithotripsy and obstetrical ultrasonography. Assuming uniform and Gaussian distributions in the focus of the beam cross section, it was possible to estimate the temperature elevation arising in lithotripsy for various repetition frequencies of shock-wave pulses and for various radii of the beam. In obstetrical ultrasonography where the blood perfusion is difficult to determine, the authors suggested that the insonation time be used as the decisive factor for the temperature determination. Values of focal intensities were found necessary to increase the tissue temperature by 1 degree C as a function of the insonation time and the beam radius which exclude the possibility of any hazardous effect caused by temperature elevation. PMID- 1781076 TI - Cyclic changes of blood echogenicity in high-frequency ultrasound. AB - Ultrasound images from human arteries obtained in vivo with an intravascular 30 MHz ultrasound imaging device show that blood echogenicity changes during the cardiac cycle. Quantitative measurements of blood echogenicity during the cardiac cycle suggest that these variations may be related to changes in the state of erythrocyte aggregation, which are induced by varying shear rate. PMID- 1781077 TI - Ultrasonic cavitation indirectly induces single strand breaks in DNA of viable cells in vitro by the action of residual hydrogen peroxide. AB - Direct exposure of cells to vigorous ultrasonic cavitation results predominantly in mechanical cell lysis, but latent effects due to production of toxic sonochemicals can also be present. Phosphate buffered saline (PBS) was exposed to 1.61 MHz ultrasonic cavitation at 20 degrees C in a rotating tube exposure system to build up sonochemical products. Single strand DNA breaks (SSBs) were then induced by treating Chinese hamster ovary (CHO) cells with the cavitated PBS for 30 min on ice. The SSBs resided in viable cells, as evidenced by their ability to repair the breaks when warmed. This indirect effect could be explained by the action of cavitation-generated hydrogen peroxide that had built up (e.g., to 16 microM after 30 min exposure) in the PBS. Dissolution of argon gas in the PBS before exposure enhanced the SSB effect and the H2O2 production. Addition of catalase to the cavitated PBS before cell treatment eliminated the H2O2 and the SSB gamma effect. Tests with hydrogen peroxide showed that 16 microM H2O2 treatment for 30 on ice was as effective as 1 Gy dose of 60Co gamma rays in producing single strand breaks. The SSB effect of H2O2 and gamma rays was reduced by addition of the radical scavenger cysteamine to the cells before treatment, but cysteamine did not reduce the SSB effect of direct exposure to ultrasonic cavitation. These results help to clarify the potential for genetic effects from ultrasonic cavitation. These effects help to clarify the potential for genetic effects from ultrasonic cavitation. PMID- 1781078 TI - Echoencephalography & hyperostosis. Frontalis interna. PMID- 1781079 TI - Vaginal discharge. PMID- 1781080 TI - Diagnosis of STD in developing countries. PMID- 1781081 TI - Diagnosis of STD in men in industrialized countries. PMID- 1781082 TI - The STD diagnostic network: priorities for diagnosis of STDs in resource-poor settings. PMID- 1781084 TI - Medical decision analysis. PMID- 1781083 TI - Evaluation of diagnostic tests. PMID- 1781085 TI - Operational models for dealing with sexually transmitted disease. PMID- 1781086 TI - Antigen detection tests for the diagnosis of sexually transmitted diseases: basic principles. PMID- 1781088 TI - Does this woman with pelvic pain have PID? PMID- 1781087 TI - Detection of sexually transmitted pathogens with nucleic acid techniques. PMID- 1781089 TI - The laboratory diagnosis of Chlamydia trachomatis. PMID- 1781090 TI - Laboratory diagnosis of gonorrhoea. PMID- 1781091 TI - The diagnosis of syphilis. PMID- 1781092 TI - Haemophilus ducreyi and other etiological agents of non-treponemal genital ulcer disease. PMID- 1781093 TI - General aspects on the diagnosis of HIV infection. AB - For the laboratory diagnosis of HIV infection antibody assays with unprecedented sensitivity and specificity have been developed. In combination with proper confirmatory tests, these assays enable an accurate diagnosis of HIV infection to be made in almost all cases. In special cases, most notably during very early infection, in seronegative individuals with strong suspicion of infection and in babies of infected mothers, other methods, in particular antigen detection, HIV isolation and PCR, may be utilized. PMID- 1781094 TI - Diagnosis of infections caused by hepatitis viruses. PMID- 1781095 TI - Immunological investigations of the genital tract. PMID- 1781096 TI - Methods in epidemiologic research. PMID- 1781097 TI - HIV and reproductive events. PMID- 1781099 TI - Urethral discharge in males. PMID- 1781098 TI - HIV prevention as exemplified by action taken in Italy. PMID- 1781100 TI - Accuracy of magnetic resonance imaging compared to computerized tomography and renal selective angiography in preoperatively staging renal cell carcinoma. AB - During 1986 and 1987, 47 patients with renal cell carcinoma were evaluated preoperatively with CT, angiography and MRI. The preoperative tumor stage (T), lymph node metastases and venous involvement determined with the three methods were compared to the operative and histopathological findings. For T stage, angiography proved less accurate (54%) than CT (64%) or MRI (63%). MRI was found to be superior to CT in assessing lymph nodes, with an overall accuracy of 89% and sensitivity of 100% compared to 77 and 60%, respectively, of CT. For venous involvement CT was overall more accurate (74%) than angiography (65%) or MRI (63%). All three methods expressed a low sensitivity (between 31 and 41%) and a high specificity (between 95 and 100%) for detecting venous involvement. The minimal advantages of MRI compared to its high cost do not justify its routine use. CT remains the method of choice in staging preoperatively renal cell carcinoma. PMID- 1781101 TI - Morphological and cytogenetic aspects of renal-cell carcinoma. AB - The medical history of 'hypernephroma' is characterized by errors which arose from the notion of 'disseminated adrenocortical foci.' Its origin from tubule epithelia of the kidney is on the other hand to be substantiated both in morphological and in immunological terms. Many attempts to arrive at a clinically serviceable establishment of the prognosis on the basis of the morphology have proved to be inadequate for the large group of the classical forms. Only the sarcomatous tumors and the oncocytes could be classified prognostically with sufficient certainty. An attempt is made in the present study to propagate the idea that besides the histogenetic, morphologically more or less tangible characteristics, molecular biological features are also important for the biological behavior of a tumor and should be used to appraise the prognosis. PMID- 1781102 TI - Does the immunophenotype of renal cell carcinoma correlate with its clinical stage? AB - The following comparative study is an analysis of the clinical data, morphology and immunophenotype of 93 patients who have been operated on for renal cell carcinoma. We were able to show a close link between the histological grade and the occurrence of distant metastases: 33% of the patients with grade III tumours versus 11.5% of the patients with grade I tumours had developed metastasis by the time of the surgery. Histological subtyping per se did not give prognostic hints. Immunohistochemistry has revealed an inconsistent reaction pattern for the cytokeratin marker K11 (18/22). For proper diagnosis a panel of cytokeratin markers should be employed. The reaction patterns of monoclonal antibodies against the epidermal growth factor receptor (EGFR) and against myelomonocytic antigens in normal renal tissue (positive for the tubulus system) and in renal carcinoma indicate that renal cell carcinoma derive from the tubulus system. The proliferation marker Ki-67 correlates well with the histological grading. Although only a limited number of snap-frozen tumours have been investigated, this study indicates that EGFR is expressed by normal and by malignant renal tissue and that Ki-67 may serve as a prognostic marker. PMID- 1781103 TI - Oncogenes and growth factors in renal cell carcinoma. AB - Oncogenes and growth factors play a role in normal cellular processes such as growth and differentiation. In addition, considerable circumstantial evidence indicates that these genes may be responsible for the induction and/or maintenance of human malignancies. There are different oncogene families; up to now only a small number has been tested in renal cancer cells. PMID- 1781104 TI - Classic and modern prognostic indicators in renal cell carcinoma. Review of the literature. AB - The value of classic and modern prognostic factors in renal cell carcinoma as reported in the literature is determined in a review. Tumor stage is the most important single independent prognostic factor. The presence or absence of distant metastases is highly prognostic and presence of lymph node metastases is of higher prognostic value than the presence of renal vein invasion. For each given tumor stage tumor grade (especially nuclear grade) is the most reliable additional independent prognostic factor predicting patient survival. The significance of DNA cytometry as an independent prognostic factor is less clear, though it might be useful in combination with nuclear grading. Patient-related potential prognostic factors such as age, sex and serologic parameters are of lesser, if any, importance. In the future, data from molecular analysis on oncogenes and suppressor genes are likely to provide additional prognostic information. PMID- 1781105 TI - Partial nephrectomy for renal carcinoma. AB - A change in the patient population with kidney tumors has reactivated the discussion on conservative procedures. The asymptomatic low-stage tumors are over represented. A majority of these patients are eligible for conservative surgery, with a statistical risk identical to that of radical procedures. However, an excess need of security and the absence of a specific biological marker often exclude submaximal solutions. The possibilities of partial nephrectomies for small renal tumors are actually underexploited. PMID- 1781106 TI - Inferior vena caval tumor extension in renal cell carcinoma. AB - Tumor extension into the inferior vena cava occurs in 4-10% of renal cell carcinomas. The presence of such inferior vena caval involvement by tumor may be considered the only extrarenal manifestation of renal cell carcinoma which does not significantly affect prognosis which is determined by lymphatic and blood spread distant metastasis. The indication for operation should therefore not be restricted by the presence of tumor in the inferior vena cava, but the operative approach is influenced by the extent of the tumor thrombus. For this reason, precise preoperative diagnosis is crucial. PMID- 1781107 TI - Anatomy and pathophysiology of Peyronie's disease and congenital deviation of the penis. AB - 42 specimens from resected plaques of Peyronie's disease (IPP) and connective tissue obtained according to Nesbit were examined microscopically. The specimens were divided into three layers and the respective structures were counted in each layer in 15 fields of view with 100-fold magnification. 14 of 20 patients i.e. 70% of patients with IPP showed more than 10 perivascular infiltrates of lymphocytes and plasma cells/45 fields. 60% of all infiltrates were localized in the mid portions. 30% in the dorsal aspect and only 10% in the lower layers near the corpus spongiosum, where IPP is supposed to have its origin. A significant reduction of the quantity of inflammatory infiltrates related to the duration of the disease could not be proved. The same applies to vascular sections. The total number of vascular cross-sections found in the IPP plaque is 3 times as high as in the macroscopically inconspicuous tissue obtained according to Nesbit. 61% of blood vessels were localized in the mid portion, 22.3% in the dorsal aspect and only 16.5% in the basel portion near the corpus spongiosum. Bone formation was found in 4 of the 20 analyzed specimens from patients with IPP. These quantitative morphological studies have shown that the plaque undergoes reactive processes which even persist after years. PMID- 1781108 TI - Evaluation of conservative therapeutic approaches to Peyronie's disease (fibrotic induration of the penis). AB - Conservative approaches to the treatment of Peyronie's disease are limited. Irradiation is of no value because the efficacy has not been proven and it may cause tissue damage requiring or hampering subsequent surgery. Vitamin-E therapy is ineffective and is also not recommended. p-Aminobenzoate treatment has to be discontinued because of intolerance in one third of the cases, and the response rate is not superior to that of a placebo. Local infiltration of the plaques with orgotein (Peroxinorm) results in a marked improvement in just under 50% of cases and is therefore a justified approach in the early stages of the disease. It is, however, unclear how great the placebo effect and the spontaneous remission rate are. Surgery suited to the individual case must be considered in patients with severe angulation of the penis rendering introitus impossible, calcium deposits, or worsening of the condition despite injections of Peroxinorm. PMID- 1781109 TI - Surgical treatment of Peyronie's disease. AB - Surgical measures usually represent the last step in the treatment of Peyronie's disease. Straightening of the penile shaft and relief of pains during erection are the main goals of the operation. From December 1987 to April 1990, 11 patients with a mean age of 58.3 years underwent surgical treatment. Three of them complained of erectile dysfunction prior to surgery. The plaques were located distally in 8 patients, proximally in 1 patient and in the middle of the shaft in 2 patients. Complete resection was performed and defects of the tunica albuginea were closed by means of running sutures (3 patients) or grafts of autologous skin (5 patients) and lyophilized dura mater (3 patients), respectively. After a mean follow-up of 21 months, 6 patients reported spontaneous erections, whereas 3 patients needed corpus cavernosum autoinjection therapy. In 2 cases implantation of a penile prosthesis was necessary. Surgical treatment of Peyronie's disease yields satisfactory results if conservative therapy proves unsuccessful. However, diagnostic evaluation of erectile dysfunction should precede operative treatment and if present, be treated accordingly. PMID- 1781110 TI - Collagen content in the rat urinary bladder following removal of an experimental infravesical outlet obstruction. AB - A partial urethral obstruction was induced in female rats. After 6 weeks, detrusor weight had increased eightfold and collagen concentration had decreased to about 40% compared to controls. Due to the weight gain, the total amount of detrusor collagen had increased more than threefold. Removal of the obstruction led to a rapid decrease in detrusor weight to 70, 34 and 30%, 2, 4 and 6 weeks postobstruction, although control levels were not reached. Collagen content decreased more slowly than detrusor weight, and for the same groups was 97, 69 and 67% of the value in the obstructed detrusor. This led to a rapid increase in detrusor collagen concentration which already 4 weeks after removal of the obstruction had increased to a level that did not significantly differ from the control value. The discrepancy between decrease in detrusor weight and in collagen content after removal of the obstruction suggests that a large proportion of the collagen synthesized during the period of outlet obstruction remained. Changes in the ratio between muscle and nonmuscle tissue were limited between control, obstructed and nonobstructed bladders. This suggests that the collagen concentration following obstruction and removal of obstruction is to a large extent due to changes in collagen concentration in the interstitial connective tissue rich in collagen. PMID- 1781111 TI - Combined effect of interleukin 2 and bacillus Calmette-Guerin in the therapy of mice with transitional cell carcinoma. AB - We investigated the effect of combination therapy with interleukin 2 (IL-2) and Bacillus Calmette-Guerin (BCG) on C3H/HeN mice implanted with mouse bladder tumor cells (MBT2). MBT2-bearing mice were treated with a local injection of BCG into the tumor at a dose of 1 mg/day for a total of 3 times and/or a 10-day continuous subcutaneous infusion of 5 x 10(4) units IL-2/day from day 11 to day 20. As a result, the growth of the tumor in mice treated with IL-2 alone was slightly suppressed, while tumor growth was hardly suppressed in mice treated with BCG alone. However, when IL-2 was administered with BCG, tumor growth was strongly suppressed and mean survival time was prolonged. Natural killer cell activity in the spleen cells was most elevated in mice treated with IL-2 and BCG, while lymphokine-activated killer cell activity was not observed in all groups. Lymphocyte subset analysis showed that there was little change in the ratio of Lyt2-positive lymphocytes or that of L3T4-positive lymphocytes. These findings suggested that clinical evaluation of combination therapy with IL-2 and BCG may be worthwhile. PMID- 1781112 TI - Aspects on estimation of the risk of calcium oxalate crystallization in urine. AB - A previously formulated simplified estimate of the ion activity product of calcium oxalate, AP(CaOx) index, was modified in order to better correspond numerically to the ion activity product obtained by computed iterative approximation with the EQUIL 2 program. The new index, AP(CaOx) index EQ, was given the following form for a 4-hour urine: 1.9 x Ca(0.84) x Ox x Mg-(0.12) x Cit-(0.22) x V-(1.03), where the excretion of calcium, oxalate (Ox), magnesium and citrate (Cit) was expressed in millimoles excreted during the period, and urine volume (V) in liters. There was a good correlation between AP(CaOx) index and AP(CaOx) index EQ (r = 0.98). A standardized index calculated for a 24-hour urine volume of 1.5 liters, AP(CaOx) index EQ(s), was significantly higher in stoneforming men (p less than 0.001) and women (p less than 0.001) than in normal subjects. The mean ion activity products of CaOx at the start of crystallization in salt solutions and dialyzed urine were 2.74 +/- 0.25 x 10(-8) and 3.50 +/- 0.33 x 10(-8) (mol/l)2, respectively. In the urine from normal subjects, AP(CaOx) index EQ at the point of crystallization was 4.3 +/- 1.1 and in the urine from stone formers 2.8 +/- 0.5 (p less than 0.001). From calculation of AP(CaOx) index EQ in hourly collected urine, it was assumed that the risk of exceeding the level where crystallization starts during periods with the highest supersaturation can be anticipated when the 24-hour AP(CaOx) index EQ value exceeds 2.0. PMID- 1781113 TI - [Our experience in single-stage bilateral cataract extraction]. PMID- 1781114 TI - [Technique of suprachoroidal space drainage in the prevention and treatment of ciliary-choroidal detachment after glaucoma surgery]. AB - The authors recommend cross-like sclerotomy to prevent and treat a ciliary choroidal detachment after antiglaucoma surgery. Double cross-like sclerotomy was performed in the upper half of the eye simultaneously with trabeculectomy in 30 patients with open-angle glaucoma to prevent the development of ciliary-choroidal detachment. Thirty patients subjected to similar surgery but without prophylactic sclerotomy have made up the reference group. The results evidence that double cross-like sclerotomy is an effective method for the prevention of ciliary choroidal detachment: the incidence of this complication has dropped by 8 times (from 26.7 to 3.3%). Gross-like sclerotomy performed to treat utricular ciliary choroidal detachment resulted in cure in all the 14 cases. The suggested sclerotomy technique is simple and low-traumatic. PMID- 1781115 TI - [State of the cornea after early surgery of congenital cataract with subsequent contact correction]. AB - Eighteen cases (28 eyes) with congenital cataracts are analyzed. Transciliary lensectomy technique was used for cataract extraction (the ages of the infants at the moment of surgery varied from 3.5 to 16 months), aphakia was corrected by highly hydrophilic soft contact lenses worn during the daytime. The limbic vessels, corneal epithelium, endothelium, and thickness were examined. No changes in the epithelium were revealed. Only in one case a trend to a moderate dilatation of a limbic vessel in the upper segment was seen in the presence of microphthalmia. Analysis of endothelial morphometry data has revealed a universal tendency in all the cases: cell square increased and their density reduced (by 45 and 19%, respectively) immediately after surgery. Wearing of contact lenses was associated with a somewhat rise of the cell count, this count persisting below the norm by 10% on an average. Corneal thickness increased by 0.05 mm after surgery and by 0.03 mm during lens correction. PMID- 1781116 TI - [Umbilical tissue transplantation in progressive myopia]. AB - A new allo-scleroplasty material, umbilical tissue, easily available in clinical practice, is suggested for allo-scleroplasty in progressive myopia. A total of 229 operations were carried out in 144 patients. Indications to and contraindications against umbilical allo-scleroplasty in progressive myopia were defined and the choice of the surgical technique validated. Immediate results of surgery and postoperative complications are analyzed. Umbilical tissue preservation in thymol and lithium chloride solution was found proof enough against the development of postoperative complications. The functional effects achieved by umbilical allo-scleroplasty persisted in remote periods after surgery. PMID- 1781117 TI - [Use of low-frequency ultrasound in preoperative care of the conjunctival cavity]. AB - Experimental and clinical studies of the efficacy of preoperative treatment of the conjunctival cavity with low-frequency ultrasound were carried out. Ultrasound parameters employed were as follows: 20-70 kHz frequency, 25-35 microns oscillation amplitude, length of exposure 60-120 sec. Such treatment was found to reduce bacterial contamination of the conjunctival cavity. Clinical studies were carried out on 20 eyes of 14 patients operated on for cataracts and glaucomas at the department for ocular diseases of the Moscow municipal clinical hospital No. 15. Low-frequency ultrasound treatment of the conjunctival cavity was carried out before surgery in all these patients. In the reference patients (n = 15, 15 eyes) the conjunctival cavity was washed with 1:5000 furacilin solution and 30% sodium sulfacil solution or kanamycin solution (10,000 U in 1 ml) on the operation table. The bacterial contamination of the conjunctival cavity prior to surgery in 24 eyes has made up 84.1 bacterial colonies per Petri dish on an average. Preoperative treatment of the conjunctival cavity with low frequency ultrasound has reduced the bacterial contamination to 6.3 colonies per Petri dish, i.e. by 13.3 times. PMID- 1781118 TI - [Low-intensity helium-neon laser irradiation in multimodal treatment of corneal injuries]. AB - He-Ne laser stimulation was used in multiple-modality treatment of 512 patients with various corneal conditions: 217 with perforating wounds, 75 with chemical and thermal burns, 48 with ulcers of various origins, and 162 with endothelial epithelial dystrophy resulting from cataract extraction with implantation of the intraocular lens. A course of treatment consisted of 6 to 10 daily 3 min exposures at radiation power density of 50-100 micro W/cm2 on the cornea. The effect achieved by laser stimulation was significantly superior to that of routine methods of treatment used in the reference groups. He-Ne laser stimulation was conducive to a sooner reduction of the inflammatory processes, to recovery of the corneal sensitivity and epithelialization, and to shortening hospital treatment. PMID- 1781120 TI - [Ergonomic analysis of the results of radial keratotomy]. AB - The examinations carried out before and in various periods after surgery (in 3, 6, and 12 months) included assessment of the visual function at a short distance (vision acuity, absolute accommodation volume, relative accommodation reserve, ciliary muscle working capacity, vision production, subjective assessment of the vision from a short distance), sensitivity to glare, sensitivity to changed contrast, and dusk vision status. The best condition for studies at a short distance after surgery are created in patients with high myopia, whereas in medium and weak myopia a period of adaptation to close vision is necessary. The studies have revealed a reduced sensitivity to changed contrast and elevated sensitivity to glare. No reliable data on changes in the light sensitivity were available. PMID- 1781119 TI - [Results of phlebo-destruction surgery and blood rheology indicators in patients with central chorioretinal dystrophy]. AB - Hemorheologic parameters were analyzed in 34 patients with central chorioretinal dystrophy and the effects of these parameters on the outcome of phlebodestruction studied. Blood viscosity and red cell aggregation coefficient were found increased in such patients. Phlebodestruction was found ineffective in the patients with significant disturbances of blood rheology. The authors come to a conclusion on the usefulness of using blood rheologic parameters for the prediction of phlebodestruction surgery outcome in patients with central chorioretinal dystrophy. PMID- 1781121 TI - [Experience in the use of streptodecase in the treatment of intraocular hemorrhage]. AB - Addition of streptodecase to combined therapy of intraocular hemorrhages, mainly of vascular origin, in 37 patients improved the treatment efficacy. This manifested by a noticeable improvement of the vision acuity and by a more marked and complete resorption of the hemorrhages. The results were better if the drug was administered in the earliest periods of the disease. Local allergic reactions, seen in 27% of patients, were the most frequent side effect of streptodecase therapy. PMID- 1781122 TI - [Clinical aspects of inflammatory diseases of the orbit of autoimmune origin]. AB - Basing on her clinical experience, the author describes and distinguishes three autoimmune diseases of the orbit, clinically coursing like a true tumor of the orbit, but characterized by morphologic signs of nonspecific inflammatory granulomatous process: orbital vasculitis (pseudotumor variety), Wegener's disease, and orbital sarcoidosis (Besnier-Boeck-Schaumann's disease). PMID- 1781123 TI - [Validation of the use of brachytherapy in uveal melanomas of juxtapapillary localization]. AB - Forty-two patients with juxtacapillary melanomas of the choroid were treated by brachytherapy. The treatment was carried out in two stages: Stage I--separating laser coagulation, Stage II--irradiation with ophthalmologic applicators (90Sr, 90I). Complete resorption was achieved in 12 patients, partial regression with the process stabilization in 17, no effect in 13, in 11 of these enucleation had to be performed. The mean follow-up period has made up 6.8 years. Analysis of brachytherapy results has lead the authors to a conclusion that this treatment modality may be considered as enucleation alternative in patients with juxtacapillary melanomas located by the optic disk and covering not more than 1/3 of its perimeter, with the prominence of less than 3 mm; brachytherapy applicator in this case should be US monitored. PMID- 1781124 TI - [Possibilities of ultrasound biometry in the differential diagnosis of early melanomas and nevi of the choroid]. AB - The authors analyse the results of echobiometry carried out in 21 patients with choroid nevi and in 8 patients with primary melanomas of the choroid, administered no treatment for this or that reason. Nevi with a prominence of less than 1 mm were found to be the most incident, and their elevation did not increase over the course of the follow-up. Only in two patients with nevi these formations were found elevating, this corresponding with the manifestation of clinical signs of primary melanoma. The tumor progress was clearly seen in the patients with primary melanoma of the choroid, it was permanently elevating. PMID- 1781126 TI - [Study of binocular vision by the binary metric method]. AB - The authors describe a method for binocular vision studies with the use of spatial visual effects emerging when double images are fused in physiologic diplopia. Various forms of binocular cooperation were detected and a clinical classification of these forms developed, based on the ability to obtain a binocular visual image. One of the distinctions of the suggested method is the detection of not only binocular fusion, but of the ability to in-depth perception. The authors analyze the status of binocular function in subjects with various forms of binocular sensor cooperation, basing on binary metric data and the findings of the color test and synaptophore studies. Binocular cooperation impairments, detected by binary-metry, appear less severe than if detected by the color test or synaptophore studies in the same patients. PMID- 1781125 TI - [Role of biopotentials of the retina in the study of mechanisms of the development of nystagmus]. AB - Total and local electroretinograms were studied simultaneously with registration of visual evoked potentials in 174 patients with nystagmus without pathologic shifts in the anterior section of the eyeball. Clinical and electrophysiologic findings permitting dividing the patients with nystagmus into two groups with different prognosis of the disease course: that without apparent changes in the fundus oculi with normal and subnormal parameters of the total and local ERG and that with pathologic changes in the retina and optic nerve and the corresponding electrophysiologic symptoms. Central mechanisms of nystagmus origin may be supposed in Group 1; visual function improved after pleoptic treatment. In Group 2 sensory mechanisms of nystagmus development are possible; visual functions did not improve after therapy. The mechanisms of vision deterioration in nystagmus are to be studied. PMID- 1781127 TI - [A case of Axenfeld's syndrome]. AB - This syndrome has occurred in three generations of one family. It involves congenital aniridia, lens opacity, congenital glaucoma because of anterior chamber angle dysgenesis. The authors emphasize a high risk of inheriting this condition and recommend the subjects suffering from it consult medical geneticists if they wish to marry and have children. PMID- 1781128 TI - [A case of recurrent gonoblennorrhea conjunctivitis]. PMID- 1781129 TI - [Experience in the organization of offices for specific vision correction]. AB - Three new kits of optic devices for the selection of means facilitating orientation in the space, for writing, reading, and other work involving the visual control, and devices that help operate these kits have been developed for rooms organized to correct the vision of poor-sighted patients. Problems of training personnel and rehabilitationologists for work at enterprises for blind people are discussed, as are those concerned with production, use, and realization of optic amplifiers. PMID- 1781130 TI - [A method of treatment of open-angle glaucoma]. AB - Describes a new surgical technique consisting in combination of trabeculectomy and formation of intrascleral drainage routes. Presents the immediate and late results of antiglaucoma interventions carried out according to the suggested method in 187 patients (200 eyes) with various stages of primary open-angle glaucoma. PMID- 1781132 TI - [Causes, terminology and classification of blood circulation disorders in the optic nerve vessels (review of the literature)]. PMID- 1781131 TI - [Correction of aphakia after early surgery of congenital cataracts (review of the literature)]. PMID- 1781133 TI - [Apiotherapy of eye diseases (review)]. PMID- 1781134 TI - [Several aspects of the pathogenesis of vitreoretinal proliferation (review of the literature)]. PMID- 1781136 TI - Experimental reproduction of acute lesions of porcine pleuropneumonia with a haemolysin-deficient mutant of Actinobacillus pleuropneumoniae. AB - The role of the heat-labile haemolysin of Actinobacillus pleuropneumoniae in acute porcine pleuropneumonia was examined. A virulent strain was compared with an isogenic haemolysin-deficient mutant in experimental infections. The pigs which received the virulent strain showed clinical signs of acute respiratory disease whereas the animals infected with the mutant strain appeared to be less severely affected. At post mortem examination, both groups showed similar acute pulmonary lesions and pleurisy typical of A pleuropneumoniae infection. The bacterial antigen representing the haemolysin was detected in lung lesions infected with the parent strain but not in those infected with the mutant. These results demonstrate that the haemolysin of serotype 2 A pleuropneumoniae is not an essential factor for the production of the lesions of pleuropneumonia in pigs. PMID- 1781135 TI - [Clinical evaluation of the hypotensive effectiveness of Betoptic preparation]. AB - Clinical trials of the hypotensive effect of 0.5% betoptic, an antiglaucoma drug manufactured by Alcon (USA), were carried out at three ophthalmologic hospitals. Similar results obtained in all the trials permit a conclusion on a high hypotensive efficacy of this drug in patients with primary open-angle glaucoma. The drug was well tolerated by the patients. PMID- 1781137 TI - A mild outbreak of bovine mastitis associated with Mycoplasma bovigenitalium. AB - Mycoplasma bovigenitalium was isolated from milk samples from 16 of 99 cows on one farm during a 15-week period in the summer of 1986. One cow was severely affected, four cows had relatively mild signs of mastitis, and three had only altered dry-cow udder secretions. Eleven of the infected cows were dry and three had been calved less than 48 hours. The abrupt method of drying-off and improvements in cleaning of the milking equipment were introduced, but no other control measures were instituted to eradicate the mycoplasma infections. After this mild outbreak of mastitis the herd was monitored for the next 17 months. In total 19 cows had a mycoplasma isolated from udder secretions. Acholeplasmas were isolated from 14 cows but were not associated with clinical mastitis. The udder infections with mycoplasmas apparently resolved without resorting to the segregation and culling of infected animals. PMID- 1781138 TI - Fatal nephrosis in a cat after topical application of fenthion. PMID- 1781139 TI - Homoeopathic remedies. PMID- 1781140 TI - Tackling hereditary diseases in dogs. PMID- 1781141 TI - Veterinary prescription diets. PMID- 1781142 TI - Echinostomatid flukes in pigeons. PMID- 1781143 TI - Paresis in dogs and Neospora caninum. PMID- 1781144 TI - A simple, rapid method for differential cell counts in porcine mammary secretions. AB - The use of the fluorescent dye acridine orange for making differential cell counts in mammary secretions from sows was investigated, and the variations in cell type during the lactation period were also studied. In untreated samples of mammary secretions polymorphonuclear leucocytes, mononuclear phagocytes, lymphocytes and epithelial cells could be identified with certainty, and the methodological error was small (1.80 to 2.22 per cent). The mammary secretions could be stored at 4 degrees C for six hours without any effect on the differential count. Washing the secretions decreased the percentage of polymorphonuclear leucocytes and increased the percentage of epithelial cells. The polymorphonuclear leucocytes predominated in colostrum (58.0 to 65.5 per cent) and epithelial cells predominated in milk (60 to 89 per cent). Polymorphonuclear leucocytes were the predominant phagocytes in all mammary secretions (7.6 to 65.5 per cent). PMID- 1781145 TI - Mortality during an outbreak of blue wing disease in broilers. PMID- 1781146 TI - Confirmation of degenerative effects on psoroptic mites from scab lesions. PMID- 1781147 TI - An investigation of size in Irish wolfhounds with supraventricular cardiac arrhythmias. PMID- 1781148 TI - Embryo transfer. PMID- 1781149 TI - Control of blow fly strike in sheep by coumarin. PMID- 1781150 TI - Avian immunology and immunosuppressive diseases. PMID- 1781151 TI - Nutrition--mechanisms of immunosuppression. AB - Nutritionists must formulate diets that supply adequate amounts of nutrients from five major groups. These are carbohydrate, protein (amino acids), fat, minerals and vitamins. Carbohydrate is usually a cheaper source of energy than fat, but fat is often used to increase the caloric concentration of the diet. Variations in energy intake which may effect immunocompetence usually result from management practices rather than diet formulation. Feed restriction for broiler breeders and withholding feed in forced molting practices may affect immunocompetence. Feed restriction causes higher plasma corticosterone levels, which are known to decrease the immune response, possibly through effects on cytokines. Excessive feed, through forced feeding, may also have short-term effects on indicators of humoral immunity. Protein and amino acid nutrition have been studied in relation to immunocompetence. The level of dietary amino acid needed to maximize growth and feed efficiency will also generally maximize measures of immunocompetence. The level of amino acids needed for maximum growth is lower in chicks which have been immunologically stressed than in chicks which have not. An immune response changes metabolism so that less growth occurs, thereby decreasing the need for amino acids. Dietary levels of minerals can affect immunocompetence. While deficient levels of sodium and chloride decrease humoral immunity, levels of these nutrients which supported maximum growth also supported maximal humoral immunity. Low dietary zinc levels did not affect indicators of immunocompetence in the chick. The effect of fat soluble vitamin levels on the immune system has been studied. Vitamin A is needed to maintain epithelial tissue and prevent infection. Cellular immune response is decreased when the chick is deficient in this nutrient. Several indicators of immune responsiveness are depressed when chicks are vitamin E and/or selenium deficient. Since these nutrients serve as antioxidants, cellular integrity may be affected by a deficiency. Cellular integrity is very important for receiving, and responding to the messages needed to coordinate an immune response. High levels of vitamin E (greater than 10 times the required level) have been found to be immunostimulatory. PMID- 1781152 TI - Immunogenetics and the major histocompatibility complex. AB - The poultry immune system is a complex system involving many different cell types and soluble factors that must act in concert to give rise to an effective response to pathogenic challenge. The complexity of the immune system allows the opportunity for genetic regulation at many different levels. Cellular communication in the immune response, the production of soluble factors, and the rate of development of immune competency are all subject to genetic influences. The genes of the major histocompatibility complex (MHC) encode proteins which have a crucial role in the functioning of the immune system. The MHC antigens of chickens are cell surface glycoproteins of three different classes: Class I (B F), Class II (B-L) and Class IV (B-G). The MHC antigens serve as essential elements in the regulation of cell-cell interactions. The MHC has been shown to influence immune response and resistance to autoimmune, viral, bacterial and parasitic disease in chickens. The MHC has been the primary set of genes identified with genetic control of immune response and disease resistance, but there are many lesser-characterized genes outside of the MHC that also regulate immunoresponsiveness. Polygenic control has been identified in selection experiments that have produced lines of chickens differing in antibody levels or kinetics of antibody production. These lines also differ in immunoresponsiveness and resistance to a variety of diseases. Understanding the genetic bases for differences in immunoresponsiveness allows the opportunity selectively to breed birds which are more resistant to disease. Indirect markers that can be used for this selection can include the MHC genes and immune response traits that have been associated with specific or general resistance to disease. PMID- 1781153 TI - Overview of the avian immune system. AB - The avian immune system operates on the same general principles as the mammalian immune system. Antigenic stimulation initiates an immune response that involves cellular cooperation most notably between macrophages, B lymphocytes and T lymphocytes. Macrophages process the antigen and present the antigen to the lymphocytes. B lymphocytes, the principal cells that mediate humoral immunity, transform into plasma cells and produce antibodies. T lymphocytes, most important for cellular immunity, differentiate into functionally diverse subpopulations. The subpopulations of avian T cells have been identified with monoclonal reagents and appear to be similar to those of mammalian T cells. Lymphokines, the soluble products secreted by immune cells, mediate the functions of these cells. Studies on avian lymphokines have lagged behind those on mammalian lymphokines because the genes coding for avian lymphokines have not been cloned. The avian lymphokines studied thus far appear to function along the same lines as the mammalian lymphokines. The immune response in birds is highly regulated and breakdown in regulation often results in immunodepression. PMID- 1781154 TI - Mechanisms of immunosuppression. AB - Immunosuppresive disease is a major economic concern in domestic poultry production. Although many immunosuppressive agents have been described, mechanisms of how infectious and noninfectious agents compromise the immune system are poorly understood in avian species. Two categories, generalized and antigen-specific immunosuppression have been described in mammals. Generalized immunosuppression produces overall reduced responsiveness and increased susceptibility to a wide variety of infectious and neoplastic diseases. The best characterized immunosuppressive mechanisms are described in HIV-1 infections that lead to acquired immune deficiency syndrome (AIDS) in humans. In contrast, the antigen-specific suppression observed in human leprosy illustrates how an infecting agent selectively suppresses host responses against itself favoring bacterial spread. Both diseases have well-defined clinical staging classifications that correlate with specific immunological defects. An approach to studying immunosuppressive mechanisms in the avian suggests the need for relating pathogenesis with tests of immune responsiveness using a series of increasingly more specific immunological assays to pinpoint defects. PMID- 1781155 TI - Historical perspective: the bursa of Fabricius and its influence on B-cell development, past and present. AB - The bursa of Fabricius has a history and a future. The history included its description by Hieronymus Fabricius and the discovery in the 1950s of its pivotal role in humoral immunity. The apparent obligate role of the bursa in B-cell development was modified by research in the 1960s and 1970s which described the synthesis of immunoglobulin in bursaless birds and led to the concept of extra bursal sites. Then in the 1980s, supported by the research of the past 25 years and the new technology, the obligate role of the bursa in orchestrating the V gene repertoire-antibody diversity was revealed. Microenvironmental studies in the 1970s and 1980s announced the importance of bursal epithelium, secretory dendritic cells, and other reticuloepithelial cells in interpreting the ontogeny of B-cell differentiation. The past history of the bursa will be remembered for its contribution to present and future research and the present and future will be promising if the experiences of the past are not forgotten. PMID- 1781156 TI - Pathology of lymphoid organs with emphasis on immunosuppression. AB - A review of the literature is presented to include recent diagnostic and research histopathology accessions from poultry produced on the Delmarva peninsula region of the U.S.A. Emphasis is placed on immunosuppression (IS) and pathology of primary lymphoid organs of the chicken. The evolutionary relationship of the avian and mammalian lymphoid systems is based on a common reptilian past with 160 million years of evolutionary dichotomy. Four methods used to assess IS anatomically include: (1) recognition of marked reduction of lymphocytes in both primary and secondary lymphoid organs; (2) recognition of diseases commonly associated with IS; (3) recognition of known immunosuppressive diseases; (4) germinal center enumeration. An experimental method of qualifying and quantifying IS related to single or multiple insults is explored through the use of germinal center enumeration. The effect of stress and inanition on avian lymphocytes must be considered in histological evaluations as chickens are a steroid sensitive species. PMID- 1781157 TI - Chicken anemia agent. AB - Chicken anemia agent (CAA) is a small, spherical, non-enveloped virus containing a circular single-stranded DNA genome. CAA remains unclassified and probably should be classified in a new virus family. The chicken is the only recognized natural host for CAA. CAA was initially isolated in Japan and the associated disease chicken infectious anemia described in 1979. The virus has a world-wide distribution and is common in intensive poultry raising areas. Chicken infectious anemia is not a new disease but a newly recognized disease. CAA is now thought to play a key role in several multiple etiology disease syndromes; hemorrhagic syndrome; aplastic anemia, gangrenous dermatitis, hemorrhagic anemia syndrome, hemorrhagic aplastic anemia syndrome, anemia dermatitis and blue wing disease. The pathogenesis of chicken infectious anemia is described. Vertical transmission appears to be more important than horizontal spread. A yellow fatty bone marrow is the most characteristic lesion and thymic atrophy is the most consistent finding in CAA infection. Thymic and bone marrow intranuclear inclusion bodies occur with infection but are of limited value diagnostically and are very transient and rarely seen. Five different disease-producing scenarios that lead to clinical CAA infection in young chickens are presented. PMID- 1781158 TI - Mycotoxicosis: mechanisms of immunosuppression. AB - Mycotoxins are structurally diverse secondary metabolites of fungi that grow on feedstuffs consumed by animals and man. The clinical toxicologic syndromes caused by ingestion of fungal toxins have been characterized in domestic animals, poultry and laboratory animals and range from acute mortality to decreased production. Consumption of some mycotoxins, at levels that do not cause overt clinical mycotoxicosis, suppress immune functions and may decrease resistance to infectious disease. The sensitivity of the immune system to mycotoxin-induced immunosuppression arises from the vulnerability of the continually proliferating and differentiating cells that participate in immunemediated activities and regulate the complex communication network between cellular and humoral components. Mycotoxin-induced immunosuppression may be manifested as depressed T or B lymphocyte activity, suppressed immunoglobulin and antibody production, reduced complement or interferon activity, and impaired macrophage-effector cell function. Although the cellular-molecular basis for many of the specific immunosuppressive effects of mycotoxins are presently unclear, inhibition of DNA, RNA and protein synthesis via a variety of different mechanisms appears to be directly or indirectly responsible for the immunosuppressive action of many mycotoxins. PMID- 1781159 TI - Stress--mechanisms of immunosuppression. AB - Stress, a term commonly used to describe varied phenomena, should be restricted to describe an adaptive response by an animal to threats to homeostasis. The threats to homeostasis are called stressors. Stressors include a variety of physical, psychological, chemical, or infectious causes that are modified by intrinsic and extrinsic factors. Examples of modifiers include stressor severity, duration, novelty, host genetics and immune status. What may be a stressor to an animal in one situation, when modified, may not be a stressor in another situation. Mechanisms of stress once thought to involve a single pathway described by Seyle as the General Adaptation Syndrome, have been rejected. Four pathways, some incompletely defined, have been implicated in modulation of the immune system. They include autonomic nervous system, the hypothalamic adrenal axis, extra-adrenal pathways involving neuropeptides and neurotransmitters and neuroimmunological mediators. The mechanisms of stress-induced immunosuppression resistance are poorly defined in domestic fowl and will require careful experimentation linking defined stressors with altered physiological responses that affect specific immune function and result in increased disease susceptibility. PMID- 1781160 TI - [The effect of turpentine baths on the function of the cardiorespiratory system in athletes]. PMID- 1781162 TI - [The effect of the internal use of radon water on the recovery processes in experimental stomach ulcer]. AB - Radon experiments have established that oral courses of water containing either radon or its decay products in optimal doses can promote healing of gastric ulcer. The speed of such healing is believed to depend on the dose absorbed by a thin layer (about 100 microM) of gastric mucosa. PMID- 1781161 TI - [The effect of balneotherapy on the gastrointestinal hormone level of patients with digestive organ diseases subjected to small doses of radiation exposure]. AB - Balneotherapy with several mineral waters at health resorts proved effective in 228 patients with GI diseases. All of them were exposed to low-dose radiation as a result of the Chernobyl accident. Such treatment promoted a decrease in initially elevated basal level of insulin, improved production of gastrin and C peptide. PMID- 1781163 TI - [The immunological rehabilitation of patients with chronic nonspecific lung diseases at sanatoria and health resorts]. AB - Basing on the data obtained from a comparative study of hypoxia-hypercapnia training according to "return" respiration versus an apilactose course in patients treated in sanatoria for chronic nonspecific pulmonary diseases, the authors developed an effective complex correcting local, systemic immunity and hormonal levels. PMID- 1781164 TI - [The effect of mud treatment on the function of the bile-secreting system]. AB - Ultrasonic scanning following a course of mud therapy found out a stimulatory effect of the treatment on gallbladder motility. The bile composition reflected an anti-inflammatory action of mud applications which also enhanced bile lithogenesis. PMID- 1781165 TI - [Early rehabilitative physiotherapy following the microsurgical reconstruction of the fallopian tubes (a clinico-chronobiological validation)]. AB - Three preformed physical factors (low-frequency alternating magnetic field, supersonic frequency current, low-frequency monopolar square-wave impulses for electrostimulation of the uterine tubes) were tested in aftercare following plastic microsurgery in gynecology. The treatment can be started as early as postoperative day 1. The criteria of the differential choice of the modalities have been developed. The use of the above physiotherapy was found valid. PMID- 1781166 TI - [The action of an impulse magnetic field on the motor function recovery of the peripheral nerve trunks]. AB - The cut sciatic nerve trunk was sutured perineurally to study in chronic rabbit experiments of the neuromuscular functional recovery upon the exposure to impulse magnetic field with the intensity 1.2 T. Nonexposed animals served control. Myographic activity of reinnervated crural muscles in the irradiated animals recovered two times more rapidly compared to the controls, so did motor function of the limb operated on. It is inferred that impulse magnetic field produces therapeutic and preventive effect on neurodystrophy resultant from the nerve dissection. PMID- 1781167 TI - [The mechanism of the therapeutic action of ultrasound and phonophoresis in vertebrogenic cervico-brachialgia (based on electrophysiological and biochemical research data)]. PMID- 1781168 TI - [Reparative osteogenesis in bone fractures under the experimental and clinical influence of exposure in the early trauma period to a UHF electrical field]. AB - A 4-mm fracture-induced radius defect in rabbits was exposed to UHF electric field (40, 68 MHz, 20 W). The exposure promoted reparative osteogenesis though consolidation of the fragments followed the pattern of periosteal osteogenesis. Clinical data agreed with the above experimental findings. PMID- 1781169 TI - [The hemodynamic control of balneotherapy in cardiology patients]. PMID- 1781170 TI - [The use of the electrophoresis of mud preparations in bronchopulmonary diseases]. PMID- 1781171 TI - [The efficacy of decimeter-wave therapy and drug treatment at a day hospital in pathology of the pharyngeal lymphoid ring in children]. PMID- 1781172 TI - [The use of air-radon baths for rehabilitating the immune system of patients with bronchial asthma]. AB - A clinicoimmunological trial of air radon baths has been performed in patients suffering from bronchial asthma. A total of 157 asthmatics inhaled air radon mixture. The treatment proved effective with correlation of the response to immune status recovery. This allows one to refer this radon therapy to pathogenetic methods of bronchial asthma management. The highest efficacy was recorded in atopic asthma. PMID- 1781174 TI - [Physical factors in the therapy of patients with plastic induration of the penis (Peyronie's disease)]. PMID- 1781173 TI - [The incidence and structure of chronic morbidity in schoolchildren]. PMID- 1781175 TI - [The preparation of a sanatorium for the transition to market relationships]. PMID- 1781176 TI - [Current methods in blood preservation: recovery of blood components using a multi-bag system]. AB - A new method of blood preparation by use of a multiple plastic bag system is prescribed. Buffy coat free red cell suspensions in additive solution (SAG-M), fresh frozen (recovered) plasma and random platelet concentrates can thus be produced. Apart from the so far clinically not instantaneously available stored platelets the storage time of the red cells is remarkably increased up to 42 to 49 days and the cellular contaminations (red cells and leucocytes in platelet concentrates, thrombocytes and leucocytes in FFP) are markedly diminished leading to a higher quality of these components. The Red Cross Blood Transfusion Service of Upper Austria presents its data obtained by the use of a quadruple plastic bag (RC Transfusion Production Center Eugendorf/Salzburg) with cellular contamination parameters far below the generally accepted limits. Apart from the increased quality of the components a very high level of clinical acceptance concerning especially the stored random platelet concentrates has been experienced. In conclusion the necessity of changing to a multiple bag system is strongly emphasized thus not only better fulfilling the clinical needs for the different blood components but also delivering higher qualities. Red cell preparations containing the buffy coat should therefore not be used any longer. PMID- 1781177 TI - [Cardiovascular diseases in the Viennese emergency medical service in the year 1986]. AB - Information about the acute and emergency care of patients with cardiovascular diseases in Vienna up to now has been sparse. We used the routine data of the Vienna Doctors' Chamber's central deputizing service to throw light upon the diagnostic situation and at the method of management at the start of acute and emergency care in these patients. The most frequent disease visited was angina, followed by hypertension, cardiac failure, paroxysmal tachycardia and hypertensive crisis. The suspicion of coronary infarction (mostly before ECG) follows as the sixth in line. The patient's condition is more frequently described in terms of symptoms before the visit than after the visit. Diagnostic information at the telephone fails completely only in single cases which stay below statistical significance. An improvement in the author's opinion could only be attained by standardized telephone assessment and cooperation with patients. If a visit needs acceleration, it is mostly ordered as a blue light, most accelerated, visit, which happens in 9% of all visits. In over 50% of blue light visits cars are on their way in the first 10 minutes after the phone call. PMID- 1781178 TI - [Dying kinetics of H. influenzae in fibrin clots under the influence of various antibiotics]. AB - Traditional test methods with determination of MIC values alone are not sufficient for the estimation of antimicrobial activity in tissues. Various other parameters like protein binding, the pH value of tissues and other yet unknown parameters influence bacterial killing under the influence of various antibiotics. In an in vitro model using fibrin clots kill kinetics of H. influenzae were determined. Concentrations of antibiotics were determined in fibrin clots. In these in vitro experiments the eradication of H. influenzae from fibrin clots was investigated under the influence of various antibiotics in different concentrations. The results demonstrate, that the relationship between MIC value and tissue concentration is of little value to determine the antimicrobial activity of beta lactam antibiotics and macrolide antibiotics of H. influenzae in fibrin clots. Macrolide antibiotics demonstrate a bactericidal mode of action. PMID- 1781179 TI - Current state-of-the-art in human cell transformation in culture. AB - The immortalization and transformation of cultured human cells has far-reaching implications for both cell and cancer biology. Human cell transformation studies will increase our understanding of the mechanisms underlying carcinogenesis and differentiation. The neoplastic process can now be studied in a model human cell culture system. The accompanying biochemical and genetic changes, once identified, will help define the relationship between malignancy and differentiation. The present studies indeed demonstrate that the neoplastic process can now be studied in a human cell model system. Primary human cells treated with various carcinogens became immortalized in culture but were not tumorigenic. Additional exposure to either retroviruses, chemical carcinogenes or X-ray irradiation to these cells induced morphological alterations associated with the acquisition of neoplastic properties. These findings demonstrate the malignant transformation of human primary cells in culture by the combined action of either a DNA transforming virus and a retrovirus or a DNA virus and a chemical or X-ray irradiation, and support an multistep process for neoplastic conversion. It has been known that normal human cells in culture are remarkably resistant to experimentally induced tumorigenicity. However, as shown above, normal human cells could now be transformed into tumorigenic cells. PMID- 1781180 TI - Effect of excitability-inducing material on regenerative Ca++ release of rat ventricular muscle. AB - The effects of excitability-inducing materials (EIM) and electrical stimulation on Ca+(+)-induced Ca++ release were studied in this experiment. Direct application of three EIM (bacterial EIM, alamethicin, Nal) did not release Ca++ from skinned rat cardiac fibers or from an SR suspension. Direct electrical stimulation of the SR suspension had no effect on Ca++ release either. However, both electrical stimulation and pre-treatment with an EIM augmented Ca+(+) induced Ca++ release in the skinned fiber and led to increased contractility of the fiber in a dose-dependent manner. When electrical stimulation and EIM application were superimposed, their effects were additive, suggesting that information transfer across the junction between T-tubule and SR is at least chemical in nature. PMID- 1781181 TI - Na(+)-Ca2+ exchange transport and pacemaker activity of the rabbit SA node. AB - Recent electrophysiological data have provided the evidences that background currents such as Na(+)-Ca2+ exchange can significantly modulate cardiac pacemaker activity. In this study, the effects of extracellular Na+ and Ca2+ concentrations on the pacemaker activity were investigated by measuring the intracellular Na+ activity (aiNa) with Na(+)-selective microelectrodes and the results are summarized as follows. 1) In the rabbit SA node, aiNa was 3.2 +/- 0.3 mM and mean MDP (maximal diastolic potential) was -63.3 +/- 1.4 mV. 2) Graded decreases of external Na+ concentration resulted in the loss of spontaneous beating, hyperpolarization and the decrease of aiNa. 3) An increase in extracellular Ca2+ concentration in low Na+ solution augmented the transient decrease of aiNa, about 3 minutes in low Na+ solution, until aiNa started to increase. 4) In low Na+ solution, which had extracellular Ca2+ concentration according to the calculation based on the equilibrium state of Na(+)-Ca2+ exchange, aiNa was continuously decreased. It was concluded that intracellular Na+ activity modulated by Na(+) Ca2+ exchange could play an important role in the initiation of pacemaker potential. PMID- 1781182 TI - Study of the skin concentrations after administration of the various phototoxic drugs. AB - The skin concentrations of 8-methoxypsoralen (8-MOP), 5-methoxypsoralen (5-MOP), and 4, 5', 8-trimethylpsoralen (TMP) were studied in the guinea pig following oral administration and bathing. The skin concentration of phototoxic drugs after oral administration peaked at 1.5 hours, and the concentration of 8-MOP was 3.5 times greater than that of 5-MOP. The skin concentration of TMP was not detected in our study (limit of sensitivity 5ng/ml). The skin concentrations of phototoxic drug after bathing decreased in the order of 5-MOP, TMP, and 8-MOP. PMID- 1781183 TI - In vitro effect of interleukin-2 on proliferative responses of peripheral blood T cells from leprosy patients. AB - Because of the important role played by interleukin-2(IL-2) in T cell growth and differentiation, we investigated the effect of exogenous IL-2 on the proliferative response of peripheral blood mononuclear cells(PBMCs) from 77 leprosy patients. The proliferative responses of PBMCs from lepromatous leprosy(LL) or borderline lepromatous leprosy(BL) patients to M. leprae were significantly lower(cpm 6,051 +/- 803 for LL type; 4,951 +/- 2,529 for BL type) than those from tuberculoid leprosy(TT) or borderline tuberculoid leprosy(BT) patients (28,853 +/- 28,916 for TT type; 15,884 +/- 334 for BT type). To investigate the effect of exogenous IL-2, purified IL-2 was added at the start of culture at 100 unit/ml. There was an apparent increase in 3H-thymidine incorporation of M. leprae-stimulated PBMCs(18,723 +/- 6,503) in the presence of IL-2 compared to the results without IL-2(6,051 +/- 803) in LL patients. Twenty nine out of 33 LL patients belonged to the responders to IL-2 and four patients were nonresponders. Therefore we conclude that the defective cell mediated immune response in LL patients may result from diminished production of IL-2, but we can not exclude the possibility of diminished expression of the IL-2 receptor. And we suggest that the immunologic heterogeneous response of an individual to M. leprae is important to the pathogenesis of clinical disease in the same LL patients. PMID- 1781184 TI - Epidural morphine on ventilatory function in chest trauma and thoracotomy patients. AB - Epidural morphine injection was done in nineteen patients who had been admitted from March to August 1990 to the Intensive Care Unit, Severance Hospital, Yonsei Medical Center for respiratory care including ventilator care. Morphine suplphate, 2.67 +/- 0.27 mg was injected one to three times to four patients after chest trauma, and to fifteen patients after thoracotomy. Tidal volume and vital capacity were increased from 4.45 +/- 0.48 and 8.31 +/- 0.50 to 6.91 +/- 0.41 and 12.81 +/- 0.73 mg/kg. However, respiratory rates decreased from 26.07 +/ 1.41 to 20.07 +/- 1.16/min. Inspiratory force increased from -13.40 +/- 1.31 to 26.53 +/- 1.82 cmH2O. Pain score decreased from 9.22 +/- 0.57 to 3.56 +/- 0.83 during this period. PaCO2 did not differ significantly (39.33 +/- 1.13 and 39.48 +/- 1.42 mmHg). Side effects such as pruritus and urinary retention were treated with naloxone 7 approximately 10 ng/kg/min. Mean arterial pressure and pulse rates stayed stable during the study periods. Ventilator hours and ICU stays differed from the control group. However, the duration was not statistically significant. The control group consisted of patients who were admitted during the six months from September 1989 to February 1990 to the ICU for respiratory care, without epidural morphine injection. PMID- 1781185 TI - A cultural psychiatric study on tattoos of young Korean males. AB - In 2, 178 tattooed male conscripts in ages of 19-24 years, the most frequent tattoo was a heart mark or a mark of heart and arrow. The Chinese characters which mean "one mind," eagles, dragons, some of 12 zodiacal animals, flowers, and flowers and butterflies or birds were also frequent. The ten Korean symbols of long life and symbols which have been traditionally believed as having evil repelling powers, for example, blue dragon or white tiger were also found. The frequency of images were different between the provinces with different historical and cultural backgrounds. Data was obtained through interviews with 781 tattooed males. Analysis of the data revealed the following. The prevalence of tattooing was 5.6%. The most prevailing motivation to having tattoos was a contemporary group craze or fashion. Of the 781 tattooed men, 62% had tattoos on their forearms, 34.2% had self-injured scars on their bodies, and 18.6% had criminal convictions. The results of MMPI showed high scores in items of psychopathic deviate and schizophrenia. This suggests that those with tattoos were impulsive, hostile and were prone to delinquent behavior. These results indicate that selection of the image to be tattooed is heavily influenced by inner needs and the cultural background of individuals. PMID- 1781186 TI - Moyamoya disease in Korea. AB - Thirty eight cases of moyamoa disease, 21 children, 17 adults were encountered during a 16-year period at Yonsei University Medical Center. Clinical manifestations, together with computed tomography (CT) and angiographic findings were analyzed with a review of the literature. The mean age was 6.3 +/- 3.5 years in children and 36.8 +/- 9.9 years in adults. The majority of attacks occurred in spring in both adults and children. The most common chief complaint on admission was hemiparesis followed by convulsion in children, while in adults, loss of consciousness was most common followed by headache. Of transient neurologic deficits, hemiplegia was most common in children, while cranial nerve involvement was common in adults. Hemiplegia, also was the most common permanent neurologic manifestation in children, while hemiparesis and intellectual deterioration were the most common in adults. Of the children, 90.6% showed infarction on CT, while 88.2% of adults had hemorrhage. Bilateral occlusion of the carotid arteries was the most common site of lesions in both adults and children on cerebral angiogaphy. PMID- 1781187 TI - Hodgkin's disease in a child with acute lymphoblastic leukemia. AB - Hodgkin's disease, manifested as a second malignant neoplasm in acute lymphoblastic leukemia, rarely occurs, with seventeen cases reported including this cases. We presented the clinical and pathological features of a nine-year old male child with acute lymphoblastic leukemia in remission. He had cervical lymph node involvement 22 months after the diagnosis of leukemia as an initial presentation of Hodgkin's disease of mixed cellularity. A brief review of related literatures was also done. PMID- 1781188 TI - Salmonella enterica subspecies diarizonae bacteremia in an infant with enteritis- a case report. AB - The septicemia caused by the Arizona group organism is rare and usually observed in adults with underlying diseases. In Korea, Salmonella infection is common, but a report of Arizona infection is unknown. We isolated S. entercia subsp. diarizonae from blood of a 6-month-old infant. The serovar was determined as 28:z10:-, a rare one in America. The isolate was susceptible to ampicillin, chloramphenicol, cotrimoxazole and others. The patient rapidly recovered with ampicillin and gentamicin therapy. Clinical laboratories should consider that the infection exists in Korea and should attempt to isolate and identify Arizona organism in certain patients. PMID- 1781189 TI - [Effect of pancreastatin on insulin secretion and the exocrine pancreas in rats]. AB - Pancreastatin, a 49-amino-acid C-terminal amidated peptide, was isolated from porcine pancreas in 1986. It has been reported to inhibit insulin release and exocrine pancreatic secretion, but both these effects have been disputed. In the isolated perfused rat pancreas we therefore studied the effect of pancreastatin on insulin and exocrine pancreatic secretion. Neither basal exocrine pancreatic secretion, nor exocrine secretion stimulated by CCK-8, bombesin or secretin were affected by pancreastatin. 20 or 200 pM pancreastatin, however, significantly inhibited stimulated insulin release. We conclude that pancreastatin seems to be yet another inhibitory peptide, which--for unknown reasons--inhibits insulin release both in vivo and in vitro, but exocrine pancreatic secretion only in vivo. PMID- 1781190 TI - [Fasting blood gastrin levels in colon adenomas and colorectal carcinomas]. AB - The trophic effect of gastrin in the intestine has been shown. Fasting gastrin levels of patients with adenomatous polyps or adenocarcinoma and in control subjects were determined (n = 141). The mean value of fasting gastrin of control subjects (n = 75) was 47.1 pg/ml +/- 17.8, of patients with adenomatous polyps (n = 49) 49.8 pg/ml +/- 20.7, of patients with carcinoma (n = 17) 50.1 pg/ml +/- 23.3. Neither in the group of patients with adenomatous polyps nor in the group of patients with carcinoma, fasting gastrin levels were elevated compared to control subjects. Our study indicates that there is no significant difference in fasting gastrin between either group (control subjects, colon polyps and carcinoma). PMID- 1781191 TI - DNA aneuploidy and proliferation in spontaneous human and dimethylhydrazine induced murine colorectal carcinogenesis. AB - DNA aneuploidy and proliferative abnormalities were studied by flow cytometry in 169 colorectal specimens from 162 patients. Of 37 adenomas, three showed aneuploidy and another seventeen revealed a "near diploid" DNA pattern. The rate of aneuploid and "near diploid" DNA changes in 92 carcinomas was 53.3% and 23.9%, respectively. No correlation was seen between the ploidy distribution and the stage or histologic grade of the carcinomas. The S-phase fractions of both adenomas and carcinomas significantly increased from the diploid (8.1 +/- 0.8% and 7.8 +/- 0.9% respectively; mean +/- SEM) to the "near diploid" (14.9 +/- 1.2% and 12.6 +/- 1.5%) and aneuploid (20.4 +/- 1.3% and 11.4 +/- 1.6%) lesions. To better understand neoplastic progression at very early stages, flow cytometry was also performed on 195 colonic specimens of 44 rats treated by weekly subcutaneous injections of 21 mg/kg Dimethylhydrazine. There was a single "near diploid" carcinoma in this group, and all other induced neoplasms (39 carcinomas and 27 adenomas) revealed a diploid DNA pattern. The S-phase fractions were as follows: controls (38 untreated animals) 8.6 +/- 0.1%, normal mucosa (of Dimethylhydrazine exposed rats) 10.1 +/- 0.25% (p less than 0.0001), adenomas 13.9 +/- 0.6% (p less than 0.01), and carcinomas 14.7 +/- 0.6% (p less than 0.01). These findings support the conclusion that genomic alterations and proliferative abnormalities may already be present in premalignant human colonic lesions. However, despite strong morphological similarities, major biological differences exist between the Dimethylhydrazine-induced murine intestinal carcinogenesis and spontaneously occurring human colorectal neoplasms. PMID- 1781192 TI - [Prevalence of fecal incontinence and degree of information possessed by family physicians and health insurance]. AB - Previous investigations have demonstrated that the prevalence of fecal incontinence ranges between 1.5 and 5% in the general population. It is, however, known that only a small portion of these patients consult a doctor for the complaints. To investigate the prevalence of fecal incontinence in Germany and to determine the reliability of epidemiological data from different sources, we distributed a questionnaire to healthy controls. In addition, two samples of patients were drawn from a local health insurance organization. Finally, the family physicians of incontinence patients from a specialized outpatient clinic which are covered by this health plan (AOK) were interviewed for whether they had noted the incontinence symptoms and had reported them to the health plan. It is shown that approximately 5% of people suffer from occasional incontinence, but that only 1.5% shown severe incontinence excluded fecal soiling. In patients with various disorders, the prevalence ranges between 0.2 and 0.35% according to health insurance data. However, in only about 75% of cases, the family physicians knew about the symptom, and in less than 50% of cases they had informed the health insurance. Epidemiological data, thus, contain a detection bias leading to an underestimation of the true prevalence of fecal incontinence. PMID- 1781193 TI - [Therapy of chronic pancreatitis]. AB - Therapy of chronic pancreatitis is dependent on the stage of the disease and its possible complications. A conservative therapy has to focus 1) on pain relief which implicates an understanding of the multiple causes of pain, 2) on therapy of the exocrine insufficiency by application of the appropriate pancreatic enzymes, dietary regimes, and substitution of fat soluble vitamins, and finally 3) therapy of endocrine insufficiency with insulin. The most important therapy is abstinence from alcohol. One special topic of this review is a discussion about the problem of "negative feedback regulation" of the exocrine pancreas with its question whether one can inhibit pancreatic secretion by application of pancreatic enzymes and, thus, reach a pain relieving effect. Various surgical procedures and possibilities of interventional endoscopy are briefly discussed. PMID- 1781194 TI - [Digitalized documentation of imaging and findings in ambulatory endoscopy of a gastroenterological department]. AB - Digitalized storing of pictures and reports in gastrointestinal endoscopy achieves high quality and reduction in time and place in archiving. Rapid recall and easy statistical analysis becomes possible. We present hardware and software of the system developed in our department. Our experience promises large distribution of these systems in the near future with great advantages for clinical routine and scientific analysis. PMID- 1781195 TI - [Value of magnetic resonance tomography in gastroenterological diagnosis]. AB - The value of magnetic resonance imaging (MRI) in the gastrointestinal tract has not yet been determined. In neoplastic disease, MRI has a high sensitivity in the detection of liver metastases secondary to colorectal cancer. MRI is superior to CT in differentiating recurrent rectal cancer from fibrosis. The high sensitivity of MRI in the detection of fistulae in Crohn's disease and the differentiation from fibrosis represents an advantage over other modalities in imaging of inflammatory bowel disease. Further development of MRI and the use of contrast media for both oral and intravenous administration may offer new perspectives of MRI in diseases of the gastrointestinal tract. PMID- 1781196 TI - [HIV infection of the intestinal mucosa and HIV enteropathy]. PMID- 1781197 TI - [Experimental biology of aging]. PMID- 1781198 TI - [Kinematics of biological aging. II]. AB - Using privation instead of physical time, a function of the theoretical vitality is found which depends on the parameter x. It is given by the quotient of growth rate to age-rate. Consequences which could result from a possible continuity of such a relation are discussed. PMID- 1781199 TI - [Habituation in the open field and age-dependent object memory in female NMRI mice]. AB - There are hints that long-term memory of 21-month-old female NMRI mice is worse than in 3-month-old ones, as tested by habituation in the open field. Object memory as tested here was too easily disturbed to exhibit significant age differences. PMID- 1781200 TI - [Morphometric studies of biological changes in synapses of the human caudate nucleus]. AB - In the adult the caudate nucleus decreases with increasing age. Light microscopic measurements result in smaller sized neurons and a reduced neuropil in the aged. Comparable to a sintering, nerve cells move nearer, and in consequence, their density increases. The total number of nerve cells, however, does not change remarkably. Using electronmicroscopic methods the aging of synapses was morphometrically examined: Blocks of the caudate nucleus were cut out of formalin fixed brains from 43 males who had died between the 22nd and 102nd year of age without any neurological symptoms. The blocks were contrasted with EPTA (ethanolic phosphotungstic acid) and embedded in araldite. Though the whole tissue was autolytic, presynaptic and postsynaptic densities were well-preserved and clearly visible. Their numbers and sizes were measured with semiautomatic procedures. The regression analysis shows a significant decrease of the density of synapses with increasing age. The aging of the human caudate nucleus is characterized by a decrease of its volume, by a reduction of the size of neuronal perikarya, and a diminution of the number of synapses per neuron. But the total number of nerve cells remains nearly constant. PMID- 1781201 TI - On the detection of a blood-joint barrier for radiosulfate and [3H]glucosamine in single joints of aging rats. AB - A blood-joint barrier effect has been detected for two precursors of glycosaminoglycan biosynthesis (35SO4 and [3H]glucosamine) in single joints of adult Wistar rats by calculating the ratio between their blood plasma levels in the equilibrium range and their incorporation rates into joint tissues of knee joints (tibia and femur parts, patella) or femur and humerus heads. The barrier effect appears to be joint specific in the adult rat, because it was not found in joints of one month old rats and in tendon tissue. In 17 months old rats the barrier effect increased indicating a diminished supply of the joints with both precursors. Incorporation rates into the joint tissues, however, were higher than into the isolated glycosaminoglycans of aged rats indicating the barrier effect to be not the only cause for a diminished glycosaminoglycan biosynthesis in joint cartilage of aging rats. PMID- 1781202 TI - [Quantitative analysis of a differentiation characteristic of hyaline cartilage in the aging process]. AB - Changes in the distribution patterns of chondrocytes in the permanent hyaline cartilage were studied in order to analyze a process of differentiation quantitatively. Sections of 29 specimens of arytenoid cartilage and 42 specimens of Carina tracheae from newborn up to the age of 91 years were used. The chondrocytes were transferred via a mirror to paper, and the resulting patterns were analyzed. Various distribution functions were calculated. The most important one is the pair correlation function. The behavior of the differentiation is resembling in both organs. Especially in arytenoid cartilage there were found the following results: The clearest process of differentiation took place up to the 3rd decade of life. Initial hard core distribution is followed by soft core distribution up to the final of puberty. After the 2nd decade of life clustering was found. The grade of differentiation decreases in the 5th decade of life and later. PMID- 1781203 TI - [Methods in age determination in human skeletons exemplified by inhumation and cremation burials of the Hallstatt period]. AB - Discussed were the usual methods presently applied in anthropology for determining a person's age at death by means of specific characteristics of the human skeleton. The inhumation and cremation burials from two tumulus cemeteries of the Hallstatt period (750-500 BC), Dietfurt and Schirndorf, which are both located in the Upper Palatinate, Bavaria, were used as illustrations. In the case of the skeleton of an adult a combined method of age-determination, which took the following four factors into account, proved to be effective: 1. the stage of closure of the endocranial suture, 2. changes in the symphyseal surface of the pubis, 3. and 4. changes in the structure of the spongiosa of the proximal humerus epiphysis and femur epiphysis. In addition the degree of abrasion of the teeth can be taken into account. In the case of skeletons of non-adults, teeth cutting and the epiphyseal fusion should be paid particular attention to. Using the described methods, the following data relating to age-structure for the inhumation burials of both Hallstatt cemeteries could be attained. The death-apex was reached in the adult age-class. The average life-expectancy of both men and women in Dietfurt and Schirndorf was approximately 31-32 years. The average life expectancy at the time of birth was 32.3 years in Dietfurt and 26.9 years in Schirndorf. The varying results are due to the fact that more children of the age classes infants I and infants II could be proved for the Schirndorf cemetery. PMID- 1781204 TI - [Auto-oxidation test for the determination of lipid peroxidation capacity of liver tissue homogenates of young and old mice]. AB - The activity of superoxide dismutase (SOD) and the lipid-peroxidation capacity, i.e., the autoxidation of lipids during incubation at 37 degrees C for 3 h under aerobic conditions was measured in liver tissue homogenates of young (1.5-month old) and old (24-month-old) inbred female Balb/c mice. The lipid peroxidation capacity was found to be significantly higher in young mice than in old ones. The pretreatment of young mice with allopurinol, a specific inhibitor of xanthine oxidase, remarkably decreased the lipid peroxidation capacity without any modification of SOD activity. SOD levels were equal in young and old mice. Our results suggest that the lipid peroxidation capacity of liver tissue depends, not only on the level of polyunsaturated fatty acids, but, in general, also on the state of a finely regulated counterbalance of pro- and antioxidant factors. The autoxidation test seems to be a suitable in vitro method for measuring the lipid peroxidation capacity of liver tissue. PMID- 1781205 TI - [Environmentally-induced causes of aging-dependent DNA modifications and possible consequences: current methods for the assessment of genotoxic potential of mixed pollution]. AB - The deoxyribonucleic acid (DNA) is subject of a series of modifications with time, which are connected with the development of cancer and the process of aging. However, an efficient and nearly perfect repair system works against them, which eliminates most but not all of these changes. A series of tests has been developed for assessment of genotoxic potential of compounds and mixed pollution of environment. Three fast assay systems (umu test, DIT test, and Visko test) are discussed, whose results are obtained more quickly than by using conventional methods (e.g., Ames test or sister chromatid exchange). PMID- 1781206 TI - [Age-dependent changes in glucocorticoid receptors in rat liver following functional loading in in-vivo and in-vitro systems]. AB - In aging the transformation, nuclei binding, and recycling of glucocorticoid receptor complexes (GRC) seem to be retarded or disturbed, as shown in the rat liver after stress and in an in vitro-system. Reasons of the retarded in vitro transformation and DNA-binding could be changed properties of the receptor protein or of cytosolic modulators, in which the tested heat-stable factor f is not responsible for the aging changes. The observed aging differences, when studying the nuclei binding after Ca2+ addition, result in the question, to what extent phosphorylation/dephosphorylation processes play a role in transformation and nuclei binding of GRC. PMID- 1781207 TI - [Growth factors and their significance in aging. Presentations and discussions of the Aschau Meeting on 20 November 1990. Introduction]. AB - Since ancient times, men tried to slow down the process of aging. This was done mainly by dietary means, and since the work of McCay and coworkers, it is general knowledge that caloric restriction is the most reliable technique in prolonging life of laboratory animals. To date, the importance of DNA-methylation, its influence on the three-dimensional structure of the genomic DNA, and the importance of growth factors on the process of aging are well known. Many of these factors modify the velocity of both transcription and cell growth and promote transformation of aging cells. First studies with growth hormone have been performed to investigate its influence on the process of aging. PMID- 1781208 TI - [The treatment of aging subjects with growth hormone]. PMID- 1781209 TI - [Growth factors and modification of in-vitro fibroblasts]. PMID- 1781210 TI - [Molecular aspects of the aging process]. PMID- 1781211 TI - [Use of an opioid antagonist naloxone and the agonist-antagonist nalbuphine during the awakening period to eliminate depressive effects of fentanyl]. PMID- 1781212 TI - [Various aspects of using minor regulatory peptides in anesthesiology]. AB - Dalargin is a Soviet synthetic analog of leu-enkephalin. It was used in a complex of anesthesiological protection (in the form of permanent infusion at a rate of 40-55 micrograms/kg/h) in 331 patients who suffered different operations on the heart, lungs and abdominal cavity. Potential mechanisms of the protective action of the drug were studied in experimental surgical distress. It was found advisable that dalargin may be included into combined general anesthesia to maintain intraoperative organ protection, to stabilize vital functions of the patient at the most crucial and traumatic stages of intervention, and to decrease requirements of narcotic analgetics. It is assumed that dalargin may interact with peripheral opiate receptors. The interaction is likely to be viewed as the main mechanism by which the protective properties of the drug are realized. PMID- 1781214 TI - [A method of studying carbohydrate metabolism]. AB - A new method of studying carbohydrate metabolism is described. It involves glucose injection according to a certain glucose law, followed by measurement of the dynamics of its concentration in the peripheral blood and computation, based on the models suggested, of the quantitative characteristics of metabolism; compartment of glucose distribution, maximum assimilation of glucose from its supply, and so forth. The individual characteristics of carbohydrate metabolism are shown to change within broad ranges (from 0.92 to 0.11 g/min). Materials on the method reproducibility are provided. PMID- 1781213 TI - [Endocrine response to extracorporeal circulation]. AB - The authors analyze the results of measuring the content of vasopressin, renin, angiotensin II and aldosterone coupled with the results of studying hemodynamics, acid-base state, and lactate in the arterial blood during operations on the heart in 32 patients with different acquired heart diseases. The main attention was concentrated on studies into the nature of humoral changes during extracorporeal circulation in three types of anesthesia. In group I, anesthesia was maintained by fentanyl given in a dose of 5-6 micrograms/kg/h, diazepam (0.1 mg/kg/h), and arduan (0.02 mg/kg/h). In the second observation group, at the beginning of perfusion the patients were administered trimetotan (artonad) (0.2 mg/kg), and in group III, the dose of fentanyl was raised during perfusion to 10-12 micrograms/kg/h. It is concluded that during extracorporeal circulation, it is desirable that the dose of fentanyl be increased to attain more adequate anesthesia in that period of heart surgery. The magnitude of humoral changes occurring in the body during extracorporeal circulation served as a criterion for anesthesia adequacy. PMID- 1781215 TI - [Evaluation of metabolic disorders in surgical patients]. AB - The paper treats the problems of metabolism derangement in surgical patients. Special emphasis is laid on the correction of metabolic abnormalities in the pre- and postoperative periods and on the use of parenteral feeding in surgical complications: incompetence of anastomosis sutures, peritonitis, intestinal fistulas, and so forth. The authors define the role of the drugs of directed action in such a severe pathology as hepatorenal insufficiency. PMID- 1781216 TI - [Pathophysiological substantiation of using fasting-diet therapy in the treatment of certain categories of patients]. AB - It is not advisable to prescribe any types of the diet to patients with acute surgical diseases of the abdominal cavity in the early postoperative period because of membranous digestion disturbances and intestinal motility dysfunction. The fasting of the patients with the normal nutritional status may be based physiologically in such cases till the recovery of digestive function, since it favours significant desensitization, namely a decrease of the number of postoperative complications and creation of functional rest for the intestine. PMID- 1781217 TI - [Evaluation of hypoxia by studying the metabolism of purine compounds]. PMID- 1781218 TI - [Occlusion pressure P100 as a criterion of the central regulation of respiration in respiratory insufficiency and anesthesiological care]. AB - Measurement of occlusion pressure in the airways within the first 100 msec of the inspiration (P100) is a simple noninvasive test for estimating the central inspiratory activity in patients. This test does not require any sophisticated diagnostic equipment, it is not burdensome and does not demand the patient's cooperation. The P100 criterion noticeably varies in healthy subjects, in patients with exacerbation of chronic respiratory failure, and in the immediate postoperative period. The use of the test has additional advantages in patients in critical conditions where the carrying out of different tests (hypoxia, hypercapnia) to estimate the central inspiratory activity is not feasible or unsafe for the patient. PMID- 1781219 TI - [Neuromuscular disorders in patients with cancer after radical operations on the stomach]. AB - Detection and stimulus-detection electromyography were used to study the bioelectrical activity of limb muscles in patients operated on for gastric carcinoma. Exercise tolerance and the level of work fitness according to the ergokinetic data were examined at a time. Depending on the indicators 66 patients were distributed into 3 groups. A relationship was shown between the bioenergy and the electromyographic data and the stage of the disease, the scope of operative intervention, and the postoperative interval. PMID- 1781220 TI - [Protective effect of anti-staphylococcal immunosorbent on the phenotype of lymphocyte membrane in diffuse Staphylococcus-Pseudomonas peritonitis]. AB - An antistaphylococcal and an antitetanic immunosorbents on a silica carrier were tested in diffuse staphylococcal pyocyanic peritonitis to protect receptor expression on the general T and B lymphocyte populations and of Fc-receptors to IgM, IgG and IgA. Plasma of animals with peritonitis was shown to exert a powerful suppressive effect on lymphocyte receptors. Perfusion of toxic plasma over the antistaphylococcal immunosorbents resulted in specific adsorption of microbial toxins and completely prevented Fc gamma-, Fc mu- and Fc alpha-receptor expression on cells. Plasma treated with the antitetanic immunosorbent retained suppressive effects. The low protection of receptors may be explained by nonspecific adsorption of texins. PMID- 1781221 TI - [Treatment of endotoxemia in generalized suppurative infection]. AB - The authors describe the experience gained for many years in treating generalized purulent infection in surgical patients with sepsis and peritonitis. Provide the clinical characteristics of endotoxicosis in different types of surgical sepsis (traumatic, peritoneal, gynecological, therapeutic). Special attention is focused on the development carried out for many years of the methods of conservative and particularly active detoxifying with the use of their different combinations. Application of a complex of active treatment methods permitted the lethality to be reduced by 25%. PMID- 1781222 TI - [Endolymphatic therapy of children with chronic osteomyelitis of the long tubular bones]. AB - A study was made of the clinical efficacy and immune status in 40 children with chronic osteomyelitis of long tubular bones. Of these, 13 patients received antibiotics endolymphatically and 27 patients were given conventional antibiotic therapy (intramuscularly, intravenously). In view of the predominance of the staphylococcal flora, endolymphatic therapy included the use of gentamycin and lincomycin, the treatment course lasted up to 10 days. Endolymphatic antibacterial therapy has been demonstrated to produce a beneficial clinical effect there was a decrease in fever duration, the amount of postoperative complications, and the duration of inpatient treatment. After endolymphatic therapy the patients' blood manifested a more remarkable, as compared to the control group, rise of the absolute count of T lymphocytes, "active" population of T lymphocytes, together with an increase of the functional activity of lymphocytes in blast transformation, and a reduction, to an equal degree, of the neutrophil and monocyte counts, attesting to a decline of antigenic load of phagocytes. In patients who received antibiotics endolymphatically, the general blood analysis showed a decrease of neutrophilia and marked lymphocytosis. All this mirrored the intensity of immunity activation. PMID- 1781223 TI - [Effect of various factors on the distribution of inhaled substances]. AB - Pulmonary radioaerosol distribution at different inhalation regimens was studied in 11 patients with chronic nonspecific pulmonary disease and 28 individuals without respiratory abnormalities by radionuclide assay by employing 99mTc labelled human albumin. Respiration rate had the most significant action on the penetration of inhaled particles in the preset values. During inhalation, cough was an important determinant of inhaled aerosol distribution. Causes of these influences are considered in the paper. PMID- 1781224 TI - [Mechanisms of development of brain edema in neurosurgical pathology]. AB - As many as 120 neurosurgical patients were examined after the excision of hemispheric gliomas, basal and subtentorial tumors. Based on an the computer aided analysis biochemical and clinical data, attempts have been made to unify the mechanisms responsible for brain edema development in patients with neurosurgical pathology. In the early postoperative period, brain edema occurs in 95% of neurosurgical patients. Edema development, spreading and intensity depend on the site and nature of the primary pathological focus as well as on traumatism of surgical interventions. It is proved that edema is an original, biologically expedient brain response to its injury. This response manifests in hyperhydration of all tissues, with the maximum intensity being concentrated in the focus of injury. Specific (neurogenic neurohumoral) and nonspecific (biochemical, autoimmune, mechanical, and so forth) factors of brain edema development may be distinguished. The differences in the neurogenic and neurohumoral mechanisms by which brain edema develops may be accounted for by the topography of the focus of injury. The closer the pathological focus is to the stem and diencephalic structures, the more remarkable the action of neurogenous and neurohumoral factors and the more distinct the tendency toward edema generalization are. At the diencephalic level of injury, damaged are the structures responsible for central regulation of metabolism and trophicity of nerve cells. The neurogenously precipitated diffuse impairment of permeability of the cells entails their hyperhydration, which marks cellular (cytotoxic) edema. The subtentorial process that affects the vasomotor centre of the stem triggers the neurogenic diffuse alterations in the vascular tone, manifesting in an increase of permeability for water and plasma proteins which is characteristic of vasogenic edema.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781226 TI - Salbutamol identification in liver and urine by high-performance thin-layer chromatography and densitometry. AB - This paper describes a rapid method for the identification of salbutamol in liver and urine. Salbutamol is extracted from liver with an acid solution, purified on Baker columns and eluted with methanol. After derivatization, salbutamol is detected on HPTLC plates as a blue spot. Urine samples are directly purified on the C18 columns and then the same procedure is followed as for the liver samples. Using this screening method, salbutamol can be semi-quantitatively determined at the micrograms/kg level. PMID- 1781225 TI - Evaluation of the extent of the early Maillard-reaction in milk products by direct measurement of the Amadori-product lactuloselysine. AB - A new method for the evaluation of the extent of lysine modification caused by the Maillard reaction is presented, based on the direct determination of the Amadori product lactuloselysine plus unmodified lysine after complete enzymatic hydrolysis by ion-exchange chromatography. Using a simple mathematical relation, the amount of modified lysine in milk products can be estimated without knowledge of the initial lysine value before heating or storage. PMID- 1781227 TI - Determination of thiabendazole residues in meat by HPLC using ultraviolet and fluorometric detection. AB - An HPLC method is described for the residue analysis of thiabendazole in meat. The recovery varies from 62 to 75%. Thiabendazole is extracted from the tissue using 3 mol HCl, eluted from the Extrelut-20 column with dichloromethane and then injected onto a C18 column. The optimum conditions for detection are described using ultraviolet and fluorescence spectroscopy. The sensitivity is such that thiabendazole can be determined at a level of 5 micrograms/kg meat. The absolute detection limit with fluorometry is 100 pg. PMID- 1781228 TI - [Belgian Royal Society of Surgery. Members' list 1991]. PMID- 1781229 TI - Triflusal versus acetylsalicylic acid: a double-blind study for the prophylaxis of deep vein thrombosis after hip surgery. AB - The authors report the results of a randomised double-blind study comparing the antithrombotic activity of a new anti-platelet drug (Triflusal) with that of acetylsalicylic acid (ASA). 99 patients who underwent hip surgery were included in the study (total hip replacement, osteosynthesis of a pertrochanter fracture or Moore's prosthesis for intracapsular fracture of the femoral neck). Of the 48 patients having received Triflusal, 7 (14.5%) developed deep vein thrombosis as indicated by 125I-fibrinogen isotopic scanning and confirmed by phlebography. Of the 51 patients treated with ASA, 11 (21.6%) presented the same complication as diagnosed by the same techniques. This difference is not statistically significant, considering the number of cases studied. Nevertheless, Triflusal appears to provide prevention of thromboembolic risk to patients who have undergone hip surgery, particularly total hip replacement. PMID- 1781230 TI - Orbital fractures. AB - In this paper the importance of the clinical, ophthalmological and radiological examination in the diagnosis of orbital fractures is stressed. Indications for operative treatment can be esthetic or functional, such as enophthalmos or diplopia. A plea is made for early diagnosis and treatment. An open approach is used for all displaced fractures in order to obtain an anatomical reduction. Currently, miniplates and screws are used more frequently for stabilization. Defects in the orbital floor should be covered preferably with autogenous bone or, if unavailable, with bovine cartilage or some synthetic material. PMID- 1781231 TI - Herniation in the intact falciform [correction of forearm] ligament. AB - A case report of an internal hernia with the greater omentum trapped in the intact falciform ligament is presented. The literature on the subject is reviewed. PMID- 1781232 TI - [A case of abdominal aortic coarctation]. AB - Report of a case with segmental thrombosis of the infrarenal abdominal aorta in a young person secondary to coarctation (probably congenital). Review of the literature. PMID- 1781233 TI - Evidence for secretion channels in the gastric mucous sheet of the cat. AB - Ultrastructural investigations give evidence of secretion channels in the mucous sheet of the gastric mucosa of the cat. These channels are filled with basophilic mucin which may transport the gastric acid to the luminal surface. PMID- 1781234 TI - Morphological changes in human chorionic villi cultivated in conditioned atmospheres of gases. AB - With the aim to verify the changes that a reduction of the oxygen rate may elicit in the morphological pattern of the human chorionic villi, a new experimental procedure has been suggested. Chorionic villi from human early placentas were incubated in Dulbecco's modified medium of Eagle in the presence of oxygen, air or CO2 at a gas pressure equal to 0.7 atm. The specimens were fixed, dehydrated and embedded in resin, and semithin sections were obtained. Using an image analyser, the thickness of the trophoblastic layer and the mean radius of the villi were evaluated and the results submitted to a statistical analysis. The results show a decrease in the ratio thickness of the trophoblast/mean radius of the villus, directly proportional to the reduction of the oxygen percentage in the employed gases. The interesting conclusions demonstrate that the changes which affect the chorionic villi occur very early and are easily evaluable with quantitative methods; a clinical interest in the use of the proposed quantitative procedure can be emphasized. PMID- 1781236 TI - Vagal communicating branches between the facial and glossopharyngeal nerves, with references to their occurrence from the embryological point of view. AB - A rare and hitherto not reported case in which a branch of the vagal nerve communicated simultaneously with the facial and the glossopharyngeal nerves was encountered in the body of a Japanese male cadaver in an anatomy class. This vagofacial-vagoglossopharyngeal (X.VII-X.IX) communicating branch was found to issue from the vagal nerve truck in close association with the pharyngeal branches (rami pharyngei nervi vagi), bifurcating soon into a vagofacial (X.VII) and a vagoglossopharyngeal division (X.IX). The X.VII division coursed forward and reached the posterior belly of the digastric muscle; after entering this muscle, this division broke up into filaments to communicate with the ramus digastricus of the facial nerve which was found to play an equivalent role in making the vagofacial ansa. The X.IX division, in contrast, took its course medially to reach the stylopharyngeal muscle. After entering this muscle, the X.IX division communicated with the stylopharyngeal branch of the glossopharyngeal nerve, which was found to be the equivalent to the X.IX division; these two form together the vagoglossopharyngeal ansa. Therefore, it could be concluded that the X.VII-X.IX communicating branch constitutes the vagal moieties of the vagofacial as well as the vagoglossopharyngeal ansae. The background of the appearance of the communicating branches observed in this report is discussed in the text from the developmental viewpoint on the basis of the findings obtained in chick embryos stained in whole mounts with anti neurofilament protein antibody. PMID- 1781235 TI - Sexually dependent changes in rat somatotropic cells following bilateral adrenalectomy. AB - In order to elucidate the existence of gender-related variations in both growth hormone (GH) release and the activity of somatotropic cells following bilateral adrenalectomy, a morphometric analysis was performed on GH-immunoreactive cells from adult male and female rats after bilateral adrenalectomy, correlating the findings with the serum levels of the hormone. The results obtained were compared to those found in untreated animals. Bilateral adrenalectomy was seen to induce a decrease in serum GH levels (p less than 0.01) in male rats; this was accompanied by a significant decrease in cellular area (p less than 0.01), cytoplasmic area (p less than 0.05) and nuclear area (p less than 0.01) and by a decrease in the cytoplasmic immunoreaction intensity of GH cells. By contrast, the above mentioned changes did not appear in the female rats. These results suggest that the action of glucocorticoids on the synthesis and release of GH depends on the sex of the animal. PMID- 1781237 TI - Microscopic study of the rabbit mandibular periosteum and attached structures. AB - The structure of the mandibular periosteum in rabbits of different ages has been studied by different histological staining techniques and polarization microscopy. The periosteum consisted of two layers. From the inner, cellular layer the functional state could be determined. A reproducible pattern of resorptive and depository areas was found on the bony surface. In the outer, fibrous periosteal layer, collagenous and elastin fibers were running in distinct directions. The masticatory muscles appeared to be attached directly endomysially or indirectly endomysially, via the perimysium or tendinous attachment. From the periosteal structures and the characteristics of muscular fiber attachments to the bone and periosteum, especially in the ramal and condylar areas, it could be concluded that a mechanical influence of the periosteum on condylar growth is very well possible, which will probably vary during life. The masticatory muscles seemed to be only of minor influence in condylar activity. PMID- 1781238 TI - Light- and electron-microscopic observations on the mandibular condylar cartilages in growing rats on a low-calcium diet. AB - In order to obtain more insight into the physiologic mechanism of endochondral ossification, histological changes occurring in the mandibular condylar cartilage of growing rats fed on a low-calcium diet were investigated by light and electron microscopy. Twenty-three-day-old rats were fed on a normal diet or a low-calcium diet for 8 weeks. For the histological observations the mandibular condyles were dissected from each animal at 1, 2, 4, 5 and 8 weeks after the initiation of the experiment. Histological changes occurring in the mandibular condylar cartilages of the rats fed on a low-calcium diet were as follows: (1) narrow proliferative and mature cell zones and a wide hypertrophic cell zone, (2) inhibition of development of cell organelles in the mature chondrocytes, (3) decrease in dead cells in the proliferative zone, (4) decrease in glycogen accumulation in the chondrocytes and (5) inhibition of calcification in the extracellular matrix of the hypertrophic cell zone. Additionally at the end of the experimental period, the following findings were observed: (1) appearance of small light cells in the mature cell zone and the hypertrophic cell zone and (2) decrease in proteoglycan granules and appearance of large collagen fibrils in the pericellular region of the hypertrophic cell zone. PMID- 1781239 TI - Microfibril-microvessel connections in the uvea and optic nerve of the mammalian eye. AB - Light- and electron-microscopic examination of arterioles, venules and capillaries of the eyes of several mammalian species has shown that the microfibrils of ocular elastic tissue attach to microvascular basement membranes throughout the uvea (iris, ciliary body, choroid) and optic nerve. Although described sporadically in prior investigations, this report shows that the connections are a common feature of the mammalian eye. The connections appear most numerous at venules and capillaries and are sparse at arterioles. The connections may provide a mechanism by which perivascular elastic tissue influences microvascular function, e.g. the control of blood pressure in them or their response to changes in intraocular pressure. PMID- 1781240 TI - The vestibular apparatus of the opossum (Didelphis virginiana) prior to and immediately after birth. AB - The vestibular apparatus of the opossum was examined shortly before and immediately after birth. A band of about 20 sensory cells was observed within the forming utricle by 24 h prior to birth. Stereocilia projecting from the apices of the sensory cells appeared intimately associated with a well-defined population of overlying otoliths. These morphological observations suggest that a functional utricle may be present at the time of birth and together with other senses (tactile, olfaction) may aid the newborn of this species in its migration from the birth canal to the pouch. PMID- 1781241 TI - Morphological study on the 'seams' in the multiroot formation of rat molar teeth. AB - 'Seams' of the root furcation with multiroots in rat molar teeth, termed by Lester and Boyde, were investigated using transmitted light and scanning electron microscopy in the formation process. The seam was formed in the junctional line of Hertwig's epithelial root sheaths. The seam formation will be classified into three types in the initial stage based on the position of the epithelial root sheaths approaching each other: (1) the close junction or the very narrow slit or gap formed between them, (2) the clear gap containing mesenchymal cells and (3) the gap containing one blood vessel. When the roots were formed, the seam was formed as follows: (1) the slight ridge composed of the cellular cementum, (2) the proliferation or the depression in the dentine formation and (3) the accessory or lateral canal of the root. These structures were variously combined with each other into one seam, although the slight ridge was very common. PMID- 1781242 TI - A morphometric and comparative study of the malleus. AB - This study has attempted to research, in detail, the dimensions and form of the malleus, and to indicate possible differences with regard to race, sex and side of origin (left or right). The ossicles were obtained from 75 adult cadavers and the dimensions were determined with the aid of a reflection microscope. Clear statistically significant differences were found between the Negroid and Caucasoid races, as well as between the right and left ossicles. No meaningful differences were determined between male and female ossicles. PMID- 1781243 TI - Electron microscopy of histamine-induced contraction of the in vitro swine coronary artery. AB - Dose-dependent contractions of the in vitro swine coronary artery were induced by application of histamine and acetylcholine, but not of angiotensin II, ergonovine, noradrenaline, prostaglandin F2 alpha and serotonin. Ultrastructural changes especially of the tunica intima during the contractions were observed at 2, 5 and 30 min after application of histamine and acetylcholine. The intimal gutter spirally running along the longitudinal axis of the vessel was obscured, and the intimal surface became extensively indented. Exclusively in the histamine treated samples, the increase in number and size of the intracellular vacuoles and the dilation of the intercellular clefts to the extent of the intercellular vacuoles were observed in the endothelium. Moreover, the enhancement of the endothelial permeability was indicated by the marker experiments using horseradish peroxidase. Such endothelial cell damages and the enhancement of the endothelial permeability may amplify the coronary artery contraction. PMID- 1781244 TI - Capillary and fiber size interrelationships in regenerating rat soleus muscle after ischemia: a quantitative study. AB - The present study examines the influence of ischemia on the muscle fibers and capillarization in rats. Muscle ischemia was achieved by a pneumatic tourniquet at a pressure of 300 mm Hg for 2, 4 and 6 h (groups I, II and III, respectively) to the right hindlimb above the knee. Numerous regenerative fibers were seen at 4 and, especially, 8 and 12 days after ischemia in groups II and III. The quantitative data revealed a significant decrease in the size of muscle fibers (regenerative fibers) in ischemic skeletal muscle, with a concomitant increase in fiber density. The capillary to fiber ratio shows a decrease at 4, 8 and 12 days after ischemia in the three experimental groups: in group I because of a decrease in capillary density; in groups II and III because of an increase in fiber density with respect to capillary density. PMID- 1781245 TI - Course and relationships of the arteria maxillaris. AB - The course and relationships of the arteria maxillaris in the left and right infratemporal fossae were examined by means of dissection of 49 South African Negroid cadavers. Eighty-nine specimens of the infratemporal fossae were used. The results were classified according to six variations and were compared to existing findings on Europeans and Asians. In some categories there were significant differences between the Negroid group and the white groups with which it was compared, while in other categories there were no significant differences. PMID- 1781246 TI - Electron-microscopic study of the parathyroid gland of epinephrine-treated golden hamsters subjected to hypergravity environment. AB - The ultrastructure of the parathyroid glands of golden hamsters subjected to 5 gravity environment after administration of epinephrine was studied. In the epinephrine-treated animals exposed to a hypergravity environment, the Golgi complexes associated with numerous prosecretory granules were significantly increased compared with those of the control, centrifuged and epinephrine-treated animals, as well as the cisternae of the granular endoplasmic reticulum compared with those of the control and centrifuged animals. In addition, many secretory granules were situated close to the the plasma membrane of the chief cells in the epinephrine-treated animals exposed to a hypergravity environment. Those observations suggest that the secretory activity of the parathyroid gland may be markedly stimulated in the epinephrine-treated animals exposed to a hypergravity environment. PMID- 1781247 TI - Histochemical and ultrastructural changes in the extracellular matrix of the developing chick semilunar heart valves. AB - The present study analyzes the composition and organization of the extracellular matrix (ECM) and its changes in the course of development of the chick embryo semilunar heart valves. In the present work we have employed chick embryos from stage 29 until hatching, using silver and picrosirius red staining, lectin probes and light and transmission electron microscopy. Our results show that during semilunar valve development a series of elements arise and are organized in the ECM which seem to be more closely related to the maintenance of the structural and biomechanical properties of the valvular leaflets than with morphogenetic processes per se. PMID- 1781248 TI - Ultrastructural morphology of ectoplacental cone trophoblasts of hamster embryos. AB - The invasiveness of trophoblast cells is well known, but it is not clear whether they achieve this property by being transformed to other cell types (like malignant ones) or remain benign. Trophoblasts, in culture, were studied ultrastructurally by examining the surface morphology of the cell vis-a-vis their cytoplasmic outgrowth, and the presence and/or absence of ruffling membranes, filopodia, microvilli, pinocytotic pits or bleb-like structures was observed. Results revealed formation of ruffling membranes only on the leading edge, a presence of slender filopodia and pinocytotic pits but an absence of microvilli and bleb-like structures, the characteristic features of a transformed cell. The study indicated that the trophoblast cells, in spite of being invasive, do not convert to any other cell type. PMID- 1781249 TI - Lymphatic vessels in the developing diaphragm of the rat. AB - Diaphragms of fetal, neonatal and young albino rats have been observed both under light and electron microscopes to examine the presence and distribution of lymphatic vessels and their morphological features. In fetal diaphragms of between 18 and 22 days of gestation, no normal lymphatic vessels can be seen; only after birth, specifically in neonatal and 2-day-old rats, small lymphatic vessels appear; they are in close proximity to the blood vessels in the inner areas of the muscle. As the rats get older, lymphatic vessels are also observed in the subserosa where an abundant connective tissue is present. The fine structure of diaphragmatic lymphatic vessels is different at different ages. In neonatal rats of up to 2 days, the endothelial wall is very thin and often holed. The relationships between contiguous endothelial cells are characterized by simple end-to-end or overlapping structures. The basement membrane is virtually absent. Within the first week of life, the endothelial wall becomes more complex; along the wall, complex interdigitations between two contiguous endothelial cells often touch. A discontinuous basement membrane and collagen and elastic fibers surround the vessels. In the older rats (from 14 to 25 to 140 days), next to the complex interdigitations which characterize the junction between two contiguous endothelial cells, cellular flaps interdigitate forming a channel which opens out either to the exterior or the interior of the vessel. Dense bundles of elastic and collagen fibers are closely apposed to the endothelial wall. PMID- 1781250 TI - Study of the transformation of amoeboid microglial cells into microglia labelled with the isolectin Griffonia simplicifolia in postnatal rats. AB - The transformation of amoeboid microglial cells into ramified microglial cells in the brain of postnatal rats has been studied by labeling the cells with the isolectin Griffonia simplicifolia (GSA1-B4). The latter served as a specific membrane marker of the cell type. Thus, at the light-microscopic level, the amoeboid microglial cells in 1- to 5-day-old rats were intensely stained with GSA1-B4. All the stained cells appeared round. In 10-day-old rats, while most of the stained cells were round, some had assumed an oval appearance. In older rats, i.e. 15-22 days, all the stained cells became flattened or fusiform with long cytoplasmic processes. The present electron-microscopic study confirmed the above features but also added the fact that the reaction for GSA1-B4 was localized at the plasma membrane in the amoeboid microglial cells in all the age groups studied. The reaction for the isolectin was also detected in some vacuoles in the cytoplasm of the round cells. It was concluded from this study that the round amoeboid microglial cells differentiate to become the ramified microglia with age. In the course of this transformation, they retained specific membrane receptors for the isolectin which distinguished them from other glial cell types. PMID- 1781251 TI - Surgical anatomy of the mandibular ramus of the facial nerve in Chinese adults. AB - One hundred and twenty Chinese adults' facial halves were selected for this study. The description of the mandibular ramus of the facial nerve was presented under 4 items: (1) the relationship with the lower border of the mandible, (2) the number of its rami, (3) the relationship with the retromandibular vein, the facial vein or the facial artery, and (4) its anastomoses with the buccal ramus and/or the cervical ramus. In these specimens, anterior to the facial artery, 90% of the mandibular rami ran above the lower border of the mandible, and 10% of the mandibular rami ran below the lower border of the mandible. Posterior to the facial artery, 67% of the mandibular rami ran above the lower border of the mandible, and 33% of the lowest mandibular rami passed in an arc with an average of 0.95 cm (the lowest point being 3 cm or less) below the lower border of the mandible. In 32% of the specimens, the mandibular ramus had no branch and in 68% of the specimens, the mandibular ramus had two or more rami. There were 100% of the mandibular rami lying superficially to the retromandibular vein and the facial vein, while in 5% of the specimens, some other mandibular rami ran deeply to the facial vein. In 83% of the specimens, the mandibular rami lay only superficially to the facial artery and in only 2% deeply to the facial artery. The remaining 15% ran both deeply and superficially to the facial artery. There were 60% of the specimens in which the mandibular rami had one or more anastomoses with the buccal rami.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781252 TI - Morphogenesis of cartilage canals: experimental approach in the rat tibia. AB - This paper studies the participation of vessels in the canal morphogenesis. The proximal chondroepiphysis of the left tibia of 44 five-day-old rats was exposed and the vessels of the intercondylar fossae, near the attachment of cruciate ligaments, were cauterized. In addition to the vascular lesion this assay induced a perichondral lesion. However, the canal appeared and joined to the secondary ossification center. 36 tibiae of 4-day-old rats were removed under sterile conditions and cultured in a serum-free chemically defined medium. The cultures were carried out for as long as 15 days. A canal lumen structure was found on the first days of culture, and grew in depth to the central region of the chondroepiphysis during the culture. The secondary ossification center was not found. The vessels and mesenchymal cells observed in the control canal were not found in the culture. We suggest that the presence of vessels, perivascular cells or perichondrium does not appear to be necessary in canal morphogenesis. PMID- 1781253 TI - Ultrastructural study of cathepsin B immunoreactivity in rat brain neurons: lysosomal and extralysosomal localizations of the antigen. AB - Cathepsin B was localized in multiple neurons of the rat central nervous system by means of the peroxidase-antiperoxidase technique and immunogold labeling using a polyclonal antiserum produced in rabbits against rat liver enzyme. The main intracellular locus of cathepsin B antigenic sites was in lysosomes. In some cases, however, immunoreactive material was also detected outside lysosomes (i.e. at the membranes of the rough endoplasmic reticulum). The findings are discussed with respect to the proposed role of the enzyme in the general protein metabolism of the brain and the potency of the antiserum to label the proform of cathepsin B. PMID- 1781254 TI - Lectin histochemistry of mucus-secreting cells in the calf bulbourethral gland. AB - The bulbourethral glands of 2-month-old calves were studied by means of lectin histochemical methods. The lectin-binding sites for each considered lectin can be divided into three groups according to their zonal topography. In the first group including PNA, MPA, RCAI, SBA and BPA binding sites were seen in most of the secreting tubules and end pieces. In the second group (WGA, GSI, DBA, UEAI and Con A) the reactive cells were limited to a reduced number of tubuloalveolar units generally located at the periphery of the gland. The third group was composed of two lectins, GSII and LTA for which the bulbourethral parenchyma was unreactive. These findings can be related to the glandular activity of the calf bulbourethral gland except for restricted peripheral areas with an appearing functional differentiation. This duality in the histochemical nature of glycoconjugates was compared with previous results obtained in other groups of mammals. PMID- 1781255 TI - Morphological changes in the bovine articular cartilage subjected to moderate and high loadings. AB - This study aims at examining the morphological changes in the cartilage structure of the bovine knee joint when the amputated joints are subjected to (a) a moderate load of 150 kg and (b) a high load of 300 kg and fitted on a knee joint articulating machine at 45 cycles/min for 2 h. The scanning-microscopic study of the surface structure of the experimental and control cartilage shows no appreciable change in the surface morphology of the cartilage when subjected to the moderate load of 150 kg. However, in the case of the high load (300 kg) there is appreciable change in the fibrillary structural pattern of the surface morphology. Histologically too, no appreciable change was noticed when subjected to moderate loadings, but in the case of high loading the cartilage develops roughness of the surface with occasional small clefts. PMID- 1781256 TI - Architecture of the myosalpinx of the isthmus in the guinea pig by means of scanning electron microscopy. AB - The three-dimensional architecture of the isthmic myosalpinx in the guinea pig was investigated by means of a technique that involves stretching the myosalpinx under a dissecting microscope, followed by selective digestion of the interstitial connective tissue with KOH and, finally, observation under a scanning electron microscope. The images obtained in this way prove that the myosalpinx is arranged in single bundles of smooth muscle cells which essentially do not show any specific geometrical course. Furthermore, smooth muscle cell bundles following an oblique course, not referred in the literature prior to this report, were demonstrated. These new three-dimensional microanatomical results call for a reevaluation of the functional role of oviduct motility. PMID- 1781257 TI - Morphometric comparison of uterine glandular epithelium in the early secretory phase from patients treated with different superovulatory drugs on an in vitro fertilization programme. AB - The glandular structure in the uterine epithelium of three groups of patients on standard superovulatory regimes was studied using a fully automated image analysis system. It was found that one treatment (buserelin stimulation) produced more glandular area than either of the other two. We suggest that buserelin gives the morphometric appearance of the most normal endometrial glands and find that our morphometric analysis is a reliable means to evaluate glandular structure in patients on superovulatory therapy. PMID- 1781258 TI - The aqueductus vestibuli--a morphological study. AB - The morphology of the aqueductus vestibuli enjoys considerable attention as it may possibly play a role in the cause of Meniere's disease. In this study, silicone rubber casts of human temporal bones were used, and the aqueductus vestibuli was then measured by means of a reflection microscope. By this method the morphometry of the aqueductus vestibuli was determined accurately. PMID- 1781259 TI - Effects of training and an anabolic steroid on murine red skeletal muscle. A stereological analysis. AB - The purpose of this study was the evaluation of changes induced by training (swimming 1 h/day, 5 days/week, 6 weeks) and an anabolic hormone (nandrolone decanoate, intramuscular injections of 15 mg.kg-1 per week) on fiber size, capillarization and mitochondrial fraction of murine soleus muscle. The animals (n = 32) were divided into 4 groups: a control group (C), that received the arachis oil carrier; a steroid group (S), that received the hormone; a training group (T), and a group that was submitted to training and to the administration of hormone (S + T). The soleus muscle was selected for quantitative light- and electron-microscopic evaluation. The muscle fiber size was increased in group T and decreased in groups S and S + T. The axial length of capillaries per unit volume of muscle decreased significantly in groups S and T. The number of capillaries per number of fibers showed a significant decrease in groups S and S + T and an increase in group T. The mitochondrial content decreased in group S, which suggested that anabolic steroids can be harmful for these organelles. This hypothesis was confirmed by histological evaluation at the electron-microscopic level. Many swollen and disrupted mitochondria were found in groups S and S + T. The results suggest that administration of nandrolone decanoate may have some deleterious effects on the muscle respiratory system (capillaries and mitochondria). PMID- 1781260 TI - A study of the os goniale in man. AB - The anterior process of the malleus of the middle ear develops irrespective of Meckel's cartilage through an intramembranous ossification center that appears in the human embryo of 26.5 mm crown-rump length at a caudomedial position in relation to Meckel's cartilage. The malleus has a double origin: the anterior process originates from the os goniale through intramembranous ossification, and the rest from Meckel's cartilage, through endochondral ossification. PMID- 1781261 TI - Ultrastructure of mineralized nodules formed in rat bone marrow stromal cell culture in vitro. AB - Rat bone marrow stromal cells were cultured in vitro. At days 14-15 of culture, dense clusters of polygonal cells were formed, and they mineralized 2-3 days later. The cells resembling osteoblasts or young osteocytes were histologically observed to be embedded in mineralized or unmineralized extracellular matrices of the nodules. Next, these mineralized nodules were electron-microscopically examined. The osteoblastic cells associated with the nodules had a well-developed rough endoplasmic reticulum, an evident Golgi apparatus and some mitochondria as their intracellular organellae. Some lysosomes and microfilaments were also visible in the cytoplasms. Moreover, some cells protruded cell processes toward the neighboring cells through the extracellular matrix. The extracellular matrix consisted of numerous collagen fibrils which were striated with 60-70 nm axial periodicity and which was similar to bone tissue collagen. A large number of matrix vesicles were scattered among the collagen fibrils in the unmineralized area of the nodules. In contrast, in the mineralized area, numerous matrix vesicles at different stages of maturation and many calcified spherules were observed. That is the mineralization in this culture system was considered to be initiated in association with the matrix vesicles and to progress along the collagen fibrils. From these findings, it was confirmed by the present study that the mineralized nodules formed in this bone marrow stromal cell culture were ultrastructurally similar to bone and that the mineralization also proceeded by going through the normal calcification process. This culture system is considered to be available to study osteogenic differentiation and calcification mechanisms. PMID- 1781262 TI - Histological and histochemical study of paraoxon myopathy in the rat. AB - Time and dose dependency of paraoxon-induced myopathy in rats was studied in relation to esterase inhibition and clinical symptoms. High-dose poisoning resulted in a major cholinergic crisis with concomitant acetylcholinesterase inhibition in the first few hours with rapid restoration thereafter. Dose dependent segmental muscle fiber necrosis occurred in clusters around the end plates and was more frequent in diaphragms as compared to gastrocnemius muscles. However, in low-dose poisoned rats without major cholinergic symptoms or end plate cholinesterase inhibition, necrotic fibers were also present. This indicates that not only end-plate cholinesterase inhibition but also neural or neuronal factors might be responsible for acetylcholine overflow and muscle fiber degeneration. PMID- 1781263 TI - [Mental akinesia and memory disorders following carbon monoxide poisoning]. AB - A 32-year old woman presented with serious memory impairment and a mental syndrome named loss of psychic auto-activation or psychic akinesia following carbon monoxide poisoning. The MRI findings were bilateral pallidal lesions probably associated with thalamic lesions. The evolution was favourable. PMID- 1781264 TI - Bilateral faciobrachial paresis as a consequence of symmetrical capsular infarcts. AB - A 32-year old man presented with a bilateral faciobrachial paresis, pyramidal signs in the upper limbs and dysarthria. Computer tomographic (CT-)scans showed bilateral cortical zones of contrast enhancement and strikingly symmetrical capsular hypodensities. Angiography revealed a stenosis of the left internal carotid artery and an occlusion of the right internal carotid artery. Essential thrombocythemia was diagnosed as the underlying disorder. Since there are no indications of pontine lesions, we assume that the signs and symptoms in this patient could mainly be attributed to the bilateral capsular lesions, that resemble lacunar infarcts. PMID- 1781265 TI - Decrease of frontal metabolism demonstrated by positron emission tomography in a population of healthy elderly volunteers. AB - Frontal metabolism measured with positron emission tomography is shown to be decreased relatively to that in other cortical or sub-cortical areas, in a population of healthy elderly compared to young volunteers. Cortical atrophy or neuronal depopulation are unlikely to entirely explain this physiological phenomenon, and sub-cortico-cortical deactivation should play a role, analogous to that proposed in subcortical diseases. PMID- 1781266 TI - Fractures in multiple sclerosis. AB - In a cross-sectional study of 299 MS patients 22 have had fractures and of these 17 after onset of MS. The fractures most frequently involved the femoral neck and trochanter (41%). Three patients had had more than one fracture. Only 1 patient had osteoporosis. The percentage of fractures increased with increasing age and disease duration. Among 34 deceased MS patients 4 had had fractures. These findings are discussed in relation to physical and cognitive impairment in MS. A case-control study is recommended. PMID- 1781267 TI - Differential diagnosis of anesthesia induced rhabdomyolysis. A case report. AB - A four year old boy suffered from a prolonged cardiac arrest during anesthesia. Laboratory examination subsequently demonstrated extensive rhabdomyolysis. The possibility of an underlying muscle disease in this family was investigated by muscle biopsy, histological examination and in-vitro contracture testing. The latter test result was consistent with malignant hyperthermia susceptibility. This case history illustrates the differential diagnosis of anesthesia induced rhabdomyolysis. PMID- 1781268 TI - [Multiple lateral cervical lymph node metastases in laryngeal carcinoma: incidence and prognostic significance]. AB - In laryngeal oncology histological evidence of neoplastic invasion of the latero cervical lymph nodes (N+) is considered extremely serious in terms of prognosis. To find evidence of metastasis in more than one latero-cervical lymph node is, in fact, not unusual. The purpose of the present work has been to evaluate the clinical and prognostic aspects of multiple latero-cervical metastases in a group of 440 patients suffering from laryngeal carcinoma and who had undergone either total or partial laryngectomy with mono or bilateral lymph node dissection and who had been followed up for at least three years. Of the 440 patients examined 128 (29%) proved histologically N positive and of these 71 (71/128, 55%) showed multiple lymph node metastases, even in those cases of NO. On the average, from a prognostic point of view, the presence of multiple lymph node metastases halved the NED survival rate at three years (38% vs. 65%), clinical staging being equal. In conclusion, in agreement with the literature, the present observations indicate that the number of latero-cervical lymph nodes invaded must be taken into consideration along with the common prognostic factors used in cases of laryngeal carcinoma. In fact, the presence of multiple metastases has a broad, negative affect on survival. Nonetheless, it is not yet possible and is still risky to translate multiple metastases into a preoperative prognosis. PMID- 1781269 TI - [Free forearm skin flap with vascular microanastomosis in the reconstruction of the posterior pharyngeal wall]. AB - The posterior wall of the oropharynx and hypopharynx is a single anatomo functional structure which is artificially divided into oro and hypo by an imaginary line at the valleculae floor level. From the oncological point of view this division serves merely for classification purposes. In fact, the tumors of the posterior wall of both the oro and hypopharynx have the same risk factors, the same lymphatic drain, the same clinical behaviour, the same means of treatment and, almost certainly, the same prognosis. One of the most important problems after posterior pharyngeal wall resection and larynx preservation, is reconstruction without interfering with laryngeal functions. Between April 1990 and April 1991 four patients with squamous cell carcinoma of the posterior pharyngeal wall underwent, surgery after a complete staging including CT and panendoscopy. All underwent bilateral neck dissection, resection of the tumor preserving the larynx and free forearm flap reconstruction. The anastomosis between the radial and superior thyroid arteries and between the venae comitantes and the branches of the internal or external jugular veins were performed under operating microscope with the microvascular technique. The overall average surgical time was 8 hours. No flap necrosis, fistulae or donor site morbidity were observed. Postoperative radiotherapy was initiated without delay. This approach was chosen because, in the authors' experience, in cases of advanced posterior pharyngeal wall cancer, the results of radiotherapy alone are quite disappointing. The feasibility of surgical resection with good, radical macroscopic margins, easily allows margins which are microscopically free of disease and this is an important prognostic factor.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781270 TI - [Ectopic thyroid gland]. AB - Based upon the observation of four cases of ectopic lingual thyroid the authors discuss the etiopathogenetic, clinical-diagnostic and therapeutic aspects of this pathology. The clinical characteristics of the mass, scintigraphy, echography and CT scan of the neck, the T3, T4, TSH doses in the blood and fine needle aspiration of the mass have made adequate appraisal of its possible nature and have led to the identification of the presence of thyroid tissue in other sites. In regard to therapy, the authors believe that surgery is compulsory for patients showing clinical signs of upper airway obstruction despite suppressive therapy or when the lesion shows signs of malignant degeneration. After having mentioned the more commonly employed surgical approaches, emphasis is placed on median pharyngotomy as it permits the best visualization of the region, a careful excision of the mass and a valid control over bleeding. In most cases a tracheotomy proves unnecessary. The post surgical hormonal situation suggests the opportunity of a possible substitutive therapy with synthetic hormones or thyroid derivatives. PMID- 1781271 TI - [Positional rhinomanometry in specific nasal hyperreactivity]. AB - Following up the results obtained in a previous work testing Positional Rhinomanometry in normal subjects, the authors performed this test in subjects affected with specific nasal hyperreactivity. The aim was to offer an objective evaluation of decubitus-caused variations in air flow resistance through the nasal cavities. Thirty subjects suffering from allergic rhinitis (18 from seasonal and 12 perennial allergic rhinitis) underwent Anterior Active Rhinomanometry during the intercritical period of the disease. Tests were performed in the seated, supine positions homolateral and contralateral to the fossa in question. The positional tests show a marked difference between normality and specific hyperreactivity as a consequence of paradoxical responses. Moreover it can indicate the greater increase in nasal resistance, expression of a clear disreactivity of the cavernous tissue stimulated by variations in posture and found mostly in the perennial allergic rhinitis subjects. PMID- 1781272 TI - [Nasal dimorphism and respiratory dysfunction. Preoperative selection of patients and follow-up using computerized rhinomanometry]. AB - Indications and results of corrective nasal surgery are at times uncertain with the traditional clinical evaluation. To find more certain parameters a study was made with active anterior computerized rhinomanometry (C.R.) pre- and post operatively in 50 patients randomly chosen from those proposed for rhinoseptoplasty during 1990. The level of total basal resistance (TR) and total residual resistance after pharmacological decongestion were used as objective indicators of respiratory stenosis. Clinically these patients showed some degree of nasal deformity, usually associated with septal deviation. Difficulty in breathing did not always correspond to the level of TR recorded. At times habit or psychological factors related to nasal aesthetics could play an important role. Using CR it was possible to divide the patients into three categories: a) the first (9 patients with normal total basal resistance) required treatment for exclusively aesthetic reasons; b) the second (18 patients with increased basal TR but normal residual TR) required treatment of the conchae and medical therapy; c) the third (23 patients with increased basal and residual TR) had the broadest functional and aesthetic indications. Six months after surgery normal residual TR was found in 96% of these cases. Only 12% of the patients were functionally unsatisfactory, with residual anatomical alteration (4%), phlogosis (4%) or sensations "sine materia" (4%). The present experience confirms the value of CR as an objective test for surgical selection and functional results. PMID- 1781273 TI - [Histological and ultrastructural aspects of oto-mastoid cholesteatoma in children]. AB - Cholesteatomas were intraoperatively removed from subjects under 14 years of age presenting widespread cholesteatoma with bone erosion. The samples were studied under light and transmission electron microscopy in order to consider the features of inflammation and bone erosion. The results showed that the perimatrix of cholesteatoma in children is rich in mononuclear inflammatory elements and generally presents the features of chronic, as well as acute, inflammation. The perimatrix infiltrates and erodes the surrounding bone. Next to the resorption areas many areas were observed having new bone the surface of which is lined with osteoblasts. The new bone formation activity is marked in these cases of childhood cholesteatoma and appears to be an attempt at spontaneous repair which is thwarted by the persistence of inflammation. PMID- 1781274 TI - [Lyophilized bone homografts in reconstructive surgery of the middle ear]. AB - The authors present their experience with stored lyophilized bone allografts utilized in middle ear reconstructive surgery. The implants were cut from the cortical substance of the long bone in subjects deceased. A demineralization in 0.6 N HCl solution was performed in order to induce osteoinductive capacity to the bone matrix. From November 1986 to December 1988 this material was utilized in 45 operations: 31 canal up techniques; 7 canal down techniques; 4 anatomical and functional rehabilitation of old radical cavities. Good anatomical results without perforation of the tympanic membrane and without signs of inflammation or retraction were obtained in 33 cases (79%). Furthermore, no extrusion was observed in cases with retraction of the graft and protrusion of the prosthesis. In cases in which the homografts were utilized for ossiculoplasty, the post operative air-bone gap was 21 dB and the mean hearing gain was 15 dB. The histological examination of two homografts, removed 13-18 months after implantation, appeared to be coated with normal mucosa and to contain areas of active bone formation. PMID- 1781275 TI - [Brain mapping of middle latency auditory potentials in normal subjects]. AB - The MLRs of 20 normal hearing adults were recorded by cerebral mapping. In regard to the Pa and Na waves, it is suggested that two different generation sites exist because of the different spatio-temporal distribution of the waves over the scalp. It is demonstrated that amplitudes measured by the "grand average" technique are constantly lower than those obtained with the manual determination, and they conclude that manual determination represents the most reliable method in order to calculate waves amplitude. Finally, it is suggested that, due to the different generation sites for Pa and Na waves and to the uneven distribution of the Na wave over the scalp, Pa amplitude should be measured from the baseline and not from the Na negative deflection. Moreover, in 14 cases, when one ear was stimulated the Pa wave obtained at most recording points was significantly larger than the one recorded contralaterally. PMID- 1781276 TI - [Synchronous association of carcinoma of the superior aerodigestive ways and lymph node metastasis of papillary adenocarcinoma of the thyroid: presentation of 6 cases]. AB - Six cases are reported of an unusual synchronous association between aerodigestive squamous cell carcinoma and papillary carcinoma of the thyroid. Six males (47-62 years) were observed until 1975 at the Department of Head and Neck Surgical Oncology of the Istituto Nazionale Tumori, Milan. All were affected by aerodigestive cancer: oral cavity (1), pyriform sinuses (1), larynx (2), lip (1) and oropharynx (1). Clinical examination of the thyroid was always negative. For this reason they underwent surgery, complete surgical approach to aerodigestive neoplasm; one hemithyroidectomy and one total thyroidectomy were also performed. Unexpectedly pathological examination of the dissected lymph nodes indicated the presence of metastases of papillary carcinoma of the thyroid. Three of the six cases had only metastases of thyroid papillary carcinoma while the others presented both squamous cell and papillary carcinoma metastases. Excluding the 2 patients who had undergone thyroid surgery during aerodigestive cancer therapy, in 3 of the 6 patients, two total thyroidectomies and one hemithyroidectomy were performed after the metastases were discovered. In all cases, primary thyroid cancers were demonstrated. One patient did not undergo any subsequent surgery on the thyroid gland because of negative thyroid scanning and bad prognosis due to aerodigestive cancer. Two of the 6 patients died of aerodigestive cancer at 54 and 34 months, 2 are still alive and free of both diseases while one was lost after a 43 month follow-up. PMID- 1781277 TI - [Presence of the regulatory peptide endothelin in the vascular endothelium of the human nasal mucosa]. AB - Endothelin is a 21-amino acid peptide originally isolated from cultured endothelial cells. Besides being the most potent vasoconstrictor peptide. Endothelin is known to produce a wide range of biological effects: contraction of smooth airway muscle, stimulation of cell growth and modulation of hormone and neurotransmitter release. The aim of the present study was to use immunocytochemical techniques in investigating the possible occurrence of endothelin in normal human nasal mucosa. Endothelial cells of both capacitance and resistance blood vessels of the mucosa displayed endothelin-like immunoreactivity. It is reasonable to presume that endothelin, produced and released locally by endothelial cells, may play a role in controlling blood flow, in neuromodulation and in wound healing via a paracrine mechanism. PMID- 1781278 TI - Pharmacokinetics and bioavailability of famotidine in 10 Chinese healthy volunteers. AB - The pharmacokinetics and bioavailability of famotidine were investigated by HPLC method in 10 Chinese healthy volunteers. Data obtained from HPLC were analysed automatically using a MCPKP program on microcomputer. Linear pharmacokinetics were observed following either iv or po administration. After 20 mg iv, plasma levels declined biexponentially with an initial T1/2 of 0.3 +/- 0.2 h and terminal T1/2 of 3.5 +/- 0.8 h. The plasma elimination T1/2 following po administration were 3.4 +/- 0.7 h and 3.5 +/- 0.5 h for capsules and tablets respectively. Oral absorption was incomplete. The absolute bioavailabilities were 38 +/- 10% for capsules and 43 +/- 11% for tablets. Renal excretion was the major route of elimination. About 72% of the dose were recovered as unchanged famotidine in urine. Mean renal and plasma clearance were 416 and 541 ml.min-1 respectively. PMID- 1781279 TI - Effect of ubiquinone on ischemic arrhythmia in conscious rats. AB - Ubiquinone 6.2, 12.5 or 2.5 mg.kg-1 respectively twice iv 24 h and 30 min before coronary artery ligation, ameliorated the ischemic arrhythmia in conscious rats, and there was a close positive correlation between the ubiquinone concentration in myocardium and plasma and its anti-arrhythmic effect. Ubiquinone iv 3.1, 6.2, and 12.5 mg.kg-1 increased, while 25 mg.kg-1 decreased 6-keto-PGF1 alpha, and 12.5 and 25 mg.kg-1 decreased TXB2, which was in accordance with inhibitory effects on the synthesis of 6-keto-PGF1 alpha and TXB2 in vitro. But the ratio of metabolites of PGI2/TXA2 in vivo was increased in all ubiquinone groups. These results indicated that ubiquinone possesses protective effects on ischemic arrhythmia of conscious rats and the beneficial effects on myocardial ubiquinone content and PGI2/TXA2 seem to contribute to its myocardial protective action. PMID- 1781280 TI - Positive inotropic effect of apomorphine on guinea pig myocardium is mediated by dopamine DA1 receptors. AB - Dopaminergic agonist apomorphine (Apo, 1-100 mumol.L-1) had a concentration dependent positive inotropic effect on guinea pig left atria. This effect was not changed obviously when the influences of sympathetic and parasympathetic nerves were eliminated by reserpine and atropine, respectively. Apo had little inotropic action on guinea pig papillary muscles. The time course of positive inotropic effect of Apo was different from that of isoprenaline and phenylephrine. Apo influenced the isometric contraction curves in a different way from isoprenaline. Dopaminergic antagonist haloperidol antagonized the positive inotropic effect of Apo. This effect was also competitively antagonized by dopamine DA1 antagonist SCH 23390. While dopamine DA2 antagonist domperidone, beta-adrenergic antagonist propranolol and alpha-adrenergic antagonist phentolamine did not obviously influence the effect of Apo. We concluded that the positive inotropic effect of Apo was mediated by postsynaptic dopamine DA1 receptors in guinea pig left atria. PMID- 1781281 TI - Effect of tiapride on electroacupuncture analgesia. AB - Tiapride icv 400 micrograms/rabbit exhibited analgesic and synergistic effects on electroacupuncture analgesia (EAA) in rabbits. Both electroacupuncture (EA) and tiapride (icv 400 micrograms/rabbit) enhanced the beta-endorphin-like immunoreactive substance (beta-EPIS) level in cerebrospinal fluid (CSF) measured by radioimmunoassay (RIA). When EA and tiapride were used in combination, a further increase of beta-EPIS content was found. The results suggested that promotion of beta-EPIS release by tiapride may be one of the mechanisms of synergistic effect of tiapride on EAA. PMID- 1781282 TI - Binding of potassium [3H]embelate to rat brain synaptosomes. AB - [3H]Embelate (potassium salt of 2,5-dihydroxy-3-undecyl-1,4- benzoquinone), a new analgesic compound, showed a specific and saturable binding in rat brain synaptosomes which was not influenced by naloxone and morphine. The binding characteristics were correlated with its non-narcotic central analgesic action. PMID- 1781283 TI - [Pharmacokinetic-pharmacodynamic model of magnesium sulfate in treatment of pregnancy-induced hypertension]. AB - Ten pregnancy-induced hypertension gravidas aged 24-36 (28.1 +/- 3.31) yr were infused iv with fast (7.5 g in 1 h) and slow (7.5 g in 5 h) rates consecutively. Blood pressure were measured and blood samples were collected at 0, 1, 6, 7, 9, 11, 15 h. The drug concentration of each sample in the serum was determined by colorimetric method. The integrated pharmacokinetic and pharmacodynamic model was used to analyze the data. The serum data were fitted to a biexponential equation and the effect data were fitted to a sigmoid Emax model. Their pharmacodynamic parameters were: Kco = 0.52.h-1, T1/2(kco) = 1.33 h, Emax = 20.5% Cc (50) = 6.15 micrograms.ml-1), y = 3.64. kco was not equal to k21 of the mammillary model. It shows that the site of action is situated in the effect compartment. The predicted effect could last 24 h. PMID- 1781284 TI - [Influence of carbenicillin on pharmacokinetics of ribostamycin in 7 volunteers when they were used combinedly]. AB - The experiment consists of two groups, namely the ribostamycin (Rib) group and the Rib and carbenicillin (Car) combination group. There were 7 healthy volunteers in each group. The Rib concentration in blood and urine was detected with the improved microbiology method. The organism tested was Bacillus pumilus. The results demonstrated that the drug serum level was in line with the one compartment open model. The parameters such as K, Ka, T1/2, T1/2a, Tp, Cmax, and AUC in the Rib group and the combination group were 0.43 +/- 0.03 and 0.41 +/- 0.04 h-1, 3.09 +/- 1.37 and 2.82 +/- 1.48 h-1, 1.61 +/- 0.12 and 1.72 +/- 0.17 h, 0.26 +/- 0.12 and 0.31 +/- 0.15 h, 0.91 +/- 0.20 and 1.01 +/- 0.31 h, 37 +/- 4 and 34 +/- 6 micrograms.ml-1, 123 +/- 17 and 120 +/- 16 micrograms.h.ml-1, respectively. The 24-h urinary recovery rates of the 2 groups were 84 +/- 3% and 84 +/- 5%, respectively. There was no significant difference (P greater than 0.05) between the parameters of the 2 groups. The results indicate that Car has no apparent effect on the pharmacokinetics of Rib in the healthy volunteers. PMID- 1781285 TI - [Distribution of bromo[methylene-3H]acetamide in Oncomelania snails, carps, and mice]. AB - Bromoacetamide show a high molluscicidal effect, low toxicity to fish and good solubility in water. It is a promising molluscicide. The present paper reported the distribution of bromo[methylene-3H]acetamide in Oncomelania snails, carps, and mice. Radioactivity in animals was measured by liquid scintillation counting. In Oncomelania snails the radioactivity gradually increased with exposure time and drug concentration. The highest level was found in the head-foot, reaching 12.5 x 10(3) dpm.mg-1 after exposure to the drug for 24 h, whereas the levels in liver and other tissue were 3.0 x 10(3) and 3.8 x 10(3) dpm.mg-1 respectively. Carps absorbed bromo[methylene-3H] acetamide similarly as in Oncomelania snails, but the levels in tissues were less than those in Oncomelania snails. Bromo[methylene-3H]acetamide 0.5 ml (1.4 mumol.L-1) was given ig to mice. Blood samples of 3 mice were collected at 0.5, 1, 3, 6, 12, 24 and 96 h after ig. The peak levels was found within 12 h and then declined gradually. PMID- 1781286 TI - [Effect of enhancers on cutaneous permeation of piroxicam in vitro]. AB - Enhancing effects on the permeation of piroxicam (Pir) through excised hairless mouse (inbred HRS mice) skin were investigated by measuring flux. Azone 1% was found to be the most effective enhancer studied, increasing the flux about 21 times. The effect of Azone was enhanced by the presence of propylene glycol. Oleic acid, ethylacetate, and ethanol promoted the diffusion of Pir. Other enhancers, such as DMSO, PEG 400, acetone, urea and salicylic acid, showed little or no effect. Pir-beta-cyclodextrin inclusion compound increased the flux about 3 times. The results revealed that lipophilic enhancers were more effective than lipophobic ones. PMID- 1781287 TI - [Antagonistic effects of dextromethorphan on vasoconstriction of phencyclidine in vitro]. AB - Bioassay and spectrophotofluorometry were used to study the antagonistic effect of dextromethorphan (DM) on phencyclidine (PCP) vasoconstriction in rabbit ear artery. DM (5 mumols.L-1) antagonized enhancement of PCP, N-[1-(2-thienyl) cyclohexyl] piperidine (TCP) and dizocilpine maleate (MK-801) (5 mumols.L-1) on electrical stimulation-induced vasoconstriction by 86 +/- 18%, 84 +/- 17%, and 86 +/- 18%, respectively (n = 6, P less than 0.01), but had no obvious bioactivity itself at the same concentration. DM (1, 2.5, and 5 mumols.L-1) inhibited the PCP effect and reduced the maximal effect of PCP with pD2' = 5.3 +/- 0.3 (n = 4). The contents of norepinephrine (NE) in control, PCP, and DM + PCP groups were 5 +/- 6, 12 +/- 8, and 5 +/- 6 ng.ml-1, respectively (n = 9). PCP (10 mumols.L-1) increased the NE release (P less than 0.05) but DM (10 mumols.L-1) inhibited it (P less than 0.01). The results suggest DM may be a noncompetitive blockader for PCP receptors. PMID- 1781288 TI - [Drug evaluation of huperzine A in the treatment of senile memory disorders]. AB - Huperzine A is an alkaloid which was first isolated from Huperzia serrata (Thumb) Trev by Zhejiang Academy of Medical Sciences and Shanghai Institute of Materia Medica, Chinese Academy of Sciences. It exhibits a significant anticholinesterase activity and has been used on myasthenia gravis patients. The therapeutic effects were studied by random, match and double-blind method on 56 patients of multi infarct dementia or senile dementia and 104 patients of senile and presenile simple memory disorders. The curative effects were evaluated by Wechsler memory scale. The im dose for multi-infarct dementia was 0.05 mg bid for 4 wk, whereas that for senile and presenile simple memory disorders was 0.03 mg bid for 2 wk. Saline was used on control group. The result showed that the curative effect of huperzine A was significant. Only a few patients felt slight dizziness and this did not affect the therapeutic effects. PMID- 1781289 TI - [Effects of panaxadiol and panaxatriol saponins on action potentials of normal and xanthine-xanthine oxidase damaged cultured myocardial cells]. AB - Wistar rat myocardial cells were cultured. PDS 20-80 micrograms.ml-1; PTS 1.25-20 micrograms.ml-1 dose-dependently decreased their action potential parameters, indicating the possibility of being concerned in the blockage of Ca channel. After the free radical damage was induced by xanthine 0.42 mmol.L-1--xanthine oxidase 5.3 nmol.L-1 (X-XO). All the action potential parameters of the cardiac cells decreased without exception. Both PDA and PTS antagonized the electrical appearance of membrane damage induced by X-XO, suggesting that both PDS and PTS protect the myocardial cells from oxidative damage. PMID- 1781290 TI - [Effects of l-stepholidine on isolated rabbit basilar artery, mesenteric artery, and thoracic aorta]. AB - l-Stepholidine (SPD) has been shown to be effective in treating migraine, but its mechanism is not clear. So the effects of SPD on isolated rabbit basilar artery (BA), mesenteric artery (MA) and thoracic aorta (TA) were studied. The contractions of BA and MA were induced by KCl (10-160 mmol.L-1) and the contraction of TA was caused by 5-HT (0.1-100 mumol.L-1). Ketanserin was used as reference. SPD (0.1-0.2 mmol.L-1) relaxed the contractions of BA and MA induced by KCl in a noncompetitive manner with pD'2 3.4 +/- 0.3 and 4.0 +/- 0.3, respectively. SPD had no selectivity in BA and MA. SPD also inhibited the contraction of TA induced by 5-HT with pA2 9.7 +/- 2.0 and pD'2 5.4 +/- 0.6, which showed a dual of both competitive and noncompetitive antagonisms. These results suggested that SPD had a blockade effect on the calcium channel and 5-HT2 receptors. PMID- 1781291 TI - [Protective action of sophoridine on acute myocardial infarction in anesthetized dogs]. AB - The effects of sophoridine on acute myocardial infarction induced by ligation of left anterior descending coronary artery in 16 anesthetized and open-chest dogs were studied. Treatment with sophoridine 20 mg.kg-1 iv reduced the size of myocardial infarct 6 h after ligation and lowered the elevated plasma levels of lactic acid and pyruvic acid 15, 30 and 60 min after ligation. Sophoridine also lowered the activity of serum CPK 60 and 120 min after ligation and reduced TXB2 and increased 6-keto-PGF1 alpha, hence the metabolites of PGI2/TXA2 ratio after ligation was increased. Electron microscopy showed that sophoridine protected mitochondria of ischemic cells. These results indicated that sophoridine showed protective effects on acute myocardial infarction. The beneficial effect on PGI2/TXA2 and mitochondria seems to contribute its protective action. PMID- 1781292 TI - [Effect of alpha-difluoromethylornithine on sporogony of Plasmodium yoelii]. AB - The effect of alpha-difluoromethylornithine (DFMO) on the sporogony of P yoelii was studied by electron microscopy. DFMO sugar solution was fed to female mosquitoes. Scanning electron microscopy (SEM) revealed that the oocysts were smaller and the surface of oocysts was uneven as compared with control. Transmission electron microscopy (TEM) showed that cytoplasm of the affected oocysts contained vacuoles and the multilamellate structures increased. The number of matrix cavitations and deformations of mitochondria increased. Nuclear membrane was damaged. The number of autophagocytic vacuoles increased. The membrane system was markedly affected. PMID- 1781293 TI - [Relationship between inhibitory action of tanshinone on neutrophil function and its prophylactic effects on myocardial infarction]. AB - In isoprenaline-induced myocardial infarction in rabbits, the circulating neutrophils (neu) were in an activated state. tanshinone (tan, ig) suppressed the neu functions (acid-phosphatase release, adhesiveness, and phagocytosis) dose dependently and reduced myocardial necrosis concomitantly. There was a positive correlation between neu functions and myocardial necrosis. In addition, tan caused an obvious decrease in content of lipoperoxide malondialdehyde in serum and myocardium, an increase in superoxide dismutase activity, an inhibition of leukocytic infiltration, and a production of prostaglandin E2 in myocardium. These effects were also related closely to the suppression of neu functions. Anti inflammatory drug dexamethasone was used as control and had similar effects on Neu functions and myocardial infarction. It is suggested that the prophylactic effects of tan on myocardial infarction may result from the inhibition of circulating neu functions. PMID- 1781294 TI - [Effects of econazole and clotrimazole on TXB2 and PGE2 production in calcimycin stimulated neutrophils and arachidonic acid-stimulated platelets]. AB - The effects of econazole and clotrimazole which are used as antifungal agents, on TXB2 and PGE2 production in calcimycin (A-23187)-stimulated rat pleural neutrophils and arachidonic acid (AA)-stimulated washing rabbit platelets were examined by radioimmunoassay. Econazole and clotrimazole 0.05-100 mumol.L-1 inhibited TXB2 production both in rat pleural neutrophils and in rabbit platelets with a dose-dependent manner. The most potent inhibition was found in rabbit platelets. At the concentration of 50 mumol.L-1, econazole and clotrimazole were sufficient to inhibit TXB2 production in rabbit platelets by up to 99% and 98% respectively. Econazole and clotrimazole 0.05-5 mumol.L-1 also increased PGE2 biosynthesis in rabbit platelets. But econazole and clotrimazole 50 mumol.L-1 reduced the PGE2 production in rabbit platelets to 11% and 37% of the amounts of 5 mumol.L-1 econazole and clotrimazole respectively. The results suggest that econazole and clotrimazole at lower concentration may have a selective inhibitory effect on thromboxane synthetase, at higher concentration they also inhibit cyclooxygenase. PMID- 1781295 TI - [Effects of sodium 18 beta-glycrrhetinic acid on the production of active oxygen species and the concentration of intracellular free Ca2+ in rat neutrophils]. AB - The effects of sodium 18 beta-glycyrrhetinic acid (SGA) on the production of active oxygen species (AOS) and the concentration of intracellular free Ca2+ ([Ca2+]i) in the rat neutrophils were studied by the methods of luminoldependent chemiluminescence and calcium indicator Fura-2 loading. The results showed that SGA 0.8-12.7 mumol.L-1 selectively inhibited calcium inophore A-23187-stimulated AOS production with IC50 1.4 mumol.L-1, while SGA 25.4-203 mumol.L-1 stimulated neutrophils to generate AOS and potentiated the action of chemotactic peptide f MLP on inducing AOS production. SGA 25.4-203 or 6.3-50.7 mumol.L-1 depressed the [Ca2+]i rise in neutrophils stimulated by A-23187 or f-MLP; in the contrast, verapamil or diltiazem has higher effective concentration more than 100 or 200 mumol.L-1 to f-MLP and left [Ca2+]i rise induced by A-23187 unaffected. SGA 101.5 203 mumol.L-1 also caused [Ca2+]i rise in neutrophils. The result analysis indicate that the effect of SGA on AOS production has no relationship with its regulation to [Ca2+]i in neutrophils. PMID- 1781296 TI - [Antifertility effect of the implant containing 16-methylene-17 alpha-acetoxy-19 norprogesterone (ST-1435)]. AB - The silastic capsules containing ST-1435 (0.5, 1, 2, 4, 6 or 8 mg) showed "burst effect" with a peak value of 4-15 micrograms.h-1 after incubation in vitro. A constant release rate was gradually approached within 1-2 wk. After the capsules were subcutaneous implanted or vaginally administrated, the rats manifested diestrus within 24-48 h. The normal estrus cycles and fertility were restored as soon as the release rate of implants decreased to 10 micrograms.d-1 in vitro. ST 1435 did not inhibit the superovulation induced by PMSG and HCG in immature female rats, but blocked the ovulation induced by LHRH in mature rats. PMID- 1781297 TI - Radical-promoting "free" iron level in the serum of rats treated with ferric nitrilotriacetate: comparison with other iron chelate complexes. AB - Iron plays a critical role in the production of activated oxygen species and the activity of chelated iron in the biological system depends on the chemical forms of the chelators. In the present study, we used ferric nitrolotriacetate (Fe-NTA, molar ratio of iron to chelators = 1:3), ferric ethylenediaminetetraacetate (Fe EDTA, 1:3 complex) and ferric Desferal (Fe-Des, 1:1.1 complex) to see their "free" iron content in aqueous solutions in vitro and in the serum obtained after a single intraperitoneal injection of the chelates to rats (7.5 mg of iron/kg). "Free" iron was measured by the bleomycin-assay system. When Fe-NTA was dissolved in water, "free" iron increased linearly with total iron concentration up to 10 microM, whereas Fe-EDTA and Fe-Des showed no "free" iron with corresponding iron concentrations. When these three ferric chelates were dissolved in normal rat serum, "free" iron in Fe-NTA increased abruptly between 40 microM and 60 microM iron concentrations, then increased slowly up to 100 microM. Fe-Des did not show any "free" iron at comparable iron concentrations. Fe-EDTA had an intermediate "free" iron level in the serum. Among the ferric chelate complexes, Fe-NTA showed a much faster increase of and a higher content of "free" iron in the serum than the other two complexes after a single injection of the chelates into rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781298 TI - Aldehyde dehydrogenase deficiency, flush patterns and prevalence of alcoholism: an interethnic comparison. AB - A study was performed to verify that the prevalence of alcohol abuse and dependence in Formosan aborigines differs from that of Taiwanese (Chinese Han people), using analysis of aldehyde dehydrogenase (ALDH) isozymes and flush patterns on randomly sampled 70 Atayal, 66 Paiwan, 61 Yami and 94 Taiwanese subjects were studied. The activity of an isomer of ALDH having a low Km (ALDH-I) in hair roots was analysed by isoelectric focusing assay. The subjective experience of flushing response after alcohol ingestion was assessed. Results showed that the rate of ALDH-I deficiency in Taiwanese (51.1%) was significantly higher than in aborigines, i.e., 6.4%, 3.9%, and 0% in Atayal, Paiwan, and Yami subjects, respectively. The percentage occurrence of ALDH-I deficiency and prevalence of alcohol dependence in Taiwanese and aborigines were negatively correlated. The predominant pattern of self-reported flush response after alcohol use among aborigines was of slow onset. The flush response to alcohol ingestion was examined in relation to aldehyde metabolizing enzyme. Since alcohol sensitivity is an important factor in the development and maintenance of the alcohol ingestion habit in humans, our results support the hypothesis that there is a biological basis in the different rates of alcohol abuse and dependence among different ethnic groups. PMID- 1781299 TI - Use of ventricular assist devices in patients with postcardiotomy shock. AB - Over the last three years, we have used ventricular assist devices (VAD) in 7 patients. Of these 7, four patients with combined aortic and mitral valvular disease underwent double valve replacement; one patient with annuloaortic ectasia underwent a Cabrol's operation; another had aortic valve replacement; the last patient had triple coronary artery bypass grafts. The only patient who could be weaned from CPB developed cardiogenic shock after the operation. LVADs supported 6 patients for 4 to 8 days and a BVAD supported one patient for 9 days. All patients survived the weaning procedure. Three were discharged from the hospital and survived 7 to 21 months. The 4 other patients died of multiple organ failure. Three of these four suffered from both renal failure and infection, while one patient had arrhythmia and died of ileus. These data suggest that renal failure and major infection can be serious detrimental complications to VAD support. PMID- 1781300 TI - Effects of antioxidants on survival of adult rat hepatocytes under various oxygen tensions in serum-free primary culture. AB - Effects of antioxidants, such as superoxide dismutase, vitamin C, vitamin E, 4-(0 benzylphenoxy)-N-methylbutylamine hydrochloride (bifemelane), and selenite on survival of adult rat hepatocytes were examined under normoxic and hyperoxic conditions in serum-free primary culture. The tested antioxidants, except for vitamin C, significantly increased the survival rate of hepatocytes under the normoxic condition (under air). Thus, even the normoxic culture condition is hyperoxic for hepatocytes. Elevation of oxygen tension (40% O2) caused severe morphologic degeneration of hepatocytes and remarkable decrease in the survival rate of the cells. Addition of the antioxidants effectively protected hepatocytes from the morphologic degeneration, and significantly improved the survival of the cells under the hyperoxic condition. These findings indicate that the antioxidants can maintain the long-term survival of hepatocytes in serum-free primary culture. PMID- 1781301 TI - A human T cell leukemia virus type-I carrier with recurrent thrombocytopenia and various autoantibodies. AB - A 34-year-old woman infected with human T cell leukemia virus type-I(HTLV-I) with recurrent thrombocytopenia and various autoantibodies is described. The platelet counts fluctuated between 1.3 x 10(4)/microliters and 14.8 x 10(4)/microliters without any medical treatment, and thrombocytopenia improved with a decrease of platelet-associated IgG (PA-IgG). Autoantibodies such as rheumatoid factor, antinuclear factor, anti-Sm, anti-RNP and anti-SSA antibodies were also recognized. Marker analysis of peripheral mononuclear cells showed an increase in the proportion of CD 25+ cells, CD 3+ HLA-DR+ cells, CD4+ HLA-DR+ cells and CD8+ HLA-DR+ cells. The recurrent thrombocytopenia and development of various autoantibodies in this HTLV-I carrier are speculated to be due to the alteration of B cell functions by T cells infected with HTLV-I. PMID- 1781302 TI - An autopsy case of spinal arteriovenous malformation (Foix-Alajouanine syndrome). AB - An autopsy case of spinal arteriovenous malformation (AVM) was reported. The patient was a 75-year-old male and his initial neurologic symptoms were paraplegia, paresthesia below the umbilical level and urination difficulty. Subsequently night delirium and parkinsonism also appeared. The clinical and pathological findings in this case are identical with those in the spinal AVM except for Parkinson's disease. In addition, the lateral funiculus of the spinal cord in the middle thoracic segment showed pallor: Under light microscopy, the funiculus was spongiform, with a thinner wall of the myelin sheath, enlargement of the axon and the perivascular infiltration of phagocytes without plasma exudation. The changes in the lateral funiculus seemed to indicate early congestive changes. PMID- 1781303 TI - Lack of thyroid hormones but not their excess affects the maturation of olfactory receptor neurons: a quantitative morphologic study in the postnatal rat. AB - To study quantitatively actions of thyroid hormones on maturation of olfactory receptor neurons (ORN), surface density and total number of receptor knobs (1 knob/ORN) were measured in 1 mu sections from septal olfactory epithelium of newborn, 12- and 25 day normal, hypo- and hyperthyroid rats. Hypothyroidism was induced by adding to drinking water n-propylthiouracil (0.1% w/v) from birth. Hyperthyroidism was induced by daily injection of pups with T4 (1-thyroxine, 0.3 microgram/g b.w., s.c.). Experimental pups showed all the signs of hypo- and hyperthyroidism. Between days 1-25, normal pups showed marked increase in surface area of septal olfactory epithelium (6x), total number (12x) and surface density (#/mm2, 2x) of mature ORNs. Thyroid deficient rats showed, by day 12, marked reductions in epithelial surface area and total number of mature ORNs; these and the surface density deficits became very pronounced by 25 day (30% area, 27% density, 47% # mature ORNs). Hyperthyroid rats, however, did not show an increase in any of these parameters over controls. Although total number of ORNs (mature and immature), as measured by number of nuclei, was also reduced in hypothyroid pups, surface density was not altered, indicating that maturation of ORNs, but not their local accretion is altered in thyroid deficiency. The results indicate that thyroid hormones are essential for normal proliferative expansion of olfactory epithelium and for maturation of ORNs postnatally. These actions of thyroid hormones are not increased or accelerated by excess T4 suggesting saturation of the hormone receptor system at the normal plasma level. PMID- 1781304 TI - Influence of early chronic phenobarbital treatment on cerebral arteriovenous differences of glucose and ketone bodies in the developing rat. AB - The influence of an early chronic phenobarbital treatment on cerebral arteriovenous differences of glucose, lactate, pyruvate, beta-hydroxybutyrate and acetoacetate was studied in suckling rats. The animals were treated from day 2 to 21 after birth by a daily injection of 50 mg/kg phenobarbital or by saline and were studied at 10, 14 and 21 days. Phenobarbital treatment induced a decrease in cerebral arteriovenous difference of glucose at P14 and no change at P10 and P21. The barbiturate did not have any influence on cerebral arteriovenous difference of lactate and pyruvate at the three stages studied. Cerebral uptake of beta hydroxybutyrate was unchanged at P10 and increased by two-fold at P14 and by threefold at P21 by phenobarbital. Cerebral arteriovenous difference of acetoacetate was low and did not change with the pharmacological treatment. At P14 and P21, the calculated amount of oxygen used by the brain for the oxidation of ketone bodies was twice as high in barbiturate- as in saline-treated rats and reached values of 47 and 16% respectively in phenobarbital-exposed animals. In addition, the barbiturate seemed to affect the carrier process of beta hydroxybutyrate from blood to brain. The results of the present study are in good agreement with previous data from our laboratory showing that an early chronic phenobarbital treatment is able to induce a shift in the cerebral energy metabolism balance in favor of ketone bodies. PMID- 1781305 TI - Different in vitro response to rIL-1 beta of newborn and adult rat astroglia. AB - In recent literature, lymphokines have been reported to be able to promote both proliferation and maturation of some glial populations. In this paper, we compare the effect of rIL-1 on newborn and adult rat astroglial cells in vitro. In newborn, but not in adult astrocytes, 100 U/ml of rIL-1 beta increase [3H]thymidine incorporation with a maximal response by 3 days as compared to the control untreated culture. In contrast, rIL-1 beta induces an increase of GFAP immunoreactivity both in newborn and in adult astrocytes, as compared to the control untreated cells. These data indicate that, while both newborn and adult astroglial cells are capable of responding to rIL-1 beta, only newborn astrocytes can respond to this lymphokine with proliferation. Thus, it appears likely that different factors, other than rIL-1 beta, are needed by adult astrocytes to proliferate. PMID- 1781306 TI - Fetal alcohol effects: decreased synaptic formations in the field CA3 of fetal hippocampus. AB - The effects of prenatal ethanol exposure on the synaptic formation in the field CA3 of the hippocampus of fetal rats have been investigated on gestational day 21. Significantly decreased number of synaptic junctions was observed in the fetus showing decreasing cerebral weight either with or without decreasing body weight. The administration of 0.01% zinc with ethanol or 0.02% alpha-tocopherol acetate with ethanol during pregnancy resulted in an increased cerebral weight, but did not result in an increased synaptic formation compared to ethanol alone. This result indicates that one of the most vulnerable factors in rat fetus exposed to ethanol in utero is the synaptic formation in the hippocampus. In conclusion, ethanol exposure in utero during a period of brain development roughly equivalent to the first and second human trimesters can produce consistent dysforming effect of synapses and may be associated with the functional impairement of the central nervous system in the fetal alcohol effects. PMID- 1781307 TI - Neuro-immune network. Basic structural and functional correlates. AB - The relationship among the nervous, endocrine and immune systems can be addressed in a number of ways. In this minireview, after introducing the immune microenvironment and outlining the principal domains of neuroimmune investigations, the preference was given to the influence of lesioning and stimulation of brain structures on immunological responsiveness; the relationship between micromagnetic fields, brain and immunity; the humoral and cell-mediated immunological features of certain neurological and psychiatric diseases; and the effect of stress on immune reactions. Described phenomena support the contention that there are numerous and continuous intercommunications between the nervous system and the immune system. PMID- 1781309 TI - The application of the human stress model to psychoneuroimmunology. PMID- 1781308 TI - Stress, cancer and immunity. New developments in biopsychosocial and psychoneuroimmunologic research. AB - Research in biobehavioral oncology has been focused on stress as one dispositional factor in the multifactorial origin and in the clinical progression of malignant disease. New insights into the transduction of environmental influences to the immune system and to other body systems by the brain and neurotransmitters have increased the salience of this approach. Behavioral medicine in the area of cardiovascular disease has been successful due to the introduction of a "Type A" or coronary prone behavior pattern in large epidemiologic studies. This pattern is marked by both psychologic and physiologic hyperresponsiveness. Type A persons appear to be hostile, easily angered, competitive and hard-driving. More recently, behavioral oncologists have similarly attempted at conceptualizing a "Type C" or biopsychosocial cancer risk pattern, as they have noted the denial and suppression of emotions, in particular anger. Other features of this pattern are "pathological niceness", avoidance of conflicts, exaggerated social desirability, harmonizing behavior, over compliance, over-patience, as well as high rationality and a rigid control of emotional expression ("anti-emotionality"). This pattern, usually concealed behind a facade of pleasantness, appears to be effective as long as environmental and psychological homeostasis is maintained, but collapses in the course of time under the impact of accumulated strains and stressors, especially those evoking feelings of depression and reactions of helplessness and hopelessness. As a prominent feature of this particular coping style, excessive denial, avoidance, suppression and repression of emotions and own basic needs appears to weaken the organism's natural resistance to carcinogenic influences. This may mean that the excessive use of denial and suppression/repression has important psychophysiologic effects linked to tumor biology and host-defense. Recent studies reveal that psychosocial stressors which are met by inadequate and repressive coping styles are associated with changes in immunocompetence, including both humoral and cell-mediated immunity. Relationships between different immune parameters (natural killer cell activity, lymphocytes, serotonin uptake, mean platelet volume) and mood states, psychological coping styles and personality variables are outlined. Recent findings indicate also that in certain malignancies (eg. breast cancer) the clinical course of the disease is influenced by psychosocial factors and coping style, as well as that the risk of cancer recurrence and metastasis is influenced by the type and duration of a given stressor. Individuals with a more favorable outcome have higher fighting spirit, a greater potential for aggression and lesser suppressive tendencies. Psychological intervention in cancer patients in its different forms and within the frame of the over-all treatment has now become a matter of scientific discussion and research.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1781310 TI - Psychoneuroimmunology: yesterday, today and tomorrow. PMID- 1781311 TI - Interactions between glucocorticoid hormones and interleukins in T cell development: another possible link between neuroendocrine and immune systems. PMID- 1781312 TI - Hypothalamus-pituitary-adrenal (HPA) axis in physiological and pathological aging brain. PMID- 1781313 TI - Effect of stress on cardiovascular regulation in neurological diseases with dysautonomia. AB - Ten patients with Multiple Sclerosis (MS) and ten with Myotonic Dystrophy (MD) underwent an evaluation of cardiovascular reflexes by classic tests, tilt table test and mental stressors. Sympathetic and parasympathetic changes were detected by classical tests in MS patients. Mental stressors appeared able to reveal blood pressure control impairment in MD patients. Lower differential blood pressure was observed during mental stressors administration in MS with brainstem lesions at MRI. PMID- 1781314 TI - Interactions between prolactin and immune processes. PMID- 1781316 TI - Industrial animal cell reactor systems: aspects of selection and evaluation. PMID- 1781315 TI - Alterations in immune competence in outcome of coma following severe head trauma. AB - The homeostasis established by the interaction among the central nervous system, the immune system and the endocrine system, is radically altered by prolonged comatose state following severe head trauma. This must be taken into account when deciding on therapy and rehabilitation. In a group of post-comatose patients, we studied peripheral lymphocyte subpopulations, defined by monoclonal antibodies, and delayed hypersensitivity. Our findings are indicative of an immunological impairment originating at glioneuronal level, following head trauma. Such a temporary immune deficiency may in turn affect the equilibrium between the reconstitution of the blood-brain barrier and neuronal repair activity. PMID- 1781317 TI - Bioconversions of ergot alkaloids. AB - Ergot alkaloids are very important pharmaceutical substances with wide medical use. Their bioproduction is usually followed by chemical modification. Bioconversions of ergot alkaloids on an industrial scale have become more important in recent years. The aim of this study is to collect the available data on ergot alkaloid bioconversions and to show their potential applications. The paper deals with conversions of clavines, e.g. biooxidations, glycosylations of the alkaloids, and bioconversions of lysergic acid derivatives. A part of it is aimed at bioconversions of ergot alkaloids in mammalian organisms and obtaining their metabolites by biotransformation. The use of immobilized systems and cofermentation is also discussed. PMID- 1781318 TI - Membrane bioreactors: present and prospects. AB - Membrane bioreactors have a very handy in-situ separation capability lacking in other types of bioreactors. Combining various functions of membrane separations and biocatalyst characteristics of enzymes, microbial cells, organelles, animal and plant tissues can generate quite a number of membrane bioreactor systems. The cell retaining property of membranes and selective removal of inhibitory byproducts makes high cell density culture possible and utilizes enzyme catalytic activity better, which leads to high productivity of bioreactors. Enzyme reactions utilizing cofactors and hydrolysis of macromolecules are advantageous in membrane bioreactors. Anaerobic cell culture may be efficiently carried out in membrane cell recycle systems, while aerobic cultures work well in dual hollow fiber reactors. Animal and plant cells have much a better chance of success in membrane reactors because of the protective environment of the reactor and the small oxygen uptake rate of these cells. Industrial use of these reactors are still in its infancy and limited to enzyme and animal tissue culture, but applications will expand as existing problems are resolved. PMID- 1781319 TI - Shear effects on suspended cells. AB - Shear has been mainly considered in the technical literature as a destructive element, when applied to microorganisms and cells. Indeed, most of the research work addressing the subject aims at the identification of damaging levels of shear on a given culture. The present work is focused on the effects of shear on suspended cultures before the damaging levels are attained. Inspection of the literature reveals that shear may influence growth rate, cellular volume, metabolite production rate and distribution, and membrane permeabilities. Available devices for study and evaluation of shear effects on suspended cultures are described and critically reviewed. The review reveals the possibility of an influence of the liquid dynamics on the kinetics of the biochemical process. This is relevant for bioreactor design and scale up, and stresses the importance of using structural bioreactor models in order to describe the hydrodynamics of the system. PMID- 1781320 TI - New molecular insights on the development of the peripheral nervous system. PMID- 1781321 TI - Spinal cord slices with attached dorsal root ganglia: a culture model for the study of pathogenicity of encephalitic viruses. AB - We describe here a culture system for long-term growth of organotypic slices of spinal cord, with attached dorsal root ganglia (DRG) derived from 13-14 day mouse fetuses. This is a unique in vitro tool in which both central and peripheral nervous tissue grow and differentiate in culture to become heavily myelinated. During cultivation the slices and the ganglia become flattened so as to allow microscopical and immunocytochemical staining. When both central and peripheral myelin had been formed (usually around the third week of cultivation), cultures were infected with 5 x 10(6) PFU of West Nile Virus (WNV). Progeny virions appeared first in about 10% of the neurons and were subsequently observed between lamellae in the central myelin sheath of several axons. Such viral arrangement in relation to myelin membranes, might provide a novel concept for a possible mechanism underlying slow viral infection. PMID- 1781322 TI - Human fetal brain cultures: a model to study neural proliferation, differentiation and immunocompetence. PMID- 1781323 TI - DNA content revealed by cytophotometry in neurons: variability related to neuroplasticity. PMID- 1781324 TI - Origin of microglia and their regulation by astroglia. PMID- 1781325 TI - Structure and function of glia maturation factor beta. PMID- 1781326 TI - Brain extracellular matrix and nerve regeneration. PMID- 1781327 TI - Human nerve growth factor: biological and immunological activities, and clinical possibilities in neurodegenerative disease. PMID- 1781328 TI - Prenatal development of the rat amygdaloid complex: an electron microscopic study. AB - The prenatal development of the rat amygdaloid complex was studied ultrastructurally day by day starting from the 12th embryonic day (ED12) until birth (ED22). In the earlier stages of embryogenesis, the nerve cells were observed to be of small size. A thin cytoplasmic ring rich in free ribosomes surrounded the oval nuclei. The nucleoli were prominent their number being two or more in a nucleus. The intercellular spaces were wide. A significant advance in the development of the nerve cells and the neuropil was detected in the period between ED15 and ED18. This advance was represented by an increase in the cytoplasmic volume, appearance and development Golgi zones, grouping of the free ribosomes into rosettes, appearance of single synaptic contacts, and a ramification of large-calibre nerve processes that continued during the later stages of the embryogenesis (ED19-ED22). By the end of the prenatal period the number of the synaptic contacts increased and well-developed synaptic apparatuses were observed. The development of the organelles in the perikarya was also advanced. Nissl bodies were found in some neurons. The number of enlarged Golgi zones and mitochondria increased. PMID- 1781329 TI - Schwann cell proliferation during postnatal development, Wallerian degeneration and axon regeneration in trembler dysmyelinating mutant. PMID- 1781330 TI - Basic FGF and its actions on neurons: a group account with special emphasis on the parkinsonian brain. PMID- 1781331 TI - Molecular and morphological correlates following neuronal deafferentation: a cortico-striatal model. PMID- 1781332 TI - Monosialoganglioside GM1 and modulation of neuronal plasticity in CNS repair processes. PMID- 1781333 TI - Nerve growth factor in CNS repair and regeneration. PMID- 1781334 TI - Ordered disorder in the aged brain. PMID- 1781335 TI - Recent findings on the regulation of axonal calibre. PMID- 1781336 TI - Nicotinic cholinergic receptors in human brain: effects of aging and Alzheimer. PMID- 1781337 TI - ADP-ribosylation: approach to molecular basis of aging. PMID- 1781338 TI - The biogenic monoamines as regulators of early (pre-nervous) embryogenesis: new data. PMID- 1781339 TI - Hormone-dependent plasticity of the motoneurons of the ischiocavernosus muscle: an ultrastructural study. PMID- 1781340 TI - Critical periods of neuroendocrine development: effects of prenatal xenobiotics. AB - Phenobarbital, when administered prenatally in a small dose to animals, produced profound, and permanent effects on reproductive function in the offspring. Preliminary analysis of a unique cohort of adolescents who were exposed to phenobarbital in utero, suggests that long-term effects are also evident in the human. The precise nature of these effects is currently being determined and will be reported separately. These effects may be qualitatively and quantitatively different from effects seen in animals because of species difference in the timing or neuroendocrine differentiation. Of greater importance, however, is the fact that biologic and pharmacologic effects can be seen in the human following exposure to xenobiotics perinatally. Implications for other pharmacologic agents await further investigation. The rat model appears to have validity for extrapolation to man. PMID- 1781341 TI - The endocytic pathway for human immunodeficiency virus infection. AB - We have presented data supporting the view that HIV infection of T cells and monocytes proceeds via receptor-mediated endocytosis. Biochemical analysis of the pathway for internalization of 32P-labeled HIV revealed the presence of intact, intercellular virions and provided evidence for subsequent uncoating of these particles and release of viral RNA to the cytoplasm. Electron microscopy demonstrated virions within vesicles and documented fusion between viral and endosomal membranes. Others have provided evidence supporting the notion that endocytosis is not required for HIV infection. In consequence of this apparent paradox, it has been suggested that both mechanisms, i.e. direct fusion to the plasma membrane and endocytosis, are functional pathways for HIV entry. I do not favor this position. Examination of the biology of CD4, its role in lymphocyte activation, and its function as the receptor for HIV imply a more active role for this molecule in virus infection than simply as a transient anchor for fusion events. The principal experiment of concern is the report by Maddon, et al., that human CD4- expressing murine cell lines remain resistant to infection by VSV pseudotypes bearing the HIV envelope glycoprotein. This paper and a subsequent review of HIV entry by Marsh and Dalgleish comment on the possibility that endocytosis of human CD4 may not occur in murine cells hence, the block to infectious entry of these pseudotype virions. Resolution of the mechanism for HIV infection is more than rationalization or semantics. The pathway of endocytosis presents an unique feature of cell biology. Should HIV infection be proven to occur via this mechanism, then appropriate assays for novel classes of antiviral agents could be developed. Other features of the endosomal vesicle, such as the unique composition of its membrane or the possible presence of specific proteolytic activities might play important roles in HIV infection and thus, present new targets for the development of antiviral agents. Indeed, the synthetic liposome AL721 is an effective inhibitor of HIV infection in vitro. This antiviral agent probably acts by decreasing the cholesterol content of the virion envelope. It was shown previously that the envelope is specifically enriched in cholesterol, a property not associated with the plasma membrane but clearly involved in Semliki Forest virus fusion within the endosome.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1781342 TI - CD4 envelope interactions of HIV-1 and related human retroviruses. PMID- 1781343 TI - Molecular analysis of receptor binding and viral tropism. PMID- 1781344 TI - Role of the human immunodeficiency virus type I envelope glycoprotein in cytopathic effect. PMID- 1781345 TI - The assembly of the HIV-1 env glycoprotein into dimers and tetramers. AB - The envelope (env) glycoprotein of human immunodeficiency virus 1 (HIV-1), initially synthesized as a precursor molecule termed gp160, is cleaved into two noncovalently associated subunits prior to delivery to the plasma membrane. We have studied the oligomeric structure of this protein using chemical cross linking, velocity gradient sedimentation, and SDS-resistance. We find that gp160 forms stable homodimers after synthesis. After cleavage to gp120/gp41 the molecule becomes less stable to detergent solubilization and centrifugation but remains dimeric. Interactions between the 129 amino terminal residues in the ectodomains of adjoining gp41 subunits are both sufficient and necessary for assembly. In addition, tetramers composed of two dimers were also formed. Larger structures were not observed. The tetrameric paramyxovirus F protein, which has structural and functional similarities to the HIV-1 env protein, also forms a dimer of dimers. PMID- 1781346 TI - Cells infected by human immunodeficiency virus in vivo. PMID- 1781347 TI - Mediators of fusion between HIV-infected macrophages and lymphoid cells. PMID- 1781348 TI - HIV-1 infection of a non-CD4-expressing variant of HUT-78 cells: lack of inhibition by Leu3A antibodies and enhancement by cationic DOTMA liposomes. PMID- 1781349 TI - Capillary electrophoresis for the analysis of cellular nucleotides. PMID- 1781350 TI - Molecular analysis of hypoxanthine-guanine phosphoribosyltransferase deficiency in Japanese patients. PMID- 1781351 TI - Expression of normal and variant human hypoxanthine-guanine phosphoribosyltransferase in E. coli. AB - 1. ECPR is a rapid and effective means for generating recombinant human HPRT. 2. The Bl21 (DE3) T7 polymerase/T7 promoter system provides high level expression of human HPRT constructs after induction of the T7 polymerase gene with IPTG. 3. Human HPRT constructs expressed in E. coli mimic the variant properties originally demonstrated in lymphoblast extracts from affected individuals. 4. Human HPRT expressed in E. coli can be rapidly purified to near homogeneity by a two step purification scheme. PMID- 1781352 TI - HPRT gene mutations in a female Lesch-Nyhan patient. PMID- 1781353 TI - A single HPLC system for the evaluation of purine and pyrimidine metabolites in body fluids. PMID- 1781354 TI - Molecular analysis of human hprt gene deletions and duplications. PMID- 1781355 TI - Rat hypoxanthine phosphoribosyltransferase cDNA cloning and sequence analysis. PMID- 1781356 TI - Rescue of a lethal purine nucleoside phosphorylase mutation in the mouse via a second locus interaction. PMID- 1781357 TI - Genetic models of purine nucleoside phosphorylase deficiency in the mouse. PMID- 1781358 TI - 5'-nucleotidase--an overview of the last three years. PMID- 1781359 TI - Simple method for the quantitative analysis of dihydropyrimidines and N-carbamyl beta-amino acids in urine. PMID- 1781360 TI - Studies on the structure and biosynthesis of the phosphatidyl-inositol-glycan anchor and the carbohydrate side chains of human placental ecto-5'-nucleotidase. PMID- 1781361 TI - Diphosphonucleosides are indispensable cofactors of AMP-specific cytoplasmic 5' nucleotidase catalysed reaction. PMID- 1781362 TI - Purine nucleoside phosphorylase: allosteric regulation of a dissociating enzyme. PMID- 1781363 TI - Purine nucleoside phosphorylase of bovine liver mitochondria. PMID- 1781365 TI - A comparative study of the small forms of adenosine deaminase from various organisms. PMID- 1781364 TI - Uridine and purine nucleoside phosphorylase activity in human and rat heart. PMID- 1781366 TI - Adenosine deaminase in the diagnosis of pleural effusions. PMID- 1781367 TI - Molecular forms of human kidney AMP-deaminase. PMID- 1781368 TI - Molecular analysis of acquired myoadenylate deaminase deficiency in polymyositis (idiopathic inflammatory myopathy). PMID- 1781370 TI - Diagnostic potential of HPLC: experimental and clinical trials. PMID- 1781369 TI - Molecular genetic analysis of chromosome 9p in methylthioadenosine phosphorylase deficient glioma cell lines. PMID- 1781371 TI - S-adenosylhomocysteine hydrolase activity in erythrocytes from HIV-infected patients. PMID- 1781372 TI - Rapid purification of a bifunctional protein complex possessing phosphoribosylaminoimidazole carboxylase (EC 4.1.1.21) and phosphoribosylaminoimidazolesuccinocarboxamide synthetase (EC 6.3.2.6) activities. PMID- 1781373 TI - Highest ADA expressing mouse tissues also exhibit cell-type specific coordinate up-regulation of purine degradative enzymes. PMID- 1781374 TI - Cytidine deaminase: a rapid method of purification and some properties of the enzyme from human placenta. PMID- 1781375 TI - Expression and substrate specificities of human thymidine kinase 1, thymidine kinase 2 and deoxycytidine kinase. PMID- 1781376 TI - Pyrimidine 5'-nucleotidase(s) of human erythrocytes: enzymatic and molecular characterization. PMID- 1781377 TI - GTP activates two enzymes of pyrimidine salvage from the human intestinal parasite Giardia intestinalis. PMID- 1781378 TI - Guanine metabolism in primary rat neuronal cells. PMID- 1781379 TI - Urinary pterins in Lesch-Nyhan syndrome. PMID- 1781380 TI - Basis for the chondro-osseous dysplasia associated with adenosine deaminase deficiency: selective toxicity to immature chondrocytes. PMID- 1781381 TI - Analysis of forebrain dopaminergic pathways in HPRT-mice. PMID- 1781382 TI - Reference values of orotic acid, uracil and pseudouridine in urine. PMID- 1781383 TI - Adenylosuccinase activity and succinylpurine production in fibroblasts of adenylosuccinase-deficient children. PMID- 1781384 TI - Purine nucleotide cycle, molecular defects and therapy. PMID- 1781385 TI - Guanine ribonucleotide depletion inhibits T cell activation. PMID- 1781386 TI - Pyrimidine pathways: news concerning the mechanism of orotidine-5'-monophosphate decarboxylase. PMID- 1781387 TI - Automated quantitative analysis for orotidine and uridine/thymine in urine by high-performance liquid chromatography with column switching. PMID- 1781388 TI - Dihydropyrimidine dehydrogenase deficiency in a Hutterite newborn. PMID- 1781389 TI - Superactive UMP hydrolase: cause or consequence of haemolytic anaemia? PMID- 1781390 TI - NAD synthesis in ADA deficient erythrocytes of the opossum Didelphis virginiana. PMID- 1781391 TI - Pyridine nucleotide metabolism: purification and properties of NMN adenylyltransferase from human placenta. PMID- 1781392 TI - NAD synthesis in human erythrocytes: determination of the activities of some enzymes. PMID- 1781393 TI - A syndrome of megaloblastic anemia, immunodeficiency, and excessive nucleotide degradation. PMID- 1781394 TI - Adenine nucleotide catabolism in the erythrocytes of uraemic patients. PMID- 1781396 TI - Nucleotide catabolism in red blood cells of rabbit. PMID- 1781395 TI - HPLC assay of uridine monophosphate synthase (UMPS) in chorionic villus samples (CVS) and erythrocytes (RBC). PMID- 1781397 TI - The effect of aspirin on blood cell nucleotides in vivo. PMID- 1781398 TI - Z-nucleotides formation in human and rat cells. PMID- 1781399 TI - Purine metabolism in regenerating liver-bearing rats. PMID- 1781400 TI - Purine nucleotide synthesis in rat liver after castration. PMID- 1781402 TI - A RP-HPLC method for the measurement of guanine, other purine bases and nucleosides. PMID- 1781401 TI - Effects of oral ribose on muscle metabolism during bicycle ergometer in patients with AMP-deaminase-deficiency. PMID- 1781403 TI - Some aspects of purine nucleotide metabolism in human lymphocytes before and after infection with HIV-1 virus: nucleotide content. PMID- 1781404 TI - Prenatal diagnosis of Lesch-Nyhan syndrome by purine analysis of amniotic fluid and cordocentesis. PMID- 1781405 TI - Gene therapy in man and mice: adenosine deaminase deficiency, ornithine transcarbamylase deficiency, and Duchenne muscular dystrophy. PMID- 1781406 TI - Regulation of the human adenosine deaminase gene by first intron sequences: a T cell enhancer. PMID- 1781407 TI - Expression of the APRT gene in an adenovirus vector system as a model for studying gene therapy. PMID- 1781408 TI - Transcriptional regulation of ribonucleotide reductase. PMID- 1781409 TI - An improved screening method for inherited disorders of purine and pyrimidine metabolism by HPLC. PMID- 1781410 TI - Mutational basis of adenine phosphoribosyltransferase deficiency. AB - The mutational basis of APRT deficiency was studied in non-Japanese and Japanese patients. Fifteen different mutations have been identified altogether. Of these 4 were common, 6 were located in exon 3, and two at the exon 4-intron 4 junction. The common mutations were a missense mutation in exon 3 (asp65----val) and a T insertion at the exon 4-intron 4 junction in non-Japanese patients, a nonsense mutation in exon 3 (trp98----end) in Type I Japanese patients, and an exon 5 missense mutation (met136----thr) in Type II patients. The other mutations in Type I patients consisted mainly of single base changes and small deletions. PMID- 1781411 TI - Analysis of the promoter region of the CHO APRT gene. PMID- 1781412 TI - Germline and somatic mutations leading to adenine phosphoribosyltransferase (APRT) deficiency. PMID- 1781413 TI - Long-term evolution of type 1 adenine phosphoribosyltransferase (APRT) deficiency. PMID- 1781414 TI - A strategy for the creation of mutations in human HPRT-cDNA and the expression of recombinant proteins in E. coli. PMID- 1781415 TI - Pharmacokinetics, safety, and ability to diminish leukotriene synthesis by zileuton, an inhibitor of 5-lipoxygenase. AB - Zileuton is a potent and specific inhibitor of 5-lipoxygenase, the first dedicated enzyme in the metabolism of arachidonic acid to the leukotrienes. The leukotrienes have been implicated in numerous pathological conditions. Zileuton was given to normal human volunteers in single doses of 200 mg to 800 mg. Results of these studies indicated that zileuton was well absorbed orally with an elimination half-life of approximately 2.5 hours. Leukotriene B4 production by ex vivo calcium ionophone stimulated whole blood was inhibited by up to 80% of baseline and correlated with plasma concentrations. Zileuton did not significantly inhibit cyclooxygenase as demonstrated by thromboxane B2 levels. There were no safety concerns that would preclude development. PMID- 1781416 TI - Conformational dynamics of the formyl peptide receptor: a prototype for studies of receptor dynamics and binding pocket structure. AB - We have used spectrofluorometric and flow cytometric techniques to examine the interactions of formyl peptide ligands (L) with their cell surface receptors (R). Kinetic studies suggest that L binds to R at a diffusion limited rate and that R undergoes rapid transitions involving three states (LR, LRG, the ternary complex of L and R with the G protein, and a desensitized receptor "LRX" which forms within seconds) prior to internalization. A spectroscopic analysis of the interaction between L and R show that the binding pocket of R is large enough to contain no more than 6 amino acids and that a fluorescein-labelled pentapeptide is quenched upon binding to R. We hypothesize that histidine 90 (putatively located in the extracellular loop connecting the second and third transmembrane domains) protonates L and quenches the probe. New technology will extend the analysis of structure and dynamics to low affinity peptide receptors of living biological systems. Such technology will have implications in the design of peptidomimetic ligand and drug molecules. PMID- 1781417 TI - Combined DMARDS in rheumatoid arthritis: past, present and future. AB - The potential for combined therapy in rheumatoid arthritis is rapidly increasing considering the recent development of various new treatment modalities. However, an aggressive effort must be made to stage patients according to various clinical and immunological parameters. Only then can appropriate combined therapy be used effectively in this disease process. The development of such combined therapy could expand into other diseases such as scleroderma, systemic lupus erythematosus and multiple sclerosis. PMID- 1781418 TI - Role of cytokines in inflammation and autoimmunity. PMID- 1781419 TI - Cytokines and drugs workshop. PMID- 1781420 TI - C. Gordon Van Arman Scholarship competition. PMID- 1781421 TI - Cytokine modulation of bacterial cell wall-induced arthritis. AB - Bacterial cell wall-induced arthritis in experimental animals is dependent on mononuclear cell infiltration and accumulation. These mononuclear cells secrete cytokines which promote synovial hyperplasia and erosive destruction of bone and cartilage. Whereas local administration of cytokines may exacerbate these events, systemic administration of TGF-beta or gamma IFN effectively suppresses both the acute and chronic phases of the disease. PMID- 1781422 TI - Stromelysin: structure and function. AB - Stromelysin, a member of the metalloproteinase gene family, may play a crucial role in pathological turnover of connective tissues. The following manuscript will review structural features and functional properties of stromelysin and its related proteinases. PMID- 1781423 TI - The regulation of connective tissue metalloproteinases by natural inhibitors. AB - The family of matrix metalloproteinases have a fundamental role in the breakdown of connective tissue matrices in both physiological and pathological processes. The endogenous levels of the tissue inhibitors of metalloproteinases are a key determinant in the regulation of the activity of these enzymes. Current research on the mode of action of these inhibitors at the molecular level, aimed at their use as models for low molecular weight inhibitors, is outlined. Preliminary evidence for inhibitor deficiency in disease states and their potential use as therapeutic agents are summarised. PMID- 1781424 TI - Probing the role of interleukin-1 beta convertase in interleukin-1 beta secretion. AB - Interleukin-1 beta must be processed from its precursor form of 31.5 kDa to its mature form of 17 kDa in order to elaborate its wide array of bioactivities. The recent identification of a monocyte-specific endoprotease, termed interleukin-1 beta-converting enzyme (ICE), capable of generating authentic, bioactive 17 kDa IL-1 beta suggests that this protease may serve a specific role in the processing and subsequent secretion of IL-1 beta. To test this hypothesis, we describe initial attempts to establish a monocytic cell-based system to test if mutant preIL-1 beta molecules which are poor substrates for ICE in vitro will be processed and secreted by monocytic cells. PMID- 1781425 TI - The proteolytic activation of interleukin-1 beta. AB - Interleukin-1 beta (IL-1 beta) is released from an inactive precursor by a proteolytic cleavage. A monocytic protease has been identified that appears to be involved in the physiological activation of this cytokine. Two situations have been found in which precursor IL-1 beta exists without the monocytic processing enzyme, and in these cases other proteases, such as neutrophil elastase, cathepsin G and cathepsin L, may be involved in generating the active cytokine. PMID- 1781426 TI - NSAID association with gastrointestinal bleeding and peptic ulcer. AB - This paper reviews recent data describing the increased risk of bleeding and peptic ulcer with NSAID use in arthritis and non-arthritis populations. We briefly report personal studies on both aspects. By objective testing in 66 GI bleeders the use of NSAIDs, especially ASA, was more strongly associated with GI bleeding from both ulcer and non-ulcer sources, including colonic, than previously reported (82% vs. 21% in controls). ASA abuse, often surreptitious, may account for many, if not most, treatment-resistant peptic ulcers. We report 29 such patients. Adverse effects of NSAID use add considerably to economic cost, excess morbidity and mortality, especially in the elderly. Bleeding and peptic ulcer are separate risks of NSAID use. This conclusion carries major implications for prophylaxis strategies. PMID- 1781427 TI - James H. Sterner--chemist, occupational physician, industrial hygienist, and educator. PMID- 1781428 TI - Analysis of air for tertiary amine catalysts used in the polyurethane foam industry. PMID- 1781429 TI - Subacute inhalation toxicity of benzaldehyde in the Sprague-Dawley rat. AB - Benzaldehyde was administered by inhalation to female and male Sprague-Dawley rats for 14 consecutive days (low level: 500 ppm; medium level: 750 ppm; high level: 1000 ppm). Effects of this chemical were investigated during and at the end of the exposure period. Throughout the experiment, significant hypothermia and a reduction of motor activity were observed in all rats exposed to benzaldehyde and were accompanied in high-level rats by a severe impairment of the central nervous system, as evidenced by abnormal gait, tremors, and a positive Straub sign. Histopathologic examination of tissues from exposed rats showed a goblet cell metaplasia that was largely confined to the respiratory epithelium lining the nasal septum in male rats. No other abnormal microscopic changes were observed. A no effect level was not observed in these studies. PMID- 1781430 TI - An evaluation of airborne nickel, zinc, and lead exposure at hot dip galvanizing plants. AB - Industrial hygiene surveys were conducted at three hot dip galvanizing plants to determine occupational exposure to nickel, zinc, and lead. All three plants employed the "dry process" and used 2% nickel, by weight, in their zinc baths. A total of 32 personal and area air samples were taken. The air samples were analyzed for nickel, zinc, and lead. Some samples were also analyzed for various species of nickel (i.e., metallic, soluble, and oxidic). The airborne concentrations observed for nickel and its three species, zinc, and lead at the three plants were all well below the current and proposed threshold limit values recommended by the American Conference of Governmental Industrial Hygienists (ACGIH). PMID- 1781431 TI - Collection efficiency of a personal sampler for microbiological aerosols. AB - A modified personal impinger (MPI) for sampling airborne microorganisms was tested for collection efficiency with the jet nozzle placed at various positions above and below the liquid surface. The sampler was operated with 10 mL of water and sampling rates between 1.08 and 3.4 L/min. The collection efficiencies for a polydisperse aerosol of diethylhexyl phthalate (DEHP) and monodisperse aerosols of polystyrene latex particles (ULP) were determined with an optical particle counter. The results show that a test aerosol generated from a suspension, such as ULP, gives test results that agree better with theoretical predictions than a polydisperse oil aerosol such as DEHP. The measured aerodynamic 50% cutoff diameters (D50) agreed with those predicted from impaction theory with the jet nozzle 4 mm from the flask bottom. For preservation of viability during sampling of microorganisms, it is common to use impingers with the jet nozzle above the liquid surface. These tests showed that if the MPI is operated with the jet nozzle above the liquid surface, D50 will be displaced toward larger particle sizes because the jet-to-plate distance/jet diameter ratio increases substantially when a soft impaction surface such as the liquid is used. The increased D50 could to some extent be compensated for by increasing the flow rate. An increased flow rate will, however, result in more losses because of aerosol regeneration. PMID- 1781432 TI - Experimental examination of factors that affect dust generation. AB - A method is presented to examine factors that affect the amount and size distribution of dust generated by falling granular material in still air. This work was conducted by using an apparatus with separate dust generating and dust measuring sections. The dust generated by a falling material was carried into an elutriation column equipped with a slotted Sierra high-volume impactor at the top. This apparatus can measure dust generation rates for particles between 0.4 and 25 microns in aerodynamic diameter as well as the amount of air entrained by the falling material. Four granular materials were tested, and a simple model was developed to describe the dust generation rate of these materials as a function of particle size, drop height, material flow, and moisture content. Moisture content strongly influenced the interparticle binding forces and the amount of dust generated. Drop height and material flow influenced the material separation forces and also significantly influenced the amount of dust generated. PMID- 1781433 TI - Contaminant reduction by ventilation in a confined space model--toxic concentrations versus oxygen deficiency. AB - Airborne contaminants can create hazardous conditions in confined spaces (CS) across a broad range of concentrations, e.g., from relatively low, potentially toxic levels (ppm) to much higher levels (%) causing oxygen deficiency. This study investigated ventilation characteristics for isobutylene (IBE) at relatively low concentrations, simulating toxic levels. Experimental data were compared to results from previous studies of oxygen deficiency. Data were obtained at several locations in a cubical CS model, with several variable test parameters: ventilation mode (exhaust and supply), volume flow rate ("air changes" per hour), and ventilation inlet/outlet elevation (% of model height). Findings indicated similar ventilation characteristics, in general, for simulated toxic (IBE) levels compared to oxygen deficiency. Both IBE and O2 deficiency data have shown that supply ventilation is typically more effective than exhaust and that CS locations aligned with supply outlets experience much more rapid contaminant reduction than do other locations. The data suggest that highly accurate predictions of ventilation characteristics cannot be expected for all cases with widely different contaminants and concentrations. Findings from this study indicate that ventilation guidelines for one range of contaminant concentration (e.g., causing oxygen deficiency) can be extended reasonably to encompass a broader range of concentration (e.g., to include toxic or flammable atmospheres). PMID- 1781434 TI - Occupational exposure of electrical utility linemen to pentachlorophenol. AB - Occupational exposure to pentachlorophenol (PCP) for a crew of electrical utility linemen was monitored over a 6-month period by using total PCP in urine per gram of creatinine as a biological monitoring parameter. Urine samples were collected from three groups: A, B, and control, at a 4-week frequency during 1989. Group A was required to use new gloves after each 4-week work period; Group B changed gloves on a need basis as per normal operating procedure. The control group consisted of members of the administrative office staff who were not occupationally exposed. The used gloves returned by Group A were monitored for contamination. On the basis of analysis of the collected data the following conclusions were noted. (1) The linemen experienced a seasonal exposure pattern with exposures peaking in July and August. This seasonal effect was also observed with glove contamination data. (2) The glove contamination levels were significantly associated with urine PCP concentrations when both these variables were expressed as geometric means for the individuals in Group A. Inclusion of work experience as an additional variable enhances this association. Less experienced linemen tended to perform more activities with higher current exposure and had higher urine and glove PCP measurements and higher correlations between these variables than more experienced linemen. (3) Over the study period, the difference in long-term exposures of Group A and Group B linemen was not statistically significant. (4) The long-term individual exposures, calculated as the geometric mean of each individual's sequential sample readings, were all below the biological monitoring guideline value of 1000 micrograms PCP/g creatinine. PMID- 1781435 TI - Environmental versus analytical variability in exposure measurements. AB - Measurements of 8-hr time-weighted average (TWA) exposures are subject to environmental variability and collection and analytical error. Environmental variability can be represented by the geometric standard deviation (GSD) of the lognormally distributed 8-hr TWAs; analytical variability can be represented by the coefficient of variation (CV) of the normally distributed collection and analytical errors. A mathematical expression is derived for the variance of the measured 8-hr TWAs as a function of the GSD of the true daily average exposures and the total CV of the industrial hygiene method used in monitoring. For typical values of the GSD and CV, environmental variability is far more important than analytical variability in determining the variance of the measured 8-hr TWAs. A resulting policy implication is that the Occupational Safety and Health Administration inappropriately focuses on analytical variability when determining compliance with its permissible exposure limits. PMID- 1781436 TI - Threshold limit values. PMID- 1781437 TI - Validation of sampling data from the Occupational Safety and Health Administration (OSHA) Integrated Management Information System (IMIS) PMID- 1781438 TI - Accredited laboratories. PMID- 1781439 TI - 1991 Cummings Memorial Award Lecture. Industrial and environmental hygiene: professional growth in a changing environment. PMID- 1781440 TI - Characterization of emission factors related to source activity for trichloroethylene degreasing and chrome plating processes. AB - A study at an automotive parts fabrication plant evaluated four metal surface treatment processes during production conditions. The evaluation provides examples of how to estimate process emission factors from activity and air concentration data. The processes were open tank and enclosed tank degreasing with trichloroethylene (TCE), chromium conversion coating, and chromium electroplating. Area concentrations of TCE and chromium (Cr) were monitored for 1 hr periods at three distances from each process. Source activities at each process were recorded during each sampling interval. Emission rates were determined by applying appropriate mass balance models to the concentration patterns around each source. The emission factors obtained from regression analysis of the emission rate and activity data were 16.9 g TCE/basket of parts for the open-top degreaser; 1.0 g TCE/1000 parts for the enclosed degreaser; 1.48 1.64 mg Cr/1000 parts processed in the hot CrO3/HNO3 tank for the chrome conversion coating; and 5.35-9.17 mg Cr/rack of parts for chrome electroplating. The factors were also used to determine the efficiency of collection for the local exhaust systems serving each process. Although the number of observations were limited, these factors may be useful for providing initial estimates of emissions from similar processes in other settings. PMID- 1781441 TI - Physiologic and subjective effects of respirator mask type. AB - The effect of alternate airflow path designs on full-face mask air-purifying respirators was assessed in 14 healthy volunteers during submaximal exercise. Respirator designs included no respirator (N), full-face mask, dual-cartridge with no nasal deflector (FN), full-face mask respirator with nasal deflector (FD), and a powered air-purifying respirator (PA). Physiologic effects were measured by using respiratory inductive plethysmography and subjective responses by two visual analog scales. There were significant effects of airflow path design upon the physiologic parameters of ventilation, tidal volume, and mean flow rate. There were no significant physiologic or subjective differences between the full-face mask respirators with and without the nasal deflector in place. The PA had less physiologic impact than the nonpowered models but did not show significant subjective benefit. The study suggests that both subjective and objective physiologic responses must be utilized in assessing respirator design. PMID- 1781442 TI - Occupational noise exposure and hearing loss in fire fighters assigned to airport fire stations. AB - The National Institute for Occupational Safety and Health (NIOSH) was requested to conduct a health hazard evaluation (HHE) at a large metropolitan fire department. The request concerned the hearing levels and noise exposures of fire fighters who were assigned to two fire stations serving the international airport. There was concern that these fire fighters were at a greater risk of accruing hearing loss than fire fighters located at other fire stations because of the addition of aircraft noise to their occupational noise exposures. The city also requested that NIOSH investigate other fire stations, not influenced by the airport, for noise exposures and hearing ability among a larger population of the fire fighters. NIOSH investigators conducted noise surveys at five fire stations and examined the hearing ability of 197 fire fighters. The noise surveys consisted of personal noise dosimetry on fire fighters assigned to the fire station for the entire 24-hr tour of duty over 2 consecutive days at each of the five stations. A NIOSH investigator accompanied the fire fighters on their vehicle to log response times and activities. The audiometric examinations were pure-tone, air conduction tests administered according to the Occupational Safety and Health Administration's (OSHA's) hearing conservation amendment. The noise dosimetry results revealed time-weighted averages (TWAs) that ranged from 60 to 82 dBA. However, the levels encountered during Code 3 responses (warning lights, sirens, and air horns) reached 109 dBA for a 1-min time period. The audiometric results showed that the average fire fighter exhibited a characteristic noise induced permanent threshold shift.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781443 TI - Comparisons of air and liquid personal cooling for intermittent heavy work in moderate temperatures. AB - Personal microenvironmental cooling has been used to enhance safety and extend the work capacity of laborers wearing protective clothing. Previous studies of air and liquid cooling have used either very low work rates or high environmental temperatures. Emergency work tasks frequently require high work rates and occur in moderate ambient temperatures. The purpose of this research was to examine the efficacy of intermittent personal cooling during rest and to compare liquid and air cooling systems in subjects engaged in hard work. Fourteen volunteers wearing chemical protective clothing performed treadmill walking at a metabolic rate of 430 W for 45 min followed by a 15-min rest at a wet-bulb globe temperature of 25 degrees C. During rest, volunteers received either no cooling, air cooling, or liquid cooling. Both cooling systems partially alleviated heat strain and increased work time with the air system offering slightly more effective cooling. PMID- 1781444 TI - Tri (2-chloroisopropyl) phosphate--an unexpected organochlorine contaminant in some charcoal air-sampling sorbent tubes. AB - Air sampling in a government building was necessary in response to reports of a cancer cluster. SKC (Eighty Four, Pa.) charcoal coconut shell-based sorbent tubes (226-01 lot 120) were recommended for this procedure. A recently purchased supply was present at the University of British Columbia and consequently was used for this particular study. Analysis of the front charcoal section showed the presence of a flame retardant, tri (2-chloroisopropyl) phosphate, which was confirmed by gas liquid chromatography (GLC) and mass spectrometry analysis. In an effort to identify the source of this fire retardant in the building, it became apparent from the analysis done on unknown field blanks that tri (2-chloroisopropyl) phosphate was a contaminant of the sorbent tubes used. Analysis of additional blank tubes identified the foam separators as the most likely source of contamination. Levels of tri (2-chloroisopropyl) phosphate in the front charcoal section ranged from 1.3 to 5.9 micrograms. The foam separator contained between 11.4 and 16.5 micrograms, and the backup charcoal section contained between 14.5 and 24.0 micrograms of tri (2-chloroisopropyl) phosphate. In addition, another flame retardant, tri (1,3 dichloro-2-propyl) phosphate was also found. Because these contaminants have long column retention times in GLC, it may not be apparent that these contaminants are present and consequently are likely to have modified the sorbent characteristics of the activated charcoal. Another batch of sorbent tubes bearing the same catalog number and lot number was purchased from the supplier; no flame retardants were found in this batch.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781445 TI - Early stages of trophoblastic invasion of the maternal vascular system during implantation in the macaque and baboon. AB - Trophoblastic invasion and remodeling of the uteroplacental (spiral) arteries in primates are well-documented, but virally nothing is known of the early stages of these phenomena. Therefore, we examined invasion of the maternal vasculature in macaques and baboons at, and immediately following, implantation. Following penetration of the uterine epithelium (day 9), trophoblast spreads along the residual epithelial basal lamina. By day 10, cytoplasmic processes penetrate the epithelial and endothelial basal laminae, and syncytial trophoblast insinuates itself between maternal endothelial cells. As lacunae develop, both syncytial and cytotrophoblast are exposed to maternal blood. Endovascular cytotrophoblast was first observed in subepithelial dilated capillaries and venules. These vessels are lined by increasingly hypertrophied endothelial cells. The spiral arterioles are unmodified at this time. Particularly interesting was the observation that there is rapid extensive endovascular trophoblast invasion of the spiral arterioles immediately beneath the implantation site. By day 14-16 nearly all of the small arterioles directly beneath the site are completely occluded. There is no invasion of the veins in this region. Somewhat later, the deeper arterioles in the principal zone are invaded. Rather than a continuous stream of cells invading the deeper arterioles, these endovascular cells occur in clusters ranging from a few cells to groups of cells that completely plug the lumen. Our results indicate that trophoblastic invasion of maternal vessels occurs very early; and, at least initially, trophoblast can migrate between and along endothelial cells without causing their lysis. The endovascular cells eventually interrupt the endothelial lining of the arterioles and penetrate the walls of the vessels. The occlusion of arterioles underneath the site suggests that circulation through the lacunae at this stage is indirect. Corresponding stages of human development were examined, and no invasion of arterioles could be observed prior to formation of an extensive cytotrophoblastic shell. PMID- 1781446 TI - Chorioallantoic placenta formation in the rat: II. Angiogenesis and maternal blood circulation in the mesometrial region of the implantation chamber prior to placenta formation. AB - Rat gestation sites were examined on days 7 through 9 of pregnancy by light microscopy and transmission and scanning electron microscopy to determine the extent of vascular modifications in the vicinity of the mesometrial part of the implantation chamber (mesometrial chamber). At a later time, the mesometrial chamber is, in conjunction with the uterine lumen, the site of chorioallantoic placenta formation. On day 7, in the vicinity of the mesometrial chamber, vessels derived from a subepithelial capillary plexus and venules draining the plexus were dilating. By early day 8, this network of thin-walled dilated vessels (sinusoids) was further enlarged and consisted primarily of hypertrophied endothelial cells with indistinct basal laminas. Sinusoids were frequently close to the mesometrial chamber's luminal surface which was devoid of epithelial cells but was lined by decidual cell processes and extracellular matrix. By late day 8, cytoplasmic projections of endothelial cells extended between healthy-appearing decidual cells and out onto the mesometrial chamber's luminal surface, and endothelial cells were sometimes found on the luminal surface indicating that endothelial cells were migrating. The presence of maternal blood cells in the mesometrial chamber lumen suggested that there was continuity between the chamber and blood-vessel lumens. On day 9, the mesometrial chamber was completely lined with hypertrophied endothelial cells, and sinusoid lumens were clearly continuous with the lumen of the mesometrial chamber. Mesometrial sinusoids and possibly the mesometrial chamber lumen were continuous with vessels in vicinity of the uterine lumen that were fed by mesometrial arterial vessels. Clearing of the mesometrial chamber lumen during perfusion fixation via the maternal vasculature indicated the patency of this luminal space and its confluence with mesometrial arterial vessels and sinusoids. The conceptus occupied an antimesometrial position in the implantation chamber on days 7 through 9, and it was not in direct contact with uterine tissues in the vicinity of the mesometrial chamber. These observations suggest that angiogenesis, not trophoblast invasion or decidual cell death, plays a major role in the opening of maternal vessels into the mesometrial chamber lumen before the formation of the chorioallantoic placenta. PMID- 1781447 TI - Trophoblast-uterine interactions during equine chorionic girdle cell maturation, migration, and transformation. AB - The structure of the equine chorionic girdle between days 28 and 42 of gestation was examined. Of particular interest were differentiation of trophoblastic cells within the girdle, adhesion between girdle and endometrium, invasion and displacement of the uterine epithelium, and the nature of the endometrium when girdle cells migrate into it to form endometrial cup cells. The chorionic girdle, identified initially as a band of tall columnar cells, becomes a stratified columnar epithelium indented by clefts and pits. Adhesion to and penetration through the endometrial luminal epithelium are rapid and occur initially in very limited areas. Stromal invasion occurs as strands of contiguous trophoblast cells invade through the basal lamina. Only girdle cells that are adjacent to the basal lamina or have entered the endometrial stroma undergo hypertrophy and differentiate into cup cells. At the initiation of trophoblastic invasion, the luminal epithelium contains numerous, large, intraepithelial, granular lymphocytes; small lymphocytes then accumulate in the stroma, but by day 42 lymphocytes are largely confined to the periphery of the cup. Although adhesion of trophoblast to the endometrial surface is initiated by small groups of girdle cells on restricted areas of the endometrial folds, the area is then increased by new areas of adhesion and by expansion of the initial invasion. Areas of girdle cells that do not attach undergo necrosis, as do superficial portions of areas of invasion. Consequently the girdle cells that form cups may be a minority of the original population. It is suggested that the differentiation of girdle cells is closely programmed and that cells that do not reach the stroma become necrotic at the same time that endometrial cup cells are differentiating. PMID- 1781449 TI - Hyaluronic acid influences the migration of myoblasts within the avian embryonic wing bud. AB - Myoblasts migrate in a proximodistal direction within the avian embryonic wing bud during normal limb development. Since the presence and distribution of hyaluronic acid within the wing bud coincide with the time and with the direction of the migration of myoblasts, we microinjected hyaluronic acid into chicken wing buds that had received grafts containing quail myoblasts. It was found that injected hyaluronic acid has a strong positive effect on the migration of myoblasts: it causes a migration of myoblasts in donor-host combinations in which this is normally not the case, and it can cause migration in a proximal direction, a phenomenon not observed during normal development. From this it may be concluded that hyaluronic acid can influence myoblast migration in vivo. A similar effect could be observed after the microinjection of dextran sulfate, a synthetic compound having similar physicochemical properties. Hyaluronic acid, therefore, may play an important role in the control of the migration of myogenic cells in vivo by its physiocochemical properties. PMID- 1781448 TI - Growth of mouse ectoplacental cone cells in subcutaneous tissues. Development of placental-like cells. AB - Ectoplacental cones of mouse embryos collected on day 8 of pregnancy were grafted into the dorsal subcutaneous tissue of host mice. The grafts were collected between days 3 and 8 after transfer and processed for light and electron microscope morphological analysis as well as for cytochemistry of nonspecific alkaline phosphatase. Fragments of normal mouse placentas collected between days 12 and 18 of pregnancy were processed similarly. About 37% of the grafts were nonhemorrhagic nodules formed by different kinds of trophoblastic cells. These cells had many morphological and cytochemical features of cells present in normal mouse placentas. Nonphagocytic giant cells, glycogen cells, as well as cells with a well-developed granular endoplasmic reticulum were similar to cells found in the placenta and were always present in the grafts. Cells showing features intermediate between the above-mentioned cells and those whose cytoplasm was poor in organelles also were found in the grafts. The latter resembled cells of layer 1 of the labyrinth of the placenta. These results suggest that trophoblastic cells of the ectoplacental cones had differentiated into placental cells following their transfer to the subcutaneous tissue. PMID- 1781450 TI - Growth and development of the human infant breast. AB - Seventy-two samples of infant breasts, aged from newborn to 2 years, were collected at necropsy. Whole-mount preparations and histological sections were made. A system of classification was devised to study the extent of the structural development of the ductal system (morphological types I, II, and III) and the functional differentiation of the lining epithelium (functional stages I to V). There was no correlation between the age of the infant and the type of development of the ductal system. In contrast, the epithelial differentiation followed a chronological pattern, starting with secretory changes and apparently going through a period characterized by apocrine metaplasia before post-secretory involution. These epithelial changes were not associated with the morphological type of the ductal system. There were no distinguishing features between the breasts from the two sexes. Immunoperoxidase staining for actin and kappa-casein was carried out to study the myoepithelial cells and secretory cells, respectively. Myoepithelial cells were present at all stages and prominent staining for casein was observed up to 2 months of age. Embryonic-type adipose tissue was seen in 7 cases, in one of which it was associated closely with the developing ductal system. Extramedullary hematopoiesis was observed in the periductal connective tissue until 4 months of age. This paper describes the most extensive anatomical and histological study of the human infant breast to date and lays the foundation for a detailed study of the epithelial and stromal changes that take place during human breast development. PMID- 1781451 TI - Numbers of myosatellite cells in white axial muscle of growing fish: Cyprinus carpio L. (Teleostei). AB - By means of transmission electron microscopy (TEM), the percentage of myosatellite cells was shown to decrease from about 6% in carp of 5 cm standard length (SL) to less than 1% in carp larger than 18 cm SL. The ratio between muscle nuclei and non muscle nuclei remained constant. These TEM data, combined with data on the amount of DNA per gram of muscle tissue and per nucleus, were used to calculate the numbers of myosatellite cells per gram of tissue (TEM-DNA method). Total numbers of myosatellite cells could be calculated from the TEM-DNA data and the calculated amounts of muscle tissue per fish. After a slight initial increase, the total number of myosatellite cells in the white axial muscle of a carp appears to be rather constant during the growth phase of the fish. But the myosatellite cells become more and more diluted over an increasing number of myonuclei with age. In addition, the reliability of two new light microscopic methods for the determination of numbers of myosatellite cells was examined. The percentages of myosatellite cells were determined by counting the numbers of total nuclei and of heterochromatic nuclei situated inside the muscle fibers' basal laminae which were stained using an antibody against laminin. These percentages were not significantly different from those determined with TEM. The yield of myosatellite cells per gram of muscle tissue, isolated with a previously developed dissociation method, showed a direct relation to the number of myosatellite cells calculated to be present in the tissue (TEM-DNA method), but at a 1% level. Both methods are alternative ways to determine numbers of myosatellite cells when it is impossible or difficult to use TEM (e.g., large sample sizes, combination with immunohistochemical methods). PMID- 1781452 TI - Myofiber orientation in the weanling mouse heart. AB - This study provides a quantitative description at the cellular level of myofiber orientation throughout the ventricles of the mouse heart. We employed computer based methods of three-dimensional reconstruction from 3 microns plastic-embedded serial sections. Registration marks were introduced by drilling minute holes into each plastic block. Subfields of selected sections were photographed at 20 x magnification, using a computer-controlled microscope. The 35-mm film frames were projected onto a digitizer tablet and the epi- and endocardial boundaries were digitized manually. The "heads" and "tails" of linear segments of a representative myofiber sample present in each projected image were digitized in point mode. The many x-, y-, z-coordinate tables generated by digitization were reassembled automatically, giving a numerical description of the myofiber pattern. This pattern was studied interactively on a high-performance graphics workstation. We find that the heart wall is, to a first approximation, a "sandwich," in which the myofibers in the middle layer run mainly circumferentially, whereas those in the inner and outer layers run parallel or oblique to the apical-basal axis, a variant of the classical model of the myofiber pattern. We observed a "sleeve" in the interventricular septum, formed by longitudinal and oblique myofibers, a feature which apparently has not been described previously. Myofibers not running parallel to the transverse or longitudinal planes were not resolved in this study. We conclude that three dimensional reconstruction of the cardiac myofiber pattern at the light microscopic level, while laborious, is technically feasible and scientifically worthwhile. PMID- 1781453 TI - The role of growth factors in the embryogenesis and differentiation of the eye. AB - The vertebrate eye is composed of a variety of tissues that, embryonically, have their derivation from surface ectoderm, neural ectoderm, neural crest, and mesodermal mesenchyme. During development, these different types of cells are subjected to complex processes of induction and suppressive interactions that bring about their final differentiation and arrangement in the fully formed eye. With the changing concept of ocular development, we present a new perspective on the control of morphogenesis at the cellular and molecular levels by growth factors that include fibroblast growth factors, epidermal growth factor, nerve growth factor, platelet-derived growth factor, transforming growth factors, mesodermal growth factors, transferrin, tumor necrosis factor, neuronotrophic factors, angiogenic factors, and antiangiogenic factors. Growth factors, especially transforming growth factor-beta, have a crucial role in directing the migration and developmental patterns of the cranial neural-crest cells that contribute extensively to the structures of the eye. Some growth factors also exert an effect on the developing ocular tissues by influencing the synthesis and degradation of the extracellular matrix. The mRNAs for the growth factors that are involved in the earliest aspects of the growth and differentiation of the fertilized egg are supplied from maternal sources until embryonic tissues are able to synthesize them. Subsequently, the developing eye tissues are exposed to both endogenous and exogenous growth factors that are derived from nonocular tissues as well as from embryonic fluids and the systemic circulation. The early interaction between the surface head ectoderm and the underlying chordamesoderm confers a lens-forming bias on the ectoderm; later, the optic vesicle elicits the final phase of determination and enhances differentiation by the lens. After the blood-ocular barrier is established, the internal milieu of the eye is controlled by the interactions among the intraocular tissues; only those growth factors that selectively cross the barrier or that are synthesized by the ocular tissues can influence further development and differentiation of the cells. An understanding of the tissue interactions that are regulated by growth factors could clarify the precise mechanism of normal and abnormal ocular development. PMID- 1781454 TI - Monkey photoreceptor calycal processes and interphotoreceptor matrix as observed by scanning electron microscopy. AB - Photoreceptors and the interphotoreceptor matrix of monkey retina were observed by scanning electron microscopy. Cone photoreceptors are easily distinguished from rod photoreceptors by their wide conical inner segments. The calycal processes of 50 rods and 50 cones were counted and measured. The calycal processes of cones were distinct, short, and uniform in diameter (0.1 micron). They were arranged equidistantly and, in most cases, were not continuous with longitudinal inner segment ridges, as previously suggested. In contrast to cones, rod calycal processes were fewer in number, were about one-fourth the number of the cones, were of variable length (0.7 micron to 3.0 micron), and tapered to a fine point at their distal ends. The interphotoreceptor matrix appeared spongelike, made up of anastomosing plates and strands filling the interphotoreceptor space. Other than an increased amount of matrix around cones, no structural difference between rod- and cone-associated interphotoreceptor matrix was observed. PMID- 1781455 TI - The fine structure of the elasmobranch renal tubule: intermediate, distal, and collecting duct segments of the little skate. AB - Sharks, skates, and rays (Elasmobranchii) have evolved unique osmoregulatory strategies to survive in marine habitats. These adaptations include a complex renal countercurrent system for urea retention. The fine structure of the complete renal tubular epithelium has yet to be elucidated in any species of cartilagenous fish. The present study, which is a companion to our recent paper describing the ultrastructure of the neck and proximal segments of the elasmobranch nephron, uses thin sections and freeze-fracture replicas to elucidate the fine structural organization of the intermediate, distal, and collecting duct segments of the little skate, Raja erinacea, renal tubule. The epithelium of the intermediate, distal, and collecting duct segments consists of two major cell types: nonflagellar cells, the major epithelial cell type; and flagellar cells, described elsewhere. The intermediate segment consists of six subdivisions lined by cuboidal-columnar cells with variously elaborated microvilli and interdigitations of lateral and basal cell plasma membranes, as well as some subdivisions with distinctive vesicles and granules. The distal segment consists of two subdivisions, both of which are lined by a simple epithelium, and are distinguished from each other by their distinctive contents; dense bodies and granules. The collecting duct segment also has two subdividions, the first lined by a simple columnar epithelium and the second by a stratified columnar epithelium. Both subdivisions have apical secretory granules. The present findings show a more highly specialized and diverse epithelium lining the renal tubule of these cartilagenous fish than is found in either of the "adjacent" phylogenetic taxa, Agnatha or Ostheichthyes, suggesting significant differences among these groups in transepithelial transport mechanisms and renal function. PMID- 1781456 TI - Human spinal arachnoid septa, trabeculae, and "rogue strands". AB - This study was undertaken because of confusion arising from a diversity of names, descriptions, and drawings of the human spinal subarachnoid septa and trabeculae in the standard texts and dictionaries. Sixty-two complete human cords were examined under the dissecting scope. The finely "woven" adult arachnoid membrane was two-layered, and there were essentially no connecting septa or trabeculae between the cord and the arachnoid membrane anteriorly. Posteriorly, in the upper cervical region there is a scanty series of connecting fibers and fenestrated sheets 1 or 2 mm on either side of the midline; these become progressively more extensive in the lower cervical region, remain extensive to the lumbar enlargement, beyond which they progressively dwindle to end abruptly at the filum terminale origin. Throughout the cauda equina, strands are haphazardly arranged connecting the roots and supporting blood vessels. These occasionally become tangentially adherent to the arachnoid membrane. Throughout the length there are many unexplained, redundant, nonbranching, beaded, thicker "rogue strands". All of the above are of a different character from the right-angle fiber arrangement of the denticulate ligament, the two leaves of which are often separated form segmental longitudinal tunnels. The nerve rootlets (fila radicularia) for each dermatome are joined by strands and webs to each other. There was no evidence of change in number or type of connection with age. PMID- 1781458 TI - Principles of drug-use review approved by APhA, AMA, and PMA. PMID- 1781457 TI - S-antigen and glial fibrillary acidic protein immunoreactivity in the in situ pineal gland of hamster and gerbil and in pineal grafts: developmental expression of pinealocyte and glial markers. AB - Postnatal development of S-Ag and GFAP immunoreactivity in the in situ pineal glands of golden hamsters and gerbils was examined using the avidin-biotin peroxidase immunohistochemical technique. S-Ag was present in the gerbil pineal gland on the first postnatal day (P1), whereas it did not appear in the hamster pineal until P6. GFAP-immunoreactive astrocytes were first observed in the hamster pineal gland on P7 and in the gerbil pineal gland on P10. The number of S Ag-immunoreactive pinealocytes and GFAP-immunoreactive astrocytes in the pineal glands of hamsters and gerbils increased with increasing age from P7 to 3 weeks. By 4 weeks, strong S-Ag and GFAP immunoreactivity was observed in both hamster and gerbil pineal glands. GFAP-immunoreactive stellate astrocytes were distributed evenly throughout the gerbil superficial pineal gland, but they were more often located in the peripheral region of the hamster superficial pineal. For the pineal grafts, pineal glands from neonatal (3-5 day old) hamsters were transplanted into the third cerebral ventricle (infundibular recess or posterior third ventricle) or beneath the renal capsule of adult male hamsters. S-Ag immunoreactivity appeared in the pineal grafts within 1 week following transplantation. By 4 weeks the pineal grafts showed strong S-Ag immunoreactivity which was maintained until at least 12 weeks after transplantation. The time course of glial cell maturation in the cerebroventricular pineal grafts is generally parallel to the hamster pineal gland in situ before 4 weeks. By 12 weeks, however, more astrocytes differentiated and developed GFAP immunoreactivity in the pineal grafts than in the in situ pineals. These studies have described the postnatal development of S-Ag and GFAP immunoreactivity in in situ pineal glands and in neonatal pineal grafts. PMID- 1781459 TI - VA pharmacies' controls over addictive drugs are inadequate, government study finds. PMID- 1781460 TI - Medication errors, toxic effects most common causes of preventable iatrogenic cardiac arrests. PMID- 1781461 TI - Change needed for i.v. rifampin preparation instructions. PMID- 1781462 TI - Is ketorolac more cost-effective? PMID- 1781463 TI - Methylphenidate use in Michigan. PMID- 1781464 TI - Refractometry of controlled substances. PMID- 1781465 TI - Which bottom line? PMID- 1781466 TI - More information on hardening of carbamazepine tablets. PMID- 1781467 TI - Goals for health-care reform. PMID- 1781468 TI - Illumination and errors in dispensing. AB - The relationship between the level of illumination and the prescription dispensing error rate in a high-volume Army outpatient pharmacy was investigated. The prescription error rate was determined by direct, undisguised observation and retrospective prescription review under three levels of illumination (45, 102, and 146 foot-candles) during 21 consecutive weekdays. Illumination was controlled in the prescription-checking area of the pharmacy by using additional fluorescent lamps and filters. The three levels of illumination were randomly assigned to the 21 days to provide a total of 7 days of observations per level. The final sample consisted of 10,888 prescriptions dispensed by five pharmacists. The overall prescription error rate (including both content and labeling errors) was 3.39% (369 prescriptions). An illumination level of 146 foot-candles was associated with a significantly lower error rate (2.6%) than the baseline level of 45 foot candles (3.8%). There was a linear relationship between each pharmacist's error rate and that pharmacist's corresponding daily prescription workload for all three illumination levels. The effect of the observer was minimal. The rate of prescription-dispensing errors was associated with the level of illumination. Ergonomics can affect the performance of professional tasks. PMID- 1781469 TI - Formulary evaluation of second-generation cephamycin derivatives using decision analysis. AB - Use of decision analysis in the formulary evaluation of the second-generation cephamycin derivatives cefoxitin, cefotetan, and cefmetazole is described. The rating system used was adapted from one used for the third-generation cephalosporins. Data on spectrum of activity, pharmacokinetics, adverse reactions, cost, and stability were taken from the published literature and the FDA-approved product labeling. The weighting scheme used for the third-generation cephalosporins was altered somewhat to reflect the more important aspects of the cephamycin derivatives and their potential role in surgical prophylaxis. Sensitivity analysis was done to assess the variability of the final scores when the assigned weights were varied within a reasonable range. Scores for cefmetazole and cefotetan were similar and did not differ significantly after sensitivity analysis. Cefoxitin scored significantly lower than the other two drugs. In the absence of data suggesting that the N-methyl thiotetrazole side chains of cefmetazole and cefotetan cause substantial toxicity, these two drugs can be considered the most cost-efficient members of the second-generation cephamycins. PMID- 1781470 TI - Therapeutic interchange of ampicillin-sulbactam for cefoxitin. AB - A therapeutic interchange program based on microbial patterns within an institution is described. A change in anaerobic susceptibility patterns, increased prevalence of enterococcal infections, and cost factors provided the rationale for the therapeutic interchange of ampicillin-sulbactam for cefoxitin. Ampicillin-sulbactam was recommended for prophylaxis in intraabdominal or gynecological surgery as well as for treatment for gynecological infections. Cefoxitin was restricted to penicillin-allergic patients and women who were pregnant or breast-feeding. The transition from cefoxitin to ampicillin-sulbactam proceeded smoothly as a result of preliminary education of pharmacists and physicians. Pharmacists participated in continuing-education programs and received concise guidelines for the interchange and follow-up instructions; physicians learned of the program from the drug newsletter published by the pharmacy department. Three months after the program began, only one physician was resistant to the interchange. After the program began, 11 antimicrobials, including cefoxitin, were used less frequently and ampicillin-sulbactam use increased. No adverse clinical consequences from the interchange were detected. A therapeutic interchange program based on institution-specific microbial patterns and educational efforts by the pharmacy department produced a change in physician prescribing. PMID- 1781471 TI - Inability to justify a part-time clinical pharmacist in a community hospital intensive-care unit. AB - The potential for justifying the cost of a part-time clinical pharmacist position was evaluated. Patients in the medical and surgical intensive-care units of a community hospital were monitored two hours per day for 32 weekdays by a part time staff pharmacist. The pharmacist completed an initial review of the charts of all patients newly admitted to the units and further evaluated each medical record for at least five minutes each day to determine the need for drug therapy interventions. The pharmacist contacted physicians to make any recommendations for changes in therapy. At the end of the study, the pharmacist calculated the difference in the costs of the original and recommended drug regimens for all recommendations accepted by physicians. A total of 147 patients were monitored during the 32-day period. There were 122 recommended interventions for 60 patients, and 101 (83%) of these recommendations were accepted. Estimated drug cost savings totaled $1651.35, but the cost of the pharmacist, $2599.35, resulted in a net cost to the hospital of $948. There was no significant difference in drug cost savings with respect to the day of the week when the monitoring was performed, the time of day, or the interaction of day with time. A part-time clinical pharmacist in the intensive-care unit of a community hospital reduced the costs associated with drug therapy, but the savings realized were not sufficient to offset the cost of the position. PMID- 1781472 TI - Stability and compatibility of fluorouracil and mannitol during simulated Y-site administration. AB - The stability and compatibility of fluorouracil admixtures with mannitol during simulated Y-site administration was studied. Fluorouracil injection 50 mg/mL was diluted with 5% dextrose injection, 0.9% sodium chloride injection, and 5% dextrose and 0.45% sodium chloride injection to final concentrations of 1 and 2 mg/mL. Combinations of fluorouracil admixtures with 20% mannitol injection were made using equal volumes in glass test tubes; immediately after mixing and at one, two, and four hours, the samples were examined for visual incompatibilities. Duplicate combinations of fluorouracil admixtures with 20% mannitol injection were made using equal volumes in plastic syringes; immediately after mixing with internal standard in glass test tubes and at 2, 4, 8, and 24 hours, samples were removed for chemical analysis. A high-performance liquid chromatographic assay was used to determine fluorouracil concentrations. No evidence of precipitation, color change, or haze was observed. During the 24-hour study, fluorouracil concentrations remained within 6% of initial concentrations for all combinations with mannitol. Fluorouracil 1 and 2 mg/mL in 5% dextrose injection, 0.9% sodium chloride injection, and 5% dextrose and 0.45% sodium chloride injection was chemically stable and visually compatible when combined with 20% mannitol injection during simulated Y-site administration. PMID- 1781473 TI - Compatibility of ciprofloxacin injection with selected drugs and solutions. AB - The compatibility of ciprofloxacin injection with selected antimicrobials and aminophylline was studied. Ciprofloxacin, amikacin sulfate, aminophylline, clindamycin phosphate, gentamicin sulfate, and tobramycin sulfate were mixed separately in minibags containing 0.9% sodium chloride injection or 5% dextrose injection; admixtures were stored for up to 48 hours at either 4 degrees C or 25 degrees C. Ciprofloxacin was also combined separately with each of the other drugs and solutions and stored under the same conditions. In addition, ciprofloxacin was combined with metronidazole in ready-to-use mini-bags of the latter drug and stored at 25 degrees C. Drug concentrations were measured by fluorescence polarization immunoassay or high-performance liquid chromatography. All admixtures were also examined visually. Stability was defined as retention of at least 90% of the original drug concentration with no visual evidence of incompatibility. With one exception, drugs in all single-drug admixtures were stable for 48 hours. The drug concentration eight hours after amikacin was mixed in 0.9% sodium chloride and refrigerated was 89% of the original concentration. When ciprofloxacin was combined with gentamicin, metronidazole, or tobramycin, all of the involved drugs were stable for 48 hours. Compatibility of ciprofloxacin-amikacin admixtures depended on the fluid and storage temperature; all such admixtures were stable for at least eight hours. A precipitate formed immediately whenever ciprofloxacin was mixed with clindamycin and within four hours after ciprofloxacin was mixed with aminophylline. Ciprofloxacin injection was compatible with gentamicin, metronidazole, and tobramycin and incompatible with aminophylline and clindamycin. The compatibility of ciprofloxacin-amikacin admixtures depended on the i.v. solution and storage temperature. PMID- 1781474 TI - Activity of octreotide acetate in a total nutrient admixture. AB - The activity of octreotide acetate in a total nutrient admixture (TNA) and the effect of the drug on the stability of lipid emulsion in the TNA were studied. Octreotide acetate injection was added to a standard solution containing 3% lipids, amino acids, dextrose, electrolytes, vitamins, and trace elements to achieve a theoretical concentration of 45 micrograms/dL. Samples were stored at room temperature for 48 hours. Octreotide concentrations were determined in triplicate by radioimmunoassay; physical stability of the solutions was assessed by lipid particle-size determination, pH measurement, and visual observation of emulsion integrity at 0, 12, 24, and 48 hours. The activity of octreotide in two samples of each solution (with and without lipid) was analyzed immediately after preparation and after seven days under refrigeration. There was no evidence of emulsion breakdown or pH change in any solution over the study period. In addition, particle-size distributions at 48 hours and 7 days were comparable to those at time zero, suggesting physical stability. Octreotide acetate activity was not consistently greater than 90% (mean +/- S.D.) after storage for 48 hours. Octreotide acetate at a theoretical concentration of 45 micrograms/dL in a TNA solution containing 3% lipids appeared to be physically compatible for 48 hours at room temperature and for 7 days under refrigeration. However, the chemical activity of octreotide in TNA was not consistent after storage for 48 hours. PMID- 1781475 TI - Use of a blood substitute in a patient who refuses to accept a transfusion. PMID- 1781476 TI - Visual compatibility of idarubicin hydrochloride with selected drugs during simulated Y-site injection. PMID- 1781477 TI - Stability of clindamycin phosphate, ranitidine hydrochloride, and piperacillin sodium in polyolefin containers. PMID- 1781478 TI - Visual compatibility of fludarabine phosphate with antineoplastic drugs, anti infectives, and other selected drugs during simulated Y-site injection. PMID- 1781479 TI - Treatment of snakebite poisoning. AB - The epidemiology, mechanics, prevention, pharmacology, clinical manifestations, and treatment of snakebites are reviewed. Poisonous snakes bite approximately 8000 persons annually in the United States, causing approximately 12-15 deaths per year. Pit vipers (rattlesnakes, copperheads, cottonmouths, and massasaugas) are responsible for 99% of all snakebite poisonings; coral snakes and other foreign exotic species are responsible for the additional 1%. Envenomation is characterized by pain, edema, and ecchymoses at or near the site of venom injection, followed by cardiac, hematologic, neurologic, renal, and pulmonary toxicity. The major clinical finding in most snakebite poisonings is local tissue necrosis. Immediate treatment for snakebite includes limiting movement and placing a constriction band proximal to the site of venom injection. If medical care is more than 30 minutes away, the wound may be incised and suctioned. Antivenin therapy is the mainstay of medical treatment of snakebite, along with administration of plasma expanders, pain medication, diazepam, tetanus toxoid, antiseptics, and antibiotics. Patients who have pain, swelling, ecchymoses, systemic symptoms, or abnormal laboratory findings within 30 minutes to one hour of a bite are probable candidates to receive antivenin therapy. Before receiving antivenin therapy, the patient must be tested for hypersensitivity to the antivenin. Antivenin therapy is most effective when given within four hours of the snakebite. Pharmacists--especially those serving rural areas--should be familiar with current snakebite treatments, both local and systemic, and should be prepared to provide important information and dispel any myths about snakebite poisoning. PMID- 1781480 TI - The ultimate stigma of mental illness. PMID- 1781481 TI - Models of the mind: their role in the clinical teaching of psychoanalytic psychotherapy. AB - In acquiring psychoanalytic ideas, psychotherapy trainees are often hampered by preconceptions about what constitutes a psychoanalytic perspective. These preconceptions can even constitute unarticulated models of pathogenesis and cure, which organize how trainees assimilate a supervisor's suggestions. We have identified two such models: the "passive-learning" model and the "cathartic" model. Realizing that trainees are operating under one of these models can help the supervisor to understand many of their errors. A traditional model emphasizing conflict and compromise formation addresses the deficiencies of these models and provides an initial framework for a psychoanalytic understanding of psychopathology and change. Certain guidelines for technique arise from this model: understanding rather than trying to change behavior, attending to the patient's emotional set, and using the therapist's emotional set. We describe one resident's use of the compromise-formation model to overcome an impasse in his treatment of a patient, and discuss some implications for clinical supervision. PMID- 1781482 TI - Self psychology and family therapy. AB - Family systems that are characterized by narcissistic deficits are difficult to treat in systemically oriented therapy. Self psychology can help to understand these "narcissistic systems," identify the shortcomings of family therapy when applied to them, and develop methods for treating them. In narcissistic systems, each member uses the others as a selfobject, in a nonreciprocal, i.e., pathological manner. There are characteristic boundary formations, power relationships, expectations of others, and subjective experiences among the members. Narcissistic systems present for treatment in identifiable ways. Because of their narcissistic deficits, these systems have difficulty complying with the demands of family therapy. To treat these families the therapist must become a selfobject to the family. However, functioning as a selfobject is risky for the therapist and the family. In successful therapy, the family is able to modulate its rage and shame, develop realistic goals, and participate in more insight oriented or directive therapy. PMID- 1781483 TI - Family factors in failure of psychotherapy. AB - Family factors involved in the failure of psychotherapy for some adolescents and young adults are explored. These treatment failures are distinguished by expulsion of the therapist(s) and by reunification of the previously adversarial patient and parents. Such abrupt terminations may occur when treatment challenges the family's habitual image and understanding of the identified patient. The revolution against therapy appears to result from: (a) an intolerable threat to the family's heretofore stable delineation of the patient, along with (b) the therapist's failure to empathically engage the parents and ease their commitment to that delineation. It is shown how a parallel process can lead to failure in individual, adult psychotherapy. When therapy threatens the patient's familiar but dystonic self-image, and calls for change to a new image that is discordant with the family image of him/her, separation anxiety may precipitate a regressive flight from treatment. Clinical implications are discussed. PMID- 1781484 TI - The supervisory process reflected in dreams of supervisees. AB - The study supports the notion that what may be concealed in the supervisory process may be revealed in the dreams of supervisees. Supervision as well as patient work mean an intense emotional experience for supervisees, especially for beginners in psychotherapy. This emotional experience was reflected in dreams. The supervisory situation reactivates the supervisees' earlier relationships and problems with authority people. This was also expressed in dreams. Stages in the supervisory process have earlier been described in terms of the learning experiences of the supervisees. The present study provides evidence that the supervisory process should not only be described in terms of different stages of learning, but also in terms of different emotional stages, where especially the beginning and end period mean a strong emotional investment. PMID- 1781485 TI - Clinical use of dreams with latency-age children. AB - Although various authors have discussed the technical modification required for dream interpretation with children, the basic conceptualization of the psychotherapeutic use of the dream with children has remained virtually identical to that with adult analysands. Examining various sources including formal studies on the nature of children's dreams, clinical case reports and series, and cognitive theories, the authors conclude that a dream arising in the course of a child's therapy must be conceptualized theoretically as a posttraumatic phenomenon. This holds whether or not there has been overt trauma to the child. The reasons for the conceptualization include both the heightened degree of anxiety contained in a dream reported in the course of psychotherapy as well as the specific cognitive abilities of children to contain anxiety and abstract and generalize symbolic meanings. A specific technique based on this conceptualization is then detailed that calls for translation of the dream into more tangible expression (drawing, play, etc.) and a noninterpretative approach. The authors also discuss the more general problem of the nature of insight in children. PMID- 1781486 TI - Neurasthenia: a paradigm of social psychopathology in a transitional society. AB - A particular social aspect of an illness is reflected in an emphasis on those symptoms that the society considers socially detrimental and/or destabilizing. Thus, in the work- and production-oriented society, chronic fatigue, which affects one's productivity and ability to work, becomes a hallmark of neurasthenia or neurasthenia-like syndrome. In a society based on rigid social structures and severely limited possibilities for social change, excessive irritability and outbursts of anger are perceived as a greater threat to the stability of the existing social order, and therefore they come to dominate the concept of neurasthenia. In Yugoslavia, neurasthenia has been primarily conceived of as a manifestation of an accumulated social frustration and anger; neurasthenia has then been constructed as a mental disorder because anger was expressed in a way that the society considered inappropriate, maladaptive, and pathological. A far-reaching, underlying purpose of this conceptualization of neurasthenia has been a preservation of the social status quo. While neurasthenia as a distinct mental disorder remains controversial, its dependence on the social context cannot be denied. Although the designation of neurasthenia so often seems provisional, because it symbolizes limitations and failures of our diagnostic and nosological systems, it serves a definite social purpose, which varies from time to time, and from one culture to another. PMID- 1781487 TI - Drama therapy as a means of rehabilitation for schizophrenic patients: our impressions. AB - The authors describe the development of drama therapy and its place in the system of psychosocial treatment of schizophrenic patients. Organizational and therapeutic elements are illustrated with the help of work done by a group of 12 patients on an adaptation of Shakespeare's Hamlet. The aim of this form of outpatient treatment is to use the acting technique in order to make it easier for patients to improve their understanding of themselves--their feelings, motivations and behaviors--and also of other people. The participation of a professional director and the general attractiveness of this type of therapy are considered to play an important role in motivating those patients who would not benefit from traditional psychotherapy. In this form of group psychotherapy verbalization of feelings and problems are structured by the role; thus creating a safe atmosphere and greater motivation to participate. The purpose of our work is to make the roles and the play a constructive aspect of the patient's functioning. This is only possible by uniting what for a schizophrenic patient is characteristically separate, namely, internal experience with external expression. Clinical effects are documented by two case vignettes. PMID- 1781488 TI - The unbearable obscurity of being. AB - This cross-disciplinary study attempts to investigate the Being-question: what is the ultimate ground of everything there is? Psychotic solutions to this problem are compared with Kundera's literary approach (On the Unbearable Lightness of Being), and with famous metaphysical solutions. Special attention is given to Heidegger's attempt to grapple with this question, as exemplified in his four- (in the English translation) volume study of Nietzsche--who regarded Being as "a vapor and a fallacy." Psychoanalytic conceptions of the origin of the sense of Being in the mother-infant interaction, and in the ego's ongoing awareness of itself are examined, especially since in psychoses, borderline disorders, and other narcissistic disorders the sense of Being and the ego's experience of itself often are defective. Genetic and dynamic psychoanalytic considerations also clarify the historical preoccupation with the Being-question. It is concluded that only through consensual validation can psychotic solutions be distinguished form solutions having a general sense of validity. The methodology for exploring the validity of answers to the Being-question is contrasted with scientific method, and the necessity for clear exposition--limited by the inevitable boundaries of one's culture and language--is emphasized; for only through a historical process of dialectic can there be hope of eventual consensual validation on solutions to the problem. PMID- 1781489 TI - Psychotherapy of an Arab patient by a Jewish therapist in Israel during the Intifada. AB - Fragments of a psychotherapy of an Arab patient by a Jewish psychotherapist in Israel, during an exacerbation of a historical political conflict, are presented. In addition to the delineated characteristic difficulties embedded in a cross cultural/ethnic/national psychotherapy, an Arab-Jewish dyad evokes a complicated interaction between external political reality and the therapeutic space, confusing and obscuring the discourse, the transference, and the countertransference. We believe that the complex and intricate relationship between external reality and inner psychic reality, as it appeared in the therapeutic space, endangered the psychotherapeutic process by blurring the boundaries and creating a fertile ground for projective identification. Both the use of political reality as a defense, or its denial may preclude the possibility for a real dialogue. Implications for emphasizing the differences between patient's and therapist's ethnic affiliations, guarding sensitively the authenticity of interaction, and strengthening both participants' identity in all the relevant levels are pointed out to facilitate the dialectic process of the psychotherapy. PMID- 1781490 TI - Athletic trainers. PMID- 1781491 TI - Everyone needs an edge. PMID- 1781492 TI - The normal shoulder during freestyle swimming. An electromyographic and cinematographic analysis of twelve muscles. AB - The shoulder in swimming is subjected to multiple factors that can lead to a high injury rate. To prevent injury, one must understand the biomechanics of swimming. This paper describes the electromyographic and cinematographic findings of 12 shoulder muscles in competitive swimmers without shoulder pain. The results show the three heads of the deltoid and the supraspinatus functioning in synchrony to place the arm at hand entry and exit, the rhomboids and upper trapezius to position the scapula for the arm, the pectoralis major and latissimus dorsi to propel the body, the subscapularis and serratus anterior as muscles with constant muscle activity, the teres minor functioning with the pectoralis major, and the infraspinatus active only to externally rotate the arm at midrecovery. This information is important to design optimal preventative and rehabilitative exercise programs. PMID- 1781493 TI - The painful shoulder during freestyle swimming. An electromyographic cinematographic analysis of twelve muscles. AB - The purpose of this paper is to describe the patterns of activity of 12 shoulder muscles in painful shoulders, and compare those patterns of activity with normal shoulders. The results show significant differences in 7 of the 12 muscles. Those muscles included the anterior deltoid, middle deltoid, infraspinatus, subscapularis, upper trapezius, rhomboids, and the serratus anterior. There were no significant differences between muscle activity patterns of normal versus painful shoulders in the latissimus dorsi, pectoralis major, teres minor, supraspinatus, or the posterior deltoid. This information will contribute to the development of muscle conditioning programs to optimize performance and prevent injury, as well as develop programs for scientific rehabilitation strengthening. PMID- 1781494 TI - The accuracy of three-dimensional magnetic resonance imaging in the diagnosis of ruptures of the lateral ligaments of the ankle. AB - In a prospective study, the diagnostic accuracy of three-dimensional magnetic resonance imaging in the evaluation of ruptures of the lateral ligaments of the ankle was determined by comparing three-dimensional magnetic resonance findings with operative findings. In a series of 18 consecutive cases of acute significant inversion trauma to the ankle, a three-dimensional fast imaging with steady-state precession pulse sequence (3D FISP) was performed. The study included only those cases in which views showed a difference in talar tilt of 15 degrees or more, and a difference in anteroposterior drawer of 10 mm or more between the imaged and the normal ankle. All ankles were scheduled for surgical exploration. Compared with operative findings, the sensitivity, specificity, and accuracy of 3D FISP imaging were, respectively, 100%, 50%, and 94.4% for ruptures of the anterior talofibular ligament and 91.7%, 100%, and 94.4% for ruptures of the calcaneofibular ligament. We believe that 3D FISP magnetic resonance imaging is a noninvasive, fast, and very accurate diagnostic aid to operative planning for double ligament tears in younger competitive athletes. PMID- 1781495 TI - Comparative biomechanical effects of the standard method of ankle taping and a taping method designed to enhance subtalar stability. AB - The purpose of this study was to compare the restrictive effects of the widely recognized standard method of ankle taping with those of a modified ankle taping method that incorporates an additional component, the subtalar sling. Both ankles of 30 college football players were measured for maximal passive motion before taping, immediately after taping, and after a 2 to 3 hour football practice session. Downward and inward motions of the foot within the sagittal and frontal planes were induced separately and in combination with each other to allow quantification of four ankle motions. The data were analyzed by a 2 x 4 x 2 multivariate analysis of variance, a separate 2 x 3 analysis of variance for each of the four ankle motions, and the Newman-Keuls method of multiple comparisons of cell means. The results of this study suggest that the incorporation of the subtalar sling greatly enhances the protective function of ankle taping, but may impede performance of certain athletic skills. PMID- 1781496 TI - Retrospective direct comparison of three intraarticular anterior cruciate ligament reconstructions. AB - A long-term retrospective study (minimum 5 years) was done looking at three groups of anterior cruciate deficient knee patients using both subjective and objective anterior cruciate tests. Twenty-seven chronic anterior cruciate ligament deficient knees reconstructed with the middle third of the patellar tendon and 28 chronic anterior cruciate ligament deficient knees reconstructed with the semitendinosus tendon were included in this consecutive group of patients and were felt to be directly comparable. It was found that the chronic anterior cruciate ligament deficient group reconstructed with the semitendinosus tendon had 4 excellent, 10 good, 7 poor, and 7 failures with an objective score averaging 4.5 of a possible 12, while the comparable group reconstructed with the middle third of the patellar tendon had 16 excellent, 7 good, 3 poor, and only 1 failure with a score of 10 of a possible 12 (P less than 0.0032). For completeness sake, 20 anterior cruciate deficient knees from this group of consecutive patients that were reconstructed acutely with the semitendinosus tendon were also examined. This group had 8 excellent results, 9 good, 3 poor, and no failures with a score of 9.8 (P less than 0.03 compared to the other group using the semitendinosus tendon). This comparison between the two groups where the semitendinosus tendon was used in the anterior cruciate ligament reconstruction was made only to show the difference between studies dealing with knee reconstructions. There may be a significant difference between a study dealing with acutely reconstructed knees versus one focusing on chronically reconstructed knees, most likely because of both patient selection and time between injury and reconstruction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781497 TI - Pes anserinus and iliotibial band transfer for anterior cruciate insufficiency. AB - Twenty-one patients with chronic anterior cruciate ligament insufficiency were treated with a combined iliotibial band (Ellison) and pes anserinus (Slocum Larson) transfer procedure. Preoperatively, the most prominent instabilities were drawer laxity in 16 patients and anteromedial rotation in 5 patients. After a median of 34 months of followup, 15 patients were absolutely satisfied with the result, 2 were fairly satisfied, and 4 were not satisfied at all, including 2 patients who had been reoperated. All of the patients with unsatifactory results had a pivot shift and a positive Slocum test. Intraarticular derangements had no influence on the results. At followup, 14 patients demonstrated an anteromedial rotatory instability, indicating that the lateral stabilization procedure acted better than the medial one. Only a few patients returned to their preinjury levels of sports activity. Compared with other extraarticular procedures in the literature, the results were quite similar. The operative procedures used in this study cannot be recommended in cases with combined instabilities of the knee. PMID- 1781498 TI - Biomechanical analysis of rehabilitation in the standing position. AB - Biomechanical analysis of the two-dimensional models composed from roentgenographic pictures and electromyographic analysis of the shear force exerted on the tibia during standing on both legs were conducted in 21 young adult males. The simultaneous contraction of the quadriceps and hamstrings was observed in all electromyograms. Amplitude observed on electromyograms of the hamstrings increased as the trunk flexion angle increased. The calculated average values of shear force were negative at every knee flexion angle (negative value means posteriorly directed force). As the trunk flexion angle increased, posterior drawer force increased at knee flexion angles of 30 degrees and 60 degrees. The simultaneous contraction of the quadriceps and the hamstrings was considered to be the main factor that influenced these results. Standing on both legs with knee and trunk flexion was considered to be applicable in the early stages after anterior cruciate ligament reconstruction. PMID- 1781499 TI - Physiologic responses to maximal treadmill and deep water running in men and women. AB - Maximal physiologic responses to treadmill running and deep water running using a flotation device were compared in 12 trained men and 12 trained women. Although the men had significantly higher ventilation volumes, VO2max (liters of oxygen per minute and milliliters of oxygen per kilogram per minute), there were no significant differences in maximal heart rates or respiratory exchange ratios between the sexes. Significantly lower ventilation volumes, VO2max (LO2.min-1 and mlO2.kg-1.min-1), and heart rates were obtained in response to maximal water running compared to treadmill running, regardless of gender. Neither the men's nor women's maximal respiratory exchange ratios were significantly different between modes. The analysis of variance indicated that there were no significant interactions for any of the maximal responses to the tests between the sexes. The magnitude of these differences is similar to that found between treadmill running and cycling ergometry and should not preclude deep water running as a training technique. Caution, however, is advised if the training intensity is to be prescribed on the basis of land-determined heart rates. PMID- 1781500 TI - Nordic ski jumping injuries. A survey of active American jumpers. AB - Little data are available in the medical literature on nordic ski jumping injuries. Injury questionnaires were sent to all active American ski jumpers registered either with the United States Ski Association or with a jumping club registered with the United States Ski Association. One hundred thirty-three of 286 (46.5%) injury questionnaires were returned. Eighty-one of the 133 respondents (60.9%) had been injured sufficiently to require examination by a physician at least once during their jumping careers. This report describes the types and frequencies of injuries sustained by this group of nordic ski jumpers as well as provides demographic data about American ski jumpers. The risk of injury per 100 participant years was 9.4, a rate less than that reported for most high school or college intermural sports. PMID- 1781502 TI - Use of the fascia sheath coverage and exogenous fibrin clot in the treatment of complex meniscal tears. AB - In a previous series, complex meniscal tears, including double flap, double longitudinal, and radial tears, there was reported a high failure rate (14 of 58 repairs, 24%) when treated by conventional arthroscopic repair techniques. There was only one tear in the anterior middle one-third of the lateral meniscus in this group. The use of a fascia sheath to cover the repaired area improves healing rates an additional 17% (from 75% to 92%) with these tear classifications, with the exception of radial split tears in the middle one-third of the lateral meniscus. The present repair technique includes rasp abrasion of the parameniscal synovium, peripheral white rim, and tear surface of the handle fragment. The meniscus is sutured with fully diverged sutures. A rectangle of fascia from the distal anterolateral thigh, trimmed to 25 x 35 to 40 mm, is prepared with the double-armed meniscus suture run along opposite sides. One or two "hold-down" sutures are tied to the superior and inferior main sutures. The four hold-down sutures from the corners and the previously placed hold-down sutures are pulled through the capsule with previously placed pull-through sutures to pull the fascia over the meniscal repair. The exogenous blood clot is injected in the tear under the sheath. This preliminary report suggests that improved healing rates can be obtained with most complex tears by meticulous meniscal repair followed by coverage with the fascia sheath and then exogenous clot injection. Repairs of tears in the middle one-third of the lateral meniscus still show a high failure rate. PMID- 1781501 TI - Limitation of motion following anterior cruciate ligament reconstruction. A case control study. AB - Limitation of motion following ACL reconstruction is a well-recognized and disturbing complication. The purposes of this study were to identify and characterize those patients who developed this complication from a series of 527 ACL reconstructions, determine etiologic factors, and make recommendations regarding prevention and management. The case group included 37 patients who required a manipulation under anesthesia because of failure to gain a satisfactory range of motion after an ACL reconstruction. Unsatisfactory motion was defined as a flexion deformity of 10 degrees or more and/or limitation of flexion to less than 120 degrees by 3 months following ACL reconstruction. The control group of patients were selected randomly from the overall series and all had a satisfactory range of motion. The cases and controls were then compared by analyzing these variables: age, sex, knee, time from injury to reconstruction, type of tissue used, meniscal abnormalities or surgery, repair of the medical collateral ligament, and postoperative immobilization and rehabilitation. The cases were followed up to assess the range of motion compared to the opposite knee at an average of 26 months postmanipulation. Thirty-seven patients (7%) underwent a manipulation under anesthesia, 9 of these (24.3%) also had an arthroscopic arthrolysis. Reconstructions done less than 2 weeks postinjury showed a statistically significant higher rate of knee stiffness. The same trend was also present for those reconstructed 2 to 6 weeks postinjury. All other variables failed to show a significant statistical difference. At followup, the average loss of extension was 4 degrees and loss of flexion 5 degrees.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781503 TI - Arthroscopic meniscal repair evaluated by second-look arthroscopy. AB - Of 353 arthroscopic peripheral meniscal repairs performed using the "outside to inside" suturing technique with rasp preparation of the tear region, 74 repairs (50 medial and 24 lateral) were assessed by second-look arthroscopy and are the basis of this report. Results were graded as either healed, incompletely healed, or failed; these findings were correlated with clinical symptoms and associated ACL deficiency. Overall, asymptomatic healing occurred in 84%, with 65% healed and 19% incompletely healed. The failure rate was 16%. All failures were symptomatic while all healed and incompletely healed menisci were asymptomatic. Failure was associated with ACL deficiency in all cases. No failures occurred in either an ACL uninjured knee or an ACL reconstructed knee. Failure was also associated with tear location in the posterior horn of the medial meniscus. Eleven of 12 failures (92%) involved posterior medial meniscal tears with only 1 failure located posterolaterally. Visual evidence of healing required a 4 month time interval. PMID- 1781504 TI - The effects of knee brace wear on perceptual and metabolic variables during horizontal treadmill running. AB - Past research has indicated that runners who wear a Lenox Hill Derotation Brace during treadmill running at 6 mph have an approximate 5% increase in oxygen consumption compared to those who run without the brace. The present study expanded those findings by determining the metabolic and perceptual effects of wearing four commercially available braces while treadmill running at speeds of 6, 7, and 8 mph. The four braces used in this study were the Generation II Poli Axial Knee Cage, the Orthotech Performer, the CTi Brace, and the Lenox Hill Derotation Brace. Results indicated that the braces caused increases (P less than 0.008) in oxygen consumption, heart rate, and ventilation in the 3% to 8% range compared to running without the brace. Peripheral ratings of perceived exertion were also elevated (P less than 0.001) between 9% and 13%. However, no significant differences were found between the braces. Analysis of covariance indicated the weight of the brace accounted for the increased oxygen consumption during the treadmill runs. We concluded that the braces examined in this study will cause a consistent increase in metabolic cost, which is related to the weight of the braces. PMID- 1781505 TI - Traumatic pseudodislocation of the acromioclavicular joint in children. A fifteen year review. AB - Traumatic acromioclavicular separation in the skeletally immature patient is frequently overdiagnosed and overtreated. Fifty-eight children, aged 5 to 16 years, who presented over a 15 year period with injuries to the distal clavicle, were reviewed retrospectively. The majority showed coracoclavicular widening radiographically, suggesting acromioclavicular separation. In 45 cases, a distal clavicular fracture was identified, while an acromioclavicular separation without fracture was initially diagnosed in 13. Long-term followups of these patients demonstrate excellent results with conservative management. "Pseudodislocation" involves a clavicular fracture of the lateral metaphysis or metaphyseal epiphyseal separation and not an acromioclavicular disruption. This pseudodislocation of the acromioclavicular joint in the skeletally immature patient must be differentiated from the adult counterpart to avoid unnecessary operative intervention. PMID- 1781506 TI - Stress fractures. Identifiable risk factors. AB - To answer the question why such large differences in stress fracture morbidity rates (2% to 64%) exist in different countries, we prospectively evaluated 312 recruits for possible risk factors for stress fractures. Prior to training, each recruit underwent an evaluation including the following: orthopaedic examination, foot and tibial radiographs, measurements of tibial bone width, bone mineral content, bone density, aerobic physical fitness and leg power, assessments of somatotype and smoking habits, and evaluation of sociological and psychological factors. Using a multivariate analysis, two risk factors were identified: recruits with stress fractures had significantly narrower tibiae (P less than 0.001), and a higher degree of external rotation of the hip (P = 0.016). These two variables were independent and cumulative. Stress fracture morbidity was 17%, 29%, and 45% when neither, one, or both risk factors were present, respectively (P less than 0.001). Identification of these risk factors might explain the susceptibility of some people to stress fractures. PMID- 1781507 TI - Quantitative assessment and training of isometric cervical extension strength. AB - The purpose of this study was to evaluate the reliability and variability of repeated measurements of isometric cervical extension strength and determine the effect of 10 weeks of dynamic variable resistance cervical extension training on isometric cervical extension strength. Seventy-three subjects (age, 29 +/- 12 years [mean +/- SD]) completed isometric cervical extension strength tests on 4 separate days (D1, D2, D3, and D4). For each test, isometric cervical strength was measured at 126 degrees, 108 degrees, 90 degrees, 72 degrees, 54 degrees, 36 degrees, 18 degrees, and 0 degrees of cervical flexion. Between-day correlation coefficients over the eight angles of cervical flexion were high for D2 versus D3 (r = 0.90 to 0.96). Test variability (standard error of estimate) between D2 versus D3 was low (7.4% to 10.2% of mean) through the entire range of motion. Regression analysis showed that the isometric cervical extension strength curve is linear and descending from flexion to extension. In a second study, 14 subjects (age, 25 +/- 3 years) trained the cervical extensor muscles for 10 weeks while 10 subjects (age, 23 +/- 3 years) served as controls. Training included 8 to 12 cervical extensions to volitional fatigue, 1 day per week. The training group improved isometric cervical extension strength at six of eight angles before to after training (P less than or equal to 0.05). During the same time period the control group did not change. These data indicate that repeated measures of isometric cervical extension strength are highly reliable and can be used for the quantification of isometric cervical extension strength through a 126 degrees range of motion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781508 TI - Reproducibility of the knee signature system. AB - To assess trial-to-trial, installation-to-installation, and day-to-day effects of the Knee Signature System, we studied anterior/posterior translation measurements in six normal subjects. The protocol consisted of testing both knees on 6 days with three installations per day and three trials per installation. We recorded anterior, posterior, and total anterior/posterior translation at +/- 20 and +/- 40 pounds of force at 30 degrees of flexion. Additionally, after measuring anterior/posterior translation during passive knee extension, active extension, and active extension with 15 pounds of weight at the ankle, we calculated the difference in anterior translation at 30 degrees of flexion between each of these three conditions. We analyzed the size of the effects and computed 90% confidence limits using analysis of variance. Means and 90% confidence limits for total anterior/posterior translation measured at +/- 20 pounds of force were: right knee, 6.8 +/- 2.3; left knee, 8.2 +/- 2.0; and right/left difference, 1.5 +/- 2.7 mm. Left knee translation means were significantly greater than right knee means in all tests. Day-to-day effects, while statistically significant for right and left knee measurements, showed no significant effects for right/left differences. Trial-to-trial and installation-to-installation effects were not significant for any parameter. Right/left differences during knee extension testing were smaller than for the stress test, measuring 0.1 mm or less, but confidence limits were larger, being +/- 3.7 mm for active extension-passive knee extension, +/- 1.5 mm for 15 pounds of weight at the ankle-active extension, and +/- 4.6 mm for 15 pounds of weight at the ankle-passive knee extension. Active extension produced 6.3 mm more anterior translation at 30 degrees of flexion than passive extension.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781509 TI - Bilateral chronic exertional compartment syndromes of forearm in an adolescent athlete. Case report and review of literature. PMID- 1781510 TI - Saphenous nerve injury. An unusual arthroscopic complication. AB - The surgeon should use strict technical vigilance to prevent intraoperative arthroscopic complications. An expert understanding of the anatomy, along with visualization of all instruments during surgery, should prevent inadvertent injury to neighboring structures. This case report represents one unusual complication associated with arthroscopic knee surgery and should serve to heighten the surgeon's awareness that arthroscopy is not a benign procedure. PMID- 1781511 TI - Blastomycosis of the knee and skull after arthroscopy. PMID- 1781512 TI - [A classic case of Ludwig's angina]. AB - The AA. have the chance to review the etiology, the clinic and the management of this risky process, through a characteristic Ludwig's angina of their own practice. A middle age man carrying an odontogenic inflammation developed a spreading infection into the deep neck tissues. The problem was successfully resolved with antibiotherapy and surgical drainage. PMID- 1781513 TI - [Keratosis obturans]. AB - The Keratosis obturans is a disease localized in the EAC. It is an important pathology because its physiopathology differs from other analogous diseases of the same site, and has a clinical and pathological aspect uniform and peculiar, in spite of its evolutive course. The AA. review the bibliography and report their experience with the aim to define and classify this disorder. PMID- 1781514 TI - [Laryngoceles. Clinical and therapeutic study]. AB - We present 2 cases of mixed Laryngocele of big size operated by lateral cervical approach. Owing to the bulging inward of the laryngeal surface an urgent tracheostomy would be done in each case. No associated malignancy was verified in the resected piece, nevertheless this possibility must be always distrusted. PMID- 1781516 TI - [Oculographic findings in the Arnold-Chiari malformation type I]. AB - The paper deals with 5 adults carriers of this syndrome diagnosed by means of nuclear magnetic resonance (NMR). Neither the conventional radiography nor the plain computerized tomography showed indicative clues of the deformity. However electronystagmography prove in all cases a vertical down beating nystagmus. In one instance the nystagmus become rotatory at lateral glance. In all cases appeared an altered smooth pursuit and a lack of suppression fixation of the vestibular nystagmus. The AA. emphasize the diagnostic value of the electronystagmography (which tracings could spare several other, sometimes expensive, examinations) and suggest a prompt MRI. PMID- 1781515 TI - [Reoperations in otosclerosis. Indications, intraoperative findings, and results]. AB - The audiological outcome of 140 stapedectomy revisions done between 1977 and 1987, as well as the pre- and intraoperative findings and the subjective appraisal of the revisions, are presented. The recurrence of the conductive deafness was the most often indication for the surgical revision and the shift of the prosthesis, verified intraoperatively, the most encountered finding. Audiological results showed, as mean value, an important reduction of the transmissive hearing loss whilst the bone conduction remained unaltered. Patients' subjective evaluation of the results were worse than audiometric controls. From the retrospective study of these 140 revisions the AA' experience is that the stapedectomy revision offers no major risk for the inner ear. PMID- 1781517 TI - [Primary branchiogenic carcinoma or metastasis of an unknown epidermoid cancer]. PMID- 1781518 TI - [Cervical metastases of unknown origin]. AB - Report of 10 cases of this thinly scattered process and explanation of exploratory routine. The management recommended and done, by the AA., is first of all the radical neck dissection followed by a complementary radiotherapy. PMID- 1781519 TI - [Endoscopic naso-sinusal surgery. Experience with 150 cases]. AB - The AA. expose their experience drawn out from 150 cases of naso-sinusal pathology, treated through endoscopic surgery after the Messerklinger-Stammberger technique. They emphasize either the advantages of the procedure, in comparison with the classic methods, and the postoperative pitfalls. This procedure call for an exact knowledge of the endoscopic anatomy of the ethmoidal area, which can be gained only through corpses training. PMID- 1781520 TI - Clonidine--a horse or an ass? PMID- 1781521 TI - Predicting difficult intubation. AB - Two pre-operative tests for the prediction of difficult intubation are assessed. A modified Mallampati test and a measurement of thyromental distance were performed at the pre-operative visit of 244 patients whose tracheas were subsequently intubated under general anaesthesia. Patients in whom the posterior pharyngeal wall could not be visualised below the soft palate, who also had a distance of less than 7 cm between the prominence of the thyroid cartilage and the bony point of the chin proved significantly more likely to present difficulty with intubation. The performance of these two simple tests on all patients before operation should allow the majority of cases of difficult intubation to be anticipated. PMID- 1781522 TI - Low-flow anaesthesia. Practice, cost implications and acceptability. AB - An 8-week survey was conducted to determine whether the introduction of low-flow anaesthesia (a fresh gas flow of 4 litres/minute or less) into routine use would be acceptable to members of a representative anaesthetic department and if the consequent reduction in use of volatile anaesthetics would result in financial savings. The hourly consumption of the volatile agents was measured during anaesthesia conducted using either conventional or low fresh gas flows. Anaesthetists' acceptance of low-flow anaesthesia was assessed using a questionnaire. Data were gathered on 286 patients undergoing inhalational anaesthesia for routine operative procedures. A 54.7% reduction in the consumption of isoflurane and a 55.9% reduction in that of enflurane was found. Of the 28 anaesthetists at the hospital, 21 would use low-flow anaesthesia routinely. The routine use of low-flow anaesthesia would therefore be acceptable and could result in annual savings of 26,870 pounds at Northwick Park Hospital. PMID- 1781523 TI - The effect of intravenous clonidine on the forearm circulation. AB - The effect of two doses of clonidine on forearm blood flow was compared with an inert treatment using mercury strain gauge venous occlusive plethysmography. In the clonidine treated groups, forearm blood flow was unaffected in the resting state, but decreased sharply with tracheal intubation. In the saline group, blood flow increased with intubation. Forearm vascular resistance increased in the clonidine treated groups, but decreased in the saline group. These results suggest that clonidine has a peripheral action in anaesthetised normotensive individuals, and is not a purely centrally acting drug. PMID- 1781525 TI - Stressful pre-operative preparation procedures. The routine removal of dentures during pre-operative preparation contributes to pre-operative distress. AB - One hundred and twenty-four patients (76 women and 48 men) were interviewed within the first 36 hours after operation. Fifty per cent of those studied were denture wearers. They were asked to fill in a questionnaire which registered their levels of distress about the various pre-operative preparation procedures. The most common factors contributing to pre-operative distress were waiting for transfer to the operating theatre, the prohibition of fluids and the removal of dentures. PMID- 1781524 TI - Gastric emptying following caesarean section and the effect of epidural fentanyl. AB - The rate of absorption of paracetamol following oral administration was used as an indirect measure of the rate of gastric emptying. This was to determine the effect on gastric motility of the addition of fentanyl to a solution of local anaesthetic given into the epidural space to provide pain relief following Caesarean section. Thirty subjects were randomly allocated to receive either bupivacaine plus fentanyl or bupivacaine alone. The area under the curve of the graph of plasma paracetamol concentration versus time was calculated for each subject at 45 and 90 minutes after administration of the epidural injection, and this value was used as an index of the rate of gastric emptying. This study demonstrated that gastric emptying may be normal immediately following Caesarean section under epidural anaesthesia, but that if fentanyl is added to the epidural solution, gastric emptying is significantly slower in the first 45 minutes following surgery (p less than 0.05). PMID- 1781526 TI - The effect of a priming epidural injection of adrenaline on epidural blockade with bupivacaine. AB - Twenty-four patients receiving epidural anaesthesia were studied to test the hypothesis that 1:200,000 adrenaline administered into the epidural space 5 minutes before 20 ml bupivacaine 0.5% would improve nerve block and delay systemic absorption of the local anaesthetic. Group A/B received 20 ml adrenaline 1:200,000 5 minutes before 20 ml bupivacaine 0.5%, group S/BA 20 ml saline followed by 20 ml bupivacaine 0.5% with 100 micrograms adrenaline, and group S/B saline 20 ml followed by 20 ml plain bupivacaine 0.5%. Mean maximum plasma concentrations of bupivacaine tended to be lower in the adrenaline groups. A delay in the time to peak plasma concentration of bupivacaine was noted in the A/B group; this indicated that priming with adrenaline may be effective at delaying early systemic uptake of the local anaesthetic. In both adrenaline groups a more prolonged epidural block and increased efficacy were noted, although this was only significant for the duration of block at T6 (p = 0.023) and duration of motor block at Bromage level 1 (p = 0.016) in group A/B. There seems little clinical advantage in administering adrenaline 5 minutes before bupivacaine. PMID- 1781527 TI - Septic atrial thrombus. A complication of central venous catheterisation. AB - A 77-year-old man underwent repair of a vesicocolic fistula following which he had a protracted stay in the intensive care unit due to recurrent septicaemia, which was initially caused by bowel anastomosis breakdown. Management included central venous cannulation and pulmonary artery catheter monitoring. A septic, mobile right atrial thrombus developed, which was successfully treated. The literature on this condition is reviewed. PMID- 1781528 TI - Reversal of prolonged suxamethonium apnoea with fresh frozen plasma in a 6-week old infant. AB - A period of apnoea lasting 480 minutes following suxamethonium in a 6-week-old male infant is described. Neuromuscular function recovered following the administration of fresh frozen plasma. The infant was found to be homozygous for atypical cholinesterase (E1a E1a). This is believed to be the youngest reported case of suxamethonium apnoea. PMID- 1781529 TI - Respiratory failure as presentation of achalasia of the oesophagus. AB - A 68-year-old woman with a history of hiatus hernia developed aspiration pneumonia after operation for fractured neck of femur. After 8 days, acute respiratory failure was caused by massive retention of air and food in the oesophagus. This was relieved by aspiration, and treated by balloon dilation of the gastric cardia. PMID- 1781530 TI - A serious complication of minitracheotomy. AB - A previously unreported complication of minitracheotomy is described. The minitracheotomy introducer was lost into the pleural cavity and a thoracotomy was required to remove it. PMID- 1781531 TI - Variable apparatus deadspace. AB - A variable apparatus deadspace was used to maintain normocapnia during artificial ventilation of the lungs in anaesthetised adults. End-tidal carbon dioxide tension could be varied, if the need arose, within the range 4.0-5.2 kPa in both open and circle breathing systems when a fixed tidal volume of 12 ml.kg-1 and minute volume ventilation of 120 ml.kg-1.min-1 were employed. PMID- 1781532 TI - Continuous direct and indirect blood pressure measurement (Finapres) in the critically ill. AB - Continuous noninvasive blood pressure measurement is of great potential use in the critically ill. This study was designed to find out whether measurements of blood pressure by a Finapres accurately represented intra-arterial pressure. Comparisons were made between readings from a radial artery line and from a Finapres finger cuff in 10 critically ill patients. There was an unpredictable but usually stable difference between measurements from the two sources; this difference varied in magnitude and direction in individual patients. At present the Finapres cannot be recommended as a substitute for intra-arterial blood pressure measurement in the critically ill. PMID- 1781533 TI - The impact of the appearance of the anaesthetist on the patient's perception of the pre-operative visit. AB - The clinician's appearance is often considered a symbol which identifies and defines specific characteristics of the individual. Opinion of both lay and medical personnel on appropriate clothing inclines towards formal dress. Our aim was to assess the effect of the anaesthetist's appearance during a ward visit on the patient's evaluation of either the visit or the anesthetist himself. In our sample of 66 patients we found no evidence that the style of dress (formal: suit and tie, informal: jeans and open-necked shirt) affected that evaluation. However, when 138 patients were asked to rate the desirability of items of clothing for a male hospital doctor they expressed a preference for traditional clothing; a suit was rated as desirable and jeans as one of the four most undesirable items. We conclude that despite the conservatism of expressed opinions, the clothing worn by the anaesthetist is irrelevant to the patient's satisfaction with the visit. PMID- 1781534 TI - Guided isoflurane injection in a totally closed circuit. AB - Twenty-six patients undergoing middle ear surgery were anaesthetised using a completely closed circuit into which liquid isoflurane was injected using a syringe pump. The injection rate was guided by a table of calculated rates of isoflurane uptake, utilising the square root of time principle, at succeeding time intervals in different weight groups. A constant alveolar concentration of 1.3 MAC was aimed for. The injection rate was changed to that for the higher or lower weight group appropriate to the time interval whenever clinical signs indicated inappropriate depth of anaesthesia. A mean of 10.3 ml liquid isoflurane was used to maintain anaesthesia for a mean of 82.3 minutes. Blood pressure was maintained at 75% of the pre-operative value. Mean arterial blood gas data and changes in plasma catecholamine levels were within the normal range. The mean recovery time was 10.5 minutes. Syringe pump delivery of liquid isoflurane avoided fluctuations that result from bolus injections of unit dose. The implemented injection rate table, working as a therapeutic window, guided redosing, reduced calculation time and served as a record. The technique is safe, economic and adaptable to variations in uptake and response to inhalational anaesthetics. PMID- 1781535 TI - Antireflux valves in intravenous opioid analgesia: are they necessary? AB - A study was conducted in patients receiving intravenous opioid analgesia to determine the incidence and degree of retrograde flow along the parallel gravity driven infusion line. From 1187 hours of observations retrograde flow was found in 2.5% of the total time. In 70% of these cases this was equivalent to less than 1 mg of pethidine and in 96% this was equivalent to less than 5 mg of pethidine. The need for routine use of antireflux valves during intravenous opioid analgesia is therefore questioned. PMID- 1781536 TI - Oral fluids prior to day surgery. The effect of shortening the pre-operative fluid fast on postoperative morbidity. AB - One hundred day surgical patients undergoing first trimester termination of pregnancy were randomly allocated to receive either 150 ml of clear fluid 1.5-2 hours before anaesthesia or to remain fasted from midnight the night before. Patients were anaesthetised using a total intravenous technique which consisted of propofol and alfentanil. No adverse intra-operative events were noted in either group. There were no significant differences in immediate recovery time, or pain, nausea and headache scores at 30 or 120 minutes following recovery. The fasted group had less pain (p less than 0.05) at 60 minutes after recovery than the fluid group, although the mean pain scores in both groups were low. Eighty two per cent of the patients returned questionnaires about pain, nausea and headache scores on arriving home, and at 12 and 24 hours after surgery. There were no significant differences between the two groups. In conclusion, pain, nausea and headache scores are low following total intravenous anaesthesia with propofol and alfentanil for termination of pregnancy and these were unaffected by the administration of 150 ml of clear fluid given approximately 1.5 hours pre operatively. PMID- 1781537 TI - Effect of prior administration of cold saline on pain during propofol injection. A comparison with cold propofol and propofol with lignocaine. AB - A single-blind, randomised, controlled study was undertaken to compare the efficacy of three methods of preventing pain during injection of propofol on induction of anaesthesia. Patients were allocated randomly to receive unmodified propofol, propofol with 0.05% lignocaine, propofol at 4 degrees C and unmodified propofol preceded by 10 ml of 0.9% saline at 4 degrees C. Prior injection of cold saline reduced the incidence of pain and discomfort significantly (22%) compared with unmodified propofol (75%; p less than 0.005) and was similar to that after cold propofol (33%) and propofol with lignocaine (44%). There was no significant difference between the treatment groups. PMID- 1781538 TI - Policies for oral intake during labour. A survey of maternity units in England and Wales. AB - A postal survey was conducted to gain information on the use of policies on oral intake, selection of mothers and type of intake given during established labour by all maternity units in England and Wales. A response rate of 91.6% (351 out of 383) was achieved; 79.5% of units had a written policy for oral intake, 96.4% of units allowed mothers some form of oral intake and 68.3% of these units selected mothers according to risk categories. Of the 268 units allowing oral intake, 67.2% gave drink only and 32.8% drink and food. Of those allowing food, all but 13.6% had a selection policy. Of the 85 units not selecting mothers, 78.8% gave water only; the remaining 21.2% gave water and other drink or food. This survey demonstrates a wide variation in policies for oral intake during labour. PMID- 1781539 TI - Postoperative pain control. A survey of current practice. AB - A survey of postoperative analgesia in 195 anaesthetic departments in England and Wales was undertaken. The results showed that 64% of respondents were dissatisfied or very dissatisfied with the present situation. Large differences were demonstrated between what was regarded as the safest technique and what would form the ideal management of postoperative pain. PMID- 1781540 TI - Quality of anaesthesia during spontaneous respiration: a proposed scoring system. PMID- 1781541 TI - Laryngeal mask airway for coronary artery bypass grafting. PMID- 1781542 TI - Laryngeal mask and gastric dilatation. PMID- 1781543 TI - Laryngeal mask to aid tracheal intubation. PMID- 1781544 TI - Intra-operative airway maintenance for short ophthalmological procedures in children. PMID- 1781545 TI - Ketamine and propofol for TIVA. PMID- 1781546 TI - Prolonged apnoea, trismus and ketamine. PMID- 1781547 TI - The oesophageal detector device. PMID- 1781548 TI - Cardiac arrhythmias during rigid oesophagoscopy. PMID- 1781549 TI - Isoflurane anaesthesia in children. PMID- 1781551 TI - A better extensometer. PMID- 1781550 TI - Trimeprazine premedication in children. PMID- 1781552 TI - Continued problems with diclofenac injections. PMID- 1781553 TI - Cardiorespiratory changes during upper gastrointestinal endoscopy. PMID- 1781554 TI - Safe use of propofol in a patient receiving tranylcypromine. PMID- 1781555 TI - Hazard with a triple lumen catheter. PMID- 1781556 TI - Percutaneous tracheostomy insertion can be difficult. PMID- 1781557 TI - Extradural vein puncture--an avoidable complication. PMID- 1781558 TI - Resolution of acute brachial artery embolism following brachial plexus block. PMID- 1781559 TI - Doxapram and shivering. PMID- 1781560 TI - Obstructed ventilation: the blocked catheter mount. PMID- 1781561 TI - Under pressure. PMID- 1781562 TI - [A comparative study of the efficacy and tolerance of dipotassium clorazepate and flunitrazepam for oral premedication]. AB - The literature shows that benzodiazepines, in view of their anxiolytic, sedative, amnesic, muscle relaxant and anticonvulsive action, are the most important substances for premedication. Eminent workers regard anxiolysis as the most important aim of premedication. In the present clinical study, oral administration of the two different benzodiazepine derivatives, flunitrazepam (F) and chlorazepate dipotassium (CD) have been explored with a view to side effects, tolerance, quality of sleep during the night, anxiolytic effect and sedation. The study involved 108 women patients aged from 20 to 60 years (ASA class I or II), all scheduled to undergo gynecological surgery in general anesthesia. There were also 20 women who received no premedication. The three groups of patients were further divided into early (operation started before 10:30 a.m.) and late operation (operation started after 10:30 a.m.) groups. The test drugs were administered as follows: 43 women received 50 mg CD p.o. on the evening before the operation, followed by 25 mg p.o. in the morning; 45 women received 2 mg F p.o. on the evening before the operation, followed by 1 mg p.o. in the morning. All patients took the preoperative premedication at 7 o'clock in the morning. Following this medication, the anxiolytic, sedative, and amnesic effects, side effects, vigilance and O2 saturation (SaO2) were determined at defined points during the day of the operation and the 1st postoperative day. Blood pressure and heart rate were recorded and interpreted as physiological stress parameters. Anxiolysis was determined using the Erlangen Anxiety Scale (EAS) of Galster and Sporl; the degree of sedation was assessed by the anesthesiologist; amnesia was determined by the patients' recognition of picture cards; vigilance and side effects were assessed by standardized questionnaires. Both active drugs clearly improved the quality of sleep in the night before the operation over that experienced with no premedication. There were no significant differences among the three groups in the physiological stress parameters. The preoperative SaO2 saturation was decreased significantly by oral F, but it was always more than 95%. CD had little influence on the SaO2. Unwanted somatic symptoms were found a little more frequently in the group without any premedication. There were no signs of restricted tolerance for either of the test drugs. In the premedicated groups, pre- and postoperative anxiety decreased significantly.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1781563 TI - [Rectal, oral and nasal premedication using midazolam in children aged 1-6 years. A comparative clinical study]. AB - Midazolam is often used for the premedication of children in the pre-school age group. Different noninvasive routes of administration have been described. In a prospective study we compared the effects of oral, rectal, and nasal midazolam in commonly used dosages. PATIENTS AND METHODS. Ninety children undergoing surgery under general anesthesia were assigned to oral (0.4 mg/kg) (MO), rectal (0.5 mg/kg) (MR), or nasal (0.2 mg/kg) midazolam (MN), according to the child's and/or parent's preferred route of administration, after having obtained the parent's informed consent. It was applied on the ward before transport to the operating room. The following parameters were assessed by the observer and the anesthesiologist at different times: sedation, acceptance (child, anesthesiologist), mood, emotion, resistance, pain, nausea and vomiting, blood pressure, and heart and respiratory rates. The Wilcoxon test (P less than 0.05) was used for statistical analysis. RESULTS. All groups were comparable with respect to age, weight, and surgery experience. There was no difference in the anesthesiologist's acceptance of the premedication or the cooperation of the children. The children accepted MO significantly better compared to MN and MR. The fastest onset of sedation was found after MR. Immediately after MN many children became euphoric, and it turned out that the effect of MN was rather euphoric than sedative. The effect of MO was good in many children, but less predictable. This led to a significant delay in transport to the operating room. MO children experienced more nausea and vomiting (P less than 0.05) in the postoperative period. There were no differences in physiological parameters. DISCUSSION AND CONCLUSIONS. The results can be explained by the different characteristics of absorption and patient acceptance. The route of administration according to the child's or parent's choice can be recommended but does not guarantee success. MR had the fastest onset of sedative action due to faster absorption of the drug. MN had a euphoric effect that resulted almost immediately. Oral premedication was best accepted, nasal administration worst. MO produced more side effects than MR and MN in the postoperative period. If the child accepts the rectal route of administration, this should be preferred because of the high success rate and few side effects. PMID- 1781564 TI - [Slowing down of the EEG during hypoventilation in emergence from anesthesia]. AB - Electroencephalographic (EEG) recordings were made using a "Narkograph", which performs an automatic on-line interpretation of electroencephalographic data obtained during anesthesia. The EEG was classified into one of 13 stages from A (awake) to F (very deep narcosis). In 20 of roughly 600 patients EEG changes were observed that could not be explained by the effects of anesthetics. Slowing of the EEG occurred during the transition from controlled to spontaneous ventilation and disappeared after minute ventilation increased. The alterations seen during hypoventilation were similar to the effects of hypoxia described in the literature. During the slowing in the rough EEG, waves appeared that were very regularly formed and corresponded to sharp peaks in the power spectrum. These features are rather atypical of the effects of anesthetics such as thiopental, propofol, halothane, isoflurane, and enflurane and were not observed when patients went back to sleep after extubation. If depth of anesthesia is monitored by EEG recording, clinical circumstances should be taken into account because conditions such as hypoxia may cause alterations of the EEG that bear a resemblance to the effects of anesthetics. PMID- 1781565 TI - [The use of pulse oximetry in the compartment syndrome]. AB - After conservative therapy of a left-sided radius fracture a 14-year-old patient developed a compartment syndrome; within 24 h, that required immediate surgical intervention. Despite palpable peripheral pulsation of the radial and ulnar arteries, it was not possible to measure the arterial oxygen saturation by pulse oximetry on the forefinger and fifth finger of the left hand, so that a compartment syndrome due to a disorder of perfusion could be diagnosed. After fasciotomy, it became possible to measure the oxygen saturation by pulse oximetry as well as plethysmographic visualization of the pulse curve. In this case pulse oximetry confirmed the indication for surgical intervention and immediately demonstrated its success. PMID- 1781566 TI - [Non-surgical removal of a knotted Swan-Ganz catheter]. AB - Intracardiac knotting is a rare complication of pulmonary arterial catheterization. This paper describes a 68-year-old male patient who had a 7-F Swan-Ganz catheter inserted via the internal jugular vein. The postoperative chest roentgenogram revealed a catheter knot in the right ventricle. Using fluoroscopy it was possible to pull back the knot up to the indwelling introducer. By pulling the knot against the introducer its size was reduced to a minimum. After this manoeuvre, both the introducer and the small knot could be withdrawn from the jugular vein without further incident. The possible complications of this method and of alternative techniques are described and discussed. Surgical intervention in the case of a knotted Swan-Ganz catheter may only be necessary when intracardiac fixing of the knot is encountered. PMID- 1781567 TI - Diastolic mechanics and the origin of the third heart sound. AB - The third heart sound (S3) is observed for various hemodynamic conditions in both the normal and diseased heart. A theory is proposed in which myocardial viscoelasticity is primarily responsible for S3. A mathematical model is developed based on the mechanical aspects of diastolic function: nonlinear elasticity, viscoelasticity, and pressure generation. The model is provided as an electrical analogy of the left ventricle and circulatory system. S3 is predicted for the normal heart and the heart with dilated cardiomyopathy. An elevation of S3 intensity is indicated for cardiomyopathy, as is often observed in the clinic. S3 is produced experimentally by volume loading of the open-chest canine preparation and mathematically by imposing the conditions of volume loading on the model. Consistency of theory and experiment imply that it is valid to attribute S3 to myocardial viscoelasticity. The animal whose heart possessed the largest constant of viscoelasticity produced the greatest level of S3, in both cases. Nonlinear ventricular compliance is not found to be an essential requirement for sound generation, although increased compliance led to an increase in sound. S3 is predicted to change in response to venous return, ventricular stiffness, contractility, heart rate, and duration of contraction, as observed by others. In general, the coupling of these quantities to S3 is explained in terms of an excitation of viscous properties of the ventricle. PMID- 1781568 TI - A comparison of two boundary conditions used with the bidomain model of cardiac tissue. AB - In the bidomain model, two alternative sets of boundary conditions at the interface between cardiac tissue and a saline bath have been used. It is shown that these boundary conditions are equivalent if the length constant of the tissue in the direction transverse to the fibers is much larger than the radius of the individual cardiac cells. If this is not the case, the relative merits of the two boundary conditions are closely related to the question of the applicability of a continuum model, such as the bidomain model, to describe a discrete multicellular tissue. PMID- 1781569 TI - Sensitivity of CO2 washout to changes in acinar structure in a single-path model of lung airways. AB - A numerical solution of the convection-diffusion equation with an alveolar source term in a single-path model (SPM) of the lung airways simulates steady state CO2 washout. The SPM is used to examine the effects of independent changes in physiologic and acinar structure parameters on the slope and height of Phase III of the single-breath CO2 washout curve. The parameters investigated include tidal volume, breathing frequency, total cardiac output, pulmonary arterial CO2 tension, functional residual capacity, pulmonary bloodflow distribution, alveolar volume, total acinar airway cross sectional area, and gas-phase molecular diffusivity. Reduced tidal volume causes significant steepening of Phase III, which agrees well with experimental data. Simulations with a fixed frequency and tidal volume show that changes in blood-flow distribution, model airway cross section, and gas diffusivity strongly affect the slope of Phase III while changes in cardiac output and in pulmonary arterial CO2 tension strongly affect the height of Phase III. The paper also discusses differing explanations for the slope of Phase III, including sequential emptying, stratified inhomogeneity, and the issue of asymmetry, in the context of the SPM. PMID- 1781570 TI - The pressure-volume relation in the left ventricle and the pump function of the heart. AB - The concept of body force (force per unit volume) is introduced to account for the effect of the force generated in the radial direction by the active state of the myocardium in an elastic model of the left ventricle represented as a thick walled cylinder contracting symmetrically. Experimental evidence for the validity of the model is presented. It is shown how the radial force/unit area developed by the myocardium on its inner surface can be included in the equation of the pressure-volume relation (P-V relation) of the left ventricle according to the Suga-Sagawa model, as well as in the formalism that describes the pump function of the heart. PMID- 1781572 TI - Blackout detection as a multiobjective optimization problem. AB - We study new fast computational procedures for a pilot blackout (total loss of vision) detection in real time. Their validity is demonstrated by data acquired during experiments with volunteer pilots on a human centrifuge. A new systematic class of very fast suboptimal group filters is employed. The utilization of various inherent group invariancies of signals involved allows us to solve the detection problem via estimation with respect to many performance criteria. The complexity of the procedures in terms of the number of computer operations required for their implementation is investigated. Various classes of such prediction procedures are investigated, analyzed and trade offs are established. Also we investigated the validity of suboptimal filtering using different group filters for different performance criteria, namely: the number of false detections, the number of missed detections, the accuracy of detection and the closeness of all procedures to a certain bench mark technique in terms of dispersion squared (mean square error). The results are compared to recent studies of detection of evoked potentials using estimation. The group filters compare favorably with conventional techniques in many cases with respect to the above mentioned criteria. Their main advantage is the fast computational processing. PMID- 1781571 TI - Noninvasive estimation of cardiac output with nonprescribed breathing. AB - A noninvasive method to estimate cardiac output Q without special patient cooperation was developed by modifying a previous acetylene-helium (C2H2-He) rebreathing technique (ART). Estimation of Q using ART is based on a single compartment model that is valid only under prescribed breathing; e.g., fast, deep breathing, and emptying of the rebreathing bag on each breath. To make the ART less dependent on subject cooperation, a more sophisticated mathematical model and estimation method are needed. For this purpose, we modeled the C2H2 and He concentration dynamics at the mouth over successive breaths using a multi compartment model. This model takes into account the effects of breathing pattern, compartmental volumes, and gas solubility. From computer simulations and sensitivity analysis, we found that Q could be estimated from the available data with adequate precision. Our model and estimation method were tested on a group of six normal adult subjects, at rest and during submaximal exercise (75 watts). Estimates of Q from our new method (6.5 +/- 0.4 L/min at rest, 12.5 +/- 0.4 L/min at 75 watts) were in agreement with those obtained using a previous ART (7.0 +/- 0.3 L/min at rest, 12.6 +/- 0.5 L/min at 75 watts). We conclude that this approach promises to provide reliable estimates of Q in patients (e.g., children and elderly), at rest and during exercise, without the need of prescribed breathing patterns or changes in rebreathing bag volume. PMID- 1781573 TI - Comments on "Effect of interfacial tension on flow of fluorochemicals in the vasculature of the lung: a theoretical and experimental study". PMID- 1781574 TI - [Delusion and certitude (diagnostic criteria of delusion)]. PMID- 1781575 TI - [Being mad takes time]. PMID- 1781576 TI - [What is a delusional idea, delusion, chronic delusion? An attempt at definition]. PMID- 1781577 TI - [Untimely considerations on chronic delusions]. PMID- 1781578 TI - [Values and limitations of the notion of chronic hallucinatory psychosis. Study of 17 cases]. PMID- 1781579 TI - [Reflections apropos of paranoia]. PMID- 1781580 TI - [Current status of late onset delusion in the elderly]. AB - In the field of chronic delusions, authors make synthesis of the delusion with late emergence in the elderly. This delusion is at once replaced in the history of its nosographic position, then defined in its presentation. The question of its refer with depression and its place in the limits of dementia are approached. Authors outline the importance of biological, psychological and sociological factors in induction of this particular delusion to clarify the means for its management. PMID- 1781581 TI - [Chronic paranoid delusions and pathological personalities]. PMID- 1781582 TI - [Course of chronic paranoid delusions during pregnancy and post-partum]. AB - In order to analyse the evolution of the mental state of patient suffering from chronic delirium, during their pregnancy and the postpartum period, we researched the medical history of some pregnant women about 50 pregnancies. It appears that the period preceding the birth is calm in the great majority of cases. However the delirium reappears in the days following the birth in a brutal fashion in nearly a third of the cases. No malformation in the child is found, but we should note there was one case of infanticide and one young baby was abandoned in the street. The delirium, often concerning the identity or the theft of the child, has necessitated the hospitalisation. The termination of psychotropic drugs is justified during the months of pregnancy. However it often brings with it, an end to psychiatric follow up and the absence of any return to treatment, which seems necessary to us immediately after the birth. PMID- 1781583 TI - [Chronic paranoid delusions and the new nosographic classifications]. PMID- 1781584 TI - [Chronic paranoid delusion and social integration]. PMID- 1781585 TI - [Round table. Psychological and psychotherapeutic relation with patients with chronic paranoid delusion]. PMID- 1781586 TI - [Birth marks: from epidemiology to clinical practice]. PMID- 1781587 TI - [Cutaneous lesions during the 1st week of life in 306 consecutive newborn infants]. AB - The authors report the results of a systematic study of the skin conducted during three months in 306 neonates born in a hospital maternity unit in the Hauts-de Seine departement, France. Two hundred and ninety-nine infants could be examined: 91 (30.5 p. 100) developed erythema toxicum neonatorum; 102 (34 p. 100) had port wine naevus; 42 (14 p. 100) mongolian spot, and 10 (3.5 p. 100) pigmented epidermal naevus. Various other abnormalities were found. These findings are compared with those of previous French (5, 14) and foreign (1, 3, 7-11, 13, 16, 17-19) studies. PMID- 1781588 TI - [Cutaneous metastasis disclosing primary angiosarcoma of the aorta]. AB - A 68-year old man presented with erythemato-telangiectatic nodules on his right lumbar fossa, associated with right-sciatica. A skin biopsy was performed. Microscopic examination showed tumour embolism in the lumen of the dermal vessels. Immunohistochemical staining and electron microscopy confirmed the diagnosis of angiosarcoma metastasis. An arteriography showed the primary neoplasm as a polypoid tumour with anterior pedicle, narrowing the aortic lumen below the renal arteries. The patient died a few months later, with multiple metastasis in the lower half on his body. To our knowledge, this is the twelfth case of arterial primary angiosarcoma reported in the literature and the fifth one with skin metastasis. The previously published cases are reviewed. PMID- 1781590 TI - [Touraine-Solente-Gole syndrome and papular mucinosis. Apropos of a case]. PMID- 1781589 TI - [Nevus of Ota and benign cutaneous blue nevus associated with malignant cerebromeningeal melanoma]. PMID- 1781591 TI - [Cutaneous schistosomiasis. Apropos of a case]. PMID- 1781592 TI - [Papulonodular tuberculids of the lower limbs. An unusual anatomo-clinical form]. PMID- 1781593 TI - [Contact dermatitis from vinyl gloves. Apropos of a case of polysensitivity to medical gloves]. PMID- 1781594 TI - [Polyclonal cryoglobulinemia associated with lymphoma]. PMID- 1781595 TI - [What is your diagnosis? Osteolytic hemangiomatosis or Gorham's disease]. PMID- 1781596 TI - [What is your diagnosis? Streptococcal dactylitis]. PMID- 1781597 TI - [Contact dermatitis from surgical gloves]. PMID- 1781598 TI - [Erythromelalgia]. PMID- 1781599 TI - [Bones and retinoids]. PMID- 1781600 TI - [Vitamins: nutriments and drugs, their frontier]. AB - Current food of french normal subjects is sufficient and even surpasses the caloric recommended apport. Though repartition between glucids, protids and lipids is not ideal, the recommended daily apports (RDA) for vitamins are satisfied at a 75-80% level in spite of some exceptions (vitamins B1, D, folates). For this reason, every vitamin complementation must be moderate. The National Academy of Medicine has logically recommended ("wish" of the 20th of June 1989) to limit this complementation at the level of the vitaminic fraction probably lost by caloric restriction. In the french present situation, it would be limited at 0.5 RDA and well balanced for all vitamins without any exception. This is related to nutritional concept and is not a drug. On the contrary, all particular or "risk" situations may demand more concentrated, eventually not balanced formulas or isolated vitamins at varied doses. These are drugs because they are without efficiency if not adapted, often useless or perhaps long term dangerous. Therefore, the proposed frontier between nutriment and drug is not based on always controversial definitions but on their real nature allowing further adaptation to habits and knowledge. PMID- 1781601 TI - [Quercetin-3-glucuronide, main flavonoid of Alchemilla, Alchemilla xanthochlora Rothm. (Rosaceae)]. PMID- 1781602 TI - [Defined media for hybridoma culture: do they really replace serum and why are they attractive?]. AB - The cell culture efficiency of serum free media is still the main question which limits the use of such a product. However, the experience due to a long usage of serum free media allows to certify that for hybridomas the proliferation growth is often similar to the levels attained with serum. Antibodies secretion is also good or superior to the one obtained with classical media used in different culture devices like flasks and cytocultures. Finally the higher purity degree of monoclonal antibodies in the cell culture supernatant is also a major advantage of serum free media. PMID- 1781603 TI - [Gasometric determination of carbon dioxide in carbano-apatites of calcified tissue]. AB - The determination of carbon dioxide in carbonato-apatites is carried out a new gasometric method. Its application, in this paper, concerns the bones of skull and mandibles of Cory's shearwater (Calonectris diomedea borealis) and Mallard (Anas platyrhynchos). The results lead to appreciable differences between some organs of this two species. PMID- 1781604 TI - [Synthesis and pharmacological study of alpha-phenyl-1-adamantanemethanamine]. AB - The alpha-phenyl-1-adamantanemethanamine 2 was synthesized and its pharmacological action was studied on mice. The behavior effects obtained with this compound (at low dose) as well as the antagonism of the convulsions and the lethality (induced by the amine 2 at high dose) by desimipramine, N-linoleylGABA or N-linoleylglycine, could suggest the existence of glutamatergic (NMDA), anti GABAergic and antiglycinergic components in the action mechanism of this adamantanamine. PMID- 1781605 TI - [Research of alkylating agents: chloroalkylamides derivatives of coumarin]. AB - The condensation of conveniently substituted acid halides with 3-amino-coumarin, lead to the corresponding chloroalkylamides. The derivatives tested on murine leukemia P 388 were inactive. PMID- 1781606 TI - [Serum bisalbuminemias: their clinical value]. AB - Bisalbuminemias are characterized on serum electrophoresis with a double band of albumin. They could be hereditary or acquired. This double band is composed of a protein with a normal mobility and with a protein with an other mobility which migrates in a more anodic or more cathodic position. PMID- 1781607 TI - [A plea for conservative treatment without celiotomy in hepatic contusions]. PMID- 1781608 TI - [Hemorrhagic gastro-duodenal ulcers. In which cases should emergency surgery be performed?]. AB - From January 1983 to December 1987, 127 patients with bleeding peptic ulcer were admitted to hospital. The mean age of the 85 males was 57 years and 72 years for 42 females. All but four of the patients were managed medically after emergency endoscopy. Twenty-seven patients required surgical operations (21.2%): seven for cataclysmic haemorrhage, eight for persistent haemorrhage, twelve for recurrent bleeding. An analysis of factors leading to the necessity of surgical haemostasis was undertaken by considering the clinical status, endoscopic findings and laboratory results. The size of the ulcer (greater than 2 cm) was the most significant parameter (less than 0.01). Five other criteria (rectal bleeding) shock, endoscopic signs of recent haemorrhage, gastric or duodenal posterior ulcer) were also significant (p less than 0.05). Considering the gravity of these patients (six deaths among twenty-seven), clinical trials in bleeding peptic ulcer disease should only include patients in the high risk group. PMID- 1781609 TI - [Method for the correction of ventral hernia using a parietal prosthesis held by a metal stapler. Apropos of seventy cases]. AB - The authors propose a technique of fixation of the parietal prosthesis by metallic staples in order to reduce the operation time which is often long. The operation was performed according to J Rive's principles, using a Dacron patch (n = 65) or a polyglactin patch (n = 5). A mechanical stapler for aponeurotic suture was used for fixation of the patch. The bent shape of the stapler made it possible to very easily insert the lateral edge of the patch, previously hemmed, to slip it under the rectus abdominis muscle and to clamp it onto the lateral linea alba. We placed the patch under tension very easily with circular clamping. Seventy ruptures were treated by this technique. In 80% of cases, the rupture was frontal and in 20% of cases, it was fronto-lateral. The mean diameter of the parietal defect was 15 cm (E = 10-35 cm). The time for fixation of prosthesis was less than 5 min; the usual duration of the operation was therefore considerably reduced. In every case, we obtained optimal tension of the suture, without any folds, and this very easily. There was no mortality. Two postoperative hematomas, one consecutive to an injury of the epigastric artery required a second operation. We only had one case of superficial parietal sepsis. None of these complications required removal of the parietal prosthesis. The functional results were always satisfactory for the patients who suffered no pain induration over the metallic staples. A radiological follow-up of the position of the prosthesis encircled by the metallic staples was systematically performed after every operation. Only one relapse, due to a technical error, was observed. If we consider that the follow-up of these results is about two years (3 months-5 years), they suggest that the use of a stapler allows strong fixation, without any fold and with a regular tension, of the prosthetic patch used in the treatment of large incisional hernia. If we compare this technique with the usual techniques of fixation, we can say that this technique significantly reduces the duration of the operation which is often long. These technical advantages help to reduce the long operating time and the risk of sepsis, which is always serious, also minimizing recurrences of the rupture. PMID- 1781610 TI - [Pre-gluing of circular instrumental anastomoses]. AB - The enforcement of digestive anastomoses with glue is recognized now. It is possible to glue a circular instrumental anastomosis by applying or spraying a fibrin glue. PMID- 1781611 TI - [Primary resection-anastomosis in perforated diverticular sigmoiditis. Apropos of 58 cases of peritonitis, 31 of them generalized]. AB - Fifty-eight cases of peritonitis due to perforated sigmoid diverticulitis observed over a period of 10 years were treated by emergency mechanical resection anastomosis without any post-operative anastomotic complication with a mortality in 2 cases (4%). An early operation with large resection and suture as far as possible from the initial focus give results similar to those of a regular anastomosis. The degree of peritoneal affect and especially the general state of health can impose limits to colectomy in the emergency situation. In the light of the results obtained, the use of the circular stapler with the triple stapling technique is now recommended without any particular protection of the suture. PMID- 1781612 TI - [Complications of intestinal malrotation in adults. Apropos of 3 cases]. AB - Three cases of anomalies of intestinal rotation are reported in order to show the difference between chronic and acute presentations of this entity. After a short embryologic review diagnostic difficulties and surgical treatment are discussed. PMID- 1781613 TI - [Helicobacter pylori infection and the surgically treated stomach]. AB - In 38 patients who had been operated for peptic ulcer (32) or gastric cancer (6), we performed upper GI endoscopy with biopsies. HP was found in the mucosa in 8 out of 10 patients with highly selective vagotomy, 5 out of 11 patients with gastrectomy for ulcer, 6 out of 11 patients with vagotomy-pyloroplasty and in only 1 case out of 6 with gastrectomy for cancer. These results are in agreement with other publications. Bilio-pancreatic reflux into the stump probably explains why HP was found in only 50% of cases with suppression of pyloric function, compared with 80% after highly selective vagotomy. Interstitial gastritis was present in every case infected with HP, but the same gastritis was present in one half of mucosas, without infection by HP. This particular gastritis in probably caused by reflux. The role of HP in the relapse of ulcers therefore remains to be demonstrated. PMID- 1781614 TI - [Letter to the editor: chronic alcoholic pancreatitis]. PMID- 1781615 TI - [In situ femoro-popliteal bypass grafts. Study of 85 cases using Cartier's technique]. AB - From January 1985 to december 1989, 83 patients (69 men, 14 women) underwent an in situ femoro-popliteal bypass using a semi-closed technique and the valvulotome developed by Dr Paul Cartier. Most patients (67%) were operated for severe ischemia while 33% were for claudication. HTA was present in 31% of patients, diabetes in 38% and CAD in 57%. Mean preoperative ABI was 0.33 +/- 0.20 and mean ankle pressure was 50 +/- 30 mm of Hg. Arteriographic popliteal run-off showed three vessels in 21 cases (25%), two vessels in 17 cases (20%) and one vessel in 38 cases (45%). Nine patients (10%) presented an isolated popliteal artery. Bypass was constructed below knee in 62 patients (73%) and above knee in 23 (27%). Five mortalities (5.8%) and two major complications (2.3%) were related to surgery. Four early graft failures (4.4%) were noted but 3 were successfully reoperated. Postoperative ABI was 0.71 +/- 0.23 mm of Hg and 81% of patients had complete relief of their symptoms. With a mean follow-up 19 months, graft patency was 91% +/- 6% and 84% +/- 11% at one and two years and was not influenced by operative indication: hypertension, diabetes, preoperative ABI, arteriographic findings or distal anastomotic site. Overall survival was 80% +/- 10% and 69 +/- 13 at one and two years. The in situ technique using the Cartier valvulotomes is an excellent operation and compares favourably with other techniques. PMID- 1781616 TI - [Critical aortic stenosis in newborn infants. Twenty-five years' experience]. AB - Operative mortality for critical aortic stenosis in newborn having been reported as high as 20-80%, the percutaneous aortic valvuloplasty is looked upon as an alternative therapy. We elected to review our surgical experience in the last 25 years before changing our therapeutic approach. Among 37 infants included in the study, 28 were boys and 9 girls. Mean age at diagnosis was 14.5 days (1 to 113 days) and decreased to 4.1 days in the last 5 years. Surgery was done at a mean of 37.2 days; 22 infants were operated on before one month of age and 9 in their first week of life. Five died from ventricular fibrillation at incision. Trans ventricular valvulotomy was attempted in 4 and remaining 28 had trans aortic valvuloplasty. The overall survival of 40% had improved in last five years to 75%. All patients with trans-ventricular approach died and also did the only child with percutaneous angioplasty. Only 13% patients weighing less than 3 kg survived the operation. Follow-up was of 93.3% with a mean time of 66 months. All but one are in NYHA class 1 or 2. Our study identified the following risk factors: preoperative hemodynamic state, surgical weight, associated anomalies of the left ventricle, transventricular valvulotomy and the year of surgery. In view of improved survival, surgery remains a good therapeutic choice. PMID- 1781617 TI - [Thoracotomy with muscle sparing]. AB - Muscle sparing thoracotomy is suggested more frequently in recent literature. From March 1988 to February 1990, a muscle sparing technique was used in 77 (58%) of 132 consecutive thoracotomies. There were 50 men and 27 women, age varied from 23 to 81 years, with a mean of 58 years. Forty-four lobectomies, 10 pneumonectomies, 9 lung biopsies, 6 wedge resections, 6 bullectomies and 2 segmentectomies were performed. A horizontal incision was used in 47 (61%) patients and a vertical mid-axillary incision in 30 (39%). For optimal exposure, transection of the latissimus dorsi muscle was needed in 14 (30%) of the horizontal incisions. Inadvertent rib fracture occurred in 10 (13%) cases. Continuous epidural analgesia was added in 46 (60%) patients for an average of 40 hours. Mechanical ventilation in 14 (18%) patients for a mean duration of 22 hours and an average stay of 2 days in the ICU and 7 days in the hospital, were required. There was 1 (1.3%) hospital mortality, 4 (5%) patients developed a seroma that required aspiration. Muscle sparing thoracotomy can be used safely for most thoracic procedures and we believe it permits easier pain control and early preservation of full shoulder motion. However the operative field is more restricted. A horizontal incision, permitting section of the latissimus dorsi for better exposure should be used for hilar or invasive lesions. PMID- 1781618 TI - [Arterial surgery of the upper limb]. AB - Arterial surgery of the upper limb represents 2.5% of peripheral vascular procedures in our center. From 1976 to 1989, 58 procedures were performed in 45 patients. There were 26 men and 19 women with average age of 52 years, ranging from 6 to 92 years. These patients were grouped in three categories according to etiology: 1) trauma; 2) acute non traumatic ischemia and 3) chronic ischemia. Sixteen patients (35.5%) were operated on for arterial trauma including three false aneurysms. Blunt trauma was the cause in 9 patients, penetrating in 6 and iatrogenic in one. Angioplasty and primary end to end anastomosis were used in 6, bypass in 4, simple ligation in 3, thrombectomy in 3. The outcome was excellent in 15/16 (93%). Non traumatic acute ischemia occurred in 16 patients (35.5%) and was due to emboli of cardiac origin in 92%. All patients were treated by thromboembolectomy. This group had a high mortality (5/16, 31%) because of associated medical conditions. The third group of 13 patients (29%) underwent surgery for chronic ischemia of the upper limb localized to the subclavian artery in 92%. They were treated with carotid subclavian bypasses in 9, other types of bypass in 3 and endarterectomy in 1. Excellent results were obtained in 10/13 (78%). Overall, satisfactory results were obtained in 90% of surviving patients. Operative mortality was 11.1% and the amputation rate was 13%. PMID- 1781619 TI - [Post-sternotomy mediastinitis: strategy of treatment]. AB - To determine the incidence, the mortality, the risk factors and the most appropriate method for treatment of sternal infections, 9,742 charts were reviewed retrospectively of patients having undergone a sternotomy for cardiac surgery at the Montreal Heart Institute. One hundred and eleven sternal infections (1.1%) were identified: 55 (0.57%) superficial, 56 (0.57%) profound (mediastinitis). The treatment for these profound infections was either debridement, open or closed with drainage irrigation, pectoral flap closure repair, or epiplooplasty closure. The risk factors for those patients experiencing profound infections were diabetes, obesity, length of the surgical intervention, the time spent in the operating room, and the duration of endotracheal intubation. Eleven of the 111 patients died. The average length of hospitalization were similar for those patients treated by pectoral flap repair and by the epiplooplasty closure. All patients (100%) treated by the epiplooplasty closure developed an epigastric hernia. Six cases of recurrent infection were observed in the group treated by debridement. The average hospital stay was shortened for those patients benefiting from the pectoral flap and epiplooplasty closures. A high incidence of mortality is associated with profound sternal infection. The methods of treatment are various. We recommend as treatment of choice, the pectoral flap closure because there is relatively low risks with this procedure, little to no recurrence of infection, a shorter hospital stay and this procedure does not provoke epigastric hernia. PMID- 1781620 TI - [Ruptured abdominal aortic aneurysm: long-term survival]. AB - Despite technological improvement, surgery for ruptured aortic abdominal aneurysm (AAA) only gets about 50% of patients to survive past the operative period. This series addresses the long-term outcome of those survivors. Eighty consecutive patients operated on for ruptured AAA between January 1983 and June 1990 at l'hopital du Saint-Sacrement by three vascular surgeons, were studied and compared to 279 patients submitted to elective aneurysm surgery during the same period. The operative mortalities were respectively of 45% (ruptured) and 6.1% (elective). Five year survivals added up to 30 and 68%. When the 5 year survivals were recalculated, including only patients who were discharged from hospital, we found no statistically significant difference (p greater than 0.05) between the ruptured (55%) and the elective groups (68%). Data from this series demonstrate that long-term survival of patients undergoing ruptured AAA surgery is good and compares with that of AAA elective surgery. Therefore, aggressive treatment of ruptured AAA remains justified. PMID- 1781621 TI - [Mediastinoscopy in ambulatory surgery: nine years' experience]. AB - Ambulatory facilities are being used more and more for various diagnostic and therapeutic procedures. We report 183 consecutive mediastinoscopies and/or anterior mediastinotomies performed in an ambulatory setting from July 1981 to January 1991. There were 140 patients with a neoplasia: 131 bronchogenic carcinomas, 5 lymphomas, 2 carcinoid tumors, 1 teratocarcinoma, 1 carcinoma of the stomach. Forty-three patients had a benign condition, including 32 sarcoidosis and 11 miscellaneous diseases. Twenty-eight (15%) patients were admitted the same day: 12 for elective surgery in view of bed availability, 9 for medical observation, and 7 required overnight admission for non-medical reasons. Eight non-fatal complications were encountered: hemoptysis (2), atrial fibrillation (1), pneumonia (1), mediastinal self-contained bleed (1), tear of a pulmonary artery (1), temporary palsy of the recurrent laryngeal nerve (1) and wound infection (1). There was no operative mortality. Overall, ambulatory mediastinoscopy and anterior mediastinotomy permitted a diagnosis in 58 patients (29%), and confirmed unresectable malignant disease in 36 patients, thus sparing unnecessary admission to a surgical ward in 89 (49%) of the 183 patients. Mediastinoscopy and anterior mediastinotomy are safe in an ambulatory setting and alleviate the need for hospitalization in a substantial number of patients. PMID- 1781622 TI - [Development of organ transplantation in Quebec from 1985 to January 1990]. AB - In Quebec, the first organ transplantations have been realized in 1958. Several kidney transplant programs started at that time. Cardiac, liver, pancreas and lungs programs followed and reached a full development in the eighties when Cyclosporin became available. Today, there are 4 university transplant programs in Quebec (McGill, Montreal, Laval and Sherbrooke) with a total of 7 kidney, 4 liver, 4 heart, 2 pancreas and 2 lungs centers. More than 2,900 transplantations have been realized. Since 1970, organ procurement and distribution is organized by a central agency called Quebec-Transplant (previously Metro-transplantation). Organ donation is done on a voluntary basis as every where in North America. More than 90% of the organs comes from cadaveric donors and more than 90% of the relatives accept organ donation. 50% of the donors have deceased from head trauma and 50% from cerebral hemorrhage. In 1989, multi-organ harvesting has been realized in 64% of the donors. Despite efforts and progresses, the number of patients awaiting an organ transplant is steadily growing and outlast the number of available organs. It is hoped that maximal utilisation of the donors and growing exchanges at a national and international level will help to solve this crucial problem. PMID- 1781623 TI - [Selective galactophorectomy for mono-orificial nipple discharge without associated mass: technique and results. Apropos of seventy-three cases]. AB - A single duct mammary discharge is a sign of an underlying disease: inflammatory, benign proliferative disease or even cancer. Selective resection of a ductolobular tree insures appropriate diagnosis and causative and definitive treatment of the discharge. Mammogram is essential. Galactography is quite usefull and reliable but may be unindicated or contraindicated. Surgery includes catheterization of the hole, methylene blue dye staining of the duct, circumareolar or radial incision, dissection, pyramidal resection of the whole galactophoric tree and closure with a retracting suture of the nipple. Woman's age, color of the discharge, pre-operative galactography suggest the diagnosis which has been in our series of 73 cases an inflammatory process in 53.4% of cases, a benign proliferative in 42.5% of cases and an epithelioma in situ in 4.1% of cases. The 46 cases of serous, serosanguinous or sanguinous discharge were due to an inflammatory process in 15 cases (32.6%), a benign proliferative in 28 cases (60.9%) and an in situ carcinoma in 3 cases (6.5%). PMID- 1781624 TI - [Neurovascular transfer of the m. gracilis for the treatment of Volkmann's contracture following supracondylar fracture in childhood]. AB - Children are particularly prone to developing moderate to severe Volkmann's ischemic contracture following a supracondylar fracture of the humerus or its treatment. In order to treat such contractures, intensive hand therapy and a gracilis free muscle transfer to the digital flexors were used in 8 patients at an average age of 6 years 2 months. All transfers were successful. At follow-up (1 to 8 years, average 3 years), despite limited wrist extension in 5/8 patients and mean grip and pinch strengths between 22 and 43% of normal for age and dominance, all patients regained considerable finger flexor excursion (tip to crease distances of 0 to 5.0 cms, average 1.68 cms). Although fine motor assessment using the M.A.N.D. battery of tests placed the patients in the moderate disability range, 7/8 patients became independent in the tested activities of daily living with the exception of buttoning a cuff with the involved hand, which was difficult for 5/8 subjects. Quantifiable measurements underestimated the renewed importance of the operated hand. Compensatory motion at the shoulder allowed positioning the hand which changed from being nearly useless to becoming a functionally non-dominant hand well integrated into daily life. PMID- 1781625 TI - [Surgical treatment of arteriovenous malformations in eloquent zones of the brain. Apropos of eleven cases]. AB - The site of a cerebral arteriovenous malformation, particularly in an eloquent area of the brain, is a significant factor that may influence the therapeutic approach. In these cases, surgery is often viewed as a contraindication. We report our experience of eleven consecutive cases of cerebral arterio-venous malformation in an eloquent area of the brain treated surgically. The resection was complete as confirmed by post-operative angiogram in ten patients. There were no post-operative mortality. One patient had a mild neurological deterioration and all patients have resumed their normal activities. The technical aspects which allowed these results are discussed. PMID- 1781626 TI - [Perineal retraining in urinary stress incontinence]. AB - Twenty patients suffering from urinary stress incontinence were treated by perineal reeducation. The assessment included a medical and urological questionnaire, a physical examination, a urine analysis and culture, a cystoscopy, urinary flow and cystometry, a urethral pressure profile and a subjective evaluation of the perineal musculature. The 20 patients selected had documented stress incontinence, had never been operated on for incontinence and had a stable bladder at urodynamic assessment. Treatment was identical for all patients and included 12 biofeedback and electrostimulation sessions over a 4 to 6 week period. The questionnaire, urodynamic and perineal assessment were repeated at the end of treatment. No complication occurred. Micturition frequency decreased in all patients. Clinical correction of incontinence was observed in ten patients, improvement in nine and no change in one for an overall cure or improvement rate of 95%. The urethrocystocele evaluation did not change. Perineal evaluation and urodynamic parameters were only slightly improved. At follow-up evaluation 6 to 9 months post treatment, a 75% cure or improvement rate was still present. Perineal reeducation is a non morbid and effective modality to correct urinary stress incontinence. Its long term efficacy and its use for other types of incontinence has to be demonstrated. PMID- 1781627 TI - [In vitro evaluation of the maximal possible deformation imposable on the median collateral ligaments in rabbits]. AB - With this study, we identified the maximal level of deformation applicable to medial collateral rabbit ligaments in vitro. According to scanning electron microscopy photographs of ligaments fixed at different elongation level 0% (n = 5), 5% (n = 4), 6% (n = 5), 8% (n = 5), 10% (n = 7), 15% (n = 4) and 20% (n = 4), we concluded that a 6% deformation would be optimal. At that level, the collagen fiber undulation are completely unstretched, and still, no collagen ruptures could be observed. PMID- 1781628 TI - [Pierre Masson: the father of histopathology teaching in Canada]. AB - Pierre Masson's influence on teaching of pathology in Canada has been unique. One of the most eminent pathologist, director of the Institute of anatomopathology of Strasbourg, he accepts, in 1926, to be the ambassador of the french science in North America. He is named professor and Chairman of the Department of pathology of the University of Montreal. Very soon, his "school" is world renowned and contributes to the excellent reputation of his new country of adoption. During his career, Pierre Masson has published more than 131 original scientific papers and written his masterpiece "Les tumeurs humaines" which has been translated in English. Masson died in 1959, but his influence is prolonged be his collaborators and students who still cherish his memory. PMID- 1781629 TI - [What type of heart valve prosthesis after age 70]. AB - The choice of a valve replacement in patients over 70 years of age must take into account various parameters: the type of valve disorder being operated, the probability of post-operative survival in view of the stage of the valve disease and the age of the subject, and the advantages and draws-backs related to the replacements used. In the case of mechanical replacements, the main risks are related to the embolic and hemorrhagic problems inherent in anticoagulant treatment. In the case of biological replacements, the problems are related to the primary degeneration of these valves, which appears to be less frequent the higher the age. In patients over 75 years of age, bioreplacements have more advantages than mechanical valves. In subjects between 70 and 75 years of age, a mechanical valve can be recommended if there is no contraindication to anticoagulant treatment, if there is some other grounds for long-term anticoagulation and if the life expectancy appears to be greater than 10 years. In other situations, a bioreplacement is recommended. PMID- 1781630 TI - [Thrombolysis in unstable angina]. AB - Anatomical, coronary angiographic and angioscopic observations have revealed the frequent presence of a thrombus in the lumen of the artery responsible for ischemia in patients suffering from labile angina. A thrombus is more frequently found if coronary angiography is carried out within a few hours of angina-type pain, and its presence is a factor predicting complications (infarction, sudden death, necessity for revascularization). These observations constitute the basis of clinical trials of thrombolytic agents administered by intracoronary or intravenous route. The thrombolytic treatment does not reduce the incidence of the angina attacks (defined clinically or electrically), nor that of infarction; it produces little or no reduction (15%) in the degree of stenosis. Although lysis of the thrombus is achieved in most cases and is accompanied by immediate clinical improvement, it does not forecast the outcome in the following days. Clinical deterioration may occur, even when thrombolysis has been effective and accompanied by an improvement in the angiographic images. PMID- 1781631 TI - [Silent ischemia. Therapeutic strategy]. AB - "Painless" or silent myocardial ischemia is common and may be associated with all types of coronary insufficiency. Repeated ischemia impairs the functional and anatomical status of the ventricle and the aim of the treatment of coronary insufficiency must be to reduce not only pain, when present, but also ischemia. A distinction must be drawn between: 1) Painless ischemia after myocardial infarction occurring in a high risk group. This requires investigation of the patient, medical treatment and, according to results, angioplasty or surgery. 2) Painless ischemia associated with stable or unstable angina. It is known that in stable angina 50 per cent of ischemia attacks are painless and that complete treatment must seek to reduce the duration of ischemia. Treatment is adjusted on the basis of the results of investigations and the severity of ischemia. 3) Silent ischemia alone which requires precise diagnostic evaluation and assessment of risk based upon the patient's condition. PMID- 1781632 TI - [Modern techniques of assistance and mechanical replacement of cardiac function]. AB - There has been intensive technological and clinical research for many years into the assistance and mechanical replacement of cardiac function. The simplest systems (extracorporeal circulation using centrifuge pumps, hemopump) and more complex systems (orthotopic or heterotopic pneumatic ventricles, electric ventricles) have been shown to be effective in a variety of situations which up to now could not be controlled by pharmacological methods. These situations are made amenable to improvement by the application of these techniques. They make it possible to await the recovery of autonomous function or, in its absence, transplantation. Experience over the past 30 years provides guidance for current research into the artificial heart. PMID- 1781633 TI - [Coronary disease in patients after heart transplantation]. AB - The thinking about coronary artery disease in heart transplant patients has changed recently. This term includes not only the traditional accelerated delayed atherosclerosis of the transplant, but also proximal inflammatory vascularitis associated with severe acute rejection and distal vascularitis, which is independent of interstitial rejection. This term is also used to describe purely atheromatous lesions of the large coronary vessels which usually occur in high risk patients. The morphology, significance and prognosis of these various vascular lesions are discussed on the basis of material obtained from biopsies, transplantectomies and autopsies in the cardiovascular surgery service of the la Pitie Hospital. PMID- 1781634 TI - [Management of subrenal aneurysm of the abdominal aorta]. AB - This update, intended for cardiologists, is not concerned with technical surgical considerations but rather considers the problems facing the physician in abdominal aortic aneurysm (AAA). 1) What form does AAA take: an atheromatous, spindle-shaped and partially thrombotic ectasis. 2) How is it detected: traditionally by clinical examination and increasingly by ultrasound. 3) What additional examinations are useful: the most simple and commonly repeated is ultrasound. Aortic angiography is useful only in cases with a surgical indication. 4) What is the risk of spontaneous development: above all, rupture, the statistical risk of which becomes considerable once the diameter of the aneurysm exceeds 6 cm. 5) What are the risks and results of surgical treatment: it has become an operation presenting little danger and one that beyond all doubt increases life expectancy. 6) Which patients should undergo surgery: all aneurysms dating from more than 6 cm and/or showing symptoms. PMID- 1781635 TI - [Focus on anticoagulants]. AB - More and more heparins are available to the prescriber and low molecular weight heparins have brought about a modification of prescribing habits. Some complications linked to the use of heparins remain insufficiently known: thrombocytopenia and acute pulmonary hypertension during neutralization for example. Treatment monitoring must be clearly codified to increase effectiveness and reduce the number of accidents thus achieving a better risk/benefit ratio for such treatment. Some of the Vitamin K antagonists have specific properties which should be known, particularly relating to their half-life. Monitoring is important, it is provided by INR and adapted to the indications. The world of anticoagulants is in flux; the movement must be followed as it may well accelerate with the arrival of new antithrombotic drugs. PMID- 1781637 TI - Otolaryngology in the era of subspecialisation. PMID- 1781636 TI - [Painful left bundle-branch block during exertion]. AB - Two new cases of exercise related left-bundle branch block are reported in this study. They should be added to the twenty established and published cases. Comparison opens the way to discussion of the mechanism of onset. Ischemia is often accused, although no exploration has been able to demonstrate its responsibility in the origin of the problem. These two cases have novel features, particularly in describing the first case of painful exercise related bundle branch block in a subject twenty-three years of age. Ischemia linked to epicardial coronary lesions cannot be held responsible, but the possibility of micro-circulatory ischemia is suggested. PMID- 1781638 TI - Pectoralis major myocutaneous flap reconstruction in head and neck surgery- experience with 60 cases. AB - The aim of this paper is to evaluate the results of the use of the pectoralis major myocutaneous flap for reconstruction in 60 otolaryngology--head and neck patients over a five year period. There were 52 patients with Stage III (30%) and Stage IV (70%) untreated squamous cell carcinomas. Of the eight recurrent tumours, three patients had nasopharyngeal carcinoma with extensive post radiation neck failures requiring extended neck dissections and flap reconstruction. The oral cavity and oropharynx were the predominant sites for reconstruction accounting for 70% of the operations performed. Twenty-eight patients had composite resections, ten with pectoralis osteo-myocutaneous flap incorporating a vascularised split sternum bone graft and titanium plate fixation for immediate mandibular reconstruction. All 52 patients underwent post-operative radiation. Major necrosis did not occur but minor tip necrosis of the skin island occurred in two cases (3%). The mean hospitalisation was 19 days for all patients and 21 days for patients with composite resections. The pectoralis major myocutaneous flap in our experience is not only a versatile flap but also a very reliable and robust flap for single stage immediate head and neck reconstruction. PMID- 1781639 TI - Retropharyngeal abscess--the foreign body connection. AB - Retropharyngeal abscesses have been described to be more common among children especially under the age of three or four years and oropharyngeal infection have been implicated as a common etiological factor. However, this series reveals that retropharyngeal abscesses are more commonly seen in adults in our local population. Regional trauma resulting from an ingested foreign body is the leading cause of retropharyngeal abscess in this series. Twenty-three patients seen consecutively between January 1983 and June 1989 at the Department of Otolaryngology, Singapore General Hospital were reviewed retrospectively. Factors such as age, sex, racial distribution, presenting symptoms and signs, methods used to arrive at diagnosis, therapy and complications were studied and analysed. A lateral radiograph of the neck was the single most valuable investigation in the evaluation of the retropharyngeal space. Retropharyngeal and retrotracheal width were measured in 210 normal lateral neck radiographs to establish a normal range in our population. Retropharyngeal widening greater than 5 mm and retrotracheal widening greater than 15 mm was considered significant and was noted in all 23 patients. Regional trauma resulting from an ingested foreign body was the cause of the retropharyngeal abscess in thirteen (56.5%) patients. PMID- 1781640 TI - Parapharyngeal space tumours. AB - Parapharyngeal space tumours are rare, forming 0.5% of all head and neck tumours. They are of interest because of the varied histological types, diagnostic puzzle and challenge at surgical excision. Thirteen patients, seen over an eight year period (from 1981 to 1988) in the Department of Otolaryngology, Singapore General Hospital, are presented. Clinically most patients presented with a painless upper neck lump and on examination, a lateral pharyngeal wall bulge was noted. The main investigation after ruling out a nasopharyngeal primary tumour is a high resolution Computer Tomographic (CT) scan with intravenous contrast. Only if a vascular tumour is suspected on CT scanning, should angiography be performed. Pathologically, the commonest tumours are salivary gland tumours, neurolemmomas and paragangliomas. The surgical approaches at removing these tumours are discussed, emphasising maximal exposure and control of the vascular structures in the head and neck. Recognising these tumours enable the correct sequence of investigations to be performed rather than a 'lymph node' biopsy or 'tonsillectomy' which may be done resulting in an increased morbidity for the patient and an embarrassment for the attending physician. PMID- 1781641 TI - A cytogenetic study of 74 nasopharyngeal carcinoma biopsies. AB - Cells from 102 nasopharyngeal biopsies of patients suspected of Nasopharyngeal Carcinoma (NPC) and family members of NPC patients were cultured. Metaphases were successfully obtained from 74 of the biopsies of which 52 were subsequently histologically confirmed to be NPC. Cytogenetical analysis using Q-banding showed abnormalities in 15 cultures, and these included polyploidy, aneuploidy and marker chromosomes. Of the 15 abnormal cultures, 14 were from confirmed NPC patients and in five of these, a consistent 5q+ abnormally was seen involving 5q31. The only other abnormal chromosome changes seen was in a patient with olfactory neuroblastoma. PMID- 1781642 TI - Cisplatin and 5-fluorouracil continuous infusion for metastatic nasopharyngeal carcinoma. AB - The activity of cisplatin and a 120-hour continuous infusion of 5-fluorouracil (5 FU) was evaluated in 25 patients with metastatic nasopharyngeal carcinoma. Cisplatin 100 mg/m2 and 5-FU 1000 mg/m2/day by continuous infusion for 120 hours were given via an implanted venous access device and ambulatory infusion pump. Eighteen (72%) patients had multiple sites of metastases and seven (28%) patients had only bony metastases. Subjective responses in terms of pain relief and improvement in performance status were seen in 21 (84%) patients. Overall objective response was seen in 19 (76%) patients with two complete remissions (CR) and 17 partial remissions (PR). Locoregional disease responded more completely and rapidly than bony or visceral metastases. Toxicities included nausea, vomiting, neuropathy and one septic death. Cisplatin and 5-FU by continuous infusion represent an effective treatment for metastatic nasopharyngeal carcinoma. PMID- 1781643 TI - Blood loss and transfusion in head and neck tumour surgery. AB - Major head and neck surgical procedures at the Department of Otolaryngology, Singapore General Hospital during a two year period were reviewed. Sixty-three patients were available for study. Data obtained included tumour site and stage, surgical procedure, duration of operation, preoperative haemoglobin and haematocrit, estimated surgical blood loss, amount of blood ordered and used. Data were grouped by procedure. Temporal bone resections showed the highest average estimate of blood loss (1203 mL) and the highest average blood use (3.0 units), followed by composite resections (1067 mL and 2.3 units) and maxillectomy/midface procedures (616 mL and 1.4 units). The degree of blood loss showed a positive correlation with the duration of operative procedure. The majority of patients (62%) met all criteria to qualify as autologous blood donors making autologous transfusion a feasible option for these patients. PMID- 1781644 TI - Results of middle ear reconstruction surgery. AB - Reconstructive surgery of the middle ear comprises two types of operations, i.e. reconstruction of the surroundings of the middle ear (external auditory canal) and reconstruction of the tympano ossicular contents of the middle ear (tympano ossiculoplasty). Reconstruction of the external auditory canal may be total after certain open techniques, or partial after certain closed techniques. The results are markedly better when cortical bone autografts are used rather than materials such as Ceravital or Hydroxylapatite. Furthermore, cavity obliteration gives excellent results in 90% of cases (using bone powder, biomaterial powder, fibrin glue and covering muscular flaps). Tympano-ossiculoplasty gives on the whole, good results. Based on statistics of over 2200 cases, the author dwells in particular on the use of ossicular homografts, the results of which are generally superior to those of the best biomaterial (Ceravital and Hydroxylapatite). PMID- 1781645 TI - Radical mastoido-epitympanectomy with tympanoplasty and partial obliteration: a new surgical procedure? AB - The modern concept of an open cavity is to combine a safe with a dry, self cleansing ear. The prerequisites to achieve this goal are: the radical exenteration of the mastoid, antrum and epitympanum, the maximal reduction of the volume of the cavity by extensive lateral removal of bone and the adequate shaping of the cavity walls by obliteration of the bone pockets. To perform correctly a radical mastoido-epitympanectomy with tympanoplasty and partial obliteration is difficult and requires a perfect anatomical knowledge of the deepest regions of the temporal bone, particularly of the supralabyrinthine space. Using the technique exposed in this article, 75 out of 79 ears (95% of our revision cases) achieved a dry and self cleansing cavity at three years follow up. PMID- 1781646 TI - Stapedotomy: the JB Causse technique. AB - The Jean-Bernard Causse technique of stapedotomy, derived from Jean Rene Causse "Teflon-interposition" technique, offers an optimum reconstitution of the function of the annular ligament of the stapes footplate. The quantity and quality of hearing depend significantly, among other things, on the function of the stapes footplate annular ligament. Its impedance keeps the perilymph motion within a physiological acoustic amplitude quantum level unless the movements are so excessive as in barotrauma and acoustic trauma which would have overworked even the annular ligament of a normal footplate. This surgical technique permits snorkling, scuba-diving, airplane landing, eustachian tube dysfunction after surgery as in a normal individual who did not undergo otosclerosis surgery. A comparative study on the postoperative hearing based on 3,000 out of 14,000 cases done by J C Bausse technique, 127 cases with small fenestra technique and 267 cases of complete platinectomy showed too large stapedotomy gives poor high tones and too small stapedotomy poor low tones. Five year follow-up on the hearing loss indicated that total platinoctomy has 1.7 times more alteration of 4 kHz frequency in comparison to the technique reconstituting the annular ligament. Yearly audiogram to check the evolution of cochlear otospongiosis may lead the surgeon to prescribe sodium fluoride if the mid-frequencies are deteriorating and vascular drugs if the high pitch frequencies are deteriorating. PMID- 1781647 TI - Prognostic factors in idiopathic sudden hearing loss. AB - A retrospective study of 60 cases of idiopathic sudden hearing loss admitted to the Department of Otolaryngology, Singapore General Hospital over a five year period was carried out. The age ranged from 16 years to 74 years. No racial predisposition was found. All cases were treated as an otological emergency and managed as inpatients. All were treated with high dose steroids. Fifty-five percent recovered their hearing significantly. Several factors associated with poorer recovery of hearing were found: severity of hearing loss; high tone loss; longer time from onset to initial audiogram; hypofunctioning vestibular organ and age older than 60 years and under 19 years. PMID- 1781648 TI - Hearing loss and hearing aids: the Singapore School for the Deaf experience. AB - This is a retrospective study of the population of 180 students in the Singapore School for the Deaf between September 1989 to June 1990. It was found that the average age at which the hearing loss was diagnosed was four years. Rubella accounted for 13 cases (7.2%), hereditary factors for nine cases (5.0%), ototoxicity for two cases (1.1%), trauma for two cases (1.1%) and the other 154 cases (85.6%) were of unknown causes. The average hearing loss at 500 Hz, 1 and 2 kHz is 98 dBHL. The students use either the body-worn type or the behind-the-ear type of hearing aids for amplification. There was little motivation to use the aids because some of them were non or malfunctioning, thereby giving little benefit or they were improperly adjusted for the child, resulting in uncomfortably loud amplification. Also, poorly fitting earmoulds give rise to feedback problems. Although early detection of hearing loss is important, it would be of little value if there is no provision of a good intervention programme with ongoing support. PMID- 1781649 TI - Management of the hearing-impaired adults in Singapore. AB - A preliminary study to investigate that the pure-tone air-conduction hearing threshold level which is not an accurate index of amplification need profile applies to the hearing-impaired population in Singapore. Results obtained from a sample of twenty users of monaural amplification indicate that the hearing impaired patients showed a significant reduction in communication difficulties with their hearing aids and are overall satisfied with their monaural amplification despite certain problems with background noise, regardless of the severity of their hearing losses. PMID- 1781650 TI - Moulds of the nasopharynx. AB - A method of making moulds of the nasopharynx is described. Thirteen moulds are illustrated. A mould constitutes one form of morphologic study of the nasopharynx. A mould shows clearly the form and shape of nasopharynx. A positive cast may be made. Moulds are useful for class demonstrations and for teaching purposes. PMID- 1781651 TI - Current problems in radiotherapy, chemotherapy and staging of nasopharyngeal carcinoma (NPC). AB - Nasopharyngeal carcinoma (NPC) in South East Asia is almost entirely of the undifferentiated or poorly differentiated squamous cell types which are more radiosensitive and have better prospect for locoregional control. Cross-sectional imaging can now detect disease in the parapharynx which is commonly involved by this carcinoma. This has resulted in up-staging and technique modification for better local control. Poor prognostic factors include parapharyngeal, skull bone, cranial nerve or other wide-spread involvements locally. Neck nodes in the supraclavicular fossae or bulky nodes also confer poor prognoses. A simplified staging classification system is proposed. With the availability of afterloading machines, a booster dose of intracavitary radiotherapy can conveniently be given. When given shortly after the usual external radiotherapy, the desired high dose to the primary can be achieved without increasing the risk of long-term side effects. Chemotherapy given before radiotherapy helps to achieve prompt control of bulky neck nodes which distort the anatomy and pose problems in radiotherapy dosimetry. However, the eventual survival rate is still not improved. As staging and major prognostic factors are better defined, trials of adjuvant chemotherapy given after radiotherapy should be undertaken. However, the ultimate control of NPC may rest on the feasibility studies on screening for early NPC. PMID- 1781652 TI - Conservation surgery for laryngeal carcinoma. AB - Partial laryngeal surgery as a treatment for certain laryngeal carcinomas is sound in principle and practice. Knowledge of intralaryngeal barriers to spread is necessary for selection of appropriate patients and for surgical planning. Ten partial laryngeal procedures are discussed including selection criteria and cure rates for each. With meticulously accurate tumour staging and mapping, the practitioner can perform partial laryngeal surgery safely. Results equal or better those achieved by radiation therapy or total laryngectomy while preserving vocal function. PMID- 1781653 TI - Modified radical mastoid surgery for chronic ear disease. AB - The aim of surgery in chronic ear disease is to produce a dry, clean, safe, waterproof ear and to reconstruct the hearing. The techniques available are of the so-called "open" variety or "closed". This article avoids any controversy about the merits of each but presents a method of surgery which in most cases will fulfil the above aims. The techniques of mastoid surgery are well documented. In this article, the finer points are discussed with emphasis on the areas which if insufficiently treated, will lead to recurrence of disease and continuing discharge. These areas are the anterior epi-tympanum, the recess between the tympanic membrane and the anterior and inferior canal walls, the facial ridge and the sump that can form behind it, the sino-dural angle and the mastoid tip. PMID- 1781654 TI - Acoustic neuroma: surgical approaches and complications. AB - Acoustic neuroma is the commonly used term for benign schwannomas arising from the vestibular divisions of the eighth cranial nerve. They are relatively common lesions and present a therapeutic challenge. Three approaches are used for removal of acoustic neuromas: middle fossa, retrosigmoid, and translabyrinthine. Each approach has advantages and disadvantages. The advantage of the middle fossa and retrosigmoid approaches is the possibility of preserving hearing. Both require more brain retraction and have greater risk to the facial nerve than the translabyrinthine approach. The translabyrinthine approach sacrifices hearing but has lower incidence for all other complications. The details of each of these surgical approaches are described. The advantages and disadvantages of each approach are detailed, and then the complications which are common to the procedures are described. PMID- 1781655 TI - Stapedectomy--past and present. AB - Surgical technics for bypassing ankylosis of the stapes in the management of otosclerosis gradually evolved; modifications were prompted by problems which were revealed by the ongoing audits carried out by earlier surgeons. Auditing of performance must remain an integral part of any otologist's work. The natural history of otosclerosis should be taken into account so that a patient may be fully informed of treatment alternatives available. Stapedectomy will remain a most effective operation which can be recommended with confidence, provided the surgeon has acquired the skill to perform it properly. It is now accepted that many ear, nose and throat surgeons are neither physically nor temperamentally capable of this task and should not perform stapedectomy. PMID- 1781656 TI - Medical and surgical treatment of Meniere's disease. AB - To create a rational treatment system for Meniere's disease, it is helpful to recall what is known for sure and what is probably true about Meniere's disease, so as to recognise the stages through which the disease passes from beginning to end. Meniere's disease is a complex disorder of the inner ear, characterised by fullness, tinnitus, fluctuant hearing loss and dizzy spells. Meniere's disease is always associated with, and probably caused by endolymphatic hydrops, although all patients with endolymphatic hydrops do not have Meniere's disease. Meniere's disease is almost always associated with, and probably caused by a small, underdeveloped, abnormally-placed, malfunctioning endolymphatic sac. The first stage is entirely cochlear, where endolymphatic hydrops usually begins, with fullness, tinnitus and low-tone, sensorineural hearing loss, and is most amenable to medical treatment. In the second stage, the endolymphatic hydrops is more widespread, involving the vestibular labyrinth as well. There is fluctuant, low tone sensorineural hearing loss, fullness and tinnitus, together with dizzy spells. In the third stage, the hearing loss is more severe and no longer fluctuates, with poor comprehension, but fullness, tinnitus, and dizzy spells are the chief complaints. In the fourth and final end-stage, the hearing is very bad, at 55 to 60 db, and no longer fluctuates, with very poor comprehension, fullness and tinnitus, but usually no more dizzy spells, although the patient is unsteady, especially in the dark. Most ears in Stage IV have reduced or absent response to rotation test. PMID- 1781657 TI - Endoscopic sinus surgery. AB - Many intranasal sinus surgical procedures can be undertaken using the endoscope which provides the surgeon with a clear and well illuminated field of vision, and the ability to inspect recesses with angled distal lenses. Functional Endoscopic Sinus Surgery (FESS) distinguishes the Messerklinger technique, which aims at restoring the natural mucociliary clearance mechanism, drainage and aeration of the sinuses by a minimally invasive anterior-to-posterior technique, from more conventional and radical posterior-to-anterior endoscopic sinus surgery. Hopkins improved the endoscope by replacing lenses with solid rods and fibreoptic illumination, and aided by improved techniques in computer assisted tomography, this has allowed more precise preoperative diagnosis. Meticulous postoperative management, may be the key to the success of endoscopic sinus surgery. Very encouraging results have been reported by many authors. With adequate training and cadaver dissection, endoscopic procedures should not be associated with a higher incidence of complications than ethmoidal surgery by other routes. PMID- 1781658 TI - Acute epiglottitis. AB - Acute epiglottitis, a fulminating infection in the supraglottic tissue due to Haemophilus influenzae type B can cause relentlessly progressive airway obstruction in infants, children and sometimes in adults. Rapid infection and swelling of the epiglottis and aryepiglottic folds causes airway obstruction which can be relieved by endotracheal intubation. The systemic infection and septicaemia must be treated by the appropriate intravenous antibiotics. Acute epiglottitis must be differentiated from viral laryngotracheitis or "croup" which is very common and from pseudo-membranous bacterial tracheitis which is rare. A protocol for management of acute inflammatory airway obstruction must involve an orderly sequence of diagnostic and therapeutic measures, instituted without delay. PMID- 1781659 TI - The cricoid split: an alternative to paediatric tracheostomy. AB - Advances in neonatal intensive care has increased the salvage rate of preterm infants. Many of these require ventilatory support for Respiratory Distress Syndrome or other cardiopulmonary problems. This has lead to an apparent increase in the incidence of acquired subglottic stenosis with difficulties in extubation. In the past, after several attempts at extubation, a tracheostomy is performed with definitive therapy instituted later. Since the first report of the Anterior Cricoid Split (ACS) in 1980, the extubation success rate of all centres average about 77%. The ACS is thus an alternative to tracheostomy, provided it is done for the correct indications and strict selection criteria are applied. How it works is still unclear, but certainly it achieves laryngotracheal decompression with relief of tension and oedema of the cricoid ring. The original indication was for cases of non-fibrous subglottis stenosis; these have now been expanded in recent years to include children with glottic pathology and with a tracheostomy in situ. The availability of excellent intensive care facilities is a prerequisite to doing an ACS; otherwise a tracheostomy is a safer option. PMID- 1781660 TI - Spontaneous retropharyngeal emphysema--case report. AB - Retropharyngeal emphysema is a radiological finding with a cause for concern. When associated with oesophageal perforation due to an impacted foreign body or recent oesophageal instrumentation, it heralds potentially fatal complications such as mediastinitis. Early diagnosis leading to prompt surgical intervention is essential. Spontaneous retropharyngeal emphysema is an uncommon disease entity. Its clinical course is relatively benign and recovery usually uneventful. Two cases are presented. The anatomy etiology and pathophysiology of the disease are reviewed. Barium swallow studies are recommended for all cases of retropharyngeal emphysema to exclude oesophageal perforation due to foreign body impaction and Boerhaave's syndrome. PMID- 1781661 TI - A preliminary study of clinical applications of auditory brainstem response in neurotology. AB - The advent of the Auditory Brainstem Response (ABR) has markedly enhanced detecting site of lesion in hearing patients suspected of having an VIIIth nerve tumour. In these patients, changes may occur in latency, morphology, or both in the affected ear. Four clinical cases illustrating the usefulness of the ABR test as a cross-check of medical imaging procedures in the evaluation of patients suspected of having VIIIth nerve tumours are presented. PMID- 1781662 TI - Otorhinolaryngology--head and neck surgery--its beginnings and development in Singapore. AB - Otolaryngology which had a modest beginning in Singapore as part of general surgery in the late twenties, developed into a full-fledged independent unit by 1957. From the provision of simple basic emergency and secondary patient care during the early period, the speciality has progressed steadily to its present advanced state where its area has been enlarged from the traditional Ear, Nose and Throat to extend from the Skull Base down to the Neck. Microsurgery was introduced in 1958 and this enabled widening of the scope of work. Increased traineeship programmes along with subspecialisation in various fields in Otolaryngology have significantly enlarged the pool of available specialists. This, together with advanced diagnostic and supportive facilities have contributed to much better patient management. PMID- 1781663 TI - Embryotoxicity and teratogenicity of cadmium chloride in Xenopus laevis, assayed by the FETAX procedure. AB - The embryotoxicity and teratogenicity of cadmium chloride (CdCl2) were tested by the FETAX (Frog Embryo Teratogenesis Assay: Xenopus) procedure in the South African frog, Xenopus laevis. In five assays, groups of Xenopus embryos were grown in media that contained CdCl2 at concentrations ranging from 0.75 to 56 mumol per L; control groups were incubated in the same medium without added CdCl2. The exposures to CdCl2 were begun at the blastula stage (five hours post fertilization) and were terminated 96 hours later (101 hours post-fertilization). The embryos were counted, fixed in formalin, and examined by microscopy to score malformations and measure head-to-tail lengths. In control groups, greater than or equal to 95 percent of the embryos survived at 101 hours post-fertilization, and the incidence of malformations was less than or equal to 7 percent. In Cd(2+) exposed groups, there was concentration-dependent mortality, and the embryos showed a concentration-related pattern of malformations, including gut malrotation, ocular anomalies, bent notochord, misshapen dorsal fin, facial dysplasia, cardiac deformities, and dermal blisters. Other abnormalities, not categorized as malformations, included stunted growth and hypopigmentation. The minimum concentration of CdCl2 that inhibited growth (MCIG) was 18 mumol per L. The median embryolethal concentration (LC50) of CdCl2 was 32 (SE +/- 4) mumol per L; the median teratogenic concentration (EC50) was 3.7 (SE +/- 1) mumol per L; the teratogenic index (TI = LC50/EC50) was 8.6. This study demonstrates that CdCl2 is teratogenic for Xenopus laevis and provides a standardized experimental model for studies of the molecular mechanisms of cadmium teratogenesis. PMID- 1781664 TI - Laboratory monitoring of gestational diabetes. AB - The consequences of uncontrolled gestational diabetes is severe to both maternal and fetal well-being. An ideal laboratory test to monitor gestational diabetes should accurately reflect short-term glucose changes. Glycated albumin, by virtue of its short half-life of 14 to 19 days, lends itself as a test to monitor and control gestational diabetes. Analytical approaches for the measurement of glycated albumin are reviewed, and the non-specificity of the simple colorimetric fructosamine assay is stressed. The performance characteristics of fructosamine assay, and the merits of the one hour oral glucose screening test and three-hour oral glucose tolerance test are discussed. An objective strategy for laboratory monitoring of gestational diabetes would include other assays such as fasting plasma glucose to correlate with glycated albumin (fructosamine) and even to complement the less sensitive glycated hemoglobin assay. PMID- 1781665 TI - Polypoid adenosquamous carcinosarcoma of the epiglottis with blastomatous features. AB - A case is reported of polypoid adenosquamous carcinosarcoma with blastomatous features arising in the epiglottis. A 69-year-old man with hoarseness and sore throat was found to have a six cm pedunculated mass located on the epiglottis. Upon examination by light microscopy, it was found that the tumor was composed of not only well to poorly differentiated in situ and invasive squamous cell carcinoma but also adenocarcinoma with blastomatous features and a malignant primitive stroma, with features of undifferentiated sarcoma and focal chondrosarcomatous differentiation. To the best of our knowledge, this appears to be the second case of laryngeal adenosquamous carcinosarcoma with blastomatous features reported in the English literature and the third case in the world literature. PMID- 1781666 TI - Irradiation effect on aging red blood cells. AB - Irradiation of stored red blood cells (RBC) is increasingly utilized for patients who are immunosuppressed or on chemotherapeutic regimens. With the growing demand for irradiated cellular blood products, there has been an increasing need for transfusion services to store previously irradiated blood until needed for transfusion. The effect of irradiation on aging stored RBC has not been studied to date. Five units each of group A, RBC collected in CPD-Adsol (AS-1) with a prior shelf-life of 10, 20, 30, and 40 days, respectively, were divided equally utilizing a sterile docking device and stored at 1 to 6 degrees C. Baseline samples from each bag were obtained for the measurement of extracellular potassium (K+), plasma free hemoglobin (PFH), total lactate dehydrogenase (LD), and erythrocyte 2,3-DPG activity. One of each pair received 2,000 rads of gamma irradiation. Samples were obtained at 3 and 7 days post-irradiation, and multiples of 7 days until expiration. All irradiated units reached a state of K+ equilibrium at 60 to 70 mmol per L irrespective of the length of previous storage with an inverse relationship of RBC age at irradiation and the time required to reach the state of equilibrium. Increased K+ leakage from irradiated aging RBC suggests the need for including in vivo studies of cell survival to establish a post-irradiation storage life. Length of storage prior to irradiation had no effect on PFH, LD activity, and 2,3-diphosphoglycerate (2,3-DPG) activity compared to paired controls. PMID- 1781668 TI - Business or service? PMID- 1781667 TI - Cord blood thyrotropin screening for congenital hypothyroidism. Three years' experience on the Island of Saint Lucia. AB - Cord blood thyrotropin (TSH) screening for congenital primary hypothyroidism has been in effect on the island of St. Lucia for the past three years. Umbilical cord blood samples are obtained on Guthrie filter paper and then transported 3,000 miles to Loyola University of Chicago and delivered to the Illinois State Metabolic Screening Laboratory. There TSH is measured by radioimmunoassay (RIA). After three years, 1,789 newborns have been screened, and the mean value is 6.23 +/- 0.13 microIU per ml. This mean value is less than previously reported by us in 1986 (10.23 +/- 0.29 microIU per ml).13 It is concluded that this screening service continues to be possible far removed from the population under observation. No case of primary hypothyroidism has been detected. Our decreased mean TSH value is due to the new method currently used by the Illinois State Metabolic Screening Laboratory. Congenital hypothyroidism will not be missed provided internal controls are established and rigidly observed. PMID- 1781669 TI - Iron and folate status in Zairian mothers and their newborns. AB - An evaluation of iron and folate status was carried out on 166 Zairian pregnant women from Kinshasa at delivery and in cord blood from their newborns. Anemia, defined as a low hematocrit value (less than 33%), was observed in 38% of pregnant women. Iron deficiency, recognized by a combination of abnormal values for serum ferritin level (less than or equal to 12 micrograms/l) and transferrin saturation (less than 16%) was present in 54% of pregnant women. Folate deficiency, defined by a red blood cell folate of less than 100 micrograms/l, was observed in 6% of cases. In anemic mothers, anemia was associated with iron deficiency in 57% of cases and with folate deficiency in 5%. Correlations between maternal and newborn iron and folate indicators were found. This study points out the necessity for developing strategies in African countries to combat nutritional anemias during pregnancy by specific measures combined with general strategies. PMID- 1781670 TI - Recovery of rats from vitamin D-deficient mothers. AB - Two separate studies were conducted using weanling rats from either an unsupplemented, low vitamin D colony or a supplemented, adequate vitamin D colony. Severe hypocalcemia, slower increases in body weight gain, and lower apparent calcium, magnesium, and phosphorus balance values occurred in the rats from the low vitamin D colony fed a purified AIN-76A, vitamin D-devoid diet compared to rats from the vitamin D-adequate colony fed the same diet. Apparent calcium, magnesium, and phosphorus balance values, as well as most other measurements, in rats from the low vitamin D colony fed a purified AIN-76a, vitamin D-adequate diet were greater than or equal to those of rats never subjected to low vitamin D. This was suggestive of overcompensation in recovery from low maternal vitamin D. However, rats from the low vitamin D colony fed an unrefined (chow), vitamin D-adequate diet had lower apparent balance and bone values compared with rats from the vitamin D-supplemented colony fed the same diet. Presumably high levels of calcium, magnesium, and phosphorous in the unrefined diet prevented any overcompensation during recovery, as occurred with purified diets, from the earlier vitamin D deficiency. Overall, results indicated weanling rats from a low vitamin D colony had low vitamin D stores and were marginally vitamin D-deficient. In addition, recovery from the marginal deficiency had occurred to a large extent after feeding a purified, vitamin D adequate diet. The results suggest the use of low vitamin D colony rats as a model for human, marginal vitamin D deficiency. PMID- 1781672 TI - Separate and sequential effects of exercise and meal ingestion on energy expenditure. AB - The present study was undertaken to determine whether or not untrained, non-obese college-aged females (n = 10) would exhibit a greater thermic response when exercise (E) (treadmill walking at 56% VO2max) preceded a meal (F) [3,846 kJ (920 kcal), 60% carbohydrate, 25% fat, and 15% protein] (EF) compared with exercise only (ENF) or a meal alone (NEF). A protocol in which neither exercise nor food (NENF) was present served as a baseline. Energy expenditure during 60 min of recovery increased 21.5% for the NEF condition, did not change in the ENF condition, and increased 20% in the EF condition over the corresponding resting metabolic rate. It was concluded that there was no interactive thermic effect from the exercise food sequence above the thermic effect of the meal alone. PMID- 1781671 TI - Influence of weight reduction on plasma high-density-lipoprotein cholesterol concentrations in severe obesity: interrelationships with plasma insulin levels. AB - The influence of caloric restriction and of weight loss during a weight maintaining diet on lipid profile and in particular on high density lipoprotein (HDL) is controversial. In this study we analyzed the effect of a period of very low caloric diet (VLCD) and of a period of hypocaloric diet followed by 30 days of weight stabilization on lipoprotein levels, especially on HDL cholesterol and its subfractions (HDL2 and HDL3) and on the summated means of glucose (sigma glucose) and insulin levels (sigma IRI) after an oral tolerance test in a group of obese females. Body weight decreased significantly during the VLCD and hypocaloric diet. Total cholesterol decreased significantly after the VLCD and hypocaloric diet, but after the period of the weight-maintaining diet it was superimposable to the initial value. Very low density lipoprotein (VLDL) and low density lipoprotein (LDL) cholesterol behaved like total cholesterol. HDL2, HDL3 and HDL cholesterol decreased significantly after the period of VLCD. Then, after the hypocaloric diet the values of HDL2, HDL3 and HDL cholesterol returned towards the initial values and only after the period of the weight-maintaining diet did their values increase significantly. sigma glucose did not vary significantly at any time of the study, while sigma IRI reduced significantly both after the hypocaloric diet and the weight-maintaining diet. HDL2 and HDL cholesterol changes were found to be positively correlated to the variations of sigma IRI both at day 45 and 75 of the study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781673 TI - Prediction of insecticidal activity of Bacillus thuringiensis strains by polymerase chain reaction product profiles. AB - A rapid analysis of Bacillus thuringiensis strains predictive of insecticidal activity was established by using polymerase chain reaction (PCR) technology. Primers specific to regions of high homology within genes encoding three major classes of B. thuringiensis crystal proteins were used to generate a PCR product profile characteristic of each insecticidal class. Predictions of insecticidal activity were made on the basis of the electrophoretic patterns of the PCR products. Included in the screen were PCR primers specific for cryI, cryIII, and cryIV genes, which are insecticidal for lepidopterans, coleopterans, and dipterans, respectively. Known B. thuringiensis strains as well as unidentified strains isolated from soil and insect cadavers were analyzed by PCR. Small amounts of crude sample lysates were assayed in a single PCR reaction containing 12 to 20 primers capable of distinguishing between the different insecticidal genes. Insecticidal activity predicted by the PCR screen was found to correspond with the insecticidal activity of insect bioassays. In addition to identifying strains with known insecticidal genes, the PCR screen can identify strains with altered electrophoretic patterns containing potentially novel genes. PMID- 1781674 TI - Isolation of a neuraminidase gene from Actinomyces viscosus T14V. AB - A genomic library of Actinomyces viscosus T14V DNA in lambda gt11 was screened for expression of neuraminidase activities. Four recombinant clones were detected that gave blue fluorescence upon incubation with a fluorogenic substrate, 2'-(4 methylumbelliferyl)-alpha-D-N-acetylneuraminic acid. Of these, two were identical, and all of the neuraminidase-positive clones shared a common 3.4-kbp DNA region. Expression of the enzyme activities in Escherichia coli carrying the cloned DNA was independent of the lacZ promoter of the vector. Maxicell analysis revealed that the 3.4-kbp DNA insert directed synthesis of a protein with an apparent molecular mass of 100,000 Da. The protein from cell extracts of E. coli clones migrated as a single band that stained for enzyme activity after electrophoresis in a nondissociating polyacrylamide gel. Moreover, human erythrocytes incubated previously with cell lysates from neuraminidase-positive E. coli were hemagglutinated by Actinomyces spp. The enzyme expressed by E. coli was active on substrates containing alpha-2,3 and alpha-2,6 ketosidic linked sialyl residues. Similar substrate specificities were obtained for both the extracellular and cell-associated neuraminidases from A. viscosus T14V. The 3.4 kbp insert hybridized to DNA fragments in a Southern blot containing A. viscosus T14V chromosomal DNA that had been digested with various restriction endonucleases. Data from hybridization studies show that A. viscosus T14V contains a single copy of the neuraminidase gene. PMID- 1781675 TI - Comparison of the adhesion properties of Deleya marina and the exopolysaccharide defective mutant strain DMR. AB - Deleya marina 219 (ATCC 25374) produces large quantities of an acidic exopolysaccharide and characteristically forms mucoid colonies and large aggregates of cells. The exopolysaccharide of wild-type D. marina cells appears to occur as both film and fibrils in electron micrographs. The organization of exopolymeric material was indicative of structural heterogeneity. A spontaneous rough-colony mutant defective in exopolysaccharide, D. marina DMR, has been isolated. The absence of exopolymer corresponds to a nonmucoid, nonaggregating, adhesion-altered phenotype. In microplate adhesion assays, wild-type cells grown at 19 or 25 degrees C attached to hydrophilic surfaces but not to a hydrophobic surface. In contrast, mutant cells exhibited a significantly reduced level of attachment to hydrophilic surfaces and increased adhesion to a hydrophobic surface. PMID- 1781676 TI - Biochemical and serological characterization of Carnobacterium spp. isolated from farmed and natural populations of striped bass and catfish. AB - A comparative analysis of the phenotypic and serological properties of Carnobacterium strains associated with mortalities of cultured striped bass and channel catfish and the properties of isolates from wild brown bullhead catfish in the Chesapeake Bay area in Maryland was conducted. All of the strains were gram-positive, facultatively anaerobic, nonmotile, non-spore-forming rods occurring singly or in short chains. They did not produce cytochrome oxidase or catalase, did not reduce nitrate, failed to produce H2S, were unable to grow on acetate medium, and did not produce gas from glucose or gluconate. The temperature and salinity ranges for most of the strains were 10 to 37 degrees C and 0 to 6% NaCl, respectively. The strains all fermented mannitol and inulin and were arginine dihydrolase positive; these are typical characteristics of Carnobacterium piscicola. The carbohydrate fermentation pattern exhibited by all of the isolates with the API-50 CHL system was also very similar to that shown by C. piscicola. Acid was produced from ribose, glucose, fructose, mannose, mannitol, N-acetylglucosamine, amygdaline, arbutin, esculin, salicin, cellobiose, maltose, sucrose, trehalose, and gentiobiose. The Carnobacterium strains did not show proteolytic, lipolytic, amylolytic, or hemolytic activity. Eighteen drugs were tested; all strains proved to be resistant to chloramphenicol, gentamicin, kanamycin, streptomycin, trimethoprim, quinolones, and nitrofurans. The analysis of membrane proteins supported the phenotypic similarities, two main patterns were established, one shared by the striped bass isolates and the reference strain of C. piscicola and another shared by most of the catfish strains. However, the agglutination assays demonstrated that only one Carnobacterium strain from striped bass was serologically related to C. piscicola ATCC 35586.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781677 TI - Isolation of a bacterium resembling Pirellula species from primary tissue culture of the giant tiger prawn (Penaeus monodon). AB - During attempts to establish tissue cultures from hepatopancreas, heart, and hemolymph of the giant tiger prawn (Penaeus monodon), using a medium including penicillin, streptomycin, and amphotericin B, bacterial contamination in the form of a sheet of growth attached to the tissue culture vessel was a persistent problem. Contaminant bacteria were teardrop-shaped cells arranged in rosettes, and electron microscopy revealed buds, crateriform structures, and the absence of a peptidoglycan layer in the cell wall, features characteristic of bacteria in the Planctomyces-Pirellula group, a phylogenetically distinct group of eubacteria. Two strains of contaminant bacteria were isolated in pure culture. Both exhibited morphology and antibiotic resistance consistent with their membership in the Planctomyces-Pirellula group (order Planctomycetales) of eubacteria. Tissue culture media for marine invertebrates may select for such bacteria if high concentrations of cell wall synthesis-inhibiting antibiotics are included. PMID- 1781678 TI - Mineralization of the sulfonated azo dye Mordant Yellow 3 by a 6-aminonaphthalene 2-sulfonate-degrading bacterial consortium. AB - Under anaerobic conditions the sulfonated azo dye Mordant Yellow 3 was reduced by the biomass of a bacterial consortium grown aerobically with 6-aminonaphthalene-2 sulfonic acid. Stoichiometric amounts of the aromatic amines 6-aminonaphthalene-2 sulfonate and 5-aminosalicylate were generated and excreted into the medium. After re-aeration of the culture, these amines were mineralized by different members of the bacterial culture. Thus, total degradation of a sulfonated azo dye was achieved by using an alternating anaerobic-aerobic treatment. The ability of the mixed bacterial culture to reduce the azo dye was correlated with the presence of strain BN6, which possessed the ability to oxidize various naphthalenesulfonic acids. It is suggested that strain BN6 has a transport system for naphthalenesulfonic acids which also catalyzes uptake of sulfonated azo dyes. These dyes are then gratuitously reduced in the cytoplasm by unspecific reductases. PMID- 1781679 TI - Biotransformation of nitrobenzene by bacteria containing toluene degradative pathways. AB - Nonpolar nitroaromatic compounds have been considered resistant to attack by oxygenases because of the electron withdrawing properties of the nitro group. We have investigated the ability of seven bacterial strains containing toluene degradative pathways to oxidize nitrobenzene. Cultures were induced with toluene vapor prior to incubation with nitrobenzene, and products were identified by high performance liquid chromatography and gas chromatography-mass spectrometry. Pseudomonas cepacia G4 and a strain of Pseudomonas harboring the TOL plasmid (pTN2) did not transform nitrobenzene. Cells of Pseudomonas putida F1 and Pseudomonas sp. strain JS150 converted nitrobenzene to 3-nitrocatechol. Transformation of nitrobenzene in the presence of 18O2 indicated that the reaction in JS150 involved the incorporation of both atoms of oxygen in the 3 nitrocatechol, which suggests a dioxygenase mechanism. P. putida 39/D, a mutant strain of P. putida F1, converted nitrobenzene to a compound tentatively identified as cis-1,2-dihydroxy-3-nitrocyclohexa-3,5-diene. This compound was rapidly converted to 3-nitrocatechol by cells of strain JS150. Cultures of Pseudomonas mendocina KR-1 converted nitrobenzene to a mixture of 3- and 4 nitrophenol (10 and 63%, respectively). Pseudomonas pickettii PKO1 converted nitrobenzene to 3- and 4-nitrocatechol via 3- and 4-nitrophenol. The nitrocatechols were slowly degraded to unidentified metabolites. Nitrobenzene did not serve as an inducer for the enzymes that catalyzed its oxidation. These results indicate that the nitrobenzene ring is subject to initial attack by both mono- and dioxygenase enzymes. PMID- 1781680 TI - Biochemical fingerprinting of water coliform bacteria, a new method for measuring phenotypic diversity and for comparing different bacterial populations. AB - A simple, automated microplate system for biochemical characterization of water isolates can be used to obtain fingerprints of the bacterial flora from various water samples. Mathematical models for calculating the diversities and similarities between bacterial populations are described for such fingerprints. The diversity may give information on whether an indigenous or allochthonous flora is present, and the similarities between bacterial populations, as calculated by using a population similarity coefficient (Sp), may indicate contaminations between different water samples. The system was demonstrated on coliform bacterial populations from various water samples, with or without suspected intercontamination. For unrelated water samples, the Sps were close to 0, whereas repeated samples of the same source showed Sps of 0.64 to 0.74. The Sp values from several water samples were also clustered to form a dendrogram, thus indicating the relative similarities between the bacterial populations to confirm suspected common sources of pollution. PMID- 1781681 TI - Role of hydrosulfide ions (HS-) in methylmercury resistance in Saccharomyces cerevisiae. AB - Methylmercury-resistant mutants were obtained from Saccharomyces cerevisiae. They were divided into two complementation groups, met2 (homoserine O acetyltransferase deficiency) and met15 (enzyme deficiency unknown), as reported previously. It was found that met15 was allelic to met17 (O-acetylserine and O acetylhomoserine sulfhydrylase deficiency). Methylmercury toxicity was counteracted by exogenously added HS-, and both met2 and met17 (met15) mutants overproduced H2S. On the basis of these results, we conclude that met2 and met17 (met15) cause accumulation of hydrosulfide ions in the cell and that the increased level of hydrosulfide is responsible for detoxification of methylmercury. PMID- 1781682 TI - Biodegradation of 2,4-dinitrotoluene by a Pseudomonas sp. AB - Previous studies of the biodegradation of nonpolar nitroaromatic compounds have suggested that microorganisms can reduce the nitro groups but cannot cleave the aromatic ring. We report here the initial steps in a pathway for complete biodegradation of 2,4-dinitrotoluene (DNT) by a Pseudomonas sp. isolated from a four-member consortium enriched with DNT. The Pseudomonas sp. degraded DNT as the sole source of carbon and energy under aerobic conditions with stoichiometric release of nitrite. During induction of the enzymes required for growth on DNT, 4 methyl-5-nitrocatechol (MNC) accumulated transiently in the culture fluid when cells grown on acetate were transferred to medium containing DNT as the sole carbon and energy source. Conversion of DNT to MNC in the presence of 18O2 revealed the simultaneous incorporation of two atoms of molecular oxygen, which demonstrated that the reaction was catalyzed by a dioxygenase. Fully induced cells degraded MNC rapidly with stoichiometric release of nitrite. The results indicate an initial dioxygenase attack at the 4,5 position of DNT with the concomitant release of nitrite. Subsequent reactions lead to complete biodegradation and removal of the second nitro group as nitrite. PMID- 1781683 TI - Analysis of Legionella pneumophila serogroup 6 strains isolated from a hospital warm water supply over a three-year period by using genomic long-range mapping techniques and monoclonal antibodies. AB - Over a period of 3 years, Legionella pneumophila serogroup 6 strains were isolated from warm water outlets and dental units in the Dental Faculty and from the Surgery and Internal Medicine Clinics at the University of Dresden, Dresden, Germany. In the bacteriological unit of the above-mentioned facility, L. pneumophila serogroups 3 and 12 were grown from warm water specimens. The medical facilities are located in separate buildings connected with a ring pipe warm water system. All L. pneumophila serogroup 6 strains isolated from the warm water supply reacted with a serogroup-specific monoclonal antibody, but not with two other monoclonal antibodies which are subgroup specific, reacting with other serogroup 6 strains. The NotI genomic profiles obtained by pulsed-field gel electrophoresis of 25 serogroup 6 strains isolated from the Dental Faculty over a 3-year period, 1 isolate from the Internal Medicine Clinic, and 4 strains from the Surgery Clinic were identical. Furthermore, all these strains hybridized with a 300-kb NotI fragment when a legiolysin (lly)-specific DNA probe was used. The NotI pattern, however, differed from those of six serogroup 6 strains of other origins, one serogroup 12 strain from the bacteriological unit, and another six unrelated strains of serogroups other than serogroup 6. L. pneumophila serogroup 6 strains which can be divided into only two subgroups by the use of monoclonal antibodies are differentiated in at least six NotI cleavage types obtained by pulsed-field electrophoresis. PMID- 1781684 TI - Determination of killer yeast activity in fermenting grape juice by using a marked Saccharomyces wine yeast strain. AB - The Escherichia coli beta-glucuronidase gene has been used as a marker gene to monitor a killer Saccharomyces cerevisiae strain in mixed-culture ferments. The marked killer strain was cured of its M-dsRNA genome to enable direct assessment of the efficiency of killer toxin under fermentation conditions. Killer activity was clearly evident in fermenting Rhine Riesling grape juice of pH 3.1 at 18 degrees C, but the extent of killing depended on the proportion of killer to sensitive cells at the time of inoculation. Killer activity was detected only when the ratio of killer to sensitive cells exceeded 1:2. At the highest ratio of killer to sensitive cells tested (2:1), complete elimination of sensitive cells was not achieved. PMID- 1781685 TI - Frankia genus-specific characterization by polymerase chain reaction. AB - The polymerase chain reaction (PCR) is an in vitro procedure for primer-directed enzymatic amplification of specific template nucleic acid sequences. In order to determine whether a given actinomycete isolated from an actinorhiza (nodule) belongs to the genus Frankia or is a contaminant, we have developed a test based on the PCR. Primers complementary to sequences of two DNA regions corresponding to the nif genes (nifH and nifD) and the rRNA genes (16S and 23S) were specifically chosen to differentially amplify DNAs from Frankia strains but not those from other microorganisms. A series of positive and negative controls were set up by using universal or selective primers resulting in a discriminant amplification, which could be detected after agarose gel electrophoresis. In the nif region, degenerate oligonucleotide primers were used to amplify a target common to all the nitrogen-fixing microorganisms tested, while another set of primers amplified a target with a high specificity for Frankia strains. In the rRNA gene region, universal and specific primers were characterized and tested with DNAs from a wide range of microorganisms. The efficiency of this rapid and sensitive PCR assay was tested with an isolate obtained from Alnus nepalensis nodules, confirming results obtained by nodulation tests. PMID- 1781686 TI - Heterotrophic plate counts of surface water samples by using impedance methods. AB - Membrane filtration, spread plating, and pour plating are conventional methods used to determine the heterotrophic plate counts of water samples. Impedance methods were investigated as an alternative to conventional methods, since sample dilution is not required and the bacterial count can be estimated within 24 h. Comparisons of impedance signals obtained with different water samples revealed that capacitance produced faster detection times than conductance. Moreover, the correlation between heterotrophic plate count and detection time was highest (r = 0.966) when capacitance was used. Linear and quadratic regressions of heterotrophic plate count and impedance detection time were affected by incubation temperatures. Regressions between heterotrophic plate counts based on conventional methods and detection times of water samples incubated at less than or equal to 25 degrees C had R2 values of 0.878 to 0.933. However, regressions using detection times of water samples incubated at greater than or equal to 30 degrees C had lower R2 values, even though water samples produced faster detection times. Comparisons between broth-based versions of R2A medium and plate count agar revealed that the latter correlated highly with heterotrophic plate count, provided that water samples were incubated at 25 degrees C and impedance measurements were conducted with the capacitance signal (r = 0.966). When the linear regression of this relationship was tested with 100 water samples, the correlation between predicted and actual log10 CFU milliliter-1 was 0.869. These results indicate that impedance methods provide a suitable alternative to conventional methods. PMID- 1781687 TI - Shuttle plasmid vectors for Lactobacillus casei and Escherichia coli with a minus origin. AB - Recombinant plasmids which can be used as shuttle vectors between Escherichia coli and the industrially used strains of Lactobacillus casei were constructed. They have replication regions closely related to those of pUB110 and are likely to replicate by a rolling-circle mechanism via a plus-strand-specific DNA intermediate in L. casei. Both orientations of palA from the staphylococcal plasmid pC194 and those of the intergenic region from coliphage M13 are identified as active minus origins in L. casei, in contrast to the pAM alpha 1 delta 1-derived BA3 minus origin which does not function in L. casei. Stability of the plasmids increased in L. casei when one of these two active minus origins was inserted. All the DNA sequences of the constructed vectors were known. PMID- 1781688 TI - Metabolism of phenanthrene by Phanerochaete chrysosporium. AB - The white rot fungus Phanerochaete chrysosporium metabolized phenanthrene when it was grown for 7 days at 37 degrees C in a medium containing malt extract, D glucose, D-maltose, yeast extract, and Tween 80. After cultures were grown with [9-14C]phenanthrene, radioactive metabolites were extracted from the medium with ethyl acetate, separated by high-performance liquid chromatography, and detected by liquid scintillation counting. Metabolites from cultures grown with unlabeled phenanthrene were identified as phenanthrene trans-9,10-dihydrodiol, phenanthrene trans-3,4-dihydrodiol, 9-phenanthrol, 3-phenanthrol, 4-phenanthrol, and the novel conjugate 9-phenanthryl beta-D-glucopyranoside. Identification of the compounds was based on their UV absorption, mass, and nuclear magnetic resonance spectra. Since lignin peroxidase was not detected in the culture medium, these results suggest the involvement of monooxygenase and epoxide hydrolase activity in the initial oxidation and hydration of phenanthrene by P. chrysosporium. PMID- 1781689 TI - Double-antibody sandwich enzyme-linked immunosorbent assay for quantitation of endoglucanase I of Trichoderma reesei. AB - A sensitive and specific enzyme-liked immunosorbent assay for endoglucanase I (EG I) has been developed. The monoclonal antibody a-EG-I 2, directed against an epitope on the core part of the enzyme, was used to capture the antigen in microtiter plate wells. A second, polyclonal antibody against the enzyme was then used to detect and quantitate the bound antigen. The test was specific for EG-I; neither endoglucanase II nor cellobiohydrolase I or II interfered. As little as 20 pg of EG-I protein could be detected. The coefficients of variation were 3.8% within plates and 6% between plates for a diluted Trichoderma reesei culture supernatant that contained 31 ng of EG-I per ml. Binding of the antigen to the monoclonal antibody was pH dependent and restricted to values between pH 6.5 and 10.5 with a maximum around pH 9. Standard solutions of EG-I were very stable at concentrations as low as 5 ng/ml when prepared in buffer that contained 1% bovine serum albumin and that was stored at -20 degrees C. After 37 weeks the antigenicity was still 97%. With this test it was possible to monitor the production of EG-I in a cellulase-producing strain of T. reesei and to demonstrate the apparent absence of the enzyme in a strain with the eglI gene deleted. PMID- 1781690 TI - Streptomyces marker plasmids for monitoring survival and spread of streptomycetes in soil. AB - Plasmid constructs pNW1 through pNW6 containing a controllable xylE gene (for catechol 2,3-dioxygenase) were introduced into Streptomyces lividans strains to provide a selectable marker system. xylE functions in S. lividans under the control of bacteriophage lambda promoters lambda pL and lambda pR. Thermoregulated expression of xylE is provided through the lambda repressor cI857. Catechol 2,3-dioxygenase activity was increased 2.8-fold from plasmid construct pNW2 (lambda pL, xylE, cI857) and 9.5- and 7.4-fold from constructs pNW3 (lambda pR, xylE, cI857) and pNW5 (lambda pR, xylE, cI857), respectively, when the temperature was shifted from 28 degrees C to 37 degrees C. The stability of the constructs varied from 4.7% for pNW2 to 99.4% for pNW4 (lambda pL, xylE) over two rounds of sporulation. Marked S. lividans strains released into soil systems retained the XylE phenotype for more than 80 days, depending on the marker plasmid, when examined by a selective plating method. Furthermore, S. lividans harboring plasmid pNW5 was detectable by nucleic acid hybridization at less than 10 CFU g-1 (dry weight) of soil as mycelium and 10(3) CFU g-1 (dry weight) of soil as spores with the xylE marker DNA extracted from soil and amplified by using the polymerase chain reaction. PMID- 1781691 TI - Two novel strains of Bacillus thuringiensis toxic to coleopterans. AB - Two novel strains of Bacillus thuringiensis were isolated from native habitats by the use of genes coding for proteins toxic to coleopterans (cryIII genes) as hybridization probes. Strain EG2838 (isolated by the use of the cryIIIA probe) contained a cryIIIA-hybridizing plasmid of approximately 100 MDa and synthesized crystal proteins of approximately 200 (doublet), 74, 70, 32, and 28 kDa. Strain EG4961 (isolated by the use of a cryIIIA-related probe) contained a cryIIIA hybridizing plasmid of approximately 95 MDa and synthesized crystal proteins of 74, 70, and 30 kDa. Structural relationships among the crystal proteins of strains EG2838 and EG4961 were detected; antibodies to the CryIIIA protein toxic to coleopterans reacted with the 74- and 70-kDa proteins of EG2838 and EG4961, antibodies to the 32-kDa plus 28-kDa proteins of EG2838 reacted with the 30-kDa protein of EG4961, and antibodies to the 200-kDa proteins of EG2838 reacted with the 28-kDa protein of EG2838. Experiments with B. thuringiensis flagella antibody reagents demonstrated that EG2838 belongs to H serotype 9 (reference strain B. thuringiensis subsp. tolworthi) and that EG4961 belongs to H serotype 18 (reference strain B. thuringiensis subsp. kumamotoensis). A mixture of spores plus crystal proteins of either EG2838 or EG4961 was toxic to the larvae of Colorado potato beetle (Leptinotarsa decemlineata), and significantly, the EG4961 mixture was also toxic to the larvae of southern corn rootworm (Diabrotica undecimpunctata howardi). DNA restriction blot analysis suggested that strains EG2838 and EG4961 each contained a unique gene coding for a protein toxic to coleopterans. PMID- 1781692 TI - Development of the BIOLOG substrate utilization system for identification of Legionella spp. AB - The genus Legionella consists of 51 serogroups comprising 34 species. Biochemical reactions and cell wall fatty acid and quinone analyses may confirm that an isolate is a Legionella sp. and indicate to which species it belongs, but DNA hybridization studies have been necessary for a definitive identification. Recently, the commercially available BIOLOG identification system has offered a standardized, easily reproducible system of substrate metabolism by bacteria resuspended in multiwell plates. A tetrazolium dye acts as an electron acceptor during the oxidation of the wide range of substrates and forms an irreversible, highly colored formazan when reduced. The 95 substrate wells are read rapidly with a conventional plate reader, and the results are downloaded for comparison with a computer data base, allowing quick identification. The BIOLOG system's ability to test more diverse classes of substrates, including amino acids, peptides, carboxylic acids, and carbohydrates, was used in this study to establish a new data base and identify the asaccharolytic Legionella spp. In particular, Legionella pneumophila behaved as a microaerophile, and the fastest, most diverse metabolic activities occurred after the development of a low-oxygen incubation environment. Alternatively, bacteria could be successfully incubated in air when their concentration was double that recommended by the manufacturer. Similar results were obtained by using either Page's amoebal saline or distilled water as the resuspending and incubation medium. Type strains did not cross identify with any of the strains already in the manufacturer's data base. The results indicate that this modified system has value in being able to identify Legionella isolates to the species level. PMID- 1781693 TI - Effect of the lactoperoxidase system on Listeria monocytogenes behavior in raw milk at refrigeration temperatures. AB - Activity of raw milk lactoperoxidase-thiocyanate-hydrogen peroxide (LP) system on four Listeria monocytogenes strains at refrigeration temperatures after addition of 0.25 mM sodium thiocyanate and 0.25 mM hydrogen peroxide was studied. The LP system exhibited a bactericidal activity against L. monocytogenes at 4 and 8 degrees C; the activity was dependent on temperature, length of incubation, and strain of L. monocytogenes tested. D values in activated-LP system milk for the four strains tested ranged from 4.1 to 11.2 days at 4 degrees C and from 4.4 to 9.7 days at 8 degrees C. The lactoperoxidase level in raw milk declined during a 7-day incubation, the decrease being more pronounced at 8 degrees C than at 4 degrees C and in control milk than in activated-LP system milk. The thiocyanate concentration decreased considerably in activated-LP system milk at both temperatures during the first 8 h of incubation. LP system activation was shown to be a feasible procedure for controlling development of L. monocytogenes in raw milk at refrigeration temperatures. PMID- 1781695 TI - Intracellular pH of acid-tolerant ruminal bacteria. AB - Acid-tolerant ruminal bacteria (Bacteroides ruminicola B1(4), Selenomonas ruminantium HD4, Streptococcus bovis JB1, Megasphaera elsdenii B159, and strain F) allowed their intracellular pH to decline as a function of extracellular pH and did not generate a large pH gradient across the cell membrane until the extracellular pH was low (less than 5.2). This decline in intracellular pH prevented an accumulation of volatile fatty acid anions inside the cells. PMID- 1781694 TI - Metabolism of and inhibition by chlorobenzoates in Pseudomonas putida P111. AB - Pseudomonas putida P111 was isolated by enrichment culture on 2,5 dichlorobenzoate and was also able to grow on 2-chloro-, 3-chloro-, 4-chloro-, 2,3-dichloro-, 2,4-dichloro-, and 2,3,5-trichlorobenzoates. However, 3,5 dichlorobenzoate completely inhibited growth of P111 on all ortho-substituted benzoates that were tested. When 3,5-dichlorobenzoate was added as a cosubstrate with either 3- or 4-chlorobenzoate, cell yields and chloride release were greater than those observed from growth on either monochlorobenzoate alone. Moreover, resting cells of P111 grown on 4-chlorobenzoate released chloride from 3,5 dichlorobenzoate and produced no identifiable intermediate. In contrast, resting cells grown on 2,5-dichlorobenzoate metabolized 3,5-dichlorobenzoate without release of chloride and accumulated a degradation product, which was identified as 1-carboxy-1,2-dihydroxy-3,5-dichlorocyclohexadiene on the basis of gas chromatography-mass spectrometry confirmation of its two acid-hydrolyzed products, 3,5- and 2,4-dichlorophenol. Since 3,5-dichlorocatechol was rapidly metabolized by cells grown on 2,5-dichlorobenzoate, it is apparent that 1-carboxy 1,2-dihydroxy-3,5-dichlorocyclohexadiene is not further metabolized by these cells. Moreover, induction of a functional dihyrodiol dehydrogenase would not be required for growth of P111 on other ortho-chlorobenzoates since the corresponding chlorodihydrodiols produced from a 1,2-dioxygenase attack would spontaneously decompose to the corresponding catechols. In contrast, growth on 3 chloro-, 4-chloro-, or 3,5-dichlorobenzoate requires a functional dihydrodiol dehydrogenase, yet only the two monochlorobenzoates appear to induce for it. PMID- 1781696 TI - Recovery of injured Campylobacter jejuni cells after animal passage. AB - Sixteen freeze-thaw-injured nonculturable stocks of Campylobacter jejuni were passed through rat gut, and seven were reisolated. These reisolated strains were converted to toxin producers, as they were before preservation, following consecutive passages through rat gut. This observation indicated the existence of an injured, viable, but nonresuscitated form of C. jejuni which can be resuscitated to a culturable and fully virulent form by passaging the organism through a susceptible host. PMID- 1781697 TI - Cellular fatty acid analysis as a potential tool for predicting mosquitocidal activity of Bacillus sphaericus strains. AB - Gas-liquid chromatography of fatty acid methyl esters and numerical analysis were carried out with 114 Bacillus sphaericus strains. Since only two clusters harbored mosquitocidal strains, this technique could be developed in screening programs to limit bioassays on mosquito larvae. It also allows differentiation of highly homologous strains. PMID- 1781698 TI - Bacterial nitrification in chloraminated water supplies. AB - Nitrifying bacteria were detected in 64% of samples collected from five chloraminated water supplies in South Australia and in 20.7% of samples that contained more than 5.0 mg of monochloramine per liter. Laboratory experiments confirmed that nitrifying bacteria are relatively resistant to the disinfectant. Increased numbers of the bacteria were associated with accelerated decays of monochloramine within distribution systems. The combination of increased concentrations of oxidized nitrogen with decreased total chlorine residuals can be used as a rapid indicator of bacterial nitrification. PMID- 1781699 TI - Defined substrate technology test for E. coli. PMID- 1781700 TI - [Comparative study of fungicidal and herbicidal activities of salts of polyenic macrolide antibiotics]. AB - The fungicidal and herbicidal activities of water soluble salts of levorin, nystatin, mycoheptin and amphotericin B, polyenic macrolide antibiotics, were studied. The biological tests showed that the antibiotics had fungicidal and low herbicidal activities. They also had a growth regulating action. PMID- 1781701 TI - [Effect of rifampicin and doxycycline on the chemiluminescence of leukocytes]. AB - The effect of rifampicin and doxycycline on spontaneous and zymosan-induced chemiluminescence of polymorphonuclear leukocytes was studied on guinea pigs. The cells were incubated in the presence of the antibiotics, washed and stimulated by zymosan. Under such conditions rifampicin in therapeutic doses of 0.1 to 10 micrograms/kg and doxycycline in a dose of 100 micrograms/kg potentiated the leukocyte chemiluminescence. Investigation of the antibiotics effect on the cells without washing failed because of the direct interference of rifampicin and doxycycline with the cell-independent stage of the chemiluminescent reaction. PMID- 1781702 TI - [Microcalorimetric study of the kinetics of the antibacterial effect of third generation cephalosporins in an in vitro dynamic system]. AB - The antimicrobial effect (AME) kinetics of cefotaxime and ceftizoxime was studied with respect to 4 bacterial strains (E. coli, S. aureus, K. pneumoniae and P. aeruginosa) in an in vitro dynamic model. The mean integral concentrations, i.e. the AUC values divided by the dosing interval observed in blood of humans after the drug single intravenous administration in doses of 0.25, 0.5, 1 2 and 4 g. were simulated. The simulated concentrations of cefotaxime and ceftizoxime were 6.25 and 6.75, 12.5 and 13.5, 25 and 27, 50 and 54 and 100 and 108 mg/kg, respectively accounting for the differences in their pharmacokinetics. The changes in the microbial count were recorded microcalorimetrically by the rate of heat output with the BioActivity Monitor LKB 2277-202. The AME was expressed by TE reflecting the shift of the microbial growth curve in the presence of the cephalosporins against the control growth curve (in the absence of the drugs). It was noted that in simulating the concentrations observed after the drugs administration in various doses cefotaxime was mainly superior to ceftizoxime in terms of the TE, the value of the TE correlating with the respective values of the MICs. Some discrepancies between the TE and MICs were explained by the complicated shape of the TE vs. concentration or AUC curve observed earlier in regard to cefotaxime as well as by the differences in the steady state and dynamic conditions of the experiment. PMID- 1781703 TI - [Pharmacokinetics of an antibiotic administered in cell carriers]. AB - Tissue distribution of erythrocyte membrane-bound gentamicin was studied in non inbred albino rats. Gentamicin was administered to the animals intravenously in single doses of 3.3 mg/kg as a free substance of the antibiotic or in carrier erythrocytes. The gentamicin concentration was determined in serum, blood and tissues of the liver, kidneys, lungs, spleen and the skeletal muscles by fluorescence polarization immunoassay (TDx, Abbott). Encapsulation of gentamicin in erythrocytes caused changes in its pharmacokinetics: the antibiotic half-life and mean retention time appeared to be higher and the antibiotic accumulation in the liver, spleen and kidneys increased 1.7-3.0, 19-27 and 1.5 times respectively depending on the technique of the carrier erythrocytes preparation. Exposure of the erythrocytes to tannin led to an increase in the rate of the antibiotic release from the carrier erythrocytes. PMID- 1781704 TI - [Effectiveness of dioxidine in a model of Staphylococcal necrotic-suppurative encephalomeningitis (according to electron microscopy data]. AB - Dioxidine efficacy was studied on a model of staphylococcal necrotic suppurative encephalomeningitis. There was a relationship of the development of disease signs to the value of the contaminating dose. Dioxidine was shown to have a therapeutic effect. Purulent inflammation in the brain either undevelop or was more limited. Examination of the changes in the ultrastructure of the nervous tissue also confirmed the efficacy of dioxidine. The treated mice had single inflammation infiltrations in the presence of the intact structure of the nervous tissue, the cell composition of the infiltrations changing in the direction of predominance of the mononuclear phagocytes. The phagocytes were in the state of hyperactivity and phagocytosis was of the completed nature. Secondary phagocytosis of the phagocytes and cell detritus was recorded. PMID- 1781706 TI - [Immunogenic properties of neomycin conjugates with macromolecular carriers]. AB - To obtain diagnostic antibodies to neomycin, immunogenic properties of the neomycin conjugates with macromolecular carriers were studied. Bovine serum albumin and copolymers of N-vinylpyrrolidone with crotonic acid and N hydroxyphthalimide ether of crotonic acid were used as carriers. It was shown that immunization of mice by the conjugates in combination with Freund's adjuvant resulted in production of neomycin antibodies, the titer being 1/80 to 1/130. When the antibiotic conjugates with the copolymers of N-vinylpyrrolidone were used and not the neomycin conjugates with the carrier of the protein nature, the neomycin antibodies were produced in the absence of Freund's full adjuvant. With the use of the isolated antibodies to neomycin a method for indirect solid phase enzyme immunoassay of neomycin was developed at the minimum detectable level of 25 ng/ml. PMID- 1781705 TI - [Treatment of endophthalmitis with a single intravitreous administration of cefotaxime and gentamicin in an experiment]. AB - Experimental endophthalmitis was treated with single intravitreous administrations of cefotaxime (claforan) and gentamicin. It was found that a single administration of cefotaxime to the vitreous body prevented development of endophthalmitis in rabbits previously infected with Staphylococcus aureus, E. coli and Pseudomonas aeruginosa. Vitrectomy in the treatment of endophthalmitis was shown to be promising and provide satisfactory anatomical and functional results. PMID- 1781707 TI - [Comparative levels of amphotericin B in the skin and subcutaneous fatty tissue after cutaneous application of amphotericin ointment by phonophoresis and with preliminary treatment by dimethyl sulfoxide]. AB - A comparative study of the amphotericin B contents in the skin and subcutaneous fatty tissue was performed on guinea pigs after local application of amphotericin ointment by phonophoresis and with preliminary treatment of the skin by dimethyl sulfoxide (DMSO). When the amphotericin ointment was used in combination with ultrasound the content of amphotericin B in the skin and subcutaneous fatty tissue 1, 3, 24, 48 and 72 hours after the application was much higher than that after the ointment local application without the ultrasonic treatment. When the amphotericin ointment was applied locally after the preliminary treatment with DMSO the maximum content of the antibiotic in the skin and subcutaneous fatty tissue was observed 3 hours after the application which was significantly higher than the content observed after the ointment application by phonophoresis and especially locally without the ultrasonic treatment. In 24, 48 and 72 hours the amphotericin B concentration in the skin and subcutaneous fatty tissue under any conditions lowered and in 24 hours had a tendency to level in the areas treated with ultrasound and DMSO. In 48 and 72 hours the highest concentrations of the antibiotic were in the skin and subcutaneous fatty tissue after the ointment application by phonophoresis. PMID- 1781709 TI - [Sensitivity of Pseudomonas mallei to fluoroquinolones and their efficacy in experimental glanders]. AB - Thirteen strains of P. mallei were found to be highly sensitive to ciprofloxacin and ofloxacin and resistant to norfloxacin. Ciprofloxacin and ofloxacin showed a high efficacy on models of malleus in guinea pigs and hamsters. The animals were infected with various strains of P. mallei. In the in vitro experiments, ciprofloxacin proved to be the most active and efficient. Norfloxacin appeared to be inefficient. PMID- 1781708 TI - [Study of the processes of butyl acetate regeneration from butanol-butyl acetate solutions by etherification of butanol with acetic anhydride (for use in production of penicillins]. AB - Etherification of butanol by acetic anhydride in butanol-butyl acetate mixtures containing 0.09 to 3 per cent water was investigated. A method for processing the butanol-butyl acetate mixtures with the weight part of butanol up to 16 per cent by etherification of the latter with acetic anhydride was developed, the yield being 96 to 97 per cent and the weight part being at least 97.5 per cent. On the basis of the estimate of the raw material use for regeneration of butyl acetate from the butanol-butyl acetate solutions by etherification of butanol with acetic anhydride, the technical and economic advantages of the processing of such solutions by the described method were shown. PMID- 1781710 TI - [A liposomal form of diamidine: reduced toxicity]. AB - The cultures of Nuttalia eque mainly develop in the reticuloendothelial organs and so in treatment of nuttaliosis in horses and the Nuttalia carriers diamidine, an analog of imidocarb or imidozoline, was used encapsulated in liposomes. The liposomes were prepared with a modification of the phase inversion method (the lipids were dissolved in a mixture of freon-11 and chloroform). The content of the organic solvents in the preparation, as evidenced by gas liquid chromatography, was less than 0.2 per cent. The main fraction consisted of particles 1.5 to 2.5 microns in diameter. The tests on animals of various species revealed a significant decrease in the toxicity of diamidine when used encapsulated in liposomes as compared to the use of the free diamidine. The LD50 of the liposome encapsulated diamidine administered intravenously and intramuscularly was for albino mice 52 and 6000 mg/kg, respectively whereas that of the free diamidine was 0.8 and 84 mg/kg, respectively. In a dose of 10 mg/kg administered intramuscularly the free diamidine induced death in 100 per cent of the horses while in a dose of 10 mg/kg the liposome encapsulated diamidine was satisfactorily tolerated by the animals. The liposome encapsulated diamidine had no unfavourable effect on hepatic antitoxic and metabolic functions. One should hope that the low toxicity of the liposome-encapsulated diamidine will provide its higher chemotherapeutic index. PMID- 1781711 TI - [Chemotherapy of newborns with intestinal infections caused by opportunistic gram negative aerobic bacteria]. AB - A clinical bacteriological examination was applied to 100 newborns with intestinal infections caused by opportunistic gram-negative aerobes. There was a correlation between the decrease in the quantity of the bifidobacteria and the predominance of various species of opportunistic gram-negative aerobes and their associations, as well as high sensitivity of clinical isolates of the opportunistic bacteria to phosphocin, gentamicin, polymyxin and specific bacteriophages. The study showed that the combined use of antibiotics with the biopreparations (the specific bacteriophages and bifidumbacterin) was effective in treating the newborns with the above mentioned infections. PMID- 1781712 TI - [Chemotherapy of Pseudomonas aeruginosa infections in children during the first three months of life]. AB - The data on the efficacy of antibacterial drugs and their combinations in treatment of 150 three-month old infants with generalized infection due to Pseudomonas aeruginosa are presented. The clinical isolates of P. aeruginosa were found to be carriers of multiple drug resistance which markedly complicated the chemotherapy. Only combined antibacterial therapy of such infants proved to be rational. High activity of aminoglycosides, azlocillin and cefotaxime against P. aeruginosa and the synergistic action of their combinations observed in the patients permitted to recommend the use of combinations of the above drugs in the empirical chemotherapy. PMID- 1781713 TI - [Ways of increasing the efficacy of antibiotic therapy in young children with severe forms of acute pneumonia]. AB - Examination of 136 children with the severe form of acute pneumonia treated in a resuscitation unit revealed a marked suppression of the immunity and lowered antibiotic sensitivity of the bacterial microflora isolated from the respiratory tracts. The patients were previously treated with antibiotics of 2 to 5 families. Auto-blood irradiated with X-rays without the host was transfused to 72 children (group 1) with immunomodulating purposes. 64 children (group 2) were treated with the same purposes with eleuterococcus, pentoxyl and methyluracil. After transfusion of the auto-blood irradiated with x-rays without the host there was an increase in the antibiotic sensitivity of the bacterial flora along with a marked and rapid improvement of the immunity status. The severe state was alleviated earlier in the patients of group 1. The inflammatory lesions in the lungs of the group 1 patients were arrested sooner and the patients were discharged from the hospital 11 days earlier than the children treated with the routine immunomodulators. PMID- 1781714 TI - [Ciprofloxacin in the prevention and treatment of surgical infections]. AB - A clinico-laboratory study on ciprofloxacin made by Bayer (Germany) was applied to patients with extended posttraumatic wounds and performed with the aim of preventing postoperative purulent complications in patients operated on the organs of the gastrointestinal tract. In the both groups ciprofloxacin was administered orally in doses of 500 and 1000 mg and intravenously in a dose of 200 mg. The results of the assay on ciprofloxacin sensitivity of the isolates from the wound excretion and urine showed that they were more sensitive to ciprofloxacin than to aminoglycosides and cephalosporins. 15 minutes after the intravenous administration the serum concentration of ciprofloxacin amounted to 7.5 +/- 0.9 micrograms/ml and in 6 hours it was equal to 0.45 +/- 0.45 micrograms/ml, the mean concentrations of ciprofloxacin being attained in the bile (8.7 +/- +/- 3.9 micrograms/ml), gallbladder wall (5.5 +/- 3.8 micrograms/g), liver (0.73 micrograms/g), muscles (1.93 micrograms/g) and tendon (0.15 microgram/g). After the oral administration in a dose of 500 mg ciprofloxacin was detected in the blood serum in an amount of 2.0 +/- 0.7 micrograms/ml in 1 hour and in an amount of 0.9 +/- 0.13 micrograms/ml in 6 hours. After the drug oral administration in a dose of 1000 mg the maximum concentrations were: 6.34 +/- 4.2 micrograms/ml on the average and 2.1 +/- 0.8 micrograms/ml in 6 hours (0.4 micrograms/g in the muscles, 1.4 micrograms/g in the skin and 0.34 micrograms/g in the bones). The study showed that ciprofloxacin was a highly efficient antimicrobial agent in the treatment of the complicated wound infections and the prophylaxis of the purulent complications during the postoperative period in the patients operated on gastrointestinal organs. PMID- 1781715 TI - [Antimicrobial properties of fibrous cellulose and other polymeric materials modified with chlorhexidine]. AB - Since fibrous cellulose and other polymeric materials are widely used as dressings, it was of interest to study the mechanism of the antimicrobial action of the products from such materials physically and chemically modified by chlorhexidine, a broad spectrum antiseptic. As vehicles and prolongation agents the following products were used: dressing gauze and cation exchange derivatives of cellulose and starch i.e. monocarboxycellulose (MCC), phosphate cellulose (PC), carboxymethyl cellulose (CMC), monocarboxyl starch (MCS) and alginic acid (AA), a natural compound. It was shown that chemical attachment of chlorhexidine provided a 2-4-fold increase in the antimicrobial effect of the preparations as compared to the use of physical sorption. The antimicrobial effect of the polymeric form of chlorhexidine based on MCC and PC was much higher than that based on MCC, MCS and AA. PMID- 1781716 TI - [Aeromonads, their biological properties, antibiotic sensitivity, role in infection development]. PMID- 1781717 TI - [Symposium: "Ciprofloxacin in clinical practice. New data on the use of the drug"]. PMID- 1781718 TI - [Drug resistance of opportunistic enterobacteria isolated from various sources]. AB - Resistance of 159 strains of opportunistic enterobacteria to 9 antibacterial drugs was studied. The strains were isolated from man and cattle. It was shown that the overwhelming majority of the isolates (93 per cent) were polyresistant irrespective of the genus. There was a high frequency of the strains resistant to the widely used antibiotics such as chloramphenicol (73 per cent), ampicillin (73.6 per cent) and rifampicin (95.6 per cent) and sulfanilamides (99.3 per cent). Gentamicin and nalidixic acid proved to be the most active against the cultures: 11.9 and 10 per cent of the resistant strains, respectively. The strains of enterobacteria isolated from different sources had a sensitivity to the antibiotics. Multiple antibiotic resistance to at least 5 drugs, variability of the spectra and high resistance were more characteristic of the isolates from the animals. The necessity of a rational use of antibacterial drugs in veterinary is indicated. PMID- 1781719 TI - [Resistance of hospital Staphylococci to beta-lactam antibiotics]. AB - Resistance of hospital Staphylococci to beta-lactam antibiotics was studied. The strains were isolated in two obstetric hospitals during an outbreak of purulent inflammatory infections in them. A modification of the "clover leaf" procedure providing elucidation of the resistance mechanism was used in the study. Development of the resistance to the beta-lactam antibiotics was shown to be mainly due the activity of beta-lactamases which makes it possible to discuss their role in the mechanism of resistance development. PMID- 1781720 TI - On a particular method of isolation of the human placenta trophoblastic cells. AB - With the purpose of demonstrating the presence of different types of cells in the syncytial and cytotrophoblast of the human placenta, a new technique of cell isolation was performed by utilizing a light enzymatic digestion and a separation on density gradients. Normal human placentas of the first trimester of pregnancy have been studied. After an accurate and light washing in saline and anticoagulant substances, whole villi have been incubated in a trypsin solution for various periods of time at 40 degrees C in a thermostatic stirrer. Detached cells have been collected, rinsed and separated by means of different density gradients of Percoll (d = 1.038 and 1.080). Three cellular layers have been collected and processed for the studies at light and electron microscopy. The first layer was mostly composed by multinucleated elements with a morphological pattern closely related to the histological characteristics of the syncytiotrophoblast; the second fraction was composed by mononucleated elements with the structural findings of the Langhans' cells; the third layer was represented almost exclusively by blood cells. The obtained results demonstrated the high utility and accuracy of the suggested method of cell isolation. PMID- 1781721 TI - [The synaptic ribbons in the retina of the turtle (Pseudemys scripta elegans): ultrastructural and chronobiological study]. AB - The Authors investigate the morphology and the behaviour of the synaptic ribbons (NS) in the outer plexiform layer of the retina of the turtle Pseudemys scripta elegans during the 24 hrs cycle; the animals were subjected to a light-dark cycle = 12:12 hours. New ultrastructural features are demonstrated in the rod arciform density and in the fibers connecting the central axis of the ribbon with the presynaptic membrane (Figs. 1 A-B). As to chronobiological data, the existence of different kinds of ribbons, each typical of a single period of the 24 hrs cycle is excluded: identical NS can likewise be observed at different hours of the day and under various environmental light stimulations (Figs. 2-3-4). Furthermore, it is also demonstrated that during the light period, every rod synapse in the outer plexiform layer has a typical ultrastructural topography of its own (Figs. 5 A-B C). During the dark period, the ribbon with its neighbouring vesicles moves towards the nucleus, thus leaving the synaptic region (Figs. 6 A-B-C). From the analysis of our results, we are of the opinion that all previously demonstrated changes in number are only in part dependent on cyclic disruption and reconstruction. On the contrary, they can be the result of a different topographical arrangement of the organelles. When NS modify their relationship with the presynaptic membrane of the rods, they may behave as switch on the nervous circuits of the retina and play a facilitatory or inhibitory role on the discharge of synaptic vesicles during the different periods of the 24 hrs cycle. PMID- 1781722 TI - [3-dimensional characterization of the synoviocytes of the human synovial intima]. AB - The intimal synovial surface in normal conditions, using a scanning electron microscope, has been studied. The three synovial membrane types are clearly recognizable: fibrous (Fig. 8), adipose (Figs. 9 and 10) and areolar (Figs. 1 and 2); but only in the areolar type, the characterization of the main two cellular types: synoviocytes B and A, is possible. Synoviocyte B represents the constitutive element which characterizes the synovial intima; it has a cellular body of irregular shape and long cytoplasmic processes directed towards the joint cavity (Figs. 3, 4 and 5). The cellular body and the cytoplasmic processes are covered by small blebs (Fig. 6). and similar vesicles, probably of the same cellular origin, are scattered throughout the extracellular matrix. These cells are likely responsible for the specific structure of the interstitial tissue adapted to the exchanges and to the regulation of the composition of the synovial fluid (Okada et. al. 1981; Linck and Porte, 1978, 1981). Synoviocyte A is a small minority; it has many long and irregular membrane infoldings which define a complicated system of intracellular canaliculi of various depth (Fig. 7). The ultrastructural characteristics of their surface and the peculiarity of their organelle apparatus, described by other AA. (Fell et. al., 1976), demonstrate that these elements carry out a macrophagic function. The clear majority of the synoviocytes B in the intimal surface suggests that in normal conditions, the synthesizing processes prevail over the phagocytosis ones. PMID- 1781723 TI - [Update on the presence of taste buds on the laryngeal surface of the epiglottis]. AB - Previous investigations have ascertained, according to the results obtained by Bradley et al. (1980) in the sheep, that the laryngeal surface of the epiglottis of goat and bovine is always provided with numerous taste buds. These observations have verified in other ruminant species, as the moufflon and the buffalo, the validity of the above-named datum and have ascertained that it is always inconstant in the other animal species considered (wild boar, coypu). These taste buds show a typical structure (diameter of the outer taste pore varying from 2.7 to 4.2 micron, width of the chemoreceptors varying from 30 to 60 micron and length from 27.5 to 57.5 micron). Moreover, the normal structure of the above-named taste buds is also testified by the arrangement of their innervation and particularly by the integrity of the synaptic contacts. The results of the present research have permitted a critical and more severe examination of the probable functional role of those laryngeal receptors. In fact, in the ruminants they may protect the deep airways precluding to food particles the larynx in the phase of food regurgitation. PMID- 1781724 TI - [Scanning electron microscopy study of the meniscus of the knee in patients with anterior cruciate ligament lesions]. AB - In the aim of bringing a contribution to role of the knee menisci and the functional connection between meniscal lesions and knee joint instability, four patients have been studied, who underwent arthroscopy for sub-acute tear of anterior cruciate ligament without clinical or morphological evidence of meniscal pathology. In these patients biopsies have been taken from one of the menisci and processed for the examination by the SEM. As control, meniscal fragments from two healthy knees have been studied from patients who underwent amputation at thigh for accidental trauma with irreparable lesion of femoral artery. In patients affected by ligamentous tear, on the meniscal surface a lot of deposited material appears, as well as many microlesions as clefts or cracking and distortion of superficial collagenous fibers. All described alteration are more evident in the central portion of menisci than in the anterior or posterior horns. The above mentioned patterns suggest a strong correlation of the knee instability due to ligamentous lesions and meniscal degenerative process which would onset before its clinical or macroscopical evidence. PMID- 1781725 TI - Enzymes of pyrimidine metabolism in the musculus complexus of the chick during development. AB - The pattern of cytidylate and uridylate phosphatase, uridine phosphorylase, cytidine and cytosine deaminase activities has been studied in M. complexus during chick development. The comparison of these enzyme activities with thigh muscles ones has shown that quantitative and temporal changes occur, in parallel with the unusual pre-natal and early post-natal development of M. complexus. The results suggest that during the first period of incubation, UMP might follow the anabolic pathway UMP-UTP, which leads to cytidine nucleotides, while approaching the hatching, the catabolic pathway should prevail. In addition, immediately after hatching, pyrimidine metabolism is especially supported by cytidine nucleotides. PMID- 1781726 TI - [Neuron-specific enolase in ophthalmology]. AB - Tissue location and biochemical aspects of the enolase, enzyme belonging to the glycolytic pathway, are presented. Embryological applications of the dimer gamma gamma (Neuronal Specific Enolase) as a biological marker of the neuroectodermal derivatives is discussed. The authors stress the clinical importance of the NSE in the early detection of tumors. PMID- 1781727 TI - An electron microscopy study of wall expansion during Candida albicans yeast and mycelial growth using concanavalin A-ferritin labelling of mannoproteins. AB - Depending upon growth temperature, Candida albicans can exhibit two different morphologies, a budding yeast or a mycelium. By studying the distribution of concanavalin A-ferritin particles on the cell wall surface during bud and germ tube formation, we have elucidated the way cell wall extension occurs. Both processes initially require the localized lysis of the wall in order to allow the incorporation of the newly synthesized material. Later on, the cell wall behaves as an elastic structure, allowing extension by an intussusception process and, as a consequence, cell growth. PMID- 1781729 TI - Anaerobic degradation of toluene in denitrifying Pseudomonas sp.: indication for toluene methylhydroxylation and benzoyl-CoA as central aromatic intermediate. AB - The anaerobic degradation of toluene has been studied with whole cells and by measuring enzyme activities. Cultures of Pseudomonas strain K 172 were grown in mineral medium up to a cell density of 0.5 g of dry cells per liter in fed-batch culture with toluene and nitrate as the sole carbon and energy sources. A molar growth yield of 57 g of cell dry matter formed per mol toluene totally consumed was determined. The mean generation time was 24 h. The redox balance between toluene consumed (oxidation and cell material synthesis) and nitrate consumed (reduction to nitrogen gas and assimilation as NH3) was 77% of expectation if toluene was completely oxidized; this indicated that the major amount of toluene was mineralized to CO2. It was tested whether the initial reaction in anaerobic toluene degradation was a carboxylation or a dehydrogenation (anaerobic hydroxylation); the hypothetical carboxylated or hydroxylated intermediates were tested with whole cells applying the method of simultaneous adaptation; cells pregrown on toluene degraded benzyl alcohol, benzaldehyde, and benzoic acid without lag, 4-hydroxybenzoate and p-cresol with a 90 min lag phase, and phenylacetate after a 200 min lag phase. The cells were not at all adapted to degrade 2-methylbenzoate, 4-methylbenzoate, o-cresol, and m-cresol, nor did these compounds support growth within a few days after inoculation with cells grown on toluene. In extracts of cells anaerobically grown on toluene, benzyl alcohol dehydrogenase, benzaldehyde dehydrogenase, and benzoyl-CoA synthetase (AMP forming) activities were present. The data (1) conclusively show anaerobic growth of a pure culture on toluene; (2) suggest that toluene is anaerobically degraded via benzoyl-CoA; (3) imply that water functions as the source of the hydroxyl group in a toluene methylhydroxylase reaction. PMID- 1781730 TI - Imidazolidin-2-one prostaglandin analogues. AB - The 5-desoxy analogue of BW245C, imidazolidin-2-one 3, has been synthesized by reduction of the N-benzyl hydantoin derivative 6. Compound 3 was found to be approximately equipotent with BW245C as an inhibitor of platelet aggregation and this result indicates that the 5-keto group of BW245C is not essential for platelet inhibitory activity. PMID- 1781728 TI - Cloning and nucleotide sequence of the structural genes encoding the formate dehydrogenase of Wolinella succinogenes. AB - The formate dehydrogenase of Wolinella succinogenes is a membraneous molybdo enzyme which is involved in phosphorylative electron transport. The gene (fdhA) encoding the largest subunit was isolated from a gene bank by immunological screening. The fdhA gene was located in an apparent transcriptional unit (fdhA,B,C,D) together with three more structural genes. The N-terminal sequences of three polypeptides present in the isolated enzyme were found to map within the fdhA, B and C structural genes. A polypeptide corresponding to fdhD was not detected in the enzyme preparation. This suggested that the functional formate dehydrogenase was made up of three or four different subunits. The genes fdhA and C encode larger preproteins which differ from the corresponding mature proteins by N-terminal signal peptides. The N-terminal half of the mature FdhA is homologous to the larger subunits of the formate dehydrogenases of E. coli (formate-hydrogenlyase linked) and Methanobacterium formicicum as well as to three bacterial reductases containing molybdenum. It harbours a conserved cysteine cluster and two more domains which may be involved in binding the molybdenum cofactor. FdhB may represent an iron-sulphur protein, twelve cysteine residues of which are arranged in two clusters which are typical of ligands of the iron-sulfur centers in ferredoxins. FdhC is a hydrophobic protein with four predicted transmembrane segments, which appears to be identical with the cytochrome b present in the isolated formate dehydrogenase. It may form the membrane anchor of the enzyme and react with the bacterial menaquinone. PMID- 1781731 TI - Synthesis of 5'-N-(alpha-amino-beta-mercaptoacyl)amino-5'-deoxynucleosides as potential antiviral compounds. AB - 5'-N-(alpha-Amino-beta-mercaptoacyl)amino-5'-deoxynucleosides have been synthesized by coupling of N-formylthiazolidines derived from D- and L penicillamine, and D- and L-cysteine to 5'-amino-5'-deoxynucleosides using the DCC/HOSu method, followed by deprotection in N HCl in MeOH under argon. Although these compounds were designed as potential anti-HIV-1 agents, none of them showed anti-HIV-1 activity in MT-4 cells or antiviral effect against some other viruses, at concentrations below the cytotoxicity threshold. PMID- 1781732 TI - [The pharmacokinetics of antilipemic agents. 8. Unequivocal characterization of ciprofibrate-O-beta-d-glucuronide]. AB - After an oral single dose Ciprofibrate (1) is eliminated mainly (greater than 90%) as its glucuronide renally and to a small amount on the biliary route. This conjugate could be extracted out of the urine of volunteers. By methylation of the carboxy group and acetylation of the three hydroxy groups of the glucuronic acid the hydrophobic methyl-(2,3,4-tri-O-acetyl-beta-D-glucopyrano)-uronate was formed. This derivative could be identified unequivocally by HPLC using the reference substance which can be obtained easily. Due to the chirality of 1 its glucuronide and the corresponding hydrophobe derivative (melting range 67-78 degrees C) are a mixture of diastereomeres. The latter could be separated analytically into the diastereomeres using a cyclobond I-column. PMID- 1781733 TI - Methoxy- and acetoxy-8-oxoberbines--synthesis, antitumor activity, and interaction with DNA. AB - Most of the methoxy-8H-dibenzo[a,g]isoquinolin-8-ones 3a-h and their acetoxy derivatives 6a-e were synthesized by condensation of 1-oxo-1,2,3,4 tetrahydroisoquinolines 4a-c and homophthalic acid anhydrides 5a and b, ether cleavage and acetylation. These protoberberinones were tested for cytostatic activity in vitro using MDA-MB-231 mammary tumor cells and for interaction with native calf thymus DNA. Tetramethoxy-8-oxoberbine 3f shows an inhibition of cell proliferation of 87% at a concentration of 10(-5) mole; its cytostatic effect does not depend on intercalation into DNA. PMID- 1781734 TI - Arsenic: opportunity for risk assessment. AB - Arsenic is a human carcinogen that in small amounts is widely distributed in food and water. It has been regulated for almost 100 years worldwide and in the United States, on the judgment of the Royal Commission on Arsenic that a classical threshold of toxicity exists and that a daily intake of 400 micrograms/day is safe. Modern regulatory thinking in the United States has not accepted safe levels for carcinogens and is thus in conflict with the arsenic standard. Recent epidemics of arsenicism have quantitatively confirmed that threshold not only for the non-cancerous arsenical skin lesions but also for arsenical skin and internal cancers. Research shows that arsenic is a general gene inducer. Genes induced are involved in proliferation, recombination, amplification and the activation of viruses. This characterizes arsenic as an indirect carcinogen and provides a molecular basis for risk assessment and the observed threshold dose response. In the United States at present, about 300 cases of occupational arsenical cancer, declining in numbers, are known. Background arsenic below the drinking water standard is not known to have produced disease. The conspicuous nature of arsenical skin disease presents an unusual opportunity for a simplified survey of arsenical skin disease to support regulatory standards for arsenic. PMID- 1781735 TI - Nephrotoxicity of sodium dichromate depending on the route of administration. AB - A comparison of the effects of intraperitoneal and subcutaneous routes of administration of sodium dichromate on nephrotoxicity in rats was studied. Dichromate when injected subcutaneously (SC group) produced a higher degree of nephrotoxicity than when administered intraperitoneally (IP group). It caused severe progressive proteinuria followed by polyuria and glucosuria, reaching maximum levels at 3 days after treatment in the SC group, whereas it produced mild proteinuria without glucosuria in the IP group. The dose-dependent increases in blood urea nitrogen (BUN) and creatinine concentrations, shown in the SC group, were not observed in the IP group. However, between the two groups, there were no great differences in either the urinary excretion rate of chromium or the electrophoretic patterns of urinary protein in the day 1 urine specimens. Pretreatment of phenobarbital (PB) had no remarkable effect on the dichromate induced nephrotoxicity. In contrast, it potentiated dichromate-induced hepatotoxicity, the indices of which were the elevation in serum alanine aminotransferase (ALT) activity and hepatic lipid peroxide formation. These results suggest that the dependence of dichromate-induced nephrotoxicity on the route of administration is related to the chemical forms of chromium reaching the kidney, and the necrotizing property of dichromate results from its metabolic fate in vivo. PMID- 1781736 TI - Immunochemical detection of cytochrome P450 isozymes induced in rat liver by n hexane, 2-hexanone and acetonyl acetone. AB - Cytochrome P450 isozymes induced in rat liver by treatment with n-hexane, 2 hexanone and acetonyl acetone (given intraperitoneally 5 mmol/kg for 4 days) were investigated using enzyme assays (benzene, toluene, 7-ethoxyresorufin and 7 pentoxyresorufin metabolism) and monoclonal antibodies (anti-P450IA1/2, anti P450IIB1/2, anti-P450IIC11/6, anti-P450IIE1(91) and anti-P450IIE1(98)). n-Hexane treatment enhanced the activities of low-Km benzene aromatic hydroxylase and toluene side-chain oxidase, but not 7-ethoxyresorufin O-deethylase or 7 pentoxyresorufin O-depentylase. 2-Hexanone or acetonyl acetone treatment enhanced the activities of low- and high-Km benzene aromatic hydroxylases, toluene side chain oxidase and 7-pentoxyresorufin O-depentylase, but not of 7-ethoxyresorufin O-deethylase. Immunoblot analysis showed that anti-P450IA1/2 did not bind liver microsomal protein from either control and treated rats in the region of cytochrome P450s, whereas with anti-P450IIE1(98) a clear-cut band was seen in liver microsomes from control and treated rats, with intensities in the following order: 2-hexanone = acetonyl acetone greater than or equal to n-hexane greater than control greater than phenobarbital. With anti-P450IIB1/2, a band was detected in microsomes from phenobarbital-treated rats, and to a lesser extent, in microsomes from 2-hexanone- and acetonyl acetone-treated rats. Like the immunoblot analysis, anti-P450IIE1(91) inhibited toluene side-chain hydroxylase activity in all microsomes, except in preparations from phenobarbital-treated rats and anti-P450IIB1 in microsomes from phenobarbital-, 2-hexanone- and acetonyl acetone-treated rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781737 TI - Kinetics of granulocytic and erythroid progenitor cells are affected differently by short-term, low-level benzene exposure. AB - In previous work, we determined that granulocytic (CFU-GM) and erythroid (CFU-E) progenitor cell populations exhibited disparate responses to short-term benzene exposures. We now report on work investigating possible mechanisms for these observed disparate responses. Mice were exposed to either air or 10 ppm benzene for 6 h/d X 5 d. Immediately after the last exposure, mice were injected, i.v., with either saline or hydroxyurea (HU). The dose of HU was sufficient to kill hematopoietic cells in or near S-phase of the cell cycle and sufficient to synchronize the surviving populations of hematopoietic cells. Three days after benzene exposure, CFU-E numbers had declined to 50% of control values while CFU GM numbers were equal to control values at this time. The benzene exposures were sufficient to double the percentage of CFU-E in S-phase but produced no such increase among CFU-GM. During 3 days of recovery from benzene exposure and HU treatment, the CFU-E population expanded 30-fold while the CFU-GM population expanded less than 3-fold. Following benzene exposure and HU treatment, both progenitor cells produced elevated numbers of their respective progeny. When CFU E from benzene-exposed mice were cultured with varying concentrations of erythropoietin (EPO), the response at maximal EPO concentration was 66% of the response by control CFU-E. This strongly suggests that the CFU-E populations from benzene-exposed mice had been depleted of cells in or near S-phase.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781738 TI - A study of the effects of p,p'-DDE and other related chlorinated hydrocarbons on inhibition of platelet aggregation. AB - A series of chlorinated hydrocarbons of interest in environmental toxicology were investigated concerning their effects on human platelet aggregation. Most potent in inhibiting platelet aggregation were p,p'-DDE and Arochlor 1242. Aggregation induced by arachidonic acid (1 mM) was more sensitive to inhibition by p,p'-DDE than was aggregation induced by ADP (10 microM). The former was completely inhibited by p,p'-DDE at a concentration of 1 x 10(-4) M, whereas there was only a 31% inhibition of the latter. Addition of Ca2+ (1 mM) blocked the inhibitory effect of p,p'-DDE on aggregation induced by both arachidonic acid and ADP. Calmodulin (1 microgram/ml) blocked the inhibitory effect of p,p'-DDE on aggregation induced by arachidonic acid but not that induced by ADP. The calmodulin inhibitory drugs trifluoperazine and calmidazolium had no effect at all or only a weak effect (-14%), respectively, on platelet aggregation. Increasing the concentrations of p,p'-DDE and Arochlor 1242 caused a delay in the onset of aggregation induced by the addition of arachidonic acid. The synthesis of thromboxane B2 and other prostaglandins in platelet membranes was dose dependently reduced by p,p'-DDE. The structurally closely related isomers o,p' DDE and p,p'-DDT did not significantly inhibit arachidonic acid-induced platelet aggregation or thromboxane B2 synthesis. It is concluded that p,p'-DDE and Arochlor 1242 inhibited platelet aggregation by inhibiting platelet cyclooxygenase activity. PMID- 1781739 TI - Interaction of methamidophos with hen and human acetylcholinesterase and neuropathy target esterase. AB - Methamidophos causes acute cholinergic toxicity in several species, including man, and organophosphate-induced delayed polyneuropathy which has been reported in man but not in the hen. Acetylcholinesterase (AChE) and neuropathy target esterase (NTE) are thought to be the molecular targets of acute and delayed toxicity, respectively. The rate constants of inhibition (ka) and reactivation (k + 3) of human and hen brain AChE and NTE by methamidophos resolved optical isomers are here reported. NTE inhibition was progressive and irreversible. Human and hen NTE ka (M-1.m-1) for D-(+) methamidophos was 88 and 59, respectively, and for L-(-) methamidophos 3.2 and 3.0, respectively. AChE spontaneously reactivates after inhibition. D-(+) methamidophos 10(-3).ka (M-1.m-1) for human and hen AChE was 0.24 and 0.13; 10(3).k+3 (m-1) was 0.83 and 0.69, respectively. L-(-) Methamidophos 10(-3).ka (M-1.m-1) for human and hen AChE was 5.7 and 2.8, whereas 10(3).k+3 (m-1) was 6.50 and 1.52, respectively. L-(-)-Inhibited AChE reactivated to about 60% for human and 30% for hen enzymes, respectively. D-(+)-Inhibited AChE reactivated to about 10-20% for both species. Maximal reactivation occurred within 4-6 h when a plateau was reached. The larger and faster reactivation of human AChE inhibited in vitro by L-(-) methamidophos suggests that a corresponding effect might be possible in vivo and therefore explain, in part, the relatively higher susceptibility of man to delayed polyneuropathy induced by racemic methamidophos which occurs, however, with doses always causing severe cholinergic toxicity. PMID- 1781741 TI - Percutaneous absorption and metabolism of aldrin by rat skin in diffusion cells. AB - Using a static diffusion cell with varying receptor fluids the viability of isolated rat skin mounted as whole skin or as split thickness skin has been studied. Skin viability decreased with time with phosphate buffer or Eagles MEM and was not supported with ethanol/water as the receptor fluid. The pesticide aldrin was absorbed through the skin into ethanol/water but not the aqueous receptor fluids. With viable skin preparations aldrin was metabolised to dieldrin and absorbed aldrin and the metabolite remained in the skin. Viable skin preparations must be used to assess in vitro, the degree of metabolism of xenobiotics which occurs during percutaneous absorption. PMID- 1781740 TI - Fate of carbaryl in rat skin. AB - Metabolism of carbaryl by rat liver and skin post-mitochondrial fraction has been measured in the presence and absence of cofactors to promote different metabolic pathways. The metabolic capacity was compared with the metabolism of carbaryl during percutaneous absorption in a static skin diffusion system using a variety of receptor fluids. Carbaryl was metabolised by hydrolysis, and ring hydroxylation followed by conjugation to the glucuronide or sulphate with liver post-mitochondrial fraction. Using skin post-mitochondrial fraction only hydrolysis and conjugation were detected. No metabolism was seen during percutaneous absorption in vitro even with receptor fluids which maintain the skin tissue viability. Studies using post-mitochondrial fraction indicate the metabolic capacity of the tissue, whereas during absorption, rates of absorption and accessibility of substrate to the metabolising enzymes must be considered. PMID- 1781742 TI - Effects of thiourea tolerance on plasma histamine, and lung vascular permeability. AB - Adult male rats treated with a lethal edematogenic dose of thiourea (TU) (10.0 mg/kg, intraperitoneally) responded with significant elevations in plasma histamine, lung vascular permeability and 100% mortality over a subsequent 24-h period. When rats were pretreated with a small non-lethal dose of TU (0.5 mg/kg) and subsequently challenged with the lethal dose at 1, 4, 8, 16 and 32 days later, there was complete protection against death for at least 8 days and partial protection for an additional 24 days. This decrease in mortality correlated quite closely with reduced plasma histamine levels and diminished pulmonary vascular permeability. The results suggest that reduced exposure of the pulmonary vasculature to histamine may offer a partial explanation for tolerance to thiocarbamide compounds in the rat. PMID- 1781743 TI - Effects of inhaled ethylene oxide on the lens glutathione redox cycle in rats. AB - The effects of chronic ethylene oxide (EtO) inhalation on the lens glutathione redox cycle were investigated. When Wistar male rats were exposed to 500 ppm EtO for 6 h a day, 3 times a week for 13 weeks, glutathione reductase decreased significantly in the lens while glutathione peroxidase did not. Glutathione reductase activity decreased time dependently, by as much as 81% after 13 weeks. In spite of changes in the glutathione redox cycle, reduced and oxidized glutathione levels were not affected. Our results raise the possibility that EtO inhalation may produce a cataract via changes in the glutathione redox cycle. PMID- 1781744 TI - Prevalence and distribution of dental caries in a late medieval population in Finland. AB - The aim was to document the late medieval material and to compare the results with findings in other medieval populations and present-day Finns. The sample consisted of the remains of 410 individuals and included 4581 permanent and 600 deciduous teeth. Age determination was based on the stage of dental development and on the attrition pattern in the molar region. Scoring the presence and location of caries was done visually with the aid of a dental probe. In the younger age groups, caries was most prevalent in the occlusal fissures, but the proportion of cavities at these sites declined with age, possibly because occlusal attrition progressed more rapidly than did caries. In the permanent dentition, carious lesions were most frequently observed at the cementum-enamel junction, particularly on the approximal surfaces. The prevalence of caries was lower than among modern populations of similar ages. In addition, the relative distribution of caries was strikingly different, with root caries being the most common type. PMID- 1781745 TI - The effects of storage after extraction of the teeth on human dentine permeability in vitro. AB - Freshly extracted third molars were stored for one week in one of four solutions: 70% ethanol, 10% formalin, distilled water with thymol and phosphate-buffered saline with thymol. Crown segments were prepared and initial permeability measurements taken. Each specimen was placed in a fresh preparation of its original solution, and permeability was measured over two periods: 1, 4, 6 and 8 days or 1, 8, 15 and 22 days. Ten crown segments were used for each solution for each time sequence. Permeabilities were lower for those specimens stored in ethanol and formalin than in water/thymol and saline/thymol, but most specimens showed increased permeability with time. Both storage solution and storage time had statistically significant effects (p less than 0.05), with significant differences between specimens stored in water/thymol and saline/thymol and those stored in ethanol and formalin. Thus, type of storage solution effects dentine permeability over time. PMID- 1781746 TI - Metalloproteinases in the mineralized compartments of porcine dentine as detected by substrate-gel electrophoresis. AB - Several gelatinolytic activities were detected in the 4M guanidine HCl-soluble fraction extracted from demineralized porcine dentine matrix. These matrix proteinases were active in the range of pH 6-9, and the activities were enhanced by calcium ions. The enzymes also degraded some of the non-collagenous proteins coexisting in the extract. The results indicate that the changes in the composition of non-collagenous proteins during the development of dentine are related to proteolytic enzyme activity. PMID- 1781747 TI - The distribution of fungiform papillae and taste buds on the human tongue. AB - Investigations on monkeys have shown that the application of the acidic dye Ponceau S red or the basic dye Alcian blue to the tongue surface facilitates identification of fungiform papillae and taste buds. Both of these dyes were now used in varying degrees of acidity on fixed and unfixed human cadaveric tongues in an attempt to determine the regional distribution of papillae and buds. Satisfactory staining was obtained with acidic Ponceau S red in 10% formalin and 10% trichloracetic acid (pH 2.5). For six tongues, the number of fungiform papillae ranged from 171 to 253 (mean 195) and these were located predominantly at the tip. Of the fungiform papillae, 67% had no staining of taste bud pores. The average number of visible taste pores on the other fungiform papillae was 3 (range 1-21). The correlation between the number of stained taste pores and underlying taste buds was confirmed using serial histological sections of 90 fungiform papillae. This work has shown that a mean of 193 taste buds are carried on fungiform papillae of the human tongue and that 87% of these are located in the anterior 2 cm. PMID- 1781748 TI - Regurgitation erosion as a possible cause of tooth wear in ancient British populations. AB - Clinically, in modern populations, tooth wear can be differentiated into three main types--attrition, abrasion and erosion, acting either separately or together. Anthropologists generally have not recognized erosion as a factor affecting the teeth of past populations. This study compares the patterns of wear known to be associated with erosion in present-day dental patients with those found in some British, pre-Conquest, skeletons. It is concluded that erosion may have been a major factor causing the extensive tooth wear in some 20 of 151 individuals. PMID- 1781749 TI - Distribution of fluoride across human primary enamel. AB - The distribution of fluoride was described in detail from the incisal to the cervical region in 10 pairs of primary lower central incisors. Fluoride analyses were done on the right incisors; optical microscopic studies were done on the left. The distribution data obtained from fluoride analyses of the right incisors were superimposed on micrographs of sections through the left incisors. An abrasive microsampling technique (Weatherell et al., 1985) was used to determine the fluoride concentration and distribution. Fluoride concentration was the highest at the enamel surface and decreased from there to the interior. The fluoride distribution did not level off to an even plateau in the enamel interior, as suggested by earlier studies. Apart from the high concentration in the surface region, the fluoride levels in prenatal and postnatal enamel were rather similar. The fluoride concentration tended to be low at the neonatal line. PMID- 1781750 TI - Immunocytochemical localization of laminin in the epithelial rests of Malassez of immature rat molars. AB - Immediately after disruption of Hertwig's root sheath, epithelial cells were found near the root apex, singly or in groups of two or three cells. They were irregular in shape with only a partial lining of basal lamina. Immunoreactivity for laminin was intense in the basal lamina and weak between projections of the epithelial cells. In 5-week-old rats, the epithelial rests consisted of about five cells and still had an incomplete basal lamina with collagen fibrils in the intercellular spaces. Immunoreaction products were seen in the basal lamina and diffusely in the intercellular spaces. The epithelial rests of 9-week-old rats had more cells, an almost complete lining of basal lamina, and narrowed intercellular spaces. Immunoreaction products were seen in the basal lamina but not in the intercellular spaces. These findings indicate the basal lamina is involved in the formation of the epithelial rests. PMID- 1781751 TI - Serum interleukin-2 receptor levels and cutaneous T-cell lymphoma. AB - The serum of twenty-four patients with histopathological confirmation of cutaneous T-cell lymphoma, including three with Sezary's syndrome, and twenty age matched controls was examined for soluble interleukin-2 receptor using a commercially available ELISA kit. Whilst there was no significant difference in the mean concentration of the interleukin-2 receptor between patients with mycosis fungoides and controls, six of twenty-one patients had interleukin-2 receptor levels outside the mean plus two standard deviations of the age matched cohort. Patients with Sezary's syndrome had markedly elevated levels of this receptor. Our data support a previous report suggesting serum levels of soluble interleukin-2 receptor increase with advancing age, highlighting the need for age matched controls when studying soluble interleukin-2 receptor levels in disease states. PMID- 1781752 TI - Formulation of 1-alpha,25-dihydroxycholecalciferol topical ointment for psoriasis treatment. AB - A means of accurate and rapid formulation of 1-Alpha,25-dihydroxycholecalciferol topical ointment is described. The accuracy of the formulation technique is within 95% of the theoretical ointment concentration (lug/gram of petrolatum base). Moreover, the stability of the formulated ointment is examined at room temperature (21 degrees C) and refrigerated (2 degrees C) over 40 days storage. When protected from light the loss of potency is 6% at 21 degrees C and negligible at 2 degrees C. PMID- 1781753 TI - The management of venous ulcers of the legs. AB - The first step in the management of venous leg ulcers is correct diagnosis of the ulcer as venous in type. Calf pump dysfunction and resultant increased venous pressure are significant factors in the pathogenesis of venous leg ulcers. Good management is aimed at correcting these. Exercise, elevation and compression are the most effective means of achieving this and form the mainstay of treatment. The use of topical preparations entails a high risk of sensitization and irritancy. If these develop, healing may be slowed by further damage to the ulcer tissue. Reducing the number of preparations used and avoiding the injudicious use of topical antibiotics minimises this risk. Frequent assessment of the ulcer is also essential. Once healed, prevention of recurrence is an integral part of correct management of venous leg ulcers. PMID- 1781754 TI - Brown pigmented papules in three generations of a family. PMID- 1781755 TI - Reticulate pigmented anomaly of the flexures of Dowling Degos disease. PMID- 1781756 TI - Sweet's panniculitis. AB - We report the development of acute, tender, erythematous plaques in a 65 year old female with Myelodysplastic Syndrome transforming to Acute Myeloid Leukaemia. The clinical presentation strongly suggested Sweet's syndrome. Histopathological examination of the plaques showed a normal epidermis, dermal and subcutaneous oedema, and large numbers of polymorphs in the panniculus. The eruption responded quickly to systemic steroids, with recrudescence when steroid dosage was reduced. She remained symptom free when prednisolone dosage was reduced more slowly. PMID- 1781757 TI - Bullous pemphigoid induced by a burn. AB - Following a burn and slow healing, a spreading blistering eruption developed and the diagnosis of bullous pemphigoid was made. Other causes of 'induced' bullous pemphigoid are reviewed. PMID- 1781758 TI - A new treatment for acquired reactive perforating collagenosis. AB - Acquired reactive perforating collagenosis is reported in an insulin dependent diabetic patient with renal impairment, managed successfully with surgical debridement and split skin grafting. The literature on treatment of reactive perforating collagenosis is reviewed. PMID- 1781759 TI - White piedra. AB - A 39-year-old Thai man had eczema on the left groin accompanied by asymptomatic white nodules on the public hair for two weeks. Examination with the Wood's lamp, microscopic examination, culture and biochemical testing showed organisms compatible with Trichosporon beigelii. The diagnosis of "White Piedra" was made, and this is the first case of White Piedra to be reported in Thailand. PMID- 1781760 TI - Tuberculous infection of the male genitalia. AB - The extremely rare occurrence of genital tuberculosis affecting the penis, seminal vesicles, epididymides, vas deferens and Cowper's gland is described. Diagnosis was made by demonstration of fragmented acid fast bacilli in the discharge, and caseating epithelioid cell granulomata with Langhan's giant cells detected on histopathology. Response to antitubercular drugs was prompt. PMID- 1781761 TI - Safety and efficacy of mometasone furoate cream in the treatment of steroid responsive dermatoses. AB - The safety and efficacy of once daily application of mometasone furoate cream 0.1% was determined by comparison with twice daily applications of betamethasone dipropionate cream 0.05% in a single blind, dual centre, randomized study in patients with a variety of steroid-responsive inflammatory dermatoses, the most common of which was psoriasis. Morning plasma cortisol levels revealed little adrenal suppression in either of the two study groups and there was no significant difference between the two groups. Routine laboratory investigations showed no trends in values outside the normal ranges that were of clinical significance. Less skin atrophy was seen in the group treated with mometasone furoate. In comparison to the betamethasone dipropionate treated group, those treated with mometasone furoate exhibited only slight evidence of skin atrophy, and this was not observed before four to twelve weeks of treatment. Eighteen percent of patients using mometasone reported adverse reactions but all were of limited duration and did not persist despite continued application of the drug. Nine percent of patients using betamethasone dipropionate reported adverse effects. Both drugs were found to be highly effective with no significant difference between the two groups at the termination of the treatment period. Of importance is the fact that whilst mometasone furoate is found to be a highly effective treatment for a variety of steroid-responsive dermatoses, this drug has only a limited potential for production of local and systemic side effects. Thus, a high margin of safety can be expected for patients using this drug. PMID- 1781762 TI - Chemiluminescence as a marker of myocardial ischemia. AB - Dog experiments were performed using the measurement of tissue chemiluminescence to clarify the peculiar role of reactive oxygen species in ischemic heart damage. Following left thoracotomy and pericardiotomy, the left anterior descending coronary artery (LAD) was ligated for 2 h and 24 h. Epicardial and endocardial muscle specimens were excised, homogenized, and centrifuged to detect chemiluminescent difference in the supernatants after t-butyl hydroperoxide induction at each time interval. Characteristic alterations were found between the infarcted region, border zone, and intact area. The induced photoemission differs in an altered kinetic as well as in intensity values. It is assumed that interrelations exist between the observed light burst and the actual scavenger state. Antioxidant application advantageously modifies the chemiluminescence effect, especially at the border zone. Induced chemiluminescence is a good method to characterize ischemically altered myocardial cellular metabolism. PMID- 1781763 TI - Modulation of baroreflex and baroreceptor function in experimental heart failure. AB - The reflex control of the circulation is clearly abnormal in heart failure. It has been known for many years that the baroreflex control of heart rate is depressed in both humans and animals with heart failure. The mechanisms for these abnormalities have not been well worked out. We have carried out experiments to determine the relative roles of the various components involved in the arterial baroreflex arc which may be abnormal in chronic heart failure. An experimental model of chronic heart failure was used which involved continuous ventricular pacing in dogs for periods of up to 6 weeks. This model is characterized by progressive increases in left atrial and left ventricular enddiastolic pressure with increases in resting heart rate and decreases in mean arterial pressure. The dogs become edematous, showing both pulmonary and peripheral edema and ascites. Exercise tolerance is also reduced. Three sets of experiments are described. In the first study, the activity from arterial baroreceptors was recorded in normal dogs and in dogs with heart failure. Carotid sinus pressure-receptor discharge curves were constructed along with pressure-diameter curves. Increasing carotid sinus pressure using either static or pulsatile pressure steps from below threshold to saturation levels caused an increase in discharge at each step. The curves generated in each group of dogs showed that the baroreceptor discharge sensitivity was significantly depressed in the dogs with heart failure. The peak slope of the curves as well as the threshold were significantly different from the normal dogs. There were no differences in carotid sinus compliance curves between the two groups of dogs. Perfusion of the carotid sinus with a dose of ouabain which did not constrict the carotid sinus (0.01 micrograms/ml) caused a shift in the pressure-discharge curve back to that seen in normal dogs. This dose of ouabain did not affect discharge sensitivity in normal dogs. These data suggest that an augmentation of Na-K ATPase in baroreceptor nerve endings in heart failure contributes to the poor discharge sensitivity. In the second series of experiments, the baroreflex control of heart rate was evaluated in dogs before and after heart failure had been induced. Both reflex tachycardia (in response to nitroglycerin) and reflex bradycardia (in response to phenylephrine) were depressed in dogs with heart failure. The use of cholinergic and beta adrenergic blocking drugs indicated that both arms of the autonomic control of the heart were partly responsible for this depressed chronotropic response.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1781765 TI - Phenomenon of the adaptive stabilization of sarcoplasmic and nuclear structures in myocardium. AB - In adaptation of rats to repeated stress exposure, a mechanism gradually forms at the level of heart to provide a considerable increase in the organ resistance to reperfusion paradox and toxic concentrations of catecholamines and Ca2+. Sarcoplasmic reticulum and mitochondria isolated from the hearts of adapted animals are highly resistant to autolysis, and nuclei to the damaging action of one-chain DNA. These changes are named phenomenon of the adaptive stabilization of structures (PhASS). An important role of myocardial heat shock protein (HSP) accumulation in the mechanism of PhASS is shown. The development of PhASS is accompanied by an increased resistance of myocardium to ischemic necrosis. PMID- 1781764 TI - Protective effect of ACE- and kininase-inhibitor on the onset of cardiomyopathy. AB - Attempts at treating idiopathic cardiomyopathy have been made both clinically and experimentally using the cardiomyopathic Syrian hamster. In recent years, the angiotensin converting enzyme (ACE) inhibitor has attracted considerable attention as an agent to treat heart failure. We administered the ACE inhibitor captopril to the cardiomyopathic hamster. In this study, 15 mg/kg body weight of captopril was administered to the cardiomyopathic hamster J2N at 5 weeks of age for 10 weeks; age matched J2N hamsters were used as non-treated control animals. At the end of captopril administration, blood was collected from the ventral aorta. Serum malondialdehyde (MDA), serum CPK, aldolase and LDH were determined, and myosin isoenzyme patterns of the extirpated myocardium were compared. Additionally, ECGs were compared and the fibrotic ratio of both ventricles determined. Serum MDA, CPK, and aldolase increased significantly in the cardiomyopathic hamster, whereas these indices were significantly inhibited in the hamster treated with captopril. The pathological ECG findings and the ventricular V3 predominant myosin isoenzyme patterns of the J2N were also much improved in the captopril group. However, the improvement in these parameters by enalapril administration was less than that seen with captopril. These results suggested that the effect of captopril is not only due to decrease of the angiotensin II level, but also due to increase in tissue kinin and vasodilatory prostaglandin which play an important role in the beneficial effect of captopril. PMID- 1781766 TI - Cardioprotection: endogenous protective mechanisms promoted by prostacyclin. AB - Evidence is accumulating that acute stress situations such as ischemia, adrenergic dominance, and ouabain intoxication enhance production of endogenous substances (PgI2, adenosine, NO) which may protect the myocardium from harmful consequences of these stress situations. PgI2 and its stable analogue 7-oxo-PgI2 exert an early direct- and induce a delayed indirect antiischemic, antiarrhythmic, and cytoprotective effect. The direct action is shortlasting; it protects from myocardial ischemia and arrhythmias, at least partly, by its vasodilating, antiaggregatory, and "membrane-stabilizing" effects. The delayed, long-lasting PgI2-induced protection from postocclusion, reperfusion- and ouabain arrhythmias is dose- (optimal 50 micrograms/kg) and time- (optimal 48 h after treatment) dependent. Its mechanism is probably based on a 7-oxo-PgI2 induced increase in the activity of Na/K-ATP-ase, and further, on a reduced sensitivity to beta-adrenergic agonists and to changes at the cardiac membrane level, resulting in a prolongation of the action potential duration and the effective refractory period. PMID- 1781767 TI - Myocardial fibrosis: role of ventricular systolic pressure, arterial hypertension, and circulating hormones. AB - The myocardium contains myocyte and non-myocyte cells. A disproportionate growth of the nonmyocyte cell population can alter myocardial structure and lead to pathologic hypertrophy. Myocardial fibrosis, the result of cardiac fibroblast growth or abnormal accumulation of fibrillar collagen within the interstitial space, can adversely influence myocardial stiffness and ultimately ventricular function. We have examined the relative importance of ventricular systolic and arterial pressures and the effector hormones of the renin-angiotensin- aldosterone system in mediating this reactive fibrous tissue response in the hypertensive left and normotensive right ventricles in various experimental models of arterial hypertension. To date, our findings implicate arterial hypertension, together with an elevation in plasma aldosterone, as being contributory to the fibrosis in renovascular hypertension that creates tissue heterogeneity in either ventricle and impaired diastolic function. The endocrine properties of aldosterone in this nonclassical mineralocorticoid target tissue, the myocardium, requires further investigation. PMID- 1781768 TI - Effects of nifedipine and moxonidine on cardiac structure in spontaneously hypertensive rats (SHR)--stereological studies on myocytes, capillaries, arteries, and cardiac interstitium. AB - Light and electron microscopic stereological studies were performed on the myocardium of spontaneously hypertensive rats (SHR) before and after treatment with nifedipine (27 mg/kg b.w./day) and the sympatholytic agent moxonidine (8 mg/kg b.w./day). The treated groups were compared with nontreated SHR and normotensive WKY (n = 10 in each group). When the therapy was started in 6-month old male SHR, blood pressure was increased and left ventricular hypertrophy had developed. On the other hand, pathologic changes of myocardial structure were not observed. After 3 months, the nontreated hypertensive rats showed cardiac fibrosis (volume density of fibrosis + 45%), activation and proliferation of interstitial cells (volume density of nonvascular interstitium + 240%), media hypertrophy of small arteries (total volume of arterial media in the left ventricle + 180%), reduced capillarization (length density of capillaries--11%), as well as focal degeneration of myocytes at the ultrastructural level. Both treatments showed similar effects on blood pressure, degree of hypertrophy, and cardiac structure. Blood pressure as well as degree of hypertrophy were significantly reduced (relative left ventricular weights: --25% and --16%). As far as myocardial fibrosis, capillarization, and regressive changes of myocytes are concerned a complete normalization was observed. Microarteriopathy and activation of nonvascular interstitial cells (first step in development of interstitial myocardial fibrosis) were significantly suppressed by therapy (total media volume --40%, volume density of nonvascular interstitium --38%), but the normal level of the normotensive control could not be maintained (+ 70%, + 111% vs WKY). This may be due to the slightly elevated systolic blood pressure despite therapy (+ 25%, vs WKY) or to hormonal factors in SHR which are independent of blood pressure. Since nifedipine and moxonidine are pharmacologically different drugs with different effects on sympathetic activity, one may cautiously conclude that increase in blood pressure itself is an important determinant of arterial, interstitial as well as myocellular alterations which are related to the pathogenesis of hypertensive heart muscle disease. PMID- 1781769 TI - A new concept for the mechanism of Ca+(+)-regulation of muscle contraction. Implications for physiological and pharmacological approaches to modulate contractile function of myocardium. AB - Recent development of an experimental protocol to determine kinetics of active cross-bridge turnover is muscle allows analysis of possible Ca+(+)-effects on cross-bridge turnover kinetics. This analysis enabled us to distinguish the two main hypotheses about the mechanism of regulation of muscle contraction. In the first hypothesis, the number of actively turning over cross-bridges is changed, while cross-bridge turnover kinetics are unaffected by Ca++ (regulation by "cross bridge recruitment"). In the other hypotheses, cross-bridge turnover kinetics are controlled by Ca++, while the number of actively turning over cross-bridges is essentially unaffected (regulation by "rate modulation"). It is found that the major mechanism of regulation of muscle contraction is by a change in the rate constant (fapp) that determines the transition of a cross-bridge from the weak binding (non-force generating) configuration to its strong-binding (force generating) configuration. It is demonstrated that the concept of "rate modulation" requires reinterpretation of force-pCa relations and of the mechanisms of physiological and pharmacological modulation of force-pCa relations. On this basis, an additional mechanism for positive inotropic interventions is demonstrated which may have advantages over the previously established mechanisms. PMID- 1781770 TI - Large and rapid changes of myofibrillar total calcium during the cardiac cycle. Electron probe microanalysis of voltage-clamped guinea-pig ventricular myocytes. AB - At 36 degrees C and 2 mM [Ca2+]o, single guinea-pig ventricular myocytes were voltage clamped with patch electrodes. When paired pulsing had potentiated the contraction to the maximum, the cells were shock-frozen for electron probe microanalysis (EPMA). Shock-freezing was timed at the end of diastole (-80 mV) or at different times during systole (+5 mV). The same paired-pulse protocol was applied to another group of myocytes from which contraction was recorded and [Ca2+]i was estimated by microfluospectroscopy (50 microMNa-Indo-1). In potentiated cells, during the first pulse, contraction peaked within 128 +/- 25 ms after start of depolarization. [Ca2+]i peaked within 25 ms to 890 /+- 220 nM (mean +/- SEM) and fell within 100 ms to about 450 nM. sigma Camyo, the total calcium concentration in the overlapping myofilaments (A-band), was measured by EPMA in 17 potentiated myocytes. During diastole, sigma Camyo was 2.6 +/- 0.4 mmol/kg dry weight (dw), which can be converted to 0.65 mM (mmoles per liter myofibrillar space). Since [Ca2+]i was 180 nM, we estimate that 99.97% of total calcium is bound. A time-course for systolic sigma Camyo was determined by shock freezing 13 cells at different times after start of depolarization to +5 mV. sigma Camyo was 5.5 +/- 0.3 mmol/kg dw (1.4 mM) after 15-25 ms, 4.6 +/- 0.5 mmol/kg dw (1.1 mM) after 30-45 ms, and 3.1 mmol/kg dw (0.8 mM) after 60-120 ms. The fast time-course of sigma Camyo suggests that calcium binds to and unbinds from troponin C at a fast rate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781771 TI - Nucleotide profile in rat liver and intestine at portal vein obstruction and reflow. AB - Liver and intestinal nucleotides and energy charge levels were examined in rats at portal vein clamping for 1, 5 or 30 min and after reflow for 1 or 6 h following 30 min clamping. In both tissues, clamping resulted in a loss of ATP, energy charge, UTP, GTP, UDP-glucuronic acid and UDP-N-acetylhexosamine levels, which all, except ATP and total adenosine phosphates, essentially recovered at 1 h reflow. At 6 h reflow, liver UDP-glucuronic acid and liver glutathione decreased in both clamped and sham operated rats. PMID- 1781772 TI - Hypolipidemic activity of some hydropolyborate salts in rodents. AB - A series of hydropolyborate salts were observed to possess hypolipidemic activity in rodents. Tetramethylammonium octahydrotriborate, tetramethylammonium hexahydrohexaborate, tetramethylammonium dodecahydrododecaborate and triethyl ammonium dodecahydrododecaborate proved to be very effective in lowering serum cholesterol and triglyceride levels in CF1 mice, i.p. and Sprague Dawley rats, orally. Tissue lipids were reduced by these agents e.g. liver cholesterol, and triglyceride and small intestine mucosa cholesterol levels. [3H] Cholesterol distribution studies confirm that steroid levels are lower in most major tissues. The rat serum lipoprotein lipid content was altered by drug treatment, with cholesterol and triglyceride being reduced in the VLDL and cholesterol being reduced in the LDL. HDL cholesterol levels were elevated by drug treatment. The fecal lipids were increased with select derivatives. The enzyme activities involved in de novo synthesis of hepatic lipids were affected by the hydropolyborate salts including cytoplasmic ATP-dependent citrate lyase, acetyl CoA synthetase, acyl CoA cholesterol acyl transferase, sn-glycerol-3-phosphate acyl transferase and phosphatidylate phosphohydrolase. PMID- 1781773 TI - Effect of stobadine on brain lipid peroxidation induced by incomplete ischemia and subsequent reperfusion. AB - The ability of stobadine (ST) to prevent lipid peroxidation was tested in incomplete rat cerebral ischemia induced by 4 hour ligation of the common carotid arteries with a subsequent 10 min reperfusion. The extent of lipid peroxidation was determined by the measurement of the level of conjugated dienes (CD) and thiobarbituric acid reactive substances (TBARS). The levels of CD and TBARS were significantly elevated in brain cortex samples from animals subjected to ischemia followed by reoxygenation in comparison with ischemic samples without reperfusion, samples from sham operated or control animals. The concentration of CD and TBARS significantly decreased in animals treated with therapeutic doses of ST (2 mg/kg) administered i.v. immediately before reperfusion or 10 min after the onset of reperfusion. Stobadine was more effective than the known lipid antioxidant vitamin E, given in a dose of 30 mg/kg.day i.m. over 3 consecutive days prior to ischemia. The beneficial effect of ST on survival of rats was more effective in comparison with vitamin E. Significant changes were found in the activities of the antioxidative enzymes, i.e. increase in superoxide dismutase (SOD) and decrease in glutathione peroxidase (GP) in brain cortex samples from animals subjected to ischemia followed by reoxygenation. Stobadine prevented these changes. Catalase (CAT) activity was not detectable. It may be concluded from the increased SOD activity that oxygen radicals play a significant role in cerebral ischemia followed reperfusion. In addition to its antioxidant effect, stobadine probably prevents superoxide radical generation. The mechanism of xanthine oxidase inhibition is not involved in preventing superoxide radical generation by stobadine. Stobadine maintained high GP activity, probably by preventing glutathione oxidation. PMID- 1781774 TI - Influence of inhibition of insulin degradation on Scatchard analysis in H35 rat hepatoma cells. AB - Inhibition of insulin degradation by the use of chloroquine and bacitracin leads to a straight line in the Scatchard plot after correction for internalized insulin (r = 0.978 +/- 0.011). Analysis according to a model with two groups of heterogeneous binding sites showed a significant reduction in the total number of binding sites (p less than 0.01) in the chloroquine-bacitracin treated cells, with a disappearance of the low affinity binding sites and an increase in the assessment of the number of high affinity binding sites (p less than 0.002). The assessment of the high affinity association constant showed a decrease in the chloroquine-bacitracin treated cells (p less than 0.05). Analysis according to a model with a homogeneous group of binding sites with negative cooperativity also showed a decrease in the assessment of the number of binding sites (p less than 0.05) with a significant reduction in the Ke/Kf ratio from 4.5 +/- 1.5 to 1.16 +/ 0.22 (p less than 0.002). These results indicate that inhibition of insulin degradation leads to disappearance of negative cooperativity; the data are inconsistent with the two site model. PMID- 1781775 TI - A comparative study of phospholipids in human, goat and chick amniotic fluid. AB - In human, goat and chick amniotic fluid the contents of lecithin, lysolecithin and phosphatidyl ethanolamine increase during embryonic development. The sphingomyelin content however, increased during the early period only and declined during the latter part of development. PMID- 1781777 TI - Does Tris-HCl effectively participate in transamination during hemoglobin pyridoxylation? AB - To test whether Tris is required for covalent binding of pyridoxal phosphate (PLP) to hemoglobin, we carried out the reaction in solutions of Tris homologues, carrying a blocked amine function. With the exception of Mono-Tris, these compounds permitted the synthesis of modified hemoglobins with acceptable spectral properties, P50 values, cooperativity and methemoglobin content, refuting Tris HCI participation during hemoglobin pyridoxylation. PMID- 1781776 TI - Aggregation of human plasma high density lipoproteins induced by poly(ethylene glycol). AB - The influence of different surface charge densities (induced by varying pH, addition of positively charged amphiphilic molecules and chemical modification) of high density lipoproteins (isolated by ultracentrifugation) on poly(ethylene glycol) induced aggregation was studied. The effects of different molecular masses of PEG, HDL concentration and the presence of other serum proteins on the PEG mediated aggregation were investigated. The PEG concentration necessary for HDL aggregation is inversely proportional to the used HDL concentration and its molecular weight, and is directly proportional to the presence of other proteins and the magnitude of the negative surface charge density of HDL. The results are in accordance with the predictions of the volume exclusion theory taking into account the influence of repulsive electrostatic forces on the interaction of HDL particles. PMID- 1781778 TI - Duration of EEG alpha wave blockade by tone stimulation is prolonged in early stage of presenile onset dementia of the Alzheimer type. AB - The EEG alpha rhythm suppression by sudden unexpected tones in a relaxed wakefulness state (Berger response) was measured in four groups of patients and healthy control subjects. One patient group with early cognitive deficits probably caused by a mild stage of presenile onset primary degenerative dementia of the Alzheimer type (DAT), a second patient group with cardiovascular disease and a stage of questionable dementia, an age-matched group of older healthy control subjects and a younger control group. Only half of the DAT group in the mild stage had significantly prolonged Berger responses and a retarded or disturbed habituation. In agreement with other data of their cognitive deficits this indicated a weakening in focussing attention and selective inhibition. PMID- 1781779 TI - Studies on the changes in plasma lipids and lipoproteins in CMF treated breast cancer patients. AB - In a comparative study on the effect of CMF (Combination of Cyclophosphamid, Methotroxate and 5-Fluorouracil) on the pre and postmenopausal women with breast cancer, a number of differences were observed in circulating plasma lipid concentration. Plasma lipids, phospholipids, triglycerides, cholesterol and free fatty acids levels were all lower in blood obtained from CMF treated breast cancer patients. HDL-cholesterol level were significantly increased in these patients. These differences remained when the patient groups were subdivided according to their menopausal status. HDL cholesterol had been significantly increased in pre and post menopausal CMF treated breast cancer patients when compared with untreated breast cancer patients. PMID- 1781780 TI - Effect of phosphoenolpyruvate on energy metabolism of ischemic liver in anesthetized rats--31P-MRS study. AB - The effect of phosphoenolpyruvate (PEP) on energy metabolism of ischemic liver was examined in anesthetized rats. In vivo 31P-NMR spectroscopy (31P-MRS) was used to monitor cellular energy metabolism. Hepatic ischemia was induced by temporarily clamping the portal vein for 60 minutes. The liver adenosine triphosphate (ATP) levels decreased remarkably during ischemia, and they gradually increased after ischemia but did not return to pre-operative levels. PEP effectively increased the levels of ATP. The ATP levels of the PEP-treated rats were significantly higher than those of the control rats, and also intracellular acidosis was improved during post-ischemic reperfusion. These findings suggest that PEP may have a cytoprotective effect and improve the energy metabolism in the ischemic liver. PMID- 1781781 TI - Chemical modification of PABA synthase. AB - p-Aminobenzoic acid (PABA) synthase catalyses the first step in folic acid biosynthesis, the conversion of chorismate to p-aminobenzoate. In general, difficulties in purification have permitted only limited investigation of this enzyme. However, in an attempt to identify possible active site residues, the E. coli enzyme has been incubated with a range of protein modifying agents. Results indicate that cysteine, histidine, arginine and tyrosine residues are important for enzyme activity. Attempts were made to determine the subunits upon which these residues were located. PMID- 1781782 TI - Effects of starvation on the tissular lipogenic rate in the obese Zucker rat. AB - The lipogenic rate of the obese rats was significantly higher than that of the lean rats in liver, white adipose tissue, skeletal muscle, heart and carcass. In the lean rats, a 24 h starvation period caused a significant decrease in the lipogenic rate of white adipose tissue and skeletal muscle while it increased that of heart, brain and brown adipose tissue. In the obese rats, starvation decreased the lipogenic rate in liver, skeletal muscle, white adipose tissue, brown adipose tissue and carcass. In spite of this, liver and skeletal muscle showed higher rates of lipid synthesis than the corresponding fed lean. It is concluded that starvation induces a qualitatively similar response in the obese versus the lean rat although the total lipogenic capacity of the animal is still higher. PMID- 1781783 TI - Peripheral biochemical marker for organophosphate-induced delayed neurotoxicity. AB - Neurotoxicesterase (NTE) activity was assayed in platelets of human and mice as well as in the brain of mice in vitro and in vivo. Mipafox, a well known organophosphate, to induce delayed neurotoxicity, at doses of 5, 10 and 15 mg/kg, subcutaneously, was used to examine the relationship between inhibition of brain and platelet NTE activity in mice. It was observed that the platelet NTE activity of mice was less than in humans. The optimum pH for both brain and platelet NTE of mice, and human platelets, was 8. The results indicate that mipafox produces a dose dependent inhibition of brain and platelet NTE activity in vivo and concentration dependent inhibition in vitro. It can be concluded that assay of platelet NTE can be a useful peripheral biochemical marker for organophosphate induced delayed neurotoxicity. PMID- 1781784 TI - Effects of thiamine deficiency on the biosynthesis of insulin in rats. AB - The effect of thiamine deficiency on insulin biosynthesis was studied. In thiamine deficient rats the total pancreatic protein content was not altered when compared to control rats whereas the pancreatic insulin content was decreased. Though the in vivo incorporation of 3H-leucine and the in vivo conversion of U 14C-glucose into proinsulin and insulin were not affected in thiamine deficient rats, the tolbutamide induced increased in vivo incorporation of 3H-leucine and in vivo conversion of U-14C-glucose into proinsulin and insulin was not seen in thiamine deficient rats. These results suggest that the biosynthesis of insulin is impaired in thiamine deficiency. Even tolbutamide could not increase the biosynthesis of insulin in this condition. PMID- 1781785 TI - Characterization of the skin collagen of a surface water fish Scomberoides commersonianus. AB - The molecular organization of the skin collagen in the fish S. commersonianus has been investigated. The contents of imino acids proline and hydroxyproline are less in the skin collagen. The major collagenous component of fish skin is homologous to type I collagen. The number of CNBr peptides in fish skin collagen alpha 1 chains is two times that of rat skin alpha 1 CNBr peptides. The proline hydroxyproline ratio in the six peptides studied was 1.66-3.5 as compared to that of rat skin collagen (0.67-1.94). This indicates that proline and hydroxyproline are not uniformly distributed in the collagen molecule in fish skin collagen. PMID- 1781786 TI - Monitoring anthracycline binding to nucleotides by two dimensional cosy NMR experiments. AB - The nucleotide binding ability of the novel anthracycline drug, 3-fluoro-4 demethoxydaunomycin, has been studied by two dimensional 1H NMR correlated spectroscopy (COSY). In the COSY spectrum of the nucleotide mini-helix d(CTGCAG)2 cross-peaks are observed from the spin-coupled H6 and H5 protons of the cytidine bases. Additional cytidine H6/H5 cross-peaks are observed in the COSY spectrum of the anthracycline-d(CTGCAG)2 complex. These additional cytidine cross-peaks enable the identification of the anthracycline binding sites and the determination of the relative kinetic stability of the bound drug at each binding site. PMID- 1781787 TI - Glucose has regulatory effects on insulin release also in the virtual absence of extracellular Ca2+. AB - The glucose effect on insulin release in a Ca(2+)-deficient medium was analyzed in perifusion experiments with aggregates of cells prepared by dispersal of the beta-cell-rich pancreatic islets of ob/ob-mice. Hyperosmolar additions of 20 mM D glucose or its poorly metabolized transport analogue 3-0-methyl-D-glucose resulted in 50% suppression of the secretory rate. However, after isosmolar additions of the sugars, replacing non-penetrating sucrose, there was a stimulation of insulin release. Whereas D-glucose was less effective than 3-O methyl-D-glucose in stimulating insulin release after isosmolar addition, the opposite was found for the enhanced secretory response obtained when the sugars were excluded from the perifusion medium. The studies indicate that D-glucose has regulatory actions on insulin release also in the virtual absence of extracellular Ca2+. This effect is not only due to osmolar influences but involves also direct suppression of the secretory activity probably mediated by the metabolism of the sugar. PMID- 1781788 TI - Physiological role for zinc in prevention of apoptosis (gene-directed death). AB - Chronic lymphatic leukaemia (CLL) cells were used to study regulation of apoptosis by Zn2+. Apoptosis occurred spontaneously in a proportion of the cells during culture for 18h and in most of the cells exposed to colchicine. Spontaneous and colchicine-induced DNA fragmentation and cell death were completely inhibited in the presence of physiological concentrations of Zn2+ with Zn2+ ionophores. Chelation of intracellular Zn2+ induced DNA fragmentation and morphological changes of apoptosis in most CLL cells within 5hr, but not in a population of CLL cells which were resistant to other apoptotic stimuli. Phorbol esters inhibited apoptosis induced by colchicine and other stimuli, but had no effect on apoptosis induced by chelation of intracellular Zn2+. We propose that an intracellular pool of chelatable Zn2+ blocks apoptosis and that this pool is increased by uptake from the medium. PMID- 1781789 TI - Regulation of protein kinase C by Zn(2+)-dependent interaction with actin. AB - Zn2+ influences diverse cellular processes by poorly understood mechanisms. Some of these effects may be mediated by the protein kinase C (PKC) family of enzymes, since an influx of Zn2+ greatly increases their binding of regulatory ligand phorbol ester and induces their translocation from cytosol to the cytoskeleton. Using a model with purified components, we now show that Zn2+ acts by forming a phospholipid-dependent complex of PKC with filamentous actin, which results in expression of new binding sites for phorbol ester and phosphorylation of actin. These results provide a basis for the observed localization of PKC at actin membrane junctions, in-vivo. PMID- 1781790 TI - Vanadate activates pentose phosphate pathway and glycolysis, and raises fructose 2,6-bisphosphate concentration in slices of lactating rat mammary gland. AB - In mammary gland slices from lactating rats, vanadate increased the rate of glucose oxidation via the pentose phosphate pathway by 36% and raised the glucose flux via glycolysis by 47%. Furthermore, vanadate increased the fructose 2,6 bisphosphate (Fru-2,6-P2) level by 33%. The effect of vanadate on glucose oxidation was compared to the effect of insulin. The present data indicate that 0.5mM vanadate has an effect on glucose utilization similar to that of insulin but does not reach the same level. PMID- 1781791 TI - L-cell growth stimulation by a beta-casein peptide: the importance of its phosphorylation site for activity. AB - L-cell proliferation was markedly enhanced by addition to the medium of a synthetic peptide corresponding to residues 1-18 of human beta-casein. Experiments using several synthetic peptides of decreasing length demonstrated that L-S-S-S-E-E (residues 7-12), a major phosphorylation site in beta-casein, appeared to be important for the activity. The phosphorylated beta-casein peptide showed no activity. Recent findings have demonstrated that a similar sequence, S E-E-E or S-D-D-E, is commonly present in many oncoproteins derived from nuclear oncogenes such as myc, myb and E1A, and plays an important role in transformation functions. The beta-casein peptide may affect mammalian cell proliferation through a modification of of the oncoprotein functions. PMID- 1781792 TI - 4-Trifluoromethylumbelliferyl glycosides as new substrates for revealing diseases connected with hereditary deficiency of lysosome glycosidases. AB - The following glycosides of 4-trifluoromethylumbelliferone: alpha-D mannopyranoside, alpha-L-fucopyranoside, alpha-D-glucopyranoside, beta-D glucopyranoside, alpha-D-galactopyranoside, beta-D-galactopyranoside, alpha-L iduronide and beta-D-glucuronide were studied. 4-Trifluoromethylumbelliferyl glycosides were shown to be substrates for glycosidases. Some of them were cleaved even better than the corresponding methylumbelliferyl glycosides. 4 Trifluoromethylumbelliferyl glycosides were applied for revealing the corresponding enzyme deficiencies upon diagnosis of Gaucher and Hurler diseases as well as GM1 gangliosidosis and alpha-mannosidosis. 4 Trifluoromethylumbelliferone released after enzymatic hydrolysis of 4 trifluoromethylumbelliferyl glycosides exhibits more contrast yellow fluorescence in UV-light than the blue one of methylumbelliferone upon exposure of enzyme activity on solid supports. Therefore 4-trifluoromethylumbelliferyl glycosides are convenient substrates for revealing glycosidase activity directly in tissue samples, e.g. in placenta, and thus for fast prenatal diagnosis of lysosomal diseases. PMID- 1781793 TI - Role of adrenergic and cholinergic mediators in gastric mucus phospholipid secretion. AB - The role of adrenergic and cholinergic mediators in phospholipid secretion by gastric mucosal cells maintained in the presence of [3H]choline was investigated. The secretion of [3H]choline phospholipids over 30 min period averaged 1.98% of the total cellular labeled phospholipids in the absence of any mediator, and was enhanced by beta-adrenergic agonist, isoproterenol, to a greater extent than the cholinergic agonist, pilocarpine. A 2-fold increase in phospholipid secretion was achieved with isoproterenol, while pilocarpine evoked 1.3-fold increase. The stimulatory effect of isoproterenol was inhibited by alprenolol and that of pilocarpine by atropine. The phospholipids secreted in response to isoproterenol exhibited a 30% decrease in lysophosphatidylcholine, while 2.1-fold enrichment in this phospholipid occurred with pilocarpine. The results, for the first time, demonstrate the involvement of neural mediators in the regulation of phospholipid secretion in gastric mucus. PMID- 1781794 TI - Effect of vitamin D deficiency on D-glucose and citrate transport in rat renal basolateral membrane vesicles. AB - We had previously reported that feeding rats on Steenbock and Black's rickets inducing diet markedly influences the metabolic picture of the kidney and the transmembrane transport systems of D-glucose and citrate in renal brush-border membrane vesicles. We have now studied D-glucose and citrate transport into basolateral membrane vesicles prepared from kidney cortex of control and rachitic rats and the effect of 1,25-dihydroxyvitamin D3 on these transport systems was also investigated. D-glucose and citrate uptake, determined in the presence of a Na(+)-gradient, was lowered in rachitic animals and 1,25-dihydroxyvitamin D3 administration proved to be ineffective in restoring normal values. Citrate transport, determined in the presence of a K(+)-gradient, was not influenced by both rickets and 1,25-dihydroxyvitamin D3 supply. The in vitro addition to vesicle preparations of calcium or phosphate or citrate or 1,25-dihydroxyvitamin D3 did not show a selective influence on D-glucose and citrate uptake. PMID- 1781795 TI - Trypanosoma cruzi: incorporation of [3H]-palmitic acid and [3H]-galactose into components shed by trypomastigotes. AB - Trypomastigotes were metabolically labeled with [3H]-palmitic acid or [3H] galactose and labeled components were detected in the culture medium. Thin layer chromatography of the shed material showed several lipids in the [3H]-palmitic acid labeled sample while the sugar was mainly incorporated into macromolecules. The material incorporated with the lipidic precursor was fractionated by DEAE Sephadex (acetate form) and the amount of radioactivity was ten times higher in the acidic lipids than in the neutral lipids. When acidic lipids were further separated by Unisil, 73% of the radioactivity was recovered in the less polar fraction. Different patterns were obtained on comparison of the shed components with the lipids remaining in the parasite. PMID- 1781796 TI - Efficacy and tolerability of memantine in patients with dementia syndrome. A double-blind, placebo controlled trial. AB - The efficacy and tolerability of memantine (1-amino-3,5-dimethyl-adamantane hydrochloride, Akatinol Memantine; CAS 41100-52-1) was investigated in a double blind, randomized clinical study versus placebo in 66 patients aged between 65 and 80 years predominantly suffering from mild to moderate vascular dementia. The target variables assessed were the baseline differences of the Sandoz Clinical Assessment Geriatric scale (SCAG) and Syndrom-Kurz-Test (SKT) total scores and the total time required in the subtests of Activity of Daily Living tests (ADL). Additional parameters assessed were the physician's global impression, the Mini Mental State Evaluation (MMSE), the Tapping and Trace tests for fine motor rating and the quality in performing the ADL tests. Adverse drug effects were recorded by DOTES/TWIS. 59 of the 66 patients included in the study terminated the trial (29 in the placebo and 30 in the memantine group). For the baseline differences of the SCAG total score a statistically significant improvement was observed already after 14 days of memantine treatment as compared to placebo. After 42 days this difference was still more pronounced and highly significant. Significant improvements after 14 and 42 days of memantine treatment could also be demonstrated for the SCAG subscales cognitive disturbances, lack of drive, emotional disturbances, social behaviour and somatic disturbances. Additionally, the efficacy of the drug could be confirmed by the SKT and ADL tests. Particularly striking in the ADL tests was the considerable improvement achieved in the quality of performing the tasks under memantine treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781797 TI - [Gallopamil and changes of adenosine diphosphate- and collagen-induced thrombocyte aggregation]. AB - In blood samples of 12 healthy volunteers (5 female, 7 male) the influence of Gallopamil (Procorum, CAS 16662-47-8) on the adenosine-diphosphate- (ADP-) and collagen-induced platelet aggregation was studied. Measurements in platelet rich plasma after induction with 1 mumol ADP and 0.5 microgramml collagen with gallopamil were performed. After incubation mit 250 mumol gallopamil a second test was carried out. The parameters were compared with the U-test. After application of 250 mumol gallopamil a significant reduction of ADP- and collagen induced platelet aggregation could be observed. This is a sign for a protective effect of gallopamil in atherosclerotic disorders due to its calcium-channel blocking property. PMID- 1781798 TI - Administration of gallopamil by long-term venous infusion in spontaneous angina. A single-blind, self-controlled study versus placebo. AB - In order to assess the efficacy and tolerability of gallopamil (D-600, CAS 16662 47-8) by long-term venous infusion in the treatment of spontaneous angina, 15 consecutive patients were studied in a single-blind, self-controlled trial versus placebo. Following a 24-h Holter ECG recording of the patients receiving a saline infusion (run-in phase), i.v. administration of gallopamil was started at a dose of 0.02 mg/kg/h preceded by a 0.03 mg/kg bolus. After 24 h, the dosage was increased to 0.03 mg/kg/h and the infusion was maintained for another 48 h. The Holter ECG recording was repeated in the last 24 h of treatment and after 6 h from withdrawal (washout phase). The reduction in the number of angina attacks, as shown by a comparison between the average of the two placebo periods (run-in and washout phases) and the three days of treatment, was 68.2%, 92.5%, and 87%, respectively. Consumption of glyceryl trinitrate decreased by 92.5% on each one of the three days of treatment. The reduction in the number of ischemic episodes (IEs) with symptomatic (-91.6%) and silent (-98.0%) ST elevation, and with symptomatic (-100%) and silent (-90%) ST depression, also proved significant. Heart rate decreased only moderately. One patient showed a mild first-degree heart block, while another suffered a transient episode of isorhythmic A-V dissociation. In conclusion, when administered by venous infusion, gallopamil has been found to be well tolerated and highly effective in the treatment of spontaneous angina.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781799 TI - Different stressors and blood lipid peroxidation. AB - Elevation of lipid peroxidation (LOX) was observed in rabbits and mice after the intravenous administration of 0.2 micrograms.kg-1 of lipopolysaccharide (LPS) and 100 micrograms.kg-1 of peptidoglycan (MP). The peak was reached sooner after peptidoglycan, and 2-4 h after LPS administration. The trends of lipid peroxidation were the same in both species. 8-10 h later original LOX blood levels were reached. Mild horizontal vibration (1 h) induced in both species a significant lowering of LOX. This appeared already immediately after the vibration. Original values were gained again after 8-10 h. The difference between the internal stressors, LPS and MP, and the external stressor, vibration, are discussed. PMID- 1781800 TI - Study on the interaction between sucralfate and diclofenac/piroxicam in healthy volunteers. AB - The possible interaction between sucralfate (Ulcogant, CAS 54182-58-0) on the one hand and diclofenac (CAS 15307-86-5) and piroxicam (CAS 36322-90-4) on the other hand was investigated in two groups each consisting of twelve healthy volunteers. The AUC (0-t) was calculated at 1670 +/- 492 ng/ml x h for diclofenac alone and at 1817 +/- 682 ng/ml x h for diclofenac plus sucralfate. The mean AUC (0-t) for piroxicam alone was 91 +/- 19 micrograms/ml x h whilst that for piroxicam plus sucralfate was 91 +/- 20 micrograms/ml x h. The mean relative bioavailability was 116% for diclofenac plus sucralfate compared to diclofenac alone, and 100% for piroxicam plus sucralfate compared to piroxicam alone. Thus there is no interaction between sucralfate and diclofenac resp. piroxicam. PMID- 1781801 TI - Inhibition of cholesterol biosynthesis by a water-soluble garlic extract in primary cultures of rat hepatocytes. AB - Cultured rat hepatocytes continually synthesize cholesterol form radiolabeled acetate during a 24 h incubation period and export it, presumably as VLDL (very low density lipoprotein) to the culture medium. Mevastatin inhibits cholesterol biosynthesis by 90%. Incubation of the cultures with water-soluble extracts of garlic powder (Kwai, Sapec) diminish cholesterol biosynthesis (20-25%) as well as its export into the medium (30-35%). The IC50-value is 90 micrograms/ml. Between about 0.25 and 10 mg/ml the average maximal inhibition amounts to about 23%. Cytotoxicity of the extracts is apparent at concentrations above 125 mg/ml only. Pure alliin alone, or after incubation with alliinase (conversion to allicin) in concentrations corresponding to its content in the extracts does not exert any inhibition. Replacement of 14C-acetate by 14C-mevalonate omits the inhibitory effect. The activity of HMGCoA (hydroxymethylglutaryl-CoA) reductase is significantly reduced by garlic extracts at 50 micrograms/ml. At higher concentrations fatty acid synthetase, cholesterol 7 alpha-hydroxylase and cholesterol acyltransferase are slightly inhibited. Fatty acid synthetase is the only one of these enzymes which is inhibited by alliin at very high concentrations. These results demonstrate that water-soluble garlic extracts diminish hepatic cholesterol biosynthesis, thus contributing to the reduction of blood cholesterol. The main target site seems to be HMGCoA-reductase. The actual active principle(s) is still unknown. Alliin, however, does not seem to be of major significance. PMID- 1781802 TI - Attenuation of azosemide's action in the loop of Henle of rat kidney by nonsteroidal anti-inflammatory drugs. AB - The purpose of the present study, which was performed in anaesthetized rats, was to clarify whether the nonsteroidal anti-inflammatory drugs (NSAIDs) indomethacin and meclofenamate interact with the diuretic action of the new loop diuretic azosemide (Luret, CAS-27589-33-9). Since azosemide's diuretic action shows a lower onset and a more prolonged duration as compared to classical loop diuretics it was also tested whether azosemide's tubular action is mediated by an active metabolite. The results demonstrate that azosemide, when infused directly into the lumen of superficial loops of Henle, dose-dependently diminished the loops sodium and chloride reabsorption. A half-maximum effect was observed at an azosemide concentration of 3 x 10(-6) mol/l. These results clearly prove that the diuretic effect of azosemide is exerted by the drug itself and does not require metabolism to an active metabolite. Luminal application of the drug also dose dependently increased early distal sodium and chloride concentrations, indicating that the drug's tubular action is located in the thick ascending limb of Henle's loop. Indomethacin and meclofenamate blunted the diuretic, natriuretic and chloruretic response to azosemide, and microperfusion experiments on single loops of Henle revealed an attenuation by NSAIDs of azosemide's inhibitory action on the loops sodium and chloride reabsorption. The quantitative extent of this interaction was nearly identical to that observed previously for the NSAID furosemide interaction. PMID- 1781803 TI - [The effect of glycine on the gastroduodenal tolerability of acetylsalicylic acid. An endoscopic, controlled double-blind study in healthy subjects]. AB - In a randomized double-blind study the gastroduodenal tolerability of daily 500 mg acetylsalicylic acid (ASA, CAS 50-78-2) in combination with 250 mg glycine (CAS 56-40-6) (Godamed) and 500 mg ASA without addition of glycine were evaluated in 20 healthy volunteers giving upper GI-endoscopy. Both ASA-preparations have been taken over a period of 4 weeks. Endoscopic controls were performed at entry, and repeated after 7, 14 and 28 days of treatment. Both ASA-preparations induced comparable gastroduodenal damages during the whole test period: The lesions score of both groups on day 7, 14 and day 28 was almost identical. In contrast to plain ASA, where 9 of 10 volunteers reported gastrointestinal side effects, all subjects receiving ASA in combination with glycine did not complain from any dyspeptic symptoms, i.e. epigastric pain etc. The reasons for the apparent better tolerability of ASA in combination with glycine are discussed. PMID- 1781804 TI - Antifilarial efficacy in vitro of 2-tert-butyl-benzothiazole derivatives on adult Litomosoides carinii. AB - Six 2-tert-butyl-benzothiazole derivatives (2-tert-butyl-6-isothiocyanato-5 methyl-benzothiazole (CGP 21306); 3-[(2-tert-butyl-5-methyl-benzothiazole-6 yl)aminothiocar-bonyl thiol] propionic acid (CGP 21835); 2-tert-butyl-5-methyl-6 (N-methyl-piperazinyl-thiocarbonylamino)- benzothiazole(CGP 21833); 2-tert-butyl 5-methyl-6-(4-dimethylamino-piperid-1-yl-thiocarbo nylamino)- benzothiazole (CGP 26702); CGP 20376, the 5-methoxy analogue to CGP 21835 and CGP 20309, the 5 methoxy analogue to CGP 21833) were tested in vitro against adult Litomosoides carinii. When exposed to the drugs in protein-free medium RPMI 1640 drug concentrations of 1 nmol/ml caused complete immobilization of female worms within 4 h (CGP 21306, 21835, 20376) or 20 h (CGP 21833, 26702, 20309). Short term exposure for 1 h had similar effects with CGP 21306, 21835, 21833 and 20376. However, the levels of CGP 26702 and 20309 (both thiourea derivatives) had to be increased to 10 nmol/ml to obtain complete immobilization after short term exposure. Male parasites were more resistant to the drugs than females under these experimental conditions. When the medium was supplemented with 10% foetal calf serum (FCS) the efficacy of all compounds was reduced. The effect of the compounds during permanent and short term exposure on the release of microfilariae was determined over an incubation period of 7 days (medium RPMI 1640/10% FCS). In general only drug concentrations which affected markedly the motility of the worms within 2 days reduced significantly the number of microfilariae released by treated worms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781805 TI - Studies on the antibacterial action of novel gem-diphenyl-spiro-cyclopropano- oxazolones and 2-aryl(alkyl)-4-ylidene-oxazol-5-ones. AB - The preparation and in vitro antibacterial activity of a novel series of gem diphenyl-spiro-cyclopropano-oxazolones (cis-1,2,2,5-tetraphenyl 6-oxa-4 azaspiro[2.4]hept-4-en-7-one) are described. The overall activity of these compounds was higher than that of the 2-aryl(alkyl)4-ylidene-oxazol-5-ones (azlactones). The gem-diphenyl-spiro-cyclopropano-oxazolones 1-4 have emerged as the most potent derivatives when tested against bacteria. PMID- 1781806 TI - [The effect of sulbactam on the in vitro activity of mezlocillin, piperacillin and cefotaxime]. AB - The in vitro activity of mezlocillin (MZL, CAS 51481-65-3), piperacillin (PIP, CAS 61477-96-1) and cefotaxim (CTX, CAS 63527-52-6) alone and in combination with sulbactam (SBT; CAS 68373-14-8) against mezlocillin-resistant pathogens was determined in a multicenter study. A total of 870 strains were investigated (481 Enterobacteriaceae, 57 Pseudomonas aeruginos, 41 Acinetobaster spp., 194 Bacteroides fragilis, and 97 Staphylococcus spp.). Determinations of MIC were performed according to DIN-guidelines (agar-dilution method for aerobes and microbroth-dilution method for anaerobes). Sulbactam was added in fixed concentrations of 5 mg/l and 10 mg/l. In all sulbactam-combinations examined mean MIC as well as MIC50 and MIC90 were reduced compared to the respective values for the antibiotics alone. Consequently, percentages of susceptible strains increased significantly: i.e. for Enterobacteriaceae: MZL 1% vs. MZL + 10 mg/l SBT 53%; PIP 4% vs. PIP + 10 mg/l SBT 54%; CTX 52% vs. CTX + 10 mg/l SBT 68%. The effect of sulbactam was most pronounced in Bacteroides spp. with an increase in susceptible strains from 2% to 97% for MZL, from 6% to 95% for PIP and from 7% to 98% for CTX. The results indicate that by adding sulbactam the in vitro activity of mezlocillin, piperacillin and cefotaxim against resistant pathogens is augmented significantly. In addition, the spectrum of antibacterial activity is extended to anaerobic pathogens such as Bacteroides spp. The availability of sulbactam as a monosubstance for combination with various beta-lactam-antibiotics thus represents a useful improvement of therapeutic options in bacterial infections. PMID- 1781807 TI - [The biological availability of cefadroxil given simultaneously with N acetylcysteine]. AB - A preliminary study revealed that similarly to the antibiotics amoxillin, thiamphenicol, erythromycin and doxycycline, the oral cephalosporin cefadroxil (CAS 66592-87-8) can be administered simultaneously with the mucolytic n acetylcysteine (CAS 616-91-1). In the present study 12 healthy male volunteers received in a randomised cross-over design a single oral dose of 1000 mg cefadroxil or a single oral dose of 1000 mg cefadroxil (Bidocef) plus 200 mg n acetylcysteine. The two study days were separated by a wash-out period of one week. To determine the pharmacokinetic profile of cefadroxil, plasma and sputum were analysed by HPLC at defined intervals. Regarding the bioavailability of cefadroxil, the free combination is bioequivalent to the individual component. After administration of cefadroxil plus n-acetylcysteine, a higher cefadroxil concentration was found in the sputum compared to an administration of cefadroxil alone. However, the difference was not statistically significant. According to the results, simultaneous administration of the oral cephalosporin cefadroxil and the mucolytic n-acetylcysteine is possible without changes in the bioavailability of cefadroxil being observed. PMID- 1781808 TI - Comparative investigations on the bioavailability of cefuroxime axetil. AB - In a three-way cross-over study the bioavailability of cefuroxime was determined in 12 healthy volunteers after oral administration of 250 mg as cefuroxime axetil (Elobact; CAS 64544-07-6) in a plain aqueous suspension and as tablets from different batches. The tablet formulations showed nearly identical pharmacokinetic parameters and were bioequivalent. The mean maximum serum concentration was 4.7 micrograms/ml, achieved after 2.1 h. The serum half-live was 1.2-1.4 h, the area under the serum concentration-time curve was 14.3-14.4 micrograms/ml.h and the urinary recovery of unchanged cefuroxime was 54%. The bioavailability of cefuroxime after administration of cefuroxime axetil in aqueous suspension was lower, but bio-inequivalence was not demonstrated. PMID- 1781809 TI - Antifungal activity of the new agent latoconazole in two tinea models. AB - In vitro and in vivo antifungal activities of the new imidazole derivative latoconazole ((+-)-(E)-[4-(2-chlorophenyl)-1,3-dithiolan-2-ylidene]-1- imidazolylacetonitrile, NND-318; CAS 101530-10-3) were studied in comparison with three major topical agents, clotrimazole, bifonazole and tolnaftate. The in vitro activity of latoconazole against dermatophytes was much stronger than that of any reference agent tested. Both the recently developed tinea pedis model and the conventional tinea model in guinea pigs were employed for evaluation of topical usefulness of latoconazole. The 1% solution or cream preparation of latoconazole was highly effective in both of the two tinea models and its 5 or more doses achieved almost complete mycological cure. However, both tinea models, especially the former, were considerably resistant to the therapeutic treatment of all of the reference drugs. These results suggest that latoconazole is a promising topical antifungal agent, probably applicable to the treatment of tinea pedis as well as other types of dermatomycoses. PMID- 1781810 TI - [Reversal of multidrug resistance with (R)-verapamil in vitro and in vivo]. AB - The clinical use of racemic (R/S)-verapamil (CAS 52-53-9) as resistance modifier is limited because of the cardiovascular activity of the substance. The stereoisomer (R)-verapamil shows significant less cardiovascular activity. Therefore we tested the resistance modifying abilities of (R)-verapamil and (R/S) verapamil in murine multidrug-resistant L 1210 ascites-tumor-cells in vitro and in vivo. The present results demonstrate, that the (R)-isomer has the same resistance modifying effects as racemic verapamil. Both modifying substances have no effects in the parental (sensitive) and cytosine-arabinoside resistant L 1210 ascites-tumor-cells. Thus, (R/S)-verapamil and (R)-verapamil show their resistance modifying abilities only in multidrug-resistant tumor-cells. PMID- 1781811 TI - [Pharmacokinetic aspects of the combination of interferon-alpha-2b and folic acid with fluorouracil]. AB - The plasma levels of fluorouracil (5-fluorouracil, 5FU; CAS 51-21-8) after intravenous administration have been monitored without, under influence of interferon-alpha-2b (IFN) and under influence of IFN combined with folic acid (FA). IFN causes a highly significant change of the pharmacokinetic parameters of 5FU (p less than 0.001) compared to 5FU administration without IFN. The bioavailability of 5FU (compared as the AUC0-60 values) is elevated to 80%. In contrary, the combination of IFN with FA leads to a non-significant change of the 5FU pharmacokinetics, although the bioavailability is increased to 18%. The higher plasma levels of 5FU under the influence of IFN might be causes by a changed renal clearance, which is indicated by the reduction of the total plasma clearance at about 53%. The combination IFN/FA did not show a similar effect. Yet, in both cases an improvement of the tumor response and of the clinical picture could be observed. PMID- 1781812 TI - Migraine and vertebrobasilar ischemia. AB - I studied 9 patients with migraine and posterior circulation ischemia. Inclusion criteria were (1) brainstem or cerebellar infarcts or transient ischemic attacks, (2) satisfactory vertebrobasilar angiograms, and (3) migraine. Excluded were patients with only occipital lobe ischemia, known arteriosclerosis, or other nonmigrainous vascular disease. Two women and 7 men, ages 6 to 58 years (mean, 34.7), had transient attacks only (2), single strokes (4), single stroke followed by attacks (1), or multiple strokes (2). Five had antecedent classic, 2 common migraine, and classic migraine began only after the initial ischemic event in the other two. The 7 stroke patients all had CT- or MRI-documented brainstem (4) or cerebellar (6) infarcts. Angiography was normal (3) or demonstrated basilar artery (BA) narrowing (2) or occlusion (4), or branch occlusion (1). In 3 patients the initially occluded BA later reopened. At follow-up (average 4.3 years, range 1 to 9 years), 5 were normal and 4 had important clinical deficits. I conclude that (1) "basilar migraine" is not always benign; it affects both sexes and a wide age range; (2) the pattern of headaches, attacks, and strokes varies; (3) migraine may appear only after ischemia; (4) some patients have BA occlusion or diffuse narrowing; and (5) BA occlusion can be temporary. PMID- 1781813 TI - The influence of elastic compression stockings on deep venous hemodynamics. AB - To determine the effect of elastic compression stockings on deep venous hemodynamics we measured ambulatory venous pressure, venous refill time, maximum venous pressure with exercise, amplitude of venous pressure excursion, and duplex derived common femoral and popliteal vein diameter and peak flow velocities with and without stockings in 10 healthy subjects and 16 patients with chronic deep venous insufficiency. The effects of below-knee and above-knee 30 to 40 torr and 40 to 50 torr gradient stockings were studied. Despite documentation of substantial stocking compressive effects by skin pressure measurements, neither below-knee or above-knee elastic compression stockings significantly improved ambulatory venous pressure, venous refill time, maximum venous pressure with exercise, or the amplitude of venous pressure excursion in healthy patients or in patients with deep venous insufficiency (p greater than 0.05). In patients with deep venous insufficiency stockings modestly increased popliteal vein diameter and flow velocity in the upright resting position (p less than 0.02). After tiptoe exercise without stockings deep venous peak flow velocity increased in healthy patients and in patients with deep venous insufficiency by a mean of 103% in the popliteal vein and 46% in the common femoral vein (p less than 0.01). With the application of elastic compression stockings only modest augmentation of deep venous flow velocity occurred in both groups above that seen in the bare leg after exercise. Thus elastic compression stockings did not improve deep venous hemodynamic measurements in patients with deep venous insufficiency. The beneficial effects of stockings in the treatment of deep venous insufficiency must relate to effects other than changes in deep venous hemodynamics. PMID- 1781814 TI - The importance of preoperative evaluation of the subclavian vein in dialysis access planning. AB - Adequate venous outflow is critical to the proper function of a vascular-access graft (arteriovenous fistula) used for chronic hemodialysis. Stenosis of the subclavian vein can significantly compromise this venous outflow. The development of such subclavian vein stenoses has been associated with the prior placement of temporary subclavian vein dialysis catheters. We evaluated the importance of preoperative detection of these stenoses before placement of a permanent vascular access graft in the upper extremity. Upper extremity venography was performed before placement of a permanent vascular-access graft in 43 patients. A total of 62 extremities were evaluated. A 40% prevalence of moderate or severe subclavian vein stenosis was found in patients with prior or existing temporary dialysis catheters in the subclavian vein. No stenoses were found in patients without a history of dialysis catheters in the subclavian vein. This difference in the prevalence of subclavian vein stenosis is statistically significant (p less than .001). In no case was the stenosis suspected clinically. Before placement of a permanent vascular-access graft, the subclavian vein should be evaluated in all patients with a history of a temporary dialysis catheter in the subclavian vein. The use of sites other than the subclavian vein for temporary dialysis is strongly encouraged. PMID- 1781815 TI - Contraception--a look forward, Part I: New spermicides and natural family planning. AB - The number of contraceptive choices for couples in the United States has declined in recent years, as has public and corporate sponsorship of the development of new contraceptives. Nevertheless, there are many possibilities for future birth control methods under active investigation. Six of the most interesting of these are described in this three-part review. Part I examines new spermicides and natural family planning. Current spermicides, though popular, are limited in number, have strict requirements for effective use, and cause a number of side effects. Investigational agents promise greater efficacy, simpler use, longer duration, and fewer adverse effects. Natural family planning methods are the only ones acceptable to a large number of couples, but they are seriously flawed by unacceptably low use-effectiveness and intensity of training requirements. Home chemical assays for biological markers of the fertile period, including urinary hormones and cervical enzymes, may improve the acceptability and effectiveness of natural family planning. PMID- 1781816 TI - Program at Ontario university gives students taste of Third World medicine. PMID- 1781817 TI - Physicians, formula companies, and advertising. A historical perspective. AB - The recent advent of new advertising campaigns for infant formulas aimed at the general public via television commercials, newspapers, free formula coupons, and lay periodicals has disrupted a comfortable symbiotic relationship between infant food manufacturers and the medical profession that has endured for more than 50 years. In the late 19th century, physicians were concerned about the advertising claims of these products and generally felt that indications and directions for their use should be the province of the physician. Between 1929 and 1932, the American Medical Association, through its Committee on Foods and "Seal of Acceptance," essentially required the entire formula industry to advertise only to the medical profession. Since 1932, the US formula industry has developed into a $1.6 billion market. In 1988, Nestle (absent from the US infant formula industry since the 1940s) acquired the Carnation Company and launched an advertising campaign to the general public for its formula products. Bristol Myers/Mead Johnson, in cooperation with Gerber Products Company, quickly followed suit. These actions threaten to once again remove the realm of infant feeding from the exclusive supervision of the medical profession. The new multimedia public advertising campaigns may increase the cost of infant formula to the general public and have a negative impact on the incidence of breast-feeding. In addition, formula advertising campaigns will likely increase the danger of advertising hyperbole and affect the level of financial support by formula companies for scientific meetings, medical research, education, and social events at medical meetings. PMID- 1781818 TI - Ultrastructural study of Norrie's disease. AB - We studied the clinicopathologic and ultrastructural features of a full-term infant with Norrie's disease. The infant had bilateral retrolental fibrous vascular masses and retinal detachment with no other apparent physical abnormalities and no family history of ocular defects. A vitrectomy and a membrane peeling were attempted, and specimens of the retina, the retrolental membrane, and a vascularized epiretinal peripheral mass were examined by light and electron microscopy. The retrolental membrane was composed of layered collagenous tissue and contained structures resembling blood vessels. Inner and outer neuroblastic layers were identified in the retinal tissue, but no vessels were present. In the epiretinal mass, portions of retina and cortical vitreous were seen along with primitive vascular structures. The histologic appearance of these specimens suggests that the major pathologic event of Norrie's disease occurs in the retina in the third to fourth gestational month. We believe the subsequent ocular abnormalities found in this patient were secondary to this early retinal malformation and did not represent a progressive ocular disorder. PMID- 1781819 TI - Posttraumatic stress disorder following recent-onset psychosis. An unrecognized postpsychotic syndrome. AB - Clinical experience with psychotic patients early in the course of their illness suggested that symptoms of posttraumatic stress disorder (PTSD) may not be uncommon after recovery from an acute psychotic episode. Thirty-six patients recovering from an acute psychotic episode within 2 to 3 years of onset of their illness were assessed as inpatients and followed up on two occasions during the year after discharge. The prevalence of PTSD was found to be 46% at 4 months and 35% at 11 months, measured by a questionnaire linked to DSM-III criteria. The relationships between negative symptomatology and PTSD symptoms and between depressive symptomatology and PTSD symptoms were also examined; a significant correlation was found only for the latter. The psychopathological, preventive, and therapeutic implications of these findings are discussed, and future research strategies are proposed. PMID- 1781820 TI - Dystrophin expression and somatic reversion in prednisone-treated and untreated Duchenne dystrophy. CIDD Study Group. AB - The mechanism by which prednisone improves muscle strength and function in Duchenne muscular dystrophy (DMD) is unknown. We addressed the possibility that clinical improvement was related to prednisone-induced alterations in skeletal muscle dystrophin. We performed muscle biopsies on patients at the conclusion of a randomized, double-blind, 6-month trial of prednisone and analyzed dystrophin content using Western blots and antibody staining of tissue sections. These studies demonstrated no significant differences in dystrophin content between treatment (prednisone 1.5 mg/kg/d, n = 12; prednisone 0.75 mg/kg/d, n = 9) and placebo (n = 12) groups. Of interest, however, was the presence of varying numbers of dystrophin-positive fibers (revertants) occurring individually or in clusters in antibody-stained tissue sections of more than one-half of the Duchenne patients. Mutation analysis revealed that revertants occurred in DMD patients with identifiable deletions half of the Duchenne patients. Mutation analysis revealed that revertants occurred in DMD patients with identifiable deletions or duplications, and in nondeletion patients. Prednisone treatment did not influence the prevalence of revertants. Revertants are most likely due to a second-site mutation occurring in a somatic cell allowing for restoration of the translational reading frame of the dystrophin transcript. PMID- 1781821 TI - Preemployment evaluations: dilemmas for the family physician. AB - Preemployment evaluations present primary care physicians with numerous medical, ethical, and legal dilemmas. These examinations are especially problematic for community-based primary care providers unaccustomed to standards used by physicians in occupational settings. In response to a mailed questionnaire, 255 family physicians and general practitioners described their current methods of performing these examinations. Forty percent reported that employers routinely provide no information about the job for which the prospective employee is being evaluated. Respondents differed according to number and type of laboratory tests routinely included as part of a preemployment evaluation and in the proportion of prospective employees disqualified on the basis of the examination. Twenty-four percent reported no disqualifications, and 34 percent disqualified 5 percent or more. The percentage reporting medical and psychological information also varied. One-half routinely reported alcohol and drug abuse to employers, and of these, only one-half obtained a waiver for the release of such information. Five of every 6 physicians believed that it was more important to "tell the truth to the employer" than to "protect the interests of the employee." Our findings show that no consensus exists among the primary care physicians in our survey about the performance of preemployment evaluations. Because this can have serious consequences to workers, employers, and physicians, we propose guidelines for primary care physicians who perform preemployment evaluations. PMID- 1781822 TI - Comparison of ionic and non-ionic contrast agents in cardiac catheterization: the effects of ventriculography and coronary arteriography on hemodynamics, electrocardiography, and serum creatinine. AB - We compared two nonionic contrast agents (ioxaglate and iohexol) with an ionic agent (Renografin-76) on the effects of ventriculography and coronary arteriography on the hemodynamics, electrocardiography, and serum creatinine in one hundred consecutive patients. Patients were randomized to nonionic or ionic groups and were further evaluated regarding the effect of fluid loading prior to catheterization. The ionic agent more often produced subjective reactions (rash, nausea/vomiting). Following ventriculography, both ionic and non-ionic agents produced an increase in left ventricular end diastolic pressure and this effect was undetermined by fluid loading. Nonionic agents decreased aortic diastolic pressure following ventriculography and this effect was unaltered by fluid loading. In contrast, the ionic agent produced profound hemodynamic changes (drop in both systolic and diastolic pressures) following coronary arteriography and these effects were blunted by prior fluid loading. The ionic agent produced significantly greater heart rate slowing and prolongation of the QT interval than the nonionic agents, suggesting that the latter are potentially less arrhythmogenic. Comparing the two non-ionic agents, we found that both decreased aortic diastolic pressure and increased left ventricular end diastolic pressure following ventriculography. Iohexol produced greater heart rate slowing than did ioxaglate, though the increase was minor compared to the ionic agent. Neither nonionic agent appeared to significantly affect serum creatinine. In conclusion, the two nonionic agents appeared to offer significant advantages over the ionic agent in ventriculography and coronary arteriography. PMID- 1781823 TI - 20 simple things RDs can do to save the earth. PMID- 1781824 TI - Abortion attitudes and practices of family and general practice physicians. AB - BACKGROUND: Approximately 1.5 million abortions are performed each year in the United States. Little information has been published on the abortion attitudes and practices of family physicians. The object of this investigation was to assess the abortion attitudes and practices of family and general practice physicians in Kansas. METHODS: A 19-item self-administered survey questionnaire was designed and mailed to 856 family and general practice physicians in Kansas. RESULTS: A 63% survey response rate was obtained. Seventy-eight percent of the physicians reported that abortion should be legal, but only 56% of the respondents classified themselves as pro-choice. Conversely, only 8% reported that legal abortion should not be available, even though 33% classified themselves as pro-life. The majority of physicians reported that abortion is an appropriate option to save the life of the mother, in cases of rape or incest, and when a fetal anomaly is diagnosed. Only three respondents (0.5%) had performed abortions during the previous year. In general, female physicians and physicians over the age of 40 years (regardless of sex) were more likely to be pro-choice and to view a woman's personal decision as a circumstance in which abortion may be appropriate. CONCLUSIONS: Physician's views about abortion and their practice patterns are important components of health care for thousands of women each day. PMID- 1781825 TI - Food for New Zealanders. PMID- 1781826 TI - Creutzfeldt-Jakob disease and blood transfusion. PMID- 1781828 TI - Making sense of venepuncture. PMID- 1781827 TI - Eating disorders in young adults with insulin dependent diabetes mellitus: a controlled study. AB - OBJECTIVE: To determine the prevalence of clinical eating disorders and lesser degrees of disturbed eating in young adults with insulin dependent diabetes and a matched sample of non-diabetic female controls. DESIGN: Cross sectional survey of eating habits and attitudes in diabetic and non-diabetic subjects. SETTING: Outpatient clinic catering for young adults with diabetes; community sample of non-diabetic women drawn from the lists of two general practices. SUBJECTS: 100 patients with insulin dependent diabetes (54 women and 46 men) aged 17-25 and 67 non-diabetic women of the same age. MAIN OUTCOME MEASURES: Eating habits and eating disorder psychopathology were assessed by standardised research interview adapted for the assessment of patients with diabetes (eating disorder examination). Glycaemic control was assessed by glycated haemoglobin assay. RESULTS: In both non-diabetic and diabetic women disturbed eating was common, and in diabetic women the degree of disturbance was related to control of glycaemia. Twenty of the diabetic women (37%) had omitted or underused insulin to influence their weight. This behaviour was not restricted to those with a clinical eating disorder. None of the men showed any features of eating disorders, and none had misused insulin to influence their weight. CONCLUSIONS: There was no evidence that clinical eating disorders are more prevalent in young women with diabetes than in non-diabetic women. Nevertheless, disturbed eating is common and is associated with poor control of glycaemia, and the misuse of insulin to influence body weight is also common in young women with diabetes. PMID- 1781829 TI - Businesses face uneasy situations with sexual harassment issues. PMID- 1781830 TI - Vitamin D deficiency in elderly people. PMID- 1781831 TI - The impact of lithium on human leukemic cells. PMID- 1781832 TI - Collagen injections. PMID- 1781833 TI - Terminology of hemolytic-uremic syndrome. PMID- 1781834 TI - Medial palpebral tendon repair for medial ectropion of the lower eyelid. PMID- 1781835 TI - Delayed human immunodeficiency virus-1 seroconversion in a hemophilia B patient in Japan. PMID- 1781837 TI - Efficacy of captopril in postponing nephropathy. PMID- 1781836 TI - Condylomata acuminata and risk of cancer: an epidemiological study. AB - OBJECTIVE: To determine whether patients with condylomata acuminata have an increased risk of developing cancer. DESIGN: Prospective cohort study on patients diagnosed as having condylomata acuminata. The number of malignant tumours in the cohort was compared with national incidences obtained from the Swedish Cancer Registry. SETTING: Dermatology department of the Karolinska Hospital, Stockholm, Sweden. SUBJECTS: 3260 patients (2549 males and 711 females, median (range) age 23 (1-80) years) seen during 1969-84, with a mean follow up of 7.8 years. MAIN OUTCOME MEASURES: Number of malignant tumours observed in the cohort during the study period and expected number from national incidence. RESULTS: There were 27 malignancies in the study group. There was no significant increase genital cancer in females compared with the national incidence. Only one patient had invasive cervical cancer (relative risk = 1.8; 95% confidence interval 0 to 10.1). Seventeen women had cervical carcinoma in situ (1.5; 0.9 to 2.5) compared with an expected number of 11.5; this increase was not significant. For males 22 cancers were observed at all sites (1.6; 1.0 to 2.5). The number of genitourinary cancers observed in males was almost three times higher than expected (2.6; 1.2 to 5.0). CONCLUSION: The results indicate that the risk of developing cervical carcinoma in situ or invasive cervical cancer after a genital human papillomavirus infection is less than previously thought. The implications of increase in the genitourinary malignancies in males are uncertain. PMID- 1781838 TI - Terodiline and torsades de pointes. PMID- 1781839 TI - Vital statistics of births. PMID- 1781840 TI - Prisoners with psychiatric disorders. PMID- 1781842 TI - A tax on infertility? PMID- 1781841 TI - Health informatics in the undergraduate curriculum. PMID- 1781843 TI - Neonatal screening programme for phenylketonuria. PMID- 1781844 TI - Growth of asthmatic children. PMID- 1781845 TI - New deal for old hearts. PMID- 1781846 TI - Special report on Quebec creates controversy. PMID- 1781847 TI - Jehovah's Witness. PMID- 1781848 TI - Chronic cough. Sometimes you have to look at a tree to see the forest. PMID- 1781849 TI - An immunoinhibitory cell wall glycoprotein (Mannan) from Trichophyton rubrum. PMID- 1781850 TI - Brain metastasis and lung carcinoma. PMID- 1781851 TI - Bio-psycho-social diagnosis: the Achilles' heel of medicine. PMID- 1781852 TI - Civilian gunshot wounds to the head. PMID- 1781853 TI - Brainstem infarct. PMID- 1781854 TI - Postoperative examination for endophthalmitis. PMID- 1781855 TI - Laboratory investigations utilizing dogs. PMID- 1781856 TI - Development of resistance to ciprofloxacin during therapy for a Pseudomonas aeruginosa lung abscess. PMID- 1781857 TI - Outbreak of 'tetanus'. PMID- 1781858 TI - Medical diets for dogs and cats. PMID- 1781859 TI - Birth order in multiple sclerosis. PMID- 1781860 TI - Preemployment evaluation. PMID- 1781861 TI - Cervical spondylolysis. PMID- 1781862 TI - Defensiveness and lifetime prevalence of psychiatric disorder. PMID- 1781863 TI - Safer use of MAOIs with nifedipine to counteract potential hypertensive crisis. PMID- 1781864 TI - Effects of midazolam and/or butorphanol. PMID- 1781865 TI - Muscle infarction in sickle cell anemia. PMID- 1781866 TI - Porphyria cutanea tarda and acquired immunodeficiency syndrome: pathogenetic implications. PMID- 1781868 TI - Mammary artery grafts. PMID- 1781867 TI - Atrial natriuretic peptide and blood volume during red cell transfusion in preterm infants. PMID- 1781869 TI - Medication-induced bilateral anterior uveitis. PMID- 1781871 TI - Cellular basis of bilirubin toxicity. PMID- 1781870 TI - Progression of HIV disease in a haemophilic cohort followed for 11 years and the effect of treatment. AB - OBJECTIVE: To describe the progression of HIV disease in a haemophilic cohort and to show the influence of treatment. DESIGN: 11 year longitudinal clinical and laboratory study. SETTING: A haemophilia centre. PATIENTS: 111 patients infected with HIV during October 1979 to July 1985. MAIN OUTCOME MEASURES: Symptoms of HIV infection, AIDs, and death. INTERVENTIONS: 26 asymptomatic patients started taking zidovudine or placebo (1000 mg/day) during November 1988 to February 1990; 10 patients with CD4+ counts of 0.2 x 10(9)/l started zidovudine 500 mg/day during January to November 1990. 35 patients used pentamidine for primary or secondary prophylaxis. RESULTS: At 11 years from seroconversion the estimated rate of progression to AIDS was 42% (95% confidence interval 27% to 57%); to symptoms 85% (75% to 95%); and to death 41% (25% to 57%). Progression to AIDS was significantly faster in patients aged 25 and over than in those aged less than 25 (relative risk 5.0 (2.4 to 10.4); p less than 0.00001) and in those with previous cytomegalovirus infection than in those not infected (relative risk 3.0 (1.4 to 6.8); p = 0.006). 16 of 27 (59%) patients with p24 antigenaemia developed AIDS compared with 17 of 84 (20%) patients without p24 antigen (p less than 0.001). The risk of progression to AIDS before 30 November 1988 in patients with CD4+ counts less than or equal to 0.2 x 10(9)/l was higher than after November 1988 (relative risk 1.9 (0.85 to 4.43); p = 0.1). For 1989 and 1990 the observed cumulative numbers of AIDS cases (among 81 patients with sufficient CD4+ counts) were 22 and 25 compared with 29 and 37 predicted from the rate of fall of CD4+ counts up to the end of 1988 (p = 0.03). CONCLUSION: Treatment seems to be reducing the progression of HIV disease in this haemophilic cohort. PMID- 1781873 TI - Cement thickness and microleakage under Dicor crowns: an in vivo investigation. AB - This in vivo study recorded the microleakage and marginal discrepancies of cast glass-ceramic cemented crowns compared to gold onlays and a metal ceramic restoration. Within the limits of the small number of samples and the variables inherent in an in vivo study, it was found that (1) dentin bonding agents are not strong enough to produce a gap-free cementation, (2) the marginal adaptation of beveled metal restorations is better than that of glass-ceramic crowns, and (3) the marginal adaptation of cast glass-ceramic crowns is clinically acceptable. PMID- 1781872 TI - In vitro shear bond strength of dentin adhesives. AB - This in vitro study compared the shear bond strengths of current dentin adhesives. Freshly extracted human molars were prepared to a flat surface and treated with dentin adhesives and composite resin light polymerized in a plastic matrix. Completed samples were stored in 37 degrees C water and thermocycled 1,500 times. Samples were sheared at the tooth/composite resin interface using a wire loop. The reliability index varied significantly between materials. Large coefficients of variation were found for all dentin adhesives. One dentin adhesive was able to achieve a bond strength to dentin that was 47% of the control bond strength of enamel. PMID- 1781874 TI - An investigation of an ion strengthening paste for dental porcelains. AB - The effect of a commercial ion exchange paste on the tensile strength of high- and low-expansion dental porcelains was investigated. Strength measurements were correlated with changes in surface chemistry. The paste was found to be more effective for aluminous porcelains than for an inlay ceramic, although only when applied to the surface placed in tension. Surface finish also influenced the effectiveness of the paste. The depth of ion exchange was assessed by energy dispersive x-ray analysis and was found to extend to at least 100 microns, although the most marked change occurred within a 10-microns layer below the surface. PMID- 1781875 TI - Clinical use of a new castable glass ceramic material. AB - The dimensional change of a new castable ceramic material (CD-200) was measured after casting, ceramming, and surface coloring. The marginal and internal adaptations of single crowns were evaluated, as was the fracture strength of single crowns and fixed partial dentures. The material expanded 0.57% after casting, ceramming, and application of surface colorant. Marginal openings ranged between 2.8 and 11.2 microns. Single crowns exhibited fracture strengths lower than or comparable to Dicor single crowns, and fixed partial dentures made from CD-200 were weaker than those fabricated with Dicor. PMID- 1781876 TI - The effect of surface treatment on the Knoop hardness of Dicor. AB - One advantage cited for the use of Dicor over other ceramic materials is a reported Knoop hardness comparable to human enamel. However, when fabricating dental restorations, a Dicor glass-ceramic casting generally is subjected to several different surface treatments because of processing, esthetic, and functional requirements. Therefore, this study compared the Knoop hardness of Dicor specimens under three conditions: (1) cerammed, (2) cerammed and shaded, and (3) sectioned to reveal internal material. Knoop hardness differences between groups were significant (P less than or equal to .05). The cerammed surface was the hardest; it was harder than human enamel. Shaded specimens had a surface hardness comparable to dental porcelain. However, the internal glass-ceramic material, located beneath the shading porcelain and cerammed surface, had a Knoop hardness slightly higher than that of human enamel. PMID- 1781877 TI - Ion release from Ni-Cr-Mo and Co-Cr-Mo casting alloys. AB - The substance loss from four commercially available Ni-Cr-Mo and four Co-Cr-Mo alloys was examined using a solution of 0.1 mol/L lactic acid and 0.1 mol/L sodium chloride. Dissolved ions were analyzed over a 5-week period using atomic absorption spectroscopy. The results revealed a considerable range of corrosion rates among the Ni-Cr-Mo alloys, with average values after 35 days between 0.54 and 3,261 micrograms/cm2, while the distribution of values for the Co-Cr-Mo alloys was not as wide--between 0.43 and 34.9 micrograms/cm2. PMID- 1781878 TI - The polished surface contour: a new approach. AB - Proper shaping of the polished surface of a denture is important to facilitate the intraoral manipulation and control of the prosthesis by the patient. A method for the assessment of the polished surface form and tooth position in processed dentures is described. Low-viscosity silicone impression material is placed on the dentures, and the patient's chewing movements are used to define those areas requiring modification. PMID- 1781879 TI - Force versus time profiles of selected heat-processed denture liners. AB - The potential correlation of the force versus time behavior of four resilient lining materials and their acceptance by patients was investigated. Two modified acrylic resins and two silicone denture lining materials were tested. The response of the soft lining materials to a programmed indentation test was used to define a parameter for each denture liner product. A parameter defined as the "Rebound Index," using force-time data obtained from the indentation measurements, was significantly different for the modified acrylic resins compared to the silicone materials. Improved patient acceptance was correlated with higher values of this index. PMID- 1781880 TI - The dimensional accuracy of 12 impression material and die stone combinations. AB - This study determined the dimensional accuracy of dies made using a combination of four impression materials and three Type IV die stones. A metal die was prepared for a molar complete cast crown, and 10 stone replicas were made using 12 different combinations of impression materials and die stones. The distances between reference points on the metal and stone dies were measured in three directions with a traveling microscope. Analysis of variance and Duncan's MR comparisons (P less than or equal to .05) showed that all of the stone dies were larger than the metal die. Although there were significant differences between some of the impression material/die stone combinations, all of the stone dies were measured to be within 9 microns of each other. No one impression material/die stone combination consistently produced the smallest or largest die in the three measured directions. PMID- 1781881 TI - Retention profiles of stud-type precision attachments. AB - This study measured the retention profiles of 11 commercially available stud-type attachment systems suitable for use with overdentures. The vertical distance over which resistance to separation existed was recorded and related to the configuration of the attachments. In many of the systems tested, only a small portion of the vertical length of the attachment contributed to the retention of the unit. PMID- 1781882 TI - Antimicrobial effects from incorporation of disinfectants into gypsum casts. AB - Five microorganisms--Escherichia coli, Streptococcus mutans, Staphylococcus aureus, Serratia marcescens, and Bacillus subtilis--were placed into the canine, first premolar, first molar, and second molar of sterilized quadrant addition reaction silicone impressions. Four disinfectant solutions--iodophor, neutral glutaraldehyde, phenol, and sodium hypochlorite--were spatulated with sterilized Type IV stone and vibrated into the intentionally contaminated impressions. The casts were removed at 1 and 24 hours, and the surfaces were swabbed, plated on BHI agar, and incubated at 37 degrees C for 3 days. Colony forming units were counted. At 1 hour, only sodium hypochlorite and glutaraldehyde effectively reduced the number of bacteria to the negative control. Incorporation of sodium hypochlorite, glutaraldehyde, and iodophor into gypsum casts reduced viable bacteria to a level equal to the negative controls at 24 hours. PMID- 1781884 TI - Stoichiometric complexation of Streptomyces subtilisin inhibitor and subtilisin. AB - Subtilisin (Sbt) and Streptomyces subtilisin inhibitor (SSI) were analyzed either alone or together using sodium dodecylsulfate (SDS)-polyacrylamide gel electrophoresis (PAGE). With all ratios of Sbt to SSI tested, the proteins formed a stoichiometric complex, and migrated abnormally at the top of the gel. Electroblotting and amino acid sequence analysis of the complex band showed both Sbt and SSI present at approximately equal molar ratios. When excess Sbt was present, it migrated as a free but still folded form slightly above the band corresponding to the complex. When excess SSI was present, it migrated as several species with molecular weights smaller than the intact form; in fact, the sequences of some of these species indicated that they lacked different amounts of N-terminal and possibly C-terminal residues. PMID- 1781885 TI - Active prorenin: evidence for the formation of a conformational variant of recombinant human prorenin. AB - Using highly purified recombinant human prorenin, we report the first evidence for the formation of a stable, partially active, conformational variant of the recombinant proenzyme. The enzymatically active prorenin exhibits the following characteristics: (1) the proenzyme N-terminal sequence and molecular weight are maintained; (2) the active proenzyme is capable of cleaving a novel fluorogenic peptide substrate based on the sequence of human angiotensinogen and exhibits about 30% of mature renin specific activity for the fluorogenic substrate; (3) the active proenzyme conformation binds to, and can be eluted from, a pepstatin affinity column; and (4) the activity of the active proenzyme can be inhibited by a novel peptidomimetic renin inhibitor. PMID- 1781883 TI - Heptad motifs within the distal subdomain of the coiled-coil rod region of M protein from rheumatic fever and nephritis associated serotypes of group A streptococci are distinct from each other: nucleotide sequence of the M57 gene and relation of the deduced amino acid sequence to other M proteins. AB - Streptococcal M protein, a dimeric alpha helical coiled-coil molecule, is an antigenically variable virulence factor on the surface of the bacteria. Our recent conformational analysis of the complete sequence of the M6 protein led us to propose a basic model for the M protein consisting of an extended central coiled-coil rod domain flanked by a variable N-terminal and a conserved C terminal end domains. The central coiled-coil rod domain of M protein, which constitutes the major part of the M molecule, is made up of repeating heptads of the generalized sequence a-b-c-d-e-f-g, wherein "a" and "d" are predominantly apolar residues. Based on the differences in the heptad pattern of apolar residues and internal sequence homology, the central coiled-coil rod domain of M protein could be further divided into three subdomains I, II, and III. The streptococcal sequelae rheumatic fever (RF) and acute glomerulonephritis (AGN) have been known to be associated with distinct serotypes. Consistent with this, we observed that the AGN associated M49 protein exhibits a heptad motif that is distinct from the RF associated M5 and M6 proteins. Asn and Leu predominated in the "a" and "d" positions, respectively, in subdomain I of the M5 and M6 proteins, whereas apolar residues predominated in both these positions in the M49 protein. To establish whether the heptad motif of M49 is unique to this protein, or is a general characteristic of nephritis-associated serotypes, the amino acid sequence of M57, another nephritis-associated serotype, has now been examined. The gene encoding M57 was amplified by PCR, cloned into pUC19 vector, and sequenced. The C-terminal half of M57 is highly homologous to other M proteins (conserved region). In contrast, its N-terminal half (variable region) revealed no significant homology with any of the M proteins. Heptad periodicity analysis of the M57 sequence revealed that the basic design principles, consisting of distinct domains observed in the M6 protein, are also conserved in the M57 molecule. However, the heptad motif within the coiled-coil subdomain I of M57 was distinct from M5 and M6 but similar to M49. Similar analyses of the heptad characteristics within the reported sequences of M1, M12, and M24 proteins further confirmed the conservation of the overall architectural design of sequentially distinct M proteins.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1781886 TI - Chemical modification of Pseudomonas fluorescens malonyl-CoA synthetase by diethylpyrocarbonate: kinetic evidence for an essential histidyl residue on alpha subunit. AB - Malonyl-CoA synthetase from Pseudomonas fluorescens was inactivated by diethylpyrocarbonate (DEP) with the second-order rate constant of 775 M-1 min-1 at pH 7.0, 25 degrees C, showing a concomitant increase in absorbance at 242 nm due to the formation of N-carbethoxyhistidyl derivatives. The inactivated enzyme at low concentration of DEP (less than 0.2 mM) could be completely reactivated by hydroxylamine but not completely reactivated at high concentration (greater than 0.5 mM), indicating that there may be another functional group modified by DEP. Complete inactivation of malonyl-CoA synthetase required the modification of seven residues per molecule of enzyme; however, only one is calculated to be essential for enzyme activity by a statistical analysis of the residual enzyme activity. pH dependence of inactivation indicated the involvement of a residue with a pK alpha of 6.7, which is closely related to that of histidyl residue of proteins. When alpha subunit treated with DEP was mixed with beta subunits complex, the enzyme activity completely disappeared, whereas when beta subunit complex treated with the reagent was mixed with alpha subunit, the activity remained. Inactivation of the enzyme by the reagent was protected by the presence of malonate and ATP. These results indicate that a catalytically essential histidyl residue is located at or near the malonate and ATP binding region on alpha subunit of the enzyme. PMID- 1781887 TI - Clostridium botulinum types A, B, C1, and E produce proteins with or without hemagglutinating activity: do they share common amino acid sequences and genes? AB - Clostridium botulinum produce the antigenically distinct 150 kD neurotoxin serotypes (e.g., A, B, C1, and E) and simultaneously proteins, A Hn+, B Hn+, C Hn+, and E Hn-, that have high, low, and no hemagglutinating activity. A Hn+ and B Hn+ are serologically cross-reactive. A Hn+, B Hn+, and C Hn+ found as large aggregates (900-220 kD) can be dissociated on SDS-PAGE into multiple subunits, the smallest for A Hn+, B Hn+ is 17 kD and 27 kD for C Hn+. The 116 kD E Hn- does not aggregate. We determined the sequences of 10-33 amino terminal residues of the 17, 21.5, 35, and 57 kD subunits of A Hn+ and B Hn+. Each of these subunits have unique sequences, indicating that the larger units studies are not homomers or heteromers of smaller units. The subunits of A Hn+ and B Hn+ of comparable size have striking sequence identity (e.g., 21.5 kD subunits from the two are identical and 57 kD subunits have 80% identity). In vitro proteolysis of 116 kD E Hn- with different proteases did not impart hemagglutinating activity to the fragments. The 116 kD E Hn- and one of its proteolytic fragments (87 kD) were partially sequenced. Sixty-two base pairs downstream from the termination codon of the cloned 33 kD subunit of C Hn+, there is an initiation codon followed by an open reading frame for at least 34 amino acid residues (Tsuzuki et al., 1990). The derived amino acid sequence of this open reading frame, we found, has 73-84% sequence identity with those of the 17 kD subunits of A Hn+ and B Hn+ and significant identity with the N-terminal of E Hn-. These highly conserved sequences show existence of genetic linkage among the Hn+ and Hn- proteins. PMID- 1781889 TI - [Pharmacognostical studies on the ethnic substitutes of duzhong derived from Euonymus spp]. AB - Macro-and microscopic characters were observed on the more popular ethnic substitutes of dutzhong derived from 21 species of Euonymus (Celastraceae). A chart of major characters and a key to each species are given. PMID- 1781890 TI - [Karyotype analysis on bulbus Lilii]. AB - A karyotype analysis has been made of the chromosome of five original species of Lilium. Lanceleaf Lily is the allotriploid. PMID- 1781888 TI - Basic fibroblast growth factor is a beta-rich protein. AB - The conformation of the 153-residue form of human basic fibroblast growth factor (bFGF) was studied with circular dichroism (CD) and sequence prediction methods. The far-UV CD spectrum with a minimum at 202 nm resembled that of an unordered polypeptide/protein or a protein rich in distorted antiparallel beta-sheets. Analysis of the CD spectrum by the least-squares method of Chang et al. (1978) and the CONTIN program of Provencher and Glockner (1981) suggested that about one half of the molecule consisted of beta-sheet and there was no alpha-helix. These estimates agreed with the prediction by the sequence method of Garnier et al. (1978) using decision constants based on CD results. bFGF had an unusual CD band at 187 nm, which disappeared upon ionization of Tyr side chains at pH 11.7. It also had another unusual property of irreversibly converting the CD spectrum to a helix-like one with a double minimum at 205 and 215 and a maximum at 189 nm upon heating the solution to above 55 degrees C. The helicity was also enhanced in trifluoroethanol and in sodium dodecyl sulfate. The mutant bFGF in which cysteines 76 and 94 were replaced by serine residues had essentially the same properties as the wild-type. PMID- 1781891 TI - [Determination of myristicin and safrol in the volatile oil of semen Myristicae and its processed products by TLC-scanning]. AB - This paper reports the determination of myristicin and safrol in the volatile oil of Semen Myristicae and its processed products by TLC-Scanning. The results showed that in the processed products myristicin decreased markedly and safrol decreased slightly. The quantity of myristicin roasted with paste less than with wheat bran less than with talcum powder less than the unprocessed one. The toxicity of Semen Myristicae is related to the quantities of myristicin. PMID- 1781892 TI - [Analysis of Trace elements in processed products of Pinellia ternata (Thunb.) Breit]. AB - This article reports the detecting result of trace elements in processed products of Pinellia ternata and of the contents of As, Hg, Pb in the products processed with sulfur. The result shows that all the processing procedures are necessary and safe. PMID- 1781893 TI - [Application of differential derivative spectrophotometry to the determination of total chlorogenic acid in Lonicera japonica Thunb. and yinqiao jiedu pian]. AB - The total chlorogenic acid in Lonicera japonica and yinqiao jiedu pian was determined by differential derivative spectrophotometry in this paper. Quantitative analysis of this component in eight mixtures of medicinal herbs can be done without any separation. The average recovery of total chlorogenic acid is 100.40 +/- 1.82% (CV). The method features good reproducibility, favorable stability and high sensitivity. PMID- 1781894 TI - [Experiment on stability of total flavones in guanshu tablet]. AB - This paper reports the study on the stability of total flavones in guanshu tablet by heating and accelerating method. Taking the total flavone contents of the tablet as the index, the time of validity of guanshu tablet at room temperature 25 degrees C is calculated to be 9.6 years by chemical kinetic analysis. PMID- 1781895 TI - [Constituents of the root of Berneuxia thibetica Decne]. AB - Three crystals have been isolated from the root of Berneuxia thibetica. On the basis of spectral data, crystals A and B have been identified as chrysosplenetin B and 22,23-dihydrospinasterone respectively, while crystal C is a mix of spinasterol and 22,23-dihydrospinasterol. PMID- 1781896 TI - [Isolation and structure determination of furan sesquiterpene from Chinese traditional herb ezhu (rhizome of Curcuma zedoaria Rosc.)]. AB - It has been reported that curdione is a major component in Chinese traditional herb ezhu. But no curdione was found in the herb ezhu collected from Guangdong province, instead a furan sesquiterpene was isolated. Its structure and configuration were determined by the analysis of IR, UV, MS, NMR and circular dichroism. PMID- 1781897 TI - [Isolation and identification of aloesin from the leaves of Aloe vera L. var, chinensis (Haw.) Berger]. PMID- 1781898 TI - [Quantitative analysis of calcium bilirubin in calculus bovis by infrared spectrometry]. AB - This paper reports the method of quantitative analysis of calcium bilirubin in calculus bovis by infrared spectrometry. This method is simple and quick, requiring no separation and only small amount of sample, not destroying the sample and having few interferences. PMID- 1781899 TI - [The absorption of Fe, Zn, Cu in siwu, sijunzi, and Liuwei dihuang decoction by small intestine in rats]. AB - In this study the absorption of Fe, Zn and Cu in decoctions of siwu decoction, sijunzi decoction and liuwei dihuang decoction by the small intestine in anesthetized rats was observed. The experimental results showed that the absorption of Cu and Fe from siwu decoction was much higher than that from other decoctions which might be related to the hematopoietic function of Cu and Fe rich in the decoction. PMID- 1781900 TI - [Comparison of Spatholobus suberectus Dum, Euonymus alatus (Thunb.) Sieb. and Eupolyphaga sinensis Walker on regulation of plasma lipid]. AB - The Spatholobus suberectus (SS) of hexue type, the Euonymus alatus (EA) of huoxue type and the Eupolyphaga sinensis (ES) of poxue type were selected and their influence on plasma lipid in the experimental hyperlipidemia quails was observed. The ES could raise plasma HDL-C/TC ratio and increase LCAT activity. The SS could raise plasma HDL2-C/HDL3-C ratio. The effect of EA on plasma HDL-C/TC, HDL2 C/HDL3-C and LCAT levels was between SS and ES. All the three huoxue huayu Chinese drugs could lower plasma HDL3-C level and slow down the progress of atherosclerosis to a certain degree. The above-mentioned results show that certain orders exist between the action range of huoxue huayu drugs and their effect on regulating plasma lipid. PMID- 1781901 TI - [Effect of alcohol-extract from scorpion on checking externally active cysticerus cellulosae]. AB - Putting the alcohol-extract from scorpion in the ordinary aqueous solution of 15% pork bile and having it cultured at the temperature of 37 degrees C have proved for the first time that in contrast with the chemical albendazole, Scorpion has a conspicuous effect on the external killing of the cysticercus cellulosae, The action of killing cysticercus cellulosae has almost nothing to do with the difference of processed products or of the parts used in medicine. PMID- 1781902 TI - [Nursing in 1991 and 1992: Cheers!]. PMID- 1781904 TI - [The nurse specialist and professional content]. PMID- 1781903 TI - [Assistance in suicide--a contribution to the discussion]. PMID- 1781905 TI - [Saint Anthony Hospital Sneek--moving and renewal]. PMID- 1781906 TI - [Observation and documentation simply must improve. Harry van der Bruggen and the bowel movement. Interview by Toine de Graaf and Tonny van de Pasch]. PMID- 1781907 TI - [As guest in Lithuania]. PMID- 1781908 TI - [Nutrition in heart and vascular diseases. Heart for your heart? Know and measure what you eat!]. PMID- 1781909 TI - [Chepkono, in the heart of a paradise]. PMID- 1781910 TI - [Is quality determined by the director? The role of hospital administration in quality assurance]. PMID- 1781911 TI - [Developments in the labor market (2). Psychiatric hospitals]. PMID- 1781912 TI - Gas chromatography and mass spectrometry of dimethylethylsilyl ether derivatives of norethisterone metabolites in plasma. AB - Metabolites isolated from human plasma after oral administration of norethisterone were assayed as their novel dimethylethylsilyl ether derivatives by gas chromatography--mass spectrometry--ion selective monitoring. The major metabolite is 3 alpha, 5 alpha-tetrahydronorethisterone. The unchanged drug is present in a measurable amount even after 8 h of drug administration. The method is accurate, precise and highly sensitive. PMID- 1781913 TI - Structure elucidation of the photolysis and hydrolysis products of tinidazole. AB - A labile intermediate in the photolytic rearrangement of the antibacterial drug tinidazole was isolated after photolysis of the drug in acetone. The intermediate was identified through structural studies as 1-[2-(ethylsulphonyl)ethyl]-2-methyl 4-hydroxyimino-5-oxo-im idazole. A second product was identified as N-[2 (ethylsulphonyl)ethyl]-5-methyl-1,2,4-oxadiazole-3-carboxa mid e. A different compound, N-[2-(ethylsulphonyl)ethyl]-oxamide, crystallized in an ethanolic solution of tinidazole exposed for four months on a sunny window sill. Tinidazole was hydrolyzed completely to 2-methyl-5(4)-nitroimidazole when refluxed in 0.1 M NaOH solution, and was converted to 4-nitro isomer when refluxed in water with a catalytic amount of base. PMID- 1781914 TI - Chewing gum and lozenges as delivery systems for noscapine. AB - Chewing gum and lozenges were evaluated as delivery systems for noscapine with the aim of developing improved antitussive preparations. The formulations studied were prepared with both the water-soluble hydrochloride salt of noscapine and with the poorly soluble embonate salt and noscapine free base. The release characteristics of the preparations were evaluated both in vitro and in vivo, and their taste properties examined. Only the formulations containing noscapine base were without any appreciable taste. Chewing gum containing this compound showed, however, a low level of drug release both in vitro and in vivo and is therefore not a suitable dosage form. Only a lozenge formulation containing noscapine base fulfilled the requirements of taste acceptability and adequate release properties. PMID- 1781915 TI - Synthesis, enzymatic hydrolysis and physico-chemical properties of N-substituted 4-(aminomethyl)benzoate diester prodrugs of ganciclovir. AB - Various N-substituted 4-(aminomethyl)benzoate diesters of ganciclovir were synthesized and evaluated as prodrug forms with the aim of improving the delivery characteristics of ganciclovir. The esters were hydrolyzed enzymatically by human plasma to the parent drug, the hydrolysis proceeding through formation of the corresponding monoester. The nature of the amino substituents had a marked influence on the rate of enzymatic hydrolysis, the most enzymatically labile ester being the 4-(morpholinomethyl)benzoate derivative. All esters were more lipophilic than ganciclovir in terms of octanol-pH 7.4 buffer partition coefficients. These properties combined with good aqueous solubility and high chemical stability in weakly acidic solutions make the N-substituted 4 (aminomethyl)benzoate diesters a promising prodrug type for ganciclovir to enhance its delivery characteristics for e.g. parenteral administration. PMID- 1781916 TI - Disposition of alprazolam in human volunteers. Differences between genders. AB - The disposition of alprazolam in 16 young healthy volunteers (eight females and eight males) was investigated. All volunteers were given a 1 mg dose of alprazolam. Dose/kg was 13.3 micrograms/kg (SD +/- 0.89 micrograms/kg) on average for male volunteers and 17.5 micrograms/kg (SD +/- 1.84 micrograms/kg) for the female volunteers. Pharmacokinetic parameters were calculated separately for both sexes in order to detect possible gender-dependent differences. The elimination rate constant (beta) for alprazolam proved to be significantly higher in the female population 0.067 hr-1 vs. 0.053 hr-1 (p = 0.03). The closely related parameters, elimination half-life (t1/2) and clearance (Cl) were also significantly different. The total area under the serum concentration curve (AUCtot), maximum serum concentration (cmax) and volume of distribution (Vd) were not significantly different. AUCtot corrected for differences in dose/kg was on the other hand significantly higher in males (p = 0.003) while cmax corrected in the same manner was not. PMID- 1781917 TI - Chemical compatibility of mitoxantrone and etoposide (VP-16). PMID- 1781918 TI - Effects of GM1 ganglioside upon neuronal degeneration during withdrawal from alcohol. AB - In previous studies we demonstrated that chronic alcohol consumption induced hippocampal cell and synapse loss in offset with an increase in the length of granule cell dendrites. In addition we observed that withdrawal after long periods of alcohol intake worsened the degenerative processes and that dendritic alterations were no longer apparent. In an attempt to reverse these structural changes we tested the action of GM1 ganglioside during the withdrawal period as there is evidence that GM1 may enhance neuronal recovery after different kinds of brain lesions. Cell and synaptic quantifications were performed and the branching pattern of the granule cell dendritic arborizations was analysed. The number of dentate granule and CA3 pyramidal cells from GM1-treated animals was found not to be significantly different from that of the alcohol-treated and withdrawal groups. No quantitative changes were found in the number of mossy fiber-CA3 pyramidal cell synapses when the aforementioned groups were compared. Whether the lack of effectiveness of GM1 can be related to the model employed or not is thoroughly discussed. PMID- 1781920 TI - Studies of urine-associated acetaldehyde as a marker for alcohol intake in mice. AB - A study was undertaken in 16 male C57BL mice to evaluate the effect of ethanol intake via the drinking water (10% v/v) on urinary-associated acetaldehyde. Eight received ethanol and 8 served as controls. Urinary-associated acetaldehyde (UAA) was measured using a fluorigenic high performance chromatographic assay. Ethanol consumption did not impair growth over the two weeks of the experiment. Following administration of ethanol, UAA increased and remained significantly elevated over levels seen in controls until ethanol administration ceased (11.3 +/- 3.6 SEM microM for ethanol-consuming mice vs. 0.69 +/- 0.33 microM for controls). Ethanol in the urine was found to interfere with the assay for acetaldehyde. However, following cessation of ethanol, acetaldehyde in urine was found to be significantly elevated in urine at 24 hours, after ethanol levels were no longer detectable. In conclusion, measurement of urinary-associated acetaldehyde discriminates ethanol-consuming from nonconsuming mice during ethanol ingestion as well as 24 hours following cessation of ethanol when ethanol levels are no longer detectable in urine. Thus measurement of urinary acetaldehyde may be a useful marker for monitoring ethanol intake. PMID- 1781919 TI - Effects of ethanol on the secretion of hepatic secretory protein in rat alcoholic liver injury. AB - It has been pointed out that one of the pathogenetic causes of alcoholic liver injury is the hepatocytic accumulation of exportable proteins due to a decrease in hepatic microtubules caused by acetaldehyde. To confirm and extend this secretory protein accumulation in the hepatocytes, the effects of alcohol treatment on the intracellular transport of secretory protein in the hepatocyte was studied using radioisotope-labeled leucine and fucose. Acute ethanol administration to rats did not show any effects on intrahepatocytic transport and secretion of transferrin. In alcohol pyrazole hepatitis rats, the secretion of transferrin labeled with both radioactive leucine and fucose into the serum was significantly delayed. Delaying in the secretion of fucose-labeled transferrin was more prominent than in leucine-labeled transferrin. This secretory inhibition was accompanied by a corresponding increase in the hepatic retention of both leucine- and fucose-labeled transferrin. At the time of the maximum inhibition of secretion, radioisotope labeled transferrin mainly retained in the Golgi apparatus. These results indicated that movement of secretory proteins along the secretory pathway impaired in alcoholic liver injury and that accumulation of the secretory proteins might play an important role in the development of alcoholic liver injury. PMID- 1781921 TI - Alterations in hepatic delta-aminolevulinic acid synthetase and heme oxygenase activities after chronic ethanol consumption in rats. AB - In the present study, the effect of chronic ethanol consumption in rats on the hepatic heme metabolism was investigated. Male Wistar rats were fed a nutritionally adequate liquid diet containing ethanol as 36% of the total calories for 5 weeks. After an overnight fast, the livers were excised and centrifuged to obtain mitochondrial and microsomal fractions. Chronic ethanol feeding of rats resulted in about 19% hepatomegaly as represented by the increased liver/body weight ratio. There was no difference in the mitochondrial protein content between the ethanol-treated and control rats, but the microsomal protein content was significantly increased in the ethanol-treated rats. Hepatic microsomal content of cytochrome P-450 (P-450) was markedly enhanced by chronic ethanol ingestion. Microsomal contents of cytochrome b5 (b5) and total heme were also increased to a lesser extent. After chronic ethanol abuse, the hepatic activity of delta-aminolevulinic acid (ALA) synthetase, which is a rate-limiting enzyme for heme production, was significantly increased and that of the heme oxygenase was slightly increased. These data indicate that ALA synthetase activity is induced by the negative feedback mechanism in order to compensate the depletion of heme caused by the utilization of heme for P-450. It is also speculated that, in response to excessive production of heme as described above, heme oxygenase activity is secondarily induced to regulate the amount of heme. PMID- 1781922 TI - Effect of ethanol dependence on GABAA antagonist-induced seizures and agonist stimulated chloride uptake. AB - The functional state of GABAA receptors during physical dependence on ethanol was evaluated in two ways. First, the ability of ethanol dependence to change the convulsant potency of GABAA antagonists microinjected into the inferior colliculus was examined. A second approach evaluated the effects of ethanol dependence on the ability of muscimol or pentobarbital to stimulate chloride uptake in rat brain vesicles. In the studies examining changes in convulsant potency, bilateral microinfusions of GABAA antagonists, bicuculline methiodide and picrotoxinin, as well as the excitatory amino acid agonist, kainic acid (used as a positive control) induced similar dose-related increases in the frequency of wild-running seizures. Ethanol dependence did not significantly change susceptibility to wild-running seizure induction by an of the convulsants, although susceptibility to the more severe, clonic seizures was significantly increased for each convulsant. This suggested that the receptor-blocking effects of GABAA antagonists responsible for inducing wild-running seizures were not selectively increased by ethanol dependence, but that spread of seizure activity responsible for clonic seizures following the initiation of wild running was generally increased. Finally, in studies examining changes in GABAA receptor mediated chloride uptake, both muscimol and pentobarbital were found to induce concentration-dependent increases in chloride uptake in rat brain vesicles. However, responses to these drugs were not reduced by ethanol dependence suggesting that a generalized adaptive decrease in GABAA receptor function was unlikely. Together these results do not provide support for the hypothesis that the GABAA receptor-chloride channel complex is down-regulated during the development of physical dependence on ethanol. PMID- 1781923 TI - Correlation of sedative effects with brain levels of barbiturates in LS and SS mice. AB - Long-sleep (LS) and short-sleep (SS) mice, genetically selected for their differential CNS sensitivity to ethanol, have also been shown to differ in their response to other sedative-hypnotics, including the barbiturates. We have applied a gas-chromatographic method of analysis of brain barbiturate concentrations following IP administration of either the water-soluble barbiturate diethylbarbital (DB) or the lipid-soluble barbiturate secobarbital (SB). Brain barbiturate levels were assessed at loss of righting response, and at regaining righting response (waking). In addition, latency to loss of righting response and duration of loss of righting response were measured following IP barbiturate administration. We have observed a differential sensitivity of LS and SS mice to the sedative effects of DB, with LS mice having greater sensitivity compared to SS. This differential sensitivity to DB, as measured by a lower concentration of DB which caused loss of righting in LS, was accompanied by an equal rate of water soluble barbiturate brain distribution and elimination in the two lines. With the lipid-soluble barbiturate SB, LS and SS mice did not differ in brain SB concentration at loss of righting response or at waking. However, sleep time was much longer in SS mice than LS due to slower brain clearance of the barbiturate in SS. Therefore, duration of loss of righting (sleep time) did not adequately reflect central sensitivity to the lipid-soluble barbiturate. These data suggest the importance of quantifying brain concentrations at loss of righting reflex when assessing central sensitivity to sedative-hypnotic agents.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1781924 TI - Anxiogenic behavior in rats during acute and protracted ethanol withdrawal: reversal by buspirone. AB - This study investigated the effectiveness of buspirone in reversing the anxiogenic behaviors occurring during ethanol withdrawal as measured in the elevated plus-maze. In response to anxiogenic drugs, rats spend less time in and make fewer entries onto the open arms of an elevated plus-maze, whereas anxiolytic drugs produce opposite effects. In this study, rats were fed a liquid diet containing 4.5% ethanol for 7 days. Twelve h (acute withdrawal) and 7 days (protracted withdrawal) following cessation of the ethanol diet, rats were tested on the elevated plus-maze. During these withdrawal periods, the percent open-arm entries and time spent on the open arms were significantly reduced relative to animals fed an ethanol-free diet, suggestive of anxiogenic-like symptoms. Buspirone (0.32-1.25 mg/kg) dose dependently reversed the withdrawal-induced decreases in open-arm activity. The anxiolytic-like activity of buspirone observed during ethanol withdrawal may be due to a reduction in serotonergic neurotransmission through activation of presynaptic 5-HT1A autoreceptors. The results obtained in this study suggest that pharmacotherapy with selective 5-HT1A agonists may be beneficial in alleviation of anxiety during ethanol withdrawal. PMID- 1781925 TI - Influence of copper status on the response to acute ethanol exposure in rats. AB - An acute dose of ethanol was used to investigate the biochemical response of tissues with a compromised antioxidant defense system to a surge of oxygen radical production. The copper (Cu)-deficient rat served as the animal model for this study based on its compromised antioxidant defense system. Rats were fed control (10 micrograms Cu/g) or Cu-deficient (0.2 microgram Cu/g) diet for 14 days. In order to minimize secondary effects associated with chronic Cu deficiency, the chelator triethylenetetramine was added to the Cu-deficient diet to shorten the time required for the induction of Cu deficiency. On day 14, rats were gavaged with ethanol (4.5 g/kg b.wt.) or saline and killed 9 hours postgavage. Rats fed the Cu-deficient diets had lower liver superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities than controls. Ethanol treatment had no effect on liver CuZnSOD or Gpx activity, while MnSOD activity was higher than saline control levels following EtOH treatment. Despite low GPx and SOD activity, Cu-deficient rats did not exhibit higher hepatic thiobarbituric acid reacting substances (TBARS) than controls; in fact, hepatic microsomal TBARS were lower in saline-treated Cu-deficient rats relative to Cu-sufficient rats. Ethanol treatment resulted in higher whole homogenate and mitochondrial TBARS than in saline-gavaged rats. Copper status did not influence hepatic TBARS production in response to an acute EtOH load. These data suggest that compensatory mechanisms contribute to the protection of the liver from excessive free radical production in this model of Cu deficiency. PMID- 1781926 TI - Response expectancies affect the acquisition and display of behavioral tolerance to alcohol. AB - Two experiments demonstrated that a learned expectation of a favourable consequence for drug-compensatory performance enhanced behavioral tolerance to alcohol, and when the expectancy was trained, the subsequent display of tolerance depended upon its consequence. Both experiments involved each of four groups of six male social drinkers each, who drank 0.62 g/kg alcohol on four sessions, and a placebo on a fifth session. Experiment 1 provided two groups with the opportunity to learn the response expectancy by performing a motor task under alcohol with either an informative consequence (IO) or information plus money contingent upon drug-compensatory performance (MI). Two control groups performed with either no outcome (N), or with money for compensatory performance but no information about earnings until the experiment concluded (MO). The effects of learning history were evident on sessions 4 and 5 when the same consequence was contingent upon the performance of all groups. Compared to controls, the groups that had received response expectancy training (MI and IO) displayed significantly more alcohol tolerance and greater compensatory facilitation of performance under placebo. In Experiment 2, all groups received the same response expectancy training, and the effect of the consequence of compensatory performance was demonstrated during subsequent test sessions 4 and 5. An informative consequence (MI or IO) enhanced tolerance and the compensatory response to placebo, whereas performance with no response contingent information (N or MO), revealed little tolerance or compensatory response to placebo. Theoretical and practical implications of the findings were discussed. PMID- 1781927 TI - Selective effect of ethanol on norepinephrine- and nicotine-induced emesis in cats. AB - The effect of acute ethanol administration into the cerebral ventricles of the unanesthetized cat upon emesis produced by norepinephrine and nicotine injected similarly was investigated. Ethanol inhibited the norepinephrine- and nicotine induced emesis. The inhibitory effect of ethanol occurred after a transient and inconsistent emetic action of the drug. Ethanol was about 10 times more potent inhibiting the emesis caused by nicotine. On the other hand, intracerebroventricular ethanol had virtually no effect on emesis produced by intragastric copper sulfate. The inhibitory effect of ethanol is ascribed to an action on alpha-noradrenergic and nicotinic receptors in the area postrema. Differential responses to ethanol most probably reflect the microenvironment of alpha-noradrenergic and nicotinic synapses in the area postrema of the cat. PMID- 1781928 TI - Quality problems in waters used for drinking purposes in Italy. AB - With a grant from the Italian Ministry of the Environment, the National Institute of Health (Istituto Superiore di Sanita) promoted and coordinated some activities aimed at determining the extent and the intensity of contamination of waters used for human consumption by some chemical agents, and describing causes and modalities of contamination and human health implications. The chemical agents examined were herbicides, nitrates, trihalomethanes, asbestos, manganese and fluoride. In this paper a first nationwide picture of these problems is reported. PMID- 1781929 TI - Radiation effects on the immunological functions and membranes of alveolar macrophages of rats. AB - Alveolar macrophages (AM) from BCG activated Wistar rat were irradiated with different doses of Gamma rays in vitro. The effects of radiation on their immunological functions and membrane damage were studied. The non-specific cytotoxicity and specific phagocytosis of AM irradiated with dose of 0, 100, 300 and 500 Gy decreased with the increase in dose. The relative fractions of Lactate Dehydrogenase and Beta-glucuronidase (beta-glu) activity in supernatant increased with the increase in dose. There was a correlation between the suppression of immunological functions and the degree of damage of cytoplasmic and lysosomal membranes of AM after irradiation. Na2SeO3, a protective agent of cell membranes, alleviated this effect on the suppressive cytotoxicity indices of irradiated AM. PMID- 1781931 TI - Indoor air pollution in four cities in China. AB - The study reports the investigation of indoor air pollution carried out in four cities in China (Chengde, Shanghai, Shenyang and Wuhan). The concentrations of RP, SO2, CO and NO2 were measured in kitchens and bedrooms, both in summer and in winter. The results showed that indoor air pollution, as measured by RP, SO2, CO, was heavy when coal was used as domestic fuel. This was particularly severe in winter. For example, the concentrations of SO2 in homes with coal stoves were more than 10 times higher than those in homes with gas or LPG in Shanghai. The concentrations of pollutants in kitchens were higher than those in bedrooms. The source of pollutants was fuel combustion from kitchen. The highest concentrations in kitchen could reach 665 micrograms/m3 (RP), 860 micrograms/m3 (SO2) and 14.07 mg/m3 (CO). The concentrations in bedrooms were up to 270 micrograms/m3, 502 micrograms/m3, and 13.67mg/m3, respectively. PMID- 1781930 TI - Damage to hepatic thyroxine 5'-deiodination induced by pathogenic factors of Keshan disease and the preventive effects of selenium and vitamin E. AB - Experiments were performed to investigate the change of hepatic T4 5' deiodination and the preventive effects of selenium (Se) and vitamin E in rats fed grains from a Keshan disease (KD) endemic area. The results showed that consumption of the endemic grain for 8 weeks caused a significant reduction in hepatic T4 5'-monodeiodinase and glutathione peroxidase activities, and a marked enhancement of hepatic malondialdehyde content. These changes could be effectively prevented through Se or vitamin E supplementation to the diet. These observations confirm the reduced ability of hepatic T4 5'-deiodination induced by the pathogenic factors existing in the endemic grains, and the preventive effects of selenium and vitamin E on the alterations. The present study suggests that the reduction in hepatic T4 deiodination in these animals may be the consequence of hepatic damage owing to uncontrolled free radical metabolism, and that the relative deficiency of vitamin E, besides selenium deficiency, may also play a role in the pathogenesis of KD. PMID- 1781932 TI - Effect of sodium nitrite on myocardial glutathione peroxidase and protective action of vitamin E and selenium. AB - Under the condition of acute NaNO2 poisoning, the changes of myocardial GSH-Px activity of rats fed a diet composed of grains grown in the endemic region of Keshan disease and the same diet with supplementation of vitamin E or selenium were investigated. By gavage of toxic doses of NaNO2, the myocardial GSH-Px was significantly reduced (P less than 0.05). Vitamin E or selenium supplementation protected the enzyme activity from reducing. It is suggested that the simultaneous action of an increase in selenium and vitamin E intake and a decrease in nitrite intake might greatly prevent the occurrence of Keshan disease. PMID- 1781933 TI - Acute toxicity of methyl isocyanate in mammals. IV. Biochemical and hematological changes in rabbits. AB - Subcutaneous administration of methyl isocyanate (MIC) in 0.5 LD50 and 1.0 LD50 to female rabbits resulted in significant increases of hemoglobin concentration, hematocrit and leukocyte count in blood, as well as plasma total proteins, urea and cholesterol. A significant decrease in plasma albumin level was only observed in the 1.0 LD50 group. Urine of MIC intoxicated animals showed presence of protein, bilirubin, elevated urea and urobilinogen, while urine volume was reduced. The hematological and biochemical changes induced by MIC are perhaps the result of fluid loss from the vascular compartment as evidenced by the histopathological observations. This study further substantiates the view that acute toxicity of MIC is mediated in vivo by its effects on vascular beds. PMID- 1781934 TI - Chemical forms of selenium in corn and rice grown in a high selenium area of China. AB - The chemical forms of selenium were determined in maize grown near Yutangba Village and in rice grown near Haubei village, Exi Prefecture, Enshi county of Hubei Province, China. The maize sample contained 18 ppm and the rice samples an average of 3.6 ppm selenium. After they were ground to obtain a fine flour, this was acid hydrolyzed with hydrochloric acid in an inert atmosphere and the hydrolyzates chromatographed on columns of Dionex DC6A resin. The results indicate that the majority of the selenium is present as selenomethionine in both rice and corn. PMID- 1781935 TI - Residues of polychlorinated biphenyls (PCBs) in fish, water and sediment from Shing Mun River. AB - The level and pattern of contamination by polychlorinated biphenyls (PCBs) were investigated in tilapia, Oreochromis mossambicus (Peters), sediment, and water from the Shing Mun River. The range of total PCBs was 12.9 ng/g to 181.6 ng/g wet weight in tilapia, 12.7 ng/g to 46.0 ng/g freeze-dried weight in sediment, and 3.8 ng/L to 13.6 ng/L in water. The effect of biomagnification was also observed, PCB concentrations increased from water to sediment to tilapia. PCB congeners occurred in such a way that lower chlorinated PCBs comprised a higher fraction of the total PCBs in water, sediment, and tilapia muscle, whereas higher chlorinated PCBs were more commonly found only in tilapia. PMID- 1781936 TI - Radiotracer study on mancozeb residues in tomato plants. AB - A study on the persistence, residues and residue distribution of mancozeb in tomato plant-soil system, as well as effects of cooking on transformation of residual mancozeb were carried out with radiotracer technique. Half-life values for total mancozeb residues on tomato leaves and in soil were observed to be 9.5 and 7.6 days, respectively. The results also suggested that mancozeb residues in soil were readily uptaken by plants and leach to soil layer as deep as 28cm within two weeks, although over 90% of the residues remained in the upper layer (0-6cm) of the soil. Translocation of the residues of mancozeb, especially the water soluble metabolites including ETU, throughout the plants could be one of the factors responsible for the contamination of tomato fruits. Deposit of sprayed mancozeb on the fruit skin was another important factor leading to the contamination of fruits. Fruit skin contained higher levels of residues than the pulp. Washing with water could remove more than 50% of the residues on the skin. It was also found that 20-30% of the residual mancozeb degraded to ETU during cooking process. The tomatoes should be washed to reduce the residues of the fungicide and ETU in food. PMID- 1781937 TI - Pesticide residue control in the years 1986-1987. AB - Results of analytical surveys on pesticide residue levels in foods for the years 1986-1987 are presented. Analytical data obtained from regional laboratories are tabulated in terms of various commodity groups (vegetables, fruit, cereals, processed or derived foodstuffs, other commodities, legumes, environmental samples, others) and are compared with maximum legal tolerances established by the ministerial ordinance (Italian Ministry of Health) 6.6. 1985. On a total number of 4715 determinations of classes of compounds or of single compounds made on 1601 commodities samples, only N 53 (1.1%) violative results appeared. No residue was found at levels exceeding regulatory limits or found in commodities where a tolerance had not been established for a specific pesticide/commodity combination. PMID- 1781938 TI - Toxic effects of bound malathion residues in rats. AB - The level of bound malathion residues in treated wheat grain and its toxic effects on rats were investigated. Wheat grain was treated with [14C] malathion (specific activity: 2.76 MBq/mg) to determine the bioavailability of bound residues in rats. At the same time, grain was treated with nonlabeled malathion to test for possible toxic effects of bound residues in a subchronic (90 days) feeding study in rats at two dose levels, 10 and 100 ppm. It was observed that the level of malathion-bound residues amounted to 11.28% of the applied dose (for six months). Also, it was noted that the main route of [14C]-malathion excretion was through the urine. This signifies that grain-bound malathion was bioavailable. In subchronic test on rats bound malathion residues (both dose levels) induced effects to some extent in organ weight (spleen and adrenals), and blood ChE activity. In both, males and females, there was an increase in SGPT activity (lower dose), and in alkaline phosphatase in females (higher dose). Hematological data showed changes only in hemoglobin concentration in males (both dose levels). PMID- 1781939 TI - The effects of organic ligands on the survival of Daphnia in Zn solution. AB - Bioassays involving zinc alone and in combinations with two organic ligands, namely histidine and EDTA were conducted on Daphnia longispina over a period of 96 h. The percentage of mortality was recorded and the Median Lethal Concentration (LC50) at 96 h estimated. The 96 h LC50 of D. longispina in zinc solution was 91 micrograms/l whereas no values of LC50 were revealed when D. longispina were exposed to histidine or EDTA alone although the organic ligands seemed to exert harmful effects (e.g. The mortality at 96 h was 18% at a concentration of 10 x 10(-5) M histidine and 16% at a concentration of 6 x 10(-6) M EDTA). However, addition of histidine and EDTA effectively reduced the toxicity of zinc to the test animals. The detoxification effect was the most obvious at the concentration of 100 micrograms/l Zn added with 5 x 10(-5) M histidine and 3 x 10(-6) M EDTA where 7-fold and 5-fold reduction in terms of mortality were noted. PMID- 1781940 TI - Cyanide intoxication in mice through different routes and its prophylaxis by alpha-ketoglutarate. AB - Antagonising effects of alpha-ketoglutarate (alpha-KG) could be attributed to complexing of the reactive nucleophile (CN-) to form cyanohydrin in cyanide intoxication. However, an enormous protection obtained could not be delineated on account of possible in situ binding of alpha-KG given intraperitoneally (i.p.) in mice to cyanide administered through the same route. The present study was designed to see the efficacy of alpha-KG alone or in combination with sodium nitrite (SN) and/or sodium thiosulfate (STS) in male mice exposed to cyanide administered through subcutaneous (s.c.) or inhalation route. A technique for generation of hydrogen cyanide (HCN) is also discussed. On the basis of protection index (PI), defined here as the LD50 of cyanide in protected mice/LD50 of cyanide in unprotected mice and survival time, STS + alpha-KG regimen was equipotent to the conventional SN + STS regimen. This is further substantiated by effect of alpha-KG in reducing plasma cyanide levels. The efficacy of alpha-KG remains undeterred irrespective of the route of cyanide intoxication, while the magnitude of protection varies. PMID- 1781942 TI - Studies on the cross stand hydrogen bonds in DNA double helices. AB - A systematic analysis has been carried out to examine all the stereochemically possible bifurcated hydrogen bonds including those of cross strand type between propeller twisted base pairs in DNA double helices by stereochemical considerations involving base pairs alone and by molecular mechanics studies on dimer and trimer duplexes. The results show that there are limited number of combinations of adjacent base pairs that would facilitate bifurcated cross-strand hydrogen bond (CSH). B-type helices concomitant with negative propeller twist seem to be more favored for the occurrence of CSH than canonical A-type helices because of slide in the latter. The results also demonstrate that helices with appropriate sequences may possess continuous run of these propeller twist driven cross strand hydrogen bonds indicating that they may in fact be considered as yet another general structural feature of DNA helices. PMID- 1781941 TI - Experimental and theoretical study of energetics of complex formation between nucleic acid bases and the bases with amide group. AB - A number of nucleic acid base pairs and complexes between the bases and the amide group of acrylamide have been studied experimentally by using mass spectrometry and theoretically by the method of atom-atom potential function calculations. It has been found from temperature dependencies of peak intensities in mass spectra of m2.2.9(3) Gua.m1Ura, m9 Ade.m1Cyt, m2.2.9(3) Gua.m1Gua.m1Cyt pairs that enthalpy values, delta H, of the complex formation are equal to 14.2 +/- 1.1, 13.5 +/- 1.3 and 16.4 +/- 1.4 kcal/M, respectively, and those of acrylamide with m1.3(2) Ura and m1Thy corresponds to 9.7 +/- 1.0 and 6.8 +/- 0.6 kcal/M. There is a good agreement of the experimental data with calculations when taking into account both the amino-oxo and the amino-hydroxy tautomeric forms of guanine. A combined use of the data allows us to determine the energy, the modes of interaction and the structure of the complexes. The results are discussed in connection with the modelling of molecular structure of biopolymers by the method of classical potential functions, protein-nucleic acids recognition and fidelity of nucleic acids biosynthesis. PMID- 1781943 TI - DNA polymorphism and local variation in base-pair orientation: a theoretical rationale. AB - Basepair stacking calculations have been carried out to understand the conformational polymorphism of DNA and its sequence dependence. The recently developed self-consistent parameter set, which is specially suitable for describing irregular DNA structures, has been used to describe the geometry of a basepair doublet. While for basepairs without any propeller, the favourable stacking patterns do not appear to have very strong features, much more noticeable sequence dependent stacking patterns emerge once a propeller is applied to the basepairs. The absolute minima for most sequences occurs for a doublet geometry close to the B-DNA fibre models. Hence in the B-DNA region, no strong sequence dependent features are found, but the range of doublet geometries observed in the crystal structures generally lie within the low energy contours, obtained from stacking energy calculations. The doublet geometry corresponding to the A-DNA fibre model is not energetically favourable for the purine-pyrimidine sequences, which prefer small roll angle values when the slide has a large negative value as in A-DNA. However positive roll with large negative slide is allowed for GG, GA, AG and the pyrimidine-purine steps. This is consistent with the observed geometries of various steps in A-DNA crystals. Thus the general features of the basepair doublets predicted from these theoretical studies agree very well with the results from crystal structure analysis. However, since most sequences show an overall preference for B-type doublet geometry, the B----A transition for random sequence DNA cannot be explained on the basis of basepair stacking interactions. PMID- 1781944 TI - Stereochemical analysis of interaction of signal peptide with phospholipids at the initiation of protein translocation across the membrane. AB - Stereochemical analysis of signal peptide interaction with E. coli membrane phospholipids revealed the structural complementarity of N-terminus of signal peptide alpha-helix and acid phospholipids. The formation of their complex leads to neutralization of charges and decrease in hydrophilicity of both components, and promotes insertion of peptide and phospholipid into the membrane, not separately but as a complex. Interaction of acid phospholipids with the E. coli alkaline phosphatase (AP) signal peptide was thoroughly analyzed, and it was shown that in this case a complex of signal peptide alpha-helix with phosphatidylglycerol is inserted into the membrane with the lowest energy expense. On the basis of the results of stereochemical analysis and the available experimental data, a molecular mechanism of protein translocation initiation across the membrane has been proposed, in which the key events are the formation of the complex "signal peptide alpha-helix-acid phospholipid", the coupled insertion of hydrophobic peptide-lipid complex into a nonpolar membrane interior and translocation across the membranes. PMID- 1781945 TI - The mechanism of recognition of templates by DNA polymerases from pro- and eukaryotes as revealed by affinity modification data. AB - Pt(2+)-containing derivatives of oligodeoxyribonucleotides were used to evaluate the ligand affinity to the template sites of Klenow fragment of DNA polymerase I from E. coli and DNA polymerase alpha from human placenta. The values of Kd and Gibb's energy (delta G degree) for the complexes of oligodeoxyribonucleotides and their derivatives with the template sites of these enzymes were determined from the effects protecting the enzyme from inactivation by Pt(2+)-containing oligonucleotides. Kd and delta G degree values of the complexes made by DNA polymerases and orthophosphate, triethylphosphate, d(pC)n, d(pT)n, d(pG)n, d(pA)n (where n = 1-25), heterooligonucleotides of various length and structure, and oligothymidylates with partially and completely ethylated internucleotide phosphates were evaluated. The obtained data enabled us to suggest 19-20 mononucleotide units of the template to interact with the protein. Only one template internucleotide phosphate forms a Me(2+)-dependent electrostatic contact (delta G = -1.1...-1.7 kcal/mol) and a hydrogen bond (delta G = -4.4...-4.9 kcal/mol) with the enzyme. It is likely that the mononucleoside units of the template form hydrophobic contacts with the enzymes. The efficiency of such interaction changes with the hydrophobicity of the bases: C less than T less than G approximately A. For both homo- and heterooligonucleotides the contributions of nucleoside units to the affinity of the templates to the enzymes is due to the complementary interactions with the primers. A hypothetical model for the template-primer interaction with DNA polymerases is suggested. PMID- 1781946 TI - Sequence selective binding to the DNA major groove: tris(1,10-phenanthroline) metal complexes binding to poly(dG-dC) and poly(dA-dT). AB - Molecular modelling and energy minimisation calculations that incorporate solvent effects have been used to investigate the complexation of delta and lambda [Ru(1,10-phenanthroline]2+ to DNA. The most stable binding geometry for both enantiomers is one in which a phenanthroline chelate is positioned in the major groove. The chelate is partially inserted between neighbouring base pairs, but is not intercalated. For delta, though not for lambda, a geometry with two chelates in the major groove is only slightly less favourable. Minor groove binding is shown to be no more favourable than external electrostatic binding. The optimised geometries of the DNA/[Ru(1,10-phenanthroline]2+ complexes enable published linear dichroism spectra to be used to determine the percentage of each enantiomer in the two most favourable major groove sites. For delta 57 +/- 15% and for lambda 82 +/- 7% of bound molecules are in the partially inserted site. PMID- 1781947 TI - A circular dichroism study on the conformation of d(CGT) modified with N-acetyl-2 aminofluorene or 2-aminofluorene. AB - The trinucleotide d(CGT) was modified by covalent binding of the carcinogen N acetyl-2-aminofluorene (AAF) or 2-aminofluorene (AF) at the C8 position of the guanine base. The conformations of d(CGT)-AAF and -AF were studied by comparing the absorption and circular dichroism properties with those of dCMP + dGMP-AAF or -AF + dTMP in a molar ratio of 1:1:1 and AAF- and AF-containing dGMP. For both AAF- and AF-d(CGT) complexes the results show significant stacking interactions between the fluorene residue and the base(s) and are discussed in terms of the conformation of d(CGT)-AAF and -AF. In d(CGT)-AF we observe a clear interaction between AF and thymine, whereas the C-G stack is still intact. In the case of d(CGT)-AAF the C-G stack is weakened and the glycosidic rotation angle of dGuo-C8 AAF is most probably syn. The specific fluorene-base interactions persist at elevated temperatures. The carcinogen-base interactions are stronger in the AAF carrying d(CGT) than in the case of the deacetylated complex. This is consistent with the higher mobility of the AF-adduct and its conformationally heterogeneous appearance in DNA. PMID- 1781948 TI - Circular dichroism studies of the structure of DNA complex with berberine. AB - The binding of the benzodioxolo-benzoquinolizine alkaloid, berberine chloride to natural and synthetic DNAs has been studied by intrinsic and extrinsic circular dichroic measurements. Binding of berberine causes changes in the circular dichroism spectrum of DNA as shown by the increase of molar ellipticity of the 270nm band, but with very little change of the 240nm band. The molar ellipticity at the saturation depends strongly on the base composition of DNA and also on salt concentration, but always larger for the AT rich DNA than the GC rich DNA. The features in the circular dichroic spectral changes of berberine-synthetic DNA complexes were similar to that of native DNA, but depends on the sequence of base pairs. On binding to DNA and polynucleotides, the alkaloid becomes optically active. The extrinsic circular dichroism developed in the visible absorption region (300-500nm) for the berberine-DNA complexes shows two broad spectral bands in the regions 425-440nm and 340-360nm with the maximum varying depending on base composition and sequence of DNA. While the 425nm band shows less variation on the binding ratio, the 360nm band is remarkably dependent on the DNA/alkaloid ratio. The generation of the alkaloid associated extrinsic circular dichroic bands is not dependent on the base composition or sequence of base pairs, but the nature and magnitude of the bands are very much dependent on these two factors and also on the salt concentration. The interpretation of the results with respect to the modes of the alkaloid binding to DNA are presented. PMID- 1781949 TI - Circular dichroism studies of salt- and alcohol- induced conformational changes in cyanophage S-2L DNA which contains amino 2 adenine instead of adenine. AB - DNA molecules containing AT pairs exhibit cesium cation specific conformational behavior. This specificity is shown to be cancelled with the title DNA, which not only concerns its conformational alterations in high-salt aqueous solutions but also the B-to-A transition induced by ethanol. S-2L DNA easily adopts the A conformation in the presence of millimolar concentrations of CsCl which completely destabilize the A-conformation in calf thymus DNA. The present results demonstrate that the specific effects of cesium cations on DNA are connected with their binding to the AT pairs in the DNA minor groove. PMID- 1781950 TI - Unhooking dynamics of U-shaped DNA molecule undergoing gel electrophoresis. AB - It has been found that DNA molecules are often hooked around obstacles in a U shaped configuration in gel electrophoresis. To understand the dynamics of the unhooking of U-shaped DNA molecules undergoing gel electrophoresis, we have examined the length changes of the longer and shorter arms of the U-shape as a function of time. Two types of unhooking have been found. In one type, the length changes of both arms are expontential in time but with different time constants. In another type, the length changes of the shorter arm is exponential and that of the longer one is linear with time. The interpretation is that the extent of stretch of the spring-like DNA chain decreases as the length difference between the two arms increases during the unhooking processes, and that the frictions at the pivot point can be relatively large depending upon the local structure of the gel. The friction coefficient at the pivot point is estimated to be nu 0 = (2.98 +/- 1.42)x10(-5) g/sec. PMID- 1781951 TI - Serotonin-immunoreactivity in the cerebellum of two neurological mutant mice and the corresponding wild-type genetic stocks. AB - Using a serotonin (5-HT)-specific antibody, we examined the 5-HTergic innervation of the cerebellum in the normal mouse (+/+) and in two neurological mutants: weaver (wv/wv), which are characterized by a genetically determined loss of granule cells, and 'Purkinje cell degeneration' (pcd/pcd), which are characterized by a genetically determined loss of Purkinje cells. In normal cerebellum, serotonin-immunoreactive (5-HT-ir) fibers are discrete and ascend to all three layers of the cerebellar cortex. Serotonin-immunoreactive fibers have a much higher density in the atrophic cerebella of both weaver and pcd mutants, where they form multidirectional contours. These anatomical findings provide a profile of 5-HT axon innervation of mouse cerebellum and extend previous neurochemical observations on the metabolic state of cerebellar 5-HT in neurological mutants. PMID- 1781952 TI - Leukocyte-mediated epithelial injury in ozone-exposed rat lung. AB - Both epithelial injury and inflammation are characteristic findings in the centriacinar regions of the lungs of rats exposed to ozone. In humans such effects could lead to long-term lung damage and disease. In animals, neoplastic change in the lungs after exposure to ozone has been described previously. The possible relationships between inflammatory cell recruitment, epithelial injury, and hyperplasia, with special regard to the important role of repair processes in leading to increased incidence of tumors in some species, have been addressed in the present study. We have previously described that leukocytes from lungs inflamed by different agents can injure epithelial cells in vitro. We have suggested that this leukocyte-mediated epithelial injury could enhance epithelial turnover in ozone-exposed lungs and so enhance the likelihood of tumor development. We, therefore, set out to test the hypothesis that bronchoalveolar leukocytes from ozone-exposed lungs can injure epithelial cells in vitro. PVG rats were exposed to 0.2, 0.4, 0.6, and 0.8 parts per million2 (ppm) ozone for seven hours per day for up to four days. On the morning following the last exposure, bronchoalveolar lavage was used to sample the bronchoalveolar leukocytes and the following parameters were assessed: total number, differential leukocyte count, production of oxidants, ability to degrade fibronectin, and ability to injure epithelial cells. In addition to these parameters, which were measured at all concentrations and time points in limited experiments, we also assessed macrophage size in short-term culture and inflammation in histological sections of lungs. Total number of lavageable cells was not affected by ozone inhalation. However, the percentage of macrophages decreased with ozone treatment and the percentage of neutrophils increased on days 1 and 2 at 0.6 and 0.8 ppm ozone. There was no significant effect of ozone exposure on the ability of neutrophils to degrade fibronectin or injure epithelial cells. Production of superoxide anion in response to stimulation with phorbol myristate acetate was significantly decreased by exposure to 0.6 ppm ozone, as described in previous studies. Macrophages from the lungs of rats exposed to ozone were larger than control macrophages. PMID- 1781953 TI - The 48,XXYY syndrome. Follow-up data on clinical characteristics and psychological findings in 4 patients. AB - In this study we report the physical and psychological findings in 4 males with 48,XXYY syndrome. They were diagnosed at the ages of 4, 6, 18 and 25 years respectively. The major indication for chromosomal analysis in these four slightly mentally retarded males was not their clinical appearance but the presence of behavioral problems with personality disturbances i.e. psychotic reactions, loss of structure, violent and impulsive reactions. These data are compared with previous findings in the literature. PMID- 1781954 TI - Inverted distal duplication of the long arm of chromosome 8: borderline intelligence and discrete dysmorphic syndrome. AB - In this report, we describe an 11-years-old girl with inverted duplication in the distal part of the long arm of chromosome 8 (inv dup(8)(q24.11----q24.3). The most remarkable finding is her borderline intelligence and her nearly normal phenotype. PMID- 1781955 TI - Trichomegaly, pigmentary degeneration of the retina and growth disturbances. A probable autosomal recessive disorder. AB - Two brothers are described with trichomegaly, early pigmentary degeneration of the retina, growth retardation, anterior pituitary deficiencies and peripheral neuropathy. This syndrome, initially reported in a boy by Olivers and Mac Farlane in 1965 (6), and thereafter in six sporadic cases of both sexes, is not associated with a recognizable chromosomal defect. The present report of two brothers of healthy parents with negative familial history suggests an autosomal recessive mode of inheritance of this entity. PMID- 1781956 TI - Lobar holoprosencephaly and Xq22 deletion. AB - A 20 weeks gestation female fetus with a lobar holoprosencephaly and Xq22 deletion is described. The phenotype correlation of the cerebral defect with the facial features is positive. On the contrary phenotypic-karyotypic correlation is non obvious. PMID- 1781957 TI - Ring chromosome 9 in a newborn male presenting with facial dysmorphia, hypospadias and skeletal abnormalities. AB - A newborn male presenting with a peculiar appearance, hypertonia, a flexum attitude, hypospadias and skeletal abnormalities was found to bear a r 9 chromosome. A phenotypic distinction between early and late presenting forms is discussed. PMID- 1781958 TI - Epidemiology of diaphragmatic hernia in Languedoc-Roussillon. AB - The frequency of diaphragmatic hernia (DH) varies, according to the studies, between 1/2000 and 1/7000. In the Languedoc-Roussillon (South of France), due to the presence of a Regional Foeto-Pathology Department and Medico Surgical Paediatric Department, it was possible to itemize all of the DH over a 24 month period (June 1989----May 1991). 20 children presenting DH (10 foetuses and 10 liveborns) were examined for a total population of 49.350 foetuses and liveborns (frequency of DH: 0.40/1000). 10 DH were associated with extra-pulmonary malformations (50%). 4 chromosome abnormalities were found (20%). Prenatal chromosome analysis in cases of ultrasound malformation detection has increased the number of karyotype abnormalities diagnosed. PMID- 1781959 TI - A case with laryngeal atresia and partial trisomy 9 due to maternal 9;16 translocation. AB - A newborn with a partial trisomy 9 and a partial trisomy 16q is described. The child died shortly after birth because of laryngeal atresia. The chromosome anomaly was the result of a 3:1 segregation of a maternal translocation t(9;16) (q22;q24). The pertinent literature on both partial trisomy 9 and partial trisomy 16q is reviewed. All cases with partial trisomy 9 were either de novo or the result of a maternal translocation, possibly indicating the influence of imprinting on this chromosomal abnormality. The relationship between the laryngeal atresia and other features in the patient and the chromosome anomalies remains uncertain. PMID- 1781961 TI - Non-natural 14-hydroxy steroids. II. 13 alpha,14 alpha and 13 beta,14 beta isomers of methyl 14-hydroxy-1,7,17-trioxo-5 beta-androst-8-ene-19-oate. AB - C20H24O6, Mr = 360.41 lambda (Cu K alpha) = 1.54056 A, room temperature. (I) (5 beta,10 beta,13 alpha,14 alpha)-Methyl 14-hydroxy-1,7,17-trioxoandrost-8-ene-19 oate, triclinic, P1, a = 7.9514 (5), b = 9.2892 (5), c = 12.8534 (12) A, alpha = 81.256 (6), beta = 75.796 (6), gamma = 77.908 (5) degrees, V = 894.85 (11) A3, Z = 2, Dx = 1.338 Mg m-3, mu = 0.77 mm-1, F(000) = 383.96, final R = 0.043 for 2912 observed reflections. (II) (5 beta, 10 beta, 13 beta,14 beta)-Methyl 14-hydroxy 1,7,17-trioxoandrost-8-ene-19-oate, monoclinic, P21/n, a = 12.8704 (9), b = 10.4481 (9), c = 13.1482 (5) A, beta = 104.103 (5) degrees, V = 1714.77 (20) A3, Z = 4, Dx = 1.396 Mg m-3, mu = 0.81 mm-1, F(000) = 767.92, final R = 0.055 for 2516 observed reflections. These two non-natural steroids bear a methoxycarbonyl group at C(10). In both molecules the relative stereo-chemistry is cis for the A/B ring junction and cis for the C/D ring junction. The relative orientations of MeO2C--C(10) and HO--C(14) are anti for (I) and syn for (II). The methoxycarbonyl group lies at the axial position for (I) and equatorial for (II), relative to ring A. The energies of possible conformations for (I) and (II) are evaluated, wherein the A rings adopt a chair conformation. PMID- 1781960 TI - Proteus syndrome in 7 patients: clinical and genetic considerations. AB - The Proteus syndrome is a congenital hamartomatous disorder delineated in 1983. Because of its polymorphic appearance, the syndrome was named after the greek god Proteus whose name means much less than the polymorphous much greater than. Major clinical findings include hemi hypertrophy, macrodactyly, exostoses, scoliosis, epidermal nevi, haemangiomas, deeply rugated soles of the feet and a variety of deep and subcutaneous masses. We report on 7 new cases of Proteus syndrome. All reported cases have been sporadic. Therefore this syndrome could be due to the action of a dominant lethal gene surviving by mosaicism. PMID- 1781962 TI - Structure of the anti-cancer drug complex tetrakis (mu-acetato)-bis(1 methyladenosine)dirhodium(II) monohydrate. AB - [Rh2(C2H3O2)4(C11H16N5O4)2].H2O, Mr = 1024.6, triclinic, P1, a = 7.808 (3), b = 11.469 (4), c = 12.091 (2) A, alpha = 69.55 (2), beta = 79.46 (2), gamma = 76.61 (3) degrees, V = 980.7 (6) A3, Z = 1, Dx = 1.735 g cm-3, lambda (Cu K alpha) = 1.5418 A, mu = 77.6 cm-1, F(000) = 522, room temperature, R = 0.053 for 3638 unique reflections. Structure consists of two rhodium(II) ions in a metal--metal bond bridged by four acetate groups. The remaining axial coordination sites on the rhodium ions are coordinated to the N(7) positions of two 1-methyladenosine molecules. PMID- 1781963 TI - Structure of 6-oxo-1,6-dihydro-3,4'-bipyridine-5-carbonitrile hydrogen bromide. AB - 5-Cyano-6-oxo-1,6-dihydro-3,4'-bipyridinium bromide, C11H8N3O+.Br-, Mr = 278.11, triclinic, P1, a = 7.827 (2), b = 9.796 (2), c = 15.548 (4) A, alpha = 76.53 (2), beta = 75.40 (2), gamma = 74.36 (2) degrees, V = 1093.4 (4) A3, Z = 4, Dx = 1.689 Mg m-3, lambda (Mo K alpha) = 0.71073 A, mu = 3.70 mm-1, F(000) = 552, T = 293 K, R = 0.084 for 3989 observed reflections. The bipyridinium ions are planar, the C(2)-C(1)-C(1')-C(2') torsion angles being -3.3 (10) and 2.2 (11) degrees for molecules (1) and (2), respectively. The symmetry-independent bipyridinium ions are assembled in separate chains by hydrogen-bonding Br bridges [respective distances: Br(1)...N(3) 3.227 (6); Br(1)...N(4') 3.374 (6); Br(2)...N(3*) 3.263 (5); Br(2)...N(4'*) 3.540 (7) A] and by forming N...O hydrogen bonds between pyridinium NH groups and keto O atoms, the N(4')...O(4) and N(4'*)...O(4') distances being 2.835 (7) and 2.706 (7) A, respectively. These chains are connected by the series of stacking interactions with an average C...C distance of 3.5 A. PMID- 1781964 TI - Functional brain imaging and Alzheimer-type dementia. AB - Alzheimer disease is a common neurodegenerative disorder consisting of memory impairment and intellectual function that produces not only profound disabilities in the patient, but a significant cost to society as well. The biochemical basis for Alzheimer disease is not completely understood, but both positron-emission tomography and single-photon-emission computed tomography provide insights into the in vivo biochemistry associated with this disease. Both techniques show characteristic brain abnormalities, which consist of reductions in temporal parietal metabolism that progress in severity and extent as the disease itself shows clinical progression. Such noninvasive biochemical assays may ultimately prove to be of assistance in clinical management, and are clearly helpful in understanding the pathophysiologic mechanisms associated with the production of this disease. PMID- 1781965 TI - Cerebral white matter perfusion in dementia of Alzheimer type. AB - Local cerebral blood flow was measured in 19 patients with probable dementia of Alzheimer type (DAT) by using xenon-enhanced computerized tomography (CT) and CT densitometry to accurately differentiate white from gray matter. Patients met standard diagnostic criteria for probable DAT and results were compared with similar measures in 26 age-matched, neurologically and cognitively normal volunteers. Perfusions of frontal and occipital white matter as well as frontal, parietal, temporal, and occipital cortex were reduced in DAT compared with age matched normals. White matter perfusion differences were not observed among DAT patients with and without risk factors for stroke. Reduced perfusion of frontal white matter correlated significantly with reduced perfusion of thalamus and putamen in patients with DAT. Results confirm the frequent association of white matter abnormalities in patients with DAT that are possibly caused by amyloid angiopathy and may contribute to cognitive impairments. PMID- 1781966 TI - Ratings of personality change in patients being evaluated for memory disorders. AB - Caregivers of 35 mildly to moderately memory-impaired patients rated current and premorbid personalities with the NEO Personality Inventory. We then examined changes in the five domains of personality tapped by the NEO. There were significant changes in four of the five domains of normal personality functioning toward less conscientiousness, lower extraversion, higher neuroticism, and lower openness. The difference toward lower agreeableness was not significant when controlling for multiple comparisons. Spearman rank correlation coefficients indicated that changes in conscientiousness and vulnerability were not related to rated premorbid personality patterns and thus appear to describe shifts for all patients evaluated for memory disorders. These data suggest that personality inventories may be helpful in characterizing caregivers' observations of memory impaired patients and thus represent a critical source of information for the clinician in charge of care. PMID- 1781967 TI - Cognitive decline in patients with Alzheimer disease: differences in patients with and without extrapyramidal signs. AB - We investigated the relationship between extrapyramidal signs (EPSs) in patients diagnosed with Alzheimer disease (AD) and the average rate of decline in different areas of cognition. The presence of tremors, cogwheel rigidity, or bradykinesia were scored as EPS using the California State Department of Health Services AD Diagnostic and Treatment Center Form. Measures of decline were computed by determining patients' average rates of decline on the Mini-Mental State Examination (MMSE). Of the 81 patients, 24 were determined to have EPS not related to medications. Overall, patients with EPS deteriorated 67% faster on MMSE (4.5 points per year) than did patients with no evidence of EPS (2.7 points per year). Our findings indicate that the clinical presence of EPS is a poor overall prognostic sign in patients with a clinical diagnosis of AD. PMID- 1781968 TI - Recent studies on dementia senilis and brain disorders caused by atheromatous vascular disease: by A. Alzheimer, 1898. AB - In 1898, Alzheimer wrote an exhaustive update on psychogeriatric issues. He discussed paralytic dementia, involutional melancholia, senile dementia, presenile dementia, arteriosclerotic dementia, Binswanger disease, stroke-induced dementia, and other dementias of vascular origin. In this paper, he appeared to describe his very first case of Alzheimer disease, he anticipated the ischemic score, and outlined his opinion about numerous issues of dementia research that are of current interest. PMID- 1781969 TI - Cytoskeletal changes underlying dementias: new evidence from Lewy body research. PMID- 1781970 TI - Current clinical trials of cognitive enhancers in Japan. AB - The primary purpose of this paper is to review the clinicopharmacological properties of brain metabolism enhancers available in Japan. The major target symptoms of brain metabolism enhancers are peripheral psychiatric symptoms (symptoms of the noncognitive type) of demented patients. A review of double blind studies of major brain metabolism enhancers in Japan revealed that 60-70% of patients were better than slightly improved and 20-30% better than moderately improved in treatment of cerebrovascular disorders. In treatment of Alzheimer type dementia, on the other hand, the better than slightly improved patients comprised 30-70% in mild to moderately demented cases. Severe cases of dementia showed a lower improvement rate. The incidence of side effects ranged from 4-9%. In our geriatric outpatient clinic, 72.5% of elderly demented patients (85% were mild-moderate dementia) exhibited better than a moderate improvement with combined psychopharmacotherapy, so far as peripheral psychiatric symptoms were concerned. Psychophysiological analysis of cases in terms of improvement of scores on Hasegawa's dementia scale strongly suggested that sporadic cases with cognitive improvement were brought about, at least secondary to improved vigilance, or with improved concentration and attention. PMID- 1781971 TI - Clinical issues of cognitive enhancers in Alzheimer disease. AB - Cognitive enhancers is a provocative and vague label for drugs used to treat dementia of the Alzheimer type. Several issues have to be carefully considered in order to perform reliable clinical trials with such compounds. The lack of an animal model appropriately matching the human pathology, the difficulty in finding worldwide criteria for clinical diagnosis and determining which patients are eligible and how they are best tested, methods of treatment, and interpreting results are undoubtedly the major problems to be solved. A review of the literature points out that the "day-after" approach of treatment (once severe neuropathological damage has been established) is no longer feasible, or has limited advantages. A different pharmacological approach, based on preventive measures during the first stages of the neurodegeneration, seems mandatory. PMID- 1781972 TI - Assessment issues in clinical trials of tetrahydroaminoacridine and studies to alter decline in Alzheimer disease. AB - The concept that Alzheimer disease (AD) and senile dementia of the Alzheimer type (SDAT) are the same disease, the increase in the elderly population, and the knowledge of AD neurochemistry have considerably expanded our knowledge regarding the pathophysiology of this disease. Improvement in clinical evaluation has resulted in diagnostic accuracy approaching 85%. Clinical drug trials currently being carried out are being designed either to improve the core symptoms of the disease or to alter the natural rate of decline. Issues regarding the assessment of patients in clinical trials and the utility of instruments have not yet been completely resolved. PMID- 1781973 TI - Behavioral evaluation of Alzheimer disease in clinical trials: development of the Japanese version of the GBS Scale. AB - GBS scale with four subscales and 26 total items is a behavior rating scale for dementia syndromes, and is now being used as one of the measures to assess the effects of drug therapy in dementia in Japan. In this article, the reliability and validity of the Japanese version of GBS Scale (GBSS-J) in 246 patients with dementia are examined. Two pairs of raters independently rated 20 patients to test inter-rater reliability of the 26 items. Pearson's correlation coefficients indicated good agreement between the raters except for nine items. The validity of the 26 items was examined by comparing them with the Functional Assessment Staging. Physical disability was evaluated by the Rapid Disability Rating Scale. Twenty items of GBSS-J measured the severity of dementia with sufficient validity. In addition, the items of eating, impaired physical activity, impaired wakefulness, and irritability were related to severity of physical disability rather than to dementia by the results from an analysis of variance and covariance. Although internal reliabilities by Cronbach's alpha of the three subscales were relatively high except for the subscale of different symptoms common in dementia, a factor analysis of the 26 items raised questions concerning the construct validity of the original four subscales. PMID- 1781974 TI - Neuropsychological assessment in clinical trials of Alzheimer disease. AB - A fundamental problem in research aimed at developing and testing new treatments for Alzheimer disease (AD) is determining drug efficacy. At the present time, while there are no biological markers for diagnosing or assessing this disease, investigators must rely on clinical judgment and neuropsychological outcome measures to determine if and when a new treatment may be beneficial. The following article provides an overview of the issues involved in conducting a clinical trial in AD when measures of cognitive and behavioral changes are used. It is based on the proceedings from an international workshop on this topic that was convened by the National Institute on Aging in January 1990. PMID- 1781975 TI - EEG brain mapping in diagnostic and therapeutic assessment of dementia. AB - EEG brain mapping has been proven to be a valuable method in diagnostic and therapeutic assessment in dementia trials, because it is a readily available, inexpensive, high time-resolution method for objective and quantitative evaluation of the neurophysiological aspects of dementias. In 111 mildly to moderately demented patients diagnosed according to DSM-III as both degenerative [senile dementia of the Alzheimer type (SDAT)] and vascular [multi-infarct dementia (MID) type], we were interested in showing not only differences between SDAT and MID patients and normal controls but also the relationship between CT scans, EEG maps, clinical ratings and psychometric tests. CT measures included 10 cerebrospinal fluid (CSF) space variables as well as 17 cortical density measures (1.7 mm3 cubes, Hounsfield units). Clinical investigations consisted of the SCAG score/factors, the digit symbol substitution test, the trailmaking test and the digit span forward test. In brain maps, SDAT patients showed slightly to moderately more slow and less alpha and beta activity as well as a slowing of the dominant frequency (DF) and the centroid (C) than did normal controls. These findings were most prominent in parietal and temporal regions. MID patients exhibited markedly augmented delta/theta and attenuated alpha and beta activity and a slowing of the DF and C. These neurophysiological findings suggest a deterioration of vigilance. Differences between SDAT and MID patients were found mostly in measures concerning differences in the maps. Brain maps of correlation coefficients between CT and EEG variables demonstrated: the greater the anterior horn distance, lateral ventricle distance, and Evan's index, as well as the less cortical density, the more delta/theta and the less alpha and beta activity in the EEG. Moreover, the higher the delta/theta, the less alpha and beta activity, the higher the SCAG scores, and the worse the psychometric performance. From the pharmacological point of view, we observed a significant improvement in vigilance after administration of several nootropic drugs both in normal and pathologically aging subjects, which was associated also with improvement of psychopathometric scores. Based on multi-variante analysis of variance (MANOVA)/Hotlelling T2 we observed a drug's effect in different brain regions of MID and SDAT patients. Thus, pharmaco-EEG mapping mediates valuable information regarding if, how, when, in which dosage, and where a nootropic drug acts on its target organ--the aging human brain. PMID- 1781976 TI - Efficacy and clinical relevance of cognition enhancers. AB - Changes from the end of 4-week placebo (washout) baselines to the end of 3-month therapy with three chemically different cognition enhancers (CEs) [i.e., piracetam, acetyl-L-carnitine, and nimodipine (NIM)], and parallel changes in placebo controls, were compared to determine the influence of the severity of disease at study entry. Four trials published elsewhere, showing significant treatment differences between active drugs and placebo, were selected according to their (a) sharing at least one global measure for treatment outcome and having shown effects on at least one additional scale or test, and (b) presenting an obvious rank order in the severity of disease. Each study was a standard controlled clinical phase III trial with greater than 100 psychogeriatric in-or outpatients. The patients' symptoms met the criteria for mild to moderate/severe age-related organic brain syndrome, a core syndrome of senile dementia, either from the primary degenerative, mixed, or multi-infarct type. The extent of changes on placebo was clearly influenced by the mean pretreatment severity of disease. On the whole, the improvements on active drugs reached or exceeded the baseline variability of psychogeriatric scales and tests. PMID- 1781977 TI - Girls who use "masculine" problem-solving strategies on a spatial task: proposed genetic and environmental factors. AB - This study investigated strategy and performance differences between right-handed boys and girls on a mental rotation task. Based on predictions from Casey and Brabeck's (1990) theory of sex differences, the study was also designed to identify a target group of right-handed girls with the optimal combination of genetic and environmental factors (high math/science achievers with nonright handed immediate relatives). They were predicted to show strategies and performance more similar to those of the boys than to those of both the low math/science achieving girls and the high math/science girls with all right handed immediate relatives (predicted to have the nonoptimal genotype). Strategy preference was measured using selective interference, whereby subjects solved mental rotation items concurrently with either verbal or visual-spatial interference tasks. Group comparisons were made on the amount of decrement in mental rotation performance as a result of the two types of interference tasks. This provided a basis for comparing the groups on the use of visual-spatial or verbal strategies on the mental rotation task. The boys: (1) did not show a significant advantage over the girls on the mental rotation items, but (2) did depend more on visual-spatial strategies than the girls, and (3) depended less on verbal strategies than the girls. The target girls: (1) outperformed the low math/science achieving girls on the mental rotation items and did not show a significant advantage over the other high math/science group, (2) depended more on visual-spatial strategies than both the other two groups of girls, and (3) depended less on verbal strategies than the low math/science girls, while showing no significant difference compared to the nonoptimal high math/science girls. Examining within-group differences, the boys preferred visual-spatial strategies, while the girls in both the nontarget groups preferred verbal ones. However, for the target girls, no within-subject strategy differences were found. The present findings support the theory that, like the boys, the target girls depend more on visual-spatial strategies than do other girls. It is possible that the target girls use a combination of visual-spatial and verbal strategies when solving mental rotation tasks. PMID- 1781978 TI - Question-asking strategies after severe closed head injury. AB - This investigation examined problem solving behaviors in survivors of severe closed head injury. Fourteen patients and 10 neurologically intact controls were administered the Twenty Questions procedure, requiring them to guess items the examiner was thinking of in a picture array. Relative to controls, survivors required more trials to guess the items and utilized a strategy characterized by attention to the individual pictures rather than to their shared conceptual features. The importance of problem solving impairments to neurobehavioral outcome after head injury is discussed. PMID- 1781979 TI - Speed of processing within semantic memory following severe closed head injury. AB - This study investigated the effects of severe closed head injury (CHI) on the speed of information processing within semantic categories. The question of whether subjects were able to benefit from priming was also investigated. Survivors of severe CHI who were less than 1 year postinjury and survivors who were greater than 1 year postinjury were compared with neurologically normal matched controls utilizing a category judgement task. The results demonstrated slower processing within semantic memory for both groups of CHI patients compared to normal controls. Furthermore, individuals with CHI were able to benefit from priming to the same relative degree as control subjects. Overall, the results suggested semantic organization remains intact after severe CHI, but accessing semantic information is slowed. PMID- 1781980 TI - Visual detectability gradients: effect of illiteracy. AB - When subjects are required to detect a target pattern presented simultaneously with a number of similar non-target patterns in a brief exposure, marked differences of target detectability are observed as a function of the spatial location of the target (Efron, Yund, & Nichols, 1987, 1990a, b, c; Yund, Efron & Nichols, 1990a, b, c). These differences in detectability as a function of retinal locus, referred to collectively as a "detectability gradient," have been attributed to a central serial processing mechanism, which scans the decaying neural representation of the image. There also is evidence suggesting that, at least in some circumstances, this gradient may be influenced by the direction in which subjects normally read (Heron, 1957; Mishkin & Forgays, 1952; Efron et al., 1987). The object of the present experiment was to determine whether the detectability gradient obtained with the non-linguistic stimuli used in our previous experiments would differ as a function of previous reading experience. The experiment was performed on a group of 60 illiterate subjects and on a socioeconomic-matched group of 60 literate subjects. While the overall accuracy of target detection was identical in the two groups, there were significant differences between the detectability gradients of the literate and illiterate subjects. The nature of these differences indicates that reading, or learning to read, causes the scanning mechanisms of literate subjects to adopt more consistent scan paths, from subject to subject, than they would have adopted without this reading experience. PMID- 1781981 TI - Visual detectability gradients: effect of high-speed visual experience. AB - The detectability of a target pattern presented briefly with a number of similar nontarget patterns varies as a function of the spatial location of the target. Previous work attributes these detectability gradients to a visual search process -a non-eye movement serial scan--that examines a decaying neural representation of the image. (Heron, 1957; Efron, Yund, & Nichols, 1987, 1990a,b,c; Yund, Efron, & Nichols, 1990a,b,c). The results reported in the companion paper (Ostrosky Solis, Efron, & Yund, 1991) indicated that literacy did not affect overall performance levels but did influence scanning behavior: "...reading, or learning to read, caused the scanning mechanisms of literate subjects to adopt more consistent scan paths, from subject to subject, than they would have adopted without this reading experience." The purpose of the present experiment was to determine the effect on this scanning mechanism, if any, of an entirely different type of visual experience--the high-speed visual processing required of tennis players. Unlike reading which requires the linguistic interpretation of a highly structured visual input, tennis skill requires rapid target detection and tracking in three-dimensional visual space as well as large scale visual-motor coordination. As in the previous experiments, subjects were required to detect a vertical stripe pattern among a number of similar non-target patterns. The experiment was performed on a group of 52 tennis players and on an age- and sex matched group of 52 non-tennis players. The overall accuracy of target detection was greater among the tennis players than among the non-tennis players and, of more interest, there was a significant difference in the detectability gradients. The detection advantage of the tennis group seemed to reach its maximum in the first half of the scan and then to deteriorate as the scan proceeded. These results indicate that visual experience other than reading can affect the habitual activity of the scanning mechanism. PMID- 1781982 TI - Personal relevance and the human right hemisphere. AB - Brain damage can selectively disrupt or distort information and ability across the range of human behaviors. One domain that has not been considered as an independent attribute consists of acquisition and maintenance of personal relevant entities such as "familiar" faces, persons, voices, names, linguistic expressions, handwriting, topography, and so on. In experimental studies of normal mentation, personal relevance is revealed in studies of emotion, arousal, affect, preference and familiarity judgments, and memory. Following focal brain damage, deficits and distortions in the experience of personal relevance, as well as in recognizing formerly personally relevant phenomena, are well known to occur. A review and interpretation of these data lead to a proposal that the right hemisphere has a special role in establishing, maintaining, and processing personally relevant aspects of the individual's world. PMID- 1781983 TI - In situ histochemical analysis of region-specific gene expression in the adult rat epididymis. AB - The epididymal tubule is a dynamic structure, in which spermatozoa undergo distinct physiological and morphological changes. The epithelial cells lining the ductuli vary dramatically in their histochemical and cytological properties according to the region of the tubule in which they are located. Additionally, regional variation is observed regarding the biosynthetic, secretory, and absorptive properties of the epithelial cells. Using in situ histochemical analysis, we document here the region-specific expression of a variety of genes that are transcriptionally active in the adult rat epididymis. Radiolabeled antisense riboprobes were used to localize, within the efferent duct/caput epididymis, transcripts encoding protein B/C, protein D/E (acidic epididymal glycoprotein), sulphated glycoprotein 1, sulphated glycoprotein 2, cellular retinol-binding protein, and the neuroendocrine peptide precursor proenkephalin. Each species of mRNA exhibits a unique pattern of hybridization, revealing that gene transcription within the efferent duct/caput epididymis is also highly region specific. This observation may partially elucidate the molecular basis underlying the phenomenon of regional alterations in the composition of protein factors within the tubule lumen. PMID- 1781984 TI - Stored mRNA in early embryos of a fern Marsilea vestita: a paternal and maternal origin. AB - In early embryos of the fern Marsilea vestita, we have shown that transcription did not begin until the 8-cell stage, even though protein synthesis was taking place. As in animal species, the pre-existence of stored maternal mRNA has been suspected in embryonic cells. To investigate the presence of such long-lived mRNA we have used in situ hybridization method using [3H]polyuridylic acid, [3H]poly(U), as a probe. Temporal and spatial changes in the distribution of poly(A)+ RNA were followed throughout all the different phases of embryogenesis. Poly(A)+ RNA was present in the cytoplasm of both unfertilized and fertilized eggs and early embryos, while the nucleus exhibited no, or a moderate, [3H] poly(U) binding activity. New poly(A)+ RNA was detected in the nucleus only at the 16-cell stage, when cytological differentiation of the root apical cell became morphologically detectable. After in situ hydridization with the labeled probes, the numerous silver grains detected autoradiographically over the mature sperm, indicate the presence of poly(A)+ RNA molecules associated with the male genome. We discuss the possible role of poly(A)+ RNA of maternal origin in supporting early translation prior to synthesis of new mRNA. Additional studies are needed to elucidate the role of stored paternal mRNA. PMID- 1781985 TI - Birth of lambs after in vitro maturation, fertilization, and coculture with oviductal cells. AB - Control ovine oocytes matured and fertilized in vitro were transferred to intermediate recipient ewes. After 5 days, 59% of eggs were recovered. Thirty-one (38%) reached morula/blastocyst stage. Twenty-one embryos at the morula or blastocyst stage were transferred to six recipient ewes, resulting in five pregnancies, of which four were maintained. Nine lambs were born (43%). In the experiment, 72 ooctyes matured and fertilized in vitro were cocultured for 5 days with sheep oviductal epithelial cells. Thirty-one eggs (43%) developed to the noncompacted morula stage. Transfer of 26 embryos to 11 recipient ewes resulted in two pregnancies (18%). Two male lambs were born. The result indicates that the coculture of in vitro matured and fertilized ovine eggs with sheep oviductal epithelial cells throughout the preimplantation period is compatible with further development to term. PMID- 1781986 TI - Quantification of Y chromosome bearing spermatozoa of cattle using in situ hybridization. AB - An easy assay for quantification of Y chromosome-bearing sperm (Y-sperm) is needed, especially to monitor sperm separation techniques. In the present study a tritiated bovine male-specific DNA fragment was tested for identification of Y sperm by in situ hybridization. A protocol for in situ hybridization to bovine sperm was developed and used to study the proportion of Y-sperm of 12 bulls. The usefulness of the method in optimization of sperm separation procedures is illustrated through analysis of fractions of sperm separated by Percoll density gradient centrifugation. PMID- 1781987 TI - Biochemistry of seminal secretions of the crab Scylla serrata with reference to sperm metabolism and storage in the female. AB - Biochemical studies on the male reproductive tissues and seminal secretions have been made with reference to sperm metabolism and different stages of maturity in the crab Scylla serrata. The results reveal that the seminal plasma and spermatophores are rich in protein, carbohydrate, and lipid. In general, organic components of spermatophores are considerably higher than those of seminal plasma. Enzyme studies show that the succinate dehydrogenase (SDH) activity is very low, whereas fumarate reductase (FR) and lactate dehydrogenase (LDH) exhibit high activity. Electrophoretic studies on LDH show that, in addition to the occurrence of a sperm-specific fraction, LDHx, the M-type subunits are predominant in the mature spermatophores. These results from enzyme studies suggest that sperm metabolism is mainly anaerobic, utilizing the carbohydrates as substrates. The results for maturational changes reveal that the male reproductive tissues and their secretions contain lesser quantity of organic components in the immature crabs; as the maturity proceeds, there is not only concentration of organic substances but also an increase in the size of spermatophores. The concentration of biochemical constituents is highest in the proximal vas deferens (PVD), suggesting that the granular seminal plasma as well as the sperm-agglutinating substance and spermatophoric wall are secreted in this region. The spermatheca of the unmated female crabs are poor in organic constituents. After mating, their contents are enriched by organic substances derived from contributions of the seminal substances. During sperm storage in the spermatheca, only the carbohydrates decline steeply. A low activity of SDH, but a moderate level of LDH and a high level of FR activity, is recorded in the spermathecal content of mated crabs, providing further evidence for anaerobic metabolism of sperm during storage in female. A sharp fall in the stored carbohydrates constitutes further evidence in this regard. PMID- 1781988 TI - Comparison of sperm binding potential of uninseminated, inseminated-unfertilized, and fertilized-noncleaved human oocytes under hemizona assay conditions. AB - In this study, human oocytes obtained after ovarian hyperstimulation for in vitro fertilization (IVF) and gamete intrafallopian transfer (GIFT) were utilized to evaluate sperm/zona pellucida binding potential. Three groups of oocytes were evaluated: 1) uninseminated; 2) inseminated-unfertilized; and 3) fertilized uncleaved. All oocytes had undergone germinal vesicle breakdown at the time of retrieval and were salt-stored (pH 7.2) for not more than 30 days. Sperm binding was recorded under hemizona assay (HZA) conditions using spermatozoa from eight fertile men (HZA control) and from 1) four teratozoospermic (HZA test) and 2) four normozoospermic (HZA test) infertile men. First, the mean numbers (+/- SD) of sperm tightly bound for fertile controls and teratospermic men to hemizonae from uninseminated oocytes were 69.7 +/- 16 and 14.5 +/- 7, respectively (P = 0.02). Likewise, hemizonae from uninseminated oocytes bound 102.0 +/- 19 and 114.0 +/- 28, respectively, for fertile controls and normospermic men (P = 0.5). Second, hemizonae obtained from inseminated-unfertilized IVF oocytes bound 44.2 +/- 12 and 19.7 +/- 6 for fertile controls and teratospermic men, respectively (P = 0.02). This category of oocytes bound 100.5 +/- 7 and 108.5 +/- 11 sperm, respectively, for fertile controls and normospermic semen (P = 0.3). Third, HZA results of fertilized but uncleaved oocytes showed a mean number of tightly bound sperm of 6.0 +/- 4 compared with 65.0 +/- 1 in control, uninseminated oocytes using fertile sperm. These results demonstrate that uninseminated and inseminated unfertilized human oocytes, salt-stored under controlled pH conditions, give reliable information regarding sperm binding potential under HZA conditions. PMID- 1781989 TI - In vivo secretion and association of clusterin (SGP-2) in luminal fluid with spermatozoa in the rat testis and epididymis. AB - Clusterin (sulfated glycoprotein-2) is a heterodimeric glycoprotein synthesized and secreted by rat Sertoli cells. An antigenically similar form is synthesized and secreted by the epididymis. The goal of this study was to define the epididymal regions in which clusterin is present and the regions in which clusterin is secreted and interacts with developing spermatozoa. Seminiferous tubule (STF), caput, corpus, and cauda fluids were collected by micropuncture and/or microperfusion and two-dimensional Western blot analysis was performed with a polyclonal antibody directed against Sertoli cell clusterin. Clusterin was found in both STF and epididymal fluid. STF contained predominantly the clusterin heavy chain (45 kd); however, a 70 Kd heterodimer was present under nonreducing conditions. Two subunits of clusterin with lower molecular weights (41 kd, heavy chain; 32 kd, light chain) and higher isoelectric points were present in the luminal fluid of all epididymal regions. The intraluminal levels of the heavy and light chains decreased from caput to cauda. Analysis by two-dimensional gel electrophoresis of proteins secreted directly into the epididymal luminal fluid revealed that clusterin was secreted by caput epithelium and not by the corpus and cauda epithelium. Western blots of membrane extracts from testicular, caput, and cauda spermatozoa revealed that testicular clusterin was associated with testicular sperm and epididymal clusterin with predominantly caput sperm. Our findings suggest that clusterin is secreted into the caput epididymal lumen, where it binds to sperm and then dissociates from sperm to be endocytosed by cells of the distal epididymal epithelium. PMID- 1781990 TI - Effects of the size and number of zona pellucida openings on hatching and trophoblast outgrowth in the mouse embryo. AB - The present studies were performed to establish the effects of the size and number of artificial holes produced in the zona pellucida (ZP) on hatching and trophoblast outgrowth in vitro. Limited partial zona dissection (PZD) produced small, narrow incisions, and zona drilling with acidic Tyrode's (AT) across a larger area in the ZP was used to produce bigger round holes. Some embryos were micromanipulated once; others were micromanipulated several times. Blastocysts hatched preferentially through the artificial gaps, but completion of hatching was dependent on the size of the hole. Only 16% (26/167) of PZD embryos migrating through narrow holes hatched completely; the remainder were trapped in a typical figure-eight shape. Seventy-two percent (43/60) of those migrating through larger PZD holes hatched, but trophoblast outgrowth was not observed. Significantly (P less than 0.001) more AT-blastocysts hatched (248/270; 92%) and showed trophoblast outgrowth (176/248; 70%). Simultaneous hatching through several openings was rarely observed in AT-embryos (14/167; 8%), but this did occur in 36% (73/201) of the PZD embryos. Trapping of PZD-embryos could be almost entirely avoided by drilling with AT elsewhere on the ZP. Embryos with multiple holes in their zonae preferentially hatched through the largest opening. The results suggest that the ability of microsurgically treated human embryos to fully hatch in vitro, should be carefully (re)assessed prior to application of clinical micromanipulation systems. Micromanipulated embryos with small holes in their zonae may be rescued by performing an additional more aggressive opening procedure elsewhere on the ZP. PMID- 1781991 TI - [Valve replacement with Macchi prosthesis]. AB - OBJECTIVE: to evaluate the performance of a new ball valve prosthesis. DESIGN: set up of two groups of patients who underwent mitral valve replacement with two different prosthesis: the Macchi prosthesis under evaluation and the well known Starr-Edwards model prosthesis. The chi-square test was used to compare the results. PATIENTS: Patients referred for valvular surgery. INTERVENTIONS: One group of 98 consecutive patients who underwent isolated mitral valve replacement with a Macchi prosthesis from January 1984 to June 30 1986 was compared to a matched group of 49 patients who received a Starr-Edwards prosthesis in the same period of time. Follow-up data were available from 99% patients in the Macchi group 96% in the Starr-Edwards group, with a mean follow-up time of 35.2 (2-57) and 42.9 (4-62) months, respectively. RESULTS: There was no statistical difference in the incidence per 100 patients--month of prosthetic complications- thromboembolism, hemorrhagic events, prosthetic endocarditis, reoperation and mechanical failure. CONCLUSIONS: In our experience and with the available follow up data the Macchi prosthesis is a good cost effective option when there is indication for a ball valve prosthesis. PMID- 1781992 TI - [Value of two-dimensional echocardiography in the prognosis of patients after acute myocardial infarction]. AB - OBJECTIVES: To evaluate the prognostic importance of two-dimensional echocardiography in patients (pts) with acute myocardial infarction. SETTING: Department of Cardiology in a Central Hospital. METHODS: In 71 pts (63 men and 8 women) aged 35 to 75 years interned with a proved myocardial infarction, a score of left ventricular segmental wall motion was used on echocardiographic examination performed during the late hospital phase, to evaluate left ventricular function. Two groups of pts were considered: group A constituted by 38 pts with complication detected during follow-up that ranged 4 to 18 months; group B by 33 pts with no cardiac events for the same period. The relation of the wall motion score with each group and the location of myocardial infarction was performed. RESULTS: In group A, the mean score index was 1.67 in pts with angina, 1.08 in pts with heart failure and 0.82 in pts who died. The mean score index was 1.25, 1.57 and 1.18 respectively in pts with an anterior, inferior and antero inferior infarction. In group B, the mean score index was 1.70 in pts with an anterior infarction, 1.85 in those with an inferior infarction and 1.33 in the patient with an antero-inferior infarction. Patients with a non-Q wave infarction had a mean score index of 2. The mean score index was significantly different between group A and B (respectively 1.33 vs 1.79; p less than 0.00001) and a mean score index of 1.53 was considered the mean risk value. CONCLUSIONS: Two dimensional echocardiography performed during hospital predischarge permits risk stratification after acute myocardial infarction, specially for death and heart failure. PMID- 1781993 TI - [Changes in coronary angiography in young patients with myocardial infarction]. AB - OBJECTIVE: To assess the coronariographic changes and left ventricular function of a group of young patients (pts) (less than 40 years) with myocardial infarction. DESIGN: Retrospective analysis on clinical data and cineangiography. SETTING: Patients studied in the Cardiology Department and Cardiothoracic Department of the Santa Marta Hospital in Lisbon. PATIENTS AND INTERVENTIONS: Sequential sample of 40 pts 39 male and one female submitted to coronariography after an acute myocardial infarction (mean age--34 +/- 3 years). MEASUREMENTS AND RESULTS: Twenty one pts had one vessel disease, 6 pts two vessel disease, 3 pts three vessel disease, 1 left main disease (2.5%) and 9 normal coronary arteries. More than a half (22) had a lesion on the left anterior descending artery (proximal in 12-30%), 13 a lesion on the right coronary artery (proximal in 3) and 8 on the circunflex coronary artery. There were 22 (55%) total occlusions (3 of the circunflex, 9 of the left anterior descending artery and 10 of the right coronary artery). Of these 8 were proximal. We divided the pts according to the regional contractility score in three groups. Most of them had a moderate decrease in contractility. Three pts had an apical aneurysm and 8 pts had apical discinesia. Three of these 11 pts had no significant coronary lesions, six had one vessel disease and 6 had a proximal lesion of the left anterior descending artery. The mean ejection was 53% and none was less than 30%. There was a statistical difference of score and ejection fraction between anterior and inferior myocardial infarctions (6.5 +/- 1.8 versus 7.8 +/- 1.6 e 48 +/- 11.6 versus 55.4 +/- 10.8), p less than 0.05 and between those with and without a proximal lesion of the anterior descending coronary artery (5.5 +/- 1.5 versus 7.9 +/- 1.5 and 41.4 +/- 7.9 versus 56.3 +/- 9.9), p less than 0.0005. Neverthless, when we tried to separate the pts with or without atherosclerotic lesions (6.9 +/- 1.7 versus 7.9 +/- 2.2 and 50.4 +/- 11 versus 54.8 +/- 14.3) or with and without multivessel disease (7.2 +/- 1.8 versus 6.7 +/- 1.9 and 52.9 +/- 12.2 versus 46.6 +/- 8.7), no statistical difference of score and ejection fraction was found. CONCLUSION: Young patients with myocardial infarction are predominantly males; - There is an important number of one vessel disease and in many patients no coronary significant lesions were found; - The functional changes depended more on the proximal location than on the number of diseased vessels. PMID- 1781994 TI - [Congenital cardiopathies at an internal medicine service]. AB - STUDY OBJECTIVE: Description of 32 cases of congenital heart disease in the adulthood, admitted in the First Department of Medicine of Hospital Santa Maria, Lisboa between 1980 and 1989. DESIGN: Retrospective study. SETTING: Admission from the Emergency Room and Outpatients Clinic to an Internal Medicine Department of a General Hospital. PATIENTS: Adult patients with congenital heart disease. MATERIAL AND METHODS: All the 32 cases of congenital heart disease admitted between the 1st January 1980 and the 31st December 1989 were studied retrospectively. The clinical findings diagnosis and special examinations were analysed. MAIN RESULTS: The admission age varied between 15 and 83 years old being 21 female (65.6%) and 11 males (34.4%). The 32 cases of congenital heart disease, were distributed as follows: 19 were atrial septal defects (ASD); 4 were bicuspid aortic valves; 3 were coarctations of the aorta; 3 were tetralogy of Fallot; 2 were patent ductus arteriosus; 1 was an Ebstein anomaly with cianosis. From the 19 cases of atrial septal defect (ASD), 15 were female and 4 were male. The mean age of admission was 57.1 +/- 14.9. Congestive heart failure (CHF) was the reason for admission in 11 cases. The EKG findings were atrial fibrillation (AF) in 11 cases and atrial flutter in 1. Pulmonary hypertension was observed in the 17 echocardiographically documented cases. Infeccious endocarditis was diagnosed in 2 of the 4 bicuspid aortic valves. CONCLUSIONS: Congenital heart disease is not a very rare disease. In our 32 cases, 19 (59%) were ASD. CHD and AF were very common in this patology, in relation to the advanced age of this population. The echocardiography was a very useful diagnostic procedure. The 2 infective endocarditis cases between the 4 bicuspid aortic valves, is a way to remember the importance of prophylaxis. PMID- 1781995 TI - [Transesophageal echocardiography. Evaluation of the technique and clinical indications. Experience at the Center of Thoracic Surgery of the S. Joao-Porto Hospital]. AB - The purpose of this paper is to report the early experience with Transesophageal Echocardiography (TEE) after its availability at Thoracic Surgery, Hospital S. Joao, Oporto, Clinical advantages of the esophageal acoustic window over other approaches and technical development background of the procedure are reviewed. Updated clinical indications of the procedure and illustrative clinical cases from daily practice are presented. From October 1990 to February 1991, 75 examinations have been performed, 59 in awake patients and 16 in unconscious patients, either in the operating theatre or in intensive care unit. The examination protocol was similar to the one followed at Mayo Clinic. All patients accepted to undergo the study when indicated. No technical difficulties were found and no complications were reported during the study period. Finally, based on this introductory experience, a comment is made on main indications for using TEE complemented by few notes on future perspectives with this using ultrasound technique. PMID- 1781996 TI - [Asymptomatic aortic dissection with large aneurysm of the ascending and the transverse aorta. Report of a case]. AB - The authors present a cae of asymptomatic type I of the DeBakey aortic dissection with a voluminous aneurysm of the false channel. In the absence of suggestive symptoms, the diagnosis was established by chance through two dimensional echocardiography and later confirmed by magnetic resonance imaging. They ignore the period of time between the beginning of the dissection and the diagnosis, but they consider that it could have exceeded five years. During that time, besides as well tolerated aortic incompetence and aneurysmatic enlargement of the false channel, no other problems were detected. Based on this case, the authors are going through the literature and are discussing the importance of some noninvasive imaging techniques in the diagnosis and follow-up of this patients. PMID- 1781997 TI - [The study of dermatoglyphic parameters on 1000 Tibetans]. AB - This paper reports 14 dermatoglyphic parameters of 1000 Tibetans sampled in Tibet. Relatedness between Tibetans and Hans is much closer than that between Tibetans and Minnesotians in the USA. Compared with 12 nationalities. The Tibetan showed smaller difference with the Hani and the Han and greater difference with the Uygur. Comparison among the Tibetans living in different regions suggests that the Tibetans in Tibet have less difference with the Tibetans in Pingwu Region of Sichuan Province and much difference with the Tibetans in Gannan Region of Gansu Province. This report indicates that dermatoglyphic Parameters should not be used indifferently in different ethnic groups or even in different geographic groups of the same nationality. PMID- 1781998 TI - [Comparative studies of cytokinesis-block and conventional micronucleus test in human lymphocytes cultured in vitro. II. Genotoxicological effects of mitomycin C]. AB - The authors have studied genotoxicological effects of MMC by means of CB- and C MNT to evaluate practical value of CB-MNT. The main results are as follows: (1) In 0.025-0.4 microgram/ml of MMC MNFs in lymphocytes detected by CB- and C-MNT presented dose-dependent increase, but the MNT detected by C-MNT was higher than that by CB-MNT, this difference became greater as MMC concentrations were increased. The minimum concentrations were 0.1 microgram/ml for CB-MNT and 0.025 microgram/ml for C-MNT respectively. Therefore C-MNT is more sensitive to MMC than to CB-MNT; (2) The mean volume of MN detected by CB- and C-MNT was estimated separately. The volume of MN detected by CB-MNT was about 3 times as large as that by C-MNT. The authors suggested that the fusion between micronuclei in cytoplasm of CB- cells could lead to increase of MN volume and decrease of MN numbers; (3) In healthy donors the background MNF in lymphocytes detected by CB MNT was significantly higher than that by C-MNT, it could be one of the reasons that led to the decrease of the sensitivity of CB-MNT to low doses of mutagens. Finally, the practical value of CB- and C-MNT was discussed. PMID- 1781999 TI - [Electron microscopic observation of synaptonemal complexes in spermatocytes of six species of fishes]. AB - The synaptonemal complexes (SCs) in spermatocytes of six species of fishes were detected with a combination of surface spreading and silver staining technique and observed under both light and electron microscopes. These fishes are Tilapia nilotica, T. mossambica and Mastacembelus sinensis of Perciformes. Sarcocheilichthys nigripinnis, Pseudorasbora parva and Hemibarbus maculatus of Gobioninae in Cypriniformes. The formation of SCs started in Zygotene and completed at Pachytene. During the pachytene, each SC was morphologically intact, preferentially stained and attached to the nuclear envelope by a dense terminal plaque. Interlock in SCs frequently occurred in Zygotene. In several cases breakage and disentangling of interlocked lateral elements were observed. SCs disappeared in diplotene. The pairing of the SCs started at telomeres and stretched towards kinetochore. The sex determination of Mastacembelus sinensis was xx/xy. The X and Y chromosomal SCs' axes had a distinctive morphology at pachytene and were clearly distinguishable from autosomal SCs. The X and Y chromosomes begain to pair at early pachytene. The X and Y chromosome axes paired to form a length of SC that is somewhat longer than the unpaired portion at the mid-pachytene. There was a dense substance at unpaired portion. Quantitatine evaluation demonstrated that relative length and arm ratio were distinctive characteristics for each autosomal SC. The consistency of relative length and arm ratio indicates the stability of the techniques. The idiograms of SC karyotypes of three species (Tilapia niloticus, T. mossambicus and Mastacembelus sinensis) have been constructed. PMID- 1782000 TI - [Studies of the blood-group of chicken. X. Analysis of blood-group and plasma protein polymorphism in eleven Chinese native fowl breeds]. AB - This paper reports the results of blood-group and plasma protein polymorphism of eleven Chinese native fowl breeds. 1. The distribution frequencies of the blood group genes (3 loci 12 alleles) in eleven Chinese native fowl breeds were significantly different in A and C loci, but not significant in B locus. The coefficients of homozygosity of blood-group gene in all breeds were almost similar, except in Gushi and Chonren pitted chickens. The distribution of blood group factors in all breeds was extensive, and this means that the selection potential in these local breeds was very large. 2. The gene frequencies of alkaline phosphatase (Akp and Akp-2) transferrin (Tf) in some breeds were more different, while that of esterase (Es-1) was less different. Among Chinese Japanese and American-European native breeds, the difference of gene frequencies of esterase was greater, while that of alkaline phosphatase and transferrin was smaller. It showed the identity or diversity in breed origin and evolution in these Chinese local breeds and Japanese or American-European native breeds. 3. The cluster analysis of the eleven Chinese native fowl breeds showed that these breeds could be divided into four groups: White ear-lobe- Shouguang- Luyuan chickens; Xiaoshan-Xianju- Pudong chickens; Langshan- Taihe Silky- Beijing Youkei chickens and Gushi-Chonren pitted chickens. PMID- 1782001 TI - [Y chromosome heterochromatin and human morphophysiological variability]. AB - Eighty morphophysiological traits were studied in 55 males with a morphologically identical heterochromatin subtotal deletion of Y chromosome and in 55 males with a normal Y chromosome. No significant differences were found between these groups in mean values of most traits except some hematologic parameters. Using the pattern recognition algorithm a combination of 20 traits which differentiated the groups under comparison with the recognition errors 4.6% was extracted. The recognition system consisted the informative traits including electrocardiographic parameters (25% of the traits), some anthropological and hematologic traits and subjects' age. The results suggest that the Y chromosome heterochromatin appears to have a modifying effect on the phenotypic relationship between morphophysiological traits during human ontogenesis. PMID- 1782002 TI - [The method of weighted least squares for estimating genetic parameters on the basis of lot means of generations]. PMID- 1782003 TI - [Studies on mtDNA of Ustilago maydis. II. Restriction mapping]. AB - A restriction map was constructed for mtDNA of Ustilago maydis. The fragment order for each restriction enzyme was determined by DNA hybridization and fragment overlapping. The restriction sites were located by analysing the secondary digestions of the cloned mtDNA fragments. It was also found that the mtDNA of U. maydis was a circle molecule (60.7 kb), without recognizable repeat sequence. PMID- 1782004 TI - Why "tight" glucose control? PMID- 1782005 TI - Is hyperglycemia risky enough to justify the increased risk of hypoglycemia linked with tight diabetes control? AB - There is an ongoing debate about the possible disadvantages of human insulin use with respect to a possibly lower awareness of hypoglycemia than is associated with animal insulin usage. Participants in this debate have not, however, discussed a major contributory factor to this life-threatening acute complication of diabetes, the pressure on patients to achieve normal levels of blood glucose. This pressure stems from the view that hyperglycemia is the major causative factor in the long-term diabetic complications. However, the evidence that supranormal levels of tissue and plasma glucose contribute to the diabetic tissue damage is not as strong as the arguments on behalf of this position. Indeed, elevated glycemia may be no more than a crude index of other, unknown metabolic derangements which may be causative agents in diabetes-associated tissue damage. Intensive efforts to "normalize" glycemia lack experimental and clinical justification, distract attention from other possible mechanisms, and may impose an unnecessary risk on the insulin-dependent diabetic population since intensive "normalization" of glycemia lowers hypoglycemia awareness, and thus increases risk of hypoglycemia, irrespective of the type of insulin used. PMID- 1782006 TI - The role of propylene glycol metabolism in lactatemia in the rabbit. AB - Propylene glycol (1,2-propanediol PD) has been reported to significantly alter the blood parameters when administered as a drug vehicle. In this study, experiments were performed to estimate the pH, levels of PD, and its metabolites to determine the acute effect of PD in blood. PD was administered to rabbits orally in a single dose of 1 ml 28.4% aqueous solution per 100 g body weight equivalent to 38.66 mmol/kg. Whole blood pH and the levels of PD and metabolites were estimated at fast (O.O h, before feeding PD) and at 0.25, 1, and 3 h after the dose. PD elevated the concentrations of blood PD to its maximum (41.04 +/- 9.98 mmol/liter, n = 4) at 1 h; whereas blood PD is normally absent during fasting. PD significantly increased (P less than 0.01) the concentration of L lactate in blood, which reached its plateau (2.55 +/- 0.62 mmol/liter, n = 4) at 0.25 h and was 2.45-fold higher than the observed fasted values (1.04 +/- 0.22 mmol/liter, n = 4). Production of D-lactate in blood was similarly increased significantly from 5.1 +/- 5.0 mumols/liter at fast to 150.0 +/- 30.4 mumols/liter at 3 h after oral PD (P less than 0.001, n = 4). As was observed in the fasted blood of PD treated rabbits, D-lactate levels at fast and after saline ingestion in the control animals was found either absent or too low. Despite this increase in lactate, blood pH did not alter significantly when appropriate anticoagulant, i.e., heparin + 4-methylpyrazole, was employed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782007 TI - Glucocorticoid hepatopathy: effect on receptor-mediated endocytosis of asialoglycoproteins. AB - Histologic and electron microscopic examination of liver tissue from glucocorticoid-treated dogs (GT dogs) showed a markedly abnormal hepatocellular morphology which consisted of severe hepatocellular swelling, vacuolation, and peripheral displacement of subcellular organelles. The abnormal cell morphology was typical of that seen in clinical cases of canine Cushing's Syndrome. The hepatocyte isolation procedure used here works equally well for the preparation of viable hepatocytes from both normal and GT dogs even though GT dogs displayed a pronounced hepatopathy. Cell yields (10(9) cells from a 30-cm3 section of liver) are similar to those reported for rat hepatocytes using whole liver in situ perfusion and cell viability is routinely greater than 85%. The isolation procedure preserved the "abnormal" state or swollen morphology of the hepatocytes from GT dogs and thus can be used in pathophysiological studies of glucocorticoid induced hepatopathy. The isolated hepatocytes were 3.2 times greater in cell volume than normal hepatocytes. We also observed over a 12.3-fold increase in alkaline phosphatase activity and the appearance in both the liver and the serum of GT dogs of the unique, corticosteroid alkaline phosphatase isozyme (CALP). In spite of the obvious abnormal liver morphology and elevated serum and liver alkaline phosphatase activities, the function of the hepatic cell surface carbohydrate binding protein, the Gal/GalNAc or asialoglycoprotein receptor, was not impaired. We found a trend of about a 1.5-fold increase in the initial rate of ligand uptake as well as 1.6-fold more receptors on GT dog hepatocytes compared to normal hepatocytes. The ligand binding affinity of these receptors, as well as the rate of ligand degradation, was identical in hepatocytes isolated from normal and diseased dogs. When intestinal alkaline phosphatase (IALP) is used as the ligand, approximately 25% was exocytosed intact following endocytosis. These results demonstrate that dogs with glucocorticoid hepatopathy possess a normally functioning Gal/GalNAc receptor. Furthermore, these data are consistent with the hypothesis that structurally related IALP and CALP isozymes may also be metabolically related through the Gal/GalNAc receptor endocytosis pathway. That is, a portion of the IALP normally endocytosed through the Gal/GalNAc receptor pathway in glucocorticoid-treated dogs may be recycled and converted (hyperglycosylated) to the abnormal serum CALP isozyme rather than being degraded. PMID- 1782008 TI - Differential action of thyroid hormones on the activity of certain enzymes in rat kidney and brain. AB - In rat kidney several mitochondrial and soluble enzyme activities are stimulated by thyroid hormones and the mitochondrial membrane fluidity is also increased. However, the ketone metabolism enzyme activities of D-3-hydroxybutyrate dehydrogenase and of 3-oxoacid CoA-transferase are not significantly affected by the hyperthyroid state and the ketone body concentration is not greatly changed. Therefore, in hyperthyroid rats the response of the kidney, as far as the ketone bodies and their metabolizing enzymes are concerned, is at variance with that of the liver and the heart. In the brain of young rats, age 8-9 weeks, the activities of the enzymes of ketone body metabolism and those responsible for other metabolic pathways are not influenced by the hyperthyroid state. In these animals, however, the activities of two enzymes, NAD-isocitrate dehydrogenase and pyruvate kinase, are still stimulated by 28 and 41%, respectively. This can be probably related to the higher energy requirement for definitive brain maturation in young hyperthyroid rats. PMID- 1782009 TI - The effect of malate on propionate mitochondrial toxicity. AB - Propionic acidemia occasionally produces a toxic encephalopathy resembling Reye's syndrome, indicating disruption of mitochondrial metabolism. Liver mitochondria respiratory control ratios were reduced 46% by 5 mM propionate; inhibition correlated with matrix propionyl-CoA levels. L-Malate prevented the toxic effect of propionate and reduced the propionyl-CoA matrix concentration by 62%. The beneficial effect of L-malate is apparently due to stimulation of succinate efflux because the effect is blocked by benzylmalonate, an inhibitor of the dicarboxylate carrier. Matrix concentration of label from [1-14C]propionate was not affected by L-malate and/or benzylmalonate. L-Malate may be useful in the treatment of patients with propionic acidemia. PMID- 1782010 TI - Evidence for kinetic and immunologic heterogeneity of dihydrofolate reductase in L1210 leukemia cells. AB - Two species of DHFR were identified in wild-type L1210 murine leukemia cells by analysis of the kinetics of the binding of MTX and dissociation of the MTX-enzyme complex at pH 5.0 and pH 7.2. The two forms of DHFR were also distinguished by immunoinhibition of the binding of MTX and the catalytic reduction of FH2 to FH4 using an antiserum raised to the purified high affinity form of DHFR. The Ka for the binding of MTX by the low affinity form of the enzyme is 4.5 x 10(7) M-1, substantially lower than the reported Ka for the binding of this drug by the high affinity enzyme. The low affinity form of the enzyme catalyzed the reduction of FH2 to FH4 at a rate slower than the high affinity form of DHFR. PMID- 1782011 TI - Effect of ammonium acetate-induced hyperammonemia on metabolism of guanidino compounds. AB - Guanidino compounds are synthesized from arginine in various tissues such as liver, kidney, brain, and skeletal muscle. Guanidino compounds such as arginine and creatine play an important role in nitrogen metabolism, whereas other guanidino compounds such as guanidinosuccinic acid and alpha-N-acetylarginine are known toxins. In order to understand the changes in the metabolism of guanidino compounds during ammonia toxicity, we investigated the effect of hyperammonemia induced by an ammonium acetate injection on the levels of guanidino compounds in plasma, liver, kidney, and brain of rats. Control animals were injected with an equal volume of saline. Blood and tissues were removed 1 h following ammonium acetate or saline injection and guanidino compounds were analyzed by high performance liquid chromatography. Plasma and kidney levels of guanidinosuccinic acid were significantly elevated in rats challenged with ammonium acetate. Brain alpha-N-acetylarginine levels were also significantly higher in rats injected with ammonium acetate as compared to those in controls. Our results suggest that guanidinosuccinic acid and alpha-N-acetylarginine may play an important role in hyperammonemia. PMID- 1782012 TI - Chemiluminescence is increased in a subgroup of PHA-stimulated lymphocytes from patients with systemic lupus erythematosus and inhibited by 5-lipoxygenase inhibitors. AB - Chemiluminescence (CL) was examined in phytohemagglutinin (PHA)-stimulated control and lupus lymphocytes because oxidative radicals have the chemical potential to generate DNA changes recently observed in lupus lymphocytes. Increased CL was found in 30 of 65 PHA-stimulated lupus lymphocyte samples by a luminol assay. CL did not correspond statistically to oxidative potential measured by a nitroblue tetrazolium assay. CL did not appear to be related to disease activity, organ involvement, or drug therapy. However, six of six males tested had positive CL activity. Cocultivation of CL-positive PHA-stimulated lupus lymphocytes with metabolic inhibitors of various oxidative enzymes revealed that 50 microM arachidonic acid dramatically inhibited the excess oxidation. A specific inhibitor of 5-lipoxygenase activity, 3 microM nordihydroguaiaretic acid, abolished excess CL activity. These studies suggest that chemiluminescence assays can be used to better understand the oxidative metabolism in lupus lymphocytes. The enzyme 5-lipoxygenase may be dysfunctional in a subgroup of lupus patients. PMID- 1782013 TI - Structure and variability of mammalian peroxisomal membrane proteins. AB - Peroxisomal membrane proteins (PMPs) from the Swiss-Webster mouse are analyzed and compared to those of rats and humans using sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and immunoblotting. A purification procedure for fresh mouse, rat, or human biopsy liver which enriches peroxisomal/mitochondrial marker enzyme ratios over 100-fold is characterized. When analyzed by SDS-PAGE, membranes of purified liver peroxisomes are shown to contain the same complement of 145-, 70-, 55-, 36-, and 22-kDa PMPs in rats, mice, and humans. A rabbit polyclonal antibody raised against mouse peroxisomal membranes demonstrates immunoreactivity to 145- and 70-kDa proteins in fresh liver homogenates from all three species and in control or Zellweger syndrome fibroblasts from humans. Human autopsy or placental tissues which were refrigerated before analysis exhibited 105-, 55-, and 36-kDa peptides which may be derived from the 145- and 70-kDa peptides. Such conversions, if related to degradation, may explain difficulties in purifying peroxisomes from human autopsy specimens. Variable amounts of the 55-kDa peptide also occurred in mouse adrenal and lung, and the conversion of higher to lower molecular weight PMPs could not be demonstrated by in vitro incubation of mouse liver. Further definition of the structure and variability of mammalian PMPs should be helpful in understanding polyenzymopathies such as Zellweger syndrome. PMID- 1782014 TI - H-7 reduces the nuclear binding of [3H]dexamethasone in rat liver slices but does not affect the phosphorylation of glucocorticoid receptor. AB - The effect of 1-(5-isoquinolinesulfonyl)-2-methylpiperazine dihydrochloride (H 7), an inhibitor of protein kinase C, on the nuclear binding of [3H]dexamethasone and on the phosphorylation of glucocorticoid receptor was studied in rat liver slices to ascertain the role of protein kinase C in the expression of glucocorticoid action. H-7 reduces the nuclear binding of [3H]dexamethasone in rat liver slices. It does not affect the extent of phosphorylation of glucocorticoid receptor both in the absence or in the presence of glucocorticoid. These findings indicate that protein kinase C may be involved in the nuclear binding of glucocorticoid receptor but does not directly influence the receptor phosphorylation. PMID- 1782015 TI - Displacement of hepatic ornithine carbamoyltransferase from mitochondria to cytosol in Reye's syndrome. AB - In two patients with fatal Reye's Syndrome, total ornithine carbamoyltransferase (OCTase) activity in the liver was 50 and 75% of that found in three control livers. The levels of enzymatic activity would not be expected to have resulted in the 7- and 17-fold elevations in plasma ammonia levels found in the patients. Levels of 47 and 60% of the OCTase activity, however, were found in the cytosolic fraction compared to an average of 7% for control livers. Thus, the amount of enzymatic activity in the mitochondrial fractions was only 20 and 30% of that found in control mitochondrial fractions. This study suggests that, if only mitochondrial OCTase is active in the urea cycle, the decreases in functional enzyme found in Reye's Syndrome may be considerably greater than that reflected in total enzyme assays. PMID- 1782016 TI - Molecular forms of human heart muscle AMP deaminase. AB - Chromatography on phosphocellulose revealed the presence of two, kinetically different forms of human heart AMP deaminase. The main portion of the activity eluted from the column at about 1.1 M KCl, and the enzyme present in this eluate manifested a sigmoidal type of substrate saturation kinetics. The results from gel filtration indicate that human heart AMP deaminase is a tetrameric protein capable of aggregating in more complex active structures. PMID- 1782017 TI - Effect of an interferon inhibitor on the antiproliferative signal of interferon alpha. AB - We have described a nonantibody type inhibitor of interferons (IFN) in the blood of patients with AIDS, advanced neoplastic disorders, and lupus erythematosus in earlier reports (1,2). In the present study we show that the semipurified inhibitor blocks the antiproliferative signal of IFN-alpha in Daudi cells and the membrane potential shifting ability of IFN-alpha is modulated by the interferon inhibitor preparation (IFI). PMID- 1782018 TI - A simple test for the detection of the delta F508 cystic fibrosis mutation. PMID- 1782019 TI - Vasoactive intestinal peptide: a chronoimmunomodulator? PMID- 1782020 TI - [Evaluation of the status of cardiac perfusion after implantation of extra cardiac conduits]. AB - The work discusses the findings of experimental study of perfusion of the myocardium after creation of a peculiar "new" outflow tract from the left ventricle of the heart. As a result, perfusion of a heart with an unnatural outflow tract from the left ventricle was found to be satisfactory. The authenticity of the results was determined by means of two, complementing each other, radioisotope methods--standard study with the use of 201Tl and a new method for producing a positron-emission image. It is concluded that the supply of blood to the myocardium after implantation of an ++apico-aortic conduit is sufficiently effective. PMID- 1782021 TI - [Heart valve bioprostheses of the "Bionix" series. 6-year experience with the mitral valve replacement]. AB - The main cause of cardiac valve bioprosthesis dysfunction is mechanical rupture of the cusps consequent upon the development of "fatigue" tensions and calcification of the biologic tissue. The technology of "Bionix" prostheses manufacturing implies prevention of these complications by means of supporting frameworks of variable rigidity (dumping stroke loads) and the use of a calcinosis inhibitor in the process of chemical stabilization. Experimental research confirms the certain effectiveness of such an approach to solving the problem of bioprosthesis durability. Experience in clinical application of biological valves of this series showed that by the 5th postoperative year the stability of good results was 90.0 +/- 2.2%; absence of thromboembolic complications in 93.3 +/- 2.4%, and no need to operate because of dysfunction of the bioprosthesis in 96.6 +/- 2.1%. PMID- 1782023 TI - [Biventricular auxiliary system for restoration of cardiac activity]. AB - Thirty experiments were conducted on calves for hemodynamic study of mechanical aid to the heart (biventricular bypass by two artificial ++"Module"+ ventricles of the heart) in acute cardiac failure. The cavities of the heart were cannulated with a special perforating device which, when necessary, is an obturator of the main line. Analysis of the hemodynamic values showed a sufficiently high efficacy of biventricular shunting in acute cardiac failure. The device for draining the heart cavities has advantages over the traditional main lines, in particular the number of complications from bleeding and air embolism reduces with its use. PMID- 1782022 TI - [Surgical treatment of supraventricular tachycardia]. AB - The article deals with the modern approaches to the treatment of supraventricular tachycardia . The authors analyse the results of operations in ectopic atrial tachycardias, the Wolff-Parkinson-White syndrome, modal re-entry tachycardias, and atrial fibrillation . The last-named is of most interest because the authors possess experience in a new operation for isolation of the internodal tracts. In all conditions the authors obtained convincing evidence on the efficacy of modern surgical treatment in supraventricular tachycardias. PMID- 1782024 TI - [Operations on the coronary arteries of the working heart without using an apparatus for extracorporeal circulation]. AB - Operations for aorto-coronary shunting and mammary-coronary shunting on a working heart were carried out without the use of a heart-lung machine in 19 patients with various forms of unstable angina pectoris in early periods (7 to 30 days) after the onset of the disease and in high left-ventricular end-diastolic pressure. There were no fatal outcomes. The post-operative follow-up periods ranged from 4 weeks to 2.5 years. PMID- 1782025 TI - [Extra-peritoneal operations in arteriosclerotic lesions of the abdominal aorta and its branches]. AB - The study is based on the analysis of the results of examination and operative treatment of 692 patients with atherosclerotic lesions of the aorta, its branches, and the limb arteries. The advantages of the extraperitoneal approach to the aorta over the transperitoneal approach in aorto-femoral reconstructions is proved. Stable postoperative intestinal paresis, peritonitis, intraabdominal bleeding, eventration, and adhesive disease do not occur with this approach. Such operations are not attended by a high incidence of coronary and cerebral vascular complications during and after the operation. The work gives the first appraisal of the results of postoperative plasmapheresis (21 patients) applied for normalization of hemorheological and lipoprotein disorders in different periods after the operation. The suggested complex approach to the treatment of atherosclerosis obliterans facilitates improvement of the immediate and late-term results of reconstructive operations on the vessels. PMID- 1782026 TI - [Surgical treatment of mitral and tricuspid valve defects]. AB - The results of surgical treatment of 265 patients with mitral-tricuspid valvular diseases are analysed. The operations were carried out in the period from Jan. 1, 1977 to Jan. 1, 1990 with various plastic procedures on the tricuspid valve. Hospital mortality was 13.2%. The late-term results were studied in follow-up periods of 6 months to 12 years in 207 (90%) patients. The results were good in 187 (75.9%), satisfactory and poor in 28 (13.5%) patients; 22 (10.6%) patients died. With the hospital losses taken into account, 5-year survival came to 73% and 10-year survival to 54%. Stability of good postoperative results was 79% by the 5th year and 49% by the 10th year. Among the surviving patients 85% are related to functional classes I and II and lead an active life. Plastic operations on the tricuspid valve can be undertaken in 92% of patients with mitral-tricuspid valvular diseases; they produce good late-term results in most cases, ensure stable normalization of hemodynamics, and should be performed more often in clinical practice. PMID- 1782027 TI - [Evaluation of late results of radical correction of tetralogy of Fallot based on treadmill test]. AB - The treadmill test was conducted, according to an elaborated program for evaluating insufficient pumping function of the left/right heart and the threshold of +lactic acidosis decompensation, in 53 patients before and in 86 patients after radical correction of Fallot's tetralogy. Insufficiency of left heart pumping functions occurred after the operation significantly less frequently in patients with a monocuspic graft (14 +/- 7%; M +/- m) and more frequently in suture plastics (54 +/- 14%). A similar tendency was also authentic for right-ventricular ejection and decompensation of acidosis load. It was proved that patients with a monocusp are distinguished by higher and most stable results for a period of 5 years after the correction. Lower results were characteristic of transannular plastics and of patients who were operated on through a longitudinal approach; the lowest results occurred in suture plastics through a transverse approach. It was found that ++re-shunting of the ventricular septal defect levels the results of the various types of correction of the anomaly. It is shown that the criteria of insufficiency of the heart pumping function may be used in the diagnosis of latent stenoses and regurgitations of the infundibulum of the heart and the pulmonary artery whose functional significance is revealed only during a load. PMID- 1782028 TI - [Ultrasonic diagnosis of acute iliofemoral venous thrombosis]. PMID- 1782029 TI - [Results of surgical treatment of calcified aortic valve stenosis in 80-year-old patients]. AB - The authors discuss surgical treatment of 67 patients for aortic stenosis in 1978 1988. Their ages ranged form 80 to 90 years. In a relatively low operative risk (8.9% mortality) the results provide evidence of marked improvement both in the functional condition (96% of patients are related to the NYHA classes I and II) and in survival (3-year survival 78.2%). The results of balloon valvuloplasty were much poorer. The indications for aortic valvuloplasty are very limited and determined with difficulty. PMID- 1782030 TI - [Evaluation of peripheral circulation in infants with aortic coarctation by transcutaneous pO2 measurement]. AB - Fourteen patients 6 weeks to 8 months of age with coarctation of the aorta (CA) were examined before and after correction of the anomaly. In inspiration of increasing concentrations of O2 the TavO2 was progressively delayed below CA as compared to the region above CA, which reflected latent tissue oxygen deficiency. After CA correction the TavO2 values were practically the same in both regions. Measurement of TavO2 at two points during inspiration of increased O2 concentrations (0.65) may be an objective method for confirming the existence of CA in infants. PMID- 1782031 TI - [Experimental studies after resection of the bronchi with a plasma scalpel]. AB - Experimental studies on 18 mongrel dogs showed that resection of large bronchi can be accomplished effectively with a plasma scalpel even in the presence of purulent bronchitis. Reliable hemo- and aerostasis are provided, a marked bactericidal effect is produced, the zone of irreparable thermal changes is relatively small, and proliferative processes prevail in healing. The obtained information allow plasma scalpel to be recommended for resection of large bronchi in clinical practice. PMID- 1782032 TI - [Hazards and complications of endoscopic laser operations in thoracic surgery]. AB - The danger and complications of endoscopic operations with the use of IAN- and argon lasers are characterized. Among 327 bronchoscopic laser interventions carried out for tumors of the respiratory tract, 7 (3.1%) were attended by complications in the form of perforation, hemorrhage, and laryngospasm. One case with empyema of the pleura was encountered among 35 patients after laser photocoagulation of the lung through a thoracoscope. Measures for the prevention and management of these complications were developed. PMID- 1782033 TI - [Use of neodymium YAG laser in endoscopic hemostasis in thoracic surgery]. AB - YAG-laser radiation was used for endoscopic hemostasis in 33 patients with bleeding endobronchial carcinomas and in 4 patients with chest injury complicated by bleeding from wounds of the lung and chest wall. For conducting laser photocoagulation, the authors prefer a rigid bronchoscope and a thoracoscope and pulsed laser radiation with a power of up to 40 Wt. As the results of treatment, hemostasis was achieved in 24 patients with lung carcinoma and in 4 patients with trauma of the chest. In some patients with pulmonary carcinoma laser photocoagulation creates conditions for successful surgery or chemoradiotherapy. The performance of thoracoscopic laser operations in chest injuries and traumas allows wide thoracotomy to be avoided in some patients. Complications were not registered in endoscopic laser operations. PMID- 1782034 TI - [Results of conservative treatment of short burn-induced strictures of the esophagus]. AB - The authors had 135 patients with short esophageal burn strictures, 120 of them were treated by bougienage. The immediate and late-term results of treatment of this category of patients were studied. A complex of methods for the examination of patients with short burn strictures of the esophagus was defined concretely. Bougienage along a string-guide under ++roentgeno-television control is the main method for the treatment of this category of patients, it produced good results in 83.3% of cases. The optimal bougienage methods and operative treatment of such patients were elaborated. PMID- 1782035 TI - [Mediastinal form of Brill-Symmers disease (giant follicular lymphoma)]. AB - Three clinical cases with the mediastinal form of Brill-Symmers disease are discussed. The variants of its symptomatology and course are described. The methods of diagnosis and surgical tactics are dealt with. Operative treatment of mediastinal giant follicular lymphoma in the stage of a benign course is the method of choice. The late-term results (of up to 20 years) were studied in 2 of the 3 patients. PMID- 1782036 TI - [Surgical tactics in bronchiectasis in children]. PMID- 1782037 TI - [Pathogenesis and prevention of calcinosis of bioprostheses]. PMID- 1782038 TI - [Vascular ring and pulmonary loop: experience with the surgical treatment]. AB - Operation was carried out on 143 children (aged from 5 days to 16 years) for tracheobronchial obstruction caused by vascular rings. A double arch of the aorta was found in 50 patients, double arch of the aorta with atresia of the left arch- in 50 patients, right arch of the aorta with ligamentum arteriosum--in 30, left arch of the aorta with an aberrant right subclavian artery--in 10, and a pulmonary loop in 3 patients. Stridor was the main clinical manifestation of the vascular ring. The diagnosis was established by means of two-projection chest radiography and esophagography with a barium meal, bronchoscopy, and angiography. The surgical approach was gained through a posterolateral (left or right) thoracotomy. No deaths occurred during the operation. Two infants died in the postoperative period from a severe bacterial infection of the respiratory tract. On the basis of a rich clinical experience the authors came to the conclusion that the presence of a right aortic arch (except for cases with situs inversus) is always pathognomic because it either causes the appearance of a vascular ring without any intracardiac anomaly, or it may be combined with a congenital heart disease in which a vascular ring is usually not encountered (tetralogy of Fallot, truncus arteriosus communis, etc.). The authors never encountered atresia of a segment of the right aortic arch. The last-named was either patent or absent. PMID- 1782039 TI - [Use of valve-including homologous aortic transplant for correction of pulmonary artery atresia with interventricular septal defect]. PMID- 1782040 TI - [Ligation of the thoracic duct]. PMID- 1782041 TI - [Surgical tactics in critical stenosis and atresia of the pulmonary artery with intact interventricular septum in infants under 1 year of age]. AB - The article analyses experience in surgical treatment of critical stenosis and atresia of the pulmonary artery with an intact interventricular septum in 53 infants. The patients were divided into two groups: group A--26 patients with a hypoplastic cavity of the right ventricle (RV), and group B--27 patients with a normal RV cavity. In group A, 15 patients underwent transpulmonary valvulotomy in combination with subclavian-pulmonary anastomosis by means of a Gortex prosthesis, 6 were subjected to isolated transpulmonary valvulotomy, and 5 patients underwent reconstruction of the RV outlet tract under conditions of extracorporeal circulation. In group B, 3 patients were treated by transpulmonary valvulotomy and subclavian-pulmonary anastomosis with a Gortex prosthesis, 16 by isolated valvulotomy, and 8 patients by reconstruction of the RV outlet tract under extracorporeal circulation. Six (22.2%) patients in group B died; 18 (69.2%) patients in group A died. Experience shows that in patients with critical stenosis of the pulmonary artery without RV hypoplasia preference is given to transpulmonary valvulotomy with occlusion of the venae cavae or, in marked infundibular stenosis of the RV--to reconstructive operation on the RV outlet tract under conditions of extracorporeal circulation. Transpulmonary valvulotomy in combination with subclavian-pulmonary anastomosis is advisable in patients with atresia or critical stenosis of the pulmonary artery and RV hypoplasia. PMID- 1782042 TI - [Surgical treatment of ischemic heart disease associated with lesions of the valvular apparatus of the heart]. AB - Every fourth patient over 45 years of age in a group of patients with valvular heart diseases suffers from affection of the coronary arteries. Experience in 71 operations for the combination of these diseases showed that the success of surgical treatment is determined by the method of myocardial protection. First the shunts are sutured and then additional cardioplegia is carried out through them. Valvular prosthetics is performed after that. Blood cardioplegia is preferred. Most surgical failures are connected with the complex character of the initial pathology. The direct and late-term results show the developed method for surgical management of this complicated pathology is effective and justified. PMID- 1782043 TI - [Coronary thrombosis, mechanisms of thrombolysis and the tactics in radiographically guided endovascular treatment of patients with acute myocardial infarction]. AB - The radio-angiographic features of coronary blood flow were studied in 119 patients in the first 24 hours of a macrofocal myocardial infarction. In 100 (84%) patients with recognized occlusion of the coronary artery responsible for the infarction the semeiotics of the occluding coronary thrombosis is described, and the characteristics of the residual stenoses after intracoronary thrombolysis were studied. In more than 60% of cases the radiographic features of these stenoses were found to be similar to those of primarily revealed stenoses responsible for infarction of the coronary arteries in degree, form, and the presence of mural thrombus. The mechanism of the formation of these stenoses was of a common character--lysis of the occluding thrombus, which was medicinal in the first case and spontaneous in the second. Medicinal thrombolysis is an analogue of the natural physiological mechanism--spontaneous coronary thrombolysis. It was established that the process of medicinal lysis of the coronary thrombus, a mural thrombus among others, is fully completed by the end of the second day of myocardial infarction. The obtained information makes it possible to formulate some principles of radiologically-guided intravascular treatment of patients with myocardial infarction. PMID- 1782044 TI - [Regional thrombolytic therapy of thrombosis of arteries of the pelvis and lower extremities]. AB - Regional thrombolysis was performed in 62 patients with thrombosis of the aorta and arteries of the pelvis and lower extremities. The thrombolytics used were avelysin (20 patients) and celiase (42 patients). Complete lysis of the thrombi was recorded in 49 cases. After successful thrombolytic therapy balloon angioplasty of the revealed stenoses was carried out in 39 patients. After thrombolysis was completed 15 patients underwent various reconstructive operations which failed to produce an effect in 4 patients and the extremity was amputated. The complications of thrombolysis included hematomas at the site of catheterization of the arteries in 5 patients, distal embolism in 7, and an allergic reaction in one patient. The authors appraise the dependence of thrombolysis efficacy on the level, extent, and duration of the thrombotic occlusion. PMID- 1782045 TI - [Experience with a prosthesis of the pulmonary artery trunk at the A.N. Bakulev Institute of Cardiovascular Surgery, Academy of Medical Sciences, USSR]. AB - From April 1975 to March 1991 sixty-four operations were carried out on 61 patients with various congenital heart diseases attended by impaired anatomical connection between the right ventricle and the pulmonary arteries. The patients' ages ranged from 9 months to 28 years (8 years on average). The most frequent clinical diagnoses were total transposition of the great vessels with ventricular septal defect and stenosis of the pulmonary artery (26 cases), type I common arterial trunk (14), Fallot's tetralogy (11 cases). Origin of the aorta and pulmonary artery from the right ventricle with stenosis of the pulmonary artery was encountered in 5 cases, origin of the aorta and pulmonary artery from the left ventricle with stenosis of the pulmonary artery in 4, and type II atresia of the pulmonary artery in one case. Three patients were reoperated on (reimplantation of an artificial pulmonary trunk). Synthetic prostheses with a biological (xenoaortic) valve made at the Institute, Bjerk-Sheily (USA) and Tascon Medical Technology (USA) "conduits", and synthetic prostheses devoid of valves were used. A "fresh" aortic alloprosthesis was used in one case. A statistically significant tendency towards reduction of operative mortality has been recorded (the mortality rate for the last 5 years is 14%). The late-term postoperative results were studied in 30 patients in follow-up periods of 12 months to 14.5 years (5 years and 5 months on average). Analysis of the late-term results shows the method to be highly effective. Stenosis of the prosthesis is the most significant problem of the late-term period. PMID- 1782046 TI - [Problems of diagnosis and surgical tactics in the treatment of occlusion of the abdominal aorta]. AB - Ultrasonic examination in occlusion of the abdominal aorta and its visceral branches is effective in 87.7% of cases. In combined lesions of the aorta and its visceral branches the authors suggest one-stage reconstructive operations to correct the blood flow. The mortality rate in such cases reduced by 6.76%. PMID- 1782047 TI - [Immediate results of reconstructive operations in arteriosclerosis obliterans of the iliac and femoral arteries]. AB - The work generalizes the immediate results of restoration of the main and collateral blood flow in 240 patients with arteriosclerosis obliterans of the iliac and femoral arteries. The outcomes of surgical treatment were judged according to the clinical and ultrasonic evaluation of regional hemodynamics. The results were found to be good in 84 (35.0%), satisfactory in 104 (47.5%), and poor in 42 (17.5%) patients. The results of operations on the iliac and femoral arteries are shown separately, as well as the results of surgery in their combined lesions. Thromboses of the reconstructed arteries and prostheses were encountered in 10 (4.17%), hemorrhages in 8 (3.33%), wound infection in 16 (6.67%), and venous thromboses in 4 (2.5%) patients. For the prevention of thromboses of the deep veins the author claims dosed physical exercises on a constructed training apparatus to be advisable. Amputation of the extremity was carried out in 10 (4.17%) patients because surgical correction of the blood flow proved ineffective and specific complications occurred. PMID- 1782048 TI - [Does the existing terminology reflect the progress in the treatment of chronic diseases of the veins of the lower extremities?]. PMID- 1782049 TI - [New methods of image creation in the diagnosis of superior vena cava syndrome]. AB - A program for the examination of patients with the superior vena caval syndrome, including digital subtraction angiography and computed-tomographic phlebography, is discussed. A combination of these methods is optimal and makes it possible to obtain detailed diagnostic information which is necessary for determining the therapeutic tactics in cases with the compression syndrome. PMID- 1782050 TI - [Hemopleuritis in closed thoracic injuries and multiple trauma]. AB - In examination of 817 patients with closed chest injury and multiple trauma 57% of them were found to have obvious or latent hemopleuritis. According to the character of the primary damage and the developing pathophysiological changes, 3 forms of hemopleuritis were revealed: cardiac, pulmonary, and abdominal. A single complex of symptoms forms finally: pulmonary hypertension, venous stasis in the lungs, right-ventricular cardiac insufficiency. As a result, venous blood escapes through the lymph nodes, mainly those of the right lung, and together with the lymph flows in the dilated lymph vessels of the lungs into the pleural cavity. The differential-diagnostic signs of each form of hemopleuritis are pointed out, the prognostic criteria of their development are revealed, and the pathogenetically substantiated therapy is determined. PMID- 1782051 TI - [Broncho-esophageal fistula]. AB - The authors analyse experience in the examination and treatment of 69 patients with bronchoesophageal fistulas (33 males and 36 females aged from 13 to 66). The etiological factors, pathogenesis, and clinical symptomatology of bronchial fistulas are discussed. The modern methods for the diagnosis of this pathological condition are indicated, the main ones being radiological and endoscopic methods. The indications for radical and palliative operations in bronchoesophageal fistulas are determined and their techniques are described. The methods for the prevention of complications are discussed. The late-term results of nonoperative treatment and various types of operations were studied. PMID- 1782052 TI - [Prevention and treatment of pleuropulmonary complications after simultaneous reconstructive operations on the esophagus in esophageal cancer]. AB - Pleuropulmonary complications in 50 patients who underwent operation for esophageal carcinoma with simultaneous esophagogastroplasty were most frequent (59%) and serious and accounted for up to 60% of all causes of early postoperative mortality. In operations through a transthoracic approach these complications occur more frequently (75%) than in operations without thoracotomy (48%). The possible causes and measures for the prevention of pleuropulmonary complications in the pre-, intra-, and postoperative periods are discussed. Particular attention is focused on the acute respiratory insufficiency syndrome during resection of the esophagus without thoracotomy. It is concluded that this serious pathological condition can be avoided by a complex of preventive and therapeutic measures carried out in all stages of treatment. PMID- 1782053 TI - [A rare case of foreign body in the posterior mediastinum]. PMID- 1782054 TI - [Diagnosis and surgical treatment of parasternal diaphragmatic hernia]. PMID- 1782055 TI - [Surgical correction of congenital heart defects in infants and young children]. AB - The results of surgical treatment of congenital heart diseases in 595 children under 3 years of age are generalized. There were no fatal outcomes after correction of coarctation of the aorta (9 cases), patent ductus arteriosus (312), pulmonary and aortic stenoses (7). Among 62 patients who underwent removal of an atrial septal defect 3 (4.8%) died. Operations were performed on 140 patients for a ventricular septal defect with high pulmonary hypertension, 31 (22.1%) of them died from various causes. Operations for complicated heart diseases were acts of despair in children whose condition was critical. PMID- 1782056 TI - Bone marrow transplantation with unrelated volunteer donors. PMID- 1782057 TI - Should surgery remain the initial treatment of "operable" breast cancer? PMID- 1782058 TI - New anthracycline derivatives: what for? PMID- 1782059 TI - Radiosurgery for brain tumours. PMID- 1782060 TI - Unproven methods in oncology. PMID- 1782061 TI - Bone marrow micrometastases in primary breast cancer: prognostic significance after 6 years' follow-up. AB - Using an antiserum to epithelial membrane antigen we have screened multiple bone marrow aspirates from 350 patients with primary breast cancer taken at the time of initial surgery. 89 (25%) patients were found to have micrometastases and their presence was related to pathological size (P less than 0.01), the presence of peritumoral vascular invasion (P less than 0.001), and positive lymph nodes (P less than 0.005) but not menopausal status. At a median follow-up of 76 months (range 34-108) 107 patients had relapsed with distant metastases. 48% (43 of 89) of these patients had micrometastases initially compared with 25% (64 of 261) who did not (P less than 0.005). The test predicts for relapse in bone (P less than 0.01) and other distant sites excluding bone (P less than 0.001) and is associated with a shorter overall survival (P less than 0.005). We conclude that the detection of micrometastases signals a high likelihood of early relapse and decreased survival in breast cancer. PMID- 1782062 TI - Prognostic factors in axillary lymph node-negative (pN-) breast carcinomas. AB - Axillary lymph node-negative (pN-) breast carcinomas (n = 281) were analysed histoquantitatively for two mitotic indexes (MAI, mitotic activity index; M/V, volume corrected mitotic index) and nine nuclear factors with special emphasis on disclosing prognostic factors during a follow-up of 12 years. The M/V index (P = 0.0018), tumour size (P = 0.0052), MAI (P = 0.0115) and histological grade (P = 0.0565) predicted the recurrence-free survival. MAI (P = 0.0007), M/V index (P = 0.0046), tumour size (P = 0.0133), histological grade (P = 0.0528) and S.D. of the nuclear perimetry (P = 0.07) predicted the disease-related survival. In Cox's analysis, MAI (P = 0.004), adjuvant therapy (P = 0.03) and tumour size (P = 0.09) predicted survival independently. Recurrence-free survival was related independently to nuclear perimetry (P less than 0.001), SD of nuclear area (P = 0.01) and MAI (P = 0.019) in Cox's analysis. In small (diameter less than or equal to 20 mm) tumours, S.D. of nuclear perimetry predicted recurrence-free survival (P = 0.03) in Cox's analysis. The results advocate the use of mitotic indexes and nuclear factors in place or in combination with conventional histological grading in predicting the survival and tumour recurrence in axillary lymph node-negative breast carcinomas. PMID- 1782063 TI - A prospective comparison between magnetic resonance imaging, meta iodobenzylguanidine scintigraphy and marrow histology/cytology in neuroblastoma. AB - A prospective comparison between magnetic resonance imaging (MRI), 123I meta iodobenzylguanidine (mIBG) scintigraphy and posterior iliac crest marrow aspiration and trephine biopsy in 30 assessments (19 patients) showed concordance between the three techniques in 16 assessments (53.3%). In 10 (33.3%), MRI and mIBG revealed abnormalities not detected by marrow biopsy. MRI was the only technique to demonstrate marrow abnormality in four assessments (13.3%). In addition, MRI revealed more sites of abnormality in 16 parallel assessments. We conclude that MRI shows promise as a non-invasive means of detecting bone marrow infiltration by neuroblastoma, but that further evaluation of the specificity of MRI in this setting is indicated. PMID- 1782064 TI - Synchronous cisplatin infusion during radiotherapy for the treatment of metastatic melanoma. AB - In two pilot studies, 55 patients with symptomatic metastases from malignant melanoma were treated with irradiation and concurrent cisplatin. In the first group, cisplatin was given as a continuous intravenous infusion of 20 mg/m2 per day on days 1-5 and 22-26, with irradiation on days 2, 5, 9, 16, 23 and 26. The second group received 20 mg cisplatin over 24 h commencing 1 h before each fraction of irradiation on days 1, 4, 8, 11, 15 and 18. The first series of 28 patients had 30 lesions treated. Nine (30%) of these lesions responded completely and 10 (33%) achieved partial response for an overall response rate of 63% (95% confidence interval 44-80%). Survival was not evaluated in this group. The second group was comprised of 27 patients, with one irradiated lesion each. 1 patient achieved a complete response and 13 (48%) a partial response for an overall response rate of 52% (32-71%). Median survival was 21 weeks (16-31 weeks). Treatment was well tolerated with nausea and vomiting being the most common toxicity. Synchronous cisplatin infusion with radiotherapy achieves high response rates in metastatic melanoma. Whether it is superior to radiotherapy alone will require evaluation in a randomised trial. PMID- 1782065 TI - Limb function following conservation treatment of adult soft tissue sarcoma. AB - Quality of life and limb function were studied in 54 patients who were disease free 2 or more years after limb-conserving treatment for soft tissue sarcoma of the leg or pelvic girdle. Tumours of the thigh predominated (25 patients) and the mean tumour size was 9.9 cm. 41 patients had been treated with a combination of surgery and radiotherapy (29 with conventional and 12 with high dose), 12 with surgery alone and one with irradiation and intra-arterial doxorubicin. Only 15 patients had a normal range of movement in all lower limb joints and only 12 had normal power in all muscle groups; tumours of the lower leg were particularly unfavourable in this respect. Gait was normal in 42 patients but 8 required a walking aid and 4 a joint support. 16 had detectable lymphoedema but only 2 needed to wear compression hosiery. 35 patients still experienced pain at some time but only 6 required analgesia. However, when assessed by questionnaire for locomotion, grooming and home/leisure/vocational activities, 37 patients (68%) reported excellent function, and only 2 had moderate impairment. Function loss was most marked in leisure (25 patients) and vocational (8) activities, but was mild in 66% of cases. Multivariate analysis was carried out to determine the prognostic factors for poor limb function. The results suggested that overall functional score was predominantly determined by gait (P less than 0.001), muscle power or range of movement (P less than 0.001), with increasing age, female sex and the use of radiotherapy poor prognostic factors. Reduced muscle power or range of movement were the major factors determining gait (P less than 0.02) with the use of radiotherapy the significant prognostic factor for both in the conventionally treated group. Doses in excess of 60 Gy resulted in increased fibrosis and a worse functional outcome. Extent of surgery was not an independent prognostic factor for limb function, although univariate analysis suggested an association with range of movement in the conventionally treated group (P less than 0.025). Despite significant objective loss of range of movement and muscle power patients retain excellent limb function and quality of life following limb conserving treatment. For optimal function, radiotherapy should be given with small fractions to a dose not exceeding 60 Gy. PMID- 1782066 TI - Recombinant interleukin-2 in metastatic renal cell carcinoma--a European multicentre phase II study. AB - This multinational, multicentre study represents the introduction of recombinant interleukin-2 (rIL-2) in Europe. From December 1987 to June 1989, 57 eligible patients with metastatic renal cell cancer were treated with rIL-2 administered as continuous intravenous infusion. 8 out of 51 evaluable patients responded (16%), 2 complete remission (CR) and 6 partial remission (PR). 10 patients had no change (20%). The response duration for CR was 209 and 394+ days. The median response duration for PR was 371 (range 140-506+) days. Dose-limiting grade 3-4 toxicities were hypotension in 52% of the patients, arrhythmia (4%), dyspnoea (8%), creatinine rise (4%), peripheral neurotoxicity (10%) and central neurotoxicity (10%). Toxicities most often recovered solely on interrupted therapy. 2 patients died due to catheter-related septicaemia and one patient died of rIL-2 induced renal failure. The study confirmed the antitumour efficacy of rIL-2 in renal cell cancer. Toxicities were numerous, but manageable by close observation in a normal oncology ward without routine use of an intensive care unit. PMID- 1782067 TI - Early cardiac toxicity of 4'-iodo-4'-deoxydoxorubicin. AB - 4'-iodo-4'-deoxydoxorubicin was administered intravenously to 35 patients with advanced malignant neoplasms. The doses were escalated as follows: 2, 4, 6, 7, 10, 14, 19, 26, 52, 70, 80 and 90 mg/m2. Myocardial function was assessed by Holter monitoring and echocardiography. The prevalence of arrhythmias that could be attributed to the drug in the 24 h following infusion was 14.3% (supraventricular) and 10.6% (ventricular). Echocardiographic heart function variables were unchanged at 24 h and 21 days from drug injection. The data indicate the absence of significant, acute cardiotoxic effects of 4'-iodo-4' deoxydoxorubicin. PMID- 1782068 TI - Phase II study of nimustine in metastatic soft tissue sarcoma. European Organization for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group. AB - The EORTC Soft Tissue and Bone Sarcoma Group has conducted a phase II trial in 33 eligible patients with metastatic soft tissue sarcoma with nimustine 100 mg/m2 every 6 weeks. In 31 evaluable patients there were 3 (10%) partial responses lasting 4.5, 6 and 7.5 months, and 5 cases of stable disease. 12 patients had progressive disease and 11 patients early progressive disease. Toxicity consisted mainly of leukopenia and thrombocytopenia and nausea and vomiting. It is concluded that nimustine has only minor activity in soft tissue sarcoma. PMID- 1782069 TI - Low-grade follicular lymphomas: analysis of prognosis in a series of 281 patients. AB - From 1963 to 1988, 281 patients with newly diagnosed follicular lymphomas were treated and followed at the Foundation Bergonie. Distribution of stages was: 72 I, 61 II, 83 III and 65 IV. Within stage III, two subgroups were retrospectively defined: stages III1 (32 cases) included patients with less than 8 involved sites, only 1 or 2 above diaphragm, and no spleen or mediastinal enlargement. Stage III2 (51 cases) included the remaining stage III cases. Median follow-up was 9 years. Complete remission (CR) rate was 82%. 10-year overall survival (OS) and time to treatment failure (TTF) rates were, respectively 38% and 29.5%. 10 year time to relapse (TTR) rate was 36%. Statistical analyses showed concordant results with two main prognostic factors: age (less than 60/greater than 60) and stage (I to III1/III2 and IV). Age was the most important factor for OS analysis and stage for CR and TTR analysis. This leads to only three prognostic groups with different outcome. The first includes younger patients (less than 60 years) with limited stages (less than or equal to III1); the second, patients either older than 60 or with advanced stages; the last, elderly patients with advanced stages. CR rates of these three groups were, respectively 97%, 75% and 57%. 10 year OS were, respectively 73.5%, 27% and 0%; 10-year TTR were 54%, 22% and 0%. These results have lead to data which are easy to handle and which can help to establish a rationale for further prospective trials. PMID- 1782070 TI - Haemodynamic effects of recombinant interleukin-2 administered by constant infusion. AB - Adoptive immunotherapy with recombinant interleukin-2 (rhIL-2) has been reported to induce tumour regression in some patients with refractory cancer. However, the cardiovascular toxicity of bolus therapy requires invasive monitoring of patients in the intensive care unit (ICU). In an effort to examine the haemodynamic alterations caused by a constant infusion of IL-2, as opposed to bolus therapy, we studied the haemodynamic variables of 10 patients, with no evidence of heart disease, receiving 3 x 10(6) IU/m2 per day of rhIL-2 as a continuous infusion for 5 days. Measured and derived haemodynamic variables were obtained immediately prior to, at 2, 24, and 48 h during, and upon termination of the infusion. There was no evidence of clinical haemodynamic instability in these patients. Except for development of fever and tachycardia, there were no clinically significant differences in any measured or derived haemodynamic parameter. Moreover, continuous electrocadiographic monitoring of these patients during the infusion did not reveal any abnormalities. Invasive haemodynamic monitoring in an ICU is not necessary in carefully selected patients receiving constant infusion rhIL-2, at the described dose and schedule. PMID- 1782071 TI - Mitoxantrone in malignant pleural mesothelioma: a study by the EORTC Lung Cancer Cooperative Group. AB - 46 patients with malignant pleural mesothelioma were entered in a phase II study of mitoxantrone 14 mg/m2 every 3 weeks. Histology was confirmed by a pathology panel. None of the patients had received previous chemotherapy. Toxicity was mainly mild gastrointestinal and haematological side-effects. Out of 34 patients evaluated for response, only 1 partial response was recorded. Mitoxantrone at this dose and schedule has marginal activity in malignant mesothelioma. PMID- 1782072 TI - Parathyroid hormone-related protein(50-69) and response to pamidronate therapy for tumour-induced hypercalcaemia. AB - A region-specific radioimmunoassay has been employed to measure levels of immunoreactive parathyroid hormone-related protein(50-69) (iPTHrP(50-69)) in patients with tumour-induced hypercalcaemia (TIH). This assay is based on an antiserum raised against synthetic human PTHrP(50-69). The assay showed no cross reactivity with human or bovine parathyroid hormone(1-84). The effect of a single dose (60 mg) of pamidronate was studied in 25 consecutive patients with TIH. All were rehydrated prior to treatment. All but 2 patients (8%) became normocalcaemic after treatment; both of these had very high levels of iPTHrP(50-69). Time to achieve normocalcaemia, as an index of relative resistance to pamidronate, correlated positively with pretreatment level of iPTHrP(50-69). Absence of radiological evidence of bone metastases also predicted relative resistance to pamidronate. In this study, iPTHrP(50-69)-induced osteoclastic bone resorption was a more important mechanism in the causation of TIH than PTHrP-induced renal reabsorption of calcium as assessed by the renal thresholds for calcium and phosphate. PMID- 1782073 TI - The importance of added albumin during continuous intravenous infusion of interleukin-2 with alpha-interferon. AB - We treated 14 patients (4 malignant melanoma/10 renal carcinoma) with a combination of continuous infusion interleukin-2 (IL-2) and subcutaneous alpha interferon. Variable concentrations of albumin were added to the infusion of IL 2. The toxicity of this regimen seems to be related to the percentage of albumin added to the IL-2 infusion. Partial responses were observed in 3 cases. Interestingly, 1 patient's response appeared dependent on the addition of human serum albumin. The mechanism of these effects is unknown, but the use of albumin with IL-2 should be carefully investigated in future studies. PMID- 1782074 TI - Phase I study of DABIS maleate given once every 3 weeks. AB - DABIS maleate is an alkylating quaternary nitrogen. In a phase I study DABIS maleate was administered as a single intravenous infusion once every 3 weeks. 32 patients with solid tumours were studied, at least 3 per dose level (50-1400 mg/m2). Dose-limiting toxicity was severe paresthaesias in the face, around the mouth and in the tongue. Cerebellar ataxia developed at 750 mg/m2 or higher. Haematological toxicity was minimal. Nausea and vomiting were mild to moderate. No other non-haematological side-effects were noted. The recommended dose for phase II studies at once every 3 weeks is 750 mg/m2 intravenously as a 15 min infusion. PMID- 1782075 TI - Phase II study of teniposide in patients with AIDS-related Kaposi's sarcoma. AB - Antitumour activity of cytotoxic agents, evaluated in patients with AIDS-related Kaposi's sarcoma (KS), is about 30-80%. However, responses are mostly partial and short. Experience with etoposide is similar. Teniposide has a longer elimination half-life and superior antitumour activity compared with etoposide in some experimental models. Thus a phase II trial was done in 25 patients with AIDS related KS. Teniposide was given by 60-min infusion at 360 mg/m2 every 3 weeks. 10 (40%) showed a partial response, median duration of 9 (6-20) weeks. The main side-effects were leukopenia, thrombocytopenia, nausea and vomiting, alopecia and mucositis. PMID- 1782076 TI - Differential c-myc protein expression in Burkitt's lymphomas and EBV-transformed lymphoblastoid lines. AB - The levels of c-myc protein expression in three types of Epstein-Barr virus (EBV) transformed human B-cell derived lines were examined with an ELISA assay. Six independently maintained sublines of the same EBV-transformed pro-B-cell line (FLEB-14), six B-cell lines (LCL) and six Burkitt's lymphoma lines (BL) were compared. The average amount of c-myc protein, calculated from at least three independent tests on each line, differed between the three groups. Expressed in relative units, the ratio of the means was 1:2:5 for the LCL:FLEB:BL lines. The differences were statistically significant at P less than 0.01. PMID- 1782077 TI - ras p21 expression in relation to DNA ploidy, S-phase fraction and prognosis in colorectal adenocarcinoma. AB - ras p21 expression, as indicated by the monoclonal antibody ras 11, was estimated using immunohistochemistry on 69 primary colorectal adenocarcinomas. Also, DNA ploidy and S-phase fraction (SPF) were analysed with flow cytometry. Positive staining for ras 11 tended to be more common in DNA non-diploid tumours (P = 0.11), but was significantly correlated with high SPF (P = 0.038). Positive ras 11 staining, Dukes' stage, DNA ploidy and SPF were related to the recurrence-free interval of patients with Dukes' A-C tumours (P = 0.0014, P = 0.023, P = 0.035 and P = 0.040, respectively). ras 11 staining was a prognostic factor independent of both Dukes' stage and DNA ploidy (P = 0.011). The results indicate that pan ras p21 expression is associated with proliferative activity and has an independent prognostic value in colorectal adenocarcinoma. PMID- 1782078 TI - The phospholipid analogue, hexadecylphosphocholine, inhibits protein kinase C in vitro and antagonises phorbol ester-stimulated cell proliferation. AB - The antineoplastic agent, hexadecylphosphocholine, a phospholipid analogue, inhibited phosphatidylserine-activated protein kinase C in vitro at concentrations higher than 40 mumol/l. The half-inhibitory concentration (IC50) was 62 mumol/l. Another alkylphosphocholine, dodecylphosphocholine, did not have an inhibitory effect on protein kinase C. At the same concentrations, hexadecylphosphocholine antagonised the phorbol ester-stimulated proliferation of Madin-Darby canine kidney cells whereas dodecylphosphocholine had no effect. In addition, phorbol ester-induced morphological changes of these epithelial cells were antagonised by hexadecylphosphocholine. Both effects of hexadecylphosphocholine, the inhibition of protein kinase C and the antagonisation of the altered cell morphology induced by phorbol ester, were comparable to those observed after treatment with sphingosine, a known protein kinase C inhibitor. We conclude that one possible mechanism of the antineoplastic action of hexadecylphosphocholine is mediated by inhibition of protein kinase C. PMID- 1782079 TI - Characterisation of a cell line (LCC-18) from a cultured human neuroendocrine differentiated colonic carcinoma. AB - A cell line (LCC-18) from a neuroendocrine colonic tumour was established. The tumour cells retained their endocrine characteristics through more than 100 passages and showed positive immunocytochemistry for synaptophysin, vasoactive intestinal polypeptide (VIP) and glucagon. The culture medium also contained VIP and glucagon, which indicates that mechanisms for release of some of the active peptides were preserved. Transplantation of LCC-18 tumour cells into nude rats resulted in tumour formation with similar endocrine characteristics. The c-myc gene was amplified which might have been a prerequisite for establishment of the cell line. The chromosomes in LCC-18 were studied by G-banding and C-banding. The cell line had a distinctive mode in the hypotriploid region, at S = 61. The double minute (Dms) positive stemline karyotype showed numerical and structural aberrations more similar to findings in ordinary colonic adenocarcinomas than to observations in previously studied, pure intestinal neuroendocrine tumours. The Dms may be correlated with amplification of c-myc. LCC-18 may become valuable for studies of neuroendocrine differentiation, regulation of growth and production and release of hormones and for studies of drug effect. PMID- 1782081 TI - Improvement of DNA repair in lymphocytes of breast cancer patients treated with Viscum album extract (Iscador). AB - We investigated alteration in DNA repair during therapy with an immunomodulator. 14 patients with advanced breast cancer were treated parenterally with Iscador, an extract of Viscum album (mistletoe). As a parameter for measurement of DNA repair the incorporation of (3H) thymidine into DNA of unstimulated lymphocytes after ultra violet light (UV) damage was taken. The DNA repair values in the patients were very low before treatment and on day 1: on average 16% of those in a healthy control population. Values started to increase on day 2 and on days 7-9 were on average 2.7 times higher than before treatment. 12/14 patients showed an improvement in repair. The values of spontaneous DNA synthesis were not altered during the treatment. We suggest that the increase of DNA repair could be due to a stimulation of repair enzymes by lymphokines or cytokines secreted by activated leukocytes or an alteration in the susceptibility to exogenic agents resulting in less damage. PMID- 1782080 TI - Neoadjuvant chemotherapy in operable breast cancer. AB - Primary chemotherapy in localised breast cancer may prevent tumour spread during surgical treatment and reduce proliferation of micrometastases. A randomised clinical trial, in 196 premenopausal and postmenopausal patients with operable (T2-3, N0-1b) breast cancer, was started in November 1983 at the Institut Curie to compare neoadjuvant and adjuvant regimens of chemotherapy with radiotherapy with or without surgery. The patients have been followed up for 35-70 months (median 54). A neoadjuvant group received two monthly cycles of intravenous doxorubicin/cyclophosphamide/5-fluorouracil before locoregional therapy and four cycles subsequently. Six monthly cycles following locoregional therapy were administered to the adjuvant group. Because of inclusion of postmenopausal and/or node-negative patients, compliance was less than optimal in 39 patients who were analysed separately according to actual dose received. Tumour response, evaluated after two cycles of neoadjuvant chemotherapy, was significantly associated with dose (P = 0.003). Survival showed a slight non-significant advantage for the neoadjuvant group. Survival plotted by actual dose was also similar. Neoadjuvant chemotherapy was safe and at least as effective as the adjuvant regimen. Patients have been accrued to a subsequent larger trial of chemotherapy as first-line treatment. PMID- 1782082 TI - Interleukin-2 therapy for refractory and relapsing lymphomas. AB - Recombinant interleukin-2 (rIL-2) has been reported to be active in metastatic renal cell carcinoma and malignant melanoma. The purpose of this trial was to determine the efficacy and toxicity of rIL-2 administered in continuous infusion in patients with Hodgkin's disease (HD) and non-Hodgkin lymphoma (NHL). 21 patients with HD (4 patients), diffuse large-cell NHL (7) or low-grade NHL (10) in failure or relapse after multiple-conventional treatments were included in this trial. rIL-2 therapy consisted of an induction period of two cycles separated by 3 weeks of rest, and, in the absence of progressive disease or undue toxicity, a maintenance period of 4 monthly cycles. Each induction cycle comprised the continuous infusion of rIL-2: 18 x 10(6) IU/m2 per day on days 1-5 and days 12-16. Each maintenance cycle comprised the continuous infusion of rIL 2: 18 x 10(6) IU/m2 per day on days 1-5. Among the 21 treated patients, 5 (all of those with low-grade NHL) responded to the induction phase (1 complete response, 4 partial responses) and 2 patients had a mixed response. Conversely, no response was observed in patients with HD or large-cell NHL. The median duration of response was 4 months. rIL-2 administered as a continuous infusion was well tolerated and most patients received the full dosage, and management did not require intensive care. During the induction period, 2 patients experienced grade III cardiovascular or renal toxicity. During the maintenance period, rIL-2 had to be interrupted in 1 patient because of a myocardial infarction. This trial confirms the inefficacy of rIL-2 for the treatment of large-cell NHL and HD. Conversely, in low-grade NHL, rIL-2 activity needs to be explored by further studies. rIL-2 may have a place in the early phase of the disease, when the immune system is not compromised, as an adjuvant treatment in residual disease in order to improve the duration of response. PMID- 1782083 TI - In vitro methods for screening agents with an indirect mechanism of antitumour activity: xanthenone analogues of flavone acetic acid. AB - Xanthenone-4-acetic acid (XAA) resembles flavone acetic acid (FAA) in its effects on solid tumours in mice. The activity of methyl-substituted XAA derivatives in vitro was determined using 18 h 51Cr-release assays, continuous exposure growth inhibition assays and stimulation of tumouricidal activity of cultured murine resident peritoneal macrophages. The macrophage assay identified the high biological activity and dose potency of 5-MeXAA in vivo, and was the most accurate in vitro predictor of the ability of congeners to induce either haemorrhagic necrosis of subcutaneous Lewis lung and colon 38 tumours or splenic natural killer activity. In vitro immune stimulation may be more appropriate than direct cytotoxicity for screening compounds with indirect mechanisms of antitumour activity. PMID- 1782085 TI - Left handedness is uncommon in breast cancer patients. AB - Left handedness was found to be significantly less common among patients with breast cancer in southern Sweden (1.5%) than among a female referent population (5%) (P less than 0.0025). The findings lend support to theories suggesting that hormonal factors in early life are of importance both for handedness and for the risk of breast cancer. PMID- 1782084 TI - M-VAC (methotrexate, vinblastine, doxorubicin and cisplatin) for advanced carcinoma of the bladder. The French Federation of Cancer Centers experience. AB - 70 patients with advanced transitional cell carcinoma of the bladder received methotrexate, vinblastine, doxorubicin and cisplatin (M-VAC). Complete responses (CR) were obtained in 13 of the 67 (19%) evaluable patients and partial responses (PR) in 25 patients for an objective response rate of 57% (95% CI 45-69%). Of the 54 patients who have had a minimum follow-up of 2 years, 8 patients (15%) are disease-free or have stable residual disease. Median survival of the 70 patients was 13 months. Toxicity was acceptable with no drug-related deaths. Because of myelosuppression, only 15 patients (21%) received treatment without delays in drug administration or modifications from the planned schedule. Our results confirm that this regimen is effective, with some patients being long-term survivors. PMID- 1782086 TI - A systematic survey of breast cancer incidence in the Departement of Rhone, France. AB - A systematic survey of all centres of diagnosis and care of breast cancer patients in the Rhone "departement" of France was carried out to evaluate, for the year 1985, the incidence rate of breast cancer in an urban, industrialised part of France not covered by a cancer registry. Two hundred and fifty seven institutions or individuals were involved, covering the public and private sectors in the Rhone departement, but also in neighbouring cities and elsewhere in France, which also enabled a search to be carried out for cases diagnosed or treated outside the departement. Altogether, over this 1-year period, 801 new cases were identified (791 women and 10 men). This study demonstrated a high incidence of female breast cancer (80.5 new cases per 100,000 woman-years, standardised to the world population) which was particularly marked among women aged 40-60. This incidence is higher than that described by the cancer registry of the neighbouring departement of Isere, but is close to the incidence found in Geneva. Results also concur with the relatively high mortality rate from breast cancer observed in the Rhone departement. PMID- 1782087 TI - Cancer registration and incidence in Hawaii. PMID- 1782088 TI - Genetics and cancer. PMID- 1782089 TI - Phase II study of combination vincristine, epirubicin and cyclophosphamide in advanced breast cancer in Chinese patients. PMID- 1782090 TI - Increased levels of soluble interleukin-2 receptors in supernatants from peripheral blood mononuclear cells of patients with lung cancer. PMID- 1782091 TI - Acute megakaryoblastic leukaemia in a child. PMID- 1782092 TI - Homoeostatic response criteria for cancer therapy. PMID- 1782093 TI - [Analgesia and sedation in dentistry with nitrous oxide and oxygen inhalation]. PMID- 1782094 TI - [Dentofacial injuries (3). Statistical study of tooth injuries in a group of Seville children]. PMID- 1782095 TI - [Computerization in prosthetics. The Cerec system]. PMID- 1782096 TI - [Parry-Romberg syndrome. Presentation of an early case]. PMID- 1782097 TI - [Provisional dentures in the treatment of temporomandibular dysfunction. Presentation of a case]. PMID- 1782098 TI - Do estrogens increase bone formation? PMID- 1782099 TI - The effect of sodium fluoride on trabecular architecture. AB - The effect of sodium fluoride therapy on iliac trabecular bone has been studied in 15 patients with primary osteoporosis by comparing bone biopsies taken before and after two years of treatment. A marked increase in bone volume (43%) was observed, which was attributable to an increase in trabecular thickness (46%) rather than their number. Because the trabecular bone surface, the trabecular number, the bone volume/trabecular width ratio, and the trabecular terminus number do not change significantly after fluoride treatment, we conclude that fluoride does not induce the de novo generation of trabeculae, nor does it restore trabecular connectivity despite the restoration of bone mass. These data suggest that the restoration of skeletal mass with fluoride may not lead to a comparable decrease in the risk of future fracture. PMID- 1782100 TI - Salmon calcitonin treatment by nasal spray in primary hyperparathyroidism. AB - The hypocalcemic and hypophosphatemic effect of salmon calcitonin (sCT) given by intranasal (i.n.) spray to 12 patients with histological confirmed primary hyperparathyroidism (1 degree HPT) was studied. The concentration of ionized calcium in whole blood (B-Ca++), serum phosphate (S-P), magnesium (S-Mg), plasma sCT (Pl-sCT), and endogenous CT (hCT) was followed during five 24-hour periods with at least three days between. After period I (control day), 100 IU sCT was given intramuscularly (i.m.) in period II. In periods III-V, either 110, 200, or 400 IU of sCT were given intranasally (i.n.) in randomized order. Although B-Ca++ decreased from the baseline value with all four sCT treatments and at 4.5 hour on the control day (p less than 0.05-0.001), the i.n. sCT treatments had no significant hypocalcemic effect, as the change of the area under the B-Ca++ curve (delta AUC B-Ca++) for the three i.n. treatments was not significantly different from the control period (p less than 0.001, ANOVA). Only the i.m. injection of calcitonin had a calcium-lowering effect (p less than 0.001, ANOVA). Three subjects were considered nonresponders with a decrease in B-Ca++ less than 0.06 mmol/L. S-P decreased within three hours after 200 IU sCT i.n. and 100 IU i.m., but the S-Mg levels showed no consistent changes. The area under the curve for the Pl-sCT levels did not correlate with delta AUC B-Ca++ except for i.m. given sCT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782101 TI - Effect of a short course of 1,25-dihydroxyvitamin D3 on biochemical markers of bone remodeling in adult male volunteers. AB - To investigate the stimulatory effect of vitamin D on biochemical markers of bone remodeling, 15 normal men (aged 26-45 years, mean 33.2) were treated orally with 1,25-dihydroxyvitamin D3, 2 micrograms daily for 7 days, and followed for a total of 16 weeks. Serum concentrations of 1,25-dihydroxyvitamin D3 rose 43% during the first week (p less than 0.01), with no significant alteration in the level of 25 hydroxyvitamin D3. Serum level of immunoreactive parathyroid hormone (1-84) (iPTH) decreased markedly (p less than 0.02), and the maximal renal reabsorption capacity of phosphate (TmP/GFR) increased (p less than 0.05), both indicating the impact of the raised vitamin D level on target tissues. Serum phosphate and serum calcium increased during the treatment week (p less than 0.05), as did the fasting renal excretion of phosphate and calcium (p less than 0.01). However, a gradual fall in the excretion of hydroxyproline was seen in the observation period. The serum activity of acid phosphatase increased in the first weeks after vitamin D treatment, reaching significance at the end of week 2 (p less than 0.05). Acid phosphatase activity was still increased at the end of the observation period (p less than 0.02). These observations suggest a synchronization and recruitment of new bone resorptive cells. The immediate response to 1,25-dihydroxyvitamin D administration on the biochemical markers of formative bone cells was a marked increase in the serum level of osteocalcin (BGP), (p less than 0.002) with a gradually fall during the next weeks. A secondary increase, however, was observed in the last two months of the follow-up period.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782102 TI - Phospholipid changes in the bones of the hypophosphatemic mouse. AB - The mineral and lipid composition of the bones of 35 day old hypophosphatemic (Hyp/Y) and control (+/Y) mice were compared in order to test the hypothesis that phosphate status has an effect on the complexed acidic phospholipid content of developing bones. The Hyp/Y bones were found to be rachitic and osteomalacic, having significantly reduced mineral content. That mineral was shown by X-ray diffraction to consist of larger/more perfect crystals than that in +/Y animals, indicating either a preference for crystal growth rather than new mineral deposition, or an increased mineral turnover. The increased crystal perfection was confirmed by chemical analyses which showed an increased calcium to phosphorus ratio in the Hyp/Y bones. The bones of Hyp/Y animals had significantly reduced complexed acidic phospholipid contents relative to those of control animals. Since these complexes are believed to play a role in vitro and in vivo mineral deposition, it is suggested that the deficiency of these complexes contributes to the mineralization defect. The magnitude of the complexed acidic phospholipid deficiency in the Hyp/Y animals indicates the importance of phosphate for the formation of these lipids. Although the proportion of phosphatidylserine and phosphatidylinositol and lysophospholipids tended to be reduced in the Hyp/Y bones, the absence of other statistically significant phospholipid abnormalities in the bones and brains of these animals suggests that the lipid defect is not systemic, but is associated with a decrease in phosphate at the site of bone formation. PMID- 1782104 TI - Appendicular skeletal status and hip fracture in the elderly: 14-year prospective data. AB - Fourteen-year follow-up of 535 elderly people included in a British survey in 1973 revealed 23 incident hip fractures. The relationship between appendicular bone mass, assessed in the initial survey by metacarpal morphometry, and fracture risk was analyzed. There was an increased risk of hip fracture with declining metacarpal cortical index at baseline. The risk increase, however, was not statistically significant. It remained similar after adjustment was made for the reported prevalence of falls. These prospective data suggest that osteoporosis may contribute less to the risk of hip fracture in the very elderly than in younger individuals. PMID- 1782103 TI - Mechanical properties and biochemical composition of rat cortical femur and tibia after long-term treatment with biosynthetic human growth hormone. AB - The influence of biosynthetic human growth hormone (b-hGH) on female rat cortical femur and tibia was studied after administration of hormone doses of 0.16, 1.10, or 8.33 mg/kg body weight/day for 90 days. The mechanical properties, dimensions, real density, ash weight, and the mineral and collagen concentrations of the bones were measured. In both femur and tibia a positive linear relation was found between the dose of hormone and ultimate load, ultimate stiffness, energy absorption at ultimate load, load at failure, energy absorption at failure, and deflection at failure. In the femur a positive correlation between dose and deflection at ultimate load was also found. After normalizing the mechanical data for the dimensions of the bones, no differences were found in the hormone treated groups compared to placebo, except for the elastic modulus (Young's modulus), which was decreased in the femur in the group given 8.33 mg b-hGH. The mineral and collagen concentration were unaffected in both femur and tibia, whereas the real density was decreased in the femur. The growth-hormone-induced changes in the mechanical properties seem to be caused mainly by increased dimensions of the bones. PMID- 1782105 TI - Synthesis and studies of alkynyl pyrimidinones as metaphase inhibitors. AB - Methods are described for the syntheses of chloromethyl propargyl ethers and propargyl halides substituted with a hydroxyalkyl group, and their use in alkylation reactions of 2-pyrimidinones. The N-alkynyl derivatives are reversible inhibitors of mitosis in the metaphase of the cell-cycle. The in vivo screening was on Chang liver cells. PMID- 1782106 TI - Synthesis of some 3',5'-dideoxy-5'-C-phosphonomethyl nucleosides. AB - Ammonium [1-(3',5',6'-trideoxy-beta-D-erythro-hexofuranosyl)thymine]-6'- phosphonate (1), ammonium 3',5'-dideoxycytidine-5'-C-methylphosphonate (2) and 3',5'-dideoxyadenosine-5'-C-methyl phosphonic acid (3) have been synthesized and tested for anti-HIV activity. The key steps involved an Arbuzov reaction between triethyl phosphite and 3,5,6-trideoxy-6-iodo-1,2-O-isopropylidene-alpha-D-erythro hexofuranose (7), followed by condensation with the appropriate nucleoside bases. The substances 1, 2 and 3 have been tested in vitro against HIV. PMID- 1782107 TI - Synthesis of a phosphonomethyl analogue of 3'-deoxy-3-fluorothymidine. PMID- 1782108 TI - Variables and paradoxes in "maintenance" therapy of lymphoblastic leukemia. PMID- 1782109 TI - Central nervous system-directed treatment in acute lymphoblastic leukemia: less effective in boys? PMID- 1782110 TI - Prognostic significance of methotrexate and 6-mercaptopurine dosage during maintenance chemotherapy for childhood acute lymphoblastic leukemia. AB - Tolerance of full-dose methotrexate/6-mercaptopurine (MTX/6MP) maintenance therapy for childhood acute lymphoblastic leukemia (ALL) without side effects could reflect insufficient systemic drug exposure, and drug withdrawals due to toxicity might reduce the chance of cure. The present study included 122 children with non-B cell acute lymphoblastic leukemia with a median follow-up of 84 months. Leukopenia and hepatotoxicity were calculated as weighted means of all white cell counts and all serum aminotransferase measurements, respectively, registered for each patient. Forty-five patients relapsed (30 in bone marrow). Patients tolerating an average dose of MTX of more than 75% of the recommended protocol doses and having cumulated drug withdrawals of less than 1% of the period of maintenance therapy had an increased risk of hematological relapse (p = 0.008) as well as of any relapse (p = 0.03) when compared to the remaining patients. Patients with a cumulative withdrawal of MTX or of 6MP for greater than 10% of the maintenance therapy period had an increased risk of hematological relapse (MTX: p = 0.009, 6MP: p less than 0.0001) and of any relapse (MTX: p = 0.16, 6MP: p = 0.0002). Liver toxicity was the main reason for cumulative long term drug withdrawals. However, patients with a mean aminotransferase level above the upper normal limit (40 IU/l) who were kept on therapy (cumulative withdrawals of neither drug for more than 5% of their maintenance therapy period) had a significantly lower risk of hematological relapse (p = 0.02) as well as of any relapse (p = 0.06) than the remaining children. The concept of treating to toxicity seems warranted for maintenance therapy of childhood lymphoblastic leukemia. PMID- 1782111 TI - Pediatric hematology and oncology in Norway: a brief historical review. AB - Before World War II no real subspecialization occurred in Norweigan pediatrics. In the early 1950s hematology and oncology were adopted as fields of special interest by a few Norwegian pediatricians. Gradually an increasing expansion has taken place, particularly in pediatric oncology, in parallel with the great advances in cancer treatment. PMID- 1782112 TI - Acute leukemia in an infant with Marfan's syndrome: a case report. AB - We describe a familial case of Marfan's syndrome with associated intrathoracic stomach detected during the neonatal period. The patient developed a primitive leukemia at 3 months of age. Acute leukemia in a patient with Marfan's syndrome has not previously been reported. PMID- 1782113 TI - Neonatal congenital Factor X deficiency. AB - Four neonates with congenital Factor X deficiency presented soon after birth with bleeding episodes. Two of the newborns had intracranial hemorrhages; one of them also had antenatal ventricular dilatation and postnatal hydrocephalus and died of massive intracerebral hemorrhage at four months. One patient was lost for follow up. The two surviving infants were followed up for four years and two years respectively, while on replacement therapy with three injections of 40 units/kg prothrombin complex a month. In spite of markedly elevated prothrombin time and partial thromboplastin time, these two infants remain free of major bleeding manifestations except for troublesome petechiae and ecchymoses. A schedule for substitution therapy with Factor X is proposed for infants and children to prevent bleeding in severe Factor X deficiency. PMID- 1782114 TI - Simultaneous pulmonary leiomyosarcoma and leiomyoma in pediatric HIV infection. AB - The case of a 7-year-old girl with acquired immunodeficiency syndrome treated for 5 years with AZT and intravenous gamma globulin is reported. Shortly before her demise she developed a pulmonary leiomyosarcoma and leiomyoma. Does prolonged survival in pediatric acquired immune deficiency syndrome increase the incidence of secondary malignancies? PMID- 1782115 TI - Imerslund-Grasbeck syndrome in two brothers: renal biopsy and ultrastructural findings. AB - In two Chinese siblings with Imerslund-Grasbeck syndrome, light microscopy of renal biopsies showed no remarkable change. Ultrastructurally, there were small possible focal defects in the glomerular basement membrane. Neither podocytes nor tubular cells showed evident change. No electron dense deposit was found. Our observations on renal ultrastructure differ from the previous five reports. The literature on renal pathology of this syndrome is reviewed. PMID- 1782116 TI - High-dose methylprednisolone for the treatment of priapism in childhood leukemia. PMID- 1782117 TI - Late intracranial hemorrhage in childhood lymphoblastic leukemia. PMID- 1782118 TI - The importance of the bone marrow examination in cystinosis. PMID- 1782119 TI - Use of the Nd:YAG laser in the surgical treatment of lung metastases in children. PMID- 1782120 TI - Urinary vanilmandelic acid and homovanillic acid: markers of two distinct cell populations in neuroblastoma? PMID- 1782121 TI - Idiopathic thrombocytopenic purpura in infants. PMID- 1782122 TI - Influenza in the world. 1 October 1990-30 September 1991. PMID- 1782124 TI - The application of PCR amplification and the polymorphic marker KM.19 to dried blood spots: comparison with deletion 508 for the confirmation of the neonatal screening test for cystic fibrosis. AB - Cystic fibrosis (CF) screening by measurement of immunoreactive trypsin (IRT) lacks specificity: only 9% of hypertrypsinemic neonates have CF. We have studied retrospectively 114 hypertrypsinemic samples (including 37 CF) for KM.19 polymorphic DNA marker and made risk calculations. If the neonate is homozygous for KM.19 allele 2, the risk of CF rises to 55%; if homozygous for allele 1, the risk is very low (less than 1%) and if heterozygous, the risk is intermediate (4%). In a prospective study including 28,000 IRT tests, 76 neonates with IRT greater than 800 micrograms/L have been identified: 16 were homozygous for allele 2 (8 CF), 30 for allele 1 (1 CF), and 30 were heterozygotes (no CF). Deletion 508 was present in 10 neonates: 4 homozygotes (4 CF) and 6 heterozygotes (3 CF). Two CF did not carry any copy of deletion 508. We have studied 181 (presumably non CF) neonates with IRT greater than 600 micrograms/L. The KM.19 genotypes distribution is significantly different from the one expected in the French population: homozygotes for allele 2 are more numerous. Furthermore, heterozygotes for deletion 508 are 1 in 15 (expected: 1 in 42). In conclusion, molecular biology in dried blood spots can enhance the specificity of CF neonatal screening, but IRT and genotype may not be independent. PMID- 1782123 TI - Current issues in neonatal screening for cystic fibrosis and implications of the CF gene discovery. AB - Many questions remain regarding the efficacy, toxicity, and costs of CF neonatal screening. It would be premature, in our opinion, to implement mass population screening of newborns for CF until the benefits and risks have been fully defined, and an adequate and logistically feasible testing system developed and/or highly effective therapy for CF lung disease becomes available. In addition, the ethical issues described herein need to be resolved. This pertains not only to the CF patient but also the heterozygote carrier. These reservations notwithstanding, the discovery of the CF gene should have a favorable impact both directly and indirectly on neonatal screening for the disease. Mutation analysis coupled to IRT testing seems most attractive at this time, at least on a research basis, but primary molecular diagnostic procedures might supervene in the future, particularly if they are financially feasible. PMID- 1782125 TI - Parental attitudes toward newborn screening for cystic fibrosis. PMID- 1782126 TI - Psychological impact of false-positive results when screening for cystic fibrosis. PMID- 1782127 TI - Respiratory physiological measurements in infants with cystic fibrosis. PMID- 1782128 TI - Early respiratory course in infants with cystic fibrosis: relevance to newborn screening. AB - Respiratory morbidity and mortality during infancy are important problems in the care of CF patients whether they are diagnosed conventionally or through newborn screening. Although the mechanisms of lung disease in CF remain to be elucidated, two potential pathophysiologic mechanisms--viral infection and undernutrition- can be associated with respiratory morbidity in infancy. Colonization of some infants with Pseudomonas and the presence of early mucus casts and cytokines in bronchoalveolar lavage suggest that pathophysiologic processes that are important in later life may begin in infancy. The early respiratory abnormalities, morbidity and mortality seen in CF indicate the need for future investigations of the respiratory course and interventional trials in infancy. PMID- 1782129 TI - Is clinical status at diagnosis a prognostic factor in CF infants identified by neonatal screening? PMID- 1782130 TI - Screening for cystic fibrosis: why, how, and when? PMID- 1782131 TI - Fat-soluble vitamins in infants identified by cystic fibrosis newborn screening. AB - Fat-soluble vitamin status was assessed in 36 infants diagnosed with cystic fibrosis by newborn screening in the Colorado Program. At the time of diagnosis of cystic fibrosis, 36% of infants were hypoalbuminemic, 21% had vitamin A deficiency, 35% had vitamin D deficiency, and 38% had vitamin E deficiency. None had vitamin K deficiency. Supplementation with pancreatic enzymes, a multiple vitamin preparation, and additional vitamin E was associated with normalization of serum albumin, retinol, and 25-hydroxyvitamin D and negative PIVKA testing at age 6 and 12 months. Several patients remained vitamin E deficient, but this was felt to be due to poor compliance. Biochemical evidence of fat-soluble vitamin deficiency is common before age 3 months in infants with CF and responds to supplementation in the first year of life. PMID- 1782132 TI - Nutritional assessment of infants with cystic fibrosis diagnosed through screening. AB - Presymptomatic infants diagnosed through neonatal screening for cystic fibrosis can have biochemical evidence of malnutrition. With aggressive dietary management and treatment with pancreatic enzymes, normal biochemical indices of nutrition can be achieved at 12 months of life in most cases. Males with cystic fibrosis appear to be more at risk than females for abnormal growth and biochemical indices of nutrition in the first year of life. This may be related to the observed decrease in fat intake when compared to females. Males, especially, should be carefully observed for development of nutritional abnormalities based on this data. Careful attention should be paid to vitamin E and essential fatty acid status in all CF infants. The numbers in this study are small and the long term consequences of early nutritional intervention await the conclusion of the randomized, controlled study on-going in Wisconsin. PMID- 1782133 TI - Growth evaluation at one year of life in infants with cystic fibrosis diagnosed by neonatal screening. PMID- 1782134 TI - Assessment of pancreatic function in screened infants with cystic fibrosis. AB - Previously we have reported that 37% of infants with cystic fibrosis diagnosed by neonatal screening with the dried blood spot immunoreactive trypsin assay have pancreatic sufficiency. However, 34 of the 78 infants had pancreatic function tests an average 2.3 years after diagnosis, thus it was possible that the percentage with neonatal pancreatic sufficiency was underestimated, due to the loss of pancreatic function with time in some infants. To assess this hypothesis we have assessed pancreatic function at the time of diagnosis in a further 20 infants since the completion of the previous study. Results of fecal fat determinations and/or pancreatic stimulation tests indicate that 10 (50%) of these infants have pancreatic sufficiency. Combining these results with those of the previous study, 31 of 64 patients (48%) have pancreatic sufficiency at this early age. We have also monitored the progression of pancreatic disease in the 39 patients with pancreatic sufficiency recognized to date. Eleven have developed pancreatic insufficiency and require enzyme replacement therapy. Five others have shown further improvement of colipase secretion with age. We conclude that the dried blood immunoreactive trypsin screening program for cystic fibrosis does recognize patients with pancreatic sufficiency, and at diagnosis nearly half the patients are in this category. To date, 28% of patients with pancreatic sufficiency have demonstrated a variable decline in pancreatic function with age. PMID- 1782135 TI - Newborn screening for cystic fibrosis: a historical perspective. AB - The historical development of blood immunoreactive trypsin as a screening procedure performed on neonatal dried blood is described. Our experience of false positive, and false positive results using the original procedure has led to some useful modifications which reduce these errors to an acceptable level. A satisfactory national screening programme has been in place in New Zealand for 10 years. PMID- 1782136 TI - The international quality assurance program (IRTIQAS) for the assay of immunoreactive trypsin in dried blood spots. PMID- 1782137 TI - Laboratory quality control issues related to screening newborns for cystic fibrosis using immunoreactive trypsin. AB - We have incorporated the IRT assay for CF to our newborn screening program, relying heavily on electronic data processing to optimize the test results in order to provide the most reliable data possible from the specimen at hand. We have established an internal cut-off of 100 ng/mL and an external referral of 180 ng/mL; this virtually eliminates the possibility that analytical imprecision will result in misidentifying a positive patient specimen. The relationship between IRT levels and various mutant forms of CF are not well established, and it is possible that various forms of CF may exhibit different levels of IRT in the first few days of life. We believe that IRT screening for CF could be a useful procedure for early identification of potential CF. However, by comparison with other newborn screening tests, its sensitivity, 90%, presents a concern. The expectation for PKU, hypothyroidism, MSUD, and galactosemia screening is 100% sensitivity. A false-negative usually results in litigation. The use of IRT in routine newborn screening will require considerable education of the general public and physicians receiving test results. Our program, along with many others, is anxiously watching the developments in the area of gene testing. We feel the relatively inexpensive IRT, used for mass screening can be successfully coupled with the more definitive (and expensive) gene test on a selected population to identify CF at the earliest possible age in a more effective manner. It is possible that in the near future gene probe tests will be applied in a cost effective manner to the initial filter paper specimen. PMID- 1782138 TI - A Xenopus multifinger protein, Xfin, is expressed in specialized cell types and is localized in the cytoplasm. AB - Xfin is a member of a large family of Kruppel-type transcripts stored in the Xenopus egg, whose function is unknown. By using polyclonal antibodies raised against fusion proteins containing different portions of Xfin, we have identified the Xfin gene product and established its pattern of expression in some adult tissues and during oogenesis and embryogenesis. The corresponding mRNA localization has been studied by in situ hybridization on ovary and testis sections. The Xfin product is found in the cytoplasm, both during oogenesis and adulthood; in adult tissues, it is differentially expressed in a cell-type specific fashion. The expression of the protein in specialized cell types and its cytoplasmic localization may favour the hypothesis that it could be involved in cell differentiation events through protein-RNA interactions. PMID- 1782139 TI - Interaction between torso and dorsal, two elements of different transduction pathways in the Drosophila embryo. AB - Early development of the Drosophila embryo is under the control of some maternal genes responsible for the establishment of its general pattern. Three sets of genes determine the anteroposterior pattern; two distinct systems specify anterior and posterior development and a third one, the terminal system, is responsible for the development of the poles of the embryo. A different set of genes specifies dorsoventral polarity, which is established by the graded activity of the dorsal gene product. Here I analyze the effect of the terminal system on the expression of two zygotic genes involved in dorsoventral pattern, snail and decapentaplegic, and I show that this effect is mediated by a reduction on dorsal activity by the terminal system. Due to the interaction of these two systems, both of which use transmembrane signalling mechanisms, the poles adopt a more dorsalized fate than their counterparts in the middle of the embryo. PMID- 1782140 TI - Replication and transcription in the course of DNA amplification of the C3 and C8 DNA puffs of Rhynchosciara americana. AB - The synchronous development of a sibling group of Rhynchosciara larvae enables us to follow the relationship between the local transcription and extrareplication of C3 and C8 DNA puffs. Although DNA amplification at these two loci takes place during the last cycle of DNA duplication in salivary gland chromosomes, a different timing of puff expression was observed for the two regions analysed. C3 puff transcription is a late event in relation to the C8 counterpart. We present evidence that this might be a consequence of the different firing of DNA amplification in both loci. No signs of DNA rearrangements were detected with probes that extend the previously analysed regions. PMID- 1782141 TI - Over-expression of an endogenous milk protein gene in transgenic mice is associated with impaired mammary alveolar development and a milchlos phenotype. AB - The whey acidic protein (WAP) gene is expressed in mammary epithelial cells at late pregnancy and throughout lactation. We have generated transgenic mice in which a mouse WAP transgene is expressed precociously in pregnancy. From 13 founder mice bearing WAP transgenes, two female founders and the daughters from a male founder failed to lactate and nurture their offspring. We named this phenotype milchlos. Mammary tissue from postpartum milchlos mice was underdeveloped, contained too few alveoli and resembled the glands of non transgenic mid-pregnant mice. The hypothesis that alveolar development in milchlos mice was functionally arrested in a prelactational state is consistent with low levels of alpha-lactalbumin mRNA, and an unidentified keratin RNA in mammary tissue from postpartum mice. Defects in alveolar function in milchlos mice were detected at mid-pregnancy; in non-transgenic mice, WAP was secreted into the alveolar lumen but remained preferentially in the cytoplasm of the alveolar epithelial cells in the milchlos mice. Since deregulated WAP expression resulted in impaired mammary development, it is possible that WAP plays a regulatory role in the terminal differentiation and development of mammary alveolar cells. PMID- 1782142 TI - Suitability of PCR methods for forensic investigation. Analysis of the 3'apoB VNTR system in an Italian population sample. AB - The PCR method has been applied to amplify a Variable Number Tandem Repeat (VNTR) sequence located at the 3' end of the apolipoprotein B (ApoB) gene. The study was conducted on an Italian population sample and in a 3-generation family of 13 members, whose relationships were previously established using conventional blood systems. The allele frequencies found were compared with those reported in the literature. The results also confirmed the Mendelian inheritance of the alleles and the suitability of the PCR method for forensic purposes. PMID- 1782143 TI - Sex determination and species exclusion in forensic samples with probe cY97. AB - A total of 120 human samples of blood, saliva and semen stains, hair roots, bone and skin fragments, obtained from 30 males and 16 females were analyzed in Southern blots with probe cY97. Only the male samples gave a specific band of 5.7 kb. In dot blot, under high stringency conditions, male DNA gave signals equivalent to a quantity of female DNA eight times higher. Probe cY97 did not react with 9 different vertebrate species but gave a signal for monkey DNA when used at low stringency. The advantage of using a probe specific for the centromeric region for sex determination and species exclusion is discussed. PMID- 1782144 TI - Hepatitis C in deceased drug addicts. AB - Needle sharing among drug addicts leads to the transmission of infectious diseases such as hepatitis B and AIDS. After development of a test system based on gene technology against the hepatitis C virus (HCV), drug addicts have been regarded as an important reservoir for hepatitis C. In our study 113 (40.1%) out of 282 addicts who died from drug abuse in Hamburg between 1988 and 1990 had antibodies against HCV (anti-HCV). The prevalence of anti-HCV differed in various age groups; the highest prevalence was found in addicts aged 30-34 years. Co infections with hepatitis B and hepatitis C virus were found in 57 drug addicts (59.4%) out of 96 deceased with antibodies to hepatitis B (anti-HBc), whereas only 8 out of 23 HIV-infected were anti-HCV positive (34.8%). PMID- 1782145 TI - ABO blood grouping of semen from mixed body fluids with monoclonal antibody to tissue-specific epitopes on seminal ABO blood group substance. AB - Practical methods were developed for ABO blood grouping of semen from mixed body fluids. An monoclonal antibody (P6-5H) which recognizes a tissue-specific epitope on a seminal ABO blood group substance (alpha 2-seminoglycoprotein) was used as a solid phase antibody for selective capture of the seminal ABO blood group substance. ABO blood group epitopes of secretor and non-secretor semen were detected in dilutions of 8 x 10(3)-3.2 x 10(4) and 8 x 10(3)-fold, respectively, by sandwich ELISA. ABO blood group epitopes were also detected in dilutions up to 4 x 10(3)-fold, irrespective of secretor status, by the sandwich absorption elution test. PMID- 1782146 TI - Postmortem neopterin concentrations: comparison of diagnoses with and without cellular immunological background. AB - Increased neopterin levels in urine and serum of living humans indicate an activation of the cellular immune system. We investigated 119 urine and 48 serum samples from 129 corpses taken at necropsy; 29 cases with a background of cellular immune activation were compared to 100 corpses with no such indication. Our investigations show the feasibility of postmortem neopterin measurements. However, different kinetics of serum and urine concentrations after death were observed. In addition, the data show that urine and serum neopterin concentrations were significantly higher when cellular immunological abnormalities were present when compared to the control group and to living healthy controls. The findings suggest, that increased postmortem urine neopterin concentrations in necropsy indicate pathological processes linked with cellular immune activation. PMID- 1782147 TI - Identification of species of weeds using high performance liquid chromatography in three crime cases. AB - Stains on clothing from two victims which were later on determined as grass stains, and a blade of dried grass taken from another were examined to identify the sites of crimes. The species of each sample was identified based on the characteristic distribution pattern of flavonoids seen on high performance liquid chromatography. The scene of the crime was clearly traced from the evidential material. PMID- 1782148 TI - Two deaths from intravenous nifedipine abuse. AB - An incident is reported in which 2 intravenous drug abusers died as the result of uncontrolled experimentation with intravenous injection of the common anti hypertensive and anti-anginal drug Nifedipine (Adalat t.m. Bayer), probably in mistake for the commonly abused short-acting benzodiazepine drug Temazepam. Large quantities of Nifedipine were identified in the blood of both decreased men by gas chromatography. Apart from intense gastric mucosal congestion, pulmonary oedema and general visceral congestion, the autopsy findings were entirely nonspecific. The similarity in colour, shape and texture between capsules of Nifedipine and those of Temazepam is likely to have prompted the mistake. PMID- 1782149 TI - Fatal poisoning with intravenously injected methadone and no fresh injection marks found. AB - Drugs addicts are commonly brought to casualty wards where they often pose a diagnostic problem. They are typically brought in unconscious with no signs of disease or trauma. The suspicion of poisoning arises by the finding of fresh injection marks. This paper describes a case in which a young male drug addict was dead on arrival in hospital without recognizable recent injection marks but with some old wounds or necroses in both groins. The autopsy and toxicological analyses revealed that death was caused by an overdose of methadone and that the necroses in the groins were fistulas facilitating administration of the drugs directly into larger veins. PMID- 1782150 TI - Malignant transformation of mouse BALB/3T3 cells by polyoma middle T antigen requires epidermal growth factor receptor expression. AB - The mouse cell line MO-5, which is defective in receptor-binding activity of epidermal growth factor (EGF), is very poorly transformed by polyoma middle T antigen or v-src gene, but activated c-H-ras and v-mos gene can induce the transformation (M. Ono, M. Yakushinji, K. Segawa, and M. Kuwano, Mol. Cell. Biol., 8: 4190-4196, 1988). We established clones of MO-5 expressing a functional EGF receptor (EGF-R) after introduction of the human EGF-R complementary DNA into MO-5 (MNER23 and MNER31), and we also established a clone (BNER4) expressing human EGF-R from the parental cell line, BALB/3T3. MNER23, MNER31, and BNER4 expressed EGF-R activity at about 2- to 6-fold higher levels than did control BALB/3T3 cells. A marked increase in DNA synthesis in response to EGF was observed in these BNER4, MNER23, and MNER31 cell lines compared to BALB/3T3 cells; however, there was little if any increase in DNA synthesis of MO-5 in the presence of EGF. Introduction of the polyoma middle T antigen gene into BALB/3T3, BNER4, MNER23, and MNER31 resulted in the appearance of transformation foci, but MO-5 again showed little response. We purified clones B4-mT-2, M23-mT-1, M23-mT 2, M23-mT-3, and M31-mT-13 from transformation foci of BNER4, MNER23, and MNER31 cells, which were respectively transfected with the middle T antigen. All of the middle T antigen-positive transfectants demonstrated abilities to form both colonies in soft agar and tumors in nude mice. The presence of EGF-R appears to be indispensable for malignant transformation by polyoma middle T antigen. PMID- 1782151 TI - Stimulation of interferon beta gene transcription in vitro by purified NF-kappa B and a novel TH protein. AB - The human interferon beta (IFN-beta) regulatory element consists of multiple enhanson domains which are targets for transcription factors involved in inducible expression of the promoter. To further characterize the protein-DNA interactions mediating IFN-beta induction, positive regulatory domain (PRD) II binding proteins were purified from phorbol ester induced Jurkat T-cells and from IFN primed, cycloheximide/polyinosinic-polycytidylic acid treated HeLa S3 cells. From HeLa cells, two major proteins of 52 and 45 kilodaltons (kD) copurified with DNA binding activity, whereas from T-cells, four proteins--a major protein of 52 kD and three minor proteins of 82, 67, and 43-47 kD--were purified. Also, an induction specific DNA binding protein was purified from HeLa cells that interacted with the (AAGTGA)4 tetrahexamer sequence and the PRDI domain. This protein is immunologically distinct from IRF-1/ISGF2. Uninduced or Sendai virus induced HeLa extracts were used to examine transcription in vitro using a series of IFN beta promoter deletions. Deletions upstream of the PRDII element increased transcription in the uninduced extract, indicating predominantly negative regulation of the promoter. A 2-4-fold increase in IFN-beta promoter transcription was observed in Sendai virus induced extracts, and deletion of PRDI and PRDII elements decreased this induced level of transcription. When purified PRDII and tetrahexamer binding proteins were added to the induced extract, a 4 fold increase in transcription was observed. These experiments demonstrate that it is possible to modulate IFN-beta transcription in vitro but indicate that additional proteins may be required to fully activate IFN-beta transcription. PMID- 1782152 TI - Autocrine and paracrine regulation of tissue inhibitor of metalloproteinases, transin, and urokinase gene expression in metastatic and nonmetastatic mammary carcinoma cells. AB - Acquisition of metastatic competence by tumor cells is frequently accompanied by increased expression of extracellular proteases capable of degrading basement membrane and extracellular matrix. However, very little is known about how the genes encoding these enzymes and their inhibitor proteins are regulated in metastatic versus nonmetastatic cells. In this report, we have compared autocrine and paracrine regulation of tissue inhibitor of metalloproteinases (TIMP), transin, and urokinase plasminogen activator (uPA) genes in genetically related nonmetastatic SP1 and metastatic A3a cell lines. Compared to SP1 cells, metastatic A3a cells showed 15-20-fold higher transin, 3-5-fold less TIMP mRNA, and comparable levels of uPA mRNA. A qualitatively similar shift in expression of these genes was rapidly (i.e., 4-8 h) induced in nonmetastatic SP1 cells following the addition of conditioned medium from A3a cells. The gene-regulating activity present in A3a conditioned medium was heat-labile, suggesting that it was protein in nature. The responsiveness of SP1 cells to the factor(s) secreted by A3a conditioned medium was inhibited by cycloheximide. Basic fibroblast growth factor mimicked the effect of the A3a conditioned medium as an inducer of transin expression in the tumor cells. Although medium conditioned by the tumor cells did not affect uPA expression, addition of epidermal growth factor to the tumor cells transiently induced expression of uPA with a biphasic response that differed in SP1 and A3a cells. Initial induction of uPA at 2-4 h was similar for both cell lines, but after 24 h of exposure to epidermal growth factor, SP1 cells showed a net reduction in uPA, whereas metastatic cells returned to the unstimulated levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782153 TI - Cyr61, product of a growth factor-inducible immediate early gene, is associated with the extracellular matrix and the cell surface. AB - cyr61 is a specific target for activation by platelet-derived growth factor and fibroblast growth factor and is inducible by the oncogene v-src. It is a member of the class of immediate early genes that includes those encoding protooncogene products, transcription factors, and cytokines. We have previously characterized the synthesis and degradation of the cyr61-encoded mRNA and protein. Although the deduced Cyr61 protein sequence contains an NH2-terminal secretory signal, it is not detectable in the conditioned medium of serum-stimulated cells. We show here that in rapidly growing cell cultures, newly synthesized Cyr61 is secreted and is associated with both the extracellular matrix and the cell surface. In contrast, Cyr61 secreted in serum-stimulated quiescent cells is directed to the cell surface and is hot incorporated into the extracellular matrix. Once associated with the extracellular matrix, Cyr61 has a half-life of greater than 24 h, whereas intracellular and cell surface-associated Cyr61 has an apparent half-life of approximately 30 min. Furthermore, Cyr61 appears to bind heparin with high affinity. These observations suggest similarities among Cyr61, the fibroblast growth factors (heparin-binding growth factors), and the protooncogene product Int-1 and are consistent with the hypothesis that Cyr61 plays a role in cell-cell communication involving the interaction of neighboring cells. PMID- 1782154 TI - How do we restore and maintain a clear cornea in a poor rural villager? Penetrating keratoplasty in developing countries and international eye banking. PMID- 1782155 TI - Photorefractive keratectomy with an argon fluoride excimer laser: a clinical study. AB - The results of excimer laser photorefractive keratectomy (PRK) in 16 blind and 120 sighted eyes (136 patients) are presented. Follow up for the blind eyes was 22 months and for the sighted eyes 8 to 18 months (mean, 1 year). A Summit Technology UV200 excimer laser with fluence fixed at 180 mJ/cm2, beam diameter 4 mm, a frequency of 10 Hz, and ablation rate of 0.22 mu per pulse was used. The range of preoperative myopia was - 1.50 diopters to - 17.50 D (spherical equivalent). Ninety percent of patients undergoing a -2.00 D correction and 75% of patients undergoing a -3.00-diopter correction were within +/- 1.00 D of intended refraction at 6 months. This figure fell to 40% and 20% for the groups undergoing -6.00 D and -7.00 D corrections, respectively. While the trend is toward undercorrection, around 70% of patients in all groups have benefited from a reduction of their myopia by at least half that intended. A variable degree of anterior stromal "haze" was detected in 110 patients (92%) despite a rigid high dose topical corticosteroid regime over 3 months. Best spectacle corrected visual acuity, however, was greater than or equal to preoperative levels in 111 patients (93%). Six patients experienced a reduction of one line of Snellen acuity at 6 months and three of the high myopes lost two lines. No patients lost more than two lines of Snellen acuity. Ninety-four patients (78%) noticed a "halo" around lights at night, more marked in the early postoperative period, which we attribute to the 4-millimeter diameter ablation zone. With a large pupil, both central and paracentral cornea can contribute simultaneously to the retinal image. We have demonstrated considerable individual variation in response to this surgery, which is more marked in high myopia. Although follow up at the present time is limited, to date PRK appears to be a safe procedure that holds considerable promise for refractive surgery in the future. PMID- 1782156 TI - Epidemiology of corneal blindness in developing countries. PMID- 1782157 TI - The International Federation of Eye Banks and Tissue Banks International. PMID- 1782158 TI - Corneal transplantation worldwide: helping others to help themselves. PMID- 1782159 TI - Penetrating keratoplasty is an inappropriate procedure for underserved populations in developing countries. PMID- 1782160 TI - Community efforts in the reduction of corneal blindness in developing countries. PMID- 1782161 TI - Sociocultural and religious attitudes in eye banking. PMID- 1782162 TI - Legal considerations in international eye banking. PMID- 1782163 TI - Corneal disease in Africa. PMID- 1782164 TI - Penetrating keratoplasty and eye banking in South Africa. PMID- 1782165 TI - Corneal transplantation at the King Khaled Eye Specialist Hospital. PMID- 1782166 TI - Penetrating keratoplasty in Jordan. PMID- 1782167 TI - Corneal transplantation and eye banking in India. PMID- 1782168 TI - The Sri Lanka experience in eye banking. PMID- 1782169 TI - Penetrating keratoplasty and eye banking in Bangladesh. PMID- 1782170 TI - Penetrating keratoplasty in Indonesia. PMID- 1782171 TI - A survey of penetrating keratoplasty in China. PMID- 1782172 TI - Cornea transplant statistics in the United States. PMID- 1782173 TI - The Cardona keratoprosthesis: 40 years experience. PMID- 1782174 TI - Keratoprosthesis: possible utilization in developing countries. PMID- 1782175 TI - The International Eye Foundation and corneal blindness: a historical perspective. PMID- 1782176 TI - Eye banking in Central and South America--activities of the Pan American Association of Eye Banks. PMID- 1782177 TI - Eye banking, corneal surgery, and the World Health Organization. PMID- 1782178 TI - Project ORBIS: cornea transplantation in the 90s. PMID- 1782179 TI - [The use of cultured endothelial cells in studies of pathophysiology of diseases]. AB - The endothelial cells comprise a single layer of polygonal cells lining the entire length of blood vessels and the heart. It plays a pivotal role in modulating a number of physiological and pathophysiological processes. This review focuses on the endothelial cell function. To obtain information on endothelial cell functions and its biological behavior, a critical step is studying endothelial cells separated from other types of cells. Methods of isolation, culture and identification of endothelial cells are briefly described. Moreover, there is described a wide variety of applications of cultured endothelial cells in the study of pathophysiology of diseases, and are picked up several points to be solved on this. PMID- 1782180 TI - [Biological characteristics of cultured papilla cells--localization of androgen receptors and chemotactic factor(s) for epithelial cells]. AB - We have reported that cultured papilla cells (PCs) grown by isolation and cultivation of human hair papillae show some biological characteristics. In the present report, some important biological characteristics of PCs are showed. 1) localization of androgen receptors on PCs Localization of androgen binding protein in PCs was examined. Cytochemical staining of PCs using DHT-peroxidase conjugate gave positive reactions in the niclei of PCs originating from scalp and axilla-dermal papillae. These results suggest that androgen receptors exist in PCs. 2) chemotactic factor (s) for keratinocytes It has been demonstrated in animal experiments by Oliver, et al. that the hair papillae have an induction effect on the hair follicles. The mechanism is unknown, but PCs potentially produce and secrete chemotactic factor (s) for keratinocytes. Chemotactic response of epithelial cells to chemoattractants derived from papilla cells was examined using Bayden chamber assay. These results suggest that PCs have keratinocyte-chemotactic factors. PMID- 1782181 TI - [Regeneration of the respiratory epithelium]. AB - It is very important to clarify the mechanism of the regeneration of the respiratory epithelium in not only Oto-Naso-Laryngology but also in the field of chest medicine and surgery. Because of the experimental study carried out on dogs, involving the curing process of the tracheal anastomosis site, a scanning electron microscopic study showed that after two weeks, ciliated cells could be seen making a thin layer. It took nine weeks or more till the whole tracheal anastomosis site was completely covered by the ciliated epithelial cells. Having reviewed the experimental papers concerning the regeneration of the respiratory epithelium which have been published since 1953, a conclusion has been reached that after the injury of the respiratory mucosa, the existence of the basement membranes remains were covered by the migration of the traditional epithelium from the margin of the wound and four weeks later, the wound was covered by the normal epithelium. It has been stated up until now that the differentiation of the epithelium was covered from basement cells, but in fact, it seems to occur from the secretory cells. This has been demonstrated by the culture process of the respiratory epithelium. From these facts, the cultured respiratory epithelium cells are very important in elucidating carcinogenesis. PMID- 1782182 TI - [Regeneration of bone marrow tissue. Growth and differentiation of hematopoietic stem cells and the role of bone marrow microenvironment on hematopoiesis]. AB - Hematopoietic stem cell proliferation and differentiation is regulated by a multistep process involving stem cell self-renewal, commitment, differentiation and maturation. Each process is controlled by a variety of humoral factors and cell-cell interactions, i.e., (i) growth factor and growth inhibitor acting toward the cascade of stem cell proliferation and differentiation, (ii) cytokine network involving cytokine-producing hematopoietic cells and stromal cells, (iii) interaction between hematopoietic cells and bone marrow microenvironment that is consisted of stromal cells and extracellular matrix. Recent advances in cell biology and cell physiology enabled us to understand the roles of these marrow microenvironments on hematopoiesis in molecular basis. We here discuss the complexities of hematopoietic system and the mechanism of the regeneration of hematopoietic tissues in special reference to bone marrow transplantation. PMID- 1782183 TI - [The physiological function of human endometrium]. AB - The cyclic change of human endometrial cells are controlled by the interaction between hypothalamus, pituitary gland and ovaries, thus making the endometrium proliferate, differentiate, exfoliate and then reproduce. The menstrual cycle is divided into three phases which are called follicle, ovulatory and luteal phase by the morphological change of the ovarium. The endometrial cycle is also classified to proliferative, secretory and menstrual phase. Estradiol (E2) stimulates the proliferation of endometrial cells by the indirect positive mechanism activated by the binding of E2 to E2 receptor. Growth factors (IGF- I, EGF, TGF- alpha etc.) induced by the transcription of the gene promote the proliferation of endometrial cells. Progesterone (P) has antagonistic effects on E2 actions and transform proliferative phase to secretory phase in endometrium. It is suggested that the possible mechanism of carcinogenesis of normal endometrium is the progression of endometrial hyperplasia due to the prolonged and unphysiological exposure to E2. The additional role of oncogenes (fos, fms, myc, myb, erb-B, neu) and growth factors on the mechanism of carcinogenesis of hyperplasia to cancer is very interested. PMID- 1782184 TI - [Human neuroblastoma cell lines having smooth muscle cell markers]. AB - The neural crest gives rise to a variety of tissues, including peripheral neurons, Schwann cells, melanocytes and ectomesenchymal cells, which include the smooth muscle cells of large arteries. Cell lines derived from neuroblastoma (a neural crest tumor) have at least two distinct morphological cell types, a neuroblastic phenotype (N-type) and an epithelial-like phenotype (S-type) with characteristics of substrate-adhesiveness. We have analyzed 17 human neuroblastoma cell lines using a panel of monoclonal antibodies against cytoskeletal proteins. Three neuroblastoma cell lines (KP-N-SI, KP-N-YN and SMS KCN) bound an alpha -smooth muscle actin antibody. In addition, one of these cell lines (KP-N-SI) bound anti-desmin monoclonal antibodies as determined by indirect immunofluorescence. A total of eight cloned cell lines were obtained from the above parent cell lines. These were composed of either N- or S-type cells and were confirmed to be the common neuroblastoma origin from each parent cell line by chromosomal analysis. Alpha-smooth muscle actin and desmin were demonstrated in the S-type cloned cells by indirect immunofluorescence, as well as by two dimensional Western blot analysis. These results were confirmed by Northern blot analysis using a specific probe (pSH alpha SMA-3'UT) to human alpha-smooth muscle actin mRNA. This is the first report of the presence of alpha-smooth muscle actin and desmin in neuroblastoma cell lines. These data show that in addition to giving rise to cells with neural, Schwann cell and melanocyte markers, neuroblastoma can also give rise to the cells expressing smooth muscle cell markers. PMID- 1782185 TI - Establishment and characterization of a novel megakaryoblastic cell line, MOLM-1, from a patient with chronic myelogenous leukemia. AB - Based on the morphological resemblance to megakaryocytes and upon the expression f the platelet specific glycoprotein antigen, CD61, it is highly l y that MOLM-1 is a clonal leukemic cell population of megakaryoblastic origin . PMID- 1782186 TI - Cephalometric analysis comparing five different methods. AB - A commonly used cephalometric analysis was performed repeatedly on five lateral cephalometric radiographs using a variety of methods, and the angular values obtained compared. Two computerized methods, one utilizing direct digitization of the radiograph and the other digitizing an enhanced video image of the radiograph, were compared with each other and also against the traditional manual method of tracing. In addition, a single manual tracing of each of the radiographs was digitized using each computer method. It was found that direct digitization is less precise than both the traditional method and digitization of a tracing. The facility to enhance the radiographic image using video techniques did not produce any significant improvement in precision of the cephalometric variables studied. PMID- 1782187 TI - The assessment of antero-posterior dental base relationships. AB - The reliability and validity of four methods of assessing skeletal pattern (Reidel's method, Eastman correction, Ballard's method, and 'Wits' analysis) from cephalometric tracings have been examined, and the levels of agreement between them investigated. The possibility of the Y-axis length and SN-Y-axis angle having a bearing on the skeletal pattern was also examined. Strong correlation was found between the four methods considered. Ballard's method correlated very closely with Reidel's method, and like 'Wits' method, is not as unreliable as previously reported. Measurement of the SN-Y-axis angle was not found to be of benefit to the assessment of the anteroposterior dental base relationship. Reidel's method, which is the easiest to apply, is recommended as the method of choice, and routine application of the Eastman correction is not recommended. PMID- 1782188 TI - Direct orthodontic bonding to porcelain: an in vitro study. AB - The shear/peel and tensile/peel bond strengths of mesh-backed orthodontic brackets bonded to porcelain, using a highly filled composite and four different silane bonding agents were determined. Sites of failure were recorded for each method of testing. A method of debonding ane restoring the porcelain surface to its original state after debonding was also investigated. All silane bonding systems tested provided adequate bond strength for clinical use. Fusion produced significantly higher force values to failure in shear testing. There was no significant difference between the bond strengths obtained in tensile testing. Patterns of failure differed in each mode of testing, suggesting that a shear mode of debonding is more likely to cause porcelain fracture and that the possibility of porcelain fracture during function or debonding cannot be excluded. The use of a Lift-Off plier is recommended in debonding brackets from porcelain where a silane bonding agent has been used. Diamond polishing paste was better at restoring the procelain surface to its original appearance than Shofu polishing stones. PMID- 1782189 TI - Method errors recorded by inexperienced operators of the reflex microscope. AB - The Reflex Microscope has become a standard instrument for the precision measurement of orthodontic record models. In this study, 31 individuals with no previous experience of the microscope were assessed for their precision at identifying well defined landmarks. Considerable initial variation existed in the precision of landmark identification, but despite only a limited training period, some of the novices tested achieved a high standard of precision. Mean errors were greatest in the z axis, i.e. along the axis of the eye, and astigmatism was common amongst those recording the greatest errors in this axis. A group of individuals who performed poorly initially, were retested after additional training and practice with the microscope. Method errors were significantly reduced for the majority of those retested, but the test apparatus identified two individuals for whom further measurement with the microscope would be inadvisable. PMID- 1782190 TI - Unerupted premolars--an alternative approach. AB - These two cases illustrate variations of an alternative technique for moving unerupted teeth into the mouth. Previously described techniques may damage the tooth or the periodontium and the regular adjustments required can be uncomfortable and are unpleasant for the patient and the operator. The method described provides a stress free alternative which is readily acceptable to patients. Adjustments are rarely needed, but if required they usually involve repositioning a magnet in the removable appliance, a procedure carried out simply by the operator or technician using cold cure acrylic. PMID- 1782191 TI - A 'bonding' typodont. AB - A new technique is presented for the construction and use of a typodont suitable for teaching correct bracket positioning. The advantages of the method are illustrated. PMID- 1782192 TI - Late forming supernumeraries in the mandibular premolar region. AB - A case is presented in which two supernumerary teeth developed in the mandibular premolar region during orthodontic treatment. Their presence was only detected on a routine post-treatment radiograph. The potential hazards of space closure with such teeth present are considered, although there were no detrimental effects in the case illustrated. PMID- 1782193 TI - Use of the face mask in the treatment of maxillary retrusion--a case report. AB - A case report is presented of a Class III malocclusion with a Class III skeletal pattern and maxillary retrusion. The patient, an 11-year-old girl, was treated with an orthopaedic face mask in conjunction with standard Edgewise mechanics. Treatment was completed after 14 months, and proved to be stable following the active treatment and at recall 4 years later. PMID- 1782194 TI - Management of the palatal ectopic and unerupted maxillary canine. AB - Some problems associated with the diagnosis of the ectopic maxillary canine are discussed. A treatment regimen is outlined for the tooth that is displaced palatally and unerupted. PMID- 1782195 TI - An investigation into the relationship between human beings and Norfolk terriers. AB - Two Norfolk Terriers were used as experimental subjects to investigate the means by which human beings relate to Norfolk Terriers in maintaining their overall dental health. The study was divided into two parts: the Hard Cheese Study (HCS) and the Oral Hygiene Study (OHS). The difficulties in conducting experiments on this breed are highlighted and an evaluation of random error in measurements is undertaken using an Index termed Jaw Occlusions in a Kennel Environment (JOKE). PMID- 1782196 TI - Formocresol toxicity: is there a suitable alternative for pulpotomy of primary molars? AB - Some concern has been expressed in recent years about the use of formocresol for vital pulpotomy treatment of primary molars. This paper reviews the literature concerning the toxicity of formocresol and considers the evidence for the use of calcium hydroxide and glutaraldehyde. It is concluded that more work is required in this field before an alternative to formocresol can be recommended and that, in the meantime, a 1:5 dilution of the standard formocresol solution should be used but not included in the zinc oxide-eugenol sublining. PMID- 1782197 TI - A study of natal teeth in Hong Kong Chinese. AB - The purpose of this study was to review cases of natal teeth in babies born between January 1984 and December 1988 at the Queen Elizabeth Hospital Hong Kong. There were 53678 births at the hospital during this period and 48 babies had natal teeth, a prevalence of 1:1118. The 48 babies had 72 natal teeth, all mandibular central incisors. The natal teeth in two babies were supernumerary teeth of a predeciduous dentition. Twenty nine natal teeth were extracted because they were hypermobile, three were extracted because they traumatized the ventral surface of the babies's tongue, and 16 were not extracted. The subjects were reviewed one day after the initial examination, and then after 1 week, 1 month and at 6-month intervals. No appreciable space loss occurred following the extractions. Root development occurred in teeth that were not extracted, but the crowns were hypoplastic in three cases. PMID- 1782198 TI - Dental caries experience of 5-year-old children related to their parents' education levels: a study in an Arab community in Israel. AB - The purpose of this study was to examine the influence that parents' education may have on the prevalence of dental caries in young children. The study was conducted on 210 kindergarten children aged 5 years in an Arab village. The presence of caries was determined according to the WHO criteria, with an explorer and a dental mirror under natural light. The education of the parents was assessed on a scale of 1-6 according to information obtained from a questionnaire to the parents. The results of this study showed that children of highly educated parents had relatively low dental caries experience. The influence of the mothers was apparent at a lower educational level than that of the fathers. In this population only 0.6% of the dental treatment needs were met. Of the kindergarten children 99.5% had experienced caries. The caries experience was extremely high: the mean dmfs was 17.7 (+/- 12.15), and the means dmft 8.04 (+/- 8.37). PMID- 1782199 TI - Resorption of the crown of an unerupted permanent molar. AB - This case report describes an unusual phenomenon where resorption occurred in the crown of an unerupted permanent molar. It was an incidental radiological finding. After eruption the tooth was extracted. Histological examination revealed resorption of enamel and dentine, and partial replacement by calcific material. The possible aetiology of the condition is discussed. PMID- 1782200 TI - Dental abnormalities associated with a chromosome 2 deletion. AB - This case report describes the dental and physical anomalies observed in a young female patient who had a chromosome abnormality involving deletion of the q 33-q 35 region of chromosome 2. The dental dysplasia observed in this patient is proposed to be of genetic origin but the complication of anoxia at birth makes it difficult to assign the intellectual and physical impairments solely to the genetic deletion. PMID- 1782201 TI - Congenital absence of all primary and permanent lateral incisors in a carrier of X-linked hypohidrotic ectodermal dysplasia. AB - A case report is presented of congenital absence of all primary and permanent lateral incisors in a female patient who was a carrier of X-linked hypohidrotic ectodermal dysplasia. Congenital absence of all lateral incisors is extremely rare. PMID- 1782202 TI - Non-reducing terminal linkage position determination in intact and permethylated synthetic oligosaccharides having a penultimate amino sugar: fast atom bombardment ionization, collisional-induced dissociation and tandem mass spectrometry. AB - Certain linkage positions in oligosaccharides can be discerned by collision activated dissociation mass spectrometry, rationalized by molecular modelling. Previous work on synthetic oligosaccharides has suggested that daughter ion patterns can distinguish among intact compounds which terminate in alpha-L-fucose and have a penultimate amino sugar. The current study indicates that these observations can be extended to oligosaccharides terminating in beta-D-galactose. In addition, we have observed that protonated, ammoniated and lithiated molecular ions all produce linkage-specific daughter ion spectra in these two sets of oligosaccharides. Sodiated molecular ions could be fragmented usefully under high collision energy offset conditions; potassiated ions were stable and not dissociable under conditions available in a triple-quadrupole instrument. We also show linkage discernment among the permethylated set of these six synthetic oligosaccharides. Methylated derivatives of this set of compounds give more useful product ions, including a 3-linkage specific ion. A novel relationship was noted by a plot of collision energy against (daughter ion/parent ion) ratio, which gave a unique slope for each of the non-reducing terminal linkage positions 3, 4 and 6 in the set of six compounds. The slope of this plot is related to the ability of each linkage position in the oligosaccharide to absorb collisional energy. Rotational freedom of the individual glycosidic linkage is hypothesized to play a role in this phenomenon. PMID- 1782203 TI - The matrix effect in particle beam liquid chromatography/mass spectrometry and reliable quantification by isotope dilution. AB - The transport efficiency of the particle beam liquid chromatography/mass spectrometer interface is influenced by analyte concentration contributing to a widely reported non-linearity. In this work, coeluting, isotope-labeled internal standards were investigated as 'carriers' to improve the transport efficiency and linearity. Three styrene metabolites--mandelic, phenylglyoxylic and hippuric acids--and their pentadeutero analogs were separated by reversed-phase liquid chromatography (LC) with an ammonium acetate-acetonitrile mobile phase. Selected positive ions produced by electron ionization were monitored to generate particle beam LC/MS calibration curves. The present study demonstrates that particle beam LC/MS not only is non-linear, but also is subject to a matrix effect presumably by the same mechanism responsible for non-linearity. Coeluting, isotope-labeled internal standards were ineffective at linearizing the particle beam liquid chromatograph/mass spectrometer detector response. Isotope dilution quantification, however, compensates for variable transport efficiencies, linearizes calibration and compensates for the matrix effect, affording reliable quantification of the styrene metabolites. PMID- 1782204 TI - Analysis of effector cell-derived lyso platelet activating factor by electron capture negative ion mass spectrometry. AB - Quantification of 1-O-alkyl-2-lyso-sn-3-glycero-phosphocholine (lysoPAF) and determination of the different molecular species released by cells has been hampered by the molecules's lack of intrinsic bioactivity, unavailability of a suitable internal standard, and reliance on derivatives requiring electron impact techniques. We have synthesized trideuterated internal standards (labeled on the terminal carbon of the alkyl chain) for both C16:0 and C18:0 lysoPAF. Using these standards, we isolated and quantified lysoPAF released from A23187-stimulated human neutrophils and rat alveolar macrophages. Extracted lysoPAF was purified by solid-phase extraction and thin-layer chromatography. The polar phosphorylcholine group was removed with 29 M HF or phospholipase C. The two free hydroxyl groups were derivatized with pentafluorobenzoyl chloride. The resultant bis pentafluorobenzoyl derivative, analyzed by gas chromatography/electron capture negative ion mass spectrometry, underwent substantial fragmentation. Lowering of the ion source temperature resulted in a dramatic increase in signal-to-noise ratio, with the vast majority of the ion current carried in the molecular anion. Stimulated neutrophils released 16.3 and 10.2 ng/10(6) cells of C16:0 lysoPAF and C18:0 lysoPAF, respectively. Rat macrophages synthesized 15.9 ng/10(6) cells of C16:0 lysoPAF, but C18:0 lysoPAF was variably detected at low levels. We conclude that use of the bispentafluorobenzoyl ester derivative of lysoPAF allows facile quantification of this autacoid metabolite in biological matrices. PMID- 1782205 TI - Enantiospecific quantification of hexobarbital and its metabolites in biological fluids by gas chromatography/electron capture negative ion chemical ionization mass spectrometry. AB - A highly sensitive and specific assay based on gas chromatography/electron capture negative ion chemical ionization mass spectrometry has been developed for the analysis of the enantiomers of hexobarbital and its major metabolites in human urine and plasma. S-(+)-(5-2H3)hexobarbital and R-(-)-(5-2H3)hexobarbital were synthesized for clinical studies along with (+/-)-(1,5-2H6)hexobarbital and the deuterated major metabolites for use as internal and reference standards. Hexobarbital enantiomers and their metabolites were analyzed after pentafluorobenzyl and trimethylsilyl derivatization, following solid-phase extraction from plasma and urine. Intense negative ion spectra were observed for all of the derivatives. The base peak in the spectra corresponded to the M pentafluorobenzyl anion [M-PFB]- except for 1,5-dimethylbarbituric acid, where M . was the most abundant ion. The applicability of the method was demonstrated by following the plasma concentration-time profiles and urinary excretion in a male extensive metabolizer of mephenytoin who was given a pseudoracemic oral dose of hexobarbital containing equal 50 mg amounts of S-(+)-2(H0)hexobarbital and R-(-) (2H3)hexobarbital. Marked stereoselective disposition was observed, with the R-( )-enantiomer being more efficiently metabolized, primarily by alicyclic oxidation and ring cleavage. PMID- 1782206 TI - Identification of 4-methoxybenzoyl-N-glycine in urine by gas chromatography/mass spectrometry. AB - An unusual metabolite was detected in the urine of two children with neurological dysfunctions of unclear aetiology by using gas chromatography/mass spectrometry (GC/MS). On the basis of the analysis of its fragmentation pathways, synthesis of tentative compound and its GC/MS analysis it was stated that the unknown metabolite is 4-methoxybenzoyl-N-glycine. PMID- 1782207 TI - A comparative study of the effects of clofibrate, ciprofibrate, WY-14,643, and di (2-ethylhexyl)-phthalate on liver protein expression in mice. AB - Chemical, physical, or mechanical insults to a cellular system cause changes in the rates of protein synthesis or degradation. To define patterns of quantitative protein changes and identify the biochemical basis of those changes, we are studying fluctuations in mouse liver protein abundance in response to factors such as stages of maturation, changes in diet, and exposure to chemicals. Two dimensional gel electrophoresis (2DE) together with computer-assisted data analysis is used to collect quantitative data from groups of 2DE patterns. Our analysis of liver protein expression in mice treated with four different chemicals known to cause peroxisome proliferation serves as an example of the changes in protein expression that can be monitored by using this approach. The database we are building indicates that changes specific to a particular treatment as well as generalized effects can be identified, providing the opportunity to identify patterns of protein expression that are indicators of biological response to different types of cellular insults. PMID- 1782208 TI - Separation of normal human erythrocyte membrane proteins by high resolution two dimensional gel electrophoresis. AB - Different factors influencing two-dimensional gel electrophoresis of red cell membrane proteins were studied: membrane preparation and sample solubilization with a special regard to proteolytic artifacts, urea addition, slab gel acrylamide concentrations and silver staining methods. Spot patterns were analyzed both visually and by means of computer-assisted densitometry. A resolution of around 450 spots was achieved on 10% acrylamide slab gels. The reproducibility of the whole two-dimensional gel electrophoresis procedure was assessed by analysis of computer generated spot densities on gels which were run simultaneously with the same sample. It was shown that the standard red cell membrane preparation method does not lead to proteolysis, contamination by cytosolic proteins, or proteins from other cell types. In comparison with previous studies the relatively high resolution seemed to be due to a high solubilization efficiency combined with the use of a sensitive silver staining method. PMID- 1782210 TI - Automatic detection of noisy spots in two-dimensional Southern blots. International Electrophoresis Society Meeting, Washington DC, March 16-19, 1991. AB - One of the problems of automatically quantitating 2D DNA gels, is clearly detecting spots visualized by Southern hybridization blots using DNA probes (Rogan et al. in this conference). Spots appear noisy due to multiple transfer steps. If one applies standard 2D PAGE protein gel spot segmentation methods, spots fragment due to highly textured image noise and a weak radioautograph signal and thus are poorly detected. We have observed that these spots are all of a minimum size. Therefore an image processing filter which both takes minimum spot size into account and has immunity to image texture-type noise should be able to reliably detect this class of spots. The 'Busse' Laplacian filter used in the GELLAB-II system, is a modification of the standard (1-21) digital approximation of the Laplacian. In the Busse Laplacian, the sampling interval is n pixels (n greater than 1) instead of 1. In addition, 3 x 3 averaged 'super pixel' values are used instead of single pixels for each element of the Laplacian convolution. This gives the needed noise immunity by filtering out the high spatial frequency image noise while preserving the low spatial frequency character of the spots. We have used this filter successfully on 2D DNA Southern blot image data. PMID- 1782209 TI - An improved method for determining high molecular weights by protein immunoblotting: application to apolipoprotein(a) phenotyping. AB - The determination of very high molecular weights (greater than 500 kd) by protein immunoblotting is limited by a lack of commercially available molecular weight standards in that range. We have therefore investigated the use of the human haptoglobin 2-2 phenotype polymeric series as a high molecular weight standard curve. Using pre-electrophoresed 3-12% SDS polyacrylamide gradient gels, non dissociated haptoglobin 2-2 serum was separated, transferred and probed with anti human haptoglobin. We were able to visualize up to 13 bands, with a theoretical molecular weight range of 171.9-859.5 kd, in non-dissociated haptoglobin 2-2 serum. Molecular weights up to 584 kd were confirmed by comparison with available standards. The method was then applied to the determination of apolipoprotein(a) [apo(a)] phenotype molecular weights. Precision of the method was excellent, with intra-run CVs of less than 2.9% and inter-run CVs of less than 3.2% for apo(a) molecular weight. This method of molecular weight calibration is applicable to the characterization of any high molecular weight protein that can be successfully electrophoresed, transferred and visualized. PMID- 1782211 TI - Electrophoretic size separation of particles with diameters in the micron range, using polymer solutions. AB - Polystyrene-sulfate particles ranging in size from 536 to 2,170 nm diameter were subjected to electrophoresis (10 V cm-1, 25 degrees C) in K-MES, 0.03 M ionic strength, pH 6.12, 50 mM CHAPS in liquid polymer media contained in horizontal glass tubes of 1 mm ID. The polymer media were linear polyacrylamide [0.3 to 0.9% Mr = 5 x 10(5) and 5 x 10(6), as well as a commercial solution of the latter in 4 M urea, 7.5% Na2SO4 designated as Gelamide-250] or polyvinylalcohol (0.25 to 2.5%, Mr = 6.5 x 10(5), designated PVA). In these polymer solutions, the polystyrene sulfate particles exhibit linear Ferguson plots [log(mobility) vs polymer concentration]. Their slope, KR, is directly related to the diameter of the particle when electrophoresis is conducted in Gelamide-250 or slowly 25 degrees C solubilized PVA solutions, indicating a molecular sieving mechanism. By contrast, KR is inversely related to the particle diameter when electrophoresis is conducted in linear polyacrylamide of 5 x 10(6) molecular weight or in PVA rapidly solubilized by autoclaving (121 degrees C, 1.2 kg cm-2 pressure), suggesting a particle exclusion (gel permeation) mechanism of size separation. Electrophoresis in solutions of polyacrylamide of 5 x 10(5) molecular weight exhibits the same degree of retardation for the entire size range of polystyrene particles used, i.e. a viscosity effect only and no size separation. Retardation of electrophoretic migration by either a sieving or a permeation mechanism is highly reproducible in polyacrylamide solutions, but not in PVA solutions (whether solubilization conditions favoring an apparent permeation mechanism or a sieving mechanism are applied).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782212 TI - Identification of a cell retention signal in the B-chain of platelet-derived growth factor and in the long splice version of the A-chain. AB - The B-chain homodimer of platelet-derived growth factor (PDGF) is only very inefficiently secreted and remains largely associated with the producer cell; in contrast, the dimer of the short, and most common, splice variant of the A-chain is secreted. To identify the structural background to the differences in the secretory pattern between the different isoforms of PDGF, a set of chimeric PDGF A/B cDNAs was generated and expressed in COS cells. Analyses of the biosynthesis and processing of the corresponding products led to the identification of a determinant for cell association in the carboxy-terminal third of the PDGF B chain precursor. Introduction of stop codons at various positions in the carboxy terminal prosequence of the PDGF B-chain localized this determinant to an 11 amino-acid-long region (amino acids 219-229). This region contains an 8-amino acid-long basic sequence that is homologous to a sequence present in an alternatively spliced longer version of the PDGF A-chain. In contrast to the short splice variant, the long splice A-chain version, like the B-chain, was found to remain predominantly cell associated. Thus, we have identified a conserved sequence that inhibits the secretion of some of the PDGF isoforms. Our data also suggest that switching of splicing patterns can be a mechanism to regulate the formation of secreted or cell-associated forms of PDGF-AA and possibly other growth factors. PMID- 1782213 TI - Ca(2+)-induced Ca2+ release amplifies the Ca2+ response elicited by inositol trisphosphate in macrophages. AB - We have studied the rise in intracellular calcium concentration ([Ca2+]i) elicited in macrophages stimulated by platelet-activating factor (PAF) by using fura-2 measurements in individual cells. The [Ca2+]i increase begins with a massive and rapid release of Ca2+ from intracellular stores. We have examined the mechanism of this Ca2+ release, which has been generally assumed to be triggered by inositol trisphosphate (IP3). First, we confirmed that IP3 plays an important role in the initiation of the PAF-induced [Ca2+]i rise. The arguments are 1) an increase in IP3 concentration is observed after PAF stimulation; 2) injection of IP3 mimics the response to PAF; and 3) after introduction of heparin in the cell with a patch-clamp electrode, the PAF response is abolished. Second, we investigated the possibility of an involvement of Ca(2+)-induced Ca2+ release (CICR) in the development of the Ca2+ response. Ionomycin was found to elicit a massive Ca2+ response that was inhibited by ruthenium red or octanol and potentiated by caffeine. The PAF response was also inhibited by ruthenium red or octanol and potentiated by caffeine, suggesting that CICR plays a physiological role in these cells. Because our results indicate that in this preparation IP3 production is not sensitive to [Ca2+]i, CICR appears as a primary mechanism of positive feedback in the Ca2+ response. Taken together, the results suggest that the response to PAF involves an IP3-induced [Ca2+]i rise followed by CICR. PMID- 1782214 TI - Transforming growth factor-beta (TGF-beta) isoforms in rat liver regeneration: messenger RNA expression and activation of latent TGF-beta. AB - Expression of transforming growth factor-beta s (TGF-beta s) 1-3 was studied in normal liver and during liver regeneration after partial hepatectomy in the rat to determine whether each of these isoforms might be involved in hepatocyte growth in vivo. Expression of the mRNAs for all three TGF-beta isoforms increases in the regenerating liver. In addition, the levels of expression of the mRNAs for several extracellular matrix proteins, including fibronectin, vitronectin, laminin, and collagen, also increase in the regenerating liver. Immunohistochemical staining analysis shows a similar distribution of all three TGF-beta s in normal and regenerating liver; however, in both tissues, the level of expression of TGF-beta 1 is 8- to 10-fold higher than that of TGF-beta 2 as determined by sandwich enzyme-linked immunosorbent assay. Expression of all three TGF-beta mRNAs is restricted to liver nonparenchymal cells. Although hepatocytes from normal and regenerating livers do not synthesize TGF-beta, they are sensitive to inhibition of growth by all three TGF-beta isoforms. Hepatocytes from regenerating livers are capable of activating latent TGF-beta 1 complexes in vitro, whereas normal hepatocytes are not. The different TGF-beta isoforms may function in an inhibitory paracrine mechanism that is activated during liver regeneration and may also regulate the synthesis of extracellular matrix components in the regenerating liver. PMID- 1782215 TI - Regulatory functions of a non-ligand-binding thyroid hormone receptor isoform. AB - Gene regulation by thyroid hormones is mediated through multiple nuclear receptors. Only some of these thyroid hormone receptor (TR) isoforms become transcriptional enhancers in the presence of the thyroid hormone T3. Here we analyze the regulatory function of the human TR alpha 2 isoform. This protein does not bind T3 and is not a transcriptional activator of thyroid hormone responsive elements (TRE). Transfected TR alpha 2 functions as a constitutive repressor of the transcriptional activators TR alpha 1 and TR beta 1 but also represses heterologous receptors, including the retinoic acid receptor and the estrogen receptor, which can activate TRE-controlled genes. TR alpha 2 protein showed strongly reduced DNA binding to a palindromic TRE when compared with the active TRs. Hybrid receptor analysis revealed that the special properties of the TR alpha 2 protein, including its repressor function and DNA binding characteristics, are intrinsic properties of its carboxyterminus and can be transferred to other receptors. Although it has been shown that the active TRs can act as repressors and silencers due to their strong DNA binding in the absence of hormone, our data show that TR alpha 2 is unlikely to inhibit TRs and other receptors through a competitive DNA binding mechanism. Antibody gel shift experiments suggest that repression by TR alpha 2 might result from interaction with active receptors. Thus, the receptor-like TR alpha 2 isoform differs from typical nuclear receptors in its DNA-binding and ligand-binding properties and appears to regulate the activity of other receptors via protein-protein interaction. PMID- 1782217 TI - The remote control of transcription, DNA looping and DNA compaction. AB - mRNA synthesis can be controlled at some distance from the start of transcription in eukaryotes and prokaryotes. It is generally assumed that the distal elements of the transcriptional machinery directly interact with the proximal elements, forcing the DNA to bend in a loop. DNA loop formation and transcription can be affected by the distance between the sites, their helical positioning, their orientation, their concentration (responsible for a cis- or a trans-effect of the DNA sequences), and DNA compaction in chromatin. The corresponding in vitro and in vivo situations have been critically examined for a number of systems, mostly prokaryotic. PMID- 1782216 TI - p67SRF is a constitutive nuclear protein implicated in the modulation of genes required throughout the G1 period. AB - Indirect immunofluorescence analysis, using antibodies directed against peptide sequences outside the DNA-binding domain of the 67-kDa serum response factor (p67SRF), revealed a punctuated nuclear staining, constant throughout the cell cycle and in all different cell lines tested. p67SRF was also tightly associated with chromatin through all stages of mitosis. Inhibition of p67SRF activity in vivo, through microinjection of anti-p67SRF antibodies, specifically suppressed DNA synthesis induced after serum addition or ras microinjection, suggesting that these antibodies were effective in preventing expression of serum response element (SRE)-regulated genes. A similar inhibition was also obtained in cells injected with oligonucleotides corresponding to the DNA binding sequence for p67SRF protein, SRE. Moreover, this inhibition of DNA synthesis by anti-p67SRF or SRE injection was still observed in cells injected during late G1, well after c fos induction. These data imply that genes regulated by p67SRF are continuously involved in the proliferation pathway throughout G1 and that p67SRF forms an integral component of mammalian cell transcriptional control. PMID- 1782218 TI - The interaction of wheat germ tyrosyl-tRNA synthetase and the tRNA-like end of brome mosaic virus RNA has no effect on in vitro viral protein synthesis and on in vitro encapsidation. AB - The effect of aminoacylation of the tRNA-like end of brome mosaic virus RNA during in vitro protein synthesis and in vitro viral encapsidation was investigated. The components of the homologous system were: BMV RNA, wheat germ cell-free protein synthesizing system and pure tyrosyl-tRNA synthetase from wheat germ. During in vitro protein synthesis directed with tyrosylated as well as non tyrosylated BMV RNA, no differences were observed in the amount and in the class of polypeptides formed neither in the velocity of the translation reaction. Excess active TyrRS was added during in vitro translation, without modifying the translation efficiency. BMV RNA and active TyrRS were preincubated prior to translation in order to interact without the translation system components and then subjected to translation in vitro. Similar results were obtained when BMV RNA was preincubated with inactive TyrRS or BSA. These results indicate that the aminoacylation of BMV RNA has no pronounced effect on viral protein synthesis in vitro. During BMV RNA encapsidation either tyrosylated or non-tyrosylated BMV RNA 4 could be encapsidated in a similar way. PMID- 1782219 TI - Monovalent cation-dependent reversible phosphorylation of ribosomal protein S8 in growth arrested Tetrahymena: kinetics of formation, phosphoamino acids, and phosphopeptides of mono-, and diphosphorylated derivatives of protein S8. AB - The kinetics of formation of mono-, and diphosphorylated derivatives of ribosomal protein S8 in Tetrahymena starving in the presence of Na+ have been determined, and the phosphoamino acids present in these derivatives have been identified. The mono-phosphorylated product, S8', contains only phosphoserine, and behaves kinetically as the precursor of the diphosphorylated product S8" which contains phosphoserine, and phosphothreonine. Tryptic digestion release a single major phosphoserine containing peptide from both S8' and S8", and a single phosphothreonine containing peptide from S8". PMID- 1782220 TI - The major pterin in Tetrahymena pyriformis is 6-(D-threo-1,2,3-trihydroxypropyl) pterin (D-monapterin) and not 6-(L-threo-1,2-dihydroxypropyl)-pterin (ciliapterin). AB - The major pterin in Tetrahymena pyriformis, strain W, earlier suggested to be L threo-biopterin and named ciliapterin [1] is now identified as D-threo-neopterin (D-monapterin). This is the first example of a natural D-monapterin. This compound was characterized by its chromatographic behavior, its fluorescence properties and by its oxidation product with alkaline permanganate. The final identification was obtained by comparison with an authentic material using an exchange ligand chromatography method with D-phenylalanine as chiral modifier and Cu (II) as metal ion. D-monapterin is also present as the major pterin in Tetrahymena pyriformis strains GL and ST, and in Tetrahymena thermophila. PMID- 1782221 TI - Hexose metabolism in pancreatic islets. Effect of (-)-hydroxycitrate upon fatty acid synthesis and insulin release in glucose-stimulated islets. AB - Anaplerotic reactions leading to the de novo synthesis of fatty acids, were recently proposed to participate in the coupling of metabolic to secretory events in the process of glucose-stimulated insulin release. In an attempt to validate such a proposal, the effect of (-)-hydroxycitrate upon fatty acid synthesis and insulin release was investigated in glucose-stimulated rat pancreatic islets. The inhibitor of ATP citrate-lyase, when tested in the 1.0-2.0 mM range, failed to affect glucose-stimulated insulin release, but also failed to inhibit the incorporation of 14C-labelled acetyl residues derived from L-[U-14C]leucine into islet lipids. A partial inhibition of fatty acid labelling by 3H2O was only observed in islets incubated for 120 min in the presence of 5.0 mM (-) hydroxycitrate and absence of CaCl2. These findings suggest that (-) hydroxycitrate is not, under the present experimental conditions, a useful tool to abolish fatty acid synthesis in intact pancreatic islets. PMID- 1782222 TI - UAG readthrough is not increased in vivo by Moloney murine leukemia virus infection. AB - Expression of the pol gene of the murine leukemia viruses is subject to translational control at the UAG termination codon of the upstream gene gag. Previous experiments have suggested that: i) Moloney murine leukemia virus infection induces a tRNA(Gln)iii) in an in vitro system using the tobacco mosaic virus as template, this tRNA is able to increase readthrough at the UAG codon [1]. Here we demonstrate that, in vivo, Moloney murine leukemia virus infection does not increase translational readthrough at either the tobacco mosaic virus or the Moloney murine leukemia virus UAG stop codons. PMID- 1782223 TI - Interactions of cholesterol with the membrane lipid matrix. A solid state NMR approach. AB - The effects of cholesterol on the structure and dynamics of dimyristoylphosphatidylcholine (DMPC) model membranes have been monitored as functions of temperature and cholesterol concentration in the membrane. The use of deuterium labels both on the cholesterol fused ring system and on the lipid chains in conjunction with solid state deuterium nuclear magnetic resonance (2H NMR) afforded to monitor the degree of ordering of both molecules in a mixed system. The degree of ordering of the lipid head group was followed by phosphorus 31 (31P)-NMR. New findings on the effect of cholesterol on DMPC may be summarized as follows: i) cholesterol disorders the lipid chains below temperature of the DMPC gel-to-fluid transition (Tc) and orders them above; the effect is linear with cholesterol concentration at 0 and 60 degrees C but for intermediate temperatures, a saturation effect is observed at 20-30 mol %; ii) the ordering disordering effects are perceived similarly by all chain segments with, however, a greater sensitivity for positions near the bilayer center; iii) below Tc, the lipid head group is considerably disordered by increasing amounts of cholesterol but slightly affected above; iv) the degree of ordering of cholesterol is quasi temperature independent for fractions greater than or equal to 30%; v) the average orientation of the cholesterol rigid body is perpendicular to the bilayer surface and exhibits little variations with temperature and cholesterol concentration. Variations in membrane dynamics are interpreted in terms of cholesterol-induced changes in bilayer thickness.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782224 TI - Oxysterols: biological activities and physicochemical studies. AB - To improve the understanding of the various biological activities of oxysterols (oxygenated derivatives of cholesterol), studies of their physicochemical properties have been undertaken. Oxysterols modify membrane dynamic properties which consequently trigger several biological effects. Despite the presence of at least one oxygenated group in addition to the C3 beta-hydroxyl, oxysterols insert perfectly into the lipidic bilayer of the membrane inducing a condensing effect similar to, but less potent than, that of cholesterol. In biological membranes oxysterols probably interact with membrane components as they are not easily exchanged after their incorporation into the cell membrane. These lipid-protein interactions are probably crucial for the expression of the biological activities of the oxysterols. PMID- 1782225 TI - Membrane-related oxysterol function: preliminary results on the modification of protein kinase C activity and substrate phosphorylation by 7 beta,25 dihydroxycholesterol. AB - Oxysterols exhibit a wide variety of biological activities, including potent immunosuppressive effects. 7 beta,25-Dihydroxycholesterol (7,25-OHC), a synthetic oxysterol, has been shown to strongly inhibit the lymphocyte response to different stimuli. This compound has been chosen as a model compound to investigate the mechanisms underlying the immunosuppressive effects of oxysterols. As protein kinase C (PKC) constitutes a key enzyme in the pathways leading to cell activation, we have studied the effect of 7,25-OHC on PKC activity in the cytosolic and particulate fractions of spleen cells. Lymphocytes treated with 7,25-OHC showed a decrease of the relative PKC activity in the particulate fractions compared to control cells. These results are confirmed by the observation that 7,25-OHC also reduces the phosphorylation of the endogenous PKC substrates. Thus oxysterols interfere with two membrane related phenomena, ie the modification of membrane PKC activity and the inhibition of the phosphorylation of the substrates of PKC located in the membrane. Previous results obtained by fluorescence polarisation revealed a modification of the membrane fluidity after oxysterol treatment. Furthermore, it has been demonstrated that oxysterols are incorporated into cell membranes. The alteration of the cell membrane could impair the signal transduction and may explain the immunosuppressive activity of oxysterol. Thus, along with other biological effects previously reported, oxysterols decrease membrane associated PKC activity in immune cells. PMID- 1782226 TI - Dietary cholesterol, membrane cholesterol and cholesterol synthesis. AB - After describing the main steps of cholesterol biosynthesis the author recalls that the cholesterogenesis rate is feedback-inhibited by dietary cholesterol and examines the various processes of modulation. Hydroxy-3-methylglutaryl (HMG) CoA reductase, the key rate-limiting enzyme, is a 97 kDa endoplasmic reticulum glycoprotein, anchored 7-fold in this membrane. The N-terminal membrane-bound domain plays a fundamental role in the modulation of reductase activity. This modulation is essentially mediated by decreased gene transcription and enhanced degradation of the protein. The possible modulation by a bicyclic cascade system involving phosphorylation (inactivation) and dephosphorylation (activation) of reductase does not seem to play an essential role in vivo. Finally, recent data show that the lipid composition (C/P molar ratio) of some reticular membranes (fibroblasts, for example) can strongly modulate the activity of this ubiquitous enzyme. PMID- 1782227 TI - Ursodeoxycholic acid (UDCA) in the treatment of chronic cholestatic diseases. AB - Several studies suggest that UDCA treatment has beneficial effects in chronic cholestatic diseases. We designed a controlled trial to assess the efficacy and tolerance of UCDA in primary biliary cirrhosis (PBC): 73 patients received UDCA (13-15 mg/kg per day) and 73 a placebo. One side-effect required interruption of therapy in each group. The relative risk of treatment failure (doubling of the bilirubin level or occurrence of a severe complication of cirrhosis) was 3 times higher in the placebo group. Pruritus resolved in 40% of the patients of UDCA group vs 19% in placebo group. Biological and histological parameters significantly improved in the patients receiving UDCA. Unexpectedly, immune parameters, including IgM levels and anti-mitochondrial antibody titers, also improved. The Mayo risk score was significantly different between the two groups at one and two years, suggesting that UDCA could prolong survival in PBC. Recent studies suggest that UDCA could have immunoregulating properties. Abnormal MHC class I expression by hepatocytes, observed in PBC, was dramatically reduced by UDCA treatment. Cholestasis itself induces hepatic MHC expression: hepatocyte MHC class I expression was present in 6/6 cholestatic patients vs 0/8 control subjects. Experimental cholestasis in the rat induced MHC class I expression. Cyclosporin or corticosteroids had no effect on this overexpression, suggesting that an immune mechanism is not involved in this phenomenon. To assess the effect of bile acids on MHC expression, human hepatocytes were incubated with bile acids. Chenodeoxycholic acid (CDCA) (an endogenous bile acid) but not UDCA induced a dose-dependent MHC class I hyperexpression. UDCA suppressed the CDCA induced MHC hyperexpression.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782228 TI - Genitoanal papillomavirus infection: diagnostic and therapeutic objectives in the light of current epidemiological observations. AB - During the past decade a wide span of heterogeneity has been demonstrated for human papillomaviruses (HPVs), and some basic properties of the HPV genome have been revealed. The use of hybridization assays for HPV DNA detection in infected epithelia, and the recent introduction of synthetic HPV peptides for detection of type-specific circulating antibodies, have resulted in a major rethinking of HPV epidemiology. Recent data indicate that various HPVs may be transmitted perinatally during early infancy and that a long latency with periodic reactivation seems to be quite common. The present review attempts to assess recent epidemiological data with the concept of genitoanal papillomavirus infection (GPVI) as a predominantly sexually transmitted disease. Some diagnostic and therapeutic aspects are outlined with a pragmatic approach to the clinical relevance of GPVI. PMID- 1782229 TI - Partner notification: operational considerations. PMID- 1782230 TI - Molluscum contagiosum: a neglected sentinel infection. AB - Perigenital molluscum contagiosum in adults is recognized as being a sexually transmitted infection. A retrospective casenote review was performed on patients attending a department of genitourinary medicine (GUM) who had been diagnosed as having molluscum. One or more co-existent sexually transmitted diseases (STD) were present in 30.4% of 158 men and in 32.1% of 78 women. High rates of concurrent STD were also found in patients whose only presenting symptom was molluscum-in 23.2% of men and 10.5% of women. These rates of STD would undoubtedly have been higher still had the screening of these patients been more comprehensive. In view of these findings it is advisable that adults with perigenital molluscum contagiosum be screened for other STD and that their sexual partners be contact-traced. This wil usually required referral to a department of GUM. PMID- 1782232 TI - Epidemiology of an outbreak of infectious syphilis in Alberta. AB - An outbreak of 1089 cases of infectious syphilis (primary, secondary and early latent) which occurred in the province of Alberta from 1981 to 1987 was analysed by stage of disease, age, sex, sexual preference and geographic distribution. The majority of cases occurred between 1983 and 1985 inclusive. Men accounted for 75.8% of the study population. The majority of men (71%) and women (98.5%) were heterosexual. Of the infected women, 58.7% were North American Indians and many worked as prostitutes. There was clustering in urban locations with 71.8% and 17.7% of cases reported in Edmonton and Calgary, respectively. Clinical signs of syphilis were more commonly present in men than women. Contact tracing played an important role in controlling the outbreak with 15.9% of men and 44.7% of women being diagnosed and treated as a result of this activity. PMID- 1782231 TI - Autonomic dysfunction in patients with human immunodeficiency virus infection. AB - Autonomic function tests have been recorded in 40 male homosexual patients with serum antibodies to human immunodeficiency virus (HIV) and 12 male homosexuals without such antibodies. Abnormalities of autonomic function were found in 15 of 31 patients without other recognized reasons for autonomic dysfunction. Four patients had two or more test abnormalities. The profile of these abnormalities was found to be different from that of autonomic neuropathy associated with diabetes and other disorders and was consistent with the presence of sympathetic overactivity. Abnormalities in autonomic function were particularly associated with clinically identifiable neurological complications of HIV infection. PMID- 1782233 TI - Choice of sexual partner according to rate of partner change and social class of the partners. AB - Models for the spread of sexually transmitted diseases, including AIDS, rely on sexual partner mixing patterns in the population. From data acquired through partner notification for infection with Chlamydia trachomatis among young people in Gothenburg, Sweden, it was possible to construct contact matrices for the variables 'rate of partner change' and 'social class' of the partners in pair formations. These matrices show a restricted mixing between these two variables for young heterosexual women. Therefore random mixing models will probably overestimate rate of spread and possibly final size of an epidemic of a sexually transmitted disease. PMID- 1782234 TI - Sexually transmitted diseases in prostitutes in Moshi and Arusha, Northern Tanzania. AB - Sexually transmitted diseases are thought to be important in facilitating transmission of HIV in sub-Saharan Africa. This study reports the prevalence of several sexually transmitted diseases in 106 prostitutes in Arusha and Moshi Northern Tanzania. The seroprevalence of HIV was 73% compared with 3% for local blood donors. Over half (51%) of the subjects had evidence of N. gonorrhoeae infection. Seventy-four per cent had a positive TPHA and 27% a positive RPR. Of 47 subjects tested 12 (25%) had Chlamydia trachomatis antigen detected in endocervical swabs. No significant statistical association was found between the presence of any of the STDs investigated and HIV seropositivity. PMID- 1782235 TI - Admission for HIV-1 related disease in a Dublin hospital 1987-1990. AB - Between January 1987 and December 1990, 179 patients (131 men, 48 women) infected with human immunodeficiency virus type 1 (HIV-1) were admitted 408 times to St James's Hospital, Dublin. One hundred and thirty-two (73.7%) patients were intravenous drug users. The commonest cause of admission was bacterial lower respiratory tract infection (84 patients, 21%). At the time of study 95 (53%) patients fulfilled Centers for Disease Control (CDC) criteria for stage IV disease. HIV antibody status in 26 of these patients with stage IV disease was unknown prior to their admission to hospital with symptomatic disease. Pneumocystis carinii pneumonia was the most frequent stage IV defining diagnosis. The mean length of hospital stay for patients with CDC stage II/III and stage IV disease was 8.5 (median 7) and 13.5 (median 8) days respectively. PMID- 1782236 TI - Patients' assessment of and suggestions for a genitourinary medicine service. AB - One thousand consecutive attenders at a Department of Genitourinary Medicine (GUM) completed an anonymous questionnaire to assess the GUM services and provide suggestions for improvement. The replies showed patient preferences to be for an appointment system (68%), separate waiting rooms (84% women, 57% men) and to see the same doctor at each visit (75%). Forty-six per cent of women and 33% of men preferred to be seen by a doctor of the same sex, 38% requested evening clinics and 20% of patients wished to be interviewed with their partner. PMID- 1782237 TI - Sexual behaviour and HIV infection risks in Indian homosexual men: a cross cultural comparison. AB - A comparison of sexual activities in 49 homosexually active northwest Indian men attending STD clinics was made with 173 homosexually active Australian men from a community sample. There were major differences between the two on frequency of marriage and of bisexual behaviour (significantly higher in the Indian sample), condom use for anal intercourse, and of oral sex (significantly higher in the Australian sample). There was also a substantial level of heterosexual anal intercourse reported in the Indian sample. While preliminary and based on nonmatched and nonrandom samples, these data suggest that the sexual activity profile and degree of risk of homosexual behaviour may differ considerably between the two cultures, and that data on homosexual activities in western societies should not be generalized to nonwestern cultures. PMID- 1782238 TI - Diffuse cerebral lymphoma in the acquired immunodeficiency syndrome. PMID- 1782239 TI - Donovanosis (granuloma inguinale) in pregnancy. PMID- 1782241 TI - AIDS Literature Index. PMID- 1782240 TI - Non-parenteral transmission of hepatitis C virus. PMID- 1782242 TI - Tuberculosis. PMID- 1782243 TI - African sleeping sickness: an historical review. PMID- 1782244 TI - The great pox. PMID- 1782245 TI - Plague and cholera. PMID- 1782246 TI - AIDS: lessons learnt? PMID- 1782247 TI - The history and management of AIDS: a Biblical and Jewish view. PMID- 1782248 TI - AIDS: a Christian view. PMID- 1782249 TI - AIDS: The Government's view. PMID- 1782250 TI - Smallpox. PMID- 1782251 TI - Autologous adrenal medullary, fetal mesencephalic, and fetal adrenal brain transplantation in Parkinson's disease: a long-term postoperative follow-up. AB - We report on the clinical status of 5 patients with Parkinson's disease (PD) 3 years after autologous adrenal medullary (AM)-to-caudate nucleus (CN) implantation, and of 2 PD patients, 2 years after fetal ventral mesencephalon (VM)- and fetal adrenal (A)-to-CN homotransplantation. Current clinical evaluation of 4 of the AM grafted patients revealed sustained bilateral amelioration of their PD signs, most notably of rigidity, postural imbalance and gait disturbances, resulting in a substantial improvement in their quality of life. The disease-related dystonia of one of them disappeared only 2 years after surgery. The levodopa requirements of 2 of these patients and the anticholinergic therapy of another have been reduced. In agreement with the satisfactory clinical evaluation of these 4 patients, their neuropsychological and electrophysiological improvements, initially registered 3 months after surgery, have been maintained for 3 years. After 1 year of significant recovery, the 5th patient of this group has almost returned to her preoperative state. The 2 homotransplanted patients also showed sustained bilateral improvement of their PD signs. Two years after surgery, the most improved signs of the fetal VM case were rigidity, bradykinesia, postural imbalance, gait disturbances and facial expression. The fetal A case has only shown amelioration of rigidity and bradykinesia. Neither of them has shown significant neuropsychological changes. Their current levodopa requirements are less than before surgery. The improvements shown here by PD patients after brain tissue grafts go beyond those obtained using any other therapeutic approach, when levodopa fails. Although more studies and the development of these procedures are obviously required, these initial human trials appear to be resisting the test of time. PMID- 1782252 TI - Microencapsulated dopamine (DA)-induced restitution of function in 6-OHDA denervated rat striatum in vivo: comparison between two microsphere excipients. AB - Biodegradable controlled-release microsphere systems made with the biocompatible biodegradable polyester excipient poly [DL lactide-co-glycolide] constitute an exciting new technology for drug delivery to the central nervous system (CNS). The present study describes functional observations indicating that implantation of dopamine (DA) microspheres encapsulated within two different polymer excipients into denervated-striatal tissue assures a prolonged release of the transmitter in vivo. Moreover, in this regard, the results show that there were clear cut temporal differences in the effect of the two DA microsphere formulations compared in this study, probably reflecting variations in the actual composition (i.e., lactide to glycolide ratio) of the two copolymer excipients examined. This technology has considerable potential for basic research with possible clinical application. PMID- 1782253 TI - Fetal cortical transplants in adult rats subjected to experimental brain injury. AB - Fetal cortical tissue was injected into injured adult rat brains following concussive fluid percussion (FP) brain injury. Rats subjected to moderate FP injury received E16 cortex transplant injections into lesioned motor cortex 2 days, 1 week, 2 weeks, and 4 weeks post injury. Histological assessment of transplant survival and integration was based upon Nissl staining, glial fibrillary acidic protein (GFAP) immunocytochemistry, and staining for acetylcholinesterase. In addition to histological analysis, the ability of the transplants to attenuate neurological motor deficits associated with concussive FP brain injury was also tested. Three subgroups of rats receiving transplant 1 week, 2 weeks, and 4 weeks post injury were chosen for evaluation of neurological motor function. Fetal cortical tissue injected into the injury site 4 weeks post injury failed to incorporate with injured host brain, did not affect glial scar formation, and exhibited extensive GFAP immunoreactivity. No improvement in neurological motor function was observed in animals receiving transplants 4 weeks post injury. Conversely, transplants injected 2 days, 1 week, or 2 weeks post injury survived, incorporated with host brain, exhibited little GFAP immunoreactivity, and successfully attenuated glial scarring. However, no significant improvement in motor function was observed at the one week or two week time points. The inability of the transplants to attenuate motor function may indicate inappropriate host/transplant interaction. Our results demonstrate that there exists a temporal window in which fetal cortical transplants can attenuate glial scarring as well as be successfully incorporated into host brains following FP injury. PMID- 1782254 TI - Motor deficits are produced by removing some cortical transplants grafted into injured sensorimotor cortex of neonatal rats. AB - Fetal frontal cortex was transplanted into cavities formed in the right motor cortex of neonatal rats. As adults, the animals were trained to press two levers in rapid succession with their left forelimb to receive food rewards. Once they had reached an optimal level of performance, the effect of removing their transplants was assessed. Surgical removal of transplants significantly impaired the performance of 2 of 4 subjects. Placing a cross-strain skin graft to induce the immunological rejection of the transplants produced a behavioral deficit in 1 of 2 subjects with complete transplant removal. Skin grafts produced no behavioral effects in four subjects that had surviving transplants. Since the motor deficits produced by transplant removal resembled those observed following the removal of normal motor cortex, we propose that these three transplants functioned within the host brain. Histology showed that the procedures used to remove cortical grafts did not injure any host brains. Therefore, host brain damage is unlikely to account for the behavioral deterioration that followed transplant removals. PMID- 1782255 TI - Quantitative estimation of the ratio of GABA-immunoreactive cells in neocortical grafts. AB - Somatosensory anlage from 17-18 day old rat embryos were transplanted in place of the removed barrel cortex in adult rats. Six to eight months after transplantation, the grafts were either completely separated by glial scar or partly separated and partly confluent with the host neocortex. Each was studied histologically and immunostained for GABA. It was found that in partly confluent grafts the neuronal density was similar or even higher than in the host cortex, while the cell number in the separate grafts was much lower than in the nearby host cortex. The number of GABA-positive cells, however, was in all grafts significantly lower (2.9% on average) than in the normal cortex (11.8% on average). The decline in GABA-stained nerve cells was highest in separated grafts, but was somewhat less marked in transplants partly confluent with the host tissue. The possible role of partial or total deafferentation as well as the relative vulnerability of the transplanted tissue by temporary hypoxia and other metabolic disturbances are discussed as the probable factors in selective decline of GABA-ergic cells in the transplanted somatosensory cortex. PMID- 1782256 TI - New surgical approach to overcome the inability of injured mammalian axons to grow within their environment. AB - We present a new method for creating conditions conductive to axonal growth in injured optic nerves of adult rabbits. The surgical approach consists of making a cavity in the adult rabbit optic nerve, into which a piece of nitrocellulose soaked with conditioned medium originating from regenerating fish optic nerves is implanted. In addition, daily irradiation (10 days, 5 min, 35 mW) with low energy He-Ne laser is carried out. Such a combined treatment may open a door to neurobiologists and clinicians, hoping to unravel the enigma of mammalian CNS regeneration. PMID- 1782257 TI - Is Phaseolus vulgaris leucoagglutinin (PHA-L) a useful marker for labeling neural grafts? AB - The lectin Phaseolus vulgaris leucoagglutinin (PHA-L) has come into wide use as an anterograde neuroanatomical tracer. The ability of this lectin to fill entire neurons and remain in place over long periods suggested it might be an ideal marker for donor cells to be grafted into hosts for long survival periods. We have used the lectin PHA-L to mark fetal rat olfactory bulb (OB) cells prior to grafting into host rat OBs. Hosts were sacrificed at various times up to 9 weeks after grafting, and tissue was immunohistochemically processed for PHA reactivity. After 2 and 4 weeks survival, sparse patterns of labeled cells were observed within the host OBs. However, after 9 weeks survival, few if any labeled cells were visible within host tissue. We conclude that PHA-L may be a less than satisfactory marker for fetal rat cells (other than astrocytes) which are to be identified in host tissue after a period of several weeks. PMID- 1782258 TI - [Nutrition team. Units of nutritional support]. AB - During the VIII National Congress of the Spanish Society of Parenteral and Enteral Nutrition (SENPE) held in Santander on 5th, 6th and 7th of June last, a subject was raised among several others, which for us was of great current interest and not often found in scientific affairs, related to the organizational affairs of the discipline of Artificial Nutrition, namely the Nutritional Teams or Nutritional Support Units. The aim was to respond to the many problems raised by this discipline: What does it consist of? Is it necessary? What is its purpose? Who is involved in it? What qualifications must these people have? Does it enter into competition with Nutritional, Clinical and Dietetic Services? To reply to these and many other questions, we invited a number of professionals with wide experience in nutritional and other fields, in an attempt to form a group of experts in different specialties with interests in the subject. We were also lucky enough to be able to invite Doctor Rombeau, an internationally recognized expert, in whose country there exists great experience in the organization of these units. This summary of our Round Table was prepared by the organizer, Doctor Ordonez, and an attempt was made to respect the spirit of each author's contribution. PMID- 1782259 TI - [Nutritional support units]. PMID- 1782260 TI - [Malnutrition and surgery]. PMID- 1782261 TI - [Practice guideline for the administration of drugs with parenteral nutrition]. AB - The "Y" administering of drugs or administering them during parenteral nutrition should not be a normal practice in daily clinical operations, due to the problems of the possible lack of physio-chemical stability in the lipid emulsion forming the mixture of aminoacids, glucose, lipids, electrolytes, vitamins and oligoelements or the chemistry of the drug itself with these components. Also, the "Y" administration of drugs in parenteral nutrition increases the risk of infection in the catheter, since it is handled much more often. Despite these problems, there are clinical situations (such as preoedema of the lung, inadequate syndrome of the antidiuretic hormone in bone marrow transplants), in which it is necessary to restrict to a minimum the fluids to be perfused. As an example, we could mention Ranitidine in TPN or the elimination of second line peripheric maintenance serum and the administering of other drugs in "Y" using a syringe or microdrop system. The same case as in patients subjected to bone marrow transplants, where due to polypharmacy and transfusions, drugs should be administered in "Y". This study is an updated review of the chemical stability of drugs administered in "Y" or in parenteral nutrition, and the physio-chemical stability of the lipid emulsion. PMID- 1782262 TI - [Preoperative nutritional status in geriatric patients with digestive neoplasm]. AB - Between October 1987 and January 1989, a prospective study was performed on the nutritional state of 100 elderly patients aged 65 and over, with digestive neoplasia. We found that 47% were suffering from malnutrition. This was associated to greater postoperative complications and mortality, and prealbumin and weight-loss percentages were the nutritional parameters most often altered, and which showed better correlations to the development of postoperative complications. Based on these two parameters, we prepared a classification system for these patients, dividing them into three surgical risks groups from the nutritional standpoint, which enabled us to select those patients who would most benefit from preoperative nutritional support, and evaluate the effectiveness of this treatment in reducing postoperative complications and mortality, by means of a corresponding prospective study. PMID- 1782263 TI - [Caldesmon and calponin are proteins, participating in the regulation of myosin and actin interaction in nonmuscle and smooth muscle cells]. AB - The structure and properties of two novel regulatory proteins of nonmuscle cells and smooth muscles are reviewed. The localization of the "light" caldesmon isoform in nonmuscle cells and the involvement of this protein in the formation of cytoskeleton structures are described. A detailed description of the "heavy" caldesmon isoform and of localization of sites of caldesmon interaction with actin, tropomyosin, myosin and calmodulin, is given. The data on caldesmon phosphorylation by protein kinases are reviewed. Some present-day concepts concerning the mechanism of caldesmon function during regulation of myosin interaction with actin are considered. The structure, properties and phosphorylation of calponin are described. The properties of calponin and caldesmon are compared with those of troponin components involved in the regulation of the contractile activity of striated muscles. PMID- 1782264 TI - [Conformational analysis of lipotropic acton of human somatotropin and peptide analogs]. AB - Based on the results of a semi-empirical analysis, several structural types of human and sea whale somatotropins and placental lactogen lipotropic actons which correspond, apparently, to the biologically active conformation common for the given molecular family, were identified. Chemical modification of human somatotropin lipotropic acton whose conformational possibilities selectively model the most preferential structure of the natural oligopeptide are proposed. PMID- 1782265 TI - [Regulation of the heart mitochondrial respiration rate. Comparison of oxidation of succinate and NAD-dependent substrates]. AB - Regulation of respiration at all rates between State 4 and State 3 was studied in heart mitochondria oxidizing FAD- and NAD-dependent substrates (succinate, pyruvate + + malate and palmitoylcarnitine). The creatine phosphokinase ADP regenerating system was used which allows to fix the concentrations of extramitochondrial adenine nucleotides in such a way that the rate of respiration is controlled by mitochondrial processes alone. It was shown that respiration is controlled by delta mu(H+)-utilizing system within the respiration rate interval from State 4 till 70-80% of the maximal rate in State 3 (corresponding to physiological rates) both for NAD- and FAD-dependent substrates. The main step in the control of respiration near State 4 is proton leakage through the inner mitochondrial membrane, whereas in all the other parts of the mentioned interval this role is assigned to the adenine nucleotide translocator (ANT). The control coefficient for ANT is higher, while that of proton leakage is lower at the same relative rates of respiration with NAD-dependent substrates compared with succinate. These differences were found to be related to much higher values of the membrane potential generated at the same relative rates of succinate oxidation in comparison with the case with pyruvate + + malate. The contribution of delta mu(H+)-utilizing system to respiration control sharply decreases, whereas that of the delta mu(H+)-generating system increases at maximal rates of respiration near State 3. This phenomenon in more characteristic of succinate. In this case the control coefficient of ANT drops to zero, while that of succinate dehydrogenase rises to 0.7. PMID- 1782266 TI - [Neutral alpha-mannosidase in human B- and T-lymphoid cells]. AB - The presence of neutral alpha-mannosidase activity in normal and pathological lymphoid cells has been demonstrated. The specific activities of the enzyme in different cell types were similar with the exception of B-cells from B-CLL patients when it was a little higher. The activity of acid alpha-mannosidase was also determined in these lymphoid cells. The neutral to acid alpha-mannosidase activity ratio was different in B- and T-cells: in the former neutral alpha mannosidase activity prevailed, whereas in the latter the predominance of acid alpha-mannosidase activity was apparent. Neutral alpha-mannosidases from pathological B- and T-cells were partially purified and their properties were investigated. In both cell types the enzyme was localized in the cytosol, was very labile and could be stabilized with Mn2+ and dithiothreitol. The enzyme was activated by Co2+ and inhibited by Zn2+ and EDTA. Swainsonine inhibited the B cell neutral alpha-mannosidase somewhat more strongly in comparison with the T cell enzyme. PMID- 1782267 TI - [Crystallization of free aspartate aminotransferase from chicken heart cytosol]. AB - Homogeneous aspartate aminotransferase (purity--99%, yield--70%) has been prepared from chicken heart cytosol. The purification procedure included fractionation with ammonium sulfate and ethanol and crystallization. Crystals (0.3 x 0.5 x 2 mm) of the free enzyme were prepared from ammonium sulfate solution and studied by X-ray analysis at 2.5 A resolution. PMID- 1782268 TI - [Biochemical mechanisms of resistance to a new antineoplastic drug CRC 680578 from the nitrosourea class]. AB - The biochemical mechanisms of resistance to CRC 680578, a new antitumour chloroethylnitrosourea alpha-amino acid derivative, were studied. Alterations in DNA, RNA and protein syntheses, SH-group content, drug efflux, activities of replicative and repair enzymes, such as ribonucleotide reductase, thymidine kinase, O6-alkylguanine-DNA-alkyltransferase and DNA polymerases alpha and beta and damages of the DNA secondary structure were investigated in sensitive and resistant to CRC 680578 leukemia L1210 cells. It was found that the total SH group number in drug-resistant cells was increased (about 1.3-fold in comparison with sensitive cells) which seems to be due to the mechanisms of drug resistance. CHC 680578 induced less pronounced inhibition and more rapid restoration of DNA and RNA synthesis in resistant cells. No differences between the ribonucleotide reductase and thymidine kinase activities were found either in intact cells of the both strains or after drug administration. The efficiency of repair of DNA chloroethyl adducts by O6-alkylguanine-DNA-alkyltransferase in leukemia cells of various sensitivity was found to be identical. The differences in enzyme activities in intact cells of the both strains were insignificant. It was supposed that factors other than changes in the level of O6-alkylguanine-DNA alkyltransferase in leukemia cells may be responsible for the resistance to CRC 680578. The increase in the levels of DNA polymerase alpha and, especially, of DNA polymerase beta, in sensitive (but not resistant) mouse leukemia cells 48 hours after drug administration is though to define the mechanism of resistance to the new antitumour agent CHC 680578. PMID- 1782269 TI - [Oxidative activity and Delta(Psi) of liver mitochondria of active and hibernating ground squirrels during various incubation conditions]. AB - A comparative analysis of delta psi of liver mitochondria of active and hibernating gophers was carried out, and the effect of the decrease of the medium tonicity on the oxidase activity and delta psi of liver mitochondria of both animal groups was studied. The delta psi of hibernating gopher liver mitochondria was shown to be lower than that of active animals mitochondria and displayed a higher sensitivity to the uncoupler and some different restoration dynamics after the decline following the ADP addition. Swelling of liver mitochondria of hibernating gophers in hypotonic media or in media containing potassium acetate and a 3-fold freeze-thawing procedure resulted in the enhancement of the oxidase activities accompanied (in case of hypotonicity) by an delta psi increase and a decrease of its sensitivity to the uncoupler, 2.4-dinitrophenol. Inhibition of phospholipase A2 prevented the enhancement of the oxidase activity in all cases and the delta psi increase in hypotonic media. PMID- 1782270 TI - [Activation of oxidative phosphorylation and energy-dependent absorption of Ca2+ and K+ ions by liver mitochondria of hibernating ground squirrels in hypotonic media]. AB - Activation of initially suppressed oxidative phosphorylation and energy-dependent uptake of Ca2+ and K+ ions by liver mitochondria of hibernating gophers which is prevented by phospholipase A2 inhibitors, has been shown to occur in hypotonic media. Partial inhibition of the respiratory chain of liver mitochondria of active gophers by antimycin A which causes a decrease in the uncoupled respiration rate and delta psi down to values typical of mitochondria of hibernating gophers, practically exactly reproduced the suppression of oxidative phosphorylation and energy-dependent uptake of cations observed during hibernation. It was concluded that partial deenergization arising as a result of inhibition of the respiratory chain is the main and unique cause of suppression of energy-dependent functions of liver mitochondria of hibernating gophers. PMID- 1782271 TI - [Ukhtomskii--the teacher (based on memoirs and letters)]. AB - This article has been written by pupil of A.A. Ukhtomsky, well-known professor of Moscow State University M.V. Kirzon. The article discovers the personal qualities of outstanding biologist A.A. Ukhtomsky, who has founded one of the famed physiological scientific schools in the Soviet Union. PMID- 1782272 TI - [The identification of the membrane proteins of human and animal viruses]. AB - The review deals with the methods of identification of virus-specific proteins on virion and infected cell surface. The isotopic labeling of membrane proteins, their extraction by proteolytic enzymes and selective solubilization by detergents are considered. The plasmatic membrane isolation by centrifugation and by means of microcarriers is described. The methods of membrane protein localization using monoclonal antibodies and radioimmunoprecipitation are presented. PMID- 1782273 TI - [The antiulcer action of antidepressants. II. The effect of the antidepressants inkazan, azafen, and OF-743 in combination with arginine on ethanol-evoked damage to the gastric mucosa in rats]. AB - Mucosal gastric damages in rats induced by intragastric ethanol introduction decreased considerably on the background of action of one of the antidepressants (asaphen, inkasan and OF-743) in combination with arginine. The combination OF 743 with arginine has the largest protective action, the least one--asaphen with arginine. A comparison of protective action of some antidepressants with action of antidepressants in combination with arginine revealed a tendency to more expressed antiulcerogenic effect in studied combinations. PMID- 1782274 TI - [The effect of cyclooxygenase inhibition on the indices of the thrombocyte vascular link in hemostasis and on the free-radical processes of lipid oxidation in experimental Salmonella intoxication]. AB - Injection of Salmonella typhimurium endotoxin to the laboratory animals (rabbits) in dose of 1 mg/ml (LD84) induces the particular changes in the thrombocyte vessels system of hemostasis: decrease of aggregatory ability of thrombocytes, increase of thromboxane A2 and prostacyclin activation of lipid peroxidation process. Use of indomethacin--the cyclooxygenase inhibitor--leads to less progressive alterations of the studied parameters of the thrombocyte vessels hemostasis and lipid peroxidation processes. PMID- 1782275 TI - [The genetic-demographic approach in anthropological research. IX. The spatial structure of Khakass populations]. AB - The rural population of Khakassia is characterized by genetic isolation due to marital traditions and ethnic-territorial subdivisions. The type of Khakass settling limits the choice of a marital partner within the territory occupied by one ethnographic group, preventing an active migration of alleles from one population to another. Formation of local zonal anthropologic type (84% of marital couples) occurs on the territory approximately equal to the area of one administrative district. PMID- 1782276 TI - [The use of component analysis for assessing the physical development of men]. AB - A physical development is regarded as somatic equivalent of capacity for physical work. Two integrative indexes of size and shape of body have been revealed using the component analysis. It is possible to estimate their values for length, weight and chest circumference. The influence of subcutaneous fat on the indexes of size and shape is removed using the linear regression. A conclusion on the type of physical development may be made on the basis of their combination. PMID- 1782277 TI - Liquid preservation of polymorphonuclear leukocytes: effect of various additives on chemotaxis preservation. AB - Adequate storage of polymorphonuclear leukocytes would allow an easier in vitro study of their structure and their functions, an easier study of polymorphonuclear leukocyte diseases (e.g. chronic granulomatous disease) and an easier use of polymorphonuclear leukocytes as a clinical tool (e.g. for localizing infections). Unfortunately, polymorphonuclear leukocytes are nearly impossible to preserve, even in short-term storage. This study proposes a model for the study of polymorphonuclear leukocyte storage in a synthetic medium: Plasmion. For storage over a period of 24 h, we found that supplementation with each of the following additives: bicarbonate buffer, glucose, adenosine triphosphate (ATP), ascorbic acid, nicotinamide adenine dinucleotide (NADH), nicotinamide adenine dinucleotide phosphate (NADPH), alpha-tocopherol acetate, amikacin and ampicillin, significantly improves (p less than 0.05) one or several functions of the polymorphonuclear leukocytes. When samples were stored for 48 h, we found that the addition of bicarbonate buffer after 24 h significantly improves the maintenance of several functions of polymorphonuclear leukocytes, in particular chemotaxis. Preservation for 96 h was achieved by making additions of supplements on each day of storage, with a chemotaxis maintenance of 83% at 24 h, 59% at 48 h, 46% at 24 h and 20% at 96 h. In conclusion, by using the Plasmion medium, and adding the above-mentioned compounds on each day of storage, chemotaxis can be satisfactorily maintained over 4 days. PMID- 1782278 TI - Enzyme activities in urine: how should we express their excretion? A critical literature review. AB - Different methods and reference bases for characterizing the excretion of urinary enzymes (relation to volume, time, creatinine, specific gravity, osmolality and fractional excretion) are reviewed with regard to their advantages and disadvantages when using urinary enzyme excretion as a diagnostic tool. The problems of timed and untimed urine samples for the analysis of urinary enzyme excretion and the influence of diuresis on the quantity and composition of enzymes excreted are discussed. The use of the second morning urine as a random urine sample, and determination of the relation of enzyme activity to urinary creatinine (enzyme/creatinine ratio; enzyme/creatinine index) represent a satisfactory compromise for the characterization of urinary enzyme excretion. The calculation of enzyme excretion per unit time or other modes of expression should be used only in special cases. PMID- 1782279 TI - Digoxygenin-labelled DNA-probe: a rapid non-radioactive method for hepatitis B virus DNA detection in serum. AB - The sensitivity and specificity of two non-radioactive spot hybridization assays for hepatitis B virus DNA (HBV-DNA) using biotin and digoxygenin-labelled DNA probes were investigated in parallel in 122 serum samples from patients with chronic hepatitis B and 50 controls. The results were compared with an isotopic technique using a 32P-labelled probe. HBV-DNA was detected in 56 (80%) out of 70 hepatitis B "e" antigen (HBeAg)-positive cases and in 4 (8%) out of 52 antibody to hepatitis B "e" antigen (anti-HBe)-positive cases using the digoxygenin or 32P labelled probes. No false positives were found with either method. Using the biotin-labelled probe, 16% of sera gave discordant results, which were considered to be false positive. The time required for detection of serum HBV-DNA was 2 hours for the non-radioactive probes and 16 hours for the isotopic probes. This study suggests that the digoxygenin-labelled probe for detection of HBV-DNA is the most rapid and sensitive method for routine diagnosis of viral replication in clinical laboratories. PMID- 1782280 TI - Aminoterminal propeptide of type III procollagen: a marker of disease activity in schistosomal patients. AB - The serum concentration of aminoterminal propeptide of type III procollagen was measured in 44 Egyptian healthy controls and 29 patients with hepatosplenomegaly originating from endemic areas for schistosomiasis in Egypt. Patients were classified into two main groups according to the histopathological pattern of the liver biopsy: patients with active schistosomal liver fibrosis and patients with inactive schistosomal liver fibrosis. Serum aminoterminal propeptide of type III procollagen levels were elevated in most of patients with active fibrosis but not in those with inactive schistosomiasis. From the present work, it is suggested that aminoterminal propeptide of type III procollagen can be used as a marker for active fibrogenesis in patients with schistosomal liver fibrosis. PMID- 1782281 TI - Diamine oxidase activity in amniotic fluid for diagnosis of ruptured membranes. AB - Diamine oxidase in vaginal effluent is used as a parameter for ascertaining the state of fetal membranes. A new method using tritiated putrescine as a substrate is described for the determination of diamine oxidase in amniotic fluid and vaginal effluents. A number of tests are used for the diagnosis of premature rupture of fetal membranes. The described procedure for diamine oxidase activity determination can be used in general hospitals and has advantages over other parameters such as pH, glucose or fructose concentration, and the amniotic fluid crystallization test. PMID- 1782282 TI - The value of laboratory tests in patients suspected of acute appendicitis. AB - The clinical usefulness of laboratory tests was examined in 258 patients admitted to the emergency room with the general practitioner's tentative diagnosis, acute appendicitis. Acute appendectomy was performed on 91 patients. Histological examination of the appendix confirmed the diagnosis in 69 cases (acute appendicitis 20, phlegmonous appendicitis 36, perforation 13). Seven patients with appendicular infiltrate were not subjected to operation but the diagnosis was clear from clinical examination. On close examination/operation by the surgical team, 96 admitted patients were excluded from the primary diagnosis, acute appendicitis, and served as a control group. Receiver Operation Characteristic curves (ROC-curves) showed that the sensitivity and specificity and hence diagnostic efficiency for total white blood cell count, number of segmented leukocytes and C-reactive protein concentration for the detection of acute appendicitis were higher than for erythrocyte sedimentation rate, alpha 1 antiproteinase concentration and body temperature. We observed that when all three parameters, C-reactive protein, white blood cell count and segmented leukocytes, are within the normal range the diagnosis, acute appendicitis is highly unlikely. The diagnostic value of the different laboratory parameters appears, moreover, to be highly dependent on the degree of inflammation/perforation and the development of appendicular infiltration. However, diagnostic efficiency can be improved, and unnecessary surgery prevented, by performance of an appropriately selected combination of laboratory tests combined with evaluation of clinical symptoms. PMID- 1782283 TI - Evaluation of a new chemiluminescence technique for human thyrotropin (BeriLux hTSH): diagnostic value of five immunometric assay methods. AB - A new commercially available human thyrotropin immunochemiluminometric assay (ICMA) kit was evaluated. The BeriLux assay (Hoechst Co., Germany) was compared with two other non-radioisotopic methods (AIA-1200 and IMx) and two other immunoradiometric assays (RIA-gnost TSH IRMA and EIKEN IRMA kits) in 32 normal subjects and 104 patients with Graves' disease, divided into seven groups: 1) untreated hyperthyroidism; 2) hyperthyroidism during treatment; 3) euthyroid with negative thyroliberin test (subclinical hyperthyroidism); 4) euthyroid with low thyroliberin test; 5) euthyroid with normal thyroliberin test; 6) euthyroid with high thyrotropin level (subclinical hypothyroidism); and 7) primary hypothyroidism. Patients in groups 2-6 were undergoing treatment with mercazole and propylthiouracil. The new immunoluminometric assay (ILMA) BeriLux kit was shown to have a remarkably improved analytical and clinical sensitivity. The minimal detectable level of thyrotropin in the assay was 0.006 mU/l. The precision was 2.8% and 6.1% at 0.093 +/- 0.003 mU/l and 0.028 +/- 0.002 mU/l, respectively, whereas the precision of the other methods was above 17.2% and 59.4% respectively. Seven patients from the untreated hyperthyroid group were given 500 micrograms thyroliberin i.v. (the thyroliberin test). The thyrotropin pattern before and after thyroliberin administration was always less than 0.006 mU/l with the BeriLux kit, whereas the other methods showed random fluctuations indicating their low accuracy at this concentration. Using the BeriLux kit, 7 of the 16 overt hyperthyroid patients undergoing treatment showed a measurable thyrotropin level below 0.01 mU/l but a negative thyroliberin test.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782285 TI - International Federation of Clinical Chemistry (IFCC), scientific division: IFCC recommendation on sampling transport and storage for the determination of the concentration of ionized calcium in whole blood, plasma and serum. AB - The substance concentration of ionized calcium (cCa2+) in blood, plasma or serum preanalytically may be affected by pH changes of the sample, calcium binding by heparin, and dilution by the anticoagulant solution. pH changes in whole blood can be minimized by anaerobic sampling to avoid loss of CO2, by measuring as soon as possible or by storing the sample in iced water to avoid lactic acid formation. cCa2+ and pH should be determined simultaneously. PMID- 1782284 TI - Measurement of alkaline phosphatase activity in serum with N-methyl-D-glucamine as a buffer: evaluation of the method for routine use. AB - Some aspects of the measurement of alkaline phosphatase activity concentration in human serum, using N-methyl-D-glucamine as a buffer, were evaluated with a view to the possible routine use of the method. The evaluated characteristics included: the temperature-dependence of the pH of the buffer; the effect of adding the magnesium/zinc ions buffer; the effect of the serum volume fraction; the substrate-starter versus the serum-starter mode; the effect of modifying the formulation of reagents; the within-run and the between laboratory imprecision; the correlation with an alternative routine method. Also, sex- and age-related reference values were produced, based on 2968 values from selected reference sample groups in 7 laboratories. In general, the results demonstrate the robustness of the method, its adaptability to a variety of mechanized analysers, and hence its feasibility as a routine measurement method. PMID- 1782286 TI - Arylsulfatases are present in seminal plasma of several domestic mammals. AB - Mammalian spermatozoa and seminal plasma both contain high levels of arylsulfatases (AS), enzymes that remove sulfate from sulfated glycoconjugates. In ejaculated semen of boars, 85% of AS was found in seminal plasma whereas only 13% was found in spermatozoa. A comparable distribution of AS between spermatozoa and seminal plasma was observed in other domestic mammals. The presence of AS in seminal plasma was not due to leakage from spermatozoa because sperm cells had intact acrosomes and plasma membranes after their separation from seminal plasma, and because 84% of the acrosomal marker enzyme hyaluronidase was retained in washed spermatozoa. Spermatozoa in boar semen diluted with Beltsville Thawing Solution (BTS) deteriorated faster during storage at 17 degrees C than spermatozoa stored in BTS without seminal plasma. This suggests that seminal plasma has a deleterious effect on mammalian spermatozoa. We propose that (1) sulfated glycoconjugates stabilize sperm plasma membranes; (2) AS present in seminal plasma contribute to the deterioration of spermatozoa by desulfating these glycoconjugates; and (3) AS present in seminal plasma could well play a role in sperm capacitation. PMID- 1782287 TI - Influence of estradiol on the secretion of oxytocin and prostaglandin F2 alpha during luteolysis in the ewe. AB - Twenty ewes of mixed breeds were randomly assigned in equal numbers to one of four groups in a 2 x 2 factorial design. The factors were x-irradiation to destroy ovarian follicles or sham irradiation and the administration of estradiol containing or empty (placebo) implants. Surgery for irradiation was performed on Day 8 of the cycle. Blood samples were withdrawn from jugular catheters at 1.5-h intervals from Day 10 to Day 17. Luteolysis was not observed by Day 17 in 4 of 5 placebo-treated ewes after destruction of ovarian follicles. Luteolysis was observed in 4 of 5 ewes of the sham-irradiated, placebo-treated group and in all ewes that received estradiol whether or not ovarian follicles had been destroyed. The longest (p less than 0.07) interval between peaks of 13,14-dihydro-15-keto prostaglandin F2 alpha (PGFM) was observed in the x-irradiated, placebo-treated group, whereas the administration of estradiol reduced (p less than 0.01) the interval between PGFM peaks. These findings indicate that a short interpulse interval in the secretion of prostaglandin F2 alpha (PGF2 alpha) is associated with luteolysis. It is possible that the reduced interpulse interval was either an effect of estradiol that caused luteolysis or a secondary event resulting from luteolysis. The administration of estradiol decreased (p less than 0.05) the number of episodes of oxytocin secretion during luteolysis and increased (p less than 0.01) the interval between episodes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782288 TI - Season but not age affects Sertoli cell number in adult stallions. AB - To evaluate the effect of age and season on Sertoli cell number per paired testes, ratio of germ cells per Sertoli cell, and daily sperm production, testes were obtained from 184 adult (4-20 yr) stallions at slaughter throughout one year. Numbers of Sertoli cells or germ cells were derived from nuclear volume density, volume of individual nuclei, and parenchymal volume. Germ cell to Sertoli cell ratios were calculated from cell numbers. Regression analysis was used to detect age-related differences in the breeding season (May-Jul) or throughout the year. A two-way analysis of variance was used to evaluate time periods (Nov-Jan, Feb-Apr, May-Jul, and Aug-Oct) and age groups (4-5.5, 6-12.5, or 13-20 yr). Paired parenchymal weight and daily sperm production per horse increased significantly with age. Neither regression nor analysis of variance revealed an effect of age on Sertoli cell number. While season contributed (p less than 0.01) to variation in Sertoli cell number per horse, there was no (p greater than 0.05) age x season interaction or age effect on Sertoli cell number. In testes obtained from adult stallions, age had no effect on the number of Sertoli cells per horse, the ratio of maturation-phase spermatids to Sertoli cells, or the ratio of all stage VIII germ cells to Sertoli cells. Given no age effect within a given season on Sertoli cell number per horse, the number of Sertoli cells in the recrudesced testis of the breeding season probably is not significantly different for a given stallion between 4 and 20 yr of age. PMID- 1782289 TI - Immunohistochemical demonstration of androgen-binding protein in the rat prostatic gland. AB - Androgen-binding protein (ABP) is one of the best-characterized products of synthesis by the Sertoli cells in the rat. Although the exact physiological role of ABP remains to be determined, it has been widely used to study Sertoli cells and testicular function in this species. Since this protein is the principal carrier for testosterone in rat testis and epididymis, we decided to investigate ABP immunoreactivity (ABP-I) in androgen-dependent organs, including testicle, epididymides, prostate, and seminal vesicles. The location of ABP was investigated by immunohistochemistry using specific antisera against rat ABP. As previously described in the testis, rat ABP-I was identified in the seminiferous tubules within the cytoplasm of the Sertoli cells and the tubular luminae. The epididymis showed ABP-I only in epithelial cells of the proximal caput. We demonstrated ABP-I in the apical portions of epithelial cells of the rat prostate. Short-term castration and/or ligation of the efferent ducts did not suppress prostatic ABP-I. ABP-I was not present in seminal vesicles of control rats nor under any of the experimental conditions used throughout this study. The results also indicate the presence of ABP-I in prostatic epithelium, probably because of a mechanism similar to that described in epididymis. Our data support and enhance the concept that ABP may serve as a transmembrane carrier protein for androgens in androgen target organs in the male reproductive tract. PMID- 1782290 TI - Absence of female-induced luteinizing hormone release in orchidectomized, sexually active mice. AB - This experiment was designed to determine whether the reflexive LH pulses induced in male mice by exposure to a female are dependent upon the presence of the testes. B6D2F1 males were studied because, unlike most males, these hybrids remain sexually active indefinitely after castration, demonstrating that they still recognize females and are sexually arousable. We reasoned that if LH reflexes occur independently of the testes, then exposing castrated B6D2F1 males to a female should elicit a pulse. We observed female-induced pulses in 67% of intact, naive males and 80% of intact, sexually experienced males, but they were absent in castrated, sexually experienced males. Spontaneous pulses were too frequent in castrated, naive males to distinguish potential LH reflexes. Thus, the induction of LH reflexes depends upon the presence of the testes in these hybrid males. Secondarily we found more frequent spontaneous pulses in sexually naive than in experienced mice regardless of their gonadal status. These unexpected results imply that long-term mating activity slows the pace of spontaneous LH pulses in these hybrids. Considered together, the differential effects of the testes and sexual experience on both types of LH pulses suggest that two distinct pulse-generating mechanisms exist in male mice. PMID- 1782291 TI - Effects of in utero ultrasound exposure on the development of the fetal mouse testis. AB - The effect on the developing fetal testis of in utero exposure to 1-MHz, continuous-wave ultrasound in the spatial peak, temporal average intensity range 0.5-10 W/cm2 for durations of 400-30 sec on Day 9, 12, or 15 of gestation was determined. Results show that two subtle, yet potentially deleterious, effects occurred: a reduction in the Sertoli cell population and an apparent delay in the cessation of gonocyte mitosis. An increase was also seen in the number of fetal resorptions and stillborn pups per number of implantation sites in the exposed specimens as compared to the sham and cage controls. Because the reduction in testis weight was proportional to decreased body weight and because there was no difference in Sertoli cell numbers due to day of treatment, the testicular effects may reflect a generalized delay in growth. Whether this effect of ultrasound on fetal testis will be translated into an equal reduction in germ cell numbers in the adult testis remains to be determined. PMID- 1782292 TI - A developmental study of the gonadotropin-releasing hormone neuronal system during sexual maturation in the male Djungarian hamster. AB - The number, morphology, and distribution of gonadotropin-releasing hormone cell bodies were studied in the brain of the male Djungarian hamster during sexual maturation. Males were reared in long days (16L:8D) and were killed at 15, 25, or 40 days of age, before (n = 5), during (n = 4), or after puberty (n = 4), respectively. Brain sections (60 microns) from the rostral olfactory tubercle to the medial basal hypothalamus were processed for GnRH immunocytochemistry. Unipolar and bipolar neurons were immunolabeled for GnRH; both subtypes had smooth cell contours. Analysis of every section from the olfactory tubercle to the arcuate nucleus indicated that at all ages more than 75% of all GnRH immunoreactive cell bodies were distributed in the diagonal band of Broca, medial preoptic area, lateral preoptic area, and lateral hypothalamic area. GnRH positive somata were also found in other brain regions, but in each of these areas they represented less than 6% of the total GnRH neuron number. In peripubertal 25-day-old males, during the rapid phase of testes growth, the number of unipolar, but not bipolar, GnRH-labeled cells nearly doubled in the diagonal band of Broca compared to soma numbers in this location in prepubertal 15-day-old males. The same number of unipolar GnRH-stained somata were found in this region in 40-day-old as in 25-day-old hamsters. In the medial preoptic area, a similar doubling of unipolar neuron numbers was observed at 25 days, but by 40 days the number of unipolar immunostained GnRH cells was secondarily reduced to a level comparable to that at 15 days.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782293 TI - Unique state of sexual dimorphism of crossing-over in diplotene spermatocytes and oocytes of Mesocricetus brandti, a species with neonatal oogenesis. AB - Sexual dimorphism of recombination has been held by classic genetic theory to disfavor the heterogametic sex. Assessment of chiasma frequencies at the diplotene stage of meiosis has been used as a valid measure of this concept and in many species has revealed, as expected, an increased frequency in female vs. male germ cells. Mesocricetus brandti, a species currently used in investigations of gonadal regression, photoperiods, and hibernation, was found by this measure to be an exception to this rule, with an average of 29.81 chiasmata in spermatocytes and 23.16 in oocytes. Sites of crossing-over unique to each sex were also detected. Oogenesis occurs in this species as a postnatal phenomenon and is suggested as a possible critical factor for the exceptional recombinant behavior. PMID- 1782294 TI - Relationship between nuclear remodeling and development in nuclear transplant rabbit embryos. AB - The present study characterized the profile of nuclear remodeling in nuclear transplant rabbit embryos and investigated the relationship between chromatin behavior after transfer and embryo development. The developmental potential and pattern of remodeling of donor nuclei from cleavage-, morula-, and blastocyst- (inner cell mass ICM, and trophectoderm, TE) stage donors were evaluated. In addition, we determined whether a modification in the synchrony between blastomere fusion and oocyte activation altered the profile of nuclear remodeling and affected development of reconstituted embryos. Development to blastocysts was similar with 8- and 32-cell-stage donor nuclei (42% and 33%, respectively, p greater than 0.1). However, it was reduced with ICM transplants (17%, p less than 0.05), and development of TE transplants did not progress beyond the 8-cell stage. Upon blastomere fusion into nonactivated oocyte cytoplasm, nuclear remodeling was characterized by premature chromosome condensation (PCC), followed by pronuclear (PN) formation and swelling. PCC occurred synchronously within 1.2 1.5 h post-fusion with all stages of donor nuclei (p greater than 0.1). PN formation in 8- and 32-cell transplants occurred approximately 4 h after fusion, and was synchronous to that of female pronuclei in activated oocytes; however, it was delayed in ICM and TE transplants (p less than 0.01). With all stages of donor nuclei, final nuclear diameter was similar to, or larger than, that of female pronuclei. Fusion to activated oocyte cytoplasm, as opposed to nonactivated cytoplasm, prevented PCC and extensive nuclear swelling (16.0 +/- 0.7 vs. 30 +/- 0.7 microns, respectively, p less than 0.01). Nuclear diameter in early embryos was smaller (p less than 0.01), and development to blastocysts was reduced (p less than 0.05). The results indicate that remodeling of the donor nucleus is not essential for development to blastocysts; however, it is beneficial. Furthermore, complete reprogramming seems possible only after remodeling of the donor nucleus, i.e., PCC in nonactivated cytoplasm, followed by nuclear swelling upon activation of the oocyte. PMID- 1782295 TI - Nuclear maturation of domestic cat ovarian oocytes in vitro. AB - Using the domestic cat as a model for salvaging genetic material from rare Felidae, we collected oocytes from ovarian tissue and placed them in 1 of 3 treatments to observe time-related, meiotic changes of in vitro oocyte maturation. Oocytes obtained from ovaries collected at ovario-hysterectomy were assigned to 1 of 3 treatment groups: 1) modified Krebs-Ringer bicarbonate buffer (mKRB) + 4% BSA and 5 micrograms/ml FSH (+FSH, n = 499); 2) mKRB + 4% BSA (-FSH, n = 502); or 3) mKRB + 5% natural estrus cat serum (NE, n = 873). They were placed in the respective media in a 5% CO2 humidified environment at 38 degrees C. Beginning at 16 h, oocytes were removed at 4-h intervals through 48 h, and the meiotic status was evaluated by means of cytogenetic analysis. On the basis of chromosomal analysis, each cell was placed into one of the following categories: metaphase II (MII); metaphase I (MI); pre-MI (germinal vesicle [GV], GV breakdown, or diakinesis); degenerate or unidentifiable. The percentage of oocytes with degenerate chromatin increased over time in all culture treatments, but was always greatest (p less than 0.05) in the NE group. In the +FSH and -FSH treatments, the proportion of oocytes with nuclear material reaching MII increased with time in culture to 32 h and was equal to or greater than the proportion of oocytes with pre-MI + MI chromatin at this time interval (-FSH, 55%; +FSH, 38%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782296 TI - Patterns of circulating gonadotropins and ovarian steroids during the first periovulatory period in the developing sheep. AB - This report provides evidence that an increment in serum gonadotropin levels occurs at puberty in the sheep and that this reflects the critical hormonal event culminating in first ovulation in this species. Blood samples were collected from 6 female lambs at 4-h intervals for a period of approximately 2 mo around the expected time of puberty (32 wk of age) until behavioral estrus was observed and ovulation was verified by assay of serum progesterone. Patterns of circulating LH, FSH, progesterone, and estradiol concentrations were characterized during the peripubertal period for each lamb. A rise in serum levels of both LH and FSH began approximately 7-10 days before the first preovulatory surge of gonadotropins. Although the increase in gonadotropin levels occurred gradually over several days, serum estradiol levels rose only during the final 40-60 h prior to the preovulatory surge of gonadotropin. Serum progesterone profiles revealed, however, that normal (14-16-day) luteal phases were induced in only 2 of 6 females as a result of the first surge. In four lambs, a short luteal phase of 2.5 days' duration occurred, which was followed by another estradiol rise and a preovulatory surge that then resulted in a full luteal phase of 14 days' duration. These data demonstrate clearly that the precipitating event at puberty in the female sheep is an increase in circulating gonadotropin levels and that the estradiol secreted from the newly stimulated follicle provides the signal for the first preovulatory surge. PMID- 1782297 TI - Roles of estradiol and gonadotropin-releasing hormone in controlling negative and positive feedback associated with the luteinizing hormone surge in ovariectomized pigs. AB - Ovariectomized gilts (n = 63) were given estradiol benzoate (estradiol), antiserum to neutralize endogenous GnRH, and pulses of a GnRH agonist (GnRH-A) to stimulate release of LH. GnRH-A was given as 200-ng pulses hourly from 0 to 54 h and as 100- or 200-ng pulses every 30 or 60 min from 54 to 96 h after estradiol. Estradiol alone suppressed LH from 6 to 54 h and elicited an LH surge that peaked at 72 h. When GnRH-A was given every 30-60 min from 0 to 96 h, estradiol suppressed LH for 6-12 h, but then LH returned to pre-estradiol concentrations. When pulses of GnRH-A were given only between 54 and 96 h after estradiol, the surge of LH was related positively to dose and frequency of GnRH-A. We conclude that 1) estrogen acts at the hypothalamus to inhibit release of GnRH for 54 h and then causes a synchronous release of GnRH; 2) estrogen acts at the pituitary to block its response to GnRH for 6-12 h and enhances the accumulation of releasable LH; and 3) magnitude of the LH surge is dependent on the amount of GnRH stimulation. PMID- 1782298 TI - Effects of dietary energy on ovarian function, estrogen suppression of luteinizing hormone and follicle-stimulating hormone, and competency of the gonadotropin surge. AB - Fall-born ewe lambs were utilized to test the hypotheses that 1) inhibitory effects of increasing day length supersedes the stimulatory effects of increased nutrient intake on secretion of LH; 2) chronic undernutrition impairs ovarian function independent of changes in secretion of LH; and 3) undernutrition alters hypothalamic-pituitary responsiveness so as to influence feedback effects of estradiol on secretion of gonadotropins. Lambs were fed a low-energy diet (LE) from 14 to 26 wk of age to maintain a body weight of 24 kg during an inhibitory photoperiod. At 26 wk of age (experiment 1), lambs were either switched to a high energy diet (HE; n = 10) or maintained on LE (n = 10). During increased nutrient intake, the frequency of pulses of LH remained at prepubertal levels, indicating that the inhibitory effects of photoperiod on tonic secretion of LH prevent the stimulatory effects of increased nutrition in chronically undernourished lambs. In experiment 2, lambs (33 wk of age) received hourly injections of ovine LH (15 micrograms; n = 6/diet group) or saline (n = 4/diet group) for 60 h during an inhibitory photoperiod. Chronically undernourished lambs were able to secrete estradiol, elicit a surge of LH, and form luteal tissue in the same manner as well-nourished lambs. After experiment 2, 4 lambs in each diet group were either bilaterally ovariectomized (OVX) or sham operated (INT) for experiment 3. At 36 wk of age, lambs were infused with estradiol-17 beta at a linearly increasing rate of 0.08 pg/ml for 56 h.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782299 TI - Seasonal variations in the testis and epididymis of vizcacha (Lagostomus maximus maximus). AB - Seasonal changes in reproductive activity in the adult male vizcacha (Lagostomus maximus maximus), a South American rodent, were investigated. Monthly, for 2 yr, the animals were killed and decapitated during the night near their burrows in the vicinity of San Luis, Argentina. The testes, epididymides, and pineal glands were removed and used for biochemical and structural studies. Significant changes associated with seasonal cycles were found. 1) In July-August (winter in South America), a short hibernal period of sexual quiescence, decline in testicular and epididymal weights, arrest of spermatogenesis, and decrease of serum testosterone were observed. The gonads regressed during this period, with regression most pronounced in August. 2) During September-November (spring), a recovery period- without arrest of spermatogenesis--was observed, with significant expression of gonadal activity during April-May (autumn). In this season, gonadal weight was increased and spermatogenesis was complete. These results indicate an increase in sexual activity as well as in the ability to secrete testosterone. A gradual reduction of testicular activity appeared in June-July (early winter). Conversely, in this period, the pineal hydroxyindole-O-methyl transferase activity decreased in contrast to the highest values observed in winter. Our findings indicate that the male adult vizcacha under natural conditions exhibits an annual reproductive cycle. A possible relationship between increased pineal activity and gonadal regression is also suggested. PMID- 1782300 TI - Cellular distribution and cycle phase dependency of gonadotropin and eicosanoid binding sites in bovine corpora lutea. AB - Bovine luteal functions are regulated by gonadotropins and eicosanoids. The specific binding sites that presumably mediate the actions of these regulatory agents have previously been characterized in bovine luteal tissue. However, the cellular distribution and/or the cycle phase dependency of these binding sites have never been investigated. In the present study, we investigated these parameters by using quantitative light microscope autoradiography. The results showed that both small and large luteal cells contained binding sites for LH/hCG, prostaglandin (PG)E2, PGF2 alpha, PGI2, and leukotriene (LT)C4. In addition, luteal blood vessels contained LH/hCG and LTC4 binding sites and luteal fibroblasts contained PGE2 binding sites. On a per cell basis, there were more binding sites for all ligands in large luteal cells as compared to small or nonluteal cells. After correction for the cellular area differences, small luteal cells contained more LH/hCG, PGE2, PGI2, and LTC4 binding sites, while large luteal cells contained more PGF2 alpha binding sites. The small and large luteal cell binding of hCG, PGE2, PGI2, and LTC4 increased from early to mid luteal phase, followed by a decline in the late luteal phase. PGF2 alpha binding, on the other hand, increased from early to late luteal phase. In contrast to luteal cells, binding of hCG and LTC4 to luteal blood vessels and binding of PGE2 to luteal fibroblasts did not change during the cycle. These results suggest that LH/hCG and eicosanoid regulation of luteal function is more complex than previously envisioned and it involves both small and large luteal cells and, in some cases, also nonluteal cells. PMID- 1782301 TI - Diet-induced hyperlipidemia in cattle modifies the intrafollicular cholesterol environment, modulates ovarian follicular dynamics, and hastens the onset of postpartum luteal activity. AB - Three experiments were conducted with female cattle during the postpartum period and during the estrous cycle to examine the effects of diet-induced hyperlipidemia on lipoprotein-cholesterol and triglyceride (TG) metabolism, ovarian follicular dynamics, and incidence of postpartum luteal activity. Dietary lipid effects were examined independently of metabolizable energy intake. Feeding a high-lipid (HL) diet (8% total lipid) for the first 3 wk of the puerperium (Experiment 1) increased (p less than 0.0001) the concentration of total cholesterol and high-density lipoprotein-cholesterol (HDL-CH), but not TG, within follicular fluid (FF) of estrogen-active (E-A) and inactive (E-I) follicles. Increases (1.4- to 1.7-fold) were similar in proportion to those observed in peripheral blood serum, but absolute concentrations were about 45% of that in serum. Greater than 95% of the cholesterol in FF was HDL-CH, with a greater (p less than 0.06) proportion of HDL-CH sequestered by E-A compared to E-I follicles. The HL diet increased (p less than 0.06) the number of medium-sized (3.1-9.9 mm) follicles present at ovariectomy 19-21 days postcalving and increased (p less than 0.03) concentrations of FF androstenedione in E-I follicles 5-fold. Granulosa cells from preovulatory follicles (Experiment 2) of heifers fed HL diets secreted 2.1- to 3.5-fold greater (p less than 0.03) quantities of pregnenolone and progesterone in vitro. Finally, feeding HL supplements to postpartum range cattle for 30 days increased (p less than 0.05) the incidence of ovarian luteal activity by 18% (Experiment 3). Shifts in lipid metabolic status modify reproductive potential in cattle, independently of dietary energy intake. PMID- 1782302 TI - Review article: assessment of drug therapy in inflammatory bowel disease. AB - This review article surveys the clinical and laboratory parameters used to assess and quantitate inflammation in ulcerative colitis and Crohn's disease, with particular reference to their usage in controlled trials of drugs in inflammatory bowel disease. PMID- 1782303 TI - The pro-drug sulindac may reduce the risk of intestinal damage associated with the use of conventional non-steroidal anti-inflammatory drugs. AB - To test the hypothesis that administration of a non-steroidal anti-inflammatory drug formulated as a pro-drug, inactive as a cyclooxygenase inhibitor until after absorption, might cause less intestinal damage than conventional non-steroidal anti-inflammatory drugs, intestinal permeation to 51Cr-EDTA and mannitol was assessed in healthy volunteers before and after oral treatment for 1 week with either the pro-drug sulindac or the conventional non-steroidal anti-inflammatory drug indomethacin. Indomethacin, but not sulindac, significantly increased intestinal permeation to 51Cr-EDTA and reduced haemoglobin and haematocrit; neither affect mannitol permeation. PMID- 1782305 TI - Effects of ranitidine, given t.d.s., on intragastric and oesophageal pH in patients with gastrooesophageal reflux. AB - The purpose of this study was to determine the effects of 150 mg ranitidine, 300 mg ranitidine or placebo, administered every 8 h, on gastro-oesophageal pH and heartburn parameters in reflux patients. Twelve symptomatic reflux patients received each of the three treatments in a randomized, double-blind, crossover fashion. Intragastric and oesophageal pH were monitored continuously for a 24 h period. Meals were standardized, consumed at set times and patients were allowed to recline and sleep from 23.00 hours until 06.00 hours only. The gastric record was analysed for the percentage of time that the pH was greater than or equal to 4. The oesophageal record was analysed for acid contact time (percentage time (%) pH less than or equal to 4.0) and reflux episode frequency. Finally, patients recorded each new episode of heartburn and graded daytime heartburn severity at the end of each hour. Ranitidine increased the median (%) time that the intragastric pH remained at or above 4, from 4.5 (placebo) to 33.9% (150 mg dose) and 33.3% (300 mg dose). Ranitidine dose-dependently reduced the median 24-hour oesophageal acid contact time from 13.3% (placebo) to 6.8% (150 mg dose) and 2.5% (300 mg dose). The 300 mg dose significantly reduced daytime heartburn episode frequency and severity while the 150 mg dose reduced heartburn severity only. We conclude that 150 and 300 mg doses of ranitidine administered every 8 h have major, sometimes dose-dependent effects on the objective parameters and symptoms of gastro-oesophageal reflux. PMID- 1782304 TI - Influence of cisapride on antroduodenal motor function in healthy subjects and diabetics with autonomic neuropathy. AB - Antroduodenal manometry was used to assess motility in 10 healthy volunteers and 15 diabetics with cardiac autonomic neuropathy whilst they received 20 mg cisapride orally or an apparently identical placebo. Interdigestive motility was recorded after an overnight fast and for 2 hours following a 500 kcal liquid meal. Active treatment did not influence the number or duration of interdigestive motility cycles in either group although antroduodenal co-ordination in both the fasting and the fed state was enhanced by cisapride (P less than 0.05). In diabetics the postprandial antral motility index was increased by cisapride, whereas in healthy subjects antral and duodenal motility indices were increased both fasting and in the fed state (P less than 0.05). These results suggest that impaired antroduodenal co-ordination is of importance in delaying gastric emptying by diabetic subjects. PMID- 1782306 TI - Famotidine (20 mg) b.d. relieves gastrooesophageal reflux symptoms in patients without erosive oesophagitis. Famotidine/GERD Investigation Group. AB - Previous clinical trials have evaluated a large number of symptomatic individuals with heartburn. Most studies have documented the need for multiple daily dosing with H2-antagonists to achieve clinical and statistical efficacy for symptom relief. The purpose of this study was to compare the safety profile and efficacy of famotidine oral dosing regimens, 40 mg nocte and 20 mg b.d. with placebo in the relief of symptoms in patients suffering from frequent heartburn found to have endoscopically normal oesophageal mucosa or mild non-erosive oesophagitis. Famotidine (20 mg) b.d. reduced and eventually completely relieved gastro oesophageal reflux disease symptoms in most patients during the 6-week trial. Global assessment of improvement at 2 and 6 weeks indicated significantly greater improvement with a b.d. treatment regimen than with either a 40 mg nocte or placebo treatment. No statistically significant differences between famotidine and placebo in the number of patients who experienced clinical adverse experiences were noted and no serious adverse events attributable to famotidine occurred. Based upon these findings, patients with gastro-oesophageal reflux symptoms experience good relief of their complaints with twice daily famotidine in standard doses. PMID- 1782307 TI - Effect of different doses of omeprazole on 24-hour oesophageal acid exposure in patients with gastro-oesophageal reflux. AB - To define the optimum doses of omeprazole appropriate for acute and long-term therapy of patients with gastro-oesophageal reflux disease, 24-h oesophageal pH was measured in 12 patients with symptomatic reflux and an abnormal 24-h oesophageal acid exposure time (greater than 6%) in a randomized, double-blind, four-way crossover study comparing the effects of omeprazole 10, 20, or 40 mg/day and placebo. Total reflux time over 24 hours, number of reflux episodes per hour, and the number of reflux episodes lasting greater than 5 minutes were measured by ambulatory 24-h oesophageal pH monitoring. All doses of omeprazole were superior to placebo in decreasing gastro-oesophageal reflux as measured by each index. With placebo, oesophageal acid exposure was 16.3% of the 24 hours, 10 mg omeprazole/day reduced that to 6.3%, 20 mg/day lowered acid exposure to 0.9%, and 40 mg/day to 0.6%. Thus only the 20 and 40 mg doses reduced acid exposure to within the normal range. Similar results were obtained with the other indices of reflux. These data suggest that a rational dose regimen for reflux oesophagitis is 20 mg/day, a regimen that has proved effective in clinical trials. The present study indicates that 24-hour oesophageal pH monitoring is a practical approach to the determination of drug dosage in patients with gastro-oesophageal reflux. PMID- 1782308 TI - The effect of bile acids on the growth and adherence of Helicobacter pylori. AB - Bile reflux gastritis occurs in the absence of Helicobacter pylori (H. pylori). The aim of this study was to see if the bile acids cheno or ursodeoxycholic acid affected the growth or adherence of H. pylori in vitro. Twenty-seven strains growth were inhibited by 0.1% chenodeoxycholic acid whereas only 11 out of the 27 were inhibited by 0.1% ursodeoxycholic acid. Growth was totally inhibited by a combination of 0.05% chenodeoxycholic acid +0.05% ursodeoxycholic acid. Chenodeoxycholic acid was a more effective inhibitor of adherence in that the number inhibited and percentage inhibition were greater than with ursodeoxycholic acid. Bile salts might be useful in the treatment of H. pylori infection. PMID- 1782309 TI - Omeprazole. PMID- 1782310 TI - [Cat-scratch disease]. PMID- 1782311 TI - [Pneumocystis carinii pneumonia]. AB - We present twelve cases of Pneumocystis Carinii Pneumonia (PCP) hospitalized at the Internal Medicine Service of the Hospital Clinico de Valencia between 1989 and 1990. All patients were infected by HIV-1, with ages between 25 and 32 years, with circulating CD4 lymphocytes lower than 25% or 200 cells per cubic millimeter and with positive p24 antigen. Ten of them were parenterally drug addicts and two of them, homosexuals. Diagnosis was made by fibrobronchoscopy (FB) with bronchoaspiration (BAS) and bronchoalveolar lavage (BAL), or sputum induced by physiological serum aerosol at three per cent, using in both cases blue tinction with toluidine 0 of the samples obtained. Given the foreseeable increase of this disease in our country, we stress the risk of a potential change in its clinical spectrum, affecting new population groups, mainly the elderly, as well as the development of new early diagnosis techniques and the emergence of new treatments, including corticotherapy. PMID- 1782312 TI - [Alterations of the hypophyseal-gonadal axis in chronic renal insufficiency and after renal transplantation]. AB - The purpose of this study is to assess hormonal disorders of the hypophysis-gonad axis in 92 patients with chronic renal failure undergoing hemodialysis and in 14 patients after renal transplantation; concentrations of testosterone, free testosterone, estradiol, progesterone, gonadotropins and prolactin are analyzed. We have tried to establish typical alteration patterns, and to this effect, we have analyzed the results according to the etiology of chronic renal failure and to the impact of several dialysis factors on the hormones assessed. A typical patterns of hormonal disorder in the hypophysis-gonad axis has not been observed, nor a disorder that may be typical of a given etiology. Hyperprolactinemia affects men and women in equal proportion. No impact of dialysis factors on hormonal disorders has been observed. After renal transplantation, hormonal disorders disappear and normality of hypophysis-gonad axis is restored. PMID- 1782313 TI - [Expediency of hospital admission for acute diarrhea syndrome in a short-stay unit]. AB - We present the results of a 187 cases acute diarrhea study managed in the Short Stay Unit of Clinic Universitary Hospital of Zaragoza during 1987-1988. To that aim, we designed an actuation protocol which included the gathering of several data, the realization of complementary studies and the evolutive pursuit. The coproculture resulted positive in a 54.5% of cases and Salmonella was the microorganism more frequently isolated. Most of the species were sensible to common antibiotics and all of them sensible to norfloxacin. Nearly a third part of patients developed some kind of complication. Therefore we infer that acute diarrhea may be subsidiary of diagnosis and treatment in Short Stay Units. PMID- 1782314 TI - [Primary Sjogren's syndrome in men: evolution to acute lymphoblastic leukemia]. AB - A clinical case of a 55-year-old man with syndrome of primary Sjogren, seronegative, normoglobulinemic and normocomplementary with 7 years of evolution, which developed acute lymphoblastic leukemia, having suffered recurrent lympho adenopathy and paresthetic meralgia as previous clinical signs, is presented. Clinical, serological and immunologic characteristics of this syndrome are reviewed, highlighting its rare appearance among men. While appearance of malignant lymphoproliferation disorders is well known, evolution to acute or chronic myeloid leukemia is very rare and so far, an acute lymphoblastic leukemia as the one presented in this study has never been described. PMID- 1782315 TI - [Brucellar hepatic abscess: resolution with antibiotic treatment]. AB - Liver damage in Brucellosis is in the form of granulomas and the finding of liver abscess is not frequent. Most of the cases reported in the medical literature have been described in Spain. The treatment was surgery. We present a hepatic abscess due to Brucellosis that responded to medical treatment. For we discuss the indication of surgery in the case described. PMID- 1782316 TI - [Microangiopathic hemolytic anemia associated with mitomycin-C treatment]. AB - We present a case of a patient with non-resected epidermoid carcinoma of the anal canal, treated with a combination of radiotherapy regional and chemotherapy according to MMC-Ufelos protocol. After the application of the fourth chemotherapy cycle, the patient presented microangiopathic hemolytic anemia associated to Mitomycin-C, which was treated with the application of recurrent plasmapheresis and restricted transfusions of red corpuscles concentrate. The physiopathology of this disorder and its therapeutical implications are review. PMID- 1782317 TI - [Pulmonary lymphangioleiomyomatosis. Presentation of a new case]. AB - A 48-year-old woman hospitalized because of spontaneous pneumothorax. She suffered dyspnea since three years before. Diffuse reticulonodular interstitial pattern was observed in the radiography. The transbronchial biopsy suggested lymphangioleiomyomatosis, the diagnosis being supported by open pulmonary biopsy. Usefulness of transbronchial biopsy is discussed and several treatment modalities are described. PMID- 1782318 TI - [Perspectives on pancreas transplantation in diabetes mellitus type 1]. AB - Pancreatic transplantation (PT) is a therapeutical procedure which is being currently assessed for the treatment of insulin-dependent Diabetes Mellitus. Organ PT is a real alternative, whereas islets PT is a method still in its clinic and animal experimental stages. Different surgical methods of drainage, preservation, selection of donor, complications and immunosuppressive therapy are analyzed. PMID- 1782319 TI - [Ovarian hyperstimulation syndrome. Serous manifestations]. PMID- 1782320 TI - [Fibronectin, platelets, endothelium and arteriosclerosis]. PMID- 1782321 TI - [Carpal tunnel syndrome associated with tuberculosis of the urinary tract]. PMID- 1782322 TI - [Analytic alterations in giant cell arteritis]. PMID- 1782323 TI - [Intractable cough from enalapril]. PMID- 1782324 TI - Interleukin-1 beta induces an early decrease in insulin release, (pro)insulin biosynthesis and insulin mRNA in mouse pancreatic islets by a mechanism dependent on gene transcription and protein synthesis. AB - In an attempt to further characterize the mechanisms of action of recombinant interleukin-1 beta (rIL-1 beta) on mouse pancreatic islets, islets were exposed for different periods of time (6, 12 and 24 h) to 50 U/ml rIL-1 beta. After 6 h there was already a significant decrease in glucose (16.7 mM)-induced insulin release. This was followed at 12 h by a decrease in insulin mRNA contents and (pro)insulin biosynthesis and, after 24 h, by a decrease in islet insulin contents. There was no decrease in total protein biosynthesis or DNA contents in any of the studied time points and the glucose oxidation rates were not affected by rIL-1 beta after 12 h of exposure. A similar inhibition of insulin release, (pro)insulin biosynthesis and insulin mRNA content was observed 12 h after a short (2 h) exposure of the islets to rIL-beta, suggesting that a brief exposure of mouse islets to the cytokine can modify their function for several hours. When islets were exposed for 12 h to 50 U/ml rIL-1 beta in the presence of either an inhibitor of gene transcription (actinomycin D) or an inhibitor of mRNA translation (cycloheximide) there was a complete protection against the suppressive effects of rIL-1 beta on insulin release, (pro)insulin biosynthesis and insulin mRNA contents. However, when islets were exposed for 2 h to rIL-1 beta in the presence of actinomycin D, and studied 12 h later, actinomycin counteracted the inhibitory effects of rIL-1 beta on insulin release, but not on (pro)insulin biosynthesis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782325 TI - Hybridomas to specific streptococcal antigen induce tissue pathology in vivo; autoimmune mechanisms for post-streptococcal sequelae. AB - A gross examination of organs from approximately 100 mice which were producing ascites fluids toward a series of streptococcal reactive monoclonal hybridomas showed, in some animals, what appeared to be autoimmune-like findings. A pattern of major lung pathology was associated with specific clones. These specific hybridomas led to the development of an experimental autoimmune animal model mimicking a Goodpasture's syndrome. Tissue injury was induced in mice, on a dose dependent basis, by the injection of monoclonal antibody generated against streptococcal cell membrane (SCM) antigens. A more severe onset of the pathology, also on a dose dependent bases, was induced by placement of the anti-SCM mAb secreting hybridoma cells into the peritoneal cavity of the host. Severity of observed lesions was dependent upon the number of cells injected (10(5), 5 x 10(5), 10(6) or 10(7], as well as the animals' sex. Severe and total hemorrhagic lungs were seen in animals challenged with 1 x 10(6) hybridomas cells when sacrificed on the tenth day. In all cases the lesions were greater in the female litter mate than the male. Gross and histologic observations were confirmed by lung/body weight ratios. Pulmonary hemorrhage ranged from slight, when mAb was injected at a low dose of 24 micrograms/g, to severe when 96 micrograms/g was injected. Reported findings were based on the review of approximately 300 mice. Immunochemical evaluations and ELISAs confirmed the ability of these anti-SCM mAb to react with glomerular basement membrane (GBM) antigens as well as lung basement membrane (LBM). Mitogenic experiments indicated that the parent immunogen (SCM) used to generate immunocytes was non-stimulatory to lymphocytes. PMID- 1782326 TI - Histological and functional changes in the thyroid glands of mice implanted with hybridomas secreting monoclonal autoantibody against mouse thyroglobulin. AB - Mouse hybridoma cells secreting monoclonal antibody (mAb) against mouse thyroglobulin were established. The implantation of the hybridomas succeeded to induce high titers of circulating mAb against thyroglobulin in sera of mice. By using the implantation of the hybridomas in mice, the effect of autoantibody on the thyroid glands was studied histologically and functionally. In these mice the thyroid follicles were significantly swollen and warped, whereas there was no infiltration of inflammatory cells. The 125I-uptake in their thyroid glands was markedly decreased. There were no functional changes in control mice implanted with non-secreting P3U1 partner cells. Therefore, it was suggested that high titers of anti-thyroglobulin autoantibody could definitely cause the histological and functional damages in the thyroid glands. PMID- 1782327 TI - Anti-ligand antibodies as potential autoantigens: in vitro and in vivo characteristics of anti-bungarotoxin antibodies in the idiotype network. AB - Some antibodies to ligands of a receptor will have combining sites that structurally resemble the receptor's binding site for that ligand. The network hypothesis predicts that anti-idiotypic antibodies to these anti-ligand antibodies will also bind to the receptor. We pursued these hypotheses in the well-defined ligand-receptor system, alpha-bungarotoxin(BTX)-acetylcholine receptor (AChR). Monoclonal antibodies (mAbs) to BTX were generated; native BTX was used as the immunogen to optimize the probability of obtaining mAbs to the AChR binding site. These mAbs were then characterized for their ability to "mimic" AChR in the following in vitro assays: neutralization of BTX binding to native AChR on the surface of the cell line TE671, formation of a ternary complex with 125BTX-AChR, and ability of cholinergic ligands to interfere with binding to BTX. Three aBTX mAbs which had in vitro attributes of the AChR on the basis of these assays, were injected into C3H mice and serial sera tested for antibodies to Torpedo and murine AChR. Anti-AChR antibodies directed primarily to the gamma and delta subunits of the Torpedo AChR were detected, as well as low amounts of anti-mouse AChR antibody. The generation of anti-AChR antibodies by immunization with aBTX antibodies supports the network hypothesis and provides a theoretical basis for initiation of autoimmunity to cell receptors. PMID- 1782329 TI - A new murine model of autoimmune orchitis induced by immunization with viable syngeneic testicular germ cells alone. II. Immunohistochemical findings of fully developed inflammatory lesion. AB - Previous studies demonstrated that experimental autoimmune orchitis (EAO) was produced in C3H/He mice with very high incidence by two or three subcutaneous injections of viable syngeneic testicular germ cells, without the use of any adjuvants or immunopotentiators and that the disease induced was characterized by a complete lack of epididymitis despite a definite orchitis with hypospermatogenesis. In this report, immunohistochemical characterization of immune cells in the fully-developed orchitic lesion was carried out using monoclonal antibodies and immunoperoxidase staining. Thy-1.2+ cells, Mac-1+ cells, B220+ cells and cytoplasmic Ig-bearing cells in the lesion were estimated to be approximately 30, 15, 20 and 30% of all inflammatory cells, respectively. Major phenotype of T cells in the lesion was CD4+ (approximately 85%) with the remainder (approximately 15%) being CD8+. The percentages of cytoplasmic IgG-, IgA- and IgM-bearing cells were estimated as approximately 35, 60 and 5% of all cytoplasmic Ig-bearing cells, respectively. Deposits of immunoglobulins and third component of complement were identified on the basement membrane of the seminiferous tubules, interstitium between the tubules, vessel endothelium and degenerated germ cells in the lesion. Circulating antibodies directed against the acrosomal portion of germ cells were detected in IgG and IgM classes but not in IgA class. Inflammatory cells (including macrophages, B cells and, probably, activated T cells) in the lesion were Ia+, but Leydig cells, Sertoli cells and germ cells did not stain for Ia at all. PMID- 1782328 TI - Kobner phenomena as a complication of immune therapy of neoplastic disease. PMID- 1782330 TI - Increased vascular permeability of Brucella abortus bacilli in the thymus of NZB/W F1 mice. AB - Various amounts of the bacterium, Brucella abortus (BA) were injected intravenously into autoimmune NZB/W F1 mice and non-autoimmune BDF1 mice and then the localization of BA in the thymus was traced using an immunohistochemical method at 30 min and 3 h after injection. The results showed that a greater amount of BA became consistently localized in the thymic parenchyma in a free form or in a phagocytized form in NZB/W F1 mice in comparison with BDF1 mice, indicating a marked increase of vascular permeability in the thymus of NZB/W F1 mice. The extravascular leakage of BA was clearly dose-dependent. The significance of invasion of bacterial antigens from the general circulation into the thymic parenchyma is discussed in relation to autoimmune states. PMID- 1782331 TI - Apolipoprotein (a) concentrations are not related to the risk of venous thrombosis. AB - The protein moiety of lipoprotein (a) consists of apoB-100 and apolipoprotein (a). Lipoprotein (a) is an independent risk factor for premature atherosclerosis. Apolipoprotein (a) and plasminogen are structurally homologous. Through interference with the fibrinolytic system, lipoprotein (a) may act as a thrombogenic factor. Therefore, we have determined apolipoprotein (a) in 203 patients with venous thrombosis and/or embolism below the age of 45 years and in 115 healthy volunteers. The frequency distribution of apolipoprotein (a) in thrombosis patients resembled that in the reference group. It is concluded that there is no clinically relevant association between apolipoprotein (a) concentrations and the risk of venous thrombosis in young subjects. PMID- 1782332 TI - Activated fibrinolytic enzymes in the synovial fluid during acute arthritis induced by urate crystal injection in dogs. AB - To identify the relationship of the severity of inflammation and fibrinolytic activity in arthritis, the fibrinolytic activity of synovial fluid was studied in acute experimental arthritis induced by injecting monosodium urate crystals into dogs' knee joints. The maximum activity in the synovial fluid was observed 6 h after crystal injection. It was inferred that the fibrinolytic activity was mainly due to plasminogen activator based on fibrin plate assays, substrate specificity, inhibitor effects and zymography. On the other hand, the activity of lysosomal enzymes (beta-glucuronidase and cathepsin G) reached a peak in the synovia after 12 h. Histological examination of the synovial membrane after 12 h also showed greater inflammation than at 6 h. The peak in fibrinolytic activity preceded the peak of lysosomal enzymes and histological changes. These results suggest that an increase in fibrinolytic activity by plasminogen activator may contribute to the development of an acute inflammatory response. PMID- 1782333 TI - Potential thrombogenicity of heat-treated prothrombin complex concentrates in Haemophilia B. AB - We have studied the potential thrombogenicity of two different heat-treated prothrombin complex concentrates (PCC) in patients with Haemophilia B. Seven patients were studied on nine separate occasions. Four of the patients had chronic hepatitis C (HCV) associated liver disease and three were HIV-antibody positive. The PCCs were Profilnine (Alpha Therapeutics, Thetford, UK) and 9A (Bio Products Laboratory, Elstree, UK) and the dose administered ranged from 35 to 60 U/kg. Blood samples were taken on ten separate occasions; twice before the infusion and at 15, 40, 60, 75 and 120 min and 4, 8 and 24 h after the infusion of PCC. Investigations included prothrombin time, kaolin cephalin clotting time, thrombin time, fibrin(ogen) degradation products, factor VIII, factor IX, antithrombin III and fibrinopeptide A (FPA). Fibrinopeptide A rises were seen following two of six infusions of 9A and one of three infusions of Profilnine. On all three occasions the rise in FPA was transient, returning to baseline levels within 120 min. Plasma beta-thromboglobulin (BTG) was assayed in three patients and in one patient, the rise in FPA was followed by an increase in BTG. No other changes were observed and there were no clinical features of disseminated intravascular coagulation. Our results indicate that even with normal clinical doses of PCC, intravascular thrombin generation can occur in patients with Haemophilia B. However, this effect is inconsistent both with respect to PCC batch and patient, but may occur in the absence of HIV infection and HCV liver disease. PMID- 1782334 TI - Thrombin-hirudin complex stability: a comparison with the thrombin-antithrombin III complex. AB - In the present in vitro study the stabilities of the thrombin-hirudin and the thrombin-antithrombin III complexes were investigated. After incubation of the complexes with free inhibitors the thrombin-antithrombin III levels were determined by ELISA. The thrombin-hirudin complex proved to be stable in the presence of antithrombin III or heparin. However, in the presence of heparin and plasma equivalent concentrations of antithrombin III, the thrombin-hirudin complex dissociated and hirudin was displaced. In contrast, both thrombin antithrombin III and thrombin-antithrombin III/heparin complexes are very stable even in the presence of a large excess of hirudin. PMID- 1782335 TI - Vasopressin and haemostatic responses to inguinal hernia repair under local anaesthesia. AB - Major abdominal surgery is accompanied by intra-operative increases in factor VIII (FVIII), plasminogen activator activity (PAA) and fibrinopeptide A (FPA). Vasopressin (aVP) released during surgery mediates some of the effects but the mechanisms involved in this response are unclear. To investigate the role of the operative procedure, 20 subjects were studied during inguinal hernia operation under local anaesthesia. Venous blood samples were taken for FVIII coagulant activity (FVIII:C), euglobulin clot lysis time (ECLT), FPA, crosslinked FDPs (XL FDP) and a VP. In six patients, aVP rose from (median) 0.5 to 38.3 pg/ml at bowel manipulation and fell to 4.1 pg/ml post-operatively. PAA rose from 33 units to 377 and 316 units (P less than 0.01), FVIII:C from 1.58 to 2.4 IU/ml (P less than 0.01) and FPA from 5.0 to 6.8 and 11.0 pmol/ml intra-operatively (P less than 0.002). XL-FDP rose from a median value of 34 ng/ml pre-operatively to 230 ng/ml post-operatively. In 14 patients plasma aVP levels remained constant and both FVIII:C and PAA remained unchanged. FPA rose from 2.6 pmol/ml to 5.9 pmol/ml intra-operatively (P less than 0.05) and XL-FDP fell from 110 to 60 ng/ml. Between groups, the changes were significantly different for FVIII:C (P less than 0.05) and PAA (P less than 0.03) with no differences in blood pressure, pulse or symptoms. These results support the hypothesis that aVP secretion during surgery mediates increases in FVIII and PAA. FPA tended to be higher in the aVP secreting group which indicates that aVP mediated activation of coagulation results in a hypercoagulable state. PMID- 1782336 TI - Study of contact activation in endemic hepatosplenomegaly. AB - Factors of the contact activation complex--FXII, FXI, high-molecular-weight kininogen (HMWK) and prekallikrein (PK) as well as D-dimer were measured in 68 schistosomal patients with and without co-existing chronic hepatitis B virus infection (HBV). Fifty-four cases had mixed hepatosplenic schistosomiasis and HBV infection whereas 14 were suffering from hepatosplenic (HS) schistosomiasis alone. A group of twelve age-matched, healthy individuals served as controls. All coagulation parameters were significantly reduced in both disease groups compared to the healthy controls. The decreased activity of the contact proteins could be attributed to decreased hepatic synthesis, consumption due to disseminated intravascular coagulation (DIC) and to the effect of endotoxins. In mixed schistosomiasis and HBV infections, however, the levels of the contact activation factors were not significantly different from those obtained in patients with HS alone. This apparently paradoxical finding does not, however, exclude a role for co-existing HBV infection in speeding up complications in hepatosplenic schistosomiasis. PMID- 1782337 TI - Prevalence of HIV infection in a cohort of patients with congenital coagulation defects of the prothrombin complex factors. AB - Twenty-seven patients suffering from congenital coagulation defects of the prothrombin complex factors were investigated: six had haemophilia B; 14, factor VII defect; four, factor X defect; and three, factor II defect. Nineteen patients (70.3%) had previously received plasma and/or clotting factors concentrates. Among these, markers of hepatitis B infection (HBV) were present in five cases (26.3%) and hepatitis C (HCV) antibodies were found in seven cases (36.8%). The HIV1 prevalence was similarly high. In fact, five patients (26.3%), previously infused with factor IX or prothrombin complex factors concentrates, developed HIV1 infection. No patient with factor VII deficiency became HIV1 positive, despite the administration of unheated factor VII concentrates and the consequent HBV and HCV contamination. In the HIV1 positive group, three patients showed a false positivity for HIV2 antibodies. Five years after seroconversion, three patients developed AIDS (stage IV) and died, one had persistent generalized lymphadenopathy (stage III), and one with post-hepatitis liver cirrhosis was asymptomatic (stage II) for HIV infection. The significant decrease in total white cells, T4 lymphocytes and platelet counts and increase of beta 2 microglobulin and neopterin levels confirmed the prognostic value of these markers for the progression of HIV1 disease. Only one HIV1 negative transfused patient developed anti-HTLV-I p19 antibodies. PMID- 1782338 TI - Haemarthrosis in patients with mild coagulation factor deficiency. AB - While haemarthrosis is a common finding in severe factor VIII or IX deficiency, it is unusual in mild coagulation factor deficiencies. We describe three patients with mild factor IX, X or XI deficiency who presented with spontaneous haemarthrosis. All underwent joint puncture with subsequent worsening of the haemarthrosis in the affected joint. This report indicates that: (i) even mild coagulation factor deficiency may be associated with haemarthrosis; (ii) patients with suspected haemarthrosis should undergo routine screening coagulation tests before joint puncture; and (iii) any abnormalities in the screening tests indicate a need for further evaluation of the coagulation status. In such cases puncture of the joint should be deferred and specific therapy started immediately. PMID- 1782339 TI - The role of drugs, particularly oral contraceptives, in triggering thrombosis in congenital defects of coagulation inhibitors: a study of six patients. AB - It is well established that pregnancy and puerperium, surgery and trauma may often trigger thrombotic events even in the normal population. On the other hand, patients with congenital deficiency of clotting inhibitors may develop spontaneous thrombotic episodes, although they become often symptomatic when one of the above-mentioned triggering factors is present. We found this to be true in 40 out of 81 symptomatic patients with congenital defects of coagulation inhibitors. In six (15%) of these cases medications (mainly oral contraceptives) triggered the thrombotic event. The incidence of pharmacological factors as a cause of thrombosis is commonly maintained to be low. This study indicates that this is not so and underlines the potential importance of drugs, particularly oral contraceptives, in the pathogenesis of thrombotic events in patients with congenital defects of clotting inhibitors. PMID- 1782340 TI - DDAVP infusion: a possible useful tool in the diagnosis of the haemophilia A carrier state. PMID- 1782341 TI - Glutathione S-transferases: reaction mechanism, structure, and function. PMID- 1782342 TI - 4-Aminobiphenyl-hemoglobin adduct formation as an index of in vivo N-oxidation by hepatic cytochrome P-450IA2. PMID- 1782344 TI - Structure-activity study of paracetamol analogues: inhibition of replicative DNA synthesis in V79 Chinese hamster cells. AB - Experimental and theoretical evidence pertaining to cytotoxic and genotoxic activity of paracetamol in biological systems was used to formulate a simple mechanistic hypothesis to explain the relative inhibition of replicative DNA synthesis by a series of 19 structurally similar paracetamol analogues, 5 of which were specifically analyzed for the current study. It was hypothesized that the observed activity variation of the paracetamol analogues was based on the relative abilities of these compounds to undergo H atom loss at the phenolic oxygen, and on the relative stabilities of the resulting free-radical species. Three calculated parameters were found to be relevant--the partial atomic charge on the ring carbon attached to the phenolic oxygen, the partial charge on the phenoxy radical oxygen, and the energy difference between the parent phenolic paracetamol analogue and the corresponding radical dissociation products. The variation in parameter values was significantly correlated with the relative inhibition of DNA synthesis and was easily rationalized in terms of the mechanistic hypothesis proposed. More specifically, competitive reaction with a tyrosyl radical species involving the transfer of a hydrogen atom at the active site of ribonucleotide reductase was suggested as the underlying mechanistic basis for the observed activity variation of the paracetamol analogues. Comparison of calculated parameters for a model tyrosyl species and the paracetamol analogues was entirely consistent with this view. PMID- 1782343 TI - The molecular mechanism of the carbon disulfide mediated cross-linking of proteins. PMID- 1782345 TI - Biotransformation of methyl isocyanate in the rat. Evidence for glutathione conjugation as a major pathway of metabolism and implications for isocyanate mediated toxicities. AB - S-(N-Methylcarbamoyl)-N-acetylcysteine (AMCC), a chemically labile mercapturic acid conjugate, was identified by liquid chromatography-mass spectrometry (LC-MS) in the urine of rats dosed intraperitoneally with methyl isocyanate (MIC; 45.2 mumol). The corresponding cysteine conjugate, however, was not detected in urine. Following methylation, urine extracts were analyzed by thermospray LC-MS and the AMCC methyl ester was quantified by means of a stable isotope dilution assay procedure which utilized S-(N-methylcarbamoyl)-N-[2H3]-acetylcysteine [( 2H3]AMCC) as internal standard. The results showed that the fraction of the injected dose of MIC which appeared in 24-h urine collections as AMCC was 24.8 +/ 1.9% (mean +/- SD, N = 4). Thus, conjugation of MIC with glutathione (GSH), followed by metabolism of the resulting adduct to AMCC, appears to represent a quantitatively important pathway of biotransformation of MIC in the rat. However, in view of the known carbamoylating properties and in vitro cytotoxicity of S linked conjugates of MIC, it seems unlikely that the GSH pathway of metabolism fulfills a conventional detoxification role in the case of MIC. In contrast, it is proposed that carbamate thioester conjugates of MIC, which can revert spontaneously to free MIC under physiological conditions, may actually contribute to the multisystem adverse effects of this highly toxic isocyanate in vivo. PMID- 1782346 TI - Metabolism of the hydrochlorofluorocarbon 1,2-dichloro-1,1-difluoroethane. AB - 1,2-Dichloro-1,1-difluoroethane (HCFC-132b) is a potential substitute for some ozone-depleting chlorofluorocarbons and a model for other 1,1,1,2 tetrahaloethanes under consideration as chlorofluorocarbon substitutes. Male Fischer 344 rats were given 10 mmol/kg HCFC-132b dissolved in corn oil by intraperitoneal injection. An NMR assay for covalent binding of HCFC-132b metabolites to liver proteins was negative, whereas binding was observed in halothane-treated rats. Total urinary metabolites excreted by rats given HCFC 132b during the first 24 h amounted to 1.8 +/- 0.1% of the injected dose, as determined by 19F NMR. During the first 6 h, metabolites of HCFC-132b corresponding to 2-chloro-2,2-difluoroethyl glucuronide, unknown metabolite A, chlorodifluoroacetic acid, and chlorodifluoroacetaldehyde hydrate [both free and conjugated (unknown metabolite B)] were excreted in urine in the approximate ratio 100:9:3:7, respectively. Metabolite A is apparently an O-conjugate of 2 chloro-2,2-difluoroethanol; unconjugated 2-chloro-2,2-difluoroethanol was not detected in urine. The 19F NMR spectrum of metabolite B indicates the formation of a hemiacetal of chlorodifluoroacetaldehyde. Repeated exposure of rats to HCFC 132b significantly increased both the rate of chlorodifluoroacetic acid excretion and the relative fraction of the HCFC-132b dose excreted as chlorodifluoroacetic acid in urine. Incubation of HCFC-132b with rat hepatic microsomes yielded chlorodifluoroacetaldehyde hydrate as the only fluorinated product. The in vitro metabolism of HCFC-132b was increased in microsomes from pyridine-treated rats as compared with control rats, and HCFC-132b metabolism was inhibited by p nitrophenol, indicating that the cytochrome P-450 isoform IIE1 is largely responsible for the initial hydroxylation of HCFC-132b. PMID- 1782347 TI - The catalytic effect of bovine serum albumin on the ortho rearrangement of the potential ultimate carcinogen, N-(sulfooxy)-2-(acetylamino)fluorene, generated enzymatically from N-hydroxy-2-(acetylamino)fluorene and evidence for substrate specificity of the enzymatic sulfonation of arylhydroxamic acids. AB - This investigation examines the catalytic effect of bovine serum albumin on the ortho rearrangement of the possible ultimate carcinogen, N-(sulfooxy)-2 (acetylamino)fluorene, generated from N-hydroxy-2-(acetylamino)fluorene by the sulfotransferase(s) in the cytosol of rat liver. With various preparations of cytosol, 55-75% of the substrate, N-hydroxy-2-(acetylamino)-fluorene, was found to rearrange to the nonmutagenic and noncarcinogenic o-(sulfooxy) esters, 1- and 3-(sulfooxy)-2-(acetylamino)fluorene, in the presence of bovine serum albumin, while less than 1% of the substrate rearranged in its absence. In presence of bovine serum albumin the cytosolic reduction of N-(sulfooxy)-2 (acetylamino)fluorene to 2-(acetylamino)fluorene decreased by 60-90% and its solvolytic degradation to 4-hydroxy-2-(acetylamino)fluorene by 80-90%. The covalent interaction of enzymatically generated N-(sulfooxy)-2 (acetylamino)fluorene with the nucleophilic acceptors, N-acetyl-L-methionine and guanosine, was lowered by greater than 90% by addition of bovine serum albumin. These measurements indicated that the albumin-catalyzed ortho rearrangement controls the rates of concurrent metabolic and degradative reactions of N (sulfooxy)-2-(acetylamino)fluorene. The results are in agreement with previous findings of a catalytic effect of serum albumin on the ortho rearrangement of synthetic N-(sulfooxy)-2-(acetylamino)fluorene. In contrast to its catalytic effect on the formation of o-(sulfooxy) esters from N-(sulfooxy)-2 (acetylamino)fluorene, bovine serum albumin had no effect on the formation of o (acetylamino)fluorenols. To assess the substrate specificity of bovine serum albumin, its effect on the rearrangement of N-hydroxy-2-(benzoylamino)fluorene, a carcinogenic analogue of N-hydroxy-2-(acetylamino)fluorene, was analyzed under conditions of cytosolic sulfonation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782348 TI - Detection of 3'-hydroxy-1,N6-benzetheno-2'-deoxyadenosine 3'-phosphate by 32P postlabeling of DNA reacted with p-benzoquinone. AB - 2'-Deoxyadenosine 3'-phosphate was reacted with a mixture of p-benzoquinone (p BQ) and hydroquinone in aqueous medium at pH 6, and the main product was isolated and characterized by 1H NMR spectroscopy, liquid secondary ion mass spectroscopy (LSIMS), and high-resolution direct chemical ionization mass spectroscopy (HRDCIMS). The structure of this covalent adduct was assigned as 3'-hydroxy-1,N6 benzetheno-2'-deoxyadenosine 3'-phosphate. Reaction of DNA with p-BQ produced three major adducts as detected by 32P postlabeling; the relative abundance was 1.1%, 22.4%, and 72.4%. Cochromatography of 32P-postlabeled 3'-hydroxy-1,N6 benzetheno-2'-deoxyadenosine 3',5'-bisphosphate with the 32P-postlabeled DNA-p-BQ reaction mixture established this compound, adduct 3, as the second most abundant product of the reaction. PMID- 1782349 TI - Determination of the structural features of (+)-CC-1065 that are responsible for bending and winding of DNA. AB - Analysis of the anomalous migration in electrophoretic mobilities of (+)-CC-1065 modified oligomers following ligation reveals that (+)-CC-1065 induces DNA bending and winding of the helix. (+)-CC-1065 is a potent antitumor antibiotic produced by Streptomyces zelensis. This drug selectively bonds covalently to N3 of adenine and lies in the minor groove of DNA, reacting in a highly sequence selective manner. Structurally, (+)-CC-1065 consists of three subunits: two identical pyrroloindole units (subunits B and C) and a third subunit containing the DNA-reactive cyclopropane ring (subunit A). While the bonding reaction is the main determinant of DNA sequence selectivity of (+)-CC-1065, binding interactions between the inside edge substituents of the B and C subunits and the floor of the minor groove of DNA can modulate or fine tune this sequence selectivity, [Hurley, L. H., Lee, C.-S., McGovern, J. P., Mitchell, M. A., Warpehoski, M. A., Kelly, R. C., & Aristoff, P. A. (1988) Biochemistry 27, 3886-3892]. The A subunit of (+)-CC 1065 is responsible for the bending of DNA, and close van der Waals contacts between the inside edge of (+)-CC-1065 and the floor of the minor groove of DNA cause winding equivalent to about 1 base pair per alkylation site and stiffening of DNA. The magnitude of DNA bending induced by (+)-CC-1065 and related compounds is about 14-19 degrees, which is equivalent to that produced by an adenine thymine tract of about 5-6 base pairs in length. Experiments using oligomers containing both an adenine tract and a unique (+)-CC-1065 bonding site approximately one helix turn apart demonstrate that the directionality of drug induced bending is in toward the minor groove and the locus of bending is about 2 3 base pairs to the 5'-side of the covalently modified adenine. A circularization efficiency assay shows that the optimum size of circles produced by (+)-CC-1065 and related drugs is between 168 and 180 base pairs. These results are discussed in relation to the molecular basis of the DNA sequence selectivity of (+)-CC 1065, and the (+)-CC-1065-induced DNA bending is compared with the intrinsic bending associated with adenine tracts. Since (+)-CC-1065 induces effects on local DNA structure that appear similar to those produced naturally by adenine tracts and certain DNA binding proteins, the relevance of this phenomenon to biological effects of (+)-CC-1065 and related drugs is considered. PMID- 1782350 TI - Hepatotoxicity after 3'-hydroxyacetanilide administration to buthionine sulfoximine pretreated mice. AB - The administration of 3'-hydroxyacetanilide, a regioisomer of acetaminophen, to mice failed to produce hepatotoxicity even after the administration of diethyl maleate. In contrast, hepatotoxicity did occur when 3'-hydroxyacetanilide was administered to buthionine sulfoximine pretreated mice. Although the administration of 3'-hydroxyacetanilide in conjunction with either diethyl maleate or buthionine sulfoximine depleted total hepatic glutathione, only the combined buthionine sulfoximine-3'-hydroxyacetanilide treatment decreased hepatic mitochondrial glutathione concentrations to below 20% of control values. In addition, pretreatment with buthionine sulfoximine increased the amount of 3' hydroxyacetanilide bound to mitochondrial proteins. These results, in conjunction without previous results on the involvement of mitochondrial damage in the pathogenesis of hepatotoxicity caused by acetaminophen, suggest a probable relationship between mitochondrial damage caused by the buthionine sulfoximine-3' hydroxyacetanilide treatment and hepatotoxicity caused by this treatment. PMID- 1782351 TI - Role of the benzoyloxyl radical in DNA damage mediated by benzoyl peroxide. AB - Benzoyl peroxide (BzPO) is both a tumor promoter and progressor in mouse skin; however, BzPO is neither an initiator nor a complete carcinogen in this tissue. Although not mutagenic, BzPO has been observed to produce strand breaks in DNA of exposed cells. These actions are presumed to be mediated by free-radical derivatives of BzPO. Previous studies suggested that the metabolism of BzPO in keratinocytes proceeds via the initial cleavage of the peroxide bond, yielding benzoyloxy radicals which, in turn, can either fragment to form phenyl radicals and carbon dioxide or abstract H atoms from biomolecules to yield benzoic acid. Benzoic acid is the major stable metabolite of BzPO produced by keratinocytes. In the present study we have investigated the role of BzPO and its metabolites in the generation of strand scissions in a cell-free system using phi X-174 plasmid DNA. In this system BzPO produced DNA damage that was dose-dependent over a concentration range of 0.1-1 mM and required the presence of copper but not other transition metals. By contrast, benoic acid did not produce DNA damage in this system, either in the presence or in the absence of copper. The inclusion of spin trapping agents, such as N-tert-butyl-alpha-phenylnitrone (PBN), 3,5-dibromo-4 nitrosobenzenesulfonate, and nitrosobenzene, in incubations was found to significantly reduce the extent of DNA damage generated via the copper-mediated activation of BzPO. Electron paramagnetic resonance spectroscopy studies suggested that the primary radical trapped by PBN following copper-mediated decomposition of BzPO was the benzoyloxy radical.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782352 TI - Metabolism of L-canavanine and L-canaline in the tobacco budworm, Heliothis virescens [Noctuidae]. AB - The metabolism of L-canavanine and L-canaline were investigated in larvae of the tobacco budworm, Heliothis virescens [Noctuidae]. H. virescens larvae were treated with L-[1,2,3,4-14C]canavanine or L-[U-14C]canaline with sufficient cold carrier to provide 5 mg g-1 canavanine or a molar equivalent of canaline (3.81 mg g-1). The preponderant catabolite in both canavanine- and canaline-treated larvae was [14C]homoserine. Other minor metabolites derived from canavanine included [14C]aspartate/asparagine, [14C]glutamate/glutamine, [14C]2-aminobutyrate, [14C]ornithine, [14C]proline, and [14C]isoleucine. Canaline yielded [14C]glutamate/glutamine, [14C]aspartate/asparagine, and [14C]-2-aminobutyrate. Our current studies support the belief that this destructive insect tolerates L canavanine and L-canaline because of its ability to reductively cleave these potentially insecticidal natural products to L-homoserine and guanidine or ammonia, respectively. PMID- 1782353 TI - Molecular dynamics simulation in vacuo and in solution of cyclolinopeptide A: a conformational study. AB - The conformation of cyclolinopeptide A [c-(Pro-Pro-Phe-Phe-Leu-Ile-Ile-Leu-Val)], a naturally occurring peptide with remarkable cytoprotective activity, has been investigated by means of molecular dynamics simulations in various molecular environments. Structural and dynamical properties have been analyzed and compared with those experimentally determined. A detailed analysis of hydrogen bonds is reported. PMID- 1782354 TI - A molecular dynamics study of thermodynamic and structural aspects of the hydration of cavities in proteins. AB - The structure and activity of a protein molecule are strongly influenced by the extent of hydration of its cavities. This is, in turn, related to the free energy change on transfer of a water molecule from bulk solvent into a cavity. Such free energy changes have been calculated for two cavities in a sulfate-binding protein. One of these cavities contains a crystallographically observed water molecule while the other does not. Thermodynamic integration and perturbation methods were used to calculate free energies of hydration for each of the cavities from molecular dynamics simulations of two separate events: the removal of a water molecule from pure water, and the introduction of a water molecule into each protein cavity. From the simulations for the pure water system, the excess chemical potential of water was computed to be -6.4 +/- 0.4 kcal/mol, in accord with experiment and with other recent theoretical calculations. For the protein cavity containing an experimentally observed water molecule, the free energy change on hydrating it with one water molecule was calculated as -10.0 +/- 1.3 kcal/mol, indicating the high probability that this cavity is occupied by a water molecule. By contrast, for the cavity in which no water molecules were experimentally observed, the free energy change on hydrating it with one water molecule was calculated as 0.2 +/- 1.5 kcal/mol, indicating its low occupancy by water. The agreement of these results with experiment suggests that thermodynamic simulation methods may become useful for the prediction and analysis of internal hydration in proteins. PMID- 1782355 TI - Topographical requirements for delta-selective opioid peptides. AB - The conformational possibilities of three different delta-selective opioid peptides, which are DPDPE (Tyr-D-Pen-Gly-Phe-D-Pen), DCFPE (Tyr-D-Cys-Phe-D-Pen), and DRE (Tyr-D-Met-Phe-His-Leu-Met-Asp-NH2, dermenkephalin), were explored using energy calculations. Sets of low-energy conformers were obtained for each of these peptides. The sets consisted of 61 structures for DPDPE, 32 for DCFPE, and 38 for DRE, including various types of rotamers of the Tyr and Phe side-chain groups. Comparison of the geometrical shapes of the conformers was performed for these sets using topographical considerations, i.e., examination of the mutual spatial arrangement of the N-terminal alpha-amino group, and of the Tyr and Phe side-chain groups. The results obtained suggest a model for the delta-receptor bound conformer(s) for opioid peptides. The model suggests the placement of the Phe side chain in a definite position in space corresponding to the g- rotamer of Phe for peptides containing Phe4 and to the t rotamer for peptides containing Phe. The position of the Tyr1 side chain cannot be specified so precisely. The proposed model is in a good agreement with the results of biological testing of beta-Me-Phe4-substituted DPDPE analogues that were not considered in the process of model construction. PMID- 1782356 TI - The kinetics of chain exchange in two-chain coiled coils: alpha alpha- and beta beta-tropomyosin. AB - Measurements are presented on the time course of chain exchange among two-chain alpha-helical coiled coils of rabbit tropomyosin. All experiments are in a regime (temperature, protein concentration) in which coiled-coil dimers are the predominant species. Self-exchange in alpha alpha-tropomyosin was investigated by mixing alpha alpha species with alpha* alpha*, the asterisk designating an alpha chain whose lone sulfhydryl (C190) has been blocked by carboxyamidomethylation. The overall process alpha alpha + alpha* alpha* in equilibrium with 2 alpha alpha* is followed by measurement of the fraction (h) of alpha alpha* species as a function of time. Similarly, self-exchange in beta beta-tropomyosin is examined by measurements of the overall process: beta beta + beta* beta* in equilibrium with 2 beta beta*, in which beta* signifies a beta-chain blocked at both sulfhydryls (C36 and C190). The observed time course for both chains is well fit by the first-order equation: h (t) = h (infinity) (1-e-k1t), with h (infinity) congruent to 0.5. This long-time limit is as expected for self-exchange, and agrees with experiments that attain equilibrium after slow cooling of thermally dissociated and unfolded chains. The simplest consonant mechanism is chain exchange by rate-limiting dissociation of dimers followed by random reassociation. Kinetic analysis shows k1 to be the rate constant for the chain dissociation step, a quantity not previously measured for any coiled coil. This rate constant for beta beta species is about an order of magnitude greater than for alpha alpha. In both, the activation enthalpy and entropy are very large, suggesting that activation to an extensively (greater than 50%) unfolded species necessarily precedes dissociation. Experiments are also reported for overall processes: alpha alpha + beta* beta* in equilibrium with 2 alpha beta* and alpha* alpha* + beta beta in equilibrium with 2 alpha* beta. Results are independent of which chain is blocked. Again h (infinity) congruent to 0.5, in agreement with equilibrium experiments, and the time course is first order. The rate constants and activation parameters are intermediate between those for self-exchange. PMID- 1782357 TI - The hydration response of poly (L-lysine) dynamics measured by 13C-NMR spectroscopy. AB - 13C-nmr measurements are reported for samples of poly (L-lysine) both static and spinning at the magic angle in the beta-sheet form as a function of water content. The addition of water decreases the side-chain line widths considerably. Measurements of the cross-polarization time constants indicate that hydration by either H2O or D2O increases the time constant. Measurements of spin-lattice relaxation times in the laboratory frame and the rotating frame indicate that hydration does not change the dynamics of the backbone carbon atoms in the beta sheet structure appreciably, but the side-chain atoms experience considerable increase in local mobility with increasing hydration. Deuteration of the exchangeable protons or the water has only small effects on the carbon relaxation times, indicating that relaxation is driven by intramolecular dipole-dipole interactions. PMID- 1782358 TI - Molecular and crystal structures of Aib-containing oligopeptides Boc-Leu4-Aib Leu4-OBzl and Boc-(Leu4-Aib)2-OBzl. AB - Sample peptides Boc-Leu4-Aib-Leu4-OBzl and Boc-(Leu4-Aib)2-OBzl, were crystallized by the solvent-evaporation method. Both crystals are monoclinic, with space group of P2(1) and Z = 2. The cell parameters are a = 16.580 (7), b = 21.105 (7), c = 11.583 (4) A, and beta = 104.90 (3) degrees (Boc-Leu4-Aib-Leu4 OBzl), and a = 15.247 (9), b = 19.04 (1), c = 16.311 (9) A, and beta = 117.10 (1) degrees [Boc-(Leu4-Aib)2-OBzl]. Crystal structures were solved by the direct method and refined to R values of 0.096 (the former peptide) and 0.112 (the latter). Peptide backbones fold into a right-handed alpha-helix, except for the C terminal Aib residue in Boc-(Leu4-Aib)2-OBzl. Both peptide molecules are stabilized by six (the former) or seven (the latter) intramolecular (5----1) hydrogen bonds, and arranged in the head-to-tail fashion, which makes an infinite column. In this column, one (the former) or two (the latter) intermolecular hydrogen bonds link the neighboring molecules. In the case of Boc-Leu4-Aib-Leu4 OBzl, the solvent molecule N,N-dimethylformamide was found in the difference Fourier map. There was a hydrogen bond between peptide and solvent molecule. Along the lateral direction, only hydrophobic contacts were observed between adjacent peptide molecules. PMID- 1782359 TI - Synthesis, crystal structure, and molecular conformation of N-Ac-dehydro-Phe-L Val-L-Val-OCH3. AB - The peptide N-Ac-dehydro-Phe-L-Val-L-Val-OCH3 (C22H31N3O5) was synthesized by the usual workup procedure and finally by coupling the N-Ac-dehydro-Phe-L-Val-OH to valine methyl ester. It was crystallized from its solution in acetonitrile-water mixture at 4 degrees C. The crystals belong to the space group P1 with a = 8.900(3) A, b = 11.135(2) A, c = 12.918(2) A, alpha = 90.36(1) degrees, beta = 110.14(3) 14(3) degrees, V = 1207.7(6) A, 3Z = 2, dm = 1.156(5) Mgm-3, dc = 1.148(5) Mgm-3. The structure was determined by direct methods using SHELXS86. The structure was refined by full-matrix least-squares procedure to an R value of 0.077 for 3916 observed reflections. The molecular dimensions and conformations of the two crystallographically independent molecules are in good agreement. In the dehydro residues, the average C alpha-C beta distance is 1.31(2) A whereas the bond angle C alpha-C beta-C gamma is 132(1) degrees. The average backbone torsion angles are omega 0 = 169(1) degrees, phi 1 = -40(1) degree, psi 1 = 50(1) degree, omega 1 = -177(1) degree, phi 2 = 54(1) degree, psi 2 = 46(1) degree, omega 2 = -174(1) degree, phi 3 = 103(1) degree, psi T3 = -139(1) degree, and theta T3 = -176(1) degree. The acetyl group is in the trans conformation, while the backbone adopts a right-handed and left-handed helical conformation alternatingly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782360 TI - Solvent reorganization contribution to the transfer thermodynamics of small nonpolar molecules. AB - The experimental thermodynamic data for the dissolution of five simple hydrocarbon molecules in water were combined with the solute-solvent interaction energy from a computer simulation study to yield data on the enthalpy change of solvent reorganization. Similar data were generated for dissolving these same solute molecules in their respective neat solvents using the equilibrium vapor pressure and the heat of vaporization data for the pure liquid. The enthalpy and the free energy changes upon cavity formation were also estimated using the temperature dependence of the solute-solvent interaction energy. Both the enthalpy and T delta S for cavity formation rapidly increase with temperature in both solvent types, and the free energy of cavity formation can be reproduced accurately by the scaled particle theory over the entire temperature range in all cases. These results indicate that the characteristic structure formation around an inert solute molecule in water produces compensating changes in enthalpy and entropy, and that the hydrophobicity arises mainly from the difference in the excluded volume effect. PMID- 1782361 TI - Cytomorphology of metastatic melanoma--use of S-100 protein in the diagnosis of amelanotic melanoma. AB - The cytomorphological features of cells from 52 cases of metastatic melanoma obtained by fine needle aspiration cytodiagnosis were studied. Morphologically, 11, 19 and 22 cases were classified as spindle, epithelial, and mixed cell types of metastatic melanoma respectively. There were 34 melanotic and 18 amelanotic melanomas. Besides melanin, the presence of intranuclear cytoplasmic inclusions, eosinophilic macronucleoli and giant cells were helpful in the diagnosis of a melanoma. Where attempted, staining for S-100 protein was positive in all the 19 cases (eight amelanotic and 11 sparsely pigmented melanomas). In addition eight cases of metastatic tumour where a differential diagnosis of poorly differentiated carcinoma or large cell lymphoma was entertained, were also studied for localization of S-100 protein and all were found to be negative. Electron microscopy was performed in five cases and showed the presence of melanosomes and/or premelanosomes. PMID- 1782362 TI - The cytological diagnosis of nasopharyngeal carcinoma using a silk swab stick. AB - A prospective study was carried out to investigate the efficacy of exfoliative cytology for the diagnosis of nasopharyngeal carcinoma. Exfoliated nasopharyngeal cells were collected from patients with a clinical suspicion of carcinoma by scraping the nasopharyngeal mucosa with a piece of silk wrapped around one end of a wooden stick. Ninety-eight patients were investigated in this manner, and the results of cytological investigation compared with the histological findings. The sensitivity of cytological investigation was 71% and the overall accuracy was 86%. The combined use of cytology and serology as a method of screening for nasopharyngeal carcinomas is discussed. PMID- 1782363 TI - Chromosomal abnormality t(9;22)(q22;q12) in an extraskeletal myxoid chondrosarcoma characterized by fine needle aspiration cytology, electron microscopy, immunohistochemistry and DNA flow cytometry. AB - A multidisciplinary approach was taken to characterize a soft tissue tumour. In smears prepared from aspirated material, uniform tumour cells, embedded in a myxoid matrix and partly arranged in a lace-like pattern, were found. Histopathology showed a lace-like pattern of cells in a matrix of hyaluronidase stable mucins. Cytoplasmic positivity for S-100 protein was found in some tumour cells. Electron microscopic analysis revealed intracisternal aggregates of microtubules. All these features are consistent with the diagnosis of extraskeletal myxoid chondrosarcoma (EMC). DNA flow cytometry showed a diploid DNA content. Cytogenetic examination revealed the tumour karyotype 45,XY,t(2;11)(q31;p15),t(9;22)(q22.3;q12),dic(13;22)(p11;p13). Because similar 9;22-translocations have been described in two other cases of EMC, we conclude that t(9;22)(q22-31;q11-12) is a specific rearrangement in this tumour type. Cytogenetic analysis may thus be of diagnostic value in the examination of tumours with this and similar histologies. PMID- 1782364 TI - Malacoplakia of the uterine cervix and endometrium. AB - A rare case of malacoplakia involving the female genital tract is presented. The characteristic granular histiocytes with intracytoplasmic Michaelis-Gutmann bodies were identified in a cervical smear. The cytological preparation also showed prominent capillary vessels and differed from biopsy material in that cytoplasmic bacteria were easily identified. PMID- 1782365 TI - Effect of introducing a restrictive cervical screening policy on the detection of cervical cancer. PMID- 1782366 TI - Screening tests for colorectal neoplasia. PMID- 1782367 TI - Colorectal neoplasia: Screening average risk individuals. PMID- 1782368 TI - Follow-up surveillance in patients with adenomas. PMID- 1782369 TI - Transplantation in primary biliary cirrhosis. AB - Improved immunosuppressive regimens, better postoperative intensive care and judicious patient selection have all resulted in increased patient survival following orthotopic liver transplantation (OLT), which has become the preferred option for most patients with end-stage primary biliary cirrhosis (PBC). As with most other clinical series, PBC is now the most common indication for OLT in the King's College hospital and Cambridge programmes. To date (30 July 1990), 129 patients with PBC have been transplanted, with overall actual 1 and 5 year survival rates of 65 and 63% respectively. When patients transplanted since 1985 are considered, both the 1 and 2 year survival rates are 78%. Immediate operative mortality was 4.5%, generally due to uncontrollable bleeding, while further mortality within 30 days of operation--mainly consequent upon infection and multi organ failure--has fallen from 40% prior to 1985 to 9% since 1988. Thirteen per cent of patients have been retransplanted for vanishing bile duct syndrome, manifest in this series invariably within the first 6 months following OLT. Although rehabilitation in this series was excellent, a significant percentage of cases have continuing problems with metabolic bone disease, hypertension and renal impairment, mainly due to cyclosporin toxicity. PMID- 1782370 TI - Can the pathologist forecast causation of primary biliary cirrhosis? PMID- 1782371 TI - Primary biliary cirrhosis: is there an environmental contribution? PMID- 1782372 TI - Primary biliary cirrhosis: symptomatic treatment. PMID- 1782373 TI - Antigen presentation and effector mechanisms in 'auto-immune' diabetes. PMID- 1782374 TI - Non-alcoholic steatohepatitis: impaired antipyrine metabolism and hypertriglyceridaemia may be clues to its pathogenesis. AB - Non-alcoholic steatohepatitis resembles alcoholic liver disease in hepatic morphology but appears to have a different natural history. We sought to assess the nature of non-alcoholic steatohepatitis by a prospective study of its clinical progression and the relationship of biochemical abnormalities to changes in serum lipids among 15 patients with this disorder. In addition, antipyrine clearance (Cl-AP), which reflects hepatic microsomal oxidative capacity, was measured serially. Although initial liver histology included micronodular cirrhosis in five cases and bridging fibrosis in another three, only one patient developed a hepatic complication during 1-10 years (median: 3.7) of follow up. This confirms the relatively benign nature of non-alcoholic steatohepatitis. Moreover, Cl-AP, which was below the normal range in 13 patients, did not change significantly during 10-40 months of follow up. However, compared with other chronic liver diseases, the reduced Cl-AP was disproportionately low relative to the uniformly normal serum albumin concentration and other indices of hepatic metabolic function. This is consistent with selective impairment of endoplasmic reticular drug oxidizing enzymes. Hyperlipidaemia was present in 11 patients. In three of these, diet-induced correction of serum triglyceride elevation was associated with reduction of hepatocellular damage as indicated by serum enzyme levels. A hypothesis that unites these and earlier findings is that release of cytokines may occur in non-alcoholic steatohepatitis and produce accumulation of free fatty acids in the liver, leading to focal necro-inflammatory lesions and the destruction or down-regulation of cytochrome P450. PMID- 1782375 TI - Role of hepatic artery in haemodynamics in normal and cirrhotic livers in rats. AB - To examine the degree of influence of the hepatic artery on microcirculation in the liver, microscopic observation of blood flow in the hepatic minute blood vessels and the sinusoids and pressure measurements at key points in hepatic vascular pathways in vivo were performed before and after hepatic artery ligation in normal and cirrhotic rats. In normal rats, portal vein pressure (109 mmH2O) fell 10 mmH2O after hepatic artery ligation, but the pressures of the terminal portal venule, the terminal hepatic venule and the inferior vena cava did not change. In cirrhotic rats, portal vein pressure (206 mmH2O) and terminal portal venule pressure (106 mmH2O) fell 23 and 10 mmH2O after hepatic artery ligation respectively: the pressures in the terminal hepatic venule and the inferior vena cava did not change. These results suggests that the pressure transmitted from the hepatic artery was mostly supplied to the intrahepatic portal vein in normal rats and both to the intrahepatic portal vein and to the sinusoids in cirrhotic rats. In both normal and cirrhotic rats, however, the pressure transmitted from the hepatic artery was about 10 per cent of the initial portal vein pressure, and the blood flow in minute vessels and sinusoids did not change after hepatic artery ligation. Accordingly, it is believed that the hepatic artery plays only a small role in the haemodynamics of the liver in both normal and cirrhotic rats, irrespective of the distribution and manner of the hepatic arterial termination. PMID- 1782376 TI - Significance of different conjugate forms of bilirubin in the formation of pigment gallstones. AB - The aim of the present study was to analyse bile samples from cases with gallstones by high performance liquid chromatography according to the type of stones present, with special reference to the glucoside and xyloside conjugates of bilirubin, and to investigate their deconjugation. The composition of bilirubin conjugates in bile was similar between cholesterol and black pigment stones except that the total bilirubin concentration was about 5 times higher in black pigment stone cases with haemolysis. Unconjugated bilirubin was higher in brown pigment stone cases than in cholesterol stone cases, although total bilirubin concentration was lower in the former. In addition, in brown pigment stone cases, bile contained statistically less bilirubin diglucuronide and more bilirubin diglucoside and monoglucoside than in bile with cholesterol stones (P less than 0.05). Glucoside and xyloside conjugates are also major components, regardless of the types of gallstones present, accounting for as much as 18 to 25%. Incubation experiment revealed that bilirubin diglucuronide was more readily deconjugated than bilirubin diglucoside or bilirubin monoglucoside monoxyloside. Therefore, glucuronide conjugates were likely to be the main source of unconjugated bilirubin in the formation of pigment gallstones. PMID- 1782377 TI - Effects of stress on growth of transplanted hepatic tumours and immune responses. AB - Growth of transplanted hepatic tumours (T-9) was enhanced in immune rats under stress, compared with immune rats in an unstressed condition. Compared with unstressed immune rats, killer activity of mononuclear cells infiltrating the tumours against T-9 cells was significantly reduced in stressed immune rats. In contrast, killer activity of splenocytes obtained from stressed immune rats against T-9 cells was elevated compared with that from unstressed immune rats. In addition, natural killer cell activity of mononuclear cells infiltrating the tumours obtained from stressed immune rats was significantly reduced compared with that from unstressed immune rats. Cell populations infiltrating tumour tissues were identified by flow cytometric analysis. The percentage of CD8+ cells in mononuclear cells isolated from tumour tissues of stressed immune rats was reduced compared with that of unstressed immune rats. Furthermore, interleukin-2 responsiveness of splenocytes was suppressed in stressed immune rats, whereas T cell function as reflected by phytohaemagglutinin- or Concanavalin A-reactivity was unaffected by stress. Collectively, it is likely that stress suppressed the generation of cytotoxic cells from the spleen cells of immune rats. PMID- 1782378 TI - Liver regeneration: an overview. PMID- 1782380 TI - Science, democracy and quality. PMID- 1782379 TI - Ventilation/perfusion after liver transplantation in decompensated cirrhosis. PMID- 1782381 TI - Health service accreditation in the United Kingdom. AB - Political and professional attitudes in the United Kingdom are now increasingly supportive of systematic quality assurance, particularly in the acute sector. This paper describes general progress towards organisational audit or accreditation of hospitals and outlines the structure, process and findings of two developing programmes--one based at the King's Fund Centre in London, the other in the South Western Region in Bristol. PMID- 1782382 TI - Implementing continuous quality improvement (CQI) in hospitals: lessons learned from the International Quality Study. AB - Continuous Quality Improvement is in the process of being implemented in hospitals around the world. In an attempt to gain a better understanding of the "best management practices" the International Quality Study is being conducted in four countries--Canada, Germany, Japan and the United States--and across four industries--Health Care, Banking, Automotive and Computers. Information collected through a survey process will be analysed through causal modeling to determine correlations between management practices and achievement of quality objectives. Given both the complexity of the models and the number of key concepts involved, 400 hospitals have been invited to participate. The preliminary results show direct correlations between cultural influences and the concept of quality. The perceived definition of quality by the various countries varies and therefore the application of "quality concepts" differs. Once complete, this database of "best management practices" will serve as a worldwide benchmark for quality progress. PMID- 1782383 TI - The Quality Assurance Project: introducing quality improvement to primary health care in less developed countries. AB - Persistently excessive morbidity and mortality rates in less developed countries (LDCs) served by primary health care systems suggest that the quality of services is inadequate. The PRICOR project, sponsored by the United States Agency for International Development, has designed and implemented methods for quality assessment and problem solving in LDC health systems. After developing comprehensive lists of essential activities and tasks, similar to practice parameters, for seven child survival interventions, PRICOR supported comprehensive quality assessment studies in twelve LDC countries. The studies, yielding over 6000 observations of health worker-client encounters, indicated highly prevalent, serious program deficiencies in areas including diagnosis, treatment, patient education and supervision. To facilitate corrective action, PRICOR assisted managers in conducting operations research to resolve priority problems revealed by the assessments. The recently initiated Quality Assurance Project is building on PRICOR techniques in designing and implementing sustainable continuous quality improvement programs for LDC health systems. PMID- 1782384 TI - Using Q-Probes to improve the quality of laboratory medicine: a quality improvement program of the College of American Pathologists. AB - This paper will review the reasons for the increasing emphasis on quality assurance in American healthcare and laboratory medicine. This emphasis is driven in part by economic, social and regulatory concerns as well as the traditional commitment to the search for excellence in services provided to patients. The Q Probes Program of the College of American Pathologists (CAP) represents a response to these pressures and will be described in some detail. The program is based upon the historical success of interlaboratory comparison programs developed and sponsored by the CAP in achieving demonstrable improvement in laboratory performance. These programs are dependent on the gathering of data from large numbers of laboratories in order to establish provisional "benchmarks" of quality practice which serve as a baseline for systematic quality improvement efforts. The Q-Probes Program gathers peer-group specific institutional data concerning defined aspects of quality practice in pathology and laboratory medicine. These highly structured programs provide laboratories and pathology services with a format to collect data for submission to the CAP for analysis and to compare their performance against that of appropriately stratified peer groups. Several representative examples chosen from clinical laboratory medicine and pathology will be presented. We will attempt to demonstrate how individual laboratory and pathology services utilize aggregate data to effect specific changes in practice that lead to improvement in processes of patient care and better patient outcomes. PMID- 1782385 TI - Evaluation of drug consumption and quality of pharmacological therapy in the Friuli Venezia Giulia Region (Italy). AB - A program for automatic reading of medical prescriptions has been introduced in Friuli Venezia Giulia (Italy), to control the quality of medical care and the physicians' prescribing methods in office-based medical practice. Data on the prescribing practice of general practitioners, drug consumption and costs are collected, and then general practitioners are confidentially informed, through patient-specific medication profiles, on the number and costs of their prescriptions. The first data often showed inappropriate prescription practice on the part of doctors. Through this program an approach based on quality assurance principles is made possible to improve prescribing practice. Being "peer review" activities, bereft of fiscal or punitive ends, they are more readily acceptable by physicians who feel directly involved in improving the use of drugs, with positive connotations for containing costs. PMID- 1782386 TI - Patient satisfaction--does it matter? AB - The paper aims at answering the question: Has the measurement of patient satisfaction improved the quality of care? After concluding that there is no evidence in the literature, the paper proceeds to look at why the evidence is lacking. Four factors seem to explain it: the objectives, the focus and the originator of the patients satisfaction studies and measurements and difficulties related to the interpretation of the findings. The last part of the paper analyses why patient satisfaction should be taken seriously although we do not know whether its measurement improves the quality of care. They include the fact that the patients are partners in health care; they literally feel in their skin whether care is good or bad. They are also the best judges of certain aspects of care, such as amenities and interpersonal relations. The second reason is the transformation of health care from a sellers' market to a consumers' market where the satisfaction of the patients' needs is part of the definition of quality. Finally, there is the ideological reason that, in a democratic society, the patients should have the right to influence decisions and activities influencing them. Measurement of patient satisfaction realizes the principle of community participation in health care. PMID- 1782387 TI - Avoidable mortality. Is it an indicator of quality of medical care in eastern European countries? AB - Age-standardized time trends (1979-1988) for avoidable mortality in two Eastern European countries (Hungary and Czechoslovakia) and selected developed countries (England and Wales, France, Italy, Japan, Portugal and USA) have been analysed. Mortality from both all avoidable causes and all other causes declined in the selected developed countries during the period of observation, the decline in rates for avoidable causes was faster than that for all other causes. In Hungary and Czechoslovakia the death rates from both groups of causes increased in the first part of the period studied and a decline in mortality from both types of causes could be observed from 1985. As a consequence, the difference in avoidable mortality between the Eastern European countries and the developed countries increased by the end of the observation. Studies on mortality from individual amenable causes showed that the death rates are usually much higher in Hungary and Czechoslovakia than in the developed countries and the differences did not diminish during the period of study. In Hungary and Czechoslovakia the bad pattern of mortality from conditions amenable to medical interventions is believed to reflect, at least in part, the crisis in the health services which these countries have experienced for the past decades. PMID- 1782388 TI - Quality assessment in hernia surgery. AB - Questionnaires were sent five years postoperatively to all patients between 15 and 80 years old at operation who were treated for inguinal or femoral hernia in 1984 at Motala Hospital. Patients were asked about pain or a lump in the operation area and a clinical examination was offered. Of 137 patients with 142 hernias, 92% answered the questionnaire and 88% came to the examination. Among patients who answered the questionnaire and attended the examination the cumulated recurrence rate was 19%, when recurrence was defined as an indication for reoperation or a bulge in the operation area that appeared or increased during abdominal straining. Predictive values for positive and negative questionnaire answers in relation to hernia recurrence were 69% and 95%, respectively. In 14% of hernia operations a reoperation had been performed or was needed. Testicular atrophy was found in 2.7% of male patients. A questionnaire follow-up may be appropriate for identifying patients with symptomatic recurrencies, but it is inadequate as a single indicator of quality assessment in hernia surgery. PMID- 1782389 TI - Factors affecting inappropriate hospital stay. AB - Fifty-four per cent of hospital stay days on the medical wards in a large teaching hospital, 40% on surgery and 26% on pediatrics, were found to be unjustified, using an assessment method based on explicit criteria. Despite the observed differences between the various specialties, the frequency distribution of the reasons for unjustified hospital stay days was essentially similar. Most of the unjustified hospital stay days were attributed to diagnostic evaluation, non-emergency treatment and immediate follow-up, which were carried out within the hospital rather than on an ambulatory basis. The major factors for unjustified hospital stay days were age, ethnic group, ward of admission and diagnostic category. These findings may contribute to the implementation of hospital utilization management programs aimed at cost containment. PMID- 1782390 TI - Quality of alternative medicine--complications and avoidable deaths. PMID- 1782391 TI - The effects of elongational stress exposure on the activation and aggregation of blood platelets. AB - Hemodynamic shear is known to stimulate blood and endothelial cells and induce platelet activation. Many studies of shear-induced platelet stimulation have employed rotational viscometers in which secondary flow effects are assumed to be negligible. Shear induced platelet activation occurs at elevated shear rates where secondary flows may contribute a significant percentage of the total hydrodynamic force experienced by the sample. Elongational stress, one component of this secondary flow, has been shown to alter transmembrane ion flux in intact cell and the permeability of synthetic membrane preparations. Elongational flow also occurs in the vasculature at sites of elevated shear stress. Secondary flow components may contribute to platelet activation induced during shear stress application in rotational viscometry. A unique 'constrained convergence' elongational flow chamber was designed and fabricated to study platelet response to elongational stress exposure. The elongational flow chamber was capable of producing an elongation rate of 2.1 s-1 with a corresponding volume averaged shear rate of 58.33 s-1. Significant changes were observed in the total platelet volume distribution and measured response to added chemical antagonists after elongational stress exposure. The total platelet volume histogram shifted toward larger particle sizes, suggesting the formation of large aggregates as a result of elongational stress exposure. Platelets exposed to elongational stress demonstrated a dose dependent decrease in added ADP-induced aggregation rate and extent of aggregation. PMID- 1782392 TI - Network thermodynamic analysis of vasomotion in a microvascular network. AB - The modulation of microvascular blood flow by vasomotion in the individual vessels of a simple vascular network was simulated by means of a network thermodynamic model. The flow is driven under a pulsating pressure through two arcades of branching vasoactive arterioles into a passive resistance representing the capillary and venular beds. Each vessel was assumed to have the capability of decreasing rhythmically the local diameter over a short section by a specified fraction of the maximum value and to change the average diameter along its total length in response to alterations in intraluminal pressure. Blood was assumed to exhibit a simple linear viscous flow resistance. Alterations in flow rate and distribution through the network were determined as a function of the magnitude and frequency of vasomotion within the individual arterioles supplying blood to the microvascular bed. Specific cases are shown to illustrate how blood flow can be influenced by the patterns of vasomotion within the network. PMID- 1782394 TI - Non-newtonian behavior of whole blood in a large diameter tube. PMID- 1782393 TI - The specific hydraulic conductivity of bovine serum albumin. AB - Previous studies of extracellular matrix hydraulic conductivity have characterized the flow resistance of glycosaminoglycans, proteoglycans and collagen. This work focuses on serum albumin, present in significant quantities in many connective tissues, but not previously considered for its role in determining connective tissue flow resistance. The specific hydraulic conductivity of bovine serum albumin solutions, as a function of concentration, was calculated from sedimentation and ultrafiltration data available in the literature. A rigid particle hydrodynamic model compared favorably with these results. Experimental measurements on an albumin ultrafiltration cell were in agreement with this model (within experimental error); furthermore, the experimental data confirmed the theoretical prediction that there is no (or negligible) pressure drop through the concentration polarization layer. Use of the hydrodynamic model for albumin specific hydraulic conductivity with literature values for the hindrance of albumin when passing through a glycosaminoglycan (GAG) matrix allows an estimate of the relative importance of the albumin on tissue hydraulic conductivity: in non-cartilaginous tissues with moderate GAG concentrations, tissue levels of albumin can generate flow resistance effects comparable to those of the GAGs, although well less than the flow resistance of these tissues. PMID- 1782395 TI - Japanese Society of Biorheology. Annual meeting, Tokyo, Japan, 20-22 June 1990. Abstracts. PMID- 1782396 TI - Rationale for the design of biomaterials and the evaluation of their biocompatibility. AB - The biocompatibility of a material can be considered as the ideally expectable result of its interactions with living tissues with which it is interfaced. This property determines the ability of devices involving this material in their constitution, to correctly assume their ascribed function; reciprocally a bad fitting, between devices and their intended use, coming from a non-optimized design or from an inappropriate prescription, may alter the original biocompatibility of constitutive materials. Accordingly, the actual biocompatibility of a biomaterial depends upon both its intrinsic properties and the application in which it is involved. Such considerations must be taken into account by specialists who try to design more performant biomaterials, or new assist devices, should they be implantable or not; but they draw also methodological guidelines for the evaluation of the biocompatibility of these biomedical products. PMID- 1782397 TI - Contributions to biorheology during hemodialysis. AB - Thrombogenicity is the property of a foreign surface to induce clotting processes or formation of aggregates after contact with blood. Beside the sort of anticoagulation patient's prethrombotic state, rheological factors as well as physicochemical properties of foreign membranes decisively influence thrombogenicity. We examined the influence of chronic renal failure and different hemodialyzers and blood transfusion therapy during hemodialysis on hemorheological parameters. Different membranes cannot be discriminated by the used hemorheological parameters. We clearly could demonstrate the close relationship between the hemofiltration rate and an increase of viscosity. Blood transfusion therapy or elevated hematocrit in combination with increased hemofiltration rate have influence on the flow behaviour of blood, especially in disturbed microcirculation. PMID- 1782398 TI - Chronic captopril treatment reverses the enhanced vascular concentrations of 3 methylhistidine in the spontaneously hypertensive rat. AB - Morphometric studies conducted on the blood vessels of the spontaneously hypertensive rat have provided evidence that medial hypertrophy is a key characteristic of the vascular change which occurs in hypertension. In the present study, we determined whether 3-methylhistidine (3MH), a post translationally modified amino acid which is found uniquely in the actin and myosin of muscle, could provide a biochemical marker of such change. Our results indicated that the concentrations of 3MH were selectively elevated in the blood vessels from the spontaneously hypertensive rat, when compared with concentrations in vascular tissues from the Wistar-Kyoto rat. The concentrations of 3MH in non-vascular tissues were similar in the two strains. Chronic captopril treatment prevented the development of hypertension in the spontaneously hypertensive rat and was associated with a reduction of the vascular concentrations of 3MH. We therefore conclude that blood vessel concentrations of 3MH are a useful biochemical index of the changes in vascular smooth muscle contractile protein which occur during the development of hypertension in the spontaneously hypertensive rat. PMID- 1782399 TI - Modest pressure natriuresis and autoregulation during water diuresis in dogs. AB - The effects of renal arterial pressure change on renal output of sodium and volume were measured during water diuresis in 25 chloralose-anesthetized dogs. Conditions included a minimal invasive stress, limited sodium administration, and mean renal arterial pressures varied suprarenally, by aortic balloon inflation to lowermost levels of 82-106 mm Hg. Group A dogs received no aldosterone; group B, C and D dogs were given aldosterone. Dogs of group C also received (1-Sar, 8-Ile) angiotensin II. Group D dogs received phenylephrine which elevated arterial and right atrial pressures moderately without decrease in renal blood flow. In groups A, B and C, mean changes in sodium output, volume output, fractional excretions and free water clearances were not detectable with mean renal arterial pressure reductions, which averaged 29 +/- 2.9, 22 +/- 2.8 and 27 +/- 5.2 mm Hg, respectively. Right atrial pressures, effective renal blood flows and glomerular filtration rates did not change with the renal arterial pressure changes in these groups. In the group D dogs, during the larger pressure reductions of 54 +/- 6.6 mm Hg from higher values of 158 +/- 7.0 mm Hg, mean urine flow and effective renal blood flow remained constant while glomerular filtration rate and sodium output decreased only slightly. Output efficiency ratios related to perfusion pressure were calculated. With no more than modest pressure-induced excretory changes, it is concluded that excretory sodium and urinary volume autoregulation in concert with nearly perfect circulatory autoregulation were demonstrated with regionally varied mean renal arterial pressure. The same preglomerular myogenic responses to transvascular pressure, which restrict glomerular and transcapillary pressures, are viewed dominantly responsible for both circulatory and excretory autoregulation under normal conditions of minimal stress and low fractional sodium excretions. Homeostatic implications are discussed concerning likely relevance to the Guyton-Coleman theory for the long-term control of arterial blood pressure. PMID- 1782400 TI - Catecholamine and neuropeptide Y levels in tissues from young Dahl rats following 5 days low- or high-salt diet. AB - The mesenteric vasculature of Dahl salt-sensitive (DS) rats on high-salt diet is supersensitive to nerve stimulation and to norepinephrine. The current experiments were undertaken to examine whether the enhanced sensitivity to nerve stimulation is due solely to the postsynaptic supersensitivity to norepinephrine, to increased sympathetic innervation, to altered transmitter release or to the presence of another transmitter acting as a potentiator. Catecholamine content and neuropeptide Y (NPY) presence were determined in tissues from young (approximately 5 weeks old) male Dahl rats exposed to 5 days of high (7%) or low (0.45%) salt diet. Catecholamine content from mesenteric artery, renal artery, caudal artery, right atrium, aorta, vas deferens and adrenal gland was quantified by high-pressure liquid chromatography with an electrochemical detector. A strain difference, independent of diet, between young DS and Dahl salt-resistant (DR) rats was seen only in adrenal epinephrine content. DS high-salt (+) rats displayed reduced norepinephrine content relative to DR+ in the mesenteric artery and right atrium. The release of norepinephrine from isolated mesenteric vasculature into the perfusate in response to transmural stimulation showed no significant differences between DS+ and DR+ preparations under basal, or deoxycorticosterone acetate (DOCA; 30 microM) perfusion conditions. The addition of 5 microM cocaine to the DOCA perfusion, while increasing total norepinephrine outflow in all preparations, failed to differentiate between DS+ and DR+. NPY immunofluorescence along mesenteric artery sections of DS+ and DR+ rats was not significantly different. Thus, in the tissues examined, enhanced responsiveness of vascular smooth muscle may not be explained by hypernoradrenergic innervation, elevated NPY innervation or altered release of transmitter. PMID- 1782401 TI - Relaxant effect of chemotactic peptides on rabbit vascular strips: evidence for nitric oxide release from a nonendothelial source. AB - Two distinct peptides, C5a and f-Met-Leu-Phe (FMLP), that are chemotactic for phagocytic leukocytes affect profoundly the circulation in various in vivo systems. These peptides are known to relax strips of rabbit isolated blood vessels, the portal vein and pulmonary artery. In the present study, the effect of recombinant human C5a (2.5-25 nM) was examined and found to be qualitatively similar to that previously reported for FMLP. Indomethacin completely or partially inhibited the vasorelaxations induced by either peptide in the pulmonary artery and the portal vein, respectively. The relaxation induced by C5a was not abolished by removing the endothelial lining of the model vessels. The C5a or FMLP effects were more tachyphylactic in tissues continuously exposed to cycloheximide; this phenomenon was particularly pronounced for FMLP. A series of experiments were focused on the indomethacin-resistant component of the relaxation induced by either peptide on the portal vein. This component was not inhibited by capsaicin pretreatment or by endothelium removal, but was suppressed by treatment with NG-nitro-L-arginine or reduced by LY-83583. These findings suggest that the chemotactic peptides elicit their mechanical effect on rabbit vascular smooth muscle through the release of secondary mediators not related to the endothelium; the mediators are tentatively identified as prostaglandins and nitric oxide. It is the coordinated combinations of the metabolic pathways that are involved in the final responses, with inherent differences between vessel sources and the agonists used. PMID- 1782402 TI - Intracellular pH measurement with fluorescent dye in canine basilar arteries. AB - The intracellular pH (pHi) of basilar artery rings was determined with 2',7'-bis (carboxyethyl)-5,(6)-carboxyfluorescein (BCECF) by measuring the ratio of emitted (540 nm) fluorescence intensities (FI) at excitation wavelengths of 500 and 440 nm. There was a dye loss from the rings in 90 min (39.3 +/- 3.6%, p less than 0.001). We found that the ratio of fluorescence intensities does not adequately correct for dye loss; hence, we derived a method to correct for dye loss during pHi determinations. Calibration curves of the ratio versus pHi were constructed for the artery rings. The slope and intercept of the calibration curves depended on FI440. Linear regression lines for the slope and intercept versus FI440 were: [formula; see text] In solutions with different pH and different concentrations of free BCECF, the slope of the ratio versus pH of the solution was steeper at high concentrations of BCECF. Thus, pHi was calculated from a calibration curve in which the slope and intercept were determined from FI440 with the above formula. The corrected pHi was 7.37 +/- 0.05 (n = 25) at pHo 7.4 and 37 degrees C. PMID- 1782403 TI - SKF-525A does not inhibit release of endothelium-derived relaxing factor from rat thoracic aorta and dog mesenteric and femoral artery. AB - SKF-525A (proadifen) inhibits endothelium-dependent relaxations induced by acetylcholine, arachidonic acid and the calcium ionophore A23187. This suggests that SKF-525A is an inhibitor of endothelium-derived relaxing factor (EDRF) and that EDRF may be a product of arachidonic acid metabolism formed via a cytochrome P-450-dependent pathway or that EDRF release is dependent on cytochrome P-450. We tested this postulate using both isolated rings of rat thoracic aorta and dog mesenteric and femoral artery and the perfusion-superfusion bioassay. Rings of rat thoracic aorta and dog mesenteric and femoral artery with intact endothelium were precontracted with an EC50 concentration of norepinephrine (0.1 nmol/l) or U46619 (0.05 mumol/l) and the relaxation to acetylcholine (ACh), bradykinin, adenosine triphosphate (ATP) or nitroglycerin (GTN) were obtained before, 30 min after addition of, and 30 min after washout of SKF-525A (50 mumol/l). SKF-525A inhibited ACh-induced endothelium-dependent relaxation of rat aortic rings and endothelium-dependent relaxation of the dog mesenteric and femoral artery produced by ACh and ATP, but did not affect relaxation to bradykinin or GTN. The inhibitory effect on SKF-525A on ACh and ATP-induced relaxation was partially reversed upon its washout from the muscle chamber. Pretreatment of the blood vessels with ibuprofen (1 mumol/l) did not attenuate SKF-525A-mediated inhibition of the relaxations to any agonist. Selective exposure of dog femoral artery (donor) to SKF-525A (50 mumol/l) for 60 min did not affect the relaxation responses of endothelium-rubbed coronary artery (bioassay tissue) to basal EDRF nor to the effluent from donor tissues stimulated with ACh (10-1,000 pmol), ATP (1-100 nmol) or bradykinin (3-100 pmol). The results show that SKF-525A exhibited a reversible inhibition of endothelium-dependent relaxation by a smooth muscle mechanism unrelated to the generation of EDRF from endothelium. PMID- 1782404 TI - Effect of papaverine on endothelial cell harvest from canine external jugular veins. AB - Endothelial cell seeding procedures have been developed to line prosthetic bypass grafts used in peripheral vascular disease; however, because of current inefficient cell harvest techniques a high ratio of vein-to-graft area is necessary. This study was done to determine if the use of papaverine, a smooth muscle cell relaxant, would affect the number or viability of endothelial cells harvested from canine external jugular veins. Using a 0.12 mg/ml solution of papaverine in tissue culture medium to bathe the veins during dissection and excision, the viable cell yield was 2.20 +/- 1.16 (cells x 10(4)/cm2). A control group of veins using standard dissection technique gave a yield of 0.97 +/- 0.40 (p = 0.025). A second group of veins dissected while bathed in tissue culture medium alone gave a yield of 1.82 +/- 0.75, compared to a yield of 2.73 +/- 0.45 for papaverine harvested veins (p = 0.009). Percent cell viability was not significantly different for any of the groups: 73, 70, and 76% for papaverine, control and media only veins, respectively. The papaverine-harvested cells and those harvested with medium alone grew to 95% confluence in tissue culture in 9.8 +/- 1.1 and 9.9 +/- 0.9 days, respectively. Compared to conventional surgical techniques, use of papaverine more than doubled the endothelial cell yield from excised vein segments without adversely affecting viability or rate of growth in cell culture. PMID- 1782405 TI - Morphometric analysis of monkey cerebral arteries exposed in vivo to whole blood, oxyhemoglobin, methemoglobin, and bilirubin. AB - Whether vasospasm results from smooth muscle contraction or from arterial wall infiltration by cells and other material is subject to debate. Computer-assisted image analysis was used to measure lumen area, total wall area, and area of tunica media plus tunica intima of cross-sections of monkey right middle cerebral arteries (MCAs), exposed in vivo for 6 days to whole blood (n = 4), oxyhemoglobin (OxyHb, n = 5), methemoglobin (MetHb, n = 5), bilirubin (n = 5), mock cerebrospinal fluid (CSF, n = 6), and supernatant fluid from an incubated mixture of autologous blood and mock CSF (n = 5). Five control (left) MCAs from each group and 4 MCAs contracted in vitro with potassium chloride were measured. Significant angiographic vasospasm occurred in groups receiving whole blood, supernatant fluid, and OxyHb (p less than 0.05). There was significant correlation (r = 0.58, p less than 0.05) between right MCA diameter on angiography and diameter calculated from lumen area. When compared to effects of mock CSF, OxyHb significantly increased total wall area. When right and left MCAs were compared within groups, total wall area increased in every group with significant increases in groups exposed to mock CSF, OxyHb, and bilirubin (p less than 0.05). No changes developed in area of tunica media plus tunica intima, whether comparing right versus left MCAs within groups or right MCAs between groups. Contraction in vitro did not significantly increase total wall area or area of tunica media plus tunica intima. Light microscopy demonstrated inflammatory debris in the tunica adventitia of arteries from every group. This study shows that whole blood, OxyHb, and supernatant fluid, which contains OxyHb, cause vasospasm. Increases in total wall area are not sufficient to account for luminal narrowing, and therefore, changes such as cell proliferation and arterial wall fibrosis in the intima or media apparently do not contribute primarily to arterial narrowing of vasospasm but could be related to persistence of narrowing. Vessel wall thickening, which does occur, is caused by increased tunica adventitia area only and is nonspecific in that it develops after injection of substances not associated with vasospasm. The data are consistent with the hypothesis that oxyHb causes vasospasm (both angiographic and morphologic) by inducing muscle contraction in the media. PMID- 1782406 TI - Functional and morphologic endothelial damage in rabbit external jugular veins stored in heparinized normal saline. AB - Previous studies have demonstrated that vein storage in normal saline leads to significant mechanical morphological, and biochemical aberrations. However, little information is available regarding the functional damage that occurs. The purpose of this study was to evaluate the effect of saline storage on venous smooth muscle and endothelial function. Segments of ten external jugular veins from male New Zealand White rabbits were placed nondistended in either modified Krebs solution at 37 degrees C (Krebs-stored, KS) or heparinized normal saline at room temperature (saline-stored, SS) for 1 h. Segments 4 mm in length were then simultaneously studied in vitro under isometric tension. There was no difference in maximum tension or sensitivity to either bradykinin or histamine. Acetylcholine-induced relaxation in KS segments was not significantly different from relaxation in a historical cohort of nonstored segments (nonstored 87.4 +/- 1.0% vs. KS 84.5 +/- 2.0%; p = NS). However, there were significant attenuations in SS segment endothelium-dependent relaxation in response to both acetylcholine (KS 84.5 +/- 2.0% vs. SS 76.4 +/- 2.7%, p less than 0.02) and adenosine diphosphate (KS 47.9 +/- 2.9% vs. SS 40.6 +/- 3.7%, p less than 0.002). Relaxant responses to sodium nitroprusside (endothelium-independent) were not significantly different in the two groups (KS 94.6 +/- 1.6% vs. SS 95.7 +/- 2.2%; p = NS). Electron microscopic evaluation of SS segments revealed endothelial cell disruption with cellular edema and loss of intact junctions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782407 TI - Comparison between human umbilical artery and rabbit abdominal aorta as substrata for platelet adhesion and platelet thrombus formation under flow conditions. AB - Rabbit abdominal aortas and human umbilical arteries are currently used as substrata for the study of platelet adhesion and aggregate formation under flow conditions. Using immunohistochemical and ultrastructural methods, we have analyzed both vessel surfaces. The reactivity towards platelets of the subendothelium (SE) exposed on these vessels after mechanical or enzymatic digestion (alpha-chymotrypsin) was morphometrically quantified and the nature of the interaction studied in the electron microscope. After mechanical damage, the ultrastructural study of rabbit aortas showed a clearly defined internal elastic lamina (IEL). In contrast, umbilical vessels lacked a consistent IEL and masses of amorphous material often located deeper in the media were the main constitutents of the SE. Immunohistochemical labeling of the von Willebrand factor bound to both types of vessel differed considerably. Quantification of platelet interactions after perfusion of citrated blood showed qualitative differences between mechanically damaged rabbit or human vessels. Enzymatic digestion produced a more thrombogenic surface on rabbit aortas (p less than 0.01 vs. nondigested), but decreased their reactivity towards platelets on umbilical arteries (p less than 0.01 vs. nondigested). The ultrastructural study of the interacting platelets revealed that aggregates, when present, were found on the extracellular matrix underlying endothelial cells of rabbit aortas, but interacting with fibrillar structures probably derived from cell elements of the media in the case of umbilical arteries. These findings indicate that rabbit aortas and umbilical arteries possess structural characteristics that result in different thrombogenic properties with respect to circulating platelets. PMID- 1782408 TI - Release of nerve growth factor from cultured aortic smooth-muscle cells. AB - Conditioned medium from cultured aortic smooth-muscle cells from rat aorta yielded neurite-extending effects on sensory and sympathetic ganglia of chick embryos. These effects were blocked by adding specific antiserum against 2.5S nerve growth factor (NGF), suggesting that NGF might be released from vascular smooth-muscle cells. PMID- 1782409 TI - Multiple serotonin receptors on large arterioles in striated muscle. AB - In rat striated muscle, serotonin (5-hydroxytryptamine; 5-HT) constricts large arterioles (first-order; A1) via 5-HT2 receptor activation but dilates smaller arterioles via a 5-HT1-like receptor. In this preparation, A1 arterioles possess little basal tone. The purpose of this study was to determine if 5-HT would elicit A1 dilation if arteriolar tone was first induced. In anesthetized rats, A1 diameters of the cremaster muscle were measured via in vivo videomicroscopy. Topical application of angiotensin II caused a 26 +/- 3% constriction of the vessels. 5-HT dilated the preconstricted A1s by 36 +/- 7% while constricting normal tone A1s by 33 +/- 5%. This dilation was enhanced by blocking 5-HT2 receptors with LY53857, but abolished with methysergide, a 5-HT1 and 5-HT2 receptor antagonist indicating that the dilation was mediated by a 5-HT1-like receptor. Thus, A1 arterioles possess both 5-HT2 and 5-HT1-like receptors. The net result of 5-HT application in striated muscle, dilation or constriction, will depend on the initial tone of the vessels. PMID- 1782410 TI - Cholinergic binding sites in pericytes isolated from retinal capillaries. PMID- 1782411 TI - Seasonal variations of serotonin-induced contractility in vitro in bovine middle cerebral artery. PMID- 1782412 TI - Blood vessel wall matrix flow sensor: evidence and speculation. PMID- 1782413 TI - Role of leukotrienes and platelet activating factor in gastric mucosal damage and repair. AB - Gastric mucosal integrity depends upon the balance between "aggressive" factors and "defensive" mechanisms. The formation of mucosal lesions results from the disruption of defense lines, including the breaking of unstirred mucus layer, the reduction of surface hydrophobicity, extensive exfoliation of surface epithelium, penetration of offending agents deeply into the mucosa and damage to the microvessels. The release of proinflammatory and vasoactive mediators such as leukotrienes (LT), thromboxanes, platelet activating factor (PAF), endothelins and others has been thought to be involved in the pathomechanism of mucosal injury, especially damage to the microvascular endothelium, increased vascular permeability, reduction in mucosal blood flow, vascular stasis, tissue ischemia and glandular cell necrosis. This paper reviews the mechanisms and possible pathogenetic implication of two related compounds, LT and PAF in acute mucosal injury by topical irritants such as ethanol, aspirin, bile salts and by stress. LT and PAF arise from similar membrane phospholipids and may regulate the biosynthesis of one another in the damaged mucosa. Although pharmacological studies have clearly demonstrated the noxious effects of cysteinyl LT and PAF on the mucosa, especially when exposed to topical irritants, recent publications have challenged the primary role of these mediators in the pathogenesis of mucosal lesions and ulcerations because the treatment with agents that selectively antagonize their biosynthesis or the receptor sites at the target cells did not always interrupt the chain of events leading to mucosal injury. The role of these mediators in the mucosal repair processes has been little studied but both cysteinyl LT and PAF seem to delay the restitution and healing of the mucosa. Further studies are necessary to clarify to what extent the biosynthesis of LT and PAF and the pharmacological inhibition of their action on the target tissues is related to noxious, protective and reparative events in the mucosa exposed to mild irritants and ulcerogens. PMID- 1782414 TI - Leukotrienes in mucosal damage and protection. AB - Exposure of the rat gastric mucosa to ethanol stimulates the generation of leukotriene (LTC4) and 15-hydroxyeicosatetraenoic acid, but not of thromboxanes and prostaglandins. Lipoxygenase activation is not found with other topical irritants or nonsteroidal anti-inflammatory drugs. A number of gastroprotective drugs dose-dependently inhibit the stimulatory action of ethanol on mucosal LTC4 formation closely parallel to their protective activity suggesting that ethanol induced damage and activation of lipoxygenases may involve common targets which are simultaneously counteracted by certain types of protective agents. Selective inhibition of 5-lipoxygenase, however, does not confer protection against gastric mucosal damage caused by topical irritants or non-steroidal anti-inflammatory drugs. Thus, although leukotrienes may mediate certain reactions elicited by gastric ulcerogens such as submucosal venular constriction and mucosal microvascular engorgement, they do not appear to be major mediators of ulcerogen induced tissue necrosis. The contribution of other products of the various pathways of arachidonic acid metabolism to gastric mucosal injury and the mechanism underlying the close interrelationship between protection and inhibition of LTC4 formation observed with certain compounds remains to be investigated. PMID- 1782415 TI - Role of mucus in gastric mucosal protection. AB - Even though there is no general agreement as to the mechanism of gastric mucosal protection, the consensus is that the initial brunt of luminal insults falls on the mucus layer which constitutes the only identifiable physical barrier between the gastric lumen and the mucosal surface. The continuous renewal and resilient nature of this layer efficiently counters peptic erosion of the gel, assures its viscoelastic and permselective properties, and provides a milieu for containment of the diffusing luminal acid by mucosal bicarbonate. Disturbances in this delicate balance lead to the impairment of the protective function of mucus resulting in gastric disease. Indeed, the weakening of gastric mucosal defense is intimately associated with the diminished viscoelastic qualities of mucus, decrease in hydrogen ion retardation capacity, and the extensive proteolysis of its mucin component. Although until recently the disintegration of the mucus coat was attributed exclusively to the enhanced activity of intragastric pepsin, our studies provided strong argument that a bacterial factor, namely infection by Helicobacter pylori, through the action of its protease and lipase enzymes also is highly detrimental to the integrity of gastric mucus. Hence, agents capable of interfering with the pathogenic activity of this bacteria are becoming the drugs of choice in peptic ulcer therapy. PMID- 1782416 TI - Role of polyamines in gastroprotection induced by epidermal growth factor. AB - Polyamines have been shown to stimulate cellular growth and differentiation, though their role in the prevention of acute gastric lesion induced by various noxious agents has been little studied. Epidermal growth factor (EGF) exhibits gastroprotective and ulcer healing properties due to its potent mitogenic and growth promoting action. This study was designed to compare the gastroprotective effects of spermine and EGF against gastric damage induced by absolute ethanol, acidified aspirin and stress and to determine the role of endogenous polyamines in EGF-induced gastroprotection. Spermine and EGF significantly reduced the lesions induced by all three ulcerogens. Oral administration of spermine or subcutaneous infusion of EGF in 24 h fasted rats with chronic gastric fistula resulted in similar inhibition of gastric acid and pepsin secretion. Pretreatment with difluoromethylornithine (DFMO), an irreversible inhibitor of ornithine decarboxylase (ODC), a key enzyme in the biosynthesis of polyamines, did not affect ethanol lesions, but reversed the protective effect EGF but not spermine against ethanol. This finding indicates that polyamines mediate, at least in part, EGF-induced gastroprotection. In tests with oral administration of aminoguanidine that is known to suppress the activity of diamino-oxidase (DAO) and to inhibit the degradation of polyamines, EGF showed a markedly enhanced gastroprotective activity against ethanol damage. Since indomethacin failed to affect the gastroprotective effects of spermine and EGF and neither of these agents influenced the mucosal generation of PGE2 in intact or injured gastric mucosa, we conclude that prostaglandins are not the major factors in spermine- and EGF-induced gastroprotection. This study demonstrates that polyamines are highly effective against gastric lesions induced by various ulcerogens and that they act as primary mediators of EGF-induced gastroprotection. PMID- 1782417 TI - The effect of menadione on sarcoplasmic reticulum Ca2+ and contractions of single guinea-pig cardiomyocytes. AB - We investigated the effect of 2-methyl-1,4-naphtoquinone (Menadione) on sarcoplasmic reticulum (SR) Ca2+ content and electrically stimulated contractions (ESCs) of single isolated myocytes of guinea-pig ventricular myocardium. The contractures initiated by means of microinjections of caffeine into the close vicinity of the cell were used as an indirect index of the SR Ca2+ content. Superfusion of the cells for 45 min with Menadione resulted in gradual disappearance of contractile responses to caffeine, prolongation of time to peak amplitude of ESCs by 48 +/- 15% and complete inhibition of postrest and postextrasystolic potentiation. These results are consistent with those of Floreani and Carpenedo (7) who found that Menadione strongly inhibits the SR Ca2+ ATPase. Despite depletion of the SR Ca2+ the amplitude of ESCs did not change which suggests that contractions were initiated in the cells treated with Menadione by Ca2+ derived from the sources other than the SR. PMID- 1782418 TI - Impact of wildlife on the environment. AB - Wildlife has a considerable and highly varied impact on the environment. Furthermore, in transforming the environment, man has indirectly altered some of the many links which associate animals with the environment. Food chains are an essential link, for they associate animals to plants (in the case of depredators such as herbivores, fruit- and grain-eaters) and to other animals (in the case of predators). Food chains determine the equilibrium of populations in their habitat. The various roles and activity of animals within different ecosystems are described. Birds are discussed at some length, given their role in pollination and the dissemination of plants, and also their potential for acting as reservoirs or carriers of pathogens. Mention is also made of disturbances to the environment resulting from the introduction, by humans, of various species which can threaten the ecological balance of the host region. These topics form a basis for further reflection on the conservation of particularly endangered natural resources. PMID- 1782419 TI - [Desertification and animal health in the Sahel]. AB - This article reviews the causes of desertification proposed by various authors. For a long time, overgrazing of pastures in the Sahel was considered responsible for rapid degradation of the soil. Consequently, the owners of livestock have been accused of enlarging their flocks, and animal husbandry services of involuntary complicity, since their action has reduced the occurrence of epizootics which used to decimate the flocks. The underlying causes of overstocking of pastures and of desertification are in fact multiple and intertwined: population pressure, drought, changes in land ownership systems, social changes. For this reason, the problems of animal production cannot be treated in isolation, and strategies devised by numerous organisations for combating desertification are taking into account the different causes of a situation which can be described, without exaggeration, as a catastrophe. So far there has been no consensus on a given strategy, and results seem to be disappointing, perhaps because the resources have been inadequate, and the schemes have not been supported by the populations involved. Moreover, projects conceived on a global and theoretical basis may not cater for the diversity of actual situations. In contrast, animal health actions, by their concrete nature, directly involve nomadic and sedentary owners of animals and motivate the populations. They remain an indispensable factor in the development of livestock husbandry and its necessary integration with agriculture where both activities can coexist. They are also a preliminary step to intensification in pastoral zones, which makes better management of forage resources possible. PMID- 1782420 TI - Environmental problems of aquaculture in Asia and their solutions. AB - During the past decade aquaculture has expanded very rapidly in Asia. Extensive, semi-intensive and especially intensive systems are currently in use. These systems require careful management to avoid deterioration of the environment and mass mortality of cultured species. Taking shrimp culture as an example, the author discusses the major environmental factors which affect the health of aquatic species. Solutions to the various problems are also discussed. PMID- 1782421 TI - [The role of nitrogen and phosphorus in pollution of animal origin]. AB - Despite some variability in the data, the author has been able to establish the average characteristics of animal wastes, and to formulate an overall view of nitrogen and phosphorus wastes originating from livestock, in order to compare them with other wastes. Nitrogen is originally present mainly in the form of dissolved ammonia, whereas phosphorus is present in inorganic particles. Ammonium nitrogen is toxic for the aquatic fauna and, in favourable conditions, can be oxidised into nitrates and nitrites, which are undesirable constituents, capable of affecting the health of consumers. Phosphorus and nitrogen compounds in excess of the requirements for soil fertilisation are responsible, among other things, for degrading the quality of surface water, leading to eutrophication. PMID- 1782422 TI - Pollution by animal production in The Netherlands: solutions. AB - Provided that the application rates of manure do not exceed the crop uptake of nutrients, pollution by animal production is mainly caused by nitrogenous substances. Applying manure outside the growing season causes pollution of groundwater and surface water due to leaching and runoff. In regions with a high livestock density, the evaporation of ammonia has a serious impact on the environment. It contributes to acidification and causes a nutrient imbalance in natural vegetation. The prevention of nutrient losses from manure is unprofitable. The environmental impact is not caused by the individual farmer but is a result of the sum of activities in a region. This means that legislation is necessary to impose limits in order to arrive at production without pollution. Within this framework, the farmer should optimise the utilisation of minerals from manure by more efficient animal nutrition and better handling of the manure. One of the most difficult problems is the prevention of ammonia evaporation. A reduction of these losses generally also has a favourable effect on odour emissions. A new development is the processing of manure surpluses into a dried manure of sufficient quality to compete on the fertiliser market. As is usually the case with pollution control, these measures raise the costs of livestock production. PMID- 1782423 TI - [Canine excrement in the urban environment: what is the solution?]. AB - With the increase in urban dog populations during the 1960s and 1970s, the problem of canine excreta has become more serious, and has become a typical subject of concern for the urban environment and the quality of life. While there may be a discrepancy between the often controversial treatment of the subject by the media and the actual situation for city dwellers, responsibility lies with the local authorities. This article presents the results of ten years of theoretical study and practical applications, undertaken on behalf of the French Association for Information and Studies on Companion Animals (AFIRAC) by experts from many disciplines: doctors, veterinarians, ethologists, teachers, landscape gardeners, town planners and architects, in collaboration with those responsible for open spaces, roadways, urban cleaning, etc. The results obtained are illustrated by the success of programmes implemented by cities such as Grenoble, Le Havre and Mulhouse, and they have led to the establishment of basic principles designed to solve the problem of canine excreta in the urban environment. Details of these principles are provided: the need for an overall approach to animals in towns, a permanent long-term programme under centralised guidance, suitable regulations complemented by information, education, etc. Next there is an account of sanitary equipment specific for dealing with the problem of canine excreta in the urban environment. Cleaning and general maintenance of such equipment are also discussed. PMID- 1782424 TI - [Wild animals, sentinels of the pollution of the natural environment?]. AB - By following the cycles of contaminants in the environment, it is possible to demonstrate the existence of species particularly sensitive to certain substances through their diet, behaviour or location. Analysis of such situations can lead to the use of the species to provide evidence of the burden of pollution of an ecosystem. The existence of threshold concentrations, above which certain phenomena may occur, strengthens the role of sentinels. Examples are drawn mainly from mammals, birds and fish, and concern radionuclides, plant protection chemicals, petroleum hydrocarbons and heavy metals. The list is by no means exhaustive. PMID- 1782425 TI - [The role of companion animals in the spread of zoonoses of parasitic origin]. AB - This paper provides parasitological data necessary to the epidemiology of the major parasitic zoonoses transmitted by companion animals. Possible modes of contamination of humans are reviewed, along with various factors linked to parasites, host animals and human beings in the spread of zoonoses. PMID- 1782426 TI - Virus survival in the environment. AB - Viruses pass into the environment from clinically ill or carrier hosts; although they do not replicate outside living animals or people, they are maintained and transported to susceptible hosts. Population concentrations and movement, both animal and human, have been steadily increasing in this century, enhancing transmission of respiratory and enteric viruses and compounding the difficulty of preventing environmental transmission. Studies on environmental survival factors of viruses have been most definitive for polioviruses, foot and mouth disease viruses and Aujeszky's disease virus. In addition, heat resistance studies have been reported on adenoviruses, African swine fever virus and the Norwalk virus. Resistance to disinfectants has been studied for many viruses, including picornaviruses, papovaviruses, reoviruses and retroviruses. Survival of viruses in and on a variety of fomites has been studied for influenza viruses, paramyxoviruses, poxviruses and retroviruses. The subacute spongiform encephalopathy agents, under extensive current studies, are being found to have incredible stability in the environment. PMID- 1782427 TI - Pathogenic anaerobic bacteria and the environment. AB - The distribution of pathogenic anaerobes in the environment and the relationship with diseases in animals are discussed. A distinction between the spore-bearing anaerobes (clostridia) and the Gram-negative non-spore-forming anaerobes is necessary. The main habitat of clostridia is the soil but they are also found in dust, sewage, rivers, lakes, sea water, milk, vegetables, fresh meat, fish, insects and the intestinal tract. The Gram-negative non-spore-forming anaerobic bacteria are also widely distributed among animals, principally on mucous membranes of the alimentary tract. After a general introduction and a section on the isolation of anaerobes, the various diseases caused by clostridia (botulism, tetanus, blackleg, malignant oedema, infectious necrotic hepatitis, enterotoxaemia and gas gangrene) and Gram-negative anaerobes (infections due to Fusobacterium and Bacteroides spp., such as diphtheria, footrot, etc.) are discussed. In particular, information concerning the reservoir of the causative agent and the mode of transmission is presented. PMID- 1782428 TI - Salmonellae in the environment. AB - Salmonellae are part of the bacterial flora normally found in Man and animals, although the frequency of occurrence is variable, reflecting the general level of Salmonella in food, water and the environment. They are widely disseminated into environments which have been disturbed by human activities. Wildlife may harbour the organisms but do not appear to be a major conduit by which the organisms enter the human and animal food chain. In areas associated with Man, salmonellae in wild animals and birds reflect the serovars disseminated into the environment. Seasonal changes in infection occur, and the capacity of the organisms to survive in nature varies. Water plays an important role in the spread of the organisms to Man and animals. Control of salmonellae must start with a significant decrease in the number of organisms which are discharged into the environment. PMID- 1782429 TI - Listeria in effluents from the food-processing industry. AB - There is general agreement that listeriosis has a significant impact on Man as well as on animals. Listeria monocytogenes has been isolated from the faeces of healthy human and animal carriers and from various environmental sources. L. monocytogenes is the pathogenic species most responsible for abortion, septicaemia and meningitis in animals and Man. Listeria ivanovii is a primary cause of abortion in animals. Owing to a number of epidemics and single cases caused by food contaminated with L. monocytogenes, listeriosis has received more attention in the past ten years than ever before. Entry of the organism into food processing plants is primarily caused by animals which excrete Listeria in their faeces. Other sources of entry are raw foods of animal origin and personnel in food establishment. Proliferation of Listeria is promoted by high humidity and nutrient waste in certain food production plants. Removal of Listeria is almost impossible by routine disinfection. Listeria-contaminated sites pose a serious risk of recontamination of food-processing equipment and processed foods. Moreover, such sites represent an inexhaustible source of entry for Listeria in plant effluents. There is no denying that effluents from food-processing plants increase the spread of Listeria in the environment. However, considering the existence of other sources of entry, such as human and animal husbandry wastes, and that circulation and recontamination within the environment itself are also possible, this may not be a particularly important risk. PMID- 1782430 TI - Yersinia in effluents from the food-processing industry. AB - Yersinia enterocolitica and Yersinia pseudotuberculosis are current sources of pathogenic strains in humans and animals. Yersiniae infections occur throughout the world, but are most prevalent in regions with moderate and subtropical climates. In Australia, Central Europe and North America, cases of human infections with Yersinia enterocolitica now rank in third place. The food processing industry may influence the epidemiological situation in different ways. Effluents which contaminate the environment may originate from slaughterhouses; e.g. from sewage contaminated with faeces from the lairage or contaminated effluents from the actual slaughter areas. The carcasses may serve as carriers of the organisms to the food-processing plants where they eventually contaminate the processed foods. Rodents and pests may also be carriers. Pathogenic Y. enterocolitica and Y. pseudotuberculosis strains mainly occur in swine and pork. The ability to multiply under refrigeration and in vacuum packaged products means that pathogenic Y. enterocolitica can cause foodborne diseases. If a plant harbours any pathogenic Yersiniae, transfer of the contaminant to the sewage is possible. Although pathogenic Yersiniae from infected animals can survive in sewage and in surface waters, the role of properly treated sewage in the transmission of yersiniosis seems to be of minor importance. If the recommendations for modern slaughter techniques are properly followed, the spread of pathogens in the slaughterhouses and, subsequently, into other food-processing plants can be minimised. PMID- 1782431 TI - Survival of pathogenic micro-organisms and parasites in excreta, manure and sewage sludge. AB - The causative agents of many infectious diseases are excreted by the faecal route and also with other excretions or secretions of the body. Some pathogens are also excreted from clinically healthy animals, from those with latent infections and in cases of transmissible multifactorial diseases. In all types of livestock housing, the pathogens finally reach the floor with the installations for collecting manure as a solid or liquid. Under these conditions livestock owners do not realise that manure may contain pathogens, and therefore do not take precautions against possible spread of diseases by utilisation of manure. The pathogens do not survive very long in stored farmyard manure because of the temperatures and biological and biochemical activities prevailing in the middens. But the conditions in slurry are different because the temperature does not rise and biochemical activity is low. Therefore the pathogens survive for rather long periods in slurry. To avoid disease transfer by utilisation of manure and slurry as fertilisers, certain precautions are necessary and these are described in detail. The agricultural utilisation of municipal sewage sludge is common in many countries. However, these sludges contain pathogens which are excreted by the human population served by the sewers and sewage treatment plants. In the sewage purification processes most of the pathogens are reduced in number but not completely eliminated. They are enriched by sedimentation processes in the sewage sludge. To protect the livestock of farms utilising sewage sludge as fertiliser or for amending soils it is necessary to sanitise hygienically dubious sludges prior to their use. The epidemiological aspects of agricultural sludge utilisation are discussed and details of the available sanitation technologies are given. PMID- 1782432 TI - Effects of wastewater irrigation of pastures on the health of farm animals and humans. AB - Wastewater recycling and reuse through agricultural irrigation can provide an economical means of preventing pollution of surface water sources, while conserving water resources and valuable nutrients for increased crop production and grazing pastures. With proper methods of wastewater treatment, health risks to farmers and farm animals as well as to the public who consume agricultural produce can be prevented. The possibility of transmission of the beef tapeworm Taenia saginata, Salmonella sp. and Mycobacteria sp. to farm animals grazing on wastewater-irrigated pasture is evaluated. While such transmission is possible when raw, untreated wastewater is used for irrigation, the risk is greatly reduced and essentially eliminated with effluent treated to meet the new World Health Organisation (WHO) recommended microbial guidelines for effluent. These guidelines call for one or less helminth eggs per litre and a mean of 1,000 faecal coliform bacteria per 100 ml. In warm climates and where land is available, one of the most economical methods of achieving this standard is the use of multi-cell stabilisation ponds designed for a 25-day detention period. In colder climates and where land is a limiting factor of wastewater treatment, conventional secondary biological treatment followed by disinfection can also be applied to meet this standard. PMID- 1782433 TI - Environmental protection during animal disease eradication programmes. AB - This paper identifies animal disease eradication (ADE) programme activities which may have a negative impact on the environment. It suggests ways to lessen the impact of such activities without compromising the programme objectives. Reducing losses from livestock and poultry diseases with prevention, control and eradication programmes produces a net positive impact on the environment. An Environmental Impact Statement (EIS) should be integrated into the planning of any ADE programme. Decision-makers should give due consideration to the environmental effects of ADE programme activities, together with cost, personnel needs and other, more traditional, management concerns. A better environment will be a supplemental benefit from ADE programmes. PMID- 1782434 TI - [Effect of precurving of canal instruments on their cutting capacity]. AB - The author investigated the surface morphology and the cutting capability of endodontic instruments. One-hundred sixty flexofiles and 160 flexoreamers of various size, of which 40 were pre-curved by hand, 40 using hemostatic tweezers, 40 others were curved with an instrument designed for that purpose, and 40 remained unbent as a sample group, were used in the test. They were tested with a special device to determine the cutting capability. A morphological analysis of the surface was also performed with a stereomicroscope. The conclusions drawn were that pre-curving with hemostatic tweezers reduces the cutting capability by 75% for the flexofiles and by 50% for the flexoreamers doing irreparable damage to the surface structure of the endodontic instruments. PMID- 1782435 TI - [Access cavity for endodontic treatment of anterior teeth]. AB - In this study the authors investigated a group of front teeth, extracted because of the periodontal problems, into which an access cavity have been drilled at the point shown on an x-ray between two straight lines which start at the apex and are tangent to the pulp chamber. These teeth were then horizontally sectioned at the cement-enamel junction to see how much dental substance remained compared to a control group into which a traditional opening had been made through the palatal surface. The result show a greater conservation of dentin when the direct method of opening discussed herein was used. PMID- 1782436 TI - [Evaluation of radiation risk associated with endodontic radiography]. AB - Endodontic patients are sometimes concerned about the risks of tumors or cataracts from radiation exposure during root canal therapy. By using established dose and risk information, we calculated the extent of these risks. The chance of getting leukemia from an endodontic x-ray survey using 90 kVp was found to be 1 in 7.69 million, the same as the risk of dying from cancer from smoking 0.94 cigarettes or from an auto accident when driving 3.7 km. Risk of thyroid gland neoplasia was 1 in 667,000 (smoking 11.6 cigarettes, driving 45 km) and risk of salivary gland neoplasia 1 in 1.35 million (smoking 5.4 cigarettes, driving 21.1 km). Use of 70 kVp radiography reduced these risks only slightly. To receive the threshold dose to eyes to produce cataract changes, a patient would have to undergo 10,900 endodontic surveys. PMID- 1782437 TI - [Mechanical resistance of endodontically treated upper first premolar crowns]. AB - This work shows the results of mechanical strength tests effected over first superior bicuspids before endodontically treated. The Authors show the strength differences, in connection to the access-cavity, between endodontically treated and non-treated teeth. Finally it was found that the demolition of only one marginal ridge reduces the tooth strength to withstand the occlusal forces. PMID- 1782438 TI - [Pulp necrosis following prosthetic-periodontal treatment of vital teeth]. AB - This study investigated the frequency of periapical lesions following pulpal necrosis in vital teeth used as abutments in periodontal-prosthetic therapy. The study was conducted on a continuative series of 1000 teeth treated at least 2 years before the start of the investigation. 500 teeth were treated by specialist and 500 by general practitioners. The dental records of this sample were stored into a computer, analyzed and compared, and the chi-square index was calculated. Periapical lesions were found in 22.6% of the teeth. Maxillary incisors had the highest number of lesions (36.8%). The percentage of lesions increased as periodontal involvement became more severe (37.2%) with severe involvement as opposed to 18.5% with moderate involvement). The frequency of lesions was lower in the group of teeth treated by specialists than in the group treated by general practitioners (13.8% as opposed to 31.4%). PMID- 1782439 TI - [Morphological analysis of lower permanent incisor roots]. AB - Using horizontal sections at various levels and subsequent examination through a stereoscopic microscope, the authors examined 144 roots from the same number of mandibular incisors, in order to determine the number of canals in the coronal third, in the medial third and in the apical third of the root. It was found that 36.1% of the sample displayed multiple root canals. PMID- 1782440 TI - [Root resorption. 1. Etiopathogenesis, diagnosis and clinical manifestations]. AB - The authors, after having thoroughly reviewed the literature regarding all types of root resorption, specifically investigated those of clear endodontic pertinence, and evaluated the etiopathogenesis, the possibility of diagnosis, and the clinical incidence. PMID- 1782441 TI - [Clinical trial of a 15% supermicronized hydroxyapatite gel for dentin hypersensitivity]. AB - In this study the authors investigated the problem of hypersensitivity of the dentin by examining the clinical aspects and therapeutic methods. The authors present the positive results of their study on the effectiveness of a new therapeutic product, a 15% supermicronized hydroxyl apatite gel. PMID- 1782442 TI - [Use of the stereo-microscope in endodontic surgery]. AB - The authors present several significant photographs of the apical anatomy of a tooth made using a stereo-microscope in the course of surgery. The authors generally use the stereo-microscope from the time of preparation of the apex to the retrograde filling. One of the changes which the authors have brought to traditional surgical procedures, the use of endodontic cement to improve the amalgam seal is illustrated. It consists of a modification which they introduced into their practice more than six years ago and even though it may be a simple clinical technique to use, it assured a significant long-term improvement in the cases treated. PMID- 1782443 TI - [Understanding lateral and vertical gutta-percha condensation technique]. AB - After a brief analysis of the materials and of the various techniques for filling root canals, the authors present the results obtained by a group of 5th year dental students of the Corso di Laurea in Odontoiatria e Protesi Dentaria from their first experiences at filling root canals. The techniques they used, lateral and vertical condensation of gutta-percha, were chosen for their widespread use and for the greater guarantee they offer. The results, which confirmed the expectations, show how lateral condensation is easier to perform by dentists with little experience. The vertical condensation technique, judging from our results, should be used only after a dentist has acquired experience and skill, because in the cases we observed there was a consistent unsatisfactory apical closure. PMID- 1782444 TI - Production of fertilizable oocytes. Introduction. PMID- 1782445 TI - The action of transforming growth factors and inhibin-related proteins on oocyte maturation. PMID- 1782446 TI - Construction of the zona pellucida during production of fertilizable mouse eggs. AB - All mammalian eggs are surrounded by a thick extracellular coat, or zona pellucida. Construction of the zona pellucida is an essential step during the production of fertilizable mammalian eggs. Zona pellucida glycoproteins are synthesized exclusively by oocytes during their growth phase and are then assembled in a highly specific manner into a thick extracellular coat. These unique glycoproteins play important roles during mammalian oogenesis, fertilization, and preimplantation development. Consequently, construction of the zona pellucida is a major activity of growing oocytes as they prepare for ovulation and fertilization. PMID- 1782447 TI - [Hormonal regulation of multiple forms of esterase in the mouse epididymis]. PMID- 1782448 TI - Plasminogen activator and inhibin in the human testis. An immunohistochemical investigation. AB - It is generally accepted that Sertoli cells are the main source of active proteins in the human testis, these proteins can act by autocrine and/or paracrine mechanism, modulating both the gametogenic and the endocrine function of the male gonad. As to the Plasminogen Activators (T-PA, U-PA) the immunocytochemical reactivity was detectable in the Sertoli cells and in some Leydig cells. A positivity in spermatocytes and early spermatides appeared to be in relation to the stage of the cycle of the seminiferous epithelium. Inhibin was studied in foetal as well in prepubertal and adult life. The positivity for alpha human and alpha porcine subunits was intense only in the interstitial cells at 12 15 weeks of foetal life. Afterwards the staining was detectable in the Sertoli cells while it decreased in the interstitial cells. In prepubertal life, only the Sertoli cells were stained. In adult life, at the light microscopic level the Sertoli and Leydig cells were positive as well as the spermatocytes. At the electron microscopic level, coated pits and vesicles containing labelled golden particles were shown in both Sertoli cells and spermatocytes, suggesting a paracrine activity of the substance. PMID- 1782449 TI - [Image cytometry of the form and the texture of nuclei of human spermatids and spermatozoa]. PMID- 1782450 TI - [Comparative study of the characteristics of the activity of androgen-dependent protein secretion of the epididymis of the lizard and the mouse]. PMID- 1782451 TI - Immunodissection of sperm surface modifications during epididymal maturation. PMID- 1782452 TI - [Specific proteins of the epididymis of the mouse]. PMID- 1782453 TI - Endocytosis and secretion of proteins in the extratesticular duct system of the adult male rat. PMID- 1782454 TI - [Epithelial cell differentiation in precocious testicular morphogenesis]. AB - Testicular morphogenesis in the rat foetus, requires at least two distinct steps of differentiation. One of these steps is the differentiation of Sertoli cells. This is the first morphological event which allows identification of the male gonad. The other truly morphogenetic step is the acquisition of epithelial characteristics by Sertoli cells: aggregation, polarization, expression of cytokeratin. This step, which is obtained in vitro if gonads are cultured in synthetic medium, is impaired when gonads are cultured in serum-supplemented medium. In both cases Sertoli cells differentiate morphologically and physiologically. Immunohistochemically detectable cytokeratin (monoclonal antibody Lu-5) was found in Sertoli cells incorporated in seminiferous cords either in vivo or in vitro, but not in undifferentiated somatic cells or in Sertoli cells of cordless gonads. These results suggest that the expression of cytokeratin, in the differentiating testis, cannot be considered as a marker of the origin of the cells, but rather is related to the adhesion of Sertoli cells to each other. PMID- 1782455 TI - Mitotic activity of ovine foetal Sertoli cells in vitro: preliminary results. PMID- 1782456 TI - Phagocytosis and endocytosis in Sertoli cells of the rat. PMID- 1782457 TI - Paracrine interactions between the interstitial and the tubular compartment of the testis. AB - In the present paper we will briefly review the role of testicular peptides in the interactions between the tubular and the interstitial compartment. Two interactions are discussed in some more detail. 1) It is shown that the effects of FSH on Leydig cell function may be mediated by at least three types of diffusible mediators produced by Sertoli cells: SCF (a 10-30 kD protein), IGF-I and one or more other still unidentified factors. 2) Evidence is presented that some of the effects of androgens on Sertoli cells may be mediated by diffusible factors produced by peritubular cells and that similar or identical mediators are also produced by prostatic stromal cells. PMID- 1782458 TI - Secretion of epididymal proteins and their interactions with spermatozoa. PMID- 1782459 TI - [Contribution of experimental intersexuality in chickens to the problem of gonadal differentiation and its abnormalities in amniotic vertebrates]. AB - The grafting of embryonic testes to chick embryos realizes an experimental model which is near the spontaneous situation of the cattle "free-martin". It allows to obtain a masculinization of female host embryos developing in some cases up to a total and definitive reversal of sex differentiation. Indeed, it is possible, by this way to obtain testes induced under the influence of substance(s) secreted by the grafts which determine epigenetically a sexual phenotype opposite to the genotype of the host embryos. The analysis of such testis morphogenesis shows that it results from an inhibitory mechanism. Some experimental data strongly suggest to ascribe it to the anti-Mullerian hormone secreted by the graft. The ovotestes and testes observed in adult treated animals present various degrees of development, especially at the level of seminiferous tubules in which the spermatogenesis, when present, may be completed until spermatozoa. Some gonadal abnormalities interesting genetically female human beings, like a majority of the hermaphrodites, or certain XX men, are discussed at the light of these experimental data. PMID- 1782460 TI - [Anti-mullerian hormone and natural and experimental freemartin effect]. AB - To determine whether anti-Mullerian hormone (AMH) is responsible for the gonadal anomalies observed in bovine female "freemartins" united by placental anastomosis to a male twin, fetal rat and ovine prospective ovaries were exposed to purified bovine AMH in organ culture. We show that AMH reproduces the caracteristical "freemartin effect"; namely the initial inhibition of gonadal and germ cell development, and the differentiation of fetal Sertoli cells forming seminiferous cord-like structures and producing immuno and bioactive AMH. In addition, fetal ovine ovaries submitted to AMH release testosterone instead of estradiol due to an inhibiting effect upon the biosynthesis of their aromatase enzyme. Taken together, these results indicate that AMH is probably the testicular factor responsible for the abnormalities of freemartin gonads and suggest that this hormone could play a pivotal role in normal testis differentiation. PMID- 1782461 TI - [Seminar on normal and pathologic gonadal differentiation]. PMID- 1782462 TI - [Germ cells and post-natal development of testicular function: in vitro studies]. AB - Studies in recent years have clearly established that, in addition to the well known endocrine regulation by gonadotrophin hormones, spermatogenesis is under the modulatory control of a complex set of paracrine regulators. Whereas the role of Leydig cells (testosterone) and of Sertoli cells (nurce cells of germ cells) in spermatogenesis has focused most of the attention, until recently little was known about the contribution of germ cells in the spermatogenetic process. This was the aim of the present experiments. We have used, in vitro, 3 complementary approaches; 1) we measured the influence of the removal of germ cells contaminating Sertoli cell cultures by a hypotonic treatment; 2) in coculture, we examined to what extend isolated germ cells could affect Sertoli cell function; 3) we investigated the effects of germ cell conditioned media on Sertoli cell cultures. Our results indicate that germ cells are able to modulate Sertoli cell function in vitro. This germ cell influence varies according to: 1) the germ cell fraction tested (pachytene spermatocytes, early spermatids or cytoplast from elongated spermatids/residual bodies); 2) the parameter of Sertoli cell function studied (inhibition of oestradiol; stimulation of androgen-binding protein, transferrin...); 3) the age of the Sertoli cell donors; 4) the hormonal environment (+/- FSH). Furthermore we wave demonstrated that germ cell effects were partly at least mediated via proteinaceous factor(s) detected in germ cell spent media. Taking into account previous in vivo studies and these in vitro results, we have hypothesized that germ cells, in conjunction with hormones (LH, FSH, testosterone) play an important role in the ontogenesis of Sertoli cells and therefore in spermatogenesis. PMID- 1782463 TI - [Clinical aspects of gonadal dysgenesis]. AB - Gonadal dysgenesis are classified according to the aspect of external genitalia. The group with female genitalia includes Turner's syndrome, and "pure" dysgenesis; the group with male genitalia involves Klinefelter's syndrome, XX males and may be anorchia; the group with ambiguous genitalia includes "mixed" gonadal dysgenesis, true hermaphroditism and Leydig-cell agenesis. An algorythmic approach to patients with ambiguous external genitalia is presented in order to distinguish between gonadal dysgenesis and male or female pseudohermaphroditism. PMID- 1782464 TI - [Gonadal dysgenesis and agenesis: anatomical expression]. AB - The term of gonadal dysgenesis designates generically any anatomical alteration due to abnormal embryological development of a gonad. The spectrum of these gonadal abnormalities is large and includes the following entities: The gonadal agenesis is characterized by a rudimentary streak gonad. It is composed of a dense, hyalinized fibrous tissue in which the germ cells or the germ structures are entirely missing. Usually the gonadal dysgenesis is a bilateral and symmetrical lesion. The gonadal dysgenesis is characterized by the presence of residual germ structures (follicles or tubules). These structures can be more or less easily identified within a dense fibrous tissue. The gonadal dysgenesis alterations are often unilateral and always asymmetrical. Usually the ipsilateral gonad is a testis. The ovotestis is characterized by the coexistence within the same gonad of differentiated germ structures. Most commonly, the gonadal dysgenesis are associated with sexual chromosome abnormalities and an increased risk of neoplastic change (gonadoblastoma). This risk can reach 30% in the asymmetrical gonadal dysgenesis. PMID- 1782465 TI - The pig zona pellucida--composition and sperm receptors. PMID- 1782466 TI - Induction of maturation of rat oocytes by interruption of communication in the cumulus-oocyte complex. PMID- 1782467 TI - Superovulation in cattle: effects of purity of FSH preparation on follicular characteristics in vivo. AB - When cattle were superovulated with an FSH preparation containing no detectable LH (FSH-W), more viable embryos were recovered as compared with a standard preparation containing LH (FSH-P), with no change in the total number of ova + embryos recovered (Donaldson et al., 1986). To determine the basis for the increased embryo viability, we compared numbers of developing follicles and concentrations of estradiol in their follicular fluid at two times during the course of superovulatory treatment with FSH-P vs. FSH-W. Holstein heifers (n = 10/group) were injected with 3.5 mg of FSH-P or FSH-W twice daily beginning on Day 9 of the estrous cycle. Animals were ovariectomized either 48 h (Group 1) or 72 h (Group 2) after the initiation of treatment; heifers in Group 2 were also given a luteolytic injection of prostaglandin F2 alpha 24 h before ovariectomy. All follicles greater than S mm in diameter were dissected from the ovaries and follicular fluid was aspirated and stored frozen. Heifers injected with FSH-W had more follicles greater than 5 mm than heifers treated with FSH-P (21 + 4 vs. 11 + 3 in Group 1 and 28 + 5 vs. 20 +/- 5 in Group 2, respectively; p less than 0.05) and a significantly greater percentage of follicles from FSH-W animals were healthy (estrogen-active; 99 vs. 85% in Group 1 and 98 vs. 89% in Group 2, respectively; p less than 0.025). Estradiol concentrations in follicular fluid were more strongly correlated (p less than 0.001) with follicular size when heifers were treated with FSH-P vs. FSH-W.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782469 TI - Intermediate filaments in oocytes. PMID- 1782468 TI - Regulation of processes involved in mammalian oocyte maturation. PMID- 1782470 TI - Development of immature bovine oocytes into viable embryos in vitro. PMID- 1782471 TI - [Genetic factor of sex determination]. AB - We have analyzed 40 cases of human XX male or XX true hermaphrodites negative for Y DNA sequences including ZFY. Among these patients we were able to demonstrate the existence of at least 3 mechanisms. 1) In one case a mosaiscism 46XY/46XX is limited to the gonad and only detected by PCR. 2) Familial cases compatible with the mutation of an autosomal (or pseudo-autosomal) down stream sex determining gene. 3) We finally observed 5 cases lacking ZFY meanwhile carrying Y specific sequences near to the pseudo-autosomal boundary, redifining the region where TDF must lie. PMID- 1782472 TI - Reproductive implications of responses of the cumulus to the ovulatory surge. PMID- 1782473 TI - [Oocyte production and quality]. PMID- 1782474 TI - Roles of protein synthesis in the control of chromosome behavior during egg maturation and activation. PMID- 1782475 TI - Cell to cell communication in the cumulus-oocyte complex and cytoplasmic maturation in pig oocytes. PMID- 1782476 TI - Microstructural events of human egg investments during in vitro fertilization. Ultrastructure of the zona pellucida and cumulus oophorus. PMID- 1782477 TI - Developmental capacity acquisition requires exposure of uncondensed chromosomes before maturation of bovine oocytes. AB - Immature bovine oocytes are forming an heterogeneous population since only one third of all morphologically normal cumulus-oocyte-complexes will result in a developing embryo after in vitro culture. To increase developmental competence, it is essential to improve the quality of the 2/3 not responding to the in vitro maturation context. To achieve this goal we can address the cytoplasmic domain or the nucleus capacity to control future events leading to normal fertilization and development. To influence for example the quantity and quality of RNA present at meiotic resumption (MR), we need access to uncondensed chromatin before that period. Maintenance of the germinal vesicle for a minimum of 24 h can be achieved with protein synthesis or phosphodiesterase (PI) inhibitors or with cAMP accumulation at a level higher that the one required in the cumulus-granulosa portion to stimulate MR. It is suspected that in vivo, the granulosa layer is responsible for the arresting signal since follicular fluid (BFF) alone is not sufficient for a complete effect in vitro. Low concentrations of granulosa cells in vitro (10(6)/ml) stimulate MR but monolayers with their conditioned medium provide inhibitory conditions (33% GV) to oocytes adhering to the monolayers. To achieve a complete meiotic arrest for 24 h (greater than 75% GV), a high concentration of granulosa cells must be used (10(7)/ml). The embedding of cumulus-enclosed oocytes in agar prior to culture with the cells prevents the significant effect of the cells on MR indicating either a need for contact stimulation or a very labile product.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782478 TI - Effects of puromycin and 6-DMAP on mouse oocyte maturation. PMID- 1782479 TI - Apparent polycythaemia. AB - Patients with apparent polycythaemia are characterised by a raised packed cell volume (PCV; males above 0.51, females above 0.48) but normal red cell mass (RCM; less than 25% greater than predicted). Prediction and interpretation of RCM and PV should be based on height and weight, since the use of body weight alone is misleading. Patients with PCV values up to 0.60 may have apparent polycythaemia but only 18% have a reduced PV (relative polycythaemia). Therefore, the most common cause of the raised PCV is a change in RCM and/or PV within their normal ranges. The clinical associations and possible causes for the RCM/PV changes include male sex, obesity, dehydration, diuretics, smoking, hypertension, alcohol, arterial oxygen desaturation, renal disease and increased catecholamine levels. Retrospective studies of patients with apparent polycythaemia and information from other groups of polycythaemic patients suggest an increased risk of vascular occlusion, although other factors, such as hypertension and smoking, are also involved. Proposed management includes modification of possible underlying causes and examination for risk factors for vascular occlusion. In patients with PCV levels chronically above 0.54 venesection should be used, but patients with PCV values below this level should only be venesected if they are considered to be at risk of vascular occlusion. The suggested target value for PCV for venesected patients is 0.45 or below. PMID- 1782480 TI - The place of radiotherapy in stage I and IIA Hodgkin's disease (or radiotherapy revisited). AB - For the majority of patients presenting with early Hodgkin's disease, the chance of death due to their disease is related to prognostic factors, e.g. age, systemic symptoms, ESR bulk, number of sites of disease, histology, haemoglobin, lymphocyte count etc. More than 50% of those with Stage I and IIA disease fall into an intermediate prognostic category where a variety of initial treatment strategies--chemotherapy alone (CT), radiotherapy alone (RT) or a combination of chemotherapy and radiotherapy (combined modality therapy CMT) result in comparable survival rates. There is therefore increasing emphasis on incidence of relapse and treatment related morbidities rather than on survival alone when evaluating the role of different treatment for Hodgkin's disease. Radiotherapy has an essential part to play in any initial strategy aiming to keep relapse rate low, as chemotherapy alone has been demonstrated to be less effective in treating macroscopic disease. Late side-effects associated with radiation are largely associated with obsolete techniques involving very wide fields, high doses and large fraction size delivered to anterior structures within the thorax. The risk of second solid tumour appears related to the volume of radiation fields and the risk of cardiac damage is probably related to both total dose and dose per fraction delivered. There is still uncertainty as to the potential late toxicity of modern techniques, particularly in combination with chemotherapy. Increasingly numbers of patients are likely to be treated with initial CMT rather than RT alone to reduce relapse rates. The risk of leukaemia associated with CMT to patients with curable Hodgkin's disease appears to have been overestimated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782481 TI - Treatment of resistant acute myeloid leukemia. AB - Although combination cytotoxic chemotherapy induces complete remission in 60-80% of adults with previously untreated acute myeloid leukemia, most patients will ultimately relapse and die from leukemia. Strategies which have been developed for patients with relapsed leukemia include the use of active non-cross-resistant chemotherapeutic agents, allogeneic or autologous bone marrow transplantation, or combined sequential therapy with hematopoietic growth factors and chemotherapy. Most salvage chemotherapeutic regimens use high-dose cytarabine; other agents which have activity include idarubicin, mitoxantrone, etoposide, and high-dose cyclophosphamide. Bone marrow transplantation represents the preferred approach for patients with resistant leukemia offering a likelihood of prolonged disease free survival. Unique combinations of high-dose chemotherapy and growth factors may provide an alternative therapeutic role in the treatment of resistant leukemia. PMID- 1782482 TI - Management of thrombophilia in pregnancy. AB - Thromboembolism remains a major cause of maternal morbidity and mortality. The incidence of thrombosis associated with pregnancy is stated to be around 0.09%1 but is greater in women with familial or acquired thrombophilia. Around 50% of pregnancies in women with antithrombin III deficiency are complicated by thrombosis. Anticoagulation throughout pregnancy and the puerperium is recommended in women with antithrombin III deficiency. Because thrombosis is less common in women with protein C or protein S deficiency less aggressive management may be appropriate during pregnancy but anticoagulation post partum is generally recommended. The most important acquired thrombophilic abnormality is the development of antiphospholipid antibodies ('lupus anticoagulants'). Women with these antibodies may present major problems but no clear guidelines for their management currently exist. The majority of women with a history of thrombosis have no identifiable haemostatic abnormality. Management of pregnancy in these patients depends on individual circumstances. PMID- 1782483 TI - Fibrin glue. AB - Fibrin glue is a topical biological adhesive, the effect of which imitates the final stages of coagulation. The glue consists of a solution of concentrated human fibrinogen which is activated by the addition of bovine thrombin and calcium chloride. The resultant clot aids haemostasis and tissue sealing and is completely absorbed during wound healing without foreign body reaction or extensive fibrosis. The fibrinogen component of fibrin glue can be produced from fresh frozen plasma obtained from single unit donations thereby reducing the risks of transfusion transmitted infections encountered by exposure to pools from large numbers of donors. Methods involving precipitation of fibrinogen by cryoprecipitation, polyethylene glycol or ammonium sulphate have been described and evaluated. The risk of transmission of infection can be further reduced by using plasma from 'accredited donors' who are plasma donors regularly tested for ALT and markers of viral infection or by use of fibrinogen prepared in advance of surgery from autologous blood. The second component, a mixture of thrombin and CaCl2, is quantitatively and qualitatively well defined and commercially available (Armour Pharmaceutical Co., Thrombinar (bovine thrombin]. Thrombin is applied to the operation site simultaneously and in equal volume to the fibrinogen but from a separate syringe. In the UK a commercial heat treated fibrin glue prepared from pooled plasma is available on a doctor/named patient basis (Tisseel, Immuno, Vienna). The haemostatic and adhesive properties of fibrin glue can be employed in virtually every surgical specialty. The usefulness of the glue is particularly well documented in the fields of cardiovascular surgery, ENT and neurosurgery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782484 TI - Human plasma fractionation and the impact of new technologies on the use and quality of plasma-derived products. AB - Recent years brought several important changes in the domain of human plasma derived products. High purity and effective anti-viral treatment became a reality. This radically improved the quality of patient treatment. At the same time recent discoveries in molecular biology paved the way for the production of several crucial plasma components by recombinant technology. In the light of these developments the future possibilities for different plasma components production is widely discussed and the eventual benefit of more expensive technologies is being evaluated. This paper, analyzes and presents methods applied by different producers to obtain plasma derived components preparations. The impact of these technologies, the quality of the products and the future of the plasma industry is being discussed. PMID- 1782485 TI - Liposomes in haematology. AB - Liposomes were first described nearly a quarter of a century ago and have been useful models for studying the physical chemistry of lipid bilayers and the biology of the cell membrane. It was also realised that they might be used as vehicles for the delivery of drugs but clinical applications have been slow to emerge. Proposed clinical uses have included vaccine adjuvancy, gene transfer and diagnostic imaging but the major effort has been in the development of liposomes as targetable drug carriers in the treatment of malignancy. Although based on good in vitro data and animal studies, the strategies have been mostly impractical due to the predominant but unwanted uptake by the reticuloendothelial system and the limited extent of extravasation. The same features have nonetheless been turned to advantage in the case of amphotericin B which has recently become the first liposomally formulated agent to be licensed for parenteral use. Liposomal doxorubicin is currently also being evaluated in clinical trials. The early evidence suggests that while liposomal encapsulation may not greatly enhance their efficacy the toxicity of these agents is greatly attenuated. PMID- 1782486 TI - Choice and chance in low risk maternity care. PMID- 1782487 TI - Injuries from land mines. PMID- 1782488 TI - Survey of "do not resuscitate" orders in a district general hospital. AB - OBJECTIVE: To evaluate the local use of written "Do not resuscitate" orders to designate inpatients unsuitable for cardiopulmonary resuscitation in the event of cardiac arrest. DESIGN: Point prevalence questionnaire survey of inpatients' medical and nursing records. SETTING: 10 acute medical and six acute surgical wards of a district general hospital. PARTICIPANTS: Questionnaires were filled in anonymously by nurses and doctors working on the wards surveyed. MAIN OUTCOME MEASURES: Responses to questionnaire items concerning details about each patient, written orders not to resuscitate in the medical case notes and nursing records, whether prognosis had been discussed with patients' relatives, whether a "crash call" was perceived as appropriate for each patient, and whether the "crash team" would be called in the event of arrest. RESULTS: Information was obtained on 297 (93.7%) of 317 eligible patients. Prognosis had been discussed with the relatives of 32 of 88 patients perceived by doctors as unsuitable for resuscitation. Of these 88 patients, 24 had orders not to resuscitate in their medical notes, and only eight of these had similar orders in their nursing notes. CONCLUSIONS: In the absence of guidelines on decisions about resuscitation, orders not to resuscitate are rarely included in the notes of patients for whom cardiopulmonary resuscitation is thought to be inappropriate. Elective decisions not to resuscitate are not effectively communicated to nurses. There should be more discussion of patients' suitability for resuscitation between doctors, nurses, patients, and patients' relatives. Suitability for resuscitation should be reviewed on every consultant ward round. PMID- 1782489 TI - Parathyroid hormone related protein and hypercalcaemia in breast cancer. AB - OBJECTIVE: To see whether parathyroid hormone related protein has a humoral role in breast cancer. DESIGN: Plasma concentrations and tumour expression of parathyroid hormone related protein were determined (by two site immunoradiometric assay and immunohistochemistry respectively) in women with breast cancer and related to the presence of bone metastases and serum calcium concentrations. SUBJECTS: Plasma concentrations of parathyroid hormone related protein were measured in 57 women with early breast cancer without apparent bone metastases, 28 women with bone metastases, and 13 women with bone metastases and hypercalcaemia. Tissue positivity for parathyroid hormone related protein was determined retrospectively in 106 primary breast tumours from women without apparent bone metastases and 72 tumours from women with bone metastases, 25 of whom subsequently developed hypercalcaemia. RESULTS: Plasma parathyroid hormone related protein concentrations were detectable (greater than 0.23 pmol/l) in 12 (92%) of the 13 hypercalcaemic patients with bone metastases compared with 10 (36%) of the 28 normocalcaemic patients with bone metastases and five (9%) of the 57 normocalcaemic patients without bone metastases. Parathyroid hormone related protein concentrations were significantly higher in hypercalcaemic than normocalcaemic patients with bone metastases. Tumour staining was positive for parathyroid hormone related protein in 22 (88%) of the 25 primary breast cancers from patients with bone metastases. Tumour staining was positive for parathyroid hormone related protein in 22 (88%) of the 25 primary breast cancers from patients with bone metastases who later developed hypercalcaemia compared with 25 (53%) of the 47 from women in this group who remained normocalcaemic and 55 (52%) of the 106 early breast cancers from women without known metastases. CONCLUSION: Tumour derived parathyroid hormone related protein may have an important humoral role in hypercalcaemia associated with metastatic breast cancer. PMID- 1782491 TI - Social and functional impact of minor fractures in elderly people. PMID- 1782490 TI - Dogs that bite. AB - OBJECTIVE: To study the circumstances of dog bites and identify risk factors. DESIGN: Postal questionnaire survey and case note review of victims of dog bites referred between 1982 and 1989. SETTING: One referral based regional plastic surgery unit. PATIENTS: 146 consecutive patients referred for primary treatment of dog bites, for whom current addresses were available for 133, 107 (81%) of whom returned the questionnaire. RESULTS: The male to female ratio was 74:72; 79 (54%) patients were aged below 15 years. The commonest dogs producing bites were Staffordshire bull terriers (15 cases), Jack Russell terriers (13), medium sized mongrels (10), and Alsatians (nine). 82 of 96 (85%) dogs were male. 29 of 47 (62%) adults were bitten at home and 45 of 60 (75%) children at a friend's, neighbour's, or relative's house. 91 of 107 (85%) bites occurred in the dog's home. Bites occurred during playing with 13 (12%), petting 14 (13%), or waking 16 (15%) dogs. 45 (42%) bites were judged as unprovoked. 32 bites were identified as severe and 11 attacks as sustained. CONCLUSIONS: Most victims are bitten by male dogs which they either own or have had frequent contact with, and the bite occurs in the dog's home. PMID- 1782492 TI - Transmission of Plasmodium falciparum by heart transplant. PMID- 1782493 TI - What happens to patients with non-vascular leg pain? PMID- 1782494 TI - Outcome of planned home births in an inner city practice. AB - OBJECTIVE: To assess the outcome of pregnancy for women booking for home births in an inner London practice between 1977 and 1989. DESIGN: Retrospective review of practice obstetric records. SETTING: A general practice in London. SUBJECTS: 285 women registered with the practice or referred by neighbouring general practitioners or local community midwives. MAIN OUTCOME MEASURES: Place of birth and number of cases transferred to specialist care before, during, and after labour. RESULTS: Of 285 women who booked for home births, eight left the practice area before the onset of labour, giving a study population of 277 women. Six had spontaneous abortions, 26 were transferred to specialist care during pregnancy, another 26 were transferred during labour, and four were transferred in the postpartum period. 215 women (77.6%, 95% confidence interval 72.7 to 82.5) had normal births at home without needing specialist help. Transfer to specialist care during pregnancy was not significantly related to parity, but nulliparous women were significantly more likely to require transfer during labour (p = 0.00002). Postnatal complications requiring specialist attention were uncommon among mothers delivered at home (four cases) and rare among their babies (three cases). CONCLUSIONS: Birth at home is practical and safe for a self selected population of multiparous women, but nulliparous women are more likely to require transfer to hospital during labour because of delay in labour. Close cooperation between the general practitioner and both community midwives and hospital obstetricians is important in minimising the risks of trial of labour at home. PMID- 1782495 TI - A form to help learn and teach about assessing medical audit papers. PMID- 1782496 TI - Audit activities in Australia. PMID- 1782497 TI - Interim guidelines on confidentiality and medical audit. Conference of Medical Royal Colleges and their Faculties in the United Kingdom. PMID- 1782498 TI - Identifying "high risk situations" for preventing AIDS. PMID- 1782499 TI - Needs assessment, priority setting, and contracts for health care: an economic view. PMID- 1782500 TI - James Scott: next professor of medicine at the Hammersmith. Interview by Richard Smith. PMID- 1782501 TI - Medical manpower. PMID- 1782502 TI - ABC of vascular diseases. Epidemiology of atherosclerosis. PMID- 1782503 TI - Caring for larger lists. PMID- 1782504 TI - Oral iron chelation is here. PMID- 1782505 TI - Peak bone mass and bone loss in postmenopausal osteoporosis. PMID- 1782506 TI - Orthopaedic surgeons and thromboprophylaxis. PMID- 1782507 TI - Randomized clinical trials in clinical practice. PMID- 1782508 TI - Manslaughter convictions for making mistakes. PMID- 1782509 TI - Doctors and the Children Act. PMID- 1782510 TI - Assault after ingestion of antidepressant. PMID- 1782511 TI - Rugby injuries. PMID- 1782512 TI - Adolescent smokers seen in general practice. PMID- 1782513 TI - Bell ringers' bruises and broken bones. PMID- 1782514 TI - Rationing: at the cutting edge. PMID- 1782515 TI - Individual differences in cognitive processes: towards an explanation of schizophrenic symptomatology. AB - A study is reported that examined the relationship between a measure of schizophrenic-like characteristics (schizotypy) in normal subjects and cognitive inhibition. Both repetitive and semantic measures of priming were used. It was found that low schizotypes showed negative priming (i.e. longer reaction times to the re-presentation of initially ignored stimuli) while high schizotypes did not; high schizotypes exhibited semantic facilitation (i.e. shorter reaction times to previously ignored stimuli) but low schizotypes did not. A model is suggested, including both inhibitory and facilitatory processes, which can account for these findings. Theorizing about these processes is of interest as it may shed some light on the mechanisms involved in the specifically cognitive symptoms of schizophrenia. PMID- 1782516 TI - Daily hassles and mental health: a longitudinal study. AB - This paper examines the effects of daily hassles and coping styles on mental health in a prospective longitudinal study of a community sample. It was found that daily hassles correlated with psychological symptoms, even after previous symptom levels were controlled. Early experience of hassles influenced later coping practice, and direct coping was more adaptive than suppression in coping with daily hassles. PMID- 1782517 TI - The psychological impact of unemployment and unsatisfactory employment in young men and women: longitudinal and cross-sectional data. AB - Data are presented from the seventh wave of a longitudinal study of school leavers that commenced in 1980. Four groups were compared: satisfied employed, dissatisfied employed, unemployed and full-time tertiary students. The groups differed initially with respect to only one background variable, teacher-rated academic potential, and did not differ on any of the psychological measures of well-being. In general, the unemployed and dissatisfied employed groups displayed poorer psychological well-being than the satisfied employed and student groups on a range of measures. The longitudinal data suggested that this was because the two disadvantaged groups showed smaller improvements than the others, rather than any deterioration. The results also suggested that for the males unemployment was worse than unsatisfactory employment, but that for the females unsatisfactory employment was worse than unemployment. PMID- 1782518 TI - Children's perception of safety and danger on the road. AB - This study investigates the ability of children between 5 and 11 years to select safe places to cross the street. The children were presented with situations which were either extremely safe or manifestly dangerous and were asked to correctly identify these. In other cases, they were asked to choose for themselves routes across the road which they thought would be safe. The tasks were presented in various ways: by means of a table-top simulation on which traffic scenarios had been contrived; by means of photographs of road situations; and by taking the children to real-world sites in the streets near their schools. All the experiments showed a similar pattern of results. Five- and 7-year-olds exhibited very poor skill in identifying dangerous road-crossing sites. Their judgments relied exclusively on the visible presence of cars in the vicinity. Other factors such as blind summits, obscuring obstacles or complex junctions were never recognized as threatening situations. They also showed an unwillingness to make detours when planning their own routes, even where the direct route was manifestly dangerous. Nine-year-olds showed a higher level of ability and 11-year-olds showed quite good skill in these judgements. No sex differences were apparent. These results suggest that young children up to about 9 years must often be at considerable risk as they do not have the ability to recognize a location as dangerous, even if they know the mechanics of the Green Cross Code. The implications for road safety education are discussed. PMID- 1782519 TI - Inhibitory mechanisms of attention: locus, stability, and relationship with distractor interference effects. AB - This paper examines three properties of attentional inhibition mechanisms. First, previous research has suggested that the inhibitory mechanism of selective attention has a central locus between perception and action. We attempt to confirm the locus of this inhibition. Second, the processing of an unattended stimulus has been observed via the effects of the stimulus on a concurrent target (interference), and on a subsequent target (negative priming). The former effect demonstrates that distractors interfere with the processing of the target, and the latter negative priming effect implies that distractors are inhibited during selection. We demonstrate that these two measures of unattended processing can be dissociated. Third, we reveal that inhibition appears to be a stable mechanism of selection, in that effects do not decline after a large number of experimental trials. PMID- 1782520 TI - The politics of welfare policy in Sweden: structural determinants and attitudinal cleavages. AB - The article analyzes attitudes to Swedish welfare policies, using data from a survey conducted in 1986. In the first section, a number of indices tapping various aspects of attitudes to welfare policy are constructed. In the second section these indices are used to give an empirical assessment of competing theories about the impact of different structural determinants on attitudes. It is concluded (a) that there is general support for Swedish welfare policies, which, however, is mixed with criticisms of bureaucracy and suspicion about abuse of welfare programs, and (b) that class position and 'class-related' determinants such as income are more important than factors such as gender, private or public sector location or consumption groups in structuring attitudes. In the concluding section, these findings are discussed in relation to recent theorizing about newly emerging lines of division in the population. It is argued that either Sweden must be seen as a deviant case, which for specific historical and institutional reasons is characterized by class conflicts rather than other sectional splits, or the theories about new lines of division are simply mistaken. PMID- 1782521 TI - Metabolic patterns associated with non-specific magnetic resonance imaging abnormalities in temporal lobe epilepsy. AB - We investigated the cerebral metabolic patterns associated with non-specific hyperintense T2-weighted image on Magnetic Resonance Imaging (MRI) in Temporal Lobe Epilepsy (TLE). Nineteen patients suffering from TLE with a normal CT scan underwent Positron Emission Tomography (PET) using 18F-fluorodeoxyglucose; 8 had hyperintense T2-weighted image on MRI in the epileptogenic temporal lobe and 11 had a normal MRI. Interictally, PET exhibited focal hypometabolism in all the patients with hyperintense T2-weighted image and in 8 of the 11 whose MRI was normal. The hypometabolic area was significantly more extensive in patients with hyperintense T2-weighted image in whom it always encompasses the site of the MRI abnormality. Moreover, these patients had higher metabolic asymmetry index in the temporal and parietal lobes than patients with a normal MRI. One patient with mesial temporal hyperintense T2-weighted image underwent an ictal PET, which showed that the focal hypermetabolism fitted remarkably with the site and size of the abnormal MR signal. Thus, non-specific hyperintense T2-weighted images are associated with particular interictal and ictal metabolic patterns which might suggest that these MRI abnormalities reflect an epileptogenic lesion. PMID- 1782522 TI - 'So-called' cortical deafness. Clinical, neurophysiological and radiological observations. AB - Two patients with severe, persistent hearing loss caused by bilateral cerebral lesions are described. To determine the location of lesions responsible for the severe hearing loss, we examined magnetic resonance images and compared the lesions in these 2 patients with those in another with only mild hearing loss following extensive bilateral temporoparietal lesions. The extent of bilateral damage to the white matter adjacent to the posterior half of the putamen proved crucial in determining the severity of the hearing loss. Hearing loss was more severe when the white matter immediately ventral and lateral to the posterior half of the putamen was involved bilaterally. Based on this observation and from a review of the literature, we infer that the auditory radiations in humans course in a dense tract from the medial geniculate body up to the sublenticular region, and disperse from there to the primary auditory cortex as well as to the other auditory-related areas, partly by coursing through the white matter immediately ventral to the posterior half of the putamen, and partly by penetrating the ventral and lateral portions of the posterior half of the putamen. Accordingly, bilateral lesions in the white matter ventral and lateral to the posterior half of the putamen appear to interrupt all the projection fibres from the medial geniculate bodies to the auditory-related areas, resulting in severe, persistent hearing loss. PMID- 1782523 TI - Role of the right temporal neocortex in retention of pitch in auditory short-term memory. AB - In order to investigate the neural mechanisms underlying short-term memory for auditory information, 71 patients who had undergone focal excision from the left or right temporal or right frontal or fronto-temporal area for the relief of intractable epilepsy were tested, together with 18 normal control subjects, on a task requiring short-term retention of tonal pitch. In the control condition, a target tone was presented, followed 1650 ms later by a comparison tone, and subjects determined whether the two had the same pitch or not. In the interference condition a series of interpolated tones was presented between target and comparison tone. Results indicated that there was no significant impairment in any patient group on the control task. In the interference task there was a significant deficit in retention of tonal information in the patients with right temporal-lobe damage, as well as in those with lesions in the right frontal lobe, and in the right frontal and temporal area. Patients with left temporal-lobe excisions did not demonstrate a significant deficit. These findings are in agreement with research on non-human primates suggesting that structures in the superior temporal gyrus are important in retaining auditory information over short time spans, and further indicate that the human right temporal area is specialized for this function. PMID- 1782524 TI - The visual defect in multiple sclerosis and optic neuritis. A combined psychophysical and electrophysiological investigation. AB - Chromatic and achromatic visual function were investigated using psychophysical and evoked potential techniques in 32 patients with multiple sclerosis (MS) or optic neuritis. There was no evidence for either chromatic or achromatic vision being selectively damaged. There was, however, some evidence that demyelination of the optic nerve causes a visual defect in which the transmission of high temporal frequencies is imparied. In some patients either a red or blue deficit was evident, but overall there was no evidence of a wavelength specific colour vision defect in our patient group. Reduction of chromatic sensitivity as determined psychophysically had a statistically significant correlation with the amplitude and latency of the chromatic visual evoked potential. PMID- 1782525 TI - The pathophysiology of acute optic neuritis. An association of gadolinium leakage with clinical and electrophysiological deficits. AB - Eighteen patients with acute optic neuritis underwent optic nerve magnetic resonance imaging (MRI) before and after injection of gadolinium-diethylene triamine pentacetic acid (Gd-DTPA). Ten were re-examined 4 weeks later. Leakage of Gd-DTPA across the blood-optic nerve barrier was a consistent finding in the acute lesion, and its presence was associated with abnormal visual acuity and colour vision, retro-ocular pain on eye movement, and afferent pupillary defect, and a reduced amplitude of the P100 component of the visual evoked potential. Gd DTPA leakage had ceased in 9/11 nerves when restudied 4 wks later, and this evolution was associated with improved visual acuity and an increased P100 amplitude. Leakage is likely to reflect inflammation, and we conclude that the latter plays an important part in the production of conduction block and clinical deficit, and that its resolution is an important step in clinical remission from acute episodes of demyelination. PMID- 1782526 TI - Origin of the secondary increase in firing probability of human motor neurons following transcranial magnetic stimulation. Studies in healthy subjects, type I hereditary motor and sensory neuropathy and multiple sclerosis. AB - In tonically active human motor neurons serving upper limb muscles there is a late rise in firing probability following transcranial magnetic stimulation termed the secondary peak (SP). The aim was to study the mechanism of SP and the pathway that mediates it. For this purpose, the response to transcranial magnetic stimulation of 62 repetitively firing low threshold single motor units from upper limb muscles was studied with peri-stimulus time histograms in 8 healthy subjects and in 13 patients with either Type I hereditary motor and sensory neuropathy (HMSN) or multiple sclerosis (MS). Separate peri-stimulus time histograms, constructed for trials in which the motor unit fired in the primary peak (PP) and those in which it fired in SP, showed that SP was not caused by a resumption of firing after the preceding PP. In the first dorsal interosseous muscle, the observed increase in the interval between PP and SP in patients with either HMSN or MS, when compared with healthy subjects, suggested that the pathway mediating SP had both peripheral and central components. Evidence for a peripheral component was substantiated by the observed slope of the line relating the latency of SP in different upper limb muscles to peripheral conduction distance, which was more than 3 times greater than that for PP, and by comparisons in the same motor unit made between the latency of responses to finger taps and to transcranial magnetic stimulation. Evidence for the origin of SP was consistent with a long loop reflex, or with collateral activation of gamma motor neurons and subsequent motor neuron firing from muscle afferent inputs. SP discharges were found to occur earlier than expected on the basis of the spontaneous motor unit firing rate, suggesting that SP was caused by the rising phase of an excitatory post-synaptic potential, rather than by the decay of an inhibitory postsynaptic potential. PMID- 1782527 TI - Potentials evoked in human and monkey cerebral cortex by stimulation of the median nerve. A review of scalp and intracranial recordings. AB - Somatosensory evoked potentials (SEPs) are generated in afferent pathways, subcortical structures and various regions of cerebellar and cerebral cortex by stimulation of somatic receptors or electrical stimulation of peripheral nerves. This review summarizes current knowledge of SEPs generated in cerebral cortex by stimulation of the median nerve, the most common form of stimulation for human research and clinical investigations. Major sources of data for the review are intracranial recordings obtained from patients during diagnostic or neurosurgical procedures, and similar recordings in monkeys. Short-latency cortical SEPs in the 20-40 ms latency range consist of P20 and N30, recorded from motor cortex and frontal scalp; P25 and N35, recorded from cortex near the central sulcus and central scalp; and N20 and P30, recorded from somatosensory cortex and parietal scalp. Several lines of evidence including cortical surface and intracerebral recordings, neuromagnetic recordings and lesion studies in humans and monkeys, strongly support the conclusion that these potentials are generated in contralateral somatosensory cortex in areas 3b and 1, in contrast to the conclusion of many previous studies that SEPs recorded from the frontal scalp are generated in motor cortex and other frontal lobe areas. These potentials are primarily mediated by cutaneous afferents of the dorsal column-medial lemniscal system; the contribution of muscle afferents has not been completely resolved but appears to be small. There is currently no evidence that short-latency SEPs are generated in cortex other than primary somatosensory cortex. Recordings from the vicinity of the second somatosensory area, from the supplementary motor and sensory areas and from surface cortex other than sensorimotor cortex have not detected reliable short-latency activity, although some of these regions generate long-latency potentials. Consequently, short-latency SEPs recorded from the scalp are similar to those recorded from the surface of sensorimotor cortex. Old World monkeys such as Macaca mulatta and M. fascicularis provide an excellent model for human short-latency SEPs. All the potentials described above in humans have corresponding monkey analogues, with similar distributions over the cortical surface. The squirrel monkey, a New World species, exhibits the same potentials, but due to the different morphology of sensorimotor cortex, the surface distribution of SEPs is quite different. PMID- 1782528 TI - Paraesthesias are elicited by single pulse, magnetic coil stimulation of motor cortex in susceptible humans. AB - A minority of normal humans experience paraesthesias (usually tingling) projected to the contralateral hand in response to individual transcranial magnetic coil (MC) pulses. The cortical source of the paraesthesias was sought by comparing their incidence with that of muscle responses to focal MC stimulation with either a figure 8 MC or with edge stimulation of a tilted round MC in 4 susceptible subjects. In all 4, paraesthesias were best felt with MC stimulation either at, or anterior to sites yielding movement, implying an initial source in precentral gyrus (and possible premotor cortex), rather than parietal cortex. In the two subjects exhibiting the strongest paraesthesias, the threshold for the paraesthesias was less than that for movement in the relaxed arm. The optimal site of the paraesthesias within the hand was usually in the digits, but differed among subjects. Motor responses and paraesthesias following a given stimulus occurred at different sites in the hand, implying that excitation of differing sets of motor cortical neurons subserved sensory and motor responses. In only one subject were the paraesthesias sufficiently reproducible to warrant interacting electrical digital and transcranial MC pulses. The data suggested that central processing of the response to the MC pulse is slowed by an antecedent digital stimulus, but the delay for perception of each type of stimulus does not greatly differ. The central sense of movement (Amassian et al., 1989a) elicited by MC stimulation of motor cortex is compared with the paraesthesias. Both are attributed to brief, high frequency discharge by motor cortical neurons accessing the perceptual system more readily than after excitation of post-central gyrus, which requires prolonged repetitive stimulation (Libet et al., 1964). Given also the normal pattern of muscle responses in the 4 subjects, their paraesthesias are best explained by a heightened sensitivity of the perceptual system to the motor cortical response to MC stimulation. PMID- 1782529 TI - The decline of working memory in Alzheimer's disease. A longitudinal study. AB - A previous study (Baddeley et al., 1986) explored the hypothesis that patients suffering from dementia of the Alzheimer type (AD) are particularly impaired in the functioning of the central executive component of working memory. It showed that, when patients are required to perform 2 concurrent tasks simultaneously, the AD patients are particularly impaired, even when level of performance on the individual tasks is equated with that of age-matched controls. Although the results were clear, interpretation was still complicated by 2 issues: first, the question of comparability of performance on the separate tests between AD and control patients; secondly, the question of whether our results could be interpreted simply in terms of a limited general processing capacity being more taxed by more difficult dual tasks than by the individual tasks performed alone. The present study followed up the AD and control patients after 6 and 12 mths. We were able to allow for the problem of comparability of performance by using patients as their own control. Under these conditions, there is a very clear tendency for dual task performance to deteriorate while single task performance is maintained. A second experiment varied difficulty within a single task in which patients and controls were required to categorize words as belonging to 1, 2 or 4 semantic categories. There was a clear effect of number of categories on performance and a systematic decline in performance over time. There was, however, no interaction between task difficulty as measured by number of alternatives and rate of deterioration, suggesting that the progressive deterioration in performance shown by AD patients is a function of whether single or dual task performance is required, and is not dependent on simple level of task difficulty. Implications for the analysis of the central executive component of working memory are discussed. PMID- 1782530 TI - Inspection time, psychometric intelligence and clinical estimates of cognitive ability in pre-senile Alzheimer's disease and Korsakoff's psychosis. AB - Ten pre-senile Alzheimer's patients, 11 patients with Korsakoff's psychosis and 11 age- and pre-morbid intelligence-matched controls were given a test of Inspection Time, which estimates the efficiency of visual encoding or iconic memory. Alzheimer's patients had impaired Inspection Time while the Korsakoff group performed very similarly to the controls. Inspection Time performance correlated significantly with psychometric tests of cognitive ability and with clinical tests of cognitive ability (Mini Mental State Examination and Cambridge Mental Disorders of the Elderly Examination). The early stage of information processing measured by the Inspection Time procedure appears to be damaged by the Alzheimer's disease process, and to impose a rate-limiting effect on a wide variety of mental tests. PMID- 1782531 TI - The role of sensorimotor experience in object recognition. A case of multimodal agnosia. AB - Object recognition was studied in a 19-yr-old male patient who presented severe multimodal amnesia and agnosia without significant intellectual, linguistic or perceptual deficits. Bilateral temporal lobe lesions involved medial, polar and anterior infero-temporal structures. Although visual recognition was impaired to various extents for all categories of objects, preservation of certain capacities were demonstrated. In particular, the patient was able to determine specifically how to manipulate certain objects, in spite of his incapacity to define their function or their context of utilization. It is argued that object recognition involves different processing modes such that when direct access to representations of an object is impaired, sensorimotor information activated via alternative cortical and subcortical pathways may provide a limited mechanism for recognition. PMID- 1782532 TI - Covert and overt recognition in prosopagnosia. AB - Prosopagnosic patients suffer an inability to recognize familiar people by visual inspection of their faces. Despite the absence of overt recognition, though, some prosopagnosic patients continue to process the identities of familiar faces covertly. A longstanding controversy concerns whether the recognition deficit in prosopagnosia is specific for faces, or also affects other types of visual stimuli. We investigated whether the patient P.H., who has severe problems with within-class recognition of many types of visual stimuli, would show covert recognition for all stimuli which he cannot recognize overtly. Such a finding would be consistent with the idea that face recognition and recognition of other visually similar stimuli are performed by the same underlying functional mechanisms. We assessed this possibility with a forced-choice decision between correct and incorrect alternative names for familiar faces, cars and flowers, and with comparisons of P.H.'s ability to learn true versus untrue names to familiar faces, cars and flowers. Results indicated that P.H. does show covert recognition of cars and flowers, as well as faces. In addition, the covert effects observed in the forced-choice name decision and learning tasks used here were shown to have a potential common basis. Finally, the possibility of using covert knowledge as a basis for rehabilitation was explored. As was observed by Sergent and Poncet (1990) in their patient, P.H. could achieve some overt face recognition under very specific circumstances. PMID- 1782533 TI - Differential impact of right and left hemisphere lesions on facial emotion and object imagery. AB - Thirty-six patients with unilateral hemispheric lesions of the right hemisphere (RHD), left hemisphere (LHD), or no neurologic disease were evaluated on two tasks of visual imagery: one involved imagery for facial emotions and the other involved imagery for common objects. As a group, the RHD patients were more impaired on the emotional than the object imagery task, whereas the LHD patients showed the opposite pattern. Individual case analyses suggested that the RHD group consisted of different behavioural subtypes. One patient with a right inferior occipito-temporal lesion had a facial emotion imagery generation defect, other RHD patients displayed a facial affect agnosia (being impaired on emotional imagery and emotional perceptual tasks), while other RHD patients had perceptual defects with sparing of imagery performance. A final RHD group was globally impaired across all imagery and perceptual tasks. These findings support the hypothesis that the right hemisphere may contain a 'lexicon' of facial emotions. Furthermore, these findings argue against current views that it is exclusively the left or right hemisphere that mediates visual imagery. Rather, hemispheric asymmetries in imagery performance are to some extent material-representation specific and may arise when (a) the representations of objects/events to be imaged are differentially represented in the hemispheres, and/or (b) when the operations acting on these imaged events are differentially lateralized. PMID- 1782534 TI - Amnesia in man following transection of the fornix. A review. AB - Published accounts of the effects of fornix damage on memory in man are critically evaluated. Most weight is given to cases of surgical transection of the fornix, though other causes of fornix damage are briefly discussed. It is concluded that fornix transection causes amnesia. PMID- 1782535 TI - A specific deficit for numbers in a case of dense acalculia. AB - In this study we investigated the acalculic condition of a patient, C.G., with the classical signs of Gerstmann's Syndrome: finger agnosia; right-left disorientation; a profound agraphia (but with an equally profound alexia) and a remarkably dense acalculia. Using a series of number processing and number knowledge tasks, a selective impairment for numbers was demonstrated. Within the category of numbers C.G. showed a largely preserved ability to deal with numbers below 4, in all tasks and in all modalities, while she was totally unable to deal with numbers above 4. The consistency of responses and the ineffectiveness of cueing indicated that numbers above 4 were lost, rather than hard to access. Further testing showed that this impairment did not result from a more general semantic memory problem, a difficulty in understanding quantities or a deficit in reasoning abilities thought to underlie the concept of numbers. Difficulty with some other ordinal structures was also present, but appeared unrelated to those affecting numbers. PMID- 1782536 TI - Temporal dissociation of motor responses and subjective awareness. A study in normal subjects. AB - The aim of the present study was to examine the timing of different responses given simultaneously to a single event, the sudden displacement of a visual object occurring at the onset of the grasping movement directed at that object. The subjects were requested to correct their movement in order to reach accurately for the object and to signal the time at which they became aware of its displacement by a simple vocal utterance (Tah!). The onset of the motor adjustment was measured using kinematic landmarks obtained from the hand trajectory. Movements executed during trials where the object was displaced had an earlier peak in acceleration (107 ms) than movements executed during control trials (120 ms). By contrast, the vocal signal occurred 420 ms following object displacement, that was more than 300 ms after the onset of the motor correction. Control experiments were performed in order to verify the influence of possible interferences between the two tasks. Motor corrections performed without vocal utterance had the same timing as when the vocal signal was produced. Vocal signals produced in response to object's displacements but in the absence of reaching movements had the same latency as when movements were performed. We conclude from these results that the two responses were generated independently of each other. Assuming that the vocal responses in this experiment did signal the subject's awareness, the observed delay between motor corrections and these responses suggests that neural activity must be processed during a significant and quantifiable amount of time before it can give rise to conscious experience. This dissociation between motor responses and awareness in normal subjects is discussed in the light of clinical cases where overt behaviour and conscious experience are dissociated by cerebral lesions. PMID- 1782537 TI - Neuropsychological correlates of stereotactic subcaudate tractotomy. A prospective study. AB - Stereotactic subcaudate tractotomy is a surgical procedure performed for the alleviation of intractable affective disorders. It involves the destruction of bifrontal pathways located beneath and in front of the head of the caudate nucleus. We report the first prospective study of the neuropsychological correlates of this operation in 23 patients. Tests of general intelligence, speed and attention, as well as a wide range of focal cognitive tests, including tasks which have been reported in the literature to be sensitive to frontal lobe dysfunction, were administered 1 wk before the operation, 2 wks after the operation and approximately 6 mths after the operation. The results indicated that this operation does not cause any significant, long-term adverse, cognitive deficits. In the post-operative assessment, however, patients show a significant deterioration in their performance on recognition memory tests and a large proportion of them present with a marked tendency to confabulate on recall tasks. In addition, their performance on some of the tasks which are considered to be sensitive to frontal lobe dysfunction is found to be significantly impaired. These deficits are interpreted to reflect frontal lobe dysfunction due to widespread post-operative oedema rather than damage to the subcaudate pathways. The potential for research on these transient effects of the operation for the advancement of our understanding of frontal lobe functions is discussed. PMID- 1782538 TI - Plateau-wave phenomenon (I). Correlation between the appearance of plateau waves and CSF circulation in patients with intracranial hypertension. AB - Plateau waves, as described by Lundberg (1960), can often be observed in patients with increased intracranial pressure (ICP) resulting from brain tumours, benign intracranial hypertension and other causes. The clinical significance of the waves, however, is still debated. In this study, the ICP was recorded continuously, the size of the ventricular system was evaluated using computerized tomography (CT), the cerebrospinal fluid (CSF) flow was studied using isotope cisternography, and the absorptive capacity of the CSF was determined by measuring the conductance to CSF outflow, in 94 patients with increased ICP. All patients who received continuous ICP monitorings had a basic ICP level of more than 200 mmHg, and these patients were assigned to two groups on the basis of the presence or absence of the plateau waves in the ICP recordings: group I comprising 17 patients without plateau waves but with a high ICP resulting from subarachnoid haemorrhage or hypertensive intracerebral haemorrhage, within 5 days after the start of bleeding; and group II consisting of 77 patients with both plateau waves and a high ICP resulting from brain tumours, meningitis carcinomatosa, benign intracranial hypertension, superior sagittal sinus thrombosis and communicating hydrocephalus. The isotope cisternography and conductance to CSF outflow studies showed that there was neither a delay in CSF circulation nor an impairment of CSF absorption in the group 1 patients and these patients showed no ventricular dilatation on CT, whereas there was a marked sluggishness in the CSF flow and a severe defect in the CSF absorption capacities of the group II patients irrespective of the presence or absence of ventricular dilatation on CT. The present observations indicate that patients with a plateau wave phenomenon have a marked impairment of CSF absorption and CSF flow. We suggest that the phenomenon is an important sign indicating an impairment of CSF absorption capacities. PMID- 1782539 TI - Plateau-wave phenomenon (II). Occurrence of brain herniation in patients with and without plateau waves. AB - From 1980 to 1989, during intracranial pressure (ICP) recording, brain herniation (central transtentorial herniation associated with uncal herniation) developed in 15 patients as a result of aneurysmal rebleeding, uncontrollable brain swelling and/or oedema in spite of attempts at treating increased ICP. The relationship between the ICP level at which herniation occurred and the ICP fluctuation patterns in continuous ICP recordings prior to the development of the herniation was studied retrospectively. As for the ICP fluctuation patterns, the patients were assigned to 2 groups on the basis of the presence or abscence of plateau waves of Lundberg: group I comprising 8 patients without plateau waves but with a high ICP, and group II comprising 7 patients with both plateau waves and a high ICP. In the group I patients the herniation occurred as a result of aneurysmal rebleeding or brain swelling after subarachnoid haemorrhage, and in the group II patients the herniation resulted from brain tumour, meningitis carcinomatosa and superior sagittal sinus thrombosis. In the group I patients the herniation developed at a mean ICP level of 70-98 mmHg, and in the group II patients it occurred at a mean ICP level of 120-150 mmHg, far higher than the ICP level causing herniation in the group I patients. It has been shown that patients with a plateau-wave phenomenon in continuous ICP recordings have a marked impairment of cerebrospinal fluid (CSF) absorption and a delayed CSF flow.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782540 TI - Localization of brain activity during auditory verbal short-term memory derived from magnetic recordings. AB - We have studied magnetic and electrical fields of the brain in normal subjects during the performance of an auditory verbal short-term memory task. On each trial 3 digits, selected from the numbers 'one' through 'nine', were presented for memorization followed by a probe number which could or could not be a member of the preceding memory set. The subject pressed an appropriate response button and accuracy and reaction time were measured. Magnetic fields recorded from up to 63 sites over both hemispheres revealed a transient field at 110 ms to both the memory item and the probe consistent with a dipole source in Heschl's gyrus; a sustained magnetic field between 300 and 800 ms to just the memory items localized to the temporal lobe slightly deeper and posterior to Heschl's gyri; and a sustained magnetic field between 300 and 800 ms to just the probes localized bilaterally to the medio-basal temporal lobes. These results are related to clinical disorders of short-term memory in man. PMID- 1782541 TI - Vasopressin release within the supraoptic and paraventricular nuclei of the rat brain: osmotic stimulation via microdialysis. AB - The combination of microdialysis and a highly sensitive radioimmunoassay was used in order to monitor the in vivo release of arginine vasopressin (AVP) within hypothalamic supraoptic (SON) and paraventricular (PVN) nuclei of the rat brain. A dialysis probe was inserted into the SON or PVN area and microdialysis was performed in conscious or urethane-anesthetized animals before, during and after hypertonic artificial cerebrospinal fluid (aCSF, with 1 M NaCl) was delivered via the probe. The recovery of AVP in vitro was 1.60%, that of [3H]OH in vitro 14.2% and in vivo 8.44% (SON) and 9.26% (PVN), respectively. AVP was consistently detected in both SON and PVN dialysates; basal levels averaged 0.87 +/- 0.22 pg/30-min dialysate (SON, n = 51) and 0.80 +/- 0.24 pg/30-min dialysate (PVN, n = 6), respectively. Hypertonic aCSF given over a period of 30 min, 60 min or 90 min, resulted in an increased AVP release within the SON which, however, reached its peak (to 8.86-10.27 pg/sample; P less than 0.001 as compared to basal) only in the poststimulation period, i.e. after replacement of hypertonic with isotonic aCSF. An identical osmotic stimulus given 150-210 min after the first one produced similar, though slightly declined, changes in AVP release. In the PVN, AVP release patterns prior to and in response to the first hypertonic pulse were similar to those in the SON; a possible functional difference between the two nuclei is indicated by the lack of a rebound increase in AVP release following the second stimulation. The physiological significance of intranuclearly released AVP remains to be shown.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782542 TI - The magnocellular and parvocellular divisions of the monkey subthalamic nucleus as revealed by cluster analysis of neuronal sizes. AB - Cluster analysis of neuronal somal sizes in the subthalamic nucleus of rhesus monkeys from newborn to adult age allows the segregation of two territories with predominance of small and large cells, respectively. The topographic distribution of the 'parvocellular' and 'magnocellular' segments is similar when samples are obtained from coronal, horizontal and sagittal series of sections. The parvocellular component occupies the rostral pole, the entire rostrocaudal extent of the medial tip and dorsomedial border, and probably also the caudal cap. The magnocellular segment is in the central core extending to the ventrolateral border except for the medial tip. These findings and their correlation with the results of other morphologic and physiologic studies allow the following conclusions. (1) The monkey subthalamic nucleus contains at least two differentially distributed cell subpopulations. (2) The magnocellular division is more related to the pallido-subthalamic-pallidal loop involving the lateral pallidal segment. (3) The parvocellular division appears strategically located to control the pallidal output to diencephalic and mesencephalic targets. (4) Cluster analysis can reveal the existence of more than one neuronal population in a particular brain structure where an overall unimodal distribution of cell sizes may suggest the presence of a single type. PMID- 1782543 TI - Interleukin-1 (IL-1) stimulates the release of corticotropin-releasing factor (CRF) from superfused rat hypothalamo-neurohypophyseal complexes (HNC) independently of the histaminergic mechanism. AB - We demonstrated previously that interleukin-1 (IL-1) (recombinant human IL-1 alpha and -1 beta) stimulated the release of corticotropin-releasing factor (CRF) from the superfused rat hypothalamo-neurohypophyseal complex (HNC), independently of the cholinergic system. In the present study we studied the effects of IL-1 on the release of CRF not only from the HNC but also from the isolated hypothalamus of rats in a superfusion system to define the origin of measured CRF and the site of IL-1 action. We also studied the possible involvement of the histaminergic system in the mediation of the stimulation by IL-1. An increase in CRF was elicited from the HNC and the isolated hypothalamus in a dose-dependent manner by human recombinant IL-1 beta in concentrations of 0.1-10 nM with similar time courses. Histamine in concentrations of 1-100 nM also elicited qualitatively similar increases of CRF from these two types of explants. The increases in CRF release from the HNC induced by 10 nM of histamine were completely suppressed in the combined presence of pyrilamine (10 microM) and cimetidine (10 microM), an H1 and an H2 receptor antagonist, respectively. On the other hand, the increase in CRF release induced by 10 nM IL-1 beta was not affected by the combination of these two antagonists. These results indicate that IL-1 stimulates CRF release from the median eminence through an action on the hypothalamus, and that the stimulatory effect of IL-1 is probably independent of the histaminergic system. PMID- 1782544 TI - Effect of hypothalamic administration of growth hormone-releasing factor (GRF) on feeding behavior in rats. AB - To examine the role and working site of growth hormone-releasing factor (GRF) in feeding behavior, we first tested the effect of the intracerebroventricular (i.c.v.) injection of GRF on food intake after 24 h of food deprivation. Cumulative food intake was measured 1, 3 and 6 h after injection. A lower dose of GRF stimulated food intake in a dose dependent manner (3 h; GRF 100 pmol 8.64 +/- 1.06 g vs saline 5.50 +/- 0.60 g, P less than 0.05), while a higher dose (1 nmol, 500 pmol) suppressed food intake (3 h; GRF 1 nmol 2.65 +/- 0.70 g vs saline 5.50 +/- 0.60 g, P less than 0.01). Second, the effect of i.c.v. injection of 100 pmol of GRF on peripheral metabolites was examined. The subsequent levels of plasma insulin, glucagon, glucose and non-esterified fatty acid showed no significant difference from those of saline administration. Third, the effect of microinjection of GRF (5 pmol) into several hypothalamic areas on food intake was examined. Injection into the ventromedial hypothalamic nucleus (VMN) stimulated food intake (3 h; GRF 5 pmol 10.32 +/- 1.04 g vs saline 6.92 +/- 0.32 g, P less than 0.05), but no significant effect was observed following injection either into the lateral hypothalamic area (LHA), paraventricular nucleus (PVN) or medial preoptic area (MPOA). Finally, we tested the stimulatory effect of GRF on food intake in bilateral VMN lesioned rats. I.c.v. injection in these animals had no more significant effect on food intake than did saline injection in VMN lesioned rats (3 h; GRF 100 pmol 6.27 +/- 0.87 g vs saline 5.34 +/- 0.44 g).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782545 TI - Muscimol-associated changes in local cerebral glucose use following chronic diazepam administration. AB - Local cerebral glucose use (LCGU) was determined in parallel groups of conscious rats receiving muscimol (1.5 mg/kg i.v.) after either saline pretreatment (28 days i.p.), saline pretreatment (27 days i.p.) followed by a single dose of diazepam (5 mg/kg i.p.) 24 h prior to muscimol administration, or chronic diazepam pretreatment (5 mg/kg i.p. daily for 28 days). Acute administration of muscimol produced a significant reduction in LCGU in 25 out of 66 structures examined compared with vehicle-treated controls. The pattern of reductions was heterogeneous. Thalamic and most cortical areas showed reductions of the order of 30-45%, whereas more modest depressions of 15-20% were observed in some limbic structures (e.g. basolateral amygdala, anterior thalamic nuclei, nucleus accumbens, subiculum). This contrasts with the more extensive and homogeneous pattern of LGCU reductions (around 20%) produced by diazepam. Neither acute diazepam treatment the previous day nor chronic diazepam pretreatment altered the LGCU response to muscimol. These data suggest that high-affinity GABA receptor mediated responses are unchanged by both acute and chronic benzodiazepine pretreatment. It would appear unlikely that alterations in these responses contribute to the mechanism of benzodiazepine tolerance. PMID- 1782546 TI - Insulin influences astroglial morphology and glial fibrillary acidic protein (GFAP) expression in organotypic cultures. AB - Variations in the levels and timing of exposure to insulin-related peptides influence the phenotypic appearance of astroglia present in organotypic cultures of the E17 mouse cerebellum as well as the expression of glial fibrillary acidic protein (GFAP) mRNA and its encoded protein. The morphology of GFAP immunoreactive cells was influenced by the levels of insulin added in an age specific manner. Fetal radial glia were selectively and significantly (P less than 0.001) increased by high (10 micrograms/ml) insulin levels, comprising the majority of the GFAP-positive cells seen. In contrast, there was an almost complete reversal of this pattern elicited by low (10 pg/ml) insulin levels, where GFAP-positive cells appeared undifferentiated and epithelioid (P less than 0.001). In newborn cultures, on the other hand, the morphological responses to both high and low levels of insulin were considerably attenuated and involved radial glia primarily, whose numbers were significantly increased by the high insulin levels. Exposure to high levels of insulin was accompanied by an increase in GFAP mRNA expression, as determined by non-isotopic (biotin) in situ hybridization histochemistry, and intense GFAP immunoreactivity, while low insulin levels elicited minimal expression of both message and protein product. In view of the critical interdependence of developing neurons and radial glia with respect to neuronal migration and the differentiation of neurons and astroglia, the responses observed suggest developmentally regulated mechanisms by which insulin-related peptides themselves may influence directly and indirectly both neuronal and astroglial differentiation. PMID- 1782547 TI - Electrically-evoked release of norepinephrine in the rat cerebellum: an in vivo electrochemical and electrophysiological study. AB - Norepinephrine (NE) release from the locus coeruleus (LC) afferents to the cerebellar cortex of urethane anesthetized rats was achieved by electrical stimulation of the locus coeruleus or by local administration of potassium into the cerebellum. Both methods evoked an overflow of NE-like electroactive species. Electrically-evoked and potassium-induced overflow of NE-like responses were found to be reversible and reproducible. Releases were not observed in cerebellar white matter, an area which is relatively devoid of monoamine containing terminals. Systemic administration of desipramine, a potent and selective norepinephrine re-uptake blocker, significantly augmented the electrically-evoked electrochemical responses. Measurements of evoked release taken using high-speed chronoamperometry support the idea that a predominant contributor to electrically induced signals was NE. Electrophysiological recordings of single Purkinje cells were performed with the same Nafion-coated single carbon fiber electrodes used for electrochemical recordings. Electrical stimulation of the LC was seen to depress Purkinje cell firing rates; an increase in electroactive species was detected at the same site that paralleled the time course of the electrophysiological response. These studies provide further direct evidence that the LC norepinephrine-containing cells have a direct inhibitory effect on Purkinje cells in the cerebellum, and that both pre- and postsynaptic events can be measured with the same recording sensor. PMID- 1782548 TI - Microglia are associated with the extracellular neurofibrillary tangles of Alzheimer disease. AB - When neurons die, the filaments of neurofibrillary tangles (NFT) undergo structural and antigenic modifications. The exact mechanism of this modification is unknown, but glial cells could play an important role. Previous studies have shown that astroglial processes infiltrate extracellular NFT. In this study we use double immunolabelling to show that microglia also infiltrate extracellular NFT. Therefore, along with the previously identified astroglia, the microglia could be responsible for the modification of extracellular NFT. PMID- 1782549 TI - Elevated expression of jun and fos-related proteins in transplanted striatal neurons. AB - The basal expression of the immediate-early gene protein products fos, fos related antigens (FRA's), jun and krox-24 was examined using immunocytochemical methods in intrastriatal grafts derived from fetal striatal primordia. Whereas very few, if any, normal adult striatal neurons expressed jun, many neurons in the striatal graft expressed jun at high levels. FRA's, but not fos, were also occasionally induced in some grafted striata. krox-24 was expressed in normal adult striatal neurons, and to a lesser extent in transplanted striatal neurons. These results show that neurons of intrastriatal grafts express jun at substantially higher levels than host striatal neurons, and this may be related to the previously reported increased transcription of neuropeptides in striatal grafts, and/or to the possible failure of transplanted neurons to fully establish normal connections with the host tissue. PMID- 1782550 TI - Identification of cardio-inhibitory neurons in the thoracic ganglion of the isopod crustacean Bathynomus doederleini. AB - We identified cell bodies of a pair of the cardio-inhibitory (CI) neurons in the first thoracic ganglion (TG1) of Bathynomus doederleini. Each of the cell bodies gives rise to a single axon, which runs into the contralateral hemiganglion of TG1 via the commissure and runs to the heart via the fourth root as CI axon. Some fine processes arise from the axon at two points in both hemiganglia. PMID- 1782551 TI - Sex pheromones selectively stimulate the medial olfactory tracts of male goldfish. AB - The olfactory tracts of teleost fish are comprised of medial and lateral sub tracts which previous studies suggest convey responses to pheromones and food odors respectively. This study tested this possibility by recording electrical responses from the medial and lateral tracts of male goldfish exposed to sex pheromones and food odors. Only the medial olfactory tract responded to pheromones and both tracts responded to an L-amino acid and crude food odor. These findings verify earlier studies of peripheral olfactory sensitivity to pheromones and confirm that pheromonal information is carried within the medial tracts. They also suggest that the neural processes responsible for food recognition are more complex than previously supposed. PMID- 1782552 TI - Morphological differentiation of rat pheochromocytoma cells (PC12 cells) by electric stimulation. AB - The effects of electric stimulation on the morphological differentiation of PC12 cells are described. PC12 cells were stimulated with the 'theta' (4-7 Hz electroencephalogram (EEG) rhythm) pattern-electric stimulation, which was known to elicit stable long-term potentiation (LTP) in the CA1 region of the hippocampus. The stimulation induced the neurite outgrowth of PC12 cells, as well as nerve growth factor (NGF). This result suggests that the electric signal has a differentiating potential equivalent to the receptor-ligand interaction. PMID- 1782553 TI - Effects of muscular contraction on discharge patterns of neurons in the medullary raphe nuclei. AB - Cells of the medullary raphe nuclei were characterized as sympathoinhibitory (SI), sympathoexcitatory (SE) or serotonergic (5-HT). When muscular contraction (MC) was evoked by stimulation of the L7 and S1 ventral roots, putative SI cells were inhibited while putative SE cells were excited. 5-HT cells were unaffected by MC. These data are discussed in relation to integration of somatosensory and cardiovascular reflexes. PMID- 1782554 TI - Light and electron microscopical localisation of 5-HT-immunoreactive boutons in the rat trigeminal motor nucleus. AB - We have used pre-embedding EM immunohistochemical methods to obtain quantitative data on the frequency and post-synaptic targets of 5-hydroxytryptamine immunoreactive (5-HT-IR) boutons within the rat V motor nucleus. Thirteen percent (69/531) of all synaptic contacts in the motor nucleus involved 5-HT-IR boutons. Seventy-four percent of 5-HT-IR boutons made axo-dendritic contacts, 20% axo somatic contacts, and 6% axo-axonic contacts. We conclude that a significant fraction of boutons in the motor nucleus are 5-HT-IR and most contribute to postsynaptic rather than presynaptic effects on trigeminal motoneurones. PMID- 1782555 TI - Various hippocampal lesions induced by multi-fractional ibotenic acid injections and amygdala kindling in rats. AB - Hippocampal degenerative lesions were made bilaterally by means of multiple ibotenic acid injections and development of amygdala kindling was studied. In groups with lesions in either bilateral dorsal or ventral hippocampus, stimulations required for kindling were almost the same as those of controls. In the group with lesion of the entire hippocampus, kindling development was remarkably slow especially in the early stage of the kindling process. However, kindling effect was finally established in all groups. PMID- 1782556 TI - Evidence for the presence of L-arginine in the glial components of the peripheral nervous system. AB - L-Arginine is a precursor of nitric oxide that has been identified as an endogenous activator of soluble guanylate cyclase. We have recently reported the immunocytochemical localization of free L-arginine in glial cells in the central nervous system (CNS) using specific anti-arginine antibody. In the present study, we focused our attention on this particular amino acid in the peripheral nervous system (PNS). In the cochlea of the inner ear, arginine-like immunoreactivity was localized in satellite cells surrounding neurons of the spiral ganglion. In the dorsal root ganglia, satellite cells surrounding sensory neurons were found to be immunoreactive. In the superior cervical ganglion, L-arginine was concentrated in satellite cells around neuronal cells. In ganglia of the enteric plexus, supporting cells that covered neuronal cells were stained. These results show that free L-arginine in the PNS is concentrated in satellite and supporting cells, both of which correspond to glial cells in the CNS. Thus, those cells in ganglia of the PNS may support and/or control the neural activity by providing L arginine to the neurons that they surround. PMID- 1782557 TI - Basal forebrain stimulation modifies auditory cortex responsiveness by an action at muscarinic receptors. AB - We have hypothesized that auditory cortex plasticity involves modification of thalamocortical transmission by basal forebrain (BF) cholinergic neurons, and that this action may involve muscarinic receptors. In a first test of this hypothesis, we report that BF stimulation can suppress or facilitate, depending on the intensity of stimulation, auditory cortical responses elicited by thalamic stimulation. BF-mediated facilitation is antagonized by atropine, implicating muscarinic receptors. These data suggest that BF cholinergic neurons functionally modify auditory cortex by regulating thalamocortical transmission. PMID- 1782558 TI - Lesions of the rostral dorsolateral pons have no effect on afferent-evoked inhibition of inspiration. AB - This study investigated a possible role of the rostral dorsolateral pons (including nucleus parabrachialis medialis and Kolliker-Fuse nucleus) in mediating several inspiratory inhibitions. These inhibitions included the transient inhibition of phrenic inspiratory motor output produced by stimulation of the superior laryngeal nerve (SLN), the intercostal nerve (ICN) or the phrenic nerve (PN), as well as the inspiratory termination produced by trains of stimuli delivered to the SLN or ICN. In decerebrate, paralyzed, and artificially ventilated cats, the inhibitions produced by stimulation of these nerves were observed before and after lesioning (either radiofrequency, n = 8, or electrolytic, n = 9) the dorsolateral pons. Delivery of stimulus trains to the SLN or the ICN continued to elicit inspiratory termination following pontine lesions with no significant change in the threshold. There were no significant effects of bilateral dorsolateral pontine lesions on the threshold, onset latency, or duration of the short-latency, transient inhibitions produced by SLN, ICN or PN stimulation. From these data, we conclude that the rostral dorsolateral pons is not required in the production of any of these inhibitory reflexes. PMID- 1782559 TI - Effects of cocaine and footshock stress on extracellular dopamine levels in the ventral striatum. AB - Behavioral and neurochemical cross-sensitization between cocaine and stress was examined. The effects of stress and cocaine on extracellular levels of dopamine and its metabolites, 3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA), were measured by in vivo microdialysis in the rostral ventral striatum, including the nucleus accumbens. Pretreatment with a daily 20 min footshock stress (0.45 mA/200 ms/s) for 5 days enhanced the cocaine-induced increase in extracellular dopamine levels in shock compared to sham shock-pretreated rats. The motor stimulant response to acute cocaine was also augmented in shock pretreated rats. There was a slight but significant decrease in the levels of DOPAC and HVA in both groups following cocaine but no differences between shock and sham shock animals. In contrast, in the converse experiment, pretreatment with daily cocaine (15 mg/kg, i.p.) for 5 days did not significantly alter the stress-induced levels of extracellular dopamine compared to controls. The levels of DOPAC and HVA were not different between cocaine- and saline-pretreated groups although there was a trend towards enhanced metabolite levels in cocaine pretreated animals. These data in part support a role for enhanced dopamine neutrotransmission in mediating behavioral cross-sensitization between psychostimulants and stress. PMID- 1782560 TI - Melatonin deacetylation: retinal vertebrate class distribution and Xenopus laevis tissue distribution. AB - Deacetylation is a rapid clearance mechanism for ocular melatonin. We have studied the distribution of retinal melatonin deacetylase activity among vertebrate classes. Exogenous radiolabeled melatonin is metabolized by ocular tissue prepared from the amphibian Xenopus laevis, the reptile Anolis carolinensis, the teleost fish Carassius auratus, and the bird Gallus domesticus. In contrast, we were unable to detect ocular melatonin breakdown in rat or pig. In each species exhibiting ocular melatonin breakdown, melatonin is first deacetylated to 5-methoxytryptamine, which is deaminated, producing 5 methoxyindoleacetic acid and 5-methoxytryptophol. Deacetylation of melatonin is inhibited by eserine (physostigmine), causing a reduction in the levels of all 3 metabolites. Deamination of 5-methoxytryptamine is inhibited by the monoamine oxidase inhibitor pargyline, such that 5-methoxyindoleacetic acid and 5 methoxytryptophol levels are decreased while levels of 5-methoxytryptamine are increased. Incubation with the deacetylase inhibitor eserine increases endogenous melatonin levels in Xenopus and Carassius eyecups, indicating that endogenous melatonin is metabolized via the deacetylase. We also studied the tissue distribution of the deacetylase in Xenopus laevis. Melatonin deacetylation occurs in retina, retinal pigment epithelium, and skin, all of which are sites of melatonin action. These results indicate that among non-mammalian vertebrates, deacetylation is a common clearance mechanism for ocular melatonin, and may degrade melatonin at other sites of action as well. Melatonin deacetylation may help regulate local melatonin concentration, and generates other biologically active methoxyindoles. PMID- 1782561 TI - Extracellular characteristics of putative cholinergic neurons in the rat laterodorsal tegmental nucleus. AB - The extracellular electrophysiological properties of neurons in the laterodorsal tegmental nucleus (LDT), a major source of cholinergic afferents to the thalamus, were studied in chloral hydrate-anesthetized rats. A combination of antidromic activation from the thalamus and histological verification of recording sites was used to correlate the identity of extracellular recordings in the rat LDT with cholinergic neurons in that region. All neurons antidromically activated by stimulation of the anteroventral thalamus were histologically verified to be within clusters of cholinergic (NADPH-d-positive) cells in the LDT or in the adjacent nucleus locus coeruleus (LC). The thalamically projecting LDT neurons had a homogeneous neurophysiological profile consisting of long duration action potentials (mean = 2.5 ms), slow conduction velocities (mean = 0.78 m/s), and lengthy chronaxie values (mean = 0.725 ms). The appearance and axonal characteristics of these neurons resembled those of noradrenergic LC neurons, but the two populations exhibited substantially different spontaneous activity patterns and sensory responsiveness. These characteristics may be useful in the preliminary identification of putative cholinergic neurons in vivo, and thereby provide a foundation for exploring the neuropharmacology, afferent modulation, sensory responsiveness and behavioral correlates of the brainstem cholinergic system. PMID- 1782562 TI - Unique microvascular characteristics of the dorsal root ganglion in the rat. AB - Physiological characteristics of dorsal root ganglia microvessels have not been reported in detail. In this study we examined local blood flow and oxygen tension in the L4 dorsal root ganglion (DRG) of the rat. Under normal physiological conditions, local DRG blood flow measured 36.1 +/- 2.7 ml/100 g/min, over twice that within the endoneurium of the sciatic nerve. DRG blood flow was better maintained during hypotension than endoneurial blood flow suggesting partial autoregulation. Unlike endoneurium, there was relative constancy of flow between mean arterial pressures of 60 and 120 mm Hg. Hypercarbia with acidosis, and hypocarbia with alkalosis did not influence blood flow. The histogram of oxygen tensions within the dorsal root ganglion resembled that in brain but included more values at lower tensions than observed in published endoneurial histograms. Theses findings suggest that the DRG differ from endoneurium in ways that reflect the higher metabolic requirements of neural soma. PMID- 1782563 TI - In vitro electrical activity in the suprachiasmatic nucleus following splitting and masking of wheel-running behavior. AB - Djungarian hamsters (Phodopus sungorus sungorus) were chronically exposed to constant light (60 lux) in order to generate a split rhythm of wheel-running behavior. The animals were killed and coronal hypothalamic slices prepared for extracellular recording from the left and right suprachiasmatic nuclei (SCN). Nine hamsters which exhibited a split in overt behavior also had bimodal peaks (280 cells) of SCN firing frequency (5.4 +/- 1.1 and 5.8 +/- 0.7 Hz); these peaks were about 180 degrees antiphase. Two troughs in firing frequency were also apparent (1.8 +/- 0.4 and 2.4 +/- 0.5 Hz) and coincided with the projected time of wheel-running activity. Differences in circadian pattern of electrical activity between the right and left SCN were not observed. When wheel-running activity in 5 hamsters was suppressed with high intensity (500 lux) constant light, the SCN firing profile (154 cells) failed to exhibit a daily rhythm. Firing frequency was consistently high (5.8 +/- 1.4 Hz) throughout the 24-h period. These results indicate that in vitro electrical activity of the SCN is related to overt behavior in Djungarian hamsters, in that high electrical activity occurs when locomotor activity is minimal. PMID- 1782564 TI - Extension of the range of recognition sequences for triple helix formation by oligonucleotides containing guanines and thymines. AB - Oligodeoxynucleotides containing G and T can bind to homopurine.homopyrimidine sequences on double-stranded DNA by forming C.G x G and T.A x T base triplets. The orientation of the third strand in such triple helices depends on the number of GpT and TpG steps. Therefore a single oligonucleotide can be designed to bind to two consecutive homopurine.homopyrimidine sequences where the two homopurine stretches alternate on the two strands of DNA. The oligonucleotide switches from one homopurine strand to the other at the junction between the two sequences. This result shows that it is possible to extend the range of DNA sequences that can be recognized by a single oligonucleotide. PMID- 1782565 TI - A novel type of RNA-binding protein is potentially encoded by the opposite strand of the trans-spliced c-myb coding exon. AB - Recently, we reported evidence suggesting that expression of c-myb thymic mRNA species involves the intermolecular recombination of coding sequences (ET and c myb) localized on two different chromosomes, both in chicken and human. Our present studies demonstrate that the ET locus encodes, in the antisense orientation, a novel member of the RNA binding protein family in these two species. PMID- 1782566 TI - [HLA-A29 sub-types and "Birdshot" choroido-retinopathy susceptibility: a possible "resistance motif" in the HLA-A29.1 molecule]. AB - The Birdshot choroidoretinopathy (BSCR) is an ocular disease strongly associated with HLA-A29. The HLA-A29 specificity can be split using immunoelectrofocusing in two subtypes A29.1 and A29.2. BSCR susceptibility is exclusively linked to the HLA-A29.2 molecule. The sequence of HLA-A29.2 was established (EMBL X60108 and found to be identical between patients and healthy individuals. A single difference was found (H----D) 102) in the extra cellular domains between HLA A29.2 and HLA-A29.1. The HLA-A29 sub-types shares the consensus HLA class I sequence (D102). The mutation exhibited by HLA-A29.1 (H102) is unique to that molecule. The ancestral type is thus HLA-A29.2 that confers the susceptibility to BSCR whereas HLA-A29.1 has arisen from a more recent mutation conferring resistance to BSCR. Another single amino-acid difference between HLA-A29.1 and HLA-A29.2 was found in the intracytoplasmic part of the molecule, HLA-A29.2 exhibiting the HLA-A consensus sequence whereas A29.1 shares with AW33.1 the mutation S----F321. In addition, the A29 specificity was assigned to L and Q amino-acids at position 62-63, which can interact with peptides into the binding groove. No specific T or B epitope of susceptibility could be considered involving the region of the mutation discriminating HLA-A29.2 from HLA-A29.1. The HLA-A29.1 mutation is unable to interact with the T cell receptor and did not seem to induce significant structural changes in the peptide-binding groove. Conversely, its position suggests that the A29.1 mutation might interfere with the binding of an accessory molecule, the CD8 molecule being the most likely candidate for that role. PMID- 1782567 TI - [Anti-beta 2 glycoprotein I antibodies in systemic lupus erythematosus: a marker of thrombosis associated with a circulating anticoagulant]. AB - An ELISA technique for the detection of anti-beta 2 glycoprotein I (beta 2gp I) antibodies was developed. Among 47 systemic lupus erythematosus patients, 17 had anti-beta 2gp I antibodies. These antibodies were statistically associated with anticardiolipin antibodies, lupus anticoagulant and thrombosis. Out of 18 patients with anticardiolipin antibodies without anti-beta 2gp I antibodies or lupus anticoagulant, only one had thrombosis (due to nephrotic syndrome). Therefore the presence of anti-beta 2gp I antibodies is a new immunologic marker of lupus patients with thrombosis. In addition, we propose that anti-beta 2gp I antibodies may be directly responsible for lupus anticoagulant activity. PMID- 1782568 TI - Some ABC's of skeletal pathophysiology. 6. The growth/modeling/remodeling distinction. PMID- 1782569 TI - Some ABC's of skeletal pathophysiology. 7. Tissue mechanisms controlling bone mass. PMID- 1782570 TI - A population-based comparison of quantitative dual-energy X-ray absorptiometry with dual-photon absorptiometry of the spine and hip. AB - Dual photon absorptiometry (DPA) is currently the most widely used method for noninvasive bone mineral density (BMD) measurement of the axial skeleton. Dual energy X-ray absorptiometry (DEXA) is a recently developed technique that uses an X-ray tube as a photon source; it has demonstrated several significant advantages over DPA in preliminary studies. We report here a quantitative comparison of the DEXA and DPA technologies using a Hologic DEXA (Hologic QDR model 1000, Waltham, MA) scanner and a Lunar DPA (Lunar Radiation DP3, gandolineum-153 source) scanner at both the proximal femur and lumbar spine sites using bone density measurements from a population-based sample of older white men and women who had complete DEXA and DPA measurements of the hip (n = 217) or the spine (n = 176). To examine the relationship of BMD measured by the DPA scanner to BMD measured on the DEXA scanner, normal least squares linear regression was used to regress the DPA BMD on the DEXA BMD for each site. DEXA values were consistently lower than DPA values, with an average difference of 16%. The squared multiple correlation (R2) values were at or above 0.95 for almost all sites, with Ward's triangle having the lowest value (0.89). The slope for all sites was similar, ranging from 0.94 to 1.1. Research and clinical centers that wish to change to DEXA technology because of its shorter examination time and greater precision can therefore compare DEXA with DPA values using representative conversion factors. PMID- 1782571 TI - In vitro dissolution of calcium carbonate preparations. AB - Calcium supplements are widely used for the treatment of osteoporosis. The bioavailability of these preparations is unknown. Because poor tablet dissolution accounts for a majority of drug bioavailability problems, we determined the in vitro dissolution at 30, 60, and 90 minutes of 27 commercially available calcium carbonate supplements using the method of the U.S. Pharmacopoiea. At 30 minutes, five preparations (18%) were more than 75% dissolved, four (15%) between 33 and 74%, and the remaining 18 (67%) were less than 33% dissolved. After 90 minutes, 17 (63%) of the preparations were less than 50% dissolved. Dissolution correlated negatively with the weight of filler (noncalcium carbonate material in the tablet) (rs = -0.51, P less than 0.01) but not with tablet hardness or cost. Similar to previous studies, we also found no correlation of dissolution with the stated calcium content, chemical source of calcium carbonate (oyster shell or chemical precipitate), or retail source. We conclude that there is a wide range of in vitro dissolution among the calcium carbonate preparations tested, and that the filler is an important determinant of the dissolution of these tablets. These results raise concern about the bioavailability of the calcium in these preparations and may have important implications for the therapeutic use of the various calcium carbonate supplements. PMID- 1782572 TI - Dual-energy X-ray absorptiometry versus single photon absorptiometry of the radius. AB - Radial diaphyseal bone mineral density (BMD) was measured at the standard one third site by dual-energy X-ray absorptiometry (DEXA) and by 125I single photon absorptiometry (SPA) in 70 consecutive subjects, aged 12-86 years, with metabolic disorders of the skeleton. Each patient was measured once by the DEXA (Hologic QDR-1000) instrument and four times by the SPA (Norland 2780) instrument on the same day by one or the other of 2 technicians. The DEXA and SPA measurements were linearly related and highly correlated (r = 0.975, P less than 0.0001) over a range from severe osteopenia to high normal BMD. Ninety-five percent of the variation in the BMD determined by SPA was accounted for by DEXA, so that the BMD(SPA) = 1.035 +/- 0.027 (SEM) x BMD(DEXA)-0.007 +/- 0.019 (SEM). This permits continued use of previously accumulated SPA data-bases. The coefficient of variation for repeat measurements by DEXA was 1.2% and by SPA 1.6%. Examination time by DEXA was 6-7 minutes, about 45% shorter than the corresponding SPA determinations. DEXA is the superior method for evaluation of the radius, as it provides faster and more precise measurements in clinical practice. PMID- 1782573 TI - A comparison of the effects of inhibitors of carbonic anhydrase on osteoclastic bone resorption and purified carbonic anhydrase isozyme II. AB - We have assessed the effects of five sulfonamides with widely varying inhibitory activity for carbonic anhydrase (CA) in the bone slice assay using disaggregated rat osteoclasts (OCs), and in the Maren assay where the catalytic activity of purified CA isozyme II (CA II) was measured. There was an excellent correlation between the relative potencies of the compounds in the two assays: ethoxzolamide (ETH) greater than acetazolamide (AZ) greater than M&B 21659 greater than M&B 9811 greater than M&B 7973. In the bone slice assay, ETH and AZ were found to be the most potent inhibitors of OC bone resorption, with IC50 values of 0.09 and 0.8 microM, respectively (from plan surface area of bone resorbed). These results support previous observations showing that OCs use CA II to generate protons during bone resorption and that CA II activity is essential for OCs to be able to resorb bone. PMID- 1782574 TI - Effects of inositol trisphosphate on calcium mobilization in bone cells. AB - The effect of inositol 1,4,5 trisphosphate (IP3) on calcium mobilization was studied in human osteosarcoma lines, Saos-2 and G292, as well as isolated rat osteoblastic and osteoclastic cells. Cells were permeabilized with saponin and calcium mobilization was studied with the fluorescent dye, fura-2 in a recording spectrofluorometer. IP3 (10 microM) increased calcium release in all cell types studied. The effect was dependent on ATP and occurred in the presence of mitochondrial inhibitors. The effect was not seen with inositol 1-phosphate (IP) or inositol 1,4-diphosphate (IP2). Inositol 1,3,4,5 tetrakisphosphate (IP4) appeared to elicit a decrease in the calcium released. Depletion of the intracellular pool with the calcium ionophore, ionomycin, as well as incubation with the inhibitor of intracellular calcium mobilization, TMB-8, obliterated the IP3 effect. The results are consistent with the hypothesis that increases in IP3 can cause a rapid elevation of bone cell cytosolic calcium. PMID- 1782575 TI - Effect of warfarin on early rat tooth development. AB - Rat pups were treated from birth to 5 days of age with the vitamin K antagonist warfarin in order to investigate possible functions of the vitamin K-dependent dentin Gla protein (DGP) in tooth development. Warfarin completely eliminated the immunocytochemically detectable DGP which is a prominent feature of dentin in control rat pups, and also caused an increased concentration of DGP in odontoblasts. Warfarin treatment did not affect the ultrastructure of cells or the extracellular matrix in the tooth germs. The width of the predentin layer, which is considered to be correlated with the rate of mineralization, was unchanged. These results are the first to demonstrate that warfarin treatment prevents the accumulation of DGP in dentin, and that the deposition of DGP has no influence on the overall rate of dentin matrix mineralization in tooth germs. PMID- 1782577 TI - [Oral prednisone in the treatment of angioma in infants (an analysis of 253 cases)]. PMID- 1782576 TI - Effect of glass ceramic and titanium implants on primary calcification during rat tibial bone healing. AB - The effect of bone bonding (KG Cera, Mina 13, and titanium) and nonbone bonding (KGy-213, M 8/1) implants on primary calcification in endosteal bone was examined by comparing changes in the morphometry of matrix vesicles to those occurring during normal bone healing following ablation of rat tibial marrow. The concentration of matrix vesicles, their diameter, and their distance from the calcification front were determined using computerized cytomorphometry at the transmission electron microscopic level. The results demonstrated that bone bonding materials supported an increase in matrix vesicle concentration when compared with control bone at 6 and 14 days postimplantation. At 14 days, there were fewer matrix vesicles in the bone adjacent to the nonbonding implants. Though matrix vesicle diameter decreased in the control bone between 6 and 14 days, it increased in all of the experimental samples. Diameters were significantly greater in the bone bonding samples at 14 days and significantly lower in the nonbonding samples at 6 days. Distance from the calcification front decreased between 6 and 14 days in all groups except in bone adjacent to the KGy 213 implants. In bone adjacent to the bone bonding implants, distance from the calcification front was comparable to or further than that of control bone; in the nonbonding samples it was closer to the calcification front. These results demonstrate that production and maturation of matrix vesicles is influenced in a differential manner by the presence of implant materials. PMID- 1782578 TI - [Re-establishment of sensory function of flaps by nerve implantation]. AB - Taking the afferent sensory fiber discharges as an indicator, re-establishment of sensation of the abdominal island flap was investigated in rabbits. The flap, being fed by the superficial epigastric artery, was transplanted to the leg, and the saphenous nerve was implanted into it. The restoration of flap sensation was studied neuroelectrophysiologically. It was shown that nerve fiber discharges were detected within the boundary of the flaps, and mainly in the central portion of the flap along the course of the implanted nerve, in the nerve implantation animals. There was definite evidence of re-establishment of tactile, pressure, pain and temperature sensations in the flap, except that the unit discharges evoked by lower threshold stimulation were less than normal. In the flaps without nerve implantation nerve fiber discharge was rare, and pain and temperature sensation discharges could not be recorded. In 8 patients, nerve implantation was done in an attempt to re-establish sensations in the fingers. Altogether, 11 lateral antebrachial cutaneous nerve grafts were implanted to 10 fingers. The longest nerve graft was 9cm, and the shortest 2.5cm. They were implanted under the dermis of the denervated palmar skin of fingers or flaps. The follow-up time was 97-924 days. The results were very satisfactory. PMID- 1782579 TI - [Mechanism of the wound coverage and the formation of keratinous substance after microskin grafting]. AB - Autologous microskin-grafts were observed morphologically sequentially after being grafted to 6 extensive burn patients. The epidermal cells of the microskin grew into the dermal layer of the allograft and crept over the surface along the newly formed granulation. Finally, the epidermal cells of the microskin covered the wound. The allograft may exert an inducing effect on the growth of epidermal cells. Keratinous substance was formed as a result of the degeneration of the epidermal cells of the microskin. PMID- 1782580 TI - [Clinical analysis of 90 cases of electric contact burns of the wrist]. PMID- 1782581 TI - [Significance of determination of serum and urinary hydroxyproline in healthy subjects and patients with hyperplastic scars]. PMID- 1782582 TI - [Vaginal reconstruction with an upper abdominal island flap]. AB - This paper presents a method for vaginal reconstruction. On the basis of anatomic studies, we designed an island flap obtained from the upper abdomen, with the blood supply from the deep inferior epigastric artery. At the time of operation, this flap was transferred under the symphysis pubis to the artificial space created between the urinary bladder and rectum. The operation was done on 7 patients and complete survival of the flap was seen in 6 cases. The failure was due to a twist of the flap vessel pedicle. The patients were followed up for 6 months to 2 years, and it was found that the vaginal wall was not only pliable but elastic, and the married patients enjoyed a satisfactory sexual life. PMID- 1782583 TI - [Clinical application of expanded forearm reverse dorsal interosseous artery island flap]. AB - The island flap based distally on the posterior interosseous artery has been proven to be available for the correction of severe cicatricial contracture deformity of the ipsilateral hand. However, the main disadvantages of this flap are the second donor area deformity and muscle or tendon adhesions after skin grafting. Both these complications may be ameliorated by means of tissue expansion to obtain a secure blood supply to the flap. The surgical procedure has been performed in 7 patients with satisfactory result since August 1989. PMID- 1782584 TI - [Combined ketamine, diazepam and procaine intravenous anesthesia in operations on burn patients (a report of 893 cases)]. PMID- 1782585 TI - [Clinical uses of a reverse narrow pedicled fascio-vascular flap from the medial aspect of the leg]. AB - The authors presented a new technique of using a narrow distally pedicled fascio vascular flap from the medial aspect of the lower leg to cover soft tissue defects in the lower third of the leg, ankle and foot regions. 7 cases of traumatic scar have been treated with reversed narrow pedicled fascio-vascular flap since January 1987. The maximum covered area by the flap was 16cm x 15cm and the rotational angle ranged from 90 to 180 degrees. The flap survived in 6 cases resulting in satisfactory results. The only failure was a loss of 1cm over the tip of the flap because of the presence of a scar, left by a II degree burn, that ran across the flap. The advantages of this flap are as follows: the quality of the flap is good; there is a narrow fascio-vascular pedicle; this flap was easily rotated as an island flap; a high survival rate; simplicity of technique; no main artery is sacrificed, and the function of the leg is not affected. The authors believe this is an ideal method for resurfacing soft tissue defects in the lower third of the leg, ankle and foot regions with exposure of deeper structures. PMID- 1782586 TI - [Correction of redundant fold after operation for double folded eyelid]. PMID- 1782587 TI - [Relation between peroxidation and hypermetabolism and protein metabolism in rats after burn injury]. PMID- 1782588 TI - [Pathological changes in epididymis of rats after phosphorus burns and mechanism of development]. AB - The present study is to investigate the pathological changes in the epididymis of the rats within a period of 90 days after third degree phosphorus burns involving 30% of TBSA. By light microscopy and electron microscopy and histochemistry, varying degrees of degeneration and necrosis of epididymal epithelial cells, peritubular tissues and luminal spermatozoa and degenerative spermatid were found. The occurrence and development of all these changes might be divided into: the initiation and reaction phase of injury; the advanced phase; and the recovering phase. It is considered that epididymal tissue damage in advanced phase is so extensive and severe that the morphological, physiological and metabolic maturation of the spermatozoa may be affected, and the storing function of the epididymis as well. With the recovery of the burns, there was repair of the damaged tissues, and it could be inferred that the effect of phosphorus burns on the long-term reproductive capacity of male animals is probably mild. PMID- 1782589 TI - [Pathological changes in adrenal cortex in rats after phosphorus burn (stereological and histochemical changes)]. AB - The experiment dealt with stereological and histochemical study on the submicroscopic structure of adrenal cortex after phosphorus burn within 15 days. The main findings were as follows: (1). The increased dense lysosome-like bodies in the adrenal cortical cells after burn were not all lysosomes, and it was conjectured they were hormone carrier-protein which might come from the Golgi complex; (2). The ZR cells developed better and had more abundant organelles and higher enzymic activity than other zonal cells. These differences were more obvious after burn. We speculated that ZR was not a degenerated zone, but an important functional area of synthesis and secretion of steroid hormone; (3) Different cellular functional conditions in adrenal cortex were related to the secretory rhythm of the cells. PMID- 1782590 TI - [Mechanism of damage to erythrocytes after burn injury in rat--changes in lipid peroxidation, antioxidant function and sulfhydryl groups]. AB - Thermal burn on the back of rat (20% TBSA full-thickness burn) was used to study the changes in free radicals and lipid peroxidation and function of the antioxidation of erythrocytes postburn. It was found that there were increase in the concentration of lipid peroxides and decrease in activity of glutathione peroxidase (GSHpx) in plasma. The activity of RBC GSHpx increased significantly on day 1 postburn. When RBC GSHpx could not resist the injury, the function of antioxidation decreased, such as the activities of G6PD, GSHpx and the concentration of GSH and NPSH. RBC LPO increased, which cross-linked with sulfhydryl proteins and inflicted injury to RBC membrane. It might be concluded that the mechanism of damage of RBC after burn injury is due to chain reactions of free radicals and lipid peroxidation of the cell membrane. It also proved that there were changes in functional capability of antioxidation in vivo after burn injury. Further study is needed to locate the site of production of free radicals within or/and in the neighborhood of RBC and elucidate the transfer of the messages which cause the change. PMID- 1782591 TI - [Sequential changes in free amino acid pool in burned rabbits]. AB - Free amino acid (FAA) levels in plasma, erythrocytes, bone marrow, skeletal muscle, heart, liver, lung, brain, kidney and spleen were measured simultaneously in rabbits with burn injury. Results of study showed that, 86%-87% of skeletal muscle (remote from burn site), liver and lung FAA, 80%-82% of brain, bone marrow and erythrocyte FAA, 73% of heart, spleen and kidney FAA, and 57% of skeletal muscle (underneath the burn site) FAA varied in levels with the trends similar to that in plasma. These results suggest that the changes in profile of plasma free amino acids may essentially represent that of total amino acid pool after burn injury, and that the plasma amino acid kinetics seems to be a useful index for clinical study. PMID- 1782592 TI - [Prevention of injurious effect of free radicals to island skin flap with mannitol and anisodamine--an experimental study]. AB - Rat abdominal skin flaps were subjected to total venous occlusion for 8 hours. Prior to and immediately following release of the vascular occlusion, mannitol, anisodamine or placebos were administered. Mannitol and/or anisodamine significantly enhanced island flap survival. LPO or water content was significantly lower in drug groups than in placebo groups. However, XOD was not affected by the drugs. These findings indicated that oxygen free-radical played an important role in post-ischemic flap injury. PMID- 1782593 TI - [Alterations in insulin receptor in injured rats and the effects of dexamethasone and silybin]. AB - The purpose of this study is to examine the alterations in hepatocyte insulin receptors in rats subjected to scald and restrained water immersion stress and the effects of dexamethasone and silybin. In scalded rats, plasma glucose and insulin levels were higher than that of normal rats, suggesting the occurrence of insulin resistance following injury. The maximal binding capacity (Ro) and highest insulin binding rate (Bo/T) of hepatocyte insulin receptors were significantly reduced in rats 72h postscalding, while there was no obvious change in affinity (Ke Kf). The Ro and Bo/T of the restrained water immersion stress rats were also reduced significantly, but the affinity was increased. Dexamethasone significantly enhanced Ro in rats 72h postscalding with significant decrease in affinity (Ke). Silybin significantly enhanced Ro and Bo/T 72h postscalding with no obvious change in affinity. It is suggested that insulin resistance following injury may be a consequence of receptor defect of the target cells, and for disturbance of glucose metabolism following injury, it is not beneficial to use dexamethasone, but silybin may be used with benefit. PMID- 1782594 TI - [Relation between the failure in barrier functioning of the gastrointestinal tract and intestinal bacterial translocation]. PMID- 1782595 TI - Action potentials in gastrointestinal smooth muscle. AB - Recent investigation of the ultrastructure and electrophysiology of gastrointestinal smooth muscle layers has revealed a fascinating heterogeneity in cell type, cell structure, intercellular communication, and generated electrical activities. Networks of interstitial cells of Cajal (ICC) have been identified in many muscle layers and evidence is accumulating for a role of these networks in gut pacemaking activity. Synchronized motility in the organs of the gut result from interaction between ICC, neural-tissue, and smooth muscle cells. Regulation of cell to cell communication between the different cell types will be an important area for further research. Progress has been made in the elucidation of the ionic basis of the slow wave type action potentials and the spike-like action potentials. The mechanism underlying smooth muscle autorhythmicity seems different from that encountered in cardiac tissue, and evidence exists for metabolic regulation of the frequency of slow wave type action potentials. PMID- 1782596 TI - Adaptation of intestinal glucose transport in rats with diabetes mellitus occurs independent of hyperphagia. AB - Chronic diabetes enhances intestinal absorption of glucose and induces hyperphagia. We examined the enhanced intestinal absorption of glucose in ad libitum-fed rats with streptozocin-induced diabetes mellitus and compared these results with those obtained from pair-fed diabetic animals. Maximal transport capacity (Vmax) and carrier affinity (K0.5) were determined by measuring jejunal and ileal short circuit current (Isc) responses to varying concentrations of 3-O methyl-D-glucopyranose and D-glucose. Pair-fed diabetic animals maintained the same body weight as animals fed ad libitum, although ad libitum-fed diabetic rats had an increased oral chow intake. Age-matched control rats maintained a constant jejunal and ileal Vmax and K0.5 throughout the study. Diabetic rats fed ad libitum demonstrated an enhanced Vmax and K0.5 in both jejunum and ileum. Pair feeding diabetic animals further enhanced jejunal Vmax while lowering jejunal K0.5 levels. In contrast, pair feeding diabetic animals delayed and blunted changes in ileal Vmax and prevented changes in ileal K0.5. In conclusion, signals other than those of hyperphagia regulate kinetic changes in glucose absorption during diabetes mellitus. Furthermore, these changes have differing effects on jejunum and ileum. PMID- 1782597 TI - Calcitonin gene-related peptide: an inhibitor of guinea pig gallbladder contraction. AB - Calcitonin gene-related peptide (CGRP) relaxes vascular and intestinal smooth muscle. This study localized CGRP in the guinea pig gallbladder, examined the effects of CGRP on KCl- and ACh-induced contraction, and determined CGRPs site of action in the gallbladder. The gallbladder of male Hartley guinea pigs was used in in vitro tension studies, radioimmunoassay, or immunocytochemical studies. Radioimmunoassay showed that 8.0 +/- 0.5 pmol/g of immunoreactive CGRP was present. Immunocytochemistry demonstrated that immunoreactive-CGRP nerve fibers occurred around blood vessels, in gallbladder smooth muscle layers, and were associated with ganglia. No immunoreactive cell bodies were observed, even after colchicine treatment. The in vitro tension studies showed that CGRP inhibits either KCl- or acetylcholine-stimulated contraction. CGRP may in part act directly on the gallbladder smooth muscle to inhibit contraction. PMID- 1782598 TI - Acute severe carbon monoxide exposure in the rat: effects of hyperglycemia and hypoglycemia on mortality, recovery, and neurologic deficit. AB - Human and animal studies suggest a poorer outcome in the presence of abnormal blood glucose concentration during cerebral hypoxia-ischemia. It is unknown whether this is also the case in acute severe carbon monoxide poisoning. Using Levine-prepared rats, three groups were established and exposed to CO to answer this question: (1) hyperglycemics resulting from the administration of a 50% glucose solution, (2) hypoglycemics resulting from the administration of normal saline, and (3) untreated controls. The rats inhaled 2400 ppm CO for 90 min in the absence of anesthesia. Blood glucose was raised to a mean value of 402 mg/dL just prior to CO exposure in group 1. This resulted in an increased mortality rate (i.e., 54%), and during 4 h of room air recovery an impaired ability to regain body temperature, an increased plasma lactate dehydrogenase activity, and an increased neurologic deficit as compared with group 3. Hypoglycemia, which developed during CO exposure in group 2 (mean minimum glucose after 90 min, 44 mg/dL), resulted in an increased mortality rate (i.e., 46%), and during 4 h of room air recovery an impaired ability to regain body temperature and an increased neurologic deficit as compared with group 3. Blood glucose concentration in the rats in groups 2 and 3 that died during or shortly after CO exposure was significantly depressed relative to the survivors of those groups. Plasma insulin activity was elevated during CO exposure in group 1 as compared with group 3, but fell during recovery; insulin remained low throughout CO exposure and recovery in group 2. The results demonstrate the deleterious effects of both a very high and a very low blood glucose concentration during acute CO exposure. PMID- 1782599 TI - Comparative effects of dopamine and dobutamine on glucoregulation in a rat model. AB - The influence of dopamine as compared with dobutamine on glucose homeostasis has been assessed in thyroidectomized euthyroid rats. Both sympathomimetic agents were given intravenously over 6 h at four dosages, varying from 2 to 30 micrograms.kg-1.min-1. Immediately before the end of the infusion period, serum concentrations of glucose and insulin as well as plasma glucagon concentrations were measured. Dobutamine infusions did not exert any influence on these parameters. At a dose of 7.5 micrograms.kg-1.min-1, dopamine infusion caused a decrease in glucose concentrations, accompanied by a rise of glucagon and insulin levels. Glucose levels were significantly increased in the presence of unaltered insulin and decreasing glucagon levels at higher dopamine doses. The rise in glucose levels was reversed by 8 micrograms.kg-1.min-1 and inverted to a decrease by 12 micrograms.kg-1.min-1 of the alpha-adrenergic blocking agent phentolamine, simultaneously infused with 15 micrograms.kg-1.min-1 dopamine, while the insulin levels were increased and glucagon levels remained elevated. These findings demonstrate that dopamine acts on glucoregulation divergently, according to the dosage applied. The data suggest that dopamine rather than dobutamine treatment may disturb glucose homeostasis. PMID- 1782600 TI - Inhibitory effects of tetramethyl and tetraethyl derivatives of pyrazine on dog saphenous vein. AB - The effects of two structurally similar pyrazine derivatives, tetramethylpyrazine (TMP) and tetraethylpyrazine (TEP) on the contractile responses of dog saphenous vein to KCl (via membrane depolarization), phenylephrine (PHE, alpha 1-adrenergic agonist), and B-HT 920 (alpha 2-adrenergic agonist) were investigated. The relaxant or inhibitory effect of TMP and TEP was most potent on KCl-induced responses and least potent on PHE-induced responses. Their effect on KCl-induced responses was more prominent at 30 mM KCl than at 100 mM KCl. In Ca(2+)-free medium, PHE and B-HT 920 elicited transient responses, which were also markedly and reversibly inhibited by TMP and TEP. Similar results were also obtained when prostaglandin F2 alpha was used as an agonist. In all four types of contractile responses involving different receptors, the inhibitory effect of TEP was consistently more potent than that of TMP. We conclude that both TMP and TEP behave as a nonselective smooth muscle relaxant having similar and multiple actions including their general interference with the processes involving both Ca2+ entry and intracellular Ca2+ release. PMID- 1782601 TI - Reduction of tissue noradrenaline content in the isolated perfused rat heart during ischemia: importance of monoamine oxidation. AB - The effect of ischemia on myocardial noradrenaline concentration and endogenous noradrenaline output was studied in the isolated perfused rat heart. Following a 15-min stabilization period, regional ischemia was produced by coronary artery ligation. After 60 min of ischemia, noradrenaline concentrations were significantly reduced in the interventricular septum and left ventricle but not in the right ventricle. The reduction in tissue noradrenaline concentration was not prevented when the 60-min ischemia was replaced by a 10-min ischemia followed by a 50-min perfusion. No modification in noradrenaline output was observed during a 60-min ischemia. In contrast, reperfusion was accompanied by a washout of noradrenaline in the coronary effluent, corresponding to only 2% of the amount lost by the tissue. The effect of monoamine oxidase inhibition during the whole ischemic period was studied by perfusing the preparation with pargyline starting 10 min before the artery ligation. Although the administration of pargyline did not alter the noradrenaline output, it did prevent a reduction in myocardial noradrenaline concentration. It was concluded that monoamine oxidase may contribute to the elimination of the noradrenaline lost by the cardiac tissue during ischemia. PMID- 1782602 TI - Potentiation of the natriuretic effect of clonidine following indomethacin in the rat. AB - Previous studies have demonstrated a diuretic effect of clonidine at low intrarenal infusion rates with a natriuretic effect being observed at high infusion rates (greater than or equal to 3 micrograms.kg-1.min-1). The natriuresis at high infusion rates may have been secondary to increased renal prostaglandin production. We therefore evaluated the effects of indomethacin (a cyclooxygenase inhibitor) on the response to clonidine in the anesthetized rat. Intrarenal infusions of saline (vehicle) or clonidine (0.1, 0.3, 1, and 3 micrograms.kg-1.min-1) were examined both in the presence and absence of pretreatment with indomethacin (5 mg/kg, i.p.). Clonidine produced a dose-related increase in urine volume and free water clearance at 0.3, 1, and 3 micrograms.kg 1.min-1 as compared with the vehicle group. Sodium excretion and osmolar excretion were increased only at the highest infusion rate investigated. Following indomethacin pretreatment, clonidine produced a greater increase in urine volume at each infusion rate investigated. The indomethacin pretreatment also resulted in a potentiation of the natriuretic effect of clonidine at all infusion rates. Interestingly, this was associated with an increase in osmolar clearance but not free water clearance. These effects of indomethacin were reversed by infusion of prostaglandin E2. An infusion of prostaglandin E2 attenuated the indomethacin-induced increase in both urine flow rate and sodium excretion, indicating that the effects of indomethacin were mediated by prostaglandin inhibition. These results suggest that endogenous prostaglandin production attenuates the renal effects of clonidine, and as well, that in the presence of alpha 2-adrenoceptor stimulation, prostaglandin E2 mediates an antidiuretic and antinatriuretic effect. PMID- 1782603 TI - Effects of various secretagogues on [Ca2+]i in cultured human nasal epithelial cells. AB - Recent studies conducted on cultured canine tracheal cells have suggested that a complex relationship exists between cAMP and Ca2+ in the control of electrolyte secretion. The goal of this study was to determine if the Ca2+ second messenger system functions in a similar fashion in cultured human nasal epithelial cells, a tissue in which control of electrolyte secretion is known to be disrupted in the genetic disease, cystic fibrosis. Human nasal epithelial tissue was obtained as a by-product of surgery and put into monolayer cell culture. After 4-5 days in culture, cells were loaded with fura-2 and intracellular free Ca2+ measured as previously reported. We found that bradykinin increased intracellular free Ca2+ in all cells tested, whereas isoproterenol increased intracellular free Ca2+ in only half the cells tested, suggesting that more than one transporting cell type may be present in this tissue. Epinephrine and prostaglandin E2 had no effect on intracellular free Ca2+. We found that the voltage-sensitive Ca2+ channel blocker verapamil had no effect on the bradykinin-induced change in intracellular free Ca2+. Removal of Ca2+ from the bathing saline only slightly attenuated the increase in intracellular free Ca2+ that resulted from stimulation with bradykinin. We conclude that the source of the increased intracellular free Ca2+, observed during stimulation with secretagogues, was primarily intracellular stores. PMID- 1782604 TI - Plasma epinephrine in chronically adrenodemedullated rats: lack of response to acute or chronic exercise. AB - Even if it is well established that epinephrine is a hormone originating from the adrenal medullae, the reappearance of circulating epinephrine has been reported in rats a few days after adrenodemedullation. To verify if the extra-adrenal tissue responsible for this epinephrine production can be stimulated, sham operated or adrenodemedullated rats, either trained or kept sedentary, were submitted to an acute exercise stimulation test. Blood sampling was done before and after the test in precannulated rats for the determination of plasma epinephrine, norepinephrine, and corticosterone levels. Basal epinephrine levels were significantly reduced in trained and sedentary adrenodemedullated rats compared with their sham-operated counterparts. In response to exercise, there was no significant rise in epinephrine levels in both groups of adrenodemedullated rats. The norepinephrine levels in the basal state and in response to exercise were not altered by adrenodemedullation nor by physical conditioning. Basal corticosterone levels were similar between adrenodemedullated and sham-operated animals, either trained or kept sedentary. In response to exercise, corticosterone levels increased significantly in each group of rats but to a lesser extent in both groups of adrenodemedullated animals. These data indicate that the extra-adrenal epinephrine secretion that develops in the absence of adrenal medullae is not influenced by acute exercise nor by physical training. PMID- 1782605 TI - Early adaptations in blood substrates, metabolites, and hormones to prolonged exercise training in man. AB - This study was designed to investigate the effect of short-term, submaximal training on changes in blood substrates, metabolites, and hormonal concentrations during prolonged exercise at the same power output. Cycle training was performed daily by eight male subjects (VO2max = 53.0 +/- 2.0 mL.kg-1.min-1, mean +/- SE) for 10-12 days with each exercise session lasting for 2 h at an average intensity of 59% of VO2max. This training protocol resulted in reductions (p less than 0.05) in blood lactate concentration (mM) at 15 min (2.96 +/- 0.46 vs. 1.73 +/- 0.23), 30 min (2.92 +/- 0.46 vs. 1.70 +/- 0.22), 60 min (2.96 +/- 0.53 vs. 1.72 +/- 0.29), and 90 min (2.58 +/- 1.3 vs. 1.62 +/- 0.23) of exercise. The reduction in blood lactate was also accompanied by lower (p less than 0.05) concentrations of both ammonia and uric acid. Similarly, following training lower concentrations (p less than 0.05) were observed for blood beta-hydroxybutyrate (60 and 90 min) and serum free fatty acids (90 min). Blood glucose (15 and 30 min) and blood glycerol (30 and 60 min) were higher (p less than 0.05) following training, whereas blood alanine and pyruvate were unaffected. For the hormones insulin, glucagon, epinephrine, and norepinephrine, only epinephrine and norepinephrine were altered with training. For both of the catecholamines, the exercise-induced increase was blunted (p less than 0.05) at both 60 and 90 min. As indicated by the changes in blood lactate, ammonia, and uric acid, a depression in glycolysis and IMP formation is suggested as an early adaptive response to prolonged submaximal exercise training. PMID- 1782606 TI - Insulin secretion and islet endocrine cell content at onset and during the early stages of diabetes in the BB rat: effect of the level of glycemic control. AB - Although it is agreed that autoimmune destruction of pancreatic islets in diabetic BB rats is rapid, reports of endocrine cell content of islets from BB diabetic rats at the time of onset of diabetes vary considerably. Because of the rapid onset of the disease (hours) and the attendant changes in islet morphology and insulin secretion, it was the aim of this study to compare islet beta-cell numbers to other islet endocrine cells as close to the time of onset of hyperglycemia as possible (within 12 h). As it has been reported that hyperglycemia renders the beta cell insensitive to glucose, the early effects of different levels of insulin therapy (well-controlled vs. poorly controlled glycemia) on islet morphology and insulin secretion were examined. When measured within 12 h of onset, insulin content of BB diabetic islets, measured by morphometric analysis or pancreatic extraction, was 60% of insulin content of control islets. Despite significant amounts of insulin remaining in the pancreas, 1-day diabetic rats exhibited fasting hyperglycemia and were glucose intolerant. The insulin response from the isolated perfused pancreas to glucose and the glucose-dependent insulinotropic hormone, gastric inhibitory polypeptide (GIP), was reduced by 95%. Islet content of other endocrine peptides, glucagon, somatostatin, and pancreatic polypeptide, was normal at onset and at 2 weeks post onset. A group of diabetic animals, maintained in a hyperglycemic state for 7 days with low doses of insulin, were compared with a group kept normoglycemic by appropriate insulin therapy. No insulin could be detected in islets of poorly controlled diabetics, while well-controlled animals had 30% of the normal islet insulin content.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782607 TI - Effect of renal denervation on plasma renin activity after aortic baroreceptor deafferentation. AB - Renal nerves are thought to play an important role in cardiovascular regulation under both normotensive and hypertensive conditions. In the present study the effect of renal denervation on the changes in plasma renin activity (PRA) after aortic baroreceptor deafferentation (tADN) were investigated in the rat. Bilateral renal denervation did not alter arterial pressure (AP, 100 +/- 4 mmHg; 1 mmHg = 133.32 Pa), heart rate (HR, 363 +/- 12 bpm), or PRA (2.9 +/- 0.6 ng.mL 1.h-1) compared with the respective sham renal denervation values of 106 +/- 3 mmHg (AP), 385 +/- 13 bpm (HR), and 3.3 +/- 0.7 ng.mL-1.h-1 (PRA). On the other hand, bilateral tADN resulted in significant increases in AP, HR, and PRA. One and 3 days after tADN, AP was 130 +/- 4 and 127 +/- 6 mmHg, HR was 461 +/- 15 and 463 +/- 20 bpm, and PRA was 9.1 +/- 3.0 and 11.9 +/- 4.5 ng.mL-1.h-1, respectively. Renal denervation before tADN prevented the increases in AP and PRA, but it did not affect the increase in HR. These data indicate that renal denervation does not alter basal PRA in normotensive animals but prevents the increased renin release observed in neurogenic hypertension. These data suggest that the increased PRA may be one of several factors that contributes to the elevated AP after tADN. PMID- 1782608 TI - H-reflex modulation during walking in spastic paretic subjects. AB - Hoffman (H) reflexes were elicited from the soleus muscle during treadmill walking in 21 spastic paretic patients. The soleus and tibialis anterior muscles were reciprocally activated during walking in most patients, much like that observed in healthy individuals. The pattern of H-reflex modulation varied considerably between patients, from being relatively normal in some patients to a complete absence of modulation in others. The most common pattern observed was a lack of H-reflex modulation through the stance phase and slight depression of the reflex in the swing phase, considerably less modulation than that of normal subjects under comparable walking conditions. The high reflex amplitudes during periods of the step cycle such as early stance seems to be related to the stretch induced large electromyogram bursts in the soleus in some subjects. The abnormally active reflexes appear to contribute to the clonus encountered during walking in these patients. In three patients who were able to walk for extended periods, the effect of stimulus intensity was examined. Two of these patients showed a greater degree of reflex modulation at lower stimulus intensities, suggesting that the lack of modulation observed at higher stimulus intensities is a result of saturation of the reflex loop. In six other patients, however, no reflex modulation could be demonstrated even at very low stimulus intensities. PMID- 1782609 TI - Correlation between cerebral blood flow, somatosensory evoked potentials, CT scan grade and neurological grade in patients with subarachnoid hemorrhage. AB - Cerebral blood flow (CBF) and central conduction time (CCT) were recorded from 58 subarachnoid hemorrhage patients and from 49 age-matched controls. CBF was calculated following Xenon inhalation and CCT was determined from somatosensory evoked potentials (SSEP's) following median nerve stimulation. Each patient had a CT scan on the day of admission which was graded from I-IV. CBF, CCT and neurological grade (Hunt and Hess classification) were concomitantly recorded 1, 4, 7 and 14 days after subarachnoid hemorrhage. Mean CBF was highest in patients with neurological grades I and II (48.6 +/- 12.3 and 48.1 +/- 10.3 ml/100gm/min respectively) and lowest in patients with neurological grade IV (37.3 +/- 9.6 ml/100gm/min). Patients in neurological grade I or II had mean CBF and CCT measurements that were significantly different from those obtained from patients in neurological grade IV (P less than 0.05). Neurological grade and CT scan grade correlated with CBF (P less than 0.0001) better than CCT (P = 0.015). Unexpectedly low CBF's from patients in neurological grades II and III (less than 37 and less than 31 ml/100gm/min respectively) failed to significantly prolong CCT suggesting CCT is unable to detect marginal ischemia. A significant correlation between CBF and CCT occurred only when CBF was less than 30 ml/100gm/min (R = 0.75, P = 0.05). It appears that prolonged CCT is associated with a drop in CBF only when CBF drops below a certain threshold. PMID- 1782610 TI - Intraparenchymal and intraventricular hemorrhage without mass effect in traumatic coma. AB - A group of 57-head injured patients showing computerized tomographic (CT) findings compatible with "diffuse brain injury" or of the so called "diffuse axonal injury" is analyzed. Thirty-four patients showed intraparenchymal hemorrhage in the CT scan study, 8 intraventricular hemorrhage and 15 patients had both intraparenchymal and intraventricular hemorrhage. Forty percent (23/57) of those with these findings had associated intracranial focal lesions. The deep nuclei are the most common location of intraparenchymal hemorrhage. Signs of brain stem hemorrhage were seen in 9 patients. Forty-nine percent of patients in this series had a good outcome. Old age (greater than 60), abnormal motor response, abnormal eye signs, associated with focal lesions, and evidence of brain stem hemorrhage are reliable prognostic parameters for a grave outcome. PMID- 1782611 TI - Complications of the transsphenoidal approach to sellar lesions. AB - Transsphenoidal surgery is currently performed extensively for lesions of the sella turcica. The mortality and morbidity of this surgical approach are minimal, and the results satisfactory overall. Only a few studies have addressed the complications of this approach. The authors present a retrospective study of 200 transsphenoidal procedures in 196 patients over an eleven year period. There was one death due to meningitis. Major morbidity consisted of intraventricular hemorrhage in three patients, false aneurysm of the internal carotid artery in one patient and thalamic infarction in another patient. Minor morbidity details are presented. The pathogenesis of the most serious of these complications along with possible preventive measures are discussed. PMID- 1782612 TI - Long-term evaluation of Sinemet CR in parkinsonian patients with motor fluctuations. AB - The safety and efficacy of Sinemet CR, a controlled-release formulation of carbidopa/levodopa, were investigated in a three year, open-label trial involving 18 parkinsonian patients with fluctuating motor response. The average daily levodopa dosing frequency did not change significantly during long-term treatment. Efficacy measures generally revealed a gradual progression of parkinsonian disability. Patient diaries of motor fluctuations revealed relative stability of time "on" but with a tendency toward increased time "on with dyskinesias" over the 36 month follow-up period. There were no adverse laboratory results deemed to be related to Sinemet CR and no unexpected side effects were observed. PMID- 1782613 TI - Inter-observer agreement in assessing comatose children. AB - Inter-observer agreement was evaluated for twelve items used in the neurological assessment of comatose children. Data were obtained prospectively on fifteen patients examined independently by two observers in a double-blind fashion. Observer variability was measured by using the Disagreement Rate and Kappa statistic. The Disagreement Rate ranged from 0.01 to 0.12 for all items. Values for Kappa statistic were generally in accordance with those for Disagreement Rate. The data suggest fair to almost perfect inter-observer agreement for the items used to assess comatose children in this study. PMID- 1782614 TI - Multi-joint reaching movements and eye-hand tracking in cerebellar incoordination: investigation of a patient with complete loss of Purkinje cells. AB - Performance on an eye-hand tracking task and a multi-joint reaching movement to a visual target was studied in a patient with stable cerebellar ataxia and in control subjects. The patient subsequently died and a full neuropathological examination was performed. The neuropathological findings were similar to those seen in patients with paraneoplastic cerebellar degeneration, but no tumor was found at autopsy eight years after onset of the patient's cerebellar syndrome. A severe cerebellar cortical degeneration with complete Purkinje cell loss was demonstrated, whereas cerebellar nuclei and brainstem structures showed no neuronal loss. Tracking performance by the patient was characterized by abnormally large numbers of high velocity movements and hand direction reversals, and by excessive lagging of the hand behind the target in time. In the multi joint reaching movement, the patient showed a delay in movement onset at the elbow joint compared to movement onset at the shoulder joint. The velocity profile of the movement at the shoulder joint was abnormal. The duration of the acceleration phase was poorly correlated with both peak angular velocity and the duration of the deceleration phase. One of the most striking findings was the inability of the patient to consistently produce the same movement direction from trial to trial while reaching to the same target. Our data suggests that the cerebellar cortex is involved in multiple aspects of motor control including visuomotor integration mechanisms. PMID- 1782615 TI - Clinical correlates and electroencephalographic characteristics of two additional patterns related to 14 and 6 per second positive spikes. AB - Two additional patterns, minuscule 28 per second positive spikes and huge N-shape potentials, have been identified exclusively in the EEGs of patients with 14 and 6 per second positive spikes. They occur predominantly during drowsiness and light sleep, usually in children, seldom in young adults. Their presence adds little to the clinical relevance of positive spikes. Familiarization with the N shape potentials--the commoner of the two patterns--is important, lest they are mistaken for interictal abnormalities of significance such as atypical spike-wave complexes. PMID- 1782616 TI - 3-Nitropropionic acid-exogenous animal neurotoxin and possible human striatal toxin. AB - 3-Nitropropionic acid (3-NPA)--a suicide inhibitor of succinate dehydrogenase--is a widely distributed plant and fungal neurotoxin known to induce a damage to basal ganglia, hippocampus, spinal tracts and peripheral nerves in animals. Recent reports from Northern China indicate that 3-NPA is also likely to be responsible for the development of putaminal necrosis with delayed dystonia in children after ingestion of mildewed sugar cane. This article discusses the role of 3-NPA in the causation of the disease in China, its neurotoxic effects in animals and the potential role for this compound as a probe of selective neuronal vulnerability. PMID- 1782617 TI - Current status of radiosurgery for arteriovenous malformations. AB - Cerebral arteriovenous malformations (AVM), regardless of the mode of discovery, have an annual risk of hemorrhage of approximately 4 percent. A progressive obliterative vasculitis culminating in the occlusion of an AVM may be induced by the administration of radiation doses of approximately 20 Gy given in a single fraction. The process takes about two years and occlusion occurs in approximately 80% of patients so treated. Such a dose may be accurately administered to AVMs up to 3 cm in diameter with very little radiation imparted to the adjacent brain by means of multiple highly collimated radially arranged cobalt sources (the Gamma Knife) or by means of a modified linear accelerator turned through an arc or arcs with the target AVM as the centre of rotation. The Gamma Knife and the modified linear accelerator have nearly equal accuracy. Recent experience with modified linear accelerators indicates efficacy equal to the Gamma Knife. Both devices are effective treatment for small AVMs but the cost of modifying a pre-existing linear accelerator is only a few percent of the acquisition and installation costs of the Gamma Knife. PMID- 1782618 TI - Auricular myoclonus. AB - We describe a young man with a two and a half year history of idiopathic irregular contractions of an antitragicus muscle in the absence of a more generalized movement disorder. These contractions persisted in sleep and could not be replicated voluntarily. Because proximal nerve block temporarily eliminated the movements and complex hand movements reduced their amplitude and frequency, we suspect a central generator. However, these movements were not associated with any known pathologic condition. PMID- 1782619 TI - The association between polycystic kidney disease and cerebral aneurysms. AB - Rupture of cerebral aneurysms is an important cause of morbidity and mortality in patients with adult polycystic kidney disease (PKD). In the present paper, we review the literature regarding the association of cerebral aneurysms and PKD and emphasize, by means of a case report, the importance of familial clustering of aneurysms in patients with PKD. We conclude that the prevalence of intracranial aneurysms in patients with PKD approaches 40% and is likely significantly higher in patients with PKD and a positive family history for cerebral aneurysm. We recommend that screening cerebral angiography be strongly considered in all patients with PKD and a family history of cerebral aneurysm or subarachnoid hemorrhage. PMID- 1782620 TI - Pupillary areactivity in hydrocephalus of recent onset. AB - A patient who presented with bilateral loss of all pupillary reactions and normal ocular motor function is reported. Investigation revealed the presence of massive hydrocephalus. The syndrome developed shortly after transsphenoidal surgery for a suprasellar craniopharyngioma. Pupillary function returned to normal following the insertion of a ventriculo-peritoneal shunt. It is suggested that the syndrome was due to compression of the visceral oculomotor nuclei by a dilated sylvian aqueduct. PMID- 1782621 TI - Eosinophilic granuloma of the occipital bone presenting as intracranial venous hypertension. AB - Intracranial venous sinus thrombosis is an uncommon cause of pseudotumor cerebri. The diagnosis is often not confirmed on the rationale that treatment will not be altered. We report a case presenting a pseudotumor cerebri where the underlying pathology disclosed dural sinus thrombosis resulting from compression by an eosinophilic granuloma of the occipital bone. Routine CT of the head and Technetium-99m brain scan initially demonstrated neither tumor nor thrombosis. Plain skull x-rays subsequently revealed a lytic lesion of the occiput. When reinvestigated with CT using bone density windows the tumor was revealed. Excision of the tumor and a short course of cobalt therapy was curative. Special techniques in nuclear scanning, CT and MRI designed to improve the sensitivity for diagnosing venous sinus thrombosis are described. This case illustrates the importance of establishing a definitive diagnosis and shows the importance of pre test consultation between clinicians and radiologists to ensure that specific investigative techniques are properly utilized. PMID- 1782622 TI - Clival chordoma presenting with acute brain stem hemorrhage. AB - The authors present a case of a 29-year-old man who developed rapidly progressive cranial nerve palsies and a right hemiparesis secondary to a pontine hemorrhage. The rare but correct diagnosis of a clival chordoma which had invaded the brain stem and subsequently hemorrhaged was based on computed tomography and magnetic resonance imaging. The diagnosis was confirmed at surgery when the patient underwent a successful operative decompression of tumor and clot from the pons via a sub-occipital craniotomy. This represents the first case of a clival chordoma to hemorrhage into the brain stem, which was diagnosed preoperatively and the patient survived. PMID- 1782623 TI - Anesthesiology and allergy. PMID- 1782624 TI - Anaphylactic and anaphylactoid reactions. Clinical presentation. PMID- 1782625 TI - Risk factors for allergic or pseudoallergic reactions in the perioperative period. PMID- 1782626 TI - Allergy to protamine. AB - Recent advances in medicine, such as cardiac catheterization, phoresis, dialysis, and cardiopulmonary bypass technology, have increased the need for heparin anticoagulation. To antagonize heparin's effect and prevent hemorrhagic complications after the procedure, protamine has likewise been used more frequently. With its increased use have come increased reports of adverse protamine reactions consisting of rash, urticaria, elevation of pulmonary artery pressure, systemic hypotension, and, at times, death. The elevation of pulmonary artery pressure, which appears to be a rather common occurrence in animals, may be an isolated finding without clinical consequences in humans. However, this pulmonary vasoconstriction may, when severe, lead to acute right-sided heart failure and systemic hypotension. Other protamine reactions involve a decrease in systemic vascular resistance and systemic hypotension without changes in pulmonary artery pressure. Causes of acute protamine reactions may involve the generation of anaphyatoxins and prostanoids either from protamine-heparin complexes or complement-fixing antiprotamine IgG antibodies, from inhibition of plasma Carboxypeptidase N, from crosslinking of cell-surface antiprotamine IgE on mast cells and basophils with subsequent mediator release, or from potentiation of IgE-mediated release of histamine through a polycationin-recognition site. Although we have come a long way in understanding the mechanisms by which protamine can cause its ill effects in humans, more work is clearly needed to define, in prospective studies, the incidence of and risk factors for protamine reactions in various patient groups, and to delineate more clearly which mechanisms are involved in each clinical type of acute protamine reaction. Hopefully, this will lead to strategies and protamine alternatives that will prevent or diminish, in frequency or severity, adverse protamine reactions. Alternatively, a clearer picture of the risk factors important for protamine reactions and the predictive value of diagnostic tests (e.g., protamine IgE antibody) can also minimize the clinical impact of this increasingly common adverse event. PMID- 1782627 TI - Allergy to formaldehyde and ethylene-oxide. PMID- 1782628 TI - Allergy to latex. PMID- 1782629 TI - Accidents resulting from local anesthetics. True or false allergy? PMID- 1782630 TI - Management of anaphylactic and anaphylactoid reactions during anesthesia. PMID- 1782631 TI - Tobacco control--action and obstacles. AB - World experience has shown the crucial need for government commitment, funding, and action in reducing the tobacco epidemic. It is recommended that each country establish a national council on tobacco or health to coordinate a comprehensive tobacco control program. This program should incorporate data collection including evaluation of specific anti-tobacco measures; legislative measures including strong, rotating health warnings, limits on harmful substances, establishment of smoke-free areas, bans on any new forms of tobacco use, and a total ban on all promotion of tobacco products; health education campaigns; and taxation and price policies. The support and involvement of the medical profession are vital. Obstacles to success include cultural factors, the intertia of governments and the medical profession, but most importantly the tobacco industry, the largest, wealthiest, most determined, and strongest opposition to tobacco control worldwide. PMID- 1782632 TI - Mortality from respiratory and digestive cancers among asbestos cement workers in Italy. AB - A cohort study is presented on the mortality of blue-collar workers in an asbestos-cement production plant that has been operating since 1907. Use of both crocidolite and chrysotile is reported. The cohort includes 2608 men and 759 women who were employed in the plant on Jan. 1, 1950 and those who started to work between 1950 and 1980. Follow-up was terminated on April 15, 1986 with 97.9% traced. Expected deaths were estimated from the age- and sex-specific regional mortality rates for the years 1969 to 1981. The data have been analyzed for the period 1964 to 1986 based on person-years at risk: 43,000 for men and 14,494 for women. A statistically significant increase was found in both sexes for mortality from all causes. From 1964 to 1986, 728 men died from all causes (608 expected), 275 with cancer at any site (158 expected) 110 with lung cancer (41 expected), 28 with pleural tumors (1 expected) and 85 with asbestosis (less than 1 expected). Corresponding figures for women were--all causes: 136 deaths versus 102 expected; all cancers: 79 verses 32 expected; lung cancer: 7 versus 2 expected; pleural tumor: 15 versus 0 expected and asbestosis: 4 versus 0 expected. Deaths from digestive tract cancer were in excess only among women (18 observed versus 10 expected, p less than 0.01). No excess was found for deaths from laryngeal cancer. Standardized mortality rates (SMR) for lung cancer among males showed a clear increase in direct relationship with length of follow-up. SMR according to length of employment were 234 for length 10 to 19 years, 363 for 20 to 29 years, and 256 for 30 years or longer (p less than 0.05 and lower). PMID- 1782633 TI - Prospective mortality study among iron miners. AB - A prospective mortality study was conducted over a period of 5 years on a group of 13,801 iron miners, who were alive on January 1, 1982. During this 5-year period, 1813 deaths were registered. For 1222 (67.4%), the cause of death and work history are known. For 135 (7.4%), the cause of death is known, but not the work history. For 455 (25.1%), the cause of death is unknown. Proportional mortality ratio (PMR) is significantly higher than 1 for lung cancer (PMR = 2.51, p less than 0.001) and for stomach cancer (PMR = 2.31, p less than 0.001). The results are discussed in regard to occupational risks that result in these two kinds of increased mortality rates, and the hypothesis of redox activity on the surface of dust particles is advanced as a common denominator. PMID- 1782634 TI - Community-based cancer prevention--the Stockholm Cancer Prevention Program. AB - The Stockholm Cancer Prevention Program (SCPP) is among the first comprehensive community intervention programs in the world aimed at reducing cancer incidence and mortality. The program began in 1987 in an urban area with more than 1.6 million inhabitants. In its work, SCPP utilizes a community-based approach focusing on (1) reduction in tobacco consumption, (2) reduction in dietary fat consumption and increase in dietary fiber consumption, and (3) changing sunbathing behavior in order to reduce the incidence of malignant melanoma. The overall philosophy of the program is to initiate activities capable of affecting the life style of the Stockholm population in these directions. SCPP intends to influence behavior through individual face-to-face contact. The tool for this contact is collaboration with independent organizations which are already active in the target communities. Food supply to the general public will be influenced through food producers, wholesalers, retailers, and caterers. Tobacco use, food habits, and sunbathing habits will be influenced via occupational health services; public health services including primary care, schools and municipal social services; voluntary organizations; and mass media. A model for possible ways of evaluating the program has been designed. PMID- 1782635 TI - Prevention and early detection activities in primary care: new directions for implementation. AB - Physicians in primary care generally do not perform recommended prevention and early detection services. Many factors influence the utilization of these services; however, often not considered and/or well understood is the very process whereby these services are adopted within the primary care setting. Understanding the process, and factors affecting the process, suggest new directions for designing and implementing effective intervention strategies which increase the use of such services. New directions include the importance of identifying a discrepancy between what the practice is doing vis-a-vis what it should be doing as the first stage in the adoption process; the identification of the particular stage within the overall adoption process which best characterizes the practice and tailoring specific interventions to the requirements of that stage; emphasizing the reshaping of work actually performed within the practice beyond simply changing knowledge and attitudes of physicians and support personnel; recognition that there is a changing set of expectations to which the practice is at risk to be held accountable in any litigation; and finally that the interventions have realistic time expectations. PMID- 1782636 TI - The estimation of sensitivity and specificity in colorectal cancer screening methods. AB - The sensitivity and specificity of three screening tests for colorectal cancer were evaluated using latent class analysis. This type of analysis is useful in situations where screening tests are performed on each person and follow-up diagnostic test results are not available for individuals with negative test results. Traditional methods of evaluation, which assume these individuals to be disease free, may be biased under these circumstances. In addition to providing the parameter estimates, the latent class technique gives standard errors and permits significance tests for differences in sensitivity and specificity. It was found that the radial immunodiffusion technique was significantly more sensitive (p less than 0.001) than either the rehydrated or nonrehydrated Hemoccult II tests for detecting occult blood in patients with cancer or adenoma. While comparable to the rehydrated Hemoccult II test in terms of specificity, the radial immunodiffusion technique was significantly less specific (p less than 0.01) than the nonrehydrated Hemoccult test. Similar results were observed when restricting the analysis to cancer only. PMID- 1782637 TI - Effect of a mass screening program on the risk of cervical cancer. AB - In Finland, the organized mass screening program for cervical cancer was initiated in the mid-1960s. In the early 1970s, the program became nationwide and it covered the age groups of 30 to 55 years. Currently, the screened age groups are 25 to 60 years, and the screening interval is 5 years. The organized program has resulted in a substantial decrease in the incidence of and mortality from cervical cancer. The reduction in age-specific incidence for all age groups from 30-34 to 50-54 years between the 1960s and 1980s was over 70%. At the age of 60 years and over there has been a slight decrease since the mid-1970s. The trends in mortality from cervical cancer have decreased correspondingly. Between the 1960s and 1980s, the reduction in age-specific mortality for age groups from 30 34 to 54-59 years was about 80%. The decrease was about 50% in the age group 60 to 69 years. At the age of 70 years and over, the decrease was smaller. PMID- 1782638 TI - Neopterin as a marker for activated cell-mediated immunity: application in malignant disease. AB - A review is presented on studies concerning neopterin determination in patients with malignant neoplastic diseases. Neopterin is produced chiefly by human macrophages through their activation by T-cell-derived interferon gamma. In vivo, determinationof neopterin in various body fluids provides a convenient way to monitor early events that are involved in cell-mediated immune responses. In malignant neoplasia, elevation of neopterin concentrations in body fluids depends on tumor type. Within a given type of tumor, more advanced stages are generally associated with higher levels than early disease. In a variety of different tumor types and sites, a significantly poorer prognosis was associated with high pretherapeutic neopterin concentrations. This predictive value is independent of several possible confounders such as stage or therapy. During follow-up malignant disease, neopterin elevations may predict deterioration of the clinical status of the patients and thereby provide a valuable additional marker for monitoring such patients. Possible immunobiological implications of the results are discussed. PMID- 1782639 TI - Selenium therapy in patients with precancerous and malignant oral cavity lesions: preliminary results. AB - Baseline selenium (Se) levels in serum samples were collected from 22 patients with precancerous and 19 with malignant oral cavity lesions as well as from 13 healthy controls of the same geographic areas. Mean serum Se levels were 105, 101, and 77.03 ng/ml in the precancerous, controls, and malignancy groups, respectively. A statistically significant difference (p less than 0.005) was found between the neoplastic and both the precancerous and control groups. After careful clinical evaluation, precancerous patients received three 4-week cycles of Se, in either inorganic or organic form. Of the 22 precancerous patients entering the study, 18 were available for evaluation of clinical response. The analysis of serum Se variations revealed that serum Se levels tended to increase after the first and second cycles and then gradually returned to baseline values. At the end of the therapy, there were two complete responses (CR), five partial responses (PR), six minor responses (MR), and five stable diseases (SD) with an objective response (CR + PR) of 38.8%. Progression after suspension of therapy occurred in 7 of 18 patients; this may indicate the need of a longer treatment period with this essential trace element. PMID- 1782640 TI - Anandron (RU 23908) in metastatic prostate cancer: preliminary results of a multicentric Italian study. AB - Between March 1986 and March 1987, 48 patients with stage D prostate carcinoma were entered into a multicentric pilot study using the pure nonsteroidal antiandrogen nilutamide (Anandron--RU 23908) at the dose of 100 mg t.i.d. as the only therapy until disease progression or the occurrence of toxicity. Minimum follow-up was 15 months. Median age of patients was 72 (56 to 83) and median initial Performance Status (PS) was 1 (0 to 3). Of the 48 patients, 29 were untreated, while 19 patients were progressing following treatment by orchiectomy, LHRH analogs, or other endocrine therapies. According to the National Prostatic Cancer Project (NPCP) criteria, 43 patients were evaluable for response. Overall best response in untreated patients was partial response (PR), 41.6%; stationary disease (SD), 54.1%; 73.6% of pretreated patients achieved SD. Median progression free survival and overall survival in untreated patients were 325 and 696 days, respectively, and 174 and 447 days, respectively, in pretreated patients. The more common side effects were G.I. toxicity (65%), hemeralopia (27%), and alcohol intolerance (6.2%). Results of this study suggest that Anandron may be a safe and effective treatment for patients with advanced prostatic cancer. PMID- 1782641 TI - Percutaneous transluminal coronary angioplasty of a coronary artery stenosis at the site of myocardial bridging. AB - The incidence of myocardial bridging observed at angiography (0.5-16%) is far less than at pathologic study (greater than 50%). Myocardial bridging is felt to have a 'protective effect' on the coronary artery at the site of bridging, and significant atherosclerosis within the bridge is almost never seen at pathologic examination. To date, there have been no reports of significant atherosclerosis at the site of angiographically documented myocardial bridging. We report a unique case of an angioplasty of a left anterior descending artery stenosis within a myocardial bridge. This report also discusses the possible difference in the protective effect of myocardial bridging that is seen at angiography and myocardial bridging that is only appreciated pathologically but not angiographically. PMID- 1782642 TI - Evaluation of intensified prehospital treatment in out-of-hospital cardiac arrest: survival and cerebral prognosis. The Odense ambulance study. AB - During a period of 3 years three different types of emergency medical service (EMS) systems were evaluated in a city with about 238,000 inhabitants/population density of 570/km2. Included were 393 out-of-hospital cardiac arrest patients in whom prehospital cardiopulmonary resuscitation was provided by personnel on basic, intermediate, or advanced care training. When ordinary ambulances (basic EMS) were used, 8 (5%) patients were discharged alive. When ambulances with specially trained paramedics (intermediate EMS) were used, 2 (1%) patients were discharged. Finally medically staffed ambulances with doctors collaborating (advanced EMS) were used, and 11 (13%) patients were discharged. The intermediate EMS system was used in another area with 45,000 inhabitants/population density of 340/km2, and in this area 20 (18%) patients were discharged. Among the survivors a psychological assessment in form of a test for dementia was assessed in long term survivors (n = 30) together with 28 patients surviving acute myocardial infarction and 11 control persons. The results of the investigation demonstrate that the more intensive the prehospital treatment of out-of-hospital cardiac arrest, the more patients survive and the more patients survive with good cerebral function. However, the ambulances with specially trained paramedics were only effective in the area with 340 inhabitants/km2. PMID- 1782643 TI - Seminars in thrombosis, thrombolysis, and vascular biology. Part 5: Cellular rheology and plasma viscosity. AB - The fundamental determinants of coronary blood flow include the vessel radius, pressure gradient, and the physical characteristics of the cellular components and fluid medium. Specifically, cellular rheology and plasma viscosity determine, to a significant degree, both macro- and microcirculatory blood flow, particularly when either is compromised by existing atherosclerotic narrowing or reperfusion injury. Among individuals with coronary heart disease, abnormalities in cellular rheology and plasma viscosity may be the best predictors of subsequent cardiac events. Therefore, efforts to limit morbidity and mortality may depend on a more in-depth understanding of these basic areas. PMID- 1782644 TI - Prognosis in patients with ST-T changes but no rise in serum enzyme activity as compared with non-Q-wave infarction. AB - We evaluated the prognosis for 419 patients admitted to hospital due to suspected acute myocardial infarction (AMI) who developed ST-T changes, but no rise in serum enzyme activity, and compared it to that of 508 patients developing non-Q wave AMIs. We conclude that these patients have a high 1-year mortality (13%), although significantly lower than in patients with non-Q-wave AMIs (31%). The mortality is higher in patients with only ST depression (n = 86; 22%) than in patients with only T-wave inversion (n = 264; 8%). PMID- 1782645 TI - Predictive value of a negative exercise electrocardiogram. AB - Conventionally, if an exercise electrocardiogram does not show evidence of ischemia, the patient must have achieved at least 85% of the predicted maximum heart rate for that test to be considered negative. However, no documentation of the validity of this practice exists. Thus, we evaluated the exercise electrocardiograms of 164 patients who had also undergone coronary angiography within 6 months of the exercise test. The predictive value of a negative exercise electrocardiogram was determined for each percentage point between 50 and 90% of the age-predicted maximum heart rate achieved or exceeded. The predictive value was found to increase modestly between 65 and 80% of the predicted maximum heart rate with no major changes above or below this range. Thus, it appears reasonable (in the setting of a hospital-based exercise laboratory) to either consider a negative exercise electrocardiogram as a valid finding if at least 80% of the predicted maximum heart rate is achieved, or preferably to simply report the negative finding with the percent maximum heart rate attained and the proviso that the predictive value of the test is progressively improved as higher heart rates are attained. PMID- 1782646 TI - Left ventricular function immediately after exercise in elite cyclists. AB - To determine the response to exercise of the left ventricle of endurance-trained athletes, 6 elite (world class) cyclists were compared to 6 untrained healthy control subjects. In athletes the stroke volume increased with exercise. In untrained volunteers the stroke volume did not change with exercise. This difference of the response of the stroke volume to exercise reflected a difference of the left ventricular end-diastolic volume. In athletes the left ventricular end-diastolic volume tended to increase. In control subjects the end diastolic volume decreased. In conclusion, athletes increased cardiac output by increasing stroke volume and heart rate, whereas control subjects increased their cardiac output only by increasing their heart rate. PMID- 1782647 TI - Electrocardiographic findings in athletic students and sedentary controls. AB - We have investigated resting electrocardiograms from 1,299 athletic students taken in the same laboratory during the years 1973-1982 and compared them with electrocardiograms recorded in 151 age- and sex-matched sedentary controls. Fifty two parameters were recorded for each electrocardiogram and computerized. We found that athletic students had a significant lower heart rate, longer PQ time and a prolonged QTc compared to control subjects. Athletes had higher maximal Q amplitudes in precordial leads, higher R in V1, and higher indices of right ventricular hypertrophy (RV1 + SV5) and left ventricular hypertrophy (Sokolow Lyon and Grant indices). Furthermore, the athletes had higher maximal ST elevation and higher maximal T wave amplitudes in precordial leads. Sinus bradycardia was more frequent in athletes. All control subjects were in sinus rhythm whereas 0.9% of the athletes had other rhythms (nodal, coronary sinus or wandering pacemaker). Athletes and control subjects did not differ significantly with regard to premature beats, atrioventricular block, bundle branch block or the Wolff-Parkinson-White pattern. We conclude that training induces significant changes in heart rate, conduction times, ST elevation. QRS and T voltage, slow rhythm disturbances and atrioventricular and sinoatrial block were infrequent in the resting electrocardiogram taken in the supine position and disappeared immediately on sitting and during exercise. Training-induced electrocardiographic changes may partly be due to alterations in autonomic tone and partly to structural changes in the myocardium. Different normal criteria for left ventricular hypertrophy may be warranted in athletes. PMID- 1782648 TI - Echocardiographic and color Doppler flow diagnosis of double-chambered right ventricle. AB - Double-chambered right ventricle is a rare condition in adults. This report of a 38-year-old asymptomatic woman details the importance of echocardiography, color flow imaging and continuous-wave Doppler for the noninvasive diagnosis of this entity. PMID- 1782649 TI - Dissecting aortic aneurysm--failure of standard noninvasive and invasive diagnostic techniques. AB - The diagnosis of cardiac tamponade due to dissection of an ascending aortic aneurysm in a middle-aged woman was not confirmed by the usual noninvasive and invasive procedures. The decision for surgery was based on clinical grounds only, resulting in an unnecessary delay of surgical intervention. Although some of the current noninvasive techniques seem to be most useful in the investigation of these patients, the clinical findings remain the cornerstone of a correct diagnosis. PMID- 1782650 TI - Molecular interactions between the photoreceptor G protein and rhodopsin. AB - 1. The visual transduction system of the vertebrate retina is a well-studied model for biochemical and molecular studies of signal transduction. The structure and function of rhodopsin, a prototypical G protein-coupled receptor, and transducin or Gt, the photoreceptor G protein, have been particularly well studied. Mechanisms of rhodopsin-Gt interaction are discussed in this review. 2. The visual pigment rhodopsin contains a chromophore, and thus conformational changes leading to activation can be monitored spectroscopically. A model of the conformational changes in the activated receptor is presented based on biophysical and biochemical data. 3. The current information on sites of interaction on receptors and cognate G proteins is summarized. Studies using synthetic peptides from amino acid sequences corresponding to Gt and rhodopsin have provided information on the sites of rhodopsin-Gt interaction. Synthetic peptides from the carboxyl terminal region of alpha t mimic Gt by stabilizing the active conformation of rhodopsin, Metarhodopsin II. 4. The conformation of one such peptide when it is bound to Metarhodopsin II was determined by 2D NMR. The model based on the NMR data was tested using peptide analogs predicted to stabilize or break the structure. These studies yield molecular insight into why toxin-treated and mutant G proteins are uncoupled from receptors. PMID- 1782651 TI - Proteoglycan synthesis in cultures of murine retinal neurons and photoreceptors. AB - 1. In recent years, a number of histochemical and immunocytochemical studies have suggested that proteoglycans, particularly those in the interphotoreceptor matrix, exhibit altered distributions in several murine models for retinal degenerations. We are using a cell culture system to characterize the proteoglycans synthesized by neurons and photoreceptors derived from mouse retina, with the long-term goal of analyzing their role in retinal degenerations. 2. In this study we describe initial studies using cells derived from the retinas of normal mice. Cultures of retinal neurons and photoreceptors, which were free of glial, epithelia, or endothelial cells, were labeled with 3H-glucosamine and 35SO4. Proteoglycans isolated from the medium and cell layer were analyzed on the basis of charge, relative hydrodynamic size, and glycosaminoglycan content. 3. The studies indicate that the cultures actively synthesize proteoglycans. The medium contained predominantly chondroitin sulfate/dermatan sulfate, while the cell layer had a higher proportion of heparan sulfate, indicating a differential distribution between the two compartments. PMID- 1782652 TI - Posttranslational modifications of tubulin in teleost photoreceptor cytoskeletons. AB - 1. Posttranslational modifications of tubulin by acetylation and detyrosination have been correlated previously with microtubule stability in numerous cell types. 2. In this study, posttranslational modifications of tubulin and their regional distribution within teleost photoreceptor cones and rods are demonstrated immunohistochemically using antibodies specific for acetylated, detyrosinated, or tyrosinated tubulin. 3. Immunolocalization was carried out on isolated whole cones and mechanically detached rod and cone inner/outer segments. 4. Acetylated tubulin within rods and cones is found only in microtubules of the ciliary axoneme of the outer segment. Detyrosinated tubulin is also enriched in axonemes of both rod and cone outer segments. 5. Distributions of tyrosinated and detyrosinated cytoplasmic microtubules differ within cones and rods. In cones, detyrosinated and tyrosinated tubulins are both abundant throughout the cell body. In rods, the ellipsoid and myoid contain much more tyrosinated tubulin than detyrosinated tubulin. Comparisons between whole cones and cone fragments suggest that detyrosinated microtubules are more stable than tyrosinated microtubules in teleost photoreceptors. 6. Our findings provide further evidence that microtubules of teleost cones differ from rod microtubules in their stabilities and rapidity of turnover within the photoreceptor inner segment. PMID- 1782653 TI - [An epidemiologic survey on a type E hepatitis (HE) outbreak]. AB - This article deals with a HE outbreak, which occurred in Sulagong Village, Pan jin Township, Yining County, Xinjiang. There was a total of 214 patients involved in the village, with an attack rate of 6.15 percent. Among the patients young people formed the majority. The attack rate between 20 to 24 years of age reached 17.9 percent. Attack rate of pregnant women between 18 to 35 years of age was significantly higher than that of the non-pregnant ones. The condition in pregnant patients was rather severe. Their case fatality rate was 5.88 percent and abortion rate was 17.64 percent. By epidemiological investigation, it was shown that the chief contributing cause of the HE outbreak was probably contaminated drinking water, and direct or indirect contact with the patients in the infectious stage was also a risk factor. PMID- 1782654 TI - [A study on the secondary infection in families in which hepatitis A patients were isolated and treated in hospitals and those in which patients stayed at home]. AB - This study was conducted during the epidemic season in Hang Zhou, zhejiang in the spring of 1988. HAV infection rates were compared between close contacts of the hepatitis A patients isolated in hospitals and those stayed at home. It was found that there was significant difference between the HAV infection rates in the group of close contacts of hepatitis A patients who have been hospitalized within 5 days and those in the group stayed at home or those in other groups. Whereas the HAV infection rates in the group of close contacts of HA patients remained at home were not significantly different from those in other groups. The results showed that HA patients had to be isolated and treated in hospital early. HAV inapparent infection rate was 86.21% in this study. The ratio between HAV apparent infection and inapparent infection was 1:6.25. PMID- 1782655 TI - [Preliminary serological survey on Mycoplasma and Chlamydia infection among gonorrhoea cases]. AB - The antibodies to Mycoplasma hominis (Mh) and Chlamydia trachomatis (Ct) in 123 sera from the patients with gonorrhoea and 108 sera from the healthy persons control were detected with micro-indirect hemagglutination test. The results showed that the antibody to Mh positive rate was 23.58%, GMT 1: 7.60, and to Ct 72.35%, GMT 1: 8.71 in the patients. The differences of the antibody levels between the patients and the controls were significant. It was suggested that the urogenital infections caused by Mh and/or Ct are common in the patients with gonorrhoea in Liuzhou area, Guang Xi Autonomous Region of China. The significance and distributional characteristics of Mh and Ct infections in the urogenital system and the reasons about higher positive rate in the patients with gonorrhea were discussed. PMID- 1782656 TI - [Investigation on the source of burn wound infection due to Staphylococcus aureus in children]. AB - 115 children with burn injuries were admitted between April 1988 and February 1989. Samples were taken from burn wounds, anterior nares and hands of every patient: anterior nares and hands of family members within 24 hours after admission. Samples were also taken from anterior nares and hands of medical personnel, air of ward and taps etc. 276 strains of S. aureus were isolated from 1544 samples. The rate of burn wound infection due to S. aureus was 25.2% and nasal carrier rates of patients, family members, nurses, doctors were 30.4%, 18.1%, 27.3% and 18.3%, respectively. S. aureus with the same plasmid profiles (1.6 and 1.9 Md) and phage type (618) as those of the burn wounds was only isolated from the anterior nares and hands of the family members and not from the medical personnel. It indicated that the S. aureus of burn wound infection mainly came from the hands of their family members and not from the medical personnel. This may be due to that care of burn wound was mainly taken by the family members. PMID- 1782657 TI - [Logistic regression analysis of risk factors influencing the occurrence of category III pneumoconiosis in the coal mine]. AB - Using 1:4 matched method, we have selected 40 cases of category III pneumoconiosis and 160 controls in a coal mine, and analyzed the factors which influenced the occurrence of category III pneumoconiosis by Multiple Logistic Regression Model. The results were as follows: Tuberculous infection and the type of radiographic appearance manifested mainly as small round opacities were positively correlated with the attack of category III pneumoconiosis. The time of starting exposure to dust, the years and the kinds of work were not led into regression model as significant factors. PMID- 1782658 TI - [Cryptosporidiosis in children in Wuhu]. AB - From May to September 1989, a survey was carried out on the prevalence of cryptosporidiosis in the outpatients with diarrhea from paediatric department of five hospitals in Wuhu, Anhui Province. Cryptosporidium oocysts were identified in stool specimens from 67 of 3,498 outpatients (1.9%). No difference was found between the prevalence of cryptosporidiosis in males and that in females. No Cryptosporidium oocysts was identified in stool specimens from infants under 6 month-old. 86.2% of the cases were distributed in the age range from 7-month-old to 4-year-old. The prevalence of cryptosporidiosis in rural outpatients was two fold of that in urban outpatients. The occurrence of cases was highly sporadic. The prevalence began to rise from the last third of June. In our survey, 92.5% of the cases was distributed in the time range from the last third of June to September. In all of the cases no unique characteristic was found in clinical manifestations and stool appearance, and symptoms were resolved spontaneously. The duration of symptoms seems shorter than documented. PMID- 1782659 TI - [Efficiency evaluation of combined intervention measures with improving drinking water first to prevent infantile acute diarrhea]. AB - The paper analysed factors of acute diarrhea in children under five by Mantel Haenszel stratification and Logistic regression. The total person-years of observation were 1332. The results showed that the combined risk factors which caused diarrhea were drinking the pond water and failure to wash hands before eating and so on. The combined intervention Measures, especially improvement of drinking water had effectively decreased the incidence rate of infantile acute diarrhea through the observation in the past two years. PMID- 1782660 TI - [Efficacy evaluation of measles vaccine in fields]. AB - The result of determining the effectiveness of measles vaccine is reported. It included 196 samples of measles vaccine from 1986 to 1989 in Xiangfang City. There were 14 samples found unqualified. Thus we took the relevant measures and the result was rather good. The investigation confirmed that the cold-chain equipment now available had played a guarantee role for the quality of vaccines. In addition, we analysed the cause of the measles vaccine with low titre. The influences of different districts and seasons on the stability of vaccine had been studied. Some measles vaccine were of low titre but rather high level in HIAb. This problem was investigated and discussed theoretically. PMID- 1782661 TI - [A study of ecology of Plesiomonas shigelloides]. AB - In order to understand further about its natural character for Plesiomonas Shigelloides (Ps) and the disease caused by this bacterial genus, we reported a special studying about ecology of Ps. We tested 398 samples from different natural water 99 strains of Ps were isolated, the average positive rate is 24.87%, the highest positive rate is in sewage-water samples. The genus of Ps can be isolated in all seasons, this rate is more in summer than in winter, its rate in pig is 2.56%, duck 21.70%, fish of fresh-water 29.22%, decorative animal 32.35%. This study have proved that Ps has birds natural host. Its positive rate is 14.70% in all population, 13.15% in diarrhoea patient, there is no significance difference (chi 2 = 0.40 P greater than 0.05), between normal and diarrhea patients. Positive rate in rural is more than city, and children higher than adult. By all 50 O sera we found that 71.08%, strains was serotype however, they fell into 42 O ser-types. PMID- 1782662 TI - [Study on the elimination of bacteria from the cultures of Lyme disease spirochetes (Borrelia burgdorferi)]. AB - Contaminated cultures of strains H11, H20 from ticks, and strain R9 from patient were purified by antisera for bacteria, chemicals, filtration dilution and animal inoculation. Most of bacteria were eliminated after adding antisera into contaminated strains H11, H20. The preliminarily decontaminated cultures of strains H11, H20 or those with a few bacteria such as strain R9 could be completely purified by filtration, chemicals, dilution, or animal inoculation, but filtration is the simplest and the most effective purification method. PMID- 1782663 TI - [Epidemiologic study of chronic diseases]. PMID- 1782664 TI - [Differential diagnosis of brucellosis]. PMID- 1782665 TI - Polarized sorting of GPI-linked proteins in epithelia and membrane microdomains. AB - Taken together, our results with endogenous and transfected GPI-anchored proteins (summarized in Table 6) suggest that covalent attachment to GPI functions as an apical transport signal in polarized epithelial cells. This is the first example of a well-defined targeting signal for the post-Golgi sorting of plasma membrane proteins in polarized epithelia; the only other known post-Golgi targeting signal is mannose-6-phosphate, which functions in the recognition of lysosomal hydrolases and directs them to lysosomes. PMID- 1782666 TI - Evolutionary aspects of GPI metabolism in kinetoplastid parasites. AB - There is a growing, but still very patchy, data base of GPI structure, biosynthesis and function. In this article we speculate freely on the function of GPI anchors, and the origins of GPI-related molecules, primarily with reference to the protozoan parasites Trypanosoma brucei and the Leishmania. The views expressed draw on fairly wild extrapolations and some will, no doubt, not stand the tests of time. Several of the hypotheses presented should therefore be taken with a pinch of salt, some lemon, and large quantities of tequila! PMID- 1782667 TI - Cell behavior and actomyosin organization in Dictyostelium during substrate exploration. AB - The behavior of individual Dictyostelium amebae was quantitatively analyzed with the computer-assisted "Dynamic Morphology System" (Soll, Voss, Varnum-Finney and Wessels, (1988) J. Cell. Biochem., 37: 177-192.). The same amoebae were then fixed and analyzed for filamentous (F-) actin and myosin (myosin-II, or "conventional" myosin) by fluorescence microscopy using the "agar-overlay method" (Yumura, and Fukui (1985) Nature, 314: 194-196.). This procedure provides a novel description of the behavior and morphometric changes preceding the static analysis of cytoskeletal organization in the same cell. It is demonstrated that when translocating cells make contact with an etched-smooth glass interface, 14% cross the interface, 20% either reverse direction or migrate along the interface, and the remaining 45% stay at the site. Cells contacting the interface from the smooth or etched side show equivalent behavioral responses. Upon contact with the interface, they project numerous lamellipodia and pseudopodia. While the lamellipodial projections exhibit cycles of spreading and retraction, the pseudopodia show lateral scanning motion, analogous to "substrate exploration" in fibroblasts (Albrecht-Buehler (1976) J. Cell Biol., 69: 275-286.). F-actin is localized in the lamellipodia and pseudopodia of amoebae contacting the interface. There is also discernable cortical F-actin, while conventional myosin appears to be excluded from the cortex and dispersed throughout the cytoplasm. The myosin displays a transient filamentous lattice at the base of newly forming lamellipodia. The ultrastructural study suggests that the new lamellipodia are formed on the dorsal surface and subsequently make contact with the substrate, indicating the dorsoventral sequence of polarity of the motile/sensory cellular organs. The present study demonstrates substrate exploration in Dictyostelium amoebae, and suggests its coupling to dynamic reorganization of the actomyosin cytoskeleton. The possible role of single-headed small myosin(s) (myosin-I, or mini-myosin) is discussed. PMID- 1782668 TI - Immunoelectron microscopic localization of cell surface antigens on rat hepatocytes detected with monoclonal antibodies (HAM2 and HAM4). AB - The localization of surface antigens and the binding activity of two monoclonal antibodies, HAM2 and HAM4, which recognize the rat major histocompatibility complex (MHC) antigen class I and the rat hepato-renal antigen respectively, on dissociated (free) hepatocytes was examined by light (LM) and electron microscopy (EM), and by radioimmunoassay (RIA). Fixed hepatocytes, fixed before dissociation, and fresh hepatocytes, dissociated by collagenase, were treated by direct staining with HAM2- or HAM4-immunogold complexes (HAM2-gold and HAM4 gold). Some of the directly stained hepatocytes were further mixed with antimouse IgG-gold complex (IgG-gold) to supplement the direct staining. The polarity of the sinusoidal and contiguous faces and the bile canaliculus, i.e. the in situ morphology, was well preserved in the fixed hepatocytes, while the fresh cells had lost the polarity and were round. On the fixed hepatocytes HAM2-gold particles were distributed predominantly on the sinusoidal face, while HAM4-gold particles were localized on both the bile canalicular and sinusoidal faces. No different antigen distribution on the fresh cells was detected with the two antibodies. Supplementation by IgG-gold was noticeable in most cases. The extent of binding activity in both the immunogold and RIA experiments was lower in the fixed cells than in fresh cells. These results suggest that HAM2 and HAM4 are useful monoclonal antibodies for detecting the localization of the MHC class I antigen and the hepato-renal antigen on the hepatocytes, respectively. PMID- 1782669 TI - A cell cycle ts mutant, tsJT16, is defective in p70 synthesis through protein kinase C-dependent and -independent pathways. AB - tsJT16 is a G0/G1 ts mutant from the Fischer rat fibroblast line. It has a ts defect in a function operating early after growth stimulation with fetal bovine serum (FBS). A primarily induced gene product, p70, was not synthesized at 40 degrees C after stimulation with serum, while c-fos and c-myc mRNAs accumulated under the same condition. This paper reports that p70 was synthesized following stimulation of G0-arrested cells with platelet-derived growth factor, epidermal growth factor (EGF), and 12-0-tetradecanoylphorbol-13-acetate (TPA) at 34 degrees C, but not at 40 degrees C. However, it was synthesized at both temperatures after addition of A23187. In protein kinase C-deprived cells, peptide growth factors and A23187 induced p70 at 34 degrees C, whereas TPA did not. Fibroblast growth factor and insulin did not induce p70. Induction of c-fos and c-myc occurred at both temperatures after the stimulation with FBS, TPA or A23187. These results indicated that the defect in tsJT16 to induce p70 is likely to be located at the common downstream of protein kinase C-dependent and -independent pathways, but is independent from the pathway of calcium mobilization. PMID- 1782670 TI - Involvement of prostaglandin-producing pathway in the cytotoxic action of tumor necrosis factor. AB - To elucidate the cytotoxic mechanism of tumor necrosis factor (TNF), we isolated TNF-resistant sublines of L929 cells. As compared with L929 cells, TNF-resistant cells retained similar number and affinity of TNF-binding sites, and showed a similar growth rate. TNF stimulated arachidonate release from L929 cells, while no stimulation was observed at all in TNF-resistant cells tested. The cytotoxic action of TNF on L929 cells was inhibited by indomethacin, suggesting that prostaglandin may be involved in the action. Therefore, TNF-stimulated prostaglandin production was examined in L929 and TNF-resistant sublines. The amount of PGE2 produced by L929 cells was increased more than 5-fold after the addition of TNF, whereas the amount of PGE2 did not change in the resistant sublines following addition of the factor. TNF-stimulated arachidonate release and PGE2 production were reversed by islet-activating protein (IAP)-treatment of L929 cells. These results suggest that arachidonate release and subsequent prostaglandin production are important for the cytotoxic action of TNF and that these processes are mediated by GTP-binding protein (G protein) that is coupled to the TNF-receptor. PMID- 1782671 TI - Imaging of calcium wave propagation in guinea-pig ventricular cell pairs by confocal laser scanning microscopy. AB - We describe here the use of a confocal laser scanning microscope for imaging fast dynamic changes of the intracellular calcium ion concentration ([Ca2+]i) in isolated ventricular cell pairs. The scanning apparatus of our system, paired galvanometer mirrors, can perform narrow band scanning of an area of interest at a high temporal resolution of less than 70 msec per image. The actual [Ca2+]i is obtained directly through the fluorescence intensity of injected fluo-3, which responds to changes of [Ca2+]i in optically sectioned unit volumes of the cell. Images of the calcium wave obtained during propagation between paired cells revealed that the wavefront is constant in shape and propagates at constant velocity without any delay at the cell-to-cell junction. The confocal laser scanning microscope with depth-discriminating ability is a valuable tool for taking pictures of the sequence of biological events in living cells. PMID- 1782672 TI - Characterization of lipoprotein secreted by cultured eel hepatocytes and its comparison with serum lipoproteins. AB - The lipoprotein secreted by cultured eel hepatocytes was fractionated by density gradient ultracentrifugation and compared with eel serum lipoproteins. Eel hepatocytes were cultured for 7 to 10 days as a monolayer in Williams' medium E containing 5% fetal bovine serum and 0.16 microM insulin on a dish precoated with fibronectin of horse serum. The only lipoprotein secreted by eel hepatocytes was a very-low-density lipoprotein like one which consisted of 69% triglyceride, 15% phospholipid, 4% cholesterol, and 12% protein. On the other hand, very-low density lipoprotein and high density lipoprotein were found in eel serum, in which high density lipoprotein was a main lipoprotein. The secreted lipoprotein contained apo B and apo A as the main protein components. Furthermore, the lipoprotein contained proapo A-I in addition to apo A-I, which was proved by comparing the amino acid composition of both proteins. In our discussion, we noted that the lipoprotein secreted by eel hepatocytes was a good material for the study of high-density lipoprotein formation. PMID- 1782673 TI - Isolation and characterization of S. cerevisiae mutants deficient in amino acid inducible peptide transport. AB - The transport of small peptides into the yeast Saccharomyces cerevisiae is subject to complex regulatory control. In an effort to determine the number, and to address the function, of the components involved in peptide transport and its regulation, spontaneous mutants resistant to toxic di- and tripeptides were isolated under inducing conditions. Twenty-four mutant strains were characterized in detail and fell into two phenotypic groups; one group deficient in amino acid inducible peptide uptake, the other with a pleiotropic phenotype including a loss of peptide transport. Complementation analysis of recessive mutations in 12 of these strains defined three groups; ptr1 (nine strains), ptr2 (two strains), and ptr3 (one strain). Isolation and screening of 31 additional N-methyl-N-nitro-N Nitrosoguanidine (MNNG)-induced, peptide transport-deficient mutants produced one ptr3 and 30 ptr2 strains: no additional complementation groups were detected. Uptake of radiolabeled dileucine was negligible in ptr1 and ptr2 strains and was reduced by 65% and 90% in the two ptr3 mutants, indicating that all strains were defective at the transport step. We conclude that the S. cerevisiae amino acid inducible peptide transport system recognizes a broad spectrum of peptide substrates and involves at least three components. One gene, PTR3, may play an indirect or regulatory role since mutations in this gene cause a pleiotropic phenotype. PMID- 1782674 TI - AUG codons in the RNA leader sequences of the yeast PET genes CBS1 and SCO1 have no influence on translation efficiency. AB - We report that the major transcription start sites of the yeast PET gene SCO1 are located at positions -149 and -125 relative to the AUG initiation codon of the SCO1 reading frame. The leader sequences of the resulting mRNAs possess a single AUG codon at position -49, which initiates a short open reading frame of three amino acids. The recent finding of a similar situation in the case of the PET gene CBS1 prompted us to address the question as to whether these AUG codons might play some role in the expression of these PET genes. After removal of the upstream AUG codons by site-directed mutagenesis, expression was monitored by use of lacZ fusions and compared to the respective wild-type constructs. Our data show that under all growth conditions tested the leader-contained AUG initiation codons have no significant influence on the expression of both PET genes. PMID- 1782675 TI - Chemical mutagenesis and DNA synthesis in cdc8, a DNA replication mutant of Saccharomyces cerevisiae. AB - Incubation of cdc8 mutants of the yeast Saccharomyces cerevisiae in YPD under permissive conditions, when DNA replication is taking place, prior to transfer to restrictive conditions, strongly stimulates induction of cdc+ colonies of ethyl methane sulphonate (EMS)- and methyl methane sulphonate (MMS)-treated yeast strains HB23 (cdc8-1/cdc8-3), HB26 (cdc8-3/cdc8-3) and HB7 (cdc8-1/cdc8-1). After diepoxybutane (DEB) treatment, both the induction of cdc+ colonies and their stimulation after incubation in YPD under permissive conditions is low. The results obtained show that stimulation of induction of cdc+ colonies under permissive conditions occurs not only after UV-treatment, but also after treatment with such mutagens as EMS and MMS. PMID- 1782676 TI - Analysis of nuclear sequences homologous to the B4 plasmid-like DNA of rice mitochondria; evidence for sequence transfer from mitochondria to nuclei. AB - Nuclear sequences homologous to the plasmid-like DNA, B4, were analyzed in the Japonica rice variety, Fujiminori. Homologous sequences existed at several positions in the nuclear genome, but each contained only a portion of the B4 sequence. It was impossible to reconstruct the entire sequence of B4 even by collating all the homologous sequences. Overlaps between some of the B4 sequences present in the nuclear genome resulted in parts of the sequence being represented more than once. These features indicate that nuclear sequences homologous to B4 are not the origin of B4 and that they have been transferred from mitochondria and integrated into the nuclear genome. Five other foreign sequences originating in the chloroplast or mitochondrial genome were found within 1 kb of the B4 homologous sequences. Structural analysis is consistent with the hypothesis that the DNA sequences were transferred via RNA. PMID- 1782677 TI - Two potential Petunia hybrida mitochondrial DNA replication origins show structural and in vitro functional homology with the animal mitochondrial DNA heavy and light strand replication origins. AB - Four Petunia hybrida mitochondrial (mt) DNA fragments have been isolated, sequenced, localized on the physical map and analyzed for their ability to initiate specific DNA synthesis. When all four mtDNA fragments were tested as templates in an in vitro DNA synthesizing lysate system, developed from purified P. hybrida mitochondria, specific initiation of DNA synthesis could only be observed starting within two fragments, oriA and oriB. When DNA synthesis incubations were performed with DNA templates consisting of both the A and B origins in the same plasmid in complementary strands, DNA synthesis first initiates in the A-origin, proceeds in the direction of the B-origin after which replication is also initiated in the B-origin. Based on these observations, a replication model for the P. hybrida mitochondrial genome is presented. PMID- 1782678 TI - Linear DNA plasmids of the perennial ryegrass choke pathogen, Epichloe typhina (Clavicipitaceae). AB - Epichloe typhina is a clavicipitaceous ascomycete which systemically infects grasses, causes choke disease of host inflorescences, and is related to a group of mutualistic grass endophytes. Three plasmids of 7.5, 2.1 and 2.0 kilobase pairs were found in mitochondrial DNA preparations of an E. typhina isolate from perennial ryegrass (Lolium perenne). Results of nuclease digestion indicated that the plasmids, designated Et7.5L, Et2.1L, and Et2.0L, were linear, double-stranded DNAs with protein linked to their 5'-ends (plDNA). The plasmids shared little or no homology with each other, and were not integrated into the mitochondrial or nuclear genomes. No homologous plasmids were detected in isolates of E. typhina from other grass hosts, anamorphic endophytes, or other Clavicipitaceae. However, other plasmids were present in Balansia obtecta and Claviceps purpurea. A partial sequence of one of the E. typhina plasmids, Et2.0L, indicated an open reading frame when UGA was assumed to encode tryptophan. The inferred amino acid sequence had 24% identity over 258 amino acids in two regions of the reverse transcriptase encoded by the circular Mauriceville and Varkud plasmids of Neurospora spp. The homologies included six segments conserved in RNA template-dependent DNA or RNA polymerases. PMID- 1782680 TI - Measles epidemic in Waterloo region, Ontario, 1990-1991. PMID- 1782679 TI - The linear plasmid pMC3-2 from Morchella conica is structurally related to adenoviruses. AB - pMC3-2, one of two linear plasmids localised in the mitochondria of the ascomycete Morchella conica, was completely sequenced. It is 6044 bp in size, contains terminal inverted repeats of 713 and 710 bp length and two open reading frames, ORF1 and ORF2, spanning 2706 bp and 918 bp, respectively. ORF1 probably encodes a viral B-type DNA-polymerase. Concerning ORF2, no homology to any other published protein- or DNA-sequence could be detected. According to the structure of DNA-polymerases, linear plasmids can be grouped into two classes reflecting their localisation either in the cytoplasm or within the mitochondria. In general, the structure of plasmid pMC3-2, as well as of other linear plasmids from filamentous fungi, indicates a close relationship of these genetic elements to adenoviruses. PMID- 1782681 TI - [Progress in the pathology of diseases of the respiratory system]. PMID- 1782682 TI - [Morphologic and morphometric studies of pulmonary artery endothelial abnormalities in rats induced by smoking]. AB - Scanning electron microscopy (SEM), transmission electron microscopy (TEM) and ultrastructural quantitation technique were applied to analyze the alterations of surface characteristics and intracytoplasmic composition of pulmonary artery endothelium from rats after exposure to smoking. The results showed that the important endothelial change was endothelial proliferation and intimal fibrosis. The endothelium surface comprised thick, deep, intertwined "cable-like" or "corduroy-like" ridges. Endothelial fenestrae became apparent accompanied with increased adhesion of blood elements. There was also dilation of the mitochondria with reduced numerical density, and significant increase of volume density of rough endoplasmic reticulum (P less than 0.05) microfilament (P less than 0.001) and pinocytic vesicles (P less than 0.05) in the endothelial cells, which possibly indicates the increase of endothelial metabolic function. The authors consider that the development of endothelial abnormalities may be due to increase of arterial wall thickness, causing further alteration of pulmonary hemodynamics and hemorrheology, which plays a critical role in the development of pulmonary hypertension induced by smoking in the rats. PMID- 1782683 TI - [Morphology of the ferruginous bodies and characteristics of lesions in coal mine pneumoconiosis]. AB - Ferruginous bodies were found in lung tissue collected from 105 coal miner autopsies in Beijing coal area. The incidence rate was 83.8%. Cores of the ferruginous bodies consist of black or transparent fibres partially or entirely coated with golden brown colored iron-protein. They were polymorphic in appearance, and were widely distributed in the lungs. Most of them located in the pulmonary alveoli, and some in the inflammatory or carcinomatous lesions. Besides the pneumoconiosis lesion, there were also abundant multinuclear foreign-body giant cells, and proliferation of type II alveolar cells in the alveoli. Regardless of contact history with coal dust, the average number of ferruginous bodies found in the lungs of workers with no pneumoconiosis was much lower than that with pneumoconiosis lesions (P less than 0.05). The number of ferruginous bodies tends to increase with the severity of the pneumoconiosis lesion. The authors consider that it is worth while to make a further study in elucidating the relationship between ferruginous body and the high incidence of pneumoconiosis in Beijing coal area. PMID- 1782684 TI - [An experimental pathological study of the effect of bronchiolitis on emphysema and cor pulmonale pathogenesis]. AB - Nitric acid and elastase were injected into the tracheae of Wistar white rats and the effect of bronchiolitis on the pathogenesis of experimental emphysema and cor pulmonale was studied. The result showed that, although simple bronchiolitis and obstruction of the bronchioles produced no decisive effect on the development of emphysema, it aggravated the lesion and further induced pulmonary hypertension and cor pulmonale. Data also showed that when there was no bronchiolitis, blood gas, pulmonary artery pressure and right ventricular weight of the experimental rats would still be maintained within normal range even though emphysema was severe. The result indicates that although emphysema often goes together with chronic bronchitis clinically, cor pulmonale can be prevented if inflammation of the respiratory tract is effectively controlled. PMID- 1782685 TI - [Image analysis on pulmonary arterioles in chronic cor pulmonale]. AB - Thickness and area of the vessel wall and caliber and area of the vessel lumen of pulmonary arterioles obtained from 13 cases of chronic cor pulmonale were analysed. The relative ratios of vessel lumen area/total area(EA/TA), vessel wall area/total area(WA/TA) and vessel wall thickness/vessel external diameter(WD/TD) were calculated with image analysor. The results showed that compared with the pulmonary arterioles in patients without cor pulmonale, the relative ratios of EA/TA decreased significantly, while the values of WA/TA and WD/TD increased significantly in those with cor pulmonale owing to chronic bronchitis and diffuse interstitial fibrosis. The results obtained are of meaning for quantitative study and diagnosis about the pathology of cor pulmonale. PMID- 1782686 TI - [Orthotopic xenotransplantation of human lung giant cell carcinoma and study on its invasion and metastasis]. AB - Human lung giant cell carcinoma cell strains were implanted into the lungs of nude mice via an intrabronchial procedure. Tumorigenicity, invasion and metastasis of the xenografts, and their morphological features, including the findings by light and electronic microscopy and immunohistochemistry were investigated. Dissemination of xenografts within the airway (2/8), invasion to diaphragm (5/8), and development of bloody hydrothorax (5/8), were discovered. Metastasis via lymphatic and blood vessel routes as well as seeding metastasis occurred in all the tumor-bearing animals. The morphological features of xenografts were consistent with those of the parental giant cell carcinoma. These results indicate that lung cancer cell strains grow autonomously and the behavior of invasion and metastasis of the xenografts imitates more closely the clinical manifestation of lung cancer than their subcutaneous counterparts. Since microenvironment influences the biological behavior of the transplants, this model seemed to be more ideal for further investigation experimentally. PMID- 1782687 TI - [Pathologic study of pleural and peritoneal mesotheliomas of rats induced by asbestos]. AB - Forty-six cases of mesotheliomas of rats induced by asbestos, 2 cases of human mesotheliomas and 10 cases of adenocarcinomas were studied by light microscopy, electron microscopy, histochemical and immunohistochemical staining. The results indicated that mesothelioma probably originates from the multipotential subserosal cell which has the features of myofibroblast. In addition to the epithelial, fibrous and mixed types of mesothelioma classified by WHO, poorly differentiated type of mesothelioma can also be found in rats. Electron microscopy, histochemical and immunohistochemical staining are very helpful in differentiating mesotheliomas from adenocarcinomas. PMID- 1782688 TI - [Ultrastructural study of the lethal effect of lymphokine activated killer (LAK) cell on liver cancer cells]. AB - Co-cultured subcloned LAK cell and human liver cancer cell (H7402) were fixed in situ for scanning electron microscopic and transmission electron microscopic examinations. The SEM and TEM findings gave a new evidence in answering how LAK cells kill the cancer cells. First, the activated killer cells recognized and made close contact with the target cell. Then some kind of lethal hit produced by intact killer cells was delivered, injuring the target cell, boring holes and pole-like tunnels on the cell surface or even penetrating into the cytoplasm of the cancer cells. Eventually, cell death in the manner of apoptosis and necrosis occurred as the end result of the damage to the cancer cell. These findings strongly support the idea that the death of the target cells is mediated by LAK cells. PMID- 1782689 TI - [Glomerular alterations in glycerol-induced acute renal failure in rabbits]. AB - Experiment was performed to study the glomerular alterations in glycerol-induced acute renal failure in rabbits. At the 3rd, 6th, 24th, 72nd hour after injection of 50% glycerol subcutaneously, glomerular ultrastructural alterations were observed by scanning and transmission electron microscopy. The results showed that impaired glomerular microcirculation and reduced glomerular filtration rate were the main factors accountable for acute renal failure. It seems of great significance to study the effects of toxin-like material in the pathogenesis of acute renal failure. PMID- 1782690 TI - [A light and electron-microscopic study of epileptogenic discharge focus in temporal lobe epilepsy]. AB - Study of the structure of epileptogenic discharge focus in 16 cases of cryptic temporal lobe epilepsy was carried out through light and electron-microscopy. Microvascular malformation in both meninges and parenchyma of the brain were found in 9 cases. Ultrastructurally, all the 16 cases showed presence of tortuous capillaries in various extent accompanied with uneven thickening and splitting of the basement membrane, and 11 of them presented proliferation of the collagen fibers. Changes obtained in neurons were similar to those of the delayed neuronal death during ischemic damages of the brain tissue. Degeneration and edema of astrocyte processes were also available. These suggest that the local circulatory disturbance as a result of microvascular malformations may damage the inhibitory neurons of the hippocampus and amygdala and lead to the development of epileptic seizure. PMID- 1782691 TI - [Monocyte chemotactic factor produced by human umbilical vein endothelial cells in vitro]. AB - The blood monocytes have been well known as one of the origins of foam cells in atherosclerotic plaque, but the mechanism controlling the migration of monocytes into the subendothelial space is still unclear. The chemotactic activity of the conditioned medium from cultured human umbilical vein endothelial cells for human blood monocytes was investigated by micropore filter assay; meanwhile, heat stability and enzyme digestion assays were undertaken. The results showed that the conditioned medium from the cultured endothelial cells was significantly chemotactic rather than chemokinetic for monocytes. The conditioned medium from the cultured endothelial cells still retained the chemotactic activity for monocytes although it was heated at 80C and 100C for 15 min respectively, whereas after digestion with protease, the chemotactic activity vanished. From the above mentioned facts, it is reasonable to believe that cultured human umbilical vein endothelial cells can secrete a chemotactic factor for monocytes, which is a kind of peptide. PMID- 1782692 TI - [Ultrastructural changes of myocardial biopsy from six children with latent Keshan disease]. AB - Myocardial biopsy from six children with latent Keshan disease was performed. Samples taken from right heart ventricles were prepared and investigated under an H-600 electron microscope. Some samples were also prepared with the lanthanum preparation for studying the membrane permeability of the myocardium. Ultrastructurally, most of the sarcolemma of myocardial cells remained intact, and some occasionally showed local minimal defects. Lanthanum particles are located outside the myocardial cells, and only a small number of them entered into the cells; but they were located between myofibrils and mitochondria. Mitochondria showed some extent of proliferative and degenerative changes. Some of them were swollen, and their cristae resolved and matrix lightly stained. Transverse system, sarcoplasmic reticulum and the perinuclear cisterns were dilated apparently. Myolytic foci could be seen scarcely. Proliferation of collagen fibers could also be found here and there in all the samples. It was showed that certain permeability disorders of the sarcolemma were still existent, although these patients were in a period of compensation and reparation. Perhaps, some pathogenic factors were still acting on them at that time. PMID- 1782693 TI - [Influence of experimental varicocele on the junctions of seminiferous epithelium]. AB - Experimental varicoceles were created in adult male Wistar rats by partially occluding the left renal vein. The affect of the varicocele on ipsilateral testis was studied at intervals over 15 weeks via ultrathin sections and freeze-etching replica technique examined under electron microscope. Observations showed that varicocele resulted in injuries of Sertoli-Sertoli cell and Sertoli cell spermatid junctional complexes. Abnormal changes of Sertoli cell-spermatid junctional complexes might lead to spermiogenic arrest and spermatids slough, while those of Sertoli-Sertoli cell junctional complexes to dysfunction of barrier and abnormal alteration of microenvironment of seminiferous tubule. Probably, this is one of the reasons that the fertility was not improved in some patients even after high level ligation of the internal spermatic vein. PMID- 1782694 TI - [Pathomorphological studies on vulvar dystrophy]. AB - Two hundred and thirteen cases of vulvar dystrophy were analysed pathologically. The main pathological and ultrastructural changes were degeneration of cells, capillary impairment, and inability of collagenous formation. These resulted in local dystrophy and induced vulvar "Leucismus" secondarily. Its canceration rate was low. The pathogenesis of vulvar dystrophy is discussed. PMID- 1782695 TI - [San-jie cream in the treatment and prevention of muscular lumps through intramuscular injections]. PMID- 1782696 TI - [Preoperative skin preparation with chemical depilation]. PMID- 1782697 TI - [Influence of the nervous system due to plateau hypoxemia]. PMID- 1782698 TI - [Nursing care of nasopharyngeal cancer patients with intracavitary radiotherapy]. PMID- 1782699 TI - [The investigation of intrahospital infection in cardiovascular surgery and its nursing strategy]. PMID- 1782700 TI - [Nursing care for renal biopsy]. PMID- 1782701 TI - [Postoperative care of Bentall's operation for Marfan's syndrome]. PMID- 1782702 TI - [Nursing care of the phonic prosthesis]. PMID- 1782703 TI - [Prevention and nursing of lung complications]. PMID- 1782704 TI - [An unusual cause of intestinal occlusion: endometriosis of the sigmoid]. AB - Colo-rectal endometriosis involving extensive intestinal wall may result in obstruction. This report is based on two patients having symptomatic intestinal endometriosis that required operative treatment. Diagnostic, pathologic and therapeutic findings were reviewed. Current treatment is the removal of the endometriomas, while removal of the reproductive organs should be made only after evaluation on the patient's menstrual status, age and future pregnancy desire. PMID- 1782706 TI - [Acute cholecystitis (pathogenetic and clinico-therapeutic aspects]. PMID- 1782705 TI - [Extra-ocular sebaceous carcinoma: report of a case]. AB - The Authors streamed the rarity of this pathological entity for which the histologic diagnosis is even very difficult. Treatment is based on a wide surgical excision; the value of postoperative irradiation and chemotherapy is discussed. The prognosis is poor. PMID- 1782707 TI - [Gastric carcinoma in the elderly (clinical findings and results)]. AB - On the basis of a series of 643 patients operated on for gastric cancer, the Authors seek to establish whether this disease presents clinical differences with advancing age of such a nature as to have a significant effect on therapeutic management. The series is divided into two groups, the first consisting of patients aged below 70 and the second of patients aged over 70. The following aspects were evaluated: sex, tumour site, oncological stage, type of surgery performed, operative mortality, postoperative survival, as assessed in overall terms and also differentiated in relation to curative or palliative surgery and oncological stage. Analysis of the data confirms that, apart from certain particular aspects, carcinoma of the stomach in the elderly benefits from the same sort of indications and techniques as those proposed for younger patients, with comparable postoperative survival rates, but with a higher operative mortality. To achieve better operative results, what is needed, in addition to correction of metabolic and functional abnormalities, is thorough assessment of risk factors. In patients with tumours at advanced stages, usually characterized by very poor postoperative results, the presence of major risk factors may raise serious doubts as to the actual advisability of the surgical indication itself. PMID- 1782708 TI - [Recent findings on the etiopathogenesis of multinodular goiter. II. Thyroid growth factors]. AB - In the last ten years several experimental data have suggested that growth factors may play an important role in modulating thyroid growth and function. Epidermal Growth Factor (EGF) is present in large quantities in thyroid tissue, where it appears to stimulate DNA synthesis and inhibit cellular function. Insulin-like Growth Factors (IGFs), Interleukin I (IL-I) and Fibroblast Growth Factor (FGF) show the same stimulation on cell proliferation. On the contrary Transforming Growth Factor beta (TGF-beta) and somatostatin display inhibitory effects on follicular growth. Therefore it is likely that growth factors' altered production and/or their receptors abnormal expression on the thyroid cells surface might be involved in the development of multinodular goiter and some thyroid neoplasms. PMID- 1782709 TI - [Thoracoscopy in the staging of tumors of the lung]. AB - The Authors review the results of thoracoscopy in 15 cases of pleural effusions concomitant with tumours of the lungs. In addition to defining the aetiology of the pleural effusion, the investigation completes the staging of the malignancy and affords both the possibility of reducing the number of exploratory thoracotomies and of resolving a number of cases at exeresis. PMID- 1782710 TI - [Thoracoscopy in the diagnosis of pleural mesothelioma]. AB - The Authors assess the results of thoracoscopy in 21 cases of pleural mesothelioma observed over the period from 1982 to 1991. The procedure yielded a correct diagnosis in 18 cases (in 2 cases, CTM due to adenoma at cytology allowed histological definition of the tumour). In 3 cases, thoracoscopy failed to detect the tumour, which was confirmed at a later stage. This type of investigation is indicated for the diagnosis of all pleural diseases and, in particular, for diagnosing mesothelioma (reliability in our series: 85.7%). PMID- 1782711 TI - The future of temporal bone pathology. PMID- 1782712 TI - Combined glottographic changes in the elderly. AB - This study investigates by combined glottography the effect of the anatomical changes of ageing on laryngeal movement during the vibratory cycle. 10 adult males less than 25 years of age were compared to 10 males over 60 years of age. The speed quotient was increased in the elderly group; thus, ageing in the larynx results in a slowing of the opening of the vocal folds. This may account for the different voice quality in the elderly. The clinician must consider the subject's age when interpreting speed quotient values. PMID- 1782713 TI - Composite tragal perichondrial/cartilage autografts vs cartilage or bone paste grafts in tympanoplasty. AB - Extrusion of plastic or ceramic implants is a significant cause of failure in ossiculoplasty for chronic ear disease. This paper reports the use of a composite tragal cartilage and perichondrial autograft compared to cartilage or bone paste between the graft and tympanic membrane. At 2 years, there were no extrusions in the group with the composite graft (n = 18) and 5 extrusions in the cartilage/bone paste group (n = 18) (P = 0.02). The mean average air-bone gap was significantly better for the composite grafts at 2 years (15 dB vs 24 dB) (P less than 0.05). Extrusions were eliminated and hearing results better at 2 years using the composite graft. PMID- 1782714 TI - Temporal changes in unilateral middle ear pressure under basal conditions. AB - Spontaneous changes in middle ear pressure were measured tympanometrically in 15 healthy adults over 7.5 h under basal conditions. Despite fluctuation of middle ear pressure no temporal pattern existed and there was no evidence of reciprocal changes in pressure between sides. When awake but at rest the middle ear pressure fluctuates around ambient pressure. Recordings of positive pressure may represent supportive evidence in favour of a net basal tendency to produce a positive middle ear pressure. PMID- 1782715 TI - A randomized prospective comparison of two methods of administering topical treatment in otitis externa. AB - Ten patients with bilateral moderate or severe otitis externa were studied. Following aural toilet each patient was subjected to two different treatments: one ear had alternate day dressings containing a topical antibiotic/steroid mixture, while the external canal of the other was filled with the same topical preparation (sump filling). Improvement in the severity of the otitis externa was assessed after 1 week. 9 out of 10 ear canals improved in each group. An estimate of the relative cost of each treatment was made and sump filling was found to be less expensive. The results suggest that sump filling is a low cost alternative to standard treatment in moderate and severe otitis externa. PMID- 1782716 TI - An evaluation of post-operative packing in nasal septal surgery. AB - The need for nasal packing in septal surgery is not proven though its use is widespread. Post-operative complications, while uncommon, are frequently pack related. Consenting adults were prospectively randomized to one of the following: Vaseline gauze nasal packing or 30 Dexon mucosal suture. All patients were operated on by one surgeon who was made aware of the randomization decision only when the corrective surgery was complete. Details of post-operative morbidity were collected and pain scored subjectively by a visual analogue scale the morning after surgery. The first 50 available pain scales illustrated a difference between the groups (P less than 0.05), means 4 and 3 in the pack and suture group respectively. There was no demonstrable difference in post-operative haemorrhage, adhesions, nasal crusting or mucosal atrophy. The need for nasal packing is not supported. PMID- 1782717 TI - Senior registrar training in otolaryngology: an audit of trainees. AB - Senior registrars in otolaryngology were asked to complete a questionnaire about the opportunities for training and research offered by their current post. Trainees were asked whether, in their opinion, the post complied with the SAC requirements for a training post. Completed replies were received from 53 (66%) trainees. Most trainees were fairly satisfied with their post but 26% considered that it did not meet with the ideals of a training post as laid down by the SAC. Large variations were noted between posts in the exposure to specialist clinics, own operating lists and research opportunities. Outpatient experience and, in particular, whether the trainee was able to follow up their own post-operative cases adequately appeared to be an important determinant in whether or not trainees were satisfied with their current post. PMID- 1782718 TI - Analgesia in tonsillectomy: a double-blind study on pre and post-operative treatment with diclofenac. AB - The efficacy and tolerability of diclofenac suppositories given pre and/or post operatively were investigated in a randomized double-blind study on 99 patients undergoing tonsillectomy. In one group, 50 mg diclofenac was given 1 h preoperatively, followed by 50 mg directly after the operation. In another group, diclofenac 100 mg was given only immediately post-operatively. A significantly lower consumption of rescue analgesics (paracetamol and/or pethidine) was found in the group treated preoperatively with diclofenac and the average time until first demand of rescue analgesics was significantly longer compared to the group given diclofenac post-operatively only. The tolerance was good and no serious bleeding complications occurred in either group. In the treatment of post operative pain after tonsillectomy, the combination of pre and post-operative administration of diclofenac suppositories resulted in significantly lower consumption of rescue analgesics and is thus preferable to administration solely post-operatively. PMID- 1782719 TI - A comparison of sleep nasendoscopy and the Muller manoeuvre. AB - Knowledge of the level of pharyngeal obstruction during sleep is an important factor in deciding whether or not a patient suffering from obstructive sleep apnoea syndrome (OSAS) will benefit from uvulopalatopharyngoplasty. The Muller manoeuvre has been advocated as a method of obtaining this information. We compared the findings from the technique of sleep nasendoscopy, which actually allows visualization of the level of obstruction in the sleeping patient, with the results of the Muller manoeuvre performed in the same patients while awake. We found the Muller manoeuvre to be less accurate than previously believed. PMID- 1782720 TI - Arachidonic acid cascade and oral squamous cell carcinoma. PMID- 1782721 TI - Effects of respiration on blood pressure and heart rate variability in humans. AB - 1. Non-invasive continuous finger blood pressure (BP) measurement and a spectral technique based on the Fourier transform (FT) were recently combined to quantify short-term fluctuations in haemodynamic variables. 2. Systolic BP (SBP) recording combined low frequency (LF, Mayer waves) plus high frequency (HF, respiratory) oscillations. The presence of HF oscillations of SBP probably reflects fluctuations in cardiac output. Heart rate (HR) also exhibited a combination of low and HF (respiratory) oscillations. The vagus nerve mediates the efferent control of the respiratory sinus arrhythmia (RSA). 3. During controlled breathing in a supine position, a change in SBP is associated with an opposite consequent change in HR. Respiratory sinus arrhythmia could therefore depend on the baroreceptor-HR response to underlying SBP oscillations. 4. The fast regulation of R-R interval by SBP through the baroreceptor-HR reflex may explain why the respiratory variations in the diastolic BP are small. PMID- 1782722 TI - The use of non-invasive blood pressure measurements to measure pressor responses in rats during air stress. AB - 1. A non-invasive tail cuff method was validated against direct intra-arterial blood pressure measurements (r2 greater than 0.9) and then used to measure the systolic blood pressure (SBP) responses to air-jet stimulation in mature conscious Sprague-Dawley (SD) and spontaneously hypertensive rats (SHR). The experiments with the SHR were conducted in parallel with age matched SD rats. 2. All rats were trained to remain in perspex holders and when their SBP had stabilized, a jet of air of 10 min duration was directed at the rat's nose via rubber tubing. The blood pressure was measured during the first, fifth and tenth minute. 3. The maximum SBP response normally occurred during the first min of air jet stimulation and averaged +30 mmHg in the SHR and +21 mmHg in the SD. Although of higher magnitude in the SHR, when expressed as a percentage of the control SBP, the rise was similar for both strains, 13% and 14%, respectively. 4. The pressor response of three SD rats stimulated daily for up to 12 days did not show any evidence of habituation to the stimulus. 5. The pressor responses to air-jet stimulation were abolished in anaesthetized rats, suggesting that they are primarily higher centre responses. PMID- 1782723 TI - Calcium-channel blocking agents verapamil and diltiazem are inhibitors of vasopressin-induced human platelet activation. AB - 1. This study investigated the influences of calcium-channel blocking agents verapamil and diltiazem on platelet responses induced by arginine vasopressin (AVP) and lysine vasopressin (LVP). 2. The substances inhibited platelet aggregation induced by both low and high AVP concentrations, LVP and adrenaline plus AVP. IC50 values of each drug are lower than those determined for ADP- and collagen-elicited aggregation. Verapamil and diltiazem also decreased AVP-induced thromboxane B2 synthesis. 3. Other series of experiments showed that the addition of ethyleneglycol-bis-(beta-amino-ethyl ether) N, N'-tetra-acetic acid to platelet-rich plasma samples also prevented the platelet response to vasopressin polypeptides. 4. Our data provide evidence that the effects of verapamil and diltiazem on vasopressin-induced platelet responses may be directly related to inhibition of extracellular calcium entry. PMID- 1782724 TI - Oral iron absorption in hemodialysis patients treated with erythropoietin. AB - The effect of the erythropoietic activity of the bone marrow on oral iron absorption was investigated in hemodialysis patients. The subjects were enrolled in the Canadian Multicentre Erythropoietin (EPO) Trial; four patients were in the placebo group and four were in the EPO group. All patients were maintained iron replete with oral and intravenous iron as required to maintain ferritin greater than 200 micrograms/L. All patients had two oral radio-labelled iron (59Fe) absorption tests. The first took place during the last two months of the EPO trial, and the second within the first three months of the maintenance phase where all patients received EPO. The erythropoietic activity of the bone marrow was changed by administration of EPO to the placebo group. The group with an unchanged EPO prescription served as controls. The placebo group absorbed 4.5% and 3.9% of 59Fe pre- and post-EPO, respectively (delta NS). The control group absorbed 3.2% and 4.4% of 59Fe and thus similarly showed no change in iron absorption. Oral iron absorption is low in hemodialysis patients, and is not augmented by short-term EPO therapy. The high level of iron stores (i.e., ferritin) present in the Canadian EPO study patients may prevent an effect of the erythropoietic stimulation on iron absorption. Although an increase in iron absorption by EPO was not demonstrated, a type II error could not be excluded. PMID- 1782725 TI - The effect of xenotransplantation of human thyroid tissue following radioactive iodine-induced thyroid ablation on thyroid function in the nude mouse. AB - We have attempted to determine whether xenotransplanted human thyroid tissue into nude mice would act as a physiological substitute for the mouse thyroid gland after the mice had been rendered hypothyroid, using radioactive iodine (131I). The dosage of 0.2 millicuries of 131I was given to each mouse. The xenotransplantations of human thyroid tissue, i.e., normal, Graves' and nontoxic multinodular goitre, were carried out three weeks after radioactive ablation. The values of TSH in all mice rose to high levels (71 +/- 15.6 ng/ml, +/- SD) by three weeks after 131I administration. The TSH values in the mice declined rapidly and reached normal levels by 3-5 weeks after xenotransplantation. In addition, the serum T4 values were generally in the euthyroid range by 3-6 weeks after xenotransplantation. There were no marked differences in the changes of serum T4 and TSH when the three groups were compared. These results indicated that the xenografted human thyroid tissue permitted a return to a normal feedback system as reflected by normal serum TSH and T4 values in the animals. The Graves' thyroid tissue reverted to normal physiological function when removed from its human (abnormal) immune environment, signifying that Graves' thyrocytes are mere passive captives to immune events. This model should prove to be useful in the study of human thyroid physiology and pathophysiology. PMID- 1782726 TI - Parameters of calcium metabolism during a pilot study of cyclosporin A in patients with symptomatic primary biliary cirrhosis. AB - Twelve patients with serologically and histologically defined symptomatic primary biliary cirrhosis were randomized to receive either oral cyclosporin A or vehicle placebo. The cyclosporin A-treated group had improvement in serum alkaline phosphatase and gamma-glutamyltransferase, suggesting a moderating effect on the course of the liver disease. However, other indices of the liver disease, including liver biopsies, did not show significant improvement. The purpose of this study was to examine the effect of the cyclosporin A treatment on serum indicators of bone and mineral metabolism in these patients, as in its later stages, primary biliary cirrhosis is associated with significant osteopenic bone disease. There were no significant changes in serum calcium, phosphate, magnesium, or vitamin D metabolites between the two groups. However, after one year of treatment, mean serum parathyroid hormone level was significantly lower in the cyclosporin A treatment group, and serum osteocalcin rose significantly. There were no significant changes in any parameter of mineral metabolism in the placebo group. The changes in parathyroid hormone and osteocalcin following cyclosporin A therapy suggest a reduction in the secondary hyperparathyroidism commonly seen with primary biliary cirrhosis and also an increase in bone formation, respectively. This study therefore provides preliminary evidence that cyclosporin A therapy seems to have a mild beneficial effect on the abnormalities of mineral metabolism seen with this disorder. PMID- 1782727 TI - Independence of myocardial disease in the JCR:LA-corpulent rat on plasma cholesterol concentration. AB - The JCR:LA-corpulent rat is one of the strains incorporating the corpulent (cp) gene. Animals homozygous for the cp gene are obese, insulin-resistant and hyperlipidemic. Corpulent males, but not females or lean rats, spontaneously develop atherosclerotic and ischemic myocardial lesions. Administration of clofibrate to corpulent male rats reduced the plasma cholesterol ester concentration by 50% to that of lean controls rats. Unesterified cholesterol was slightly raised by the treatment. The markedly raised triglyceride concentrations were lowered modestly (from 282 to 220 mg/100 ml), but significantly in young rats and more markedly (from 305 to 136 mg/100 ml) in 9-month-old chronically treated rats. Apolipoproteins A-1 and E were reduced and Apo B increased by clofibrate treatment. Fasting plasma glucose and insulin concentrations were not altered nor was there any change in the impaired glucose tolerance in clofibrate treated rats. Myocardial lesion frequency was also not reduced by clofibrate treatment. These results are consistent with others that showed inhibition of myocardial lesion formation only when the plasma insulin levels were reduced. Thus myocardial lesion formation in this strain of rats, while probably dependent upon the presence of hypertriglyceridemia, is most critically dependent upon hyperinsulinemia. PMID- 1782728 TI - The biological activity of undenatured dietary whey proteins: role of glutathione. AB - This study compared the effects of different sources of whey protein concentrate (20 g/100 g diet) and of casein on the spleen, liver, and heart glutathione content of C3H/HeJ mice, and on the immune response of their spleen cells to sheep red blood cells. Body weight curves were similar in all dietary groups. Our data indicate that the humoral immune response is highest in mice fed a dietary whey protein concentrate exhibiting the highest solubility (undenatured conformation) and a greater relative concentration of the thermolabile bovine serum albumin and immunoglobulins. In addition, the mice fed this type of whey protein concentrate exhibit higher levels of tissue glutathione. The presence in the serum albumin fraction of glutamylcysteine groups (rare in food protein) and the specific intramolecular bond as related to the undenatured conformation of the molecule are considered to be key factors in the glutathione-promoting activity of the protein mixture. PMID- 1782729 TI - Heterogeneity of patients with late onset ornithine transcarbamylase deficiency. AB - Fourteen patients, 10 males and 4 females, with "late onset" ornithine transcarbamylase (OTC) deficiency were diagnosed by enzyme assays performed on their liver tissues. Age of first clinical presentation ranged widely from 10 weeks to 23 y (mean = 6.1 y). Peak plasma ammonia levels varied widely from a low of 105 mumol/L to as high as 800 mumol/L. All patients had elevated plasma levels of glutamine whereas plasma levels of citrulline were normal in 6 patients. Plasma ornithine levels were not elevated in any patient. Orotic aciduria of variable degree was detected in 13 patients. Residual hepatic OTC activity was detectable in 13 out of the 14 patients ranging from 0.7 to 28.3 mumol/g/min (normal = 80.6 +/- 19.1, mean +/- SD, n = 52). Ten patients were alive at the time of this report and 5 of them had psychomotor delay. PMID- 1782730 TI - Quantitation of beta-thalassemia genes in Quebec immigrants of Mediterranean, southeast Asian, and Asian Indian origins. AB - Beta-thalassemia minor occurs at 5% frequency (on average) in populations migrant (since 1945) from Mediterranean countries to the province of Quebec. Individuals of Southeast Asian/Chinese and Asian Indian origin now living in the province also carry beta-thalassemia genes at similar frequencies. We characterized beta thalassemia genes on 68 chromosomes (19 patients and 30 carriers identified by screening) to describe heterogeneity of beta-thalassemia alleles and to evaluate desirability of DNA tests in carrier screening. Thirteen different mutations account for 74% of the 68 beta-thalassemia chromosomes: seven occur on Mediterranean chromosomes (IVS I,nt110, Non 39, IVS I,nt6, IVS I,nt1G----A, IVS II,nt1, Fr8, IVS II,nt745) another three on SE Asian chromosomes (Fr 41-42, IVS II,nt654, HbE) and yet another three on Asian Indian chromosomes (IVS I,nt5, 619 bp del, IVS I,nt1G----T). Twenty-six percent (18/68) of the chromosomes carried none of 17 alleles accounting for 92-96% of beta-thalassemia molecular pathology in reference populations. The Italian beta-thalassemia chromosomes in the Quebec sample least resembled those in the corresponding source population. Until the spectrum of mutations in Quebec populations is fully defined, phenotype assay remains the most reliable and efficient method for beta-thalassemia carrier screening. PMID- 1782731 TI - Growth hormone response in very short children. AB - Growth hormone (GH) response to standardized exercise, L-DOPA/propranolol and a 6 h diurnal GH profile (GHP) were evaluated in twenty-three children with very short stature and abnormal growth velocities. Standardized exercise (Jones Stage I) was performed on a cycle ergometer at 53% of the maximum oxygen consumption (VO2max) for 20 min. VO2max was determined by an incremental progressive workload until exhaustion. The mean +/- SEM peak GH concentration (ng/ml) for each test was: exercise, 8.7 +/- 1.3; L-DOPA/P: 12.8 +/- 1.9 and GHP: 3 +/- 0.7. There was no statistical difference between exercise and L-DOPA/P peaks but both peaks were significantly higher than the peak observed during the profile. During exercise 14 of 23 patients had a GH response greater than 8 ng/ml. Two patients were found to be GH deficient. Therefore 16 of 23 patients (86%) had a result concordant with their final diagnosis. During the L-DOPA/P test 17 of 23 patients had a GH response greater than 8 ng/ml. By contrast only 6 of 23 patients had a positive response during GHP. Standardized exercise is as effective as L-DOPA/P as a stimulation test for growth hormone response in very short children with abnormal growth velocities. Exercise has the advantages of being physiological, having minimal side effects, and requiring fewer blood samples. In this population of children, exercise and L-DOPA/propranolol are significantly better than the 6-h growth hormone profile for assessing GH secretion. PMID- 1782732 TI - Immunization with Haemophilus influenzae type b polysaccharide vaccine at 18 and 24 months of age: evidence of decreased immunogenicity. AB - In order to assess the immunogenicity of a two-dose regimen of Haemophilus influenzae type b polysaccharide vaccine, the immune response to vaccine given at both 18 and 24 months of age was compared to the response to a single dose at 24 months of age. Following immunization at 24 months of age, the geometric mean antibody concentration of children previously immunized at 18 months (0.53 micrograms/ml) was significantly lower than that of children who received a single dose of vaccine at 24 months (1.03 micrograms/ml; p = 0.03). A four-fold rise in antibody concentration was demonstrated in 31% of children who had received two immunizations and 53% of children immunized for the first time at 24 months of age (p = 0.02). These results suggest that the administration of a dose of plain polysaccharide vaccine at 18 months of age blunted the response to reimmunization at 24 months of age. A subgroup of children who failed to respond to one or two doses of plain polysaccharide vaccine were immunized with polysaccharide-diphtheria toxoid conjugate vaccine. The majority of these children developed a significant rise in antibody concentration in response to conjugate vaccine. PMID- 1782733 TI - Right ventricular diastolic function after experimental right ventricular infarction: effects independent of the pericardium. AB - To determine if an isolated right ventricular wall infarct (RVI) alters right ventricular diastolic function (RVDF), 6 mongrel dogs were studied before and after a right ventricular wall infarct was produced by ligating the right coronary artery and embolizing the distal right coronary artery with mercury. Right ventricular diastolic function was assessed by prior instrumentation of the animals with an RV Millar catheter and segment length crystals attached to the infarct (I) and non-infarct (NI) territory of the right ventricle. The time constant of RV isovolumic relaxation (Tau) was assessed by fitting right ventricular pressure decline after minimum dp/dt to the equation 1nP = At + B, where A represents the slope of the relationship, a negative number, tau = -1/A. The right ventricular diastolic pressure segment length relationship (RVD PSR) was analyzed using a multiple linear regression model whereby the independent effects of heart rate, segment length, and right ventricular wall infarct could be assessed. Right ventricular wall infarct reduced stroke volume to 63% of baseline values largely by increases in RV-I end-systolic segment length. Tau was significantly prolonged. However, there was no significant upward shift in RVDPSR in any animal. These data suggest that in this model RV diastolic relaxation is impaired. However, the degree of this impairment is not significant enough to shift the right ventricular diastolic pressure segment length relationship, as long as the pericardium remains open. PMID- 1782734 TI - Interpretation of the urine osmolality: the role of ethanol and the rate of excretion of osmoles. AB - One purpose of this report is to illustrate that calculating the rate of excretion of osmoles in the urine can be of value in the differential diagnosis of hypernatremia and polyuria. A second purpose is to illustrate a clinical example where the osmolality of the urine did not reflect the lack of action of ADH. A patient with ethanol intoxication seemed to have central diabetes insipidus on clinical grounds. However, the osmolality of the urine was 287 mosm/kg H2O, a value which made this diagnosis unlikely. Since the concentration of ethanol in plasma was 119 mmol/L, we suspected that the urine contained an appreciable quantity of alcohol; this might obscure the lack of action of ADH. A study was performed to document the quantitative relationship between the concentrations of ethanol in plasma and urine. The concentration of ethanol in the urine was approximately 1.4-fold greater than in plasma. Using this correction factor, the osmolality of the urine adjusted for ethanol in the patient was only 120 mosm/kg H2O, a value more consistent with the diagnosis of central diabetes insipidus. PMID- 1782735 TI - The banking of DNA for the prevention of genetic disease. PMID- 1782736 TI - Policy statement concerning DNA banking and molecular genetic diagnosis. Canadian College of Medical Geneticists. PMID- 1782737 TI - Felodipine clinical pharmacokinetics. AB - Absorption of felodipine is rapid and complete. A pronounced first-pass metabolism results in a bioavailability of 15%, irrespective of the oral formulation used. The peak plasma concentrations and area under the plasma concentration-time curve are linearly related to the dose. The variability in plasma concentrations is wide, and individualization of the dosage is recommended. Plasma felodipine concentrations are increased in the elderly, and in patients with congestive heart failure or liver cirrhosis; in these patients felodipine should be started at a low dosage. Food intake has no clinically significant effect on felodipine absorption. Serum digoxin concentrations are increased by felodipine in plain tablet form, but not when it is administered as extended release tablets. Activators, inducers and inhibitors of the cytochrome P450 system affect the plasma concentrations of felodipine. No displacement reactions with high affinity protein binding drugs have been observed. There is a significant correlation between plasma concentration and haemodynamic effect. The mean elimination half-life of 24h together with the extended release formulation of felodipine favours once-daily dosage in patients with hypertension. PMID- 1782738 TI - Drug absorption in gastrointestinal disease and surgery. Clinical pharmacokinetic and therapeutic implications. AB - Drug absorption from the gastrointestinal (GI) tract and the impact of GI surgery and disease on drug absorption are discussed. Recommendations are made to manage problems of drug malabsorption. Absorption from the GI tract is a first-order process described by its rate and extent. GI surgery changes the anatomy of the GI tract and alters important variables in the absorption process. In the wake of procedures which diminish small bowel surface area, the extent of absorption of phenytoin, digoxin, cyclosporin, aciclovir, hydrochlorothiazide and certain oral contraceptives is reported to be reduced. The underlying cause of the reduction is unknown. When gastric emptying time or pH are altered by surgery, the rate of drug absorption appears to be reduced. However, it is not clear which variable is more important in determining therapeutic effects. The effects of coeliac and inflammatory bowel diseases on the distribution and clearance of drugs must be considered before attributing abnormal serum concentrations of drugs to malabsorption. GI disease may slow gastric emptying and delay the complete absorption of drugs when their rate of absorption depends on gastric emptying time. Other inflammatory GI diseases such as graft-versus-host disease (GVHD) of the gut, Behcet's syndrome and scleroderma involving the GI tract may directly reduce absorption of drugs such as cyclosporin, amitriptyline, benzodiazepines, anticonvulsants, paracetamol (acetaminophen) and penicillamine. GI diseases which alter gut pH affect the absorption only of drugs with limited water solubility and pH-dependent dissolution such as ketoconazole. Clinicians should be aware of the variable absorption seen after GI disease and surgery and monitor their patients accordingly. PMID- 1782740 TI - Individualising gentamicin dosage regimens. A comparative review of selected models, data fitting methods and monitoring strategies. AB - The various components required for individualising clinical drug dosage regimens are reviewed, including a study of 3 types of fitting procedures, 2 types of gentamicin pharmacokinetic model and the utility of D-optimal times for obtaining serum gentamicin concentrations. The combination of the current Bayesian fitting procedure, the kslope pharmacokinetic model [in which the elimination rate constant (kel) can change from dose to dose with changing creatinine clearance] and the explicit measurement of the assay error pattern yielded predictions of future serum gentamicin concentrations which were (a) slightly better than those found using weighted nonlinear least squares; (b) somewhat better than those found with Bayesian fitting and a fixed-kel model; (c) better than those found using the traditional linear regression fitting procedure and a fixed kel model. D-Optimally timed pairs of concentrations also predicted future concentrations at least as well, and more cost effectively. PMID- 1782741 TI - Pharmacokinetic justification of antiprotozoal therapy. A US perspective. AB - Infections with parasitic protozoa have always been problems for the developing world and are becoming of greater importance to the developed world in this age of easy international travel. The major human protozoal diseases are summarised with an emphasis on their presentation in normal hosts and in immunocompromised individuals and current US drug treatment recommendations are discussed. Present antiprotozoal regimens are based either on a pharmacokinetic rationale or on clinical trial and error. Regimens based on trial and error include amphotericin B against leishmaniasis and arsenic against African trypanosomiasis. Regimens which are to some extent driven by pharmacokinetic or biochemical considerations include paromomycin and metronidazole against amoebiasis, sodium stibogluconate against leishmaniasis, halofantrine and mefloquine against malaria, dihydrofolate reductase (DHFR) inhibitors against Pneumocystis carinii and toxoplasmosis and aerosolised pentamidine against P. carinii pneumonia. The majority of pharmacokinetic studies have been performed only on agents which have some therapeutic activity against other diseases of the developed world. Despite the trend toward rational treatment regimens, no studies have been performed that permit optimisation of antiprotozoal treatment regimens on the basis of clinical conditions such as renal failure. PMID- 1782742 TI - Identification of an Arg-Gly-Asp (RGD) cell adhesion site in human immunodeficiency virus type 1 transactivation protein, tat. PMID- 1782743 TI - An inhibitor of the protease blocks maturation of human and simian immunodeficiency viruses and spread of infection. PMID- 1782739 TI - Pharmacokinetic interactions with calcium channel antagonists (Part II). AB - Since calcium channel antagonists are a diverse class of drugs frequently administered in combination with other agents, the potential for clinically significant pharmacokinetic drug interactions exists. These interactions occur most frequently via altered hepatic blood flow and impaired hepatic enzyme activity. Part I of the article, which appeared in the previous issue of the Journal, dealt with interactions between calcium antagonists and marker compounds, theophylline, midazolam, lithium, doxorubicin, oral hypoglycaemics and cardiac drugs. Part II examines interactions with cyclosporin, anaesthetics, carbamazepine and cardiovascular agents. PMID- 1782744 TI - Endemic Kaposi's sarcoma in human immunodeficiency virus type 1 seronegative persons: demonstration of retrovirus-like particles in cutaneous lesions. PMID- 1782745 TI - CD4 and CD8 T cells from SIV-infected macaques have defective signaling responses after perturbation of either CD3 or CD2 receptors. PMID- 1782746 TI - Affairs of the heart: cholesterol and coronary heart disease risk. PMID- 1782747 TI - An apolipoprotein CII mutation, CIILys19----Thr' identified in patients with hyperlipidemia. AB - Five hyperlipidemic patients (one with Type III, three with Type IV, and one with Type V hyperlipoproteinemia) were found on isoelectric focusing to have both the normal isoform of apolipoprotein CII and a second isoform whose isoelectric point was consistent with a single charge change. The structure of the apolipoprotein CII variant was determined to be the same as normal apolipoprotein CII except for replacement of the normal Lys at amino acid residue 19 by Thr (C2K19T). The mutation was absent from 160 apoCII alleles screened from normolipemic subjects. The C2K19T substitution occurs in a domain of apolipoprotein CII postulated to contain a lipid-binding amphipathic alpha-helix. The presence of C2K19T in unrelated hyperlipidemic patients of various racial backgrounds suggests that, in combination with other factors such as mutations in apolipoprotein E, it plays a role in the development of hyperlipoproteinemias. PMID- 1782748 TI - Clonal cytogenetic changes in atherosclerotic plaques including trisomy 20. AB - To examine the possible implications of chromosomal changes in the etiology of atherosclerotic plaques, we cytogenetically investigated cultured cells from atheromata at different sites of six patients. Fixed metaphase chromosomes from short-term cultures of cells obtained from atherosclerotic plaques were examined by GTG banding. One case, characterized by the presence of two abnormal related clones, showed numerical and structural karyotypic changes. This observation, confirms the presence of chromosome abnormalities in cells from atherosclerotic plaques, and contributes to the debate on the origin of this cell neoproliferation. PMID- 1782749 TI - HLA-B40: a marker for susceptibility to lung disease in rheumatoid arthritis. AB - We have compared the frequency of HLA antigens in groups of patients with rheumatoid arthritis (RA) who had pulmonary manifestations, other extra-articular features or articular disease alone. There was a significantly increased frequency of the antigen HLA-B40 in patients with lung involvement compared to other forms of extra-articular RA (relative risk 40.54), and when compared to the total RA group (relative risk 4.94). In contrast there was little variation in the frequency of HLA-DR4, which was significantly increased in all patient groups. These data suggest that HLA-B40 is a marker of increased susceptibility to lung disease in patients with rheumatoid arthritis. PMID- 1782750 TI - Emotion or science? PMID- 1782751 TI - Medicaid spending skyrockets. PMID- 1782752 TI - National Practitioner Data Bank: year one. PMID- 1782753 TI - Starting a practice: preventive law. PMID- 1782754 TI - AIDS and lawmakers. PMID- 1782756 TI - Interorgan transport and catabolism of carnosine and anserine in rainbow trout. AB - 1. After large amounts of carnosine or anserine were injected into rainbow trout white muscle, they were promptly washed out into blood and incorporated mainly into kidney. 2. These dipeptides were transported only a little to the other portions of white muscle but significantly to red muscle. 3. After anserine administration, pi-methyl-L-histidine, a constituent of anserine, increased largely in the kidney, followed by liver and muscles. 4. Histidine, a decomposed product of carnosine, increased in muscles after carnosine administration prior to the increase in kidney and liver. PMID- 1782755 TI - Interstrain differences in red cell enzyme activities in mice and rats. AB - 1. Interstrain differences in red blood cell enzyme activities were studied in mice (BALB/c, C57BL/6, C3H/He, DBA/2 and ddY) and rats (Donryu, F344/N, SD, Wistar and Wistar/ST), and were also compared with hamster, guinea-pig and rabbit. 2. The enzyme activities measured were: glutathione S-transferase (GST), glucose-6-phosphate dehydrogenase (G-6-PD), 6-phosphogluconate dehydrogenase (6 PGD), NADPH-diaphorase (ND), hexokinase (Hx), glutamate oxaloacetate transaminase (GOT), lactate dehydrogenase (LDH) and acetylcholinesterase (AChE). 3. There were marked variations in the activities of some red cell enzymes (e.g. GST, Hx, ND), while others (e.g. G-6-PD, 6-PGD) were much less variable both within different strains and species. PMID- 1782757 TI - Time-course variations of effective proton conductance and GDP binding in brown adipose tissue mitochondria of rats during prolonged cold exposure. AB - 1. Time-course variations of the thermogenic pathway in rat brown adipose tissue (BAT) mitochondria were examined. 2. Several parameters of mitochondrial energization, protonmotive force and its components pH gradient and membrane potential were investigated. The specific binding of GDP was compared with the effective proton conductance (CmH+) of the membrane. 3. Ten-days cold exposure led to maximal GDP binding and GDP-dependent CmH+. 4. The subsequent relative decrease in GDP binding observed during prolonged cold exposure (40 days) was functional and led to a lower GDP-dependent CmH+. CmH+ showed greater variation than GDP binding. 5. The CmH+ decrease was not due to a masking of active sites of the uncoupling protein. 6. Basal GDP-independent CmH+ was not modified. 7. Results are discussed with reference to the significance of biochemical measures and to the physiological regulation of BAT thermogenesis. PMID- 1782758 TI - Glycosaminoglycan concentrations in horse plasma and serum. Differences with other animal species and identification of affecting factors. AB - 1. The measured values of acid glycosaminoglycan (GAG) concentration in plasma or in serum show significant differences between trained and untrained horses and among sedentary horses and other animal species (cattle, rabbit, sheep). 2. Diurnal variations in serum GAG levels are reported (cattle), and changes in plasma GAG concentrations after road transport (horses) and in late pregnancy (mares, cows), while sex, age and breed do not affect them. PMID- 1782759 TI - Collagenolytic activity of crustacean midgut serine proteases: comparison with the bacterial and mammalian enzymes. AB - 1. We have investigated the collagenolytic activity of the following serine proteases: proteinase K, subtilisin Novo, Staphylococcal endoproteinase Glu-C, Streptomyces pronases, the trypsins and chymotrypsins from shrimp midgut and bovine pancreas. 2. By assays on both the insoluble 3H-collagen fibrils and the soluble type I collagen, it was demonstrated that the shrimp midgut serine proteases, and less efficiently, the pronases from Streptomyces griseus, could hydrolyze collagen while the other serine proteases tested could not. 3. Our data indicate that the trypsins and chymotrypsins of shrimp (Penaeus monodon) directly and indirectly digest native collagen, and that the indirect pathway probably involves activation of procollagenase in the native collagen by these serine proteases. PMID- 1782760 TI - Radioligand receptor assay for prolactin using chicken and turkey kidney membranes. AB - 1. A sensitive and specific radioreceptor assay for measuring prolactin in tissue extracts, culture media and serum has been developed utilizing membrane fractions prepared from either chicken or turkey kidney, and an ovine prolactin standard and tracer. 2. Assay sensitivity was 1.0 +/- 0.1 ng per tube, 50% inhibition of binding occurred with 12.8 +/- 1.2 ng of unlabeled ovine prolactin standard, and intra- and interassay coefficients of variation were 3.9% and 8.8%, respectively. 3. The 47,800 g kidney membrane preparation, which yielded maximum specific binding of 20-40%, offered advantages over current methods including use of an easily available and inexpensive tissue, no need for pretreatment of the donor animal, a high yield of receptor protein, and a simplified method of membrane preparation. PMID- 1782761 TI - Selective effects of some anesthetics and detergents on lipid peroxidation of mouse heart homogenates. AB - 1. The effects of some anesthetics and detergents on the Fe2+/ascorbate stimulated non-enzymatic lipid peroxidation potential and on the NADPH-dependent enzymatic lipid peroxidation capacity were characterized in mouse heart homogenates. 2. Chlorpromazine turned out to be the most efficient inhibitor, causing a 50% inhibition at a concentration of 0.03 mM in the non-enzymatic assay, and at a concentration of 0.02 mM in the enzymatic assay. 3. Tetracaine was about a 10-times weaker inhibitor with IC50-values of 0.25 mM. High concentration of dibucaine (1 mM) exerted a 60% inhibition in the non-enzymatic assay, but lidocaine and procaine had no prominent effect with the concentrations used. 4. In the non-enzymatic, Fe(2+)-stimulated system, a 50% inhibition was obtained by using SDS, Triton X-100, and deoxycholic acid at concentrations of 0.004, 0.03, and 0.15%, respectively. 5. In the NADPH-dependent enzymatic lipid peroxidation system, corresponding concentrations were 0.02, 0.04 and 0.1%. Deoxycholate and Triton X-100 even stimulated (10-20%) the enzymatic lipid peroxidation at the lowest concentrations (0.005-0.01%). Saponin was the least effective of these detergents. 6. It is suggested that anesthetics and detergents induce structural rearrangements in the myocardiac membranes which result in the unavailability of phospholipid substrates to lipid peroxidation. PMID- 1782762 TI - Taurine content of isolated rat alveolar type I cells. AB - 1. Rat alveolar type I cells were isolated by enzymatic digestion and purified by centrifugal elutriation and specific surface adsorption. 2. The identity of the harvested cells was confirmed using electronic cell sizing and transmission electron microscopy. 3. Purified cell preparations contained 4.6 +/- 2.3 x 10(6) type I cells/rat lung with a purity of 79 +/- 3%. 4. Isolated type I cells exhibited the following characteristics: mean cell volume = 716 +/- 48 microns 3; diameter = 11.1 +/- 0.7 microns; and cell water content = 0.50 +/- 0.03 microliter/10(6) cells. 5. Taurine content of these alveolar type I cells was measured by HPLC. 6. The intracellular taurine concentration of type I cells was 0.14 +/- 0.07 mM, a value close to that of plasma (0.1 mM). PMID- 1782763 TI - A dopamine- and octopamine-sensitive adenylate cyclase in the nervous system of Octopus vulgaris. AB - 1. Adenylate cyclase activity was assayed in the optic lobe of Octopus vulgaris. 2. Both octopamine and dopamine stimulate the octopus adenylate cyclase, apparently by competing with the same receptor site. 3. (+/-)-2-Amino-6,7 dihydroxy-1,2,3,4-tetrahydronaphthalene-HBr (6,7-ADTN) and a number of phenylethanolamine derivatives stimulate the octopus adenylate cyclase activity. 4. The dopamine D-1 antagonists R(+)-7-chloro-8-hydroxy-3-methyl-1-phenyl- 2,3,4,5-tetrahydro-1H-3-benzazepine-HCl (SCH-23390) and (+/-)-7-bromo-8-hydroxy-3 methyl-1-phenyl-2,3,4,5-tetrahydro-1H- 3-benzazepine-HCl (SKF-83566) are unable to antagonize the effects of dopamine and octopamine, and similarly ineffective is the agonist (+/-)-1-phenyl-2,3,4,5-tetrahydro-1H-3- benzazepine-7,8-diol-HCl (SKF-38393). 5. No detectable binding of labelled SCH-23390 occurs on membrane preparations from octopus optic lobe. PMID- 1782764 TI - Vitellogenin--homologs of mammalian apolipoproteins? AB - 1. To determine if a relationship exists between vertebrate vitellogenins and mammalian plasma proteins the EMBL and NBRF computer databases were searched with two partial amino acid sequences from Xenopus laevis and Gallus gallus vitellogenin. 2. A significant relationship was found between vitellogenin and human apolipoprotein B-100 genes, and confirmed using homology-determination programs. 3. Further analysis shows that unique multiple proline consensus regions found in apolipoprotein B-100 are significantly similar to proline dominant regions in vitellogenin. 4. This work suggests that these proteins are functionally and structurally related and should be categorized as a functional group of hepatic lipid transport and metabolism proteins. PMID- 1782765 TI - New trends in the use of metals in jewellery. AB - Owing, on the one hand, to the constant increase in the %s of nickel sensitization in the majority of allergy departments of dermatology and, on the other, to the fact that sensitization to nickel is almost always through contact with jewellery and imitation jewellery, an update was carried out on the metal alloys principally used in the manufacture of such jewellery (earrings, bracelets, necklaces, rings, watch straps, etc.) The conclusions of this review demonstrate that nickel is irreplaceable in the majority of the alloys, because of its excellent technical properties and low price and, as a result, the % of sensitizations to this allergen will not only maintain their present high level but will probably increase in the future. PMID- 1782766 TI - New hydroxyisoflavans as contact sensitizers in cocus wood Brya ebenus DC (Fabaceae). AB - A 15-year-old girl developed perioral dermatitis and swelling of the lips, having played a flute made of cocus wood for 2 years. Patch tests with wood shavings, as well as with subsequently isolated constituents named Cocus I and Cocus II, were strongly positive. After complete purification, both contact allergens were identified as isoflavan derivatives. While Cocus I was shown to be 7,8-dihydroxy 2',4',5'-trimethoxyisoflavan, the structure of Cocus II could not be elucidated exactly. It could have been either 7,8,3'-trihydroxy-2',4'-dimethoxyisoflavan or 7,8,2'-trihydroxy-3',4'-dimethoxyflavan. The exact position of the hydroxy and methoxy group in C-2' and C-3' can be determined only by complete synthesis of both compounds or by isolation of greater amounts of Cocus II for further oxidation experiments. Due to the stronger patch test reaction and the higher yield of Cocus I in the wood, this hydroxyisoflavan must be recognized as the main contact allergen. PMID- 1782767 TI - Patch testing in children: a study of 562 schoolchildren. AB - 562 schoolchildren from Oporto were patch tested with the standard series of the Portuguese Contact Dermatitis Group (GPEDC). 13.3% of the children had positive reactions, the most common being to neomycin, thimerosal, para-tertiary butylphenol-formaldehyde (PTBPF) resin and fragrance-mix. Thus contact allergy in children seems not to be as unusual as previously thought. PMID- 1782768 TI - Studies of the quenching phenomenon in delayed contact hypersensitivity reactions. AB - Studies in guinea pig and man have shown that eugenol can quench non-specifically contact urticarial responses, whereas limonene seems largely ineffective. In a comprehensive series of studies, there was little evidence of quenching of delayed contact hypersensitivity reactions to cinnamic aldehyde or citral, including in 'pre-quenched' material supplied by a perfume/flavour company, and in a similar mixture prepared in this laboratory, in the guinea pig model. In addition, there was no evidence of the quenching by eugenol of allergic reactions to cinnamic aldehyde in a panel of human subjects with a proven history of cinnamic-aldehyde-induced allergic contact dermatitis. Overall, the results lend little credibility to earlier literature reports of quenching phenomena in delayed contact hypersensitivity responses. PMID- 1782769 TI - Assessment of the relative skin sensitizing potency of 3 biocides using the murine local lymph node assay. AB - The relative skin-sensitizing potency of 3 biocides, 5-chloro-2-methyl-4 isothiazolin-3-one (the major active ingredient in Kathon CG), 1,2 benzisothiazolin-3-one and 2-methyl-4,5-trimethylene-4-isothiazolin-3-one, was assessed using the murine local lymph node assay. Potency was ranked according to the lowest dose of material which, following epicutaneous exposure, induced a significant proliferation of T lymphocytes in the draining lymph nodes. The results showed that 5-chloro-2-methyl-4-isothiazolin-3-one was able to induce proliferative activity at significantly lower dose levels than the other 2 biocides and that it may therefore be a more potent skin sensitizer. PMID- 1782770 TI - Immediate-type reaction to buserelin acetate in a nasal spray. PMID- 1782771 TI - Ig-E-mediated contact and generalized urticaria from Eruca sativa. PMID- 1782772 TI - Purpuric rash caused by dermal exposure to d-limonene. PMID- 1782773 TI - Integrins in human corneal epithelium. AB - Monoclonal antibodies (Mabs) were used for immunohistochemical location of integrin beta- (beta 1,3, and 4) and alpha subunits (alpha 1-6 and alpha v) in the epithelium of both normal and tissue-cultured human cornea. Immunoreaction for the beta 1 integrin subunit was the most intense at the membranes of the basal epithelial cells and weaker at the superficial cell membranes. Anti-beta 4 immunofluorescence appeared in the basal part of the epithelium only, apposing the basement membrane. Both anti-alpha 2 and anti-beta 3 Mabs showed an immunoreaction with distribution similar to the beta 1 integrin subunit. Immunoreaction for the alpha 6 integrin subunit resembled the distribution of the beta 4 subunit. Anti-alpha v showed a faint immunoreaction at the basal and lateral aspects of the basal cell layer. Antisera against beta 3, alpha 1, alpha 4, and alpha 5 integrin subunits showed no specific reactions. The present results suggest that both the normal and tissue-cultured human corneal epithelium contain alpha 2 beta 1, alpha 3 beta 1, and probably also alpha v beta 1 and alpha 6 beta 4 integrin dimers or complexes. We discuss their role as possible receptors for some known ligands. PMID- 1782774 TI - In vitro transfer of rabbit corneal epithelium from carriers to denuded corneas or cryolathed lenticules. AB - Rabbit corneal basal epithelial cells seeded onto fixed gelatin membranes or commercial collagen shields formed 3 to 5 cell layers after 1 to 3 weeks of culture at 35 degrees C in nutrient medium. The cells grew better, by comparison, in the collagen shields and eventually formed a multilayered tissue that resembled the stratified morphology of native epithelium. Transfer of multilayered cultures (prior to stratification) from these carriers in vitro to denuded corneal buttons or cryolathed lenticules resulted in complete adhesion of the grafted tissue to the underlying recipient buttons after 24- to 48-h incubations. After mechanically removing the carriers, most of the epithelial cells remained attached to the stromal surface. Our experimental findings indicated that both kinds of carriers may be suitable for epithelial transplantation, although the collagen shield is probably superior because of its better biocompatibility and physical characteristics. PMID- 1782775 TI - The effect of tarsorrhaphy on normal healing of corneal epithelial defects in a rabbit model. AB - The presumed benefits of occlusive patching are patient comfort and enhancement of corneal healing. However, there is little experimental evidence to document a beneficial effect of eyelid occlusion on corneal healing. We produced corneal abrasions by mechanical debridement within a 4 mm trephine-marked area on 1 eye each of 23 New Zealand albino rabbits. Homatropine 5% solution and erythromycin ointment were instilled. Then we divided the animals into three groups. The abraded eyes of the first group (7 rabbits) were sutured shut by a temporary tarsorrhaphy. The eyes of the second group (7 rabbits) were left open until 12 h postinjury, when they were sutured shut in a similar fashion. The abraded eyes of the control group (9 rabbits) were left open for the entire observation period. We monitored fluorescein staining patterns of the epithelial defects photographically at a set focal length at 12-h intervals. By 48 h, corneal staining had resolved in 87% of eyes. We performed computerized planimetry on the photographs of wound size for each time point. There was no statistically significant difference in the rate of healing of corneal abrasions in the occluded versus of the unoccluded eyes. PMID- 1782776 TI - Topical autologous fibronectin in patients with recurrent corneal epithelial defects. AB - We designed a clinical trial to evaluate the effect of topical fibronectin (an adhesive protein) for prevention of recurrent corneal epithelial defects. Fifteen eyes (11 patients) with 2 documented epithelial defects within 12 weeks were included. Purity and biological activity of the prepared solutions of autologous plasma fibronectin were confirmed by sodium dodecyl-sulfate polyacrylamide gel electrophoresis and gelatin binding affinity, respectively. According to randomization, fibronectin or saline was given 5 times per day for 11 weeks to 1 eye of 11 patients. Eyes of 4 patients with bilateral disease were paired, 1 eye receiving fibronectin and the other saline. We examined the patients weekly. The following recurrence parameters were retained for analysis: number of weeks with an epithelial defect, area under recurrence curves, and number of weeks with discomfort. The randomized and paired data analyses suggest that topical autologous plasma fibronectin does not prevent recurrent corneal epithelial defects. We describe a patient who received two treatment courses bilaterally, each eye crossing over to the alternate medication after a first treatment course. The response to treatment of each eye appeared unassociated to the medication. PMID- 1782777 TI - Effect of angle closure glaucoma and surgical intervention on the corneal endothelium. AB - To assess the effect of acute angle closure glaucoma (AACG) and related surgical intervention on the corneal endothelium, specular microscopy was performed following surgery in a series of 69 patients: 27 for AACG, 9 for incipient angle closure, 17 for chronic angle closure glaucoma (CACG), and 16 for chronic open angle glaucoma (COAG). Peripheral iridectomy for incipient angle closure glaucoma caused no significant effect on the corneal endothelium, but, following peripheral iridectomy or drainage operation for AACG, significant lowering of the endothelial cell count was present in the affected eye (p less than 0.05) with 1,000 cells/mm2 in 7 cases. This was related to the presence of segmental iris atrophy (p less than 0.01). Peripheral iridectomy for CACG or incipient angle closure glaucoma was not accompanied by a significant effect, but drainage operation for CACG or COAG was associated with a significant fall in count (p less than 0.01). Thus, both AACG and drainage operation significantly affect the corneal endothelium, and this should be assessed before undertaking further surgery. PMID- 1782778 TI - Results of penetrating keratoplasty with posterior chamber intraocular lens implantation in the absence of a lens capsule. AB - We studied 21 consecutive cases of posterior chamber intraocular lens implantation in the absence of an intact lens capsule performed during penetrating keratoplasty. Twenty patients had iris sutures to support the posterior chamber intraocular lenses (one required no suture). Twelve patients had closed-loop anterior chamber intraocular lenses, and five patients had other types of intraocular lenses explanted at the time of surgery. Postoperative follow-up time averaged 10 months, ranging from 2 to 19 months, with ten eyes having at least 1 year follow-up. All 21 grafts remained clear at their latest examinations. Seven eyes (33%) had 20/50 or better visual acuity, nine (43%) had a visual acuity from 20/60 to 20/150, and five (24%) had a visual acuity of 20/200 or worse at their latest examinations. All patients had improved vision postoperatively, and nine eyes (43%) achieved an improvement in vision of five lines or better. Of the ten eyes with at least 1 year follow-up, all had their sutures removed and four (40%) had 20/40 or better visual acuity. Of the remaining six patients (60%) with visual acuity worse than 20/40, all had significant retinal disease and/or glaucoma. PMID- 1782779 TI - Prevalence of superficial fibrillary lines of the cornea in contact lens wearers and nonwearers. AB - Superficial corneal epithelial striations described as fibrillary lines have been documented as a common finding in normal and keratoconic eyes. We first noticed these fine white structures in both soft and rigid contact lens wearers. This prompted us to investigate whether the prevalence of these lines was greater in contact lens wearers than in non-lens wearers. Our results indicated that although the lines were more frequently observed in lens wearers (35.7% of 42 patients) than in the controls (19.0% of 42 patients), the difference was not statistically significant (p = 0.0867, chi 2 analysis). We speculate that lens wear makes fibrillary lines more visible but is not responsible for their presence. PMID- 1782780 TI - Effect of intracanalicular collagen implants on the absorption of topically applied sodium fluorescein. AB - Absorbable intracanalicular collagen implants were placed in both canaliculi of one eye of nine human volunteers. The other eye served as a control. Twenty-four hours later 2% sodium fluorescein was placed into both conjunctival sacs. Serial corneal fluorescein concentrations were measured with a scanning ocular fluorophotometer from 2 to 90 min after fluorescein administration. The mean corneal fluorescein concentration averaged over all time points was greater in 7 of 9 eyes with collagen implants compared to unimplanted controls. When the data from each subject were analyzed collectively, the mean corneal fluorescein concentration in the implanted eyes (1,218 micrograms/ml +/- SEM 83) was significantly greater (p less than 0.001) than the mean concentration in the control eyes (823 micrograms/ml +/- SEM 83). The use of absorbable intracanalicular collagen implants may increase the bioavailability of topically applied ocular solutions. PMID- 1782781 TI - Detection by brush cytology of mast cells and eosinophils in allergic and vernal conjunctivitis. AB - The presence of eosinophils in the conjunctival epithelium is indicative of allergies, and detection is currently performed by cotton swab scrapings. Although mast cells are thought to be chemotactic for eosinophils and thus presage their accumulation, the former's use as early indicators of allergy has heretofore been hindered by poor detection methods. The recent development of a special brush now makes it possible to collect many cells with less disturbance of the conjunctival epithelium. In the present study, we have used this brush for conjunctival scraping in 18 patients with vernal and allergic conjunctivitis, and 10 patients serving as controls. The superior and inferior tarsal conjunctiva in both eyes were examined, and the specimens were stained using Hansel's method. Mast cells were observed in at least one of the tarsal conjunctivae in all cases of vernal and allergic conjunctivitis, whereas eosinophils were so observed in only eight cases (44.4%). Neither mast cells nor eosinophils were present in the conjunctivae of the normal group. Although treatment by mast cell stabilizers produced clinical remissions, they induced disappearance of mast cells in only 10 cases (55.6%), whereas in six cases (33.3%) the mast cells increased, and in two cases they were unchanged (11.1%). Six cases (33.3%) each showed disappearance of, increase in, and no change in eosinophils, reflecting even less of a response of these allergic cells to the treatment. The presence of mast cells and eosinophils, as determined by our cytologic method, was found to be correlated with the early detection, but not the clinical severity, of allergic conjunctivitis. PMID- 1782782 TI - Long-term storage of endocytosed latex beads in keratocytes in vivo. AB - Endocytosis by keratocytes (corneal fibroblasts) is an important part of the host defense system. To investigate the long-term fate of endocytosed materials, we injected polystyrene latex beads into the corneal stroma of four rabbits. The corneal stroma was observed under a transmission electron microscope 4 and 800 days after the injection. After 4 days, the beads were found not only between the collagen fibers of the stroma, but also in some keratocytes. After 800 days, no extracellular beads were seen, but endocytosed beads remained, surrounded by limiting membranes, in the cytoplasm of keratocytes. These observations demonstrate that keratocytes endocytose latex beads and store them for a long time, isolating these foreign materials from the corneal stroma. These observations suggest that keratocytes, like some other fibroblasts perform a noninflammatory and nonimmunological defense function. PMID- 1782783 TI - Ocular complications of Stevens-Johnson syndrome and toxic epidermal necrolysis in patients with AIDS. AB - Recent reports suggest that acquired immunodeficiency syndrome (AIDS) patients are at higher risk of developing mucocutaneous reactions such as toxic epidermal necrolysis and Stevens-Johnson syndrome (SJS). Resultant dry eye may be further exacerbated by human immunodeficiency virus (HIV) related lacrimal gland dysfunction and lead to a chronic keratoconjunctivitis. We report one patient with AIDS and toxic epidermal necrolysis and two patients with AIDS and SJS who developed severe dry eye misdiagnosed as infectious keratoconjunctivitis. Cicatrizing mucocutaneous reactions should be suspected in AIDS patients and the dry eye treated to control symptoms and prevent complications. PMID- 1782784 TI - Intraocular lens implantation in anterior megalophthalmus. Case report. AB - We report three cases of extracapsular cataract extraction with intraocular lens implantation in two patients with anterior megalophthalmus. This is the first report, to our knowledge, of intraocular lens implantation in this rare condition. PMID- 1782785 TI - Wegener's granulomatosis presenting as dacryoadenitis. AB - Wegener's granulomatosis is a life-threatening condition characterized by the triad of necrotizing granulomatous inflammation of the respiratory tract, vasculitis, and glomerulonephritis. During early stages of the disease, some patients may present with only one or two components of the triad. Other patients may be affected by the limited form of Wegener's which lacks the renal involvement. We report an 18-year-old female who initially presented with bilateral dacryoadenitis. A lacrimal gland biopsy was consistent with Wegener's granulomatosis. A few months later she developed glomerulonephritis and responded well to cyclophosphamide treatment. Wegener's granulomatosis remains a diagnostic challenge and is frequently underdiagnosed. Early diagnosis is crucial in saving many lives because the disease is potentially curable with cytotoxic therapy. Dacryoadenitis may be one of the initial presentations of Wegener's granulomatosis. PMID- 1782786 TI - A fifteen year follow-up of a case of developmental prosopagnosia. AB - The term developmental prosopagnosia refers to an impairment in the recognition of familiar faces which has been present from birth in the absence of neurological disease or birth complications. The first reported study was by McConachie (1976, Cortex, 12: 76-82) and we report here a fifteen year follow-up on this case (AB). Recently developed theoretical models postulating separate processes involved in face perception and recognition were used to guide the exploration of her functional deficit. Our investigations with AB showed that basic visuo-sensory functions (acuity, contrast sensitivity, colour, etc.) were largely intact. General face perception (e.g. distinguishing between a face and a "nonface") was relatively well preserved. Recognition of familiar faces was severely impaired and she also showed problems with other face processing tasks (e.g. analysis of facial expression) and in object recognition. In object recognition she made errors based on visual similarity, and she had problems identifying exemplars from categories with many visually similar items. In addition, she was very poor at identifying objects or silhouettes from an unusual viewpoint. We conclude that AB has always been poor at constructing an effective internal representation sufficient to permit recognition of items which are visually difficult to discriminate. Therefore, she may not have been able to acquire useable stored representations either, because this deficit has been present since birth. This functional account was supported by subsequent studies which demonstrated a complete absence of covert face recognition. PMID- 1782787 TI - Spatial processing of images and hemisphere function. AB - Forty subjects performed both of the following tasks. In the imagery task, simple dot patterns were presented for five seconds in free vision, followed by a three second fixation field. Subsequently, a circle was briefly presented in either the right or the left visual field and subjects were required to indicate whether or not the circle surrounded a point previously occupied by a dot. The perceptual task was similar except that the dot patterns remained on the screen while the circle was presented. Reaction times and error data indicated a left visual field advantage on the imagery task only, suggesting a right hemisphere superiority for extraction of spatial information from images. PMID- 1782788 TI - Hand preferences in the skilled gathering tasks of mountain gorillas (Gorilla g. berengei). AB - Manual dexterity of 44 wild gorillas of all ages and both sexes was investigated on six naturally acquired feeding tasks of varied logical structure, which included multi-stage and bimanually coordinated procedures. At least 400 min observation of feeding per animal, and analysis at the level of bouts rather than individual actions, can be expected to produce statistically robust results; 22 years background data allowed effects of genealogy and injury to be investigated. Five tasks elicited very strong hand preferences in most animals (weakest on the simplest task), while one was usually performed with a strategy in which left and right hands were used symmetrically; the preferences were fully established at 3 years old. Preferences were highly correlated within each of two sets of tasks, but between the two sets there was no correlation across animals in direction or strength of preference. No population trends towards left or right handers were found in either set of tasks, or both sets pooled; distributions were U-shaped and approximately symmetric, with a slight bias towards right-handed fine manipulation in one set of tasks. Processing efficiency was only slightly greater with the preferred hand, and similar in left- and right-handed animals. Neither direction nor strength of hand preference showed a tendency to run in families, but females showed greater strength of preference. Major injury masked strong hand preference, but injuries could not account for the overall distribution of preference; instead this may reflect inbreeding. Feedback acting on initially random hand choices, and imitation at the "program" level rather than slavish copying of acts, are proposed to account for the results. PMID- 1782789 TI - Visual learning deficits in nonresected patients with right temporal lobe epilepsy. AB - A visual learning test Diagnostikum fur Zerebralschaden (DCS) was revised and applied to three matched patient groups defined by interictal and ictal EEG findings: 24 patients with left temporal lobe epilepsy (LTE), 19 patients with right temporal lobe epilepsy (RTE) and 34 patients with a bitemporal epileptic involvement (BTE). Fifty seven healthy subjects served as controls. Performance on a measure of sustained attention and visual construction was also assessed. Results were as follows: (1) In contrast to controls and LTE patients, patients with right temporal epileptic involvement (RTE/BTE) showed a significantly reduced immediate recall as well as a reduced learning capacity and mean learning performance. (2) Patients made significantly more errors than controls, with RTE patients exhibiting the most visuo-spatial errors. (3) RTE/BTE patients additionally showed impaired performances on visuo-construction, but when visual construction scores were used as covariate, they did not diminish the strong group effects upon learning. (4) Attentional deficits were independent from memory deficits and rather reflected the bitemporal extention of epilepsy. As a conclusion, the data suggest an impairment of visual-spatial consolidation processes in patients with right temporal lobe epilepsy. PMID- 1782790 TI - Hemisphere differences in conditional learning: an ERP-study. AB - The present ERP-experiment investigated brain asymmetry in encoding and representation of the formation of conditional associations in a Pavlovian framework. Two consonant-vowel syllables were used as conditional stimuli, one of them paired with an unconditional noise during the acquisition phase (CS+), the other never paired with noise (CS-). During a subsequent test phase, both CS cues were presented dichotically i.e. at the same time. Half of the subjects had the CS+ probe presented to the right ear (contralateral to the left hemisphere). The other half of the subjects had the CS+ presented to the left ear (contralateral to the right hemisphere). ERPs from F3, Fz and F4 leads were recorded. The paradigm used was an adaptation of the standard dichotic listening technique for the study of learned associations. The results showed that conditional associative learning occurred during the acquisition phase in both "groups". The P235 latency was furthermore delayed over the left hemisphere to the CS+ probe. During the dichotic test phase, there was a clear laterality or asymmetry effect between the groups for both the N125 and N450 components, possibly supporting an interpretation of asymmetry in encoding and cortical representation of a conditional association, although alternative interpretations remain open. PMID- 1782791 TI - Bilateral hemispheric control of foot distal movements: evidence from normal subjects. AB - Normal subjects have been tested for interhemispheric transfer (IT) of visuo motor information using a simple reaction time (RT) paradigm and lateralized stimuli and responses (the so-called Poffenberger paradigm). In this paradigm IT time is assumed to correspond to the RT difference between crossed and uncrossed stimulus-response combinations (CUD). In Experiment 1, two types of movements were used: a unilateral flexion of the thumb and a unilateral plantar flexion of the big toe. A reliable CUD (7.4 msec) was found only with manual responses. Changing stimulus retinal eccentricity (10 degrees vs. 70 degrees) or attentional demands (blocked vs. random stimulus presentation) did not result in any reliable effect on the CUD. In Experiment 2 the number of RTs for each subject was considerably increased and several visual field sites (from areas close to the vertical meridian to the monocular crescent) were tested. Notwithstanding these modifications, this experiment confirmed the lack of CUD found for foot responses in Exp. 1. Taken together, these results are in keeping with a less lateralized hemispheric control of distal foot movements in comparison to hand movements. PMID- 1782792 TI - Speech lateralisation and phonological skill. AB - A phoneme segmentation task requiring Ss to produce deliberate spoonerisms was performed by 78 undergraduates, along with a dichotic monitoring task and tests of hand preference and hand skill. The hypothesis that those performing badly on the speech task would include a higher proportion of individuals with left ear advantage on the dichotic task was supported. The distribution of cases was consistent with other findings for relationships between cerebral speech lateralisation and side of ear advantage and also consistent with predictions of the right shift theory of handedness and cerebral speech (Annett, 1972, 1985). PMID- 1782793 TI - The effects of emotionality on auditory comprehension in aphasia. AB - Twelve exclusively left brain damaged aphasic male patients (8 global, 3 Wernicke and 1 mixed transcortical) were administered an auditory single word discrimination task. The stimuli were 7 emotional action words, 7 nonemotional action words, 7 emotional object names and 7 nonemotional object names. Results showed significantly better performance on emotional words versus nonemotional words. Implications for assessment and treatment of aphasia are discussed. PMID- 1782794 TI - Handedness is not related to self-reported disease incidence. AB - A hand preference inventory and a disease questionnaire were administered to a sample of 743 undergraduate students. The incidence of left-handedness was not related to the report of any of the diseases surveyed. Among right-handers, preference scores were slightly lower (less right-handed) in those reporting drug allergies or migraine. These data provide no support for the argument that handedness and immune disorders are related. PMID- 1782795 TI - T-maze discrimination and reversal learning after unilateral temporal or frontal lobe lesions in man. AB - The interpretation of conditional discrimination and reversal learning as acquisition of declarative knowledge suggests that subjects with temporal lobe/hippocampal lesions are likely to be impaired on such tasks. Patients with unilateral left or right temporal lobectomy (and small hippocampal excisions) and patients with unilateral frontal lobe resections were compared with healthy controls on a discrimination reversal task, embedded in a computer game modelled on T-maze tasks traditionally used in animal experiments. The right temporal group showed a deficit in acquiring an initial conditional discrimination, and the frontal group tended to display a marginal impairment in discrimination reversal. These findings are compared with results from animal studies in terms of the mechanisms underlying reversal learning. PMID- 1782796 TI - Spatial compression in visual neglect: a case study. AB - In the standard account of left neglect, some manner of attentional boundary is postulated such that elements to the left of that boundary are cognitively neglected. We propose an alternative model in which space is distorted ('compressed') in neglect. A new task is devised whereby the subject must follow 'in imagination' the direction of an arrowhead across 'empty' space to its corresponding position in a numerical target array. The two-dimensional array is Euclidian and all four arrow/array relationships are incorporated (arrow to the left/right of a vertical array, arrow to the top/bottom of a horizontal array). Normal subjects perform at ceiling, with excellent accuracy in all orientations and positions. A patient with severe left neglect (consequent upon lesion of the right temporo-parietal region) shows systematic deflections in her judgement of target positions. These distortions are fully consistent with a model whereby points in 'left space' are compressed rightwards; the compression function is linearly proportional to the coordinates of Euclidian space. PMID- 1782797 TI - The relationship between oral spelling and phonological breakdown in a conduction aphasic. AB - Unsolicited oral spelling has been observed in conduction aphasics during word production difficulty (Kohn, 1985), but has never been examined systematically. In the present study, the possible role of oral spelling in the word-production process of a conduction aphasic (JM) is explored. Oral spelling occurred much more frequently during picture naming than during either oral reading or repetition, and it seemed to be operating as a strategy to lessen the phonemic output deficit often observed in this syndrome. PMID- 1782798 TI - Detection of aldehyde dehydrogenase activity in human corneal extracts. AB - The major soluble protein in bovine corneal epithelial extracts is a 54 kD protein (BCP 54) which has recently been identified as the corneal aldehyde dehydrogenase. Although ALDH activity has been reported in human corneal extracts it was not yet clear whether this was identical with the 54 kD protein described in bovine corneas. To investigate this question, we studied human corneal extracts for the presence of ALDH using enzyme analysis, SDS-PAGE, native electrophoresis, isoelectric focusing and immunoblotting techniques. The corneal epithelium was the most active layer (8.46 +/- 1.9 IU/mg protein) followed by the stroma (2.83 +/- 0.56 IU/mg protein) and endothelium (0.06-3.6 IU/mg protein). When comparing substrate specificity between human and bovine corneal ALDH, using NADP as coenzyme, it was shown that the human enzyme preferred benzaldehyde whereas the bovine enzyme revealed the strongest enzymatic activity with hexanal. Human corneal ALDH was partly inhibited by disulfiram. Bovine and human cornea ALDH lost their enzymatic activity after heating at temperatures above 56 degrees C. Both human and bovine corneal extracts contained a prominent 54 kD protein which reacted with a rabbit anti BCP 54 antibody. Isoelectric focusing followed by enzyme staining in the gel revealed 5 human corneal isozyme species and 4 in bovine corneal extracts, migrating at a pH between 6.5 and 7.0. All isozymes could also be detected after immunoblotting with a rabbit anti BCP 54 antibody. PMID- 1782799 TI - Chemotactic activity of the peroxidized retinal membrane lipids in experimental autoimmune uveitis. AB - We investigated the mechanism for amplification of intraocular inflammation in rats with experimental autoimmune uveitis by examining the chemotaxis potentials of peroxidized lipids extracted from the retinas. Utilizing thin layer chromatography, we found that the peroxidized products isolated from the inflamed retinas were fatty acid hydroperoxides that corresponded to the autooxidized products from commercial methyl docosahexaenoate, with Rf values ranging from 0.30 to 0.37. These were not demonstrated in similar preparations from normal retinas or in unoxidized docosahexaenoate. Boyden chamber assay revealed that the hydroperoxides isolated from inflamed eyes and the products of oxidized methyl docosahexaenoate possessed significantly higher chemotactic activity than did the retinal lipids isolated from normal eyes (P less than 0.01). These findings may help to explain the mechanism of inflammatory amplification induced by peroxidized retinal lipids that is seen in this animal model of uveitis. PMID- 1782800 TI - Murine trabecular meshwork cells in tissue culture. AB - Trabecular meshwork cells from an inbred strain of mice (A/J) were established in tissue culture. Within 1 hour of enucleation, tissue containing the cornea and the chamber angle was excised and placed in tissue culture. Two to five days later, three cell types grew from the explants. Two of these cell types, corneal endothelium and fibroblasts, grew together, with the fibroblasts preferentially spreading on top of the endothelial cells. The trabecular meshwork cells extended from the explant as a distinct morphological type. The corneal endothelium and its associated fibroblasts were then removed from the culture flask with a sterile cotton swab, leaving a monolayer of pure trabecular meshwork cells. These cells required 3-4 weeks to reach confluency and could be passaged five times. They were actively phagocytic in culture and exhibited immunoreactivity to antibodies against two extracellular matrix components, laminin and collagen type IV. Mouse trabecular meshwork cells also expressed receptors for acetylated low density lipoprotein, a property shared by trabecular meshwork cells derived from other species. The availability of trabecular meshwork cells from an inbred strain of mice will facilitate future in vivo functional studies of these cells in a syngeneic system, as well as investigations of potential immunoregulatory properties of the trabecular meshwork. PMID- 1782801 TI - Production of platelet-activating factor in photocoagulated retinas. AB - Platelet-activating factor (PAF), an 1-0-alkyl-2-acetyl-sn-glycero-3 phosphocholine, plays an important role in tissue inflammation and ischemia. Previous results from our laboratory have shown that PAF is synthesized in the cornea after injury and that PAF antagonists reduced inflammation in an experimental model of anterior uveitis. This study was conducted to determine the effect of photocoagulation on PAF levels in the retina. Dutch belted pigmented rabbits underwent panretinal photocoagulation in the right eye with an argon blue green laser. The left eye of each animal served as the control. Four hours later, the animals were killed. PAF was isolated from retinal extracts using high performance liquid chromatography (HPLC) and was quantitated by platelet aggregation activity. In each animal the level of PAF in the photocoagulated retina was one-and-one-half to four times higher than in the control retina. The specific PAF antagonist BN52021 completely inhibited PAF activity in each sample. Due to the proinflammatory properties of PAF, its increase after laser application may be implicated in some of the clinical side effects seen after this therapy. PMID- 1782802 TI - Reconstitution of the filamentous backbone of lens beaded-chain filaments from a purified 49kD polypeptide. AB - The beaded-chain filaments unique to the fiber cells of the crystalline lens are composed of a linear array of spheroidal particles which appear to be connected by a filamentous backbone. In order to determine the existence of the putative backbone and to characterize its constituents, one of the major proteins associated with beaded-chains in the chicken lens was investigated. 49kD was isolated in an enriched fraction derived from the 8M urea extract of the lens cell water-insoluble residue. The polypeptide (which exists in several charge isoforms, the major at pI 5.2) was purified sequentially by gel filtration on Sephacryl S-200, hydrophobic interaction chromatography on phenyl-Sepharose, and anionic exchange chromatography on Mono Q, all under denaturing conditions. Immunoblot analyses established that 49kD was immunologically distinct from vimentin, actin, and tubulin/MAPs (representing the three classes of cytoplasmic filaments), as well as from the crystallins. Amino acid analyses demonstrated compositional differences for 49kD compared with lens actin and vimentin, and one and two-dimensional peptide mapping of 49kD and vimentin revealed no homology. Electron microscopy demonstrated that short, contorted filaments were produced upon removal of purified 49kD from urea to low-salt buffers. In the presence of physiological salt concentrations 49kD assembled into extensive 4-6nm diameter, straight filaments similar to the backbone seen in native beaded-chain filaments, but morphologically distinct from the other cytoplasmic filament classes. PMID- 1782803 TI - Phagocytic challenge induces changes in phosphorylation of retinal pigment epithelium proteins. AB - Changes in protein phosphorylation induced by phagocytic challenge were identified in cultured rat retinal pigment epithelium (RPE) following exposure to isolated rat rod outer segments (ROS) or to polystyrene latex microspheres (PSL). RPE phosphoproteins were characterized based on molecular weight and isoelectric point and 32P incorporation into phosphoproteins was quantified by digitized image analysis of two-dimensional gel autoradiograms. Changes in the phosphorylation of RPE proteins were determined by comparing 32P gel data from phagocytically challenged cultures with control cultures. ROS-specific changes were defined as those occurring only in response to ROS while nonspecific changes were those associated with either ROS or PSL phagocytosis. A parallel study was conducted to identify those proteins which also show increased phosphorylation following protein kinase C (PKC) activation by phorbol-12-myristate-13-acetate. ROS-specific increases in the phosphorylation of 2 RPE proteins were found, 1 of which also showed an increase with PKC activation. Nonspecific increases included the phosphorylation of 11 RPE proteins, 10 of which were also phosphorylated with PKC activation. ROS-specific decreases were observed in 12 RPE phosphoproteins while 3 proteins showed nonspecific decreases in their phosphorylation. These findings demonstrate that phagocytic challenge of the RPE with either specific or nonspecific particles is linked to the activation of phosphatases and kinases and that activation of PKC may play a role in phagocytosis of both particle types. The identification of two distinct groups of changes in phosphorylation supports the hypothesis that different pathways exist for phagocytosis of ROS-specific and nonspecific particles by the RPE. PMID- 1782804 TI - Increased immunoreactivity of collagen types I, III and V, fibronectin and TGF beta in retinal vessels of rats with experimental autoimmune uveoretinitis. AB - The immunoreactivity of types I, III and V collagen, fibronectin and transforming growth factor-beta (TGF-beta) was studied by an immunogold labeling method in retinal vessels of rats with experimental autoimmune uveoretinitis (EAU) induced by retinal S-antigen. The basal lamina of retinal capillaries in normal rats showed low immunoreactivities for the extracellular matrix components and TGF beta. However, at the peak of inflammation (day 13-16 postimmunization), labeling of all three types of collagen and fibronectin increased considerably in the basal lamina of retinal vessels. TGF-beta immunoreactivity was detected mainly in the vascular endothelium and the pericytes. The results suggest that TGF-beta synthesized by the endothelial cells and pericytes may regulate the synthesis and composition of extracellular matrix components in the vascular basal lamina during the course of EAU development. PMID- 1782806 TI - Intramembranous particle distribution and filipin binding in dysplastic canine retina. AB - We examined dysplastic canine retina for changes in intramembranous particle (IMP) density and filipin binding to sterols. Differences in IMP density were identified in incipiently dysplastic fetal retina and also in the degree of filipin binding near the onset of the dysplastic process. The data suggest that there are temporal differences in IMPs and filipin-sterol complexes that may be related to the formation of retinal folds and disorganized dysplastic retina proliferation. PMID- 1782805 TI - Melittin-induced conformational changes in human lens protein. AB - Circular dichroism and fluorescence measurements showed a reduced conformational order in proteins of a normal human lens when they were incubated in vitro with melittin, a bee venom peptide. Since melittin is also known to react with lipids to induce a breakdown of vesicular structure, the observed denaturation of water soluble proteins of a human lens that developed a cataract due to multiple bee stings may be accounted for by the effects of melittin to some extent. The melittin-induced decrease of conformational order, as observed in our in-vitro studies could thus be of physiological significance. PMID- 1782807 TI - An improved method for isolation and culture of pigment epithelial cells from rat retina. AB - An improved method for isolation and culture of pigment epithelial cells from normal rat retinas is described. Following a brief incubation in the neutral protease Dispase, large epithelial sheets can be harvested rapidly. The separation of the choroid from the pigment epithelium prior to retinal detachment greatly reduces the risk of contamination of the cultures with choroidal cells. Growth of pigment epithelial cells on Matrigel-coated microporous filters in hormonally-defined medium allows for development of high levels of transepithelial electrical resistance as well as for preservation of the differentiated pigment epithelial cell phenotype. This method should be useful for studies of pigment epithelial cell permeability and structural differentiation in vitro. PMID- 1782808 TI - Early disappearance of alpha-transducin in light-induced photoreceptor degeneration in albino rats. AB - Progressive degeneration of retinal photoreceptor cells occurs in albino rats when exposed to continuous lighting. Three proteins involved in the phototransduction cascade were immunodetected in these cells after various durations of continuous illumination. We found that S-antigen (arrestin) and rhodopsin immunoreactivities persisted for 1-2 months during the degenerative process, whilst immunoreactivity of the alpha subunit of transducin totally disappeared between day 2 and day 4 of continuous light exposure. This suggests that continuous illumination could impair alpha-transducin synthesis, a possible causal factor of photoreceptor damage. PMID- 1782809 TI - Electron microscopic appearance of the chronic Campylobacter jejuni enteritis of mice. AB - Campylobacter jejuni is a major cause of human enteritis which mimics the inflammatory bowel disease (IBD). In this study, microstructural changes on the surfaces of the murine gastrointestinal tract persistently colonized by Campylobacter jejuni, strain GJ-S131, were investigated by using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). The results revealed that the appearance of the gastrointestinal mucosa in both BALB/C and KM mice resembled that in human with inflammatory bowel disease. Under SEM, the mucosa of the jejunum and ileum, with broken or distorted villi had a "worm eaten" look; crypts were irregular in shape and size, and the mucosa showed atrophy, especially in the colon. Epithelial junctions demonstrated furrows, clefts or deep crevasses, with exudates containing a large number of leukocytes. Cytologic appearances were characterized by microvilli dysplasia and/or atrophy, patchy erosions or necrosis and pelade-like appearance due to absence of microvilli, which were similar to the findings under TEM. PMID- 1782810 TI - Phosphorylated neurofilament epitopes in the achromasic neurons of corticonigral degeneration. AB - By employing monoclonal phosphorylated neurofilaments antibody, we studied the abnormally pale-staining neurons in 3 cases of corticonigral degeneration by the avidin-biotin immunoperoxidase method. For comparison, the central chromatolysis in anterior horn cells secondary to cervical spine fracture and "ballooned" neurons in a case of Pick's disease and a case of Alzheimer's disease were studied with similar procedure. Achromasic neurons in the case of corticonigral degeneration and ballooned neurons in Pick's disease and Alzheimer's disease showed positive immunostaining, while neurons with central chromatolysis secondary to axonal injury did not. Our observations show that the achromasic neurons in corticonigral degeneration contain phosphorylated neurofilaments which share common antigenic characteristics with ballooned neurons in Pick's disease and Alzheimer's disease. The absence of positive immunostaining in reactive central chromatolysis suggests that despite the similarities in appearance with the usual histopathologic stains this cytoplasmic change is pathogenetically different from that in the other neuronal disorders mentioned above. PMID- 1782811 TI - Blood supply and structural changes of canine intact tibia following plate fixation with different rigidities. AB - To study the causes of osteopenia after plate fixation in the treatment of fractures and bone diseases, intact tibiae of 26 dogs were fixed by 3 different plates at various rigidities. The dogs were killed at 24 hours 3, 6, 12, 20 weeks. Disulphine blue was injected intravenously before killing. The results showed that in addition to stress shielding the disturbance of blood supply was the main cause of osteopenia in the early stage. Reaction to the implant might be another cause in the middle stage. The disuse of the affected limb was the most important factor in the late stage. Osteopenia can be treated by active exercises and normal weight-bearing before plate removal. PMID- 1782812 TI - Prenatal diagnosis of mucopolysaccharidosis by continuous, monodimensional electrophoresis of amniotic fluid glycosaminoglycans. AB - A continuous dimensional electrophoretic method was used in 15 urine samples of clinically diagnosed mucopolysaccharidoses I or IV. Twelve of the 15 were glycosaminoglycans band positive. Of the 12 one was KS band positive but methyl toluidine blue test was negative. The other 11 were positive with both methods. Prenatal diagnosis was done in 10 cases during their next pregnancy with the same method on the amniotic fluid. Two affected fetuses were diagnosed and proved, one after induced abortion and the other after full-term delivery. PMID- 1782813 TI - Magneto recrystallization of genomic and associated structures potentially applicative to such diverse concerns as cancer, AIDS, and CNS regeneration. AB - Physiologic magnetic fields on the order of magnitude 10(-8) gauss have been unified with their propitiators: quantum genetic particles, the gravitational potential of which is about a few ergs. As these fields are applied to the equations for solenoidal models, B = microNI/L, currents of about a microampere are derived; in perfect accord with recent clinical data indicating the therapeutic efficacy of weak currents in repair and growth of soft tissue, bone and nerve. The mechanism of reorientation of spin angular momentum of leptons and baryons influencing molecular magnetic domains to bring about "particle jumps" is presented to obtain a clinical picture. The clinical picture is that of an organism placed at right angles to flux lines in the midst of a solenoid immersed in water. The patient is then exposed to exogenously sourced resonant physiologic magnetic fields which convert malalligned atomic lattices of oncogenes and associated particles to homologous normal structures. PMID- 1782814 TI - The role of endoscopy in diagnosis of Barrett's esophagus. PMID- 1782815 TI - Measurement of serum TSH level by ultrasensitive method in inhabitants of endemic goiter area supplied with iodized salt for 25 years. AB - Recently, we surveyed thyroid function and TSH concentration of villagers in an endemic goiter area where iodized salt had been supplied for 25 years; it was found that the serum FT3 and TSH levels determined with immunoradiometric analysis (IRMA) were higher and the FT4 level was lower than that of the controls. It was shown that the inhabitants of the endemic goiter area had subclinical hypothyroidism based on the "ultrasensitive" method for TSH assay. We suggest that the best biochemical techniques for monitoring the iodized salt prophylaxis program and the physiological response of the villagers to iodine should be the periodical measurement of serum TSH level using ultrasensitive assay and determination of FT4 level. PMID- 1782816 TI - Epidemiologic investigation on an outbreak of hepatitis C. AB - An outbreak of hepatitis in plasma donors occurred in a village of Hebei Province in the period of September to October 1985. The morbidity rate was 40.0% (26/65) in the plasma donors, which was significantly higher than that in whole blood donors (1/88) and in persons who were not blood donors (1/400). One to one paired survey was carried out, and the incidence was 46.4% (26/56) in the plasma donors, while there were no such outbreak in the control group. The distribution of cases showed positive correlation with the number of plasma donors from the production brigade. No secondary infection was found in their families. The peak of outbreak was about 2 months later than the peak of plasma donation. 26 cases of hepatitis in plasma donors all showed negative results for anti-HAV IgM, HBsAg, anti-HBC IgM, anti-CMV IgM and anti-EBV IgM. Sera of 25 cases were selected and sent to CDC, USA to confirm with Chiron C100 reagent. 24 cases were anti-HCV positive. This outbreak of hepatitis was demonstrated to be related to cross contamination during plasma donation. PMID- 1782817 TI - Endotracheal administration of epinephrine during cardiopulmonary resuscitation. AB - A hypoxia-induced canine cardiac model was used to study the effectiveness hemodynamic response, arterial blood gas and pulmonary pathologic changes after endotracheal (ET) epinephrine administration in comparison with those from intravenous (IV) administration. The results indicated that the survival rate was the same with the drug given by either route. The increase of hemodynamic indices was lower in the group after ET administration than that after IV administration. No significant influence was exerted on the drug effects whether the drug is diluted in normal saline or in distilled water and no serious detrimental effects occurred on the lung tissues following ET epinephrine administration. PMID- 1782818 TI - Androgen receptors in laryngeal carcinoma and their clinical significance. AB - Specific radioligand [3H] methyltestosterone incubation and dextran-coated charcoal absorption technique (DCC) were used to test cytosol androgen receptors (AR) of laryngeal carcinoma in 33 patients. In all specimens, high level AR ranged from 3 to 16.9 fmol/mg of cytosol protein (mean 10 +/- 3.9 fmol/mg), and dissociation constant was 1.7 x 10(-9) mole. Laryngeal carcinoma is considered a sex hormone-dependent tumor. High level of AR in laryngeal carcinoma may indicate a super-demand on androgen; when the content of AR increases the tumor proliferates perniciously. Antiandrogen endocrine therapy may be helpful in treating laryngeal carcinoma. PMID- 1782819 TI - Radioimmunolocalization of human malignant tumors with In-111 labeled monoclonal antibody. AB - An anti-human colon carcinoma monoclonal antibody 2C10 was radiolabeled with In 111 and studied in 15 patients with gastrointestinal and ovarian carcinoma. The labelling efficiency approached 100% and immunoactivity of the labeled antibody was over 75%. 2-3 mCi (1 mg) In-111-2C10 was given to the patients intravenously and scintigraphy was performed 72 hours after administration with a gamma camera. Specimens were also scanned in some of the patients. The resected tumors and remote margin were examined immunohistochemically. Positive scintigraphic images were obtained in 12/15 patients with colorectal cancer (10) and ovarian cancer (2). Negative results were seen in the two patients with gastric cancer. The scintigraphic results of 10 patients were confirmed surgically and pathologically. The remaining 5 were confirmed by endoscopy, B-ultrasonography or X-ray CT. Most patients had been definitely diagnosed before imaging except one patient with metastatic focus from ovarian cancer to colon and one with recurrent colon cancer were first detected with RIAD, showing the unique advantage the latfer. The high background radioactivity in the liver, however, is a conspicuous problem to be solved. PMID- 1782820 TI - [The incidence rates in 1986 of stroke in urban and rural areas of the People's Republic of China]. AB - This paper reports the results of a sample survey of incidence rates of cerebral stroke in the P.R. China. It was found that the incidence rate for cerebral stroke in 1986 was 109.95 per 100,000 people. The adjusted incidence rate by composition of population of the cities and the rural areas in the P.R. China in 1986 was 110.58/100,000. The age-adjusted incidence rate by 1982 population of China was 84.07/100,000. The age-adjusted incidence using the world standard population was 115.87/100,000. The features of distribution of stroke incidence rates in the place, time, and population were analysed in the paper. PMID- 1782821 TI - [Prevention of in vivo formation of NMBz A and the formation of oesophageal tumour by tea in rats]. AB - Five groups of rats (22 per group) were intubated with precursors of N Nitrosomethylbenzylamine (NMBzA), i.e. methylbenzylamine (1 mmol/kg) and sodium nitrite (0.5 mmol/kg), and five varieties of Chinese tea. One positive control group was intubated with precursors of NM2A without tea and one negative control group with tap water and sodium nitrite. After 12 week's treatment, significantly less lesions and papillomas in esophageal mucosa, examined by naked eye or by microscope, were found in the tea-treated groups than in the non-tea-treated positive control group. The results confirmed the anti-tumour ability of Chinese tea by blocking the in vivo formation of NMBzA in rats. PMID- 1782822 TI - [Analysis of serum levels of selenium, zinc, and copper in 132 patients with malignant tumors]. AB - Since March 1987 to December 1988, serum levels of selenium, zinc, and copper were determined in 132 patients with malignant tumors and in a control group of 43 patients with benign disease. The mean level of selenium in 132 patients with malignant tumors was 0.074 microgram/ml, it was lower than in the control group (P less than 0.01). Zinc was 0.814 microgram/ml, it was low compared to the control group (P less than 0.05). Copper was 1.27 microgram/ml, it was significantly increased (P less than 0.05). Cu/Zn was higher than in the control group (P less than 0.01). An analysis of all the readings showed that the lowest levels of selenium and zinc are associated with advanced gastrointestinal cancer. PMID- 1782823 TI - [The effect of Bulbus allii on precancerous lesions of the esophagus due to N methyl-N-amylnitrosamine in rats]. AB - In so much as precancerous lesions of the esophagus are a stage that must pass in the course of formation of carcinoma of the esophagus, inhibiting its occurrence is an important measure in the prevention of esophageal. The test was carried out in 84 Wistar rats of both sexes randomly divided into 2 groups, one group fed with 50% aqueous extract of Bulbus allii and the other as control. After 105th day of experiment, results showed that Bulbus allii inhibited significantly precancerous lesions of the esophagus due to N-methyl-N-amyl-nitrosamine (P less than 0.05) increases of the splenic index (P less than 0.001) in rate and the percentage of peripheral T-lymphocyte (P less than 0.01) in rats. The results suggested that Bulbus allii had a preventive action against carcinoma of the esophagus, which could be attributed to increasing the immunity. PMID- 1782824 TI - [Study on relationship between occurrence of intragastric lesions and drinking water and nitrate intake via water in the inhabitants from a high-risk area for stomach cancer]. AB - According to results of endoscopic and pathological evaluations of gastric mucosa, we investigated some aspects of drinking water for three groups of subjects with various intragastric lesions from a high-risk area (Moping County) for stomach cancer. Their nitrate intakes via drinking water were estimated. The results showed that the occurrence of stomach cancer and other intragastric lesions in these subjects was closely related to their drinking water quality and nitrate intake via water. PMID- 1782825 TI - [Determination of lead and cadmium concentration in children's toys]. AB - Soluble lead and cadmium in 24 kinds of children's toys were determined by atomic absorption spectrophotometer. The results showed that the concentration of soluble lead and cadmium in the toys which had a paint coating were respectively from 110.3 mg/kg to 5,156.0 mg/kg and from 0.34 mg/kg to 35.50 mg/kg, but soluble lead and cadmium concentration in the toys which did not have a paint coating were very low. This study suggested that the children's exposure to lead and cadmium was mainly from the paint coating of toys, and that the important problem was too high concentration soluble lead in the colouring and varnishing substances. In preventing children's exposure to low lead and cadmium level, the hazards from toys containing soluble lead should be paid attention. PMID- 1782826 TI - [The preliminary study on aluminum toxicity to mice]. AB - Mice were tested orally to study the toxic effects of Al on their skeleton and brain. The results showed that the Al content in brain increased along with its intake increase, but pathological examination of brain revealed no apparent change between test and control groups. Relative femur weight of mice in the highest dose group was lower than those of the other groups (P less than 0.05). The bone Al content was increased along with Al intake increase (P less than 0.05). There was negative correlation between the bone Al content and relative femur weight (P less than 0.05), and positive correlation between the bone Al content and the Al intake (P less than 0.01). Pathological examination of femurs revealed that the pathological changes of osteoporosis and osteoblast atrophy tended to increase while both Al intake and bone Al content were increased. PMID- 1782827 TI - [The transplacental effect of methylmercury on the chromosome of embryo liver cells in rat]. AB - The effect of methylmercury on the chromosome of embryo liver cells of rat was studied in vivo. The results showed that the rate of chromosome aberration both of embryo liver cells and maternal bone marrow cells increased linearly with the dose of methylmercury. The linear equations were as follows: Yembryo liver cell = 10.30 + 2.54D (r = 0.9573, P less than 0.01) Ymarrow cell = 2.34 + 0.71D (r = 0.9782, P less than 0.01). PMID- 1782828 TI - [A logistic regression analysis of relations between juvenile myopia and TV watching, trace elements, and psychological characteristics]. AB - With a paired study, 23 factors were investigated in 204 school children aged 9 14 in Taiyuan. The results of analysis of logistic regression showed that there was a close relationship between juvenile myopia and TV-watching distance, myopia in parents, Zn: Cu ratio in hair, N score of EPQ, Pscore of EPQ, and verbal IQ. The relations between myopia and some factors were discussed. PMID- 1782829 TI - Imaging cytometry by multiparameter fluorescence. AB - A system is described for performing multicolor fluorescence image cytometry of cell preparations. After the setting up stage, the operation is automatic: the microscope fields are found and focused; then images are acquired for each fluorophore, corrected and analyzed, without any operator interaction. Human peripheral blood lymphocytes on microscope slides were used as a test system. In these experiments, three fluorescent antibodies were used to identify lymphocyte sub-populations, and a DNA content probe was used to identify all nucleated cells. The cell subset percentages determined by image cytometry were comparable to percentages obtained when cells from the same preparation were analyzed by flow cytometry. Multicolor fluorescence imaging cytometry can potentially be extended to the analysis of cells in smears, fine needle biopsies, imprints, and tissue sections. PMID- 1782830 TI - Time window analysis and sorting. AB - Flow cytometric hardware and procedures were developed to continuously analyse and to sort a particular time window in a kinetic response. The technique uses balanced air pressure to drive a stimulus-bead mixture from a vial to a t junction where it mixes passively with cells. The t-junction is distanced from the flow cell and air pressure regulated so that the stimulation occurs at a fixed and adjustable time before the cells are interrogated by the laser beam. Practical applications of the device demonstrate utility with cells whose responses are seen in seconds or minutes. The device is easily implemented on any sorting flow cytometer. PMID- 1782831 TI - Influence of tissue preparation techniques on p53 expression in bronchial and bladder carcinomas, assessed by immunofluorescence staining and flow cytometry. AB - In a series of bronchial and bladder carcinomas, p53 protein expression was examined. Samples from formalin-fixed, paraffin-embedded tissue (routine-treated) were compared with parallel samples of fresh tissue and tissue fixed in paraformaldehyde and ethanol. The expression of p53 was measured by immunofluorescence staining and dual parameter flow cytometry, with simultaneous monitoring of DNA content. For each tumor, p53 fluorescence with different fixatives was expressed relative to fresh tissue. The p53 fluorescence signals were on average brighter from routine-treated tissue than from fresh tissue. The tissue fixed in paraformaldehyde showed no difference from fresh tissue. In the ethanol-fixed tissue, however, fluorescence signals were reduced by nearly 70%, and the fraction of detectable p53 positive cells in tumor tissue was reduced by more than 50%. This loss of fluorescence was probably due to a leakage of the antigen from nucleus to cytoplasm. Pepsin treatment did not influence p53 fluorescence. Within the same tumor, the S-phase fraction in p53 positive cells was significantly higher than in p53 negative cells (13.1 +/- 2.0% vs. 6.5 +/- 0.8%). This pattern was not influenced by formalin fixation or pepsin treatment. Our study demonstrates that in measuring a nuclear antigen, tissue handling may influence the results, and care should be taken to optimize the preparation procedure. Using the antibody PAb 1801, p53 expression measured in archival material is not reduced as compared to fresh tissue. PMID- 1782832 TI - Tumor cytokinetic effects of acute starvation versus polyamine depletion in tumor bearing mice. AB - Previous investigations in our laboratory have demonstrated that both acute host starvation and polyamine depletion by means of the irreversible ODC-inhibitor (ODC = ornithine-decarboxylase) fluoro-methylornithine (DFMO) lead to pronounced growth retardation of rapidly proliferating tumors. The aim of this investigation was to elucidate how these different interventions affect cell kinetics and cell cycle phases in vivo. Adult nongrowing mice (C57Bl/J) bearing a poorly differentiated rapidly growing methylcholanthrene induced sarcoma were used. Combined measurements of bromodeoxyuridine incorporation into DNA and flow cytometric techniques were used. Starvation and DFMO treatment resulted in a prolonged cell cycle transit compared to freely fed animals. Tumor cells from DFMO-treated mice demonstrated an increased time for DNA synthesis and a relatively larger accumulation of cells in the G2M phase, whereas tumor cells from starved animals were accumulated in the G0G1 phase. The fractional cell loss of tumor cell during proliferation was calculated to be around 18% higher in DFMO treated animals compared to starved and freely fed tumor-bearing mice. This study demonstrates that different mechanisms are involved in tumor growth suppression from substrate deficiency (starvation) and from inhibition of polyamine synthesis. PMID- 1782833 TI - Measuring potential doubling times of murine tumors using flow cytometry. AB - Flow cytometric analysis of bromodeoxyuridine (BrdUrd) labeled cells has led to the description of various methods for determining population potential doubling times (Tpot) from samples obtained at a single time point. There have been several reports of results from human tumor samples using these various methods of analysis, but little documentation of the validity of these approaches in experimental tumor models. Recently, we reported results using in vitro cell cultures and determined the most reliable method for these. In this paper we report the results of this methodology when applied to two in vivo murine tumor models (MCaK and FSA). The analytic approach tested is summarized as follows: The relative movement (RMlu(t], a measure of the mean DNA fluorescence of BrdUrd labeled cells that have not undergone division at the time of sampling, and a quantity v, a function of the fractions of BrdUrd-labeled divided and undivided cells, were measured for a series of time points following labeling. From each value of RMlu(t) an estimate of the length of S-phase (TS) was computed and from each v and TS a value for Tpot was found. These results were compared to the values of TS and Tpot obtained by fitting all the values simultaneously. Tumor MCaK values of TS and Tpot of 9.6 and 28.0 h were obtained from fitting all of the data. Tumor FSA gave values of 16.8 and 42.3 h for TS and Tpot, respectively. The results of this analysis show that single time point measurements can give reliable estimates of TS and Tpot. PMID- 1782834 TI - Characterization of effector-target conjugates for cloned human natural killer and human lymphokine activated killer cells by flow cytometry. AB - The present studies demonstrate that the intracellular fluorochromes calcein and hydroethidine can be used for quantification of effector-target conjugates involving cloned human natural killer (NK) or interleukin-2 (IL-2) activated human lymphokine activated killer (LAK) cells by dual color flow cytometry without potential artifacts that might result from extensive modification of effector and/or target cell membranes. Cloned NK cells and LAK cells form conjugates with cultured cell lines regardless of susceptibility to lysis. The strength of the interactions in these conjugates was investigated using a variable speed vortexer. Even relatively gentle vortexing disrupted most conjugates involving fresh human peripheral blood lymphocytes (PBL) but only about one-fourth of conjugates between K-562 cells and human PBL that had been cultured with or without IL-2 by this treatment. The rate of conjugate formation for LAK cells was determined to be about 3 times faster than for cloned NK cells, and both rates are considerably faster than the reported rate of formation of cytotoxic T lymphocyte (CTL) target conjugates. The differences in the rate of conjugate formation are apparently not related to target cell specificity, since LAK cells form conjugates with susceptible and resistant cell lines at comparable rates. When effector-target conjugates are incubated at 37 degrees C in the absence of calcium--thereby precluding lysis--the percentage of conjugated LAK or cloned NK cells decreases logarithmically with time. These results suggest that an initial equilibrium between free and conjugated lymphocytes gradually shifts in favor of unconjugated cells. PMID- 1782835 TI - Simultaneous flow cytometric method to measure phagocytosis and oxidative products by neutrophils. AB - We developed a rapid and sensitive two-color flow cytometric method which allows the simultaneous quantification of both the phagocytosis rate and the oxidative burst activation of polymorphonuclear leukocytes (PMNLs). The oxidation of hydroethidine (HE) to ethidium bromide (EB) was performed by the oxidative neutrophil products within the cells during the respiratory burst, which was stimulated by phagocytized fluorescein-labeled Staphylococcus aureus. By means of flow cytometry we measured red EB fluorescence emission together with green fluorescence, which was emitted by the ingested fluoresceinated bacteria. The fluorescence intensity was proportional to the number of bacteria ingested. Adherent bacteria were distinguished from the ingested ones. This two-color cellular staining permits measurement of two different functions of neutrophils in one step. This method could be of interest for the determination of the interactions between neutrophils and bacteria and for the investigations on infectious diseases in chronic granulomatous disease patients. PMID- 1782836 TI - Captopril pharmacokinetics, blood pressure response and plasma renin activity in normotensive children with renal scarring. AB - We studied blood pressure response, plasma renin activity (PRA) and captopril pharmacokinetics in 8 children receiving orally 0.7 mg/kg of the drug. The drug increased PRA in all patients, in 5 to abnormally high levels. Peak captopril concentrations were achieved between half an hour and 2 h, and ranged between 100 and 547 ng/ml. Mean elimination half-time (T1/2) was 1.5 h, ranging between 0.98 and 2.3 h. There was a significant positive correlation between the area under the curve (AUC) and elimination T1/2 of the drug. There was a significant inverse correlation between AUC or elimination T1/2 and percent change in diastolic blood pressure; the 2 children who had no change in diastolic blood pressure had the largest AUC and the lowest apparent clearance of captopril. The kidney is the major site of captopril's pharmacological action. It is possible that longer retention of captopril in the plasma, evidence by larger AUC, may reflect less captopril available to modulate renin activity in the kidney. PMID- 1782837 TI - Changes in salivary antipyrine pharmacokinetics during adolescence, correlated with age, hormonal levels and Tanner stage. AB - To evaluate the effect of puberty on antipyrine metabolism, we measured antipyrine pharmacokinetics in 17 healthy subjects aged 6-21 years. The subjects received a single oral dose of antipyrine, 18 mg/kg. Salivary antipyrine levels were determined 3, 6, 9, 12 and 24 h after dosing. Age, weight, body surface area and Tanner stage were highly intercorrelated. Volume of distribution (liters) was highly correlated with all of these factors. The weight-corrected clearance of antipyrine declined significantly with age (r = 0.55, p less than 0.025). Patients were classified as immature and other based on serum hormone levels (immature = females with serum estradiol less than 25 pg/ml and males with serum testosterone less than 25 ng/dl). The uncorrected antipyrine clearance was significantly lower in the immature group (mean +/- SD 22.65 +/- 6.04 ml/min) than in others (mean +/- SD 41.30 +/- 13.26; p less than 0.01). This difference disappeared when the weight-corrected antipyrine clearance was compared for these two groups. The change in uncorrected antipyrine clearance with sexual maturation appeared to be due to increased body size, probably related to the adolescent growth spurt. PMID- 1782838 TI - Amikacin dosing in neonates: evaluation of a dosing chart based on population pharmacokinetic data. AB - A dosing chart for amikacin (AMK) was developed from average pharmacokinetic parameters for infants with varying postnatal ages and birth weights ranging from less than 800 to greater than 2,500 g. This chart was then evaluated in 38 infants (648-5,404 g; 25-43 weeks postconceptional age, estimated glomerular filtration rate (GFR) 9.0-49.0 ml/min/1.73 m2) with suspected infection by comparison of predicted versus observed steady-state peak (Cssmax) and trough (Cssmin) serum AMK concentrations. Additionally, the apparent elimination half life (t1/2) for AMK was determined for each infant using two postinfusion serum concentrations obtained at steady state. As expected, linear correlations were found between the elimination rate constant (Ke) for AMK and both postconceptional age (PCA; y = -0.54 + 0.005x; r = 0.59, p less than 0.01) and estimated GFR (y = 0.05 + 0.002x; r = 0.65; p less than 0.01). The dosing chart produced desired therapeutic Cssmax values (e.g. 20-30 micrograms/ml) in 76.3% of patients, with 2.6 and 21.1% having values less than 20 and greater than 30 micrograms/ml, respectively. Desired therapeutic Cssmin serum AMK concentrations (e.g. 4-10 micrograms/ml) were obtained in 71.1% of patients, with 10.5 and 18.4% having concentrations of less than 4 and greater than 10 micrograms/ml, respectively. However, significant linear correlations were not found between the predicted versus observed values for either Cssmax or Cssmin. The AMK dosing chart for neonates enables attainment of desired therapeutic serum concentrations in the majority of infants at the initiation of therapy despite wide variability in PCA, birth weights and estimated GFR. PMID- 1782839 TI - Diuretics, hypochloremia, and outcome in bronchopulmonary dysplasia patients. AB - We evaluated retrospectively the outcome of patients with severe bronchopulmonary dysplasia who required hospitalization (greater than 90 days) to determine the role of diuretics aminophylline and chloride deficiency in the fatal outcome of these patients. Total cumulative amounts of furosemide, chlorothiazide, spironolactone accrued during hospitalization (dosage per patient per day), and a diuretic index (logarithm of the sum of the cumulative dosage of the three diuretics) were calculated for each patient. Other predetermined variables included in the analysis were birth weight, gestational age, duration of mechanical ventilation, duration of oxygen therapy, caloric intake, fluid and electrolyte intake, echocardiographic data, and duration and type of acid base balance disturbances. No differences were found between survivors and nonsurvivors in diuretic and aminophylline use. Hypochloremia did not discriminate between the groups. Duration of mechanical ventilation, the ratio between days with serum bicarbonate concentration greater than 30 mEq/l and total days of hospitalization, and the difference between head circumference at discharge or death and birth head circumferences were the most important factors which contribute to the difference between survivors and non survivors. PMID- 1782840 TI - Effects of prenatal cocaine exposure on perinatal morbidity and postnatal growth in the rabbit. AB - Prenatal cocaine (CC) exposure may result in increased fetal loss, growth retardation, altered neurodevelopment, and sudden infant death syndrome (SIDS). We sought to establish an animal model for prenatal cocaine exposure which (1) would allow us to distinguish the direct effects from the indirect and nutritional effects of the drug, and (2) might be used to address questions of cocaine's toxicity, specifically to the developing respiratory control system. The study design included 38 New Zealand White rabbit does among CC, pair-fed (PF), and free-fed (FF) groups. Miniosmotic pumps were implanted in each doe on day 10 of timed gestation providing continuous subcutaneous administration of either 30 mg/kg/day of cocaine HCl in H2O (CC) or sterile H2O alone (PF and FF). Mean (SEM) plasma cocaine concentration was 1.71 +/- 0.21 mumol/l (519.4 +/- 64.4 ng/ml). Pregnancy outcome compared for incidence of stillbirth, maternal death, spontaneous abortion, and gross malformation among 211 pups was significant only for increased stillbirths among CC pups (18%, p less than 0.04) as compared to PF (6%) and FF pups (7%). External and renal malformation and postnatal weight, crown-rump length, and snout-occiput head circumference for pups aged 4 and 5 days of age did not differ among groups. The direct effects of prenatal cocaine evaluated in our model do not reproduce the altered perinatal outcome observed among humans. However, our results do not determine if physiologic function has been altered. Investigation of the physiologic and pathologic abnormalities that are relevant to this human condition, specifically to the developing respiratory control system, should add clarity to the mechanism of action of cocaine during pregnancy. PMID- 1782841 TI - Effect of intrapartum meperidine on the behavioral consequences of neonatal oxygen deprivation in rhesus monkey infants. AB - The endogenous opiate system is thought to play a unique role in the adaptive response to hypoxia during the fetal and neonatal period. Exogenous opiates used as analgesics during labor may also affect this adaptive response. Infant monkeys (Macaca mulatta) were exposed to oxygen deprivation (15-min period breathing 12% O2) on the day of birth. One half of the infants had been exposed to meperidine during parturition via treatment of the dam (2 mg/kg, i.v.). An additional control group received neither treatment. All infants were evaluated for growth, development and neurobehavioral performance over a subsequent 14-week period. Compared to controls, infants exposed to oxygen deprivation had somewhat slower weight gains during the early neonatal transition from weight loss to weight gain, were less responsive to sensory stimulation on the day of the oxygen deprivation episode, slept more on the first night after the episode, had fewer active and mature behaviors during a 3-week period of rapid motor development, and had impaired fine motor skills. Prior exposure to labor analgesia apparently prevented many of these effects. Use of opiate drugs during the perinatal period needs to take into account the unique properties and functions of the endogenous opiate system during this developmental period. PMID- 1782842 TI - [Determination of cell nuclear DNA content in polyps and cancerous degeneration in the large intestine]. AB - Nuclear DNA content was measured by microspectrophotometry in 40 biopsy specimens from patients with large bowel polyps (10 juvenile polyps and inflammatory polyps, 25 adenoma subdivided into 3 groups with 10 Grade I, 10 Grade II and 5 Grade III, 5 cancerous degeneration), and 5 normal epithelium of large intestine. The mean DNA value increased steadily as follows: normal epithelium of intestine (13.54 +/- 1.76 Au); juvenile polyps and inflammatory polyps (14.89 +/- 0.40 Au); adenoma Grade III (21.96 +/- 0.92 Au); cancerous degeneration (24.47 +/- 1.48 Au). The difference in DNA value in these groups was statistically significant (P less than 0.05-0.01). These results suggest that measurement of nuclear DNA content may serve as an objective quantitative parameter for diagnosis of large bowel carcinomatous change of polyps and classification of polypoid adenomas. PMID- 1782843 TI - [Inhibition by polyamine biosynthesis inhibitor DFMO of the growth of transplanted human colon cancer in nude mice]. AB - A human colon cancer cell line Hce-8693 was heterotransplanted in nude mice. polyamine biosynthesis inhibitor alpha-difluoromethylornithine (DFMO) showed a marked reproducible inhibition in this model. The size and weight of transplanted tumor in DFMO group were smaller than those of the control group and the average inhibition rate was 72.8% (P less than 0.001). DFMO showed higher tumor inhibitory rate than 5-Fu (35.4%) (P less than 0.001). Furthermore, DFMO demonstrated less severe bone marrow inhibition in the nude mice than 5-Fu (20.0% vs 53.2%, P less than 0.001). There was no synergistic action in these two drugs at the experimental doses. The concentration of putrescine and spermidine in the serum and tumor tissue in the DFMO group were 70% lower than those of the control group (P less than 0.001). These results indicate that the anti-tumor effect of DFMO might be explained by the inhibition of polyamine biosynthesis and this study provides an experimental basis for future clinical application of DFMO. PMID- 1782844 TI - [Pharmacokinetic comparison of intraperitoneal and intravenous 5-Fu administration]. AB - Pharmacokinetic comparison of 5-Fluorouracil (5-Fu) administered ip versus iv was made in rabbits. Ip administration of bolus and large volume of 5-Fu could maintain high, stable and sustained concentration in the peritoneal cavity, portal vain and liver while sparing the systemic circulation. After iv bolus administration of 5-Fu, drug concentration in the systemic circulation was very high. Although iv administration of 5-Fu could lead to high concentration in the portal vein and liver, sustainment of concentration was relatively of short duration and the 5-Fu concentration was very low in the peritoneal fluid. The authors believe that ip chemotherapy has a significant pharmacokinetic advantage over the conventional iv route in preventing and treating recurrences in the peritoneal cavity and liver metastasis after surgery for gastro-intestinal malignancies. PMID- 1782845 TI - [Fetal breast estrogen receptor (ER) and breast cancer]. AB - The estrogen receptor in bilateral breasts of 36 6 to 10-month fetuses (17 male, 19 female) were examined. All fetal breasts had ER positive cells (greater than 50-90%). The ER levels were similar regardless of sex and age. When the ER status of 84 female breast cancer patients was analysed, ER was considered as an essential but not the only etiologic factor in mammary carcinogenesis. A positive correlation between the degree of differentiation and the ER level of breast cancer cells was demonstrated and the ER level did not correlate with the clinical staging of breast cancer. The results are briefly discussed in relation to the rationale of hormonal therapy of breast cancer. PMID- 1782846 TI - [Immunohistochemical study on human epithelial ovarian carcinoma after radioimmunodetection with 131I-labelled polyclonal antibodies]. AB - We report the results of our immunohistochemical study on the distribution and the retention time of the injected labelled antibodies in both primary and recurrent ovarian epithelial carcinomas and the regional lymph nodes, following the radioimmunodetection with injection of 131I-labelled polyclonal antibodies (including 5 cases of intravenous injection group and 35 cases of subcutaneous injection group). Six other tumors or tumor-like lesions, 8 normal ovaries and 7 normal fallopian tubes were used for control. The results demonstrated: 1. The labelled antibodies were specific for ovarian epithelial carcinoma, 2. The concentration of the labelled antibodies in the lymph node metastasis was higher in the subcutaneous injection group than in the intravenous injection group. Therefore, the subcutaneous route should be used both for imaging and radioimmunotherapy of lymph node metastasis, 3. The retention time of the antibodies in the lymph node metastasis was not more than 24 days. With this reference, the total dose of radioimmunotherapy can be calculated. PMID- 1782847 TI - [Lectin histochemical assay in endometrial proliferation, hyperplasia and adenocarcinoma]. AB - The binding capacity of five lectins in endometrial proliferation, hyperplasia and adenocarcinoma was studied histochemically. The staining density of ConA and WGA bound to intercellular and basal portion, the positive reaction and the density of both agglutinins to luminal borders were increased with the proliferative degree of endometrial glandular cells from proliferation to neoplasm, with the most significant binding in adenocarcinoma. However, WGA and RCA binding to basal portion of malignant cells was weak, but stronger in the outer edge of tumor mass. The authors suggest that lectin binding capacity provides a new probe to judge the proliferative degree and malignant transformation of endometrial glandular cells. PMID- 1782848 TI - [Nuclear DNA assay in gynecologic malignant tumors and its clinical significance]. AB - This paper analyzes the nuclear DNA content in 80 gynecologic tumors by microspectrophotometry and correlates the results of ovarian malignant tumors with the clinico-pathologic features of the tumor. The DNA content and the percentage of nuclei with over octaploid were significantly higher in gynecologic malignant tumors and ovarian germ cell tumors than in gynecologic benign tumors and ovarian epidermic tumors. The percentage of nuclei with over octaploid was significantly higher in advanced than in early tumors. It seems that DNA content assay may be helpful in the pathological diagnosis of gynecologic tumors. PMID- 1782849 TI - [Clinical application of beta-glucuronidase (beta-GCD) assay in the diagnosis of malignant tumors--analysis of 743 cases]. AB - Chromatometric assay of beta-GCD in the urine, gastric juice and saliva was conducted in 743 subjects. In the urine of 104 normal persons, 5 (4.8%) were beta GCD positive. In the urine of 35 urinary bladder cancer patients, 20 (57.1%) were positive. beta-GCD content was very low in the gastric juice and saliva of normal subjects, giving a positivity of 0%. But it was high in the gastric juice of stomach cancer patients, giving a positive rate of 83.3%. The positivities in the saliva of stomach cancer and malignant ovarian tumor patients were both 62.2% which was higher than that of patients suffering from other malignancies or benign tumors. beta-GCD assay is simple, stable and is valid in the diagnosis of stomach cancer and ovarian malignancies. The mechanism of beta-GCD elevation and its relation to metastasis are discussed. PMID- 1782850 TI - [Imaging diagnosis of splenic metastasis]. AB - The splenic metastasis of malignant diseases is uncommon. The relative paucity of this condition is thought to be due to the property of the spleen as an organ of immunity and the sharp angle of the splenic artery at its origin from the coeliac axis making it difficult for the tumor emboli to enter the spleen. The primary sites of 15 splenic metastases were: 7 (43%) ovarian tumors, and 8 (57%) others. All 15 patients had been repeatedly examined by ultrasonography. 6 patients were shown to give hyperechoic, 6 hypoechoic and 3 nonechoic findings. 10 patients had been examined by CT scan. Except one splenic metastasis of malignant teratoma with calcification, reduced density lesions were seen on ordinary and enhanced CT scans in all. We are of the opinion ther the most common route of splenic metastasis is hematogenous or direct seeding. The high incidence of splenic metastasis in gynecologic tumors may be related to their particular biologic behavior of being prone to direct seeding. PMID- 1782851 TI - [The study of lymph nodes metastasis and staging of carcinoma of the gastric cardia by computer]. AB - A total of 605 cases of the carcinoma of gastric cardia resected were analysed univariantly using program of analysis for risk states and survival analysis by life table method on IBM-PC computer. The significance of lymph nodes metastasis in different situations concerning prognosis was evaluated. Our results suggest that the lymph nodes with metastasis at the lower part of esophagus should be grouped as N 1 in the TNM staging system for carcinoma of the gastric cardia. We propose a new staging method, using number of lymph nodes metastasis and degree of tumorous infiltration to the adjacent organs as main indices, for the advanced carcinoma of the gastric cardia clinically and pathologically. PMID- 1782852 TI - [Endometrial carcinoma treated by radiotherapy alone]. AB - 90 patients with endometrial carcinoma treated from 1958 to 1984 by radiotherapy alone are presented. They constituted 18.7% of all cases of endometrial carcinoma treated in the same period. According to the clinical staging system of FIGO, there were 28.89% Stage Ia, 8.89% Stage Ib, 38.89% Stage II, 20% Stage III and 3.33% Stage IV lesions. In this series, 82 patients suffered from adenocarcinoma and 8 patients from adenoacanthoma. Two treatment regimens were adopted: 1. intracavitary Ra (137Cs or 60Co) as the major form of treatment supplemented by external irradiation in 82 patients (including 5 by intracavitary 137Cs afterloading), 2. external irradiation supplemented by intracavitary Ra (or 137Cs) radiation in 8 patients. The overall 5-year survival rate was 48.89% (Stage I 58.82%, Stage II 51.42%, Stage III 33.3% and Stage IV 0%). Complications were proctitis in 17 cases hematuria in 4 and rectovaginal fistula in 1. The 5 patients treated by intracavitary afterloading radiation with high doses at reference points A and F all survived for more than 5 years. This may imply a bright future for this form of radiotherapy in the treatment of endometrial carcinoma. PMID- 1782853 TI - [Clinico-pathologic studies of 95 cases of Hodgkin's disease]. AB - From 1961 through 1986, 95 cases of Hodgkin's disease were biopsied in our hospital. Sex distribution: male 70, female 25. Age incidence: 27% were under 20 years and 75% under 40. 93% of lesions had originated from the lymph nodes. Clinical stage: I 14, II 37, III 25 and IV 19 cases. 20 patients were treated by chemotherapy, 26 by radiotherapy and 49 by combined chemotherapy and radiotherapy. The CR + PR rate was 86.2% and the 1-, 3-, 5- and 10-year survival rates were 83.2% (79/95), 57.6% (53/92), 46.4% (32/69) and 31.3% (15/48), respectively. The results showed that the 4 pathological types (LP, NS, MC, LD) and 10 subtypes (D,N in LP; LP, MC, LD in NS; LP, MC, LD in MC; R, DF in LD) and the predominance of reticulum cells (S-R cells, HD cells, histiocytes, lymphocytes, fibrosis, collagenous changes) in the tumor were all irrelevant to the prognosis (P greater than 0.05). However, the clinical stage, immediate response and the method of treatment were very prognostic (P less than 0.05) The authors believe that intensive chemotherapy combined with radiotherapy and intensive radiotherapy could lead to long survival. PMID- 1782854 TI - [A new concept on clinical manifestations in relation to staging of renal cell carcinoma]. AB - With the advent of sonography and CT, renal cell carcinoma has increasingly been diagnosed in its early stage, with simple hematuria or no symptoms as the incidence of patients with masses and extrarenal extensions decreased. Correlating the clinical manifestations with stage, hematuria and pain may not imply an advanced lesion (31.4% Stage I). By adequate use of B ultrasonography and/or other instrument, many of renal cell carcinoma could be detected in its asymptomatic stage, a crucial requirement for better therapeutic results. The authors' data showed that fever, elevated ESR, varicocele and general malaise did imply advanced lesions or possible early metastasis after operation. On the other hand, complication with hypertension or erythremia could speak for an early lesion if diagnosis is made in time. Therefore, stratification of the extrarenal manifestations into endocrine and non-endocrine phases may help assess prognosis. PMID- 1782855 TI - [Rapid percutaneous trough-needle biopsy of lesions in the lung--report on 68 cases]. AB - The results of rapid percutaneous trough-needle biopsy of lung lesions in 68 cases (76 punctures) is reported. It was successful in 60 of the 68 cases (89.1%). After localizing the lesion on the simulator, TV screen of X-ray machine, or chest film, the procedure was performed with the X-ray switched off. Pneumothorax was observed in 8 cases (8/76 punctures, 10.5%) by routine chest film taken 1 1/2-2 hours after biopsy. 4 patients were asymptomatic (atelectasis below 20%). Pneumothorax could be induced if the needle was at an acute angle with the surface of the pleura at the time of puncture. The needle should pierce the pleura perpendicularly. Premature removal of the pith with the slot tip half through the pleura might have been another cause of pneumothorax. As the movement of a coin lesion is wide during respiration, the patient must be trained to hold his breath at the end of inspiration or expiration and remains so during the puncture. The chance of success in puncturing a coin lesion could be increased if the lesion is so immobilized and visualized as it is pin-pointed with the rib out of the way at the time of puncture. PMID- 1782856 TI - Differential stability of expression of similarly specified endogenous and exogenous genes in the sea urchin embryo. AB - The object of these experiments was to determine whether competitive titration in vivo of factors required for expression of the CyIIIa.CAT fusion gene would affect expression of the endogenous CyIIIa gene in the same embryos. Earlier work showed that expression of this fusion gene after injection into sea urchin eggs is stoichiometrically reduced when low molar excesses of DNA fragments containing only its regulatory domain are coinjected. In order to compare endogenous (i.e. CyIIIa) and exogenous (i.e. CyIIIa.CAT) expression simultaneously in embryos bearing excess competitor regulatory DNA, we developed, and here describe, a new procedure for generating transgenic sea urchin embryos in which all of the cells in many embryos, and most in others, bear the exogenous DNA. Such large reduction of mosaicism can be achieved by multiple injection of the exogenous DNA fragments into fertilized eggs. Using this method, we demonstrate that at a level of competitor DNA incorporation which reduces CyIIIa.CAT expression by 85%, endogenous CyIIIa mRNA levels are wholly unaffected. Nor is spatial expression of the endogenous CyIIIa gene disturbed. Since the CyIIIa.CAT genes are properly expressed under control of the CyIIIa regulatory sequences, they must participate in the same set of necessary DNA-protein interactions. However, we infer from the results that we report here that the regulatory complexes in the endogenous CyIIIa gene are greatly stabilized relative to those of the exogenous CyIIIa.CAT genes. PMID- 1782857 TI - 'Promoter trapping' in Caenorhabditis elegans. AB - A screen of gene expression patterns has been developed for the nematode Caenorhabditis elegans. Promoter-reporter gene fusions were constructed in vitro by ligating C. elegans genomic DNA fragments upstream of a lacZ gene. Patterns of beta-galactosidase expression were examined by histochemical staining of C. elegans lines transformed with the constructs. beta-galactosidase expression depended on translational fusion, so constructs were assayed in large pools to expedite detection of the low proportion that were active. Expression in a variety of cell types and temporal patterns was observed with different construct pools. The most striking expression patterns were obtained when the beta galactosidase activity was localized to subcellular structures by the C. elegans portion of the fusion protein. The active constructs of three selected pools were identified subsequently by an efficient combinatorial procedure. The genomic locations of the DNA fragments from the active constructs were determined and appear to define previously uncharacterized genetic loci. PMID- 1782858 TI - Xenopus temporal retinal neurites collapse on contact with glial cells from caudal tectum in vitro. AB - Nasal and temporal retinal neurites were confronted in culture with glial cells from the rostral and caudal parts of the optic tectum and with glial cells from the diencephalon. Twenty of each of the six classes of encounter between individual growth cones and isolated glial cells were analysed by time-lapse videorecording. The results show that growth cones from the temporal retina collapse when they contact glial cells from the caudal tectum, but do not collapse when they contact glia from other areas. Growth cones of nasal retinal fibres do not collapse on contact with any of the glial types examined. This suggests that the inhibitory phenomena described by others are in part due to the cell surface characteristics of glial cells, and that there are differences between glia from the front and back of the optic tectum. PMID- 1782859 TI - Distribution and function of the lethal of scute gene product during early neurogenesis in Drosophila. AB - Genes of the achaete-scute complex (ASC) participate in the formation of the central nervous system in the Drosophila embryo. Previous genetic analyses have indicated that lethal of scute (l'sc) is the most important gene of the complex in that process. We have obtained antibodies against the l'sc protein to study the expression of the gene during early neurogenesis. The protein is found in groups of embryonic neuroectodermal cells, analogous to the proneural clusters that precede the appearance of precursors of peripheral sensory organs in imaginal epithelia. The groups appear in different regions of the neuroectoderm, accompanying the three successive waves of neuroblast segregation. Most neuroblasts delaminate from these clusters and express position-specific levels of l'sc protein. No significant differences have been found between the distribution of l'sc RNA and protein. Phenotypic analysis of a l'sc deficiency has shown that the gene is required for neuroblast commitment, although this requirement is less widespread than the domain of l'sc expression, suggesting a high degree of redundancy in the function of genes that participate in the process of neuroblast segregation. The ASC genes have been postulated to play a role in the control of NB identity, revealed by the generation of a defined lineage of identifiable neurons. However, our study in l'sc mutants of the expression of fushi tarazu, engrailed, and even-skipped, used as markers of neuronal identity, has not provided evidence to support this hypothesis. PMID- 1782860 TI - Roles of wingless in patterning the larval epidermis of Drosophila. AB - The larval epidermis of Drosophila shows a stereotyped segmentally repeating pattern of cuticular structures. Mutants deficient for the wingless gene product show highly disrupted patterning of the larval cuticle. We have manipulated expression of the wg gene product to assess its role in this patterning process. We present evidence for four distinct phases of wg function in epidermal cells: (1) an early requirement in engrailed-expressing cells to establish and maintain stable expression of en, (2) a discrete period when wg and en gene products act in concert to generate positional values in the anterior portion of the ventral segment and all values of the dorsal and lateral epidermis, (3) a progressive function (dependent on prior interaction with the en-expressing cells) in conferring positional values to cells within the posterior portion of the segment, and (4) a late continuous requirement for maintaining some ventral positional values. PMID- 1782861 TI - Fate maps of the first quartet micromeres in the gastropod Ilyanassa obsoleta. AB - Cell fate specification in the gastropod mollusc Ilyanassa obsoleta involves both cell autonomous and inductive mechanisms, which depend on determinants localized first in the polar lobe and then in the D quadrant of the embryo. A complete cell lineage is lacking for this embryo and is essential for a critical interpretation of previous experimental results and an analysis of the mechanisms at the molecular level. Lineages of the first quartet micromeres were followed using Lucifer Yellow dextran as a tracer. The tracer was injected into individual first quartet micromeres using iontophoresis and patterns of fluorescence were analyzed in the larva after 8 days of development. Fluorescence was limited to head structures, including eyes, tentacles and velum. Structures on the left side were derived from 1a and 1d micromeres; 1a gave rise to the left eye, including the lens. Right side structures were derived from the 1c micromere and 1b contributed to the apical plate between the eyes and symmetrically to both sides of the velum. First quartet lineage data are compared with results from previous cell ablation experiments and with lineage data from other species. PMID- 1782862 TI - Production of antisense RNA leads to effective and specific inhibition of gene expression in C. elegans muscle. AB - We have used an antisense strategy to effectively disrupt the expression of two genes encoding myofilament proteins present in C. elegans body wall muscles. DNA segments from the unc-22 and unc-54 genes have been placed in reverse orientation in vectors designed to produce RNA in body wall muscles. When the resulting plasmids are injected into oocytes, progeny with defects in muscle function are produced. These animals have phenotypes consistent with reduction and/or elimination of function of the gene to which antisense RNA has been produced: twitching and disorganization of muscle filaments for the unc-22 antisense constructs and lack of muscle tone, slow movement, and egg laying defects for the unc-54 antisense constructs. A fraction of the affected animals transmit the defective-muscle trait to subsequent generations. In these cases the transforming DNA is present at high copy number and cosegregates with the observed muscle defects. We have examined several of the unc-22 antisense plasmid transformed lines to determine the mechanistic basis for the observed phenotypes. The RNA product of the endogenous unc-22 locus is present at normal levels and this RNA is properly spliced in the region homologous to the antisense RNA. No evidence for modification of this RNA by deamination of adenosine to inosine was found. In affected animals the level of protein product from the endogenous unc-22 locus is greatly reduced. Antisense RNA produced from the transforming DNA was detected and was much more abundant than 'sense' RNA from the endogenous locus. These data suggest that the observed phenotypes result from interference with a late step in gene expression, such as transport into the cytoplasm or translation. PMID- 1782863 TI - Pattern formation in the nematode epidermis: determination of the arrangement of peripheral sense organs in the C. elegans male tail. AB - The developmental process that determines the arrangement of ray sensilla in the Caenorhabditis elegans male tail has been studied. It is shown that the adult arrangement of rays is determined by the placement of ray cells at specific sites in the epidermis of the last larval (L4) stage. Placement of ray cells at specific epidermal sites results from the generation of neurons and support cells in the epidermis near to their final positions, and the subsequent refinement of these positions by an active mechanism involving specific cellular associations. Positions of ray cells and adjacent epidermal cells have been studied during ray development by means of indirect immunofluorescence staining with an antibody to a cell junctional antigen. Mutations are described in six genes that alter the adult arrangement of the rays, frequently resulting in fusion of rays. Changes in the adult pattern of rays in mutants appear to result from prior changes in the epidermal positions of ray cells, and for two mutants it is suggested that this may be due to the inappropriate clustering of processes from neurons and support cells of adjacent rays. Development of the wild-type arrangement of rays appears to require the specification of molecular differences between the rays that affect the specificity of their cellular associations. PMID- 1782864 TI - Restricted spatial and temporal expression of G-protein alpha subunits during Drosophila embryogenesis. AB - Of the known signal transduction mechanisms, the most evolutionarily ancient is mediated by a family of heterotrimeric guanine nucleotide binding proteins or G proteins. In simple organisms, this form of sensory transduction is used exclusively to convey signals of developmental consequence. In metazoan organisms, however, the developmental role of G-protein-coupled sensory transduction has been more difficult to elucidate because of the wide variety of signals (peptides, small molecules, odorants, hormones, etc.) that use this form of sensory transduction. We have begun to examine the role of G-protein-coupled signaling during development by investigating the expression during Drosophila embryogenesis of a limited set of G proteins. Since these proteins are a common component of all G-protein-coupled signaling systems, their developmental pattern of expression should indicate when and where programmed changes in gene activity are initiated by, or involve the participation of, G-protein-coupled signaling events. We have focused on the spatial and temporal expression pattern of three different Drosophila G-protein alpha subunits by northern blot analysis, in situ hybridization and immunocytochemistry using antibodies directed to peptides specifically found in each alpha subunit. From the spatial and temporal restriction of the expression of each protein, our results suggest that different forms of G-protein-coupled sensory transduction may mediate developmental interactions during both early and late stages of embryogenesis and may participate in a variety of specific developmental processes such as the establishment of embryonic position, the ontogeny of the nervous system and organogenesis. PMID- 1782865 TI - Binding of a factor to an enhancer element responsible for the tissue-specific expression of the chicken alpha A-crystallin gene. AB - We have characterized a regulatory region of the chicken alpha A-crystallin gene using transfection assays, which revealed that a 84 base pair element (-162 to 79) in the 5' flanking sequence is necessary and sufficient for lens-specific expression. A multimer of this element functions as lens-specific enhancer and synergistically activates transcription from chicken alpha A-crystallin or beta actin basal promoters fused to the CAT gene. In vivo competition experiments demonstrated that DNA sequences containing the 84 bp element reduced alpha A crystallin-CAT fusion gene expression. A nuclear factor present exclusively in lens cells binds to the 84 bp element in the region between positions -165 and 140. Southwestern blot analysis showed that 61,000 Mr (61 x 10(3) Mr) lens nuclear protein exhibited DNA-binding activity specific to the 84 bp element. Our data suggested that the 61 x 10(3) Mr nuclear protein, and the 84 bp element that it interacts with, may be involved in regulating the alpha A-crystallin gene expression in vivo. PMID- 1782866 TI - Effect of egg composition on the developmental capacity of androgenetic mouse embryos. AB - Analysis of the developmental capacities of androgenetic and gynogenetic mouse embryos (bearing two paternal or two maternal pronuclei, respectively) revealed a defect in blastocyst formation of androgenetic, but not gynogenetic, embryos that was a function of the maternal genotype. Androgenetic embryos constructed using fertilized eggs from C57BL/6 or (B6D2)F1 mice developed to the blastocyst stage at frequencies similar to those previously reported, whereas androgenetic embryos constructed with fertilized eggs from DBA/2 mice developed poorly, the majority failing to progress beyond the 16-cell stage and unable to form a blastocoel-like cavity, regardless of whether the male pronuclei were of C57BL6 or DBA/2 origin. This impaired development was observed even in androgenetic embryos constructed by transplanting two male pronuclei from fertilized DBA/2 eggs to enucleated C57BL/6 eggs, indicating that the defect cannot be explained as the lack of some essential component in the DBA/2 cytoplasm that might otherwise compensate for androgeny. Rather, the DBA/2 egg cytoplasm apparently modifies the incoming male pronuclei differently than does C57BL/6 egg cytoplasm. Several specific alterations in the protein synthesis pattern of DBA/2 androgenones were observed that reflect a defect in the regulatory mechanisms that normally modulate the synthesis of these proteins between the 8-cell and blastocyst stages. These results are consistent with a model in which cytoplasmic factors present in the egg direct a strain-dependent modification of paternal genome function in response to epigenetic modifications (genomic imprinting) established during gametogenesis and indicate that preimplantation development can be affected by these modifications at both the morphological and biochemical levels. PMID- 1782867 TI - The nuclear-cytoplasmic distribution of the Xenopus nuclear factor, xnf7, coincides with its state of phosphorylation during early development. AB - We describe the characterization in Xenopus laevis of a nuclear protein, xnf7, which is first detected in the oocyte GV and is eventually enriched in nuclei of cells of the adult brain. Previous studies have shown that this protein contains zinc-finger-like structures and acidic domains typical of transcriptional activators, and is phosphorylated in vitro by p34cdc2 protein kinase. The protein also binds to double-stranded DNA. These data suggest that xnf7 may function as a transcription factor. During oocyte maturation, xnf7 is released into the cytoplasm and is not detectable in nuclei until the mid-blastula-gastrula stage of development. Western blot analysis of xnf7 isolated from oocytes and eggs showed the existence of multiple bands or isoforms of the protein. Unique isoforms that are generated during oocyte maturation are the result of phosphorylation. The phosphorylated isoforms remain in the cytoplasm until the mid-blastula stage. The re-accumulation of protein in the embryonic nuclei at this time correlates with the increase in abundance of the less phosphorylated isoforms. The xnf7 protein possesses a nuclear localization signal (NLS) similar to the bipartite signal found in nucleoplasmin. Newly synthesized xnf7 accumulated in the oocyte GV to detectable levels within a few hours following synthesis suggesting that retention of the protein in the cytoplasm during early cleavage may be due to a process that interferes with the function of the NLS. These data suggest that compartmentalization and/or post-translational modification of the nuclear protein xnf7 may be involved in regulating its function during early development. PMID- 1782868 TI - Basic fibroblast growth factor induces retinal pigment epithelium to generate neural retina in vitro. AB - During embryogenesis, the cells of the eye primordium are initially capable of giving rise to either neural retina or pigmented epithelium (PE), but become restricted to one of these potential cell fates. However, following surgical removal of the retina in embryonic chicks and larval amphibians, new neural retina is generated by the transdifferentiation, or phenotypic switching, of PE cells into neuronal progenitors. A recent study has shown that basic fibroblast growth factor (bFGF) stimulates this process in chicks in vivo. To characterize further the mechanisms by which this factor regulates the phenotype of retinal tissues, we added bFGF to enzymatically dissociated chick embryo PE. We found that bFGF stimulated proliferation and caused several morphological changes in the PE, including the loss of pigmentation; however, no transdifferentiation to neuronal phenotypes was observed. By contrast, when small sheets of PE were cultured as aggregates on a shaker device, preventing flattening and spreading on the substratum, we found that a large number of retinal progenitor cells were generated from the PE treated with bFGF. These results indicate that bFGF promotes retinal regeneration in vitro, as well as in ovo, and suggest that the ability of chick PE to undergo transdifferentiation to neuronal progenitors appears to be dependent on the physical configuration of the cells. PMID- 1782869 TI - Expression of the mouse anti-mullerian hormone gene suggests a role in both male and female sexual differentiation. AB - We describe here the isolation of cDNA and genomic clones corresponding to the mouse gene encoding anti-Mullerian hormone, and the use of these clones as molecular probes to study AMH gene expression. We constructed a 14.5 days post coitum (dpc) mouse fetal testes library and isolated a cDNA clone using bovine, human and rat partial cDNAs as probes. This clone contained a 1 kb insert, which was confirmed by sequencing to be the mouse homologue of AMH. Probes derived from the mouse cDNA clone were used to screen genomic libraries and a 12 kb DNA fragment containing the complete coding region of mouse AMH was isolated. In situ hybridisation was used to determine the precise timing and localisation of AMH expression in male and female embryos and postnatal testes and ovaries. AMH transcripts were first detected in fetal testes at 12.5 dpc when differences between testes and ovaries first become visible. The signal was specific for the Sertoli cells of the testes. Other fetal tissues or female embryos were negative for AMH transcripts. During male development, AMH expression is shut off postnatally. In the female, the expression of AMH was first detected at day 6 after birth and is restricted to granulosa cells. We have correlated the pattern of AMH expression in both sexes with cellular events occurring in gonadal development and discuss some implications that this may have for its function and regulation. PMID- 1782870 TI - Perturbation of neuronal differentiation and axon guidance in the spinal cord of mouse embryos lacking a floor plate: analysis of Danforth's short-tail mutation. AB - The floor plate of the vertebrate nervous system has been implicated in the guidance of commissural axons at the ventral midline. Experiments in chick have also suggested that at earlier stages of development the floor plate induces the differentiation of motor neurons and other neurons of the ventral spinal cord. Here we have examined the development of the spinal cord in a mouse mutant, Danforth's short-tail, in which the floor plate is absent from caudal regions of the neuraxis. In affected regions of the spinal cord, commissural axons exhibited aberrant projection patterns as they reached and crossed the ventral midline. In addition, motor neurons were absent or markedly reduced in number in regions of the spinal cord lacking a floor plate. Our results suggest that the floor plate is indeed an intermediate target in the projection of commissural axons and support the idea that several different mechanisms operate in concert in the guidance of axons to their cellular targets in the developing nervous system. In addition, these experiments suggest that the mechanisms that govern the differentiation of the floor plate and other ventral cell types in the neural tube are common to mammals and lower vertebrates. PMID- 1782871 TI - Generation of pigmented stripes in albino mice by retroviral marking of neural crest melanoblasts. AB - The pigment cells of the skin are derived from melanoblasts which originate in the neural crest. The dorsoventral migration of melanoblasts has been visualized in pigment stripes seen in aggregation chimeras, and the width of these bands has suggested that the entire pigmentation of the coat is derived from a small number of founder cells. We have generated mosaic mice by marking single melanoblasts in utero to gain information on the clonal history of pigment-forming cells. A retroviral vector carrying the human tyrosinase gene was constructed and microinjected into neurulating albino mouse embryos. Albino mice are devoid of pigmentation due to deficiency of tyrosinase. Thus, transduction of the wild-type gene into the otherwise normal melanoblasts should rescue the mutant phenotype, giving rise to patches of pigmentation, which correspond to the area colonized by the mitotic progeny of a marked clone. Mosaic animals derived from the injected embryos indeed showed pigmented bands with a width strikingly similar to the 'standard' stripes seen in aggregation chimeras. These results are consistent with the notion that the unit width bands seen in aggregation chimeras represent the clonal progeny of a single melanoblast and verify Mintz's (1967) conclusion that a few founder melanoblasts give rise to coat pigmentation. The pigment cells of the eye are of dual origin: the melanocytes in choroid and outer layer of the iris are derived from the neural crest and those in the pigment layer of the retina from the neuroepithelium of the optic cup. Marked clones in both lineages were observed in the eyes of many mosaic animals. PMID- 1782872 TI - The nature of the mesoderm-inducing signal in Xenopus: a transfilter induction study. AB - A transfilter apparatus is described, which is suitable for neutralization experiments on embryonic induction, and it is used to investigate the sensitivity of the Xenopus mesoderm-inducing signal to various inhibitors. The vegetal (inducing) tissue is placed on one side of a membrane sandwich and the animal (responding) tissue on the other side. The sandwich consists of a nylon gauze in between two Nucleopore filters and enables inhibitors in the solution to have effective access to the gap between the tissues. Control experiments show a high proportion of positive inductions of a ventral character. Using this apparatus, it is shown that the protein follistatin, which effectively inhibits activin A and B in vitro, has little or no effect on the natural signal. Likewise, antibodies to basic fibroblast growth factor, which inhibit in vitro, do not inhibit the natural signal. The two inhibitors together have a slight effect. It is concluded that neither activin nor bFGF are major components of the signal emitted by the vegetal cells of the Xenopus blastula and transmitted across the liquid gap, although they might have some other role to play in the process. Two agents of lower specificity do inhibit the transfilter induction: heparin and suramin. Suramin will also inhibit induction in animal-vegetal combinations with no intervening membranes while heparin does not. This suggests that the heparin inhibition can only occur when there is a liquid gap between the tissues, presumably because it can neutralize the signal in solution but cannot penetrate the explants themselves. The endogenous mesoderm-inducing factor(s) should therefore be sensitive to heparin in vitro. PMID- 1782873 TI - Curvature of the caudal region is responsible for failure of neural tube closure in the curly tail (ct) mouse embryo. AB - Delayed closure of the posterior neuropore (PNP) occurs to a variable extent in homozygous mutant curly tail (ct) mouse embryos, and results in the development of spinal neural tube defects (NTD) in 60% of embryos. Previous studies have suggested that curvature of the body axis may delay neural tube closure in the cranial region of the mouse embryo. In order to investigate the relationship between curvature and delayed PNP closure, we measured the extent of ventral curvature of the neuropore region in ct/ct embryos with normal or delayed PNP closure. The results show significantly greater curvature in ct/ct embryos with delayed PNP closure in vivo than in their normal littermates. Reopening of the posterior neuropore in non-mutant mouse embryos, to delay neuropore closure experimentally, did not increase ventral curvature, suggesting that increased curvature in ct/ct embryos is not likely to be a secondary effect of delayed PNP closure. Experimental prevention of ventral curvature in ct/ct embryos, brought about by implantation of an eyelash tip longitudinally into the hindgut lumen, ameliorated the delay in PNP closure. We propose, therefore, that increased ventral curvature of the neuropore region of ct/ct embryos imposes a mechanical stress, which opposes neurulation and thus delays closure of the PNP. Increased ventral curvature may arise as a result of a cell proliferation imbalance, which we demonstrated previously in affected ct/ct embryos. PMID- 1782874 TI - Influence of paternally imprinted genes on development. AB - The parental origin of chromosomes is critical for normal development in the mouse because some genes are imprinted resulting in a predetermined preferential expression of one of the alleles. Duplication of the paternal (AG: androgenones) or maternal (GG/PG: gynogenones/parthenogenones) genomes will result in an excess or deficiency of gene dosage with corresponding phenotypic effects. Here, we report on the effects of paternally imprinted genes on development following introduction of the AG inner cell mass into normal blastocysts. There was a striking increase in embryonic growth by up to 50%, and a characteristic change in embryonic shape, partly because of the corresponding increase in length of the anterior-posterior axis. These changes, between e12-e15, were proportional to the contribution from AG cells to the embryo. However, a contribution of AG cells in excess of 50% was invariably lethal as development progressed to e15. A limited number of chimeras were capable of full-term development provided there was a relatively low contribution from AG cells. The distribution of AG cells in chimeras was not uniform, especially later in development when there was a disproportionate presence of AG cells in the mesodermally derived tissues. Their contribution was consistently greater in the heart and skeletal muscle, but was considerably lower in the brain. Chimeras detected after birth were either dead or developed severe abnormalities of the skeletal elements, particularly of the ribs which were enlarged, distorted and fused, with greatly increased cartilaginous material with an absence of normal ossification. These phenotypic effects in chimeras are reciprocal to those observed in the presence of GG/PG cells, which resulted in a substantial size reduction approaching 50%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782875 TI - Early ablation of target muscles modulates the arborisation pattern of an identified embryonic Drosophila motor axon. AB - The Drosophila RP3 motor axon establishes a stereotypic arborisation along the adjoining edges of muscles 6 and 7 by the end of embryogenesis. The present study has examined the role of the target muscles in determining this axonal arborisation pattern. Target muscles were surgically ablated prior to the arrival of the RP3 axon. Following further development of the embryo in culture medium, the morphology of target-deprived RP3 motor axons was assayed by intracellular injection with the dye Lucifer Yellow. Axonal arborisations were formed on a variety of non-target muscles when muscles 6 and 7 were removed and these contacts were maintained into stage 16. The pattern of axonal arborisations over non-target muscles varied between preparations in terms of the number of muscles contacted, and the distribution of arborisations on individual muscles. Following removal of muscle 6, the RP3 motor axon frequently contacted muscle 7, and axonal arborisations were present along the distal edge of the muscle. In the absence of muscle 7, the RP3 axon often did not contact muscle 6 and when muscle 6 was contacted, the arborisation of RP3 was poorly developed. Axonal processes were retained on non-target muscles when only one target muscle was present. Therefore, the establishment of a stereotypic arborisation by the RP3 motor axon is apparently dependent on growth cone contact with both target muscles. PMID- 1782876 TI - The Mus musculus domesticus Tdy allele acts later than the Mus musculus musculus Tdy allele: a basis for XY sex-reversal in C57BL/6-YPOS mice. AB - Consomic C57BL/6 males, carrying either the Mus musculus musculus-derived C57BL/6 Y chromosome or the Mus musculus domesticus-derived Poschiavinus Y chromosome, were outcrossed to females of the inbred strains C3H/Bi and CXBH/By and to females of the random bred strain MF1/Ola. In a study at 12.5 days post coitum, gonads of XYC57 and XYPOS fetuses were assessed for the presence of testicular cords. It was found that XYPOS fetuses had a later onset of testicular development than XYC57 fetuses. Limb development, which was monitored as a measure of overall development, was unaffected by the strain of Y present. These data were supported by a longitudinal study in which the increased growth rate of the testes relative to undifferentiated gonads, was also shown to be delayed in XYPOS fetuses. The extent of the delay was estimated to be approximately 14 h. It is concluded that this delay in the onset of testicular differentiation must be caused by differences between the two Y-chromosome types, most probably allelic differences in the testis determinant Tdy. PMID- 1782877 TI - The sisterless-b function of the Drosophila gene scute is restricted to the stage when the X:A ratio determines the activity of Sex-lethal. AB - The gene scute (sc) has a dual function: the scute function which is involved in neurogenesis and the sisterless-b function which is involved in generating the X:A signal that determines the state of activity of Sxl, a gene that controls sex determination and dosage compensation. We show here that the lethal phase of sc- females is embryonic and caused by the lack of Sxl function. We also analyze the time in development when sc and Sxl interact by means of (a) determining the thermosensitive phase (TSP) of the interaction between Sxl and sc and (b) a chimeric gene in which sc is under the control of a heat-shock promoter (HSSC-3). Pulses of sc expression from the HSSC-3 activate Sxl only at a very specific and early stage in development, which coincides with the TSP of the interaction between sc and Sxl. It corresponds to the syncytial blastoderm stage and coincides with the time when the X:A signal regulates Sxl. At this stage sc undergoes a homogeneous transient expression in wild-type flies. We conclude that the sc expression at the syncytial blastoderm is responsible for its sisterless-b function. Since sc expression from the HSSC-3 fully suppresses the sisterless-b phenotype, we further conclude that the sisterless-b function is exclusively provided by the sc protein. Finally, we have analyzed, by in situ hybridization, the effect of sc and sis-a mutations on the embryonic transcription of Sxl. Our results support the view that the control of Sxl by the X:A signal occurs at the transcriptional level. PMID- 1782878 TI - Skull base surgery issues. PMID- 1782879 TI - Advances in non-invasive measures of vocal acoustics. AB - Objective assessment of vocal pitch, loudness, and quality is a crucial adjunct to endoscopy in the diagnosis and treatment of vocal pathology. Historically, this assessment was made through subjective, perceptual measures that were questionable in terms of validity and reliability. Recent advances in electronic technology now permit objective analysis of the acoustic characteristics of voice. Kay Elemetric's Visi-Pitch, DSP 5500 Digital Spectrograph, and Nasometer are representative of these new instruments and are used as illustrations in the discussion of the assessment of speech acoustics. PMID- 1782880 TI - Non-invasive assessment of phonatory and respiratory dynamics. AB - Evaluation of vocal pathology and the accompanying dysphonia should include an assessment of laryngeal structure and mobility as well as respiratory dynamics. Laryngeal structure is best observed through laryngoscopy which provides an accurate assessment of the tissues and their mobility. Respiratory measures of lung volume, air-flow and pressure, and breathing dynamics are typically determined via spirometry and pneumotachography. While the above are traditional invasive procedures which interfere with normal speech production, recent advances in electronic technology have resulted in the development of non invasive procedures to assess phonatory and respiratory dynamics. These procedures, when used as an adjunct to laryngoscopy, can provide information that is useful in the diagnosis and management of vocal tract dysfunction. The Laryngograph and Computer-Aided Fluency Establishment Trainer, described here, are examples of this new technology. PMID- 1782881 TI - Pseudohypacusis in a military population. AB - Pseudohypacusis, or non-organic hearing loss, was investigated as a possible marker for poor adaptation within the military environment. Eighteen active duty military patients who demonstrated pseudohypacusis were identified retrospectively from among all patients who underwent audiological evaluation at Naval Hospital, San Diego, during 1988. A control group of 33 patients with normal hearing was also randomly selected from the same population. Age, rank and military status one to two years later were compared, showing a significant difference between the groups in the rates of premature separation from the military. The results suggest that pseudohypacusis in a new recruit is a strong indicator that the subject may be separated prematurely from active duty in the military; this implies that it may be cost-effective for these patients to be separated from duty as soon as the diagnosis is made. Other trends in the data are discussed, and the literature is reviewed. The problem of pseudohypacusis as a method of increasing Veterans Association benefits is discussed. The signs of pseudohypacusis are important for all clinicians involved in audiological testing in order to make a correct diagnosis, avoid costly medical workup and refer affected patients for psychiatric evaluation when indicated. PMID- 1782882 TI - Cholesteatoma of the paranasal sinuses: case report & review of the literature. AB - Cholesteatoma of the paranasal sinuses is uncommon but makes interesting the differential diagnosis of unilateral sinus masses. When present, it is most often located in the frontal sinus; less commonly in the ethmoids and maxillary sinuses. Its presence elicits a spectrum of symptomatology differing among the varying locations of occurrence. Ultimately, complications of untreated sinus cholesteatoma can lead to severe disfigurement, carcinomatous degeneration or death. A review of this century's English literature revealed only twenty reported cases of cholesteatoma of any paranasal sinus. The distinguishing features of these cases are presented along with our personal experience with a cholesteatoma of the maxillary sinus. Treatment recommendations to avoid long term complications are the total excision of the cholesteatoma with adequate drainage and sinusotomy for post-operative follow-up. CAT scanning plays an important role in diagnosis and follow-up. PMID- 1782883 TI - Cystic ameloblastic fibroma. AB - A seven-year-old white male presented with an enlarging mass in the mandible which was a cystic ameloblastic fibroma. This case, the third reported in the literature, demonstrated several unusual histopathologic findings and presented several controversies in management. PMID- 1782885 TI - Options in ossiculoplasty. AB - To achieve good results in ossicular reconstruction residual and recurrent disease must be eliminated. The surgeon must assess the anatomic, physiologic and pathologic situation and consider the available options. Staging is mandatory in many cases. Indication, surgical technique, hearing results and causes of failure are presented in a retrospective study of 138 consecutive operations. PMID- 1782884 TI - Nasofacial conidiobolomycosis. AB - A case of Nasofacial Zygomycosis in a 15-year-old male patient from South India is reported. This patient had typical thickening of the nasofacial mucosa and the skin overlying it. The diagnosis was confirmed with fungal cultures. Although initially good response to treatment with potassium iodide was achieved, later the response was unsatisfactory, probably partly due to irregularity in treatment. Treatment with sulphamethoxazole--trimethoprim and prednisolone combination has resulted in remarkable improvement. PMID- 1782886 TI - A suction-irrigation system for endoscopic sinus surgery. PMID- 1782887 TI - PC based system for analysis of the voice of patients with laryngeal disease. AB - A low cost microcomputer system for analysis of the voice of patients with laryngeal diseases is proposed. The system realizes an evaluation of the following speech parameters affected by laryngeal disease: voice degree of hoarseness; pitch period (T0); pitch period perturbations; degree of subharmonic components; and number of the stops in T0 generation during sustained vowel phonation. Other nonacoustic parameters concerning the patient's status are input into the computer using the keyboard. The hardware consists of a microphone and an ADC-board (plugged into the PC) allowing the PC to be used as a system for pathological voice analysis. Preliminary experimental research has shown the effectiveness of the system. PMID- 1782888 TI - Multiple branchiogenic anomalies. AB - A family with three generations of male-to-male transmission of a rare syndrome is presented. The syndrome includes bilateral cervical branchial sinuses, bilateral preauricular sinuses, bilateral malformed auricles and bilateral hearing impairment. Two important aspects of this syndrome are discussed. First, male-to-male transmission rules out a sex-linked mode of inheritance. Second, the finding of both conductive and sensorineural hearing loss is puzzling since the middle and inner ear differ in embryogenesis as to both origin and timing. Few explanatory mechanisms are discussed. PMID- 1782889 TI - Microcystic adnexal carcinoma. AB - Microcystic adnexal carcinoma is an unusual, locally aggressive tumor that recently has been recognized as a distinct clinicopathologic entity. It typically occurs on the face of young or middle-aged women and often requires extensive surgical excision to gain local control. A case involving the upper lip and columella of a young woman is described and the available literature reviewed. The difficult reconstructive challenge this lesion usually presents is illustrated in this patient who required upper lip and complete columellar reconstruction. PMID- 1782890 TI - Primary meningiomas of the middle ear: do they exist? PMID- 1782891 TI - Facial palsy following fine needle aspiration biopsy of parotid hemangioma: a case report and review of the literature. AB - We present here a case of cavernous hemangioma of the parotid which presented as an acute emergency with sudden pain, trismus and swelling. The patient subsequently developed a complete lower motor neuron facial palsy a few hours after a fine needle aspiration biopsy was performed. Total parotidectomy with preservation of the facial nerve relieved the patient of all his symptoms with complete recovery of facial function in six weeks. PMID- 1782892 TI - Submandibular sialadenitis presenting as Ludwig's angina. AB - Previous descriptions of Ludwig's angina have focused on the odontogenic etiology and the absence of gland involvement. Incision and drainage of the involved fascial spaces without excision of the submandibular gland has traditionally been the recommended surgical treatment. Two case reports of edentulous patients illustrate acute submandibular sialadenitis spreading onto the fascial spaces described in association with Ludwig's angina. Surgical procedures included incision and drainage, along with excision of the submandibular gland. In select cases clinically resembling Ludwig's angina where submandibular sialadenitis is the etiology, we advocate that gland excision be included with a definitive incision and drainage procedure. PMID- 1782893 TI - Rapid orthodontic extrusion of crown root and cervical root fractured teeth. AB - This study concerns the relapse tendency and extent of root resorption in 33 extruded non-vital crown root fractured or cervical root fractured teeth in 32 patients 10-20 years old. They constitute all orthodontically extruded teeth at the Orthodontic or Pedodontic Departments, Eastman Institutet, Stockholm (1982 1987). A simple extrusion mechanism exerted a force of 60-70 p along the root axis of the tooth. An extrusion of 2-3 mm was obtained in most patients; the most extreme effect was 6 mm. In 16 patients the extrusion was achieved within 3 weeks, in 12 it lasted for 4-6 weeks and in 5, 7-9 weeks. The treatment was more complicated in the lower jaw. After the extrusion, a fibrotomy was done and in most patients also a gingival recontouring to create an optimal relation between the gingiva and the margin of the restoration. Periodically identical radiographs were taken immediately before and after the extrusion, after 3 months and after 1 year. A minor relapse, about 0.5 mm, was observed in 3 patients. Limited root resorption was found in 6 teeth and severe in only 1. The resorptions did not progress in the following 2 years of observation. PMID- 1782894 TI - Comparison between two ultrasonic units in shaping curved canals in teeth using macroradiography. AB - The efficacy of two ultrasonic units in shaping curved canals in teeth were compared. Twenty teeth were instrumented using the Cavi-Endo unit at a power setting 1 using the technique recommended by the manufacturer. Another group of 20 teeth received similar treatment but were instrumented with the Enac unit. The time taken to instrument each canal was recorded. The pre- and post-instrumented radiographs of the teeth of x 10 magnification were taken using a microfocal technique. The radiographs were subjected to a subtraction technique to result in composite images of the pre- and post-instrumented shapes. The canal shape and the incidence of elbows were evaluated using various measurements taken from the radiographs. The manner the dentine was removed was similar in both groups. All canals exhibited unequal removal along the canal with more dentine being removed at the coronal end. The Enac group exhibited a higher incidence of elbows which occurred further apically than those in the Cavi-Endo group. There was no significant difference between groups in the following: time of instrumentation, amount of apical and coronal canal enlargement, apical deviation and change in width at the elbow. These findings were no different from those of another study using simulated canals. PMID- 1782895 TI - Glass ionomer cements and dental pulp. AB - Only slight pulp reactions to glass ionomer cements occurred when inserted in Class V cavities of dog teeth. Most inflammatory reactions were due to bacteria at the tooth/filling interface. Special dentin reactions were noted in almost half the teeth, including hematoxyphilic bands in the dentin and a disturbance of the mineralization pattern of predentin. The clinical significance of these dentin reactions is not known. PMID- 1782896 TI - An in vitro comparison of root canal content extrusion using ultrasonic and hand instrumentation. AB - The purpose of this study was to evaluate apical extrusion of root canal content using ultrasonic and hand instrumentation. Forty-nine tooth models were fabricated with clear resin. Each model contained a canal in the center. Each tooth model was mounted in a plastic cube (1 x 1 x 2 cm) with white dental plaster so that the coronal 2-3 mm of the model was exposed for instrumentation. Methylene blue dye with glycerin was used as a marker for root canal content. The study consisted of three groups. In group I, Enac ultrasonic instrumentation was used 1 mm from the apex; in group II, Enac ultrasonic instrumentation was used 3 mm from the apex; in group III, K files were used with a push-pull instrumentation technique, 1 mm from the apex. After instrumentation the resin models were extracted and the plaster blocks were sectioned through the long axis of the models. Photographs were made of the area of apical leakage and the amount of dye penetration was measured using a planimeter. There were no differences between hand instrumentation and both ultrasonic groups. At p less than 0.05, ultrasonic instrumentation 3 mm from the apex leaked significantly more than the ultrasonic instrumentation 1 mm from the apex. PMID- 1782897 TI - Vitality of human lip fibroblasts in milk, Hanks balanced salt solution and Viaspan storage media. AB - The purpose of the study was to compare the effect of storage in milk, Hanks balanced salt solution (HBSS) and Viaspan on the vitality of human lip fibroblasts. Confluent monolayers of the fibroblasts were grown in petri dishes. The growth medium was poured off and replaced in 27 dishes each with Viaspan, fresh whole milk and Hanks balanced salt solution respectively. Three of the original plates were analyzed at time zero to obtain the average number of cells each plate contained at confluence. At times ranging from 2 to 168 hours the average number of vital cells remaining was measured using the trypan blue exclusion test. The groups stored in milk maintained a high percentage of vital cells for 6 hours (68.2%). At 12 hours milk's effectiveness had dropped to 43.4% vital cells and it was not effective at all at 48 hours (0.024% vital cells). H.B.S.S. was extremely effective for 24 hours with 71.3% vital cells remaining. At 48 hours, the percentage of vital cells dropped to 38.0% and by 120 hours no cells survived. Viaspan was the most effective storage medium at all observation periods and at 168 hours still had 37.6% vital cells present. PMID- 1782898 TI - Enamel-dentin crown fractures bonded with various bonding agents. AB - A method is described, by which the fracture strength of bonded, previously fractured incisors can be measured. The study employed incisors from sheep, which could be obtained in suitable numbers and with limited variation in size. The incisors were fractured parallel to the incisal edge. The mean fracture area +/- SD of central incisors was 8.45 +/- 0.89 mm2 and of lateral incisors 6.50 +/- 0.64 mm2. The enamel area constituted about 30% of the total fracture area. Acid etching of the enamel and bonding of the fractures with an unfilled resin yielded a fracture strength, which was approximately 38% of the fracture strength of fractured teeth restored with acid etching of enamel, Gluma treatment of dentin and bonding with the unfilled resin. Teeth restored in this way, but using the dentin bonding agent Tenure or Scotchbond2 instead of Gluma, exhibited mean fracture strengths which were not significantly different from that obtained when Gluma was employed as the bonding agent. The mean fracture strength by using one of the three bonding agents in combination with acid etching of enamel was about 8 MPa, which is approximately 50% of the fracture strength of intact teeth. PMID- 1782899 TI - Reinforcement of bonded crown fractured incisors with porcelain veneers. AB - A method is described by which porcelain laminate veneers are used to reinforce crown-fractured incisors which have been restored by reattachment of enamel dentin fragments using enamel etching and a dentin bonding system. In an experimental model using sheep incisors, it was found that fracture strength equal to that of intact incisors could be achieved by employing this method. This is in contrast to fracture strengths of reattached enamel-dentin tooth fragments without porcelain laminates which were only 50% of intact incisors. It is suggested that porcelain laminate veneers may be used to supplement fragment bonding, thereby enhancing dental esthetics and function. PMID- 1782900 TI - Canal markings produced by endosonic instruments. AB - It has been recognised that ultrasonic files leave a diagonal pattern within the canal following endosonic instrumentation. There is confusion on the causative factor on the production of these marks. Furthermore there is little information about the marks produced by sonic files. An in vitro system consisting of highly polished dentin discs demonstrated that the ultrasonic K-file made a diagonal pattern that was an imprint of the cutting edges of the file. The sonic files produced different markings which were the result of their longitudinal and transverse motion. Root canals of extracted teeth were prepared with these instruments and similar grooves were observed. The ultrasonic K-file had diagonal grooves in the coronal and middle third of the root canal but longitudinal marks in the apical third. The rispisonic and shaper files produced debris even in the presence of NaOCl. This debris was formed into discrete parallel bands. Both longitudinal and transverse grooves were present and the canal had many other scratches similar to those seen with the dentin discs. There were differences between the marks produced by either ultrasonic or sonic endosonic instruments but it is unknown whether this influences the long term prognosis of the root canal therapy. PMID- 1782901 TI - Delayed endodontic and prosthetic treatment of two traumatized incisors. AB - This case report describes the delayed endodontic and prosthetic treatment of two maxillary central incisors in a 16-year-old patient. Both teeth had been traumatized eight years previously. The examination revealed arrested root formation with wide open apices, periapical inflammation and inflammatory resorption. Endodontic treatment with calcium hydroxide led to formation of hard tissue barriers in both teeth so that definite obturation could be performed. One tooth was lost due to a deep crown-root-fracture and replaced by an intraosseous implant, whereas the other incisor was retained for nearly four years. PMID- 1782902 TI - Surface architecture of a low-temperature thermoplasticized gutta-percha. AB - The surface characteristics of two Ultrafil materials, Regular set (RS) and Firm set (FS) were analyzed by scanning electron microscopy (SEM). The samples of Ultrafil were obtained from both RS and FS cannules which were pre-heated to 70 degrees C. Another RS and FS samples were obtained at room temperature from un heated cannules. Samples of standard gutta-percha points obtained from the same manufacturer were studied for comparative purposes. RS samples obtained from pre heated and un-heated cannules exhibited rough surfaces containing randomly distributed crystal-like structures. Heated and un-heated FS samples featured smoother surfaces with fewer crystal-like structures. The gutta-percha points also exhibited smooth surfaces and absence of crystal-like structures. The consequence of the possible release of these structures from Ultrafil in a biological system is discussed. PMID- 1782903 TI - Delayed treatment of a mid-root fracture. AB - A case of delayed treatment of a mid root fracture is presented. A radiolucent lesion at the fracture line was treated with calcium hydroxide in the coronal fragment for nine months. Clinically, the tooth became firm and the radiographic results showed healing of the lateral lesion and hard tissue filling in the space at the fracture line. PMID- 1782904 TI - Entrapped air and its effects on dye penetration of voids. AB - This study was conducted to determine the effect of entrapped air on the ability of methylene blue dye to penetrate known and measurable voids. Thirty six capillary tubes were sealed at one end and had standardized voids created within the lumen. Three equal groups of 12 test specimens and 4 controls were subjected to dye penetration by the methods of passive immersion for 7 days, centrifuging at 3,000 rpm for 5 minutes and immersion in a vacuum of 26 mm of mercury for 5 minutes. Measurement of linear dye penetration was made by removing shavings from the sealed end until dye could be observed. Negative controls showed no dye penetration and positive controls showed complete penetration. The vacuum method showed 100% penetration in all cases, while centrifuging had a mean of 91.7 /+ 8.7% penetration and passive immersion had a mean of 20.7 +/- 5.4% penetration. This study demonstrates that passive dye leakage studies are unreliable and very variable. The vacuum method whereby all entrapped air is removed is the most reliable method for dye penetration studies. PMID- 1782905 TI - Pulp capping of immature teeth with anatomic anomalies. AB - This case report describes the treatment of two immature teeth with anatomic anomalies which created plaque retentive areas and in one case occlusal disturbance. Periodontal and pulpal consequences were inevitable. Reshaping of the teeth was carried out which as expected led to exposure of the pulp in both instances. Pulp capping was then performed under aseptic conditions. The vitality of the teeth was maintained and continued root development was observed. PMID- 1782906 TI - Retrograde approaches in endodontic therapy. AB - The routine use of retrograde fillings during apical surgery, as well as the material of choice for that purpose, have been debated. A retrograde filling is placed so as to seal an infected root canal causing periapical pathosis. Therefore, retrograde root canal fillings should be performed routinely during apical surgery regardless of the apparent technical quality of the root canal obturation, unless orthograde endodontic treatment is performed in conjunction with surgery. When orthograde treatment is not performed, retrograde root canal filling enhances the prognosis of apical surgery. An array of potential retrograde filling materials have been extensively investigated in vitro and in vivo. Once that the biocompatibility of the materials is confirmed a clinical comparison, rather than in vitro sealability studies, is the most valid evaluation method. Some of the difficulties encountered in long term clinical studies in patients may be avoided in animal studies. The review of the relevant literature of the past decade suggests that amalgam used in conjunction with cavity varnish is the retrograde filling material of choice. It must be stressed, however, that retrograde filling is not comparable to debridement and obturation of the entire root canal. Therefore, when the only way to approach the root canal is from the apical direction, rather than placing an apical retrograde filling, a retrograde endodontic treatment of the entire canal should be preferred, if it is feasible. PMID- 1782907 TI - Thermodynamics of Mn(2+)-binding to goat alpha-lactalbumin. AB - By means of reaction calorimetry we measured the apparent enthalpy change, delta Happ, of the binding of Mn(2+)-ions to goat alpha-lactalbumin as a function of temperature. The observed delta Happ can be written as the sum of contributions resulting from a conformational and a binding process. In combination with the thermal unfolding curve of goat alpha-lactalbumin, we succeeded in separating the complete set of thermodynamic parameters (delta H, delta G, delta S, delta Cp) into the binding and conformational contributions. By circular dichroism we showed that NH+4-ions, upon binding to bovine alpha-lactalbumin, induce the same conformational change as do Na+ and K+: the binding constant KappNH+4 equals 98 +/- 9 M-1. PMID- 1782908 TI - 1H NMR investigation of reduced copper-cobalt superoxide dismutase. AB - Human copper-cobalt superoxide dismutase in the reduced form has been investigated through 1H NMR techniques. The aim is to monitor the structural properties of this derivative and to compare them with those of reduced and oxidized native superoxide dismutases. The observed signals of the cobalt ligands have been assigned as well as the signals of the histidines bound to copper(I). The latter signals experience little pseudocontact shifts which allow a rough orientation of the magnetic susceptibility tensor in the molecular frame. The connectivities indicate that, although the histidine bridge is broken in the reduced form, the interproton distances between ligands of both ions are essentially the same. PMID- 1782909 TI - Single cardiac outwardly rectifying K+ channels modulated by protein kinase A and a G-protein. AB - Elementary K+ currents were recorded at 19 degrees C in cell-attached and in inside-out patches excised from neonatal rat heart myocytes. An outwardly rectifying K+ channel which prevented Na+ ions from permeating could be detected in about 10% of the patches attaining (at 5 mmol/l external K+ and between -20 mV and +20 mV) a unitary conductance of 66 +/- 3.9 pS. K+(outw.-rect.) channels have one open and at least two closed states. Open probability and tau open rose steeply on shifting the membrane potential in the positive direction, thereby tending to saturate. Open probability (at -7 mV) was as low as 3 +/- 1% but increased several-fold on exposing the cytoplasmic surface to Mg-ATP (100 mumol/l) without a concomitant change of tau open. No channel activation occurred in response to ATP in the absence of cytoplasmic Mg++. The cytoplasmic administration of the catalytic subunit of protein kinase A (120-150 mu/ml) or GTP-gamma-S (100 mumol/l) caused a similar channel activation. GDP-beta-S (100 mumol/l) was also tested and found to be ineffective in this respect. This suggests that cardiac K+(outw.-rect.) channels are metabolically modulated by both cAMP-dependent phosphorylation and a G-protein. PMID- 1782911 TI - [Now, in Sao Jose dos Campos, the most modern and ecological technology in sterilization]. PMID- 1782912 TI - ["The past is a garment that no longer serves us"]. PMID- 1782910 TI - Calcium and temperature regulation of the stability of the human platelet integrin GPIIb/IIIa in solution: an analytical ultracentrifugation study. AB - The human platelet integrin GPIIb/IIIa (228 kDa), a Ca-dependent heterodimer formed by the alpha IIb subunit (GPIIb, 136 kDa) and the beta 3 subunit (GPIIIa, 92 kDa), serves as the fibrinogen receptor at the surface of activated platelets. The degree of dissociation of the GPIIb/IIIa heterodimer (s degrees 20*, 8.9 S) into its constituent glycoproteins (GPIIb, 5.8 S; and GPIIIa, 3.9 S) has been assessed by analytical ultracentrifugation in Triton X100 buffers, and its Ca(2+) and temperature-dependence correlated with Ca(2+)-binding to GPIIb/IIIa and its temperature dependence. At 21 degrees C half-maximal dissociation of GPIIb/IIIa occurs at 5.5 +/- 2.5 x 10(-8) M Ca2+, very close to the dissociation constant of the high affinity Ca-binding site of GPIIb/IIIa (Kd1 8 +/- 3 x 10(-8) M) (Rivas and Gonzalez-Rodriguez, 1991) and much lower than the Kd of the 3.4 medium affinity Ca-binding sites (Kd2 4 +/- 1.5 x 10(-5) M), which seems to demonstrate that the stability of the heterodimer in solution at room temperature is regulated by the degree of saturation of the high-affinity Ca-binding site. At 4 degrees C, the stability of the heterodimer is apparently Ca(2+)-independent, while at room and physiological temperatures (15-37 degrees C) the degree of dissociation of the heterodimer is regulated by the degree of dissociation of the high- and medium-affinity Ca-binding sites, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782913 TI - [Communication as an interactive process of the nurse-client therapeutic relationship]. AB - The present study, aims mainly to present some specifications concerning the way the communication can work in the interactive process; the specifications show not "what" but "how" the communication can be part of a therapeutic method. Along this study it is intend to make an approach about the theory of communication, pointing out some items believed to be agreed upon either about the efficiency or inefficiency in the therapeutic relationship nurse patient. Especially concerning the nonverbal communication. PMID- 1782914 TI - [Relatively intact at the bottom of a well]. PMID- 1782915 TI - [You and your plaster cast--educating for health]. AB - The study was developed in order to give patients carrying a plaster cast orientation into self-care. The authors supported their work on pre-existing works on the same theme. They point to Education for health as a means for health professionals to prevent problems arising from misinformation to people under medical attendance. PMID- 1782916 TI - [Packing materials in the sterilization process using ethylene oxide]. AB - The article points out the role of wrapping packages of medical and hospital items both for the manufacturer and, in special, for the user. The following aspects are enhanced: sterilization circle by ethylene oxide, quality requirements for a package; procedures for package qualification; and different package; types available for medical and hospital items. Last of all, there's a table showing the conexion between structure resistance of packing films and several sterilization processes. PMID- 1782917 TI - Nutritional considerations in the variability of plasma cholesterol measurements. AB - The concentration of plasma cholesterol is influenced by biological factors as well as clinical and analytical ones. Day-to-day variation can provide a misleading estimate of plasma cholesterol as it can differ by up to 12%. Seasonal variations occur with elevated concentrations in (northern hemisphere) winter relative to summer, possibly due to diet and life-style influences. Clinical and analytical factors also contribute to the variation. These include the manner with which blood is collected, the nutritional state of the subject and subsequent specimen handling. Analytical factors such as the effectiveness of the reagents and controls chosen, as well as the extent of interference by agents of metabolic or dietary origin, can introduce a bias into the analysis. More control can be exerted over the clinical and analytical factors compared with biological variation. PMID- 1782918 TI - Xerophthalmia in Ethiopia: a nationwide ophthalmological, biochemical and anthropometric survey. AB - A total of 6636 children, aged from 6 months to 6 years and selected throughout the country using a multi-staged stratified sample design, were examined for signs of xerophthalmia. The concentrations of retinol and of beta-carotene were measured in 742 children, including those with xerophthalmia and every twentieth of the remaining children. Anthropometric measurements were made on 2909 of the children. Bitot's spots were seen in 1.0% of all children, with a higher prevalence in the pastoral (1.6%) and cropping (1.1%) agro-ecological zones than in the zones characterized by cash crops (0.4%) and 'ensete' (false banana, Ensete ventricosum) (0.0%). One case of corneal xerosis and 2 cases of corneal scar were also seen. Serum retinol levels were in the 'deficient' range (less than 0.35 mumol l-1) in 16% and 'low' (0.35-0.69 mumol l-1) in 44% of children. Serum retinol and clinical signs did not show any correlation with occupation and education of head of household, household size or anthropometric measurements. More stunting than wasting was observed, with peak prevalence of these signs of malnutrition being observed in the second year of life. PMID- 1782919 TI - The impact of feeding problems on growth and energy intake in children with cerebral palsy. AB - Retrospective data on growth and cross-sectional data on growth outcome, anthropometric measurements and energy intake have been analysed according to the presence or absence of feeding problems in 42 children with cerebral palsy (CP) between 1 and 13 years of age. The mean age for boys and girls was 5.1 and 5.9 years, respectively. The study revealed a high frequency of feeding problems (50%) and growth retardation (48%) in the group. The results of weight for height, triceps skinfold thickness and energy intake indicate that 15% of the children were undernourished at the time of study. The cross-sectional analyses showed that children with feeding problems at the time of study (n = 22) had significantly lower height for age, weight for height, triceps skinfold thickness and upper-arm circumference than children without problems (P less than 0.05). Children with feeding problems also tended to have lower energy intake, but the differences were not significant. The feeding problems were most frequent among the severely disabled children. This study has shown that the presence of feeding problems is one important predictor of low growth outcome in children with CP. When parents report on feeding problems, feeding evaluation, training and nutritional intervention should be offered immediately. This is important for alleviating the heavy care-load for parents and health-workers and for some children it may be necessary to maintain an acceptable nutritional state. PMID- 1782920 TI - On the importance of processing conditions, product thickness and egg addition for the glycaemic and hormonal responses to pasta: a comparison with bread made from 'pasta ingredients'. AB - The importance of processing conditions, product thickness and effect of egg addition for the glycaemic and hormonal responses to pasta was studied. Healthy subjects were given test meals with an equivalent amount of available carbohydrate from extruded high-temperature dried spaghetti and three varieties of fresh roll-sheeted linguine (thick, thin, thin with egg) made from the same ingredients (durum wheat, water and monoglycerides). As a reference bread was baked from the same ingredients as in the pasta products. Glucose, insulin and C peptide levels were measured over a 3 h period. Glycaemic, insulin and C-peptide indexes (GI, II, CI) were calculated using 120 min areas under the curves. Glycaemic index was also calculated using the 90 min area. Also studied were the rates of in vitro starch digestion. The four pasta products produced significantly lower peak values (glucose, insulin, C-peptide) and lower GI (90 min), II (120 min) and CI (120 min) than the corresponding bread. The rate of in vitro starch digestion in pasta was also slower than in bread. In contrast to the pasta products, bread resulted in a prominent hypoglycaemia in the late phase, that is a drop below fasting blood glucose level. Minor differences in metabolic responses also appeared in the pasta products. In particular, the insulin and C peptide response to the thin linguine was accentuated in the phase around 120 min. PMID- 1782921 TI - Adipose tissue essential fatty acid composition in patients with atopic eczema. AB - We have measured adipose tissue total lipid and plasma phospholipid essential fatty acid composition by capillary column gas chromatography in patients with atopic eczema. In both adipose tissue and plasma phospholipids there was a significant elevation of linoleic acid in patients compared to a control group (adipose tissue P less than 0.05; plasma P less than 0.001), and a substantially higher ratio of linoleic acid to the sum of its longer chain highly unsaturated derived fatty acids, dihomogamma linolenic acid and arachidonic acid. These findings add support to the proposition that patients with atopic eczema have a defect in the conversion of linoleic acid. PMID- 1782922 TI - Failure of oral zinc supplementation in atopic eczema. AB - An eight week double-blind placebo-controlled trial of oral zinc sulphate 185.4 mg per day was undertaken in 50 children with atopic eczema aged 1-16 years. In those receiving zinc there was no significant improvement in disease severity as assessed by surface area affected and degree of erythema, symptom scores of itch, sleep disturbance and redness of skin, or weight of emollient or topical steroid use. PMID- 1782923 TI - Apolipoprotein A1 as an early index of protein-energy malnutrition. AB - Protein-energy malnutrition (PEM) is, together with infectious and parasitic diseases, a major cause of childhood illness in Africa. Diagnosis and treatment of PEM requires an accurate, simple and reliable method of assessing nutritional status from a blood sample. Plasma apolipoprotein (apo A1), prealbumin and albumin were measured in a group of Senegalese children suffering from PEM who had been hospitalized for refeeding, and in a group of control children. Statistical analysis of the results indicated that: (1) Plasma apo A1 was significantly correlated with prealbumin in assessing nutritional status (P less than 0.005 on day 8 of refeeding); (2) plasma apo A1 alone was sufficient for diagnosing and monitoring the dietary treatment of PEM; it was capable of detecting subclinical forms; (3) apo A1 could be used for differential diagnosis of forms of PEM; (4) plasma apo A1 concentration began to increase earlier (94% of control values at day 8) than did prealbumin (73% on day 8). We therefore propose apo A1 as an index of nutritional status in children living in areas where infectious and parasitic diseases are endemic. PMID- 1782924 TI - Effect of refeeding on the energy metabolism of adolescent girls who have anorexia nervosa. AB - The effect of refeeding on resting energy expenditure (REE) and substrate utilization was studied in 18 hospitalized adolescent girls (aged 12.9-19.1 years) suffering from anorexia nervosa. Changes in body composition were monitored weekly and included weight, fat body mass (FBM), lean body mass (LBM) and total body potassium (TBK). REE was studied weekly by open-circuit calorimetry. Weight gain was noted in all patients (38.2 +/- 5.6 to 44.5 +/- 5.3 kg), involving increased FBM and LBM. REE increased per kg of weight (91.6 +/- 15.1 to 101.7 +/- 18.0 kJ kg-1 d-1) and LBM over the first weeks of refeeding (P less than 0.025) and then stabilized. Substrate utilization showed an increase in carbohydrate and protein utilization (P less than 0.001) during the first few weeks of refeeding. We also studied the thermic effect of food (TEF) in 14 of the 18 subjects. Upon admission the subjects had a reduced TEF (36.4 +/- 24.3 kJ 2 h 1) (P less than 0.001). With refeeding TEF rose to a peak or plateau, then decreased to normal levels (61.9 +/- 36.0 kJ 2 h-1) before discharge from hospital. We conclude that the energy metabolism of adolescent girls adapts to semi-starvation by a reduction in both REE and TEF; with refeeding there is reversal of this adaptive function. PMID- 1782926 TI - Are physically active elderly women in a better nutritional condition than their sedentary peers? AB - The generally observed decrease in physical activity with age has its influence on energy requirements and to a lesser extent on micronutrient requirements of the elderly. In this study it was hypothesized that physically active people can more easily obtain their recommended nutrient intake without becoming overweight, because of their increased energy needs. Nutritional intake, body composition and vitamin status were assessed in two groups of women aged 60-79 years. The groups showed large differences in pattern and level of physical activity as estimated by a previously described questionnaire. Dietary intake was assessed by dietary history. Body composition was assessed using anthropometric measures and bioelectrical impedance. Blood levels of haematological parameters, blood lipids and several vitamins were measured. Differences in food consumption were not statistically significant. However, the more physically active women tended to have a food pattern more in line with dietary allowances according to the Dutch guidelines. At the same body height the physically active and sedentary women had body weights of 64.9 +/- 10.9 and 77.1 +/- 12.0 kg (mean +/- SD) respectively (P less than 0.001). Percentage of body fat was higher in the sedentary women. Blood levels did not differ significantly between both groups of women except for higher beta-carotene in the active women. PMID- 1782925 TI - Influence of enteral parasites on the blood vitamin A levels in preschool children orally supplemented with retinol and/or zinc. AB - A sample of 471 pre-school children who frequented schools and creches in a poor district of Manaus (Amazonas), Brazil, were randomly submitted to faecal parasitological tests. Two-hundred-and-forty children from both sexes between the ages of 3 and 7 years with Ascaris lumbricoides and/or Giardia lamblia were selected. The objective of the study was to determine the possible influence of these two intestinal parasites and vitamin A and/or zinc supplementation on the serum retinol levels of primary school children. The children were submitted to clinical and anthropometric examinations, dietary interviews and biochemical examinations of retinol and carotene in the serum and of zinc in the hair. The parasitic incidence was 85.0% and about 54% of the children were polyparasitic. During the pretreatment phase, the retinol and carotene serum levels were 36% and 57%, respectively, below the normal levels. Using the Waterlow classification, the anthropometric analyses revealed that 88% of the children showed normal growth. A significant effect was observed of the anti-parasitic medicine on the serum retinol levels. PMID- 1782927 TI - Effects of the increasing consumption of dairy products upon iron absorption. AB - The effect of the increasing consumption of dairy products upon the iron absorption was tested in vivo on volunteers using the extrinsic tag method (with 55 Fe and 59 Fe). The total iron absorption coefficient of a typical French meal and of the same meal after addition of a glass of low-fat skimmed milk or plain yoghurt was measured. Non-heme iron absorption was 2.2% for the standard meal alone, 2.0% with the yogurt and 2.1% with the glass of milk. Total iron absorption (i.e. measured non-heme iron absorption plus estimated heme iron absorption) for the three meals was, respectively, 9.7%, 9.5% and 9.4%. These results suggest that, under real-life conditions, increasing the amount of dairy products probably has no effect upon iron absorption in meals containing appreciable amounts of dairy products. PMID- 1782928 TI - Effects of conventional sucrose-based, fructose-based and isomalt-based chocolates on postprandial metabolism in non-insulin-dependent diabetics. AB - Milk chocolate is rich in both sucrose and fat, and is therefore considered unsuitable for diabetics. Nevertheless there is little information on the metabolic effects of conventional chocolate or specialized formulations with reduced sucrose content. In the present study six male non-insulin-dependent diabetes mellitus patients (age range 35-60 years; body-mass index less than 28) consumed test meals of chocolate (75 g) on three separate occasions. The control chocolate contained sucrose (45.5% w/w); the test chocolates contained either fructose (45.5% w/w) or isomalt (45.1% w/w). The latter is a sweet disaccharide alcohol which has no glycaemic effect when consumed as a pure compound. Venous blood samples were obtained at 30 min intervals for 5 h, and analysed for glucose, insulin, lactate and triglycerides. All three chocolates provoked a sustained rise in blood glucose, which reached a maximum at 90 min after ingestion and returned to baseline values by 5 h. The highest blood glucose levels occurred after conventional chocolate, and differences were statistically significant at 60 and 90 min (P less than 0.05). The area under the glycaemic curve for isomalt chocolate was 36% smaller than that for conventional chocolate (P less than 0.05), and there were differences in insulin and lactate levels, consistent with the lower glycaemic effect. The glycaemic response to the fructose-based chocolate was also lower than that to control chocolate but the difference was not significant. All three chocolates led to a similar sustained rise in serum triglyceride levels. Isomalt appears to be a palatable alternative sweetener capable of reducing the glycaemic effect of diabetic confectionary. PMID- 1782929 TI - Multicentre study of the determination of peak oxygen uptake and ventilatory threshold during bicycle exercise in chronic heart failure. Comparison of graphical methods, interobserver variability and influence of the exercise protocol. The VO2 French Study Group. AB - Assessment of the ventilatory threshold (VT) has been proposed to assess exercise tolerance more objectively, particularly in clinical trials, but reproducibility, interobserver variability and feasibility of the graphical methods for determination of VT have not been properly studied in patients with chronic heart failure (CHF). Fifty-one patients with mild to moderate CHF (mean peak oxygen uptake (VO2): 20.5 ml.min-1.kg-1) were assessed during two consecutive bicycle exercise tests within 8 days. Two graded exercise protocols were compared with stages of 30 W every 3 min (22 patients) or 10 W/min (29 patients). VT was determined separately by five trained physicians using five different graphical methods. The 'crossing method' (first crossing of the VCO2 and VO2 curves) yielded the highest rate of determination (88%) but tended to overestimate the mean VT. The VE method (disproportionate increase of ventilation relative to VO2) produced the best interobserver agreement (coefficient of variation = 78%). Peak VO2 was very highly reproducible in both exercise protocols (relative difference 2-test 1/test 1 = -0.32% for the 30 W 3 min protocol; +2.18% for the 10 W.min-1 protocol). The reproducibility of VT was slightly lower regardless of the graphical method used to determine it (relative differences varied from -3.3% to +7.3%). Therefore, peak VO2 appears more suitable than VT for assessment of exercise tolerance in CHF. PMID- 1782930 TI - Myocardial perfusion imaging with positron emission tomography and single photon emission computed tomography: frequency and causes of disparate results. AB - The purpose of this study was to compare rubidium-82 PET with thallium-201 SPECT imaging in 150 patients. Both techniques followed a single dipyridamole-handgrip stress, and images were displayed using the same 3-dimensional format and quantitative colour scale. Coronary arteriography was employed to assign the correct diagnosis in situations of disparity. Results of PET and SPECT were at least partially concordant in 110 patients (73%), although 22 had more than one defect. A reversible perfusion defect was identified in 60 patients, but the scans were concordant in only 20 (33%). These disparities were chiefly due to false-negative SPECT imaging (22 patients, 55%), and probable delayed thallium redistribution (13 patients, 33%). No patients had ischaemia correctly identified by SPECT in the presence of normal PET imaging. Persistent defects were identified in 91 patients, some of whom also had reversible defects, and the results were consistent in 54 (59%). Other than the delayed thallium redistribution group, the major categories causing disparities were false positive (6 patients, 16%), and false negative SPECT (8 patients, 22%), attributable to attenuation and scatter. PET appears able to identify smaller, less ischaemic areas subtended by milder coronary stenoses. The availability of a true resting scan with Rb-PET enhances the discrimination between ischaemia and infarction. Attenuation correction, and the high energy photons of positron annihilation, yield more accurate evaluation of inferior wall defects and greater specificity in the presence of soft tissue attenuation. PMID- 1782931 TI - Independent prognostic value of supraventricular arrhythmias on 24-h ambulatory monitoring following myocardial infarction. AB - To determine the prognostic value of supraventricular arrhythmias, in addition to ventricular arrhythmias and clinical variables after myocardial infarction, 99 consecutive patients had 24-h ambulatory monitoring within 2 weeks of discharge. All patients completed at least 4-year follow-up (mean 56 +/- 6 months). During follow-up there were 29 cardiac events (13 cardiac deaths and 16 reinfarctions). The highest risk was associated with ventricular tachycardia (positive predictive accuracy 100%, negative predictive accuracy 75%, risk ratio 4.0) and supraventricular tachycardia i.e. paroxysmal tachycardia or AV nodal tachycardia (positive predictive accuracy 86%, negative predictive accuracy 80%, risk ratio 4.2). By multivariate analysis, supraventricular tachycardia proved to be an independent predictive variable, in addition to ventricular tachycardia, premature ventricular depolarisations greater than or equal to 10 h-1 and the presence of Killip class greater than or equal to II while in the coronary care unit for future cardiac events. These data suggest that supraventricular tachycardias detected on 24-h ambulatory monitoring shortly after discharge carry a poor prognosis and may indicate a different pathophysiology as compared to ventricular tachycardias. PMID- 1782932 TI - Discontinuous transdermal nitroglycerin as treatment for stable angina in the elderly: a double-blind multicentre study. The Transdermal TNG Trial Group of Istituto Nazionale Ricovero e Cura Anziani (I.N.R.C.A.). AB - A transdermal nitroglycerin (TNG) patch (10 mg.24 h-1), using a daily overnight 8 h free interval, was assessed by means of a multicentre trial in 96 elderly patients with stable angina (age greater than or equal to 65 years). The main entry requirement was a reproducible exercise-induced ST depression (greater than or equal to 1 mm) appearing at a load of 60 to 90 W, during an incremental bicycle ergometer test (10 W.min-1). During the study only one other antianginal drug and sublingual TNG tablets were allowed. The protocol consisted of a run-in period (mean 10 days), followed by a double-blind, randomized, parallel, placebo controlled 28-day phase and a single-blind active treatment phase of the same duration. The exercise test parameters, the number of spontaneous anginal attacks and any unwanted effects were evaluated at the end of every study phase. In the double-blind phase, no ergometric values changed with placebo while transdermal TNG significantly improved total workload and double product by 36.4% and 7.7% at the maximal workload respectively and by 49.8% and 13.5% at the time to onset of 1 mm ST depression respectively and reduced ST depression (-58.8%) at the equivalent baseline workload. Anginal attacks decreased by 61.5% and 30.8% with TNG patch and placebo respectively. A similar trend was seen at the end of the single-blind active treatment period in patients who had received placebo in the double-blind phase. Nine patients failed to complete the study; six for unwanted effects (four in the active group and two in the placebo group) and three for other reasons.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782933 TI - Reduced occurrence of atrial fibrillation in acute myocardial infarction treated with streptokinase. AB - In a historical follow-up study of 152 hospital patients with acute myocardial infarction, the frequency of life-threatening arrhythmias (ventricular fibrillation, sustained ventricular tachycardia, 3rd degree AV-block, 2nd degree AV-block (Mobitz type II), and asystole) and atrial fibrillation in 76 patients treated with streptokinase was compared with their frequency in 76 patients who did not receive a thrombolytic therapy. Among those treated with streptokinase two patients (3%) developed atrial fibrillation, compared with 12 (16%) in the control group (P = 0.009). Life-threatening arrhythmias occurred with equal frequency in the two groups. Further studies should confirm and clarify the mechanism of the reduced frequency of atrial fibrillation in the streptokinase treated patients. PMID- 1782934 TI - Coronary artery thrombosis and thrombolysis in baboons: the effect of atenolol treatment on myocardial infarct size. AB - The effect of the beta-blocker atenolol on experimental infarct size was studied in a non-human primate model. In 12 baboons thrombosis of the left anterior descending coronary artery (LAD) was induced and atenolol (0.1 to 0.2 mg.kg-1 intravenously, sufficient to lower the heart rate by 20%) was administered 10 min after the onset of ischaemia in six animals, whereas the others received placebo. Thrombolysis was induced 60 min after the onset of ischaemia by intravenous injection of rtPA (12 micrograms.kg-1.min-1) in all animals. Heart rate dropped significantly after atenolol injection (128 +/- 9 beats.min-1 versus 163 +/- 15 beats.min-1, P less than 0.001) and was also lower than in the control group (128 +/- 9 beats.min-1 versus 158 +/- 22 beats.min-1, P less than 0.05). Blood pressure remained unchanged after atenolol treatment. As compared to the control group, atenolol limited infarct size, expressed as a percentage of left ventricular mass (4.6 +/- 1.9% versus 7.9 +/- 1.3%, P less than 0.05) or as a percentage of the perfusion area (26 +/- 8% versus 43 +/- 8%, P less than 0.05). PMID- 1782935 TI - Left ventricular function after total correction of tetralogy of Fallot. AB - Conflicting data are available concerning left ventricular (LV) function in patients after total correction of tetralogy of Fallot (TOF). The response to afterload stress determined by methoxamine challenge and the peak systolic blood pressure-end-systolic volume relationship were evaluated echocardiographically in 20 postoperative TOF patients (age range 9 to 15 years, mean 12 +/- 2). All patients were without significant residual shunts or pulmonary stenosis. Results were compared with those in 10 control subjects (age range 9 to 15 years, mean 11 +/- 2). The TOF group had higher mean end-diastolic (76.9 +/- 14.4 vs 66.2 +/- 7.2 ml.m-2 P less than 0.05) and mean end-systolic (36.7 +/- 8.5 vs 29.6 +/- 3.9 ml.m-2, P less than 0.05) volumes than controls. Stroke volume index (SVI) and LV ejection fraction were similar in the two groups. In normal subjects, methoxamine caused a decrease in SVI in seven out of 10 patients and a mild increase in three; the mean value of SVI at rest was not significantly different from the mean value at peak pressor effect (36.5 +/- 4.4 vs 35.9 +/- 4.0 ml.m-2, P = NS). In the TOF group, methoxamine induced a reduction in SVI in all patients; the mean value of SVI at peak pressor effect was significantly lower than the mean value at rest (31.3 +/- 5.4 vs 40.2 +/- 6.9 ml.m-2, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782936 TI - Systolic intra-cavitary gradients following aortic valve replacement: an echo Doppler study. AB - Systolic left ventricular flow was studied by pulsed and continuous wave Doppler in 41 patients following aortic valve replacement for severe stenosis (mean valvular area: 0.58 cm2; range 0.3-0.75 cm2). Maximal left ventricular velocities by continuous wave Doppler study, were higher than 2.5 m.s-1 with a sharp peak at end-systole in five patients in basal condition and in four others after amyl nitrite inhalation. Pulsed Doppler study showed that the high velocities started from the apex or mitral papillary muscle level with a marked chamber narrowing at two-dimensional echography. Only one patient had a systolic anterior motion (SAM) of the anterior mitral leaflet with mitral-septal contact. The left ventricular dimensions, as measured by M-mode echography were compared in the various patient groups. High velocities seemed statistically associated with the smaller systolic and diastolic diameters of the left ventricle and outflow tract and the larger relative thickness of the posterior wall. The highest pressure gradients disappeared after correction of hypovolaemia (one patient), clearance of pericardial effusion (one patient), or beta-blocker treatment (three patients). The present study confirms that left intra-ventricular dynamic gradients can occur after clearance of fixed outflow obstruction, for which Doppler examination is a reliable and innocuous diagnostic means. Haemodynamically, this syndrome resembles hypertrophic obstructive cardiomyopathy, but the scarcity of the systolic anterior motion of the mitral leaflets is suggestive of a different mechanism that could be cavity obliteration or mid-ventricular obstruction. PMID- 1782937 TI - Ventricular conduction defects and atrial fibrillation after coronary artery bypass grafting. Multivariate analysis of preoperative, intraoperative and postoperative variables. AB - Preoperative, intraoperative and postoperative variables, which might play a role in the development of ventricular conduction defects (VCD) and atrial fibrillation (AF) following coronary artery bypass grafting (CABG), were evaluated in 236 consecutive patients. VCD and AF developed postoperatively in 15.5% of patients: 4.5% had VCD (subgroup A), 11.0% had AF (subgroup B). In 84.5% of patients VCD and AF did not occur (subgroup C). Univariate analysis showed statistically significant differences between subgroups A and C with respect to: left main significant stenoses and number of diseased vessels. Bypass pump time and aortic cross-clamp time were significantly longer in subgroup B. Multivariate analysis showed a significantly greater incidence of left main disease and of right coronary artery occlusion associated with significant stenosis of the proximal left anterior descending artery in subgroup A. In subgroup B, the duration of aortic cross-clamp time was significantly higher. Ischaemic injury, with increasing duration of cardioplegic arrest, seems to play a key role in the development of AF. Nonhomogeneous cardioplegic delivery to critical areas of myocardium, and particularly to the specialized conducting system, may cause VCD after CABG. PMID- 1782938 TI - Left ventricular flow from apex to base during systole and isovolumic relaxation in a patient with hypertrophic cardiomyopathy and midventricular obstruction. AB - The occurrence of a left ventricular anterograde flow velocity (maximal: 3.9 m.s 1) is demonstrated in a 32-year-old patient with hypertrophic cardiomyopathy and midventricular obstruction, beginning at early systole and persisting throughout the isovolumic relaxation. Cardiac catheterization with simultaneous dual high fidelity pressure measurements in the apical and basal chambers confirmed the presence of the Doppler maximal instantaneous pressure gradient of 60 mmHg. Contrast left ventricular angiography excluded apical dyskinesia. In the two intracavity compartments, isovolumic relaxation time and the time constant of pressure decay (tau) were abnormal whereby tau was more delayed in the apical than in the basal portion. The presence of an apical high pressure zone during systole with impeded and delayed emptying through the midventricular obstacle and the late onset and prolongation of relaxation are thought to be the cause of the intraventricular flow from apex to base lasting from early systole throughout isovolumic relaxation. PMID- 1782939 TI - Constrictive pericarditis without typical haemodynamic changes as a cause of oedema formation due to protein-losing enteropathy. AB - A 41-year-old man presented with physical signs of leg oedema and a laboratory value of decreased serum albumin of 2.4 g.dl-1. Loss of protein via the gastrointestinal tract was demonstrated by an increased faecal excretion of 51 chromium-labelled-albumin and by elevated stool clearance of alpha 1-antitrypsin. No anatomical lesions or intestinal disease were found to explain this protein loss. Constrictive pericarditis was suspected as the cause of protein-losing enteropathy but could not be confirmed by right heart catheterization, in which normal filling pressures and no sign of 'dip and plateau' pressure pattern were found. However, magnetic resonance imaging clearly demonstrated a thickening of the pericardium over the right heart and a tubular-shaped right ventricle as signs of constrictive pericarditis. Peripheral oedema disappeared and serum protein concentration returned to normal after pericardectomy. This demonstrates that moderate pericardial constriction not resulting in discernible pressure abnormalities in the right heart can be associated with protein-losing enteropathy and thus result in hypoproteinaemic peripheral oedema. In this condition a morphological investigation by magnetic resonance imaging is of importance in order not to miss the diagnosis of a potentially treatable disease. PMID- 1782940 TI - Sudden cardiac death while taking amiodarone therapy: the role of abnormal repolarization. AB - Torsade de pointes may occur as a complication of amiodarone therapy. We report a patient receiving amiodarone who was resuscitated from cardiovascular collapse and documented ventricular fibrillation. At subsequent electrophysiology study, while the patient was taking amiodarone therapy, monophasic action potentials with early after depolarisations were recorded which were not present when the patient was restudied 6 weeks after discontinuation of amiodarone. Early after depolarisations may be important in the genesis of polymorphic ventricular tachycardia complicating amiodarone therapy. PMID- 1782941 TI - Herniation of the left atrial appendage through a congenital partial pericardial defect. AB - We present a case of herniation of the left atrial appendage through a congenital partial absence of the pericardium. The diagnosis was demonstrated by echocardiography and the surgical correction achieved with autologous pericardium. PMID- 1782942 TI - Evaluation of the Reynolds Pathfinder II system for 24 h heart rate variability analysis. AB - Heart rate variability (HRV) in 24-h Holter recordings is normally determined using commercially available Holter equipment. However, short-term speed variations in tape-based Holter systems have not been thoroughly investigated and recommendations for speed control are vague. In this study, overall accuracy and precision of RR interval measurement was assessed for two types of tape recorder replayed on the same Reynolds Pathfinder II system. Artificial QRS complexes spaced at exact intervals were recorded simultaneously by the two recorders. In addition, records of 118 healthy subjects were evaluated for false-positive normal-normal intervals. During replay, digital output from the pathfinder was processed by a locally developed personal computer-based HRV system. Using the recorded crystal generated timing track (TT) for speed control and the TT dependent speed surveyor (SS), set to allow speed errors up to +/- 3.1%, mean RR per 5 min.h-1.24 h-1, for test tapes, corresponded exactly to true RR, for both recorders. Beat-to-beat variation, for 1000 ms test intervals, calculated as standard deviation (SD) and root mean square of successive differences (RMSSD) was 3 ms, 3 ms versus 5 ms, and 8 ms for Oxford and Tracker tapes respectively. No difference between sequential intervals exceeded +/- 10 ms versus +/- 20 ms for Oxford and Tracker respectively. Reproducibility of mean RR and HRV parameters for patient records, expressed as a coefficient of variation, was 0.1 1.7%. False positive normal-normal intervals greater than 2.3 s, due to artifacts, were found in 99 of 118 records, and these increased mean SD and RMSSD values significantly, whereas percent successive RR interval differences greater than 50 ms were unaffected. A crystal generated TT (60/16 Hz) and an SS allowing a maximum error of +/- 3.1%, together correct speed during recording and replay to a degree that is acceptable for HRV analysis. A simple estimate of HRV counts of successive RR interval differences greater than 50 ms is a reliable parameter as it is relatively insensitive to artifact. PMID- 1782943 TI - Cardiopulmonary effects of constant-flow ventilation in experimental myocardial ischaemia. AB - The cardiopulmonary effects of constant-flow ventilation were investigated in dogs with normal heart function (control-phase, n = 14) and after development of acute myocardial ischaemia (ischaemia phase, n = 14). Heated, humidified and oxygen-enriched air was continuously delivered with an inspiratory flow rate of 1.21.kg-1.min-1 via two catheters positioned within each mainstem bronchus. Continuous positive pressure ventilation with a positive end-expiratory pressure of 0.5 kPa (5 cmH2O) was used as a reference. During control, neither continuous positive pressure ventilation nor constant-flow ventilation showed impairment of cardiopulmonary performance. Oxygenation and CO2 removal were more efficiently achieved by continuous positive pressure ventilation (P less than or equal to 0.05). Acute myocardial ischaemia was induced by occlusion of the left anterior descending (LAD) coronary artery; measurements during the ischaemia phase were performed 60 min following LAD occlusion. Myocardial ischaemia resulted in moderate changes of cardiac output, left ventricular end-diastolic pressure and dP/dtmax. Both modes of ventilation were well tolerated in the ischaemia phase, and cardiovascular performance revealed no significant differences between continuous positive pressure ventilation and constant-flow ventilation. Haemodynamic parameters could be more precisely assessed during constant-flow ventilation. Oxygenation deteriorated, but hypoxaemia did not occur in any animal and CO2 elimination remained unchanged. It is concluded that 'non-conventional' ventilation by continuous intrabronchial gas flow maintains adequate gas exchange with no adverse effects on haemodynamics in dogs with acute myocardial ischaemia. Constant-flow ventilation may be advantageous in the experimental setting to study cardiac function without cyclic heart-lung interaction due to airway pressure alterations. PMID- 1782944 TI - Relationship between signal-averaged electrocardiography and dangerous ventricular arrhythmias in patients with left ventricular aneurysm after myocardial infarction. AB - We performed signal-averaged electrocardiography (SAECG) and Holter monitoring, and subsequently followed-up 53 ambulatory patients with left ventricular aneurysm (LVA) after myocardial infarction (MI). A history of spontaneous episodes of sustained ventricular tachycardia (VT) was also analysed. Out of 53 patients, 25 (47%) had an abnormal SAECG. Abnormal SAECG correctly identified nine out of 10 cases with a history of sustained VT. Complex ventricular arrhythmias were detected on Holter monitoring in 23 patients: in five out of 28 with normal SAECG (18%) and in 18 out of 25 with abnormal SAECG (72%) (P less than 0.001). During follow-up (mean 19 months) sustained VT and/or sudden cardiac death (SCD) occurred in eight cases, out of which seven had an abnormal SAECG. The negative predictive value of SAECG (no VT or SCD during follow-up) was very high, 96%, similar to the negative predictive value of a history of sustained VT (93%). Using multivariate analysis only a history of sustained VT was an independent factor in predicting the outcome of patients in this study. We conclude that an abnormal SAECG identifies those post infarction patients with LVA who are prone to complex ventricular arrhythmias. A normal SAECG and an absence of a history of sustained VT strongly indicate that the risk of developing arrhythmic events is very low. PMID- 1782945 TI - The value of the intracoronary electrogram for the early detection of myocardial ischaemia during coronary angioplasty. AB - The clinical value of intracoronary electrography for the detection of myocardia ischaemia was assessed during coronary angioplasty and compared to a standard technique of surface ECG monitoring. In 73 patients undergoing single lesion angioplasty, an intracoronary electrogram and four representative surface ECG leads were obtained. During angioplasty of the left anterior descending artery leads, I, V3, V5, V6 were recorded. For the circumflex artery leads I, aVL, aVF, V6, and for the right coronary artery leads II, III, aVF, V6 were monitored. Eight patients were excluded due to transient intraventricular conduction disturbances during balloon inflation; 65 patients remained for further analysis. Out of a total of 154 balloon inflations (35 in the circumflex, 71 in the left anterior descending and 48 in the right coronary artery), the percentage that produced a greater than or equal to 1 mm ST segment elevation, the time to the appearance of a greater than or equal to 1 mm ST segment elevation and the maximal ST segment elevation were recorded. During inflations in the circumflex artery, the respective values of these three parameters were 20%, 22.6 +/- 11.5 s and 0.37 +/- 0.80 mm in V6, the most sensitive surface lead, versus 70% (P less than 0.001), 14.4 +/- 9.6 s (P less than 0.01) and 5.82 +/- 6.35 mm (P less than 0.0001) on the intracoronary electrogram.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782946 TI - Echocardiographic assessment of myocardial performance after prolonged strenuous exercise. AB - To determine the effect of strenuous prolonged exercise on systolic and diastolic left ventricular function, 11 non-elite marathon runners aged 37 +/- 7 years (mean +/- SD) were studied before and during early recovery from a marathon race. Cavity dimensions, wall thickness, and fractional shortening were computed from two-dimensionally guided M-mode echocardiograms. Doppler left ventricular inflow tract recordings were analysed for peak early and late velocities and their ratio. In seven subjects, heart frequency was recorded throughout the race. These subjects ran the marathon at 87 +/- 4% of their maximal heart rate. Left ventricular diastolic dimension was slightly reduced at the end of the race (49.4 +/- 4.2 mm to 47.3 +/- 5.1 mm; P less than 0.05). Fractional shortening remained unchanged, although blood pressure (P less than 0.001) and systolic wall stress (P less than 0.01) were decreased. The left ventricular filling pattern was unchanged, and the ratio of early to late velocities remained constant. These results suggest that the fractional shortening was a result of the opposing effects of changes in preload and afterload. However, the absence of a change in the end systolic dimension, despite a marked reduction in afterload and the occurrence of septal akinesia in one subject after the race could only suggest that strenuous prolonged exercise may alter myocardial performance. PMID- 1782947 TI - Cardiac function and maximal exercise capacity early after acute myocardial infarction. AB - The purpose of the study was to assess the relationship between left and right ventricular function measured at rest and maximal exercise capacity in patients with recent acute myocardial infarction (AMI). Forty-three male patients (Killip Class I, n = 36; Killip Class II, n = 7) with a wide range of left ventricular (LV) function and size underwent graded bicycle exercise testing less than 4 weeks after AMI (mean 21 days, 17-27). None of the patients had exercise limiting factors other than dyspnoea and fatigue. Left and right ventricular ejection fractions were determined by a radionuclide ventriculographic method which also allowed determination of absolute LV volumes and actual LV peak filling rate. LV ejection fraction had a weak association to estimated maximal oxygen uptake (VO2 max) (r = 0.37). No association was found between LV size, LV stroke volume, or LV peak filling rate and estimated VO2 max. Similarly, right ventricular ejection fraction showed no correlation to estimated VO2 max. Patients with well preserved LV function had a higher exercise induced increase in systolic blood pressure than patients with reduced LV function, but the increase in systolic blood pressure could not be used to estimate LV function with any reasonable accuracy. We conclude that the maximal exercise capacity of patients with recent AMI is virtually independent of their left and right ventricular function determined at rest, and that exercise testing and radionuclide ventriculography should be regarded as complementary procedures in the evaluation of patients with AMI. PMID- 1782948 TI - Exercise induced increase in diastolic blood pressure. Is it an indicator of coronary artery disease? AB - It has been previously reported that an increase in diastolic blood pressure greater than 15 mmHg comparing values at rest with those on treadmill exercise, with or without ST changes, enhances the probability of coronary artery disease. To investigate whether the diastolic blood pressure variation keeps its diagnostic value during upright bicycle exercise, we evaluated the diastolic blood pressure variations in 111 patients with angiographically documented coronary artery disease without previous myocardial infarction and in 53 patients with normal coronary arteries undergoing maximal stress testing on a bicycle ergometer. The sensitivity of diastolic blood pressure (DBP) variations to detect coronary artery disease was 66%, the specificity 32%, the positive predictive value 67%, the negative predictive value 31% and the predictive accuracy 55%. The respective values for ST depression were 83% (P less than 0.001 vs DBP variations), 53% (P less than 0.05 vs DBP variations), 64% (P less than 0.05 vs DBP variations) and 75% (P less than 0.001 vs DBP variations). Forty-nine of the 75 patients with multivessel coronary artery disease and 60 of the 89 patients without coronary artery disease or with single vessel disease had abnormal DBP variations (sensitivity 65; specificity 33%). The sensitivity of ST segment depression in predicting multivessel disease was 91% (P less than 0.001 vs DBP variations), and the specificity 42%. Thus, for bicycle ergometer exercise testing, ST segment depression seems to be more accurate than DBP variations in the diagnosis of coronary artery disease. PMID- 1782949 TI - Dobutamine stress test to diagnose the presence and severity of coronary artery lesions in angina. AB - To calculate the accuracy of dobutamine infusion as a stress test to detect coronary lesions, 90 patients with angina and nine asymptomatic subjects with nonsignificant coronary lesions were submitted to a dobutamine test and coronary arteriography. Dobutamine was given in doses of 5, 10, 15 and 20 micrograms kg-1 min-1 every 5 min; a 12 lead ECG and blood pressure was monitored. Pressure x rate product increased from 8240 +/- 1667 to 14,898 +/- 3042. The test was negative (neither angina pain, nor ST segment shift) in 31 patients, and positive in 68. The ST segment was depressed in 33 cases and elevated in 20. Significant (greater than or equal to 50%) coronary lesions were seen in 63 patients and functional (coronary spasm or vasoconstriction) abnormalities in six. The sensitivity of the dobutamine test for the detection of coronary lesions was 95%, specificity 78%, predictive value of a positive test 88%, of a negative test 90% and diagnostic efficiency 89%. Strongly positive tests predicted severe lesions in 91% of the cases, and slightly positive tests ruled out severe lesions in 84%. ST segment elevation was induced in 20 cases and corresponded to a severe coronary lesion. In conclusion, the dobutamine stress test is a simple and accurate method of predicting coronary artery disease in patients with angina, distinguishing between severe and mild lesions. It can be a good alternative to an exercise test. PMID- 1782950 TI - Experience of percutaneous transluminal coronary angioplasty in orthotopic cardiac transplant recipients. AB - We evaluated the role of percutaneous transluminal coronary angioplasty (PTCA) in a series of orthotopic cardiac transplant recipients with severe epicardial coronary occlusive disease. Ten orthotopic cardiac transplant patients treated by PTCA up to March 1990 were reviewed. All had significant epicardial coronary artery lesions (greater than 70% stenosis compared with the adjacent healthy artery) and exercise electrocardiogram or isotope perfusion evidence of myocardial ischaemia in the relevant region. Primary angiographic PTCA success was achieved in 12 of the 16 lesions attempted (75%). Mean stenosis improvement was from 80% of adjacent healthy artery (range 70-90%) to 12% (range 0-20%). Median angiographic follow-up of 9 months (2-25 months) is available for all patients. The mean recurrence rate is 33% (4 of 12 successfully treated lesions) defined as greater than 50% reduction in the original gain at the PTCA. We have shown that PTCA is technically possible in a series of cardiac transplant recipients. The primary success and recurrence rates are comparable to the use of PTCA in conventional atherosclerotic coronary disease. PMID- 1782951 TI - Tissue plasminogen activator in refractory unstable angina. A randomized double blind placebo-controlled trial in patients with refractory unstable angina and subsequent angioplasty. AB - To evaluate the effect of recombinant tissue plasminogen activator (alteplase) on the clinical course, angiographic changes and the outcome of subsequent coronary angioplasty, 36 patients with angina at rest, despite bedrest and medical treatment including heparin, and with concomitant ECG changes, were studied. After diagnostic angiography, patients were randomized to receive either alteplase 100 mg in 3 h (19 patients), or placebo (17 patients). The mean interval between qualifying anginal episode and initial angiography was 10 and 9 h for the alteplase and placebo group, respectively. Angiography was repeated and angioplasty was performed within 24 hours. Between the first and the second angiogram, five patients in the alteplase and seven in the placebo group had recurrent ischaemic episodes, while four alteplase and three placebo patients showed signs of myocardial necrosis (creatine kinase (CK) rise greater than or equal to twice the upper limit for normal). Intracoronary clots were recognized in three alteplase patients and one placebo patient at the first angiogram, while two alteplase patients and one placebo patient showed total occlusion of the ischaemic-related vessel. After infusion, thrombi were present in four alteplase patients and one placebo patient, and total occlusion in three alteplase patients and one placebo patient. Quantitative coronary angiography showed no change in the percentage diameter stenosis of the ischaemia-related segment after drug infusion, (alteplase 67 +/- 16 to 69 +/- 16%; placebo 65 +/- 11 to 63 +/- 12%). Angioplasty was successful in 14 of 19 alteplase and 14 of 16 placebo patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1782952 TI - Magnesium substitution in acute ischaemic heart syndromes. AB - It has recently been suggested that intravenous infusion of magnesium may reduce mortality and the incidence of serious arrhythmias in patients with ischaemic heart disease and acute myocardial infarction. In the present double-blind, placebo-controlled study, 298 patients with suspected acute myocardial infarction were randomized to receive either intravenous magnesium chloride (80 mmol.24 h-1) or placebo. Infusions were started immediately after admission to the coronary care unit. One hundred and fifty patients received magnesium and 148 the placebo. Ischaemic heart disease was diagnosed in 244 patients. Acute myocardial infarction was observed among 83 patients in the magnesium group and 79 in the placebo group. Both treatment groups were comparable regarding sex, age, clinical status, previous cardiac disease and medication. Serum magnesium was significantly raised during magnesium infusion compared to placebo (P less than 0.01). Fatal events were only observed among patients with myocardial infarction, but neither the in-hospital mortality (magnesium: 12.1%; placebo 10.1%) nor the mortality after a follow-up period of 245 days (median observation time) was affected by magnesium substitution. Magnesium infusion was accompanied by a significantly increased incidence of atrioventricular conduction disturbances. The results suggest that patients suffering from acute ischaemic heart syndromes do not benefit from intravenous magnesium supplementation. PMID- 1782953 TI - Oral contraceptives, sex steroid-induced antibodies and vascular thrombosis: results from 1318 cases. AB - The role of antiethinyl estradiol antibodies (anti EE Ab) and associated risk factors was evaluated in 1318 cases of venous or arterial thrombosis in oral contraceptives (OC) users, and compared to 61 non-users and 124 healthy current users. Anti EE Ab were absent in non-users and present in 33% of healthy users and 72% of those with thrombosis, either arterial or venous. Age, duration of use, hyperlipidaemia and smoking were factors associated with thrombosis only in women with an arterial disease. While the two predominant factors, anti EE Ab and smoking may be risk factors in their own right, the combination of both was found in 47.7% of women with thrombosis. It is proposed that thrombosis associated with OC use may be explained by an immunological disease in which anti EE Ab and their complexes with the circulating synthetic hormones may be harmful to the vessels, as also suggested by the type of lesions already described in OC users. The determination of anti EE Ab in healthy users may identify a group at risk of thrombosis. PMID- 1782954 TI - Hypercoagulable state and thromboembolism following warfarin withdrawal in post myocardial-infarction patients. AB - Nine out of 47 (19%) patients on chronic anticoagulation with warfarin, as secondary prophylaxis after myocardial infarction, initially treated with streptokinase, had thromboembolic complications within 4 weeks after sudden (7/25) or gradual (2/22:NS) warfarin withdrawal. The biochemical effects of warfarin withdrawal were repeatedly studied in 20 of the patients during the first 14 days following drug cessation. During the first 4 days, the levels of coagulation factors VII and IX increased more rapidly than proteins C and S. Thus, a gap was created between the factors provoking and inhibiting the coagulation process. Furthermore, plasma concentrations of fibrinopeptide A (FPA) increased, reflecting activation of the coagulation system. These laboratory findings suggest that withdrawal of warfarin creates a transient hypercoagulable state, imposing a risk of thromboembolic events in patients given anticoagulant treatment as secondary prophylaxis following myocardial infarction. PMID- 1782955 TI - Chemical ablation by subendocardial injection of ethanol via catheter- preliminary results in the pig heart. AB - This study was set up to discover how a subendocardial application of ethanol administered via a catheter would affect an animal model. A 7 F bipolar catheter with a lumen, through which a 2 mm needle was inserted, was placed in the left ventricle of 11 pigs. Altogether, 33 subendocardial injections into the left ventricular myocardium were performed under fluoroscopic control using a mixture of 0.5-1.5 ml ethanol and 0.5-1 ml iopamidol as contrast medium. The mixtures were injected into the apical, lateral and septal walls of the left ventricle. After 25 days, the hearts were removed and the lesions examined pathologically. The calculated volume of the lesions was about 60 mm3, the area in projection to the endocardium about 35 mm2, the depth relative to the endocardium about 1.5 mm and the maximum diameter about 8 mm. Perforation of the myocardial wall by pericardial injection occurred twice without further complications. Subendocardial application of concentrated ethanol by catheter caused a controlled local necrosis. This technique may become a new approach with which to treat ventricular tachycardia by chemical ablation. PMID- 1782957 TI - Hypertrophic cardiomyopathy: is a left ventricular outflow tract gradient a major prognostic determinant? PMID- 1782956 TI - Right ventricular dilated cardiomyopathy associated with primary biliary cirrhosis. AB - A case of right ventricular dilated cardiomyopathy associated with primary biliary cirrhosis is described. The patient was a middle aged woman, who initially complained of fatigue and itching. The diagnosis of primary biliary cirrhosis was made based on clinical, biochemical and histological evidence of the disease. Seven years later severe right-sided heart failure developed. The diagnosis of right ventricular dilated cardiomyopathy was made based on echocardiographic and angiographic evidence of a globally dilated and poorly contracting right ventricle. Left ventricular function was within normal limits. Autoimmune serology screening at this time revealed the presence of organ specific cardiac antibody (titre 1/20) and of antinuclear antibody (titre 1/80) by indirect immunofluorescence. There were no findings of mitochondrial antibody or other non-organ specific or organ-specific antibodies. Overall, this assessment demonstrates autoimmunity in both hepatic and heart muscle disease in a patient with primary biliary cirrhosis and right ventricular dilated cardiomyopathy. PMID- 1782958 TI - The validity of the common symptoms and signs for the clinical diagnosis of heart failure (HF) in patients in whom a previously unrecognized heart failure was suspected. PMID- 1782959 TI - Effect of antioxidant therapy on cyclooxygenase-derived eicosanoid release during intestinal ischemia-reperfusion. AB - Conflicting data have been reported on the relationship between reactive oxygen intermediates and the formation of oxygenase-derived eicosanoids. Plasma levels of prostacyclin (PGI2, measured as the stable metabolite 6-keto-PGF1 alpha) and thromboxane A2 (TxA2, measured as TxB2) in the effluent blood of a canine ileal segment were determined following 1 or 2 h of ischemia. The synthesis of both eicosanoids was significantly stimulated during reperfusion, but extension of the ischemic interval from 60 to 120 min was not followed by a further increase. The role of oxidants potentially involved in the process was investigated by using materials that inactivate the xanthine-oxidase-generated intermediates. Previous studies on the same in vivo animal model had demonstrated the effectiveness of antioxidant therapy in reducing the postischemic histamine release. There was no significant alteration in the amount of eicosanoids synthesized following oral allopurinol, catalase, dimethylsulfoxide, mannitol or desferrioxamine treatment. Intravenously administered allopurinol, however, significantly elevated the postischemic 6-keto-PGF1 alpha/TxB2 ratio. The results suggest that these antioxidants at doses inhibitory to histamine liberation are not effective in influencing the postischemic eicosanoid release. Intravenously administered allopurinol could exert a potentially beneficial effect through a mechanism other than the blockade of xanthine oxidase. PMID- 1782960 TI - Reoxygenation injury following anoxic perfusion preferentially impairs bile acid independent bile flow. AB - We perfused isolated rat livers with Krebs-Ringer buffer, with no recirculation. Bile flow virtually stopped during 30 min of anoxia and resumed following reoxygenation to reach a plateau of 44% of the control level. When taurodehydrocholic acid (TDHC, 50 nmol/min/g liver) was administered during reoxygenation, bile flow increased three-fold (16.1 +/- 1.3 to 45.3 +/- 6.3 microliters/g liver). The increase in bile output with TDHC was 27.8 microliters/g liver, which was 89% of the control output. Bile acid output during this period was 1.4 mumol/g liver, which was 93% of the control level. Addition of allopurinol (50 nmol/min/g liver) without TDHC increased bile flow significantly (16.1 +/- 1.3 to 21.3 +/- 1.2 microliters/g liver), but the change was not significant when allopurinol and TDHC were given. The addition of allopurinol also reduced the cumulative release of lactate dehydrogenase from the liver during the reoxygenation period, but had no effect on hepatic adenosine triphosphate levels. Our data suggest that the bile acid-independent bile flow is sensitive to reoxygenation injury following anoxia whereas bile acid output and bile acid-dependent bile flow are resistant. PMID- 1782961 TI - In vivo fluorescence microscopy for quantitative analysis of the hepatic microcirculation in hamsters and rats. AB - Using intravital fluorescence microscopy and epi-illumination, the hepatic microcirculatory system of Syrian golden hamsters was analyzed, and the morphology and microhemodynamics were compared to those of rats. After contrast enhancement with 1 mumol/kg acridine orange i.v., the epi-illumination technique allows for visualization of capillary sinusoids and postsinusoidal venules, which are running in parallel with the liver surface, while afferent microvessels could be visualized in only few of the liver lobules investigated. In rat livers, the capillary sinusoids showed morphology similar to that of hamsters, however, postsinusoidal venules could frequently not be observed when applying epi illumination, since these microvessels are piercing perpendicularly into the depth of the liver tissue. Microhemodynamic analysis, including the sinusoidal perfusion rate, sinusoidal red blood cell velocity and diameters, microvascular white blood cell (WBC) count and the phenomenon of WBC-endothelium interaction, as well as the hepatocellular uptake of the fluorescent compound acridine orange were found to be similar in hamsters as compared to rats. Although transillumination for in vivo microscopy may have the potential to visualize the complete hepatic microcirculatory system due to an increased focus depth, the epi illumination technique has the advantage for quantitative assessment not only of the morphology of the hepatic microcirculatory system and microvascular blood perfusion, but also allows for evaluation of cellular phenomena within the hepatic microvessels, such as WBC accumulation, WBC-endothelium interaction, phagocytotic activity of Kupffer cells, and hepatocellular transport of fluorescent compounds. Hepatic microcircular disturbances, including accumulation of WBCs and WBC-endothelium interaction are causative in the development of organ failure in conditions such as hemorrhagic and septic shock, and, in particular, postischemic reperfusion injury following liver surgery and liver transplantation. Since accumulation of WBCs and their interaction with the microvascular endothelium are primarily found in postsinusoidal venules, in vivo microscopy of the hamster liver represents a favorable model for studies on cellular phenomena within the hepatic microcirculation. PMID- 1782963 TI - Effect of hepatic artery or portal vein occlusion on liver tumour blood flow. AB - To study the blood flow in normal liver tissue and in liver malignancies after occlusion of the hepatic artery or the portal vein, an adenocarcinoma was inoculated in the left liver lobe of 10 rats. Eight days postoperatively, blood flow in normal hepatic tissue and tumour was estimated by laser Doppler flowmetry (LDF). In both normal tissue and tumour, occlusion of the hepatic artery reduced LDF values by approximately 30%, whereas occlusion of the portal vein reduced LDF values by approximately 70%. These findings indicate that changes of hepatic blood flow can be monitored by LDF, and that the portal blood flow is dominating also in liver metastasis. PMID- 1782962 TI - Hepatic vascular exclusion as a model for complete and stable hepatic ischemia in dogs. AB - In order to confirm a complete ischemia model, 1-hour warm hepatic ischemia by hepatic vascular exclusion (HVE) was studied in dogs, in comparison with that by inflow occlusion (IOC) only. The splanchnic venous bed and/or infrahepatic inferior vena cava were decompressed by a centripetal pump-driven venovenous bypass. Indocyanine green retention test revealed no hepatic blood flow in the HVE model during ischemia, while hepatic blood perfusion was still present in the IOC model. All 5 of the IOC dogs survived more than 7 days after revascularization, while 4 of the 5 HVE dogs died within 9 h. After the induction of hepatic ischemia, lactate increased in both HVE and IOC dogs. After revascularization, transaminases and guanase were elevated, the arterial ketone body ratio (acetoacetate/3-hydroxybutyrate) decreased and the serum lactate accumulated more in HVE dogs than in IOC dogs. The hepatic redox state of IOC dogs was significantly decreased by additional clamping of the inferior vena cava. It is concluded that the HVE model with a pump-driven active bypass provides complete and stable hepatic ischemia, resulting in greater deterioration of hepatic cellular functions; hence it is more suitable as a model of complete hepatic ischemia than the IOC one. PMID- 1782964 TI - Temporary portal vein arterialization as an attractive option in canine orthotopic partial liver transplantation. AB - We performed 22 canine orthotopic partial liver transplantations (PLTs) with three different revascularization methods; portal vein arterialization (PVA group, n = 11), hepatic arterial shunt (HAS group, n = 5), and conventional portal vein reperfusion (control group, n = 6). Our purpose was to evaluate the feasibility of PVA as a revascularization technique in PLT assessing the changes in arterial ketone body ratio (KBR) as an index of hepatic energy status. After the first anastomosis (left hepatic vein), the ischemic partial liver graft was revascularized with arterial blood flow shunted from the external iliac artery to the hepatic side of the portal vein (PVA group) or the proper hepatic artery (HAS group). Both anhepatic period and ischemia time were significantly shortened in groups PVA and HAS as compared with those in control. In the PVA group, 10 out of 11 recipients survived for at least 5 days (14.2 +/- 3.8 days, mean +/- SEM), while 3 out of 5 (5.2 +/- 1.0) survived in the HAS group and 4 out of 6 (6.2 +/- 1.3) in the controls. Although portal blood flow during PVA was only about 25% of the total hepatic blood flow at preclamping, the KBR was rapidly restored after PVA and showed almost the same values at preclamping. The KBR values during the arterialization time and initial velocity of KBR recovery in the PVA group were significantly higher than those in the HAS and control groups. These results suggest that PVA presents an attractive option in PLT. PMID- 1782965 TI - Renal function derangements induced by portacaval anastomosis in normal rats. AB - The purpose of this study was to determine the renal function derangements that portacaval shunting caused in previously normal rats. Eight rats suffered a surgical portacaval shunt (PCS) and another 8 a sham operation (SHAM). Renal function was investigated by determining urinary volume, sodium, potassium, creatinine and aldosterone excretion, in basal conditions and after sodium overload. Plasma renin concentration and urinary excretion of PGE2, 6-keto-PGF1 alpha and TXB2 were also determined in basal conditions. PCS rats showed increased urinary volume, creatinine excretion and endogenous creatinine clearance, either in basal conditions or after sodium load. After the latter, PCS animals also showed sodium retention and hyperaldosteronuria. PCS caused in basal conditions a striking diminution in urinary excretion of all prostaglandins and no changes in plasma renin. In conclusion, PCS in the normal rat caused a renal dysfunction consisting of polyuria, possibly related to ADH disfunction and an inability to manage a sodium load. PMID- 1782966 TI - Small bowel transplantation in the rat: impact of various immunosuppressive regimens on graft-versus-host reaction. AB - The effect of ciclosporin (CS) and methotrexate (MTX) on the development of graft versus-host (GvH) disease was examined after small bowel allotransplantation in the rat. The drugs were tested either alone or in combination. Lewis small bowel allografts were transplantated into Brown Norway recipients in a heterotopic position. The native small bowel, spleen, liver, skin, mesenteric lymph nodes and the kidney of the recipients were examined histologically 5, 10 and 20 days after allotransplantation. Intraepithelial lymphocyte numbers were determined quantitatively in the native small bowel. The relative spleen weight of the host was determined after sacrifice for estimation of the severity of GvH disease. Grade I GvH reaction of the native small bowel occurred in the animals without immunosuppression, but graft rejection predominated in this group. Treatment with CS was effective in the early postoperative periods; after 10 and 20 days GvH lesions in the native small bowel were comparable to those observed in the allogeneic combinations. MTX had a detrimental effect on the allografts and the GvH reaction was augmented. When CS and MTX were combined, GvH lesions were comparable to those in the animals treated solely with CS. Animals, however, suffered from heavy side effects. The spleen, liver, lymph nodes and kidney exhibited only unspecific histologic changes, which could not unequivocally be recognized as a GvH reaction. This was true for all groups. As a conclusion it can be said that GvH reaction occurs in the early postoperative period in a fully allogeneic model and cannot be prevented by CS in the dosae used. MTX was not seen to be of any value in this regard. PMID- 1782967 TI - Failure of secretin to increase sodium taurocholate-induced pancreatic necrosis in alcoholic rats. AB - Recently we indicated that pancreatic secretory stimulation with pancreozymin superimposed on chronic alcohol intake increases the tissue necrosis in rat pancreas caused by intraductal bile salt administration, and proposed a new theory of the pathogenesis of acute alcoholic pancreatitis. The purpose of the present work was to study whether secretin and alcohol have a similar damage expanding coeffect in this experimental model of acute pancreatitis. Though secretin treatment seemed to increase the pancreatic necrosis slightly in both alcoholic animals (four groups, n = 5 in each group) and control animals (four groups, n = 5 in each group), no difference was found in the amount of tissue necrosis between alcohol-treated and control animals after secretin treatment and intraductal taurocholate. The mean percentages of necrosis in pancreatic parenchyma were 21.7, 16.1 and 16.3% in alcoholic groups and 15.9, 19.9 and 17.6% in control groups, when secretin was given 15, 45 and 90 min before sodium taurocholate. When preceding secretin stimulation was not given, the mean percentage of necrosis caused by taurocholate was 13.3% in alcoholic animals and 12.0% in control animals. Taken together with our earlier studies the results suggest that the synergism between chronic alcohol intake and pancreozymin formerly reported is neither due to a different response of alcoholic animals from that of control animals to increased flow of pancreatic juice during taurocholate-induced experimental acute pancreatitis nor caused by malnutrition often associated with chronic alcoholism. These results give indirectly further support to the theory that alcohol-induced alterations in the pancreozymin pathway, particularly, may play a crucial role in the pathogenesis of acute alcoholic pancreatitis. PMID- 1782968 TI - Platelet aggregability and prostacyclin/thromboxane A2 ratio after endoscopic injection sclerotherapy with different sclerosants. AB - Platelet aggregability and coagulative and fibrinolytic systems were analyzed with regard to positive effects and for side effects of 5% ethanolamine oleate (EO) versus 5% sodium morrhuate (SM) used for endoscopic injection sclerotherapy (EIS). Twelve patients each were treated with each sclerosant. There was a temporary activation of coagulative and fibrinolytic systems within 1 h in both groups. Platelet aggregability was significantly suppressed to 78.6 +/- 8.9% of that before EIS in the EO group, but was activated to 110.0 +/- 10.5% in the SM group at 1 h after EIS. The ratio of concentrations of prostacyclin (PGI2) to thromboxane A2 (TXA2) increased in the EO group and decreased in the SM group after EIS. The clinical effect in the SM group after the initial session was weaker than that in the EO group with regard to endoscopic findings at the second session. As change in platelet aggregability after EIS is apparently induced by alterations in the ratio of PGI2/TXA2, there would be related effects concerning the sclerosants. PMID- 1782969 TI - Diathermy-induced inflammation does not affect suture holding capacity of intestinal anastomoses. AB - We compared the suture holding capacity of rat intestinal anastomoses after division of the bowel with scissors or diathermy. Two sets of experiments differing in suture technique were done. In one set the amount and solubility of anastomotic collagen were measured, and neutrophil accumulation quantified with a myeloperoxidase (MPO) assay. MPO activity 24 h after surgery was 60% higher (p less than 0.05) after division with diathermy than after division with scissors. Suture holding capacity (breaking strength) decreased by approximately 70% (p less than 0.001) in both groups when sutures were inserted near the bowel edges, while no decrease was noted when sutures were inserted at a farther distance, regardless of the mode of bowel division. After 7 days MPO levels approached baseline values in both groups and the bowel always ruptured outside the anastomosis. Collagen content was not adversely affected by diathermy. Although the reduction in early anastomotic strength may be mediated by local neutrophil activity, suture holding capacity was not influenced by the increased neutrophil accumulation elicited by diathermy. PMID- 1782970 TI - Effect of sodium D-3-hydroxybutyrate on amino acidemia in hemorrhagic hypotension. AB - The effect of sodium D-3-hydroxybutyrate (3-OHB) on the amino acidemia caused by hemorrhagic stress was studied. Rats were infused 3-OHB (3-OHB group, n = 11) at a rate of 30 mumol/min.kg or the same volume of saline (control group, n = 11) for 1 h prior to hemorrhage. Mean arterial pressure was maintained at 40 mm Hg using reserved bottle for 30 min. While ketosis was suppressed in control group, plasma ketone body concentration increased from 2,062.9 +/- 223.7 to 3,151.4 +/- 794.8 mumol/l in the 3-OHB group during hemorrhage. Although significant difference in plasma concentrations of amino acids were not shown between two groups at the onset of shock, it was shown after 30 min of shock in alanine, proline, and threonine. Particularly severity of hyperalaninemia was clear. In the control group plasma alanine concentration increased as shock proceeded (p less than 0.01), and no significant change was shown in the 3-OHB group. These results indicate that pretreatment with 3-OHB suppress the hyperalaninemia seen in hemorrhagic hypotension. Ketone body administration may inhibit the protein catabolism in stressed states, such as hemorrhagic hypotension. PMID- 1782971 TI - The assessment of the systemic effects of inhaled glucocorticosteroids. The effects of inhaled budesonide vs oral prednisolone on calcium metabolism. AB - In a randomized, double-blind crossover study, the effects of 0.8, 1.6 and 3.2 mg/day inhaled budesonide and 5, 10 and 20 mg/day oral prednisolone on mineral metabolism were compared. Twelve healthy subjects (4 m, 8 f) were treated for 1 week at each dosage level, the graduated dosages being given in ascending order. Budesonide and prednisolone were given twice daily and once daily, respectively, which reflects the schedules common in clinical practice. Serum calcium and the regulatory hormones of calcium metabolism (parathyroid hormone, vitamin D metabolites and calcitonin) were not changed either by prednisolone or budesonide. Prednisolone significantly increased 24 h and 08.00 h fasting urinary calcium excretion and decreased renal calcium reabsorption, while budesonide had little or no effect on urinary calcium loss and increased renal reabsorption at the highest dose level. Both drugs significantly increased renal phosphate reabsorption and serum phosphate levels, but prednisolone caused greater increases than budesonide. In conclusion, during short-term treatment with the dosages used, inhaled budesonide had less effect on calcium and phosphate metabolism than oral prednisolone, and so it may have a lesser action on the skeleton of the type contributing to osteoporosis during long-term treatment. PMID- 1782972 TI - Transdermal fentanyl for the treatment of pain after major urological operations. A randomized double-blind comparison with placebo using intravenous patient controlled analgesia. AB - Transdermal fentanyl 75 micrograms/h (Fentanyl-TTS) was compared with placebo in a randomized double-blind study in the early postoperative period, using 50 patients recovering from major urological operations. Analgesic efficacy was individually titrated with intravenous fentanyl by means of a PCA pump (demand dose 34 micrograms, lockout time 5 min). The test systems were applied 8 h before anaesthesia and were left in situ for 24 h. During the PCA period (18.2 h) patients with Fentanyl-TTS required significantly less additional fentanyl (0.48 vs 0.93 micrograms.kg-1.h-1) and reported less pain than patients in the placebo group. Patient acceptance was high in both groups. Side-effects were of only minor intensity and did not differ between the two groups. In particular, there was no case of clinically relevant respiratory depression. PMID- 1782973 TI - Impact of environmental and genetic factors on codeine analgesia. AB - The polymorphic cytochrome P-450 DB1 (P-450 IID6) is responsible for the O demethylation of codeine to morphine by human liver microsomes. The influence of P-450 DB1 variable activity on the bioactivation of codeine in vivo to morphine and on its analgesic effect was investigated in phenotyped healthy volunteers--7 extensive [EM] and 1 poor [PM] metabolizer of debrisoquine. After pretreatment with oral placebo or quinidine sulphate 50 mg, codeine phosphate 100 mg or placebo were administered orally according to a double-blind randomized crossover design. In EM subjects the plasma morphine Cmax was 17.9 nmol/l, whereas virtually no morphine was detectable after quinidine pretreatment (1.5 nmol/l), and in the PM subject (0.60 nmol/l). In EM codeine significantly increased subjective (VAS) and objective (R-III reflex) pain thresholds in response to selective transcutaneous nerve stimulation, whereas no significant analgesia was detected after placebo, or after codeine with quinidine pretreatment, or in the PM. In PM of genetic origin, or due to environmental alteration of the phenotypic expression (i.e. drug interaction), codeine is not activated into morphine and is an inefficient analgesic. PMID- 1782974 TI - Consumption of analgesics and anti-inflammatory drugs in the nordic countries between 1978-1988. AB - Comparative wholesale statistics from the five Nordic countries show an increase of 15-42% in the total consumption of analgesics and anti-inflammatory drugs (including antirheumatics) in the period 1978-1988. Denmark had the highest total consumption (112 DDD/1000 inhab/day in 1988) and Norway had the lowest (61 DDD/1000 inhab/day). Iceland and Finland, with the highest increases in total consumption (45% and 35%), overtook Norway in the early to mid 1980's. Division of total consumption into subgroups showed that Denmark had the highest consumption of analgesics (90 DDDs) and that Finland and Iceland had the lowest figure. The latter countries, however, had the highest consumption of nonsteroidal anti-inflammatory drugs (NSAID), 35 and 30 DDDs, respectively, in 1988. The increase in NSAID consumption was 57% in Finland and 54% in Iceland, while Denmark had only an 18% increase. The new NSAIDs introduced in the 1970's appear to have increased the overall consumption of pain relievers in the Nordic countries, especially in Finland and Iceland. PMID- 1782975 TI - The disposition of paracetamol and the accumulation of its glucuronide and sulphate conjugates during multiple dosing in patients with chronic renal failure. AB - We have compared the disposition of oral paracetamol (1.0 g t.d.s. for 10 days) in 6 healthy volunteers and 6 conservatively-managed patients with chronic renal failure (mean plasma creatinine 451 mumol.l-1). Blood was sampled daily for 10 days before the morning dose of paracetamol. Each day the pretreatment plasma concentrations of paracetamol were higher in the renal failure patients than in the volunteers, with mean values over the 10 days of 3.1 and 1.1 mg.l-1 respectively. The mean daily plasma concentrations of the sulphate and glucuronide conjugates of paracetamol were markedly higher in the renal failure group and apparent steady-state concentrations of about 25 and 85 mg.l-1 were reached on the 2nd and 6th days respectively. The mean steady-state plasma concentrations of the glucuronide conjugate on the 7th to 10th days of treatment were positively correlated with the plasma creatinine concentration (r = 0.97), but this relationship did not hold for the sulphate conjugate. Cysteine and mercapturate conjugates could only be detected in one patient. Predictions of steady-state concentrations based on previous studies with single doses of paracetamol in renal failure patients were remarkably accurate for the glucuronide but not for the sulphate conjugate. These results are consistent with some extra-renal elimination of retained paracetamol conjugates in patients with chronic renal failure, with limited regeneration of the parent compound. The sulphate metabolite did not accumulate as predicted, possibly because of depletion of inorganic sulphate. PMID- 1782977 TI - Buccal versus intravenous nitroglycerin in unstable angina pectoris. AB - The clinical syndrome of unstable angina includes patients with the first onset of angina, change in a previous stable pattern or the development of chest pain at rest. Administration of intravenous nitroglycerin is established therapy in unstable angina. Buccal nitroglycerin has been introduced as an alternative means of administering nitroglycerin, which provides relief of anginal pain within 2 to 3 min and a sustained effect for 3 to 5 h. Twenty-nine patients admitted to the coronary care unit due to unstable angina were randomized to receive treatment with nitroglycerin i.v. for 24 h or buccal nitroglycerin every 4 h. Therapy was titrated according to haemodynamic effects. The mean dose of buccal nitroglycerin was 4.42 mg versus 0.45 micrograms.kg-1.min-1 in the intravenous group. The efficacy of treatment was similar in the two groups. Buccal nitroglycerin appeared to cause fewer adverse effects, especially less haemodynamic intolerance and headache, although the differences were not significant. Repeated administration of buccal nitroglycerin appears to be a safe and well tolerated alternative to high-dose i.v. nitroglycerin treatment in unstable angina pectoris. PMID- 1782976 TI - A lack of effect of captopril on platelet aggregation in patients with congestive heart failure. AB - We have studied the acute and chronic effects of an ACE inhibitor (captopril) on platelet function and the renin-angiotensin system in patients with congestive heart failure. Plasma concentrations of angiotensin II fell significantly after a single dose of captopril (25 mg) and during long-term treatment with captopril (2 weeks, 75 mg/day). Plasma renin activity increased significantly after both the single and repeated doses. Captopril did not affect ADP-induced platelet aggregation or concentrations. It seems unlikely that circulating angiotensin II affects ADP-induced platelet aggregation in patients with congestive heart failure. PMID- 1782978 TI - Flecainide: evidence of non-linear kinetics. AB - The pharmacokinetics of flecainide has been studied in 12 patients with ventricular arrhythmias, both after single administration and during chronic treatment. Both the half-life and the AUC were significantly increased during chronic treatment. This suggests that the kinetics of flecainide might be non linear also in patients with normal kidney and liver function. The increase in plasma flecainide levels during chronic treatment could not be predicted, so close monitoring of its plasma levels is advisable. PMID- 1782979 TI - Elimination of flecainide as a function of urinary flow rate and pH. AB - In order to evaluate the influence of urinary flow rate at different pH values on the pharmacokinetics of the basic antiarrhythmic drug flecainide 7 healthy men received 50 mg flecainide under 4 different conditions: 1. acidic urine (pH 5) and a high fluid load (125 ml.h-1) 2. acidic urine (pH 5) and a low fluid load (25 ml.h-1) 3. alkaline urine (pH 8) and a high fluid load (125 ml.h-1) 4. alkaline urine (pH 8) and a low fluid load (25 ml.h-1) At acidic pH the half life, the amount of unchanged drug in the urine (Ae), renal clearance (CLR) and area under the curve (AUC) were independent of the fluid load. At alkaline pH Ae (5.8 vs 2.6 mg) and CLR (73 vs 33 ml.min-1) were significantly affected by fluid load (high vs low), whereas half-life and AUC were not different (15.7 vs 16.0 h, 1480 vs 1540 ng.ml-1.h). When comparing acidic and alkaline urinary pH conditions, half-life, Ae, CLR, and AUC were different. For a high fluid load the values at acidic vs alkaline pH were half-life 10.0 vs 15.7 h; Ae 15.9 vs 5.8 mg; CLR 288 vs 73 ml.min-1; AUC 976 vs 1480 ng.ml-1.h. For a low fluid load the corresponding values at acidic vs alkaline pH were half-life 10.1 vs 16.0 h; Ae 15.9 vs 2.6 mg; CLR 267 vs 33 ml.min-1; AUC 1045 vs 1540 ng.ml-1.h. It is concluded that urinary pH affects flecainide pharmacokinetics independently of urinary flow rate, and that a high flow enhances the elimination of flecainide only with an alkaline urine. This effect of flow rate does not appear to be of clinical relevance. PMID- 1782980 TI - Pharmacokinetics of intravenous and oral chlordesmethyldiazepam in patients on regular haemodialysis. AB - The pharmacokinetics of a single 2 mg IV dose of chlordesmethyldiazepam has been studied in 11 patients with renal failure on regular haemodialysis and in 11 age matched healthy controls. The kinetics was also examined after a single 2 mg oral dose in 6 of the 11 renal failure patients. After intravenous administration the kinetics of total chlordesmethyldiazepam in renal patients and controls were the same. The unbound fraction of the drug in renal patients was higher (5.5%) than in controls (2.9%). Correction for differences in protein binding revealed a reduced apparent volume of distribution (47 vs. 140 l.kg-1) and a reduced clearance (5.0 vs. 10.5 ml.min-1.kg-1) in the patients. The systemic availability of oral chlordesmethyldiazepam was good (82%) despite a relatively slow absorption rate. PMID- 1782981 TI - Nimodipine in migraine: clinical efficacy and endocrinological effects. AB - Serum prolactin is increased during chronic flunarizine treatment of patients suffering from migraine. In order to clarify the role of calcium in control of the secretion of anterior pituitary hormones, a study has now been made of the effects of chronic nimodipine and propranolol treatment of migraine patients on prolactin (PRL), luteinizing hormone (LH) and growth hormone (GH) levels. 11 patients were treated with nimodipine and 8 with propranolol for four months. A statistically significant reduction in the frequency of the attacks was demonstrated in both groups. No significant change was found in the hormones levels during nimodipine treatment. PMID- 1782982 TI - Effect of felodipine on histamine and adenosine induced bronchoconstriction in patients with asthma. AB - The effect of felodipine, a new selective calcium antagonist, was assessed on histamine and adenosine monophosphate (AMP) induced bronchoconstriction in 9 mild atopic asthmatics. Felodipine did not alter the baseline FEV1, but showed a small significant inhibitory effect upon histamine and AMP induced bronchoconstriction. PMID- 1782983 TI - Oxidative polymorphism of dextromethorphan in a Burundi population. AB - The wide availability, metabolism by the same cytochrome P450 as debrisoquine and, above all, the inocuity of dextromethorphan (DMP) favour the frequent choice of this drug as the test substance in determining oxidation phenotypes. 100 healthy Burundian volunteers (94 m and 6 f) in this study ingested 50 mg DMP bromhydrate, i.e. 38.5 mg of DMP base. Urine was collected for 8 h following the dose and TLC was used to analyse it. The method was particularly useful in view of its low cost, speed and the ease of applying it to a large study group. 5% of the Burundian subjects were poor metabolizers. PMID- 1782984 TI - Steady state pharmacokinetics of piroxicam in children with rheumatic diseases. AB - Ten children with rheumatoid arthritis, aged 7-16 y and weighing 20-63 kg, were treated with piroxicam mean dose 0.4 mg.kg-1 once daily for 2 weeks. On Day 15, blood was sampled from 2-120 h after the last dose. The Cmax for piroxicam ranged from 3.6 to 9.8 (mean 6.6) mg.l-1 and its half-life by log linear computation was 22 to 40 (mean 32.6) h. The volumes of distribution and the total body clearance were estimated as the ratio of actual volumes of distribution and actual clearances to availability. The volumes of distribution (V/F) were 0.12 to 0.25 (mean 0.16) l.kg-1, and the total body clearances (CL/F) were 2.1 to 5.0 (mean 3.4) ml.kg-1.h-1. Thus, piroxicam clearance in these patients was higher and its half-life was shorter than those previously reported in young adults, yet V appeared similar. PMID- 1782985 TI - Kinetics of cholinesterase inhibition by eptastigmine in man. PMID- 1782986 TI - L-arginine-dependent production of nitrogen oxides by rat pulmonary macrophages. AB - Rat alveolar and pleural macrophages incubated with lipopolysaccharide, opsonized zymosan or recombinant interferon-gamma, but not with recombinant tumor necrosis factor-alpha, produced nitrite dose and time dependently. This production depends on the presence and amount of L-arginine in the culture medium. The precursor of the nitrite was demonstrated as being nitric oxide, by bleaching of ferredoxin at 410 nm when added to the culture medium. Addition of NG-monomethyl-L-arginine, an inhibitor of nitric oxide synthesis, and cycloheximide, a protein synthesis inhibitor, to the medium resulted in a decrease of nitrite production. Glucocorticoids were able to block the induction of nitrite production in alveolar macrophages. These data indicate that pulmonary macrophages are capable of secreting L-arginine-derived nitrogen oxides. PMID- 1782987 TI - Bradykinin-induced airway microvascular leakage is potentiated by captopril and phosphoramidon. AB - Bradykinin can be inactivated by the peptidases angiotensin-converting enzyme (ACE) and neutral endopeptidase (NEP), both of which are present in the airways. We evaluated the role of these enzymes in bradykinin-induced airway microvascular leakage and lung resistance in anesthetized and mechanically ventilated guinea pigs. We studied the effects of captopril (inhaled; 350 nmol), a specific ACE inhibitor, and phosphoramidon (inhaled; 7.5 nmol), a specific NEP inhibitor. Airway microvascular leakage was measured with the albumin marker Evans Blue dye (20 mg/kg i.v.), and airflow obstruction was measured as lung resistance (RL). Bradykinin was given by inhalation (0.1, 0.3 and 1 mM; 45 breaths), and caused a dose-dependent increase in both RL and airway microvascular leakage. Inhibition of NEP or ACE potentiated the bradykinin-induced microvascular leakage in main bronchi and proximal and distal intrapulmonary airways. However, only NEP inhibition significantly potentiated the extravasation of Evans Blue dye into the tracheal wall and lumen. The combined inhibition of NEP and ACE significantly potentiated plasma leakage at all airway levels, as well as the increase in RL induced by inhaled bradykinin. Recovery RL after one lung inflation significantly correlated with the extravasation of Evans Blue dye in the tissue at all airway levels, indicating that airway edema may have contributed to airway narrowing. We conclude that in the guinea pig, both NEP and ACE modulate bradykinin-induced airway microvascular leakage. PMID- 1782988 TI - Cromakalim inhibits contractions of the rat isolated mesenteric bed induced by noradrenaline but not caffeine in Ca(2+)-free medium: evidence for interference with receptor-mediated Ca2+ mobilization. AB - The effects of the K+ channel opener cromakalim on phasic contractions induced by noradrenaline and caffeine were studied in the rat isolated mesenteric bed. In the presence of 1.4 mM Ca2+, 1-s pulses of noradrenaline increased the perfusion pressure of the preparation concentration dependently (midpoint at 92 +/- 10 microM noradrenaline). Cromakalim (0.3 and 1 microM) inhibited these contractions in a non-competitive manner. Contractions elicited by 1-s pulses of noradrenaline (100 microM) were inhibited by the dihydropyridine Ca2+ antagonist isradipine by maximally 24 +/- 1%, indicating that only a minor component of this contraction depended on Ca2+ entry via dihydropyridine-sensitive Ca2+ channels. Cromakalim was a much more effective inhibitor of these contractions (maximum inhibition by 80%, midpoint of the inhibition curve at 171 +/- 15 nM). The effect of cromakalim was stereoselective, inhibited by the sulphonylurea glibenclamide, and abolished in partially depolarizing media (KCl = 35 and 50 mM). In Ca(2+)-free medium, cromakalim inhibited the contraction induced by noradrenaline (100 microM) by maximally 69 +/- 4%, with a midpoint at 58 +/- 14 nM. The effect of cromakalim was again stereoselective, inhibited by glibenclamide, and abolished in the presence of 50 mM KCl. Contractions induced by caffeine (10 and 100 microM) were not affected by cromakalim (1 microM). The results indicate that, in rat mesenteric resistance vessels, cromakalim interferes with the ability of noradrenaline, but not caffeine, to mobilize Ca2+ from intracellular stores. The antivasoconstrictor effect of cromakalim against noradrenaline is inhibited by glibenclamide and appears to be linked to the ability of cromakalim to hyperpolarize the cell membrane. PMID- 1782989 TI - Phospholipase C-induced anion secretion and its interaction with carbachol in the rat colonic mucosa. AB - Phospholipase C (PLC) from clostridium perfringens induced a biphasic increase in short-circuit current (Isc) in the rat colon. The Isc rose rapidly to a transient peak, before it increased again to a plateau lasting for several hours. Ion replacement experiments and sensitivity to furosemide or a Cl- channel blocker indicated that PLC induced Cl- secretion. The first peak was suppressed by indomethacin, indicating mediation by prostaglandins. In contrast, the second phase was only partially sensitive to the cyclooxygenase blocker. The long-time action of PLC was dependent on intra- and extracellular Ca2+, although PLC did not induce an increase in the intracellular Ca2+ concentration of the enterocytes. The effect of PLC was blocked by the protein kinase inhibitor, staurosporine. Carbachol, when added during the second phase of the PLC response, induced a 'paradox' change in Isc: a rapid, transient increase in Isc was followed by a long-lasting decrease. This inhibition of the PLC response was more pronounced after elevation of the external Ca2+ concentration. A Ca2+ ionophore, ionomycin, and a Ca2+ channel activator, BAY K 8644, also inhibited the PLC response. The results suggest dual dependence of the action of PLC on the intracellular Ca2+ concentration. PMID- 1782990 TI - Influence of MK-801 on the anticonvulsant activity of antiepileptics. AB - MK-801 (a potent non-competitive antagonist of N-methyl-D-aspartic acid-mediated events) in subcutaneous doses of 0.1 and 0.2 mg/kg increased the threshold for electroconvulsions and in doses of 0.0031 and 0.0125 mg/kg enhanced the protective activity of valproate against maximal electroshock-induced convulsions in mice. Valproate-induced side-effects (evaluated by means of dark-avoidance acquisition and retention testing and the chimney test) at its ED50 against maximal electroshock (i.e. 268 mg/kg) were pronounced whereas they were absent in the case of a combined treatment with MK-801 (0.0125 mg/kg) and valproate (91 mg/kg). This treatment provided 50% protection against maximal electroshock induced seizures. Moreover, MK-801 (0.0125 and 0.05 mg/kg) potentiated the anticonvulsant action of phenobarbital, reducing phenobarbital-induced motor impairment totally at 0.05 mg/kg, but did not influence the protection offered by carbamazepine and diphenylhydantoin at 0.05 mg/kg. The N-methyl-D-aspartic acid antagonist did not affect the total plasma levels of either valproate or phenobarbital (as measured by immunofluorescence), so a pharmacokinetic interaction, in terms of total plasma levels at least, is unlikely to be involved in the observed effects. The finding that the combined treatment of MK-801 with valproate or phenobarbital, apart from the distinct potentiation of their anticonvulsant activities, is devoid of side-effects should be carefully considered. PMID- 1782991 TI - Biphasic effects of mianserin and desipramine on serotonin-evoked current and Cl- efflux in Xenopus oocytes. AB - Serotonin (5-HT, 1 microM) elicited two phases of Cl- inward current in Xenopus oocytes injected with rat brain mRNA: a transient current (T-current), which was generated rapidly (within 1 min), and a sustained current (S-current), which persisted for 10 min. Each type of 5-HT-evoked response was time-dependent after mRNA injection. The T-current was generated at 20-30 h and the S-current at 30-40 h. Although mianserin at 0.1 microM completely inhibited the T-current, 10 microM mianserin was required to suppress the S-current. 5-HT also caused Cl- efflux from oocytes preloaded with 36Cl-. Cl- efflux during 1 min, corresponding to the T-current, was inhibited by 0.1 microM mianserin. A higher concentration of mianserin (10 microM) was required to block the efflux for 10 min, corresponding to the S-current, as well as the current response. Desipramine selectively inhibited the T-current and Cl- efflux for 1 min. The mechanisms underlying the different sensitivity to mianserin of oocytes injected with rat brain mRNA are discussed. PMID- 1782992 TI - Behavioral and biochemical effects of a novel calcium antagonist, KB-2796, on the central dopaminergic system. AB - The effect of a novel calcium antagonist, KB-2796, on the central dopaminergic system was behaviorally and biochemically studied in mice and compared with that of flunarizine, nicardipine and chlorpromazine. Neither KB-2796 nor nicardipine had an inhibitory effect on apomorphine-induced cage climbing and turning behavior in mice with unilateral lesions in the striatum, even at a high dose of 100 mg/kg p.o. Both drugs slightly inhibited methamphetamine-induced increases in locomotor activity and turning behavior but only at a high dose (100 mg/kg p.o.). KB-2796 and nicardipine did not affect the content of dopamine (DA), norepinephrine, and serotonin, or the content of their metabolites homovanillic acid (HVA), dihydroxyphenylacetic acid (DOPAC), and 5-hydroxyindoleacetic acid, or the DA turnover rate in the forebrain of mice. However, flunarizine and chlorpromazine inhibited behavioral changes induced by apomorphine or methamphetamine in a dose-dependent manner, increased the content of DOPAC and HVA and accelerated the DA turnover rate in mouse brain. These results suggest that KB-2796 has a negligible effect on the central dopaminergic system. PMID- 1782993 TI - Modulation of the mesolimbic dopaminergic system by beta-endorphin-(1-27) as assessed by microdialysis. AB - In the present study we used in vivo microdialysis to examine the influence of beta-endorphin-(1-27) (beta-EP-(1-27) upon beta-endorphin (beta-EP)-induced dopamine (DA) release in the nucleus accumbens of anesthetized rats. Microdialysis probes were inserted into the nucleus accumbens and perfusates were analyzed for DA and its metabolites, dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA), using a reversed-phase HPLC system with electrochemical detection. Intracerebroventricular (i.c.v.) administration of beta-EP-(1-27) (5 20 micrograms) resulted in a dose-dependent increase in DA release which was smaller than the beta-EP-induced DA release, whereas metabolite levels were not altered. Pretreatment with beta-EP-(1-27) (5-20 micrograms) significantly altered the beta-EP (5 micrograms)-induced increase in DA release. These results indicate that beta-EP-(1-27) antagonizes the beta-EP-induced release of DA in the nucleus accumbens. In addition to its antagonistic properties at the beta-endorphin binding site, beta-EP-(1-27) appears to be a partial agonist, inducing increased DA release. These findings suggest a regulatory function for this naturally occurring beta-EP fragment within the mesolimbic system. PMID- 1782994 TI - Brain kinetics and specific binding of [11C]PK 11195 to omega 3 sites in baboons: positron emission tomography study. AB - We characterized, in vivo, using positron emission tomography in baboons, the kinetics and specific binding of i.v. injected [11C]PK 11195 to omega 3 sites in the brain. Following immediate access to brain tissue, the brain kinetics of [11C] K 11195 showed a slow elimination for the 60 min of study. Both coinjection and pulse-chase (at t = 8 min) with saturating amounts of cold PK 11195 immediately enhanced the availability of radiotracer to brain tissue, but also markedly increased the rate of washout. These effects presumably reflect displacement or inhibition of specifically bound [11C]PK 11195 to both peripheral and central omega 3 sites, respectively. These results indicate that [11C]PK 11195 has easy access and binds with moderate specificity to the normal primate brain in vivo. PMID- 1782995 TI - Effect of verapamil on cardiac protein kinase C activity in diabetic rats. AB - We examined the effect of verapamil treatment on cardiac protein kinase C (PKC) activity in streptozocin-induced diabetic rats. Basal cardiac PKC activity in diabetes increased in both cytosolic (by 94%, P less than 0.01) and membrane (by 41%, P less than 0.05) fractions as compared with that in controls. Subcutaneous administration of 8 mg/kg verapamil twice a day for 8 weeks induced a significant decrease in both cytosolic (by 59%, P less than 0.01) and membrane (by 50%, P less than 0.01) PKC activity in diabetes as compared with the activity in the non treated diabetic groups. In contrast, cardiac cytosolic PKC activity in control rats was significantly (P less than 0.01) decreased by 41% as compared with that of the non-treated control group without there being any change in membrane PKC activity. Our data demonstrate that verapamil treatment may ameliorate the abnormal activation of cardiac PKC in diabetes. PMID- 1782996 TI - Influence of thiorphan and phosphoramidon on the relaxant effect of vasoactive intestinal polypeptide and non-adrenergic non-cholinergic neurone stimulation in the rat gastric fundus. AB - Relaxations were induced in longitudinal muscle strips of the rat gastric fundus by exogenous administration of vasoactive intestinal polypeptide (VIP) and by transmural stimulation in the presence of atropine. These responses were not influenced by two neutral endopeptidase inhibitors, thiorphan (3 X 10(-5) M) and phosphoramidon (10(-5) M). This suggests that neutral endopeptidase is not involved in the breakdown of exogenous VIP and non-adrenergic non-cholinergic inhibitory transmitters of the rat gastric fundus. PMID- 1782997 TI - Single photon emission computed tomography imaging of monoamine reuptake sites in primate brain with [123I]CIT. PMID- 1782998 TI - Marked decrease of extraneuronal dopamine after alcohol withdrawal in rats: reversal by MK-801. PMID- 1782999 TI - SDZ 205-557, a selective antagonist at 5-HT4 receptors in the isolated guinea pig ileum. PMID- 1783000 TI - Molecular biology of the dopamine receptors. AB - Because of their importance in pathophysiology, the dopamine receptors have been the subjects of intense pharmacological and physiological research. Their structures have remained mostly unknown until recently with the application of molecular biological approaches. The cloning of the first dopamine receptor, the D2 receptor opened a new era in dopamine receptor research. It has led not only to new studies of its own biology but also to the characterization of the other dopamine receptors. The most striking conclusion of this fast moving research is that the dopamine receptors are more diverse than expected from their pharmacological characterizations. We discuss here the history of the cloning of the dopamine receptors and the impact that this research had on our understanding of the dopamine system. PMID- 1783001 TI - Analysis of the interaction of reserpine with actin by the photoaffinity labelling method. AB - The interaction of reserpine with one of the cytoskeletal proteins, actin, was analyzed by the photoaffinity labelling method using [3H]reserpine. Reserpine bound sufficiently to G- or oligomeric actin, but hardly to F-actin under the same experimental conditions. This result could be explained if reserpine binds to a specific region of the G-actin molecule that is responsible for actin-actin interactions. It is concordant with this idea that [3H]reserpine bound only to specific proteolytic fragments of actin. When reserpine was mixed with crude extracts of two kinds of tissues, chicken gizzard smooth muscle and bovine adrenal medulla, it bound to the 42 kDa protein of sodium dodecyl sulfate polyacrylamide gel electrophoresis in both cases. Its molecular size and abundance suggest strongly that this 42 kDa protein is actin. The binding of reserpine to actin was inhibited by dopamine in a dose-dependent manner. These results suggest that actin could be one of the target molecules of reserpine. PMID- 1783002 TI - Vasocontractile muscarinic M1 receptors in cat cerebral arteries: pharmacological identification and detection of mRNA. AB - The nature of the muscarinic receptor subtype mediating the acetylcholine (ACh) induced constriction of the cat middle cerebral artery was investigated in vitro by recording the smooth muscle isometric tension of precontracted endothelium denuded arterial segments. The ability of selective (pirenzepine, UH-AH 371, AF DX 116, methoctramine, AQ-RA 741, 4-diphenylacetoxy-N-methylpiperidine methiodide (4-DAMP) and hexahydro-sila-difenidol (HHSiD)) and non-selective (atropine) antagonists to inhibit the constriction elicited by ACh was estimated. In addition, using a subtype-specific ribonucleotide probe directed against mRNA encoding the human m1 (Hm1) muscarinic receptor, identification of the corresponding vascular receptor was undertaken in total RNA extracts from cat cerebral blood vessels. The potent inhibition of the ACh-induced constriction by M1 antagonists (pirenzepine and UH-AH 371; pA2 values respectively of 8.08 and 8.64), together with lower affinities of M2 (AF-DX 116; pA2 = 6.50, methoctramine; pA2 = 6.27 and AQ-RA 741; pA2 = 7.60) and M3 compounds (4-DAMP and HHSiD; with pA2 values of 8.85 and 7.76, respectively) strongly suggested the involvement of a pharmacological M1 receptor in this vasomotor response. Furthermore, Northern blot hybridization with the selective Hm1 ribonucleotide probe showed the presence of mRNA transcripts for this muscarinic receptor subtype in the cat cerebrovascular bed. The results indicate that muscarinic constriction in the feline cerebrovascular bed is mediated by a pharmacological M1 receptor subtype and that the corresponding m1 receptor mRNA is present in cat cerebral blood vessels. These findings clearly point to a role of M1 muscarinic receptors in cerebrovascular function. PMID- 1783003 TI - Differential effects of long-term lithium and carbamazepine administration on Gs alpha and Gi alpha protein in rat brain. AB - The G protein subunits, Gs alpha, Gi alpha, and Go alpha, have been quantitated in various rat brain regions using enzyme-linked immunosorbent assay (ELISA) techniques. Chronic (3-week) treatment with carbamazepine decreased Gs alpha in several brain regions reaching significance in the neostriatum, while chronic lithium treatment had no unequivocal effect. Lithium significantly increased Gi alpha in the hypothalamus and hippocampus, whereas carbamazepine decreased Gi alpha in the frontal cortex. Both treatments had no consistent effects on Go alpha. We conclude that long-term treatment with lithium and carbamazepine exerts differential effects on G protein alpha subunits, and that this modification of signal transduction represents a potential mechanism of antibipolar drug-induced neural plasticity. PMID- 1783004 TI - Regulation of G proteins by chronic antidepressant drug treatment in rat brain: tricyclics but not clorgyline increase Go alpha subunits. AB - The effect of long-term (3-week) administration of various antidepressant drugs on the steady-state concentrations of G protein alpha subunits, Gs alpha, Gi alpha, and Go alpha, has been investigated in rat brain using an enzyme-linked immunosorbent assay. Tricyclic antidepressants and clorgyline decreased Gs alpha and, to a lesser extent, Gi alpha in several brain regions, while Go alpha was increased by tricyclics but not clorgyline. We conclude that long-term treatment with antidepressant drugs exerts differential effects on G protein alpha subunits, and that antidepressant efficacy may potentially be based on functional modifications of signal transduction. PMID- 1783005 TI - A trypsin inhibitor-like peptide PEC-60 reduces the affinity of dopamine D2 agonist binding sites in rat neostriatal membranes. PMID- 1783006 TI - Aggregation-related toxicity of synthetic beta-amyloid protein in hippocampal cultures. PMID- 1783007 TI - Purification and properties of the low-molecular-weight alpha-crystallin from normal goat lens: comparison with bovine lens. AB - Low-molecular-weight alpha-crystallin (alpha L-crystallin) isolated from decapsulated lens of goat (Capra hiscus) has been purified to an apparently homogeneous population. Goat alpha L-crystallin closely resembles its bovine counterpart in size, shape, exposition of sulfhydryl groups, subunit composition and the nature of its UV-absorption profile. Like bovine alpha L-crystallin, dissociated subunits of goat alpha L-crystallin assemble upon reassociation into a particle of almost half the size of the native one. However, subunits of goat alpha L-crystallin are found to contain more aromatic amino acid residues than those of bovine subunits leading to a higher value of extinction coefficient (E1cm1%) at 280 nm for the goat protein. PMID- 1783008 TI - Surface glycoconjugates of cynomolgus monkey trabecular cells. AB - Non-ionic detergent-soluble and detergent-resistant cynomolgus monkey trabecular cell surface glycoconjugates have been identified using three radiolabeling procedures and polyacrylamide gel electrophoresis in the presence of sodium dodecyl sulfate. The cell surface glycoconjugates were radiolabeled with tritiated sodium borohydride after treatment with: (1) neuraminidase/galactose oxidase; (2) galactose oxidase; or (3) sodium metaperiodate. The non-ionic detergent soluble components were removed by treatment of the monolayer cell culture with 1% Triton X-100 in hypotonic buffer. The radiolabeled trabecular cell surface glycoconjugates in the Triton X-100 soluble and insoluble fractions were resolved by sodium dodecyl sulfate polyacrylamide gel electrophoresis under reducing conditions and visualized by fluorography. Treatment of the monkey trabecular cells with neuraminidase/galactose oxidase/tritiated sodium borohydride resulted in the radiolabeling of five components ranging in apparent molecular weight from 128,000 to 39,000 in the Triton X-100 soluble fractions, while 12 radiolabeled glycoconjugates with apparent molecular weights ranging from 240,000 to 26,000 were resolved in the Triton X-100 resistant fraction. PMID- 1783009 TI - Effects of adrenergic agents on transepithelial electrical measurements across the isolated iris-ciliary body. AB - Transmembrane electrical measurements were performed on the isolated rabbit iris ciliary body to study direct effects of adrenergic drugs on the ciliary epithelium. Alpha-adrenergic agonists (epinephrine, norepinephrine, or phenylephrine) lowered the short-circuit current (SCC) in a dose-dependent fashion relative to which chamber side the drug was added: simultaneous addition to both chambers greater than blood side only greater than aqueous side only. Pretreatment (5 x 10(-5) M) with the non-selective beta-adrenergic antagonist timolol had no effect while the non-selective alpha-adrenergic antagonist, phentolamine, completely prevented the alpha agonist-induced decrease in SCC. The alpha-adrenergic response was mediated by the alpha 1 subtype since prazosin, but not yohimbine, blocked the induced reduction in SCC. The beta-adrenergic agonist isoproterenol caused a dose-dependent decrease in the SCC. The decrease was similar when the drug was added to only the blood side or to both sides of the chamber. Addition to only the aqueous chamber had no effect. Pretreatment with beta-adrenergic antagonists blocked the isoproterenol response: non-selective = selective beta 2 greater than selective beta 1. The isoproterenol-induced decrease in SCC was also blocked by non-selective alpha-adrenergic antagonists. The response was mediated by the alpha 1 subtype since prazosin, but not yohimbine, blocked the isoproterenol response. This suggests that isoproterenol interacted with the alpha 1-adrenergic sensitive pathway in the rabbit ciliary process. PMID- 1783010 TI - Preretinal pH changes in the rabbit under conditions of light and dark. AB - Preretinal pH was measured in the avascular region of 19 rabbit retinas during alternating cycles of light and dark, using a miniature, needle-type pH electrode. In 14 experiments with the rabbits breathing room air, cyclic changes in pH, decreasing in the dark and increasing in the light, were observed. The transition from light to dark caused a mean pH decrease of 0.047 +/- 0.029 U (n = 14). An inversion of the light/dark pH response was observed in five experiments. In three of these, the effect was induced by having the rabbits breathe 100% O2. In the five rabbits showing a reversed response, a mean pH increase of 0.034 +/- 0.025 pH U was observed in the dark; light-ON caused a decrease of 0.035 +/- 0.025 pH U. The direction of the preretinal pH change is thought to be the net effect of light/dark-induced changes in the metabolism of the photoreceptors and inner retinal layers (defined for the purpose of this paper as the region between the outer synaptic layer and the inner limiting membrane). In six separate experiments, retinal metabolism was assessed by measuring preretinal PO2 during alternating cycles of light and dark while the rabbits breathed room air. Oxygen tension declined from a mean of 14.5 +/- 6.2 (S.D.) mmHg in the light to 10.1 +/- 5.4 (S.D.) mmHg in darkness, and increased from a mean of 10.9 +/- 5.1 (S.D.) mmHg in darkness to 15.4 +/- 5.8 (S.D.) mmHg in the light. The time courses of the pH and the PO2 changes were similar.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783011 TI - New ocular micromanipulator for measurements of retinal and vitreous physiologic parameters in the mammalian eye. AB - A new ocular micromanipulator for introducing a microelectrode into the mammalian eye is described. Included is a technical description of the device, incorporating arched tracks and DC motors to provide for angular motion around a scleral entrance point. Applications for in vivo measurements of local PO2 in the retina and vitreous of miniature pigs and cats are shown. The new design features of this micromanipulator allow for smooth microelectrode movements over large retinal areas, facilitating the rapid collection of data in many different areas of the retina and vitreous. PMID- 1783012 TI - Hyaluronan stimulates corneal epithelial migration. AB - Hyaluronan (hyaluronic acid), well-known for its viscoelastic properties, is also recognized as a biological signal to cells. Using organ cultures of the rabbit cornea, we investigated the effects of hyaluronan on the migration of corneal epithelium. The addition of hyaluronan to the culture medium increased the length of the path of the corneal epithelial layer in a dose-dependent fashion. Other glycosaminoglycans (chondroitin, chondroitin sulphate, keratan sulphate and heparan sulphate) were also tried, but only hyaluronan exhibited a stimulatory effect on corneal epithelial migration. The effects of hyaluronan and fibronectin or epidermal growth factor (EGF) were additive; the addition of antisera against fibronectin or against EGF did not alter the stimulatory effect of hyaluronan. These results demonstrate that hyaluronan stimulates corneal epithelial migration by mechanism(s) different from those of fibronectin and EGF. PMID- 1783013 TI - Radioimmunoassay of epidermal growth factor in human lenses at various stages of development of cataract. AB - By using a highly specific and sensitive homologous radioimmunoassay, we found that the content of epidermal growth factor (EGF) in the lateral one-third of whole cataractous human lenses (age range 45-85 yr) extracted at elective intracapsular lens surgery, varied from undetectable to 106.25 pg mg-1 water soluble protein (WSP) (mean +/- S.D. = 39.70 +/- 38.90). When the lenses were grouped according to the stage of the cataract, i.e. immature (n = 3), mature (n = 4), and hypermature (n = 3), the means +/- S.D. were 92.56 +/- 26.23, 23.89 +/- 7.71, and 7.92 +/- 2.00 pg mg-1 WSP, respectively. In ten age-matched whole 'normal' lenses that we removed within 2-12 hr after death, the values in EGF of the lateral one-third of the lenses ranged from 2.91 to 36.40 pg mg-1 WSP (19.39 +/- 13.65). No correlation between the age of the lenses and the content of EGF could be demonstrated at the 95% confidence interval for the cataractous and 'normal' lenses. The quantity of endogenous EGF correlated significantly (P less than 0.01) with the clinical stage of the cataract and is probably related to the mitotic activity of the equatorial proliferative zone. We discuss the importance of EGF in normal and cataractous lenses and postulate that EGF in the lens is endogenous in origin. PMID- 1783014 TI - Monoclonal antibodies which recognize endoplasmic reticulum in the retinal pigment epithelium. AB - Balb/c mice were immunized with dissociated chick retinal pigment epithelial cells and monoclonal antibodies prepared. Retinas of chick, bovine, rabbit, rat and mouse were examined with the monoclonal antibodies by immunofluorescence microscopy. Among the antibodies obtained, two (S5D8 and S5H8) stained the cytoplasm of epithelial cells of the animals examined in finely granular pattern and recognized a 63-kDa protein in retinal pigment epithelial cells. These antibodies, however, did not react with the rest of the chick eye (cornea, iris, ciliary body, lens and sclera) nor with extraocular tissues (liver, kidney, intestine, brain, testis, adrenal gland, heart, gizzard and skeletal muscle). Immunoelectron microscopy revealed that the antigen was localized in the endoplasmic reticulum of retinal pigment epithelial cells. PMID- 1783016 TI - Effects of 5-fluorouracil on proliferating fibroblasts in vivo. AB - 5-Fluorouracil (5-FU) is a potent inhibitor of the proliferation of fibroblasts, the main cell mediators of scar formation. The mechanism of the toxic effect of 5 FU on cancer cells is well known but unclear in nonmalignant cells. The histopathological effects of 5-FU on proliferating fibroblasts in vivo, 2 and 4 weeks after drug injection, are demonstrated here. An insertion of homologous fibroblasts into rabbits' vitreous followed by one injection of 1 mg 5-FU causes intracytoplasmic accumulation of vacuoles, morphological changes and inhibition of collagen deposition in the matrix. PMID- 1783015 TI - Adaptive changes in visual cell transduction protein levels: effect of light. AB - Long-term environmental light-mediated changes in visual cell transduction proteins were studied to assess the influence of rearing environment on their levels and their potential effects on intense light-induced retinal damage. The levels of rhodopsin, S-antigen and the alpha subunit of transducin were measured in whole eye detergent extracts, retinal homogenates or rod outer segments isolated from rats reared in weak cyclic light or darkness, and following a change in rearing environment. Rats changed from weak cyclic light to darkness had 22% more rhodopsin per eye than cyclic-light rats after 12-14 days in the new environment. Western trans-blot analysis of retinal proteins from these dark maintained animals contained 65% higher levels of immunologically detectable alpha transducin; S-antigen levels were approximately 45% lower than in cyclic light rats. In rats changed from the dark environment to weak cyclic light, rhodopsin levels decreased by 18% during a comparable period; retinal alpha transducin was 35% lower, S-antigen was 30% higher. At various times after the change in rearing environment, some rats were exposed to intense visible light to determine their susceptibility to retinal damage. Two weeks after an 8-hr exposure, cyclic-light reared rats had rhodopsin levels only 10% lower than control (2.1 nmol per eye). However, rhodopsin was 75% lower when cyclic-light rats were maintained in darkness for 2 weeks before intense light. For animals originally reared in darkness, rhodopsin was 78% lower following 8 hr of intense light, whereas only 30% rhodopsin loss occurred in dark-reared rats after previous maintenance for 2 weeks in weak cyclic-light.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783017 TI - The effect of insulin and aldose reductase inhibition on the phosphate metabolism of streptozotocin-diabetic rat lens. AB - Sorbitol-3-phosphate (S3P) and fructose-3-phosphate (F3P) are novel phosphorus compounds recently discovered and identified in the crystalline lens as well as other tissues. These phosphates increased with diabetes progression in streptozotocin-diabetic rat lenses. Treatment of these rats with an orally administered aldose reductase inhibitor eliminated S3P and intramuscularly injected insulin obliterated F3P. These results indicate that enzymes catalyzing S3P and F3P formation co-activate with aldose reductase activation and hyperglycemia, respectively. PMID- 1783018 TI - Truncation of alpha A-crystallin from the human lens. PMID- 1783019 TI - Optokinetic response of simple spikes of Purkinje cells in the cerebellar flocculus and nodulus of the pigmented rabbit. AB - Under anesthesia with N2O (70%) and halothane (2-4%), Purkinje cell activities were extracellularly recorded in the flocculus and nodulus of immobilized pigmented rabbits. Large field (60 degrees x 60 degrees) optokinetic stimulation (OKS) was delivered to the central visual field of one eye with a constant velocity (0.1-4.0 degrees/s) at 0 degrees, 45 degrees, 90 degrees or 135 degrees to the horizontal plane of the eye. Most of the Purkinje cells in the flocculus and the nodulus showed significant simple spike modulations to OKS delivered to either eye. As a whole, the preferred directions of simple spike responses in the flocculus had the same orientation as those of complex spike responses. However, the preferred directions and amplitudes of modulation of simple spike responses did not necessarily correlate with those of complex spike responses in individual flocculus Purkinje cells. On the other hand, the preferred directions of simple and complex spike responses were not necessarily in the same orientation in the nodulus. The optimum velocity for simple spike responses was in the range 0.1-2.0 degrees/s for Purkinje cells in both the flocculus and the nodulus. The amplitude and time to peak of the simple spike responses of nodulus Purkinje cells were significantly smaller and longer, respectively, than those of flocculus Purkinje cells. In both the flocculus and the nodulus, Purkinje cells whose simple spikes preferred the horizontal orientation (H cells) and the vertical orientation (V cells) showed clustering. In particular, zonal organization was noted in the flocculus. H cells were localized in a dorso-ventral zone in the rostral one third of the flocculus, and V cells were in two distinct zones rostral and caudal to the H cell zone. The locations of H and V cells in the flocculus correspond to the H zone and V zones, respectively, determined on the basis of the preferred directions of complex spike responses to OKS. This indicates that the same subdivisions of the flocculus are supplied with optokinetic signals with the same orientation selectively through both mossy and climbing fibers, and suggest that such subdivisions of the flocculus are functional units which control horizontal and vertical components of optokinetic eye movements. The present results indicate that the flocculus and the nodulus are supplied with distinct optokinetic signals through mossy fibers and play different roles in controlling optokinetic eye movements. PMID- 1783020 TI - Excitation and inhibition of trigeminal motoneurons by palatal stimulation. AB - Excitation and inhibition of jaw-closing motoneurons (Masseteric and Temporal Motoneurons, Mass. and Temp. Mns) during transient jaw closing, the so-called jaw closing reflex, and prolonged jaw opening elicited by palatal stimulation were studied. By pressing the anterior palatal surfaces sustained jaw opening was elicited, suggesting that sustained jaw opening results from inhibition of tonic background activity of jaw-closing motoneurons by inhibitory postsynaptic potentials (IPSPs) elicited by mechanical stimulation of the anterior palatal mucosa. Recordings showed that the onset of IPSPs was 80 ms earlier than the onset of jaw opening. Application of diffuse pressure stimulation to the posterior palatal surfaces elicited bursts of spikes triggered on excitatory postsynaptic potentials (EPSPs), suggesting that mechanosensory receptors from the posterior palatal mucosa send excitatory synaptic inputs to jaw-closing motoneurons. Furthermore, it is suggested that mechanosensory inputs from the posterior palatal mucosa may excite neurons in the central pattern generator and provide the motor patterns responsible for jaw closure during the jaw-closing reflex. We have demonstrated that excitation of Mass. Mns innervating the deep masseter muscle mainly contributed to maintaining the occlusal phase of jaw closure during the jaw-closing reflex. However, the onset of EPSPs was 100 to 160 ms (n = 27) earlier than the onset of jaw closure. In studies on spontaneously occurring jaw closure it was demonstrated that there was a proportional increase in the number of spikes of the Temp. Mn and the mechanical response (jaw closure). PMID- 1783021 TI - Effects of midline medullary lesions on velocity storage and the vestibulo-ocular reflex. AB - 1. Crossing fibers were sectioned at the midline of the medulla caudal to the abducens nucleus in four cynomolgus monkeys. In two animals the lesions caused the time constant of horizontal and vertical per- and post-rotatory nystagmus to fall to 5-8 s. The slow rise in optokinetic nystagmus (OKN), as well as optokinetic after-nystagmus (OKAN) and cross-coupling of horizontal to vertical OKN and OKAN were abolished. Steady state velocities could not be maintained during off-vertical axis rotation (OVAR). Pitch and yaw nystagmus were affected similarly. We conclude that the ability to store activity related to slow phase eye velocity, i.e., "velocity storage", was lost in these monkeys for nystagmus about any axis. Velocity storage was partially affected by a small midline lesion in the same region in a third animal. There was no effect of a more superficial midline section in a fourth monkey, and it served as a control. 2. The gain (eye velocity/head velocity) of the vestibulo-ocular reflex (VOR) was unaffected by the midline lesions. Saccades were normal, as was the ability to hold the eyes in eccentric gaze positions. The gain of the fast component of OKN increased in one monkey to compensate for the loss of the slow component. 3. One animal was tested for its ability to adapt the gain of the VOR due to visual-vestibular mismatch after lesion. Average changes in gain in response to wearing magnifying (2.2x) and reducing (0.5x) lenses, were +35% and -30%, respectively. This is within the range of normal monkeys. Thus, a midline lesion that abolished velocity storage did not alter that animal's ability to adapt the gain of the VOR. 4. Lesions that reduced or abolished velocity storage interrupted crossing fibers in the rostral medulla, caudal to the abducens nuclei. Cells that contributed axons to this portion of the crossing fibers are most likely located in central portions of the medial vestibular nucleus (MVN) and/or in rostral portion of the descending vestibular nucleus (DVN). The implication is that velocity storage arises from neurons in MVN and DVN whose axons cross the midline. PMID- 1783022 TI - A re-appraisal of the role of layer VI of the visual cortex in the generation of cortical end inhibition. AB - These experiments examine the effect of blockade of layer VI of the cat striate cortex on the length tuning of hypercomplex cells in the overlying layers II, III and IV. It has previously been suggested that local inactivation of layer VI results in the complete loss of length selectivity in all hypercomplex cells in layers II, III and IV above the blocked region, by removal of an inhibitory mechanism within layer IV, driven from layer VI. However, we have found that, using iontophoretic application of the inhibitory substance GABA to block the activity of layer VI, 29% of hypercomplex cells were unaffected by blockade of the underlying layer VI. The predominant effect on hypercomplex cells was a reduction in visual responsiveness, seen in 71% of cells, with responses reduced on average by 43%. In 50% of these cells (35% of the population) this reduction was apparently specific to responses to the optimum bar length; responses to longer stimuli were unaffected. Iontophoretic application of the potent GABAA analogue muscimol in layer VI showed a similar spectrum of effects on hypercomplex cells. In these cases, however, the cortical blockade was slowly increased to encompass the recorded cell. In each case, any decreases in length selectivity were also the result of a decreased visual responsiveness. Thus, decreases in length selectivity seen when using either GABA or muscimol were almost exclusively the result of decreased responsiveness to the optimal length of bar stimulus, rather than an increase in response to non-optimal, long stimuli. This suggests the loss of a facilitatory influence from layer VI to layer IV, rather than the loss of inhibition. PMID- 1783023 TI - Responses of primary endings of cat muscle spindles to locally applied vibration. AB - Responses of muscle spindles in the cat soleus muscle have been studied during vibration applied locally to the belly of the muscle. Bursts of vibration at 170 Hz and with a peak amplitude of 200 microns were applied to a site at which local pressure initiated impulses from the spindle. The response to vibration depended on the conditioning of the muscle immediately beforehand and the placement of the vibrator. The length at which the vibration was applied was called the test length; this was typically 10 mm less than the muscle's maximum length in the body. After a fusimotor strength contraction at a length 2-5 mm longer than the test length, vibration sensitivity, measured on return to the test length, was low. If the muscle was contracted at a length 2-5 mm shorter than the test length, vibration sensitivity was high. The low vibration sensitivity following conditioning at the longer length was attributed to the development of slack in intrafusal fibres. In the presence of slack, stimulation of some static fusimotor fibres was able to restore vibration sensitivity fully. It is suggested that the vibration sensitivity of passive spindles arises largely in bag2 intrafusal fibres. PMID- 1783024 TI - Sexual dimorphism in the mossy fiber synapses of the rat hippocampus. AB - The presence of sexual dimorphism in the hippocampal formation has long been recognized. Differences between male and female rats have been detected with respect to the number of dentate granule cells and branching patterns of dentate granule and hippocampal pyramidal cell dendrites. Groups of 6 male and 6 female Sprague-Dawley rats were studied at 180 days of age. Based on light microscopical Timm-staining and Golgi-impregnation and electron microscopy, and applying morphometric techniques, we now report that the total number of synapses between mossy fibers and the apical dendritic excrescences of CA3 pyramidal cells is the same in male and female rats, despite a higher numerical density in the latter. Moreover, the volume of the mossy fiber system was found to be smaller in females. Because the number of dentate granule cells is smaller in females than in males, the increased numerical density of synapses may be thought of as a compensatory mechanism to equalize the number of synaptic contacts between dentate granule and CA3 pyramidal cells in the two sexes. We demonstrate that an increase in the number of mossy fiber boutons in female rats is a determining factor for the sexual differences found. PMID- 1783025 TI - Disparity selective units in the superior colliculus of the opossum. AB - Binocular visual responses can be recorded in two regions of the superficial layers of the superior colliculus of the opossum. The direct binocular region (DBR) represents the binocular portion of the contralateral hemifield whereas the rostral pole (RP) represents the binocular portion of the ipsilateral hemifield. In the present study single units from both of these regions were tested with binocular and monocular stimulation. Most cells in both regions showed response facilitation when both eyes were simultaneously stimulated and, when tested with different binocular disparities, most cells showed broadly-tuned disparity selectivity. DBR units usually preferred disparities near zero whereas RP units had a wider range of preferred disparities, with a tendency toward positive (crossed) values. This data indicates that the superior colliculus of the opossum could provide a neural substrate for a coarse analysis of depth and also might help control vergence eye movements. The different ranges of disparity selectivity of DBR and RP are consistent with the previously reported monocular receptive-field data and suggest that DBR and RP analyze different depths of the 3-dimensional visual scene. PMID- 1783027 TI - Cognitive spatial-motor processes. 7. The making of movements at an angle from a stimulus direction: studies of motor cortical activity at the single cell and population levels. AB - Two rhesus monkeys were trained to move a handle on a two-dimensional (2-D) working surface either towards a visual stimulus ("direct" task) or in a direction orthogonal and counterclockwise (CCW) from the stimulus ("transformation" task), depending on whether the stimulus appeared dim or bright, respectively. Thus the direction of the stimulus (S, in polar coordinates) and the direction of the movement (M) were the same in the direct task but differed in the transformation task, such that M = S + 90 degrees CCW. The task (i.e. brightness) condition (k = 2, i.e. direct or transformation) and the direction of the stimulus (m = 8, i.e. 8 equally spaced directions on a circle) resulted in 16 combinations (k x m = 16 "classes") that were varied from trial to trial in a randomized block design. In 8 of these combinations the direction of the stimulus was the same for both tasks, whereas the direction of the movement was the same in the remaining 8 cases. The electrical signs of cell activity (N = 394 cells) in the arm area of the motor cortex (contralateral to the performing arm) were recorded extracellularly. The neural activity was analyzed at the single cell and neuronal population levels, and a modeling of the time course of single activity during the transformation task was carried out. We found the following. (a) Individual cells were active in both tasks; no cells were found that were active exclusively in only one of the two tasks. The patterns of single cell activity in the transformation task frequently differed from those observed in the direct task when the stimulus or the movement were the same. More specifically, cells could not be consistently classified as "movement" or "stimulus"-related for frequently the activity of a particular cell would seem "movement-related" for a particular stimulus-movement combination, "stimulus related" for another combination, or unrelated to either movement or stimulus for still another combination. Thus no real insight could be gained from such an analysis of single cell activity. (e) In a different analysis, we explored the idea that a changing directional signal could be detected in the time course of single cell activity during the reaction time. For that purpose we modeled the time course of single activity observed in the transformation task as a linear, weighted combination of influences from the direct task, taking the time patterns of cell activity during the stimulus, intermediate and movement directions in the direct task as estimates of the postulated directional influences.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1783026 TI - Behavior-dependent paired-pulse responses in the hippocampal CA1 region. AB - Paired-pulses of 20-100 ms interpulse interval (IPI) were delivered to the Schaffer collaterals/commissural fibers in order to excite the apical dendrites of the hippocampal CA1 region in freely behaving rats. Significant differences were observed for the paired-pulse responses during different behavioral states. The responses recorded during awake immobility (IMM), and slow-wave sleep (SWS) were similar, but as a group, were different from those during walking (WLK) and rapid-eye-movement sleep (REM). During WLK and REM, the population spike evoked by the second pulse (P2) at IPI of 30 and 50 ms, was greatly facilitated as compared to the population spike evoked by the first pulse (P1), i.e. P2 greater than P1. During IMM and SWS and using moderate stimulus intensities, P2 was generally smaller than P1 (paired-pulse suppression) at IPI of 30 and 50 ms. The P2/P1 relation with behavior was not caused by the slight variations of P1 with behavior. In addition, paired-pulse facilitation of the population excitatory postsynaptic potentials (EPSP) was relatively small and not significantly dependent on behavior. Behavioral dependence of the paired-pulse responses was not generally found for IPI of 20 or 100 ms. It is concluded that paired-pulse facilitation at 30-50 ms IPI can best be explained by EPSP facilitation combined with a behaviorally dependent disinhibition. PMID- 1783028 TI - Regional and time dependent variations of low Mg2+ induced epileptiform activity in rat temporal cortex slices. AB - In order to study spatial interactions during low magnesium induced epileptiform activity, changes in extracellular potassium concentration ([K+]0) and associated slow field potentials (f.p.'s) were recorded in thin rat temporal cortex slices (400 microns) containing the neocortical temporal area 3 (Te3), the entorhinal cortex (EC) and the hippocampal formation with the dentate gyrus, area CA3 and CA1 and the subiculum (Sub). The epileptiform activity was characterized by short recurrent epileptiform discharges (40 to 80 ms, 20/min) in areas CA3 and CA1 and by interictal discharges and tonic and clonic seizure like events (SLE's) (13 88s) in the EC, Te3 and Sub. While interictal discharges occurred independent of each other in the different subfields, the three areas became synchronized during the course of a SLE. The EC, Te3 and Sub all could represent the "focus" for generation of the SLE's. This initiation site for SLE's sometimes changed from one area to another. The characteristics of the rises in [K+]0 and subsequent undershoots were comparable to previous observations in in vivo preparations. Interestingly, rises in [K+]0 could start before actual onset of seizure like activity in secondarily recruited areas. The epileptiform activity could change its characteristics to either a state of recurrent tonic discharge episodes or to a continuous clonic discharge state reminiscent of various forms of status epilepticus. We did not observe, in any of these states, active participation by area CA3 in the epileptiform activity of the EC in spite of clear projected activity to the dentate gyrus. Even after application of picrotoxin (20 microM), area CA3 did not actively participate in the SLE's generated in the entorhinal cortex. When baclofen (2 microM) was added to the picrotoxin containing medium, SLE's occurred both in the entorhinal cortex and in area CA3, suggesting that inhibition of inhibitory interneurons by baclofen could overcome the "filtering" of projected activity from the entorhinal cortex to the hippocampus. PMID- 1783029 TI - Influence of the pontine and medullary reticular formation on synchrony of gamma motoneurone discharge in the cat. AB - Discharges of gamma motoneurones were recorded from cut filaments of the nerve to the gastrocnemius medialis muscle in the cat decerebrated at an intercollicular level. Gamma motoneurones exhibited a background discharge in the absence of intentional stimulation, or could be made to discharge by continuous, innocuous stimulation of the skin of the heel. The discharges were periodic and regular (low coefficient of variation of interspike intervals), and no correlation was observed between the discharges of pairs of individual gamma efferents. Electrolytic lesion of the ipsilateral pontine and medullary reticular formation in the nucleus subcoeruleus, the nucleus reticularis gigantocellularis or the nucleus reticularis magnocellularis, invariably decreased regularity of discharge and resulted in short term synchrony. Lesions of the peri-aqueductal grey, the nucleus raphe dorsalis or the midline raphe nuclei did not induce synchrony. Surgical lesions in the locus coeruleus caused irregular firing and synchrony only when the lesion extended into the adjacent nucleus subcoeruleus. We conclude that monoaminergic neurones of the nucleus subcoeruleus, or a closely associated tegmental field, with axons descending through the gigantocellularis and magnocellularis fields, are the most likely origin of the bulbospinal control of synchronizing influences on gamma motoneurone discharge. PMID- 1783030 TI - Binocular phase specificity of striate cortical neurones. AB - Sensitivity to binocular positional mismatch was evaluated in cat striate cortical neurones, for paired, dichoptically presented, moving sine-wave gratings whose interocular positional phase relationship was varied. Spatial frequency, orientation and velocity were optimized for each neurone. Binocular responses for each spatial phase were compared with monocular stimulation of either eye. Binocular responses ranged from facilitation, through complete or partial summation, to partial or binocular occlusion. Counter to previous reports, all functional classes of neurones (simple neurones; special, intermediate and standard complex neurones) were represented in phase-specific and phase insensitive groups. Most simple neurones, together with a small minority of standard complex neurones, exhibited near-total phase-sensitive modulation, the most significant new finding being that a minority of simple neurones were relatively insensitive to binocular mismatch. The majority of complex neurones, of all types, showed shallower modulation depths (typically around 30%), distributed in a continuum, with no indication of bimodality. It is concluded that the property of positional sensitivity is not attributable solely to simple neurones; and that positional insensitivity is not seen only in complex neurones. At least some neurones of all functional categories evince either kind of behaviour. These results are interpreted as a two-stage mechanism for convergence and matching of inputs from the two eyes. PMID- 1783031 TI - Visual response characteristics of neurons in the nucleus isthmi magnocellularis and nucleus isthmi parvocellularis of pigeons. AB - The visual response characteristics of single cells in the nucleus isthmi (NI) of pigeons were investigated using standard extracellular recording techniques. The results show that both major components of NI, the parvocellular NI (Ipc) and the magnocellular NI (Imc), have a tight retinotopic organization where nasal regions of the visual field are mapped onto the rostral poles of Ipc and Imc, and temporal regions of the visual field are mapped onto the caudal poles. The more ventral regions of these nuclei receive input from more inferior regions of visual space. The receptive fields (RFs) of both Ipc and Imc are large and oval shaped, and their long axis is oriented vertically in the visual field. Most RFs are distributed on the contralateral visual horizon, and no binocular responses were found in either Ipc or Imc. All of the excitatory RFs of NI cells were surrounded by large inhibitory regions which participated in the dramatic modulation of the driven visual response when a large background pattern was moved across this zone. Although both Ipc and Imc neurons are driven best by small dark spots, some of them also show orientation selectivity to bars which may result from their oval-shaped RF (74% of Imc cells, 20/38, were orientation selective as compared to 10% of the Ipc cells, 3/30). It is suggested that some tectal cells with small RFs, and which originate from a vertically oriented zone may converge onto a single NI neuron to produce the elliptical shaped receptive fields. PMID- 1783032 TI - Neuromagnetic investigation of somatotopy of human hand somatosensory cortex. AB - In order to investigate functional topography of human hand somatosensory cortex we recorded somatosensory evoked fields (SEFs) on MEG during the first 40 ms after stimulation of median nerve, ulnar nerve, and the 5 digits. We applied dipole modeling to determine the three-dimensional cortical representations of different peripheral receptive fields. Median nerve and ulnar nerve SEFs exhibited the previously described N20 and P30 components with a magnetic field pattern emerging from the head superior and re-entering the head inferior for the N20 component; the magnetic field pattern of the P30 component was of reversed orientation. Reversals of field direction were oriented along the anterior posterior axis. SEFs during digit stimulation showed analogous N22 and P32 components and similar magnetic field patterns. Reversals of field direction showed a shift from lateral inferior to medial superior for thumb to little finger. Dipole modeling yielded good fits at these peak latencies accounting for an average of 83% of the data variance. The cortical digit representations were arranged in an orderly somatotopic way from lateral inferior to medial superior in the sequence thumb, index finger, middle finger, ring finger, and little finger. Median nerve cortical representation was lateral inferior to that of ulnar nerve. Isofield maps and dipole locations for these components are consistent with neuronal activity in the posterior bank of central fissure corresponding to area 3b. We conclude that SEFs recorded on MEG in conjunction with source localization techniques are useful to investigate functional topography of human hand somatosensory cortex non-invasively. PMID- 1783034 TI - Asymmetrical trajectory formation in cyclic forearm movements in man. AB - Predictions of the minimum-jerk model for a human cyclic motion were given in terms of asymmetry in movement trajectories. A detailed kinematic analysis of cyclic forearm motion, i.e., extension/flexion movements around the elbow joint in a horizontal plane ranging in frequency from 2-5.5 Hz, was made to examine the validity of the predictions. The kinematics of the trajectories were described in terms of deviation from symmetry in velocity and acceleration profiles, and jerk cost. The asymmetry could be accounted for by the solution of the minimum-jerk model using the boundary condition differences between extension and flexion during a movement cycle. The trajectory was asymmetrical at relatively low frequencies, and symmetrical at higher frequencies; the frequency boundary from asymmetrical to symmetrical trajectories differed among subjects with a range of 3-4.3 Hz. It was suggested for the asymmetrical trajectory formation that consecutive extension and flexion in a cycle could be processed as a unit in which speed and acceleration in each direction were differentiated. The shift from asymmetrical to symmetrical trajectories with increasing frequency was accompanied by a reduction in jerk cost and mechanical energy. The oscillators underpinning the high frequency movements were mainly non-linear. The results suggested a shift of control from the "rhythmic" sequencing of extension and flexion which resulted in trajectory asymmetry, to non-linear oscillation with no directional difference. PMID- 1783033 TI - Visual motion perception from stimulation of the human medial parieto-occipital cortex. AB - Visual phenomena evoked by direct electrical stimulation of extrastriate cortex were observed in 30 epileptic patients as part of a presurgical investigation. An incremental sequence of low-level bipolar stimulation trains was delivered at medial and lateral pairs of contacts of stereotaxically-implanted multilead intracerebral electrodes in parietal, occipital and posterior temporal regions. Diffusion of stimulus afterdischarges was monitored by electrodes in temporal and frontal lobes and by the non-stimulated contacts of the stimulated electrode. Localized stimulations evoked few visual phenomena. The strongest anatomo perceptual correlation was found for stimulation in the medial parieto-occipital fissure which evoked visual motion phenomena in all three patients stimulated in that region. The evoked motion perceptions were not associated with eye movements or any particular localization of the epileptic focus. These perceptions were only evoked once outside of the medial PO region at the 61 sites examined. The results suggest that the medial parieto-occipital region is closely linked to the human visual motion processing system. PMID- 1783035 TI - Lip muscle reflex and intentional response levels in a simple speech task. AB - Sensorimotor integration in human lip muscle was studied by recording muscle activity while subjects produced simple speech utterances in response to mechanical stimulation. On each trial subjects were instructed either to produce the syllable "pa" or not respond when they detected movement of a small paddle held between the lips. Mechanical stimuli were adequate to elicit reflexes over poststimulus intervals of 15-30 ms (R1) and 30-50 ms (R2). EMG recordings were obtained from upper and lower lip muscles, and EMG levels were calculated for individual trials over several poststimulus time intervals. The independent effects of stimulus magnitude, prestimulus EMG, and reaction time on poststimulus response levels were assessed using multiple regression analysis. R1 and R2 levels were positively correlated with stimulus magnitude, but stimulus magnitude had little modulating effect on intentional lip muscle responses. Both reflex and intentional response levels showed positive associations with prestimulus EMG level. Instructional set had significant modulating effects on reflex responses in 9 of 10 subjects, but the nature of these effects varied among subjects. These various findings are discussed in relation to similar studies on limb motor systems and lip motor control for speech. PMID- 1783036 TI - Control of vergence: gating among disparity inputs by voluntary target selection. AB - The ability of human beings to shift their vergence between multiple disparity stimuli was investigated. The stimulus was a stereogram consisting of a single bar (1 x 0.3 degree) projected in the center of a larger circular pattern (28 degrees dia) of dots (0.3 degree dia). In the initial condition, the subjects perceived a single bar in the center of a cluster of dots, all lying in a single depth plane. The subjects were instructed to fixate either the bar or one of the dots close to the bar. Stepwise changes of target-vergence of either the bar, or of all dots, or of both configurations in opposite directions, were imposed in a random sequence. Under these conditions, ocular vergence was controlled by the target-vergence of the selected target at all times, even if this implied a loss of binocular fusion for the non-selected target. The effect of target selection per se, without concomitant changes in retinal position of the selected target, was studied in two experienced subjects with stabilized image techniques. The subjects viewed a configuration containing short vertical bars placed at either side of a long vertical bar. The short bars on different sides of the long bar had opposite (crossed or uncrossed) disparities. After stabilization of the configuration while the subject fixated the long bar, subjects attempted to fixate the short bars alternatingly. Due to the stabilization the ensuing eye movements did not affect the retinal positions, and thus the disparity, of the bars. Attempted fixation of a parafoveally viewed, short bar induced vergence responses in the appropriate direction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783037 TI - Contribution of peripheral afferents to the activation of the soleus muscle during walking in humans. AB - Small, rapid stretches were applied to the soleus muscle during the stance phase of walking by lifting the forefoot with a pneumatic device. Stretch responses were induced in the soleus muscle by the disturbance. The amplitude and time course of the responses from the soleus muscle were a function of both the kinematics of the disturbance and the time in the step cycle when the disturbance was applied. The step cycle was divided into 16 equal time parts, and data obtained within each of these parts were averaged together. The electromyographic (EMG) response of the soleus muscle showed a time course that was similar to the time course of the angular velocity induced by the disturbance at the ankle. Three linear equations were used to predict the EMG response from the soleus muscle as a function of the angular kinematics of the disturbance: 1) velocity, 2) velocity and displacement, 3) velocity, displacement and acceleration. Introduction of a pure delay between the EMG and the kinematics substantially improved the predictions. Most of the variance (70%) in the EMG response could be accounted for by the velocity of the disturbance alone with an optimal delay (average 38 ms). Inclusion of a displacement term significantly increased the variance accounted for (85%), but further addition of an acceleration term did not. Since the velocity of the disturbance accounted for most of the variance, the reflex gain was estimated from the velocity coefficient. This coefficient increased in a ramp-like fashion through the early part of the stance phase, qualitatively similar to the increase in the H-reflex.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783038 TI - Three-dimensional localization of SMA activity preceding voluntary movement. A study of electric and magnetic fields in a patient with infarction of the right supplementary motor area. AB - Previous studies by magnetoencephalography (MEG) failed to consistently localize the activity of the supplementary motor area (SMA) prior to voluntary movements in healthy human subjects. Based on the assumption that the SMA of either hemisphere is active prior to voluntary movements, the negative findings of previous studies could be explained by the hypothesis that magnetic fields of current dipole sources in the two SMAs may cancel each other. The present MEG study was performed in a patient with a complete vascular lesion of the right SMA. In this case it was possible to consistently localize a current dipole source in the intact left SMA starting about 1200 msec prior to the initiation of voluntary movements of the right thumb. Starting at about 600 msec prior to movement onset the assumption of a current dipole source in the left primary motor cortex was needed to account for the observed fields. Measurements of brain potentials were consistent with MEG findings of activity of the left SMA starting about 1200 msec prior to movement onset. PMID- 1783039 TI - The effect of D-penicillamine on CCl4-induced experimental liver cirrhosis. AB - The effect of D-penicillamine (Pe) on liver fibrosis-cirrhosis induced by chronic CCl4 and phenobarbital (Pb) administration in Fischer 344 male rats was studied. Morphometric analysis did not reveal a decrease in the amount of connective tissue fibers after Pe-treatment. Compared to the CCl4 and Pb-treated control groups, Pe had no significant effect on the concentrations of hydroxyproline, a parameter of collagen degradation, either; however, it increased the glycosaminoglycan concentrations. Lymphocyte stimulation by Con-A in the Pe treated groups did not differ from that of the CCl4 and Pb-treated ones. According to our studies, Pe-treatment was ineffective in rats with liver fibrosis-cirrhosis induced by CCl4 and Pb administration. It seems that Pe can be effective only in the cirrhosis types accompanied by a considerable copper accumulation due to suppression of the toxic effects of copper. PMID- 1783040 TI - Cardiac carnitine acyltransferase activities in exercised normal and dystrophic hamsters. AB - Carnitine acyltransferase activities in the hearts of normal and dystrophic, sedentary and swim exercised hamsters were studied, in order to analyze the relationship between carnitine metabolism and exercise in cardiomyopathy. After 12 weeks, the mean specific activities of cardiac carnitine acetyltransferase (CAT), carnitine octanoyltransferase (COT) and carnitine palmitoyltransferase (CPT) were significantly higher in the dystrophic sedentary group, relative to the normal sedentary group (p less than 0.05). There was no significant effect of exercise on the mean specific activity of the carnitine acyltransferases, compared to the dystrophic or normal sedentary controls. Thus, the improvements in cardiac histopathology due to exercise noted previously are not associated with altered carnitine acyltransferase activity. PMID- 1783041 TI - Eicosanoids in atherosclerosis. PMID- 1783042 TI - Effects of testosterone on the liver of castrated rats: morphologic study. AB - It is well known that castration in rats causes atrophy of the sexual organs and, to a lesser extent, of other organs. We have observed that castration causes a reduction of the liver weight due to a reduction (-10%) of the numerical density of the hepatocytes after castration (p less than 0.01). Testosterone administration at high concentration (2.5 mg/100 g b. wt.) as well as at low concentration (0.025 mg/100 g) in the castrated rats causes an increase of the liver weight due to an increase (+30%) in the cellular area (p less than 0.001) as well as in the nuclear area (+20%) (p less than 0.01) of the hepatocytes, revealing a powerful hypertrophic effect of the hormone in the liver. PMID- 1783043 TI - Experimental CNS tumors in rats. Testing field for a computerized classification and tumor grading. AB - The purpose of this study was to verify the efficiency of a previously described method for the computerized histological diagnosis of experimental brain tumors (Kroh et al. 1988). 117 tumors (astrocytomas, glioblastomas, meningosarcomas, neurinomas, oligoastrocytomas and oligodendrogliomas), experimentally induced in rats, were studied. In every case the same 50 histological characteristics used for the elaboration of a computerized system for the diagnosis of experimental brain tumors in mice were analyzed. Our results demonstrate the efficiency of this diagnostic method for experimental brain tumors. Furthermore, the grade of malignancy of these tumors was also determined by using a previously described computer program. PMID- 1783044 TI - The effect of acetylsalicylic acid on the development of the skeletal system in rats. AB - The authors wished to clarify the cause of micro- and phocomelia developing in rat fetuses following administration of acetylsalicylic acid. It has been proved by histological examinations that the positive ground substance of the epiphyseal cartilage, detected by Rivanol reaction, became disarranged or negative. The sulphation of glycosaminoglycans was diminished or inhibited by acetylsalicylic acid in the chondrocytes depending on the dose applied. The conclusion has been drawn that the malformation developed is due to the reduced production of sulphated mucopolysaccharides. PMID- 1783045 TI - Succinyl trialanine p-nitroanilide hydrolytic activities in plasma and the aorta of rabbits experimentally immunized with soluble elastin. AB - Experimental immunization of rabbits with soluble porcine elastin was performed. Elastase-like activities in plasma and the aorta were assayed using succinyl trialanine p-nitroanilide. A statistically significant increase in the elastase like activity in plasma of the immunized animals was observed. Estimations of the elastase-like activity in the rabbit aorta showed the rise of analyzed parameters in the experimental group. PMID- 1783046 TI - Pro-inflammatory actions of the platelet activating factor: relevance to rheumatoid arthritis. PMID- 1783047 TI - Isoenzymes of pyruvate kinase, lactate dehydrogenase and alkaline phosphatase in epithelial cell lines of rat liver. AB - In cultured epithelial cells of rat liver the isoenzyme patterns of pyruvate kinase, lactate dehydrogenase and alkaline phosphatase were studied and compared with those of freshly isolated parenchymal and non-parenchymal liver cells. In all epithelial cell lines pyruvate kinase was not activated by fructose 1,6 bisphosphate, suggesting the absence of the L-isoenzyme. Cell lines derived from livers of newborn rats expressed LDH-4 and -5, whereas cell lines developed from fetal rat livers contained all 5 lactate dehydrogenase isoenzymes. In the latter case the pattern was found to depend on the state of confluence. All cell lines exhibited only a single alkaline phosphatase form, however, differences were found with respect to electrophoretic mobility. PMID- 1783048 TI - Pulmonary histiocytosis X cells phagocytize Staphylococcus aureus in vitro. AB - The broncho-alveolar lavage from an 18-year-old girl with proven histiocytosis X of the lung has been cocultivated with Staphylococcus aureus. Electron microscopy revealed that the bacteria adhere to the membrane of HX cells and become ingested afterwards. PMID- 1783049 TI - Relation between renal and hepatic excretion of drugs. XIV. Elimination of ioglycamic acid after nephrectomy, bile duct ligation, and after treatment with hormones or xenobiotics in young and adult rats. AB - Ioglycamic acid (IGA) is effectively eliminated in young and adult rats via urine and bile. After administration of low doses hepatic excretion dominates whereas following high supply renal elimination surpasses biliary excretion. Hepatic transport of IGA is active, indicated by the occurrence of a transport maximum in vivo and by a distinct accumulation of this drug within liver slices in vitro. Renal removal of IGA is preferentially caused by glomerular filtration. A tubular reabsorption obviously does not occur because forced diuresis (mannitol, furosemide) does not increase renal excretion of this substance. As calculated from our clearance data and as a result of accumulation experiments in vitro on renal cortical slices the active tubular secretion of this organic anion can be excluded. In principle there are no qualitative changes in IGA elimination between the 20th and 55th day of life, but active hepatic transport of the drug is significantly lower in young, immature rats. After bile duct ligation, renal excretion of IGA increases distinctly in both age groups, whereas in adult rats bilateral nephrectomy (NX) is followed by a significant decrease in its hepatic excretion in dependence on time after kidney removal. In young rats NX is without consequences on hepatic excretion of IGA. It is possible to stimulate renal and/or hepatic excretion of IGA by repeated administration of T3, dexamethasone, or phenobarbital. The effect of stimulation is different in kidney and liver and depends on age, too. PMID- 1783050 TI - The influence of the radiation syndrome on cytochrome P450-dependent monooxygenation in rat liver. AB - Cytochrome P-450 concentration and the monooxygenation activities of some cytochrome P-450 forms were determined in rat liver in the course of the acute radiation sickness. Ethylmorphine N-demethylation, ethoxycoumarin, ethoxyresorufin, and pentoxyresorufin O-dealkylation were used as indicator reactions. After radiation a distinct decrease in the hepatic biotransformation capacity can be observed, most pronounced at the climax of the radiation syndrome. Phenobarbital treatment (60 mg/kg b. m. at 3 consecutive days each) increases the concentration and the monooxygenase activities of some cytochrome P 450 forms. The degree of this induction effect is not altered at the third day after radiation, whereas at day 7 no significant inducibility can be observed. PMID- 1783051 TI - Ultrastructure of the liver after hypoxia in the postnatal period. AB - Repeated phases of hypoxia (8 h daily for 2 to 5 days at pO2 11.33 kPa = 5.000 m in altitude) were induced to Sprague-Dawley rats in the postnatal period as well as up to the 64th day of age, and after different recovery phases the ultrastructure of hepatocytes was qualitatively and quantitatively analysed. Major results were as follows: 1. Increases in body and liver weights were delayed but were balanced off after 64 days. 2. Qualitative alterations are reversible spherical transformations of mitochondria, a degradation of lipids and a slight increase in autophagocytosis. 3. The quantitative mitochondrial parameters (volume density, number per unit area, average volume) were not even adjusted to control values after 64 days. Granular endoplasmic reticulum and ribosomes/polysomes were insignificantly reduced in comparison to control animals, structure and arrangement are regular. Lipids and glycogen were differently altered. 4. The findings of the hepatocytes after postnatal hypoxia were reversible, though the majority of parameters had not yet returned to normal after 2 months. An adaptation to repetitive hypoxic conditions is not provable. PMID- 1783052 TI - A new influenza surveillance system in France: the Ile-de-France "GROG". 2. Validity of indicators (1984-1989). AB - The evaluation of the validity of the GROG's indicators is based on the first five years of activity, four of which being epidemic ones. A virological criterion for identifying epidemics is used as the gold standard. For each non specific indicator, the ratio of epidemic weeks to non-epidemic weeks is outlined. Therefore we can define four epidemic situations in relation with the strains circulating and the non-specific indicators. Influenza A epidemics, which are known as a mortality problem can also be described according to its impact upon morbidity. As a result, it is possible to set up a sensitive and specific surveillance system for early detection of influenza epidemics. This objective is achieved by combining both the weekly collection of virological data as well as the collection of other available indicators either in routine practice or as provided by a network of sentinel practitioners. Such detection can pave the way for an improvement in preventive measures against the harmful effects on health of influenza epidemics. PMID- 1783053 TI - History of tonsillectomy and appendectomy in Hodgkin's disease. AB - The study comprised all 113 clinically and histologically confirmed cases of Hodgkin's disease aged 15-39 years who were treated at the Department of Hematology of the Faculty of Medicine in Belgrade from January, 1 to June, 30, 1987. For each patient, two individually matched controls were selected. Neighbourhood controls were the first neighbours of the same sex, age, and residence history. Hospital controls consisted of accidentally injured individuals, and they were matched in terms of sex, age, place of residence, and educational level. Comparison of cases and controls revealed that removal of the lymphoid tissue (either tonsils or appendix) did not affect the risk of developing Hodgkin's disease in any way. An association found by some previous studies has been explained by the confounding effect of socioeconomic status. PMID- 1783054 TI - Dengue surveillance in French Polynesia: an attempt to use the excess number of laboratory requests for confirmation of dengue diagnosis as an indicator of dengue activity. AB - The excess number of weekly laboratory requests for confirmation of dengue diagnosis over the expected number of requests forecasted by the modified Serfling method is proposed for the surveillance of dengue in French Polynesia, in addition to conventional methods. Retrospective analysis of the seasonal curves of dengue activity related to the number of laboratory requests is described for the years 1982-1987 where dengue type 4 was the only active flavivirus at the time when the forecast was initiated. By using past epidemic data, the probability of failing to recognize an increase in excess of requests as possibly epidemic was of 13.2% and 5.8%, respectively, when the criterion for epidemic increase was set respectively at 2 and 3 successive weeks during which the epidemic threshold is exceeded. A weekly surveillance was set up prospectively for 1988 using these criteria. PMID- 1783055 TI - Iron and ferritin in Italian subjects. AB - We studied the iron status of 400 Italian subjects, 200 men and 200 women, equally distributed in four 10-year age groups between 20 and 60 years. The frequency of iron deficiency was elevated in women of childbearing age. On average 13% of the women in the three younger age groups showed low serum ferritin levels and 16-18% a low transferrin saturation index. Only 6% of the women over 50 were iron deficient. Signs of iron deficiency were never observed in more than 2% of the men in the age groups under 50, with the percentage rising slightly in the men over 50. In the women an inverse correlation was found between serum ferritin levels and number of births [log ferritin (ng/ml) vs number of births, b +/- SE (b): -0.252 +/- 0.088] and between serum ferritin and duration of menstruation [log ferritin (ng/ml) vs duration of menstruation (days), b +/- SE (b): -0.160 +/- 0.065]. Furthermore, hemoglobin levels were 0.700 (+/- 0.248, SE) g/dl lower in the women with 'abundant menstrual flow', and hemoglobin levels correlated inversely with number of births [hemoglobin (g/dl) vs number of births, b +/- SE (b): -0.354 +/- 0.115]. Our study showed an elevated frequency of iron deficiency in women of reproductive age. The number of births and abundance of menstrual flow were both important factors in predisposing younger women to developing iron deficiency. PMID- 1783056 TI - Maternal hyperthermia during pregnancy and cardiovascular malformations in the offspring. AB - During pregnancy, a number of factors predisposing to hyperthermia, such as sleeping in a water bed, sauna bathing, heatwave, high workplace temperature, and fever, are believed capable of harming the foetus. This study aimed to clarify possible associations of maternal workplace temperature, season of birth, sauna bathing, upper respiratory infection, and fever, with cardiovascular malformations in the offspring. The material was composed of all 573 cardiac malformations registered in Finland in 1982-84, and 1055 randomly chosen healthy controls. The mothers were interviewed at maternity welfare centers about three months after delivery. Fever (greater than or equal to 38 degrees C) during early pregnancy was more prevalent among case mothers (10%) than controls (6%) (p less than 0.01), largely manifest as increased risks of atrial septal defect and hypoplastic left heart. Upper respiratory infection was also more common among case mothers (26%) than controls (18%) (p less than 0.001). By contrast, maternal workplace temperature, sauna bathing, and temperature of the environment (seasonal variation) were not associated with risk of cardiac malformation in the offspring. The use of acetylsalicylic acid-containing medication for reducing fever was equally common (7%) among case and control mothers. PMID- 1783057 TI - Epidemiology of Crohn's disease in Sicily: a hospital incidence study from 1987 to 1989. "The Sicilian Study Group of Inflammatory Bowel Disease". AB - An epidemiologic study of Crohn's disease was carried out in the Province of Palermo, Italy, between 1987 and 1989. The incidence of first hospitalization was prospectively evaluated in this period. A total of 103 patients (59 males, 44 females) were diagnosed. The standardized annual incidence was 2.7/100,000. The incidence was quite constant during the 3 years of the study (1987: 2.9/100,000; 1988: 2.4/100,000; 1989: 2.99/100,000). Incidence rates were slightly higher in men than in women. The disease had a bimodal age distribution in female (with peaks at age 20-29 and 60-69) and males (with peaks at age 30-39, 40-49). No cases were observed at age 0-9. The incidence of Crohn's disease in southern Italy is comparable to that reported in northern Europe. PMID- 1783058 TI - Surgical infections surveillance: results of a six-month incidence study in two Italian hospitals. AB - In a six-month incidence study of surgical wound infections (SWI) in two Italian hospitals, 1,019 surgical patients, in three general surgery wards, and 433 surgical patients in one orthopedics ward were studied. For the SWI surveillance, the DANOP-DATA system was used: this microcomputer program was developed by Danish authors and tested in a European multicenter study coordinated by the World Health Organization in 1989. Two Italian hospitals participated in the multicenter study. The overall infection rate was 1.2 per 100 operations in orthopedics and 4.9/100 in general surgery. The risk of infection increased with age (RR = 2.06; 95% CL = 1.20-3.53), wound class (RR = 3.38; 95% CL = 1.97-5.8), length of pre-operative stay (RR = 2.71; 95% CL = 1.54-4.74), and duration of operation (RR = 2.59; 95% CL = 1.48-4.54). The infection rates ranged from 3.7 to 7.3/100 among the three general surgery wards; this variability by ward was only partially explained by differences in the age distribution of in-patients, wound class, duration of operation and length of pre-operative stay. When all these risk factors were simultaneously taken into account using a logistic regression model, the odds radio, comparing one of the three general surgical wards with the other two, was still 2.29 (95% CL = 1.23-4.26). The observed variability can be attributed to differences, among the participating wards, in the case-mix of patients treated and/or to differences in the quality of infection control programs implemented. PMID- 1783059 TI - Serum selenium and precursors of cardiovascular risk factors in adolescents. AB - The aim of this study was to determine, in a population of Italian adolescents, the association of serum selenium levels with precursors of biochemical and anthropometric variables known as being among the major risk factors for cardiovascular diseases in the adult population. The following measurements were taken in a school sample of 627 adolescents (aged 12-13 years); serum selenium, total cholesterol, high density lipoprotein cholesterol, non-HDL cholesterol, height, weight, body mass index, systolic blood pressure and diastolic blood pressure. The serum selenium levels were slightly higher in males (83.1 +/- 10.1 micrograms/l) than in females (81.7 +/- 11.0 micrograms/l), but the difference was not statistically significant. Serum selenium was positively correlated with total cholesterol, diastolic blood pressure and HDL cholesterol in both sexes; moreover it was positively correlated with non-HDL cholesterol and negatively correlated with height in males only. PMID- 1783060 TI - Preoperative stay as a risk factor for nosocomial infection. AB - To evaluate the relationship between duration of preoperative stay and the risk of nosocomial infection, we studied 449 patients who underwent surgery at the University Hospital of Granada during the first six months of 1986. Patients were chosen from two cross-sectional surveys. Nosocomial infection was studied throughout each patient's hospital stay. Other variables included preoperative stay, age, severity and total length of stay. The data were analyzed by comparing nosocomial infection for different lengths of preoperative hospitalization, age and severity by calculating the Odds Ratio. The effects of age and severity were studied by stratifying patients by duration of preoperative stay. Two multivariate regression models were used to confirm the results of the stratified analysis. The results suggest that lengthening the preoperative stay may increase the risk of nosocomial infection in surgical wounds and in other sites, and may simultaneously potentiate the effects of other risk factors such as age and severity of the patient's condition, whose influence on susceptibility to infection increases with the duration of preoperative stay. PMID- 1783062 TI - No evidence of HIV-2 infection in subjects at risk for AIDS living in north-east Italy. AB - Sera samples from 1134 individuals (824 HIV-1 seropositive and 310 HIV-1 seronegative), collected from January 1988 to April 1990, were tested for HIV-2 antibodies by whole virus assays and synthetic peptide-based assays to determine the prevalence of HIV-2 infection in populations at risk for AIDS in North-East Italy (Veneto Region). Partial reactivities on HIV-2 Western Blot were a common finding in HIV-1 seropositive samples. None of the sera fulfilled the criteria for HIV-2 seropositivity, since only low-level reactivity was observed with an HIV-2 competitive ELISA test, and no reactivity occurred with an HIV-2 specific peptide. Therefore, there is no evidence of HIV-2 infection in this geographical area, to date. PMID- 1783061 TI - Mycobacterium xenopi isolation from clinical specimens in the Florence area: review of 46 cases. AB - The occurrence of Mycobacterium xenopi (MX) isolates is not homogeneous in various geographic zones. In the Florence area, between 1975-1989, strains of MX from 64 different patients have been isolated. The review of bacteriological and clinical data of 46 of them, from whose sputum MX had been grown, allowed to diagnose for 26% the commensal nature of this finding, for 41% the concomitance with a tubercular infection and for the remaining 33% the pathogenicity of this microorganism. The increased occurrence of MX isolates, their high rate of pathogenicity and the remarkable homogeneity of their biochemical, cultural and antimicrobial sensitivity patterns seem to suggest the hypothesis of an endemic focus of this species in the Florence area. PMID- 1783063 TI - Species identification and detection of oxacillin resistance in coagulase negative Staphylococcus blood isolates from neutropenic patients. AB - One hundred coagulase-negative staphylococcal isolates from septicemic neutropenic patients with hematologic malignancies were identified to a species level by means of the French API STAPH strip system and by the Automicrobic VITEK system. According to these two methods, which concurred in 95% of cases, S. epidermidis (80-82% of the isolates) was the most frequently identified species, followed by S. haemolyticus (6-7% of the isolates). The susceptibility to oxacillin was also evaluated by macrodilution MIC, Automicrobic VITEK system and agar screen, and 76, 78 and 79 of the 100 isolates, respectively, were found resistant to this antibiotic. All oxacillin-resistant isolates according to Automicrobic VITEK were confirmed resistant by agar screen. A 48h incubation was required to determine oxacillin resistance in 11 of 79 isolates with agar screen and in 10 of 76 isolates with macrodilution MIC. Automicrobic VITEK system may represent a useful method for rapid identification to a species level and early recognition of oxacillin resistance in coagulase-negative staphylococci. PMID- 1783064 TI - Salmonellosis diagnosed by the laboratory of the 'L. Sacco' Hospital of Milan (Italy) in patients with HIV disease. AB - We reviewed the cases of typhoid fever (3 cases) and non-typhoid salmonellosis (62 cases) diagnosed from 1987 to 1989 in the Laboratory of Clinical Chemistry and Microbiology of the 'L.Sacco' Hospital, Milan. Two cases of typhoid fever and 24 cases of non-typhoid salmonellosis occurred in patients without clinical symptoms of HIV infection. One case of typhoid fever and 38 cases of non-typhoid salmonellosis occurred in patients with clinical symptoms of HIV infection. In AIDS patients living in the Milan province the annual incidence of non-typhoid salmonellosis was estimated to be 100-fold greater than that observed in the general population. In patients with non-typhoid salmonellosis, bacteremias was found only in subjects with HIV disease (P = 0.0009). The frequency of bacteremia was higher in patients with AIDS than in patients with other manifestations of HIV disease (P = 0.0356). Finally, a significant difference between patients with and without HIV disease was found with regard to Salmonella serotypes distribution (P = 0.0196). PMID- 1783065 TI - Epidemiological aspects of hepatitis B in Palermo: changes in HBV spread. AB - Prevalence of HBV infection in Palermo was investigated in 1989, in comparison with similar data observed in 1982. Between September 1988 and April 1989, 1001 serum samples taken from healthy individuals or from patients with pathology unrelated to liver diseases, in the age groups 0 to 59 years, were collected. Prevalence of HBsAg and anti-HBc was, respectively, 2.7% and 24.3% in males, 2.3% and 19% in females. Prevalence was inversely related to socioeconomic level as defined by occupation, educational level and area of residence. Prevalence of HBV markers in 1989 was compared with that of a sample of sera taken in 1982 and stored at -20 degrees C. Prevalence was lower in 1989 for age groups under 20, while no difference was seen in older age groups. PMID- 1783066 TI - Urethritis caused by neisseria meningitidis: a case report. AB - Isolation of N. meningitidis from the male urethra has become more common in recent years and this has been attributed to sexual activities and changes in social attitudes. We describe a further case of acute urethritis caused by transmission of N. meningitidis occurring after a single sexual contact (fellatio) in a heterosexual man. The urethritis was initially diagnosed as being caused by N. gonorrhoeae on a presumptive basis, then attributed to N. meningitidis serogroup Y. This case shows the need of accurate diagnostic procedures in all cases resembling gonococcal urethritis. PMID- 1783067 TI - Influence of socio-economic and other factors on rheumatic fever occurrence. AB - Conditional logistic regression analysis of case-control study data showed that the following factors were significantly related to rheumatic fever occurrence: home dampness, change of place of residence during the last 5 years, low education of mother, body weight below normal, frequent sore throat and positive family history of rheumatic fever. PMID- 1783068 TI - Improved immunoblotting for the detection and quantitative analysis of antibodies to human immunodeficiency virus. AB - Detection of antibodies to single HIV-1 proteins was performed by modified Western-blotting procedure. The use of [35S]-Streptavidin instead of Avidin peroxidase conjugate greatly enhances the sensitivity of the method and enables useful quantitative analysis of results. PMID- 1783069 TI - Smoking behaviour of medical students in Belgrade (Yugoslavia) PMID- 1783070 TI - HIV infection in drug using transvestites and transexuals. PMID- 1783071 TI - Creutzfeldt-Jakob disease in Italy. PMID- 1783072 TI - Acute mountain sickness susceptibility, fitness and hypoxic ventilatory response. AB - In a party of 17 subjects who travelled together to 4,500 m, hypoxic ventilatory response (HVR) and maximum oxygen consumption (VO2max) were measured before departure. HVR was measured under constant and varying alveolar carbon dioxide tension (PACO2) conditions. VO2max was measured by both standard expired gas collection technique on a treadmill and using the "shuttle run" technique. On arrival at altitude, symptoms of acute mountain sickness (AMS) were scored daily for three days. There were no cases of severe AMS but half of the party had mild to moderate degrees of AMS. There was no correlation between AMS scores and HVR by either method of measurement or with VO2max measured by either method of measurement or with VO2max measured by treadmill or shuttle run. PMID- 1783073 TI - Prevention of leucocyte elastase-induced emphysema in mice by heparin fragments. AB - Heparin and its derivatives inhibit human leucocyte proteinases i.e. elastase and cathepsin G, but do not inhibit porcine pancreatic elastase and Pseudomonas aeruginosa elastase. In vitro experiments, reported here, also indicate that elastin, one of the physiological substrates of human leucocyte elastase (HLE), could decrease by 30-fold the inhibitory potential of an hexadecasaccharide heparin fragment (dp 16) isolated from CY 222. Nevertheless, the inhibitory capacity of the heparin fragment still remains elevated with IC50 = 2.7 x 10(-7) M and still inhibits HLE in its free and adsorbed state to elastin. These overall data prompted us to evaluate the influence of CY 222 in HLE-induced emphysema. Emphysema was induced in mice eight weeks old, following a single instillation of 200 micrograms of HLE. CY 222 treated animals received 2.5 mg.kg-1 subcutaneously once daily, 6 days per week during 4 weeks prior to HLE instillation, and for eight weeks following HLE instillation. The heparin fragment treatment of the mice halved the mortality rate observed early following HLE instillation. After 8 weeks, surviving animals were examined for lung histological and morphometrical changes: mean linear intercept (MLI) and internal alveolar area (ISA). The CY 222 heparin fragments exerted a protective effect against HLE-induced emphysema by decreasing by 70% the MLI; these heparin fragments exerted no effect on emphysema induced by pancreatic elastase in hamsters or mice. Heparin derivatives represent a new class of physiological HLE low molecular weight inhibitors capable of preventing HLE-induced emphysema. PMID- 1783074 TI - Accuracy of diagnostic tools for the management of nosocomial respiratory infections in mechanically ventilated patients. AB - This article reviews the medical literature concerning available diagnostic tools for managing nosocomial respiratory infections in mechanically ventilated patients. The first part deals with the reliability of the clinical criteria used in diagnosing nosocomial pneumonia in such patients and the accuracy of simple markers of pneumonia such as elastin fibres stain and antibody-coated bacteria. The second part reviews the presently available non-invasive and invasive methods for diagnosing pulmonary infections acquired during mechanical ventilation. With regard to invasive methods, protected specimen brush and bronchoalveolar lavage are extensively discussed in view of the different results in the literature. At the present time, these two methods seem to be the most accurate techniques available. The fact that bronchoalveolar lavage may combine the cytological examination and the quantitative culture of the sample obtained is noted. The role of percutaneous lung needle aspiration is also mentioned. Finally, histological diagnosis of pneumonia and pulmonary postmortem biopsy cultures are reviewed as "gold-standard" reference methods for investigation in this field. Future directions for further clinical research are addressed. PMID- 1783075 TI - Lack of usefulness of blood cultures to diagnose ventilator-associated pneumonia. PMID- 1783076 TI - Bronchial asthma improved after removal of a phaeochromocytoma. AB - It is uncommon for bronchial asthma to be a symptom of phaeochromocytoma. We describe a patient with a phaeochromocytoma who presented with worsening of her asthma and persistent dyspnoea between attacks. She had markedly elevated levels of catecholamines. After surgical resection of the phaeochromocytoma there was a lasting improvement of the bronchial asthma. We hypothesize that worsening of bronchial asthma in phaeochromocytoma patients may be due to catecholamine induced deterioration of asthma. PMID- 1783077 TI - Pulmonary schistosomiasis resembling acute pulmonary tuberculosis. AB - Pulmonary involvement of schistosomiasis is usually characterized by a miliary mottling or diffuse nodular infiltrates. In most cases, pulmonary involvement is associated with an apparent clinical involvement of other organs. This report describes a 35 yr old patient who developed a cavity, a parenchymatous infiltrate and hilar adenopathy in association with pulmonary schistosomiasis. Schistosoma eggs were demonstrated in transbronchial biopsies from the lung. Pulmonary involvement of schistosomiasis is reviewed and atypical features are discussed, which may lead to diagnostic difficulties, particularly compared to tuberculosis. PMID- 1783078 TI - Spontaneous haemopneumothorax: a rare clinical entity. AB - A 39 yr old man presented with a spontaneous pneumothorax. On initial pleural drainage 120 ml of haemorrhagic fluid were collected. Twenty four hours, after re expansion of the lung, shock developed and 1,200 ml of haemorrhagic fluid were spontaneously collected. The diagnosis haemopneumothorax was considered and at operation a bleeding vessel, which originated from the parietal pleura, was located and coagulated. The occurrence of an air fluid line at radiological examination, the development of a haemorrhagic pleural effusion and shock should alert the physician of this entity. This case stresses the importance of early recognition and surgical intervention because of the possible lethal evolution. PMID- 1783079 TI - Pulmonary veno-occlusive disease: a case report and a review of therapeutic possibilities. AB - We describe the observation of a 12 yr old girl who died of pulmonary veno occlusive disease (PVOD). Diagnosis was based on histological examination of an open lung biopsy. The differential diagnosis, pathogenesis and possible therapies are discussed. Although medical therapy can sometimes give some temporary relief, lung transplantation might offer these patients a better chance of survival and a better quality of life. PMID- 1783080 TI - Interstitial pneumonitis and pulmonary vasculitis in a patient taking an L tryptophan preparation. AB - A case is presented of interstitial pneumonitis and pulmonary vasculitis ascribed to the ingestion of an L-tryptophan preparation. An unintended rechallenge supported the causal relationship. There was neither myalgia nor peripheral eosinophilia. Bronchoalveolar lavage fluid contained 12% eosinophils but few were present in the surgical lung biopsy specimen. Lung infiltrates receded after withdrawal of the drug and treatment with steroids. Dyspnoea and pulmonary hypertension persisted. Cyclophosphamide had no effect. Sclerodermiform skin lesions appeared as a late sequel. Chromatographic analysis of the L-tryptophan revealed no suspect impurities. PMID- 1783081 TI - Effort and dyspnoea during work of varying intensity and duration. AB - This study quantified the separate contributions of the intensity of exercise and its duration to muscular effort and dyspnoea during cycle ergometry. Six normal subjects estimated the perceived intensity (Borg scale 0-10) of peripheral muscular effort and dyspnoea during incremental exercise to their maximum work capacity (Wcap). On separate days, the same subjects exercised to endurance or 60 min at work rates rated for leg effort on the initial incremental test as: 2 ("slight", 33.1 +/- 1.45% Wcap) (mean +/- SE); 3 ("moderate", omission 83.6 +/- 3.87% Wcap). Perceived leg effort increased by a factor of 4.4 (2(2.13)) with a doubling of work rate and by 1.3 (2(0.39)) with a doubling of duration, as expressed by: Leg effort = k x %Wcap2.13 x Time0.39 (r2 = 0.87) Perceived dysponea increased 5.3-fold with a doubling of work rate and by 1.4-fold with a doubling of duration: Dysponea = k x %Wcap2.41 x Time0.47 (r2 = 0.75) Changes in work intensity, rather than duration, dominated symptom magnitudes such that in the performance of a given task, halving the intensity and doubling the duration of activity reduces the maximal intensity of muscular effort and dyspnoea to less than a third. PMID- 1783082 TI - Oral diamorphine: lack of effect on dyspnoea and exercise tolerance in the "pink puffer" syndrome. AB - The aim of this study was to assess the effects of diamorphine on breathlessness and exercise tolerance in patients with severe chronic airflow obstruction and normal arterial carbon dioxide tension (PCO2) levels ("pink puffer" syndrome). In this double-blind, cross-over, randomized study we examined both acute and chronic effects of single and multiple doses of oral diamorphine in 14 "pink puffer" patients. Their mean resting forced expiratory volume in one second (FEV1) was 36% predicted normal, mean arterial oxygen tension (PaO2) was 9.2 kPa and mean PaCO2 was 5.2 kPa. Ten patients took either diamorphine 2.5 or 5 mg or placebo elixir 6 hourly for 2 weeks, recording on a diary card dyspnoea, sleepiness and well-being on a visual analogue scale (VAS). The final treatment was given 30 min before measuring spirometry, arterial blood gases, plasma morphine levels, 6 min walking distances, time walked on treadmill and self assessment of dyspnoea on a VAS scale after exercise. On two further days, eight patients took two doses, 4 h apart, of either diamorphine 7.5 mg or placebo elixir. Spirometry, 6 min walking distance with a VAS score for dyspnoea were measured before and at 1 h after each dose. Morphine levels and blood gases were also measured. Whether given in single or repeated doses, oral diamorphine had no significant effect on exercise tolerance and breathlessness when compared with placebo. Diamorphine 2.5-7.5 mg produced neither sleepiness nor a deterioration in blood gases. However, plasma levels associated with analgesic efficacy were not achieved with these doses. Thus, as given in this study, oral diamorphine is unlikely to have therapeutic potential in the treatment of dyspnoea in the "pink puffer" syndrome. PMID- 1783083 TI - Immunoglobulin G subclasses and spirometry in patients with chronic obstructive pulmonary disease. AB - Immunoglobulin G (IgG) subclass levels were measured in 58 patients with chronic obstructive pulmonary disease (COPD) and in 125 healthy controls. Total IgG values were significantly lower in the 27 COPD patients on steroid therapy compared with patients not taking steroids (8.31 (0.14) vs 9.80 (0.14), p less than 0.05), geometric mean (log SD). Total IgG (9.80 (0.14) vs 12.18 (0.16), p less than 0.005), IgG1 (5.87 (0.19) vs 6.68 (0.12), p less than 0.05) and IgG2 levels (2.75 (0.21) vs 3.70 (0.20), p less than 0.005) were significantly reduced in the COPD patients not taking steroids compared with the controls. IgG3 values were significantly elevated in smokers compared with nonsmokers in both the control and COPD groups. Fifteen COPD patients (25.9%) had a low level of one or more subclasses. IgG2 subclass deficiency was the most common, being present in 9 patients. A significant correlation was found between forced expiratory volume in one second (FEV1) and IgG2 subclass levels (r = 0.415; p less than 0.005). IgG subclass deficiencies may contribute to the development and progression of respiratory disease in COPD patients. PMID- 1783084 TI - Inherited factors in diffuse bronchiectasis in the adult: a prospective study. AB - To evaluate the prevalence of inherited respiratory ciliary structure and underlying mucus abnormalities in the diffuse bronchiectasis syndrome, we investigated 53 subjects comprising 38 patients with diffuse bronchiectasis confirmed by high-resolution thoracic computed tomography, ten with chronic bronchitis and no diffuse bronchiectasis and five healthy nonsmoking control subjects. The clinical history was determined by means of a standardized questionnaire. Axonemal abnormalities of respiratory cilia were evaluated on bronchial or nasal mucosa samples by transmission electron microscopy (structure) and stroboscopic observation (function). Cystic fibrosis (CF) and Young's syndrome were detected by means of the sweat test and semen analysis when male infertility was suspected. Among the 38 patients with diffuse bronchiectasis, a primary ciliary dyskinesia (PCD) was detected in five (13%) with a high proportion (range: 55-100%) of cilia showing axonemal ultrastructural abnormalities always involving the dynein arms. The prevalence of this inherited condition was higher in North African (36%) than in European patients (4%) (p less than 0.01). After exclusion of the five patients with PCD, the patients with diffuse bronchiectasis showed axonemal ultrastructural abnormalities similar to those with chronic bronchitis. The diagnosis of underlying mucus disorders was based on two types of criterion, i.e. for CF, sweat chloride levels greater than 80 mmol.l-1, or the combination of diagnostic criteria proposed by Stern et al. Respectively, five (three Young's syndrome and two CF) and seven (one Young's syndrome and six CF) cases of inherited mucus disorders were suspected. Our results showed that PCD was highly prevalent among the adult North African patients with diffuse bronchiectasis but relatively rare in the Europeans. PMID- 1783085 TI - Total respiratory resistance and reactance in ankylosing spondylitis and kyphoscoliosis. AB - Ankylosing spondylitis and kyphoscoliosis both alter the function of the lung by modifying the mechanical properties of the thoracic cage. The purpose of the present study was to assess the changes in total respiratory resistance (Rrs) and reactance (Xrs) in these patients and to compare these data with conventional pulmonary function tests. In 16 patients with ankylosing spondylitis and seven with kyphoscoliosis we measured lung volumes, maximal flows, diffusing capacity, airway resistance, lung compliance and Rrs and Xrs between 2-26 Hz by means of the forced oscillation technique (FOT). In the patients with ankylosing spondylitis mean total lung capacity was 83% predicted (range 60-105%). Mean values of Rrs were normal; there was a small decrease in Xrs at the lowest frequency. In the patients with kyphoscoliosis mean total lung capacity (TLC) was 41% predicted for arm span (range 26-75%). Mean Rrs was elevated with a negative frequency dependence, and mean Xrs was decreased. The observed differences in Rrs and Xrs between the two groups of patients are related to differences in severity of the restriction. There is evidence that the changes in Rrs and Xrs in both groups are mainly attributable to an increase in chest wall resistance and a decrease in chest wall compliance, while in the patients with kyphoscoliosis an increase in airway resistance and a decrease in lung compliance also intervenes. PMID- 1783086 TI - Correlations between findings at computed tomography (CT) and at thoracoscopy/thoracotomy/autopsy in pleural mesothelioma. AB - Thirty five computed tomography (CT) scans of the thorax and upper abdomen of thirty three patients with malignant pleural mesothelioma were correlated with the findings at thoracotomy (28 patients), thoracoscopy (2 patients) or autopsy (5 patients). Pleural thickening with contrast medium enhancement was detected on the CT scans of all patients. This finding was a valuable diagnostic tool, especially in cases of large amounts of pleural effusion and/or only thin layers of tumour barely or not at all visible on plain film chest X-rays. Difficulties in defining the exact extent of the diseases for clinical staging and/or evaluation of treatment response arose at the following sites: diaphragmatic pleura, chest wall, pericardium, mediastinum and mediastinal lymph nodes. Extension into the lung was difficult to identify following chemo- and/or radiotherapy. Our results show that CT is essential in the clinical management of mesothelioma. We recommend that CT scans of the chest and upper abdomen, using contrast medium enhancement, should be required in routine practice and in particular in clinical trials involving pleural mesothelioma. PMID- 1783087 TI - Ventilatory parameters in healthy nonsmoking adults of Adriatic islands (Yugoslavia). AB - Forced expiratory volumes and flows (forced vital capacity (FVC), forced expiratory volume in one second (FEV1) peak expiratory flow (PEF), maximal expiratory flow at 25% (MEF25%), 50% (MEF50%) and 75% (MEF75%) of the FVC) have been measured in 909 healthy nonsmoking men and women, ranging in age from 18-86 yrs, who live on Eastern Adriatic islands (Yugoslavia). This area is essentially free from air pollution. The results have been analysed in terms of age and height and regression equations for each sex were derived. The equations for FVC and FEV1 were reliable and those for forced expiratory flows were not. Comparisons were made with prediction equations derived for other populations, especially with those which are commonly used in daily medical practice. PMID- 1783089 TI - Effect of salbutamol on dry air- and acetylcholine-induced bronchoconstriction in the canine lung periphery. AB - We examined the effect of salbutamol on dry airflow-induced bronchoconstriction (AIB) and acetylcholine-induced bronchoconstriction (Ach-IB) in the canine lung periphery using a wedged bronchoscope technique. Collateral system resistance (Rcs) and airway wall temperature (Taw) were monitored in a peripheral lung segment before, during and after airflow challenge. Rcs before and after aerosolized acetylcholine was recorded in a contralateral lung segment. Intravenous salbutamol (2.5 micrograms.kg-1) significantly attenuated the peak fall in Taw during airflow challenge and the peak rise in Rcs following challenge. Intravenous salbutamol attenuated Ach-IB to a similar degree. Significant systemic effects were recorded following i.v. salbutamol. In contrast, aerosolized salbutamol (50 micrograms) minimally decreased the fall in Taw during airflow challenge, while virtually eliminating AIB. The same dose of aerosolized salbutamol only partially attenuated Ach-IB. Aerosolized salbutamol did not affect mean arterial pressure or heart rate. Intravenous salbutamol may in part inhibit AIB by increasing pulmonary blood flow, secondary to its systemic circulatory effects, and decrease heat and water loss during airflow challenge. In contrast, aerosolized salbutamol abolished AIB, while only minimally effecting airway cooling. These data suggest that AIB is a result of mediator release and/or smooth muscle contraction. PMID- 1783090 TI - Influence of water content of inspired air during and after exercise on induced bronchoconstriction. AB - This study looked at the influence of inspired air water content on exercise induced bronchospasm (EIB). On separate days, 12 mild asthmatics (4M, 8F), aged 18-39 yrs (mean: 27 yrs), performed four six minute steady-state exercises on ergometer at 80% of their maximum workload. Exercises were randomized to the following inspired air conditions: dry air (0% relative humidity (RH] during exercise followed by dry (DD) or humid air (100% RH) (DH) after exercise, humid air during exercise followed by dry (HD) or humid air (HH). Room temperature was kept constant (22 +/- 1 degree C) at all visits. Forced expiratory volume in one second (FEV1) was measured before and every 5 min for 25 min after exercise. Ventilation (VE) was not significantly different whether the exercise was done under dry or humid air. There was a residual bronchodilatation at the end of exercises performed in humid air, while at this time FEV1 was already lower than baseline when exercise was done in dry air conditions. The maximal fall in FEV1(%) following exercise was significantly greater after those performed in dry air: DD (29 +/- 5.6%) and DH (30 +/- 5.8%) than in humid air: HD (12 +/- 4.9%) and HH (20 +/- 4.9%) (p less than 0.05). The time-course of recovery from bronchoconstriction was significantly improved when inhaling dry air after exercise. However, the difference found in the maximal % fall in FEV1 after exercise when recovery was in dry compared to humid air did not achieve statistical significance. In conclusion, EIB is influenced by the changes in water content during and after exercise. Bronchoconstriction following exercise is minimal if exercise is done in humid air and recovery in dry air, and maximal if the exercise is performed in dry air and recovery in humid air. PMID- 1783088 TI - Bronchoalveolar lavage fibronectin in patients with sarcoidosis: correlation to hyaluronan and disease activity. AB - Bronchoalveolar lavage was performed in 51 patients with sarcoidosis and in 21 healthy nonsmokers. The concentration of fibronectin was significantly higher (p less than 0.001) in lavage fluid from sarcoid patients (median 267 micrograms.l 1) than in that of controls (46 micrograms.l-1). Furthermore, a significantly higher concentration of fibronectin was found in patients with active disease than in those in whom the disease was inactive (p less than 0.001). In a six month follow-up perspective, patients with a progressive disease course had significantly higher levels of fibronectin than those who had a stable or regressive disorder (p less than 0.01). Correspondingly, lavage hyaluronan was higher (p less than 0.001) in sarcoid patients (55 micrograms.l-1) than in controls (9 micrograms.l-1) and higher (p less than 0.01) in those with active than in those with inactive disease. Patients with progressive disease had higher (p less than 0.01) concentrations of hyaluronan than those in whom the disease was stable. A significant correlation was found between lavage fibronectin levels and hyaluronan (r = 0.81, p less than 0.001). The percentage of mast cells was also higher in patients with active than in those with inactive disease (p less than 0.01) and higher in progressive than in stable sarcoidosis (p less than 0.001). Ten out of 10 patients with progressive disease had mast cells greater than or equal to 0.5%, hyaluronan greater than or equal to 50 micrograms.l-1 and fibronectin greater than or equal to 350 micrograms.l-1 compared to eight out of 41 patients with stable or regressive disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783091 TI - The interaction of acetylcholine and histamine on human bronchial smooth muscle contraction. AB - The interaction of histamine (Hist) and acetylcholine (ACh) on human isolated bronchial smooth muscle (HIBSM) contraction, and the influence of the epithelium, was assessed using HIBSM obtained from 15 patients undergoing thoracotomy. Cumulative concentration effect curves for ACh and Hist, together with combinations of equipotent concentrations of both agonists, were generated using both epithelium-intact and epithelium-denuded HIBSM. In epithelium-denuded HIBSM both ACh (p less than 0.05) and Hist (p less than 0.005) produced a significantly enhanced maximal response and a 2.1 fold increase in the potency of ACh (p less than 0.02, n = 13). When ACh and Hist were added simultaneously, in equipotent concentrations, to epithelium-intact HIBSM, a significantly less (p less than 0.0005, n = 13) than additive response occurred with only 60% of the predicted maximum response being observed. However, following epithelium removal, an additive interaction between the two agonists (n = 8) occurred. Using HIBSM from five of the original 15 patients, similar experiments were performed to determine the influence of the muscarinic receptor antagonist atropine (0.1 microM) and the H1 receptor antagonist mepyramine (10 microM). Both resulted in a significantly less than additive interaction (40-50% of predicted tensions). Similar experiments were also performed in the presence of the cyclo-oxygenase inhibitor indomethacin (5 microM) and these failed to reverse the inhibition observed in HIBSM contraction (n = 5). The inhibitory interaction between ACh and Hist appears to be epithelium dependent and is not mediated via the release of prostanoids. Thus, there appears to be a complex interaction between contractile agonists and the epithelium, which is not just a simple summation of the activation of individual receptors on HIBSM. PMID- 1783092 TI - Henryk Gabriel Godlewski 1914-1989. PMID- 1783094 TI - Influence of melatonin on rat thyroid, adrenals and testis secretion during the day. AB - The effect of pinealectomy and exogenous melatonin on circadian rhythm of triiodothyronine (T3), thyroxin (T4), corticosterone and testosterone in sham operated and pinealectomized rats were investigated. The hormones concentration were RIA-measured and the circadian rhythm secretion were analysed by cosinor method. The findings suggest that pinealectomy abolishes the rhythmical character of corticosterone secretion and disturbs the circadian rhythm of T3, T4 and testosterone. Exogenous melatonin has the suppressive effect of diurnal secretion of T3, T4 and testosterone in pinealectomized rats but stimulates the rhythmical corticosterone secretion. PMID- 1783093 TI - Melatonin and adrenal cortex steroid production: in vivo and in vitro studies. AB - The present study was designed to clarify the interaction between the pineal melatonin and adrenal cortex steroid production. Experiments with male rats under chronic stress conditions (sleep deprivation) revealed that melatonin circadian pattern was fully destroyed and daytime plasma concentration were significantly elevated. Constant illumination (2500 lux) during the nighttime was not able to suppress melatonin production in the stressed animals. Plasma concentration of corticosterone were increased in the stressed rats as well. The modulatory effect of melatonin on corticosterone and progesterone production by rat adrenals was studied in a superfusion system. During melatonin challenge progesterone secretion was two-three fold elevated with no effect on corticosterone content in the plasma samples. Pineal cytoplasmic glucocorticoid and progesterone receptors were investigated as well. A specific binding was not observed in that case. Presented data support the existence of direct communication between the pineal and adrenal glands. PMID- 1783095 TI - Selected immunohistochemical markers in stromal neoplasms of the gastrointestinal tract. AB - We studied immunohistochemical reactions to vimentin, desmin and protein S-100 in 43 cases of stromal tumors of the gastrointestinal tract. The material studied included: 1 esophageal tumor, 18 gastric tumors, 19 small intestinal tumors and 5 colonic tumors, classified in 13 cases as benign and in 30 cases as malignant neoplasms of various degree of malignancy. Mean age of the patients was 58.9 years. A positive reaction to vimentin was found in 37 cases, a negative reaction concerned an esophageal tumor, two benign tumors (gastric and small intestinal) and three malignant tumors (gastric and two small intestinal). A positive reaction to desmin was detected in an esophageal tumor and in nine gastric tumors. Only one benign small intestinal tumor and three benign colonic tumors showed a positive reaction to desmin. Protein S-100 was found in an esophageal tumor and in 7 out of 18 gastric tumors and in 12 out of 24 intestinal tumors. Coexpression of vimentin and desmin was found in 8 gastric tumors, only in one small intestinal tumor and in three colonic tumors. Three gastric tumors showing both these reactions were all benign. Coexpression of desmin and protein S-100 was found in 7 out of 43 tumors of the alimentary tract. In six cases these tumors were benign. Basing on the results we may say that the presence of these antigens reflects the degree of differentiation of gastrointestinal stromal tumors of the gastrointestinal tract, though it does not allow to choose unequivocally conclusions as to their histogenesis. PMID- 1783096 TI - The mast cells derived from mouse bone marrow grow in close apposition with the reticular cells. AB - Cultures of mast cells of more than 95% purity were grown from bone marrow of BALB/c mice, and examined with various morphological methods. The presence of elongated, reticular cells was documented in the adherent layer on day 7 of the culture. The committed stem cells as well as immature bone marrow-derived mast cells (BMMCs) growing in clusters over the reticular cells were observed. After 14 days of cultivation BMMC harvested from the medium showed extensive plasma membrane ridges and numerous immature granules in their cytoplasm. These BMMCs increased their histamine to 0.7-1.1 pg/cell as compared to 0.1-0.2 pg/cell on the day 7. In the adherent layer BMMCs were seen in close apposition to the reticular cells. Their microvilli interdigitated with one another, forming end-to end contracts. Our findings provide the evidence that for differentiation and proliferation of BMMCs in vitro close contacts with reticular cells in the adherent layer are necessary. PMID- 1783097 TI - Ultrastructural studies on the blood-testes barrier of the rat. AB - Typical pinocytic vesicles were visible in electron micrographs in both outer and inner cellular layers of rat boundary tissue. FF technique revealed that they formed characteristic ribbons of foveoli. Foveoles less numerous were present in outer lamina for the most part of the investigated material. So we believe that this phenomenon speaks in favor of myoblastic origin of that layer. PMID- 1783098 TI - Argentaffin mast cells in the thymus of the frog. AB - Mast cells are common in the thymic parenchyma of the European common frog, Rana temporaria. They are stained meta chromatically with toluidine blue and the majority of them are impregnated with silver during the argentaffin reaction. The latter phenomenon indicate that these cells store serotonin. At the ultrastructural level, mast cells contain specific granules with electron-dense and electron-lucent parts. The silver grains are located exclusively over the electron-lucent part of the mast cell granules indicating that serotonin is stored just in this compartment. PMID- 1783099 TI - [An attempt to detect genetic information by means of molecular cytochemistry]. AB - In situ hybridization is a histochemical technique that attracts many cell biologists and others interested in developmental biology, virology, genetics and neuroendocrinology. This method gives us the precise localization and identification of individual cells which contain specific nucleic acid sequences, in a similar manner to the immunohistochemistry of cells which have a particular protein. There has been a wide range of applications for this technique. One of the most important and significant applications of in situ hybridization is the demonstration of specific mRNA in particular cells. This is quite valuable in heterogeneous tissue such as that of the hypothalamus with a various types of different cells. The combination with the immunohistochemistry enables us to study the dynamics of peptides or proteins in a certain tissue or cell. In this mini-review the logic and methodology of molecular cytochemistry, particularly, in situ hybridization, with its application in the endocrinological field was presented. PMID- 1783100 TI - [Cation metabolism and the effects of circulating factors in pregnancy induced hypertension]. AB - In order to clarify the pathophysiological significance of changes in intracellular ionized calcium and sodium levels in pregnancy induced hypertension (PIH), the intracellular ionized calcium concentration in platelets (p-[Ca2+]i) and the intracellular ionized sodium concentration in red blood cells (r-[Na+]i) were measured simultaneously in PIH women in the third trimester. p-[Ca2+]i in the first trimester showed a slightly greater increase than in the women of normal luteal phase. In the second trimester, p-[Ca2+]i decreased significantly compared to first trimester, and the third trimester and first trimester levels were the same. In women with mild and severe PIH, the levels in both groups were significantly increased compared with that in normal pregnant women. Thus mechanisms not associated with platelet activation were considered as the cause of the increase of p-[Ca2+]i of women with PIH. r-[Na+]i in mild and severe PIH were also significantly increased compared to normal pregnancy. No correlation between p-[Ca2+]i and r-[Na+]i and diastolic blood pressure was observed in normal pregnancy, but a positive correlation was observed in PIH. When the male platelets were incubated with serum from non-pregnant or normal pregnant women, p [Ca2+]i did not show any significant changes. On the other hand, p-[Ca2+]i was significantly increased after the incubation with serum from PIH women. Moreover, p-[Ca2+]i was significantly increased after the incubation with 17 beta estradiol, parathyroid hormone (PTH), or endothelin-1 (ET-1). These data suggest that the increase of p-[Ca2+]i and r-[Na+]i in PIH is important in the initiation and maintenance of hypertension by influencing peripheral vascular resistance, and also various factors in the serum of PIH women may contribute to the accumulation of intracellular ionized calcium in patients with PIH. PMID- 1783101 TI - [A case of idiopathic hypoparathyroidism complicated with chronic thyroiditis]. AB - It has been suggested that autoimmunity and genetic factors may play a specific role in the development of idiopathic hypoparathyroidism. We reported a case of idiopathic hypoparathyroidism complicated with chronic thyroiditis. The patient, a woman 40 years old, visited our clinic because of tetany of both hands and dizziness. She was of short stature with a round face. She also had a goiter, hypocalcemia, hyperphosphatemia and decreased parathyroidal function, but renal function was normal. Her TSH level was slightly high with a positive microsome test (x 1600), and the levels of thyroid hormones tended to be low. Based on Ellsworth-Howard test findings, a diagnosis of idiopathic hypoparathyroidism was made, with the complication of chronic thyroiditis confirmed by the thyroidal biopsy. Administration of l alpha-OH-D3 normalized the level of serum calcium. No special treatment was given for the chronic thyroiditis in order to observe its natural course. Her TSH returned to normal, and the level of thyroid hormones was increased to normal ranges. Tests were positive for anti-adrenal antibody and anti-gastric antibody. The complication of chronic thyroiditis, an autoimmune disease, and a positive finding for every antibody suggested the possible involvement of autoimmunity in the mechanism of development of idiopathic hypoparathyroidism. The administration of 1 alpha-OH-D3 resulted in an increase in the serum calcium level and also normalization of levels of TSH and thyroid hormones. Thus, it is likely that the elevation of the calcium ion or immunoregulation by active vitamin D may have induced the increase in thyroid hormone secretion. PMID- 1783102 TI - Lipid metabolism during seed development in oilseed rape (Brassica napus L. cv. Shiralee). PMID- 1783103 TI - A rapid method for Golgi membrane isolation from etiolated pea epicotyls. PMID- 1783104 TI - Interactions between a xylosyltransferase and a glucuronyltransferase involved in glucuronoxylan synthesis in pea epicotyls. PMID- 1783105 TI - Secretion of a chymosin-insulin fusion in Trichoderma reesei. PMID- 1783106 TI - Specificity of a protease from ovine adrenal medulla chromaffin granules. PMID- 1783108 TI - The sodiummotive NADH-ubiquinone oxidoreductase of Vibrio alginolyticus. PMID- 1783107 TI - Formation of glucuronoxylan linked to protein in plant Golgi and plasma membranes. PMID- 1783109 TI - Roles of molybdenum, FAD and iron-sulphur domains in molybdenum-containing hydroxylases: molecular genetic, kinetic and spectroscopic studies. PMID- 1783110 TI - Ischaemia/anoxia-induced increases in cardiac mitochondrial respiration: changes in Complex I. PMID- 1783112 TI - Studies of lotus-extracted haptoglobin in inflammatory bowel disease. PMID- 1783111 TI - MOA-stilbene: a new effector of the Qi site of the chloroplast cytochrome bf complex. PMID- 1783113 TI - Protein engineering of the surface loops of chymosin. PMID- 1783114 TI - Engineering the pH profile of chymosin. PMID- 1783115 TI - Modifying the substrate specificity of chymosin. PMID- 1783116 TI - Lipid metabolism in tissue cultures of olive (Olea europeae). PMID- 1783117 TI - Production of the amylolytic enzymes of Penicillium expansum. PMID- 1783118 TI - Immobilisation of enzymes to nylon film. PMID- 1783119 TI - Aminopeptidase A from Lactococcus lactis. PMID- 1783120 TI - Extraction of organic acids using a supported liquid membrane. PMID- 1783121 TI - Mass transfer studies on the extraction and separation of proteins using reverse micelles. PMID- 1783122 TI - Stimulation of cardiac protein synthesis by insulin-like growth factors. PMID- 1783123 TI - Analysis of a novel elongation factor: EF-3. PMID- 1783124 TI - Role of the 5' mRNA leader in heat shock gene expression in yeast. PMID- 1783125 TI - The use of allosuppressor alleles of the SAL4 gene in the study of translational fidelity in Saccharomyces cerevisiae. PMID- 1783126 TI - Metallothionein gene expression in the intestinal cell: modulation of mRNA and protein synthesis by copper and zinc. PMID- 1783127 TI - The molecular basis of the interaction of EF-Tu with kirromycin: overproduction of perdeuterated EF-Tu. PMID- 1783128 TI - Growth-related proteinase activity in a recently-established human tumour cell culture. PMID- 1783129 TI - Purification and characterisation of cysteine proteinases from human osteoclastomas. PMID- 1783131 TI - The multicatalytic proteinase complex: interaction between catalytic sites? PMID- 1783130 TI - Potential metal ligands in the insulinase superfamily of endopeptidases. PMID- 1783132 TI - Catalytic subunits of the multicatalytic proteinase. PMID- 1783134 TI - Proteolysis of lung elastin by human neutrophil elastase. PMID- 1783133 TI - Immunocytochemical localization of the multicatalytic proteinase in rat liver and in L-132 cells. PMID- 1783136 TI - Limited proteolysis as a probe for protein folding. PMID- 1783135 TI - Membrane-bound peptidases of Helix aspersa. PMID- 1783137 TI - The relationship between thaumatin, a sweet protein and thaumatopain, a cysteine protease, from the arlis of Thaumatococcus daniellii. PMID- 1783138 TI - Expression of HIV-1 proteinase in E. coli. PMID- 1783139 TI - Decidualisation-associated protein is an anti-proteinase and inhibits lymphocyte proliferation. PMID- 1783140 TI - Biochemical effects of environmental pollution in fishes from the Spanish South Atlantic littoral. PMID- 1783141 TI - HPLC isoenzyme patterns of glutathione transferase from marine fishes with different levels of pollution. PMID- 1783142 TI - Sexual dimorphism in trans-cypermethrin hydrolysis in the domestic chicken. PMID- 1783143 TI - Polymorphisms of human liver carboxylesterases. PMID- 1783144 TI - Location and characteristics of epidermal growth factor binding to enterocyte plasma membranes. PMID- 1783145 TI - Arachidonic acid as a feedback inhibitor of phospholipid methylation in rat polymorphonuclear leucocytes. PMID- 1783146 TI - Disturbed methionine metabolism in pancreatitis. PMID- 1783147 TI - Sensitivity of serum insulin concentrations to glucagon-like peptide 1 (7 36)amide in sheep. PMID- 1783148 TI - Structural comparison of three viral "fusion" proteins. PMID- 1783149 TI - Nuclear magnetic resonance studies on the mode of action of erythromycin A. PMID- 1783150 TI - Chylomicrons are the preferred substrate for lipoprotein lipase in vivo. PMID- 1783151 TI - Gastric inhibitory polypeptide responses to nutrient absorption in ruminants. PMID- 1783152 TI - Ferric iron reduction and uptake by mouse duodenal mucosa. PMID- 1783153 TI - Iron speciation in hypotransferrinaemic mouse serum. PMID- 1783154 TI - Lipid changes in individual membranes of Acanthamoeba castellanii during temperature adaptation. PMID- 1783155 TI - Synthesis of 5-aminolevulinate in pea (Pisum sativum L) leaves. PMID- 1783156 TI - The effect of oleate and spermine on the subcellular distribution of phosphatidate phosphohydrolase (PAH, EC 3.1.34). PMID- 1783157 TI - Fatty acid profile of plasma lipids from patients with Crohn's disease before and after 4 weeks on elemental diet ("O 28" or "Vivonex"). PMID- 1783159 TI - Lack of apolipoprotein synthesis by rat spleen. PMID- 1783158 TI - Adenosine (Ado) uptake in brush-border membrane vesicles from rat kidney (BBM). PMID- 1783160 TI - Comparative hepatic metabolism of chylomicron remnants prepared in vivo or in vitro. PMID- 1783161 TI - Parital characterisation of a TRH-immunoreactive peptide from rabbit prostate. PMID- 1783162 TI - The effect of block co-polymers on the uptake of model polystyrene microspheres by Kupffer cells--in vitro and in vivo studies. PMID- 1783163 TI - Detection of genes encoding novel members of the ligand responsive transcription factor superfamily in Xenopus laevis. PMID- 1783164 TI - The effects of interleukin-5 on mitogenically stimulated rat spleen cells. PMID- 1783165 TI - Purification of xanthine oxidase from human milk. PMID- 1783166 TI - Digestive enzymes of the West African giant land snail, Archachatina marginata. PMID- 1783167 TI - Activity and characteristics of an acid cholesteryl ester hydrolase in the rat lactating mammary gland. PMID- 1783168 TI - Bacterioferritin: structural modelling and molecular symmetry of Escherichia coli BFR. PMID- 1783169 TI - A potential motor neurone-specific monoclonal antibody (MN-1). PMID- 1783170 TI - The mouse U7 small nuclear RNA gene promoter functions efficiently in Xenopus oocytes. PMID- 1783171 TI - Isolation of a potato U6 small nuclear RNA gene. PMID- 1783172 TI - Unusual compartmentalisation of mouse U7 small nuclear transcripts in Xenopus oocytes. PMID- 1783173 TI - Deletions downstream of the 3' box of the mouse U7 small nuclear RNA gene dramatically affect transcription. PMID- 1783174 TI - The determination and biological role of 4'carbamoyl pyridoxal 5'-phosphate. PMID- 1783175 TI - The influence of testosterone on phospholipid metabolism. PMID- 1783176 TI - DL-allothreonine and L-threonine aldolase in rat liver. PMID- 1783177 TI - The purine nucleotide content in normal human lymphocytes. PMID- 1783178 TI - An evaluation of purine nucleotide metabolism in human lymphocytes. PMID- 1783179 TI - Aspects of molecular organization and ultrastructure in starch granules. PMID- 1783180 TI - Current and potential food and non-food applications of fructans. PMID- 1783181 TI - Useful characteristics and commercial applications of fructo-oligosaccharides. PMID- 1783182 TI - Molecular biology of fructan accumulation in plants. PMID- 1783183 TI - Fructan quality and fructan synthesis. PMID- 1783184 TI - Towards the construction of a universal NAD(P)(+)-dependent dehydrogenase: comparative and evolutionary considerations. PMID- 1783185 TI - Iron-sulphur clusters in electron transfer, catalysis and control. PMID- 1783186 TI - Bacterial dimethyl sulphoxide reductases and nitrate reductases. PMID- 1783187 TI - Biochemistry and expression of bacterial capsules. PMID- 1783188 TI - Capsule production in Escherichia coli: co-ordinate regulation of biosynthesis and export by environmental factors. PMID- 1783189 TI - Genetics of Haemophilus influenzae lipopolysaccharide expression. PMID- 1783190 TI - Rhizobium meliloti exopolysaccharides: genetic analyses and symbiotic importance. AB - Genetic experiments have indicated that succinoglycan (EPS I), the acidic Calcofluor-binding exopolysaccharide, of the nitrogen-fixing bacterium Rhizobium meliloti strain Rm1021 is required for nodule invasion and possibly for later events in nodule development on alfalfa and other hosts. Fourteen exo loci on the second megaplasmid have been identified that are required for, or affect, the synthesis of EPS I. Mutations in certain of these loci completely abolish the production of EPS I and result in mutants that form empty Fix- nodules. We have identified two loci, exoR and exoS, that are involved in the regulation of EPS I synthesis in the free-living state. Certain exo mutations which completely abolish EPS I production are lethal in an exoR95 or exoS96 background. Histochemical analyses of the expression of exo genes during nodulation using exo::TnphoA fusions have indicated that the exo genes are expressed most strongly in the invasion zone. In addition, we have discovered that R. meliloti has a latent capacity to synthesize a second exopolysaccharide (EPS II) that can substitute for the role(s) of EPS I in nodulation of alfalfa but not of other hosts. Possible roles for exopolysaccharides in symbiosis are discussed. PMID- 1783191 TI - Genetic regulation of asparagine-linked oligosaccharide synthesis. PMID- 1783192 TI - Protein engineering to change thermal stability for food enzymes. AB - In this review we have briefly indicated how the present state of knowledge allows proteins to be mutated to increase or decrease stability. We have discussed experiments on both model proteins and those of relevance to the food industry, and show how hydrophobic forces are a major driving force for folding as well as having a major role in thermostability. We have also indicated the large contribution that hydrogen bonding, electrostatic interactions and, in a less well predicted way, disulphide bridges make to thermostability. PMID- 1783193 TI - Protein engineering of chymosin and expression in Trichoderma reesei. PMID- 1783194 TI - Characterization of protein-containing reversed micelles. PMID- 1783196 TI - Development of bacteriophage-resistant strains of lactic acid bacteria. PMID- 1783195 TI - Proteinase genes of cheese starter cultures. AB - The proteolytic enzymes of lactococci are of eminent importance for milk fermentations. By the combined action of proteinases and peptidases milk protein is degraded to peptides and amino acids which are required for cell growth and contribute to the organoleptic properties of the foods. The importance of the proteolytic system for dairy product quality has resulted in an increased fundamental research of the enzymes and genes involved. Proteinase plasmids have been identified and plasmid stability problems offered an explanation for the apparent instability of proteolysis in certain strains of lactococci. Chromosomal integration has recently been used to stably anchor the proteinase genes in the chromosome of Lactococcus lactis. The structural proteinase genes of a number of strains have been cloned and sequenced, and some of the properties of the enzymes they specify will be discussed. The product of a second gene is necessary for the activation of the proteinase, a proteinase maturation process that is unique in the bacterial world. PMID- 1783198 TI - Flavour peptides: the potential role of Lactococcal peptidases in their production. PMID- 1783197 TI - The development of Aspergillus niger var. awamori as a host for the expression and secretion of heterologous gene products. PMID- 1783199 TI - Micro-organisms as a novel source of flavour compounds. PMID- 1783200 TI - Anti-microbial substances produced by food associated micro-organisms. PMID- 1783201 TI - DNA probes and the detection of food-borne pathogens using the polymerase chain reaction. PMID- 1783202 TI - Plant cell culture in the production of flavour compounds. PMID- 1783203 TI - Types and families of endopeptidases. PMID- 1783204 TI - Substrate specificities and activation mechanisms of matrix metalloproteinases. PMID- 1783205 TI - ATP-promoted interaction between Clp A and Clp P in activation of Clp protease from Escherichia coli. AB - Clp protease is a high relative molecular mass, ATP-dependent protease found in the cytoplasm of Escherichia coli. Clp protease is composed of two protein components, Clp A, which has ATPase activity, and Clp P, which has the proteolytic active site and is activated by Clp A in the presence of ATP. Clp P subunits (Mr = 21,500) are arranged in two hexagonal rings directly superimposed on each other, and under low salt conditions two dodecamers associate to form a particle with Mr approximately 440,000. Clp A (subunit Mr = 83,000) and Clp P do not associate in the absence of nucleotide, but Clp A with ATP bound associates with Clp P to form an active proteolytic complex with Mr approximately 700,000. Although adenosine 5'-[beta gamma-imido]triphosphate (AMPPNP) weakly promotes association between Clp A and Clp P, non-hydrolysable analogues of ATP do not activate proteolysis, indicating that association between the components is not sufficient to allow proteolysis. Association between Clp A and Clp P does not alter the basal ATPase activity of Clp A, but addition of protein substrates is accompanied by an increase in ATP hydrolysis by Clp A. Chemically-inactivated Clp P or inactive mutants of Clp P also associate with Clp A, but no increase in the ATPase activity of Clp A is observed, either in the presence or absence of protein substrates, when Clp P is inactive. Thus the increased ATP hydrolysis is dependent on active proteolysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783206 TI - Lysosomal and non-lysosomal proteolysis in the eukaryotic cell: studies on yeast. PMID- 1783207 TI - Enzyme-mediated selective toxicity of an organophosphate and a pyrethroid: some examples from a range of animals. PMID- 1783208 TI - Microsomal activation of benzo[a]pyrene by Alligator mississippiensis: mechanisms, mutagenicity and induction. PMID- 1783209 TI - Mechanisms of xenobiotic activation in marine invertebrates. PMID- 1783210 TI - Role of esterases in resistance of insects to insecticides. PMID- 1783211 TI - Enzymic factors in the resistance of stored-product pests to insecticides. PMID- 1783212 TI - Enzymes and resistance to insecticides in Heliothis virescens. PMID- 1783213 TI - Sterol biochemistry in filamentous fungi: a coming of age. PMID- 1783214 TI - Squalene epoxidase as a target for the allylamines. PMID- 1783215 TI - Sterol 14 alpha-demethylase and its inhibition: structural considerations on interaction of azole antifungal agents with lanosterol 14 alpha-demethylase (P 450(14DM)) of yeast. PMID- 1783216 TI - Cytochrome P-450-dependent 14 alpha-sterol demethylase of Candida albicans and its interaction with azole antifungals. PMID- 1783217 TI - Morpholine antifungals and their mode of action. PMID- 1783218 TI - Molecular modelling of the sterol C-14 demethylase of Saccharomyces cerevisiae. PMID- 1783219 TI - Molecular genetic studies on the mode of action of azole antifungal agents. PMID- 1783220 TI - Behavioral development and maternal care in tufted capuchins (Cebus apella) and squirrel monkeys (Saimiri sciureus) from birth through seven months. AB - Fourteen infant capuchins and eight squirrel monkeys reared by their mothers in captive species-typical social groups were observed from birth through 7 months. Motoric altriciality of the neonatal capuchin relative to the squirrel monkey is a key feature of behavioral differences between the species in the first few months after birth. Infants of the two species differed substantially in age at onset of independent locomotion, the developmental profile of independent activities, and the overall amount and rate of particular social activities. Capuchins displayed a lag of 7 weeks relative to squirrel monkeys in the pattern of increasing time spent alone; lags in other indices of independent activity and exploratory behaviors were also evident, although not as clear-cut. The species also differed substantially in the nature and frequency of social interactions between infants and others. Capuchins, especially later-born infants of multiparous mothers, experienced a more socially interactive infancy than squirrel monkeys. Contrasts in behavioral developmental and infant care in the two species are related to the timing and duration of the weaning process. PMID- 1783221 TI - The effects of intrauterine position on the degree of corpus callosum deficiency in two substrains of BALB/c mice. AB - Measures of several intrauterine position variables as well as an index of abnormality of fetal commissure development (z score) were obtained for fetuses of two substrains of BALB mice, BALB/cWah1 and BALB/cWah2, known to differ as adults in the proportion of animals exhibiting deficient corpus callosum (about 55% & 20% respectively). The extent of midline commissure development at embryonic Day 17.5 for most strain 1 fetuses was significantly reduced compared to strain 2 fetuses of the same chronological age. The two substrains also differed with respect to mean litter size and mean body weight (strain 2 greater than strain 1 for both measures). The ovarian and cervical positions for strain 2 uteri were found to be the most favorable for body and placental growth; no such differences were evident in strain 1. In strain 2, fetuses in the left uterine horns showed lower z scores (more retardation) than littermates on the right side, but this difference was not evident in strain 1; no other right/left differences were found in strain 2 which could help to explain the right side advantage. None of the other position variables either separately or in combination was found to be important in predicting the z score index. Tests for randomness failed to provide evidence for nonrandom distribution of severely affected fetuses. We suggest that nongenetic variability resulting from stochastic events early in development and intrinsic to the fetus may be responsible for only certain BALB fetuses within a litter exhibiting the callosal anomaly. PMID- 1783222 TI - Rhythmic organization of neonatal heart rate and its relation to atypical fetal growth. AB - The rhythmic organization underlying long-term heart rate variability was examined in 36 newborn infants. Heart rate was registered every 30 s for 2 continuous hr while infants rested in a temperature-controlled isolette. Spectrum analysis of the time-series of the 240 observations detected rhythmically organized changes in the heart rates of 33 of the 36 infants. Thirty of the 33 infants showed a basic rhythm at 1.5 +/- .5 cycles per hr (one cycle every 30 to 60 min). While 9 infants showed this single cycle in behavioral activity, 24 infants showed additional cycles at a wide range of faster frequencies. Infants with signs of atypical fetal growth less often showed evidence of these multiple cycles, had reliably fewer cycles in heart rate, and had a marginally lower power in their basic cycle than infants with typical patterns of fetal growth. Infants with multiple cycles in the power spectra, independent of fetal growth group, were more often observed in Alert and Active Alert behavioral states and less often in Active Sleep than comparison infants. Results indicate that 1) heart rates of newborn infants show evidence of the 30- to 60-min cycle characteristic of the Basic Rest-Activity Cycle found in other behaviors, and 2) the complexity of behavioral rhythms may be affected by prenatal malnutrition. Viewed within a dynamical systems approach to development, results suggest that the complexity of rhythms in behavior may reflect the complexity of behavioral organization. PMID- 1783223 TI - Acute prenatal experience with alcohol in the amniotic fluid: interactions with aversive and appetitive alcohol orosensory learning in the rat pup. AB - Prenatal alcohol acute contamination of the amniotic fluid and different postnatal manipulations with this drug alter subsequent responsiveness to EtOH's chemosensory cues. In this study, the interaction between prenatal and postnatal alcohol-related experiences was examined. Alcohol administered in the amniotic fluid during gestational Day 21 potentiated subsequent alcohol-odor conditioned preferences resulting from postnatal pairings between the odor and sucrose intraoral infusions. No interaction was attained when examining the impact of the in utero experience with postnatal aversive conditioning defined by alcohol odor citric acid pairings (Exps. 1a & 1b). In Exp. 2, infantile alcohol aversions derived from a state of acute ethanol intoxication were inhibited by prior alcohol experience in utero. Examination of alcohol levels in fetal trunk blood and the amniotic fluid suggests that the antenatal experience is related to the chemosensory perception of the drug rather than its intoxicating properties (Exp. 3). These results strongly suggest that the alcohol-related memory generated proximal to birth can modulate subsequent learning with the drug. PMID- 1783224 TI - Rapid threshold estimation using the "chained-stimuli" technique for auditory brain stem response measurement. AB - The "chained-stimuli" technique for rapid auditory brain stem response (ABR) threshold estimation involves lengthening the averaging time window and presenting a series ("chain") of click stimuli. Each stimulus chain contains, in addition to a silent interval, click stimuli of 10, 20, 30, 40, 50, 60, and 70 dB nHL that are separated by 10 msec intervals. Using this method, the single averaged response to the chained-stimulus contains up to seven individual ABRs. The responses elicited by each level of click stimulus within the chain can be analyzed separately. In this study, chained-stimuli ABR threshold estimations for normal hearers were essentially equivalent to those obtained using an automated conventional ABR method. The data for a seven point latency-intensity function using the chained-stimuli technique were obtained in a mean time of only 8 min per ear. PMID- 1783225 TI - The amplitude modulation-following response as an audiometric tool. AB - The amplitude modulation-following response (AMFR) is an auditory scalp-recorded potential, evoked using continuous, amplitude-modulated tones. The current study was designed to explore the audiometric utility of the AMFR by demonstrating the frequency specificity of the response and assessing the relation between behaviorally measured pure-tone thresholds and AMFR detection thresholds. Subjects in this study were six normal-hearing and four hearing-impaired adults. High-pass masking results in the normal hearing subjects demonstrated that the AMFR is associated with a narrow range of activation along the cochlea around the carrier frequency. Frequency-specific results from the hearing-impaired subjects confirmed this finding. Thresholds for the AMFR, defined in spectral terms, were consistent with the behavioral estimates in both the normal and the hearing impaired subjects. PMID- 1783226 TI - Hearing aid gain for loudness-density normalization in cochlear hearing losses with impaired frequency resolution. AB - A theoretical criterion for preliminary prescription of hearing aid gain and frequency response was formulated on the basis of Zwicker's loudness model, modified for impaired auditory frequency resolution in cochlear hearing losses. The procedure was designed to restore normal relative loudness contributions from each frequency band of input speech. Prescribed frequency responses had less steep bass cut than recommended by either the Prescription of Gain/Output or the National Acoustic Laboratories' procedures, regardless of various model assumptions. Prescribed overall gain depended on the loudness growth assumed in the model. In cases where auditory filters are wider than normal and loudness recruitment is complete, the procedure yielded a nonlinear relation between hearing aid gain and hearing loss: Required insertion gain (in dB) was 25 to 30% of hearing threshold loss (in dB HL) for mild to moderate losses, but this percentage increased for more severe impairments. For cases with incomplete loudness recruitment, the model prescribed that insertion gain should be 40 to 50% of hearing threshold loss for a wide range of impairments. PMID- 1783227 TI - Sound quality and speech reception for prescribed hearing aid frequency responses. AB - Four different prescriptions of hearing aid insertion gain versus frequency were validated with a group of 26 moderately hearing-impaired, elderly hearing aid users. Three prescriptions were based on calculating the loudness and articulation index (AI) for aided speech, and ranged from a frequency response with moderate high-frequency emphasis, restoring normal loudness for speech peaks, to a response with the greatest high-frequency emphasis, maximizing the AI. The fourth prescription was a well-established formula of the half-gain type. The frequency responses were evaluated by paired comparison ratings of the pleasantness and intelligibility of speech in noise, and by speech identification tests in noise. The subjects rated the flattest response as significantly more pleasant than the other responses, and significantly more intelligible than the prescription with maximal high-frequency emphasis. There were no detectable differences in signal/noise ratios required for 50% speech identification. These results indicate that a prescription that restores normal loudness for speech peaks in each critical band is probably more easily accepted than either a procedure which is intended to make all speech bands equally loud, or a prescription which maximizes the AI. PMID- 1783228 TI - Loudness judgment procedures for evaluating hearing aid preselection decisions for severely and profoundly hearing-impaired listeners. AB - Hearing aid fitting involves a two-phase process of preselection and evaluation (Seewald RC and Ross M. Amplification for the Hearing Impaired 1988:213-271). The purpose of the present study was to examine alternative procedures that clinicians might use in the evaluation phase to verify the adequacy of hearing aid preselection decisions for severely and profoundly hearing-impaired listeners. Bekesy tracking, loudness rating, and conventional bracketing procedures were used to determine threshold, most comfortable listening level, and uncomfortable listening level for 10 hearing-impaired young adults. Stimuli were pulsed pure tones of 500, 1000, and 2000 Hz and filtered words. Means and standard deviations of most comfortable listening levels and uncomfortable listening levels derived from loudness judgments of the 10 subjects showed only nominal differences across procedures. However, correlation analysis (Pearson r) indicated that individuals responded to the three procedures in varying ways, producing different loudness judgments and overall dynamic ranges. Thus, test procedure may influence the clinician's final evaluation of a preselected hearing aid. Initial work suggests that closed-set response categories such as loudness rating can limit measurement variability and potentially guide the clinician's evaluation of hearing aid preselection decisions. PMID- 1783229 TI - Evaluation and assessment of FM systems. AB - In the past, frequency modulated (FM) systems were recommended for use only in educational settings for children with severe or profound hearing losses. Recent studies, however, have suggested that FM systems may be appropriate in nonacademic settings and also may benefit children with minimal hearing loss. In addition to the more widespread application of FM use, advances in amplification technology have provided audiologists with a variety of devices and coupling options, resulting in more variables to evaluate in the fitting process. There are three commonly used methods of evaluating FM systems: functional gain measures, probe tube microphone measures, and coupler measures. This paper is intended to provide the audiologist working with FM systems with an overview of the complexities involved in selecting and setting FM systems and the benefits and limitations of each evaluation method. Each evaluation method is examined in view of how well it answers three basic questions related to frequency response, maximum output, and distortion in FM systems. Finally, other issues which may impact on the selection of an FM system for a given individual are discussed. PMID- 1783230 TI - Audiologic findings in botulism poisoning. AB - Botulism poisoning results in a presynaptic failure of neuromuscular transmission, and may be expected to impair Eustachian tube and stapedius reflex function. The audiologic findings in five normal-hearing patients with type A botulism poisoning are presented. Results were varied. Two patients demonstrated type B or C tympanograms during the early stages, while three with normal middle ear function demonstrated marked bilateral or unilateral stapedius reflux threshold elevation. One patient had a reversible reflex decay, and the superimposition of a second stimulus upon the first resulted in complete recovery of reflex amplitude. A number of possible pathophysiological mechanisms are discussed. PMID- 1783231 TI - Repeatability of high-frequency thresholds. AB - High-frequency (10, 12, 14, 16, and 18 kHz) thresholds were obtained for each ear of 50 young adults having normal low-frequency hearing across four test sessions separated by at least 1, but no more than 2, weeks using a Beltone 2000 audiometer. The threshold differences between each possible test session comparison (N = 6) were not significantly (p greater than 0.05) different for ear, test session comparison, or frequency. Overall, intrasubject high-frequency thresholds were found to be repeatable and within a clinically acceptable range of +/- 10 dB for at least 94% of the ears, regardless of test session comparison and frequency. PMID- 1783232 TI - A clinical research form for use in the documentation of middle ear effusion. AB - A form for use in both the clinical and research setting for documenting the presence and course of otitis media with effusion by pneumatic otoscopy has been developed. The form is based on the data obtained in a large Finnish study on pneumatic otoscopy signs and findings at myringotomy (Karma P, Penttila M, Sipila M, & Kataja M, Int J Pediatr Otorhinlaryngol 1989). The rationale for development and the clinical and research applications of the form are discussed. PMID- 1783233 TI - Hearing in the elderly--the Framingham cohort, 1983-1985: Part II. Prevalence of central auditory processing disorders. AB - The relation between central auditory processing disorders (CAPD) and age has been described in selected subjects. However, the prevalence of CAPD in the general population has not been established. We tested 1026, 64- to 93-yr-old members of the Framingham Heart Study cohort with Central Institute for the Deaf W-22 lists (CID W-22) in quiet, the Synthetic Sentence Identification test with ipsilateral competing message (SSI-ICM), and the Staggered Spondaic Word test. The presence or absence of CAPD could be established with at least one of three indices in 1018 subjects. The CID W-22 performance-intensity function rollover index was greater than 0.20 in 1.4% of 1009 subjects. The difference between maximum CID W-22 and SSI-ICM (0 dB message-to-competition ratio) scores was greater than 20% in 18.2% of 816 subjects. The Staggered Spondaic Word category was moderately, severely, over-corrected moderately, or over-corrected severely abnormal in 10.7% of 941 subjects (using 12-59-yr-olds' norms and adjusting scores when appropriate). Abnormal results on any one index occurred in 22.6% of the subjects. Thus, we conclude that the prevalence of CAPD in the elderly is less common than previous studies would suggest. Furthermore, although the rate of CAPD increased with age, age accounted for no more than 15% of the variability of any of the three indices. Therefore, its presence is dominated by factors other than chronological age. PMID- 1783234 TI - The effectiveness of screening programs based on high-risk characteristics in early identification of hearing impairment. AB - Prompt identification of educationally significant hearing loss is yet an unattained goal. However, there is some evidence that the ability to identify and diagnose hearing loss at an early age has been significantly improved through the use of carefully designed screening protocols such as birth certificate-based high-risk registries. To evaluate the efficiency of birth certificate-based screening programs, 70 parents and guardians of 6- to 9-yr-old children with significant sensorineural losses were surveyed regarding their child's identification history. Each of these children was born in the state during the time a birth certificate-based screening program was in full operation. Results indicate that children with at least one risk factor for hearing impairment were identified an average of 7.7 mo earlier than children with no risk history. However, only 50% of the children with sensorineural hearing losses exhibited any of the risk factors and a significant number of children with risk factors were missed by the system. Had admission to a neonatal intensive care unit been considered a risk factor, 63% of the children would have exhibited at least one risk factor. More extensive implementation of high-risk registries in conjunction with more widespread education of parents and primary care providers regarding early behavioral indicators of hearing loss, procedures for referral, and appropriate intervention and management services needs to be considered. PMID- 1783235 TI - Communication and social growth: a developmental model of social behavior in deaf children. AB - A cognitive developmental model for the social interaction and behavior of deaf children is proposed. This model takes into account reports of high-frequency behavioral and social problems manifested by deaf children. Emphasis is placed on the role of language in the development of social perceptions and interactions. Problems of social interaction are attributed to the delayed language development of some deaf children. Implications for intervention strategies are discussed. PMID- 1783236 TI - Nonverbal play interaction between hearing mothers and young deaf children. AB - The following preliminary study assessed the nonverbal play interactions of two hearing mothers and their profoundly hearing-impaired infants using a nonverbal coding scheme adapted from descriptors used by Fein (1979) and Bruner (1975a,b). The goal also was to describe the nonverbal components of their interactions during play relative to normally hearing mother-child dyads. More specifically, the goal was to determine if the behavioral patterns exhibited by the hearing mothers and their hearing-impaired children were consistent with patterns that have been reported for verbal components of play interactions. The nature of the behavioral patterns were in agreement with much of the previous literature on verbal and social interactions between hearing mothers and hearing-impaired children, but some notable differences were observed. PMID- 1783237 TI - Considerations in selecting and validating an adult/elderly hearing screening protocol. AB - This article presents important factors related to hearing impairment, medical concerns related to hearing, hearing handicap, and epidemiological principles as considerations in selection of a protocol in adult/elderly hearing screening (18 yr and older). I encourage protocol validation which incorporates a series of criteria: medical conditions, rates of failure for handicap and impairment, handicap perspectives, hearing aid use and satisfaction, and follow-up data when referred. Three different pure-tone fence levels (20 dB, 25 dB, and 40 dB at 1000, 2000, and 4000 Hz) are proposed for further study by virtue of their utility for different settings and populations. Finally, a possible protocol is proposed for use with the different pure-tone fences. PMID- 1783238 TI - Prevalence of hearing loss in adults with sickle cell disease. AB - Hearing status in 75 adult subjects with sickle cell disease was examined. Thirty one (or 41%) of the subjects failed the hearing screening. When examined by hemoglobin type, it was found that persons with sickle cell C disease had the greatest incidence of hearing loss, although all subject groups exhibited greater prevalence rates than the general population. The results suggest that routine audiologic assessment be incorporated into the regular medical examination for adults with sickle cell disease. PMID- 1783239 TI - Hearing disorders in sickle cell disease: cochlear and retrocochlear findings. AB - The auditory system was assessed in 34 adult subjects with sickle cell disease using standard audiometric test techniques. The study results indicate that patients with sickle cell disease are at risk for retro-cochlear as well as cochlear dysfunction of the auditory system. However, there is no consistent audiometric pattern that is pathognomonic of sickle cell disease. The test results indicate that auditory status should be carefully monitored in all adult patients with sickle cell disease. PMID- 1783240 TI - Test-retest reliability of the hearing handicap inventory for adults. AB - The test-retest reliability of the Hearing Handicap Inventory for Adults (HHIA) was assessed on a sample of 28 hearing-impaired adults. Reliability estimates were obtained to set the stage for using the HHIA as an outcome measure in aural rehabilitation. The test-retest reliability was quite high (r = 0.97) and the standard error of measurement was low for the HHIA and its screening version (HHIA-S). In light of the psychometric adequacy, the HHIA and HHIA-S have potential as indices of hearing aid benefit in hearing-impaired adults. PMID- 1783241 TI - Electrocochleography: a method for making the Stypulkowski-Staller electrode and testing technique. AB - A method for making the Stypulkowski-Staller tympanic membrane electrode is described step by step. Our testing technique with inserted earphones utilizing click stimulus is reported. PMID- 1783242 TI - A clinical comparison of Grason Stadler insert earphones and TDH-50P standard earphones. AB - Recent investigations have reported numerous advantages of insert earphones. However, no data have been reported regarding Grason Stadler (GS) insert earphones. The purpose of this investigation was to compare results obtained using the GS insert earphone to those obtained using a standard earphone on pure tone thresholds, ipsilateral effective masking levels, and an estimate of interaural attenuation. Twenty-seven normal-hearing listeners participated. Pure tone thresholds and ipsilateral effective masking levels obtained were not significantly different for the two transducers. However, the GS insert earphones yielded significantly greater interaural attenuation. PMID- 1783243 TI - Case history: asking the right questions. AB - The importance of asking the right question is highlighted in this case study. The patient was a 76-yr-old man with hearing loss that initially appeared to be a classic case of presbycusis. Without asking the right question this patient might have been managed in a manner inappropriate to his true hearing sensitivity. PMID- 1783244 TI - Effect of linguistic interference on sentence identification. AB - This study was designed to investigate the extent to which continuous speech competition, in sentence identification paradigm, produces linguistic interference over and above acoustic masking. We evaluated performance on the Synthetic Sentence Identification (SSI) test in 24 bilingual speakers of English and Spanish under four experimental conditions: (1) target and competition both in English, (2) target and competition both in Spanish, (3) target in English, competition in Spanish, and (4) target in Spanish, competition in English. After controlling for the effects of acoustic masking, results showed significantly better performance in conditions when target and competition were in different languages (interlingual interference) than when target and competition were in the same language (intralingual interference). The difference in performance is attributed to the effects of greater linguistic interference when target and competition were in the same language. PMID- 1783245 TI - Telephone use by patients fitted with the Ineraid cochlear implant. AB - A survey of telephone use by 66 patients fitted with the Ineraid cochlear prosthesis revealed that 51% initiate telephone calls (most calls are to family or friends) and that 66% answer the telephone. Of the patients who answer the telephone, 49% indicated that they could identify the gender and/or age of the caller most of the time, 27% could identify a familiar caller most of the time, and 48% indicated that they could understand a conversation most of the time if speaking to a familiar speaker about a familiar topic. Understanding dropped rapidly as the speaker and topic became unfamiliar. PMID- 1783246 TI - Liver transplantation in patients with a surgical portasystemic shunt. AB - Of 220 patients undergoing liver transplantation between March 1982 and April 1991, eighteen (8.1 percent) already had a surgical portasystemic shunt. Four patients had a distal splenorenal shunt, six a side-to-side portacaval shunt, three an end-to-side portacaval shunt, and five, a mesocaval shunt. The splanchnic venous system was assessed by Doppler ultrasound examination and angiography before liver transplantation. Perioperative mortality rate was higher but not significantly different from that observed in the population of patients without previous portasystemic shunt (33.3 percent versus 21.7 percent). Liver transplantation was particularly difficult in the six patients with a previous side-to-side portacaval shunt, in which the perioperative mortality rate was high (66.6 percent). Liver transplantation is feasible in patients with a previous portasystemic shunt but carries a higher risk. It is easier when no previous dissection of the hepatic pedicle has been done. Suppression of the shunt after revascularization of the graft must be performed in order to provide optimal venous flow to the hepatic graft. PMID- 1783247 TI - [The "Sydney system": a consensus approach to gastritis. Is a new "classification" necessary?]. PMID- 1783248 TI - [Clinical tolerance, intestinal absorption, and energy value of four sugar alcohols taken on an empty stomach]. AB - Sugar alcohols are incompletely digested in the human small intestine. The residual amounts reaching the colon are digested by colonic bacteria or excreted in stools. Clinical tolerance and energy value of sugar alcohols are related to their respective rates of digestion in the small intestine and the colon. Six healthy volunteers were tested in 5 periods during which they ingested 10 g lactulose, and then, in a random order, an iso-osmotic solution of 20 g isomalt, sorbitol, maltitol, and lactitol. The fraction of sugar alcohols absorbed in the small intestine was evaluated by comparing the amounts of hydrogen excreted in breath for 8 h after the ingestion of lactulose and of sugar alcohols. Energy value of sugar alcohols was determined knowing the amounts absorbed in the small intestine and digested in the colon. Tolerance to the sugar alcohols was good in all volunteers, and not different between sugar alcohols. The mean percentage of malabsorption in the small intestine was significantly higher for lactitol (84 +/ 14 percent, m +/- SEM) than for maltitol and isomalt (44 +/- 7 and 40 +/- 7 percent), its energy value (2.3 +/- 0.3 kcal/g) was significantly lower than the energy value of maltitol (3.1 +/- 0.1 kcal/g, P less than 0.05); whereas those of sorbitol and isomalt were close (2.7 +/- 0.2 and 2.8 +/- 0.1 kcal/g, respectively). In spite of these differences, our results suggest that in our experimental conditions, bacterial digestion of the sugar alcohols reaching the colon was complete, and did not affect their clinical tolerance. PMID- 1783249 TI - [Impaired fibrinolytic response to the venous occlusion test in patients with cryptogenic colitis]. AB - The fibrinolytic response to venous occlusion was studied in 17 patients with inflammatory bowel disease: 7 with Crohn's disease, 10 with ulcerative colitis and compared with those obtained in 20 controls. Patients with inflammatory bowel disease showed decreased tissue-type plasminogen activator antigen release (t-PA Ag), no significant Von Willebrand antigen release (vWF Ag), and a residual plasminogen activator inhibitor activity (PAI activity) after venous occlusion. These modifications were more important in the evolutive colitis group compared with the remission group. Hypofibrinolysis, as defined by a defective t-PA release, and a residual PAI activity after venous occlusion might contribute to digestive and/or extra digestive thrombotic manifestations observed during the course of inflammatory bowel diseases. PMID- 1783250 TI - [Esophagitis in progressive systemic scleroderma. Prevalence and risk factors in forty-six patients]. AB - Forty-six patients with progressive systemic sclerosis (37 women and 9 men) were successively evaluated by endoscopy, manometry, and esophageal pH monitoring. Fourteen patients (30.4 percent) had erosive esophagitis. Twenty-four patients were symptomatic; nineteen patients complained of dysplagia. Erosive esophagitis was significantly more frequent in symptomatic patients than in asymptomatic patients (50.0 percent vs 9 percent, P less than 0.01) and especially in patients complaining of dysphagia (57.9 percent vs 11.1 percent, P less than 0.01). Erosive esophagitis was not correlated with symptoms of gastroesophageal reflux. Abnormal esophageal motility was found in 34 patients (73.9 percent). Occurrence of erosive esophagitis was not linked with esophageal dysmotility. In patients with erosive esophagitis lower esophageal sphincter pressures were significantly lower than those in patients without erosive esophagitis. Twenty-four hr-pH monitoring showed pathological gastroesophageal reflux in 20 patients (43.5 percent). Erosive esophagitis was more frequent in patients with pathological gastroesophageal reflux than in patients with normal gastroesophageal reflux (50.0 percent vs 15.4 percent, P less than 0.02) especially in patients with pathological supine nighttime gastroesophageal reflux (61.5 percent vs 18.2 percent, P less than 0.01). Our data suggest that symptoms, dysphagia, diminished lower esophageal sphincter pressures, and pathologic nighttime gastroesophageal reflux are reliable predictors of the presence of erosive esophagitis in patients with progressive systemic sclerosis. PMID- 1783252 TI - [Lipid emulsions in parenteral nutrition. Metabolism, effects, indications, their relation to fatty acid metabolism]. PMID- 1783251 TI - [Digestive hemorrhage following gastroduodenal ulcers caused by non-steroidal anti-inflammatory agents]. AB - The aim of this retrospective study was to describe the clinical and prognostic characteristics of bleeding ulcers following gastrotoxic agent use. From 1984 to 1988, 244 patients were admitted in our Intensive Care Unit for bleeding ulcers; 133 (54.5 percent) were using gastrotoxic agents. Patients not taking gastrotoxic agents were compared with patients taking non steroidal antiinflammatory drugs (n = 77) or aspirin (n = 35). Patients receiving non steroidal antiinflammatory drugs differed (P less than 0.05) from patients not taking gastrotoxic agents: they were older, had less history of ulcer, hemorrhage, and alcohol abuse. Patients taking aspirin had less severe hemorrhage and took anticoagulant therapy less frequently than patients not taking gastrotoxic agents. Patients taking aspirin were younger, had less severe hemorrhage and had more frequent history of alcohol abuse and ulcer disease than patients taking non steroidal antiinflammatory drugs. There was no difference with regard to endoscopic data and mortality (7 percent). Two thirds of hemorrhages following non steroidal antiinflammatory drugs occurred during the month following the onset or the modification of treatment. The distribution of non steroidal antiinflammatory drugs in the group of patients who bled after non steroidal antiinflammatory drugs differed from that of regional sales. These results suggest that upper gastrointestinal tract bleeding associated with the use of gastrotoxic agent are frequent, particularly in elderly patients, are not associated with poor prognosis, and occur soon after the beginning of treatment. PMID- 1783253 TI - [Nodular regenerative hyperplasia of the liver associated with azathioprine therapy]. AB - Three cases of nodular regenerative hyperplasia of the liver associated with azathioprine therapy are reported. The indication of azathioprine differed in each of the 3 cases including kidney transplantation, graft-versus-host disease following bone marrow transplantation, and suspicion of bowel inflammatory disease, respectively. In all three patients, nodular regenerative hyperplasia was discovered after a prolonged administration of azathioprine (24 to 40 months), with a cumulative dose of 52 to 120 g. Under light microscopy, vascular lesions were associated with nodular regenerative hyperplasia in the 3 cases and consisted of sinusoidal dilatation (2 cases), perisinusoidal fibrosis (2 cases), and peliosis (1 case). In two patients, nodular regenerative hyperplasia was responsible for severe portal hypertension which was treated by portacaval shunt. These findings are strongly suggestive of a role of azathioprine in the occurrence of nodular regenerative hyperplasia. The mechanism of azathioprine induced nodular regenerative hyperplasia could be related to sinusoidal lesions caused by azathioprine and responsible for liver hypoperfusion, with regenerative hyperplasia in the areas remaining normally perfused. Patients receiving long term therapy with azathioprine should be followed-up regularly and liver biopsy should be performed when clinical or biochemical liver abnormalities are observed. PMID- 1783254 TI - [Severe hemoptysis due to portal hypertension. Responsibility of acquired splenopulmonary shunt and treatment by proximal splenorenal anastomosis]. AB - Hemoptysis is not considered as an hemorrhagic complication of portal hypertension. We report a patient with liver cirrhosis and portal hypertension who developed a hitherto unreported porto-pulmonary transdiaphragmatic collaterality many years after splenectomy. Life threatening hemoptysis complicated this unusual shunt after banal bronchitis. A proximal splenorenal shunt was performed and was completely effective at 26 months. PMID- 1783255 TI - [Neuro-lupus associated with Zollinger-Ellison syndrome with hepatic metastases: an incidental association?]. AB - A 29-year old woman presented with neuro-lupus and hepatic metastases of gastrinoma. We suggest that this hitherto undescribed association might not be fortuitous. PMID- 1783256 TI - [Glomerular and tubular renal disease in primary biliary cirrhosis]. PMID- 1783257 TI - [African histoplasmosis of the colon]. PMID- 1783258 TI - [Helicobacter pylori and erosive lesions of the gastric mucosa in cirrhosis]. PMID- 1783259 TI - [Randomized double-blind trial with a liquid suspension of alginate for the treatment of pyrosis]. PMID- 1783260 TI - [Simvastatin-induced acute pancreatitis: two cases]. PMID- 1783261 TI - [A new case of simvastatin-induced acute pancreatitis]. PMID- 1783262 TI - [Aphagia after removal of a percutaneous endoscopic gastrostomy tube]. PMID- 1783263 TI - [Treatment of low forms of colorectal hemorrhage by rectal irrigation using volatile fatty acids]. PMID- 1783264 TI - [Anticytoplasmic auto-antibodies of polynuclear neutrophils: a common biologic marker in hemorrhagic rectocolitis and primary sclerosing cholangitis]. PMID- 1783266 TI - Desensitization to native molecular forms of gonadotropin-releasing hormone in the goldfish pituitary: dependence on pulse frequency and concentration. AB - Homologous desensitization of gonadotropin-releasing hormone (GnRH) was investigated using goldfish pituitary fragments in vitro. The two native GnRH peptides, sGnRH [( Trp7, Leu8]-GnRH) and cGnRH-II [( His5, Trp7, Tyr8]-GnRH) were administered either continuously or in pulsatile fashion at different frequencies and concentrations. Continuous treatment (60 min) with either sGnRH or cGnRH-II at 10(-7), 10(-8), and 10(-9) M resulted in desensitization of goldfish pituitary in a biphasic fashion, characterized by an initial rapid peak of GTH release (phase 1), followed by a lower sustained release of GTH remaining at a stable concentration above the basal level (phase 2). Pititary fragments were then washed for 60 min and further treated continuously (60 min) with the same concentrations of sGnRH or cGnRH-II (second treatment). Total sGnRH- or cGnRH-II induced GTH release during the second treatment period was significantly lower than that observed during the initial treatment period, depending upon the concentration of the peptides. The second phase of GTH release was more pronounced at lower concentrations compared to that observed following 10(-7) M treatment, especially for sGnRH. Pulsatile treatment with either sGnRH or cGnRH II (2-min pulses of 10(-7), 10(-8), and 10(-9) M given every 20 min) resulted in significant desensitization of the pituitary GTH release. Reduction of pulse frequency to 2 min treatment every 60 min resulted in a lower degree of desensitization; little or no desensitization was observed following treatment with 10(-8) and 10(-9) M cGnRH-II or 10(-9) M sGnRH. A further reduction in frequency to 2-min pulses of sGnRH or cGnRH-II (10(-7) or 10(-8) M) given every 90 min did not result in desensitization of the pituitary GTH release. In summary, the present study demonstrates that GnRH-induced desensitization is dependent on both pulse frequency and concentration in the goldfish pituitary. These findings support the hypothesis that pulsatile secretion of the native GnRH peptides may be essential for maintenance of normal pituitary GTH release in goldfish. PMID- 1783265 TI - Purification of tilapia thyrotropin from a crude pituitary homogenate by immunoaffinity chromatography using a matrix of antibodies against porcine follicle-stimulating hormone. AB - An immunoadsorbent matrix using antibodies against porcine follicle-stimulating hormone (pFSH), a high heterothyrotropic stimulant in tilapia, was used to purify tilapia thyrotropic hormone (t-TSH) from crude pituitary extracts. A homologous bioassay monitored TSH bioactivity during the purification. Thyroid hormones (thyroxine, T4; triiodothyronine, T3; and reverse triiodothyronine, rT3) and testosterone were measured in vivo in Tilapia nilotica. TSH activity eluted as one major peak at pH 2.8 using a PBS-glycine buffer. The TSH fraction increased plasma T4 and plasma rT3. The potency of tTSH was comparable to that of pituitary extract or its Con A II fraction; however, pFSH was a stronger thyroid stimulant. tTSH had no effect on plasma T3 levels and was free of gonadotropic activity, as indicated by its failure to alter plasma testosterone concentrations. Chromatographic and electrophoretic analyses demonstrated a high degree of purity. Like other vertebrate TSHs, the tTSH appeared to have a subunit structure with a possible microgeneity in one subunit. PMID- 1783267 TI - Biosynthesis of 17 alpha,20 beta-dihydroxy-4-pregnen-3-one in the ovaries of grey mullet (Mugil cephalus) during induced ovulation by carp pituitary homogenates and an LHRH analogue. AB - Three female mullets received a priming injection of carp pituitary homogenate followed by a resolving injection of an LHRH analogue 24 hr later. Ovarian biopsies were obtained just prior to the first injection (phase I), 24 hr after the first injection (i.e., immediately before the second injection, phase II), and 8 hr after the second injection (phase III). Two fish (Nos. 1 and 3) spawned approximately 12 hr after the second injection. Serum levels of testosterone increased to some extent during phase II in all of the fish. Testosterone levels decreased abruptly during phase III in both fish Nos. 1 and 3. In contrast the concentration of 17 alpha,20 beta-dihydroxy-4-pregnen-3-one (17 alpha,20 beta diOHprog) was undetectable in phases I and II, and increased dramatically during phase III in the same fish. In fish No. 2, which did not spawn, neither the decrease of testosterone nor the increase of 17 alpha,20 beta-diOHprog was observed. Ovarian tissues of all the fish were pooled in each phase and incubated with 14C-labeled progesterone or 17 alpha-hydroxyprogesterone to investigate steroid metabolism. During phases I and II progesterone was converted to 17 alpha hydroxyprogesterone, androstenedione, and testosterone. During phase III, production of these steroids decreased drastically, and in turn, synthesis of 20 beta-hydroxy-4-pregnen-3-one and 17 alpha,20 beta-diOHprog was induced. Using 17 alpha-hydroxyprogesterone as a substrate, androstenedione and testosterone were produced during phases I and II, whereas they decreased considerably during phase III. This was followed by the production of 17 alpha,20 beta-diOHprog as the major metabolite.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783268 TI - The phylogeny of Met-enkephalin and Leu-enkephalin: studies on the holostean fish Lepisosteus platyrhincus and the Australian lungfish, Neoceratodus forsteri. AB - Acid extracts of the brain of the holostean fish Lepisosteus platyrhincus and the forebrain of the dipnoan fish Neoceratodus forsteri were separately fractionated by Sephadex G-50 column chromatography. For both species, Met-enkephalin-related immunoreactivity was detected coeluting with the total volume internal standard. Higher-molecular-weight Met-enkephalin-containing immunoreactive peaks were not detected in these chromatographs. Furthermore, immunoreactive forms with antigenic determinants identical to mammalian dynorphin A(1-17), dynorphin A(1 8), alpha-neo-endorphin, or dynorphin B(1-13) were not detected in either species. Reverse-phase HPLC analysis of enkephalin-sized immunoreactive material indicated the presence of authentic Met-enkephalin and Leu-enkephalin in the extracts of both species. In the brain of L. platyrhincus the molar ratio of Met enkephalin to Leu-enkephalin was approximately 3:1, whereas, the molar ratio of these enkephalins in the forebrain of N. forsteri was approximately 5:1 [corrected]. C-terminally extended forms of Met-enkephalin were also detected in the extracts of both species. These results suggest that the ancestral proenkephalin gene of both actinopterygian and sarcopterygian fish contained both the Met-enkephalin and Leu-enkephalin sequences. PMID- 1783269 TI - Lack of essential enzymes for the biosynthesis of C19 and C18 steroids in gonads of the migratory locust, Locusta migratoria. AB - Ovaries and testes of the African migratory locust, Locusta migratoria migratorioides, were incubated in vitro with six tritiated steroid precursors. Three developmental stages were investigated--1 day, 14 days, and 6 weeks after adult moulting. 20 alpha-Hydroxysteroid dehydrogenase (HSD), 20 beta-HSD, 17 beta HSD, 3 beta-HSD/isomerase, C17-C20 lyase, glucuronyl-transferase, sulfotransferase, and acyltransferase were identified in both sexes. A synthesis of androgens or estrogens comparable to the vertebrate type, however, was not apparent in the locust gonads. 20 alpha-HSD, 20 beta-HSD, and 17 beta-HSD activities were high, while more important steps in steroid synthesis such as 3 beta-HSD and C17-C20 lyase were far less intense. Ovarian 17 alpha-hydroxylase activity was slight. Aromatase activity was not demonstrated. Water-soluble conjugate formation was high in the incubations of "14th-day" and "6th-week" gonads but was absent in "1st-day" ovaries and testes. Active ester formation of pregnenolone was demonstrated in "6th-week" testes. The other steroid conversions were similar in all developmental stages investigated. Major differences between testes and ovaries were not observed. The gonads of the migratory locust are concluded not to produce androgens or estrogens. PMID- 1783270 TI - Daily pattern of melatonin secretion in an antarctic bird, the emperor penguin, Aptenodytes forsteri: seasonal variations, effect of constant illumination and of administration of isoproterenol or propranolol. AB - Daily variations in circulating melatonin concentrations have been measured at monthly intervals from April to December 1986 in an Antarctic bird, the emperor penguin, Aptenodytes forsteri, maintained under natural conditions. Both duration of the elevated nighttime melatonin levels and amplitude of the day-night rhythm displays an annual variation closely related to variations in the daylength. Duration of the nocturnal peak of melatonin secretion depended upon the duration of the darkness, decreasing with increasing daylength and disappearing completely during the summer solstice. The duration of the nighttime melatonin peak melatonin increased inversely with decreasing daylength. The amplitude of the day night rhythm decreased in such a way that the nocturnal peak of melatonin completely disappeared during the winter solstice. Three days of constant illumination in September did not suppress the nighttime peak of melatonin secretion. The response of melatonin secretion, decreasing after beta-adrenergic agonist treatment and increasing after antagonist treatment, reinforces the hypothesis that in birds the regulation of melatonin synthesis differs from that of the rat. Receptors other than beta receptors may be involved. PMID- 1783271 TI - Effects of 17 beta-estradiol and carp gonadotropin on vitellogenesis in normal and hypophysectomized European silver female eel (Anguilla anguilla L.) employing a homologous radioimmunoassay for vitellogenin. AB - The European silver eels are at the early stages of vitellogenesis before the marine reproductive migration. Vitellogenesis was induced by 17 beta-estradiol (E2) alone and by a purified carp gonadotropin (cGTH). We studied and compared their effects on plasma vitellogenin (Vg) levels and ovarian yolk contents in female normal (N) and hypophysectomized (H) eels for both treatments. To this purpose an homologous radioimmunoassay (RIA) was established. Eel Vg was purified to homogeneity on 0.1% SDS-Electrophoresis. Native Vg has a molecular weight of 340 +/- 15 kilodalton (kDa) and was partially separated into subunits. The RIA was established with a sensitivity of 1.1 ng and was specific for eel Vg. In control (N and H) silver eels, plasma Vg levels were 0.04 +/- 0.02 microgram/ml and unchanged throughout the experiment. Similarly, yolk was indetectable in control ovarian extracts. E2 treatment increased plasma Vg levels proportionally with time to 783.4 +/- 130.7 micrograms/ml in N eels. The same profile was seen in H eels but terminally the mean value was 36.7 times lower than in N eels (P less than 0.01). Yolk at 0.005 microgram/g in N eels was indetectable in H eels. cGTH treatment gave a biphasic kinetic change: plasma Vg increased within 12 days, peaked at 93.6 +/- 13.0 micrograms/ml at 20 to 24 days, and stabilized to decrease at 40.2 +/- 7.5 micrograms/ml. The gonadosomatic index (GSI) increased alongside the yolk content (980.4 +/- 153.1 micrograms Vg/g). The kinetic profile for H eels was different: a peak was not apparent, rather there was a delayed increase, and at 67 days levels were still 8.23 times lower than in N eels (P less than 0.01). The GSI increased as the yolk content to 202.7 +/- 64.8 micrograms Vg/g ovary showing an ovarian incorporation of Vg in H eels. PMID- 1783272 TI - Neuropeptide Y stimulates in vivo gonadotropin secretion in teleost fish. AB - The effects of the neuropeptide Y (NPY), alone or in combination with a gonadotropin-releasing hormone analogue, D-Ala6-desGly10-Pro9-Net LHRH (LHRHa), have been studied on the in vivo secretion of the maturational gonadotropin (GtH2) in the rainbow trout Oncorhynchus mykiss and the common carp Cyprinus carpio. Depending on the species, two routes of administration were used: in trout, intraperitoneal injection (20 micrograms/kg body wt); in carp, direct infusion (3 micrograms/kg body wt) into the third ventricle via a temporary brain cannula. In both cases NPY alone induced a twofold increase in GtH2 secretion and peaked 2 to 4 hr administration regardless of the route of injection. The plasma gonadotropin levels returned to basal within 8 hr. The relative increases (peaked secretion/basal secretion) did not differ with the route of injection. When the animals were first treated with NPY and then LHRHa (20 micrograms/kg) 1 hr later, the magnitude of the response to LHRHa was greater in the animals pretreated with NPY, indicating either a potentiation of LHRHa action by NPY or additive effects of the two peptides. The return to basal levels also took longer in fish receiving NPY first. NPY may act directly at the pituitary level or activate central neuromediatory systems. PMID- 1783273 TI - Calcitonin-immunoreactive cells are present in the brains of some cyclostomes. AB - In the brains of four species of cyclostomes (two species each of lampreys and hagfishes), immunoreactive calcitonin-producing cells (iCT cells) were located immunohistochemically by the peroxidase-antiperoxidase method using anti-salmon calcitonin antiserum. In the case of both the adults and the ammocoetes of the brook lamprey (Lampetra reissneri) which lives in freshwater throughout its life, iCT cells were found in two distinct areas: in the pars ventralis hypothalami of the diencephalon and in the torus semicircularis of the mesencephalon. The iCT cells in the diencephalon are classified as bipolar nerve cells, and those in the mesencephalon are classified as multipolar nerve cells. In both the anadromous and catadromous arctic lamprey (Lampetra japonica), iCT cells were present only in the diencephalon, and those were bipolar nerve cells. There seemed to be no differences in the numbers and the immunostainability of the iCT cells, despite the different environments inhabited by the lampreys. In the hagfishes (Eptatretus burgeir and Paramyxine atami) that inhabit seawater throughout their lives, iCT cells were also found only in the diencephalon, although they were very few in number and exhibited poor immunostainability. PMID- 1783274 TI - Involvement of gonadotropin in the uptake of vitellogenin into vitellogenic oocytes of the rainbow trout, Oncorhynchus mykiss. AB - The effects of two fully characterized, structurally distinct gonadotropins, GtH I and GtH II, on the uptake of vitellogenin (VTG) into oocytes of the rainbow trout, Oncorhynchus mykiss, were investigated both in vivo and in vitro. GtH I, injected into maturing vitellogenic females at a dose of 10 micrograms.kg body wt 1, increased the rate of [3H]VTG uptake into oocytes by more than two-fold, effectively doubling their rate of growth. Ovaries from females similarly treated with GtH II sequestered VTG at rates similar to controls. In vitro, GtH I stimulated VTG uptake in a dose-dependent manner. At a GtH I concentration of 100 ng.ml-1 and above, the rate of VTG uptake was significantly greater than that of the controls and at 1000 ng.ml-1 the rate of uptake was more than doubled. GtH II did not significantly increase VTG sequestration into isolated oocytes at concentrations up to, and including, 1000 ng.ml-1. These data provide the first evidence that GtH I has a primary function in stimulating VTG uptake and strongly support the contention that at least two functionally distinct GtHs occur in fish. PMID- 1783275 TI - The effects of norethindrone on the mullerian ducts of the American alligator. AB - Norethindrone, a reported aromatase inhibitor, has been used to examine the role of estrogens in the unilateral regression of the mullerian ducts that occurs in female chick embryos. The mullerian ducts are embryonic oviducts that regress in most male vertebrates under the influence of the testicular hormone, mullerian inhibiting substance (MIS). The ovaries of the chick also produce MIS during early development, but only the right duct regresses. Based on the finding that the left duct contains significantly more estradiol binding sites than the right duct, it has been proposed that the left duct is protected from the effects of MIS by preferentially binding estradiol from the ovaries. In support of this theory, norethindrone (0.1 and 0.5 mg) injected into the airsac of chick eggs results in regression of the left mullerian duct of female embryos, presumably by blocking the synthesis of estradiol. In the present study, it was hypothesized that crocodilians, because of the common ancestry they share with birds, would respond in a similar manner by exhibiting regression of both mullerian ducts in response to norethindrone. However, the application of norethindrone (0.5 mg) to the chorioallantoic membrane of female alligator embryos in ovo resulted in significant hypertrophy of the ducts, indicating that norethindrone had an estrogenic effect in the alligator rather than acting as an aromatase inhibitor. There was no effect of norethindrone on the gonads. PMID- 1783276 TI - Differential appearance of the subunits of glycoprotein hormones (LH, FSH, and TSH) in the pituitary of bullfrog (Rana catesbeiana) larvae during metamorphosis. AB - The ontogeny of gonadotrophs and thyrotrophs in the bullfrog pituitary was examined immunohistochemically using monoclonal antibodies against bullfrog lutropin beta-subunit (LH beta), follitropin beta-subunit (FSH beta) and its alpha-subunit, and polyclonal anti-human thyrotropin beta-subunit (TSH beta) serum. Immunoreactive alpha-subunit- and TSH beta-, but not FSH beta- and LH beta containing cells were observed at embryonic stage 24 (Shumway's classification). Immunoreactive FSH beta cells first appeared at Taylor-Korllos stage V, and immunoreactive LH beta cells at stage X. Throughout metamorphosis, several gonadotrophs containing both FSH and LH were found in the ventrocaudal region, but most gonadotrophs contained only FSH. Immunoreactive alpha-subunit cells were always more frequent than the sum of immunoreactive beta-subunit cells, which was confirmed by quantitative studies using immunohistochemical and RIA techniques. PMID- 1783277 TI - Prostaglandins in the kidney, urinary bladder and gills of the rainbow trout and European eel adapted to fresh water and seawater. AB - Prostaglandins in kidney, gills, and urinary bladder of freshwater-adapted and seawater-adapted rainbow trout, Oncorhynchus mykiss (= Salmo gairdneri), and European eel, Anguilla anguilla, were determined by solid-phase extraction of tissue homogenates and high-pressure liquid chromatography. Prostaglandins E2, E1, F1 alpha, F2 alpha, and D2 and the more stable metabolite of prostacyclin, 6 keto F1 alpha, occurred in these osmoregulatory tissues. In gill filaments and kidneys of both eel and trout, prostaglandins D2 and 6-keto F1 alpha were major prostaglandins. Concentrations of these prostaglandins were significantly lower in the eel after seawater adaptation, but not in the trout. The urinary bladder of the trout contained the highest levels of prostaglandins; bladders of seawater adapted trout contained prostaglandin D2 at 6.7 ng/mg wet tissue, the highest level of any prostaglandin determined in the present studies. Prostaglandin D2 was not detected in bladders of freshwater-adapted trout. PMID- 1783278 TI - Optimal conditions for the analysis of Pasteurella haemolytica lipopolysaccharide by sodium dodecyl sulphate-polyacrylamide gel electrophoresis. AB - The optimal conditions for the analysis of the lipopolysaccharide (LPS) of two serotype A1 isolates and a serotype A2 isolate of Pasteurella haemolytica by sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE) and silver staining were determined. The LPS of the A1 isolates possessed O side chains, consisting of high molecular mass bands with the appearance of a ladder-like pattern, as well as a low molecular mass core-oligosaccharide region; the LPS of the A2 isolate consisted only of the core-oligosaccharide region. Furthermore, the LPS of the two A1 isolates differed in the core-oligosaccharide region. Optimal resolution of low molecular mass LPS components was obtained in a 15% acrylamide resolving gel containing 4 M urea whereas optimal resolution of high molecular mass components was obtained when urea was omitted. Conventional silver staining resulted in excellent visualisation of LPS bands, whereas a modified staining method did not detect additional bands, as has been demonstrated with the LPS of Pseudomonas aeruginosa. Proteinase K digestion of outer membranes gave more clearly defined LPS profiles than did similar digestions of whole cells, and more closely resembled the profiles of purified LPS. With the exception of slight variation in the average molecular mass of a group of O side chains between logarithmic and stationary phases there were no differences in LPS profiles at various stages of the growth cycle; freezing and thawing of LPS samples had no effect on the profiles. PMID- 1783279 TI - The pathogenicity of Aeromonas strains relative to genospecies and phenospecies identification. AB - The relative pathogenicity of 80 Aeromonas strains typed by biochemical (phenospecies) and genetic (genospecies) methods was assessed by determining the 50% lethal dose for each isolate in Swiss-Webster mice by intraperitoneal injection. Overall, the maximum difference in virulence potential observed between the least and most pathogenic strains was a four log (10,000-fold) difference. Results according to phenospecies designation supported previous investigations indicating that both A. hydrophila and A. sobria are inherently more pathogenic for mice than A. caviae. According to genospecies designation, the relative virulence of individual groups in decreasing order was as follows: HG 9 (A. jandaei) greater than HG 1 (A. hydrophila) and HG 12 (A. schubertii) greater than HG 10 (A. veronii biotype veronii) greater than HG 8 (A. veronii biotype sobria) greater than HG 11 (unnamed) greater than HG 2 (unnamed) greater than HG 3 (A. salmonicida), HG 4 (A. caviae) and HG 6 (A. eucrenophila) greater than HG 5 (A. media) greater than HG 7 (A. sobria). PMID- 1783280 TI - Relatedness between Streptococcus pneumoniae and viridans streptococci: transfer of penicillin resistance determinants and immunological similarities of penicillin-binding proteins. AB - The occurrence of highly variable penicillin-binding proteins (PBPs) in penicillin-resistant Streptococcus pneumoniae suggested that transfer of homologous genes from related species may be involved in resistance development. Antiserum and monoclonal antibodies raised against PBPs 1a and 2b from the susceptible S. pneumoniae R6 strain were used to identify related PBPs in 41 S. mitis, S. sanguis I and S. sanguis II strains mostly isolated in South Africa with MIC values ranging from less than 0.15 to 16 mg/ml. Furthermore, the possibility of genetic exchange was examined with 30 penicillin-resistant strains of this collection (MIC greater than 0.06 mg/ml) as donors using S. pneumoniae R6 as recipient in transformation experiments. The majority of S. mitis and S. sanguis II strains but none of the S. sanguis I strains could transform penicillin resistance genes into S. pneumoniae R6. All positive donor strains and all susceptible isolates of S. mitis and S. sanguis II strains contained PBPs which cross-reacted with the anti-PBP 1a and/or anti-PBP 2b antibodies. On the other hand, only five of the 14 S. sanguis I strains contained a PBP that reacted with one of the antibodies. This strongly suggested the presence of genes homologous to the pneumococcal PBP 1a and 2b genes in viridans streptococci, and documents that penicillin resistance determinants can be transformed from viridans streptococci into the pneumococcus. PMID- 1783281 TI - A plasmid from a virulent strain of Legionella pneumophila is conjugative and confers resistance to ultraviolet light. AB - The presence of a single apparently cryptic plasmid of approximately 36 MDa was demonstrated in the virulent Dodge strain of Legionella pneumophila. 'Tagging' of the plasmid with Tn5 enabled transfer to be demonstrated to other strains of Legionella (though not to Escherichia coli or Pseudomonas aeruginosa) as well as a definitive assessment to be made of its stability. Plasmid carriage confers resistance to UV light probably by means of an error-prone UV repair system. The plasmid is compatible with plasmids of the IncP and IncW incompatibility groups. PMID- 1783282 TI - Colicinogeny of O55 EPEC diarrhoeagenic Escherichia coli. AB - Approximately 24% of a sample of pathogenic Escherichia coli strains from different serogroups were found to synthesize colicins. Serogroup O55 had an unusually large proportion of such strains (33%). In a sample of 27 O55 isolates, one synthesized a class A colicin (identified as ColE9), five produced class B colicins (three ColIa, two, unidentifiable), and three a class A and a class B together. PMID- 1783283 TI - Influence of yeasts and of their constituents on nucleoside uptake in peritoneal murine macrophages. AB - A marked reduction of [3H]-uridine uptake was observed when mouse peritoneal macrophages (pM phi) were exposed to heat-killed Candida albicans or Saccharomyces cerevisiae. By contrast, an increased nucleoside uptake was promoted by yeast products such as zymosan, laminarin, or yeast cell-wall extracts, which are mainly composed of beta-glucans and alpha-mannans. In a search for the active fungal component(s), the uptake process was shown to be differently affected by monosaccharides and polysaccharides. These findings support the view that a specific recognition of a pM phi membrane receptor is mediating the effect of the various substances. PMID- 1783284 TI - RNA polymerase heterogeneity in Streptomyces aureofaciens: characterization by antibody-linked polymerase assay. AB - Using antibody-linked polymerase assay we studied the polypeptide composition of DNA-dependent RNA polymerase from Streptomyces aureofaciens and immunological cross-reaction with Escherichia coli RNA polymerase. We identified about 25 'ALPA reactive' polypeptides which are probably involved in the transcriptional apparatus. We demonstrated that beta' and beta subunits from S. aureofaciens and E. coli are immunologically related and sigma70 (E. coli) shows immunochemical similarity with sigma35 (S. aureofaciens). According to the reconstitution of RNA polymerase holoenzyme and antibody-linked polymerase assay we identified sigma factors responsible for recognition of two promoters. PMID- 1783285 TI - Structural heterogeneity of the lipopolysaccharides of the Neisseriaceae. AB - Lipopolysaccharides from 5 different genera of the Neisseriaceae were analyzed on sodium dodecylsulfate-polyacrylamide gel electrophoresis, and visualized by silver staining. Significant heterogeneity in the banding patterns was observed with some of the strains producing only low molecular mass molecules and others producing O-repeating units. All genera examined except Branhamella contained strains that were able to produce an O-repeating side chain on their lipopolysaccharides. The ability to produce the repeating subunit did not correlate with the presence of plasmids. PMID- 1783286 TI - Physiological studies on the utilization of oleic acid by Saccharomyces cerevisiae in relation to microbody development. AB - We studied the influence of specific growth conditions on the induction of beta oxidation enzymes and rate of microbody proliferation in S. cerevisiae by oleic acid. Of all conditions tested, highest enzyme levels and microbody numbers were achieved in glucose-limited continuous cultures, supplemented with oleic acids second carbon source. Comparable enzyme levels were observed in identical cultures of peroxisome-deficient (pas) mutants of S. cerevisiae. These experiments showed chemostat cultures on glucose/oleic acid mixtures to be a method of choice for future studies on microbody biogenesis/assembly in constructed, conditional pas mutants. PMID- 1783287 TI - Histone preopsonisation increases the respiratory burst response of phagocytes to Pneumocystis carinii. AB - Preincubation of Pneumocystis carinii with histone caused an increase in polymorphonuclear leucocyte and macrophage chemiluminescence when parasites were mixed with phagocytes compared with that obtained when unopsonised parasites were used. Toxic oxygen moieties released during the respiratory burst may cause tissue damage. PMID- 1783288 TI - The ability of rifampin-resistant Escherichia coli to colonize the mouse intestine is enhanced by the presence of a plasmid-encoded aerobactin-iron(III) uptake system. AB - Rifampin-resistant Escherichia coli are known to be poor colonizers of the animal intestine. In this report, we show that the colonizing ability of rifampin resistant E. coli cells is increased dramatically in the presence of the aerobactin-mediated iron(III) uptake system. In contrast, the colonization by nalidixic acid-resistant E. coli does neither depend on the aerobactin-iron(III) nor on the dicitrate-iron(III) uptake system. Likewise, it does not depend on the production of the siderophore enterochelin. PMID- 1783289 TI - Ability of a bacterial chromosome segment to invert is dictated by included material rather than flanking sequence. AB - Homologous recombination between sequences present in inverse order within the same chromosome can result in inversion formation. We have previously shown that inverse order sequences at some sites (permissive) recombine to generate the expected inversion; no inversions are found when the same inverse order sequences flank other (nonpermissive) regions of the chromosome. In hopes of defining how permissive and nonpermissive intervals are determined, we have constructed a strain that carries a large chromosomal inversion. Using this inversion mutant as the parent strain, we have determined the "permissivity" of a series of chromosomal sites for secondary inversions. For the set of intervals tested, permissivity seems to be dictated by the nature of the genetic material present within the chromosomal interval being tested rather than the flanking sequences or orientation of this material in the chromosome. Almost all permissive intervals include the origin or terminus of replication. We suggest that the rules for recovery of inversions reflect mechanistic restrictions on the occurrence of inversions rather than lethal consequences of the completed rearrangement. PMID- 1783290 TI - swi6, a gene required for mating-type switching, prohibits meiotic recombination in the mat2-mat3 "cold spot" of fission yeast. AB - Mitotic interconversion of the mating-type locus (mat1) of the fission yeast Schizosaccharomyces pombe is initiated by a double-strand break at mat1. The mat2 and mat3 loci act as nonrandom donors of genetic information for mat1 switching such that switches occur primarily (or only) to the opposite mat1 allele. Location of the mat1 "hot spot" for transposition should be contrasted with the "cold spot" of meiotic recombination located within the adjoining mat2-mat3 interval. That is, meiotic interchromosomal recombination in mat2, mat3 and the intervening 15-kilobase region does not occur at all. swi2 and swi6 switching deficient mutants possess the normal level of double-strand break at mat1, yet they fail to switch efficiently. By testing for meiotic recombination in the cold spot, we found the usual lack of recombination in a swi2 mutant but a significant level of recombination in a swi6 mutant. Therefore, the swi6 gene function is required to keep the donor loci inert for interchromosomal recombination. This finding, combined with the additional result that switching primarily occurs intrachromosomally, suggests that the donor loci are made accessible for switching by folding them onto mat1, thus causing the cold spot of recombination. PMID- 1783291 TI - Extrachromosomal recombination is deranged in the rec2 mutant of Ustilago maydis. AB - Transformation of a leu1 auxotroph of Ustilago maydis to prototrophy with an autonomously replicating plasmid containing the selectable LEU1 gene was found to be efficient regardless of whether the transforming DNA was circular or linear. When pairs of autonomously replicating plasmids bearing noncomplementing leu1 alleles were used to cotransform strains deleted entirely for the genomic copy of the LEU1 gene, Leu+ transformants were observed to arise by extrachromosomal recombination. The frequency of recombination increased severalfold when one plasmid of the pair was made linear by cleavage at one end of the leu1 gene, but increased 10-100-fold when both plasmids were first made linear. The increase in recombination noted in wild-type and rec1 strains was not apparent in the rec2 mutant unless the members of the pair of plasmids were cut at opposite ends of the leu1 gene to yield linear molecules offset in only one of the two possible configurations. Use of a pair of plasmid substrates designed to measure nonreciprocal and multiple exchange events revealed only a minor fraction of the total events arise through these modes, and further that no stimulation occurred when the plasmid DNA was linear. It is unlikely that the defect in rec2 lies in a mismatch correction step since a high yield of Leu+ recombinants was obtained from the rec2 mutant when it was transformed with heteroduplex DNA constructed from plasmids with the two different leu1 alleles. PMID- 1783293 TI - Chromosome rearrangement by ectopic recombination in Drosophila melanogaster: genome structure and evolution. AB - Ectopic recombination between interspersed repeat sequences generates chromosomal rearrangements that have a major impact on genome structure. A survey of ectopic recombination in the region flanking the white locus of Drosophila melanogaster identified 25 transposon-mediated rearrangements from four parallel experiments. Eighteen of the 25 were generated from females carrying X chromosomes heterozygous for interspersed repeat sequences. The cytogenetic and molecular analyses of the rearrangements and the parental chromosomes show: (1) interchromosomal and intrachromosomal recombinants are generated in about equal numbers; (2) ectopic recombination appears to be a meiotic process that is stimulated by the interchromosomal effect to about the same degree as regular crossing over; (3) copies of the retrotransposon roo were involved in all of the interchromosomal exchanges; some copies were involved much more frequently than others in the target region; (4) homozygosis for interspersed repeat sequences and other sequence variations significantly reduced ectopic recombination. PMID- 1783292 TI - Identification of grandchildless loci whose products are required for normal germ line development in the nematode Caenorhabditis elegans. AB - To identify genes that encode maternal components required for development of the germ line in the nematode Caenorhabditis elegans, we have screened for mutations that confer a maternal-effect sterile or "grandchildless" phenotype: homozygous mutant hermaphrodites produced by heterozygous mothers are themselves fertile, but produce sterile progeny. Our screens have identified six loci, defined by 21 mutations. This paper presents genetic and phenotypic characterization of four of the loci. The majority of mutations, those in mes-2, mes-3 and mes-4, affect postembryonic germ-line development; the progeny of mutant mothers undergo apparently normal embryogenesis but develop into agametic adults with 10-1000 fold reductions in number of germ cells. In contrast, mutations in mes-1 cause defects in cytoplasmic partitioning during embryogenesis, and the resulting larvae lack germ-line progenitor cells. Mutations in all of the mes loci primarily affect the germ line, and none disrupt the structural integrity of germ granules. This is in contrast to grandchildless mutations in Drosophila melanogaster, all of which disrupt germ granules and affect abdominal as well as germ-line development. PMID- 1783294 TI - The rosy locus in Drosophila melanogaster: xanthine dehydrogenase and eye pigments. AB - The rosy gene in Drosophila melanogaster codes for the enzyme xanthine dehydrogenase (XDH). Mutants that have no enzyme activity are characterized by a brownish eye color phenotype reflecting a deficiency in the red eye pigment. Xanthine dehydrogenase is not synthesized in the eye, but rather is transported there. The present report describes the ultrastructural localization of XDH in the Drosophila eye. Three lines of evidence are presented demonstrating that XDH is sequestered within specific vacuoles, the type II pigment granules. Histochemical and antibody staining of frozen sections, as well as thin layer chromatography studies of several adult genotypes serve to examine some of the factors and genic interactions that may be involved in transport of XDH, and in eye pigment formation. While a specific function for XDH in the synthesis of the red, pteridine eye pigments remains unknown, these studies present evidence that: (1) the incorporation of XDH into the pigment granules requires specific interaction between a normal XDH molecule and one or more transport proteins; (2) the structural integrity of the pigment granule itself is dependent upon the presence of a normal balance of eye pigments, a notion advanced earlier. PMID- 1783295 TI - Female sterile mutations on the second chromosome of Drosophila melanogaster. II. Mutations blocking oogenesis or altering egg morphology. AB - In mutagenesis screens for recessive female sterile mutations on the second chromosome of Drosophila melanogaster 528 lines were isolated which allow the homozygous females to survive but cause sterility. In 62 of these lines early stages of oogenesis are affected, and these females usually do not lay any eggs. In 333 lines oogenesis proceeds apparently normally to stage 8 of oogenesis, but morphological defects become often apparent during later stages of oogenesis, and are visible in the defective eggs produced by these females whereas 133 lay eggs that appear morphologically normal, but do not support normal embryonic development. Of the lines 341 have been genetically characterized and define a total of 140 loci on the second chromosome. Not all the loci are specific for oogenesis. From the numbers obtained we estimate that the second chromosome of Drosophila contains about 13 loci that are relatively specific for early oogenesis, 70 loci that are specifically required in mid to late oogenesis, and around 30 maternal-effect lethals. PMID- 1783296 TI - Escape from genomic imprinting at the mouse T-associated maternal effect (Tme) locus. AB - Genomic imprinting occurs at the paternally inherited allele of the mouse T associated maternal effect (Tme) locus. As a consequence, maternal transmission of a functional Tme gene is normally required for viability and individuals that receive a Tme-deleted chromosome (Thp or tlub2) from their mother die late in gestation or shortly thereafter. Here we report that a rearranged paternally derived chromosome duplicated for the Tme locus can act to rescue animals that have not received a maternal copy of the Tme locus. Unexpectedly, all rescued animals display an abnormal short/kinky tail phenotype. Somatic transfer of genomic imprinting between homologs by means of a transvection-like process between paired Tme and T loci is proposed as a model to explain the results obtained. PMID- 1783297 TI - Germline selection: population genetic aspects of the sexual/asexual life cycle. AB - Population geneticists make a distinction between sexual and asexual organisms depending on whether individuals inherit genes from one or two parents. When individual genes are considered, this distinction becomes less satisfactory for multicellular sexual organisms. Individual genes pass through numerous asexual mitotic cell divisions in the germline prior to meiosis and sexual recombination. The processes of mitotic mutation, mitotic crossing over, and mitotic gene conversion create genotypic diversity between diploid cells in the germline. Genes expressed in the germline whose products affect cell viability (such as many "housekeeping" enzymes) may be subjected to natural selection acting on this variability resulting in a non-Mendelian output of gametes. Such genes will be governed by the population genetics of the sexual/asexual life cycle rather than the conventional sexual/Mendelian life cycle. A model is developed to investigate some properties of the sexual/asexual life cycle. When appropriate parameter values were included in the model, it was found that mutation rates per locus per gamete may vary by a factor of up to 100 if selection acts in the germline. Sexual/asexual populations appear able to evolve to a genotype of higher fitness despite intervening genotypes of lower fitness, reducing the problems of underdominance and Wright's adaptive landscape encountered by purely sexual populations. As might be expected this ability is chiefly determined by the number of asexual mitotic cell divisions within the germline. The evolutionary consequences of "housekeeping" loci being governed by the dynamics of the sexual/asexual life cycle are considered. PMID- 1783298 TI - Twenty-five years of cell cycle genetics. PMID- 1783299 TI - Specificity of base substitutions induced by the acridine mutagen ICR-191: mispairing by guanine N7 adducts as a mutagenic mechanism. AB - As the most nucleophilic site in DNA, the guanine N7 atom is a major site of adduction by a large number of alkylating mutagens and carcinogens. Aflatoxin B1, a powerful mutagen, is believed to act through its reaction with this DNA site. On the basis of the specificity of base substitutions induced by various adduct forms of aflatoxin, we have proposed that bulky guanine N7 adducts elicit base substitutions by two mechanisms. The first mechanism is similar to that observed for a number of bulky noninstructive lesions, whereas the second mechanism invokes mispairing between N7-adducted guanine and thymine. A prediction of the mispairing hypothesis is that diverse bulky guanine N7 adducts (regardless of structural similarities with the aflatoxins) should induce predominantly G-to-A transitions. Accordingly, we have recently observed that base substitutions induced by the acridine half-mustard ICR-191 in the M13 double-stranded DNA transfection system are predominantly G:C-to-A:T transitions. Here, by transfecting ICR-191-treated M13 AB28 single-stranded DNA into Escherichia coli, we show that base substitutions are predominantly targeted to guanines. Since the N7-adducted-guanine:thymine mispairing is proposed to require N1 deprotonation promoted by the primary N7 lesion, guanine imidazole ring-opening should abolish this mispairing property, and thereby alter the specificity of mutagenesis. Here, we show that the incubation of ICR-191-treated RF DNA at pH 10.5 results in a significant reversal of the specificity of G:C-targeted substitutions such that G to-T transversions predominated over G-to-A transitions.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783301 TI - Genetic differentiation and inversion clines in Indian natural populations of Drosophila melanogaster. AB - To study the genetic differentiation and inversion clines in Indian natural populations of Drosophila melanogaster, 14 natural populations (6 from the north and 8 from the south) were screened for chromosome inversions. The chromosomal analysis revealed the presence of 23 paracentric inversions, which include 4 common cosmopolitan, 4 rare cosmopolitan, 2 recurrent endemic, and 13 unique endemic (new inversions detected for the first time) inversions. The difference in karyotype frequencies between populations from the north and south were highly significant and the level of inversion heterozygosity was higher in populations from the south. Statistically significant negative correlations were found between each of the four common cosmopolitan inversions and latitude. These findings are in accord with results from other worldwide geographic regions and show that Indian populations of D. melanogaster have undergone considerable genetic differentiation at the level of inversion polymorphism. PMID- 1783302 TI - The chromomere map of the pachytene spermatocyte of the Turkish hamster (Mesocricetus brandti). AB - The chromomere map of the early to mid pachytene spermatocyte of the Turkish hamster (Mesocricetus brandti) is described. Each autosomal bivalent was identified and a total of 304 chromomeres was found. A sex bivalent with a despiralized Xq protruding from the sex vesicle and a small number of the polymorphic 16q bivalents were observed. PMID- 1783300 TI - On the deletion of inverted repeated DNA in Escherichia coli: effects of length, thermal stability, and cruciform formation in vivo. AB - We have studied the deletion of inverted repeats cloned into the EcoRI site within the CAT gene of plasmid pBR325. A cloned inverted repeat constitutes a palindrome that includes both EcoRI sites flanking the insert. In addition, the two EcoRI sites represent direct repeats flanking a region of palindromic symmetry. A current model for deletion between direct repeats involves the formation of DNA secondary structure which may stabilize the misalignment between the direct repeats during DNA replication. Our results are consistent with this model. We have analyzed deletion frequencies for several series of inverted repeats, ranging from 42 to 106 bp, that were designed to form cruciforms at low temperatures and at low superhelical densities. We demonstrate that length, thermal stability of base pairing in the hairpin stem, and ease of cruciform formation affect the frequency of deletion. In general, longer palindromes are less stable than shorter ones. The deletion frequency may be dependent on the thermal stability of base pairing involving approximately 16-20 bp from the base of the hairpin stem. The formation of cruciforms in vivo leads to a significant increase in the deletion frequency. A kinetic model is presented to describe the relationship between the physical-chemical properties of DNA structure and the deletion of inverted repeats in living cells. PMID- 1783303 TI - Cytological characterisation of heterochromatin in mitotic and meiotic chromosomes of the Old World screwworm fly, Chrysomya bezziana (Diptera: Calliphoridae). AB - Mitotic and meiotic chromosomes of the Old World screwworm fly, Chrysomya bezziana, were studied using C-banding and quinacrine and counterstain-enhanced fluorescence techniques. The five autosomes in the karyotype are evenly graded in size, with somewhat variable arm ratios. Distinguishing all autosomes on these features alone can be difficult. C-banding produces small centromeric bands in the autosomes, whereas the much longer X and Y chromosomes have extensive dark C band blocks with intermediate background staining. Most bright fluorescence occurs in the sex chromosomes, particularly the X chromosome, which has remarkable banding detail. Band resolution is greatly increased in mitotic metaphase cells from embryos. Quinacrine staining of mitotic chromosomes produces bright fluorescence at the centromere regions of chromosomes 2, 3, and 4, assisting in their identification. Meiotic chromosomes have distinctly reduced brightness and resolution of fluorescent bands and show marked chromatid asynapsis in the brighter regions of the sex chromosomes. Fluorochromes staining A.T-rich DNA (quinacrine and 4,6-diamidino-2-phenylindole (DAPI) produce bright staining in a large proportion of the sex chromosomes. By contrast chromomycin, which binds preferentially to G.C-rich DNA, stains a much smaller proportion of the sex chromosomes than expected from reciprocal staining. Together with the asynapsis data this indicates that much of the heterochromatin in the sex chromosomes has unusual structural properties. PMID- 1783304 TI - [New Robertsonian populations of the house mouse (Mus musculus domesticus) from north of the Alps]. AB - New Robertsonian (Rb) populations of the house mouse (Mus musculus domesticus) carrying different combinations of centric fusions are reported in France, Switzerland, and Germany. In Alsace (France), the diploid number varied from 2n = 38 to 34; four fusions were present, with Rb(4.12) homozygous in all populations whereas Rb(5.10), Rb(5.7), or Rb(10.14) were found to be segregating. In Switzerland, only all-acrocentric mice (2n = 40) were present in Bern while Rb(5.7) and Rb(9.16) occurred in Basel. In the Konstanz locality from southern Germany, all the mice were homozygous for nine Rb fusions: Rb(1.18), Rb(2.5), Rb(3.6), Rb(4.12), Rb(7.15), Rb(8.17), Rb(9.14), Rb(10.11), and Rb(13.16). The phylogenetic relationship of these new Rb populations with those already known is discussed. PMID- 1783305 TI - A novel Robertsonian translocation in a family of Walker hounds. AB - A 5-year-old female Walker hound was presented to the Washington State University Veterinary Teaching Hospital as a result of a narrowing of the vulva, which prevented natural breeding. All other physical and clinical findings were normal. Cytogenetic analysis disclosed a chromosome number of 77, with three metacentric chromosomes comprised of two X chromosomes and a Robertsonian translocation of two acrocentric autosomes, chromosomes 21 and 33. Cytogenetic analysis of two full-sister siblings with histories of absence of estrus disclosed one with the same translocation and one with a normal female chromosome constitution. The propositus was artificially inseminated with semen from a karyotypically normal male Walker hound and gave birth to nine live grossly normal pups, six females and three males. Another female pup was stillborn but was grossly normal. Cytogenetic analysis of the live pups disclosed that four (three males and one female) of the nine had the same translocation in all lymphocytes. The remaining five pups (five females) had normal female chromosome constitutions. The litter size was average for this breed. This is a previously unreported Robertsonian translocation in dogs. PMID- 1783306 TI - [Leukocyte esterase in the rapid detection of intraamniotic infection]. AB - Several lines of evidence support the view that premature rupture of the membranes and premature labor are associated with bacterial infection of the amniotic cavity. The standard method of diagnosing intraamniotic infection is amniotic fluid culture, but the results become available only after 72 hours. Methods for more rapid diagnosis of bacterial invasion are therefor needed. We examined leukocyte esterase activity for this purpose. Amniotic fluid obtained from 62 women in preterm labor was cultured for aerobic, anaerobic and mycoplasma species. Leukocyte esterase activity was measured with a Bio-dynamics test strip. The sensitivity of the test was 50.0% and its specificity 93.4%. It was found to be a simple and rapid method for the detection of intraamniotic infection. PMID- 1783307 TI - [Intracavernous pharmacotherapy for treatment and evaluation of impotence]. AB - Impotence affects about 10% of all men. During the past decade it has been treated with self-injection of vasoactive drugs into the erectile tissue. In 1982 Virag reported experience with intracavernous injection of papaverine. Since then other vasoactive drugs, such as prostaglandin E1 (PGE1), have been used successfully, and self-injection has been advised. Between 1987-1989 we evaluated 550 patients with erectile dysfunction and 95 aged 21-79, mean 53.7, were found suitable for this treatment, of whom 80 were entered into an autoinjection protocol, of 74 were treated with a mixture of papaverine and regitine and 6 with PGE1. The volume of the injections ranged from 0.1 to 1.0 ml, and erections lasted from 15 minutes to 8 hours. 72% of the patients continued autoinjection during a mean follow-up of 9.9 months and were satisfied with the results. There were 5 cases of corporal fibrosis, and 3 cases had prolonged erections, usually after the papaverine test. The method is simple and inexpensive, and allows many impotent men to resume sexual life. It is a good alternative to the insertion of a penile prosthesis. PMID- 1783308 TI - [High-dose immunoglobulins in children with Guillain-Barre syndrome]. AB - High-dose intravenous immunoglobulin was effective in 3 children with severe Guillain-Barre syndrome (GBS). They presented with mild to moderate, flaccid weakness which progressively deteriorated to severe tetraparesis and weakness of ocular, facial and bulbar muscles. 1 of them was treated with steroids with no response. Serum immune globulins were infused (1g/kg/day) for 2 consecutive days. There was marked clinical improvement in all 3 after the second day of infusion, and there were no adverse affects. All became ambulatory and were able to walk within the first week. Ocular, facial and bulbar impairment gradually subsided and disappeared, as did hypertension in 1. A 6-year-old boy completely recovered after 3 weeks while the 2 girls, both aged 9 years, still have mild weakness which is gradually improving. High-dose immunoglobulin therapy may be effective in children with severe GBS, with no significant adverse effects. It presumably provides idiotypic antibodies that block the autoimmune process responsible for demyelination. PMID- 1783309 TI - [Adult respiratory distress syndrome complicating acute pyelonephritis in pregnancy]. AB - On the fifth day of a course of antibiotic therapy for acute Klebsiella pyelonephritis, a 21-year-old pregnant woman developed adult respiratory distress syndrome. She improved rapidly on fluid restriction and intravenous furosemide and did not require mechanical ventilation. 17 weeks later, after 40 weeks of pregnancy, she spontaneously delivered a healthy male infant weighing 3280 g. PMID- 1783310 TI - [Malignant transformation of perianal condyloma acuminatum]. AB - A case of squamous cell carcinoma developing in a perianal condyloma acuminatum in a 38-year-old man treated for over 5 years with podophyllin is presented. Although there are many reports of malignant transformation of condyloma acuminatum in the skin and mucosal surfaces of the male and female genitalia, it is quite rare in the perianal region. In this case there were foci of carcinoma in-situ and of frank invasion, as well as areas of squamous cell carcinoma in the large perianal condyloma. The lesion was widely excised, and completely removed, and the site covered with a split-thickness graft from the thigh. Later, repeated dilatations of the anus were required. Repeated histologic examinations of condyloma acuminatum are needed to diagnose possible malignant transformation. PMID- 1783311 TI - [Bacterial tracheitis in children]. AB - Bacterial tracheitis (BT) was found in 10 of 748 children (1.3%) admitted with croup during 1983-1990. 9.9% of all the 748 croup cases seen (74) were admitted to the pediatric intensive care unit (PICU) and 16 of the 74 required intubation. 10 of those intubated (62.5%) were found to have BT and had typical features of croup, including inspiratory stridor, hoarseness and cough. Airway obstruction resulted mainly from accumulated tracheal pus. After endotracheal intubation all required frequent suctioning of thick purulent secretions. In 2 children causative microorganisms were cultured from the blood, and in all 10 from the tracheal pus. All children were given antibiotic therapy but a 7 month-old girl died of secondary complications (respiratory syncytial virus infection, pneumonia and adult respiratory distress syndrome). The others recovered and were discharged from the PICU within 3-14 days. BT should be suspected when tracheal intubation is required in croup. In such cases close monitoring in a PICU and frequent tracheal suctioning after intubation is necessary; antibiotic therapy should be considered. PMID- 1783312 TI - [Social and functional results of brachial plexus birth injury]. AB - Long-term results of obstetrical brachial plexus injury were studied. The medical records of 10 females and 9 males (range 16-59 years, mean 27.8) who responded to a questionnaire were reviewed. According to the responses, they all had been leading normal lives, despite various degrees of impairment. PMID- 1783313 TI - [Chylous ascites imitating acute appendicitis]. AB - Acute accumulation of chyle in the peritoneal cavity is rare. It is usually idiopathic and the diagnosis is made at laparotomy, when indicated because of signs of acute peritonitis. Drainage is the only treatment required and the prognosis is excellent. A 33 year-old man who was operated on for signs of acute peritonitis is described. There was more than a liter of chyle, but no underlying pathological condition was found. 3 months after discharge, physical and laboratory examinations were normal, with no evidence of chylomicron retention disease. PMID- 1783314 TI - [Gonadotropin-releasing hormone: sexual behavior and psychosexual disorders]. PMID- 1783315 TI - [Minimal dementia and testamentary competence]. PMID- 1783316 TI - [Cardiac sarcoidosis]. PMID- 1783317 TI - [Children of incest]. PMID- 1783318 TI - [Epidural injection during treatment with aspirin and other non-steroidal anti inflammatory drugs--a protocol]. PMID- 1783319 TI - [Is taurine essential in infant nutrition]. PMID- 1783320 TI - [Conflict of interest]. PMID- 1783321 TI - [Technology-dependent children]. PMID- 1783322 TI - [Intravascular coagulation and hepatic disease]. PMID- 1783323 TI - [Integrative assessment of the developmental pharmacology and developmental toxicology, with special reference to the brain]. AB - Increasing numbers of neurotoxins or therapeutic agents that have specific target cells or receptors can be used to assess the developmental correlation between the structure and function of various organs including the brain. Patients with chronic diseases are now able to maintain their social activities but still must be medicated for a long period of their life. This might increase the potential hazard of prenatal drug exposure in the progeny. Functional teratology is quite a new concept in neuroscience. Recent observations of our laboratory and those of others suggest that the sensitive period for functional teratology might encompass the whole stage of fetal life in animals and humans. The shortage of precise information on the developmental integration of the structure and function of the neurons with different properties is a problem to be solved for the further progress of developmental pharmacology and toxicology. Single exposures to drugs at a different stage during the gestational period of rats or mice might provide more useful information on the relationship between the lesioned area and related functional disorders manifested postnatally. This paper reviews recent advances in developmental neuropharmacology and functional neuroteratology including beneficial points of the short-term exposures to drugs. PMID- 1783324 TI - [Pharmacological studies of reiousan which contains bezoar and ginseng: III. Effects on experimental cerebral ischemia]. AB - Pharmacological effects of Reiousan, a crude drug preparation consisting of bezoar and ginseng, on experimental cerebral ischemia and anoxia were studied. After administration of Reiousan, the survival time of mice subjected to hypobaric hypoxia and the gasping duration of isolated rat head tended to increase. Reiousan inhibited all the following: lipid peroxides production in rat brain homogenate, tissue swelling induced by the xanthine-xanthine oxidase system in rat brain cortical slices, rat brain swelling induced by freezing, lipid peroxides production in the rat brain after ligation of bilateral common carotid arteries, and lipid peroxides production in Mongolian gerbil brain after reperfusion following ligation of bilateral common carotid arteries. These effects may result from antioxidant activity of bilirubin, a constituent of bezoar. PMID- 1783325 TI - [Growth-promoting action of L-cysteine and its related compounds on Ehrlich ascites tumor cells in vitro]. AB - Ehrlich ascites tumor cells (EAT) could not proliferate in a basal medium (BM). L Cysteine (L-CYS) added to BM in a concentration of 0.5 to 2 mM could promote the growth of EAT. At an unusual concentration of L-CYS (1 mM), the growth-rate was 233% (n = 50) at 72 hr after EAT transplantation. A similar growth-rate was obtained when EAT was transplanted 24 hr after addition of L-CYS to BM, although the free SH content in L-CYS-added BM at this time decreased to the level of that in BM. S-Methyl- and S-benzyl-L-cysteine showed no growth-promoting effect. The metabolic products of L-CYS (L-cysteine sulfinic acid, hypotaurine and taurine) showed a lower effect or none, but L-cystine showed the same activity as L-CYS. The EAT cultured in L-CYS-added BM was found to have an increased intracellular free SH and unchanged protein SH. These findings suggest that L-CYS added to BM is changed in a non-SH compound (possibly L-cystine) that is taken up into the cells and increases the intracellular free SH, resulting in the cell growth promotion. PMID- 1783326 TI - [Effect of lisuride on experimental cerebral infarction in rats]. AB - Lisuride is an ergot derivative with central dopaminergic (D2 agonistic) and serotonergic (5-HT1A agonistic) activity. The effect of lisuride on experimental cerebral infarction in rats was investigated. Cerebral infarction was induced by intracarotid infusion of a 50-microliters mixture in which deformed and rigid red blood cells treated with hypertonic solution were contained. Lisuride or 0.9% NaCl was administered subcutaneously 30 min before induction of cerebral infarction. Lisuride (0.01 mg/kg) not only prolonged the survival time of the animals but also suppressed cerebral edema, increase in the electrolytes content and histological damage in the brain. These results suggest that lisuride has a protective effect against cerebral infarction. PMID- 1783327 TI - [The anti-pyretic mechanism of alminoprofen]. AB - The anti-pyretic activity of alminoprofen (AP), a non-steroidal anti-inflammatory agent, and its mode of action were investigated in conscious febrile rabbits. A fever was evoked by i.v. injection of lipopolysaccharide (LPS), intracisternal (i.c.) injection of leukocytic pyrogen (LP) or i.c. injection of arachidonic acid (AA). The amount of PGE2 or AP in the cerebrospinal fluid (CSF) after i.v. LPS was estimated using an RIA or HPLC method. AP (3-30 mg/kg, p.o.) dose-dependently inhibited the LPS (0.5 micrograms/kg, i.v.)-induced fever; AP, ibuprofen, indomethacin and pranoprofen had ED50 values of 9.64, 26.45, 4.41 and 11.91 mg/kg, p.o., respectively. PGE2 in the CSF was markedly increased during the elevation of body temperature after i.v. LPS (0.5 microgram/kg). AP (30 mg/kg, p.o.) markedly inhibited the increase in PGE2 that was observed in the CSF during fever developed in response to i.v. LPS (0.5 micrograms/kg). The AP concentration in the CSF 2 hr after AP (30 mg/kg, p.o.) was 2.86 x 10(-6) (1.15-4.57 x 10(-6) M, a concentration too low to inhibit PG synthesis. A dose-dependent fever was observed after i.c. LP (1-8 unit) or AA (10-100 micrograms). AP (30 mg/kg, p.o.) shifted the dose-response curves for the i.c. LP-induced fever to the right, but did not have any effect on the i.c. AA-induced fever. These results suggest that AP has a relatively potent anti-pyretic activity, and its mechanism of action involves competition with LP at a site in the CNS, but does not involve an inhibition of cyclooxygenase at a central site, which has been considered as an anti-pyretic mechanism of nonsteroidal anti-inflammatory drugs. PMID- 1783328 TI - [Effects of alminoprofen on sodium urate crystal-induced inflammation]. AB - Effects of alminoprofen (AP), a non-steroidal anti-inflammatory agent, were investigated using several experimental gouty models. AP (3-30 mg/kg, p.o.) dose dependently inhibited urate crystal-induced rat paw edema. AP (3-30 mg/kg, p.o.) inhibited the accumulation of exudate and decreased the total counts of leukocytes and the amount of PGE2 in a dose-dependent manner in sodium urate crystal-induced pleuritic rats. AP (0.3-10 mg/kg, p.o.) showed a dose-related analgesic activity on the pain response in sodium urate crystal-induced arthritic rats. AP (10(-5)-10(-3)M) inhibited the sodium urate crystal-induced beta glucuronidase release from guinea pig neutrophils at more than 10(-4) M. AP (10( 5)-10(-3)M) did not inhibit the sodium urate crystal-induced production of O2- from guinea-pig neutrophils. AP (10(-6)-10(-4) M) inhibited dose-dependently the chemotaxis of leukocytes induced by chemotactic factors from guinea pig neutrophils stimulated with sodium urate crystals. AP (10(-6)-10(-4) M) inhibited the sodium urate crystal-induced production of PGE2 from rat peritoneal leukocytes in a dose-related manner. These results suggest that AP has a potent anti-inflammatory and analgesic activity in sodium urate crystal-induced inflammations, and these effects are exerted through its combined inhibitions of PGE2 synthesis, leukocyte chemotaxis and lysosomal enzyme release. PMID- 1783329 TI - [Effects of intrauterine contraceptive devices (IUD) on rat ovarian steroidogenesis and conception control]. AB - To elucidate the action mechanisms of the IUD, I examined the relationships between ovarian steroid levels and contraceptive mechanisms in IUD-inserted rats. Female Wistar rats, 59-61 days old, were used and a polyethylene tube was into the bilateral uterine horns. Half of animals were injected with 1 mg indomethacin at the 30th and 31st days after the operation. All animals were decapitated at 1 hr after the 2nd injection. The presence of the IUD significantly increased the uterine weights due to the hypertrophy of the uterine wall, and it significantly increased ovarian testosterone and tended to increase ovarian estradiol and the estradiol/progesterone ratio. However, administration of indomethacin did not reduce these increased levels back to the levels of sham-operated rats. These results indicate that the presence of the IUD increased ovarian testosterone and estradiol, disturbing the balance between estrogen and progestin, with estrogen becoming dominant. It seems that these changes bring about the delay of fertilized egg development and disrupts the development of proper conditions for implantation, so that implantation of the fertilized egg on the endometrium is inhibited. Furthermore, this study suggests that the changes of the ovarian steroid levels in IUD-inserted rats may involve the participation of unknown uterine factors but not prostaglandins. PMID- 1783330 TI - [Effects of mecobalamin on testicular dysfunction induced by X-ray irradiation in mice]. AB - Experimental testicular dysfunction were produced by X-ray irradiation to the testes in mice. Mecobalamin (CH3-B12) was orally administered at a daily dose of 0.01, 0.1 or 1 mg/kg six times a week for 8 weeks from the next day after the irradiation. The control mice received physiological saline in the same manner. On 4th- and 6th-week after the irradiation, the weights of testes and epididymides were decreased, although those of the body and accessory sex glands (seminal vesicle, coagulating gland and prostate) were nearly equal to those of non-irradiated mice. At the same time, the diameter of seminiferous tubules decreased and sperm parameters (sperm count, sperm motility and sperm abnormality) deteriorated. When CH3-B12 (1 mg/kg) was administered, the diameter of seminiferous tubules increased and sperm parameters improved as compared to those of the control. The results indicate that CH3-B12 improved the experimental testicular dysfunction in mice induced by the irradiation. These results suggest that CH3-B12 might accelerate testicular function. PMID- 1783331 TI - [Effects of cooling on cholinergically-mediated contractions of tracheal muscle taken from immature and mature guinea pigs]. AB - The tracheal strip-chain preparations taken from immature (less than 2 weeks old) and mature (greater than 16 weeks old) guinea pigs were used to study the cooling effects of bathing temperature on cholinergically-mediated contractions. In the tracheal muscles from immature animals, cooling of the bathing temperature from 37 degrees C to 20 degrees C augmented both the contractions induced by electrical stimulation (0.05-2 Hz, 0.6 msec, 150 mA) of intramural cholinergic nerves and contractions in response to acetylcholine (0.01-3 microM), while the cooling inhibited the carbachol (0.01-3 microM)-induced contractions. The pretreatment of the tissue with physostigmine (0.05 microM) also augmented both contractions induced by cholinergic nerve stimulation and those in response to acetylcholine (0.01-3 microM), but the cooling did not produce further augmentation of the responses. On the other hand, the tracheal muscles from mature animals showed a reduced contraction in response to cholinergic nerve stimulation by cooling, although the response was potentiated by the physostigmine pretreatment. Histochemical distributions of acetylcholinesterase activities were more marked in the tracheal muscles of immature guinea pigs than in mature ones. From these results, we conclude that increased responsiveness by cooling of the isolated immature guinea pig tracheal muscle to cholinergic nerve stimulation or exogenous acetylcholine may involve the decrease of intramural acetylcholinesterase activities which might be decreased age-dependently. PMID- 1783332 TI - Assessing hypostasis by colorimetry. PMID- 1783333 TI - Murder by stabbing. AB - A series of 100 deaths from homicidal stabbing has been analysed for the causation of the violence, the age and sex of both the victim and the assailant, the multiplicity of wounds, the site of single wounds, the incidence of defence wounds, association with other injuries and the weapons used. PMID- 1783334 TI - Postmortem interval estimation by creatinine levels in human psoas muscle. AB - A new method was tested for estimating time after death in the middle range of postmortem interval (weeks). Creatinine muscular concentration in human cadaver is positively correlated to postmortem estimation. Temperature should be mainly related to the creatinine transformation rate. A stronger correlation was found at 11 degrees C up to 30 days and at 20 degrees Celsius up to 15 days. PMID- 1783335 TI - Injuries by chicken bills: characteristic wound morphology. AB - A 90-year-old woman, hampered in walking, was found dangerously wounded in a farm next to a chicken yard. On the occasion of forensic clinical investigation in hospital we found hematomas and many peculiar injuries of the epidermis and some defects even reaching the extremities of the subcutis and fascia. After experimental investigations we could show that these injuries were caused by the bills of chickens. PMID- 1783336 TI - Non-fatal injuries due to interpersonal violence in Johannesburg-Soweto: incidence, determinants and consequences. AB - A prospective, hospital based sampling procedure conducted between June 8th, 1989 and August 24th, 1990 identified 1592 victims of interpersonal violence in six state and five private hospitals serving the Johannesburg magisterial district (which includes Soweto). For the 1282 victims resident in the area, this corresponded to crude annualised incidence rates per 100,000 population of 3821 for coloureds, 1527 for blacks, 467 for whites, 433 for asians and 1380 for all residents. Males, most of whom were aged 20-24 years, constituted 83.9% of all victims and were most often attacked on the streets. The majority of females were attacked at home by a spouse or lover, and most incidents occurred between dusk and midnight on weekends. Sharp violence was the most frequent type, involving 52.2% of the male and 51.4% of the female victims. Analysis by racial classification of the overall findings for mechanism of injury and relationship to aggressor showed dramatic differences. Limitations of the findings are discussed. After comparison with similar data for two United States cities and Copenhagen, Denmark, it is hypothesised that the racial differences in the present findings reflect the interplay of universal structural determinants and a specific colonial factor rooted in the sociology and psychology of oppression. Some implications of these findings and hypothesised determinants for violence prevention initiatives are mentioned. PMID- 1783337 TI - Identification of human hair stained with oxidation hair dyes by gas chromatographic-mass spectrometric analysis. AB - This paper describes the gas chromatographic-mass spectrometric (GCMS) analysis of oxidation hair dyes from human hair. Diamines from the dyes were directly extracted from the hair in basic solution and aminophenols were extracted after neutralization. Both extracts were derivatised with trifluoroacetic anhydride and analysed by GCMS. Five components of oxidation hair dyes namely, p phenylenediamine, toluene-2,5-diamine, o-aminophenol, m-aminophenol and p aminophenol were clearly identified, whilst no other compounds originating from the hair dyes were detected. The presence and relative amounts of these dye components from hair extracts may assist in the discrimination of human hair especially in cases involving forensic science. PMID- 1783338 TI - Allele frequency distributions of four variable number tandem repeat (VNTR) loci in the London area. AB - Allele frequency distributions of four hypervariable minisatellite loci were obtained from a large sample of individuals in the London area. The sample is subdivided into three major ethnic groups; Caucasian, Afro-Caribbean and Asian, and histograms for these groups are displayed for comparison. The distributions are discussed in relation to mutation rates, heterozygosity and the computer analysis and processing of results. PMID- 1783339 TI - Evaluation of an enzyme linked immunosorbent assay (ELISA) method for ABO and Lewis typing of body fluids in forensic samples. AB - An ELISA for the detection of the ABO group and secretor status of body fluids and stains other than blood is described, together with the validation procedures employed before its introduction into forensic casework. Criteria for the interpretation of results have been formulated for the method in use in this laboratory. The method was found to be reliable and to have a higher success rate than the haemagglutination techniques previously employed. PMID- 1783340 TI - Blood alcohol concentrations of sudden unexpected deaths and non natural deaths. AB - This study reports on the relationships between the blood alcohol concentration (BAC) and the cause of death - which is of course common knowledge for forensic scientists! Our special aim was to gain unselected data for generalizing conclusions. The blood of 2465 consecutive cases (86% of all 2852 sudden unexpected and unnatural fatalities investigated at the Institute for Legal Medicine in Hamburg during the year 1989) was analysed. The BAC was evaluated according to sex, age, cause of death and place of death. In natural causes of death there were 80% cases under 0.05% BAC. Endocrine and digestive system diseases in particular were associated with positive BAC values. In unnatural death cases the BAC under 0.05% was found in 64% of the suicides, 62% of the accidents, 54% of the homicides and 51% of the drug intoxications. The drowning cases showed higher BAC's than traffic accidents. In suicides middle aged males had high BAC's. PMID- 1783342 TI - [Prostate carcinoma--a tumor with many open questions]. PMID- 1783341 TI - Autopsied cases of drowning in Denmark 1987-1989. AB - In the 3-year period 1987-1989, 219 drowning cases were submitted to medico-legal autopsy in Denmark. The demographic data including the manner of death and the external findings are reported. In 74 accident cases analysis for blood-alcohol concentration was performed. In 53% a concentration of more than 0.1% was found. In 91 drowning cases (age more than 18 years and where the time interval in the water was less than 24 h) the average weight of both lungs was 1.411 g, compared to 994 g in 20 control cases. In 7% of the drowning cases the weight was less than 1.000 g, so called dry lungs. Finally the weight of the lungs and the amount of pleural transsudate in relation to the time interval in the water were registered in 198 cases. For a longer time interval in the water the weight of the lungs decreased, while the amount of pleural transsudate increased. By adding these two parameters, the combined weight was between 1.000 and 2.200 g in more than 75% of the cases as long as the interval in the water was less than 30 days. PMID- 1783343 TI - [Current value of transrectal fine needle biopsy. High predictive value in the diagnosis of prostate carcinoma, minimal discomfort to the patient]. AB - Seventy-eight patients with palpatory or transrectal US prostatic findings or elevated prostate-specific antigen, were submitted simultaneously to transrectal fine needle aspiration biopsy and a US-guided perineal core-needle biopsy of the prostate. A carcinoma of the prostate was detected in 42 cases, with cytology being positive in 36 and core-needle biopsy in 32 cases. Despite the use of transrectal ultrasound, which permits guided biopsy of the prostate, fine needle aspiration is clearly superior to ultrasound-guided core-needle biopsy, with a sensitivity of 83.7% vs. 74.4%. Presumably for method-related reasons, the material obtained with fine needle aspiration biopsy is certainly more representative of the entire gland as compared with core-needle biopsy. Furthermore, transrectal ultrasonic findings are too unspecific to permit US guided core-needle biopsy to provide better results than obtainable with the conventional finger-guided core-needle biopsy. PMID- 1783344 TI - [Epidemiology of prostatic carcinoma. From the Work Group Urology in the Munich Tumor Register]. AB - At approximately 11%, carcinoma of the prostate is the third leading cause of tumor-related death. The etiology of the disease remains unknown. In 1989, 9,074 deaths from this disease were recorded in the Federal Republic of Germany. With a five-year survival rate of 75%, carcinoma of the prostate is one of the cancers with a favorable prognosis. The number of new cases occurring annually in the Federal Republic of Germany (formerly West Germany) is probably between 17,000 and 19,000, or roughly 60 per 100,000 men. The (true) number of prostatic cancer patients is about fivefold, approximately 90,000. The first population-related figures for such clinical parameters as initial symptomatology, distribution of stage and the pattern of progression are now available from the Munich Tumor Registry. Another such parameter is the figure of 15% describing patients in whom bone metastases presented at the time of the diagnosis. PMID- 1783345 TI - [Cytostatic agents. 1: Cytostatically active antibiotics]. PMID- 1783346 TI - [Antacid therapy of upper abdominal symptoms. Double-blind study on the effect and tolerance of 2 antacids in gastritis , esophagitis and functional upper abdominal symptoms]. AB - In a randomized, multicenter, double-blind study involving a total of 97 patients, the effectiveness and tolerance of Gelofalk, a new type of antacid combination comprising smectite--a natural alum earth, the specific molecular structure of which permits it to bind aggressive substances particularly well- aluminium hydroxide and magnesium hydroxide were investigated in comparison with a commercially available aluminium hydroxide antacid used by patients with gastritis, esophagitis and functional upper abdominal complaints over a treatment period of 4 weeks. The buffering capacity of a daily dose of Gelofalk was 135 mval, in the case of the reference antacid 210 mval. In terms of pain relief, reduction of accompanying symptoms, and endoscopic healing properties, Gelofalk proved very effective. Because of its particular properties, the preparation proved significantly superior to an aluminium hydroxide suspension in the case of most test parameters, in particular pain relief, onset of effect and heartburn. Gelofalk was very well tolerated; constipation or diarrhea occurred in only 2 cases each. PMID- 1783347 TI - [AIDS dementia caused by deficient myelin synthesis]. PMID- 1783348 TI - [Early stage of liver carcinogenesis. Enzyme histochemical, immunohistochemical and microbiochemical analysis]. PMID- 1783349 TI - [Refractive surgery of the cornea. Corneal surgery--an alternative to optical aids?]. AB - Errors of refraction of the eye can be corrected not only by means of spectacles, contact lenses or intra-ocular lenses, but also by operative procedures on the cornea. At present, correction of myopia is accomplished with radial keratotomy (RK), a procedure that achieves the best results in the range up to - 6.0 diopters. However, on account of its side effects, in particular poor predictability, the method is no true alternative to the use of optical aids. Epikeratoplasty done to correct hyperopia and aphakia, is even more imprecise, and should only be employed in exceptional cases. Laser surgery of the cornea is still undergoing clinical testing, but has already produced promising results. PMID- 1783350 TI - [Cytostatic agents. 4: Cytostatically active vinca alkaloids]. PMID- 1783351 TI - [Role of bile acids in the development of peptic lesions. Studies on the bile acid-binding capacity of a new kind of antacid]. AB - Bile acids are a factor in the pathogenesis of peptic lesions of the mucosa. The introduction in the literature of the term type C gastritis reflects the recognition of this fact. It is possible that antacids develop their effect not merely via the neutralization of hydrochloric acid, but, to an appreciable extent, through the adsorption of toxic substances. Since antacids often elevate the gastric pH only slightly, we investigated bile acid binding not only as a function of dose, but also at low pH values. The aim of the study was, in a follow-on to previous studies of a layer-lattice antacid to describe the characteristics of an antacid of the mixed type (aluminium-magnesium hydroxide + smectite). Already at neutral pH, Gelofalk manifests a high level of bile acid absorption, which increases further at low pH values. The high bile acid absorption capacity of Gelofalk shows no correlation with decreasing bile acid polarity; the dose-dependency is lower at high than at low pH levels. This indicates that bile acid absorption by Gelofalk must, at least in part, involve other mechanisms than those operative in the case of pure layer-lattice antacids. PMID- 1783352 TI - [An examination of the speaking function]. PMID- 1783353 TI - Long-term follow-up investigation of the effects of the biopsychosocial approach (BPSA) to bronchial asthma. AB - The recent rapid increase in the number of allergic patients is becoming a social problem. Studies of the causes of this phenomenon involve various fields, with much attention focused on finding new antigens in food, air, articles encountered in daily living, etc. Recent studies of psychoneuroimmunology (PNI) also suggest a strong influence of emotions on allergic reactions. The number of allergic patients is increasing in all civilized countries without exception, and the stress prevalent in modern civilized society is related to this increase. Modern allergology does not yet have sufficient countermeasures for such stress states. We applied a biopsychosocial approach (BPSA) to treatment programs for allergic disease, incorporating treatment of physical and psychosocial problems en bloc. We studied the long-term effects of BPSA therapy on 82 patients who were treated for more than 3 months in the hospital and were examined 2 to 3 years after discharge. Results showed that more than 80% of patients maintained improvement and 45% of those with intractable asthma were able to withdraw from steroid hormones. BPSA achieved better results than those with standard medication administered only to the body. Improvements after treatment included physical changes, normalization of MV (microvibration) type, decreased levels of plasma histamine, and normal circadian rhythms of lymphocyte subsets. These changes reflect part of the physical mechanisms by which BPSA improves asthma symptoms. From a psychological view point, the patients' feelings, personal relations, behavior, etc. were changed after BPSA, allowing a new life style and improved QOL. It is important for asthma patients to maintain good overall condition over long periods. After BPSA, 80% of our patients were able to do so. It is difficult for the therapist to approach asthma from different aspects at once, including biological, psychological, and social, so we developed a five-stage program of BPSA therapy and found that this obtained favorable results. PMID- 1783354 TI - Effects of combination therapy with pirenzepine and famotidine on tetragastrin stimulated gastric secretion in humans. AB - To determine the combined effects of the H2-receptor antagonist famotidine (FAM) and M1-receptor antagonist pirenzepine (PZ) on tetragastrin-stimulated acid production, 10 mg of FAM was intravenously injected into 6 healthy volunteers, alone and in combination with 20 mg of PZ. Physiologic saline was administered separately for control purposes. Compared with physiologic saline, both FAM and the FAM + PZ combination significantly reduced gastric secretion, acidity, acid output, and pepsin secretion. Concomitant use of PZ significantly enhanced FAM induced reduction of overall gastric secretion, but did not enhance decreases in acid output, acidity, or pepsin secretion. These results indicate that combination therapy with intravenous FAM and PZ may be more useful than monotherapy with FAM in the treatment of gastroduodenal bleeding. PMID- 1783355 TI - [Diagnosis of gastrointestinal amyloidosis with special reference to the relationship with amyloid fibril protein]. AB - Forty-five patients with proved gastrointestinal amyloidosis were examined to study the clinical and pathological features and to determine the correlation with amyloid fibril proteins. The examinations included physical examination, laboratory study, plain X-ray film of the abdomen, gastrointestinal radiography, gastrointestinal endoscopy, endoscopic biopsy, surgery, and autopsy. The results were as follows: 1) Amyloid fibril proteins consisted of amyloid light chain protein (AL) in 7 patients, amyloid A protein (AA) in 36, beta 2-microglobulin (AH) in one, and prealbumin (AF) in one. 2) At the time of examination, gastrointestinal symptoms were present in 43 (96%) of the 45 patients. The incidence of diarrhea and gastrointestinal bleeding was higher in patients with the AA type than in those with other types, whereas abdominal distension, nausea, and vomiting were more frequently evident in patients with the AL type. 3) The incidence of hypoalbuminemia, hypokalemia, and positive occult blood was higher in patients with the AA type, whereas abnormal electrocardiogram and cardiac failure were more frequently observed in patients with the AL type. The thyroid gland was enlarged in 7 patients with the AA type, and the macroglossia was evident in only 2 patients with the AL type. 4) The frequency of radiographic abnormalities in the gastrointestinal tract was as follows: 79% of the patients in the jejunum and ileum, 61% in the duodenum, 53% in the stomach, 32% in the colorectum, and 14% in the esophagus. Fine granular shadows were most frequently seen in patients with the AA type, whereas multiple polypoid protrusions and thickening of the folds were characteristic in patients with the AL type. 5) Endoscopic abnormalities were found as follows: 82% in the duodenum, 81% in the jejunum, 73% in the stomach, 42% in the colorectum, and 20% in the esophagus. Endoscopy revealed fine granular appearance in 31 (86%) of the 36 patients with the AA type, whereas multiple polypoid protrusions and thickening of the folds were evident in 5 (71%) of the 7 patients with the AL type. 6) On the histological examination of the biopsy specimens, amyloid deposition was found in the duodenum in 98% of the 45 patients studied, in the jejunum in 96% of the 26 patients, in the antrum in 93% of the 41 patients, and in the rectum in 86% of the 43 patients. 7) Histological findings of the biopsy and autopsy specimens revealed that the the degree of amyloid deposition was the highest in the duodenum and jejunum of the gastrointestinal tract.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1783356 TI - Hepatitis C virus is a more likely cause of chronic liver disease in the Japanese population than hepatitis B virus. AB - 508 Japanese patients with chronic liver disease, including chronic hepatitis, cirrhosis and hepatocellular carcinoma, and 500 controls matched for sex and age were studied. Antibody to hepatitis C virus (anti-HCV) alone was found in 233 (45.9%) patients and hepatitis B surface antigen (HBsAg) alone was present in 128 (25.2%) patients. Both anti-HCV and HBsAg were present in 18 (3.5%) patients. Anti-HCV was found in 8 (1.6%) controls and HBsAg was present in 4 (0.8%) controls. The prevalence of anti-HCV alone was 36.9% in chronic hepatitis, 49.0% in cirrhosis and 67.0% in hepatocellular carcinoma, respectively. The prevalence of anti-HCV increased with the progress of severity of liver disease. Anti-HCV was more prevalent than HBsAg both in cirrhosis and hepatocellular carcinoma (p less than 0.001). The prevalence of anti-HCV increased with age. Among patients under age 39 years, HBsAg was detected more often than anti-HCV, however, in those over age 50 years, anti-HCV was detected more often than HBsAg (p less than 0.001). It would appear that hepatitis C virus more than hepatitis B virus is a prominent cause of chronic liver disease among Japanese patients. PMID- 1783357 TI - [Effects of EGF and retinoic acid on differentiation of squamous cell carcinoma cells]. AB - Using monoclonal antibody, G6K12, a novel differentiation marker of keratinocyte, we examined the effect of EGF and retinoic acid on the differentiation of SCC-25, a cell line established from human squamous cell carcinoma. EGF inhibited the expression of cell-surface differentiation marker in low cell-density, but not in high cell-density. Retinoic acid (more than 10(-8) M) inhibited the expression of the antigens. The terminal differentiation of SCC-25 cells occurred at the condition of high cell density. These results obtained demonstrate that EGF and retinoic acid inhibit the terminal differentiation of SCC-25 cells, and that the cell density is the important factor for the commitment of the terminal differentiation. PMID- 1783358 TI - [Plasma renin activity and plasma aldosterone concentration: influence of crying]. AB - The levels of plasma renin activity (PRA) and plasma aldosterone concentration (PAC) have been known to increase by the influence of crying in infants and toddlers, but no precise informations are available. We evaluated the changes of PRA and PAC after crying by comparing values obtained from 30 infants and toddlers within one minute after the onset of crying, as induced by venopuncture, and three and five minutes after continuation of crying (PRA1, PRA3, PRA5, and PAC1, PAC3, PAC5). The age of these subjects ranged from one to thirty months (median sixteen months). PRA1, PRA3 and PRA5 were 4.0 +/- 1.8 ng/ml per hour, 5.5 +/- 2.7 ng/ml per hour, 7.8 +/- 4.2 ng/ml per hour, respectively. PAC1, PAC3 and PAC5 were 210 +/- 110 pg/ml, 231 +/- 118 pg/ml, 269 +/- 145 pg/ml, respectively. Both PRA and PAC increased with elapsing time. The increase in PRA was marked after a short episode of crying, but that in PAC was of a mild degree. When to evaluate the levels of PRA and PAC in infants and children, especially that of PRA, one should take into consideration of the conditions of the subject such as the duration of crying at blood sampling. PMID- 1783359 TI - Regional hemodynamic effects of rilmenidine and clonidine in the conscious spontaneously hypertensive rat. AB - Rilmenidine is an oxazoline analogue that has antihypertensive properties that resemble those of clonidine. Since rilmenidine has recently been described to have a relatively greater affinity for imidazoline receptors than clonidine, it was of interest to study whether this has functional consequences with regard to the regional hemodynamic responses. We investigated regional hemodynamics in conscious spontaneously hypertensive rats, equipped with miniature Doppler flow probes on the renal and mesenteric arteries and on the abdominal aorta. Clonidine (3-30 micrograms/kg) and rilmenidine (0.2-3 mg/kg) induced similar, dose dependent reductions in heart rate. Both also induced an early hypertensive response, which was greater with rilmenidine, and similar later blood pressure reductions, which were maintained over 3 h. The early hypertensive response was associated with generalized vasoconstriction. Rilmenidine caused slightly greater mesenteric and hindquarter constriction than clonidine, whereas renal effects did not differ significantly. During the hypotensive phase, rilmenidine was a less potent mesenteric and hindquarter vasodilator than clonidine. During this phase, renal blood flow was at control levels, probably indicating autoregulation of renal flow. The minor differences in regional hemodynamic effects suggest that clonidine and rilmenidine can both be used as potent antihypertensives. The fact that rilmenidine has been suggested to possess less sedative side-effects suggests that, on this basis, it may be superior for antihypertensive drug therapy. PMID- 1783360 TI - Compared peripheral vascular responses to intravenous and intra-arterial administrations of positive inotropic agents in conscious dogs. AB - In addition to their direct effects on cardiac contractility, a number of positive inotropic agents also induce, through direct peripheral vasodilation, a reduction in afterload which is of major importance in their beneficial effects in the treatment of congestive heart failure. However, the induced increase in cardiac output can indirectly improve perfusion of peripheral vessels through a flow-mediated mechanism. Thus, the goal of the present study was to compare the direct peripheral vasomotor effects assessed in the iliac vascular bed of four positive inotropic agents: DPI 201-106, ouabain, milrinone and dobutamine, in the presence and absence of simultaneous changes in cardiac function. These drugs were administered either through intravenous or intra-arterial (aorto-iliac catheter) routes in 6 conscious dogs, chronically instrumented for the measurement of heart rate, arterial pressure, left ventricular dP/dt, iliac artery blood flow and iliac artery diameter (sonomicrometry). Intravenous doses were selected as those inducing equipotent positive inotropic responses whereas intra-arterial doses were below those required to induce any significant change in systemic hemodynamics. Ouabain decreased and milrinone increased both iliac blood flow and diameter after either intravenous or intra-arterial administrations. In contrast, iliac blood flow did not change after intra arterial administration of DPI 201-106 and dobutamine whereas iliac diameter was not modified by DPI 201-106 and even decreased with dobutamine. After intravenous administration, DPI 201-106 but not dobutamine, increased both iliac blood flow and diameter. Thus, this experimental preparation can differentiate inotropic agents with direct vasodilating (milrinone) or constricting (ouabain) properties and those (DPI 201-106 and dobutamine) with indirect vasodilating effects most likely mediated by the improvement in cardiac function. PMID- 1783361 TI - Effects of cicletanine on vasoactive systems in conscious sinoaortic-denervated dogs. AB - The present study investigates the antihypertensive action of cicletanine, a new antihypertensive compound with diuretic properties (or placebo), on vasopressor (catecholamines, renin-aldosterone) as well as vasodepressor (prostaglandins, kallikrein-kinin) systems in conscious chronic sinoaortic denervated (SAD) dogs. Cicletanine (10 mg/kg twice a day, per os, for one month) lowered blood pressure and heart rate. The antihypertensive action does not involve an effect on sympathetic tone (since plasma catecholamine levels were unmodified) or on plasma aldosterone levels. By contrast, urinary 6 keto PGF1 or PGE2 levels and kallikrein activity were enhanced. This result indicates that the antihypertensive effect of cicletanine is associated with a stimulation of potential vasodepressor systems (such as prostaglandins or kinins). PMID- 1783362 TI - Influence of sex and oestrogen replacement on the disposition of dexamethasone in rats. AB - The disposition of dexamethasone (DXM, 2 mg/kg, iv) was studied in ovariectomized female rats treated with oestrogen (0.1 mg and 1 mg of oestradiol benzoate) and in male rats. Oestradiol replacement had no effect on body or liver weights or on the DXM pharmacokinetic parameters (CL, Vdss, AUC, MRT and t1/2) of the female groups. If the Vdss seemed slightly greater in male than in female rats, this difference disappeared after normalization based on body weight. In contrast, CL was greater in the male rats even after normalization. For all the animals, significant correlations were observed between body weight and Vdss (r = 0.731, P less than 0.001) or CL (r = 0.639, P less than 0.001). Terminal half life and MRT were negatively correlated with CL (r = -0.481, P less than 0.01 and r = -0.575, P less than 0.01, respectively) but not with Vdss. Although oestrogen replacement did not seem to affect the pharmacokinetics of DXM, the increase in the CL in male rats should be the main determinant observed between the sexes. These results are consistent with a slower metabolism found for various drugs metabolized by the cytochrome P-450 in female rats. PMID- 1783363 TI - Combination of long-acting furosemide and instant-acting amiloride: pharmacokinetics and pharmacodynamics in human subjects. AB - The pharmacokinetics and pharmacodynamics of the combination of amiloride (2 x 2.5 mg) and long-acting furosemide (2 x 10 mg) were compared with amiloride (5 mg) and furosemide (20 mg) in 12 healthy male volunteers aged 26.2 +/- 1.6 years and weighing 68.8 +/- 6.2 kg, after random order administration. Furosemide and amiloride plasma or urine concentrations were determined by HPLC with fluorimetric detection. The rate of absorption (tmax = 3 h) and the bioavailability of the two diuretics were not significantly modified by their combination. Furosemide plasma half-life was 2.77 +/- 1.04 h after the combination treatment and 2.76 +/- 0.98 h alone, amiloride plasma half-life was respectively 15.7 +/- 4.6 h and 14.6 +/- 3.7 h. The urinary elimination of furosemide was significantly higher in the 2-4 h interval in the combination treatment, accompanying its delayed maximum effect of diuresis. A synergistic effect was observed after the combination administration of the two diuretics; between the 2nd and the 8th hour, the sodium elimination was significantly increased (P less than 0.01) and the potassium excretion was significantly decreased (P = 0.05). After a single dose, no modification of plasma or erythrocyte magnesium levels was observed. This study shows that the combination of the two drugs entails a synergy of their activities which does not involve pharmacokinetic changes. PMID- 1783364 TI - [Changes in the plasma membrane fluidity of granulosa cells during the process of luteinization]. AB - To elucidate the membrane fluidity of granulosa cells in luteinization process, porcine granulosa cells (GCs) were cultured in the serum free medium under the stimulation of human chorionic gonadotropin (hCG). Their cell membrane anisotropy, membrane lipid composition and progesterone synthesis were measured. The GCs plasma membrane anisotropy, which is reverse to fluidity, was measured with the steady-state spectrofluorometer using a hydrophobic fluorescent probe 1, 6-diphenyl-1, 3, 5-hexatriene (DPH). Since the membrane fluidity is generally affected by concentrations of cholesterol and phospholipids, phospholipid composition and the degree of unsaturation of acyl chain, concentrations of unesterified cholesterol and phospholipids, and phospholipid composition in the plasma membranes of GCs were determined. The results obtained were as follows. 1) The value of the anisotropy (membrane fluidity) of the GCs stimulated by hCG decreased (increased) significantly as compared to that without hCG addition. 2) The concentration of cholesterol in plasma membrane fraction decreased significantly by hCG stimulation. 3) In contrast, the concentration and composition of phospholipids showed no significant changes. 4) Progesterone concentration in culture medium was significantly increased by hCG stimulation at 30 mlU/ml and 300 mlU/ml throughout the time course of this study, compared with control. These results indicate the increase of membrane fluidity of the GCs luteinization induced by hCG is due to a decrease of cholesterol/phospholipids ratio. Because transfer of cholesterol into culture medium was not observed, it seems that the cholesterol of the GCs plasma membranes was utilized for progesterone synthesis at least in the serum free medium (GIT medium) during the process of luteinization. PMID- 1783365 TI - [Detection of gonadotropin releasing hormone (GnRH) messenger RNA in the ovary and cloning of LH, chorionic gonadotropin (CG) receptor]. AB - Detection of gonadotropin releasing hormone (GnRH) mRNA in rat ovary was carried out, and cloning of LH, chorionic gonadotropin (CG) receptor in human ovary was attempted by use of polymerase chain reaction (PCR). Firstly, in an attempt to detect the expression of GnRH or related gene in rat ovaries at the RNA level, GnRH message was amplified. Total RNA from rat ovaries was converted to cDNA using reverse transcriptase and amplified in PCR using a pair of specific primers complementary to the rat GnRH cDNA. The DNA products were subcloned into plasmid vectors and their sequence determined. 1. In the rat ovary, a prominent PCR product of 462 bp was identified as a fragment of prothymosin alpha cDNA previously found in the spleen. 2. In contrast, RT-PCR amplification of hypothalamus and granulosa cell messages indicated the presence of a 244 bp product with identical sequence to GnRH. To confirm the presence of GnRH message, a second set of GnRH primers was used. PCR amplification of cDNA from hypothalamus, granulosa cells and whole ovary yielded a product identical with the authentic GnRH cDNA sequence. These data demonstrated the presence of mRNA for GmRH and prothymosin alpha in the rat ovary. Secondly, a part of the human LH, CG receptor was obtained from human granulosa cells by selective amplification with PCR of DNA segments presenting possible sequence similarity with genes for the porcine or rat LH, CG receptor. Total RNA from human granulosa cells was converted to cDNA and amplified in PCR using degenerate oligonucleotide primers corresponding to possible conserved regions in extracellular segments of the porcine or rat LH, CG receptor.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783366 TI - [Study on patency of small caliber synthetic vascular prosthesis--with special reference to antithrombogenesity of fibrin layer]. AB - The influence of antithrombogenesity of stable and thin fibrin layer on patency of small diameter graft was studied. Newly developed segmented polyurethane grafts (SPG), 4 cm in length and 3 mm in internal diameter, were interposed between divided carotid arteries in 20 mongrel dogs. The change of antithrombogenesity was evaluated by 111In-oxine labeled platelet scintigraphy. Autologous radiolabeled platelets were injected immediately or 1 week after implantation. Grafts and native arteries were explanted 48 hours after injection, and submitted for gamma well counting. Platelet accumulation was quantitated by a Graft/Blood Ratio (GBR) that compared radio-activity in the graft or native artery (luminal surface area 1 cm2) to simultaneously collected blood (1 ml). In SPG, GBR was significantly declined during 1 week (2.65 +/- 0.65 in immediate group, 0.72 +/- 0.18 in early group, p less than 0.05). Also each GBR in immediate or early group was by far greater than GBR in native arteries. Histologically the luminal surface in patent grafts was thinly covered with the fibrin layer, which was anchored firmly to the porous structure. On the other hand thrombus was formed at the anastmotic site in obstructive grafts. In conclusion, the stale and thin fibrin layer formed on the luminal surface has a reduced thromboactivity and maintains early graft patency. However its antithrombogenesity is far beyond that of native arteries and limits patency. PMID- 1783367 TI - [A study on blood pressure variation--the clinical validation of continuous direct blood pressure recording in patients with pheochromocytoma]. AB - Continuous direct arterial blood pressure (intra-brachial) recording (CDPR) was performed in the ward in 7 patients with documented pheochromocytoma (PHEO). They consisted of 4 patients with adrenal medulla and 3 with ectopic PHEO in the urinary bladder. Recordings were also taken from 11 patients with mild and moderate essential hypertension (EHT). The arterial pressure variations throughout the day and night were detected for either 24 hours or 48 hours unrestrictive recording (CDPR) transmitted by telemetry (SANEI INST. 270), and analyzed by signal processor (SANEI 7T17). The measurement through CDPR was repeated in all the patients with PHEO on three occasions; (1) observation period (non-medication period), (2) medical treatment period with prazosin and, (3) post operative period. RESULTS: (1) In the non-medication period, all the patients with PHEO were characterized by a steep elevation of the arterial pressure and a variability of the high blood pressure events more remarkably than the patients with EHT. The changes in arterial pressure in the patients with PHEO were accompanied by headaches, feelings of fear, trembling, sweating and palpitation. (2) At the medication period, prazosin sufficiently suppressed the sudden elevation of blood pressure. However, the paroxysmal elevation of blood pressure after voiding was not prevented in 2 of 3 patients with ectopic PHEO in the urinary bladder. Urinary and plasma catecholamine (CA) were normal in 2 of our 3 cases. Voiding elevated plasma CA which provided better diagnostic determinant in patients with this bladder tumor as well as the CDPR. (3) The CDPR provided good operative removal results through the 24-hour monitoring, and the recovery was uneventful. CONCLUSION: Evaluation of blood pressure elevation is a clue to the diagnosis of hypertension. Monitoring of the arterial blood pressure variation through 24 hours by CDPR was helpful for detecting a precise arterial pressure fluctuation, since the duration of the elevation was short and was steeply changed especially in patients with PHEO. PMID- 1783368 TI - [Integration and expression of human endogenous retrovirus]. AB - Retrovirus has been known to be integrated into host DNA as provirus. In the course of evolution, some of them have been integrated into germ cell DNA and inherited from generation to generation as host genes. Most vertebrates have accumulated tens or hundreds of retroviral sequences. To know the aspect of their integration and expression in human, lambda 4-1 and ERV3 were investigated by using genomic DNA or placental RNA from Japanese origin. Southern-blotting analysis showed more than 30 copies of lambda 4-1 or its related sequences were integrated in human DNA, whereas only one copy of ERV3 was integrated. One of the fragments (2.0 kb, EcoRI) of lambda 4-1 was polymorphic and confirmed to be inherited in Mendelian fashion. The size of ERV3 observed in Japanese after digestion by Pvull was the same as that reported in caucasian suggesting ERV3 might be integrated before ethnic diversion. Transcription of these retroviral genes was investigated in placenta by northern-blotting analysis. 4 species of mRNA; 3.6 kb, 3.0 kb, 2.2 kb, 1.7 kb, were observed by full length of lambda 4-1, whereas 3 species; 9.0 kb, 7.3 kb, 3.0 kb by env of ERV3. The amount of mRNA transcribed in human placenta was well correlated in two endogenous retroviruses (r = 0.66). Furthermore, positive immunofluorescence-staining of placental section by using antibody against lambda 4-1 env protein suggested that env protein might be translated from lambda 4-1 provirus and expressed on human placenta. PMID- 1783369 TI - [Clinical evaluation of arterial tonometry for noninvasive, continuous blood pressure monitoring during anesthesia]. AB - A new continuous, non-invasive arterial blood pressure monitoring system based on arterial tonometry was currently developed. A sensor of this system consists of an array of 15 piezoresistive pressure transducers. An automatic sensor positioning system ensure that at least one of the 15 transducers is positioned on the center of the pneumatically flattened, but not occluded, portion of the artery. Accuracy, reliability and clinical acceptance of this system were evaluated by comparing tonometric blood pressure (TBP) measurements with intra arterial blood pressure (IBP) measurements in 70 normotensive anesthetized patients (normotensive group) and 21 hypotensive anesthetized patients (hypotensive group). IBP was measured in either the right or left radial artery by a Gould P23XL calibrated transducer while TBP was measured at the radial artery of the other side. The outputs of the two systems were recorded on a PCM tape recorder for later analysis. The TBP waveform was similar to the IBP waveform. A significantly high correlation existed between the two methods for systolic, mean and diastolic measurements. Magnitudes of bias (mean difference between the two methods) of the normotensive group were -0.4 +/- 5.9 (mean +/- SD) mmHg for systolic, -0.1 +/- 4.7 mmHg for mean and 0.0 +/- 5.4 mmHg for diastolic measurements and those of the hypotensive group were -0.7 +/- 6.6 mmHg for systolic, 0.7 +/- 5.0 mmHg for mean and 2.8 +/- 5.8 mmHg for diastolic measurements. The "limits of agreement" (mean difference +/- 2SD of bias) for both groups were within the range which would be acceptable for clinical setting. These results indicate that tonometry provides accurate, reliable and real-time blood pressure measurements together with continuous display of the pressure waveform for wide range of blood pressure. It was concluded that this system may replace the conventional invasive intra-arterial blood pressure monitoring system. This system is especially useful if it is combined with pulse oximetry and capnography. PMID- 1783370 TI - [Electron microscopic study of the glomerular basement membrane charge barrier and the charge of immune deposits in lupus nephritis]. AB - In order to evaluate the pathogenesis of proteinuria and the charge of immune deposits in lupus nephritis, anionic sites of periodate-lysin-paraformaldehyde (PLP) fixed renal tissue (5 patients with renal pelvic tumor as normal control and 17 patients with lupus nephritis), were stained with the critical electrolyte concentration method. Cuprolinic blue (CB) was used as a cationic probe. Ultra structural study and semi-quantitative analysis were done. In the normal glomerular basement membrane (GBM), the CB stainable anionic sites appeared as filamentous structure with several short lateral branches. On the basis of electron microscopic observation of isolated proteoglycan, it is suggested that the central filaments are the protein core and the branches are the glycosaminoglycans of proteoglycan molecules. These filamentous anionic sites were located mainly in the laminae larae and lie close to each other forming a mesh-like network pattern. The semi-quantitative analysis of the normal GBM revealed that the number of anionic sites in the lamina rara externa (LRE) was 22.9 +/- 1.9-23.7 +/- 1.4/1000 nm GBM and in the lamina rara interna (LRI) 14.0 +/- 1.6-15.1 +/- 1.5/1000 nm GBM. These findings suggest that the anionic sites composed of heparan sulphate proteoglycan occupy large area of the laminae larae and prevent permeation of anionic molecules. In non-proteinuric 5 patients with class II lupus nephritis, the number of anionic sites of the GBM (LRE; 21.3 +/- 2.0-22.3 +/- 1.8/1000 nm GBM, LRI; 13.5 +/- 2.0-14.2 +/- 2.0/1000 nm GBM) showed no significant difference from that of the normal GBM. In contrast, the GBM of proteinuric patients with class IV (6 patients, LRE; 14.8 +/- 2.7-19.3 +/- 1.8/aooo nm GBM, LRI; 5.8 +/- 1.9-11.3 +/- 2.4/1000 nm GBM) and (V) (6 patients, LRE; 13.0 +/- 2.4-17.9 +/- 2.8/1000 nm GBM, LRI; 12.0 +/- 1.9-13.0 +/- 2.5/1000 nm GBM) exhibited loss of the anionic sites in association with the localization of the immune deposits (ID). From these findings, it is concluded that in severe and active lupus nephritis the failure of charge barrier of the GBM is responsible for the proteinuria. The ID observed in the patients with lupus nephritis were not stained with CB. This finding suggests that net charge of the ID could be cationic and that cationic immune complex and/or antibody could involve in the pathogenesis of lupus nephritis. PMID- 1783371 TI - [Study of physical fitness in children, and its application to pediatric clinics and sports medicine]. AB - To estimate the physical fitness of children, the easy and useful method for the measurement of aerobic power was developed. The method was applied to an exercise test and a therapy for obesity. Anaerobic power was also measured, and the development of the physical fitness in children was characterized according to aerobic and anaerobic capacity. Furthermore, the problems in pediatric sport medicine and the influence of sports activity were studied for the management and promotion of health in children. 1. Normal value of VO2max and PWC, parameters of aerobic capacity, were established using a bicycle ergometer adapted to children. In 112 healthy children aged 6-15 years, VO2 max/kg were boys; 62.3 +/- 12.6 ml/kg/min (m +/- SD), girls; 53.8 +/- 12.8 and PWC75%HRmax were boys; 2.39 +/- 0.55 Watt/kg, girls; 1.90 +/- 0.48. Both data were remarkably higher than in adults. 2. An exercise test measuring with aerobic power was established, and cardiovascular responses were analyzed. The test was applied to the medical check for children with periodic sports performance and who had chronic illness. 3. Aerobic power was measured in 22 obese children aged 6-14 years. VO2max/kg and PWC75%HRmax were significantly lower than the normal values. Then, an exercise system was designed for the therapy of obese children, and a good response was obtained in all children. 4. Anaerobic power was also measured using a bicycle ergometer following force-velocity test. In 22 healthy children aged 7-15 years, the peak power was 5-7 Watt/kg which was lower than in adults (9-11 Watt/kg). 5. Daily activity was evaluated by a pedometer and a heart rate monitor. Children tended to become more active as they grew older before the elementary school age, but their activity gradually decreased after that. 6. The problems in pediatric sport medicine were that they tended to exercise not in daily playing but in belonged sport club, and also tended to do sports for winning. It is desirable that children do various kinds of sports using an aerobic power to develop the physical fitness, to have fun and to raise sociality. PMID- 1783372 TI - [Isolation and expansion of glioma-infiltrating lymphocytes in vitro: an analysis of their surface phenotypes and antitumor activities]. AB - The present study was conducted in order to examine the feasibility of isolating and growing glioma-infiltrating lymphocytes in vitro as possible effector cells for use in an adoptive immunotherapy. Thirty surgical specimens obtained from patients with malignant astrocytomas were studied. The glioma-infiltrating lymphocytes were separated from tumor tissue, expanded in the presence of interleukin-2, and evaluated their anti-tumor activities in vitro. Eighteen of 30 cultures of glioma-derived lymphocytes expanded with a substantial increase in cell numbers, of at least 5 x 10(8) cells up to 5 x 10(9), 4 to 8 weeks after the initiation of culture. The expanding glioma-derived lymphocytes consisted of 88 +/- 10% CD3+ T cells including both CD4+ and CD8+ subpopulations. CD16 was expressed on 4 +/- 5% of the cells and three cultures studied exhibited 14% +/- 1 of CD56+ cells. After 4 to 8 weeks of the proliferation period, the lymphocytes ceased to grow in all cultures. The glioma-derived effector lymphocytes could lyse almost all the autologous tumor targets as well as allogeneic glioma cells. The cytotoxic activity of the glioma-derived lymphocytes appeared to be similar or inferior to that of interleukin-2-activated peripheral blood lymphocytes obtained from the same patients in killing autologous glioma cells. The glioma derived effector cells could also lyse three-dimensional glioma targets (spheroids), but this lytis activity was clearly lower than that of the activated peripheral blood lymphocytes. Ability of these effector cells to infiltrate glioma tissue was doubtful, since after 24-hours coculture of effector cells with target spheroids, the effector cells scarcely infiltrated the spheroids. In summary, glioma-derived lymphocytes expanded in bulk culture with interleukin-2 consisted predominantly of T-lymphoblasts with the ability to kill autologous glioma cells and also to lyse glioma spheroids. However a benefit of use of the glioma-derived lymphocyte as a novel effector cells in clinical trail replacing the IL-2-activated peripheral blood lymphocytes could not be found. PMID- 1783373 TI - Mammalian hexokinase 1: evolutionary conservation and structure to function analysis. AB - We have amplified and sequenced the complete coding region of bovine hexokinase isoenzyme 1 (HK1) from brain RNA with PCR primers selected for sequence conservation. The sequence information was analyzed to evaluate the evolutionary and structure-function relationships among the mammalian and yeast HK isoenzymes. Structure to function analysis identified an unduplicated, invariant N-terminal domain involved in HK1 outer mitochondrial membrane targeting, as well as putative carbohydrate and nucleotide-binding sites in the regulatory and catalytic halves of HK1 essential to enzyme function. The ATP-binding site in the catalytic half of the HK1 protein resembles nucleotide-binding regions from protein kinases, with the single amino acid replacement (lysine to glutamate) in the ATP-binding site of the amino half explaining the loss of HK1 catalytic function in the regulatory domain. Sequence comparisons suggest that the 50-kDa mammalian and yeast glucokinases arose separately in evolution. In addition to providing valuable phylogenetic and structure-function insights, this work provides an efficient strategy for rapid cloning and sequencing of the coding regions for other HKs and related proteins. PMID- 1783374 TI - New strategy for mapping the human genome based on a novel procedure for construction of jumping libraries. AB - A novel procedure for construction of jumping libraries is described. The essential features of this procedure are as follows: (1) two diphasmid vectors (lambda SK17 and lambda SK22) are simultaneously used in the library construction to improve representativity, (2) a partial filling-in reaction is used to eliminate cloning of artifactual jumping clones and to obviate the need for a selectable marker. The procedure has been used to construct a representative human NotI jumping library (220,000 independent recombinant clones) from the lymphoblastoid cell line CBMI-Ral-STO, which features a low level of methylation of its resident EBV genomes. A human chromosome 3-specific NotI jumping library (500,000 independent recombinant clones) from the human chromosome 3 x mouse hybrid cell line MCH 903.1 has also been constructed. Of these recombinant clones 50-80% represent jumps to the neighboring cleavable NotI site. With our previously published method for construction of linking libraries this procedure makes a new genome mapping strategy feasible. This strategy includes the determination of tagging sequences adjacent to NotI sites in random linking and jumping clones. Special features of the lambda SK17 and lambda SK22 vectors facilitate such sequencing. The STS (sequence tagged site) information obtained can be assembled by computer into a map representing the linear order of the NotI sites for a chromosome or for the entire genome. The computerized mapping data can be used to retrieve clones near a region of interest. The corresponding clones can be obtained from the panel of original clones, or necessary probes can be made from genomic DNA by PCR. PMID- 1783375 TI - Gene for lymphoid enhancer-binding factor 1 (LEF1) mapped to human chromosome 4 (q23-q25) and mouse chromosome 3 near Egf. AB - LEF-1 is a 54-kDa nuclear protein that is expressed specifically in pre-B and T cells. It binds to a functionally important site in the T-cell receptor alpha enhancer and contributes to maximal enhancer activity. LEF-1 is a member of a family of regulatory proteins that share homology with the high mobility group protein 1 (HMG1). The location of the LEF1 gene on human and mouse chromosomes was determined by Southern blot analysis of DNA from panels of interspecies somatic cell hybrids using a murine cDNA probe. Human-specific DNA fragments were detected in all somatic cell hybrids that retained the human chromosomal region 4cen-q31.2. Fluorescent in situ hybridization with two biotin-labeled overlapping human genomic cosmids revealed a specific hybridization signal at 4q23-q25. The homologous locus in the mouse was mapped to chromosome 3 by Southern analysis of rodent x mouse hybrid cell DNA. This chromosomal location was confirmed by the use of a restriction fragment length polymorphism (RFLP) in recombinant inbred mouse strains. The results of this RFLP analysis indicated that the mouse Lef-1 gene was closely linked to Pmv-39 and Egf and was likely placed between these loci, both of which were previously mapped to distal mouse chromosome 3. Our mapping results did not suggest involvement of this gene in previously mapped genetic disorders or in known neoplasia-associated translocation breakpoints. PMID- 1783376 TI - Isolation of the human sex determining region from a Y-enriched yeast artificial chromosome library. AB - We describe the isolation and characterization of yeast artificial chromosome (YAC) clones spanning the male sex determining region on the short arm of the human Y chromosome. The clones were isolated by hybridizing probes in the interval between the genes MIC2 and ZFY to a Y chromosome-enriched YAC library. The YAC clones were consistent with the order of probes established for this interval and may be useful for functional studies of the region in male sex determination. However, many of the YAC clones from this library carried only one arm of the vector ("half-YACs"), deleted sequences from one end, and contained much smaller inserts (148 kb average) than the size of ligated fragments selected by pulsed-field gel electrophoresis (greater than 440 kb). These problems were overcome by protecting DNA with polyamines during YAC library construction and a second Y-enriched YAC library was constructed with an average insert size of 627 kb. PMID- 1783377 TI - Generation and fluorescent in situ hybridization mapping of yeast artificial chromosomes of 1p, 17p, 17q, and 19q from a hybrid cell line by high-density screening of an amplified library. AB - A yeast artificial chromosome (YAC) library has been constructed from a somatic cell hybrid containing a t(1p;19q) chromosome and chromosome 17. After amplification, part of this library was analyzed by high-density colony filter screening with a repetitive human DNA probe (Alu). The human YACs distinguished by the screening were further analyzed by Alu fingerprinting and Alu PCR. Fluorescent in situ hybridization (FISH) was performed to localize the YACs to subchromosomal regions of chromosome 1p, 17, or 19q. We have obtained a panel of 123 individual YACs with a mean size of 160 kb, and 77 of these were regionally localized by FISH: 33 to 1p, 10 to 17p, 25 to 17q, and 9 to 19q. The YACs cover a total of 19.7 Mb or 9% of the 220 Mb of human DNA contained in the hybrid. No overlapping YACs have yet been detected. These YACs are available upon request and should be helpful in mapping studies of disease loci, e.g., Charcot-Marie Tooth disease, Miller-Dieker syndrome, hereditary breast tumor, myotonic dystrophy, and malignant hyperthermia. PMID- 1783378 TI - Genomic organization and chromosomal localization of the human CTP synthetase gene (CTPS). AB - To elucidate the organization of the human genomic sequences encoding CTP synthetase (CTPS), fragments homologous to the cDNA were isolated from genomic lambda libraries. The fragments cloned were overlapping and cover over 40 kb. Cotransfection of the DNAs into CTPS-deficient, cytidine-requiring CHO mutants can transform them to cytidine-independent growth, indicating that the complete structural gene has been isolated. Direct sequencing and enzymatic amplification of the cloned genomic fragments revealed that the coding sequences are distributed to 19 exons covering about 35 kb. Multiple transcriptional start sites were detected by primer extension in a G + C-rich 5' flanking sequence that is separated from the translational start by an approximately 3-kb intron. A panel of human-rodent somatic cell hybrids and the CTPS cDNA were used to assign the structural gene to the short arm of human chromosome 1. This assignment was further refined through the use of somatic cell hybrids bearing fragments of the short arm of the chromosome, allowing localization to 1p36.11-p31, a region notable for its disruption in many types of tumors. PMID- 1783379 TI - Inactivation of the Rps4 gene on the mouse X chromosome. AB - The human RPS4X and RPS4Y genes, located on the X and Y chromosomes, appear to encode isoforms of ribosomal protein S4. Haploinsufficiency of these genes may contribute to the human phenotype known as Turner syndrome. Although RPS4X maps near the X-inactivation center, the gene is expressed on inactive human X chromosomes. We cloned Rps4, the mouse homolog of RPS4X. Exploiting allelic variation in Rps4, we examined transcription of the gene from active and inactive mouse X chromosomes in vivo, in female mice carrying an X-autosome translocation. We report that mouse Rps4, unlike human RPS4X, is subject to X inactivation. This finding may explain, at least in part, why the phenotypic consequences of X monosomy are less severe in mice than in humans. PMID- 1783381 TI - Mapping HSA 3 loci in cattle: additional support for the ancestral synteny of HSA 3 and 21. AB - Homologs to genes residing on human chromosome 3 (HSA 3) map to four mouse chromosomes (MMU) 3, 6, 9, and 16. In the bovine, two syntenic groups that contain HSA 3 homologs, unassigned syntenic groups 10 (U10) and 12 (U12), have been defined. U10 also contains HSA 21 genes, which is similar to the situation seen on MMU 16, whereas U12 apparently contains only HSA 3 homologs. The syntenic arrangement of other HSA 3 homologs in the bovine was investigated by physically mapping five genes through segregation analysis of a bovine-hamster hybrid somatic cell panel. The genes mapped include Friend-murine leukemia virus integration site 3 homolog (FIM3; HSA 3/MMU 3), sucrase-isomaltase (SI) and glutathione peroxidase 1 (GPX1) (HSA 3/MMU ?), murine leukemia viral (v-raf-1) oncogene homolog 1 (RAF1; HSA 3/MMU 6), and ceruloplasmin (CP; HSA 3/MMU 9). FIM3, SI, and CP mapped to bovine syntenic group U10, while RAF1 and GPX1 mapped to U12. PMID- 1783380 TI - Major rearrangements in the alpha 5(IV) collagen gene in three patients with Alport syndrome. AB - The gene coding for the alpha 5 chian of type IV collagen (alpha 5(IV) collagen), which maps to Xq22, is a candidate gene for the X-linked dominant disease Alport syndrome (AS). Using three cDNA clones, covering the 3' end of the alpha 5(IV) collagen gene, 3 of 38 patients have been identified with mutations in this gene. Each of these patients shows a gross rearrangement of DNA: a deletion of at least 35 kb, an insertion/deletion event involving approximately 25 kb, and a duplication of at least 35 kb of DNA. PMID- 1783382 TI - Nearly 80% of cystic fibrosis heterozygotes and 64% of couples at risk may be detected through a unique screening of four mutations by ASO reverse dot blot. AB - A technique allowing the simultaneous screening of the four main CF mutations in the French population (delta F508, delta I507, G542X, S549N) has been developed by means of allele sequence-specific oligonucleotide (ASO) reverse dot blot. Using a strategy proposed by R. K. Saiki et al. (1989, Proc. Natl. Acad. Sci. USA 86: 6230-6234) for HLA-DQA, the seven ASOs for normal and mutant CF alleles were given a homopolymer T tail with terminal deoxyribonucleotidyltransferase and then immobilized on a nylon membrane. T-tail homopolymers were preferentially bound to the nylon, leaving the specific ASO sequences free to hybridize with amplified and radiolabeled exons 10 and 11 of a patient. These exons were simultaneously coamplified by a multiplex PCR and radiolabeled by random priming. ASO reverse dot blot currently appears to be the most efficient, rapid, and economic means of screening the population for CF mutations. This screening can detect nearly 80% of carriers and 64% of couples at risk and could prevent the birth of CF-affected infants in these families. PMID- 1783383 TI - Assignment of the human ferrochelatase gene (FECH) and a locus for protoporphyria to chromosome 18q22. AB - We have mapped the human gene for ferrochelatase (FECH; ferroheme-protolyase, EC 4.99.1.1) to chromosome 18 by hybridization of cDNA to sorted chromosomes. The probe was obtained by PCR-directed amplification of a human marrow cDNA library in lambda gt 10. Subchromosomal localization of ferrochelatase to 18q22 was determined by chromosomal hybridization in situ using a human ferrochelatase genomic clone in lambda EMBL 3 that contained a 20-kb insert. Since ferrochelatase activity is deficient in patients with the inherited disease erythropoietic protoporphyria, a locus for this disease may be assigned to 18q22, one of few monogenic defects that have been mapped to this chromosome. PMID- 1783384 TI - Rat hypoxanthine phosphoribosyltransferase cDNA cloning and sequence analysis. AB - We have determined the nucleotide sequence of the rat hprt (hypoxanthine phosphoribosyltransferase; EC 2.4.2.8.) mRNA coding region and of adjacent, untranslated 5' and 3' mRNA, and we have designed an oligonucleotide primer pair for efficient PCR amplification of the rat hprt coding region. These sequence data and rat-specific primer pair will aid workers interested in coupling well developed rat toxicologic and carcinogenicity bioassays with quantitative and molecular analyses of somatic mutation induction in rat cells in vivo and in vitro. PMID- 1783385 TI - Assignment of human pancreatic lipase gene (PNLIP) to chromosome 10q24-q26. AB - Human pancreatic lipase (EC 3.1.1.3) is a 56-kDa protein secreted by the acinar pancreas and is essential for the hydrolysis and absorption of long-chain triglyceride fatty acids in the intestine. In vivo, the 12-kDa protein cofactor, colipase, is required to anchor lipase to the surface of lipid micelles, counteracting the destabilizing influence of bile salts. Southern blot analysis, using a pancreatic lipase cDNA to probe DNA from mouse-human somatic cell hybrids, indicated that the pancreatic lipase gene (PNLIP) resides on human chromosome 10. In situ hybridization to human metaphase chromosomes confirmed the cell hybrid results and further localized the gene to the 10q24-qter region with the strongest peak at q26.1. PMID- 1783386 TI - Estimation of genetic distances between "reeler" and nearby loci on mouse chromosome 5. AB - Genetic distances between reeler (gene symbol rl) and the adjacent loci Pgy-1, Sor, and En-2 on proximal chromosome 5 were estimated using a backcross panel between rlOrl/rlOrl BALB/c and C57 mice. Pgy-1 and Sor are located approximately 7 cM away from and centromeric to reeler, whereas En-2 is located distally, approximately 8 cM from reeler. Backcrosses between rlOrl/rlOrl BALB/c and mice with the T31H translocation showed that the breakpoint is located less than 2 cM from reeler. Together with previous work, these observations suggest the following gene order: Cen-Sor/Pgy-1-rl-T31H-En-2-other loci. PMID- 1783387 TI - Autosomal dominant retinitis pigmentosa: a mutation in codon 178 of the rhodopsin gene in two families of Celtic origin. PMID- 1783388 TI - The human T-cell leukemia virus-related endogenous sequence (HRES1) is located on chromosome 1 at q42. PMID- 1783389 TI - Yeast artificial chromosome-based genome mapping: some lessons from Xq24-q28. AB - Yeast artificial chromosomes (YACs) have recently provided a potential route to long-range coverage of complex genomes in contiguous cloned DNA. In a pilot project for 50 Mb (1.5% of the human genome), a variety of techniques have been applied to assemble Xq24-q28 YAC contigs up to 8 Mb in length and assess their quality. The results indicate the relative strength of several approaches and support the adequacy of YAC-based methods for mapping the human genome. PMID- 1783390 TI - Genomic mapping by anchoring random clones: a mathematical analysis. AB - A complete physical map of the DNA of an organism, consisting of overlapping clones spanning the genome, is an extremely useful tool for genomic analysis. Various methods for the construction of such physical maps are available. One approach is to assemble the physical map by "fingerprinting" a large number of random clones and inferring overlap between clones with sufficiently similar fingerprints. E.S. Lander and M.S. Waterman (1988, Genomics 2:231-239) have recently provided a mathematical analysis of such physical mapping schemes, useful for planning such a project. Another approach is to assemble the physical map by "anchoring" a large number of random clones--that is, by taking random short regions called anchors and identifying the clones containing each anchor. Here, we provide a mathematical analysis of such a physical mapping scheme. PMID- 1783391 TI - Mouse proacrosin gene: nucleotide sequence, diploid expression, and chromosomal localization. AB - Acrosin is a serine proteinase located in the acrosome of the sperm in a zymogen form, proacrosin. As deduced from the cDNA sequences of human, boar, and mouse proacrosin, the enzyme is synthesized as a preproenzyme, preproacrosin, which contains a hydrophobic leader sequence of 15 to 18 amino acid residues. We have isolated the gene coding for mouse proacrosin from a mouse cosmid library, using cDNA clones as probes. The gene comprises six exons, and one of the five introns is located in the 5'-untranslated region. The transcription initiation site of the preproacrosin mRNA could be assigned to the residue T, 581 nucleotides upstream of the translation initiation codon ATG, with primer extension analysis. TATA and CAAT boxes could be identified at positions -26 and -97, respectively. Similar to other serine proteases, the coding sequence encompasses five exons and the three active-site residues His, Asp, and Ser are encoded by three different exons (E2, E3, E5). The proline-rich domain, which is a characteristic feature of the proacrosin polypeptide, is encoded in exon 5 with the serine active-site residue. The gene is located on chromosome 15 of the mouse genome, bands E/F, and is a member of a syntenic group that was mapped on human chromosome 22, q13-qter. During spermatogenesis the proacrosin gene in the mouse is expressed diploid, in contrast to a haploid expression observed in bull, boar, and rat. PMID- 1783392 TI - Characterization of the human gene for a newly discovered carbonic anhydrase, CA VII, and its localization to chromosome 16. AB - Six carbonic anhydrase (CA) isozymes (CA I-VI) in mammals and other amniotes have been described. We have isolated an additional CA gene from a human genomic library and designated its putative product carbonic anhydrase VII (CA VII). The gene is approximately 10 kb long and contains seven exons and six introns found at positions identical to those determined for the previously described CA I, CA II, and CA III genes. The finding of a 17-bp GT-rich segment in a position 28 bp downstream of the poly(A)+ signal and the high correspondence of the 5' and 3' splice sites of the six introns with consensus junction sequences are consistent with the gene being functional. The 5' flanking regions of the CA VII gene do not contain the TATA and CAAT promoter elements usually found within 100 bp upstream of transcription initiation, but do contain a TTTAA sequence 102 nucleotides upstream of the initiation codon. The 5' region of the gene (-243 to +551) is GC rich and contains 80 CpG dinucleotides and four possible Sp1 (GGGCGG or CCGCCC) binding sites. Northern analysis has identified the salivary gland as a major site of expression. The derived amino acid sequence of the CA VII gene is 263 amino acids long and has 50, 56, and 49% identity with human CA I, CA II, and CA III, respectively. No differences were found at any of the 39 positions that have remained invariant in all mammalian CA isozymes sequenced to date. Based on analysis of interspecific somatic cell hybrids, the human CA VII gene, CA7, was assigned to chromosome 16, with localization to the long arm at the q21-23 region by in situ hybridization. This is in contrast to the location of the CA I, CA II, and CA III gene cluster on human chromosome 8 and that of the human CA VI gene on chromosome 1. PMID- 1783393 TI - Sequence variation between alleles reveals two types of copy correction at the 27 kDa zein locus of maize. AB - In many inbred lines of maize, two 27-kDa storage protein (zein) genes are found within tandem duplications of 12 kb. Both genes of the duplicated allele from the maize inbred line A188 were sequenced and compared to a similar duplicated allele in another inbred line, W22, and to a single-copy allele in the inbred line W64A. The comparisons reveal interesting patterns in the distribution of sequence changes between these alleles. Differences between the two duplicated alleles that are conserved between the two genes of each allele are found exclusively in the 5' region. In contrast, differences between the individual genes of each allele in the 3' region are conserved between the two alleles. The first case is indicative of an intraallelic copy correction mechanism, whereas the second may result from interallelic copy correction. These may be mediated by gene conversion processes, as previously described for other multigene families. PMID- 1783394 TI - Linkage mapping of autosomal dominant retinitis pigmentosa (RP1) to the pericentric region of human chromosome 8. AB - Linkage mapping in a large, seven-generation family with type 2 autosomal dominant retinitis pigmentosa (ADRP) demonstrates linkage between the disease locus (RP1) and DNA markers on the short arm of human chromosome 8. Five markers were most informative for mapping ADRP in this family using two-point linkage analysis. The markers, their maximum lod scores, and recombination distances were ANK1 (ankyrin)--2.0 at 16%; D8S5 (TL11)--5.3 at 17%; D8S87 [a(CA)n repeat]--7.2 at 14%; LPL (lipoprotein lipase)--1.5 at 26%; and PLAT (plasminigen activator, tissue)--10.6 at 7%. Multipoint linkage analysis, using a simplified pedigree structure for the family (which contains 192 individuals and two inbreeding loops), gave a maximum lod score of 12.2 for RP1 at a distance 8.1 cM proximal to PLAT in the pericentric region of the chromosome. Based on linkage data from the CEPH (Paris) reference families and physical mapping information from a somatic cell hybrid panel of chromosome 8 fragments, the most likely order for four of these five loci and the diseases locus is 8pter-LPL-D8S5-D8S87-PLAT-RP1. (The precise location of ANK1 relative to PLAT in this map is not established). The most likely location for RP1 is in the pericentric region of the chromosome. Recently, several families with ADRP with tight linkage to the rhodopsin locus at 3q21-q24 were reported and a number of specific rhodopsin mutations in families with ADRP have since been reported. In other ADRP families, including the one in this study, linkage to rhodopsin has been excluded. Thus mutations at two different loci, at least, have been shown to cause ADRP. There is no remarkable clinical disparity in the expression of disease caused by these different loci. PMID- 1783395 TI - Autosomal dominant retinitis pigmentosa: localization of a disease gene (RP6) to the short arm of chromosome 6. AB - DNA from members of an Irish pedigree presenting with late onset autosomal dominant retinitis pigmentosa (ADRP) have been typed with a series of genetic markers from chromosome 6p. Positive two-point lod scores have been obtained with five markers (D6S89: theta = 0.10, Z = 3.338; D6S109: theta = 0.10, Z = 3.932; D6S105: theta = 0.00, Z = 6.081; HLA-DRA: theta = 0.00, Z = 4.364; and RDS: theta = 0.00, Z = 5.376). In a series of overlapping multipoint analyses a lod score of 6.6 was obtained, maximizing at HLA-DRA and hence localizing the ADRP gene (RP5) segregating in this pedigree to 6p. These data provide direct evidence for an additional autosomal dominant RP locus and strongly implicate the human equivalent of the mouse retinal degeneration slow (rds) gene, peripherin-rds, as a candidate for autosomal dominant retinitis pigmentosa. PMID- 1783396 TI - A multipedigree linkage study of X-linked deafness: linkage to Xq13-q21 and evidence for genetic heterogeneity. AB - A locus for X-linked nonsyndromic deafness has previously been allocated to the Xq13-q21 region based on linkage studies in two separate pedigrees. This has been substantiated by the observation of deafness as a clinical feature of male patients with cytogenetically detectable deletions across this region. The question of a second locus for deafness in this chromosomal region has been raised by the audiologically distinct nature of the deafness in some of the deleted patients compared to that observed in those patients upon whom the linkage data are based. We have performed detailed clinical evaluation and linkage studies on seven pedigrees with nonsyndromic X-linked deafness and conclude that there is evidence for at least two loci for this form of deafness, including one in the Xq13-q21 region. We have observed different radiological features among the pedigrees which map to Xq13-q21, suggesting that even among these pedigrees the deafness is due to different pathological processes. Given these findings, we suggest that the classification of nonsyndromic X-linked deafness based solely on audiological criteria may need to be reviewed. PMID- 1783397 TI - LINE-1 repetitive DNA probes for species-specific cloning from Mus spretus and Mus domesticus genomes. AB - Mus domesticus and Mus spretus mice are closely related subspecies. For genetic investigations involving hybrid mice, we have developed a set of species-specific oligonucleotide probes based on the detection of LINE-1 sequence differences. LINE-1 is a repetitive DNA family whose many members are interspersed among the genes. In this study, library screening experiments were used to fully characterize the species specificity of four M. domesticus LINE-1 probes and three M. spretus LINE-1 probes. It was found that the nucleotide differences detected by the probes define large, species-specific subfamilies. We show that collaborative use of such probes can be employed to selectively detect thousands of species-specific library clones. Consequently, these probes could be exploited to monitor and access almost any given species-specific region of interest within hybrid genomes. PMID- 1783398 TI - Structural analysis of the gene encoding rat uricase. AB - The uricase gene was isolated from rat genomic DNA libraries. The gene spans 40 kb and consists of eight exons. All the exon-intron junctional sequences conform to the canonical GT/AG rule. The restriction map of the isolated clones and Southern blot analysis revealed that the enzyme is encoded by a single-copy gene. Analysis of the transcription initiation site of rat uricase mRNA indicated the differential use of consecutive nucleotides; the principal repeat is located 55 nucleotides upstream from the first methionine codon. Nucleotide sequence analysis of the 5'-flanking region showed the presence of a TATA (ATAAAA) sequence at nucleotides 30 to 25 and of a CAAT (GGTCAAT) sequence at nucleotides 63 to 57 upstream of the principal transcription initiation site. The 5'-flanking region contains another possible regulatory sequence (TGTCGACA) homologous to the cAMP-regulatory element. The palindromic sequence is located 158 to 151 nucleotides upstream from the transcription initiation site, surrounded by a direct repeat (TCAGCAA). PMID- 1783399 TI - Assignment of the human gene for beta-microseminoprotein (MSMB) to chromosome 10 and demonstration of related genes in other vertebrates. AB - The gene for beta-microseminoprotein MSMB has been studied by DNA hybridization and molecular cloning techniques. Comparative analysis of restriction endonuclease digests of the cloned gene and of leukocyte DNA strongly suggested that the gene is present in a single copy in the haploid human genome. By Southern blot analysis of DNA from somatic cell hybrids, the gene was assigned to chromosome 10. The coding nucleotides of the human gene are separated into four exons by relatively large introns. A related gene might be present in other mammals, birds, and amphibians as revealed by DNA hybridization under conditions of low stringency. PMID- 1783400 TI - Linkage of plasminogen (PLG) and apolipoprotein(a) (LPA) in baboons. AB - Four allelic forms of serum plasminogen (PLG) were detected in baboons (Papio hamadryas Linneaus 1758) by isoelectric focusing and were determined to be inherited as autosomal codominant traits. Linkage analysis of data from 179 progeny and their parents revealed that PLG is tightly linked (lod score = 30.20) to the gene encoding apolipoprotein(a) (LPA), as in humans. No recombinant individuals were identified. This is the first linkage detected between PLG and LPA in any species other than humans and is the first genetic linkage identified in a nonhuman primate species by family studies. PMID- 1783401 TI - cDNA cloning of the type 1 neurofibromatosis gene: complete sequence of the NF1 gene product. AB - Von Recklinghausen neurofibromatosis, or type 1 neurofibromatosis (NF1), is a common autosomal dominant disorder characterized by abnormalities in multiple tissues derived from the embryonic neural crest. Portions of the gene have been recently identified by positional cloning, and sequence analysis has shown homology to the GTPase activating protein (GAP) family. In this report we present the results of an extensive cDNA walk resulting in the cloning of the complete coding region of the NF1 transcript. Analysis of the sequences reveals an open reading frame of 2818 amino acids, although alternatively spliced products may code for different protein isoforms. The gene extends for approximately 300 kb on chromosome 17, with its promoter in a CpG-rich island. PMID- 1783402 TI - Localization of the rhabdomyosarcoma t(2;13) breakpoint on a physical map of chromosome 13. AB - Previous investigations of the pediatric soft tissue tumor alveolar rhabdomyosarcoma have identified a characteristic translocation t(2;13)(q35;q14). We have employed a physical mapping strategy to localize the site of this translocation breakpoint on chromosome 13. Using a panel of somatic cell hybrid and lymphoblast cell lines with deletions and unbalanced translocations involving chromosome 13, we have mapped numerous probes from the 13q12-q14 region and demonstrate that this region is divisible into five physical intervals. These probes were then mapped with respect to the t(2;13) rhabdomyosarcoma breakpoint by quantitative Southern blot analysis of an alveolar rhabdomyosarcoma cell line with two copies of the derivative chromosome 13 and one copy of the derivative chromosome 2. Our findings demonstrate that the t(2;13) breakpoint is localized within a map interval delimited by the proximal deletion breakpoints in lymphoblast lines GM01484 and GM07312. Furthermore, the breakpoint is most closely flanked by loci D13S29 and TUBBP2 within this map interval. These findings will facilitate chromosomal walking strategies for cloning the regions disrupted by the alveolar rhabdomyosarcoma translocation. In addition, this physical map will permit rapid determination of the proximity of new cloned sequences to the translocation breakpoint. PMID- 1783403 TI - Characterization and functional expression of a cDNA encoding egasyn (esterase 22): the endoplasmic reticulum-targeting protein of beta-glucuronidase. AB - Egasyn (esterase-22), a member of the nonspecific carboxylesterase multigene family (E.C. 3.1.1.1), is the endoplasmic reticulum (ER)-targeting protein of beta-glucuronidase. We utilized the polymerase chain reaction (PCR) in the eventual isolation of murine egasyn cDNAs. PCR primers were based upon: (1) partial amino acid sequences derived from egasyn peptides and (2) a conserved active site region shared by carboxylesterases. The amino acid sequence deduced from the PCR product matched that obtained from egasyn protein. This product was utilized as a probe to screen a cDNA library. Two cDNAs whose composite sequence encoded an open reading frame of 562 amino acids were isolated. A message size of 1700-2000 bp was revealed by RNA blot hybridization analysis. S1 nuclease protection analyses detected mRNA in liver, kidney, lung, and submandibular gland, but not in spleen, brain, and testes. Genetic mapping confirmed the location of an egasyn cDNA fragment in cluster 1 of the esterase region on chromosome 8. Transfection of COS cells with the 2022-bp cDNA resulted in the expression of esterase activity, which comigrated on native gels with liver esterase-22. The features of the deduced amino acid sequence of the egasyn cDNA are compared with previously characterized carboxylesterases and with other lumenal ER proteins. PMID- 1783404 TI - A linkage map spanning the locus for diastrophic dysplasia (DTD). AB - Diastrophic dysplasia (DTD) is an autosomal recessive osteochondrodysplasia. Patients have short-limbed short stature and suffer from generalized joint dysplasia. We have recently mapped DTD to the distal long arm of chromosome 5. Here we report the localization of DTD in relation to 16 polymorphic markers on distal 5q. No recombinations occurred with two loci, D5S72 and D5S66. One presumptive candidate gene, osteonectin (SPARC), could be excluded on the basis of three recombinations with the DTD locus. Multipoint linkage analysis performed against a fixed order of markers placed DTD between glucocorticoid receptor (GRL) and SPARC favored by the odds of 33:1 over the next best location of DTD between D5S72 and D5S55. The sex-averaged distance between the definite flanking markers, GRL and D5S55, is 17.5 cM. From previously reported data on the physical localization of markers, we conclude that the DTD locus is in 5q31-q34. PMID- 1783405 TI - Genetic and physical mapping around the properdin P gene. AB - A CA repeat has been found on the human X chromosome within 16 kb of the gene encoding properdin P factor (PFC) and has been shown to be a highly informative marker. Two more polymorphic CA repeats were found in a cosmid containing DXS228. The CA repeats, and other markers from proximal Xp, were mapped genetically in CEPH families and the likely order of markers was established as Xpter-(DXS7, MAO A, DXS228)-(PFC, DXS426)-(TIMP, OATL1)-DXS255-Xcen. This places PFC in the region Xp11.3-Xp11.23, thus refining previous in situ hybridization data. Two yeast artificial chromosomes (YACs) (440 and 390 kb) contain both PFC and DXS426, and one of them (440 kb) also contains TIMP. This confirms the genetic order TIMP (PFC, DXS426). PFC and TIMP are located on the same 100-kb SalI/PvuI fragment of the 440-kb YAC. Given the genetic orientation of TIMP and (PFC, DXS426), this YAC can now serve as a starting point for directional walking toward disease genes located in Xp11.3-Xp11.2 such as retinitis pigmentosa (RP2) and Wiskott-Aldrich syndrome. PMID- 1783406 TI - Construction and characterization of plasmid libraries enriched in sequences from single human chromosomes. AB - Plasmid libraries enriched in sequences from single chromosome types have been constructed for all human chromosomes. This was accomplished by transferring inserts from the Charon 21A phage libraries constructed by the National Laboratory Gene Library Project into Bluescribe plasmids. Insert material freed by complete digestion of the phage libraries with HindIII or EcoRI was cloned into the corresponding sites in Bluescribe plasmids. The sizes of the Bluescribe library inserts determined by gel electrophoresis range from near 0 to approximately 6 kb. Fluorescence in situ hybridization (FISH) with the plasmid libraries showed that all hybridize along both arms of the expected (target) chromosome type with varying intensity. However, the plasmid libraries for chromosomes 1, 4, 9, 11, 16, 18, and 20 hybridize weakly or not at all near the centromeres of the target chromosome types. The libraries for chromosomes 13, 14, 15, 21, and 22 cross-hybridize near the centromeres of all members of this group and hybridize weakly to the short arms of the target chromosomes. FISH with each library allows specific staining of the target chromosome type in metaphase spreads. The signals resulting from FISH with libraries for chromosomes 1, 4, 8, 9, 13, 14, 17, 18, 21, and Y are sufficiently intense to permit analysis in interphase nuclei. Examples of the use of these libraries for translocation detection, marker chromosome characterization, and interphase aneuploidy analysis are presented. PMID- 1783408 TI - Population genetics of alpha-1-antitrypsin polymorphism in US whites, US blacks and African blacks. AB - An isoelectric focusing (IEF) procedure in an ultra-narrow pH range, 4.2-4.9, has been utilized to detect alpha 1-antitrypsin or alpha 1-protease inhibitor (PI) allele products in 2 US white and 3 US black populations as well as 1 native African black population. In addition to the 3 common alleles PI*M1, PI*M2 and PI*M3, products of the 4th allele PI*M4 have been identified in US whites at low level frequency. The presence of the PI*S, PI*Z and PI*I alleles has also been verified in our population samples. While the PI*S allele is present at a polymorphic level in US whites, it is only present sporadically in US blacks and is completely absent in African blacks. The PI*Z allele was not detected in the black populations tested. The PI allele frequency data have been used to calculate white admixture in US blacks. PMID- 1783407 TI - Frequency of HLA-DQA1 alleles in the Japanese population. AB - One of the HLA class II genes, HLA-DQA1, was typed from 290 unrelated healthy Japanese using the oligonucleotide typing method. The HLA-DQA1 gene was enzymatically amplified and typed by dot-blot hybridizations with 10 sequence specific oligonucleotide probes labeled nonradioactively. Using this method, the HLA-DQA1 genotype was theoretically classified into 36 genotypes: 8 homozygous and 28 heterozygous ones. Actually, 26 genotypes were observed in the present study, and the gene frequency of each allele was calculated. The observed numbers were in accordance with the numbers expected under the Hardy-Weinberg equilibrium. The HLA-DQA1 genotype was also determined in aged bloodstains. Since the genotype is polymorphic in the Japanese population and a very small amount of blood is required for determination, this typing is particularly useful for forensic analysis. PMID- 1783409 TI - Localization of human glandular kallikrein-1 gene to chromosome 19q13.3-13.4 by in situ hybridization. AB - Humans possess 3 fully characterized kallikrein-like genes. The gene expressed in kidney, pancreas and salivary gland (KLK), and the gene encoding prostate specific antigen (APS) have been localized to chromosome 19q13.2-qter. The present study describes the localization of the remaining gene, hGK-1, which has highest homology to and a similar tissue specificity of expression as the APS gene. Using a [3H]-labeled probe derived from a hGK-1 genomic clone, we demonstrated hybridization confined to the q13.3 and q13.4 bands of chromosome 19 and suggest that kallikrein genes may possibly be located near the border of these two bands. PMID- 1783410 TI - A Japanese family with unusual segregation of GM phenotype: a GM silent allele? AB - A Japanese family with unusual segregation of GM phenotype was found in connection with a case of disputed paternity. Typing for 27 hemogenetic marker systems revealed apparent nonmaternity in the GM system alone. When tested for 14 GM allotypes, the alleged father, the mother, and the child were of the GM A,F,Z N B0,1,3,4,5,S,T,U; GM A,Z N' G,U; and GM A,Z N' B0,3,5,S,T types, respectively. The results of a family study strongly suggested that a GM silent allele was responsible for the apparent nonmaternity; however, definitive evidence could not be obtained. PMID- 1783411 TI - Duffy blood groups and malaria in the Ao Nagas in Nagaland, India. AB - Blood samples from 324 malarial patients and 384 healthy individuals belonging to the Ao tribal community have been examined for Duffy blood group systems. The complete absence of Duffy-negative individuals among the Ao Nagas suggests that selection for resistance to vivax malaria by means of the Duffy-negative phenotype has not been available in the southeast Asian regions including the Ao Nagas. PMID- 1783412 TI - Genetic polymorphisms in southwest Alaskan Eskimos. AB - Allele frequencies of 28 genetic loci were determined in subsets (n ranged from 52 to 698) of a sample of Yupik-speaking Eskimos from southwestern Alaska. Five loci were monomorphic (Kell Kp (b+), ADA1, AK1, HBA, and PGDA). At the other loci, the most frequent alleles were AB00 (0.580), Fya (0.960), Jkb (0.513), Ms (0.333), CDe (0.591), ACPA (0.566), ESD1 (0.890), GLO2 (0.736), GPT1 (0.653), Hp2 (0.654), PGM1 (0.836), PGP1 (0.972), and UMPK1 (0.873). The most frequent immunoglobulin allotype Gm(1;21) occurred with a frequency of 0.829. The HLA alleles that occurred with highest frequencies were A24 (0.626), Bw48 (0.184), Cw3 (0.404), and DR4 (0.329). The average heterozygosity at all loci was 0.423. Based on the presence of the European allotype, Gm3;23;5,11,13, the proportion of European admixture in the Eskimo population was estimated to be 2.1%. PMID- 1783413 TI - A population genetic study in Finland: comparison of the Finnish- and Swedish speaking populations. AB - In Finland there is a substantial but geographically limited Swedish-speaking minority (in 1980 6.3% of the total population) which originates mainly from Swedish immigrants during the years 1100-1300 AD. The admixture of this population with the neighbouring Finns was studied using more than 20 blood marker loci. The reference populations, Swedes and Finns, in spite of being part of the genetically rather uniform European populations, differ from each other genetically. These quantitative and also qualitative differences in gene frequencies are mostly due to the Finnish population possessing a number of genetic markers absent or rare in the rest of Europe. The results based on a sample of 620 individuals from the Swedish-speaking population in Finland showed a rather high degree of Finnish admixture, which was estimated to about 60%. This admixture most probably occurred at an early stage since it has reached such a high and geographically homogeneous degree. PMID- 1783414 TI - Polymorphisms of serum proteins in Japanese patients with vascular diseases. I. Factor XIIIB, plasminogen and complement types in primary varicose veins. AB - The polymorphisms of the B subunit of coagulation factor XIII (F13B), plasminogen (PLG), complement C6, C7, factor B (BF) and factor I (IF) were studied among 21 unrelated Japanese patients with primary varicose veins (PVV) by isoelectric focusing followed by immunoblotting. The allele frequencies for F13B*2 and IF*A in PVV patients were significantly higher (F13B*2, p = 0.0047; IF*A, p = 0.0006) than those in healthy controls (n = 60). Significant associations of F13B 2 allotype [p = 0.0220, relative risk (RR) = 13.9] and IF A allotype (p = 0.0006, RR = 10.0) with PVV were observed; however, no significant association of PLG, C6, C7 or BF allotype with the disease was found. PMID- 1783415 TI - Monomorphism of formaldehyde dehydrogenase in different populations. AB - Blood samples from Koreans, Chinese, Hungarians and Germans were analyzed by isoelectric focusing on polyacrylamide gels and stained for formaldehyde dehydrogenase (FDH) activity. Three activity bands (one major and two minor) were observed in all blood samples studied. No distinct intra- and interpopulation differences were observed in the intensity of the three bands. Human autopsy liver samples also showed a similar three-activity band profile. An additional cathodic band was detected in a single case of autopsy liver extract from a Chinese subject. An apparent identity of FDH with the class III alcohol dehydrogenase was confirmed. PMID- 1783416 TI - Distribution of common phenotypes of sperm diaphorase (DIA3) in the Polish population. AB - The polymorphism of sperm diaphorase (DIA3) was investigated by isoelectric focusing in semen samples from 310 unrelated Polish males. The allele frequencies were DIA3*1 = 0.782, DIA3*2 = 0.200 and DIA3*3 = 0.018. PMID- 1783417 TI - Imaging Ca2+ changes in individual oligodendrocytes attacked by T-cell perforin. AB - Cytosolic-free calcium changes in cultured rat oligodendrocytes attacked with murine T-cell perforin were measured using digital image processing of fura-2 loaded cells. Permeability to the membrane impermeant dye, propidium iodide, and the ability to retain fura-2 were also assessed. Oligodendrocyte response to perforin attack was heterogeneous, ranging from small, transient increases in cytosolic calcium to rapid cell death. Changes in cytosolic calcium occurred in all cells and about half of the cells also became permeable to propidium iodide. Only a minority of these cells proceeded to lysis, as evidenced by loss of fura 2. The cytosolic-free calcium rises visualized here in single cells could initiate non-lethal effects, thereby disturbing oligodendrocyte function and synthesis and maintenance of myelin. PMID- 1783418 TI - 1,25(OH)2D3 regulates c-myc mRNA levels in tonsillar T lymphocytes. AB - The effects of 1,25(OH)2D3 on proliferation, c-myc mRNA levels and 1,25(OH)2D3 receptor expression in activated tonsillar T lymphocytes were studied. Activation of resting T cells with phytohaemagglutinin (PHA) for 72 hr led to an increase in proliferation, c-myc mRNA levels and to induction of 1,25(OH)2D3 receptor expression. However, when activation was carried out in the presence of 1,25(OH)2D3, there was inhibition of PHA-stimulated proliferation and c-myc mRNA levels. Increased cell proliferation, c-myc mRNA expression and 1,25(OH)2D3 receptor number were also observed, albeit to a lesser extent, when T cells were stimulated by phorbol myristate acetate (PMA), anti-CD3 antibody or A23187. However, in these cases 1,25(OH)2D3 was unable to prevent increased proliferation or c-myc mRNA expression. PMA and anti-CD3 used in combination produced similar or greater changes in proliferation, c-myc mRNA levels, 1,25(OH)2D3 receptor expression and responsiveness to the hormone when compared to PHA alone. Thus the inhibition of c-myc expression in activated T lymphocytes by 1,25(OH)2D3 can be related to its anti-proliferative effects. Moreover this inhibition seems to be dependent on the level of 1,25(OH)2D3 receptor expression, which in turn appears to be related to the degree of cell activation. PMID- 1783419 TI - Greatly improved recovery of in vitro B-memory cell function after enzymic dispersion of immunized mouse spleens. AB - We have used the protease dispase to disperse the fine clumps that persist after mechanical disruption of spleens from immunized mice. After 4-8 days in culture, the resulting 'D/C' cells spontaneously generated many more IgG plaque-forming cells (PFC) against sheep erythrocytes (SRBC) than did conventional (CONV) suspensions. The difference averaged 12-fold and was consistently high after a wide range of immunization protocols. The major difference between the two cell preparations proved to be in the B-cell lineage rather than in antigen-presenting cells or T cells and, indeed, the response was largely T-cell independent. Antigen-driven culture responses to SRBC were also more than 10-fold higher with D/C than with CONV suspensions, and again there was apparently an improved recovery of B-memory cells. However, when fresh cell preparations were assayed immediately for PFC, there was no D/C:CONV difference--just as we have previously reported for memory responses on cell transfer to irradiated recipients. One simple interpretation is that germinal centres tend to remain as fine clumps on mechanical disruption, and their constituent B-memory cells are enriched by our procedure. If so, their responses are much more evident in vitro than after cell transfer. PMID- 1783420 TI - B cells control the aggregability of CD4 on T cells through continuous physical interactions. AB - It has previously been demonstrated that a gene on chromosome 1 in or near Mls-1 controls, on the surface of B cells, the mobility and aggregability of major histocompatibility complex (MHC) class II molecules but not the mobility or aggregability of other B-cell molecules, such as immunoglobulin (Ig) and class I antigens. We report here that this gene may also influence the aggregability of two class II antigen-reactive molecules on the surface of T cells, the T-cell receptor complex and CD4. The aggregability of the two membrane components is markedly higher on Mls-1+ T cells than on Mls-1- T cells. The properties of this phenomenon were examined in vitro as well as in vivo with particular emphasis on CD4 aggregability. It was found that, after removal of B cells, T cells lose the ability to aggregate CD4 in our standard CD4 aggregation assay. Similarly, T cells isolated from the B-cell-deficient environment of the thymus failed to aggregate CD4. Addition of B cells to either thymic T cells or B-cell-depleted peripheral T cells established CD4 aggregability within minutes. This process can be blocked with antibody against CD4 or antibody against Ia. The Mls-1 genotype predicts within the limited tests of this study the efficacy of the B-cell ability to impose a CD4 aggregation pattern on T cells: Mls-1+ B cells are markedly more effective in this respect than Mls-1- B cells. This can be demonstrated in tissue culture as well as in the animal. Similar to the Mls-1 response, this is a one-way process: Mls-1+ B cells confer to Mls-1- mice a CD4 aggregation pattern typical of the Mls-1+ mouse while Mls-1- B cells do not impose a Mls-1b-typical CD4 aggregation pattern in Mls-1a mice. Mls-1+ B cells also influence the composition of lymphocytes in the mouse. Mls-1+ mice or Mls-1- mice treated with Mls-1+ B cells have fewer T cells and more B cells in their spleen than Mls-1- animals. The gene that encodes stimulatory Mls-1 cell-surface structures has recently been identified as an endogenous mammary tumour virus (Mtv-7). We expect that the analysis of the virus genome will produce information whether the effects described here can be attributed to the virus or not. PMID- 1783421 TI - Analysis of thymic stromal cell subpopulations grown in vitro on extracellular matrix in defined medium. III. Growth conditions of human thymic epithelial cells and immunomodulatory activities in their culture supernatant. AB - We report here on a new approach to the cultivation of human thymic epithelial (HTE) cells, which apparently allows more faithful preservation of cell function. This approach, previously developed by us for mouse thymic epithelial (MTE) cells, is based on the use of culture plates coated with extracellular matrix (ECM), and on the use of serum-free, growth factor-supplemented medium. The nutritional requirements of HTE and MTE are somewhat different. Although both are critically dependent on ECM and insulin, they differ in their dependency on other growth factors: selenium and transferrin are much more important for HTE cells, whereas epidermal growth factor and hydrocortisone play a more essential role in MTE cultures. The epithelial nature of the cultured cells is indicated by positive staining with anti-keratin antibodies and by the presence of desmosomes and tonofilaments. The ultrastructural appearance of the cells further suggests high metabolic and secretory activities, not usually found in corresponding cell lines. The culture supernatant (CS) of HTE cells exhibited a strong enhancing effect on thymocyte response to Con A stimulation, as measured by cell proliferation and lymphokine production. The effect was observed on both human and mouse thymocytes, but was much stronger in the homologous combination. Thymic factors tested in parallel did not have such a differential effect. The dose effect relationships were in the form of a bell-shaped curve, with fivefold enhancement of response at the peak and a measurable effect even with 1:1000 dilution, when human thymocytes were used. The responding thymocytes were those which do not bind peanut agglutinin and are resistant to hydrocortisone. The culture system described here may have advantages for the in vitro study of thymic stromal cell function. PMID- 1783422 TI - Phenotypic analysis of splenic lymphocytes and immunohistochemical study of hepatic granulomas after a murine infection with Salmonella abortusovis. AB - Infection in mice with an attenuated strain of Salmonella abortusovis (SAO), a specific pathogen for sheep, was used as a convenient model to understand further the induced immunity against SAO. The hypovirulent Rv6 strain, subcutaneously inoculated in salmonella-susceptible BALB/cby (Itys) mice, colonized the spleen and the liver in less than 6 days post-infection (PI) to be cleared after Day 28 PI. Simultaneously, an increase in spleen cell numbers, splenomegaly and hepatic granulomatous lesions developed to a maximum level on Day 9 PI. In spleen of uninfected mice, the number of Thy-1.2+ cells represents twice the number of surface immunoglobulin-positive cells (sIg+). Cytofluorometric analysis of the spleen lymphoid cell subsets showed a significant increase (10 times, P less than 0.05) in the number of sIg+ cells from Day 6 to Day 28 PI compared to control values. The number of Thy-1.2+ cells also significantly increased, to a lesser degree than the sIg+ cells, on Day 2 and on Day 16 PI (twice control values, P less than 0.05), but decreased on Day 6 PI compared to Day 2 PI. The highest L3T4+:Lyt-2+ ratio was observed on Day 2 PI and the lowest on Day 9 PI. On Day 28 PI, the number of sIg+ cells was still greater than the number of Thy-1.2+ cells. The granulomatous lesions were observed in the liver as early as Day 2 PI and their frequency was maximal on Day 9 PI. Immunohistochemical analysis of the granulomatous lesions showed that macrophages (F4/80+, Mac1+) were the basic cells and that L3T4+ cells were the predominant T cells. In well-developed granulomas observed on Day 9 PI, macrophages were in the centre whereas L3T4+ T cells were preferentially located at the periphery. T cells expressing Lyt-2 antigen were rarely detected. Variations in the proportion of lymphoid cells in the spleen and in hepatic granulomatous lesions suggest different and complementary effector mechanisms in induced immunity against SAO. PMID- 1783423 TI - The surface phenotypic characterization of lung macrophages in C3H/HeJ mice. AB - We have investigated the surface phenotypic profile of murine lung macrophages in frozen tissue sections, in single-cell suspensions obtained by endobronchial lavage, and in collagenase digests of parenchymal lung tissue, using a panel of monoclonal antibodies directed against pan macrophage markers and antigens present on distinct lymphoid-associated macrophage subpopulations. Our results indicate that lung macrophages from specific pathogen-free (SPF), lipopolysaccharide (LPS) hyporesponsive C3H/HeJ mice are relatively homogeneous no matter what lung tissue compartment they are obtained from. Their predominant surface phenotype was F4/80weak, M1/70-, MOMA-2+, NLDC-145+, MOMA-1+, SER-4+, which resembles the pattern of expression by lymphoid macrophages rather than representative tissue macrophages such as those found in the peritoneal cavity. These results are consistent with the current paradigm that lung macrophages, like lymphoid macrophages, play an important immunoregulatory role within their microenvironment. PMID- 1783424 TI - Echinococcus multilocularis antigens modify accessory cell function of macrophages. AB - Peritoneal macrophages and splenic lymphocytes were collected from BALB/c mice, normal or previously infected with Echinococcus multilocularis. In an accessory cell function assay, peritoneal macrophages, in increasing numbers, were added to cultures of splenic lymphocytes. Cultures were stimulated by concanavalin A (Con A) or E. multilocularis culture supernatant (EMSN). Post-infection macrophages, unlike normal macrophages, suppressed Con A- and EMSN-driven lymphocyte transformation. Modification of accessory cells could also be repeatedly induced in vivo by EMSN or a single FPLC fraction of EMSN. Lymphocytes were made more sensitive to accessory cell signals following incubation with EMSN. PMID- 1783425 TI - The comparative effects of cyclosporin A and 16,16 dimethyl prostaglandin E2 on the allogeneic induction of monocyte/macrophage procoagulant activity and the cytokines macrophage procoagulant inducing factor and interleukin-2. AB - It has recently been reported that combination immunotherapy utilizing cyclosporin A (CsA) and prostaglandin E (PGE) reduced the frequency of acute renal allograft rejection; however, the mechanism for the benefit of this combination therapy is uncertain. Since our previous studies have suggested that macrophage procoagulant activity (PCA) is an important mediator of allograft rejection, in this study we have examined the effects of CsA and 16,16 dimethyl prostaglandin E2 (dmPGE2) alone and in combination on the induction of macrophage PCA and on the lymphokines macrophage procoagulant-inducing factor (MPIF) and interleukin-2 (IL-2) in vitro. Alloantigen-induced MPIF activity could be detected within 8 hr, reaching maximal levels by 12 hr and could still be detected at 24 hr. Allogeneic induction of PCA in splenic mononuclear cells was detectable by 24 hr, reaching maximal levels at 72 hr and was still detectable after 120 hr. CsA at concentrations from 100 ng/ml to 1000 ng/ml completely inhibited production of MPIF and IL-2, but had minimal effects on the ability of MPIF to induce isolated macrophage to express PCA. In contrast, dmPGE2 (10(-12) 10(-6) M) inhibited both the induction of MPIF and the ability of MPIF directly to induce macrophages to express PCA, with lesser effects on the induction of IL 2. The effects of minimal inhibitory concentrations of CsA and dmPGE2 in combination resulted in synergistic inhibition of PCA induction. These data demonstrate the disparate actions of CsA and dmPGE2 on inhibition of PCA, MPIF and IL-2, and provide a possible mechanism for the beneficial effects of combination CsA and dmPGE2 in patients receiving organ allografts. PMID- 1783426 TI - Human recombinant macrophage colony-stimulating factor (M-CSF) increases Cl esterase inhibitor (Cl-INH) synthesis by human monocytes. AB - The ability of macrophage colony-stimulating factor (M-CSF) to influence production of complement proteins by cultured human monocytes was studied. Three day-old cultures of human monocytes were treated with 250-1000 U/ml recombinant human M-CSF (Cetus Corporation, Emeryville, CA). After 3 days the M-CSF containing medium was replaced by the same medium without M-CSF, and the cells were cultured for 3 more days. Samples taken at the removal of M-CSF and 3 days later were tested for the concentration of factor B and Cl-esterase inhibitor (Cl INH) using ELISA methods, and C2 by using an immunohaemolytic assay. M-CSF induced a marked dose-dependent increase in the synthesis of Cl-INH, but did not significantly change Bf and C2 production. The findings suggest that M-CSF is able to influence selectively the complement protein-producing ability of cultured human monocytes. PMID- 1783427 TI - Conglutinin exhibits a complement-dependent enhancement of the respiratory burst of phagocytes stimulated by E. coli. AB - Conglutinin is a mammalian C-type lectin which shows anti-bacterial activity when tested in vivo and in vitro. This study concerns the effect of conglutinin on the respiratory burst of murine spleen cells, using a chemiluminescence assay for measurement of generated reactive oxygen metabolites. Conglutinin enhances, in a dose-dependent manner, the respiratory burst of spleen cells stimulated with serum-opsonized Escherichia coli. The enhancement was only demonstrable in the presence of a functional complement system. The conglutinin-mediated enhancement of the respiratory burst was inhibited in the presence of a N-acetyl-D glucosamine, D-mannose and N-acetyl-D-mannosamine, monosaccharides reported to inhibit conglutinin-binding to zymosan and the complement factor iC3b. On the other hand, N-acetyl-D-galactosamine was non-inhibitory. PMID- 1783428 TI - Comparison of IgE expression at the mRNA and protein levels in vitro. AB - The regulating effects of IL-4 and pokeweed mitogen on IgE synthesis in vitro by human peripheral blood leucocytes has been compared with the corresponding effect of these regulators on the expression of IgE mRNA. The latter was measured by dot blot hybridization with an oligonucleotide coding for a unique six amino acid region of the CH epsilon 2 domain. Specificity of the oligonucleotide probe was established by its inability to hybridize with RNA extracted from HMY-2 (IgG) and XQ-15 (IgM) secreting cell lines whilst producing intense signals with RNA extracted from the IgE secreting cell line U266. Whilst IgE mRNA was detected in RNA extracted from PBL of both atopic and control subjects, spontaneous IgE synthesis was restricted to atopic PBL. IL-4 increased both IgE mRNA and IgE synthesis in all PBL samples but PWM, while significantly increasing IgE mRNA expression either failed to modify IgE synthesis or actively suppressed it. The assay system employed to quantitate IgE synthesis in vitro was shown to be inhibited by both IgE binding factors and IgG anti-IgE autoantibodies which are produced in PBL cultures. IgE mRNA levels might therefore more accurately monitor the regulatory effects of IL-4 and PWM on IgE synthesis than quantitation of the IgE by radioimmunoassay. PMID- 1783429 TI - Re-organization of the immunoglobulin kappa gene on both alleles is not an obligatory prerequisite for Ig lambda gene expression in human cells. AB - Re-arrangement and expression of the immunoglobulin (Ig) genes in B cells occurs under an ordered developmental control. The sequential model of Ig light chain exclusion predicts that only after non-productive re-organization or deletion of both Ig kappa alleles would re-arrangement of Ig lambda gene segments occur. To prove this model, we asked whether expression of Ig lambda light chains is always associated with rearrangement and/or deletion of both Ig kappa alleles in human cells. Therefore, we established human diploid B-cell clones in vitro that produce Ig lambda light chains. Southern blot analysis of the Ig kappa alleles revealed that three Ig lambda expressing cell lines (out of six Ig lambda+ cell lines tested) harbour one Ig kappa allele in germline configuration. Furthermore, a 1.5 kb RNA derived from the germline Ig kappa locus was detected by Northern blot hybridizations. The results implicate that the mechanism of Ig light chain exclusion is not precisely sequential and that it does not necessarily need re arrangement or deletion of both Ig kappa alleles as a prerequisite for Ig lambda light chain expression in human cells. PMID- 1783430 TI - Defined chemically cross-linked oligomers of human C-reactive protein: characterization and reactivity with the complement system. AB - Chemically cross-linked C-reactive protein (CRP) oligomers were prepared and characterized, and C1q binding and C activation were investigated. Purified human CRP was polymerized in the presence of both non-cleavable and cleavable cross linking agents and further separated by Superose 12 analytical FPLC column chromatography into fractions of 110 KDa (pentameric monomers), 220 KDa (dimers) and 330 KDa (trimers); virtually no larger oligomers were formed under a variety of experimental conditions. CRP subunits were cross-linked both within and between CRP pentamers. CRP trimers retained native CRP antigenicity without expression of neo-CRP epitopes. CRP trimers showed maximal binding and CRP dimers showed partial binding of solid phase C1q while CRP monomers bound virtually no C1q at all; CRP trimers also bound to fluid phase C1q. Binding was Ca++ independent and increased as the ionic strength or pH were lowered, characteristics comparable to binding of aggregated IgG to C1q; it was not inhibited by phosphorylcholine. CRP trimers consumed total C, C1 and C2 haemolytic activities upon incubation in fresh human serum, but much less efficiently than did CRP-protamine complexes or Agg-IgG. CRP trimers failed to deplete alternative C pathway haemolytic activity at all. The stable, chemically defined CRP oligomers described in this report, which bind C1q efficiently but display poor ability to activate the classical C pathway in the absence of an appropriate ligand, should be valuable in further studies of the interactions between CRP and the C system. PMID- 1783431 TI - A gene(s) within the H-2D region determines the development of toxoplasmic encephalitis in mice. AB - Studies were performed in a murine model to determine if there is genetic control of the development of toxoplasmic encephalitis. Ten weeks after infection with the ME49 strain of Toxoplasma gondii, mice with the H-2b haplotype (C57BL/6, C57BL/10) and H-2k haplotype (C3H/He, CBA/J) developed remarkable inflammatory changes in their brains, whereas mice with the H-2a haplotype (A/J) and H-2d haplotype (BALB/c, DBA/2) did not. In the area of acute focal inflammation in mice with the H-2b and H-2k haplotypes, tachyzoites and toxoplasma antigens were demonstrated by immunoperoxidase staining, suggesting that the focal inflammation was induced by toxoplasma organisms. B10 congenic mice were used for further analysis of this genetic regulation. Presence of the encephalitis in B10 and B10.BR but not in B10.A and B10.D2 mice at 10 weeks after infection indicated regulation of the inflammation by a gene(s) within the H-2 complex. The encephalitis developed in B10.A (2R) and B10.A (4R) mice but not in B10.A (3R) and B10.A (18R) during infection. These results clearly indicated that the development of toxoplasmic encephalitis was controlled by a gene(s) in the H-2D region. The Qa and Tla genes did not appear to be critical in determining susceptibility to the encephalitis. There was no correlation between serum toxoplasma antibody titres and occurrence of the encephalitis. Injection of a monoclonal antibody to interferon-gamma (IFN-gamma) remarkably augmented the inflammatory changes in the brains of the infected B10 mice. In contrast, the treatment did not induce any inflammatory response in the brains of the infected BALB/c mice. A similar genetic regulation may be operative in determining development of toxoplasmic encephalitis in AIDS and other immunocompromised patients. PMID- 1783433 TI - Primary hyperparathyroidism: presentation and management. AB - 164 hypercalcemic patients were examined to determine the co-relation, frequency and mode of presentation of primary hyperparathyroidism. Primary hyperparathyroidism was diagnosed in 11 patients (6.7%). All of them presented late with renal and bony complications. The incidence of primary hyperparathyroidism appears to be lower than that of the western countries, and the introduction of routine serum calcium estimates can be expected to yield more cases of primary hyperparathyroidism especially asymptomatic cases. PMID- 1783432 TI - Anti-idiotypic monoclonal antibodies reacting with idiotope on isolated-denatured chains of an anti-CD4 monoclonal antibody. AB - Hybridization of a non-secreting mouse myeloma cell line NSO with splenocytes from a BALB/c mouse hyperimmunized with the anti-CD4 monoclonal antibody (mAb) HP2/6 generated the anti-idiotypic (anti-id) mAb F11-2113, F11-2302 and F11-2444, which recognize idiotope(s) (id) that are the same or spatially close to each other and are located outside the antigen-combining site of the immunizing mAb. Binding and inhibition assay showed that id are not expressed either on other mouse anti-CD4 mAb or polyclonal immunoglobulins (Ig). Western blotting analysis showed that the id defined by anti-id mAb F11-2113, F11-2302 and F11-2444 are similarly expressed on separated heavy and light chains of mAb HP2/6 and suggested they are likely to be 'sequence-dependent' since their expression is conserved following SDS and reducing reagents treatment. This finding is unique inasmuch as 'sequence-dependent' id similarly expressed on heavy and light chains have been described only on a mouse monoclonal auto-antibody with immunoregulatory properties. PMID- 1783434 TI - Rapid cultivation of Mycobacterium tuberculosis in Veeraraghavan's liquid medium. AB - 2015 clinical samples were screened for M. tuberculosis culture in Veeraraghavan's liquid medium V (T). The liquid medium is a synthetic medium rich in amino acids, vitamins, sugars and mineral salts. Initially 111 consecutive samples of sputum and various body fluids were cultured in both LJ medium and liquid synthetic medium for comparison. As liquid medium gave satisfactory and quicker results the subsequent 1904 samples were cultured only on liquid medium to determine its usefulness in routine work. A total of 215 of the 243 ZN smear positive samples successfully grew within 48 hours in the liquid culture medium. Drug sensitivity was performed on the positive cultures at 10, 20, 40 and 80 micrograms/ml concentrations in the liquid medium with RNA. The sensitivity results were obtained within next 48 hours. The sensitivity tests on the cultures under study revealed highest sensitivity to Rifampicin and lowest to Isoniazid. Identification and pigment production of the mycobacterial culture was also done successfully in Veeraraghavan's liquid medium. The liquid medium is cost effective and is recommended for routine use. PMID- 1783435 TI - Naphthol and lens. AB - Alpha and beta naphthols, the metabolites of naphthalene, a cataractogenic agent, was tested for it's effect on sheep lens proteases and their inhibitors. It reduced protease activities, not that of inhibitor activities of lens proteins. It also increased the efflux of free amino acid from lenses which was retarded by a high concentration of tissue galactose. PMID- 1783436 TI - Humoral immune reactions in tuberculous meningitis. AB - Humoral immune reactions as reflected in sera and cerebrospinal fluid (CSF) of 50 patients with Tuberculous meningitis (TBM) were studied. CSFs and sera from 50 patients with nontuberculous neurological diseases were selected as controls. CSFs of patients with TBM showed high titres of circulating antimycobacterial antibodies than in nontuberculous subjects. The CSF-IgG index is significantly higher in patients with TBM. Humoral immune reaction could be applied in the laboratory diagnosis of TBM, particularly when repeated bacteriological methods are negative for M. tuberculosis in CSFs. PMID- 1783437 TI - Reproductive transplantations: the present and future. AB - Transplantation of reproductive organs have been unsuccessful to date because transplantation models utilised have never taken into consideration the vascular models of the reproductive system especially that of the female. This article examines the future of large organ transplantation in reproductive system and also the transplantation of cellular and tissue components as in embryo transfers. It also examines the future of such research procedures as embryo splicing, nuclear gene injections and transplantation in reproductive technologies. PMID- 1783438 TI - [Preprosthetic mucogingival surgery. Epithelial-connective tissue onlay graft to an edentulous site]. PMID- 1783439 TI - General remarks on cephalosporins and semisynthetic penicillins--aspects of clinical administration. PMID- 1783440 TI - Pharmacological properties of cephalosporins. AB - The cephalosporins differ in the substituents attached at the 3 and/or 7 positions of the molecule. Very schematically, substitution at C3 mainly modifies the overall pharmacokinetic properties whereas substitution at position 7 influences the antibacterial characteristics. When using the more common "generation" system for classification, three generations can be distinguished on the basis of their antibacterial spectrum, potency, and their stability to beta lactamases. The first generation cephalosporins have similar antibacterial and pharmacokinetic characteristics. C3-esterified cephalosporins (e.g. cephalothin and cephapirin) are significantly metabolized. The so-called second generation cephalosporins exhibit only minor differences with respect to the pharmacokinetic properties in contrast to the third generation cephalosporins. The apparent volumes of distribution of most cephalosporins range between seven and 20 1, indicating that they mainly stay in the extracellular space. Plasma protein binding is variable from compound to compound. Generally, the major route of elimination of most cephalosporins is via the kidney except for cefoperazone and ceftriaxone which are both excreted to a large extent by the biliary route. With the exception of cefonicid, cefotetan and cefriaxone, which have longer elimination half-lives (i.e. 4.5, 3.5 and around eight hours), all other cephalosporins have a half-life ranging from 0.5 to 2.5 hours. The pattern of adverse reactions is comparable for all the cephalosporins although there are slight differences in both the incidence and the type of reactions. The major categories of adverse reactions are gastrointestinal, dermatologic, hypersensitivity, haematologic, hepatic, renal as well as CNS effects. Alcohol intolerance (antabus-like effect) can occur when cephalosporins containing the NMTT moiety are administered concomitantly.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783441 TI - The meaning of the development of flomoxef and clinical experience in Japan. AB - Flomoxef is a fourth generation cephem which has the same activity against gram negative bacteria as the third generation cephems, but is also active against gram-positive organisms, especially most methicillin resistant Staphylococcus aureus (MRSA). As flomoxef induces the smallest amount of PBP-2' among all cephems, it is hoped that this will be the cephem that is able to control the increase of MRSA. High plasma levels in proportion to dosage are seen with flomoxef, the transfer to various body fluids and tissue is good, and the half life in the plasma is about 50 min. Most of the compound is excreted in the urine in the unchanged form, that is 85% in 6 h. Clinical trials in 2,494 cases with various infections showed an excellent to good response in 77.1%, and an antibacterial effect of 80 to 100%. The efficacy rate against MRSA was 83.3%. The type and incidence of side effects was common to those of other injectable cephems, and no spermatogenic or hematological side effects were observed. PMID- 1783442 TI - Interpretive criteria of antimicrobial disk susceptibility tests with flomoxef. AB - 320 recently isolated pathogens, 20 strains from each of 16 species, were investigated using Mueller-Hinton agar and DIN as well as NCCLS standards. The geometric mean of the agar dilution MICs of flomoxef were 0.44 mg/l for Staphylococcus aureus, 0.05 mg/l (Klebsiella oxytoca) to 12.6 mg/l (Enterobacter spp.) for enterobacteriaceae, 33.1 mg/l for Acinetobacter anitratus, 64 mg/l for Enterococcus faecalis, and more than 256 mg/l for Pseudomonas aeruginosa. For disk susceptibility testing of flomoxef a 30 micrograms disk loading and the following interpretation of inhibition zones using the DIN method were recommended: resistant-up to 22 mm (corresponding to MICs of 8 mg/l or more), moderately susceptible-23 to 29 mm (corresponding to MICs from 1 to 4 mg/l), and susceptible-30 mm or more (corresponding to MICs of 0.5 mg/l or less). The respective values for the NCCLS method using the American high MIC breakpoints are: resistant--up to 14 mm (corresponding to MICs of 32 mg/l or more), moderately susceptible--15 to 17 mm (corresponding to MICs of 16 mg/l), and susceptible--18 mm or more (corresponding to MICs of 8 mg/l or less). PMID- 1783443 TI - In vitro activity of flomoxef and cefazolin in combination with vancomycin. AB - 207 clinical isolates from strains of patients from the University Children's Hospital of Kiel were investigated for their in vitro activity with the agar dilution method against flomoxef and cefazolin (alone and partially in combination with vancomycin). Staphylococci were also tested with other cephalosporins (cefoxitin, cefamandole, cefotaxime, cefotetan and latamoxef). Flomoxef and cefazolin always acted more vigorously on staphylococci than the other cephalosporins. Resistance of Staphylococcus aureus strains against flomoxef and cefazolin did not occur but was found in 15 and 5 of 98 Staphylococcus epidermidis strains, respectively. Enterococcus faecalis strains were always resistant against both drugs; Streptococcus faecium strains were only moderately sensitive. Combined testing of flomoxef or cefazolin with vancomycin showed synergism in almost all staphylococcal strains. Synergism was stronger when S. epidermidis strains were only weakly sensitive to or resistant against flomoxef and cefazolin in comparison to highly sensitive strains. Flomoxef (or cefazolin) acted synergistically in combination with vancomycin on E. faecalis and S. faecium with the exception of two strains of E. faecalis which showed an additive effect of both drugs. PMID- 1783444 TI - The in vitro activity of flomoxef compared to four other cephalosporins and imipenem. AB - The antibacterial activity of the oxacephalosporin flomoxef was evaluated in comparison to cefpirome, cefuzoname, cefotaxime, ceftazidime, and imipenem against fresh clinical isolates. Flomoxef is an antibiotic with strong antibacterial activity against staphylococci including methicillin-resistant strains and streptococci with the exception of Enterococcus faecalis and Enterococcus faecium. It is very active against gram-negative cocci and rods including gram-positive and gram-negative anaerobes. Against Pseudomonas sp. flomoxef has no activity. PMID- 1783445 TI - Effect of flomoxef on blood coagulation and alcohol metabolism. AB - The effect of flomoxef, a newly developed oxacephem antibiotic with an N hydroxyethyltetrazolethiol (HTT) side chain, on blood coagulation and alcohol metabolism was compared with that of a series of cephalosporin antibiotics with N methyltetrazolethiol (NMTT), thiadiazolethiol (TDT) or methylthiadiazolethiol (MTDT) side chains in position 3' of the cephalosporin nucleus known to cause hypoprothrombinemia and bleeding in patients who are malnourished, debilitated and/or of high age. A disulfiram-like effect caused by inhibition of aldehyde dehydrogenase was observed for NMTT-containing antibiotics. Studies were carried out on healthy volunteers and on rats. Eight-day treatment with 2 g flomoxef i.v. once or twice daily in five and six healthy male volunteers, respectively, did not cause any significant changes in prothrombin time (PT), coagulation factors II, VII, IX or X, in hepaplastin values or fibrinogen levels, activated partial thromboplastin time (APTT), platelet counts, bleeding time, or collagen- and ADP induced platelet aggregation. Inhibition of vitamin K epoxide reductase was observed in rats treated with flomoxef, yet to a much lesser extent than observed for cephalosporins with NMTT, TDT or MTDT side chains. This defect was quickly normalized by vitamin K injection. There were no differences between oxacephem (1 O) and cephem (1-S) compounds with respect to effects on blood clotting and platelet aggregation. Flomoxef and its side chain HTT showed no influence on alcohol metbolism. PMID- 1783446 TI - Pharmacokinetics and hemostasis following administration of a new, injectable oxacephem (6315-S, flomoxef) in volunteers and in patients with renal insufficiency. AB - Flomoxef is a new oxacephem of broad antibacterial activity. The compound is mainly excreted through the kidneys. Two dose finding studies in patients with various degrees of renal insufficiency revealed that the dosage of flomoxef has to be reduced exactly according to the renal function. Although the N methylthiotetrazole group has been replaced by a hydroxyethyl group, an inhibitory effect of flomoxef on vitamin K metabolism persisted. This effect was, however, less pronounced than with latamoxef. Only patients with low vitamin K stores are endangered. For those in whom low vitamin K stores are suspected repeated controls of prothrombin time are advised during the treatment. In contrast to latamoxef the platelet system was not affected by flomoxef. With the exception of loose stools in some patients no other clinical side effects during treatment were observed. PMID- 1783447 TI - Cascade filtration for familial hypercholesterolemia. PMID- 1783448 TI - Ascorbic acid derivatives in two different fractions of uremic toxins. AB - The middle-molecular-weight uremic toxins which accumulate in uremic plasma seem to be associated with various uremic disorders such as uremic neuropathy and defects in the sodium pump. By a multi-step chromatographic method, two fractions of these toxins were isolated and studied because one inhibits microtubule formation in vitro (fraction 2-5), and the other impairs the sodium pump in living erythrocytes (fraction 2-3). An additional chromatographic method allows the separation of these fractions and isolation of two components: fractions 2-3 V and 2-5-III. Analyses by UV and 1H NMR spectrometry identified these compounds as two different ascorbic acid derivatives. 2-3-V is not yet totally identified and 2-5-III corresponds to ascorbic acid 2-sulfate. These two metabolites exert no toxic effects but they have the same chromatographic behavior as uremic toxins. PMID- 1783449 TI - Extracorporeal CO2 removal with hemodialysis (ECBicCO2R): how to make up for the bicarbonate loss? AB - Hemodialysis is a powerful tool for extracorporeal CO2 removal, because CO2 can be eliminated both as gas and as bicarbonate with blood flow rates as low as 10 15 ml/kg/min. An unsolved problem remains, however: how to make up for the bicarbonate loss. In an animal model we investigated three methods of realkalinisation: a) indirect alkalinisation with salts of organic anions (acetate, lactate, citrate, pyruvate, fumarate, succinate, malate) b) direct realkalinisation with hydroxyl ions (NaOH) c) direct alkalinisation with TRIS as "CO2-buffer". a) The decrease of pulmonary CO2 elimination depended on metabolism: acetate and lactate were metabolized at a rate of 1.8-3.5 mmol/min, thus allowing a steady-state elimination of 40-75 mmol CO2/min (25-40% of CO2 production). The other organic acids were not metabolized sufficiently to achieve a measurable reduction of pulmonary CO2 elimination. CO2 removal was quantitatively the same as during routine acetate hemodialysis and could not be increased using other organic acids. b) NaOH alone, through theoretically the best substitute for NaHCO3, had serious side effects and led to an increase in pulmonary artery pressure. c) with TRIS at a rate of 5 mmol/min, all metabolic CO2 could be removed for up to seven hours without clinical side effects, but not for longer periods. We conclude that a combination treatment for realkalinisation has to be worked out to compensate for the bicarbonate loss. PMID- 1783450 TI - Aging of silastic peritoneal catheters. AB - Increasing the survival of patients on CAPD is related to the long-term reliability of the peritoneal access. Six silicone Tenckhoff catheters (with strip or diffuse barium sulphate inclusion) removed after 39-69 months because of the appearance of external segment fissures, were analysed by scanning electron microscopy (SEM) and infra-red spectroscopy with attenuated total refractance (ATR). The extracorporeal portion of the catheters showed (by ATR) a more prominent oxidation peak on the external than the internal surface; SEM showed marks and cracks on the external surface and exfoliation and flattening of the silastic reticle on the intraluminal surface. No evidence of oxidation was found in the intra-abdominal portion of the catheters but biofilm was found. We suggest that barium sulphate may render the silastic brittle and physiological and environmental long-term factors (such as uv-rays, temperature, sweat and disinfectants) could cause oxidation and loss of physico-chemical properties, with critical aging of the silastic and loss of catheter resistance to mechanical injury. PMID- 1783451 TI - Extracorporeal membrane oxygenation (ECMO): extended indications for artificial support of both heart and lungs. AB - Extracorporeal membrane oxygenation (ECMO) was used to achieve temporary artificial support in cardiac and pulmonary function in 22 patients from 1987 to September 1990. Standard indications were postcardiotomy cardiogenic shock (n = 4), neonatal (n = 1) and adult respiratory distress syndrome (n = 4). ECMO was also used for extended indications, such as graft failure following heart (n = 11) or lung transplantation (n = 2). In six of these cases ECMO was instituted as a bridge device to subsequent retransplantation of either the heart (n = 4) or one lung (n = 2). One out of nine patients supported by ECMO for standard indications, and two out of 13 patients supported for extended indications are long-term survivors. This series illustrates the results with ECMO in emergency situations, in patients under immunosuppressive protocols, or in patients with advanced lung failure requiring almost complete artificial gas exchange. In such complex situations, ECMO does provide stabilization until additional therapeutic measures are in effect. ECMO cannot be recommended for postoperative cardiogenic shock but short-term ECMO support is an accepted method in most cases with graft failure or pulmonary failure or other origin. PMID- 1783452 TI - Calves chronically implanted with a total artificial heart as a pharmacological model. AB - Pharmacological therapy for congestive heart failure includes drugs that have both inotropic and vasoactive effects, although it is sometimes difficult to differentiate between the two effects. An animal with an implanted total artificial heart (TAH) allows the investigation of the vascular effect of these drugs in the absence of the effect on the myocardium. An advantage of the TAH model is its sensitivity to changes in right and left ventricular preload and afterload. Four instrumented TAH calves were given vasoactive drugs and the response was compared to control. Epinephrine, dopamine, isoproterenol, and nitroprusside were selected because of the predictability of their responses. Epinephrine caused a significant increase in systemic vascular resistance (SVR), and dopamine caused a significant increase in Pulmonary vascular resistance (PVR) and Isoproterenol caused a significant decrease in PVR. TAH implanted calves can thus serve as a pharmacological model to study the vascular response, which may be useful in investigation of new agents with inotropic and vascular effects. PMID- 1783453 TI - Static and dynamic stresses during valve closure of a bileaflet mechanical heart valve prosthesis. AB - The effect of contact geometry and component compliance on the magnitude, distribution, and state of various types of stresses on a bileaflet mechanical heart valve prosthesis during valve closure was analyzed using an Edwards Duromedics mitral valve as example. Static and dynamic stresses developing on both the leaflet and pivot ball during valve closure were modeled using finite element analysis (FEA). Uniform contact between the leaflet and housing as well as between the pivot ball and pivot slot can significantly reduce both static and dynamic stresses around the contact area. The level of the dynamic flexural stresses can be an order of magnitude higher than that of the static stresses. When both the radial and axial compliance of the housing are taken into consideration, peak dynamic stress was more than 40% less than that generated through the impact between a moving leaflet and a non-compliant rigid housing. PMID- 1783454 TI - Immunoprotection of pancreatic islet grafts within artificial microcapsules. AB - To circumvent pancreatic islet graft-directed immune destruction we enveloped porcine islets within highly biocompatible and selectively permeable algin/polyaminoacid microcapsules. These special microspheres were deposited between the inner (permeable) and the outer (impermeable) layers of an artificial, coaxial vascular prosthesis, directly anastomized to blood vessels. Five dogs with spontaneous, insulin-dependent diabetes received microencapsulated porcine islets in arterio-vein iliac prosthesis by-passes. One showed complete and the remainder partial, sustained reversal of hyperglycemia. Microencapsulation may be a potential solution to immunological problems related to islet transplantation. PMID- 1783455 TI - Improved on-line thoracic duct drainage for lymphocytapheresis. AB - Lymphocytapheresis using thoracic duct drainage (TDD) is a recognized technique of extracorporeal immunomodulation for various autoimmune diseases such as rheumatoid arthritis (RA), and its clinical benefit has been reported and generally accepted. Lymphocytapheresis using TDD is very selective for removing lymphocytes (especially helper T-cells) but raises some problems such as hypoproteinemia due to the massive removal of lymph, and difficulties in repeated treatment. Along with the development of a new polyester fiber filter, we have developed a simple and effective method of lymphocytapheresis for wide adoption for these techniques. We performed lymphocytapheresis using TDD in patients with RA and previously reported its clinical efficacy indicated by the significantly lower number of peripheral lymphocytes and T4/T8 ratio. We present here our newly developed on-line system designed to prevent hypoproteinemia. Furthermore we report on the advantages with a new subcutaneous vascular access device set up to manage the problems of repeated treatments. A small reservoir for keeping the thoracic duct open and returning lymph to the patient permitted sufficient lymph drainage and removal of lymphocytes and the clinical application of TDD is discussed. PMID- 1783456 TI - Physico-chemical and pharmacological comparison of pyridoxylated hemoglobin bound to polyoxyethylene or polymerized by glutaraldehyde. AB - Two modified hemoglobin solutions were assessed using the same physico-chemical and pharmacological techniques. The first was prepared by covalent binding of monomethoxypolyoxyethylene (MPOE) 1.9 kDa to pyridoxylated hemoglobin (PLP-Hb). The resulting conjugate had a molecular size of 100 kDa (MPOE-PLP-Hb). The solution was cleared of non-fixed MPOE through ion exchange chromatography on Spherodex, thus bringing viscosity and oncotic pressure back to physiological values. The second was prepared by limited polymerization of pyridoxylated hemoglobin with glutaraldehyde (POLY-PLP-Hb). Tangential flow ultrafiltration achieved a satisfactory polymer/oligomer return. Quality controls showed no difference between the solutions. Total isovolemic exsanguinotransfusions in the rat did not help differentiate the two solutions. Hemorrhagic shock (80% of blood volume, rat) gave definitive survival for 8 of the 14 animals tested with MPOE PLP-Hb (57%) but only 3 of the 8 animals tested with POLY-PLP-Hb (38%). None of the chemical approaches to reduce hemoglobin loss proved any more efficient than another, with the evaluation techniques employed. PMID- 1783457 TI - Alteration in progression of murine autoimmune disease by treatment with a novel immunomodulator, SM-8849. AB - The effects of SM-8849 on the development of autoimmune disease in MRL/Mp-1pr/1pr mice were examined. SM-8849 improved survival as well as renal disease, restored the deficits in splenic cell responsiveness to stimulation by mitogens or conventional antigens, and prevented lymphadenopathy and splenomegaly coincident with a decrease in the number of Thy-1+/Lyt-2-/L3T4- cells. SM-8849 also suppressed the production of the B-cell differentiation factor, possibly with a resulting preferential reduction of autoantibodies. In addition, SM-8849 depressed the production of hydrogen peroxide from macrophages. These results suggest that the administration of SM-8849 to a subject with autoimmune diseases can induce immunological improvements with possible clinical effectiveness. PMID- 1783458 TI - Preferential reductions in lymphocyte sub-populations induced by monthly pulses of chlorambucil: studies in patients with chronic progressive multiple sclerosis. AB - Thirty-three patients with chronic progressive multiple sclerosis (MS) were assigned to intervention groups receiving monthly pulses of chlorambucil (CB) for about one year. The monthly doses ranged from 0.4 to 1.5 mg/kg. Administration of CB resulted in preferential reduction in different lymphocyte subsets which was dose- and time-dependent. The number of B-cells (CD20) decreased more rapidly than NK-cells (CD16, CD56, CD16+CD56+) or T-cell (CD3) and T-cells subsets (CD4 and CD8). At 1.2 mg/kg, CB administration resulted in a preferential drop of T suppressor/cytotoxic cells (CD8) compared with T-helper cells (CD4), and of the less mature "virgin" CD4 cells (CD4+CD45RA+) compared with "memory" CD4 cells (CD4+CD45RA-). The expression of activation markers (transferrin receptor, CALLa, HLA-Dr and CD38[OKT10]) within CD4, CD8 or CD20 lymphocytes was not altered by CB administration. Our data, which show that CB administration results in a preferential fall in B-cell numbers, contrast with the effects of long-term administration of the related immunosuppressive drugs, azathioprine and cyclophosphamide. PMID- 1783459 TI - Urinary biopterin levels in mice during graft-versus-host reactions and during exposure to 5,5-diphenylhydantoin. AB - Based on evidence that urinary neopterin levels are useful markers of disordered cellular immunity in man, we investigated murine urinary biopterin excretion during acute and chronic graft-versus-host (GvH)-reactions as well as after oral exposure to drugs with documented immune disregulating potential in man. Biopterin levels were determined in urine spot samples by reversed-phase high performance liquid chromatography and expressed in relation to the urinary creatinine content. Similarly increased and decreased biopterin levels were observed during acute and chronic GvH-disease in (C57BL/6J x DBA/2J)F1 (B6D2F1) mice. Increased and/or decreased levels of urinary biopterin were observed during treatment with 5,5-diphenylhydantoin (DPH), methimazole, propylthiouracil and nitrofurantoin, but no consistent pattern could be distinguished. The DPH-induced alterations were similar in B6 and B6D2F1 mice, were dose-dependent, reversible and independent of mature T-cells, as judged by the pronounced biopterin excretion of B6-nu/nu mice in comparison with their T-cell competent litter mates. The results indicate that monitoring of urinary biopterin excretion in mice does not represent a useful biochemical marker for T-cell activation. PMID- 1783460 TI - Augmentation of cytotoxicity of tumor-infiltrating lymphocytes by biological response modifiers. AB - Lymphocyte infiltration into a tumor has been regarded as an expression of host immunity against cancer, but tumor-infiltrating lymphocytes (TIL) have little or no cytotoxicity. This study examined two different approaches to augment this low cytotoxicity. Firstly, biological response modifiers (OK-432, PSK) were injected into gastric cancer intralesionally. Intralesional injection of OK-432 or PSK significantly augmented the cytotoxicity of TIL. By the injection of OK-432, the ratio of OKT8-, Leu7-positive cells were increased in the TIL subset. In the second approach, TIL of gastric or pulmonary cancer patients were cultured with interleukin-2 (IL-2) in vitro. Co-culturing with IL-2 augmented the low cytotoxicity of TIL, and broad-reactive lymphokine-activated killer (LAK) cells were generated from TIL. PMID- 1783461 TI - Effects of saikosaponin-d on the functions and morphology of macrophages. AB - The effects of saikosaponin-d, isolated from Bupleurum Radix, on phagocytosis and spreading of mouse peritoneal macrophages were investigated. Macrophages from saikosaponin-d-treated mice showed a significant increase in spreading activity followed by an increase in phagocytic activity. An intense distribution of microfilaments and microtubules was also observed in these macrophages by immunofluorescence microscopy. PMID- 1783462 TI - Effect of saikosaponin on the immune responses in mice. AB - The in vivo effects of saikosaponin, isolated from Bupleurum radix, on the immune responses are still poorly understood. We have already shown that saikosaponin-d increases phagocytic activities of murine peritoneal macrophages such as spreading activity, phagocytosis, lysosomal enzyme activity and intracellular killing activity of living yeast. This work extends these observations by showing that treatment with saikosaponin also increased the antibody response in plaque forming cell numbers after in vivo immunization with sheep red blood cells (SRBC) and an augmentation of spleen cell proliferation responses to stimulation with T- or B-cell mitogens both before and after immunization. Furthermore, after SRBC immunization, the macrophages from mice treated with saikosaponin-d revealed significant increases in spreading activity and lysosomal enzyme activity. The chemiluminescences of the macrophages from mice treated with saikosaponin-d stimulated by opsonized zymosan and PMA were enhanced and interleukin-1 production by the cells was increased in a dose-dependent manner. These results demonstrate that saikosaponin-d may stimulate in vivo immunological lymphocyte functions, partly by activating some macrophage functions. PMID- 1783463 TI - Positive inotropic effect of interleukin-2. Role of phospholipases and protein kinase C. AB - Recently, we have shown that soluble factors released by human lymphocytes after lectin stimulation could increase the contractile tension of rat atria "in vitro" and that interleukin-2 (IL-2) could be part of this reaction. The effect of IL-2 was potentiated by the Ca2+ ionophore A23187 or free arachidonic acid (AA). In this study we demonstrate that the action of IL-2 can be prevented by pre incubation of the heart tissue with monoclonal anti-IL-2 receptor (anti-p55), suggesting that binding to the IL-2 receptor is necessary for the induction of the biologic effect. In the presence of A23187 or AA, the effect of the synthetic diacylglyceride oleoyl-acetyl-glycerol (OAG) was similar to that of IL-2. Elimination of phospholipase C activity by pre-incubation of the atria with 2 nitro-carboxyphenyl,N,N'-diphenylcarbamate (NCDC) abrogated the effects of IL-2 in the presence of A23187 or AA, but was ineffective when OAG + A23187 or OAG + AA was used. Inhibition of atrial phospholipase A2 activity with p-bromo phenacylbromide (BPB) blocked the response of atria to either IL-2 + A23187 or OAG + A23187 but was not effective when AA was used as second signal (IL-2 + AA or OAG + AA). Both the OAG and the IL-2 positive inotropic effects could be prevented by the protein kinase C inhibitor 1-(5-isoquinolinesulfonyl)-2-methyl piperazine (H7) but were poorly inhibited by N-(2-guanidinoethyl)-5 isoquinolinesulfonamide (HA1004), an inhibitor of the cyclic nucleotide-dependent protein kinases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783464 TI - The beta-blocker acebutolol down modulates the spontaneous polyclonal activation of lymphocytes in NZB X NZW lupus mice. AB - Acebutolol is a beta blocking agent that induces in C57Bl/6 mice a polyclonal activation of lymphocytes (PAL). In this study, its effect on cellular parameters of spontaneous PAL and lupus disease in NZB x NZW female mice is investigated. A significant reduction of PAL is found in 10-week-old mice after only five injections of 50 mg/kg/day of acebutolol. This effect is also observed in 7- and 9-month-old mice after 12 weeks of treatment. In these chronically treated mice, a significant decrease in incidence and levels of proteinuria as compared with untreated mice is found. No statistically significant increase in survival is observed. In conclusion, acebutolol down modulates the spontaneous PAL which characterizes the NZB x NZW mouse lupus disease and might prevent to some extent the development of nephritis. PMID- 1783465 TI - Down-regulation of monocyte functions by treatment of healthy adults with 1 alpha,25 dihydroxyvitamin D3. AB - A number of in vitro studies suggest an immunoregulatory role of 1 alpha,25 Dihydroxyvitamin D3 (1,25-(OH)2D3). The hormone inhibits production of interleukin-2 and immunoglobulin, and it blocks lymphocyte proliferation. Diverse effects on monocyte functions have been reported. However, immunological effects of 1,25-(OH)2D3 have not been substantiated in vivo. Six healthy male volunteers, aged 28-45 yr, were treated orally with 1,25-(OH)2D3 (tabl. Rocaltrol), 1 microgram twice daily for 7 days. Blood and urine samples were collected before and 7 days after initiation of treatment. Blood mononuclear cells from individuals treated with 1,25-(OH)2D3 showed a significantly reduced production of both interleukin-1 alpha (45%) and tumor necrosis factor-alpha (58%) (both measured by ELISA). Interleukin-6, production, measured by the B9 cell assay, was reduced in five individuals (78%), and unchanged in one. There was no effect on the release of interleukin-1 beta. There was no measurable effect on interleukin 2, interferon gamma or immunoglobulin production, or on mitogen-induced proliferation of blood mononuclear cells. Serum-osteocalcin and urine excretion of calcium were increased to 131 and 173%, respectively. The serum-calcium and serum-phosphate levels were unchanged. PMID- 1783466 TI - Selective depletion of immature thymocytes by oral administration of ethylene glycol monomethyl ether. AB - Although immunotoxicity of ethylene glycol monomethyl ether (EGME) has been strongly suspected, functional evaluation of the immune response in EGME-treated animals was negative in previous studies. We observed a decrease in thymic cellularity and increases in the various ex vivo immunological assays in mice, orally administered with EGME 0.5 or 1.0 mg/g body weight daily for 5 or 10 days: ex vivo lymphoproliferative responses to concanavalin A, in vitro induction of trinitrophenyl (TNP)-specific cytotoxic T-cell activity of thymocytes and splenocytes. Histopathological examination of the thymus of the treated mice disclosed a markedly atrophic cortex and almost intact thymic medulla. Study of thymocyte surface markers revealed that CD4+/CD8+, Thy-1+, PNA+ immature thymocytes were relatively decreased in EGME-gavaged mice and that, thus, ratios of CD4-/CD8+, H2+ mature thymocytes were enriched. These findings indicate that oral administrations of EGME selectively deplete immature thymocytes in mice. Although the mechanism of action remains unknown, the EGME-induced immature thymocyte depletion is not considered to be due to lymphocidal action of corticosteroids. PMID- 1783467 TI - Effect of the new immunostimulator HAB 439 on cell-mediated immunity against intracellular bacteria. AB - The isoxazoline derivative HAB 439 was tested for its enzyme inhibiting potency and was found to be an inhibitor of aminopeptidase B (IC50 = 22.5 micrograms/ml). In further immunopharmacological experiments its efficacy to stimulate cell mediated immunity was evaluated. HAB 439 was shown to stimulate DTH-reaction against Salmonella typhimurium and Listeria monocytogenes. HAB 439 protected animals against infection by reducing the bacterial load in livers and spleens and by decreasing the mortality rate. Treatment with the antibiotic ampicillin induced a decreased DTH-reaction in mice which was demonstrated to be due to a reduction of the antigen to be presented to the immune system and not to immune suppression. HAB 439 restored the impaired immune response to S. typhimurium and L. monocytogenes in a dose-dependent way. Restoration of DTH was shown to lead to an improvement of protection in ampicillin-treated mice which were challenged with the intracellular bacteria. PMID- 1783468 TI - Immunomopharmacological effects of polysaccharides from Acanthopanax senticosus on experimental animals. AB - Polysaccharides PES isolated from a common Oriental herb Acanthopanax senticosus were found to have a wide spectrum of immunomodulatory activities on experimental animals. The potential usefulness of these polysaccharides is suggested in the observations that PES inhibited transplanted tumor growths and ameliorated toxicities of the toxic substances in experimental animals. Of most interest is the observations that they suppressed human TB propagation in mice and guinea pigs, as evaluated by lymph node responses and OT skin tests in the guinea pig model, and the quantitation of the TB in the lungs in the mouse model. PMID- 1783469 TI - Implications of prostaglandin E2 synthesis and phospholipase C activation in potentiation of T-cell proliferation by LF 1695. AB - Murine spleen cells, T-enriched by nylon wool filtration, proliferate in the presence of a protein kinase C stimulator and a calcium ionophore. Using this cell proliferation system, we show that LF 1695 can potentiate phorbol myristate acetate (PMA) action in the presence of A 23187. This potentiation can be due to PGE2 inhibition since it is found that lipopolysaccharide (LPS) or A 23187 induced PGE2 release from spleen cells is inhibited by LF 1695. Indomethacin and LF 1695 gave similar stimulation of spleen cell proliferation, and exogeneously added PGE2 inhibits this phenomenon. Considering two of the main early components of intracellular signal transduction, LF 1695 induces IP3 release and calcium mobilization. However, the compound is not mitogenic per se. These results show that LF 1695 behaves only as a costimulant for T-cell proliferation. PMID- 1783470 TI - Differential protective activities of site specific lipoxygenase inhibitors in endotoxic shock and production of tumor necrosis factor. AB - Lipoxygenase inhibitors have been shown to exert beneficial effects in experimental models of endotoxin shock. In the present study it was found that lipoxygenase inhibitors prevented LPS, but not tumor necrosis factor alpha (TNF alpha)-evoked leukopenia in mice. These inhibitors protected against endotoxin lethality but not against TNF alpha induced lethality. When the protective potency of the specific 5-lipoxygenase inhibitors (MK 886, CGS 81585) was tested in endotoxin-induced leukopenia and shock, they were found to be ineffective. Site specificity of the inhibitors was assessed by comparison of their effects on the formation of LTC4 and the conversion of linoleic acid to 13 hydroxyoctadecadienoic acid (13-HODD) by macrophages. The 5-lipoxygenase inhibitors interfered with LTC4 formation in macrophages, however, they did not affect endotoxin-induced TNF alpha formation, neither in cell cultures nor in mice. The inhibitory strength of other, less specific lipoxygenase blockers to suppress TNF alpha formation correlated quantitatively with their ability to interfere with 13-HODD synthesis. From these findings it is concluded that lipoxygenase inhibitors interfere with endotoxic effects because they block TNF alpha formation. Since 5-lipoxygenase inhibitors neither prevented the formation of TNF alpha nor endotoxin leukopenia and lethality, it is suggested that a lipoxygenase product distinct from the leukotrienes is involved in TNF alpha synthesis. Based on the fact that a tight correlation exists between inhibition of TNF alpha synthesis and 13-HODD formation, activation of 15-lipoxygenase might be important for TNF alpha formation. PMID- 1783471 TI - Effect of methyl esterification of isoglutamine residue in 6-O-acylated muramyl dipeptides on expression of immunopharmacological activities. AB - The effect of methyl esterification of the isoglutamine residue in 6-O-acylated muramyl dipeptide (MDP) on some biological activities was investigated. Methyl esterification influenced more or less the expression of all activities tested. The adjuvant and colony stimulating factor (CSF)-inducing activities of 6-O acylated MDP analogs carrying a 3-hexadecanoyloxytetradecanoyl [C14-O-(C16)] group were stronger than those of the corresponding analogs carrying a 2 tetradecylhexadecanoyl (B30) group. Macrophage activation, i.e. induction of tumor necrosis factor (TNF) and promotion of phagocytosis, by 6-O-C14-O-(C16)-MDP methyl esters was weaker. PMID- 1783472 TI - Comparative immunopharmacology and toxicology of the bisbenzylisoquinoline alkaloids tetrandrine and berbamine. AB - Comparison of the bisbenzylisoquinolines tetrandrine and berbamine shows that both drugs are equipotent in terms of enhancement of antibody responses and suppression of delayed-type hypersensitivity (DTH) responses to sheep red blood cell antigens. Both compounds are also equally active when given to mice during the induction and expression phases of DTH. Using a model of experimental brucellosis in mice, it was found that both compounds did not affect antibody responses, while they caused equipotent suppression of DTH. By contrast, berbamine but not tetrandrine caused significant suppression of spleen weight. Also, berbamine caused a significantly greater enhancement of spleen colony counts of Brucella abortus than tetrandrine. Short-term toxicology studies showed no toxic effects at bioactive doses. PMID- 1783473 TI - The effects of recombinant human granulocyte-macrophage colony-stimulating factor on the induction of lymphokine-activated killer cells in vitro. AB - Granulocyte-macrophage colony-stimulating factor (GM-CSF) was added to a culture of human peripheral blood mononuclear cells in the presence of interleukin 2 (IL 2) in vitro to elucidate its effect on the induction of lymphokine-activated killer (LAK) cells. Viable cell counts of cultured cells and their cytotoxic effects against natural killer (NK) cell-resistant Daudi cells and NK cell sensitive K562 cells were measured using the trypan blue dye exclusion test and a 51Cr release assay from the tumor cells, respectively. Although GM-CSF alone did not influence either the cytotoxicities or the surface phenotypes of the cultured cells, the viable cell counts were significantly increased by the addition of GM CSF in the presence of IL-2 (P less than 0.01). These findings indicate that the addition of GM-CSF in the presence of IL-2 during the induction of LAK cells is useful for obtaining a larger number of effector cells which possess substantial cytotoxic activity. PMID- 1783474 TI - Combined effects of synthetic lipid A analogs and muramyl dipeptide on antitumor activity against Meth A fibrosarcoma in mice. AB - Combined effects of chemically synthesized lipid A analogs, the compound A-171 (acylglucosamine-4-phosphate with (R)-3-hydroxytetradecanoyl and (R)-3 hydroxytetradecanoyloxy]tetradecanoyl group at the C-2 and C-3 positions), or the compound A-172 (with (R)-3-hydroxytetradecanoyloxy]tetradecanoyl and (R)-3 tetradecanoyloxytetradecanoyl group at the C-2 and C-3 positions), and muramyl dipeptide (MDP) on antitumor activity against Meth A fibrosarcoma, were examined. Meth A fibrosarcoma cells (5 X 10(5)) were inoculated intradermally into BALB/c mice on day 0, compound A-172 and/or MDP were administered intravenously (i.v.) on day 7. Although the antitumor activity by single i.v. injection of A-172 (50 micrograms/mouse) with MDP (10 micrograms) was weaker than that of 50 micrograms of synthetic lipid A analogs (506), or 10 micrograms of bacterial lipopolysaccharide (LPS) with MDP, A-172 alone and with MDP exhibited tumor inhibition rates of 49.0 and 70.6%, respectively. When A-171 (50 micrograms) with MDP (10 micrograms) was administered i.v. twice (days 7 and 10) into mice inoculated Meth A fibrosarcoma, two of five mice caused complete tumor regression. Furthermore, L929 cell lysis by the combination of A-171, A-172 with MDP was higher than that by the analogs or MDP alone, suggesting that the lipid A analogs of monosaccharide type as well as LPS are able to enhance the production of tumor necrosis factor in the presence of MDP. PMID- 1783475 TI - Changes in leukocyte recirculation, NK cell activity, and HLA-DR expression in peripheral blood mononuclear cells of MS patients treated with Poly ICLC. AB - To investigate the cellular immune effects of the interferon inducer, Poly ICLC, in humans, peripheral blood mononuclear cells from patients with multiple sclerosis receiving Poly ICLC as part of a preliminary clinical trial were studied. Peripheral blood mononuclear cell phenotype analysis using fluoresceinated monoclonal antibodies and flow microfluorometry showed decreases in the percentages and absolute numbers of all lymphocyte subsets 24 h after infusion. These changes returned toward baseline at 48 h except the percentage of CD-4 positive cell which increased above baseline levels. The percentage of HLA DR antigen positive cells and CD-16 (Leu 11a) positive cells were increased 24 h after infusion but returned to baseline at 48 h. NK activity as determined by chromium release from K562 target cells was decreased at 24 h but increased 48 h after drug infusion. The increases in percentages of HLA-DR antigen and CD-16 positive cells at 24 h and NK activity at 48 h are consistent with the in vitro effects of IFN while the decreases in peripheral blood mononuclear cells are suggestive of changes in cell recirculation. PMID- 1783477 TI - Core journals of rehabilitation: identification through index analysis. PMID- 1783476 TI - Target-flow inspiratory muscle training: breathing patterns and metabolic costs. AB - In target-flow inspiratory muscle training (TF-IMT), the generated inspiratory mouth pressure and the duration of the inspiration and expiration are standardized to given an adequate training stimulus to the inspiratory muscles. The acute effects of TF-IMT on the efficiency of breathing were studied in a group of 12 COPD patients with a ventilatory limitation of their exercise capacity (mean age 58, mean FEV1 46.2% of predicted) and in 15 normal subjects (mean age 30). Also, the effect of a 10 week period of TF-IMT on the maximal inspiratory mouth pressure (PImax) in the COPD patients was measured. After an unloaded baseline period, the subjects started to inspire through a target-flow device during 15 min, followed by a recovery phase of 5 min. During TF-IMT minute ventilation (VE) decreased only in the COPD group. The ventilatory equivalent for O2 (VE/VO2) and the dead space to tidal volume ratio (VD/VT) decreased in both groups. During recovery, VE, VE/VO2 and VD/VT remained below baseline values in the COPD group, but not in the control group. PCO2 and lactate concentrations did not change during TF-IMT. After the 10 week training period, PImax [means) (SD] increased from 5.7(2.2) to 8.2(2.7) kPa (p less than 0.05). The results indicate that with standardized TF-IMT, the inspiratory muscles can be trained effectively in COPD patients with a ventilatory limitation. The persistence of the decrease in VE, VE/VO2 and VD/VT after a training session may be an additional beneficial effect of TF-IMT. PMID- 1783478 TI - The role of computer conferencing in delivery of a short course on assessment of learning difficulties. PMID- 1783479 TI - A half-way house for schizophrenic patients. PMID- 1783480 TI - Measurement of temporal gait parameters from videotape using a field counting technique. PMID- 1783481 TI - Gait characteristics of obese pre-pubertal children: effects of diet and exercise on parameters. PMID- 1783482 TI - Promoting behavioural medicine services in cardiology among physicians in Chile. PMID- 1783483 TI - Survey of educators' and employers' attitudes about training and hiring speech/language pathologists who are blind or quadriplegic. PMID- 1783484 TI - Transcutaneous electrical nerve stimulation (TNS) for painful osteoarthrosis of the knee. PMID- 1783485 TI - Is measurement of health status culture dependent? PMID- 1783486 TI - Difficult couplings in stepwise solid phase peptide synthesis: predictable or just a guess? AB - Stepwise solid phase peptide synthesis, Fmoc-approach, of 88 peptides varying in length from 4 to 24 amino acid residues was performed using a uniform procedure for coupling, monitoring and deprotection steps. The data of 696 couplings have been incorporated into a computer programme in order to study whether the degree of coupling can be predicted. Parameters studied are the nature of the amino acid to be coupled, the amino acid to be acylated and the length of the growing peptide chain. Using this information, prediction of "good" or "difficult" sequences, that is, peptides that can be synthesized without appreciable repeated couplings or the opposite, seems possible. PMID- 1783487 TI - Synthesis of redox derivatives of lysine and related peptides containing phenothiazine or tris(2,2'-bipyridine)ruthenium(II). AB - Boc-L-Lysine derivatives and lysine-containing peptides bearing the electron donor 10H-phenothiazine (PTZ) or the redox chromophore tris(2,2' bipyridine)ruthenium(II) dication ([Rub3]2+, where b is 2,2'-bipyridine) have been synthesized and characterized. SeO2 oxidation (53% yield) of 4,4'-dimethyl 2,2'-bipyridine, Ag2O oxidation (85% yield) of the monoaldehyde, complexation (96% yield) of 4'-methyl-2,2'-bipyridine-4-carboxylic acid (m-OH) with Rub2Cl2, activation (81% yield) of the acid [Rub2m-OH]2+ (PF6-)2, and condensation (83% yield) of the succinimido ester [Rub2m-OSu]2+ (PF6-)2 with Boc-Lys furnished the protected redox-chromophore module [Boc-Lys(Rub2m)-OH]2+ (PF6-)2 in 29% overall yield over five steps. The first two steps constitute the first practical synthesis of the monocarboxylic acid m-OH (45% overall yield). Also prepared were m-OSu, Boc-Lys(m)-OH, Boc-Lys(m)-OCH3, and [Rub2m-NHCH3]2+ (PF6-)2. Activation (91% yield) of 3-(10H-phenothiazine-10)propanoic acid (PTZpn-OH) and condensation (92% yield) of the succinimido ester PTZpn-OSu with Boc-Lys furnished the protected electron-donor module Boc-Lys(PTZpn)-OH (84% overall yield). The latter was used in solid-phase syntheses of two redox tripeptides, CH3CO-Ala-Lys(PTZpn) Ala-OH and [Rub2m-Ala-Lys(PTZpn)-Ala-OH]2+ (PF6-)2. The electrochemical properties of these redox amino acids and peptides were similar to those of PTZpn OH, [Rub2m-OH]2+ (PF6-)2, or [Rub2m-NHCH3]2+ (PF6-)2. Lys(PTZpn), [Lys(Rub2m)]2+ (PF6-)2, and other redox modules may be useful for engineering light-harvesting proteins, photovoltaic cells, and other molecular electronic devices. PMID- 1783489 TI - Acid-base properties of thymopoietin-type tri- and tetrapeptides and their derivatives. AB - The submolecular basicities of 21 immuno-modulating, thymopoietin-type di-, tri-, and tetrapeptides were studied and characterized in terms of group constants and partial microconstants. All compounds were derivatives of the H-Arg-Lys-Asp-OH tripeptide. Modifications within four covalent bonds of the basic site (esterification, acylation, curtailment or addition at C-terminal end, exchange of amino acids) cause significant changes in the scheme of protonation and in the individual basicity of proton binding sites. Configurational changes of the component amino acids, however, do not cause significantly different basicities in the diastereomers. PMID- 1783488 TI - Aminopeptidase resistant Arg-Gly-Asp analogs are stable in plasma and inhibit platelet aggregation. AB - Tetrapeptides containing the sequence Arg-Gly-Asp (RGD) antagonize fibrinogen binding to its platelet receptor (gp IIb/IIIa, integrin alpha IIb beta 3) and inhibit platelet aggregation in vitro. The peptides RGDS and RGDY(Me)-NH2 were rapidly degraded when incubated in human, rat, and dog plasma. HPLC analysis indicated that amino acids were sequentially removed from the peptide N-terminus, and this degradation was prevented by the aminopeptidase inhibitor bestatin. Analogs of RGDY(Me)-NH2 with an acetylated or deleted alpha-amino group were prepared. Both analogs were stable when incubated in plasma, blocked 125I fibrinogen binding to activated platelets (IC50 = 10-30 microM) and inhibited ADP induced platelet aggregation (IC50 = 10-30 microM). This study concludes that aminopeptidase rapidly degrades RGD peptides in plasma, an important issue for in vivo testing of RGD peptides and analogs. RGD analogs intrinsically stabilized against aminopeptidase are stable in plasma and are important tools for antithrombotic studies involving antagonism of gp IIb/IIIa. PMID- 1783490 TI - Cleavage kinetics and anchor linked intermediates in solid phase peptide amide synthesis. AB - Kinetics and cleavage conditions of peptide amide synthesis were studied using the anchor molecules 5-(4'-aminomethyl-3',5'-dimethoxyphenoxy)valeric acid (4 ADPV-OH) and 5-(2'-aminomethyl-3'-5'-dimethoxyphenoxy) valeric acid (2-ADPV-OH). Unexpectedly the anchor amide alanyl-4-ADPV-NH2 was isolated and characterized as an intermediate during the cleavage with trifluoroacetic acid (TFA) of alanyl-4 ADPV-alanyl-aminomethyl-polystyrene to yield the alanine amide. As a matter of fact the NH--CH alpha bond of the alanyl spacer has to be cleaved to form this intermediate. Using TFA-dichloromethane (1:9) alanyl-4-ADPV-NH2 was obtained as a cleavage product in 50% yield within 60 min, whereas the isomeric alanyl-2-ADPV NH2 was formed more slowly under these mild conditions. At high TFA concentration no difference between the 2- and 4-ADPV anchor was observed in the rate of formation of the free alanine amide. The presence of tryptophan amide in the cleavage mixture resulted in an anchor alkylated tryptophan amide, which remains stable in acidic solution but disappears rapidly in the presence of the resin. A low TFA/high TFA cleavage procedure is recommended for peptide amid synthesis applying the ADPV anchor. PMID- 1783491 TI - Some pharmacological properties of cyclic and linear analogs obtained by substituting each residue of an oxytocin antagonist with D-tryptophan. AB - We synthesized 10 analogs (1-10) derived from the sequence of [Pmp1,D Trp2,Arg8]oxytocin, (parent antagonist or PA), (Pmp = beta,beta-pentamethylene beta-mercaptopropionic acid) which is a potent antagonist (pA2 = 7.77) of the uterotonic effect of oxytocin (OT) in rats, as determined in our uterotonic assay. Eight of the following analogs were designed by replacement of each residue in the PA sequence, other than the residue at position 2, with D tryptophan: Ac-D-Trp-D-Trp-Ile-Gln-Asn-Val-Pro- Arg-Gly-NH2, (1); [Pmp1,D Trp(For)2,Arg8] OT, (2); [Pmp1,D-Trp2,D-Trp3,Arg8] OT, (3); [Pmp1,D-Trp2,D Trp4,Arg8] OT, (4); [Pmp1,D-Trp2,D-Trp5,Arg8] OT, (5); Aaa-D-Trp-Ile-Gln-Asn-D Trp-Pro-Arg- Gly-NH2, (6); [Pmp1,D-Trp2,D-Trp7,Arg8] OT, (7); [Pmp1,D-Trp2,D Trp8] OT, (8); [Pmp1,D-Trp2,Arg8,D-Trp9] OT, (9); [Pmp1,D-Trp2,Arg8,D-Trp(For)9] OT, (10). To avoid free mercaptan groups, Val6 was chosen in analog 1 instead of Cys and Aaa1 (Aaa = 1-adamantaneacetic acid) in analog 6 instead of Pmp1. Of the linear analogs, 1 was inactive as an OT antagonist and 6 was a very poor antagonist, with a pA2 = 5.66, but it was more potent than Aaa-D-Trp-Ile-Gln-Asn Val-Pro-Arg-Gly-NH2, which has a pA2 = 5.33, as we had previously reported. Analog 2, featuring D-Trp(For)2, pA2 = 7.37, was weaker than PA, indicating that the formyl group lowers potency. Analogs 3 and 4 were much weaker than PA, and analog 5 was inactive. Hence, other than at position 2, D-Trp is undesirable in the ring sequence of PA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783492 TI - [Hyp3]-tuftsin ([Hyp3]-TU) synthesis and biological activity. AB - [Hyp3]-tuftsin (Thr-Lys-Hyp-Arg) has been synthesized by the liquid-phase method. In biological investigations performed on rats antinociceptive and diuretic effects have been determined. It has been suggested that the presence of hydroxyl substituent in pyrrolidine ring of proline slightly modifies antinociceptive TU effect and is responsible for the increased diuretic [Hyp3]-TU activity. PMID- 1783493 TI - Preparation of N-9-fluorenylmethoxycarbonylamino acid chlorides from mixed anhydrides by the action of hydrogen chloride. AB - N-9-Fluorenylmethoxycarbonyl-(Fmoc) amino-acid chlorides have been prepared by reaction of hydrogen chloride on purified mixed Fmoc-amino acid-monoalkyl carbonic acid anhydrides in dichloromethane. The products partially undergo subsequent conversion to the corresponding esters due to the presence of the liberated alcohol, the extent depending on the nature of the alkyl group. Esterification occurred to 5-20% when the alkyl group was isopropyl. Anhydrides of monoisopropenyl carbonic acid which liberate acetone instead of an alcohol gave products uncontaminated with ester. The three components in a reaction mixture could be determined as the reaction progressed by normal phase high performance liquid chromatography of aliquots, which had been freed of excess hydrogen chloride, on a mu Porasil (underivatized silica) column using tert. butanol-hexane (1.5:98.5) as solvent. PMID- 1783494 TI - [Health administration and the health of workers]. PMID- 1783495 TI - [Validity of the occupational history assessed by interview]. AB - The study was carried out on 114 workers of a large firm in the city of Barcelona. Its objectives were to measure the validity of a questionnaire on professional history, achieved by telephone interviews, using the firm's employee register and to identify the socio-professional characteristics associated with the firm. The validity of the main and secondary occupation (name and length of the occupation) was assessed by company reported information with that in the firm's registry, which was considered as a reference criterion. The validity of the name of the main and secondary occupation was 88% and 74% respectively and the validity of their length was 57% and 64.4% respectively. The validity of professional history, in as much as the name of the main and secondary occupation was high. The validity of their length was low. PMID- 1783496 TI - [Mortality by external causes among residents of Barcelona (1983-1987)]. AB - Mortality due to external causes (EC) is an increasing problem among young people in Spain, with little epidemiologic knowledge available at the small-area level in urban settings. The objective of the present study is the assessment of the magnitude and distribution of EC-related mortality among residents in Barcelona during the 1983-1987 time period. The main EC-related deaths were traffic injuries (9.3 deaths per 100,000), suicides (7.2 deaths per 100,000), and falls (6.9 deaths per 100,000). EC have been the main cause of death up to 35 years of age, contributing to 19% of the total number of years of potential life lost. Traffic-related deaths occurred mainly in the 15-24 age group for vehicle occupants (11.7 deaths per 100,000), while deaths among pedestrians occurred primarily among people older than 75 years (16.4 deaths per 100,000). The largest share of deaths due to suicide also occurred in this same group (19.6 deaths per 100,000), followed by people 25-34 years old. Expectedly, the higher death rates due to falls occurred among elderly people, older than 75 years of age (71.8 deaths per 100,000). These results indicate that patterns of mortality due to external causes in Barcelona are rather similar to those in European countries, suggesting that the strategies to achieve the prevention and control of such deaths among Barcelona residents should presumably be close to those presently being implemented in those countries. PMID- 1783497 TI - [The role of the medical director as manager of health centers]. AB - In this review the role of physicians in management position of health services in Spain is analyzed. Araising from the high rotation rate in these positions, the experience and reports of foreing countries are reviewed. Finally, the functions of a medical director in a management team are defined. Also, the need of their influence on the profile of services an professional curricula in order to ensure continuity are discussed. Training is the key element for continuity and stability of medical directors in health services management teams. PMID- 1783498 TI - [For a new hospital model: protagonism has to go back to the health aspect]. PMID- 1783499 TI - [Influence of municipal registry errors on the identification of a sample]. PMID- 1783500 TI - Schizophrenia in British Afro-Caribbeans: two debates confused? AB - The concept and aetiology of schizophrenia remain controversial issues. Epidemiological studies reveal considerable variations in rates of diagnosed cases between groups. British Afro-Caribbeans show high rates. At the same time, their psychiatric experience is marked by a high level of conflict with the psychiatric services. The two debates--that surrounding the concept of schizophrenia, and that concerning the psychiatric experiences of British Afro Caribbeans--need to be separated so that each receives appropriate consideration. Studies based on the experiences of people diagnosed as schizophrenic may confuse rather than advance the first debate if due care is not paid to the reliability of the diagnosis. The second debate has consequences for the development of psychiatric services. Further unaddressed questions referring to the mental health of ethnic minorities are suggested. PMID- 1783501 TI - The frequency of depressive symptoms in a general population with reference to DSM-III. AB - The frequency with which symptoms of depression are found among subjects with either a lifetime diagnosis of depression or dysthymia and among subjects with no psychiatric disorders, are analysed. The data is derived from a large study (n = 862) on the lifetime prevalence of mental disorders which was conducted in Iceland. The survey instrument was the NIMH-Diagnostic Interview Schedule (DIS). Results from 379 subjects are reported in this study, these subjects have either experienced a Major Depressive Episode (n = 46), dysthymia (n = 32) or have no psychiatric disorder (n = 301). The frequency of symptoms are grouped together in hierarchical tables and displayed and analysed. In the hierarchical groupings of symptoms, males were found to report more grave symptoms of suicide than were females, both in the depression and dysthymic groups. In a comorbidity correlation between these and other disorders, sex differences emerged in the diagnosis of Tobacco Dependence, with women exhibiting higher frequencies of dependence when found in the depressed group. PMID- 1783502 TI - Social burden of positive and negative schizophrenia. AB - Sixty patients diagnosed as 'positive' or 'negative' schizophrenics were studied to evaluate social burden experienced by a key relative. The study had a prospective design and the patients were followed for a period of six months. At the time of initial assessments, in the 'positive schizophrenia' group, no significant correlation between ratings on psychopathology and social burden was observed, although at the end of the period of follow-up significant reductions in ratings on psychopathology and social burden as well as significant correlation between severity of psychopathology and burden of care were noted. In the 'negative schizophrenia' group, the severity of psychopathology and social burden were significantly correlated, but at the end of six months no significant change either in severity of psychopathology or social burden emerged. PMID- 1783503 TI - A psychiatric mobile crisis unit in New York City: description and assessment, with implications for mental health care in the 1990s. AB - This article presents a review and assessment of a community Mobile Crisis Intervention Team working on the Lower East Side of Manhattan. Of special importance, a trend is noted involving a changing philosophy and modus operandi. Some reasons are offered to explain the trend and questions are raised about the future of the delivery of mental health services in large urban areas. PMID- 1783504 TI - Single and repeated admissions to a mental health center: demographic, clinical and use of service characteristics. AB - Eight hundred and forty one patients with 1,135 consecutive admissions to a university-affiliated mental health center were studied to examine patterns of treatment program use. Twenty two percent of patients had repeat admissions accounting for 42% of hospital episodes. Single admission and repeater groups are compared, and differences among repeater subgroups with progressively greater numbers of admissions per patient are described. Only 10 patients with the highest number of admissions during the study period also were very high utilizers of all services (inpatient, crisis, day hospital, regional chronic state hospital). These patients' characteristics are discussed with implications for future study. PMID- 1783505 TI - Inpatient sociodemographic and diagnostic study from a psychiatric hospital in Libya. AB - Sociodemographic and diagnostic characteristics of 1009 patients admitted to the Psychiatry Hospital, Benghazi (Libya) in one calendar year are reported. Five hundred and four (50%) were 'first admission' cases. There were an average of 2.05 admissions for each 'readmission' case. Eighty nine percent of patients were of Libyan origin, of whom 62% were males; 66% were between 15-34 years of age, 37% were married, 28% were unemployed and 16% were in military service. ICD-9 schizophrenic psychosis was the commonest diagnosis (39%), followed by affective psychosis (17%), neurotic disorders (12%), organic psychosis (8%) and acute psychosis (7%). Neurotic depression was the commonest type of neurotic disorder and antisocial personality was the commonest among personality disorders. Relationship of sociodemographic variables with major diagnostic categories was studied in Libyan patients. Sociodemographic profiles of 'first admission' and 'readmission' cases of Libyan origin were also compared. These findings are discussed in relation to the sociocultural context. PMID- 1783506 TI - Mental health knowledge and skills of general hospital nursing staff: an exploratory study. AB - The psychiatric knowledge and skills of forty six nurses working in a general hospital in Bangalore, India were evaluated objectively using Multiple Choice Questionnaire (MCQ) and case vignettes. The results revealed that these general nurses had less than satisfactory mental health knowledge and skills. The findings highlighted the need for systematic in-service training for nursing staff in mental health problems. PMID- 1783507 TI - Adolescent risk-takers: a trauma center study of suicide attempters and drivers. AB - Adolescence is a developmental stage characterized by excessive risk-taking behavior that produces adverse health effects, typically in the form of injury. At issue is whether adolescent suicide attempters and injured adolescent motor vehicle drivers constitute a common risk group and are differentiated by the response of the emergency medical care system and by case disposition. Data originated in the medical records of a Rhode Island (USA) trauma center. The two study groups were not distinguished by religious preference, socioeconomic status or timing of the injury incident, but differed significantly by gender, race, emergency vehicle use, hospital admission rates, and seasonal injury patterns. Alcohol and drug involvement was examined, but serious data deficiencies were noted. PMID- 1783508 TI - Psychiatric nursing in Italy: an extinguished profession or an emerging professionalism? AB - Ten years after the introduction of the psychiatric reform in Italy, a case study was undertaken in Santhia' (near Turin) on the experience of psychiatric nursing, to investigate nurses' perceptions of community psychiatric work as compared to their experience of the hospital setting. Members of a nursing team attached to a CMHC were interviewed, and observation of their work over a period of six months followed. Other team members--such as doctors, psychologists and social workers were also interviewed, to gather an overview, and to investigate the interaction of the specific organisational framework with nursing professional culture. The findings suggest that the move to the community has led to an emerging psychiatric nursing professional identity related to the opportunity for nurses to experience professional practices other than the medical and custodial forms, which were typical of the hospital setting. PMID- 1783509 TI - [Peripheral thrombolysis]. PMID- 1783510 TI - [What is reliable in thrombolytic therapy of acute myocardial infarct?]. PMID- 1783511 TI - [The role of calcium antagonists in the treatment of hypertension]. PMID- 1783512 TI - [What is reliable in the treatment of glomerulonephritis?]. PMID- 1783513 TI - [Conclusive evaluation of osteoporosis therapy with fluorides]. PMID- 1783514 TI - [What is reliable in hyposensitization of IgE-induced diseases? Indications, contraindications, results and side effects]. PMID- 1783515 TI - [What is reliable in the therapy of cryptococcal meningitis?]. PMID- 1783516 TI - [47-year-old patient with bronchial asthma, polyneuropathy and rapidly increasing heart failure]. PMID- 1783517 TI - [Hepatic coma of unknown origin in an 18-year-old patient]. PMID- 1783518 TI - [Diet in hypercholesterolemia]. PMID- 1783519 TI - [Psychosis in primary hyperparathyroidism]. PMID- 1783520 TI - [Premedication for endoscopy]. PMID- 1783521 TI - Differences in N-acetylation of the experimental antitumor agent batracylin in the mouse and the rat. AB - Batracylin (NSC-320846) is a quinalzolineone recently evaluated as a potential antitumor agent by the National Cancer Institute. The analog was active against a number of murine tumors, including colon adenocarcinoma 38 and multidrug resistant sublines of P-388 leukemia. Preclinical toxicity studies revealed that batracylin was much more toxic when administered orally to rats than to mice. The combined sex LD10 in mice was 5,655 mg/m2 while 576 mg/m2 was lethal to all rats treated at that dose. We determined that following oral administration of batracylin, systemic exposure of parent drug to the rat was only 14.9% of that to the mouse. It was subsequently noted that systemic exposure of a relatively non polar metabolite was approximately 9 times greater in the rat than in the mouse. The metabolite was identified as N-acetylbatracylin by TLC, HPLC and mass spectral analyses. Observations by the National Cancer Institute that N acetylbatracylin was not toxic following oral administration to mice or rats prompted evaluation of systemic exposure following oral administration to rats. Following oral administration of N-acetylbatracylin to rats, systemic exposure was almost nil. Indeed, exposure of rats to N-acetylbatracylin was several orders of magnitude greater following oral administration of six-fold lower doses of the parent drug, batracylin. Thus, N-acetylation may play a role in the toxicity of batracylin despite the lack of toxicity observed following oral administration of N-acetylbatracylin. In addition, further metabolism of the N-acetyl conjugate, analogous to that of other aromatic amines, may be involved in the pharmacology of batracylin and similar analogs. PMID- 1783522 TI - Effects of benzoylphenyl ureas on growth of B16 melanoma cells in vitro and in vivo. AB - New analogs of diflubenzuron, a benzoylphenyl urea, are tested on their in vitro cytostatic activity against B16 melanoma cells. The following structure-activity relationship was established: substitution by a hydroxylated function at the ortho, meta or para position or by a dimethylamino function at the ortho position of the benzoyl moiety appeared to be necessary for cytostatic activity in vitro. Acetoxy functions at the ortho position or hydroxy functions at the para position of the aniline ring resulted also in active compounds. A number of these benzoylphenyl ureas are selected for in vivo evaluation of antitumor activity on B16 melanoma growing s.c.. Although many of the tested benzoylphenyl ureas delayed tumor growth during the first ten days of drug treatment, only a few increased animal life span. The best results (% T/C) were obtained with compounds 5 (127%), 7 (147%), 13 (135%) and 16 (135%), which all have hydroxylated functions in the benzoyl moiety. PMID- 1783523 TI - Antitumor activity and mechanism of action of the marine compound girodazole. AB - Girodazole, a new marine compound has been isolated from the sponge Pseudaxinyssa cantharella. Girodazole is active in vivo on several murine grafted tumors including leukemias (P388, L1210, i.p./i.p.) and solid tumors (MA 16/C mammary adenocarcinoma, M5076 histiocytosarcoma, s.c./i.v.). In addition, girodazole has identical cytotoxic properties in vitro on P388 and P388/DOX cells and retains antitumor activity in vivo on P388/DOX. Girodazole has a unique chemical structure different from those of known anticancer agents and of new compounds undergoing clinical trials. Biochemical studies indicate that girodazole inhibits protein synthesis during the elongation/termination steps. Toxicological studies have been done in mice and in dogs and did not reveal any major toxic effect which could preclude administration in patients. Girodazole is now undergoing phase I clinical studies. PMID- 1783524 TI - Phase I study of escalating dose mitoxantrone in combination with alpha-2 interferon in patients with advanced solid tumors. AB - In vitro and preclinical in vivo data have shown a synergistic antitumor activity between alpha-interferon and some antiproliferative agents. A phase I study of the concurrent administration of interferon-alpha 2 and mitoxantrone was initiated, to determine the maximum tolerated dose of mitoxantrone given i.v. every 3 weeks in escalating doses combined with a fixed dose of s.c. interferon alpha 2 (6 x 10(6) IU three times per week 3), in patients with advanced solid tumors resistant to conventional chemotherapy. At least three evaluable patients were entered in each dose level of mitoxantrone starting at 4 mg/m2, with no escalations allowed in the same patient. Twenty-seven patients received a total of 101 cycles and five dose-levels were explored (4-6-8-10-12 mg/m2 of mitoxantrone). The dose-limiting toxicities were leukopenia and granulocytopenia at 12 mg/m2 of mitoxantrone, at which dose hematological toxicity occurred in greater than 50% of cases, with one patient presenting grade 4 leuko granulocytopenia. No severe thrombocytopenia occurred. In the majority of patients transient hepatic enzyme elevations and a flu-like syndrome due to interferon alpha 2 were observed in all dose-levels explored. These observations suggest that the hepatotoxic effects of interferon alpha 2 do not emphasize mitoxantrone side-effects if given simultaneously. When mitoxantrone is administered with 6 x 10(6) IU of interferon alpha 2, the recommended dose for future phase II studies is 10 mg/m2/weeks 3 with escalation up to 12 mg/m2 in selected patients if such a combination is well tolerated in terms of myelosuppression. Regarding therapeutic activity, four out of 25 (16%) cases evaluable for response achieved a partial response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783525 TI - Phase II study of intravenous 6-thioguanine in patients with advanced gastric carcinoma. AB - In a phase II study, 18 patients with advanced gastric carcinoma were treated with intravenous 6-thioguanine. A 30-minute infusion of 55 mg/m2 (starting dose) was administered once a day for 5 consecutive days, the courses being repeated every 5 weeks. A median of 2 courses (range, 1-4) was administered. Among the 18 patients, 17 having measurable cancer and optimum follow-up were fully assessable for response. None of the patients achieved a complete or partial response. One patient achieved a transient minor response (15 weeks) of the primary gastric carcinoma but the metastatic carcinoma was unchanged. One patient had no change in his measurable carcinoma, and the other 15 patients had progressive disease while receiving intravenous-6-thioguanine. Myelosuppression, although frequent, was mild to moderate at these doses and did not result in significant morbidity. Nonhematologic toxicities were also mild. Our data suggest that intravenous 6 thioguanine given at this schedule is ineffective in previously untreated patients with advanced gastric carcinoma. PMID- 1783526 TI - Phase II trial of mitoxantrone in acute lymphocytic leukemia of childhood. A Pediatric Oncology Group study. AB - Thirty children with refractory acute lymphocytic leukemia (ALL) were treated with mitoxantrone, 8 mg/m2/day, for 5 days. Three children received a second course of the drug 3 to 4 weeks later. All but two patients had received prior anthracycline therapy. There were 2 complete responses, 4 early deaths, and 24 patients with persistent leukemia. Of the 21 patients with circulating blasts at the start of mitoxantrone who did not achieve remission, 16 (76%) had complete clearance of their peripheral blood blasts. Although all patients developed profound neutropenia (less than 100 per mm-3), mucosal and hepatic toxicities were uncommon and mild. Mitoxantrone has moderate activity in childhood ALL and should be considered for further trials in less heavily pretreated patients. PMID- 1783527 TI - Phase II study of echinomycin in patients with advanced breast cancer: a report of Cancer and Leukemia Group B protocol 8641. AB - Twenty-five women with advanced histologically documented stage IV recurrent or inoperable breast cancer were enrolled on a phase II study of echinomycin administered at a dose of 1.2 mg/m2 intravenously over 30 minutes weekly for 4 weeks followed by a two week rest period. Seventy-six percent of patients had visceral dominant disease at study entry and all patients had previously received chemotherapy. One of 21 eligible patients had a partial response lasting 147 days. The median survival for this group of patients was 5.9 months and the median time to treatment failure was 1.7 months. Nausea and vomiting was the primary toxic effect and was severe or life-threatening in 43% of patients. Transient elevation of liver enzymes occurred in 30% of patients. Bone marrow suppression was not significant. Echinomycin as employed in this study did not demonstrate significant antitumor activity in previously treated patients with advanced breast cancer. PMID- 1783528 TI - Phase II study of 2'-deoxycoformycin in patients with renal cell carcinoma. A National Cancer Institute of Canada Clinical Trials Group study. AB - The National Cancer Institute of Canada Clinical Trials Group undertook a phase II study of 2'-deoxycoformycin in patients with metastatic renal cell carcinoma. When 2'-deoxycoformycin 4 mg/m2 was administered intravenously weekly for three weeks then every two weeks no significant antitumor activity was noted in 19 evaluable patients. Toxic effects experienced were as expected, consisting primarily of nausea/vomiting, anorexia, and lethargy. It is concluded that 2' deoxycoformycin at this dose and schedule has no clinical activity in the treatment of metastatic renal cell carcinoma. PMID- 1783529 TI - Carboplatinum and cytosine arabinoside in patients with disseminated malignant melanoma. A phase II study. AB - Eighteen patients with disseminated malignant melanoma were treated with a combination of carboplatinum and cytosine arabinoside. There were 14 males and 4 females with median age of 51 years (range 36-68 years). We observed 4 complete responses (CR) and 3 partial responses (PR). Lung metastases, cutaneous and subcutaneous metastases responded more often, while liver and lymph node metastases did not respond. Two groups of toxicities were observed: gastrointestinal and hematological. Only nine grade 3 toxicities were observed. Response rates and low toxicity we observed during this study warrant its use for patients with disseminated malignant melanoma comparing it in a future studies with DTIC containing regimens. PMID- 1783530 TI - The development of high school biology. New York City, 1900-1925. PMID- 1783531 TI - A new method for analyzing smooth-pursuit eye movements. Description of a microcomputer program and evaluation in healthy volunteers. AB - The study of ocular movements has been increasingly used to detect subtle pathological modifications, caused by a wide variety of neurological diseases. We have developed a new microcomputer-based method for the analysis of smooth pursuit ocular movements induced by constant velocity targets moving unpredictably at different velocities (including velocity values as high as 100 deg/s). The ocular movements are recorded by an electro-oculographic technique using silver-silver chloride electrodes fixed near the inner and outer canthi of both eyes. The signals are amplified by two DC amplifiers after a low-pass filtering (50 Hz), sampled at 250 Hz and digitized in a 12-bit form by an analog/digital converter. For each patient's evaluation, a series of 20 sweeps of the target is generated. The data analysis, which is performed automatically by the microcomputer, is based on the calculation of four parameters: average peak eye velocity (APEV); typical target velocity (TTV); percent target matching index after saccade removal (PTMI); typical matching target velocity (TMTV) after saccade removal. APEV is calculated as the average of the peak velocities estimated from the 20 sweeps. The purpose of TTV, which is defined as the value of target velocity at which the percent gain has decreased to slightly more than one third of the maximum percent gain, is to provide an overall index of the rate at which the percent gain decreases as the target velocity increases. PTMI describes the eye performance for each value of target velocity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783532 TI - Three-dimensional transcranial Doppler in acute ischemic stroke in the territory of the middle cerebral artery: clinical and CT correlation. AB - We studied 34 patients with acute ischemic stroke in the territory of the middle cerebral artery (MCA) by three-dimensional transcranial Doppler (TCD-3D). The parameters analyzed were: mean blood flow velocity, systolic and diastolic velocities; indices of pulsatility, hemisphere asymmetry and pulsatility transmission. Of the 34 patients 11 presented marked slowing of flow velocity in the MCA on the infarct side with an asymmetry index (AI) of over 40%, 8 patients with slightly reduced flow velocity in the MCA and an AI of 25-40%, 2 patients in whom there was indirect evidence of collateral circulations in the anterior cerebral artery distribution together with slowing of MCA flow; 5 patients had stenosis of the MCA, 9 patients showed no alterations of the Doppler parameters. The correlation between neurological symptom pattern and AI was significant (r = 0.76). Noninvasive, easy to perform, performable at once and reliable, TCD-3D is a great improvement on traditional transcranial Doppler and is especially useful in assessing the hemodynamics of the cerebral circulation in ischemic stroke. PMID- 1783533 TI - A double blind randomized pilot trial of naloxone in the treatment of acute ischemic stroke. AB - Attention has focused on naloxone, an opiate receptor antagonist, because of its potential benefit in reversing neurological damage after acute cerebral ischemia. To evaluate the safety and possible efficacy of high-dose naloxone in ischemic stroke patients we planned a double blind pilot study. Between January 1989 and May 1990 24 patients were randomly assigned to the naloxone or placebo group according to age and neurological deficit. Naloxone was given in a loading dose of 5 mg/kg over 10 minutes followed by a 24-hour infusion at the rate of 3.5 mg/kg/h. 10 patients experienced minor side effects but none of them had to discontinue the treatment. 9 patients improved: 6 in the naloxone group and 3 in the placebo group, but no significant difference was found using the non parametric Mann-Whitney test. Our study suggests that naloxone is safe at the dose used, but the results do not support the planning of similar trials on a larger scale. PMID- 1783534 TI - Submaximal nerve stimulation with the Datex relaxograph NMT monitor in myasthenia gravis. AB - Recently submaximal train-of-four stimulation of motor nerves has been reported as a reliable technique for monitoring the neuromuscular function in patients awakening from anaesthesia, in order to prevent residual curarization. On the basis of the similarity between curarization and Myasthenia Gravis, we studied the neuromuscular impairment of four myasthenic patients by means of a commercially available monitor, which has been designed for routine application in the operating room. We demonstrate that the cardinal features of Myasthenia Gravis can be easily detected with this simple and painless method. PMID- 1783535 TI - Intrathymic lymphoid cell differentiation in myasthenia gravis: an immunophenotypic study. AB - Thymocytes express multiple different surface antigens according to their stage of maturation. We studied lymphocyte surface differentiation antigens using direct immunofluorescence technique in the thymus of 20 patients with myasthenia gravis (MG) and 10 controls undergoing cardiac surgery. Fluorescein isothiocyanate-conjugated monoclonal antibodies were used to stain thymic cell surface antigens. We found a decrease in the percent expression of CD1, CD5, and CD7 surface antigens and a significant increase of CD20+ cells in myasthenic thymus compared with the controls. The changes in the percent expression of CD3, CD4, and CD8 antigens were not significant. These data suggest both the decrease in the immunophenotypes corresponding to cortical thymocytes (probably reflecting the cortical atrophy of the MG thymus) and the increase of mature B Cells (CD20+), which may participate in an active immune response. PMID- 1783536 TI - Natural history and postsurgical outcome of syringomyelia. AB - The surgical treatment of syringomyelia is still debatable and the result are often poor. Several surgical procedures, based on various proposed etiopathologies, have been developed but in many cases have proved completely ineffective. We have evaluated the follow-up of 69 syringomyelic patients, some operated on, some not, in the search for clues to the management of the disease. For this purpose we devised a rating system, which we describe. 31 patients underwent surgery while 38 received no treatment. We found that half of the patients deteriorated, whether they were operated on or not; only 1 in 5 improved and the rest remained stable. For surgical treatment to be successful, the disease must be in rapid evolution but without definite paraparesis. PMID- 1783537 TI - Genetic transmission of migraine without aura: a study of 68 families. AB - 68 randomly selected patients with migraine without aura (M) and 4 generations of their relatives (N = 394) were studied in order to probe the genetic hypothesis of migraine. Significantly more of the probands were women and M was significantly more frequent among female relatives. Earlier onset was commoner among male probands. A genetic component of M is indicated by the very high frequency of at least one affected relative (85.3%) and by a disease prevalence that is similar among both first and second degree relatives. A simple autosomal mode of transmission seems unlikely from analysis of the data on the affected relatives, while a "sex-limited" transmission mode is suggested. PMID- 1783538 TI - Rigidity and painful muscle spasms in a patient with probable myelitis. AB - We describe a case of continuous motor unit potential (MUP) activity of central origin (unlike stiff man syndrome and progressive encephalomyelitis) characterized clinically by rigidity, painful muscle spasms, abnormal postures and spinal myoclonus. The topography of the manifestations, the subacute and benign course, the presence of stable sequels 2 years after onset and a searching process of differential diagnosis lead us to attribute the condition to an inflammation of the cord, which makes the case of particular clinical interest. PMID- 1783539 TI - Ocular pseudomyasthenia: report of a case with a pineal region tumor. AB - A case presenting with clinical features of ocular myasthenia and a false positive edrophonium test is reported. Brain CT and MRI scan revealed a pineal region tumor histologically verified as germinoma. We recommend evaluating patients with clinical features of myasthenia gravis (MG) confined to the ocular muscles for intracranial mass lesions. PMID- 1783540 TI - Unusual case of Fahr syndrome with motoneuron disease. AB - After commenting briefly on the literature on Fahr syndrome, we describe a patient with an unusual association of cerebral calcifications and motoneuron disease. We discuss the possible role of brain calcifications in the clinical picture and stress the importance of the routine use of CT scanning and MRI to show further similar associations, possibly leading to a better understanding of the pathophysiology. PMID- 1783541 TI - Intertrochanteric valgus osteotomy and sliding compression hip screw in fractures of the femoral neck. AB - Twenty-four patients ranging from 28 to 56 years of age with Garden grade III or IV fractures of the femoral neck are reviewed after treatment by intertrocherantic valgus osteotomy and Richards sliding compression hip screw. The rationale behind this treatment, the operative technique, and the choice of internal fixation device are all discussed. All patients were followed up after more than 2 years so that any late complications could be documented. The results were evaluated using both the Merle d'Aubigne procedure and radiographic examination: 12 (50%) were rated excellent, 5 (20.8%) good, 2 (8.4%) fair, and 5 (20.8%) poor. The unsatisfactory results are analyzed in detail, attributable to non-union in 2 cases (due to technical error), avascular necrosis in 4 cases (2 were limited and well-tolerated by the patients; 2 were early and massive and necessitated prosthetic replacement), and infection in one case. Even though valgus osteotomy and internal fixation fill a gap in the treatment of femoral neck fractures in adults by yielding good results with a conservative method, they are very demanding surgical procedures, requiring anatomical reduction, atraumatic technique, precise calculation of the valgus angle, and precise placement of the internal fixation device. PMID- 1783542 TI - Synovial ganglia of the central pivot of the knee. AB - Five patients with intraarticular synovial ganglia of the knee were treated by arthroscopic surgery. These synovial cysts were found in the intercondylar fossa and appeared to originate from the cruciate ligaments. In 3 patients the ganglia were the only pathologic finding, solely responsible for the pain and functional impairment. In the other 2 patients the ganglia were accompanied by other intraarticular lesions. The diagnostic procedure (radiography, arthrography, CT, MRI, arthroscopy), confirmed the validity of CT scan and MRI in detection, differential diagnosis, and location of the ganglia in all cases. Arthroscopy enabled us to directly observe, biopsy, and remove the ganglia, resulting in immediate disappearance of symptoms and no relapse after a minimum follow-up of 20 months. PMID- 1783543 TI - Grosse-Kempf nailing in fractures of the tibia. AB - A series of 136 tibial fractures treated with locked Grosse-Kempf nailing is reviewed, evaluating the results according to rapidity of healing, functional recovery, and complications. Locked nailing proved so reliable that immediate mobilization was possible. There was only a 6% incidence of delayed union, including infections (3 cases, 2%) and nail breakage (2 cases, 1.5%). Several details of the operative technique that were decisive in the final result are discussed. PMID- 1783544 TI - The Grosse-Kempf nail in femoral and tibial shaft fractures. AB - Interlocked nailing is a routine method that yields excellent results even in complex fractures of the lower limb. A series of 25 femoral and 29 tibial fractures is reviewed, and both advantages and technical difficulties are discussed. The authors point out that, in very special cases, interlocking nails may be used together with other methods of internal and external fixation. PMID- 1783545 TI - Magnetic resonance imaging in the diagnosis of lumbar spinal canal stenosis. AB - Twenty-two patients with clinical symptoms suggesting lumbar spinal canal stenosis underwent myelography, computed tomography (CT), and magnetic resonance imaging (MRI). Patients were divided into two groups according to myelographic findings. Group I included 19 cases in which myelograms showed spinal canal stenosis, and group II consisted of 3 patients with myelograms negative for this condition. MRI showed uniform narrowing of the dural sac, indentations on the posterior aspect, or interruption of the outline of the sac in the sagittal scans and reduced area of the sac in the transverse scans. In group I patients, the diagnostic accuracy of MRI was greater than that of CT and myelography. In Group II patients, all of whom had moderate or severe lumbar scoliosis, MRI suggested spinal canal stenosis in contrast with myelography. In spinal canal stenosis surgery may be planned on the basis of MRI findings alone, except in scoliotic patients. PMID- 1783546 TI - Traumatic breakage of the ceramic head of prosthesis in total hip replacement. AB - The authors describe breakage of the 32 mm alumina AL2 O3 ceramic head in 3 cases of total hip replacement using two different models of prosthesis (Charnley Muller and Mittelmeier). All three patients were of average height, weight, and activity (Brown et al., 1985; Callaghan et al., 1988), and the breakage had been caused by an accidental fall. The same mechanism of injury, in people the same age as our subjects, can cause femoral neck fractures. Reoperation was necessary in order to replace the component. The implants all appeared to be positioned correctly, and the patients had reported no symptoms. Before the trauma that caused breakage, there had been no other injuries worth noting. All patients were satisfied with their hip replacements. PMID- 1783547 TI - Total hip replacement in the paleoacetabulum: biomechanical considerations. AB - The authors analyze the biomechanics of the dislocated hip in preparation to total hip replacement. Using the Pauwels criteria as a starting point, the authors observe the pathologic modification of this equilibrium when the hip is congenitally dislocated. Finally, applying these criteria to the acetabular component positioned in both the neoacetabulum and the true or paleoacetabulum, the authors show that the latter is biomechanically more advantageous. PMID- 1783548 TI - The subcoracoid impingement syndrome: clinical, semeiologic and therapeutic considerations. AB - Subcoracoid impingement is a relatively obscure syndrome. Guided by studies conducted by Gerber and Patte since 1985, the authors began to select cases of periarticular disease of the shoulder in which there was clinical evidence of involvement of the subcoracoid space. These patients underwent repeated clinical examination, radiographic examination according to Bernageau, CT scan, and Arthro CT. All patients were tested with a novocaine infiltration into the subcoracoid space. This paper contains a precise diagnostic protocol that has evolved from the studies conducted by Gerber and Patte. Of the 23 patients selected, 3 were advised to undergo surgical widening of the subcoracoid space, consisting of resection of the coracoacromial and coracohumeral ligaments and special, reductive coracoidplasty. PMID- 1783549 TI - Extraforaminal lumbar disk herniation. Clinical features and computerized tomography. AB - Disk herniation lateral to the intervertebral foramen is defined as extraforaminal. Its particular anatomical site makes its clinical and neurologic features completely different from those of posteromedial and posterolateral disk herniations. Prior to the advent of computerized tomography, only diskography was capable of preoperatively identifying this rare disease. We present 5 cases of extraforaminal disk herniation, the clinical and tomographic diagnosis of which was confirmed at surgery. All patients had severe motor deficit and reported sciatica as prevalent over low back pain. The herniated disk was L4-5 in 2 cases and L5-S1 in 3 cases. The CT scan suggested disk protrusion in 2 cases, extrusion in 2 cases, and sequestration in 1 case. Four of these findings were confirmed intraoperatively. Diskectomy was done after hemilaminectomy and partial or total facetectomy. The clinical result was excellent in 2 cases and good in 3 cases after an average follow-up of 10 months. The use of CT scan as part of the routine diagnostic procedure in patients with radicular pain has lowered the number of cases which the surgical findings were inexplicably negative for disk herniation without having to resort to more complex and invasive diagnostic techniques such as myelo-CT and disk-CT. Moreover, preliminary tomographic localization of the extraforaminal disk herniation makes it possible to operate on the affected level using more conservative techniques. In any case, thorough clinical examination is essential for both correct interpretation of the CT scan and appropriate choice of treatment. PMID- 1783550 TI - The problem of blood in surgical treatment of spinal deformity. AB - In order to minimize the risks of homologous blood transfusion during surgery for spinal deformity, we perform a blood-saving procedure consisting of both intraoperative methods and auto-transfusion techniques. In this paper we compare our experience in the year 1989 with that of the past decade. When auto transfusion was used, there was a decrease in intraoperative blood loss and only 4% of the patients required homologous transfusions. PMID- 1783551 TI - Bone scanning in the evaluation of total hip replacement. AB - The value of 99mTc-MDP bone scan in the early diagnosis of cementless total hip loosening is assessed by means of a review of 26 patients who underwent total hip replacement for arthritis or femoral neck fracture. Bone scan was performed, selecting regions of interest in the proximal diaphyses of both femurs and calculating the ratio of radionuclide uptake. This ratio returned to normal 6-12 months after operation. Bone scan can therefore serve as a point of reference for the prognosis of the implant. PMID- 1783552 TI - Peripheral chondrosarcoma: ultrastructural investigation by transmission and scanning electron microscopy. AB - Ultrastructural analysis by transmission and scanning electron microscopy was performed on two grade 1 peripheral chondrosarcomas which had arisen from a preexisting osteochondroma. This analysis allowed us to determine the morphologic changes in both the cell and the matrix and suggested a low grade of malignancy. We emphasize that ultrastructural analysis with scanning and electron microscopy is only valid when conducted on representative areas of the tumor. PMID- 1783553 TI - Response of the articular cartilage to weight-bearing: comparison of hemiarthroplasty with ceramic and cobalt-chromium head in dogs. AB - The advantages of the use of ceramic in prosthetics are well-known, especially the fact that the coefficient of friction is significantly lower at the bone ceramic interface than at the bone-metal interface. For this reason, ceramic is used for the cephalic component of the hemiarthroplasty. The advantages of ceramic, however, are purely theoretical, and have never been scientifically proven. The aim of our study, conducted on 20 dogs, was to observe the long-term effects of femoral prosthesis with a ceramic or cobalt-chromium cephalic component upon the acetabular cartilage. Our research was conducted on homogeneous groups of dogs under similar conditions. At 8 months, the results showed evident cartilage damage that was equal in both groups. We therefore conclude that as far as everyday wear neither material is favored over the other. PMID- 1783554 TI - The role of arthrography in the diagnosis of meniscal tears. AB - The authors discuss the value of arthrography as a supplement to arthroscopy in the diagnosis of meniscal tears. Arthrography is superior to arthroscopy in its ability to detect lesions of the posterior horn of the medial meniscus, which are the most common meniscal tears. Moreover, arthrography can be done on an out patient basis and at low cost. In any case, the best screening remains thorough clinical examination supplemented, if necessary, by imaging studies. PMID- 1783555 TI - Comparison of CT scan diagnosis and surgical findings in lumbar disk herniation. AB - The authors compare CT scan evidence with surgical findings in lumbar intervertebral disk disease. The results confirm the reliability of the CT scan for diagnosis of disk herniation, but find it somewhat less precise as far as diagnosis of disk degeneration. The authors emphasize the irreplaceability of the clinical examination in the preoperative assessment of lumbar disk disease as well as the important confirmation provided by the imaging studies. PMID- 1783556 TI - The contribution of magnetic resonance imaging in a rare ischiatic localization of osteoid osteoma. AB - The authors present a case of osteoid osteoma (O.O.) localized in the ischiatic ramus, a very rare (incidence varying from 1.2% to 2.7% in the literature) site for this lesion. Of all the diagnostic tests used, including conventional radiography and Computerized Axial Tomography (CT), the information provided by Magnetic Resonance Imaging (MRI) was particularly valuable. MRI permits recognition of the "nidus" of the osteoid osteoma, which usually emits an intermediate signal on T1-"weighted" images, and is more sensitive than conventional radiography or CT, especially when the marked sclerotic reaction around the tumor renders diagnosis with these last two methods difficult. PMID- 1783557 TI - Langerhans' cell histiocytosis: a case report. AB - The authors describe the morphologic features of Langerhans' cell histiocytosis and discuss the main prognostic factors which divide patients into two groups requiring different treatment. They then describe a case of multifocal Langerhans' cell histiocytosis due to pelvic osteolysis and early diabetes insipidus, emphasizing the effectiveness of the combination of surgery and chemotherapy and the rapid reparative new bone formation. PMID- 1783558 TI - Bifid median nerve as a cause of carpal tunnel syndrome. Report of one case. AB - The authors describe a case of bifid median nerve at the wrist resulting in carpal tunnel syndrome, and they emphasize the rarity of this occurrence. In this case, the disorder is accompanied by agenesis of the thenar eminence and bony malformation of the radial column of the wrist. PMID- 1783559 TI - One case of rotational subluxation of the carpal scaphoid. AB - The authors describe one case of perilunate dislocation. After reduction of the dislocation, there was a residual rotational subluxation of the scaphoid due to dorsal tearing of the scapho-triquetral and radio-scaphoid ligaments. The subluxation results in post-traumatic dorsal instability of the carpus. The authors report their clinical experience and conclude that clinical and radiographic diagnosis is not always easy and treatment, which is always surgical, must aim at joint stabilization and ligament reconstruction. PMID- 1783560 TI - Enzyme-gold cytochemistry of seed xyloglucans using two xyloglucan-specific hydrolases. Importance of prior heat-deactivation of the enzymes. AB - Two pure, homogeneous xyloglucan-hydrolyzing enzymes from germinated nasturtium seeds have been used to localize xyloglucans specifically in seed cell walls. The enzymes, a novel endo (1----4)-beta-D-glucanase which shows absolute specificity towards xyloglucans and a beta-D-galactosidase which is capable of removing galactosyl residues from polymeric xyloglucans, were used to stabilize gold sols. The complexes were applied to ultrathin sections of nasturtium (Tropaeolum majus L) and tamarind (Tamarindus indica L) seeds. The gold complexes prepared from the active enzyme proteins retained enzyme activity, and such complexes gave extremely weak section-labelling or no labelling at all. When the enzymes were subjected to heat-deactivation before being used to stabilize the gold sols, gold complexes were obtained which lacked enzyme activity, but which gave strong, specific labelling of xyloglucans in ultrathin sections. The specificity of the labelling was checked by substrate-competition, by pretreatment of sections with the active and heat-denaturated enzymes and by comparing the labelling of xyloglucan-containing storage cells with other cell types in the same section. The labelling was maximal at the pH which was optimal for the active enzyme. We conclude that the enzyme-gold complexes which retain high activity against the substrate to be localized are likely to be unsuitable as cytochemical probes because they may cause in situ substrate modification. In the case of the enzyme complexes described here the specific localization obtained with the gold complexes prepared from heat deactivated enzymes may be attributable to the retention by the heat-treated enzymatically-inactive proteins of substrate recognition.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783561 TI - Morphological study of lectin binding in the rabbit temporomandibular joint disc. AB - Glycoconjugates of the extracellular matrix are important for the normal mechanical functions of connective tissue structures such as the temporomandibular joint disc. Since lectins are known to bind to sugar residues with high affinity, a variety of lectins were used to study the presence and distribution of glycoconjugates in the temporomandibular joint disc. Discs were removed from 6 to 8-month-old rabbits and either sectioned in a cryostat and processed for light microscopy or fixed in 2% glutaraldehyde and processed for electron microscopy. The frozen sections were incubated with fluorescein- or peroxidase-conjugated lectin solutions. Ultrathin sections mounted on grids were incubated with lectins combined with a colloidal gold marker system for electron microscopical study. Our results indicate that Canavalia ensiformis agglutinin (ConA) showed little or no binding to the discal tissue. Triticum vulgaris agglutinin (WGA) and Maclura pomifera (MPA) were bound strongly to both the synovium and the extracellular matrix and WGA also bound to the territorial matrix of chondrocyte-like cells. Glycine max and Arachis hypogoea agglutinins (SBA and PNA), were localized in the synovium and extracellular matrix but to a lesser degree than WGA and MPA. WGA, MPA, Griffonia simplicifolia II and Ulex europaeus were bound by discal fibroblasts. WGA was also localized in lysosomes of synovial A-cells (macrophages). The electron microscopical studies with lectins and colloidal gold marker systems indicated that some areas of the disc may be fibrocartilagenous as had been suggested by earlier immunohistochemical studies using monoclonal antibodies to characteristic glycosaminoglycans (GAGs) in cartilage. PMID- 1783562 TI - Histochemical identification of 9-O-acyl sialic acids: studies of bovine submandibular and rat sublingual gland and human colon. AB - Formalin-fixed tissue specimens containing glycoproteins with side chain O acylated sialic acids were used to re-examine, compare and evaluate the usefulness of three methods based on the periodic acid-borohydride reduction saponification-periodic acid-Schiff sequence (PA-Bh-KOH-PAS) for the histochemical identification of 9-O-acyl sialic acids (9-O-AcSA). Method I, modified from Veh et al. (1979), involved a comparison of the staining intensely obtained when both oxidation steps of the PA-Bh-KOH-PAS sequence were carried out with the selective oxidation technique of Volz et al. (1987) with that obtained when the initial oxidation step was carried out with 0.5 M periodic acid for 4 h at room temperature. Methods II and III, modified from Reid et al. (1978), involved an initial PA-Bh step under oxidation conditions that cleaved all the vicinal diols associated with neutral sugars and side chain unsubstituted and 7-O acyl sialic acids. The Schiff staining obtained following subsequent re-oxidation with either 0.5M (method II) or 1% periodic acid (method III) for 4 h at room temperature (PA-Bh-PAS procedure) identifies 9-O-AcSa.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783563 TI - Comparison of the Ruthenium hexammine trichloride method to other methods of chemical fixation for preservation of avian physeal cartilage. AB - Several methods of chemical fixation of avian physeal cartilage were compared. The Ruthenium hexammine trichloride method was compared to isotonic glutaraldehyde and neutral buffered formalin for light microscopy and paraffin embedment, and to two osmium-ferrocyanide methods and a combination of 1% glutaraldehyde and 4% formaldehyde for electron microscopy. Only the Ruthenium hexammine trichloride method prevented the loss of matrix proteoglycans and shrinkage of chondrocytes. In undecalcified paraffin-embedded cartilage, preservation of matrix and cellular detail was excellent, but Ruthenium hexammine trichloride interfered with Haematoxylin and Eosin staining. Glutaraldehyde gave more intense eosinophilia than neutral buffered formalin. Ultrastructurally, the Ruthenium hexammine trichloride method was the most consistent and gave the best overall fixation. Matrix elements and cellular and nuclear membranes were well preserved. It did result in vacuolation of the cytoplasm and mitochondria, and it increased granularity of the cytoplasm, chromatin, and rough endoplasmic reticulum. Other fixatives produced minimal vacuolation and finer granularity, but preservation was less consistent, cell/matrix contrast was often excessive, and they caused shrinkage of all chondrocytes. Large dilatations of the rough endoplasmic reticulum that appear to be cytoplasmic inclusions by light microscopy are described for the first time in avian cartilage. PMID- 1783564 TI - Lectin histochemistry of human bone marrow: investigation of trephine biopsy specimens in normal and reactive states and neoplastic disorders. AB - The lectin binding pattern of bone marrow cells in normal and reactive states and in various neoplastic disorders was investigated using trephine biopsy specimens taken from the iliac crest. The tissue samples were routinely processed (fixed in formalin and embedded in paraffin wax) and subjected to mild decalcification with EDTA. The following results were obtained. (1) More than half of the 23 fluoresceinated lectins used reacted with normal blood cells and/or their neoplastic derivatives. Inhibition tests with the appropriate sugars confirmed the specificity of binding for the majority, but not all, of the lectins. (2) WGA, Con A, PSA, STA and RCA60 and RCA120 produced a particularly intense reaction with normal, reactive and neoplastic myeloid cells. Erythroblasts exhibited weak staining in a few cases by a few lectins (WGA producing the strongest staining), while megakaryocytes nearly always remained unstained. Neoplastic lymphoid cells in various lymphoproliferative disorders and plasmacytoma cells generally reacted with the same lectins as the myeloid cells. (3) Since neoplastic myeloid cells in various myelodysplastic and myeloproliferative disorders exhibited a lectin binding pattern similar to that of myeloid cells in normal and reactive bone marrow, it is unlikely that lectin histochemistry of the bone marrow will prove of great value in the diagnosis of myelodysplastic-myeloproliferative disorders. PMID- 1783565 TI - Binding studies and localization of Escherichia coli lipopolysaccharide in cultured hepatocytes by an immunocolloidal-gold technique. AB - In this study, the uptake and localization of an Escherichia coli lipopolysaccharide, and the temperature effects on these processes, were studied in rat cultured hepatocytes using a binding assay and an immunocolloidal gold technique. The lipopolysaccharide was found to bind to the cell membrane and microvilli after short incubation times, at both 4 degrees C and 37 degrees C. This was followed by a dispersed localization into the cytoplasm, reaching mitochondria. The uptake was found not to be receptor-mediated. A decrease of temperature, delays, but does not prevent, the lipopolysaccharide internalization. PMID- 1783566 TI - Sulphated glycosaminoglycans expression in the basement membranes of colorectal adenocarcinomas. Preliminary study: correlation with histological grading. AB - The expression of sulphated glycosaminoglycans was studied at the ultrastructural level by the high iron diamine technique in the basement membranes of 26 colorectal adenocarcinomas (10 well-differentiated, 7 moderately-differentiated, 9 poorly-differentiated). Sulphated glycosaminoglycan expression was highly variable. It was scored as regular (5 cases), slightly irregular (6 cases), highly irregular (15 cases). In general, poor histological differentiation could be correlated with absent or highly irregular expression. However, in a limited number of cases, severe alterations of basement membranes were also present in well-differentiated (2 cases) and moderately-differentiated (4 cases) tumours. Such a variability shows up a heterogeneity which is not revealed by histological grading. PMID- 1783567 TI - Quantitative cytochemical demonstration of intracellular thyroglobulin in cultured human thyrocytes. Effects of fixatives, TSH and interleukin-1 beta. AB - A quantitative immunocytochemical method is described for measuring intracellular thyroglobulin in human thyrocytes grown in monolayer, based on the imidazole enhanced 3,3'-diaminobenzidine/peroxidase reaction. The influence of ten different fixatives on the content of thyroglobulin immobilized on nitrocellulose filters and in single cells and the influence of thyrotropin and interleukin-1 beta (IL-1 beta) on the amount of intracellular thyroglobulin were evaluated. The most suitable fixatives for single cells were 2% carbodiimide, Lison's 'Gendre fluid' and 2 or 4% paraformaldehyde, whereas Bouin, Carnoy A and B, formalin calcium and Lillie's formaldehyde-acetic acid-alcohol fixative all resulted in reduction of intracellular thyroglobulin. Two per cent glutaraldehyde caused a considerable reduction (p less than 0.0001). Nitrocellulose filters were not suitable for evaluation of the fixatives, since the results did not correspond to those obtained with single cells. Thyrotropin (1 U/l) increased intracellular thyroglobulin, whereas addition of interleukin-1 beta to the culture medium for three days caused a dose-dependent reduction with a plateau level at 2 x 10(-6) gl-1 (10(4) U/l) of interleukin-1 beta. It is concluded that changes in intracellular thyroglobulin concentration caused by either thyrotropin or IL-1 beta can be quantified under experimental circumstances where samples for measurements of thyroglobulin-mRNA or extracellular thyroglobulin are difficult or impossible to obtain. PMID- 1783568 TI - Localization of donor nuclei in skeletal muscle grafts by in situ hybridization to a cDNA probe. AB - The development of therapies, based upon implantation of normal muscle cell precursors, for the treatment of skeletal muscle diseases such as Duchenne Muscular Dystrophy is in its infancy. Detailed analysis of the genetic and phenotypic contribution made by donor myoblasts to the regenerated muscle is critical. Using non-radioactive in situ hybridization of a Y chromosome-specific DNA probe to sections of muscle, we have localized the position of male donor nuclei within female host muscles after myoblast implantation. These results were compared with the distribution of immunocytochemically-localized dystrophin and the expression of donor-specific glucose phosphate isomerase by isoelectric focussing. We found consistent male-specific nuclear hybridization and a close spatial relationship between the distribution of male donor nuclei and dystrophin positive muscle fibres within female, dystrophin-negative host muscles. This approach will be useful in the further analysis of myoblast implantation experiments. PMID- 1783569 TI - The application of scanning confocal microscopy in cartilage research. AB - Scanning confocal microscopy has been used in conjunction with immunofluorescent localization to address two areas of debate in cartilage research. With the enhanced resolution and optical sectioning capability of this new technique, we have demonstrated that type IX collagen is preferentially located in an area around the chondrocyte, even in young cartilage. We have also shown that cathepsin B production is not confined to de-differentiated chondrocytes. The advantages and versatility of scanning confocal microscopy have thus clearly been demonstrated. PMID- 1783570 TI - Molecular genetic studies of major histocompatibility complex genes in children with juvenile dermatomyositis: increased risk associated with HLA-DQA1 *0501. AB - Juvenile dermatomyositis (JDMS) is an inflammatory disease associated with HLA DR3. We therefore undertook molecular genetic studies of HLA region genes to determine whether HLA-DR3 itself confers susceptibility to JDMS or whether susceptibility is conferred by alleles in linkage disequilibrium with HLA-DR3. Our results indicate that JDMS is associated with the HLA-DQA1 allele DQA1 *0501 on non-DR3 haplotypes in Caucasian JDMS. Furthermore, the reported of association between the C4A gene deletion and JDMS is likely due to linkage disequilibrium with HLA-DR3. PMID- 1783571 TI - Analysis of HLA-DR2-associated polymorphisms by oligonucleotide hybridization in an Asian Indian population. AB - Among major histocompatibility complex class II antigens, HLA-DR2 appears to have a much larger degree of polymorphism than usually recognized by routine serology or restriction fragment length polymorphisms. We have utilized oligonucleotide probes to further identify the DR2 specificity and its molecular subtypes on the basis of specific DNA sequences as they occur in a select sample from the Asian Indian population. In addition, oligonucleotide typing of HLA-DQA1 and -DQB1 genes allowed us to determine specific associations of DRB1, DRB5, DQA1, and DQB1 alleles in DR2 individuals. A set of 60 oligonucleotide probes were hybridized to polymerase chain reaction (PCR)-amplified DNA from DR2 homozygous or heterozygous individuals. The most common DR2 subtypes that occurred in this selected population are: DRB1*1501 (60%), DRB1*1502 (33.8%), and DRB1*1602 (6.2%). No example of DRB1*1601 was detected. By combining these results with the allelic variations at DQA1 and DQB1, we were able to detect at least seven different haplotypes, the most common being DRB1*1502-DRB5*0102-DQA1*0103-DQB1*0601 and DRB1*1501-DRB5*0101-DQA1*0102-DQB1*0502. At least five unexpected combinations, not reported among Western Caucasians, were noticed in this sample. Thus oligonucleotide typing is a valuable tool for defining further polymorphisms in the HLA-D region as exemplified by its applications to typing DR2-positive patients with tuberculoid leprosy and pulmonary tuberculosis. PMID- 1783572 TI - Association of mucosal leishmaniasis with HLA. AB - In the search for genetic variability in individual susceptibility to mucocutaneous leishmaniasis, a disease caused mainly by Leishmania (Viannia) braziliensis, HLA typing was performed on 43 patients presenting mucosal lesions and 111 matched controls. Antigen specificities of the HLA-A, -B, -C, -DR, and DQ loci were determined and their frequencies in patients and controls were compared. There was a significant decrease in the frequency of HLA-DR2 [1 out of 38 (2.6%) patients vs. 29 out of 102 (28.4%) controls, corrected p value 0.004, relative risk 0.07, preventive fraction of the total population 0.26] as well as a significant increase of HLA-DQw3 [29 out of 38 (76.3%) patients vs. 43 out of 99 (43.4%) controls, corrected p value 0.006, relative risk 4.2, etiologic fraction of the population 0.58]. These results support participation of HLA class II molecules in individual susceptibility to mucocutaneous leishmaniasis and in the pathogenesis of metastatic, mucosal disease. PMID- 1783573 TI - Diversity in HLA-DR4-related DR,DQ haplotypes in Australia, Oceania, and China. AB - The relative distributions of 12 HLA-DR4-related DRB1 alleles in indigenous populations of Australia, Melanesia, Micronesia, Polynesia, and northern and southern China have been determined by analysis of oligonucleotide hybridization patterns of 406 examples of HLA-DR4. DRB1*0405 and DRB1*0410 were common DR4 alleles in Australian aborigines and in Melanesians, while DRB1*0403 was the predominant DR4 allele in coastal Melanesians, Micronesians, and Polynesians; DRB1*0406 was confined to Chinese. A novel DR4 allele, found in 30% of DR4 positive Australian aborigines but exclusive to one aboriginal population, was a combination of DRB1*04 and 0803 nucleotide sequences and was carried on a haplotype with DR4-like DQ linkage arrangements. DQA1 and DQB1 typing generated 12 DR4-related haplotypes; the population distributions of these reflected the ancestral affinities of aborigines and Melanesians, the overlaying of coastal Melanesia with pre-Polynesian DR4 alleles and the colonization of Micronesia by an independent, non-Polynesian group. DR4-related autoimmune disorders such as rheumatoid arthritis (RA) and insulin-dependent diabetes mellitus (IDDM) are virtually unknown in indigenous populations of Australia and Oceania and this study confirmed that high-risk RA determinants, Dw4 and Dw14, occurred rarely. However, the DQw8 allele, thought particularly to predispose to IDDM, was present in the majority of DR4-positive Polynesians and Micronesians. PMID- 1783574 TI - Rehabilitation in Hansen's disease. AB - Hansen's disease leads to deformities of the lower and upper extremities. Eventually, these deformities become a serious handicap and limit the functional capabilities of the afflicted. This paper defines the characteristics of individuals suffering from Hansen's disease and demonstrates that disabilities caused by Hansen's disease can be overcome by: (i) use of splints, (ii) reconstructive surgery, (iii) modification of the articles and tools of daily use, and (iv) proper job--worker matching. PMID- 1783575 TI - Holter monitoring in the evaluation and rehabilitation of post-cerebrovascular accident patients. AB - Coronary artery disease, overt or silent, is frequently present in patients who have suffered a cerebrovascular accident (CVA). Rehabilitation therapy of CVA patients is based mostly on physical activity, which may be limited by fear of overloading the cardiovascular system. Therefore, assessment of the severity of coronary heart disease in CVA patients is of utmost importance. In this study we assessed the usefulness of 24-hour electrocardiographic Holter monitoring in the evaluation of post-CVA patients during daily activities and rehabilitation. Of the 43 post-CVA patients, 24 (55.8%) revealed pathological changes on Holter monitoring and 17 (71%) had a history of coronary artery disease prior to CVA. Holter monitoring revealed mainly ventricular and atrial arrhythmias and in three patients detected transient ischaemic episodes. Only six patients (14%) showed aggravation of arrhythmia during rehabilitation therapy, without aggravation of ST-T changes. The mean maximum heart rate during regular daily activities was 104 +/- 20 beats/min, which was significantly higher than the mean maximum heart rate during physical therapy (100 +/- 18 beats/min; p less than 0.01) and during occupational therapy (87 +/- 18 beats/min; p less than 0.001). These findings indicate that more vigorous physical and occupational therapy can be prescribed to these patients. The performance of Holter monitoring in post-CVA patients is a valuable substitute to exercise testing, and is useful for cardiovascular evaluation during daily activities and rehabilitation therapy. PMID- 1783576 TI - Coping strategies of chronically ill adolescents and their parents. AB - The purpose of this exploratory pilot study was to determine the coping strategies used by adolescents with chronic illnesses and compare those strategies with the strategies used by their parents. Adolescent coping strategies were measured by the Jaloweic Coping Scale, while parental perceptions of their coping strategies were assessed using the Hymovich Chronicity Impact and Coping Instruments: Parent Questionnaire (CICI:PQ). Fifteen chronically ill adolescents and their parents were administered the tools. Analysis revealed that there were significant differences between the parent coping strategies and those of the adolescents in the sample. Adolescent responses on the three subscales of the Jaloweic Coping Scale were analysed using ANOVA, resulting in no significant differences in responses on the three subscales. PMID- 1783577 TI - Learning disabilities in long-term survivors of childhood cancer: concerns for parents and teachers. AB - Today more and more children are surviving childhood diseases that had been fatal in a previous generation. Medical advances and technology allow most children with cancer to enjoy long-term survival and cure. Research studies now show that there are late effects of treatment that affect growth, development, and cognitive functioning. Parents and teachers of long-term survivors of childhood cancer share concerns about deficits in cognitive functioning as it affects learning in school. Childhood cancer and the literature on cognitive late effects of treatment are discussed. Recommendations are made for early psychological evaluation and appropriate educational intervention. PMID- 1783578 TI - Potential for alterations in family process: when a family has a child with cystic fibrosis. AB - Cystic fibrosis (CF) is a disease that has profound consequences on a family unit. As a genetically transmitted, chronic illness, it influences every aspect of family life, including time constraints, finances, and relationships among family members. The purpose of this article is to demonstrate the cumulative effect of the nursing diagnoses related to the pathophysiology of CF on the nursing diagnosis, Potential for Alterations in Family Process, when a family has a child with cystic fibrosis. This nursing diagnosis was first recognized by the North American Nursing Diagnosis Association (NANDA) in 1982. It is vital that nurses are able to differentiate between a family having difficulty coping with a child with CF in the home, and one that is coping well on its own. The children of families that are not coping well tend to be hospitalized more than those of families that are coping well. The families use the hospitalizations as rest periods for themselves. By recognizing the cues identified by NANDA of a family having problems, early intervention can be initiated before the family is in a crisis. The family must live with CF on a daily basis for the remainder of the child's life; therefore it must be able to function at its optimum level. It is nursing's responsibility to be able to recognize and assist the family in need. A knowledge of the nursing diagnosis, Alterations in Family Process, will assist nurses in fulfilling this obligation to the family. PMID- 1783579 TI - Impact of traumatic brain damage on family dynamics and functioning: a review. AB - The purpose of this paper is to review the dynamics and functioning of families with a severely head-injured member. In order to stress the unique problems faced by persons with brain damage and their families, a comparison with spinal cord injured individuals is presented. The review's major conclusion is that a head injury exposes the family to a complex of problems that are unique to this disability and, therefore, necessitates the delivery of special family support services focused on the family, rather than on the head-injured person. PMID- 1783580 TI - Supported employment and compensatory strategies for enhancing vocational outcome following traumatic brain injury. AB - This paper describes two approaches to improving the employment prospects of those suffering from head injury. It is noted that unemployment within the first 7 years post-head injury is as high as 70% and that this contributes to the long term difficulties faced by the head-injured and their families. A 'supportive' approach to employment involving the use of job coordinators or job coaches is described and a number of 'compensatory' strategies described. These two approaches are compatible and are derived from the individual needs of the head injured person in relation to retaining or seeking employment. PMID- 1783581 TI - FDA monitoring program. Residues in foods--1990. AB - In 1990, under regulatory monitoring, a total of 19,962 samples of domestically produced food from all 50 states and Puerto Rico and imported food from 92 countries were analyzed by FDA for pesticide residues. Of these, 19,146 were surveillance samples, which are collected when there is no suspicion of a pesticide problem. No residues were found in 60% of domestic surveillance samples and in 64% of import surveillance samples. Of the 19,146 surveillance samples, 2.8% were violative. Under the incidence/level aspect of monitoring, 172 samples of fish/shell-fish, 330 samples of whole milk, and 3502 samples of processed foods including baby foods were analyzed for pesticide residues. Findings from these projects were consistent with regulatory monitoring data. The findings of the 1990 Total Diet Study are evidence that actual dietary intakes of pesticides are generally well below the standards established by FAO/WHO and by EPA. The 1990 results are similar to those obtained in earlier years and demonstrate the continuing safety of the food supply relative to pesticide residues. PMID- 1783582 TI - New trends in analytical technology and methods for pesticide residue analysis. PMID- 1783583 TI - Performance characteristics of methods of analysis used for regulatory purposes. Part II. Pesticide formulations. AB - The precision parameters of the method-performance (collaborative) studies published in the AOAC Journal from 1915 through 1990 for pesticide formulations have been recalculated on a uniform basis by the International Union of Pure and Applied Chemistry 1987 protocol. About 93% of the 953 accepted assays, which are predominantly gravimetric (G), volumetric (V), and gas (GC) and liquid (LC) chromatographic methods, exhibit relative standard deviations among laboratories (RSDR) that are generally less than 2 times the values predicted from the Horwitz equation: RSDR (%) = 2 exp (1-0.5 log C), where C is the concentration expressed as a decimal fraction. UV, VIS, and IR spectrophotometric (S) methods are somewhat poorer, with about 80% of the reported RSDR values less than twice the predicted RSDR value. The precision parameters of pesticide formulations analyzed by the older methods (G, V, GC) are equivalent to those previously found for drug preparations in the same concentration range; the precision parameters of pesticide formulations analyzed by LC and S are somewhat poorer. Overall, however, the precision parameters of pesticide formulations are generally independent of analyte, method, and matrix, and are primarily a function of concentration. The method-acceptability decisions of the AOAC for pesticide formulations during the past 75 years can be approximated retrospectively by using a criterion for RSDR that is less than 2 times the RSDR calculated from the Horwitz equation. PMID- 1783584 TI - Postharvest-applied agrochemicals and their residues in fresh fruits and vegetables. AB - Many agrochemicals are applied postharvest on fruits and vegetables to extend their lives and preserve quality during storage, transport, and marketing. Persistence and distribution of residues on the edible portions of produce have been reported for citrus fruits, pome fruits, stone fruits, mangos, strawberries, bananas, kiwi fruits, avocados, some minor fruit commodities, and bell peppers and tomatoes. Data on the persistance and residues of the fungicides benomyl, biphenyl, sec-butylamine, captan, carbendazim, dicloran, fosetyl-aluminum, guazatine, imazalli, iprodione, metalaxyl, o-phenylphenol, prochloraz, thiabendazole, thiophanate-methyl, triadimeton, and vinclozolin, the fumigants ethylene dibromide, methyl bromide, and sulfur dioxide, the insecticides dimethoate and fenthion, the antiscald compounds diphenylamine and ethoxyquin, and the growth regulators 2,4-D and daminozide are presented and discussed. PMID- 1783585 TI - Liquid chromatographic determination of chlortetracycline hydrochloride in ruminant and poultry/swine feeds. AB - A liquid chromatographic (LC) method is described for the determination of chlortetracycline hydrochloride (CTC) in poultry/swine and ruminant feeds in the 10-100 ppm range and in premix. CTC is extracted from ground feed/premix with acidified acetone, and the extract is filtered through a Millex-HV filter or disposable C18 column. The filtrate is partitioned with methylene chloride when additional cleanup is necessary. A Nova-Pak C18 column is used for LC separation with determination at 370 nm. The average recovery of CTC from premix was 95% with a standard deviation (SD) of 1.70 and a coefficient of variation (CV) of 1.79%. The overall average recovery from feeds was 77% with an SD of 3.18 and a CV of 4.10%. PMID- 1783586 TI - Competitive direct enzyme-linked immunosorbent screening assay for the detection of sulfamethazine contamination of animal feeds. AB - A sensitive screening method has been developed for detecting sulfamethazine (SMZ) contamination of feeds by using either polyclonal or monoclonal antibodies and a direct competitive enzyme-linked immunosorbent screening assay (ELISA). Feed samples of 25.0 g are extracted with 0.5N HCl and centrifuged. The extract is adjusted to pH 7.0 with 3.0N NaOH and recentrifuged. This pH-adjusted extract is used in the ELISA. Levels as low as 0.004 micrograms SMZ/g feed were detected in supplemented extracts by polyclonal antibodies; levels of 0.4 micrograms SMZ/g feed were detected by a monoclonal antibody. PMID- 1783587 TI - Modifications to the official method for testing chlortetracycline HCl in animal feeds. AB - Results are compared for the microbiological analysis of chlortetracycline using the AOAC method and a modified method applicable to potencies above 50 g/ton. Two modifications are presented: substitution of a pH range of 4.0-4.5 instead of the specified pH of 4.5 for the plating solution, and substitution of extraction by shaking instead of the blending procedure. There were no significant differences in results between the AOAC method and the modified method. PMID- 1783588 TI - Efficiency of two commercial ELISA kits compared with the BAM culture method for detecting Listeria in naturally contaminated foods. AB - The efficiency of 2 commercial enzyme-linked immunosorbent assay (ELISA) kits (Listeria-Tek and Tecra) for detecting Listeria in naturally contaminated foods was evaluated and compared with that of the culture method described in the Bacteriological Analytical Manual (BAM). Both ELISAs use modified University of Vermont (UVM-1) medium as a primary enrichment; the BAM method uses Listeria enrichment broth. Secondary enrichments for Listeria-Tek and Tecra, respectively, were Fraser broth and UVM-2, which contains additional acriflavin-HCl. When ELISA test results differed, secondary enrichments were tested against the other ELISA; Fraser broth was used to determine recovery rates because of its superiority over UVM-2. Of the 178 food samples examined, the presence of Listeria was detected and culturally confirmed in 38, 37, and 40 samples by the BAM, Listeria-Tek, and Tecra methods, respectively. Differences in results of the ELISAs compared with those of the BAM method were not statistically significant; however, differences between results of the 2 ELISA methods were significant. It was concluded that as rapid screening methods, the Listeria-Tek and the Tecra kits qualify as alternative methods to the BAM cultural method. PMID- 1783589 TI - Recovery of Salmonella from shell eggs. AB - A preenrichment procedure and a direct selective enrichment procedure were compared for recovery of Salmonella artificially inoculated into liquid whole egg, egg yolk, and egg albumen. For liquid whole egg and egg yolk, the 2 procedures were comparable. With egg albumen, however, preenrichment in lactose broth gave significantly higher recoveries than did direct selective enrichment in either selenite cystine or tetrathlonate broths. The lactose preenrichment procedure was used to determine the survival of S. enteritidis in egg yolk and egg albumen over a period of 7 days. As shown by most probably number determinations, counts of S. enteritidis inoculated into egg albumen decreased by 3 log units, whereas those in egg yolk did not change significantly. It is recommended, therefore, that only the egg yolk be examined for this pathogen. In a comparison of 5 different preenrichment media (lactose broth, brain heart infusion broth, trypticase soy broth, buffered peptone water, and nutrient broth), lactose broth was somewhat less productive than the other 4 media for the recovery of Salmonella from egg yolks. Trypticase soy broth gave the highest recovery. PMID- 1783590 TI - Comparison of an ELISA-based screening test with liquid chromatography for the determination of aflatoxins in corn. AB - An enzyme-linked immunosorbent assay (ELISA) screening test (CITE PROBE) was compared to liquid chromatography (LC) for the determination of aflatoxins in naturally contaminated corn samples. The CITE PROBE, with a positive/negative cutoff of 5 ng/g aflatoxin B1, was correct (based on LC results) on 47 of 51 samples. Two of the incorrect responses by the CITE PROBE were false positives on samples containing 4.4 ng/g and 4.1 ng/g aflatoxins by LC. Another incorrect response was a false negative on a sample containing 5.5 ng/g aflatoxins by LC. The fourth incorrect response was a false positive on a sample containing 1.9 ng/g aflatoxins by LC. On the basis of these results, the CITE PROBE was determined to be a reliable screening method for the detection of greater than or equal to 5 ng/g aflatoxins in corn. PMID- 1783591 TI - Gas chromatographic determination of captan, folpet, and captafol residues in tomatoes, cucumbers, and apples using a wide-bore capillary column: interlaboratory study. AB - An interlaboratory study of the determination of captan, folpet, and captafol in tomatoes, cucumbers, and apples was conducted by 4 laboratories using wide-bore capillary column gas chromatography with electron capture detection. The 3 fungicides were determined using the Luke et al. multiresidue method modified to include additional solvent elution in the optional Florisil column cleanup step used with this method. The crops were fortified with each fungicide at 3 levels per crop. Mean recoveries ranged from 86.2% for a 25.1 ppm level of captan in apples to 115.4% for a 0.288 ppm level of captafol in apples. Interlaboratory coefficients of variation ranged from 3.4% (24.7 ppm folpet) to 9.7% (0.243 ppm captafol) for tomatoes; from 2.8% (2.0 ppm captafol) to 8.2% (24.8 ppm captan) for cucumbers; and from 1.5% (0.234 ppm folpet) to 22.1% (0.266 ppm captafol) for apples. PMID- 1783592 TI - Residue analysis of glyphosate and its principal metabolite in certain cereals, oilseeds, and pulses by liquid chromatography and postcolumn fluorescence detection. AB - A postcolumn liquid chromatographic method to determine the extractable residues of glyphosate (GLYPH) and its principal metabolite, (aminomethyl)phosphonic acid (AMPA), in various cereals and beans is described. The finely ground sample is extracted with a mixture of chloroform and water, and the resulting aqueous layer is passed through a cation exchange column. The eluate is adjusted to pH 7-10 and passed through an anion exchange column. The second column is eluted with 0.3M HCl solution and the resulting acidic eluate is analyzed with liquid chromatography coupled with postcolumn fluorescence detection. The mean recoveries for GLYPH in barley, canola, dry pea, flax, soybean, wheat, and white bean ranged from 90.0 to 98.1%, with coefficients of variation (CV) from 2.9 to 10.0% and limits of detection (LOD) from 0.07 to 0.14 ppm. Similarly, mean recoveries for AMPA in the same crops ranged from 87.4 to 98.9%, with CV from 4.6 to 7.7 and LOD from 0.05 to 0.12 ppm. Using this method, an analyst can routinely analyze 6 samples per 1.5 days. The advantages of this procedure are discussed. PMID- 1783593 TI - Time required to achieve homogeneity of test substances added to dog feed. AB - The homogeneity of test substances in a carrier (animal feed) is a critical factor in conducting long-term feeding studies in laboratory animals. A method for determining the adequate amount of mixing to achieve homogeneity by a mixer of the type described has been determined when 2 distinctly different compounds are added to ground dog feed. Nicotinic acid and butylated hydroxyanisole at a concentration of 1% were separately mixed with the dog feed for 15, 30, 45, 60, and 120 min to determine optimum mixing time. Test portions were taken from 4 different sampling sites at each time period and analyzed in duplicate for the added substance. Four batches were prepared and the results were aggregated. Very little interbatch variability was observed. The variance of the average values from the 4 sampling sites at each time period was calculated and used as a simple, crude, but effective numerical quantity to monitor the approach to homogeneity of the mixture. PMID- 1783594 TI - Validation of methods used in the Florida Department of Agricultural and Consumer Services' Chemical Residue Laboratory. AB - Very few methods for detecting residues of pesticides in food or agricultural samples have undergone rigorous colloborative study and possess official AOAC status. The Chemical Residue Laboratory has formalized a method validation scheme to use when incorporating or developing new, unofficial methods. These methods are validated by assessing certain performance parameters: scope, specificity, linear range, accuracy, precision, limit of detection (LOD), and limit of quantitation (LOQ). For accuracy and precision assessment, 12 replicate fortifications must yield recoveries within the range of 70-120% with a coefficient of variation (CV) that compares favorably to the Horwitz CV. LOD and LOQ are equivalent to 3 and 10 times, respectively, the background signal contributed by a sample matrix blank. This criterion that we use for LOD/LOQ is not universal. In fact, because of differing definitions, we have encountered difficulties in enforcing a tolerance by using a registrant's method. This paper also presents an example of our method validation scheme, using a recent method development project for detecting sulfamethazine in raw milk. The sulfamethazine project also revealed unanticipated personnel problems, underscoring the importance of the human factor in quality assurance. PMID- 1783595 TI - Determination of Mirex in human blood serum containing polychlorinated biphenyls by using packed column gas chromatography. AB - An analytical method has been developed that uses electron capture/gas-liquid chromatography to determine Mirex in serum containing polychlorinated biphenyls (PCBs) (Aroclor 1260). With this method, 0.2 ppb Mirex can be determined in 4 mL serum that also contains 10 ppb PCBs. The method provides approximately 70% recovery of Mirex at 1.0 and 3.5 ppb. The coefficients of variation are 4.5 and 4.6% at 1.0 and 3.5 ppb, respectively. In a cooperative study with the Ohio Department of Health, the Centers for Disease Control used this method to determine the extent of exposure of Salem, OH, residents to Mirex. Confirmation of Mirex was obtained by using high resolution gas chromatography and high resolution mass spectrometry. PMID- 1783596 TI - Fast turnaround multiresidue screen for pesticides in produce. AB - A rapid multiresidue screen for 110 pesticides was applied to 5628 produce samples. Samples were extracted, analyzed, and evaluated within 6 1/2 h of receipt. Analyses were confirmed within a 24 h period on those samples in which a potential residue was found above the U.S. Environmental Protection Agency's tolerance level. A thorough yet quick chromatographic interpretation program is also described. PMID- 1783597 TI - Crystallization and preliminary X-ray studies of hydroxylamine oxidoreductase from Nitrosomonas europaea. AB - Hydroxylamine oxidoreductase [EC 1.7.3.4] from Nitrosomonas europaea was crystallized by the microdialysis method using ammonium sulfate. Its space group is P63 with cell dimensions of a = b = 96.4 A and c = 266.2 A. Its molecular weight was determined to be 190,000-195,000 by the X-ray small angle scattering and ultracentrifugal methods. PMID- 1783598 TI - Sympathetic activation of glucose utilization in brown adipose tissue in rats. AB - The effects of norepinephrine (NE) infusion and surgical denervation or electrical stimulation of the sympathetic nerves on 2-deoxyglucose (2-DG) uptake in interscapular brown adipose tissue (BAT) were investigated in vivo in rats to obtain direct evidence for sympathetic control of glucose utilization in this tissue. 2-DG uptake was rather low in fasted rats, but after refeeding it increased in the BAT as well as the heart, skeletal muscle, and white adipose tissue, in parallel with an increase in plasma insulin level. Cold exposure also enhanced 2-DG uptake in the BAT without the increase in plasma insulin level, while it had no appreciable effect on 2-DG uptake in other tissues. Sympathetic denervation greatly attenuated the stimulatory effect of cold exposure on 2-DG uptake in BAT, but it did not affect the increased 2-DG uptake after refeeding. Electrical stimulation of the sympathetic nerves entering BAT or NE infusion produced a marked increase in 2-DG uptake in BAT without noticeable effects in other tissues. beta-Adrenergic blockade, but not alpha-blockade, abolished the increased 2-DG uptake in BAT. It was concluded that glucose utilization in BAT is activated directly, independently of the action of insulin, by sympathetic nerves via the beta-adrenergic pathway. PMID- 1783599 TI - Carbohydrate structures of human interleukin 5 expressed in Chinese hamster ovary cells. AB - The asparagine-linked sugar chains of recombinant human interleukin 5 produced by Chinese hamster ovary cells were released quantitatively as oligosaccharides by hydrazinolysis. After N-acetylation followed by NaB3H4 reduction, each oligosaccharide was isolated by paper electrophoresis and serial lectin column chromatography. Study of their structures by sequential exoglycosidase digestion in combination with methylation analysis, revealed that they are bi-, tri-, and tetraantennary complex-type with fucosylated and non-fucosylated trimannosyl cores and high mannose type sugar chains. More than 80% of the sugar chains occur as biantennary complex-type sugar chains. Although acidic oligosaccharides amount to only 14% of the total oligosaccharides, their sialic acid residues occur exclusively as the Sia alpha 2----3Gal group. Removal of the sugar moiety from intact recombinant human interleukin 5 produced a 2.5-fold increase of its activity to induce IgM secretion. PMID- 1783600 TI - Comparative affinity labeling with reactive UDP-glucose analogues: possible locations of five lysyl residues around the substrate bound to potato tuber UDP glucose pyrophosphorylase. AB - By using two reactive analogues of UDP-Glc, uridine di- and triphosphopyridoxals, we have recently probed the substrate-binding site in potato tuber UDP-Glc pyrophosphorylase [EC 2.7.7.9]. In this work, pyridoxal diphospho-alpha-D-glucose was used for the same purpose. This compound is also a reactive UDP-Glc analogue but having its reactive group on the opposite side of the pyrophosphate linkage to those of the above two compounds. The enzyme was rapidly inactivated when incubated with the compound at very low concentrations followed by reduction with sodium borohydride. The inactivation was almost completely prevented by UDP-Glc and UTP. Complete inactivation correspond to the incorporation of 1.0 mol of the reagent per mol of enzyme monomer. The label was found to be distributed in five lysyl residues (Lys-263, Lys-329, Lys-367, Lys-409, and Lys-40. All of these results were similar to those obtained previously with the other compounds, suggesting the presence of a cluster of five lysyl residues at or near the substrate-binding site of this enzyme. However, the incorporations of labels into each lysyl residue differed depending on the compounds used. The substrate retarded the incorporations in different manners. Based on the combined results of the present and previous studies, a hypothetical model is presented for the possible locations of the five lysyl residues around the substrate bound to the enzyme. This model is consistent with the kinetic properties of mutant enzymes in which the five lysyl residues were individually replaced by glutamine via site directed mutagenesis. PMID- 1783601 TI - Preparation and properties of a lysozyme derivative in which two domains are cross-linked intramolecularly between Trp62 and Asp101. AB - A lysozyme derivative in which two domains were cross-linked intramolecularly was newly prepared by means of a two-step reaction. First, the beta-carboxyl group of Asp101 in lysozyme was selectively modified with 2-(2-pyridyldithio)ethylamine in the presence of 1-ethyl-3-[3-(dimethylamino)propyl]carbodiimide hydrochloride. After reduction of the pyridyldithio moiety of Asp101 modified lysozyme at pH 4.5 with dithiothreitol, the derivative was allowed to cross-link intramolecularly by reaction with 1,3-dichloroacetone at pH 7. Intramolecularly cross-linked lysozyme thus formed was purified by gel chromatography followed by ion-exchange chromatography. Based on the results of 1H-NMR and peptide analyses, it was concluded that Asp101 was cross-linked to Trp62 with a -CH2COCH2SCH2CH2NH-bridge in this derivative. The derivative showed minor but distinct activity against Micrococcus lysodeikticus and glycol chitin. Its melting temperature for thermal denaturation was higher by 7.3 degrees than that of native lysozyme at pH 3. PMID- 1783602 TI - Different induction of 70,000-Da heat shock protein and metallothionein in HeLa cells by copper. AB - To clarify the physiological roles of heat shock proteins induced by copper, we studied the synthesis of these proteins and metallothionein, as well as the level and nature of copper incorporated into HeLa cells. Incubation in medium containing 200 microM cupric sulfate and above induced the synthesis of 70,000-Da heat shock protein (hsp70) in these cells. However, the synthesis of hsp70 did not increase in the presence of less than 200 microM cupric sulfate. On the other hand, the synthesis of metallothionein increased due to 100 microM cupric sulfate. The uptake of copper into the cells depended on the cupric sulfate concentration in the medium. To analyze the nature of the intracellular copper, cell extracts were separated by gel filtration chromatography into three fractions: the high molecular weight, metallothionein, and low molecular weight fractions. No copper was found in the low molecular weight fraction of control cells, but appeared distinctly at 200 microM cupric sulfate and above. Copper in the high molecular weight fraction also began to increase at 200 microM cupric sulfate and above, whereas in the metallothionein fraction it began to increase even at 50 to 100 microM cupric sulfate. Furthermore, inhibition of cell growth was also observed at 200 microM cupric sulfate and above but not at 100 microM and below.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783603 TI - The study of lipid-protein interactions: effect of melittin on phase transition of phosphatidylethanolamine and sensitivity of phospholipases to phase state. AB - The effects of melittin on the bilayer-to-inverted hexagonal (HII) phase transition of egg phosphatidylethanolamine (EPE) and the influence of the phase state of membrane matrix on hydrolysis of EPE by phospholipases have been studied. The phase transitions were measured using the fluorescent probe N-(7 nitro-2,1,3-benzoxadiazol-4-yl)phosphatidylethanolamine (N-NBD-PE) and differential scanning calorimetry. In the presence of melittin at a lipid-to melittin molar ratio (R1) of 200, 100, and 20, the phase transition of EPE disappeared, indicating that melittin stabilizes the bilayer structure. In the presence of 10 mol% of cholesterol, the phase transition temperature (TH) decreased and TH was observed even in the presence of melittin at R1 of 200 and 100. The fluorescence intensity of the tryptophan residue of melittin is sensitive to the phase transition and the wavelength of emission maxima shift from 352 to 337 nm upon addition of EPE and EPE-cholesterol (10 mol%) at R1 of 200. Kinetic parameters for phospholipase-catalyzed hydrolysis of EPE in bilayer and HII phases showed that HII phase of EPE is a poorer substrate for phospholipases and that cholesterol decreases the susceptibility of EPE to phospholipases. PMID- 1783604 TI - Mastoparan binding induces Ca(2+)-transfer between two globular domains of calmodulin: a 1H NMR study. AB - The interaction between calmodulin and mastoparan at various concentrations of calcium ions was studied by 1H NMR. It was found that at lower mastoparan concentrations 1 mol of mastoparan binds to both the C-terminal-half and N terminal-half regions of calcium-saturated calmodulin. The mastoparan affinity is much greater for the C-terminal-half region than for the N-terminal-half region. At higher mastoparan concentrations, a further 1 mol of mastoparan binds to the N terminal-region of calcium saturated calmodulin. The results can be interpreted in terms of the assumption that the N-terminal-half region of calmodulin with mastoparan has a higher calcium ion affinity than the C-terminal-half region without mastoparan. It is suggested that calcium ions transfer from the C terminal-half region of calmodulin without mastoparan to the N-terminal-half region of calmodulin with mastoparan. This calcium ion transfer is discussed from the viewpoint of enzyme activation by calmodulin. PMID- 1783605 TI - Purification and characterization of acidic form of glutathione S-transferase in human fetal livers: high similarity to placental form. AB - An acidic form of glutathione S-transferase (GST) was purified from human fetal livers by means of affinity chromatography and chromatofocusing. The major peak of the acidic form of GST was focused between pH 4.8 and 4.9. Judging by SDS PAGE, the purified acidic GST was apparently homogeneous; the subunit molecular weight was estimated to be 23,000. The acidic GST catalyzed the conjugations of glutathione (GSH) with 1-chloro-2,4-dinitrobenzene (CDNB) and ethacrynic acid (EA). The immunochemical properties of the purified acidic GST were indistinguishable from those of human placental GST-pi. The N-terminal amino acid sequence of the acidic GST was identical with that of GST-pi from human placenta. The level of expression of the acidic form of GST was clearly different between human adult and fetal livers as examined on the levels of mRNA and protein. PMID- 1783606 TI - Crystallization and preliminary X-ray diffraction studies of a flavoprotein, FP390, from a luminescent bacterium, Photobacterium phosphoreum. AB - A flavoprotein, FP390, obtained from a luminescent bacterium, Photobacterium phosphoreum, in the purification of luciferase has been crystallized by the vapor diffusion procedure. Crystals obtained from polyethylene glycol 4000 solutions, whose X-ray photographs show powder diffraction patterns, were unsuitable for further crystallographic work. However, tetragonal crystals grown from potassium phosphate solution well diffracted X-rays beyond 3 A resolution. The space group of this crystal is P4(1)22 or P4(3)22 with unit-cell dimensions of a = b = 76.8 and c = 241 A. Assuming two or three molecules in an asymmetric unit, the value for the crystal volume per unit molecular mass, Vm, is calculated as 3.3 or 2.2 A3/Da, respectively. A total of 13,555 independent reflections for the native crystal was collected up to 3 A resolution using a Weissenberg camera attached to the synchrotron radiation source, the merging R factor being 0.077 for 79,335 measurements. PMID- 1783607 TI - Deficiency of apolipoprotein B synthesis in Suncus murinus. AB - We reported previously that fatty liver is easily induced in a novel experimental animal, Suncus murinus (suncus) by withholding food. In this study, we focused on lipoprotein and apolipoprotein secretion from the liver. The study of lipoproteins from this animal revealed that small amounts of lipoproteins with apolipoprotein (apo) E but without apo B were observed in the fraction of density less than 1.08 g/ml. In order to learn whether apo B is synthesized by the liver or not, isolated suncus livers were perfused with an addition of [35S]methionine. Small amounts of radioactivity were observed in apo E of VLDL, and fairly large amounts in apo E and A-I in the fraction of LDL + HDL, suggesting that VLDL was secreted with apo E but not with apo B from the liver. Northern blot analysis with use of rat apo B cDNA revealed a weak signal of hybridized rat apo B cDNA between 15 kb and 9 kb in the suncus liver and intestinal mucosa; this is almost the same size as rat apo B mRNA. This finding suggests the presence of apo B mRNA in the suncus. In conclusion, apo B is not secreted from the suncus liver, owing to a defect in intracellular post-transcriptional processing or to ineffective transcription. This might be one of the reasons for fatty deposits in the suncus liver. Suncus may be a candidate for an animal model of abetalipoproteinemia as well as fatty liver due to a defect of apo B synthesis. PMID- 1783608 TI - Cysteine protease inhibitor in egg of chum salmon. AB - Two different cysteine protease inhibitors (Forms I and II) were isolated from chum salmon egg, and their molecular weights were found to be 16,000 and 11,000, respectively. When the N-terminal amino acid sequences of Forms I and II were compared, 67% of the residues were identical but no apparent homology was found between these inhibitors and cystatins of higher vertebrates. Because the amounts of half-cystine were estimated to be 7-8 residues per molecule, they can be classified into a new group of the cystatin superfamily. PMID- 1783609 TI - An improved method for purifying antihemorrhagic factor in the serum of Habu snake (Trimeresurus flavoviridis). AB - A new method is presented for purifying antihemorrhagic factor in the serum of Japanese Habu snake (Trimeresurus flavoviridis). The method consists of specific binding of the factor to a hemorrhagic principle-conjugated Sepharose, gel filtration and reverse-phase HPLC. The improved method is simple and rapid, providing the factor with a great increase in specific activity and in a high yield. PMID- 1783610 TI - The basigin group of the immunoglobulin superfamily: complete conservation of a segment in and around transmembrane domains of human and mouse basigin and chicken HT7 antigen. AB - Basigin belongs to the immunoglobulin superfamily and may be related to the primordial form of the superfamily. Human basigin cDNA was isolated and sequenced, and the predicted protein structure was compared with that of mouse basigin and two related molecules, embigin and the chicken blood-brain barrier antigen HT7. Between human and mouse basigin, 58% of the amino acids were identical and 80% of the changes were conservative. A stretch of 29 amino acid residues in the transmembrane and cytoplasmic domains was conserved not only in human and mouse basigin but also in HT7 antigen. The conserved structure may be required for interaction with a membranous protein. In addition, the relationship of basigin with other members of the immunoglobulin superfamily has been evaluated. PMID- 1783611 TI - Isolation and characterization of the subunits of Phaseolus vulgaris alpha amylase inhibitor. AB - An alpha-amylase inhibitor (PHA-I) of the white kidney bean (Phaseolus vulgaris) was found to be composed of two kinds of subunits and they were isolated on a size-exclusion column by HPLC under denaturing conditions. The alpha-subunit was free from tryptophan and cysteine and the beta-subunit contained no methionine or cysteine. There was no marked resemblance in tryptic peptide map between these subunit polypeptides. The alpha-subunit contained 28% by weight of carbohydrate, mainly made up of high mannose-type oligosacharides, whereas the sugar moiety of the beta-subunit amounted to 7% by weight and seemed to be predominantly composed of xylomannose-type oligosaccharides. By SDS-PAGE following deglycosylation, the molecular weights of the polypeptides of alpha- and beta-subunits were shown to be 7,800 and 14,000, respectively. These values were consistent with molecular sizes obtained for alpha- and beta-subunits by gel permeation HPLC in 6 M guanidine hydrochloride. The molecular weight of the native PHA-I, 28,800, obtained by gel permeation HPLC under non-denaturing conditions, suggested a heterodimeric structure for PHA-I. PMID- 1783612 TI - Activation of acid ribonuclease from bovine brain by aluminum. AB - An acid ribonuclease (optimum pH 6.0) has been purified from bovine brain in a five-step procedure. The preparation appeared homogeneous on SDS-polyacrylamide gel electrophoresis. The molecular size of the acid ribonuclease is 70 kDa and it is a dimeric protein with a subunit molecular size of 35 kDa. The acid RNase was activated by aluminum at low concentration. Preincubation of the acid RNase with 10 microM increased the specific activity of the enzyme 2.3-fold at acid pH, while the effect of aluminum was much weaker at alkaline pH under otherwise the same conditions. A stoichiometry of 1: 1 for the binding aluminum to brain acid RNase was estimated. None of the enzyme-bound aluminum was dissociated by dialysis against 50 mM HEPES, pH 7.0 at 4 degrees C for 24 h. Citrate, EDTA, NaF, and apotransferrin abolished the effects of aluminum on the enzyme. Ribonucleic acid also protected the enzyme against the activation caused by aluminum. These results suggest that accumulation of aluminum in brain may change the regulation of ribonucleic acid metabolism. PMID- 1783613 TI - Evidence that differentiates between precursor cleavages at dibasic and Arg-X Lys/Arg-Arg sites. AB - It is well known that precursor cleavage at paired basic amino acids (e.g., Lys Arg, Arg-Arg) within the regulated secretory pathway is one of the key steps to produce bioactive peptides. On the other hand, we have recently shown that precursors with an Arg residue at the fourth residue upstream of the cleavage site besides the basic pair, i.e. with the Arg-X-Lys/Arg-Arg (RXK/RR) motif, are cleaved within the constitutive secretory pathway. To discriminate between the precursor cleavage at RXK/RR sites within the constitutive pathway and that at dibasic sites within the regulated pathway, we examined the effects of drugs affecting the secretory process, intracellular Ca2+ depletion, and a protease inhibitor on these cleavages. Chloroquine (a weak base), depletion of intracellular Ca2+ by A23187 (a Ca2+ ionophore), and the Pittsburgh-type mutant of alpha 1-protease inhibitor differentially affected these two cleavages. Brefeldin A, which impedes protein transport from the endoplasmic reticulum to the Golgi complex, inhibited both cleavages. Colchicine (an anti-microtubular drug) had no discernible effect on either cleavage. These observations support the notion that the precursor cleavages at dibasic and RXK/RR sites occur in different subcellular compartments, and are catalyzed by different processing endoproteases. PMID- 1783614 TI - Alpha B-crystallin in skeletal muscle: purification and localization. AB - Atrophy of rat soleus muscles by hindlimb suspension is characterized by an early dramatic decrease in a soluble 22-kDa protein. The 22-kDa protein was purified from rat red skeletal muscle and rat lens by three different methods of chromatography. The partial amino acid sequence (65% of total amino acids) determined for muscle 22-kDa protein was identical with that of rat lens crystallin. The HPLC elution patterns of lysylendopeptidase fragments of 22-kDa protein from the two sources were identical. Polyclonal antibodies to rat muscle and bovine lens alpha B-crystallin with the two proteins on immunoblotting. alpha B-Crystallin protein was expressed and synthesized efficiently in slow skeletal muscle and poorly in fast muscle. Thus, the decreased 22-kDa protein of slow muscle in the suspension treatment was confirmed to be alpha B-crystallin. Immunoblotting confirmed that most of the alpha B-crystallin was solubilized, though some was tightly bound to myofibrils. This bound portion was localized in Z-bands of isolated myofibrils by immunocytochemical light and electron microscopy. Muscle alpha B-crystallin is tentatively proposed to be a myofibril stabilizing protein, based upon its extraction characteristics, localization, and amino acid sequence. PMID- 1783615 TI - Organ-specific occurrence and expression of the isoforms of nonspecific lipid transfer protein in castor bean seedlings, and molecular cloning of a full-length cDNA for a cotyledon-specific isoform. AB - Four kinds of nonspecific lipid transfer proteins (nsLTP) were purified from different organs of castor bean (Ricinus communis L.) seedlings. Amino acid compositions and amino-terminal sequences of the four nsLTPs were determined and compared with those of castor bean isoforms, nsLTP-A, -B, and -C, previously reported [Takishima et al. (1986) Biochim. Biophys. Acta 870, 248-255; Takishima et al. (1988) Eur. J. Biochem. 177, 241-249]. Two isoforms from the cotyledons were identified as nsLTP-A and -C, one isoform from the endosperms as nsLTP-B, and the other was a new isoform from the axes. This new isoform was named nsLTP-D and its amino acid sequence was determined. These results demonstrated organ specific occurrence of the nsLTP isoforms in castor bean seedlings. The isoforms nsLTP-A, -B, -C, and -D showed similar transfer activity not only for phosphatidylcholine and phosphatidylethanolamine but also for monogalactosyldiacylglycerol, although the homology among their amino acid sequences ranged from 70 to 30%. Two cDNA clones (pnsLTP-C and pnsLTP-D) for nsLTPs of castor bean seedlings were isolated and sequenced. pnsLTP-C was the cDNA clone for nsLTP-C expressed in the cotyledons, and pnsLTP-D was that for nsLTP-D in the axis. A coupled in vitro transcription-translation analysis of both cDNA clones revealed that pnsLTP-C encodes the full-length of nsLTP-C precursor (pro-nsLTP-C), while pnsLTP-D encodes a part of nsLTP-D precursor. PronsLTP-C contained a 24-amino acid pre-sequence preceding the mature nsLTP-C (92 amino acids).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783616 TI - A sialidase-susceptible ganglioside, IV3 alpha(NeuGc alpha 2-8NeuGc)-Gg4Cer, is a major disialoganglioside in WHT/Ht mouse thymoma and thymocytes. AB - The disialogangliosides of WHT/Ht mouse thymomas, which were obtained by subcutaneous transplantation of a thymoma that developed spontaneously in a WHT/Ht mouse, were purified and characterized. From the results of sugar composition analysis, a permethylation study, enzymatic hydrolysis followed by TLC-immunostaining, negative-ion fast atom bombardment mass spectrometry (FAB/MS), and 1H-NMR spectroscopy, the structure of one of the five purified disialogangliosides was determined to be IV3 alpha(NeuGc alpha 2-8NeuGc)-Gg4Cer. The other 4 disialogangliosides were tentatively characterized on the basis of sialidase treatment followed by TLC-immunostaining with cholera toxin B subunit and anti-Gg4Cer antibody to be IV alpha(NeuAc alpha-NeuGc)-Gg4Cer, IV alpha(NeuGc alpha-NeuAc)-Gg4Cer, IV alpha NeuAc,II3 alpha NeuAc-Gg4Cer, and IV alpha NeuGc,II3 alpha NeuGc-Gg4Cer. In addition, another component exhibiting one spot on TLC was a mixture of IV alpha NeuGc,II3 alpha NeuAc-Gg4Cer and IV alpha NeuAc,II3 alpha NeuGc-Gg4Cer. Then the occurrence of these gangliosides in WHT/Ht mouse thymocytes was examined. As one of two major disialogangliosides, the thymocytes contained IV3 alpha(NeuGc alpha 2-8NeuGc)-Gg4Cer, which was characterized with a mass spectrum and mass chromatograms obtained by micro high performance liquid chromatography-FAB/MS. The other major disialoganglioside was tentatively characterized to be II3 alpha-(NeuGc alpha-NeuGc)-Gg4Cer by sialidase treatment followed by TLC-immunostaining. A sialidase-susceptible monosialoganglioside, IV3 alpha NeuGc-Gg4Cer [GM1b(NeuGc)], had been reported to be characteristic of mouse immune tissues [Nakamura, K. et al. (1988) J. Biochem, 103, 201-208]. Taken together, the results suggest that the pathway from Gg4Cer to IV3 alpha(NeuGc alpha 2-8NeuGc)-Gg4Cer through GM1b(NeuGc) is quite active in mouse immune tissues. PMID- 1783617 TI - Purification and partial characterization of alpha-N-acetylglucosaminidase from human liver. AB - A deficiency in alpha-N-acetylglucosaminidase is known as mucopolysaccharidosis IIIB or Sanfilippo B syndrome. We purified this enzyme almost 39,000-fold from liver to homogeneity with 3% recovery. Use of concanavalin A (Con A)-Sepharose and heparin-Sepharose resulted in 13.4-fold and 11.6-fold purifications of the enzymatic activity, respectively. The molecular mass was estimated to be 300 kDa by gel filtration and 80 kDa by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) analysis. The isoelectric point was 5.1, optimal pH was 4.5, and the Km for p-nitrophenyl alpha-N-acetylglucosamine was 0.13-0.20 mM. The purified enzyme was stable at 50 degrees C for 1 h and within the pH range of 6.5-8.5. Anti-serum against the purified enzyme raised in BALB/c mice inhibited the activities of alpha-N-acetylglucosaminidase. PMID- 1783618 TI - The medical illustration student applicant's grades and admissions policy. PMID- 1783619 TI - Translating Alzheimer's disease educational videotapes into Spanish. AB - Limited information in Spanish concerning the availability of health services results in limited access to these services for the Hispanic population. This article describes a model for producing a health education videotape in Spanish. The planning strategy, script translation, and problems encountered with non Spanish-speaking technical production staff are discussed. PMID- 1783620 TI - A comparison of video and photographic display of skin lesions for morphology recognition. AB - Color video and photographic displays were compared for their effect on the performance of dermatologists in a test of morphology recognition. The subjects made significantly more errors on images presented in video format than in photo slide format. PMID- 1783621 TI - Early life history and personal characteristics of medical illustrators. AB - This study examined 140 medical illustrators to identify factors which may relate to professional success. Early childhood activities, family backgrounds, and relationships were compared in two groups of medical illustrators perceived as being either highly successful illustrators (strongly recognized for their work and their contributions to the profession), or less successful illustrators (minimally recognized for their work and their contributions). Data collected from the biographical questionnaire were analyzed using a MANOVA statistical technique followed by univariate analyses of variance. PMID- 1783622 TI - Anion-exchange chromatography of DNA restriction fragments. AB - The abilities of several high-performance liquid chromatography (HPLC) anion exchange packings to separate DNA restriction fragments, ranging in size from 50 to 23,000 base pairs, were studied. The ion exchangers investigated include the porous packings Protein-Pak DEAE-5PW, Nucleogen-DEAE 4000-7, Poros-Q and BakerBond WP-PEI, and the non-porous packings TSK Gel DEAE-NPR, Gen-Pak FAX, and ProPac PA1. The results indicated that the non-porous packings could separate all 18 fragments (less than 600 base pairs) in a pBR322 DNA-HaeIII digest, while of the porous packings, only Nucleogen-DEAE 4000-7 could resolve DNA fragments in this size range. Only Gen-Pak FAX and TSK Gel DEAE-NPR could significantly resolve the very large DNA fragments (125-23,000 base pairs) of a lambda DNA HindIII digest. The chromatographic parameters governing this separation by Gen Pak FAX were optimized so that six of eight fragments were resolved. Split-peak phenomena were observed at low flow-rates when employing non-poros packings, but were eliminated by the incorporation of organic modifiers or surfactants, suggesting that, under certain conditions, hydrophobicity may play a significant role in separations on this packing. Gen-Pak FAX also separated 21 of 23 fragments in a 1000-base pair DNA ladder, a performance which, in addition to the quantitative capabilities of HPLC, makes anion-exchange chromatography a powerful method complementary to slab-gel electrophoresis, and perhaps preferable over agarose gel electrophoresis for applications such as the confirmation of plasmid integrity. PMID- 1783623 TI - Determination of triazines and organophosphorus pesticides in water samples using solid-phase extraction. AB - Octadecyl (C18)-bonded porous silica was evaluated for the extraction of triazine and organophosphorus pesticides from natural water. The extraction results showed an effective performance when 11 of water was passed through small glass columns containing 500 mg of 50-100-microns C18 bonded porous silica. The adsorbed compounds were removed with ethyl acetate, evaporated to 200 microliters and determined by gas chromatography. The overall average recoveries were greater than 85% except for dimethoate and trichlorfon. Application of this procedure to the analysis of natural water samples gave results that agree well with those obtained by solvent extraction methods. PMID- 1783624 TI - Rapid on-line precolumn high-performance liquid chromatographic method for the determination of benomyl, carbendazim and aldicarb species in drinking water. AB - A reversed-phase high-performance liquid chromatographic (HPLC) method has been developed for the determination of trace concentrations of benomyl, carbendazim, aldicarb, aldicarb sulphoxide and aldicarb sulphone in drinking water. A 10-ml sample of water is passed through a 3-cm precolumn, packed with 5-microns C8 sorbent, at a flow-rate of 5 ml/min. The HPLC system is then switched to an acetonitrile-water gradient elution program. The preconcentrated analytes are eluted from, and separated by, the 3-cm C8 precolumn and determined by UV absorption. The total analytical time is 25 min. The lowest detectable concentrations are in the range of 2.5 x 10(-9)-11.0 x 10(-9) g/ml for the five analytes investigated with 10 ml of sample. PMID- 1783625 TI - Reliability assessment of a gas chromatographic method for polycyclic aromatic hydrocarbons in olive oil. AB - A quality control test was developed for a gas chromatographic method to determine polycyclic aromatic hydrocarbons in olive oil. Fifteen oil specimens were fortified with eight three- to six-ring polycyclic aromatic hydrocarbons at levels of between 3.0 (approximate detection limit) and 360 micrograms/kg. Three sets of five equally fortified specimens were obtained and assayed at random by three operators. For each fortification level, the means of recovery yield were in the range 56-107%, and were independent of the polycyclic aromatic hydrocarbon congener specificity and the operator's capability. Excluding subsets of data associated with both the fortification level at the detection limit and a deviant polycyclic aromatic hydrocarbon term (benzo[ghi]perylene), an overall mean accuracy of 96% and a precision of 7% were achieved. PMID- 1783626 TI - Gas chromatography-mass spectrometry and high-performance liquid chromatographic analyses of thermal degradation products of common plastics. AB - The thermo-oxidation of five commonly used materials, namely low-density polyethylene, retarded polyethylene, paper with a polyethylene foil, a milk package and filled polypropylene, was studied. Capillary gas chromatography and gas chromatography-mass spectrometry were used to analyze the volatile degradation products, while high-performance liquid chromatography was employed to measure polycyclic aromatic hydrocarbons. The results are discussed from the point of view of toxicity of the products. PMID- 1783627 TI - Preparation of a chiral matrix. Resolution of (6R,S)-N5-formyltetrahydrofolate. AB - Combination chemotherapy involving (6R,S)-N5-formyltetrahydrofolate and 5 fluorouracil has raised considerable speculation concerning the effects of the unnatural (6R) diastereomer. The inability to obtain quantities of the individual diastereomers has greatly limited work in this area. Commercially available chiral columns, suitable for diastereomer analysis, are inadequate for preparative work. We report here on the use of epoxide-activated media in the construction of a bovine serum albumin-based high-performance liquid chromatography matrix capable of resolving the diastereomers of (6R,S)-N5 formyltetrahydrofolate in milligram quantities. Similar columns based upon alternative protein matrices may prove useful for the resolution of additional materials. PMID- 1783628 TI - Improved accuracy in the determination of field-flow fractionation elution volumes. AB - Conventional operation of field-flow fractionation (FFF) systems involves carrying out the analysis at a constant flow of carrier; the flow is temporarily interrupted after injection of a sample in order to permit its equilibration under the applied field. Retention is calculated as the ratio of elution times for a non-retained species and the sample of interest, respectively. Such time based retentions are only valid if the flow-rate is precisely known at all times during the run. The peristaltic pumps often used with FFF equipment are shown to have an output which varies unpredictably in time. Furthermore, initiation of flow after relaxation is shown to result in significant periods of transient behaviour while the system adjusts to the operating pressure. These and other variations in flow-rate can be eliminated as sources of error by basing the retention measurement on effluent weight, rather than on time. For this purpose, an electronic balance is interfaced with the system's computer, so that detector response/effluent weight data pairs are continuously monitored during the course of the FFF analysis. PMID- 1783629 TI - Application of ligand-exchange chromatography to the assay of L-alanine from DL aspartic acid by Pseudomonas dacunhae. AB - A direct chiral ligand-exchange chromatographic method was developed to monitor L alanine production by fermentation. A mobile phase containing aqueous 0.25 mM Zn2+ solution is utilized to separate amino acids in the fermentation medium. The detection limit for L-alanine is 0.5 ppm and the analysis time for one sample is about 8 min. As sample preparation is simple and the matrix effects are minimal, the assay is fast and convenient. The results indicate that the method has potential for the analysis of complicated fermentation media. PMID- 1783630 TI - Development of a screening method for five sulfonamides in salmon muscle tissue using thin-layer chromatography. AB - A thin-layer chromatographic (TLC) method was developed for the analysis of five sulfonamides [sulfadiazine (SDZ), sulfamerazine (SMRZ), sulfamethazine (SMTZ), sulfadimethoxine (SDMX) and sulfapyridine (SP)] in salmon muscle tissue. "Matrix solid-phase dispersion" was employed whereby the tissue sample was ground with C18-derivatized silica gel. This material was packed into a column and washed with 10% toluene in hexane (discarded) followed by dichloromethane which was evaporated. The residue was chromatographed on a high-performance TLC plate using ethyl acetate-n-butanol-methanol-aqueous ammonia (35:45:15:2, v/v). Sulfonamides were detected after spraying the plate with a solution of fluorescamine. Method parameters were determined by analyzing spiked salmon muscle tissue samples. The method detection limits at the 99% confidence level were 0.11, 0.44, 0.07, 0.13 and 0.13 ppm for SDZ, SMRZ, SMTZ, SDMX and SP, respectively. The lowest detectable levels were approximately 0.04 ppm for SDZ, SMTZ, SDMX and SP, and 0.10 ppm for SMRZ. The average recoveries of analyses were 61, 63, 60, 63 and 57% for SDZ, SMRZ, SMTZ, SDMX and SP, respectively, and were found to be analyst dependent. The method was found to give linear detector responses for all analytes over spiking levels ranging from 0 to 2 ppm. PMID- 1783631 TI - Simultaneous determination of prostaglandins E1, A1, and B1 by reversed-phase high-performance liquid chromatography for the kinetic studies of prostaglandin E1 in solution. AB - A method for the simultaneous determination of prostaglandins E1, A1 and B1 (PGE1, PGA1 and PGB1) in solution has been developed by reversed-phase high performance liquid chromatography using a 3 microns C18 column. The mobile phase consisted of 35% acetonitrile in 0.002 M phosphate buffer (pH 3.5) and its flow rate was 1.5 ml/min. Quantitative measurement was performed using a photodiode array detector system at 190, 220, and 280 nm for PGE1, PGA1 and PGB1, respectively. The method has been applied to the primary kinetic studies for reaction profile for PGE1----PGA1----PGB1 at 60 degrees C in pH 2.0, 7.2, 10.0 and 12.0 buffer solutions. PMID- 1783632 TI - Determination of free salsolinol concentrations in human urine using gas chromatography-mass spectrometry. AB - The urine concentrations of free salsolinol were determined in six healthy volunteers, using a gas chromatographic-mass spectrometric method with electron capture negative-ion chemical ionization after derivatization with pentafluoropropionyl anhydride. The sensitivity of this method allows the quantification of salsolinol concentrations of 0.55 pmol/ml. The synthesis of [2H4]salsolinol from dopamine and [2H4]acetaldehyde via a Pictet-Spengler condensation is described; [2H4]salsolinol was used as the internal standard for salsolinol quantification. The urine concentrations of free salsolinol ranged from ca. 1 to 6 pmol/ml. PMID- 1783633 TI - Analysis of platelet-activating factor by gas chromatography-mass spectrometry: low-energy electron impact of the corresponding 3-acetyl-2-tert. butyldimethylsilyl derivative. AB - A method for the analysis of platelet-activating factor in platelets employing gas chromatography and selected-ion monitoring mass spectrometry with low-energy electron impact and stable isotope dilution was developed. The procedure involved Bligh and Dyer extraction of the sample followed by thin-layer chromatographic purification. Platelet-activating factor is successively hydrolysed to the corresponding 2-acetyl-1-O-alkylglycerol by digestion with phospholipase C, and the product is allowed to isomerize to the more thermodynamically stable 3-acetyl 1-O-alkylglycerol before column purification and derivatization of the free OH with tert.-butyldimethylchlorosaline-imidazole. This reagent is of common use in platelet-activating factor derivatization, but is made to react with 2-acetyl instead of 3-acetyl isomer. The advantages of using the latter for the final derivatization are discussed and this method is compared with others currently available for gas chromatographic-mass spectrometric analysis of platelet activating factor. PMID- 1783634 TI - Determination of neutral oligosaccharide fractions from human milk by gel permeation chromatography. AB - A gel permeation chromatographic method for quantifying neutral oligosaccharide fractions from human milk has been developed. Oligosaccharides from monofucosyllactoses to trifucosyllacto-N-hexaoses were separated according to size on a Fractogel TSK HW 40 (S) column. Refractive index detection of monofucosyllactoses to difucosyllacto-N-tetraoses yielded a constant mass response factor of ca. 1 relative to glucose. After the addition of glucose as an internal standard, oligosaccharides were isolated from human milk by ethanol precipitation or two ultrafiltration procedures. The oligosaccharide concentrations found by the ultrafiltration procedures were significantly lower (significance level 0.05) than those determined by the ethanol precipitation procedure. PMID- 1783635 TI - Determination of plasma lactic acid concentration and specific activity using high-performance liquid chromatography. AB - Assessment of lactate metabolism is of particular interest during exercise and in disease states such as diabetes, shock, and absorptive abnormalities of short chain fatty acids by the colon. We describe an analytical method that introduces radio-active tracers and high-performance liquid chromatography (HPLC) to simultaneously analyze concentrations and specific activities (SAs) of plasma lactate. The HPLC conditions included separation on a reversed-phase column (octadecylsilane) and an isocratic buffer (30% acetonitrile in water). [3H]Acetate served as an internal standard. Lactate and acetate were extracted from plasma samples with diethyl ether following a pH adjustment to less than 1.0 and back-extracted into a hydrophilic phase with sodium carbonate (2 mM, pH greater than 10.0). Lactate is detected in the ultraviolet range (242 and 320 nm) by derivatization with alpha-bromoacetophenone. Control plasma samples were studied after an overnight fast for precision and analytical recovery. Calibration curves were linear in the range 0.18-6.0 mM (r = 0.92). The precision was 3% and the analytical recovery was 87%. The detection limit of the method was 36 pmol. Determination of lactate metabolism was performed in a patient with chronic congestive heart failure who was administered primed-continuous L-[U 14C]lactate (10 microCi bolus and 0.3 microCi/min continuously) during a 60-min rest period. Mean arterial lactate concentration and SA were 1.69 +/- 0.2 mM and 253.8 +/- 22 dpm/mumol, respectively. Systemic lactate turnover was 25.65 mumol/kg per min. Lactic acid systemic turnover, organ uptake and release rates can be accurately determined by isocratic HPLC. PMID- 1783636 TI - Determination in plasma of angiotensin-converting enzyme inhibitor by inhibitor binding assay. AB - A method of determining a new angiotensin-converting enzyme inhibitor (CS-622) and its active metabolite (RS-5139) in plasma by inhibitor-binding assay has been developed using high-performance liquid chromatography. The assay is based on the principle that the amount of inhibitor bound to the enzyme is inversely related to the amount of hippuric acid liberated on hydrolysis from the artificial substrate (hippuryl-L-histidyl-L-leucine). Plasma was heated at 60 degrees C for 15 min, to inactivate endogenous enzyme, and preincubated with rabbit-lung angiotensin-converting enzyme at 37 degrees C for 3 min. The artificial substrate (5.75 mg/ml in pH 8.3 phosphate buffer containing sodium chloride) was added to the resulting solution, and the mixture was incubated for 30 min. The reaction was terminated by the addition of 2 M hydrochloric acid. The hippuric acid liberated on hydrolysis was extracted with ethyl acetate and determined by reversed-phase chromatography using methylparaben as an internal standard. The total concentration of the inhibitor and its metabolite were determined by this method after de-esterification by rat-plasma esterase. The standard curve was obtained by the regression analysis of log concentration against logit response. The within-day and day-to-day precision were satisfactory. The proposed method is simple, rapid and sensitive enough to determine angiotensin-converting enzyme inhibitor in plasma. PMID- 1783637 TI - Purification and some properties of phospholipase C from Achromobacter xylosoxidans. AB - A non-haemolytic phospholipase C (EC 3.1.4.3) was purified from the culture medium of Achromobacter xylosoxidans with a 5% yield and a purification factor of 330. A combination of ultrafiltration, acetone precipitation and two subsequent affinity chromatographic steps was used. The affinity chromatography is a new application of 2-(4-aminophenylsulphonyl)ethyl-cellulose, a sorbent that has previously been used for the purification of phospholipase C from Bacillus cereus. The purified enzyme gave four distinct bands on polyacrylamide gel electrophoresis, and each band was catalytically active. Under our experimental conditions, the phospholipids examined were hydrolysed in the following order: phosphatidylcholine, phosphatidylethanolamine, sphingomyelin. Neither the synthetic substrate p-nitrophenylphosphorylcholine nor phosphatidylinositol was hydrolysed under different experimental conditions. For maximal hydrolytic activity toward phosphatidylcholine, the enzyme required Triton X-100 and Ca2+ ions. EDTA was inhibitory, but the enzyme activity was almost completely restored by Zn2+. The molecular mass of the phospholipase C, estimated by gel permeation, was 34,000 daltons. PMID- 1783638 TI - Automated determination of orotic acid, uracil and pseudouridine in urine by high performance liquid chromatography with column switching. AB - A column-switching high-performance liquid chromatographic method, requiring no sample preparation apart from filtration, is described for quantification of urinary orotic acid, uracil and pseudouridine. The analyses were carried out using a reversed-phase octadecylsilane-bonded column for sample clean-up and a cation-exchange column for separation; 5-20 microliters samples of urine were directly analysed, and more than 100 samples could be analysed consecutively. Each sample required only 30 min. Detection limits of these compounds were 5 pmol. Creatinine-related urinary uracil excretion was lowest in the newborn period (17.3 +/- 14.4 mumol/g of creatinine). A patient with partial ornithine transcarbamylase deficiency and his mother usually excreted a high level of uracil during the period of normal orotic acid excretion and normal serum ammonia level. PMID- 1783639 TI - Plasma B6 vitamer and plasma and urinary 4-pyridoxic acid concentrations of middle-aged obese black women. AB - Plasma B6 vitamer and plasma and urinary 4-pyridoxic acid (4-PA) concentrations of fifteen middle-aged obese black women were determined by high-performance liquid chromatography (HPLC). Estimated protein and vitamin B6 intakes of the subjects, aged 27-52 years, were 64.5 +/- 15.6 g and 1.21 +/- 0.68 mg (mean +/- S.D.), respectively. Mean HPLC-derived plasma B6 vitamer and 4-PA concentrations for these subjects were 68.9, 3.1, 1.2, 4.1, 3.4, 7.2 and 2.0 nmol/l for pyridoxal 5'-phosphate (PLP), pyridoxine 5'-phosphate, pyridoxamine 5'-phosphate, pyridoxal, pyridoxine, pyridoxamine and 4-PA, respectively. The mean urinary 4 PA/creatinine ratio of the women was 0.88 mumol/mmol. All subjects had plasma PLP levels indicative of adequate vitamin B6 status. Vitamin B6 status parameters of the middle-aged obese black women were similar to those previously reported for white nonobese women having adequate vitamin B6 status. PMID- 1783640 TI - Combined assay for phenacetin and paracetamol in plasma using capillary column gas chromatography-negative-ion mass spectrometry. AB - A gas chromatographic-mass spectrometric assay has been developed for the measurement of phenacetin and its major metabolite paracetamol in plasma. Phenacetin and unconjugated paracetamol are analysed in a single chromatographic run while total paracetamol is measured separately after enzymatic hydrolysis. The two compounds, and the deuterated analogues used as internal standards, are analysed as their trifluoroacetyl derivatives and the mass spectrometer is operated in the electron-capture negative-ion chemical ionisation mode. The negative-ion mass spectra of the derivatives contain fragment ions, formed by loss of an acetyl group from the respective molecular ions, which are the base peaks in the spectra. When these ions are specifically monitored, amounts of derivative equivalent to 1 pg of parent compound can be detected. This allowed the development of an assay for phenacetin, unconjugated paracetamol and total paracetamol in plasma having a precision of 2.6, 1.4 and 2.4%, respectively, and preliminary results for a subject given a 100-mg oral dose of phenacetin are reported. PMID- 1783641 TI - Simultaneous analysis of flunixin, naproxen, ethacrynic acid, indomethacin, phenylbutazone, mefenamic acid and thiosalicylic acid in plasma and urine by high performance liquid chromatography and gas chromatography-mass spectrometry. AB - Simple and reproducible high-performance liquid chromatographic (HPLC) and gas chromatographic-mass spectrometric (GC-MS) methods have been developed for the simultaneous analysis of several acidic drugs in horse plasma and urine. Although the capillary GC-MS column provided better separation of the drugs than the reversed-phase C8 (3 microns, 75 mm) HPLC column, the total analysis time with HPLC was shorter than the total analysis time with GC-MS. The HPLC system equipped with a diode-array detector provided simultaneous screening (limit of detection 100-500 ng/ml) and confirmation (limit 1.0 micrograms/ml) of the drugs. The HPLC system equipped with fixed-wavelength ultraviolet and fluorescence detectors provided a relatively sensitive screening [limit of detection 50-150 ng/ml for ultraviolet and 10 ng/ml for fluorescence (naproxen only) detectors] of the drugs. However, the positive samples had to be confirmed by using either the diode-array detector or the GC-MS system. The GC-MS system provided simultaneous screening and confirmation of the drugs at very low concentrations (20-50 ng/ml). PMID- 1783642 TI - Identification and determination of the two principal metabolites of minocycline in humans. AB - A chromatographic method has been developed for the quantification of minocycline in human serum and urine. The chromatographically determined concentration of minocycline correlated well with the microbiologically active concentration in serum. Two metabolites, 9-hydroxyminocycline and N-demethylated minocycline, could be isolated and identified as the principal metabolites of this tetracycline antibiotic. The structure of the 9-hydroxy compound was proved by nuclear magnetic resonance analysis for the first time. About 15% of the drug was actively converted in the body into a substance less microbiologically active than the parent compound and excreted in the urine within 96 h after the application. PMID- 1783643 TI - Assay of nicergoline and three metabolites in human plasma and urine by high performance liquid chromatography-atmospheric pressure ionization mass spectrometry. AB - A method for the simultaneous determination of nicergoline and three of its metabolites in human plasma and urine has been developed using high-performance liquid chromatography-atmospheric pressure ionization mass spectrometry. Nicergoline and its metabolites were extracted from the plasma and urine samples with chloroform and separated on a reversed-phase ODS column. The eluents were led to the atmospheric pressure ionization interface and then analysed in the selected-ion monitoring mode. The detection limits of nicergoline and three of its metabolites were ca. 2 ng/ml in plasma and ca. 10 ng/ml in urine, at a signal to-noise ratio of 4. PMID- 1783644 TI - High-performance liquid chromatographic determination of 1-beta-D arabinofuranosyl-E-5-(2-bromovinyl)uracil and its metabolite (E)-5-(2 bromovinyl)uracil in serum. AB - A high-performance liquid chromatographic method was developed to assay 1-beta-D arabinofuranosyl-E-5-(2-bromovinyl)uracil and its metabolite (E)-5-(2 bromovinyl)uracil in serum. The chloro analogue of the parent drug is used as internal standard. Human serum samples were assayed to establish the pharmacokinetic parameters. Acetonitrile, used as a protein precipitant, was evaporated to dryness and the residue, containing the analytes and internal reference, was dissolved in mobile phase prior to chromatographic analysis. The minimum quantifiable level was 0.02 micrograms of each analyte per ml of serum. PMID- 1783645 TI - Purification of domoic acid from toxic blue mussels (Mytilus edulis) and phytoplankton. AB - Domoic acid was the primary neurotoxin in blue mussel (Mytilus edulis) that caused poisoning in humans. Further research showed that the algae, Nitzschia pungens, was the source of this toxin. In this study, a method for the extraction and purification of domoic acid from contaminated mussels and phytoplankton was developed. Domoic acid was extracted from these sources by treatment with a mixture of chloroform and methanol (1:2, v/v). The resulting extract was subjected to ultrafiltration through a PM1 Millipore filter, followed by repeated high-performance liquid chromatography on a reversed-phase column. The purity and yield of domoic acid prepared by this method are compared with two previously described methods of extraction. The current method is relatively simple, rapid, and results in improved recovery with comparable purity of domoic acid. PMID- 1783646 TI - Measurements by microdialysis of free tissue concentrations of propranolol. AB - To determine the free concentration of a drug (propranolol) in the interstitial space in humans in vivo, seven male students were investigated by microdialysis of the periumbilical subcutaneous tissue. The microdialysis catheters were calibrated in vivo and the propranolol concentration was determined by high performance liquid chromatography. Ten hours after intake of 80 mg of propranolol, the total plasma and free interstitial propranolol concentrations were 80 +/- 43 and 7 +/- 2 nM, respectively. After a second dose, maximum concentration was reached after 80 +/- 10 min and 98 +/- 12 min, in plasma, and the concentrations in the interstitial water were 594 +/- 138 and 27 +/- 7 nM, respectively. In a second study, microdialysis was performed on the left ventricular wall in six pigs receiving an intravenous injection of 5 mg of propranolol followed by a constant propranolol infusion for 40 min (5 mg propranolol per h). The maximum concentrations of propranolol were 97 +/- 29 and 6 +/- 2 nM in plasma and in interstitial water, respectively. The data suggest that microdialysis is a useful tool for recording the free concentrations of a drug in the interstitial space. PMID- 1783647 TI - Determination of temazepam and temazepam glucuronide by reversed-phase high performance liquid chromatography. AB - A rapid and sensitive method for extracting temazepam from human serum and urine is presented. Free temazepam is extracted from plasma and urine samples using n butyl chloride with nitrazepam as the internal standard. Temazepam glucuronide is analyzed as free temazepam after incubating extracts with beta-glucuronidase. Separation is achieved using a C8 reversed-phase column with a methanol-water phosphate buffer mobile phase. An ultraviolet detector operated at 230 nm is used and a linear response is observed from 20 ng/ml to 10 micrograms/ml. The limit of detection is 15.5 ng/ml and the limit of quantitation is 46.5 ng/ml. Coefficients of variation are less than 10% for concentrations greater than 50 ng/ml. Application of the methodology is demonstrated in a pharmacokinetic study using eight healthy male subjects. PMID- 1783648 TI - Photosensitizers for tumor therapy: determination of bis(di-isobutyl octadecylsiloxy)silicon 2,3-naphthalocyanine (isoBOSINC) in rat tissue and serum by high-performance liquid chromatography. AB - Bis(di-isobutyl octadecylsiloxy)silicon 2,3-naphthalocyanine (isoBOSINC) is a synthetic potential photosensitizer for tumor therapy. A new method, which combines solvent extraction and several purification steps, has been developed to determine its presence in tissues. Separation and quantitation of isoBOSINC is done by high-performance liquid chromatography on a silica column with toluene as a mobile phase and using fluorescence detection (lambda ex = 365 nm, lambda em = 750 nm). For recovery studies, isoBOSINC was added to muscles at levels of 0.067 and 0.67 micrograms/g; the mean recoveries were 100%, with coefficients of variation of 6.1 and 6.4%, respectively. For liver samples, the amounts added were 0.67 and 6.7 micrograms/g and for serum 0.67 and 6.70 micrograms/ml. The mean recoveries for liver were 86 and 93%, with coefficients of variation of 7.7 and 4.4%, respectively. For serum, the mean recoveries were 99 and 96%, with coefficients of variation of 2.6 and 6.9%, respectively. Due to its low detection limit and selectivity, the method is appropriate for pharmacokinetic as well as tumor uptake studies following in vivo exposure to isoBOSINC. Preliminary data on tissue distribution of the photosensitizer in normal rats are also presented. PMID- 1783649 TI - Liquid chromatographic-mass spectrometric analysis for screening of patients with cystinuria, and identification of cystine stone. AB - Analyses of amino acids in the urine of a normal human and of patients with heterozygous and homozygous cystinuria have been carried out, using liquid chromatography-mass spectrometry with an atmospheric pressure ionization interface system. A kidney cystine stone was also analysed by this system. Very intense quasi-molecular ions ([M + H]+) of standard cystine, arginine, lysine and ornithine were observed on mass chromatograms as base peaks. Mass chromatograms of the urine samples from a normal human and from patients with heterozygous and homozygous cystinuria were easily distinguishable. The retention times in the mass chromatogram and mass spectrum of kidney stone cystine was almost the same as that of authentic cystine. PMID- 1783650 TI - Densitometry for analysis of protein and peptide hydrolysates: application to luteinizing hormone releasing hormone. AB - Densitometric analysis has been performed on various standard protein and peptide solutions and on luteinizing hormone releasing hormone hydrolysate. After thin layer chromatographic separation using two-dimensional separation on cellulose plates, the plates were mapped and each amino acid was assayed individually in order to obtain a specific integration profile of the hydrolysate. Densitometry proved to be a useful method for the screening of protein hydrolysates and is accurate enough for the assay of peptide hydrolysates. The hormone was hydrolysed with hydrochloric acid-trifluoroacetic acid (1:1, v/v) in the presence of thioglycolic acid. This limits the loss of tryptophan and does not interfere with the analysis. Results were sufficiently reliable, accurate and reproducible for routine analysis. PMID- 1783652 TI - Determination of trifluorothymidine in the eye using high-performance liquid chromatography. AB - A high-performance liquid chromatographic assay for trifluorothymidine in biological matrices of the eye is presented. Sample pretreatment was based on liquid-liquid extraction with ethyl acetate. Following evaporation, the residue was analyzed using a reversed-phase octadecylsilane column with ultraviolet detection. The lower limit of detection is ca. 50 ng/ml (ca. 3 ng on column). The method is simple, reproducible and selective. Concentrations of trifluorothymidine in the aqueous humour, vitreous humour and cornea of normal rabbits after a 50-microliters topical dose of 1% trifluorothymidine are reported. PMID- 1783651 TI - Micro-quantitative determination of ciprostene in plasma by gas chromatography mass spectrometry coupled with an antibody extraction. AB - A simple and highly sensitive method has been developed for the determination in plasma of ciprostene, 9 beta-methyl-6 alpha-carbaprostaglandin I2, using gas chromatography-mass spectrometry following solid-phase extraction on an immobilized antibody column. The anti-ciprostene antibody obtained from rabbit serum was coupled to an agarose support matrix, and the immobilized antibody thus prepared was used as an extraction phase for sample clean-up. The extracted drug was treated with pentafluorobenzyl bromide followed by bis(trimethylsilyl)trifluoroacetamide. The derivative was quantitatively analysed by negative-ion chemical ionization gas chromatography-mass spectrometry. The lower limit of quantitation was 50 pg/ml when 1 ml of human plasma was used. The plasma concentration of ciprostene in a dog treated with ciprostene at 2.5 micrograms/kg was determined successfully by this method. PMID- 1783653 TI - Liquid-liquid extraction and high-performance liquid chromatography for the determination of a novel antidysrhythmic agent (UK-68,798) in human urine. AB - A routine method for the determination of a novel class III antidysrhythmic agent, 1-(4-methanesulphonamidophenoxy)-2-[N-(4-methanesulponamidophen ethyl)- N methylamino]ethane, in human urine has been developed. The method involves solvent extraction followed by high-performance liquid chromatography on an unmodified silica column with ultraviolet detection. Despite a low recovery of drug through the three-stage extraction procedure a reliable assay with high precision (coefficient of variation less than 6%) and a limit of determination of 2.5 ng/ml was achieved. The method has been applied to the analysis of samples following single oral and intravenous doses of 1-12.5 micrograms/kg of the drug to human volunteers. PMID- 1783654 TI - Determination of the neuroprotective agent 6-nitro-7 sulphamoylbenzo[f]quinoxaline-2,3-dione in plasma using high-performance liquid chromatography. AB - A rapid, sensitive and selective high-performance liquid chromatographic method for the determination of the neuroprotectant 6-nitro-7 sulphamoylbenzo[f]quinoxaline-2,3-dione in rat plasma has been established and validated. Samples of 0.5 ml of plasma are extracted by elution from a Bond-Elut column with methanol and analysed on a reversed-phase column. The wavelength of UV detection is 254 nm. The method is linear at least up to 30 micrograms/ml, with a lowest reliable determination level of 4 mg/ml. The assays has a coefficient of variation of 13% at 10 ng/ml and 4% at 1000 ng/ml. Small variations in the extraction procedure and the liquid chromatographic conditions have minimal or no influence on the assay. PMID- 1783655 TI - Determination of a novel steroidal androgen receptor antagonist (Win 49596) in human plasma using solid-phase extraction and high-performance liquid chromatography with ultraviolet detection. AB - A rapid, sensitive and selective method was developed for the determination of a novel steroidal androgen receptor antagonist (Win 49596, I) in human plasma. The procedure involved extraction from plasma using a solid-phase phenyl support and elution directly onto a reversed-phase C8 column using a mobile phase consisting of 0.2 mol/l sodium acetate buffer at pH 7-acetonitrile (45:55, v/v). Drug was monitored by ultraviolet detection at a wavelength of 238 nm. Linear responses were observed for standards over the range 0.01-5.0 micrograms/ml. The minimum quantifiable level was 0.02 microgram/ml, using a 0.5-ml plasma sample. The precision was 5.5% and the accuracy ranged from -9.4% to 0.23%. The analytical method has been used to quantify I in plasma from dogs and rats and is projected for use with human plasma from clinical trials. PMID- 1783656 TI - High-resolution gel filtration of the ecdysteroid receptor-DNA complex--an alternative to the electrophoretic mobility shift assay. AB - The mobility shift assay is a well established method for proving binding of protein to DNA. However, this method depends on the stability of the protein-DNA complex during the electrophoretic process. Ecdysteroid receptor shows a strong tendency to aggregate under low-salt conditions of electrophoresis to a non DNA binding form. We have developed a high-resolution gel filtration method which allows the interaction of ecdysteroid receptor with specific DNA sequences to be studied. The method seems to be generally applicable. It does not depend on the availability of a purified protein. Crude preparations could be used to characterize the stoichiometry and the molecular parameters of the complexes formed between DNA and DNA-binding proteins. PMID- 1783657 TI - Isolation of cytochrome P-450 components from marmoset liver microsomes by high performance liquid chromatography. AB - A fast protein liquid chromatographic (FPLC) system with pre-packed and laboratory-packed columns was used for the analytical and preparative isolation of marmoset monkey cytochrome P-450 (P450) and NADPH-P450-reductase. Chromatographic separations also allowed the recovery of cytochrome b5, NADH-b5 reductase and epoxide hydratase. Cholate-solubilized liver microsomes from phenobarbital-induced marmosets were crudely purified on 8-aminooctyl-Sepharose or 6-aminohexyl-Sepharose and then fractionated into several isoenzyme groups using hydroxyapatite. Further purification on Mono S or CM-Sepharose and finally on phenyl-Superose, phenyl-Sepharose or octyl-Sepharose yielded a P450 fraction which was apparently homogeneous as judged by sodium dodecyl sulphate polyacrylamide gel electrophoresis in the automated Phast system using silver staining. Removal of excess of non-ionic detergent was effected by hydroxyapatite columns, and this was compared with other methods. For the isolation of P450 isoenzymes from untreated marmosets, Mono Q columns were employed and yielded at least two highly purified forms. NADPH-P450-reductase was recovered from the 8 aminooctyl-Sepharose column or crudely fractionated on DEAE-Sepharose Fast Flow. Subsequent purification via 2',5'-ADP-Sepharose and Superose 12 chromatography resulted in a homogeneous preparation. PMID- 1783658 TI - Hydrophobic interaction chromatography for the purification of a mycobacterial heat shock protein of relative molecular mass 60,000. AB - A recombinant mycobacterial heat shock protein of relative molecular mass 60,000 was purified by hydrophobic interaction chromatography. Chromatographic media with ligands of medium hydrophobicity, such as phenyl-Sepharose, bound too strongly to be used for the purification of this heat shock protein. Butyl Sepharose, with weak hydrophobicity, allowed binding and elution with decreasing concentrations of ammonium sulphate, but only alkyl-Superose allowed the separation of two similar proteins from the Escherichia coli clone expressing the recombinant heat shock protein (relative molecular mass 60,000) of Mycobacterium bovis BCG. The binding parameters of recombinant human heat shock proteins of relative molecular mass 60,000 and 70,000 indicate that phenyl-Sepharose also binds too strongly for the separation of these two heat shock proteins. PMID- 1783660 TI - Immobilized metal affinity chromatography as a means of fractionating microsomal cytochrome P-450 isozymes. AB - Fractionation of microsomal cytochrome P-450s is usually done by chromatography on ion-exchange resins and hydroxyapatite. The resolution of the great number of similar P-450 isozymes, however, requires additional methods based on different separation parameters. For this purpose immobilized-metal affinity chromatography (IMAC) was applied to the separation of P-450 isozymes. The method in its application to rat liver microsomes is described in detail. For method optimization and for the reproducibility of analytical fractionations a completely automatic fast protein liquid chromatographic system especially designed for IMAC is presented. Optimization is done with respect to the choice of the immobilized metal ion and the elution conditions. The chromatographic resolution is markedly enhanced by using segmented vs. linear gradients. The efficiency of P-450 resolution is demonstrated by sodium dodecyl sulphate polyacrylamide gel electrophoresis and immunoblotting, verifying the different retention behaviours of the isozymes. However, for all the isozymes analysed so far, reactivity with one particular polyclonal antibody is observed with more than two IMAC fractions of a single run. This may be explained in part by the occurrence of isozymic forms distinguishable by the pattern of chymotryptic peptides. Hence IMAC appears to be suitable for the separation of closely related isozyme forms. PMID- 1783659 TI - Isolation of multiple protein factors involved in ribosomal DNA transcription. AB - Studies were made of the molecular mechanisms which regulate ribosomal gene transcription in response to changes in the growth rate of cells. Extracts prepared from exponentially growing Ehrlich ascites cells faithfully and efficiently transcribe cloned mouse rDNA, whereas extracts from growth-arrested cells are virtually inactive. In an attempt to identify and characterize functionally the proteins that mediate the accuracy and the control of transcription initiation, a fractionation procedure was developed which allows the purification of RNA polymerase I and four accessory factors that are required for transcription initiation at the ribosomal gene promoter. Starting from about 300 ml of cell extract, each of the individual factors and the polymerase was purified on at least four different chromatographic columns, including ion exchange chromatography on DEAE-Sepharose, heparin-Ultrogel, Mono Q and Mono S, gel filtration and specific affinity chromatography. The resulting protein fractions are functionally active, as shown by reconstitution of specific rDNA transcription in the presence of purified polymerase and the additional factors. PMID- 1783661 TI - High-performance metal chelate affinity chromatography of cytochromes P-450 using Chelating Superose. AB - High-performance metal chelate affinity chromatography [immobilized metal ion affinity chromatography (IMAC)] using Chelating Superose (iminodiacetic acid adsorbent) was investigated for its suitability in purifying phenobarbital induced rat liver microsomal cytochrome P-450 isozymes (P450) and optimized for preparative purposes. Starting with an 8-aminooctyl-Sepharose fraction of partially purified P450, it was found that only Ni(2+)- and Cu(2+)-charged columns could bind P450. No binding was ever observed when Zn2+, Co2+, Mn2+, Cd2+, Fe3+, Fe2+ or Tl3+ ions were employed. Of eight commonly used elution buffers, imidazole and tryptamine were found to cause some denaturation of P450. For desorption of proteins bound to Ni(2+)-charged columns, the following order of decreasing elution buffer strength was determined: cysteine approximately histidine greater than glycine greater than histamine greater than tryptophan greater than ammonium chloride. During protein desorption with some of these buffers, metal ions were found to bleed from the gel, resulting in P450 denaturation. This could be eliminated by prebleeding the charged columns prior to sample application and had an effect on product recovery and homogeneity. Ni2+ and glycine were chosen as a standard for further optimization involving sample adsorption conditions as influenced by equilibration buffer, detergent, load capacity and flow, gradient and temperature conditions. In this way, potassium phosphate (pH 7.75) and 0.4% Emulgen 911 were used to equilibrate a 1.6-ml column and purify 20-50 nmol of P450 (5-15 mg of protein) within 15 min. One gradient fraction consisted of a single sodium dodecyl sulphate-polyacrylamide gel electrophoresis band as judged by silver staining and represented about 25% of the total P450 applied to the column; total recoveries were usually more than 80%. Comparison with the molecular weights and spectral, catalytic and immunological properties of P450 forms isolated according to established procedures indicated that the form isolated here using Chelating Superose comprises mainly P450 2B1 (PB-B). A method is described for fully automated, programmable column regeneration and sample runs. PMID- 1783662 TI - Development and optimization of a single-step procedure using protein A affinity chromatography to isolate murine IgG1 monoclonal antibodies from hybridoma supernatants. AB - Protein A affinity chromatography is a standard method of purifying murine monoclonal antibodies (mabs), primarily because it can be performed easily and achieves high-purity levels. Because of its high concentration capacity, it lends itself particularly well to the isolation of mabs from the supernatants of hybridoma cultures. Unfortunately, murine immunoglobulin (Ig) G1 antibodies, a subclass which occurs frequently in the IgG mabs of mice, binds very poorly to protein A, leading to problems in this isolation procedure. For this reason an attempt was made to increase the effectiveness of protein A affinity chromatography in purifying mabs of this IgG subclass by optimizing the binding conditions. The influence of ionic strength, pH and temperature on the binding capacity of a protein A column was studied. The results show the significance of temperature in the binding of the murine IgG1 mab tested to protein A. Further investigations were carried out to optimize the elution conditions and to study the contamination of mab preparations obtained with non-specific bovine protein A reactive Igs originating from culture medium supplement (10% foetal calf serum). An optimized, automatic single-step procedure to obtain highly purified murine IgG1 mabs from hybridoma culture supernatants was developed. PMID- 1783663 TI - The cytoskeletal protein villin as a parameter for early detection of tubular damage in the human kidney. AB - Villin is a cytoskeletal protein of brush borders in the kidney and gut. After renal tubular cell injury the brushborder fragments are shedded into the tubular lumen and excreted with urine indicating renal tubular damage (so called "renal antigen" shedding). In urine villin appears as intact molecule (95,000 dalton) and as fragment with 70,000, 45,000 and 22,000 dalton. The major villin fragment (70,000 dalton) was purified after ammonium sulphate precipitation from urine of human renal transplant recipients. Final purification of the villin 70,000 dalton fragment was achieved by gel filtration with TSK 3000 SWG preparative grade. Purification was varified by sodium dodecyl sulphate-polyacrylamide gel electrophoresis and western blotting. PMID- 1783664 TI - Purification and crystallization of yeast hexokinase isoenzymes. Characterization of different forms by chromatofocusing. AB - The yeast hexokinase isoenzymes PI and PII have been purified in large amounts (20 mg) from overproducing yeast strains. The purification procedures of hexokinase PI and PII include anion-exchange chromatography on DEAE-Sephacel and chromatofocusing on PBE 94, hydrophobic interaction chromatography on phenyl Sepharose (necessary for the isolation of the isoenzyme PI); in the final step either a Mono Q HR 5/5 or a Fractogel EMD TMAE 650(S) column was used. Hexokinase preparations were characterized before crystallization by chromatofocusing on a Mono P HR 5/20 FPLC column, where different forms of hexokinase can be rapidly distinguished by their elution behaviour. From both purified hexokinase PI and PII, large crystals were grown that diffract X-rays to high resolution. PMID- 1783665 TI - Purification of the coenzyme B12-containing 2-methyleneglutarate mutase from Clostridium barkeri by high-performance liquid chromatography. AB - Two methods are described by which the enzymes 2-methyleneglutarate mutase and 3 methylitaconate delta-isomerase from Clostridium barkeri have been separated by high-performance liquid chromatography on a much larger scale than reported previously. First, the mutase eluted before the delta-isomerase after incubation with the mild detergent 3-[(3-cholamidopropyl)dimethylammonio]-1 propanesulphonate (CHAPS) followed by high-performance anion-exchange chromatography on Mono Q in the presence of the same detergent. Second, an even better separation, although with a lower yield of mutase, was obtained by hydrophobic interaction chromatography on phenyl-Sepharose HiLoad, whereby the enzymes were eluted in the reverse order. Final high-performance anion-exchange chromatography of the latter preparation on Mono Q at pH 8 gave highly purified 2 methyleneglutarate mutase (greater than 95% purity) which had a pink-orange colour (lambda max 280, 375, 470 and 532 nm). The enzyme was active in the absence of coenzyme B12 (adenosylcobalamin) and contained 2.1 mol of this coenzyme per homotetramer (molecular mass, m = 300 kilodalton). PMID- 1783666 TI - Deconvolution method for accurate determination of overlapping peak areas in chromatograms. AB - A method is described for deconvoluting chromatograms which contain overlapping peaks. Parameters can be selected to ensure that attenuation of peak areas is uniform over any desired range of peak widths. A simple extension of the method greatly reduces the negative overshoot frequently encountered with deconvolutions. The deconvoluted chromatograms are suitable for integration by conventional methods. PMID- 1783667 TI - Chromatographic characterization of a phosphate-modified zirconia support for bio chromatographic applications. AB - A phosphate-modified zirconia was investigated for its potential use as a high performance inorganic cation-exchange support for the separation of proteins. This phosphate modification effectively blocks the sites responsible for the strong interactions of certain Lewis bases with the zirconia surface. It provides a more "bio-compatible" stationary phase, resulting in high recoveries for proteins and enzymes and retention of their enzymatic activity. The stability, loading capacity, selectivity, efficiency and separation mechanism on the phosphate-modified zirconia are reported. These studies have shown that phosphate modified zirconia is a useful high-performance ion-exchange support for the separation of cationic proteins and for blocking the sites responsible for the high affinity of zirconia towards certain anions. This makes the phosphate modification interesting in its own right and as an intermediate stage for the development of other zirconia-based chromatographic supports. PMID- 1783668 TI - High-performance liquid chromatographic column-switching technique for the determination of intermediates of anaerobic degradation of toluene in ground water microcosm. AB - A reversed-phase liquid chromatographic column-switching system was used for the determination of phenol, benzoic acid and cresol (PBC) in the presence of toluene in ground water microcosm. A precolumn was connected in series with an analytical column via a column-switching valve. After the injection, as soon as PBC were eluted from the precolumn to the analytical column, the valve was switched so that the precolumn was between the analytical column and the UV detector. Toluene and other non-polar compounds were eluted from the precolumn in a very short time and detected along with the solvent front. Subsequently, PBC were separated on the analytical column and passed through the precolumn one more time before being detected by the UV detector. The total analysis time was 15 min. This technique facilitated the study of the basic mechanism and path way of anaerobic degradation of toluene in ground water aquifer. PMID- 1783669 TI - Quantitative measurements via co-elution and dual-isotope detection by gas chromatography-mass spectrometry. AB - Dual-isotope measurements by gas chromatography-mass spectrometry (GC-MS) which mimic isotope dilution may suffer from irreproducibilities or unduly large uncertainties because of variations in ionization efficacies for the respective forms in the MS source. Such variations are sometimes avoided via extensive pretreatments and high-resolution GC separations. However, in some circumstances, an alternative approach is feasible which instead exploits the advantages of decreasing GC resolution. By forcing both forms of each analyte to co-elute, their ionization efficacies in the MS source will be virtually identical, thereby allowing for highly reproducible relative response ratios to be attained despite dramatically lowered GC resolution. The co-elution results described here are nearly as precise as results from moderate-resolution separations in the absence of interferents. Thus, dual-isotope GC-MS measurements with co-elution of the target analytes and their respective isotopically labeled internal standards offer a powerful alternative to the conventional approach of requiring expensive and labor-intensive additional pretreatments and separations; however, the effects of interferences may be exacerbated by the forced co-elution and must also be considered. PMID- 1783670 TI - Determination of carbendazim in blueberries by reversed-phase high-performance liquid chromatography. AB - A fluorescent reversed-phase high-performance liquid chromatographic method was developed for the analysis of carbendazim in blueberries. Recoveries of fortified blueberries at 27 and 810 ng/g were more than adequate with good precision. Forty commercial blueberry samples were analyzed and the amount of carbendazim ranged from none detected (detection limit of 15 ng/g) to 155 ng/g. Confirmation of carbendazim in the blueberry samples was made by enzyme immunoassay and UV photodiode array. PMID- 1783671 TI - Determination of sun-screen agents in cosmetic products by micellar liquid chromatography. AB - A micellar liquid chromatographic method was developed for the quantitative determination of sun-screen agents in cosmetic products. The qualitative analysis of parabens is also feasible. Excellent linearity was obtained (r = 0.999) and recoveries were generally greater than 98%. A variety of commercial formulations were analyzed. PMID- 1783672 TI - High-performance liquid chromatographic method for the determination of free gossypol in chicken liver. AB - A high-performance liquid chromatographic method for the determination of free gossypol in chicken liver at levels down to 0.5 ppm has been developed. Tissue was deproteinized with acetonitrile in presence of ascorbic acid and the filtrate was subjected to hydrolysis with hydrochloric acid. The liberated pure gossypol was partitioned into chloroform and analysed by gradient elution on a 10-microns C18 column. The overall recovery was 83.5 +/- 2.6%, with an overall relative standard deviation of 9%. PMID- 1783673 TI - Antineoplastic activity of parvoviruses. AB - The family of Parvoviridae is composed of small, nuclear-replicating viruses that are without envelope and contain an essentially single-stranded, linear DNA genome. Certain parvoviruses proved to have the remarkable capacity to prevent the formation of spontaneous as well as virtually- and chemically-induced tumors in laboratory animals. Established tumor cells serve as targets for the antineoplastic activity of parvoviruses, since the growth of preformed cancer cells transplanted in recipient animals can also be inhibited by these viruses. Furthermore, epidemiological studies in humans have revealed a correlation between serological evidence of parvoviral infection and a lower incidence of certain cancers. The parvoviral life-cycle appears to depend on cellular factors that are expressed as a function of proliferation and differentiation. This subordination may account for the oncotropism of parvoviruses in vivo and for the specificity of their interactions with (pre-)neoplastic cells under appropriate culture conditions. Thus, certain parvoviruses were found to preferentially lyse initiated or stably transformed cells in vitro, as a possible result of the stimulation of the production and/or activity of cytotoxic viral proteins. Parvoviruses can also have a cytostatic effect and cause the reversion of transformation traits, parallel to the down-modulation of the expression of defined genes, in particular oncogenes. Such direct disturbance of neoplastic cells or their precursors may participate in the oncosuppressive activity of parvoviruses, although indirect viral effects mediated by host defense mechanisms also deserve to be considered. Altogether, these properties suggest the possible use of parvoviruses as probes to investigate the process of malignant transformation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783674 TI - Advantages of multiple cell culture systems for detection of mixed-virus infections. AB - Simultaneous infections by two or more viruses occur frequently, especially in immunosuppressed patients. In order to detect more than one viral agent in a single specimen, multiple cell systems have been employed in our laboratory. Specimens are routinely inoculated into four different cell cultures, namely: MRC 5, a human diploid lung fibroblast cell strain; A549, a human continuous cell line; primary guinea pig embryo (GPE) cell culture, and primary rhesus monkey kidney (RhMK) cell culture. For rapid detection of cytomegalovirus (CMV) antigen, MRC-5 cells grown in shell vials containing coverslips are also inoculated with the same specimens followed by centrifugation. During 1989, nine cases of multiple-virus isolations were obtained in this laboratory. In all nine patients, CMV was detected in MRC-5 cells. Five of the nine cases were co-infected with HSV 1, three were co-infected with adenovirus, and one was co-infected with both HSV 1 and adenovirus. All four adenovirus isolates were obtained in A549 cells. Of the six HSV-1 isolates, one was detected in all three cell cultures, e.g. MRC-5, A549 and GPE; one was detected in both MRC-5 and A549 cells, and four were isolated in a single-cell type only. For nine CMV-positive cases, five were obtained by both conventional and centrifugation cultures, two each were detected by centrifugation or conventional culture only. Thus for a maximum detection of viruses present in a single specimen, it is suggested that multiple-cell-culture systems, together with more than one technique, should be employed. PMID- 1783675 TI - Performance characteristics of a rapid western blot assay system for antibody to human immunodeficiency virus type 1. AB - One hundred and twenty reactive sera were selected from specimens studied by enzyme immunoassay (EIA, Abbott Laboratories, Abbott Park, North Chicago, IL) for antibodies against human immunodeficiency virus (HIV-1). Using these sera, the 'WesPage' system (American Bionetics, Inc., Haywood, CA), was compared to the Western blot evaluation performed by a commercial reference laboratory (Abbott Laboratories, Abbott Park, North Chicago, IL). Using criteria established by the Food and Drug Administration, all major bands representing specific antigens of HIV-1 and their corresponding antibodies were identified on the immunoblot membrane when the strongly reactive control serum was used in the assay. The weakly reactive control serum demonstrated antibodies to the p24 core antigen and the gp120/160 envelope antigen of the virus in addition to others. The non reactive control serum did not react with any antigen on the immunoblot sheet. All results obtained by our evaluation agreed with the reference laboratory results. The WesPage assay offers a combination of advantages which include rapid turn around time, less direct contact with potentially infectious materials, good resolution of bands and high reproducibility of results. PMID- 1783676 TI - Comparison of rapid immunofluorescence assay to cell culture isolation for the detection of influenza A and B viruses in nasopharyngeal secretions from infants and children. AB - In the hospital setting it is often critical to isolate patients appropriately in order to prevent nosocomial infection. This is especially true with respiratory infection in infants and young children. At the present time a rapid immunofluorescence assay (IFA) for respiratory syncytial and parainfluenza viruses is routinely carried out in our laboratory. During January and February of 1990 we used monoclonal antibodies specific for influenza A and B viruses (Baxter-Bartels, Bellevue, WA) in this rapid IFA. 152 samples of NPS were tested by cell culture isolation (CCI) and IFA for the presence of influenza antigens. Twenty-seven samples were positive by both methods, and 114 were negative by both. Three samples were positive by IFA and negative by CCI, while eight samples were positive by CCI and negative by IFA. Five of these eight samples were not positive until 10 to 14 days after inoculation into cell culture, suggesting that the virus inoculum was small. Using CCI as the 'gold' standard, IFA was 90% sensitive and 93% specific. Because of its turn-around time (2-4 h) and acceptable sensitivity and specificity, IFA for influenza viruses will be a routine test in our diagnostic laboratory during the influenza season. PMID- 1783677 TI - A polymerase chain reaction assay adapted to plum pox potyvirus detection. AB - A sensitive, polyvalent assay based on the polymerase chain reaction (PCR) was developed for plum pox potyvirus (PPV) detection. This technique was adapted for a single tube, the chemical denaturation and reverse transcription of the viral RNA followed by the PCR reaction yielding a 243-base-pair product. As few as 10 fg of purified viral RNA, corresponding to approximately 2000 viral particles, were detected in plant extracts. All PPV isolates tested were amplified, and the amplified fragments were analysed by restriction endonuclease digestion. An RsaI restriction site polymorphism in the amplified fragments allowed the discrimination of two groups of isolates. In a field indexing trial, the PCR assay proved to be more sensitive than molecular hybridization using 32P-labelled RNA probes for PPV detection. PMID- 1783678 TI - Detection of nucleic acids homologous to human immunodeficiency virus in wastewater. AB - Raw wastewaters were obtained from the cities of Belle Glade, Ocala and Gainesville in the state of Florida and were concentrated using several established methods for the recovery of human enteroviruses. The nucleic acids were then extracted from the wastewater concentrates, suspended in 2 x SSC with and without 2 N NaOH (for the detection of DNA and both DNA and RNA, respectively), and dot blotted onto hybridization membranes. These membranes were then hybridized with three 32P-end-labeled 18-mer oligonucleotides directed against the LTR, gag, and env regions of the human immunodeficiency virus type 1 (HIV-1). Autoradiographic analyses of these blots indicate that sequences homologous to HIV-1 genomic RNA and proviral DNA were found in Belle Glade wastewater but not in wastewater from Ocala and Gainesville. These findings may have implications in the wastewater treatment system as well as for detection of HIV-1 in clinical samples. PMID- 1783679 TI - Enhanced chemiluminescence-based hybridization analysis for PCR-mediated HIV-1 DNA detection offers an alternative to 32P-labelled probes. AB - The efficiency of enhanced chemiluminescence based on a novel generation substrate for alkaline phosphatase, adamantyl-1,2-dioxetane phosphate, was compared with that of 32P-labelled probe for visualization of human immunodeficiency virus type 1 (HTV-1)-specific DNA-DNA hybrids. The probe used for nonisotopic detection was digoxigenin labelled and targeted by anti digoxigenin antibody Fab-fragments conjugated to alkaline phosphatase. The dot blot hybridization analysis performed on a dilution series of HIV-1 proviral DNA demonstrated a lower sensitivity limit of 0.5 pg with the nonisotopic method. However, one order of magnitude less DNA could still be detected by a random primed 32P-labelled probe. The ability of nonradioactive and radioactive probes to detect 590-bp gag gene-specific target sequences generated by the polymerase chain reaction (PCR)-mediated amplification of HIV-1 DNA was also compared. Analysis of 20 samples from individuals at increased risk for HIV infection by using the two assayed systems produced virtually equivalent signal images on corresponding specimens. Furthermore, complete concordance in the performance was found when HIV-1 proviral DNA was investigated by PCR in additional 50 samples of human blood mononuclear cells. PMID- 1783680 TI - Central projections of Limulus photoreceptor cells revealed by a photoreceptor specific monoclonal antibody. AB - Studies of lateral, median, and ventral eyes of the chelicerate arthropod Limulus polyphemus (the common American horseshoe crab) are providing important basic information about mechanisms for information processing in the peripheral visual system and for the modulation of visual responses by light and circadian rhythms. The processing of visual information in Limulus brain is less well understood in part because the specific central projections of the various classes of visual neurons are not known. This study describes a mouse monoclonal antibody, 3C6A3, which binds to Limulus photoreceptor cell bodies, their axons, and terminals, but not to any other cell type in the central nervous system. This antibody, and intracellular injection of biocytin, are used to demonstrate the central projections of each type of photoreceptor. Our main conclusions are that: 1) the photoreceptors (retinular cells) of the lateral eye project only to the lamina; 2) the photoreceptors of the lateral rudimentary eye project to both the lamina and medulla; 3) the photoreceptors of the median ocellus project only to the ocellar ganglion; and 4) the photoreceptors of the rudimentary median (endoparietal) eye project to the ocellar ganglion and also into the optic tract. These results, along with previous studies, allow us to infer the projections of the secondary cells. The eccentric cells of the lateral eye project to the lamina, medulla, optic tract, and ocellar ganglion. The arhabdomeral cells of the median ocellus project through the ocellar ganglion and to optic tract to the medulla. PMID- 1783681 TI - Hypothalamic paraventricular nucleus: a quantitative analysis of cytoarchitectonic subdivisions in the rat. AB - The boundaries of subnuclei of the hypothalamic paraventricular nucleus (PVN) were outlined on the basis of a step by step computer-assisted image analysis of coronal, serial sections of the hypothalamus in rats. The cell size-frequency histogram, cell packing density, and the cell number were determined for each PVN subdivision. Three principal cell types were distinguished: small, short diameter (d) = 6-10 microns; medium-sized, d = 10-13 microns; and large, d = 13-19 microns. None of these cell types occur exclusively in any PVN subdivision. According to the predominant cell type, the PVN can be divided into magnocellular, mediocellular and parvicellular subnuclei. Large cells appear to form one subdivision in which the cell packing density is relatively stable. Although the cell sizes showed a relatively large variation, no definitive subgroups (parts) could be distinguished. On the basis of cell packing density, the parvicellular and mediocellular subnuclei can be further divided. The mediocellular cell group can be divided into a dorsal and a posterior subdivision. The parvicellular zone is subdivided into a periventricular and a large medial subdivision. Based on inhomogeneities in cell packing density, the medial subdivision can be further divided into anterior, dorso-lateral, ventromedial and caudal parts. The estimated total cell number in the PVN (in both sides of the brain) is about 21,500. On average, 19% of this population, i.e., 4,200 neurons, was calculated in the magnocellular (neurosecretory) division. Out of this, only 66%, about 2,700 cells, falls into the category of large cells. There are approximately 5,700 neurons in the posterior and dorsal mediocellular, and about 11,600 in the periventricular and medial parvicellular subdivisions. PMID- 1783682 TI - Distribution of hippocampal CA1 and subicular efferents in the prefrontal cortex of the rat studied by means of anterograde transport of Phaseolus vulgaris leucoagglutinin. AB - Projections of the hippocampal formation to the prefrontal cortex were visualized in the rat by means of the anterograde tracer Phaseolus vulgaris-leucoagglutinin. These projections distribute only to the prelimbic and the medial orbital cortices and arise exclusively from restricted portions of field CA1 of the Ammon's horn and the subiculum. The most dorsal portion of CA1 does not contribute fibers to this projection. In the subiculum, its origin is restricted to the proximal half, i.e., the portion that directly borders field CA1. Fibers from field CA1 and the subiculum have comparable distribution patterns in the prelimbic and medial orbital cortices. The density and distribution in the prefrontal cortex of the projections from the proximal portion of the subiculum depends on the location of the injections along the dorsoventral axis of the hippocampal formation: the intermediate portion of the subiculum projects more densely and diffusely than its dorsal and ventral portions. In the prelimbic cortex, labeled fibers are present in all layers, showing marked morphological differences in deep versus superficial layers. In layers V and VI, most of the fibers are vertically oriented, while in layers II and III they are short and oriented towards the pial surface. Although no clear differences in terminal distribution were observed along the rostrocaudal extent of the prelimbic cortex, its dorsal and ventral portions show different innervation patterns. In the ventral portion of the prelimbic cortex, varicose fibers and terminal arborizations were present in all cortical layers, deep (V and VI) as well as superficial (II and III). In its dorsal part, the innervation was less dense and mostly present in the deep layers (V and VI). The fiber and terminal distribution in the medial orbital cortex was diffuse in all layers with a slight preference for layers deep to layer II. PMID- 1783683 TI - Structure of the macroglia of the retina: sharing and division of labour between astrocytes and Muller cells. AB - A detailed comparison is made between astrocytes and Muller cells of the cat's retina, with emphasis on their structural specialisations. Evidence is presented that astrocytes and Muller cells both contribute to the formation of the inner glia limitans of the retina, the glia limitans of vessels, and the glial sheaths of neurones. In particular, it was noted that both astrocytes and Muller cells wrap bundles of ganglion cells axons, that both contribute processes to the glial convergence on the initial segments and node-like structures of axons, and that both wrap the somas of neurones in the ganglion cell layer. Further, it was noted that adherent junctions form between astrocytes, between Muller cells, and between astrocytes and Muller cells, but not between these cells and neurones, or among neurones. These similarities suggest that astrocytes and Muller cells function interchangeably in many respects, and we suggest that they be regarded as variants of macroglia. Quantitative differences between astrocytes and Muller cells were noted in their ensheathment of neurones. In particular, the glial sheaths around the somas of ganglion cells are formed predominantly by Muller cells, and the glial processes attached to node-like specialisations of their axons are formed mainly by astrocytes. One qualitative difference was noted between the two cell classes. The gap junctions which form between astrocytes do not form between Muller cells or between cells of the two classes. From these differences, and previously established features of their shape, orientation, distribution and origin, a hypothesis is developed of the specialisation of macroglia represented by Muller cells. PMID- 1783684 TI - Horizontal optokinetic nystagmus in unilaterally enucleated pigmented rats: role of the pretectal commissural fibers. AB - Monocular enucleation reduces the asymmetry of horizontal optokinetic nystagmus (H-OKN) in afoveate mammals by increasing responses to naso-temporal visual stimulation. The origin of these larger responses was investigated in adult pigmented rats monocularly enucleated as neonates or as adults by analyzing retinal and commissural projections to the deafferented nucleus of the optic tract (NOT) and the functional role of this nucleus before and after section of the posterior commissure. Anatomically, monocular enucleation reduces the volume of the contralateral deafferented NOT. Anterograde tracers injected in the intact eye reveal a crossed projection of the retina to the NOT and to the dorsal (DTN) and medial (MTN) terminal nuclei of the accessory optic system as in normal rats. In addition, there is an uncrossed projection to the MTN in the rats enucleated as neonates. Retrograde tracer injected in the deafferented NOT confirms the absence of an uncrossed retinal projection but reveals connections between both NOT via the posterior commissure as in normal rats. Electrophysiologically, the larger naso-temporal optokinetic responses in monocularly enucleated rats return to normal after posterior commissurotomy. This study demonstrates that no anatomical remodelling takes place to increase naso-temporal responses in monocularly enucleated rats. The larger responses must then result from functional changes. The role of exclusive contralateral projections of the retina to the NOT and of the commissural connections in mediating the asymmetry of the optokinetic nystagmus in afoveate mammals is discussed. PMID- 1783685 TI - A PHA-L analysis of ascending projections of the dorsal raphe nucleus in the rat. AB - Ascending projections from the dorsal raphe nucleus (DR) were examined in the rat by using the anterograde anatomical tracer, Phaseolus vulgaris leucoagglutinin (PHA-L). The majority of labeled fibers from the DR ascended through the forebrain within the medial forebrain bundle. DR fibers were found to terminate heavily in several subcortical as well as cortical sites. The following subcortical nuclei receive dense projections from the DR: ventral regions of the midbrain central gray including the 'supraoculomotor central gray' region, the ventral tegmental area, the substantia nigra-pars compacta, midline and intralaminar nuclei of the thalamus including the posterior paraventricular, the parafascicular, reuniens, rhomboid, intermediodorsal/mediodorsal, and central medial thalamic nuclei, the central, lateral and basolateral nuclei of the amygdala, posteromedial regions of the striatum, the bed nucleus of the stria terminalis, the lateral septal nucleus, the lateral preoptic area, the substantia innominata, the magnocellular preoptic nucleus, the endopiriform nucleus, and the ventral pallidum. The following subcortical nuclei receive moderately dense projections from the DR: the median raphe nucleus, the midbrain reticular formation, the cuneiform/pedunculopontine tegmental area, the retrorubral nucleus, the supramammillary nucleus, the lateral hypothalamus, the paracentral and central lateral intralaminar nuclei of the thalamus, the globus pallidus, the medial preoptic area, the vertical and horizontal limbs of the diagonal band nuclei, the claustrum, the nucleus accumbens, and the olfactory tubercle. The piriform, insular and frontal cortices receive dense projections from the DR; the occipital, entorhinal, perirhinal, frontal orbital, anterior cingulate, and infralimbic cortices, as well as the hippocampal formation, receive moderately dense projections from the DR. Some notable differences were observed in projections from the caudal DR and the rostral DR. For example, the hippocampal formation receives moderately dense projections from the caudal DR and essentially none from the rostral DR. On the other hand, virtually all neocortical regions receive significantly denser projections from the rostral than from the caudal DR. The present results demonstrate that dorsal raphe fibers project significantly throughout widespread regions of the midbrain and forebrain. PMID- 1783686 TI - Preferential regeneration of spinal axons through the scar in hemisected lamprey spinal cord. AB - Axons of lamprey spinal cord can regenerate across a complete spinal transection. Thus, unlike the scar of injured mammalian spinal cords, the scar in the lamprey is not an absolute impediment to regeneration. However, it is still not known whether the scar is a relative impediment or whether it provides a favorable environment for regeneration compared to the spinal cord parenchyma. In order to answer this question, the cords of 12 large larval sea lampreys (4-5 years old) were hemisected at the level of the third gill and the animals allowed to recover for 10 weeks. The large reticulospinal neurons (Muller and Mauthner cells) or their giant axons were injected intracellularly with HRP and their regenerating neurites visualized in central nervous system (CNS) wholemounts. Forty-five of seventy-one regenerating neurites (64%) grew beyond the level of the hemisection. Of these, 36 (82%) regenerated through the scar and remained on the same side of the cord as their parent axons, while only 8 (18%) crossed the midline and grew around the scar. Thus, regenerating neurites of giant reticulospinal axons tended to grow through the hemisection scar rather than around it. Once they passed the level of injury, they continued to elongate in their appropriate paths. It is possible that this tendency for axons to regenerate through the scar reflects the greater amount of empty spaces on the hemisected side. In order to rule this out, 13 animals received contralateral simultaneous hemisections at the level of the 3rd and 7th gills. This procedure created large numbers of degenerating axons and potential empty spaces both rostral and caudal to the scars within both hemicords; 92 of 158 neurites (58%) regenerated beyond the level of their respective hemisections. All of these grew through the scar and none crossed to the contralateral side. Distal to either hemisection, neurites remained on their correct side regardless of whether the contralateral cord contained normal CNS parenchyma or axonal debris and empty spaces produced by Wallerian degeneration. Moreover, in hemisected and double hemisected animals, as well as in completely transected control animals, neurites regenerating in their correct direction grew further than those that were misrouted. Because lamprey spinal axons grow preferentially through a scar rather than around it, the scar may play a positive role in supporting axonal regeneration. PMID- 1783687 TI - Functional projections from striate cortex and superior temporal sulcus to the nucleus of the optic tract (NOT) and dorsal terminal nucleus of the accessory optic tract (DTN) of macaque monkeys. AB - The nucleus of the optic tract (NOT) and the dorsal terminal nucleus of the accessory optic tract (DTN) have been recognized to be relevant structures for optokinetic and vestibuloocular reflexes. NOT-DTN neurons relay visual information to the vestibular nuclei via the nucleus prepositus hypoglossi and to the flocculus via the dorsal cap of the inferior olive. It has been previously shown that in carnivores the NOT-DTN receives information from primary visual cortical areas in addition to the direct retinal input. In this study we demonstrate the presence and some functional characteristics such as latency and evicacy of considerable cortical projections to the NOT-DTN in macaque monkeys. In anaesthetized and paralyzed monkeys NOT-DTN neurons were identified physiologically and tested for cortical input by electrical stimulation in various cortical areas. Successful sites of stimulation to activate NOT-DTN neurons orthodromically lie in the primary visual cortex (V1) and in the motion processing areas in the superior temporal sulcus (STS). In contrast, electrical stimulation in area V4 and in parietal areas in most cases did not yield orthodromic responses. Overall latencies of action potentials elicited by stimulation in V1 were 0.5 ms longer than those elicited from STS. These short latency differences between V1 and STS stimulation suggest a direct projection from both V1 and STS to the NOT-DTN. The physiological results were supported by the results of anatomical experiments by using horseradish peroxidase as anterograde tracer. Both injections into V1 and into the lower bank of STS resulted in anterogradely labelled fibers and terminals around the recording sites of direction-specific NOT-DTN neurons. This paper is a first step in clarifying the significance of corticofugal projections from individual areas involved in the analysis of visual motion for the optokinetic reflex. PMID- 1783688 TI - Reinnervation of developing rat muscle by non-axotomized motoneurons. AB - To study the ability of developing motoneurons to reinnervate their denervated muscle, axotomized motoneurons in rat neonates and pups were retrogradely labeled with two fluorescent tracers. Fluorogold (FG), a long-lasting fluorescent dye, was injected into intercostal muscle T8 to retrogradely label the motoneurons that innervated it. Two days later intercostal nerves T7-T9 were cut. The intercostal muscle denervated at birth was reinnervated within 10-20 days, as evidenced by nerve-evoked muscle contraction. Three weeks following axotomy, tetramethylrhodamine isothiocyanate (TRITC) was injected into the same muscle to label the motoneurons that reinnervated it. The motoneurons double-labeled with FG and TRITC were, therefore, axotomized motoneurons that regenerated to reinnervate T8. In neonates, axotomy resulted in a significant reduction in the number of FG-labeled motoneurons, which suggests that axon transection at early postnatal days causes a massive motoneuron death. The percentage of double labeled motoneurons was significantly smaller than that in non-axotomized rats. TRITC-labeled motoneurons constituted the majority of stained motoneurons; these were located in different nuclei than the intercostal motoneurons. These findings suggest that muscle reinnervation is, at least in part, by motoneurons which originally did not innervate intercostal muscle T8. Unlike axotomy at birth, axotomy performed 2-3 weeks after birth did not result in a significant motoneuron loss. The number of stained motoneurons labeled with both FG and TRITC was significantly smaller, however, than in non-axotomized spinal cords. Our data indicate that in pups only a small percentage of axotomized motoneurons reinnervated the denervated muscle. PMID- 1783689 TI - Changes in expression of provasotocin and proisotocin genes during adaptation to hyper- and hypo-osmotic environments in rainbow trout. AB - The physiological roles of neurohypophysial hormones, vasotocin (VT) and isotocin (IT), are not yet clear in teleosts. Since information on responsiveness of hypothalamic neurosecretory neurons to environmental stimuli may contribute to an understanding of their physiological roles, effects of environmental hyper- and hypo-osmotic stimuli on expressions of VT and IT precursor (proVT and proIT) genes in rainbow trout were investigated, using an in situ hybridization technique in which 46 mer synthetic oligonucleotides were used as hybridization probes. The probes corresponded to the mRNA loci encoding chum salmon proVT (-5 to 11) and proIT (-5 to 11), and were labeled at the 3'-end with 35S. Autoradiographic silver grains which represent the hybridization signals of proVT and proIT mRNAs were localized in both magnocellular and parvocellular neurons in the nucleus preopticus magnocellularis (NPOmg). Localizations of proVT and proIT hybridization signals coincided with those of VT- and IT-immunoreactive neurons in adjacent sections, and showed that proVT and proIT genes are expressed in separate neurons. The intensity of proVT hybridization signals as determined by grain counting in magnocellular neurons in the NPOmg was conspicuously decreased after transfer from fresh water (FW) to 80% seawater (SW). The proVT mRNA levels in SW trout were consistently lower than those of FW trout for up to 2 weeks. After return from 80% SW to FW, the proVT mRNA level increased, attaining the initial FW level. The proIT mRNA levels in SW trout were not statistically different from those in FW trout, except for the 1st day after transfer to SW.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783690 TI - The effect of unsaturated and saturated dietary lipids on the pattern of daily torpor and the fatty acid composition of tissues and membranes of the deer mouse Peromyscus maniculatus. AB - Dietary lipids strongly influence the pattern of torpor and the body lipid composition of mammalian hibernators. The object of the present study was to investigate whether these diet-induced physiological and biochemical changes also occur in species that show shallow, daily torpor. Deer mice, Peromyscus maniculatus, were fed with rodent chow (control diet) or rodent chow with either 10% sunflower seed oil (unsaturated diet) or 10% sheep fat (saturated diet). Animals on the unsaturated diet showed a greater occurrence of torpor (80-100% vs 26-43%), longer torpor bouts (4.5 vs 2.25 h), a lower metabolic rate during torpor (0.96 vs 2.25 ml O2.g-1.h-1), and a smaller loss of body mass during withdrawal of food (2.35 vs 3.90 g) than animals on the saturated diet; controls were intermediate. These diet-induced physiological changes were associated with significant alterations in the fatty acid composition of depot fat, leg muscle and brain total lipids, and heart mitochondrial phospholipids. Significant differences in the total unsaturated fatty acid (UFA) content between animals on saturated and unsaturated diet were observed in depot fat (55.7% vs 81.1%) and leg muscle (56.4% vs 72.1%). Major compositional differences between diet groups also occurred in the concentration of n6 and/or n3 fatty acids of brain and heart mitochondria. The study suggests that dietary lipids may play an important role in the seasonal adjustment of physiology in heterothermic mammals. PMID- 1783691 TI - Role of splanchnic nerve on steroid-hormone-induced alteration of adrenomedullary catecholamines in untreated and reserpinized pigeon. AB - The aim of the present investigation was to ascertain (1) the effect of steroid hormones (corticosterone, dexamethasone, deoxycorticosterone, progesterone, testosterone and oestrogen) on the neural regulation of adrenomedullary catecholamine (CA) content, and (2) the neural modulation of the effect of glucocorticoid hormones (corticosterone and dexamethasone) on reserpine-induced resynthesis of CA. The experiment was conducted on unilaterally splanchnic denervated pigeons. The findings revealed that 7 consecutive days of steroid treatments (2.5 mg.kg b.w.-1, i.m.) resulted in significant changes of CA content. Interestingly, the changes of epinephrine (E) content differed significantly between the innervated and denervated glands. This clearly indicates that the splanchnic nerve regulates steroid-induced alterations of E content in the pigeon. The results further revealed that the glucocorticoid hormones augmented reserpine-induced resynthesis of CA specifically in the innervated glands. This confirms that the splanchnic nerve is essential for the synergistic action of glucocorticoids and reserpine in accelerating resynthesis of CA. PMID- 1783693 TI - Respectfully yours. PMID- 1783692 TI - The effect of carbonic anhydrase inhibitors on secretion by the parotid and mandibular glands of red kangaroos Macropus rufus. AB - The effects of carbonic anhydrase inhibitors on secretion by macropodine parotid and mandibular glands were investigated using anaesthetized red kangaroos. In the parotid gland, acetazolamide (500 mumol.l-1) reduced a stable acetylcholine evoked, half-maximal flow rate of 2.02 +/- 0.034 to 0.27 +/- 0.023 ml.min-1 (87% reduction). Concurrently, salivary bicarbonate concentration and secretion fell (129.4 +/- 1.46 to 80.9 +/- 1.63 mmol.l-1 and 264.8 +/- 7.96 to 22.3 +/- 2.30 mumol.min-1, respectively), phosphate and chloride concentrations rose (14.0 +/- 0.79 to 27.6 +/- 0.85 mmol.l-1 and 5.6 +/- 0.25 to 27.5 +/- 1.32 mmol.l-1, respectively), sodium concentration and osmolality were unaltered, and potassium concentration fell (8.8 +/- 0.33 to 6.4 +/- 0.29 mmol.l-1). High-rate cholinergic stimulation during acetazolamide blockade was unable to increase salivary flow beyond 11 +/- 0.9% of that for equivalent unblocked control stimulation. However, superimposition of isoprenaline infusion on the acetylcholine stimulation caused a three-fold increase in the blocked flow rate. These treatments were accompanied by small increases in salivary phosphate and chloride concentrations but not bicarbonate concentration. Methazolamide infusion caused similar changes in parotid secretion. In the mandibular gland, acetazolamide infusion had no effect on salivary flow rate during either low- or high-level acetylcholine stimulation. Acetazolamide caused no alterations in salivary electrolyte secretion at low flow rates, but curtailed the rise in bicarbonate concentration associated with high level acetylcholine stimulation. Acetazolamide administration did not affect the increase in salivary flow rate associated with isoprenaline infusion, but did block the concomitant increase in bicarbonate concentration and secretion substantially.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783694 TI - Enamel hypoplasia in the primary dentition: a review. AB - Clinical significance of enamel hypoplasia includes poor esthetics, tooth sensitivity, malocclusion and predisposition to dental caries. It may provide diagnostic clues as to genetic influences and systemic diseases, as well as to any trauma during the span of dental development. These systemic factors include birth trauma, infections, nutritional disorders, metabolic diseases, and exposures to chemicals such as tetracycline, lead, and fluoride. Inherited types form a relatively small component overall, including genetic abnormalities of enamel formation, or dental features of many inherited diseases or dysmorphic syndromes. Developmental enamel defects range in prevalence from 4 percent to 60 percent, depending on the criteria and the population studied. It is likely that many of these individual factors may in fact act through a central mechanism: mineral deficiency. PMID- 1783695 TI - Dental treatment of fearful children, using nitrous oxide. Part I: Treatment times. AB - This study investigated the influence of nitrous oxide on treatment time when it is used as an additional aid to behavior management. Different parts of the treatment of highly anxious child dental patients may vary during sequential dental visits, and separate consecutive parts of the treatment were considered in terms of their duration. Fifty-six children between the ages of six and eleven, each with a previous negative dental experience, were selected. They were randomly assigned into one of two matching groups: one with behavioral management only (control); the other also having nitrous oxide sedation (experimental). Interval 1, involved getting used to the procedures; interval 2 was sedation; interval 3, local anesthesia; and interval 4, preparation and filling. Most children required between four and six sessions. Results show that in terms of total treatment time (TTT), the use of nitrous oxide does not save time, although dental treatment did not require a greater number of sessions. For the dentist to erase the negative imprint of a previous dental experience, special skills are required. Further research is advised concerning the anxiety levels of this age group. PMID- 1783696 TI - An analysis of the phenomenon of increased parental participation during the child's dental experience. AB - The role of the parent during their child's dental experience, in contemporary society, has changed during the past decade and should be addressed by pediatric dentists. Included in this matter are issues regarding risk management and practice management. Behavioral pediatric dentistry is in flux, much like the world that it serves; there appear to be schisms within the profession regarding one aspect of this: the presence of parents in the dental operatory. Presented here is an analysis of the paradigm-shifts in society since World War II, when a postfigurative parenting strategy was in vogue. An explication of noted anthropologist Margaret Mead's descriptions of this and two subsequent parenting styles, including configurative (or transitional) and prefigurative (contemporary) are presented. They are analyzed in terms of parental attitudes concerning trusting their child to authority figures, including the dental clinician. This emerging protective instinct is termed "social hypertrophy", based on social biologist Edward O. Wilson's work. Dentists are encouraged to understand parental attitudes and avoid unnecessary conflict. PMID- 1783697 TI - Trends in the prevalence of dental caries in Israel. AB - This study's objective was to assess the prevalence of dental caries in five-year olds and twelve-year-olds in Jerusalem, Israel. A total of 166 children comprised the younger group; and 147 children represented the twelve- to thirteen-year olds. Examinations took place in the classrooms under natural lighting, using a mouth mirror and a probe. It was found that 27.7 percent of the younger children were caries-free, with a mean dif(t) value of 3.65 +/- 3.58. At the age of twelve years, only 4.8 percent were caries-free, with a mean DMF (T) value of 4.9 +/- 3.09. Nearly 58 percent of these carious permanent teeth had been treated. In Jerusalem, fluoridation of the water supply was implemented only recently. There are signs of increased public awareness of prevention methods. PMID- 1783698 TI - Evaluation of fluoride exposures in children. AB - This paper reports the findings of a study looking at children's fluoride exposures in detail beyond the fluoride content of home drinking water. What emerges are the most clinically relevant questions to ask parents when conducting histories of fluoride exposure of child patients. Dental caries in children has decreased dramatically in the U.S. and other developed countries. At the same time, the prevalence and severity of dental fluorosis in the U.S. may be increasing because of the widespread ingestion of fluoride. Children are vulnerable to fluorosis, according to the results of a fifty-item questionnaire administered to mothers through the University of Iowa. Patients have reported multiple water sources and fluoride levels, use of soy-based formulas, toothpaste ingestion, and dietary fluoride supplements. PMID- 1783699 TI - The etiology, prevalence, and sequelae of infraclusion of primary molars. AB - Dental infraclusion, teeth below the occlusal plane, is a common condition, especially in mandibular primary molars, with more than seventy references in the literature. Most claim infracluded molars do not exfoliate within normal time limits and must be extracted to prevent detrimental sequelae. The few documented studies on this topic suggest, however, that most infracluded teeth exfoliate normally; however, there is a tendency toward a delay of six months. The degree of infraclusion does not appear to correspond with exfoliation time. The frequent sequelae of severely infracluded teeth, space loss and molar tipping, may be prevented by either restoring the height of the affected tooth or by using space maintainers without extraction. The successors of infracluded molars reportedly develop normally and have few occlusal abnormalities. PMID- 1783700 TI - Treatment of a pseudo-class III relationship in the primary dentition: a case history. AB - In conclusion, posterior and anterior crossbites of the primary dentition should be corrected, once recognized, to allow for normal dental base development and subsequent favorable skeletal growth, provided the analysis of the case reveals no gross boney discrepancies. To quiet any archaic ideas of delaying posterior crossbite correction until the eruption of the permanent first molars, a pilot is being undertaken to determine whether there is a statistical difference in the need for retreatment of patients, when the permanent first molars erupt with the use of either the Porter, Quadhelix, or R.P.E.-type appliances. It is hoped that this will support the low retreatment frequency of 7.6 percent reported by Kutin and Hawes. PMID- 1783701 TI - Local anesthetic mortality: report of case. AB - The case of a healthy five-year-old, thirty-six pound female patient scheduled for multiple extractions is reported. The child received a total dose of 270 mg of mepivacaine, instead of the correct dose of 72 mg, which resulted in multiple seizures, hospital admission, pneumonia, and death caused by anoxic brain injury secondary to cardiopulmonary arrest following the overdose. PMID- 1783702 TI - Intraoral etiology of a life-threatening infection in an immunocompromised patient: report of case. AB - Oral infections are one of the major causes of morbidity and mortality in patients with hematologic malignancies. Total body irradiation and chemotherapy suppress the ability of the immune system to respond to the more virulent pathogens that can attack the compromised patient. The case of an 8.5-year-old girl is reported, in which an oral infection and a clinically observed motility resulted in a communication with the submandibular space; a significant hard, brawny edema of her right submandibular area resulted. Surgery, strict oral hygiene, and regular irrigation with a chlorhexidine gluconate solution resulted in successful healing. PMID- 1783703 TI - ADA Council looks at tooth whiteners. PMID- 1783704 TI - Moving targets: bicycle-related injuries and helmet use among university students. AB - We conducted a cross-sectional study to evaluate bicycling habits and helmet use in a sample of university students in a southwestern state university. Thirty-one of 100 students in our sample owned bicycle helmets; of these, 17 (54.8%) wore helmets during most (more than three fourths) of their bicycle trips. Almost half of the students reported that more than 25% of their bicycling was done in heavy traffic but they rarely used bicycle trails. Sixty-five students in the sample had sustained at least one minor injury during the previous 5 years, and 18 had been hospitalized as a result of bicycle-related injuries. We found no substantial differences between male and female subjects in bicycle-related hospitalizations, although male subjects were more likely to sustain minor injuries than were females. Helmet ownership was most strongly associated with previous injury experience, especially hospitalization resulting from bicycling injuries (OR = 3.6; 95% CI = 1.3, 10.1). We also observed an association between helmet ownership and possession of insurance coverage for bicycling injuries (OR = 3.0; 95% CI = 1.2, 7.6). Ethnicity was a factor in helmet ownership--helmets were owned by 26 of 69 (37.7%) of non-Hispanic whites, in contrast to 1 of 24 (4.2%) of all other ethnic groups combined. Our survey data suggest that perceived risk is an important factor in bicyclists' use of safety helmets. PMID- 1783705 TI - Development and validation of a condom self-efficacy scale for college students. AB - This study proposed to develop and validate a scale for the college population that measures self-efficacy in using condoms. The Condom Use Self-Efficacy Scale (CUSES) was derived from several sources and consisted of 28 items describing an individual's feelings of confidence about being able to purchase condoms, put them on and take them off, and negotiate their use with a new sexual partner. This scale was administered to a sample of 768 college students. It was found to possess adequate reliability (Cronbach's alpha = .91; test-retest correlation = .81) and correlated well with the Attitude Toward the Condom Scale (r = .51) and the Contraceptive Self-Efficacy Scale for women (r = .55). Our scale also correlated with a measure of intention to use condoms (r = .40) but was unrelated to a measure of social desirability. Students who differed on measures of previous condom use as well as on sexual intercourse experience also showed significant differences on this scale in the expected direction, indicating evidence of this scale's discriminant validity. The potential uses of this scale in a college population are discussed, along with the issues underlying condom usage self-efficacy. PMID- 1783706 TI - Developing a screening questionnaire for problem drinking in college students. AB - The CAGE questionnaire is one of several brief screening instruments that has been successful in detecting alcoholism in a general population. There is evidence, however, indicating that none of these instruments has sufficient validity for detecting the less severe pattern of problem drinking that is more typical of college students. This study analyzed survey data, including CAGE questions, to identify items that would have sufficient test operating characteristics more valid for screening problem drinkers. Problem and normal drinking patterns were defined by combining certain categories of quantity frequency data with categories of alcohol-related problems. Problem and normal drinkers were identified as those students at the ends of the quantity frequency/alcohol-problems continuum. Differences between the two groups in response frequencies to a 17-item alcohol-use survey were examined using chi square analyses. Five items showing highly significant differences were identified, and sensitivity, specificity, and positive predictive values were calculated at possible cutoff points. These items were (1) a positive response to any 2 of the 4 CAGE items, (2) reporting rarely or never choosing nonalcoholic beverages at social events, (3) driving under the influence at least 6 to 10 times or more in the last year, and (4) having started regular use of alcohol before the college years. At the recommended cutoff score for a positive test, the items have a sensitivity of 88%, specificity of 87%, and positive predictive value of 52%. When used for screening in a population similar to this, it will fail to identify 12% of the problem drinkers and will falsely classify 13% of all normal drinkers as problem drinkers.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783707 TI - Do videotapes improve knowledge and attitudes about AIDS? AB - Three popular videotapes were assessed for their effectiveness in improving knowledge and attitudes about acquired immune deficiency syndrome (AIDS). One hundred forty-four university students completed knowledge and attitude questionnaires and then watched either an AIDS or a control tape. Half the students completed posttest questionnaires immediately after seeing the tape, and half were tested 1 month later. Students who viewed an AIDS tape showed increased knowledge at immediate and 1-month posttesting (p less than .01); the amount of increase declined over the month, however (p = .012). Students who saw two of the AIDS tapes showed an increase in compassion toward people with AIDS when tested immediately after the tape (p less than .01); but 1 month later, only those students who had viewed a third AIDS tape showed an increase in compassion (p less than .01). The AIDS tapes failed to bring about improvements in attitudes toward preventive behavior. The authors concluded that tapes about AIDS can lead to modest changes in knowledge and perhaps in attitudes; more significant changes, however, probably depend on multimedia interventions that include guided discussions as well as audiovisual and other components. PMID- 1783708 TI - International students at a college of nursing: concerns and coping. PMID- 1783709 TI - College health toward the year 2000. PMID- 1783710 TI - TMJ disorders. PMID- 1783711 TI - Capitation. PMID- 1783713 TI - Licensure by credentials. PMID- 1783712 TI - Amalgam. PMID- 1783714 TI - Implantology. PMID- 1783715 TI - ADA calls for studies on Sargenti paste. PMID- 1783716 TI - Booth Memorial awarded funds to cover dental costs for AIDS patients. PMID- 1783717 TI - Children with leukemia show high incidence of oral problems. PMID- 1783718 TI - Clarification. PMID- 1783719 TI - Facing the challenges of the future. PMID- 1783720 TI - A national survey of women dentists. PMID- 1783721 TI - Words of wisdom from ADA women. PMID- 1783722 TI - Why women choose dentistry. PMID- 1783723 TI - Dental CAD-CAM systems. What is the state of the art? PMID- 1783724 TI - To your health. Keeping fit for life in dentistry. AB - This article outlines the physical and mental aspects of human health, defining health in both areas. Developing your own personal health definition can be the important first step toward achieving personal and professional satisfaction in life. PMID- 1783725 TI - Measuring harmful levels of bacteria in dental aerosols. AB - The potential spread of the bacteria in aerosols emphasizes the familiar triad- gloves, masks and eyewear--for all operative procedures. PMID- 1783726 TI - A case report: acoustic neuroma confused with TMD. AB - A patient received treatment for temporomandibular joint dysfunction, but it was later discovered that his facial pain resulted from a brain tumor. PMID- 1783727 TI - Investigating incidental remission of subpontic hyperostosis. AB - Removing a fixed partial denture may be an option as valid as surgery to treat patients who have subpontic osseous hyperplasia. PMID- 1783728 TI - To bleach or not to bleach? PMID- 1783729 TI - Dentists married to dentists. PMID- 1783730 TI - Selecting a post system. AB - Posts retain cores when tooth structure is lost. Many posts are on the market, but root structure is the best guide to post selection. PMID- 1783731 TI - Antibiotic interference with oral contraceptives. ADA Health Foundation Research Institute, Department of Toxicology. PMID- 1783732 TI - Where the women are or where are the women? PMID- 1783733 TI - Sterilization required for infection control. Council on Dental Materials, Instruments and Equipment. PMID- 1783734 TI - Dithiocarbamate analog N-(4-methoxybenzyl)-N-dithiocarboxy-D-glucamine reduces the retention of ingested cadmium in rats. AB - This study was performed to evaluate the effect of oral and intraperitoneal treatment with N-(4-methoxybenzyl)-D-glucamine dithiocarbamate monohydrate (MeOBDCG) after a single oral administration of 115mCd to 6-week-old rats. Oral treatment reduced the retention of 115mCd in the whole body, gut, liver and kidney by 5, 3, 4 and 3 times respectively, and intraperitoneal treatment reduced the retention by 7, 2.5, 16 and 4.5 times, respectively. This finding is new, since it was believed that oral dithiocarbamate treatment would increase the toxicity and absorption of ingested cadmium. PMID- 1783735 TI - Ultrastructural localization of silver in rat testis and organ distribution of radioactive silver in the rat. AB - The deposition of silver after a single intravenous injection (2 micrograms Ag g 1 body weight) was studied in the testes of Wistar rats 24 h and 1 and 2 weeks after dosing with radiolabelled 110AgNo3 (2 micrograms Ag and 1.2 kBq g-1 body weight). Also, the temporal accumulation of silver during the experimental period was monitored in the blood, testes, epididymides, kidney, liver and brain. The subcellular distribution of silver within the testes was demonstrated by using the histochemical technique of autometallography. Silver was cleared rapidly from the blood. After an initial rise, concentrations in organs remained almost stable throughout the experimental period. Silver was especially abundant in interstitial macrophages and in the basement membrane. Deposits of silver were found in all cell types of spermatogenesis and in the lysosomes of the Sertoli cells. PMID- 1783736 TI - Carcinogenic effects of bis(2,3-dibromopropyl)-phosphate in Wistar rats. AB - Four groups of 40 Wistar rats of each sex per dose level were fed diets containing 0, 80, 400 or 2000 ppm of the magnesium salt of bis(2,3 dibromopropyl)phosphate (Bis-BP) for 24 months. A high incidence of tumours was induced, in both sexes, in the digestive system. Tumours included papillomas and adenocarcinomas of the tongue, oesophagus and forestomach, adenocarcinomas of the intestine and hepatocellular adenomas (neoplastic nodules) and carcinomas. Pre terminal mortalities were associated with an increased incidence of forestomach papillomas in both sexes, adenocarcinomas of the small intestine in male rats and increased incidence of hepatocellular carcinomas in females. The data suggest that Bis-BP is a more potent proximate carcinogen than tris-(2,3 dibromopropyl)phosphate (Tris-BP). PMID- 1783737 TI - Complexing of toxic hydrolysable tannins of yellow-wood (Terminalia oblongata) and harendong (Clidemia hirta) with reactive substances: an approach to preventing toxicity. AB - Ruminants consuming either tannic acid or hydrolysable tannins from the Australian yellow-wood tree (Terminalia oblongata) and the Indonesian shrub Clidemia hirta are intoxicated by simple phenolics liberated in the gut. The affinity of these tannins and of the simple phenolic gallic acid for the two proteins casein and pepsin, polyvinylpyrolidone (PVP), activated charcoal and Ca(OH)2 was examined in vitro. The studies were undertaken to predict the effect of these phenolics on digestion and to identify substances that would act as antidotes by precipitating phenolics. Tannins but not gallic acid were precipitated as stable complexes with both pepsin and casein at pH 3-5. Optimal complexing of tannin with protein occurred at a weight ratio of 1:1. Ionic strength and temperature did not affect the amount of tannin precipitated from solution with protein. The precipitation of tannins with PVP and Ca(OH)2 was unaffected by pH within the range 2-8 while maximum binding with activated charcoal occurred between pH 3 and 7. In contrast to protein, the other substances complexed with gallic acid; only gallic acid-PVP complexes were affected by pH. Calcium hydroxide bound more tannin and gallic acid on a weight basis than PVP and charcoal. Both Ca(OH)2 and activated charcoal should complex with phenolics in the forestomach, abomasum and intestines. The reaction of hydrolysable tannins and proteins at the pH found in the abomasum suggests that hydrolysable tannins would interfere with enzyme function and protein digestion post-ruminally rather than in the forestomach. PMID- 1783738 TI - Serum histamine and the elicitation of murine contact sensitivity. AB - We report that challenge of previously contact-sensitized mice results in a significant increase in the concentration of serum histamine. In an attempt to determine whether this phenomenon might form the basis of an alternative method for the evaluation of elicitation reactions in experimental contact sensitivity, we have compared challenge-induced increases in ear thickness with elevations in serum histamine. Challenge of sensitized mice revealed that both ear thickness changes and increases in the serum level of histamine were dependent upon the concentration of oxazolone used for sensitization. The kinetics of changes in serum histamine concentration were found to be biphasic, with a small increase measurable 2 h following challenge and the maximal response at 24 or 48 h. In contrast, increases in ear thickness were monophasic, although maximum responses were also observed at 24 h. It is concluded that, although they do not exactly parallel increases in ear thickness, changes in histamine concentration may provide a useful serological correlate of the challenge reaction in contact sensitivity. PMID- 1783739 TI - Inhalation toxicity of furfural vapours: an assessment of biochemical response in rat lungs. AB - The pulmonary biochemical response, particularly the effects on mixed-function oxidases, was investigated in rats exposed to 40 ppm furfural for 1 h daily, 5 days per week, for periods of 7, 15 and 30 days. This concentration is ca. 22% of the acute LC50 dose. Exposure to furfural increased the activities of acid and alkaline phosphatases and glutamic-pyruvic transaminase, inhibited the activities of arginase and succinic dehydrogenases and elevated the concentration of lactic acid in the lungs. In the group of mixed-function oxidases, the activities of aminopyrene-N-demethylase and aniline hydroxylase (phase I, cytochrome P-450b specific) significantly increased and the activity of Benzo[a]pyrene hydroxylase (phase I, cytochrome P-450c specific) decreased. The activity of glutathione-S transferase (phase II component) also was increased concurrently with a decrease in the concentration of glutathione. The magnitude of biochemical alterations in most cases was related directly to the duration of exposure. Our observations indicate that furfural caused pulmonary irritation, parenchymal injury and the regenerative proliferation of type II pneumocytes. Selective (cellular and/or cytochrome P-450 isozyme specific) enhancement of pulmonary mixed-function oxidases by furfural appears to stimulate its own pulmonary biotransformation, and the excretion of oxidative metabolites was facilitated by their enzymatic conjugation with glutathione. PMID- 1783740 TI - Cadmium accumulation in the lung, liver and kidney of mice and rats chronically exposed to cigarette smoke. AB - Cigarette smoking constitutes a major source of cadmium exposure via inhalation in man. To determine how smoke exposure affects the organ distribution and accumulation of cadmium, male C57B1 mice and Sprague-Dawley rats were exposed daily for 52-60 consecutive weeks to mainstream smoke from the University of Kentucky reference cigarettes (2R1) in a nose-only exposure system. Exposed mice and rats averaged blood carboxyhemoglobin values of 17.7 and 7.2%, and a daily total particulate matter (TPM) dose of 7.2 and 3.2 mg kg-1 body wt. per exposure, respectively. These results suggested effective inhalation of smoke by the animals. The tissues were acid digested and analyzed for cadmium by atomic absorption spectrometry. Cadmium levels 5-6- and 2-3-fold greater than control levels were detected in the lungs and kidneys, respectively, of exposed animals of both species. In contrast, the liver did not show increased cadmium levels in exposed mice or rats. The data suggest that low-dose chronic inhalation exposure to cigarette smoke leads to highest cadmium accumulation in the lung, followed by the kidney, with minimal effects on cadmium levels in the liver. PMID- 1783741 TI - Toxicity of 1,4-bis(aminocyclohexyl)methane. AB - 1,4-Bis(aminocyclohexyl)methane (PACM; CAS No. 1761-71-3) is a white solid considered for use in polymeric systems. PACM is moderately toxic systemically, with the acute oral lethal dose in rats between 670 and 1000 mg kg-1. PACM is a weak dermal sensitizer in the guinea pig. Instillation of as little as 10 mg of PACM to the rabbit eye produces severe injury. This damage could be permanent and was not reduced by rinsing the eye with water. Dogs given oral doses of 50 mg PACM kg-1 5 days per week for up to 18 months showed kidney and liver damage, along with local irritation of the gastrointestinal tract. The chemical is highly irritating and contact with it should be avoided. PMID- 1783742 TI - Acetaldehyde. PMID- 1783743 TI - Metaldehyde. PMID- 1783744 TI - Paraldehyde. PMID- 1783745 TI - Inhibition of acetylcholinesterase activity by organic isocyanates: a possible mechanism. PMID- 1783746 TI - A chronic study with lead acetate in female rats. PMID- 1783747 TI - Varus-rotated fifth digits are frequently observed during podopediatric examination. PMID- 1783748 TI - The distal akin osteotomy: a new approach. AB - The authors describe a modification of the Akin procedure using a distal oblique osteotomy with rigid internal fixation. The anatomic, biomechanic, and physiologic advantages of this modification are discussed. Its proper use and an analysis of results is included. PMID- 1783749 TI - Foot ulcers: a 54-month retrospective study. AB - A 54-month study of 65 patients with foot ulcers was performed at Community Hospital of Lubbock. These 65 patients constituted 73 hospital admissions. This article outlines the diagnosis, classification, and treatment of foot ulcers. PMID- 1783750 TI - Operative treatment of Brodie's abscess. AB - This manuscript deals with a unique operative management of unilateral Brodie's abscess in a 16-year-old male. Brodie's abscess is a common finding in childhood osteomyelitis. A review of the radiographic appearance, clinical presentation, and surgical management is presented. PMID- 1783751 TI - Synovial chondromatosis. AB - Synovial chondromatosis is a benign problem of synovial tissue. It is thought to be induced by trauma and affects only one joint. These masses often cause articular damage. Treatment of choice is surgical excision. PMID- 1783752 TI - A retrospective analysis of distal Chevron and Basilar osteotomies of the first metatarsal for correction of intermetatarsal angles in the range of 13 to 16 degrees. AB - A retrospective study was performed for Austin (Chevron) and basilar type osteotomies of the first metatarsal in patients with preoperative intermetatarsal angles in the range of 13 to 16 degrees. Results indicated better radiographic correction for both groups than in previous studies. When comparing the results for the Chevron and basilar groups, the radiographic results were almost identical, but the Chevron group appeared to have a slightly better subjective result with less complications of metatarsalgia and callus formation and a better range of motion. Comparing intermetatarsal angle correction as a function of the preoperative hallux adductus, no definitive conclusions were made. However, the trend appears to have reduced correction with higher hallux abductus angles. PMID- 1783753 TI - Calcified tendo Achillis insertion: a new surgical approach. AB - The authors present a new surgical approach to the medical condition that is known as enthesiopathy of the tendo Achillis. The cases presented demonstrate a surgical technique that addresses the calcified Achilles tendon at its insertion, without weakening the insertion fibers. This technique allows bone-to-bone healing instead of tenodesis and significantly reduces the likelihood of a ruptured tendo Achillis. PMID- 1783754 TI - Case studies of the ischemic foot and management with bypass surgery. AB - Four case studies are presented to demonstrate the interdisciplinary approach used in management of the ischemic foot. In each case, bypass surgery was used to increase vascularity to the affected limb. This surgical aggressive approach, medical management combined with local wound care, provided a satisfying clinical outcome. PMID- 1783756 TI - Accessory soleus muscle simulating a soft tissue tumor of the posteromedial ankle region. AB - The author reports the case of an adolescent male diagnosed with a symptomatic accessory soleus muscle. Surgical exploration with intraoperative appearance is depicted. This malady is uncommon, although it has been reported primarily as a unilateral entity. PMID- 1783755 TI - Effects of stretching the gastrocnemius muscle. AB - Many authors currently disagree on the amount of time necessary to provide an adequate stretch flexibility. Since gastrocnemius equinus has been recognized as a cause of athletic injury, the authors performed a study to test what may be an adequate amount of stretching a gastrocnemius to improve flexibility. This study could not be conducted blind, and it was hoped that the contralateral leg could offer some control. The results of this study are presented here and should be kept in mind when evaluating and treating patients with ankle equinus, especially when considering surgical intervention. PMID- 1783757 TI - The possible use of coralline hydroxyapatite as a bone implant. AB - Hydroxyapatite developed from sea coral has been utilized as a bone implant. The primary application at this time is in maxillofacial surgery along with experimental use in orthopedic surgery. The acceptance of this implant in bone and by the body has been found to be excellent without signs of rejection or increase in the incidence of infection. Advantages of this material over autogenous and allogenic bone grafts will be discussed along with its potential application to podiatric surgery. PMID- 1783758 TI - Osteonecrosis in the foot. AB - Osteonecrosis is a pathologic condition that affects bones in the lower extremity. Circulatory impairment, forces of weightbearing, and increased intraosseous bone marrow pressure can interact to create this malady. Radiologic identification is paramount to accurate diagnosis. The authors present various examples of this condition in the foot. PMID- 1783759 TI - Thrombosed varix of venous origin in the foot. AB - Thrombosed varix of venous origin may be difficult to diagnose. A literature review of previously identified lesions is presented and a brief discussion of venous anatomy and thrombus pathogenesis is included. The authors present a case report and conclude that surgical intervention is curative. PMID- 1783760 TI - Peritalar dislocation without fracture. AB - The case report of a 28-year-old male who sustained a pure peritalar dislocation, without fracture, is presented. The injury is potentially devastating and seldom seen in clinical practice. In this discussion, the etiology and treatment protocol is reviewed to alert the practitioner for prompt evaluation and treatment. PMID- 1783761 TI - Closing base wedge osteotomy. AB - The authors have completed a retrospective study on closing base wedge osteotomies. This review includes preoperative and postoperative clinical and radiographic evaluation. A total of 61 procedures were evaluated on 47 patients. All procedures were performed at The Podiatry Hospital of Pittsburgh. Subjective analysis of patient acceptance is included, as well as an in-depth discussion of surgical technique, with emphasis on fixation. PMID- 1783762 TI - First metatarsal head shape in juvenile hallux abducto valgus. AB - A round first metatarsal head has been implicated as a predisposing factor in hallux abducto valgus. The shape of one hundred first metatarsal heads was analyzed on 50 weightbearing dorsoplantar x-rays of 10-year-old children with a hallux abductus angle in excess of 15 degrees and osteophytic thickening of the first metatarsophalangeal joint. The metatarsals were subjectively described as either round or square. A measurement technique was then devised to quantify in millimeters the difference between the two types. Using chi-square analysis, a very strong statistical association (p less than 0.001) was found between the subjective assessment and the objective measurement. A weak relationship was found between the metatarsal head shape and the degree of hallux abducto valgus (HAV) (r = -0.294). While the trend of this correlation is consistent with accepted wisdom, that is, the squarer the metatarsal head the less the hallux abducto valgus, the association is not strong enough to scientifically confirm it. This finding along with the presence of so many square metatarsal heads in children with advanced HAV indicates that assessment of metatarsal head shape has little place in the scientific assessment of first metatarsophalangeal joint pathology. PMID- 1783763 TI - Congenital hallux varus: case presentation and review of the literature. AB - Congenital hallux varus is uncommon as an isolated deformity. Many authors cite this deformity in conjunction with metatarsus varus or talipes equino varus deformities. An unusual case of bilateral congenital hallux varus is presented in a 9-month-old. A review of etiologies and treatment methods are given. PMID- 1783764 TI - Medial column instability in the Lisfranc's fracture dislocation injury. AB - The authors present a descriptive report on medial column instability with Lisfranc's fracture dislocation injuries. Subtleties of recognizing and diagnosing this injury are emphasized within a literature review. Eleven cases of tarsometatarsal injuries were reviewed over an 18-month period. Eight cases involved acute injuries, while three cases presented as delayed or misdiagnosed injuries. Due to the instability of the medial column, failure in reduction methods for this injury consistently occurred. With proper sequential placement of Kirschner wires, reduction failure is minimized. A fixation method for medial column Lisfranc's injuries with Kirschner wire placement is described. PMID- 1783765 TI - Epidemiology and clinical impact of gram-negative sepsis. AB - Gram-negative sepsis, which was uncommon in the pre-antibiotic era, has become a major problem throughout the latter half of this century, particularly among persons with severe underlying diseases. The development of antibiotics with dramatic bactericidal activity against these pathogens and advances in supportive care have improved the outlook. Nonetheless, the mortality remains high among the growing numbers of elderly patients with chronic illnesses, immunocompromised patients, patients subjected to invasive procedures, and patients in critical care units colonized with highly antibiotic-resistant flora. PMID- 1783766 TI - Gram-negative septicemia and septic shock. PMID- 1783767 TI - Current understanding of the pathogenesis of gram-negative shock. AB - There is increasing evidence that gram-negative bacteria via endotoxin induce the excessive production of inflammatory cytokines, which are active in the pathogenesis of septic shock, multiorgan failure, and ARDS. In animals the injection of TNF induces pathophysiologic and histopathologic changes that are characteristic of the septic shock syndrome, and in patients there is a close association between levels of TNF and the severity of the shock. IL-1 and IFN gamma markedly potentiate the toxic TNF effects in animal experiments. IL-6 is frequently released into serum during septic shock, and its levels are associated with the severity of the shock. The cytokine is probably not directly involved in the pathogenesis of the shock but may contribute to fever, neutrophilia, and production of acute-phase proteins. Endothelial cells and neutrophils are important target cells for the cytokines in mediation of septic shock and late complications. Underlying conditions like cancer, trauma, burns, and other kinds of stress may alter the induction mechanism of the cytokines and the susceptibility of the organism. The pathogenetic significance of TNF and other cytokines in different categories of septic shock remains to be clarified. PMID- 1783768 TI - Sepsis syndrome. New insights into its pathogenesis and treatment. AB - Recent insights into the pathogenesis of sepsis and its sequelae have opened up new approaches to treatment. For maximum effectiveness, however, treatment must be given as early as possible in the course of illness--but only to patients who are at high risk of developing shock. The definition of sepsis syndrome outlined in this article provides a method by which to identify such patients before the onset of shock. PMID- 1783769 TI - Cardiovascular management of septic shock. AB - The first goals in the treatment of septic shock are to preserve life and to sustain organ function while beginning definitive treatment. The immediate management of septic shock includes three essential steps. A five-step treatment program is described in detail. PMID- 1783770 TI - Antibiotic therapy for gram-negative bacteremia. AB - Although antibiotic therapy is the mainstay of therapy for gram-negative bacillary bacteremia, the amelioration of the underlying conditions, the correction of predisposing factors, the drainage of abscesses, the removal of infected foreign bodies, and adequate supportive care are also of paramount importance for curing the infection and should not be neglected. Beginning in the late 1960s, most of the clinical work on gram-negative infections has focused on the evaluation of new antibiotics. Numerous studies have shown that early, appropriate antibiotic treatment of gram-negative bacteremia significantly improved patients' outcomes and prevented the development of septic shock. Prescribing standard doses of antibiotics does not necessarily mean that therapeutic levels will be reached in all patients, and relapses of infections or breakthrough bacteremias can occur in patients with subinhibitory serum levels of antibiotics. The monitoring of serum concentrations of antibiotic is therefore recommended in critically ill septic patients. Whereas initial studies on the antibiotic treatment of gram-negative bacteremia were carried out in nonneutropenic patients, more recent clinical investigations have been performed almost exclusively in cancer patients with neutropenia. Studies conducted in the 1970s and 1980s among these patients have shown the following: (1) early empirical therapy reduced the mortality of gram-negative bacteremia; (2) therapy with a combination of two antibiotics, be it an extended spectrum penicillin plus an aminoglycoside or a third-generation cephalosporin, has significantly improved patients' outcomes; and (3) triple-drug combinations (i.e., a penicillin plus a cephalosporin plus an aminoglycoside) are not superior to combinations of beta lactams and aminoglycosides. For the treatment of gram-negative bacteremia, clinicians today have a choice between well-established antibiotic combinations and broad-spectrum single-agent therapy with third-generation cephalosporins or carbapenem antibiotics. Although recent studies suggested that monotherapy could be as effective as combination therapy for the empirical treatment of fever in the neutropenic host, no definitive study has so far unquestionably demonstrated the equivalence of these treatments in patients with gram-negative bacteremias, especially those caused by P. aeruginosa, or in patients with adverse prognostic conditions, such as persistent and profound granulocytopenia. This literature should however be reviewed with great caution. Indeed, only a minority of studies have included a sufficient number of patients to confidently assess the impact of therapy on patients' outcomes. Obviously, small studies can have a significant risk of type II errors, that is, making false-negative conclusions.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1783771 TI - Prevention of infection by gram-negative microorganisms. AB - The epidemiology and prevention of gram-negative infections are discussed. In addition, the controversial concept of selective decontamination is addressed. PMID- 1783772 TI - Lipid A analogs aimed at preventing the detrimental effects of endotoxin. AB - Evidence has been presented for two potential methods of administering lipid A derivatives for the reduction of endotoxicity: 1. Use of low doses of agonists to induce early-phase tolerance for a sufficiently long period to protect patients at risk of endotoxin shock. 2. Administration of high doses of antagonists to the LPS-induced release of proinflammatory cytokines. The strengths and weaknesses of both approaches can be summarized as follows: Approach 1 appears promising for patients at risk for septicemias, based on iatrogenic induction of neutropenias or genetically caused neutropenic states, e.g., in cancer patients receiving aggressive chemotherapy or irradiation and in patients receiving immunosuppressive therapy (transplantations, myelodysplastic syndromes, and so forth.) Strengths. A long lasting effect can be expected. Broad protection against many types of infectious organisms. Strong potentiation of antibiotic chemotherapy anticipated irrespective of resistance patterns to antibiotics. Weaknesses. Only prophylactic treatment appears possible. Potential for endotoxic side-effects remains. Approach 2, the administration of LPS antagonists, appears most promising in clinical situations when interference with acute endotoxic shock symptoms subsequent to polytrauma is necessary. Strengths. Immediate onset of activity would be expected. Lower risk of side-effects. Weaknesses. Therapy may already be too late. Activity is restricted to endotoxicity, there being no anti-infectious potential. High drug levels might be required for a prolonged period. Synergism with antibiotics is not yet established. Together, these new lipid A derivatives open up new potential therapeutic avenues for the prophylaxis and therapy of septic shock, septicemias, and infections. Clinical studies will soon show whether the exciting pharmacologic effects observed in animals can be translated into humans. PMID- 1783773 TI - Corticosteroids for the treatment of septic shock. AB - Despite the substantial amount of data supporting the use of glucocorticoids in experimental models in septic shock, patients with severe sepsis and signs of deteriorating hemodynamic status or organ function do not benefit from glucocorticoid administration as given under the conditions of two well-done prospective, controlled trials. In fact, some glucocorticoid-treated patient subgroups showed increased mortality. Thus, the conclusion must be drawn that, despite potential theoretical and experimental value, glucocorticoids should not be used in the septic patient. PMID- 1783774 TI - Pharmacologic interventions aimed at preventing the biologic effects of endotoxin. AB - In summary, an increased understanding of the pathogenesis and pathophysiology of septic shock has led to the development and evaluation of potential adjunctive therapies. Although several agents show promise in certain experimental settings, definitive recommendations regarding the use of these agents are not yet possible. Although several therapies have shown benefit when the subject receives treatment prior to the onset of sepsis, most have had varying degrees of success following the development of septicemia. PMID- 1783775 TI - The role of monoclonal antibodies in the management of gram-negative sepsis. Experience with the E5 antibody. AB - Immunologic targeting of the mediators of sepsis is a new approach to reducing mortality associated with this often-fatal complication. When sepsis is due to infection with a gram-negative pathogen, endotoxin plays a key role in its pathogenesis. Antiendotoxin antibody E5 binds endotoxin from a broad spectrum of clinically relevant gram-negative bacteria and reduces mortality from endotoxemia and bacteremia in animal models. It seems to be safe to administer to patients with suspected gram-negative sepsis; fewer than 2% of patients experienced allergic-type reactions, a frequency similar to that seen with third-generation cephalosporins. When administered in a dose of 2 mg/kg daily for two days, E5 reduces mortality and improves the outcome of multi-organ failure in patients with gram-negative sepsis, especially when administered before the development of refractory shock. Patients with sepsis of other etiology have not been shown to benefit from antiendotoxin immunotherapy. E5 antibody appears to be an effective agent for the adjunctive treatment of gram-negative sepsis. Further evaluation of E5 antibody is warranted in the treatment of patients with neutropenia, burns, and shock. PMID- 1783776 TI - Thomas D.C. Grace--insect tissue culture pioneer. PMID- 1783777 TI - Entomopathogens of phlebotomine sand flies: laboratory experiments and natural infections. AB - The susceptibility of different geographical strains of Phlebotomus papatasi to a cytoplasmic polyhedrosis virus (CPV) was determined experimentally by feeding polyhedra to larvae. Of the Indian P. papatasi, 15.6% became infected, whereas Egyptian P. papatasi were mostly refractory. Infection rates were not augmented in colony flies from the Jordan Valley, 23.8% of which were naturally infected with CPV. The infectivity of Serratia marcescens and Beauvaria bassiana to P. papatasi were determined experimentally. A suspension of B. bassiana spores or S. marcescens bacteria, ingested by P. papatasi in sucrose solution, did not significantly augment mortality rates or reduce the number of eggs oviposited. However, B. bassiana spores smeared on a filter paper constituting 1 or 5% of the surface area available to flies induced 100% mortality of P. papatasi on days 5 and 4, respectively. Mortality in Lutzomyia longipalpis reached 100% on day 4. There were markedly lower mortality rates in the control groups and more eggs were produced by these females (P. papatasi: control = 48.5; experimental = 0.9 1.6 eggs/female; L. longipalpis; control = 17.1; experimental = 0 eggs/female). From wild-caught Colombian Lutzomyia spp., a nonfluorescent pseudomonas, an Entomophthorales fungus, and a Trypanosomatid protozoon (probably Leptomonas) were isolated in culture media. Gregarines (Ascogregarina saraviae) and nematodes (Tylenchida and Spirurida) were also recorded. In laboratory-reared flies, an ectoparasitic fungus was associated with high mortality rates of first instar Lutzomyia spp. larvae. Opportunistic ectoparasitic aggregates of bacteria, yeast, and fungi on the tarsi of colonized L. longipalpis and P. papatasi hindered their mobility and were associated with reduced colony vigor. Aspergillus flavus, B. bassiana, and S. marcescens were isolated from laboratory-bred P. papatasi adults. PMID- 1783778 TI - Morphology and mobility of oyster hemocytes: evidence for seasonal variations. AB - Hemocytes of Crassostrea virginica were video recorded and tracked to determine their locomotive rates and to assign these rates to Wright-stained morphological variants. From 24 oysters examined in January, February, March, and May, 1571 hemocytes were video recorded, identified, and their rate of locomotion (ROL) measured. Granulocytes (three types) and agranulocytes (one lymphoid and three nonlymphoid types) were recognized. Focusing on 15 oysters in March and May, 20,318 hemocytes were counted from duplicate slides to verify the classification and to show that predominant hemocytes vary greatly between samples and among individual oysters, yet population differences can be detected. Measured rates of locomotion indicate that the granulocyte subpopulation moved significantly faster (3.3 microns/min) than the agranulocyte subpopulation (0.7 microns/min) because most (81%) agranulocytes were not mobile. Of the mobile hemocytes, granulocytes were also significantly faster (4.8 microns/min vs. 3.5 microns/min, P less than 0.0001), and basophilic granulocytes (BASOs) were the most active and abundant cell type. Examination of monthly percentages of cells and ROL indicates, however, that granulocyte dominance and ROL are not invariable. Granulocyte percentages of more than 60% in January, February, and March decreased to 32% in May, and BASO dominance was reduced to 15%. Further, percentages of mobile granulocytes decreased from greater than 65% in January, February, and March to 50% in May. ROL for all cells decreased from greater than 2.3 microns/min in these months to 1.0 microns/min in May. The fewer mobile hemocytes tracked in May had significantly (P less than .05) lower average ROL (4.0 microns/min) than those in January and March (4.7 microns/min each). Agranulocytes increased in May due to an increase in nonlymphoid cells. PMID- 1783780 TI - Amblyospora sp. (Microspora, Amblyosporidae) infecting nerve ganglia of Culex pipiens (Diptera, Culicidae) from Egypt. AB - A species of Amblyospora-infecting neurones of Culex pipiens is described. Diplokaryotic meronts, which divided by binary fission, were distinguished at the electron microscope level by their unthickened plasma membranes. Sporonts with an electron-dense surface coat gave rise to eight uninucleate sporoblasts within a sporophorous vesicle, cytoplasmic division occurring at the quadrinucleate or octonucleate stages. Indications that nuclear fusion and chromosome reorganization occurred in merogony and sporogony were obtained by light microscopy but meiosis was not detected at the ultrastructural level. Spores were typical of Amblyospora, being ovoid when fresh, truncate when stained, and having an exospore of two membranous layers subtended by a thick amorphous layer, an electron-lucent endospore, an anisofilar polar filament, and a polaroplast comprised of an anterior region of close-packed lamellae and a posterior region of expanded sacs. The metabolic products in the sporophorous vesicle took the form of large globules, small globules with electron-dense borders, and fine granules. These were depleted in mature sporophorous vesicles, though a surface layer of fine granules on the spores may have been derived from them. Many stages were degenerate and it is suggested that C. pipiens may be an accidental host in which the parasite could develop suboptimally in nervous tissue only. Infections in larvae hatched from eggs in the laboratory indicate that vertical transmission occurs. PMID- 1783781 TI - Microsporidium aedium n. sp., from the mosquito Aedes cantans. PMID- 1783782 TI - Killing ticks with parasitic nematodes of insects. PMID- 1783779 TI - Alternate pathogenesis of systemic neoplasia in the bivalve mollusc Mytilus. AB - The proliferative disease systemic neoplasia, also termed hemic neoplasia or disseminated sarcoma, was studied in four Puget Sound, Washington populations of the bay mussel (Mytilus sp.). Using flow cytometric measurement of DAPI-stained cells withdrawn from the hemolymph, DNA content frequency histograms were generated for 73 individuals affected by the disease. The cells manifesting systemic neoplasia were found to exist as either of two separate types, characterized by G0G1 phase nuclear DNA contents of either approximately 4.9 x haploid (pentaploid form) or approximately 3.8 x haploid (tetraploid form). The two disease forms were found to coexist in all four mussel populations sampled, with overall relative prevalences of 66% pentaploid form, 29% tetraploid form, and 5% exhibiting both disease forms simultaneously. These findings represent the first unequivocal demonstration of multiple cell types in a bivalve neoplasia. The two forms appear to represent separate pathogenetic processes rather than sequential stages of a single pathogenesis. Two cell cycling parameters associated with proliferative activity were employed to compare the alternate forms: (i) the percentage of cells assigned to the DNA Synthesis (S) phase of the neoplastic cell cycle, and (ii) the proportion of neoplastic cell mitotic figures in hemocytological preparations. Mean values for both parameters were significantly higher for mussels with the tetraploid form of the disease, suggesting a higher rate of proliferation relative to the pentaploid form. Qualitatively, cells of the tetraploid form contained slightly lower nuclear and cytoplasmic volumes compared to those of the pentaploid form. An observed wide variation in neoplastic cell nuclear size within either disease form may reflect the distribution of cells in the G0G1, S, and G2M phases of the cell cycle. Potential etiologic relationships between the two forms are discussed. PMID- 1783783 TI - Nucleotide sequence of the gene coding for p40, an occluded virion-specific polypeptide of Bombyx mori nuclear polyhedrosis virus. PMID- 1783784 TI - Dr. Dharmendra. Born: 1-2-1900 died: 10-3-1991. PMID- 1783785 TI - The utility of animal models for selection of a candidate vaccine for leprosy. PMID- 1783786 TI - An attempt to produce experimental tuberculoid leprosy in the nine-banded armadillo. AB - In an attempt to produce experimental tuberculoid leprosy, three nine-banded armadillos, two with borderline tuberculoid lepromin reaction, and one with tuberculoid lepromin reaction, were chosen. They were injected subcutaneously in a four square centimetre area in the abdominal skin with saline suspension of 6.5 x 10(7) M. leprae. Induration of skin at the injected site appeared in 24 hours and persisted for 6 months in one and for 18 months in the other two animals. Histopathological examination of the infected site at 6 weeks, 18 and 20 months showed progressively decreasing granulomatous inflammation; but the cutaneous nerves were uninvolved. Autopsy examination of the three animals failed to show disseminated disease. Since there was no evidence of nerve involvement, experimental transmission of tuberculoid leprosy to armadillos could not be established in this study. PMID- 1783787 TI - The factors influencing the operational efficiency of leprosy case detection programme. AB - Under our National Leprosy Eradication Programme, Leprosy cases are being detected by para-medical workers by conducting population surveys. In order to detect the leprosy cases early, for their timely anti-leprosy treatment, it is necessary that the leprosy surveys are implemented and supervised efficiently. However, present experience indicates that the existing survey efficiency needs to be improved, for which it is necessary to analyse the factors which may interfere with the optimal survey efficiency of para-medical workers. An attempt has been made through present piece of work to identify such factors in relation to (i) the para-medical workers and survey facilities, (ii) the implementation and supervision of leprosy survey and (iii) the community involved in survey. These factors are discussed in detail to assist the NLEP Administrators in devising a suitable action plan to improve leprosy case detection efficiency. PMID- 1783788 TI - Comparison of a urine spot test and blood tests as indicators of patient compliance. AB - Irregular drug intake has been a concern of leprosy control programmes for many years and various methods have been used to monitor and encourage patient compliance. This study compares the results of a urine spot test for dapsone as proposed by Huikeshoven, with blood levels measured in the same patients by the modified Bratton Marshall method and by high performance liquid chromatography. Two hundred-sixty urine and blood specimens were obtained from subjects who were taking supervised and unsupervised medications as well as from controls who were taking no medications. The results indicate that the urine spot test is simple and easily performed, and for monitoring patient compliance under routine clinical conditions (hospital or field work) it compares favourably with blood levels of dapsone estimated by the Bratton Marshall method or by high performance liquid chromatography. The study also shows that dapsone level is not a good indicator of compliance in patients who are also taking daily rifampicin but the urine spot test remains useful in such patients. PMID- 1783789 TI - Skin smear examination in paucibacillary leprosy patients. PMID- 1783790 TI - Problems and needs of women leprosy patients in Bombay and Goa--a preliminary report. AB - By studying the status of 151 women leprosy patients (24 from a leprosy asylum and 127 attending urban leprosy centres at Goa and Bombay), it was noticed that a sizeable proportion experienced problems in society ascribable to the disease especially at the initial stages of the disease. However, most of them seemed to have managed to settle well in their families as housewives subsequently. Younger women leprosy patients expressed the need for financial assistance for completing their own education and for starting small scale business. The older women were more interested in educating their children. PMID- 1783791 TI - Steroid therapy in recent "quiet nerve paralysis" in pure neuritic leprosy. PMID- 1783792 TI - Clinical and bacteriological relapse after MDT in a lepromatous patient: a case report. PMID- 1783793 TI - Camptodactyly simulating claw hand in a patient with indeterminate leprosy. PMID- 1783795 TI - 'Pulse therapy'. PMID- 1783794 TI - Borderline tuberculoid leprosy developing in a pure neuritic case. PMID- 1783796 TI - Hypopigmented lesions in early leprosy. PMID- 1783797 TI - Absence of clinicopathological correlation in a case of leprosy. PMID- 1783798 TI - Negativity rate in multibacillary leprosy after MDT. PMID- 1783799 TI - [A mechanism of usefulness of treatment with erythromycin for diffuse panbronchiolitis]. AB - The clinical usefulness of treatment with erythromycin for diffuse panbronchiolitis (DPB) patients have been well reported to date, although its mechanisms remain unknown. In a previous study, we demonstrated that DPB patients were found to have large percentages of neutrophils in their lower respiratory tracts and suggested that neutrophils play an important role in the pathogenesis of DPB (Chest 99: 917-923, 1990). While in vitro and in vivo studies have demonstrated that erythromycin decreases neutrophils directed migration. In the present study, we performed bronchoalveolar lavage (BAL) on eight patients with DPB to clarify the cell populations in the lower respiratory tract before and after treatment with erythromycin. Neutrophils percentages in BAL fluid were significantly reduced after treatment with erythromycin (54.3 +/- 22.4% to 13.1 +/- 13.5%, p less than 0.01). No significant variance of BAL lymphocyte percentages was demonstrated after treatment with erythromycin. These results suggest that a main mechanism of clinical usefulness of treatment with erythromycin for DPB may be inhibition of neutrophils migration into the lower respiratory tract instead of intrapulmonary bactericidal activity against organisms. PMID- 1783800 TI - [Trends of tissue hypoxia following chemotherapy of acute malaria in mice]. AB - The effects of antimalarial treatment on the blood oxygen-transporting properties and on the tissue hypoxia were investigated in severe murine malaria, using mice infected with Plasmodium berghei (NK65). Five week old male ddY mice were inoculated intraperitoneally with 1 X 10(7) of P. berghei-infected red blood cells and treated with Fansidar (20 mg/kg body weight sulfadoxine and 1 mg/kg body weight pyrimethamine orally) on day 5 after inoculation. Parasitemia in these mice decreased rapidly on day 1 after treatment. Blood hemoglobin concentration, however, decreased on days 1 and 2 of treatment, then began to increase. The actual oxygen equilibrium curve (OEC) in vivo (actual pH; actual Pco2; 36.5 degrees C) was calculated from the measured OEC and the results of blood gas analysis. Looking from arterial and venous Po2 of each group, blood oxygen-transporting properties decreased markedly on day 2 of treatment. This decrease resulted mainly from the decrease of hemoglobin concentration and also partly from the raised hemoglobin affinity for oxygen. Adenosine triphosphate concentration in liver tissues, however, began to increase on day 1 of treatment. Adenylate energy charge of liver tissues also recovered on day 1. Blood glucose concentration began to increase and blood lactate concentration began to decrease simultaneously on day 1 of treatment. Glucose concentration in liver tissues, in contrast, decreased on days 1 and 2 of inoculation. Lactate concentration in liver tissue decreased earlier on day 1. These data indicate that tissue hypoxia was removed on day 1 following antimalarial treatment although blood oxygen transporting properties decreased on days 1 and 2 after treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783801 TI - [Pharmacokinetics of cefpirome (CPR) in patients with impaired renal function]. AB - The pharmacokinetics of cefpirome (CPR), a new injectable cephem, were studied in 9 patients with various degrees (classified by Ccr.) of impaired renal function. Serum and urinary concentrations of CPR were measured by bioassay. The pharmacokinetic analyses were based on a two compartment open model. As renal impairment increased, higher serum concentrations were maintained in beta-phase and higher urinary concentrations were kept over a long time, as well. As a conclusion, it is necessary to consider the adequate administration and dosage for patients with renal impairment to prevent side effects caused by the maintenance of cefpirome in serum over a long time. PMID- 1783802 TI - [In vivo and in vitro growth of the TK-1 strain of Coxiella burnetii]. AB - All A/J, BALB/c and C57BL/6 murine strains were resistant against the intraperitoneal infection with TK-1 strain, but an enhancement of susceptibility of mice were revealed by the administration of cyclophosphamide (CPA) in BALB/c and A/J strains. CPA-treated BALB/c mice allowed an increase of TK-1 strain up to 1.7 x 10(6) coxiellar particles/mg spleen. But athymic nude mice of BALB/c strain showed only a slight increase of coxiellar particles in spleen. The resident peritoneal macrophages from BALB/c and A/J, but C57BL/6, showed proliferation of the TK-1 strain in the large infected cell population, and a part of the infected macrophages allowed TK-1 strain to survive. On the other hand, the elicited peritoneal macrophages from resistant C57BL/6 showed the largest infected cell population, number of intracellular coxiellar particles, and following decrease of TK-1 strain in later stage of infection. These in vitro infectivity of TK-1 strain seemed to relate to the in vivo infectivity in mice, and indicated existence of macrophage subpopulation, in which destruction or proliferation of TK-1 strain occurred. PMID- 1783803 TI - [Epidemiological analysis of Salmonella serovar enteritidis isolated from patients with sporadic cases of diarrhea in 1989]. AB - A total of 184 strains of S. Enteritidis isolated from patients with sporadic cases of diarrhea during the period from April 1985 to March 1991 in Yamanashi Prefecture, were examined for their drug susceptibility, phage typing and plasmid profile. The results can be summarized as follows: 1) In 1989, cases of sporadic diarrhea due to S. Enteritidis has drastically increased twenty-eight-fold from 4 to 112 cases. 2) The most predominant ages of S. Enteritidis isolates were that of 2 years age. 3) The predominant phage type (PT), accounting for almost 71% of the strains isolated, was PT 34 in 1989. 4) Eighty-two (73.2%) out of 112 strains of S. Enteritidis were resistant to SM single in 1989. In 1990, SM single resistant strains were 49 (90.7%) out of 54 strains of S. Enteritidis. 5) The predominant plasmid profile of S. Enteritidis isolates were 60, 55 Kbp plasmids. 6) In 1989, the characteristic of S. Enteritidis isolated from the cases of sporadic diarrhea were resistant to SM single, identified as belonging to PT 34 or PT 4. Almost S. Enteritidis strains of PT 34 carrying 60, 55 Kbp plasmids and many strains of PT 4 S. Enteritidis possessed only 60 Kbp plasmid. PMID- 1783804 TI - Comparative study of Vibrio cholerae non-O1 isolated from 2 rivers according to antibiotics and metals susceptibility. AB - Vibrio cholerae non-O1 was isolated at six locations on each of two different rivers in 1984 and 1985. A study of the strains isolated from these rivers according to antibiotic and metal susceptibility and the incidence of resistant strains produced the following results. 1) Tests to determine susceptibility to eight antibiotics (chloramphenicol, tetracycline, streptomycin, kanamycin, ampicillin, gentamicin, nalidixic acid and polymyxin-B) indicated that there was virtually no difference in the susceptibility of strains isolated from the two rivers. Of the 115 environmental strains, 81 (70.4%) showed resistance to one or more drugs. However, no strains were resistant to gentamicin. There was considerable variation in the concentration of susceptibility to polymyxin-B, and for this reason it was difficult to determine the resistance concentration. 2) 64.3% (74/115) of the strains isolated from the two rivers showed ampicillin resistance and produced beta-lactamase. 3) 67.9% (55/81) of all resistant strains were resistant only to ampicillin, while 16.0% (13/81) were resistant to ampicillin and nalidixic acid. The rate of resistance to these substances was higher than to the other drugs. 4) The incidence of resistant strains differed according to environmental conditions along the two rivers. These variations appear to reflect the influence of environmental conditions in the catchment areas. 5) There was no metallic contamination in either the Sagami River, which has good water quality, or the Sakai River, which is heavily polluted. This meant that there was no variation in the metal susceptibility of the isolated strains according to differences in the degree of water pollution. Furthermore, none of the strains showed resistance to metals. PMID- 1783805 TI - [Bacterial meningitis in the elderly with neurosurgical procedures]. AB - Bacterial meningitis is one of complications in the elderly with neurosurgical procedures. In an attempt to find the clinical features of this complication we analyzed 10 cases, which were found in 30 cases of the bacterial meningitis in Tokyo Metropolitan Geriatric Hospital from 1972 to 1989. The patients were 4 males and 6 females, 52-86 years old (the mean, 69). While 2 Enterococcus species were isolated after craniotomy, Staphylococci were common pathogens (4 S. aureus, 4 S. epidermidis and 1 P. aeruginosa) in patients with shunt infection. Most of these patients lacked typical manifestations of meningitis except the fever. Symptoms occurred long after surgery with little abnormality in the data of serum and cerebrospinal fluid. However, blood cultures were positive in 75% of the cases. Removal of the infected catheter was effective in the cases of shunt infection. PMID- 1783806 TI - [Detection of Chlamydia trachomatis from urethral swab in male urethritis by polymerase chain reaction]. AB - A polymerase chain reaction (PCR) with Chlamydia trachomatis-specific primers was applied for detection of C. trachomatis from urethral swab in male urethritis. The results were compared with those of culture method for detection of C. trachomatis. Of 18 clinical specimens tested in this study, inclusion bodies of C. trachomatis were detected in 11 specimens by the culture method. For PCR, sample DNA was prepared from transport medium in which urethral smear was suspended and two oligonucleotides based on sequences within the major outer membrane protein gene from C. trachomatis serovar L2 were used as extension primers. In 12 of the 18 specimens, 242bp DNA fragment was amplified by PCR and demonstrated to be the DNA fragment of C. trachomatis by Southern blot hybridization. No DNA of 242bp was amplified by PCR from five specimens in which any inclusion bodies of C. trachomatis were observed or from a specimen in which one inclusion body per cover slip was detected by culture method. C. trachomatis DNA of 242bp was amplified from all specimens in which 14 and more inclusion bodies per cover slip were detected by culture method. In two specimens concluded s negative by culture method, amplified C. trachomatis DNA were detected by PCR. Thus, the PCR would be a more simple and sensitive method for detection of C. trachomatis, compared with the culture method. PMID- 1783807 TI - [Evaluation of micro particle enzyme immunoassay technique (MEIA)-IMx for the detection of IgM class antibody to hepatitis B core antigen]. AB - The new Micro Particle Enzyme Immunoassay technique (MEIA, IMx HBc-M, Abbott) had been recently introduced for the detection of IgM class antibody to hepatitis B core antigen (IgM anti-HBc). To evaluate the feasibility of using the IMx HBc-M, we carried out comparison tests between this method. RIA and EIA using sera from acute hepatitis B and type B chronic liver disease. Results obtained were as follows: In the test of 98 sera from acute hepatitis B patients, 92 (93.9%) were positive for IgM anti-HBc by IMx HBc-M, 96 (98.0%) by RIA and 82 (83.7%) by EIA. The four sera which were positive by RIA, but not by IMx were ones obtained from 5 to 12 month after onset. In the test of 267 sera from B type chronic liver disease patients, 93 (34.8%) were positive by IMx HBc-M, 109 (40.8%) by RIA and 23 (8.6%) by EIA. There was a difference in the positive rate between IMx HBc-M and RIA among type B chronic liver disease: the positive rate was higher in RIA than in IMx HBc-M among type B active chronic hepatitis, but only a little higher in IMx HBc-M than RIA among hepatocellular carcinoma. IgM anti-HBc titer was significantly higher in acute hepatitis type B than in chronic liver disease, and was so even in the phase of HBsAg negative in acute hepatitis. IgM anti-HBc was assayed within 45 minutes by IMx, and the procedure was simple because of the auto analyser used in this method.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783809 TI - [Isolation of Legionella spp. from cooling tower water in Kinki District, Japan]. AB - Distribution of Legionella spp. were surveyed two different times in Kinki District, Japan. The first time, eighty six building cooling tower waters were collected from Osaka, Hyogo and Nara Prefecture between April and December, 1987. The second time, thirty five waters were studied from Nishinomiya City in Hyogo Prefecture on July, 1989. BMPA alpha agar plate was used as the isolation medium for the first eighty six samples and MWY agar plate for the second thirty five samples. Legionella were isolated from forty two samples (48.8%) of the first eighty six samples. Three different species of Legionella were isolated simultaneously from one sample and two species from eight samples. L. pneumophila serogroup 1 was the most predominant species. Twenty three samples (65.7%) were positive in culture from the second thirty five samples. Three different species of Legionella were isolated simultaneously from three samples and two species from eleven samples. Legionella anisa was more predominant than L. pneumophila serogroup 1 in this study. PMID- 1783808 TI - [Bacteriological studies on pharyngeal and tracheal colonization in patients of operations and patients in ICU]. AB - Bacterial colonization of the pharynx before and one week after operation, and contamination of the trachea during intubation in 7 patients who underwent operations were investigated. And bacterial colonization of pharynx, tracheas, and mechanical-ventilators in 7 ICU patients was investigated. Flora of palms of 10 ICU personnel was also examined: 1) Oral bacteria began to be found in the trachea several hours after intubation. 2) In oropharyngeal flora, one week after operation, Neisseria and anaerobes which belong to normal flora decreased because of antibiotics, but no new resistant bacteria appeared. 3) Although isolates from pharynx of preoperative patients were normal flora, those of ICU patients were Staphylococcus epidermidis, Enterococcus spp., gram-negative rods such as Pseudomonas aeruginosa, and yeast liked organisms etc, which were resistant to antibiotics. 4) From the trachea of intubated patients in ICU, oral bacteria were isolated. 5) Pseudomonas pickettii was isolated from the expiratory side of ventilator circuits in one patient, but it was not isolated from the patient. 6) From hands of ICU personnel, gram-positive bacteria such as coagulase negative staphylococci, Coryne bacterium spp. and Bacillus spp. were isolated. 7) One patient in ICU, who developed pneumonia due to resistant Bacteroides fragilis following oropharyngeal colonization, was reported. These studies suggested the importance of environmental control, careful selection of antibiotics, and attention to change of flora. PMID- 1783810 TI - [Analysis of 98 cases of thoracic empyema]. AB - Ninety-eight cases of empyema thoracis admitted to Juntendo University Hospital between 1979 and 1990 were reviewed. Males accounted for 78 cases and females 20 cases. Thirteen pediatric patients ranged in age from 17 days to 4 years, while the 85 adult cases ranged from 16 to 89 years (mean: 58.4 years). The mortality rate increased with age. Fifty-three cases of community-acquired empyema thoracis consisted of 24 with no underlying disease (including 13 pediatric cases), and 29 with diabetes mellitus, alcoholic liver damage or chronic obstructive bronchopulmonary disease. Forty-five nosocomial empyema cases occurred after chest operation or thoracocentesis, or due to a subdiaphragmatic pathogenic condition or congestive heart failure complicated with aspiration pneumonia. In this series, 63 patients (64.3%) had para- or post-pneumonic empyema. Compared with the community-acquired infection cases, the mortality rate of the nosocomial infection cases was very high. Seventy-eight cases were culture-positive, including 3 positive for Mycobacterium tuberculosis. The remaining 20 cases were culture-negative. In 75 cases of culture-positive pleural fluid, aerobic bacteria were isolated from 31 cases (mortality rate: 22.6%), anaerobes mixed with aerobes from 21 cases (mortality rate: 52.4%), and anaerobes only from 23 cases (mortality rate: 21.7%). Thus, the mortality rate of mixed infected cases was highest. Anaerobes were frequently isolated from the community-acquired empyema cases, and were often found in para- or postpneumonic lesions, including aspiration pneumonia. The most commonly encountered aerobe was Staphylococcus aureus. Among the anaerobes, Bacteroides spp., microaerophilic streptococcus, Peptostreptococcus and Fusobacterium spp. were most common. A single organism was isolated in pure culture from 39 cases. Single organisms isolated from fluids were more frequently aerobes (25) than anaerobes (14). The cases harboring Bacteroides spp. showed the worst outcome, with 11 deaths in 25 such cases. PMID- 1783811 TI - [The study on bacterial infection in chronic lower respiratory tract infection- from the viewpoints of acute and chronic infection]. AB - Using mainly changes in the amount of sputum as an index of the infectious course of chronic lower respiratory tract infection associated with purulent sputum over years, the disease was divided into stable and acute exacerbated phases and a bacteriological investigation using transtracheal aspiration (TTA) conducted. TTA was performed 107 and 45 episodes during stable phases and acute exacerbated phases respectively. Monomicrobial and polymicrobial infection were detected most frequently during the stable and acute exacerbated phases respectively (p less than 0.01). During the stable phases, the single organisms detected most frequently were H. influenzae (26 episodes) and P. aeruginosa (20 episodes), while in the cases in which multiple organisms were detected during stable phases, combination including H. influenzae were most common (19 episodes). H. influenzae was the most frequently detected organism in cases showing single organisms during acute exacerbated phases (7 episodes). In the cases in which multiple organisms were detected as well, H. influenzae was the most commonly detected organism assumed to predispose to exacerbation (7 episodes), while P. aeruginosa was not found. These results suggest that in chronic lower respiratory tract infection. H. influenzae and P. aeruginosa are important as persistent infective organisms, while H. influenzae are important in acute exacerbation. PMID- 1783812 TI - [Isolation and identification of Chlamydia spp. from effusion of otitis media]. AB - Three chlamydial strains isolated from patients of otitis media with effusion were studied by comparing reactivity to monoclonal antibody (MAb) and polyclonal antibody (PAb) produced against one clinical isolate (named Mk), which was first isolated by Dr Mukai (Mukai Microbiological Research Laboratory, Yamato-shi, Kanagawa prefecture). Commercially supplied antibody (Microtrak (Syva), Culture set (Ortho diagnostic system)) was also used. To isolate the Chlamydia spp, the yolk sacs of eggs were immediately inoculated with sample effusions (0.2 to 0.4 ml per sac) as soon as the samples were received. The eggs were observed every day for a period of 12 days thereafter for signs of life or death. One to two blind passages were first done in the eggs and then in HeLa 229 cells. The reactivity was examined by both micro-IF tests, among various strains of Chlamydia (C. trachomatis: L2. C. pneumoniae, C. psittaci: Budgerigar, Izawa, Meningopneumonitis (MP)) and by immunoblot analysis. Chlamydia spp were isolated in two of the twenty-nine sample effusions (6.9%). These isolates were then tested for reactivity to MAb and PAb. It was found that MAb reacted with MP and Mk, but not with Budgerigar, Izawa and C. pneumoniae. The antibody of Culture-set reacted with C. trachomatis C. pneumoniae and C. psittaci. No reactivity was observed in Mk by MicroTrak. Immunoblot analysis revealed that MAb reacted with about 95 KDa protein of Mk, the two clinically isolated Chlamydia spp and MP. By using PAb from rabbits, similar blotting patterns were observed in Mk, the clinical isolates and MP.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783813 TI - [Cryptosporidium diarrhea developing in two Japanese adults--one in AIDS and the other in a normal host. Research Group for Infectious Enteric Diseases, Japan]. AB - Case I: A middle-age homosexual male developed AIDS with Pneumocystis carinii pneumonia (PCP) and esophageal candidiasis in 1986 during his stay in an European country about five months prior to transfer to Tokyo Metropolitan Komagome Hospital, Tokyo, in 1987. He was also diagnosed as having cryptosporidiosis presenting with mild diarrhea a month following the diagnosis of PCP. Diarrhea was successfully treated with spiramycin. On transfer to Tokyo Metropolitan Komagome Hospital, he was febrile but had no diarrhea. Serum HIV and TPHA were positive and his blood lymphocyte subset T4a was markedly decreased. On the 13th day after transfer to the hospital, watery diarrhea appeared. Cryptosporidium oocysts were detected from the feces taken on the 17th hospital day. The patient died of Escherichia coli septicemia on the 38th hospital day. Autopsy finding yielded Cryptosporidium infection widely spread over the stomach, ileum, bile and pancreatic ducts. Case II: A 31-year-old previously healthy female presented with abrupt onset of mucous stool five times daily. Mucous passage continued on the subsequent days despite administration of loperamide, and the passage increased to 20 times daily with mucous to watery diarrhea associated with mild abdominal cramps and nausea on the 4th day after onset of illness. On the 6th day of illness, she visited Tokyo Metropolitan Komagome Hospital. She denied close contact with pet animals or contact with any person presenting diarrhea. She had no recent history of travelling anywhere outside Tokyo. On examination she was an apparently healthy woman except for a slightly distended abdomen with localized tenderness in the right upper quadrant.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783815 TI - Ophthalmic nurses participate in government panel. PMID- 1783814 TI - [Three cases of human fascioliasis]. AB - Three patients with hepatic fascioliasis are presented. (case 1) A 36-year-old female was admitted in January, 1988, because of intermittent high-grade fever. Laboratory findings included white blood cell count 8,050/mm3 with 29% eosinophils, and CRP 9.5 mg/dl. There was a positive intradermal reaction to Fasciola hepatica antigen. Liver biopsy revealed eosinophilic abscess, granulation and many Charcot-Leyden crystals. (case 2) A 54-year-old male was admitted in June, 1985, because of abdominal fullness. Marked hepatomegaly was noticed. Laboratory findings included white blood cell count 10,200/mm3 with 26% eosinophils, and CRP 2.2 mg/dl. (case 3) A 48-year-old male was admitted in March, 1989, because of intermittent high-grade fever. Hepatomegaly was noticed. Laboratory findings included white blood cell count 7,310/mm3 with 30.3% eosinophils, and CRP 3.5 mg/dl. His condition was complicated by pleuritis with invasion of Fasciola hepatica. In all patients, stool specimens were negative for ova and immunoelectrophoresis was positive for F. hepatica antigen. Computed tomography demonstrated multiple low-density areas in the periphery of the liver in cases 1 and 3, and disseminated areas in case 2. After treatment with bithionol 40 mg/kg every other day for 40 days, all three patients became asymptomatic. PMID- 1783816 TI - Making a difference. PMID- 1783817 TI - Jurdean Reed, R.N., CRNO. Interview by Marsha Parker. PMID- 1783818 TI - The research report: analysis of the findings, Part 1. AB - The purpose of the results section of the research report is to answer the research questions (the hypotheses) in the order they were asked (Thomas, 1990), to justify the use of the analytic technique used to answer the questions, to use tables and figures (where appropriate) to clarify and highlight relevant findings with an accompanying narrative, and to identify limitations. PMID- 1783819 TI - An experience in practice-based research. AB - As experts in the area of ophthalmic care, nurses have a responsibility to the nursing community at large to be a scientific resource. Researching questions that arise in the clinical setting will strengthen our nursing practice and ourselves as practitioners. PMID- 1783820 TI - Management of the pediatric patient through three dimensional phases of surgery. AB - The three dimensional phases of the operative procedure can either be extremely traumatic, or a pleasant experience. The ophthalmic nurse can help to control which type of experience it will be for the pediatric patient. PMID- 1783821 TI - In honor of nurses. PMID- 1783822 TI - Nursing agenda for health care reform. PMID- 1783823 TI - Caution: systemic adverse reactions from eye drop medications. PMID- 1783824 TI - Introduction to first assisting in cataract surgery. PMID- 1783825 TI - Sickle cell retinopathy. AB - Sickle cell retinopathy was described as early as 1930 and research has been ongoing as to the pathophysiology of the disease, its effects on the eye and successful treatment. Disease stages have been identified and treatment modalities have been established for each stage. Research results and case reports have been published in medical journals available to physicians; however, there are no identifiable publications applicable to the nursing skills required to deal with this disease. Ophthalmic nurses should be knowledgeable of the sickle cell diseases and specifically the resultant retinopathy. PMID- 1783826 TI - Teaching aids for patients diagnosed with choroidal melanoma. AB - Patients who are diagnosed with choroidal melanoma are frequently devastated and overwhelmed. Simple and creative teaching aids including photographs, visual fields, eye models with clay tumors, actual prostheses, business cards, post operative teaching sheets, and an example of a support book are discussed as methods to assist in patient teaching. PMID- 1783827 TI - Preventing eye injuries--the nurse's role. AB - Federal estimates report that approximately 2 1/2-3 million people each year are affected by eye injuries and approximately 40,000 of those individuals are permanently blinded as a result of that trauma. The National Society for the Prevention of Blindness believes that 90% of those injuries could be prevented through proper education and recognition of the potential hazards. This presentation will focus on the specific preventive actions that can be taken to decrease the incidence of ocular trauma. Also discussed will be the significant role the ophthalmic registered nurse can play in the prevention of ocular trauma through education of colleagues and community members. PMID- 1783828 TI - Vision and migraine. AB - Migraine is classified into four basic categories: common, classic, cluster, and complicated. Ocular migraine is a periodic loss of vision in one eye typically lasting 30 minutes or less. Ophthalmoplegia is a severe ipsilateral hemicranial headache that is preceded by aura of lightning flashes and expanding circles of light, accompanied by temporary ocular motor nerve palsies. PMID- 1783829 TI - Ethics: issues of concern. AB - Awareness of the aforementioned issues (confidentiality and privacy, deception and debriefing, and publication of study results and data analysis) is a major step in preventing the violation of a patient's dignity as a human being during a research study. Also, with patients themselves in unison with patient advocates demanding "humane" care and voicing the patient's "right to know" about alternative procedures, we must not assume our study participants to be naive and blindly trusting of nursing. On the other hand the public perception of nursing as a profession of "care givers" and not "harm doers" is one that we should perpetuate in good faith. PMID- 1783830 TI - ORN role in an office based ASC. AB - This article outlines the role of an ophthalmic registered nurse (ORN) in an office based ambulatory surgical center (ASC). Advantages of this concept to both nurse and client will be outlined. In an office based ambulatory surgery center the opportunity exists for the professional nurse to follow the client throughout the preoperative, intraoperative and postoperative phases of the surgical procedure. PMID- 1783831 TI - Position paper. The role and scope of professional ophthalmic nursing. PMID- 1783832 TI - Position paper. Position statement on the ophthalmic R.N. first assistant. PMID- 1783833 TI - The young adult with recent vision loss: a pilot case study. AB - When in the full course of a sighted life an individual becomes blind, it is an end of that sighted life. However it comes, it is the end to a way of life that had become part of that person. It is the end of familiar methods of doing things. Carroll (1961) believes that it is naive, if not superficial, to think of blindness as a blow to the eyes only, to sight only. He believes that it is a destructive blow to the self-image which one has carefully, though unconsciously, constructed throughout the lifetime. PMID- 1783835 TI - [Progress on diagnosis of mixed connective tissue disease]. PMID- 1783834 TI - [Progress on diagnosis of collagen diseases]. PMID- 1783837 TI - [Progress on diagnosis of Behcet's syndrome]. PMID- 1783836 TI - [Progress on diagnosis of Sjogren's syndrome]. PMID- 1783838 TI - [Progress on diagnosis of Felty's syndrome]. PMID- 1783839 TI - [Progress on diagnosis of Wegener's granulomatosis]. PMID- 1783840 TI - [Progress on diagnosis of aortitis syndrome]. PMID- 1783841 TI - [Assessment of test results in the diagnosis of collagen diseases]. PMID- 1783842 TI - [Decision on therapeutic course and follow-up study of collagen diseases]. PMID- 1783844 TI - [Diagnosis of human adjuvant disease]. PMID- 1783845 TI - [Diagnosis and therapy of diffuse eosinophilic fasciitis]. PMID- 1783843 TI - [Diagnosis and therapy of adult Still's disease]. PMID- 1783846 TI - [Topics on eosinophilia-myalgia syndrome]. PMID- 1783847 TI - [Topics on Lyme disease]. PMID- 1783848 TI - [Diagnosis, therapy and life guidance of outpatients with collagen diseases]. PMID- 1783849 TI - [A case of adult T-cell leukemia with various bone lesions]. PMID- 1783850 TI - [A case of scrub typhus with disseminated intravascular coagulation, meningitis and pulmonary fibrosis]. PMID- 1783851 TI - [Autopsy case of systemic disseminated atypical mycobacterium infections]. PMID- 1783852 TI - [A case of liver cirrhosis associated with nephrotic syndrome and IGA deposits in the kidney glomerulus]. PMID- 1783853 TI - The effect of cyclooxygenase inhibition on the ocular hypotensive action of topical carbonic anhydrase inhibitors in rabbits. AB - Experiments were undertaken in normal albino rabbits to determine if cyclooxygenase inhibition by nonsteroidal anti-inflammatory drugs modified the ocular hypotensive activities of topically applied MK-507, MK-927 and L-662,583, three water-soluble carbonic anhydrase inhibitors (CAI). Cyclooxygenase was inhibited either by systemic indomethacin or by topically administered flurbiprofen, and epinephrine was included as a positive control. Both a 1-hr pretreatment with indomethacin (5 mg/kg i.p.) and topically applied 0.03% flurbiprofen antagonized the ocular hypotensive effect of one drop (50 microliters) of 1% epinephrine. Two percent solutions of the three CAIs were instilled three times with 10 min between each drop in order to obtain a meaningful and reproducible reduction in intraocular pressure (IOP). This dosage schedule elicited a peak decline in IOP ranging from 4.6 mm Hg to 6.2 mm Hg which was achieved via a local action within the eye. The ocular hypotensive effects of MK-507, MK-927 and L-662,583 were unaltered either by a 1-hr pretreatment with indomethacin (5 mg/kg i.p.) or by topically administered 0.03% flurbiprofen. These studies indicate that the IOP lowering actions of the three CAIs, unlike that of epinephrine, in rabbits are not mediated by endogenous prostaglandins and/or other prostanoids. PMID- 1783854 TI - Histamine and its synthesis in mammalian retinas. AB - Histamine (HA) content and histidine decarboxylase (HDC) activity were studied in the sensory retinas of the rat, guinea-pig, rabbit, dog, monkey, bovine and pig. Using a highly sensitive and specific method developed for the determination of histamine using high-performance liquid chromatography, HA was detected in the retinas of all species examined. HA content ranged from 11 (bovine) to 540 pmole/g wet tissue (dog), and HDC activity ranged from 2 (rabbit) to 150 (dog) fmol HA synthesized/min/mg protein. With the exception of the dogs, the retinal values were one order lower than those in the brain in all species examined. The canine retinas had the high HA and HDC values among the species examined, and were approximately equal to those in the brain. However, the ratios of HDC activity to HA content ranged from 0.04/min to 0.51/min. These values resembled those in the brain and were much higher than those in mast cells. This suggests that histamine in the retinas exists mainly in the neurons even though the actual amounts are small and may be involved in the physiological and the pathological responses in mammalian retinas. PMID- 1783855 TI - Cyclosporine: a therapy in inflammatory eye disease. AB - Severe uveitis is a relatively common and difficult clinical management problem in ophthalmology. Recently, cyclosporine-A (Cs-A) has been shown to be of therapeutic benefit in the management of sight threatening inflammatory eye disease. In order to examine the efficacy and long term safety of Cs-A, we conducted an open uncontrolled study in 22 patients with sight threatening uveitis whose disease had previously been refractory to treatment with systemic corticosteroids (22 patients), azathioprine (5 patients) and cyclophosphamide (2 patients). Uveitis was idiopathic in 16 cases, one patient had Reiter's syndrome, two had Vogt Koyanagi Harada disease and one patient had sarcoidosis. There were twelve males and ten females with a mean age of 40.5 years (range 22-67 yrs). Nineteen patients (86%) showed significant clinical improvement after treatment with Cs-A (10 mgm/kg/day) with decreased inflammatory activity and improved visual acuity. Three patients failed to respond to Cs-A therapy, while 4 subjects whose disease had initially responded to Cs-A relapsed on attempted withdrawal of this medication. Side effects were common in patients receiving Cs-A [5 mgm/kg/day (or greater)], with hypertension, tremor, hirsutism and raised serum creatinine being most frequent. We conclude that CS-A is an effective immunosuppressive agent in the treatment of patients with uveitis; however, its usefulness is limited by frequent side effects and disease relapse on attempted drug withdrawal. PMID- 1783856 TI - Antioxidant enzymes in human tears. AB - Minimally stimulated tear samples collected from human subjects were assayed for the major antioxidant enzymes: superoxide dismutase, catalase and glutathione peroxidase. No catalase or glutathione peroxidase activity was detected. However, human tear film does contain the CuZn superoxide dismutase (103 +/- 32 ng/mg soluble protein), which is inactivated by hydrogen peroxide (0.2 mM). These data indicate that the tear film has the enzyme generally required for control of inflammatory conditions but is lacking the usual physiological defense systems against the toxicity of hydrogen peroxide. Concern has been raised as to the safety of contact lens disinfectant solutions containing hydrogen peroxide. These results indicate that the tear film is lacking the enzyme systems to provide significant protection to the cornea, to the tear film itself, or to the SOD of the tear film from the oxidant action of hydrogen peroxide. PMID- 1783857 TI - Review: avian models for experimental myopia. AB - Myopia poses a serious threat to unaided vision among the human population, affecting as much as fifty per cent or more of individuals in some subpopulations and at some age levels. Because the etiology of the condition remains obscure, attention has been directed toward a search for experimental animal models for myopia: the hope is that any environmental or experimental intervention found to increase eye size, especially axial length, or to lead to negative refractive error, may suggest some parallels in clinical experience. As well, the availability of myopic animal subjects affords the opportunity to test the efficacy of both preventative and pharmacological measures as they become available. PMID- 1783858 TI - Management of external ear trauma. AB - External ear trauma has been an area of continuing interest for otolaryngologists, plastic surgeons, rural-practicing general surgeons, and emergency physicians. Strict adherence to the general principles of both medical and surgical management of these injuries must be maintained to achieve optimal results. This presentation will discuss current concepts in the management of blunt, thermal, and sharp auricular injuries, and will present a logical outline in attempting to obtain optimal cosmetic and functional results. PMID- 1783859 TI - Disseminated sarcoidosis: a case report. AB - Sarcoidosis is a systemic granulomatous disease of unknown etiology, most frequently involving the lungs, lymph nodes, spleen, liver, eyes and skin. Gastrointestinal sarcoidosis is uncommon, with rare histological documentation of noncaseating granulomas. Bone marrow sarcoidosis is also infrequent, and we are only aware of one case of documented gastric and bone marrow sarcoidosis in the same patient, which was diagnosed at autopsy. We herein report a case of endoscopic biopsy proven gastric sarcoidosis in a patient with systemic sarcoidosis with known hepatic and bone marrow involvement. To our knowledge this is the first description in a living patient of gastrointestinal and bone marrow involvement of systemic sarcoidosis. PMID- 1783860 TI - Survey of Louisiana physicians on communicable disease reporting. AB - We evaluated the participation of Louisiana physicians in the reporting of communicable diseases. In the spring of 1990 we surveyed a stratified random sample of Louisiana physicians from specialties likely to see patients with reportable diseases. Between 30% and 67% of physicians indicated that they reported all the cases of the queried diseases they had seen during the past year. The proportion reporting all cases differed by disease. AIDS and pertussis were always reported by more than half of the respondents. Mumps was least reported. Perceived barriers and suggestions to improve reporting are discussed. PMID- 1783861 TI - Syphilis: the great facilitator. PMID- 1783862 TI - Lobular carcinoma in situ within a fibroadenoma. AB - The entity of lobular carcinoma in situ within a fibroadenoma is being increasingly recognized. Clinical examination, mammography, and fine-needle aspiration are the cornerstones in managing breast masses. A patient is presented with three lumps in the left breast. Although the workup was completely negative, pathological examination revealed lobular carcinoma in situ within one of the fibroadenomas. PMID- 1783863 TI - Ultrasound guided fine needle aspiration cytology with immunoperoxidase confirmation prior to reexploration for recurrent hyperparathyroidism. PMID- 1783864 TI - ECG of the month. Circling the block. AV nodal reentry tachycardia. PMID- 1783865 TI - The written composing ability of children with learning disabilities: a review of the literature from 1980 to 1990. AB - This article reviews the literature pertaining to the written composing ability of students with learning disabilities that was published primarily in the decade from 1980 to 1990. The papers included are either reports of research or discussions of instructional procedures that are based on research. The topics addressed include story composition, expository writing, training/intervention research, and rationales/procedures for instruction. PMID- 1783866 TI - Designing assessment procedures for educationally at-risk Southeast Asian American students. AB - This article discusses unique conditions of educational risk in the Southeast Asian-American student population. It points out the need to help traumatized refugee students deal with emotional difficulties before they can benefit from instruction. It includes a framework for assessing Southeast Asian-American students in which a shift in current assessment goals and practices is proposed. The article also addresses the issue of identifying skills previously developed in a different environment and explores an approach to help refugee children make the transition into the academic context. PMID- 1783867 TI - Individual differences in the self-image of adolescents with learning disabilities: the roles of severity, time of diagnosis, and parental perceptions. AB - The self-images of 49 adolescents with learning disabilities (Grades 9 through 12, mean age = 15.9) and 49 normally achieving peers (Grades 9 through 12, mean age = 16.0) were compared using the Offer Self-Image Questionnaire (OSIQ). The group with LD scored significantly lower than the comparison group on 4 of the 10 OSIQ scales. Later-diagnosed adolescents with LD scored significantly higher than early-diagnosed adolescents on two of the scales. Severity of the learning disability was not found to be related to self-image scores. In a second study, parental perceptions of the self-images of 28 of the 49 students with LD were studied by administering the Offer Parent-Adolescent Questionnaire (OPAQ) and an informal questionnaire to their parents. On 6 of the 10 OPAQ scales, parents perceived their children as having a lower self-image than the adolescents themselves reported. Significant but moderate relationships were found between parents' perceptions and adolescent self-image scores. Results of the two studies are interpreted in terms of a multidimensional conception of self-image that considers factors inherent to the individual as well as interpersonal and institutional factors. PMID- 1783869 TI - The impact of a transitional training program for young adults with learning disabilities. AB - A study was conducted in 1988-1990 at Lesley College's (Cambridge, Massachusetts) Threshold Program, one of the few campus-based, comprehensive transition programs in the country for young adults with learning disabilities functioning in the low average intellectual range. The goal of the study was to assess the ability of program graduates from the classes of 1984 to 1987 to successfully manage the demands of independent living and competitive employment after intensive training in Threshold's 2- to 3-year program. From a total of 71 graduates contacted, 45 participated in the study, including 34 females and 11 males. The subjects ranged in age from 21 to 31 with the average age being 24. Information was gathered from all subjects through written questionnaires and personal or telephone contact. Small-group interviews were conducted with a sample of eight subjects. Factors contributing to the stability of competitive employment and independent living, support systems most commonly used, and specific impacts of the Threshold program on the lives of its graduates were studied. The data revealed that 61% of the respondents were currently employed in one of Threshold's fields of training, 52% had held their jobs for at least 1 year, and 42% (excluding cohort '87) held their jobs for at least 2 years. Seventy-five percent were living independently and 84% of those had maintained an apartment for more than 1 year. Subjects found compatibility with roommates and money management to be the biggest challenges. They perceived themselves as being quite independent and felt they would not be as successful without the opportunity of this program model. PMID- 1783868 TI - Methodological issues and learning disabilities diagnosis in clinical populations. AB - Previous research suggests that the diagnosis of a comorbid learning disability is dependent on the method used for making the LD diagnosis. This study investigated that proposition by studying the effects of using three approaches to the assessment of learning disabilities in a sample of 177 six- to thirteen year-old boys referred to outpatient mental health clinics for behavior problems. The use of these three procedures to diagnose comorbid learning problems produced significantly different results. All methods identified significant numbers of children in the clinical population as learning disabled; however, each method identified children with differing characteristics. Consistent with predictions from measurement theory, the commonly used simple standard score discrepancy method was more likely to identify children with above-average IQs as learning disabled, whereas a regression approach identified learning disabilities more consistently across the ability range. These results were interpreted as supporting the use of regression approaches to diagnose co-occurring learning disabilities, as that method is less likely to be biased by the child's intelligence test score. The implications of the use of each method in research investigations is also discussed. PMID- 1783870 TI - Effects of methylphenidate on the auditory processing abilities of children with attention deficit-hyperactivity disorder. AB - Stimulant medications are widely used as part of the treatment for children with attention deficit-hyperactivity disorder (ADHD). The current study investigated the effects of methylphenidate on auditory vigilance, auditory processing abilities, and receptive language abilities of children with ADHD. Twenty subjects (17 males and 3 females) ranged in age from 7 to 13 years. Each subject had been diagnosed as having ADHD and had been prescribed methylphenidate for the control of hyperactivity. The test battery included the Auditory Continuous Performance Test (ACPT), SCAN (a screening test for auditory processing disorders in children), and the Token Test for Children. Results indicated that there was significant improvement in the children's performance on all measures when on methylphenidate. Implications of these findings are discussed. PMID- 1783871 TI - Writer's cramp: the experience with botulinum toxin injections in 25 patients. AB - Twenty-five writer's cramp patients have been attending the Movement Disorder Clinic at the Division of Neurology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok during three years period (between January 1988 - January 1991). There were 17 male subjects and the male to female sex ratio was 2.125:1. The mean age of the patient was 36.80 (SD 10.21) years with the range of 18-60 years. The mean duration of illness of all patients was 5.88 (SD 7.14) years with the range of 1 to 30 years. Eighteen patients (72.0%) were classified as simple writer's cramp and seven patients (28.0%) were dystonic writer's cramp. The mean age of the patients of both groups was not different while the duration of illness in the dystonic group was statistically significantly longer than the simple group, i.e. 12.0 (SD 12.1) versus 3.9 (SD 3.1) years. Fourteen patients (56%) had associated pain during writing and 6 patients (24%) had hand tremor. All patients were right handed and had a history of various pharmacological treatments without any consistent benefit. They included muscle relaxants, tranquillisers, antiepileptic drugs, and betablockers. Fourteen patients from 17 available history records (82.4%) had been spending at least 4-10 hours writing each day. Twenty-one patients (84%) had botulinum toxin injections, 40-80 international mouse units were given in 2-4 divided doses over the overactive forearm muscles observed during writing without the electromyographic glidance. There was no loss to the follow-up. Fourteen of the 21 subjects (66.7%) showed definite improvement in hand writing, 4 patients (19.0%) improved minimally and 3 patients (14.3%) revealed no improvement. Arm pain in all 12 patients associated during writing was abolished after the injections. There were complications in 7 patients (33.3%) presented as transient finger drop (5 patients, 23.8%) and easily fatigued arm (2 patients, 9.5%). These preliminary results confirm that botulinum toxin injections is a successful treatment for many patients with writer's cramp without performing complex electromyographic recordings while the patients are writing. The constraints of this treatment are its high cost (i.e. 1 vial of 100 units costs 300 US dollars) and its benefit lasts for only 4-6 months. PMID- 1783872 TI - Results of Pap smear examinations in women with abnormal ovaries. AB - Using the VCE technique, the Pap smears of 249 women with abnormal ovaries were examined at the Cytological Laboratory, Siriraj Hospital. The cases, ranging in age from 15 to 85 years (the mean age being 42.1 +/- 14.7 years), were diagnosed as follows: 49 cases with cysts, 89 cases with tumours and 111 cases with cancer. The mean ages of the women with cysts, tumours and cancer of the ovaries were 34.0 +/- 8.6, 37.2 +/- 12.8 and 49.5 +/- 14.8 years, respectively. The percentages of women with cysts, tumours and cancer diagnosed cytologically as having a normal smear were 44.9, 28.1 and 23.4; and infection and inflammation of abnormal ovaries 49.0, 49.4 and 41.5, respectively. The percentages of those with abnormal cells at the uterine cervix were 6.1, 21.4, and 31.5; endometrial adenocarcinoma 0, 1.1 and 0; and ovarian adenocarcinoma 0, 0 and 3.6, respectively. Although Pap smear examination using the VCE technique is sensitive in the early detection of cervical cancer, it is not a sensitive method in the detection of ovarian cancer. PMID- 1783873 TI - Maternal perception of sound-provoked fetal movement as a test of antepartum fetal wellbeing. AB - Maternal perception of sound-provoked fetal movement test was studied on 506 occasions in 443 women with obstetric or medical antenatal risk factors after 26 weeks gestation. The response was compared with a nonstress test (NST) performed immediately after a three-second vibroacoustic stimulation with an electronic artificial larynx. A positive response to sound stimulation, recorded as a fetal movement by the mother, occurred on 497 occasions (97.3%) and was accompanied by a reactive NST on 484 occasions; giving a specificity of 99.6 per cent and a negative predictive value of 97.4 per cent. An inconclusive or negative response to sound (2.7%) had a sensitivity of 35.0 per cent and a positive predictive value for a nonreactive NST of 77.8 per cent. Results of sound-provoked fetal movement test and NST, performed within a week of delivery, in 434 women were compared with fetal outcome. The maternal perception of sound-provoked fetal movement test had better specificity (99.1% vs 96.9%), positive predictive value (55.6% vs 35.0%) for poor fetal outcome than the NST, although its sensitivity (50.0% vs 70.0%) and negative predictive value (98.8% vs 99.3%) were lower. Maternal perception of sound-provoked fetal movement test may suffice as an inexpensive and simple method of evaluating antepartum fetal well-being in risk situations. When the mother does not feel any sound provoked fetal movement, NST is then performed. This clinical application can be helpful in a primary health care setting where rapid assessment of fetal health at risk is required. PMID- 1783874 TI - Clostridium sordellii in diarrhoeal stools, its medical significance. AB - The 3 Clostridium sordellii strains were isolated from the immunocompromised patient's infected-stool. These isolates were studied in detail. One strain revealed the weakly positive cytotoxin with human diploid fibroblasts whereas the other strain showed induration and edema (VP factor). All strains were confirmed to be Cl.sordellii with specific Cl.sordellii antitoxin. None of them harboured enterotoxin but they were very sensitive to imipenem cefoxitin, moderately sensitive to moxalactam. The role of probable pathophysiologic infection in the human bowel of these isolates are also discussed in this article. PMID- 1783875 TI - Pulmonary nocardiosis in Chulalongkorn Hospital. AB - From 1982 to 1988, 20 patients with pulmonary nocardiosis were diagnosed at the Department of Medicine, Chulalongkorn Hospital University. The infection was found to be common in immuno-compromised hosts particularly in patients who were suffering from lymphoreticular malignancy, systemic lupus erythematosus, nephrotic syndrome, pulmonary alveolar proteinosis and in patients who were receiving corticosteroids. The clinical manifestations were usually nonspecific. Diagnosis of pulmonary nocardiosis in cases who presented with a short duration of fever and productive cough was often delayed because they were considered to have acute bacterial pneumonia. The findings on chest roentgenogram were nonspecific as nonhomogeneous airspace infiltrates, cavitary lesions, nodule, or miliary infiltrates. The complete blood count frequently showed leukocytosis and neutrophilia. The diagnosis of nocardiosis was suspected if the staining of specimens obtained from the lesions showed typically weakly gram-positive and modified acid-fast branching filament organism and the diagnosis was confirmed by culture. The skin and the central nervous system were the most common hematogenous disseminations. Sulfamethoxazole and trimethoprim in combination were the drugs of choice. The treatment for a minimum of 6 months was appropriate in order to prevent relapse. Poor prognostic factors in nocardiosis were acute infection, Cushing's disease; and disseminated infection involving the central nervous system. PMID- 1783876 TI - Nitrendipine in treatment of hypertension. AB - Twenty-three mild and moderate essential hypertensive patients, 3 males and 20 females without any complications were given nitrendipine or Baypress, a new calcium antagonist, 10-20 mg once daily for 23 weeks. The blood pressure of all 23 patients was significantly reduced (p = less than 0.01) in both systolic and diastolic blood pressures. No serious side effects were observed. There were only headache (4 cases), palpitation (2 cases), and paroxysmal ventricular contraction (1 case). No hematological, urinalysis and biochemical changes of kidney and liver functions, fasting blood sugar, cholesterol and triglyceride except for sodium and potassium which were raised and weight reduction was observed. All patients tolerated the drug very well. We conclude that, nitrendipine is safe and suitable for management of mild and moderate uncomplicated essential hypertension. PMID- 1783877 TI - Effect of Eupatorium odoratum on blood coagulation. AB - The purified compound, 4', 5, 6, 7-tetramethoxyflavone, is an active ingredient isolated from Eupatorium odoratum, a Thai indigenous plant that has long been used to stop bleeding. This compound was studied in vitro for the effect on blood clotting factor activities. It was found that the compound enhanced blood coagulation, the observed APTT being shorter than that observed in the control. The result suggested that the compound accelerated clotting time through the intrinsic pathway of the coagulation which may involve the reaction of factor XII, factor XI, factor IX or factor VIII. PMID- 1783878 TI - Grisel's syndrome: a case report. AB - A 7-year-old girl came to the orthopedic department complaining of neck pain and torticollis following upper respiratory tract infection for 3 days. Roentgenographic examination of the antero-posterior open-mouth view showed type one C1-C2 subluxation. The patient was treated with appropriate antibiotics and cervical traction. A SOMI brace was used for immobilization. The subluxation returned to the normal position after 3 days. PMID- 1783879 TI - Tuberculosis of the parotid gland: a case report. AB - A case of tuberculosis of the parotid gland, which involved the intraparotid lymph nodes of a 39-year-old Thai man is reported. The histologic characteristics of caseating granulomas with presence of acid and alcohol fast bacilli were criteria for diagnosis. This case is thought to be the first report of tuberculosis of the parotid gland in Thailand. PMID- 1783880 TI - Interferon-alpha is a reproductive hormone. PMID- 1783881 TI - The effect of plasma protein binding on the metabolism of steroid hormones. AB - Earlier views indicated that globulin (corticosteroid-binding globulin (CBG) or sex hormone-binding globulin (SBG)) but not albumin binding in plasma, protects steroids from splanchnic metabolism in man. Also, the splanchnic extraction (HE) of a steroid seemed to be highly dependent on the rate of disassociation of the steroid-protein complex. However, the faster rate of disassociation (tau 1/2 = 0.9 s) of cortisol-CBG, as determined by later accurate fluorescence methods, intuitively meant that this complex must disassociate completely in a single 9 s passage through the liver. The low HE of total cortisol was then a puzzling anomaly. Using a differential equation solver (TUTSIM) and a model with unbound, albumin- and globulin-bound pools of steroid (with metabolism of unbound and also possibly albumin-bound steroid), the mechanism of splanchnic metabolism has been studied. The 'complex', probably most realistic, model includes 13 steroids, which can simultaneously bind to plasma albumin, CBG and SBG. The steroid concentration and numbers of occupied binding sites of the globulins decrease during the time of metabolism. The experimental data used are the in-vitro binding characteristics of the steroid-protein complexes, including the equilibrium constants and rates of disassociation and the in-vivo HE of nine steroids, usually measured by direct analysis of hepatic venous blood. However, the HE of cortisol had to be calculated from the metabolic clearance rate/splanchnic blood flow, giving a maximum value of 12%. The fractional metabolic rate of unbound steroid is generally represented by e. A certain value of e (RE) is required to give a remaining steroid concentration after 9 s of metabolism, which is made equal to (1-HE) in the model to simulate splanchnic extraction. If the fractional rate of metabolism of albumin-bound steroid is h (f = h/e), then RE will depend on the value of f. The maximum RE for cortisol is RE0 = 0.42 and RE1 = 0.16 for f = 0 and 1 respectively. For either value of RE, there will be the appreciable reassociation of cortisol to CBG after disassociation of the cortisol-CBG complex. With such reassociation, the total cortisol remaining after 9 s metabolism is fairly independent of the rate of dissociation of the cortisol-CBG complex. This explains the low total HE of cortisol in spite of the high rate of disassociation of cortisol-CBG.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1783882 TI - Rapid effects of parathyroid hormone(1-34) and prostaglandin E2 on bone blood flow and strontium clearance in the rat in vivo. AB - The vascular effects of noradrenaline, ATP, parathyroid hormone (PTH) and prostaglandin E2 (PGE2) were investigated in the rat. Additionally, the exchange of mineral ions between bone and blood was assessed by measuring strontium clearance, with the aim of investigating whether the vascular effects of these agents altered uptake of mineral ions or if this exchange could be changed independently of blood flow. Radioactive microspheres and 85Sr were used to establish bone blood flow and mineral clearance. Measurements of bone blood flow and arterial pressure were made in each animal and used to calculate vascular resistance. A measurement of 85Sr clearance was also obtained. Arterial blood pressure was significantly affected by noradrenaline (P less than or equal to 0.003) and ATP (P less than or equal to 0.015). Additionally, noradrenaline significantly (P less than or equal to 0.03) reduced bone blood flow. This decrease was related to a significant increase in vascular resistance. Arterial blood pressure and bone blood flow were significantly reduced by both bovine PTH(1-34) (P less than or equal to 0.001, P less than or equal to 0.02) and PGE2 (P less than or equal to 0.005, P less than or equal to 0.001). Vascular resistance to bone was increased by both agents but this was only statistically significant in the case of PGE2 (P less than or equal to 0.01). A significant (P less than or equal to 0.001) reduction in strontium was also produced by PGE2. In each group the relationship between bone blood flow and strontium clearance was then analysed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783883 TI - Expression of hepatic mRNAs for insulin-like growth factors-I and -II during the development of hypothyroid rats. AB - The effect of thyroid status on the expression of insulin-like growth factors-I and -II mRNAs in the liver of developing rats has been investigated. Northern blot analyses of the specific mRNA demonstrated the presence of four IGF-II mRNA species which were strongly expressed in fetal liver and progressively declined after birth, becoming undetectable after week 3. This decrease was markedly delayed in the liver of hypothyroid rats. In addition, expression of IGF-I mRNA, absent in fetal liver, began during week 1 after birth and progressively increased with age. This increase was markedly delayed in the liver of hypothyroid rats. The data suggest that thyroid hormones regulate rat development via the co-ordinate expression of hepatic IGF-II and IGF-I mRNAs. PMID- 1783884 TI - Calcium transport in the proximal convoluted tubule and loop of Henle of rats made diabetic with streptozotocin. AB - In-vivo microperfusion was used to localize the reabsorptive defect responsible for the hypercalciuria of diabetes mellitus and to investigate possible causative factors. Unidirectional proximal calcium absorption was not significantly different in rats made diabetic with streptozotocin compared with controls, providing evidence against the involvement of this nephron segment in the phenomenon. Calcium absorption by the loop of Henle, was however, significantly (P less than 0.01) lower in diabetic animals (32.1 +/- 1.2 vs 40.4 +/- 0.6 pmol/min). Based on our knowledge of calcium movements within the loop, it is likely that the reabsorptive defect residues within the thick ascending limb. The calcium lesion was found to be independent of acute changes in intraluminal glucose concentration and could not be corrected by acute insulin treatment. The study also provides new information on the relationship between intratubular glucose and fluid movements in the rat nephron. In diabetic rats a proximal perfusate containing 30 mmol glucose/l resulted in fluid absorption comparable with that seen in control rats perfused with 5 mmol glucose/l. However, intraluminal glucose had a stimulatory effect on fluid absorption in the loop of Henle of diabetic rats (10.7 +/- 0.5 vs 7.9 +/- 0.4 nl/min; P less than 0.01). PMID- 1783885 TI - Absence of pregnancy-induced alterations in tissue insulin sensitivity in the offspring of diabetic rats. AB - We have previously demonstrated insulin resistance in the liver and peripheral tissues of the adult offspring of rats made diabetic with streptozotocin (SDF rats). In this study, a euglycaemic hyperinsulinaemic clamp was used to test the hypothesis that insulin resistance is further aggravated during pregnancy in SDF rats. Normal pregnancy was accompanied by a decrease in the sensitivity of the liver and peripheral tissues to insulin, with a normal responsiveness to insulin. In SDF rats no further decrease in the sensitivity of peripheral tissues to insulin occurred during pregnancy when compared with non-pregnant rats, and the dose-response curves of the glucose metabolic clearance rate during hyperinsulinaemia were similar in pregnant control and pregnant SDF rats. There was, however, a modest decrease in the sensitivity of the liver to insulin during pregnancy in SDF rats. The normal increase in plasma insulin levels during pregnancy was blunted in SDF rats: this resulted in increased glucose levels in maternal and fetal rats and increased fetal insulin concentrations, features compatible with mild 'gestation diabetes'. In conclusion, gestational diabetes develops in pregnant SDF rats, although there is no further deterioration in peripheral insulin resistance. PMID- 1783886 TI - Sex differences in the ultradian pattern of plasma growth hormone concentrations in mice. AB - Ultradian patterns of plasma GH concentration were determined in adult male and female mice. Serial blood samples were collected every 15 min over 8 h through surgically placed chronic indwelling right atrial catheters and assayed for GH content by an homologous radioimmunoassay. In both sexes, GH concentrations fluctuated episodically from baseline values that were often in the range of 2 micrograms/l which approached the limit of assay sensitivity, to peak values sometimes reaching 100 micrograms/l. Male mice, however, demonstrated a regular periodicity of GH peaks approximately every 2.5 h with interposed stable baseline concentrations that were significantly longer in duration than in females. The absence of extended baseline concentrations in females reduced cycle length to an average of 1.4 h and significantly increased the overall mean GH concentration. The duration, height and area of GH peaks and the average concentration between peaks were comparable in males and females. Sexual dimorphism in the ultradian patterns of serum GH concentrations have been shown in both mice and rats to regulate the expression of several sex-specific phenotypes. Comparing endogenous GH patterns in mice and rats demonstrates that males of both species have less frequent peaks than females over the same interval of time. This separation of GH peaks appears to be an essential element for the expression of masculine GH dependent traits. PMID- 1783887 TI - Effect of follicular fluid and inhibin immunoneutralization on FSH-induced preovulatory follicle growth in the ewe. AB - The potential direct ovarian effects of immunoneutralization of inhibin, which increases, and follicular fluid treatment, which inhibits, follicle development in normal ewes was investigated in a sheep model in which endogenous FSH and LH secretion was suppressed thus removing any potential effects of treatment-induced alterations in endogenous FSH or LH secretion. Eighteen Welsh Mountain ewes were treated with two agonist implants containing 3.3 mg buserelin giving a total of 6.6 mg buserelin per animal. During week 5 of treatment all ewes were given a 72 h continuous infusion of ovine FSH (5 micrograms/h) starting at 09.00 h. Six ewes were treated with antiserum to the 1-26 alpha peptide fragment of porcine inhibin 0 h and 24 h after the start of the FSH infusion, and a further six ewes were treated with charcoal-stripped ovine follicular fluid (oFF) as a source of inhibin, at 09.00 and 17.00 h throughout the 72 h of FSH infusion. The plasma concentrations of both FSH and LH were significantly reduced in all ewes after 5 weeks of treatment with buserelin, and no large follicles greater than 2.5 mm in diameter were present. Treatment with inhibin antiserum or oFF had no effect, compared with control ewes, on the plasma concentrations of either FSH or LH during the FSH infusion period. After 72 h of FSH infusion there was no difference in the number of small follicles (less than 2.5 mm in diameter) or large follicles (greater than 2.5 mm in diameter) or the size of the largest follicles between control ewes and ewes treated with either inhibin antiserum or oFF.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783888 TI - Autoradiographical localization of oxytocin-binding sites in the guinea-pig ovary at different stages of the oestrous cycle. AB - The discovery that oxytocin is synthesized and stored in corpora lutea of ruminants has fostered a renewed interest in the possible roles of oxytocin in ovarian function. In the present study we describe the distribution of binding sites for oxytocin in the guinea-pig ovary. Sections were reacted with a radioiodinated oxytocin antagonist (125I-labelled OTA) to yield autoradiograms on film. Specific binding sites for oxytocin were defined as those which bound 0.05 nmol 125I-labelled OTA/l and where 1 mumol non-radioactive oxytocin/l displaced the radioactivity. 125I-Labelled OTA consistently labelled the ovarian stroma and the theca interna, but not the corpora lutea, the granulosa cells or the theca externa. The amount of 125I-labelled OTA bound to ovarian stroma and theca interna was high in animals killed during dioestrus, and low during and shortly after oestrus. These data suggest that the binding sites are regulated by steroid hormone levels and that in the guinea-pig ovary oxytocin could exert a role in follicular steroidogenesis, maturation or ovulation rather than in luteal function. Oxytocin-binding sites were also shown in the uterus but their numbers varied only slightly during the cycle. PMID- 1783889 TI - Mechanism of secretion of plasma insulin-like growth factor-I into milk of lactating goats. AB - 125I-Labelled insulin-like growth factor-I (IGF-I) was infused as the free form directly into the pudic artery supplying one gland of lactating goats (n = 6). The infusion was for 60 min and 0.4 +/- 0.09% (S.E.M.) of the infusate was secreted into milk from the infused gland during its first passage through that gland. A large proportion of the 125I-labelled IGF-I escaped into the systematic circulation and was secreted into milk of both glands. A total of 5.2 +/- 0.4% of infused radioactivity was recovered in milk from both glands from 0 to 720 min. Radioactivity consisted of trichloroacetic acid (TCA)-precipitable and -soluble counts which were shown by gel filtration to be authentic IGF-I and degraded products of the peptide. The amount and time course of TCA-soluble radioactivity in milk from both glands was similar, suggesting degradation of 125I-labelled IGF I at extramammary sites. Maximum specific activity for 125I-labelled IGF-I in milk from the infused gland was reached 80-120 min after the start of infusion and was 2.5-fold greater than milk from the non-infused gland. The time course of appearance of 125I-labelled IGF-I in milk suggests that transfer was via the transcellular pathway and this was further supported by comparing the pattern of transfer of [14C]sucrose and [14C]amino acids. When excess unlabelled IGF-I was included in the infusate, specific activity in milk from the infused gland was reduced to that of the non-infused gland, indicating a competitive and saturable mechanism of secretion for 125I-labelled IGF-I.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783890 TI - Temporal changes in LH and testosterone and their relationship with the first antler in red deer (Cervus elaphus) stags from 3 to 15 months of age. AB - Blood samples were taken from six tame red deer stags at 3-15 months of age once a month from a jugular catheter every 30 min for 24 h to investigate hormonal secretion during puberty and during growth of the pedicle and first antler. All plasma samples were analysed for LH and testosterone concentrations and the resultant data were analysed using the PULSAR pulse detection routine. In addition each stag was injected wih gonadotrophin-releasing hormone (GnRH; 20 ng/kg body weight) after the above samples had been taken and the bleeding regimen was continued for a further 2 h. Body weight, antler size and status (i.e. whether the stags had a pedicle or antler) were also recorded. The pulsatile secretion of LH could be considered to have occurred in three phases. The first of these was one of development, with the LH pulse frequency increasing to 8 pulses/24 h, the second a phase of regression, with a decrease in LH pulse frequency to 2 pulses/24 h, and finally a second phase of development characterized by increased LH pulse frequency to 12 pulses/24 h. Testosterone secretion generally followed the same pattern. During the period before the permanent bony pedicles grew, there were less than five LH pulses/24 h. When the pedicles were growing, LH and testosterone pulsatile secretion increased but the pulse frequency of both hormones fell during velvet antler growth.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783891 TI - Pro-opiomelanocortin messenger RNA levels increase in the fetal sheep pituitary during late gestation. AB - Plasma levels of ACTH and cortisol in fetal sheep increase progressively during late pregnancy, providing the stimulus for birth. However, little information is available concerning either sources of pro-opiomelanocortin (POMC, the precursor to ACTH) or changes in POMC gene expression, which may be responsible for the elevated fetal plasma ACTH concentrations. We therefore studied the relative amount of POMC mRNA in fetal sheep hypothalami, anterior pituitaries and adrenals at discrete times of pregnancy between day 60 and term (approximately 145 days) and from newborn lambs. Total RNA from these tissues was analysed by Northern blot hybridization using a human POMC DNA probe, and the amount of POMC mRNA was expressed relative to the signal obtained for 18S ribosomal RNA. A single 1.2 kb transcript was detected by day 60 in the anterior pituitary, and its relative amount did not change significantly until after days 125-130. Pituitary POMC mRNA levels increased significantly at days 138-143, remained elevated at term and increased further in newborn lambs. In contrast, POMC mRNA was undetectable in hypothalami and adrenal glands of fetuses at all ages. The results suggested that the prepartum rise in plasma ACTH concentrations in fetal sheep is due to increased POMC biosynthesis in the fetal pituitary. The increase in POMC mRNA occurs at a time when fetal plasma cortisol concentrations are elevated, indicating that the negative feedback effects of circulating glucocorticoids on the fetal hypothalamic-pituitary axis may be obscured by other mechanisms that increase pituitary POMC mRNA accumulation during the last week of gestation. PMID- 1783892 TI - Localization and endogenous concentration of endothelin-like immunoreactivity in human placenta. AB - The aim of this study was to investigate the localization of endothelin-like immunoreactivity (ET-IR) in human placenta, chorion and amnion and to compare the endogenous concentration of immunoreactive endothelin (ET) in these tissues before and after the onset of labour. ET-IR was detected in the endothelium of stem vessels in placental villi, as well as in decidual stromal cells in the basal maternal plate, by immunocytochemistry using primary polyclonal rabbit antibody. A specific radioimmunoassay was used to detect endogenous concentration of ET in homogenized placental tissues. The endogenous concentration of ET-IR was significantly greater in amnion than in chorion and placenta (amnion 249 +/- 13 fmol/g; chorion 190 +/- 11 fmol/g; placenta 169 +/- 14 fmol/g; means +/- S.E.M.; n = 12; P less than 0.01). No significant difference was seen before or after the onset of labour. The detection of ET-IR in placenta, chorion and amnion suggests that the ETs may play a role in the paracrine control of human uterine function. PMID- 1783893 TI - Estrogen-independent growth of mouse vaginal epithelium in organ culture. AB - A serum-free vaginal explant culture system was established to investigate the in vitro effect of estrogen on the growth of mouse vaginal epithelium. Vaginal explants were isolated from 40-day-old, ovariectomized BALB/cCrgl mice and cultured in a basal unsupplemented medium or in basal medium plus various doses of 17 beta-estradiol. Explants were processed for histology at the end of culture periods or were given 4-hour pulses of tritiated thymidine at various times and processed for autoradiography. Vaginal epithelium increased 3- to 5-fold in thickness and 2-fold in the number of epithelial cell layers during 72 hours of culture without estrogen; addition of estrogen did not significantly influence epithelial growth. Keratinization of vaginal epithelium occurred within 48 hours of culture in the absence of estrogen, and again addition of estrogen did not accelerate its appearance. Covering the explants with collagen decreased the estrogen-independent growth of vaginal epithelium. Autoradiography showed that ca. 70-90% of basal epithelial cells entered S phase during the initial 4 hours of culture and that this number declined rapidly after 48 hours to ca. 20%. Addition of 1.8 nM 17 beta-estradiol significantly decreased the labelling index of basal cells at 48 hours, but did not affect the labelling index at 24 and 72 hours. Stromal cells were not labelled at any time. Thus, DNA synthesis, cellular proliferation, and differentiation (keratinization) of vaginal epithelium in organ culture occurred without estrogen and were not stimulated by the addition of estrogen. PMID- 1783894 TI - Neuropeptide schistosomin inhibits hormonally-induced ovulation in the freshwater snail Lymnaea stagnalis. AB - This study examines the interaction between the caudodorsal cell hormone (CDCH) and schistosomin, a peptide secreted by the central nervous system of the snail (Lymnaea stagnalis) infected with the avian schistosome Trichobilharzia ocellata. Non-infected snails were injected with synthetic as well as native CDCH in the absence or presence of purified schistosomin. The response to 2 pmol of synthetic CDCH was blocked for 90% by coinjection with 3.5 pmol of schistosomin. The ovulation-inducing activity of extracts of cerebral commissures (the storage area of native CDCH) was also blocked by schistosomin. The degree of inhibition (65%), however, was less than that observed with synthetic CDCH. These results show that schistosomin inhibits ovulation and egg laying in Lymnaea. This explains the decrease or absence of egg laying in schistosome-infected freshwater snails. PMID- 1783895 TI - Cell to cell communication and pH in the frog lens. AB - Fiber cells of the lens are electrically and diffusionally interconnected through extensive gap junctions. These junctions allow fluxes of small solutes to move between inner cells and peripheral cells, where the majority of transmembrane transport takes place. We describe here a method utilizing two intracellular microelectrodes to measure the cell to cell resistance between fiber cells at any given distance into the intact lens. We also use ion-sensitive microelectrodes to record intracellular pH at various depths in the intact lens. We find that gap junctions connecting inner fiber cells differ in pH sensitivity as well as normal coupling resistance from those connecting peripheral cells. The transition occurs in a zone between 500 and 650 microns into the lens. Fiber cells peripheral to this zone have a specific coupling resistance of 1.1 omega cm2, whereas those inside have a specific coupling resistance of 2.7 omega cm2. However, when the cytoplasm of fiber cells is acidified by bubbling with CO2, peripheral cells uncouple and the cell to cell resistance goes up more than 40-fold, whereas junctions inside this zone are essentially unaffected by changes in intracellular pH. In a normal frog lens, the intracellular pH in fiber cells near the lens surface is 7.02, a value significantly alkaline to electrochemical equilibrium. Our data suggest that Na/H exchange and perhaps other Na gradient-dependent mechanisms in the peripheral cells maintain this transmembrane gradient. Deep in the lens, the fiber cell cytoplasm is significantly more acidic (pHi 6.81) due to influx of hydrogen across the inner fiber cell membranes and production of H+ by the inner fiber cells. Because of the normally acid cytoplasm of interior fiber cells, their loss of gap junctional sensitivity to pH may be essential to lens survival. PMID- 1783896 TI - Simultaneous measurement of Ca2+ in muscle with Ca electrodes and aequorin. Diffusible cytoplasmic constituent reduces Ca(2+)-independent luminescence of aequorin. AB - Estimates of cytoplasmic Ca2+ concentration ([Ca2+]i) were made essentially simultaneously in the same intact frog skeletal muscle fibers with aequorin and with Ca-selective microelectrodes. In healthy fibers under truly resting conditions [Ca2+]i was too low to be measured reliably with either technique. The calibration curves for both indicators were essentially flat in this range of [Ca2+], and the aequorin light signal was uniformly below the level to be expected in the total absence of Ca2+. When [Ca2+]i had been raised to a stable level below the threshold for contracture by increasing [K+]o to 12.5 mM, [Ca2+]i was 38 nM according to aequorin and 59 nM according to the Ca-selective microelectrodes. These values are not significantly different. Our estimates of [Ca2+]i are lower than most others obtained with microelectrodes, probably because the presence of aequorin in the cells allowed us to detect damaging microelectrode impalements that otherwise we would have had no reason to reject. The observation that the light emission from aequorin-injected fibers in normal Ringer solution was below the level expected from the Ca(2+)-independent luminescence of aequorin in vitro was investigated further, with the conclusion that the myoplasm contains a diffusible macromolecule (between 10 and 30 kD) that interacts with aequorin to reduce light emission in the absence of Ca2+. PMID- 1783897 TI - Presynaptic facilitation at the crayfish neuromuscular junction. Role of calcium activated potassium conductance. AB - Membrane potential was recorded intracellularly near presynaptic terminals of the excitor axon of the crayfish opener neuromuscular junction (NMJ), while transmitter release was recorded postsynaptically. This study focused on the effects of a presynaptic calcium-activated potassium conductance, gK(Ca), on the transmitter release evoked by single and paired depolarizing current pulses. Blocking gK(Ca) by adding tetraethylammonium ion (TEA; 5-20 mM) to a solution containing tetrodotoxin and aminopyridines caused the relation between presynaptic potential and transmitter release to steepen and shift to less depolarized potentials. When two depolarizing current pulses were applied at 20 ms intervals with gK(Ca) not blocked, the presynaptic voltage change to the second (test) pulse was inversely related to the amplitude of the first (conditioning) pulse. This effect of the conditioning prepulse on the response to the test pulse was eliminated by 20 mM TEA and by solutions containing 0 mM Ca2+/1 mM EGTA, suggesting that the reduction in the amplitude of the test pulse was due to activation of gK(Ca) by calcium remaining from the conditioning pulse. In the absence of TEA, facilitation of transmitter release evoked by a test pulse increased as the conditioning pulse grew from -40 to -20 mV, but then decreased with further increase in the conditioning depolarization. A similar nonmonotonic relationship between facilitation and the amplitude of the conditioning depolarization was reported in previous studies using extracellular recording, and interpreted as supporting an additional voltage-dependent step in the activation of transmitter release. We suggest that this result was due instead to activation of a gK(Ca) by the conditioning depolarization, since facilitation of transmitter release increased monotonically with the amplitude of the conditioning depolarization, and the early time course of the decay of facilitation was prolonged when gK(Ca) was blocked. The different time courses for decay of the presynaptic potential (20 ms) and facilitation (greater than 50 ms) suggest either that residual free calcium does not account for facilitation at the crayfish NMJ or that the transmitter release mechanism has a markedly higher affinity or stoichiometry for internal free calcium than does gK(Ca). Finally, our data suggest that the calcium channels responsible for transmitter release at the crayfish NMJ are not of the L, N, or T type. PMID- 1783898 TI - Antigenic switching and pathogenicity: environmental effects on virulence gene expression in Bordetella pertussis. PMID- 1783899 TI - Electrophoretic karyotypes of clinically isolated yeasts of Candida albicans and C. glabrata. AB - One-hundred-and-four isolates of yeast were collected from the vaginas of 97 outpatients. The isolates were identified by their characteristics in a carbohydrate assimilation test, a serological test and from their morphology. Candida albicans and Candida glabrata were the major isolates (75% and 20%, respectively). The karyotypes of the isolates were analysed by pulsed-field gel electrophoresis and almost all the karyotypes were distinguishable from one another when the band mobilities were carefully compared. Characteristics and karyotypes were not directly correlated, but seven C. albicans isolates (from six patients) had a common atypical karyotype and shared the same phenotype. These isolates are inferred to be generated by a wide genomic reorganization and mutation and the phenotypic changes may be advantageous for survival. The karyotypes of the isolates recovered from individual patients after intervals of 1-6 months were all identical except for one or two highly variable bands which were identified with an rDNA probe. This suggests that the variable bands are too variable to be useful for distinguishing strains, but from the patterns of the identical bands (i.e. except for the variable bands) we concluded that strains from individual patients do not change, at least over short periods. This, coupled with the extensive inter-isolate variability in karyotype, will be useful for Candida source determination and epidemiological studies. PMID- 1783900 TI - Purification, characterization and comparison of two non-haem bromoperoxidases from Streptomyces aureofaciens ATCC 10762. AB - Two non-haem bromoperoxidases (BPO 1 and BPO 2) were purified from the 7 chlorotetracycline-producing strain Streptomyces aureofaciens ATCC 10762. Both enzymes showed azide-insensitive brominating activity, and bromide-dependent peroxidase activity. BPO 1 was a dimer (Mr 65,000) with subunits of identical size (Mr 31,000). The pI was estimated to be 4.5. The enzyme did not cross-react with antibodies raised against the non-haem bromoperoxidase (Mr 90,000) from S. aureofaciens Tu24, a strain that also produces 7-chlorotetracycline. The Mr of BPO 2 was estimated to be 90,000. The enzyme had three identical subunits (Mr 31,000), and its isoelectric point was 3.5, identical with that of the bromoperoxidase from S. aureofaciens Tu24. Moreover, BPO 2 was immunologically identical with the bromoperoxidase from S. aureofaciens Tu24, although both it and BPO 1 could be distinguished electrophoretically from the latter bromoperoxidase. PMID- 1783901 TI - Relationship between threonine dehydratase and biosynthesis of tylosin in Streptomyces fradiae. AB - To elucidate the repression mechanism of ammonium ions on the biosynthesis of tylosin in Streptomyces fradiae NRRL 2702, enzyme activities involved in the metabolism of the aspartate family of amino acids were evaluated in relation to the ammonium ion concentration and tylosin production. It was found that aspartate aminotransferase was essential for both cell growth and tylosin production. However, both threonine dehydratase and valine dehydrogenase were repressed by supplemented ammonium ions at concentrations higher than 50 mM. Threonine dehydratase was purified from cell-free extracts by acetone precipitation, ion-exchange chromatography and gel filtration, and its molecular mass was estimated to be 67,200 Da. The optimum pH and temperature for threonine dehydratase activity were 7.5 and 25 degrees C, respectively, and the Km value for threonine under these optimum conditions was 21 mM. The inhibition pattern of ammonium ions on the activity of threonine dehydratase appeared to be a mixed type. PMID- 1783902 TI - Alkene monooxygenase from Mycobacterium: a multicomponent enzyme. AB - A NADH- or NADPH-dependent alkene monooxygenase (AMO) activity has been detected in cell-free extracts of the ethene-utilizing Mycobacterium E3 and Mycobacterium aurum L1. The activity was not linear with protein concentration in the assay suggesting AMO is a multicomponent enzyme. The inhibition pattern of AMO activity was very similar to the inhibition patterns published for the three-component soluble methane monooxygenases. Fractionation of crude extracts revealed that combination of two fractions was required to restore alkene monooxygenase activity. The first fraction was inhibited by acetylene, indicating it contained an oxygenase component. The second fraction contained reductase activity which was absent from non-induced cells. This reductase activity is probably the NADH acceptor reductase of AMO. PMID- 1783903 TI - Variation in the expression of cell envelope proteins of coagulase-negative staphylococci cultured under iron-restricted conditions in human peritoneal dialysate. AB - Strains of coagulase-negative staphylococci (CNS), including Staphylococcus epidermidis, S. hominis, S. warnerii, S. simulans, S. capitis, S. haemolyticus and S. saprophyticus, were isolated from patients with continuous-ambulatory peritoneal-dialysis-related peritonitis. The cell wall and cytoplasmic membrane protein profiles of CNS strains cultured in either nutrient broth (NB) or pooled human peritoneal dialysate (HPD) were compared. Some interspecies variation in both the wall and membrane protein profiles was noted. However, the cell wall protein profiles of HPD-grown CNS strains differed markedly from those cultured in NB. Growth in HPD resulted in a marked reduction in the total number of cell wall-associated proteins but up to three antigenically related proteins in the 40 56 kDa range, depending on the species, predominated. Growth in HPD also resulted in the induction of two iron-repressible cytoplasmic membrane proteins (IRMPs) of 32 and 36 kDa in S. epidermidis. Other CNS strains only appeared to express a single IRMP, which varied in molecular mass from 32 to 36 kDa. Whilst the IRMP in these CNS strains showed considerable antigenic homology with the 32 kDa IRMP, the S. warneri IRMP showed cross-reactivity with both the 32 and 36 kDa IRMPs of S. epidermidis. Immunoblotting experiments revealed that whilst the CNS cell wall proteins were poorly immunogenic, the IRMPs were the immunodominant CNS protein antigens, reacting strongly with antibodies present in HPD. This finding provides evidence to suggest that the IRMPs are expressed in vivo during infection. PMID- 1783904 TI - Capsulation gene loss and 'rescue' mutations during the Cap+ to Cap- transition in Haemophilus influenzae type b. AB - Genes for Haemophilus influenzae type b capsule expression are duplicated to form a potentially unstable structure, cap, of directly-repeated chromosomal regions of approximately 17 kb. Capsule-deficient mutants arise in a two-stage process, initiated by rec-dependent reduction of this region from two copies to one. This recombinational event is usually lethal, only about 1/200 surviving to form slow growing colonies of organisms that continue to synthesize polysaccharide but are defective in its export. A variety of secondary 'rescue' mutations within cap can occur to reduce polysaccharide synthesis and restore normal organism appearance and colony morphology. PMID- 1783905 TI - Nucleotide sequence of a Lactococcus lactis gene cluster encoding adenylate kinase, initiation factor 1 and ribosomal proteins. AB - We have previously isolated a putative promoter from the Lactococcus lactis subsp. lactis chromosome. We now report the sequence of the promoter fragment and its extension in the 5'-direction. The region contains several open-reading frames which correspond to ribosomal protein L15, SecY, adenylate kinase, initiation factor 1 and ribosomal proteins B and S13. The order of the genes, rplO (L15), secY, adk, infA, rpmJ (B) and rpsM (S13), is similar to that in the spc and alpha operon region of Bacillus subtilis, with the exception of the map gene, coding for methionine amino peptidase, which is located between adk and infA in B. subtilis. The putative promoter is located between adk and infA. PMID- 1783906 TI - The possible involvement of protein synthesis in the injection of PL-1 phage genome into its host, Lactobacillus casei. AB - The process of genome DNA injection, after adsorption, by phage PL-1 into host cells of Lactobacillus casei was monitored by using the electron microscope. Injection of DNA was inhibited by the protein-synthesis inhibitors chloramphenicol and erythromycin at concentrations where the colony-forming ability of cells not infected by phage was unaffected. The results suggest that protein synthesis may be involved in some way in the process of genome injection. PMID- 1783907 TI - Hyperpolarization and intracellular acidification in Trichoderma viride as a response to illumination. AB - Using indirect methods based on uptake of [3H]tetraphenylphosphonium cation and [14C]benzoic acid by cells of the fungus Trichoderma viride we found that the illumination-induced transient hyperpolarization of the plasma membrane is followed immediately by a rapid temporary decrease in intracellular pH. Hyperpolarization and intracellular acidification were completely suppressed by 150 mM-KCl and by the K(+)-ionophore valinomycin. The light-induced acidification of the cytoplasm was not observed in the presence of the cytochrome respiratory chain inhibitors antimycin A and mucidin. Based on these results, we hypothesize that the hyperpolarization of the cells is the consequence of an efflux of K+ through a light-activated K(+)-channel in the plasma membrane. The loss of positive charge in the cytoplasm caused by this efflux of cations is counterbalanced by H+ originating from the light-activated mitochondrial respiratory chain. PMID- 1783908 TI - Regulation of compatible solute accumulation in Salmonella typhimurium: evidence for a glycine betaine efflux system. AB - The regulation of glycine betaine accumulation has been investigated in Salmonella typhimurium. The size of the glycine betaine pool in the cells is determined by the external osmotic pressure and is largely independent of the external glycine betaine concentration. Analysis of the activity of the ProP and ProU transport systems suggests that other systems must be active in the regulation of the glycine betaine pool. Addition of p-chloromercuribenzoate (PCMB) or p-chloromercuribenzene sulphonate (PCMBS) to cells that have accumulated glycine betaine provokes rapid loss of glycine betaine. The route of glycine betaine efflux under the influence of PCMB is independent of either the ProP or ProU transport systems. Rapid loss of the accumulated pool of glycine betaine in the presence of PCMB is specific to glycine betaine and proline; accumulated pools of serine and lysine are not significantly affected by the -SH reagent. A specific glycine betaine/proline efflux system is postulated on the basis of these data and its role in the regulation of glycine betaine and proline accumulation is discussed. PMID- 1783909 TI - Membrane fatty acids as phenotypic markers in the polyphasic taxonomy of methylotrophs within the Proteobacteria. AB - A polyphasic approach to bacterial taxonomy attempts to integrate phylogenetic relationships with phenotypic marker analysis. This study describes the application of membrane fatty acids as a phenotypic marker for methylotrophs. Detailed phospholipid, ester-linked fatty acid (PLFA) profiles are reported for 17 methylotrophic eubacterial strains. These profiles included verification of double bond positions and geometries, both critical features for this analysis. Multivariate cluster analysis was used to indicate groupings of these strains along with literature values of both methylotrophs and non-methylotrophs based on the PLFA phenotype. Like many phenotypic characteristics, PLFA profiles were influenced by environmental conditions. The instabilities displayed, however, were predictable from physiological studies including increased trans/cis and cyclopropyl/cis ratios. Cluster analysis of PLFA profiles generated by separate investigators with different culture conditions indicated reproducibility by strain and species. The PLFA phenotype relationships compare favourably with phylogenetic associations based on 16S rRNA data for methylotrophs and will continue to be a valuable phenotypic marker for Proteobacteria taxonomy. PMID- 1783910 TI - Effects of antibiotics on the growth and morphology of Pasteurella multocida. AB - The effects of subminimal inhibitory concentrations (subMICs) of certain antibiotics, namely penicillin G, tetracycline and trimethoprim/sulphamethoxazole, on the growth and morphology of Pasteurella multocida were evaluated. SubMICs of penicillin markedly reduced the growth of P. multocida. Tetracycline and trimethoprim/sulphamethoxazole had no effect on its growth. SubMICs of penicillin greatly affected the morphology of P. multocida. At the highest concentrations tested (1/2 and 1/4 MIC) cells were acapsulate, and long filamentous cells (4-6 microns) were observed with some isolates. There was no correlation between the observed differences in the penicillin-binding proteins of the P. multocida isolates, and the extent of cell filamentation induced by penicillin G. SubMICs of tetracycline and trimethoprim/sulphamethoxazole did not seem to affect capsule production although filamentation was observed. Our results indicate that subMICs of penicillin can reduce growth of P. multocida. Furthermore, results also indicate that subMICs of antibiotics can affect the production of capsular material and the morphology of P. multocida. PMID- 1783911 TI - Classification of medically important clostridia using restriction endonuclease site differences of PCR-amplified 16S rDNA. AB - Restriction maps were constructed of enzymically amplified 16S rRNA genes (rDNA) isolated from eight Clostridium species. Using maximum parsimony, a dendrogram was constructed from these and published 16S rRNA sequence data. Two distinct clusters were identified: cluster I contained C. difficile, C. sordelli, and C. bifermentans, and showed 30 of 35 restriction sites in common; cluster II contained C. tetani, C. perfringens C. sporogenes and C. botulinum C and G, and showed 20 of 35 restriction sites in common. Further analysis of cluster I organisms revealed that of five HpaII fragments, two were found in equal amounts in all organisms, one was found in varying amounts in all organisms, and two were found, in varying amounts, only in C. sordelli and C. bifermentans. C. sordelli specific and C. bifermentans-specific HpaII fragments were demonstrated by Southern hybridization of rDNA. One HpaII site within the rDNA was present on most alleles in C. bifermentans, present on a minority of alleles in C. sordelli and absent in C. difficile. This suggested that there were two 16S rRNA alleles with different sequences present within each of the genomes of C. bifermentans and C. sordelli. PMID- 1783912 TI - Neurogenic dysphagia. PMID- 1783913 TI - Perfusion mapping with Tc-HMPAO in cerebral haematomas. AB - The cerebral distribution of HMPAO was mapped tomographically by SPECT in 20 patients with an intra cerebral haematoma. The images were assessed visually and by an analysis of an asymmetry index (AI) for various cerebral areas. Visual inspection identified the lesion in each of the 20 cases. Reduced tracer activity and abnormal AI were consistent findings. Remote effects (diaschisis) were also observed in the adjacent (19 cases) and frontal (14 cases) cortex, and in the controlateral cerebellum (16 cases). Sequential studies at 60, 150 and 300 minutes in 10 patients showed remarkably stable patterns. HMPAO maps were compared with cerebral blood flow (CBF) measured with 133 Xenon (133Xe) in eight cases. The two methods showed similar results in the region of a lesion, but remote effects were more obvious with the 133Xe in two patients. PMID- 1783914 TI - The United Kingdom transient ischaemic attack (UK-TIA) aspirin trial: final results. AB - From 1979-85, 2435 patients with a transient ischaemic attack or minor ischaemic stroke were randomly allocated to receive long term "blind" treatment with aspirin 600 mg twice daily (n = 815), aspirin 300 mg once daily (n = 806) or placebo (n = 814). No patient was lost to follow up. The "intention to treat" comparison included all the serious vascular events and deaths which occurred before the end of the follow up period on 30 September 1986. There was no difference in efficacy between the 300 mg and 1200 mg daily doses of aspirin, but the lower dose was undoubtedly less gastrotoxic. Also, there was no definite difference in the response of males and females to aspirin. The odds of suffering a major stroke, myocardial infarction or vascular death were 15% less in the combined aspirin groups compared with the placebo group (95% confidence interval 29% reduction to 3% increase in odds) which is compatible with the continuing overview of all the similar trials of antiplatelet drugs where the relative reduction in odds was 25%. There was no statistically significant reduction in the likelihood of either disabling major stroke and vascular death or vascular death occurring. PMID- 1783915 TI - Intense immunosuppression in chronic progressive multiple sclerosis: the Kaiser study. AB - The value of a short course of intensive immunosuppression with cyclophosphamide in stabilising chronic progressive multiple sclerosis (MS) was examined in a randomised single-blinded, placebo-controlled clinical trial. Forty two patients, from the Kaiser Permanente Medical Care Program, Northern California, were studied. Twenty two patients received a short course of cyclophosphamide in an outpatient neurology clinic until their leucocyte counts fell below 4000/mm3, and 20 patients received folic acid. Level of disability, impairment of functional systems, and performance of social roles were assessed before randomisation and reassessed 12, 18, and 24 months after therapy. In both the cyclophosphamide and folic acid groups, the mean level of disability increased from the baseline examination to the 12 month follow up examination (the primary endpoint) by 0.5 on Kurtzke's Expanded Disability Status Scale, indicating similar disease progression in the two groups. Although immunosuppression therapy can be safely administered to MS patients in an outpatient clinic, evidence of substantial benefits was not found. PMID- 1783916 TI - Acute treatment of myasthenia gravis with intranasal neostigmine: clinical and electromyographic evaluation. AB - The effectiveness of intranasal neostigmine (9.3-13.8 mg) was tested in 20 subjects with myasthenia gravis, classified as Osserman grades 2A and 2B. In all cases the drug produced significant clinical and electromyographic improvement. No side effects were reported during the treatment. PMID- 1783917 TI - Are sensorimotor strokes lacunar strokes? A case-control study of lacunar and non lacunar infarcts. AB - To determine whether sensorimotor strokes should be considered as lacunar syndromes 34 consecutive patients with first-ever ischaemic sensorimotor stroke were evaluated and compared with 103 patients with non-lacunar infarcts and another 88 patients with lacunar infarcts. Potential thromboembolic sources were more frequent in patients with non-lacunar infarcts (p = 0.003, versus sensorimotor strokes). Although the overall prevalence of hypodense lesions at CT scan was not significantly different among the three groups, lacunar lesions were found in 47.1% of sensorimotor strokes, compared with 6.8% of non-lacunar infarcts (p less than 0.0001). In a mean follow up period of 28.7 months, the incidence of stroke and myocardial infarction among sensorimotor strokes was similar to that of patients with lacunar infarct, but significantly lower than in non-lacunar infarcts (p less than 0.05). These results demonstrate important differences between sensorimotor and non-lacunar infarcts, but quite similar findings in sensorimotor and lacunar strokes, and thus support the theory that sensorimotor strokes are commonly due to lacunar lesions. PMID- 1783918 TI - Ambrose Pare 1510-90. PMID- 1783919 TI - 3,4-Diaminopyridine in the treatment of congenital (hereditary) myasthenia. AB - Congenital or hereditary myasthenia describes a heterogeneous group of disorders in which the immune system is not implicated. Treatment has previously depended on anticholinesterase medication. The effectiveness of 3,4-diaminopyridine (3,4 DAP), a preparation that enhances acetylcholine release from motor nerve terminals, has been evaluated using a series of standardised strength measures. Sixteen patients (aged seven to 47 years) were studied in an open prospective trial, and four of them in a double blind crossover trial; existing anticholinesterase medication was continued. For the group as a whole, there was a highly significant increase in muscle strength (p less than 0.001; n = 16). In individual paired comparisons, 13 out of 16 showed significant improvement in the open trial and four out of four in the blind crossover trial. In conclusion, 3,4 DAP, either alone or combined with anticholinesterase medication, may be a useful additional treatment in congenital myasthenia. PMID- 1783920 TI - Epilepsy in a mitochondrial disorder. AB - In a large family with maternally inherited mitochondrial disease, a mild defect in the NADH-ubiquinone oxidoreductase step (complex 1) in the respiratory chain was found. Epilepsy was seen in nine (22%) of the 37 family members. Five of them, belonging to one branch of the family, had myoclonus epilepsy and EEG abnormalities consistent with this. The remaining four patients, belonging to other branches of the family tree, had partial epilepsy. Neurological symptoms also varied in different parts of the family. Possible explanations for the differences in phenotypic expressions are discussed. PMID- 1783921 TI - The anatomical basis of somaesthetic temporal discrimination in humans. AB - Somaesthetic temporal discrimination (STD) is the ability to perceive as separate two successive somaesthetic stimuli applied to the same or different parts of the body. Paired electrical stimuli were applied to the index finger, using different time-intervals, to study the STD threshold (STDT) in 84 normal subjects and 51 patients with focal cerebral lesions. Abnormal STDT values were found on the affected side of patients with a lesion of the primary somatosensory cortex, and internal capsulethalamus. Lesions which did not produce sensory impairment but caused abnormal STDT were located in the posterior parietal cortex, the head of the caudate nucleus, the putamen, the medial thalamus and the lenticular nucleus. Frontal, temporal and occipital cortex lesions did not produce any abnormality in the STDT, but one patient with a bilateral lesion of the supplementary motor area (SMA) had abnormal STDT. These results indicate that normal perception of two somaesthetic stimuli as separate in time depends not only upon the integrity of the somatosensory pathway and primary somaesthetic cortex, but also of the posterior parietal cortex, SMA and subcortical structures such as the striatum and thalamus. PMID- 1783922 TI - Early orientation of attention toward the half space ipsilateral to the lesion in patients with unilateral brain damage. AB - Posner has suggested that unilateral spatial neglect could be due to a difficulty in disengaging attention from its current focus to orient it toward the neglected half space. Clinical and experimental data suggest, however, that this disengaging difficulty could be only one aspect of a more complex disturbance also characterized by an early automatic orienting of attention toward the half space ipsilateral to the lesion. To test this hypothesis, two different investigations in unselected groups of patients with right and left brain-damage were carried out. The first investigation, to evaluate forms of lateral orienting of attention severe enough to provoke an overt gaze deviation, consisted of the systematic assessment of the phenomenon of "magnetic gaze attraction". The second investigation, to detect milder forms of automatic orienting of attention, analysed the temporal sequence followed in identifying the pictures represented in an "Overlapping Figures task", to see if patients tended to identify first figures lying in the half space ipsilateral to the lesion. In both investigations results consistently showed: a) that patients with right brain damage tend to orient attention automatically toward the ipsilateral half space more than patients with left brain damage; b) that this tendency is tightly linked to the presence of behavioural manifestations of hemi-neglect. These results are therefore consistent with the hypothesis that hemi-neglect is a multi-component syndrome with an early orienting of attention toward the half space ipsilateral to the lesion as the first of these components. PMID- 1783923 TI - Familial dystonic choreoathetosis with myokymia; a sleep responsive disorder. AB - A family is presented with paroxysmal dystonic choreoathetosis transmitted as a dominant trait over five generations. The family is unusual in the marked responsiveness of the episodes to short periods of sleep in several members, in the very variable age of onset, and in the association with prominent myokymia in some cases. These overlap features suggest a link between paroxysmal dystonic choreoathetosis and familial paroxysmal ataxia with myokymia. PMID- 1783924 TI - Articulatory deficits in parkinsonian dysarthria: an acoustic analysis. AB - Twelve patients with idiopathic Parkinson's disease had acoustic speech analysis of sentence utterances to provide information on speech tempo and accuracy of articulation. As a measure of rate of speech the duration of opening-closing movements during articulation was determined from speech wave variables. The intensity of sound emission during articulatory closure as required for stop consonant production, for example, magnitude of p, magnitude of t, magnitude of k, was used as an index of the degree of closure. Speech tempo was not significantly different from normal. The patients, however, had a reduced capacity of completing articulatory occlusion. This was interpreted as reflecting a reduction in movement amplitude of the articulators. Articulatory "undershoot" was not uniform but influenced by linguistic demands in that the closures associated with a stressed syllable were performed at the expense of unstressed ones. Furthermore, switching between opening and closing movements of the articulators in sentence production seemed undisturbed. These results indicate that motor planning of speech differs from arm movement control. PMID- 1783925 TI - Motor and somatosensory evoked potentials in hereditary spastic paraplegia. AB - Motor evoked potentials (MEPs) from the arms and legs to transcranial stimulation of the motor cortex and somatosensory evoked potentials (SSEPs) from stimulation of the nerves of the arms and legs, were recorded in 11 patients with hereditary spastic paraplegia. Electrophysiological abnormalities were found to be distributed differently among the systems examined; the longer the pathway, the higher the incidence and severity of impairment. MEPs from the leg were either absent or clearly reduced or prolonged in all patients. Eight patients showed abnormal cortical SSEPs on stimulation of the leg (absent or reduced responses in four, slowed central conduction velocity in seven), but only two of these patients had abnormal MEPs from the arm (absent responses). Cortical SSEPs on stimulation of the median nerve were reduced in two patients. Mean values of amplitude and central conduction velocity for MEPs and SSEPs from the leg were significantly different between patients and controls. Such differences were not found for either MEPs or SSEPs from the arm. This distribution of abnormalities, which suggests a differential involvement of the spinal pathways, parallels the reported pathological pattern in which degeneration of axons is more common and severe in the motor and sensory fibres supplying the leg. PMID- 1783926 TI - Electrophysiological profile in arsenic neuropathy. AB - Comprehensive electrophysiological studies were performed on 13 patients with arsenic neuropathy. The most prominent finding was a marked abnormality in sensory nerve conduction in the presence of moderate abnormalities in motor nerve conduction. The motor nerve conduction studies and needle EMG were typical of those seen in axonal degeneration which was confirmed by sural nerve biopsy. PMID- 1783927 TI - Saccade deficits after a unilateral lesion affecting the superior colliculus. AB - A 70 year old patient with a small haematoma largely restricted to the area of the right superior and inferior colliculi is reported. Eye movements were electro oculographically recorded 17 and 80 days after the onset of the haematoma. At the first examination, latency of lateral reflexive visually-guided saccades was asymmetrical, both in the gap task (central fixation point switched off 200 ms before the onset of the lateral target) and in the overlap task (central fixation point remaining switched on). Furthermore, latency of leftward saccades in the overlap task was increased, and accuracy of these saccades was impaired, at both examinations. In the immobility task (fixation straight ahead while lateral targets suddenly occurred) and in the anti-saccade task (saccade made away from the lateral target), the percentages of errors (saccades made to the target) were high at the first examination, and noticeably lower at the second. These results suggest that the superior colliculus plays an important role both in the triggering and inhibition of reflexive visually-guided saccades. PMID- 1783928 TI - Alzheimer's disease in a patient with posterior cortical atrophy. AB - Posterior cortical atrophy (PCA) is characterised by slowly progressive dementia with cognitive and perceptual deficits suggestive of bilateral parieto-occipital disease. A case is reported of a patient with PCA and neuropathological findings consistent with Alzheimer's disease. PMID- 1783929 TI - Variations on a theme--singing as an epileptic automatism. AB - A case report giving the clinical and EEG details of a patient with right temporal lobe epilepsy in whom singing was the predominant feature of the automatism. PMID- 1783930 TI - A prospective follow up of thunderclap headache mimicking subarachnoid haemorrhage. PMID- 1783931 TI - Differential diagnosis of spontaneous and traumatic intracranial haemorrhage. PMID- 1783932 TI - Intracranial haemorrhage and death after iohexol myelography. PMID- 1783933 TI - Plasma infusion in childhood Guillain-Barre syndrome. PMID- 1783934 TI - Bilateral ptosis, ataxia and areflexia--a variant of Fisher's syndrome. PMID- 1783935 TI - Binswanger's clinical and neuropathological criteria for "Binswanger's disease". PMID- 1783936 TI - Motor neuron syndrome in the arms after radiation treatment. PMID- 1783937 TI - The incidence of muscle cramp. PMID- 1783938 TI - Two types of sympathetic axon innervating the juxtaglomerular arterioles of the rabbit and rat kidney differ structurally from those supplying other arteries. AB - Ultrastructural analyses of serial thin sections have revealed two structurally different types of sympathetic axon innervating the afferent and efferent juxtaglomerular arterioles and the intralobular arteries in the outer cortex of the rabbit kidney. Both types of axon have also been found in association with an afferent arteriole in rat kidney. One axon type consists of relatively large diameter unmyelinated axons bearing varicosities in the form of slight expansions. The varicosities have a distinct structural zonation: synaptic vesicles occupy the expansion which faces the smooth muscle cells, whereas the rest of the axon is filled with numerous microtubules. The other axon type has varicosities containing vesicles and mitochondria but few microtubules. The varicosities are generally small and the intervaricosities very thin. The relationship of both axon types with support cells and/or basal lamina is sometimes poorly defined. Both axon types are catecholaminergic as their vesicles take up 6-hydroxydopamine and both types form junctions with arteriolar smooth muscle cells. As well as differing from each other, both types of intrarenal axon differ in several respects from those which innervate other arterial vessels. PMID- 1783939 TI - The roles of the synaptic basal lamina and of innervation in directing the accumulation of a synaptic molecule, mAb 3B6 antigen, in regenerating skeletal muscles. AB - We have recently described a novel nonhomogeneous distribution of a muscle synaptic molecule following denervation. Monoclonal antibody (mAb) 3B6 antigen, a molecule concentrated at endplate/junctional regions and myotendinous junctions in innervated muscles, appears in denervated muscles in restricted perijunctional regions that are continuous with and centered on endplates. In the present study we examine the roles of the synaptic basal lamina and of innervation in directing the accumulation of the molecule in newly formed regenerating muscle fibres. In denervated regenerating muscle fibres, mAb 3B6 antigen was associated with the plasma membrane and localized at former junctional and perijunctional regions. In those muscle fibres which displayed the perijunctional distribution, the molecule was preferentially colocalized with and centered on former endplate areas. Altogether, a preference for the localization of mAb 3B6 at former endplate regions was observed in 86-90% of denervated regenerating myofibres. A similar preference was observed in 97-99% of innervated regenerating muscle fibres. However, whereas 85.9% of denervated regenerating muscle fibres displayed a perijunctional distribution of the molecule, only 50.5% of innervated regenerating myofibres exhibited a perijunctional distribution. In addition, mAb 3B6 antigen was detected in the cytoplasm of most of the denervated regenerating myofibres but in none of the innervated ones. These results indicate that the basal lamina directs the preferential accumulation of mAb 3B6 antigen at original synaptic sites. Innervation, which is not a prerequisite for the expression of the molecule by regenerating muscle, down-regulates its overall production and presence in perijunctional regions. PMID- 1783940 TI - The synaptic organization of the prepacemaker nucleus in weakly electric knifefish, Eigenmannia: a quantitative ultrastructural study. AB - Weakly electric knifefish (Eigenmannia sp.) produce continuous electric organ discharges at very constant frequencies. Modulations of the discharges occur during social interactions and are under control of the diencephalic prepacemaker nucleus. Abrupt frequency modulations, or 'chirps', which are observed predominantly during the breeding season, can be elicited by stimulation of neurons in a ventro-lateral portion of the prepacemaker nucleus, the so-called PPn-C. The PPn-C consists of approximately 100 loosely scattered large multipolar neurons which send dendrites into three territories, called 'dorso-medial', 'dorso-lateral', and 'ventral'. In the present ultrastructural investigation, the synaptic organization of these neurons, identified by retrograde labelling with horseradish peroxidase, was studied quantitatively. Somata and dendrites of the PPn-C receive input from two classes of chemical synapses. Class-1 boutons contain predominantly agranular, round vesicles and are believed to be excitatory. Class-2 boutons display predominantly flattened or pleiomorphic vesicles and are probably inhibitory. The action of the agranular vesicles in the synaptic boutons of these two classes may be modulated by the content of large dense-core vesicles. These comprise approximately 1% of the total vesicle population and are found predominantly in regions distant from the active zone of the synaptic bouton. The density of chemical synapses exhibits marked topographic differences. Class-1 boutons occur typically at densities of 3-12 synapses per 100 microns of profile length on dendrites and cell bodies. No significant differences in density of class-1 boutons could be found between distal dendrites of the three territories, proximal dendrites and cell bodies. The density of class-2 synapses, on the other hand, increases significantly from usually less than 1 synapse per 100 microns of profile length on distal dendrites to 2-3 synapses per 100 microns of profile length on proximal dendrites and cell bodies. Such a topographic organization could enable the proximal elements to 'veto' the depolarizing response of distal dendrites to excitatory inputs. The growth of dendrites in the dorso-medial territory during the breeding season, as shown in a previous study, and the concurrent doubling of excitatory input received by class 1 synapses, could overcome the inhibition caused on somata and proximal dendrites by class-2 synapses and thus account for the dramatic increase in the fish's propensity to chirp in the context of sexual maturity. PMID- 1783941 TI - Postnatal increases in neurofilament gene expression correlate with the radial growth of axons. AB - Neurofilament gene expression appears to play an important role in regulating axonal calibre. In the dorsal root ganglia of mature mammals, large sensory neurons contain high levels of neurofilament mRNAs and give rise to large-calibre myelinated axons (with diameters up to 8 microns in rat), while small sensory neurons contain undetectable levels of neurofilament mRNAs and give rise to unmyelinated axons (with diameters less than 1 micron). In the present study we used a combination of morphological and molecular approaches to examine the relationships among postnatal increases in neurofilament gene expression, growth in perikaryal size, growth in axonal calibre and myelin formation in lumbar sensory neurons of rat. Using in situ hybridization, three populations of sensory neurons could be clearly distinguished at birth: (1) neurons containing relatively high levels of neurofilament mRNAs; (2) neurons containing low levels of neurofilament mRNAs; and (3) neurons containing undetectable levels of neurofilament mRNAs. Perikaryal size was greater for neurons with high levels of neurofilament mRNAs than for those with either low or undetectable levels. The proportion of neurons expressing high levels of neurofilament mRNAs increased from approximately 10% at birth to 30% by 28 days of age; increases in the abundance of neurofilament mRNAs in these neurons between 0 and 28 days of age, as documented by blot analyses of RNA purified from dorsal root ganglia, correlated with increases in perikaryal size. This postnatal rise in neurofilament gene expression also correlated with an increase in the cross sectional areas of myelinated axons in the L5 dorsal root. As axons matured in their relationship to Schwann cells (polyaxonal pockets----ensheathed--- segregated----myelinated), their cross-sectional areas increased. Thus, growth in both perikaryal size and axonal calibre correlated closely with increased neurofilament gene expression in these sensory neurons. These findings are consistent with the hypothesis that neurofilament expression plays an important role in the sequence of events leading to the radial growth and myelination of axons. PMID- 1783942 TI - The distribution and phosphorylation of the microtubule-associated protein MAP 1B in growth cones. AB - Primary cultures of dissociated embryonic day 18 rat cerebral cortices were labelled by immunofluorescence with antibodies directed either against phosphorylated and non-phosphorylated MAP 1B (antibody 81) or against phosphorylated MAP 1B (antibody 150). Both antibodies stain cortical neurons, including their neurites and growth cones, in early (18 h) cultures, whereas only antibody 81 stained glial cells. By 4 days in culture, phosphorylated MAP 1B is largely restricted to axonal processes and growth cones, where it is often distributed in a gradient that is highest distally. In axonal processes and growth cones after 18 h and 4 days in culture, the phosphorylated form of MAP 1B is present both in a soluble form and bound to microtubules. Growth cones isolated from postnatal day 5 rat forebrain were labelled in vitro with 32P orthophosphate and detergent soluble and insoluble (cytoskeleton) fractions prepared. SDS-PAGE analysis revealed several major phosphoproteins in isolated growth cone cytoskeletons, including MAP 1B. Phosphorylated MAP 1B was also present in the detergent soluble fraction of growth cones. Immunoblotting and immunoprecipitation with MAP 1B antibodies confirmed the identification of MAP 1B and that the protein is phosphorylated in growth cones. These data show that MAP 1B, in particular the phosphorylated isoform, is present in growth cones and suggest that phosphorylation of MAP 1B may play an important role in neurite elongation. PMID- 1783943 TI - Distribution of glutamic acid decarboxylase (Mr 67,000) in the basal ganglia of the rat: an immunohistochemical study with a selective cDNA-generated polyclonal antibody. AB - Distinct isoforms of glutamic acid decarboxylase, the synthetic enzyme for GABA, exist in brain. Their distribution at the cellular level is not known, because previous studies have been confounded by the lack of monospecificity of available antibodies. We have examined the distribution of glutamic acid decarboxylase (Mr 67,000; GAD67) in the basal ganglia of the rat with a polyclonal antibody generated against the protein expressed in bacteria transformed with the corresponding cDNA. This antibody, which is directed against a portion of GAD67 non homologous to other known glutamic acid decarboxylase isoforms, selectively recognizes GAD67 on western blots. We show that GAD67 is present to various degree in all types of GABAergic neurons previously described in these regions. In contrast with results obtained with non-selective antibodies for glutamic acid decarboxylase, GAD67-positive neuronal cell bodies were readily detected in sections of the striatum, pallidum and substantia nigra in the absence of colchicine treatment. Modifications in the immunohistochemical procedure favoured staining of glutamic acid decarboxylase-positive fibres with the same antibody, indicating that GAD67 is also present in axon terminals of GABAergic neurons. The results suggest that GAD67 may be involved in GABA synthesis in both cell bodies and axon terminals of all GABAergic neurons of the basal ganglia, but is particularly abundant or accessible in their cell bodies. PMID- 1783944 TI - Macrophage-like cells invading the suboptic necrotic centres of the avian embryo diencephalon originate from haemopoietic precursors. AB - Macrophage-like cells have been previously shown within the suboptic necrotic centres of chick embryos during the period just previous to, and coinciding with, growth of the earliest optic axons through suboptic necrotic centres. In this paper, light and electron microscopy observations of chick embryos suggest that these macrophage-like cells originate from blood cells. Immunocytochemical techniques in chick-quail yolk sac chemeras, constituted of a chick embryo and a quail yolk sac, revealed that the macrophage-like cells within the suboptic necrotic centres are labelled with anti-MB1 antibody, which is specific for quail haemopoietic and endothelial cell lineage. These findings demonstrate that these phagocytic cells are of blood cell lineage, and originate in the extraembryonic tissues of the yolk sac. Diffuse staining around some suboptic necrotic centre macrophage-like cells suggests that they release MB1 antigens which may play a role in the growth of the optic axons through the suboptic necrotic centres. PMID- 1783945 TI - Formation of new muscle fibres and tumours after injection of cultured myogenic cells. AB - We examined the effects of implantation of cultured myogenic cells from a permanent cell line into soleus muscles of histocompatible adult mice. Myogenic cells (10(6) or 10(4)) were implanted into intact muscles, muscles frozen with liquid nitrogen, paralysed with botulinum toxin or reinnervated after long-term (seven months) denervation. Formation of numerous muscle fibres in myogenic cell injected muscles raised the total number of fibres up to ten times above control by four weeks. Larger effects were found in freeze-damaged than in paralysed muscles. The new fibres had small calibers, considerable length (greater than 1.3 mm, maximum distance over which serial sections were made), were multinucleated and were oriented parallel to the large-diameter fibres of the host muscles. In some experiments beta-galactosidase, introduced into myogenic cells via retroviral transfection, was detected in small and large muscle fibres 4-20 weeks after implantation, indicating survival of the grafted cells and formation of mosaic (host-donor) and new fibres of donor origin. Muscle weight increased significantly and, rather surprisingly, a parallel increase was found in isometric tetanic tension of isolated nerve-muscle preparations; thus tension per mg muscle tissue was not different from normal. By eight weeks reduction of acetylcholine sensitivity and down-regulation of neural cell adhesion molecule to normal were observed, indicating that synaptic transmission at the new fibres was mature. After different periods of time (5-20 weeks, depending on the subclone used) tumours developed in most but not all injected limbs (37 out of 39). The tumours were destructive to the muscles and were classified as rhabdomyosarcomas. Prior to tumour formation, neural cell adhesion molecule positive cells reappeared in the muscles; since the myogenic cells initially produced differentiated muscle fibres, it appears that malignant growth is induced by factors in vivo. Thus, at present the outcome of such implantation is unpredictable. PMID- 1783946 TI - Ultrastructural study of transcellular transport of native and cationized albumin in cultured goat brain microvascular endothelium [corrected]. AB - The interaction of native and cationized bovine serum albumin-gold complex with confluent monolayers of goat [corrected] brain microvascular endothelial cells was investigated. These cells were used as an in vitro model of the blood-brain barrier. After exposure to both complexes for 5, 15, 30, and 60 min, the endothelial cells were washed with phosphate-buffered saline, fixed, and processed for electron microscopy. The results obtained suggest that (a) contrary to previous observations in vivo, cultured endothelial cells were able to transfer native bovine serum albumin-gold complex particles from apical to basolateral surfaces presumably via a fluid-phase mechanism; (b) the most conspicuous difference in the interaction of both albumin-gold complexes consisted in a significantly greater adsorption of cationized than of native bovine serum albumin-gold complex to the apical surface of the endothelial cells; (c) the further fate of the endocytosed complexes was similar, that is, their major part was internalized into endosomes, multivesicular bodies and lysosomes whereas a smaller fraction was apparently transferred to the basolateral plasma membrane where presumably they were exocytosed into the subendothelial space. These observations provide new ultrastructural evidence that both native and cationized albumin are endocytosed and eventually transported by a non-specific, fluid-phase mechanism, and also support the results of earlier quantitative studies indicating the absence of albumin receptors in brain endothelia. PMID- 1783947 TI - Forward pattern masking: effects of spatial frequency and contrast. AB - Contrast thresholds of Gabor targets presented after sine-wave grating maskers were measured. All the patterns were isochromatic. The duration of both masker and target was 33 ms. The interstimulus interval was 33 ms. Masker spatial frequency, masker contrast, and target frequency were varied. Two experiments were conducted. In the first there were four target frequencies: 0.5, 1, 2, and 4 c/deg, with five masker frequencies covering a range of +/- 2 octaves around each and five masker contrasts (0.05-0.8). In the second there were three target frequencies (1.5, 2, and 2.83 cycles per degree), five masker frequencies around each, and 13 contrasts (0.005-0.8). Masking functions were bandpass, with maximum masking near the target frequency. Target thresholds increased with masker contrast. Over the shorter, sparser contrast range of experiment 1, functions appear roughly linear or concave upward. When they are plotted on log-log coordinates, functions for different masker frequencies diverge as masker contrast increases. Experiment 2 makes it apparent that some of these functions contain two increasing segments with a flat segment between them. These results are well described by a theory postulating that detection of these targets is mediated by two or three mechanisms that are differentially tuned to spatial frequency. The effect of the forward masker is briefly to desensitize the mechanisms that respond to it. The theory is fitted to the results of experiment 2, and its parameters are estimated. PMID- 1783949 TI - Determination of lights that are isoluminant for both scotopic and photopic vision. AB - A set of lights can be defined as D isoluminant if it is simultaneously isoluminant for both photopic and scotopic vision. Methods for determining sets of D-isoluminant lights are provided. It is shown that monochromatic lights cannot be made D isoluminant with one another for most of the spectrum and that particular white lights can each be made D isoluminant with a particular monochromatic light. Rules are provided for determining D isoluminance in dichromatic and trichromatic mixtures. The potential uses and limitations of D isoluminant stimuli are discussed. PMID- 1783948 TI - Theory of eccentric photorefraction (photoretinoscopy): astigmatic eyes. AB - An optical analysis of eccentric photorefraction (photoretinoscopy) of astigmatic eyes is presented. The size and the angular tilt of the dark crescent appearing in the subject's pupil are derived as a function of five variables: the ametropia of the eye (Dsph, Dcyl, axis), the eccentricity of the flash, e, and the distance of the camera from the subject's eye, dc. A simplified solution and a solution of the inverse problem, which enable one to calculate the degree of ametropia from the size and the tilt of the crescent, are also presented. If the crescent is smaller than the pupil, both the size and the tilt of the dark crescent are independent of the pupil size. The angular tilt of the crescent is also independent of the eccentricity. Characteristic changes of the crescent as a function of the cylinder axis are illustrated for compound and mixed astigmatisms. The validity of the theoretical predictions was experimentally verified on a model eye. PMID- 1783950 TI - Interphase cytogenetics in paraffin sections of routinely processed hydatidiform moles and hydropic abortions. AB - The differential diagnosis of complete (CM) and partial (PM) hydatidiform moles and hydropic abortions (HA) can be difficult when based on histology alone. Therefore, a more objective approach of chromosome ploidy analysis as detected by in situ hybridization (ISH) was performed on 6 microns paraffin sections of seven cases, originally classified as three CM, two PM, and two HA with a histologic pattern suggestive of triploidy. Probes for repetitive DNA targets in the (peri)centromeric region of chromosomes 1 and X and in the q arm of chromosome Y were used to determine chromosome ploidy and sex chromosome composition. The findings in the three CM were consistent with diploidy: two copies of chromosomes 1 and X and none of chromosome Y. In the two HA with a histologic pattern suggestive of triploidy, three copies of chromosomes 1 and X and none of chromosome Y confirmed triploidy. Two cases originally classified as PM both appeared to have two copies of chromosome 1 with an XX pattern in one case and an XY pattern in the other case, which is consistent with diploidy instead of triploidy. After reviewing, both cases most likely represented CM. We conclude that interphase cytogenetics by ISH on paraffin sections of hydatidiform moles and hydropic abortions enables chromosome ploidy analysis with preservation of histological context.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783951 TI - Morphometric analysis of the glomerular capillary area--a comparison of minimal change nephrotic syndrome, focal glomerular sclerosis, and pre-eclampsia. AB - A morphometric analysis was performed to compare the capillary area in non sclerotic glomeruli in focal glomerular sclerosis (FGS), pre-eclampsia with focal sclerotic change of the glomeruli, and minimal change nephrotic syndrome (MCNS). The mean and standard deviation of the capillary area was greater in FGS than in pre-eclampsia and MCNS. Tubulo-interstitial lesions, such as tubular atrophy, interstitial fibrosis, and lymphocytic infiltration, were more severe in FGS than in pre-eclampsia. The presence of tubulo-interstitial changes including tubular atrophy and interstitial fibrosis with lymphocytic infiltration is thought to be an important prognostic factor in pre-eclampsia as well as in FGS. Unequal dilatation of the glomerular capillaries in non-sclerotic glomeruli may be harmful to the glomeruli and may lead to the development of glomerular sclerosis. PMID- 1783952 TI - Standardization of interphase Ag-NOR measurement by means of an automated image analysis system using lymphocytes as an internal control. AB - Using an automated image analysis system, we have developed a procedure for standardizing the measurement of silver-stained proteins of the nucleolar organizer regions (NORs) in cancer cells, irrespective of the fixative employed and the time of the staining reaction. We observed that the area of Ag-NOR proteins from the same tumour was smaller in samples fixed with formalin containing solutions, buffered formalin, and Bouin liquid, compared with those fixed with absolute ethanol and 'methcarn' solution (1.77 +/- 0.26micron 2 and 2.36 +/- 0.35 micron2 versus 3.34 +/- 0.54 micron2 and 3.72 +/- 0.61 micron2). Increased values of the Ag-NOR area were also observed after lengthening the silver staining reaction. However, in both cases no difference was observed in the ratio between Ag-NOR area of cancer cells and that of the lymphocytes infiltrating the stroma. The value of the ratio, which is called the 'Ag-NOR index', was in fact very similar, for the same cancer, after employing different fixatives or staining times. The use of lymphocyte Ag-NOR area as an internal control for the standardization of Ag-NOR evaluation in cancer tissues was made possible by the fact that lymphocyte Ag-NOR area is almost constant in human tumours independent of sex and age. PMID- 1783953 TI - Caffeine potentiation of mefenamic acid-induced lesions in the rat renal medulla. AB - The effect of caffeine given in combination with mefenamic acid on the renal medulla was examined. Sprague-Dawley rats were divided into four groups and gavage fed either vehicle suspension (control), mefenamic acid, mefenamic acid+caffeine or caffeine only for 4 months. Renal tissue taken from the corticomedullary junction was processed for electron microscopy. Ultrathin sections were cut after identification of vasa rectae on survey sections. On subsequent morphometric analysis, percentage interstitial tissue was calculated from the total area of vasa recta less the non-interstitial tissue. The median percentage of interstitial tissue in the mefenamic acid and caffeine group was 41 (range 33-50; n = 15) compared with 34 (20-48; n = 20) in mefenamic acid (P less than 0.01), 29 (15-42; n = 15) in caffeine only (P less than 0.001) and 32 (20 46; n = 18) in vehicle-treated animals (P less than 0.001). There were no significant differences between mefenamic acid alone and vehicle or caffeine-only groups or between caffeine-only and vehicle-treated controls. This suggests that caffeine potentiates the effect of the non-steroidal anti-inflammatory drug, mefenamic acid, on the rat renal medulla, resulting in a quantitative increase in the interstitial tissue between adjacent afferent and efferent vasa recta. PMID- 1783954 TI - Cell proliferation. AB - The composition of a series of critical summaries is necessarily idiosyncratic, but in this compilation I have been guided by the recent publication of reviews and monographs on the subject. Consequently, it seems reasonable to focus on more fundamental areas of research which may lie outside the normal reading of most pathologists. Nevertheless, I regard these burgeoning areas as being likely to impinge on our research, if not our practice, in the near future. I will concentrate on four areas that I consider of particular interest. First, regulation of the cell cycle; second, arrest of proliferation; third, programmed cell death; and finally, the generation of novel markers of proliferation. PMID- 1783955 TI - Koch's postulates revisited. PMID- 1783956 TI - An exploratory study on the viability and efficacy of a pet-facilitated therapy project within a hospice. AB - In this exploratory study an attempt was made to determine what attitudinal, behavioral, and interactive changes were exhibited by terminally ill patients and their caregivers when a miniature poodle was introduced as a resident at a hospice. Pre-test, post-test, and follow-up phases were conducted, where interviews, observations, and videotape were used to collect data. Over the three phases, 14 patients and 15 staff members were sampled. The resident poodle appeared to facilitate staff-patient interactions, ease patient-visitor relations, and improve staff and patient morale on a situational basis. Patients who felt isolated or alone appeared to have no particular affection for the poodle, contrary to current Pet-Facilitated Therapy theory. Also, it appears that the longest and most frequent behaviors exhibited by both dog and human were those that had a relaxing or comforting effect on the human. PMID- 1783957 TI - Symptom control in a regional cancer centre: an innovative outpatient approach. AB - The number of patients per year diagnosed with cancer continues to increase dramatically; this growth is predicted to persist into the twenty-first century. Palliative care, working in conjunction with the family doctor, has shown that a significant and possibly cost-effective contribution to the care of these patients can be made through use of outpatient clinics and in-home service. The Ottawa Regional Cancer Centre initiated such a clinic in mid-1990; this report gives details of its first six months of operation and its first series of 25 patients. The provision of outpatient and home care services in most instances fulfilled the desires of both patient and family for a dignified and comfortable death in the patient's home. PMID- 1783958 TI - From migration to palliation: uncharted waters. AB - Attention to the unique health care needs of people who have immigrated to Canada should not wait until they are dying. The culture of the past and the reasons for migration are blended into their understanding of health care values and affect their response to interventions. Health professionals should understand that the family and the cultural community play a special role in the integration and acceptance of Canadian methods of care. Palliative home care nurses are participant-observers of the family ties to the past. They can share these observations with other health care workers. PMID- 1783959 TI - Relief of suffering: the doctor's mandate. PMID- 1783960 TI - What about odor in terminal cancer? AB - Daily care involving proximity with a malodorous patient in the terminal stage of cancer has often proved difficult for the caregiver. Whatever the cause of the primary cancer, three sources of noxious odor can exist or coexist: necrosis, superinfection, and perspiration and/or discharge. The proposed treatment calls for a twofold approach: internal or general and external or local. The internal treatment consists mainly of antibiotics and often involves the combined use of two drugs. Local treatment is applied "a la carte" according to the origin of the odors. Wounds, vomiting, diarrhea, and so on can be treated with specific treatments which will be discussed further. PMID- 1783961 TI - Role of the palliative care unit pharmacist. AB - As a member of the palliative care team, the pharmacist makes valuable contributions towards decision making regarding appropriate drug therapies. The most challenging aspect of being a palliative care pharmacist is to isolate the etiology of a symptom to facilitate optimum symptom management and suggest alternate routes and medications. PMID- 1783962 TI - The evolution of palliative care: a perspective from the European community. PMID- 1783963 TI - Fellowship in palliative medicine--University of Ottawa. PMID- 1783964 TI - Antidepressants in cancer pain. AB - Studies conducted in recent years have helped define the role of antidepressant drugs in the management of cancer pain. The antinociceptive action of these agents seems to be independent of beneficial effect on depression or mood. Among antidepressant drugs, those of the tricyclic class are preferred when an analgesic effect is sought. Their primary application is for pain due to nerve injury, so-called "neuropathic pain". Although the co-administration of tricyclic antidepressants may increase plasma morphine concentrations, any potentiation of morphine analgesia is thought not to be due to an increased bioavailability of the opiate, but to an intrinsic analgesic effect of antidepressants. On this basis, the use of antidepressants in combination with opioids for the treatment of cancer pain is suitable when a component of deafferentation is present or when there is concomitant depressive illness. PMID- 1783965 TI - The mechanism of pain memory in the elderly patient. PMID- 1783966 TI - Hypodermoclysis (HDC) for symptom control vs. the Edmonton Injector (EI). AB - Hypodermoclysis (HDC) is a well-known method of providing symptom control in terminally ill patients. In this article we make reference to two previous reports describing our use of HDC and a new method of subcutaneous narcotic delivery called the Edmonton Injector (EI). The rationale for using HDC mainly for rehydration and the EI when subcutaneous narcotics are needed is explored. The controversy surrounding the treatment of dehydration in the terminally ill is examined. Finally, the advantages on our palliative care unit of the convenience, increased flexibility, and cost and time saving of these two treatment methods are discussed. PMID- 1783967 TI - Determinants of the grief experience of survivors. PMID- 1783968 TI - Teaching palliative care in general practice: a survey of educational needs and preferences. AB - We surveyed general practitioners in the Bath District Health Authority to determine their educational needs in palliative care and their preferred methods of learning, in order to develop an appropriate education program. The survey confirmed our ideas as to the content of the program. There was support for our hypothesis that the majority would favor didactic approaches and would feel generally uncomfortable with experiential methods. The issue of professionals' needs in stressful situations proved to be a surprisingly strong one. PMID- 1783969 TI - [Gas-liquid chromatography with Fourier-transform infrared spectrophotometry. Application in the analysis of drugs. 2: Benzodiazepines]. AB - High working temperatures were used during the separation of benzodiazepines by capillary gas chromatography with Fourier transform infrared detection (FTIR). Spectral identification of these drugs give very good results with 10 micrograms of drug injected. On the contrary, the precision of the quantitative determination is poor. PMID- 1783970 TI - [Toxic effects induced by the repeat administration of Allium sativum L]. AB - Female and male rats were given 300 and 600 mg/kg/24 h of a Garlic bulb aqueous extract for 21 days. The results showed that garlic extract causes toxic effects affecting weight growth, biologic parameters and histologic structures. PMID- 1783971 TI - [Synthesis and evaluation of the aldose reductase inhibitory activity of new diaryl pyridazine-3-ones]. AB - It has been possible to prepare from 4,6-diaryl pyridazinones a series of derivatives substituted in the 2-position by chains of various lengths bearing a carboxylic acid function. Pig lens aldose reductase inhibitory activity was evaluated for all compounds. N-acetic acid derivative 3c with a chlorine atom on the phenyl nucleus at the 6-position on the pyridazin ring was the most active pyridazinone with an IC50 value of 1.2 x 10(-5) M. Furthermore, it has been shown that lipophilicity and spatial configuration of the synthesized compounds took a prominent part on enzymatic activity. PMID- 1783972 TI - The concentration of the cross-linking agent as a tool for the control of release and swelling properties of gelatin microspheres. AB - The effect of the concentration of a cross-linking agent (gelatin hardener) on gelatin microspheres was evaluated. A concentration increase of the gelatin hardener (formaldehyde) produced a decrease of drug loading, swelling degree and drug release rate. The cross-linking agent concentration affected also the kinetics of water absorption and drug release. This paper suggests a decreasing significance of the diffusion-type mechanism of drug release as the concentration of the cross-linking agent increased. PMID- 1783973 TI - [Influence of the speed of spheronization on the physical properties and dissolution availability of theophylline minigranules prepared by extrusion spheronization]. AB - From the minigranules of the theophylline-based that prepared by extrusion spheronization, the authors have envisaged the study of one of the parameters of operation (spheronizer speed) on the physical properties and lyoavailability of the active ingredient. It emerges that there is a clear influence of that parameters on the particle size distribution, the hardness, the friability, the density and the lyoavailability. PMID- 1783974 TI - [Radiation sterilization of drugs]. AB - Radiation sterilization can be carried out on the final packaged drug, is applicable to heat or ethylene oxyde sensitive compounds and is eased in control and monitoring. Most of the drugs seem to be not affected by irradiation, however it is necessary to be established that any traces of radiolytic products formed are not toxic. E.S.R. is a good detection method for irradiated drug. PMID- 1783975 TI - [Reactions and interactions of drugs]. PMID- 1783976 TI - Attenuation of depressor response induced by platelet activating factor and acetylcholine in streptozotocin-induced diabetic rats. AB - The in vivo and in vitro effects of platelet-activating factor (PAF, 1-O hexadecyl-2-acetyl-sn-glycero-3-phosphorylcholine) and acetylcholine (ACh) on vascular relaxation responses were examined in streptozotocin-induced diabetic rats. Intravenous injection of PAF and ACh (0.03 to 10 micrograms/kg) decreased the mean blood pressure in both control and diabetic rats in a dose-dependent fashion. Initial blood pressure in diabetic rats did not significantly differ from that in control rats. However, depressor responses induced by PAF and ACh in diabetic rats were attenuated more than those in control rats. In perfused mesenteric arterial bed preconstricted with methoxamine (10(-5) - 10(-4) M), PAF (10(-11) -3 x 10(-10) M) produced a concentration-dependent relaxation. However, this relaxation was significantly attenuated in the diabetic preparation compared with the control preparation. ACh also produced a concentration-dependent vasodilation in perfused mesenteric arterial bed. The concentration-response curve for the relaxation of the mesenteric arterial bed to ACh in diabetic preparation was shifted to the right compared with that in control preparation. A pretreatment with oxyhaemoglobin (10(-6) M) also shifted the concentration response curves for relaxation to ACh in both control and diabetic preparation to the right. There was no difference in relaxation induced by sodium nitroprusside between the diabetic and the control preparation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1783977 TI - Regulation of epidermal growth factor receptors in rat gastric mucosa: effect of fasting and sialoadenectomy. AB - The effect of fasting and sialoadenectomy on the binding of human epidermal growth factor (hEGF), beta-urogastrone, to plasma membranes isolated from rat gastric mucosa was studied to investigate the physiological changes in gastric EGF receptors for developing hEGF as an anti-ulcer drug. The binding of [125I]hEGF to the gastric membranes was significantly decreased after 40 h of fasting. Maximal binding was decreased to 74% of the control value without alteration of the binding affinity (Kd = 0.42 and 0.44 nM for the control and fasting group, respectively). There was little change in the binding of [125I]insulin to the gastric plasma membranes in response to fasting. Removal of the submandibular glands did not decrease EGF binding to the gastric membranes. These results indicate that changes in EGF binding to its receptors occur on plasma membranes of the rat gastric mucosa depending on the nutrient state. PMID- 1783978 TI - Aged-related changes in learning and memory, choline acetyltransferase activity and number of neuronal cells in rats. AB - In a water maze task, the goal latency and distance of swimming onto the platform of aged rats (24 months old) were slowly shortened by repeated training compared with those of young rats (8 weeks old). A significant decrease in choline acetyltransferase activity in the frontal cortex, parietal cortex and striatum was observed in aged rats. Moreover, the number of neuronal cells in the hippocampal CA1 subfield and dentate gyrus of aged rats was smaller than that of young rats. The atrophy of striatal cells was observed. These results suggest that age-related delay of acquisition is due to the above-mentioned biochemical and histological changes, and that rates of aging in biochemical and morphological parameters are different in the discrete brain areas. PMID- 1783979 TI - In vitro effects of synthetic dyes on the syntheses of prostaglandin E2 (PGE2) and 5-hydroxyeicosatetraenoic acid (5-HETE). AB - The effects of thirty-one synthetic dyes (tar dyes in Japan), which are permitted in cosmetics, on three different enzymes were evaluated as an initial step in developing in vitro safety screens. The activities of the prostaglandin (PG) synthetase from rabbit renal medulla and the lipoxygenases from potato tubers and guinea pig peritoneal polymorphonuclear leukocytes (PMN) were determined based on the biosyntheses of PGE2 and 5-hydroxyeicosatetraenoic acid (5-HETE), respectively. Xanthene dyes with halogen substituents exhibited marked inhibition on the PG-synthetase. Among the dyes which are permitted for any pharmaceutics and cosmetics, only the xanthene dyes exhibited inhibitory effects on the PG synthetase at 2.5 mM. The xanthene dyes also showed inhibition and stimulation of potato lipoxygenase and PMN lipoxygenase, respectively. PMID- 1783980 TI - CPT-11 converting enzyme from rat serum: purification and some properties. AB - A rat serum enzyme that catalyzes the conversion of a pro-drug, 7-ethyl-10-[4-(1 piperidino)-1-piperidino] carbonyloxycamptothecin (CPT-11), to an anticancer drug, 7-ethyl-10-hydroxycamptothecin (SN-38), was purified and its properties were characterized. The enzyme was purified by column chromatography on diethylaminoethyl Toyopearl 650M, QAE-Sephadex, Sephadex G-150, Con A-Sepharose and high performance liquid chromatography with an ion-exchanger column. It was most active at pH 7.5 and was stable at pH 4-9 for 1 h at 30 degrees C. The molecular weight was estimated to be 60 and 57 kDa by gel filtration and sodium dodecylsulfate-polyacrylamide gel electrophoresis methods, respectively, and the isoelectric point was 4.6, as determined by isoelectric focusing. The Km value for CPT-11 was 0.28 microM. This enzyme was inhibited by diisopropyl phosphorofluoridate (DFP) and phenylmethanesulfonyl fluoride (PMSF) but insensitive to eserine, p-chloromercuribenzoate (PCMB) and ethylenediaminetetraacetate (EDTA). The enzyme also hydrolyzed p nitrophenylacetate (p-NPA), a commonly used substrate for esterases, but was not active toward acetylcholine, suggesting that the enzyme is a carboxylesterase[EC 3.1.1.1]. During the hydrolyses of CPT-11 and p-NPA, an initial burst phenomenon similar to that found in the alpha-chymotrypsin-catalyzed hydrolysis of p-NPA was observed. Kinetic analysis revealed that the deacylation of the enzyme is the rate-limiting step in substrate hydrolysis. This enzyme was found to also split other ester derivatives of SN-38 besides CPT-11. PMID- 1783982 TI - [Metabolic fate of bufalin in rats]. AB - In an attempt to evaluate the metabolic fate of "Kyushin", which is a traditional medicine containing Toad venom, a 3H-labeled compound of bufalin, which is one of the main active components, has been synthesized. The metabolic fate of the 3H bufalin was studied after its single and repeated oral administration in rats. After a single administration of the 3H-bufalin (20 micrograms/kg), the radioactivity in the blood reached a maximum level at 15 min. The radioactivity in the blood declined in a triphasic manner with half-life times of 18 min, 2.6 and 86 h. Within 24 h after the single administration, the excretion of the radioactivity into the urine and feces amounted to 1.3% and 81% of the administered dose, respectively. Tissue radioactivity was higher in the stomach, small intestine, liver, lung, kidney and pancreas, while the radioactivity in other tissues was lower than that in blood. Radioactivity disappeared rapidly from any tissues. In case of repeated administration for 14 d, the disposition of radioactivity was almost same as the result after a single dosing, and radioactivity scarcely remained in any tissues after the last administration. PMID- 1783981 TI - [Aging and drug metabolism: alteration of liver drug metabolizing ability in male rats. Is it functional deterioration or feminization of the liver?]. AB - The profiles of hepatic drug metabolism were obtained by using young and old male and female rats. The profile obtained from old male rats was completely different from that from young male rats, while it was almost identical to those of females of any ages. This was due to the selective decrease in male hepatic enzyme activities showing higher activities than females to the activity levels of females which did not alter much with aging. Castration of young adult male rats caused a decrease in enzyme activities but did not result in the feminization of the metabolic profile. Administration of testosterone to old male rats resulted in the recovery of the profile of young male rats, but the levels of activities were not as high as young male rats. Plasma testosterone levels were found to decrease in parallel with drug metabolizing activities of male rats during aging. These results suggest that sex hormones play important roles in the alteration of drug metabolizing activities in male rats with aging. The loss of male characteristics in profile of drug metabolism during aging was evaluated by use of antibody to the male specific cytochrome P-450, P-450 m1. Anti-P-450 ml strongly inhibited imipramine N-demethylase activity, which showed marked sex (male greater than female) and age (young greater than old) differences, while this did not inhibit imipramine 2-hydroxylase activity, which showed no sex or age differences. The portion of N-demethylase activity inhibited by this antibody decreased in old rats while the portion not inhibited did not decrease with age. These results indicate that the decrease of sex specific cytochrome P-450 is responsible for the age-associated decrease in at least one of the drug metabolizing enzyme activities in male rats. It is suggested that some processes of the control mechanism of the gene expression of male specific cytochrome P-450 may be altered with old age. PMID- 1783983 TI - [Releasing properties of water soluble drug in internal water phase of W/O/W multiple emulsions]. AB - A stable water/liquid paraffin system water-in-oil-in-water (W/O/W) multiple emulsion was prepared by the two-step procedure of emulsification using a variety of nonionic emulsifying agents, such as Span 80 and Tween 20. After comparison of the releasing properties of such water soluble drugs as cefadroxil, cephradine, 4 aminoantipyrine and antipyrine which were entrapped separately in the inner aqueous phase of the W/O/W multiple emulsion, a large difference was observed. It was ascertained that the difference in these releasing properties was due to no physical rupture by the microscopic observation and the results of the release test of W/O/W multiple emulsion with two kinds of drugs entrapped simultaneously in an inner aqueous phase. This reason was presumed to be dependent on permeation in the oily phase of the drug itself. It was proved that the differences of releasing properties tended to depend on the molecular weight and were closely related to the drug concentration of outer aqueous phase of W/O/W multiple emulsion containing the drug in both aqueous phases prepared as an experimental model. Therefore, two possible mechanisms for the releasing of drugs in W/O/W multiple emulsion may be interpreted as follows: the first is that the mixed and inversed micelles formed by Span 80 and Tween 20 agents in the oily phase act as a carrier of drugs, and the second is that drug molecules diffuse through small pore existing in very thin lamella of the emulsifying agents partially formed in the oil layer owing to the fluctuation of the thickness. PMID- 1783984 TI - [Proline specific peptidases and their specific inhibitors]. AB - Several proline specific peptidases were newly isolated from mammalian organs, plants and microorganisms, and their enzymatic properties characterized. The genes of prolyl endopeptidase, aminopeptidase P and proline iminopeptidase from some microorganisms were cloned and their nucleotide sequences determined. By high expression of these genes in Escherichia coli, the enzymes became possible to be used for the industrial application as well as its basic research. Novel inhibitors specific for the prolyl endopeptidase and dipeptidyl aminopeptidase IV were synthesized and some inhibitors for prolyl endopeptidase found to show an anti-amnesic effect. PMID- 1783985 TI - [Studies on the chemical constituents of Rutaceae++ plants. LXVI. The chemical constituents of Toddalia asiatica (L.) Lam. (T. aculeata Pers.). (1). Chemical constituents of the root bark]. AB - Chemical constituents of the root bark of Toddalia asiatica (L.) Lam. (T. aculeata Pers.), Rutaceae, were examined. In addition to twelve known coumarins [toddaculin (2), coumurrayin (5), toddanone (6), 8-(3,3-dimethylallyl)-6,7 dimethoxycoumarin (7), isopimpinellin (8), 6-(3-chloro-2-hydroxy-3-methylbutyl) 5,7-dimethoxycoumarin (9), 6-formyllimettin (10), 5,7,8-trimethoxycoumarin (12), toddasin (13), (+)-toddanol (14), 6-(2-hydroxy-3-methoxy-3-methylbutyl)-5,7 dimethoxycoumarin (18), and toddalolactone (21)] five new coumarins [toddalenol (17), toddalosin (19), 5-methoxysuberenon (23), toddalenone (24), and 8 formyllimettin (25)] were isolated. Furthermore seven known benzo[c]phenanthridine alkaloids [des-N-methylchelerythrine (4), oxychelerythrine (15), arnottianamide (16), oxyavicine (22), avicine (30), chelerythrine (31), and chelerythrine-psi-cyanide (34)] and four known quinoline alkaloids [N methylflindersine (11), 4-methoxy-1-methyl-2-quinolone (20), skimmianine (35), integriquinolone (36)], one known triterpenoid [beta-amyrin (3)], and four unknown components [unknown I-IV (26)-(29)] were isolated. PMID- 1783986 TI - [Studies on the chemical constituents of rutaceous plants. LXVII. The chemical constituents of Toddalia asiatica (L.) Lam. (T. aculeata Pers). Examination of coumarins using supercritical fluid and soxhlet extraction. Is toddalolactone a genuine natural coumarin?]. AB - It is well known that toddalolactone (1) is a main component of Toddalia asiatica (L.) Lam. (T. aculeata Pers.) (Rutaceae). However, supercritical fluid (SCF) extraction of the plant by using CO2 showed that a main component of the extract was not 1, but aculeatin (2), a coumarin having an epoxy ring on the side chain. The same result was obtained from Soxhlet extraction by using aprotic solvents. On the other hand, Soxhlet extraction by using methanol yielded 13, corresponding to a methanol adduct of 2, as an additional component, which was able to be also produced in 50.2% yield only by heating pure 2 in methanol, indicating that the epoxy ring in 2 can be easily attacked by a weak nucleophile like methanol. These facts strongly suggested that 1, corresponding to the hydrate of 2, was an artefact derived from 2 during extraction. SCF extraction under various conditions was examined in detail by quantitative analyses of 1 and 2 by high performance liquid chromatography and the optimum condition extracting the both components was found to be at 40 degrees C and at 300 kg/cm2. The condition was applied to the plant treated with aqueous sodium hydrogen carbonate in order to remove any acidic substances and 1 was still detected in the extract. Thus, it is conclude that 1 should be a genuine natural coumarin but that previous isolation of 1 as a main component resulted in an isolation of an artefact derived from 2. SCF extraction was suggested to be a useful extraction method. PMID- 1783987 TI - [Effect of protoporphyrin IX on the induction of respiratory impairment of hepatic mitochondria by carbon tetrachloride in rats]. AB - The effect of pretreatment with protoporphyrin IX (PP) on the impairment of hepatic mitochondrial respiration induced by carbon tetrachloride (CCl4) was studied in rats. Treatment of animals intraperitoneally with CCl4 resulted in marked impairment of states 4 and 3 respirations, respiratory control and oxidative phosphorylation of mitochondria in the presence of succinate, beta hydroxybutyrate or glutamate as substrates. The PP, given intravenously, caused no alterations in those mitochondrial functions. The treatment with PP prior to the administration of CCl4 inhibited the induction of mitochondrial respiratory impairment by CCl4. CCl4 increased markedly the contents of lipid peroxide in the liver but not those in the mitochondria. The increase of hepatic lipid peroxides by CCl4 was markedly reduced by the pretreatment with PP. These results indicate that PP effectively protects the mitochondria from the functional disorder caused by CCl4. PMID- 1783988 TI - A population analysis of the pharmacokinetics and pharmacodynamics of midazolam in the rat. AB - The concentration-EEG effect relationship of midazolam in the rat was studied from a population perspective. Plasma concentration and EEG effect data from 27 rats were available for analysis. Effect parameters derived from aperiodic EEG analysis were used as effect parameters. The population analysis gave results that were similar to the sample theory estimates (means s and SDs) obtained from the fits to individual data sets. Reanalysis of the EEG data using mean population pharmacokinetic parameters as input to the pharmacodynamic model led to poorer estimation of the pharmacodynamic parameters: particularly EC50. Inclusion of one observed plasma concentration per individual significantly improved the estimation of the pharmacodynamic parameters and led to results that were virtually indistinguishable from those obtained using complete pharmacokinetic data. PMID- 1783989 TI - Maximum entropy and drug absorption. AB - The application of maximum entropy to the calculation of drug absorption rates was introduced in an earlier paper. Here it is developed further, and the whole procedure is presented as a problem in scientific inference to be solved using Bayes' theorem. Blood samples do not need to be taken at equally spaced intervals, and no smoothing, interpolation, extrapolation, or other preprocessing of the data is necessary. The resulting input rate estimates are smooth and physiologically realistic, even with noisy data, and their accuracy is quantified. Derived quantities such as the proportion of the dose absorbed, and the mean and median absorption times, are also obtained, together with their error estimates. There are no arbitrarily valued parameters in the analysis, and no specific functional form, such as an exponential or polynomial, is assumed for the input rate functions. PMID- 1783990 TI - Two-compartment basophil cell trafficking model for methylprednisolone pharmacodynamics. AB - A two-compartment closed model was used to characterize the movement of basophils between blood and extravascular sites resulting from methylprednisolone (MP) exposure. This model is consistent with the view that corticosteroids cause a decrease in the recirculation of these cells from peripheral compartments. Methylprednisolone (Solu-Medrol) was given to healthy males at doses of 10, 25, and 40 mg. Blood samples were collected and assayed for MP by HPLC for pharmacokinetic analysis. Whole blood histamine, an index of circulating basophils, was assessed by RIA over 32 hr. Nonlinear least-squares analysis was carried out to solve for the model parameters reflecting cell movement between compartments and sensitivity (IC50) to the steroid. This model quantitiates the fall and return pattern of biologic response to corticosteroids with a minimal number of parameters which jointly fit several dose/response curves and yields a mean IC50 value of 8.1 ng/ml similar to receptor binding of MP. Properties of the temporal and integrated response curve and model extrapolations over a wide dose range were explored with simulations. Because corticosteroids exert similar effects on other cells in blood, this model may be applicable to various regulatory and immunosuppressive effects. PMID- 1783991 TI - A kinetic-dynamic model to explain the relationship between high potency and slow onset time for neuromuscular blocking drugs. AB - To account for experimental data showing increased onset time with increased potency of neuromuscular blocking drugs, a pharmacokinetic-pharmacodynamic model is presented. It is characterized by a finite concentration of receptors (R) in the effect compartment. Transfer from central to effect compartment is linearly related to concentration gradient. A sigmoid Emax model is used to describe the relationship between receptor occupancy and effect. Plasma concentrations found in the literature are used. Differential equations are solved numerically for equipotent doses of drugs of different potencies. Because the density of receptors constitutes a significant drain of drug molecules for potent drugs, the model predicts an inverse relationship between speed of onset and potency. The concentration of receptors in the effect compartment R which best fits experimental data obtained in humans is 0.28 mumol/L. With this value of R, onset times are prolonged when the ED95 (dose for 95% blockade) is less than 0.1 mumol/kg. It is concluded that, in the development of a short-acting nondepolarizing neuromuscular blocking drug, agents having an ED95 of 0.1 mumol/kg or greater appear more promising. PMID- 1783992 TI - Model representation of salicylate pharmacokinetics using unbound plasma salicylate concentrations and metabolite urinary excretion rates following a single oral dose. AB - The pharmacokinetics of salicylic acid (SA) and its metabolites have been studied in 5 volunteers after administration of 3 g salicylic acid (as sodium salicylate) and collection of serial samples of blood and urine. SA and its metabolites were assayed with a HPLC method specific for each species. The urinary excretion rates of individual metabolites were analyzed using unbound plasma SA concentrations and Lineweaver-Burke plots. The analysis confirmed that the formation of SA urate (SU) and SA phenolic glucuronide (SPG) metabolites are saturable processes, and showed that the Michaelis-Menten values derived are consistent with earlier estimates derived solely from urinary data. The unbound salicylate plasma concentration-time profiles were then analyzed with various models assuming either saturable clearances for metabolite formation and/or saturable protein binding. The data were best described with a model that included both saturable protein binding and saturable metabolism. The model assumed first-order absorption kinetics and instantaneous distribution into extravascular and tissue compartments. The model was validated by comparing predicted relationships between the apparent volume of distribution, clearance, and plasma salicylate concentrations with previous relationships obtained using steady state data. PMID- 1783994 TI - Estimation of the permeability coefficient from a finite-dose, in vitro percutaneous drug permeation study. PMID- 1783993 TI - Disposition of prednisone and prednisolone in the perfused rabbit liver: modeling hepatic metabolic processes. AB - The livers of 15 rabbits were perfused in situ with prednisone (PO) or prednisolone (POH) over a wide range of steady state concentrations, resulting in multiple experimental measurements per organ. Linearity of extraction, an apparent lack of oxidative conversion, and marked preference for the reduction of PO to POH was observed. Predictions of hepatic tissue concentrations were made using both the well-stirred and parallel-tube model approximations. Glucocorticoid disposition across the liver was described by a series of differential equations. Discrimination between the two models was accomplished by examining the effects of changes in flow rate upon the availability of the highly extracted drug PO. The well-stirred model very closely predicted the observed changes in availability of PO, whereas the parallel-tube model provided poor predictions. The intrinsic clearances of interconversion and elimination of PO and POH were subsequently calculated by population analysis using NONMEM. This method assumed the well-stirred model and resulted in intrinsic clearance estimates of 26 ml/min for the elimination of POH, 157 ml/min for reductive conversion of PO to POH, and 205 ml/min for the irreversible elimination of PO. A mechanism of intrahepatic disposition of these glucocorticoids was proposed using well-stirred model predictions of hepatic drug concentrations, the perfusion rate limitation to drug transport, and the assumption of no oxidative interconversion of POH to PO. In this case, the capacity for reduction of PO to POH approaches the elimination clearance of PO and the elimination of PO is about 13 times greater than the elimination clearance of POH. PMID- 1783995 TI - VSTRGRSN: a LOTUS 1-2-3 spreadsheet for variance-stabilized linear regression applied to the analysis of drugs in biological fluids. PMID- 1783996 TI - Mean residence time of drugs in pharmacokinetic systems with linear distribution, linear or nonlinear elimination, and noninstantaneous input. PMID- 1783997 TI - Systemic morphine pharmacokinetics after ocular administration. AB - Pharmacokinetics of a single dose of morphine ocularly applied is reported in rabbits before and after lacrimal canaliculi ligature. Our investigations are based on a sensitive reversed-phase ion-pair chromatographic determination of morphine. This study describes the various resorption sites of morphine when administered through the conjunctiva. After ocular administration, morphine rapidly reaches high blood levels compatible with pharmacological activity. Ocular bioavailability of morphine is higher than after non-parenteral routes. Canaliculi ligature modifies the morphine pharmacokinetic profile without significant modification of drug bioavailability. Our results suggest a great capacity of drug resorption for the conjunctiva, and indicate the major role of nasal mucosa in physiological conditions. PMID- 1783998 TI - Pharmacokinetics of diazepam intramuscularly administered to rhesus monkeys. AB - The purpose of this study was to define the pharmacokinetics of diazepam in monkeys following an im injection of 100 micrograms/kg (the minimum effective dose that prevents nerve agent-induced convulsions in pyridostigmine-pretreated, atropine- and 2-PAM-treated monkeys) in order to predict what im dose in humans is needed to prevent nerve agent-induced convulsions. Six rhesus monkeys were administered diazepam in the hind limb. Blood (3 mL) was collected via an indwelling saphenous catheter immediately prior to and 5, 10, 15, 25, 40, 60, 90, 120, 180, and 240 min after diazepam dosing. A contract laboratory, blind to the labeling code, analyzed diazepam serum concentrations by electron-capture gas chromatography and the percentage of unbound diazepam by equilibrium dialysis. The concentration-time data for total (unbound and bound) diazepam individually determined for each animal was best described by a one-compartment open model with first-order absorption and elimination. The average maximum serum concentration (50 ng/mL) was reached in 29 min. The volume of distribution and systemic clearance, assuming 100% bioavailability, were 1.5 L/kg and 19.4 mL/min/kg, respectively. The percentage of diazepam unbound to serum proteins was 4.6% and, therefore, the maximum concentration of free diazepam was 2.3 ng/mL. These results, when compared with human pharmacokinetic studies, allow a means of extrapolating effective monkey anticonvulsant doses to humans on a pharmacokinetic basis. PMID- 1783999 TI - A computer program for the deconvolution of mass spectral peak abundance data from experiments using stable isotopes. AB - A computer program is described for deconvoluting the overlap which is often found in mass spectral peak abundance data from stable isotope experiments. Peak intensity data from calibration standards are corrected using parameters calculated from the analysis of separate external standard solutions of analytes and internal standard. If the calibration data are satisfactory, the same parameters and the slope and intercept values from the least squares analysis of the calibration data are used to correct and quantitate the mass spectral peak intensity data from the quality assurance and experimental samples. Reports and graphs appropriate to the process are produced. Applications are given for the analysis of plasma samples from stable isotope experiments with carprofen, cifenline, and midazolam. PMID- 1784000 TI - Kinetics of drug action in disease states. XXXVIII: Effect of body temperature on the convulsant activity of pentylenetetrazol in rats. AB - The purpose of this investigation was to determine the effect of body temperature on the pharmacodynamics (convulsant activity) of pentylenetetrazol (PTZ). Rats received an iv infusion of PTZ until the onset of maximal seizures, at which time samples of cerebrospinal fluid (CSF), brain, and blood (for serum) were obtained for subsequent determination of PTZ concentrations by HPLC. The PTZ infusion caused a decrease in body temperature of approximately 4 degrees C within 20 min and onset of seizures in approximately 40 min. Compared with animals whose temperature was maintained in the normal range by heating pads, the hypothermic rats required significantly larger doses and higher serum, brain, and CSF concentrations of PTZ to produce seizures. Other rats received an injection of brewer's yeast to produce fever. Then, PTZ was infused 6, 12, or 24 h later when body temperature was elevated by an average of 1.3, 1.1, or 0.4 degrees C, respectively. Compared with control rats, whose temperature was maintained in the normal range by heating pads, moderate hyperthermia had no significant effect on the dose and concentrations of PTZ required to produce maximum seizures. Pentylenetetrazol exemplifies a drug that can produce hypothermia which, in turn, reduces the sensitivity of rats to its pharmacologic action. Unlike the central nervous system (CNS) depressants phenobarbital and ethanol, whose pharmacologic activity in rats is enhanced at elevated body temperature, the activity of the CNS stimulant PTZ is apparently not altered by fever. PMID- 1784001 TI - A comparative in vitro study of transdermal absorption of a series of calcium channel antagonists. AB - The in vitro transdermal absorption of five calcium channel antagonists (nifedipine, nitrendipine, nicardipine, felodipine, and nimodipine) was studied using the skin of hairless rats as a membrane. The aim of this study was to determine the penetration parameters [permeability constant (Kp), lag time (T1, and flux (J)] as measures of the intrinsic transdermal permeabilities of these drugs, in order to predict the potential capacity of these drugs to be formulated in a therapeutical transdermal system (TTS). Reliable prediction of Kp values, using K'w (extrapolated capacity factor in 100% water) and P (n-octanol-water partition coefficient) values as independent variables in the parabolic, bilinear, and hyperbolic functions, were assayed. Nicardipine showed a higher mean transdermal penetration (Kp; 4.9 x 10(-3) cm.h-1) value than the other dihydropyridines. Nifedipine showed the shortest mean T1 value (5.1 h). The permeability rate constants of the calcium channel antagonists assayed can be predicted from their n-octanol-water partition coefficients, using the parabolic function (r = 0.984, p less than 0.01). Nicardipine would be the most suitable candidate for formulation in a TTS design. PMID- 1784002 TI - Design of 9-beta-D-arabinofuranosyladenine (ara-A) transdermal delivery system for animal studies: regulation of drug concentration in vivo. AB - Transdermal delivery systems of 9-beta-D-arabinofuranosyladenine (ara-A), having controlling membranes of various permeabilities, were developed and applied to Azone-pretreated hairless mouse abdominal skin. It was confirmed that the blood concentrations of ara-A and its metabolite 9-beta-D-arabinofuranosylhypoxanthine (ara-H) in hairless mice are controlled by the permeability of the controlling membrane in the transdermal patch. Furthermore, these blood concentrations were found to closely agree with the values obtained from theoretical model calculations. Finally, but importantly, the "micropharmacokinetic" behavior of ara-A in cutaneous tissue could also be predicted. These results suggest that the transdermal patch may be employed in dermal and transdermal ara-A efficacy studies in the treatment of cutaneous herpes virus infections in hairless mice. PMID- 1784004 TI - Facile hydrolysis of mebeverine in vitro and in vivo: negligible circulating concentrations of the drug after oral administration. AB - The HPLC methods for the determination of plasma concentrations of the antispasmodic agent mebeverine (0.01-10 micrograms/mL) and its hydrolysis product veratric acid (0.1-50 micrograms/mL) are presented. Mebeverine was demonstrated to hydrolyze readily in fresh unbuffered human and rat plasma samples ex vivo. Hydrolysis in human plasma was completely inhibited in the presence of the esterase inhibitor physostigmine sulfate, at a concentration of 130 micrograms/mL. However, the inhibitor was only partially effective in blocking mebeverine hydrolysis in rat plasma. After oral administration of mebeverine.HCl (270 mg) to fasted human volunteers, measurable concentrations of the drug were not found in plasma. By contrast, the metabolite veratric acid achieved considerable concentrations (mean peak plasma concentration of 13.5 micrograms/mL at 40-80 min). After iv administration of mebeverine.HCl (2 mg) to rats, the drug was rapidly eliminated from plasma (mean half-life of 29 min) with simultaneous appearance of veratric acid (mean peak plasma concentration of 1.80 micrograms/mL at 15-30 min). However, after oral administration of the same dose, only traces of mebeverine were found in plasma, with the exception of one rat. Veratric acid again achieved considerable concentrations (mean peak plasma concentration of 0.90 micrograms/mL at 15 min-4 h). The results show that mebeverine undergoes rapid and extensive first-pass metabolism involving hydrolysis of the ester function, and that negligible circulating concentrations of the parent drug are found in humans. PMID- 1784003 TI - Kinetics of aluminum in rats. II: Dose-dependent urinary and biliary excretion. AB - Previous iv studies from our laboratories have shown that the disappearance half life of blood aluminum increased with dose. Experiments were initiated to determine if saturation of biliary and/or urinary excretion could be responsible for this dose-dependent behavior. Biliary aluminum excretion (0-12 h) accounted for less than 1% of the injected amount at 0.1- and 1.0-mg/kg doses. During the same interval, urinary excretion accounted for 16.7 +/- 2.66 and 8.85 +/- 2.2% of administered dose at the low and high doses, respectively (p less than 0.05); corresponding long term (0 to 13 or 22 days) urinary recoveries were 37.6 +/- 3.67 and 28.4 +/- 1.88% of the injected dose (p less than 0.05), with most (66 70%) of the excretion occurring in the first 24 h. This is consistent with many previous reports showing that urinary excretion is one major elimination pathway for aluminum. Both biliary and urinary clearances decreased with increasing blood aluminum concentration; the biliary and urinary clearance values at low concentrations (500-900 ng/mL) were approximately four- and threefold higher than the corresponding values at higher concentrations (10,000-12,000 ng/mL), respectively. It appears that this apparent saturability of biliary clearance may be due to concentration-dependent of transfer from blood to liver, rather than from liver to bile. In vitro ultrafiltration studies support the hypothesis that decreases in urinary clearance were due to decreased filterability of aluminum at the glomerulus as its blood concentration was increased.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1784005 TI - Preparation and evaluation of Eudragit gels. I: Eudragit organogels containing drugs as rectal sustained-release preparations. AB - New organogels containing salicylic acid, sodium salicylate, procaine, and ketoprofen were prepared by using Eudragit L and S, and propylene glycol. The physical properties (e.g., penetration and extensibility) of the organogels were affected considerably by the incorporation of a basic drug, such as procaine, rather than an acidic drug, such as salicylic acid. In in vivo evaluation using rabbits, it was found that 30% Eudragit L organogels containing 1.25% (w/w) salicylic acid or 2.5% (w/w) ketoprofen showed sustained plasma salicylic acid or ketoprofen levels and almost the same AUC as compared with Witepsol H-15 suppositories containing these drugs. Furthermore, the relative bioavailability for salicylic acid and ketoprofen released from 30% Eudragit L organogels, with 10% (w/w) linolic acid or oleic acid as absorption enhancer, increased to 1.55 1.75- and 1.46-1.85-fold, respectively, compared with 30% Eudragit L organogels without these unsaturated fatty acids. PMID- 1784006 TI - Quantitative structure-activity relationships of the metabolism of drugs by uridine diphosphate glucuronosyltransferase. AB - Quantitative structure-activity relationships of the metabolism of drugs by uridine diphosphate (UDP)-glucuronosyltransferase have been investigated. It is observed that most of the variation in the rate of glucuronidation of phenols, thiols, and some other miscellaneous compounds can be accounted for by the lipophilic property of the molecules. The results are consistent with the previous finding with primary and secondary alcohols, and benzoic acids. The optimum lipophilicity for these compounds undergoing metabolism by UDP glucuronosyltransferase appears to be a log P of 2. PMID- 1784007 TI - Statistical analysis of the extended Hansen method using the bootstrap technique. AB - In this study, simple bootstrap techniques are combined with the extended Hansen solubility approach to calculate biases, standard errors, and confidence limits of the partial solubility parameters and to obtain bias-corrected values for these solubility parameters. The bootstrap method is rather new in its application to problems in the pharmaceutical sciences and, therefore, is described here in some detail. This method provides measures of the statistical variation of ratios of regression coefficients without making unwarranted assumptions about data variability. The bootstrap can be used in many statistical packages such as MINITAB, SPSS, SAS, BMDP, or GLIM, all of which are widely available, and could be useful in other areas of the pharmaceutical sciences where regression analysis is employed. PMID- 1784008 TI - Reparameterization to implementing kinetic constraints in pharmacokinetics. AB - Polyexponential expressions are widely used in pharmacokinetic system analysis to represent various functions and pharmacokinetic responses. It is often necessary to impose simple constraints (e.g., non-negativity, monotonicity, etc.) to make such expressions agree with obvious kinetic conditions or general assumptions made. Enforcement of such constraints is typically obtained by specifying upper and/or lower limits for the polyexponential parameters in the curve fitting procedure. However, this method often limits the search to only a subset of all possible polyexponentials expressions which satisfy the specified constraints. A less restricted search may be performed by not specifying a lower or upper limit on some polyexponential parameters, but this may occasionally result in violations of the constraints. A reparameterization approach is presented to overcome the above problems. Various schemes are presented that allow a completely unrestricted search to be done among all possible polyexponential expressions which satisfy various constraint configurations. The practical significance of this approach is discussed and demonstrated with some examples. It is pointed out that evaluation of various pharmacokinetic processes in the context of specific models or families of models may intrinsically impose certain constraints that may not be justified when the kinetics is analyzed in a more general system analysis context. The application of system analysis principles in conjuction with an enforcement of functional constraints in a "model-free" context by reparameterization appears to be a rational alternative to current methods. PMID- 1784009 TI - Heat of fusion measurement of a low melting polymorph of carbamazepine that undergoes multiple-phase changes during differential scanning calorimetry analysis. AB - Two polymorphs of carbamazepine that melt at 176 and 189 degrees C and are known to be enantiotropic have been characterized more fully than in previous reports. For the first time, a value for the heat of fusion (29.3 kJ/mol) of the lower melting form is estimated, even though single melting DSC endotherms were not obtained. A method is described for summing the heat flows of intermediate transitions that occur when low melting carbamazepine is heated to a temperature where it will remain melted. The method should have general applicability in studies of polymorphs. Other characteristics of the carbamazepine enantiotropic pair are reported, including the transition temperature (71 degrees C). PMID- 1784010 TI - A new method of dissolution in vitro, the "Bio-Dis" apparatus: comparison with the rotating bottle method and in vitro: in vivo correlations. AB - The aim was to study a new method of dissolution in vitro, the "Bio-Dis" apparatus, and to compare it with the classical rotating bottle method. Several theophylline controlled-release drug dosage forms were studied. Dissolution testing was performed in increasing pH in standard conditions and after treatment with peanut oil in order to simulate high fat meals and to correlate the in vitro percent dissolved with the in vivo results obtained. The in vivo study was carried out on three groups of healthy volunteers receiving each dosage form in a randomized order just before a high fat breakfast or in the fasting state. The in vitro percent dissolved obtained was compared with those published results obtained with rotating bottles. A linear relationship was established between these results. From the in vivo absorbed percentages calculated according to the Wagner-Nelson method, a linear relation was found between the in vivo percent absorbed and the in vitro percent dissolved in the different conditions. The relationships observed are similar for all the forms under both conditions. The "Bio-Dis" offers advantages over the rotating bottle method. The study reported allows this dissolution apparatus to be proposed as an alternative to the rotating bottle apparatus. PMID- 1784011 TI - X-ray structural studies and physicochemical characterization of (E)-6-(3,4 dimethoxyphenyl)-1-ethyl-4-mesitylimino-3-methyl- 3,4-dihydro-2(1H)-pyrimidinone polymorphs. AB - The polymorphism of (E)-6-(3,4-dimethoxyphenyl)-1-ethyl-4-mesitylimino-3-methyl 3,4-di hydro- 2(1 H)-pyrimidinone (FK664; 1) was characterized by using X-ray powder diffractometry, differential scanning calorimetry (DSC), and IR spectroscopy. Structures of two polymorphs (Forms A and B) were determined by X ray crystallographic analysis. Form A crystallized in the monoclinic space group P2(1)/c, with a = 13.504(2), b = 6.733(1), c = 24.910(8) A, beta = 96.55(4) degrees, z = 4, and dcal = 1.203 g/cm3, while Form B crystallized in the same space group, with a = 8.067(2), b = 15.128(4), c = 18.657(4) A, beta = 102.34(3) degrees, z = 4, and dcal = 1.216 g/cm3. The conformational features of 1 were very similar between the two polymorphs. Compound 1, in both crystal forms, took an energetically reasonable conformation in three rigid planes, such as 2 pyrimidone, trimethylphenyl, and dimethoxyphenyl rings, but the molecules were packed in different ways between the two polymorphs. In the Form B crystal, a short contact was possible, to form pi-pi interactions between two dimethoxyphenyl groups related with the inversion center in the crystal lattice; this interaction seems to contribute to stabilizing the crystal structure of Form B. Both Forms A and B showed only one endothermic peak due to fusion at 115 and 140 degrees C, respectively, on the DSC thermograms; therefore, it is suggested that there are no transition points between the two polymorphs. The heats of fusion obtained from the DSC thermograms were 33.2(2) kJ/mol for Form A and 36.8(1) kJ/mol for Form B.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1784012 TI - Congenital cleft foot deformity (split foot or lobster claw). AB - A case of congenital cleft foot deformity, also known as lobster claw or split foot, is presented. The condition is rare. A review of the literature reveals that this deformity will often coexist as part of a constellation of congenital and familial abnormalities. Surgical correction of the cleft foot is difficult and often deferred. PMID- 1784013 TI - Reflex sympathetic dystrophy. Objective clinical signs in diagnosis and treatment. AB - Diagnosis and follow-up treatment of reflex sympathetic dystrophy is difficult because of the subjective, nonspecific nature of its primary symptom, burning pain. Early diagnosis and aggressive treatment of reflex sympathetic dystrophy with epidural nerve blocks improves clinical resolution. Temperature difference between extremities and dependent cyanosis are reliable objective signs for clinical diagnosis and the evaluation of progress for treatment for reflex sympathetic dystrophy. PMID- 1784014 TI - Lower extremity cycling biomechanics. A review and theoretical discussion. AB - An updated review of cycling biomechanics of the lower extremity is presented. Special attention is directed toward the known data pertaining to foot function. A theoretical discussion on foot function during cycling and its possible link to knee injury is also presented. It is suggested that supinatory and pronatory moments applied to the foot during cycling result in referral of adverse forces to the knee. PMID- 1784015 TI - Digital fractures. A comprehensive review. AB - Fractures of the phalanges of the feet are the most common types of injury to the forefoot. There is, however, little available literature concerning pedal digital fractures. There is a misconception that fractured toes will heal by themselves. In fact, mistreated digital fractures can lead to many painful and serious complications. A review of the classifications, mechanisms of injury, clinical presentation, complications, and various treatments of digital fractures is presented. PMID- 1784016 TI - Management of keloids and hypertrophic scars. AB - Keloids and hypertrophic scars may complicate elective foot surgery. Differentiation between these two entities is important before treatment is contemplated. The authors review current theories on the etiology of these lesions and outline various treatment options. PMID- 1784017 TI - Cutaneous foot depigmentation following an intra-articular steroid injection. AB - Local skin depigmentation is a potentially troublesome side effect of local steroid injection. Although many authors believe that it is a rare occurrence, this rarity may be a result of the low number of cases that are actually reported. The authors are of the opinion that the practitioner should take the time to explain depigmentation as a possible side effect of local steroid injection to those patients whose skin color places them at cosmetic risk. PMID- 1784018 TI - Hallux hammer toe secondary to pseudomonas osteomyelitis. AB - The authors present two cases of resultant hallux hammer toe secondary to the definitive treatment of hallux sesamoidal osteomyelitis. Pseudomonas osteomyelitis developed in both cases following puncture wounds to the first metatarsophalangeal joint complex. The authors also review the literature on pseudomonas osteomyelitis secondary to puncture wounds and the development of hallux hammer toe after removal of the involved sesamoid bones. PMID- 1784019 TI - Idiopathic diabetic bullosum. A case report. AB - The authors describe a case in which an 88-year-old black male with a long standing history of diabetes, blindness, and dialysis therapy presented with idiopathic diabetic bullosum of the left foot distal extremities. The lesions usually are intraepidermal and resolve spontaneously over a period of weeks with no resulting scar formation. The lesions are highly recurrent. In this specific case, the long healing time may be attributed to the age of the patient as well as the decrease in immune and systemic response to injury, weakened by dialysis therapy and his poor arterial status. PMID- 1784020 TI - AIDS and AIDS-related diseases. Implications for the podiatric physician and patient. PMID- 1784021 TI - Effect of induction-delivery and uterine-delivery on apgar scoring of the newborn. AB - Very short or prolonged induction-delivery interval (i.e. less than 5 minutes or more than 15 minutes) and uterine-delivery interval of more than 90 seconds has a definite effect on the apgar scoring of a newborn especially when general anaesthesia is administered as compared to regional anaesthesia for caesarean section. PMID- 1784022 TI - Effect of ingestion of raw garlic on serum cholesterol level, clotting time and fibrinolytic activity in normal subjects. AB - The effect of raw garlic on serum cholesterol, fibrinolytic activity and clotting time was studied in 50 medical students of the age group of 17 to 22 years before and after feeding raw garlic. All pre-experimental values ranged within normal limits. The volunteers were then divided into experimental and control groups. The subjects of the experimental group were given 10 gm of raw garlic daily after breakfast for two months. Fasting blood samples of all the subjects were investigated after two months. In the control group, there was no significant change in any of the above parameters. In the experimental group, there was a significant decrease in serum cholesterol and an increase in clotting time and fibrinolytic activity. Hence, garlic may be an useful agent in prevention of thromboembolic phenomenon. PMID- 1784023 TI - Beneficial effects of Allium sativum, Allium cepa and Commiphora mukul on experimental hyperlipidemia and atherosclerosis--a comparative evaluation. AB - Oral administration of petroleum ether extract of Allium sativum, Allium cepa and ethylacetate extract of Commiphora mukul in albino rats significantly prevented rise in serum cholesterol and serum triglyceride level, caused by atherogenic diet. All the three agents were also found to confer significant protection against atherogenic diet induced atherosclerosis. PMID- 1784024 TI - Rupture uterus: changing trends in etiology and management. AB - Sixty-four cases of rupture uterus which occurred during the period 1980-89 were studied and compared with 70 cases in the preceding decade (1970-79). The changing trends in etiological factors and management of this condition have been demonstrated. While spontaneous rupture continued to account for about two-thirds of the cases (70.3%), the incidence of traumatic rupture uterus has become less than half, from 17.1 to 7.8%, and that of scar rupture has increased to more than double (from 11.4 to 23.4%). As regards management, there are improved results seen with conservative repair of the uterus. It was also seen that a subtotal hysterectomy was more commonly resorted to than total hysterectomy in the later decade. There was a decrease in the overall morbidity from 42.8 to 35.9% and also in the mortality rate from 24.3 to 18.7%. PMID- 1784025 TI - Developmental anomalies associated with hypospadias. AB - Hundred and thirty patients with hypospadias were studied between 1983 and 1990, with an aim of analysing the associated anomalies in these patients. Urogenital anomalies were observed in 30% and extra-urogenital anomalies were noted in 16%. Undescended testis was the most frequently seen anomaly, having been noted in 6.9% of 130 cases. Vesico-ureteral reflux was present in 5.4% and inguinal hernia in 3.8%. The incidence of these anomalies increased in proportion to the severity of penile deformity. The present article emphasizes the need for systemic urological and endocrinal examination, especially in severe cases of hypospadias. PMID- 1784026 TI - Surgical management of tetralogy of Fallot with anomalous coronary artery. AB - Fifteen patients of tetralogy of Fallot with an anomalous left anterior descending coronary artery arising from the right coronary artery were operated during a period of 1982 and 1988. One patient died in the early post-operative period (6.6%). Two patients had a hemodynamically insignificant residual ventricular septal defect. Post-operative peak systolic pressure gradient between the right ventricle and pulmonary artery ranged from 10 mm Hg to 40 mm Hg (mean 24 mm Hg) in 4 patients. There was no incidence of inadvertent coronary artery division. PMID- 1784027 TI - Results of pars plana vitrectomy in 24 cases of endophthalmitis. AB - Twenty four cases of endophthalmitis were subjected to pars plana vitrectomy. A final vitreous clearance was obtained in 62.50% cases. Visual improvement occurred in 41.67% cases. It was concluded that prompt detection and early and vigorous therapy--medical and surgical--is the mainstay in the management of endophthalmitis. PMID- 1784028 TI - Can we dispense with Ayurvedic samskaras? AB - Crude aconite is an extremely lethal substance. However, the science of Ayurveda looks upon aconite as a therapeutic entity. Crude aconite is always processed i.e. it undergoes 'samskaras' before being utilised in the Ayurvedic formulations. This study was undertaken in mice, to ascertain whether 'processed' aconite is less toxic as compared to the crude or unprocessed one. It was seen that crude aconite was significantly toxic to mice (100% mortality at a dose of 2.6 mg/mouse) whereas the fully processed aconite was absolutely non-toxic (no mortality at a dose even 8 times as high as that of crude aconite). Further, all the steps in the processing were essential for complete detoxification. PMID- 1784029 TI - Micromethod for PMN function studies in neonates. AB - Polymorphonuclear neutrophils play an important role in host defense mechanism. To assess PMN function in neonate a micromethod using only a few drops of blood was standardised. PMN adherent to coverslip were incubated with bacteria and using a differential staining with Acridine Orange (AO) phagocytic and bactericidal capacity were estimated. PMID- 1784030 TI - Ribavirin in acute viral hepatitis. AB - Sixty-four patients suffering from acute viral hepatitis (excluding those suffering from hepatitis B) were selected for the double blind clinical trial. They were randomly allocated to either ribavirin therapy (200 mg four times a day) or placebo. Four patients were lost to follow up and therefore final analysis was carried out on 60 patients (thirty had received ribavirin and the rest placebo). Patients receiving ribavirin showed significant rapid improvement, with the disappearance of annoying symptoms (e.g., nausea, vomiting, etc) and return of good appetite; moreover, the abnormal blood parameters showed significant rapid changes towards normal values in ribavirin treated patients as compared to those observed in placebo group. Ribavirin was well tolerated and there were no side effects. Since acute viral hepatitis is endemic with outbreaks of epidemics in many areas at various times and as yet there is no effective anti viral drug available with the physicians in India, ribavirin is indeed a most welcome drug for its therapy. PMID- 1784031 TI - Neuroleptic malignant syndrome (a case report). AB - An adult schizophrenic patient developed neuroleptic malignant syndrome following treatment with parenteral haloperidol. An early recognition of the syndrome, immediate discontinuation of the offending agent and prompt treatment with bromocriptine and lorazepam produced a good recovery. The various features of the case are discussed in view of the potential lethality of the syndrome. PMID- 1784032 TI - Klinefelter's syndrome with unelevated serum gonadotropin levels (a case report). AB - Two cases of Klinefelter's syndrome with 47 XXY karyotype associated with unelevated follicular stimulating hormone (FSH) and luteinizing hormone (LH) levels are reported. The literature is briefly reviewed. PMID- 1784033 TI - Malignant hypertension due to reflux nephropathy in an adolescent (a case report). AB - Malignant hypertension in an adolescent due to reflux nephropathy (RN) is rare. Here we are presenting such a case unassociated with the usual symptoms of hypertension. The problems of diagnosis, management, prognosis and prevention of RN are discussed with a review of relevant literature. PMID- 1784034 TI - Ileo-caeco-colic intussusception due to extensive benign lymphoid hyperplasia of the ileo-caecal region (a case report). AB - An unusual case of extensive benign lymphoid hyperplasia of the ileo-caecal region causing ileo-caeco-colic intussusception is presented here, with a review of relevant literature. The diagnosis of intussusception was reached with the help of an abdominal ultrasound and barium enema. Histopathology of the resected specimen, revealed lymphoid hyperplasia. PMID- 1784035 TI - Traumatic ischaemic optic neuropathy (a case report). AB - A 22-year-old patient presented with a clinical picture of unilateral optic neuropathy following blunt trauma to the orbit. Clinical findings, fundus fluorescein angiography and neurophysiological studies were suggestive of an ischaemia, a rare etiology. PMID- 1784036 TI - Anaesthetic management of a patient with organophosphorus poisoning (a case report). AB - Anaesthesiologist may encounter problems while anaesthetising a patient following organophosphorus poisoning. These problems and the necessary precaution are described. PMID- 1784037 TI - Choledochal cyst (a case report). AB - A case of choledochal cyst is presented. The cyst was found in an infant aged 40 days and was treated surgically by resection followed by Roux en-Y hepaticojejunostomy. PMID- 1784038 TI - The radiology of juvenile rheumatoid arthritis. A review of the English language literature. AB - The radiologic abnormalities seen in patients with juvenile rheumatoid arthritis (JRA) include disturbances of growth, various types of joint destruction, abnormalities of bone density, periostitis, and soft tissue abnormalities. We review the English language literature, which deals with the radiologic abnormalities in general, and at specific sites. We also review briefly radiologic abnormalities seen in other organ systems. The role of the other imaging modalities in the assessment of JRA is discussed. PMID- 1784039 TI - Human disease caused by dog heartworm. AB - Pulmonary infection with D. immitis is an infrequently reported cause of lung disease in humans. Approximately 80 cases have been reported in the United States, with increasing numbers reported in recent years. The largest single series from one institution is a series of 6 patients from Ochsner Clinic in New Orleans, Louisiana. Although our series consisted of 3 females and no males, the disease is detected and diagnosed in males twice as often. The usual age range is 40 to 60 years. No case has yet been seen in children. Unfortunately, it is essentially impossible to diagnose by clinical means. The definitive diagnosis can be made quite easily, however, by histologic examination which reveals the worm within the lesion. It should be noted that the parasites are seen in a minority of sections; therefore, diagnosis may be missed. As a result, given the setting of pulmonary infarction with granulomatous response, multiple sections of the lesion should be examined. Other larval worms also occurring in the lung which might be confused with D. immitis include Enterobius vermicularis, Wuchereria bancrofti, Brugia malayi, and Onchocerca volvulus. These, however, are much less common and are morphologically distinct from D. immitis. Also, it is easily distinguished from ascarids, strongyloids, and hookworm larvae which are much smaller than the dirofilarial worms and do not contain reproductive organs. In North American, the occurrence of fragments of nematode within a pulmonary infarct is essentially pathognomonic for PD. PMID- 1784040 TI - Initial assessment of the rape victim. PMID- 1784041 TI - Disposal of medical/infectious waste: its present status in Mississippi. PMID- 1784042 TI - AIDS and homosexuality. PMID- 1784043 TI - Altered lymphocyte subsets and natural killer cells of patients with obstructive jaundice in perioperative period. AB - Sepsis is a common and occasionally lethal complication of obstructive jaundice. The reasons for the increased susceptibility to infection are not fully understood. This study was conducted to examine lymphocyte subsets and natural killer cells of patients with obstructive jaundice in perioperative period. In these patients, when compared with normal controls, there was a significant reduction in the percentage of Leu 4 (pan T lymphocytes), Leu 3a (T helper cells) and Leu 7 (natural killer cells) before operation, and the immune suppression induced by surgical operation was more marked and persistent. PMID- 1784044 TI - Effect of arginine on immune function in rats with obstructive jaundice. AB - In this study we used an experimental model produced by bile duct ligation (BDL) in rats to demonstrate relation between immune function and susceptibility to infection associated with obstructive jaundice and immunoregulatory effect of arginine in BDL rats. Our experimental results showed that thymus weight, content of lymphocytes in thymus and responsiveness to Con A in vitro were dramatically reduced in BDL rats as compared to rats with sham operation and that the impairment of lymphocyte function was significantly related to the susceptibility to infection. Arginine, as a T cell stimulator, markedly improved immune function and decreased susceptibility to infection of BDL rats. PMID- 1784045 TI - Experiences in intravenous urokinase treatment of 100 acute myocardial infarction patients. AB - From 1980 to 1990 we treated 100 cases of AMI with i.v. urokinase (UK). According to the way of management and the dosage administered all these cases were divided into three groups: first stage of small dosage, second stage of trial big dosage, and third stage of comprehensive dosage. 36 patients of the first stage were treated with small dosage, 1-20,000 U b.i.d. for 1 week. 75% of the UK-treated and only 17% of the control group obtained relief of pain. Decrease of elevated ST reaching base line was 50 vs 8%, and FDP increased in 94%. 22 patients of the second stage were undergoing trial of big dosage. They were subdivided into larger dosage (more than 800,000 U) and smaller dosage (less than 300,000 U) groups. From the larger dosage group, 2 patients showed definite sign of recanalization, but unexpectedly 2 patients died of cardiac rupture. Since the recanalization rate of larger dosage group was 42.9%, but no case showed sign of recanalization in smaller dosage group, we are of the opinion that the dose of 800,000 U is rational for patients with symptoms' onset less than 3 h. Cardiac rupture was thought to be mostly due to reperfusion injury. Thus we designed the third stage of comprehensive dosage of UK. In this stage we used different dosage of UK and different ways of administration in 52 patients, based on the different symptoms' onset, so as to bring the effect of UK in full play. The aim of using UK is chiefly fibrinolysis as well as improvement of blood viscosity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1784046 TI - Studies on the antifertility components from Marsdenia koi. AB - By random screening test, Marsdenia koi was found to have antifertility activity on SD rat. From MeOH extracts of this plant two steroidal glycosides, marsdekoiside A and B, were isolated, and their structures were elucidated on the basis of spectral evidence and by comparison of the hydrolysis products with the authentic samples. Both are newly identified compounds, and marsdekoiside A has good antifertility activity. PMID- 1784047 TI - A histological observation on the flexor tendon healing within intact sheath. AB - In this study we allowed the sutured chicken flexor tendons to glide back into the uninjured sheaths in order to keep the healing process of flexor tendon from being affected by the healing of surrounding wounded tissues. By observing 12 chickens, 72 digits, with light microscope and transmission electron microscope, it was found that the visceral and parietal synovium of the sheath were the regions with earliest and most active cell proliferation and the major source of repairing cells during the healing process of the flexor tendon. Tendon cells had the ability of intrinsic healing, but delayed as compared to synovium cells. Adhesion between intact parietal synovium and healing tendon and its surrounding tissue could not be avoided. PMID- 1784048 TI - Hemodynamic effects of high frequency jet ventilation during acute hypovolemia. AB - The hemodynamic effects of high frequency jet ventilation (HFJV) at three different rates (60, 100, 200/min) and at rate 200/min combined with jet sighs 12/min (HFJV-200 + 12S) during two degrees of hemorrhagic hypovolemia were investigated in dogs. Also, the results were compared with those of intermittent positive pressure ventilation (IPPV). Two degrees of hypovolemia were produced by bleeding dogs until mean arterial pressure was 25% or 50% lower than basic value respectively. At both periods of hypovolemia, HFJV at rate 60 or 100 were found to have better hemodynamic effects than IPPV due to their lower airway pressures. However, HFJV at rate 200 or HFJV-200 + 12S did not demonstrate the same superiority because of their higher airway pressure, the latter even represented a tendency of worse hemodynamic effect than IPPV. The best cardiovascular effect was seen during HFJV at rate 100. Our study indicated that the hemodynamic effect of HFJV better than that of IPPV during acute hypovolemia can be seen only when proper ventilatory settings are chosen. Jet sighs at 12/min added to usual HFJV are not beneficial to circulatory function. It is recommended that HFJV at a rate below 200/min without jet sighs be used in patients who need respiratory support during acute hypovolemia or shock. PMID- 1784049 TI - Purification of rat liver microsomal glutathione transferase. AB - The rat liver microsomal glutathione transferase was activated by N ethylmaleimide, solubilized by Triton X-100 and purified by chromatography on hydroxyapatite and CM Sephadex C-50. A 28-fold purification resulted in a 38% yield. The purified protein moved as a band with an apparent molecular weight of 14,000 on sodium dodecyl sulphate polyacrylamide gel electrophoresis and appeared to be nearly homogeneous. The N-terminal amino acid of the purified enzyme was alanine, identified by the dansyl method. Optimum pH and temperature were 6.8 and 30 degrees C, respectively. PMID- 1784050 TI - Study on mutagenicity and identification of organic pollutants in wastewater of industrial area. AB - In this study, wastewater samples from three industrial wastewater channels and 12 related factories were collected. Nonvolatile organic chemicals were concentrated on H-103 resin and analysed by GC/MS/DS techniques. The mutagenicity of organic extracts from the samples was examined by using S. typhimurium assay (Ames test). The results of both Ames test and chemical analysis showed that the mutagenic compounds in the Loujia Channel mainly come from Dyestuff Factory, and that Pharmaceutical Factory is a main pollution source of mutagenic compounds for the Xindun Channel. Our experimental results also showed that it is necessary to examine the mutagenicity of industrial wastewater by using short term bioassay for evaluating long-term effect of industrial wastewater on human health. PMID- 1784051 TI - The contraceptive effect of breast feeding--an update. PMID- 1784052 TI - A comparative study of cells and anti-microbial proteins in colostrum of mothers delivering pre- and full-term babies. AB - The different anti-infective factors in the colostrum of 25 mothers delivering pre-term (33.04 +/- 2.18 weeks gestation) and 10 mothers full delivering term (39.1 +/- 0.87 weeks gestation) babies were measured. The mothers of both the groups were comparable with respect to age, parity, nutrition, and haemoglobulin levels. Although the mean volume of colostrum (12 hours) was significantly lower in pre-term (32.28 +/- 7.92 ml) than in full term (44 +/- 4.83 ml) colostrum (P less than 0.05), the concentrations of total protein, sIgA, lysozyme, and lactoferrin were significantly higher in preterm than in full-term colostrum. IgG and IgM levels were similar in both the groups of colostrum. In both the groups, s-IgA was the predominant immunoglobulin. Moreover, the absolute counts of total cells, macrophages, lymphocytes, and neutrophils were significantly higher in pre term compared to full-term colostrum. Macrophage were the predominant cells. Degree of prematurity has been found to have profound influence on the volume, protein concentration, and cell and macrophage counts of colostrum. Thus, more pre-term the newborn was, the mother produced less amount of colostrum. Total protein concentration and absolute cell count were significantly higher in the colostrum samples of mothers delivering between 28 and 32 weeks as compared to those delivering between 33 and 36 weeks. It is concluded that the colostrum of mothers delivering pre-term, though less in amount, is rich in soluble anti infective agents and cells. The higher concentration of protective factors compensates for the limited capacity of milk intake in the pre-term infant. PMID- 1784053 TI - After rehydration: what happens to the child? AB - Three-hundred infants and toddlers with diarrhoea were followed up for 5 days after initial rehydration with oral rehydration solution (ORS). When an average of 300-340 ml per day was given at home (520 ml if the diarrhoea was watery), only two children required re-hospitalization; one other child died whose voluminous losses should not have been treated at home. Fifteen per cent of the children still had watery diarrhoea and vomiting by the fifth day, perhaps as a result of multiple drug therapy. Continued feeding, especially breast milk and cereal grains, should reduce the duration of diarrhoea and vomiting (and perhaps the number of drugs). The amount of time a mother can spend giving ORS ultimately limits the amount a child receives. PMID- 1784054 TI - Maternal chest radiography as supporting evidence for the diagnosis of tuberculosis in childhood. AB - Routine chest radiography of the mothers of 163 children investigated for possible tuberculosis accompanied by sputum culture from those mothers with suspicious chest radiographs identified active pulmonary tuberculosis in 12 (10 per cent) of the mothers of the 117 children with probable (49 cases) and confirmed (68 cases) tuberculosis. All but one of the cases of active maternal tuberculosis were identified in the mothers of children less than 1 1/2 years of age. Chest radiography of the mothers of children less than 1 1/2 years of age will aid the diagnosis of tuberculosis in the child and expedite the reduction of the infectious pool of active pulmonary tuberculosis cases in adults in the community. PMID- 1784055 TI - HLA antigen frequencies in children with cardiac disease in Cairo. AB - The study of Histocompatibility Locus Antigen (HLA) frequencies in 48 cases with congenital heart disease (CHD) in children in Cairo showed high incidence of A10. Cases with atrial septal defect have shown a significant association with A3 besides A10. There is also a significant association between B12-45 and right loop anomalies (Fallot's and pulmonary stenosis) together with A10. On the other hand, children with rheumatic heart disease have shown strong positive association with HLA group B8 and negative association with A28. PMID- 1784056 TI - Acute purulent pericarditis in Omani children. AB - A total of eight children admitted to the Royal Hospital, Muscat with purulent pericardial effusions were analysed. Six of the cases were in children less than 2 years of age. Five of the eight children had positive blood cultures: Haemophilus influenzae was cultured from two patients, Streptococcus pneumoniae from one patient, E. coli from one patient and Streptococcus viridans from the remaining child. In three children both blood and pericardial cultures were sterile; two of these children had received prior antibiotics. In our experience early diagnosis by cross-sectional echocardiography followed by adequate surgical drainage and parenteral administration of broad spectrum antibiotics helped prevent the high morbidity and mortality usually reported in this condition in developing countries. PMID- 1784057 TI - Impact of preschool education component in Integrated Child Development Services programme on the cognitive development of children. AB - Integrated Child Development Services (ICDS) is India's most comprehensive programme to increase the survival rate and enhance the health, nutrition, and learning opportunities of pre-school children and their mothers through a package of services. The present study was carried out to measure the impact of the preschool education component of the ICDS on the cognitive development of children in the age group of 3-5 years. The study design used was case/control (ICDS attending children v. Non-ICDS). Results of the study revealed the ICDS Anganwadi attendance had positive influence on the cognitive development of children. The mean cognitive score of the attenders was 40.7 as against a mean score of 30.3 in the case of non-attenders. PMID- 1784058 TI - Congenital hepatic fibrosis in Saudi Arabia. AB - Congenital hepatic fibrosis (CHF) is a recognized cause of portal hypertension with oesophageal varices, gastro-intestinal haemorrhage and cholangitis in children without significant impairment of hepatic or renal function. This report describes the varied clinical presentation of CHF as seen at King Faisal Specialist Hospital and Research Centre (KFSH & RC) and emphasizes the clinical patterns that should enable a pediatrician to consider the diagnosis. Fourteen children with CHF were diagnosed between 1981 and 1988. The age at presentation ranged from 1.8-14 years (mean: 7.5 years); clinical manifestations at diagnosis were splenomegaly (12), hepatomegaly (11), failure to thrive (10), marked abdominal distention (4), and fever (4). Liver function tests were normal except for high alkaline phosphatase. Eight patients had polycystic kidneys confirmed on ultrasound examination. Upper gastro-intestinal endoscopy showed oesophageal varices of variable severity in all eight patients examined. Splenoportography revealed splenic vein occlusion in one patient. One patient died within days of admission with convulsions, coma, and aspiration pneumonia. One patient was lost to follow-up. The remaining 12 patients are all alive and receive regular follow up. Two patients required splenorenal shunt. In view of the prevalence of consanguinity in Saudi Arabia, the diagnosis of CHF should be considered in children with hepatomegaly despite normal liver function tests, and particularly in those with renal abnormalities and/or evidence of portal hypertension. PMID- 1784059 TI - Clinical implications of growth monitoring: experiences from Sierra Leone. AB - A 1-month survey of the growth records of children attending Under Fives' Clinics in urban Sierra Leone was performed. Current weight for age of all attendees (n = 877) revealed an overall 17 per cent to be less than 80 per cent reference weight for age (RWA). The 0-5-month-old groups had the lowest incidence (8 per cent) less than 80 per cent RWA and the 12-23-month-old had the highest incidence (31 per cent) less than 80 per cent RWA. Episodes of weight loss greater than 2 per cent of previous recorded weight (n = 299) were analysed retrospectively. The peak incidence (32 per cent) of an episode of weight loss was again in the 12-23 month-olds. Overall respiratory and malarial symptoms were associated with the greatest number of episodes. Dysentery was the most important symptom in the 12 23-month-old (other than multifactorial), was associated with severe degrees of weight loss and had the highest incidence of slow progress following treatment. Episodes of weight loss attributed to helminthic infection became increasingly evident with age. Following treatment, 75 per cent of children had returned to their pre-episodic centile within 6 weeks. PMID- 1784060 TI - Quality of survivals on conservative neonatal care. AB - Quantity as well as quality of survivals determine the performance of a neonatal centre. Our centre has succeeded in improving survival with low cost technology without compromising the quality. Neurodevelopmental handicap was low on a 1-year follow-up. No baby had retinopathy of prematurity or hearing deficit. Dropout rate has been high although comprising of mainly full-term or near-term babies with mild perinatal asphyxia or mild respiratory distress or requiring instrumentation during delivery. Longer follow-up is desirable. PMID- 1784061 TI - The Butajira rural health project in Ethiopia: mortality pattern of the under fives. AB - A total of 492 deaths of children below 5 years of age were registered during a 2 year period of demographic surveillance in a rural population of Ethiopia, where an epidemiologic study base population of 28,780 individuals was established in 1987. Data were collected by lay-reporters using a verbal autopsy method. The under-five cumulative mortality rate was 209 per 1000 children. When sub-divided into infants and children 1-4 years, the respective yearly mortality rates were 101 and 32.3 per 1000. There were considerable variations within the district by Peasants' Associations. Rural Lowlands experienced the highest mortality rates, especially for children 1-4 years. Mortality trends over a 2-year period indicate a significant increase for the child population, but not for infants. Similar trends were observed for boys and girls although the rates for boys were generally higher especially during infancy. More deaths occurred in the months of April, June, and July, and October and November indicating two peak seasons in both years. More deaths occurred in Peasant's Associations that were furthest from the health centre. Major probable causes of death were acute respiratory infections, measles, and diarrhoea. It is concluded that even in rural areas of a developing country it is possible to collect from mothers the much needed and valid fertility and mortality data through epidemiological surveillance by using lay-reporters. PMID- 1784062 TI - Study of tetanus neonatorum in Tanta Fever Hospital, 1988-1989. AB - Neonatal tetanus (NT) is the most under-reported fatal infectious disease. Ministry of Health statistics in Egypt reflect only 10% of NT cases. This study aims at evaluating the effect of the campaign to immunize pregnant women against tetanus in Gharbia governorate in Egypt. In this report it is shown that NT admission decreased sharply in 1989, compared to the previous years, and that the severity of the disease was also less. The value of a sentinel site is also demonstrated. To eliminate NT, however, educational programmes and better perinatal care are needed in addition to vaccination. PMID- 1784063 TI - Beyond adjustment. PMID- 1784064 TI - Prospects of eliminating neonatal tetanus in Nigeria by the year 1995. PMID- 1784065 TI - Microbiological evaluation of food samples sold to primary school children in Lagos, Nigeria. PMID- 1784066 TI - Antibody to PPD, BCG, H37 RV and antigen 5 in tuberculous meningitis. PMID- 1784067 TI - Ineffectiveness of vitamin E supplementation on growth and anaemia of prematurity. PMID- 1784068 TI - Pseudo allergy to milk in a neonate. PMID- 1784069 TI - Ocular findings and vitamin A levels in cases of malnutrition in the Sivas region of Turkey. PMID- 1784070 TI - [Clinical evaluation of a combination treatment with cefminox and fosfomycin for infections complicated in patients with hematological disorders]. AB - We evaluated clinical effects and toxicities of a combination treatment with cefminox (CMNX) and fosfomycin (FOM) for infections complicated with hematological disorders in 56 patients. Among those, 52 patients including 22 with malignant lymphoma, 19 with acute leukemia, and 11 with other hematological disorders were evaluable. Excellent and good responses were obtained in 33 (63.5%) of the 52 patients. This treatment was also effective in 5 of 9 cases in which granulocyte counts were less than 500/mm3 through the course of administration. Side effects were observed in only one patient. Mild nausea occurred but was not serious. These results indicate that the combination of CMNX and FOM is an effective and safe regimen for the treatment of infections complicated in patients with hematological disorders. PMID- 1784071 TI - [Treatment of gonococcal urethritis]. AB - Results of the treatment of 5 cases of males with uncomplicated gonoccocal urethritis using levofloxacin (LVFX, DR-3355), the L-type optical isomer of ofloxacin (OFLX), were compared with those treated with OFLX itself. Three hundred mg/day of LVFX or 600 mg/day of OFLX was given to each patient for 5 days. Both drugs showed excellent clinical results in all the patients. When MICs of the 2 drugs were compared against 57 isolated strains of Neisseria gonorrhoeae including 3 penicillinase-producing N. gonorrhoeae, it was found that MICs of LVFX were approximately one half of those of OFLX. PMID- 1784072 TI - [Flomoxef in neonates and young infants; clinical efficacy, pharmacokinetic evaluation and effect on the intestinal bacterial flora]. AB - Forty-three newborn and young infants including 13 low-birth-weight (LBW) infants were treated with flomoxef (FMOX) and the clinical efficacy and side effect were evaluated. The ages of the patients ranged from 0 to 99 days, and their body weights from 797 to 9,000 g. Dose levels were 10.5 to 48.5 mg/kg every 6 to 8 hours for 3 to 12 days. Those patients who responded to the FMOX treatment included 8 infants with sepsis, 14 with suspected sepsis, 6 with intrauterine infection, 2 with meningitis, 7 with pneumonia, 1 with staphylococcal scalded skin syndrome, 1 with epididymitis and 4 with urinary tract infections. The results were excellent in 17 and good in 22 patients. The drug was well tolerated, although diarrhea occurred in 2, slightly elevated serum concentrations of transaminases in 2, and eosinophilia and thrombocytosis in 1 patient each. Pharmacokinetic studies on FMOX with 20 mg/kg dose were done in 19 patients including 8 LBW infants. Serum concentrations at 15 minutes after intravenous bolus injection in five 1- to 6-day-old LBW, five 1- to 6-day-old and four 8- to 19-day-old mature infants were 52.6, 52.7 and 58.0 micrograms/ml, respectively, and those at 4 hours were 22.1, 13.3 and 5.2 micrograms/ml, respectively. Serum half-lives of the drug were 3.93, 2.29 and 1.62 hours, respectively, and excretion rates of this drug into urine in the first 6 hours after administration were 30.4, 45.1 and 58.7%, respectively. Mean serum concentrations just after intravenous 1-hour drip infusion in three 8- to 54-day old LBW and two 8- and 10-day-old mature infants, were 31.5 and 18.9 micrograms/ml, respectively, and those at 4 hours were 15.3 and 4.3 micrograms/ml, respectively. Serum half-lives of the drug were 2.88 and 1.75 hours, respectively, and excretion rates of the drug into urine in the first 6 hours were 22.6 and 47.5%, respectively. The cerebrospinal fluid level at 3 hours after a dose was 7.09 micrograms/ml on the second day of treatment in a patient with Staphylococcus aureus meningitis receiving 50 mg/kg of the drug every 6 hours per day. Its level at 1 hour after a dose was 3.52 micrograms/ml on the 8th day of treatment in the same patient. The influence of FMOX on the fecal flora was studied in 7 patients. The characteristic pattern observed during the drug administration was the disappearance of Bifidobacterium, the decrease or disappearance of Enterobacteriaceae and the preservation of Streptococcus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1784073 TI - [Pharmacokinetics and clinical efficacy of flomoxef in neonates]. AB - Clinical pharmacology and efficacy of flomoxef (FMOX) in neonates were investigated. And the following results were obtained. 1. Mean serum concentrations of FMOX at 30 minutes after administration were 24.3 micrograms/ml, 47.6 micrograms/ml, and 85.8 micrograms/ml at doses of 10 mg/kg, 20 mg/kg, and 40 mg/kg administered, respectively. 2. Mean serum half-lives of FMOX were 3.4 hours in 0-3 day-old neonates, and 2.6 hours in 4 day-old or older subjects. 3. A dose response was evident among different dose groups given 10 mg/kg, 20 mg/kg, and 40 mg/kg. 4. Urinary recovery rates of FMOX in the first 6 hours after administration ranged between 12.8 and 51.1%. 5. FMOX was effective in 7 out of 8 cases in which causative pathogens were identified. 6. Diarrhea was observed in 1 case as a side effect of the drug, but the symptom was relieved soon after the completion of the treatment. There was no case in which any abnormal laboratory results were observed. 7. FMOX has a broad spectrum of activities against Gram-positive and Gram-negative aerobes and anaerobes. It is stable against most of beta-lactamases. It was demonstrated to be highly effective in our study, and yet without any serious side effects. FMOX is therefore considered to be one of the useful agents of the first choice for the treatment of bacterial infections such as sepsis and urinary tract infections in neonates and infants. PMID- 1784074 TI - [Pharmacokinetic and clinical studies on flomoxef in neonates and premature infants]. AB - Studies were made on pharmacokinetics, clinical effects and influence on intestinal bacterial flora in neonates upon administration of flomoxef (FMOX), and the results obtained are summarized as follows: 1. Serum concentrations of FMOX after intravenous administration of 20 mg/kg/dose were 48.5 micrograms/ml in 30 minutes, 33.0 micrograms/ml in 1 hour and 7.3 micrograms/ml in 6 hours. The T 1/2 was 2.7 hours. FMOX at a dose of 40 mg/kg was given to only one new born baby on the 1st day after birth, and serum concentrations were 73.6 micrograms/ml in 30 minutes, 55.9 micrograms/ml in 1 hour and 16.9 micrograms/ml in 6 hours. The T 1/2 was 4.60 hours. 2. FMOX was administered to 21 neonates between 0 and 32 days of age. Clinical effects were evaluable in 8 of 21 cases. The results were excellent in 2 cases, good in 5 cases and poor in 1 case. Of the 21 cases, diarrhea in 1 case, elevation of eosinophile in 2 cases (9.5%), elevation of platelet count in 3 cases (14.3%), and elevation of GOT in 2 cases (9.5%) were recognized during treatment. 3. FMOX was detected in feces at levels of 0.84-44.4 micrograms/g. Except for a slight decrease in numbers of anaerobes, little fluctuations of intestinal flora were observed during treatment. PMID- 1784075 TI - [Studies of flomoxef in neonates]. AB - Studies on pharmacokinetics and clinical effects of flomoxef (FMOX), a parenteral oxacephem antibiotic, were carried out in neonates. The results obtained are summarized as follows. 1. Mean peak serum concentrations of FMOX upon single administrations at doses of 20 mg/kg and 40 mg/kg were 33.3 +/- 7.33 micrograms/ml and 68.9 micrograms/ml, respectively. 2. Mean urinary recovery rates of FMOX in the first 6 hours after administration of the above doses were 35.2% and 48.3%, respectively. 3. FMOX was administered to 4 cases including 1 prophylactic case, 1 case each with aspiration pneumonia and sepsis, hypodermic abscess of the head, and itrauterine infection, at a dose of 20-30 mg/kg 2 or 3 times a day. Clinically, excellent results were obtained in 3 cases including an methicillin-resistant Staphylococcus aureus case. 4. No side effects nor abnormal laboratory test results were observed. PMID- 1784076 TI - [Pharmacokinetic and clinical evaluations of flomoxef in neonates]. AB - To evaluate pharmacokinetics and clinical efficacy of flomoxef (6315-S, FMOX) in neonates, FMOX was administered to 21 neonates. With 20 mg/kg and 40 mg/kg of intravenous drip-infusion of FMOX 60 minutes, half lives (T 1/2's) was 64.9 minutes and 130.3 minutes, respectively, and when 20 mg/kg of FMOX was infused intravenously to 2 cases, half lives were 70.8 minutes and 110.1 minutes, respectively. When 45-100 mg/kg of FMOX was administered to 17 neonates with infections (pneumonia 8, sepsis 1, sepsis suspected 2, intrauterine infection 2, urinary tract infection 2, omphalitis 2), the efficacy rate was 88.2% (15 of 17). No adverse reactions were observed clinically in the 21 neonates. Transient elevation of eosinophilia was observed in 1 case and transient elevation of S-GOT and S-GPT 1 in another. These results suggest that FMOX is an effective and safe antibiotic to use in neonates. PMID- 1784078 TI - [Clinical evaluation of flomoxef in neonatal infections]. AB - Serum concentrations, urinary excretion and clinical responses of flomoxef (FMOX) were studied. The results are summarized as follows. 1. Serum concentrations of FMOX were 17.4 micrograms/ml 1-hour after intravenous injection on the average in 5 cases who received approximately 10 mg/kg, 41.8 micrograms/ml in 2 cases given 20 mg/kg, and 69.6 micrograms/ml in 2 cases given 40 mg/kg, indicating that serum concentrations of FMOX changed in a dose-dependent manner in this range. Average serum half-life (T 1/2) in 4 mature babies was 2.48 hours and that in 6 premature babies was 3.17 hours, indicating that elimination rates in premature cases tend to be slower than those in mature cases. Urinary recovery rates averaged 39.2% in the first 6 hours in 5 cases examined. 2. Five newborns or premature babies received FMOX 33.1-80.2 mg/kg (b.i.d. or t.i.d.) via intravenous route for 5 to 8 days. FMOX showed excellent or good clinical effectiveness in the treatment of all patients including 1 case each of sepsis with urinary infection, furunclal otitis, impetigo, uterogenic fetus infection and urinary infection. Bacteriological responses were also studied, and eradication of identified organisms (Escherichia coli 3 strains and Staphylococcus aureus 2 strains) was obtained upon the FMOX treatment, but in 1 strain of S. aureus showed only a decrease. No adverse reactions were observed in any cases, but a slight elevation of eosinophil was noted in 1 patient receiving a dose of 210 mg a day. From the results obtained in these tests, FMOX appears to be very usefull and safe for the treatment of some infectious diseases in neonates. PMID- 1784077 TI - [Laboratory and clinical evaluations of flomoxef sodium in neonates]. AB - Flomoxef sodium (FMOX) was evaluated experimentally and clinically in neonates. 1. Serum concentrations and urinary excretions of the drug were examined after a bolus intravenous injection at 20 mg/kg to 22 neonates 1-30 days after birth (durations of pregnancy 31-43 weeks, weights at birth 1,650-4,040 g) and 5 infants 50-95 days after birth (durations of pregnancy 33-40 weeks, weights at birth 1,720-3,308 g). Serum concentrations were 10.8-67.6 micrograms/ml (mean 32.7 +/- 2.8 micrograms/ml) and 25.1-52.0 micrograms/ml (mean 38.9 +/- 4.3 micrograms/ml) in the neonates and the infants, respectively, at their peaks (0.5 hour value), decreased thereafter with half-lives of 0.96-5.59 hours (mean 2.20 +/- 0.26 hours value), and 0.97-1.54 hours (mean 1.22 +/- 0.12 hours value), respectively. Serum levels decreased to 0.2-17.1 micrograms/ml (mean 2.9 +/- 0.6 micrograms/ml) and N.D. -1.1 micrograms/ml (mean 0.4 +/- 0.2 micrograms/ml) after 8 hours, respectively. The urinary recovery rates of the drug in the first 8 hours after administration were 15.0-96.0% (mean 53.7 +/- 4.9%) and 29.9-73.3% (mean 62.4 +/- 9.4%) in the neonates and in the infants, respectively. 2. FMOX was administered to 78 neonates (durations of pregnancy 31-42 weeks, weights at birth 1,420-3,860 g) in whom bacterial infections were established or suspected, and clinical, bacteriological, and side effects were evaluated. In 47 neonates examined (1 with sepsis, 3 with acute upper respiratory infections, 18 with acute pneumonia, 1 with umbilical infection, 1 with impetigo, 4 with acute urinary tract infections, 1 with acute otitis externa, 1 with periproctal abscess, and 17 with intrauterine infections), the treatment was markedly effective in 41, and effective in 6, with an overall efficacy rate of 100%. The bacterilogical effects of the drug on 3 strains of Staphylococcus aureus, 1 strain of Streptococcus pneumoniae, 1 strain of Streptococcus agalactiae, 9 strains of Escherichia coli, and 2 strains of Haemophilus influenzae which were responsible for these infections were all rated as "eradicated". Moreover, the drug, administered with or without prophylactic intentions showed complete prophylactic effects in all 27 cases tested. No side effects were observed in any of the patients. Concerning abnormal clinical laboratory results, increases in GOT were noted in 2, eosinophilia in 1, and thrombocytosis in 1, but these abnormalities were invariably mild and the normalized in 1 patient without treatment. The results suggest that FMOX is useful and safe also in neonates. PMID- 1784079 TI - [Pharmacokinetic and clinical studies on flomoxef in mature and premature infant]. AB - Pharmacokinetic and clinical studies of flomoxef (FMOX) in neonates and premature infants were conducted, and the results obtained are summarized below. 1. Plasma concentrations of FMOX at 15 minutes after one shot intravenous injection of 20 mg/kg to 6 cases were in a rang of 33.0-69.9 micrograms/ml and half-lives (T 1/2's) were between 0.68 and 4.89 hours. The plasma concentration of FMOX at 15 minutes after one shot intravenous injection of 40 mg/kg to 1 case was 79.9 micrograms/ml and the half-life (T 1/2) was 2.45 hours. Drug concentrations in plasma upon 1-hour intravenous drip infusion were 71.1-114.0 micrograms/ml and T 1/2's were 1.64-3.41 hours. T 1/2 tended to be couse shorter as ages of babies increased. 2. Urinary excretion rates in the first 6 hours after one shot intravenous injection of FMOX 20 mg/kg to 1 case and 1-hour intravenous drip infusion of FMOX 40 mg/kg to 2 cases were 60.4%, and 27.2 and 55.3%, respectively. 3. Clinical effects of FMOX against 12 cases of bacterial infections were excellent in 6 cases, good in 5 cases and poor in 1 case, thus the clinical efficacy rate was 91.7%. FMOX was also given to 6 cases for prophylaxis and prophylactic effects were observed in all the cases. 4. No adverse effects were observed in the 21 cases examined, but elevations of S-GOT and S-GPT were found in 1 case. The abnormal laboratory test results were probably due to this drug. PMID- 1784080 TI - [Pharmacokinetic studies of flomoxef in the neonatal field]. AB - Flomoxef (FMOX), a new broad spectrum oxacephem antibiotic, was studied in the neonatal field and the pharmacokinetic results obtained are summarized below. 1. Serum concentrations of FMOX after dosages of 20 mg/kg via 1 hour drip infusion were 21.8 +/- 7.59 micrograms/ml, 15.4 +/- 4.35 micrograms/ml, 4.3 +/- 2.88 micrograms/ml at 1, 2 and 5 hours after administration, respectively, and T 2/1 (beta)'s averaged 2.08 +/- 1.01 hours. 2. Urinary excretion rates were 53.38 +/- 16.94% in the first 7 hours after administration. PMID- 1784081 TI - [Flomoxef in the pediatric surgical field]. AB - Basic and clinical studies of flomoxef (6315-S, FMOX) were performed in the pediatric surgical field. The results obtained are summarized as follows: 1. FMOX was administered to 7 pediatric patients with biliary atresia (FMOX 20 mg/kg, i.v.d.). Peak biliary levels of FMOX were obtained at 1 hour after finishing administration by drip infusion, and were higher than those in blood 1 hours after finishing administration by drip infusion. 2. Urinary excretion was excellent, and urinary recovery rates were 57.8-97.8%. 3. FMOX was administered to 5 patients in the pediatric surgical field. One case was phlegmon, and other 4 cases were premature babies for postoperative prophylactic use. Clinical results were excellent in 1 case, good in 4 cases, with an overall efficacy rate of 100%. No clinical and laboratory side effects due to the administration FMOX were observed. It was concluded that FMOX was a safe and effective antibiotic in the pediatric surgical field. PMID- 1784082 TI - Isolation of the 66-kilodalton polypeptide from promastigotes of Leishmania donovani as a ligand molecule for binding to macrophages. AB - A 66-kDa major plasma membrane-associated molecule of promastigotes of Leishmania donovani (UR6) was purified by affinity chromatography. The immunoreactivity of the 66-kDa molecule was lost upon exposure to heat or treatment with trypsin. The metaperiodate oxidation significantly reduced its immunoreactivity. The 66-kDa molecule is, therefore, glycoprotein in nature. With a fluorescent probe, the 66 kDa molecule was found to be located on the tip of flagellum and on the kinetoplast. The exposure of promastigotes of L. donovani to monospecific anti-66 kDa antibodies significantly reduced the percentage of macrophages with attached promastigotes in the cultured cell line (J774G8). The data suggested that promastigotes of L. donovani utilize the 66-kDa molecule in recognizing and as ligand for binding to macrophages. PMID- 1784083 TI - Lipids and fatty acids of Leptospira interrogans serovar copenhageni virulent strain Shibaura. AB - Lipids and fatty acids of Leptospira interrogans serovar copenhageni virulent strain Shibaura were analyzed by thin-layer chromatography, gas-liquid chromatography, gas-mass spectrometry and infrared absorption spectrometry. The virulent cells possessed a characteristic lipid pattern consisting of free fatty acid (FFA) (41.8%), one major unidentified phospholipid (14.8%), phosphatidylethanolamine (PE) (12.9%), cholesteryl ester (CE) (9.3%), lysophosphatidylethanolamine (LPE) (4.9%) and diphosphatidyl-glycerol (DPG) (1.1%). Various fatty acids such as hexadecanoic (26.9%), hexadecenoic (15.4%), octadecenoic (26.5%) and octadecadienoic (27.4%) acids were detected in the FFA. The fatty acid composition of the major unidentified phospholipid distinctly differed from those of other lipids including PE, LPE, DPG and CE, and comprised mainly tetradecadienoic (53.6%), tetradecatrienoic (14.0%) and octadecanoic (13.8%) acids. This phospholipid with a large amount of polyunsaturated fatty acids with chain lengths of 14 carbon atoms was detected only in the lipids of the virulent cells. PMID- 1784084 TI - Anisakidae larvae found in marine fishes and squids from the Gulf of Tongking, the East China Sea and the Yellow Sea. AB - Marine fishes and squids caught in the Gulf of Tongking, the East China Sea and the Yellow Sea were dissected, and many Anisakidae larvae were found in them. The larvae of Anisakis simplex (Anisakis Type I larvae), the most important causative agent of anisakiasis, was found in about 30% of fishes and squids caught in the Gulf of Tongking and in about 60% of those caught in the East China Sea and the Yellow Sea. Larvae belonging to three other genera than Anisakis--Raphidascaris or Raphidascaroides, Hysterothylacium, and Terranova (Cannon Type I)--were also detected. PMID- 1784085 TI - [Scintigraphic quantification of myocardial necrosis using "hot spot" imaging agents in acute myocardial infarction]. AB - Both technetium-99m pyrophosphate/thallium-201 dual nuclide SPECT and indium-111 antimyosin antibody/thallium-201 dual nuclide SPECT were performed in identical 11 patients with acute myocardial infarction. Infarct size was calculated by both hot spot imaging agents on dual nuclide SPECT. Antimyosin accurately accumulated in the infarcted area in all 11 patients on SPECT images corresponding with the electrocardiography, but pyrophosphate accumulated at the site of infarct in 10 of 11 patients. The mean volume obtained from pyrophosphate was 32.5 ml and that from antimyosin was 21.9 ml. The relationship between infarct volume calculated by pyrophosphate and that by antimyosin was linear and correlated well (r = 0.98, p less than 0.001). However the volume of infarction determined with pyrophosphate exceeded that with antimyosin SPECT by 1.64 (p less than 0.001). The reason for this difference is not yet known, but may relate to pyrophosphate uptake in border zones that may or may not be irreversibly injured. PMID- 1784086 TI - [Assessment of myocardial viability by 24-hour imaging after stress thallium-201 scintigraphy]. AB - Twenty-four-hour delayed imaging after stress thallium-201 scintigraphy was assessed for more accurate detection of viable myocardium. Thirty-two patients with coronary artery disease who showed fixed perfusion abnormality (FPA) at 3 hr imaging after stress Tl study were evaluated with 24 hr delayed imaging. Of 37 areas with FPA, 19 areas (51%) showed redistribution (RD) at 24 hr imaging. After successful coronary artery bypass grafting (n = 19) or transluminal coronary angioplasty (n = 3), stress Tl scintigraphy was performed. Of 13 areas with RD at 24 hr imaging, 12 revealed improvement of Tl uptake after revascularization. On the other hand, of 12 areas with FPA until 24 hr, 8 showed no improvement. In conclusion, conventional stress Tl-201 scintigraphy underestimates myocardial viability, and additional 24 hr imaging permits more accurate assessment of myocardial viability. PMID- 1784087 TI - [Quantitative evaluation of myocardial viability using Tl-201 myocardial SPECT]. AB - In order to evaluate myocardial viability, we developed a new method for quantification of redistributed area in Tl-201 myocardial SPECT, and it was applied to 71 patients with LAD lesion. Initial image was subtracted from delayed image, and redistributed area was displayed as an unfolded map (viability map). Extent and viability score, which correspond to extent and degree of the viable area, was also calculated. In the cases with prior myocardial infarction, viability score was widely distributed and extent score was smaller, while the cases with angina pectoris had larger extent score. Visual assessment of redistribution to the infarcted area was compared with % score, which was calculated as ratio to initial defect score. When the criteria of viability was defined as % viability score greater than 36 or % extent score greater than 16, quantitative evaluation agreed with visual assessment, and corresponded to clinical course. This method was considered to be effective for evaluation of extent and degree of myocardial viability, but further evaluation need to be done in comparison with reinjection, PET study, and so on, and usefulness in multi vessel disease. PMID- 1784088 TI - [Hemodynamic assessment before and after PTMC by using cardiac blood pool scintigraphy]. AB - Rest and exercise cardiac blood pool scintigraphy with 99mTc-RBC were performed in 12 patients with symptomatic mitral stenosis before percutaneous transvenous mitral commissurotomy (PTMC) and at one week, one month after PTMC. Comparison of hemodynamic parameters before and one month after PTMC showed that LVEDV (97.4 +/ 8.9 vs. 111.4 +/- 12.1 ml; p less than 0.01) and diastolic indices (1/3FF: 23.6 +/- 6.5 vs. 30.9 +/- 4.1%; p less than 0.01) both increased, while there was no significant change in LVEF and RVEF. Comparison of symptom-limited bicycle exercise before and one month after PTMC showed that the duration of exercise time (7.6 +/- 1.6 vs. 8.6 +/- 1.4 min; p less than 0.02) and anaerobic threshold (10.6 +/- 3.0 vs. 15.4 +/- 3.2 ml/min/kg; p less than 0.01) increased. In comparison of hemodynamic response before and one month after PTMC, there were significant increases in cardiac output (CO) at the same workload (15 W: 3.9 +/- 0.7 vs. 4.8 +/- 0.8 l/min; p less than 0.05, 30 W: 3.9 +/- 0.7 vs. 5.2 +/- 1.2 l/min; p less than 0.05) despite similar CO at rest (3.5 +/- 0.8 vs. 3.9 +/- 0.7 l/min; NS). We conclude that cardiac blood pool scintigraphy is useful to evaluate improvement of hemodynamic parameters and exercise capacity after PTMC non-invasively. PMID- 1784089 TI - [Intra-arterial and intraportal infusion liver scintigraphy using 99mTc-labeled colloid]. AB - Intra-arterial infusion liver scintigraphy was performed in 11 patients with primary or metastatic liver tumor, and intraportal infusion liver scintigraphy was performed in 6 patients for prophylaxis of liver metastasis from colorectal cancer. 99mTc-Sn colloid or 99mTc-phytate was administered through the catheter of which tip was placed in the portal vein or the hepatic artery, and then liver image was obtained. When 99mTc-phytate was infused intra-arterially, significant amount of the infused tracer passed through the liver and we could not get sufficient information to assess the distribution of drug administered through the catheter. On the other hand, intraportal infusion liver scintigraphy using 99mTc-Sn colloid or 99mTc-phytate and intra-arterial infusion liver scintigraphy using 99mTc-Sn colloid revealed heterogeneity of liver uptake, tracer uptake in spleen, low uptake area corresponding to the liver tumor and high uptake area around it. The findings will be clinically useful, and these methods are thought to be helpful to confirm the satisfactory drug distribution. PMID- 1784090 TI - [Diagnosis of pancreatic cancer using 201Tl-chloride and a three-head rotating gamma camera SPECT system]. AB - 201Tl SPECT was performed on 17 patients with pancreatic cancer or chronic pancreatitis using a three-head rotating gamma camera SPECT system. In 7 of 10 patients with pancreatic cancer, the lesions were clearly delineated by 201Tl SPECT. Whereas the lesion of 30 mm in diameter was visualized, a large tumor of 80 mm in diameter could not be visualized. Namely, it was thought that 201Tl uptake by pancreatic cancer might be well correlated with tumor blood flow and/or its histological subtype rather than with tumor size. In 5 of 7 patients with chronic pancreatitis, no uptake by the pancreas was shown. The sensitivity, specificity, and accuracy in diagnosing pancreatic cancer by 201Tl SPECT were 70%, 71%, and 71%, respectively. The present results obtained by 201Tl SPECT were thought satisfactory enough to evaluate pancreatic cancer under the present conditions where there was no useful imaging agent for visualizing pancreatic cancer by SPECT. 201Tl SPECT is expected to be a new diagnostic tool for investigation of pancreatic tumorous lesion. PMID- 1784091 TI - [Follow-up study in a case of traumatic epilepsy with increased accumulation of 123I-N-isopropyl-p-iodoamphetamine]. AB - Recent studies suggested the potential use of 123I-N-isopropyl-p-iodoamphetamine (IMP) for the assessment of pathophysiology of epilepsy. We studied a case of epilepsy with increased accumulation of IMP. Brain SPECT scan of IMP was performed in a case of 31-year-old male with traumatic epilepsy. Increased accumulation of IMP was observed in the left temporal area on both early (20 min after injection) and delayed (3 hr) images of studied 6 weeks after the head trauma. X-CT did not show any abnormalities. The accumulation of IMP decreased as the symptom of the patient improved. The SPECT study performed 3 months after the accident showed slightly decreased uptake in the left temporal area on the early image with homogeneous uptake in the delayed image. These findings suggested the altered retention mechanism of IMP in this case. PMID- 1784092 TI - [Blood flow measurement of brain tumor by 123I-IMP using 3-heads rotating gamma camera SPECT]. AB - Using 3-heads rotating gamma camera SPECT system, regional blood flow was measured from the super-early image obtained 4 to 6 minutes after the intravenous injection of 123I-IMP on 11 patients with various brain tumors. Two cases of olfactory groove meningioma and malignant astrocytoma showed significantly high 123I-IMP uptake by the lesion visualized by MRI compared to the uptake by normal brain cortex on super-early image but 123I-IMP uptake by the tumor decreased on early image. In both cases, blood flow of the tumor measured from super-early image showed values much higher than those of normal brain cortex. It was thought that usual correction method based on early image did not correctly represent the blood flow of the lesion but that the present method based on super-early image could show the increase of blood flow of the tumor. PMID- 1784093 TI - [Thallium-201 myocardial scintigraphy after intravenous infusion of adenosine triphosphate disodium: a preliminary study in the diagnosis of coronary artery disease]. AB - The feasibility and safety of thallium-201 myocardial scintigraphy after the intravenous infusion of adenosine triphosphate disodium (ATP) (Adetphos, Kowa) were studied in eight patients with angina pectoris and/or old myocardial infarction. Coronary arteriography (CAG) was performed by the conventional method in all patients. ATP was infused for 5 min and thallium was injected at 3 min after the start of ATP infusion. ATP was given at 0.12 mg/min/kg in two patients (group A), 0.16 mg/min/kg in three patients (group B), 0.20 mg/min/kg in one patient (group C) and 0.28 mg/min/kg in two patients (group D). SPECT images were obtained at 10 min and 180 min after thallium injection. No significant hemodynamic changes were observed in group A and B. Severe hypotension was observed in group C and one member of group D. Chest pain was experienced by one patient in group A, two in group B, one in group C, and both of the two in group D. ST depression on the electrocardiogram (ECG) was documented in one patient each of groups B and C. In one group D patient, the study was discontinued because of complete atrioventricular block persistent for 5 beats. The correlation between thallium imaging and CAG was unclear in group A, reasonable in groups B and C, and obscure in group D because of side effects. None of the patients who developed side effects of ATP were administered sublingual nitroglycerin or intravenous aminophylline. Their symptoms or ECG changes improved spontaneously within 2 min and disappeared within 5 min after termination of infusion. In conclusion, the optimal ATP regimen for this purpose was considered to be a 5 min infusion at 0.16 mg/kg/min and this method was found to be feasible and safe. PMID- 1784094 TI - [Serum myosin light chain I concentration in patients with primary hypothyroidism]. PMID- 1784095 TI - [Evaluation of serological detection of anthracycline-induced myocardial damage: possible application of an immunoradiometric assay kit for cardiac myosin light chain I]. PMID- 1784096 TI - [Measurement of bone mineral content by dual photon absorptiometry in patients with metabolic bone diseases]. PMID- 1784097 TI - [An approach to tuberculosis in newcomers from Asia and Africa]. AB - In recent years, it has been documented that tuberculosis frequently occurs among recently entered foreigners dominantly from Asia. We studied 85 cases admitted to our hospital for active tuberculosis from 1986 to 1990. Many of those cases, we believe, were infected in countries of origin and were reactivated soon after or before entering Japan. In spite of higher rate of involving recurrent cases and resistance to anti-mycobacterial drug agents, chemotherapy has been generally efficient. In some cases, continuance of treatment was difficult because of their illegal stay, misunderstanding of the disease or other problems such as customs and economic difficulties. PMID- 1784098 TI - [Therapeutic efficacy of kanamycin and clofazimine combined with muramyl dipeptide against Mycobacterium intracellulare infection induced in mice]. AB - Therapeutic efficacy of kanamycin (KM) and clofazimine (CFZ) combined with N2-[(N acetyl-muramyl)-L-alanyl-D-isoglutaminyl]-N6-stearoyl-L-ly sine, MDP-Lys (L18), against Mycobacterium intracellulare infection induced in mice was studied, based on suppression of incidence of gross lung lesions and bacterial growth at the sites of infection (lungs and spleen), and the following results were obtained. Firstly, KM (0.5 mg) was given sc to mice, daily six times per week in combination (or not) with sc injections of MDP-Lys(18) (0.1 mg) either 1, 3 or 5 times weekly. In this case, KM alone markedly suppressed the incidence of pulmonary gross lesions and the growth of organisms in the lungs and spleen (2 2.5 log-decrease in CFU per organ at week 8) in infected mice. MDP-Lys(18) alone also exhibited similar effect but the efficacy was much lower than that of KM. No synergism was observed for combined use of KM with MDP-Lys(18) in any protocols tested. Secondly, CFZ (0.5 mg) was given to mice by gavage, daily six times per week in combination with or without injections of MDP-Lys(18) (0.1 mg), either 1, 3 or 5 times weekly. In this case, CFZ alone decreased the incidence of gross pulmonary lesions in infected mice and the weaker suppressive effect was noted for MDP-Lys(18) alone. Moreover, CFZ alone suppressed bacterial growth in the lungs and spleen (1.5-2.0 log-decrease in CFU per organ at week 8), while MDP alone failed to cause such a marked reduction in bacterial CFU in the visceral organs.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1784099 TI - [Estimating the year of eradication of tuberculosis in Japan]. AB - The time of eradication of tuberculosis has been discussed for several countries, and based on those results, a new strategic plan and goals have been elaborated. Considering such developments, and in order to make a new tuberculosis control strategy, it is important to determine the point at which eradication of tuberculosis would be achieved in Japan. Styblo proposed the two conventional definitions of eradication of tuberculosis, namely that the incidence of smear positive tuberculosis has fallen below 1 per million population or that the prevalence of tuberculosis infection in the general population has fallen below 1% and continues to decrease. The bacteriological results of new cases have been reported since 1975 in Japan. However, those results are still of doubtful validity and reliability. Therefore, the author estimated the year of eradication of tuberculosis, according to the criterion that tuberculosis is eradicated when the proportion of the population infected with tubercle bacilli is less than 1%. If the risk of infection is changing at a regular rate, it is possible to estimate the risk of infection at any time in the past and in the future. Once the risk of infection is determined, it is also possible to calculate the age specific prevalence of infection and the proportion of the population infected with tubercle bacilli at various times in the past and in the future. In Japan, the risk of infection before World War II was assumed to be around 4% and not to vary with calendar year. And based on the data from the prevalence surveys in Okinawa in 1968 and 1973, the risk of infection was estimated 0.3% in 1968 and has declined on average, by 10 to 11% annually. At that time, Okinawa was the only area free from BCG vaccination in Japan. The incidence rate in Japan also has declined, on average, by 10% annually. However, since late 1970s, the annual speed of decline of the incidence rate has been slowed down. Therefore, I assumed that the recent trend of the infection risk is the same as the trend of the recent incidence rate among the 0-29 year age-group. The size of the effect of age on the risk of infection has been discussed. The author also considered age effects in the model. The weight applied to the risk of infection by age was determined by examining the age-specific positive rate in the 1930s before the era when BCG vaccination was widely used.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1784100 TI - [Clinical comparison of active primary tuberculosis in recent years and the past]. AB - Three hundred and forty-four cases of active primary tuberculosis admitted to the National Sanatorium Seiransou Hospital from 1980 to 1987 were studied and compared with 101 cases admitted from 1966 to 1969. None had a previous history of tuberculosis, and all were diagnosed via positive smears for acid-fast bacilli and/or positive Mycobacterium tuberculosis cultures. The age distribution showed that in the recent cases, the highest incidence among the male patients was observed in the middle-age group (30-59 yr) and in the older age group (over 60 yr) among the female patients. In the earlier cases, the younger (under 29 yr) and middle-age groups showed a higher incidence than the older age group for both sexes. However, when the prevalence rate was calculated for recent and past cases using the total population of the districts where the patients lived, it was observed that tuberculosis was most prevalent among the older age group for both sexes. Seventy percent of these cases were admitted to the hospital due to self conscious symptoms, and 20% were referred as a result of mass-screening chest X ray examinations. The rest of cases were discovered by routine radiographs taken during admission for unrelated illnesses. Some of the middle- and older-aged patients had predisposing factors, such as diabetes mellitus, gastric ulcers and malignancy, in their past histories or as complicating diseases. Twenty percent of all cases had a family history of tuberculosis. In most cases, a second family member was admitted with tuberculosis within 10 years after the first family member's presentation; however, some cases developed after 30-40 years. This fact suggests a possible hereditary or genetic disposition rather than direct transmission of M. tuberculosis. Drug resistance was observed in 5-19% of the primary cases, highest in the younger age group, in whom tuberculous lesions revealed on chest X-rays were unilateral rather than bilateral as in the older patients. Radiograph findings were primarily infiltrative in the past, whereas cavitation was the prominent feature in recent cases. Tuberculin skin testing was 90% positive in all groups except the older-age males, whose positivity rate was 71%. In the past, 25% of the cases were treated with both surgery and chemotherapy, including SM, PAS and INH, whereas only 2.5% were operated in recent cases. There were 11 cases (3.2%) of extrapulmonary tuberculosis that included involvement of the urinary tract, larynx, ribs and cervical lymph nodes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1784101 TI - [A case report on tuberculosis with remittent fever after tonsillectomy in a patient under CAPD]. AB - This report pertains to a case of chronic renal failure with remittent fever after tonsillectomy. The patient was 45-year-old female who had been undergoing continuous ambulatory peritoneal dialysis (CAPD) for five years. She was admitted to our hospital after being diagnosed as having pyrexia with tonsillitis. A tonsillectomy was performed. Although several symptoms and signs, such as fever, positive CRP and accelerated ESR, improved transiently by the seventh postoperative day, remittent fever and cervical lymph node swelling suddenly recurred after the eighth postoperative day. In spite of the antibiotic therapy, the fever continued for two weeks thereafter. A culture to check for acid-fast bacilli was negative, but on epithelioid cell granuloma with a small central abscess was found in the biopsy specimen of the lymph node. INH was prescribed to her. After three days of INH administration, the patient became afebrile. Patients with long-term dialysis are known to be very susceptible to tuberculous diseases. However, to date, there has been no report of tuberculosis being accompanied by a fever after a tonsillectomy. As it might be difficult to make a tubercular diagnosis on such a febrile patient, early antituberculous chemotherapy is recommended for patients with antibiotic-refractory fever. PMID- 1784102 TI - [Recent trend of studies on "atypical mycobacteria"]. PMID- 1784103 TI - An approach to white matter diseases of the central nervous system. PMID- 1784104 TI - An update on bacterial meningitis. PMID- 1784105 TI - Chromosome abnormalities in amniotic and chorionic villus cells in Singapore. PMID- 1784106 TI - Drug induced hepatitis. PMID- 1784107 TI - Necrotising enterocolitis--an overview. PMID- 1784108 TI - Cystic duplication of the caecum mimicking intussusception. AB - Diagnosis of gut duplications are often only made intraoperatively as they are uncommon and do not feature strongly in the differential diagnoses. A case of caecal cystic duplication mimicking intussusception is discussed with the aim of improving diagnostic accuracy in future cases. A 7 month old boy presented with the classical triad of abdominal pain, bleeding per rectum and a palpable mass. Barium enema revealed a mass in the caecum suggestive of an intussusceptum. Repeated attempts at hydrostatic reduction were unsuccessful as the mass was immobile. Laparotomy revealed cystic duplication of the caecum without intussusception. The bleeding per rectum was due to an ulcer in the colonic epithelium overlying the cyst. PMID- 1784109 TI - Cardiomyopathy in paediatrics. PMID- 1784110 TI - Congenital heart disease in tylosis: case report. AB - Hereditary palmoplantar keratoderma (1) has been found to be associated with syndromes such as corneal defects, (2) periodontosis, carcinoma of esophagus but not so much with congenital heart disease. A case of Tylosis with pulmonary stenosis is reported. Very many hereditary disorders characterised by diffuse or focal thickening of the palms and soles have been described. Tylosis is determined by an autosomal dominant gene and presents with slight thickening of palms and soles first evident in early infancy and fully described by the sixth month. There have been no congenital anomalies associated with tylosis in the literature. PMID- 1784111 TI - Cockayne syndrome--a case report, and a review of the premature aging syndromes in paediatrics. AB - The premature aging syndromes are a rare eccentric group of syndromes in which predominantly senile features develop prematurely. Cockayne Syndrome is one of several premature aging syndromes; it has been recognised, but hitherto unreported in the local literature. This is a case report of a child with the classical features of Cockayne Syndrome. PMID- 1784112 TI - Social class distribution of obese Chinese children. AB - Four hundred and eighty four obese Chinese children who were defined obese by a relative weight of more than 120% of standard weight-for-height had their social status evaluated. The social class of each child was arbitrarily determined according to the father's occupation. The distribution of obese children in various social levels was compared with that of the working population in Singapore. Significantly greater proportions of children were in the upper and middle social classes compared with the general working population. Such trends may be related to the increased affluence of the society and the accompanying changes in life-styles and eating habits, and will influence measures in health education and control of childhood obesity in the future. PMID- 1784113 TI - Munchausen syndrome by proxy. AB - Munchausen syndrome by proxy is the falsification of symptoms by parents which results in their children having unnecessary and sometimes harmful hospital procedures. We describe a case of Munchausen syndrome by proxy in a 15 month-old toddler. The diagnosis, management and outcome of this syndrome is also discussed. PMID- 1784114 TI - Controversies in the diagnosis and management of neonatal seizures. PMID- 1784115 TI - Effective management of long Q-T syndrome with cardiac pacing. PMID- 1784116 TI - A quick and accurate line-sampling technique to quantify myelinated axons in peripheral nerve cross-sections. AB - A quick and accurate computer-assisted method of quantifying the number of myelinated axons in normal and experimental or regenerated peripheral nerve cross sections is described. Using an IBM-PC, quantitation software and a light microscope with a camera lucida attachment, the number of axons in a sciatic nerve can be calculated in fifteen minutes. Nine nerve samples with various nerve diameters and axon densities were used to test the technique. Total counts (actual count) were compared to the number of axons estimated by the line sampling technique (projected count) and the two groups varied up to 15%. The principle advantage of this method is that it saves time by eliminating photography and performing total counts. The technique can be applied to normal and regenerated peripheral nerve. PMID- 1784117 TI - Improved imaging of rat hindfoot prints for walking track analysis. AB - Walking track analysis is an investigative technique that allows a researcher to assess objectively the functional capacity of the limb in the rat sciatic nerve model. This study has shown that paint and paper is a better method for imaging the rat foot plantar surface than other methods described in the literature. The block printing paint has the distinct advantage of keeping radial diffusion error to a minimum. Paint more correctly images the important anatomical landmarks of the rat plantar surface. There is better traction (less slippage) rendering the prints easier to interpret. The authors conclude that the paint and paper is a superior method to the other methods currently available. PMID- 1784118 TI - Vibrodissociation of sliced mammalian nervous tissue. AB - A new simple and reliable mechanical method of the acute isolation of viable neurones from mammalian brain slices is described. The method is based on the local application of mechanical vibration directly on the chosen site of a slice and does not require the enzymatic pretreatment of the tissue. The application of the method to the isolation of the CA1 pyramidal neurones from rat hippocampal slices has been shown to be highly efficient. The characteristic morphology and sensitivity to N-methyl-D-aspartate and other substances of liberated cells are maintained. Clearly, this method should be attractive in patch-clamp studies of individual cells. PMID- 1784119 TI - Isolation and characterisation of proliferating cells from the telencephalic vesicles of gestational-day 13 rats. AB - A method of isolating in culture a specific subpopulation of cells in the "S" phase of the mitotic cycle, from embryonic forebrain, is described. Different enzyme treatment and different substratum pretreatment are compared quantitatively to ensure optimal yield. These cells, isolated from the telencephalic vesicles of embryonic day (E) 13 rat embryos, were maintained in culture and their morphological and immunocytochemical characteristics were investigated at one and eight days in vitro. PMID- 1784121 TI - Application of circular statistics to the study of neuronal discharge during locomotion. AB - An application of circular statistics is described which permits one to readily and efficiently describe neuronal discharge patterns recorded during locomotion. The method can be adapted to any data which are normally plotted as post-event histograms (PEHs) and can also be used to describe the pattern of electromyographic (EMG) activity during the step cycle. Data can be objectively classified with respect to both the mean direction and amplitude of their discharge, as well as to the variability (angular deviation) of that discharge. In addition, the Rayleigh test for directionality can be used to determine whether cells are modulated or unmodulated. Finally, the ability to describe each cell's discharge as a single vector allows the data from several different neurones to be displayed on a single figure and provides an efficient method for comparing the discharge of a population of cells under two or more different conditions. PMID- 1784120 TI - An improved invertebrate synaptosomal preparation with cholinergic properties. AB - Our laboratory has previously characterized a high affinity choline uptake system (HAChUS) in Limulus tissues and synaptosomes. We report here on the characterization of the HAChUS in synaptosomes prepared selectively from central nervous system tissues shown to be enriched for presumed cholinergic functions; namely the protocerebrum, corpora pedunculata and abdominal ganglia. Synaptosomes were prepared from these tissues by means of a modification of the subfractionation procedure developed by Dowdall and Whittaker. In our modification, we harvested a PP2L fraction exclusively from the S2 fraction. Compared to the P2L fraction, the PP2L was greater than three times more efficient in [3H]choline uptake and was significantly more sensitive to inhibition with micromolar concentrations of hemicholinium-3. The PP2L fraction HAChUS was shown to have characteristics common to the HAChUS of identified cholinergic tissues. PMID- 1784122 TI - Simulation of self-motion in tethered flying insects: an optical flow field for locusts. AB - A low-cost solution for a visual flow field device is described. The apparatus generates progressive and regressive patterns of motion with variable angular speeds and intensities. Additionally, rotational stimuli can be applied. First results show the efficiency of the flow field in producing flight behavior and steering responses in visual interneurons of locusts. PMID- 1784123 TI - Room temperature culture extends the useful life of adult neurons for voltage clamp experiments. AB - Isolated superior cervical ganglion (SCG) neurons were maintained in vitro at 22 degrees C (22 degrees C neurons) for up to 4 days in an effort to inhibit process outgrowth and thus extend the useful life of SCG neurons for voltage-clamp experiments. The neurons were viable after 4 days in vitro and remained roughly spherical whereas neurons maintained in vitro at 37 degrees C (37 degrees C neurons) developed extensive neurite processes after 2 days. The resting potential of 22 degrees C neurons was more hyperpolarized and the action potential duration was reduced compared to acutely isolated neurons (acute neurons) or 37 degrees C neurons. The steady state Na+ current activation and inactivation parameters of the acute and 22 degrees C neurons were similar whereas the half activation voltage was hyperpolarized and the slope factor of inactivation was reduced for the 37 degrees C neurons compared to the other two groups. The Na+ currents recorded from the 37 degrees C neurons displayed obvious signs of poor voltage control which were not observed in the acute or 22 degrees C neurons. The acetylcholine (ACh) sensitivity of both 22 degrees C and 37 degrees C neurons was significantly less than that of the acute neurons. This report demonstrates that room temperature culture of SCG neurons is a simple method which prevents process outgrowth and thus extends the useful life of the neurons for voltage-clamp experiments. PMID- 1784124 TI - Methods for repeated recording in visual cortex of anesthetized and awake behaving infant monkeys. AB - This report describes methods for making repeated recordings from visual cortex in infant macaque monkeys (age range 5 weeks to 7 months) both under nitrous oxide anesthesia and in an alert behaving state. These methods permitted successful collection of single-unit data from inferior temporal cortex and other areas in a longitudinal fashion from individual infants. For the anesthetized experiments, modifications of our standard techniques for surgical preparation and maintenance of the animal in an anesthetized, artificially ventilated state permitted repeated recording sessions while assuring the animal's continued health and normal growth. Following implantation with an eye coil, monkeys as young as 5 weeks could be trained to perform a fixation task during alert recording sessions which were likewise performed on a repeated basis with maintained health and development. Further, comparison of results from anesthetized and awake recording sessions indicates that alert recording is preferable for collecting certain types of data from visual cortex in infant monkeys. PMID- 1784125 TI - Stereotaxic lesions of the hippocampus in monkeys: determination of surgical coordinates and analysis of lesions using magnetic resonance imaging. AB - A technique is described for producing accurate stereotaxic lesions of the hippocampus in monkeys. This technique overcomes the problem that the size and shape of the brain can vary considerably from monkey to monkey. Magnetic resonance imaging (MRI) is used to create an individual brain atlas for each monkey. The atlas is then used to derive coordinates for making stereotaxic radio frequency lesions of the hippocampus. There are two key features of this procedure. First, a specially-designed, acrylic, stereotaxic headholder was constructed that could be used safely with the MR magnet. Second, small glass beads, anchored to the skull of the monkey, served as common landmarks from which lesion coordinates were determined in the MR images and then again in neurosurgery. MRI techniques are also described for determining the extent of tissue damage postoperatively. This technique could also prove useful in other areas of neuroscience research that depend on accurate stereotaxic placement of electrodes (e.g., electrophysiological studies and neuroanatomic tracing studies). PMID- 1784126 TI - Calibration of ion-selective microelectrodes for use with high levels of interfering ions. AB - Ion-selective electrodes are often used in solutions which contain interfering ions. Calibration under these conditions is usually achieved by the fixed interference method, in which the concentration of the test ion is varied in a fixed background of interfering ion. The present paper describes a method for analyzing fixed interference calibration data which allows the Nicolski coefficients to be extracted using commercially available computer software. The method produces an accurate numeric description of the calibration curve. It also enables an accurate correction for the situation where the experimental level of interfering ion is not identical to that of the standard solutions. PMID- 1784127 TI - A simple non-iterative procedure for fitting of multiexponential functions. AB - An efficient procedure for finding parameters of multiexponential function from experimental data is described. All time-constants are determined by roots of the corresponding characteristic polynomial and weighting factors are then found from the system of linear equations. Due to the non-iterative character of the fitting procedure it is fast and does not need a guess about the initial values of parameters of multiexponential function. For single- or double-exponential fitting explicit algorithms are given, for which programming is straightforward. PMID- 1784128 TI - An analysis of the oscillatory patterns in the central nervous system with the wavelet method. AB - This paper discusses a simple application of the wavelet transformation to analyse nerve cell impulse patterns. The action potentials converted into delta, or Dirac, functions were convoluted in the time domain with a modified Gauss (the negative of the second derivative of Gauss) function, varying in width between 0.6 and 384 ms. The width of the Gauss function was varied in 640 steps. Some parts of the transformation were extended, analysed and averaged in the frequency domain to explore oscillatory components of the impulse pattern. The sequences of action potentials of retinal ganglion cells evoked by short flashes are taken as examples. The present analysis demonstrate some properties of mathematical "microscopic" application to transient responses of the central nervous system (CNS), whereby the degree of magnification (steps of transformation) was varied. PMID- 1784129 TI - A new cuff electrode for reversible conduction blocking. AB - A cuff electrode of novel design (rigid body and lid) is presented. It contains a closed cavity surrounding the nerve, through which a cooled liquid (Ringer solution) can be circulated. Recording sites at both ends of the cavity permit monitoring of the conduction blocking, which occurs at different temperatures for different units. Reversible blocking with chemical agents is equally possible with this device. PMID- 1784130 TI - A concentration-clamp system allowing two-electrode voltage-clamp investigations in oocytes of Xenopus laevis. AB - A system for rapid solution exchange (concentration-clamp) was developed for Xenopus laevis oocytes. The exchange time (t90) was 10 ms. The system allows two electrode voltage-clamp investigations. PMID- 1784131 TI - An apparatus for recording synaptic potentials from neuronal cultures using voltage-sensitive fluorescent dyes. AB - Voltage-sensitive dyes offer the promise of noninvasive multicell recording of electrical activity, and should therefore be useful for studying the synaptic interactions of small networks of cultured neurons. We have designed and built a system for recording from microcultures of 1-15 neurons from the rat superior cervical ganglion (SCG), using voltage-sensitive fluorescent dyes of the styryl class. The apparatus comprises a standard inverted epifluorescence microscope; a mercury arc lamp with an optical feedback regulator; a 256-pixel fiber-optic camera with individual photodiode detectors and very low-noise amplifiers; and a personal computer-based data acquisition system. Its dark noise and illumination fluctuations are low enough that at typical fluorescence levels for these cells, it is limited by shot noise (the inherent physical limit of detection). Recording from SCG neurons, the signal-to-noise ratio is high enough to see large subthreshold synaptic potentials without signal averaging. This apparatus should be useful for studying long-term synaptic plasticity in cultures of vertebrate neurons, and several of its features should apply to optical recording from other preparations. PMID- 1784132 TI - [Preparation of Staphylococcus aureus antigens for evaluation of their immunological reactivity with the human sera by the western blot method]. AB - Extracellular antigens as well as cell wall extracts of 4 S. aureus strains isolated from different kinds of infection were analysed by Western-Blott technique. Materials obtained in two systems of bacteria cultivation (with and without aeration) were compared. Four systems of PAGE (native conditions, with 8.0 M urea, with SDS and SDS after previous reduction of the material with 2 mercaptoethanol) were compared in order to get the best differentiation of proteins and antigens. Immunological reactivity of the antigens mixture with two human sera: highly positive (with three S. aureus antigens in ELISA) from patient with staphylococcal sepsis and negative (from blood donor) were analysed. The best results were obtained after reduction of the cell wall extracted material in SDS-PAGE. The different protein patterns depending on the strain and the method of bacteria cultivation were observed. The standardisation of Western-Blott technique was performed, including titration of the sera to get the best differentiation of the antigens. The difference in immunological reactivity of the positive and negative sera with staphylococcal antigens mixture showed rather quantitative than qualitative character. PMID- 1784133 TI - [Humoral response to Staphylococcus aureus antigens evaluated by the western blotting method]. AB - Cellular antigens extracted from the cells of four Staphylococcus aureus strains from different kinds of infections (sepsis, osteomyelitis, furunculosis) were analysed by the western blotting technique. Antibiotic sensitivity pattern of the strains was compared. One isolate was found to be MRSA strain. Sera samples from patients of whom strains were isolated and four sera from blood donors (as a control) were used in the investigation. IgG levels for purified staphylococcal antigens (lipase, alpha-toxin and teichoic acid) were estimated. Interaction between extracted bacterial antigens and serum antibodies of IgG class were analysed in homologous and heterologous systems. The most strong immunological reaction of the investigated sera with staphylococcal antigens was observed in the case of homologous system. Serum from sepsis patient was found to be the most reactive serum with all staphylococcal antigens mixtures. PMID- 1784134 TI - [Use of latex test for detection of Salmonella in meat]. AB - The aim of this study was to examine the usefulness of latex test for detection of Salmonella in raw ground meat . Five hundred and fifty samples of meat were examined, including 368 samples artificially contaminated with S. enteritidis and S. typhimurium. Samples for latex test were also derived from classical microbiological culture (2 ml) which was run in parallel. Coincidence of positive results obtained in latex test with positive results in microbiological method was 7.6% to 15.3% (after introductory multiplication) and from 38.2% to 73.9% (after selective multiplication). There was no bacteriological confirmation for 7 samples (3.9%) positive in latex test. Ground meat environment and its bacterial flora have no qualitative influence on a result of latex test; the detection of Salmonella takes place if there is a sufficient concentration of somatic antigens of these microorganisms in a tested sample. However, these factors as well as a method od preparation of bacterial culture have influence on the sensitivity of latex test. In the light of this study it seems possible to use latex test for selection of samples. Positive samples could be eliminated from further bacteriological examination. The further studies are necessary involving other types of food products and studies on optimalisation of preparation of samples for latex test are also required. PMID- 1784135 TI - [Latex test used for diagnosis of dysentery caused by Shigella sonnei]. AB - The aim of this study was to evaluate the usefulness of latex reagent coated with immunoglobulins specific for antigens of phase I and II of S. sonnei for detection of these antigens in primary, mixed bacterial cultures. The study was performed on 919 fecal samples from individuals with clinical symptoms of dysentery, convalescents and from contact individuals. Material used for the test was bacterial suspension collected from McConkey or SS agars and a culture from selenite F broth heated at 100C. The results of the latex test were compared with the results of isolation of S. sonnei from the same cultures. S. sonnei was isolated from feces of 140 individuals (15.2%), while the latex test was positive in 215 cases (23.4%). The highest testing effectiveness , significantly higher than when isolation of pathogen was performed, was obtained only when 18-20 hr culture on Selenite F medium was used for latex test. The correlation between efficacy of testing for S. sonnei and phosphate content of Selenite F and a mode of its preparation was found. The latex test allows to eliminate from further bacteriological studies cultures free of S. sonnei thus it gives measurable economical profits and it shortens significantly time period of bacteriological examination. PMID- 1784136 TI - [Occurrence of conjugated R-plasmids in bacteria of the Aeromonas genus isolated from purified urban sewage water]. AB - The aim of the study was to determine a participation of Aeromonas sp., having conjugation R plasmids, in a population of the bacteria present in purified urban sewage . In 1 ml of sewage 1.8 x 10(3) - 50 x 10(3) of Aeromonas sp., were found. The isolated strains belonged to the following genera: A. hydrophila, A. caviae, A. sorbia. All tested strains were sensitive to gentamicin, tetracycline, kanamycin and nalidixic acid. Among 186 strains of Aeromonas sp., two belonging to A. caviae genus transferred resistance to streptomycin to A. hydrophila and E. coli recipients on the other hand two strains of A. caviae transferred resistance to streptomycin exclusively to A. hydrophila recipient. PMID- 1784137 TI - [Evaluation of thermostability of lyophilized BCG vaccines by using an accelerated thermal degradation test]. AB - The degree of thermal degradation of BCG vaccines prepared from various substrains, using a test evaluating number of viable particles of BCG was determined. Thermal degradation coefficient were established for particular vaccines in different temperatures and a prognosis time curve of 50% CFU titer loss was constructed. It was found, that polish vaccine does not differ essentially from danish and french vaccines in respect to thermostability. Japanese preparation showed higher stability in all temperatures tested as compared to above mentioned vaccines. It was shown that when based on presented figures, and using interpolation method, it is possible with a high degree of probability foresee a decrease of vaccine titer at optional temperature. PMID- 1784138 TI - [A simplified method of rapid hemagglutination test for determining the levels of tetanus antibodies]. AB - A new, simplified methodology of preparation of lyophilized chrome-coated turkey blood cells (formalin-treated ) for rapid identification of tetanus antibodies in indirect hemagglutination test is described. Blood cells diagnostic preparations obtained in this way were easier and three times faster to prepare than tanned cell preparations . They maintained unchanged capability for specific agglutination during at least one year of storage when kept at 4 degrees C. proposed methodology enable to start a production of laboratory kits necessary for controlled prophylaxis of tetanus. PMID- 1784139 TI - [Effect of various components of the fungal cell wall on adhesion of Candida albicans to the mouth mucosa epithelium in vitro]. AB - An influence of mannan++, its component methyl-D-mannopyranoside+ and N acetylglucosamine on in vitro adhesion of Candida albicans strains to buccal mucosal epithelium was studied. These substances inhibited adhesion when added to adherence test in a concentration of 10 mg/ml and 25 mg/ml despite whether were added to the test incubation medium or when preincubated with fungi or epithelial cells. Preincubation of fungal cells and epithelial cells with mannan had no influence on attachment; preincubation of epithelial cells with methyl-D mannopyranoside+ and N-acetylglucosamine decreased adherence significantly. On the other hand preincubation of fungal calls with methyl-D-mannopyranoside+ increased their adhesive properties, having no influence on adherence after preincubation of fungi with N-acetylglucosamine. PMID- 1784140 TI - An original method for assessment of the jumping test. AB - A study was carried out in mice to evaluate jumping activity, using an original methodology which makes graphical automatization and objectivization possible. The effects of guanfacine (an adrenergic alpha 2-agonist) in morphine-dependent mice and the ability of caffeine to induce a pseudosyndrome were also studied. This new method is useful for quantifying the jumping activity while also being able to evaluate other symptoms of abstinence. Furthermore, the method avoids manipulation of the animals during the abstinence period. PMID- 1784142 TI - Cerebrospinal fluid interleukin-1 beta (IL-1 beta) in Alzheimer's disease and neurological disorders. AB - Recent studies indicate that patients with Alzheimer's disease (AD) exhibit an immune dysfunction at the central and peripheral levels. We have studied the concentration of IL-1 beta in the cerebrospinal fluid (CSF) of patients with AD, multi-infarct dementia (MID), normal pressure hydrocephalus (NPH), and multiple sclerosis (MS). CSF IL-1 beta levels were significantly higher in AD (131 +/- 17.33 pg/ml) than in MID (79.71 +/- 24.37 pg/ml, p less than 0.01), NPH (84.75 +/ 23.17 pg/ml, p less than 0.01), and MS (79.4 +/- 10.23 pg/ml, p less than 0.01). In patients with neurological disorders CSF IL-1 beta levels showed a progressive increase with age (r = +0.49, p less than 0.015). The concentration of IL-1 beta in CSF of demented patients correlated with mental deterioration (r = -0.476). According to these results we postulate that high levels of central IL-1 beta in AD might reflect a reactive neuroimmune response to: (a) abnormal epitopes exposed by lesioned neurons, (b) reactive microglia activated by exogenous and/or endogenous factors and (c) endogenous neurotrophic activation. PMID- 1784143 TI - Isolated paced guinea pig left atrium: a new ouabain-induced arrhythmia model. AB - Ouabain (1.0 x 10(-6) M) produced a uniform, consistent and reproducible arrhythmia on paced guinea pig left atrium bathed in Ringer-Locke solution. A second spell of arrhythmia of similar intensity and pattern, which had the same latency to onset, was reproduced 60 min after the first spell of arrhythmia. Lignocaine (3.46 x 10(-5) M) and propranolol (1.69 x 10(-5) M) gave full protection against the second spell of arrhythmia, whereas lower doses of these drugs were able to delay the onset and reduce the duration. Clonidine (3.75 x 10( 5) M), however, was found to be ineffective. This model can be used for the detection and assessment of directly acting antiarrhythmics in very low concentrations, since this is a sensitive and reliable method. PMID- 1784141 TI - Comparative study of the adverse effects of various radiographic contrast media, including ioversol, a new low-osmolarity medium. II. The complement system and endothelial cells. AB - The effects of ioversol, iohexol, iopamidol and meglumine sodium amidotrizoate (MSA) on the complement system and endothelial cells were investigated. The protein bindings of the radiographic contrast media (RCM), each tested with guinea pig plasma, were less than 1%. When guinea pig serum was incubated with any of the RCM, activation of the complement system, which leads to hemolysis, was not influenced by the nonionic agents, ioversol, iohexol or iopamidol. However, MSA, an ionic agent, significantly reduced hemolytic activity at 370 mgI/ml. Perfusion of the abdominal aorta with nonionic agents did not elicit significant endothelial damage; ioversol induced the least damage among the nonionic RCM, while MSA caused remarkable endothelial damage. Although MSA caused a marked release of endothelin-1 from cultured endothelial cells obtained from porcine aorta, nonionic RCM did not induce significant endothelin-1 release; no influence was elicited by ioversol and iohexol caused a weak suppression, while iopamidol had the opposite effect. These results indicate that ioversol could be used as a safe contrast medium in intravascular administration. PMID- 1784144 TI - Linear modeling of the effect of intravenous histamine infusion on rat gastric acid secretion: a biostatistical evaluation by splitting the time-effect curves. AB - Lumen perfusion experiments have been widely employed for the evaluation of gastric acid secretion in rats. The advantage of the lumen perfusion models is the simplicity in evaluating the effectiveness of secretagogues and antisecretagogues. There is, however, no efficient methodology for biostatistical modeling of gastric acid secretion in lumen-perfused rats. In order to optimize methodology, we applied a linear regression model after splitting the time-effect curves obtained from histamine-induced gastric acid secretion in rats. PMID- 1784145 TI - Gas-liquid chromatographic determination and pharmacological studies of six clinically-used local anesthetics. AB - A gas-liquid chromatographic method was developed for the simultaneous assay of six local anesthetics, including amethocaine, bupivacaine, etidocaine, lignocaine, mepivacaine and prilocaine, in biological samples. These drugs and internal standard (clomipramine) in basified samples were extracted into 5 ml n hexane, and the extract was analyzed by a temperature programming method (the column temperature was kept at 210 degrees C for 5 min, then raised to 280 degrees C at the rate of 10 degrees C/min) using a 3% W/W SP 2250 glass column (2 m x 2 mm i.d.) connected to a nitrogen sensitive detector. The injector and detector temperature were maintained at 300 degrees C. The pKa values, partition coefficients (K) and buccal absorptions of six local anesthetics were determined. The results showed that the onset of action and duration could be shown to be dependent on the pKa values and partition coefficients, respectively. A relatively good positive correlation (r = 0.991) was observed between the percentage of buccal absorption at pH 7.4 and the logarithms of K in n-hexane Sorensen buffer system, and hence the more lipid soluble the local anesthetic, the greater the buccal absorption. The buccal absorption test supplemented by the n-hexane-buffer partition coefficient could be used as indicators for the ability of the anesthetics to penetrate biological barriers. The lipid penetration of the drugs, and thus their pharmacological action, is also influenced by the pKa values of the anesthetics. PMID- 1784146 TI - Pharmacokinetics of epirubicin after intravenous administration: experimental and clinical aspects. AB - A method is described for the extraction and determination of epirubicin and its main metabolites epirubicinol and glucuronides in plasma, using high performance liquid chromatography (HPLC) with fluorescence detection. The extraction was performed with column Sep-Pak C18, which allowed a quantitative recovery of compounds. This method was used first in studies performed in five rabbits after intravenous administration of 3 mg/kg epirubicin, and later in a cancer patient, who received 50 mg/m2 epirubicin in rapid intravenous infusion. Although not statistically significant, kinetics of epirubicin were fitted in both cases to a tri-exponential model. Common metabolites were detected in rabbits and human, particularly the glucuronides. However, kinetics of epirubicin glucuronides and epirubicinol glucuronides were very different. Production and elimination were very fast in rabbit at very low levels and were undetectable two hours after administration, while in human, elimination was slower and greater amounts were detected 1-2 h after administration. The rabbit seemed to be an interesting animal species for pharmacokinetic studies because of easy blood sampling, detection of small amounts of glucuronides and because of a good fit to tri exponential kinetics model. PMID- 1784147 TI - In vivo-in vitro correlation of salbutamol release from a controlled release osmotic pump delivery system. AB - The drug release of salbutamol from a controlled release (osmotic pump) tablet was determined in vitro by four different dissolution apparatuses. From published in vivo data, percent of drug absorbed and percent of drug released in vivo were estimated. The highest correlation was obtained between percentage released in vitro versus percentage released in vivo using polynomial regression. PMID- 1784148 TI - Automated analysis of the McKenzie test through color slide digitization and processing. AB - The McKenzie test is performed to compare the antiinflammatory activity of topical corticosteroids. Each drug induces a local whiteness of the skin called blanching. The blanchings are classically evaluated on the basis of visual score. This paper proposes a new blanching index and a methodology for designing such an index by digitizing and processing color slides. Several indices derived from classical color models are proposed and compared to the visual scores. This work demonstrates the significant improvement of quantitation derived from digitized images with respect to the observer assessment. The difference of chromatic green between the blanching patch and the surrounded healthy skin is proposed for analysis of the McKenzie test. PMID- 1784149 TI - Studies on antinephritic effect of TJ-8014, a new Japanese herbal medicine, and its mechanisms. PMID- 1784150 TI - Environmental mycobacteria and human disease. PMID- 1784152 TI - Lipid-laden macrophages in bone marrow of leprosy patients. AB - While conducting a study to observe bone marrow cytomorphological changes in multibacillary leprosy, lipid laden macrophages as seen in sphingolipidoses were noted. The present study was planned to observe the occurrence and morphological characterization of these macrophages in various types of leprosy. Bone marrow records from 48 cases of paucibacillary and 72 cases of multibacillary leprosy were analysed. The macrophages accounting at the most for 3.5% of marrow cells were observed in 5 cases of paucibacillary and 43 cases of multibacillary leprosy with a maximum incidence being observed in patients with ENL (16/17). The lipid present in the cytoplasm of these cells could be derived from the lipid of the cell wall of Mycobacterium leprae. To the best of our knowledge, these cells have not been reported in leprosy so far. PMID- 1784151 TI - Comparison of polymerase chain reaction technique with other methods for detection of Mycobacterium leprae in tissues of wild nine-banded armadillos. AB - Thirty, nine-banded armadillos weighing between 3 and 5 kilograms trapped from an area endemic for armadillo leprosy were collected at random; killed, autopsied and examined histopathologically. Also, one of the right inguinal lymph nodes was removed under sterile precautions and examined using PCR, direct smear examination, mouse footpad study, culture in laboratory media and histopathology with a view to detecting Mycobacterium leprae. Blood was collected at death and tested for IgM antibodies to PGL-1. According to the PCR study of the inguinal lymph nodes 16 of 30 armadillos (53.3%) had evidence of M. leprae. Significant levels of IgM antibodies to PGL-1 and identifiable lepromatous granuloma in inguinal lymph nodes were found in 2 animals (6.7%) with advanced disseminated disease. The prevalence of generalized leprosy according to autopsy study was 13.3% and according to histopathological examination of ear tissue 3.3%. The presence of M. leprae in the tissues evoked no special tissue reaction in the early stages. The pattern of spread of the disease in 2 animals closely resembled that found in experimental animals infected intracutaneously. Initiation of infection by inoculation of M. leprae through thorn pricks remains a distinct possibility. PMID- 1784153 TI - Squamous cell carcinoma in chronic ulcers in leprosy: a review of 38 consecutive cases. AB - The histories of 38 consecutive cases of squamous cell carcinoma (SCC) arising in chronic ulcers of leprosy patients treated between 1981 and 1990 at the McKean Rehabilitation Centre, Northern Thailand were analysed retrospectively. The study included 37 individual patients; 29 males and 8 females. The average age was 60 years, the average duration of leprosy was 34 years and the average duration of ulcers was 12 years. Most patients (76%) came from leprosy settlements. Patients with borderline-tuberculoid (BT) leprosy were most commonly affected (63%), followed by lepromatous (LL) leprosy (21%) and borderline-lepromatous (BL) leprosy (16%). Four patients (11%) had histories of SCC on other extremities. Metastatic spread was observed in 2 cases (5%), both instances leading to death. The commonest site of involvement of SCC was the foot, but it was seen on the knee in 1 patient and on the hand in 2 others. The incidence rate of SCC in the group at risk (leprosy patients with disability grading 1 and 2) is calculated as being 0.79:1000 per year. SCC was seen in 1.8% of all cases admitted for ulcer care at the Centre. Treatment is by radical amputation. SCC in chronic ulcers in leprosy patients cannot be considered rare and emphasizes the need for an active policy of disability prevention in leprosy programmes. PMID- 1784154 TI - Nasal myiasis in leprosy. AB - Infestation of the nose with larvae of certain files can occur in leprosy patients. This results in severe distress and agony and can cause extensive tissue damage. The predisposing factors, clinical presentation and treatment is described. PMID- 1784155 TI - An educational approach to leprosy control: an evaluation of knowledge, attitudes and practice in two poor localities in Bombay, India. AB - Based on the hypothesis that a systematic, carefully planned educational approach to leprosy would yield results in terms of knowledge, attitudes and case presentation superior to those of the established and traditional mass survey method, ALERT-India launched a programme in S ward of Bombay in February 1985, to compare the two. An intensive programme of health education, using trained teams, was carried out in one zone of this ward over a period of 12 months. Eight months later, mass survey work (as used routinely in previous years and on a country wide basis) was carried out in an adjacent zone. In 1987, the Centre for Social and Technological Change in Bombay, in association with the School of Oriental and African Studies, University of London, was requested to evaluate the effect of the above educational approach in terms of knowledge, attitudes and practice in both the trial and control zones. Other aspects of this experimental approach, including its cost and effectiveness in identifying cases of leprosy, will be published separately. The design of the 'KAP' evaluation and the social and environmental controls introduced in the statistical analysis are described. The results pointed to a considerable degree of ignorance about leprosy as a disease (and its treatment) in both the study and the control zones. Knowledge about early symptoms was particularly weak and on all aspects scores for women were invariably lower than men. General education enhanced the absorption of specific knowledge, and the education of children compensated adequately for lack of parental education in this respect. Overall the evaluation indicated that the intensive educational approach was superior to the survey approach in terms of improving knowledge, attitudes and practice. PMID- 1784156 TI - Psychosocial aspects of deformed leprosy patients undergoing surgical correction. AB - A psychosocial study was conducted on 25 randomly selected leprosy patients undergoing corrective surgical procedures for their deformities. High anxiety and depression levels found preoperatively, reduced significantly after operation. Psychiatric assistance is needed for these patients in order to clear their psychic aberrations, create awareness, boost morale and to give self-confidence. Only 50-75% of preoperative expectations were satisfied but that was only in 40% of patients. This calls for a preoperative counselling session with the patients to help them reach the realistic goals that they can achieve. They should be told what benefits surgery can offer them and be made aware of the problems which will persist after operation, such as anaesthesia and analgesia. PMID- 1784157 TI - The private GP and leprosy: a study. AB - In urban and rural areas alike, people in India tend to prefer private medical care to the existing government health services. Nevertheless, the large private health care sector has hitherto been virtually alienated from activities of public health importance including priority disease control programmes. This study of 106 private general practitioners (GPs), practising in low socioeconomic areas of Bombay, shows a gross lack of knowledge and awareness among private doctors about leprosy and also about the National Leprosy Control Programme. The possible reasons are discussed. Effective involvement of GPs in the National Leprosy Control Programme should facilitate both integration and better implementation of leprosy control activities. The study also highlights some areas for future interventions at both primary and secondary health care levels and the need for a strategy, based on larger studies, to train and make private doctors participate in controlling diseases of major public health concern like leprosy. PMID- 1784158 TI - Pattern of leprosy in Queensland, Australia, 1855-1990. AB - Leprosy was first diagnosed in Queensland in 1855. From then until 1990, 929 patients with the disease were notified. The pattern of notification has varied with the passage of time, and with the changing pattern of migration into Queensland. In the early days, Chinese, Melanesians and Caucasians featured prominently. The first Aboriginal notification was in 1892. In the latter part of this century, significant numbers of Torres Strait Islanders and migrants from South East Asia have been recorded. Among Caucasians, the incidence peaked in the decade 1931-1940, although the prevalence rate in this population remains much higher than in Caucasians. The control of leprosy is at a high level in Queensland today, but there is a continuing low level of new case reporting, many of them imported. PMID- 1784159 TI - Type II (ENL) reaction in histoid leprosy in a child. PMID- 1784160 TI - Suggested new technique for skin biopsy under field conditions. PMID- 1784161 TI - Comment: Carvable silicone rubber prosthetic implant for atrophy of the first web in the hand. PMID- 1784162 TI - The continuing spread of AIDS. PMID- 1784163 TI - Medicine and public health in Baltimore during the early years of the Sinai Hospital of Baltimore. PMID- 1784164 TI - Donald E. Wilson MD Dean of the University of Maryland School of Medicine: an interview with MMJ's editor. PMID- 1784165 TI - The use of a low-level stage during exercise testing in predicting severe coronary disease. PMID- 1784166 TI - Insignificant blunt maternal trauma with lethal fetal outcome: a case report. AB - We report a case of a twenty-nine-week breech fetus with skull fracture, intracranial bleeding, and liver laceration sustained in a vehicular accident. This case describes insignificant maternal trauma with poor fetal outcome. PMID- 1784167 TI - Dr. Nathaniel Potter's contributions to medicine and the University of Maryland. PMID- 1784168 TI - The treatment of sleep disorders of older people: a response. PMID- 1784169 TI - Alternatives to the injection of insulin. PMID- 1784170 TI - The state of medicine in the Soviet Union. PMID- 1784171 TI - Molecular design and modeling: concepts and applications. Part A. Proteins, peptides, and enzymes. PMID- 1784172 TI - Mutational analysis of protein folding mechanisms. PMID- 1784173 TI - Modeling of side chains, loops, and insertions in proteins. PMID- 1784174 TI - Hydrophobic potentials from statistical analysis of protein structures. PMID- 1784175 TI - Neural networks for protein structure prediction. PMID- 1784176 TI - Comparative modeling of homologous proteins. PMID- 1784177 TI - Pattern-based approaches to protein structure prediction. PMID- 1784178 TI - Combined procedures of distance geometry and molecular dynamics for determining protein structure from nuclear magnetic resonance data. PMID- 1784179 TI - Electrostatic effects in protein folding, stability, and function. PMID- 1784180 TI - Biosynthetic method for introducing unnatural amino acids site-specifically into proteins. PMID- 1784181 TI - Stabilization of functional proteins by introduction of multiple disulfide bonds. PMID- 1784182 TI - Complete mutagenesis of protein coding domains. PMID- 1784184 TI - Use of homologous sequences to improve protein secondary structure prediction. PMID- 1784183 TI - Molecular modeling and dynamics of biologically active peptides: application to neuropeptide Y. AB - A methodology is presented to allow results from molecular dynamics simulations to be combined with pharmacological binding and activity measurements in order to study the structure-function relationships of neuropeptide Y. This approach is a general one and should also be applicable to other peptides for which stable structures are known to exist in solution. The basis of the method is the calculation of energetically stable structures via a simulate and test approach. This approach uses molecular dynamics simulations to search conformational space in order to find low potential energy structures. The energetic stability of the structures is then tested via additional simulations. Once energetic stability has been achieved, perturbations of the structure may be performed via molecular modeling. The simulate and test approach is then used to obtain energetically stable structures for the perturbed compound. Comparison between the energetically stable starting and perturbed structures can then be made concerning both structural and dynamic changes. By using an energetically stable structure prior to the perturbation, the assumption can be made that the calculated differences are primarily due to the perturbation rather than to one or both of the structures reaching a more energetically favorable state. It should be emphasized that the calculations are being performed employing a limited physical model such that the influence of that model on the observed results must always be taken into account. PMID- 1784185 TI - Diffusion-controlled enzymatic reactions. PMID- 1784186 TI - Theoretical calculations of relative affinities of binding. PMID- 1784187 TI - Quantitative structure-activity relationships and molecular graphics in evaluation of enzyme-ligand interactions. PMID- 1784188 TI - Hydrophobic parameter: measurement and calculation. PMID- 1784189 TI - Conformation of beta hairpins in protein structures: classification and diversity in homologous structures. PMID- 1784190 TI - Enzymatic catalysis in organic synthesis. PMID- 1784191 TI - Modification of enzyme catalysis by engineering surface charge. PMID- 1784192 TI - Mutational remodeling of enzyme specificity. AB - With the advent of genetic engineering techniques has come the ability to modify proteins as desired. Given this stunning capability, the question remains what residues should be altered, and how should they be changed to achieve a particular specificity pattern. The goals of such modifications are likely to fall into either of two categories: probing the function of a protein or attempting to alter its properties. In either case, our understanding of the consequences of a mutation, as ascertained by our ability to predict the results, is currently quite limited. The problem is extraordinarily complex; our understanding of how to calculate the energetics involved is still incomplete, and we are just beginning to accumulate experimental data which may help guide us. On the positive side, theoretical methods are now being developed and refined that should prove useful in the drive to engineer enzyme specificity. What may be most important at this juncture is to expand the experimental database interrelating sequence, function, and structure. That is, there should be a concerted effort to combine functional analysis of mutant proteins with structural analysis. Only from this combined examination of the effects of mutations can sufficient data be accumulated to test and improve both qualitative and quantitative approaches or methods for remodeling enzyme specificity. PMID- 1784193 TI - Modulation of enzyme specificity by site-directed mutagenesis. PMID- 1784194 TI - Analysis of structure-function relationships by formation of chimeric enzymes produced by gene fusion. PMID- 1784196 TI - Modeling of structure of human immunodeficiency virus-1 protease with substrate based on crystal structure of Rous sarcoma virus protease. PMID- 1784195 TI - Generation of allosteric enzymes from nonallosteric forms. PMID- 1784197 TI - Modulation of specificity and activity in mammalian cytochrome P-450. PMID- 1784199 TI - Cytochrome P450. PMID- 1784198 TI - Protein engineering in analysis of protein folding pathways and stability. PMID- 1784200 TI - Heterologous expression of mammalian P450 in COS cells. PMID- 1784201 TI - Expression of mammalian P450s in Escherichia coli. PMID- 1784203 TI - V79 Chinese hamster cells genetically engineered for stable expression of cytochromes P450. PMID- 1784202 TI - Modeling of mammalian P450s on basis of P450cam X-ray structure. PMID- 1784204 TI - Expression of cytochrome P450 cDNAs in human B lymphoblastoid cells: applications to toxicology and metabolite analysis. PMID- 1784205 TI - Expression of mammalian cytochrome P450 enzymes using yeast-based vectors. PMID- 1784206 TI - Functional analysis of mutant P450(C21) genes in COS cell expression system. PMID- 1784207 TI - Characterization of human P450IIC isozymes by using yeast expression system. PMID- 1784208 TI - Production of site-specific P450 antibodies using recombinant fusion proteins as antigens. PMID- 1784209 TI - Immunoisolation of human microsomal cytochromes P450 using autoantibodies. PMID- 1784210 TI - Identification of human cytochrome P450s as autoantigens. AB - Antimicrosomal antibodies in inflammatory liver diseases all seem to be directed against members of the cytochrome P450 family of proteins. These autoantigens seem to be genetically polymorphic, the autoantibodies are inhibitory, and the autoepitopes are generally conserved among species. Anti-P450 autoantibodies share these characteristics with other autoantibodies, for example, antinuclear antibodies in systemic lupus erythematosus. The identification of P450s as human autoantigens is clinically important. Diagnostic tests will be developed on the basis of cloned antigen, facilitating a better diagnosis of drug-induced and idiopathic autoimmune hepatitis. It is unknown what triggers autoantibody production against cytochrome P450 proteins. Furthermore, their pathogenetic role and thus their involvement in tissue destruction is unclear. In this context LKM1 autoantibodies may serve as a model. Although LKM1 antibodies are inhibitory, all LKM1 antibody-positive patients tested so far are extensive metabolizers for drug metabolism mediated by P450IID6 and express this protein in their livers. Thus, the inhibitory LKM1 autoantibody does not sufficiently penetrate through the intact liver cell membrane to inhibit enzyme function in vivo. Presumably, tissue destruction in autoimmune hepatitis is mediated by liver-infiltrating T lymphocytes. T lymphocytes have been cloned from liver tissue that specifically proliferate in the presence of recombinant cytochrome P450IID6. The construction of overlapping cDNA subclones is also valuable to identify immunodominant B cell as well as relevant T cell epitopes. PMID- 1784211 TI - Antipeptide antibodies in studies of cytochromes P450IA. PMID- 1784212 TI - Rat hepatic P450IIA and P450IIC subfamily expression using catalytic, immunochemical, and molecular probes. PMID- 1784213 TI - Expression of genes within mouse IIA and IID subfamilies: simultaneous measurement of homologous P450 mRNAs. PMID- 1784214 TI - CYP4A subfamily: functional analysis by immunohistochemistry and in situ hybridization. PMID- 1784215 TI - Isolating cytochrome P450 cDNA and genomic clones: library screening with synthetic DNA oligomers. PMID- 1784216 TI - P450 gene nomenclature based on evolution. PMID- 1784217 TI - Mutagenesis of cytochromes P450cam and b5. PMID- 1784218 TI - Cytochrome P450 turnover. PMID- 1784219 TI - Induction of diabetes and evaluation of diabetic state on P450 expression. PMID- 1784220 TI - Hepatocyte culture in study of P450 regulation. PMID- 1784221 TI - Induction protocols for cytochromes P450IIIA in vivo and in primary cultures of animal and human hepatocytes. PMID- 1784222 TI - Induction protocols for the cytochrome P450IVA subfamily in animals and primary hepatocyte cultures. PMID- 1784223 TI - Cytochrome P450 expression and metabolism in isolated rabbit renal epithelium. PMID- 1784224 TI - Culturing steroidogenic cells. PMID- 1784225 TI - Selections for and against cells possessing cytochrome P450IA1-dependent aryl hydrocarbon hydroxylase activity. PMID- 1784226 TI - Xenobiotic responsive elements controlling inducible expression by planar aromatic compounds and phenolic antioxidants. PMID- 1784227 TI - Induction of cytochromes P450IA1 and P450IA2 and measurement of catalytic activities. PMID- 1784228 TI - Omega- and (omega-1)-hydroxylation of eicosanoids and fatty acids by high performance liquid chromatography. PMID- 1784229 TI - Cytochrome P450 arachidonic acid epoxygenase: stereochemical characterization of epoxyeicosatrienoic acids. PMID- 1784230 TI - Measurement of steroid hydroxylation reactions by high-performance liquid chromatography as indicator of P450 identity and function. PMID- 1784231 TI - P450-catalyzed steroid hydroxylation: assay and product identification by thin layer chromatography. PMID- 1784232 TI - Assay of aromatase activity. PMID- 1784233 TI - Reversed-phase high-performance liquid chromatography assay of cholesterol 7 alpha-hydroxylase. PMID- 1784234 TI - Chemical modification of interaction between adrenodoxin and cytochrome P450scc. PMID- 1784235 TI - Induction, inhibition, and analysis of vitamin D metabolism in cultured cells. PMID- 1784236 TI - Measurement of cytochrome P450 activation of xenobiotics using the Ames Salmonella test. PMID- 1784237 TI - Breath tests as noninvasive assays of P450s. PMID- 1784238 TI - Site of action of substrates requiring cytochrome b5 for oxidation by cytochrome P450. PMID- 1784239 TI - Mechanism-based inactivation of cytochrome P450: isolation and characterization of N-alkyl heme adducts. PMID- 1784240 TI - Dihalomethyl compounds as mechanism-based inactivators of cytochromes P450. PMID- 1784241 TI - Active site-directed inhibitors of steroid hydroxylase cytochromes P450. PMID- 1784242 TI - Cytochrome P450 metabolic intermediate complexes from macrolide antibiotics and related compounds. PMID- 1784243 TI - Azidowarfarin as photoaffinity probe of cytochromes P450. PMID- 1784244 TI - Bacterial cytochromes P450: isolation and identification. PMID- 1784245 TI - Characterization of cytochrome P450 in extrahepatic tissues. PMID- 1784246 TI - Identification and localization of cytochromes P450 expressed in brain. PMID- 1784247 TI - Cell-free analysis of targeting of cytochrome P450 to microsomal membranes. AB - Analysis of P450 biosynthesis in cell-free systems has been useful in studying the mechanism of the targeting of P450 to the membrane. These techniques have allowed the demonstration that the N-terminal region of P450 is an uncleaved signal sequence for SRP-dependent membrane insertion. Lack of protection from protease indicated that most of the P450 is on the cytoplasmic side of the membrane. Substitution of basic amino acids at the P450 N terminus or replacing the N terminus of P450 with a secretory signal sequence results in partial or complete translocation across the membrane. This result indicates that at most one and probably none of the internal hydrophobic regions function as stop transfer signals, which would be present if the protein spanned the membrane more than once. PMID- 1784248 TI - Identification of cytochrome P450 in extrahepatic tissues by cross-hybridization of oligonucleotides and cDNAs. PMID- 1784249 TI - Identification and localization of cytochromes P450 in gut. PMID- 1784250 TI - Biosynthesis and intracellular sorting of mitochondrial forms of cytochrome P450. PMID- 1784251 TI - Expression of mammalian cytochrome P450 using baculovirus. PMID- 1784252 TI - Significance of sinking particles in the distribution of motile Aeromonas during the winter season. AB - The role of sinking particles in the distribution of motile Aeromonas species was studied during the winter season. Various environmental parameters and microbial populations were investigated to elucidate the relationship with motile aeromonads. Motile Aeromonas species were enumerated by most probable number technique with alkaline peptone water as the enrichment medium and modified pril xylose ampicillin agar as the plating medium. Aeromonas species were isolated in a water column in any one of the two procedures but sediment and plankton samples exhibited an irregular isolation pattern for these organisms. Aeoromonas species were continuously isolated in sinking particles with the highest counts during January. Of the 206 isolates identified, three known motile Aeromonas species were observed of which A. caviae accounted for 51.4% of the total. Toxin characterization showed that 20% of the strains produced haemolysin as well as cytotoxin, and A. hydrophila was highly toxigenic. Statistical analyses revealed that nutrients govern the distribution of Aeromonas. It may be that riverine discharge influences the distribution of motile aeromonads in this environment. PMID- 1784253 TI - Cell surface charge and sugar residues of Crithidia fasciculata and Crithidia luciliae. AB - The surface charge of Crithidia fasciculata and Crithidia luciliae was analysed by measurement of the zeta-potential and labelling of the protozoan surface with cationized ferritin particles. Both trypanosomatids have a net negative surface charge, with a zeta-potential of -10.39 mV and -11.12 mV for C. luciliae and C. fasciculata, respectively. Enzyme treatment showed that phosphate groups, but not sialic acid, significantly contributed to the negative surface charge. Lectin induced agglutination was used to analyse the presence of surface-exposed carbohydrates in C. fasciculata and C. luciliae. The cells did not agglutinate when incubated in the presence of lectins which recognized L-fucose, N-acetyl-D glucosamine and sialic acid. However, lectins which bind to N-acetyl-D galactosamine, D-galactose and D-mannose agglutinated both protozoa. PMID- 1784254 TI - Factors influencing the in vitro growth of Mycobacterium leprae: effect of oxygen. AB - In our efforts to evaluate factors responsible for in vitro growth of Mycobacterium leprae in DH medium and also to improve the system, effects of oxygen tension on in vitro growth of M. leprae were determined. This was achieved by varying the ratio between DH medium and free air space above the medium in the culture tubes. Growth-competent M. phlei (ATCC 11758) could tolerate all the oxygen it can get in the medium. On the other hand, M. leprae seemed to be of microaerophilic nature. In vivo-grown M. leprae cells were more sensitive than their counterparts that were adapted to in vitro environment. In vivo-grown cells grew better when 70% of the space in culture tube was occupied by DH medium. These in vitro-adapted cells gave optimum growth in subcultures when the air spaces in the culture tubes were 40-50%. The role of oxygen tensions in the development of lesions in leprosy patients and armadillos has been discussed. PMID- 1784255 TI - Cloning and expression of cDNAs from enterically-transmitted non-A, non-B hepatitis virus. AB - The fragment gene of enterically-transmitted non-A, non-B hepatitis virus (ET NANBHV) was cloned as a cDNA and inserted into an expression vector pUEX2. The recombinant protein was expressed in Escherichia coli HB101 as a fusion protein with beta-galactosidase (beta-Gal). The fusion protein reacted with the sera of infected cynomolgus monkeys and of patients from Myanmar. This reaction was highly related with ET-NANBHV infection, and obviously demonstrates in that the recombinant protein can be used for the detection of ET-NANBHV infection. PMID- 1784256 TI - Stimulation of phagocytic processes and antibody-dependent cellular cytotoxicity of human neutrophils by cefmetazole. AB - Interactions between antimicrobial agents and phagocytic cells, especially neutrophils, have a potential role in the treatment of infections. The in vitro effects of cefmetazole, a novel beta-lactam antibiotic, at a therapeutic concentration reached in plasma (50 micrograms/ml) on phagocytic and cytotoxic functions of human neutrophils have been studied. In human neutrophils, adherence capacity to nylon fiber and to substrate, chemotaxis, attachment to and ingestion of Candida albicans (with serum, with decomplemented serum and without serum), ingestion of inert particles (latex beads), candidicidal activity and superoxide anion production were all stimulated by cefmetazole. Cefmetazole at this dose was a chemotactic agent for neutrophils. Antibody-dependent cellular cytotoxicity (ADCC) was also increased by this anti-microbial agent. PMID- 1784257 TI - Lysis of murine macrophages by lymphokine-activated killer-like cells induced by BCG in vitro. AB - The lymphokine-activated killer (LAK)-like activity was found to be induced in mouse splenocytes cultured together with Bacillus Calmette-Guerin (BCG). The killer cells induced by BCG were capable of killing both NK-sensitive (YAC-1, P388D1) and NK-resistant (P815) tumor cells. As an important finding, they also lysed syngeneic macrophages (M phi). The anti-M phi killer activity appeared on day 2, and reached a peak on day 5 of culture. Phenotype analysis of the killer cells by depletion techniques using monoclonal antibody (mAb) and complement indicated that the majority of these anti-M phi killer cells were Thy-1+ and asialo GM1+. This M phi cytolysis could be inhibited by the addition of cold M phi, YAC-1 tumor cells, and P815 tumor cells, suggesting that the same population of the effector cells recognize M phi and tumor cells. The addition of anti-MHC class I, anti-MHC class II, anti-L3T4, or anti-Ly-2 mAb directly to assay cultures did not affect anti-M phi cytolysis, suggesting that the MHC molecules are not involved in the cytolysis of M phi by the BCG-induced killer cells. The addition of anti-LFA-1 mAb partially inhibited the cytotoxicity, suggesting importance of the contact between targets and effectors in the cytolysis. Our present data suggest that activation of murine lymphocytes with BCG induces LAK like cells capable of killing a wide variety of tumor cells as well as M phi and this anti-M phi cytolysis is mediated by nonspecific killer cells. PMID- 1784258 TI - S layer protein of Clostridium tetani: purification and properties. AB - S layer protein of Clostridium tetani strain AO 174, a nontoxigenic derivative of strain Harvard A 47, was prepared from the cell walls by 4 M urea extraction and purified by DEAE-Sepharose CL-6B chromatography followed by a combination of anion-exchange chromatography and reverse-phase chromatography using an HPLC system. The molecular weight of the S layer protein was estimated to be 140 kilodaltons (kDa) by SDS-PAGE. The amino acid composition of the 140 kDa protein was very similar to those of S layer proteins from the other bacterial species: it was rich in acidic amino acid and lacked cysteine. Also, the protein was unique in its extremely low content of proline (0.02 to 0.03 mol%). Multiple isoelectric forms ranging from pH 4.0 to 4.5 were observed in the purified preparation. Immunodiffusion analysis showed that the 140 kDa protein was a common antigen to the three strains of C. tetani tested. PMID- 1784259 TI - Serological evidence that the Q fever agent (Coxiella burnetii) has spread widely among dairy cattle of Japan. AB - Serological examination of bovine and human sera for antibodies against Coxiella burnetti was carried out by the immunofluorescence technique. Twenty to 30% of the cows examined were antibody-positive. Sera from two veterinarians also had antibody against C. burnetii. These results suggest an increase in the number of infected cows with C. burnetii in Japan since 1954, and also imply the possibility of the prevalence of acute Q fever in the human population, which had been underestimated and undiagnosed for the last three decades. PMID- 1784260 TI - An indirect microhemagglutination test for Lyme disease. AB - We have developed an indirect microhemagglutination test (IMHA) for detecting antibodies to Borrelia burgdorferi using formalin-fixed chicken erythrocytes sensitized with a sonicated extract of the bacteria. The specificity of IMHA for Lyme disease was compared with that of a conventional indirect immunoperoxidase technique (IP) using sera from the patients with syphilis, randomly-chosen outpatients unrelated to Lyme disease, and from normal individuals. The IMHA was more specific than IP, giving little cross-reaction with syphilis. The IMHA also gave little background reactions with the sera of individuals unrelated to Lyme disease or syphilis. Therefore, the IMHA could be a useful test for the serodiagnosis of Lyme disease. PMID- 1784261 TI - [Cytokines in chronic polyarthritis. Pathogenesis and new principles of therapy]. PMID- 1784262 TI - [Pharmacotherapy of immune diseases]. PMID- 1784263 TI - [Sports and the immune system. Training enhances immunocompetence]. PMID- 1784264 TI - [Acetylsalicylic acid in migraine]. PMID- 1784265 TI - [Incineration of old drugs?]. PMID- 1784266 TI - [Interactions between acetylcysteine and iron salts?]. PMID- 1784267 TI - [How does the rapid cholesterol tests work?]. PMID- 1784269 TI - Evaluation of anti-human immunodeficiency virus effect of recombinant CD4 immunoglobulin in vitro: a good candidate for AIDS treatment. AB - CD4 molecule, a surface marker of helper T lymphocytes, interacts with gp120 of human immunodeficiency virus (HIV) with a high affinity and, hence, serves as a virus receptor. Soluble chimeric CD4-immunoglobulin (Ig) possesses anti-HIV activity due to its binding activity to gp120. Furthermore, this recombinant molecule has unique Ig-like properties representing Fc receptor-binding activity and a long half-life in vivo. In this report we have thoroughly evaluated the effect of this compound on HIV infection using different in vitro systems. Treatment with 4 micrograms/ml of recombinant CD4-Ig after infection completely blocked the HIV-specific cytopathic effect, antigen expression, and virus release in MT-4 cells, a human T cell line which is highly susceptible to HIV. Similarly, this molecule blocked the HTLV-III/B and YU-1 strains of HIV infection in peripheral blood mononuclear cells even at 1 microgram/ml. Pretreatment of the Fc receptor-positive cell line U937 with this reagent resulted not in enhancement but again in blocking of HIV infection. About 95% of HIV infection was inhibited in U937 cells when cells were treated with this compound at the time of exposure to HIV. Recombinant-CD4-Ig also completely inhibited HIV-induced syncytia formation between MOLT-4 and MOLT-4/HIV and resulting virus release at 8 and 2 micrograms/ml, respectively. Due to its stability and long half-life, this compound could be a promising therapeutic agent against HIV infection. PMID- 1784268 TI - The different hemolysins of Escherichia coli. PMID- 1784270 TI - Recognition by peptide mapping of three different structural groups of outer membrane protein YOP-1 of Yersinia enterocolitica and Yersinia pseudotuberculosis. AB - The structural relation of YOP-1 of "european" and "american" Yersinia enterocolitica serotypes O:3, O:9, O:5,27, and O:8 and O:20, respectively, and Y. pseudotuberculosis serotypes I, II, and III was compared by sodium dodecyl sulfate polyacrylamide gel electrophoresis and peptide mapping using Staphylococcus aureus protease V8. Apparent molecular weights of YOP-1 ranged from 206,000 (O:3) to approx. 180,000 (O:8). According to their respective peptide maps YOP-1 of the "european" and "american" Y. enterocolitica serotypes and Y. pseudotuberculosis serotypes could be assigned to three different groups. Evaluation of several isolates of Y. enterocolitica serotypes O:3, O:9, and O:8 by peptide mapping indicated that YOP-1 is conserved within a serotype. However, one serotype O:8 isolate differed from the consensus peptide pattern of the other serotype O:8 and O:20 isolates. The similarity of the peptide patterns of Yersinia serotypes which predominate in certain geographical locations, i.e., "european" and "american" Y. enterocolitica serotypes, suggest common evolution of YOP-1 of these serotypes independent of the evolution of the other serotypes. PMID- 1784271 TI - Application of the polymerase chain reaction to study the M protein(-like) gene family in beta-hemolytic streptococci. AB - Evaluation of homologous regions of published M protein (emm) gene sequences from group A streptococci (GAS; Streptococcus pyogenes) was used to design three primer pairs for polymerase chain reaction (PCR) and three oligonucleotide probe sequences internal to the amplified products. One set of primers and corresponding probe should detect and lead to amplification of emm(-like) genes of virtually every type ("all M"), another ("SOR-M") should only amplify emm( like) genes from GAS negative for serum opacity reaction (SOR) and the third ("SOR+ M") should expand only emm(-like) genes from SOR+ GAS. Using the "allM" primer pair for PCR on the genomic DNA from GAS of 29 different M types as well as from a group C and a group G streptococcal isolate, DNA fragments within the expected size range were amplified in every assay. All PCR products reacted with the "allM" probe. Related sequences were not detected in genomic DNA of an S. agalactiae and an Enterococcus faecalis isolate. Applying the "SOR-M" and "SOR+M" primers to identical assays led to mutually exclusive amplification products. The "SOR-M" and "SOR+M" probes hybridized only to their corresponding products. Exceptions to this exclusivity were the SOR- GAS of M types 3, 8, 27, 34, 42, 67, and 69, which consistently reacted only with the "SOR+M" primer/probe set. Analysis of sequence data from the amplified emm(-like) 2, 3, 18, and 19 genes revealed interesting specific features such as conserved gaps in the C-terminal sequence regions from SOR+ and the exceptional SOR- GAS strains. These data indicate the existence of a subgroup of strains among SOR- GAS and may advance our understanding of phylogenetic relationship between different serotypes of GAS. PMID- 1784272 TI - Stimulation of NADH oxidation by xanthine oxidase and polyvanadate in presence of some dehydrogenases and flavin compounds. AB - The rates of NADH oxidation in presence of xanthine oxidase increase to a small and variable extent on addition of high concentrations of lactate dehydrogenase and other dehydrogenases. This heat stable activity is similar to polyvanadate stimulation with respect to pH profile and SOD sensitivity. Isocitric dehydrogenase (NADP-specific) showed heat labile, SOD-sensitive polyvanadate stimulated NADH oxidation activity. Polyvanadate-stimulated SOD-sensitive NADH oxidation was also found to occur with riboflavin, FMN and FAD in presence of a non-specific protein, BSA, suggesting that some flavoproteins may possess this activity. PMID- 1784273 TI - Stability of the anti-oxidative enzymes in aqueous and detergent solution. AB - Activities of the anti-oxidative enzymes, superoxide dismutase (SOD), glutathione peroxidase (GPx) and catalase were studied in rat tissues to determine the ability of detergents both to solubilize the enzymes and also to stabilize enzyme activity. Rat brain, heart and liver were homogenized in 0.1M KCl, 0.1% sodium dodecyl sulfate, 0.1% lubrol, or 0.1% cetyl-trimethylammonium bromide. In general lubrol was more effective than the other solutions in solubilizing GPx and catalase. Lubrol and 0.1M KCl were equally effective in solubilizing SOD. The highest enzyme activities were (1) SOD: 2484 ng/mg (brain), 2501 ng/mg (heart), and 5586 ng/mg (liver); (2) GPx: 224 mU/mg (brain), 1870 mU/mg (heart), and 7332 mU/mg (liver); (3) catalase: 2.8 mU/mg (brain), 10.6 mU/mg (heart), and 309 mU/mg (liver). While cetyl trimethylammonium bromide is marginally better than sodium dodecyl sulfate in solubilizing active enzyme, neither ionic detergent has any advantage over lubrol or 0.1M KCl. For catalase and GPx, enzyme activity loss with time is biphasic. After initial, rapid activity loss (1-5 days for GPx and 7 10 days for catalase) the differences noted among the homogenizing solutions disappear and very little if any activity loss is noted over the next 2-3 weeks. For catalase and GPx, only baseline enzyme activity from t = 0-3 weeks is found in the most chaotropic solution, 0.1% sodium dodecyl sulfate while biphasic activity loss is most pronounced in 0.1% lubrol. These results may indicate active GPx and catalase species stabilized by a lipid-like environment. Correlating in vitro catalase or GPx measurements with in vivo anti-oxidative protection may underestimate tissue defences. PMID- 1784276 TI - ["Microband F" extraoral traction appliance. Antero-posterior symmetry and asymmetry]. AB - The Authors describe a new appliance for monolateral asymmetric and/or bilateral symmetric extraoral anterior tractions. This new device doesn't need chin rest; it is specifically suggested for patients suffering from TMJ dysfunctions; from the esthetic point of view it is well accepted by patients. PMID- 1784274 TI - Comparative study of the expression of Rb and p53 genes in human colorectal cancers, colon carcinoma cell lines and synchronized human fibroblasts. AB - We have compared the expression of the retinoblastoma (Rb) and p53 genes in normal human fibroblasts, colon carcinoma cell lines, matched pairs of colorectal tumor tissues and adjacent normal mucosa and in synchronized human diploid fibroblast cell line WI38. The increased expression of Rb and p53 RNA was observed in a majority of colorectal cancers in comparison to adjacent normal mucosa and is accompanied by proportional increase in the expression of histone H3 gene. The Rb and p53 RNA levels varied significantly between the various colon carcinoma cell lines. However, we found that the expression of Rb and p53 RNA is regulated differently in cell cycle synchronized normal human fibroblasts. The Rb mRNA level did not change with the position in the cell cycle and did not differ significantly whether the cells were serum deprived or in 10% serum. But p53 mRNA expression follows the same pattern as histone H3 mRNA. PMID- 1784275 TI - Purification and characterization of G proteins from human brain: modification of GTPase activity upon phosphorylation. AB - Three G proteins from human brain membranes were purified to near homogeneity by conventional techniques including preparative electrophoresis. These G proteins were characterized by their ability to bind GTP, GDP and GTP analogs. Two of these proteins have molecular weights of 50,000 (G50) and 36,000 (G36), as determined on SDS-gels. G36 was ADP-ribosylated by pertussis toxin. Thus, G50 could represent a Gs alpha subunit, whereas G36 could be Gi alpha or Go alpha. G50 was phosphorylated by cAMP dependent protein kinase and protein kinase C. G36 was phosphorylated by a protein kinase independent of calcium and phospholipid, a proteolytic product of protein kinase C, analogous to protein kinase M. Phosphorylation of G36 by this protein kinase induced a dramatic decrease in its GTPase activity. The third G protein, of molecular weight 22,000 probably belongs to the group of monomeric G proteins possessing functional similarities with ras gene products. The regulation of G proteins involving calcium-dependent and independent pathways is delineated. PMID- 1784277 TI - [Arthromuscular interrelations in TMJ functional pathology]. AB - TMJ disorders includes: TMJ and masticatory muscles, pain, joint sounds, deviation and limitation of mandibular movements. A critical analysis of the literature dealing with the relationship between joint and muscle disorders in other joints (knee), leads to evaluate the reliability of the hypothesis of the existence of an arthro-myogenous relation in the aetiopathogenesis of craniomandibular disorders. As a preliminary conclusion we can say that the joint derangement seems the primary factor in the pathogenesis of TMJ disorders and cannot to differentiate muscle from joint involvement seems a difficult task. PMID- 1784278 TI - [Prevalence of caries and malocclusion in Ferrara school children]. AB - The Authors examined 459 children for caries and malocclusion in Argenta. 77% of the whole sample had caries and 65% of children had malocclusion. Dental health education and public preventive programs should be organized to prevent caries and malocclusion. An extension and improvement of local epidemiological studies are needed to achieve this purpose. PMID- 1784279 TI - [Hemifacial microsomia: cephalometric evaluation]. AB - Among the facial deformities one of the most frequent is the hemifacial microsomia. The Authors after a revision of the literature refer about their study. They utilize lateral, antero-posterior cephalometry and orthopantomogram to exactly identify the deformities. The Authors report the results of the analysis and emphasize that the functional alterations of the stomatologic system are of basical importance in the genesis of the syndrome. PMID- 1784280 TI - [Morphological surface analysis of nickel-titanium wires. Preliminary SEM observations]. AB - Authors studied with Scanning Electron Microscopy (SEM) the surface morphology of new manufactured orthodontic arches made of rectangular NiTi wires. All the wires exhibite various patterns of superficial defects such as scratches and pits. Results suggest to further investigate the changes of wire surfaces subsequent to their use in oral environment and sterilization procedures. PMID- 1784281 TI - [Comparative study of some cephalometric analyses. 1]. AB - In this article the measurements proposed by some Authors in their cephalometric analysis will be briefly described for the facial tiptology analysis, for the maxillarys divergence analysis, for the skeletal Class analysis and for the aestetic analysis. PMID- 1784282 TI - [Relationship of orthodontics and periodontal support]. AB - The Authors, in the light of available data in the published literature and using their own personal experience as a basis, examine the relationship existing between orthodontia and periodontology, giving prominence to the more immediate and dynamic aspects of the comparison. An obvious cause-and-effect relationship often links the position of the teeth and the periodontal pathology; if this relationship is understood by the orthodontist, it can guide him in his choice of treatment, both where curative treatment is required but also, and more importantly, where prevention can be provided. Emphasis is placed on how serious can be the damages caused to the periodontium where the monitoring of the bacterial plaque and of the inflammation which it brings about is not sufficiently constant. Certain programs of treatment are proposed which, using orthodontal methods, can make a substantial contribution to solving periodontal problems, the kind of problems which are hard to control when traditional methods are used. PMID- 1784283 TI - [Transposition of upper permanent canine and premolar. Orthodontic, surgical and conservative solutions]. AB - According to the bibliography and their personal experiences, the Authors take into account the transposition of the canine and first premolar, in order to discuss their causes and consider the different therapeutical possibilities. Three clinical cases are here treated. PMID- 1784284 TI - [Surgically assisted rapid palatal expansion using corticotomy of the upper jaw]. AB - After a brief review of the techniques reported for the rapid maxillary expansion surgically assisted, the Authors describe their surgical approach and present two cases of RPE in combination to surgery. PMID- 1784285 TI - [Functional anterior limits of the dentition. 2]. AB - The Authors search in the most used cephalometric techniques the values defining superior incisor position relationship with cephalometric planes. They assess cephalometric values on 50 functionally stable patients at the end of treatment with axiographic method. PMID- 1784286 TI - [Dental compromise for bite closing in patients with minimal or negative overjet]. AB - The Authors evaluate the most common techniques to close the bite in patients with no overjet, then they suggest a method (anterior cross-bite elastics) that can obviate some of the disadvantages experienced using those techniques. PMID- 1784287 TI - [Electromyographic and electrognathographic analysis of patients with juvenile rheumatoid arthritis]. AB - Seven patients, affected by JRA, underwent an examination by electromyography and electrognathography, to judge variations in the activity of some masticatory muscles and in the movements of the jaw. The muscular activity and masticatory mechanics show a reduction in the freedom of movement. The system cannot work in all the positions allowed by the physiological mobility of the TMJ. PMID- 1784288 TI - [Analysis of force distribution in occlusal splints]. PMID- 1784289 TI - [Relation of dental classes and TMJ. Survey of 2100 students]. AB - The Authors have examined 2100 students of Sassari (mean age 17 years) to point out eventual relationship between different Angle Classes and the health of TMJ. There was found an incidence of disorders more high in the right TMJ. This datum is turned out valid to statistical table. PMID- 1784290 TI - [Relationship between TMJ pathology and types of orthodontic treatment]. AB - The Authors report the incidence of temporo-mandibular joint disease in young people which are treated with different type of orthodontic therapy. The incidence is variable according to the absence of orthodontic therapy or the presence of treatment with removable or not removable appliances. PMID- 1784291 TI - [Experimental measurement of force exerted by palatal bars. 1]. AB - The Authors have prepared a protocol of research to evaluate the forces of lateral expansion expressed by the palatal bar et different degrees of activation. A special instrument has been built to this purpose. The forces expressed at the different degrees of activation are then evaluated and confronted in relation to the following variables: --length of the bar;--the presence or the absence of a U loop; --the more or less bowed conformation given to the bar. It is shown how, on the same terms, the presence of the U loop reduces the force made by the bar by about the half and that the more or less bowed conformation of the bar influences the force in the same way. PMID- 1784292 TI - [Use of the perpendicular vertical in cephalometric analysis]. AB - Cephalometric analysis is a useful diagnostic tool in orthodontics. The intracranial planes, commonly used as reference lines for cephalometric measurements, are not constant in the population. The variation of these references could constitute source of diagnostic error. On the light of this potential errors, the use of the vertical to the ground (or of its perpendicular line, orizzontal to the ground) constitutes a better reference for cephalometric measurements. The advantage of the vertical as reference is represented by its consistency in the same individuals and between different subjects. PMID- 1784293 TI - [Dynamic changes in nasal resistance and cephalometric parameters in mouth breathing children two years after adenotonsillectomy]. AB - The Authors show the results of a research after 2 years from adenotonsillectomy or adenoidectomy. The comparison between the results after 6 and 24 months shows there are no differences among these results. PMID- 1784294 TI - [Lip posture and facial profile standards in mass-media models]. AB - It is considered that, among the elements that contribute to the formulation of an individual aesthetic judgement, the most important are the conditionings exercised on the subject by the modern proposals of the mass-media. In this work the positioning of the lips is defined and, more in general, an attempt is made to interpret the requirements of the facial profile in 150 models, whose face has appeared in the press over the last two years, based on the findings of an accurate photogrammetric examination. PMID- 1784295 TI - [New directions on the postural, skeletal and dental effect of the custom activator]. AB - From the beginning and up till now the activator followed the improvement of the orthodontic thought, thus keeping its informing principles. Through research it has come to light that the main action of the activator is simply on the vertical plane. PMID- 1784296 TI - [Distalization of the upper second molar: biomechanics]. AB - The Author shows a system to dystalize the second upper molars and, if necessary, the third upper molars. This system, easy to be adapted, is made up by a palatal bar inserted between the first upper molars, by a sectional and a 100 grams precalibrated open Sentalloy coil spring used as an active force. PMID- 1784297 TI - [Distalization of the upper second molar: clinical case]. AB - The Authors showed a clinical case in which has been put on a distalizing system together with a palatal bar between the first upper molars, a sectional placed between the first and the second molar and a 100 g precalibrated Sentalloy coil. PMID- 1784298 TI - [Cloning of the gene and immunochemical specificity of recombinant immunoglobulin binding protein V7 from Streptococcus valente (group G)]. AB - The fragment of the structural gene coding for the Fc-receptor of Streptococcus Valente (G group) has been cloned. The resulting recombinant plasmid pPGSV1 contains the O, kb HindIII fragment of streptococcal chromosomal DNA inserted into the vector plasmid pUC19 and determines the expression of the 31 kD protein in Escherichia coli cells. The protein binds the immunoglobulins of human, rabbit, guinea pig origin, but in contrast to the G protein of another G group streptococcus it is nonreactive with mouse, pig and sheep IgG. PMID- 1784299 TI - [Hybrid plasmid pSKEFT5 assures the transfer of plasmids Sa from Escherichia coli cells into cells of the tularemia microbe vaccine strain cells]. PMID- 1784300 TI - [Protein expression of Yersinia pestis during changes due to long-term cultivation in vivo]. AB - The electrophoretic study of Yersinia pestis proteins made possible to find the significant modification of Yersinia pestis polypeptide specters when the bacteria were cultivated in semi-penetrable cells implanted into the guinea pigs peritoneum. The proteinogramms of the isolates from the implanted cells lacked the stained bands characteristic of Yersinia pestis cells grown in vitro and contained the new polypeptides absent from the bacteria grown on the Hottinger agar plates. The difference was found at the late stage of bacteria incubation in implanted cells and had the predominantly reversible characteristics. The protein of Yersinia pestis being changed in vivo is proposed to be the species specific fraction I. PMID- 1784301 TI - [Cloning of the REP-region of plasmids from a broad circle of pM3 hosts (INC P 9)]. AB - The rep-region of a broad host range plasmid pM3 (IncP-9) has been cloned by connecting the 7.2 kb PstI fragment of the plasmid with the 1.4 kb PstI fragment of the pUC4K vector plasmid. The latter includes the gene for kanamycin resistance and is unable to replicate by itself. The obtained minireplicon designated pMT2 contains rep-genes permitting its inheritance in the different gram-negative cells and a mob-site coding for incompatibility and temperature instability characteristic of the parent plasmid pM3. PMID- 1784302 TI - [Localization of fragments binding nuclear proteins in the promotor region of the human alpha-1-antitrypsin gene]. AB - Human and mice nuclear extracts from livers and mice spleen extract were analysed in an attempt to find any proteins capable of binding to the human alpha 1 antitrypsin gene promoter. The nuclei of all studied tissues contain such proteins. The proteins were partially purified on DEAE-trisacryl, heparin sepharose and phosphocellulose columns. The multiple sites for liver nuclear proteins binding to the human alpha 1-antitrypsin gene promoter were found by the DNAse I footprinting technique. PMID- 1784303 TI - [Isolation and certain properties of the dermonecrotic toxin from Pasteurella multocida]. AB - The procedure for isolation and purification of Pasteurella multocida serovariant D toxin has been described. It includes the three steps of protein precipitation from cultural filtrates by 70% ammonium sulfate, chromatography of the concentrated material on Ultragel AcA44 gel-filtration on Sephracryl S-200. The proposed technique permits one the 155-fold purification of the preparation with 32.6% yield estimated by biological activity. The obtained purified preparation is homogeneous in polyacrylamide gel electrophoresis. The immunological methods also confirm the homogeneity of the preparation. The minimal dermonecrotic dose for guinea pigs of the purified 120 kDa toxin is 78 ng and LD50 for mice is 280 ng. Pasteurella multocida toxin is found to be a thermolabile protein sensitive to trypsin, glutaraldehyde and formaldehyde treatments. PMID- 1784304 TI - [Methods of detecting polypeptides, nucleic acids and lipopolysaccharides with silver and gold stains]. AB - The main modifications of the modern techniques for indication of polypeptides, nucleic acids and lipopolysaccharides using silver and gold staining are presented. The mechanisms for staining, sensitivity and reproducibility of the methods are evaluated. PMID- 1784305 TI - [Simple methods of enzymatic amplification of DNA for clinical practice]. AB - The methods for enzymatic DNA amplification in vitro that allow to avoid the step of preliminary DNA extraction and purification are proposed. Lysates of blood cells in the solution or immobilized on the nylon membrane filters and dried blood spots on the filter paper blotters were used directly in amplification permitting one to solve the problems of adapting the method of polymerase chain reaction in clinical practice, for instance, in massive screening of genome mutations, viral infections etc. PMID- 1784306 TI - [Analysis of the nucleotide sequence of a small colicinogenic plasmid Cold gene coding for lysis]. AB - The nucleotide sequence of a DNA fragment of a small colicigonenic plasmid Cold CA23 containing the lysis gene cdl has been defined. An open reading frame has been found within the fragment for 48 amino acid polypeptide with the molecular mass 4920 Da. The polypeptide is homologous to the lysis proteins encoded by the small colicinogenic plasmids ColE1 and CloDF13. The homology was also found for the structural and functional arrangement of the cdl gene and the plasmid CloDF13 lysis gene. The analysis of the possible secondary structures of the lysis protein encoded by cdl gene has revealed the amino acid sequences able to form the alternative structures. The described feature is supposed to be required for lysis protein translocation from cytoplasmatic to outer membrane of Escherichia coli cells. PMID- 1784307 TI - Stability of classification of filamentous fungi under changes in character coding strategy. AB - The characteristics of a number of filamentous fungal cultures were obtained from two previously published numerical taxonomic studies on Penicillium and Phoma. The coding strategies for some of the physiological and morphological properties employed in the original studies were re-examined and the data was re-coded by combining sets of characters into single ordered multistate characters. The different coding procedures were compared by generating average linkage (UPGMA) dendrograms which were in turn compared by calculating correlation coefficients between the final similarity matrices implied by these dendrograms. The character conversions had no significant effect on the final outcome of the clustering. PMID- 1784308 TI - Mycotoxins and mycotoxigenic moulds in nuts and sunflower seeds for human consumption. AB - A survey was carried out to obtain data on the occurrence of mycotoxins and the mycotoxin-producing potential of fungi isolated from nuts (almonds, peanuts, hazelnuts, pistachio nuts) and sunflower seeds in Spain. Thin-layer chromatography was used to separate the toxins. Aflatoxins were detected in one sample of almonds (95 ppb aflatoxin B1 and 15 ppb aflatoxin B2) and in one sample of peanuts at a level below 10 ppb of aflatoxin B1. 100% of samples showed variable incidence of fungal contamination. The predominant fungi present in samples were Penicillium spp, Aspergillus niger, A. flavus, A. glaucus and Rhizopus spp. The results showed that isolates of different species were able to produce aflatoxins B1, B2, G1, and G2, sterigmatocystin, ochratoxin A, patulin, citrinin, penicillic acid, zearalenone, and griseofulvin. PMID- 1784309 TI - Studies on the relationship between paracoccidioidomycosis in ddY mice and their estrous cycle. AB - The relationship between paracoccidioidomycosis in ddY mouse and its estrous cycle was studied. Adult ddY mice of both sexes were used as experimental animals. Estrous cycle of female mice was examined before inoculation of Paracoccidioides brasiliensis yeast cells and mice were divided into 5 groups such as proestrus, estrus, metestrus-I, metestrus-II and diestrus. Each mouse was inoculated intravenously with 10(6) P. brasiliensis yeast cell units and sacrificed on day 28 after inoculation. Their internal organs were cultured, and in addition, their histopathologies were studied. As a result, there was no difference in the organ cultures among the male and the female mice of 5 groups. However, histopathologically, the female groups at estrus, metestrus-I and metestrus-II were affected more severely than the male group, and the susceptibility of the female mice to the fungus was closely related to their estrous cycles. PMID- 1784310 TI - Comparison between antifungal and antibacterial activities of several strains of Epicoccum purpurascens from the Mediterranean area. AB - The antimicrobial activities of seven Epicoccum purpurascens strains isolated either from evergreen oak leaves (Quercus ilex) collected over a period of one year, or from the atmosphere were compared in vitro. Two strains sporulated and conspicuously inhibited the growth of Staphylococcus aureus and Trichophyton mentagrophytes. Thin-layer chromatographic studies showed the existence of some compounds, such as flavipin, which were common to all the strains. Epicorazine B was present in the extracts of only the two most active strains. PMID- 1784312 TI - How do surgeons decide when to operate? PMID- 1784311 TI - An integrated approach to Phoma systematics. AB - Physiological and morphological characters were recorded from 55 strains of 17 Phoma taxa and one Pyrenochaeta. The results were subjected to numerical analysis and UPGMA dendrograms produced. The full results were compared with TLC profiles of secondary metabolites. Seven distinct clusters were recovered from dendrograms based on full and partial character sets and the grouping of strains within each cluster discussed. The new combination Phoma sambuci-nigrae (Sacc.) Monte, Bridge & Sutton is proposed for P. herbarum f. sambuci-nigrae Sacc. PMID- 1784313 TI - Internal fixation of the odontoid: a newer approach to an old problem. AB - A surgical approach to cervical spine instability associated with odontoid fracture is described. Internal fixation of the odontoid (IFO) has advantages over traditional posterior surgical treatments currently employed. This approach to the odontoid process is easier for the surgeon comfortable with anterior discectomy to perform than other techniques described in the spine literature. PMID- 1784314 TI - Congenital syphilis in Nebraska: a case report. AB - In the United States, the incidence of acquired syphilis has increased thirty four percent in the last decade with young, black, urban dwelling, drug dependent females representing the highest risk group. Concomitantly, congenital syphilis has increased causing spontaneous abortions, stillbirths, and neonatal morbidity and longterm neurologic sequela. Because physicians are no longer familiar with the disease, it is estimated that only twenty-five percent of neonatal syphilis is diagnosed during the first year of life. This report describes the first reported case of congenital syphilis in Nebraska. Our patient demonstrates the typical clinical findings of lethargy, extremity swelling and the pseudoparalysis of Parot, while laboratory evaluation showed anemia, abnormal hepatic enzymes, hypoproteinemia, and confirmatory positive neonatal VDRL and FTA-ABS. The plain film radiographic survey illustrated the characteristic findings of periostitis, metaphyseal banding and cortical erosion. By relying upon the relatively inexpensive and easy to obtain radiographic long bone survey a prompt diagnosis can be made and immediate treatment instituted while awaiting confirmatory serology. We must reacquaint ourselves with the increasing incidence of acquired and congenital syphilis. This will enable us to make a timely and cost-effective diagnosis of cogenital syphilis and prevent its devastating complications. PMID- 1784315 TI - Prenatal therapy for the chronically hypertensive patient. PMID- 1784316 TI - Revised recommendations for the prevention of bacterial endocarditis. PMID- 1784317 TI - The Health Care Quality Improvement Act of 1986: National Practitioner Data Bank. PMID- 1784318 TI - ECMO update: what's new after 3 years? PMID- 1784319 TI - Physician payment reform: a paradox. PMID- 1784320 TI - Combined pancreas--kidney transplantation in Nebraska. AB - In the last 2 years, we have performed combined pancreas-kidney transplantation in 38 Type I diabetics with nephropathy. The mean age of the recipient group was 35 years (range 24-51) with a mean duration of diabetes of 22 years (range 13 41). All patients received quadruple immunosuppression with OKT3 induction. All patients are normoglycemic and insulin independent with a mean glycosylated hemoglobin level of 5.2 +/- 1.1% and a mean serum creatinine of 1.9 +/- 0.5 mg/dl. Metabolic effects of pancreas transplantation included fasting hyperinsulinemia and hyperglucagonemia with exaggerated insulin and glucagon responses to glucose and arginine, respectively, that improved slightly with time. Patient and kidney graft survival are 100% and pancreas graft survival is 94.7% after a mean follow-up interval of 15 months. CONCLUSION: Combined pancreas kidney transplantation is the treatment of choice for selected Type I diabetics with nephropathy and results in euglycemia despite immunosuppression. PMID- 1784321 TI - Heparin-flush associated thrombocytopenia--induced hemorrhage: a case report. AB - Thrombocytopenia is a well known complication of heparin. It occurs when heparin is used in full therapeutic dose or in subcutaneous mini-doses for prophylaxis. This has also been reported with minuscule dose of heparin used in heparin flushes to keep vascular access catheters patient. We are reporting for the first time, a case of severe hemorrhage due to thrombocytopenia associated with heparin flushes. PMID- 1784322 TI - Current issues in neural tube defects. PMID- 1784323 TI - Effects of low selenium diets on antioxidant status and MPTP toxicity in mice. AB - To investigate the role of chronic oxidative stress in MPTP neurotoxicity, C57BL mice were maintained 6-8 weeks on diets deficient in nutrients essential to cellular antioxidant defenses, selenium (Se) and alpha-tocopherol (vit E), and the effects on tissue antioxidant status and MPTP toxicity were evaluated relative to controls on supplemented diets. Activities of the major antioxidant enzymes, glutathione peroxidase (GPx), catalase, and superoxide dismutase, and levels of malondialdehyde as a marker for oxidative stress, were measured in brain, lung, liver and blood. Caudate depletion of dopamine and its metabolites served as a measure of MPTP neurotoxicity. For mice on the Se deficient diet, levels of the selenoenzyme GPx decreased from 50% in brain to 90% in blood. No compensatory changes in the activities of the other antioxidant enzymes were observed and addition of vit E to the diet did not alter antioxidant enzyme activities or malondialdehyde levels. In animals not treated with MPTP, the Se deficient diet significantly increased malondialdehyde only in liver. No protective effect of the antioxidant supplements against caudate depletion of dopamine and its metabolites were observed. However, malondialdehyde levels were increased in the brains of MPTP treated mice on the low Se diets, suggesting the possibility of secondary oxidative damage to tissues accompanying the destruction of substantia nigra neurons by MPTP. PMID- 1784324 TI - The effects of adrenalectomy and thermal stress on glutamic acid decarboxylase activity in different regions of the rat brain. AB - Glutamic acid decarboxylase (GAD) enzyme activity was measured in synaptosomes prepared from the hypothalamus, the hippocampus, the striatum and the cerebral cortex of control, adrenalectomized and rats exposed to a thermal stress. Adrenalectomy caused a statistically significant decrease in the enzyme activity in the striatum, while it had no effect in the other three brain areas. On the other hand, exposure to the thermal stress resulted in a dramatic increase of GAD specific activity in all brain areas examined. This thermal stress-induced increase in enzyme activity was observed in both non-operated and adrenalectomized animals, which implies that it is not mediated by glucocorticoids. PMID- 1784326 TI - Effects of brief starvation on brain protease activity. AB - Changes in the activity of proteases (cathepsin D and calpains) caused by 48-h food withdrawal were studied in the brain, liver, kidney, spleen, and heart of 3 , 12-, and 24-month-old Fischer rats. Cathepsin D activity was similar in brain, liver, and heart of control animals; in kidney it was 5-fold higher and in spleen about 10-fold higher. With age, activity increased in all organs tested except spleen. Brief starvation caused no change of cathepsin D activity in brain, but caused an increase in liver and a decrease in spleen. Neutral proteolytic activity in control was highest in the pons-medulla-cerebellum fraction of brain, and activity in liver and heart was below that in brain. Activity increased with age in brain and decreased in other organs. Brief starvation in young animals caused an increase in activity in brain, and a decrease in liver and spleen. Isolated calpain II activity was high in control brain. It increased with age in the cerebrum. Brief starvation resulted in a decrease in the brain. The results indicate that the protease content of the brain is altered with age and in malnutrition, with changes not being the same for all proteases, and changes in brain being different from those in other organs. PMID- 1784325 TI - Effects of potassium on the anion and cation contents of primary cultures of mouse astrocytes and neurons. AB - In astrocytes, as [K+]o was increased from 1.2 to 10 mM, [K+]i and [Cl-]i were increased, whereas [Na+]i was decreased. As [K+]o was increased from 10 to 60 mM, intracellular concentration of these three ions showed no significant change. When [K+]o was increased from 60 to 122 mM, an increase in [K+]i and [Cl-]i and a decrease in [Na+]i were observed. In neurons, as [K+]o was increased from 1.2 to 2.8 mM, [Na+]i and [Cl-]i were decreased, whereas [K+]i was increased. As [K+]o was increased from 2.8 to 30 mM, [K+]i, [Na+]i and [Cl-]i showed no significant change. When [K+]o was increased from 30 to 122 mM, [K+]i and [Cl-]i were increased, whereas [Na+]i was decreased. In astrocytes, pHi increased when [K+]o was increased. In neurons, there was a biphasic change in pHi. In lower [K+]o (1.2-2.8 mM) pHi decreased as [K+]o increased, whereas in higher [K+]o (2.8-122 mM) pHi was directly related to [K+]o. In both astrocytes and neurons, changes in [K+]o did not affect the extracellular water content, whereas the intracellular water content increased as the [K+]o increased. Transmembrane potential (Em) as measured with Tl-204 was inversely related to [K+]o between 1.2 and 90 mM, a ten fold increase in [K+]o depolarized the astrocytes by about 56 mV and the neurons about 52 mV. The Em values measured with Tl-204 were close to the potassium equilibrium potential (Ek) except those in neurons at lower [K+]o. However, they were not equal to the chloride equilibrium potential (ECl) at [K+]o lower than 30 mM in both astrocytes and neurons.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1784327 TI - Acetylcholine formation from glucose following acute choline supplementation. AB - The effects of choline administration on acetylcholine metabolism in the central nervous system are controversial. Although choline supplementation may elevate acetylcholine (ACh) content in brain, turnover studies with labelled choline precursors suggest that systemic choline administration either has no effect or actually diminishes brain ACh synthesis. Since choline supplementation elevates brain choline levels, the apparent decreases in previous turnover studies may reflect dilution of the labelled choline precursor pool rather than altered ACh formation. Therefore, brain ACh formation from [U-14C]glucose was determined after choline supplementation. A two to three fold elevation of brain choline did not alter ACh levels or [U-14C]glucose incorporation into ACh in the cortex, hippocampus or striatum. Although atropine stimulated ACh formation from [U 14C]glucose in hippocampus, two to three fold increases in brain choline did not augment ACh synthesis or content in atropine pretreated animals. Atropine depressed brain regional glucose utilization and this effect was not reversed by choline treatment. These results suggest that short-term elevation of brain choline does not enhance ACh formation from [U-14C]glucose, and argue against enhanced presynaptic cholinergic function after acute, systemic choline administration. PMID- 1784328 TI - Quantitative in vivo receptor binding. IV: Detection of muscarinic receptor down regulation by equilibrium and by tracer kinetic methods. AB - Newly-developed methods for estimation of in vivo binding to neurotransmitter receptors should enable the detection and quantification of physiologic or pathologic changes in receptor numbers. In the present study, both equilibrium and kinetic experimental strategies for in vivo muscarinic receptor determination were applied to the detection of receptor changes induced by chronic inhibition of acetylcholinesterase in the rat. Following one week of treatment, in vitro receptor autoradiography utilizing [3H]scopolamine revealed significant losses of muscarinic binding in the cerebral cortex, hippocampus, striatum and in cranial nerve motor nuclei. The in vivo distribution of [3H]scopolamine, following infusion to approach equilibrium binding in the brain, revealed reductions in binding which paralleled the pattern and magnitude of changes detected in vitro. A simplified tracer kinetic estimation following bolus injection of the ligand also detected substantial reductions in forebrain muscarinic receptor binding. These results indicate the feasibility of detecting receptor changes underlying neuropathologic conditions in vivo, and suggest that either equilibrium or kinetic experimental approaches may be extended to clinical research applications with the use of positron or single-photon emission tomography. PMID- 1784329 TI - Studies on the compartmentation of DOG metabolism in the brain. AB - Using 31P-NMR studies we have observed that 1. 2-Deoxyglucose leads into the brain in vivo and in superfused cortical slices in vitro to a maximum concentration at between 45 and 60 min, when 80% of the material is in the phosphorylated form. 2. The phosphorylated DOG6P disappears from the n.m.r. spectra with a half-life of ca 130 min. 3. Two resonances of DOG6P are observed in the actively metabolising tissue, whereas only one is visible in deproteinised tissue extracts. This suggests that the DOG6P is in two separate compartments which differ in pH. 4. Compartmentation between mitochondria, nerve endings and cytoplasm was concluded to be unlikely from subcellular fractionation studies, but the possibility of compartmentation between neurones and glia could not be so clearly assessed. PMID- 1784330 TI - Some metabolic relationships between biopterin and folate: implications for the "methyl trap hypothesis". AB - Tetrahydrobiopterin and the folate coenzymes can reciprocally interact in ways that would be useful to the metabolic pathways subserved by both of these coenzymes. Thus, through one of the reactions catalyzed by methylene tetrahydrofolate reductase, 5-CH3-H4-folate can regenerate BH4 from q-BH2 and q BH2 can provide an escape from the "methyl trap." PMID- 1784331 TI - The measurement of regional rates of cerebral protein synthesis in vivo. PMID- 1784332 TI - Fluoroacetate and fluorocitrate: mechanism of action. AB - The concept of lethal synthesis as suggested by Peters is reviewed in the light of the more recent work in this area. It is suggested that fluorocitrate is a "suicide" substrate for aconitase rather than a competitive inhibitor as originally suggested. The use of these substances to study glial-neuronal relationships is considered. PMID- 1784333 TI - Mechanisms of immune-mediated demyelinating disease of the central nervous system. PMID- 1784334 TI - The circulation, metabolism, and functional activity of the human brain. PMID- 1784335 TI - How neurochemistry regained its specific biological components: experimental and cognitive advance, 1935-1955. AB - Neurochemistry in the 1850s was part of comparative animal chemistry, which became incorporated into physiological chemistry. By 1900, the connection with physiological chemistry had largely lapsed or been vehemently repudiated. Growth of biochemistry, especially from the 1920s to 1950s, provided techniques and findings sufficient to reintegrate chemical knowledge of neural systems with neural functioning. Vitamin, coenzyme, respiratory and other metabolic studies made large contributions to this outcome. Regarding mental illness as a social problem and scientific challenge gave impetus and funds to such work, which resulted in major experimental and cognitive progress. PMID- 1784336 TI - Cerebral circulation revisited: an historical essay. AB - Three centuries of investigations relevant to cerebral circulation, from the discoveries of circulation by Harvey (1628) and Willis (1664) to the 2 deoxyglucose methods of Sokoloff (1977), have been surveyed. Perspective is provided from discussion of such developments as: the discovery of oxygen and its role in combustion, respiration and cellular metabolism; recognition of the blood brain barrier especially as selective exchange transport systems; introduction of the concept of metabolism and elucidation of details of glycolysis and oxidative phosphorylation; the discovery of neurotransmitters and an understanding of the ionic bases for conduction and neural activity; and introduction of modern techniques for studying cerebral circulation and metabolism, specifically, the Kety-Schmidt N2O method and the Sokoloff [14C]deoxyglucose autoradiographic method for regional and local applications, with subsequent adaptation to PET studies in situ. PMID- 1784337 TI - Louis Sokoloff, neurochemist par excellence. PMID- 1784338 TI - PET: a biological imaging technique. AB - Like in vivo autoradiography, PET provides a means to image and measure rates of biological processes throughout the distributed and interrelated systems of the entire living brain. In addition, both techniques can track and image the functional interactions of the brain with other systems throughout the entire body. Technological advances are yielding higher image spatial resolution and "Electronic generators" for automated synthesis of positron labeled compounds. The expanding number of labeled compounds (greater than 500) is providing a growing number of biological assays (i.e., substrate metabolism, pre and post synaptic processes, enzyme activity, interaction of medical and illicit drugs with biological systems of the brain, immune system, membrane processes). Studies of normal cerebral function focus on mapping evoked responses of various components of motor, visual, somatosensory, memory and cognitive functions. Cerebral development, neuronal plasticity, and compensatory reorganization to lesions or surgery are active areas of investigation. Various types of assays have been used to identify specific biological alterations, map progression and determine therapeutic responses in a wide variety of neuropsychiatric disorders and drug abuse. PMID- 1784339 TI - An overview of gamma-hydroxybutyrate catabolism: the role of the cytosolic NADP(+)-dependent oxidoreductase EC 1.1.1.19 and of a mitochondrial hydroxyacid oxoacid transhydrogenase in the initial, rate-limiting step in this pathway. AB - Two enzymes have been found which catalyze the initial step in the catabolism of GHB. The oxidation of GHB to SSA, catalyzed by both of these enzymes, is coupled to the reduction of an oxoacid. In the case of the mitochondrial transhydrogenase, the coupling is obligatory. Although coupling is not obligatory for the GHB dehydrogenase, the stimulation provided by the coupled reaction, and the nature of the kinetics of the uncoupled reaction, may not only allow the reaction to proceed, but may provide a means of regulating the rate of the reaction under in vivo conditions. Since the oxidation of GHB to SSA is the rate limiting step in the overall catabolic pathway (the rate of conversion of GHB to SSA proceeds at approximately one one thousandth of the rate at which SSA is oxidized to succinate by SSA dehydrogenase (30)), factors which regulate the rate of either or both of these enzymes will, in turn, influence tissue levels of endogenous GHB as well as the duration and magnitude of the physiological effect of a dose of GHB. PMID- 1784341 TI - Enzyme levels in cultured astrocytes, oligodendrocytes and Schwann cells, and neurons from the cerebral cortex and superior cervical ganglia of the rat. AB - Data are presented for 16 enzymes from 8 metabolic systems in cell cultures consisting of approximately 95% astrocytes and 5% oligodendrocytes. Nine of these enzymes were also measured in cultures of oligodendrocytes, Schwann cells, and neurons prepared from both cerebral cortex and superior cervical ganglia. Activities, in mature astrocyte cultures, expressed as percentage of their activity in brain, ranged from 9% for glycerol-3-phosphate dehydrogenase to over 300% for glucose-6-phosphate dehydrogenase. Creatine phosphokinase activity in astrocytes was about the same as in brain, half as high in oligodendrocytes, but 7% or less of the brain level in Schwann cells and superior cervical ganglion neurons and only 16% of brain in cortical neurons. Three enzymes which generate NADPH, the dehydrogenases for glucose-6-phosphate and 6-phosphogluconate, and the NADP-requiring isocitrate dehydrogenase, were present in astrocytes at levels at least twice that of brain. Oligodendrocytes had enzyme levels only 30% to 70% of those of astrocytes. Schwann cells had much higher lactate dehydrogenase and 6 phosphogluconate dehydrogenase activities than oligodendrocytes, but showed a remarkable similarity in enzyme pattern to those of cortical and superior cervical ganglion neurons. PMID- 1784342 TI - Naloxone increases the release of oxytocin, but not vasopressin, within limbic brain areas of conscious parturient rats: a push-pull perfusion study. AB - The influence of naloxone on the release in limbic brain areas of both oxytocin (OXT) and vasopressin, measured by radioimmunoassay, was studied in conscious parturient rats. Three consecutive 30-min push-pull perfusions (20 microliters artificial CSF/min) were made, via previously implanted guide cannulae, within the medio-lateral septum and dorsal hippocampus of parturient animals given saline or naloxone hydrochloride (5 mg/kg body weight) after delivery of the second pup. OXT release in the hippocampus, but not in the septum, was increased during parturition, compared to day 1 post partum. During the first 30-min collection period following naloxone administration, release of OXT was significantly elevated within the septum (44% compared to saline controls, p less than 0.002), but not in the dorsal hippocampus; vasopressin release was not affected. In contrast, on day 1 post partum, naloxone, administered 5 min after starting two consecutive perfusions failed to alter OXT release in septum or hippocampus in conscious rats. Naloxone, known to increase the release of OXT also from the posterior pituitary during parturition, speeded the parturition process significantly between the birth of pups 4 and 8 during push-pull perfusion of septum or hippocampus. The data suggest that endogenous opioid inhibition is involved in the regulation of central OXT release, but not vasopressin release, during parturition. Together with previous studies on OXT release from the posterior pituitary, it seems that during parturition there is coordinated endogenous opioid action on the release of OXT both into blood and into the brain. PMID- 1784340 TI - Regulation by thyroid hormone of microtubule assembly and neuronal differentiation. AB - In this review we examine successively: 1) the major effects of thyroid hormone deficiency seen during brain development with special emphasis on the changes in neuronal morphology and migration occurring postnatally in the cerebellum. 2) The effects of this hormone on microtubule assembly during neurite outgrowth and acquisition of neuronal polarity. 3) The changes in expression of the different tubulin isoforms occurring during development in the normal and hypothyroid rat brain. 4) The regulation by thyroid hormone of the transition occurring during development between the juvenile and adult microtubule-associated protein Tau. PMID- 1784343 TI - Attenuation of the suckling-induced prolactin release and the high afternoon oscillations of plasma prolactin secretion of lactating rats by antiserum to vasopressin. AB - To investigate the role of vasopressin in prolactin (PRL) release during lactation, vasopressin antiserum (VP-Ab) was administered to lactating rats, giving it intravenously 15 min before permitting their previously isolated pups to suckle or to continuously suckled rats. The suckling-induced rise in plasma PRL levels was significantly less in VP-Ab-treated mothers than in rats receiving a similar amount of normal rabbit serum (NRS). The inhibitory effect of VP-Ab could not be detected on the next day. Angiotensin II antiserum (AII-Ab) had no effect on plasma PRL response induced by suckling. VP-Ab given to continuously suckled rats reduced the high amplitude oscillation of PRL concentration observed in NRS-injected rats. A transient increase of water intake was detected on the day of VP-Ab treatment only, which provides direct evidence for at least partial neutralization of vasopressin in the circulation. These findings suggest that vasopressin released from the neural lobe of the pituitary gland is essential for the normal PRL secretory response induced by suckling and the episodic pattern of PRL release in continuously suckled mother rats. Furthermore, these results support the assumption that disturbance in the regulation of water and electrolyte balance at the level of the neuro-intermediate lobe of the pituitary gland may alter PRL secretion during lactation. PMID- 1784344 TI - Influence of gonadectomy and testosterone supplementation on the postnatal development of the vasopressin and oxytocin-containing nucleus of the pig hypothalamus. AB - We have studied the effects of gonadectomy and testoterone supplementation on the development of the vasopressin- and oxytocin-containing nucleus (VON) of the pig hypothalamus that shows a decrease in neuron number during the first weeks postnatally, followed by an increase during puberty. Neonatal gonadectomy caused a 2.5-fold increase in VON volume and neuron number in males and 3-fold in females at the age of 16 weeks, the onset of puberty. However, the difference between gonadectomized and nongonadectomized animals disappeared after puberty (38 weeks). Testosterone replacement from 16 weeks onwards induced a decrease in neuron number and volume of the VON. The present study indicates that the development of the VON is influenced by gonadal steroids although it seems improbable that these hormones affect the VON directly. PMID- 1784345 TI - Endogenous opioid suppression of luteinizing hormone pulse frequency and amplitude in the ewe: hypothalamic sites of action. AB - Evidence suggests that endogenous opioid peptides (EOP) inhibit pulsatile luteinizing hormone (LH) secretion during both the luteal and follicular phases of the ovine estrous cycle. Further data from sheep and other species indicate that the hypothalamus is the primary site of action for this EOP inhibition. The purpose of the following experiments was to determine which areas of the hypothalamus are involved in the EOP inhibition of pulsatile LH secretion. Regularly cycling ewes (n = 10) were stereotaxically implanted with guide tubes into the preoptic area (POA) and medial basal hypothalamus (MBH). Implants containing the EOP antagonist WIN 44,441-3 (WIN) were placed into each of these areas. Blood samples were collected at 12-min intervals for 3 h before and during WIN administration in the luteal phase and for 4 h before and during WIN administration in the follicular phase of the estrous cycle. During the luteal phase, WIN implants in either area increased (p less than 0.01) LH pulse frequency (POA 1.4 +/- 0.3/3 h before vs. 3.1 +/- 0.4/3 h during; MBH 1.1 +/- 0.2/3 h before vs. 2.8 +/- 0.5/3 h during). There was no effect on LH pulse amplitude. In contrast, during the follicular phase, WIN implants selectively increased (p less than 0.01) LH pulse frequency when implanted in the POA (3.2 +/ 0.4/4 h before vs. 5.2 +/- 0.6/4 h during) while increasing (p less than 0.05) only LH pulse amplitude when placed in the MBH (0.7 +/- 0.2 ng/ml before vs. 1.4 +/- 0.3 ng/ml during).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1784346 TI - Serum luteinizing hormone, prolactin, and thyrotropin and their pituitary subunit mRNA levels during proestrus in the Syrian hamster. AB - mRNA levels for alpha, luteinizing hormone beta (LH beta), and prolactin (Prl) were examined during the hamster estrous cycle, with sampling most frequent (1 hour intervals) on the afternoon of proestrus. These transcripts encode the peptide subunits for the pituitary hormones LH and Prl which are necessary for reproductive function. Serum hormone levels of LH and Prl, analyzed by 24-hour periodic regression, exhibited a 24-hour periodicity on proestrus characterized by a large surge peaking at about 18.00 h. Combining the data for non-proestrous days of the cycle disclosed a rhythm with similar timing for LH and Prl. Thyroid stimulating hormone (TSH) and TSH beta RNA profiles during hamster proestrus are reported for the first time. Serum TSH exhibited a pronounced peak coincident with that of the other hormones on proestrus. Because of variations at other times on the day of proestrus, however, a 24-hour periodicity was not manifested by regressional analysis. Combined non-proestrous serum TSH data also revealed no consistently timed regressional 24-hour periodicity. During proestrus, pituitary mRNA values for alpha, LH beta, and Prl simultaneously exhibited a rise from the lowest to the highest of all proestrous values in the 3-5 h prior to the time of the pre-ovulatory peak of circulating hormone concentrations. RNA for TSH beta exhibited an earlier, broader peak on proestrus. Periodic regression indicated a significant 24-hour rhythm for alpha mRNA in data pooled from non-proestrous days (acrophase 05.00 h) and for TSH beta mRNA on proestrus (acrophase 04.54 h).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1784348 TI - 5,7-Dihydroxytryptamine and gonadal steroid manipulation alter spine density in ventromedial hypothalamic neurons. AB - Golgi impregnation was used to examine changes in dendritic spine density in the ventromedial hypothalmic nucleus (VMN) of intact and gonadectomized (GDX) rats treated with 5,7-dihydroxytryptamine (5,7-DHT) and/or estrogen. In intact rats of both sexes 5,7-DHT injection resulted in a large increase in dendritic spine density in the VMN. The combination of 5,7-DHT and estrogen treatment in GDX females resulted in a further increase in dendritic spine density. In male rats gonadectomy increased dendritic spine density on VMN neurons, and estrogen treatment partially reversed this effect. When GDX males were treated with 5,7 DHT and estrogen, there was no effect on dendritic spine density. These results complement a previous study in which it was demonstrated that dendritic spine density in the VMN was greatest during proestrus and after estrogen administration to ovariectomized females. The relevance of these findings to gonadal-steroid-mediated lordosis is discussed. PMID- 1784347 TI - Influence of 5-HT1 and 5-HT2 receptor antagonists on insulin-induced adrenomedullary catecholamine release. AB - Previous works have indicated that insulin stress activates the serotonin (5-HT) and sympathoadrenal systems in the fasted rat. In addition, recent studies have shown that activation of either the 5-HT1A, the 5-HT1C or the 5-HT2 receptor triggers adrenal catecholamine release. Then, the aim of this study was to investigate whether brain 5-HT, by means of these receptors, mediates insulin induced adrenal catecholamine release. For that purpose, both plasma epinephrine (Epi), norepinephrine (NE) and glucose levels were measured in conscious rats bearing intracardiac catheters. The intravenous administration of insulin (1 IU/kg) triggered hypoglycemia throughout the following 120 min in both fed and overnight fasted rats. Insulin stress elicited within 30 min a 5- and 38-fold increase in plasma Epi levels in fed and fasted rats, respectively. This change was associated with significant elevations in plasma NE levels in the fasted rats only. The intravenous administration of the mixed 5-HT1A receptor/beta adrenoceptor blocker (-)-propranolol (5 mg/kg) to fasted rats did not modify plasma glucose and catecholamine peak responses to insulin; however, at later times, insulin triggered hypoglycemic convulsions in (-)-propranolol- but not in saline-pretreated rats. Besides, pretreatments with the 5-HT1C/5-HT2 receptor blocker LY 53857 (0.5 mg/kg), or the 5-HT1/5-HT2 receptor antagonist metergoline (3 mg/kg), did not diminish plasma catecholamine responses to insulin stress. Similarly, none of these antagonists affected plasma glucose recovery. These results seem to indicate that the sympathoadrenal response to insulin administration is not mediated by 5-HT. PMID- 1784349 TI - [Tissue perfusion in anesthesia]. PMID- 1784350 TI - [Cerebral perfusion in anesthesia and recovery]. PMID- 1784351 TI - [Perfusion of the splanchnic system in anesthesia]. PMID- 1784353 TI - [Tissue perfusion in anesthesia]. PMID- 1784352 TI - [Perfusion in muscular tissue (leg) in anesthesia]. PMID- 1784354 TI - [The Italian reality in health emergency]. PMID- 1784355 TI - [Priority of ambulatory intervention]. PMID- 1784356 TI - [Monitoring in ambulatory emergencies: indications and limitations]. PMID- 1784357 TI - [Guidelines for the anesthesiologic treatment in emergencies]. PMID- 1784358 TI - [In-hospital treatment: advantages and prospects of the departmental management]. PMID- 1784359 TI - [Trauma in pregnancy]. PMID- 1784360 TI - [Activities of integrated coordination in health care in Cagliari: experiments, results]. PMID- 1784361 TI - [Recent advances in sea rescue]. PMID- 1784362 TI - [Psychologic aspects of the preparation for surgery: the presence of parents in the anesthesia room]. PMID- 1784363 TI - [The problem of consensus]. PMID- 1784364 TI - [Preoperative fasting in pediatrics]. PMID- 1784365 TI - [Antibiotic prophylaxis in pediatric surgery]. PMID- 1784366 TI - [Effect of propofol at the subcellular level]. PMID- 1784367 TI - [Effect of various general anesthetics on the metabolism of isolated mitochondria]. PMID- 1784368 TI - [Physical basis, possibilities of use and limitations of computerized tomography and ultrasonography]. PMID- 1784369 TI - [Pulmonary CAT in acute and chronic respiratory insufficiency]. PMID- 1784371 TI - [Brain imaging in intensive care]. PMID- 1784370 TI - [Echography in intensive care. Indications and limitations]. PMID- 1784372 TI - [Possibilities and limitations of echography in the critical patient]. PMID- 1784373 TI - [Nuclear medicine and the critical patient]. PMID- 1784374 TI - [Controversies in neuroanesthesia and neuroresuscitation]. PMID- 1784375 TI - [The seated position, yes or no?]. PMID- 1784376 TI - [Inhalation anesthesia or intravenous anesthesia?]. PMID- 1784377 TI - [Monitoring of safety, of specific risk, of guidance to treatment]. PMID- 1784378 TI - [Intracranial hypertension: hyperventilation or pharmacologic treatment?]. PMID- 1784379 TI - [Preanesthetic drugs]. PMID- 1784380 TI - [Preanesthetic medication in emergencies in newborns and children]. PMID- 1784381 TI - [Preanesthetic medication in the cardiopathic patient]. PMID- 1784382 TI - [Preanesthetic medication in the neurosurgical patient]. PMID- 1784383 TI - [Preparation of the myopathic patient]. PMID- 1784384 TI - [Preparation to loco-regional block]. PMID- 1784385 TI - [Pain measurement in children]. PMID- 1784386 TI - [Deleterious consequences of acute pain]. PMID- 1784387 TI - [Protocols for the use of non-steroidal anti-inflammatory agents in acute pain]. PMID- 1784388 TI - [Use and limitations of opioid agents in acute pain]. PMID- 1784389 TI - [Rationale for the use of adjuvants in acute pain]. PMID- 1784390 TI - [Pharmacologic rationale for the use of non-steroidal anti-inflammatory agents in acute pain]. PMID- 1784391 TI - [Brain protection: constants, variables and drug management]. PMID- 1784392 TI - [Brain resuscitation]. PMID- 1784393 TI - [Anesthesia in obstetrics]. PMID- 1784394 TI - [Infections in intensive care: diagnostic assessment and therapeutic approach]. PMID- 1784395 TI - [The difficult intubation]. PMID- 1784396 TI - [Computerized systems for a resuscitation and intensive care center]. PMID- 1784397 TI - [Disseminated intravascular coagulation: diagnosis and therapy in the 90s]. PMID- 1784398 TI - [Prostaglandins in intensive care]. PMID- 1784399 TI - [Organ oxygenation: evaluation methods in anesthesia and recovery]. PMID- 1784400 TI - [Hyperbarism and carbon monoxide poisoning]. PMID- 1784401 TI - Assessment of respiratory mechanics during anesthesia-paralysis. PMID- 1784402 TI - Ventilatory response to hypoxia in the perioperative period. PMID- 1784403 TI - [Operative risk--surgical risk--anesthesiologic risk]. PMID- 1784404 TI - [The role of prolactin in endometrial lesions]. AB - The Authors examine serum levels of HPRL in basal conditions and after TRH and sulpiride test in 15 patients with endometrial lesions (hyperplasia) and in 15 patients with endometrial adenocarcinoma included in a age range between 44 and 62 years, in which 7 patients present obesity, 10 patients present hypertension and 2 patients are hyperglycemic. The same examination is carried out in a control group of 30 healthy patients. Then the 15 patients with adenocarcinoma and 3 patients with adenomatosa hyperplasia are subjected to surgery and they estimate HPRL levels in endometrium. The results prove that there is no correlation between HPRL plasma levels and endometrium lesions and between endometrium HPRL. The Authors conclude that HPRL does not play a significant role in the pathogenesis of endometrial lesions; use of HPRL plasma levels as a marker of endometrial lesions is not possible. PMID- 1784405 TI - [Prospectives of the study of seminal fluid in the diagnosis of infertility]. AB - Biochemical components usually evaluated in seminal plasma are lower than those in blood serum. In this study the concentration of different constituents in seminal plasma has been analyzed: creatinine, urea, glucose, uric acid, sodium, potassium, triglycerides, cholesterol, bilirubin, alkaline phosphatase, glutamic oxalacetic transaminase (SGOT), glutamic pyruvate transaminase (SGPT), cholinesterase, creatin phospho chinase (CPK), gamma glutamyl transpeptidase, lactic dehydrogenase (LDH), proteins, in comparison with the concentrations of the same constituents in blood. With the exception of uric acid, all the biochemical components in the seminal plasma were either significantly higher or lower than in blood serum, an index of the complexity of the mechanism regulating the presence and distribution of the single components in seminal plasma compared with blood serum. Isoelectro-focussing for proteins showed, in seminal plasma, a higher quantity of fragments and a different distribution of this in comparison with blood serum. PMID- 1784406 TI - [Determination of the copper content in healthy placenta and placenta in gestosis using atomic absorption spectrophotometry]. AB - Several complications in pregnancy seem to be related to the fluctuations of serum copper. In particular, values of serum copper over the normal range, have been associated to pregnancies complicated by EPH-gestosis. In this study we have evaluated the copper concentration in samples of placenta from 15 gravidas affected by EPH-gestosis and from 15 healthy gravidas with atom absorption spectrophotometry. The results of our study confirm the presence of an elevated copper concentration in the EPH-gestosis patients group (mean value: 196 micrograms/100 g of placental tissue). We can hypothesize that the result is due to a reduced copper uptake from the fetus. PMID- 1784407 TI - [Colposcopic-histologic results in 97 patients with mild dysplasia shown by Pap test]. AB - Colposcopy and biopsy were performed in 97 patients whose referral smears showed mild dysplasia (CIN 1). Of 97 women, 40 (41.2%) had a biopsy or a colposcopic examination alone considered normal, 36 (37.1%) had CIN 1 or HPV changes, 12 (12.4%) had CIN 2 and 9 (9.3%) had CIN 3. No invasive cancer was detected. This data suggest that, if colposcopy resources are available, repeat smear alone is inadequate to follow women who have a mild dysplasia smear. PMID- 1784408 TI - [Delivery after previous cesarean section. Experience with 173 patients]. AB - We have taken into consideration the obstetric outcome in 173 women, with prior cesarean section, who were delivered in our hospital between june 1988 and january 1991. This group of patients represented 5.3% of our obstetric population. Overall 64 patients (37%) achieved vaginal delivery and 109 (63%) underwent an iterative cesarean section. Considering the 76 patients (44%) admitted to trial of labour, 64 (84.2%) achieved vaginal delivery and 12 (15.8%) were delivered with iterative cesarean section. No maternal or neonatal complications occurred, even though the silent dehiscence of the uterine scar, found during cesarean section, seems to occur four times (12%) more frequently than that reported in recent literature. It follows that vaginal delivery after prior cesarean section is, in our experience, lacking in risks, and we think that such management may be widely adopted. In 1986 iterative cesarean section represented 35% of cesarean section indications, in 1990 this rate was reduced to 23.7% by the introduction of a policy to allow women to undergo trial of labour. PMID- 1784409 TI - [Fibrinogen and factor VII levels in patients under estrogen-progestin therapy]. AB - During a 3 month period the Authors have evaluated the possible modification of some coagulation parameters which can be of relevance for thrombophilic state. Fibrinogen and factor VII were measured and following 3 months of oestro progestinic treatment in 11 women in good general health and without known controindications to contraceptive treatment. No significant difference in some levels of fibrinogen and factor VII were found. We conclude that in the short term fibrinogen and factor VII are not significantly altered but a longer period of follow up is indicated in order to estimate the risk of cardiovascular accidents. PMID- 1784410 TI - [Effect of autogenic respiratory training on labor pain. Use of the Vaona algometer]. AB - In our research we have evaluated the effects produced by obstetric psycho prophylaxis on women previously prepared by us. To carry out this research we used a method of pain evaluation, quickly and easily administered: Vaona algometer, based on the association between the visual analogue and the scale of greys. The results of the research allow us to confirm that the RAT method, applied during labour, thanks to the positive influence on neuromuscolar relaxation and the psychological aspects of the women, induces a favourable modulation on the perception of pain. PMID- 1784411 TI - [Prenatal diagnosis of a case of obstruction of the uretero-pelvic junction]. AB - The Authors report a case of bilateral ureteropelvic junction obstruction in a pregnant woman at to 20th week of gestation. The pathology arose suddenly during the second trimester. An anhydramnios was picant and the enlarged kidneys filled the entire fetal abdomen. The woman decided for abortion. The Authors describe the etiopathology and management of this disease. PMID- 1784412 TI - [Congenital toxoplasmosis. Report of a case treated with spiramycin in the 24th week of pregnancy]. AB - The Authors present one case of congenital toxoplasmosis; it was sustained by a primary maternal infection, contracted at the XXIII week of gestation. Even if we started the treatment with spiramycin at the XXIV week of gestation, both the prenatal ultrasound examination of the fetus, and the postnatal investigation of the newborn, showed that the young patient was affected by a severe form of congenital toxoplasmosis. PMID- 1784413 TI - [Use of indomethacin in the therapy of poly-hydramnios. Description and comments on a case]. AB - The Authors report their experience of two pregnancies complicated by polyhydramnios, treated with indomethacin (100 mg/day for 10 and 7 days respectively). The outcome of both pregnancies was foetal intrauterine death. The absence of foetal anomalies incompatible with life and the presence of tissue lesions by asphyxia led the Authors to think that indomethacin might have had a determinant role in the foetal death. This study suggests that the use of indomethacin in polyhydramnios is questionable. PMID- 1784415 TI - Activation of corticotropin-releasing factor-containing neurons in the paraventricular nucleus of the hypothalamus by interleukin-1 in the rat. AB - Interleukin-1 (IL-1) alpha was injected into the lateral ventricle of the rat. An antiserum against Fos oncoprotein was used to detect the activated neurons immunohistochemically. A large number of neurons in the parvocellular paraventricular nucleus of the hypothalamus, in an area corresponding to the location of the corticotropin-releasing factor (CRF)-containing neurons, were strongly Fos-like immunoreactive (LI). Double immunostaining for Fos and CRF revealed that many of the Fos-LI cells were CRF-LI. Furthermore, the CRF-like immunoreactivity was greatly enhanced in the rats injected with IL-1 alpha, indicating an increase in CRF synthesis. PMID- 1784414 TI - Anoxia-resistant turtle brain maintains ascorbic acid content in vitro. AB - The isolated turtle brain maintains intra- and extracellular concentrations of ascorbate when incubated in ascorbate-free physiological saline for as long as 24 h. After incubation for 1 h, total tissue content of ascorbate in the turtle cerebellum was the same as in unincubated controls. After 20-24 h, tissue ascorbate content remained at 65% of control levels, while extracellular ascorbate concentration, measured with carbon fiber voltammetric microelectrodes, was 56% of the initial value. For an intermediate incubation period of 6 h, reduced ascorbate content was maintained at about 80% of control levels, regardless of whether incubation was under normal conditions or in the absence of glucose or oxygen. By contrast, only 4% of the ascorbate content of guinea pig brain slices remained after a 6 h incubation. Maintenance of high levels of ascorbate by the anoxia-resistant turtle brain could be an important factor in the amelioration of oxidative injury in this tissue. Inclusion of ascorbate in media used for in vitro studies of mammalian brain tissue is recommended. PMID- 1784416 TI - Rhythm generation in brainstem cultures grown in a serum-free medium. AB - Electrophysiological studies were carried out on long term cultured brainstem tissue taken from neonatal rats with the object of investigating mechanisms underlying respiratory rhythm generation. The preparations were derived from 360 microns thick horizontal medullary slices which were explanted into a chemically defined nutrient medium and which remained organotypically intact for ca. 1 month. In 44 of the 50 explants examined both periodic and aperiodic bioelectric activity was detected, the cycle length of the former ranging from 0.5 to 10 s (mean, 2.7 s) at a pH of 7.4 and bath temperature of 32 degrees C. Periodic activity could take several forms, but commonly consisted of regularly repeated, 100-300 ms long, depolarizing (D-) waves or sequences of inhibitory and/or excitatory postsynaptic potentials. Lowering the pH of the superfusate by lowering the bicarbonate concentration, increasing the pCO2 or adding H+ shortened the interval between periodic events, and increased both the amplitude and duration of the D-waves. The interval was also shortened when the bath temperature was increased (Q10: ca.2.5). The mean resting membrane potential of neurons exhibiting periodic activity was -49 mV (n = 62) and not significantly different from that of aperiodically discharging neurons either in the same preparations or in cultured explants from the neocortex. These observations suggest that brainstem cultures constitute a useful 'model' system for studying pH-dependent rhythm generation in small neuronal networks of the medulla. PMID- 1784417 TI - Interference of AlF4- with nucleotide and DNA binding of rat histone H1 in vitro. Implications for the pathogenesis of Alzheimer's disease. AB - We demonstrate here that the H2PO4- analogue AlF4- binds to the nucleotide binding site of rat liver histone H1 in vitro, and interferes with nucleotide recognition and H1 DNA binding. AlF4- may thus compromise the genetically determined pattern of protein synthesis through binding to H1, the general repressor. The present findings are of interest as a number of studies have implicated aluminium as a factor in the pathogenesis of Alzheimer's disease. PMID- 1784418 TI - Insulin stimulates ganglionic protein synthesis and reduces thymidine incorporation in support cells of the in vitro regenerating adult frog sciatic sensory neurons. AB - Insulin was tested for effects on crush injured, in vitro regenerating, adult frog sciatic sensory axons. A wide range of insulin concentrations (0.01-10 micrograms x ml-1) was found to stimulate incorporation of radioactive leucine into ganglionic protein by 50-80%, without affecting the regeneration distance. Simultaneously insulin inhibited the proliferation of the support cells at the crush region by 30%, as measured by thymidine incorporation. Experiments using compartmentalized culture dishes indicated that the proliferation inhibitory effect could be indirect and mediated by the neuronal cells. The results suggest that insulin influences the metabolism of adult peripheral neuronal cell bodies. The stimulated nerve cells could in turn affect the proliferation of support cells in the nerve trunk. PMID- 1784419 TI - Isolation and sub-chromosomal localization of a DNA fragment of the human choline acetyltransferase gene. AB - A DNA fragment of 219 bp was obtained by polymerase chain reaction (PCR) on human genomic DNA using two oligonucleotide mixtures derived from peptide sequences of human placenta choline acetyltransferase (ChAT) and from partially conserved amino acid sequences of rat, porcine and Drosophila ChAT. Sequence homology with porcine ChAT demonstrated that this fragment is part of the human ChAT gene. This gene was assigned to chromosome 10 by hybridization of the 219 bp DNA probe with DNA from human-hamster somatic cell hybrids, and to region 10q11.2-10qter by PCR experiments. PMID- 1784420 TI - Pressor, dipsogenic, natriuretic and kaliuretic response to central carbachol in rats with lesion of the medial septal area. AB - In the present study we investigated the effect of electrolytic lesion of the medial septal area (MSA) on the dipsogenic, natriuretic, kaliuretic and pressor responses elicited by intracerebroventricular (i.c.v.) injection of the cholinergic agonist carbachol. Freely moving rats with sham or MSA lesion (1-7 days and 14-18 days) and a stainless steel cannula implanted into the lateral ventricle were studied. In sham rats, i.c.v. injection of carbachol (7.5 nmol) produced an increase in water intake (10.2 +/- 1.5 ml/h), mean arterial pressure (MAP) (35 +/- 5 mmHg) and urinary Na+ and K+ excretion (551 +/- 83 and 170 +/- 17 muEq/120 min, resp.). The pressor (18 +/- 3 and 14 +/- 4 mmHg, resp.) and natriuretic responses (178 +/- 58 and 172 +/- 38 muEq/120 min) produced by i.c.v. carbachol in acute or chronic MSA-lesioned rats were reduced. No change was observed in urinary K+ excretion and a reduced water intake (5 +/- 1.3 ml/h) was observed only in acute MSA-lesioned rats. These results suggest that the MSA plays an important role for the pressor and natriuretic responses induced by central cholinergic activation in rats. A small influence of this structure on water intake may also be suggested. PMID- 1784421 TI - FMRFamide-like immunoreactivity in cells and fibers of the holothurian nervous system. AB - Immunoreactivity to FMRFamide (FMRFa) was detected in several components of the nervous system of the sea cucumber, Holothuria glaberrima. Neurons and fibers expressing immunoreactivity to this peptide were found in the radial nerves, and in nerve plexuses of the esophagus, and large and small intestine. The neurons in the enteric nervous system were located in the serosal layer and immunoreactive fibers appeared to innervate the longitudinal muscle. Co-existence of immunoreactivities to FMRFa and cholecystokinin was detected in most of the enteric fibers. Therefore, in the holothurians, neurons expressing FMRFa and FMRFa/cholecystokinin might be involved in the physiology of the digestive tract. PMID- 1784423 TI - Identification and dissociation of cardiovascular neurons from the medulla for patch clamp analysis. AB - This study describes a preparation that will enable us to study, using voltage clamp techniques, ionic currents from dissociated cardiovascular neurons that have retained their anatomical and functional identity of the intact animal. To identify dispersed preganglionic cardiac motoneurons various fluorescent dyes (rhodamine, fluorogold, microspheres, bizbenzimide and dextrans) were examined to determine which can be absorbed by preganglionic cardiac motorneuron nerve terminals (without surgical penetration of cardiac tissue), transported retrogradely to their soma in the medulla and retained during dissociation of the neurons. Rhodamine fulfilled these criteria. Dissociated preganglionic cardiac motorneurons had resting membrane potentials of -52.4 +/- 3 mV and input resistances of 236 +/- 71 M omega (mean +/- S.E.M., n = 10). Depolarizing voltage steps to -50 mV or above evoked a tetrodotoxin (TTX) sensitive inward sodium current followed by a biphasic outward current. PMID- 1784422 TI - Changes in seizure latency correlate with alterations in A1 adenosine receptor binding during daily repeated pentylentetrazol-induced convulsions in different mouse brain areas. AB - The seizure latency changed during daily pentylentetrazol (PTZ) induced convulsions showing an increase between days 2 and 4, a rapid decrease between days 5 and 10 and a slight increase again between days 11 and 14. At the respective timepoints, [3H]CHA binding, in cortex and cerebellum of PTZ treated animals followed exactly the same pattern, suggesting that the alterations in A1 receptors in these areas may partly determine the PTZ seizure latency curve. On the contrary, the changes of [3H]CHA binding in hippocampus (sustained increase) and striatum (sustained decrease) didn't follow the latency curve pattern. These results suggest that changes in A1 receptor density in specific brain areas may be involved in the modulation of seizure susceptibility. PMID- 1784424 TI - High sensitivity to internal tetraethylammonium in K(Ca) channels of cerebrovascular smooth muscle cells. AB - Patch clamp methods were used to study the properties of calcium-dependent K(Ca) channels in enzyme dissociated smooth muscle cells from the cerebral arteries of adult rats. Dissociated muscle cells were maintained at 4 degrees C for up to 48 h prior to use. Inside-out membrane patches excised from these cells contained a K(Ca) channel with a conductance of 92 +/- 2.6 pS in symmetrical 140 mM potassium solutions. This channel was activated by membrane depolarization and by cytoplasmic calcium, and showed negligible permeability to sodium or cesium ions. Single channel currents were reduced by internal application of tetraethylammonium ions, with a Kd = 0.31 mM. PMID- 1784425 TI - Expression of c-fos mRNA in rat brain after intracerebroventricular administration of corticotropin-releasing hormone. AB - Expression of the proto-oncogene c-fos is known to increase in rat brain following various types of seizures. Measuring c-fos mRNA or protein levels was shown to be a good cellular marker for neurons activated during central nervous system (CNS) excitation. In this study, we used in situ hybridization analysis of c-fos mRNA to determine brain regions activated by a peptide that has been closely linked to stress responsivity and kindling-like seizure activity. Corticotropin-releasing hormone (CRH) was injected into the left lateral ventricle of rats and produced the late onset of seizures between 1.5-5 h after its administration. Rats were sacrificed at various time points after the administration of CRH or sterile water, and c-fos mRNA levels were determined. In the preseizure state, CRH increased c-fos unilaterally in several cerebral cortical structures (most prominently in the dorsal endopiriform nucleus and in the piriform and insular cortices). CRH-induced seizures increased c-fos bilaterally in the same cortical regions, and in addition, in the hippocampus and olfactory bulb. The data are congruous with the hypothesis that intracerebroventricularly (i.c.v.) administered CRH elicits a rapid kindling-like response. PMID- 1784426 TI - Contrasting effects of HEPES vs HCO3(-)-buffered media on whole-cell currents in cultured chemoreceptors of the rat carotid body. AB - In this study we compared the effects of physiological bicarbonate/CO2-buffered media (BBM) with the commonly used N-2-hydroxyethylpiperazine-N'-2-ethane sulfonic acid (HEPES)-buffered media (HBM) on whole-cell currents in cultured rat arterial chemoreceptors (i.e. glomus cells) using the perforated-patch technique. Two separate effects were observed on switching from HBM to BBM. First, in the majority of cells tested (31 of 36) there was an increase in the leakage conductance (ca. 5 fold) and a concomitant increase in channel noise, which in preliminary studies appears to arise from the opening of large-conductance anion channels. Second, there was a reversible decrease in voltage-activated outward K+ current which we attribute to cytoplasmic acidification, catalysed by carbonic anhydrase in glomus cells. PMID- 1784427 TI - Chronic ethanol treatment differentially affects muscarinic receptor responses in rat hippocampus. AB - Sensitivity of hippocampal field potentials to local (iontophoretic) application of acetylcholine (ACh) was investigated in chronic ethanol treated (CET) and sucrose-fed (control) rats. CET and control rats were fed a liquid diet containing either ethanol or sucrose for 28 weeks. Five to six months after ethanol or sucrose was withdrawn, hippocampal slices were taken and ACh was applied in stratum pyramidale or stratum radiatum of CA1 to observe population spike facilitation or field EPSP inhibition, respectively. Population spikes were facilitated to a considerably lesser extent in CET slices relative to controls, while no treatment differences were observed for dendritic EPSP inhibition. These data suggest that ACh response properties in CA1 exhibit differential sensitivity to CET, and may reflect a distinct susceptibility of muscarinic receptor subtypes to the neurotoxic effects of ethanol. PMID- 1784428 TI - Tetrahydroaminoacridine (THA) reduces voltage-dependent calcium currents in rat sensory neurons. AB - Tetrahydroaminoacridine (THA) is a centrally active anticholinesterase that also interacts with neuronal K+ and Na+ channels and cardiac Ca2+ channels. The effects of THA on neuronal voltage-dependent Ca2+ channels are not known. We tested the effects of THA (25 nM-250 microM) on the Ca2+ current components of acutely dissociated rat nodose ganglion and dorsal root ganglion (DRG) neurons using the whole cell patch clamp recording technique. THA reduced the low threshold (T) and high-threshold (N/L) Ca2+ current components in a concentration dependent manner (IC50 approximately equal to 125 microM for T; approximately equal to 80 microM for N/L). Minimal current reduction was seen below approximately 10 microM. Our results show that THA reduces voltage-dependent Ca2+ currents in rodent sensory neurons suggesting another means by which THA may affect Ca(2+)-dependent physiologic processes. PMID- 1784429 TI - Effects of body temperature on chemosensory activity of the cat carotid body in situ. AB - The effects of changes in body core temperature (TB) upon the frequency of chemosensory discharges (fx) from one carotid nerve were studied in pentobarbitone anesthetized cats. Raising TB from 35 to 40 degrees C increased fx in some cats, an effect more commonly seen after contralateral carotid neurotomy. In other animals, the simultaneously increased alveolar ventilation counteracted the above effect. A multiple correlation analysis of global data showed predicted increases in fx in response to raising TB at different CO2 levels. PMID- 1784430 TI - Circadian rhythm of cortical acetylcholine release as measured by in vivo microdialysis in freely moving rats. AB - Circadian changes in cortical acetylcholine (ACh) release were examined in freely moving rats using long-term in vivo microdialysis and high performance liquid chromatography with electrochemical detection. A microdialysis probe was implanted into the frontal cortex and a dialysate was collected every 30 min for two or three days under a 12 h light/dark (LD 12:12) cycle and for the succeeding 2 or 3 days under constant dark (DD) conditions. When animals were exposed to the LD cycle, dialysate concentrations of ACh showed a clear circadian rhythmicity with the highest peak in the dark phase and the lowest peak in the light phase. The mean cortical ACh release during the dark phase under the LD cycle was approximately 33% higher than that during the light phase. Under DD conditions, circadian changes in ACh release persisted with similar amplitudes as observed in the LD condition. These results suggest that cortical ACh release is under the control of a circadian oscillator. PMID- 1784431 TI - A unified mechanistic view of oxidative reactions catalysed by P-450 and related Fe-containing enzymes. PMID- 1784433 TI - Autonomous practice. PMID- 1784432 TI - Tropane alkaloids. PMID- 1784434 TI - The dress rehearsal. PMID- 1784435 TI - A collective responsibility. PMID- 1784436 TI - Bipolar affective disorder. PMID- 1784437 TI - Shaping the future. PMID- 1784438 TI - Complementary therapies in 1992. PMID- 1784439 TI - Pawn in the game. PMID- 1784440 TI - The clinic. PMID- 1784442 TI - How to survive conversion. PMID- 1784441 TI - Striking back at stroke. PMID- 1784444 TI - Court overturns asbestos products ban. PMID- 1784443 TI - Developing confidence. PMID- 1784445 TI - OSHA terminates N.C. agreement. PMID- 1784446 TI - Michigan company fined $1,002,400. PMID- 1784447 TI - Handling the cold with dexterity. PMID- 1784448 TI - Controlling cold stress and injury. PMID- 1784449 TI - Focus on portability and quickness in industrial hygiene instrumentation. PMID- 1784450 TI - Health promotion can be a valuable strategy to assist in cost containment. PMID- 1784451 TI - Bloodborne pathogens. AB - Worker exposure to bloodborne diseases can be minimized through: . training and education programs; . use of personal protective equipment such as gloves, gowns, face masks and eye protection; . work practices such as thorough hand washing after each patient contact; . proper handling of sharps; . engineering controls such as biological safety cabinets and puncture-resistant sharps containers; . immunization programs; . proper disposal of contaminated waste; . use of disinfectants; . labeling and signs. PMID- 1784452 TI - Proper nutrition gaining importance in workplace health-promotion effort. PMID- 1784453 TI - Coal-mining officials plead guilty. PMID- 1784454 TI - Radiation sensitivity of cultured bovine lens epithelial cells. AB - The radiosensitivity of cultured bovine lens epithelial cells was measured. Data are given as survival curves for immediate plating (IP) and delayed plating (LP) after a recovery period of 48 h and for plating of cells irradiated in the exponential stage of growth (Exp). The survival curves obtained are strongly exponential, showing no shoulders in the low-dose range, with D37 values of 1.38 (Exp), 2.08 (IP) and 3.28 (LP), respectively. Data of in vitro radiosensitivity are discussed in relation to lens radiosensitivity in vivo. The study was possible by introducing poly-L-lysine hydrobromide coating of culture dishes. PMID- 1784455 TI - Prostaglandin E2 in the vitreous body of the normal rabbit eye and after ocular trauma. AB - Rabbit eyes were enucleated and frozen in liquid nitrogen. The vitreous was removed and analyzed for prostaglandin E2 (PGE2). The mean level (+/- SEM) of PGE2 in the anterior as well as in the posterior vitreous was 0.09 +/- 0.016 ng/ml (n = 12 rabbits). Animals pretreated with indomethacin 15 min before death, in order to prevent the formation of prostaglandin during enucleation, showed in both the anterior and posterior vitreous mean PGE2 levels of 0.04 +/- 0.008 ng/ml (n = 12) which were significantly lower. Ocular trauma such as paracentesis of the anterior chamber, indentation of the sclera or laser photocoagulation in the fundus 1 h before death of the animals did not increase the concentration of PGE2 in the vitreous humor. There is no evidence either for local release of PGE2 from tissues in the fundus of the eye or for diffusion of PGE2 from the anterior chamber into the vitreous humor. PMID- 1784456 TI - pH, ionized calcium and osmotic artifacts can affect determination of rabbit corneal deturgescence in vitro. AB - Freshly isolated stroma-endothelial preparations were perfused with a glucose, adenosine and glutathione-supplemented Ringer solution at 37 degrees C at a hydrostatic pressure of 20 cm H2O. The composition (tCO2, pH, Ca2+ and osmolality) of the stromal-side bathing solution was analyzed during a 90-min equilibration period during which this solution was covered or deliberately left open to the atmosphere. If exposed to the atmosphere, even for a few minutes, substantial changes in pH, osmolality and ionized calcium occurred such that, when silicone oil was subsequently applied to the stromal surface, significant increases in both the rate and amplitude of deturgescence were observed. The rates and amplitude were proportional to the corneal thickness prior to silicone oil application. The results further indicate that the physicochemical state of the stroma is an important determinant in the corneal deturgescence mechanism. PMID- 1784457 TI - Photooxidation of the nonenzymatic browning products in calf lens alpha crystallin. AB - The browning reaction (or advanced glycation) of calf lens alpha-crystallin generates chromophores which absorb light at wavelengths above 300 nm. They display an absorption shoulder above 300 nm, a positive circular dichroism band at 320-340 nm, and a blue fluorescence at 460 nm (Ex = 370 nm). Upon irradiation by UV-A light at a wavelength of 320-350 nm, the intensity of the absorption shoulder displayed an increase, but both circular dichroism and blue fluorescence intensities decreased. It appears that browning chromophores were photolyzed and converted to species which absorb more light at 320-330 nm, but are optically inactive. The browning products are thus susceptible to photooxidation from radiation of light above 300 nm and add an oxidative stress to the lens proteins. PMID- 1784458 TI - Effect of permeation enhancers on beta-endorphin systemic uptake after topical application to the eye. AB - Solutions of human beta-endorphin were applied topically to the eyes of rabbits. Atrial blood was collected and plasma beta-endorphin was assayed using a Nichols Diagnostics radioimmunoassay kit. Levels peaked rapidly (within 10-20 min) at greater than 5 ng/ml with 1% beta-endorphin and no enhancer, and then returned to background within 2 h. When the permeation enhancers Brij-78 or BL-9 were added to the formulation applied topically, plasma levels were elevated above 30 ng/ml and remained elevated above 1 ng/ml over 1 h. Plasma levels were actually higher after topical application using either enhancer than after intravenous injection at the collection points of 45 min and later. The data suggest that topical application to the eyes can be an efficacious method of systemic delivery of peptide drugs. PMID- 1784459 TI - Naphthalene-induced cataract in the rat. II. Contrasting effects of two aldose reductase inhibitors on glutathione and glutathione redox enzymes. AB - This investigation compared the effects of two types of aldose reductase inhibitors on several biochemical parameters in naphthalene-induced cataract of the rat over a time span of 102 days of treatment. Feeding of naphthalene daily to brown Norway rats resulted in gradual, progressive development of zonular opacities. As compared to control animals, the values of soluble protein, soluble glutathione (total of oxidized plus reduced) and activities of glutathione peroxidase and glutathione reductase were decreased in rats fed either naphthalene or naphthalene + FK366, a carboxylic-acid-type aldose reductase inhibitor. In marked contrast, treatment with A11576, a hydantoin-type aldose reductase inhibitor, maintained the values of most parameters (with one exception) at levels that were similar to those of the controls, and all lenses remained clear. A decline of glutathione was noted in all naphthalene-fed rats, irrespective of whether these animals had been treated with an aldose reductase inhibitor. The great decrease of glutathione with A11576 suggests that this inhibitor acts at some step in naphthalene metabolism following formation of naphthalene epoxide. PMID- 1784460 TI - Roles of catalase and the glutathione redox cycle in the regulation of anterior chamber hydrogen peroxide. AB - The effects of inhibition of both glutathione synthesis and of glutathione reductase and catalase activities have been determined in the regulation of hydrogen peroxide (H2O2) in the anterior chamber of pigmented rabbits. Glutathione reductase inhibition using intravitreal 1,3-bis-(2-chloroethyl)-1 nitrosourea (BCNU) did not significantly alter either total glutathione or the percent oxidized glutathione fraction in the iris-ciliary body. Intravitreal buthionine sulfoximine (BSO) significantly reduced the total glutathione content of iris-ciliary body and corneal endothelium, while not altering the oxidized fraction. BCNU increased the oxidized fraction of glutathione in the aqueous humor from 22 to 63% without significantly altering total glutathione levels. BSO, however, reduced total glutathione by 70% in the aqueous humor, and the oxidized fraction doubled. Decreases in the reduced glutathione concentration caused by BSO correlate with increases in the normally stable ratio of H2O2 to ascorbate concentrations in the aqueous humor, strongly suggesting that glutathione metabolism is correlated with H2O2 regulation at endogenous levels of this oxidant. Both BSO and 3-aminotriazole (3AT) separately increased the half time for the loss of exogenously added H2O2 from the anterior chamber. BSO increased the half-time by 77% after 10 microliters of 10 mM H2O2 was injected intracamerally, while suppression of catalase activity with 3AT increased it by only 40%. With intracameral injections of 10 microliters of either 25 or 50 mM H2O2, however, 3AT had a greater effect than BSO. The half-time values after 3AT pretreatment were 61 and 135% greater than control values at the concentrations of 25 and 50 mM H2O2, respectively; those after BSO pretreatment were at 14 and 78%. From these data we conclude that the glutathione redox system protects the anterior segment tissues from hydrogen peroxide at low concentrations of this oxidant, while catalase assumes a greater role at higher concentrations of hydrogen peroxide. PMID- 1784461 TI - Fractionated beta-irradiation of a conjunctival lymphangioma. AB - Fractionated beta-radiation was applied on a conjunctival lymphangioma, which had been known for several years. Histological diagnosis was established 3 years previously. Excision was not possible because the tumor had involved a considerable part of the conjunctiva. Using a strontium-90 applicator a total dose of 30 Gy was applied in 6 fractions with 5 Gy each. The initial tolerance was satisfactory. No radiogenic damage occurred, an involution of the tumor could be observed. During a follow-up time of nearly 2 years no further progression was noted. We consider the beta-radiation as an interesting therapeutic alternative for conjunctival lymphangiomas which are difficult to treat surgically due to their size. PMID- 1784462 TI - [Differential diagnosis of retinoblastoma]. AB - An 8-year-old boy presented with a white pupillary reflex. This clinical picture suggested a diagnosis of retinoblastoma or Coats' disease. Ultrasonography did not reveal the characteristic signs often seen in retinoblastoma. However, diagnostic vitrectomy and subsequent enucleation confirmed the diagnosis 'retinoblastoma'. PMID- 1784463 TI - Adult-form galactosialidosis: ocular findings in three cases. AB - We reported ocular findings of 3 patients with adult-form galactosialidosis. Diffuse fine opacities in the deep layer of the corneal stroma, an obscure cherry red spot of the macula and optic nerve atrophy were noted in all cases. Punctate lenticular opacities were observed in 2 cases. Slowly progressive visual disturbance was seen in all cases, and it might be due to secondary optic nerve atrophy caused by retinal ganglion cell death. PMID- 1784464 TI - New surgical method for nystagmus without null point. AB - We report our results in nystagmus without null point surgery, utilizing a new technique consisting in the placement of a silicone encircling band around the globe over the four recti muscles, in the retroequatorial position. This method was tried only in nystagmus without null point and with both horizontal and vertical movements. We have not observed any ischemic complication of the anterior segment nor any important variation of intraocular pressure probably because the silicone band was not tightened. Other advantages of this method are its reversibility (cutting the silicone band) and the possibility of combining it with recession-resection of recti muscles at the same or at a later date. PMID- 1784465 TI - Octopus program G1X. AB - The glaucoma program G1 is widely employed by Octopus users. In addition to a specific distribution of test locations, its main advantages are the quick comparison of results with normal values and an easy follow-up. The program, however, is relatively time consuming and, therefore, tiring for some patients. For this reason, the program was modified to 'G1X'. This program is interruptable at any time and provides information, including statistical analysis based on the available data. The test sequence is rearranged in accordance with the importance of the information. The available information, including the confidence limits, is continuously calculated and presented on the screen of the Octopus 1-2-3 during the test procedure. This provides the possibility of adapting the measurement to the patients and their state of health. The principal features as well as clinical applications are described. PMID- 1784466 TI - Electrooculogram in central retinal vein obstruction. AB - The electrooculograms (EOGs) of 24 patients with central retinal vein obstruction (CRVO) were correlated with fundus appearance and with the electroretinogram (ERG) b/a wave ratio. Of the 24, 17 (70.8%) showed abnormal EOGs [light peak versus dark trough ratio (Lp/Dt) of less than 1.85]. The EOG Lp/Dt ratio was abnormal in 64.7%, although the ERG b/a ratio was within normal limits. Though the exact mechanism is still not entirely clear, the EOG became abnormal in most patients with CRVO and correlated well with the severity of the disease. PMID- 1784467 TI - Pursuit deficits in bilateral pulvinar lesions. AB - A 58-year-old man had bilateral pulvinar infarctions. The patient developed smooth pursuit deficits in both the horizontal and vertical directions, while metrics of saccadic eye movements were normal. The gain of optokinetic nystagmus was slightly reduced. These findings strongly support the idea that the efferent fibers from the cortical pursuit center pass through the pulvinar in the human brain, in the same manner as previously described in the monkey cerebrum. PMID- 1784468 TI - Inherited corneal amyloidosis predominantly manifested in one eye. AB - We report 2 cases of lattice corneal dystrophy type III and gelatinous drop-like corneal dystrophy predominantly manifested in one eye. These 2 corneal dystrophies are found frequently in Japan. The case of lattice corneal dystrophy type III is the second, and the case of gelatinous drop-like corneal dystrophy is the first report at this time. PMID- 1784469 TI - Capillary permeability and basolateral endocytic pathway of the epithelium in the mouse endolymphatic sac in vivo. AB - The capillary permeability and the basolateral endocytic pathway of the mouse endolymphatic sac (ES) epithelium were examined in vivo using intravenous injection of horseradish peroxidase (HRP). The capillaries of the ES were classified as either fenestrated or non-fenestrated. Because dense reaction products were observed soon after injection of HRP in macrophages near both types of capillaries, they were both considered to be permeable to macromolecules. In non-fenestrated capillaries, the basement membrane and small vesicles of the endothelium of the ES were stained with reaction product. These non-fenestrated capillaries were considered to be of muscle type. After 15 min, ES epithelial cells absorbed HRP basolaterally, and the multivesicular bodies and lysosomes of epithelial cells were stained with reaction product. The process of basolateral absorption in the ES epithelium was similar to that in the intestinal epithelium. Our results provide further evidence that the ES is a metabolically active organ which plays an important role in fluid transport in the inner ear. PMID- 1784470 TI - Guinea pig cochlear blood flow under definite sound exposure-hydrogen clearance measurement. AB - Blood flow measurements were carried out on 18 coloured guinea pigs (8 animals served as control group) before and during definite sound exposure (12 kHz, 110 dB SPL). The exposure time amounted to 60 min. The anaesthesia was carried out according to the following schedule: a mixture consisting of 70 mg alpha chloralose/kg b.w. and 400 mg urethane/kg b.w. was injected intraperitoneally. The relaxation was performed by means of i.p. application of 3 mg Tricuran/kg b.w./h. The hydrogen clearance measurements (HCM) were carried out under artificial respiration with control of arterial pH, endexpiratory CO2 content, as well as blood pressure and body temperature. After a duration of noise exposure of 30-45 min the cochlear blood flow reached an average level of 80% of the initial point. This level remained mainly unchanged until the end of noise exposure (60 min). Our HMC's confirm Laser Doppler flowmetry findings. PMID- 1784471 TI - Tinnitus-induced weight loss in rats. An animal model for tinnitus research. AB - Growing rats were exposed to noise and/or tinnitus-producing drugs (sodium salicylate, quinine, gentamycin). Growth inhibition or weight loss was absent or significantly lower in the noise-only and salicylate-only/quinine-only groups than in the groups exposed to both noise and drugs. In the gentamycin groups, initially the same trend was found, but general toxicity soon prevailed, leading to heavy weight losses in both groups. The findings clearly favor the hypothesis that tinnitus-induced stress may be the cause for this effect. The experimental set-up thus could serve as an animal model for tinnitus research. In humans, high doses of salicylate or quinine should be avoided in persons exposed to elevated noise levels. PMID- 1784472 TI - Asymptomatic electronystagmographic abnormalities in patients with type I diabetes mellitus. AB - Only a few studies have investigated vestibular function in diabetes mellitus (DM), showing contradictory results. We have performed an electronystagmographic (ENG) evaluation of 46 individuals with type I DM and 37 healthy controls. No patient reported subjective vestibular symptoms. Duration of caloric-induced nystagmus (DN) was significantly lower (2.1 +/- 0.7 vs. 2.6 +/- 0.4 min, p less than 0.01), and central nystagmus frequency of caloric response also nonsignificantly tended to be decreased (37.4 +/- 16.5 vs. 41.7 +/- 12.7 beats/30s, p = 0.21) in DM patients, as compared to controls. The latter comparison achieved significance after exclusion of newly diagnosed diabetic patients (33.4 +/- 16.1 vs. 41.6 +/- 12.7 beats/s, p less than 0.05). Depressed caloric reactions were seen in 21.8% of patients. DN was lower in patients with microalbuminuria and retinopathy, but this was not observed after exclusion of newly diagnosed diabetic patients, all of whom had normal ENG responses and no chronic diabetic complications. The existence of a lower DN and central nystagmus frequency should be borne in mind when interpreting ENG tracings in patients with long duration type I diabetes mellitus. PMID- 1784473 TI - Reduced concentration of secretory IgA indicates changes of local immunity in children with adenoid hyperplasia and secretory otitis media. AB - Children with adenoid hyperplasia and secretory otitis media show significantly lower immunoglobulin A (sIgA) concentrations in their saliva compared to matched controls. Salivary albumin and cortisol levels do not differ in both groups. Changes in local immunity, dilution or stress as possible factors for the reduction of sIgA concentrations are discussed. PMID- 1784474 TI - Restoration of hearing with type V tympanoplasty. AB - Type V tympanoplasty with fenestration of the oval window and protection of the round window in a residual hypotympanic cavity can be considered as the last chance procedure for rehabilitation of hearing in ears with 'canal wall down' or other conditions. The review of 64 cases suggests that restoration of hearing can be adequate in the majority of cases. PMID- 1784475 TI - The nasolabial skinflap in intraoral reconstruction. AB - Twenty-four patients underwent reconstruction of the lower anterior part of the oral cavity with a total of 29 nasolabial skinflaps, following ablative surgery for squamous cell carcinoma. Partial necrosis due to biting occurred in one flap. The rest healed without complications. Cosmetic impairment was minimal and postoperative functional problems were related to the extent of the primary resection rather than the flap. The nasolabial flap has proved to be a very safe and useful alternative for reconstruction of relatively small defects in the lower anterior part of the oral cavity. PMID- 1784476 TI - High-resolution magnetic resonance imaging of the human temporal bone. AB - A magnetic resonance imaging (MRI) system (Hitachi, Naka, Japan) with a superconductive magnet running at 2.11 T was used to obtain 2-mm-thick slices of fixed, decalcified and celloidin-embedded human temporal bone. The temporal bone was then sectioned and stained for routine histological evaluation. Both the MR images and the histological sections were in the mid-modiolar slice plane, and comparable images and sections were analyzed to confirm the identity of the inner ear structures visualized on the MR images. The cochlear duct, scala tympani, scala vestibuli and basement membrane of all three cochlear turns were clearly imaged on MRI. In addition, the vestibule and three semicircular ducts were also clearly seen. This study raises the possibility of some day using MRI for the diagnosis of inner-ear diseases. PMID- 1784477 TI - Acute peripheral facial palsy simulating Bell's palsy in a case of probable multiple sclerosis with a clinically correlated transient pontine lesion on magnetic resonance imaging. AB - A transient pontine lesion was demonstrated in a young adult male who had a complete acute peripheral facial nerve palsy due probably to multiple sclerosis. In the acute stage of the palsy. T2-weighted magnetic resonance imaging (MRI) revealed a high signal intensity in the ipsilateral pons in the region of the nucleus and pontine part of the facial nerve. The patient recovered completely 5 weeks after the onset of the palsy, and at this stage, the lesion in the brainstem was no longer demonstrable on MRI. The onset and course of the disease resembled the idiopathic form of facial palsy (Bell's palsy): the present findings along with recent MRI and topodiagnostic studies may indicate that in some cases of Bell's palsy the primary lesion is located centrally. By improved MRI techniques and intravenous contrast agents it may be possible to visualize and follow the disease process and ascertain more of the pathogenesis of Bell's palsy. PMID- 1784478 TI - Intramuscular hemangioma of the masseter muscle: its characteristic appearance on magnetic resonance imaging. AB - A 10-year-old girl presented with a 6-month history of right facial swelling. Magnetic resonance imaging (MRI) revealed a tumor in the masseter muscle. On exploration through a preauricular incision, a vascular mass was found located in the lateral aspect of the right masseter muscle. The characteristic MRI appearance of the intramuscular hemangioma of the masseter muscle is shown and the value of MRI for a preoperative differential diagnosis is discussed. PMID- 1784479 TI - [Osteosynthesis using Kirschner pins in dislocation fractures of the head of the humerus]. PMID- 1784480 TI - [Experimental substantiation of using gentacycol for prevention of wound infection in gunshot bone fractures of the extremities]. AB - There have been experimentally studied the antibacterial properties of the preparation "gentacycol" developed in the research institute of antibiotics. Its effective agent is gentamycin and as the matrix of a carrier modified collagen is used. It is indicated that in vitro and at implantation in preliminary infected ordinary and gunshot osseous wounds in rabbits and dogs gentacycol inhibits the growth of aerobic and, that is especially important, anaerobic microflora, limits the development of inflammatory Process and stimulates, to a certain extent, reparative osteogenesis. The obtained data allows to recommend gentacycol application for prophylaxis of wound infection in treatment of gunshot limb bone injuries. PMID- 1784481 TI - [Surgical treatment of inveterate injuries of peripheral nerves of the forearm and hand]. AB - In the article is described the method of application of the wrapping epineural suture, proposed by the authors. There are demonstrated the advantages of the given suture in relation to the ordinary epineural one in comparative aspect. Moreover, there is proposed the method of autoneuroplasty at injuries of the median and ulnar nerves with regard to the direction of transplants in the "cable". 18 patients have been operated on according to the proposed method of autoneuroplasty . The positive effect has been detected when studying the remote results. The operated nerve function restores much quicker due to the application of the local hyperthermia of a limb beginning from the 6th post-operative day during 2-3 months. The comparative evaluation of the results of treatment demonstrated the efficiency of the proposed methods. PMID- 1784482 TI - [Clinical characteristics of using the rod apparatus for external fixation in diaphyseal fractures of the humerus]. PMID- 1784483 TI - [Hemodynamic and metabolic disorders in the early period of traumatic disease]. AB - In the article are presented the results of study and treatment of 804 patients with polytrauma. In part of the patients in early period of the traumatic disease have been studied in complex the states of hemodynamics (circulating blood volume, specific peripheral resistance, cardiac index, central venous pressure, arterial pressure, heart rate) and metabolism (total protein, basal metabolism, the level of endogenous nitrogen in urine). On the basis of the obtained data there is proposed the evaluation of the hemodynamics changes, energetic and plastic losses at polytrauma that formed the basis of the pathogenetic therapy ensuring simultaneous correction of the detected disturbances. It allowed the author to reduce the number of unfavourable outcomes (anatomical by 20.9% (p less than 0.05), functional by 20.7% (p less than 0.05), labour by 19.5% (p less than 0.05) and lethality (at the multiple damages by 2.0% (p less than 0.05), at associated craniocerebral injury by 3.0%, at associated trauma of internal organs and locomotor system by 6.0% (p less than 0.05). PMID- 1784484 TI - [Organ-sparing treatment of finger injuries caused by a punching]. AB - There have been studied 1037 cases of hand and finger punch injuries, observed in 786 victims. An analysis of the trauma causes allowed to carry out the complex of preventive measures. The efficiency of these measures is testified by 3-fold decrease of occupational traumatism at Lysvensk metal works during 5 recent years. It has been stated that 496 (52.6%) of 945 finger and hand wounds were tissue avulsion and crush. These damages are typical ones in case of finger injuries with a punch. There have been analysed the results of treatment of 341 patient with scalped wounds, open fractures, finger and hand avulsions and crushes (482 wounds). It has been stated that careful surgical treatment of a wound with edge dissection, removal of damaged fatty tissue and free fractured fragments is a reliable method of infectious complication prophylaxis when the wound has been stitched without intention and the skin defects closed by means of the first skin plasty. The first skin plasty has been used for treatment of 62 wounds. Complete graft survival has been noted in 70.9% cases. In 85% of cases there have been obtained good functional results. A special section of sparing treatment presents finger replantation in case of their avulsion. Microsurgical technique has been applied with 9 patients. There have been replanted 13 fingers and 1 hand (survived 10 fingers and the hand). There have been revascularized 3 fingers (2 of them have survived). PMID- 1784485 TI - [Functional characteristics of the upper leg stumps after knee joint disarticulation and prosthesis]. AB - In this article is presented the 20-years experience of surgical preparation and prosthetics of 62 invalids with the femur stumps after knee joint exarticulation at the age of 5-65 years in the clinic of LNIIP. New methods of distal epiphysis transposition with muscle connection preservation instead of diaphysial femur amputations were applied to the patients with the integument defects. There have been broadened and made more accurate indications for knee joint exarticulation as a consequence of a trauma as well as in case of vascular diseases. Prosthetic appliances are made with utilization of modified monocentric knee units, polycentric modules and frame-type full-contact sockets of new design. PMID- 1784486 TI - [Surgical treatment of subcutaneous injuries of the extensor tendons at the level of distal interphalangeal joints of the fingers]. PMID- 1784487 TI - [Immobilization in fractures of the clavicle]. PMID- 1784488 TI - [Systematic treatment of crural bone fractures in an agricultural region]. PMID- 1784489 TI - [Linguistic manual for searching scientific documents on the subject "Orthopedics and traumatology". The automated search system in orthopedics and traumatology]. PMID- 1784490 TI - [Organization of the control of traumatism in children]. PMID- 1784491 TI - [Osteosynthesis in patients with associated cranio-cerebral trauma]. AB - In the article are presented the results of surgical treatment of 176 patients with associated craniocerebral injury. To the primary osteosynthesis in the first post-hospital day have been subjected 75 patients and to the postponed osteosynthesis--101 patient. For osteosynthesis there have been applied the methods of stable-functional osteosynthesis by plates (57.3%), by means of the external fixation apparatus (19.8%), by rods (10.8%) and by other means. The experience of the primary osteosynthesis, including the experience of simultaneous operation on 2-3 segments with application of the atraumatic technique, indicates that the operation doesn't aggravate the severity of injury but ensures more quick rehabilitation of the patients with craniocerebral injury, guarantees the complete restoration of function during 1-2 post-operative months. PMID- 1784492 TI - [Differential diagnosis of giant cell bone tumors]. PMID- 1784493 TI - [Structure of the local body reaction--an information-dependent process]. PMID- 1784494 TI - [Evaluation of the severity of the condition of patients with bone injuries]. PMID- 1784495 TI - [Prognosis of probable development of suppurative complications of open diaphyseal fractures of the lower extremities]. PMID- 1784496 TI - [Comparison of various systems of evaluating the restoration of the functions of the injured flexor tendons of the fingers]. PMID- 1784497 TI - [Stable metal osteosynthesis in fractures of long tubular bones and cranio cerebral trauma]. AB - On the basis of an experience of application of modern methods of trans-osseous (123), intraosseous (67) and osseous (3) metallo-osteosynthesis and their combinations (30) in 159 victims (aged 4.5-86 years) with associated craniocerebral injury is drawn a conclusion on the expediency of application of different methods of metallo-osteosynthesis of long bones depending on a number of indications. In this case the severity of the craniocerebral injury and the victim state, the character and association of the bone fractures, the period of the traumatic disease are taken into consideration. The most efficient is the early application of stable metallo-osteosynthesis. Combination of the stable connection of fractured fragments with the principle of minimum intervention damaging is of special significance. For this reason in the period of early compensation (2 initial post-traumatic days) the trans-osseous osteosynthesis is preferable. Metallo-osteosynthesis is expedient according to the rigorous indication in the period of stable compensation (9-21 post-traumatic days), preferably at the closed fractures of femur and forearm. The results of treatment have been evaluated with 123 (77.36%) operated patients. The positive outcomes have been noted with 95% of patients that is indicative of the efficiency of the applied methods. PMID- 1784498 TI - Coping with chronic pain: a critical review of the literature. AB - A growing number of investigators have used models of stress and coping to help explain the differences in adjustment found among persons who experience chronic pain. This article reviews the empirical research which has examined the relationships among beliefs, coping, and adjustment to chronic pain. Although preliminary, some consistent findings are beginning to emerge. For example, patients who believe they can control their pain, who avoid catastrophizing about their condition, and who believe they are not severely disabled appear to function better than those who do not. Such beliefs may mediate some of the relationships between pain severity and adjustment. Although coping strategies appear to be associated with adjustment in chronic pain patients, methodological problems limit conclusions regarding the strength and nature of this association. Our recommendations for future research include the development of coping and belief measures which: (1) do not confound different dimensions (e.g., coping, beliefs, and adjustment) in the same measure; (2) assess specific (rather than composite) constructs; (3) are psychometrically sound; and (4) assess behavioral coping strategies more objectively. We also recommend a greater use of experimental research designs to examine causal relationships among appraisals, coping, and adjustment. PMID- 1784499 TI - Early and late effects of prolonged topical capsaicin on cutaneous sensibility and neurogenic vasodilatation in humans. AB - Cutaneous sensibility and neurogenic vasodilatation (flare) were measured before, during and after long-term topical application of capsaicin in humans. Each subject applied a vehicle cream containing 0.075% capsaicin (Axsain, GalenPharma Inc.) to a 4 cm2 area of skin on one volar forearm and vehicle alone to an identical treatment area on the other forearm, according to a double-blind procedure. Each substance was applied 4 times/day for 6 weeks. Psychophysical measurements of sensory detection thresholds, magnitude of suprathreshold heat pain, magnitude and duration of histamine-induced itch and flare area were obtained before, at 1, 3 and 7 days after the first application, and once a week thereafter for a total of 8 weeks. Capsaicin produced mild burning in all subjects which diminished in magnitude and duration over several weeks. Capsaicin significantly altered detection thresholds for heat pain and the magnitude of pain produced by suprathreshold painful stimuli. Mean detection threshold for heat pain was lowered 1.6 degrees C following 1 day of capsaicin application but subsequently increased to become elevated 3.5 degrees C after 6 weeks of application. In addition, mean magnitude of suprathreshold heat pain diminished progressively after 1 week. Heat pain thresholds returned to or near pretreatment values within 2 weeks after discontinuing application. Detection thresholds for touch, cold sensation and pain induced by low temperature and by mechanical stimulation were not altered by capsaicin. Similarly, capsaicin did not alter the magnitude or duration of itch produced by intradermal injection of 1 microgram histamine. However, the area of flare produced by histamine was significantly reduced in capsaicin-treated skin. These studies demonstrate that prolonged application of capsaicin at low concentration selectively diminishes sensations of heat pain and neurogenic vasodilatation, presumably via desensitization of heat-sensitive nociceptors. It is also shown that the decrease in heat pain is temporary and is maintained with repeated capsaicin application. There appears to be a therapeutic role for capsaicin in cutaneous painful syndromes mediated, at least in part, by activity of heat-sensitive nociceptors. PMID- 1784500 TI - Impairment of corneal pain perception in cluster headache. AB - Despite many studies, the mechanisms underlying the pathogenesis of pain in cluster headache (CH) still remain obscure. An involvement of substance P (SP) containing neurons of the Gasserian ganglion and/or of the spinal trigeminal nucleus has recently been suggested, e.g., by impairment of inhibitory descending pathways on trigeminal nociceptive neurons. The electrically elicited corneal reflex was studied in 21 CH patients (15 in active phase, 6 in remission). This method allows simultaneous measurements of the trigemino-facial reflex and corneal pain perception. A significant reduction of pain thresholds (more evident on the pain side) was observed in CH during the active phase, while normal values were recorded during the remission phase. Ten out of 15 patients in the active phase showed a significantly reduced corneal pain threshold on the pain side, while tactile sensibility was normal. Moreover, latency, amplitude and duration of the corneal reflex were normal for both painful and painless stimulations during both phases. The threshold of the nociceptive muscular response in the active phase was significantly reduced, suggesting that the excitability of trigeminal nociceptive neurons or of the motor neurons is increased in CH. The results agree with the hypothesis that a reversible impairment of several integrative functions, including the activity of trigeminal pain control system, exists in CH during the active phase. PMID- 1784501 TI - The effect of pre-incisional infiltration of tonsils with bupivacaine on the pain following tonsillectomy under general anesthesia. AB - The aim of the present study was to test the hypothesis that blockade of nociceptive input with bupivacaine during tonsillectomy can decrease pain beyond the immediate postoperative period. Fourteen patients between the ages of 6 and 18 years scheduled for tonsillectomy (with or without adenoidectomy) were randomly divided into two groups. The patients of both groups received 0.006 mg/kg atropine and anesthesia was induced by inhalation of halothane. Atracurium 0.5 mg/kg was used for myorelaxation. After oral intubation anesthesia was maintained with isoflurane plus nitrous oxide 67% in oxygen. In the bupivacaine group, 5 min before incision the tonsillar fossae were infiltrated with 0.25% bupivacaine with epinephrine (1 : 200,000). In the control group, the tonsillar fossae were infiltrated with normal saline with epinephrine (1 : 200,000). All patients received morphine 0.07 mg/kg (in the recovery room) and oral elixir with codeine 0.05 mg/kg plus acetaminophen 5 mg/kg every 4 h. Pain assessments were made using the visual analog (100 mm scale) self-rating method. Two types of pain were assessed: constant incisional pain and pain caused by drinking 100 ml of water. In the bupivacaine group, the constant pain score on the second day after surgery was 19 +/- 6 compared to 74 +/- 8 in the saline group (P less than 0.0002). By the 4-5th day after surgery almost no constant pain occurred in the bupivacaine group, but the pain score remained at the 40-60 level in the saline group. The difference in pain intensity on swallowing between the bupivacaine and saline groups was present even on the 10th postoperative day (1 +/- 1 vs. 14 +/- 5, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1784502 TI - Self-report of chest pain symptoms and coronary artery disease in patients undergoing angiography. AB - The relation of self-reported chest discomfort to the presence of atherosclerosis was examined, taking age and gender differences into account. Sixteen practicing cardiologists independently rated the items of a self-report questionnaire of angina pectoris (AP) symptoms according to their adjudged likelihood of being associated with coronary artery disease (CAD). Inpatients' (130 male and 82 female) responses to this questionnaire were obtained on the day prior to coronary angiography and scored according to their reporting of 12 symptoms endorsed by all 16 cardiologists, 25 symptoms endorsed by at least 90% of the cardiologists, and responses to items used in the Rose questionnaire, a brief survey tool for diagnosis of chest pain. Finally, patients' angiographic results were rated for presence of 75% or more CAD of one or more coronary arteries. Surprisingly, more symptoms were reported by patients without significant CAD, regardless of age or gender. PMID- 1784503 TI - Central pain and thalamic hyperactivity: a single photon emission computerized tomographic study. AB - Five patients with central post-stroke pain (CPSP) accepted to be studied according to the following paradigm: a single photon emission computerized tomography (SPECT) using [123I]N-isopropyl-iodoamphetamine (IMP) was made in each patient 20 min following i.v. injection of IMP; during this time, the patients were stimulated in order to reproduce their spontaneous pain. Of the five patients, two had CPSP with hyperpathia following a stroke (with a lesion on CT scan involving the thalamo-cortical pathway in one and involving the thalamus in the other); two had CPSP following a stroke in the middle cerebral artery area, without hyperpathia; and the last patient suffered pain from algodystrophia following a fracture of the wrist. In the two cases with hyperpathia, SPECT demonstrated a contralateral relative hyperactivity in a central region corresponding to the thalamic area. This was not observed in the three other patients. In the two patients with hyperpathia, a second SPECT scan with stimulation of the contralateral pain-free arm did not demonstrate any hyperactivity in the thalamic area. These results suggest that a thalamic neuronal hyperactivity may characterize some hyperpathic syndromes and, in accordance with our previous results obtained in the rat, that the loss of inhibition on medial thalamic neurons may be a main feature of hyperpathia following certain cerebral stroke syndromes. PMID- 1784504 TI - Hyperalgesia and myoclonus with intrathecal infusion of high-dose morphine. AB - We report the case of a patient who developed myoclonus and hyperalgesia following administration of high-dose subarachnoid morphine. This complication occurred with 40-80 mg/day continuous infusion. The pathophysiology of these side effects is discussed. PMID- 1784505 TI - Piriformis syndrome: a rational approach to management. AB - Although rarely recognized, the piriformis syndrome appears to be a common cause of buttock and leg pain as a result of injury to the piriformis muscle. Four cases representing a broad spectrum of presentations are described here. The major findings include buttock tenderness extending from the sacrum to the greater trochanter and piriformis tenderness on rectal or pelvic examination. Symptoms are aggravated by prolonged hip flexion, adduction, and internal rotation, in the absence of low back or hip findings. Minor findings may include leg length discrepancy, weak hip abductors, and pain on resisted hip abduction in the sitting position. Myofascial involvement of related muscles and lumbar facet syndromes may occur concurrently. The diagnosis is primarily clinical as no investigations have proved definitive. The role of MRI of the piriformis muscle is assessed and other investigative tools are discussed. A rational management schema is demonstrated: (1) underlying biomechanical factors and associated conditions should be corrected; (2) the patient is instructed in a home program of prolonged piriformis muscle stretching which may be augmented in physical therapy by preceding ultrasound or Fluori-Methane (dichlorodifluoromethane and trichloromonofluoromethane spray); (3) a trial of up to three steroid injections is attempted; and (4) if all these measures fail, consideration should be given to surgical sciatic nerve exploration and piriformis release. PMID- 1784506 TI - The effects of oral morphine and buprenorphine on autotomy following brachial nerve sections in rat. AB - This study assessed the relationship between autotomy and opioid systems following brachial nerve sections in the rat. Morphine, buprenorphine and/or naloxone were self-administered orally to rats following nerve sections. Oral morphine and buprenorphine increased the severity of autotomy. Naloxone alone had no effect, but reversed oral morphine effect on autotomy. These results suggest that mu-receptor activation by morphine and buprenorphine can increase the severity of autotomy. PMID- 1784507 TI - Central pruritus: case report. PMID- 1784508 TI - Comment on 'Toward an integrated understanding of fibromyalgia syndrome. I. Medical and pathophysiological aspects', by Boissevain and McCain in PAIN, 45 (1991) 227-238. PMID- 1784509 TI - Understanding and treating motivation difficulties in ventilator-dependent SCI patients. AB - Motivation for spinal cord injury rehabilitation is a difficult management task for clinicians. Ventilator-dependent quadriplegics experience conditions which are particularly likely to lead to motivational problems. The following article provides a theoretical model with which to understand patient motivation. The model conceptualizes patient motivation as a patient-rehabilitation environment fit problem and employs concepts from social learning theory to facilitate understanding and intervention with such difficulties. The model is applied to two ventilator-dependent rehabilitation cases. Recommendations for clinical practice are provided. PMID- 1784510 TI - Semen retrieval in spinal cord injured men. AB - A fertility programme for spinal cord injured men has been in progress for nearly 5 years. Thirty eight men have been treated in this programme. Electroejaculation, vibration ejaculation and subcutaneous physostigmine have all been used successfully to obtain semen. Semen has been obtained from 21 of 24 men with a lesion at T8 or above, and from 4 of 11 men with lesions below T10. There have been 8 pregnancies from 6 couples. PMID- 1784511 TI - Physiological responses to maximal exercise on arm cranking and wheelchair ergometer with paraplegics. AB - This study describes the responses of 20 paraplegic athletes (mean age: 26.8 +/- 1.6 years) to a continuous incremental workload test until exhaustion on an arm cranking ergometer (ACE) and on a wheelchair ergometer (WCE). Both ergometers used the same electromagnetic braking device allowing a fair comparison between results. Tests were conducted at a 24 hour interval at the same time of the day. Oxygen uptake (VO2), heart rate (HR), workload (W), blood pressure (BP), Borg index, and mechanical efficiency (ME) were measured at every minute during the effort and the cool down periods of both tests. The purpose of this study was to analyse the different responses obtained on ACE and on WCE during maximal effort by paraplegics, and also to determine which ergometer permits the higher ME. Results indicate that paraplegics reached the same max HR on ACE and on WCE (97% of the predicted max HR). The lack of significant difference (p less than 0.05) between ACE and WCE in terms of maximal values of VO2, VE and HR suggests that the subjects reached their maximal capacity on each test regardless of the type of ergometer. Nevertheless, W max (in Watts) was 26% higher on ACE than on WCE. Maximal ME values were respectively 16% and 11.6% on ACE and WCE. Results suggest that ergometers and protocol used in this study are appropriate to measure physiological responses of paraplegic athletes during arm cranking and wheelchair exercise without excessive or early arm fatigue. PMID- 1784512 TI - Pulse volume recording disturbances in paraplegic patients. AB - Spinal cord injuries may modify vascular reactivity in the denervated region. This study presents an original observation of altered vascular response in paraplegic patients. A group of 30 consecutive paraplegic otherwise normal individuals underwent a thorough vascular examination. There were 29 male and 1 female patient, 21 to 67 years old (average 41), all with traumatic spinal cord injury. Average time since injury was 17 years. All had good peripheral pulses and normal segmental Doppler pressure measurements. In 8 patients, plethysmography--pulse volume recording (PVR) was normal as expected. In 22 patients an unusual feature of the vascular examination was recorded, consisting of normal peripheral arterial pressures with PVR waveforms indicating poor pulsatility. This group was older than the group with normal studies: ages 44 +/- 13 vs 34 +/- 8 years (p = 0.05), and more time had elapsed since injury-20 +/- 12 vs 10 +/- 4 years (p = 0.015). The altered pulsatility demonstrated in most of those paraplegic patients may play a role in deficient wound healing frequently observed below the level of spinal neurological loss. PMID- 1784513 TI - Constipation associated with chronic spinal cord injury: the effect of pelvic parasympathetic stimulation by the Brindley stimulator. AB - Ten subjects with severe constipation due to complete spinal cord injury (SCI) had prolonged oro-anal transit time (p less than 0.01), diminished faecal water content (p less than 0.05) and a reduced frequency of defaecation (p less than 0.01) compared to 10 non-SCI subjects. Paraplegics with an implanted Brindley S234 anterior sacral nerve root stimulator had a significant increase in frequency of defaecation (p less than 0.01), compared to the SCI group while the faecal water content was less although not significantly so. The Brindley stimulator group also showed a more rapid colonic transit than the SCI group but this did not reach statistical significance. SCI is associated with constipation which therefore appears to be favourably influenced by the Brindley S234 anterior nerve root stimulator. The effects produced are compatible with stimulation of left colonic motility, which facilitates the emptying of the distal colon, but also suggest that part of the response restricts transit in some areas of the colon or rectum. Since the motility changes induced by the Brindley stimulator do not affect the right colon a relatively greater residence time of the faecal bolus in this part of the large bowel would enhance water absorption. PMID- 1784514 TI - Prediction of ramp traversability for wheelchair dependent individuals. AB - The purpose of this research was to obtain a single objective criterion that would constitute a reliable prediction of length and grade limits for ramps that can be traversed by any special category of wheelchair dependent individuals (WDI). The maximal voluntary force (MVC) is the main limiting factor of the performance of WDI, thus the force required to traverse a ramp has been established by means of a simple mechanical model. The real time course of force application during ascent was experimentally obtained. Then, a simplified law of force application was introduced in a computer simulation program of kinetics and kinematics of ascent. Inputs to the model were also the mass of the subject plus wheelchair, the initial velocity of the chair, and the ramp length. The output of the program was the force requirement for any given length/grade. When capsizing conditions were encountered the simulation ended. We tested the results thus obtained having some selected WDI successfully traversing ramps with the predicted length/grade specifications. PMID- 1784515 TI - Ramp length/grade prescriptions for wheelchair dependent individuals. AB - The aim of this work was to provide well defined criteria for ramp construction for wheelchair dependent individuals (WDI). Force capability was measured in a large sample (140) of WDI, who presented different levels of motor impairment. Levels of impairment were established on the basis of the answers given in a questionnaire regarding the degree of self sufficiency at home as well as outside the home and active participation in sports events. Taking into account those WDI who exhibited at least a minimal level of self-sufficiency, the following prescriptions are indicated. For a 1 metre ramp length, allowable maximal incline 15%; up to 3 metre ramp length, maximal incline 10%. The reliability of such prescriptions was confirmed by having a test ramp traversed by 43 WDI. These values are suggested as confidence limits when faced with public building accommodations. Special prescriptions could be adopted for selected populations of WDI. PMID- 1784516 TI - The use of bone-chip grafts fixed with absorbable bone sealant (Absele). AB - In this study we have investigated the use of bone-chip grafts which were fixed by Absele. In the study 33 adult guinea-pigs were used. Bone grafts for cervical intervertebral fusions were carried out. At the end of the sixth week the bones were examined histopathologically. Both in the control fusion group and in the experiment group the bone grafts were found to be in good condition, but in the free graft group some bone fragments were found in muscle tissue. There was no evidence of foreign body reaction. PMID- 1784517 TI - Investigation of the afferent nerves of the lower urinary tract in patients with 'complete' and 'incomplete' spinal cord injury. AB - In 52 patients with a post-traumatic spinal cord lesion, both proprioception and exteroception in the lower urinary tract were investigated by determination of filling perception and with sensory threshold measurement towards electrical stimulation. Patients with incomplete lesions had one or both types of perception. Of the 42 patients, with a lesion diagnosed clinically as complete, 15 perceived bladder filling, electrical stimulation or both stimuli, indicating the existence of a nervous afferent pathway between the lower urinary tract and the cerebral cortex. PMID- 1784518 TI - The effect of rectal electrostimulation (to produce ejaculation) on spasticity. PMID- 1784519 TI - Body composition and resting energy expenditure in long term spinal cord injury. PMID- 1784520 TI - Benign breast disease: the relationship between its histological features and risk factors for breast cancer. AB - Associations between histologically defined proliferative, but benign, epithelial disorders of the breast and risk factors for breast carcinoma were examined in 568 patients whose breast biopsies were submitted consecutively to the laboratory. Some disorders were associated with multiparity. Blunt duct adenosis was associated with a family history of breast cancer. Apart from a positive association with fibroadenoma, use of oral contraceptives was not associated with any proliferative lesion. Proliferative epithelial lesion changes were not associated with other aspects of obstetric or gynecological history. PMID- 1784521 TI - Test and teach. Number 66. Diagnosis: Hemolytic anemia and thrombocytopenia in a patient with breast cancer. PMID- 1784522 TI - Malignant melanoma of the female genital tract. A report of nine cases in the Chinese of Hong Kong. AB - Ten cases of malignant melanoma of the female genital tract were diagnosed in Chinese patients in Hong Kong over the 12 yr period from 1978 to 1990. Of the 9 cases considered here, 4 involved the vagina alone, 2 the vagina and cervix, 2 the uterine cervix alone, and 1 occurred on the vulva. Thus, contrary to the usual reported distribution, the vulva was an uncommon site. While the mean age of the patients was 58 yrs, 2 patients were in their thirties and both had a history of a recent pregnancy. Vaginal bleeding or discharge were the presenting symptoms in most cases. The primary origin was confirmed histologically in 6 of the 9 cases and all were of the mucosal lentiginous type. Deep invasion, beyond 3 mm, was present in all cases at the time of diagnosis. Five patients died of the disease 2-22 months after diagnosis. The 4 surviving patients were clinical Stage I and II (FIGO) when diagnosed and have a median survival of 18 months to date. Both the FIGO clinical stage and Breslow's tumor thickness proved to be good prognostic indicators. PMID- 1784524 TI - Urgent ("stat") testing in chemical pathology--position paper. AB - Increasingly heavy use is made of the pathology laboratory in many hospitals. This can cause problems, particularly with regard to urgent ("stat") tests, where a result is required in a short time. Many small laboratories are forced to offer a wide battery of tests, many of which may not help greatly in the acute diagnosis and/or management of the patient, and are expensive and inconvenient to perform. This paper addresses the questions as to which (chemical pathology) analytes should be available as emergency ("stat") tests, and how long should it take for results to come back. PMID- 1784523 TI - Macular and lichenoid amyloidosis: a possible secretory product of stimulated basal keratinocytes. An ultrastructural study. AB - This study examined the histogenic pathways of amyloid formation in skin-limited amyloidosis. Skin biopsies taken from 10 cases of macular or lichenoid amyloidosis were studied with the light and electron microscope. Keratinocytes with filamentous degeneration were frequently encountered. They were normally eliminated either transepidermally through the surface or by macrophages at the dermoepidermal junction. Only occasionally was amyloid deposition observed to be associated with apoptotic keratinocytes undergoing filamentous change. On the other hand, small aggregates of amyloid were frequently observed at the dermoepidermal junction closely applied to healthy non-degenerate basal keratinocytes. The early appearance of amyloid at the dermoepidermal junction, its pattern of distribution and its intimate association with overlying active basal keratinocytes suggest that these fine, straight, interlacing fibrils may be a secretory product of stimulated basal keratinocytes. PMID- 1784525 TI - The suitability of the Australasian reference thromboplastin for use on an automated centrifugal analyser. AB - The Australasian Reference Thromboplastin (ART) is now produced in a low turbidity form (ART-LT) for use in photo-electrical coagulometers. This study was designed to assess the suitability of ART and ART-LT for use on a fully automated centrifugal analyser, the ACL300 Research (ACL). These reagents were compared to Thromborel S (TRL), the reagent currently in successful use in our laboratory. It was found that regular ART was an unsuitable reagent for the ACL due to poor daily quality control testing (QC) precision at an INR of 4.5. The ACL also had the effect of significantly altering the ISI of ART from its recommended value as determined for manual testing. ART-LT was found to be an acceptable reagent on the ACL even though its QC precision was lower than that of TRL. The reagent was stable throughout its 8 wk shelf-life. The ACL significantly altered the ISI (International Sensitivity Index) of ART-LT. This may no longer be a disadvantage, as ART-LT is now provided with an ISI specifically for its use on the ACL. PMID- 1784526 TI - Four cases of IgD multiple myeloma. AB - The pathological and clinical findings in 4 cases of IgD multiple myeloma are presented. Two patients presented with renal failure and 2 with bone pain and weight loss. Three had IgD lambda paraproteins and 1 an IgD kappa paraprotein. One patient also developed hypercalcemia and extraosseous spread of tumor to pleura, skin, and palate. There were no distinctive bone marrow or histological findings which suggested this unusual type of myeloma. PMID- 1784527 TI - The microbiology of peritonitis in continuous ambulatory peritoneal dialysis- experience in a provincial centre 1986-1989. AB - Laboratory procedures for isolating the causative microbe from infected effluent in continuous ambulatory peritoneal dialysis (CAPD) are still being refined. Our recovery rate from culturing centrifuged deposits of 10 mL of fluid averaged 55% for leukocytotic fluids from 1986 to 1989, a little lower than the published reports using blood culture methods. A combined use of spun deposit and blood culture broth should improve the yield without excessive cost in time and labor. Gram staining was worthwhile only for leukocytotic fluids. PMID- 1784528 TI - Diarrheal disease due to Clostridium difficile in general practice. AB - A total of 288 stool samples from patients attending their general practitioners was examined for the presence of Clostridium difficile. C. difficile or its cytotoxin was found in 16 patients (5.5%) and was the most common enteric pathogen detected. Most patients had only mild to moderate diarrhea but in the majority of patients the diarrhea was protracted. Eleven of the 16 patients had received antimicrobial agents in the 3 mths preceding onset of diarrhea and there was good circumstantial evidence that 2 other patients had also been exposed. None of the patients had a history of any inflammatory bowel disease or possible occupational exposure. The prescribing habits of general practitioners with regard to antimicrobial agents were monitored for a 1 yr period. Tetracyclines and amoxycillin accounted for approximately 25% each of all prescriptions dispensed. Ten of the 16 patients were treated with antimicrobials (mainly metronidazole) and in most cases the diarrhea resolved. We conclude that C. difficile may be a significant cause of community-acquired diarrhea. PMID- 1784529 TI - Soft tissue lipoleiomyoma. AB - A primary tumor composed of mature adipose tissue and smooth muscle occurring in the anterior abdominal wall of a 46 yr old Filipino woman is described. The tumor was not attached to the uterus, but had an appearance similar to a uterine lipoleiomyoma. It appeared as a soft, rubbery, encapsulated 11 cm ovoid mass with a uniform, white cut surface. Histologically, there were long intersecting bundles of bland smooth muscle mixed with nests of mature fat cells. The presence of differentiated smooth muscle was confirmed by fuchsinophilia, desmin positivity and electron microscopy. The patient also had 6 intramural leiomyomas, an area of adenomyosis, a subcutaneous lipoma of the subscapular region and chronic schistosomiasis of the appendix and left adnexa. PMID- 1784530 TI - Estimation of rheumatoid factor. PMID- 1784531 TI - The impact of the QAP survey on the performance of red cell folate assays. PMID- 1784532 TI - Silver amalgam under attack. PMID- 1784533 TI - Root surface marginal microleakage of composites: comparison of Cavosurface finishes. AB - The effect on microleakage of a modification of the cavosurface finish was evaluated using extracted thermalcycled teeth. Composite resin was placed in cavity preparations on root surfaces of teeth and finished to leave either a flash of material on the margin or finished flush to the margin. The teeth were thermalcycled for 10 days at 5 and 55 degrees C. The teeth were evaluated for microleakage using the silver nitrate staining procedure. Results showed a significant decrease in the amount of microleakage on the margins finished leaving a flash of composite resin. Clinical trials placing these restorations on root surfaces will be necessary to evaluate the impact on the periodontal health. PMID- 1784534 TI - Longevity of cusp-covered amalgams: survivals after 15 years. AB - The longevity of 124 cusp-covered class 2 amalgam restorations and 644 restorations placed without cusp coverage was assessed over periods of up to 15 years. The survivals of both groups of restorations were approximately 72% after 15 years. The longevity of the cusp-covered restorations was not affected significantly by the use of pins for retention, or by patient age. The survivals were much better than the estimates of longevity generally ascribed by dentists to cusp-covered or complex amalgam restorations. PMID- 1784535 TI - Shear bond strength of composite resin to amalgam: an experiment in vitro using different bonding systems. AB - The shear bond strength between amalgam and composite resin with and without the use of adhesive systems was evaluated. It was found that the application of Cover Up II or Prisma Universal Bond prior to placement of composite resin enhanced the shear bond strength between amalgam and composite resin more than five times; and a shear strength of 4.34 and 4.30 MPa was measured respectively. Acid-etching of the roughened amalgam surface prior to application of Prisma Universal Bond decreased the bond strength by nearly 45%. PMID- 1784536 TI - Treating dental caries as an infectious disease. PMID- 1784537 TI - Restoration of severely fractured teeth using a flexible facial matrix. PMID- 1784538 TI - Assessing microleakage at the junction between amalgam and composite resin: a new method in vitro. AB - A new dye-diffusion test method was utilized to evaluate the microleakage between amalgam and composite resin. An amalgam cylinder was made to which a base of composite was added. The effects of several factors upon the microleakage were investigated. The test results indicated less microleakage when bonding agent was applied directly to the roughened amalgam prior to placement of composite resin. The most microleakage was found when roughened amalgam surface was acid-etched before placement of bonding agent and composite resin. PMID- 1784539 TI - [Effect of hemodialysis on left-ventricular contractility]. AB - 43 patients with end-stage renal failure maintained on hemodialysis were studied by echocardiography before and after hemodialysis. Considering possibility, that left ventricule can be enlarged due to intrinsic factors impairing their performance, like myocardial fibres damage in coronary disease or inflammation and extrinsic factors like hypertension, overhydration, anemia, arteriovenous shunt and humoral changes (electrolyte imbalance, uremic toxins, acidosis) three groups of patients were chosen: A--with normal left ventricular diameter, B--with enlarged left ventricule before and after dialysis, C--with enlarged left ventricule only before dialysis. Mean velocity of circumferential fibre shortening (mVcf) and ejection fraction (EF) as left ventricular contractility indexes and end-systolic meridional wall stress as afterload index were determined. Stress-shortening relations before and after hemodialysis were compared in groups, to determine possible intrinsic contractility impairment of the left ventricule. No differences in groups were found in preload reduction (weight loss) and humoral changes (BUN, creatinine, pH, potassium, calcium, hematocrit), also blood pressure was not significantly different in all groups. Hemodialysis improved contractility only in patients with normal left ventricular diameter and significant reduction of afterload. In group A and C stress shortening relation increased after dialysis. In group B decreased probably because of the lack of mVcf improvement despite reduction of stress in two patients. It is possible that these two patients had impaired contractility and enlarged left ventricle due to intrinsic factors. PMID- 1784541 TI - [Value of phase-contrast microscopy in differential diagnosis of erythrocyturia]. AB - In 41 patients with erythrocyturia the usefulness was assessed of phase-contrast microscopy of erythrocytes in urinary sediment. In all 28 patients with non glomerular erythrocyturia (less than 20% of changed sediment erythrocytes) non glomerular, mainly urological, causes of erythrocyturia were found. In 13 cases of glomerulonephritis confirmed by biopsy erythrocyturia was in 6 cases of glomerular character (greater than 60% of changed sediment erythrocytes), in the remaining 7 cases it was of mixed character (greater than 20-60% of changed sediment erythrocytes). In cases of glomerulonephritis a correlation was found between the per cent of changed sediment erythrocytes in this microscopy and the severity of glomerulopathy and the coexistence and intensity of interstitial tubular changes in renal biopsy. The accepted mode of differential diagnosis of erythrocyturia includes presently renal biopsy in case of glomerular erythrocyturia and undertaking of urological diagnostic procedures in case of non glomerular erythrocyturia. In case of mixed erythrocyturia the diagnostic procedure is as yet as in non-glomerular erythrocyturia. This will be eventually changed when our experience will increase. PMID- 1784540 TI - [The role of Helicobacter pylori in the development of chronic gastritis and gastroduodenal ulcers]. AB - To determine the correlation between Helicobacter pylori colonization of the gastric mucosa and the incidence of chronic gastritis as well as gastric and duodenal ulcer, 52 patients (26 women and 26 men) aged 19-77 years (mean 46 years) with gastrointestinal symptoms were studied. Biopsy specimens for histological and bacteriological examinations were taken during upper gastrointestinal tract endoscopies. Helicobacter pylori was found in 21 (40%) patients: 14 women and 7 men (p less than 0.05). The organisms were present more often in cases with chronic gastritis and duodenal ulcer (p less than 0.05). They were not identified in any of 7 persons with normal histologic features (p less than 0.01). Helicobacter pylori was found on the gastric mucosa in 6 (75%) of 8 patients with duodenal ulcer but in none of 5 cases after partial gastrectomy with the methods of Billroth I or Billroth II (p less than 0.05). PMID- 1784542 TI - [Interferon in the treatment of chronic hepatitis B]. PMID- 1784543 TI - [Acquired platelet storage pool deficiency in rheumatoid arthritis]. AB - A 64-year-old woman with a 15-years-history of rheumatoid arthritis developed generalized hemorrhagic diathesis. Routine coagulation tests revealed a slightly diminished platelet count only. Platelet aggregation in vitro induced by ADP, collagen, thrombin, arachidonic acid and ristocetin were reduced. The patient's plasma aggregating activity was significantly diminished which was due to a decrease of the intraplatelet nucleotide pool. The number of mepacrine labelled bodies as well as dense bodies in electron microscopy was below the normal values as well. Moreover, the intraplatelet concentration of cyclooxygenase- malonylodialdehyde (MDA) and lipoxygenase pathway products were lowered. Total platelet immunoglobulin G and M contents were significantly increased. The platelet survival time (in vitro aspirin method) was slightly shortened. Finally the diagnosis of delta-acquired platelet storage pool deficiency (delta-SPD) was established and possibilities of treatment were discussed. PMID- 1784544 TI - [Effect of ephedrine on gastric emptying in obese patients]. AB - In 8 obese women the effect was assessed of ephedrine (Ephedrinum hydrochloricum, Polfa) on gastric emptying after solid food. The authors found that ephedrine in a dose 50 mg p.o. revealed a significantly inhibiting of the gastric emptying in obese women. PMID- 1784545 TI - 'I don't care' is not an answer. PMID- 1784546 TI - Post-polio dysphagia: alarm or caution? PMID- 1784547 TI - Results of the multicentric Italian experience on the Gamma nail: a report on 648 cases. AB - In a multicentric study, the data of 628 trochanteric fractures, two non-unions, and 18 pathologic or impending fractures treated by Gamma nail in 13 Italian traumatology services were collected and analyzed. In 70% of the patients weight bearing was allowed in the first postoperative week and 78% of the controlled patients returned to their pretrauma walking ability. Complications included intraoperative (1.4%) and postoperative (1.2%) shaft fractures, "cut out" of the lag screw (2.6%), and nail failure (0.5%). There were no cases of infection. An analysis of complications showed that most of them were due to technical mistakes. The safest procedure is 2 mm diaphyseal overreaming, introduction of the nail without hammering, and distal locking; the lag screw should be placed in the lower part of the head of the femur. PMID- 1784548 TI - Arthroscopic treatment of degenerative joint disease of the knee. AB - The role of arthroscopy in the management of degenerative conditions of the knee continues to evolve. This study was undertaken to: (1) assess the efficacy of arthroscopic treatment, (2) identify significant prognostic factors, and (3) further define the indications for treatment. A retrospective review of charts and operative videotapes along with follow-up evaluation was obtained for 43 knees in 40 patients. Average age was 54 years. Average follow up was 24 months; 72.1% of patients had good results at follow up, 16.3% had fair results, and 11.6% were treatment failures. Preoperative clinical status, severity of degenerative changes, and number of pathologic entities encountered at the time of surgery correlated with the results of treatment. We believe that arthroscopic debridement is an effective means of treatment for mild to moderate degenerative joint disease after failure of conservative measures. By using this treatment option, more extensive surgical procedures may be delayed or avoided. PMID- 1784549 TI - Pulmonary dysfunction and sleep disordered breathing as post-polio sequelae: evaluation and management. PMID- 1784550 TI - Neuromuscular function in polio survivors. AB - Although there is no documented, objective evidence that symptomatic post-polio subjects are rapidly losing strength, they have a number of neuromuscular deficits related to a more severe poliomyelitis illness that may explain why they complain of problems with strength, endurance, and local muscle fatigue. Symptomatic post-polio subjects were hospitalized longer during the acute poliomyelitis, recovered more slowly, and had electromyographic evidence of greater loss of anterior horn cells. Additionally, recent assessment demonstrated that they were weaker, had a reduced work capacity, and recovered strength less readily after activity in the quadriceps muscles as compared to asymptomatic subjects. Of great clinical importance, rating of perceived exertion in the muscle during exercise was the same in symptomatic and asymptomatic post-polio and control subjects, indicating that symptomatic subjects have a mechanism to monitor local muscle fatigue that could be used to avoid exhaustion. A study of pacing (interspersing activity with rest breaks) showed that symptomatic subjects had less local muscle fatigue and greater strength recovery when they paced their activity than when they worked at a constant rate to exhaustion. We recommend that post-polio individuals pace their daily activity to avoid excessive fatigue. PMID- 1784551 TI - Electrophysiology and electrodiagnosis of the post-polio motor unit. AB - Post-poliomyelitis syndrome refers to new symptoms that may occur years after recovery from poliomyelitis. The most common of these symptoms are new weakness, fatigue, and pain. This article describes electrodiagnostic studies--conventional electromyography (EMG), single fiber electromyography (SFEMG), and macroelectromyography (macro-EMG)--that have provided information on the post polio motor unit and on the possible etiology of some post-polio syndrome symptoms. Muscular fatigue, and indirectly, general fatigue, may be due to neuromuscular junction transmission defects in some post-polio individuals, as suggested by reduction of the compound motor action potentials on repetitive stimulation, and increased jitter and blocking on SFEMG. Progressive weakness and atrophy in post-polio syndrome is probably due to a distal degeneration of post polio motor units with resultant irreversible muscle fiber denervation. Electrodiagnostic evidence of ongoing denervation includes fibrillation and fasciculation potentials on conventional EMG, increased jitter and blocking on SFEMG, and smaller macro-EMG amplitudes in newly weakened post-polio muscles. However, even though electrodiagnostic studies have provided insight into the possible causes of some post-polio syndrome symptoms, no specific electrodiagnostic test for the syndrome is currently available. PMID- 1784552 TI - A rat model of the post-polio motor unit. AB - We examined the long-term effects of muscle usage on a rat model of the post polio motor unit. Isometric tensions, type I and type II muscle fiber areas, the incidence of collateral sprouting, and motor endplate morphology were examined following 1, 3, 6, and 9 months of partial denervation in rat plantaris muscle. Full morphologic and functional stability of the expanded motor units occurred at 6 months post-partial denervation. Fiber hypertrophy was observed, possibly the result of compensatory work hypertrophy due to muscle overuse. Following 9 months of partial denervation and muscle overuse, the twitch and tetanic tensions and type I and type II muscle fiber areas were significantly reduced as compared to sham controls; angulated myofibers and group atrophy also were seen. The percent collateral sprouting, the number of terminal branches per endplate, and the endplate area were all increased, possibly a compensatory response to a decreased synthesis of neurotrophic factor(s) and/or transmitter-related components. These aging-like changes seem to occur earlier in chronically stressed, overenlarged, and overworked motor units. PMID- 1784553 TI - The RBRVS: steeped in controversy. PMID- 1784554 TI - Evaluation-based protocols: a new approach to rehabilitation. PMID- 1784555 TI - [Changes in the yeast oral flora in patients in orthodontic treatment]. AB - The Authors analyzed the modifications of some components of salivary microflora (S. mutans, Lactobacillus and yeasts) induced by orthodontic treatment. This one is able to modify the oral microflora, increasing cariogenic microorganisms concentrations in plaque and saliva. Our results demonstrated a high caries risk for the subjects of the experimental group; this data suggest the need for a critical evaluation of preventive protocols applied to the orthodontic patients. PMID- 1784556 TI - [Disinfection and sterilization]. PMID- 1784557 TI - [Custom mouthguards: indications and construction]. AB - Dealing with the personal endoral protections today it is possible to choose between different methods, which present various difficulties in application, but result in being more functional and comfortable than semi-individual protections. The cost shouldn't be a determining factor in athletes wanting maximum performances. In addition, in the case of athletes with cranium-mandibular diseases, articular clicks, and other problems, the personal endoral protection, represents not only an efficient method of prevention, but serves as a therapy. PMID- 1784558 TI - [Hygienists in Norway and the world]. PMID- 1784559 TI - [Gloves: some unknowns]. AB - The diffusion of transmissible diseases such as the Acquired Immunodeficiency Syndrome, well known as AIDS, has induced in the population a great sensibility to the problem of disease transmission. Dentists and patients, because of peculiar features of oral environment and dental procedures, are very exposed to these risks. For this reason every technique which reduces the risk of cross infections patient to patient and patient to dentist to patient are absolutely necessary. From this point of view the use of gloves is very important to protect dental operator and patients. The aim of this study is: a) to stress the importance of mechanical barriers, like gloves, in dentistry in order to sensitize dental practitioners to the use of gloves; b) to underline that the quality of dental gloves in Italy is lower than in other countries which have a quality standard. PMID- 1784560 TI - Iodine toxicity in large white turkey breeder hens. AB - Iodine was fed to turkey breeder hens during a 20-wk laying cycle to determine the appropriate dietary level to support reproduction and avoid toxicity. A basal diet that contained by analysis. 7 ppm iodine supported good hatchability of Large White turkey eggs. Supplementing 35 or 350 ppm iodine to the basal diet resulted in toxic effects (P less than or equal to .05) on hatchability. Feeding 350 ppm also depressed (P less than or equal to .05) egg weights, egg production, and eggshell water vapor conductance. Embryonic mortality data indicated that toxic effects of iodine on embryos occur principally during the 1st wk of incubation and immediately prior to and during pipping. It was concluded that iodine toxicity may occur in Large White turkey breeder hens when 350 ppm are fed in the diet. PMID- 1784561 TI - Effect of age of hen, egg weight, and sex on chick performance and lipid retention. AB - Experiments were conducted to determine whether age of hen, weight of the egg, and sex of the chick affected fat retention and growth of the broiler chick. Chicks were fed a corn and soybean meal diet containing 5% supplemental poultry fat. In the first study, eggs from two ages of hens were compared (30 and 52 wk) with six egg weight classes per age. The second experiment consisted of three hen ages (31, 37, and 47 wk) with three egg weight classes per age. The results indicated that as hen age and egg weight increased, BW gain of the chicks increased but feed efficiency and fat retention were not affected. Females had improved fat retention when compared with males. When analyzed within each egg weight class, there was no age effect on fat retention, BW gain, or feed efficiency. PMID- 1784562 TI - Characterization of growth and development of male British United turkeys. AB - Body weight and the size of various organs (tibia, pectoral muscle, leg muscle, liver, spleen, and testes) were monitored in growing male turkeys (British United Turkeys) in an effort to characterize their growth pattern. The results were fitted with either a single- or a double-component Gompertz equation, describing single and diphasic growth patterns, respectively, using an iterative nonlinear estimation algorithm. The diphasic model with an early and a late growth component provided a better description of the body weight function than the single-phase model. The start of sexual maturation, evidenced by testicular development, marked the transition age between the early and the late phases of growth. A single-component Gompertz equation was sufficient to describe growth of various individual organs. Growth of bone and liver appeared to follow the early growth component, whereas the path of muscle development appeared to be closer to the later growth component. The results suggest that the diphasic growth behavior of male turkeys is caused by a differential growth rate of various organs, rather than by a periodicity in the overall growth rate. PMID- 1784563 TI - Interaction of naturally occurring aflatoxins in poultry feed and immunization against fowl cholera. AB - A total of 1,175 poultry feed samples originating from different farms were analyzed for aflatoxin. Poor growth rate and reduced egg production were the main complaints. The rate of contamination with aflatoxin ranged from 10 to 54% of all samples. Of samples examined 30.7% proved positive for aflatoxin with a concentration ranging from 1 to 2,000 ppb. Outbreaks of fowl cholera were diagnosed on two farms where aflatoxin was detected in the rations used. The impact of aflatoxin in the feed on the efficacy of immunization against fowl cholera was monitored by a hemagglutination test and the titers of the involved farms were compared with experimental groups fed on aflatoxin-free rations and vaccinated with the same polyvalent fowl cholera bacterin. The antibody titers of the experimental groups were 4 to 15 times higher than those of the involved farms. PMID- 1784564 TI - Xylose-lysine-tergitol 4: an improved selective agar medium for the isolation of Salmonella. AB - A study was conducted to evaluate a new selective plating medium for isolating Salmonella using pure bacterial cultures, and poultry environmental specimens containing high numbers of competing enteric bacteria. Xylose-lysine-tergitol 4 (XLT4) agar was found to strongly inhibit Proteus, Pseudomonas, Providencia, and many other nonsalmonellae and to provide good differentiation between Salmonella and Citrobacter. The XLT4 medium significantly improved Salmonella isolation from chicken farm environmental drag-swab samples over the other selective plating media evaluated. PMID- 1784565 TI - Effect of fructooligosaccharide on Salmonella colonization of the chicken intestine. AB - The influence of fructooligosaccharide (FOS) on the ability of Salmonella typhimurium to grow and colonize the gut of chickens was investigated. In vitro studies showed that Salmonella did not grow when FOS was the sole carbon source. When FOS was fed to chicks at the .375% level, little influence on Salmonella colonization was observed. At the .75% level, 12% fewer FOS-fed birds were colonized with Salmonella compared with control birds. When chicks given a partially protective competitive exclusion (CE) culture were fed diets supplemented with .75% FOS, only 4 of 21 (19%) chickens challenged with 10(9) Salmonella cells on Day 7 became colonized as compared with 14 of 23 (61%) chickens given CE alone. When chickens were stressed by feed and water deprivation on Day 13 and challenged with 10(9) Salmonella on Day 14, 33 of 36 (92%) chickens fed a control diet were colonized compared with only 9 of 36 (25%) chickens fed a .75% FOS diet. Chickens treated with FOS had a fourfold reduction in the level of Salmonella present in the ceca. Feeding FOS in the diet of chickens may lead to a shift in the intestinal gut microflora, and under some circumstances may result in reduced susceptibility to Salmonella colonization. PMID- 1784566 TI - The effects of stress, Escherichia coli, dietary ethylenediaminetetraacetic acid, and their interaction on tissue trace elements in chicks. AB - The present study determined effects of Escherichia coli infection, crowding stress, and EDTA supplementation on Cu, Fe, and Zn levels in the serum, liver, bursa of Fabricius, and spleen of chickens. Organ weights as a percentage of BW were affected by treatments prior to and after infection. Liver and spleen weights as a percentage of BW increased with infection but bursa weight decreased. One week of stress increased hepatic Cu, but 3 wk of EDTA ingestion increased serum Cu and serum, hepatic, bursal, and splenic Fe. These elemental changes resulting from EDTA may have predisposed the chicks to a higher mortality rate from E. coli compared with controls. Peak mortality occurred 2 days after infection, coincident with an increased serum Cu, decreased serum and bursal Fe and Zn, and increased hepatic and splenic Zn. At 7 days postinfection, recovering chicks experienced decreased hepatic Fe, elevated hepatic Zn, decreased bursal Cu, Fe, and Zn, and increased splenic Cu, Fe, and Zn. The current study demonstrates the interactive effects of EDTA, stress, and E. coli infection on serum and organ trace element concentration. PMID- 1784567 TI - Influence of protein concentration, amino acid supplementation, and daily time to access to high- or low-protein diets on egg weight and components in laying hens. AB - Feeding a 13% CP diet based on corn and soybean meal and supplemented with methionine to laying hens results in reduced egg weight in comparison with hens fed a corn and soybean meal methionine-supplemented diet containing 16% CP. An experiment was conducted to determine whether the egg weight reduction could be eliminated by supplementing the low-protein diet with additional lysine, methionine, and tryptophan or by adding glycine and glutamic acid to increase the amino nitrogen to a level equivalent to 16% CP. The influence of the dietary treatments on the weight of the major egg components was also determined. In a second experiment, the influence of time of day of feeding the 13 or 16% CP diets on egg weight and egg components was determined. Adding additional amino nitrogen in the form of glycine and glutamic acid or increasing the levels of lysine, methionine, or tryptophan individually or in combination failed to prevent the depression in egg weight of hens fed the lower protein diet. Measurement of egg components demonstrated that the reduction in egg weight was primarily associated with a reduction in albumen content of the egg. Feeding a high-protein diet from 1400 to 0800 h and a low-protein diet from 0800 to 1400 h resulted in egg weight equivalent to that from hens continuously fed the high-protein diet. The lower weight of the albumen in eggs from hens fed a 13% CP diet may be due to a lower availability of amino acids for protein synthesis during the 3- to 4-h period when the ovum is in the magnum. PMID- 1784568 TI - Effects of feeding flax and two types of sunflower seeds on fatty acid compositions of yolk lipid classes. AB - Single Comb White Leghorn laying hens were fed diets high in oleic, linolenic, or linoleic acid prepared by incorporation of high oleic acid sunflower seed (HOAS), full-fat flax seed (FLAX), or regular high linoleic acid sunflower seed (HLAS), respectively, to investigate the effects of dietary fats on the fatty acid compositions of major lipid classes of chicken eggs. Egg production, Haugh units, specific gravity, and yolk total lipid content were measured. After 3 wk of feeding, the fatty acid compositions of yolk total lipids, triglycerides, phosphatidylcholine (PC), and phosphatidylethanolamine (PE) were measured by gas chromatography. Dietary treatments had no effect on egg production, Haugh units, specific gravity, or yolk total lipid content. Feeding HOAS increased yolk oleic acid by 17%, and the change was only in triglycerides. The increases of yolk linoleic and arachidonic acids upon HLAS feeding were distributed evenly among triglycerides and PC, with moderate effect in the PE fraction. The enrichment of linolenic acid in eggs from the FLAX regime was mainly in triglycerides. The longer chain n-3 fatty acids, such as eicosapentaenoic, dososapentaenoic, and docosahexaenoic acids, were deposited exclusively in phospholipids, particularly in PE. The contents of the longer chain n-3 fatty acids in PE were three to seven times those in PC, indicating a preferential incorporation of these fatty acids into PE. PMID- 1784569 TI - Posthatching changes in the immunoglobulin A concentration in the jejunum and bile of turkeys. AB - An experiment was conducted to document the age-related changes in IgA concentration in the small intestine of newly hatched turkey poults reared in floor pens and to determine whether infection with stunting syndrome (SS) affects age-related changes. Day-old turkey poults were dose per os with .5 mL of saline carrier (control) or with .5 mL of one of two dilutions (250- or 2.5 x 10(6) fold) of a "crude" SS-causing inoculum. Inoculation with the 250-fold dilution depressed body weight gain (P less than .01) throughout the experiment and impaired feed efficiency (P less than .05) at 5 and 9 days of age as compared with the control group. After 9 days of age, all inoculated poults utilized feed more efficiently than did control poults (P less than .01). Stunting syndrome did not affect IgA concentrations in either bile or jejunum at any specific age. Age related changes in IgA concentrations, however, were observed. Bile IgA decreased from 1 to 9 days of age, and then increased until 29 days of age. The IgA concentration in jejunal tissue increased linearly from 1 to 29 days of age (P less than .01), whether expressed as IgA concentration per gram of wet tissue or as percentage of total protein in jejunum. Age-related changes in IgA concentration in both bile and jejunum suggest that the secretory immune system associated with the digestive mucosa is not fully developed at the time of hatch. PMID- 1784571 TI - Assessment of body composition of poultry by nuclear magnetic resonance imaging and spectroscopy. AB - Nuclear magnetic resonance (NMR) imaging and spectroscopy were used to assess body composition of the chicken and turkey poult. The NMR imaging was performed using a clinical, whole-body imaging system operating at 1.5 tesla (T; 63 MHz). Three-dimensional reconstruction of cross-sectional images made along the transaxial plane was used to estimate mass of the Pectoralis muscle of chickens ranging in weight from 140 to 2,760 g. Results indicate that NMR imaging can be used to determine size of the Pectoralis muscle (R2 = .99) in the bird, thus permitting repetitive measurements during the growth and development of the bird. The NMR spectroscopy was performed using an imaging spectrometer operating at 4.7 T (200 MHz). Integral areas of the water and lipid proton peaks of the spectra were compared with the water and lipid content of the whole body as determined by chemical analysis. Regression analysis of measurements made on turkey poults, ranging in weight from 115 to 630 g (n = 6), resulted in R2 values of .94 for NMR water proton peak area and total body water, .93 for NMR lipid proton peak area and total body lipid, and .96 for NMR water proton peak area and total body protein. From NMR spectroscopy of chickens weighing 528 +/- 18 g (n = 6), the relative area of the lipid peak correlated with whole-body lipid (R2 = .97). Thus, whole-body spectroscopy of smaller birds can be used to measure total body water, protein, and lipid content. PMID- 1784570 TI - Effect of feeding palmitic, oleic, and linoleic acids to Japanese quail hens (Coturnix coturnix japonica). 1. Reproductive performance and tissue fatty acids. AB - A study 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) on reproductive performance, fatty acid composition of egg yolk, plasma, and liver, and total plasma phosphorus of Japanese quail. Each diet was fed to 20 individually caged hens from 5 wk of age. A 24-wk production period started at 8 wk of age. Fertile eggs for incubation were obtained by placing at random a male in the cage with the female for 15 to 20 min twice per week. The males were kept in separate individual cages and fed a turkey grower diet throughout. Feed consumption, egg production, egg output, and the number of chicks per hen were higher (P less than .05) in birds fed Diet PA than in those fed Diet OA or Diet LA. Hatchability was not different (P greater than .05) between Diet PA and Diet OA, but they were higher (P less than .05) than that of Diet LA. Quail weight at hatch from birds fed Diet LA was heavier (P less than .05) than those from Diet OA, but not different (P greater than .05) from those fed Diet PA. Total plasma phosphorus concentration was higher (P less than .05) in birds fed Diet PA than in those fed Diet LA. High levels of oleic and linoleic acids were found in egg yolk, plasma, and liver lipids from birds fed Diet OA and Diet LA, respectively. Feeding Diet PA resulted in elevated levels of palmitoleic acid in all three tissues. The highest overall reproductive performance on Diet PA suggests that palmitic acid has some physiological role in reproduction. The sustained near maximal levels of egg production and fertility achieved in this trial indicate the superiority of the mating procedure, which would also permit testing the response of male and female birds while minimizing injuries incurred by the females. PMID- 1784572 TI - The effects of enzyme supplementation on the nutritive value of rye grain (Secale cereale) for the young broiler chick. AB - Two dose-response experiments utilizing differing enzyme concentrations were carried out to determine the level of a crude enzyme preparation (Trichoderma viride cellulase) required to obtain maximum growth performance in young broiler chicks fed a 60% rye diet. Enzyme concentrations utilized in these studies ranged from .05 to 12.8 g enzyme/kg diet. Enzyme supplementation at the 3.2 g/kg diet level yielded increases in feed consumption and weight gain of 71 and 193%, respectively; and the feed to gain ratio was improved by 43% compared with that for the unsupplemented rye control diet. As no further growth response was obtained by increasing the enzyme concentration, the enzyme level utilized in a subsequent study was 3.2 g/kg diet. A balance study using 2-wk-old broiler chicks was carried out to determine the effect of enzyme supplementation on the bioavailable energy (AMEn) and apparent protein digestibility (APD) of a 60% wheat diet replaced by rye in 10% increments. In the 60% rye diets, the enzyme addition increased the dietary AMEn and APD by 23 and 12%, respectively, compared with the unsupplemented diet. The AMEn and APD of the 60% wheat control diet were increased 9.7 and 4.6%, respectively, by enzyme addition. The data suggest that the AMEn of rye grain is increased by enzyme supplementation; however, alternate methodology will have to be employed to quantitatively determine the extent of these improvements. PMID- 1784573 TI - Effect of overcooked soybean meal on turkey performance. AB - Three turkey growth experiments were conducted to evaluate the effect of overcooked soybean meal (SBM) on BW gain and gain:feed ratio (FE). On two occasions soybean meals were custom prepared by changing the temperature and the retention time (RT) of the desolventizer-toaster unit at a commercial soybean processing plant. Three different meals were produced for each occasion mainly by altering RT from normal to approximately 1.35 and 2.43 times normal operating conditions (designated SBM1 to 3 on the first occasion and SBM4 to 6 on the second occasion). For SBM1 to 6, urease activities were .06, .00, .20, .01 and .00 delta pH, protein solubilities in .1 M borate at 40 C were 44, 45, 16, 44, 32, and 24%, and protein solubilities in .2% KOH were 86, 84, 76, 90, 85, and 85%, respectively. In two sequential long-term experiments, SBM1 to 3 were fed to turkeys from 0 to 8 wk, then a control (normal processing conditions, SBMF), was fed to the all treatment groups from 8 to 12 wk of age. The SBM4 to 6 were fed from 12 to 18 wk of age after rerandomizing treatment allocation of replicate pens. In the first trial, poults fed SBM3 showed significantly reduced BW gain from 3 wk on and a lower FE shown at 9 wk. No difference in BW gain and FE was observed in the trial from 12 to 18 wk. In a 15-day, short-term experiment starting with 3-day-old poults and feeding diets containing SBM2 to 6, BW gain and FE did not differ among treatment groups. It is concluded that SBM did not show a detrimental effect on turkey growth until it was overcooked by 2.4 times the normal conditions. The usual operating conditions in a commercial processing plant are well within the range for producing adequate SBM for poultry feed. PMID- 1784574 TI - Chemical composition of glycosaminoglycan fractions from the comb and wattle of single comb white Leghorn roosters. AB - Glycosaminoglycan (GAG) fractions were isolated from papain digests of comb and wattle tissues of 52-wk-old Single Comb White Leghorn roosters and the chemical composition of each fraction was examined. Total GAG concentrations were greater in the comb than in the wattle tissue with the ratio of hyaluronic acid to sulfated GAG being similar between the two tissues. L-iduronosyl-N acetylgalactosamine-4-sulfate was the predominant disaccharide unit in the sulfated GAG fraction. PMID- 1784575 TI - The effect of dietary iodine on the hatchability of eggs from two commercial strains of turkeys. AB - Supplemental dietary iodine (3.5 mg/kg) was fed to two commercial strains [British United Turkeys (B) and Nicholas (N)] of turkey breeder hens. The basal diet contained .7 mg/kg of iodine. Observations were made on hen body weights, feed consumption, hatchability, egg weights, and egg functional characteristics to test the hypothesis that there are differences between commercial strains of turkey breeder hens in the dietary iodine requirement for reproductive success. Supplemental iodine decreased (P less than or equal to .05) functional egg characteristics of both strains. Egg production and hatchability were influenced by an interaction between strains and dietary iodine (P less than or equal to .05). In Strain B hens, egg production and hatchability declined (P less than or equal to .05) when hens were fed supplemental iodine but in Strain N hens no effects on hatchability were observed and egg production increased (P less than .05) with iodine supplementation. The decline in hatchability of eggs from Strain B hens was due to significant (P less than or equal to .05) increases in embryonic mortality during the 1st wk of incubation and during pipping. The treatments resulting in depressed hatchability caused embryos to rely more (P less than or equal to .05) on glycogenolysis than gluconeogenesis during pipping and hatching. The Strain B embryos utilized gluconeogenesis more during pipping (P less than or equal to .05) than Strain N embryos and embryos from Strain B iodine-fed hens had a lower rate of gluconeogenesis than those from hens not fed iodine. It is concluded that there are differences among strains of turkey breeder hens in their dietary iodine requirement for optimal hatchability. PMID- 1784576 TI - Research note: relationship of comb color to liver appearance and fat content in Single Comb White Leghorn laying hens. AB - A flock of commercial Single Comb White Leghorn laying hens, diagnosed as having fatty Liver Hemorrhagic Syndrome (FLHS), was surveyed to ascertain the relationship between comb color and selected FLHS characteristics. Twenty-eight hens with and without pale combs were selected from 14 cages for paired comparisons. Hens with pale combs had a higher (P less than or equal to .05) liver score and relative liver weight than hens with normal combs. Differences were not detected in BW, comb weight, relative comb weight, liver fat and plasma estrogen concentration. In flocks diagnosed with FLHS, comb appearance is associated with a higher incidence of FLHS. PMID- 1784577 TI - Research note: feed restriction in broiler breeders causes a persistent elevation in corticosterone secretion that is modulated by dietary tryptophan. AB - The corticosterone response of immature broiler breeder males to feed restriction and the administration of increased levels of dietary Trp was investigated. Corticosterone levels were significantly (P less than .01) higher in birds placed on a skip-a-day (SD) feed restriction regimen from 4 to 15 wk of age than in birds fed an ad libitum intake. Elevated levels in SD birds persisted for the duration of the study. Levels were also higher in SD birds on those days on which feed was withheld (FEED-OFF) than on those days on which feed was delivered (FEED ON). The SD males consuming a diet containing 1.5% Trp showed a change in the pattern of hormone secretion as compared with SD control birds (.19% Trp), with corticosterone levels increasing on the FEED-ON days and decreasing on the FEED OFF days. It is concluded that SD feed restriction causes a persistent elevation of plasma corticosterone in broiler breeders. The secretory pattern of corticosterone can be modulated by increasing the Trp content of the diet, possibly as a result of reciprocal interactions between the serotonergic system and the hypothalamic-pituitary-adrenal axis. PMID- 1784578 TI - Research note: sodium and potassium chloride drinking water supplementation effects on acid-base balance and plasma corticosterone in broilers reared in thermoneutral and heat-distressed environments. AB - One experiment utilizing 188 Vantress x Arbor Acres broilers was conducted to evaluate the effects of isomolar KCl (.5%) and NaCl (.39%) drinking water supplementation on venous pH, PO2, PCO2, HCO3-, hematocrit, and plasma corticosterone as well as rectal temperature and water consumption of broilers reared in heat-distressed and thermoneutral environments. Birds were allotted at 5 wk posthatch into either a thermoneutral (TN; 24 C) or cycling temperature (24 to 35 C) environmental chamber. Heat-distressed (HD) controls had elevated (P less than .05) body temperature (42.9 versus 41.7 C) and PO2 (144.5 versus 108.4 mm Hg). Blood pH, PCO2, and HCO3- (P greater than .1) were not affected by high ambient temperature, but hematocrit (31 versus 32%) for HD controls was reduced (P = .07) compared with TN control birds. At 35 C, drinking water NaCl supplementation decreased (P less than .05) venous PCO2 and HCO3-, increased (P less than .05) PO2, and had no effect on venous pH and water consumption relative to HD controls. Potassium chloride lowered (P = .07) venous pH, decreased (P less than .05) HCO3-, and increased water consumption at 35 C, but PO2 and PCO2 were unaffected relative to HD controls. Heat distress increased (P less than .05) plasma corticosterone by 53%. Sodium chloride failed to impact (P greater than .1) plasma corticosterone but KCl reduced (P less than .05) its concentration during heat distress and increased (P less than .05) bird survivability as compared with heat-distressed controls. The data reported herein suggests that KCl and to a lesser extent NaCl reduces HD consequences by a mechanism as yet undefined. PMID- 1784579 TI - Assessment of triethanolamine salicylate release from the dermatological bases and the commercial products. AB - Recently, triethanolamine salicylate (TEAS) is frequently being incorporated in several over-the-counter topical analgesic pharmaceutical products. Since the clinical efficacy of such dosage form depends upon the release of the active ingredient at the site of application, the present study was undertaken to study the in vitro release of the (TEAS) from commonly used ointment bases and two most popular commercial products in the U.S. market. Also, the effects of various penetration enhancers, such as, ethanol, propylene glycol, polyethylene glycol 400, dimethyl-sulfoxide (DMSO), polysorbate-80 and urea were evaluated. In general, the drug release from the experimental formulations was higher than the commercial products studied. The inclusion of the penetration enhancing ingredients increased the drug release from some of the formulations evaluated. The hydrophilic emulsion base with 10% ethanol exhibited the best in vitro drug release. The apparent viscosity profiles of the formulations showed no definite relationship with the amounts of drug release. However, significant differences in the (TEAS) release from the experimental formulations were observed. PMID- 1784580 TI - [The light sensitivity of corticosteroids in crystalline form. Photochemical studies. 59. (1)]. AB - The light sensitivity of corticosteroids in the solid state have been investigated and the photodecomposition rates of the compounds have been estimated by HPLC. After 48 h UV-irradiation desoxycortone acetate, hydrocortisone, hydrocortisone acetate, prednisolone, methylprednisolone, dexamethasone, betamethasone and triamcinolone acetonide decompose between 20 and 50%. Cortisone acetate, prednisone and fluocinolone acetonide show photostability in contrast to requirements of the Pharmacopeia for light protections. PMID- 1784581 TI - Matrix type controlled release systems: I. Effect of percolation on drug dissolution kinetics. AB - Matrix type controlled release tablets were prepared by compression of binary mixtures of a soluble brittle model drug (caffeine) and a plastic matrix substance (ethyl cellulose). The drug content of the tablets was varied from 10% to 100% (weight/weight) and the drug dissolution from one flat side of the tablets was studied. By means of percolation theory the release kinetics could be explained over the whole range of drug loadings. For low drug concentrations up to the lower percolation threshold the release was incomplete because most of the drug was encapsulated by the matrix substance. For drug loadings between the lower and the upper percolation threshold the release was matrix-controlled. For high drug loadings a change to zero order dissolution kinetics was observed. Close to the percolation threshold the diffusion coefficient obeys a scaling law, from which a simple equation to estimate the value of the lower percolation threshold was derived and applied to the measured dissolution data. The critical porosity (lower percolation threshold) was found to be 0.35, corresponding to a drug content of about 28% (weight/weight). PMID- 1784582 TI - Investigations of epidermal growth factor in semisolid formulations. AB - Three simple formulations, with various physicochemical characteristics, were designed as potential pharmaceutical bases for delivery of epidermal growth factor (EGF) to open wounds. The compatibility of EGF with formulation excipients and the release of EGF from each formulation were evaluated in vitro using a release cell apparatus. Samples were analyzed by competitive heterogeneous radioimmunoassay. The apparatus and procedures used in the study were validated to ensure EGF stability during the study, and to verify the absence of excipient interference with analytical procedure. Batches of Pluronic F-127 25% gel formulation and Carbopol gel formulation showed similar average EGF release rates of 17.12 and 16.55 micrograms/cm2/hr, respectively. A vanishing cream formulation similar to the commercial product Silvadene showed much slower release of 0.5 microgram/cm2/hr. PMID- 1784583 TI - Micronization by means of supercritical fluids: possibility of application to pharmaceutical field. AB - The state of the art in drug micronization is briefly reviewed. The Authors propose and discuss the adoption of a new micronization technique based on supercritical fluids properties: high solvent power and selectivity, fast solute precipitation. A supercritical spray apparatus that has been designed to maximize micronization of pharmaceutical interest products is described. A preliminary scanning of supercritical solvents and cosolvents suitable to dissolve poorly soluble products is also proposed. PMID- 1784584 TI - Diazepam-induced feeding in captive gray wolves (Canis lupus). AB - Diazepam doses of 0.2, 0.4, and 0.8 mg/kg induced feeding in sated gray wolves in a dose-dependent manner (p less than 0.001). Neither 0.8 mg/kg of the benzodiazepine antagonist, beta-CCP (p = 0.36), nor 0.8 mg/kg of the benzodiazepine inverse agonist, beta-CCE (p = 0.85), decreased the diazepam induced hyperphagia. Five of 6 naive wolves (p = 0.003) ate dry dog food within 15.4 +/- 1.9 min of being given 0.4 mg/kg diazepam and freely chose dog food after the single diazepam administration. PMID- 1784585 TI - Effects of THA on passive avoidance and spatial performance in quisqualic acid nucleus basalis-lesioned rats. AB - Bilateral quisqualic acid nucleus basalis (NB) lesions impaired passive avoidance (PA) retention. NB lesions did not impair acquisition performance (stable platform location) in the water maze (WM). However, NB-lesioned rats were impaired in learning the new location of the escape platform in WM. Pretraining injections of tacridine (an anticholinesterase, THA) at 3 mg/kg, but not at 1 mg/kg, slightly improved PA retention performance in NB-lesioned rats. THA (1 or 3 mg/kg) did not alleviate NB lesion-induced WM defect. The results further suggest that loss of NB neurons impair PA acquisition and relearning of the new platform location in WM, and that cholinergic neuron loss may be at least partially involved in the NB lesion-induced performance defect. PMID- 1784586 TI - 3,4-Methylenedioxyamphetamine (MDA) self-administration and neurotoxicity. AB - 3,4-Methylendioxyamphetamine (MDA), a drug with both stimulant- and hallucinogen like properties, has been used for both medical and recreational purposes. The present study examined the reinforcing effects of MDA in rats and evaluated the resulting neurotoxicity. Self-administration of various doses (0.10, 0.05 and 0.025 mg/injection) was examined on a Fixed Ratio 1 (FR1) and a Progressive Ratio (PR) schedule. MDA supported self-administration at all doses on the FR1 schedule, but overdoses and deaths occurred at the 0.10 mg/injection dose. The breakpoints established on the PR schedule were relatively low. High performance liquid chromatography analyses of the cortex, hippocampus, striatum and nucleus accumbens subsequent to MDA self-administration revealed significant depletion of 5-HT in the hippocampus. The results suggest that MDA is moderately reinforcing and that self-administration of low doses of MDA over several days is selectively neurotoxic. PMID- 1784587 TI - Effects of cholecystokinin on morphine-elicited hyperactivity in hamsters. AB - The effects of the octapeptide cholecystokinin (CCK) on hamster locomotor activity were investigated in three experiments. In Experiment 1, the effect of CCK (25, 50, 75 micrograms/kg) on morphine (2.5 mg/kg)-elicited hyperactivity was studied. Results indicated that CCK antagonized morphine-elicited hyperactivity and that CCK alone elicited hypoactivity. There were no effects of dose of CCK. In Experiment 2, the effects of intraperitoneal (IP) and subcutaneous (SC) routes of administration of CCK (25 micrograms/kg) on locomotor activity were studied. Compared to saline controls, CCK induced hypoactivity that was of greater magnitude and of longer duration when administered IP than SC. Experiment 3 was designed to replicate the route of administration effect observed in Experiment 2 and to determine whether sensitization to CCK-induced hypoactivity develops over the course of a few injections. Results indicated that CCK-induced hypoactivity was greater after IP than SC administration but that sensitization was not detectable. It is concluded that CCK antagonizes morphine-elicited hyperactivity in the hamster by acting, in part, independently of morphine to produce opposite behavioral effects. PMID- 1784588 TI - The effect of ofloxacin and ciprofloxacin on pentylenetetrazol-induced convulsions in mice. AB - There have been several reports that convulsions, although rare, occur in patients who received fluoroquinolones. In this study, conducted for the evaluation of the convulsant action of fluoroquinolones, the effect of ofloxacin and ciprofloxacin on pentylenetetrazol-induced convulsions were investigated in mice. Mice were pretreated intraperitoneally (IP) with saline, ofloxacin (20 or 80 mg/kg) or ciprofloxacin (20 or 80 mg/kg) 30 minutes before subcutaneous (SC) administration of pentylenetetrazol (40 or 60 mg/kg). In another experiment, diazepam (5 mg/kg) was injected (IP) in mice alone or in combination with ofloxacin (80 mg/kg) 30 minutes before pentylenetetrazol (40 mg/kg) administration (SC). In each experiment mice were observed over the following hour for the incidence and onset of clonic convulsions. Results showed that both doses of ofloxacin increased the incidence of clonic convulsions induced by 40 mg/kg pentylenetetrazol. This effect, however was only significant in the higher dose and inhibited by diazepam. On the other hand, a similar proconvulsant effect by ciprofloxacin could not be demonstrated. PMID- 1784589 TI - DOI-induced inhibition of copulatory behavior in male rats: reversal by 5-HT2 antagonists. AB - Relatively little is known regarding the role of 5-HT2 receptor activity in male rat sexual behavior. Previous work has yielded equivocal results, and both facilitation and inhibition of copulation have been reported to follow administration of selective 5-HT2 antagonists. In the present series of experiments, the ability of a variety of 5-HT2 antagonists to block inhibition induced by the 5-HT2/5-HT1C agonist DOI was examined. Systemic ritanserin, pirenperone and ketanserin all potently blocked DOI-induced (1.0 mg/kg SC) inhibition of mounts, intromissions and ejaculations. None of these drugs influenced the sexual behavior of the male rats when given alone in doses that effectively blocked DOI-induced inhibition. In addition, unlike ritanserin and ketanserin, pirenperone produced a biphasic effect on DOI-induced inhibition, exhibiting a diminished blockade at higher doses. This may be due to activity at receptors other than 5-HT2. Overall, the present data suggest that activity at 5 HT2 receptors mediates an inhibition of male rat sexual behavior. PMID- 1784590 TI - Modulation of the dose-dependent effects of atropine by low-dose pyridostigmine: quantification by spectral analysis of heart rate fluctuations in healthy human beings. AB - The interaction between a low-dose cholinesterase inhibitor, pyridostigmine (PYR), and atropine was investigated by spectral analysis of heart rate fluctuations in eight healthy humans. Each subject was given increasing boluses of IV atropine during treatment with PYR (30 mg.3/day) or placebo. PYR attenuated the bimodal dose-dependent changes in the respiratory peak (which respresents the parasympathetic control) in response to atropine. We suggest that spectral analysis can be used for quantifying the complex dose-dependent cholinergic agonist-antagonist interactions, and may help to disclose an asymptomatic low dose intoxication with acetylcholinesterase inhibitors. PMID- 1784591 TI - Cocaine-induced respiratory depression in urethane-anesthetized rats: a possible mechanism of cocaine-induced death. AB - Urethane-anesthetized rats were used to study the mechanism of cocaine-induced death. Continuous recording of the changes in five physiological parameters, including respiratory rate (RR), electroencephalogram (EEG), blood pressure (BP), electrocardiogram (ECG), and body temperature (BT), were conducted after intraperitoneal (IP) administration of a single dose of cocaine HCl (70 mg/kg). In the control group (normothermic with core body temperature 37.7 +/- 0.1 degree C and spontaneously breathing), the death rate was 88% (15/17), and the average time to respiratory arrest was 12.99 +/- 1.40 min (mean +/- SEM). The first set of experiments investigated the contribution of hypothermia to cocaine-induced death. The hypothermic group (core body temperature 33.9 +/- 0.3 degrees C and spontaneously breathing) had a death rate of 81.5% (22/27), and an average time to respiratory arrest of 16.70 +/- 1.24 min, which was significantly (p les than 0.05) prolonged. A substantial decrease in respiratory rate was seen in normothermic group, while all the other measured parameters remained relatively stable until respiratory arrest. Sequential arterial blood gas data in this group showed a decrease in PaO2 from 116.0 +/- 5.7 mmHg to 57.7 +/- 4.6 mmHg, an increase in PaCO2 from 27.7 +/- 2.2 mmHg to 42.7 +/- 3.0 mmHg, and a decrease in pH from 7.467 +/- 0.039 to 7.357 +/- 0.003. To confirm that respiratory depression was an important mechanism of cocaine-induced death in this model, ten normothermic rats underwent mechanical ventilation, and all survived cocaine exposure. This study points to the important role of respiratory depression as a cause of cocaine-induced death. PMID- 1784592 TI - Salmon calcitonin-induced modulation of free intracellular calcium. AB - Salmon calcitonin (sCT), a hormone shown to modulate calcium in the periphery modulated free, intracellular calcium, ([Ca++]i), in mouse brain synaptosomes as measured by changes in fura-2-mediated fluorescence. A 5-min incubation of synaptosomes with sCT produced an increase in the basal levels of [Ca++]i and an increase in KCl-stimulated levels of [Ca++]i. A 5-min pretreatment of mice with intraventricularly administered sCT antagonized morphine-induced antinociception in the tail-flick test, and facilitated naloxone antagonism of morphine. Conversely, pretreatment of synaptosomes for 1 h with salmon CT produced a decrease in depolarization-stimulated levels of [Ca++]i. The sCT-induced decrease in the stimulated rise in [Ca++]i at 1 h correlated temporally to sCT-induced antinociception in vivo. The effects of sCT in the electrically stimulated guinea pig ileum bioassay appeared to correlate to sCT effects in vivo. The data indicate that calcitonin may function as a neuromodulator via modulation of Ca++ within the central nervous system. PMID- 1784593 TI - Inhibitory effects of Maharishi-4 and Maharishi-5 on microsomal lipid peroxidation. AB - The effects of Maharishi-4 (M-4) and Maharishi-5 (M-5) on microsomal lipid peroxidation were examined in vitro. Rat liver microsomes were incubated with an NADPH-generating system or with sodium ascorbate and an ADP-iron complex to stimulate enzymatic or nonenzymatic lipid peroxidation respectively. Alcoholic or aqueous extracts of M-4 or M-5, when added to these incubation systems, inhibited hepatic microsomal lipid peroxidation in a concentration-dependent manner. The aqueous extract of M-4 was the most effective antiperoxidant in these systems. A 10% (w/v) aqueous extract of M-4 inhibited ascorbate or NADPH-induced lipid peroxidation by approximately 50% when added at volumes of 8 microliters and 3.5 microliters respectively to the incubation mixtures (total incubation volume, 2 ml). These findings suggest that M-4 and M-5, by virtue of their antiperoxidant properties, may be useful in the treatment of free radical-linked drug toxicities and disease states. PMID- 1784594 TI - Flumazenil (Ro15-1788) does not affect ethanol tolerance and dependence. AB - There are conflicting reports concerning whether flumazenil (Ro15-1788) can antagonize the central effects of ethanol and ethanol withdrawal reactions. C57BL/6J mice were treated chronically with an ethanol liquid diet. Control mice were pair fed an isocaloric diet containing no ethanol. These mice were injected with either Ro15-1788 (25 mg/kg) or vehicle immediately before, 14 h or 24 h before ethanol withdrawal. Under these conditions, no attenuation of the severity of handling-induced withdrawal seizures or of withdrawal hypothermia was observed in the ethanol-dependent mice injected with Ro15-1788. Likewise, there was no abolition or attenuation of tolerance to the ataxic effects (sleep time and horizontal dowel tests) and hypothermic effects of ethanol by Ro15-1788 when the mice were tested on day 3 of ethanol withdrawal. It is concluded that Ro15-1788 (25 mg/kg) has no effect on ethanol tolerance and dependence. PMID- 1784595 TI - Are the differential effects of chloral hydrate on hooded rats vs. albino rats due to pigmentation or strain differences? AB - Effects of chloral hydrate anesthesia on EEG power spectra and VEP components were examined as a function of both pigmentation and strain differences in rats. Ten albino Westenberg Long Evans rats (WLE A) were compared to ten pigmented Westenberg Long Evans rats (WLE P), and to ten Wistar albino (Wis A) rats. Albino rats required less chloral hydrate to reach a deep level of anesthesia than pigmented rats. Wistar rats remained anesthetized longer than WLE rats. During deep levels of anesthesia, the lowest EEG frequency band contained more power in Wistar rats than in WLE rats. During moderate levels of anesthesia, frequencies less than 4 Hz lost power while frequencies greater than 13 Hz gained across all rats. Wistar rats had more power in the frequencies less than 8 Hz than did WLE rats; pigmented rats had more power in the frequencies greater than 13 Hz than did albinos. VEP component latencies of pigmented rats were shorter than albinos. Component amplitudes were not significantly different between groups. PMID- 1784596 TI - Wild running and switch-off behavior elicited by electrical stimulation of the inferior colliculus: effect of anticonvulsant drugs. AB - The behavioral and motivational effects of electrical stimulation of the inferior colliculus (IC) were investigated. Electrical stimulations of either the dorsal part or ventral part of the IC both elicited wild running (WR). Nevertheless, the ventral part was found more sensitive than the dorsal part, as lower intensities were needed to elicit WR. Moreover, WR differed depending on the part of the IC stimulated. It stopped as soon as the stimulation was switched off when the ventral IC was stimulated, whereas it further persisted in a poststimulus WR when the dorsal IC was stimulated. This poststimulus WR was abolished by anticonvulsant drugs such as diazepam, phenytoin or sodium valproate. In an operant escape conditioning paradigm (switch-off test), only stimulation of the ventral IC readily sustained switch-off learning. Dorsal IC stimulations did not, possibly because of the poststimulus enduring effects of the stimulation, as evidenced by poststimulus WR. Indeed, the anticonvulsant drugs which abolished this poststimulus WR also permitted switch-off of dorsal IC stimulations. It is concluded that electrical stimulations of the IC (dorsal or ventral) elicit aversive effects and that WR elicited either by ventral or dorsal stimulation may represent the overt expression of these aversive effects. PMID- 1784597 TI - Long-term suppression in mice of the development of complementary memory storage sites: effect of a muscarinic antagonist. AB - Bitemporal injections of puromycin consistently induce amnesia of aversive maze learning in mice when administered within 3 days of training. These bitemporal puromycin injections lose their amnestic effectiveness, if the latency between training and injection is extended beyond 6 days. Consistent with other evidence, we conclude that in our experimental paradigm, complementary memory storage sites normally develop in additional cerebral areas during the 6 days following training. Previous experiments have indicated that the central adrenergic system is critically involved in this process. We now present evidence that the central cholinergic system is also critically involved. This conclusion is based upon our results with the muscarinic receptor antagonists, scopolamine and methyl scopolamine. PMID- 1784598 TI - Apparent enhancement by SCH 23390 of apomorphine-induced locomotor activity in mice. AB - Effects of the dopamine (DA) D1 antagonist SCH 23390 and the DA D2 antagonist (-) sulpiride on apomorphine-induced characteristic changes in spontaneous motor activity were investigated in mice using the system we have devised for automatically analyzing animal behaviors in mice. Apomorphine (3 mg/kg, SC) markedly increased parameters of spontaneous motor activity such as locomotor activity and rearing time. Apomorphine-induced increase in locomotor activity had peaks at 5-20 and 30-50 min after administration, and its trough was closely related to the marked increase in rearing time induced by this agonist. Apomorphine-induced locomotor activity accumulated over a 40-min period from 5 to 45 min after apomorphine injection, during which apomorphine-induced increase in rearing time peaked, was significantly increased by intraperitoneal administration of 0.03 and 0.1 but not 0.01 mg/kg SCH 23390. Apomorphine-induced increase in rearing time was dose-dependently depressed by this antagonist. In contrast, (-)-sulpiride (10-40 mg/kg, IP) decreased apomorphine-induced increases in rearing time and locomotor activity rather than enhancing the latter parameter. These data suggest that the apparent enhancement by SCH 23390 of apomorphine-induced locomotor activity is mediated through DA D1 receptors and does not always correlate with depression of apomorphine-induced rearing behavior in mice. PMID- 1784599 TI - Tolerance to ethanol and cross-tolerance to pentobarbital and barbital in four rat strains. AB - Chronic ethanol treatment by gastric intubation conferred tolerance to ethanol induced motor impairment and hypnosis in four different rat strains: Fischer 344, Long-Evans, Sprague-Dawley, and Wistar. Cross-tolerance to barbital was also observed in all strains after chronic treatment with ethanol. However, chronic ethanol treatment failed to produce cross-tolerance to pentobarbital-induced motor impairment and hypnosis in any of the four strains. The demonstration of cross-tolerance to barbital and the lack of it to pentobarbital after chronic ethanol treatment confirms and extends recent observations on the specificity of the site and/or mechanism of action of sedative-hypnotic drugs that differ in lipid solubility. PMID- 1784600 TI - Possible noradrenergic involvement in training stimulus intensity. AB - Day-old chicks trained on a single trial passive discrimination avoidance task using a concentrated chemical aversant, methyl anthranilate (MeA), have been shown to exhibit three stages of memory processing: short, intermediate and long term. A similar learning task with the aversant diluted to 20% in ethanol leads to short- and intermediate-term memory only, but not to long-term memory. The emergence of long-term memory has been shown to be associated with the production of a nonenergy-dependent phase of the intermediate memory stage. Subcutaneous administration of propranolol proved capable of inhibiting this nonenergy dependent phase of memory under a number of training regimes: strongly reinforced training, and with weakly reinforced training presented twice or coupled with a selected dose of the stress-related hormone ACTH. This study supports the notion that there is a phase of memory that occurs prior to the protein synthesis dependent phase of memory which is susceptible to interference by drugs affecting noradrenergic processes and which may be associated with the intensity of the training stimulus. PMID- 1784601 TI - Cocaine-induced locomotor activity in rats. AB - Rats were injected SC or IP with a dose of cocaine at 20 mg/kg twice daily or saline (2 ml/kg) for 15 consecutive doses. Horizontal (including ambulatory and repetitive activity) and ambulatory locomotor activities were assessed following the first (acute) and the 15th (chronic) injections. Total locomotor activity (area under curve, AUC) following the acute and the chronic administration of cocaine were comparable, regardless of the route of drug administration. However, the temporal patterns of activity were significantly different; the peak of locomotor activity occurred earlier (chronic vs. acute, 20 vs. 40 min after IP; 130 vs. 180 min after SC) following chronic cocaine administration. Furthermore, the peak activity was significantly higher (3-fold after IP and 50% after SC) in chronically than in acutely treated rats, providing evidence for sensitization. In contrast, activity in the late session (240-280 min after SC) was significantly lower following the chronic SC cocaine administration, providing evidence for desensitization. The absolute slope values of the ascending phase and the descending phase were significantly larger following chronic administration of cocaine than that following the acute dosing. The possibility of changes in locomotor activity with alteration of pharmacokinetics on chronic cocaine treatment is discussed. PMID- 1784602 TI - Noradrenergic innervation to the VMN or MPN is not necessary for lordosis. AB - The purpose of the present study was to determine the importance of noradrenergic neurons terminating in the ventromedial nucleus (VMN) and medial preoptic nucleus (MPN) of the hypothalamus for lordosis behavior in ovariectomized, estrogen/progesterone-treated female rats. Seven days following bilateral injections of the noradrenergic neurotoxin 5-amino-2,4-dihydroxy-alpha methylphenylethylamine (5-ADMP) into the ventral noradrenergic bundle (VNAB), norepinephrine (NE) concentrations (ng/mg protein) were reduced to 30-35% of control in the VMN and MPN. 5-ADMP-induced lesions of the VNAB also reduced lordosis quotients in these animals, and this effect was reversed by intracerebral ventricular administration of the alpha 1-adrenergic receptor agonist phenylephrine. These results indicate that neurotoxin-induced disruption of noradrenergic neurons in the VNAB is associated with a deficit in sexual receptivity in female rats. To determine if the reduction in sexual receptivity following 5-ADMP-induced lesions of the VNAB resulted from loss of noradrenergic neuronal projections specifically to the VMN or MPN, lordosis quotients were determined in ovariectomized, estrogen/progesterone-treated rats in which noradrenergic terminals in these hypothalamic nuclei were selectively lesioned. Injection of 5-ADMP directly into either the VMN or MPN reduced NE concentrations to 17% of control in these hypothalamic nuclei, but failed to alter lordosis. Furthermore, injection of phenylephrine into either the VMN or MPN of VNAB lesioned rats failed to reinstate lordosis to the levels comparable to sham lesioned controls. Taken together, these results indicate that noradrenergic neurons terminating in either the VMN or MPN are not essential for gonadal steroid induction of sexual receptivity in ovariectomized female rats. PMID- 1784603 TI - Stability and reproducibility of time structure in spontaneous behavior of male rats. AB - The computer pattern recognition system for the study of spontaneous rat behavior has allowed new analytical techniques which expand the definition of experimentally induced changes in behavior. As with any technique, the stability of the measures must be considered when evaluating overall sensitivity. This study evaluates the stability and reproducibility of three behavioral measures: a measure of the number of initiations of specific behavioral acts, a measure of the total time of each act, and a measure of behavioral time structure. Normal statistical parameters are used to evaluate the significance of changes detected using the first two measures, but the third measure utilizes K-functions, the bootstrap and ad hoc criteria to evaluate significance of observed changes. This study compares the stability of results from these three measures as applied to fourteen different groups of control Sprague-Dawley male rats. All three measures provided stable and reproducible results, but the measure of time structure, the K-function analysis, provided the greatest consistency. Behavior, particularly spontaneous behavior, has traditionally been perceived as being intrinsically variable. However, this study shows that the computer pattern recognition system and its analytical techniques provide stable and reproducible values that vary only a few percent. PMID- 1784604 TI - L-tyrosine fails to potentiate several peripheral actions of the sympathomimetics. AB - We have recently reported the ability of L-tyrosine (L-TYR) to potentiate the anorectic activity of various mixed-acting sympathomimetics including phenylpropanolamine (PPA), l-ephedrine (EPH) and d-amphetamine (AMP). Included in those studies was the attenuation of L-TYR's effect when coadministered with L valine, a large neutral amino acid which competes with L-TYR for uptake into the brain, suggesting a central locus for the action of L-TYR. To determine to what extent L-TYR can potentiate peripheral actions, we investigated the effects of L TYR with either PPA (20 mg/kg), EPH (20 mg/kg) or AMP (1.75 mg/kg) on gastric transit, gastric retention and intrascapular brown adipose tissue thermogenesis. In each of the paradigms studied, PPA, EPH and AMP significantly increased the expected sympathomimetic-mediated response, but no potentiation of L-TYR was observed. These results are consistent with the hypothesis that L-TYR potentiates the anorectic activity of the mixed-acting sympathomimetics largely via an action at a central locus. PMID- 1784605 TI - Is tolerance to intrathecal morphine in intact rats supraspinally mediated? AB - The effect of repeated intrathecal (IT) injections of 5 micrograms of morphine on the tail flick (TF) was determined in rats that were tested either 0.5 h or 5.0 h after administration on each of five successive days. Tolerance developed rapidly in animals tested 5.0 h after each injection. Animals tested 0.5 h after each injection did not become tolerant. Animals that were tested 5.0 h after an intrathecal saline injection on the first four days were also tolerant to a 5 micrograms dose of morphine on the fifth day. These data are discussed in the context of previous conflicting reports concerning tolerance to intrathecal morphine. It is suggested that, under certain conditions, tolerance to intermittent intrathecal morphine administration may be due to a supraspinal opiate action. PMID- 1784606 TI - Nimodipine improves spatial working memory and elevates hippocampal acetylcholine in young rats. AB - The calcium channel blocker nimodipine has been reported to improve cognitive performance in aged and brain-damaged animals. In the present study, the effects of nimodipine and placebo on spatial working memory and hippocampal acetylcholine were studied in young Fischer-344 rats. Nimodipine or placebo was administered via subcutaneously implanted, sustained-release pellets. Each active pellet contained 20 mg of nimodipine and released the drug over approximately 21 days. Two days after the drug or placebo pellets were implanted, training in the 8-arm radial maze started and continued for 12 days. Rats were required to learn a win shift surgery. Nimodipine-treated animals learned the maze more rapidly than a placebo-treated group as indicated by the number of correct choices out of the first eight arms visited (p less than 0.001). Treated rats also made twice as many choices per unit time during the first week of training (p = 0.005). To assess hippocampal acetylcholine release, in vivo microdialysis was performed while animals were awake and unrestrained, 19-21 days after pellet implantation. A probe with a 3 mm semipermeable tip was placed in the hippocampus (CA1 and dentate gyrus), and individual microliters dialysate samples were collected at 2 microliters/min and immediately analyzed by high performance liquid chromatography with electrochemical detection. Significantly higher extracellular ACh levels were found in nimodipine-treated rats (71.4 +/- 3.6 nM; n = 4) compared to controls (52.5 +/- 2.5 nM; n = 5) (p = 0.003) and in another group of rats of the same age that received identical drug treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1784607 TI - Anxiogenic beta-carboline FG 7142 produces activation of noradrenergic neurons in specific brain regions of rats. AB - By measuring the levels of two major metabolites of rat brain noradrenaline (NA), 3-methoxy-4-hydroxyphenylglycol (MHPG) and 3,4-dihydroxyphenylglycol (DHPG), we investigated the effects of anxiogenic beta-carboline FG 7142, an inverse agonist of benzodiazepine (BZD) receptors, on brain noradrenergic activity of rats. Thirty min after treatment with FG 7142 (15 mg/kg IP), levels of both MHPG and DHPG in the hypothalamus, amygdala and thalamus, but not in the hippocampus and cerebral cortex, significantly increased. These increases were significantly antagonized by pretreatment with BZD receptor antagonist Ro 15-1788 (15 mg/kg, IP). Sixty min after treatment with FG 7142 at the same dose, significant increases in both metabolite levels occurred in the hypothalamus, amygdala, thalamus and cerebral cortex, and increases in MHPG levels only were observed in the hippocampus. These increases were significantly blocked by pretreatment with alpha 2-adrenoreceptor agonist clonidine (100 microgram/kg, IP). The present findings suggest that FG 7142 can produce increases in brain noradrenergic activity in specific brain regions by interacting with BZD receptors, and may support the hypothesis that hyperactivity of brain noradrenergic systems may be one neural mechanism in provocation of aversive emotional changes (anxiety, fear or panic). PMID- 1784608 TI - Naloxone-induced hypoalgesia: effects of noradrenergic antagonists and agonist. AB - The present experiments confirmed that rats injected with naloxone and exposed to a heated floor acquired a hypoalgesic response, as indexed by the latencies to lick their paws. The expression of these latencies were unaffected by yohimbine, clonidine, propranolol, or by relatively moderate doses of prazosin, suggesting that the conditioned hypoalgesic response induced by pairings of naloxone and a heated floor is not mediated by the release and turnover of noradrenaline. PMID- 1784609 TI - Impaired escape reaction from noxious and nonnoxious heat in rats treated with the selective noradrenergic neurotoxin DSP-4. AB - The escape reaction, as an indicator of behavioral thermoregulation, was studied in rats pretreated with the selective noradrenergic neurotoxin DSP-4. The animals were kept for 30 min in a heated floor (42, 44, 46, 48 and 50 degrees C) cage containing a wooden platform placed at a height of 12 cm, which enabled the rats to escape from the warm floor. The latency of escape and the time spent on the platform were recorded. The performance of DSP-4-treated rats was significantly inferior to that of the control rats at all tested temperatures. These findings indicate a general function of the central noradrenergic neurons in defense alarm reactions, including a significant role in heat defense behavior. PMID- 1784610 TI - The effects of phenobarbital on responding under delayed-matching-to-sample procedures with differential and nondifferential outcomes. AB - Pigeons were exposed to delayed-matching-to-sample procedures in which food or a flash of the feeder light followed correct responses. When these consequences were correlated with a particular stimulus (e.g., food followed matching responses to red and a flash of the feeder light followed matching responses to green), accuracy was significantly higher (i.e., stimulus control was greater) than when discriminative stimuli and consequences were not correlated. Acute administrations of phenobarbital (10-40 mg/kg) produced similar effects regardless of whether or not differential outcomes were arranged for correct responses to a particular stimulus. At doses of 30 and 40 mg/kg, phenobarbital significantly decreased accuracy under both variations of the delayed-matching-to sample procedure. Given these results, it appears that degree of stimulus control in the absence of drug did not modulate drug effects in the present study. PMID- 1784611 TI - Voluntary wheel running reduced the effects of acute ethanol on activity and avoidance in C57BL/6J mice. AB - C57BL/6J mice were given five weeks of voluntary wheel running and then studied for behavioral impairment after an intoxicating dose of ethanol. Forty-four mice, 22 males and 22 females, were assigned to Wheel (free access to a running wheel in the home cage) or No Wheel conditions. At the end of the training period, animals were removed from the exercise cages and tested for noise avoidance after 2.4 g/kg ethanol (EtOH) or physiological saline (Sal). Mice could avoid 87.5-dB noise by entering and remaining in a randomly designated "safe corner." In unexercised animals, EtOH caused a strong suppression of locomotor activity and avoidance behavior: No Wheel EtOH mice differed significantly from No Wheel Sal mice on both measures. In exercised animals, EtOH failed to cause significant suppression: Wheel EtOH animals did not differ significantly from Wheel Sal animals on either measure. The present results suggest that prior exercise training may be effective in offsetting the effects of acute ethanol intoxication. PMID- 1784612 TI - Gangliosides improve a memory deficit in pentylenetetrazol-kindled rats. AB - Epileptic patients often show impairments in a number of cognitive functions. Kindling is considered to be a useful experimental model for human epilepsy. Recently we have demonstrated a learning impairment in a shuttle box experiment in pentylenetetrazol (PTZ)-kindled rats. This model offers the possibility to investigate the relation between repeated convulsions and their consequences on learning and on the other side to test the effectiveness of substances on both processes. Although systemic application of gangliosides has neither an effect on the development of seizures induced by repeated injections of PTZ, nor on seizures induced by PTZ in kindled animals, the treatment protects against the memory-impairing effect of convulsions. These findings suggest a new useful strategy in the therapy of epileptic patients with the aim of diminishing the psychosocial problems in persons with seizure disorders: a combination of the anticonvulsive basic therapy and gangliosides. PMID- 1784613 TI - [Quantitative determination of crystallin insulin in insulin-zinc suspensions as an in-process control]. AB - A method is described for the quantitative determination of amorphous and crystalline insulin contents in insulin zinc suspensions. The different resolving rates of the modifications in acid dilutions are utilized for the test. Measurements are made by UV spectroscopy. Information is given on the application of this method for the analysis of the course of insulin crystallization and it is compared with the USP XXI method. PMID- 1784614 TI - [Automatic, electronic determination of resting time in small laboratory animals and the effect of psychopharmaceuticals]. AB - The free movements of a small laboratory animal on the bottom of a cage, containing capacitive sensors, are measured as electrical signals which are then amplified, classified in a classification device and counted. With reference to the class of the highest sensitivity and by the choice of appropriate device parameters, signals are only counted during the time in which animal movements are below a level defined as rest. By this, the resting time can be determined which expresses the time in which animals are in the defined rest during the whole test time. The ED50, namely the doses after which the resting time increases by 50% during the first 10 min of the exploration phase of mice has been determined of diazepam, chlordiazepoxide, haloperidol, droperidol, fluphenazine, butaperazine, 7-fluorobutaperazine, and chlorpromazine and it was compared with the ED 50 determined in the contact bottom plates motimeter according to Knoll et al. in mice and in the catalepsy test according to Wirth et al. in rats. respectively. The method of resting time determination has proved as to be striking more sensitive (5- to 10-fold) than the other methods. PMID- 1784615 TI - [Methodologic aspects of determination of ranitidine in plasma with HPLC]. PMID- 1784616 TI - Lithium sulphate Gastrointestinal Diffusion System: how to avoid a lag-time effect? PMID- 1784617 TI - [Determination of the mixing grade of homeopathic triturations]. PMID- 1784618 TI - Evaluation of some Mannich bases of 1-aryl-1-ethanones and related ketones for anticonvulsant activities. PMID- 1784619 TI - [The anticonvulsant action of 5-hydroxy-L-tryptophan in various seizure models in the mouse]. PMID- 1784620 TI - Central action of new derivatives of 2,3,4,5,6,7-hexahydro-1H-1,4,7 benzotriazonin-2,5-dione. PMID- 1784621 TI - [Antibacterial activity of vapors of protoanemonine]. PMID- 1784622 TI - Raparin, a new heparinoid from Rapana venosa (Valenciennes). PMID- 1784623 TI - Critical ketoconazole dosage range for ciclosporin clearance inhibition in the dog. AB - Ciclosporin (CsA) is metabolized exclusively by the hepatic cytochrome P-450 mixed function oxidase system. Ketoconazole (KC) is a potent inhibitor of this enzyme system. CsA was administered alone and in combination with five different doses of KC (1.25, 2.5, 5.0, 10.0, 20.0 mg/kg/day) under steady-state conditions to 7 adult mongrel dogs. KC produced a highly significant (p = 0.0001), dose dependent decrease in CsA total body clearance [Cl(T)]. The critical KC dosage range for this to occur was found to be between 2.5 and 10 mg/kg/day. The reduction of CsA CL(T) was insignificant (p greater than 0.05) at a KC dose of less than 2.5 mg/kg/day, and the 92% reduction observed using 20 mg/kg/day KC was not significantly greater than the 85% reduction occurring after only 10 mg/kg/day KC (p greater than 0.05). The dose of concomitant KC was also highly correlated with a reduction in the whole blood CsA parent/parent + metabolite ratio as determined using high-performance liquid chromatography and polyclonal fluorescent polarization immunoassay for CsA measurement (r = 0.998, p less than 0.0001). The absolute oral bioavailability of CsA as well as the time required to reach its maximum concentration in the blood following oral administration did not change significantly over the course of the study (p greater than 0.05). We conclude from these new observations that the KC-induced decrease in CsA Cl(T) in the dog in vivo is dose-dependent and maximized within the KC dosage range of 2.5 10 mg/kg/day. The effect does not appear to involve a decrease in the rate of CsA oral absorption, and may be compensated for by an appropriate reduction in the concomitantly administered dose of CsA. PMID- 1784624 TI - Influence of the mode of intravenous administration on the penetration of ceftazidime into tissues and pleural exudate of rats. AB - The influence of the mode of intravenous (i.v.) administration (bolus injection or continuous infusion) on the tissue penetration of ceftazidime was studied in the rat. The antibiotic concentration was monitored in serum, pleural exudate, vitreous humor, kidney, liver, lung, testicles and epididymal fat tissue. Administration as a bolus resulted in a significantly higher AUC in pleural exudate and in higher peak levels in serum, liver and lung than continuous infusion, which produced a higher peak concentration in kidney than a bolus. No differences in AUC and peak concentrations between the two methods of administration were observed in the other tissues or fluids. With either method of administration the highest antibiotic accumulation was observed in kidney. PMID- 1784625 TI - Analgesic and thermic responses to intravenously administered morphine in 8- and 24-week-old rats. AB - The analgesic and thermic responses to morphine (5 and 10 mg/kg) injected intravenously to 8- and 24-week-old male Sprague-Dawley rats were determined. Greater analgesic and lower hyperthermic responses to morphine in 24-week-old rats in comparison to 8-week-old rats were observed. The pharmacokinetic parameters of morphine administered intravenously were also determined. Cmax for 5 and 10 mg/kg doses of morphine were smaller in 24-week-old rats in comparison to 8-week-old rats; however, AUC0----infinity was smaller only for 5 mg/kg dose. For 10 mg/kg dose, mean residence time (MRT) and the apparent steady state volume of distribution (Vss) for the older rats were higher than for the younger ones, but for 5 mg/kg dose the values did not differ. The enhanced responses to morphine in older age group of rats for 5 mg/kg dose cannot be explained solely on the basis of pharmacokinetics. However, for 10 mg/kg dose of morphine, the greater responses in 24-week-old rats could probably be related to increases in MRT and Vss. Factors other than serum kinetics, like kinetics of morphine in the brain as well as the brain opiate receptors, may also be involved in the differential effects of morphine in rats of different ages. PMID- 1784626 TI - Pharmacological characterization of the postsynaptic serotonergic receptor in the human uterine artery. AB - Serotonergic receptors are involved in many vascular functions, but only a few studies have been made in human vessels. Thus, this study aimed to characterize these receptors in the human uterine artery without endothelium. The pD2 value of serotonin (5-HT) was 5.96, but the intrinsic activity was 59% of that of noradrenaline. Spiperone and ketanserin shifted the concentration-response curves of 5-HT to the right (pA2 = 8.56 and 9.76; slopes = 0.98 and 0.83, respectively). Propranolol, yohimbine, prazosin and atropine did not significantly shift the concentration-response curves to 5-HT. Phentolamine inhibited the 5-HT response (pA2 = 6.69), and previous treatment of the vascular strips with 6 hydroxydopamine only partially reduced such an effect. The results demonstrate the existence, in the human uterine artery, of 5-HT2 receptors which are blocked by high concentrations of phentolamine. In this tissue, 5-HT does not release noradrenaline from perivascular nerves. PMID- 1784627 TI - Furosemide dynamics: influence of dietary sodium and of saralasin. AB - The influence of dietary sodium and saralasin on the natriuretic and diuretic response to furosemide (5 mg/kg i.v.) was studied in three groups of conscious rabbits maintained for 4 weeks on either a normal sodium diet (NSD), or a low sodium diet (LSD) or a high sodium diet (HSD). Neither the sodium content in the diet nor saralasin affected glomerular filtration rate or renal plasma flow. Compared to the NSD, an LSD did not affect the furosemide-induced increment in urinary excretion of sodium (dUNaV) but increased the increment in urinary excretion (dUV) (p less than 0.05). An HSD reduced the furosemide-induced dUNaV and dUV (p less than 0.05). Plasma renin activity (PRA) increased following furosemide administration in animals on an NSD and an LSD, but not in those on an HSD. Independent of diet, a positive correlation occurred between the increment in PRA and the dUNaV (p less than 0.001). Saralasin increased PRA and decreased baseline urinary excretion of sodium (UNaV). In addition, in rabbits on an LSD, saralasin reduced the furosemide-induced dUNaV and dUV by 34 and 27% (p less than 0.05), respectively. It is concluded that furosemide-induced diuresis is increased in rabbits on an LSD and decreased in rabbits on an HSD. In animals on an LSD, the increase in furosemide response appears to be associated with changes in the activity of the renin-angiotensin system and in rabbits on an HSD, the decrease in furosemide effect is probably the net result of several factors. PMID- 1784628 TI - Inhibition of glycemic and hormonal responses after repetitive sucrose and starch loads by different doses of the alpha-glucosidase inhibitor miglitol (BAY m 1099) in man. AB - In two randomized, placebo-controlled, double-blind studies, the efficacy, duration of action and tolerability of a single morning dose of 25, 50, and 100 mg miglitol (BAY m 1099), an absorbable inhibitor of intestinal alpha glucosidases, were assessed after repetitive sucrose or maize-starch loads (50 g of carbohydrates in 400 ml of water each at 08.00, 12.00, and 17.00 h). With sucrose, miglitol reduced the postprandial rise in blood glucose, serum insulin and serum gastric inhibitory polypeptide concentrations at any dosage. This effect was dose-dependent and confined to the first carbohydrate load in the morning, thus indicating the duration of alpha-glucosidase inhibition of less than 4 h. Sucrose malabsorption, indicated by breath hydrogen responses, occurred dose-dependently with 50 and 100 mg, but not with 25 mg of miglitol. Similarly, symptoms of carbohydrate malabsorption were absent with 25 mg of the inhibitor and mild to moderate after 50 and 100 mg of miglitol. With starch as the substrate, BAY m 1099 led to a significant amelioration of glycemic and hormonal rises after the first meal, but not thereafter. A numerical dose dependency was recognized, but this was not significant at the 5% level. Symptoms of carbohydrate malabsorption were absent with 25 mg and negligible with 50 mg BAY m 1099, but occurred almost regularly with the 100-mg dose. Breath hydrogen concentrations increased gradually with the dose of miglitol administered. A single morning dose of 25-100 mg of miglitol thus may be useful for the control of postprandial hyperglycemia after breakfast. Due to the duration of action of less than 4 h, this substance should be given with the three main meals. PMID- 1784629 TI - Glutathione deficiency produced by inhibition of its synthesis, and its reversal; applications in research and therapy. AB - Glutathione, which is synthesized within cells, is a component of a pathway that uses NADPH to provide cells with their reducing milieu. This is essential for (a) maintenance of the thiols of proteins (and other compounds) and of antioxidants (e.g. ascorbate, alpha-tocopherol), (b) reduction of ribonucleotides to form the deoxyribonucleotide precursors of DNA, and (c) protection against oxidative damage, free radical damage, and other types of toxicity. Glutathione interacts with a wide variety of drugs. Despite its many and varied cellular functions, it is possible to achieve therapeutically useful modulations of glutathione metabolism. This article emphasizes an approach in which the synthesis of glutathione is selectively inhibited in vivo leading to glutathione deficiency. This is achieved through use of transition-state inactivators of gamma glutamylcysteine synthetase, the enzyme that catalyzes the first and rate limiting step of glutathione synthesis. The effects of marked glutathione deficiency, thus produced in the absence of applied stress, include cellular damage associated with severe mitochondrial degeneration in a number of tissues. Such glutathione deficiency is not prevented or reversed by giving glutathione. The cellular utilization of GSH involves its extracellular degradation, uptake of products, and intracellular synthesis of GSH. This is a normal pathway by which cysteine moieties are taken up by cells. Glutathione deficiency induced by inhibition of its synthesis may be prevented or reversed by administration of glutathione esters which, in contrast to glutathione, are readily transported into cells and hydrolyzed to form glutathione intracellularly. Research derived from this model has led to several potentially useful therapeutic approaches, one of which is currently in clinical trial. Thus, certain tumors, including those that exhibit resistance to several drugs and to radiation, are sensitized to these modalities by selective inhibition of glutathione synthesis. An alternative interpretation is suggested which is based on the concept that some resistant tumors have high capacity for glutathione synthesis and that such increased capacity may be as significant or more significant in promoting the resistance of some tumors than the cellular levels of glutathione. Therapeutic approaches are proposed in which normal cells may be selectively protected against toxic antitumor agents and radiation by cysteine- and glutathione-delivery compounds. Current studies suggest that research on other modulations of glutathione metabolism and transport would be of interest. PMID- 1784630 TI - Macrophage-derived angiogenesis factors. AB - A majority of angiogenic factors has been shown to be produced by macrophages. This review will give a concise description of their biochemical nature, their isolation from macrophages and their angiogenic activity. Among the factors with mitogenic effects on endothelial cells are basic fibroblast growth factor (bFGF), transforming growth factor-alpha (TGF-alpha) and very probably insulin-like growth factor-1 (IGF-1). Other secretory products such as angiotropin and human angiogenic factor (HAF) are nonmitogenic but promote angiogenesis by inducing migration of endothelial cells. Prostaglandins, platelet-derived growth factor (PDGF), granulocyte-macrophage- and granulocyte-colony stimulating factor (GM CSF, G-CSF), interleukin 6 (IL-6) and angiotensin converting enzyme (ACE) have also been shown to be angiogenic, but their mode of action is still to be clearly defined. As the extracellular matrix appears to be involved in the control of angiogenesis, macrophage-derived factors that can alter this structure via degradation or via the clotting system will also be discussed. Tumor necrosis factor alpha (TNF-alpha), interleukin 1 (IL-1) and transforming growth factor beta (TGF-beta) have complex actions on endothelial cells, and can partially inhibit angiogenesis. Among the factors which solely inhibit neovascularization are the interferons. As it is not known whether all of these factors play a role in angiogenesis in vivo attempts to detect them in situ during the course of neovascularization will be described. Finally macrophages will be discussed as cells that may not be mandatory for each phase of the angiogenic process but whose angiogenic capabilities are comprehensive and unsurpassed by any other cell. PMID- 1784631 TI - Interactions of the catharanthus (Vinca) alkaloids with tubulin and microtubules. AB - The dimeric Vinca alkaloids represent a group of important anti-tumor compounds whose intracellular target is tubulin, the protein monomer of microtubules. In this review data on the binding of these drugs to tubulin and microtubules in vitro are examined. The binding to tubulin is linked to a protein self association reaction described by Na and Timasheff (1986a) as a ligand-induced plus ligand-mediated isodesmic self-association reaction. The simplest model which fits the binding data is one in which there is one intrinsic site which is linked to the self-association process. Effects of solution variables on the binding and self-association explain the wide variation of reported apparent binding constants for Vinca alkaloids to tubulin. The Vinca drugs also bind to microtubules via a low number of sites at the ends of microtubules with apparent high affinity and which are involved in the inhibition of tubulin dimer addition to the microtubule ends, and to sites along the microtubule wall with apparent low affinity which are involved in the disruption of the microtubules into spiraled protofilaments. This review also compares available binding data for different natural and semi-synthetic Vinca alkaloids. PMID- 1784632 TI - Drug metabolism in carcinogenesis and cancer chemotherapy. AB - Cytotoxic drugs have become invaluable for the clinical oncologist in the treatment of neoplastic disease. Frequently, these therapeutic agents are used in combination in order to combat the heterogeneity imposed by the variable tumor cell biochemistry of the neoplastic cell population. Hence, one could argue polypharmacy has become the rule rather than the exception in cancer chemotherapy. The use of such regimens obviously increases the potential for drug drug interactions and also may potentiate the effects of interindividual variation in drug metabolism. Altered expression of drug metabolizing enzymes may also predispose certain individuals to cancer through enhanced metabolic activation and decreased detoxication of environmental, dietary and possibly endogenous procarcinogens. Many anticancer drugs can be considered as prodrugs which require metabolic activation to exert their selective cytotoxic effects. Recent molecular and biochemical advances have increased our understanding of the factors which govern the regulation of drug metabolizing enzymes and have improved our knowledge of the metabolism and action of anticancer agents. The aim of this review is not to exhaustively document all the work in the area of drug metabolism in relation to cancer, but to provide a comprehensive update of some of the recent advances in drug metabolism which have helped to rationalize the mechanism of action of some anticancer drugs and which may help to optimize future patient selection for certain novel chemotherapeutic regimens. This review also discusses some of the more recent breakthroughs in the area of carcinogenesis and highlights directions for future studies. PMID- 1784633 TI - The photochemistry of iodo, methyl and thiomethyl substituted aryl azides in toluene solution and frozen polycrystals. AB - The photolysis of para-methyl and para-thiomethylphenylazide at 77 K produces the corresponding triplet nitrenes which can be detected by electron paramagnetic resonance (EPR) spectroscopy. Photolysis of these azides in frozen toluene at 77 K leads to insertion of the nitrene into a benzylic C-H bond of the matrix in modest yields. Photolysis of iodinated aryl azides under these conditions does not produce triplet nitrenes that can be detected by EPR spectroscopy. In contrast to the para-methyl and para-thiomethyl substituted phenyl nitrenes, photo-induced coupling of iodo-substituted phenyl nitrenes to toluene proceeds in very poor yield. PMID- 1784634 TI - Regioselective photoreduction of zinc(II) porphyrins to give chlorins. AB - The ascorbic acid/organic base photoreduction of zinc(II) porphyrins was investigated. It was established that certain substituents can direct the photoreduction to the site of the macrocycle to which they are attached. For example, zinc(II) vinylporphyrins (8, 12, 16, 20) are photoreduced with cis stereochemistry on the ring bearing the vinyl group to give the corresponding chlorins. Zinc(II) acetylporphyrins (22, 24) were likewise reduced to chlorins such that cis-hydrogenation took place on the ring bearing the acetyl group. Zinc(II) formylporphyrins 33 also appear to reduce at the ring bearing the formyl group. When the zinc(II) acrylic porphyrin 28 was photoreduced, reduction did take place at the ring bearing the acrylic side chain, but migration of the acrylate double bond was very rapid, and the product isolated was the corresponding porphyrin propionate 30. Reduction of a zinc(II) porphyrin 35 bearing both a vinyl group and a nuclear carboxylic ester took place at the ring bearing the carboxylic ester. The reaction provides a general method for regioselective synthesis of chlorins from zinc(II) porphyrins without any evidence of formation of over-reduction products characteristic of many other procedures for formation of chlorins from porphyrin precursors. PMID- 1784635 TI - Time-resolved fluorescence of nitrobenzoxadiazole-aminohexanoic acid: effect of intermolecular hydrogen-bonding on non-radiative decay. AB - The fluorescence kinetics of the nitrobenzoxadiazole (NBD) chromophore were studied at low concentrations in solvents with varying polarity and hydrogen bonding donor strength. The emission decay was essentially single exponential in all solvents studied. While the absorption and fluorescence solvatochromism is determined largely by the solvent polarity, the S1 state decay kinetics are strongly modulated by the solvent H-bonding capacity. The NBD emission lifetime, generally approximately 7-10 ns in the aprotic solvents, is reduced to 0.933 ns in water. The solvent deuterium isotope effect on the fluorescence decay is substantial in D2O and in methanol-d4, but is insignificant in DMSO-d6. These results are consistent with acceleration of S1----S0 internal conversion through an accepting vibrational mode created by intermolecular hydrogen-bonding of the NBD chromophore to an H atom-donating solvent. This work bears on the practically of using NBD as a fluorophore in assays for estrogen and progesterone receptors. PMID- 1784637 TI - Photohemolysis sensitized by psoralen: reciprocity law is not fulfilled. AB - The effect of the intensity of ultraviolet-A (UV-A) radiation (366 nm) on delayed photohemolysis sensitized by psoralen (PUV-A hemolysis) was studied. It was shown that PUV-A hemolysis induced by UV-A radiation at low fluence rate (20 W m-2) develops according to the well-known colloid-osmotic mechanism: there was no threshold dose of PUV-A treatment. After irradiation all the cells were hemolysed. The rate of PUV-A hemolysis was proportional to the square of the fluence. Hemolysis was delayed in the presence of sucrose. When the fluence rate of UV-A radiation was increased to 150 W m-2, the character of PUV-A hemolysis changed drastically. A threshold fluence appeared, below which PUV-A hemolysis was not induced. At fluences slightly exceeding the threshold, only part of the cells in the suspension were lysed. The dependence of the portion of hemolysing cells on fluence was S-shaped. Increasing the fluence resulted in complete (100%) hemolysis. The rate of complete hemolysis decreased at higher fluences, but was many-fold higher than the rate of low-intensity PUV-A hemolysis at equal fluences. The main features of high intensity PUV-A hemolysis (dependences on fluence and temperature, effect of sucrose) were the same for the hemolysis induced by the addition of previously photooxidized psoralen. We suggest that high intensity PUV-A hemolysis is induced with participation of photooxidized psoralen as an intermediate. PMID- 1784636 TI - Carboxylated zinc-phthalocyanines--II. Dimerization and singlet molecular oxygen sensitization in hexadecyltrimethylammonium bromide micelles. AB - The dimerization of the diamide of zinc-tetracarboxyphthalocyanine was studied spectroscopically in hexadecyltrimethylammonium bromide (CTAB) micelles at surfactant concentrations from 0.026 to 0.1 M and dye concentrations between 0.1 and 10 microM. The apparent dimerization constant in CTAB 0.1 M is 8.6 x 10(5) M 1, while the intramicellar dimerization constant is 1.8 x 10(3). The dimer absorption spectrum was also obtained. Singlet molecular oxygen sensitization was studied by steady state photolysis using 1,3-diphenylisobenzofurane as scavenger in 0.1 M CTAB. The usual sensitization mechanism is extended to include dimer reactions. Singlet molecular oxygen sensitization yields for monomer and dimer in the micelles are 0.7 and 0.1, respectively. With the reported values it is possible to calculate the average yield of singlet molecular oxygen production at any surfactant and dye concentrations. PMID- 1784638 TI - Modification of membrane composition, eicosanoid metabolism, and immunoresponsiveness by dietary omega-3 and omega-6 fatty acid sources, modulators of ultraviolet-carcinogenesis. AB - Dietary sources of lipids containing predominantly n-3 or n-6 fatty acids (FA) have been examined for effect upon several potential pathophysiologic parameters. Epidermal, plasma, and red blood cell (RBC) membrane FA composition exhibited marked differences between animals fed the respective dietary lipid sources. Reduced levels of 18:1, 20:3 and 20:4 occurred in the n-3 FA fed animals which exhibited significantly higher levels of 20:5 and 22:6. Approximately equal levels of 18:2 were present in animals fed either diet. Despite marked differences in RBC membrane FA composition, only marginal effect upon osmotic fragility occurred. Lower levels of 20:3 and 20:4 found in n-3 fed animals could result from a deficit of elongase and/or delta 5-desaturase activity. Whether lower 20:4 levels in n-3 fed animals could rate-limit eicosanoid metabolism is unknown, but epidermal capacity to metabolise arachidonic acid in these animals was found to be closely related to n-6 FA intake. Animals fed n-3 FA exhibited markedly lower levels of plasma PGE2, even when the diet was supplemented with n 6 FA. In addition, UV-radiated animals receiving the n-3 FA source demonstrated a reduced (approximately 30%) response to inflammatory stimulus and a greater (4.5 fold) delayed hypersensitivity (DH) to dinitrochlorobenzene than animals fed the n-6 FA source. These data demonstrate that dietary lipid strongly influences tissue FA composition, eicosanoid metabolism, and, in the case of DH, at least one type of T-cell mediated immune response in UV-irradiated animals. PMID- 1784639 TI - Non-dimer DNA damage in Chinese hamster V-79 cells exposed to ultraviolet-B light. AB - To understand and characterize non-dimer DNA damage and cytotoxicity induced by ultraviolet-B light (UV-B, 290-320 nm), an alkaline elution technique for analysis of DNA damage was used on Chinese hamster V-79 cells. Ultraviolet-B exposure produced a dose-dependent induction of DNA single strand breaks and DNA protein crosslinks; however, there was an absence of DNA-DNA interstrand crosslinks. Neither of these types of DNA damage were repaired within a a 24 h incubation of the cells following a single UV-B exposure; rather the damage increased. Using a colony forming assay, we found that UV-B exposure resulted in an increase of cytotoxicity in a dose-dependent fashion. In addition, UV-B exposure inhibited DNA and RNA synthesis. The role of non-dimer DNA damage in the cytotoxicity induced by UV-B is discussed. PMID- 1784640 TI - Cyclobutane dimers and (6-4) photoproducts in human cells are mended with the same patch sizes. AB - The size of excision repair patches corresponding to excision of (6-4) pyrimidine pyrimidone photoproducts and (5-5, 6-6) cyclobutane dimers have been independently determined by using bromodeoxyuridine substitution and density increases in isopycnic gradients of small DNA fragments. The two classes of photoproducts were distinguished by using (a) a xeroderma pigmentosum (XP) revertant cell line that excises (6-4) photoproducts normally, but does not excise cyclobutane dimers from bulk DNA or from an actively transcribed sequence; (b) an XP cell line containing the denV gene of bacteriophage T4, which repairs only cyclobutane dimers by a unique glycosylase mechanism, and (c) normal cells analyzed during time intervals in which cyclobutane dimer repair is the main repair process in action. The patch sizes for the two lesions were similar under all conditions and were estimated to be approximately 30-40 bases. These values are slightly large than corresponding estimates for Escherichia coli and Saccharomyces cerevisiae but close to estimates from in vitro experiments with human cell extracts. The size of 30 bases may consequently be very close to the actual distance between cleavage sites made on either side of a photoproduct during repair. PMID- 1784641 TI - Wavelength dependent formation of thymine dimers and (6-4) photoproducts in DNA by monochromatic ultraviolet light ranging from 150 to 365 nm. AB - We investigated the wavelength dependence of cyclobutane thymine dimer and (6 4)photoproduct induction by monochromatic UV in the region extending from 150 to 365 nm, using an enzyme-linked immunosorbent assay with two monoclonal antibodies. Calf thymus DNA solution was irradiated with 254-365 nm monochromatic UV from a spectrograph, or with 220-300 nm monochromatic UV from synchrotron radiation. Thymine dimers and (6-4)photoproducts were fluence-dependently induced by every UV below 220 nm extending to 150 nm under dry condition. We detected the efficient formation of both types of damage in the shorter UV region, as well as at 260 nm, which had been believed to be the most efficient wavelength for the formation of UV lesions. The action spectra for the induction of thymine dimers and (6-4)photoproducts were similar from 180 to 300 nm, whereas the action spectrum values for thymine dimer induction were about 9- and 1.4-fold or more higher than the values for (6-4)photoproduct induction below 160 nm and above 313 nm, respectively. PMID- 1784642 TI - Effect of protonation on the isomerization properties of n-butylamine Schiff base of isomeric retinal as revealed by direct HPLC analyses: selection of isomerization pathways by retinal proteins. AB - Alumina adsorption chromatography and ion-pair reversed-phase chromatography were developed to analyze the isomers of unprotonated and protonated n-butylamine Schiff base of retinal (RSB and PRSB), respectively. Photoisomerization starting from the all-trans, 11-cis and 13-cis isomers was traced for RSB in n-hexane, acetonitrile, methanol and 1-butanol, and for PRSB in methanol, acetonitrile and 1-butanol. The quantum yields of photoisomerization for the all-trans, 9-cis, 11 cis and 13-cis isomers were determined for RSB and PRSB in the above solvents except 1-butanol. On the other hand, photoisomerization of isomeric retinal bound (through Schiff base linkage) to bovine serum albumin (RBSA) in aqueous solution (pH 3, 7 and 12) as well as thermal isomerization of RSB (in n-hexane), PRSB (in methanol) and RBSA (in aqueous solution, pH 7) were traced starting from the all trans, 11-cis, and 13-cis isomers. Protonation of RSB drastically changes the pathway of photoisomerization and increases the quantum yields of isomeric RSB. The solvent polarity increases the quantum yields of RSB differently depending on the configuration. Protonation enhances thermal isomerization also. The results of the above model systems are compared with those of retinal proteins to rationalize their selection of the particular isomerization pathways. PMID- 1784643 TI - A new reducing agent of flavins and its application to the assay of bacterial luciferase. AB - Copper(I) plus ethylenediaminetetraacetic acid, Cu(I)-EDTA, reduces flavins. Using Cu(I)-EDTA reduction of riboflavin 5'-phosphate, a new assay method for bacterial luciferase is established. In previous assay methods, flavin and aldehyde substrates for luciferase have been routinely added to luciferase at different times; the new assay permits aldehyde and Cu(I)-reduced flavin to be injected simultaneously into air-saturated buffer containing luciferase. In the new assay method using Cu(I), bovine serum albumin is not required, the initial emission intensity is more than twice and the overall yield is about twice of that in the so-called standard assay for luciferase. PMID- 1784644 TI - Room-temperature fluorescence properties of the polynucleotide polydA.polydT. AB - The room-temperature fluorescence spectrum of the non-alternating polynucleotide polydA.polydT is found to have its maximum at about 325 nm and, when exciting in the spectral region where both adenine (A) and thymine (T) absorb, to coincide with that obtained for excitation at 293 nm where thymine is selectively excited. The fluorescence anisotropy is found to be equal to 0.18 and independent of the excitation and emission wavelengths. These observations are consistent with: (i) emission stemming from T; and (ii) transfer of electronic energy from A to T being not efficient. These inferences are also supported by the observed dependence of the fluorescence quantum yield on the excitation wavelength. PMID- 1784645 TI - Artifacts in fluorescence emission spectroscopy related to Wood's anomaly. AB - Fluorescence emission spectra of porphyrins acquired with a monochromator using a 1500 line/mm holographic grating were affected by polarization-induced effects (Wood's anomaly) which affected the transmission of different wavelengths of light. This effect resulted in a blue-shift in the emission optimum, and distortions in the fluorescence spectrum at longer wavelengths. These anomalies could be eliminated by insertion of polarizers, orientation = 0 degrees, in emission and excitation paths. A monochromator with a 1200 line/mm holographic grating was essentially free from these distortions. PMID- 1784646 TI - The savant syndrome and extrasensory perception. AB - D.A. Treffert, following B. Rimland, cited examples which he states show ESP to be occurring in certain autistic savant children. The evidence is questioned on the ground that it is hearsay, uncorroborated by independent scrutiny. PMID- 1784647 TI - Effects of various music conditions on multiple dimensions of behavior of emotionally disturbed adolescents. AB - The effects of music on the behaviors of 5 to 8 emotionally disturbed adolescents were investigated. Six behavioral categories of aggressive motor, aggressive verbal, disruptive motor, disruptive verbal, nondisruptive/off task, and on task, were monitored in class daily for 40 min. for 12 wk. to assess whether three conditions of "sedative," "stimulating," and "no music" influenced the frequency of these behaviors. Analysis indicated no significant differences in frequencies of any of the six behavior categories among music conditions. PMID- 1784648 TI - Correlations among WISC-R IQs and several measures of receptive and expressive language for children referred for Special Education. AB - For 42 children from rural north central Kansas school districts (27 boys, 15 girls) who were referred for Special Education testing, the WISC-R IQs (Full Scale, Verbal, and Performance), the means on the Expressive One Word Picture Vocabulary Test, the Peabody Picture Vocabulary Test--Revised, and the Test of Language Development were recorded from the children's files. No sex differences on any variable were noted; all variables correlated (Pearson) significantly but varied in magnitude. This group of tests, being intercorrelated, can be used to collect information on children's academic, speech, and language abilities. Valid judgments can be made regarding children's academic abilities for school when multiple tests are administered by professional staff. PMID- 1784649 TI - Work experiences of minority managers and professionals: individual and organizational costs of perceived bias. AB - The present study examined the relations of the way minority managers and professionals described their treatment within their organizations, and their organizations' acceptance and openness to minorities within measures of satisfaction, commitment, skill utilization, and integration. Data were collected from 81 minority managers and professionals in early career stages using questionnaires completed anonymously. Minority managers experiencing more positive treatment in their organization, and employed in organizations more accepting of minorities, were more satisfied, committed, and integrated. PMID- 1784650 TI - False heart-rate feedback, social anxiety and self-attribution of embarrassment. AB - 120 subjects high or low on social anxiety were asked to speak in front of a camera. While watching a replay of their performance, false heart-rate feedback was presented. Highly anxious subjects (n = 36) reported significantly more embarrassment than subjects who scored low in anxiety. Further, subjects reported being embarrassed according to the direction of false heart-rate information. Results offer support for the self-attribution theory of emotions. PMID- 1784651 TI - Personality, stress, and motivational factors in drinking as determinants of risk for cancer and coronary heart disease. AB - Alcohol consumption is a well-known risk factor for cancer, coronary heart disease (CHD), and various other diseases. It is here suggested that motivational factors may be important in mediating any effects of drinking on health. In particular, the hypothesis was tested that drinking to drown one's sorrows (S type) was much more a risk factor than pleasure drinking (P-type). A total of 1,706 men were tested and followed for 13 years, when death and cause of death were established. The hypothesis was supported for all levels of drinking. In addition, subjects were divided into those 900 who were under stress at the beginning of the study and those 806 who were not. Stress and drinking combined in a complex fashion to form a risk factor for disease, and motivation combined with both in the predicted direction. PMID- 1784652 TI - Interpersonal relations and helping norms among university students of Japan, Taiwan, and Korea. AB - This study investigated the effects of interpersonal relations on some aspects of moral judgment among 68 Japanese, 70 Chinese, and 92 Korean university students. The subjects were asked to judge agents' acts in stories about varied helping situations which formed a factorial design: familiarity and kinship between subjects and the agent, those between the agent and the victim, and actions. Analysis showed that the two relationships between the agent and the victim significantly affected judgments in three cultures. The magnitudes of the effects of kinship between agent and victim varied across the cultures. PMID- 1784653 TI - The Tridimensional Personality Questionnaire: U.S. normative data. AB - The Tridimensional Personality Questionnaire is a self-report personality inventory measuring three major personality dimensions: Novelty Seeking, Harm Avoidance, and Reward Dependence. Normative data, based on a U.S. national probability sample of 1,019 adults, are presented and the psychometric properties of the questionnaire are discussed. PMID- 1784654 TI - Correlation between psychic and somatic symptoms and vision in aged patients before and after a cataract operation. AB - The connection between psychic and somatic symptoms with vision was investigated by studying 100 cataract operation patients, aged 71 to 76 years, 25 of them being men and 75 women. The investigations were conducted one day before the operation and three months afterwards. The cataract operation restored sufficient acuity of vision for reading (minimum E-test value 0.40) to 79% of the old people. Psychic symptoms were tested with the Brief Psychiatric Rating Scale, Mini-Mult MMPI, and direct questions. Somatic symptoms were studied through questionnaires. Psychic symptoms showed a statistically significant correlation with vision before the cataract operation but not afterwards. Psychic symptoms increased with deterioration of the acuity of vision and diminished when the acuity of vision improved. Somatic symptoms did not show similar association with vision but the symptoms were significantly alleviated after the cataract operation. Restoration of vision through the cataract operation normalized the old people's psychic condition and reduced their somatic symptoms to correspond with their prior chronic diseases. PMID- 1784655 TI - Perceptions of leadership traits: comparison of adolescent and adult school leaders. AB - This study compares the responses of 58 adolescent and 58 adult school leaders on the Leadership Traits Inventory. Adolescent leaders rank integrity, good listening, and knowledge or skills highest and rank compassion, consistency, and flexibility lowest. Adult leaders, in comparison, rank sense of purpose, integrity, and knowledge or skills highest and rank flexibility, compassion, and creativity lowest. Rank-order differences between the groups are significant. Adolescent leaders rank good listening and creativity significantly higher than adult leaders. Adults rank sense of purpose, consistency, and flexibility significantly higher than adolescents. Moreover, adolescent school leaders tended to be girls. The results are viewed in terms of leadership qualities, gender, and the developmental differences between adolescents and adults. PMID- 1784656 TI - Another quasi-experimental study of understanding/appreciation of editorial satire. AB - College students completed a 17-item scale measuring the "propensity to argue controversial topics" and 7 other nominal-scale independent variables. They then read three editorial satires and checked which of five statements was the intended thesis of each satire's author. They also rated each satire on interestingness and funniness. Analysis indicated dependence between understanding of satire and sex and regular readership of "The Far Side." PMID- 1784657 TI - Microsocionomics versus macrosocionomics as a model for examining suicide. AB - The role of social variables in suicide is examined from a microsocionomic and a macrosocionomic perspective. As an example, the influence of divorce on suicide is explored and hypothesized to differ for the individual and for the society as a whole. PMID- 1784658 TI - Item difficulty and discrimination as a function of stem completeness. AB - The effects on item difficulty and discrimination of stem completeness (complete stem or incomplete stem) for multiple-choice items were studied experimentally. Subjects (166 junior education students) were classified into three achievement groups (low, medium, high) and one of two forms of a multiple-choice test was randomly assigned to each subject. A two-way factorial design (completeness x achievement) was used as the experimental model. Analysis indicated that stem completeness had no effect on either item discrimination or difficulty and there was no interaction effect with achievement. It was concluded that multiple-choice items may be very robust in measuring knowledge in a subject area irrespective of variations in stem construction. PMID- 1784659 TI - Self-defeating personality and perceptions of family environment. AB - People scoring higher on a scale of self-defeating personality perceived their family environments as lacking cohesiveness. Men also perceived their family environments as discouraging open expression of feelings, being unconcerned about school and work achievement, and providing no ethical or religious values. Results were seen as lending validity to clinical theories of masochism which relate lack of family support and lack of reinforcement for assertive, efficacious behavior to the development of self-defeating behavior patterns. PMID- 1784660 TI - Psychology of computer use: XXV. Locus of control, information-system dialogues, and end-users' satisfaction. AB - This study examined the correlation of locus of control and end-users' satisfaction for three computer dialogue treatments--question/answer, menu, and command language. In the present study, 390 subjects were classified as internally or externally oriented according to an abbreviated form of Rotter's I E Scale. Subjects then utilized an information system possessing one of three randomly selected dialogues to solve a problem in selecting employees. Their over all satisfaction with the system was measured. Analysis of variance did not support the hypothesis that locus of control is associated with users' satisfaction. PMID- 1784661 TI - Black and white women's attitudes toward interracial marriage. AB - 50 white women and 50 black women, US citizens between the ages 18 and 23 years, were asked to rate their attitudes about interracial marriage on a 10-point response scale. The white women were somewhat more favorable, if not significantly so, than the black women about men and women of their race marrying persons of another race. However, scorers at the extremes of the scale were significantly different. The white women tended to cluster at the scale extreme favoring interracial marriage, whereas the black women tended to cluster at the other unfavorable extreme. Implications and research needs are discussed. PMID- 1784662 TI - Changes in learning style preference during a three-year longitudinal study. AB - Kolb's (1985) Learning Style Inventory and theories of learning preferences have stimulated much research and theory construction. A number of researchers have argued that, as students move through their college careers, their learning styles are likely to change significantly. This paper reports on the completion of a three-year study to assess the actual extent of change that occurred in a sample of college students. Our results offer mixed support for the proposition that students' learning styles change during the college experience. PMID- 1784663 TI - The original vs an abbreviated version of the Treatment Evaluation Inventory: systematic measurement error. AB - The Treatment Evaluation Inventory was used by 164 undergraduates to rate the acceptability of each of six treatments. The differences between the (scale corrected) total score and the total of items representing the short form were analyzed. Analysis suggested that the short form, as compared to the original scale, systematically underestimates the acceptability of overcorrection and overestimates the acceptability of differential reinforcement of other behavior. PMID- 1784664 TI - Magical thinking and alcohol labels. AB - 31 men and 29 women were randomly assigned to conditions in which they drank water they had labeled as either WATER, ALCOHOL, or NOT ALCOHOL, then completed a mood measure. Subjects given the ALCOHOL label who reported low frequency of using alcohol had a significantly greater positive mood and a less negative mood than subjects in the other conditions. PMID- 1784665 TI - Indeterminacy in psychology. AB - There is an irreducible uncertainty in the prediction of human behavior because the dynamics of the brain, as a self-organizing system consisting of many millions of elements, are inherently indeterminate. Thus the Laplacian ideal of universal laws relating knowable causes to predictable effects cannot be realized in psychology. PMID- 1784666 TI - Effects of humorous stimuli and sense of humor on discomfort. AB - The effects of humor on increasing discomfort thresholds were tested with Transcutaneous End Nerve Stimulation (TENS). Undergraduate students (n = 31) with high or low scores on Martin and Lecourt's Situational Humor Questionnaire were randomly assigned to a humor or nonhumor condition. Discomfort thresholds for TENS were assessed before and during treatment. There was a significant increase in discomfort thresholds in the humorous treatment compared to the nonhumorous condition. Evidence was found for subjects to smile "wryly" (an increase in zygomatic and corrugator tensions) more during humorous stimuli than nonhumorous stimuli when they were waiting to be stimulated with the TENS. PMID- 1784667 TI - Convergent and discriminant validity of FIRO-B questionnaire. AB - The Kramer-Froehle controversy about the construct validity of FIRO-B questionnaire was evaluated with a multitrait-multimethod design. 113 women and 26 men completed the FIRO-B questionnaire. After the examiner had given a lecture on the FIRO-dimensions, the subjects rated themselves on these dimensions. Only three out of six intercorrelations on the validity diagonal were statistically significant. Of the discriminant validity comparisons 80% met the required criterion. Our results confirmed Kramer's results about the construct validity of the FIRO-B questionnaire. PMID- 1784668 TI - Personality and attitude towards religion among adult churchgoers in England. AB - A sample of 165 regular churchgoers completed the short form of the Revised Eysenck Personality Questionnaire, together with the Francis scale of attitude towards Christianity. While the data demonstrate that the central thesis of Eysenck's theory relating personality with religious attitudes holds good among a religious sample, they also suggest that other aspects of personality theory and measurement relating personality with religious attitudes may function differently in a religiously committed sample than in more general samples. PMID- 1784669 TI - Low MMPI diagnostic performance for the DSM-III--R obsessive-compulsive personality disorder. AB - This study investigated the diagnostic performance of the MMPI validity and clinical scales, and especially of Scale 7 (Pt), for the DSM-IIII--R obsessive compulsive personality disorder by comparing the MMPI variables for 24 obsessive compulsive with those for 58 nonobsessive-compulsive inpatients. Both groups were diagnosed by semistructured interview (SCID-II). The obsessive-compulsive group obtained for the mean MMPI profile a 2-(6-1) (D-Pa-Hs) code, with a tendency for a lowered Scale 4 (Pd) score, compared to the nonobsessive-compulsive group. Neither the ROC analysis of the individual MMPI scales, including Scale 7 (Pt), nor the analyses of frequency of two-point codes and elevated (T greater than 69) scales showed any clear indications of good diagnostic performance for the DSM III--R obsessive-compulsive personality disorder. PMID- 1784670 TI - Can innuendos in headlines affect perceptions? AB - The effect of innuendos in headlines on the memory and attitudes of 67 male and 81 female college student who read simulated news articles were studied. Analysis indicated no main or interactive effect of headlines containing innuendo on memory, rated responsibility of the accused or victim, or on sentencing. Memory and attitudes were affected by identification and stereotyping. PMID- 1784671 TI - Suicide rates in major cities and their states. PMID- 1784672 TI - Young adults' expectations about sex-roles in midlife. AB - Male and female college students (N = 106) in the developmental stage of transition to young adulthood (mean age = 19.9 yr.) were asked to imagine themselves at midlife in three life settings: work, personal relationships/family, and leisure. For each setting they described themselves on the instrumental and expressive scales of the Personal Attributes Questionnaire and on scales of agentic and communal competencies. Subjects anticipated more instrumental traits, more agentic competency, and less communal competency in work settings than in personal relationships, with no differences between men and women. Gender and setting interacted for expressiveness: women anticipated more expressive traits than men in personal relationships, with no difference in the other settings. The anticipated traits and competencies of these subjects were related more to setting than to gender. This may reflect a shift in the definition of sex-role boundaries in American culture. PMID- 1784673 TI - Do police officers have accurate information about suicide? PMID- 1784674 TI - Teachers' perceptions of factors contributing to children's social status. AB - Factors related to children's friendships have been empirically related to social development and social status. Identifying specific factors related to peer status is important for teachers and counselors in recognizing children at risk for behavior and emotional problems. 370 teachers' global opinions about the importance of factors associated with peer status were assessed through a statewide survey. Analysis indicated that social skills, physical attractiveness, and outgoingness were the most frequently cited factors contributing to students' social status. Implications for research and practice are discussed. PMID- 1784675 TI - Comparisons of Purpose in Life scores between alcoholics with early and later onset. AB - No significant differences were found on Purpose in Life scores of 33 early onset (before age 40) and 27 late onset (after 40 years of age) alcoholic men in alcoholism treatment centers. Differences were found between the later onset group and another group of early onset alcoholics (n = 38) as well as an older nonalcoholic group of 20 tested by Meier and Edwards. PMID- 1784676 TI - Differences in perceptions of managerial roles by gender among southern business students. AB - Perception of the roles necessary for managerial success based on the 10 verbal descriptors of the Mintzberg roles were gathered from 128 business students at a southern U.S. university. The objective was to assess whether these 72 men and 56 women viewed the importance of the roles differently. Ratings were collected on the 10 roles for each of four different types of managers. The data were analyzed by one-way analysis of variance, chi-squared analysis, and Spearman rank-order correlation. No differences were observed in the perception of men and women in these roles or of their relative importance. PMID- 1784677 TI - Positional influences on job satisfaction and job performance: a multivariate, predictive approach. AB - This study examined relationships between job attitudes, work environment perceptions, and supervisors' ratings of job performance among health care employees occupying both medical care and administrative positions in ambulatory clinic settings. Between-group differences were noted on the perceived relationship with the supervisor, level of job/role conflict, and working conditions. Results are discussed in terms of functional and dysfunctional aspects of control systems and path-goal theory of leadership. PMID- 1784678 TI - Rates of attempted suicide and completed suicide in European community nations. PMID- 1784679 TI - National differences in dexamethasone suppression test results and suicide rates. PMID- 1784680 TI - Junior and senior faculty women: commonalities and differences in perceptions of academic life. AB - The purpose of this study was to explore the commonalities and differences in the perceptions of senior and junior faculty women regarding the barriers to success experienced early in academic careers. The population consisted of 22 pairs of junior and senior faculty women who participated in a mentoring program at a major public research university. Descriptive data indicate close agreement among junior and senior women faculty regarding the importance of the majority of potential barriers. Nonetheless, important differences exist. An exploratory factor analysis identified four underlying dimensions: personal security, work priorities, sense of belonging, and scholarly accomplishment. There was a significant difference between the two groups in their perceptions of personal security. PMID- 1784681 TI - Reconsidering response sets, test-taking attitudes, dissimulation, self deception, and social desirability. AB - This paper provides a summary of an examination of three lines of personality research involving response sets, empirical keying, and social desirability. The roots of these respective constructs are traced from their origins in Wundt's laboratory through the classic works of Meehl and Hathaway and Edwards up to Cattell's current reconstructions which take the form of trait-view theory and perturbation theory. After a careful analysis of the research and theoretical formulations from these three areas, it is concluded that Cattell's (1986) perturbation theory not only provides the most comprehensive system for understanding how respondents systematically distort their responses on personality questionnaires but also provides a solid framework for multivariate studies designed to test and refine his formulations. PMID- 1784682 TI - Venereal diseases and aggression management among Native Americans. AB - An analysis of secondary data yielded no significant ecological correlations for venereal disease rates and aggression management indices based on suicide and homicide rates for the 11 US Indian Health Services areas. This outcome does not cross-culturally replicate research on Field's aggression management hypothesis. PMID- 1784683 TI - Sibling and environmental correlates of young adults' status attainment. AB - This study used longitudinal data to investigate associations among sibling related variables, adolescents' perceptions of family and school learning environments, and social-status attainment measures, for 300 young Australian adults from different social-status groups. The findings indicated that: (a) sibling-related variables continued to have a number of significant associations with young adults' social-status attainment after taking into account mediating relationships between adolescents' learning environments and the attainment measures, and (b) these relationships between sibling and attainment measures varied for young adults from different social-status groups. PMID- 1784684 TI - Changes in nonverbal behavior of therapists and depressed patients during cognitive therapy. AB - Nonverbal behavior of 8 patients and 7 therapists during the first few minutes of 20 therapeutic sessions (either 2 or 3 per therapist-patient pair) was used as a baseline measure to assess whether there were systematic changes by the end of a single therapeutic session. The nonverbal behavior of both patients and therapists showed increases in prosocial behavior. Also, increases in signs of anxiety were noted in the nonverbal behavior of therapists. Significant correlations between nonverbal behavior of patients and therapists occurred for certain classes of behavior. It appears worthwhile to assess changes in nonverbal behavior during therapeutic sessions. PMID- 1784685 TI - Symptom correlates among adolescents showing Posttraumatic Stress Disorder versus Conduct Disorder. AB - 21 adolescents with a primary diagnosis of Posttraumatic Stress Disorder, 24 Conduct Disordered, and 23 control adolescents were compared on measures of depression, anxiety, behavior problems, and fears. Analyses showed that posttraumatic adolescents showed associated symptoms of depression and state anxiety, Conduct Disordered adolescents showed depressive trends, and both groups were evaluated by their teachers as showing significant behavior problems. PMID- 1784686 TI - Locus of control in rural southern elementary gifted students. AB - The locus of control as measured by the Nowicki-Strickland Locus of Control Scale was investigated for 68 rural, southern elementary gifted students, ages 8 to 14 years. The scores became more internal with older ages, and the girls (n = 34) tended to have more internal locus of control across grades. PMID- 1784687 TI - Administrative role and educational administration program effectiveness: perception by principals. AB - A survey of 85 graduates from 14 midwestern universities offering doctoral degrees in educational administration was carried out to assess perceptions of graduates regarding their training program. The emphasis of the survey was on how closely their training corresponded to current perceptions of their roles as educational administrators. Most indicated emphasis in graduate training should more closely match the roles of administrators. PMID- 1784688 TI - Bem Sex-role Inventory stereotypes for men and women varying in age and race among National Register psychologists. AB - 554 psychologists listed in the National Register of Health Care Providers in Psychology used the Bem Sex-role Inventory to rare a "mature, healthy, socially competent" individual in one of 18 target groups (a black or race-unspecified man, woman, or adult in their late 20s, late 40s, or late 60s). Factor analysis produced factors which generated three scales--nurturant, agentic, and self governing. The attributes "feminine" and "masculine" were treated as individual items. Old targets were viewed as less agentic than younger targets and as less self-governing than the middle-aged. Female targets were perceived as more feminine and less masculine than were men. Interactions for agentic and self governing suggest age and race and sex of target influence person perceptions. PMID- 1784689 TI - Personality correlates of intelligence in a clinical group. AB - The relationship between personality and intelligence test performance among 84 psychiatric patients was examined using a reduced version of the Wechsler Adult Intelligence Scale together with the Eysenck Personality Questionnaire. Introverts were inclined to do better than extraverts on all WAIS scales, the difference being statistically significant for the verbal subtests of Information and Similarities only. A 2-way multivariate analysis of variance gave a significant main effect for Social Conformity, in which low Lie scorers obtained higher scores on all subscales, particularly Verbal IQ. There was no main effect for Psychoticism but there were two interactions (Psychoticism x Lie) for the verbal subscales. For individuals characterized by high social conformity, the high Psychoticism scorers displayed lower scores on those scales associated with sensory associative intelligence (Information, Similarities, and Picture Completion). The results were discussed with particular reference to two competing theories relating personality and intelligence. PMID- 1784690 TI - Treating drunk drivers with Moral Reconation Therapy: a three-year report. AB - 115 DWI-convicted male inmates were treated with the cognitive behavioral system of Moral Reconation Therapy during their incarceration. Three years after their release, subjects' postrelease arrest and reincarceration records were collected. In the treated group, 24 subjects participated in an extended aftercare program and were compared to a control group of 65 DWI-convicted inmates who did not enter treatment due to limited bed space. Analysis showed reincarceration rates of 36.9% for the 65 controls, 22.6% of the 115 treated subjects, and only 16.7% of the 24 aftercare clients. PMID- 1784691 TI - The use of the MMPI-2 in conjunction with the NEO-Personality Inventory. AB - The combined use of the MMPI-2 Basic and Content Scales and NEO-Personality Inventory has produced data that describe the interplay of psychiatric disorders and personality traits. Diagnostic and clinical implications include the patient's coping style, flexibility, motivation, organization, and compliance in treatment. PMID- 1784692 TI - Effects of moon phase and other temporal variables on absenteeism. AB - Previous research on the effects of lunar phase on deviant behavior has produced weak and inconsistent results and has been criticized for failing to use appropriate statistical controls. This study examined the effects of the full moon on daily absenteeism rates in a large organization while correcting for autocorrelation and controlling for the effects of the day of the week, month, and proximity to a holiday. Contrary to expectations, the full moon was associated with a significant (but very slight) decrease in absenteeism. Reasons for persistent beliefs in the effects of the full moon are discussed. PMID- 1784693 TI - Psychotherapists' attitudes toward observations of nonverbal communication in a greeting situation: I. Psychometrics of a questionnaire. AB - A questionnaire was designed for the assessment of psychotherapists' attitudes toward nonverbal communication and their observation of it in a reference situation, i.e., the first time the therapist and the patient meet in a waiting room. The interrater reliability of the questionnaire was measured. Upon minor modifications, a final version of the questionnaire was completed, and the intrarater (test-retest) reliability, the discriminating capacity, and the homogeneity of the questionnaire were studied. The questionnaire has satisfactory psychometric qualities for use in research on nonverbal communication in psychotherapeutic greeting. PMID- 1784694 TI - Gender stereotypes for paranoid, antisocial, compulsive, dependent, and histrionic personality disorders. AB - To assess similarity between gender-role stereotypes and the personality disorder prototypes, university students (31 women and 13 men) were asked to assign gender to six descriptions of DSM-III--R personality disorders. Significant agreement was found in gender assignment for five of the six descriptions. Descriptions of the paranoid, antisocial, and compulsive personality disorders were viewed as male, and descriptions of the dependent and histrionic personality disorders were viewed as female. The description of schizoid personality disorder was not significantly gender-typed. PMID- 1784695 TI - Self-regulated learning and achievement by middle-school children. AB - The relationship of self-regulated learning to the achievement test scores of 62 Grade 6 students was studied. Generally, the metacognitive and affective variables correlated significantly with teachers' grades and standardized test scores in mathematics, reading, and science. Planning and self-assessment significantly predicted the six measures of achievement. Step-wise multiple regression analyses using the metacognitive and affective variables largely indicate that students' and teachers' perceptions of scholastic ability and planning appear to be the most salient factors in predicting academic performance. The locus of control dimension had no utility in predicting classroom grades and performance on standardized measures of achievement. The implications of the findings for teaching and learning are discussed. PMID- 1784696 TI - Childlessness, suicide and homicide. PMID- 1784697 TI - Reassessment of the Miller Social Intimacy Scale: use with mixed- and same-sex dyads produces multidimensional structures. AB - The dimensional structure of the Miller Social Intimacy Scale has not been assessed. This investigation examined internal reliability and principal components of the scale for nonspousal same- and mixed-sex dyads with 149 male and 210 female undergraduate students. Analyses yielded high internal reliability over-all and unique multidimensional structures for each dyad type. This clarifies and enhances subsequent use of the scale for studying intimate friendship patterns which vary in sex composition. PMID- 1784698 TI - Depression, suicidal preoccupation and scores on the Rokeach Value Survey. PMID- 1784699 TI - Physicians' detection of psychological distress in primary-care clinics. AB - This study investigated the amount of psychological distress reported by 182 soldiers in the Israeli military and compared soldiers' self-ratings of distress with ratings by military physicians of observed distress. Comparisons indicated a low detection rate by physicians with only 13% of self-reported cases of emotional distress identified. This and several related findings were taken to indicate shortcomings in medical care. Possible remedies include additional psychiatric training for military physicians, less frequent rotation of physicians to allow for more stable care, and the initiation of mental health education among soldiers. PMID- 1784700 TI - Unipolar delusional depression. Outcome in reactive versus endogenous types. AB - A sample of 83 first-admitted patients with delusional depression were diagnosed according to DSM-III, ICD-9 and reactive and endogenous types. They were followed up twice after a mean of 10 and 18.5 years. As to background, course and outcome variables DSM-III schizoaffective patients were closely related to affective patients. A small difference between reactive and endogenous type was accounted for by the endogenous subgroup of DSM-III schizoaffective patients. The study provides evidence for dismissing the reactive-endogenous distinction in terms of psychotic depressive disorder, but in terms of schizodepressive disorder the issue is less clarified based on course and outcome. PMID- 1784701 TI - Were Langfeldt's schizophreniform psychoses really affective? AB - Langfeldt's cases of schizophreniform psychoses were reclassified according to the ICD-9 and DSM-III-R diagnostic systems. The main purpose was to reexamine the validity of his concept of 'schizophreniform psychoses' to see whether it supported the existence of a 'third psychosis', and whether his material could be helpful in identifying good prognostic features in schizophrenia. Most of the schizophreniform psychoses turned out to be affective disorders with psychotic features. The number of other psychotic disorders was too small to facilitate a more thorough examination. PMID- 1784702 TI - Course and outcome in paranoid disorders. AB - All consecutively admitted patients suffering from paranoid psychoses and admitted to the Department of Psychiatry, University of Oslo, during two defined periods (1946-1948 and 1958-1961) have been personally followed up by the author after 5-18 years and by Stein Opjordsmoen after 22-39 years. After the first follow-up period 65% were without psychotic symptoms, after the last period 44%. According to Scandinavian diagnostic tradition, there is a gradual shift from very good clinical and social outcome for patients with reactive psychoses to very poor outcome for schizophrenics, patients with schizophreniform psychoses being in between. According to the DSM-III system, patients with affective and schizoaffective psychoses score best, followed by those with paranoid and schizophreniform disorders. Those with schizophrenia score worst. Course and outcome are primarily dependent on the diagnostic category, not the type of delusion. Of the patients with Kraepelin's paranoia, about one-third were without psychotic symptoms at last follow-up. PMID- 1784703 TI - Paranoid (delusional) disorders in the light of a long-term follow-up study. AB - A large sample of first-admitted hospitalized patients with delusional psychoses were personally followed up after a mean of 10 and 30 years. At last follow-up 42% showed good overall functioning and 44% were in ordinary work. Patients with affective disorder according to DSM-III had most homogeneous and favorable outcome, while a striking heterogeneity of outcome was noticed in schizophrenia, schizophreniform and paranoid disorder. Along with other reports the study showed that precipitating events indicated favorable prognosis for patients with schizophreniform, schizoaffective and paranoid disorder. Moreover, in the total sample the findings indicated that short duration of symptoms prior to admission was a good prognostic sign, indicating that early intervention is important for delusional patients. PMID- 1784705 TI - Methodological aspects of follow-up studies on psychotic patients in a polydiagnostic perspective. AB - Polydiagnostic follow-up studies should explore whether certain definitions of a given disorder permit better prediction of the illness course than others and whether this good predictive validity is related to specific etiopathogenetic conditions. In order to carry out such studies successfully they should be based on broadly defined samples and comprise provisions for additional validation such as genetic data, neuropsychological testing etc. After an assessment at baseline and at discharge from hospital, the follow-up assessments should comprise five steps: (1) Identification of successful and unsuccessful diagnostic systems; (2) identification of features determining successful attribution; (3) analysis of successful systems; (4) analysis of unsuccessful systems, and (5) analysis of cases which have changed diagnostic attribution. The conclusions drawn from these analyses are intended to refine classification in psychiatry. PMID- 1784704 TI - Prognosis in paranoid disorders and mortality in reactive psychoses. AB - The present paper shows that the short-term prognosis of patients with paranoid disorders hospitalized nowadays is poor for the majority. The best prognosis is attached to patients with affective or other not specified psychotic disorders. Socio-vocational variables at the time of first admission contain more predictive value than clinical variables. The term reactive psychosis as a term with good prognosis is questioned and the findings of a mortality study are presented in support of this view when concerned with hospital populations. PMID- 1784706 TI - Why do the results of follow-up studies in delusional disorders differ? AB - In this paper 4 studies on the course of delusional disorders of midlife, partly diagnosed as 'late schizophrenias' in the sense of M. Bleuler, published up to the 70s and 3 studies on the same topic which were published in the 80s, all European, are analysed with regard to differences in their results in order to find out factors operating on these differences and to propose standards to be followed in such studies. Four such factors are stressed: different follow-up times leading to different rates of loss of probands by death, unreliable use of diagnostic terms and, probably more influential, unreliable use of terms describing the course, and different preconditions of the recruiting process by differences in the care systems the probands are collected in. Four conclusions are derived from this finding: the need for comprehensive and valid information, for reliable use of terms describing the course, for information about the care system the patients come from as an important precondition of the process of recruiting probands, and probably for the further development of a 'language' for the description of course. PMID- 1784707 TI - Paranoid disorders following war brain damage. Preliminary report. AB - Roughly 3,000 war veterans with moderate or severe brain injury have suffered from a psychiatric disturbance. Psychotic disorders are found in approximately 750 cases. The material of this preliminary report consists of the first 100 veterans with paranoid disorders. Delusional psychosis is the most common main diagnosis (28% of veterans), followed by major depression (21%), delirium (18%) and paranoid schizophrenia (14%). Paranoid schizophrenia and paranoid schizophreniform psychosis develop earlier (in 23% of cases within 1 year) than delusional psychosis (4%). Delusional psychosis lasted less than a year in 28% of the cases and more than 5 years in 40% of cases. The corresponding figures for paranoid schizophrenia and paranoid schizophreniform psychoses are 26 and 63%. Jealousy or fear of being sexually betrayed constitutes the most prominent individual content of delusions. PMID- 1784708 TI - The Ulleval acute ward follow-up study: a personal 7-year follow-up of patients with functional psychosis admitted to the acute ward of a catchment area. AB - Eighty-eight patients were admitted to the acute ward of a catchment area suffering from the following functional psychoses: schizophrenia (S; n = 41), affective disorder (AD; n = 22), other disorders (OD; n = 25). Follow-up data were obtained for 97%. Ten patients were dead at follow-up, 8 due to suicide. Sixty-five were personally interviewed. While nearly all the patients had only brief periods of rehospitalization, most had used neuroleptics during the follow up period. Compared to other samples, functioning at follow-up was fairly good for the AD and OD patients, but rather poor for the S patients. PMID- 1784709 TI - Temporal stability of diagnostic criteria for functional psychoses. Results from the Vienna follow-up study. AB - 200 first admissions with functional psychoses were interviewed with PSE and rated simultaneously according to different diagnostic criteria (ICD-9, RDC, DSM III, St. Louis, Taylor, Vienna Research Criteria). At follow-up 7 years later 186 patients could be traced and a course diagnosis was applied to each patient. Temporal stability of diagnostic criteria was calculated for ICD-9, RDC and DSM III by stability coefficient and kappa values and was used as a criterion for validity. Schizophrenia and affective disorder display considerable stability over time, no matter whether one uses ICD-9, RDC or DSM-III. The data for schizoaffective disorder are less impressive, the stability coefficient is much higher for schizoaffective bipolar than for schizoaffective depressive patients. PMID- 1784710 TI - Ribosomal DNA: molecular evolution and phylogenetic inference. AB - Ribosomal DNA (rDNA) sequences have been aligned and compared in a number of living organisms, and this approach has provided a wealth of information about phylogenetic relationships. Studies of rDNA sequences have been used to infer phylogenetic history across a very broad spectrum, from studies among the basal lineages of life to relationships among closely related species and populations. The reasons for the systematic versatility of rDNA include the numerous rates of evolution among different regions of rDNA (both among and within genes), the presence of many copies of most rDNA sequences per genome, and the pattern of concerted evolution that occurs among repeated copies. These features facilitate the analysis of rDNA by direct RNA sequencing, DNA sequencing (either by cloning or amplification), and restriction enzyme methodologies. Constraints imposed by secondary structure of rRNA and concerted evolution need to be considered in phylogenetic analyses, but these constraints do not appear to impede seriously the usefulness of rDNA. An analysis of aligned sequences of the four nuclear and two mitochondrial rRNA genes identified regions of these genes that are likely to be useful to address phylogenetic problems over a wide range of levels of divergence. In general, the small subunit nuclear sequences appear to be best for elucidating Precambrian divergences, the large subunit nuclear sequences for Paleozoic and Mesozoic divergences, and the organellar sequences of both subunits for Cenozoic divergences. Primer sequences were designed for use in amplifying the entire nuclear rDNA array in 15 sections by use of the polymerase chain reaction; these "universal" primers complement previously described primers for the mitochondrial rRNA genes. Pairs of primers can be selected in conjunction with the analysis of divergence of the rRNA genes to address systematic problems throughout the hierarchy of life. PMID- 1784711 TI - The manly art of self-defense: on the neutrality of fitness components. AB - Data on 15 physical characteristics of contenders in 137 championship prizefights in three weight categories (light-, middle-, and heavyweights) have been analysed. These data are seen as being drawn from a highly culled population, and as bearing on what are, in effect, components of fitness. In heavyweights, the analysis suggests that these characteristics are indeed related to winning or losing (i.e., they are selectively important). As an overwhelmingly general rule, however, winners and losers do not differ significantly with respect to these measures nor, for the lighter weight classes, is there evidence of stabilizing selection. The exceptions to this general rule are discussed ("just-so" story): under some circumstances, a correlation between total fitness and one of its components may be detected in a highly selected population. Under most circumstances, on the contrary, this correlation all but vanishes. PMID- 1784712 TI - The application of the molecular replacement method to the de novo determination of protein structure. PMID- 1784713 TI - Bacteriorhodopsin: a biological material for information processing. PMID- 1784714 TI - A method to correct a single premolar tooth in crossbite. AB - In Class I malocclusions, when the only complaint is the localized crossbite of a premolar, resulting from a mild shortage of space, correction can be simply undertaken. Adams clasps and an expansion screw are incorporated into a simple removable appliance designed to provide space to align the malpositioned tooth, which is then guided into the line of the arch by a piece of elastomeric thread stretched between the Adams clasps. PMID- 1784715 TI - Bonded composite resin/ligature wire splint for stabilization of traumatically displaced teeth. AB - Two cases in which tooth splinting was required after traumatic dental injuries are documented. In each patient, an acid-etch-retained composite resin/ligature wire splint was used to stabilize displaced teeth after they were replaced into their proper positions. The step-by-step splinting technique is described, and the rationale for the method is reviewed. PMID- 1784716 TI - Factors affecting displacement of free-end saddle removable partial dentures. AB - Tissueward movement of the free-end saddle of a removable partial denture during function takes place around the most distal fulcrum created by the most mesial rests. Displacement because of sticky foods takes place around the fulcrum created by the most distal rests. These and other factors affecting displacement of the free-end saddle removable partial dentures are discussed, and designs intended to increase retention are presented. The forces applied to the most anterior and posterior axes of rotation can be calculated mathematically to reveal the hazards of a too-short lever arm in combination with a strong retentive clasp system. PMID- 1784717 TI - Prefabricated dentitions for complete-denture prosthodontics. AB - A technique employed in China to simplify the fabrication of complete dentures is described. Prefabricated dentitions (an alignment of teeth en bloc with little denture base) are used instead of arranging individual teeth into an arch. This procedure can be performed intraorally without articulator mounting. It is economical and saves time. The results of clinical application of this technique are presented. PMID- 1784718 TI - Histopathology according to G.V. Black. AB - Eighty-eight handmade microscope slides prepared by G.V. Black are discussed. Black sectioned tissues using a homemade microtome and razor blades. Different sections of the same material were stained with various stains or double stained. Because of the importance of Black's writings, it was interesting to find slides that he prepared, to try to compare them to his publications, to study the way in which he obtained information, and to find the conclusions he drew from his experiments. PMID- 1784719 TI - Resin-to-enamel bond strengths with various etching times. AB - It has been advocated recently that etching times of enamel be reduced from 60 seconds to as low as 15 seconds. However, the minimal etching time needed to achieve adequate retention of composite resin to enamel has not been identified. In this study, an attempt was made to find the minimal enamel-etching time that still allowed adequate bond strength of composite resin to enamel surfaces. Adequate bond strength was defined as equivalent to the bond strength established for the conventional 60-second etch. Results seemed to indicate that a 5-second etch was sufficient to allow adequate bond strength; however, further study is required to determine the effects of short etching times on microleakage. PMID- 1784720 TI - Surface detail reproduction of Type IV dental stones with selected polyvinyl siloxane impression materials. AB - Four polyvinyl siloxane impression materials and 14 modified Type IV dental stones were evaluated for their abilities to reproduce surface detail. Each combination of impression material and dental stone was used to duplicate a 20 microns-wide line. Surface detail reproduction was observed by two paired-rater groups. The line was reproduced in all impression material specimens, but in only 32% of the stone cast specimens. Some combinations of impression material/dental stone reproduced the line all or most of the time, but 12 combinations did not reproduce the line at all. PMID- 1784721 TI - The relationship between chewing sticks (Miswak) and periodontal health. 3. Relationship to gingival recession. AB - Aggressive or improper toothbrushing techniques may have a detrimental impact on the gingiva. The purpose of this study was to examine the relationship between chewing sticks (Miswak) and gingival recession. Gingival recession was measured on the mid facial surfaces of the incisors, canines, and premolars in 238 patients presenting for routine dental appointments. All patients had been interviewed previously regarding their oral hygiene habits and use of Miswak. Patients were divided into three groups: Miswak group, toothbrush group, and Miswak/toothbrush group. The Miswak users had significantly more (P less than or equal to .05) sites gingival recession than did the toothbrush users. Furthermore, the severity of the recession was significantly more (P less than or equal to .05) pronounced in the Miswak users than it was in the toothbrush users. PMID- 1784722 TI - In vitro tooth color change with repeated bleaching. AB - The interest of patients in vital tooth bleaching has created a demand for treatment. However, few objective data are available to help determine the number of bleaching appointments necessary and the lightening that can be expected. The purpose of this study was to measure color changes in bleached extracted teeth and compare these to control groups. Group A was etched and bleached with 35% stabilized hydrogen peroxide. Group B was treated the same as group A, but the bleaching solution was replaced with distilled water. Group C was not treated, but was stored in water. Mean color difference after one treatment was 3.33 for group A, 1.67 for group B, and 0.48 for group C. After six treatments, the overall color difference was 3.82, 2.41, and 1.38 for groups A, B, and C, respectively (P less than .01). Color changes beyond those found after the first treatment were small, suggesting that there was little benefit in repeated bleachings under the conditions of this study. PMID- 1784723 TI - [ITI-Bonefit implant system--implant bed preparation]. PMID- 1784724 TI - [Parapulpal anchored Class IV restorations (2)]. PMID- 1784725 TI - [Titronic-K anchor system--rational method of prosthetic restoration of endodontically treated teeth]. PMID- 1784726 TI - [Care of young female patient using adhesive attachments and removable partial denture]. PMID- 1784727 TI - [Significance of vertical dimension in orthodontic-surgical interventions of maxilla]. PMID- 1784728 TI - [Labial gingival recession with and without treatment with mucosal transplantation in orthodontically treated children--influence of retrusion and infection]. PMID- 1784729 TI - [Interpretation of radiographs]. PMID- 1784730 TI - [ABC of practice management: M-Marketing (2)]. PMID- 1784731 TI - [Electromyographic study of relation between pain management of sternocleidomastoid muscle and occlusal interference]. PMID- 1784732 TI - [Oral durability of crown and bridge materials]. PMID- 1784733 TI - Weight changes during pregnancy and the postpartum period. AB - Weight gain during pregnancy is considered a major determinant of fetal growth. Low maternal weight gain is associated with an increased incidence of low birth weight infants who are at higher risk for increased mortality. For the past twenty years, weight gain recommendations have been centered around one value (11 kg) as representative of a weight gain objective. Newer recommendations are based on what is considered optimal infant outcomes and not necessarily on maternal health considerations. These recent recommendations indicate the importance of pregravid weight in setting weight gain goals with overweight gravida advised to gain less than normal weight or underweight gravida. When confounding variables are controlled, maternal weight gain is similar in adolescents and older women. Reports on weight loss during the postpartum period indicate a high degree of variability in total weight change. In general, with current levels of weight gain, each successive birth adds about 1 kg of body weight above that normally gained with age. There is very little evidence to suggest that breast feeding as compared to other methods of infant feeding, causes body weight to return to prepregnancy levels at a faster rate. PMID- 1784734 TI - Assessment of the uricogenic potential of processed foods based on the nature and quantity of dietary purines. AB - Foods rich in nucleic acids, which elevate serum uric acid levels, are restricted in the diets of hyperuricemic individuals. This restriction has been based on the amount of total dietary nucleic acids or all purines, assuming no differences in uricogenic effects of individual purines (adenine, guanine, hypoxanthine, and xanthine). However, inspite of their biochemical similarity, purines are metabolized differently and produce different uricogenic effects in animals and humans. Among the four purine bases, adenine and hypoxanthine have been reported to be more uricogenic than guanine and xanthine. Moreover, free adenine has been shown to be more uricogenic than its nucleoside or nucleotide when fed to animals. Changes in the contents of purines and release of free bases have been reported to occur during various cooking procedures such as stewing, roasting, boiling, and broiling of meat, poultry, and fish products. The differences in metabolic effects of individual purines, and modification in the amount and form of purines caused by processing would suggest that the uricogenic potential of processed foods should be based on the nature and quantity of dietary purines. Recent data on purine contents of processed foods, and information on metabolic effects of dietary purines are reviewed to assess the uricogenic potential of processed foods. PMID- 1784735 TI - 'New data from old': epidemiology and record-linkage. AB - Record linkage in the context of epidemiology refers to the putting together of information (records) on the same person which may have been recorded on different occasions and became part of different data collections. The objective of this article is to provide an overview of the use of record linkage in epidemiology, particularly as it pertains to nutrition and food studies. A short description of epidemiological methodology is provided in order to clarify what epidemiologists expect to achieve by record linkage. A general description of the mechanics of record linkage explains how the methodology relates to the quality of the resulting data sets. The potential impact of the approach of record linkage on epidemiological research is discussed, particularly as it relates to nutritional and other food related studies. Ethical considerations related to record linkage are discussed, and in conclusion the future of record linkage is considered. PMID- 1784736 TI - Cigarette smoking-nutritional implications. AB - Although the effects of cigarette smoking on a variety of diseases, from cancer through emphysema and cardiovascular illness are well documented, direct effects on the levels of macro- and micronutrients in the body are reported less frequently. In fact, imbalances in these nutrients may have a role in many of the pathological conditions attributed to smoking. Tobacco smoke contains numerous compounds emitted as gases and condensed tar particles, many of them being oxidants and prooxidants, capable of producing free radicals thus enhancing lipid peroxidation in biological membranes. Vitamin E, vitamin C, B-carotene and selenium are involved in the overall cellular anti-oxidant defense against deleterious effects of reactive oxygen species. Smoking has been shown to lower the level of vitamin C and B-carotene in plasma. Cadmium, naturally found in tobacco, decreases the bioavailability of selenium and acts antagonistically to zinc, a cofactor for the antioxidant enzyme, superoxide dismutase. Vitamin E, the principle lipid-soluble antioxidant, may be at suboptimal levels in tissues of smokers. In addition, tobacco constituents have been shown to reduce levels of several vitamins of the B-complex. Nutritional status in smokers may be further compromised by an inadequate diet. Data from the Second National Health and Nutrition Examination Survey indicates that smokers are less likely to consume fruits and vegetables, particularly those high in vitamin C and carotenes. Cessation of smoking is the obvious solution to ending cigarette-related problems. In the world as it is, however, the medical community should be responsible for making recommendations to lower the risk in smokers to tobacco related diseases. Nutritionists could have a role in this process. There exists a lively debate as to where levels of nutrients should be set. Additional vitamin C has already been recommended for smokers. Should other antioxidants also be increased? Arguments for the against are considered. PMID- 1784737 TI - Interaction of iron and folate during reproduction. AB - Biochemical evidence collected from both clinical and non-institutionalized populations indicate that iron and folate deficiencies frequently occur simultaneously. Supplementation trials of iron-deficient patients with either iron or iron and folate has helped to illustrate that a complex interrelationship exists between these two nutrients. Controlled animal trials in which dietary iron and folate content has been systematically manipulated reveal that iron deficiency can cause altered folate utilization. The impact of iron deficiency on folate metabolism is most dramatic during the reproductive and neonatal stages of the life cycle. Rat pups and piglets nursed by dams fed iron-depleted diets exhibit signs of altered folate utilization. Depressed milk folate secretion is an early manifestation of iron deficiency in the rat dam and is a prime factor responsible for folate depletion in their nursing pups. Impaired milk folate secretion during iron deficiency is not due to a decrease in the amount of folate supplied to the mammary gland; rather, the defect causing this reduction is specific to the mammary gland. PMID- 1784738 TI - Iron deficiency; non-hematological manifestations. AB - Iron deficiency has far reaching consequences on systemic functions apart from the well known feature of anemia. Because iron deficiency anemia is easy to recognize and treat, the non-hematological manifestations of this trace element deficiency have been overlooked. There is a large body of evidence accumulated from animal and human studies to indicate that iron deficiency states are associated with alterations in cellular function, growth, motor development, behaviour and cognitive function. There are consequences for the host's level of immunocompetence against infection, for physical work and metabolic stress, for altered fetal outcome and premature labour in pregnant women. The gastrointestinal functions and other organ systems are also affected as a result of iron deficiency. The purpose of this review is to emphasize the importance of the non-hematological manifestations of iron deficiency and to highlight areas of interest, both to basic scientists and health care professionals. PMID- 1784739 TI - [Left ventricular insufficiency from diastolic dysfunction alone]. PMID- 1784740 TI - [Study of viral replication in HbsAg positive chronic hepatitis]. AB - Viral replication seric markers (VRSM), (BeHAg, BcHAg, and DNA-VHB) and the hepatic tissue BcHAg of thirty four patients suffering from chronic hepatopathies (6 PCH, 18 ACH, and 10 cirrhosis) were investigated. The greatest incidence of RVSM was observed in PCH. The combined study using all the markers demonstrated a positive correlation: DNA-VHB and BeHAg (p less than 0,001); DNA-VHB and BcHAg (p less than 0,001); BeHAg and BcHAg (p less than 0,001). The same result was obtained when comparing BcHAg (n) with the rest of RVSM: DNA-VHB (p less than 0,001), BeHAg (p less than 0,001) and seric BcHAg (p less than 0,01). Patients with a most intense histologic activity according to the Knodell index, presented a higher ratio of positive nuclei for BcHAg. The conclusion is that there is a good correlation amongst replication markers, specially hepatic BcHAg and DNA VHB. PMID- 1784741 TI - [Evaluation of nutritional status in patients admitted to an internal medicine department. Study of 100 cases]. AB - We have confirmed that malnutrition is very frequent in hospitalized patients. There is no agreement about which are the indexes or criteria agreement about which are the indexes or criteria that can be used to define malnutrition, specially in early stages. In the present work, we have studied 100 patients randomly chosen amongst the admissions that occurred in the Internal Medicine Department over a period of one year. The patients were submitted to a protocol which included the following: anthropometric measurements, seric proteins and routine determinations (sugar level, cholesterol, uric acid, etc.) It has been considered as malnourished those patients who presented some marker with a value lower than 90% of the standard value. According to these criteria, 25 of them had a caloric-protein malnutrition, 24 had a proteic malnutrition and 25 of them had mixed malnutrition. The most sensible parameters had been the triceps skin fold and retinal transporting protein. PMID- 1784742 TI - [Skill in the handling of aerosols by health care personnel]. AB - Aerosol bronchodilators are extensively used in bronchial asthma treatment and other obstructive pulmonary diseases. Its therapeutic efficacy is closely related to a correct administration technique. We present the results obtained in a prospective study on the skill in the use of the health care professionals in our hospital. A total of 127 physicians and nurses were interviewed, being 110 finally included in the study. Only 22.7% of them used the aerosol correctly and we did not find significant differences between the three groups into which we divided the study (Staff physicians, Residents, and nurses). The most frequently found mistakes were not maintaining as correct apnea after inhalation (62.7%) and not shaking the aerosol before use (48.2%). Up to a 57.2% of those interviewed made two or more of the evaluated mistakes. We conclude that although aerosol bronchodilators and corticoids are extensively prescribed, the lack of knowledge about their correct use by health care professionals is very high, and this could contribute to their misuse by patients under their care. PMID- 1784744 TI - [Snake bites in our environment. A biannual review of 7 cases]. AB - The clinical picture, treatment and evolution of seven patients presenting snake bites are analyzed. Local symptoms were constant, with a spontaneous favorable evolution in 7 to 10 days. The most relevant systemic manifestations were coagulation anomalies which appeared in two patients. Treatment always included local wound care, antitetanicum antibiotic and anticoagulant prophylaxis with specific antiophidic serum in five patients. PMID- 1784743 TI - [AIDS: clinical and necropsy correlation. Analysis of 45 patients]. AB - We have reviewed the autopsies performed on 45 AIDS patients who died in our hospital until June 1989, comparing the post-mortem diagnosis with those made while the patient was alive and in his last hospital admission. Bacterial pneumonia, CMV infection and atypical mycobacteria were the diseases most frequently unnoticed. On the contrary, HIV encephalitis and pulmonary mycosis were the disease with the greatest number of non confirmed clinical diagnosis. The routine performance of necropsy studies to AIDS patients permits to know the most prevalent infections in our environment and should improve the diagnostic precision. PMID- 1784745 TI - [Listeria meningitis and HIV infection]. AB - Although listeria monocytogenes is an opportunistic pathogen, infection by this bacteria is infrequent in AIDS patients. We were describe a case of L. monocytogenes meningitis in a patient infected by the human immunodeficiency virus (HIV). Literature is reviewed, and the pathogenesis of infection by this bacteria and its relation to AIDS is discussed. PMID- 1784746 TI - [Malignant Mediterranean boutonneuse fever. Septic shock of unknown origin?]. AB - Mediterranean Botonous Fever (MBF) is an infectious disease which provokes multisystemic vasculitis due to endothelial proliferation of rickettsia conorii. Its incidence, in our environment, has greatly increased during the last years being endemic in many large cities and their surrounding suburbs. In some cases its evolution is specially malignant resulting in septic shock, adult respiratory distress syndrome, and multiorgan failure. The purpose of this communication is to present a new case of malignant MBF with a bad evolution factor which has not been previously referred to, which is the persistence of vector ticks in the inoculation spot. PMID- 1784747 TI - [Tuberculin test: usefulness of an old technique]. AB - Tuberculin test was first used as a diagnostic test of tuberculous infection during the first decades of this century. From the up to date, no other method has proven to be more efficient for this task. In the present work we try to explain what the test consists of, what is its use, how it is interpreted, and which are the indications for the Mantoux intradermal reaction. We emphasize the importance of performing this technique correctly so as to not invalidate the results of this test which is essential both from a individual as from an epidemiological point of view. PMID- 1784748 TI - [A boy with hepatosplenomegaly]. PMID- 1784749 TI - [Hodgkin's disease and AIDS]. PMID- 1784750 TI - [Metaraminol provocation test in a case of familial Mediterranean fever]. PMID- 1784751 TI - [Mixed cryoglobulinemia associated with Mediterranean boutonneuse fever]. PMID- 1784752 TI - [Flapping tremor associated with nonketotic hyperglycemic hyperosmolarity]. PMID- 1784753 TI - [Influence of diagnostic delay in fibrinolytic treatment]. PMID- 1784754 TI - [Chylous ascites associated with breast carcinoma]. PMID- 1784755 TI - [Bronchiolitis obliterans with organizing pneumonia. Secondary to chlorine gas inhalation?]. PMID- 1784756 TI - [Intense thrombocytosis and iron deficiency anemia]. PMID- 1784757 TI - [Hypocalcemic cardiopathy: a rare cause of cardiac insufficiency]. PMID- 1784758 TI - [Is good collaboration in spirometry a criterion for predicting the correct use of inhalation bronchodilators?]. PMID- 1784759 TI - [Non-insulin dependent diabetes: beta-cell failure or insulin resistance, an unsolved controversy]. PMID- 1784760 TI - [Adrenal gland gammagraphy in the study of Cushing's syndrome-disease]. AB - A retrospective study is presented of 19 patients who suffered Hypercortisolism who were examined by adrenal gammagraphy, echography, and CT scan in order to evaluate the usefulness of gammagraphy in the diagnostic approximation of this pathology. The gammagraphy findings had an excellent correlation with anatomopathologic findings, probably due to the combined morphologic and functional evaluation obtained with this technique which facilitates a complementary vision to the other diagnostic image exams (CT scan and echography) which, although they are the first choice given their availability and good resolution, they can easily lead to diagnostic errors which can be avoided if we can perform an adrenal gammagraphy; it is of special interest in the study of macro-micro-nodular hyperplasia and its differentiation from single adenomas. PMID- 1784761 TI - [Control of colorectal cancer recurrence treated with curative surgery: results of a prospective study]. AB - Eighty four colorectal cancer patients who underwent presumably curative surgery were considered as candidates for control recurrence study. The study protocol included physical exam, blood biochemistry, chest X-ray, and CEA every 3 months (every 6 months after the third year) as well as an opaque enema, colonoscopy, abdominal echography, and pelvic CT scan (in case of abdominoperineal resection of a distal rectum cancer) every six months (once a year after the third year). Thirteen patients (15%) refused to participate in the study or abandoned it early, thus 71 patients are finally evaluated. After a mean follow up of 64 months, 32 patients presented a total of 42 recurrences (several patients underwent complete resection of the recurrence and presented new relapses). Recurrence diagnosis was always done by conventional exam (there was no second look guided by CEA values). Complete resection of the initial recurrence was achieved in 22% of cases (7 patients), but only 2 (6.5% of total relapses) are up to date tumor free and potentially cured after a long follow up. The most useful tests for the diagnosis of organ specific recurrences were chest X-ray (lung metastasis), liver echography (liver metastasis), liver echography (liver metastasis), colonoscopy (intraluminal local recurrence) and pelvis CT scan (pelvic recurrences). The carcinoembryogenic antigen was very specific, but only moderately sensitive, in predicting tumoral recurrency. However, CEA levels at relapse predicted the complete resection of recurrent tumor (58% with carcinoembryogenic antigen equal to or lower than 10 ng/ml compared to 5.5% with carcinoembryogenic antigen above this value p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1784762 TI - [Descriptive study of the care of oncologic patients at the emergency service of a general hospital]. AB - Clinical records of 352 patients seen in the Emergency Room of Hospital La Paz between January and April 89 and previously diagnosed of a malignancy were retrospectively reviewed. From the present study we concluded: 85.5% of them had not been seen by a physician before admission; most common tumors were lung, breast and gastrointestinal; anxiety and respiratory diseases were the most frequent diagnoses. This group of patients rarely need sophisticated complementary tests or therapy, but they spend more time at the hospital than other patients. PMID- 1784763 TI - [Gastric emptying of solids in chronic alcoholic hepatopathy: role of autonomic insufficiency]. AB - Thirty one subjects are studied, 15 healthy (controls) and 16 presenting chronic alcoholic hepatopathy, in whom the existence of an autonomic insufficiency syndrome (AIS) was evaluated measuring the variations in heart rate while breathing (R index) and after standing up [O(B) index]. Vagal functioning was also studied when evaluating gastric emptying of digestible solids (VGS) and non digestible (VGSND). VGS after 45, 75 and 105 minutes in alcoholic patients was slower than in healthy controls (p less than 0.05) and in 50% of them it was slow after 105 minutes. VGSND was similar in both groups. R and O(B) indexes in alcoholic patients was smaller than in the control group (p less than 0.001), presenting 94% of them some index altered. An elevated percentage of patients suffering chronic alcoholic hepatopathy present a AIS which involves several organs, being R and O(B) indexes a better diagnostic method than VGS study. PMID- 1784764 TI - [Unilateral asterixis associated with anatomic cerebral lesions]. AB - Three patients with unilateral asterixis associated with different vascular lesions of thalamus, basal ganglia and internal and external capsules of contralateral hemisphere are described. Unilateral asterixis is a highly indicative sign of focal cerebral lesion. Its pathophysiology is still unknown. It has been postulated that asterixis is a myoclonic phenomenon resulting from malfunction within neuronal circuits of central nervous system responsible for the active maintenance of posture. PMID- 1784765 TI - [Trimethoprim-sulfamethoxazole++ in the treatment of a case of localized Wegener's granulomatosis]. AB - A 50 year old man, affected by a Wegener's granulomatosis limited to lung, is presented. The indirect immunofluorescence test for "Anticytoplasmic Antibodies" (ACPA) was negative and we got the definitive diagnostic by the histological study from thoracotomy and biopsy samples. We started treatment with trimethoprim sulfamethoxazole and a good evolution with an adequate clinical control, x-ray study and blood test was obtained. Some aspects of the value of the ACPA as diagnostic and activity markers of the disease and also the use of an antimicrobial agent on the treatment of this nosological entity are discussed. PMID- 1784766 TI - [Angiothrombotic pulmonary granulomatosis in intravenous drug addicts]. AB - Two cases of angio-thrombotic lung granulomatosis in intravenous drug addicts are described. This entity has been previously described in drug addicts who inject oral drugs intravenously. Talc, which is used in the preparation of several drugs, cotton and other substances provoke at lung vessels level, thrombotic phenomena with strange body granuloma formations. Depending on the predominating localization of these lesions, interstitial pneumonia or pulmonary hypertension can later occur, such is the case in one of our patients who had a fatal evolution in a short period of time. PMID- 1784767 TI - [Student evaluation of teaching: results of an experience at the medical school of the Autonomous University of Barcelona]. AB - The students' opinions and attitudes about their training should act as a feed back for teachers. During the course 1987-88, students from all years in the School of Medicine of Autonoma University, Barcelona, completed a questionnaire about the training they received during the previous year. The questionnaire referred to different academic aspects such as organization, theoretical lessons, practical lessons, working material, exams, and teacher-student relationship. The results indicate that almost all the variables appear to be related; the student evaluates in a similar manner and intensity all the variables. Based on the latter, it is suggested to use measuring instruments with few items when students are asked to evaluate training. PMID- 1784768 TI - [Amino-hydroxy-propane diphosphonate (APD): satisfactory therapeutic response in a patient with Paget's disease of bone]. PMID- 1784769 TI - [Pneumothorax in rheumatoid arthritis as a factor of poor prognosis]. PMID- 1784770 TI - [Arthropathy associated with human immunodeficiency virus]. PMID- 1784771 TI - [Meningitis caused by Salmonella enteritidis in adults]. PMID- 1784772 TI - [Infective endocarditis and pulmonary abscess in an intravenous drug addict caused by Veillonella parvula]. PMID- 1784773 TI - [Flunarizine-induced akathisia]. PMID- 1784774 TI - [Adenosine deaminase activity in tuberculous arthritis and other monoarthritis]. PMID- 1784775 TI - [Severe hypothermia induced by hypoglycemia. A manifestation of dysautonomic neuropathy?]. PMID- 1784776 TI - [Senile dementia: strategies for a decade]. PMID- 1784777 TI - [Cross-sectional study of the quantity and quality of fat consumed in Spain and the mortality by various types of neoplasms of the reproductive system]. AB - The possible relation between the amount and composition of fat in the diet of different regions and provinces in Spain and the mortality caused by different types of cancer is studied. The quantitative information about fat intake comes from a publication entitled "Nutrition Study" (1985) which was performed by our Nutrition Department together with the National Institute of Statistics (INE). The study sample is formed by 23,972 families and is representative of the whole country and of each of the Provinces and Autonomic Communities in it. Each family is surveyed for seven days for the "Family Direct Survey". The dietetic parameters studied have been the following: total energy intake, total lipids, total fat and fatty acids as a percentage of total caloric intake, cooking fat/total fat ratio, vegetable fat, animal fat, fish fat, saturated fatty acids, monounsaturated, polyunsaturated, and cholesterol. These parameters have been correlated with mortality date due to the following tumors: malignant tumors in general, breast, uterine neck, uterus, ovary, prostate, and testicle, in each of the provinces in our country, expressed per 100,000 inhabitants, data which was obtained from the INE publication (1986). Similarly, the corresponding correlations have been carried out between dietetic parameters and breast cancer adjusted mortality rate. From our study we can conclude that there is a statistically significant negative correlation between mortality due to testicle cancer and some dietetic parameters. However, breast, prostate, and ovary neoplasias are only affected by certain parameters. These results agree with those obtained by other authors. No statisticaly significant correlation is found when adjusted rates are used. PMID- 1784778 TI - [Zinc in arthrosis and microcrystalline arthritis]. AB - Plasma, urine, intra-erythrocytes and salivary zinc levels are not modified in Generalized Primary Arthrosis. In patients with microcrystalline arthritis (Gout and Joint Chondrocalcinosis), zinc levels do not vary in the absence of disease activity. In patients suffering gout with clinical activity, the lowest plasma zinc levels are observed. Zinc concentrations in patients presenting Chondrocalcinosis, since they belong to groups C and D ("pseudoarthrosis"), were not modified, similarly to the group of patients with arthrosis. The mechanisms of action of zinc in relation to the pathogenesis of the microcrystals induced inflammation are analyzed. PMID- 1784779 TI - [Course of cardiac autonomic neuropathy in diabetic patients++ depending on the degree of metabolic control]. AB - Thirty-one diabetic subjects, 19 males and 12 females, with a mean age of 40.5 +/ 14.0 years, 17 of whom were insulin dependent (IDDM) and 14 non-insulin dependent (NIDDM) treated with insulin and diet, were followed for a period of six months. Patients were diagnosed of diabetic autonomic cardiopathy (without other neuropathy causes, nor use of drugs except for insulin) by the alteration of at least 2 of the 5 cardiovascular tests (tCV) performed. Patients underwent an educational diabetes program and self-control, and after 6 months of treatment they were divided into two groups according to the degree of metabolic control. In group 1, in which there was a good control with mean blood sugar levels of 108 +/- 12 mg/dl (5.9 +/- 0.6 mmol/l) and triglycerides of 101 +/- 21 (1.1 +/- 0.2 mmol/l), an improvement in tCV was observed: Valsalva coefficient of 1.16 +/- 0.13 and 1.22 +/- 0.13 (initial and final respectively) (p less than 0.001), with and improvement in 56% of cases; E/I (expiration/inspiration) ratio increased from 1.13 +/- 0.11 to 1.21 +/- 0.11, improving 53% of cases (p less than 0.001); 30/50 index (RR in 30/RR beat in beat 15 after orthostatism) (n.s.); difference in systolic arterial pressure after standing (p less than 0.001) and increase in diastolic arterial pressure with isometric muscular exercise (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1784780 TI - [Reactivation of hepatitis B virus in chronic carriers with anti-HBe]. AB - Thirty-eight hepatitis B virus (HBV) carriers, AgHBs and anti-HBe positive, with histologic diagnosis of chronic hepatitis have been periodically revised for three years. Three of them were homosexuals. Fourteen patients presented reactivation of viral replication characterized by the appearance in serum of HBV DNA and an increase in transaminase levels. Only 7/27 (26%) presented spontaneous reactivation in contrast with 7/11 (64%) patients who had been treated with immunosuppression (p less than 0.05). Furthermore, in 3 cases free AgHBe was temporarily detected during reactivation. Histologic diagnosis and Knodell index were basically similar in reactivated patients and the rest. However, those who presented spontaneous reactivation presented a higher number of AgHB positive cells in liver tissue, both in nucleus and cytoplasm, than patients without reactivation, although, there were no significant differences in relation to the type of reactivation. In summary, this study suggests that immunosuppressants should not be given to HBV carriers with anti-HBe, since this would facilitate the reactivation of viral replication. PMID- 1784781 TI - [Nelson's syndrome concomitant with Cushing's syndrome]. AB - A case is presented of Nelson's Syndrome concomitant with Cushing's Syndrome in a female patient who underwent five years earlier bilateral adrenalectomy due to Cushing's Disease. Together with hyperpigmentation, very elevated ACTH, and intrasellar mass in CT scan, plasma cortisol levels without rythm and not suppressible were observed as well as increased cortisol in urine. The macroadenoma was resected though the sphenoid and later hypophysis radiotherapy was given, with a clinical remission and biochemical improvement of the syndrome. At the present time, slightly elevated ACTH levels persist, with panhypopituitarism and empty sella turcica. The clinical picture is described and a literature search is carried out. PMID- 1784782 TI - [Pulmonary thromboembolism with mobile thrombus in the right atrium. Presentation of a case diagnosed with bidimensional echocardiography and review of the literature]. AB - A case is presented of a pulmonary thromboembolism secondary to detachment of an elongated and mobile thrombus in right atrium, identified by bidimensional echocardiography in a patient without previously identified cardiac pathology. The presence of pulmonary thromboembolism in this patient was confirmed by lung angiography. In-spite of anticoagulant treatment, the patient died four days later due to massive pulmonary embolism, before a surgery could be carried out, coinciding with the disappearance of the right atrium thrombus by bidimensional echocardiography. The echocardiographic characteristics of right atrium thromboembolisms are described as well as their differential diagnosis and the most appropriate therapeutic attitude in these cases based in a literature review. PMID- 1784783 TI - [Current status of the antipneumococcal vaccine: a pending issue]. AB - In spite of antibiotic treatment, mortality due to pneumonia caused by Streptococcus pneumoniae is still considerable and it is related to the presence of bacteremia. Prophylaxis with 23-polyvalent anti-pneumococcus vaccine would prevent severe processes in high risk populations. We present in this work the current status of our knowledge about this vaccine, regarding its efficacy in preventing bacteremia, economic cost, and secondary effects, we point out the indications of this vaccine according to IPAC (Immunization Practices Advisory Committee) and those special situations which modify prophylaxis (pregnancy, revaccination and massive immunizations) are discussed. PMID- 1784784 TI - [Skin-associated lymphoid tissue and its neoplasms]. PMID- 1784785 TI - [The effect of nicotine on plasmatic osmolality]. PMID- 1784786 TI - [Tubal ligation and ectopic pregnancy]. PMID- 1784787 TI - [Familial Hirschsprung disease]. PMID- 1784788 TI - [Yersinia enterocolitica bacteremia and hemochromatosis]. PMID- 1784789 TI - [Hypereosinophilic syndrome with gastrointestinal involvement and pulmonary nocardiosis]. PMID- 1784790 TI - [Localized and systemic reaction caused by the ophthalmic instillation of pilocarpine]. PMID- 1784791 TI - [Cold-induced urticaria with activity of C3 nephritic factor]. PMID- 1784792 TI - [Aspiration of foreign bodies: its importance in adults]. PMID- 1784793 TI - [Risk of transmission of human immunodeficiency virus type 1 after accidents with needles from drug addicts, occurred in the community]. PMID- 1784794 TI - [Non-specific esophageal ulcers cured with steroid therapy in a patient with AIDS]. PMID- 1784796 TI - [Electrocardiographic semiology of progressive Duchenne's muscular dystrophy]. AB - The authors studied the ECGs of 21 boys with Duchenne's progressive muscular dystrophy (group D) aged from 8 months to 10.5 years. They were compared with 21 age matched healthy boys. There were no statistical significant differences between both groups on maximal or minimal heart rates, nor on their subtractions. There were no differences between the electrical axis of P, QRS or T waves in the frontal plane, nor in the duration or amplitude of P waves. R wave in V1 had 1.06 +/- 0.38 (mean +/- 1 standard deviation) mV in group D, and 0.62 +/- 0.29 mV in group C (p less than 0.001). R/S ratio in V1 was 1.24 +/- 0.53 in group D, and 0.70 +/- 0.50 in group C (p less than 0.01). Q wave in V6 had 0.27 +/- 0.18 mV in group D, and 0.13 +/- 0.09 mV in group C (p less than 0.01). Q/R ratio in V6 was 0.19 +/- 0.14 in group D, and 0.09 +/- 0.047 in group C (p less than 0.01). Sensibility, specificity, positive predictive value, and negative predictive values for signs over 75 percentile (Davignon standards) were: for R wave in V1 71.4%, 76.2%, 75%, and 72.7%; for R/S ratio in V1 71.4%, 76.2%, 75% and 72.7%; for Q wave in V6 38.1%, 85.7%, 72.7%, and 58%. PMID- 1784795 TI - [Renal protection in diabetic patients with ACE inhibitors]. PMID- 1784797 TI - [Clinical characteristics of gastric infection caused by Helicobacter pylori]. AB - In a series of 150 patients submitted for diagnostic gastroscopy, a prospective study of nine anamnesis variables and four exploratory ones was done. Endoscopic and histopathologic diagnoses, as well as the clinical data, were obtained by blinded observers. Helicobacter pylory (Hp) presence in antral mucosa was determined by culture. A clear relationship between Hp presence and peptic ulcer disease, bulboduodenitis and histologic gastritis was found, as expected, but no clinical variable correlated positively with it. We conclude, therefore, that Hp presence in antral mucosa cannot be predicted clinically, a fact probably related to the unspecificity of symptoms in gastroduodenal disease and not to a lack of pathogenicity of this organism. PMID- 1784798 TI - [Right ventricular function in sleep apnea syndrome and chronic obstructive pulmonary disease]. AB - The factors that contribute to the development of chronic cor pulmonale (CCP) in sleep apnea syndrome (SAS) are being continuously reviewed, as well as the role played by the coexistence of chronic obstructive pulmonary disease (COPD). Right ventricular function was evaluated in 20 SAS patients, 10 of whom presented associated (COPD). In all of them the following tests were performed while fasting: blood gasometry, spirometry, body mass index and isotopic ventriculography which included the determination of righ ventricular ejection fraction (RVEF). The RVEF of the group presenting COPD (mean +/- DS) (0.43 +/- 0.07) was not significantly different from the group without COPD (0.46 +/- 0.09). When the patients were regrouped according to the presence of hypoxemia during the day (paO2 less than 70 mmHg) a significant difference was evidenced between the mean value of the RVEF group with hypoxemia (n = 10) (0.40 +/- 0.02) and that of the group with normoxemia (n = 10) (0.50 +/- 0.09) (p less than 0.05). There were no statistically significant differences between the degree of obstruction and the BMI in either group. These results suggest that the worsening of RVF is more frequent in SAS patients who present daytime hypoxemia. PMID- 1784799 TI - [Casual arterial pressure versus ambulatory continuous monitoring of arterial pressure]. AB - Ambulatory continuous blood pressure monitorization (ACBPM) has shown that casual blood pressure (CBP) obtained at the Doctors' office is accompanied by alarm reaction (AR) which could overestimate the true blood pressure. We placed a ACBPM (24 hours) in 190 subjects (35 normotense and 155 hypertense). In normotense subjects the CBP was 137 +/- 19/84 +/- 9 mmHg and the mean value in those 24 hours was 121 +/- 11/74 +/- 6 mmHg (p less than 0.001) while in hypertense patients it was 159 +/- 22/104 +/- 11 mmHg versus 139 +/- 17/95 +/- 9 mmHg (p less than 0.001). According to the WHO classification the number of normotense and hypertense subjects varies according to wether we recommend CBP or the mean daily ACBPM. Normotense: 37 versus 53, borderline, arterial hypertension: 22 versus 26, mild arterial hypertension: 52 versus 65, moderate arterial hypertension: 54 versus 38, severe arterial hypertension: 25 versus 8 (p less than 0.005). It is therefore observed that ACBPM offers lower blood pressure values that CBP. PMID- 1784800 TI - [Severe poisoning with digitalis treated by the administration of anti-digoxin antibodies]. AB - A case report of severe digitalis poisoning in a patient with prosthetic heart valve is presented. He complained of nausea, vomiting, drowsiness, temporal disorientation and lethargy. The electrocardiogram showed idioventricular rhythm, and plasma levels of digoxin were 6.78 ng/ml. Predisposing factors por digitalis poisoning were prerenal failure and concomitant quinidine therapy. Treatment with digoxin-immune antibody fragments (FAB) promptly lead to abolition of the ventricular arrhythmia and disappearance of every clinical symptoms in hours. Plasma digoxin levels showed a steep decrease until normal values at the fifth day. The favourable course of either clinical and electrocardiographic response to IV administration of FAB are discussed, stressing the fact of the high morbidity of digitalis poisoning in opposition to the relative safety of Fabs use in its therapy. PMID- 1784801 TI - [Problems in the interpretation of changes in the ST segment after emergency cardioversion]. AB - After cardioversion with continuous current (CV) we can find alterations in the ST segment and T wave, frequently associated with an increase in CPK total and CPKmB, which can lead us to the wrong diagnosis of acute myocardial infarction (AMI). We describe five cases of transitory alterations in ST after CV: four regular tachycardias with wide QRS and an atrial fibrillation with fast ventricular response. CPK, CPKmB and ECG were monitored being the CPK abnormal in all cases. AMI was discarded in all cases. When changes in ST following CV are observed, we believe that AMI should be discarded by ECG and enzymatic monitorization. If doubts persist technetium-99mm pyrophosphate must be used. PMID- 1784802 TI - [Intestinal tuberculosis in acquired immunodeficiency syndrome]. AB - We present a case of disseminated tuberculosis with peritoneal and intestinal involvement in a homosexual patient who presented micronodular fibrosis and was infected by HIV, with an AIDS diagnosis since he had previously presented an esophagitis caused by candida. Diagnosis was made from a sample obtained from an ulcerated lesion from rectum-sigmoid region by colonoscopy, and when stained with Ziehl-Nielsen revealed acid-alcohol resistant bacilli (AARB) identified as M. tuberculosis. The torpid evolution of the process, which was complicated by the uncompensation of the cirrhosis determined the patient's death inspite of treatment. The characteristics of intestinal tuberculosis in HIV infected patients is reviewed. PMID- 1784803 TI - [Curability of malignant lymphoma]. PMID- 1784804 TI - [Which HIV-infected individuals develop AIDS faster?]. PMID- 1784805 TI - [Correlation between blood concentrations of CA 15.3 and estradiol in women with macrocystic disease of breast. Study in function of the type of cyst]. PMID- 1784806 TI - [Influence of the evaluation on the performance of pharmacology students]. PMID- 1784807 TI - [Hypertrophic osteoarthropathy as the first manifestation of bronchopulmonary carcinoma]. PMID- 1784808 TI - [Systemic mastocytosis and explorative laparotomy]. PMID- 1784809 TI - [Synovitis of the knee caused by metastasis of epidermoid carcinoma of the skin]. PMID- 1784810 TI - [Peripheral T-lymphocyte lymphomas and eosinophilia]. PMID- 1784811 TI - [Cutaneous nocardiosis and AIDS]. PMID- 1784812 TI - [Portal hypertension and hepatic fibrosis caused by vitamin A]. PMID- 1784814 TI - Organization and regulation of genes for de novo purine nucleotide synthesis in Bacillus subtilis. PMID- 1784813 TI - Positive and negative regulation controlling expression of the sac genes in Bacillus subtilis. PMID- 1784815 TI - Transcription regulation in Bacillus subtilis phage phi 29. PMID- 1784816 TI - The secretory S complex in Bacillus subtilis is identified as pyruvate dehydrogenase. AB - We have cloned the operon for the Bacillus subtilis S complex, which has been suggested to be a component of the protein secretion machinery. The S-complex operon was found to encode 4 proteins, which were identified as subunits of pyruvate dehydrogenase (PDH). The Staphylococcus aureus membrane-bound ribosome protein (MBRP) complex has been considered to be a counterpart of the B. subtilis S complex. Here, we sequenced a fragment of the MBRP operon encoding the C terminal part of E1 beta, the entire E2 and the N-terminal part of the E3 subunit of PDH, thus conclusively confirming the PDH identity of the MBRP complex as well. It appeared unlikely that PDH could be a primary component in protein secretion, thus disproving the previous hypothesis of the role of the S complex. However, attachment of the S complex (PDH) to the membrane and ribosomes may produce a biologically significant interaction. PMID- 1784817 TI - Levansucrase: a tool to study protein secretion in Bacillus subtilis. AB - The Bacillus amyloliquefaciens levansucrase gene (sacB[BamP]) was engineered in such a way that a heterologous gene could be inserted between the second and third codon of the mature levansucrase. Extracellular levansucrase activity was detected only when the heterologous protein was secreted into the growth medium. A positive selection system to isolate suppressors of signal sequence mutants in Bacillus subtilis has been developed based on the secretion of levansucrase. PMID- 1784818 TI - Cloning and expression of an amylase gene from Bacillus stearothermophilus. AB - In the industrial process of liquefying starch to make glucose or high fructose syrups, it is crucial that the amylase used is stable and active at about 105 degrees C at pH 6.5 or preferentially at a lower pH. The amylase from Bacillus licheniformis is well suited for this purpose but it is possible that other amylases might perform even better. Therefore, we cloned and characterized amyS encoding a heat-stable alpha-amylase from Bacillus stearothermophilus. Using a newly developed method for creating exact gene fusions by in vivo recombination, we attempted to increase expression of amyS in Bacillus subtilis. However, only by introducing the amyS gene into B. licheniformis, we obtained significantly better yields. PMID- 1784819 TI - The protease genes of Bacillus subtilis. PMID- 1784820 TI - Identification of Bacillus subtilis adaptive response genes by subtractive differential hybridization. AB - Subtractive differential hybridization was used to identify genes in Bacillus subtilis that are induced by nutrient limitation. Several transcription units were identified. They exhibited increased transcription when cells were deprived of certain nutrients, such as glucose, ammonium, or phosphate, or when cells were treated with decoyinine. The genes have been designated dci (for decoyinine inducible) and gsi (for glucose-starvation-inducible). Using lacZ transcriptional fusions, the dependence of dci and gsi expression on gene products of the sensor and activator classes of bacterial two-component regulatory systems was examined. Transcription of dciA was impaired by a mutation in spoOA, while expression of gsiA was dependent on the early competence genes comP and comA. The implications of these findings are discussed, and a provisional scheme for information flow during the transition phase from growth to sporulation is proposed. PMID- 1784821 TI - Expression of stage II genes during sporulation in Bacillus subtilis. AB - Two RNA polymerase sigma factors, sigma F and sigma E, are produced during the first two hours of endospore formation in Bacillus subtilis. Transcription of the structural genes for these factors is activated about one hour after the start of endospore formation. The operon encoding sigma F is transcribed by RNA polymerase containing sigma H, another secondary sigma factor, whereas the operon encoding sigma E is transcribed by RNA polymerase containing sigma A, the primary sigma factor in growing cells. Evidently, the coordinate temporal control of these transcriptional units is mediated by a factor other than the sigma factors, possibly by the DNA-binding protein encoded by spo0A. Both sigma F and sigma E activities are also regulated by mechanisms operating after transcription. PMID- 1784822 TI - Spore germination genes of Bacillus subtilis 168. PMID- 1784823 TI - Initiation of chromosome replication: structure and function of oriC and DnaA protein in eubacteria. AB - Recent advances in DNA technology have made it possible to analyse the structure and function of the replication origin region of the chromosomes of various bacteria. Comparative studies have shown that 2 basic elements, the replicator and initiator, involved in initiation of chromosome replication are common to most eubacteria but with differences in the fine organization of these elements. In this article, we first review studies of the structural analysis of the origin regions of bacterial chromosomes, and then we summarize our recent work on the function of the 2 elements in Bacillus subtilis as compared to Escherichia coli, in order to show how organization of the elements is related to the differences in regulation of the initiation of replication in the 2 bacteria. Remarkable conservation of genes and their organization in the replication origin region was found in 5 bacteria representative of 3 major branches of the bacterial phylogenic tree. It was concluded that the conserved region containing the dnaA gene is the replication origin of the ancestral bacterium. Conservation of DnaA protein and its binding sequence (DnaA box) is remarkable, suggesting that they are the initiator and replicator of the chromosomes of most eubacteria. We have recently isolated an autonomously replicating sequence (ars) from B. subtilis. The essential features of ars, the presence of DnaA boxes and repeats of an AT rich 15-mer, are the same as E. coli oriC. However, 2 DnaA-box regions flanking the dnaA gene are both required for B. subtilis ars. The function of DnaA protein in vivo was studied in detail using a temperature-sensitive dnaA mutant in B. subtilis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1784825 TI - Plasmid replication and structural stability in Bacillus subtilis. PMID- 1784824 TI - Post-initiation control of chromosomal replication in Bacillus subtilis: a mechanism for limiting over-replication or for duplicating key growth and sporulation genes? AB - We used the Bacillus subtilis dnaB37 mutant, which is defective in initiation, to synchronize DNA replication in order to identify the first fragments to be replicated following initiation and to study the control of this process under various conditions. We show by DNA/DNA hybridization analysis that, after returning the mutant from 45 degrees C to the permissive temperature (30 degrees C), the origin region relative to other sequences is over-replicated (approximately 2-fold) during the first round. This was confirmed by autoradiographic analysis. The over-replicated region is however limited to about 190 kb on the left and right arms. Replication apparently resumes from these positions during the following round of replication. We propose that, in B. subtilis, in addition to the first level of control at the origin, there is a second level or post-initiation control downstream of the origin which limits DNA replication resulting from premature initiation. We believe that these two levels of control are tightly coupled under conditions of balanced growth. Using the same system, we have now shown that DNA replication is subject to "stringent control", an important regulatory network in bacteria. These studies demonstrate that the inhibition of replication induced during the "stringent response" does not occur at the primary origin. In fact, by DNA/DNA hybridization, replication forks were found to be blocked at similar positions to the post-initiation control sites described above. Moreover, replication appears to resume from regions close to the stalled replisomes upon removal of the stringent response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1784826 TI - The SOB system of Bacillus subtilis: a global regulon involved in DNA repair and differentiation. PMID- 1784827 TI - Termination of chromosome replication in Bacillus subtilis. PMID- 1784828 TI - The European project for sequencing the yeast genome. PMID- 1784829 TI - The project of sequencing the entire Bacillus subtilis genome. AB - The results obtained during the first year of the project involving the sequencing of the Bacillus subtilis genome are presented. Different gene libraries using a yeast artificial chromosome vector and bacteriophage vectors, lambda FixII and phi 105J124, have been constructed. A total of 300 kbp have been cloned using the lambda FixII vector, 68 kbp of which have been fully sequenced. Several open reading frames showing homologies with genes of other organisms were found. Two genes, previously unknown in this organism, have been identified. PMID- 1784831 TI - Modulation of epidermal growth factor binding to receptor by isoproterenol and cholera toxin in primary cultured hepatocytes. AB - The treatment of rat hepatocytes with isoproterenol induced the increase in the affinity of high affinity binding sites and the decrease in the number of low affinity binding sites of epidermal growth factor (EGF). Similar results were obtained from the pretreatment of hepatocytes with cholera toxin. These results suggest that adenylate cyclase affects the affinity and number of EGF-receptor in hepatocytes. PMID- 1784830 TI - From data banks to data bases. AB - The information collected in national and international libraries on nucleotide and protein sequences cannot be directly treated for proper handling by existing software. Therefore we evaluated the feasibility of constructing a data base for Escherichia coli using the data present in the banks. The knowhow thus acquired was applied to Bacillus subtilis. Specific examples of the general procedure are given. PMID- 1784832 TI - Transforming activity of ethylene dibromide in BALB/c 3T3 cells. AB - Ethylene dibromide was capable of inducing in vitro transformation of BALB/c 3T3 cells either in the presence or in the absence of exogenous metabolic activation (S9-mix). This transforming effect was evidenced by the induction of a higher number of transformed foci as compared to the controls performed with untreated cells or solvent vehicle-treated cells. In the absence of exogenous activation, all assayed doses (ranging from 23.4 micrograms/ml to 187.9 micrograms/ml) exerted transforming activity. Number of foci obtained in EDB-treated plates antransformation frequency of the target cells were higher than those detected in the transformation test performed in the presence of S9-mix. PMID- 1784833 TI - Hypothyroidism inhibits the formation of inositol phosphate in response to carbachol in the striatum of adult rat. AB - The effects of hypothyroidism on the muscarinic cholinergic receptor-coupled inositol phospholipid hydrolysis in the adult rat brain were examined. Tissue slices of striatum, hippocampus, and cortex from either euthyroid or hypothyroid rats were labeled with [3H]myoinositol and incubated with carbachol, a muscarinic cholinergic agonist. In other experiments, crude plasma membranes of each brain region obtained from either euthyroid or hypothyroid rats were incubated with [3H]N-methylquinuclidinyl benzilate ([3H]NMeQNB), a muscarinic cholinergic antagonist, in the presence or absence of atropine. Carbachol produced a significant increase in [3H]inositol phosphate ([3H]IP) formation in each brain region in a dose dependent manner. Hypothyroidism caused a marked decrease in carbachol-stimulated [3H]IP formation in the striatum, whereas it did not affect the formation of [3H]IP in the cortex or hippocampus. In contrast, the affinity constant and the maximal binding of [3H]NMeQNB to plasma membranes in these regions were not changed by hypothyroidism. The present results suggest that thyroid hormones might participate in regulating the muscarinic cholinergic neurotransmission in the striatum of adult rat. PMID- 1784834 TI - Cardiac arrest and resuscitation alters the pharmacokinetics of MK-801 in the rat. AB - We investigated the effects of cardiac arrest and resuscitation on (+)-5-methyl 10,11-dihydro-5H-dibenzo[a,d]cyclohepten-5,10-imine meleate (MK-801) pharmacokinetics. The clearance of MK-801 in control animals was 108 +/- 9 mL.kg.min while its apparent volume of distribution was 12.6 +/- 0.7 L/kg. The half-life of the distribution phase was 4.9 +/- 1.2 min while that of the elimination phase was 87 +/- 8 min. Transient circulatory arrest decreased the overall clearance of MK-801 by 38% with no effect on the apparent volume of distribution. The distribution half-life was not affected although the initial distribution was increased 46%; the half-life of elimination was increased by 58%. Serum levels of transaminases in arrested animals were significantly elevated (258-322%) while blood urea nitrogen, creatinine, and creatine kinase were minimally affected, suggesting that the reduced clearance of MK-801 might be secondary to hepatic ischemic damage. Post-ischemic alterations in hemodynamics resulting in lowering and/or redistribution of cardiac output may also be responsible for the reduced clearance of MK-801 as the hemodynamic response to MK 801 in the post-ischemic animals was quite different from that in the controls. We conclude that transient cardiac arrest significantly alters the pharmacokinetics of MK-801 and that this must be taken into consideration when using this or other drugs to treat ischemic injury. PMID- 1784835 TI - Differences in tolerance to hypoxia/anoxia in mice of different ages. AB - Tolerance to hypoxic stress was examined in male C57BL mice of different ages through use of a hypoxic chamber (4% oxygen, 96% nitrogen). The basal survival times in a hypoxic chamber did not significantly differ between mice of different ages (6 wks, 8 wks, 10 months, 28 months). The pretreatment of antihypoxic prostaglandin I2 (PGI2) significantly prolonged the survival time in both adult (10-month-old and aged (30-month-old) mice, but the effect tended to be smaller in aged mice. The effect of sublethal hypoxia treatment on survival time in a hypoxic chamber was minimal in both adult and aged mice, but the effect tended to be smaller in aged mice. IP injection of sublethal doses of potassium cyanide (3.0 mg/kg) significantly prolonged the survival time in a hypoxic chamber when examined 10 min after the pretreatment in immature mice (6 wks), but in adult and aged mice, the survival time tended to be slightly shorter at that time than respective control values without pretreatment. The maximal survival time after KCN pretreatment was longest in immature mice and shortest in aged mice. The results suggest that the basal tolerance to hypoxic stress in mice is little affected by aging. However, the potential antihypoxic mechanisms appear to be progressively affected by aging. PMID- 1784836 TI - The effect of maternal administration of captopril on fetal development in rat. AB - Captopril an angiotensin converting enzyme (ACE) inhibitor, was evaluated for teratogenic potential in Wistar rats. The drug was administered daily from 6 to 15 day of gestation by gavage (0, 3, 10 and 30 mg/kg/day) and perinatal studies were conducted. Captopril decreased food consumption and suppressed gain in body weight. However, no alteration in food efficiency index was observed. The treatment of rats with captopril in doses of 10 and 30 mg/kg, significantly reduced the mean number of implants per litter size and produced intrauterine growth retardation. The incidence of external and visceral malformations were neither dose related nor significantly different from those of controls. In addition, animal treated with these dose levels showed decreased ossification of digits, sternum and skull of the offsprings. The data of the present study indicates that captopril was not found to be teratogenic to Wistar rats. However, adverse effects on intrauterine growth, fetal ossification, neonatal growth and survival rate were seen among the pups. PMID- 1784837 TI - Age- and sex-related effects on hepatic drug metabolism in rats chronically exposed to dietary atrazine. AB - Male and female Wistar rats were administered a diet containing 450 ppm atrazine as early as 60 days prior to the cohabitation period and the same diet was offered to their offspring. Hexobarbital sleeping time and further in vitro assays pointed to a monooxygenase induction which appeared to be more marked in males vs females and most significant in the offspring at weaning. At this age, induction involved also the cytosolic glutathione S-transferase, a phase II enzyme. Results would suggest that the inducing properties of the herbicide can be transferred to the offspring via the placental and/or the mammary route. PMID- 1784838 TI - Perfluorochemical emulsion effect on human albumin binding of valproic acid. AB - At 37 degrees C, valproic acid was weakly bound by a PFCE through an interaction with the emulsifiers that was independent of both buffer and PFCE concentration. The binding by PFCE was dependent on valproic acid concentration in 0.1 M buffer, but not in 0.2 M buffer. The addition of PFCE to 4% HSA increased the percent free valproic acid due to both HSA dilution and displacement of HSA bound drug. This displacement was apparently due to an interaction with the PFC liquids and/or intact PFCE droplets, and with the oleic acid component of the PFCE. PMID- 1784839 TI - Comparison of the effectiveness of dithiocarbamates on the excretion and distribution of cadmium in mice. AB - Sodium N-benzyl-D-glucamine dithiocarbamate (BGD), sodium N-p-hydroxymethylbenzyl D-glucamine dithiocarbamate (HBGD), and sodium N-p-methoxybenzyl-D-glucamine dithiocarbamate (MeOBGD) were evaluated for their efficacy in the distribution and excretion of cadmium in mice exposed to cadmium. Mice were injected i.p. with 109CdCl2 (1 mg Cd/kg and 74 kBq of 109Cd/mouse) and 30 min or 24 h later, they were injected i.p. with chelating agents (5% of an LD50). The results of this study indicated that the injection of HBGD to mice pretreated with cadmium can remove cadmium from the body without redistribution of cadmium to the brain, testes, and heart more effectively than that of BGD or MeOBGD. PMID- 1784840 TI - Inhibition of arylsulfatase B by ascorbic acid. AB - One hypothesis for atherosclerotic lesion formation is the response to injury hypothesis. If catabolism of the ground substance of the intima of blood vessels is viewed as an injury, then inhibition of this catabolism could lead to a decrease in atherosclerotic lesions. Arylsulfatase B catalyses the desulfation of glycosaminoglycans in the catabolism of the intimal ground substance. We have found that ascorbic acid inhibits arylsulfatase B (Km = 2.06 mM, KI = 4.89 mM), thus providing a possible mechanism by which ascorbic acid may decrease atherosclerosis. PMID- 1784841 TI - [Cardiac assist using autologous skeletal muscle]. PMID- 1784842 TI - [Bullous disease of the lung; pathogenesis, progression and therapy]. PMID- 1784843 TI - [Epidemiology and biostatistics in medical research, vol 1]. PMID- 1784844 TI - [Spirography--to be or not to be done]. PMID- 1784845 TI - [ICU syndrome]. PMID- 1784846 TI - [Transvenous and intracardiac two dimensional echocardiography]. PMID- 1784847 TI - [Comparative systemic and regional hemodynamic effects of dopamine and dobutamine in the elderly]. AB - Thirteen elderly subjects underwent a crossover study of dopamine and dobutamine at 5 micrograms/kg/min in order to compare the systemic and regional hemodynamic effects of the two drugs, using Doppler techniques. Although both drugs decreased mean arterial pressure significantly, cardiac index and total peripheral resistance remained unchanged. Both drugs increased heart rate significantly. Since neither drug altered the common carotid, celiac or superior mesenteric flow, there was no significant change in the resistances of these flows. Terminal aortic flow increased significantly and its resistance decreased significantly with both drugs. Both dopamine and dobutamine at 5 micrograms/kg/min act as a positive inotrope in general. Out data suggest, however, that both drugs may act mainly as a positive chronotrope in the aged and that both drugs may have direct effects on the terminal aortic vascular bed since terminal aortic flow increased significantly without augmentation in the cardiac index. PMID- 1784848 TI - [Clinical experience of the Greenfield filter--especially about tilting and distal migration of the filters]. AB - Since December 1985, we used Greenfield filter in 8 patients to prevent pulmonary embolism. Mean follow-up period was 42 month. Recurrence of pulmonary embolism was suspected in one patient after perfusion lung scan. Another patient died from other reasons. Occlusion of the inferior vena cava was not suspected in any patient clinically. Tilting and distal migration of the filters occurred frequently. 3 filters tilted greater than 5 degrees compared with the position immediately after their placement. 5 filters migrated distally more than half the length of a lumbar vertebra. Although there was no severe complications in our series, we should pay attention especially to the position and angle of the filters, since an extreme tilting position of the filter could be a possible cause of serious complications. PMID- 1784849 TI - [Effects of aging on right and left ventricular function in patients with right bundle branch block]. AB - The effect of aging on cardiac function in patients with right bundle branch block (RBBB) was commonly unknown, so left ventricular function and right ventricular function were investigated, using first-pass radionuclide angiography. Twenty-six patients with RBBB and 28 normal subjects were studied at rest and during bicycle exercise. Patients with RBBB but normal cardiovascular systems aged 33 to 75 years were divided into those within 60 years (n = 17) and those over 65 years (n = 9). Using the same method, normal subjects aged 38 to 83 years were divided into those within 60 years (n = 18) and those over 65 years (n = 10). Mean age between normal subjects and patients with RBBB didn't differ significantly. The response of left ventricular ejection fraction in normal groups rose during exercise, but its exercise tolerance function declined with aging. Left ventricular diastolic filling in normal groups declined at rest and during exercise with aging. Left ventricular function in RBBB groups showed the same results as those of normal groups. The response of right ventricular ejection fraction and its exercise tolerance function in normal groups was not influenced by aging. However, in contrast, right ventricular function in RBBB groups decreased with aging. We suggest that the mechanism of decrease of right ventricular function in aging patients with RBBB may be caused by the change of right ventricular contraction which is affected by the aging process. PMID- 1784850 TI - [A predictive value of ventricular tachycardia detected by long-term electrocardiography for sudden cardiac death]. AB - To investigate the predictive value of nonsustained ventricular tachycardia (NSVT) for sudden cardiac death (SCD), 104 patients (37 cases with myocardial disease, 17 with ischemic heart disease, 10 with hypertension, 5 with valvular heart disease, 5 with miscellaneous heart disease and 31 without heart disease) who had NSVT on 24-hour ambulatory electrocardiograms (DCG) were clinically followed. The first survey was performed when mean follow-up period reached to 26 months from the discovery of NSVT and the second one was done 60 months after the first survey. Seven SCD were found during 1st period and 4 additional SCD occurred during 2nd period. The patients with polymorphic NSVT showed more frequent SCD (6 in 11 cases with polymorphic NSVT) than with monomorphic NSVT (5 in 93 cases with monomorphic NSVT), however, the rate of VT, duration and number of episodes recorded on DCG were independent to SCD. Moreover, none of the patients without structural cardiac disease have died suddenly. In this follow-up study, SCD was occurred most frequently in the cases with cardiomyopathy, especially dilated type. PMID- 1784851 TI - [Beneficial effect of diltiazem on pulmonary hypertension in a patient with Hughes-Stovin's syndrome]. AB - A 54 year-old female who had a history of hemoptysis was admitted to our hospital because of dyspnea on effort. Pulmonary arterial pressure was elevated and pulmonary arteriography showed multiple pulmonary arterial aneurysms and occlusion of the left upper lobe pulmonary artery. Systolic pulmonary arterial pressure was 110 mmHg when measured by continuous wave Doppler echocardiography. From the clinical and angiographical findings, we diagnosed this patient as having Hughes-Stovin's syndrome (forme fruste). 30 mg of diltiazem per day was initially used, and 80 mg was used thereafter. After 2 months follow up of the medication with diltiazem, systolic pulmonary arterial pressure decreased from 110 mmHg to 61 mmHg and clinical symptoms improved dramatically. PMID- 1784852 TI - [A case of aortitis syndrome with coronary steal syndrome due to collateral circulation from the right coronary artery to intracranial vessels]. AB - A 44-year old female with aortitis syndrome complained of precordial pain on effort. Exercise electrocardiograms revealed significant ST segment depression in leads II, III, aVF and V. Coronary arteriograms demonstrated no stenosis. However, the right coronary arteriogram revealed collateral circulation arising from the sinus node artery to the bilateral vertebral arteries and the left internal carotid artery. Collateral vessels in aortitis.syndrome arising from the coronary artery to the lung have been reported sporadically. However, to our knowledge, the collateral circulation from the coronary artery to intracranial vessels as seen in the present case has never been reported. In the present case, the left ventricular hypertrophy was observed on electrocardiograms and echocardiograms. It can not be denied that it was a cause of the angina pectoris. However, exercise myocardial scintigraphy showed transient myocardial ischemia at stress on the inferoposterior wall corresponding to leads II, III, aVF and V on electrocardiograms. Therefore, coronary steal syndrome due to the collateral pathway from the coronary artery may be considered a likely cause of the angina pectoris. The collateral circulation was considered to be an important route of blood flow supply to the brain and, at the same time, a cause of coronary steal syndrome and consequently angina pectoris. PMID- 1784853 TI - [Studies on the changes of adaptation with children in the dental setting. The relationship between the changes of adaptation and various psychological tests]. AB - The purpose of this study was to discover the changes in the adaptation of children to the Dental setting, and to discover the relationship between the adaptation, and the personality of the child, the personality of the mother, as well as the relationship between the mother and child. The subjects were 60 two to six year old children and their mothers who visited at the Department of Pedodontics, School of Dentistry, Showa University. The results were as follows: 1) The changes of adaptation were classified in groups of four classes. Four groups: Continuous Adaptability (45.0%) Acquired Adaptability (18.3%) Continuous Inadaptability (16.7%) Extreme Inadaptability (20.0%) 2) The inadaptability groups (Continuous Inadaptability and Extreme Inadaptability) of the two to three year old children did not correlate to the change of adaptation and personality of the child, and the relationship between the mother and child. 3) The extreme inadaptability group with the four year old children showed a connection with the change of adaptation and the various Psychological Tests. Concerning personality, the children showed elements of "dependence" "retrogression" and "maladaptation to school (kindergarten)". Concerning the mother child relationship, there were elements of "anxiety" "dotage" "follow blindly" "disagreement". 4) Nobody showed extreme inadaptability in the group of five to six year old children. Continuous Inadaptability group with the five to six year old children showed scarcely any problems. 5) The Personality of mother did not correlate to the change of adaptation of children in the dental setting. PMID- 1784854 TI - [A study of root resorption of deciduous teeth in dogs. Influence of successional tooth germ and occlusal force]. AB - The role of successional tooth germ and occlusal force in root resorption of mandibular second deciduous molars was studied in 24 beagle dogs by means of radiographic and histologic evaluations. 70 days after birth their mandibular right third permanent premolar germs were surgically removed, and in 10 of the dogs the maxillary right and left second deciduous molars were extracted to decrease the occlusal force on the mandibular second deciduous molars. 1) When successional tooth germs were present, whether the occlusal force was normal or decreased, the alveolar bone and deciduous tooth adjacent to the tooth germ were resorbed, accompanied by eruption of the permanent tooth. After the resorption of the deciduous tooth reached half of the root, many odontoclasts were observed in the dental pulp of the deciduous tooth. The root resorption was hastened by internal resorption. 2) When successional tooth germs were removed, whether the occlusal force was normal or decreased, the root resorption was delayed. The resorption from the root surface progressed very slowly, but shortly after this resorption reached the pulp, internal resorption occurred and the deciduous tooth was resorbed in short time. 3) When the occlusal force was decreased, in the deciduous teeth in which successional tooth germs were present, the tooth resorption tended to delay to a later time. However in the deciduous teeth from which the successional tooth germs were removed, the processes of tooth resorption was very different in individuals, the difference between tooth resorption in normal occlusal force and in decreased occlusal force was not clear. 4) In all groups, shallow resorption on the deciduous root surface was observed before the successional tooth started to erupt, and this resorption was apart from the tooth germ. By repeating resorptive periods and resting periods, this resorption progressed according to the increase in age, and in the resting period, resorption was repaired by new deposits of cementum. PMID- 1784855 TI - [Study on the diagnosis of the deciduous tooth pulpitis by the blood picture in the dental pulp]. AB - The purpose of this study was to investigate the method of diagnosis of deciduous tooth pulpitis to make sure of the extent of the inflammation for more appropriate pulp therapy. The subjects were 100 decayed deciduous teeth of the 81 normal healthy children aged from 2y9m to 11y2m, which justified the vital pulp amputation therapy according to Nagasaka's deciduous tooth pulpitis diagnosis criteria. The blood picture was compared with the histological structure of the coronal pulp and then observed after treatment. The diagnosis of the deciduous tooth pulpitis was considered by the blood picture in the dental pulp. The results were as follows. 1. As to the blood picture in the deciduous dental pulp, it was suggested that the lymphocyte ratio was able to be taken for the discrimination of the deciduous tooth pulpitis, because ratio of lymphocyte in the coronal pulp was higher than its normal values in the peripheral blood picture regardless of the age. 2. As to the histological structure of the removed coronal pulp, the inflammatory degree was divided into 4 types; (-) no evidence of inflammation, (+) slightly confined infiltration of the inflammatory cells, (++) slightly or moderately diffused infiltration, ( ) severely diffused infiltration, when the numbers of the case at each degree type were (-) 0, (+) 37, (++) 47 and ( ) 16 cases. 3. As to the ratio of the lymphocyte ratio over 60% against all at each degree type, (+) 86.5% and (++) 61.7% were much higher than ( ) 0%. 4. The ratio of cases in which it was difficult to control bleeding at ratios of the coronal pulp amputations were type (+) 32.4% and (++) 25.5% in type, however, type ( ) showed high rate (62.5%). 5. As a result of the clinical and X-ray examination after vital pulp amputation therapy, the number of poor case was 12 of 42 cases (28.6%) in type (+) (++) and 4 of 4 cases (100%) in type ( ). 6. This result suggests that the vital pulp amputation therapy is not adequate when it is hard to control bleeding and the lymphocyte ratio of blood picture in the coronal pulp shows under 57%. PMID- 1784856 TI - [A supernumerary primary tooth inducing impaction of primary incisor: a case report]. AB - A case of a primary supernumerary tooth in a 18 month old girl was reported. 1. The supernumerary tooth was located in the maxillary incisor area. 2. The maxillary left primary central incisor and the primary supernumerary tooth were impacted. 3. The clinical and radiographic findings indicated that the primary tooth in the mesial position was the supernumerary tooth, and therefore it was removed. 4. Three days after extraction of the mesiodens, the left primary central incisor erupted. The tooth completely erupted in two months. 5. The radiographic examination showed no supernumerary succedenous teeth. PMID- 1784858 TI - [A study concerning radiographic diagnosis in dental caries of primary teeth. 1. The investigation on the indications for pulpotomy with formocresol]. AB - The prognosis in the pulpotomy procedure with Formocresol during primary teeth has an excellent clinical results. On the other hand, some reports of a poor prognosis in radiographic findings were found. To obtain valuable information about the indications for pulpotomy procedures is quite difficult in the case of children concerning. In 1972, Kurihara reported radiographic findings the indications for the pulpotomy procedure in primary molars with a stable stage having no root absorption. The authors investigated the clinical and radiographic changes 6 months after the pulpotomy procedure with Formocresol. 26 primary lower molars having four criteria obtained from 3 to 7 year old patients were treated, and 4 primary lower molars were used as controls without the criteria. We found that the dental lamina dura were an especially important finding to judge the indications for pulpotomy with Formocresol in primary molars. PMID- 1784857 TI - [Oral condition of infantile acute lymphatic leukemia with microbisme substitute]. AB - The oral condition of a 7 year old boy at the 12th and 13th remission induction therapy sessions since contracting acute lymphatic leukemia was investigated clinically and microbiologically. The findings obtained were as follows: 1) The appearance of gingivitis coincided with the decrease of white blood cells 7 to 9 days after administration of the anti-leukopenic drugs. 2) Gingivitis appeared on the same site of the oral cavity at both remission induction therapies sessions. 3) The bleeding from the gingival lesions corresponded to the decrease of blood platelet at both remission induction therapies sessions. Conversely, gingivitis disappeared with the improvement of peripheral blood conditions. 4) The total number of oral bacteria decreased after administration of the antibiotics, although the ratio of Candida in the oral microbial flora increased markedly. 5) Typical symptoms of oral candidiasis were not observed after the appearance of the microbisme substitute. PMID- 1784859 TI - [A case report on the achondroplasia and its dental findings]. AB - Achondroplasia is characterized by an undergrowth of arms and legs bones, low height and undergrowth of the Basis cranil. The name of this disease was called Chondrodystrohia foetalis before Parrot reported the name of this disease as Achondroplasia, distinguished from other similar diseases. We are reporting in this paper on an 11-year, 2-month-old girl with Achondroplasia. The dental findings as follows: 1) Open bite was observed for the front teeth. 2) The size, number, form and growth of the teeth were usual. 3) The tongue was a little bigger than usual. 4) According to X-ray cephalometric analysis, undergrowth of the Basis cranii and relative anterior cross-bite were visible. PMID- 1784860 TI - [The extraction of a completely impacted upper second deciduous molar: case report]. AB - A 7-year old boy visited the dental hospital complaining that the upper left second deciduous molar had not erupted. Radiographs showed that the crown of this tooth existed near the apex of the upper left first molar. Inversion of the second deciduous molar and second premolar was definite. There were no differences in location, size and shape between the left and right second premolars. A tooth-like object was observed near by the germ of the left second premolar. The impacted molar was examined histopathologically after extraction and consequently it was found that it was a supernumerary tooth. New radiographs were made which suggested that the succedaneous premolar developed normally. The tooth germ of the primolar develops on the lingual side of the deciduous molar and moves in the level of the occlusal plane of the primary molar. Later they are found between the divergent roots and, at the end of the pre-eruptive phase, below the roots of the primary molars. We concluded that the supernumerary tooth disturbed this adjustment. PMID- 1784861 TI - [A case report of supernumerary deciduous teeth with the permanent successor in the maxillary region]. AB - We found pure primary supernumerary teeth in the maxillary right deciduous incisor region of a 3 year 11 month old girl. We reported the results of her oral and X-ray analysis results. We would like to report our findings on the results of her oral and X-ray analysis. 1) Two of the primary supernumerary teeth were found between the incisor and canine teeth in the right side of the primary dental arch, and their color, form and size were very similar to normal primary lateral incisor teeth. 2) We also found pure secondary supernumerary teeth by means of X-ray analysis. 3) We suggest that the permeability of the X-ray is important for the ascertainment of both primary and secondary supernumerary teeth by mean of X-ray analysis. PMID- 1784862 TI - [A case of a calcifying odontogenic cyst associated with odontoma inducing impaction of a deciduous tooth]. AB - A 4-year-old boy was examined with a chief complaint of "Delayed eruption of maxillary right deciduous central incisor". Oral examination revealed a firm swelling on the labial gingiva at the right deciduous incisor of maxilla. Radiographic examination revealed that odontoma-like substances disturbed the eruption of the central deciduous maxillary incisor. The odontoma-like substances were removed surgically and examined histopathologically. The thin sections showed findings typical of a Calcifying Odontogenic Cyst with Odontoma. PMID- 1784863 TI - [The stomatognathic function in a case of hemifacial hypertrophy--findings of mandibular movement]. AB - We have been treating a girl with hemifacial hypertrophy since she was 5 years 8 months old. We analyzed her stomatognathic function, the dentition and occlusion, X-ray findings of TMJ, tooth contact and measurements of mandibular movement, at 9 years 2 months. The results were as follows: 1. The maxillary dental arch was almost symmetrical, but the mandibular one was complicatedly distorted in the up and down directions, and largely shifted to the left side. As a result the patient was able to occlude in the severe cross-bite condition of the area from incisors to left molars. 2. The patient had many tooth contact points on the right side and few on the left side when she bit at the intercuspal position and at the both lateral excursions. 3. From the analysis of the mandibular movements on the protrusion, lateral excursion and maximum open and close positions, it was suspected that the shift of right condyle was much less than the left one, and showed as almost rotating movement. 4. It could be concluded that the patient was accustomed to having more tooth contacts in the right dentition than in the left one because of the hypertrophy of the right half of mandible, so that she could only masticate with the right teeth also the anterior displacement of disk with reduction was resulted on the right condyle and the asymmetrical mandibular movement was noted. PMID- 1784864 TI - [Resin adhesion on the young permanent ground enamel (Report 3)]. AB - The purpose of this study was to investigate the influence of thermal cycling on the adhesion of the resin on the young permanent ground enamel which was etched with different etching times. Labial surfaces of 50 extracted and frozen bovine mandibular young permanent incisors were used. The etchant used in this study was 40% phospholic acid gel and the etching times were 0, 10, 20, 30 and 60 seconds. All of the specimens were washed with an air water spray after etching. The bonding agent and composite resin used in this study were Photo Bond and Photo Clearfil A (Kuraray Co.). After thermal cycling tests of 10,000 temperature cycles between 60 degrees C and 4 degrees C water baths, shear bond strengths on the ground enamel were measured. After the shear bond strength tests, all the test surfaces of the enamel and resin specimens were observed using the SEM. The results of this study were compared with the previous results which were not thermal-cycled. The following conclusions were obtained. 1) The etching time which showed the highest bond strength was 30 seconds (45.21 +/- 8.49 Mpa). 2) When the enamel was etched with all of the etching times, the bond strength were significantly higher than that of the enamel without etching. 3) In the etched groups, the bond strength with 20 seconds of etching time was significantly lower than those with 10, 30 and 60 seconds of etching times. 4) In the 10, 30 and 60 seconds etching times, the bond strengths with thermal-cycled groups were significantly higher than those without thermal-cycled groups. 5) On the enamel specimens after the shear bond strength tests, the frequency of the clear prism structures observed on the enamel was higher in the groups which showed higher bond strengths. However, the differences were not significant. PMID- 1784865 TI - [Study of root canal cements comprising calcium aluminate. First report on cytotoxicity]. AB - We prepared new root canal cements for trial. These cements were comprized of calcium aluminate and calcium hydroxyde for setting in a root canal and a bioabsorbable property. The biocompatibility of these cements were then evaluated with kinds of cytotoxicity tests and were compared with three kinds of root canal cements on the market such as Calvital (CV), Canals (CA) and Neodyne (ND). As a result of the millipore filter test using HeLa cells, three kinds of trial cements and CV showed moderate cytotoxicity at every stage. The toxicity of CA and ND were related to the period of administration and the two products showed severe cytotoxicity 24 hours after the administration. The cell growth inhibition test using L-929 cells revealed that the inhibition of the three kinds of trial cements was based on a strong alkalinity caused by calcium hydroxyde and the inhibition on the cell growth was related to the calcium hydroxyde content in these cements. However, the inhibition of these cements was smaller than that of CV and they showed no inhibition in the last stage of the cell culture, while CA and ND caused the mild inhibition. Therefore, we have concluded that these trial cements are useful for root canal filling because they have better affinity to the cultured cells than CV, CA and ND. PMID- 1784866 TI - [Fluoride uptake from fluoride releasing resin as an orthodontic adhesive on human enamel]. AB - FluoroBond is one kind of fluoride releasing, visible light-activated bonding system for orthodontic bracket placement. The first aim of this study was to investigate the fluoride release from FluoroBond. The second aim of this study was to determine the fluoride uptake by human enamel which was immersed in distilled water for 30 days in contact with FluoroBond. The third aim of this study was to demonstrate the fluoride uptake by human enamel adjacent to the bracket as well as by the human enamel beneath the bracket which was placed using FluoroBond, and immersed for 30 days in distilled water. The results obtained were as follows. 1) A great amount of fluoride was released from FluoroBond immediately after immersion. The fluoride released weakend rapidly over the first 10 days. However, the fluoride released became stable after the 10th day. 2) The uptake of fluoride from FluoroBond was large both on the surface and the subsurface enamel in contact with it. 3) When FluoroBond was used as a bracket bonding material, fluoride was absorbed from FluoroBond by the enamel not only under the bracket but also adjacent to the bracket. PMID- 1784867 TI - [An epidemiological study on dental caries of children in the town of Fuji. 3. Correlation between dental caries and personality characteristics]. AB - A statistical study was carried out to evaluate the dental caries of permanent teeth in the elementary school children (208 boys and 165 girls, 373 children of total) in the town of Fuji, Saga Prefectur, which is a mountain village, by means of psychological test and investigation of the living environment of children and their parents. The following results were obtained: 1. In analysis of the relationship between the increase of dental caries and personality characteristics, was shown a tendency toward a low degree of direct of correlation. However, in analysis of quantification type III, it was proven that personality characteristics that as dependency, regression, nervousness and emotional instability related to an increase in dental caries. 2. In the analysis of the relationship between living environments and personality characteristics, a tendency towards a low personality profile was recognized in the children with an increase of dental caries. 3. In pasticvcal, there was a distortion of the personality characteristics of slef-uncontrol and dependency. 4. In comparing the first half of the elementary school year with the last half, a difference in the living environment and personality characteristics was observed during the last half year. 5. The results obtained in this study indicated that early discovery of problems in the living environment and synthetic approach during the first half of the elementary school year were important for the prevention of dental caries of permanent teeth. PMID- 1784868 TI - [Subgingival microflora in children of early childhood, school age and circumpuberty. The proportion and frequency of gram-negative bacteria in periodontally healthy and gingivitis groups]. AB - The present study characterized the microbial profiles of the gingival sulci in children. Subgingival samples from 36 gingivitis lesions of 18 patients and 36 sites in 18 healthy persons were examined. The tested individuals were divided into three stages according to physiological maturation i.e. early childhood, school age, circumpuberty. Puberty was confirmed through examination of wrist radiographs. Using continuous anaerobic techniques, samples were dispersed, diluted and then inoculated on selective and nonselective media and cultured under the condition appropriate gaseous phase respectively. Isolates were identified microbiologically and counted. All values were evaluated statistically. The samples were simultaneously examined by dark-field microscopy. Changes in the proportions and the frequency of periodontophathic bacteria were distinct in different stages of physiological maturation. Black-pigmented Bacteroides species were commonly found in gingivitis lesions. Bacteroides intermedius was frequently detected in the subgingival samples from children with gingivitis. In all stages, the proportion of black-pigmented Bacteroides and B. intermedius in the gingivitis groups were found to be significantly higher than that of the healthy groups. Statistical analysis revealed that levels of B. intermedius increased in circumpuberty stage compared with the 2 younger stages. Black-pigmented Bacteroides and B. intermedius were closely related to GI, PlI in 3 stages. Bacteroides gingivalis was found only in two gingivitis sites of a circumpubertal child with gingivitis. Actinobacillus actinomycetemcomitans was detected in 4 out of 12 sites in the school age group, and in 6 out of 12 sites in the circumpuberty group with gingivitis respectively. In the circumpuberty group, the proportion of A. actinomycetemcomitans in the gingivitis group was significantly higher than that of the healthy group, and A. actinomycetemcomitans was closely related to GI, PlI, CI, PPD. Eikenella corrodens was found to be associated with gingivitis in the school age and circumpuberty groups. No correlation was found in the detection of Fusobacterium nucleatum in 3 stages. Microscopic examination showed that the proportion of rods, fusiforms, filaments, motile rods, spirochetes in the gingivitis groups was significantly higher than that of the healthy groups, while the proportion of cocci in gingivitis groups was significantly lower than that of the healthy groups in 3 stages. Spirochetes were closely related to GI, PlI, PPD in all stages. PMID- 1784869 TI - [Caries-inducing activity of soybean-oligosaccharide (SOR) in vitro and in experimental dental caries of rats]. AB - The caries-inducing activity of soybean-oligosaccharide (SOR: stachyose- and raffinose-rich sugar mixture) was examined in in vitro and in vivo experiments. Streptococcus mutans MT 8148R fermented SOR and produced acids. However Streptococcus sobrinus 6715 did not ferment. SOR was not able to act as a substrate for crude glucosyltransferases (GTase) of these mutans streptococci to synthesize the water-insoluble glucan. However, SOR did not inhibit the synthesis of water-insoluble glucan from sucrose by crude GTase. SOR was proved to be of low cariogenicity in rats infected with S. sobrinus 6715. PMID- 1784870 TI - Peripheral vascular disease. Benefits of exercise. PMID- 1784871 TI - Sports injuries and oral contraceptive use. Is there a relationship? PMID- 1784872 TI - Quantification of training in competitive sports. Methods and applications. AB - The training of competitive athletes can be assessed by retrospective questionnaires, diaries, physiological monitoring and direct observation of training behaviour. Questionnaires represent the most economical, most comprehensive and least accurate method. Diaries are more valid, but their drawbacks for long term quantitative studies are poor compliance and difficulties in processing the data they generate. Physiological monitoring (of oxygen consumption, heart rate or blood lactate concentration) provides objective measures of training intensity, and direct observation gives valid measures of most aspects of training; however, these methods are impractical for continuous, long term use. Coaches and athletes quantify training for purposes of motivation, systematisation of training and training prescription, but there has been little study of the use of training quantification by these practitioners. Motivation and systematisation are probably achieved best with diaries. Direct observation appears to be the best method of ensuring compliance with a training prescription, although heart rate monitoring is also a promising method for prescribing endurance training intensity. Sport scientists quantify training to study its effects on the performance and health status of competitive athletes. Most studies have been descriptive rather than experimental, and unvalidated questionnaires have been the predominant method of assaying training. The main areas of research include performance prediction and enhancement, overtraining, reproductive dysfunction, injury, illness, and nutritional status. Training has substantial effects in all of these areas. There is a need for more experimental studies that utilise validated measures of training to investigate how to reduce sports injuries and enhance competitive sports performance. More attention could also be given to methodological issues of training quantification. PMID- 1784874 TI - Eating disorders in female athletes. PMID- 1784875 TI - Feasibility of improving running economy. PMID- 1784873 TI - Mechanisms of exercise-induced muscle fibre injury. AB - Exercise for which a skeletal muscle is not adequately conditioned results in focal sites of injury distributed within and among the fibres. Exercise with eccentric contractions is particularly damaging. The injury process can be hypothesised to occur in several stages. First, an initial phase serves to inaugurate the sequence. Hypotheses for the initial event can be categorised as either physical or metabolic in nature. We argue that the initial event is physical, that stresses imposed on sarcolemma by sarcomere length inhomogeneities occurring during eccentric contractions cause disruption of the normal permeability barrier provided by the cell membrane and basal lamina. This structural disturbance allows Ca++ to enter the fibre down its electrochemical gradient, precipitating the Ca++ overload phase. If the breaks in the sarcolemma are relatively minor, the entering Ca++ may be adequately handled by ATPase pumps that sequester and extrude Ca++ from the cytoplasm ('reversible' injury). However, if the Ca++ influx overwhelms the Ca++ pumps and free cytosolic Ca++ concentration rises, the injury becomes 'irreversible'. Elevations in intracellular Ca++ levels activate a number of Ca(++)-dependent proteolytic and phospholipolytic pathways that are indigenous to the muscle fibres, which respectively degrade structural and contractile proteins and membrane phospholipids; for instance, it has been demonstrated that elevation of intracellular Ca++ levels with Ca++ ionophores results in loss of creatine kinase activity from the fibres through activation of phospholipase A2 and subsequent production of leukotrienes. This autogenetic phase occurs prior to arrival of phagocytic cells, and continues during the inflammatory period when macrophages and other phagocytic cells are active at the damage site. The phagocytic phase is in evidence by 2 to 6 hours after the injury, and proceeds for several days. The regenerative phase then restores the muscle fibre to its normal condition. Repair of the muscle fibres appears to be complete; the fibres adapt during this process so that future bouts of exercise of similar type, intensity, and duration cause less injury to the muscle. PMID- 1784876 TI - Diet and body composition. Effect of very low calorie diets and exercise. AB - Obesity is the presence of excess body fat and is associated with a variety of medical conditions which increase morbidity and mortality. Millions of individuals participate in weight-reduction programmes which include reduced calorie diets and may also include exercise. Very low calorie diets (VLCD) of 400 to 800 kcal/day appear attractive as they generally show an increase in weight loss from 0.2 to 0.5 kg/week found with the traditional diet to 1.5 to 2.0 kg/week. Early use of very low calorie diets with poor quality protein and loose medical supervision resulted in about 60 deaths, many of which were attributed to loss of lean body mass and in particular, cardiac muscle atrophy. Although current very low calorie diets are presumed safe, concern regarding preservation of lean body mass (LBM) remains. Investigators have used exercise to slow the depletion of lean body mass during very low calorie diets; however, the results are not conclusive. A host of different methodologies and questionable documentation and design of exercise protocols precludes a definitive statement for the benefits of exercise during very low calorie diets for the purpose of LBM retention. PMID- 1784877 TI - Osteitis pubis in athletes. Infection, inflammation or injury? AB - Medical records of 59 patients (9 females and 50 males), who presented to sports medicine clinics at the Australian Institute of Sport and the University of British Columbia between 1985 and 1990 and who were diagnosed as suffering osteitis pubis, were reviewed and comparison of data obtained was made with the literature. Women average 35.5 years of age (30 to 59 years) and men 30.3 years (13 to 61 years). Sports most frequently involved were running, soccer, ice hockey and tennis. Clinical presentations of osteitis pubis fell into 4 main groups. 'Mechanical' (sport-related) was the largest group (n = 48), followed by 'obstetric' (n = 5), 'inflammatory' (n = 4) and 'other' (n = 2). Period of follow up averaged 10.3 months (1 to 20 months) in women and 17.5 months (2 to 96 months) in men. Full recovery, when documented, averaged 9.5 months in men and 7.0 months in women. Osteitis pubis recurred in 25% of these men and none of these women at follow-up. The most frequent symptoms were pubic pain and adductor pain. Men also presented with lower abdominal, hip and perineal or scrotal pain; women with hip pain. Most common signs were tenderness of the pubic symphysis and tenderness of adductor longus muscle origin. Men also revealed tenderness of one or both the superior pubic rami and evidence of decreased hip rotation (unilateral or bilateral). Evidence of pelvic malalignment and/or sacroiliac dysfunction was frequently seen in both men and women. There was poor correlation between radiographic and isotope bone scan findings and the site and duration of symptoms and signs. Femoral head ratios were estimated on 30 hips in the series and 2 were judged to be at the upper limit of normal, perhaps indicating a form of epiphysiolysis producing tilt deformity of the head of the femur. It is clear that osteitis pubis in athletes is not uncommon and that factors such as loss of rotation of hips and previous obstetric history are important in the aetiology and management of this condition. Pelvic infection, which was believed to be the primary factor of osteitis pubis in the literature up until the 1970s, plays a very small role in this condition in athletes. PMID- 1784878 TI - The need for carbohydrate intake during endurance exercise. PMID- 1784880 TI - Impact of reduced training on performance in endurance athletes. AB - Many endurance athletes and coaches fear a decrement in physical conditioning and performance if training is reduced for several days or longer. This is largely unfounded. Maximal exercise measures (VO2max, maximal heart rate, maximal speed or workload) are maintained for 10 to 28 days with reductions in weekly training volume of up to 70 to 80%. Blood measures (creatine kinase, haemoglobin, haematocrit, blood volume) change positively or are maintained with 5 to 21 days of reduced training, as are glycogen storage and muscle oxidative capacities. Submaximal or improved with a 70 to 90% reduction in weekly volume over 6 to 21 days, provided that or improved with a 70 to 90% reduction in weekly volume over 6 to 21 days, provided that exercise frequency is reduced by no more than 20%. Athletic performance is improved or maintained with a 60 to 90% reduction in weekly training volume during a 6 to 21 day reduced training period, primarily due to an enhanced ability to exert muscular power. These findings suggest that endurance athletes should not refrain from reduced training prior to competition in an effort to improve performance, or for recovery from periods of intense training, injury, or staleness. PMID- 1784881 TI - Functional rehabilitation of the cruciate-deficient knee. AB - 'Functional rehabilitation' is an embellishment of the traditional concepts of rehabilitation which are motion and strength. Functional rehabilitation incorporates the concepts of agility, proprioception, and finally the confidence of the individual when performing whatever task he or she wishes to undertake. The determinants of rehabilitation include the patient, the type of injury the knee has sustained as well as its surgical treatment, and how innovative the director of rehabilitation is. The principles of rehabilitation include joint motion and stability as well as muscular endurance and strength. These should be considered during the immobilisation phase, the surgical and postsurgical phase, and continued through the early healing, late healing and final healing stages. The rehabilitation director must advance activity to levels of ever increasing complexity. Various modalities of rehabilitation such as bracing, passive motion machines and muscle stimulation units should be added in an effort to achieve a painless course. This course is progressive as long as errors of rehabilitation are avoided, including overtraining and too rapid a progression resulting in injury or reinjury. Realistic goals must be firmly established in the mind of the patient and the director at the outset. Determinants of rehabilitation are a guide to the reality of reaching a functional level. The functional activity programme depends upon knee stability, successful completion of lesser activities and healing of the injury or the surgery. Progressing from less difficult to more difficult activities before the patient is ready usually results in an injury or reinjury. Therefore, constant assessment of the performance level of the patient must be made before advancing to more demanding activities. Conservative and surgical treatment programmes for functional rehabilitation are essentially the same except for the time factors involved. The times of completion of different levels of activity are generally longer in the surgical programme. Time alone is not the signal for advancement from one programme to another. Attention should be paid to range of motion, strength, fluidity of performance of functional activities as well as functional testing. PMID- 1784879 TI - Exercise and heart transplantation. A review. AB - Results of heart transplantation as therapy for end-stage cardiac diseases are encouraging not only because of actuarial survival curves but also because of the recovered quality of life for the heart transplant recipient. Although heart transplantation drastically improves the physical capacity of the patients, heart recipients still have a reduced maximal aerobic capacity compared to healthy people. Altered resting and exercise haemodynamics, due to cardiac denervation, are a common finding after orthotopic heart transplantation: increases in heart rate and stroke volume at exercise are first linked with the augmented venous return and later with the increased plasmatic nor-adrenaline level. Maximal heart rate and stroke volume are both reduced when compared to innervated heart. Reduced cardiac output response to exercise therefore results in early anaerobic metabolism, acidosis, hyperventilation and diminished physical capacity. In spite of an altered ventilatory adaptation to exercise, characterised by hyperpnoea in most transplant patients, ventilation is not the limiting factor for exercise in heart recipients without associated obstructive pulmonary disease. Endurance training restores lean tissue, decreases submaximal minute ventilation, increases peak work output, maximal ventilation and peak heart rate. Guidelines for prescribing exercise are not yet standardised due to the limited number of studies on a sufficient cohort of heart recipients. Nevertheless, recommendations similar to those used for persons with coronary heart disease, with modifications due to the denervated heart, seem to be used. The cardiocirculatory and pulmonary capacity of heart transplant recipients allow them to undertake endurance sports activities such as walking, jogging, cycling and swimming, and these should be encouraged. PMID- 1784882 TI - Intravenous regional administration of methylprednisolone in rheumatoid arthritis. AB - Intravenous regional administration of corticosteroid (IVRAS) in the treatment of rheumatoid arthritis of the hand has not been reported previously. The method is based on a modification of Bier's block, with substitution of corticosteroid for local anaesthetic. Twenty-two patients were assessed in this double-blind, placebo-controlled study. The technique was safe and effective in improving grip strength, with a group mean improvement of more than 50%. Because suppression of endogenous cortisol production 24 h after treatment was commensurate with the dose of methylprednisolone used (40 mg), we could not exclude that the response may have been due to systemic steroid. Further studies are required to define the real value of IVRAS as it may offer alternative treatment of the joints and tendons within the hand and wrist in some patients rather than more prolonged oral therapy or individual, multiple joint or sheath injections. PMID- 1784883 TI - Demonstration of lymphatics in human synovial tissue. AB - Using a cocktail of monoclonal antibodies PAL-E and DE-U-10 (anti-desmin), combined in double labelling techniques with the lectin Ulex europaeus agglutinin I (UEAI), vessels consistent with lymphatics were demonstrated in normal human synovial tissue. These vessels were negative for the monoclonal cocktail and positive for UEAI, were thin-walled and were located close to deep arterioles and venules as expected. Elastin was not found to assist identification of lymphatics in synovium. In rheumatoid arthritic synovium no vessels staining in the manner of normal lymphatics were found. This may indicate absence or change of phenotype of this type of endothelium in disease. PMID- 1784884 TI - Rheumatic disease in a Philippine village. II: a WHO-ILAR-APLAR COPCORD study, phases II and III. AB - Many difficulties were encountered in a population survey of rheumatic complaints in a remote village area in the Philippines affecting the reliability of estimates of population prevalence. In phase I, a simple questionnaire identified 269 adults out of 950 who had rheumatic symptoms. In Phase II, 234 or 87% of positive respondents were requestioned using a more detailed pro forma. There were 196 with peripheral joint pain, 67 with neck pain and 137 with back pain. One third attributed their symptoms to work and 127 subjects had to stop work because of their complaints. Disability, including an inability to carry loads, affected nearly 1.8% of the population. Questions designed to detect rheumatoid arthritis and gout were not satisfactorily answered. Of those with complaints, 82% indicated that they still required help for their symptoms. In phase III, 166 subjects were medically examined. Osteoarthritis of the knee was found in 25 and 17 had Heberden's nodes. There were 16 with epicondylitis; 16 had rotator cuff pain and 35 had levator scapulae insertion pain. Three of these and three others had neck or shoulder swellings related to carrying loads on poles. Definite rheumatoid arthritis was diagnosed in two subjects and gout in five. No case of ankylosing spondylitis was identified. Thus, rheumatic complaints were common in this rural community and were frequently severe enough to cause disability and loss of time from work. Health worker education is required on how to handle these problems. PMID- 1784885 TI - Immunoglobulin isotype composition of circulating and intra-articular immune complexes in patients with inflammatory joint disease. AB - The immunoglobulin (Ig) heavy chain isotype composition of intra-articular and circulating immune complexes (ICs) were determined by a Raji cell flow cytometric assay in paired serum and synovial fluid samples from 15 patients with rheumatoid arthritis (RA) and 15 patients with other articular diseases (osteoarthritis, ankylosing spondylitis, gout, psoriatic arthritis, Reiter's disease). ICs were most prevalent in synovial fluid samples of patients with RA but were infrequently detected in serum and synovial fluid samples from the non-RA patients. ICs in patients with RA were heterogeneous both in the prevalence of Ig subclasses identified and in the distribution of the respective Ig isotypes within the complexes. Furthermore, differences were observed in the Ig isotype composition of ICs in paired serum and synovial fluid samples indicating that circulating ICs may not always arise simply by spill-over from articular sites. The possible mechanisms for IC formation in RA are discussed with reference to four patients who displayed features of extra-articular disease. PMID- 1784886 TI - Immunoglobulin allotypes are not associated with HLA-antigens, autoantibodies and clinical symptoms in systemic lupus erythematosus. Members of the SLE Study Group. AB - Immunoglobulin heavy chain (G1m, G2m, G3m, A2m) and kappa light chain (Km) allotype and phenotype frequencies of 323 central European Caucasian patients with systemic lupus erythematosus (SLE) were examined and correlated with various genetic, serologic and clinical markers of SLE. No significant associations were found between immunoglobulin allotypes or phenotypes and all 20 parameters tested (nephritis, vasculitis, arthralgias, photosensitivity, discoid lesions, central nervous system disease, Raynaud's phenomenon, sex, anti-Ro, anti-La, anti-nRNP, HLA-DR1-DR7, HLA phenotypes B8-DR3, B7-DR2). It could therefore be assumed that Gm, A2m and Km allotypes were not associated with HLA-antigens and had no influence on the serologic and clinical expression of SLE. PMID- 1784887 TI - MRI of knee arthritis in rheumatoid arthritis and spondylarthropathies. AB - The knees of fifty-two patients suffering from rheumatoid arthritis (RA), 22 patients with seronegative spondylarthopathies (SA) as well as of 20 healthy volunteers were examined by magnetic resonance imaging (MRI). Osseous erosions (RA 52%-SA 18%; P less than 0.005), Baker cysts (RA 56%-SA 12%; P less than 0.005), pannus formation (RA 67%-SA 36%; P less than 0.05), and cartilage thinning with narrowing of the joint space (RA 46%-SA 18%; P less than 0.05) proved to be more frequent MRI findings in patients with RA. Additionally, in patients with RA erosions were more extensive. Follow-up MRI examinations of 19 patients revealed an improvement in MRI changes in SA within an average interval of 6 months. No substantial changes were noted in 7 of 13 RA patients. Quantitative and qualitative MRI findings of knee arthritis differ in patients with RA and SA and this was statistically significant. However, as there is considerable overlap of the MRI and radiographic changes in both groups the discriminating diagnostic value in the individual case was limited. PMID- 1784888 TI - S-ibuprofen versus ibuprofen-racemate. A randomized double-blind study in patients with rheumatoid arthritis. AB - Ibuprofen (ibu) is a racemic 2-arylpropionic acid non-steroidal anti-inflammatory drug whose activity is due mainly to the S-enantiomer. So far only the racemic compound is in clinical use. A double-blind randomized trial was carried out for a 2-week period in 50 patients with classical rheumatoid arthritis (RA) (Steinbrocker II-III) to compare the effectiveness and tolerance of S-ibu (400 mg T.I.D.) with that of the racemic compound (600 mg T.I.D.). Ritchie-index, limitation of movement, joint pain on pressure and pain at night decreased significantly in both groups. Due to lack of effectiveness, the dose had to be increased in 3 patients from the S-ibu group as well as in 6 patients from the racemic group resulting in mean daily doses of 1220 mg S-ibuprofen and 1870 mg racemic ibu. No statistically significant difference could be found between both groups concerning efficacy and unwanted effects. Therefore, S-ibu given alone may be advantageous because the metabolic load to the human body is reduced and patients are more likely to comply with drug doses of 1.2 g/day as compared to 1.8 g/day. PMID- 1784889 TI - Histology of joint inflammation induced in rats by cell wall fragments of the anaerobic intestinal bacterium Eubacterium aerofaciens. AB - To study the arthropathic properties of human intestinal bacteria, cell wall fragments (CWF) of the anaerobic bowel bacterium Eubacterium aerofaciens were injected intraperitoneally (i.p.) in arthritis-susceptible Lewis rats. Rat paw joints were subsequently studied for histopathological changes. A persisting synovitis accompanied by marginal erosions of cartilage and bone and a marked periosteal apposition of new bone tissue were the main features of the polyarthritis induced. These results are discussed in relation to streptococcal cell wall induced arthritis and compared with histopathological findings in rheumatoid arthritis (RA) in man. PMID- 1784890 TI - Antibodies to Sm and SS-A demonstrated by enzyme immunoassay. Correlation to clinical manifestations and disease activity in patients with systemic lupus erythematosus. AB - Using commercially available antigens, enzyme-linked immunosorbent assays (ELISAs) were set up to demonstrate antibodies of IgG class against Sm and SS-A. Anti-Sm antibodies were demonstrated in 40% of patients with systemic lupus erythematosus (SLE), in 12% of patients with SJogren's syndrome, in 6% of patients with rheumatoid arthritis (RA) and in 12% of patients with miscellaneous rheumatic disorders. Anti-SS-A antibodies were seen in 63% of the SLE patients, in 37% of the patients with Sjogren's syndrome and in 23% of the patients with RA. In the patients with SLE, high levels of anti-Sm antibodies were related to the presence of Raynaud's phenomenon, whereas patients with a malar rash tended to have high levels of anti-SS-A antibodies. In 17 SLE patients followed over a period of time a correlation was seen between the levels of the anti-Sm antibodies and the disease activity. We concluded that it is useful to include ELISAs for the demonstration of anti-Sm and anti-SS-A antibodies in determining the serological profile and in the follow-up of patients with SLE. PMID- 1784891 TI - Medullary impairment at early stage of non-traumatic osteonecrosis of the femoral head. AB - We found that a painful hip without radiological changes presented a modification of the magnetic resonance image of the femoral head and neck with diffuse low T1 weighted and high T2 weighted signal. Core biopsy showed that the bone marrow was replaced from the neck to the head of the femur by fibroblastic tissue and edema without detectable trabecular bone impairment. Classical radiographic, CT, and MRI abnormalities of osteonecrosis of the femoral head were present 14 months later. This report suggested that diffuse femoral head and neck medullary impairment with fat cell replacement by fibroblastic tissue without evidence of trabecular bone necrosis can be found at the early stages of idiopathic osteonecrosis. PMID- 1784893 TI - [Physico-chemical mechanisms of the formation of calculi]. AB - Urinary stones are formed in three steps: nucleation, growth and crystal aggregation. These steps are dependent on physicochemical factors such as oversaturation of the urine and presence of substances that promote or inhibit lithogenesis. These mechanisms result in the formation of crystalline particles large enough to be detained in the lumen of renal tubules. PMID- 1784892 TI - Insights into the mechanism of gold action provided by immunotoxicology: biooxidation of gold(I) to gold(III) detected by sensitized T-cells. PMID- 1784894 TI - [Analytical methods of calculi and urinary crystals]. AB - Numerous methods can be used for the analysis of urinary stones, but few of them provide information on the structure, chemical composition and crystal phases of these stones. In a good urinary stone analysis the stone is first examined through a binocular magnifying glass, for instance, to detect its structural features including umbilication. Randall's plaque, bracketing faces and individualized or non-individualized nucleus. Morphological typing is important as it points to one pathology or another irrespective of composition. Composition must be determined quantitatively, with differentiation of crystal phases, and this requires global physical methods such as X-ray microdiffractiometry or infrared spectrophotometry. Urinary crystals can be identified by polarized light microscopy supplemented, if necessary, by infrared microscopy when the crystals are few and of unusual morphology. Studying crystalluria is a simple and efficient means of following up lithiasic patients, provided their urine is collected and stored under adequate conditions. In interpreting the results various criteria, and particularly the nature, abundance, size, facies, aggregation and frequency of crystals, must be taken into account. PMID- 1784895 TI - [Physiopathology, exploration and treatment of calcium lithiasis]. AB - The main risk factors for calcium urolithiasis that are clinically detectable are low diuresis, hypercalciuria, hyperruricuria, alkaline urinary pH, hyperoxaluria, hypomagnesuria, hypocitraturia. They should be evaluated, all the more precisely that the disease is active, under both the urological and metabolic points of view, using 24 hour urine collection made at home on a free diet with a dietary record. In the majority of the cases the calcic urolithiasis is idiopathic, i.e. not related to a cause of secondary hypercalciuria like primary hyperparathyroidism, or to a hyperroxaluria either primary or of digestive or toxic origin. Its treatment if mainly dietary with high fluid intake (diuresis greater than 2 1/24 h), normoclacic diet (800-1000h mh/24 h) with meat but not dairy product restriction, oxalate salts, carbohydrate and alcohol restriction. These dietary recommendations should be controlled by measuring the above cited parameters in the 24 hour urine samples and by measuring urea excretion which should not exceed 0.33 g/kg of body weight. When diet fails, drugs may be added mainly allopurinol, thiazides and potassium citrate. PMID- 1784896 TI - [Physiopathology, etiology and medical treatment of non-calcium lithiasis]. AB - Under the term "non-calcium nephrolithiasis", three types of renal stone formation are considered. (1) Infected nephrolithiasis, which is due to bacteriological ureolysis. Its treatment includes lowering of oversaturation by antibiotics, urease inhibition and/or acidification of the urine; lowering of crystallization by eradicating concomitant infections caused by non-ureolytic organisms; prevention of crystal adherence by exogenous glycosaminoglycans, and prevention of bacterial adherence by glycolipids. (2) Uric acid lithiasis is defined on physico-chemical and physiopathological grounds. Medical treatment consists of increasing water intake, reducing puric acid intake, alkalinizing the urine inhibiting xanthine-oxidase. (3) Cystinuria is described as a nephrolithogenic proximal tubulopathy. Medical treatment includes reduction of urinary cystine concentration by a strong increase of water intake; reduction of urinary cystine excretion by diet and increase of cystine solubility by urinary alkalinization or administration of some thiol compounds. PMID- 1784897 TI - [Diagnosis and urologic development of urinary lithiasis. Revealing manifestations, radiologic diagnosis, course complications]. AB - The presence and migration of stones in the urinary tract are the consequences of lithiasis, a pathological process whose evolutive potential determines the frequency of recurrence. The stones produce haematuria and above all obstruction which manifests itself by pain and may be complicated by infection. The most suggestive type of pain is renal colic, but other revealing manifestations may occur. Such signs require radiological exploration with plain X-ray of the abdomen, renal ultrasonography and intravenous urography. These three indispensable examinations complete each other, provide the diagnosis and in the vast majority of cases point to the appropriate treatment. The haemodynamic repercussions of urinary tract obstruction have been thoroughly documented and now form the basis of treatment of renal colic with non-steroidal anti inflammatory drugs. Obstruction and infection are the causes of all complications of urinary stones. Their management has been facilitated by recent advances in urology and should prevent the disease from destroying the kidneys and eventually causing chronic renal insufficiency. PMID- 1784898 TI - [Extracorporeal lithotripsy, endocorporeal lithotripsy]. AB - In the 1990's urologists are well equipped to treat urinary stones, using extracorporeal or intracorporeal lithotripsy, conventional surgery, ultrasounds, hydroelectric shocks, or lasers. Extracorporeal shock wave lithotripsy has revolutionized the treatment of urinary lithiasis and gradually invades all the fields of this disease. 75% of patients with calculi draw benefit from this method. However, lithotripsy cannot solve all problems, such as large stones (more than 30 mm in diameter) or ureteral stones that are impacted or difficult to locate. For this reason, intracorporeal lithotripsy and surgery remain indicated for specific cases in 20 and 6% of the patients, respectively. PMID- 1784899 TI - [Should caval interruptions be performed? Technical progress is faster than validation of indications]. PMID- 1784900 TI - [Macrolides today. Their extensive use in daily practice is justified]. PMID- 1784901 TI - [Esophageal pH-metry. Use and abuse!]. PMID- 1784902 TI - [Manifestation of immunologic origin produced by toxic compounds]. AB - Toxic agents may induce immunological manifestations by interfering with either non specific or specific pathways of immunity. The interference with the specific pathways may result in stimulatory (autoimmunity or hypersensitivity) or suppressive reactions. Mechanisms responsible for autoimmunity of hypersensitivity are now better understood. Hypersensitive reaction may be the consequence of the recognition by T cells of the xenobiotic presented by MHC class II molecules. Mechanisms leading to autoimmune reaction probably differ according to the nature of the drug. Thus drugs metabolized by liver enzymes could induce autoimmune hepatitis as a consequence of the binding of a reactive metabolite to the enzyme, thus rendered immunogenic. Other drugs like thiol or metal-containing chemicals could be responsible for autoimmunity reaction by interacting with molecules involved in T-B lymphocyte cooperation. The knowledge of the involved mechanisms should allow to develop predictive assays. PMID- 1784903 TI - [History of mechanical ventilation]. PMID- 1784904 TI - [Intermittent claudication of the lower limbs. Diagnostic orientation]. PMID- 1784905 TI - [Anti-infection immunity. Mechanisms, specific and non-specific factors]. PMID- 1784906 TI - [Black cutaneous tumors. Diagnostic orientation]. PMID- 1784907 TI - [Prolonged bleeding time. Diagnostic orientation]. PMID- 1784908 TI - [Naso-sinus infections. Diagnosis, therapeutic principles]. PMID- 1784909 TI - [Diffuse skeletal demineralization. Diagnostic orientation]. PMID- 1784910 TI - [Pain the hip. Diagnostic orientation]. PMID- 1784911 TI - [Insulin-dependent diabetes. Epidemiology, etiology, physiopathology, diagnosis, development, prognosis and therapeutic principles]. PMID- 1784912 TI - [Urinary infections: acute pyelonephritis. Epidemiology, etiology, physiopathology, diagnosis, development, prognosis, treatment]. PMID- 1784913 TI - [Psoriasis: physiopathology and therapeutic targets]. AB - Psoriatic lesions are characterized by hyperproliferation of keratinocytes associated with differentiation disorders. Hyperproliferation might be due to extrakeratinocytic signals delivered by dermal fibroblasts, protease-secreting granulocytes, lymphocytes involved in local immune reaction or growth factors produced at a distance. An alternative theory puts the blame on intrinsic abnormalities of keratinocytes which would affect the transduction phenomena or the genome. The abnormal expression of certain genes coding for growth factors is in favour of that theory. Vertically transmitted retroviral agents may also be suspected. The points of impact of the major therapies (antimitotic drugs, cyclosporin, retinoids, phototherapy) are numerous, but their common end-result is to block the mitotic activity. PMID- 1784914 TI - [Clinical aspects commented on]. AB - Psoriasis is a chronic and common disease (prevalence of 1/1000 in France). It is therefore highly probable that it will be encountered by all non-dermatologists in their practice, hence the necessity for them to be able to recognize its principal forms. The clinical presentations of psoriasis are multiple and varying in their severity. In any given patient flare-ups may constantly be similar or change in the course of time. In the vast majority of cases skin lesions are typical, leading to a purely clinical diagnosis without need for additional investigations, and treatment can be instituted. In some case, however, the lesions are atypical and the diagnosis is doubtful. This is where histological skin biopsy can be of considerable help. Finally, other skin lesions may resemble psoriasis and be misleading; here again, histology or some other laboratory examinations will provide the correct diagnosis. In this chapter all these situations are presented be means of photographs accompanied with comments, which illustrate the semeiological and clinical diversity of psoriasis. PMID- 1784915 TI - [Psoriatic rheumatism]. AB - Five to seven per cent of patients with cutaneous psoriasis develop a seronegative inflammatory arthritis which is often erosive and frequently both peripheral and axial. The most common peripheral type of psoriatic arthritis is represented by asymmetrical oligoarthritis, the localisation most suggestive of psoriasis being distal interphalangeal arthritis. Symmetrical polyarthritis may also be observed. Severe and mutilating forms of the disease are fortunately rare. Te axial type of psoriatic arthritis consists of a usually bilateral sacroiliitis and/or spinal lesions which may result in ankylosing spondylitis. Most cases of psoriatic arthritis are treated with non-steroidal anti inflammatory drugs alone and local treatments. Corticosteroid therapy must be administered with caution and restricted to the severe forms. A fairly large number of maintenance treatments for peripheral arthritis have been used, not always after controlled trials; the most commonly prescribed are gold salts, sulphasalazine and methotrexate. PMID- 1784916 TI - [Palmoplantar pustulosis]. AB - Pustulosis palmoplantaris (PPP) is a rare (0.01 to 0.05%), non-infectious acute or chronic skin disease which preferentially affects women in the 4th to the 6th decade of their life. The principal differential diagnosis is with infected dyshidrosis and with mycoses. Nosologically, PPP has a controversial relationship with psoriasis when it is isolated. Epidemiological and genetic data have shown that PPP and psoriasis are two nosologically close but distinct dermatoses. PPP may be associated with aseptic pustular osteoarthritis of the anterior chest wall (Sonozaki's syndrome). Modern treatment of PPP rests on photochemotherapy (PUVA), aromatic retinoids or, better, a combination of both (Reti-PUVA). PMID- 1784917 TI - [Specific aspects of psoriasis in children]. AB - In 15% of the cases psoriasis begins before the age of 10 years, but it is often overlooked since its typical and obviously diagnostic nummular lesions are not the most frequently found. Some clinical features are very specific of children, such as eruptive guttate psoriasis occurring soon after an upper airway infection, and, mainly, the pauci-symptomatic forms which are difficult to diagnose as they are often very mild and for a long time reduced to one single lesion. The so-called "napkin psoriasis" is the usual early expression of the disease in infants. The severe, pustular, often annular, erythrodermal congenital and arthropathic forms of psoriasis are rare in children. Treatment must be prescribed with particular caution it that age, but in the severe and/or expansive types retinoids and very short courses of PUVA therapy are required. PMID- 1784918 TI - [Local treatments of cutaneous psoriasis]. AB - Most of psoriatic patients require topical therapy. Dermal application of drugs may be the unique treatment; but it can also combined with oral drugs, or phototherapy. Patients are treated at home or in day-care centers; some require hospitalization. Topical corticosteroids are widely used: abuses are frequently observed, therefore skin and systemic side-effects may occur to varying degrees. Tars are still useful. Short-contact anthralin is active and well tolerated, and compliance is better than with conventional tar therapy, especially in children. Topical mechlorethamine clears the plaques but contact dermatitis may occur. New therapeutic approaches include Vitamin D3 analogues. PMID- 1784919 TI - [Treatment of psoriasis by UVB and PUVA phototherapy]. AB - PUVA has definitely proved effective in outbursts of extensive psoriasis vulgaris. Efficacy is enhanced by combination with retinoids. The pharmacokinetics of psoralen, which lead to adjustment of dosage to each case, is a concrete improvement which facilitates treatment. The side-effects of PUVA, and notably the risk of carcinogenesis, are well known and can be alleviated. UVB phototherapy, successfully used for a long time against psoriasis, has benefited from technical advances in the field of artificial sources of UV. In its conventional modality (wide UVB band), the adjunction of greasy excipients is necessary for efficacy. SUP and narrow-band phototherapy (311 nm lamp), more recently developed, are of considerable interest but ought to be further evaluated. PMID- 1784920 TI - [Treatment with retinoids]. AB - Aromatic retinoids are synthetic vitamin A derivatives that are particularly active in the treatment of severe psoriasis. They have two pharmacodynamic properties: a regulating effect on epidermal differentiation, and an immunomodulating effect, notably on some functions of granulocytes. Two compounds from this group are now available: etretinate (Tigason) and its active metabolite and future successor acitretin (Soriatane). Retinoids are indicated in pustular psoriasis, erythrodermic psoriasis and extensive psoriasis vulgaris. The mean daily dose in adults is 30 to 50 mg for etretinate and 30 to 35 mg for acitretin. The dose-dependent cutaneous and mucosal side-effects consist of dryness of mucous membranes, desquamation of the extremities and fragility of the skin. Laboratory tests for liver function and lipids must be performed regularly. Because of their teratogenicity, retinoids are strictly contra-indicated in pregnant women and otherwise require and efficient contraception pursued for at least two years after withdrawal of etretinate or acitretin therapy. PMID- 1784921 TI - [Cyclosporine and psoriasis]. AB - Cyclosporin has proved efficacious in severe and resistant psoriasis. When moderate doses are administered (below 5 mg/kg/day) satisfactory clinical results are obtained at the cost of side-effects that can be controlled, since they are dose-dependent and regress when dosage is reduced. The most important of these side-effects are arterial hypertension and nephrotoxicity due to vasoconstriction of glomerular arteries. It is therefore essential to use low doses (3 mg/kg/day initially) and to measure blood pressure and creatinine levels regularly. This being known, there is no doubt that cyclosporin constitutes a step forward in the treatment of severe psoriasis. PMID- 1784922 TI - [Methotrexate and psoriasis]. AB - Methotrexate is effective in the treatment of severe psoriasis. If recommended guidelines are strictly followed the drug, administered in low doses, is not dangerous. The main adverse effect is cumulative hepatotoxicity. Hematologic toxicity occurs especially if other medications are associated. PMID- 1784923 TI - [Psoriasis. Therapeutic strategy]. AB - The strategy of psoriasis treatment consists first in informing the patients about the too quick renewal of their skin with, as a consequence, the necessity of two phases in the treatment; the clearing phase aimed at suppressing the skin lesions, and a maintenance phase where it is necessary to continue the treatment on an apparently normal skin in order to avoid relapse. For local treatments (tar, anthralin, topical local steroids, mechlorethamine, vitamin D3 derivatives and ointment) and for systemic treatment (UVB, PUVA therapy, retinoids, cyclosporine or methotrexate) it is necessary that the inconvenience of the treatments (due to modifications in everyday life and due to side effects) be less important than the decrease of life quality due to psoriasis. The aim is not to clear psoriasis but to increase the quality of life of the patients. A peculiar strategy of treatment is necessary for some forms of psoriasis like flexural psoriasis, psoriasis arthritis, ungueal psoriasis, palmoplantar psoriasis, pustular psoriasis, psoriatic erythroderma and psoriasis of the child. With the various treatments that we have now, used alone or in association, it is possible to improve the quality of life of nearly all psoriatic patients. PMID- 1784924 TI - [New vaccines against viral hepatitis B. For an universal strategy of vaccination]. PMID- 1784925 TI - [New procedures of vocal restoration after laryngectomy: surgical shunts and phonatory implants. Decisive progresses]. PMID- 1784926 TI - [HLA system and corneal grafts. Undoubtedly a factor of success, if only little known]. PMID- 1784927 TI - [Neurobiology of memory]. AB - This article presents the most significant results and trends concerning current research on the neurobiological basis of memory. The important contribution of neuropsychological research and the resulting constraints that its findings impose to every neurobiological approach are briefly reviewed. The main results about the molecular mechanisms of synaptic plasticity, together with those obtained by several approaches such as electrophysiology, neurochemistry are reported and discussed with respect to their degree of pertinence and coherence with the issues. Finally, the problems relating to the nature, properties, mechanisms of construction and evolution of the internal representations are examined. PMID- 1784928 TI - [Consensus conference on imaging of non-operated common vertebral sciatica. Paris, 6-7 November 1990]. PMID- 1784929 TI - [Apropos of three portraits of Antonin Gosset (1872-1944)]. PMID- 1784930 TI - [Small intestine obstruction. Physiopathology, etiology, diagnosis, principles of the treatment]. PMID- 1784931 TI - [Erythema multiforme. Etiology, diagnosis]. PMID- 1784932 TI - [Medical secrecy]. PMID- 1784933 TI - [Social protection. Principle social risks. Taking care by the social security. Mechanisms of financing and cost]. PMID- 1784934 TI - [Pelvic pain. Diagnostic orientation]. PMID- 1784935 TI - [Headaches in children. Diagnostic orientation]. PMID- 1784936 TI - [Psychiatric complications of alcoholism. Diagnosis, principles of the treatment]. PMID- 1784937 TI - [HIV infection. Epidemiology, etiology, screening, prevention]. PMID- 1784938 TI - The onset and progression of atherosclerotic plaques as related to arterial wall changes. AB - The coronary arterial beds from more than 1200 subjects aged 1 to 65 years were investigated by both histopathological, histochemical and morphometric methods. Light microscopic aspects were analysed to reveal if plaque development and progression toward obstructive lesions were associated with arterial wall changes, particularly of the intimal connective tissue adjacent to lesions. Six patterns of plaque development in the coronary arterial tree were delineated, emphasis being placed on the observation that the onset and progression of plaques frequently appeared independent of arterial wall changes, in contrast to fatty streaks, gelatinous lesions, intimal necrotic areas, incorporated microthrombi and intramural thrombi. Our results support the view that plaques develop and progress on their own, superimposed on a preexisting arterial wall microarchitecture. PMID- 1784939 TI - Early re-extension of necrosis in myocardial infarction. Favouring factors and prognosis in the first months of evolution. AB - To determine the risk of myocardial necrosis re-extension (RN) appearance in the first month of evolution of myocardial infarction (MI) confirmed clinically, by ECG, and enzymatically, 262 patients (mean age 64.5 years, 64.6% males) were studied. The incidence of RN was found present in 67 patients (25.6%). A complex statistical analysis (stepwise regression analysis) of the variables presented by the patients (clinical, ECG and laboratory) showed that only 5 variables are important in the determination of the risk of RN namely: nontransmural localization of initial necrosis, atrial fibrillation, past history of angor pectoris, prolonged pain at onset and presence of idioventricular rhythm. The introduction of these 5 variables in a multiple regression equation will allow the distribution of patients, already at entry, in subgroups of risk of re extension necrosis within the first month of MI evolution thus allowing a more careful management of disease. PMID- 1784940 TI - Canonical correlation analysis as a special method for the study of the structural relations of risk factors in cardiovascular diseases. PMID- 1784941 TI - Non-paroxysmal ventricular tachycardia with isorhythmic atrioventricular dissociation. AB - The occurrence of ventricular tachycardias in clinical practice raises important problems of differential diagnosis and therapy. Four ECG tracings recorded in a patient admitted to the Coronary Care Unit of the Emergency Hospital Bucharest illustrate some peculiar features which might appear in such situations. PMID- 1784942 TI - Circulating immune complexes in collagen diseases. AB - In a group of 75 patients with collagen diseases a study was carried out for the structural characterization of the circulating immune complexes (CIC) and the eventual detection of a correlation between these complexes and various serum biologic parameters. The results obtained have demonstrated: (a) the great variability of the structure of immune complexes even in the same type of disease and (b) the lack of correlation between the concentration of components in the CIC structure and the level of the same components in the serum. The lack of correlation may be explained by the great variety of immune complexes formation and the increase of any of the serum immunoglobulins does not necessarily mean its total or partial aggregation in the CIC structure. PMID- 1784943 TI - The significance of low antithrombin III levels in cirrhosis. AB - Antithrombin III is an anticoagulant synthesized in the liver cells. The aim of this study was to estimate the serum level of antithrombin III in cirrhotics. Investigations were carried out in 32 patients with cirrhosis and in 20 healthy controls. Antithrombin III measured by radial immunodiffusion was found significantly lower (19.2 +/- 6.8 mg%) than in controls (28.0 +/- +/- 5.2 mg%) (p less than 0.01). The level of antithrombin III is positively correlated with pseudo-cholinesterase and, less significantly with blood albumin. Therefore decreased antithrombin III reflects liver cell disfunction in cirrhosis and its decrease may predispose to thrombotic events which occur sporadically in cirrhosis. PMID- 1784944 TI - Factors of prediction of immediate postoperative evolution in cancer of the colon. AB - A study carried out in 152 patients operated on for cancer of the colon showed that the early postoperative evolution of disease depends on the therapeutic method chosen according to the clinical stage of the tumor. The 31 deaths recorded in the first 30 postoperative days occurred mostly in the first week (45.1%) and were due either to hydro-electrolytic disturbances (69%) or to intraperitoneal septic complications (65%) with 0.66 and respectively 0.60 positive predictive value. Advanced forms of disease, emergency surgeries and presence of associated diseases are statistically significant risk factors. PMID- 1784945 TI - Activity of some lysosomal enzymes in peritoneal lymphocytes from patients with terminal renal failure treated by intermittent peritoneal dialysis. AB - Acid phosphatase (AcP), beta-glucuronidase (GR) and N-acetyl-beta-D glucosaminidase (NAG) activity was determined, using semiquantitative cytochemical methods, in the peritoneal fluid lymphocytes obtained from 50 patients with terminal renal failure treated by intermittent peritoneal dialysis. The control group included 30 subjects with normal renal function. The percentage of AcP and NAG-positive lymphocytes was significantly lower and that of the GR positive cells significantly higher in dialysed patients than in the control group. A group of 22 dialysed patients with bacterial peritonitis showed a significant increase of the percentage of NAG-positive lymphocytes as compared with both the subjects in the control group and the peritonitis-free dialysed ones. Changes of the lymphocytes enzymatic activities were distinct in cells exhibiting the granular reaction type, and to a much lesser extent in those showing granular diffuse reaction. PMID- 1784946 TI - Variations of the plasma and erythrocyte flow in various internal diseases. AB - Plasma viscosity (Pv), and that of an erythrocyte suspension in isotonic saline solution (called erythrocyte viscosity--Ev) were determined by means of a viscosimeter of personal construction. The Ev/Pv ratio, called relative erythrocyte viscosity (Rv), was then calculated. The measurements were performed in flow conditions similar to the physiologic ones. An analysis of the variations of these parameters in different internal diseases has revealed high Pv values in the pathologic states associated with dysproteinemia. Pv correlates with the ESR but not with the hematocrit. Ev levels were increased in many diseases and did not correlate with any of the current laboratory parameters. Ev might be a prognostic factor for the arterial hypertension evolution. Rv analysis suggests a possible dynamic balance between Pv and Ev. PMID- 1784947 TI - Not only quantitative but also qualitative changes of serum immunoglobulins in diabetes mellitus. AB - To extend previous observations on the quantitative changes of IgA and other serum Ig in diabetics, additional immunochemical investigations were carried out in 96 patients, 63 males and 33 females, mean age 43.5 +/- 15.7 years, 51 with type 1 (insulin-dependent) and 45 with type 2 (non-insulin-dependent) diabetes. The immunological data were correlated with the clinical-metabolic aspects. In the whole group, the IgA level was increased (144.1 +/- 57.2 I.U.). Significant differences were recorded with respect to age for IgG, to age and diabetes type for IgA, to sex for IgM. Qualitative Ig changes, reflecting disturbances of molecular structure, mainly for IgG, seldom for IgM, but never for IgA, were observed in 20% of the patients with both types of diabetes, more seldom in cases with long disease duration. The IgG with qualitative changes were purified and their functional capacity of inhibiting the natural cytotoxic activity (NK) was tested in comparison with that induced by pretreatment of the effectory cells with normal IgG. Some of these modified IgG showed a reduced capacity of inhibiting the NK activity. These data confirm the existence of certain quantitative changes of the main serum Ig in diabetics and reveal the presence of qualitative disorders of the IgG molecules, with consequences on their functionality. PMID- 1784948 TI - No relationship between insulin antibodies and hypoglycemia in insulin-treated diabetic patients. AB - It has been speculated that insulin antibodies may contribute to the hypoglycemic attacks in insulin-treated diabetic patients. To address this hypothesis, we analyzed in a first part of the study the frequency to hypoglycemia in two groups of diabetic patients, one (Group A, 38 cases) with at least two episodes of severe hypoglycemia in the last year and another (Group B, 38 cases) without severe hypoglycemia in the last 3 years. In the second part of this study, we analyzed the frequency of severe and moderate episodes of hypoglycemia in another two groups of diabetics, one (Group C, 32 cases) with high insulin antibody titre (greater than or equal to 20% binding, mean +/- SD 31.2 +/- 8.1%) and another with low insulin antibody titre (less than 10% binding, mean +/- SD, 5.1 +/- 2.2%). No significant difference was found for bound insulin between diabetics with frequent hypoglycemic episodes (2.3 +/- 0.2/patient/year--Group A) and those without severe hypoglycemic episodes (Group B), i.e., bound insulin 4.89 +/- 3.21% in group A versus 5.32 +/- 4.5% in group B. Conversely, the frequency of severe episodes of hypoglycemia was similar in diabetic patients with high (31.2 +/- 8% binding in group C) and respectively low (5.1 +/- 2.1% binding in group D) insulin antibody titre, i.e., 0.15 episodes/patient/year in group C and 0.17 episodes/patient/year in group D. PMID- 1784949 TI - Evaluation of the therapeutic efficiency of Voltarene by using the in vitro chemiluminescence emitted by leukocytes polymorphonuclear. AB - It is known that antiinflammatory drugs inhibit the chemiluminescence produced by polymorphonuclear leukocytes (PMNL). In this respect, we studied in vitro, in standardized conditions (1.0 x 10(6) PMNL), the inhibitory effect of Voltarene on the chemiluminescence produced by PMNL from patients with rheumatic diseases, before and after treatment with the above drug. The stimulation index, as a quantitative measure of PMNL phagocytosis is higher in patients with rheumatic diseases than in controls. After treatment with Voltarene, the stimulation index further increases, especially in the patients with arthritis, suggesting a raised PMNL reactivity. A great differentiation of the in vitro inhibitory effect of Voltarene was observed especially for higher concentrations, function of age and the severity of disease. According to our results, Voltarene acts mainly by increasing the PMNL reactivity. The in vitro inhibitory effect of Voltarene on PMNL seems to be correlated with the in vivo action, the younger patients showing the greatest reactivity. PMID- 1784950 TI - Effect of cyclophosphamide in active nonviral cirrhosis. AB - The immunologic effects of cyclophosphamide were studied in 16 patients with active nonviral liver cirrhosis with a view to improving the pathogenetic treatment of these diseases. After months of cyclophosphamide administration first in doses of 100 mg/day (for 14 days) then in doses of 200 mg per week, the hypergammaglobulinemia present at entry was reduced significantly from 2.55 +/- 0.35 g/dl to 1.71 +/- 0.17 g/dl concomitantly with the proportional increase of the active suppressor T lymphocytes, from 29.3 +/- 3.59% to 38.0 +/- 2.1%. The use of smaller doses of cyclophosphamide, i.e., 200 mg/week, allowed the maintenance of its immunosuppressive properties and prevented its side effects. PMID- 1784951 TI - Peculiar atrial fibrillation in patients working with electric current. AB - During a period of 20 years, 8 patients with atrial fibrillation, without other cardiac abnormalities, resistant to electroconversion, but successfully defibrillated with quinidine, were examined. All were males, aged 40 to 50 years, working with electric current and exposed for many years to frequent electric shocks. The authors consider that chronic exposure to electric current induces a special form of atrial fibrillation, resistant to electric conversion. The inefficiency of the electroshock therapy in such cases might be explained by the increase of transthoracic impedance consecutive to repeated electrocutions. PMID- 1784952 TI - Morphological changes of the hypophysis-adrenal system (HAS) in albino rats with experimental gastric ulcers, under the influence of aeroionotherapy (AIT). AB - The authors followed up certain changes occurring at the level of the hypophysis adrenal axis, during the development of experimental ulcers induced by pylorus ligature in rats treated with negative air ions. Previous experiments have shown that negative aeroionotherapy had a favourable influence on the prevention and evolution of gastric ulcers. The results of the present experiment showed that, under the influence of aeroionotherapy, the number of gastric ulcers/animal, and the relative weight of the adenohypophysis and of the adrenals glands decreased; the width of the fascicular zone of the adrenal cortex, and the volume of the cell nuclei in this fascicular zone also decreased. PMID- 1784953 TI - Advances in the early diagnosis and therapy of primary liver cancer. AB - The prevalence of primary liver cancer (PLC), unlike that of the other digestive carcinomas, is constantly increasing. Epidemiologic data have revealed the risk factors for PLC. New methods of detection allow to define the cases at high risk for PLC, and an active follow-up permits the early disease detection, when the tumor can still be operated on. The diagnostic value of each method is analysed. PMID- 1784954 TI - [Methodological considerations in the interpretation of serologic screening for hepatitis B virus among blood donors]. AB - Between October 1988 and February 1989, 1,033 voluntary first-time blood donors were screened for hepatitis B infection in five blood banks in Goiana, Central Brazil. The survey was part of a major study designed to estimate seroprevalence of HBsAg and anti-HBs and to discuss methodological issues related to prevalence estimation based on data from blood banks. Donors were interviewed and blood samples were collected and tested for HBsAg and anti-HBs by ELISA tests. Prevalences of 1.9% and 10.9% were obtained for HBsAg and anti-HBs, respectively, and no statistical difference was found between the sexes. Prevalence of anti-HBs increased with age (X2 for trend = 7.9 p = 0.004). The positive predictive value and sensitivity of history of jaundice or hepatitis reported in the interview in detecting seropositives were 13.6% and 2.2%, respectively. The methodological issues, including internal and external validity of HBV prevalence estimated among blood donors are discussed. The potential usefulness of blood banks as a source of morbidity information for surveillance for Hepatitis B virus infection is stressed. PMID- 1784955 TI - [Malaria in intravenous drug users associated with HIV seropositivity]. AB - Cases of induced malaria have been notified in S. Paulo State, Brazil, in recent years. At the same time the number of cases imported from endemic regions of Brazil has been increasing. One case of induced malaria by Plasmodium vivax was registered in Presidente Prudente, located in the west of the State, in 1988 and a further eleven cases in 1989. This city is considered to be one of the main transit ports for people who come into the State from the Amazonian region. The patients declared that they had not been to any possible transmission area of malaria. All of them had, however, taken cocaine, sharing the same contaminated needle and syringe. Previously, one person with imported malaria was detected, who had transmitted the disease to the first case in 1988 and also to a further group of 3 people in 1989. One of these three latter cases then transmitted the disease to two other people. As the group of people continued to use the drug among themselves, 2 new cases arose. Afterwards, they re-infected themselves again (one of the was re-infected twice). The test for Human Immunodeficiency Virus was positive for 5 individuals, of whom one had a negative result and 2 others did not undergo the test. This information is discussed within the present context. PMID- 1784956 TI - [Miracidial attraction by Biomphalaria straminea, Lymnaea columella and Physa sp on miracidia of Schistosoma mansoni BH strain]. AB - The attraction exercised over Schistosoma mansoni miracidia by Biomphalaria straminea, Lymnaea columella and Physa sp using a specially designed apparatus consisting of two circular glass chambers joined by an open channel were studied. The molluscs or their snail-conditioned water (SCW) was placed in one of the chambers (randomly chosen). In the channel ten miracidia was deposited and the count of miracidia in each of the three compartments (the two chambers and the channel) was recorded during fifteen minutes. Ten replications of each experiment with different specimens of molluscs and miracidia were made. Statistical and ad hoc exploratory data analysis showed that: a) the three species of molluscs and their SCW attract the miracidia; b) Physa sp attract more miracidia then L. columella. There was an isolated single B. straminea specimen that had a repulsive effect to the miracidia. PMID- 1784957 TI - [Entomological surveillance of Chagas' disease in the State of Sao Paulo]. AB - Drastic modifications in agrarian space, with the reductions of primary forests, along with changes in rural production systems have led to the growth of salaried employment and also caused rural workers to move to the peripheral areas of cities. There has also been an intense and continuous intervention undertaken by the Superintendencia de Controle de Endemias (SUCEN) through the use of pesticides in the fight against triatomine bugs in houses and peridomestic areas of the State of S. Paulo. All these factors have contributed to the interruptions of the natural transmission of Chagas' disease in S. Paulo. The next step in the program was the integration of vertical vector control into primary health care involving community participation. The several years of SUCEN's work among the rural communities has encouraged them to notify the presence of triatominae bugs, and prompt response to each notification has led to the growth of the process of permanent participation. Data from 1985 and 1986 showed that 85.6% of the bugs captured inside houses were notified by the population, which confirms that the best way to maintain the epidemiologic surveillance of Chagas' disease by the mobilization of local communities for effective participation in vector surveillance. PMID- 1784958 TI - [Genetic engineering]. AB - This paper deals with the progress made in genetic engineering techniques, capable of altering the genetic potential of an organism, either by the introduction or the suppression of new structural genes. Some of the general applications are described as are also, more particularly, their uses in the field of medicine. A critical analysis of the benefits and risks involved is also undertaken. PMID- 1784959 TI - [Prevalence of obesity in a locality of the State of Sao Paulo, Brazil, 1987]. AB - The prevalence of obesity in Araraquara, a county of 150,000 inhabitants situated 250 km from S. Paulo, Brazil was studied. The study population, of 18-74 yrs. of age, resident in the urban area in 1987, was composed of 1,126 inhabitants, 502 males and 624 females, selected through a cluster equiprobabilistic sampling process. The prevalence of overweight (Quetelet 25-29.9 Kg/m2) was 26.9% for males and 27.7% for females. The prevalence of obesity (Quetelet equal or greater than 30.0 kg/m2) was 10.2% for males and 14.7% for females. These percentages are high when compared with those of affluent Anglo-saxon countries. The reasons for this phenomenon are discussed in the light of the fact that the economy of the city is affluent and is dependent on agroindustrial activities. When own cut-off criteria (P85 and P95 for Quetelet for 20-29 yrs of age, for each sex) are calculated, the "lean pattern" for Araraquara County is leaner than that for the a United States population. This raises doubts as to the possibility of applying cut-off criteria of particular regions to regions of different characteristics. PMID- 1784960 TI - [Mortality of women in reproductive age in the municipality of Sao Paulo (Brazil), 1986. III--Death by different causes: cardiovascular diseases]. AB - Further to a research project into the accuracy of death given on the causes of death given on the death certificates of women of fertile age (10-49), resident in the City of S. Paulo, SP, Brazil, in 1986, the main causes of death for the population according to age, with remarks on the mortality from cardiovascular diseases (CVD), malignant neoplasms and external causes are presented. The CVD were responsible for 23.6% of all deaths in this age group, strokes occupying the position of greatest importance (51.1% of all CVD deaths) and coronary heart disease coming second (18.2% of all CVD deaths, the greater number of them being due to acute myocardial infarction). Comparing these results with those of a similar research project undertaken in the 60s, in the same place and using the same methodology, a decline of mortality from chronic rheumatic disease of the heart is to be noted, as also a rise in the mortality from stroke and coronary heart disease, but with a global reduction in age-adjusted rates for CVD overall. There was also a great number of references to arterial hypertension both combined with stroke (78.3% of all deaths due to this cause were of hypertensives) and with coronary heart disease (where this proportion was of 63.4%). The importance of the supposedly high prevalence of high blood pressure in the fertile female population and the indiscriminate use of oral contraceptives are discussed. PMID- 1784961 TI - [Patient satisfaction at a university hospital]. AB - The results of a research project into the level of satisfaction/dissatisfaction of 158 first-time patients attending by an University hospital, Brazil, are presented. The interviews were carried out by first year medical students as part of a comprehensive project concerned with the restructuring of the Medical Curriculum. Its prime objective was to expose the students to patients/consumers as early as possible in their studies. After an introductory training program, the students asked the patients arriving at the hospital out-patient clinic for permission to observe them throughout the attendance given. A questionnaire was used which covered the various aspects of the consumers relationship with a medical institution (socio-economic variables, "art of care", outcome of the medical encounter and suggestions for improvement). Both patients and students were able to perceive the different problems that patients confront in the course of their dealings with a medical institution (reception, registration, nursing, social service and medical attention). The data showed a difference of opinion between students and patients regarding several aspects of the satisfaction/dissatisfaction items, partly because of their different social class status and party due to the different expectations regarding medical care. PMID- 1784962 TI - [Bacteriological quality of groundwaters in cemeteries]. AB - Groundwater samples collected by piezometers from three cemeteries in geologically distinct areas of S. Paulo and Santos, Brazil, were analysed in order to determine their hygienic and sanitary conditions. Fecal coliformes, fecal streptococci, sulfite reducer clostridia and Salmonella were searched for the purpose of evaluating sanitary conditions, and total coliforms, heterotrophic bacteria, proteolitic and lipolitic microorganisms for evaluating hygienic conditions. In some samples, nitrate levels were also determined. It was discovered that these waters do not present adequate sanitary and hygienic conditions and that, in some cases, nitrate levels were extremely high (75.7 mg/l). In most samples, higher levels of fecal streptococci and sufite reducer clostridia than fecal coliforms were detected, which seems to show that the two former indicators would be more appropriate for evaluating the sanitary conditions of this kind of water. Salmonella were detected in only one of 44 samples analysed and coliphages in none. In the statistical analysis, the correlation matrix showed significant correlations among three fecal pollution indicators, as well as among anaerobic and aerobic heterotrophs and lipolitic bacteria. A direct relationship between the deterioration of water quality and the geological and hydrogeological conditions of the environment studied was observed. When cemeteries are constructed these conditions should, therefore, be taken into consideration. PMID- 1784963 TI - [The Zippin's procedure for the estimation of animal populations]. AB - Zippin's procedure is one of the most accurate methods used to estimate total populations from removal trapping data. However, explicit algebraic solutions of the maximum likelihood equations do not exist. Hitherto they have been obtained from graphs known as Zippin charts. In this paper a Newton-Raphson procedure is used to obtain numerical solutions to the equations. Comparisons with the classical method show some differences in the parameters, particularly in the estimation of the standard error. PMID- 1784964 TI - [Epidemiology of "sick buildings"]. AB - The indoor environment of modern buildings, especially those designed for commercial and administrative purposes, constitutes a unique ecological niche with its own biochemical environment, fauna and flora. Sophisticated construction methods and the new materials and machinery required to maintain the indoor environment of these enclosed structures produce a large number of chemical by products and permit the growth of many different microorganisms. Because modern office buildings are sealed, the regulation of humidification and temperature of ducted air presents a dilemma, since difference species of microorganisms flourish at different combinations of humidity and temperature. If the indoor environment of modern office buildings is not properly maintained, the environment may become harmful to its occupants' health. Such buildings are classified as "Sick Buildings". A review of the epidemiology of building illness is presented. The etiology of occupant illnesses, sources of toxic substances, and possible methods of maintaining a safe indoor environment are described. PMID- 1784965 TI - [Evaluation of the performance of health services]. AB - Recent literature (up to 1988) on health services assessment in general and especially on hospital service assessment is reviewed, with special attention to its conceptual and methodological aspects. The history of this process is also examined, from the first attempts by the American College of Surgeons, through the Joint Commission for Hospital Accreditation activities up to more recent efforts. The Diagnosis Related Group methodology is commented especially, as well as its more recent complement, the severity of illness indicators. Progress made in this field is briefly examined as in the light of the Brazilian situation. The origins of the growing international concern with this field are enumerated: soaring costs of health services; the recent growth in the number of medical malpractice suits; and the sharp increase in the complexity of health services. The sources of information used in the process, such as immediate observation (case-control type studies), medical records, and summary instruments already in use for payment or financial control purposes, are commented on. Mention is made of the deep influences of the assessment process on practice as in the case of the standardization of practices and procedures, staging of the pathological processes, trajectory-type studies; the utilization of tracer situations, and, finally, the most influential on practice of all these assessment instruments: the diagnosis and treatment protocols, already in wide use in some medical fields such as cancer treatment even in developing countries. PMID- 1784966 TI - [Occurrence of meningococcal meningitis in a Southern region of Brazil, from 1974 to 1980, using the point event model]. AB - Descriptive statistical techniques and point event model methods were used to investigate the temporal series of cases of meningococcal meningitis which occurred in 100 municipalities in the Rio Grande do Sul State, Brazil, during the period 1974-1980. The data were grouped by epidemiological state (epidemic or endemic), and separated into 5 groups according to the municipal population. The number of cases of the disease notified weekly was analysed by means of incidence coefficients, with the purpose of studying the epidemic threshold for the state. The time interval between events was analysed in the light of their probability density functions and expected density functions, with the objective of studying the relationship and dependences among events. The analysis of the epidemic threshold suggests that there should not be only one threshold value for detection of outbreak of the disease throughout the state. Analysis of the expected density function extracted from inter-event intervals of the epidemic state showed a correlational structure indicating dependence between events occurring up to 14 weeks apart. No significant correlation for the endemic state, taking as reference model the shuffled version of the original intervals, was observed. PMID- 1784967 TI - [Estimate of the prevalence of tuberculosis infection among vaccinated school children by the Bhattacharya's method]. AB - The successful application of Bhattacharya's method (decomposition of frequency distribution into normal components by a graphic method) in the analysis of the results of tuberculin test performed on a population sensitized by "anonymous" strains of mycobacteria, suggested the possibility of its application to two samples of BCG vaccinated school-children, living in the city of S. Paulo (Brazil). One of the sample groups, vaccinated between the second and seventh years of life, was surveyed in 1982 and the other, vaccinated during the first year of life, was surveyed in 1988. In both populations it was possible to characterize the normal component corresponding to children infected by tuberculous bacilli and to quantify them. In the first one, the average size of the reactions was 17.40 mm, the standard deviation 3.72 mm and the proportion of infected children 7.71%, against 4.85% in the unvaccinated control group; otherwise, in the population surveyed in 1988, the average size was 17.00 mm, the standard deviation 4.67 mm and the proportion of infected children amounted to 4.14% against 4.48% in the control group. It is concluded that the method permits the estimation of the prevalence of tuberculosis infection among BCG-vaccinated school-children, provided that the vaccine has been given during the first year of life. PMID- 1784968 TI - [Death risk profile of children under one year of age residing in a locality of Sao Paulo State, Brazil, 1987]. AB - The infant mortality of children living in Botucatu, SP, Brazil, in 1987 is studied. In order to establish the risk profile for mortality, an additional risk factor (AR) was calculated on the basis some variables selected by means of a case control study. The results showed an AR for death of 15.58, 11.63, 8.50 and 4.04 respectively for the groups of preterm gestation, low birth, absence of household water supply and insufficient maternal educational level, respectively. It was shown that there is a significant difference in socio-economic status between the families of survivors and those of nonsurvivors. This fact suggests that the best strategy for overcoming the high infant mortality of the low income group is by improving their socio-economic condition so that they can enjoy similar capacity to consume goods and services, in quantity and quality, as the high socio-economic group. PMID- 1784969 TI - [American cutaneous leishmaniasis: phlebotominae of the area of transmission in the north of Parana, Brazil]. AB - Most of the cases of cutaneous leishmaniasis diagnosed in the laboratory of the State University of Maringa, Parana, Brazil, are related to areas of northern Parana State, which have been settled since 40 years age, when the destructions of vast areas of forest in this region was begun. The native vegetation, already, in large part, destroyed is constituted of dense forest of the type found in the transition from tropical to subtropical regions. The landscape is constituted of plateau with a climate of transition from tropical to subtropical and annual mean temperatures of 20 degrees C to 22 degrees C, the mean of the hottest month being superior to 22 degrees C. The native forests are represented by small, sparse patches of vegetation, with some modification in the basins of the rivers Ivai, Paranapanema and Parana and their tributaries. In this environment 24 captures of phlebotomines were made--2 per month from October 1986 to September 1987, between 6 P.M. and 1 A.M. The captures with Shannon trap were made in the outlying forest of Palmital farm. The majority of the 16,496 phlebotomines were classified into 13 species. Lutzomyia whitmani was predominant with 11,188 (67.82%) specimens, followed by Lutzomyia intermedia with 2,900 (17.58%) and Lutzomyia migonei with 1,481 (9.03%). Lutzomyia whitmani and Lutzomyia intermedia have been manifesting great capacity of adaptation in modified environments, where they have played a significant role in transmission of leishmaniasis. PMID- 1784970 TI - [Miracidial attraction by Biomphalaria tenagophila genetically selected for susceptibility]. AB - The attraction of Schistosoma mansoni miracidea by snails genetically selected for susceptibility to infection is considered. Miracidea were exposed to snails or to snail conditioned water in a specially devised three-chamber glass apparatus. Ten miracidea were used for each test and were deposited in the middle chamber (a passage); after 15 minutes, them in each of the number of the three chambers were recorded. In one of the chambers, chosen randomly at each trial, either snails or SCW were used. The snails and the SCW were chosen from either selected snails (highly susceptible) or unselected. The miracidea were of two groups: they came either from susceptible snails in previous generation or were of unselected traits. The results show that only snail generation has importance for the attraction: selected molluscs of susceptible traits do attract the miracidea more. PMID- 1784971 TI - [Evaluation of working conditions of municipal employees engaged in manual labor]. AB - The working conditions of municipal employees of Botucatu (State of S. Paulo, Brazil) are described with a view to identifying the most frequent and serious occupational risks. Office workers (clerks) were not included in this study. The morbidities registered in the municipal outpatient service (from July 17 through December 4, 1987) and in the occupational accident register for the period 1984 1987 were evaluated. The activities of the majority of the employees were found to be carried out manually with no technological assistance, likely to generate "occupational accidents" (OA) and related to inadequate (antiergonomic) positions. The coefficient of severity of the OA has increased so rapidly that in 1987 it was 1.85 times higher than in 1984. The analysis of the external sources and the nature of the lesions caused by the OA were closely related to the description of the activities and the risk factors observed. The most frequent ailments registered in the outpatient service were: arterial hypertension, lumbago, the common cold, chronic alcoholism, acute gastroenterecolitis and "personal difficulties". An occupational health program for the municipal workers in Botucatu is proposed. PMID- 1784972 TI - [Use of psychoactive substances among private school children]. AB - A study was carried out in 1988, using a random sample of 1,441 pupils attending the elementary and high schools of the Federal District, Brazil, with the purpose of determining the frequency of the use of alcohol, tobacco and other drugs. A self-administered questionnaire, adapted by the World Health Organization for this type of survey, was applied. The prevalence of general usage (covering everything from experimental to daily use) showed rates of 67.2% for alcohol, 28.7% for tobacco, 13.9% for inhalants, 6.1% for marijuana and 1.8% for cocaine. The use of the majority of drugs increases with age. As regards sex, the illegal drugs were mostly frequently used by boys. PMID- 1784973 TI - [Occurrence of human astrovirus in Sao Paulo City, Brazil]. AB - Human astrovirus was detected during a 13-month longitudinal study of the incidence of diarrhoea viruses among hospitalized children (less than 2 years of age) in a pediatric clinic of the city of S. Paulo (University Hospital). Serial fecal samples (intervals of 4 days) were collected from 146 children with and without acute diarrhoea at admission and during their stay in the hospital. Two (3%) of the 67 children with diarrhoea were positive at admission to the clinic by the highly sensitive ASTROVIRUS BIOTIN-AVIDIN ELISA, using CDC monoclonal antibodies (MAb SE7). All 79 children without diarrhoea (controls) were negative for astrovirus at admission. However, astrovirus was detected in 7 (4.8%) of the 146 hospitalized children during their stay in the clinic. Three of the positives shed astroviruses in 2 successive stool samples. All children positive for astrovirus were negative for rotavirus, adenovirus and bacterial and parasitic enteric agents. This is the first study of the detection of human astrovirus in Brazil. Astrovirus appears to be a significant cause of infantile gastroenteritis among young children in this country. PMID- 1784974 TI - [Psychosocial aspects of acquired immunodeficiency syndrome]. AB - Psychosocial aspects which arise with regard to people directly or indirectly involved with AIDS: patients, relatives and professional staff, are studied. The results show that the population assisted in the Ribeirao Preto region is predominantly young, male and drug-addicted. The patients with "positive" results show reactions similar to those described by Kluber-Ross (1977) for terminal patients. The behavior observed in relatives forms a continuum which varies from the negation of the illness to the overprotection of the patient. For the professionals, perplexity is the most common reaction when they face a population which is different from that with which they are used to dealing. Finally, the data acquired indicate that the psychologist can help the professionals to deal with the reactions of the patients by integrating them into their organic and emotional aspects. PMID- 1784975 TI - [Quality of life and urban environment. Sao Paulo city, Brazil]. AB - The concept of the quality of life is presented: its main aspects and the possibilities of this assessment and measurement are presented. Community and individual features are described and related to causal factors. S. Paulo city, Brazil, is seen to be an urban environment with quality of life problems on which some considerations are offered. PMID- 1784976 TI - [Perinatal health: low birth weight and social class]. AB - A survey was carried out in Ribeirao Preto, S. Paulo State, Brazil, between June 1978 and May 1979 with a view to studying the prevalence of low birth weight and its occurrence among different social classes. Data were collected from 8,878 singleton live births in eight maternity hospitals, accounting for 98% of all births in the area. Social classes were determinated by the use of a model proposed by Singer and modified for epidemiological purposes by Barros. Out of the 8,878 births, 660 (7.5%) were of low birth weight. The prevalence of deficient weight at birth (between 2,500 and 2,999 grams) was of 21.1%. Analysis indicated that 50.6% of children with low birth weight were at term and the majority of them suffered form intrauterine growth retardation. The prevalence of low birth weight according to social class was seen to be lower in the bourgeoisie classes (ranging from 2.8% to 3.9%) and higher in working classes (from 7% up to 9.5%). Low birth weight (defined as less than or equal to 2,500 grams) was used for purposes of comparison with other previous surveys. The percentage was lower in this study (8.3%) than that found in the Interamerican Investigation of Mortality in Childhood (8.7%), carried out in 1968-70. No statistically significant differences in the percentage of low birth weight were found in the case of Ribeirao Preto when these two surveys were compared. PMID- 1784977 TI - [Adequacy of contraceptive pill use among women in union]. AB - A total of 2,364 women in marital union, 15 to 49 years of age, were interviewed at home. They lived in poor neighbourhoods in the metropolitan area and in the interior of S. Paulo State, Brazil. The prevalence of contraceptive pill use and the association between socio-demographic characteristics of users and the presence or not of risk factors for pill use were studied. One fourth (25.8 percent) of the women interviewed were using contraceptive pills. Prevalence was higher among younger women, those with no more than one live child and those who had completed between three and eight grades of schooling. Over 40 percent of the users referred having risk factors for pill use at the time they initiated the method. No association was found between age and the percentage of women with risk factors. This percentage increased with number of children and decreased with women's schooling. The fact that pills were prescribed or obtained through the health system was not associated with the proportion of users with risk factors. The percentage of users with risk factors was similar when comparing women who did not consult any health service before initiating use with those who had consulted a public service. The prevalence of use observed in this study is similar to that described by other authors. Results show that the health system in the State of S. Paulo played no role in the improvement in the prescription of hormonal contraceptive pills. Central policy seemed not to have filtered down to the peripheral areas of the system. PMID- 1784978 TI - [The French School of Dentistry (II). Its history and vicissitudes]. PMID- 1784979 TI - [Preoperative cephalometric simulation in orthodontic surgery]. AB - The authors expand their method of cephalometric simulation, which was designed for maxillofacial surgeons performing orthognathic surgery. This method has been developed to make up for the insufficiencies of the usually available cephalometric simulations, ie. poor legibility and the lack of data that may be necessary for surgery. The authors only deal with CS on profile teleradiographs at the end of the orthodontic preparation. This method utilizes models cut out of colored polyester and representing the profile of the maxillary and mandible. All the possible movements of the skeletal parts can also be simulated and the analysis of their direction and amplitude is possible, as is, more importantly, the influence of vertical movements of the maxillary on the mandible due to the mandibular autorotation phenomenon. This method is essential to accurately assess the degree of differential impaction or egress of the mandible in the region of the incisors and of the molars, according to the accompanying movements of the mandible moving around the condyle. Examples illustrate the use of this simulation method in the various types of orthognathic surgery. Finally, the authors point out the limitations of the method and the complementary usefulness of anteroposterior cephalometric simulation and of gnathologic simulation on casts, in particular for osteotomies for the transverse direction and for asymmetria. PMID- 1784980 TI - [Temporomandibular joint arthroscopy. Therapeutic aspects]. AB - Arthroscopy is an interesting and enlarging technique that visualise the temporomandibular joint and allows surgical technics such as lysis and lavage, prediscal section, retrodiscal cauterisation, oblic protuberance cauterisation, disc suturing or shavering of the articular surfaces. PMID- 1784981 TI - [Arthrotomy for the permanent displacement of the temporomandibular meniscus. A coagulation-retraction technic of the posterior meniscal frenum]. AB - An original technique for surgical treatment by arthrotomy for permanent closed lock of the temporo-mandibular joint is described. This technique uses the temporo-meniscal compartment approach. The superior belly of the posterior meniscal attachment is dissected and retracted by a diathermy coagulation. Advantages of this technique are compared to the usual techniques of meniscopexy and meniscorrhaphy using a suture. The indications are proposed. PMID- 1784982 TI - [Epidermoid carcinoma of the lip. The contribution of surgery. Apropos of 429 cases]. AB - The surgical treatment of epidermoid carcinoma of the lip too rarely resorts to pluri-disciplinary confrontation, although all the possible techniques, i.e. surgery, curietherapy and radiation therapy, are effective. Curietherapy still is the choice method for large lesions, due to the quality of its aesthetic and functional results. The lymph node areas of N0 patients are neglected but should not be so, because the secondary evolution of an adenopathy has a poor prognosis. All the T2 and T3 patients with no general contraindication should undergo cervical exploration. PMID- 1784983 TI - [Cranio-orbital neurofibrosarcoma]. AB - We present a type 1 neurofibromatosis case with sarcomatous degeneration of a cranio-orbital neurofibroma, its surgical evolution and the cytogenetics and cellular proliferative potential features (CMF, Ki-67 antibody). PMID- 1784984 TI - [Cancer of the maxillary sinus. Apropos of 52 cases]. AB - The authors report about a retrospective study on 52 cases of malignant tumors of the maxillary sinus gathered from January 1, 1977 to December 31, 1985 in the Department of Cervicofacial and ENT Carcinological Surgery of the Salah Azaiz Institut in Tunis. Epidermoid carcinomas dominate, but the histological types encountered are quite various; the tumors are very advanced on the first consultation in most cases. Computed tomography was a great help to assess extension prior to treatment and during follow-up. The evolution involved frequent recurrence and a great number of deaths during the first year. PMID- 1784985 TI - [Medicolegal considerations. Apropos of tooth germ transplantation between 2 twins]. AB - With regard to medicolegal problems, semantics are of considerable importance: indeed, depending on whether we call grafting or transplantation of an organ the operation that takes a living organ to reimplant it in the same person or the operation that takes a living organ from a donor to reimplant it in a recipient, the issues raised are completely different. The transposition of a dental organ does not raise any particular problems apart from the technical requirements to be met; there is no special problem of prevention or ethics to be taken into consideration. The problem is a completely different one when it means taking a living organ from a living or dead subject and reimplanting it in another subject. All measures decreed from the point of view of law and regulations that are dictated by considerations of prevention and ethics must then be strictly applied. PMID- 1784986 TI - [Rhinophyma. The value of progressive dermabrasion]. AB - After briefly summing up the nosology of rhinophyma, the authors report their experience with the surgical correction of this nasal disease, on the basis of eight cases. They explain their reasons for giving up dermasection and preferring dermabrasion. PMID- 1784987 TI - [Correction of the tip of the nose in rhinoplasty]. AB - It is quite easy to significantly modify the nasal bone. In most cases, the dorsonasal skin, which is often thin and elastic, will adapt to the new osteocartilaginous frame. On the contrary, the thickness is different at the tip of the nose, where the skin is often thicker than at the dorsonasal level. Surgery should preferably be performed first on the tip of the nose, whose new shape will allow adjusting the new structure of the nasal bone. PMID- 1784988 TI - [Yahel's syndrome. Apropos of an unusual case of a foreign body lodged in the pterygo-maxillary fossa]. AB - The authors report and discuss the clinical and radiological features of a foreign body stuck in the infratemporal fossa (Yahel's syndrome). Access to the infratemporal fossa was gained using the modified Pellerin-Donazzan procedure. PMID- 1784989 TI - [Essential bone cysts of the jaw. Apropos of an unusual care]. AB - After reviewing the literature, the authors present an unusual case of essential bone lacunae. These lesions involve part of the upper maxillary and the entire horizontal branch of the mandible. The diagnosis was confirmed by surgical exploration and histological studies. During the following 8 years, surgical curetting was performed three times, without producing a bony cicatrisation of the cavities. PMID- 1784990 TI - [Intravascular endothelial papillary hyperplasia in the masseter muscle]. AB - Intravascular Papillary Endothelial Hyperplasia (IVPEH) is a benign process, even uncommon. It was first described by Masson in 1923 under the name "Hemangioendotheliom vegetant intravascular". We present a case of IVPEH located in the masseter muscle. The treatment for this lesion was surgical excision. The histological examination is very important in order to separate this lesion from angiosarcoma. PMID- 1784991 TI - An institutional experience in handling intracapsularly located prostate cancer. PMID- 1784992 TI - Long-term results of ultrasonically guided implantation of 125-I seeds combined with external irradiation in localized prostatic cancer. AB - Transperineal 125-iodine seed implantation guided by transrectal ultrasonography and subsequent external beam irradiation was employed in the treatment of 32 patients with localized prostatic carcinoma (16 poorly differentiated). Follow-up is currently 35-98 months with a median of 65 months. Distant metastases have developed in 18 patients, of whom 11 have died from prostatic cancer. Median change in prostatic volume was a reduction of 35%. Re-biopsy or transurethral resection of the prostate was performed in 25 patients after 1-4 years, revealing still malignant histology in 10 (40%), of whom 8 have developed distant metastases or died from prostatic cancer. Fourteen patients suffered from late complications of which surgical intervention was indicated in five cases. Nine patients are presently free of progression and prostate specific antigen is less than 0.5 ng/ml in 8 of these. The future role of ultrasonically guided implantation in the management of prostatic cancer is discussed. PMID- 1784993 TI - Percutaneous nephrolithotomy--the birth of a new technique. AB - Extraction of renal calculi via a percutaneous track was for the first time practised at the Karolinska Hospital in 1973. After very strict indications in the beginning because of fear of uncontrollable bleeding, the method was found to be safe and the technique was spread all over the world. Now being to a large extent replaced by extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PNL) has still many applications e.g. alone in obstructed kidneys or together with ESWL in staghorn calculi. PMID- 1784994 TI - Localized prostate carcinoma treated with TUR and neodymium-YAG laser irradiation. AB - Neodymium-YAG laser irradiation subsequent to extended transurethral resection has been practised in our department since 1981 as an alternative treatment for patients with localized prostate carcinoma. The treatment is performed endoscopically in two separate steps. The procedure is simple and complications are few. One hundred and twenty-four patients have been treated and followed up for more than 6 months. One hundred and ten patients are evaluated as disease free survivors and the overall actuarial disease free survival rate is 88% at 4-9 years of follow-up. The initial promising results persist and the results from other clinics confirm the method to be a fair alternative or patients with localized prostate carcinoma. PMID- 1784995 TI - 'Local recurrence' and 'disease-free survival'. Doubtful parameters when comparing non-randomized studies of prostate cancer. AB - We reviewed recent literature on studies with external radiation of prostatectomy for localized prostate cancer considering the definitions of 'local recurrence' and 'disease-free survival' and the reporting of patients lost to follow-up. Among studies evaluating external radiation, 5/71 (29%) mention that prostate biopsy is used for some patients in determining local recurrence, versus 6/11 (55%) for prostatectomy. Several studies, 15/28 (54%), present figures for disease-free survival without giving a definition of the parameter. In the majority of the reports no comments are made relative to patients lost to follow up. Three authors consider patients lost to follow-up as dead with disease. Considerations regarding 'local recurrence' and 'disease-free survival' warrant caution in the interpretation of data based on such parameters. In a comparison of non-randomized studies of localized prostate cancer, cancer-specific survival with prostate cancer death defined as 'death wtih diagnosed distant metastases' may be a robust parameter. PMID- 1784996 TI - Metabolic side-effects of estrogen therapy for prostatic cancer. PMID- 1784997 TI - Biochemistry of human bladder tumor invasion. AB - Bladder tumors comprise a spectrum of neoplastic diathesis. Some behave in a benign fashion, and others are highly aggressive and lead rapidly to metastatic disease and death. The metastasizing potential, often described as a sequence of interrelated steps, involve 1) tumor cell adhesion to basement membranes, 2) degradation of basement membranes and underlying connective tissue stroma, and 3) migration of tumor cells through the destroyed stroma into blood and lymphatic vessels. Each of these processes involves the expression of molecular and biochemical factors identified with tumor cells. With better understanding of the molecular basis of these factors, novel prognostic and potential therapeutic agents can be generated and applied to the clinical arena. PMID- 1784998 TI - Use of a tamponade catheter in the bleeding nephrostolithotomy track. AB - Bleeding from the nephrostomy track, which is the most common major complication of percutaneous extraction of renal stones, was treated in 5 patients with the Kaye double-lumen nephrostomy tamponade catheter. This treatment was effective in all cases. The procedure eliminates the need for more invasive measures like embolisation and open surgery with renal resection, both of which cause loss of functioning renal parenchyma. PMID- 1784999 TI - Prognostic factors in bladder carcinoma. AB - Basic and clinical research has led to a better understanding of bladder tumor disease. Better characterization of host and tumor has made it possible for the clinician to choose appropriate treatment and follow-up and to better predict prognosis. Therefore, at tumor presentation a number of variables should be determined to reach the goal. Tumor factors: T-category, grade, size, number and appearance of the primary tumors, time to first recurrence and for invasive tumors also N- and M-categories, small vessel invasion, recurrence pattern, papillary stalk or true lamina propria invasion, the presence of secondary carcinoma in situ, ureteric obstruction and response to specific treatment. Host factors: Immune status, age, performance status, sex, pretreatment length of history and hemoglobin. However, in the individual patient bladder tumor disease may not always follow the predicted course, so that we are still in need of more accurate biological predictors. A number of markers (cytogenetic and cytomorphometric characteristics, such as flow-cytometry, immunohistochemical markers such as ABH expression, T-antigen, CEA, TPA and cytokeratins, and finally ultrastructural changes, proliferative indices and morphometric analysis) have been evaluated. Some have been shown to be of clinical value, but have as yet not been included into routine clinical use. Thus, we are steadily approaching the goal to disclose the true biological potential of each individual tumor and its relation to the host. PMID- 1785000 TI - Integral photodynamic therapy of superficial bladder tumors with special reference to carcinoma in situ. AB - Whole bladder wall photodynamic therapy using hematoporphyrin derivative and argon-dye laser light 630 nm was performed on 40 patients with mainly carcinoma in situ of the bladder. Two types of laser light scattering diffuser developed at our department were used: motor-driven and endoscope-modified laser light scattering diffusers. The total energy density used was 10 to 30 Joules/cm2. Of the 40 patients, 27 (67.5%) achieved complete response and 5 (12.5%) partial response at 3-months follow-up. In 11 of the 27 patients, there was no recurrence with an average tumor-free time of 26.3+/-26.1 months ranging from 3 to 75 months. Bladder capacity was reduced to approximately 150 ml for 3 months after treatment without any evidence of hydronephrosis or excretory urograms, except for 2 patients who had contracted bladders before treatment. The suitability of sulphonated AlCl phthalocyanine, a new photosensitizer to replace HpD, is discussed. PMID- 1785001 TI - Instillation therapy in superficial urinary bladder cancer. Finnbladder Group. AB - Carcinoma in situ (TIS) is a special dilemma. Controversial diagnostic and therapeutic attitudes prevail in the literature. Mild dysplasia grade 1 seems to be a condition where 'wait-and-see policy' might be justified according to our series of 60 patients with a TIS whereas, both the TISG2 and TISG3 are real malignancies which need a more aggressive treatment than a transurethral resection (TUR) alone. Under a close control, intravesical chemo- and immunotherapy offer an alternative to cystectomy. On the other hand, for a visible superficial (Ta-T1) cancer TUR is the principal treatment, which can easily be repeated. Anyhow, the high frequency of recurring tumours and the tendency to simultaneous progression in a specific category of patients have led to adJuvant prophylactic treatments. Currently, both intravesical cytostatics and intravesical bacillus Calmette-Guerin have been proven safe with much the same effect. Adjuvant prophylaxis of a primary, single superficial tumour is not indicated, even though the treatment of T1G3 cancer is under discussion. PMID- 1785002 TI - Prophylactic instillation therapy of superficial bladder cancer. A randomized study comparing mitomycin C and adriamycin with special reference to DNA ploidy. AB - Sixty patients with Ta and T1 bladder cancer were randomized between treatment with resection only and resection and instillations with either Adriamycin or Mitomycin C. Treatment lasted for one year and patients were evaluated after a mean follow-up of 35 to 47 months if progression had not occurred. Mitomycin C was superior in reducing the recurrence rate. Progressive disease was observed in 17 patients regardless of therapy but in all patients DNA aneuploidy could be identified at a risk factor. PMID- 1785003 TI - Extracorporeal shock wave lithotripsy of urinary calculi. Results from the first 306 patients treated at the Copenhagen Municipal Stone Center with a second generation lithotriptor. AB - The first Danish experience with Extracorporeal Shock Wave Lithotripsy (ESWL) using a second generation Lithotriptor (Siemens Lithostar) is reported. 306 patients underwent 392 treatments for 363 stones. There were 339 renal calculi including 5 staghorn calculi and 54 ureteral calculi. Treatments were performed under local analgesia (82%) or epidural or general anesthesia (18%) when invasive procedures had to be done in connection with the treatment. Stone fragmentation was achieved with 2487 +/- 1262 shocks. The first months stone clearance rate was 45%; 26% had fragments less than 6 mm; 29% had residual stones. Corresponding rates after 3 and 6 months were 58%, 24% and 18% and 70%, 21% and 9% respectively. Septicemia occurred in 4 patients and cardial arrhythmia in 34 patients (11%). No serious intra- or perirenal hematomas were registered. In 9% additional procedures were required and 11 patients had residual stones removed at open surgery. The used second generation lithotriptor with X-ray based stone localisation is effective for treatment of both renal calculi and ureteral calculi in situ in all three segments of the ureter. PMID- 1785004 TI - Treatment of advanced bladder cancer category T2 T3 and T4a. A randomized multicenter study of preoperative irradiation and cystectomy versus radical irradiation and early salvage cystectomy for residual tumor. DAVECA protocol 8201. Danish Vesical Cancer Group. AB - From 1983 to 1986 183 patients with transitiocellular carcinoma of the urinary bladder, category T2-T4a, entered a randomized study. The patients were allocated to receive either preoperative irradiation (40 Gy) followed by cystectomy or radical irradiation (60 Gy) followed by salvage cystectomy in cases of residual tumor. The two randomization groups were comparable in regard to sex, age, T categories, tumor size, histological grade and concomitant dysplasia. The two randomization groups included 88 and 95 patients respectively. The treatment plan was followed by 66 patients (75%) in the planned cystectomy group and by 88 (92%) in the radical radiotherapy group of which 27 (28%) were treated with salvage cystectomy. The results showed a trend to a higher survival rate following the combined treatment with preoperative irradiation and cystectomy compared to radical irradiation followed by salvage cystectomy in case of residual tumor, but a statistical significant difference could not be demonstrated. The lack of difference also applied according to the actually given treatment. There was no difference in surgical complications between planned and salvage cystectomy and there were no postoperative deaths among the cystectomized patients. The type of late complications was different in the two treatment groups, but there were no major differences in the number of complications except for the fact that all male patients experienced erective impotence after cystectomy. The T-category, response to radiotherapy and frequency of lymph node metastases were found to be of prognostic importance.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785005 TI - Cellular origin of renal cell carcinoma--an immunohistological study on monoclonal antibodies. AB - It has been recognized in recent years that renal cell carcinoma possesses a proximal convoluted tubules origin. In an attempt of further intensive evaluation we assayed 51 renal cell carcinomas and 38 additional normal kidney specimens with 4 kidney segment-specific antibodies (Uro-2/S4, Uro-5/T16, Uro-10/T43, Anti Tamm-Horsfall Protein) directed against the nephrotic cells by indirect immunohistological techniques. Consistently stable staining was developed in the tests. The results showed that the majority of renal clear cell carcinomas expressed nephrogenous properties of proximal convoluted tubules but in part also of distal tubules and collecting ducts. Granular cell carcinoma mostly demonstrated histogenic appearance of distal convoluted tubules. PMID- 1785007 TI - Surgery of pulmonary metastases from renal and bladder carcinoma. PMID- 1785006 TI - Long-term experience with conservative surgery of renal tumors. Surgical technique, complications, results, DNA-cytometry. AB - The surgical technique, course and complications were analysed in 123 patients in whom a kidney tumor had been enucleated. Fifty-seven enucleated tumors were available for image analysis DNA-cytometry. In 49 patients there was an imperative indication for an organ-preserving operation, because nephrectomy would have made dialysis obligatory. In 74 patients with a healthy contralateral kidney the tumor was enucleated by choice. Thirty-five of 49 patients with an imperative indication are without sign of tumor progression after a mean follow up of 4.5 years. In two patients there was a recurrence after 4 and 5 years, respectively, requiring a second organ-preserving operation. In one further patient there is a suspicion of multiple small tumor lesions 2 years after the first operation. Known metastases were present in 3 of 6 patients who died of their tumors. Sixty-eight of 74 patients operated on electively are without signs of tumor progression after a mean follow-up period of 3.3 years. One patient died from tumor metastases. Two patients had tumor recurrence, requiring nephrectomy and enucleation, respectively. PMID- 1785008 TI - Peyronie's: its cause. PMID- 1785009 TI - Diverticular of the male anterior urethra symptoms, diagnosis and treatment. A report on 12 cases. AB - Ventral and dorsal midline wide-mouthed diverticula and Cowper's perforate syringoceles were diagnosed in 12 men with symptoms such as post-voiding dribbling, dysuria, urethral discomfort and haematuria. In all cases the diagnosis was made during urethroscopy and most patients were treated at the same time with transurethral incision of the diverticular wall, thereby marsupializing the diverticulum into the urethra. Diverticula of the male anterior urethra are more common than has been hitherto assumed. In patients with longstanding and/or recurring urethral symptoms and post-voiding dribbling urethroscopy should be included in the investigation. PMID- 1785010 TI - 'A lovely bunch of coconuts'. AB - Aspiration and instillation of Sodium tetradecyl sulphate into the sac was used as definitive treatment for 106 patients with hydroceles and epididymal cysts. 83 of these (78%) were cured by a single treatment. Complications were uncommon and mainly consisted of mild pain and swelling. PMID- 1785011 TI - Painful testicular lithiasis. AB - Testicular pain both acute and chronic is quite common and may result from many different diseases located both in and outside of the testis. Diffuse testicular microlithiasis is a rarely encountered problem in urology and up to now a unique sonographic appearance. We here report a case with combination of both signs and give a short review of the literature. PMID- 1785012 TI - Biocompatibility of urinary catheters--present status. AB - Biocompatibility aspects of urinary catheters have been recognized by clinicians during the 1980's. After multiple reports of severe urethral damage caused by latex catheters, a series of investigations revealed that toxic substances added to the catheters during the manufacturing process can leak from the devices in situ and cause urethritis developing severe urethral strictures. Consequently, most manufacturers have improved their catheters, but there are still some catheters of inferior quality on the market. Quality is dependent on the biocompatibility testing methods. Cell culture tests are recommended, but there are no common standards regarding these. British Standards Institution has been the first in Europe to adopt toxicity limits for a cell culture test, but those are not acceptable. It is a task for the standardization committees working for the European Community to create adequate biocompatibility testing standards with clinically relevant toxicity limits. If this is not done, the use of latex catheters should be abandoned as potentially harmful devices. PMID- 1785013 TI - Urease-induced precipitation on latex and silver coated latex in vitro. PMID- 1785014 TI - Long-term morbidity and quality of life in testicular cancer patients. AB - Today about 90% of patients with testicular cancer can be cured. The consideration of treatment-related long-term morbidity has, therefore, become an important issue. Cisplatin-based chemotherapy induces long-lasting Raynaud-like phenomena and/or peripheral sensoric, usually mild, neuropathy in 30-40% of the patients. Irreversible reduction of renal function is a frequent finding after chemotherapy, especially if high doses of cisplatin are given. Abdominal radiotherapy is generally well tolerated but may lead to slight chronic meteorism and dyspepsia. 'Dry ejaculation' represents the principal sequelae after retroperitoneal surgery. The frequency of this side effect can be reduced by nerve-sparing surgery. Both chemotherapy and radiotherapy reduce spermatogenesis transiently. About 2 years after discontinuation of treatment, sperm production has recovered in most of the patients with normal pretreatment gonadal function. At least half of the patients with a desire for post-treatment paternity are able to father a child after their treatment. Assisted fertilization may reduce post treatment infertility problems for individual couples. In general, cured testicular cancer patients are more satisfied with life than an age-matched control group, but may present a greater fluctuation of their mood and affect. In conclusion, most cured testicular cancer patients enjoy a normal life if precaution is taken to reduce therapy-related side effects to a minimum. However, reduction of the complication rate would not lead to a decrease of the present high cure rate of this malignancy. PMID- 1785015 TI - Living with a urostomy. A follow up with special regard to the peristomal-skin complications, psychosocial and sexual life. AB - Sixty-six subjected to an ileal conduit urinary diversion on account of bladder cancer (44 patients) or incontinence or bladder dysfunction (22 patients) were investigated. Stoma and skin complications were frequently observed and the patients who practiced inadequate stoma-care routines were more likely to show peristomal-skin complications, compared with the rest of the patients. With the passage of time after surgery, a quarter of the patients obtained full disability pensions. Stoma-related problems were the main causative factor in half of these cases. The majority of the bladder-cancer males reported were more likely to report decreased rather than no sexual activity. Compared with females with bladder cancer, females with the diagnosis of incontinence or bladder dysfunction were more likely to increase their sexual activity after the operation. Bladder cancer patients more frequently curtailed their social activities, compared with the patients with the diagnosis of incontinence or bladder dysfunction. PMID- 1785016 TI - Outpatient-based extracorporeal shock wave lithotripsy using EDAP LT-01. AB - Between March 1988 and March 1990, 751 patients were treated with shock wave lithotripsy using EDAP LT-01. Six hundred and eight patients had renal stones while 143 patients had stones located in the ureter. Because of difficulties in locating ureteric stones with ultrasound 92% of them were pushed back to the kidney before treatment. The mean stone size was 10 mm, range 4-30 mm. Patients with stones bigger than 15 mm had a double J-stent placed before treatment. The mean number of treatments per patient was 1.7 (range 1-8). Sixty-six per cent of the patients with renal stones were completely stone-free after ESWL monotherapy. Another 5% became stone-free after auxiliary procedures in the ureter, because of retained fragments. Fragments equal to or less than 4 mm were retained in 14% of the patients with the renal stones. Of the patients with ureteric stones mobilised back to the kidney 95% were rendered stone-free after ESWL. Most patients experienced no or very little discomfort during the treatment and only 29% of them received analgesics. General of epidural anaesthesia was given to 1% of the patients. Because of the low demand for analgesia or anaesthesia, 99% of the patients with renal stones were treated on an outpatient basis. During the second year, 74% of the patients with ureteric stones were treated on an outpatient basis. PMID- 1785017 TI - Drug treatment of pain in patients with urological cancers. PMID- 1785018 TI - Pulsed dye laser treatment of ureteral calculi. AB - During a period of 20 months 36 patients with symptomatic ureteric stones were treated ureteroscopically with laser lithotripsy. A pulsed dye laser was used through a rigid or a semi-rigid ureteroscope. The laser emits impulses at a duration of 2 microseconds and a wavelength of 504 nm. Complete disintegration was obtained in 20 patients (56%), and further 7 patients became stonefree after supplementary basket extraction of residual fragments. In 4 patients additional treatment with ultrasound probe was necessary and further 5 patients were finally treated with ESWL. Five cases of minor perforations of the ureter required no other treatment than stenting with a ureter-catheter or a double J stent. With the new generation of slender semirigid ureteroscopes based on fiberoptics the ureteroscopic procedure is simplified, as no dilatation of preoperative preparation of the ureter is needed. PMID- 1785019 TI - Continence mechanism in the female. AB - Continence is partly automatically and partly consciously regulated. It is automatically regulated until the desire to void is felt. From then on, micturition reflex elicitation is consciously inhibited. When that is no longer possible, the sequence of urethral relaxation and detrusor contraction automatically takes place. Continence may thereafter be consciously maintained through squeezing with striated muscles and then by external mechanical compression of the urethra. PMID- 1785020 TI - Evoked potentials from the lower urinary tract. II. The spino-cortical neuraxis. A methodological study. AB - Spinal and cerebral evoked potentials (EPs) on stimulation of the dorsal nerve of the penis, clitoris, bladder wall and posterior urethra were recorded in 20 normal subjects (10 females and 10 males). Responses were obtained by computer averaging of multiple potentials registered over the spinal cord (L1) and cerebral cortex. Responses from the posterior tibial nerve were also recorded. Consistent cortical responses were obtained from the pudendal nerve, bladder wall and posterior urethra, whereas spinal responses were difficult to record. The maximum responses after stimulation of the pudendal nerve, bladder wall and posterior urethra were recorded over the midline of the scalp at CZ-2 cm point. The configuration of the somatosensory evoked potentials of the pudendal nerve had a W-shape with a consistent positive peak P1 (median 42.0 msec, range 39-45 msec), whereas the responses after endovesical and endourethral stimulation mainly were M-shaped with a prominent negative peak N1 (Bladder: mean 104.0 msec, range 75-112 msec and posterior urethra: median 103.0 msec, range 78-114 msec). Conduction times within the central spinal pathways could be calculated by subtracting the latencies of the peripheral spinal potentials from the central cortical potentials. PMID- 1785021 TI - Vesicoureteral reflux in adults studied by computerized radionuclide cystography. AB - Direct radionuclide cystography in a computerized method as described by Willi and Treves was used in adults with recurrent pyelitis but without evidence of obstruction. Reflux was observed in 15 out of 38 patients. In patients with neurogenic bladder dysfunction or megaureters, reflux began early during the bladder filling and attained higher volumes than in those with uncomplicated pyelitis, who had minor reflux appearing mainly during voiding. Bladder capacity and detrusor compliance were lower in patients with reflux than in those without reflux. The low radiation exposure in radionuclide cystography permits observation of the urodynamic course of urinary reflux and correlation to the intravesical volume and pressure. The method is sensitive, and minor refluxed volumes can be detected. Radionuclide cystography can therefore be recommended for checking of surgical results and for follow-up of patients with neurogenic bladder dysfunction. PMID- 1785022 TI - The role of growth factors in the human prostate. PMID- 1785023 TI - Absorption of irrigating fluid during TURP--fact and fiction. AB - The basic requirements for intravenous (IVA) and extravascular absorption (EVA) of irrigating solutions during TURP are discussed. The operating surgeon should not rely on thumb rules but know the mechanisms behind absorption and be acquainted with the inherent risks of his irrigating systems. Peroperative monitoring of absorption has obvious advantages for the patient's safety, for the anaesthetist and for the training surgeon. The use of ethanol as a tracer for the detection of irrigant absorption and the route of absorption is herein discussed. Some hints for limiting fluid absorption during TURP is also proposed. PMID- 1785024 TI - Prostatitis, prostatosis and prostalgia. Psychogenic or organic disease? AB - The term 'chronic prostatitis syndrome' (C.P.S) encompasses chronic bacterial prostatitis, chlamydia or ureaplasma-associated disease, chronic 'abacterial' prostatitis, and patients with prostatosis or prostatosis or prostalgia. Interesting observations emerged from the evaluation of the clinical material indicating that the patients with abacterial prostatitis and those with prostatosis or prostaglia group have frequent sperm abnormalities and ultrasonographic changes suggesting a more complex pathogenesis than mere congestion and neurosis. Treatment in 144 evaluable patients treated with a long acting sulphur-trimethoprim combination was almost uniformly well tolerated; Chlamydia was eradicated in all 10 treated patients and 77.4% of patients with bacterial C.P.S. were rendered free of bacteria. Sperm abnormalities were almost invariably resistant to the treatment. Only 44.4% of patients showed a partial improvement, limited to one or more parameters. Results did not differ significantly in the various subgroup. An overall evaluation of results showed that disappearance of every presenting symptom and sign was obtained in 24.3% and a significant improvement in another 25% of patients, including those in the prostatosis-prostalgia group. These results suggest that antibacterial treatment may be followed by favourable clinical results even in patients in whom no bacteria or other aetiological agents could be isolated. PMID- 1785026 TI - When medical science conflicts with clinical medicine. PMID- 1785025 TI - The prognostic significance of ploidy and DNA-heterogeneity in the primary diagnosis and monitoring of patients with locally advanced prostatic carcinoma. AB - Single-cell DNA cytophotometry was employed to analyze the tumors of 271 patients with locally advanced prostatic carcinoma as to DNA ploidy and heterogeneity and the distribution of the phases of the cell cycle before and during therapy, with the intention of establishing prognostic factors apart from those already known (stage, grade). Follow-up periods ranged from 1 to 9 years. One hundred and ninety-eight (73%) of the 271 patients had carcinoma stage T3 NO MO, and 73 (27%) of them had carcinoma state T3/T4 N+ M1. The tumors were evaluated cytologically to establish the grades of malignancy. 11.8% were grade-1 carcinoma, 64.3% were grade-II and 23.8% were grade-III carcinoma. Single-cell DNA cytophotometry demonstrated aneuploidy rates of up to 73% and diploidy rates of up to 23.8% for the higher grades of malignancy, whereas the diploidy rate established for grade I carcinoma was 71% and the respective aneuploidy rate was 15.2%. These differences are significant (p less than 0.001). There was a significant correlation between the results of DNA cytometry and the clinical course of the disease. Patients with diploid tumor-cell nuclei developed no metastases and no local tumor progression during the follow-up of 9 years, whereas patients with aneuploid tumor-cell nuclei showed metastases and local tumor progression within 8-22 months, despite changes in therapy. These patients died of carcinoma after an average 18 months following primary diagnosis. PMID- 1785027 TI - Early prognosis of stroke outcome by means of Katz Index of activities of daily living. AB - The predictive validity of Katz' Index of ADL (Activities of Daily Living) regarding length of hospital stay, discharge to own home or death within one month, and its reproducibility in clinical practice was studied prospectively in Sodertalje and in Enkoping, Sweden. The Sodertalje study included 124 consecutive patients, who were all assessed on days 5-7 after stroke by an occupational therapist. The Enkoping study included 106 consecutive patients, who were assessed similarly by trained nurses. Ninety-six and 94%, respectively, of patients in grades A-C on days 5-7 after stroke were discharged to their own homes within one month. Ninety-six and 92%, respectively, of patients in grades D G stayed in hospital longer than one month or died. Sixty-two and 68%, respectively, of patients in grade G died within one month. The instrument is now used as a valid tool for early prognosis of stroke outcome in order to facilitate the planning of care and rehabilitation in clinical practice. PMID- 1785028 TI - Assessment of activities of daily living in the elderly. A study of a population of 76-year-olds in Gothenburg, Sweden. AB - The cumulative structure of personal daily activities (Katz' Index of ADL) and four well-defined instrumental activities (cooking, transportation, shopping, and cleaning) have been studied in a population of 76-year-olds (N = 659) in Gothenburg, Sweden. Sixty-five percent of the population were independent, 22% were dependent in instrumental activities, and 13% were dependent in both instrumental and personal activities. No person was dependent in personal ADL and independent in instrumental ADL. The internal consistency and the coefficient of scalability were well above the acceptance level, which indicated an internal reliability and validity of the new scale. The frequency of personal and home assistance care, type of accommodation, self-assessment of self-care and domestic activities were compared with the level of dependence in ADL and indicated external validity. This cumulative instrument of ADL can be used to describe and compare the level of disability in elderly populations and to define the need for personal assistance in home care among disabled persons. PMID- 1785029 TI - Standardization of grip strength measurements. Effects on repeatability and peak force. AB - The aim of our study was to test grip strength and assess the effects of various degrees of standardization on repeatability and level of peak force. Sixteen healthy persons and eight subjects with an impaired hand function have been tested using a strain-gauge dynamometer. We compared four measurement protocols: (A) the subject is free to assume a comfortable arm position; (B) the subject is also free to assume a comfortable arm position but in addition a challenging stimulus to exceed a previous maximal effort, is given; (C) the arm was held in a predescribed and partly fixated position, as recommended by the American Society of Hand Therapists; (D) the position of the dynamometer is standardized using two reference points both on the hand and on the dynamometer. We found high test retest reliabilities for each measurement protocol without any significant difference. There were, however, significant differences in strength level. With measurements according to protocol B the highest peak values were noted. Since the measurement protocol B combined good reliability with realistic peak forces, this procedure seems most suitable for grip strength measurements. PMID- 1785030 TI - The influence of functional electrical stimulation on the properties of vastus lateralis fibres following total knee arthroplasty. AB - The influence of functional electrical muscle stimulation (FES) on selected properties of vastus lateralis muscle fibres was studied in patients recovering from total knee arthroplasty for osteoarthritis. Prior to surgery, on the average, muscle biopsies from the vastus lateralis could be characterized as having a predominance of Type I fibres which were significantly larger in cross sectional area than the Type II fibres in the same sample. Following surgery, muscle biopsies from a group of patients (n = 7) which received continuous passive motion and no FES, exhibited a marked increase in the proportion of Type II fibres along with a general atrophy of both the Type I and Type II fibres. Patients receiving passive motion and FES (n = 9) also showed an increase in the relative percentage of Type II fibres. Post-operatively, however, there was no significant reduction in fibre area in the stimulated muscles. These data suggest that FES was effective in attenuating the muscle atrophy associated with total knee arthroplasty but had no influence on those metabolic properties which were related to muscle fibre type classification criteria. PMID- 1785031 TI - A placebo controlled trial of ultrasound therapy in chronic leg ulceration. AB - A controlled study of the effects of ultrasound on healing chronic leg ulcers was carried out in conjunction with standard treatment on 38 patients divided randomly into two groups. All patients received standard treatment (paste impregnated bandage and a self-adhesive elastic bandage plus placebo ultrasound or ultrasound (1.0 watt/cm2 at 1 MHz, for 10 min) twice weekly for 8 weeks. Percentage healed ulcer area and number of healed ulcers were compared after 2, 4, 6 and 8 weeks. There were no significant differences in the proportion of healed ulcers or ulcer area in the ultrasound group as compared with the placebo group. PMID- 1785032 TI - The physical and psychosocial effect of moderate osteoarthrosis of the knee. AB - To illustrate both physical and psychosocial effects of moderate gonarthrosis, clinical examination of patients has been supplemented with a questionnaire SIP (Sickness Impact Profile), to describe the functional health status. Sixty patients, 35 women and 25 men, mean age 63 years, with moderate medial osteoarthrosis of the knee and no symptoms from other joints, were included in the study. The mean BOA score and the self-selected walking speed were decreased in these patients compared to normal individuals. All patients graded pain during walking. The SIP revealed both physical and psychosocial changes in these patients with moderate gonarthrosis. Patients considered that their knee osteoarthrosis had great influence physically on ambulation, during recreation and pasttimes, during sleep and rest, and psychosocially on emotional behaviour. Significant correlations (p less than 0.01) were found between pain during walking and the psychosocial questions in the SIP, between the BOA score and questions in the SIP concerning the physical performance, and between self selected walking speed and the physical questions. It is concluded that the SIP appears to be a measure with sufficient sensitivity to detect physical and psychosocial changes in patients with moderate osteoarthrosis of the knee. In clinical practice determination of self-selected walking speed and pain during walking will appropriately reflect general function. PMID- 1785033 TI - Lasting recovery of motor function, following brain damage, with a single dose of amphetamine combined with physical therapy; changes in gene expression? PMID- 1785034 TI - Science and abortion. PMID- 1785035 TI - Genes, peoples and languages. PMID- 1785036 TI - Brain, food. Drugs based on neuropeptides may soon treat eating disorders. PMID- 1785037 TI - Skinside out. Drug delivery in reverse could be a diabetic's boon. PMID- 1785038 TI - Essay: animal thinking. PMID- 1785039 TI - Are species specious? PMID- 1785040 TI - Dyslexia: a problem of timing. PMID- 1785041 TI - Murder mystery. PMID- 1785042 TI - Amyloid protein and Alzheimer's disease. PMID- 1785043 TI - Cultured cells for the treatment of disease. PMID- 1785044 TI - The goitre-soil-water-diet relationship: case study in Plateau State, Nigeria. AB - The effect of drinking water, soil mineral composition and nutrition on the incidence of goitre in Plateau State, Nigeria, was studied. The study shows that the water used for drinking and cooking in the goitrous areas is low in iodine content and trihalomethanes, but high in mineral content, including calcium, magnesium, nitrate, chloride and total hardness. The water is also high in organic, inorganic and bacterial pollution content. Soil pH in the goitrous area is acidic and mineral composition follows the same pattern indicated from water analysis. Soil iodine content is very low. Diet in the goitrous zone consists mostly of foods with high cyanogenic glycoside and low iodide. The ratios of iodide to thiocyanate in urine excreted by subjects from both goitrous and non goitrous areas show a strong correlation with goitre endemia. These studies exemplify goitre as having multicausal factors--lack/deficiency of iodine, familial or genetic tendencies, diet, and pollutants which serve as goitrogens. PMID- 1785045 TI - Toxicological studies on the long-term effects of heavy metals (Hg, Cd, Pb) in soil on the development of Aiolopus thalassinus (Fabr.) (Saltatoria: Acrididae). AB - Long-term effects of soil treated with 0.12-12 ppm HgCl2, 2-100 ppm CdCl2 and 25 500 ppm PbCl2 on the development, reproductive capacity and viability of Aiolopus thalassinus (Fabr.) (grasshoppers) during two successive generations were studied. The hatching rate of nymphs developed from eggs laid in treated soil was significantly reduced. Mercury was the most effective in reducing the hatching rate followed by cadmium and lead. The newly hatched nymphs, which developed in the heavy-metal-treated soil, were transferred to and reared in separate cages in order that toxicological effects could be followed through the next two generations without any further treatment. No significant increase was observed in percent mortality during both the F1 and F2 nymphal stages resulting from Hg, Cd and Pb treatment. The nymphs were more tolerant than the eggs and adults to the cumulative effect of heavy metals. The mean durations of the F1 and F2 nymphal stages were prolonged in all Hg and Cd treatments, but such a prolongation in the Pb treatments was found only in F1 nymphs, those developed from the two highest soil PbCl2 concentrations (250 and 500 ppm). The adult fresh weight of the F1 and F2 generations was significantly low in the case of the Hg and Cd treatments. The lifespan of the F1 and F2 adults developed from eggs laid in Hg-, Cd- and Pb-treated soil was significantly shortened and thus the number of egg pods was reduced in comparison with the control. The hatchability of nymphs developed from eggs laid by the F1 generation was significantly lower than that of the untreated control. No significant decrease in the hatching rate was found for the eggs laid by the F2 generation, except at the highest soil concentrations of the three metals. The metal content of eggs laid by the F1 generation increased significantly with increasing soil concentrations of the three metals. In the F2 generation eggs the heavy metal content was reduced in all cases; this indicates a dilution of the metal concentration in successive generations if no further exposure takes place. PMID- 1785046 TI - Trace metals in tropical marine fish from the Bay of Bengal. AB - Concentrations of potassium, calcium, magnesium, manganese, iron, nickel, copper, zinc, lead, cadmium, strontium and rubidium were determined in the flesh of six marine fish species from the Bay of Bengal. Analytical quality was determined by analysis of standard reference material MA-A-2 (TM), Fish Flesh Homogenate, from IAEA (International Atomic Energy Agency). In most cases the results are similar to data published on fish from other marine environments. PMID- 1785047 TI - Uranium content of blood, urine and hair of exposed and non-exposed persons determined by radiochemical neutron activation analysis, with emphasis on quality control. AB - Recent reviews have highlighted the diversity (and sparsity) of data for uranium concentrations in body fluids, bone and soft tissues, and it is unclear to what extent this reflects genuine geographical or biological variations. In the present work, a very sensitive radiochemical neutron activation analysis technique (detection limit, 1-2pg g-1) was applied to an exploratory study of uranium levels in hair, urine and blood of non-exposed and occupationally exposed persons. Since quality control in much previous work has been somewhat neglected, this aspect was emphasized by the use of a wide range of suitable reference materials, by standard addition experiments, and by care in sampling and sample handling. For controls, typical levels found in hair, urine and blood were 10 ng g-1, 10 and 5 ng l-1, respectively. The urine values correspond to the lower end of the literature data, while for blood our value is about two orders of magnitude lower than the presently quoted level. In the case of occupationally exposed persons, it was found that hair shows some promise as an indicator of exposure. PMID- 1785048 TI - Occupational and environmental exposure to arsenic--increased urinary arsenic level in children. AB - The sum of concentrations of inorganic arsenic, methylarsonic acid (MMAA) and dimethylarsinic acid (DMAA) in urine from adults and children living in an unpolluted area was compared with the corresponding sum measured in urine from adults and children living in an area polluted with arsenic and in urine from persons occupationally exposed to arsenic. The median values for 22 adults and 10 children aged 3-10 years living in the unpolluted area were 9.3 and 19.8 nmol As/mmol creatinine, respectively. The corresponding ranges were 3.2-27.9 and 7.7 57.8 nmol As/mmol creatinine, respectively. The difference between adults and children was tested by Mann-Whitney's non-parametric test and found to be significant (p less than 0.0025). No significant difference was found in arsenic concentration in urine from 73 adults and 10 children living in the polluted area compared with the arsenic concentration in urine from those living in the unpolluted area. The arsenic level in urine from adult workers handling arsenic treated wood was approximately four-fold higher (p less than 0.001), with a maximum recorded concentration corresponding to 814.9 nmol As/mmol creatinine. The arsenic levels in urine from two glass workers were nine- and two-fold higher, respectively. No significantly increased arsenic levels were found in urine from workers impregnating wood and in urine from lead accumulator workers. PMID- 1785049 TI - Comparative increases of lead and barium with age in human tooth enamel, rib and ulna. AB - Lead and Ba in postmortem tooth enamel, rib and ulna of six contemporary people (67-96 years; ave. 80) were shown to exhibit similar accumulations with age in the three different types of osseous tissue: Pb/Ca (wt) = 3.0, 5.2, and 3.9 x 10( 5) in rib, ulna, and tooth enamel; and Ba/Ca (wt) = 2.4, 2.4, and 1.8 x 10(-5) in rib, ulna, and tooth enamel, respectively. Mean concentrations of Pb were 11, 19, and 14 micrograms g-1 in rib (ash), ulna (ash), and enamel (dry), respectively. Means for Ba were 8.7, 8.9, and 6.4 micrograms g-1 in rib (ash), ulna (ash), and enamel (dry), respectively. Comparison of Ba in ulna of our 80-year-old subjects with Ba determined by other investigators in bones of younger contemporary populations indicated that Ba accumulates with age at about half the rate of Pb accumulation in bone. Concentrations of Ba in rib, ulna and enamel were positively correlated and similar within an individual, but varied among subjects in proportion to variations in absorptive uptake in portal blood. Barium may diffuse from a blood-dentine source into enamel, where it replaces Ca and accumulates with age. Because of extreme Pb pollution of our 80-year-old subjects and its variation of intake with age, the correlation of Pb in tooth enamel with Pb in bone was more scattered than for Ba. It is shown by means of stable Pb isotopic tracers that: (i) among the three types of osseous tissue, the residence time of Pb is longest in enamel, where it apparently accumulates with age by diffusion with little loss through exchange; and (ii) the residence time of Pb is longer in compact ulna than in trabecular rib, as it accompanies Ca in its osteoblastic transfer from blood to bone and then in its osteoclastic transfer back to blood from bone. PMID- 1785050 TI - Natural skeletal levels of lead in Homo sapiens sapiens uncontaminated by technological lead. AB - Lead, Ba and Ca concentrations were determined in tooth enamel, femur and rib from buried skeletons of PreColumbian Southwest American Indians, 10 subjects who lived 1000 years ago on the Pacific coast at 34 degrees N, and 13 subjects who lived 700 years ago in a desert valley tributary of the Colorado River at 37 degrees N 111 degrees W, both groups living in environments uncontaminated by technological Pb. For the coastal tribe, average Pb/Ca ratios were 1.1 x 10(-7) in enamel, 2.3 x 10(-7) in femur and 4.7 x 10(-7) in rib, while Ba/Ca ratios were 1.2 x 10(-5) in enamel, 32 x 10(-5) in femur and 38 x 10(-5) in rib (wt ratios). For the desert tribe, average Pb/Ca ratios were 4 x 10(-7) in enamel, 11 x 10(-7) in femur and 37 x 10(-7) in rib, while Ba/Ca ratios were 1.1 x 10(-5) in enamel, 7.5 x 10(-5) in femur and 6.2 x 10(-5) in rib. It is shown that biologic levels of Pb and Ba in buried femur and rib at both burial sites and in buried enamel at the Arizona site are obscured by excessive diagenetic additions of Pb and Ba from soil moisture. It is shown that one-third of the Pb in enamel at the Malibu site is biologic, yielding a skeletal Pb/Ca (wt) ratio of 4 x 10(-8). This is equivalent to a mean skeletal concentration of 13 ng Pb g-1 bone ash, and a mean natural body burden of 40 micrograms Pb/70 kg adult Homo sapiens sapiens, uncontaminated by technological Pb. This value is about one-thousandth of the mean body burden of 40 mg industrial Pb/70 kg adult American today, which indicates the probable existence within most Americans of dysfunctions caused by poisoning from chronic, excessive overexposures to industrial Pb. PMID- 1785051 TI - The importance of soil adhered to vegetation as a source of radionuclides ingested by grazing animals. AB - Soil ingestion has been identified as a potentially important source of radionuclides to grazing animals. Seasonal patterns of soil adherence to vegetation and its implications for the radionuclide intake of grazing animals were measured at two west Cumbrian sites. Soil adhesion to vegetation was highly seasonal, being highest in autumn and winter. At Site 1 (a lowland pasture close to the British Nuclear Fuels plc Sellafield Reprocessing Plant, Cumbria, UK), vegetation samples were found to consist of up to 46% soil (by dry weight). Therefore, the importance of soil as a potential source of radionuclides to grazing animals was also seasonal; soil comprised up to 92% of the 137Cs and potentially all of the 239/240Pu of vegetation samples at Site 1 and up to 62% of the 137Cs at Site 2 (an upland farm contaminated following the Chernobyl accident). Analyses of sheep faecal samples confirmed the seasonal importance of soil as a potential source of radionuclides. The importance of soil adhering to vegetation, as a source of contaminant 137Cs, increased with time after the Chernobyl accident. Calculations of soil ingestion must be made when the intake of radionuclides by grazing animals is being studied. In some circumstances, present radioecological models may considerably underestimate the importance of soil ingestion. PMID- 1785052 TI - Indoor radon measurements in the Beijing area. AB - Average indoor air radon concentration of 30 Bq/m3 was determined in various types of dwellings in the Beijing area using activated carbon detectors. In this study, several related factors were also investigated: radon area exhalation rates of 136 building materials and from soil surfaces; Ra-226 contents of 143 soil samples, 34 building materials and 28 coal samples; and radon concentrations in gaseous fuel, outdoor air and drinking water. The magnitude and relative importance of different sources in terms of indoor radon are discussed, compared and evaluated. The results show that the underlying soil and building materials are important sources of indoor radon. Cracks in floors or walls are major pathways for the entry of radon into houses. Measurements of the annual effective dose equivalent from radon daughters for different types of aboveground and underground buildings gave average values of 1.1 and 1.5 mSv, respectively. PMID- 1785053 TI - Preparation and certification of rice flour-unpolished reference material. AB - Rice flour-unpolished reference material was prepared from unpolished rice collected from three locations in Japan. This reference material is certified for elemental composition and consists of three samples containing low-level (0.023 microgram/g), medium-level (0.32 microgram/g) and high-level (1.82 micrograms/g) of Cd. The unpolished rice was pulverized, oven-dried, homogenized and finally packaged into 1000 glass bottles. The prepared material satisfied the homogeneity criteria for a reference material. Collaborative analytical studies on the elemental composition of the rice flour-unpolished reference material were conducted using various analytical techniques which lead to the certification. Stable isotope dilution/ICP-MS was successfully applied to the accurate determination of Cu, Zn, Mo and Cd in the reference material. Certified values are provided for Ca, Cd, Cu, Fe, K, Mg, Mn, Mo, Na, Ni, P, Rb and Zn, based on results of determinations by at least three independent analytical techniques. Reference values are reported for Al, As, Br, Cl, Co, Cr, Hg, Se and Sr. The elemental compositions of the three rice flour-unpolished samples are very similar, except for Cd, and are considered typical of Japanese unpolished rice. PMID- 1785054 TI - Distribution and sources of polycyclic aromatic hydrocarbons (PAHs) in street dust from the Tokyo Metropolitan area. AB - Molecular distributions of polycyclic aromatic hydrocarbons (PAHs) in street dust samples collected from the Tokyo Metropolitan area were determined by capillary gas chromatography following HPLC fractionation. Three- to six-ring PAHs and sulfur-heterocyclics were detected. PAHs in the dusts were dominated by three and four unsubstituted ring systems with significant amounts of their alkyl homologues. PAHs were widely distributed in the streets, with concentrations (sigma COMB) of a few microgram/g dust. Automobile exhaust, asphalt, gasoline fuel, diesel fuel, tyre particles, automobile crankcase oils, and atmospheric fallout were also analysed. The PAH profile, especially the relative abundance of alkyl-PAHs and sulfur-containing heterocyclics, indicated that PAHs in the street dusts from roads carrying heavy traffic are mainly derived from automobile exhausts; dusts from residential areas have a more significant contribution from atmospheric fallout. PMID- 1785055 TI - Cadmium contamination of deer livers in New Jersey; human health risk assessment. AB - Eighty-six liver samples were collected from hunter-killed deer at various locations in New Jersey and analysed for cadmium. Concentrations ranged from 0.07 to 23.2 micrograms/g dry weight. Three of the highest concentrations were measured in samples collected from an area with known cadmium contamination resulting from past waste disposal practices. Significant differences in liver cadmium concentration were noted among deer from different areas (p less than 0.01) and among different age groups (p less than 0.01). No sex-related differences were observed (p = 0.48). A survey of deer liver consumption was conducted and the data were used in formulating a health advisory. The lack of knowledge about the effects of cadmium on wildlife health is discussed in relation to an expected increase in the land disposal of sewage. PMID- 1785056 TI - Lead and zinc protoporphyrin in the blood of a rural child population in Asturias, Spain. AB - Lead and zinc protoporphyrin were determined in the blood of 54 children aged from 2 to 14 years living in a rural area of west Asturias (Spain). Mean values found were 14.4 and 27.7 micrograms dl-1, respectively. Blood lead levels are considerably lower than those of children living in central Asturias, which is more highly industrialised, showing the large part played by industry and road traffic in increasing both parameters. PMID- 1785057 TI - [Method of studying the opinion of patients on the operation of an ambulatory rehabilitation center]. AB - A questionnaire has been developed to study the extent of patient's satisfaction with rehabilitative treatment under conditions of a specialized rehabilitation centre. 100 neurological and traumatological patients were surveyed by means of questionnaires. A technique for the data obtained processing has been suggested which permitted one to identify the main factors lessening the extent of satisfaction with the outcomes of treatment. A comparative analysis was made of patients' and physicians' opinion on the quality of treatment provided. The comparison of questionnaire data provided by patients and objective indicators of health institution performance is aimed at increasing the level of health care delivery. PMID- 1785058 TI - [Health status of children attending preschool facilities]. AB - A high level of morbidity among children with aggravating sociobiological factors (aggravating biological and obstetrical history, complicated newborn period, unhappy family) has been shown. The morbidity rates by cases and by days in different age groups are 1.3-2.8 times higher than those among episodically sick children. Children from unhappy families and those having a combination of 2-3 unfavourable factors in all age groups are to a greater extent suffering from chronic diseases mainly from bronchopulmonary and rhinopharyngeal diseases. Among them a small number of children (2.1-6.6%) have the I group of health. These children are in need of timely and differentiated medicopedagogical correction. PMID- 1785059 TI - [Incidence of hypertension among the rural residents of the North Bukovina region]. AB - The valid data on the prevalence of hypertensive disease can be obtained only on the basis of follow-up statistics, i.e. comprehensively using the referral method and results of medical examinations among large population groups (at least 200,000 inhabitants). The essence of the method used by us for examining the prevalence of hypertensive disease among rural inhabitants is the in-depth study of the referrals according to the data on complete registration of patient populations irrespective of the duration of a disease and methods of detection, including those who did not apply for medical aid in the remission period. The approach permitted us to obtain valid data on the prevalence of hypertensive disease among a rural population. PMID- 1785060 TI - [Subjective assessment of health in socio-hygienic studies of the population]. PMID- 1785061 TI - [Use of social marketing in population health programs (literature review)]. AB - At present health education programmes abroad make wide use of social marketing strategy. Unlike commercial marketing whose purpose is competition and struggle for the expansion of commodity markets, social marketing is aimed at disseminating certain ideas or introducing certain practices, using largely the technological base and strategy of commercial marketing. The authors give 8 fundamental principles of social marketing (consumer orientation, the theory of barter, the analysis of audience and segmentation, special surveys to detect the orientation of population, the choice of channels for information transmission application of "marketing mixture", control of ongoing programme and marketing management). Application fields of social marketing in public health are discussed. PMID- 1785062 TI - [Supervising style of health care managers]. PMID- 1785063 TI - [Environmental health promotion in the USSR during the first five-year plan periods]. PMID- 1785064 TI - [Development of the social charity system in Russia]. PMID- 1785065 TI - [Continuity of tradition in the therapeutic schools of Moscow University]. PMID- 1785066 TI - [Outstanding national medical historian Nikolai Iakovlevich Novombergskii and his contribution to the study of medicine at Moscow State]. PMID- 1785067 TI - [Some information on Scythian folk medicine]. PMID- 1785068 TI - [Evaluation of the methods of quantitative assessment of the effect of working conditions on morbidity with temporary disability]. AB - For the first time it is proposed to use the method of assessing the etiological risk for the quantitative determination of working conditions impact on morbidity associated with temporary disability. A comparison was made of indicators of working conditions impact on morbidity associated with temporary disability with the help of a single-factor dispersion analysis and by calculating etiological risk on the basis of the same background information--monthly morbidity associated with temporary disability among workshop workers and a control group: the results were the same. But the calculation of etiological risk is more simple. PMID- 1785069 TI - [Various characteristics of health status and life style of children from different social groups of the population]. PMID- 1785070 TI - [Experience with organizing regional genetic monitoring]. AB - The necessity of conducting regional genetic monitoring (GM) is substantiated, an experience on its organization and the procedure of its carrying out with the help of computer technology is provided. The analysis of GM indicated that the incidence of developmental defects registered and listed is in the population limits. Proceeding from the example of anencephaly , the role of GM in the assessment of the effectiveness of comprehensive measures on prevention of birth of children with grave defects has been demonstrated. PMID- 1785071 TI - [Family planning and maternal and child care in present-day society]. AB - The evidence is provided of a close relationship between the features of women's reproductive behaviour, their health status and the health of their children: the lack of rational planning child-birth results in increasing maternal and infant mortality rates, prematurity, birth of unwanted children. The use of abortions as one of the basic means of birth control produces a negative effect, i.e. they are a frequent cause of sterility, gynaecological diseases, complicated future pregnancies and deliveries. There is a description of the priority tasks and conditions for the effective introduction of family planning into the everyday life--the necessity of taking into account sociopsychological, regional aspects of birth control within a family, demographic situation at the local level; identification of women populations which are in need of family planning activities. PMID- 1785072 TI - [Methodological approach to calculating economic losses caused by diseases]. AB - A comprehensive solution of problems related to population's health envisages, among other important measures, the estimation of relative damage caused to national economy by some diseases. In this connection we have formulated a concept of "Relative damage to national economy caused by disease", devised its structure and determined the extent of damage within a region and an enterprise. PMID- 1785073 TI - [An expert system for the diagnosis of risk of ischemic heart disease]. AB - The RIBS expert system was created by using the means and tools of the OBSES software complex (an expert system shell). RIBS is designed for determining the risk level in the occurrence of ischemic heart disease. The knowledge base is structured and is broken down into 13 hierarchical clusters. Three types of attributes are used for knowledge base cluster representation. To calculate the significance of facts and rules, the methods of polar and score ratings and others are used. A consultation fragment report with delivery of ischemic heart disease risk integral value is provided. PMID- 1785074 TI - [Quantitative evaluation of the effect of the system of socio- hygienic factors of life style on health status indicators using mathematical models]. PMID- 1785075 TI - [Improving the teaching of history of medicine in medical schools of the country during reorganization of the activities of the institutions of higher education]. PMID- 1785076 TI - [Scientific, historical and medical aspects of the study of discussions on medicine of the past]. PMID- 1785077 TI - [All-Union scientific conference dedicated to the 225th anniversary of the Moscow University Medical Department--the First Moscow Medical Institute of the I.M. Sechenov Moscow Medical Academy]. PMID- 1785078 TI - The effect of the three columns of the spine on the instantaneous axis of rotation in flexion and extension. AB - Instrumentation designed for stabilization and correction of spinal deformities must limit the amount of motion in flexion and extension. In flexion or extension, the vertebral bodies move about a specific point called the instantaneous axis of rotation. The ability of the implant to limit this motion is a function of its relation to the axis of rotation of the spine. The goal of this study was threefold: 1) to define the instantaneous axis of rotation of the spine in flexion and extension; 2) to study the effect of the loss of the three columns of the spine on the location of the instantaneous axis of rotation; and 3) to determine how the above parameters relate to the choice of anterior or posterior instrumentation. Ten human cadaver spines were subjected to compressive loads in flexion and extension. The columns of the spine were then destroyed in sequence at L3. The instantaneous axis of rotation for each vertebral body was found by the method of Reuleaux, and the effect of the compromise of the columns on the location of the instantaneous axis of rotation was noted. Understanding the exact location of the instantaneous axis of rotation after a specific injury would allow the clinician to objectively choose the best surgical approach and the appropriate instrumentation. PMID- 1785079 TI - The histomorphologic sequence of dural repair. Observations in the canine model. AB - This study was undertaken to investigate the histopathologic events of the dural reparative process. Uniform 2-mm dural defects were created in adult beagles, repaired, and then examined in a 6-week period. Primary fibroblastic bridging of the durotomy was not seen until Postoperative Day 6, and it was not until Postoperative Day 10 that ablation of this defect was uniformly seen. Cerebrospinal fluid egress through the dural defects was prevented in the vast majority of cases by the formation of an internal patch composed of proliferative elements of pia and arachnoid mater. PMID- 1785080 TI - Using tissue expanders in spinal surgery for deficient soft tissue or postirradiation cases. AB - Prior irradiation and scarring can complicate wound closure following spinal surgery. Implanted tissue expanders were used six times in four patients to aid skin closure. Three patients had prior irradiation for cancer, and one had myelomeningocele. The average interval between placement and removal of the expanders was 46 days. Two late failures occurred because of prominent hardware. These expanders may provide adequate myocutaneous covers following spinal surgery in difficult cases. PMID- 1785081 TI - The third step of total autologous blood transfusion in scoliosis surgery. Harvesting blood from the postoperative wound. AB - In a prospective study in scoliosis and kyphosis surgery patients, red blood cells were harvested from the drainage of the postoperative closed wound and returned to the patient. Approximately 1 unit of blood per patient was saved compared with a historically similarly matched group who had no postoperative blood salvage. The authors conclude that the addition of postoperative autologous blood salvage can considerably reduce predeposit autologous blood requirements of patients undergoing Cotrel-Dubousset instrumentation and posterior spine fusion for spinal deformity. PMID- 1785082 TI - Evaluation of cryopreserved bone and synthetic biomaterials in promoting spinal fusion. AB - The purpose of the study was to evaluate the use of cryopreserved allograft bone and tricalcium phosphate in promoting spinal fusion. Nine 20-30 lb swine underwent posterior spinal fusion at T5-T6, T13-T14, and L2-L3. Autogenous bone, cryopreserved allograft bone, or equal parts of allograft bone and tricalcium phosphate were added to the decorticated posterior elements. A total of 27 sites were prepared for fusion. The spines were retrieved at 6 months and evaluated for integrity and stability of the fusion sites by clinical examination, three-point bending tests, multiplanar radiographs, and undecalcified tetracycline-labeled and decalcified histologic sections. The nine sites that received autogenous bone were solidly fused. There were one clinical and two radiographic nonunions in the nine sites that received cryopreserved allograft bone. Sites that received a mixture of allograft bone and tricalcium phosphate demonstrated slight motion at two locations and radiographic evidence of fusion at all levels. The extent and degree of fusion was not site-specific. Three-point bending analysis did not demonstrate a significant trend as to site or materials specificity. No adverse histologic response was noted. Histologic sections and tetracycline labels confirmed abundant new bone formation at all sites at 6 months. Although autogenous bone remains the gold standard for use in spinal arthrodesis, this study demonstrates the value of cryopreserved allograft bone alone and in combination with tricalcium phosphate in promoting spinal fusion. PMID- 1785083 TI - Differentiation between spinal tumors and infections with magnetic resonance imaging. AB - Distinction between spinal tumors and infections is a frequent clinical dilemma. To assess the accuracy of magnetic resonance imaging in distinguishing between spinal tumors and spinal infections, 30 patients with proven spinal tumors or infections were studied. Magnetic resonance imaging correctly diagnosed spinal tumors and infections in 29 of 30 cases (97%): 21 of 22 tumors were correctly diagnosed, and 8 of 8 infections were correctly diagnosed. The following points were learned: 1) The most consistent finding of vertebral osteomyelitis was the involvement of the disc space and adjacent vertebral body with decreased signal intensity on the T1-weighted images and increased signal intensity on the T2 weighted images. On the contrary, the disc spaces in tumor cases were uninvolved and demonstrated normal intensities on both T1- and T2-weighted images. 2) Loss of definition of the vertebral endplate was more common with infection than with tumor. 3) Contiguous vertebral involvement was seen more frequently in infections than in tumors. 4) Soft tissue changes were quite helpful: fat planes were obscured diffusely due to edema in infection, whereas fat planes were frequently intact, or obscured only focally, in tumors. 5) Cord compression was accurately diagnosed by magnetic resonance imaging in both tumors and infections. Magnetic resonance imaging was found to be superior to other imaging modalities in its ability to detect tumors or infections early and in providing information on the bone, disc, soft tissue, and neural structures. PMID- 1785084 TI - Magnetic resonance imaging evaluation of the spinal canal following arthrodesis and removal of sublaminar wires. AB - Seven patients who underwent posterior spinal fusion with Harrington instrumentation and sublaminar wires, and subsequently had these implants removed, were evaluated for evidence of spinal canal compromise with magnetic resonance imaging (MRI) at the sites of the sublaminar wires. All fusions were solid. The sites of 33 wires (27 levels) were evaluated with MRI. The average time the wires were in the spinal canal was 24.6 months. The average time following wire removal at the time of MRI was 61.7 months. Twenty-eight of 33 (85%) wire sites had no evidence of spinal canal compromise. Five sites had minimal (less than 15%) spinal canal compromise. The permanent structural changes in the spinal canal attributable to sublaminar wires appears to be quite modest. PMID- 1785085 TI - Disproportionate body growth in girls with adolescent idiopathic scoliosis. A longitudinal study. AB - Two thousand, one hundred and eighty-nine southern Chinese women, aged 8-21 years, were studied: 541 with adolescent idiopathic scoliosis (176 treated with posterior spinal fusion and Harrington instrumentation, 150 with brace, and 215 who did not require any treatment), and 1,648 age-matched normal controls from schools and colleges. Scoliotic girls treated at Duchess of Kent Children's Hospital were examined clinically, radiologically, and anthropometrically, including a roentgenogram of the left hand for bone age, at yearly intervals from their first visit to hospital until maturity. Leg:spine and leg:arm ratios were calculated to study the proportionate body growth. The data obtained at first visit and at maturity for each treatment group were compared within treatment groups, and also with normal controls (all age-matched comparisons). The results are summarized as follows: The comparison of leg:spine ratio between fusion, brace, and untreated groups at first visit using uncorrected spinal length showed inconsistent results, but when these ratios were calculated using spinal length corrected for scoliosis, the results were all consistent, showing no significant difference between these groups at first visit. At maturity, leg:spine ratios, using either uncorrected spinal length or corrected spinal length, were highly significantly greater for the fusion group compared to the brace and untreated groups. The leg:spine ratio comparisons of scoliosis groups against normals showed that brace and fusion groups had highly significantly greater ratios at first visit and at maturity, using uncorrected spinal length. Similar comparison using corrected spinal length showed minimum or no difference at first visit, but at maturity, only the fusion group had a significantly greater ratio than normals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785086 TI - The natural history of congenital kyphosis in myelomeningocele. A review of 51 children. AB - The progression of congenital lumbar kyphosis in myelomeningocele is a well-known problem, but rates of progression are not well documented in the literature. Fifty-one children with congenital kyphosis and myelomeningocele were followed for an average of 4.8 years. Minimum follow-up was 1 year. Group I (35 patients) had initial radiographs at 1 year of age or less. Group II (16 patients) had radiographs taken after the age of 1 year. Curves less than or equal to 90 degrees in Group I progressed 7.7 degrees/yr; those greater than 90 degrees progressed 12.1 degrees/yr. Curves less than or equal to 90 degrees and greater than 90 degrees progressed at similar rates, regardless of initial curve magnitude: 6.4 degrees/yr and 6.7 degrees/yr, respectively. No correlation existed among the rate of curve progression, the frequency of shunt revisions, or the presence of vertebral anomalies, aside from the dysraphism. PMID- 1785087 TI - Muscle disease as a cause of kyphotic deformity in ankylosing spondylitis. AB - The effects of ankylosing spondylitis on skeletal muscle were investigated in nine consecutive patients referred for correction of severe spinal deformity. Enzymatic studies (creatinine phosphokinase, aldolose), electromyography, and paraspinal muscle biopsy were performed. The enzyme studies and electromyography yielded only variable results, but muscle biopsy uniformly demonstrated evidence of severe skeletal muscle disease. Small, scattered, sharp angular fibers were present in all specimens along with atrophy of Type I and Type II muscle fibers. Core or targetoid fibers were present in all but one patient. These findings suggest that muscle disease may be present in all ankylosing spondylitis patients with spinal flexion deformity. PMID- 1785088 TI - Spinal cord monitoring. Results of the Scoliosis Research Society and the European Spinal Deformity Society survey. AB - The Scoliosis Research Society (SRS) and the European Spinal Deformity Society (ESDS) membership was surveyed regarding the use of intraoperative monitoring of somatosensory evoked potentials in spinal surgery. A total of 242 people responded, with 188 using intraoperative monitoring. A second survey was distributed detailing the technical aspects of monitoring, of which 71 were returned. A total of 342 neurologic deficits were reported to have occurred with monitoring in place. Two hundred forty-six (72%) were accurately detected, and 96 (28%) were not detected by sensory cord evoked potentials (SCEP). There were 1,003 false-positive cases reported. The incidence of false-negative cases was related to those not monitoring both latency and amplitude, to using fewer recording electrodes, and with those surgeons doing more kyphosis corrections. PMID- 1785089 TI - Avoiding paraplegia during anterior spinal surgery. The role of somatosensory evoked potential monitoring with temporary occlusion of segmental spinal arteries. AB - Three patients paraplegic following anterior spinal fusion for congenital kyphoscoliosis were noted to have complete somatosensory evoked potential signal loss shortly after segmental arterial ligations at the apex of their respective kyphosis. This has prompted us to use temporary segmental arterial occlusion with somatosensory evoked potential monitoring prior to ligation during anterior spinal fusion. As a result, we have noted seven additional cases, out of a total of 44 cases monitored in this fashion, in which complete loss of somatosensory evoked potential signals, reversible by release of vascular clips, has occurred. For each of these additional cases the critical segmental arteries were identified and were not ligated, usually resulting in some modifications in the planned surgical procedure, and the patients remained neurologically intact. We recommend temporary segmental arterial occlusion with somatosensory evoked potential monitoring during thoracolumbar anterior spinal fusion to potentially avert ischemic neurologic injury. Based on published data and the experience described herein, this technique should be especially important in anterior spinal fusion for congenital kyphoscoliosis. PMID- 1785090 TI - Somatosensory cortical evoked potential changes after deformity correction. AB - The somatosensory cortical evoked potentials recorded during posterior spine fusion and instrumentation for 99 consecutive patients with idiopathic scoliosis, 18 years of age or younger, were retrospectively reviewed. The potentials were recorded from scalp electrodes while synchronously stimulating both tibial nerves near the ankles. Signal changes observed during consecutive 30-minute time intervals after deformity correction were analyzed. No changes in neurologic status were observed postoperatively. Latency values tended to remain constant on average. A small, but statistically significant, decrease in the first two interpeak amplitudes was observed during the first 30-minute interval after deformity correction. The first interpeak amplitude recovered, while the second remained statistically significantly decreased. No patient had a decrease of greater than 50% in both of the first two amplitudes, which persisted throughout the 60-minute interval immediately after deformity correction. This study demonstrated a tendency for somatosensory cortical evoked potential interpeak amplitudes to decrease during the first 30 minutes after deformity correction. There was a great deal of individual variation, including amplitude increases in many patients. There was no evidence supporting an association between dramatic, sustained amplitude decreases and uncomplicated deformity correction. The value of thoroughly evaluating somatosensory cortical evoked potential signal trends while making intraoperative decisions is emphasized. PMID- 1785091 TI - Pudendal nerve evoked potential monitoring in procedures involving low sacral fixation. AB - Pudendal nerve evoked potentials were used in orthopaedic surgical procedures involving fixation below the S1 level. Pudendal nerve stimulation was used to monitor 154 patients. Eleven patients (7.14%) had responses that were either difficult or impossible to interpret in that they were not consistently replicable. In one case (0.65%), responses were lost during surgery, and there were no subsequent neurologic sequelae (false-positive response). No patients had postoperative deficit to the sacral roots or to the global cord. Although it is possible to obtain definitive dermatomal responses down to S1, the use of pudendal nerve stimulation was found to provide additional means of monitoring lower sacral roots. Since the pudendal nerve is intimately associated with bowel, bladder, and sexual dysfunction, easily obtainable routine monitoring of this nerve can provide significant safety that the conventional somatosensory and dermatomal responses give to higher spinal levels. PMID- 1785092 TI - The clinical application of neurogenic motor evoked potentials to monitor spinal cord function during surgery. AB - The purpose of this study was to report results from 300 cases (177 children, 123 adults) administered somatosensory and neurogenic motor evoked potentials during surgery. Of these 300 cases, there were 16 cases of spinal fractures, 16 neurosurgical cases, 28 vascular cases, and 240 cases of elective posterior spinal deformity requiring instrumentation. Results indicated that somatosensory evoked potentials, especially cortical components, demonstrated greater variability than neurogenic motor evoked potentials. Variability was attributed to anesthesia and unknown factors. Neurogenic motor evoked potentials proved to be a more valid indicator of postoperative motor status than somatosensory evoked potentials. Based on their anatomic substrates and results from this study, it was recommended that somatosensory evoked potentials and neurogenic motor evoked potentials be used to monitor spinal cord function during surgery that would place that structure at risk. PMID- 1785093 TI - Derotational analysis of Cotrel-Dubousset instrumentation in idiopathic scoliosis. AB - Ten patients with idiopathic scoliosis were treated with posterior spinal fusion and Cotrel-Dubousset instrumentation. Computed tomographic scans and intraoperative photographs were used to evaluate the derotational effect of the Cotrel-Dubousset instrumentation. The frontal deformity was corrected from an average of 51 degrees to 15 degrees and the kyphosis from 9.5 degrees to 18 degrees. The amount of preoperative vertebral rotation was variable, however, and insignificant postoperative changes were documented in the majority of cases. PMID- 1785094 TI - Spinal decompensation in Cotrel-Dubousset instrumentation. AB - Forty-one patients with idiopathic scoliosis having a primary right thoracic and a compensatory left lumbar curve underwent posterior spinal fusion of the primary curve only. Twenty-four patients had instrumentation with a Harrington rod or variant, and 17 patients underwent Cotrel-Dubousset instrumentation. Decompensation occurred postoperatively when the apex of the thoracic curve was located on or to the left of the center sacral line. There was no statistically significant change in the lumbosacral portion of the lumbar curve from the apex to the lumbosacral junction in both groups. Curve correction occurred cephalad to the apex of the lumbar curve, and not along the center sacral line. The decompensation rate was 4% for Harrington rod instrumentation and variants and 41% for Cotrel-Dubousset instrumentation. Cotrel-Dubousset instrumentation translated the apex of the thoracic curve 1.5 cm farther to the left than Harrington rod instrumentation and variants. When the apex of the lumbar curve is 2 cm or greater to the left of the center sacral line, the patient's spine will decompensate to the left, centered over the apex of the lumbar curve. PMID- 1785095 TI - Rotational changes of the vertebral-pelvic axis following Cotrel-Dubousset instrumentation. AB - Ten consecutive patients with adolescent idiopathic scoliosis and King-Moe curve Types II and III, scheduled consecutively for Cotrel-Dubousset instrumentation, underwent pre- and postoperative computed tomography scans with axial slices through each vertebra, and including the pelvis. Vertebral rotation was measured and referenced to the pelvis. Average derotation of the thoracic apex after surgery was 9%. King-Moe Type II curves tended to derotate more successfully (average 26% improvement), while Type III curves derotated very little, if at all (average 1.3% worsening of the rotational deformity). Type II curves often showed segmental rotational changes outside the levels of instrumentation, while Type III curves did not; more frequently the spinal-pelvic axis rotated en bloc. It appears, therefore, that Cotrel-Dubousset instrumentation does not consistently or predictably derotate the thoracic apex relative to the pelvis, and coronal plane correction may only be apparent, due to transmitted torque and rotation of the entire spinal-pelvic axis. PMID- 1785096 TI - Prevention of the crankshaft phenomenon. AB - Factors favoring development of the crankshaft phenomenon after posterior spinal fusion include immaturity and large residual deformity. Eight patients at high risk to develop the crankshaft phenomenon underwent periapical anterior growth arrest and fusion before posterior instrumentation and fusion. With follow-up to skeletal maturity, 0% developed crankshaft phenomenon. Anterior growth arrest and fusion before a posterior procedure is recommended in scoliosis patients at high risk to develop the crankshaft phenomenon. PMID- 1785097 TI - Salvage and reconstructive surgery for spinal deformity using Cotrel-Dubousset instrumentation. AB - Sixty consecutive patients who underwent Cotrel-Dubousset instrumentation as part of their reconstructive surgery (failure of previous surgery) were reviewed. The average follow-up was 3 years (range, 2-4.5 years). There were no deaths or major neurologic problems. Pseudarthrosis occurred in six patients, all of whom had long fusion to the sacrum; all six were successfully repaired. Cotrel-Dubousset instrumentation provides a far superior method of correction of deformity and internal fixation than that available previously. PMID- 1785098 TI - The use of sublaminar cables to replace Luque wires. AB - Sublaminar wires have been used in conjunction with posterior instrumentation to stabilize the spine. Sublaminar wiring has fallen into disfavor because of an increase in neurologic complications with the Luque technique as well as wire breakage, dural tears, and difficulty of removal. A cable system consisting of two 49-stranded stainless steel cables connected to one malleable leader was designed to overcome these shortcomings. Biomechanical testing revealed that the maximum yield strength of a single stainless steel cable loop was 2.85-2.94 times greater than a double 0.05-in. stainless steel wire loop. The fatigue tests demonstrated that the stainless steel cables required 6-22 times more cycles to failure than the stainless steel wire. Many of the titanium cables failed immediately under higher loads (0-100 lb) because of slipping of the crimp. The preliminary clinical results after a mean of 19 months of follow-up of 245 cables are encouraging. There has been no breakage or loosening of the cables and no complications associated with the use of the cables. The stainless steel cables are very strong, but more important, the cable flexibility prevents repeated contusions to the spinal cord during insertion of the rods and tightening of wires. The cable conforms to the undersurface of the lamina. This may lead to a decrease in neurologic complications. PMID- 1785099 TI - Survivorship analysis of pedicle spinal instrumentation. AB - Between 1985 and 1989, the senior author performed 120 consecutive pedicle instrumentation cases--78 Steffee (VSP) procedures and 42 procedures using Cotrel Dubousset instrumentation. Posterolateral or posterior fusions using autogenous iliac bone graft were performed across the instrumented vertebrae in all cases. Survivorship analysis was used to calculate a predicted cumulative rate of success for this series of patients over 10 years postoperative follow-up. The criteria of failure of pedicular instrumentation or "death" of an implant were defined as 1) screw bending, 2) screw breakage, 3) infection, 4) loosening of implants, 5) any rod or plate hardware problems, or 6) removal of hardware due to a neurologic complication. Out of 526 pedicle screws (175 Cotrel-Dubousset screws, 351 VSP screws) there were 22 problem screws (22/526 = 4.18%). Six screws had bent, none were infected, 16 screws had broken, and none were loose. The 22 problem screw events occurred in 12 patients. In seven patients, the instrumentation failure was an incidental radiographic finding, in that patients had a solid posterolateral fusion. The remaining five patients had screw breakage in association with a pseudarthrosis. Life table calculations predicted the survivorship of instrumentation without complications would be 80% at 10 years postoperative follow-up. Actuarial analysis predicted the survivorship of solid posterolateral fusion at 90% at 10 years follow-up. This survivorship rate is similar to those predicted at 10 years follow-up for other more widely used orthopedic surgical implants such as total hip arthroplasty components. PMID- 1785100 TI - Survivorship analysis of VSP spine instrumentation in the treatment of thoracolumbar and lumbar burst fractures. AB - We used survivorship analysis to study 21 burst fractures that were treated with posterior VSP spine implant and fusion, each of which was over two motion segments. There were two treatment classes: 1) eight patients whose surgery included anterior bone grafting (augmentation), seven of which were done by the transpedicular approach; and 2) 13 patients whose surgery did not include anterior bone. Eight patients, seven of whom were in the second group, met at least one of the failure criteria. Life table calculations showed 100% implant survival through 22 months in the group treated with anterior bone augmentation, while the nonaugmented group showed 92% survival at 6 months, 68% survival at 9 months, 60% survival at 13 months, and 50% survival at 19 months. Statistical comparisons of the two groups resulted in P-values of 0.05 (Breslow) and 0.04 (Mantel-Cox). Based on this method of analysis, VSP instrumentation and two-level fusion is suitable surgical treatment for many burst fractures, but high failure rates may result if anterior bone augmentation is not performed. PMID- 1785101 TI - Diagnosis and treatment of cauda equina entrapment in the vertical lamina fracture of lumbar burst fractures. AB - Posterior dural lacerations associated with lumbar burst fractures are caused by impaction of the dural sac into the vertical lamina fracture. Neural elements may be extruded outside of the dura and become entrapped in the lamina fracture. This diagnosis must be made before surgery and is based on the patient's clinical presentation, the fracture pattern, and the radiographic findings. Entrapped neural elements can be successfully extracted from the lamina fracture by an opening laminoplasty of the posterior neural arch. Patients with lumbar burst fractures and radiographic evidence of posterior displacement of the neural elements in the lamina fracture should undergo posterior exploration of the spinal canal, extraction of cauda equina neural elements, and repair of the dural laceration before any spinal reduction maneuver. PMID- 1785102 TI - Repair of pars interarticularis defect. The prognostic value of pars infiltration. AB - Ten patients with symptomatic spondylolysis or Grade I spondylolisthesis were treated with the Buck method. At follow-up, nine patients were graded as successful. All patients fused. Pain relief, level of function, and likelihood of return to work were higher in patients preoperatively selected by lidocaine infiltration of the pars defect. Pars infiltration gives an accurate prediction of successful outcome following pars repair. PMID- 1785103 TI - Classification of pseudarthroses of the lumbar spine. AB - Imaging studies and operative records of 55 patients who had undergone lumbar pseudarthrosis repair were studied, providing a total of 85 surgically documented pseudarthroses. Preoperative imaging studies were carefully analyzed for the anatomic characteristics of the involved levels and the morphology of the fusion mass. The pseudarthroses were found to fall into four distinct morphologic categories: atrophic, transverse, shingle, and complex. The atrophic pseudarthrosis type was noted to be strongly associated with the presence of intact facet joints or spinal hardware. This retrospective analysis indicates that stress shielding provided by intact facet joints or spinal implants may contribute to graft atrophy in certain patients. The classification scheme proposed may be useful in future analyses of different fusion techniques in determining the various causes of this surgical complication. PMID- 1785104 TI - [Strategies in radiologic diagnosis--CT and MRT of the esophagus]. PMID- 1785105 TI - [Modern imaging diagnosis of bile duct cancer]. PMID- 1785106 TI - [Inflammatory pseudotumor of the lung. Case report]. PMID- 1785107 TI - [MR tomography of a benign cystic teratoma of the ovary]. PMID- 1785108 TI - Transitional employment training for SSI recipients with mental retardation. AB - Transitional employment training is a promising method for assisting persons with mental retardation to gain and hold regular marketplace jobs. The Social Security Administration (SSA) has concluded a large scale demonstration project in which this training was provided to recipients of Supplemental Security Income (SSI) with mental retardation. This article introduces the concepts and practices of transitional employment and presents findings of the SSA demonstration derived from observation of demonstration operations. A followup article will discuss the effects of the demonstration services on the employment, earnings, and SSI payments of the trainees, as derived from analysis of SSI administrative records and other quantitative data. PMID- 1785109 TI - Social Security reform in four east European countries. PMID- 1785110 TI - The relevance of coronary sinus interventions in cardiac surgery. AB - The concept of arterialization of the coronary venous system was first discussed almost 100 years ago. Subsequently, those attracted by this approach have chosen the coronary veins as an alternative route for interventional and surgical therapy. Modern techniques of coronary sinus interventions (CSI) have been suggested mainly for temporary support and protection of ischemic myocardium. Based on the dense meshwork structure of the venous vasculature, CSI may be effective even in the presence of serious coronary artery disease. Three major techniques have been suggested for different indications in cardiology and cardiac surgery: 1) ECG-synchronized retroperfusion of arterial blood, which is supposed to positively affect ischemic myocardium by phasic supply of oxygen to deprived areas mainly in cardiac emergencies, 2) retroinfusion of cardioplegia in the arrested heart, which is now a well-established clinical technique, and 3) intermittent coronary sinus occlusion during antegrade cardioplegic delivery in the arrested heart and in the early reperfusion period after surgical revascularization, or in cardiac emergencies. The beneficial effect of pressure controlled intermittent coronary sinus occlusion is assumed to result from cyclic occlusion and release of the coronary sinus shifting venous blood to underperfused regions, thereby facilitating substrate delivery and subsequent washout of metabolites. Experimental studies and first clinical trials suggest that all methods of CSI are safe and feasible, and the ultimate goals of reduction of infarct size and preservation of jeopardized ischemic myocardium will be achieved. PMID- 1785111 TI - Myocardial support and protection during regional myocardial ischemia using the Hemopump assist device. AB - A study was designed to quantify the influence of the Hemopump on myocardial metabolism in regional myocardial ischemias induced by repetitive balloon occlusions (3.5 minutes) of the LAD in 12 sheep (b.w. 49-61 kg). In order to make immediate comparisons and obtain paired-couples, ischemias were carried out with and without the Hemopump in operation. An energetic unloading of the left ventricle was achieved by the Hemopump already under preocclusion conditions, reducing myocardial O2-consumption from 7.52 to 5.98 ml/min/100 g LV (= 20%) as well as lowering the LVEDP from 13.3 to 9.8 mmHg (p less than or equal to 0.01). During ischemia a clear increase of LVEDP (13.3 to 21.0 mmHg) occurs, which was prevented in the group with Hemopump-assist (9.8 to 12.1 mmHg). Combined with a sustained higher diastolic aortic pressure, a better myocardial perfusion pressure resulted. Energetic unloading and improvement of perfusion conditions might be the cause of the significantly lowered release of lactate and potassium. Due to theses fibrillation (n = 3) only occurred during occlusions without Hemopump-support. In summary, a significant reduction of the ischemic burden on the myocardium was found. Thus the Hemopump could be of benefit to patients who fail to be weaned from CPB or who are suffering from instable cardiovascular performance. PMID- 1785112 TI - A new surgical approach to tricuspid annuloplasty: possibility of an extracardial suture technique "AV-gathering". AB - A new extracardiac method of annuloplasty for tricuspid insufficiency was performed on cadavers and in dogs. This procedure effectively produced valvular ring cerclage without causing any decrease in right coronary arterial blood flow. In the animal model, using this approach experimental tricuspid stenosis was successfully attempted. The details of the procedure are reported in this article. PMID- 1785113 TI - Early and late results of the modified Waterston shunt with PTFE grafts for palliation of complex congenital cyanotic heart disease in neonates. AB - During a 12 year period from 1978 to 1989, 35 infants under 4 weeks of age underwent palliative surgery for complex congenital cyanotic heart disease with a short (1-1.5 cm) PTFE graft between the ascending aorta and the right pulmonary artery (modified Waterston shunt). Twenty-three infants had pulmonary atresia and 14 had severe pulmonary stenosis. Underlying cardiac lesions were tetralogy of Fallot (n = 11), single ventricle (n = 7), transposition complexes (n = 6), and intact ventricular septum and hypoplastic right heart syndrome (n = 13). There were 4 early deaths (10.7%) in the entire series, 2 of which were shunt related. Three of the 4 occurred during our initial experience with this shunt in 1978 and 1979. They led to the modified Waterston shunt being abandoned for 3 years in favor of other shunt procedures. Since 1983 one early death occurred in 28 infants (3.5% mortality) with no death in the latest 26 patients. All patients were followed up between 6 and 108 months. There were 4 late deaths, one of which was shunt related. We observed a significant difference in the shunt patency rate between 4 and 5 mm grafts: palliation was adequate after 2 years in 52% of the patients when a 4 mm graft was used and in 89% of the 5 mm graft group (p less than 0.005). Reshunting was necessary in 7 infants between 5 and 60 months after primary surgery. Recatheterization was performed in 17 infants for suspected shunt failure (n = 6) or diagnostic reasons (n = 11).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785114 TI - Identification of abscess formation in native-valve infective endocarditis using transesophageal echocardiography: implications for surgical treatment. AB - The object of the study was to follow patients with endocarditis-associated abscesses in order to evaluate the clinical outcome with and without surgical intervention. Transesophageal echocardiography successfully displayed the location and extent of abscess cavities in 14 patients (group A) with aortic valve endocarditis. The infective process was limited to the perivalvular tissue in two, extended into the ascending aorta in six, and included the interventricular septum, the right ventricular outflow tract, interatrial septum, and/or mitral valve annulus in six patients. The complication rate was significantly higher in group A than in group B, which consisted of 27 patients with proven signs of endocarditis but without endocarditis-associated abscesses. The complication rates were embolic events 64.3% in group A vs 29.6% in group B, need for surgery in 64.3% vs 18.5%, and death in 50.0% vs 3.7%, respectively. The duration of fever--as a marker of an active infective process--before diagnosis and the onset of adequate treatment was significantly higher in group A than in group B (46.7 +/- 8.4 days vs 7.7 +/- 2.6 days). Organisms were isolated in 71.4% in group A and in all patients of group B. Streptococcal infections were noted in A in 54.5% vs 44.4% in B., staphylococcal in 27.3% vs 40.7%. Initial surgical repair in 9 of 14 patients in A (64.3%) included nine aortic valve and one mitral valve prosthesis implantations, two aortic valve-annulus reconstructive procedures, one dacron patch closure, and three partial resections of the aorta ascendens with end-to-end anastomosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785115 TI - Early surgery for active infective endocarditis improves early and late results. AB - To investigate the timing of surgery in active infective endocarditis, the data of 54 patients, consecutively operated for this reason from September 1973 to May 1989, were analysed. Native valves were involved in 31 patients (57%): the aortic valve in 22, the mitral valve in 6, and both valves in 3 cases. Prosthetic valves were involved in 23 patients (43%): the aortic valve in 14, the mitral valve in 7, and both valves in 2 cases. There were no significant differences between involvement of native or prosthetic valves and mortality, morbidity, or consequences of morbidity. No significant correlation was found between causative microorganism and mortality, morbidity, or consequences of morbidity. The indication for operation was cardiac failure in 15 patients (28%), ongoing infection in 24 (44%) or a combination of these in 15 (28%). Major embolization occurred in 12 patients (22%) and affected women more than men (p = 0.05). Hospital mortality was 8 (15%). Morbidity involved 15 more patients; structural deterioration of the valve prosthesis occurred in 1 patient; nonstructural dysfunction of the valve prosthesis occurred 11 times in 10 patients; anticoagulation-related hemorrhage involved 2 patients (1 with nonstructural dysfunction of the valve prosthesis); endocarditis was diagnosed in 3 patients. The consequences of these morbid events concerned 14 patients; reoperations were done 9 times in 8 patients; mortality was valve related in 6 cases. Because 2 more patients died during the course of the study, total late mortality was 8. Probability of survival 5 years after operation was 72% (95% cl 56-83) and at 10 years 47% (95% cl 21-70).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785116 TI - Early and late results following coronary bypass surgery beyond the age of 75 years. AB - The indication for coronary bypass surgery in the elderly has been dramatically expanded in recent years. The results, however, are often contradictory. 1,538 consecutive patients undergoing cardiac surgery were divided into two groups by their age at the time of operation: younger than 75 years (n = 1,480) and 75 years and older (n = 58). These groups were compared with regard to influencing factors of early and late mortality, morbidity, and quality of life. Preoperatively, the clinical condition of the group greater than or equal to 75 years was significantly worse than the condition of the group less than 75 years (NYHA IV: greater than or equal to 75 years: 63.8%; less than 75 years: 31.9%). Cerebrovascular diseases occurred more often in the patients greater than or equal to 75 years (stroke or transient ischemic attack: greater than or equal to 75 years: 8.6%; less than 75 years: 2.3%). The necessity of carotid reconstruction prior to coronary surgery was significantly higher in the patients greater than or equal to 75 years: (greater than or equal to 75 years: 5.2%; less than 75 years: 1.5%). Diabetes mellitus could be observed in 19.0% of the patients greater than or equal to 75 years and in 10.1% of the patients less than 75 years. The preoperative ejection fraction was similar in both groups. Cardiopulmonary bypass time and crossclamping time of the aorta did not differ significantly. Both groups received approximately the same number of distal coronary anastomoses. Rethoracotomy due to hemorrhage had been observed more often in the older group (greater than or equal to 75 years: 8.6%; less than 75 years: 4.5%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785117 TI - Aortic regurgitation and aneurysm of Sinus of Valsalva associated with osteogenesis imperfecta. AB - A case of osteogenesis imperfecta with aortic regurgitation is described. The patient had a dilated aortic valve ring and an aneurysm of the Sinus of Valsalva. The patient manifested severe hemodynamic abnormalities and underwent aortic root reconstruction using a valved conduit. The operative problems and the pathological findings are discussed. PMID- 1785118 TI - Entodermal inclusion cyst of the tricuspid valve. AB - This is a report on an epithelial inclusion cyst covering the septal leaflet of the tricuspid valve. The tumor was an accidental finding in a 5 1/2 years-old boy with congenital heart disease including double-chambered right ventricle, ventricular and atrial septal defects and subvalvular aortic stenosis. Histological examination showed a two-layered ciliated epithelium, typically present in the respiratory system. Embryologic tissue heterotopia arising from sequestered entodermal elements from the primitive foregut during cardiac organogenesis is a possible explanation for the locality and histology of the tumor. To our knowledge, a similar case has never been presented before. PMID- 1785119 TI - Catamenial pneumothorax: report of a case and review of the Japanese and non Japanese literature. AB - A case of catamenial pneumothorax (CPT) was presented. The patient is a 34-year old Japanese woman who had two histories of right pneumothorax occurring simultaneously with the menstruation. A thoracotomy, several blue cysts and tiny perforations were noted in the diaphragm. Partial excision of the lesion gave a favorable result. Pathological examination of the excised diaphragm revealed an endometriosis. Fisterography of the perforations at thoracotomy showed the pathway between thoracic and abdominal space. But the contrast medium didn't spread widely into the abdomen, but remained localized at the right paracolonic space, in accord with the right side predominancy of the endometriosis of the diaphragm which causes the CPT. The clinical and pathological features in Japanese cases including our own case are compared with those in English literature. PMID- 1785120 TI - Carcinoid tumor invading the thoracic aorta: en-bloc resection. AB - One of the rare cases in which metastases of a carcinoid tumor infiltrate the aortic wall is reported. Cross-clamping the descending aorta and en-bloc resection of the tumor and the descending aorta were possible. The postoperative course was uneventful. PMID- 1785121 TI - [Status of heart surgery in Germany, 1990. Report of the hospital committee of the work group of the Surgeon General]. PMID- 1785122 TI - [Local and systemic immune response during experimental gingivitis]. AB - The paper deals with the intensity of local and systemic immune response to the antigen stimulation of dental plaque in experimental gingivitis. Three groups, each of 11 rats, were in contact with S. mutans, F. nucleatum, A. viscosus and B. gingivalis in order to stimulate gingival inflammation. Experimental days were 0, 3rd, 7th and 14th day. Before sacrificing experimental animals condition of gingival tissue was assessed. Gingival specimens were then taken for numeric density analysis as well as serum for antibody titer measurement. None of the young rats developed gingivitis during the experiment, whereas the adult immunized rats bled on probing. The greatest increase of the number of lymphocytes occurred in the elder immunized group and the lowest in the group of one month old rats. Serum antibody titers were low in young rats, moderate in adult and high in adult immunized rats. These results indicate that adult rats reacted stronger to plaque antigens than young rats and that previous contact with the antigens increased the reaction. PMID- 1785123 TI - [Determination of calcium content in dentine after application of ZOE paste]. AB - The calcium in dentine after the application of zinc oxide/eugenol paste (ZOE) was determined. The results were compared with the values valid for normal dentine calcium content in order to check some hypothesis suggesting that the effects of ZOE paste on dentine could reduce the calcium content and cause demineralization of dentine. The results obtained for calcium content in various layers of dentine have shown that only the layer of dentine-enamel junction (which should be removed before the application of ZOE paste) contained the increased concentration of calcium in comparison to anatomically deeper layers. The average calcium content in deeper dentine layers are very similar, especially in dentine layers directly exposed to action of ZOE paste, as well as in the layer on which ZOE paste was not applied. PMID- 1785124 TI - [The effect of vincristine on dental pulp of experimental animals]. AB - Chemotherapy is applied in the treatment of malignant disease to decrease the number of malignant cells, and to avoid damage of the living tissue and growing cells which must be reduced to the lowest level. In the combination of cytostatics Vincristine, a Vinca-alkaloid, is widely used. The purpose of this study was to analyse the pulp and dentine in experimental animals after the administration of Vincristine. Wistar rats of both sexes were used. Vincristine (Onkovin, Lilly) was injected in the neck skin fold on the 7th and the 8th postnatal day in a single dose of 0.1 mg/kg b.w. At the 24th postnatal day experimental and control animals were sacrificed. Both jaws with teeth were prepared for routine histologic examination. The results showed that Vincristine effect was different in different regions of the tooth. The number and disposition of odontoblasts was reduced in all areas of tooth sections, especially in the pulp horn. In the central part of coronal and radicular pulp tissue blood vessels were dilated and filled with blood cells. A histologic appearance of newly formed dentine was irregular. PMID- 1785125 TI - [Acid and basic glycoproteins of human saliva. 2. Investigation of glycoprotein of parotid saliva]. AB - We applied the standard diagnostic electrophoretic method on lyophilized human parotid saliva under the appropriate conditions (pH = 8.6 voltage 90 V and time of 30 seconds). The variation of the essential electrophoretic parameters (volume, time, voltage and pH) gave the best protein separation results in the natural range (pH = 7). Also in all cases, except pH = 11, the catodic side was richer in fractions than the anodic one; this was the qualitative characteristic of the protein component of the parotid saliva. Consequently, the protein content of the parotid saliva was rich in basic elements with the typical electrophoregram and densitogram for human serum and mixed saliva. The Pol-E agarose film method is appropriate for investigation and detection of the protein content in human, especially parotid saliva. It also enables differentiation of samples of mixed and parotid saliva on the basis of appropriate densitograms which are the consequence of different protein and especially glycoprotein components of the content. PMID- 1785126 TI - [Study of Co-Cr-Mo alloys in metal-ceramics]. AB - The new interest of dental workers in Co-Cr-Mo alloys has increased because of the potential risk of nickel-related allergic responses and berylium-related toxic effects. The aim of the present study was to assess the transverse bond strength, rigidity modulus and compatibility of ceramics in four selected Co-Cr Mo alloys. The obtained results indicate that oxide formation was not easily controlled and that additional sand-blasting was necessary after oxidation of the metal. The bond strength and rigidity modulus were the highest in the alloy containing titanium. Thermal shock tests confirmed the results of mechanical testing. PMID- 1785127 TI - [Craniofacial dimensions and growth. Longitudinal study]. AB - On a sample od 13 children of both sexes, aged 5-7 years, the longitudinal investigation of eight angular and five linear dimensions was carried out. Lateral cephalometric roentgenograms were used for the analyses. It was found that during the investigated period maxillary and mandibularly prognathism increased, maxillary plane inclination increased, and mandibular plane inclination decreased. None of the examined angular measurements showed a statistically significant difference in the age between five and seven year. All linear measurements increased with the age and grown. Statistically significant differences were found only for maxillary base length and upper face height. PMID- 1785128 TI - [Elimination of isolated gingival atrophy by laterally positioned flap and free mucogingival autografts in combination with coronally positioned flap]. AB - Mucogingival surgical procedures such as laterally (horizontally) positioned flap, double papillae positioned flap and free mucogingival autografts have been recommended for the prevention and treatment of isolated gingival atrophy. These procedures can bi performed either independently or in combination with coronally positioned flap. In our study, for covering of exposed tooth roots, we applied laterally positioned flap and free mucogingival autografts in combination with coronally positioned flap. The obtained therapeutic results showed that six months after the surgery the exposure of tooth necks in patients treated by laterally positioned flap, decreased by 2.54 mm. Somewhat better results were obtained in the group of patients treated by fre mucogingival autografts in combination with coronally positioned flap. Within the same time interval, the total surface area of exposed tooth roots decreased by 59.76% in the group of patients treated by laterally positioned flap, i.e. by 62.25% in the group of patients treated by free mucogingival autografts in combination with coronally positioned flap. PMID- 1785129 TI - [Examination of sensorial threshold of interocclusional perception in persons with intact denture]. PMID- 1785130 TI - [Adentol (natural sweetener) and caries prevention]. AB - Numerous epidemiological, experimental and clinical studies have established, without doubt, the correlation between the consumption of dietary sugars and caries prevalence. The increase of the sugar consumption in Yugoslavia is in direct correlation with caries activity in children. One of the aims of preventive programmes is to improve the diet habits through the use of non cariogenic sugar substitutes. Adentol is a hydrogenated glucose syrup obtained from the enzymic hydrolysis of corn starch, made by D.P.,"HPK" Bosanska Dubica Yugoslavia. Its chemical content is very similar to that of Lycasin 80/55 (Roquette Freres-France). Published data on its behaviour in acid production in vitro and in dental plaques, its effect on the oral microorganisms and the process of remineralization of initial caries lesions, suggest that hydrogenated glucose syrup (Lycasin, Adentol) is less fermentable in oral cavity and without cariogenic properties. Substitution of dietary sugars by Adentol in confectionery and syrup medicines is likely to be of significant benefit to dental health. PMID- 1785131 TI - [Radiologic examination of the temporomandibular joint. 1. One plane radiographs]. AB - A knowledge of the anatomic form and relationship of the components of the temporomandibular joint is an important factor in the evaluation, diagnosis, and treatment of temporomandibular joint disturbances. Radiographs of the temporomandibular joint in one plane are the simplest, fastest and easiest way to obtain certain information of temporomandibular joint components. Form and location of the temporomandibular joint are the limiting factors, in the radiological examination of this part of the human body. Different techniques for obtaining the optimal one plane radiograph have been developed to solve this problem. Each of these techniques depicts a different part of the joint. Thus, no method is superior to any other, and none is suitable for all situations. PMID- 1785132 TI - Changes of thymocyte subpopulations induced by activities diffusing from leukemia L1210 cells. AB - Mice with intraperitoneally inoculated leukemia L1210 cells had a lower total number of thymocytes and a markedly reduced percentage of L3T4+ Lyt2+ (CD4+ 8+) thymocytes, but increased subpopulations of L3T4+ Lyt2-, L3T4- Lyt2+, L3T4-Lyt2-. The percentage of Thy 1.2+ thymocytes was unchanged as compared with control animals. A similar effect was observed is suggested that leukemia L1210 cells produce some activities which diffuse through 0.22 microns filters and influence the subpopulations of thymocytes. PMID- 1785133 TI - Acetylcholine esterase: the structure. PMID- 1785134 TI - A stressful relationship. PMID- 1785135 TI - Investigating protein conformation, dynamics and folding with monoclonal antibodies. AB - Monoclonal antibodies with thoroughly characterized target specificities can be used as powerful probes of protein conformation. In addition to providing information on the relative arrangement of the domains in the native molecule, they can also be used to monitor both early and late stages of protein folding and conformational changes related to enzyme action. PMID- 1785136 TI - Models of protein kinase C activation. PMID- 1785137 TI - Biochemistry of asthma. AB - Asthma is a chronic condition of the airways that involves many types of inflammatory cell and the release of many mediators and neurotransmitters that have multiple effects on the various target cells in the airway. There have been important advances in understanding the biochemical events involved in signal transduction in inflammatory cells, in mediator synthesis and release, in contraction and relaxation of airway smooth muscle and in neural mechanisms. This may lead to more effective and specific therapies for this common but complex disease. PMID- 1785138 TI - Do 15-lipoxygenases have a common biological role? AB - In contrast to the well-studied role of 5-lipoxygenase in the arachidonic acid cascade that occurs in inflammatory cells, the biological role of the related 15 lipoxygenases in the metabolism of free polyenoic fatty acids is far from clear. However, the activity of 15-lipoxygenases with more complex substrates may play a crucial role in the differentiation and maturation of certain cell types and in the oxidative modification of lipoproteins in the early stages of atherosclerosis. PMID- 1785139 TI - Recognition of complex oligosaccharides by the multi-subunit asialoglycoprotein receptor. AB - The hepatic asialoglycoprotein receptor, a galactose lectin, is an oligomer of two types of similar polypeptide chains, each of which weakly binds galactose. High-affinity binding of complex oligosaccharides requires a precise geometric arrangement of receptor subunits. The two subunits have different functions in receptor assembly, ligand binding and endocytosis. PMID- 1785140 TI - Telomeres. AB - Telomeres are specialized structures at the ends of eukaryotic linear chromosomes, consisting of protein-bound tandemly repeated simple DNA sequences. Telomeric DNA is unique in that it is copied from an RNA template that forms part of the enzyme, telomerase. This review discusses the synthesis and maintenance of these unusual structures. PMID- 1785141 TI - The structure of Ras protein: a model for a universal molecular switch. AB - X-ray crystallography has revealed the molecular architecture of the cellular and oncogenic forms of p21Ha-ras, the protein encoded by the human Ha-ras gene, in both its active (GTP-bound) and in its inactive (GDP-bound) forms. From comparison of these two structures, a mechanism is suggested for the GTPase hydrolysis reaction that triggers the conformational change necessary for signal transduction. The structures have also allowed identification of the structural consequences of point mutations and the way in which they interfere with the intrinsic GTPase activity of p21ras. The p21ras structure is similar to that of the G-domain of elongation factor Tu (EF-Tu) from Escherichia coli, suggesting that p21ras can serve as a good model for other guanine nucleotide binding proteins. PMID- 1785142 TI - Electrochemically induced adsorption of radio-labeled DNA on gold and HOPG substrates for STM investigations. AB - In a scanning tunneling microscope (STM) electrochemical cell we have studied the effects of electrode potential on both the surface topography and the adsorption of deoxyribonucleic acid (DNA) to graphite and gold surfaces. Images of the surface of highly oriented pyrolytic graphite (HOPG), of the same area, in response to a positive increase in surface potential show degradation of the step edges with little change in the crystal plane. Images of the same area of a gold surface demonstrate the formation of and the progressive increase in nodular structures on the crystal planes, in response to increased potential, with little effect on the step edges. Using radio-labeled DNA we monitored electrochemical absorption onto HOPG and gold surfaces. Although at no applied potential and at negative surface potentials some DNA was bound, at positive potentials 3 to 5 times more DNA was incorporated onto both surfaces. DNA adsorbed to a surface at a positive potential was not removed by reversing the potential. PMID- 1785143 TI - Covering events in eigenimages of biomolecules. AB - Multivariate statistical analysis of a large set of micrographs of biological macromolecules involves the computation of eigenimages representing principal features, on the basis of which similar views of the complexes can be grouped. It is not generally clear what these eigenimages represent physically and which ones should be used in the classification process. In this paper, hierarchical maximum entropy discretisation and event covering are used to (1) detect statistically significant relationships in the eigenimages, (2) select the most relevant eigenimages for classifying biomolecular projections, and (3) build a prototype of the biomolecular complex under study. PMID- 1785144 TI - Acquisition and data processing in biological electron energy loss spectroscopy. PMID- 1785145 TI - Intramedullary locking femoral nails. Experience with the AO nail. AB - The AO interlocking nail was introduced to the Ulster Hospital, Dundonald in 1988 and since then has been used in over 50 patients with femoral shaft fractures. We have reviewed 45 patients with 46 femoral shaft fractures treated between June 1988 and April 1990. These included four compound fractures and 13 comminuted fractures. The results compare favourably with other series. The union rate was 98% and there were no instances of deep infection. The alternative treatment methods available are discussed along with a review of the relevant literature. PMID- 1785146 TI - Geographical variations and recent trends in cancer mortality in Northern Ireland (1979-88). AB - Cancer mortality in the 35-74 year age-range for selected sites during the period 1979-88 was investigated for the 26 district council areas of Northern Ireland. Trends in rates during the period were also studied and compared with trends in an earlier period, and with trends reported from the rest of the United Kingdom. Statistically significant differences between the age-standardised death rates in the 26 areas were observed for stomach cancer (women only), pancreatic cancer (women only), lung cancer (men and women) and for all cancers (men and women). Some evidence of spatial aggregation of rates was apparent for ovarian cancer even though rates in the 26 areas did not differ significantly. The patterns are illustrated with maps and some difficulties of interpretation are discussed. Mortality rates for oesophageal cancer increased during the period in both sexes while rates for stomach cancer decreased. Colon cancer rates increased significantly only in men, while an increase in lung cancer rates was confined to women. The mortality from all cancers increased significantly during the period by 0.8% per annum in men and 0.9% per annum in women. These trends were found to be broadly comparable with those reported elsewhere in the United Kingdom. PMID- 1785147 TI - The National Breast Screening Programme: the first 5,000 women screened in Northern Ireland. AB - The National Breast Screening Programme is an ongoing public health programme. Women between 50 and 64 years are being invited to attend for screening at three yearly intervals. The results of the first 5,000 women screened in the Eastern Health and Social Services Board's unit are presented. The breast cancer detection rate was 7.8 per thousand women screened. The malignant to benign biopsy rate was greater than 1:1. PMID- 1785148 TI - A profile of residents of old people's homes. AB - This paper describes the characteristics of the 450 residents of all statutory residential homes for the elderly within five local government districts in Northern Ireland. The residents are described in terms of demographic detail, prevalence of dementia and prevalence of problem behaviour. Results are comparable with those of other studies. There are more females, fewer are married and more are over the age of 75 years than would be predicted from the general population. Roughly half scored within the dementia range, with 56% of those over 85 years being demented. More than 33% had some degree of incontinence, 9% were immobile and 10% were physically aggressive at least once a week. Five percent were wanderers and nearly all residents required help with bathing. PMID- 1785149 TI - Hepatitis delta virus infection in Northern Ireland 1970-1989. AB - The incidence of hepatitis delta virus (HDV) infection in Northern Ireland (1970 1989) was tested by enzyme linked immunosorbent assay in 401 hepatitis B surface antigen (HBsAg) positive sera. Hepatitis delta antigen (HDAg) was tested in 388 patients and antibody to delta antigen (anti-HD) in 401 patients. Four patients (1.03%) were HDAg positive. Nine patients (2.24%) were positive for anti-HD and after acid pre-treatment of sera from eight of these patients, five were positive for HDAg. The overall incidence of HDV markers was 3.27%, which reflects the low incidence in HBsAg carriers in Northern Ireland (who were in high risk groups for delta hepatitis). The use of acid treatment of the sera to break up antigen/antibody complexes has been a useful technological improvement in the identification of this virus. PMID- 1785150 TI - Non-arterial assessment of blood gas status in patients with chronic pulmonary disease. AB - Assessment of blood gas status is important in the management of patients with chronic pulmonary disease. Arterial puncture is often painful and may damage the arterial wall. Measurement of oxygen saturation by transcutaneous oximetry offers a non-invasive alternative to arterial methods but does not allow assessment of partial pressure of carbon dioxide. We have examined the value of oximetry and dorsal hand venous carbon dioxide as an alternative to arterial puncture. Transcutaneous oxygen saturation correlated with arterial oxygen saturation (r = 0.76, p less than 0.001) with an error of 2.1% and dorsal hand venous carbon dioxide tension correlated with the arterial tension (r = 0.84, p less than 0.001) with an error of 8%. Changes in oximetric oxygen saturation and venous carbon dioxide tension following oxygen therapy reflected arterial values. Assessment of blood gas status using oximetry and dorsal hand venous carbon dioxide tension is a useful alternative to arterial puncture. PMID- 1785151 TI - Evidence of Chlamydia infection in a Belfast antenatal population. AB - Chlamydia trachomatis is an important cause of postpartum endometritis and neonatal conjunctivitis. However, the prevalence of chlamydial genital infection varies considerably from one population group to another. A study was thus conducted to determine the incidence of C trachomatis infection of the cervix in an unselected group of women attending a Belfast antenatal clinic. One hundred and six patients were screened for evidence of current cervical infection with C trachomatis or serological evidence of past infection. C trachomatis was identified in 2.9%, and there was evidence of past infection in 18.9%. No significant risk factors were identified from gynaecological, contraceptive or sexual histories. C trachomatis infection was treated with erythromycin and there were no perinatal complications ascribed to chlamydia. PMID- 1785152 TI - Prophylactic oophorectomy in Northern Ireland. AB - A postal questionnaire was sent to all gynaecological consultants and senior registrars (n = 50) in Northern Ireland to establish the prevalence of prophylactic oophorectomy. Forty three (84%) replied. 72% performed prophylactic oophorectomy (28% unilateral), 28% did not. With reference to the world literature, there appears to be no benefit from the unilateral procedure but a consensus that bilateral oophorectomy is an option which should be considered in certain cases where there is a high risk of ovarian cancer. PMID- 1785153 TI - Problems in day care surgery. AB - In-patient admission represents a failure of a day care service. The hospital records of 105 patients transferred from the day ward to the in-patient wards were studied retrospectively. Of 2,039 patients treated in the day care ward, 105 (5%) required in-patient admission over a 12 month period. Of these 105 admissions, 17% did not fulfil the criteria for day care patients, 46% had surgical problems, and 35% anaesthetic-associated problems. The in-patient admission rate could be reduced by improved out-patient selection of cases, use of a separate day care theatre, increased use of local anaesthetic techniques, reduction in the use of parenteral opioids, the use of simple oral analgesics or non-steroidal anti-inflammatory agents as pre-emptive analgesia and a wider use of propofol as an induction agent which provides superior recovery from anaesthesia. PMID- 1785154 TI - A review of 100 consecutive Richard's total knee replacements. AB - One hundred consecutive Richard's Maximum Contact (RMC) knee replacements were performed in Belfast between 1978 and 1982. Most of the 100 knees (86 patients) involved had been in severe pain, had marked stiffness or gross knee deformity, or were chairbound because of the knee. They were reviewed between five and eight and a half years (mean five years and eleven months) after operation. Thirteen patients (13 knees) died before review leaving eighty seven knees in 73 patients available for study. Using a modification of the British Orthopaedic Association knee function assessment chart, 26 knees (30%) were graded as excellent, 22 (25%) as good, 19 (22%) as fair and nine (10%) as poor. There were five implant failures, four the result of deep infection, one due to loosening. Six patients were chairbound at review and were also graded as failures. These results support the view that total knee replacement approaches the predictability and success of arthroplasty of the hip. PMID- 1785155 TI - Diabetes care by general practitioners in Northern Ireland: present state and future trends. AB - A questionnaire returned by 250 (71.4%) of the 350 general practices in Northern Ireland indicated that although only 34 practices had special arrangements for seeing their diabetic patients, 178 practices stated that they would like to be more involved in the care of their non-insulin-dependent diabetes mellitus (NIDDM) patients. One hundred and eight practices felt the same way about their insulin-dependent diabetes mellitus (IDDM) patients. One hundred practices stated that the partners felt competent to manage their diabetic patients. The main area where general practitioners felt they needed to improve their knowledge was ophthalmology (56 practices). When asked which type of care scheme would appeal most to their practice, 135 practices stated that regular attendance with the general practitioner and annual hospital review would be the preferred arrangement. Overall there was a positive attitude towards increased general practitioner involvement in diabetes care. PMID- 1785156 TI - Robert Campbell in Queen Street, 1897-1920. Day surgery in the Belfast Hospital for Sick Children. PMID- 1785157 TI - Science, public health and genetic services. Menary Lecture. PMID- 1785159 TI - Rapidly progressive obstructive jaundice due to Congo red negative amyloidosis. PMID- 1785158 TI - The scholarly work of James Smiley. PMID- 1785160 TI - An unclassifiable dermatosis affecting the periorbital areas and neck with lymphadenopathy oedema and pharyngitis. PMID- 1785161 TI - Perforation of the urinary bladder due to prolonged use of an indwelling catheter. PMID- 1785162 TI - Toxic elevation of serum lithium concentration by non-steroidal anti-inflammatory drugs. PMID- 1785163 TI - Basal cell carcinoma presenting with profound anaemia. PMID- 1785164 TI - Hiccups and oesophageal malignancy. PMID- 1785165 TI - Massive tissue necrosis can be induced by heparin or warfarin. PMID- 1785166 TI - Pseudothrombocytopenia--a cautionary tale. PMID- 1785167 TI - Legal cases involving birds: the role of the veterinary surgeon. AB - Since the passing of the Wildlife and Countryside Act 1981, veterinary surgeons have had an increasingly important role to play in legal cases concerning wild animals, especially birds. This paper proposes guidelines for those who may be asked to investigate birds clinically, to carry out post mortem examinations or to perform laboratory tests. The importance of developing and using standard techniques is emphasised and attention is drawn to the need for more detailed research in the field of avian forensic pathology. PMID- 1785168 TI - N-acetyl-beta-D-glucosaminidase test for screening milk samples for subclinical mastitis. AB - The use of the N-acetyl-beta-D-glucosaminidase (NAGase) test for detecting subclinical mastitis was investigated in surveys of milk samples from 20 farms. A milk sample was considered to be mastitic if it had a milk cell count above 400,000 cells/ml, and the NAGase test results were graded accordingly. The test gave an average of 16.6 per cent false positives and 2.0 per cent false negatives per herd. It was concluded that the NAGase test could be used as a rapid screening method for selecting suspect samples for further analysis by standard methods. PMID- 1785169 TI - Farm tracks, stockman's herding and lameness in dairy cattle. PMID- 1785170 TI - Megacolon in a cat following ovariohysterectomy. PMID- 1785172 TI - Closure of VI centres. PMID- 1785171 TI - Transport of live animals for slaughter. PMID- 1785173 TI - Veterinary prescription diets. PMID- 1785174 TI - [Immunoenzyme test systems for detecting the HIV antigen and a trial of their use in examining HIV-infected subjects]. AB - The results of the development and trials of two variants of EIA test system for the detection of HIV-1 antigen using biotinated HIV-antibody and streptavidin peroxidase or biotin-beta-lactamase enzyme complexes are presented. These diagnostic preparations proved to be highly sensitive and specific allowing the detection of the antigen in the blood of HIV-infected subjects. PMID- 1785175 TI - [The characteristics of the long-term continuous cultivation of a cell line chronically infected with the human immunodeficiency virus type-1]. AB - A chronically HIV-1-infected culture of continuous human monocytes producing infectious virus during long-term continuous cultivation (over 200 passages) without the addition of noninfected cells was generated. HIV-1 produced by this culture had typical morphology and complete set of virus-specific proteins. This cell line is proposed for use as an additional model for the evaluation of antiviral effects of various drugs. PMID- 1785176 TI - [The vaccinal prevention of the HBsAg carrier state among newborn infants]. AB - The paper presents the data on the time course of HBsAg carrier state in babies born to mothers with antigenemia indicating the dependence of the pattern of the antigen carrier state in babies upon the time of its primary detection. The stable (chronic) HBsAg carrier state in babies was shown to be formed after the first 3 months of life which attests to the necessity of using a vaccine against hepatitis B (HB) for prevention of HBsAg carrier state in newborns. The results of epidemiological survey in 185 babies developing HB with the analysis of all possible factors of their infection contraction are presented. The efficacy of the national plasma vaccine against hepatitis B is evaluated in observations of the newborn babies whose mothers were carriers of HBsAg. It was established that in vaccinated babies after 3 injections of the vaccine at 0, 1, and 6 months the rate of antigen detection was 3.3% and that of antibody 80% whereas in babies of the control group these values were 23.7% and 8.0%, respectively. PMID- 1785177 TI - [A system of the means of genetic information transfer and the possible routes of viral evolution]. AB - A system of means of genetic information transmission (MGIT) modeling the main features of modes of virus reproduction as well as an algorithmic approach to its construction and means of its schematic representation are proposed. The system may be used as the basis for virus classification including taxonomic categories above the family level and for the study of possible evolution relationships between virus groups. One of the variants of virus macroevolution model is described. PMID- 1785178 TI - [An analysis of the possible routes of viral macroevolution]. AB - A complex analysis of virus groups was carried out in order to find out possible ways of their macroevolution. The analysis was based on the detection of similar groups of viruses which could be considered to be evolutionally close. The similarity was evaluated both by a complex of virus properties (physicochemical, morphological, etc.) and using systemic analysis of means of genetic information transmission (MGIT) describing the features of replication and transmission properties. The developed systemic approach using the analysis of the MGIT system and integral differences between viruses by the totality of their properties helped to form models of virus evolution taking into account, in particular, their mono- or polyphyletic origin, more definite knowledge on pravirus(es) MGIT, etc. A monophyletic model of macroevolution of viruses was constructed. PMID- 1785179 TI - [The interrelations of the human and avian influenza viruses A(H2) determined by the mathematical processing of data on the antigenic structure of their hemagglutinin]. AB - Mathematical methods were used to analyse the data on the antigenic specificity of H2 subtype hemagglutinin of human and avian influenza A viruses. This approach allowed the evaluation of possible evolutional relationships in this little studied group of viruses. Influenza A (H2) viruses isolated from birds in the USA were found to represent a sufficiently isolated group, whereas European avian strains (A/duck/Germany/1215/73, A/pintail duck/Primor'e/695/76, A/duck/Marseilles/46/76) were close to "human" viruses. The A/Leningrad/1468/65, A/laughing gull/New Jersey/75/85, and A/pintail duck/Alberta/2728/77 strains represent marked antigenic variants apparently rather far gone as a result of hemagglutinin drift. PMID- 1785180 TI - [The use of the lectin test for detecting antineuraminidase antibodies in the sera of vaccinated subjects]. AB - The lectin test (a microvariant) was used to study the immunogenicity of live attenuated and inactivated virion divaccines of influenza A (H1N1 + H3N2) and influenza B vaccines in children 3 to 15 years of age. A good correlation was found between the general level of seroconversion of antineuraminidase and antihemagglutinin antibodies in the sera examined. This method is simple and may be useful for titration of large numbers of sera in studies on the immunogenicity of influenza vaccines or peculiarities of anti-influenza humoral immunity. PMID- 1785182 TI - [The formation of an immune response in volunteers inoculated with a live recombinant influenza vaccine]. AB - The capacity of a live influenza vaccine (LIV) to stimulate cytotoxic cells (ADCMC and NK) was studied in 49 volunteers and 56 patients with influenza. Experimental batches of LIV from influenza A and B viruses prepared by genetic recombination on the basis of cold-adapted attenuation donors were used. Type A and B LIV were shown to stimulate the cytotoxic cell-mediated and humoral immunity; the intensity of immune response, however, depended on the molecular genetic characteristics of the vaccine (genome structure, properties of the donor of attenuation), its biological activity and capacity of reproduction in tissues. PMID- 1785181 TI - [The inoculation properties of live recombinant influenza vaccine types A and B used separately and jointly in children 3 to 14]. AB - The reactogenicity and immunizing activity of vaccine influenza virus A (H1N1) and B strains used as mono- and bi-preparations in children of 3 to 14 years was studied. No increased reactogenicity after the use of bivaccine was observed in the children. Febrile reactions as well as 9 other clinical symptoms which could indicate the reactogenicity of the vaccines were identical for mono- and bivaccine and corresponded to the requirements of the technical documents for the vaccine. The optimal conditions for the evaluation of the immunogenicity of the B component by HI test were developed, and the necessity of using additionally the enzyme immunoassay for this purpose is substantiated. The above method demonstrated that the immunogenicity of the live influenza type A and B vaccine was high in children. No significant inhibition of immunological parameters was observed when the two viruses were combined in the bivaccine. PMID- 1785183 TI - [The effective use of superoxide dismutase from human erythrocytes in the late stages of experimental influenza infection]. AB - The role of reactive oxygen species (ROS) in the pathogenesis of influenza infection was studied. Bronchoalveolar lavage and serum of influenza-infected mice were shown to produce ROS following the addition of phorbole ether-PMA. The generation of ROS was the maximum in 5-6 days after virus inoculation which coincided with the beginning of animal deaths. The main form of ROS was hypochloride generated by neutrophil meyloperoxidase. Treatment of mice with superoxide dismutase (SOD) in the late period of infection (as early as 12 hours before death) led to an increase in the survival rate of mice by 30-50% depending upon the dose of the preparation. The survival rate in the controls was 10%. The treatment of mice early in the infection led to an increase in the survival rate by 80%. The use of SOD conjugates with albumin or polymers led not only to an increase in the survival rate but also to a delay in deaths. The effective use of SOD is believed to depend upon the inhibition of neutrophil influx to the lungs. PMID- 1785184 TI - [The detection of antibodies to the Venezuelan equine encephalomyelitis virus by immunoenzyme analysis using antigen purified in a water-polymer system]. AB - Human and animal sera were tested for the presence of antibodies to Venezuelan equine encephalomyelitis (VEE) virus by direct enzyme immunoassay (EIA). For the test, the plates were sensitized with a VEE virus preparation purified in a two phase system of water-soluble polymers. The proposed EIA variant was as specific as that with VEE antigen obtained by fractionation on sucrose cushion, but more sensitive. The high specificity of the assay allowed the antigen purified in the water-polymer system to be used for investigation of antigen relationships among viruses of the VEE complex. PMID- 1785185 TI - [The course of airborne infection in rabbits infected with the Venezuelan encephalomyelitis virus]. AB - The experimental data on aerosol challenge of rabbits with Venezuelan equine encephalomyelitis (VEE) virus are presented. Lethal infection of rabbits was followed by a rise in body temperature (greater than 0.5 degrees C) within 1-2 days after challenge. Two waves of lethality in aerosol infection experiments were recorded. Three variants of the infection outcome were observed after VEE virus aerosol challenge of rabbits. The causes of death of the infected rabbits are discussed. PMID- 1785186 TI - [A comparison of the protective properties of preparations of the virion and nonvirion ("soluble") antigens of the tick-borne encephalitis virus]. AB - A comparative assessment of the protective properties of virion (VA) and nonvirion ("soluble") (NA) antigens of tick-borne encephalitis virus prepared as inactivated samples close in their parameters to vaccine preparations was carried out. The NA in the preparations free from VA or containing only trace, nonprotective amounts of it, was shown to have significantly lower protective properties than VA and exerted no booster effect on the protective activity when added to VA preparations. PMID- 1785187 TI - [A comparative study of the in-vitro interaction of the Marburg virus with macrophages from different animal species]. AB - The amplification of Marburg virus in primary cultures of peritoneal macrophages of animals with different sensitivity to infection with this virus, as well as the capacity of this virus to adsorb on macrophages were studied. Macrophages of the animals sensitive to Marburg virus were capable to support its reproduction in vitro whereas those of resistant animals were not. Macrophages of the animals with intermediate sensitivity were shown to be either completely resistant to virus reproduction or to delay it. Besides, macrophages of sensitive and insensitive animals were capable to adsorb this virus, this capacity being markedly reduced in macrophages isolated from immunized animals and those sensitive animals which developed the disease after inoculation of the virus. The authors conclude that animal susceptibility to Marburg virus in vivo correlated with the capacity of macrophages to support Marburg virus reproduction in vitro and not with the capacity of the virus to adsorb on the macrophage surface. It is suggested that the evaluation of Marburg virus amplification in macrophages could be used as a criterion for evaluation of the susceptibility of animals to this virus in vivo. PMID- 1785189 TI - [An experimental infection of the seal Phoca sibirica with the morbilli virus]. AB - A Baikal seal (Phoca sibirica) was experimentally infected with Baikal seal morbillivirus (BSMV) isolated from Baikal seals during an epizootic in 1987-1988. The seal was infected with BSMV with an infectious titer of 10(7.0) TCD50/ml, and daily observations of the animal clinical condition were made. The virus-specific antibodies in the seal serum were determined by ELISA and virus neutralization test. The clinical picture showed a mild infection. The ELISA-active antibodies were detected 10 days postinfection and reached the maximum in 20 days. Virus neutralizing antibodies were detected in 16 days after infection, reached the maximum titer of 1:640 in 20 days and remained at this level for 39 days (the observation period). These data indicate that BSMV can induce a disease in the natural host with production of virus-neutralizing antibodies. The results of this work and the earlier reports show that the epizootic in Baikal seals was induced by BSMV. PMID- 1785188 TI - [An experimental study of the contact transmission of the Marburg virus]. AB - Experiments in guinea pigs and M. rhesus monkeys showed the possibility of contact infection of animals with Marburg virus. Secondary infection occurred most intensively when the monkeys were kept together but was also shown to be possible when the animals were separated but placed in the direction of the air flow from the sick monkeys as well as by "nose-to-nose" contact excluding the alimentary mode of transmission and the role of the agent excreted in the urine. PMID- 1785190 TI - [The efficacy of immobilized liposomal preparations of ribamidil in experimental Rift Valley fever]. PMID- 1785192 TI - Ethical issues and intensive care: a look to the 90s. PMID- 1785191 TI - [The cultivation of mammalian cells on a new Soviet substrate]. PMID- 1785193 TI - Promotional strategies in occupational health. Can it be extrapolated to general preventive medicine in the Caribbean Region? AB - This article highlights promotional strategies that are currently in use in occupational health which have yielded positive results in terms of cost effectiveness and the prevention of occupational disease. Suggestions are offered on the possible extrapolation of these strategies to disease prevention programmes in medical practice in the Caribbean Region. PMID- 1785194 TI - Appendicectomy at the University Hospital of the West Indies (1984-1988). A retrospective review. AB - The pathological records of appendicectomy specimens from patients with suspected acute appendicitis at the University Hospital of the West Indies during the 5 year period 1984-1988 were studied. The numbers of cases, their ages, sex and seasonal incidence were similar to those of other studies. The overall false positive diagnosis rate was 25% (16% in males, 38% in females). The main diagnostic difficulty was in young females in whom surgery for suspected appendicitis often proved unnecessary. PMID- 1785195 TI - Myasthenia gravis in Jamaica. Clinical, immunological and genetic studies. AB - Clinical, immunological and genetic parameters were studied in 73 Jamaican patients with myasthenia gravis (MG). The reported bimodal clinical distribution of females with early onset of disease and males with late onset was not observed. The female to male ratio was 2:1. The most frequent manifestations of disease were ptosis (84.9%), general muscle weakness (68.5%), bulbar symptoms (41.1%) and diplopia (32.9%). Unusual presenting features such as unilateral ptosis, recurrent chest infection and stumbling while walking resulted in diagnosis being missed in 5.8% of cases. The sensitivity of radioimmunoassay in detecting acetylcholine receptor antibody (AchR-Ab) in sera from a subgroup of 35 MG patients was 71.4% whilst that of the ELISA was only 14.2%. There was no correlation between concentration of AchR-Ab and severity of disease. Similarly, there was no association between HLA-type, thymic pathology and course of disease. HLTV-I could not be implicated in the pathogenesis of this disease. There was a paucity of other associated autoimmune conditions among MG patients. Thymectomy was an important therapeutic modality in that improvement was observed in 22 cases and remission in 11. PMID- 1785196 TI - Biochemical abnormalities in multiple myeloma. AB - Monoclonal gammopathies can either be benign or more commonly malignant. The commonest disease associated with it is multiple myeloma. Over the seven-year period 1984-1990, two hundred and thirty-four monoclonal gammopathies were seen at the University Hospital, Jamaica. Multiple myeloma was diagnosed in one hundred and fifty-six cases (84 males and 72 females). The diagnoses of most of the others were not known as the samples came from other institutions. Of the patients with myeloma, the most common immunoglobulin type was IgG followed by IgA and then pure light chain disease. Only in about half of the cases where urine was analysed was Bence-Jones protein found. The majority of the cases had abnormal total serum protein, albumin and total globulin concentrations. Most of the cases also were in renal failure. Hypercalcaemia, hyperphosphataemia, elevated alkaline phosphatase, gammaglutamyl transferase and aspartate aminotransferase occurred in about one-third of them. These results were not much different from those reported in other countries. PMID- 1785197 TI - Nocturnal enuresis in normal Jamaican children. Implications for therapy. AB - The prevalence of nocturnal enuresis has been investigated in 477 children (243 boys, 234 girls) attending government Basic Schools in Kingston, Jamaica. Enuresis, defined as wet at least 2 nights a week, occurred in 62%, 48%, 42% and 40% at 2, 3, 4 and 5 years of age, respectively. Enuresis, defined as wet at least one night a month, occurred in 68%, 58%, 53% and 52%, respectively. There was no significant difference between the sexes. Children with a family history of enuresis (first degree relatives wet beyond 8 years of age) were more likely to be enuretic than those with no family history, the difference reaching statistical significance for girls (less than 0.001) and for the sexes combined (p less than 0.001) but not for boys alone (p = 0.06). The prevalence of nocturnal enuresis in Jamaican children is higher than reported for Black children elsewhere, which in turn is higher than in their White counterparts. Cultural attitudes to bedwetting contribute to this variation and have implications for choice of therapy, both in Jamaica and elsewhere. PMID- 1785198 TI - Missing intrauterine contraceptive device presenting with strings at the anus. AB - The rare condition of strings of a missing intrauterine contraceptive device presenting at the anus is described. Partial removal was achieved via the rectum and this was followed by a normal uncomplicated pregnancy and delivery. PMID- 1785199 TI - Successful pregnancy after conservative surgery for ovarian papillary serous cystadenocarcinoma of low malignant potential. AB - Conservative surgery was performed on a 28-year-old patient with an ovarian serous cystadenocarcinoma of low malignant potential who became pregnant one year later. The good prognosis of these tumours makes conservative surgical management the treatment of choice when preservation of child-bearing potential is deemed appropriate. PMID- 1785200 TI - Haemophagocytic syndrome. AB - Two fatal cases of haemophagocytic syndrome diagnosed on the basis of autopsy findings at the Queen Elizabeth Hospital, Barbados, are presented. They were both young patients, a male 20 years of age and a female 28 years of age, with common clinical features of severe constitutional symptoms, pharyngeal haemorrhages, pancytopenia, and fever. The female patient had elevated titres to herpes simplex virus indicative of recent infection as well as postmortem evidence of overwhelming mixed bacteria sepsis. In both cases, histopathological studies showed lymphoid depletion and histiocytes displaying haemophagocytosis. PMID- 1785201 TI - Sudden death in athletes in Trinidad and Tobago. AB - Sudden death related to exercise activity is a well-recognized clinical syndrome. Although the incidence is low, it is always an agonizing experience to all concerned when a young, relatively healthy individual dies suddenly. Over the last four years, we have had six proven cases of sudden death in athletes. The cause varied from congenital to acquired pathology of the heart, and there was one case of heat stroke. From this study, we were able to analyse some of the risk factors and, from a review of the literature, we are able to determine (1) the feasibility of a screening programme, and (2) the design of such a programme as would be suitable for our environment. PMID- 1785202 TI - Pentachlorophenol toxicokinetics after intravenous and oral administration to rat. AB - 1. The toxicokinetics of pentachlorophenol (PCP) were studied in rats. Doses of 2.5 mg/kg were given i.v. (bolus, five rats) and orally (gastric intubation, five rats). Concentrations in plasma, urine and faeces were measured by capillary g.l.c. with electron-capture detection. 2. After i.v. administration, the clearance and volume of distribution at steady state were 0.026 +/- 0.003 l/h per kg and 0.25 +/- 0.02 l/kg, respectively. These two parameters exhibit low inter rat variability (coefficients of variation less than 15%). The half-life of the initial decline of PCP plasma concn. was less than 1.3 h, while the second phase half-life was 7.11 +/- 0.87 h. 3. After oral administration the peak plasma concn. (7.3 +/- 2.8 micrograms/ml) occurred between 1.5 and 2 h and absorption was complete (bioavailability = 0.91-0.97). No distinct distribution phase was observed and the elimination half-life was 7.54 +/- 0.44 h. 4. PCP clearance is essentially metabolic since only 5.3 +/- 0.2% dose is eliminated unchanged by the kidney. About 60% dose was recovered in urine, mainly as conjugated PCP and conjugated tetrachlorohydroquinone (TCHQ). 5. For both routes of administration, about 10% dose was recovered in faeces as PCP and/or metabolites, which indicates that biliary excretion contributes to total elimination. PMID- 1785203 TI - Nilutamide inhibits mephenytoin 4-hydroxylation in untreated male rats and in human liver microsomes. AB - 1. The effects of nilutamide (an anti-androgen with a hydantoin moiety) on the 4 hydroxylation of mephenytoin were studied in rat liver microsomes. Nilutamide, at a concentration expected in human liver (100 microM) during prolonged administration of nilutamide, inhibited by 40% mephenytoin (0.3 mM) 4-hydroxylase activity in liver microsomes from untreated male rats, but not in microsomes from untreated female rats, or in microsomes from dexamethasone-treated male or female rats. 2. Administration to male rats of nilutamide, in doses (20 mg/kg i.p. twice daily) known to reproduce plasma concentrations observed in human therapeutics, decreased by 60% the 24 h urinary excretion of 4-hydroxymephenytoin after administration of mephenytoin (15 mg/kg oral). 3. Nilutamide (100 microM) markedly inhibited mephenytoin 4-hydroxylase activity in human liver microsomes. Inhibition kinetics were consistent with mixed inhibition. It is concluded that nilutamide inhibits mephenytoin 4-hydroxylase activity in untreated male rats and in human liver microsomes. It is suggested that inhibition is likely to occur in vivo in humans receiving therapeutic doses of nilutamide. PMID- 1785204 TI - Malaria infection impairs glucuronidation and biliary excretion by the isolated perfused rat liver. AB - 1. The effect of the erythrocyte stage of malaria infection on hepatic glucuronidation, biliary excretion and oxidation processes was investigated using harmol, salbutamol, taurocholate and propranolol. Livers from rats infected with the rodent malaria parasite P. berghei were isolated and perfused in a single pass (harmol, taurocholate, propranolol) or recirculating (harmol, salbutamol) design. The degree of erythrocytic parasitaemia ranged from 16% to 63%. 2. The hepatic clearance (Cl) of harmol decreased from 7.8 +/- 0.4 ml/min in controls to 5.7 +/- 1.1 ml/min in the malaria-infected group in single-pass studies. This corresponded to a 40-60% reduction in hepatic intrinsic clearance (Clint). Similar changes were observed using the recirculating design when glucuronidation accounted for greater than 90% of harmol metabolism. 3. The Cl of salbutamol, metabolized exclusively by glucuronidation under the conditions used, also decreased significantly from 8.5 +/- 0.8 in controls to 6.6 +/- 1.4 ml/min in the malaria-infected group. This corresponded to a 40-70% reduction in Clint. 4. The Cl of taurocholate, excreted unchanged in bile, decreased slightly but significantly from 9.6 +/- 0.3 ml/min in controls to 8.3 +/- 0.9 ml/min in the malaria-infected group. In the same livers, there was also a slight but significant decrease in propranolol Cl (10.0 +/- 0.1 ml/min and 9.9 +/- 0.1 ml/min, respectively). Both these compounds undergo flow-limited hepatic clearance; the decreases in Clint of taurocholate and propranolol were 87% and 35%, respectively. 5. Cl and Clint of each of the compounds studied were found to correlate significantly with the degree of erythrocytic parasitaemia. This study shows that glucuronidation, biliary excretion and oxidation by liver are impaired in malaria infection in rats, with biliary excretion being the most affected. The data indicate that there is a general decrease in hepatic elimination processes during the erythrocytic phase of malaria infection. PMID- 1785205 TI - Role of flavin-containing monooxygenase in the in vitro biotransformation of aldicarb in rainbow trout (Oncorhynchus mykiss). AB - 1. The in vitro biotransformation of 14C-aldicarb was examined in liver, kidney, and gill microsomes from the rainbow trout (Oncorhynchus mykiss). 2. In all tissues the major metabolite was aldicarb sulphoxide. Addition of the cytochrome P-450 inhibitor, N-benzylimidazole, failed to alter significantly aldicarb sulphoxide levels, while co-incubation with the flavin-containing monooxygenase substrates, N,N-dimethylaniline or methimazole, caused significant decreases in sulphoxide formation in liver and gill microsomes. 3. Aldicarb sulphoxide formation was optimal at pH 8.0, and had Michaelis-Menten kinetics with an apparent Km of 46.7 microM and a Vmax of 0.216 nmol/min per mg. 4. Aldicarb sulphoxide formation was competitively inhibited by co-incubation with N,N dimethylaniline in liver microsomes. These data indicate that flavin-containing monooxygenase plays an important role in the in vitro biotransformation of aldicarb in rainbow trout. PMID- 1785206 TI - Hepatic microsomal N-hydroxylation of aniline and 4-chloroaniline by rainbow trout (Onchorhyncus mykiss). AB - 1. N-Hydroxylation of aniline and 4-chloroaniline was quantified in rainbow trout microsomal preparations using h.p.l.c.-liquid scintillation methods. Radioactive phenylhydroxylamine and 4-chlorophenylhydroxylamine metabolites were identified by co-elution with non-labelled standards. The method provided resolution of metabolite standards, and quantification of both N-hydroxylated metabolites was achieved without derivatization. 2. The maximum velocities at 25 degrees C were 33.8 +/- 1.40 and 22.0 +/- 0.98 pmol/min per mg for aniline and 4-chloroaniline N hydroxylation, respectively. The Km values were 1.0 +/- 0.11 and 0.8 +/- 0.11 mM for aniline and 4-chloroaniline N-hydroxylation, respectively. These activities were not induced by treatment of the trout with Aroclor 1254 under the conditions of this study. 3. When incubations were performed at 11 degrees C, the physiological temperature of rainbow trout in this study, the Vmax for 4 chloroaniline N-hydroxylation decreased from 22.0 to 6.4 pmol/min per mg and the Km decreased from 0.8 to 0.5 mM. 4. The pH optimum for 4-chloroaniline N hydroxylation was 8.0 while the pH optimum for aniline N-hydroxylation ranged from 7.4 to 8.0, suggesting the possible contribution of different isoenzymes. 5. The demonstration of aniline and 4-chloroaniline N-hydroxylation by rainbow trout microsomes provides further insight into the high acute:subchronic toxicity ratios observed in fish exposed to these compounds. PMID- 1785207 TI - Regulation of rat hepatic cytochrome P450IIE1 in primary monolayer hepatocyte culture. AB - 1. Rat hepatic cytochrome P450IIE1 is an ethanol-inducible enzyme which catalyses ethanol oxidation and activation of the procarcinogen, N-nitrosodimethylamine (NDMA) to its carcinogenic metabolite. 2. Initial studies in adult rat indicated that the regulation of cytochrome P450IIE1 is complex, therefore we strove to identify a central regulatory mechanism, using primary monolayer hepatocyte culture. These studies examined the effect of a range of agents (i.e. inducers, hormones, sodium butyrate and 5-aminolaevulinic acid) on amounts of cytochrome P450IIE1 protein and mRNA expression in rat hepatocytes maintained in serum-free medium on both Vitrogen and Matrigel, a laminin-rich basement membrane. 3. At time 0, immunoreactive cytochrome P450IIE1 protein was easily detectable in control cultures, yet decreased rapidly with time in culture to nearly undetectable levels at 120 h. Addition of inducers (notably, pyrazole) to the culture medium increased cytochrome P450IIE1 above that of untreated cultures at similar time points, yet did not elevate cytochrome P450IIE1 or NDMA demethylation above their levels at time 0. 4. Cytochrome P450IIE1 hybridizable mRNA also rapidly declined in culture. The decline in mRNA was not significantly altered in cultures exposed to pyrazole or any other agent. Thus, post transcriptional factors appear to play an important role in the regulation of hepatic cytochrome P450IIE1, with protein stabilization being the most probable mechanism. PMID- 1785208 TI - [State-trait characteristics of various measured variables of psychophysiologic activation, cognitive performance and mood in common everyday situations]. AB - The distinction between state and trait sources of variation in psychological variables, familiar in differential psychology ever since the work of Cattell, is translated into a linear model of state-trait analysis. On the basis of this model indices of relative state- and trait variance of a measure (independent of errors of measurement) and the psychometric reliability of the same measure (independent of true state variance) can be determined. The model is applied to a larger set of data from in-field research employing 149 male high-school students (average age 17 years) from the city of Hamburg. Following a time-sampling plan of data acquisition, subjects were requested over a period of three successive weeks and on the average twelve times a day to indicate (on a portable computerized behavioral data recorder) their current mood and feeling and had to answer short psychometric tests (in-field psychometrics); in addition, two peripheral psychophysiological measures of activation (heart rate, finger temperature) were recorded. The psychophysiological measures depended on state variations to about two thirds of their true score variance, the different cognitive tests to about 50 to 80 percent of their true score variance on trait variations. Different scales for recording current mood and feeling states gave different state-trait variance percentages. The method also allows for determining intraindividual psychometric state reliability coefficients. Fields of application of the method in different areas of psychology are indicated. PMID- 1785209 TI - [Prediction of goal-directed behavior: attitude, subjective behavioral competence and emotions]. AB - Ajzen's (1985) theory of planned behavior explaining and predicting goal-directed behavior is extended by an emotional component. The extended theory of planned behavior is tested experimentally. N = 64 subjects play with two video games (a speed- and a problem-oriented game) under an achievement-motivational orientation. One half of the subjects plays both games in an easy version, the other half in a difficult version. The verbal emotional reactions to playing video games are grouped factor-analytically into an "activity emotion" and a "security emotion". Subjects playing video games in the difficult condition feel significantly more insecure, and perceive their behavioral control as significantly lower than subjects playing in the easy condition. Tests of the extended theory of planned behavior lead to significant squared multiple correlations for the dependent variables within the range of R2 = .20 to .58. The activity emotion accounts predominantly for a significant part of the variance of the attitude and the security emotion accounts for a significant part of the variance of the perceived behavioral control. No predictive power was found for the intention to play the games successfully. PMID- 1785210 TI - [Preferred gaze direction and the vergence system at rest]. AB - In two experiments the effects of binocular vergence, head tilt, and prolonged gaze inclination on the preferred vertical gaze direction were studied. Concurrently, dark vergence was measured to test a hypothesis on the effect that binocular vergence has on the preferred vertical direction of gaze. The previously reported influence of observation distance on the preferred gaze inclination was replicated. When the head was tilted backward, the preferred gaze inclination was lower and the effect of observation distance was reduced; when the head was tilted forward, the preferred gaze inclination was higher and the effect of observation distance was increased. After prolonged upward or downward gaze inclination the preferred vertical gaze direction was shifted up or down, respectively, while the effect of observation distance remained constant. Overall the change of the preferred vertical direction of gaze upon binocular fixation of near stimuli was accompanied by a reduced discrepancy between convergence and the resting state of the vergence system; additional implications of the hypothesis on the relation between individual resting vergence and the effect of observation distance on the preferred inclination of gaze could not be substantiated. PMID- 1785211 TI - [Effect of system-related work interruptions in computer-assisted text processing: a field study]. AB - To validate laboratory research findings on the stress inducing effects of system response time in human-computer interaction, a field study was performed at the central typing office of a bank. Simultaneous subject-oriented and object oriented measures (questionnaires) of working properties were taken with a relatively high sampling rate over several days in addition to the ordinary business activities. In summary, the negative effects of system response times could also be observed in the real work setting, but were modified by subjective and situational factors which had not been considered in laboratory research yet. The users also avoided situations of temporal uncertainty by adapting their working style to the system. Therefore it is concluded, that the effects of system response time should be interpreted by the concept of user acceptance and not by temporal uncertainty. PMID- 1785212 TI - [Bradley-Terry-Luce scale of taste qualities of champagne]. AB - In a paired comparison experiment 783 subjects judged five different brands of champagne (three normal and two alcohol-reduced). Each subject judged only one single pair with respect to which one tasted more fizzy ("spritziger"), dry ("trockener"), prickling ("prickelnder") and better ("besser"). Three extended versions of the Bradley-Terry-Luce model are discussed and used to assess scale values for the criteria as well as for order effects. The results can be summarized into three points: (1) Goodness-of-fit for the simple BTL-model is satisfactory for all criteria--except for the judgement "tastes better than". (2) Using four graded response categories instead of dichotomous responses decreases goodness-of-fit considerably. (3) Alcohol-reduced brands are less "dry", but are quite within the range of the other brands with respect to the remaining criteria. It is argued that the particular scaling method used is especially useful for deciding which criteria are appropriate for measurement on a one dimensional scale and which are not. PMID- 1785213 TI - [Dependence of correct solution of phonetic information on the number and kind of picture information]. AB - It was to be shown that kindergarten children do not synthesize phonologically, auditorily presented sound sequences but solve the task primarily in a picture related manner by using visual information and selecting singular sound units or elements. The first study demonstrated that the picture material rather than the concrete sound sequence determines the extent of correct solution. In addition, the solutions are influenced by the kind of phonetic relationship among the picture information rather than by the introduction of picture distractors. These results were basically replicated in the second study. The results are discussed against the background of decision making that is mainly oriented to the situative cues of the task and only secondarily to the sound aspects. PMID- 1785214 TI - [Responsibility for damage and anger]. AB - Anger about frustration or damage was assumed to depend on how much responsibility can be attributed to the perpetrator. This hypothesis was tested experimentally (N = 120). Drawing upon constituents of the action concept (e.g. free will), three everyday situations (e.g. being obstructed while driving) were varied with regard to responsibility. Twenty subjects each were asked to imagine the three situations from one of the six levels of responsibility and to indicate how angry they would feel. In addition to state anger, anger in, anger out, and anger control were assessed. When trait anger was controlled for, state anger as well as anger out increased as a function of the perpetrator's responsibility, whereas anger control decreased. These results were in line with theoretical expectations. They demonstrate that the expression of anger is subject to social norms and depends largely on the situation. This finding complements original assumptions on the trait-like nature of anger in, anger out, and anger control. PMID- 1785215 TI - [Color-word interference in relation to comparative compatibility: evidence for two sources of interference]. AB - In previous studies on colour-word interference ('Stroop-phenomenon') stimulus response-compatibility (word-speech, colour-speech) and task mode (word reading, colour determining) have usually been confounded or not been crossed completely. An experiment is reported where these two factors were varied orthogonally (besides type of stimulus: incongruent, congruent and control). Compatibility was varied by using response keys with varying labelling of the keys (colours or words). The results show--contrary to traditional expectations--the usual pattern of interference in spite of the response key conditions. The existence of response delays of different magnitude indicates separate sources of interference. Encoding interference is found under conditions of high-compatible colour determining by coloured response keys (colour-colour key), recoding interference under conditions of low-compatible reading (word-colour key), both presented here in an isolated form. Both modes of interference should therefore contribute to the interference under conditions of low-compatible colour determining which is the traditional Stroop condition. In an attempt to predict this complete interference encoding interference was shown to be the more stable predictor. The same was true of interference as measured here in a list version. PMID- 1785216 TI - [Inhibited thinking as normal psychological phenomena]. AB - Inhibited thinking as a normal psychological phenomenon has to be distinguished from psychopathologically defined thinking disorders. Normal psychological inhibitions of thinking can be subdivided into affect-induced inhibitions ("affective inhibitions of thinking") and those caused by habituated thinking or sets ("habitual inhibitions"). In affective inhibitions of thinking, a person who is in a state of affective arousal cannot solve a problem which he usually, i.e. in view of his intellectual capacity, is able to solve. Both the quantitative and qualitative aspects of inhibited thinking can be reliably identified by means of rearrangement tasks administered under adequate situative conditions. In several studies, carried out in various groups of subjects, marked decreases in problem solving performance occurred as a consequence of affective inhibitions of thinking. Disorganized thinking which is a typical result of affective inhibitions of thinking, can either be manifested in form of extremely rigid or chaotic behaviour. First results on the individual tendency towards or proneness to affective inhibitions of thinking and their relationship to personality traits are presented. --Based upon these findings on inhibited thinking, general conclusions are drawn for both the psychology of thinking and psychological diagnostics. PMID- 1785217 TI - A case of Fournier's gangrene. AB - Authors report their case of Fournier's gangrene on the basis of their own observations and relying on data of the literature. Complete healing can be expected of immediate radical surgery and of aggressive intensive and antibiotic treatments. PMID- 1785218 TI - Intraoperative injuries during transperitoneal urological operation. AB - The mechanism of development of 19 severe side-injuries arising during 230 transperitoneal urological operations was analysed. During a total of 158 RLAs performed for testicular tumour, vascular injuries--of the aorta, inferior caval vein and renal vessels--were suffered in 10 cases, and injury of the small intestine in one case. In another case, occidental ligation and transection of the ureter were made. During radical nephrectomy, liver and splenic injuries were inflicted in two cases each. The left renal vein was injured also in two cases. In one case the contralateral ureter was ligated. Disregarding the first five cases, the injuries were always made in cases of tumours. After analysing the mistakes, suggestions were put forward for eliminating these complications. PMID- 1785219 TI - Ultrastructural changes in the nerve elements in Crohn's disease. AB - Electron microscopic investigations were carried out to study the nerve elements in the wall of the small intestine in Crohn's disease, comparing it with the control. In the ileum of Crohn's disease only a few synapses were found. The number of nerve terminals were decreased, as well as that of the vesicle population in the remaining nerve terminals. Some of the nerve processes were observed in degeneration. The number of the lysosomes in the nerve cell bodies increased. Inflammatory cells as lymphocytes, plasma cells, mast cells were noted in the tola submucosa and in the mucous membrane, their number was also increased. It is suggested that the immunological effector cells and their products could be responsible for changing the neuronal elements. PMID- 1785220 TI - Advantage of transvaginal over transabdominal sonography. AB - Results with transvaginal sonography (TVS), a new ultrasound diagnostic method, are reported. A total of 40 patients were comparatively examined by transvaginal and transabdominal sonography. In contrast to transabdominal sonography, the transvaginal examination provided additional information in 35% of the patients. The indications and advantages of transvaginal sonography are summarized as compared with the traditional method. The introduction of the method is recommended in all US laboratories where examinations of the pelvis are performed. PMID- 1785221 TI - The potentials of CO2 laser in the surgery of the liver, biliary tract and pancreas. AB - The Nd:YAG and CO2 laser can be used with benefit in the surgery of the liver, biliary tract and pancreas. The Nd:YAG laser is most suitable for cutting parenchymatous organs, as e.g. the liver. In biliary surgery the CO2 laser can be recommended. Based on their 12 cases, authors discuss the applicability of CO2 laser. PMID- 1785222 TI - A case of multiple cholangiogenic liver abscess due to residual biliary stone cured by percutaneous drainage controlled by CT and endoscopic papillotomy. AB - The case of a patient treated for multiple cholangiogenic liver abscess due to residual biliary stone after acute cholecystitis is reported. The multiple liver cyst was cured by percutaneous transhepatic double drainage controlled by CT as well as puncture and aimed local systemic antibiotic treatment. The residual gallbladder stone was removed by endoscopic papillotomy. A similar case has not been reported so far. PMID- 1785223 TI - Gastrointestinal angiodysplasia. AB - In the recent four years, 8 cases of gastrointestinal angiodysplasia (a.d.) were observed by the authors. Analysing the conclusions drawn from the patients course of disease, they found a.d. to be the cause of an unknown gastrointestinal bleeding. a.d. can be basically diagnosed by angiography. It is often associated with liver cirrhosis or arteriostenosis. The treatment of a.d. is surgical. The recurrence and repeated appearance of bleeding can be expected even after a thoroughly performed resection. PMID- 1785224 TI - Percutaneous cholecysto-lithotripsy. AB - Experience with the first 40 cases of percutaneous transhepatic cholecystolithotripsy in Hungary are reported. The indications and contraindications, results and complications of endoscopic gallstone removal performed with good results are analysed. The follow-up of patients after PTCL is considered important. PMID- 1785225 TI - Rupture of the splenic artery aneurysm during pregnancy. AB - The report deals with the rupture of a splenic artery aneurysm during pregnancy by reviewing the pathological course of a patient. Then the pathomechanism and differential diagnosis are discussed concerning the aneurysm of the ruptured splenic artery. It is stressed that the chances of survival of the patient and the fetus depend considerably on early detection and the rapid intervention, this being also interrelated with maternal and fetal mortality. PMID- 1785226 TI - In vitro biological activities of the haemopoietic growth factors: implications for their clinical use. AB - The recent availability of several haemopoietic growth factors in purified recombinant form suitable for clinical use has prompted their use in haematology and oncology. The knowledge of their various effects in vitro on cell proliferation, differentiation and function and of their target cell populations will help in the design of treatment protocols with regard to selection of the best growth factor (or combination of them) for specific desired effects. PMID- 1785227 TI - Hematopoietic growth factors: interactions and regulation of production. AB - Hematopoietic growth factors are the major regulatory molecules supporting constitutive and inducible hematopoiesis. Molecular biology techniques have led to the identification and cloning of a series of hematopoietic growth factor genes, and the synthesis of large amounts of these molecules has facilitated investigations or their physiological functions and the network of their interactions. The present article focuses on the role of hematopoietic growth factors, growth-factor-synergizing factors, and growth-factor-releasing factors in the regulation of proliferation, differentiation, and functional activation of hematopoietic stem cells and lineage-committed progenitor cells. Cellular sources of growth factors, signal transduction pathways involved in their gene activation and transcriptional and posttranscriptional mechanisms that govern regulation of expression of these genes are also detailed. PMID- 1785228 TI - Clinical role of colony stimulating factors. PMID- 1785229 TI - The role of interleukin-1 in hematopoiesis. AB - The polypeptide interleukin 1 (IL-1) is the primary mediator of the acute-phase response and is responsible for many changes that are associated with the onset of infection. It induces fever and has profound endocrinologic metabolic and hematologic effects. Two structurally related forms of IL-1 have been described, termed IL-1 alpha and IL-1 beta. Both forms of IL-1 bind to a common receptor that is present on a variety of target cells. Recently, IL-1 has been recognized as a molecule that is important in the regulation of hematopoiesis. IL-1 induces the production of several different hematopoietic growth factors including granulocyte-macrophage, granulocyte and macrophage colony-stimulating factors and interleukin 6 by a variety of accessory cells. In addition, IL-1 acts synergistically with colony-stimulating factors in the proliferation of primitive hematopoietic progenitor cells. In vivo, the administration of IL-1 accelerates hematopoietic reconstitution after chemotherapy or radiation induced myelosuppression. In untreated animals, IL-1 may induce a shift of hematopoietic progenitor cells into the peripheral blood, and these cells may be used to repopulate the bone marrow of lethally irradiated recipients. These studies suggest that IL-1 may be used as a therapeutic agent to accelerate bone marrow recovery after myelosuppression. PMID- 1785230 TI - Erythropoietin: clinical applications. AB - The last few years have seen an enormous increase in our knowledge on the haematopoietic growth factor erythropoietin (Epo), firstly with its purification and determination of its primary amino acid sequence, and more recently with the isolation of the Epo gene and its expression in mammalian cell lines. This review article summarizes the crucial biological features of Epo and critically examines the main results obtained in clinical trials on humans. PMID- 1785231 TI - The transurethral resection syndrome. AB - The transurethral resection syndrome ("TUR syndrome") is caused by absorption of electrolyte-free irrigating fluid, and consists of symptoms from the circulatory and nervous systems. The clinical picture is inconsistent and the syndrome is easily confused with other acute disorders. Mild forms are common and often go undiagnosed, while severe forms of the TUR syndrome are rare and potentially life threatening. The pathophysiology is complex but includes four mechanisms: circulatory distress from the rapid absorption of electrolyte-free irrigating fluid, adverse effects of glycine, dilution of the protein and electrolyte concentrations of the body fluids, and disturbance of renal function. The treatment of the TUR syndrome consists of general life support and in specific treatment directed towards hypotension, hyponatraemia and anuria. Methods to lower the uptake of irrigating fluid are widely used and probably reduce the incidence of the TUR syndrome. However, patient safety can be guaranteed only if the absorption is monitored. An irrigating fluid containing tracer amounts of ethanol can be used for this purpose. This permits the uptake of fluid to be indicated by measuring the concentration of ethanol in the patient's exhaled breath. PMID- 1785232 TI - Thoracic impedance as an index of body fluid balance during cardiac surgery. AB - Thoracic impedance at 2.5 (TI2.5) and 100 kHz (TI100), central venous pressure (CVP), and body fluid balance were recorded together with rectal temperature and arterial haematocrit in 15 consecutive patients subjected to coronary artery bypass grafting. I.v. fluid and blood were administered in an excess of 3.18 (1.38-9.35) 1 during the operation. TI2.5 decreased from 51.7 (39.2-66.4) to 34.9 (21.1-45.7) ohm (P = 0.001), while TI100 decreased from 41.9 (31.4-55.0) to 30.3 (18.3-40.8) ohm (P = 0.002). CVP, 6 (3-11) mmHg [0.8 (0.4-1.5) kPa], was the same before and after surgery. Temperature decreased during cardiopulmonary bypass from 35.4 (34.1-36.6) to 26.7 (22.9-31.0) degrees C and haematocrit from 39 (34 46)% to a lowest value of 27 (23-32)% (P = 0.0001). A close linear correlation between TI and body fluid balance was observed (TI2.5: r = -0.96, TI100: r = 0.95, P = 0.0001). Corrections of TI for temperature and/or haematocrit improved the correlation between TI and fluid balance to 0.99 (TI2.5) and 0.98 (TI100). The data indicate that changes in thoracic impedance can be used to monitor body fluid balance during cardiac surgery. PMID- 1785233 TI - A comparative study of intravenous and rectal administration of propofol in piglets. AB - To compare the effectiveness of propofol given intravenously and rectally, ten piglets received propofol intravenously. On the next day, the same piglets and five other piglets were given suppositories containing propofol. Serial blood samples were collected for the analysis of propofol plasma concentration. The time course of the total plasma drug concentration was fitted into a bi exponential function using a least square fitting regression computer programme. The volume of distribution was 2.5-2.8 l.kg-1, mean elimination half-life, 23.9 min and mean clearance 0.08 l.kg-1.min-1. The mean bioavailability by the rectal route was low. In contrast to the intravenously administered propofol, none of the piglets slept when given propofol rectally, reflecting the extremely low plasma propofol concentration. In veterinary medicine, propofol would seem to be clinically valuable for inducing intravenous anaesthesia, but would be ineffective when given rectally. The findings indicate that with the dosage forms used here, propofol would be clinically ineffective if given rectally to human infants and children. PMID- 1785234 TI - Effects of pleural fluid and positive end-expiratory pressure on the measurement of extravascular lung water by the double-indicator dilution technique. AB - The reliability of the double-indicator dilution technique (dye/cold) for measuring extravascular lung water (EVLW) has been studied in lung-healthy dogs after pleural fluid injection of saline (up to 20 ml/kg) during mechanical ventilation at zero and 10 cmH2O (1.0 kPa) end-expiratory pressure (ZEEP and PEEP, respectively). Pleural fluid injection had no effect on EVLW at either ZEEP or PEEP. PEEP induced changes in cardiac output, and reduced both the intravascular (dye) and the thermal indicator volumes, but with no effect on the calculated EVLW. It is concluded that pleural fluid up to 20 ml/kg and ventilation with PEEP of 10 cmH2O (1.0 kPa) do not affect the reliability of the double-indicator dilution technique for measuring extravascular lung water in the dog. PMID- 1785235 TI - Allowing pre-operative patients to drink: effects on patients' safety and comfort of unlimited oral water until 2 hours before anaesthesia. AB - The effect of allowing patients unlimited access to oral water in the time up until 2 h pre-operatively was the subject of a randomised, blind, controlled trial. No effect was seen on gastric volume or pH, or on plasma osmolality, and allowing water pre-operatively was associated with a reduction in anxiety in the anaesthetic room. PMID- 1785236 TI - Basic studies of pulse oximetry in a rabbit model. AB - We have developed an animal model for the evaluation of pulse oximetry during severe hypoxaemia. Twelve rabbits were anaesthetized and mechanically ventilated via a tracheostomy tube. Increasing fractions of nitrogen were added to the gas mixture they inhaled to obtain severe hypoxaemia (saturation range 26%-100%). On 412 occasions, simultaneous pulse oximeter (SpO2) and invasive haemoximeter (SaO2) measurements were compared. The regression analysis of the data gave the equation: y = 0.7 x + 26.7, r = 0.90. In the SaO2 range less than or equal to 85%, the bias (mean value of SaO2-SpO2) was higher when compared with SaO2 greater than 85%. In an in vitro study the light absorption characteristics of rabbit haemoglobin (Hb) were compared to human Hb. The millimolar extinction coefficients of both reduced and oxygenated Hb from rabbits were found to be similar to human Hb. We consider the animal model (rabbit) suitable for studies of pulse oximetry during physiological and pathophysiological conditions. PMID- 1785237 TI - Isoflurane in nitrous oxide and oxygen increases plasma concentrations of noradrenaline but attenuates the pressor response to intubation. AB - The haemodynamic response to laryngoscopy and intubation was evaluated in 52 ASA I patients anaesthetized with thiopentone 4-6 mg.kg-1. Vecuronium 0.1 mg.kg-1, followed by 3 min mask ventilation with nitrous oxide in oxygen with (isoflurane group) or without (control group) 3% inspired isoflurane preceded tracheal intubation. In 21 of 52 patients, concentrations of noradrenaline (NA), adrenaline and 3,4-dihydroxyphenylethyleneglycol (DHPG) were measured from central venous plasma. During the 3-min ventilation, in the isoflurane group, heart rate increased by 22% but remained stable in the control group. A marked pressor response to laryngoscopy and intubation was seen in the control but not in the isoflurane group. During the 3-min ventilation, the plasma concentration of NA was doubled in the isoflurane group and increased by 49% in the control group (P less than 0.05). The concentration of DHPG also increased in the isoflurane group. Peripheral skin temperature increased similarly after 3 min ventilation in both groups. After intubation, it was significantly higher in the isoflurane than in the control group (P less than 0.05). In conclusion, compared to nitrous oxide in oxygen, ventilation with isoflurane in nitrous oxide in oxygen causes a sympathetic activation combined with an increase in heart rate and peripheral temperature while the pressor response to laryngoscopy and intubation is attenuated. PMID- 1785238 TI - Anaesthesia for cardioversion--clinical experiences with propofol and thiopentone. AB - A 1-year population of anaesthesias for cardioversion of supraventricular tachyarrhythmias was studied. Propofol and thiopentone were used alternately for every other procedure, and the anaesthetic-, and monitoring procedures were prospectively standardized. Twenty-one thiopentone- and 23 propofol-anaesthetized patients, who had been subjected to elective cardioversions of atrial fibrillation were compared, particularly regarding possible differences in the energy requirements for cardioversion and in the time intervals to initial awakening. There were no significant differences between the two drugs in the maximum systolic blood pressure drop, in the total mean energy requirements per kg bodyweight, or in the distribution of the number of patients over the various energy levels needed for restoration of sinus rhythm. Somewhat unexpectedly, however, the mean time interval to initial awakening was significantly longer in the propofol-anaesthetized group. Apart from this minor drawback, propofol proved to be as useful an anaesthetic agent as thiopentone for the cardioversion procedure, and may be considered as an alternative drug in selected cases. PMID- 1785239 TI - A comparative study of five different techniques to reduce left ventricular dysfunction during endotracheal intubation. AB - Thirty-five non-selected, consenting patients were studied during induction of anesthesia before coronary artery bypass grafting. Anesthesia was induced with diazepam, thiopentone and fentanyl, followed by pancuronium. Before induction, 200 MBq Tc 99 m - HSA was given i.v. and ejection fraction (EF) of the left ventricle was measured with a collimated single-crystal probe. The patients were allocated to five groups (seven patients in each) treated with: Group A: nitroglycerin i.v. bolus 4 micrograms x kg-1 given 30-60 s before laryngoscopy; Group B: nitroglycerin i.v. in continuous infusion, 1 micrograms x kg-1 x min-1 started before induction; Group C: two-stage topical anesthesia of the vallecula region and larynx with lidocain; Group D: a combination of nitroglycerin and topical anesthesia (as in Group B and C); and Group E: propranolol i.v. 0.01 mg x kg-1 given 5 min before intubation. All groups reacted in the same way during induction of anesthesia up to the point of laryngoscopy. End-diastolic volume and systemic arterial pressure decreased while cardiac index remained unchanged and EF increased. During laryngoscopy and intubation, however, differences between the groups were evident. Nitroglycerin i.v. as a bolus effectively prevented a reduction in EF and an increase in left ventricular volume. In addition to these beneficial hemodynamic effects, there was a moderate increase in heart rate and a reduction of stroke index. Continuous infusion of nitroglycerin and propranolol i.v. had no effect, since EF fell and left ventricular volume increased. Patients receiving topical anesthesia demonstrated a blunted response to endotracheal intubation with a moderate decrease in EF and an unchanged (Group C) or slightly increased (Group D) left ventricular volume. PMID- 1785241 TI - Arterial desaturation in healthy children during and after minor surgery. AB - Pulse oximetry (PO) was applied to 79 otherwise healthy children during and after minor ENT surgery under general anaesthesia in private practice. The PO data were not available to the anaesthetist unless desaturation to less than or equal to 85% was present for greater than or equal to 30 s. This occurred in 12 and 9 cases during anaesthesia and recovery, respectively, only 8 and 5 cases, respectively, being diagnosed clinically. Desaturation during and after anaesthesia was more common in children undergoing adenoidectomy than during procedures for which endotracheal intubation was not performed. During recovery, desaturation was more likely to occur in the same patients again. Lower values of SaO2 were found in younger children and in children resisting or crying at induction. There was a (weak) negative correlation between SaO2 and HR. As clinically undiagnosed desaturation occurs even in healthy children undergoing minor surgical procedures, a more widespread use of PO during and after anaesthesia may be advisable. PMID- 1785240 TI - Effect of aminophylline or physostigmine on recovery from nitrous oxide-enflurane anaesthesia. AB - If facilities for recovery are limited, shortening the recovery time from general anaesthesia is important. A comparative study on the effect of 3 mg.kg-1 aminophylline or 0.04 mg.kg-1 physostigmine on duration and quality of the recovery time from nitrous oxide-enflurane anaesthesia is presented. Three groups of 35 patients were observed, placebo being included for comparison in this double-blind study. Without treatment, recovery from nitrous oxide-enflurane inhalation anaesthesia lasted 18.8 +/- 5.80 min. Aminophylline considerably shortened the recovery time (12.06 +/- 3.52 min), whereas physostigmine did not (18.97 +/- 9.18 min). In the physostigmine group, however, a remarkably calm recovery and early return of protective reflexes was observed. Although aminophylline shortens the recovery time, due to earlier incidence of pain and other disturbances, it cannot be recommended for general improvement of recovery, whereas physostigmine clearly improves the quality of recovery from nitrous oxide enflurane anaesthesia. PMID- 1785242 TI - Cardiopulmonary effects of internal cardioverter/defibrillator implantation. AB - Cardiopulmonary effects of electrophysiological testing of internal cardioverter/defibrillator (ICD) devices were studied in ten patients undergoing general anaesthesia. In the control-phase, haemodynamic performance and oxygenation were slightly impaired. After completion of the electrophysiological procedures (ICD-phase), cardiopulmonary function had deteriorated significantly. Cardiac index declined by 16%, whereas left ventricular filling pressure and pulmonary vascular resistance increased (P less than or equal to 0.01). Oxygenation, but not CO2-elimination deteriorated (P less than or equal to 0.01) and venous admixture increased by 72% (P less than or equal to 0.01). Alveolo arterial PO2-difference (PA-aO2) increased by 43% (P less than or equal to 0.01), indicating ventilation-perfusion (VA/Q) mismatching. Repeated inductions of ventricular tachycardia and/or fibrillation subject the myocardium to transient global ischaemia, leading to acute congestive heart failure, and positive inotropic intervention was necessary in 40% of the patients. Partial pulmonary insufficiency resulted possibly from interstitial oedema and VA/Q inhomogeneities. ICD implantation has detrimental effects on haemodynamics and gas exchange in patients with impaired left ventricular function. PMID- 1785243 TI - Measurement of transcutaneous PO2, PCO2 and skin blood flow at different probe temperatures using mass spectrometry. AB - Transcutaneously measured partial pressures of oxygen and carbon dioxide (PtcO2, PtcCO2) approximate the corresponding arterial values at a probe temperature of 44 degrees C. The temperature-dependent increase of PtcO2 and PtcCO2 is caused by an increased skin perfusion, a decrease in the mean diffusion path, a change of skin metabolism, a decrease of tissue solubility of oxygen and carbon dioxide and a right shift of the oxygen and carbon dioxide binding curves of blood. Seven healthy volunteer test subjects participated in the study. A transcutaneous probe connected to a mass spectrometer was placed on the earlobe of the test subject. Four measurements of the transcutaneous PO2, PCO2 and skin blood flow (from the washout kinetics of argon) were determined on each test subject. The first measurement was made with a transcutaneous probe temperature of 37 degrees C. The probe temperature was then increased to 44 degrees C before the next determination. Finally, two determinations were made at 37 degrees C, separated by a time interval of 1 h. The PtcO2 and skin blood flow increased when the probe temperature increased from 37 degrees C to 44 degrees C. However, when the probe temperature was decreased again from 44 degrees C to 37 degrees C, the estimated skin blood flow returned to the initial value while the PtcO2 remained unchanged. It required a further 1 h before the PtcO2 returned to the initial value at 37 degrees C. The most likely explanation of the experimental results is that heating of the skin to 44 degrees C causes a reversible decrease in the skin metabolism. PMID- 1785244 TI - Nebulized corticosteroid improves pulmonary function and outcome in experimental porcine septicemia. AB - Nebulized beclomethasone dipropionate was administered to six anesthetized and artificially ventilated pigs at 6-hourly intervals after infusion of live S. aureus (aerosol group). Changes in pulmonary mechanics, gas exchange and hemodynamics during an observation period of 44 h were compared with those in six pigs subjected to the same insults but given no corticosteroid (non-treatment group). Six pigs served as controls, without sepsis or aerosol, but with the same general management (control group). The septic insult induced an acute 3-fold increase in mean pulmonary artery pressure (MPAP) in the aerosol and non treatment group. MPAP fell to near baseline levels in the aerosol group, but remained significantly higher in the non-treatment group. Mean systemic arterial pressure fell more in the non-treatment than in the aerosol group, reaching its lowest level at 32 h. Pulmonary function was less affected in the aerosol group, with significantly better maintenance of arterial oxygenation, lower venous admixture and superior lung-thorax compliance than in the non-treatment group. Survival was significantly improved in the aerosol group. In this porcine model of septicemia-induced adult respiratory distress syndrome, nebulized corticosteroid thus attenuated the development of respiratory failure. PMID- 1785245 TI - Intravenous morphine and oxycodone for pain after abdominal surgery. AB - Intravenous morphine and oxycodone were given double blind in doses of 0.05 mg/kg after major abdominal surgery to 39 patients. The dosing interval was 5 min, until the patient did not want any further analgesics. Less oxycodone was needed than morphine, both to achieve the "first state of pain relief" (13.2 mg vs. 24.9 mg) and during the whole 2-h study period (21.8 mg vs. 34.2 mg). The "first state of pain relief" was achieved faster (28 min vs. 46 min) and lasted longer (39 min vs. 27 min) with oxycodone than morphine. Morphine caused more sedation and a greater decrease in the mean arterial blood pressure than oxycodone. In other respects the two opioids were comparable. PMID- 1785246 TI - Cumulation of bupivacaine, desbutylbupivacaine and 4-hydroxybupivacaine during and after continuous interscalene brachial plexus block. AB - Desbutylbupivacaine (DBB) and 4-hydroxybupivacaine (4-OHB) are major metabolites of bupivacaine. They may cumulate during continuous infusion blocks. In the present study, all patients received an interscalene brachial plexus block with 20-28 ml of 0.75% bupivacaine plus adrenaline. A catheter was introduced into the interscalene space, and an infusion of 0.25% bupivacaine (5-9 ml/h) was started and continued with ten patients for 24 h and with another ten for 48 h. An infiltration block of the suprascapular and intercostobrachial nerves was performed using 0.5% bupivacaine. Before surgery, light general anaesthesia was induced. For measurement of plasma concentrations of bupivacaine, DBB and 4-OHB blood samples were taken before the block and 30 min, 3 h, 24 h and 48 h after the blocks as well as 30 min, 1 h, 2 h, 4 h and 6 h after the termination of the infusions. The highest plasma concentrations of bupivacaine, mean 1.84 micrograms/ml, were measured 30 min after the block. There was a slight but statistically significant rise in the bupivacaine concentrations between 24 and 48 h. The bupivacaine concentration decreased by 54% and 45%, on average, during the first 6 h following the 24- and 48-h infusions, respectively. On average, the highest DBB concentrations were measured 2 h after the 24-h infusion (0.31 +/- 0.18 micrograms/ml) and 30 min after the 48-h infusion (0.33 +/- 0.13 micrograms/ml). The highest 4-OHB concentrations were measured 1 h (0.18 +/- 0.09 micrograms/ml) and 30 min (0.20 +/- 0.05 micrograms/ml) after the 24- and 48-h infusions, respectively.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785247 TI - Oral atropine enhances the risk for acid aspiration in children. AB - Two modes of administration of an anticholinergic drug were compared in 58 healthy children undergoing adenoidectomy. The study was double-blind and randomized. All children were premedicated with oral midazolam 0.5 mg/kg. Twenty nine children received oral atropine 0.03 mg/kg (Group A) and the rest were given i.v. glycopyrrolate 0.005 mg/kg at the induction of anaesthesia (Group G). In Group A, of 29 children, the stomach was empty in 2, pH was less than 2.5 in 23, the gastric volume was greater than 0.4 ml/kg in 19, and both these risk factors were present in 17 children. The same figures in Group G were 5 (NS), 14 (P less than 0.05), 10 (P less than 0.05) and 9 (P less than 0.05) children, respectively. The antisialagogue effect was similar in both groups. PMID- 1785249 TI - Local changes in venous tone due to bolus injections. AB - Solutions were infused at a constant rate into ear veins of anaesthetized sheep and changes in venous tone were measured from changes in pressures in the infusion line when boluses of drugs and solutions were given. Approximately one in six veins was unresponsive. These appeared to be larger veins and the lack of response was probably due to greater blood flow causing appreciable dilution of the test solutions with blood. Most veins gave a transient venoconstriction to boluses of saline which had been made acid or alkaline and also to boluses of drugs such as aminophylline, calcium chloride, noradrenaline, metoclopramide, pentobarbitone, ethanol and thiopentone. Transient venoconstriction was usually repeatable and in proportion to the amount of solution or drug given, but sometimes the magnitude of the response changed unpredictably. Papaverine and nicotinamide usually reduced tone. PMID- 1785248 TI - Variation in spinal analgesia with plain bupivacaine 0.5% when repeated in the same patient. AB - The study was done to see if it was possible to predict the level of analgesia in repeated spinal blocks with our routine technique where the patient is seated during injection of plain 0.5% bupivacaine 3.5 ml at the L3-L4 interspace and placed in the lithotomy position after 0.5 min. Thirty patients with tumour of the bladder had two spinal blocks during a 13-month period. The segmental spread of sensory loss was tested with the pin-prick technique. A wide range of height of blocks was found, increasing with age. Regression analysis on maximum cephalad spread of the second spinal analgesia against the first had a slope of 0.48 (P less than 0.01 for the hypothesis that the slope is zero). A significant correlation between the time for maximal cephalad spread was found, while the correlation between duration of thoracal analgesia was non-significant. PMID- 1785250 TI - Cardiovascular effects of pregnanolone emulsion: an experimental study in artificially ventilated dogs. AB - The acute cardiovascular effects of pregnanolone emulsion, a new steroid preparation for intravenous anaesthesia, were investigated in artificially ventilated dogs. The anaesthetic was administered as repeated intravenous bolus injections, doubling the dosage with each injection. The plasma concentration of pregnanolone, and the haemodynamic, respiratory and metabolic variables were determined after each injection. Cardiac output and heart rate increased from the first bolus dose of the anaesthetic (0.5 mg/kg), which produced anaesthesia lasting 10 to 15 min. Both continued to increase after administration of 1.0, 2.0 and 4 mg/kg, whereas reductions of systemic arterial pressure and estimated myocardial contractility were observed only at the two highest dosages. A decrease in vascular resistance was calculated in the systemic circulation, whereas vascular resistance increased in the pulmonary circulation. A state of circulatory shock followed administration 8, 16 and 32 mg/kg of the anaesthetic. PMID- 1785251 TI - Extradural block in obstetric patients: review of experience with gravity administration. AB - Charts of 2284 obstetric patients who received extradural block with gravity administration of local anaesthetic were evaluated retrospectively. Despite a 1.3% incidence of vascular puncture and a 1.8% incidence of dural puncture, accidental intravascular or intrathecal injection of local anaesthetic did not occur. We propose that this method may be safer than the traditional "injection by needle" technique, and has a high degree of "visualization" of the otherwise "blind" extradural block procedure. PMID- 1785252 TI - Isorhythmic atrioventricular dissociation following pancuronium. AB - We report a case of isorhythmic atrio-ventricular dissociation caused by pancuronium. The possible mechanism of the rhythm disorder is discussed and the haemodynamic consequences are described. It will be useful to realise that the circulatory effects of the arrhythmia may be pronounced in patients with decreased cardiovascular reserve. PMID- 1785253 TI - [A review: classification and ultrastructures of the anterior pituitary cells and their role in function of hormone secretion]. AB - Anterior pituitary cells first were classified by their staining behaviour in light microscopic preparations. Later they were classified according to the type of hormone they produce. Although even electron microscopy has been routinized, the functional classification of anterior pituitary cells was not easy. Experimental morphology that was mainly based on observation of the anterior pituitary after extirpation of target endocrine organs was the only method for identifying the probable function of each cell type in the anterior pituitary. The use of antibody against each hormone, that is immunohisto(cyto-)chemistry at light and electron microscopic level, was an epoch-making innovation in the technique for studying endocrine morphology. The technique revealed two or three morphologically different types in each cell group containing the same hormone. These subtypes in cell classification by immuno-electron microscopy are related to the age and sex of the animal. Cell biological research using electron microscopy, especially immunocytochemistry, clarified mechanisms concerning various steps in hormone production, for example, the synthesis of peptide hormones (precursors) in the rough endoplasmic reticulum; transfer to the Golgi apparatus; modification and processing of precursor peptides during the passage through Golgi stacks and the trans-Golgi network that corresponds to GERL; the moving of secretory granules; the mechanism of exocytosis and related membrane events; and the activity of lysosomes related to such endocrine functions as crinophagy and the recycling of membrane constituents retrieved from the cell surface after exocytosis of secretory granules. PMID- 1785254 TI - [Anatomical study on the branches of the celiac trunk (IV). Comparison of the findings with Adachi's classification]. AB - The authors studied the mode of branching of the celiac trunk in 184 Japanese cadavers during dissecting practice at Gifu University from 1985 to 1988. The findings were as follows; 1) One hundred and sixty-six of the 184 cases belonged to Type I of Adachi's classification of variation in the arrangement of the branches of the celiac trunk. One hundred and twenty-nine cases belonged to Group 1, one case to Group 2, 10 cases to Group 3, 9 cases to Group 4, one case to Group 6, 2 cases to Group 7, 8 cases to Group 8 and 4 cases to Group 11. Two cases did not belong to any group. One of them had an anastomosis between the hepatic artery and the superior mesenteric artery. The other one had the middle colic artery arising from the hepatic artery. 2) Seven cases belonged to Type II, Group 12. 3) Two cases belonged to Type III. One belonged to Group 18. The other one had an accessory right hepatic artery arising from the superior mesenteric artery. 4) One case belonged to Type IV, Group 20. 5) Three cases belonged to Type V, Group 23. 6) Two cases belonged to Type VI. One case had a gastrolienal trunk and an accessory right hepatic artery arising from the superior mesenteric artery. The other one had a gastrolienal trunk and an accessory right hepatic artery arising from the gastrolienal trunk. 7) Of the 184 cases, three could not be classified according to Adachi. Two cases had a gastrolienal trunk and the hepatic artery arising from the abdominal aorta. One case had a lienomesenteric trunk and a gastrohepatic trunk. PMID- 1785255 TI - [Pterion and epipteric bones in Japanese adults and fetuses, with special reference to their formation and variations]. AB - The formation and variations of the pterion and epipteric bones were examined in total of 614 Japanese skulls. The materials used consisted of 258 skulls of Japanese fetuses ranging from the fourth to the ninth month, 20 skulls of Japanese juveniles from the third month to 17 years of age, and 336 skulls of Japanese adults from 20 to 89 years of age. For the skulls examined the incidence of ossification in the fetal sphenoidal fontanelle was 3.6% on each side, whereas epipteric bones were observed in more than 10% of the juvenile and adult pteria. Great variation was seen in the form of the adult pterion. The most common form was a sphenoparietal contact in which the pteria were classified into usual (306 pteria), high (119), low (21), and narrow (32) types Another form of this type, a frontal process of the temporal bone without contact with frontal bone, was found in five pteria. The form of frontotemporal contact is classified into two types: One is with a frontal process of the temporal bone (17 pteria), and another is a K-shaped contact referred to as "stellate" (four). The two types were observable in adult skulls of all ages, although the fused pteria and fusing epipteric bones were most often seen in cases over 40 years of age. The results suggest that the pterion formation has two phases, the first occurring before the occlusion of sphenoidal fontanelle, and the second starting after 40 years of age. PMID- 1785256 TI - Hereditary hypotrophic axonopathy with neurofilament deficiency in a mutant strain of the Japanese quail. AB - A primary axonal disease affecting the central and peripheral nervous system was discovered in a new mutant strain of the Japanese quail, named quiver (Quv). Quv showed significantly smaller cross-sectional areas of the cervical spinal cord and the optic and sciatic nerves, when compared with controls by light microscopic morphometry. In the cervical spinal cord, electron microscopic morphometry indicated that myelinated axons in Quv were significantly smaller in size than in controls, though greater in density. The axonal circularity was not significantly different from that of controls. Electron microscopically and immunohistochemically, neurofilaments were not detected in the axons or neuronal cell bodies. Axons in Quv were composed mainly of microtubules, which were increased in number in relation to the axonal size. From these findings, the lesions observed in Quv were regarded as axonal hypotrophy (growth arrest or retardation) due to altered neurofilament expression. PMID- 1785257 TI - Lesion of the rat entorhinal cortex leads to a rapid microglial reaction in the dentate gyrus. A light and electron microscopical study. AB - Stereotaxic lesioning of the entorhinal cortex leads to an anterograde axonal degeneration in the molecular layer of the dentate gyrus. As revealed by immunocytochemical and histochemical methods, lesion of the entorhinal cortex induced a proliferation of microglia and an increased expression of established microglial activation markers within the deafferented zone. Reactive microglial cells were detected as early as 24 h after the lesion. The microglial reaction showed a maximum around day 3 post-lesion and disappeared by day 8 post-lesion. Reactive microglia were strongly positive for the B4-isolectin from Griffonia simplicifolia (GSI-B4), expressed high levels of CR3 complement receptor and 5' nucleotidase, but lacked CD4 and MHC class I and II antigens. In addition, microglial cells were identified using MUC 102, a new monoclonal antibody against rat microglia. At the ultrastructural level, reactive microglial cells were consistently seen to phagocytose degenerating terminals. Our data suggest that (1) axonal degeneration represents a sufficient stimulus for inducing microglial activation and proliferation in the deafferented dentate gyrus; (2) these activated microglial cells are characterized by immunophenotypes different from those observed in other types of CNS injury; (3) the early microglial reaction precedes the well-documented astrocyte reaction in the dentate gyrus; and (4) the timed interaction of microglia and astrocytes could be important for regulating regenerative sprouting processes in the mature CNS. PMID- 1785258 TI - A unique pattern of astrocytosis in the primary motor area in amyotrophic lateral sclerosis. AB - We examined the primary motor area (PMA, Brodmann area 4) from 23 cases of adult onset sporadic amyotrophic lateral sclerosis (ALS) with immunocytochemistry using anti-glial fibrillary acidic protein antibody. There was astrocytosis in the middle of the pyramidal cell layer in all cases except for one that did not present any upper motor neuron signs clinically. The astrocytosis was characterized by multiple clusters of astrocytes, some of which showed a close association with macrophages. In about a half of the cases, these multiple clusters of astrocytes became confluent and presented as a laminar astrocytosis in the middle of the pyramidal cell layer. Our studies demonstrate a unique pattern of astrocytosis in the PMA in ALS. This pattern of astrocytosis may be useful not only for diagnostic purposes, but also for a better understanding of the pathological process involving the PMA in ALS. PMID- 1785259 TI - Onion bulb formation in the initial complex of neurons in human dorsal root ganglion: their significance and alterations in amyotrophic lateral sclerosis. AB - We have demonstrated onion bulb-like structures in human dorsal root ganglia (DRG). These onion bulbs morphologically consist of non-continuous layers of supporting-cell cytoplasms that encase thinly myelinated axons and are immunocytochemically recognized by anti-S-100 protein and anti-glial fibrillary acidic protein antibodies. These structures are present in normal controls and preferentially involve the initial complex of the large, light, neurofilament rich neurons. The number of onion bulbs and their average number of lamellae reach a peak in the third decade and then decline. In three cases of amyotrophic lateral sclerosis (ALS), the onion bulbs involve non-myelinated axons as well as the thinly myelinated portion of the initial complex and are increased both in frequency and in average number of lamellae. Our studies suggest that these onion bulbs represent a normal biological process of DRG neurons that may be accentuated in ALS. PMID- 1785260 TI - Mitochondrial abnormalities in human sural nerves: fine structural evaluation of cases with mitochondrial myopathy, hereditary and non-hereditary neuropathies, and review of the literature. AB - Fifteen cases of mitochondrial myopathy, three cases of hereditary motor and sensory neuropathy (HMSN) VI, and 280 cases of neuropathies of different etiologies were examined by electron microscopy for the presence of mitochondrial abnormalities in the sural nerve. Altered mitochondrial were found in most cases of mitochondrial myopathy, in all cases of HMSN VI, and in 25 cases out of the series of unselected neuropathies. The mitochondrial changes comprised enlargement with an amorphous matrix and distorted cristae, with hexagonal paracrystalline inclusions, and with prominent cristae containing oblique striations, and a variety of rare changes. Most mitochondrial abnormalities were found in Schwann cells. An increase of the number of mitochondria was noted in smooth muscle and endothelial cells of epineurial arterioles of two cases with mitochondrial encephalomyopathy. Neuropathy was present in all cases of mitochondrial myopathy according to morphometrical analysis. Whether neuropathy is caused directly by mitochondrial dysfunction or by other pathogenetic mechanisms remains to be determined. PMID- 1785261 TI - Oxytalan fibres in meningiomas and meningeal neomembranes. AB - The incidence of oxytalan fibres was studied in 202 meningiomas and 30 neomembranes. Oxytalan fibres were present in all samples of neomembranes and in the majority of meningiomas; 81% of the fibroblastic meningiomas contained oxytalan fibres. Their frequency was lowest in malignant meningiomas. PMID- 1785262 TI - Meningioangiomatosis: an immunocytochemical study. AB - Meningioangiomatosis (MA) is a rare malformative lesion of the central nervous system. It has generally been thought that the main cells forming this lesion are derived from arachnoidal cap cells. We report a case of MA in which histochemical, immunoperoxidase and electron microscopic studies did not support a meningothelial origin of this lesion. Rather, the lesion in this case appears to be a vascular malformation with the dominant cells being fibroblastic, derived from vessel walls; however, their origin from arachnoid cap cells that differentiated into fibroblast-like cells could not be totally ruled out. Residual neurons within the lesion contained neurofibrillary tangles with ultrastructural and immunostaining properties identical to those seen in Alzheimer's disease except for the absence of A4 amyloid. PMID- 1785263 TI - Angiotropic lymphoma (malignant angioendotheliomatosis) presenting with rapidly progressive dementia. AB - An 87-year-old male presented with rapidly progressive dementia, disorder of consciousness and myoclonus, suggesting Creutzfeldt-Jakob disease, but with nonspecific EEG and negative CT findings. Autopsy revealed a malignant angiotropic lymphoma with accumulation of tumor cells within small vessels of the brain and visceral organs. Immunohistochemistry disclosed a large cell lymphoma of B cell type. PMID- 1785264 TI - Acta fifty years ago. Nineteen forty-one in retrospect. PMID- 1785265 TI - Doppler ultrasound assessment of endometrial pathology. AB - In forty-five metrorrhagic patients, transvaginal Doppler ultrasound examinations were performed in order to test the correlation between the modified resistance index (RI) of the uterine and intramyometrial arteries and the histopathologic findings. Uterine volume (UV) and endometrial thickness (ET) were studied. The results were compared with 19 otherwise normal patients. UV and ET were found increased in metrorrhagic patients with abnormal histopathology. These showed a significant decrease in intramyometrial RI (66.7 +/- 15.9) and uterine RI (79.6 +/- 9.4) compared with a control group (intramyometrial RI: 78.8 +/- 16; uterine RI: 87.8 +/- 9.4). Uterine resistance was significantly greater in patients with normal histopathology (intramyometrial RI: 94.2 +/- 13.2; uterine RI: 89.1 +/- 9.3). Only three false-positive and three false-negative results were found upon analysing the predictive accuracy of intramyometrial Doppler examinations. However, the uterine resistance index was less specific. Although transvaginal Doppler velocimetry cannot replace histopathologic diagnosis, it does provide a high prognostic precision in cases of metrorrhagia. PMID- 1785266 TI - Antenatal care in southern Sweden. A population-based prospective study describing the diagnostic panorama of pregnancy. AB - All pregnant women from the catchment areas of three health centres in southern Sweden, registered for antenatal care during the calendar year 1986, were included in the study population. Four hundred and nine women could be prospectively followed throughout pregnancy. By 15 completed weeks, 95% of the women were registered at an antenatal clinic. Only 2 women had no antenatal care at all. During the course of pregnancy the 409 women made altogether 6,058 (mean 14.8) visits to the health and medical services, most of them (95%) were to an antenatal clinic. Common obstetrical problems were vaginitis, symphysiolysis, threat of preterm labour, and vaginal bleeding; and common non-obstetrical problems were low back pain and respiratory tract infections. During pregnancy 42% of the women were prescribed some sort of medication, and 53% were sicklisted on one or more occasions. The outcome of pregnancy was comparable to figures for all Sweden. PMID- 1785267 TI - Sonography-guided fetal blood sampling for pH and blood gases in premature fetuses with abnormal fetal heart rate traces. AB - In nine pregnancies, remote from term, with an abnormal Non-Stress Test (NST) and Bio-Physical Profile (BPP) of 3 or above, cordocentesis for fetal blood gas analysis was performed. In seven cases an immediate post-partum blood sample was taken from the fetal cord for a similar analysis. The two tests gave very similar results. The results showed fetal acidemia (pH 7.09-7.19 and B.E. -10-15) in 4 cases, followed by immediate delivery. In the remaining 5 cases, normal blood gases were evident (pH 7.28-7.35); despite the abnormal NST, pregnancy was allowed to continue for 2 to 7 weeks, under close supervision. At birth, 2 out of 9 newborns were deemed by the neonatologist suffering from asphyxia. Both belonged to the acidemic group of women who were managed by immediate cesarean section. The other 5 fetuses, which were managed expectantly, had normal post partum blood gases or Apgar score; none had asphyxia. Fetal blood gas analysis, on samples obtained by cordocentesis, provides useful information that can assist in the management of premature fetuses suspected of being distressed, according to their heart traces. Normal fetal blood gases can identify those fetuses falsely identified by the NST as in distress and thereby spare them unnecessary premature birth with its known complications. PMID- 1785268 TI - No benefit from conservative management in nulliparous women with premature rupture of the membranes (PROM) at term. A randomized study. AB - OBJECTIVE: To compare maternal and fetal outcome in pregnancies with premature rupture of the membranes (PROM) at term with either early induction of labor or conservative management awaiting spontaneous labor. DESIGN: A prospective randomized trial. SETTING: The University Hospital of Lund, Sweden. SUBJECTS: Altogether 369 women with singleton pregnancy, cephalic presentation, gestational duration 36-41 weeks, were randomized either to induction of labor (n = 139) or conservative management up to 3 days (n = 138). Those eligible but not participating in the study totalled 92. MAIN OBSTETRIC MEASURES: Obstetric intervention rate (cesarean section or instrumental delivery) and short-term neonatal morbidity. RESULTS: No difference was found in the rate of obstetric intervention between the induction of labor group and the group with conservative management (12.2 vs. 18.8%; chi 2 = 2.3, p greater than 0.05). A slightly increased rate of neonatal infections was seen in the latter group (0.7 vs. 4.3%; chi 2 = 3.2, p less than 0.05). CONCLUSIONS: We found no benefit from conservative management for up to 3 days in women with PROM at term, compared with immediate induction of labor. There was no difference in the number of obstetric interventions during labor. The neonatal infectious morbidity was slightly higher in conservatively managed cases. PMID- 1785269 TI - Open randomized comparison of prostaglandin E2 given by intracervical gel or vagitory for preinduction cervical ripening and induction of labor. AB - Intracervical application of prostaglandin E2 (PGE2) in a viscous gel was compared with conventional wax-based PGE2 vagitories (pessaries) for ripening of the cervix prior to induction of labor. A total of 226 healthy pregnant women at term were randomly allocated to receive intracervical gel with an effective dose of 0.5 mg (n = 116) or vagitories containing 2.5 mg PGE2 (n = 110). All women had a modified cervical score of less than or equal to 4. The numbers of cases contributed by each of the three centers were similar. There was no significant difference in parity, gestational length, maternal characteristics, indications for induction or preinduction cervical scores between the treatment groups. The rate of spontaneous birth was 71% in the gel group, compared with 69% in the vagitory group. Successful treatment was defined as active labor within 24 h or a change in cervical dilatation allowing artificial rupture of the membranes with subsequent progressive labor. The success rate was not significantly different in the gel group (82%) compared with the vagitory group (80%). There were no differences in the frequency of fetal distress, outcome of labor, assisted delivery rates or maternal side effects. The cervical scores were not different at 12 and 24 h after application. Intracervical gel and intravaginal application of PGE2 were similar in their efficacy and safety for ripening of the cervix and inducing labor at term. PMID- 1785270 TI - Preinductive cervical ripening with PgE2 gel in term pregnant women with ultrasonically diagnosed intra-uterine growth-retarded fetuses. AB - Intra-uterine growth retardation (IUGR), often combined with other pregnancy related complications, constitutes a rather common indication for labor induction. The objective of this prospective study was to evaluate a strict intracervical application of 0.5 mg PgE2 in gel for cervical ripening and labor induction. Eighty term pregnant women with an ultrasonically diagnosed IUGR (less than -2 SD) and an unripe cervix were given PgE2-gel. The main indication for labor induction was IUGR, but 26 women had other complications. IUGR was verified at delivery in 50 women (study group), whereas 30 women (control group) gave birth to infants of normal birth weight (greater than -2 SD). The cervical ripening effect did not differ between the groups. In the study group, 19 nulliparous and 15 parous women out of 50 had a favorable cervix after 12 h and were delivered within 24 h of gel application. The corresponding result for the control group was 11 nulliparous and 8 parous women out of 30. Failed induction was registered in 2 and one woman respectively. On the other hand, the number of instrumental deliveries was greater in the study group, 11 caesarean sections (CS) and seven ventouses, compared with one CS and three ventouses in the control group (p less than 0.05). The frequency of operative deliveries for fetal distress (ODFD) was higher among the women with verified IUGR (14/50) than in the controls, where the corresponding figure was 3/30. No side effects were observed. We conclude that strict intracervical application of 0.5 mg PgE2 is a safe and effective method for cervical ripening and labor induction in women with IUGR. PMID- 1785271 TI - Nordic in vitro fertilization embryo transfer (IVF/ET) treatment outcomes 1982 1989. AB - In the four Nordic countries, Denmark, Finland, Norway and Sweden, data were compiled from altogether 30 in vitro fertilization (IVF) clinics regarding their treatment outcomes. Two small, recently established IVF clinics in Finland did not respond to the postal inquiry used for data collection. For each clinic, data were collected from the time they commenced activities until June 1989. Preliminary data for the latter half of 1989 was also gathered. The first IVF baby in this data set was born in Gothenburg in 1982. Seven years later, in December 1989, altogether 35 clinics in the four countries were in operation and 1,290 children had been born. The largest number of clinics, 12, was to be found in Sweden but the number of treatment cycles in relation to the population was highest in Norway with about 340 treatments per million inhabitants annually during 1988-89, with Sweden in second place: 190 treatments per million inhabitants. The ratio of private to public clinics was highest in Finland, where four out of ten clinics were privately run. A mean clinical pregnancy rate per embryo transfer of 20% was recorded and 85% were singleton pregnancies. Spontaneous abortions occurred in 25% and the ectopic pregnancy rate was 7% of all clinical pregnancies. The 'take home baby rate' for 1988-89 was 13% per embryo transfer. There were no major differences between the four countries. PMID- 1785272 TI - Pregnancy complications and short-term follow-up of infants born after in vitro fertilization and embryo transfer (IVF/ET). AB - Two hundred and six pregnancies occurring after in vitro fertilization (IVF) and embryo transfer (ET) during a 7-year period in Goteborg were analysed with respect to pregnancy outcome. The clinical abortion rate was 26%, the rate of ectopic pregnancy was 10%, the rate of ongoing pregnancies beyond 24 weeks was 15%, and the rate of deliveries was 49% (n = 100). The hospital records of 98 women with the 100 deliveries resulting in 131 infants were studied. Multiple pregnancy occurred in 27%, including one quadruplet and two triplet pregnancies. Preterm birth occurred in 30% of all pregnancies and in 20% of singleton pregnancies. Thirty-four percent of the infants had a birth weight of less than 2500 g. The perinatal mortality was 46/1000, as estimated from the 24th week of pregnancy. The incidence of major malformation, 2.3%, was similar to that reported from studies in the general population. The first 100 infants born were followed up for 18 months to 8 years. Long-term sequelae were associated with immaturity and low birth weight. No problems during follow-up were disclosed in children who had had an uneventful neonatal period. It is concluded that IVF pregnancies are an obstetric risk group requiring special attention. PMID- 1785273 TI - Risk factors in ectopic pregnancy. Results of a population-based case-control study. AB - In a population-based case-control study, possible risk factors for ectopic pregnancy were compared in 119 patients with ectopic pregnancy and in 119 age matched controls with intra-uterine pregnancy from each of the following categories: deliveries, spontaneous abortions and induced abortions. The following factors were found significantly more often in cases of ectopic pregnancy: a history of earlier ectopic pregnancy, a history of salpingitis, a history of earlier operation on the Fallopian tubes, a history of infertility, and a pregnancy that had occurred in spite of an intra-uterine contraceptive device. A history of appendectomy was also found significantly more often among the cases. There was no significant correlation between ectopic pregnancy and a history of no earlier pregnancy, earlier deliveries, earlier spontaneous or induced abortions or a history of other gynecological operations and increased risk of ectopic pregnancy. One or more of the risk factors were found in 76.5% of cases and 23% of controls. PMID- 1785274 TI - Female circumcision in Somalia and women's motives. AB - Two hundred and ninety Somalian women have participated in a study. They responded adequately to the questionnaire administered. One hundred percent of these women were circumcised, despite their relatively high socio-economic status as shown by their educational level. Eighty-eight percent of them had been circumcised with excision and infibulation, 6.5% were circumcised with clitoridectomy and the remaining 5.5% with Sunna. The majority of these women justified the practice of female circumcision with religious reasons and all were willing to circumcise their daughters. Fifty-two percent of the respondents had been operated on by medically untrained persons, usually traditional birth attendants and the majority were operated on at home. PMID- 1785275 TI - Screening for Chlamydia trachomatis infection in women and aspects of the laboratory diagnostics. AB - Nine hundred and thirty-three women who attended consecutively a gynecological clinic for various symptoms, for abortion, or for contraceptives, were screened for genital Chlamydia trachomatis infection. A total of 95 (10.2%) women were found infected. Of women below 25 years of age, 13.4% were infected, as compared with 4.9% over 25. Women with symptoms of genital infection were not over represented in the infected population. Enzyme immunoassays (EIA) verified with a direct fluorescence antigen test were evaluated and compared with culture controls. Reactive samples detected using EIA were regarded as true positive if they were also positive according to the verification test. The sensitivity of the verified EIA test was 91%, the specificity 100%, the positive predictive value 100% and the negative predictive value was 99%. The sensitivity of the culture was 90%. Low age is the most predictable risk factor for genital Chlamydia trachomatis infection. Compared with cultures, EIA verified with a direct fluorescence antigen test is a rapid and effective method for clinical use. PMID- 1785276 TI - Transvaginal ultrasound for identifying endometrial abnormality. AB - Transvaginal ultrasound was used preoperatively to evaluate the endometrium in 96 patients referred for dilatation and curettage. The sonographic display was correlated to the histopathologic diagnosis. In 45 patients with postmenopausal bleeding, 4 patients had adenocarcinoma of the endometrium. All were identified by ultrasound. None of the 22 patients with a normal sonographic appearance had an abnormal histopathologic diagnosis. An endometrial thickness (single layer) cut-off point of greater than or equal to 4 mm precluded any missed malignancies but halves the number of dilatations and curettages in this postmenopausal group. The sensitivity of ultrasound in diagnosing endometrial pathology was 100% and the specificity was 61%. The positive and negative predictive values were 39% and 100% respectively. In 51 premenopausal women there was good agreement between histology and ultrasound. In this group a cut-off point of greater than or equal to 8 mm was used. The sensitivity in diagnosing endometrial pathology was 67% and the specificity 75%. The positive and negative predictive values were 14% and 97%. With further experience, transvaginal ultrasound might be used in clinical routine for diagnosing endometrial pathology. PMID- 1785277 TI - Comparison between Cytobrush and Papaplast in sampling vaginal smears. AB - The ability of Cytobrush and Papaplast to collect endocervical cells in vaginal smears was tested in a prospective randomized comparative study including 107 women. Endocervical cells were found more often and in greater numbers with Cytobrush, also in women over 50 years of age. Papaplast missed endocervical cells twice as often as did Cytobrush. The use of the latter instrument meant that the number of repeat smears necessitated due to the absence of endocervical cells could be considerably reduced, with consequent improvement in the cost/benefit ratio. PMID- 1785278 TI - Appendectomy and carcinoma ovarii. Cytoreduction, palliation, or simple tradition? AB - The present article is based on a review of 187 patients with an ovarian cancer who had a "second-look" or debulking operation performed. Seventy-nine patients underwent appendectomy prior to or in connection with the primary cytoreductive surgery and were observed for a average of 16.6 months before secondary oncologic surgery was performed. The remaining 108 patients had their appendix in situ during the same period and were observed for an average of 14.7 months and 1 patient developed acute appendicitis. A total of 125 appendectomies were performed in patients with cancer of the ovary and 14 (11%) showed metastatic growth. The two groups were similar as regards age, period of observation, tumor type and stage. The risk of developing acute appendicitis did not exceed the incidence in healthy women and no surgical problems were experienced in observing either of the two groups during the total period of 2,900 months. The need for surgical surveillance, however, was significantly greater for those who kept their appendix during the medical oncologic treatment. It is concluded that the cytoreductive effect of an appendectomy is limited, but that the appendix should be extirpated if possible as part of the primary staging effort. Leaving an appendix in situ at primary cytoreductive surgery does not expose the patient to any significantly increased risk, but an appendectomy prevents the patient from experiencing the additional burden of an acute appendicitis during medical oncologic treatment. PMID- 1785279 TI - Normal pregnancy after curative multiagent chemotherapy for choriocarcinoma with brain metastases. AB - A case is reported of a metastatic gestational choriocarcinoma in a 25-year old woman. Extensive pelvic, pulmonary and brain metastases were associated with clinically manifest thyrotoxicosis. Multiagent chemotherapy alone was successful in achieving a durable remission and euthyroid state. The chemotherapy regimen consisted of cis-platinum, etoposide, actinomycin-D, and intrathecal methotrexate (PEA-M). The Patient conceived 2 years after completing therapy and gave birth at term to a normal infant. PMID- 1785280 TI - Prenatal diagnosis of autosomal recessive polycystic kidney disease by ultrasonography and magnetic resonance imaging. AB - Autosomal recessive polycystic kidney disease is a relatively rare congenital disease affecting the kidneys and liver. We noticed the kidney abnormality at 22 weeks gestation and observed the patient till the delivery at 36 weeks of gestation. The ultrasonographic features consisted of bilaterally enlarged hyperechogenic kidneys, oligohydramnios, lack of distention and difficulty in identifying the fetal urinary bladder. The serial sonographic features of the kidneys changed as pregnancy progressed. The kidney cysts gradually changed in size, shape and renal texture, but the umbilical velocimetry and the kidney circumference/abdominal circumference ratio did not change. Magnetic resonance imaging also showed similar characteristic features as observed by ultrasonography. PMID- 1785282 TI - A case of vesical leukoplakia. AB - A 54-year-old woman who had earlier been treated for cervical dysplasia complained of recurrent cystitis, urgency and frequency, but without signs of genital prolapse. At cystoscopy with biopsies, leukoplakia of the bladder was diagnosed. We describe how the condition is distinguished from squamous metaplasia of the trigone as seen in normal premenopausal women. An association between leukoplakia and cancer is widely accepted. Against this background, a follow-up program is outlined. The possibility of leukoplakia as a multicentric disorder of the genito-urinary tract is briefly discussed. PMID- 1785281 TI - Endometrial squamous cell carcinoma. AB - Endometrial squamous cell carcinoma is an extremely rare female genital malignancy. Only 26 cases which fulfil the Fluhmann criteria have been reported in the literature. In this report, 2 cases of endometrial squamous cell carcinoma are presented, with a review of related current knowledge. PMID- 1785283 TI - Bilirubin displacing effect of drugs used in neonatology. PMID- 1785284 TI - Fetal response to maternal ascariasis as evidenced by anti ascaris lumbricoides IgM antibodies in the cord blood. AB - The immune response of the fetus to maternal infection with Ascaris lumbricoides was studied by estimating IgG and IgM antibodies, using ELISA, in 28 paired samples of mother and cord blood. A. lumbricoides adult male, cuticle and unembryonated egg antigen was used. Toxocara canis larva antigen was used as a specificity control. Presence of IgG in the cord blood does not signify fetal response, but the presence of IgM antibodies does. IgM antibodies to Ascaris adult male antigen were present in 27 out of 28 maternal sera and 1 out of 28 cord sera. All maternal sera and only 6 cord sera showed IgM antibodies against Ascaris cuticle and 20 out of 22 maternal sera and 8 out of 22 cord sera tested, showed IgM antibodies to Ascaris unembryonated egg antigen. Sixteen out of 22 maternal sera and none out of 22 cord sera showed IgM antibody against Toxocara canis antigen, ruling out cross reaction and transplacental leak. The results of our study suggest that the Ascaris infection can spread to the fetus and elicit immune response. PMID- 1785285 TI - Longitudinal study of serum cholesterol, apolipoproteins and sex hormones during puberty. AB - In order to determine the age and sex dependency of some of the major risk factors for coronary heart disease during the period of sexual maturation a five year longitudinal study was carried out on 105 boys and 133 girls living in Plzen, Czechoslovakia. Serum cholesterol was significantly elevated in 13-year old girls (p less than 0.01), while no statistically significant sex-related differences in total and lipoprotein cholesterol and apolipoprotein A-I and apolipoprotein B levels were found in other age groups during the period of follow-up. In boys the total cholesterol showed a constant and statistically significant decrease (p less than 0.01) between the ages 11 to 13 years, but tended to rise during the last two years of study. In girls, serum cholesterol decreased significantly between the ages 11 to 15 years (p less than 0.05). A statistically significant decrease in pre-beta cholesterol was found in girls during puberty (p less than 0.05). The changes in beta lipoprotein cholesterol were similar to those for total cholesterol. The apolipoprotein A-I concentration decreased significantly between 11 and 15 years in boys (p less than 0.05), while it underwent no substantial change in girls. The apolipoprotein B level decreased permanently and significantly (p less than 0.05) during the 5-year period in girls. In boys, the concentration of this protein decreased between 11 and 14 years and increased during the 15th year when a value significantly higher than that for girls was attained (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785286 TI - Basal energy expenditure in obese and normal weight schoolchildren. AB - The present study was performed using indirect calorimetry to test the hypothesis of a reduction of the basal energy expenditure in obese prepubertal children. The obese and control children studied were comparable regarding age, height and fat free mass (FFM). Total weight and body fat percentage were significantly greater in the obese children. Plasma insulin and glucagon concentrations were significantly higher in obese than in control children. In the two groups of children the basal metabolic rates (BMRs) were comparable in both absolute values and values adjusted for FFM, age and gender utilizing the multiple regression analysis. The most important variable to predict BMR was FFM, followed by age. BMR was significantly correlated with FFM, both for obese and control children, and also when the two groups were combined. In conclusion, our data do not support the idea that a child's obesity is maintained by increased metabolic efficiency at least in basal conditions. PMID- 1785287 TI - Predicting and monitoring of growth in children with short stature during the first year of growth hormone treatment. AB - Fifteen prepubertal short stature children (10 girls, 5 boys), mean age 9.6 years (range 5.2-12.7 years), with normal response to growth hormone stimulation tests (group A) or partial growth hormone deficiency (GHD) of idiopathic nature (group B) were included in a controlled longitudinal study for evaluation of predictive parameters for the long-term growth response after administration of biosynthetic human growth hormone (B-hGH). The average knee-heel length velocity for the first 3 months was significantly correlated to total body height velocity during the following 9 months (p less than 0.0008). By contrast, this association could not be found for height velocity during the same period. The increase in serum values of alkaline phosphatase and insulin-like growth factor I (IGF-1) during the first month of treatment was not significantly correlated to height velocity during the first year. During one year of treatment with B-hGH the mean height velocity for groups A and B increased from 4.4 cm/year (range 2.5-6.5) to 7.6 cm/year (range 4.7-10.6). Bone age advanced by 1.08 +/- 0.60 per chronological year. The ratio between total height and knee-heel length prior to treatment was 3.34 +/- 0.10 and after one year 3.33 +/- 0.10, suggesting a proportional linear growth. An inverse relationship was observed between the ratio and chronological age. In conclusion, early knee-heel measurement may be a useful non-invasive predictor of long-term linear growth in children during treatment with growth hormone, and the ratio of total height to lower leg length may be of importance in detecting dysproportional growth. PMID- 1785288 TI - Growth in infancy and childhood in girls with Turner's syndrome. AB - We describe spontaneous longitudinal growth in girls with Turner's syndrome (TS), using the infancy-childhood-puberty (ICP) growth model. Length/height during the first 12 years of life was studied in 58 Swedish girls with TS. Their mean length at birth was 47.8 cm (SDS -1.4) and mean height at 12.0 years of age 127.3 cm (SDS -3.0). A clear age-dependent subnormality was observed in the change in length-height SDS (delta SDS). Mean delta SDS values at ages 0.0 to 0.5 and 3.0 to 6.0 years were normal. In contrast, the mean delta SDS at ages 0.5 to 3.0 and 6.0 to 12.0 years were subnormal. The onset of the childhood growth component (normally located between 0.5 and 1.0 year of age) was, on the average, delayed by 0.28 year. This accounts for the subnormality of delta SDS at 0.5 to 3.0 years of age. About 50% of the variation in height at 12.0 years of age, as determined by a multiple linear regression analysis, was significantly explained by length at 0.5 year of age, age at the onset of the childhood component, and delta SDS at 6.0 to 12.0 years of age. PMID- 1785289 TI - Comparison of serum and salivary antibodies in children vaccinated with oral live or parenteral inactivated poliovirus vaccines of different antigen concentrations. AB - A new antigen-rich inactivated poliovirus vaccine (IPV) in ordinary (IPV1), double (IPV2) and quadruple (IPV4) antigen concentrations was given in 2 doses to 6 and 18 week old Pakistani infants. The immune responses to poliovirus types 1 and 3 were compared to those in infants given three doses of oral poliovirus vaccine (OPV) at 6, 12 and 18 weeks of age. Enzyme-linked immunosorbent assay, ELISA, was used to estimate IgG and IgA in serum and secretory IgA (SIgA) in saliva. Two to three years later, a follow-up of the serum antibody response was carried out in the same infants using a microneutralization test. Serum IgG antibody responses to poliovirus type 1 antigen after two doses of IPV1, IPV2 and IPV4 were not significantly higher than the response after three doses of OPV at 21 weeks of age (p greater than 0.05). The serum IgG responses to poliovirus type 3 were similar to those against type 1 in all the groups. Mean neutralizing antibody titres to poliovirus type 1 was significantly higher in the IPV2 group than the rest of the groups (p less than 0.01). For type 3, these titres were highest but not significantly, in the IPV4 group (p greater than 0.05). This study shows that two doses of a new antigen-rich IPV can give similar immediate serum antibody responses as OPV but higher late responses. SIgA antibodies in saliva were more efficiently induced by OPV after three doses than after 2 doses of IPV (p less than 0.05). PMID- 1785290 TI - Specific antibodies to poliovirus type I in breastmilk of unvaccinated mothers before and seven years after start of community-wide vaccination of their infants with live, oral poliovirus vaccine. AB - Secretory IgA (SIgA) antibodies against poliovirus type 1 were determined using the ELISA method in breastmilk samples obtained each month from 100 young, healthy, unvaccinated mothers living in urban slum areas of Lahore, Pakistan. The study covered two different groups, one in 1980-1981 and the other in 1987, before and seven years after a nation-wide expanded programme of childhood immunization (EPI) had started. The SIgA titres did not change neither with duration of lactation nor with time after vaccination in the infants of the mothers studied. The seasonal breastmilk IgA antibody titres to poliovirus type 1 corresponded to the epidemiological conditions existing both before (1980-81) and after general vaccination coverage with live, oral poliovirus vaccine (OPV) had reached 80% of the infant population (1987). Neutralization titres did not seem to correlate well with ELISA titres although colostrum samples had high levels of neutralizing antibodies. The wide variation between high (greater than 10,000) and low (less than 500) individual breastmilk IgA antibody titres observed during various seasons could be of consequence for the breast-fed baby. Colostrum, which was also found to have significant neutralization capacity, might interfere with the OPV now often given on the day of birth. PMID- 1785291 TI - Congenital structural abnormalities in biliary atresia: evidence for etiopathogenic heterogeneity and therapeutic implications. AB - The clinical, surgical, laboratory and histological data of 237 children with extrahepatic biliary atresia were reviewed. Forty-seven patients (20%) had associated congenital anomalies, and of these, 28 had cardiovascular, 22 digestive and 19 splenic malformations. Of the 19 patients with splenic malformations, 13 showed the polysplenia syndrome and two had asplenia. Chromosome studies were performed in eight children, six having associated anomalies, and two of them showed karyotype abnormalities (46,XX,del 18 p- and 49,XXXXY). These observations indicated that biliary atresia could be subdivided into four distinct etiopathogenic subgroups, three involving a congenital form that could arise through a malformation, a disruption or a chromosome abnormality, and the remaining to agents active in the perinatal period (the acquired form). The surgical outcome in 171 patients operated on by an experienced surgeon was not influenced by the presence of anomalies but by the timing of surgery. Seventy-one percent of 24 patients operated on by 8 weeks of age were jaundice-free as opposed to only 34% of those who had later surgery (p less than 0.01). PMID- 1785292 TI - Antibodies to gliadin in children with coeliac disease. AB - We have measured antibodies to gliadin (AGA), bovine beta-lactoglobulin, and chicken egg ovalbumin with a four-layer solid phase radioimmunoassay (RIA) in 62 children and adolescents with coeliac disease and in 36 healthy controls. The geometric mean titre of IgG AGA in patients at initial diagnosis was more than 100-fold that of controls (p less than 0.0001). Even patients on gluten-free diet had significantly higher IgG AGA titres than the controls (p = 0.0001), the difference being more than 5-fold. All the 42 patients with active disease (30 at initial diagnosis and 12 after gluten challenge) had their IgG AGA titre above 1,000, as compared with 2 (5.7%) of the 35 controls (p less than 0.0001). Both IgG and IgA AGA were quite sensitive and specific in identifying children with coeliac disease; the sensitivities for IgG and IgA AGA were 100% and 95.2%, the specificities 94.3% and 97.2%, respectively. We conclude that determination of IgG and IgA AGA with RIA is suitable for monitoring dietary compliance in children with coeliac disease, and the method is sensitive and specific for screening for coeliac disease in children. PMID- 1785293 TI - Low colostral IgA associated with cow's milk allergy. AB - During a nutritional study of 198 infants, seven became allergic to cow's milk. The seven infants showed acute cutaneous manifestations during cow's milk challenge tests in hospital and six had increased levels of IgE cow's milk specific antibodies. Neither in the development of the levels of immunoglobulins G, A and M, nor in that of the cow's milk-specific antibodies of these isotypes did these seven patients differ from the remaining infants. Beta-lactoglobulin content and levels of cow's milk-, and beta-lactoglobulin-specific antibodies and of immunoglobulins A, G and M were measured in samples of colostrum and milk from the mothers of the seven infants with cow's milk allergy and from a comparison group (non-atopic mothers of non-atopic infants). The milk of the mothers whose infants became allergic to cow's milk contained less IgA through the lactation: 95% confidence intervals of the groups did not overlap. The difference was most marked in the colostrum. All other measurements were similar in the two groups. This suggests that an infant is more likely to develop cow's milk allergy if the mother's colostrum had a low total IgA content. PMID- 1785294 TI - Renal involvement in patients with congenital cyanotic heart disease. AB - Patients with congenital cyanotic heart disease may develop a glomerulopathy with proteinuria and impaired renal function. In order to investigate this problem we conducted a study on 27 patients with uncorrected cyanotic heart disease who were between 1 day and 25 years old. As a consequence of hypoxaemia haematocrit was elevated to 57%. Proteinuria was above 150 mg/day/1.73 m2 body surface in 12 patients. Only one of 9 children under 10 years of age had pathological proteinuria presenting as isolated albuminuria. Seven out of 10 patients between 11 and 20 years had an elevated proteinuria with a glomerular pattern. Creatinine clearance was normal in these patients. All four patients above 20 years of age had a considerable glomerular proteinuria with a mean excretion of 5.7 g/24 h/1.73 m2 body surface. These patients suffered additionally from chronic cardiac failure and creatinine clearance was below the normal range. There was a clear relationship between pathological proteinuria and age of the patients and thus duration of hypoxaemia. Patients with pathological proteinuria had a significant higher erythrocyte count (7.3 +/- 1.3 vs 5.6 +/- 1.4 10(12)/l p less than 0.01) and a lower mean corpuscular haemoglobin. In summary, children with persistent congenital cyanotic heart disease have substantial risk of developing a glomerulopathy if the cyanosis remains unchanged for more than ten years. PMID- 1785295 TI - Second malignant neoplasms in patients treated for childhood leukemia. A population-based cohort study from the Nordic countries. The Nordic Society of Pediatric Oncology and Hematology (NOPHO). AB - Among a cohort of 981 children who were followed up 4.3-26.5 years after cessation of antileukemic therapy, eight patients in remission of acute lymphoblastic leukemia (ALL) developed a distinctively new malignant disease. The second malignant neoplasms (SMN) included brain tumors, basal cell carcinomas, thyroid cancer, leiomyosarcoma and finally rhabdomyosarcoma in a patient who also had suffered from Hodgkin's disease while still on antileukemic treatment. Cranial radiation had been given to 58.4% of the patients in the study group, which consisted of 895 ALL patients who had completed various chemotherapy protocols. With one exception, the SMN appeared after 7.5-16.5 years at a location previously exposed to radiotherapy (RT). The estimated cumulative risk of SMN appearing within 20 years after diagnosis was 2.9%, and the corresponding risk for cases with RT was 8.1% compared to 0.3% for those without (p = 0.05). In a Cox regression analysis, the incidence rate ratio of SMN between patients with and without RT was 6.7 (95% CI = 0.8, 57.7). Based on age-, year- and sex specific cancer incidence figures for Norway, the overall standardized incidence rate ratio (SIR) of SMN after treatment for ALL was 5.9 (95% CI = 2.2, 12.9). The number of brain tumors among patients who had received cranial radiation was nearly 27 times greater than expected, whereas no such tumors were seen after chemotherapy. Individuals treated for childhood ALL are at increased risk of a new malignancy, and this seems mainly to be associated with previous irradiation. PMID- 1785296 TI - Fibronectin levels in septicemic neonates before and after the administration of immunoglobulin. PMID- 1785297 TI - Normal growth of children with HBsAg positive chronic active hepatitis (CAH). PMID- 1785298 TI - Intrauterine intussusception and ileal atresia presenting as acute perforation. AB - A case is reported of a girl born by caesarean section at 28 weeks gestation who developed an acute perforation of the ileum due to intussuspetion 11 days after birth. This was treated successfully by resection of the affected segment of ileum and by performing a temporary ileostomy followed by end-to-end anastomosis. She made a complete recovery. This case also demonstrates the difficulty of early diagnosis of intussusception in the neonatal period. PMID- 1785299 TI - Tay or IBIDS syndrome. A case with growth and mental retardation, congenital ichthyosis and brittle hair. AB - A new, Swedish case with Tay or IBIDS syndrome is presented. The boy had growth and mental retardation, congenital ichthyosis and brittle hair. He was the only child in an uncle-niece marriage. The boy suffered recurrent infections and died at the age of 3 years from pneumonia. Clinical data on 15 cases are presented from a study of the literature. PMID- 1785300 TI - Idiopathic dilatation of the aorta with dissection in a family without Marfan syndrome. AB - Dissection of the aorta is very rare in children, but classically occurs in the presence of Marfan syndrome or other connective tissue disorder. We present a case of spontaneous dissection in a 12-year-old boy whose half brother has an idiopathic dilated aorta and whose mother has also required surgery for dissection of a dilated aorta. No features of connective tissue disorder were present in any family member. PMID- 1785301 TI - Sex differences in vulnerability? PMID- 1785302 TI - Mineral metabolism in obese children. PMID- 1785303 TI - Growth hormone therapy and final height in girls with Turner's syndrome. PMID- 1785304 TI - Adult panhypopituritarism presenting as idiopathic growth hormone deficiency in childhood: really idiopathic? PMID- 1785305 TI - Pharmacokinetic profile of recombinant human insulin-like growth factor I given subcutaneously in normal subjects. AB - The pharmacokinetic profile of recombinant human insulin-like growth factor I (IGF-I) was studied in healthy volunteers. Following a single subcutaneous injection of 40 micrograms/kg or 80 micrograms/kg, mean serum IGF-I concentrations increased by 150 ng/ml and 245 ng/ml, respectively. During repeated daily injections of 40 micrograms/kg, a steady-state IGF-I level of 150 ng/ml above baseline was reached. Of the pharmacokinetic indices measured, only Tmax varied between single and multiple dose regimens (6.9 hours versus 3.5 hours). No hypoglycaemic symptoms were observed, and after injection of IGF-I no depression of endogenous IGF-I production was observed. Fasting insulin levels were unaltered, but postprandial insulin was lowered by IGF-I with respect to placebo. PMID- 1785306 TI - The growing season. PMID- 1785307 TI - Modern management of growth problems in skeletal dysplasias. PMID- 1785308 TI - Classification of skeletal dysplasias. PMID- 1785309 TI - Psychological impact of significantly short stature. AB - These baseline data confirm that many children with significantly short stature are vulnerable to diverse developmental, social and educational problems, and substantiate the importance of a multidisciplinary treatment approach that includes a comprehensive psychological and medical assessment. The psychological assessment should focus on the early detection of problems in academic achievement and psychosocial development, in order that appropriate educational and counselling interventions can be provided. The paediatrician can also foster a positive relationship with patients and their families to facilitate treatment compliance and improve overall outcome in several ways. These include a simple explanation of the aetiology of the child's short stature and how the diagnosis was made, a review of the treatment protocol that includes information about potential side-effects and suggestions for minimizing conflicts about injections, and an open discussion of prognosis to help families develop realistic expectations. It is further suggested that paediatricians stress that treatment outcome should be assessed in psychological terms, such as increased responsibility, as well as physical growth. These anticipatory interventions will help to ensure that the eventual outcome of comprehensive treatment is an optimally functioning young adult. PMID- 1785310 TI - Surgical correction of short stature in skeletal dysplasias. AB - Limb lengthening has been undertaken in patients with short stature, including achondroplasia, hypochondroplasia and other skeletal dysplasias. The procedure consists of osteotomy of the tibia and fibula, and fixation of the limb using an external unilateral or circular fixator. Distraction (elongation) begins 1 week postoperatively, and during distraction osseous autoregeneration occurs. Consolidation of the autoregenerate takes about twice the time needed for lengthening, and the fixator is gradually mobilized during this time to allow greater weight-bearing. In 26 patients with short stature, the mean length gain was 10.1 cm (range, 7.3-14.8 cm). Transient deviation of the limb axis was observed in 80% of the patients, but reoperation was necessary only in 15%. Other complications included transient pain (70%), infection (45%), torn wires (40%), drop foot (35%), and stiffness of the ankle (30%) or the knee (15%). Not only must the possible length gain be judged, but it must also be ensured that no loss of function occurs. PMID- 1785311 TI - How should the psychosocial impact of short stature and response to growth hormone treatment be assessed in children? PMID- 1785312 TI - Perceptions of self and short stature: effects of two years of growth hormone treatment. AB - A cohort study was carried out to determine whether childrens' perception of the problem of short stature changed over 2 years of growth hormone (GH) therapy. A total of 66 children (age range, 5-15 years; mean 10.2 years) were selected on the basis of height below the 3rd centile for chronological age, height velocity below the 25th centile for bone age, prepubertal status, and absence of any organic condition causing growth failure or likely to interfere with GH action. The children were taking part in a 2-year multicentre trial to assess the effect of authentic recombinant GH on short, slowly growing children without GH deficiency (GHD). The childrens' and parents' attitudes and emotional adjustment to shortness were assessed before GH therapy commenced, and at 6 months and 2 years, using a growth-specific psychological instrument, the Attitude to Growth scale (ATG). The children were also assessed using the Piers Harris Childrens Self Concept Scale at 2 years. The mean ATG scores increased from 34.2 (95% confidence interval, 33.2-35.2) at intake to 37.2 (95% confidence interval, 36.2 38.2) at 2 years. Younger subjects had a greater increase (p less than 0.05). No sex differences occurred. Two separate factors were identified in the childrens' attitudes: emotional preoccupation with stature and a concrete focus on practical aspects. No differences were present between childrens' and parents' mean scores, though parents' estimates differed on selected items. The mean Piers Harris score at 2 years was within the normal range, and was positively correlated to the ATG but was unrelated to height. It is concluded that GH treatment may have a beneficial effect on childrens' attitudes to being short, particularly in the younger child.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785313 TI - Short stature and school performance--the Wessex Growth Study. AB - The relationship between short stature and school performance was examined by comparing an unselected cohort of 140 'normal' short children (below 3rd centile) aged between 7 and 9 years with 140 control children of normal height (10th-90th centiles). The short children had unimpaired self-esteem and normal patterns of behaviour, but a tendency towards hyperactivity and poor concentration. Their IQ scores were normal, but attainment, especially in reading, was low. The underachievement observed in the short children is largely due to the low socio economic status of this group. All the children in the study were prepubertal and these data will serve as a baseline for further follow-up during and after puberty. PMID- 1785314 TI - The social cost of being short: societal perceptions and biases. AB - This paper has briefly summarized some of the reports of the relationships of height to perceptions of achievement and acceptance of individuals by society. Shorter members of society are perceived to be less competent than taller individuals, both during childhood and as adults; they are seen less positively by peers and perceive themselves less favourably; and they are also more likely to be in lower positions, within a given profession. An understanding by society that shorter people are unfairly disadvantaged by societal perceptions and biases is a necessary first step towards correcting these inequities. PMID- 1785315 TI - Growth at the cellular level. PMID- 1785316 TI - Control of intermediary metabolism in childhood with special reference to hypoglycaemia and growth hormone. PMID- 1785317 TI - Glucose metabolism in adults with growth hormone deficiency. AB - Adults with GHD have normal overnight fasting glucose levels and normal overall glucose turnover. In the absence of GH, insulin secretion is reduced and may be associated with impaired glucose tolerance. The lack of GH is associated with normal insulin sensitivity but reduced hypoglycaemic responsiveness, probably due to a reduced supply of gluconeogenic substrates. When GHD is associated with obesity, however, hyperinsulinaemia and insulin resistance ensue and hypoglycaemic responsiveness is restored. In adults with GHD, treatment with recombinant human GH for 6 months increased fasting plasma glucose to within the normal range, with no change in overall glucose turnover and carbohydrate tolerance, in the presence of elevated basal insulin levels. PMID- 1785318 TI - Molecular defects in the growth hormone receptor. PMID- 1785319 TI - Growth hormone insufficiency during childhood has implications for later life. PMID- 1785320 TI - Growth hormone receptor deficiency (Laron syndrome): clinical and genetic characteristics. AB - Approximately 60 cases of GHRD (Laron syndrome) were reported before 1990 and half of these were from Israel. We have described 47 additional patients from an inbred population of South Ecuador and have emphasized certain clinical features including: markedly advanced osseous maturation for height age; normal body proportions in childhood but child-like proportions in adults; much greater deviation of stature than head size, giving an appearance of large cranium and small facies; underweight in childhood despite the appearance of obesity and true obesity in adulthood; blue scleras; and limited elbow extension. The Ecuadorean patients differed markedly and most importantly from the other large concentration, in Israel, by being of normal or superior intelligence, suggesting a unique linkage in the Ecuadorean population. The Ecuadorean population also differed in that those patients coming from Loja province had a markedly skewed sex ratio (19 females: 2 males), while those from El Oro province had a normal sex distribution (14 females: 12 males). The phenotypic similarity between the El Oro and Loja patients indicates that this abnormal sex distribution is not a direct result of the GHRD. PMID- 1785321 TI - Psychomotor and mental development from birth to age of four years; sex differences and their relation to home environment. Children in a new Stockholm suburb. Results from a longitudinal prospective study starting at the beginning of pregnancy. AB - Five hundred and thirty-two pregnant women were interviewed about their psychosocial health at the beginning of pregnancy. According to various factors including alcoholism, mental disease and criminality among the women and their husbands the families were divided in three groups of different degrees according to psychosocial stress. The pregnancies, deliveries and the 497 live-born children in these families have been investigated with prospective methods. Data concerning the psychological development and psychiatric health of the child were attained by interviewing the mother and evaluating the child during visits to home (age 1 and 4). The physical health and development of the children has been followed by prospective data achieved from the child welfare centers. At one year of age 452 of the children (226 boys, 226 girls) and at four-five years of age 412 of the children (202 boys, 210 girls) were evaluated by the Griffith's Development Scales. Findings from these evaluations can now be related to a number of factors concerning the psychosocial situation, pediatric riskfactors etc. With the prospective, longitudinal methods used in this project interesting results concerning sex differences related to the mental development have been found. At one year of age girls had higher scores than boys on the Griffiths subscale measuring hearing-and-speech abilities. At four years of age several significant differences between the sexes were found. Girls had more "even" Griffiths-profiles and scored higher than boys in several Griffiths-subscales. The greatest differences at four years of age were found concerning personal social function and eye-hand-coordination. Boys seem to be specially vulnerable to the psychosocial situation in their homes as the Griffiths-results at four years of age are lower among boys from homes with psychosocial stress compared to other boys. It should be very interesting to follow and study what these sex differences mean concerning future development, the occurrence of psychopathology school difficulties. PMID- 1785322 TI - Recent advances in childhood diarrhoeal diseases. AB - Over the past 20 years there have been many important advances in knowledge about diarrhoeal diseases of children. Of these, the development of oral rehydration therapy (ORT), has been outstanding. This is based on the observation that intestinal sodium transport is enhanced by glucose transport in the small intestine and that this sodium-coupled mechanism for glucose and water transport remains intact in the enterotoxigenic diarrhoeas despite the net secretory effects of bacterial enterotoxins on the small intestinal epithelium. The World Health Organisation has adopted ORT and strongly promoted its application for treatment of diarrhoeal diseases, particularly in developing countries. This has resulted in a drop in diarrhoeal disease mortality and the application of this treatment has been described in an Editorial in the Lancet as "potentially the most important medical advance this century". PMID- 1785323 TI - Oral rehydration therapy in the management of acute diarrhoea. PMID- 1785325 TI - Effect of glucocorticoids on bone Gla protein values--BGP as a good marker of osteoporosis. AB - It is important to prevent corticosteroid(CS)-induced osteoporosis, particularly in children. One of the mechanisms is a direct inhibitory effect of CS on osteoblasts. Bone Gla protein (BGP) is produced in osteoblasts, and the serum level of BGP reflects the bone formation rate. The aim of this study is to examine the usefulness of BGP as a marker of CS-induced osteoporosis. In the present study, serum levels of 24 pediatric patients who were given prednisolone (PSL) for long periods were studied in relation to their growth rate. Serum BGP was also determined in 167 healthy children and 16 adults. In healthy children, BGP levels reached a peak at the age of 15 years in boys and 11 years in girls. In patients who were given more than 0.25 mg/kg/day PSL, serum BGP levels were significantly decreased and height growth was remarkably suppressed. In conclusion, the measurement of serum BGP is useful for early detection of CS induced osteoporosis. PMID- 1785324 TI - The effect of immunoglobulin on immune complexes in patients with Kawasaki disease (MCLS). AB - In mucocutaneous lymph node syndrome (MCLS) IgG and IgM class immune complex (IC) showed peak levels on day 10 to 20 after the onset of the disease respectively, and a transient decrease in IgM class IC was detected at the beginning of intravenous high dose gamma-globulin therapy (IHDGT). In in vitro examination, when gamma-globulin was added to the serum samples of MCLS patients, IgG class IC increased while IgM class IC decreased. Consumption of complements was also observed in these samples. Disposition of IC in the reticuloendothelial system seemed easier by both binding of gamma-globulin to IC and increasing complement bound to IC resulting in increasing complement-binding site. These results suggest that IHDGT is effective for the treatment of IC in MCLS. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) revealed 14 bands from 300 K.D. to 42 K.D. in IC of MCLS patients in the acute phase of the disease and prior to treatment. The immunoblotting method revealed that IC contains IgG, IgM, IgE, IgA, Clq, C3, and C4. PMID- 1785326 TI - Changes of anti-HB core antibody in children with positive HB surface antigen. AB - To elucidate the clinical courses of children chronically infected with HB virus (HBV), RIA values of anti-HBc were surveyed in 88 cases with positive HBs antigen. Among 56 children with positive HBe antigen, 20 had negative, indefinite or low titers of anti-HBc, and 18 (90%) of them had no liver malfunction. Out of 30 cases with abnormal liver function tests, 28 (93%) had high titers of anti HBc. Follow-up study for a period of over 12 months reveals that serum HBe antigen disappeared in 10 out of the 40 cases who were positive for this antigen. All of the 10 cases had liver malfunction and high levels of anti-HBc. Among 12 children with initially positive anti-HBe, five had high titers of anti-HBc. Out of 13 children who once had high levels of anti-HBc, 3 showed reduction in titers of anti-HBc during the follow-up period in accordance with decrease in activity of hepatitis. Four out of 16 who initially had HBe antigen and low titers of anti HBc showed high titers of anti-HBc during the observation period, while only one of 33 who had HBeAg and a high titer of anti-HBc went to the low titer group of anti-HBc, though continuously positive for HBe antigen. We presume that high levels of anti-HBc indicate previous or current liver damage due to HBV infection, while low titers of anti-HBc indicate that HBV-derived liver damage has not yet occurred or that a long time has passed since the last episode of liver damage subsided. PMID- 1785327 TI - Mass protection program of perinatal hepatitis B virus infection in Japan and impact of an optional booster vaccination on its efficacy. AB - We assessed the efficacy of a government-sponsored mass protection program in Osaka, Japan, for perinatal HBV infection in infants born to HBeAg positive HBV carrier mothers. We also evaluated the impact of optional follow-up procedures in such infants, including an evaluation of anti-HBs response and a booster dose of HBV vaccine for poor responders. The results demonstrated that this mass protection program protected 94.4% of the infants from perinatal HBV infection in the Osaka area. However, the proportion of infants with an unprotective level of anti-HBs was higher in the standard group than in the follow-up group both at 1.0 and 1.5 years of age, which was also the case for HBV events. Furthermore, the present study showed that a booster dose of vaccine in poor responders was very effective in promoting an anti-HBs response. In conclusion, we recommend that a follow-up blood test to confirm a response of anti-HBs to HBV vaccine should be performed at 4-8 weeks after the third injection of HBV vaccine in infants born to HBeAg positive HBV carrier mothers. We also recommend that a booster injection of HBV vaccine should be immediately given to poor responding infants who otherwise are at a considerable risk of developing HBV infection in late infancy. PMID- 1785328 TI - Combination therapy with transfer factor and high dose stronger neo-minophagen C in chronic hepatitis B in children (HBe Ag positive). AB - This study mainly describes the efficacy of the combination therapy with Transfer Factor (TF) and high dose Stronger Neo-Minophagen C (SNMC) for HBV carrier children with HBe Ag positive chronic hepatitis. There were 12 patients, 10 males and 2 females aged from 7 months to 14 years 8 months. Liver biopsy was done in 11 patients, and the histopathological findings of the liver were chronic active hepatitis (8 cases) and chronic inactive hepatitis (3 cases). In 6 of 8 patients, HBe-Ag became negative (75%) within 18 weeks (mean 8 weeks) after the initiation of the combination therapy with TF and SNMC (HBe-seronegative), and 4 of these 8 patients (50%) became anti-HBe positive within 29 weeks (mean 15 weeks) (HBe seroconversion). These results suggest that combination therapy with TF and high dose SNMC may be beneficial in the treatment of chronic hepatitis B in children. PMID- 1785329 TI - C3 deposition in IgA nephropathy in children and adolescents. AB - The aim of this study was to assess the significance of C3 deposition in IgA nephropathy in children and adolescents. One hundred and two patients aged 5-21 years (57 male and 45 female) were studied. The findings of C3 deposition were classified into 8 groups by immunofluorescent (IF) pattern and intensity as follows: group MC3+ (N = 12): mesangiocapillary pattern and 3+ in intensity; group MC2+ (N = 13): mesangiocapillary and 2+; group MC1+ (N = 4): mesangiocapillary and 1+; group M3+ (N = 11): mesangial and 3+; group M2+ (N = 24): mesangial and 2+; group M1+ (N = 18): mesangial 1+; group S (N = 12): only segmentally positive; and group N (N = 8): negative. Histological changes were scored semiquantitatively as an activity index (cellular proliferation, necrosis, interstitial cell infiltration, and cellular crescents) and a chronicity index (mesangial sclerosis, segmental and global glomerular sclerosis, fibrous crescents, adhesion and tubulo-interstitial change). IF findings were scored semiquantitatively and laboratory findings were also studied. The following results were obtained: 1) The scores of total activity index in MC groups were higher than in the M, S or N groups, and the greater the degree of C3 deposition, the higher the score; 2) Such result was not evident in the chronicity index; 3) High IF scores of IgG and IgM were found in the MC3+ and MC2+ groups; 4) Hematuria was more severe in MC3+ and MC2+ than in other groups, and proteinuria was more prominent in the MC than other groups. Thus the degree of C3 deposition was parallel with histological activity and urinary findings. PMID- 1785330 TI - C3 deposition in serially biopsied children with IgA nephropathy. AB - Twenty-five children with IgA nephropathy were studied by serial renal biopsy to investigate C3 deposition. The children were classified into three groups according to the immunofluorescent (IF) course of C3 deposition: group I (N = 9): unchanged or slightly decreased; group II (N = 4): changed to segmental deposition; and group III (N = 12): changed to negative deposition. Histological changes were scored semiquantitatively as an activity index (cellular proliferation, necrosis, interstitial cell infiltration and cellular crescents) and a chronicity index (mesangial sclerosis, segmental and global glomerular sclerosis, adhesion, fibrous crescents and tubulo-interstitial change). The IF findings were scored semiquantitatively and laboratory data were also studied. The following results were obtained: 1. Normal urinalysis was often observed in group III; 2. The IF scores of IgA and IgG were decreased at the second biopsy in all groups, most notably in group III; 3. The activity indices at second biopsies were decreased in all groups, most notably in groups II and III, consistently with our previous study which showed that C3 deposition increases in accordance with histological activity; 4. The chronicity index was unchanged in all groups and C3 deposition did not reflect histological chronicity. Thus, this study indicates that C3 deposition occurs as the disease progresses and reflects histological activity. PMID- 1785331 TI - An epidemic of meningococcal disease in Karachi (Pakistan): a study of children. AB - A prospective study of 112 cases of epidemic meningococcal infection in the paediatric population is presented. The natural course of the disease, its complications, prognostic factors and therapeutic agents were studied. The cases were graded according to fixed criteria of severity which correlated well with the outcome of the disease. The gram-stain of the CSF was a sensitive and a quick method of diagnosis and crystalline penicillin a cost-effective therapy giving a good response within 48 hours in 90% of the cases. PMID- 1785332 TI - Growth-promoting effect of human growth hormone on patients with achondroplasia. AB - To evaluate the effect of human growth hormone (hGH) on the growth of children with achondroplasia, three patients with achondroplasia and one patient with hypochondroplasia were treated with 0.5 IU/kg/W of pituitary-extracted hGH for 6 12 months. Mean height velocity was significantly increased from 4.0 +/- 0.4 to 7.5 +/- 0.7 cm/year (P less than 0.05) by hGH. The tibial index, defined as the length/width ratio of left tibia, did not change during the treatment, indicating that hGH promotes growth without exaggeration of tubular bone deformity. Case 2, who had atlantoaxial dislocation, developed sleep apnea and neurological deficits during the second hGH treatment, but these were cured by operation. Thus, hGH therapy is effective in promoting growth in patients with achondroplasia, but the complication of atlantoaxial dislocation should be explored and corrected before the treatment. PMID- 1785333 TI - Influence of mode of delivery on fetal pituitary-thyroid axis. AB - We measured the cord serum levels of thyroid-stimulating hormone (TSH), thyroxine (T4) and triiodothyronine (T3) in 922 neonates delivered by mothers who had no thyroid disorders. The T4 and T3 levels increased progressively from the 27th to the 40th week of gestation. However, the TSH levels varied widely and had no correlation with gestational age, because they were affected by the mode of delivery. The mean cord serum TSH level in neonates delivered by vacuum extraction was 16.3 +/- 10.0 microU/ml (n = 30), which was significantly higher than the level following normal vaginal delivery (9.5 +/- 6.0 microU/ml, n = 622) (p less than 0.005). The mean cord serum TSH level following elective caesarean section was 6.5 +/- 3.1 microU/ml (n = 79), and this was significantly lower than after normal vaginal delivery (p less than 0.005). TSH levels in high-risk neonates were significantly higher than in neonates without risk factors. A significant positive correlation was found between the duration of the second stage of labor and the cord serum TSH level (r = 0.45, n = 412, p less than 0.01). However, there was no correlation between the cord serum TSH level and the congenital hypothyroidism screening TSH level (r = 0.01, n = 468). We conclude that the cord serum TSH level reflects delivery stress and that an elevated level does not influence the congenital hypothyroidism screening TSH test in which blood is obtained at five days of life. PMID- 1785334 TI - Concentration of lipid peroxide in serum lipoproteins of insulin-dependent diabetic children. AB - Lipids, apolipoproteins and lipid peroxide were measured in the sera of 29 children with insulin-dependent diabetes mellitus. Ten non-diabetic children served as controls. High-density lipoprotein (HDL) was separated by heparin-MnCl2 precipitation. Lipid peroxides in HDL and non-HDL fractions were estimated by fluorimetric measurement of thiobarbituric acid-reactive substances. The patients were normolipidemic, and their HDL-cholesterol was increased. Apo A1 level in the patients was similar to that in the controls, while levels of apo A2 and apo B were decreased in the patients. Concentrations of lipid peroxides in the whole serum and non-HDL were unaltered, while that in the HDL was higher in the patients than in the controls. Hemoglobin AIc in the patients correlated with the triglyceride and urinary excretion rate of N-acetylglucosaminidase (NAG). The NAG correlated with the triglycerides. The triglycerides correlated with the atherogenic index, apo B and total cholesterol. The lipid peroxides in the non HDL correlated with the triglyceride, atherogenic index, and NAG. That in the HDL correlated with the HDL-cholesterol, apo A1 and endogenous creatinine clearance, and inversely with the atherogenic index and apo B. Lipid peroxides in HDL and non-HDL appeared to play different physiological roles from each other, and they have provided evidence suggesting that diabetic microvascular injury is mediated by reactive oxygen species. PMID- 1785335 TI - C-peptide/creatinine ratio in early morning urine as an indicator of residual B cell function in insulin-dependent diabetes. AB - The C-peptide/creatinine (Cr) ratio in early morning urine was evaluated to assess B-cell function. The subjects were 12 boys and 36 girls with insulin dependent diabetes mellitus (IDDM). The controls were 130 boys and 137 girls aged 4-15 years. There was a significant inverse correlation of this ratio with the duration of insulin therapy (r = -0.5807, P less than 0.01). The daily insulin dose in U/kg was significantly different among the following groups: 1.22 +/- 0.31 U/kg in group 1 with undetectable C-peptide, 0.94 +/- 0.37 in group 2 with a decreased ratio and 0.45 +/- 0.28 in group 3 with a normal ratio. HbA1 levels were 11.3 +/- 1.6% in group 1 and 9.2 +/- 1.1% in group 3. The difference was significant. The result shows that the C-peptide/Cr ratio in early morning urine is useful for assessing B-cell function in diabetic children. PMID- 1785336 TI - Massive intestinal albumin loss after Fontan operation. AB - Massive intestinal protein loss was demonstrated and the site of loss determined by abdominal scintigraphy with 99mTc-labeled human serum albumin in a 9-year-old girl following the Fontan operation for pulmonary atresia with intact ventricular septum. Significant activity accumulating in the lower small intestine and moving with its contents into the colon were shown. Her condition may have resulted from intestinal lymphangiectasia, caused by increased central venous pressure. Abdominal scintigraphy with 99mTc-human serum albumin is useful in the diagnosis of protein-losing enteropathy. PMID- 1785337 TI - Spontaneous near closure of coronary artery fistula: Doppler echocardiographic findings. AB - A 1-year-old girl was diagnosed as having a fistula between the left coronary artery and the right ventricle by selective coronary angiography. The left to right shunt ratio was 38%. At a second angiography, the fistula was markedly diminished in size. Turbulent flow was detected throughout the cardiac cycle in the left coronary artery and during systole in the right ventricle by Doppler echocardiography on the first visit. At 3 years of age the systolic component of the left to right shunt flow in the left coronary artery and the right ventricle was reduced in size. Doppler echocardiography proved useful in observing the natural history of this coronary artery fistula. PMID- 1785338 TI - Immunoblastic lymphadenopathy (IBL)-like T-cell lymphoma in a child. AB - We report the case of a 14-year-old Japanese boy with peripheral T-cell malignant lymphoma, showing progression from immunoblastic lymphadenopathy (IBL) to overt malignant lymphoma. He suffered recurrent fever, generalized lymphadenopathy, hepatosplenomegaly and maculopapular exanthema. Leukocytosis with eosinophilia and polyclonal hypergammaglobulinemia were observed during the aggressive course of the disease. In the early phase, human immunoglobulin and steroids improved the symptoms but did not induce complete remission, and the patient died one year after the onset of the illness. Four biopsies of lymph nodes revealed progression from IBL to CD4 positive T-cell lymphoma through IBL-like T-cell lymphoma. Though IBL-like T-cell lymphoma is defined as IBL with neoplastic features and overt T cell malignant lymphoma progressed from IBL-like T-cell lymphoma is excluded from the definition, it may be preferable that such malignant lymphoma as our case should also be included in IBL-like T-cell lymphoma. PMID- 1785339 TI - Kawasaki disease. With particular emphasis on arterial lesions. AB - Kawasaki disease (KD, or acute febrile mucocutaneous lymph node syndrome (MCLS)) was first described as a clinical entity in 1967 by Dr. Tomisaku Kawasaki of the Japan Red Cross Medical Center. Originally, it was thought to have a favorable prognosis, but as epidemiological surveys, augmented by pathological studies, have shown, it has come to be recognized as an often fatal disorder. In this report, the clinical symptoms, historical background, present status of research and epidemiological problems of KD are first described, and then we present a pathological and morphological outline of KD, focusing on pathological changes in the blood vessels, and the relationships of these changes to 1) the morphogenesis of arteritis, 2) the mechanism of coronary artery aneurysm formation and its sequelae, and 3) juvenile arteriosclerosis. PMID- 1785340 TI - Amyloid enhancing factor (AEF). Isolation and biochemical and pathological characteristics. AB - Neutrophils and spleens were prepared from mice after treatment to induce amyloid deposition. The deposition of amyloid was accelerated in normal recipients by intravenous injection of more than 2 x 10(4) neutrophils, and intraperitoneal injection of supernatants obtained by homogenization and centrifugation of the neutrophils and spleens. The supernatants were subjected individually to DEAE ion exchange chromatography. Amyloid enhancing factor (AEF) activity was present in peaks eluted at an NaCl concentration of 0.17 M. The fractions containing AEF were subjected to high-performance liquid chromatography (HPLC), and AEF was eluted at a position corresponding to about 15 KDa. Purified AEF was analyzed by amino acid sequencing and gas chromatography. The N-terminal amino acid was blocked, and AEF contained some saccharides including glucose, mannose, galactosamine and sialic acid, and an undefined substance (probably derived from certain proteins). Immunoelectron microscopy by the pre-embedding method using an anti-AEF antiserum demonstrated that the cytosol, but not primary and specific granules in neutrophils from the spleen of amyloid-laden mice, reacted with the antiserum. These findings suggest that AEF is a glycoprotein associated with neutrophils. PMID- 1785341 TI - Genomic DNA analysis of rat retinal tumor induced by adenovirus type 12. AB - To elucidate the pathogenesis of human retinoblastoma, we investigated the genomic expression in retinal tumors induced by human adenovirus type 12 in rats, using various DNA probes. Seven rats received a single intraocular inoculation of concentrated virus fluid within 24 hours after birth. Intravitreous tumors were induced in two out of seven animals (28.5%) within 30 to 64 days after the inoculation. A remarkably uniform histologic feature, i.e., neuroblastic cells in association with Homer-Wright pseudorosettes, was present in all cases. The adenovirus-related oncoprotein gene E1A and human retinoblastoma susceptibility gene were detected in the tumors by Southern blot hybridization. In situ hybridization analysis demonstrated expression of adenovirus type 12 E1A gene in the inner granular layer of the retina. It was suggested that integration of adenovirus type 12 E1A fragment with the host genome and expression of the gene were required for induction of this tumor. PMID- 1785342 TI - HLA-DR expression on M cells overlying Peyer's patches is a common feature of human small intestine. AB - The expression of major histocompatibility complex (MHC) class II (HLA-DR) antigens on M cells within follicle-associated epithelial cells (FAE) covering Peyer's patches was analyzed immunohistochemically. HLA-DR antigens were strongly expressed on M cells and cells with dendritic morphology, whereas other FAE covering Peyer's patches showed weak, but definite staining. Dendritic cells were also positive for S-100 protein and IL-1. These findings suggest that M cells as well as dendritic cells within FAE form an antigen-presenting cell system and contribute to the first information releaser for the mucosal immune system. PMID- 1785343 TI - OPD4-positive T-cell lymphoma of the liver in systemic lupus erythematosus. AB - Primary malignant lymphoma of the liver occupying the right lobe, 14 x 9 x 7 cm in size, developed in a 30-year-old man with a 4-year history of autoimmune hemolytic anemia. The diagnosis of systemic lupus erythematosus (SLE) accompanying thrombocytopenia had been made clinically 10 months earlier. The liver biopsy specimen revealed diffuse proliferation of large lymphoma cells expressing the activated helper/inducer T-cell phenotype (LCA+, UCHL1+, OPD4+, LN3+, MT1-, L26-, MB1-, Leu M1-, Ki-1-, KP1-). The lymphoma was successfully treated by chemotherapy and irradiation. Intractable thrombocytopenia provoked fatal esophageal hemorrhage. At autopsy, no lymphomatous lesion was identified, and the hepatic right lobe contained an encapsulated necrotic lesion without any viable tumor cells. The bone marrow revealed marked hyperplasia of erythroid and megakaryocytic series. Extramedullary hematopoiesis was demonstrated in the liver, spleen and lymph nodes. This is the second case of primary hepatic T-cell lymphoma associated with SLE. PMID- 1785344 TI - Malignant mesothelioma of the tunica vaginalis testis. Report of a case and review of the literature. AB - An autopsy case of malignant mesothelioma of the tunica vaginalis testis in a 60 year-old man is described. The tumor showed widespread metastasis via the lymphatics, leading to the patient's death five years after diagnosis. A review of 38 previously described cases is also presented. The most frequent presenting symptom was hydrocele. When a hydrocele in association with a paratesticular tumor is present, aspiration cytology should be performed first. In most of the cases with a fatal outcome, the tumors metastasized to the retroperitoneal lymph nodes. Once the diagnosis has been made, lymphangiography or CT scan should be done immediately. PMID- 1785345 TI - Coronary artery spasm and vascular biology. Cholinergic constriction. AB - Coronary artery spasm is undoubtedly one of the causative factors of ischemic heart disease, particularly variant-type angina pectoris and myocardial infarction, but the disease mechanisms involved are still unclear. The present review describes the clinical background of coronary artery spasm in relation to ischemic heart disease, including a brief history of studies in this field, and also suggests future guidelines for experimental investigations based on the characteristics of coronary artery spasm, focusing particularly on data we have obtained in our laboratory from studies of cholinergic constriction. The pig may be a suitable animal in which coronary artery spasm could be provoked with cholinergic agents following endothelial denudation. The use of such large animals would allow the study of spastic arterial segments by various methods with angiographic confirmation. After endothelial denudation it is possible that phenotypic changes in cholinergic receptors might occur in smooth muscle cells, and that such changes might remain even after endothelial repair. PMID- 1785346 TI - Endocrine cells in a normal breast and non-cancerous breast lesion. AB - The authors confirmed the presence of endocrine cells for the first time in a normal breast as well as in a non-cancerous lesion of the breast. One hundred and eighty-eight blocks of normal breast tissues in 44 cases and 74 blocks of non cancerous lesions in 35 cases were examined. Argyrophil cells were found in one block from a normal breast and in one block from a phyllodes tumor. Argyrophil cells in the normal breast showed positive reaction to anti-endocrine granule constituent (EGC) antibody with immunohistochemical method. Argyrophil cells found in the phyllodes tumor gave positive reaction to both anti-EGC and anti serotonin antibodies. The present study is thought to be the first report in the literature of serotonin-positive cells in a non-cancerous breast lesion, a phyllodes tumor. PMID- 1785347 TI - Human autoantibody to Sertoli cells detected in healthy individuals. AB - Human autoantibody to Sertoli cells was detected in normal human sera. This IgM type autoantibody was undetectable during the neonatal period and was found in 11.5% of 365 serum samples taken from adult healthy persons of both sexes. This human autoantibody to Sertoli cells exhibited quite the same target-organ specificity and multi-organ reactivity (salivary gland ductules, pancreatic intercalated duct, renal lower nephron, pituitary acidophilic cells) as those of the murine monoclonal autoantibody (IgM class) to Sertoli cells (TM-1: WHO registered code T43). The TM-1 monoclonal antibody could recognize testicular antigens with molecular weights of 67,000 and 23,000 in Sertoli cells, and had already been demonstrated capable of inducing murine experimental spermatogenic disturbance when administrated together with murine monoclonal autoantibody to seminiferous tubular basement membrane (TM-2: WHO registered code T44). These observations may suggest that human spermatogenic disturbance could be easily induced by the multi-organ reactive autoantibody to Sertoli cells even in healthy individuals under particular conditions where this autoantibody can be allowed to reach the target Sertoli cells across the barrier of seminiferous tubular wall by either autoantibody to seminiferous tubular basement membrane or other toxic damage. PMID- 1785348 TI - An autopsy case of purulent mycobacterial meningitis in AIDS. AB - The patient was a 46-year-old male hemophiliac who died of acute mycobacterial meningitis associated with AIDS (acquired immune deficiency syndrome). Autopsy revealed severe basal meningitis which was characterized by an infiltration of numerous polymorphonuclear leukocytes. Severe mural inflammation of the subarachnoid arteries was noted, and innumerable acid-fast bacilli were demonstrated. Epithelioid cell granulomas were not found in the meningeal lesion. The lungs, liver, spleen, and bone marrow contained many epithelioid cell granulomas with caseous necrosis. Massive proliferation of swollen histiocytes could not be identified in any organ. The absence of epithelioid cell granulomas in the meningeal lesion indicate a severe impairment of cell-mediated immunity in the patient; this anergic type of lesion is one of the characteristics of tuberculosis occurring in association with terminal AIDS. PMID- 1785349 TI - Neoplastic argentaffin cells with intracytoplasmic eosinophilic granules in a gastric adenocarcinoma. AB - A case of poorly differentiated adenocarcinoma of the stomach with unique histological features is reported: in addition to characteristic adenocarcinoma cells, a large number of tumor cells contained bright eosinophilic and argentaffin granules in their cytoplasm. On routine histologic examination, the latter cells closely resembled the endocrine cells present in the normal human gastrointestinal tract, although the granules were distributed throughout the cytoplasm and did not show any polarity, which is usually subnuclear in normal endocrine cells. Immunohistochemical studies demonstrated positive staining for lysozyme, CEA, gastrin and HCG. Electron microscopic examination revealed cytoplasmic neurosecretory granules, and some tumor cells were found to contain both secretory granules and mucinous material within the same cytoplasm. These neoplastic endocrine cells presumably originated from primitive digestive system elements capable of differentiating towards both endocrine and mucus-secreting varieties. PMID- 1785350 TI - Epidermoid cyst derived from an accessory spleen in the pancreas. A case report with literature survey. AB - A rare case of splenic epidermoid cyst (SEC) of the pancreas discovered in a 32 year-old Japanese female is reported. The lesion, 5 x 6 cm in size including caseous material and serous fluid in the lumen, was discovered by ultrasonography and computed tomography at the tail of the pancreas and was easily removed. Histopathologically, the cystic wall consisted of three components: the inside was lined by mature squamous epithelium with keratinization, the middle layer consisted of splenic pulp with a sinus structure, and the peripheral layer was dense fibrous connective tissue in which some involutional pancreatic ducts and islets were recognized. The literature about SEC of the pancreas is discussed in comparison with other types of epidermoid cyst including lymphoepithelial cyst and dermoid cyst in the pancreas. PMID- 1785351 TI - Apocrine adenocarcinoma of the bilateral axillae. AB - A case of apocrine adenocarcinoma arising in the bilateral axillae is reported. The patient was an 88-year-old Japanese male who complained of a mass lesion and pus-like discharge in the right axilla. Another mass was also noticed in the left axilla. No other neoplastic lesion was found in other sites of the body. The histologic appearances of the bilateral axillary tumors were almost identical. Both were adenocarcinoma with varying degrees of differentiation, composed of glands and nests of atypical epithelial cells with abundant eosinophilic cytoplasm. Some neoplastic cells exhibited cytoplasmic projections on their apical surface. Foci of in situ carcinoma were observed within the neoplastic tissue in the bilateral axillae. The neoplastic cells were immunohistochemically positive for epithelial membrane antigen (EMA) and gross cystic disease fluid protein (GCDFP-15), but negative for carcinoembryonic antigen (CEA). On the basis of their histologic and immunohistochemical features and distinctive location, the tumors were diagnosed as apocrine adenocarcinoma. PMID- 1785352 TI - Analytical aspects of the stabilization of drugs in pharmaceutical formulations. AB - The selection of a suitable procedure for stabilizing a drug in various pharmaceutical formulations requires highly specific and accurate analytical methods. In this paper the general problems associated with the specificity of the selected analytical methods (spectrophotometry, HPLC etc.) are discussed through the examples of phenyl-alkylamine and phenothiazine drugs. Studying the influence of different antioxidants on the rate of decomposition and detecting simultaneously the decomposition products, radicals and intact active ingredients enabled a better understanding of the degradation mechanism. The impurity profile (different decomposition products in the mixture) was found to be the function of the type and concentration of the stabilizers. A kinetic study demonstrated on phenylalkylamine type drugs using selective analytical methods clarified the mechanism of stabilizer action and allowed the perfect description of the degradation pathway. PMID- 1785353 TI - [Comparison of solid phase and liquid-liquid extraction of diazepam and nitrazepam]. AB - We have developed a new extraction technique for nitrazepam and diazepam using Samplex C-18 column. The blood-extractions containing diazepam and nitrazepam were diluted with acetonitrile-water 7:3 eluent. Diazepam and nitrazepam were isolated using liquid-liquid extraction technique. The blood-extracts were diluted with chloroform-ethanol 1:1 and they were evaluated by using OPLC method. Evaluation was done by TLC-scanner (Shimadzu). The efficiency and sensitivity of the methods have been compared. PMID- 1785354 TI - [Effect of microbial immunomodulators on the course of lymphocytic choriomeningitis virus infection in old mice with physiological thymus involution]. AB - Aged mice with physiological thymus involution were treated intraperitoneally with 0.2 ml of live Newcastle Disease Virus (NDV) containing attenuated NDV vaccine (HA titre: log 2(16)/ml) one day before or with Mannozym (0.1% zymosan suspension) four days and one day before intracerebral inoculation with 100 LD50 dose of LCMV. One dose of M was equal to 40 mg/kg zymosan. Both, NDV vaccine and M pretreatments contributed to the development of fatal lymphocytic choriomeningitis, thus enhanced the cellular immune response to LCMV infection. Present results are compared with earlier results which were attained on young adult suckling mice in similar system with pretreatment with different microbial immunomodulators. Present results reinforced the authors' earlier observations that the direction and degree of immunomodulatory effects can be influenced by the actual conditions, like age, of the immune system. PMID- 1785355 TI - [Preparation and analysis of hydroxycarboxylic acid, sugar acid and amino acid complexes of gallium(III)]. AB - Neutral, stable in water and not hydrolysing gallium(III) complexes were prepared and analysed by instrumental analytical methods. Nine hydroxy-carboxylic acids, four sugar acids and four amino acids were used as ligands. The chemical and physical characteristics of complexes (composition, stability, water solubility, pH in aqueous solution) significantly depend on the quality of gallium salt and ligand, the ratio of gallium and ligand, the medium used during the preparation (pH and temperature). PMID- 1785356 TI - [The origin of hyperprolactinemia associated with infertility and its treatment with Bromocriptin-Richter tablets]. AB - Authors used the tablet Bromocriptine in 22 cases for the treatment of infertility and in 15 cases for that of extra-puerperal galactorrhoea. The serum prolactin level of the patients of the two groups remained in 16 cases below and in 13 cases beyond of the upper value of the normal menstrual cycle. It turned out, that the average prolactin-level of patients, treated against infertility, diminished significantly even after one month after the treatment. Between the values of serum FSH, before and after LH treatment there have not been found any significant difference. On the contrary, in the values of serum progesterone and 17-beta-oestradiol significant differences have been observed after treatments of one month as well as of two months duration. On the basis of the results, authors can state, that the prevailing progesterone-level is the adequate indicator of potential fertility. During the treatment of hyperprolactinaemic pathologies eight pregnancies occurred (21.6%). It turned out, that hyperprolactinaemia was the real cause of procured abortion. For the registration of latent hyperprolactinaemia the Cerucal (metoclopramide) load proved to be an adequate diagnostical method. PMID- 1785357 TI - [Individual and average weight requirements of pharmaceutical preparations]. AB - Authors studied the weight deviations allowed by non-statistically constructed individual and average weight requirements of Pharmacopoeas under consideration of normal Gaussian distribution. Normality was examined on a given suppository product and has been established, that in this case theoretically the hypothesis of normal distribution is not valid. For this reason deviation characteristics calculated according to the severest and the lightest Pharmacopoean requirements have been presented, i.e. the lower limit (if the deviation is less than this limit, the preparation meets the requirements by all means), and the upper limit (if the deviation is larger than this limit, the preparation definitively does not meet the requirements) respectively. Moreover, deviation characteristics calculated for continuous Gaussian distribution and for discrete distribution with few elements (representing a good approximation of the former) are given in the paper. On the basis of these results authors suggested to modernize the requirements of Pharmacopoeas and to continue research work in this direction. PMID- 1785358 TI - [Formulation and analysis of suppositories containing papaverine hydrochloride. Part 1. Choice of the optimal vehicle and determination of the physical parameters of the suppositories]. AB - Suppositories containing 0.10 g papaverine hydrochloride were made with moulding technology to produce spasmolytic effect. The optimal vehicle was tried to be found for these suppositories. During the experiments 12 different suppository masses were used, including lipophil and lipohydrophil vehicles as well as vehicles with low and high hydroxyl numbers. Five different kinds of physical parameters were determined: melting and drop points, disintegration and special penetration times and breaking hardness. The physical parameters of suppositories without active substance and containing papaverine were examined separately. After 6 months of storage the greater part of the masses showed unfavourable changes (after-hardening, increase of the disintegration time, etc.). In the end the Estaram 299 mass, a triglyceride type of mass with a low hydroxyl number was found satisfactory in every respect, either in itself or combined with 5% Estasan neutral oil. PMID- 1785359 TI - [Formulation and analysis of suppositories containing papaverine hydrochloride. Part 2. In vitro membrane diffusion studies]. AB - Rectal suppositories with 0.10 g/2.0 g Papaverine hydrochloride content were made with 12 different vehicles. The membrane diffusion method was used to study the factors influencing the in vitro drug liberation. The Polysorbate 20 and 61 tenside pair, the optimal concentration of which was 5% each, was found to influence diffusion favourably. Neutral oils softening the consistency (Miglyol 812 and Estasan), similarly in 5%, also had a favourable effect on the in vitro diffusion by increasing the spreading properties. As to the lipophil suppository masses with high and low hydroxyl numbers, only the latter could be used favourably. The 6-month-long storage resulted in drug retention in several experimental series. Correlation was found in several cases between the physical parameters of the suppositories and their in vitro drug liberation. Finally, with the help of linear regression calculation and in view of the in vitro relative bioavailability values the optimal vehicle is suggested for the formulation of suppositories containing Papaverine hydrochloride. The triglyceride type Estaram 299 was found to be the most suitable in every respect, either in itself or combined with 5% neutral oil. PMID- 1785360 TI - Constituents and biological activity of Bidens pilosa L. grown in Egypt. AB - Column chromotography and preparative TLC of the light petroleum-diethyl ether extract from Bidens pilosa L. afforded tridecapentyn-1-ene, trideca-2,12-diene 4,6,8,10-tetrayne-1-ol, trideca-3,11-diene-5,7,9-triyne-1,2-diol and trideca-5 ene-7,9,11-triyne-3-ol. The compounds were identified on the bases of UV, 1H-NMR spectra and comparison with reported data. The chloroform extract was chromatographed to yield B-amyrin, phytosterin-B, esculetin and B-sitosterol glucoside. The petroleum ether extract afforded long chain ester, saturated hydrocarbon, long chain alcohol, B-amyrin, phytosterin-B, lupeol and lupeol acetate. GLC analysis of the fatty acids indicated the presence of 5 acids. The antimicrobial test was carried out to indicate an evident activity. The antidiabetic activity showed non significant decrease of blood glucose. PMID- 1785361 TI - [Idiopathic edema, tubular metabolism of water and sodium]. AB - PURPOSE: To look for intrinsic changes in renal tubular water and sodium metabolism in idiopathic edema (IE), independent of the underlying hormonal and vascular defects. DESIGN: Prospective controlled study in patients with edema referred to a nephrology clinic. PATIENTS: Ten female patients with IE were compared with a control group of 4 healthy women. MEASUREMENTS AND RESULTS: Patients and controls were submitted to a base-line test of water loading and lithium clearances, after 12 hours supine position, to study renal tubular handling of Na and H2O in different nephron sites and 5 h water excretion capacity. Patients were then randomized in 2 groups, both receiving standard treatment during 2 months (low-salt diet--70 to 90 mEq of Na per day, stopping diuretics and laxatives, elastic stockings). Group B received in addition carbidopa/levodopa 25/100--3 tabs/day and captopril 6.25 mg q 8 h. At the end of this 2 months period the base-line tests were repeated. We registered a good clinical response, with an average a.m. weight reduction of 2.8 kg and a decrement of the a.m. to p.m. weight gradient from 2.42 +/- 0.3 kg pre-treatment to 0.6 +/- 0.1 kg afterwards. From the several measurements obtained, only global FENa and Proximal Fraccional Reabsorption of Na were significantly different between patients and controls (0.87 +/- 0.09% vs 2.1 +/- 0.2%, p less than 0.001 and 77.4 +/- 2.9% vs 64.0 +/- 3.5%, p = 0.02 respectively), with no difference in distal Na and H2O reabsorption or water excretion capacity. Two months treatment only partially corrected global FENa, and there were no differences in the clinical and physiological effects between the 2 therapeutic groups. CONCLUSIONS: 1--In the absence of orthostatism, H2O and Na metabolism is similar between IE patients and healthy controls, only with an increased selective proximal Na reabsorption in patients. 2--Standard non-pharmacologic therapy was a clinical success, but didn't correct the physiological defect of excessive proximal sodium reabsorption. Treatment results were not improved by pharmacologic intervention. PMID- 1785362 TI - [Lupus band test: diagnostic value in disseminated lupus erythematosus]. AB - By direct immunoflurescence, deposits of immunoglubins and complement were investigated at the dermal epidermal junction in skin specimens from 210 patients divided into three groups: A--134 patients without lupus; B--54 patients with Systemic Lupus Erythematosus (SLE); C--22 patients with Discoid Lupus Erythematosus. Twenty two patients from group B were submitted to renal biopsy: 20 of these demonstrated a positive lupus band test and data suggested a positive correlation between the intensity of immunoglobulin and complement deposition at the dermal epidermal junction with more severe renal involvement. The other 32 patients were not submitted to renal biopsy; in sediment and band test, may be of value in the prevision of patients with higher probability of developing more serious renal lesions. Our results revealed a high specificity (85.5%) and sensitivity (87%). Test positivity was uninfluenced by steroid and immunosuppressive therapy. The test appears to be of great interest for use on all patients who fail to meet the criteria for the diagnosis of SLE but whose condition suggest such a diagnosis. PMID- 1785363 TI - [Evolution of the detection of interventricular septal defect]. AB - From 24.10.1969 to 31.12.1986, seventeen years, 1274 infants and children with proven isolated ventricular septal defect were observed and followed in Pediatric Cardiology of Santa Marta Hospital. There were 659 males and 615 females, ranging from 3 days to 12 years, born in portuguese territory and without syndromes. As early detection and referring is crucial to prevent pulmonary vascular disease with fixed pulmonary arterial resistance, the annual variation of the referring age was studied. The results improved since 1972 with a steady faster improvement during the last 7 years of the study. PMID- 1785364 TI - [Structural changes in pulmonary vessels and coronary arteries in hypoplastic left heart syndrome]. AB - In order to correlate gross morphological features with pulmonary and coronary vasculature changes in hypoplastic left heart syndrome (HLHS) 15 heart-lung necropsy specimens from neonates were analysed. Histology of left atrium wall, lung vessels with pulmonary arteriolar disease morphometric grading, study of intra and extra pulmonary wall veins and coronary arteries were recorded. Classic HLHS was observed in 11, and DORV with mitral atresia in 4, the foramen ovale (FO) being the only left atrium outflow tract in all. All specimens had increased % of thickness and muscular extension of arterioles and increased wall thickness of pulmonary veins, but severer arteriolar and venous changes with left atrium fibrosis were noticed in 8 specimens with either closed FO (3 cases) or mean FO diameter (d) of 5 mm when compared with specimens with mean FOd of 9 mm. Coronary arteries histology disclosed in 4 of 8 specimens with opened but hypoplastic mitral valve, intima proliferative changes with lumen narrowing, not observed in 7 specimens with mitral valve atresia. We concluded that in HLHS closed or restrictive FO and permeable mitral valve may predispose neonates to respiratory complications, right ventricle abnormal function and arrhythmias, specially after cardiac surgery. PMID- 1785365 TI - [Surgical management of acute, malignant obstruction of the left colon with colostomy]. AB - One-stage subtotal colectomy of an acutely obstructed left colon would improve quality of life while shortening the length of hospitalization. Prohibitive mortality rates, however, are ascribed to such an approach. Analyzing the Senior Author's experience we compared the one-stage approach versus the multi-stage resections concerning operative mortality and morbidity rates and the duration of hospitalization. Forty-nine of 291 (17%) large bowel cancers presented acute left sided obstruction requiring emergency surgery. Colostomy alone was performed in 18 (37%), multi-stage colectomy in 20 (41%, Group A) and one-stage subtotal colectomy in 11 (22%, Group B, all of them after 1979), the years under scrutiny being from 1973 through Sept. 1990. Both groups were comparable in age and sex distribution, TNM staging and ASA classification. Operative mortality and morbidity rates were 10% and 30% in Group A, 9% and 18% in Group B, respectively. The average length of hospitalization was 21.25 days (14-30) in Group A, 9.18 days (7-14) in Group B. Whenever an experienced surgical team is available and in the absence of contra-indications (local factors precluding a swift dissection, hemodynamic instability, gangrenous bowel) a one-stage subtotal colectomy, taking advantage of a better healing ileo-sigmoid or ileo-rectal anastomosis, carries acceptable mortality and morbidity rates while enhancing the quality of life and shortening the length of hospitalization. It should be considered the choice procedure, provided selection requirements and technical demands are met. An evaluation of the Senior Author's team experience (1973-90) in the management of acutely obstructing left colon cancer (49/291 or 17%) provides information on multi-stage resections and one-stage subtotal colectomy (Group A and B) as regards operative mortality (10% in Group A, 9% in Group B) as well as length of hospitalization (21 days in Group A, 9 days in Group B).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785366 TI - [Viral infections in intravenous drug addicts. Clinical and prognostic significance]. AB - A retrospective analysis of 135 drug addicts followed between 1986 to 1987, was done, in order to asses the seroprevalence of hepatitis B virus (HBV), hepatitis Delta virus (HDV), hepatitis C virus (HCV) and Human Immunodeficiency virus (HIV), as also their clinical and prognostic significance. A high prevalence of HBV, HDV and HCV infection was observed in this study: 81%, 64% and 83% respectively; in contrast just one case was positive for HIV. Among the drug addicts the frequency of multiple infections (HBV/HCV 51.6%; HBV/HDV/HCV 18.7%; HBV/HDV 2.2%; HCV/HIV 1.1%) was highest in comparison with isolated (HBV 5.5%; HCV 12.1%) or absent infection (73.6% vs 17.6% vs 8.8% respectively; p less than 0.001). Eleven of 12 (92%) patients with Delta hepatitis and HCV superinfection were seronegative for IgM anti-HD; in contrast the case without HCV superinfection was IgM anti-HD positive. In the former group the Alanine Amino transferases (ALT) were significantly lower comparatively with those HBV positive patients superinfected by HCV (97 +/- 92 IU/L vs 249 +/- 125 IU/L; p = 0.001), and were not different from drug addicts with isolated HCV infection (62 +/- 49 IU/L). The results of this study indicate, a low prevalence of HIV infection in the Portuguese drug addicts and a high frequency of multiple HBV, HDV and HCV infection in the same period of study. Our observations suggest that HCV may have the capacity to inhibit the replication and pathogenic activity of hepatitis Delta virus. PMID- 1785367 TI - Depression at sea. AB - Depressive symptoms were significantly higher (p less than 0.01) in married sailors undergoing a military training voyage compared to their unmarried colleagues. The results are discussed. PMID- 1785368 TI - [Pseudotumoral reaction to barium used as contrast media in acrylic cement]. AB - After some considerations about the importance of biomaterials in orthopedic surgery, the authors report a clinical case of a 72 years old male who had a cemented total hip replacement 17 years before and developed a mass against barium in the right pelvis. PMID- 1785369 TI - [Paranoia disorder as the first manifestation of AIDS]. AB - Psychotic features resembling those seen in a functional psychosis--Delusional Disorder--were found in a forty two-year-old male eighteen months before a diagnosis of A.I.D.S. was made. The causal relation between the two entities is discussed making reference to five other similar cases described in the literature. PMID- 1785370 TI - [The role of stents in endovascular surgery]. AB - Stent appears as the most recent and revolutionary acquisition in Endovascular Surgery. It represents the percutaneous permanent placement of a Vascular prosthesis. We discuss its background and evolution, the several types as well as some of its characteristics as biocompatibility, trombogenicity and biomechanics. We also describe practical aspects concerning the placement procedure. It is also discussed the present day prespectives and the future. PMID- 1785371 TI - Calcium-deficient diet in ovariectomized dogs limits the effects of 17 beta estradiol and nandrolone decanoate on bone. AB - Postmortem measurements by dual-photon absorptiometry of the femur and the second lumbar vertebra in adult dogs indicated bone loss after ovariectomy, which was more pronounced when calcium-deficient diet was given in ovariectomized dogs. This bone loss was nonhomogeneous throughout the femur. Ovariectomy resulted in trabecular and cortical bone loss, and additional calcium-deficient diet resulted in a further highly significant trabecular bone loss at the proximal epiphysis of the femur and in the vertebra. This bone loss was presumably the result of increased bone turnover, as reflected by the highly significant increase in serum alkaline phosphatase. Estrogens could only partially prevent the bone loss induced by calcium deficiency after ovariectomy, and nandrolone decanoate was not effective. We conclude that (1) ovariectomy results in bone loss in adult dogs, (2) this bone loss is more pronounced after calcium-deficient diet, (3) calcium deficiency could be a limiting factor for the preventive effect of estrogens and nandrolone decanoate, and (4) dual-photon absorptiometry allows the evaluation of nonhomogeneous bone loss throughout excised bones. PMID- 1785372 TI - Calibration of dual-energy x-ray absorptiometry for bone density. AB - Bone mineral content (BMC, g) using DEXA (Lunar DPX) was measured on known hydroxyapatite samples in a water bath in the presence of uniform and nonuniform covering of fat-equivalent materials. Selective placement of paraffin over bone had a greater effect than lard in reducing apparent BMC, and polycarbonate plastic had a lesser effect. Measured BMC was 100.1 +/- 1.1% of actual hydroxyapatite weight when (1) fat over bone was about twice the mass of hydroxyapatite, and (2) the surrounding soft tissue was 15-30% fat. There was a linear relationship between observed and expected BMC, area (cm2), and bone mineral density (BMD, g/cm2) measured on an aluminum phantom using either the Lunar DPX or the Hologic QDR-1000. The measured area with the two densitometers was identical, but BMC differed. For both an anthropomorphic phantom and human subjects, use of a constant-threshold (0.2 g/cm2) edge-detection algorithm excluded less low-density bone from the transverse processes than the standard DPX edge-detection algorithm. Differences in edge detection could influence the results obtained with phantoms and in vivo and make system intercomparison difficult. PMID- 1785373 TI - Evidence for interleukin-1 beta production by cultured normal human osteoblast like cells. AB - To determine if bone cells produce interleukin-1 beta (IL-1 beta), a potent bone resorption-stimulating agent, we studied well-characterized, nearly homogeneous cultures of normal human osteoblast-like (hOB) cells. With four strains of such cells, vehicle-treated cultures produced minimal IL-1 beta (mean +/- SEM, 1.3 +/- 0.3 pg/ml per 10(6) cells per 24 h) and showed dose-dependent (r = 0.99) increases to 2.2 +/- 0.7, 5.0 +/- 0.9, or 17.8 +/- 6.7 pg/ml, respectively, after treatment with lipopolysaccharide (LPS) at 3, 10, or 30 micrograms/ml (for increases after 10 and 30 micrograms/ml treatments, P less than 0.05). After treatment with tumor necrosis factor alpha (TNF-alpha) at 10 U/ml, IL-1 beta increased to 16.2 +/- 3.7 pg/ml (P less than 0.05). Neither 17 beta-estradiol nor bovine parathyroid hormone(1-34) (each at 10 nM), alone or in combination with LPS or TNF-alpha, affected IL-1 beta release. Northern blot analysis of total cellular RNA preparation revealed a single hybridization band at 1.9 kb when probed with a partially deleted cDNA for human IL-1 beta. The steady-state IL-1 beta mRNA levels showed a significant increase with LPS treatment and a lesser increase with TNF-alpha treatment in hOB cells. Moreover, TNF-alpha produced an even greater increase in IL-1 mRNA in HOBIT cells, a well-differentiated clonal cell line derived from normal hOB cells transfected with the SV40 large T antigen. We conclude that human cells of the osteoblast lineage produce IL-1 beta in response to well-recognized stimuli for IL-1 release from responsive tissue.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785374 TI - Interleukin-1 alpha stimulates the release of prostaglandin E2 and phospholipase A2 from fetal rat calvarial cells in vitro: relationship to bone nodule formation. AB - We have shown previously that interleukin-1 (IL-1) has biphasic effects on the formation of bone nodules in long-term cultures of fetal rat calvarial (RC) cells (Ellies and Aubin, Cytokine 2:430-437, 1990). To determine the role of arachidonic acid metabolism in this process, we have examined the release of prostaglandin E2 (PGE2) and phospholipase A2 (PLA2) from RC cells under conditions that allowed concomitant analysis of the formation of bone nodules. Recombinant human IL-1 alpha (rhIL-1 alpha) stimulated PGE2 and PLA2 release in a time- and dose-dependent manner. PGE2 release was highest in preconfluent cultures (days 1-6) and was stimulated up to 8.5-fold in response to 50 U/ml of rhIL-1 alpha. In contrast, extracellular PLA2 activity was maximal in postconfluent cultures, with 50 U/ml of rhIL-1 alpha causing a 20-fold increase by day 15. PLA2 release by RC cells was not significantly affected by PGE2, the glucocorticoid dexamethasone, or the cyclooxygenase inhibitor indomethacin. Indomethacin partially blocked the inhibition of bone nodule formation caused by rhIL-1 alpha, and exogenous PGE2 reversed this effect. Addition of group I PLA2 from Naja naja venom to RC cells had no effect on bone nodule development; however, group II PLA2 from Crotalus adamanteus venom inhibited the formation of bone nodules in a dose range similar to that induced by rhIL-1 alpha. These results indicate that PGE2 release does not have a direct temporal correlation with increases in PLA2 activity. In addition, the data show that only part of the inhibition of bone formation seen with rhIL-1 alpha is mediated by PGE2 and suggest that extracellular PLA2 also accounts for part of the inhibition. PMID- 1785375 TI - Uptake of fluorine in cortical and trabecular bone. AB - Nuclear magnetic resonance techniques can measure the fluoride levels in bone of the finger after a patient has ingested F in the treatment of osteoporosis, but does uptake in cortical bone reflect uptake in the critical trabecular bone? Investigation has been made of the relative uptake of fluoride from drinking water into trabecular and cortical bone of the rat. For fine detail of the uptake of F into the femur and vertebra, microprobe techniques were used with a spatial resolution of 10 microns; for broader studies, treating the femur as representative of cortical bone and the vertebra as typical of trabecular bone, chemical techniques using spectroscopy and ion-selective electrodes were employed. The conclusion is that in the rat uptake of F by cortical bone is indicative of uptake by trabecular bone, and that therefore as a working hypothesis NMR measurement of F in the finger may be taken as reflecting uptake of F by trabecular bone. PMID- 1785376 TI - Risk factors for hip fractures in men: a preliminary study. AB - Although hip fracture rates are higher in women than in men, for older men the lifetime risk of fractures of the femur is substantial. Very little is known about risk factors for hip fracture in men. A preliminary case control study was conducted comparing the medical charts of men with first hip fractures with two sets of age-matched controls. The major risk factors for hip fracture that emerged were preadmission ambulatory problems, confusion, heavy alcohol use, and low body mass. Although this study is limited to a medical chart review in a veteran population, these results confirm some of the known associations for hip fracture in women. Further studies in men are recommended. PMID- 1785377 TI - A new approach to defining normal vertebral dimensions. AB - We developed a method for estimating the mean and standard deviation of ratios of normal vertebral heights from a sample that includes people with and without vertebral fractures. This method assumes that the measurements in normal vertebrae have a Gaussian distribution and that, for any vertebral level, the prevalence of abnormal measurements is less than 10%. Under these assumptions, normal values for nonfractured vertebrae can be estimated from several statistical properties of Gaussian distributions. We applied these methods to the lateral spinal radiographs of 2992 women aged 65-70 years who were recruited from population-based listings. The estimated means and standard deviations for ratios of dimensions in nonfractured vertebrae were very similar to those based on studies of premenopausal women. Our method may be useful for defining normal values from large populations that include normal and abnormal women, does not require x-rays of normal premenopausal women, avoids the potential biases of defining normality based on qualitative judgment, and can be applied to other types of physical and biochemical measurements. PMID- 1785378 TI - Nonhypercalcemic 1,25-(OH)2D3 analogs potently induce the human osteocalcin gene promoter stably transfected into rat osteosarcoma cells (ROSCO-2). AB - 1,25-Dihydroxyvitamin D3 [1,25-(OH)2D3] is the active hormonal form of vitamin D3 and has potent effects on bone and calcium regulation. Over the past decade it has become apparent that 1,25-(OH)2D3 has other effects on cellular proliferation that potentially could be developed for therapy in human malignancy. Since the hypercalcemic effects of 1,25-(OH)2D3 have limited that use in the human, novel nonhypercalcemic analogs of 1,25-(OH)2D3 have been synthesized. The molecular mechanism of this divergence in these antiproliferative and calcium-regulating actions is unexplained. We have previously examined the human bone-specific gene osteocalcin as a model of the molecular mechanisms of vitamin D action in bone and have shown that induction of the osteocalcin gene by 1,25-(OH)2D3 is mediated through an unique and complex palindromic region of the promoter similar to but distinct from those of other steroid hormone-responsive elements. Using an osteosarcoma cell line permanently transfected with the vitamin D-responsive promoter of the human osteocalcin gene linked to a "reporter" gene, we have shown that there is a dose-dependent induction of CAT activity by 1,25-(OH)2D3 and that the potencies of vitamin D metabolites and analogs are comparable to those found in other vitamin D bioassays. Furthermore, vitamin D analogs, including MC-903, 22-oxa-1,25-(OH)2D3, and delta 22-1,25S,26-trihydroxyvitamin D3, which effect cellular differentiation but lack hypercalcemic activity in vivo, exhibit osteocalcin promoter inductive actions virtually identical to those of 1,25 (OH)2D3. Consideration of these and other data support the hypothesis that the divergent effects of such analogs on differentiation and calcium homeostasis reflect pharmacokinetic differences in vivo rather than distinct 1,25-(OH)2D3 sensitive pathways. PMID- 1785379 TI - [Current status of adjuvant chemotherapy of invasive bladder cancer]. AB - The current status of adjuvant chemotherapy for clinically localized but invasive transitional cell carcinoma of the bladder is reported. Since 1986, a prospective randomized study has been conducted to examine the effects of neoadjuvant cyclophosphamide + doxorubicin + cisplatin (CAP) and radiation therapy for T2-3N0 3M0. A total of 47 patients were entered. However, 4 patients were excluded from the study. All eligible patients were randomized into two groups: neoadjuvant CAP plus radiation and control group. In the neoadjuvant treated-group, a 55% complete response plus partial response rate and a 88% downstaging were noted. Both the 12- and 36-month disease-free survival rates of neoadjuvant treated group were 94.7%, and were higher than those of the control group (p less than 0.1). As for T4N0-3M0 cases, a total of 6 patients were treated with neoadjuvant methotrexate + vinblastine + doxorubicin + cisplatin (M-VAC) therapy. Favorable results were not obtained in this study at this point, because full dose M-VAC and planned recycling were not performed sufficiently. These findings suggests that neoadjuvant CAP plus radiation therapy would be useful for T2-3 invasive cancer of the bladder. Methods to administer full dose M-VAC; such as developments of new chemotherapeutic agents and of new anti-toxic agents, should be developed. In addition, a more successful regimen than M-VAC should be considered for T4 localized invasive bladder cancer. PMID- 1785380 TI - [Current status of the conservative treatment of urinary bladder for invasive bladder cancer]. AB - During the 3 years from 1987 to 1990, we gave hyperthermia to 11 of the patients who visited our department for the treatment of invasive bladder cancer. Results and prognosis are reported. Stage and grade of the cancer before the treatment in 11 cases were T2 in 5 cases, T3 in 3 cases, T4 in 3 cases, transitional cell carcinoma (TCC) grade 2 in 8 cases, TCC grade 3 in 2 cases, and TCC grade 3 + anaplastic carcinoma in 1 case. Complications were observed in 8 of the 11 cases, such as severe heart disease and others. Pretreatment of radiation therapy, transurethral resection or chemotherapy was given in all cases. Hyperthermia was performed combined with hydroxypropyl cellulose-(HPC)-adriamycin, or radiation therapy, and the following results were obtained: complete response (CR) in 4 cases, partial response (PR) in 4 cases, no change (NC) in 2 cases and progressive disease (PD) in 1 case. Among 4 cases of PR, total cystectomy was performed in 3 cases. These 3 cases and the 4 cases of CR are alive now, but the other 4 patients died. PMID- 1785381 TI - [A clinical survey of advanced bladder cancer: treatment of advanced and non resectable bladder cancer]. AB - Sixty-three patients with advanced cancer of more than T3b and/or non-resectable bladder cancer who were treated at Kanazawa University Hospital from January 1982 to June 1990 were analyzed with regard to treatment and prognosis. Thirty-one of the 63 patients had non-resectable bladder cancer; T3b in 9, T4b in 15, M1 in 6 and N4 in 4. Twenty-four of the 31 patients received anticancer therapy consisting of systemic chemotherapy, 8 MHz-RF hyperthermia, radiation or a combination of these modalities. With this treatment 9 patients achieved partial response, 4 minor response, 7 no change and 2 progressive disease. In 2 patients evaluation was not performed. Seven of the 31 patients received no treatment. One year and 2-year survival rates with the above types of treatment were 27.7% and 16.7%, respectively, and 33.4% and 16.7%, respectively, without anti-cancer treatment. There was no significant difference between the survival rates of the two groups. Thirty-two of the 63 patients underwent operation. In 17 patients, total cystectomy was carried out, 9 and 8 of whom received and did not received respectively various adjuvant therapies before operation. One-year and 2-year survivals in the group undergoing adjuvant therapy were 33.3% and 11.1%, respectively, and 66.7% and 66.7% respectively in the group without adjuvant therapy. Survival of the 2 groups did not differ significantly. These data indicate that anticancer treatment including chemotherapy, hyperthermia and radiation dose not enhance long-term survival. PMID- 1785382 TI - [Incontinent urinary diversion]. AB - We analyzed 237 patients who underwent total cystectomy with ileal conduit urinary diversion or cutaneous ureterostomy at the Center for Adult Diseases, Osaka. One-hundred and eighty-eight patients underwent ileal conduit diversion and 49 patients underwent cutaneous ureterostomy. No patient died within 30 days after the operation, but two patients who underwent ileal conduit diversion died of postoperative complications within 2 months. Early complications occurred in 94 patients (50%) in the ileal conduit group and in 18 patients (37%) in the ureterostomy group. Late complications occurred in 85 patients (45%) in the ileal conduit group and in 23 patients (47%) in the ureterostomy group. Frequent early complications in the ileal conduit group were wound infection (29%), and intestinal complications (13%) which included ileus and upper urinary tract complications (12%). The most frequent late complications were stomal complications (26%) which included peristomal dermatitis stomal stenosis, parastomal hernia, and stomal prolapse, and upper urinary tract complications which were noted in 27 patients (14%). PMID- 1785383 TI - [Current status of continent urinary reservoirs for invasive bladder cancer patients undergoing total cystectomy]. AB - Continent urinary reservoirs (CUR) have become one of the major options of urinary diversion for invasive bladder cancer patients who require cystectomy and cutaneous urinary diversion. We have experienced 100 cases of Kock pouch and 30 cases of indiana pouch during the past 5 years which comprise 45% of all cases. Standard ileal conduit and ureterocutaneostomy were performed in 34% and 20%, respectively, and orthotopic urinary reservoir by hemi-Kock pouch was done in only one case during the same years. There were 3 perioperative deaths, 2 had Kock pouch and one Indiana pouch. Early postoperative complications were not substantial. However, significantly high rates of late postoperative complications were seen in Kock pouch, i.e., both efferent (18%) and afferent (13%) nipple valves and stone formation (18%). Uretero-ileal anastomosis by hammock method done in 10 cases resulted in success in 8 cases, abolishing the afferent nipple. Indiana pouch, in which no nipple valves or foreign materials like staples or collars are necessary, has been adopted as a first choice for the past 3 years. Of 29 evaluable cases, Heineke-Mikulicz method was used in 7 cases, and ileal patch method in 22 cases. An hourglass-like deformity was seen in 2 cases in the former method. Severely difficult catheterization, parastomal abscess, and acidosis occurred in one. Overall, 24 cases (83%) have come up with satisfactory results with minimal overflow incontinence in the early postoperative course. Although much longer followup is necessary, CUR's by Kock or Indiana pouch are more acceptable by bladder cancer patients requiring cystectomy. PMID- 1785384 TI - [Present status on bladder replacement--colon bladder replacement]. AB - Bladder replacement using a detubularized right colonic segment was successfully performed on 22 male patients with bladder cancer after radical cystectomy. There were 10 early postoperative complications and one of them required reoperation. Urodynamic studies, performed on 16 patients, showed a low pressure reservoir at a large capacity without any involuntary spikes in every case. Of the 16 patients, 4 were nocturnally enuretic and 1 was partially continent. The other 11 patients (68.8%) were totally continent and voiding well, except one who was on intermittent self-catheterization. The incidence of urinary reservoir infections in patients treated with colon bladder replacement was investigated in 18 patients. The incidence rate of bacteriuria was 5.6% and the positive rate of pyuria was 27.8%. The detection rate of bacteriuria and pyuria was significantly low in patients after colon bladder replacement. These findings indicate that colon bladder replacement can be an ideal option for selected patients with bladder cancer. PMID- 1785385 TI - [Experience of extracorporeal shock-wave lithotripsy for the urolithiasis in horseshoe kidney]. AB - At Osaka City University, 1,987 patients with urolithiasis have been treated by extra-corporeal shockwave lithotripsy (ESWL) during a four-year period. We treated 5 patients with horseshoe kidney and the obtained results were analyzed retrospectively. Three of these patients, who had a solitary stone could successfully be treated by ESWL as monotherapy. One who had multiple stones required transurethral lithotripsy after ESWL due to stone-street. The remaining 1 patient who had undergone heminephrectomy developed perirenal hematoma after ESWL, which spontaneously disappeared without any specific treatment. We discuss the special care related to the use of ESWL in the horseshoe kidney. PMID- 1785386 TI - [Evaluation of the results of extracorporeal shock-wave lithotripsy (ESWL) for solitary upper urinary tract stone]. AB - We performed extracorporeal shock-wave lithotripsy (ESWL) on 1,701 patients in a total of 2,438 sessions using the Dornier kidney lithotriptor Model HM III from July 1985 to the end of June 1990. Among the patients with a solitary stone, 1,200 cases were available for the follow-up study in which the results of ESWL were analyzed according to the location and size of the stone. ESWL performed against stones at pelvis and calyces gave the best results. The results obtained on stones less than 20 mm in diameter were especially favorable with a success rate of 84%. ESWL performed against ureter stones showed poor results with a success rate of 62% for the stones smaller than 20 mm in diameter. We further studied the results of ESWL performed against ureter stones by dividing the patients into three groups: the patients treated in situ, the patients with ureteral stents and the patients with D-J stents. The results for stones larger than 10 mm in diameter were significantly better in the patients with D-J stents than in the patients treated in situ or the patients with ureteral stents. Among the patients treated in situ, the results were significantly worse for impacted stones than for non-impacted stones when the stone size was 10-20 mm in diameter. PMID- 1785387 TI - [Identification of effective region of the pons in response to inaperisone which facilitates urine storage]. AB - To identify the effective region of the pons in response to inaperisone which facilitates urine storage, inaperisone (100 mM, 0.2 microliters) was injected into the nucleus locus coeruleus alpha (LCa, the pontine micturition center), the nucleus locus subcoeruleus (LSC, the pontine urine storage center) and the nucleus reticularis pontis oralis (PoO, micturition inhibitory region) of the decerebrate cats. On reflex micturition, inaperisone injection into the LSC decreased voiding volume, and increased residual volume and bladder capacity, significantly. However, there was no difference in the maximum bladder pressure before and after inaperisone injection into the LSC. Inaperisone injection into the LCa or the PoO had no influence on reflex micturition. These results suggest that effective region of the pons in response to inaperisone is the LSC, and that inaperisone facilitates the urine storage neural mechanism in the LSC. PMID- 1785389 TI - [Urological management for stroke patients; relation between brain lesions and establishment of micturitional modality]. AB - A total of 154 stroke patients, 96 males and 58 females, were analyzed to establish the micturitional modality according to the type of detrusor function and the level of activities of daily living (ADL). All patients had only one episode of stroke attack and were checked at least one month after the onset. Localization of cerebral lesion in each patient was evaluated by neurological findings and cerebral angiography in addition to computed tomography of the brain. In the patient groups classified according to the type of detrusor function, micturitional modality was established in 50% of the patients with the underactive type, 70% of those with the overactive type and in 88% of those with normal function. This suggests that the overactive and normal type of detrusor function may not affect establishment of micturitional modality. On the other hand, when classified according to the level of ADL, none established micturitional modality in patients with poor ADL. By contrast, in the patients on higher levels of ADL who were able to transfer themselves from or to a wheel chair without any assistance it was established in 75%, and in those who were able to gait with or without a brace upon discharged from the hospital, in 91%. It is concluded that establishment of micturitional modality in stroke patients is closely related to the level of ADL or function of lower extremities, but not to localization of the brain lesion. PMID- 1785388 TI - [Study of the combined M-VAC therapy in invasive bladder cancer]. AB - We carried out combined M-VAC therapy in 12 patients with invasive bladder cancer without metastatic foci, and studied mainly the pathohistological findings and side effects before and after chemotherapy. There were 9 male cases and 3 female cases who were between 53 and 76 years old, and 66 years old on the average. After admission, 1 or 2 courses of M-VAC therapy were performed after confirmation of the pathological tissues by transurethral resection of bladder tumor (TUR-BT), and then total cystectomy (in 6 cases) or TUR-BT (in 6 cases) was conducted after 15 days on the average. According to the combined M-VAC therapy, down-stage was noted in 6 cases (50%) and down-grade in 6 cases (50%). Side effects such as anorexia, nausea and leukopenia were noted in all cases, and depilation, vomiting and thrombopenia were frequently noted. However, all these cases were transient without any serious trouble. The usefulness of the combined M-VAC therapy in invasive bladder cancer was proven, and the possibility of elevating the therapeutic response by surgery with lesser invasion was suggested. PMID- 1785390 TI - [Multivariate analysis of prognostic factors in patients with prostatic cancer]. AB - A multivariate statistical analysis of 9 potential prognostic factors was made, using data gathered on 107 patients admitted between 1975 and 1987. After each variable was assessed separately for its prognostic importance by means of univariate analysis, a multivariate analysis using Cox's proportional hazards regression model and multivariate logistic model was done. These tests identified Gleason's score as the most important factor for all patients followed by M category and alkaline phosphatase (ALP), while Gleason's score alkaline phosphatase and age at diagnosis were most important for stage D patients. For short-term survival, the significant prognostic factors were Gleason's score and M category while for long term survival they were Gleason's score and age. T. category, stage, acid phosphatase, prostatic acid phosphatase, and treatment were found to be significantly related to survival time when examined individually; they were not found to be significant in the multivariate analysis. PMID- 1785391 TI - [The effects of antiprostatic agents on the accessory sex organs of rats treated with adrenal androgens]. AB - It is well known that some adrenal androgens are converted into testosterone and dihydrotestosterone which are more powerful androgens than the adrenal androgens. However, most of the experiments to investigate the antiprostatic agents have been done on rats which secrete only a marginal amount of adrenal androgen. A study was performed to investigate the effects of antiprostatic agents on the action of the adrenals in rats. Non-sterodidal antiandrogens flutamide and 1 chloro-2-hydroxy-2-methyl-N-(3,4,5-trichlorophenyl)propanamide (AA560), steroidal anti-androgens, chlormadinone acetate (CMA) and 17 alpha-acetoxy-6-chloro-2 oxapregna-4,6-diene-3,20-dione (TZP-4238) and 5 alpha-reductase inhibitor, sodium (-)-4[2-[2,3-dimethyl-4-[1-(4-isobutylphenyl)ethoxy]benzolamino ] phenoxy]butyrate (ONO-3805) and N-(2-methyl-2-propyl)-3-oxo-4-aza-5 alpha-androst l-ene-17 beta-carboxamide (MK-906) were tested in rats treated with dehydroepiandrosterone sulfate (DHEA-S) and androstenendione (A). In the noncastrated rats not treated with DHEA-S and A, all of these agents decreased the accessory organ weights in a dose dependent manner. In the rats treated with LHRH agonist and DHEA-S and A, all agents (3.3 mg/day) showed similar effects in intact rats. However nonsteroidal antiandrogens and TZP-4238 were stronger than the others. It was not clear whether this effect was mediated through the suppression of adrenal androgen action or the inhibition of physiological increase in testosterone caused by an LHRH agonist. The effects of Flu, ONO-3805, CMA and TZP-4238 on the accessory sex organs were investigated in castrated rats receiving DHEA-S and A.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785392 TI - [Clinical studies on chronic prostatitis and prostatitis-like syndrome. (5) Evaluation of prostatitis complicated by anal disease]. AB - We analyzed the incidence of anal disease in patients with nonbacterial prostatitis (NBP) or with prostatitis-like syndrome (PLS), and evaluated the clinical efficacy. The complicated rate of anal disease in these patients was 29.7% (31.8% for NBP and 28.1% for PLS), and the overall incidence of active anal disease was 15.4% (16.2% for NBP and 14.8% for PLS), it yielded a significantly higher complicated rate than other urological disease (p less than 0.01). The most common type of anal disease was hemorrhoids, especially piles. The clinical cure rate for anal disease in NBP patients was 71.4%, and in PLS patients was 58.2%. The high incidence of hemorrhoids (especially piles) was in these patients by clinico-statistical observation suggests that the development of anal disease may be etiologically correlated with NBP and PLS. Furthermore, we noted that Kampo treatment (Keisibukuryogan) was useful in the treatment of prostatitis complicated by anal disease, especially when combined with anti-hemorrhoidal suppositories against active anal disease in PLS patients (p less than 0.05). PMID- 1785393 TI - [Clinical studies on prognostic factors in predicting pregnancy]. AB - During the 5-year period from January 1984 to December 1988, 1,025 men were investigated for infertility. The patients were classified according to WHO laboratory manual. Using life-table analysis, WHO's classification of semen analysis was a useful discriminant for infertility prognosis. The Cox's multiple regression model was employed to investigate the relationship between various semen characteristics and future fertility. The duration of infertility, sperm concentration, sperm progressive motility, the presence of female factor were independent and statistically significant factors which influence the cumulative probability of conception. PMID- 1785394 TI - [Inverted papilloma of the renal pelvis]. AB - A 60-year-old man with inverted papilloma of right renal pelvis is presented. On visit to hospital for benign prostatic hyperplasia with prostatic stone, he was found to have microscopic hematuria and intravenous pyelography and retrograde pyelography demonstrated a filling defect with papillary contour. We diagnosed a right renal pelvic tumor, which showed to be low grade because of negative cytology. Therefore, we performed tumor resection with renal preservation. Pathological diagnosis was inverted papilloma. From the Japanese and foreign literature, 16 cases of renal pelvic inverted papilloma were collected. They were reviewed clinically and pathologically, and the therapy was discussed. PMID- 1785395 TI - [A case of renal cell carcinoma similar to rhabdoid tumor of kidney in an adult; trial of radiation and chemotherapy]. AB - We report a case of sarcomatoid renal cell carcinoma in a 30-year-old woman. The pathological findings indicated renal cell carcinoma (solid sarcomatoid and pleomorphic type) similar to malignant rhabdoid tumor of kidney (MRTK). We treated her with combination chemotherapy (vincristine, adriamycin, cyclophosphamide and actinomycin D) and local irradiation after nephrectomy. The number of bone metastatic foci increased and brain metastasis occurred. However, irradiation was effective on each focus. She died 8 months after the operation caused by brain metastasis. We conclude that sarcomatoid renal cancer is highly malignant and chemotherapy-resistant, but radiation may be partially effective. PMID- 1785396 TI - [Simultaneous bilateral renal pelvic tumors: a case report]. AB - A case of simultaneous bilateral renal pelvic tumors is reported. A 64-year-old man with the chief complaint of gross hematuria and left flank pain was admitted. Clinical investigations revealed a tumor in the right pelvis and ureter, and another tumor in the left renal pelvis. The right ureteral tumor had invaded the bladder. Right nephroureterectomy, total cystectomy, left partial pyelectomy and ureterocutaneostomy were performed. By pathological examination, right renal pelvic and ureteral tumors were non-papillary transitional cell carcinoma, grade 3, pT4, and the left renal pelvic tumor was papillary transitional cell carcinoma, grade 2, pT1. To our knowledge, this is the 16th case of simultaneous bilateral urothelial tumors of the upper urinary tract in Japan. PMID- 1785397 TI - [End-stage chronic renal failure in patients treated by antireflux operation]. AB - We report 3 patients progressed to end-stage chronic renal failure after antireflux surgery. Preoperatively, the 3 patients had proteinuria, probably due to reflux nephropathy. Surgical procedures used were Paquin's method in 1 patient and Politano-Leadbetter's method in 2. Rapid deterioration of renal function was observed from puberty in all patients. In addition, renal hypoplasia was suspected in 2 patients. We concluded that both reflux nephropathy and renal hypoplasia played important roles in the progression of renal insufficiency. PMID- 1785398 TI - Emphysematous cystitis: report of a case. AB - Emphysematous cystitis is characterized by gas collection within the bladder wall and lumen. A case of emphysematous cystitis in a 74-year-old diabetic male is reported. Radiogram demonstrated an enlarged bladder with intraluminal gas. PMID- 1785399 TI - [A case of acute bacterial prostatitis caused by gram positive cocci]. AB - This report describes our experience with sulbactam/cefoperazone in the treatment of a 36-year-old man with acute prostatitis (complicated with bilateral epididymitis) caused by S. salivarius. The patient had no past history suggesting the relationship between this organism and the route of infection. The isolated strain exhibited a high susceptibility to the drug and symptoms subsided after treatment with a daily dose of 4 g sulbactam/cefoperazone for 7 days. Usually, the most causative bacteria of acute prostatitis are either GNR or E. faecalis. However, as in the present case, there may be very few cases in which the infection has been caused by a strain of Streptococcus species. PMID- 1785400 TI - [Giant mullerian duct cyst: a case report]. AB - A case of giant mullerian duct cyst is reported. The patient was a 27-year-old male, complaining of microscopic hematuria. A giant cystic abdominal mass was palpable. After screening examination including ultrasound tomography, intravenous pyelography, computed tomography and magnetic resonance-imaging, mullerian duct cyst was suspected. Operation for this cyst was performed with median incision. The cyst measured 25 x 21 x 14 cm. The surface as smooth and consistency was soft. Included fluid was slightly turbid and yellowish measuring 2,200 ml. This was considered to be the largest mullerian duct cyst case reported in the Japanese literature. PMID- 1785401 TI - [A case of testicular torsion in a neonate]. AB - A case of testicular torsion in a neonate is reported. A two-day-old boy with an abnormal hard mass in the right scrotum was referred to us. Right testicular torsion was suspected and operation was performed at 13 days after birth. During the operation extra-vaginal torsion of the right spermatic cord was revealed. The right testis appeared extensively necrotic, and right orchiectomy was selected. Histological examination revealed massively coagulo-necrotic testicular structure. To our knowledge, this is the 56th case of testicular torsion in a neonate reported in Japan. We discussed the onset, laterality, form, direction, angle and treatment of the torsion. PMID- 1785402 TI - [Tunica albuginea cyst: a case report]. AB - A 47-year-old male visited our hospital complaining of painless swelling of the right scrotum. Ultrasonography demonstrated hydrocele and a 13 x 12 x 10 mm cystic space along the margin of the right testis. Hydrocelectomy and simple resection of the cyst were performed. Pathologic examination of the excised cyst showed a serous cyst lined with simple flattened epithelium. Ultrasonography is useful for the diagnosis of tunica albuginea cyst. PMID- 1785403 TI - [A case of idiopathic calcinosis of the scrotum]. AB - We report a case of idiopathic calcinosis of the scrotum. The patient was a 33 year-old male with a complaint of multiple scrotal nodules, from which white chalky materials occasionally broke out. The nodules were first noticed 17 years ago, and since then gradually increased in size and number. Sometimes he had felt itching on the scrotum, but otherwise he had been in good health. Blood analysis and biochemical analysis revealed normal findings. In addition, there were no abnormal findings in serum electrolyte analysis including calcium and phosphate concentrations. Analysis of the intra-nodular content by infrared spectrophotometry showed that it consisted of calcium phosphate (52%) and magnesium ammonium phosphate (48%). We reviewed the literature and discuss the etiology of this disease. PMID- 1785404 TI - [A case of priapism successfully managed by local irradiation]. AB - A 42-year-old man with priapism is reported. The condition did not improve by cavernous body irrigation with heparin, intravenous administration of anticoagulant, or various surgical shunt operations. However, the condition improved after local radiation therapy: a total dose of 6Gy, 1.5 Gy daily for 4 days, was given to a site 24 cm x 24 cm which covered the small pelvic cavity and the femoral area centering around the root of the penis. Improvement of the condition became evident from Day 3 of radiation therapy. For about 1 year since then the patient has been entirely free of recurrence. PMID- 1785405 TI - [Clinical application of Modulith SL20 on extracorporeal shock wave lithotripsy for upper urinary tract calculi]. AB - Thirty-nine patients, 27 males and 12 females with renal and ureteral stones, were treated using the Modulith SL 20 between October 1990 and January 1991. Thirty-three of the 39 cases had a single session of extracorporeal shockwave lithotripsy (ESWL) and the other six cases had two sessions. The pulverization rate of ESWL by this device was 84.6%. According to the X-rays taken 21 days after ESWL, of the 37 cases, 14 (37.8%) were stone-free, 18 (48.7%) had residual sandy stones less than 4 mm in diameter, five (13.5%) had residual stone fragments larger than 4.1 mm in diameter, and two cases were not clear. Using the criterion of cases which can be expected to have spontaneous passage, in other words, residual stones less than 4 mm in diameter, lithotripsy with the Modulith SL 20 was regarded as "effective" in 32 of the 37 cases (86.5%). As side effects of this treatment, hematuria was observed for several days after ESWL in all patients, but not other serious complications were observed. Among the 37 cases in which the grade could be evaluated the evaluation for 24 (64.9%) was "useful" and that for 13 (35.1%) "useful to some extent". Therefore, ESWL was performed very successfully. PMID- 1785406 TI - [Neurogenic bladder in HAM (HTLV-I associated myelopathy)]. AB - Bladder dysfunction is one of the major symptomatologies characteristic to HAM (HTLV-I associated myelopathy). Four patients, 3 females and 1 male, were diagnosed by neurologists to have HAM with spastic gait disturbance and increased titer of antibody to HTLV-I. They complained of urge incontinence, bed wetting, difficulty in micturition and/or pollakisuria. Urodynamically, in 3 of them severe uninhibited detrusor contractions were observed. On the other hand, in one case detrusor contractility was lost completely at voiding. In all patients, bladder sensation was well preserved. Corticosteroids and interferon could not improve their urological symptoms. Clean intermittent catheterization (CIC) put on 3 patients who had a significant amount of residue relieved them of urinary incontinence. We believe that HAM in patients suffering from severe difficulty in micturition is a good indication for CIC. PMID- 1785407 TI - [Study of incidental carcinoma of the prostate. II. Nuclear DNA analysis]. AB - The clinical significance of cytofluorometric nuclear DNA analysis, ploidy pattern and DNA content, was investigated in 47 incidental prostatic carcinomas, 24 stage A1 and 23 stage A2 cases, 9 clinically advanced cases and 25 BPHs. The results were compared to clinical stage and histological differentiation. The mean nuclear DNA content of stage A1 cancer, which was similar to BPH, differed from that of stage A2 cases. The latter was almost identical to that of advanced cases. In moderately and poorly differentiated carcinomas it was higher than that of well differentiated ones. A non-diploid pattern was distributed in 33% of stage A1, 78% of stage A2 and 89% of clinically advanced cases. It was detected in 42% of the well-, 77% of the moderately- and 100% of the poorly differentiated adenocarcinomas. The DNA analysis of incidental prostatic cancer thus correlated well to the clinical and pathological parameters. If limited to well differentiated carcinomas, however, 17% of the stage A1 cases showed an aneuploid, and 29% of the stage A2 cases, a diploid pattern. No diploid pattern was detected in clinically advanced cases. Although we have not been able to prove any difference in prognosis in the present cases, these findings suggest that the nuclear DNA analysis is another parameter in defining the prognosis of incidental prostatic carcinoma. Further follow-up of the patients and accumulation of the data are necessary to determine the clinical validity of this method. PMID- 1785409 TI - [CT-guided biopsy of paraaortic lesions: report of three cases]. AB - Computed tomographic (CT)-guided biopsies of the lesions in paraaortic region were performed for three urologic disease conditions: retroperitoneal fibrosis, lymph node metastases of transitional cell carcinoma of renal pelvis and lymph node metastasis of renal cell carcinoma. The biopsies were performed without complications using the Bard Biopty biopsy gun with a Bard Biopty-Cut needle. Every biopsy specimen we obtained by the Biopty rendered an excellent biopsy core from which a definite histopathological diagnosis was made. CT-guided biopsy is considered to be safe and useful for diagnosis of the disease of the paraaortic region, even when ultrasonography guided biopsy is difficult. The use of the Biopty for CT-guided biopsy provides a high quality specimen for histopathological diagnosis. PMID- 1785408 TI - [A comparison of the quality of life of prostatic cancer patients under slow releasing LH-RH analogue (TAP-144SR Depot) treatment or synthetic estrogen treatment]. AB - The quality of life (QOL) was studied on 31 prostatic cancer (PC) patients, being followed at our out-patient-clinic during a relapse-free period. Fifteen of them were under treatment with a slow releasing LH-RH analogue (TAP-144 SR Depot) (TAP) and the other 16 prostatic cancer patients with synthetic estrogen (Honvan) (DES). The QOL of 37 benign prostatic hyperplasia (BPH) patients on conservative treatment was also studied. Concerning their general feeling of health, the prostatic cancer patients on TAP treatment felt subjectively better than those on DES. The social life of the patients on TAP or those who had BPH was less affected than that of those on DES. The quality of sexual life was worse for the prostatic cancer patients on both TAP and DES treatment than for the BPH patients. PMID- 1785410 TI - [Inferior vena caval resection for renal cell carcinoma: usefulness of renal venous pressure measurement]. AB - Renal cell carcinoma with extended tumor thrombi densely adherent to the vena caval wall sometimes requires vena caval resection. If the tumor is on the right side and the collateral veins of the left renal vein are abundant, vena caval reconstruction may not be required. We recently performed radical nephrectomy and vena caval resection on 2 right renal cell carcinoma patients. To decide the necessity of vena caval reconstruction, left renal vein pressure was measured before and after clamping of the vena cava. In case 1, because the pressure was elevated from 21 cmH2O, to 61 cmH2O, total replacement with Gore-Tex graft was performed. In case 2, because the pressure change was from 22 cmH2O to 23 cmH2O, reconstruction was not performed. The most important test to decide the necessity of vena caval reconstruction is thought to be the change of renal venous pressure before and after clamping of the vena cava. PMID- 1785411 TI - [Removal of renal cell carcinoma extending into the right atrium: report of a case]. AB - A 65-year old man presented with a seven-month history of macrohematuria and left back pain. Abdominal ultrasonography, enhanced computed tomographic (CT) scanning, magnetic resonance imaging (MRI), selective renal angiography and vena cavography revealed a left renal tumor extending into the inferior vena cava and right atrium. Surgery was performed using the cardiopulmonary bypass and the whole tumor was resected grossly except for the tumor invading into the lumbar vein. The patient recovered promptly but died from cancer metastasis six months after operation. PMID- 1785412 TI - [Enucleation performed to treat renal cell carcinoma associated with chronic nephritis: a case report]. AB - We performed enucleation on a patient with renal cell carcinoma associated with nephritis to preserve renal function. The patient was a 40-year-old man diagnosed with chronic nephritis. Ultrasonography performed during brief hospitalization for a check-up revealed a tumor in the left kidney. Enucleation was performed to treat stage 1 renal cell carcinoma. Pathological study revealed that the patient had IgA nephropathy and grade 1 clear cell carcinoma. PMID- 1785413 TI - [A case of replacement ileocystoplasty for contracted bladder]. AB - The patient was a 49-year-old male. He had a history of asymptomatic hematuria that had occurred 3 years previously. The hematuria and pollakisuria developed again from about March, 1989, and he was hospitalized for bladder tamponade in April. Bilateral percutaneous nephrostomies were performed because a contracted bladder and bilateral hydronephrosis were detected. He was then admitted to our hospital on June 21. The cause of the contracted bladder was not evident, despite extensive examination. A replacement ileocystoplasty constructed by Shishido's method was used to replace the contracted bladder. A U-shape pouch was prepared by detubularization of 25 cm of the ileum and this pouch was anastomosed to the incised end of the bladder neck after subtotal cystectomy. The ureter and ileum were then anastomosed using Coffey's method. The bladder capacity and the maximum urinary flow rate after 1 year were 350 ml and 13 ml/sec, respectively, and residual urine was not noted after urination even following abdominal pressure. Urinary incontinence was not noted either. PMID- 1785414 TI - [A case of inguinal bladder hernia]. AB - Pyelocystography on a 61-year-old man with a ureteral stone incidentally revealed the inguinal bladder hernia. He had no complaint of urinary disturbances. During the operation for the hernia, we could not find the bladder without transurethral saline instillation; only the intestine covered with peritoneum was in sight. Utility of preoperative cystography on the cases of inguinal hernia is discussed. PMID- 1785415 TI - Malignant lymphoma of the testis presenting as primary testicular tumor. AB - A case of malignant lymphoma of the testis is presented. A 49-year-old male presented with swelling and dull pain of his left scrotal content. The initial clinical diagnosis was left testicular tumor. Left high orchiectomy was performed immediately after admission and histopathology showed malignant lymphoma, large cell type, B-cell type according to the Lymphoma Study Group (LSG) classification. Extensive investigations revealed clinical stage lE, with no evidence of metastasis. Chemotherapy was initiated with vincristine, prednisolone, adriamycin and methotrexate (VEPA-M). After therapy, the patient is doing well without any evidence of metastasis. PMID- 1785416 TI - [Tunica albuginea cyst associated with hydrocele testis: report of a case]. AB - The patient is a 54-year-old male presenting with a chief complaint of a right intrascrotal mass. Ultrasonographic image of the right testis demonstrated a marginally located cyst, 5 mm in diameter, with hydrocele fluid. Partial orchiectomy and hydrocelectomy with Bergmann's method were performed without any morbidity. Histopathological diagnosis was tunica albuginea cyst. To date, this case is the sixth reported case in Japan. PMID- 1785417 TI - [Clinical statistics on inpatients and operations at Mishina Urological Office between July, 1984 to December, 1990]. AB - The total number of inpatients was 1,309. There were 1020 males and 289 females, the male to female ratio being 3.5: 1. The major diseases seen in inpatients were benign prostatic hypertrophy, bladder tumor, prostatic carcinoma, ureteral stone, urethral diverticulum, bladder neck contracture, inguinal hernia and renal tumor. The total number of patients operated on was 1,211; 953 males and 258 females. These operations were performed at 11 hospitals using a semi-open system. Major operations were transurethral resections of prostatic and bladder tumor, subcapsular prostatectomy, castration, urethral diverticulectomy, nephrectomy, inguinal hernioplasty, ureterolithotomy, radical cystectomy and transurethral ureterolithotripsy. New operation methods were radical prostatectomy by Walsh's method, Kock pouch, penis prosthesis implantation, transurethral incision of bladder diverticular orifice, Gil-Vernet method for VUR and Stamey's method for stress incontinence. Major small operations and examinations for outpatients were transperineal prostatic needle biopsies, transurethral urethral and bladder mucosal biopsies, phimotomy, transurethral intravesical surgery and percutaneous renal cyst puncture. PMID- 1785418 TI - [Assessment of the use of oxybutynin hydrochloride (Pollakisu tablets) in the elderly]. AB - Oxybutynin hydrochloride (Pollakisu tablets) was administered at a daily dose of 6 or 9 mg to 75 elderly patients with urinary tract disorders, including neurogenic bladder and unstable bladder, with chief complaints of pollakisuria, urgency on urination and urinary incontinence. A post-marketing follow-up survey (phase IV study) was then performed to evaluate the efficacy safety and usefulness of Pollakisu tablets in these patients. The administration of Pollakisu tablets produced good results in the comprehensive assessment of overall improvement, being rated as "improved" or better in 57.5% of the patients and "slightly improved" or better in 89.0%. The assessment of general safety revealed that the drug caused almost no problems, with "no problem in safety" accounting for 97.3% of the responses. The assessment of the usefulness indicated that Pollakisu tablets are highly useful, being rated as "useful" or better in 58.9% and as "slightly useful" or better in 82.2%. Evaluation of the results according to daily dose indicated that a dose of 6 mg per day was appropriate for elderly patients from the viewpoint of drug efficacy and safety. With respect to adverse reactions, thirst was found in 5 and dysuria in 3 of the 73 patients. The overall incidence of adverse reactions was 11.0%. The above results indicate the efficacy, safety and usefulness of Pollakisu tablets in treating elderly patients with pollakisuria, urgency on urination and urinary incontinence. PMID- 1785419 TI - [Clinical studies on acute uncomplicated cystitis in women]. AB - A total of 499 female patients with acute uncomplicated cystitis were observed and analyzed clinically for age distribution, characteristics of symptoms, bacterial culture of urine, behavioral aspects of recurrent cystitis and others. The patients were between 3 years and 88 years old (average: 43 years) and the majority of patients were from 20 to 69 years old. From 81.1% of the patients Escherichia coli was detected, followed by Staphylococcus spp (11.2%). The major symptoms were pain on urination (421 cases), urinary frequency (421 cases) and residual urine sensation (418 cases). The major causes of cystitis as reported by the patient were fatigue (131 cases), infrequent voiding (114 cases) and exposing the body to coldness (103); only 42 patients reported a relationship between sexual intercourse and cystitis. The patients who had been suffering from "honeymoon cystitis" were significantly inclined to be suffering from acute uncomplicated cystitis again in comparison with those who had not suffered from honeymoon cystitis. There was suggested to be a relationship between sexual intercourse and recurrent cystitis. PMID- 1785420 TI - [The role of stagnancy of urinary flow in causing urinary tract infection]. AB - A basic and clinical study was made on the significance of stagnancy of urinary flow as a factor causing urinary tract infections. A bacterial solution was inoculated into the bladder of untreated and diabetic mice with model ascending pyelonephritis. The longer the external urethral opening was clamped, the lower became the value of ID50, thus showing infection easily caused by urinary stagnancy in the bladder. Patients who had UTI within 6 months after prostatic operation were divided into two groups, one with residual urine and the other without residual urine. Then, the type of the causative organism, and the severity of pyuria and bacteriuria were determined. In the former, there were slightly more patients with infection caused by plural bacteria. However, no other differences were observed. The administration of cephem antibiotics revealed no differences in effectiveness between the two groups. In conclusion, stagnancy of urinary flow has been considered a factor easily causing infection. However, so far as residual urine is concerned, it is not an intractable factor in treatment. PMID- 1785421 TI - [Clinical response of chemotherapeutic agents with different activities on chronic complicated pyelonephritis with renal stone. A proposed index of local antimicrobial activity]. AB - In the treatment of one male patient with chronic pyelonephritis, complicated with renal stone, the pathological state of the renal inflammatory lesion was determined. The patient had been persistently infected by the same strain of S. marcescens for more than a year. When he was treated by several antimicrobial agents, the urinary bacteriological response was well correlated to the MICs of each agent. On the basis of the findings obtained, a new index of local antimicrobial activity was proposed. Analysis of such items as strains appearing after treatment, interval of relapse and the identification of the strains relapsed, were suggestive of the renal inflammatory, and pathological conditions. The clinical response also correlated well with the index. The lesion was considered to be mainly localized in the right lower calyx where a tiny stone existed. This disease is considered curable with effective chemotherapy after withdrawal of the stone. This index should be useful for evaluation of the effectiveness of antimicrobial agents. PMID- 1785422 TI - [Candida urinary tract infection with special reference to ascending pyelonephritis]. AB - The pathogenesis of Candida urinary tract infection (UTI) has been investigated clinically and experimentally with special reference to ascending pyelonephritis in rats. Among the Candida species, Candida albicans was most frequently isolated from clinical specimens including urine in two medical centers, one in Japan and the other in the United States. The isolates of C. albicans serotype B showed a significantly lower susceptibility to 5-fluorocytosine compared to those of serotype A (p less than 0.01). The distribution pattern of the serum antibody titers against C. albicans in 20 candiduria patients (C. albicans 19 and Candida tropicalis 1) was similar to that in 23 bacterial complicated UTI patients. All patients with candiduria had underlying diseases of the urinary tract, such as neurogenic bladder, bladder cancer or benign prostatic hyperplasia: indwelling urinary catheters were present in 15 patients and all had received antimicrobial agents before the study. Ascending Candida pyelonephritis has been investigated in female rats which were transurethrally inoculated into the bladder with C. albicans ATCC 10259 strain. The incidence of Candida pyelonephritis was approximately 80% in rats treated with cyclophosphamide and more than 70% in rats with partial ureteral obstruction. There was a significant relationship between renal and urinary Candida cell populations (p less than 0.01). Furthermore, a significant relationship was revealed between renal Candida cell populations and histological grades of pyelonephritis (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785423 TI - [Results of radical nephrectomy associated with regional lymphadenectomy for renal cell carcinoma]. AB - Between January, 1975 and December, 1989, 86 patients with renal cell carcinoma received radical nephrectomy associated with lymphadenectomy at our institutions. Pathological examination revealed lymph node metastasis in 15 patients (17.4%). The incidence of lymph node metastasis increased in accordance with the aggravation of tumor stage (p less than 0.01) and grade (p less than 0.05). Patients with a rapidly growing tumor showed higher incidence of lymph node metastasis than patients with a slow growing tumor (p less than 0.01). Regional lymph node metastases were found in 3 of the 41 patients with a slow growing tumor. Since these 3 patients are surviving with no evidence of disease for 38.7 months on average, the regional lymphadenectomy was considered to have been effective for their survival. Nine of the 25 patients with a rapid growing tumor had progressive lymph node metastasis. Four of them had apparent tumor thrombi as well as lymph node metastasis, and 2 of them had distant metastasis. These patients showed poor prognosis even after operation. Lymphadenectomy was of no value to the patients with apparent tumor thrombi and/or distant metastasis. PMID- 1785424 TI - [Incidental renal cell carcinoma]. AB - We reviewed the cases of incidental renal cell carcinoma that had been treated at the Kitasato University Hospital between July, 1971 and December, 1989. Forty one of the 170 (24.1%) cases were found without any direct signs of renal cell carcinoma. The patients were between 30 and 78 years old (mean 55.0 years) and consisted of 29 males and 12 females. Fifteen cases were detected at the general health check-up and the remaining 26 during the postoperative follow-up for other malignant tumors or other diseases. Twenty three cases were identified by ultrasonography followed by computed tomography (CT) and excretory pyelography in 4 cases each. Especially, the number of patients incidentally found by ultrasonography had increased in the recent 8 years. Urinalysis did not show any microhematuria in 31 of the 37 cases (83.7%), and no tumor mass could be detected by excretory pyelography in 3 cases. We believe that ultrasonography may be valuable as a screening modality for early detection of renal cell carcinoma and should be used as a screening method at the routine health check-up. PMID- 1785425 TI - [Clinical application of extracorporeal shock wave lithotripter (SD-3) to upper urinary tract stones]. AB - The extracorporeal shock wave lithotripter (SD-3) was used on 30 patients with upper urinary tract calculi from December, 1988 to March, 1989. At one month after the treatment, 11 patients (36.7%) were free from stones and 9 (30.0%) had stone fragments than 5 mm in diameter, making an effective rate of treatment of 66.7%. Gross hematuria, skin ecchymosis, pain and fever were observed as side effects, but none of them were serious. We concluded that extracorporeal shock wave lithotripsy using SD-3 for upper urinary tract stones is an effective treatment without any serious side effects. PMID- 1785426 TI - [Renal-sparing procedures in the management of renal arteriovenous fistula]. AB - Five cases of renal arteriovenous fistula which were treated by renal-sparing procedures are reported. Transcatheter arterial embolization was performed in three cases of circoid type arteriovenous fistula. Gross hematuria stopped immediately after the treatment in these three cases. Another two patients, whose arteriovenous fistula were aneurysmal type, were treated by ligation of the feeding artery. Although there were no symptoms after the surgery, the follow-up renal arteriography revealed the residue of a small amount of arteriovenous fistula in one of the aneurysmal type cases. We suggest that the renal arteriovenous fistula be classified into circoid type and aneurysmal type in the diagnosis for the appropriate treatment of renal arteriovenous fistula. It is important to select the renal-sparing procedure according to the type of renal arteriovenous fistula. PMID- 1785427 TI - [The activity of etoposide (VP16) in combination chemotherapy against human bladder cancer cells in vitro]. AB - The activity of Etoposide (VP16) in combination chemotherapy against four human transitional cell carcinoma cell lines of bladder (TCCaB) was determined by in vitro colony formation assay. Four anti-tumor agents (methotrexate: MTX, vinblastine: VBL, adriamycin: ADM, cisplatin: DDP) were used for combination chemotherapy with VP16. The ADM + VP16 combination exhibited a strong synergistic antitumor effect against the human TCCaBs compared with other combinations in this study. The combination chemotherapy of ADM + VP16 may be useful as a new chemotherapeutic regimen for advanced bladder cancer. PMID- 1785428 TI - [Le Duc-Camey antireflux ureteroileal reimplantation for continent ileal reservoir]. AB - Le Duc-Camey antireflux ureteroileal reimplantation was used on 15 patients with 30 ureters reimplanted into the ileum as part of a bladder substitution procedure (Kock pouch or ileal neobladder: U-bladder) or augmentation cystoplasty (Goodwin ileocystoplasty). In our experience, no reflux was observed, while hydronephrosis was identified in one ureter of ileal neobladder (4%). Le Duc-Camey antireflux ureteroileal reimplantation is suitable for reconstruction with the ileal reservoir. PMID- 1785429 TI - Sedative effect of detomidine in infant calves. AB - Detomidine administered intramuscularly at a dose of 10, 20 or 40 micrograms/kg body mass was evaluated for its sedative effects in 15 unfasted infant calves (age: 15-20 days; body mass: 18-33 kg). The drug produced dose-dependent sedation. At a dose of 10 micrograms/kg detomidine produced effective sedation for 30 to 45 min without any observable analgesia. At doses of 20 or 40 micrograms/kg it caused deep sedation, sternal recumbency, and moderate analgesia of the trunk. Hyperglycaemia was recorded at all dose levels. The changes in respiratory rate, rectal temperature, haemoglobin, packed cell volume, total erythrocyte count and plasma concentration of total protein were not significant. PMID- 1785430 TI - Evaluation of detomidine as a sedative in goats. AB - Intramuscular (i.m.) and intravenous (i.v.) administration of detomidine at doses of 10, 20 and 40 micrograms/kg body mass was evaluated for its sedative and analgesic properties in 15 goats (Capra hircus). The drug produced dose- and route-dependent sedation. The 10 micrograms/kg dose was effective only when administered i.v. There was no observable analgesia at this dose. Higher doses produced effective sedation and moderate analgesia of the body with either route of administration. Severe ataxia and sternal recumbency were seen in all the animals after the dose of 40 micrograms/kg. Other effects of detomidine in these goats included mild to moderate salivation, depressed respiratory rate, decreased rectal temperature, bradycardia and hyperglycaemia. Plasma concentrations of total protein, sodium, potassium and chloride were not affected. PMID- 1785431 TI - Sleep and activity of piglets weaned into cages. AB - The duration and type of sleep and activity were monitored in a group of 9 Duroc piglets weaned at 7 weeks of age and placed into a cage of 1.2 x 1.2 m. Average air temperature in the cage ranged between 20 and 23 degrees C and relative humidity was around 70%. The piglets were fed and watered ad libitum. The measurements were performed one week after the pigs had been transferred to the cages, in the period between 8 a.m. and 1 p.m. Approximately half of the 5-hour period of observation was occupied by sleep. There were, however, marked individual differences (ranges: 66 and 24%). Non-REM sleep occupied 79% while REM sleep 21% of the whole sleep time. REM episodes lasted, on the average, 3.8 + 0.58 min. The other half of the period studied was occupied by wakefulness which was devoted to movement, lying and, also, massaging and sucking each other. In some animals this activity was high and was the cause of unrest in the whole group. Differences in respiratory rate between non-REM and REM sleep recorded in heavier animals were the result of their heat load. PMID- 1785432 TI - Haemagglutinating and adhesive activity of Bordetella bronchiseptica treated with sub-minimal inhibitory concentrations of gentamicin. AB - The effect of sub-minimal inhibitory concentrations of gentamicin on the haemagglutinating activity of Bordetella bronchiseptica was studied. Gentamicin exerted dissimilar effect on the production of haemagglutinin to calf and dog erythrocytes. The drug significantly reduced the haemagglutinating titres of calf negative strains with dog red blood cells while it caused only a slight decrease in the haemagglutinating titres of calf-positive strains with bovine erythrocytes. The results support the view that bovine haemagglutinin is an adhesin of B. bronchiseptica. PMID- 1785433 TI - A new serotype of Erysipelothrix rhusiopathiae isolated from pig slurry (short communication). PMID- 1785434 TI - Subacute toxicity testing of ochratoxin A and citrinin in swine. AB - Fourteen pigs were fed ochratoxin A and citrinin through a stomach tube at daily doses of 0.02 and 0.01 mg/kg body mass for 57 days. These toxin doses correspond to the average toxin contamination level of feeds in Central Europe. The clinical status of the pigs was monitored and clinical laboratory, haematological and mycotoxin-analytical examinations were performed throughout the trial. At the end of the experiment gross and histopathological examinations were carried out. The results of ochratoxin A and citrinin determination in the blood, obtained by high performance liquid chromatography (HPLC), are important from the food hygienic point of view. The sensitivity of the method was 2 and 10 ng/ml for ochratoxin A and citrinin, respectively. The recovery rate of the mycotoxins was above 60%. PMID- 1785435 TI - Intestinal absorption of glycylproline in chicks infected with Eimeria acervulina. AB - The absorption of glycine and proline through the mid-intestines of chicks infected with Eimeria acervulina was impaired when the amino acids were presented to the mucosal surface as the dipeptide, glycylproline. PMID- 1785436 TI - Study of the acetylcholinesterase activity of Ascaridia galli: kinetic properties and the effect of anthelmintics. AB - Acetylcholinesterase (EC 3.1.1.7) activity was demonstrated in whole worm homogenates of adult Ascaridia galli with acetylthiocholine as substrate. The pH optimum was not measurable because of an autohydrolysis of the substrate. The Michaelis constant (Km) was 4 mM with saturation by excess substrate. Optimum enzyme activity was noted at a protein concentration of 200 mg/ml assay medium and at a temperature of 37 degrees C. Arrhenius plot of temperature dependence of the enzyme activity showed an energy of activation (delta Ea) of 28.962 K joule/mole above, and 25.448 K joule/mole below, the transition temperature (37 degrees C). Complete inhibition by eserine (physostigmine), a specific and classical acetylcholinesterase inhibitor, established the identity of the enzyme. A marginally higher enzyme activity was observed in females than in males as well as in homogenates from worms of mixed sexes. The enzyme was markedly activated by divalent metal cations such as Fe2+, Mg2+, Cd2+, Cu2+, Zn2+ and Ca2+, while Co2+ and Mn2+ inhibited the activity. Piperazine adipate at a concentration of 10(-3) M caused 45.5% and albendazole, a benzimidazole anthelmintic, 37.5% inhibition in the enzyme activity, while levamisole and mebendazole proved to be practically ineffective, causing an inhibition of 12 and 9%, respectively. PMID- 1785437 TI - The involvement of polymorphonuclear leukocytes in the pathogenesis of bronchopneumonia in calves. I. Activated granulocyte induced lipid peroxidation in red blood cells. AB - The influence of free radicals generated by polymorphonuclear leukocytes from bronchopneumonic calves on lipid peroxidation in red blood cells was studied. Incubation of granulocytes with red blood cells causes a rise in malondialdehyde production in these cells in linear dependence on the granulocyte number. Incubation of red blood cells with malondialdehyde causes a generation of adduct moiety of this compound with phosphatidylserine and phosphatidylethanolamine. This adduct is also present in erythrocytes which have been incubated with neutrophils of bronchopneumonic calves. Cytochrome c loaded erythrocyte ghosts showed a high reduction rate of this compound during incubation of ghosts with neutrophils of diseased calves. It is suggested that neutrophils of bronchopneumonic calves are in an activated state in the blood-stream, and free radicals generated by these cells are capable of peroxidizing the red blood cell membrane lipids and causing cross-links between phospholipid moieties in erythrocyte membranes. PMID- 1785438 TI - The involvement of polymorphonuclear leukocytes in the pathogenesis of bronchopneumonia in calves. II. Granulocyte-induced changes in erythrocyte membrane phospholipid topology. AB - Phospholipid topology in erythrocyte membranes of bronchopneumonic calves and changes in phospholipid asymmetry induced by incubation of erythrocytes with neutrophils of diseased calves were examined. Using aminophospholipid tracing by non-penetrating probe, trinitrobenzenesulfonic acid, and phospholipid hydrolysis by specific phospholipase A2 from Naja naja venom and sphingomyelinase from Staphylococcus aureus it was stated that in erythrocytes from diseased calves phosphatidylserine and, to some extent, phosphatidylethanolamine are externalized on the outer leaflet of the membrane. Similar results were obtained for erythrocytes of healthy calves after incubation with granulocytes of bronchopneumonic animals. It is suggested that granulocytes of bronchopneumonic calves cause perturbations in erythrocyte membrane phospholipid organization. PMID- 1785439 TI - Fatty acid composition of near-term and beyond-term pig placenta. AB - The fatty acid composition of four major phospholipid classes of near-term and beyond-term pig placenta was investigated. In beyond-term pig placentas much lower levels of linoleic, dihomo-gamma-linolenic and arachidonic acids were observed, as compared to near-term organs. It is suggested that beyond-term pregnancy in the pig may be caused by a deficiency of prostaglandin precursors in the placenta. PMID- 1785440 TI - Effect of nickel deficiency on biochemical variables in serum, liver, heart and kidneys of goats. AB - Nickel deficiency was induced in 2- to 4-year-old goats by feeding 0.1 mg Ni/kg dry matter with a semisynthetic diet. The control group consumed 5.0 mg Ni/kg d.m. Activity of several enzymes (SDH, LDH, HBDH, AST, ALT, ALD, CK, CHE) was determined in the serum, liver, heart and kidneys. Serum urea-N level was also measured and transmission electron microscopic (TEM) examinations were performed. Signs characteristic of nickel deficiency (retarded growth, increased mortality of dam and offspring, parakeratosis of the skin) appeared in the low-nickel group. The activity of SDH and ALD, as well as the level of urea-N was significantly lower in the serum of Ni-deficient animals than in the control. Ni deficient animals also had significantly lower enzyme activities in the heart (SDH, HBDH, AST, ALT, ALD and CK), liver (SDH and CHE) and kidneys (HBDH and CK). Electron micrographs showed degeneration of cardiac and skeletal muscle in the Ni deficient animals. Ni deficiency elicited changes primarily in the heart and these resulted in depressed activity of several enzymes. PMID- 1785441 TI - Age-related variations in some blood parameters of geese. AB - Blood samples from a total of 44 geese of the Hungarian breed, representing three age groups (3 months old, 6 months old, and adult) and originating from the Babat Goose Farm, were examined for packed cell volume (PCV), differential count, haemoglobin content, and serum levels of glucose, total protein, total lipid, calcium and phosphorus. The results revealed significant age-related variations in PCV, proportions of lymphocytes and eosinophils, total protein, total lipid, calcium and phosphorus. The changes were comparable to those obtained for 3 months old and adult Landes geese. PMID- 1785610 TI - Contribution of biological markers to occupational health. AB - Occupational diseases are now being assessed at the cellular and molecular levels; this presents new opportunities for prevention and control [Calleman et al., 1978; Ong et al., 1987; Stejskal et al., 1989; Welch and Cullen, 1988; Garry et al., 1989]. The key to these opportunities is the ability to detect biological markers that reflect exposure, response, and susceptibility. Biological markers are not new, however. Biological markers such as blood lead, urinary phenol levels in benzene exposure, and liver function assays have long been used in occupational and public health research and practice. What distinguishes the current generation of markers from previous markers is a greater degree of analytical sensitivity and the ability to describe events that occur earlier in the progression between exposure and clinical disease. There are now new domains of response that were not known to exist 20 years ago. Accompanying this sensitivity is the increased requirement to consider the numerous factors that can influence the appearance of biological markers. It has been observed that all workers with similar exposures do not develop disease or markers indicative of exposure or disease. Various acquired and hereditary host factors are responsible for this variation in responses. The role of assessing the nature and degree of variation between individuals is of paramount importance. Finally, the use of biological markers in occupational health research and practice also brings new ethical and legal considerations into high profile. This paper presents my personal opinions on how biological markers can contribute to occupational health efforts and the new requirements that they bring to the field. As with any technological change, the more we can anticipate the impact, the better our ability to adjust. PMID- 1785611 TI - Paternal occupation and congenital anomalies in offspring. AB - This paper presents the results of an exploratory case-control study of paternal occupation as a risk factor for birth defects in offspring. With the use of a population-based registry in British Columbia, 14,415 liveborn children with birth defects were identified for the period, 1952-1973. Two controls were matched to each case by using the birth files of British Columbia. Paternal occupation was obtained from the birth certificate. The analysis included 20 birth defect categories. Paternal occupations found to be associated with an increased odds ratio (OR) of birth defects include janitors [hydrocephalus (OR = 5.04), ventricular septal defects (OR = 2.45), other heart defects (OR = 2.35)], forestry and logging workers [congenital cataract (OR = 2.28), atrial septal defects (OR = 2.03), syndactyly (OR = 2.03)], painters [spina bifida (OR = 3.21), patent ductus arteriosus (OR = 2.34), cleft palate (OR = 3.36)], printers [atresia of the urethra (OR = 4.50), clubfoot (OR = 2.18)], and plywood mill workers [patent ductus arteriosus (OR = 2.52), pyloric stenosis (OR = 4.12), dislocated hip (OR = 2.71)]. This study has several limitations and the results must be viewed with caution. Nonetheless, the study provides new leads for further evaluation of the role of father's occupation in the etiology of birth defects. PMID- 1785612 TI - Alcohol, smoking, and occupational factors in cancer of the larynx: a case control study. AB - A hospital-based case-control study of laryngeal cancer was conducted in Bremen in 1986 and 1987 with 100 prevalent male laryngeal cancer patients and 100 male hospital controls with diseases not considered to be related to smoking, alcohol, or occupational exposures, who were frequency matched by age. The odds ratio for heavy smoking (more than 30 pack-years) reached a value of 3.5 (95% confidence limits (CL) 1.1, 7.9). Ex-smokers showed a significant decrease in risk; this reached the level of those who had never smoked about 15 years after smoking cessation. For daily consumers of alcohol an odds ratio of 3.2 (95% CL 1.4, 7.5) was observed. Among the 17 occupations in which at least ten subjects had worked, excess risks were observed for stock keeping and transportation workers, and for leather and textile workers. The odds ratio was significantly increased for the latter (p less than 0.05). Among all those persons ever employed in a priori defined-risk occupations, an odds ratio of 2.74 (95% CL 1.23, 6.06) was observed. Considering responses to an exposure check-list, no increased risks could be shown for exposure to asbestos, coal tar, or welding fumes. On the other hand, excess risks were observed for exposures to diesel oil, gasoline, and mineral oil, controlling for smoking and alcohol. The findings in occupational and exposure subgroups were based on small numbers of cases and controls and, consequently, were subject to large sampling errors. Many of the results are consistent, however, with occupational risk factors reported from other studies. PMID- 1785613 TI - Measurement precision of an olfactory perception threshold test for use in field studies. AB - Changes in olfactory function have been associated with workplace exposure to a variety of substances. In the workplace, smell can be particularly important, since it is commonly used to detect potentially hazardous situations or as an indicator of mask cartridge breakthrough. Sensitive quantitative measures of olfactory loss would be useful in epidemiological studies and workplace surveillance. The objective of the present study was to determine the reproducibility of an olfactory perception threshold test and variations with age, gender, and smoking status. The test was a standard olfactory kit (Olfactolab No. 11), including 18 serial dilutions of PM-carbinol, with an equal number of blanks. The forced choice method was used, with both tester and subject blinded as to which bottle contained the odorant. Olfactory perception threshold was recorded when the subject identified the same dilution three times. To assess reproducibility, testing was repeated four times over a period of 4 weeks, on the same weekday and the same time of day. Subjects (n = 63) ranged in age from 20 to 60 years (mean age: 39.7 +/- 12.5 years), 47.6% were women, 29.5% currently smoked, and 27.9% were former smokers. Results showed no inter-week differences in olfactory perception threshold (Analysis of variance for repeated measures: F = 0.59; p much greater than 0.05). Inter-class correlation for assessment of agreement of continuous variables was 0.76. Inter-week concordance of hyposmia showed fair to good agreement (0.55 greater than or equal to kappa less than or equal to 0.66). Three-way analysis of variance (ANOVA) revealed significant differences with respect to age category (F = 7.36; p less than 0.001) and current smoking status (F = 4.54; p less than 0.05), but not for gender (F = 2.32; p greater than 0.05). The multiple regression model with age and smoking as independent variables was highly significant (F = 13.03; p less than 0.001), explaining 28% of the variance; olfactory threshold increased 0.47 ds/year (t = 4.01; p less than 0.001) and 0.27 ds/cigarettes/day (t = 2.46; p less than 0.05). The findings of this study indicate that this test is reproducible and sensitive to expected changes with age and smoking status. It corresponds well to criteria for testing in the field and should be considered for studies characterizing olfactory functions and sensory loss among working populations. PMID- 1785614 TI - Occupational hearing loss in New York dairy farmers. AB - A study of 49 randomly selected, full-time dairy farmers was performed to assess the prevalence and nature of hearing loss in this population. An age- and sex matched group of rural, non-farmers was also studied. Medical, occupational, and recreational histories were taken and standard audiometric testing was administered. Sixty-five percent of farmers had hearing loss in the higher frequencies and 37% had losses in the mid-frequency range as compared to 37% and 12% of non-farmers respectively (p less than .01). Farmers' left ears were more severely affected. The age of the subjects and the number of years spent farming were highly correlated with hearing loss. Correlation and regression analyses supported the hypothesis that the difference in the prevalence of hearing loss between the dairy farmers and the non-farmers was due to occupational noise exposure on the farm. PMID- 1785615 TI - Investigation of a fatality among parathion applicators in California. AB - Staff of the California Department of Health Services investigated the death of a parathion applicator in California that was thought to be pesticide-related. A crew of eleven workers (including six sprayers, three mixer/loaders, one mixer/sprayer and one foreman) had been applying 0.125% parathion spray to almond orchards for approximately three weeks. On the day of the fatality, a sprayer rapidly developed symptoms of salivation, sweating, and convulsions after a half day of work. Despite aggressive medical treatment, the worker died within one hour of his initial symptoms. Significant laboratory results for the decreased case included: parathion residue on the inner and outer garments worn by the worker, parathion in the post-mortem gastric contents, and elevated urinary metabolites consistent with acute parathion intoxication. Interviews with the work crew revealed that three of the 10 workers had complaints of headaches, vomiting, and/or sore throat; yet, subsequent plasma and red cell cholinesterase tests of the co-workers did not show any significant depressions in comparison with pre-season baseline values. This worker death is consistent with prior reports of parathion-related sprayer/applicator intoxications and is the first worker-related parathion death in California since 1972. Substitution of pesticides with less toxic active ingredients or the elimination of parathion is recommended. PMID- 1785616 TI - A history of awareness of asbestos disease and the control of occupational asbestos exposures in The Netherlands. PMID- 1785617 TI - From conjecture and refutation to the documentation of occupational diseases in Taiwan. AB - The documentation of occupational diseases in a developing country like Taiwan is a challenge to an occupational physician. For lack of a system including material safety data sheet (MSDS), workers are usually not aware of what chemicals they are exposed to. Since many occupational diseases have long latencies and do not show any specific symptoms and signs, recognition and identification of the occupational origin are often very difficult. Using databases which provide a relatively complete list of industrial chemicals and a set of specific signs and/or symptoms, combined with the epidemiologic approach of conjectures and refutations--i.e., considering and ruling out all possible alternative explanations--we have documented eight kinds of occupational diseases and an outbreak of botulism. We recommend that a similar approach be applied to any other country with a similar situation, and that a system involving an identification sheet (e.g., MSDS) for each chemical be advocated and implemented in such countries as one means to enable prompt recognition and prevention of occupational diseases. PMID- 1785618 TI - Mortality of US embalmers and funeral directors. PMID- 1785619 TI - Rethinking the admissibility of medical treatises as evidence. AB - This Article examines the issues and questions which underlie the debate over the admission of "medical treatises" into evidence. The admissibility of this type of evidence is at issue most often in litigation involving complex medico-legal issues. This article outlines the evidentiary basis for admission of medical treatises and discusses the quality of medical treatises in an effort to determine what value to the fact-finder these treatises actually hold. The authors contend that there is an inherent untrustworthiness associated with medical treatises, but do not go so far as to suggest that medical treatises should never be admitted. The Article concludes that there is a need for greater caution in determining admissibility and recommends safeguards to better guarantee trustworthiness and reliability. PMID- 1785620 TI - The regulation of dental licensing: the dark ages? AB - Current state laws regulating the licensure of dentists place severe restrictions upon the freedom of movement of practitioners. Most state laws were enacted during a period when a strong rationale for regulating public health and welfare existed. Today, these laws hamper the free movement of dentists and are anachronisms in an era of national standards and practices. The authors contend that the extant laws rest upon outdated assumptions and serve economic and protectionist goals rather than public health and safety. This Article examines the history and application of the traditional justifications for state licensure and their present ramifications. The authors suggest that replacing the current regulatory system with a national clinical examination and a national licensure program will best serve the interests of the public and the dental profession. PMID- 1785621 TI - Examining exclusionary conduct of HMOs and PPOs: a case comment on Northwest Medical Laboratories v. Blue Cross and Blue Shield of Oregon. AB - As the climate of the health care industry has changed to one of cost-containment and competition through the growth of HMOs and PPOs, health care providers have become the subjects of antitrust litigation. One such case, Northwest Medical Laboratories v. Blue Cross and Blue Shield of Oregon, involved a medical laboratory and a radiology center who claimed that they were victims of an illegal group boycott after defendant's pre-paid health plan denied them preferred provider status. The Oregon Court of Appeals, using the traditional antitrust analysis applied to other industries for decades, failed to consider the intricacies that exist within the health care industry. This result led to an inaccurate market share computation and an inadequate rule of reason analysis. This Comment examines the shortcomings of the Northwest Medical opinion and argues that, in applying the antitrust laws to the health care industry, courts in future cases must recognize and respect the unique features of the business of providing health care. PMID- 1785622 TI - Sexual abuse by psychotherapists: the call for a uniform criminal statute. AB - Recent surveys show an alarming rate of sexual exploitation of patients by psychotherapists. As such conduct often falls outside the scope of rape, which allows a defense of consent, the psychotherapist is not prosecuted. Although all sexual contact between therapist and patient is prohibited by codes of professional ethics, the licensing boards that enforce these codes do not possess adequate power to deter this behavior. Further, professional review boards have absolutely no authority over unlicensed therapists who sexually abuse their patients. As a result, licensed therapists who have been censured in one state may practice as unlicensed therapists in another state and continue to sexually abuse patients. The only effective deterrent would be a uniform statute, adopted in all states, criminalizing this specific abuse of the unique therapist-patient relationship. Such a statute should include unlicensed therapists as potential offenders and consent to sexual contact should not be a defense. The statute also should provide for enhanced efforts to inform and protect victims. This Note first examines six of the nine criminal statutes that currently exist in order to show the full range of provisions presently in force to deter this conduct. This Note then proposes model provisions for a uniform statute. PMID- 1785623 TI - Washington Supreme Court--compulsory HIV test--State v. Farmer. PMID- 1785624 TI - Autosomal recessive malformation syndrome with minor manifestation in the heterozygotes: a preliminary report of a possible new syndrome. AB - We describe 3 patients with a new malformation syndrome in 2 sibships in a large kindred from Bahia, Brazil. The parents in both sibships are consanguineous. The syndrome is characterized by malformations of the face, ears, hands and feet, plus mixed deafness and pseudopapilledema. Fifty-four relatives were examined clinically and scored by the number of anomalies. A control sample of 54 individuals was equally examined. The distribution of the number of anomalies per individual (score) is bimodal in the relatives of the patients but unimodal in the control individuals. Detection of heterozygotes was based on the score distribution. PMID- 1785625 TI - Sacrococcygeal dysgenesis association. AB - In the malformation analysis of 445 patients ascertained only for a sacrococcygeal malformation, a new phenotype, the sacrococcygeal dysgenesis association (SDA), was delineated in 34%. In addition, sirenomelia patients were found in 12%, the VATER association in 27%, and 27% could not be classified. Heterogeneity in the patients with sacrococcygeal malformations was identified by the differences found in their associated malformations. SDA patients have a relatively small average number (3.3) of anomalies per patient as compared with 9.3 in sirenomelia and 6.2 in VATER patients. SDA abnormalities occurred to a significant degree only in 6 of 20 designated malformation categories (vertebral, rib, pelvic, lower limb, central nervous system [CNS], renal) in contrast to 17 in VATER and 18 in sirenomelia patients. The SDA vertebral malformation pattern also differed from that of VATER/sirenomelia patients as did the high sacrococcygeal agenesis:dysgenesis ratio and low thoracolumbar vertebrae and/or rib hypersegmentations. Most significantly, SDA patients had a large number of CNS anomalies and CNS-related dysfunctions of the urinary and distal intestinal tracts but no anatomic urinary or intestinal tract malformations. This contrasted sharply with the markedly increased occurrences of anatomic abnormalities in these body regions of the sirenomelia and VATER patients. Demographic data such as patient survival, twinning and, particularly, the high (28%) incidence of maternal diabetes in the SDA further support its differentiation from VATER/sirenomelia patients. PMID- 1785626 TI - Radial ray defects, triangular face, telecanthus, sparse hair, dwarfism, and mental retardation. PMID- 1785627 TI - Oto-palatal-digital syndrome type II with X-linked cerebellar hypoplasia/hydrocephalus. AB - We describe an infant with clinically apparent oto-palatal-digital syndrome Type II (OPD II), who, in addition, also has hydrocephalus and cerebellar hypoplasia. This second X-linked disorder has not been reported previously to occur in association with OPD II. This patient had 2 maternal uncles who died neonatally with congenital hydrocephalus and digital abnormalities consistent with OPD II. We suggest that these 2 entities may be located near one another on the X chromosome, and that both loci are affected in this family. PMID- 1785628 TI - Severe mental retardation and absent nails of hallux and pollex. PMID- 1785629 TI - Fuhrmann syndrome of right-angle bowed femora, absence of fibulae and digital anomalies: two further cases. AB - We describe 2 patients with bilateral right-angle bowing of femora, absence of fibulae, and reduced, flattened and nail-less toes and symmetrical fingernail deficiency in a consanguineous family of ethnic South Vietnamese Baptists and a non-consanguineous Polish family. These cases are similar to those reported by Fuhrmann et al. (in "Skeletal Dysplasias," New York: Alan R. Liss, Inc., pp 519 524), indicating possible autosomal recessive inheritance of this rare non-lethal limb malformation syndrome. PMID- 1785630 TI - Diagnosis of tetrasomy 18p using in situ hybridization of a DNA probe to metaphase chromosomes. AB - We identified an isochromosome of 18p [47,XY, +i(18p)] conclusively by in situ hybridization of an 18p-specific probe (B74; D18S3) to metaphase chromosomes of an affected patient. Clinical findings included mental retardation, microcephaly, and an atrial septal defect. Although there is similarity to patients previously described with tetrasomy 18p, it is impossible to rule out a low frequency of misdiagnoses in karyotypes determined solely by standard cytogenetic analyses. We expect the ability to conclusively identify an i(18p) to lead to the delineation of tetrasomy 18p as a distinct clinical syndrome. PMID- 1785631 TI - Deletion of the distal short arm of the X chromosome (Xp) in a patient with short stature, chondrodysplasia punctata, and X-linked ichthyosis due to steroid sulfatase deficiency. AB - We observed a boy with short stature, chondrodysplasia punctata, ichthyosis, and a terminal deletion of Xp. Steroid sulfatase deficiency was demonstrated in the patient's fibroblasts. Molecular analysis showed a deletion of the entire steroid sulfatase gene. This case represents another example of a contiguous gene syndrome in which the co-deletion of adjacent genes on a chromosome is responsible for a complex phenotype. PMID- 1785632 TI - Goldberg-Shprintzen syndrome: Hirschsprung disease, hypotonia, and ptosis in sibs. AB - We describe a brother and sister with Hirschsprung disease, hypotonia, and ptosis. Their condition resembles that in 2 sibs reported by Goldberg and Shprintzen. We conclude that the clinical characteristics in 8 reported cases with similar clinical manifestations represent a distinct autosomal recessive syndrome, Goldberg-Shprintzen syndrome. PMID- 1785633 TI - Value of clinical analysis in epidemiological research: the Spanish registry experience. AB - Using data from the Spanish Collaborative Study of Congenital Malformations (ECEMC), a hospital-based, case-control study and surveillance program, we investigated the potential value of registry systems in the identification of causes of congenital defects when their methodology includes (1) detailed reporting and coding of all anomalies present in each child, whether major or minor, (2) clinical analysis and coding of the global pattern of anomalies present in each infant, and (3) classification of all children studied according to their clinical presentation. These approaches provide great specificity and flexibility in the retrieval and analysis of data. Not only do they permit the study of specific anomalies, but also the analysis of children with MCA patterns, as well as the study of the relationship of specific defects with the rest of the anomalies present in a child. To illustrate this point, we present general data on 15,307 malformed children and more specific information on 153 cases of anal atresia/stenosis identified among the 753,410 live-births surveyed by the ECEMC between April 1976 and September 1989. PMID- 1785634 TI - Tapetoretinal degeneration in brothers with apparent Cohen syndrome: nosology with Mirhosseini-Holmes-Walton syndrome. AB - We report on 2 brothers with marked eye anomalies, documented with histopathological studies, and several other findings fitting the diagnosis of both the Cohen and the Mirhosseini-Holmes-Walton syndromes. In accordance with Norio and Raitta (Norio R, Raitta C (1986): Am J Med Genet 25:397-398) we come to the conclusion that these 2 syndromes constitute one clinical but possibly heterogeneous entity. PMID- 1785635 TI - Familial renal-hepatic-pancreatic dysplasia and Dandy-Walker cyst: a distinct syndrome? AB - Ivemark et al. first described sibs with renal-hepatic-pancreatic dysplasia (RHPD) (Ivemark BI, Oldfelt V, Zetterstrom R (1959): Acta Pediatr Scand 48: 1 11). Subsequent reports of affected individuals have described additional malformations and syndromes associated with RHPD. In this paper we describe 2 sibs with RHPD in association with Dandy-Walker cyst (DW). Through an examination of the pattern of associated malformations seen in RHPD we argue that RHPD-DW is a distinct monogenetic syndrome, and not an association. PMID- 1785636 TI - Cognitive and motor skills in achondroplastic infants: neurologic and respiratory correlates. AB - Thirteen infants with achondroplasia underwent psychometric testing as part of a comprehensive neurologic assessment. As a group, mental development was average and motor development was delayed, although a wide range of scores was obtained. Foramen magnum measurements were correlated with respiratory dysfunction, abnormal somatosensory evoked potentials, and delayed motor development. Abnormal polysomnogram outcome was associated with reduced mental capacity. In light of the reported increased frequency of respiratory dysfunction in achondroplasia, these findings warrant careful attention and further study. PMID- 1785637 TI - Prevalence of type I spinal muscular atrophy in North Dakota. AB - In order to establish the incidence and prevalence of type I spinal muscular atrophy (SMA Werdnig-Hoffmann disease) in North Dakota, we reviewed the death certificates for the past 8 years. Between 1980 and 1987 the prevalence of was 1.5 per 10,000. The incidence was 1 in 6,720. This suggests a carrier frequency of 1 in 41 in North Dakota with a gene frequency of 0.0122. In North Dakota, type I spinal muscular atrophy appears to be 3 to 10 times more common than in other locations. PMID- 1785638 TI - Weaver syndrome in two Japanese children. AB - We report on 2 Japanese patients (a 3-year-old girl and an 20-month-old boy) with the Weaver syndrome. The clinical manifestations are mild mental retardation, overgrowth with accelerated bone age, minor facial anomalies including broad forehead, mild hypertelorism, depressed nasal bridge, accentuated philtrum, micrognathia and large ears, and unique behavior characteristics with some social withdrawal. The nosology of the Weaver and Simpson-Golabi-Behmel syndromes is discussed. PMID- 1785639 TI - Diagnostic hand anomalies in Smith-Magenis syndrome: four new patients with del (17)(p11.2p11.2) AB - We report clinical and cytogenetic findings of 4 children (2 boys and 2 girls) with the Smith-Magenis syndrome. All 4 patients had an interstitial deletion of 17p: del(17) (p11.2p11.2). Their clinical manifestations included brachycephaly, midface hypoplasia, prognathism, upper lip eversion, short and broad hands with short fingers, clinodactyly of the fifth fingers, fingertip pads, moderate mental retardation, and behavior problems. Analysis of the metacarpophalangeal pattern profiles in patient 2 showed progressive shortness from the metacarpals to the proximal, middle, and the distal phalanges. The fingerpads observed in all 4 patients have hitherto been noted in only one of 26 previously reported patients with the syndrome. These findings serve as a useful clue to the diagnosis of the syndrome. PMID- 1785640 TI - Twin fetuses with abnormalities that overlap with three midline malformation complexes. AB - Twin fetuses aborted at an estimated gestational age of 145 days were concordant for oral, facial, skeletal, and central nervous system malformations. The twins were discordant for other anomalies including cardiac defects, polydactyly, and malrotated short bowel. The combination of malformations observed overlaps with that of the oral-facial-digital syndrome, hydrolethalus syndrome, and Pallister Hall syndrome. The problem of phenotypic overlap between these syndromes is discussed. PMID- 1785641 TI - Acceptance of chorionic villus sampling in the southwest region of The Netherlands: a 5-year evaluation. AB - The acceptance of chorionic villus sampling (CVS) for monitoring pregnancies at risk for chromosomal and genetic disorders was studied from its introduction in the Centre for Clinical Genetics in Rotterdam in 1984 until 1988. Special attention was given to increasing acceptance in the group with advanced maternal age (AMA) (12.6% CVS in 1984, 52.2% CVS in 1988) and the group with a high genetic risk (HGR) (42.7% in 1984, 86.7% in 1988). The odds-growth-rate in CVS was 1.64 and 1.67 respectively, which was not significantly different. The relatively limited use of CVS at AMA is most likely determined by the fact that a considerable number of patients are referred too late in pregnancy to have the option of CVS. PMID- 1785642 TI - Monozygotic twins of discordant sex both with 45,X/46,X,idic(Y) mosaicism. AB - A female twin with short stature, unusual facial appearance, widely spaced nipples, and coarctation of the aorta was found to have a peripheral blood lymphocyte karyotype of 45,X(43%)/46,X,idic(Y)(p11). Her twin brother, also short with similar facial appearance, had the same mosaicism (40% 45,X). Cultured skin fibroblast studies showed discrepant karyotypes of 45,X (100%) in the girl and 45,X (78%)/46,X,idic(Y)(p11) in the boy. The mother and the father had normal chromosomes. Comparison of 27 biochemical markers yielded a likelihood of monozygosity of 0.9977. This report documents the occurrence of discordant phenotypic sex in monozygotic twins, involving gonadal dysgenesis with an abnormal dicentric Y, which presumably occurred de novo, followed by anaphase lag probably before the occurrence of twinning. Unequal distribution of the two resultant cell lines in various tissues of each twin could account for the development of the very different phenotypes, apparently normal boy and Ullrich Turner girl. PMID- 1785643 TI - Apparent CHARGE association and chromosome anomaly: chance or contiguous gene syndrome. AB - This report concerns 2 unrelated patients with apparent CHARGE association and a chromosome abnormality, resulting from different unbalanced familial translocations involving chromosomes 2 and 18 in one family, and chromosomes 3 and 22 in the other. Although the identification of two different chromosome abnormalities might be due to chance, the observation of a long arm deletion of chromosome 22 in patients 2 and of the frequent coexistence of CHARGE association and DiGeorge anomaly raise the possibility of a contiguous gene syndrome in at least some CHARGE cases. PMID- 1785644 TI - Megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS), an autosomal recessive disorder: clinical reports and review of the literature. AB - We present 2 new patients with the megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS), review the literature, and discuss the prenatal diagnosis and treatment. MMIHS, as reported in 43 cases, is usually lethal. Most children die during the first year of life, and only 3 children survived their first year. We report the 6th pair of sibs with the disease. Overall, 17 patients reported have had sibs with MMIHS or the parents were consanguineous; 4 times the parents were first, cousins, confirming that this is an autosomal recessive disorder. The present 2 children, whose parents also were first cousins, were of different sex. They had typical MMIHS with abdominal distension due to pronounced megacystis, hydronephrosis, microcolon, and microileum, involving the distal part of the ileum, malrotation of the gut, and intestinal hypoperistalsis. Neither surgery nor medical treatment was successful and the children died at the age of 19 days and 2 1/2 months, respectively. There is no cure for the disease. However, a new protkinetic drug, Cisapride might be worth trying in these cases. Prenatal ultrasound diagnosis of MMIHS might be possible. PMID- 1785645 TI - Fryns syndrome without diaphragmatic hernia? AB - We report on a child with Fryns syndrome including lung hypoplasia, characteristic facial appearance, cleft palate, cardiac anomaly, distal limb abnormalities, absent nipples, bicornuate uterus and early death. In contrast to most patients with Fryns syndrome, diaphragmatic hernia was absent in our patient. However, the diaphragm was reduced to a fibrous web with reduced muscular component. PMID- 1785646 TI - Familial holoprosencephaly, heart defects, and polydactyly. AB - We describe a pair of sibs with microcephaly, hypoplastic nose, cleft lip/palate, a complicated Fallot-like cardiac defect, and holoprosencephaly and polydactyly. One sib appeared to have normal chromosomes. The healthy parents were second cousins. This constellation of signs has been described before in at least 14 other patients, and was possibly present in several others. Although there is overlap with a number of similar conditions, especially hydrolethalus syndrome, this probably represents a separate entity. Three pairs of sibs and consanguinity in 3 families point to autosomal recessive pattern of inheritance. PMID- 1785647 TI - A plea from so-called "Eastern-Europe". PMID- 1785648 TI - Cardiofacio cutaneous syndrome: notes on clinical variability and natural history. PMID- 1785649 TI - Isodicentric Xq in Klinefelter syndrome. PMID- 1785650 TI - Agenesis or hypoplasia of major salivary and lacrimal glands. PMID- 1785651 TI - Phenotypic definition of cleft lip and its importance to genetic studies of the trait. PMID- 1785652 TI - Uniparental disomy as the basis for an association of rare disorders. PMID- 1785653 TI - Treatment of infantile spasms with intravenous gamma-globulins. AB - In a prospective study, 23 children with infantile spasms received intravenous gammaglobulins in high doses. 19 patients present a West syndrome. 4 older patients were included in the study because infantile spasms had preceded their Lennox-Gastaut syndrome. None of the patients had recently undergone corticosteroid therapy. No effect was observed in 15 patients, while transitory clinical and/or electroencephalographic improvement was noted in 3. Complete normalization was obtained in the remaining 5 patients, of whom 4 had severe brain lesions. No correlation existed between the therapeutic results and immunological abnormalities, a deficiency in IgG subclasses in particular. On the whole, the therapeutic results were disappointing. But the existence of some cases in which spectacular electroencephalographic and/or clinical improvement was obtained leads us to suggest that IV gamma-globulins be used as auxiliary treatment in infantile spasms. PMID- 1785654 TI - Prognostic value of early somatosensory evoked potentials for adverse outcome in full-term infants with birth asphyxia. AB - SEPs were examined during the first weeks of life in 34 infants with mild to severe birth asphyxia, in an attempt to provide a more accurate prediction of neurodevelopmental outcome. Normal, delayed and absent responses were compared with the infant's acute clinical condition, imaging findings using different imaging techniques and neurodevelopmental outcome. All infants with normal SEPs were normal at follow-up. All but two of the infants with a delayed or absent response died or suffered from severe neurological sequelae. A delayed or absent N1 latency carried a risk for death or severe handicap of 71 and 100%, respectively, compared with 25 and 89% for moderate or severe encephalopathy on neurological assessment, and 29 and 85% for moderate or severe changes seen using different imaging techniques. SEPs may provide useful additional information when assessing the infant with birth asphyxia. PMID- 1785655 TI - The late waves of brainstem auditory evoked potentials in children with cerebrovascular diseases. AB - We examined brainstem auditory evoked potentials (BAEPs) in 28 children with cerebrovascular diseases and 38 normal control subjects and investigated the neuroanatomic correlations of the late waves (VI and VII) of the BAEPs. The patients included 19 patients with moyamoya disease and 9 with other cerebrovascular accidents. Wave VI was more consistently seen (only missing in 2 cases, 5%-2 ears, 3%) than wave VII (missing in 26 cases, 68%-40 ears, 53%) in the control group. Absent, depressed or prolonged wave VI correlated well with cerebral lesions involving internal capsule and basal ganglia, while wave VII had a less significant correlation with any cerebral lesions in children with cerebrovascular diseases. PMID- 1785656 TI - A screening for dystrophin gene deletions in Japanese patients with Duchenne/Becker muscular dystrophy by the multiplex polymerase chain reaction. AB - A new screening method involving the multiplex polymerase chain reaction was developed to detect dystrophin gene deletions in Japanese patients with Duchenne and Becker muscular dystrophy (DMD/BMD). Eleven exonic regions including deletion "hot spots" were analyzed. Gene deletions were found in 33% of 92 unrelated Japanese patients, mainly in the central portion (exons 43-52) and at the 5' end (exons 1-17). This is a useful laboratory test for the rapid genetic diagnosis of DMD/BMD. PMID- 1785657 TI - Effects of carbamazepine on bicuculline- and pentylenetetrazol-induced seizures in developing rats. AB - The anticonvulsant effect of carbamazepine (CBZ) was examined in 10-, 18- and 25 day-old Wistar albino rats into which bicuculline or pentylenetetrazol had been systemically injected to induce generalized epileptic manifestations typical for the specific age of the animals. The results showed that: a) in developing rats, CBZ appears to be more effective in the pentylenetetrazol than the bicuculline model of epilepsy; b) in both models of epilepsy the efficacy of CBZ increases with the age of the animals; and c) among the various epileptic manifestations, the tonic phase is the most sensitive to the anticonvulsant effect of CBZ. These conclusions are correlated with the different levels of cerebral maturation of the animals, and are discussed with reference to the mechanisms of action of CBZ and bicuculline or pentylenetetrazol. PMID- 1785658 TI - Formation of an ipsilateral corticospinal tract after ablation of cerebral cortex in neonatal rat. AB - The formation of an aberrant ipsilateral corticospinal tract after unilateral cerebral cortical ablation during the neonatal period has been confirmed in the rat. The tract was chronologically studied using the antegrade horseradish peroxidase (HRP) tracing method. An aberrant ipsilateral tract is not observed 3 days after the operation. However, ipsilateral HRP positive fibers become apparent on day 7 and progressively more prominent until day 14. These results suggest that the ipsilateral corticospinal tract is composed of collateral axons originating from pyramidal neurons in the healthy ipsilateral cerebral cortex. These results also indicate that, when cerebral cortex has the damage during early postnatal life, the remaining cortical neurons which have been freed from the damage show considerable plasticity in terms of the collateral axons. PMID- 1785659 TI - Eating seizures associated with focal cortical dysplasia. AB - A 15-year-old boy in whom seizures were precipitated by drinking is described. Ictal EEG showed biparietal slow-wave discharges of greater amplitude over the right parietal lobe. Cerebral MRI disclosed right parieto-occipital cortical dysplasia. The mechanism which may be responsible for the seizures is briefly discussed. PMID- 1785660 TI - Palatal myoclonus in Krabbe disease. AB - A seven-year-old girl with Krabbe disease presenting palatal myoclonus only when awake is reported. The patient was diagnosed as having Krabbe disease enzymatically at the age of eleven months. She developed rhythmical contractions of the soft palate, pharynx, larynx, lips and tongue at two years. The surface electromyography showed rhythmical 2 Hz electrical activities. The MRI disclosed markedly attenuated intensity in the midbrain, pons and medulla oblongata on T2 weighted images. Palatal myoclonus was not controlled by carbamazepine in therapeutic doses, but disappeared when the patient was asleep. This is the first reported case of Krabbe disease with palatal myoclonus. PMID- 1785661 TI - Minipolymyoclonus in congenital nemaline myopathy: a nonspecific clinical marker of neurogenic dysfunction. AB - The authors report a seven-month-old boy with severe hypotonia, poor spontaneous movements, breathing difficulties and recurrent respiratory infections, dysmorphisms and a peculiar movement disorder: minipolymyoclonus (MPM), previously reported only in spinal muscular atrophies. MPM is characterized by nonrhythmic myoclonic jerks associated with a rhythmic tremor of the extended fingers polygraphically detected. A muscle biopsy showed pathological changes typical of congenital nemaline myopathy (CNM). The relationship between MPM and CNM may be explained on the presumptive basis of the "neurogenic" nature of this congenital myopathy or by the non-specificity of this clinical sign. PMID- 1785662 TI - Hearing impairment in two boys with I-cell disease. AB - Auditory brainstem responses (ABR) were analyzed in 2 boys with I-cell disease. Both patients showed a prolonged latency of wave I, a normal I-V interpeak latency and an elevated threshold of wave V. The intensity-latency curve had a steep slope. These abnormal ABR findings reflect the presence of conductive hearing impairment associated with the cochlear component in I-cell disease. PMID- 1785663 TI - A case with athetosis, mental retardation, deafness, and pachygyria. AB - A 6-year-old girl with pachygyria was presented. Regions of pachygiria were seen in the frontal, temporal, and parietal areas in vivo by magnetic resonance imaging. She showed athetosis, mental retardation, deafness, short stature, and microcephalus, but did not show epilepsy. A combination of these symptoms may be a new clinical entity, caused by undetermined prenatal events. PMID- 1785664 TI - Is colloid cyst of the third ventricle a manifestation of nevoid basal cell carcinoma syndrome? AB - A 14-year-old girl with nevoid basal cell carcinoma syndrome presented with intermittent headache and nausea. Magnetic resonance imaging and a computed tomographic scan of the head revealed a colloid cyst of the third ventricle and mild dilatation of the lateral ventricle. The cyst was successfully removed by stereotaxic surgery. The occurrence of two rare disorders in the same patient could be a coincidence. Other similar patients must be found before it is established that the colloid cyst is part of the nevoid basal cell carcinoma syndrome. PMID- 1785665 TI - Introduction: hematopoiesis and hematopoietic growth factors. PMID- 1785666 TI - Erythropoietin. Biology and clinical applications. AB - Erythropoietin is a glycoprotein hormone that plays a vital role in erythropoiesis. It is mainly produced in the fetal liver till the third trimester of pregnancy. At that point, the kidney interstitium takes over this function and becomes the main source of erythropoietin. Hypoxia stimulates erythropoietin production by a mechanism that may require a heme protein as a second messenger. Erythropoietin stimulates the maturation of erythroid precursors (colony-forming unit-erythroid and burst-forming unit-erythroid) via at least two types of cell surface receptors. The higher-affinity receptors appear to be more important in modulating the effects of erythropoietin in vivo. Changes in intracellular calcium may ultimately mediate the action of erythropoietin on erythroid precursors. A specific and sensitive radioimmunoassay is now available for accurately measuring erythropoietin levels. All forms of erythrocytosis except polycythemia vera are associated with elevated erythropoietin levels. Levels are also high in cord blood obtained following fetal asphyxia. Reduced levels are seen in patients with anemia due to renal diseases. The response of erythropoietin to the degree of anemia appears to be attenuated in patients with cancer, chronic diseases, and human immunodeficiency virus (HIV) infection. Erythropoietin has been successfully used for treating patients with anemia due to renal failure. Its use has also been approved for the treatment of anemia patients receiving zidovudine for HIV infection. Encouraging results have been observed when erythropoietin was used to treat anemia due to rheumatoid arthritis, hematological malignancies, and prematurity. It has also been used to increase the yield of autologous blood collected prior to an elective surgical procedure. However, it has not proved to be useful in sickle cell anemia and myelodysplastic syndromes. PMID- 1785667 TI - Potential uses of recombinant human granulocyte-macrophage colony-stimulating factor in children. AB - Granulocyte-macrophage colony-stimulating factor (GM-CSF) is a glycoprotein necessary for the growth, differentiation, and function of cells of the granulocyte-macrophage lineage. This agent has been molecularly cloned and expressed in bacteria, yeast, and mammalian cell lines, providing a limitless source of the pure human protein for use in children. Here, we briefly review the discovery, biologic characterization, gene identification and cloning, and clinical experience to date with this new agent, focusing where possible on the use of recombinant GM-CSF in children. PMID- 1785668 TI - Interleukin-3. Its biology and potential uses in pediatric hematology/oncology. AB - The hematopoietic growth factor interleukin (IL)-3 is a potent regulator of blood cell proliferation. It promotes the survival, proliferation, and development of hematopoietic stem cells and committed progenitor cells of the granulocyte macrophage, erythrocyte, eosinophil, basophil, megakaryocyte, mast cell, and lymphocyte lineages. In addition, IL-3 enhances mature myeloid cell functions such as phagocytosis and activation of basophils and eosinophils, as well as monocyte cytotoxicity. The first phase of clinical trials suggested that IL-3 may augment myelopoiesis in a number of clinical conditions. It may be efficacious for treatment of primary marrow disorders, including myelodysplastic syndromes and aplastic anemia. However, replacement therapy with IL-3 alone is probably not sufficient to obtain maximal stimulation of myelopoiesis. Preclinical and clinical studies published to date suggest that sequential use or combinations of growth factors will be needed to obtain optimal hematopoietic responses. PMID- 1785669 TI - Erythropoietin deficiency: a complication of cisplatin therapy and its treatment with recombinant human erythropoietin. AB - Cisplatin (CDDP) has been implicated in the development of anemia via several mechanisms of action, including shortening of red cell (RBC) survival and direct toxicity of the drug on RBC bone marrow precursors. Recent studies and case reports suggest an association between CDDP and the development of hyporegenerative anemia as a consequence of relative erythropoietin (EPO) deficiency. To study the effects of CDDP on the relationship between serum EPO and hemoglobin (Hb) concentration, we measured levels of EPO in 12 patients (1-21 years of age) who were treated with cumulative doses of CDDP ranging from 300 to 720 mg/m2 for a variety of pediatric malignancies. Post-CDDP glomerular filtration rates (GFR) varied from 29 to 143 ml/min/1.73 m2 for 11 of the 12 patients studied. At the completion of CDDP therapy, an inverse linear relationship between log(10) serum EPO and Hb was noted among those patients who retained at least 40-50% of their pre-CDDP therapy GFR. One patient with chronic renal failure at the completion of CDDP therapy (GFR 25-35 ml/min/1.73 m2) exhibited a chronic transfusion-dependent, hyporegenerative anemia that was due to persistently low levels of EPO. Institution of recombinant human (r-Hu) EPO therapy resulted in an abrupt cessation of this patient's RBC transfusion dependency. Additional studies are needed to further characterize the effects of CDDP on EPO production and secretion and to determine optimal dosing schedules for r-Hu EPO in pediatric patients who receive CDDP and other myelosuppressive chemotherapy. PMID- 1785670 TI - Synergistic shortening of the bleeding time by desmopressin and ethamsylate in patients with various constitutional bleeding disorders. AB - Desmopressin and ethamsylate were evaluated for possible synergistic effects on the bleeding time. The drugs were administered individually and together to 12 patients with markedly prolonged bleeding times known to be relatively or absolutely unresponsive to desmopressin alone. The bleeding disorders studied included Glanzmann's thrombasthenia (one), other disorders of platelet function (four), pseudo-von Willebrand disease (one), and von Willebrand disease type I (three), type II (two), and type III (one). Desmopressin alone shortened the bleeding time from 23.9 +/- 1.5 to 19.5 +/- 2.3 min (p = 0.03). Ethamsylate alone was without effect. Desmopressin and ethamsylate together shortened the bleeding time to 11.2 +/- 1.4 min (p less than 0.01 compared to baseline, p = 0.02 compared to desmopressin alone). The combination was ineffective in three patients, with Glanzmann's thrombasthenia (one), and von Willebrand disease type I (one) and type III (one). Toxic effects of the drugs were not observed. Five patients received desmopressin and ethamsylate prior to dental work with mandibular block (one), heart surgery requiring cardiopulmonary bypass (two), and adenotonsillectomy surgery (two). Normal hemostasis was achieved in each case. A synergistic shortening of the bleeding time was observed with the combination of desmopressin and ethamsylate in a wide range of bleeding disorders. PMID- 1785671 TI - Late effects of childhood malignancies seen in Western Australia. AB - Eighty-nine pediatric oncology patients, in remission and off treatment for at least 4 years, were reviewed annually in the Late Effects Clinic of Princess Margaret Hospital for Children in Perth, Western Australia. Interval from time of diagnosis to follow-up ranged from 4 to 23 years (mean 10.8 years). Acute lymphoblastic leukemia (ALL) (40%) and Wilms' tumor (27%) were the most common primary malignancies in this group. Late sequelae included musculoskeletal abnormalities (23 children), growth hormone deficiency (11), second tumors (9), learning difficulties (7), puberty and fertility problems (4), and hypothyroidism (4). These complications were most often related to radiation therapy. The need for prolonged, regular follow-up of survivors of childhood malignancy for early detection of late sequelae and subsequent intervention is stressed. PMID- 1785672 TI - Comparative effectiveness of two combined modality regimens in the treatment of surgical stage III Hodgkin's disease in children. An 8-year follow-up study by the Pediatric Oncology Group. AB - The Pediatric Oncology Group compared two regimens that employed involved field radiotherapy 3,500 rad and either MOPP + Bleo or A-COPP chemotherapy, given in a sandwich fashion, as treatments for stage III Hodgkin's disease in children under the age of 18 years. Eighty-four surgically staged children from the United States and Mexico who had been randomly assigned to treatment during the period from July 1976 through October 1982 were evaluated. Unfavorable disease characteristics were distributed equally between the treatment groups. The percentages of children achieving complete remission by regimen were 84% for MOPP + Bleo and 92% for A-COPP. For those continuing in complete remission, the percentages were 71% for MOPP + Bleo and 72% for A-COPP. For those surviving 9 years, the percentage was 84% for MOPP + Bleo and 85% for A-COPP. The presence of low abdominal disease at diagnosis did not adversely influence response to therapy or survival. All deaths among MOPP + Bleo cases occurred within 4 years of study entry; 3 late deaths in A-COPP cases at 8-10 years were due to osteosarcoma, cardiopathy, and recurrent Hodgkin's disease. The preferred treatment regimen for future use cannot be determined until the cardiotoxicity of Adriamycin is eliminated by the development of drug delivery techniques that reduce cardiotoxicity or anthracycline congeners that are not cardiotoxic. PMID- 1785673 TI - Intrathoracic carcinoma in an 11-year-old girl showing a translocation t(15;19). AB - We report here a rare case of intrathoracic undifferentiated carcinoma in an 11 year-old girl. The biopsy tissue stained with antibodies against cytokeratin and carcino-embryonic antigen. The same staining was obtained using a cell line, PER 403, which was derived from the tumor. DNA from PER-403 cells was tested for the presence of Epstein-Barr virus genes, yielding a negative result. The cytogenetic analysis found a translocation t(15;19) (p12;q13), which has not previously been described in a carcinoma. PMID- 1785675 TI - Intracranial hemorrhage in a newborn with hemophilia following elective cesarean section. AB - A newborn infant with severe hemophilia developed an intracranial hemorrhage despite a delivery by elective cesarean section. This case shows that hemophiliacs can have spontaneous central nervous system bleeding during the perinatal period. Newborns at risk for hemophilia should receive prompt evaluation whatever the mode of delivery. PMID- 1785674 TI - High-dose carboplatinum and VP-16 in treatment of metastatic adrenal carcinoma. AB - We describe a case of a patient that presented to our center with Cushing syndrome and was found to have an extensive metastatic adrenal carcinoma. He underwent debulking of the abdominal disease followed by eight courses of VP 16/carboplatinum. The patient had a remarkable response and is currently alive and in complete remission. PMID- 1785676 TI - Pediatric oncology in Brazil, progress in spite of great obstacles. PMID- 1785677 TI - Use of ascorbate for the treatment of refractory idiopathic thrombocytopenic purpura in children. PMID- 1785678 TI - Myelofibrosis in a child with sickle cell anemia. PMID- 1785679 TI - Preparative steps necessary for the accurate measurement of malondialdehyde by high-performance liquid chromatography. AB - The need for a more specific, reliable, and reproducible technique for the measurement of malondialdehyde (MDA) has prompted modifications of currently available methods based on the formation and recovery of the complex between MDA and thiobarbituric acid (TBA). To 500 microliters of plasma or to 300 mg of liver homogenate, 2 ml of H2O and 500 microliters of 0.5% butylated hydroxytoluene in methanol were added to prevent further formation of MDA. Precipitation of proteins carried out with 200 microliters of 0.66 N H2SO4 and 150 microliters of 10% Na2WO4 (w/v) led to complete recovery of the MDA standard. Maximum formation of the MDA-TBA complex was obtained by adjusting the pH between 2.5 and 4.5 and heating the MDA-TBA mixture at 100 degrees C for 60 min. Extraction of the MDA TBA complex was a critical step and proved complete with n-butanol at pH less than 0.75. It was then evaporated at 37 degrees C under nitrogen. The MDA-TBA complex solubilized in H2O was shown to be stable for at least 7 days. These preparative steps led to the detection of a single peak that on spectral analysis was identified as pure MDA-TBA. This procedure offers several advantages in terms of specificity, recovery, and reproducibility. PMID- 1785680 TI - Imaging acetylcholine-receptor-induced influx of inorganic ions at single-cell resolution with ion microscopy. AB - Ion microscopy was used to image neurotransmitter-induced tracer ion flux at single-cell resolution. A mammalian muscle cell line (BC3H1) expressing the nicotinic acetylcholine receptor was exposed to 2 mM CsCl, with and without the acetylcholine analog carbamylcholine. 133Cs+, 12C+, 40Ca+, 39K+, and 23Na+ secondary ion images revealing intracellular distribution of these elements were recorded with a CAMECA IMS-3f ion microscope from freeze-fractured freeze-dried BC3H1 cells. The ion images were digitized directly from the microchannel plate/fluorescent screen detector assembly of the ion microscope using a charge coupled device imager. Submillimolar concentrations of cesium were easily imaged. Cesium images were normalized to carbon images for a direct comparison of carbamylcholine-exposed and control cells. Carbamylcholine-exposed cells showed significantly higher cesium influx than controls. Within the carbamylcholine exposed cells, cell-to-cell heterogeneity for cesium influx was observed. Injured cells were identified by their potassium, sodium, and calcium signals and omitted from the quantitative analysis of the ion image data. This method should be useful for identifying cells from various regions of the nervous system containing receptors that control the translocation of monovalent cations, including Cs+. Among these neuronal receptors in the central nervous system are those activated by acetylcholine, glutamate, aspartate, or N-methyl-D-aspartate. PMID- 1785681 TI - Endoglucanase A gene fusion vectors for monitoring protein secretion and glycosylation in yeast. AB - We have constructed a set of replicating and integrating vectors that allow expression and secretion of Clostridium thermocellum endoglucanase A in Saccharomyces cerevisiae using the alpha-factor or the invertase promoters and secretion signals. The enzyme expressed in yeast was enzymatically active regardless of its degree of glycosylation and was released into the culture medium. One advantage of using this experimental system is that secretion of the reporter enzyme can be detected in individual colonies facilitating the isolation of mutants. A second advantage is that transit through the secretory pathway, as judged from the extent of glycosylation, can be easily monitored by staining for enzyme activity in agar replicas of polyacrylamide gels. PMID- 1785682 TI - An ultrarapid filtration method adapted to the measurements of water and solute permeability of synthetic and biological vesicles. AB - An ultrarapid filtration method was adapted to the determination of water and solute permeability of membrane vesicles. This method consisted of measuring substance washout from vesicles first loaded with 3H2O or labeled solutes, placed on filters, and rinsed at high rates for short periods. The retention of the vesicles on the filters was analyzed and was found to be a function of the nature and porosity of the filters as well as of the vesicle origin. Washing buffer flow rate and washing duration did not affect vesicle retention. The diffusional water permeability of cholesterol-free liposomes was determined at 16 degrees C. Its value was reduced by a factor of 2.5 when the liposomes were prepared with 20% cholesterol and a threefold increase was noted when the liposomes were preincubated with gramicidin (6 mg/g lipid). Water permeability of liposomes was strongly temperature-dependent: Ea = 15.3 kcal/mol. Diffusional water permeability of pink ghosts was also measured: a value of (4.4 +/- 0.2) X 10(-3) cm/s (n = 3) was obtained at 13 degrees C. This permeability was reduced by 45.2% with 0.4 mM HgCl2. The urea permeability of intestinal and renal brush-border membrane vesicles was (1.15 +/- 0.18) X 10(-6) cm/s (n = 7) and (1.67 +/- 0.08) X 10(-6) cm/s (n = 9), respectively. The renal value was reduced by a factor of 4.4 by 100 mM thiourea. This ultrarapid filtration technique provides an accurate method of transport measurement in sealed membranes such as liposomes and plasma membrane vesicles. PMID- 1785683 TI - Determination of the chirality of amino acid residues in the course of subtractive Edman degradation of peptides. AB - A chiral reagent, 1-fluoro-2,4-dinitro-5-L-alanine, was synthesized for the analysis of enantiomeric mixtures of amino acids after precolumn derivatization. The resulting diastereomers can be separated and quantitated by microbore RP HPLC. These derivatives are relatively stable under the conditions used for acid hydrolysis of peptide bonds. Thus, this reagent was included in the protocol of a subtractive Edman degradation procedure of peptides to determine the sequence position of amino acid residues with concomitant identification of their chirality at a nanomolar level. PMID- 1785684 TI - Analysis and quantitation of the DNA damage produced in cells by the cisplatin analog cis-[3H]dichloro(ethylenediamine)platinum (II). AB - The anticancer drug cisplatin elicits its cytotoxicity through damaging DNA. A sensitive method for following this interaction involves the use of an analog cis [3H]dichloro(ethylenediamine)platinum(II) (cis-[3H]DEP). Cells are incubated with this analog, the DNA is purified, the enzyme is digested, and the deoxyribonucleoside-bound adducts are separated by HPLC. Other radioactive peaks can be detected by HPLC. These have been identified as arising from contaminating RNA and from the incorporation of tritium into unmodified nucleosides. A rapid DNA purification procedure that overcomes the first problem is presented. The latter problem is overcome by incubation of cells in hypoxanthine, aminopterin, and thymidine (HAT medium). Direct quantitation of levels of DNA platination can be determined in a single HPLC run by comparing the radioactivity in a specific adduct peak to the absorbance of the unmodified deoxyribonucleosides. Modifications to the synthesis of cis-[3H]DEP, the enzyme digestion of DNA, and the HPLC methodology are also described. PMID- 1785685 TI - Sequence analysis of end-labeled DNA fragments by solvolysis in aqueous solutions of different amines. AB - Cleavage of 3'-end-labeled DNA in hot aqueous solutions of different amines is comparatively examined for overall rate of DNA scission as well as for potential differences in the preference of the various amines for cleavage at the different bases. Under comparable conditions (0.5 M amine, 0.3 M NaCl, 90 degrees C), piperidine, diethylamine, morpholine, and ethylenediamine produce the same set of labeled fragments, at approximately equal overall cleavage rates. The same set of fragments is also obtained with diisopropylamine, triethylamine, and 1,4 diazabicyclo[2.2.2]octane, but at markedly lower overall cleavage rates. Solvolysis in aqueous piperidine or aqueous diethylamine leads to DNA scission predominantly at A sites, followed by G and C sites, and least frequently at T sites. In contrast, morpholine, ethylenediamine, diisopropylamine, triethylamine, and diazabicyclo[2.2.2]octane cleave the DNA predominantly at G sites. Therefore, use of one of the latter amines allows clear distinction of G bands and C bands, which could not be distinguished by the criterion of band intensity in the original one-lane sequencing method based on cleavage in hot aqueous piperidine (B. Ambrose and R. Pless (1985) Biochemistry 24, 6194-6200). The effect of varying the salt concentration on the cleavage distribution obtained with various amines is also examined, and a rationale is given for the influence of salt concentration and amine basicity on the relative rate of cleavage at G sites. PMID- 1785686 TI - A multiple mass spectral line method for determining positional specific activities in stable isotope-labeled amino acids. AB - A method for determining the position and enrichment of isotope labels in amino acids using gas chromatography/mass spectrometry is described. [alpha-15N]- and [epsilon-15N]lysine, [1-13C]- and [15N]alanine and -leucine, and [1-13C]-, [2 13C]-, [3-13C]-, and [4-13C]aspartic acid were investigated. Standards for each isotope label were prepared and analyzed under scan conditions, and line pairs characteristic for the label were identified. The standards were reanalyzed under selective ion monitoring conditions to verify the behavior of the line pairs. Mixtures of amino acids containing different isotope labels or the same label in different positions were prepared and analyzed under selective ion monitoring conditions. Enrichments were determined with high precision and relative errors ranging from 0.14 to 36%. PMID- 1785687 TI - Aqueous two-phase protein partitioning using textile dyes as affinity ligands. AB - A simple and inexpensive aqueous two-phase system for the affinity partitioning of proteins is introduced. An aqueous solution consisting of maltodextrin (M100; molecular mass, 1800) and polyvinylpyrrolidone (PVP360; molecular mass, 360,000) formed two phases at 4 degrees C when the concentration of the polymers was 22.5% (w/w) and 4.0% (w/w), respectively. When the amino derivatives of chlorotriazine textile dyes or other azo textile dyes were added to the two-phase system they partitioned asymmetrically, favoring the upper, less dense, PVP360-rich phase. The association of the textile dyes with PVP360 did not prevent them from acting as affinity ligands for proteins. Three of the dyes screened increased the partition coefficient of purified lysozyme nearly 50-fold over a control containing no dye. Parameters such as pH, ionic strength, and dye concentration modulated the affinity-partitioning effect of the system. The partition coefficient of lysozyme in an egg white protein mixture increased severalfold as the total protein content of the system approached 4% (w/w), indicating that protein concentration is also important in determining the partitioning characteristics of this two-phase system. Proteins were efficiently freed of PVP360 and textile dye by recovery in a high-salt solution when another two-phase system was formed upon the addition of a solution of concentrated potassium phosphate to the isolated upper phase of a PVP360/M100/textile dye two-phase system. The affinity-partitioning system presented here allows one to screen large numbers of potentially useful protein ligands to optimize protein separation, followed by direct scaleup to a system size determined by the user. PMID- 1785688 TI - Flow-injection determination of proteins using enhanced peroxyoxalate chemiluminescence applied to the determination of immunoglobin G and albumin in serum. AB - The intensity of the chemiluminescence (CL) signal from an aqueous peroxyoxalate CL reaction can be significantly enhanced in the presence of various proteins with hydrophobic sites. A flow-injection measurement for various hydrophobic proteins based on this CL enhancement was developed. The enhancement is due to the inclusion of the CL species in the favorable environment provided by the protein's hydrophobicity, which results in efficient light production. Various protein structures were evaluated; the degree of enhancement depends on the protein structure and CL reaction conditions. The CL enhancement measurement in the flow-injection system is made after the introduction of the protein solution to the main phosphate buffer stream followed by the addition of the CL reagent streams: (1) hydrogen peroxide in water and (2) 8-anilino-1-naphthalene sulfonic acid and 4,4'-oxalylbis-(trifluoromethylsulfonylimino)ethylene bis(4-methyl morpholinium trifluoromethane sulfonate) in acetonitrile. Although prior separation of proteins is required before the measurement, the advantage of this approach is increased sensitivity without derivatization of the protein. The enhancement was demonstrated for several proteins, including antibodies, which suggests that this approach may be generally applicable to a variety of measurements, including immunoassay determinations. This CL enhancement was used to develop a simple and accurate flow-injection measurement for the determination of albumin and IgG in human serum. PMID- 1785689 TI - A continuous fluorescent assay for measuring protease activity using natural protein substrate. AB - A continuous caseinolytic activity assay has been developed and characterized with trypsin, a serine protease, and transin, a metalloproteinase. Beta-casein labeled with both N-(7-dimethylamino-4-methylcoumarinyl)-maleimide (DACM) and fluorescein isothiocyanate (FITC) is used as the substrate in this assay. The effect of proteolysis of the substrate is a reduction of the intermolecular energy transfer from DACM to FITC. The caseinolytic activity is then monitored by the fluorescence increase. The activities of both proteases obey Michaelis-Menten kinetics with Km = 1.6 +/- 0.2 microM for trypsin and Km = 13.2 +/- 1.9 microM for transin. Protease concentrations as low as 10 ng/mL can be utilized. The pH dependence of the caseinolytic activity has been determined for both enzymes. PMID- 1785690 TI - Continuous spectrophotometric assays for dopamine beta-monooxygenase based on two novel electron donors: N,N-dimethyl-1,4-phenylenediamine and 2-aminoascorbic acid. AB - Based on the novel chromophoric electron donors, N,N-dimethyl-1,4 phenylenediamine (DMPD) and 2-amino-2-deoxy-L-ascorbic acid (2-aminoascorbic acid), two sensitive, convenient, and continuous spectrophotometric assays for dopamine beta-monooxygenase (EC 1.14.17.1) are described. Both, DMPD and 2 aminoascorbic acid are kinetically and stoichiometrically well-behaved electron donors for dopamine beta-monooxygenase with kinetic parameters comparable to the most efficient physiological electron donor, ascorbic acid. During dopamine beta monooxygenase turnover, DMPD is converted to its chromophoric cation radical which is stable under the standard assay conditions. The rate of the enzyme dependent formation of DMPD cation radical under standard assay conditions could easily be followed at 515 nm with high accuracy and reproducibility. Similarly, dopamine beta-monooxygenase-mediated oxidation of 2-aminoascorbic acid results in the formation of the known, stable chromophoric product, 2,2'-nitrilodi-2(2') deoxy-L-ascorbic acid (red pigment), which has a very strong absorption maximum at 385 nm. Both the above assays are superior to the existing assays in their convenience, reproducibility, and sensitivity for routine kinetic analysis of dopamine beta-monooxygenase and may be adopted as a simple color test for the enzyme. We propose that the above assays could also be adopted to design continuous and sensitive spectrophotometric assays for ascorbate oxidase, peptidyl alpha-amidating monooxygenase, and the chromaffin granule electron transport protein, cytochrome b561, due to their remarkable similarity to dopamine beta-monooxygenase in the chemistry of catalysis with regard to the electron donor. PMID- 1785691 TI - Electrochemical detection of proteins in high-performance liquid chromatography using on-line, postcolumn photolysis. AB - Direct detection of proteins in high-performance liquid chromatography electrochemistry (LCEC) is difficult. By using on-line, postcolumn photolysis, proteins now can be detected by LCEC at microgram per milliliter levels. The compatibilities of size exclusion chromatography (SEC), reversed-phase chromatography (RPC), ion-exchange chromatography (IEC), and hydrophobic interaction chromatography (HIC) with photolysis-electrochemical detection is described for proteins together with the analytical figures of merit. Inherent from the advantages of electrochemical detection, the method is sensitive and selective. PMID- 1785692 TI - A fluorimetric assay for acyl-CoA synthetase activities. AB - In this paper we describe a fluorimetric assay for the measurement of long-chain acyl-CoA synthetase activity in rat liver postnuclear supernatants. The method is based upon the use of acyl-CoA oxidase which catalyzes the dehydrogenation of acyl-CoA esters to yield enoyl-CoA esters and H2O2. H2O2 subsequently reacts with homovanillic acid in a horseradish peroxidase-catalyzed reaction to form a highly fluorescent dimer (see G. G. Guilbault, P. J. Brignac, and M. Zimmer (1968) Anal. Chem. 40, 190-196). The increase in fluorescence can be followed either continuously or discontinuously. The method described is able to detect acyl-CoA synthetase activities as low as 20 microU/ml which is almost as sensitive as the standard isotopic assay used in most laboratories. The method is applicable to measure the activation of a variety of fatty acids. Finally, the method provides a simple means of carrying out kinetic studies. PMID- 1785693 TI - A single-reaction method for DNA sequence determination. AB - A chemical method for the determination of DNA sequence is presented. Heating of DNA, labeled at a single 3' extremity, in the presence of formamide results in efficient cleavage of phosphodiester bonds 3' of A, G, and C residues. The relative efficiency is A = G greater than C. The bias between A and G is solved by a simple pretreatment (photoreaction in methylene blue) followed by heating in formamide. The entire procedure does not require any intermediate purification step or handling of hazardous chemicals and allows determination of the sequence on only two electrophoretic lanes. Its simplicity and rapidity favor automatization. PMID- 1785694 TI - Agarose/polyacrylamide minislab gel electrophoresis of intact cartilage proteoglycans and their proteolytic degradation products. AB - We have developed a procedure for the use of minislab gels to electrophoretically separate proteoglycans (PGs), large macromolecules with molecular masses greater than 2.5 million Da. Our procedure is a modification of the method of C.A. McDevitt and H. Muir (Anal. Biochem. 44, 612-622, 1971) for agarose/polyacrylamide, composite tube gels. These 1% agarose/1.2% acrylamide minigels are run at 35 mA for 75 min; bands are visualized by toluidine blue staining. The subtle size differences between the large aggregating PGs isolated from rat chondrosarcoma, bovine nasal septal cartilage, and adult bovine articular cartilage (which consists of two subpopulations) can be distinguished by their migration on these large pore gels. Chondroitin sulfate chains, added to all wells as a marker of constant mobility, ran immediately behind the dye front. The distance of migration into the gel of PGs incubated overnight with cathepsin B, carboxypeptidase A, papain, plasmin, elastase, or cathepsin G varied with the size of the cleavage products. We propose the use of this procedure for a convenient assessment of cartilage PGs and a rapid, reproducible assay for proteoglycanase activity. PMID- 1785695 TI - A nonradioactive assay for transfected chloramphenicol acetyltransferase activity using fluorescent substrates. AB - Studies of the transcriptional activity of gene promoters have been greatly assisted by the widespread use of the chloramphenicol acetyltransferase (CAT) gene as a reporter gene. Previous techniques for assaying CAT enzymatic activity have utilized radioactive substrates or cofactors with the resulting complications of handling radioactive materials. We report here the development of fluorescent substrates for the CAT enzyme which form the basis of a CAT enzyme assay of enzyme kinetic parameters (Km and Vmax) and sensitivity similar to those based on radioactive substrates. Fluorescent substrates were designed as analogs of chloramphenicol and were based on the structure-function requirements of the enzyme. Several fluorophores were used to derivatize chloramphenicol base; one of the most effective was the borondipyrromethene difluoride (BODIPY) fluorophore. One BODIPY-chloramphenicol analog was found to have a Km for the purified CAT enzyme of 2 microM (compared to 12 microM for 14C-labeled chloramphenicol) and a Vmax of 120 pmole/min (compared to 180 pmol/min for the radioactive substrate). To verify its usefulness, a BODIPY--chloramphenicol-based CAT assay was used to measure transient transfection of primary cultures of ovarian granulosa cells in serum-free medium. This experimental system requires a highly sensitive assay for detecting transfected CAT gene activity. Robust expression of CAT activity was easily detected in crude cellular extracts using FluoReporter FAST CAT, a kit containing the BODIPY-chloramphenicol analog. The expression was precisely quantified by methanol extraction of the substrate and products from TLC plates and subsequent measurement of fluorescence using excitation-emission spectroscopy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785696 TI - Continuous fluorometric assay of phenol sulfotransferase. AB - Phenol sulfotransferases (EC 2.8.2.1) catalyze the sulfation of the acceptor hydroxyl group using 3'-phosphoadenosine 5'-phosphosulfate (PAPS) as the donor substrate. Previous assays of these enzymes, which exhibit varied acceptor substrate specificities, have required termination of the catalysis followed by isolation and quantitation of formed sulfate ester. In this report, the sulfation of the fluorescent compound, resorufin, is investigated. Reaction of PAPS with resorufin, catalyzed by bovine lung phenol sulfotransferase, bleaches the emission of this acceptor at the pH of the reaction (pH 6.4 optimum). It is thereby possible to continuously record the sulfation reaction. Analysis of single progress curves by integrated replot can be used to determine the initial velocities and also indicates the formation of a product inhibitor, probably resorufin sulfate ester, with Ki less than Km. Sensitivity of the reaction is less than 1 pmol/min. The maximal rate of resorufin sulfation by the bovine lung enzyme is estimated at 57 nmol/mg/min, which is 10% of the rate with an optimal substrate 2-naphthol. This assay may be most sensitive for phenol sulfotransferases with optimal activities at greater than pH 6, due to the acid base properties of resorufin (pK alpha 6), which becomes nonfluorescent upon protonation. PMID- 1785697 TI - Amplification and detection of substrates for protein carboxyl methyltransferases in PC12 cells. AB - A strategy that facilitates the identification of substrates for protein carboxyl methyltransferases that form "stable" methyl esters, i.e., those that remain largely intact during conventional polyacrylamide gel electrophoresis is described. Rat PC12 cells were cultured in the presence of adenosine dialdehyde (a methylation inhibitor) to promote the accumulation of hypomethylated proteins. Nonidet P-40 cell extracts were then incubated in the presence of S-[methyl 3H]adenosyl-L-methionine to label methyl-accepting sites via endogenous methyltransferases. After labeled proteins were separated by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, gel slices were incubated in 4 N methanesulfonic acid or 6 N HCl to hydrolyze methyl esters. The resulting [3H]methanol was detected by trapping in liquid scintillation fluid. Seven carboxyl methylated proteins were observed with masses ranging from 18 to 96 kDa. Detection of five of these proteins required prior treatment of cells with adenosine dialdehyde, while methyl incorporation into one protein at 18 kDa was substantially enhanced by the treatment. The use of acidic conditions for methyl ester hydrolysis has an important advantage over assays that utilize alkaline hydrolysis conditions. In PC12 cells, and possibly other cell types where there are significant levels of arginine methylation, the methanol signal becomes obscured by high levels of volatile methylamines generated under the alkaline conditions. Carrying out diffusion assays under acidic conditions eliminates this interference. Adenosine dialdehyde, by virtue of increasing the methyl-accepting capacity of substrates for protein carboxyl methyltransferases, in combination with a more selective assay for carboxyl methylation, should prove useful in the isolation and characterization of new protein carboxyl methyltransferases and their substrates. PMID- 1785698 TI - [Allergy: risk or fate?]. PMID- 1785699 TI - [Hazardous anesthesia recovery periods ...]. PMID- 1785700 TI - [Changes in plasma histamine and catecholamines levels after injection of chymopapain in chemonucleolysis]. AB - Because pruritus, erythema and tachycardia are observed in some patients during chemonucleolysis, a prospective study was designed to investigate the plasma levels of histamine and catecholamines occurring after an injection of chymopapain. Thirteen patients (11 men and 2 women), mean age 38 +/- 11 years, were studied. They all had negative prick skin tests, human basophil degranulation tests (HBDT) and radio-absorbent tests (RAST) to chymopapain. The patients were premedicated with 100 mg hydroxyzine and 3 g tranexamic acid. Sedation was carried out using 0.1 mg.kg-1 droperidol and 0.02 mg.kg-1 phenoperidine. The nucleosus pulposus was visualized with 3 ml of contrast medium (lopamiron 300); 2 ml of chymopapain were then injected. Blood samples were obtained at T1 (after the contrast medium, but before the chymopapain), and then 5, 10, 15, 20 and 30 minutes after the chymopapain. The usual haemodynamic parameters were recorded at the same times. Four patients had clinical signs (group I), whereas the other nine (group II) did not. There was an increase in histamine levels in three patients from group 1, as well as in two in group II (up to 33 nmol.l-1). However, mean histamine and catecholamines levels were comparable in both groups at all times, and between times, of sampling. There therefore was no relationship between clinical signs and the release of histamine or catecholamines. The premedication with an antihistamine may have protected the patients, but the signs reported by four patients may also be due to the chymopapain itself. PMID- 1785701 TI - [Anesthesia for heart catheterization in children. Comparison of 3 techniques]. AB - A study was carried out to compare the haemodynamic and respiratory effects, as well as the quality of recovery, of anaesthesia with ketamine, sodium gamma hydroxybutyrate (GOH) and etomidate in children undergoing cardiac catheterization. Thirty children, mean age 48 +/- 35 months, ranked ASA 2 or 3 on account of congenital heart disease, were assigned to one of three groups (n = 10). They were given: in group E1, a 0.3 mg.kg-1 bolus of etomidate, followed by 0.1 mg.kg-1.min-1 for 10 minutes, and 0.026 mg.kg-1.min-1 thereafter; in group G2, a 50 mg.kg-1 bolus of GOH, and in group K3, a 4 mg.kg-1 bolus of ketamine followed by a continuous infusion of 0.083 mg.kg-1.min-1. The patients breathed spontaneously. Monitoring included heart rate, systolic, diastolic and mean blood pressure, pulse oximetry, and capnography. Femoral venous or arterial catheterization was performed after local anaesthesia (with no more than 2 mg.kg 1 of lidocaine). Measurements were performed before induction, and then 1, 10, 30 and 60 minutes afterwards. The quality of anaesthesia was assessed according to Steward's scale. The investigation lasted between 50 and 100 min in all three groups. There were no significant differences in haemodynamic and respiratory parameters during the investigation between the groups. Recovery was shorter and of better quality in group E1. On the opposite, 30 minutes after the end of the catheterization, all the patients in group K3 were stuporous, with 5 of them displaying involuntary movements. The patients of the other two groups reacted correctly to stimuli, but those in group G2 went back to sleep very rapidly. There were no complications.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785702 TI - [Effects of lidocaine on arterial and venous circulation of limbs in man]. AB - The effects of intravenous lidocaine on limb arteries and veins were investigated in a placebo-controlled study. Seven young healthy volunteers, 23 to 28-years old, were included. Electrocardiogram, arterial pressure and arm and leg blood flows were recorded continuously. Systolic and diastolic blood pressures were measured in the left arm by finger photoplethysmography. Limb blood flow and the limb venous system were studied by venous occlusive plethysmography. The venous parameters studied were venous tone, lowest closing pressure, venous volume at 30 mmHg, and venous distensibility. After an initial bolus of 1.5 mg.kg-1 lidocaine had been given, 30, and then 60, micrograms.kg-1.min-1 were given for one hour each. Plasma noradrenaline and serum lidocaine titres were measured before giving the lidocaine, and at the end of each one hour period. Placebo consisted in a two hour infusion of 0.25 ml.min-1 normal saline. Lidocaine titres were 1.64 +/- 0.40 microgram.ml-1 after one hour, and 2.55 +/- 0.69 microgram.ml-1 after two hours. Lidocaine increased vascular resistances in both the forearm (+81% to +93%) and the calf (+38% to +57%). There was a concomitant increase in mean arterial blood pressure (+21% to +28%) without any change in heart rate. There was a significant dose-dependent increase in plasma noradrenaline levels during the second period of the lidocaine infusion with respect to the preinfusion period and the same period during the placebo infusion. Venous capacitance measured before any infusion had been started was greater in the leg than in the arm.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785703 TI - [Comparative effects of diazepam, ranitidine , sodium citrate and enprostil on pH and gastric volume in preanesthetic medication]. AB - A study was designed to assess the efficacy of oral premedication with diazepam or enprostil in preventing the gastric aspiration syndrome in fasted patients scheduled for elective surgery, and to compare the results with those obtained with ranitidine and sodium citrate. The study included 120 consecutive patients undergoing urological or plastic surgery, randomly assigned to four groups of 30. Two hours before anaesthesia, the patients from three groups were given, with 30 ml of water, either 10 mg diazepam, or 150 mg ranitidine, or 35 micrograms enprostil. Those in the fourth group were given 30 ml of 0.5 M sodium citrate, ten minutes before induction. Anaesthesia consisted in the administration of thiopentone, fentanyl, vecuronium and nitrous oxide in oxygen. After endotracheal intubation, a gastric tube was inserted. The stomach fluid content was completely aspirated, and then again 60 and 120 min after induction, as well as at the end of surgery. Age, weight and duration of surgery were comparable in the four groups. Mean pH in the diazepam group was much lower than that in the other groups, both just after induction (2.3 +/- 1.54; p less than 0.001 vs. ranitidine and sodium citrate; p less than 0.01 vs. enprostil) and at the end of surgery (3.2 +/- 2.03; p less than 0.01 vs. ranitidine and sodium citrate; p less than 0.05 vs. enprostil). There was more than 0.4 ml.kg-1 gastric juice in the sodium citrate group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785704 TI - [Analysis of failures of spinal anesthesia as a function of practice development in a university hospital]. AB - This study is a retrospective analysis of 303 consecutive spinal anaesthesia performed in orthopaedic patients of a University Hospital between January and December 1990. Failure of spinal anaesthesia was defined as the requirement for general anaesthesia to perform surgery. The parameters studied as possible risk factors of failure were patients demographics, local anaesthetic agents and solutions and techniques of spinal anaesthesia (single injection versus continuous spinal anaesthesia). Failures were related to inadequate or incomplete extension of sensory blockade or to difficulties to perform spinal injection. Continuous spinal anaesthesia was performed in 209 patients mostly with 0.5% isobaric bupivacaine, while 94 patients received a single injection of either hyperbaric 0.5% tetracaine with adrenaline or 0.5% bupivacaine or 5% lidocaine. Failures occurred in 6.3% of the cases but were significantly less frequent with continuous spinal anaesthesia (4.8%) than with the conventional technique (9.6%). The incidence of failure was higher with hyperbaric tetracaine (11.1%) confirming its poor reliability. Inadequate extension of the anaesthetic block was the main cause of failure whatever the spinal anaesthetic technique. These results point out the reliability of continuous spinal anaesthesia but problems may occasionally occur due to spinal catheter misplacement. PMID- 1785705 TI - [Spinal anesthesia with bupivacaine without glucose in the elderly: effect of concentration and volume on the hemodynamic profile]. AB - This study aimed to compare the haemodynamic effects of two different glucose free bupivacaine solutions is thirty patients aged more than 70 years (mean age 82 years) undergoing hip surgery under spinal anaesthesia. They were randomly assigned to two groups, group A to receive 2.5 ml of a 0.5% bupivacaine solution, and group B 10 ml of a 0.125% solution in normal saline. All the patients were therefore given the same dose of bupivacaine, 12.5 mg. Lorazepam (1 mg orally) was administered to all for premedication two hours beforehand. Those patients taking antihypertensive agents were given their last dose on the eve of surgery. Lactated Ringer's solution (500 ml) was infused to all before the spinal puncture. Systolic (Pasys), mean and diastolic arterial pressures, and heart rate, were recorded every minute before volume loading, and for 30 minutes after the start of the spinal anaesthesia. Ephedrine (3 mg every two minutes if required) was given whenever Pasys decreased by more than 30% of the pre induction value. The upper level of sensory blockade was assessed by the pin prick test, and the quality of motor blockade with the Bromage scale. The cephalad spread of the solutions was similar, as well as the haemodynamic profile in each group. The total dose of ephedrine required in each group was not significantly different. It may therefore be concluded that, in the elderly, the upper level of, and the haemodynamic changes due to, spinal anaesthesia do not depend on the concentration or the volume of glucose-free bupivacaine solution. PMID- 1785706 TI - [Effectiveness of the Cell Saver and salvage from ultrafiltered extracorporeal circulation in heart surgery]. AB - The efficiency of two intraoperative techniques of blood saving were compared prospectively. During a period of eight months, in 120 adults patients undergoing heart surgery with a cardiopulmonary bypass (CPB). They all had blood removed before the start of CPB for isovolaemic haemodilution. They were randomly assigned to two groups (n = 60 for each): for group A patients, blood was salvaged during surgery before the start of the CPB, during cardioplegia, and from the CPB circuit at the end of surgery, using a Cell Saver 1V (Haemonetics), and returned to the patient in theatre or in intensive care; in group B patients, blood in the CPB circuit at the end of surgery was ultrafiltered and returned to the patient at the same time as 0.8 mg.kg-1 protamine sulfate. The same anaesthetic protocol was used in all the patients (flunitrazepam, phenoperidine and pancuronium bromide). There was no significant difference between the two groups in the volume of blood removed at the start of surgery (9.12 +/- 2.01 ml.kg-1 (A) vs. 8.85.2.22 ml.kg-1 (B)), in the amounts of replacement fluid (Haemaccel, 4% albumin) given to maintain volaemia, and in postoperative blood loss Red cell count, haemoglobin level and haematocrit were higher in the Cell Saver group at the third postoperative hour and on the first postoperative day, whereas fibrinogen levels and platelet count were higher in the ultrafiltration group at the same times. A mean of 1.02 +/- 1.71 homologous blood units were given to group A and 1.45 +/- 1.71 in group B (not significant).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785707 TI - [Effects of intravenous clonidine on postoperative shivering]. AB - A study was designed to assess the possible effects of intravenous clonidine on postoperative shivering. Fifty patients undergoing spinal fusion under isoflurane anaesthesia were randomly assigned to two groups (n = 25). Patients in one group were given intravenous clonidine (5 micrograms.kg-1 during the first hour, and 0.3 microgram.kg-1.h-1 thereafter) or placebo. Shivering intensity (rated from 0 to 2) and pulmonary artery blood temperature (theta) was recorded every ten minutes for two hours. Haemodynamic and metabolic data were obtained by way of a Swan-Ganz catheter prior to administering the test drug, and then after 1 and 2 hours. On arrival at the recovery room, theta was 36.2 +/- 0.3 degrees C in the clonidine group, and 36.5 +/- 0.2 degrees C in the placebo group. There were no significant differences in shivering between the two groups. Clonidine significantly decreased blood pressure, heart rate, cardiac output and whole body oxygen consumption. The patients in these series were free from any cardiac disease. Further studies are required to assess the possible beneficial effects of clonidine on postoperative oxygen consumption in patients suffering from heart failure. PMID- 1785709 TI - [Iterative epidural anesthesia after accidental dural puncture. Analysis with epidurography]. AB - The case is reported of a 63-year-old man who was to undergo a gastrectomy for stomach carcinoma. An epidural catheter for postoperative analgesia (epidural morphine) was inserted into the T10-11 space prior to induction of general anaesthesia. Unfortunately, cerebrospinal fluid (CSF) surged back through the Tuohy needle, which was immediately withdrawn. It was decided to make a further attempt at the L2-3 level. This was successful, and no CSF could be aspirated through the catheter. Four hours after recovery, and epidurography was carried out (12 ml of lopamiro R 300). This revealed passage of contrast, medium from the epidural space into the subarachnoid space, with opacification of the caudal cul de-sac. Another epidurography, 24 hours later, showed the same picture. The analgesic technique was therefore altered to subcutaneous buprenorphine. Careful management of this situation, in order to prevent total spinal anaesthesia, is discussed in the light of the literature. PMID- 1785708 TI - [Energy substrates in parenteral nutrition]. AB - The most appropriate nutriment for total parenteral feeding (TPF) must be nutritionally efficient, safe and easy to use. Glucose is the most used carbohydrate as it has most of these qualities, as well as a high rate of metabolism by all tissues. It has not been clearly demonstrated that the administration of exogenous insulin with glucose improves nitrogen retention. Substitutes for glucose, such as fructose, maltose, galactose or polyols (xylitol, surbitol, glycerol) are not really superior to glucose itself. On the other hand, they have major side-effects. Therefore, they are not much used as energy substrates for TPF, at least not for long term TPF. Intravenous fat emulsions have taken an important place as a source of energy during TPF. Fat emulsions containing long chain triglycerides (LCT) supply essential fatty acids (EFA) (linolenic and linoleic acids), thus preventing EFA deficiency. The metabolism of fat emulsions is influenced by various factors: age, metabolic and nutritional status, the amount of glucose intake, insulin deficiency, sepsis, heparin therapy. Recently, medium chain triglycerides (MCT) have been proposed as an alternative energy source. The latter are cleared more rapidly from the blood, and are therefore less liable to be deposited in the liver and adipose tissue; they are also oxidized more quickly and more completely. MCT are safe to use at a rate of less than 0.12 g.kg-1.h-1 and with a MCT/LCT ratio less than 3 to 1. The simultaneous administration of glucose prevents an acceleration of ketogenesis. MCT/LCT emulsions are a safe and effective source of calories. It is important that those patients for whom such nutriment may be of particular interest should be identified. Fat emulsions associated with glucose seem to be more efficient in terms of nitrogen sparing effect than glucose alone. They also avoid the problems due to the infusion of large amounts of glucose (excessive carbon dioxide production, fatty infiltration of the liver), while there is no EFA deficiency. If the infusion of TPF nutriment must be continuous in intensive care patients, or during the postoperative period, cyclic nocturnal parenteral nutrition over a 12 or 16 hour period may be used in patients who are not in a catabolic state, or only mildly so. This is a safe and efficient method of nutritional support, which reduces the incidence rate of TPF-induced cholestasis. PMID- 1785710 TI - [Peroperative massive pulmonary embolism of tumoral origin. Value of extensive monitoring]. AB - A case is reported of a 47-year-old female patient who suffered from massive tumour embolism during a nephrectomy for a renal carcinoma invading the inferior vena cava. Intraoperative monitoring consisted in direct blood pressure measurement (radial artery cannula), central haemodynamic monitoring (Swan-Ganz catheter), pulse oximetry and capnography. During the surgical manipulation of the suprahepatic vena cava, Petco2 suddenly decreased (from 25 mmHg to 14 mmHg), together with Spo2 (from 99% to 89%), and the mean pulmonary arterial pressure increased from 18 mmHg to 40 mmHg. The drop in arterial blood pressure to 50/30 mmHg, initiated an immediate sternotomy. After clamping the superior and inferior venae cavae, numerous tumour fragments were removed from the pulmonary artery. Cardiac activity restarted after internal cardiac massage, 1 mg adrenaline, 1 g calcium chloride and 150 mmol of molar sodium bicarbonate. The whole procedure lasted 30 min. Arterial blood pressure became stable at 110/50 mmHg, pulmonary arterial and wedge pressures at 20 and 5 mmHg. The Spo2 increased to 98%, and Petco2 to 25 mmHg. The nephrectomy was then carried out, the patient being given 5 micrograms.kg-1.min-1 dobutamine and 3 micrograms.kg-1.min-1 dopamine. At the end of surgery, systolic blood pressure was 120 mmHg, mean pulmonary arterial pressure 25 mmHg, and PaCO2 34 mmHg. The patient left the intensive care unit after twelve days. After one year of follow-up, no complication had occurred. The value of cardiopulmonary bypass in nephrectomy for renal carcinoma invading the vena cava, or the renal vein, is discussed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785711 TI - [Use of the PVC, a laryngoscope for difficult intubation]. AB - The PCV (Piquet-Crinquette-Vilette) laryngoscope has been designed for use in difficult endotracheal intubation in the adult. Its blade, 170 mm long, is curved, narrow (12 mm internal diameter) and semicircular in cross-section, like a closed C. An 8 mm endotracheal tube can be pushed through this blade. There is a cold light source. The use of this blade requires a teeth protector. The epiglottis will be lifted directly, and the blade will be moved into the vestibule, stopping short of the vocal cords. The endotracheal tube will then be introduced into the laryngoscope blade which guides it in between the cords. Once the tube has been checked to be within the trachea, the laryngoscope is removed by sliding the blade backwards over the tube. The PCV may be introduced into the mouth either on the right, or on the left, or behind the molar teeth, or between two teeth. It can held with the handle horizontal in case of a prominent sternum. The limits of this tool are a mouth opening of less then 20 mm, and some rare predictable difficulties which require an X-ray assessment to determine the best intubation technique to be used. Of 115 patients with a predicted difficult endotracheal intubation, fifty were intubated with the PCV without any failures. Also, twenty-five patients, out of thirty, were successfully intubated with the PCV after an attempt with a MacIntosh blade had failed. Of these five failures, one was never intubated by any technique whatsoever, two were intubated by fibroscopy and two by the ENT surgeon. PMID- 1785712 TI - [Postoperative bilateral paralysis of the abductor muscles of the vocal cords and past history of subtotal thyroidectomy]. PMID- 1785713 TI - [Intratracheal bolus of amikacin. An efficient adjuvant treatment of bronchial superinfection in major digestive surgery]. PMID- 1785714 TI - [Hemostasis evaluation and locoregional anesthesia]. PMID- 1785715 TI - [Deficiency of vitamin K-dependent factors during antibiotic prophylaxis with cefotetan]. PMID- 1785716 TI - [Demographic future of anesthesiologists and intensive care practitioners]. PMID- 1785717 TI - [Anesthesia and intensive care in France: an endangered specialty?]. PMID- 1785718 TI - [Yearly report of the European Group of Malignant Hyperthermia"]. PMID- 1785719 TI - Survey to estimate prevalence of Leptospira interrogans infection in mature cattle in the United States. AB - A total of 5,142 kidney tissue samples and 5,111 serum samples from mature cattle in 49 states and Puerto Rico were collected at slaughter. Age of cattle ranged from 1 to 16 years (mean, 6.6 years). Leptospires were isolated from 88 (1.7%) kidney tissues, and 2,493 (49%) sera contained antibodies against 1 or more of 12 Leptospira interrogans serovars. Leptospires were observed by immunofluorescence in 41 (0.8%) kidney tissues. Using agglutinin-absorption tests, 73 (83%) isolates were identified as serovar hardjo, 11 (12.5%) as serovar pomona, and 4 (4.5%) as serovar grippotyphosa. By use of restriction endonuclease analysis studies of chromosomal DNA, all isolates differed from reference serovars but were identical to strains previously isolated from cattle or swine in the United States. Of the serovar hardjo isolates, 85% were identical to restriction endonuclease analysis type (genotype) hardjo-bovis A and 11 (15%) were identical to genotype hardjo bovis B. Serovar pomona isolates were identical to genotypes kennewicki A (64%) or kennewicki B (36%), and serovar grippotyphosa isolates were identical to the RM 52 strain. Isolation rates were significantly (P less than 0.001) higher for beef cattle than for dairy cattle and were higher (P less than 0.001) for bulls than for cows. Combined culture and immunofluorescence results indicated that 2% of mature cattle were renal carriers of leptospires. PMID- 1785720 TI - Relationships between prevalence of Leptospira interrogans in cattle, and regional, climatic, and seasonal factors. AB - On the basis of serologic test results and isolation of leptospires from mature cattle, distribution and prevalence of Leptospira interrogans serovars and genotypes were compared by state and region of the United States. Relationships between isolation rate and month of sample collection, mean regional temperature, and mean regional precipitation were examined. Isolation rate and seroprevalence were significantly (P less than 0.001) higher for southeastern, south central, and Pacific coastal regions than for other regions of the United States. Isolates of genotypes hardjo-bovis A and kennewicki A and B, and of serovar grippotyphosa appeared to be randomly distributed. Genotype hardjo-bovis B isolates came from a southern area of the country that extends from Georgia to New Mexico. To the authors' knowledge, this is the first recorded isolation of serovar hardjo from Hawaii. Although significant relationship was not documented between isolation rate and month or season of the year, seroprevalence for summer, fall, and winter was significantly (P less than 0.001) higher than that for spring. Regional isolation rate was related more to mean temperature (r = 0.83; P less than 0.05) than to mean precipitation amount (r = 0.34; P greater than 0.50). PMID- 1785721 TI - Effect of Pasteurella haemolytica saline capsular extract on bovine pulmonary endothelial cells. AB - The purpose of this in vitro study was to determine whether Pasteurella haemolytica capsular extract (CE) damages bovine pulmonary endothelial cells (EC) directly or through neutrophil-mediated mechanisms. Chromium 51-labeled EC were treated with the following variables: CE (1, 10, and 100 ng of protein/ml), CE and bovine neutrophils (10(6) cells/well), and CE and polymyxin B (500 U/ml). Although only minimal damage to EC occurred by 5 hours after treatment, by 22 hours after treatment, the 10-ng and 100-ng CE dose produced severe damage to EC, as indicated by 51Cr release, cellular detachment, and loss of monolayer confluency. The component in the CE that was toxic to the EC was lipopolysaccharide, evidenced by effective neutralization of the toxic effect with polymyxin B. Neutrophils inhibited the CE-mediated EC toxicity and were activated, as indicated by shape change and adhesion to EC monolayers. We concluded that the lipopolysaccharide component of CE causes direct damage to EC, which can be attenuated by neutrophils and polymyxin B. PMID- 1785722 TI - Routes and prevalence of shedding of psittacine beak and feather disease virus. AB - Psittacine beak and feather disease (PBFD) virus was recovered from the feces and crop washings from various species of psittacine birds diagnosed with PBFD. High concentrations of the virus also could be demonstrated in feather dust collection from a room where 22 birds with active cases of PBFD were being housed. The virions recovered from the feces, crop, and feather dust were confirmed to be PBFD virus by ultrastructural, physical, or antigenic characteristics. Virus recovered from the feather dust and feces hemagglutinated cockatoo erythrocytes. The specificity of the agglutination was confirmed by hemagglutination inhibition, using rabbit antibodies against PBFD virus. During the test period, 26% (8 of 31) of the birds screened were found to be excreting PBFD virus in their feces, and 21% (3 of 14) of crop washings were positive for PBFD virus. Some birds in the sample group had active cases of diarrhea, whereas others had normal-appearing feces. Diarrhea was found to be the only significant indicator of whether a bird was likely to be excreting virus from the digestive tract. These findings suggest that exposure of susceptible birds to PBFD virus may occur from contact with contaminated feather dust, feces, or crop secretions. Viral particles that were morphologically similar to parvovirus (20- to 24 nm icosahedral nonenveloped virions) also were recovered from feces of some of the birds. PMID- 1785723 TI - Hemagglutination by psittacine beak and feather disease virus and use of hemagglutination inhibition for detection of antibodies against the virus. AB - Conditions for psittacine beak and feather disease (PBFD) virus hemagglutination and hemagglutination-inhibition (HI) test reactions are defined. The PBFD virus was found to hemagglutinate cockatoo and some guinea pig erythrocytes. The HI test was used to assay serum antibody titer in birds with active PBFD virus infections and in others that had been exposed to diseased birds. On the basis of HI antibody titers in psittacine birds that had been exposed to PBFD virus, but remained clinically normal, we suggest that some birds exposed to the virus are able to mount an effective immune response. Birds with active PBFD virus infections had lower antibody values than did birds that had been exposed to the virus, but remained clinically normal. On the basis of these findings, the ability to develop a suitable HI antibody response may be crucial in determining the disease status of susceptible birds exposed to the PBFD virus. If HI antibodies are found to have neutralizing activity, then the fact that a high HI titer was induced in birds inoculated with purified PBFD virus might suggest that an immunization program would be effective in preventing PBFD virus infections. PMID- 1785724 TI - Characterization and classification of Actinobacillus (Haemophilus) pleuropneumoniae plasmids. AB - Actinobacillus (Haemophilus) pleuropneumoniae plasmids were characterized and classified. They were isolated from A pleuropneumoniae strains different in serotype, year isolated, or location from which isolated. Six of 8 plasmids encoded streptomycin (Sm) and sulfonamide (Su) resistance (SmSu). One of the other plasmids, pVM105, encoded ampicillin (Ap) resistance and another, pHM0, encoded no drug resistance. All SmSu plasmids were transferred to Escherichia coli strains by transformation. Among them, pABO and pMS260 were 8.1 kb and incompatible with each other; they were stable in E coli. The other SmSu plasmids, pHM1, pVM104, pVM106, and pKD25, were 4.3 kb and did not replicate stably in E coli. The former SmSu plasmids were mobilized in E coli strains by a plasmid RP4, which belonged to incompatibility (Inc) group P, but the latter plasmids were not. Further, each 8.1-kb SmSu plasmid and each 4.3-kb plasmid had the same respective restriction pattern. These results indicated that there were at least 2 types of SmSu plasmids in A pleuropneumoniae. The 2 types were classified in 2 groups: H1(pMS260 and pABO) and H2(pHM1, pVM104, pVM106, and pKD25). The H1 and H2 plasmids belonged to different Inc groups, and H2 plasmids belonged to a different Inc group from that of pHMO and pVM105. PMID- 1785725 TI - Dose response to butorphanol administered subcutaneously to increase visceral nociceptive threshold in dogs. AB - Butorphanol (0.025, 0.05, 0.1, 0.2, 0.4, and 0.8 mg/kg of body weight, and placebo) was given SC to 8 healthy unmedicated dogs to determine its efficacy for visceral analgesia, using a colonic balloon for minimal threshold nociceptor stimulation. Degree of sedation; systolic, diastolic, and mean arterial pressure; and pulse rate were recorded. The highest 3 dosages, 0.2, 0.4, and 0.8 mg/kg, were found to be most effective, with 0.8 mg/kg the only dosage that was significantly different from control responses at the 45-minute interval. Duration of analgesia ranged from 23 to 53 minutes for all 6 dosages and dosing durations were not significantly different from one another. Blood pressures did not change, but pulse rate was significantly decreased by 0.8 mg of butorphanol/kg. We concluded that butorphanol is an effective visceral analgesic of relatively short duration in the dog. PMID- 1785726 TI - Market stress-associated changes in serum complement activity in feeder calves. AB - Classical hemolytic complement (C) of calves was analyzed during a protocol designed to imitate the usual market handling of feeder calves from the southeastern United States. Serum C concentrations of the calves (n = 100 x 4 years) were evaluated on their farm of origin, on arrival at an auction market, on arrival at a feedyard, and during their first 4 weeks in the feedyard. Complement concentrations (measured in CH50 units) were typically lowest at the farm of origin and highest when the calves entered the auction market 28 to 133 days later. Serum C concentrations decreased after the calves encountered the severe stresses of being in the auction market for 7 days, 24-hour truck transport (1,932 km) to the feedyard, and the first 7 days in the feedyard. The C concentrations recovered after 21 to 28 days in the feedyard. Steers had significantly (P less than or equal to 0.05) lower C concentrations than did heifers in 3 of 4 years at the farm of origin, and in 2 of 4 years at the auction market. Morbid calves had significantly (P less than or equal to 0.05) lower C values than did healthy calves on day 7 in the feedyard in 3 of 4 years. There were significant differences in C concentrations of calves from different farms of origin in each of the 4 years. There was no significant difference in C concentrations of calves that were vaccinated vs those not vaccinated with Pasteurella haemolytica. PMID- 1785727 TI - Effect of stage of gestation on efficacy of Brucella abortus strain-19 vaccination in cattle. AB - Seventy-nine cattle in all stages of gestation were inoculated with a low dose (2.5 x 10(8) colony-forming units) of Brucella abortus strain 19, then challenge exposed with pathogenic B abortus strain 2308 during the subsequent gestation. A brucellosis case was defined by isolation of strain 2308 from dam or calf samples. Cumulative incidence of brucellosis cases was 48, 33, 25, or 47% for cattle that were, respectively, not pregnant, or 19 to 87, 100 to 167, or 190 to 253 days in gestation at vaccination. The cumulative incidence was 56% in 27 nonvaccinated controls. The 95% confidence intervals for risk ratios included 1 in all cattle, except those that were 100 to 167 days in gestation at vaccination (ie, second trimester); the confidence interval for this group was 0.21 to 0.97. The prevented fraction (1-risk ratio) attributed to strain 19, in ascending order, was 0.14, 0.16, 0.4, or 0.55, respectively, for cattle that were not pregnant, or were 190 to 253, 19 to 87, or 100 to 167 days in gestation at vaccination. Potential confounders of breed, pen effect, and gestation days at challenge exposure did not significantly affect results. Results supported the hypothesis that stage of gestation at vaccination will affect the prevented fraction of brucellosis, or efficacy of strain 19, in cattle vaccinated with a low dose and, therefore, is one factor that may explain variation in strain 19 induced protection. PMID- 1785728 TI - Morphologic characterization of conjunctiva-associated lymphoid tissue in chickens. AB - Conjunctiva-associated lymphoid tissue (CALT) in the eyelids of chickens was studied by gross, histologic, and electron microscopic techniques. Structural features were characterized at 1 day of age and at posthatching week (PHW) 1, 2, 3, 4, 6, 8, 12, and 16. Beginning at PHW 1, prominent lymphoid nodules containing a heterogenous population of lymphocytes, lymphoblasts, and macrophages were first observed within conjunctival folds and fissures of the lower eyelid. Nodules contained germinal centers by PHW 2 and plasma cells by PHW 4. The epithelium associated with these nodules was flat, had short, irregular microvilli, contained intraepithelial lymphocytes, and lacked goblet cells. High endothelial venules were located at the base of lymphoid nodules and contained lymphocytes within and below the cuboidal endothelium. In the upper eyelid, CALT was morphologically similar to lymphoid tissue in the lower eyelid, but nodules were smaller and more random, lacked association with epithelial folds and fissures, and were clustered around the opening of the nasolacrimal duct. By PHW 12, CALT was characterized by basal germinal centers outlined by collagenous stroma, suprafollicular plasma cells, columnar epithelium with goblet cells, and fewer intraepithelial lymphocytes. On the basis of these features, CALT in chickens has morphologic characteristics similar to other components of the mucosal immune system and, therefore, may have a role in mucosal immunity. PMID- 1785729 TI - Evaluation of edetate and thiamine for treatment of experimentally induced environmental lead poisoning in cattle. AB - Twenty mature Holstein cows were randomized into 5 treatment groups. Cows of groups 2 to 5 were given 2 mg of elemental Pb/kg of body weight for 28 days. Clinical signs of plumbism were scored, and blood for Pb, progesterone, and hematologic analyses was collected weekly. Cows also were examined weekly for anomalous ovarian cycles. Starting on study day 28, cows in group 3 were treated once daily with 2 mg of thiamine HCl/kg (IM) for 13 days, cows in group 4 were treated twice daily with 62 mg of Na2,Ca-EDTA/kg (IV) for 4 days, and cows in group 5 were given thiamine (dosage regimen the same as for group 3) plus Na2,Ca EDTA (dosage regimen the same as for group 4). On study days 96 through 139, cows were slaughtered in a commercial abattoir and samples of blood, skeletal muscles, bones, liver, and kidneys were collected and assayed for Pb concentration. Thiamine was not effective in reducing blood Pb concentration, and treatment with Na2,Ca-EDTA and thiamine plus Na2,Ca-EDTA was effective in reducing the concentration of Pb in blood. However, treatment with thiamine was more effective than treatment with Na2,Ca-EDTA or thiamine plus Na2,Ca-EDTA in inducing remission of clinical signs of plumbism. The concentration of Pb in blood was significantly (P less than 0.05) correlated to the concentration of Pb in liver, kidneys, skeletal muscles, and bones. Significant (P less than 0.05) relationship existed between number of days from Pb exposure to slaughter and concentration of Pb in blood, liver, and skeletal muscles. Exposure to Pb did not significantly alter CBC values.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785730 TI - Evaluation of multiple reticulorumen selenium pellets as a health risk in growing Hereford steers. AB - Five groups of Hereford steers were monitored for 293 days. One group of 3 was not given selenium supplementation; the other 4 groups of 3 steers each were given 2, 4, 6, or 8 reticulorumen selenium pellets. Health, body weight, and blood selenium concentration were monitored during the study. At the finish, steers were slaughtered, and various tissues from the carcasses were analyzed for selenium content. Initial blood selenium concentration did not differ significantly among groups. However, significant (alpha = 0.01) difference among means was detected during the early period of rapid increase in blood selenium concentration in steers of supplemented groups. Means of maximal blood selenium concentration also differed among groups; however, even the highest value, 0.253 micrograms/g, was lower than the 3 micrograms/ml reported in chronic clinical cases of toxicosis in the literature. Carcass analysis indicated significant (alpha = 0.05) differences in selenium concentrations among treatment groups for almost all tissues tested. Only kidney samples (7.9 micrograms/g) from steers of the 8-pellet treatment group exceeded published normal values (7.6 micrograms/g). Health variables for most dates were not significantly different among groups, and selenium toxicosis was not evident in any steer. Analysis did not indicate risk to human beings consuming tissues from these steers. PMID- 1785731 TI - Correlation of morphologic features of the iridocorneal angle to intraocular pressure in Samoyeds. AB - The iridocorneal angle of the left eye was investigated in 203 Samoyeds. Comparison was made of judgements of the width of the anterior opening of the ciliary cleft when performing gonioscopy with an objective method of estimation based on measurements on goniophotographs. Results indicated high degree of correlation. Various degrees of narrowness of the iridocorneal angle width were revealed and clinical glaucoma with total-angle closure was found in 6 of 203 dogs. The intraocular pressure was significantly (P less than 0.01) higher in eyes with closed iridocorneal angles than in eyes with any other width of the angle. Appearance of the structures of the iridocorneal angle, particularly the pigment bands, indicated extensive individual variation. In approximately 25% of the eyes, dysplasia of the pectinate ligaments of variable degree existed, indicating that this anomaly is common in the Samoyed breed. Significant difference was not evident in intraocular pressure in eyes with different degrees of dysplasia of the pectinate ligaments. PMID- 1785732 TI - Morphologic and morphometric study of the facial nerve in clinically normal adult dogs. AB - A morphologic and morphometric study was carried out on the facial nerve: to determine normal histologic data in myelinated fibers of clinically normal young adult dogs; to establish reference values for mean fiber diameter, and to delineate the relative diameter frequency distribution curve. Few degenerative changes were observed in single teased-nerve fibers and semithin cross-sectional nerve preparations. Statistical difference was not observed between left and right facial nerves. The distribution of fiber diameters in the facial nerve was unimodal. Mean (+/- SD) fiber diameter of the facial nerve was 3.92 +/- 1.18 microns. Approximately 89% of fibers in the facial nerve had diameter between 3 and 6 microns. Fiber diameter ranged from 2 to 12 microns; however, less than 1% of fibers had diameter greater than 8 microns. PMID- 1785733 TI - Detection of anti-equine neutrophil antibody by use of flow cytometry. AB - Flow cytometric and conventional fluorescence microscopic methods were compared to detect heterologous (rabbit) neutrophil antibody bound to equine neutrophils. Unfixed and paraformaldehyde-fixed neutrophils were treated with normal rabbit serum or various dilutions of an antineutrophil serum. The cells were then reacted with fluorescein conjugates of goat anti-rabbit IgG, staphylococcal protein A, and streptococcal protein G. Antibody binding was evaluated by use of fluorescence microscopy and flow cytometry. Unfixed neutrophils treated with normal rabbit serum did not fluoresce, whereas many of the fixed neutrophils had distinct cytoplasmic and some membranous (nonspecific) fluorescence. Unfixed cells treated with the antiserum had localized areas (capping) of intense membrane fluorescence, whereas fixed cells had bright uniform membranous fluorescence. The intensity of specific fluorescence varied with the antiserum dilution and the conjugate. On flow cytometry, over 80% of unfixed cells treated with antiserum dilutions up to 1:1,024, 1:2,048, and 1:256 fluoresced, respectively, with anti-IgG, protein-G, and protein-A conjugates. Fixed cells generally had similar percentages of fluorescent cells, but at a higher (1-step) antiserum dilution. It was concluded that flow cytometry is more sensitive than conventional fluorescence microscopy to detect antibodies associated with equine neutrophils. PMID- 1785734 TI - Hematologic values of captive Mexican wolves. AB - Hematologic reference values were determined for a captive population of 11 Mexican wolves (Canis lupus baileyi). Wolf pups from 4 to 24 weeks old had progressive age-related increases in PCV, hemoglobin concentration, mean cell volume, and RBC counts similar to those seen in domestic dog pups (C familiaris). Hematologic indices in wolves older than 24 weeks were comparable to those of the adult domestic dog; however, PCV, hemoglobin concentration, and RBC counts were higher. PMID- 1785735 TI - Thermodilution estimation of cardiac output at high flows in anesthetized horses. AB - The purpose of this study was to compare the thermodilution technique for estimation of cardiac output with the indocyanine green dye dilution technique at flows between 10 and 39 L/min in halothane-anesthetized horses. The estimation of area of dye dilution cardiac output curves was made by using the fore-'n-aft (FA) triangle method. This shorthand technique was compared with logarithmic exponential extrapolation and summation (extrapolated area), using 64 cardiac output curves. Then, 256 simultaneous thermodilution measurements were compared with dye dilution measurements calculated by use of the FA technique. Forty milliliters of iced 0.9% NaCl solution containing 15 mg of indocyanine green dye was used as the indicator. This was delivered in less than 1 second to the right atrium, using a power injector. A thermistor positioned in the pulmonary artery detected the thermal indicator. Blood was withdrawn from the carotid artery through a densitometer cuvette to measure the dye concentration. The FA estimations of area were higher than those determined by use of extrapolated area. A multiplicative adjustment of 0.837 was estimated. On average, thermodilution estimates of cardiac output exceeded the adjusted FA determinations. Using a weighted linear regression, we determined the following calibration adjustment: thermal dilution cardiac output/1.048 = indocyanine green dye dilution cardiac output. PMID- 1785736 TI - Replacement of chloride deficit by use of 1.8% NaCl to correct experimentally induced hypochloremic metabolic alkalosis in sheep. AB - Five adult 40- to 50-kg female sheep were surgically fitted with a reentrant cannulae placed in the proximal part of the duodenum just distal to the pylorus. By diversion of abomasal outflow, this model has been shown to produce hypochloremic metabolic alkalosis accompanied by dehydration, hypokalemia, and hyponatremia. Each sheep was subjected to 3 separate, 12-hour IV treatment trials, in each case preceded by a control period of 48 hours, and a diversion period of 36 to 96 hours, during which a hypochloremic (Cl- less than or equal to 60 +/- 2 mEq/L) metabolic alkalosis with hypokalemia and hyponatremia was produced. Treatment 1, consisting of 6 L of isotonic Na gluconate, was designed to replace volume without replenishing the Cl-1 deficit. Although hydration improved, plasma Cl- decreased further, and the sheep became increasingly weak and depressed. Treatment 2, consisting of 2 L of 1.8% NaCl, was designed to replace the Cl- deficit without replacing total volume. Plasma Na+ and Cl- concentrations returned to normal during the 12 hours of treatment; acid-base balance and plasma K+ concentrations returned to normal within 36 hours of treatment. During treatment 3 (control, no treatment), measured metabolic values changed minimally. We concluded that the IV replacement of Cl- without K+ is effective in the correction of experimentally induced hypochloremic metabolic alkalosis in sheep. PMID- 1785737 TI - Multivariable prediction model for the need for surgery in horses with colic. AB - A survey of 1,965 equine colic cases was conducted from August 1985 to July 1986 at 10 equine referral centers located throughout the United States. The purpose of this study was to develop and validate a multivariable model for the need for surgery. Two-thirds of the cases were randomly selected for model development (1,336), whereas the remaining cases (629) were used only for subsequent validation of the model. If a lesion requiring surgical correction was found at either surgery or necropsy, the case for the horse was classified as surgical, otherwise the case was classified as medical. Only variables that were significant (P less than 0.05) in an initial bivariable screening procedure were considered in the model development. Because of the large number of missing values in the data set, only variables for which there were less than 400 missing values were considered in the multivariable analysis. A multivariable logistic regression model was constructed by use of a stepwise algorithm. The model used 640 cases and included variables: rectal findings, signs of abdominal pain, peripheral pulse strength, and abdominal sounds. The likelihood ratio for surgery was calculated for each horse in the validation data set, using the logistic regression equation. Using Bayes theorem, the posttest probability was calculated, using the likelihood ratio as the test odds and the prevalence of surgery cases (at each institution) as an estimate of the pretest odds. A Hosmer Lemeshow goodness-of-fit chi 2 statistic indicated that the model fit the validation data set poorly, as demonstrated by the large chi 2 value of 26.7 (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785738 TI - Evaluation of epiglottic augmentation by use of polytetrafluoroethylene paste in horses. AB - Epiglottic augmentation was evaluated in 7 horses, using 7 ml of polytetrafluoroethylene (polytef) paste injected submucosally on the ventral surface of the epiglottis. In 6 horses, an Arnold-Bruning intracordal injection syringe, specifically designed to inject polytef into paralyzed vocal folds in human beings, was used. At necropsy 60 days after surgery, group mean thickness measurement 20 mm from the epiglottic tip was 40% greater (P less than 0.01) and, at the epiglottic attachment of the aryepiglottic fold, was 29% greater (P less than 0.01) in the 6 polytef-augmented horses than in clinically normal nonsurgically treated controls. At necropsy, extensive epiglottic thickening was seen. This thickening was exclusively attributable to distention of submucosal areas in the ventral aspect of the epiglottis, with foreign body granulomata surrounded by fibrous connective tissue. In 1 horse, polytef paste was injected by use of a disposable syringe and needle. Excess ventral epiglottic swelling and exposed epiglottic cartilage was seen during subsequent endoscopy. At necropsy 60 days after surgery, the epiglottic contour remained deformed and a large deep mucosal ulcer was observed at the injection site. Histologic examination revealed necrotizing suppurative inflammation that extended into the epiglottic cartilage. Surgery was not technically difficult to perform through a laryngotomy, and all horses tolerated the procedure without apparent discomfort. Endoscopy performed after surgery revealed unremarkable and uniform response to the polytef paste in 4 horses, and in 3 horses, revealed excess swelling and inflammation of the ventral epiglottic tissue that resolved over time.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785739 TI - Evaluation of two applanation tonometers in cats. AB - Comparisons of the MacKay-Marg and Tono-Pen applanation tonometers in open and closed in vitro systems were made for the eyes of cats. Both instruments significantly underestimated intraocular pressure (IOP) vs direct manometry (P less than 0.001), but in readily predictable manner, with high coefficients of determination (r2 = 0.99). For tonometer 1 (MacKay-Marg), calculated actual IOP = 1.36 x (MacKay-Marg measurement) - 1.67 mm of Hg; and for tonometer 2 (Tono-Pen), calculated actual IOP = 1.37 x (Tono-Pen measurement) + 0.8 mm of HG, using measurements from 11 enucleated eyes. In vivo comparisons were initially made in 81 clinically normal eyes (n = 41 cats) by applying the Tono-Pen first followed by the MacKay-Marg. Compared with the MacKay-Marg, the Tono-Pen significantly (P less than 0.001) underestimated IOP in these cats. When the order of tonometer applanation was subsequently reversed in 73 clinically normal eyes (n = 37 cats) the Tono-Pen again significantly (P less than 0.001) underestimated IOP, compared with the MacKay-Marg. Alterations in tonometer order did not result in significant differences in measured IOP for the MacKay-Marg when compared with itself, but Tono-Pen measurements were significantly (P less than 0.05) less when its use followed, rather than preceded, that of the MacKay-Marg. Mean (+/- SD) IOP in clinically normal cats when each tonometer was used first was 22.6 +/- 4.0 mm of Hg (range, 14 to 32 mm of Hg) for the MacKay-Marg and 19.7 +/- 5.6 mm of Hg (9 to 31 mm of Hg) for the Tono-Pen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785740 TI - Efficacy of ivermectin chewable tablets and two new ivermectin tablet formulations against Dirofilaria immitis larvae in dogs. AB - One hundred four heartworm-free Beagles less than 1 year old were studied to determine the efficacy of ivermectin chewable tablets and of 2 other ivermectin tablet formulations against heartworm larvae. At 30 days after SC inoculation of dogs with infective Dirofilaria immitis larvae, all ivermectin formulations were given orally at dosage of 6 micrograms/kg of body weight. The ivermectin chewable tablets also were given orally at dosage of 2 and 6 micrograms/kg at 30 and 45 days, respectively, after injection of larvae. Replicates of 6 or 8 dogs in each study were formed on the basis of gender and body weight and, within replicates, were randomly allocated to treatment groups. At 30 days after injection of larvae, the additional dogs (in replicates of 8) were assigned to the control group and to the group given ivermectin chewable tablets at dosage of 6 micrograms/kg. All dogs were housed individually. Necropsy was performed approximately 5 or 6 months after larvae were administered. In both trials, all control dogs had heartworms at necropsy (University of Illinois--geometric mean, 35.0; Florida--geometric mean, 26.1). In both trials, the ivermectin chewable tablet (6 micrograms/kg) and both tablet formulations (6 micrograms/kg) given at 30 days after larval injection, and the chewable formulation (6 micrograms/kg) given at 45 days after larval injection were 100% effective (P less than 0.01) in preventing development of induced infection with D immitis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785741 TI - [Obstructive sleep apnea syndrome]. PMID- 1785742 TI - [Diagnostic value of the deletion of the delta F508 gene in cystic fibrosis]. AB - We have studied 70 carrier cystic fibrosis (CF) families with delta F508 mutation using the polymerase chain reaction (P.C.R.). We found that frequency of the mutation in CF chromosomes was 53%. 39% of carrier cystic fibrosis families were informative for the mutation. PMID- 1785743 TI - [Color vision defects in school children]. AB - 1,350 schoolchildren, ages 11 and 14, from Palma de Mallorca, were explored looking for colour vision defects. The medical examination was performed through Ishihara tables (numbers or letters). There was not anomaloscopy to confirm the first results. We compare our prevalence with other known prevalence from Europe. Different outcomes (learning disability, effect on employment) are discussed. PMID- 1785744 TI - [Developmental psycho-neurologic follow up of neonates with high pre-perinatal risk factors]. AB - The authors give the results of a horizontal study made in the course of the work carried out during 1988 in the Developmental Follow-up Unit of the University Hospital "Virgen Macarena" of Seville, making emphasis on the psiconeurological pathology detected and its relation to the cause consultation. A total of 443 children were studied, this number being 77% of the cases under control up to that time. 82.2% of the children (N = 364) were normal on neurological examination, with normal I.Q. at the last control. However, 147 of these children (33.2% of the total) had shown some transient neuromotor abnormality over the follow-up period. Of the total, 17.8% (N = 79) showed one more of the following permanent sequelae: Defects of mental development 15% (N = 67), Motor sequelae 8.8% (N = 39), Sensorial deficits 5.6% (N = 25), Convulsions 3.6% (N = 16), Important behaviour disorders 0.5% (N = 2). The presence of motor sequelae had a significant correlation with: CNS defects (p less than 0.001), Metabolic changes in the neonatal period (p less than 0.005), Neonatal convulsions (p less than 0.005), Isquemic-anoxic syndrome (p less than 0.05). Deficits of mental development are associated significantly with: Polimalformative syndromes (p less than 0.001), CNS defects (p less than 0.001) and with neonatal convulsions (p less than 0.001). The neuromotor abnormalities detected (in order of frequency) were: Changes in muscle tone (32%), Motor retardation (31.8%). Changes in prehensive behaviour (22%), Changes in motility (21%). Retarded expressive conduct (14.3%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785745 TI - [Vulvovaginitis in premenarche girls. A preliminary study]. AB - The study population consisted of 832 premenarcheal girls. Vaginal cultures are performed on 40 premenarcheal girls suffering from vulvovaginitis. All were less than 7 years old. This patients were seen in primary cares. In 23 cases (57.5%) E. coli was isolated, Enterococcus (30%), mixed flora (10%) and G. vaginalis (2.5%). Common clinical characteristics were pruritus (97.5%), vaginal discharge (67.5%). Dysuria and abdominal pain constituted accompanying symptoms. Only in one case masturbation was observed. PMID- 1785746 TI - [Prediction of physical endurance in athletes during puberty: analysis of high performance soccer players]. AB - Pubescent maturity is an essential element in obtaining physical capacity. Having de described the anthropometric characteristics, such as body structure and results in the physical and functional tests, of a group of football players in relation to their pubescent level, the results showed which tests has a higher predictive level on the physical capacity. Age can predict 54% of the variation of results in 500 m. run and 59% in the 60 m. dash. If pubescent maturity and the measurement of the tricipital skin-fold are also taken into consideration the prediction level goes up to 72% in 500 m. run and 75% in the 60 m. dash. PMID- 1785747 TI - [Study of LDL receptors and response to lovastatin therapy in familial homozygotic hypercholesterolemia]. AB - This study shows the results obtained with lovastatin as a combined therapy with probucol and cholestyramine on the lipid profile of two patients with homozygous familial hypercholesterolemia. Both have been diagnosed according to the clinical and biochemical criteria (tipe IIa hypercholesterolemia) as well as by the cholesterol or low density lipoprotein (LDL-C) receptor analysis. After the initial probucol and cholestyramine treatment we observed a drop of total cholesterol (T-C) of 41.7% and 46% as well as LDL-C of 51.6% and 49.3% in both patients. Respectively when lovastatin were associated an additional drop of T-C of 23.7%, LDL-C of 23.2%, high-density lipoprotein cholesterol (HDL-C) of 22.4% and the apoprotein B (Apo B) of 37% were obtained in one patient (receptor defective) but no change in the lipid profile were obtained in the other patient (receptor-negative). No adverse effects were observed with this drug. This drug could be of help as a combined therapy in the treatment of homozygous familial hypercholesterolemia, even though the treatment of choice is the LDL-plasma feresis and/or liver transplantation. We expound the difficulties relate to LDL receptor study in homocygous receptor-negative patients. PMID- 1785748 TI - [Use of flumazenil to reverse the effects of midazolam in children]. AB - We have studied the clinical usefulness of Flumazenil to reverse the sedative action of Midazolam in 12 children admitted in a Pediatric Intensive Care Unit. Two groups were established, one treated with individual dose and the other treated with continuous infusion. In four cases the indication of Flumazenil was the reversion of secondary effects and in 8 cases it was elective. The average reversion time was 1.22 +/- 0.42 minutes. Flumazenil is able to reverse immediately the effects of Midazolam. PMID- 1785750 TI - [Sexuality and adolescence: the role of the pediatrician]. PMID- 1785751 TI - [Obstructive sleep apnea syndrome in childhood: study of three cases]. AB - We report three children with obstructive sleep apnea syndrome, two secondary to pharyngeal obstruction and the third secondary to laryngomalacia. All patients presented important respiratory efforts with inspiratory stridor during sleep, frequent obstructive apneas with important hipoxemia, sweating, and arousal episodes. Two patients suffered excessive daytime sleepiness, behavioral disturbances and development delay, and the third, intelligence in the borderline retardation range, and important heart arritmias (bradycardia with ventricular extrasystoles) during obstructive apneas. In two children the Obstructive Sleep Apnea Syndrome and the secondary symptoms disappeared after adenotonsillectomy. The patient with laryngomalacia required tracheostomy. PMID- 1785749 TI - [Diet-induced changes as risk factors in obese children: arterial pressure, glycoregulation and lipid profile]. AB - In 52 both sex obese children (mean age was 9.7 +/- 2.5), blood pressure and biochemistry parameters in blood were studied after controlled hypocaloric diet. The data, collected in two out patient visits in intervals of one year and half and four years, were: blood pressure; total, HDL and LDL cholesterol; apoproteins A1 and B; NEFA; triglycerides; phospholipids; haematocrit; haemoglobin; glycosylated haemoglobins A1 and A1C; glucose; insulin; seric proteins: fibrinogen; platelets; Quick time and activated partial thromboplastin time. The group of obese children with a successful response to the hypocaloric diet treatment (significant loss of weight) showed a decrease in the plasmatic levels of Apoproteins A1 and B, triglycerides, NEFA and insulin together with an increase in the level of HDL cholesterol. These changes weren't so significant in the group of obese children who didn't lose weight. When we took into account plasmatic cholesterol, the obese patients with normal plasmatic level of cholesterol showed a significant descend in the risk factors. However, in the obese children with high cholesterol despite the dietetic treatment, the pathologic plasmatic profile didn't show any change. Finally, while the group with maintained high level of insulin showed a significant increase of apoproteins A1 and B, and total and HDL cholesterol, the group where the insulin levels became normal after treatment showed a good development of the biochemistry parameters studied. The fibrinogen level and blood precision which remained high in both visits were studied taking into account age and growth pattern. PMID- 1785752 TI - [Urodynamic study of bladder dysfunction in recurrent vesico-ureteral reflux]. AB - In the last 5 years we have treated in our service 98 patients suffering vesicoureteral reflux (VUR) with 148 refluyents units (RU) in total. The VUR recurred in 9 ureters (6.08%) in children neurologically normal. A urodynamic study was made in them getting the following diagnosis, in 5 R. U. vesical dysfunction: 4 R. U. vesico-sphinteric dyssynergia and in 1 R. U. vesical hyperreflexia with uninhibited bladder contractions. In the remaining 4 R. U. the urodynamic study was normal. PMID- 1785753 TI - [Congenital contractural arachnodactyly (Beals-Hecht syndrome). Report of a familial case]. PMID- 1785754 TI - [Idiopathic infantile arterial calcification. Radiodiagnosis]. PMID- 1785755 TI - [Necrotizing streptococcal fascitis]. PMID- 1785756 TI - [The battered child]. PMID- 1785757 TI - [Accuracy of markers in celiac disease]. PMID- 1785758 TI - [Reflex sympathetic dystrophy in childhood]. PMID- 1785759 TI - [Free ionic fluoride content in milk recently commercialized for infants]. PMID- 1785760 TI - [Red-colored urine: a new case]. PMID- 1785761 TI - [The effectiveness of BCG vaccination]. PMID- 1785762 TI - [Reply of the authors to the comment by Altet Gomez on their article: Childhood contact with tuberculous patients]. PMID- 1785763 TI - Pulmonary Emphysema: the Rationale for Therapeutic Intervention. Proceedings of a follow-up workshop on treating the underlying causes of emphysema. Tyler, Texas, April 9-10, 1991. PMID- 1785764 TI - A thirst for science: an overview of the scientific contributions of Larry L. Ewing (1936-1990). PMID- 1785765 TI - Peptide and steroid regulation of spermatogenesis in primates. PMID- 1785766 TI - Thyroid hormones and testis development: a model system for increasing testis growth and sperm production. AB - In conclusion, the unique transient hypothyroidism system described here provides a noninvasive means by which testicular size and sperm production can be increased to unprecedented degrees. This system may be useful as a model for understanding the factors which regulate testicular growth and the eventual size that the testes attain, as well as the factors which normally establish and then maintain the amount of sperm produced by an animal. PMID- 1785767 TI - The patterns of LH secretion in adult male rats associated with compensatory androgen secretion by the testis remaining after unilateral orchidectomy. PMID- 1785768 TI - Alterations in the control and function of somatic cells in the testis associated with suppression of spermatogenesis in seasonal breeders. PMID- 1785769 TI - Hormonal control of Leydig cell differentiation. AB - Leydig cell progenitors contain significant concentrations of androgen receptors. When the metabolism of DHT to 3 alpha-DIOL is blocked, DHT stimulates testosterone production by Leydig cell progenitors, most probably via an androgen receptor dependent mechanism. Rapid metabolism by 3 alpha-HSD may limit the potency of exogenous DHT to stimulate differentiation of Leydig cell progenitors in vitro. Insulin-like growth factor-I enhances androgen production by purified immature Leydig cells. The elevated sensitivity of immature Leydig cells versus adult Leydig cells to IGF-I stimulation indicates that this peptide hormone has a role in their differentiation during puberty. PMID- 1785770 TI - DNA attachment to the hamster sperm nuclear matrix and nuclear annulus. AB - Hamster sperm DNA is packaged so tightly that it is the most highly condensed eukaryotic DNA known. Nevertheless, the sperm genome is also organized in a very specific fashion by two nuclear structures, the nuclear matrix and the nuclear annulus. The nuclear matrix organizes sperm DNA into loop domains approximately 46 Kb in length by specific attachment sequences. When the sperm nucleus is induced to decondense, the nuclear matrix almost completely dissipates, leaving only the nuclear annulus, a structure located at the implantation fossa within the nucleus. All the DNA remains anchored to the annulus during decondensation. Rotary shadowing transmission electron microscopy of isolated nuclear annuli retaining only a small portion of this anchored DNA suggests that the DNA is anchored to the annulus in a series of mini-loops, 5-10 Kb in length. These data support our previous suggestions that sperm DNA is organized in a very specific manner. PMID- 1785771 TI - Four decades of research on the biology of the male reproductive system: a few landmarks. PMID- 1785772 TI - Ectoplasmic ("junctional") specializations in mammalian Sertoli cells: influence on spermatogenic cells. PMID- 1785773 TI - Biogenesis of specialized cytoskeletal elements of rat spermatozoa. AB - Our results on the formation of the ODF and perforatorium are diagrammatically summarized in Figures 30 and 31. The developmental expression of proteins making up these two cytoskeletal elements differs in timing, duration and intracellular localization. The ODF proteins are synthesized exclusively during the latter part of spermiogenesis, well after transcriptional activity in the haploid germ cell nucleus has ended. This implies that these major integral proteins of the tail are translationally regulated and that mechanisms must exist for the storage and eventual release of the mRNAs encoding these proteins. The perforatorial proteins, on the other hand, begin to be synthesized during the meiotic prophase reaching a peak of production in early spermiogenesis just before the initiation of the condensation of the spermatid's nucleus, at which time RNA synthesis stops. Another major difference between ODF and perforatorial protein production is that there seems to be a coordinated activity between the synthesis and the assembly of the ODF proteins, whereas there appears to be an almost 25 day delay between the initial meiotic synthesis and final condensation of perforatorial proteins in the subacrosomal space at the end of spermiogenesis. As for the intracellular localization of ODF and perforatorial proteins both have unprecedented distributions. The ODF proteins appear to be concentrated in a particular type of granular body which is especially abundant in the elongated spermatid at the time of peak ODF assembly. The perforatorial proteins, on the other hand, appear to be concentrated in the nuclei of pachytene spermatocytes and round spermatids until their displacement into the cytoplasm during nuclear condensation. Both forms of localization suggest a storage role for these proteins uniquely adapted by the spermatid to regulate the assemblies of the respective cytoskeletal elements. PMID- 1785774 TI - Structure-function relationships in the sperm acrosome. PMID- 1785775 TI - Endocytosis of human sex steroid-binding protein in monkey germ cells. AB - We investigate in this study the hypothesis of human sex steroid-binding protein hSBP internalization into germ cells in a primate model. Human SBP was purified from late-pregnancy serum and labeled either with colloidal gold particles (18 nm) or with [3H]delta 6-testosterone by photoaffinity treatment. The germ cells were isolated from sexually mature monkey testis or caput epididymis (Macaca fascicularis) by mechanical means and cell suspensions (4 x 10(6) per 100 microliters culture medium) were incubated in presence of hSBP-gold complex (60 ng/100 microliters) or hSBP-[3H]delta 6-testosterone complex (66 ng/100 microliters, 20,000 cpm) for 2, 5, 15, 45, and 60 min. The samples were processed for electron microscopy followed by autoradiographic treatment for the radiolabeled samples. Localization of the label occurred over the whole germ cell lineage whichever tracer was used. Spermatogonia, spermatocytes, spermatids, testicular and epididymal spermatozoa exhibited specific binding sites over the plasma membrane associated with clathrin-like coated pits and vesicles. At 34 degrees C, intracellular localization of the labeled ligand was found within coated vesicles, in early and late endosomes. In addition, in early spermatogenic cells, labeled ligand was detected in the nuclei and/or associated with the nuclear envelope whereas in late spermatids and residual bodies, the labeling was accumulated in multivesicular, prelysosomal structures. Quantitative analysis of the "labeled cells/total cells" ratio exhibited a negative correlation to the maturation steps, epididymal spermatozoa being the least labeled. The cellular distribution is similar with one or the other protein in the same spermatogenic cells. Unlabeled hSBP treatment prior to labeled hSBP reduced significantly the internalization. Lowering the temperature to 4 degrees C prevented endocytosis and enhanced membrane binding. EDTA pretreatment strongly decreased hSBP internalization and modified the early endocytic steps, namely, the pinching off of the coated vesicles. It is concluded that monkey germ cells are able to internalize the human sex steroid-binding protein through specific endocytic organelles. This endocytosis leads to the labeling of the nuclei in the early spermatogenic cells and of the multivesicular bodies in the late germ cells. This strongly suggests that steroid-binding proteins may be required for spermatogenesis in acting at the germ cell lineage level either by themselves or by serving as steroid transmembrane carriers. PMID- 1785776 TI - Updates and new models for steroid hormone action. PMID- 1785777 TI - First expression of protamine message in trout testis. AB - In situ hybridizations were performed using a biotinylated riboprobe complementary to protamine messenger RNA in order to directly examine the various cell types in the trout testis for the presence of protamine message. Computer aided optical density measurements were used to provide estimates of transcript abundance for cells identified by their DAPI-labeled nuclei. Optically detectable protamine hybridization occurred only in spermatid cells. These findings are in accord with results obtained in other species which report protamine mRNA only in the post-meiotic spermatid cell; but they are in conflict with a previous study employing solution hybridization which noted that protamine message first appears in the spermatocytes of rainbow trout. PMID- 1785778 TI - Sertoli-germ cell interactions as determinants of bidirectional secretion of androgen-binding protein. PMID- 1785779 TI - Spermatids are regulators of Sertoli cell function. AB - Spermatids are major regulators of Sertoli cell function. Specific anatomical structures exist between spermatids and Sertoli cells. Their nature evolves during spermiogenesis and they are essential mediators in the interaction between these two cell types. Spermatids play a crucial role in Sertoli cell gene expression and secretory function at different ages. Early spermatid effect is partly mediated through the secretion of soluble factor(s). The influence of late spermatids on Sertoli cell secretion in the adult testis is conserved throughout evolution and may be mediated via their implication in the conformational changes on Sertoli cells that occur during spermatogenesis and through phagocytosis of the residual bodies. PMID- 1785780 TI - Cell-cell interactions and the regulation of testis function. AB - Regulatory interactions have been shown to occur between all the testicular cell types considered. The paracrine factors mediating these interactions generally influence either cellular growth or differentiation. The regulation of cellular growth is essential in the developing testis and is required for the maintenance of spermatogenesis in the adult testis. The rapid rate of germinal cell proliferation and the continuous but slowed growth of the peritubular cells and Leydig cells requires the presence of specific growth factors in the adult. Therefore, cell-cell interactions have evolved that involve growth factors such as IGF, TGF-alpha, TGF-beta and NGF. Other growth factors such as FGF or less characterized components like the seminiferous growth factor (SGF) also may be involved in the paracrine regulation of testis cell growth. An alternate cellular parameter to cell growth to consider is the regulation of cellular function and differentiation. A number of endocrine agents and locally produced paracrine factors have been shown to control and maintain testis cell function and differentiation. Cell-cell interactions mediated by factors such as androgens, POMC peptides, and PModS are all primarily directed at the regulation of cellular differentiation. Therefore, the agents which mediate cell-cell interactions in the testis can generally be categorized into factors that regulate cell growth or those which influence cellular differentiation. The specific cell-cell interactions identified will likely be the first of a large number of cellular interactions yet to be investigated. Although a number of potentially important cell-cell interactions have been identified, future research will require the elucidation of the in vivo physiological significance of these interactions. The existence of different cell types and potential cell-cell interactions in a tissue implies that the actions of an endocrine agent on a tissue will not simply involve a single hormone and single cell. The endocrine regulation of testis function will have effects on cell-cell interactions and be affected by local cell-cell interactions. The ability of LH to influence Leydig cell androgen production promotes a cascade of interactions mediated through several cell types to maintain the process of spermatogenesis. FSH actions on Sertoli cells also promote cell-cell interactions that influence germinal cell development, peritubular myoid cell differentiation and Leydig cell function. Therefore, elucidation of the endocrine regulation of testis function requires an understanding of the local cell-cell interactions in the testis. PMID- 1785781 TI - Spermatozoa are exposed to a complex microenvironment as they traverse the epididymis. PMID- 1785782 TI - Differential patterns of regulated gene expression in the adult rat epididymis. AB - Specialization among the principal epithelial cells of the epididymal tubule is documented following the analysis of transcriptional activity of four distinct species of mRNA. In situ histochemical analysis revealed a unique pattern of expression for each transcript. This observation supports the concept that region specific patterns of transcriptional expression along the epididymal tubule serve as the major molecular basis underlying region-specific patterns of luminal proteins within the tubule. Additionally, multiple testicular factors appear to regulate expression of these mRNAs. The transcript encoding peptidyl-prolyl cis trans isomerase is constitutively expressed. Those encoding the major secretory proteins, protein B/C and protein D/E, are directly regulated by testicular androgen. That encoding the opioid peptide precursor, proenkephalin, is regulated by a non-androgen testicular factor(s), specifically, spermatozoa or a spermatozoa-related factor. Thus, a complex array of nuclear events and signals received by the principal cells serve to determine the transcriptional status of genes expressed within this epididymal cell type. PMID- 1785783 TI - Developmental regulation of epithelial- and placental-cadherin mRNAs in the rat epididymis. PMID- 1785784 TI - Characteristics of sperm motility. PMID- 1785785 TI - Clinical use and misuse of automated semen analysis. AB - During the past six years, there has been an explosion of technology which allows automated machine-vision for sperm analysis. CASA clearly provides an opportunity for objective, systematic assessment of sperm motion. But there are many caveats in using this type of equipment. CASA requires a disciplined and standardized approach to semen collection, specimen preparation, machine settings, calibration and avoidance of sampling bias. Potential sources of error can be minimized. Unfortunately, the rapid commercialization of this technology preceded detailed statistical analysis of such data to allow equally rapid comparisons of data between different CASA machines and among different laboratories. Thus, it is now imperative that we standardize use of this technology and obtain more detailed biological insights into sperm motion parameters in semen and after capacitation before we empirically employ CASA for studies of fertility prediction. In the basic science arena, CASA technology will likely evolve to provide new algorithms for accurate sperm motion analysis and give us an opportunity to address the biophysics of sperm movement. In the clinical arena, CASA instruments provide the opportunity to share and compare sperm motion data among laboratories by virtue of its objectivity, assuming standardized conditions of utilization. Identification of men with specific sperm motion disorders is certain, but the biological relevance of motility dysfunction to actual fertilization remains uncertain and surely the subject for further study. PMID- 1785786 TI - Reactive oxygen species and human spermatozoa. PMID- 1785787 TI - The effects of moderate heating of the testes and epididymides of rams by scrotal insulation on body temperature, respiratory rate, spermatozoa output and motility, and on fertility and embryonic survival in ewes inseminated with frozen semen. PMID- 1785788 TI - Sperm capacitation and the acrosome reaction. PMID- 1785789 TI - The genetics of sperm function in fertilization. PMID- 1785790 TI - Molecular analysis of the androgen receptor. PMID- 1785791 TI - Role of sex chromosomes in the control of male germ-cell differentiation. PMID- 1785792 TI - Production of mullerian-inhibiting substance (MIS) and sulfated glycoprotein-2 (SGP-2) associated with testicular differentiation in the XX mouse gonadal graft. PMID- 1785793 TI - Androgen regulation of spermatogenesis in the rat. PMID- 1785794 TI - The fibroblast growth factor family. Nomenclature meeting report and recommendations. January 17, 1991. PMID- 1785795 TI - The Fibroblast Growth Factor Family. Proceedings of a conference. January 16-18, 1991, La Jolla, California. PMID- 1785796 TI - Biological activities of fibroblast growth factors. PMID- 1785797 TI - Basic fibroblast growth factor gene expression. PMID- 1785798 TI - Nuclear translocation of basic fibroblast growth factor. PMID- 1785799 TI - Expression of modified bFGF cDNAs in mammalian cells. PMID- 1785800 TI - Expression, processing, and properties of int-2. PMID- 1785801 TI - Possible regulation of FGF activity by syndecan, an integral membrane heparan sulfate proteoglycan. PMID- 1785802 TI - New observations on the intracellular localization and release of bFGF. PMID- 1785803 TI - Basic fibroblast growth factor in the mature brain and its possible role in Alzheimer's disease. PMID- 1785804 TI - Basic fibroblast growth factor in cultured cardiac myocytes. AB - Distribution of basic-fibroblast-growth-factor-like peptides in immature cultured cardiac myocytes was investigated using specific antisera and immunolocalization. Basic FGF was detected in association with the external surface of the cell membrane, with specialized intercellular junctions and with the myofibril Z lines in the cytoplasm. Intense, punctate nuclear anti-bFGF labeling was observed in a fraction of interphase myocytes of near-confluent, proliferating cultures. This staining pattern persisted even after the dissolution of the nuclear envelope in prophase myocytes. The pattern of cellular localization of bFGF indicates a continuous participation of this factor in myocyte physiology as well as a role in the cell cycle. Furthermore, the identification of bFGF not only in cell lysates but also in culture media after gentle mechanical disruption suggests that cardiac myocytes may release bFGF in vivo following tissue damage. PMID- 1785805 TI - Characterization of the hst-1 gene and its product. PMID- 1785806 TI - The role of basic fibroblast growth factor in prenatal development in the rat. PMID- 1785807 TI - Basic FGF and growth of arterial cells. PMID- 1785808 TI - Manipulation of the wound-healing process with basic fibroblast growth factor. PMID- 1785809 TI - Preclinical wound-healing studies with recombinant human basic fibroblast growth factor. PMID- 1785810 TI - Preclinical and clinical studies with recombinant human basic fibroblast growth factor. AB - Basic fibroblast growth factor is a polypeptide belonging to a family of natural proteins also known as heparin-binding growth factors endowed with a pleiotropism of biological activities, the most striking of which are related to wound healing. Large quantities of recombinant human basic fibroblast growth factor (rh bFGF) of a clinical grade were obtained and used to undertake preclinical and clinical studies. In vivo the wound healing effect of rh-bFGF was evaluated in experimental targets such as the cornea and the tympanic membrane, showing a significantly increased epithelial healing rate in drug-treated animals. The deposition of labeled rh-bFGF after topical applications in ocular wounding models did not result in a systemic absorption of the intact rh-bFGF molecule. The acute and the subchronic toxicity studies undertaken after iv and topical administration of a stable pharmaceutical formulation of rh-bFGF did not result in irritation, and no signs of general toxicity were observed. Altogether these data permitted us to start recently with human studies, which are still ongoing, aimed to evaluate the tolerability and the activity of rh-bFGF on tegumental targets such as the cornea and the skin. PMID- 1785811 TI - Basic fibroblast growth factor protects photoreceptors from light-induced degeneration in albino rats. PMID- 1785812 TI - Expression and possible functions of the FGF-5 gene. PMID- 1785813 TI - Local fate and distribution of locally infused basic FGF. The example of the rat brain and the Xenopus tail mesenchyme. PMID- 1785814 TI - Multiple molecular weight forms of basic fibroblast growth factor are developmentally regulated in the rat central nervous system. PMID- 1785815 TI - Internalized bFGF is translocated to the nuclei of venular endothelial cells and established fibroblast cell lines. PMID- 1785816 TI - Internalization of basic fibroblast growth factor by CCL39 fibroblast cells. Involvement of heparan sulfate glycosaminoglycans. PMID- 1785817 TI - Expression and characterization of a basic fibroblast growth factor-saporin fusion protein in Escherichia coli. PMID- 1785818 TI - Basic fibroblast growth factor-saporin mitotoxin. In vitro studies of its cell killing activity and of substances that alter that activity. PMID- 1785819 TI - Stimulation of DNA and protein synthesis in epiphyseal growth plate chondrocytes by fibroblast growth factors. Interactions with other peptide growth factors. PMID- 1785820 TI - An immunoneutralizing anti-basic-FGF antibody potentiates the effect of basic FGF on the growth of FRTL-5 thyroid cells. PMID- 1785821 TI - Expression and release of basic fibroblast growth factor by epiphyseal growth plate chondrocytes. PMID- 1785822 TI - Expression of multiple forms of bFGF in early avian embryos and their possible role in neural crest cell commitment. PMID- 1785823 TI - Basic fibroblast growth factor and central nervous system injury. PMID- 1785824 TI - Fibroblast growth factors influence central nervous system development. Evidence from intraocular grafts. PMID- 1785825 TI - Localization of bFGF in human transplant coronary atherosclerosis. PMID- 1785826 TI - Distribution of fibroblast growth factor immunoreactivity in skin during wool follicle development. PMID- 1785827 TI - Changes in the immunolocalization of bFGF in the mouse endometrium during implantation. PMID- 1785828 TI - Inhibition of pregnancy in the passively and actively immunized mammals rabbit, rat, and mouse. PMID- 1785829 TI - The biodistribution of 111In-anti-bFGF in a variety of tumors. Correlation with cell-binding assays. PMID- 1785830 TI - A model for the role of basic fibroblast growth factor in pituitary tumorigenesis. PMID- 1785831 TI - The FGF6 gene within the FGF multigene family. PMID- 1785832 TI - Chemical characterization of the cysteines of basic fibroblast growth factor. PMID- 1785833 TI - The stoichiometry of Na-Ca+K exchange in rod outer segments isolated from bovine retinas. AB - Ca2+ extrusion in the outer segments of retinal rods (ROS) is mediated by a protein that couples both the inward Na+ gradient and the outward K+ gradient to Ca2+ extrusion. Na(+)-stimulated Ca2+ release from ROS requires internal K+ and is accompanied by release of internal K+, whereas a slow component of Na(+) stimulated Ca2+ release does not require K+. In this paper we discuss our observations on the K+ transport via Na-Ca+ K exchange in bovine ROS, on the electrogenicity and stoichiometry of the ROS Na-Ca+ K exchanger, and on the mechanism on coupling Ca2+ to K+ via this protein. Finally, we discuss briefly the physiological implications of Na-Ca+ K exchange. PMID- 1785834 TI - Regulation of Na-Ca exchange. An overview. PMID- 1785835 TI - Intracellular ionized calcium changes in squid giant axons monitored by Fura-2 and aequorin. AB - Squid giant axons were injected simultaneously with Ca indicators Fura-2 and aequorin. Fura-2 was calibrated in situ by measuring fluorescence at 510 nm upon UV excitation at 340 nm, 360 nm, and 380 nm with a time-sharing multiple wavelength spectrofluorimeter. Limiting values for dye fluorescence were obtained by allowing a massive load of Ca to enter the axon with the aid of procedures such as prolonged depolarization in the presence of CN (for saturation) and by sequestration of all Ca present in the axoplasm accomplished with injection of EGTA into the axon (for a zero-Ca signal). The average intracellular Ca concentration obtained with Fura-2 was 184 nM. The sensitivity of Fura-2 to intracellular Ca is at least as great as that of aequorin, thus permitting its use in the characterization of Ca homeostasis mechanisms such as Na-Ca exchange. It was found, however, that for voltage-clamp experiments requiring an internal current electrode, Fura-2 is not a convenient Ca probe because electrode reactions in the axoplasm denature the dye, thereby restricting its use in characterization of Ca movements associated with electrically induced changes in membrane potential. A comparison of aequorin luminescence with Fura-2 fluorescence demonstrated that light output by aequorin is linear with intracellular Ca concentrations up to values of 750 nM, changing to a square law relationship from 750 nM up to 10 microM Ca. PMID- 1785836 TI - Cardiac Na(+)-Ca2+ exchange system in giant membrane patches. PMID- 1785837 TI - Influence of external monovalent cations on Na-Ca exchange current-voltage relationships in cardiac myocytes. PMID- 1785838 TI - Effects of monovalent cations on Na-Ca exchange in nerve cells. PMID- 1785839 TI - Modulation of sodium-calcium exchange by lipids. PMID- 1785840 TI - Adenosine receptors modulate the Na(+)-Ca2+ exchanger in cerebral nerve endings. PMID- 1785841 TI - Activation of Ca(2+)-Na+ exchange by platelet-derived growth factor in vascular smooth muscle cells. PMID- 1785842 TI - Voltage-dependent block of the Na-Ca exchanger in heart muscle examined using giant excised patches from guinea pig cardiac myocytes. PMID- 1785843 TI - Sodium-calcium exchange in crude plasma membrane vesicles from aortic myocytes. Proteolysis partially restores exchange activity lost during vesicle preparation. PMID- 1785844 TI - Molecular studies of the cardiac sarcolemmal sodium-calcium exchanger. AB - The molecular nature of the canine cardiac sarcolemmal Na(+)-Ca2+ exchanger has been investigated by purification of the protein and by sequencing and expression of an exchanger cDNA clone. The mature exchanger protein is apparently 120 kDa, with glycosylation at a single asparagine residue near the amino terminus. A proposed model for the exchanger protein includes 11 transmembrane segments, a large cytoplasmic domain that is not involved in ion translocation, an exchanger inhibitory site, two Ca2+ interaction sites and an ion-translocation pathway. Experiments are now under way to test the proposed model. PMID- 1785845 TI - Molecular and functional studies of the cardiac sodium-calcium exchanger. PMID- 1785846 TI - Fundamental properties of the Na-Ca exchange. An overview. PMID- 1785847 TI - Molecular and mechanistic heterogeneity of the Na(+)-Ca2+ exchanger. AB - 1. Studying the effect of K+ on Na(+)-Ca2+ exchange in rat brain SPMs revealed that a consistent stimulation was obtained. This stimulation persisted also when FCCP was included in the K(+)-containing reaction mixture to minimize the effect of membrane potential on the electrogenic process. 2. Using Rb+ as a K+ analogue revealed that it was cotransported with Ca2+ in a Na+ gradient-dependent manner. The ratio between the amount of Ca2+/Rb+ transported in rat brain SPMs in a Na+ gradient-dependent manner suggests that not all the Na(+)-Ca2+ exchangers in that preparation cotransport Rb+ (K+) with Ca2+. This is supported also by the finding that Na+ gradient-dependent Ca2+ influx can proceed in rat brain SPMs in the complete absence of K+ although to a lesser extent. 3. Protein purification studies and immunological characterization indicate that a 70-kDa protein is consistently detected in rat brain SPMs. Immunological characterization of the proteins expressed in the 14-18 S mRNA-injected Xenopus oocyte in conjunction with Na+ gradient dependent Ca2+ uptake activity or in the same mRNA-fortified reticulocyte lysate suggest that proteins of about 70 kDa are specifically synthesized. 4. Torpedo electric organ Na(+)-Ca2+ exchanger differs at least in two respects from the rat brain Na(+)-Ca2+ exchanger: It has a low affinity to Na+ (K0.5 = 170 mM), and it reaches maximal activity between 15-20 degrees C. Reconstitution studies suggest that the temperature difference might reflect a difference in the proteins themselves rather then a difference in membrane fluidity due to a difference in the membrane lipid composition. PMID- 1785848 TI - Distinctive properties of the purified Na-Ca exchanger from rod outer segments. AB - The Na-Ca exchanger of rod outer segments plays an important role in the regulation of Ca levels in photoreceptor cells. While this transporter shares functional properties with other Na-Ca exchangers, it has several unique features. The purified ROS exchanger migrates as a single band at 220 kDa in SDS polyacrylamide gels, indicating that the unit size of its polypeptide is larger than other known Na-Ca exchangers (and most transporters). A specific antiserum to the ROS exchanger does not bind to the Na-Ca exchangers found in sarcolemmal vesicles or brain synaptic plasma membranes. Similarly, polyclonal antiserum specific for the cardiac exchanger does not react with ROS or brain proteins. The ROS exchanger requires K for transport activity. By incorporating the purified exchanger into proteoliposomes and measuring the sequestration of K, the actual transport of K is demonstrated. A stoichiometry of 4Na:1Ca,1K for the exchanger of ROS has been measured. PMID- 1785849 TI - Biochemical and molecular characterization of the sodium-calcium exchanger from bovine rod photoreceptors. PMID- 1785850 TI - Effect of polyclonal antibodies on the cardiac sodium-calcium exchanger. PMID- 1785851 TI - At least three functional isoforms of the cardiac Na(+)-Ca2+ exchange exist. PMID- 1785852 TI - Some molecular properties of the synaptic plasma membrane Na(+)-Ca2+ exchanger. PMID- 1785853 TI - Physiological roles of the sodium-calcium exchanger in nerve and muscle. PMID- 1785854 TI - Sodium-calcium exchange and phototransduction in retinal photoreceptors. PMID- 1785855 TI - Sodium-calcium exchange in invertebrate photoreceptors. PMID- 1785856 TI - Sodium-calcium exchange in nerve terminals. Influence on internal Ca2+ and neurosecretion. PMID- 1785857 TI - Neuron-specific and state-specific differences in calcium regulation. Their role in the development of neuronal architecture. PMID- 1785858 TI - Na(+)-Ca2+ exchange activity is increased in Alzheimer's disease brain tissues. PMID- 1785859 TI - Reverse operation of the Na(+)-Ca2+ exchanger mediates Ca2+ influx during anoxia in mammalian CNS white matter. PMID- 1785860 TI - The role of sodium-calcium exchange during the cardiac action potential. PMID- 1785861 TI - Voltage dependence of sodium-calcium exchange and the control of calcium extrusion in the heart. PMID- 1785862 TI - Spatial properties of Ca2+ transients in cardiac myocytes studied by simultaneous measurement of Na(+)-Ca2+ exchange current and indo-1 fluorescence. PMID- 1785863 TI - Sodium-calcium exchange in intact cardiac cells. Exchange currents and intracellular calcium transients. PMID- 1785864 TI - Species differences and the role of sodium-calcium exchange in cardiac muscle relaxation. AB - During normal relaxation in rabbit, guinea-pig, and rat ventricular muscle, the Na-Ca exchange system competes with the SR Ca pump, with the former being responsible for about 20-30% of the Ca removal from the cytoplasm. Ca extrusion via Na-Ca exchange is Em-sensitive, whereas Ca uptake by the SR is not. Neither the sarcolemmal Ca-ATPase pump nor mitochondrial Ca uptake appear to contribute significantly to the decline of [Ca]i during relaxation. Furthermore, the diastolic efflux of Ca from cardiac muscle cells appears to be primarily attributable to Na-Ca exchange and not the sarcolemmal Ca-ATPase pump. In rabbit ventricle Ca entry via Na-Ca exchange is favored thermodynamically during much of a normal twitch contraction and Ca extrusion occurs primarily between beats. In rat ventricle Ca efflux via Na-Ca exchange occurs during the contraction and net Ca influx may occur between beats. This fundamental difference in Ca fluxes during the cardiac cycle in rat versus rabbit ventricle may be a simple consequence of the shorter action potential duration and higher aNai in rat ventricle (due to the effects of Em and [Na] and [Ca] gradients on Na-Ca exchange). PMID- 1785865 TI - Role of reverse-mode Na(+)-Ca2+ exchange in excitation-contraction coupling in the heart. AB - A mechanism capable of eliciting SR Ca2+ release independent of Ca2+ entry through voltage-gated Ca2+ channels was investigated using whole-cell voltage- and current-clamped guinea pig ventricular myocytes dialyzed with the Ca2+ indicator, Indo-1. Depolarization-induced Na+ influx through TTX-sensitive Na+ channels caused a rapid, transient increase in intracellular Ca2+ concentration ([Ca2+]i). The INa-induced [Ca2+]i transients (a) occur after blocking voltage sensitive sarcolemmal Ca2+ channels with nisoldipine or D-600, (b) are inhibited by ryanodine, and (c) are dependent upon extracellular Ca2+. These results indicate that the INa-induced [Ca2+]i transients arise from SR Ca2+ release triggered by Ca2+ entering the myocyte, after a transient rise in [Na+]i, via a pathway distinct from sarcolemmal Ca2+ channels. One such pathway for Ca2+ entry into cardiac cells is reverse-mode Na(+)-Ca2+ exchange. Depolarization-induced Na+ influx failed to elicit Ca2+ transients when extracellular Na+ was replaced with equimolar lithium, which carries current through Na+ channels but does not readily substitute for Na+ on the exchanger. This result provides direct evidence that Ca2+ entry via reverse-mode Na(+)-Ca2+ exchange mediates the INa-induced SR Ca2+ release. Lithium also inhibited nisoldipine-insensitive [Ca2+]i transients elicited by action potentials indicating that INa and Na(+)-Ca2+ exchange may play a role in EC coupling under physiological conditions. Taken together, the results suggest that depolarization-induced Na+ influx through Na+ channels can trigger SR Ca2+ release in cardiac myocytes by activating Ca2+ influx via reverse mode Na(+)-Ca2+ exchange. The INa-induced release of Ca2+ from SR may partially account for the positive inotropic effects of cardiac glycosides and the negative inotropic effects of antiarrhythmic drugs that block Na+ channels. PMID- 1785866 TI - Contribution of sodium-calcium exchange to calcium regulation in cardiac muscle. PMID- 1785867 TI - The contribution of Na-Ca exchange to relaxation in mammalian cardiac muscle. PMID- 1785868 TI - Effects of transient changes in membrane potential on twitch force in ferret papillary muscle. Possible effects on Na-Ca exchange. PMID- 1785869 TI - Contractile properties of isolated ventricular myocytes from the spontaneously hypertensive rat. PMID- 1785870 TI - Evidence for the beat-dependent activation of the Na-Ca exchanger by intracellular Ca. PMID- 1785871 TI - Voltage dependence and kinetics of Na-Ca exchange tail current in rabbit atrial myocytes. PMID- 1785872 TI - Whole-cell current associated with Na-Ca exchange in cultured chick cardiac myocytes. PMID- 1785873 TI - Amiloride enhances postischemic ventricular recovery during cardioplegic arrest. A possible role of Na(+)-Ca2+ exchange. PMID- 1785874 TI - Late contraction in guinea-pig ventricular myocytes activated by the Na(+)-Ca2+ exchange during the action potential. PMID- 1785875 TI - Effects of amiloride derivatives as inhibitors of the Na(+)-Ca2+ exchange on mechanical and electrical functions of isolated cardiac muscle and myocytes. PMID- 1785876 TI - Translocation mechanism of cardiac Na-Ca exchange. AB - In single cardiac ventricular cells of guinea pig, we have studied the ionic translocation mechanism of the electrogenic Na-Ca exchange, that is, whether Na and Ca ions countercross the membrane simultaneously or consecutively. The dose response relations between the external Ca ([Ca]o) and the outward Na-Ca exchange current were measured at three different internal Na concentrations ([Na]i) in the absence of external Na. Hyperbolic regression curves and Hanes-Woolf linear plots of the dose-response relation revealed that apparent Km values for external Ca (K'mCao) decrease progressively as [Na]i decreases. The ratio of K'mCao to apparent Imax value (I'max) showed a slight increasing tendency as [Na]i decreased. We previously interpreted the data as consistent with the simultaneous mechanism but without statistical analysis. Here we performed careful statistical analysis, which indicated that the K'max/I'max values were not significantly different among the different [Na]i at most of the potentials. This result suggests that Na-Ca exchange is likely to be a consecutive mechanism. PMID- 1785877 TI - Sodium-calcium exchange in vascular smooth muscle. PMID- 1785878 TI - Sodium-calcium exchange in aortic myocytes and renal epithelial cells. Dependence on metabolic energy and intracellular sodium. PMID- 1785880 TI - Role of sarcolemmal membrane sodium-calcium exchange in vascular smooth muscle tension. AB - A body of information obtained by experiments with intact tissues, isolated cells, and sarcolemmal vesicles indicates, beyond a reasonable doubt, that a specific Na(+)-Ca2+ exchange system exists in vascular smooth muscle. However, its role in the regulation of cytosolic free-Ca2+ concentration and cell tension under physiological conditions remains unclear. Under pharmacological conditions in which the Na(+)-K+ pump is inhibited either by digitalis glycosides or K(+) free medium, Na(+)-Ca2+ exchange may be modulated by increases in cytosolic free Na+ to increase the cytosolic free-Ca2+ concentration and cell tension. Under pathological conditions in which the cytosolic Na+ concentration is increased as a result of inhibition of the Na(+)-K+ pump by endogenous ouabain or a digitalis like factor, or activation of the Na(+)-H+ exchange or passive permeability of Na+, the Na(+)-Ca2+ exchange activity of vascular smooth muscle and the nerve terminal may play an important role in the development and/or maintenance of hypertension. These and other premises remain to be confirmed or discounted. PMID- 1785881 TI - A comparison of free intracellular calcium and magnesium levels in the vascular smooth muscle and striated muscle cells of the spontaneously hypertensive and Wistar Kyoto normotensive rat. PMID- 1785879 TI - Evidence for Na-Ca exchange in human resistance arteries. PMID- 1785882 TI - Na-Ca exchange studies in frog phasic muscle cells. PMID- 1785883 TI - Contribution of Na(+)-dependent and ATP-dependent Ca2+ transport to smooth muscle calcium homeostasis. PMID- 1785884 TI - Free cytosolic calcium regulation via Na(+)-Ca2+ exchange in cultured vascular smooth muscle cells. PMID- 1785885 TI - Sodium-calcium exchange in bovine aortic endothelial cells. PMID- 1785886 TI - Sodium withdrawal contractures in tonic skeletal muscle fibers of the frog. PMID- 1785887 TI - The role of Na-Ca exchange in renal epithelia. An overview. PMID- 1785888 TI - Calcium extrusion by the sodium-calcium exchanger of the human platelet. PMID- 1785889 TI - Kinetic models of Na-Ca exchange in ferret red blood cells. Interaction of intracellular Na, extracellular Ca, Cd, and Mn. AB - The kinetic equation that best describes the intracellular Na dependence of Ca influx into ferret red cells is sequential; whether this implies that there is a conformation of the protein that has both Na and Ca ions bound remains to be determined. Cd and Mn substitute very well for Ca on the exchanger in ferret red cells; this suggests that the Ca-binding site does not contain an important thiol and that the one of the Na steps may be rate limiting. PMID- 1785890 TI - Photorelease of Ca2+ produces Na-Ca exchange currents and Na-Ca exchange "gating" currents. PMID- 1785892 TI - Sodium-calcium exchange in the pancreatic B cell. PMID- 1785891 TI - Norepinephrine and catecholamine release from peripheral sympathetic nerves and chromaffin cells maintained in primary tissue culture. The role of sodium-calcium exchange. PMID- 1785893 TI - Characterization of Na(+)-Ca2+ exchange in the beta cell. PMID- 1785894 TI - Evidence for sodium-calcium exchange in rodent osteoblasts. PMID- 1785895 TI - Extracellular Na+ removal stimulates chorionic gonadotropin and placental lactogen release by human placental explants. PMID- 1785896 TI - The exchange in intact squid axons. AB - The exchange in intact axons displays a number of features in common with other systems, but a number of interesting points remain to be examined. Both forward (Nao-Cai) and reverse (Cao-Nai) exchange are sensitive to changes in membrane potential, but potassium depolarization can also stimulate Cao-Nai exchange by chemical activation at a monovalent cation-binding site. By monitoring lithium uptakes into intact axons, activating cations do not appear to be transported on the exchange, but this deserves further examination under more stringent conditions. Cao-Nai exchange in intact axons appears activated by monovalent cations to a greater extent compared to dialyzed axons that exhibit little, if any, shift in the Km for Cao. The catalytic effect of Cai on Cao-Nai exchange seen in dialyzed axons proves elusive to study in intact axons, with or without introduction of Ca chelators. Experiments using ruthenium red suggest that free calcium can be dissociated from Cao-Nai exchange fluxes; this finding is also important to those studies monitoring exchange activity using Ca indicators. The possibility that Ca chelators may effect changes in the kinetics of Na-Ca exchange is a subject that needs further investigation. PMID- 1785897 TI - Mechanism of partial reactions in the cardiac Na(+)-Ca2+ exchange system. PMID- 1785898 TI - Is stoichiometry constant in Na-Ca exchange? PMID- 1785899 TI - The Acuvue disposable contact lens as a therapeutic bandage lens. AB - The Bio-Cor collagen shield (Bausch and Lomb, Rochester, NY) is thought to speed corneal epithelial healing and is available in dissolution rates of 12, 24, and 72 hours to suit the needs of the patient. It often is recommended over soft hydrophilic therapeutic lenses for short-term use, such as postoperatively and after corneal abrasions, in which cases the lens should dissolve within the specified period of time. I found these lenses to be unreliable in their dissolution rates. I presented four cases of corneal epithelial breakdown in which the collagen lenses were tried but were not successful. All cases did well with a hydrophilic soft lens, namely the Acuvue disposable lens, used for therapeutic purposes. The advantage of using a disposable lens rather than a standard therapeutic soft lens is its lower cost. Disposable lenses are cheaper than both regular soft lenses and collagen shields. It makes good economic sense to try these as a therapeutic lens of first choice when one is needed. PMID- 1785900 TI - Clinical trial with diffractive multifocal intraocular lens implantation. AB - This study presents results obtained after implantation of 25 diffractive multifocal intraocular lenses. The follow-up ranged from six to 12 months. Visual acuity for distance without correction was 0.5 or better in 72% of cases; for near, it was J1 to J3 in 84% of cases. Slight decentration of the lens and pupil size did not affect visual acuity. PMID- 1785901 TI - Acute retinal necrosis: an unusual presentation. AB - Acute retinal necrosis (ARN) is a visually devastating disease consisting of necrotizing retinitis in healthy patients. The retinitis usually begins in the midperiphery to periphery and may spread to the posterior pole. Milder cases of ARN involving the posterior pole have been described. However, these cases never progress to full-blown ARN and have relatively good visual outcomes. A case is reported of a young, white woman with ARN that originally presented in the posterior pole. Unlike mild cases, spread to the midperiphery and periphery ensued until full-blown ARN occurred. This disease may present not only as an acute mid-peripheral to peripheral retinitis, but it also must be considered in the differential diagnosis of patients with multifocal, punctate areas of retinitis in the posterior pole. PMID- 1785902 TI - Orbital cellulitis complicating strabismus surgery: a case report and review of the literature. AB - Orbital cellulitis is a rarely reported, but potentially vision- and life threatening complication after strabismus surgery. To date, only seven cases of orbital cellulitis complicating strabismus surgery have been reported in the world literature, and only two cases were reported in adult patients, both occurring more than 100 years ago. We describe a case of unilateral orbital cellulitis after bilateral strabismus surgery in an adult. Early diagnosis (aided by computed tomography) and aggressive intravenous antibiotic therapy resulted in a favorable visual outcome. Diagnosis and management are discussed, and this case is compared with previous cases in the literature. PMID- 1785903 TI - Endogenous Escherichia coli endophthalmitis in a patient with autosomal-dominant polycystic kidney disease. AB - We examined a 67-year-old man with autosomal-dominant polycystic kidney disease who had right ocular pain and visual loss. Escherichia coli was grown from the vitreous aspirate. Despite treatment, no visual improvement was obtained, and the right globe was enucleated. We believe that the patient had a rare case of endogenous E. coli endophthalmitis. PMID- 1785904 TI - Eales' disease with central nervous system infarction. AB - Eales' disease is a noninflammatory occlusive disorder of the retinal vasculature that causes recurrent hemorrhages into the retina and vitreous and ischemic changes in the eye. Extraocular manifestations of Eales' disease are rare and limited to the central nervous system. We report the case of a patient with Eales' disease and ischemic stroke, and we review the neurologic manifestations of this primarily ophthalmologic vasculopathy. PMID- 1785905 TI - Extensive fibrous downgrowth after traumatic corneoscleral wound dehiscence. AB - Two months after cataract surgery, subconjuctival would gaping developed in our patients as a result of trauma and was resutured. Subsequently, corneal edema and a retrocorneal membrane were noticed. During penetrating keratoplasty, a thick fibrous membrane was found growing from the posterior corneal surface into the anterior and posterior chambers. Histopathologic studies revealed fibrous down growth from the corneal stroma through a gap in Descemet's layer, forming a retrocorneal membrane. PMID- 1785906 TI - Adding automated perimetry to glaucoma evaluation and treatment. AB - Tangent-screen visual fields were compared with the fields determined by a newly acquired automated perimeter in 100 eyes of consecutive patients with glaucoma or suspected glaucoma. The tangent screen found defects in 12 eyes, and the automated perimeter found defects in 34 eyes. Because the automated perimeter found new defects or defects much worse than were found by the tangent-screen examinations, three patients received timolol, and a laser iridotomy, two laser trabeculoplasties, and three filtering operations were done on other patients. The major benefit in switching from tangent screen to automated perimetry was increased confidence in the visual fields tested as an indicator for treating patients with glaucoma. A minor problem in using the automated perimeter was that the testing was slightly longer and more tiring. This problem was reduced by using a translucent occluder, rather than the universally used opaque one. PMID- 1785907 TI - Dental care utilization among dental students. AB - The purpose of this study was to determine the proportion of needed dental care actually received by dental students during their dental education. This was accomplished by a review of dental records for recent Baylor College of Dentistry graduates. Collected data included restorative, periodontal, endodontic and extraction procedures planned and dental care actually accomplished prior to graduation. Comparisons of these findings were made based on gender, ethnicity and academic standing of the sample subjects. The sample size of 134 included 98 males and 36 females; 111 were Caucasian and 23 Minorities. Fifty-six individuals were in the upper academic third of their class, 37 in the middle third and 41 in the lower third. The treatments required were primarily operative dental restorations (7.28 +/- 7.19 surfaces per student), crowns (0.43 +/- 1.22 units per student) and extractions (0.90 +/- 1.58 per student). Periodontal and endodontic needs were minimal. Students received approximately 60% of the required care during their dental education. Minimal relationships were identified between gender, academic standing and ethnicity and the students' care needs and treatments. The results suggest a relatively low priority for receiving needed dental care among dental students. PMID- 1785908 TI - Type I dentin dysplasia: report of two cases. AB - Dentin dysplasia is a rare developmental disturbance of dentin affecting approximately 1:100,000 people. It has been classified as an autosomal dominant disease. Two distinct forms of dentin dysplasia have been described. As more cases of dentin dysplasia were reported these categories seemed inadequate; subclassification of type I dentin dysplasia were proposed based on root length and the presence or not of a pulpal remnant. This paper presents two cases demonstrating the classic features of type I dentin dysplasia in the mixed and permanent dentitions and discusses the suggested subclassifications. The authors suggest that while differences in root length may be useful in determining treatment options, thinking of these variables as separate types of dentin dysplasia is not warranted at this time. Justification of a subcategory of type I dentin dysplasia should be based on a different disease process, different histology, significantly different symptoms, or different etiologies, and until researchers can clearly prove from a genetic or chromosomal standpoint that the subcategories are separate entities, we should accept, as we do for many other genetic disorders, that some patients are more severely affected than others. PMID- 1785909 TI - Zeroing in on potential markets for dental services. AB - A review is provided on the relationship between dental use patterns and occupational activities. A call is made to direct the marketing of dental services by using this information to increase our attention to underserved populations and expand the market for dental services. PMID- 1785910 TI - Kimura's disease: a case report. AB - The clinical and histologic features of Kimura's disease are briefly outlined. A case presenting as a subcutaneous nodule in the region of the angle of the right mandible of a 20-year-old male is presented. The relationship of this disease to angiolymphoid hyperplasia with eosinophilia is discussed. PMID- 1785911 TI - Desmoplastic fibroma: report of a case with proliferative myositis. AB - Desmoid tumor of the mandible, or desmoplastic fibroma, is a rare disease with only a few cases reported in the literature. This paper presents the rare case of an elderly male with desmoplastic fibroma of the mandible with an uncommon accompanying proliferative myositis. The case is discussed with emphasis on the clinical presentation, differential diagnosis and treatment of this lesion. PMID- 1785912 TI - Infections of the lateral pharyngeal space: anatomy, diagnosis and management. AB - The incidence of lateral pharyngeal space infections and its dreaded complications have decreased tremendously due to antibiotic therapy. However, this fascial space infection of the deep neck is still occasionally seen. In this article, we emphasize the anatomy, diagnosis and aggressive management of this type of neck infection because of its morbid complications and mortality if not treated promptly. PMID- 1785913 TI - Serum sialic acid, fucose, sialic acid/fucose ratio as tumor markers in oral cancer. AB - To our knowledge, no study has been undertaken before by any researcher as to the direction of content of the components of serum glycoproteins simultaneously as well as their ratios in oral cancer patients. The aim of the present paper is to establish the direct relationship between fucose and sialic acid levels in the sera of such patients. The biochemical levels were studied among 37 oral cancer patients and were compared with 15 controls. PMID- 1785914 TI - The New York Academy of Dentistry Fellowship list. 1991-92. PMID- 1785915 TI - Epithelial odontogenic ghost cell tumor: report of a peripheral solid variant and review of the literature. PMID- 1785916 TI - Mechanism of action of benzoic acid on Zygosaccharomyces bailii: effects on glycolytic metabolite levels, energy production, and intracellular pH. AB - The effects of benzoic acid in the preservative-resistant yeast Zygosaccharomyces bailii were studied. At concentrations of benzoic acid up to 4 mM, fermentation was stimulated and only low levels of benzoate were accumulated. Near the MIC (10 mM), fermentation was inhibited, ATP levels declined, and benzoate was accumulated to relatively higher levels. Intracellular pH was reduced but not greatly. Changes in the levels of metabolites at different external benzoic acid levels showed that glycolysis was limited at pyruvate kinase and glyceraldehyde dehydrogenase-phosphoglycerate kinase steps. Inhibition of phosphofructokinase and several other glycolytic enzymes was not responsible for the inhibition of fermentation. Instead, the results suggest that the primary action of benzoic acid in Z. bailii is to cause a general energy loss, i.e., ATP depletion. PMID- 1785917 TI - Effect of benzoic acid on glycolytic metabolite levels and intracellular pH in Saccharomyces cerevisiae. AB - Low concentrations of benzoic acid stimulated fermentation rates in Saccharomyces cerevisiae. At concentrations near the maximum permitting growth, there was inhibition of fermentation, lowered ATP and intracellular pH, and relatively greater accumulation of benzoate. Changes in the levels of glycolytic intermediates suggested that fermentation was inhibited as a result of high ATP usage rather than of lowered intracellular pH. Specific inhibition of phosphofructokinase or of several other glycolytic enzymes was not observed. PMID- 1785918 TI - Complete degradation of polychlorinated hydrocarbons by a two-stage biofilm reactor. AB - A two-stage anaerobic-aerobic biofilm reactor successfully degraded a mixture of chlorinated organic compounds to water-soluble metabolic intermediates and carbon dioxide. Reductive dechlorination of hexachlorobenzene (HCB), tetrachloroethylene (PCE), and chloroform (CF) occurred on all tested primary carbon sources such as glucose, methanol, and acetate. However, the extent of dechlorination was maximum when the anaerobic biofilm column was fed acetate as a primary carbon source. HCB, PCE, and CF were dechlorinated to the levels of tri- and dichlorinated products (99, 80, and 32%, respectively) with acetate in the feed. This is important, since these less-chlorinated compounds can be metabolized by the aerobic biofilm. The effluent from the anaerobic biofilm column was fed directly into the aerobic column. After both columns, the total amount transformed into nonvolatile intermediates and carbon dioxide was 94, 96, and 83% for [14C]HCB, [14C]trichloroethylene, and [14C]CF, respectively. This research shows the potential application of this novel two-stage bioreactor system for treating groundwaters and industrial effluents composed of highly chlorinated aliphatic and aromatic hydrocarbons. PMID- 1785919 TI - Bacteriocin-mediated inhibition of Clostridium botulinum spores by lactic acid bacteria at refrigeration and abuse temperatures. AB - The bacteriocinogenicity of Lactococcus lactis ATCC 11454, Pediococcus pentosaceus ATCC 43200, P. pentosaceus ATCC 43201, Lactobacillus plantarum BN, L. plantarum LB592, L. plantarum LB75, and Lactobacillus acidophilus N2 against Clostridium botulinum spores at 4, 10, 15, and 35 degrees C was investigated by modified deferred and simultaneous antagonism methods. All the strains, except L. acidophilus N2, produced inhibition zones on lawns of C. botulinum spores at 30 degrees C. L. plantarum BN, L. lactis ATCC 11454, and P. pentosaceus ATCC 43200 and 43201 were bacteriocinogenic at 4, 10, and 15 degrees C. Supplementation of brain heart infusion agar with 0 to 5% NaCl increased the radii of inhibition zones during simultaneous antagonism assays. Detectable bacteriocin activities were extracted from freeze-thawed agar cultures of L. plantarum BN and L. lactis ATCC 11454 which had been grown at 4 and 10 degrees C. These results suggest that low levels of L. plantarum BN or L. lactis ATCC 11454, in the presence of 3 or 4% NaCl, could be formulated into minimally processed refrigerated food products for protection against possible botulism hazards. PMID- 1785920 TI - Effects of farnesol and the off-flavor derivative geosmin on Streptomyces tendae. AB - Effects of the sesquiterpene farnesol (3,7,11-trimethyl-2,6,10-dodecatrien-1-ol) and the sesquiterpene derivative geosmin (1,10-trans-dimethyl-trans-9-decalol) were investigated in a geosmin-producing actinomycete, Streptomyces tendae. Exposure to 300 microM farnesol reduced biomass (fresh matter) accumulation by 97% compared with biomass accumulation by controls, whereas an equal amount of geosmin did not affect biomass accumulation. Increasing exposure to farnesol corresponded with reduced optical density of the culture, reduced levels of geosmin, and reduced metabolic heat production compared with controls, while exogenous geosmin did not affect these parameters. Geosmin dissipated from unioculated medium more rapidly than farnesol, indicating that in addition to the lower toxicity of geosmin, the actual exposure to geosmin over time may be less than exposure to an equal amount of farnesol. Cultures grown on Actinomyces-B medium contained 99.5% less geosmin and were more sensitive to farnesol than those grown on Hickey-Tresner medium, indicating that geosmin synthesis was associated with reduced sensitivity to farnesol. Consumption of farnesyl moieties during geosmin synthesis may reduce the potential for farnesol-induced inhibition of growth and metabolism. PMID- 1785921 TI - Characterization of metabolic performance of methanogenic granules treating brewery wastewater: role of sulfate-reducing bacteria. AB - Granules from an upflow anaerobic sludge blanket system treating a brewery wastewater that contained mainly ethanol, propionate, and acetate as carbon sources and sulfate (0.6 to 1.0 mM) were characterized for their physical and chemical properties, metabolic performance on various substrates, and microbial composition. Transmission electron microscopic examination showed that at least three types of microcolonies existed inside the granules. One type consisted of Methanothrix-like rods with low levels of Methanobacterium-like rods; two other types appeared to be associations between syntrophic-like acetogens and Methanobacterium-like organisms. The granules were observed to be have numerous vents or channels on the surface that extended into the interior portions of the granules that may be involved in release of gas formed within the granules. The maximum substrate conversion rates (millimoles per gram of volatile suspended solids per day) at 35 degrees C in the absence of sulfate were 45.1, 8.04, 4.14, and 5.75 for ethanol, acetate, propionate, and glucose, respectively. The maximum methane production rates (millimoles per gram of volatile suspended solids per day) from H2-CO2 and formate were essentially equal for intact granules (13.7 and 13.5) and for physically disrupted granules (42 and 37). During syntrophic ethanol conversion, both hydrogen and formate were formed by the granules. The concentrations of these two intermediates were maintained at a thermodynamic equilibrium, indicating that both are intermediate metabolites in degradation. Formate accumulated and was then consumed during methanogenesis from H2-CO2. Higher concentrations of formate accumulated in the absence of sulfate than in the presence of sulfate. The addition of sulfate (8 to 9 mM) increased the maximum substrate degradation rates for propionate and ethanol by 27 and 12%, respectively. In the presence of this level of sulfate, sulfate-reducing bacteria did not play a significant role in the metabolism of H2, formate, and acetate, but ethanol and propionate were converted via sulfate reduction by approximately 28 and 60%, respectively. In the presence of 2.0 mM molybdate, syntrophic propionate and ethanol conversion by the granules was inhibited by 97 and 29%, respectively. The data show that in this granular microbial consortium, methanogens and sulfate-reducing bacteria did not compete for common substrates. Syntrophic propionate and ethanol conversion was likely performed primarily by sulfate-reducing bacteria, while H2, formate, and acetate were consumed primarily by methanogens. PMID- 1785922 TI - Detection and activity of a bacteriocin produced by Leuconostoc mesenteroides. AB - Leuconostoc mesenteroides UL5 was found to produce a bacteriocin, referred as mesenterocin 5, active against Listeria monocytogenes strains but with no effect on several useful lactic acid bacteria. The antimicrobial substance is a protein, since its activity was completely destroyed following protease (pronase) treatment. However, it was relatively heat stable (100 degrees C for 30 min) and partially denaturated by chloroform. The inhibitory effect of the bacteriocin on sensitive bacterial strains was determined by a critical-dilution micromethod. Mutants of L. mesenteroides UL5 which had lost the capacity to produce the bacteriocin were obtained. The mutant strain was stable and phenotypically identical to parental cells and remained resistant to the bacteriocin. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis was used to detect bacteriocin activity corresponding to an apparent molecular mass of about 4.5 kDa. PMID- 1785923 TI - Detection of Giardia cysts by using the polymerase chain reaction and distinguishing live from dead cysts. AB - A method was developed for the detection of Giardia cysts by using the polymerase chain reaction (PCR) and the giardin gene as the target. DNA amplification by PCR, using giardin DNA as the target, resulted in detection of both live and dead cysts. When giardin mRNA was used as the target, the ability to amplify cDNA by PCR depended on the mode of killing. Cysts killed by freezing were not detected by PCR when giardin mRNA was the target. Cysts killed by heating or exposure to monochloramine, however, gave positive detection signals for both DNA and giardin mRNA targets. The amount of giardin mRNA and total RNA was significantly increased in live cysts following the induction of excystation. Cysts killed by freezing, heating, or exposure to monochloramine did not show a change in RNA content. The detection of the giardin gene by PCR permits a sensitive and specific diagnosis for Giardia spp. Discrimination between live and dead cysts can be made by measuring the amounts of RNA or PCR-amplified product from the giardin mRNA target before and after the induction of excystation. PMID- 1785924 TI - Indigenous and enhanced mineralization of pyrene, benzo[a]pyrene, and carbazole in soils. AB - We studied the mineralization of pyrene, carbazole, and benzo[a]pyrene in soils obtained from three abandoned coal gasification plants in southern Illinois. The soils had different histories of past exposure to hydrocarbon contamination and different amounts of total organic carbon, microbial biomass, and microbial activity. Mineralization was measured by using serum bottle radiorespirometry. The levels of indigenous mineralization of 14C-labeled compounds ranged from 10 to 48% for pyrene, from undetectable to 46% for carbazole, and from undetectable to 25% for benzo[a]pyrene following long-term (greater than 180-day) incubations. Pyrene and carbazole were degraded with short or no lag periods in all soils, but benzo[a]pyrene mineralization occurred after a 28-day lag period. Mineralization was not dependent on high levels of microbial biomass and activity in the soils. Bacterial cultures that were capable of degrading pyrene and carbazole were isolated by enrichment, grown in pure culture, and reintroduced into soils. Reintroduction of a pyrene-degrading bacterium enhanced mineralization to a level of 55% within 2 days, compared with a level of 1% for the indigenous population. The carbazole degrader enhanced mineralization to a level of 45% after 7 days in a soil that showed little indigenous carbazole mineralization. The pyrene and carbazole degraders which we isolated were identified as a Mycobacterium sp. and a Xanthamonas sp., respectively. Our results indicated that mineralization of aromatic hydrocarbons can be significantly enhanced by reintroducing isolated polycyclic aromatic hydrocarbon-degrading bacteria. PMID- 1785925 TI - Identification of a locus within the hydrogenase gene cluster involved in intracellular nickel metabolism in Bradyrhizobium japonicum. AB - A 0.6-kb fragment of DNA involved in intracellular Ni metabolism was isolated and cloned from a cosmid containing 23.2 kb of hydrogenase-related genes of Bradyrhizobium japonicum. This locus is located 8.3 kb upstream of the hydrogenase structural genes. The hydrogenase activity of a mutant with a gene directed mutation at this locus (strain JHK7) showed dependency on nickel provided during hydrogenase derepression. The hydrogenase activity was only 20% of that in the wild-type strain, JH, at a concentration of 0.5 microM NiCl2. The hydrogenase activity in JH reached its maximum at 3 microM NiCl2, whereas the mutant (JHK7) reached wild-type levels of hydrogenase activity when derepressed in 50 microM NiCl2. Studies with the hup-lacZ transcriptional fusion plasmid pSY7 in JHK7 showed that the mutant JHK7 expressed less promoter activity under low nickel conditions than did strain JH. The mutant accumulated less nickel during a 45-h hydrogenase derepression period than did the wild type. However, both JHK7 and the JH wild-type strain had the same short-term Ni transport rates, and the KmS for Ni of both strains were about 62 microM. When incubated under non hydrogenase-derepression conditions, the mutant accumulated Ni at the same rate as strain JH. However, this stored source of nickel was unable to restore hydrogenase expression ability of the mutant to wild-type levels during derepression without nickel. The results indicate that the locus identified in B. japonicum is not involved in nickel-specific transport; indeed, it was not at all homologous to the "nickel transporter" hoxN gene of Alcaligenes eutrophus.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785926 TI - Competitive inhibition of an energy-dependent nickel transport system by divalent cations in Bradyrhizobium japonicum JH. AB - Both nickel-specific transport and nickel transport by a magnesium transporter have been described previously for a variety of nickel-utilizing bacteria. The derepression of hydrogenase activity in Bradyzhizobium japonicum JH and in a gene directed mutant of strain JH (in an intracellular Ni metabolism locus), strain JHK7, was inhibited by MgSO4. For both strains, Ni2+ uptake was also markedly inhibited by Mg2+, and the Mg(2+)-mediated inhibition could be overcome by high levels of Ni2+ provided in the assay buffer. The results indicate that both B. japonicum strains transport Ni2+ via a high-affinity magnesium transport system. Dixon plots (1/V versus inhibitor) showed that the divalent cations Co2+, Mn2+, and Zn2+, like Mg2+, were competitive inhibitors of Ni2+ uptake. The KiS for nickel uptake inhibition by Mg2+, Co2+, Mn2+, and Zn2+ were 48, 22, 12, and 8 microM, respectively. Cu2+ strongly inhibited Ni2+ uptake, and molybdate inhibited it slightly. Respiratory inhibitors cyanide and azide, the uncoupler carbonyl cyanide m-chlorophenylhydrazone, the ATPase inhibitor N,N' dicyclohexylcarbodiimide, and ionophores nigericin and valinomycin significantly inhibited short-term (5 min) Ni2+ uptake, showing that Ni2+ uptake in strain JH is energy dependent. Most of these conclusions are quite different from those reported previously for a different B. japonicum strain belonging to a different serogroup. PMID- 1785927 TI - Effects of solvents and alcohols on the polar lipid composition of Clostridium butyricum under conditions of controlled lipid chain composition. AB - Clostridium butyricum has been grown in media devoid of biotin, to which long chain fatty acids have been added to promote growth. We have shown previously that, under these conditions, exogenous fatty acids are extensively incorporated into the cellular phospholipids. Cells grown with elaidic acid, trans-9-18:1, have normal ratios of the glycerol acetal of plasmenylethanolamine (GAPlaE) to phosphatidylethanolamine (PE) plus plasmenylethanolamine (PlaE) compared with cells grown with biotin. When ethanol, cyclohexane, or n-octanol was added to elaidate-containing media, the ratio of GAPlaE to PE plus PlaE was significantly increased. Addition of dodecane and n-butanol did not affect this ratio. When cells were grown with oleic acid in the absence of biotin, the GAPlaE to PE plus PlaE ratio was increased 5.4-fold compared with elaidate-grown cells. In oleate supplemented media, the addition of solvents or n-alcohols produced no further increase in this ratio. We conclude that these changes in lipid composition represent cellular responses to perturbation of the equilibria between the lamellar and nonlamellar liquid crystalline phases in the cell membrane. PMID- 1785928 TI - Polymerase chain reaction-gene probe detection of microorganisms by using filter concentrated samples. AB - To detect low levels of microorganisms in environmental samples by using polymerase chain reaction (PCR)-gene probe detection, samples were concentrated by filtration. Fluoropore (Millipore Corp.) filters were compatible with PCR DNA amplification, whereas various other filters including nitrocellulose and cellulose acetate filters inhibited PCR amplification. By concentrating cells on Fluoropore filters and releasing the DNA by freeze-thaw cycling, PCR DNA amplification could be performed without removing the filter. Concentration with Fluoropore FHLP and FGLP filters permitted the detection of single cells of microorganisms in 100-ml samples by PCR-gene probes. PMID- 1785929 TI - 1,3-Propanediol production by Escherichia coli expressing genes from the Klebsiella pneumoniae dha regulon. AB - The dha regulon in Klebsiella pneumoniae enables the organism to grow anaerobically on glycerol and produce 1,3-propanediol (1,3-PD). Escherichia coli, which does not have a dha system, is unable to grow anaerobically on glycerol without an exogenous electron acceptor and does not produce 1,3-PD. A genomic library of K. pneumoniae ATCC 25955 constructed in E. coli AG1 was enriched for the ability to grow anaerobically on glycerol and dihydroxyacetone and was screened for the production of 1,3-PD. The cosmid pTC1 (42.5 kb total with an 18.2-kb major insert) was isolated from a 1,3-PD-producing strain of E. coli and found to possess enzymatic activities associated with four genes of the dha regulon: glycerol dehydratase (dhaB), 1,3-PD oxidoreductase (dhaT), glycerol dehydrogenase (dhaD), and dihydroxyacetone kinase (dhaK). All four activities were inducible by the presence of glycerol. When E. coli AG1/pTC1 was grown on complex medium plus glycerol, the yield of 1,3-PD from glycerol was 0.46 mol/mol. The major fermentation by-products were formate, acetate, and D-lactate. 1,3-PD is an intermediate in organic synthesis and polymer production. The 1,3-PD fermentation provides a useful model system for studying the interaction of a biochemical pathway in a foreign host and for developing strategies for metabolic pathway engineering. PMID- 1785930 TI - Effect of gene amplification on mercuric ion reduction activity of Escherichia coli. AB - The mercury resistance (mer) operon of plasmid R100 was cloned onto various plasmid vectors to study the effect of mer gene amplification on the rate of Hg2+ reduction by Escherichia coli cells. The plasmids were maintained at copy numbers ranging from 3 to 140 copies per cell. The overall Hg2+ reduction rate of intact cells increased only 2.4-fold for the 47-fold gene amplification. In contrast, the rate of the cytoplasmic reduction reaction, measured in permeabilized cells, increased linearly with increasing gene copy number, resulting in a 6.8-fold overall amplification. RNA hybridizations indicated that mRNA of the cytoplasmic mercuric reductase (merA gene product) increased 11-fold with the 47-fold gene amplification, while mRNA of the transport protein (merT gene product) increased only 5.4-fold. Radiolabeled proteins produced in maxicells were used to correlate the expression levels of the mer polypeptides with the measured reduction rates. The results indicated that, with increasing gene copy number, there was an approximately 5-fold increase in the merA gene product compared with a 2.5-fold increase in the merT gene product. These data demonstrate a parallel increase of Hg2+ reduction activity and transport protein expression in intact cells with plasmids with different copy numbers. In contrast, the expression level of the mercuric reductase gene underwent higher amplification than that of the transport genes at both the RNA and protein levels as plasmid copy number increased. PMID- 1785931 TI - Analysis of the polyphosphate-accumulating microflora in phosphorus-eliminating, anaerobic-aerobic activated sludge systems by using diaminopropane as a biomarker for rapid estimation of Acinetobacter spp. AB - Polyphosphate-accumulating gram-negative bacteria were isolated from different anaerobic-aerobic activated sludge systems with diverse processes for enhanced biological phosphorus (P) elimination. Of 22 isolates, 10 were allocated to the genus Acinetobacter by using multiple-test systems and soluble protein and polyamine patterns. As diaminopropane (DAP) appears to be the characteristic main polyamine compound produced by Acinetobacter spp., it was used as a biomarker for the genus. The high DAP contents of representative samples from municipal wastes with enhanced biological P elimination indicated that Acinetobacter spp. can be dominant organisms in sewage treatment plants with low organic loading and nitrification and denitrification steps. Contrary to accepted opinion, sludge from treatment plants with efficient P removal and high organic loading had a low DAP content, indicating that bacteria other than Acinetobacter spp. are responsible for enhanced biological P elimination in these plants. PMID- 1785932 TI - Purification and characterization of an endopeptidase from Lactococcus lactis subsp. cremoris Wg2. AB - An endopeptidase has been purified to homogeneity from a crude cell extract of Lactococcus lactis subsp. cremoris Wg2 by a procedure that includes diethyl aminoethane-Sephacel chromatography, phenyl-Sepharose chromatography, hydroxylapatite chromatography, and fast protein liquid chromatography over an anion-exchange column and a hydrophobic-interaction column. Gel filtration and sodium dodecyl sulfate-polyacrylamide gel electrophoresis indicated a molecular mass of the purified enzyme of 70,000 Da. The endopeptidase can degrade several oligopeptides into various tetra-, tri-, and dipeptides. The endopeptidase has no aminopeptidase, carboxypeptidase, dipeptidase, or tripeptidase activity. It is optimally active at pH 6.0 to 6.5 and in the temperature range of 30 to 38 degrees C. The enzyme is inactivated by the chemical agents 1,10-phenanthroline, ethylenedinitrilotetraacetate, beta-mercaptoethanol, and phenylmethylsulfonyl fluoride and is inhibited by Cu2+ and Zn2+. The ethylenedinitrilotetraacetate- or 1,10-phenanthroline-treated enzyme can be reactivated by Co2+. Immunoblotting with specific antibodies raised against the purified endopeptidase indicated that the enzyme is also present in other Lactococcus spp., as well as in Lactobacillus spp. and Streptococcus salivarius subsp. thermophilus. PMID- 1785933 TI - Nisin treatment for inactivation of Salmonella species and other gram-negative bacteria. AB - Nisin, produced by Lactococcus lactis subsp. lactis, has a broad spectrum of activity against gram-positive bacteria and is generally recognized as safe in the United States for use in selected pasteurized cheese spreads to control the outgrowth and toxin production of Clostridium botulinum. This study evaluated the inhibitory activity of nisin in combination with a chelating agent, disodium EDTA, against several Salmonella species and other selected gram-negative bacteria. After a 1-h exposure to 50 micrograms of nisin per ml and 20 mM disodium EDTA at 37 degrees C, a 3.2- to 6.9-log-cycle reduction in population was observed with the species tested. Treatment with disodium EDTA or nisin alone produced no significant inhibition (less than 1-log-cycle reduction) of the Salmonella and other gram-negative species tested. These results demonstrated that nisin is bactericidal to Salmonella species and that the observed inactivation can be demonstrated in other gram-negative bacteria. Applications involving the simultaneous treatment with nisin and chelating agents that alter the outer membrane may be of value in controlling food-borne salmonellae and other gram-negative bacteria. PMID- 1785934 TI - Inhibition of bacterial and phytoplanktonic metabolic activity in the lower River Rhine by ditallowdimethylammonium chloride. AB - The effects of a quaternary ammonium compound, ditallowdimethylammonium chloride (DTDMAC), on natural populations of bacteria and phytoplankton from the lower River Rhine were examined to estimate their sensitivity to the discharges of cationic surfactants in the river basin. In short-term experiments, significant decreases in the growth rate of bacterioplankton and in the photosynthetic rate of phytoplankton were observed at a nominal concentration of 0.03 to 0.1 mg of DTDMAC liter-1. Nitrification was measured with an ion-selective electrode and by the rate of acid production in ammonium-spiked river water and was found to be only sensitive to the addition of concentrations higher than 1 mg of DTDMAC liter 1. This does not support an earlier suggestion that ammonium-oxidizing bacteria are specifically sensitive to quaternary ammonium compounds. The effect of DTDMAC on thymidine incorporation was shown to depend strongly on the concentration of suspended material, which varied with the sampling date. This effect was also quantified in experimental manipulations with Rhine water. Calculations on the partitioning of DTDMAC between water and suspended matter confirmed the role of suspended solids and showed that an increase of the dissolved DTDMAC concentration in Rhine water by circa 0.01 mg liter-1 leads to a slight inhibition of the growth of heterotrophic bacteria. It is concluded that a total concentration of circa 0.01 mg of DTDMAC liter-1 measured in the River Rhine is likely to have biological consequences. PMID- 1785935 TI - Occurrence and ultrastructural characterization of bacteria in association with and isolated from Azolla caroliniana. AB - The occurrence and ultrastructure of bacteria in leaf cavities of symbiotic Azolla caroliniana were examined by transmission electron microscopy. Bacteria were observed in all leaf cavities of Azolla cultures. Five ultrastructurally distinct types of bacteria were observed in each individual leaf cavity. Features used to characterize the bacteria included morphology, cell wall structure, and cytoplasmic organization. At least one gram-positive and as many as four gram negative types of bacteria reside in leaf cavities of A. caroliniana. The morphological and ultrastructural characteristics of the gram-positive bacterium suggest that it is an Arthrobacter sp. The gram-negative bacteria could not be cultured; therefore, they have not been classified further. Bacterial cell shape and cell wall structure were similar in leaf cavities of different ages, but cell size and cytoplasmic composition varied. The relative contributions of each bacterial type to the total community within individual leaves was determined. Ultrastructural characteristics of bacterial isolates cultured from A. caroliniana in a free-living state were also examined. PMID- 1785936 TI - Immunocytochemical localization of nitrogenase in bacteria symbiotically associated with Azolla spp. AB - In situ immunogold labeling and transmission electron microscopy were used to detect nitrogenase in bacteria (bactobionts) symbiotically associated with leaf cavities of Azolla caroliniana and Azolla filiculoides. In A. caroliniana, the Fe protein of the nitrogenase complex was detected in a subset of the distinct bactobiont types present in leaf cavities of all ages. Similar results were obtained for the bactobionts of A. filiculoides with antisera against both the Fe and MoFe subunits of nitrogenase. PMID- 1785937 TI - Limited bacterial mineralization of fungal degradation intermediates from synthetic lignin. AB - The ability of selected bacterial strains and consortia to mineralize degradation intermediates produced by Phanerochaete chrysosporium from 14C-labeled synthetic lignins was studied. Three different molecular weight fractions of the intermediates were subjected to the action of the bacteria, which had been grown on a lignin-related dimeric compound. Two consortia isolated from wood being decayed naturally by a Ganoderma species of white rot fungus (the palo podrido system) mineralized 10 to 11% of the fraction with a molecular weight of approximately 500 but less than 4% of the higher- and lower-molecular-weight fractions. The consortia mineralized 5 to 9% of the original lignins. The ability of two pseudomonads isolated earlier from lignin-rich environments to mineralize the original lignins or fungus degradation products was much lower. PMID- 1785938 TI - Bacteriophages from the forestomachs of Australian marsupials. AB - Bacteriophages were observed in forestomach contents from three species of Australian macropodoid marsupials possessing a foregut fermentative digestion: the eastern grey kangaroo (Macropus giganteus), the eastern wallaroo (Macropus robustus robustus), and the rufous bettong (Aepyprymnus rufescens). Forty-six morphologically distinct phage types, representing the families Myoviridae, Siphoviridae, and Podoviridae, were identified. The range of forms varied between host species. The greatest diversity of phage types was found in forestomach contents of the wallaroo, and few phage types were recorded from the rufous bettongs. It is concluded that macropodoid marsupials, in common with their eutherian counterparts, possess diverse populations of bacteriophages in their fermentative forestomachs. PMID- 1785939 TI - Lactobacilli and azoreductase activity in the murine cecum. AB - Azoreductase activity in the ceca of mice lacking lactobacilli as members of the normal microflora (reconstituted-lactobacillus-free [RLF] mice) was compared with that of RLF mice whose gastrointestinal tracts were colonized by strains of Lactobacillus delbrueckii and Lactobacillus fermentum. Azoreductase activity was 31% lower in the ceca of mice colonized by lactobacilli. PMID- 1785941 TI - Purification and characterization of the N-methylcarbamate hydrolase from Pseudomonas strain CRL-OK. AB - A unique cytosolic enzyme that hydrolyzes the carbamate linkage of the insecticide carbaryl (1-naphthyl N-methylcarbamate) was purified from extracts of Pseudomonas sp. strain CRL-OK. Substrates of the hydrolase include the N methylcarbamate pesticides carbofuran and aldicarb but not the phenylcarbamate isopropyl m-chlorocarbanilate, the thiocarbamate S-ethyl N,N dipropylthiocarbamate, or the dimethylcarbamate o-nitrophenyldimethylcarbamate. PMID- 1785940 TI - Purification, properties, and sequence specificity of SslI, a new type II restriction endonuclease from Streptococcus salivarius subsp. thermophilus. AB - SslI, a type II restriction endonuclease, was purified from Streptococcus salivarius subsp. thermophilus strain BSN 45. SslI is an isoschizomer of BstNI. SslI activity was maximum at pH 8.8, 0 to 50 mM NaCl, 2 to 8 mM Mg2+, and 42 degrees C. Activity against phage DNA in vitro was demonstrated. PMID- 1785942 TI - Intra- and inter-individual variations in cornified envelope peptide composition in normal and psoriatic skin. AB - Cornified envelopes from the stratum corneum of healthy volunteers and from the involved and uninvolved skin of psoriatic patients were electrophoretically purified, and their peptide composition analysed by sodium dodecyl sulphate polyacrylamide gel electrophoresis (SDS PAGE) after cyanogen bromide cleavage. The resulting envelope peptide patterns (EPPs) were compared. In normal subjects, mainly quantitative minor differences in the EPPs were observed between different individuals. In the same individual, palms and soles could be distinguished from other body sites by their EPPs. The palm and sole samples presented identical patterns which were different from the patterns found with samples from other body sites. In psoriatic patients, EPPs of uninvolved skin resembled closely those of healthy epidermis, but showed striking differences from those of lesional skin. The EPPs of psoriatic lesional skin showed a characteristic accumulation of small peptides with molecular weights of 3-11 kDa. The EPP of lesional skin returned to normal during PUVA therapy, indicating that the changes in the biochemical composition of the cornified envelope are correlated with the clinical status of the disease. PMID- 1785943 TI - The level of urinary epidermal growth factor is not influenced by the extent of psoriatic lesions. AB - Epidermal growth factor (EGF) levels in the urine of 31 normal individuals and 33 psoriatic patients were measured. The amounts of urinary EGF secreted in a day by normal and psoriatic individuals were not significantly different nor were the levels of EGF in random urine specimens corrected for creatinine values. It is known that the urinary EGF content corrected for the creatinine value correlates very well with the EGF level in blood as well as in 24-h urine specimens. Our data indicate that EGF circulating in the blood may not be correlated with the extent of psoriatic lesions. PMID- 1785944 TI - Ultrastructural basis for antigen mapping using sodium chloride-separated skin. AB - In many cases of autoimmune blistering skin diseases indirect immunofluorescence with serum of patients on 1 M NaCl-separated skin represents a rapid diagnostic tool before the use of more complicated immunoelectron microscopy. The present study demonstrates that in skin samples from five adults, separated using 1 M NaCl, 0.15 M NaCl and 0.01 M phosphate buffered saline (PBS), the split formed within the lamina lucida at an identical ultrastructural level. The sub-basal dense plate (SDP) with a wreath of anchoring filaments remained on the epidermal side of the split adjacent to the hemidesmosomal part of the plasma membrane of basal keratinocytes. The base of the split blister was constituted from the lamina densa, with a remote possibility of some anchoring filaments attached. We demonstrate that antigens on the roof of the NaCl- or PBS-split blister may be associated, beside intracellular hemidesmosomal structures, with the SDP and basement membrane components between the SDP and the basal keratinocytes as well as with anchoring filaments attached to the SDP. The observations reported here allow a more precise mapping of antigen determinants in blistering skin diseases. PMID- 1785945 TI - Presence of specific IgG antibody to the A type inclusions of erythromelalgia related poxvirus in the sera of patients with epidemic erythromelalgia. PMID- 1785946 TI - [Morphological consensus on cervical neoplasia. Paris-Tolbiac 1991]. PMID- 1785947 TI - [Invasive adenocarcinoma with epidermoid carcinoma on the site of bladder exstrophy. Histochemical and immunocytochemical study]. AB - To date, one hundred and ten cases of malignant neoplasms arising from untreated bladder exstrophy have been reported. We describe another case of uncorrected bladder exstrophy with invasive adenocarcinoma and in situ squamous carcinoma discovered in a 51 year old woman. Postoperative radiotherapy was performed after cystectomy with nephroureterectomy and hysterectomy. The neoplastic samples were investigated by mucin histochemistry and immunocytochemistry. The epithelium lining the tumor villi and the surrounding mucosae was colonic with mucin histochemistry and reacted to anti KL1, EMA and ACE antibodies. These features were those of colonic and vesical adenocarcinomas. Although early vesical reconstruction is the best oncologic prevention, patients with bladder exstrophy run the risk of sigmoid adenocarcinoma after cystectomy and urinary diversion including ureterosigmoidostomy. PMID- 1785948 TI - Bilateral, spontaneous and simultaneous rupture of the quadriceps tendon in chronic renal failure and secondary hyperparathyroidism. Report of five cases. AB - Bilateral and simultaneous rupture of the quadriceps tendon of the knee without significant trauma in five patients, two males and three females, with chronic renal failure and secondary hyperparathyroidism is reported. Ruptures of the extensor mechanism are relatively rare injuries. Unilateral rupture is more common. Bilateral, simultaneous and spontaneous rupture is a very rare condition and only eleven cases have been reported in patients with a number of systemic diseases. Two cases have also been described in healthy subjects. The following points contribute to the diagnosis of quadriceps tendon rupture: 1) sudden pain and inability to extend the knee, 2) a palpable defect above the patella, 3) lateral x-rays with technique for soft tissue, reveal a defect and anterior tilting of the proximal pole of the patella. Operative repair of the ruptured tendon was the treatment in all our cases and gave excellent results. PMID- 1785949 TI - [Hoffmann-Zurhelle superficial cutaneous lipomatous nevus. Apropos of a case]. AB - The authors report a case of lipomatous naevus present for 35 years, and therefore probably congenital, in a 48 year old female patient. This bulging lesion was 2.5 cm in diameter with a slightly encephaloid appearance. The authors reviewed the limited literature on the subject in order to more clearly define this hamartomatous lesion which has a constant histological appearance, but very variable clinical and macroscopic features. PMID- 1785950 TI - [Embryonal carcinoma of the submandibular gland. Apropos of a case]. AB - The authors report a case of infantile embryonal carcinoma of the submandibular gland in a nine months old infant. The diagnosis was based on typical histopathological features, and positive reaction of tumor cells with alpha foetoprotein. The patient was treated by wide surgical excision and chemotherapy. The clinical course was favourable two years later with normalization of serum alpha-foetoprotein levels and with no abnormality on the thoraco-abdomino-facial CT scan. PMID- 1785951 TI - High level expression of isocitrate lyase gene of n-alkane-utilizing yeast Candida tropicalis in Saccharomyces cerevisiae. AB - The genomic DNA of peroxisomal isocitrate lyase (ICL) isolated from an n-alkane assimilating yeast, Candida tropicalis, was truncated to utilize the original open reading frame under the control of the GAL7 promoter and was expressed in Saccharomyces cerevisiae. The recombinant ICL was synthesized as a functionally active enzyme with a specific activity similar to the enzyme purified from C. tropicalis, and was accounted for approximately 30% of the total extractable proteins in the yeast cells. This recombinant enzyme was easily purified to homogeneity. N-Terminal amino acid sequence, molecular masses of native form and subunit, amino acid composition, peptide maps, and kinetic parameters of the recombinant ICL were essentially the same as those of ICL purified from C. tropicalis. From these facts, S. cerevisiae was suggested to be an excellent micro-organism to highly express the genes encoding peroxisomal proteins of C. tropicalis. PMID- 1785952 TI - A colicin M derivative containing the lipoprotein signal sequence is secreted and renders the colicin M target accessible from inside the cells. AB - Colicin M is only released in very low amounts by cells harbouring this plasmid encoded colicin, due to the lack of a release (lysis) protein. A fusion gene (lpp'cma) was constructed which determined two proteins: Lpp'-Cma composed of the signal sequence of the murein lipoprotein (Lpp) and colicin M (Cma), and unaltered colicin M. Cells expressing the fusion gene released 50% of the total colicin M into the culture medium, compared to 1% found in the medium of cells synthesizing only colicin M. The release resulted from partial cell lysis caused by colicin M since a colicin M tolerant strain remained unaffected. Lpp'-Cma thus mimics phenotypically the action of colicin release proteins but displays a different lysis mechanism. In strains defective in components of the colicin M uptake system, Lpp'-Cma caused lysis as effectively as in uptake proficient strains. Apparently, Lpp'-Cma renders the colicin M target site accessible from inside the cell which stands in contrast to the action of colicin M which is only bactericidal when provided from outside. PMID- 1785953 TI - Reversible interconversion of the functional state of the gene regulator FNR from Escherichia coli in vivo by O2 and iron availability. AB - FNR, the gene regulator of anaerobic respiratory genes of Escherichia coli is converted in vivo by O2 and by chelating agents to an inactive state. The interconversion process was studied in vivo in a strain with temperature controlled synthesis of FNR by measuring the expression of the frd (fumarate reductase) operon and the reactivity of FNR with the alkylating agent iodoacetic acid. FNR from aerobic bacteria is, after arresting FNR synthesis and shifting to anaerobic conditions, able to activate frd expression and behaves in the alkylation assay like anaerobic FNR. After shift from anaerobic to aerobic conditions, FNR no longer activates the expression of frd and reacts similar to aerobic FNR in the alkylation assay. The conversion of aerobic (inactive) to anaerobic (active) FNR occurs in the presence of chloramphenicol, an inhibitor of protein synthesis. Anaerobic FNR can also be converted post-translationally to inactive, metal-depleted FNR by growing the bacteria in the presence of chelating agents. The reverse is also possible by incubating metal-depleted bacteria with Fe2+. From the experiments it is concluded that the aerobic and the metal depleted form of FNR can be transferred post-translationally and reversibly to the anaerobic (active) form. The response of FNR to changes in O2 supply therefore occurs at the FNR protein level in a reversible mode. PMID- 1785954 TI - The methane monooxygenase gene cluster of Methylosinus trichosporium: cloning and sequencing of the mmoC gene. AB - Methane monooxygenase (MMO) is the enzyme responsible for the conversion of methane to methanol in methanotrophic bacteria. The soluble MMO enzyme complex from Methylosinus trichosporium also oxidizes a wide range of aliphatic and aromatic compounds in a number of potentially useful biotransformations. In this study we have used heterologous DNA probes from the type X methanotroph Methylococcus capsulatus (Bath) to isolate mmo genes from the type II methanotroph M. trichosporium. We report here that the gene encoding the reductase component, Protein C of MMO, lies adjacent to the genes encoding the other components of soluble MMO in M. trichosporium but is separated by an open reading frame of unknown function, orfY. The complete nucleotide sequence of these genes is presented. Sequence analysis of mmoC indicates that the N-terminus of Protein C has significant homology with 2Fe2S ferredoxins from a wide range of organisms. PMID- 1785955 TI - Aluminium toxicity and binding to Escherichia coli. AB - The toxicity and binding of aluminium to Escherichia coli has been studied. Inhibition of growth by aluminium nitrate was markedly dependent on pH; growth in medium buffered to pH 5.4 was more sensitive to 0.9 mM or 2.25 mM aluminium than was growth at pH 6.6-6.8. In medium buffered with 2-(N-morpholino)ethanesulphonic acid (MES), aluminium toxicity was enhanced by omission of iron from the medium or by use of exponential phase starter cultures. Analysis of bound aluminium by atomic absorption spectroscopy showed that aluminium was bound intracellularly at one type of site with a Km of 0.4 mM and a capacity of 0.13 mol (g dry wt)-1. In contrast, binding of aluminium at the cell surface occurred at two or more sites with evidence of cooperativity. Addition of aluminium nitrate to a weakly buffered cell suspension caused acidification of the medium attributable to displacement of protons from cell surfaces by metal cations. It is concluded that aluminium toxicity is related to pH-dependent speciation [with Al(H2O)6(3+) probably being the active species] and chelation of aluminium in the medium. Aluminium transport to intracellular binding sites may involve Fe(III) transport pathways. PMID- 1785956 TI - [Alcoholic dementia and divalent ions: derangement of calcium-homeostasis]. AB - We proposed a hypothesis of disintegrated Ca-homeostasis underlying chronic alcoholism from our clinical viewpoints, and we suggest that the clinical features of alcoholism result from hypocalcemia or hypocalcemia induced by hypomagnesemia. Since the alcoholism brings on the divergent symptoms and signs, various diagnoses are made even for one patient, such as hypertension, cardiomyopathy, hepatitis, pancreatitis, Parkinsonian syndrome, neuropathy, muscle atrophy, epilepsy and osteoporosis. We speculate that these pathological conditions could be interpreted unitarily and systematically by hypothesis of Ca abnormality. PMID- 1785958 TI - Concentrations of blood and urine ethanol, acetaldehyde, acetate and acetone during experimental hangover in volunteers. AB - Blood and urine samples were analyzed for ethanol, acetaldehyde, acetate and acetone during experimental hangover in 6 healthy male volunteers (A, B, C, D, E, F). They drank freely for some 4 hr. In flushers (A, F) at 9 hr after ingestion (ethanol: 92 g, 1.2 g/kg and 1.3 g/kg), acetaldehyde levels were low in the blood, but high in the urine (37 microM, 45 microM). Heavy drinkers, non-flushers of B (ethanol: 176 g, 2.5 g/kg), C (157 g, 2.4 g/kg) and E (182 g, 2.9 g/kg) had a slightly high [lactate]/[pyruvate] ratio and 3-hydroxybutyrate in the blood at 11 hr after alcohol ingestion. Blood ethanol levels were dose dependent and blood acetaldehyde in B and C had a slightly high 6.3 microM and 8.0 microM 9 hr later, respectively. B, C and E had a high urine acetone concentration (100 microM over) in hangover. In C, in particular, urine acetate and acetone levels were unusually high. The ratio in blood (urine) among alcohol metabolites at 9 hr after drinking was approximately ethanol 1000 (1000): acetaldehyde 0.2-1.0 (0.1-5.9): acetate 36 163 (22-1554): acetone 1-11 (3-47). PMID- 1785957 TI - [Vertebral bone density and its correlation with various factors related to bone metabolism in alcoholics: a quantitative study by computed tomography]. AB - We measured vertebral bone density of 59 male alcoholics (ALC) using quantitative computed tomography (QCT). Bone density of ALC was decreased measured on admission compared with age-matched healthy male controls (ALC: 144 +/- 42, CONTROLS: 173 +/- 34 mg/cm3, p less than 0.05). The bone density was not correlated with serum ALP, Ca, and Pi. Serum parathyroid hormone and calcitonin were also not correlated with the bone density in ALC. Serum 25-(OH)-D showed significant positive correlation with the bone density (p less than 0.01) and 1,25-(OH)2-D showed trend of positive correlation with the bone density (p less than 0.01) in ALC. Severity of liver diseases did not have any relation to the bone density in ALC. Although the decreased bone density was not improved at the second QCT examined about 10 weeks after first QCT without medication, patients administered 1 microgram of 1 alpha-(OH)-D3 daily showed a significant increase in the bone density (on admission: 152 +/- 37, 10 weeks later: 162 +/- 35 mg/cm3, p less than 0.02). Combination therapy of 1 alpha-(OH)-D3 and calcitonin did not increase the bone density. These results indicate that bone density was decreased in ALC and a decrease in serum vitamin D metabolites may cause a decrease in the bone density, although liver dysfunction does not have a role in it. These data also suggest that 1 alpha-(OH)-D3 is effective in an increase in the bone density in ALC with osteoporosis after abstinence. PMID- 1785959 TI - [A study of high school students with alcoholic parents]. AB - This is the first study in Japan which estimates the frequency of children with alcoholic parents in the general population and investigates the addictive substances abused by these children. In order to determine which children have alcoholic parents, a 10-item set of questions concerning the alcohol problems of parents known as CAST-J (Children of Alcoholics Screening Test-Japan) was prepared using CAST (Children of Alcoholics Screening Test) as a reference. In a preliminary survey, CAST-J and CAST were performed on 20 cases diagnosed as children of parents with alcohol-related problems by psychiatrists and 112 students of medically-related school. From these results, it was decided that those who had answered affirmatively to at least three of the 10 questions in CAST-J were children of alcoholic parents (parents with alcohol-related problems). The present survey was performed on 1,754 high school students who underwent the CAST-J and AAIS (Adolescent Alcohol Involvement Scale). The information on the experience of smoking and thinner inhalation was also obtained. Among these high school students, 11.6% of the total (8.4% of males and 15.2% of females) had alcoholic parents. Among the high school students with alcoholic parents, 21.7% were found to be alcohol misusers or alcoholic-like drinkers in the AAIS, which was significantly more than the 10.6% of students without alcoholic parents. This significant difference was seen for both males and females. It was also found that significantly more high school students with alcoholic parents had experienced smoking and thinner inhalation than those without such parents. In conclusion, it appeared that more than 10% of Japanese high school students have alcoholic parents, and they also often misuse addictive substances such as alcohol, tobacco and thinner. PMID- 1785960 TI - Modifications of ambulation-increasing effect of morphine and buprenorphine following repeated administration in mice. AB - Interaction of behavioral effects of morphine (10 and 20 mg/kg s. c.) and buprenorphine (0.3 and 1 mg/kg s. c.) were investigated by means of ambulatory activity following repeated administration of either drug in mice. The repeated administration of buprenorphine (1 mg/kg, but not 0.3 mg/kg) total of 5 times at intervals of 3-4 days induced a gradual decrease in the sensitivity to its ambulation-increasing effect. The buprenorphine-experienced mice showed an increase in the sensitivity to the ambulation-increasing effect of morphine (20 mg/kg) in parallel with the doses of buprenorphine. On the other hand, the ambulation-increasing effect of morphine (10 and 20 mg/kg) progressively enhanced during the repeated administration schedule. The morphine-experienced mice demonstrated a decrease in the sensitivity to buprenorphine (1 mg/kg). The present results may reflect differential characteristics between morphine and buprenorphine in their ambulation-increasing effects in mice. PMID- 1785961 TI - [Studies on the mode of progression of alcoholic liver disease]. AB - In order to elucidate the mode of progression of alcoholic liver disease, relationships among the drinking style, laboratory data, anti-HCV antibody and histological changes were investigated on 36 patients in whom the liver biopsy was repeatedly done. Following results were obtained (1) In the group of continuous drinking over 100g ethanol per day, histological progression was found in 11 of 13 patients (85%) regardless of positive anti-HCV. On the other hand, in the group of abstinence or temperance less than 60g daily alcohol intake, histological improvement was found in 6 of 11 patients (55%). (2) Histological improvement was predominantly seen by abstinence or temperance in the cases with lower levels of serum IgA and adenosine deaminase (ADA) on hospitalization and those with rapid decrease in serum gamma-GTP after hospitalization. In conclusion, the amount of ethanol was considered to be the most important factor to affect on a progression of alcoholic liver diseases. Assessment of laboratory data such as IgA and ADA on hospitalization and change in gamma-GTP after hospitalization were also thought to be useful in foreseeing the prognosis of alcoholic liver disease. PMID- 1785962 TI - [Effects of ethanol exposure beginning at an early age on maternal rat and their offspring]. AB - The effects of ethanol intake were studied in the three groups of Fischer strain rats. The EtOH-F group began drinking freely at 29 days of age and continued all through mating, pregnancy, delivery, and lactation days. They drank a 10% aqueous solution of ethanol, with net ethyl alcohol 9.7 g/kg b. w. on average. The EtOH-P group drank a 20% aqueous solution of ethanol for the first time on the first day of pregnancy. The solution was then given periodically once a day, oral net ethyl alcohol 3.8 g/kg b. w., through gestation, labor, and lactation. The control group was not exposed to ethanol. Comparative observation were made on both maternal rats and their offspring. 1) Maternal rats: Maternal body weight gain between the first and 20th days of pregnancy was significantly low in the two drinking groups (EtOH-F:p less than 0.01, EtOH-P:p less than 0.01), compared with the control group. Comparing the EtOH-F and the EtOH-P, it was found that body weight gain during the 20 days of pregnancy was significantly depressed in the former group (p less than 0.05). There were no significant differences in placental weight among the three groups. Histological findings disclosed that the brain, liver, and kidney had moderate changes in the EtOH-F, whereas the control showed only slight changes. 2) The average number of fetuses at the 20th day of gestation, neonates per litter, did not significantly different among the three groups. The body weights of fetuses at the 20th day of gestation, of neonates and 10-day-old offspring were recorded. In the case of the EtOH-P group, significantly low values (p less than 0.05, p less than 0.01, p less than 0.01) compared with the respective controls. In the case of the EtOH-F group, the differences were non-significant, p less than 0.01 and p less than 0.01 respectively. 3) Histological study of the brain, lung, liver, kidney, and thymus in offspring revealed that remarkable visceral immaturity and hemorrhage were in the EtOH-P and the EtOH-F groups as compared to the control, and they were more pronounced in the EtOH-F group than in the EtOH-P group. 4) Different ways of ethanol administration brought about different results: The EtOH-P group showed a clearer tendency to have low-body-weight of offspring than those the EtOH-F group.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1785963 TI - Clinical evaluation of restoration margins by an endoscopic microscope. AB - A method is presented for high magnification, clinical examination and recording of the marginal fit of dental restorations. An endoscopic microscope used in conjunction with video recording facilities affords acceptable colour records of restorative procedures for monitoring purposes. The suggestion is made that the concept of 'fit' in the clinical context has not been adequately addressed. The technique described has other clinical and research implications. PMID- 1785964 TI - Diet and feeding patterns in high risk pre-school children. AB - A survey of 60 pre-school children both from Anglo-Saxon and Lebanese backgrounds collected detailed information on subjects' oral health status and dietary and feeding habits. Lebanese subjects had significantly higher caries experience (mean dmfs = 4.88) than Anglo-Saxon subjects (mean dmfs = 0.56). Subjects from the different backgrounds varied significantly also in the frequency of exposure to cariogenic agents and health practices. In each situation Lebanese children were exposed to higher risk factors than Anglo-Saxon children. Notwithstanding the association between variables, the best single predictor of variance in caries experience of subjects, explaining 23 per cent of the variance of dmfs, was the mother's level of education. Culturally relevant health education programmes need to address the specific requirements of high risk groups. PMID- 1785965 TI - Mandibular refracture as treatment method for jaw alignment. Case report. AB - A case of malocclusion of the lower jaw following trauma and healing which was subsequently corrected by mandibular refracture is described. PMID- 1785966 TI - A clinical technique for the formation of crown cores: the Core Mould. AB - The use of moulds to facilitate the placement and formation of cores on broken down teeth prior to crown construction is described. The moulds are made of a transparent thermoplastic material and are designed in a number of configurations according to the tooth to be restored. They produce cores of a predetermined taper and an axially corrugated surface. PMID- 1785968 TI - Mongoloid features of the permanent mandibular second molar in Singaporean Chinese. AB - The permanent mandibular second molar is usually described as four-cusped, two placed buccally and two lingually. It has been reported that five-cusp forms were more commonly present in dentitions of mongoloid origin. The prevalence and features of this tooth form were examined in a Singaporean sample of 380 subjects with bilateral presence of the mandibular second molars. One-hundred and sixty four cases (43.1 per cent) were found to have bilateral occurrence of five-cusp forms and thirty-four cases (8.9 per cent) with unilateral occurrence. Six-cusp forms were detected in three cases. There was almost equal prevalence in both sexes and both sides were equally involved in unilateral cases. The extra cusp was smallest, placed disto-buccally and sometimes midway at the distal border. The occlusal outline of five-cusp second molars was rectangular with a somewhat similar groove pattern to the first molar. There was an increase in the mesio distal width of the crown. The high incidence was comparable with other studies of mongoloid dentitions and it could be considered as an important morphological and racial characteristic of the Singaporean Chinese. PMID- 1785967 TI - Clinical and microbiological investigations of anorexia nervosa. AB - Several studies have examined the relationship between anorexia nervosa and oral status. However, none has used control subjects. Furthermore, none has examined bacteriological data in these subjects to determine whether dietary restrictions, particularly of carbohydrates, change the levels of Streptococcus mutans and Lactobacillus species. Fifteen female subjects recently hospitalized for anorexia were studied along with fifteen age- and sex-matched control subjects. The parameters examined included salivary pH and flow rate, levels of S. mutans and Lactobacillus spp., DMFT scores, facial and palatal plaque scores, periodontal pocketing, gingival recession and bleeding following gentle probing. Compared with control subjects, anorexics had significantly lower salivary pH (7.1 +/- 0.4 vs 7.6 +/- 0.3, p less than 0.01), more facial and lingual surfaces with plaque scores of 1 (facial plaque 38 per cent vs 18 per cent, p less than 0.01, lingual plaque 47 per cent vs 29 per cent, p less than 0.01), more surfaces with gingival recession (1 mm-7.9 per cent vs 1.8 per cent, p less than 0.001; 2 mm-1.7 per cent vs 0.2 per cent, p less than 0.001; greater than 2 mm-0.6 per cent vs 0.0 per cent, p less than 0.001), more surfaces with bleeding on probing (16.9 per cent vs 6.5 per cent, p less than 0.001) and fewer sextants with CPITN scores of 0 (1.9 +/- 1.5 vs 3.2 +/- 1.0, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1785969 TI - An overview of industrial accidents with particular reference to facial trauma. AB - As an integral part of the economy of Saudi Arabia the industrial sector has rapidly developed in the last decade and is still open for more growth. Thus, there is likely to be an increase in industrial accidents, often with added consequences for the medical services. Because of this, cumulative information on industrial accidents is needed. This paper reports on industrial accidents in order to alert medical researchers to the need for specific studies of different industrial occupations in Saudi Arabia so that adequate administrative and medical services may be available should an industrial accident occur. PMID- 1785970 TI - Langerhans cell disease associated with pathological fracture of the mandible. AB - A 27-year-old male suffered a fractured mandible following extraction of a tooth. It was subsequently found that the fracture occurred in an area pathologically weakened by a localized lesion of Langerhans cell disease. Since lesions of the jaws may be seen either as the first manifestation or as a complication of widespread Langerhans cell disease, the dentist has a major role in the diagnosis and management of such cases. PMID- 1785971 TI - Ectopic tonsillar tissue in the mucosa of the floor of the mouth simulating a benign tumour. Case report. AB - Ectopic tonsillar tissue in the mucosa of the floor of the mouth is rare. A case of a 38-year-old man with ectopic tonsillar tissue in the mucosa of the floor of the mouth is described. The lesion was manifested as a small, painless tumour. There was difficulty in establishing a clinical diagnosis, but it was thought to be a benign tumour and was removed and then examined histopathologically to confirm the diagnosis. PMID- 1785972 TI - Mechanical properties of some tooth positioner materials. PMID- 1785973 TI - The Australian Dental Association product recognition programmes. PMID- 1785974 TI - Putting AIDS into perspective. PMID- 1785975 TI - Gloving for surgery. PMID- 1785976 TI - Infection control in dental practice. PMID- 1785977 TI - Clinical presentations of stroke: the classic and the less obvious. AB - While there are several types of stroke, the sudden or rapidly developing loss of one or more cerebral functions is the hallmark of the condition. Although classic manifestations include hemiparesis, hemianaesthesia, hemianopia, dysphasia, ataxia and cranial nerve palsies, several less typical stroke syndromes occur regularly. PMID- 1785978 TI - Early intervention in acute stroke. PMID- 1785979 TI - Radiological investigations in stroke and transient ischaemic attacks. AB - This article covers the radiological investigations of CT scanning, Doppler ultrasound, digital subtraction angiography and magnetic resonance imaging in relationship to diagnosis and management of stroke and transient ischaemic attacks. The author discusses what each technique can and cannot do. PMID- 1785980 TI - Management of transient ischaemic attacks. AB - There have been major recent advances in the investigation and treatment of transient ischaemic attacks, which represent an important prodrome of cerebral infarction. Medical therapy with aspirin reduces stroke risk, while warfarin has an important place in the prevention of cardiogenic cerebral embolism. Carotid endarterectomy is of proven value in symptomatic patients with severe carotid stenosis. PMID- 1785982 TI - Concepts in stroke rehabilitation. AB - The identification and management of neurological deficit are each essential for stroke rehabilitation. Management of the two most commonly encountered deficits, hemiplegia and communication disorder, is discussed. An eleven point Stroke Rehabilitation Outcome plan forms a good basis for discussion with relatives about what to expect. PMID- 1785981 TI - Psychological sequelae in stroke patients. AB - The psychological sequelae of depression, anxiety and dementia are discussed as they affect the stroke sufferer. The author discusses the management options available to deal with these problems. PMID- 1785983 TI - Could we do more to prevent stroke? AB - Stroke remains an important cause of death and of permanent disability in our community. Although hypertension is still a major risk factor, data from the Perth Community Stroke Study are presented to show how smoking, consumption of alcohol, diabetes and certain dietary practices affect an individual patient's risk of stroke and the extent to which these factors might contribute to the overall burden of cerebrovascular disease borne by the community. PMID- 1785984 TI - Future directions in stroke management. AB - The management of stroke patients continues to evolve, with recent advances in vascular neuroradiology and the secondary prevention of stroke. This article reviews these findings and the potential impact of new investigations and treatments that are being evaluated in research institutions. PMID- 1785985 TI - Learning more about your practice through preventive medicine projects. AB - The authors describe a brief intervention that aims to raise awareness among general practitioners of the illness prevention needs of their patients. Many patients surveyed in three general practices needed tetanus immunisation, wanted to cease smoking or reduce their use of alcohol--findings that highlight the need for general practitioners to become more involved in illness prevention programmes. PMID- 1785986 TI - Myocardial infarction. PMID- 1785987 TI - Getting help for research: the RACGP research committees. PMID- 1785988 TI - Patient education. Dangerous asthma. PMID- 1785989 TI - The diagnosis of influenza. PMID- 1785990 TI - Recurrent dislocation of shoulder. PMID- 1785991 TI - A cautionary heartburn tale. PMID- 1785992 TI - Early morning pictures. PMID- 1785993 TI - Cool cabbages for hot breasts. PMID- 1785994 TI - Mammography doubts. PMID- 1785995 TI - Zinc toxicosis due to ingestion of a penny in a gray-headed chachalaca (Ortalis cinereiceps). AB - Zinc toxicosis was diagnosed in a gray-headed chachalaca (Ortalis cinereiceps) due to ingestion of a copper-plated zinc penny. Histopathological lesions were most marked in the pancreas. These lesions included apoptosis, zymogen granule depletion, and loss of normal acinar architecture. There was also severe gizzard erosion. Heavy metal analysis revealed abnormal levels of zinc and iron in the liver. Iron pigment in the liver was most concentrated in Kupffer cells. This, along with evidence of erythrophagocytosis in the spleen, suggested that extravascular hemolysis was also associated with zinc toxicosis in this case. PMID- 1785996 TI - Serum chemistry alterations, including creatine kinase isoenzymes, in furazolidone toxicosis of ducklings: preliminary findings. AB - Furazolidone induces a cardiotoxicosis when fed in toxic concentrations to newly hatched ducklings. This preliminary experiment was designed to determine if creatine kinase (CK) isoenzymic activities or other serum analytes would be useful as indicators of these cardiac alterations. Sera from 12 ducklings (six fed a control ration and six fed the control ration with 700 mg furazolidone added per kg of feed [700 ppm] for 28 days) were analyzed for CK isoenzymic activities, electrolytes, nitrogenous metabolites, hepatic enzymic activities, bilirubin, and glucose. Statistically significant differences between control and treated groups were detected for creatine kinase MB (CK-MB, cardiac muscle origin) isoenzymic activity and bilirubin, potassium, calcium, and total carbon dioxide concentrations. Differences other than CK-MB isoenzymic activity were generally explained by factors related to the toxicosis or sample handling. These findings suggest that CK-MB isoenzymic activity may be useful to detect and monitor the progress of cardiac injury in furazolidone toxicosis, thereby increasing the usefulness of this model of dilated cardiomyopathy. Our findings, analyzed on the Kodak Ektachem 700 Dry Chemistry Analyzer, are compared with serum chemistry values reported in the literature. PMID- 1785997 TI - Effect of Bordetella avium infection on electrocardiograms in turkey poults. AB - Electrocardiograms (ECGs) were recorded from turkey poults infected with the W isolate of Bordetella avium. Strip chart data (amplitudes and intervals) were measured at 7, 14, 21, and 28 days postinoculation and compared with data from uninoculated controls. B. avium infection altered P-, RS-, and T-wave amplitudes, as well as P-R and S-T intervals throughout the 4-week experimental period. Heart rates were similar over the 4-week period in control poults, while rates in the infected birds were variable. Alterations in ECGs associated with B. avium infection appeared to be the result of disturbances in the cardiovascular system and may be associated with the pathogenicity of the organism in turkey coryza. PMID- 1785998 TI - Tracheal cilia response to exogenous niacin in drinking water of turkey poults infected with Bordetella avium. AB - Niacin was added daily to the drinking water of control and Bordetella avium infected turkey poults at a dosage of 0, 70, and 280 mg/liter over a 2-week experimental period. Fourteen days postinoculation, tracheal sections were examined by histological and morphometrical analysis of cilia, as well as agar plate isolation for bacteria. Infected poults exhibited a 96-97% loss of cilia along the tracheal epithelial border, compared with only a 4-5% loss in controls. Infected poults receiving niacin in the drinking water exhibited only a 61.0% and 76.0% loss of cilia at doses of 70 mg/liter and 280 mg/liter, respectively. The results indicate that niacin treatment may influence the pathogenicity of B. avium infection. PMID- 1785999 TI - Controlled early feed restriction as a potential means of reducing the incidence of ascites in broilers. AB - Male broiler chicks were grown at cold temperatures to enhance susceptibility to the ascites syndrome. Various feeding regimens were used to determine whether they could influence mortality due to ascites. It was found that a precisely controlled early feed-restriction regimen at the age of 6 to 11 days significantly reduced mortality from all causes and mortality due to ascites, while maintaining optimum body weight and feed conversion at marketing age. PMID- 1786000 TI - Poult malabsorption syndrome. I. Malabsorption in poult enteritis. AB - One-day-old poults were placed on littler on which poults had previously developed diarrhea, increased mortality, and stunting. Small intestines, pancreas, and liver were evaluated histologically. Morphometric evaluations were conducted to determine villous length and crypt depth. Poults were evaluated for malabsorption utilizing D-xylose and lipid absorption tests. Compared with controls, the gastrointestinal tract of affected birds was grossly distended, was fluid-filled, and had thin, flaccid walls on days 5 and 8. Ceca were distended with brown watery fluid and gas on days 5, 8, and 12. No histologic lesions were present in the liver, pancreas, or pancreatic ducts, and only mild inflammatory changes were present in the small intestine. Villous atrophy and crypt hypertrophy were present in the small intestine on days 5, 8, 12, 16, and 21. Morphometry revealed significant decreases in villous lengths and increases in crypt depth throughout the trial. D-Xylose and lipid absorption were significantly decreased on days 8 and 11. Intestinal epithelial damage by infectious agents with subsequent villous atrophy is postulated to have produced malabsorptive diarrhea. PMID- 1786001 TI - Poult malabsorption syndrome. II. Pathogenesis of skeletal lesions. AB - One-day-old poults were placed on litter on which poults had previously developed diarrhea, increased mortality, stunting, and malabsorption. Gross, microscopic, and morphometric evaluations of the proximal tibiotarsal growth plate, along with analysis of plasma calcium, phosphorus, and 25-hydroxyvitamin D3 concentrations, were conducted for 3 weeks to determine the development and character of skeletal lesions. Poults developed enteritis with diarrhea and dehydration. Body weights and shank lengths were significantly decreased. Plasma 25-hydroxyvitamin D3 concentrations were significantly decreased. Plasma calcium was significantly decreased on day 8. Plasma phosphorus concentrations were significantly increased on day 8 and were significantly decreased on days 15, 18, and 22. Growth plates narrowed on days 8 and 11 and expanded on days 15, 18, and 22. The proliferating prehypertrophy zone significantly decreased in length on days 11, 18, and 22, and significantly increased in length on day 15. The unmineralized hypertrophy zone was significantly increased in length on days 15, 18, and 22. The mineralized hypertrophy zone was significantly decreased in length on all days. Skeletal lesions during the poult malabsorption syndrome evolved from an early osteoporotic lesion associated with hypocalcemia to a rachitic lesion associated with depleted vitamin D and hypophosphatemia. PMID- 1786002 TI - Poult malabsorption syndrome. III. Skeletal lesions in market-age turkeys. AB - Skeletal deformities, a major contributing factor to economic losses in market age turkeys, may be associated with the poult malabsorption syndrome. A study was performed to determine whether the naturally occurring malabsorption syndrome produces skeletal lesions in turkeys at market age. Poults were placed on litter on which poults had previously developed malabsorption. Exposed poults developed enteric disease with 21% mortality during the first 3 weeks. Controls had no enteric disease and no mortality. At the end of the study, 20-week-old exposed turkeys weighed 0.621 kg (5%) less than controls and had a higher incidence of angular limb deformities with significantly higher angulation scores. Exposed turkeys also had a greater incidence of rotated tibias and bowed tibias. The mechanical property of tibial shear strength was significantly lower in turkeys that had survived the earlier poult malabsorption syndrome. PMID- 1786003 TI - Isolation of Campylobacter from livers of broiler chickens with and without necrotic hepatitis lesions. AB - Injured and normal livers from broiler chickens sent to slaughter plants were collected for bacterial examination. A total of 223 macroscopically abnormal livers and 50 normal livers were received. Forty-seven thermophilic Campylobacter isolates were obtained from the livers with necrotic lesions; 39 isolates were identified as Campylobacter jejuni and eight as C. coli. In normal livers, six C. jejuni isolates were obtained. C. jejuni biotype 2 was the most common isolate recovered from injured livers, and C. jejuni biotype 1 was the most frequent isolate found in normal livers. On some occasions, Campylobacter spp. could be isolated from both the liver parenchyma and bile of the same bird. Results indicated that different species and biotypes of Campylobacter can be found in the livers of broiler chickens with and without lesions of necrotic hepatitis. PMID- 1786004 TI - Serologic associations between fowl cholera and other diseases. AB - As part of a case-control study designed to identify fowl cholera risk factors, 2087 blood samples were collected from 71 California meat-turkey flocks. Samples were tested for antibodies to three mycoplasmas and four viruses pathogenic for turkeys. Flocks that had antibodies to Newcastle disease virus and/or Mycoplasma meleagridis had an increased risk of having an outbreak of fowl cholera. This information should prove useful for fowl cholera control programs in meat turkeys. PMID- 1786005 TI - California National Animal Health Monitoring System for meat-turkey flocks, 1988 1989: diagnostic testing results. AB - Six hundred fourteen meat turkeys were submitted for necropsy from 24 California ranches as part of the National Animal Health Monitoring System (NAHMS). Enteritis was the most frequent pathologic diagnosis in birds 18 days old or younger and the second most frequent diagnosis in birds 19-70 days old. Hemorrhagic enteritis was the most frequent diagnosis in birds aged 19-70 days. Tibial dyschondroplasia, bronchopneumonia, and ascaridiasis were ranked one through three in frequency of diagnoses in birds over 70 days of age. Salmonella was isolated from 71% of flocks tested, and Mycoplasma meleagridis was isolated from 33% of tested flocks over 70 days of age. Antibodies to several disease agents were detected, including hemorrhagic enteritis (100% of flocks over 70 days old) and Newcastle disease (63% of flocks over 70 days old). PMID- 1786006 TI - Use of electrocardiographic analysis for investigation of ascites syndrome in broiler chickens. AB - This study was conducted (at high altitude [1969 meters]) to determine whether chicks predisposed to cardiac failure and ascites could be identified and followed during growout with non-invasive electrocardiographic (ECG) techniques. ECG recordings were made on 40 chicks at 1 week of age. All recordings were analyzed by quantifying the amplitude in millivolts of the R-, S-, and T-waves in each of the recordings. During the study, ascites-related mortality was 40%, with the majority of the deaths occurring between 5 and 8 weeks of age. Chicks exhibiting moderate-to-severe right ventricular hypertrophy, as identified by ECG analysis at 1 week of age, were predisposed to development of ascites. Thus, the variability in ascites-related mortality observed in field cases may be directly related to the number of predisposed chicks at the time of placement in the broiler house. PMID- 1786007 TI - Acute toxicity of boric acid and boron tissue residues after chronic exposure in broiler chickens. AB - The acute oral mean lethal dose of boric acid in 1-day-old chickens was found to be 2.95 +/- 0.35 g/kg of body weight, which classifies this product as only slightly toxic to chickens. One-day-old broiler chicks were housed in floor pens in which litter had been treated with 0, 0.9, 3.6, or 7.2 kg of boric acid per 9.9 m2 of floor space. Boron residue levels in brain, kidney, liver, and white muscle were not statistically elevated following a 15-day exposure period. Boron residue levels in the same types of tissue were not significantly elevated in chicks fed 500 ppm or 1250 ppm boric acid in feed ad libitum for 3 weeks; however, residues were significantly higher in chicks fed 2500 ppm or 5000 ppm boric acid. These data indicate that broilers grown on boric acid-treated litter do not consume enough boric acid to cause elevated boron levels in tissues. PMID- 1786008 TI - Phagocytosis and intracellular killing of Campylobacter jejuni by elicited chicken peritoneal macrophages. AB - In vitro phagocytosis and intracellular survival of Campylobacter jejuni (strains B540 and Clin 1) in chicken peritoneal macrophages were studied. Macrophages were induced with Sephadex G-50 and harvested 48 hr later by peritoneal lavage. The extent of phagocytosis over time was determined by enumerating the intracellular C. jejuni after removal of extracellular C. jejuni with gentamicin. Pre incubation of C. jejuni with antiserum generally enabled the macrophages to ingest greater numbers of cells than when the organism was pre-incubated in phosphate-buffered saline. C. jejuni were exposed to macrophage uptake for 30 minutes in a 5% CO2 incubator at 42 C. This suspension was then exposed to 12.5 micrograms gentamicin/ml to eliminate extracellular bacteria. Subsequently, the intracellular survival of C. jejuni was examined by monitoring its number within the macrophage at 30 minutes, 3 hr, and 6 hr after phagocytosis. Macrophages from C. jejuni-colonized chickens and from uncolonized control chickens were able to almost destroy the organism within the experimental period. PMID- 1786009 TI - Detection of antibody to Bordetella avium using a particle concentration fluorescence immunoassay (PCFIA). AB - A fluorescent assay for detection of antibody to Bordetella avium was developed and evaluated against current serological techniques. Bordetella antigen was coated on submicron polystyrene beads and used in an antibody sandwich technique with commercially available goat anti-turkey fluorescein-labeled IgG. Positive control sera were taken from turkeys from which B. avium was isolated. Negative control sera were from turkeys from which no B. avium was isolated and which tested negative by agglutination and enzyme immunoassay. A commercial fluorescence concentration analyzer was used to quantitate the epifluorescence in a special 96-well plate designed to minimize background fluorescence. The particle concentration fluorescence immunoassay was found to be as sensitive as the enzyme immunoassay, with good reproducibility. It required less time and smaller quantities of sample and reagents. PMID- 1786010 TI - Response of broiler chickens to fowl cholera vaccination at 1 to 6 weeks of age. AB - Broiler chickens, in groups of 10, received a single vaccination by the stick wing route at 1, 2, 3, 4, 5, 6, or 11 weeks of age with live Clemson University strain of Pasteurella multocida. Twenty non-vaccinates kept in isolation served as controls. Cholera serum antibody titers in all chickens were determined by enzyme-linked immunosorbent assay at weekly intervals. Chickens vaccinated once at 1, 2, 3, 4, 5, and 6 weeks, respectively, attained 25.2%, 28.7%, 34.7%, 46.2%, 51.8%, and 64.6% of the titers of those vaccinated once at 11 weeks of age. Variation in antibody response was greatest in chickens vaccinated at 1 or 2 weeks of age. Additionally, chickens vaccinated at 1 or 2 weeks of age showed the longest response time (5 weeks) to reach maximum antibody titers after a single vaccination. When the original vaccinates were revaccinated at 11 weeks of age, all showed a secondary response equal to or greater than that seen in chickens vaccinated once at 11 weeks of age. Age of the chickens at the time of vaccination and antibody titer were positively correlated (r = 0.997). Overall antibody responses to vaccination were higher and much more uniform as birds increased in age. PMID- 1786011 TI - Studies on the detection of antibody to duck hepatitis virus by enzyme-linked immunosorbent assay. AB - An indirect enzyme-linked immunosorbent assay (ELISA) for the detection of antibody to duck hepatitis virus (DHV) is described. The results of ELISA were compared with those of an agar gel diffusion precipitin (AGDP) test and a serum neutralization (SN) test. The specificity of the ELISA was in accordance with the specificity of the AGDP and SN tests, but there was a difference in sensitivity. The positive detection rates of ELISA, SN test, and AGDP test for 93 clinical samples were 68.8%, 68.8%, and 18.8%, respectively. A positive/negative (P/N) value larger than or equal to 2.1 plus an absorbance value larger than or equal to 0.4 was used as a comprehensive positive standard for the ELISA. This eliminated false-positive reactions. The results showed that the ELISA was a rapid, sensitive, and accurate method for detecting antibody to DHV. PMID- 1786012 TI - Isolation and identification of chicken infectious anemia virus in Brazil. AB - Seven chicken infectious anemia virus (CIAV) isolates were obtained from seven broiler flocks with poor performance in two states of Brazil. All isolates induced thymus atrophy, bone-marrow aplasia, and low hematocrit values when inoculated into 1-day-old susceptible chicks. The CIAV isolates were resistant to treatment with chloroform and were able to pass through 50-nm-pore-size filters. CIAV-specific antigens could be demonstrated in tissues of experimentally infected chicks using a monoclonal antibody specific for CIAV. These characteristics of the virus and the virus-induced lesions demonstrate that CIAV is present in Brazil and that the virus is associated with production problems. PMID- 1786013 TI - Mycoplasma gallisepticum as a model to assess efficacy of inhalant therapy in budgerigars (Melopsittacus undulatus). AB - One hundred budgerigars (Melopsittacus undulatus) were infected in the nares (0.02 ml/naris), eye (0.02 ml/eye), and throat (0.2 ml) with Mycoplasma gallisepticum (MG) R strain (3.175 x 10(7) colony-forming units/ml). Fifty birds were treated with sterile broth and served as the controls; 25 of those were exposed to an inhalant, and the others were not treated. Infected birds were divided into four groups; 1) no treatment, 2) penicillin in drinking water, 3) inhalant, 4) both penicillin and inhalant. At days 3, 7, 10, 14, and 21 postinfection (PI), birds were assessed for clinical signs of disease. Five birds in each group were euthanatized at each interval PI; quantitative cultures were performed on lavages from the nares and trachea and on throat swabs; tracheas and air sacs were examined histopathologically. No clinical signs, lesions, or cultural isolations occurred in any control birds. All infected birds developed clinical signs and lesions of the trachea and air sac, but none died. The most severe clinical signs were seen in birds that were infected with MG and received no other intervention or birds that received penicillin in conjunction with infection. Increased respiratory tract lesions were associated with penicillin treatment; aerosol therapy resulted in fewer lesions. PMID- 1786014 TI - Automated monitoring system for determining embryo movement and death times following virus infection. AB - Design and performance information is presented on an automated embryo-monitoring system for intact eggs. The computer-based system has been used successfully for several months to characterize viral pathogenicity in embryonated eggs. Features include electronic sensing of embryo movement, automatic quantification of the amount of movement, and automatic recording of the results on electronic media. The system does not require that eggs be removed from the incubator or that the incubator be opened during the course of an experiment, as is necessary with the manual candling technique. It has greatly improved discrimination of viral pathogenicity effects in fertile eggs because of its sensitivity and reduced intervals between observations. One important potential application involves using the system to measure the effects on virulence of mixing closely related variants of the same strain of virus that differ in pathogenicity, which is the biological scenario most likely approximating a natural disease outbreak. PMID- 1786015 TI - Characterization of proteins of chicken infectious anemia virus with monoclonal antibodies. AB - Eight monoclonal antibodies (MAbs) against chicken infectious anemia virus (CIAV) were developed. These MAbs identified three isolates adapted to grow in the Marek's disease chicken cell line MSB1 (Cux-1, GA-1, and Conn-B) and the chicken propagated CIA-1 isolate. All MAbs stained MSB1 in the same way with mostly perinuclear staining, although larger nuclear inclusions and cytoplasmic staining were also detected. None of the MAbs neutralized Cux-1. All MAbs reacted in a direct enzyme-linked immunosorbent assay with Cux-1 antigen treated with 0.5% sodium dodecyl sulfate followed by extraction with chloroform, but not with MSB1 cells infected with Cux-1 or chloroform-extracts of these cells. Three viral proteins--VP1, VP2, and VP3--with estimated sizes of 45, 30, and 16 kilodaltons (kd), respectively, were immunoprecipitated using the MAbs and Cux-1-infected cell lysates. The 16-kd protein was the major VP. In addition, a 79-kd protein was detected in infected cell lysates by immunoprecipitation with CIAV-antibody positive and -negative chicken serum, and CIAV-specific and non-specific MAbs. PMID- 1786016 TI - Anticoccidial efficacy of diclazuril against recent field isolates of Eimeria from turkey farms in the United States. AB - In a series of laboratory tests, diclazuril was evaluated for efficacy against Eimeria adenoeides, E. meleagrimitis, E. gallopavonis, and a mixture of the three species. Four isolates of each of the species were tested. When given at 0.5, 1.0, and 1.5 ppm in the feed, diclazuril was highly efficacious against all three species and against mixtures of the three, as judged by protection against mortality from coccidiosis, reduction in droppings scores, and improvement of weight gains compared with unmedicated controls. When diclazuril was given at 1.0 ppm, the improvement in droppings scores and weight gains was better than when 0.5 ppm of diclazuril was given. Increasing the dosage to 1.5 ppm did not appear to offer any consistent or significant improvement over 1.0 ppm. PMID- 1786017 TI - Diagnoses of infections by the so-called chick anemia agent: anemia and direct transmission electron microscopic detection of virus. AB - Blood from 48 chicks was examined for anemia (packed cell volume), and plasma was examined for virus particles by direct transmission electron microscopy (DTEM). There was agreement between the occurrence of anemia and the presence of CAA virus particles in plasma from anemic chicks (Kappa = 0.2425, Z = 2.096, P = 0.036). Although DTEM is a method that can be used to diagnose CAA in chicks, more sensitive, economical and less laborious diagnostic assays are needed. PMID- 1786018 TI - Clinical, pathological, and epizootiological features of long-segmented filamentous organisms (bacteria, LSFOs) in the small intestines of chickens, turkeys, and quails. AB - Long-segmented filamentous organisms (LSFOs) are easily recognized gram-positive bacteria that infect several species of animals. The present study describes the epizootiological, clinical, and pathological characteristics of LSFOs in chicks, turkey poults, and quails in Georgia and California. LSFOs are most likely to be seen in young poultry that have gastrointestinal illnesses during winter. Concomitant infections with other bacteria and protozoans are common. Although inflammation and displacement of microvilli are characteristics of LSFO infections in these birds, LSFOs are not necessarily pathogens. They may be normal intestinal flora or commensal organisms that overgrow when certain unknown gastrointestinal conditions are correct or certain unknown events occur. PMID- 1786019 TI - Comparison of a quantitative microtiter method, a quantitative automated method, and the plate-count method for determining microbial complement resistance. AB - A quantitative microtiter method for determining the degree of complement resistance or sensitivity of microorganisms is described. The microtiter method is compared with a quantitative automated system and the standard plate-count technique. Data were accumulated from 30 avian Escherichia coli isolates incubated at 35 C with either chicken plasma or heat-inactivated chicken plasma. Analysis of data generated by the automated system and plate-count techniques resulted in a classification of the microorganisms into three groups: those sensitive to the action of complement; those of intermediate sensitivity to the action of complement; and those resistant to the action of complement. Although the three methods studied did not agree absolutely, there were statistically significant correlations among them. PMID- 1786021 TI - Experimental infection of turkeys with Mycoplasma gallisepticum of low virulence, transmissibility, and immunogenicity. AB - Three-week-old turkeys were inoculated intranasally with approximately 10(6) colony-forming units (CFU) of putative variant Mycoplasma gallisepticum (MG) strains M876, M35, or the virulent S6 reference strain. Uninoculated turkeys in each group served as contact sentinels. The hemagglutination-inhibition (HI) test and enzyme-linked immunosorbent assay (ELISA) were used to determine serologic responses. MG was isolated from 100% and 92% of S6- and M876-inoculated turkeys, respectively, on day 7 PI. However, culture-positive rates among M876-inoculated turkeys declined more rapidly, transmission to contact sentinels took longer and occurred at lower rates, and serologic responses measured by HI and ELISA were lower than in S6-infected turkeys. Testing sera from inoculated turkeys for antibodies to MG in homologous and heterologous ELISA systems indicated that strain M876 was significantly (P less than 0.05) less immunogenic than S6 (days 62 and 95 PI), and that the homologous ELISA was more sensitive (P less than 0.005). MG strain M35 failed to infect turkeys in three attempts, even though the inocula used were viable on culture media. PMID- 1786020 TI - Comparison of chicken plasma and guinea pig serum in a quantitative microtiter method of determining microbial complement resistance. AB - A quantitative microtiter method using chicken plasma is described for determining the degree of complement resistance or sensitivity of avian Escherichia coli isolates. Results obtained with the microtiter method using chicken plasma were compred with results obtained using commercially available standardized guinea pig serum as the source of complement. The test organisms consisted of five isolates of E. coli isolated from chickens. Three isolates were from flocks with colisepticemia; one was from a flock with omphalitis; and one isolate was a non-pathogenic control. Data were accumulated from the five avian E. coli isolates incubated at 35 C with either chicken plasma or guinea pig serum and with heat-inactivated chicken plasma or guinea pig serum. The microtiter results of the chicken plasma and guinea pig serum had a statistically positive correlation. The use of commercially available guinea pig serum in the test system will allow for standardization of this method. PMID- 1786022 TI - Influence of exogenous T4 on body weight, feed consumption, T4 levels, and myocardial glycogen in furazolidone-fed turkey poults. AB - Ten turkey poults each were placed in one of four groups: control, thyroxine (T4), furazolidone (FZ), and FZ + T4. Thyroxine (T4), at a concentration of 1 ppm, was included in the ration of poults fed T4 and FZ + T4, and furazolidone (FZ), at a concentration of 700 ppm, was included in the ration of poults fed FZ and FZ + T4 from 2 to 5 weeks of age. Levels of plasma T4 decreased significantly (P less than or equal to 0.05) between 2 and 5 weeks in control and FZ poults. At 5 weeks, plasma T4 levels were significantly (P less than or equal to 0.05) lower in FZ poults than in control poults and significantly (P less than or equal to 0.05) lower in the FZ + T4 poults than in the T4 poults. Exogenous administration of T4 had no effect on development of the round heart syndrome or on body weight, but significantly increased feed consumption in FZ-fed poults during weeks 4 (P less than or equal to 0.05) and 5 (P less than or equal to 0.01). Inclusion of T4 in the ration increased plasma levels of the hormone 12x in both T4 and FZ + T4 poults and significantly (P less than or equal to 0.05) increased myocardial glycogen content in T4 poults but not in FZ + T4 poults. PMID- 1786023 TI - Escherichia coli challenge in chickens selected for high or low antibody response and differing in haplotypes at the major histocompatibility complex. AB - Relative sensitivity to Escherichia coli challenge was evaluated in white leg horn chickens that had been selected for high antibody (HA) or low antibody (LA) response and that differed in haplotypes at the major histocompatibility complex (MHC). Assessments were made of relative body-weight change and of heart and air sac lesions after inoculation of 10(6), 10(5), or 10(4) E. coli via the posterior thoracic air sac. As has previously been reported, chicks from line HA were more sensitive to E. coli than those from line LA. Lesion scores were 1.58 +/- 0.12 in line HA and 1.02 +/- 0.12 in line LA (mean +/- S.E.), and ranged from 0.99 +/- 0.14 with the lowest dose of E. coli to 1.79 +/- 0.15 for the highest dose. Relative body-weight change to 72 hours after inoculation was greater in line LA (7.5 +/- 0.5) than in line HA (4.4 +/- 0.8). There was no apparent resistance or susceptibility conferred to chickens in either the HA or LA genetic background as a result of haplotypes present at the MHC. PMID- 1786024 TI - Mutagenesis of the v-mht/mil oncogene in avian carcinoma virus MH2. AB - Avian carcinoma retrovirus MH2 induces leukemia and solid tumors in chickens and transforms fibroblasts and macrophages in vitro. The genome of MH2 consists of two oncogenes, v-mht/mil and v-myc. Most of the transforming activity of MH2 is attributed to the v-myc oncogene. In contrast, the v-mht/mil oncogene alone does not induce a fully transformed phenotype of avian primary fibroblasts in vitro. It was shown previously that v-mht/mil is the avian homology of the v-raf oncogene in murine sarcoma retrovirus 3611. Because the v-raf oncogene transforms murine fibroblasts very efficiently, the present study tested the hypothesis that an extra segment in the 5' end of v-mht/mil relative to v-raf suppressed the fibroblast-transforming activity of v-mht/mil. By introducing an in-frame deletion of 195 nucleotides into the 5' end of v-mht/mil, the results demonstrate that in the presence of an inactive v-myc oncogene, the 5'-deleted v-mht/mil oncogene fails to transform chicken embryo fibroblasts. Therefore, it is likely that avian primary fibroblasts lack a cellular component that serves as a critical substrate/target for v-mht/mil-induced cellular transformation. PMID- 1786025 TI - Genetic variation in resistance of turkeys to experimental challenge with Pasteurella multocida. AB - Six hundred fifty-five male and female turkeys representing four genetic lines were challenged in 10 experiments over a 3-year period with a field isolate of Pasteurella multocida. Poults were challenged at 45 days of age with 1 ml of an inoculum containing 1.2 x 10(7) bacteria per ml. The lines of turkeys included two randombred control lines (RBC1 and RBC2), a subline (E) of RBC1 selected for increased egg production, and a subline (F) of RBC2 selected for increased 16 week body weight. The number of days from exposure to severe clinical signs or death for Line F (5.8 days) differed significantly from that of Line E (8.2 days), Line RBC1 (8.0 days), and Line RBC2 (8.2 days). There were no significant differences due to sex of poult for number of days from exposure to severe clinical signs or death. Overall mortality observed was 51.2%. Mortality was highest for Line F (72.1%) and differed significantly from that of the other lines. Mortality among male poults did not differ significantly from mortality among female poults. PMID- 1786026 TI - Evaluation of a panel of monoclonal antibodies in the subtyping of Haemophilus paragallinarum. AB - A panel of four monoclonal antibodies (MAbs) was evaluated, using a hemagglutination-inhibition test, for its ability to subtype 76 isolates of Haemophilus paragallinarum. The results of the MAb reactions were compared with the results of both the Page and Kume serotyping schemes (the serovars of the Page scheme correspond to the serogroups of the Kume scheme). One MAb (E5C12D10) was raised against a Page serovar A strain and the remaining MAbs (F2E6, D6D8D5, and B3E6F9) against a Page serovar C strain. Six different reaction patterns were found among the 76 isolates of H. paragallinarum. There was total correlation between the MAb reaction pattern and the Page scheme, and thus the Kume scheme, to the serogroup level. All 19 Page serovar A (= Kume serogroup A) strains reacted only with MAb E5C12D10, whereas all five Page serovar B (= Kume serogroup B) strains failed to react with any of the MAbs. All 52 remaining strains were Page serovar C (= Kume serogroup C), and all failed to react with MAb E5C12D10 but showed varying reaction patterns with the three other MAbs. Although the MAbs recognized four subdivisions within Kume serogroup C, these subdivisions differed from the four Kume C serovars. This panel of MAbs can be used to assign isolates of H. paragallinarum to either Page serovars or Kume serogroups. Although the subdivisions recognized by the MAbs within the Page serovar C strains do not correspond to the Kume serovars, they may be useful in epidemiological applications. PMID- 1786027 TI - Induction of oral lesions in broiler chicks by supplementing the diet with copper. AB - Copper sulfate was added to the diet of broiler chickens from 1 day to 3 weeks of age at the rate of 0.05% to 0.20% in order to evaluate its influence on the incidence of oral lesions. Both the incidence and severity of oral lesions showed a significant linear increase as the concentration of copper sulfate increased. Adding a level of sulfate equivalent to that produced by the highest level of copper sulfate failed to induce oral lesions. The severity of gizzard erosion also increased as the concentration of copper increased. Dietary copper sulfate supplementation should be considered a possible cause of oral lesions seen during the necropsy of avian species. PMID- 1786028 TI - Inflammation of the nasal gland in domestic turkeys. AB - A prominent swelling above the eye of range-reared tom turkeys was found to be due to severe inflammation and hyperplasia of the nasal or salt gland. The incidence of affected turkeys was sporadic, and no mortality or other lesions were associated with the condition. PMID- 1786029 TI - Meningoencephalitis in commercial meat turkeys associated with Mycoplasma gallisepticum. AB - Mycoplasma gallisepticum (MG) infection was diagnosed in three different flocks of 12-to-16-week-old commercial meat turkeys displaying torticollis and/or opisthotonos. MG was isolated from the brain, air sacs, trachea, and sinus of one bird with neurological signs. Histological examination of brains in all three cases revealed moderate-to-severe encephalitis with lymphoplasmacytic cuffing of vessels, fibrinoid vasculitis, focal parenchymal necrosis, and meningitis. Birds with neurological signs were seropositive for MG by the serum-plate agglutination and hemagglutination-inhibition tests. The encephalitic form of MG has been described previously but is rarely mentioned in the current literature. PMID- 1786030 TI - Cranial teratomas in two domestic ducks (Anas platyrhynchos domesticus). AB - Teratomas are rare tumors in domestic fowl, and none have been reported in the cranial area of ducks. Clinical signs and gross and microscopic findings associated with a cranial teratoma in two domestic ducks are reported. One tumor arose within the cranial vault and was associated with neurologic signs. The other tumor was subcutaneous and invaded the parietal bone but did not extend into the brain. Both tumors were tridermic. PMID- 1786031 TI - Malignant melanoma in a budgerigar (Melopsittacus undulatus). AB - A 3-year-old male budgerigar was presented for weakness. A 0.5-cm mass was located in the left patagium. Histologically, the mass was diagnosed as a malignant melanoma, previously unreported in budgerigars. PMID- 1786032 TI - Effects of in vivo manganese administration on calcium exchange and contractile force of rat ventricular myocardium. AB - The purpose of this study was to investigate the effect of prolonged (14 days) intragastric administration of Mn2+ (0.25 mmol/kg daily) on Ca2+ exchange and contractility of rat ventricular myocardium. Left-ventricular pressure and its first derivative (dP/dt) were recorded by means of a balloon catheter inserted via the left atrium into the left ventricle of the rat heart perfused by Langendorff method. Ca2+ exchange in the stimulated and rested ventricular myocardium was investigated with the aid of 45Ca under the conditions of complete equilibration of preparations with a solution containing 45Ca2+. The "cellular" 45Ca2+ content was calculated by subtraction of 45Ca2+ dissolved in the free water of extracellular space from the total tissue 45Ca2+ content. The cellular 45Ca2+ content in the stimulated (60/min) ventricles of control rats (without Mn2+) was 0.83 +/- 0.09 mmol/kg wet weight (w.w.). Ten minutes of rest resulted in a gain of 0.06 mmol 45Ca/kg w.w. (not statistically significant). Fourteen days' exposure to Mn2+ resulted in an increase of the mean 45Ca content to 1.61 +/- 0.09 mmol/kg w.w. in the stimulated preparations and to 1.35 +/- 0.06 mmol/kg w.w. in the rested ones (p less than 0.001). Thus, the control rest preparations did not change their Ca2+ content, while in the rats treated with Mn2+ the rest resulted in an increase at exchangeable Ca by 52%. The maximal ventricular developed pressure (Pmax) after 14 days of Mn2+ administration was increased by 35% and dP/dtmax was 228% of the value in the control group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786034 TI - Effect of coronary hyperperfusion on regional myocardial function and oxygen consumption of stunned myocardium in pigs. AB - The "Gregg phenomenon" implies that myocardial function and oxygen consumption (MVO2) increase when coronary perfusion is enhanced within or above the autoregulatory range. We have recently demonstrated that the "Gregg phenomenon" has no significance for regional myocardial function and MVO2 in anesthetized swine in situ. There is, however, some evidence that the "Gregg phenomenon" may exist within stunned myocardium. To test whether coronary hyperperfusion increases regional myocardial function and MVO2 in stunned myocardium, in six anesthetized swine the left anterior descending coronary artery (LAD) was cannulated and perfused at constant pressure (CAP) using an extracorporal circuit. The coronary vein which parallels the LAD was cannulated to allow measurement of regional MVO2 and regional systolic wall thickening (WT%) of the anterior myocardium was assessed using sonomicrometry. Blood flow (CBF) to the LAD was increased by increasing CAP within the extracorporal circuit or by intracoronary adenosine infusion (150 micrograms/min). In normal myocardium, increasing CBF from 71.4 +/- 19.7 (SD) to 156.7 +/- 48.8 ml/min/100 g by increasing CAP from 100 +/- 10 to 190 +/- 10 mm Hg or increasing CBF from 75.1 +/ 29.1 to 189.2 +/- 45.8 ml/min/100 g by intracoronary adenosine infusion did not increase WT% (34.3 +/- 12.2% vs 32.1 +/- 10.6% and 32.3 +/- 10.7% vs 30.1 +/- 13.2%, respectively). MVO2 was not changed during enhanced CAP (6.94 +/- 1.05 vs 8.10 +/- 1.08 ml/min/100 g) and during intracoronary adenosine infusion (6.67 +/- 1.45 vs 7.30 +/- 2.23 ml/min/100 g). Twenty min of hypoperfusion followed by 30 min of reperfusion depressed WT% by 47% (p less than 0.05). However, MVO2 was only decreased by 23% (NS). In the stunned myocardium, increasing CBF from 62.1 +/- 36.4 to 157.1 +/- 60.0 ml/min by increasing CAP was not associated with an increase in WT%. MVO2, however, increased from 5.14 +/- 1.07 to 8.88 +/- 1.83 ml/min/100 g (p less than 0.05). Comparable results were achieved when CBF was increased from 60.3 +/- 28.7 to 176.9 +/- 48.5 ml/min by intracoronary adenosine infusion. WT% was unaffected, while MVO2 increased from 4.69 +/- 0.92 to 9.46 +/- 3.39 ml/min/100 g (p less than 0.05). Thus, increasing coronary perfusion within or above the autoregulatory range increases MVO2 in stunned myocardium, but without a simultaneous increase in regional myocardial function. PMID- 1786033 TI - Autonomic influences on regional cardiac [14C]2-deoxyglucose uptake in paced dog heart. AB - Sixteen dogs were anesthetized with pentobarbital sodium and placed on positive pressure ventilation. Twelve animals were cardiac paced and four animals were non paced controls. In four of the paced animals, the left cut peripheral end of the cervical vagus was stimulated electrically. In another four animals, the decentralized left stellate ganglion was stimulated efferently. The four remaining paced animals were controls. The animals were injected i.v. with a single bolus of [14C]2-deoxyglucose, 100 microCi/kg. After 45 minutes of periodic stimulation, the hearts were removed, sectioned and prepared for autoradiography. Cardiac pacing significantly (p less than 0.02) decreased systolic blood pressure, and significantly increased (p less than 0.05) glucose utilization by all regions of the heart, with the exception of the left ventricular endocardium and the left ventricular papillary muscles. Vagal efferent stimulation elicited significant (p less than 0.05) decreases in glucose utilization in both the right atrium and right ventricle. Conversely, efferent stellate ganglion stimulation had no effect on the glucose utilization of any regions of the myocardium studied. This study demonstrates that both cardiac pacing and cardiac vagal efferent neuronal stimulation can produce distinct changes in regional myocardial glucose utilization. PMID- 1786036 TI - Angioarchitectonics of the venous vessels and morphological changes in coronary heart disease. AB - For an understanding of the effects of myocardial protection via the coronary sinus and other cardiac veins, study of the angioarchitectonic of these veins in ischemic hearts is of special interest. Venous vessels were filled with radiological contrast material (hearts of decreased patients who died from coronary disease and also normal hearts) and were then studied using the microhistoangiographic technique. It was noted that necrotic zones of the histologic preparations were similar to the corresponding microangiograms. It was found that with myocardial infarction in the process of organization, the venous vessels around the necrotic zone appear and infiltrate from the border toward the "vessel-less" space lying in the necrotic center. This points to a participation and to the importance of venous vessels in the renovation of microcirculation in the necrotic zone after myocardial infarction. PMID- 1786035 TI - The role of post-ischaemic reperfusion in the development of microvascular incompetence and ultrastructural damage in the myocardium. AB - To determine the contribution of oxygenated reperfusion to the development of myocardial microvascular incompetence and ultrastructural damage following ischaemia, isolated buffer perfused rat hearts were subjected to either temporary (n = 15) or permanent (n = 15) ischaemia for 15, 30 or 45 minutes. The temporarily ischaemic hearts were reperfused for 5 min with oxygenated Krebs Henseleit buffer. All hearts were then fixed by perfusion fixation with nitrogen bubbled glutaraldehyde. The transmural development of microvascular incompetence was determined quantitatively by scanning electron microscopy using nuclear track photographic emulsion as an intravascular marker of competent capillaries, and ultrastructural damage was examined by transmission electron microscopy. Thirty or more minutes of ischaemia where required to significantly reduce the mean density of competent capillaries in the subendocardial third of the left ventricular wall. Such ischaemic myocardium contained relatively normal, open unobstructed vessels, indicating that the microvascular incompetence arising during ischaemia per se was not due to ultrastructural change in the capillaries. Subendocardial myocardium reperfused following 15 min ischaemia also showed little ultrastructural change, but did show a significant reduction in the density of competent capillaries. However, reperfusion of more severely ischaemic myocardium resulted in obvious ultrastructural damage as well as significant further reduction in capillary competence. These findings demonstrate that oxygenated reperfusion of ischaemic myocardium paradoxically results in the further development of microvascular incompetence and, in severely ischaemic myocardium, also to additional ultrastructural damage. PMID- 1786037 TI - Effect of a diet rich in linseed oil on complex viscosity and blood pressure in spontaneously hypertensive rats (SHR). AB - The influence of a diet rich in linseed oil (10% in weight) with a content of 61.2% of alpha-linolenic fatty acid on blood pressure and complex blood viscosity was investigated in spontaneously hypertensive rats. A decrease in blood pressure by 59 mm Hg was found compared to the age-matched, untreated control group. The viscous (eta') and elastic (eta") components of viscosity were also reduced at various shear rates (gamma). The same applies to the aggregation index, which is a measure of the aggregation tendency of red blood cells (RBC). Of course, the effects on blood viscosity cannot explain the observed degree of blood-pressure lowering. Nevertheless, a decrease in the viscosity can improve the flow conditions in the microcirculation, which may lead to a better oxygen supply. PMID- 1786039 TI - Biomechanics of valvular plane displacement of the heart. AB - There has been no consensus concerning the particular movement of the valvular plane of the heart (VPM). As shown in this study involving a mathematical model based upon the momentum equation and experiments on a specially designed artificial heart pump, the VPM not only results from the shortening of the heart, but also from blood flow within the heart and large blood vessels, from the forces caused by the muscle movements, and from the elastic properties of the heart's suspension. The results of the calculations and the experiments confirm the effect of the so-called valve mechanism and its influence on the economic beating action of the heart. PMID- 1786038 TI - Transthyretin Leu 68 in a form of cardiac amyloidosis. AB - A form of transthyretin (TTR)-related cardiac amyloidosis was previously described in a German patient. Electrophoretic analysis of plasma TTR showed the presence of an electrically neutral variant. We have now characterized the variant transthyretin by comparative peptide mapping, aminoacid and DNA sequencing procedures. A new mutation in TTR with a substitution of leucine for isoleucine at position 68 of the monomer is described. PMID- 1786040 TI - [Blood analysis 200 years ago--the theory and practice of hematoscopy in veterinary medicine]. AB - Since antiquity the macroscopic judgement of blood obtained through phlebotomy was an important constituent of the medical diagnostic procedures. In the progress of blood sedimentation, the "eucrasia" or the "dyscrasia" of the humours became visible. This paper summarizes the historical and theoretical basis of the haematoscopy, and offers insight into the haemodiagnostic practices of a veterinarian at the end of the 18th century. The authority is the professor of veterinary art and medical advisor Anton Joseph Will (1752-1821), mental father and founder of the veterinary school in Munich, which opened its doors on the 1st of November 1790. Between 1786 and 1790, A. J. Will developed a research program to control animal diseases in Bavaria and examined several thousands of blood samples from healthy and sick animals. The different components of coagulated blood, infected with anthrax, were given to dogs. In this way, he could demonstrate experimentally the high infectiousness of anthrax. PMID- 1786041 TI - [Biochemical properties of avian Citrobacter amalonaticus strains]. AB - A report is given on the biochemical properties of C. amalonaticus-strains of avian origin. Some strains show decisive deviations of the "norm", usually established from mammalian strains and details are given in a table. The results are discussed and the strains considered to be avian specific. PMID- 1786042 TI - [Detection and characterization of Salmonella strains from laughing gulls (Larus ridibundus)]. AB - 25 and 17 Salmonella strains could be isolated from 429 and 423 blackheaded gulls (Larus ridibundus), respectively, during two years of examination. S. typhimurium was the most frequent serovar. All strains of S. typhimurium belonged to the biochemovar c (inosite and rhamnose negative), nearly a third of isolates caused a mannose-sensitive hemagglutination of guinea pig erythrocytes. This result is in contradiction to the literature. Furthermore the phagovars, the plasmid profiles and the resistance against chemotherapeutics were tested. The Salmonella carriage by gulls presumably reflects the contamination of the environment. PMID- 1786043 TI - [Activation of the resident microbial flora as a possibility for the improvement of humoral antibody potentials]. AB - The effect of a parenteral application of an adjuvant (Propionibacterium acnes) and an adjuvant/antigen combination (Staphylococcus aureus Cowan I/Al(OH)3, Pseudomonas aeruginosa/Al(OH)3 respectively, was tested with regard to the improvement of antibacterial resistance. Parameter was the humoral antibody production (IgG) of rabbits against six facultative pathogen bacterial species (St. aureus, Sc. faecium, Bac. cereus, P. multocida, E. coli, Ps. aeruginosa) and against sheep rod blood cell membranes. The three methods of treatment led to a significant enhancement of IgG-antibodies against the particular homologous antigen. In addition to this specific reaction the application of adjuvant/antigen combinations provoked a significant enhancement of antibodies also against heterologous antigens (P. multocida, Bac. cereus, sheep red blood cell membranes). The application of P. acnes had no distinct effect on the antibody titer against the different antigen preparations. In order to analyse the immune response qualitatively, a greater part of serum samples was examined by immuno blot technique. The number of partial antigens recognized by the sera increased during the experiments but the rise did generally not relate to developments of antibody titers. Nevertheless, the Ps. aeruginosa/Al(OH)3 treatment seemed to improve the ability of sera to detect antigenic determinants of heterologous bacterial species. PMID- 1786044 TI - [The occurrence of Cryptococcus neoformans in fecal samples from birds kept in human living areas]. AB - With help of Guizotia creatinine agar (syn. bird seed agar) Cryptococcus (Cr.) neoformans var. neoformans was isolated from 71 (7.7%) of 925 investigated droppings of birds kept within human living area. Cr. neoformans was detected in droppings of 1.2% from 164 psittacines, in droppings of 1.7% from 118 budgerigars and in droppings of 18.4% from (carrier) pigeons. This yeast was not isolated from droppings of 13 small parrots, 10 eclectus parrots, 13 rosellas, 21 cockatiels, 6 Polytelidus sp., 32 Cacatua sp., 13 Carduelis sp., 5 waxbills, 5 starlings, 120 chicken, 9 turkeys, 2 geese, 2 Turdus sp., 1 duck and 1 gull. PMID- 1786045 TI - [The therapy of the metritis, mastitis, agalactia (MMA) complex of swine]. AB - In a pig breeding unit that during years had been infected with MMA Complex the sick sows were divided into three groups: Group 1 The sows received 50 mg per kg bodyweight Ampicillin Trihydrate in one dose per day for three days i.m. Group 2 The sows received 50 mg per kg bodyweight Ampicillin Trihydrate in one dose per day for three days in form of intrauterine infusion with 200 ml of sterile saline solution. Group 3 The sows received 300 mg per kg bodyweight Ampicillin Trihydrate in one dose per day for three days in form of intrauterine infusion with 200 ml of sterile saline solution. The number of dead piglets until the tenth day of life was recorded. Group 2 and 3 showed significantly lower death rates of piglets as compared to group 1. Group 3 showed better results as compared to group 2. PMID- 1786046 TI - [The content of beta-carotene, vitamin A and ascorbic acid in different tissues of bulls, short-scrotum bulls and oxen of different body weights]. AB - Analyses of the liver of bulls of different age show, that the concentration of beta-carotene in the age of 6 to that of 25 weeks increased only from 0.43 +/- 0.16 to 1.66 +/- 0.27 and that of vitamin A from 11.49 +/- 5.87 to 13.90 +/- 5.21 micrograms/g fresh weight. The concentration of beta-carotene and of vitamin A in the testis of bulls and of short scrotum bulls up to an age of 15 weeks was similar; thereafter the concentration in the short scrotum bulls was higher. At an age of 72 weeks the concentration of vitamin A in the liver of bulls (219.17 +/- 51.86) was higher (p less than 0.01) than in that of the short scrotum bulls (144.11 +/- 27.79) and that of the oxen (135.51 +/- 41.26 micrograms/g fresh weight). Analyses of the concentration of ascorbic acid in 8 different tissues of bulls and short scrotum bulls at 6 various periods show, that the highest values mostly were found in December. PMID- 1786047 TI - Apricot as the color for nursing's academic costume. PMID- 1786048 TI - Osmotically regulated transport of proline by Lactobacillus acidophilus IFO 3532. AB - We reported previously that, when exposed to high osmotic pressure, Lactobacillus acidophilus IFO 3532 cells accumulated N,N,N-trimethylglycine (glycine betaine), which serves as a compatible intracellular solute. When grown in medium with high osmotic pressure, these cells also accumulated one amino acid, proline. The uptake of [3H]proline by resting, glucose-energized cells was stimulated by increasing the osmotic pressure of the assay medium with 0.5 to 1.0 M KCl, 1.0 M NaCl, or 0.5 M sucrose. The accumulated [3H]proline was not metabolized further. In contrast, there was no osmotic stimulation of [3H]leucine uptake. The uptake of proline was activated rather than induced by exposure of the cells to high osmotic pressure. Only one proline transport system could be discerned from kinetics plots. The affinity of the carrier for proline remained constant over a range of osmotic pressures from 650 to 1,910 mosM (Kt, 7.8 to 15.5 mM). The Vmax, however, increased from 15 nmol/min/mg of dry weight in 0.5 M sucrose to 27 and 40 nmol/min/mg of dry weight in 0.5 M KCl and in 1.0 M KCl or NaCl, respectively. The efflux of proline from preloaded cells occurred rapidly when the osmotic pressure of the suspending buffer was lowered. PMID- 1786049 TI - [A review of the present status of liver transplantation]. AB - Liver transplantation opens the view on the border lines of medicine. Its performance requires great surgical and anaesthesiological experiences. Based on the authors' own experience the selection of liver donors and the indications for liver transplantations are pointed out. Special pathophysiological aspects of liver transplantation as well as the anaesthesiological procedure and the intensive care in the early postoperative period are described. The results of liver transplantation can be improved by further research on preservation of explanted organs, early recognition of complications after transplantation and immunological suppression. PMID- 1786050 TI - [Pharmacokinetics and pharmacodynamics of local anesthetics]. AB - In clinical practice the efficacy of local anaesthesia is judged by the time of onset, duration and the quality of sensory and motor blockade. Apart from the physicochemical properties of local anaesthetics, a sufficient blockade depends on the volume and the concentration which are applied. Generally increasing the dose leads to a better quality of blockade as well as a higher risk of toxicity. This dilemma is evident in procedures, where, due to continuous or repetitive application within one day, the applied total dosage exceeds the recommended maximum limit. The values regarding maximum doses published in the German Pharmacopeia ("Rote Liste") can be defined as being more or less the product of the volume of distribution and the toxic concentration in the plasma. According to that formula the maintainance doses for continuous techniques in regional anaesthesia are derived from the product of the elimination half-life and the toxic plasma concentration. The values for toxic plasma concentrations are difficult to define since only the free protein-unbound fraction of a local anaesthetic is responsible for undesired side-effects. This fraction can be influenced by acidosis, body temperature and shortage of specific binding protein. Some well documented case reports show that another major cause of acute toxicity is nearly always due to inadvertent intravascular injections. This event can occur nearly unnoticed and leads to life-threatening complications even with lower doses than the recommended maximum doses. Only the application of high concentrations into well vascularised regions is followed by a similarly quick development of high plasma levels. Typical kinetics of local anaesthetics are presented for various methods of regional anaesthesia informing the anaesthetist on corresponding plasma concentrations if the recommended maximum doses are exceeded and thus he gets useful information for his daily work. PMID- 1786051 TI - Is early mobilization associated with lower incidence of postspinal headache? A controlled trial in 69 urologic patients. AB - Sixty-nine patients who underwent transurethral resection of the prostate under subarachnoid anaesthesia were studied. They were randomly allocated to either an early mobilisation group (group A, 30 patients), or a 24 hour bed rest group (group B, 39 patients). The incidence and severity of postspinal headache were assessed in each patient at 24, 48 and 72 hours. The incidence of headache in group B was significantly higher when compared with group A at 48 and 72 hours postoperatively (p less than 0.025 and p less than 0.01, respectively). The total incidence of headache throughout the 72 hours was also significantly higher in group B (p less than 0.01). Regarding the severity of headache the two groups did not differ significantly. Therefore, bed rest is not recommended as a prophylactic measure for postspinal headache. PMID- 1786052 TI - Cardiac dysrhythmias during dental surgery. Comparison of hyoscine, glycopyrrolate and placebo premedication. AB - The incidence of cardiac dysrhythmias was investigated in 60 patients undergoing dental operations under halothane anaesthesia following either hyoscine, glycopyrrolate or placebo as a supplement to nalbuphine for premedication. Forty five percent of the patients given 6 micrograms/kg hyoscine exhibited cardiac dysrhythmias compared to 25 percent of the group given 4 micrograms/kg glycopyrrolate and to 5 percent in the placebo group. The difference between the first two groups was not significant. But there was a significant difference between these two groups and the placebo group in which only 5 percent of the patients had cardiac dysrhythmias. There was neither a connection between the frequency of cardiac dysrhythmias and the demographic characteristics of the patients nor with their PaCO2. The author recommends to avoid premedication with anticholinergic combined with halothane anaesthesia with spontaneous respiration during dental operations. PMID- 1786053 TI - [Positioning the central venous catheter using intra-atrial ECG]. AB - In a small study (n = 9) central venous catheters were positioned in front of the right atrium using ECG. ECG was registered using a soft J-wire inside of the catheter. Big vessels were cannulated and in all cases cannulation was successful. ECG and x-ray control showed good agreement. PMID- 1786054 TI - [The history of the Society for Anesthesiology and Intensive Therapy of the DDR]. AB - In 1960 the first joined meeting of East German anaesthetists took place and in 1964 the "Society of Anaesthesiology and Intensive Therapy of the German Democratic Republic" was founded. Up to its dissolution 26 years later and the 23rd of October 1990, ten congresses with international participation, 10 workshops an 5 bilateral symposia were held. The activities of the board were supplemented by 11 special working-groups. Annually various special in-service courses were held. In 1989 the "Society of Anaesthesiology and Intensive Therapy of the German Democratic Republic" hat 2,201 members including 1,327 anaesthetists. The former members of the "Society of Anaesthesiology and Intensive Therapy of the German Democratic Republic" are now joining the "German Society of Anaesthesiology and Intensive Medicine". As far as future activities are concerned, the traditional relations with the East European neighbour societies should be given special attention. PMID- 1786055 TI - The immunology of the human foetal pancreas aged 8-13 gestational weeks. AB - The expression of MHC class I and class II antigens by the human foetal pancreas (HFP) during the first trimester is poorly documented. Using immunohistochemical techniques, we analysed 37 HFPs aged 8-13 gestational weeks (gw) and compared the results with those of 9 HFPs aged 14-16 gw. In all of the specimens, the ductal cells were class I- and class II-negative. Islets and endothelial cells expressed class I but were class II-. Interstitial class II+ cells included macrophages, B lymphocytes and dendritic-like cells that were negative for macrophage markers. While the frequency of class II+ cells in the HFP remained constant from 8 to 13 gw, a threefold increase was observed from the end of the 13th gw to the 16th gw. In conclusion, the lower density of interstitial class II+ cells in HFPs aged 8 13 gw indicates that immunomodulation is likely to be more successful in this age group. PMID- 1786056 TI - Xenotransplantation of microencapsulated pancreatic islets contained in a vascular prosthesis: preliminary results. AB - Porcine and human pancreatic islets were microencapsulated in an alginate polylysine biomembrane and put in a chamber of a new vascular prosthesis composed of an inner tubing of Dacron mesh and an outer tubing of expanded polytetrafluorethylene material. The vascular prosthesis was anastomized between the iliac artery and the contralateral vein of diabetic dogs. The recipients did not receive any immunosuppressive therapy. Function of porcine and human islets was monitored by measuring serum glucose levels and human C-peptide concentrations. After transplantation, serum glucose levels were maintained at values lower than 200 mg/dl, and C-peptide concentrations were between 0.8 and 3.2 ng/ml. Injected insulin requirements decreased by 50%-60%. Four to 8 weeks after transplantation, histologic examination showed well-preserved and functioning islets in the majority of intact microcapsules. Fibrin and inflammatory cells were not observed in the chamber. These data suggest long-term survival and function of microencapsulated pancreatic islets in the vascular prosthesis. PMID- 1786057 TI - Localization and ultrastructure of the Kupffer cells in orthotopically transplanted liver grafts in the rat. AB - Kupffer cells play an important role in the acceptance or rejection of liver grafts. We examined the ultrastructure of the Kupffer cells in transplanted rat livers, from an early to a late stage where the graft is accepted, using a DA-to PVG combination. Two days after surgery, endocytic activity of the Kupffer cells had increased, as evidenced by worm-like structures and many endocytic vacuoles. There was often close apposition to the monocytes or lymphocytes. By day 4, infiltration of mononuclear cells into the sinusoids was readily noticeable. By day 7, several Kupffer cells had migrated into the space of Disse through the openings in endothelial linings. The number of Kupffer cells reached a maximum at 14 days. They were located mostly outside the sinusoid, adhering to the hepatocytes. At this point in time, however, the Kupffer cells contained few endocytic vacuoles and phagolysosomes, in contrast to those at 2 days. The number and location of Kupffer cells became almost normal at 2 months. The present results indicate that Kupffer cells are highly activated before mononuclear cell infiltration becomes manifest in the sinusoid, and that when a rejecting reaction reaches a peak, they are usually located extrasinusoidally and show a morphologically immature profile. PMID- 1786058 TI - Renal epithelium: reversal of cytotoxic damage by addition of anti-thymocyte globulin. AB - A novel in vitro assay of renal epithelium tight junction function was used to assess the efficacy with which rabbit anti-thymocyte globulin (ATG) blocks epithelium damage mediated by lymphokine-activated killer (LAK) cells. It was found that LAK cells lysed renal epithelial cells poorly in standard chromium release assays but that they caused a rapid, and almost total, reduction in trans epithelium monolayer resistance, indicating tight junction failure and, hence, loss of tissue function. LAK cell-mediated cytolysis of the sensitive K562 cell line was completely blocked in the presence of ATG at a concentration of 200 micrograms/ml. Addition of ATG at this concentration to damaged renal cell monolayers in the presence of LAK cells allowed the trans-monolayer resistance to recover rapidly to levels approaching the values recorded before initial addition of LAK cells. On this basis it seems likely that the rapid restoration of renal function frequently observed after appropriate "rescue" therapy during episodes of acute rejection may reflect subtle changes in tissue function rather than recovery from widespread graft cell cytolysis. PMID- 1786059 TI - Methyl palmitate prevents Kupffer cell activation and improves survival after orthotopic liver transplantation in the rat. AB - The purpose of this study was to determine whether prevention of Kupffer cell activation following orthotopic liver transplantation improves postoperative survival. First, particle phagocytosis by Kupffer cells was monitored continuously from the uptake of colloidal carbon by the perfused liver. Unstored livers took up carbon at rates of around 150 mg/g per hour, whereas storage for 24 h in Euro-Collins solution nearly doubled values to about 290 mg/g per hour. Treatment of rats with methyl palmitate, an inhibitor of phagocytosis by Kupffer cells, reduced carbon uptake to about one-third to one-half of control values in unstored and stored livers, respectively. Oxygen uptake, which was increased about 25% in stored and unstored livers by infusion of colloidal carbon, was only increased 5%-10% in both groups following treatment with methyl palmitate, suggesting that Kupffer cell activation was prevented by methyl palmitate. In livers transplanted after storage for 6 h in Euro-Collins solution (nonsurvival conditions), control rats survived only about 12 h, while treatment with methyl palmitate increased survival time significantly--more than threefold--to about 40 h. These data are consistent with the hypothesis that activation of Kupffer cells following cold ischemic storage and reperfusion is an early event involved in liver graft failure. PMID- 1786060 TI - Histological features of acute pancreatic allograft rejection after pancreaticoduodenal transplantation in the rat. AB - For characterization of histopathological changes during pancreas graft rejection, pancreaticoduodenal transplants were performed in three groups: (1) Brown Norway into diabetic Lewis rats without immunosuppression, (2) Brown Norway into diabetic Lewis rats with cyclosporin A, and (3) Lewis into Lewis rats. Diffuse inflammatory infiltration of the acini by mononuclear cells indicated the onset of rejection (stage I). Shortly after acinar infiltration, damage to small and large interlobular excretion ducts occurred. This took the form of florid circumferential inflammation and vacuolar degeneration of epithelium similar to the bile duct damage seen in primary biliary cirrhosis, graft-versus-host disease, and liver allograft rejection (stage II). Thereafter, endothelialitis and destruction of islets were evident, consistent with a more advanced and irreversible stage of rejection (stage III). Acinar inflammation and moderate duct lesions were not prevented by immunosuppression but were delayed. Nonetheless, severe vascular changes and loss of islets were avoided. We conclude that duct lesions are a reliable criterion for pancreas allograft rejection. They are more sensitive than vascular changes and more specific than cellular infiltration of acinar tissue, which may also occur in infection. PMID- 1786061 TI - Results after liver retransplantation in a group of 50 regrafted patients: two different concepts of elective versus emergency retransplantation. AB - Liver retransplantation remains the only alternative therapy for irreversible graft failure. Previous studies have demonstrated lower survival rates for liver retransplantation than for primary grafts. After reviewing our clinical experience with 55 retransplantations out of 365 liver transplants, we found that the risk and results depend on the surrounding circumstances. Elective retransplantation was shown to be as safe as the first liver transplantation, while emergency retransplantation yielded significantly higher morbidity and mortality rates. PMID- 1786062 TI - Effect of the number of pregraft blood transfusions in kidney graft recipients treated with bioreagents and cyclosporin A. AB - The impact of a systematic, nondonor-specific, pregraft blood transfusion (BT) protocol was evaluated retrospectively in 446 consecutive, first renal transplant recipients with regard to graft survival rate, rejection, and incidence of infectious episodes. Cyclosporin A was the maintenance immunosuppressive treatment in all patients after a 2-week course of antithymocyte globulin or anti IL-2 monoclonal antibody. Recipients were assigned to three groups according to the number of pregraft BT (one or two, three or four, or more than four). When nonimmunological failures were excluded from the study, patients receiving three or four BT had statistically better graft survival (P less than 0.02) and a lower incidence of rejection episodes (P less than 0.05) than those in the other groups. There were no significant differences between the three groups in the distribution of HLA mismatching (A, B and DR), time interval between the last BT and transplantation, DR6 recipient phenotype, or nonimmunological failures. Our results show that the number of pregraft BT is an important factor in transplantation. PMID- 1786063 TI - The effect of cyclosporin on lower limb blood flow in renal transplant recipients. AB - We investigated the effect of electively converting stable renal allograft recipients from cyclosporin A (CyA) to prednisolone and azathioprine on limb blood. We used a non-invasive method designed to measure the hyperaemic blood flow to the lower limb following a standard ischaemic insult. The hyperaemic blood flow was greater during CyA therapy--median 14 ml/100 ml tissue per minute (95% confidence limits 10.5-16.5)--than that after conversion--median 11 ml/100 ml tissue per minute (8.3-13.8; P less than 0.01). By increasing peripheral vascular resistance and reducing limb blood flow, CyA may have caused an increase in the degree of ischaemia, so resulting in a greater hyperaemic response. PMID- 1786064 TI - Public attitudes toward organ donation. A survey in a Turkish community. AB - A survey of public attitudes toward organ donation and transplantation was conducted in a Turkish community. The 1030 subjects were chosen using a random, stratified method. Some 50.5% of those interviewed were willing to donate their organs while 33.7% refused and 15.8% were uncertain. A total of 53.6% said they would consent to donate a deceased relative's organs. Reasons for refusal to donate organs were as follows: fear that their body would be cut into pieces (43.8%), religious beliefs (26.2%), no reason (23.1%) and the belief that they would need their body and organs for their second life (6.9%). Attitudes toward organ donation were clearly related to level of education, age, sex, and socioeconomic status. PMID- 1786065 TI - Reversal of acute glomerular renal allograft rejection: a possible effect of OKT3. AB - A major cause of renal allograft loss is glomerulovascular rejection. This case report is about an episode of histologically proven acute glomerular rejection that was successfully reversed. Monoclonal antibody OKT3 may have been the effective agent. PMID- 1786066 TI - Dominoes--dogma or drama? PMID- 1786067 TI - Single tunnel extravesical ureterocystostomy in pediatric en-bloc kidney transplantation. PMID- 1786068 TI - Forty years of WHO in Europe. The development of a common health policy. PMID- 1786069 TI - ISCOMS--a novel strategy for mucosal immunization? PMID- 1786070 TI - How do peptides associate with MHC class I molecules? PMID- 1786071 TI - A new nomenclature for B cells. PMID- 1786072 TI - Debate: the mechanism of lymphocyte-mediated killing. Lymphocyte-triggered internal target disintegration. PMID- 1786073 TI - Debate: the mechanism of lymphocyte-mediated killing. Perforin-induced pore formation. PMID- 1786074 TI - Expression of perforin and granzymes in vivo: potential diagnostic markers for activated cytotoxic cells. AB - Perforin and granzymes are considered to be instrumental in cell-mediated cytolysis by cytotoxic T cells and natural killer cells. Here, Gillian Griffiths and Christoph Mueller describe the expression of perforin and granzymes, emphasizing studies in vivo, and discuss the possibility that these proteins are useful diagnostic markers for immune responses involving cytolytic cells. PMID- 1786075 TI - DH reading frame bias: evolutionary selection, antigen selection or both? Evolutionary selection. PMID- 1786076 TI - IL-6-mediated events in Alzheimer's disease pathology. PMID- 1786077 TI - AIDS and programmed cell death. PMID- 1786078 TI - On the nature and function of human uterine granular lymphocytes. AB - The 'foetal allograft' concept of the maternal-foetal relationship is currently being questioned. This is partly due to the increasing awareness of uterine large granular lymphocytes, a subset of natural killer cells found in the human endometrium at the time of placentation. Analogous cells are present in several species. The possible role of these cells in the regulation of the trophoblast maternal interface is discussed here by Ashley King and Yung Wai Loke. PMID- 1786079 TI - Extrathymic differentiation of intraepithelial lymphocytes: generation of a separate and unequal T-cell repertoire? AB - A significant number of intraepithelial intestinal T cells appear to mature extrathymically. In this paper, Leo Lefrancois discusses the implication of this for T-cell receptor selection and repertoire generation. He goes on to develop the concept that such cells may constitute discrete subsets of organ-specific lymphocytes, with unique T-cell receptor repertoires that may be evolutionary antecedents of thymus-derived T cells. PMID- 1786080 TI - Map of the human MHC. PMID- 1786081 TI - Superantigens and Kawasaki disease. PMID- 1786082 TI - Regulation of bovine endometrial secretion of prostaglandins and synthesis of 2',5'-oligoadenylate synthetase by interferon-alpha molecules. AB - Experiments were performed to (1) verify the inhibitory effect of bovine trophoblast protein-1 (bTP-1) on uterine prostaglandin synthesis, (2) evaluate whether other interferon-alpha (IFN-alpha) molecules also inhibit prostaglandin secretion, and (3) test whether the enzyme 2',5'-oligoadenylate synthetase (2-5A synthetase) can be induced in endometrium by interferon-alpha. In experiment 1, all interferon molecules (bTP-1, oTP-1, bIFN-alpha and hIFN-alpha) equally inhibited secretion of PGF and PGE2 from endometrial explant cultures obtained at day 17 of the estrous cycle. In experiment 2, endometrial explants obtained from day 17 of the cycle were cultured with and without bovine serum albumin (BSA; 50 micrograms/ml) and bIFN-alpha (0, 0.84, 4.2, and 42 nM). Addition of BSA to the culture medium greatly enhanced the accumulation of PGF into the medium. The bIFN alpha inhibited accumulation of PGF and PGE2 in both the presence or absence of BSA by 12 h. All three concentrations of bIFN-alpha were equally effective in inhibiting prostaglandin accumulation. Additionally, all concentrations of bIFN alpha increased the amounts of 2-5A synthetase in endometrium. In conclusion, these results confirm the inhibitory effect of bTP-1 on PGF release from endometrium and demonstrate that bTP-1 can also inhibit PGE2 secretion. Furthermore, other interferon-alpha molecules, including bIFN-alpha, hIFN-alpha, and oTP-1, also reduced PGF and PGE2 secretion in culture. It is likely, therefore, that conceptus and other interferon-alpha molecules exert similar effects on endometrium in vitro and that the antiluteolytic effects of bIFN-alpha in vivo are mediated in part by changes in endometrial prostaglandin synthesis. PMID- 1786083 TI - Protection by human serum from the immunosuppression induced by spermine in vitro. AB - The in vitro suppressive activity of spermine to PHA-induced proliferation of human T lymphocytes is shown to be abolished by normal human serum. This protection acts within the first 4 hr of culture and is due to a protein of 67 kDa, showing an isoelectric charge of pH 4.9. This protein does not bind, or modify, spermine and does not inhibit spermine oxidase activity, an enzyme required for the in vitro suppression. Results with acrolein confirm that this eventual cleavage product is probably not involved in the spermine-induced suppression. Nevertheless, since serum also reduces acrolein-induced suppression, it is probable that both these protective mechanisms are related. Such a protection of T lymphocytes by a serum factor may play an important role by preventing diffusion, outside the genital tract area, of a potential spermine induced immunosuppression. PMID- 1786084 TI - Antisperm antibodies on epididymal spermatozoa. AB - Still under debate is the location in the genital tract where antisperm antibodies transuded from serum and locally produced antibodies, respectively, become attached to the surface of the spermatozoa. The mixed antiglobulin reaction (MAR) for immunoglobulin (Ig) G, IgA, and locally produced secretory IgA (sIgA) could be carried out on motile spermatozoa from epididymis from 13 of 34 men undergoing vasovasostomy. Four months and one year after the operation the MAR was repeated on a fresh semen sample from all patients. It was found that transuded as well as locally produced antisperm antibodies were bound to spermatozoa at the epididymal level of the genital tract. The follow-up results on semen were almost identical to the results obtained with epididymal spermatozoa. PMID- 1786085 TI - Quantitative and qualitative changes in blood leukocytes in the porcine ovary. AB - The distribution of blood leukocytes in the preovulatory follicle (PO) and in the corpus luteum (CL) of the pig was studied by light microscopy. The number of macrophages increased in the freshly luteinized follicle, decreased subsequently in the developing and mature CL, and then increased again in the regressing CL. However, the relative proportion of macrophages as a percent of total blood leukocytes present did not change throughout the cycle. The increase in the number of lymphocytes was the greatest increase after ovulation as compared to all the other blood leukocytes observed. Even though the number of lymphocytes decreased thereafter, their numbers expressed as a percent of total blood leukocyte number remained high in the developing and mature CL. Eosinophils were the most prominent blood cell type present in thecal tissue of PO and in the regressing CL. In other stages of the CL, few eosinophils were observed. Neutrophil numbers remained moderate and unchanged throughout most of the estrous cycle except in the regressing CL, where the number of neutrophils was slightly increased. Low numbers of plasma cells were observed in all structures studied and no significant changes due to stage were apparent. The distribution of lymphocytes in the corpus hemorrhagicum (CH) and eosinophils in the regressing CL was different in different regions of the ovarian structure. In summary, blood leukocytes, most notably macrophages, lymphocytes and eosinophils, differentially migrate into specific structures of the ovary at specific stages of the estrous cycle of the pig. The possible involvement of these blood leukocytes in the modulation of ovarian events is discussed. PMID- 1786086 TI - Immunology of ovarian failure. AB - Ovarian failure is the result of depletion of ovarian follicles. Naturally occurring ovarian failure usually takes place around 50 years of age in the human. Premature ovarian failure occurs in 1% of women and is the result of acceleration of rate of ovarian follicular depletion in the majority of cases. Cytokines are involved in the mechanisms of ovarian follicular atresia, whether it occurs at a normal or accelerated rate. It is the balance between the actions of TGF alpha and TGF beta upon the granulosa cell that determines the fate of a nonluteinized follicle and between LH and INF gamma that determines destiny of a luteinized follicle. When granulosa cells express MHC antigens in response to IFN gamma or genetic stimulus, an autoimmune reaction ensures resulting in follicular atresia. If the immune processes proceed continuously rather than cyclically, premature ovarian failure occurs. Thus, not only do the immunologic and endocrinologic systems need to communicate to allow normal ovarian function, evidence exists to support the concept that they interact in the pathophysiology of ovarian failure. PMID- 1786087 TI - Porcine lymphocytes secrete a bioactive and immunoreactive LH-like factor in response to LHRH and concanavalin A. AB - Lymphocyte conditioned medium (CM) was prepared by incubating 0 (cell-free control) or 4 x 10(6) lymphocytes/ml in serum-supplemented RPMI containing 0, 10( 9), 10(-7), and 10(-5) M luteinizing hormone releasing hormone (LHRH), 10(-5) M LHRH antagonist (LHRHA), or 10(-7) M LHRH + 10(-5) M LHRHA. Treatments were applied with and without 10 micrograms/ml concanavalin A (con A), and media were analyzed for LH. Aliquots of the CM from cultures incubated for 48 h were later applied to porcine granulosa cell cultures (suspended to 1.25 x 10(5) cells in 450 mul). Thereafter, 50 mul of CM were added to granulosa cell cultures. Media were collected after 12, 24, and 48 h and progesterone determined. Immunoreactive LH increased with time of incubation in lymphocyte CM but not cell-free CM. LH content of lymphocyte CM increased as LHRH concentration increased. LHRHA significantly reduced the amount of LH measured. The presence of con A in the medium resulted in maximal concentrations of LH, irrespective of dose of LHRH or LHRHA. Cell-free CM containing LHRH, LHRHA, and/or con A did not affect progesterone production by granulosa cells at any of the time periods. Lymphocyte CM containing LHRH caused a dose-dependent increase in progesterone production at 48 h. This stimulation was blocked by lymphocyte CM containing LHRHA. Lymphocyte CM containing con A also stimulated progesterone production at all of the LHRH concentrations studied. This response was not inhibited by lymphocyte CM containing the LHRHA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786088 TI - Trophoblast immunity in human pregnancy defined by antiidiotype. AB - Successful reproduction in mammals requires the mother to immunologically accept genetically disparate tissues. Allotypic trophoblast antigens (TLX) are thought to be responsible for influencing maternal acceptance of the feto-placental graft, and faulty regulation of immunity to TLX antigens has been associated with recurrent pregnancy losses. In this report, rabbit antiidiotype (RAb2) was produced to a human TLX antibody (Ab1). This RAb2 detected TLX cross-reactive idiotypes (CRI) on antitrophoblast IgG from women with normal and abnormal pregnancies. These findings support an hypothesis that women respond immunologically to allotypic trophoblast antigens, and that idiotype-antiidiotype regulation of this response is characteristic of normal pregnancy. PMID- 1786089 TI - [Commercial investigation and identification of Chinese drug mabo]. AB - According to a commercial investigation on the Chinese drug mabo being marketed in Gansu Province, there are 17 species belonging to 2 orders, 3 families and 8 genera, of which 6 species including Calvatia candida are discovered on the market for the first time. Morphologic and microscopic characteristics have been studied. A key to the identification is given. PMID- 1786090 TI - [Identification of Chinese drugs by fluorescence spectrum]. AB - Cortex Fraxini, Radix et Rhizoma Rhei, Semen Astragali Complanati, Semen Lini, Bulbus Fritillariae Cirrhosae, Bulbus Fritillariae Thunbergii and their confused medicinal materials have been identified by the fluorescence spectrum. This is a referential method for the identification of Chinese drugs. PMID- 1786091 TI - [Identification of Yi nationality's secret recipe for treating snakebite]. AB - The authors have investigated and found an effective secret recipe for the treatment of snakebite in Mabian, an autonomous county of the Yi nationality in Sichuan Province. Morphologic identification has shown that the recipe is composed of the herb of Pedicularis muscicola and the rhizome of Polygonum viviparum in the ratio of one to one. To facilitate further application, popularization and improvement of the recipe, its histological characteristics have also been studied microscopically. PMID- 1786092 TI - [Preliminary studies on intervarietal and interspecific hybridization breeding methods of Fritillaria thunbergii Miq. and its kindred species]. AB - Intervarietal F1 hybrids of Fritiliaria thunbergii and interspecific F1 hybrids between F. thunbergii and its kindred species were successfully obtained. The methods of breaking the dormancy of F1 seeds and F1 bulbs were investigated. Moreover, the temperature off-season generational advance was preliminarily grouped. PMID- 1786093 TI - [Analysis and comparison of acidic constituents in petroleum ether-soluble fraction of radix Rehmanniae and its processed products]. AB - The acidic constituents in petroleum ether extract of the roots Rehmannia glutinosa f. hueichingensis were fractionated and analyzed by GC-MS. 19 Kinds of acidic constituents were identified and 11 of them (the main components) were compared between Rehmanniae Radix and its processed products. PMID- 1786094 TI - [Arsenic contents in native copper]. AB - Determination and comparison of arsenic contents in 11 samples of calcination and pig native copper have been conducted. The results reveal that arsenic contents in pig native copper are about 10 times of those in the calcination samples. Therefore the toxic effect of native copper can be eliminated or reduced. PMID- 1786095 TI - [Studies on the quality standards of huaijiao wan]. AB - TLC and PC have been used in the qualitative study of huaijiao wan. The contents of the total flavones and volatile oils in huaijiao wan have been determined. The proposed method can be used to control the quality of huaijiao wan. PMID- 1786096 TI - [Dual wavelength TLC densitometric determination of chansu (Venenum Bufonis) contents in shenqiaining injection]. AB - This paper reports the determination of trace chansu in shenqiaining injection by TLC densitometry. The result showed the advantages of the method in accuracy and reproducibility. PMID- 1786097 TI - [Chemical constituents of the aerial parts of six species of Bupleurum genus medicinally used in south-west region of China]. AB - The chemical constituents of the aerial parts of six species of Bupleurum genus (B. kunmingense, B. polyclonum, B. wenchuanense, B. longicaule var. franchetii, B. rockii and B. chaishoui) medicinally used in south-west region of China have been investigated with the results of obtaining eight flavonoid compounds and six triterpenoid saponins. The aglycones of these eight flavonoid compounds are quercetin and isorhamnetin, which are different from the aglycones of the flavonoid compounds isolated from the aerial parts of B. chinense, the official species in Chinese Pharmacopoeia. In the latter case, the aglycone is kaempferol. This difference may be of chemotaxonomic value in Bupleurum genus. PMID- 1786098 TI - [Steroidal constituents from Saussurea gossypiphora D. Don]. AB - Four steroids were isolated from the Saussurea gossypiphora for the fist time. They were determined as 3-stigmastanol, beta-sitosterol, stigmast-7-en-3-ol and ergostan-3,24-diol by spectral and chemical methods. PMID- 1786099 TI - [Analysis of volatile oil in pericarpium Zanthoxyli]. AB - Essential oils were extracted from the pericarp of Zanthoxylum bungeanum and Z. schinifolium. The chemical constituents were analysed by means of GC-MS and 33 compounds were identified. Their contents in the essential oil were also determined. PMID- 1786100 TI - [Effect of Tibetan drug Arenavia kansuensis Maxim. var. ovatipetala Tsui on inflammation and immunological function]. AB - It has been found that the Tibetan drug Arenaria kansuensis has significant inhibitory action on edema in the ears of mice induced by cotton oil and granuloma, on acute inflammation in the form of swollen feet of rats induced by albumen injection and carrageenan, on phagocytosis of histiocytes in the abdomen of mice, and on the formation of antibody (serum HC50). Being low in toxicity, the drug is conducive to the smooth functioning of the liver and kidney. PMID- 1786101 TI - [Experimental research of the effect of polysaccharides in semen Ziziphis Spinosae and Ziziphis Spinosae on enhancing the immune function of mice injured by radiation]. AB - This article surveys the pharmacological effect of the polysaccharides in Semen Ziziphis Spinosae and Ziziphis Spinosae. The result shows that oral administration of this polysaccharide (0.1g/kg/d) can strengthen the immune function of cells nd body fluids and to a certain extent protect mice from radioactive injuries. PMID- 1786102 TI - [Pharmacological studies on Bombyx mori L]. AB - The toxicity of the Bombyx mori extract is very low. It can promote the growth of under-aged male mice, and increase markedly the weight of the prostate glands, seminal vesicles and preputial glands in castrated rats of mice. The results of the experiments have shown that Bombyx mori has androgen-like action. PMID- 1786103 TI - [Advances and goal in the study of chemical constituents of dangshen]. PMID- 1786104 TI - An integrin overview. PMID- 1786105 TI - Regulation of leukocyte integrin function. PMID- 1786106 TI - Lymphocyte adhesion mediated by VLA (beta 1) integrins. Functional roles of multiple extracellular matrix and cell-surface ligands. PMID- 1786107 TI - Integrin alpha 4 beta 1: its structure, ligand-binding specificity and role in lymphocyte-endothelial cell interactions. PMID- 1786108 TI - Common and ligand-specific integrin recognition mechanisms. PMID- 1786109 TI - Anti-LFA-1 antibody as immunosuppressive reagent in transplantation. PMID- 1786111 TI - The effects of excitotoxic lesions of the nucleus accumbens on a matching to position task. AB - The effects of bilateral ibotenic acid lesions of the nucleus accumbens in the rat were examined on a delayed matching to position task. The lesion induced a stable delay-dependent performance deficit suggestive of a short-term memory problem. Following analysis of the impaired performance on trials with long delays, using measures akin to signal detection indices, the deficit was interpreted as being largely due to the intrusion of a side-dependent response bias. Low-dose amphetamine (0.75 mg/kg) produced a similar disruption in the sham operated rats, both in terms of accuracy impairment and degree of strategical bias. As well as mimicking the effects of low-dose amphetamine in sham-operated rats, the lesion also protected against the disruptive effects of the drug at low doses. Whilst exhibiting no performance deficit when the matching schedule lacked a delay component, the lesioned rats were very significantly impaired in switching their response strategies when exposed to a series of reversals. In addition, the lesioned rats were remarkably resistant to an extinction procedure. Both these findings indicate that the lesioned rats were unable to exhibit flexibility in their response patterns. These results, taken together with those of the delayed matching procedure, imply that one of the functions of the intact nucleus accumbens is to inhibit habitual responding under conditions of non reward and low stimulus control, possibly via its connections to the dorsal striatal system. PMID- 1786110 TI - The temporal locus of transfer of training between hands: an interference study. AB - Two experiments are presented which used a dual-task interference procedure to examine the temporal locus of lateral transfer of training. In Experiment 1, 120 undergraduates practised a sequential tapping task with either the left or the right hand, and then switched to the opposite, untrained hand for the test trials. Performance of an unrelated bulb-gripping task with the opposite hand during test trials but not during training trials effectively eliminated transfer of training between the hands for this skill. Because this contradicted the findings of Hicks, Frank and Kinsbourne (J. Gen. Psychol., 107 (1982) 277-281), we then attempted to replicate their study in a second experiment, with 48 subjects. Subjects who gripped a table leg during training trials performed as well during test trials as subjects who did not. We concluded (a) that transfer of training between the hands (cerebral hemispheres) occurs relatively late, when the individual switches to the untrained hand, and (b) that motor overflow is not critical to lateral transfer of training. These data are compatible with a callosal access model of interhemispheric interaction. PMID- 1786112 TI - The development of optokinetic nystagmus in strabismic and monocularly enucleated subjects. AB - Assymmetries of monocular optokinetic nystagmus (OKN) following anomalous visual experience are thought to be due to disruption at the cortical level. Visual disruption usually results from eye suture (in animals), unilateral dense and central cataracts or strabismus (in humans). Many form-deprived animals and humans frequently show a residual strabismus after lid opening (animals) or cataract extraction and optical correction (humans). We wanted to determine whether strabismus was unique in causing monocular asymmetries of OKN. Two independent observers rated eye movement videotapes of 20 normal subjects, the non-deviating eye of 25 unilateral strabismic subjects and 29 unilaterally eye enucleated subjects, who were watching either a nasally directed square wave grating, a temporally directed square wave grating, or a blank field. Observers rated the proportion of trials where OKN occurred, the duration of OKN in each trial and the number of beats of OKN within each trial. Monocular OKN was symmetrical in normal subjects for the proportion and duration measures, but half the normal group showed small but significant asymmetries for the beats measure. Subjects in both enucleate and strabismic groups showed asymmetries of OKN favouring nasally directed stimulation, but only the early onset strabismics (as a group) showed asymmetries that were significantly greater (P less than 0.05) than the normal group. Asymmetry scores correlated significantly with age of diagnosis of strabismus for the strabismic group but not with age of enucleation for the enucleate group. The results are discussed in terms of binocular competition. PMID- 1786113 TI - Effects of flashing-diffuse light on [2-14C]deoxyglucose uptake in the visual system of the black-hooded rat. AB - What components of the visual system process diffuse light information? A [2 14C]deoxyglucose (2-DG) autoradiographic analysis revealed that exposure of freely moving rats (wearing light-diffusing masks) to flashing-diffuse light consistently elevated 2-DG uptake in the lateral geniculate nucleus and superior colliculus to levels rivalling those occurring in rats exposed to flashing gratings. Uptake in visual cortex (area 17) in response to flashing-diffuse light, however, varied as a function of early contour experience, i.e. lower than that produced by darkness in rats reared with high contrast patterns, higher than darkness in rats which had been lid-sutured from the time of eye opening, and falling between these two extremes in 'ordinary' cage-reared rats. The findings point to subcortical mediation of discriminations based on diffuse light information. Cortex might participate in the processing of diffuse light information in the special case of animals lacking contour experience during development. PMID- 1786114 TI - Conditioned inhibition of the nictitating membrane response in rabbits following hypothalamic and mesencephalic lesions. AB - Rabbits were trained on a Pavlovian conditioned inhibition (CI) task using light as the reinforced conditioned stimulus (CS+) and the same light compounded with a tone as the nonreinforced CS-. The conditioned response was the nictitating membrane response. After attaining a criterion of CI performance, animals received radio-frequency lesions of the hypothalamus (n = 11) or midbrain (n = 14). For the hypothalamic lesion cases, primary damage extended from the optic chiasm to the pretectal region. For the mesencephalic lesion cases, primary damage ranged from the most rostral portions of the periaqueductal grey (PAG) caudally to the tegmental reticular formation at the level of the third nerve. Prior research suggested that the hypothalamic lesions would disrupt retention of CI by increasing responding to the CS-. Except where a lesion impinged upon the zona incerta, no CI disruption was observed. In accordance with previous studies (Berthier, N.E. and Moore, J.W., Physiol. Behav., 25 (1980) 667-673; Mis, F.W., J. Comp. Physiol. Psychol., 91 (1977) 975-988), post-lesioning CI disruption was observed in some of the mesencephalic lesion cases involving the posterior commissure, PAG and/or accessory oculomotor nuclei. However, CI performance recovered over the course of retraining. PMID- 1786115 TI - Distributed changes in rat brain DNA synthesis with long-term habituation and potentiation of the perforant path-granule cell synapse. AB - The involvement of brain deoxyribonucleic acid (DNA) synthesis in adaptive neural events was studied in the adult rat during long-term habituation (LTH) or potentiation (LTP) of the perforant path-granule cell synapse. Male Long-Evans rats were given 50 muCi [3H]thymidine intraventricularly under urethane anesthesia. Soon thereafter, field excitatory postsynaptic potential (EPSP) slope and population spike were monitored from the right dentate gyrus before and at various times (5, 10, 15, 60 min) following the delivery to the ipsilateral perforant bundle of a low frequency (LFS: 1.0 Hz, 160 s) or a high-frequency train (HFS: 400 Hz, 200 ms), repeated once after 5 min. Unstimulated implanted rats served as controls. DNA synthesis was evaluated by the incorporation of the radioactive precursor into DNA of several brain areas at the end of a 1 h incorporation period. In CA1, LTH and LTP increased DNA synthesis by 30% on the stimulated side. In the entorhinal cortex, LTH but not LTP increased DNA synthesis (by 30%) on the stimulated side. Conversely, in the frontal cortex, LTP but not LTH increased DNA synthesis (by 100%) on both sides. Long-lasting changes in synaptic efficacy covaried non-linearly with DNA synthesis in mono- and polysynaptically stimulated hippocampal regions, and in functionally associated neocortical areas. The co-variations of population spike amplitude were positive for LTH and negative for LTP in the dentate gyrus and frontal cortex of both sides, and in CA3/CA1 of the stimulated side, indicating higher DNA synthesis at lower values of LTH and LTP, and viceversa. Further, regional cross-correlation analyses revealed a high degree of synchronization among brain sites, following low- or high-frequency train pulses, indicating that (i) extra-target sites participate on the stimulated and on the contralateral side, and (ii) small distributed changes take place across the sampled neural networks. A modulatory role of information flow on brain DNA synthesis is inferred to take place in a diffuse, distributed manner. PMID- 1786116 TI - Weak or missing paw lateralization in a mouse strain (I/LnJ) with congenital absence of the corpus callosum. AB - Ward et al. (Brain Research 424 (1987) 84-88) have reported that reduced size of the corpus callosum (CC) was associated with a lower degree of paw preference in the mouse strain 129/J but not in the strain BALB/cCF. Both strains show individually different degrees of development of the CC but mice completely lacking CC occur rarely. The mouse strain I/LnJ shows complete agenesis of the CC. Thus, we have compared the degree of paw lateralization by means of a food reaching task in two samples of I/LnJ mice (n1 = 81, n2 = 93) with that of two common mouse strains which show a normal CC (C57BL/6JIbm, n = 44; DBA/2JZur, n = 48). The two samples of I/LnJ mice were tested in different laboratories. The first sample of I/LnJ mice had a mean age of 36 weeks. As compared to the control mice, the males but not the females showed a significantly reduced degree of paw preference. Both, callosal and acallosal mice showed a preference for left choices. The replication sample of I/LnJ mice contained only animals between 6 and 8 weeks old. All of them were ambilateral. There was no side preference and no gender difference. We conclude that congenital absence of the CC is a factor which may substantially interfere with the development of paw lateralization. However, depending on age and gender, about half of the acallosal mice develop a paw preference. PMID- 1786118 TI - Labyrinthine and other supraspinal inhibitory controls over head-and-body ventroflexion. AB - The vestibular head righting reflex can be demonstrated by holding an adult rat vertically downward, so that the snout points downward. In this situation, the animal dorsiflexes its head and neck, bringing the head towards its normal orientation in space. Bilateral labyrinthectomy not only blocks this response, but releases an actively maintained ventroflexion of the head and neck. Bilateral electrolytic lesions of the lateral hypothalamus (LH) exaggerate such ventroflexion in labyrinthectomized rats. By themselves, LH lesions had no such effect. Therefore, it is argued that there are vestibular and supraspinal inhibitory mechanisms which, in the intact adult animal, keep this ventroflexion response in check. In addition, when the rats were held with their heads down, and with gentle paw contact with the ground, they did not ventroflex. However, they ventroflexed immediately upon releasing this paw contact. These observations suggest that there are tactile mechanisms which can also inhibit this exaggerated ventroflexion released by labyrinthectomy. PMID- 1786117 TI - The role of monkey inferior parietal cortex in visual discrimination of identity and orientation of shapes. AB - Three cynomolgus monkeys (Macaca fascicularis) were tested for their visual learning ability following bilateral lesions to the inferior parietal cortex. In discrimination learning with patterns differing from each other in form and colour their performance was normal. In discriminating monochromatic patterns their performance depended on the nature of the pattern discrimination; when the discriminanda were different shapes (e.g. x,v) they performed well, while with discriminanda which differed only in the orientation of the shape (e.g. p,d) they performed relatively badly. These results were compared to the previously reported results of normal animals and animals with inferior temporal lesions performing the same task. The ratio of errors in orientation discrimination to errors in shape discrimination was significantly higher than normal in the group with parietal lesions, and significantly lower than normal in the group with inferior temporal lesions. These results suggest that the roles of inferior temporal and inferior parietal cortex in the discrimination of shape and orientation are complementary. PMID- 1786119 TI - Innate versus learned factors determining limb preference in the rat. AB - The basic factors determining forelimb preference in the performance of different skilled movements were studied in white rats. To analyse whether limb preference actually reflects an initial individual motor asymmetry or is a result of instrumental learning (the first successful movement becoming fixed), the method of retrograde amnesia from electroconvulsive shock was used. It was shown that limb preference is initial and not a results of learning and, evidently, is due to intrinsic factors. The preferred limb can be identified in as few as 3 successful movements. There is a gradation among animals according to the degree of initial limb preference and its resistance to rearrangement of the motor task. The differences of limb preference in different movements were also analysed. Dependence of the preference on the character of the required movement was shown. Four basic types of movement were revealed by factor analysis. As different muscular groups (distal and proximal), controlled by different descending motor systems can be involved in the performance of different movements, it is assumed that the initial motor asymmetry in each movement is a result of asymmetry of central motor structures involved in the realization of the movement. In the same animal asymmetry of different motor structures might be different. This could explain different limb preference in different movements. PMID- 1786120 TI - Effects of sexual interactions on the in vivo rate of monoamine synthesis in forebrain regions of the male rat. AB - The effects of heterosexual interactions on the in vivo rate of regional brain monoamine synthesis were examined in the male rat. To this end, the animals were administered an inhibitor of cerebral aromatic L-amino acid decarboxylase, NSD 1015 (100 mg.kg-1 i.p.), and regional brain DOPA and 5-HTP accumulation, over a 15-35 min period of sexual interaction, was compared with the DOPA or 5-HTP accumulation in time-matched home cage controls. Using the DOPA and 5-HTP accumulation as an estimate for the rate of tyrosine and tryptophan hydroxylase activity, respectively, the present results demonstrate: (1) an increased demand on catecholamine synthesis in the neocortex, the amygdala and in the septal area; and (2) an increased dopamine and serotonin synthesis in the ventral striatum (excluding the olfactory tubercle), and in the dorsal striatum. PMID- 1786121 TI - Improved acquisition of left-right response differentiation in the rat following section of the corpus callosum. AB - Split-brained rats learned a left-right response differentiation in a water maze significantly faster than rats with sham surgery. It is unlikely that this superiority resulted from improvement in performance variables since callosotomized rats did not differ significantly from sham operates in speed of acquisition of a brightness discrimination in the same apparatus. Additionally, callosotomy likewise had no effect on the acquisition of a water-maze task requiring consistent unilateral responses. The superiority of the callosotomized animals in forming the left-right response differentiation supports a hypothesis implicating the forebrain commissures in left-right confusion. PMID- 1786122 TI - Visual modulation of vestibularly-triggered air-righting in rats involves the superior colliculus. AB - Vision plays two roles in air-righting, it can trigger air-righting in the absence of the labyrinths, and it can modulate the onset and speed of air righting depending upon the height of the fall. While the visual cortex is known to be necessary for visual triggering, the neural systems necessary for visual modulation are unclear. In this study, the role of the visual cortex and the superior colliculus in visual modulation by rats was analysed. Rats can visually modulate vestibularly-triggered righting, but not trigger righting visually in the absence of the labyrinths. Adult rats with complete neonatal decortication, and adult rats with more specific ablation of the visual cortex were able to visually modulate air-righting. Ablation of the superior colliculi as well as the visual cortex, or ablation of the superior colliculi alone, resulted in loss of the ability to visually modulate air-righting. It is concluded that the superior colliculus is necessary for visual modulation in rats. It is hypothesized that in cats also, the superior colliculus, not the visual cortex, is necessary for visual modulation. PMID- 1786123 TI - Changes in the nigrostriatal projection associated with recovery from lesion induced behavioral asymmetry. AB - Possible neuronanatomical changes correlated with recovery from lesion-induced behavioral asymmetry were examined. Rats, with 6-OHDA injected into the substantia nigra (SN) on one side, were either assigned to a group with a 48-hour survival period, or one with a 15-day recovery period. Control groups, without a lesion, were also included. All animals were tested for behavioral asymmetry and, at the end of the survival period, had horseradish peroxidase (HRP) deposited in the caudate-putamen (CPU) ipsilateral to the lesion (right or left CPU in the controls). Both substantia nigrae of all animals were examined for HRP-labeled cells. Animals given a 15-day recovery period had more HRP-labeled cells in the SN ipsilateral to the HRP deposition site than those given a 1-day recovery period. Also animals which showed behavioral recovery had more HRP-labeled cells in their ipsilateral SN than either those which showed no recovery or those which were not given time to recover. Thus, our results suggested that behavioral recovery from lesion-induced asymmetry was associated with an increase in HRP uptake and retrograde transport by the remaining nigrostriatal terminals. Animals which recovered showed the expected decrease in ipsiversive, and increase in contraversive turning with time. Unexpectedly, animals which did not recover exhibited an increase in ipsiversive, and a decrease in contraversive turning with time. PMID- 1786124 TI - Diazepam alters brain-stimulation reward thresholds in seizure-prone sites. AB - Studies of the effect of diazepam and related compounds on the rewarding properties of brain stimulation as measured by response rates have not yielded clear results, with self-stimulation performance reported to be potentiated, diminished, or unchanged following drug administration. In this study, the effect of two doses of diazepam (2.5 and 5.0 mg/kg) and its vehicle on self-stimulation thresholds was examined in eight rats with electrode placements scattered along a 4 mm length of the medial forebrain bundle. Stimulation of the lateral preoptic area and the anterior and mid-lateral hypothalamus produced overt seizures. Rate period curves were generated for a wide range of currents and the resulting period-current trade-off functions were compared across doses. In seizure-prone sites upward shifts in period threshold were observed after 2.5 mg/kg of diazepam with little additional increases incurred by the 5.0 mg/kg dose. The majority of non-seizure sites showed no effects of diazepam upon period threshold. The results suggest that diazepam alters brain-stimulation reward thresholds by suppressing competing seizure activity. PMID- 1786125 TI - Neglect of contralateral visual stimuli in monkeys with unilateral striatal dopamine depletion. AB - Unilateral lesions of the nigrostriatal dopaminergic system were induced by injecting 6-hydroxydopamine into the substantia nigra of three monkeys trained to initiate arm movements in response to stimuli randomly presented at various locations in their immediate visual space. This procedure resulted in partial reduction of dopamine content, as compared to intact side, in both the putamen and caudate nucleus, with the exception of the putamen in one monkey. A concomitant reduction in the level of dihydroxyphenylacetic acid was observed, but less systematically than the dopamine decrease in the same striatal regions. All monkeys displayed a predominant contralateral arm hypokinesia consisting of a slowness in initiating movements, little or not affected by the hemispace of presentation of the trigger stimulus. Conversely, when the monkeys responded with the arm ipsilateral to the lesion, the movement was initiated more slowly when the trigger stimulus was presented to the hemispace contralateral to the striatal dopaminergic depletion as compared to the ipsilateral hemispace. The results suggest that the visual neglect is more conspicuous when monkeys performed with the arm ipsilateral to the damaged nigrostriatal system. This neglect may be described as a disorder in the ease with which stimuli presented to the side contralateral to the impaired dopaminergic transmission are able to elicit behavioral responses, possibly as the result of a lack of selective attention or defective movement initiation. PMID- 1786126 TI - Orofacial pain sensitivity in adult rats following neonatal infraorbital nerve transection. AB - A modification of the formalin test was used to assess orofacial pain sensitivity in adult rats that received infraorbital nerve transection at birth. Normal and neonatally lesioned adult animals received an injection of either 5% formalin or saline vehicle into the whiskerpad and the duration of whiskerpad rubbing was observed for 45 min. Normal rats given formalin exhibited the previously reported biphasic pattern of rubbing. Neonatally lesioned rats given formalin did not exhibit this pattern, and were indistinguishable from either of the saline control groups. PMID- 1786127 TI - Supratentorial masses: stereotactic or freehand biopsy? AB - CT-guided stereotactic biopsy is now an accepted method of tissue sampling in intracranial mass lesions but many surgeons still practise freehand burrhole biopsy. This study compares two groups of patients who had either stereotactically guided (n = 153) or freehand (n = 217) biopsy. Stereotactic biopsy has a lower incidence of both mortality (2.6%) and morbidity (1.3%) than freehand (7.8 and 7.8%) while diagnostic accuracy is 92.1 and 64.9%, respectively. The success rate for stereotactic biopsy is independent of the size and depth of the lesion while freehand biopsy is most successful for large, superficial lesions but its success never exceeds 88%. The stereotactic technique is superior to the freehand for all intracranial biopsies regardless of size or site. PMID- 1786128 TI - Surgical treatment of pontomedullary cavernomas. AB - Direct treatment of brainstem cavernous haemangiomas (cavernomas) naturally represents a considerable surgical challenge due to the close proximity of vital structures. The results of such treatment have only rarely been described. We report our experience in the management of seven patients with cavernomas of the brainstem treated by microsurgical resection. All patients presented with neurological symptoms directly attributable to one or more episodes of brainstem haemorrhage. CT scan examination in all cases revealed either obvious haematoma or a focal region of high density within the pons or medulla; calcification in and around the lesion was detected in two patients. MRI scanning was performed in four of our cases and was strongly suggestive of the diagnosis of cavernoma with evidence of both recent and older haemorrhage as evidenced by haemosiderin deposits. Cerebral angiography failed to disclose abnormal vessels to the cavernoma in any instance, although interestingly a co-existent but separate cerebellar venous malformation was observed in two of our cases. Surgery was performed between 19 days and 3 months following the most recent haemorrhage. Microsurgical removal of both haematoma and underlying cavernoma was accomplished either via a median suboccipital or retromastoid craniectomy, with an appropriate incision being made into that part of the brainstem most directly overlaying the lesion. Significant improvement in neurological function has followed in all seven cases. Although the natural history of symptomatic cavernous haemangiomas is incompletely understood, the favourable results obtained in our patients suggest that total surgical removal is both practicable and relatively safe even in the case of those lesions situated within the brainstem. PMID- 1786129 TI - Neurovascular relationships of the root entry zone of lower cranial nerves: a microsurgical anatomic study in fresh cadavers. AB - The study describes the microsurgical neurovascular relationships of the root entry zone of lower cranial nerves in 23 cadavers. The vessel type, frequency of contact and site of contact on the root entry zone were analysed. Three types of vascular patterns (Types I-III) were found. Facial nerve: frequency of contact 31.8%; arterial contact 92.9%, Type I (lying across) 78.9%; anterior inferior cerebellar artery in 84.6%. Glossopharyngeal nerve: frequency of contact 23.9%; arteries 54.5%, veins 45.5%; posterior inferior cerebellar artery in 83.3% and Type II (loop) 50.1%. Vagus nerve: frequency of contact 26.1%, arteries 58.3%. Types II and III (passing through) formed 42.9% each. Hypoglossal nerve: frequency of contact 78.2%; vertebral artery 88.9%. No 'grooving' on any nerve was seen. Hence, 'contact' by a vessel at the root entry zone may not be significant in the etiology of lower cranial rhizopathies. PMID- 1786130 TI - A prospective randomized comparison of continuous polydioxanone and interrupted Neurilon for neurosurgical wound closure. AB - A prospective, randomized study of continuous Polydioxanone with subcuticular vicryl closure is compared to interrupted Neurilon in a general neurosurgical practice. Ninety-nine patients were studied with 49 closed with Polydioxanone and 50 by Neurilon. The two groups were comparable with respect to risk factors and general composition. There was no significant difference in the rate of infection, wound dehiscence, CSF leak or suture protrusion, but Neurilon had a significantly higher incidence of palpable knots. Wound closure time was compared with no overall difference being found. We conclude that continuous Polydioxanone closure with subcuticular vicryl is an acceptable form of closure for neurosurgical wounds. PMID- 1786131 TI - Cranio-facial actinomycosis. AB - In the National Neurosurgical Centre in the Sultanate of Oman, four patients with cranio-facial actinomycosis were seen over a 5-year period. All patients had osteomyelitis and intracranial granulomata and the diagnosis was confirmed with histopathology. In two cases the organisms were cultured. In three patients the cranial spread was by contiguity from the scalp and face while one case had the extradural granuloma following a dental extraction. With medication there was gross reduction of proptosis and intracranial lesion in one patient and in two there was marked reduction in the size of the intracranial lesion as seen on serial computerized tomographic scanning of the head (CT head). Three patients are now asymptomatic and are being followed up while one expired with subarachnoid haemorrhage. Although eradication of the disease is difficult, with adequate medication and appropriate surgical intervention, three of these patients continue to remain relatively symptom-free for long periods of time. PMID- 1786132 TI - Intraventricular neurocytoma, a recently recognized pathological entity: report of two cases and review of the literature. AB - Neurocytoma has only recently been recognized as a distinct pathological entity. Previously a rare tumor, it is now being recognized with increasing frequency. It typically presents in an intraventricular location in young adults. Many neurocytomas were originally diagnosed by light microscopy as oligodendrogliomas. More recently they have been shown to have ultrastructural and immunohistochemical features of neuronal differentiation. This paper presents two cases of intraventricular neurocytomas and reviews the recent literature. PMID- 1786133 TI - Relation between epidural and ventricular pressures in canine brain: an experimental study. AB - Complications of epidural pressure (EDP) monitoring are much less severe than those of ventricular fluid pressure (VFP) monitoring. Hence, an insight into the relationship between the epidural and the ventricular pressures is of clinical importance. The pressure volume response as obtained during infusion tests performed on dogs can be categorized into two phases: (i) the latent phase and (ii) the monotonic rise phase. During the latent phase the VFP first rises to a maximum and then falls to a minimum, but these changes in VFP are not reflected in EDP. The latent phase is followed by the monotonic rise phase during which both VFP and EDP rise simultaneously and monotonically. Although the changes in VFP and EDP are similar the epidural pressure remains consistently less than the ventricular fluid pressure. Hence, changes in VFP can be estimated by monitoring EDP during the monotonic rise phase but not during the latent phase. PMID- 1786134 TI - Magnetic resonance demonstration of the effect of carotid artery ligation for a giant internal carotid artery aneurysm: case report. AB - Ligation of the carotid artery remains an accepted treatment for unclippable giant carotid artery aneurysms. Post-operative evaluation is commonly made subsequently by CT scan and angiography, the latter involving an invasive procedure. This paper describes the magnetic resonance (MR) appearance of a traumatic giant terminal carotid artery aneurysm treated by common carotid ligation. MR appears to be the imaging technique of choice for follow-up of giant aneurysms of the terminal carotid artery treated by carotid ligation, the accuracy of delineation of the aneurysm and its content surpassing that of the CT scan. PMID- 1786135 TI - Recurrent subarachnoid haemorrhage from an angiographically occult large distal pica aneurysm. AB - The author reports an unusual case with recurrent episodes of subarachnoid haemorrhage. Complete angiographic examination was negative on three occasions. An unexpected distal posterior inferior cerebellar artery aneurysm was found at autopsy. The case illustrates the occasional failure of angiography in the detection of aneurysms and the need to have a high index of suspicion of an aneurysm in cases with recurrent subarachnoid haemorrhage with negative angiography. The role of magnetic resonance imaging is discussed. PMID- 1786136 TI - The management of infratentorial arachnoid cyst by CT-directed stereotactic aspiration. PMID- 1786137 TI - Intrasellar cysticercosis mimicking a pituitary adenoma. AB - A case of a 50-year-old female with an intrasellar and suprasellar cysticercus cyst, which was pre-operatively misinterpreted as a macroadenoma of the adenohypophysis is described. Cranial computed tomography revealed a homogeneous hyperdense intrasellar and suprasellar lesion. In T1-weighted magnetic resonance images, a spotty hyperintense tumor of the sellar region was shown. PMID- 1786139 TI - Trigeminal neuralgia. PMID- 1786138 TI - Paraganglioma of the cauda equina: case report and review of the literature. AB - A rare paraganglioma of the cauda equina is reported. The clinical, radiological and histological features of this neoplasm are described. Diagnosis was resolved by the absence of glial fibrillary acid protein and electron microscopic evidence of neurosecretory features. Relevant literature is reviewed. PMID- 1786140 TI - Giant cell tumours of the sphenoid bone. PMID- 1786141 TI - Impalement of the head. PMID- 1786142 TI - Estimating the extent of underreporting in AIDS surveillance. PMID- 1786144 TI - Polymerase chain reaction, virus isolation and antigen assay in HIV-1-antibody positive mothers and their children. AB - Diagnosis of perinatal HIV-1 infection is complicated by the persistence of maternal antibodies and the conflicting reports on polymerase chain reaction (PCR) reactivity in children born to HIV-1-seropositive mothers. We have compared PCR with other diagnostic methods for perinatal HIV-1 infection and have attempted also to identify maternal markers which correlate with risk of transmission. PCR was the most sensitive method for early diagnosis of perinatal transmission of HIV-1, but the PCR-positive children (n = 11) developed at least one additional sign of infection. The PCR-negative children (n = 76) were clinically healthy, virus isolation negative, and their serum was HIV-1-antigen negative. All children who had become seronegative (n = 36) were both PCR- and isolation-negative. Antigenaemia in the mothers correlated significantly with higher risk of perinatal transmission of HIV-1, while no other parameters (clinical stage, lymphocyte subsets, PCR and isolation) showed such a correlation. This indicates that the level of virus expression may be of key importance for the risk of vertical transmission of HIV-1 infection. PMID- 1786143 TI - HIV-2-induced immunosuppression among asymptomatic West African prostitutes: evidence that HIV-2 is pathogenic, but less so than HIV-1. AB - Two hundred and forty-one prostitutes working in The Gambia were tested for retroviral infections and their immune system evaluated. Sixty-three were seropositive for HIV-2 only, five for HIV-1 only and six for both HIV-1 and HIV-2 (26.1, 2.1 and 2.5%, respectively). When compared to seronegative individuals, the 63 women infected with HIV-2 clearly had an abnormal immune system, with significantly lower CD4+ and higher CD8+ lymphocyte counts and percentages, lower CD4+:CD8+ ratios, lower CD25+ (activated) lymphocyte counts, and lower lymphocyte proliferation responses after stimulation with phytohaemagglutinin, purified protein derivative (PPD), Candida or pokeweed mitogen, and higher levels of neopterin and beta 2-microglobulin. However, when the HIV-2-seropositive prostitutes were compared with the five women infected with HIV-1, the former were less abnormal, with significantly higher CD4+ percentages and CD4+:CD8+ ratios and lower CD8+ percentages and counts. Immunological anomalies were seen in five women known to have been infected with HIV-2 for less than 17 months. Coinfection with HTLV-1 resulted in more severe immunological alterations than infection with HIV-2 alone. PMID- 1786145 TI - Lack of correlation between maternal antibodies to V3 loop peptides of gp120 and perinatal HIV-1 transmission. The NYC Perinatal HIV Transmission Collaborative Study. AB - Recent reports have suggested that maternal antibodies to specific epitopes of the variable region 3 (V3 loop) of gp120 of HIV-1 might protect against perinatal transmission. In an attempt to confirm these findings, sera from 34 HIV-1 seropositive mothers, representing 13 episodes of mother-to-infant transmission and 23 episodes of non-transmission (two mothers had two pregnancies each during the study period), were tested for the presence of antibodies to various regions of the gp120 V3 loop. Synthetic peptides were generated from HIV-1MN. Of the four peptides tested by enzyme-linked immunosorbent assay (ELISA), only antibody to the C53 peptide (Env310-322, principal neutralizing determinant) was present in maternal sera. Antibody to the C53 sequence was present in 11 specimens from transmitting mothers and 21 from non-transmitting mothers (84.6 and 91.3%, respectively, P = 0.6). No reactivity was detected against the C51, C57, or C58 peptide sequences, located on the sides of the V3 loop. In an antigen-limited ELISA, only two specimens from transmitting mothers and two specimens from non transmitting mothers had detectable 'high-affinity' antibodies to C53 at low antigen concentrations (15.4 and 8.7%, respectively; P = 0.6). Our results do not support previous reports that epitope-specific antibodies to the V3 loop peptides protect against perinatal transmission. Further research is required to determine whether any specific maternal humoral response might influence HIV-1 perinatal transmission. PMID- 1786146 TI - Lack of HIV-1 V3 region sequence diversity in two haemophiliac patients infected with a putative biologic clone of HIV-1. AB - Peripheral blood mononuclear cells (PBMC) from two haemophilia B patients, who presumably became infected with a putative HIV-1 biological clone following treatment with the same suspected batch of commercial factor, were used to clone and sequence the hypervariable V3 region of the HIV-1 envelope protein. In 10 of 12 clones the V3 region was identical and two (one from each patient) had a single non-synonymous point mutation. Viable reisolates (shown to be authentic by sequencing of V3) currently appear to be monocyte tropic. These results strongly indicate that the patients were infected from a common source with a very low number of infectious particles and indicate that variability under these conditions is limited. PMID- 1786147 TI - Plasma viraemia in seronegative HIV-1-infected individuals. AB - It has been reported that the period of latency between HIV-1 infection and the production of antibodies against the virus is sometimes prolonged for greater than 6 months. However, the data supporting this are still controversial and it is not known whether these individuals are actually infectious, especially through body fluids. We have performed a prospective study of 65 high-risk HIV-1 antibody-negative individuals who were followed-up for a period of at least 1 year. Twelve of these individuals were shown by polymerase chain reaction (PCR) to be carriers of HIV-1 proviral sequences. The virus was isolated from lymphocytes in five out of 10 PCR-positive subjects and from cell-free plasma in two. Our data indicate that in some cases delayed seroconversions may be associated with productive infection, suggesting that mechanism(s) other than viral latency may be responsible for the absence of antibody responses to HIV-1 proteins. PMID- 1786148 TI - Absence of HIV-1 DNA in high-risk seronegative individuals using high-input polymerase chain reaction. AB - Evidence of frequent HIV-1 infections in antibody-negative, high-risk individuals (so-called 'silent' infections) remains controversial. To evaluate whether these discrepant results may be the consequence of intermittent detection of rare infected cells (low viral load) preceding seroconversion, we developed a modification of the polymerase chain reaction (PCR) technique which enabled analysis of 10-fold greater amounts of cellular DNA per reaction than standard PCR (2 x 10(6) rather than 0.2 x 10(6) input cells). This technique allowed consistent detection of HIV-1 provirus in two seropositive individuals who had repeatedly tested negative by standard-input PCR. However, results were negative when high-input PCR was applied to 51 specimens from 39 selected high-risk seronegative individuals. These results suggest that variations in viral load preceding or in the absence of seroconversion probably do not explain discrepant evidence regarding silent HIV-1 infection. PMID- 1786149 TI - Neuropsychological assessment of HIV-seropositive haemophiliacs. AB - Neuropsychological findings from investigation of 46 HIV-seropositive asymptomatic and 14 HIV-seropositive symptomatic haemophiliacs without AIDS related complex (ARC) or AIDS, with known duration of HIV seropositivity were compared with 29 seronegative controls. Subjects were assessed blindly using a battery of sensitive computerized neuropsychological tests. They underwent a thorough neurological examination, were assessed for mood and screened for psychopathology. Symptomatic HIV-positive haemophiliacs without ARC or AIDS showed statistically significant decreased performances compared with HIV negatives in choice reaction, visuomotor coordination and global attentional performance (P = 0.018, 0.039 and 0.044, respectively). HIV-positive asymptomatic subjects gave lower performances than HIV-negative subjects in all tests, although these differences were not statistically significant. However, there was a statistically significant trend for these findings between seronegative, asymptomatic and symptomatic groups. Impairment was not associated with mood factors. Duration of seropositivity was found to be a more important factor than Centers for Disease Control stage in the choice reaction test (P less than 0.01). These findings indicate that mild cognitive impairment observed during the natural history of HIV infection in haemophiliacs without ARC or AIDS may be a progressive phenomenon not necessarily associated with the clinical expression of HIV infection. PMID- 1786150 TI - Purified trichosanthin (GLQ223) exacerbation of indirect HIV-associated neurotoxicity in vitro. AB - A formulated preparation of trichosanthin (GLQ223, Pharmaceutical Development Group, Genelabs Inc., Redwood City, California, USA) has been shown to selectively inhibit HIV replication in vitro in lymphocytes and macrophages. In view of recent anecdotal reports of central nervous system (CNS) complications associated with trichosanthin use in some HIV-infected patients, we evaluated any potential drug effects leading to neurotoxicity using a human brain cell aggregate model. Brain cell aggregate cultures were incubated with dilutions of purified trichosanthin alone (trichosanthin), supernatants of HIV-infected macrophage cultures (S-HIV), supernatants of uninfected macrophage cultures (S U), supernatants of purified trichosanthin-treated uninfected macrophage cultures (S-trichosanthin), or supernatants of purified trichosanthin-treated HIV-infected macrophage cultures (S-HIV-trichosanthin). Treatment with purified trichosanthin alone at up to 2 micrograms/ml, with S-U or with S-trichosanthin, produced no morphological signs of toxicity to brain cell aggregate cultures. S-trichosanthin treatment at 2 micrograms/ml did not result in a significant change in cyclic nucleoside phosphorylase (CNP) activity. Treatment of the brain aggregates with S HIV and S-HIV-trichosanthin did, however, result in morphological alteration of the brain aggregates, with S-HIV-trichosanthin-treated brain aggregates showing the most severe damage. Although purified trichosanthin did not appear to be directly toxic to human brain aggregate cultures, trichosanthin treatment of infected macrophages may have increased the morphological alterations caused by supernatants of HIV-infected macrophages. These experimental observations may explain anecdotal reports of adverse CNS reactions in association with trichosanthin treatment of HIV-infected patients and emphasize the neurotoxic potential of any therapy targeted at HIV-infected macrophages. PMID- 1786151 TI - Autonomic denervation in jejunal mucosa of homosexual men infected with HIV. AB - Autonomic nerves in jejunal mucosa of HIV-infected patients show severe structural damage on electron microscopic examination. The aim of this study was to quantify loss of autonomic axons from the lamina propria of HIV-infected patients in different clinical stages of disease. Jejunal biopsies were taken from 19 HIV-antibody-positive homosexual men and from 10 control patients. Autonomic fibres in the mucosa were stained with a neurone-specific polyclonal antibody, PGP 9.5. The density of axons was quantified by a point-counting technique using a Lennox eyepiece graticule under light microscopic examination. There was significant reduction in axonal density in the villi of HIV-infected patients [mean, 9.0; standard deviation (s.d.), 4.7] compared with controls (mean, 15.3; s.d., 5.2; P = 0.003), and in the pericryptal lamina propria of HIV infected patients (mean, 17.8; s.d., 5.4) compared with controls (mean, 27.3; s.d., 6.2; P = 0.0002). Although autonomic denervation occurs throughout the jejunal mucosa of HIV-infected patients, there was no correlation between the clinical stage of HIV disease and the degree of denervation. The denervation was greatest in patients with the most severe diarrhoea, but this difference was not significant. This study provides the first quantitative morphological evidence for depletion of autonomic nerves in the jejunum of patients infected with HIV. Autonomic neuropathy may contribute to chronic diarrhoea in HIV disease. PMID- 1786152 TI - Severe Helicobacter pylori infection in a patient with AIDS. AB - A 30-year-old man with AIDS presented with symptoms of fever, epigastric pain and weight loss, together with histological findings of Helicobacter pylori-induced gastritis. His symptoms resolved with treatment, as indicated by the clearing of his H. pylori infection on repeat gastric biopsy. Although uncommon, H. pylori infection can cause severe illness in patients with AIDS. PMID- 1786153 TI - Use of protein A immunoadsorption as a treatment for thrombocytopenia in HIV infected homosexual men: a retrospective evaluation of 37 cases. AB - Thirty-seven HIV-infected homosexual men with thrombocytopenia (less than 100 x 10(9)/l) received protein A immunoadsorption treatments to remove platelet sensitizing immunoglobulin (Ig) G and circulating immune complexes (CIC) from plasma. Patients received an average of six treatments each, consisting of 250 ml plasma over a 3-week period. Clinical improvement in hemorrhagic symptoms associated with substantial increase in platelet counts was achieved in 18 patients. These responses were maintained over a median follow-up period of more than 7 months in 14 evaluable patients who were not lost to follow-up (three patients relapsed in 2 weeks and one received another therapy). Generally, moderate transient treatment-related side-effects included fever, musculoskeletal pain, chills and nausea. A transient serum sickness-like reaction was observed in seven patients, leading to termination of treatment in two. Clinical responses were associated with significant decreases in levels of platelet-sensitizing Ig, including CIC. Stimulation of broadly cross-reactive anti-antigen-binding fragment [F(ab)2], antibodies contributed to these responses. Protein A immunoadsorption is an effective alternative treatment for HIV-associated thrombocytopenia. PMID- 1786154 TI - Estimating underreporting of AIDS: straightforward in theory--difficult in practice. PMID- 1786155 TI - Immunosilent HIV-1 infection: intrigue continues. PMID- 1786156 TI - Results from prospective studies of HIV-discordant couples. PMID- 1786157 TI - The prognostic importance of thrombocytopenia. PMID- 1786158 TI - AIDS presenting as Candida albicans meningitis: a case report. PMID- 1786159 TI - Comparison and analysis of HIV-1 antibody prevalence in bisexual and homosexual men. PMID- 1786160 TI - Visceral leishmaniasis involving lung and a cutaneous Kaposi's sarcoma lesion. PMID- 1786161 TI - Visceral leishmaniasis in HIV-infected patients. PMID- 1786163 TI - Sulphadiazine desensitization in AIDS patients. PMID- 1786162 TI - Long-term follow-up of subjects with an indeterminate HIV-2 western blot. PMID- 1786164 TI - Primary pulmonary hypertension and HIV infection. PMID- 1786165 TI - Structure of hexaaquanickel(II) bromate. AB - [Ni(H2O)6](BrO3)2, Mr = 422.60, cubic, Pa3, a = 10.2987 (6) A, V = 1092.3 (2) A3, Z = 4, F(000) = 824, Dx = 2.57 g cm-3, lambda(Mo K alpha) = 0.71073 A, mu = 90.79 cm-1, T = 296 K, R = 0.024 for 360 unique reflections having I greater than sigma I. The single type of nickel ion is coordinated by six water-molecule O atoms, each at an observed distance of 2.061 (2) A, in an almost regular octahedral array. The single type of bromate ion has an observed Br--O bond length of 1.655 (2) A and O--Br--O bond angle 104.25 (9) degrees. Both the nickel-oxygen complex and the bromate ion were found to manifest rigid-body behavior. The Ni--O distance corrected for rigid-body motion is 2.065 A, while the corrected Br--O bond length is 1.663 A. Location and refinement of the two inequivalent H atoms permitted a detailed analysis of the hydrogen bonding, which occurs principally between the oxygen octahedron and the bromate groups. This structure is isomorphic to the structures of hexaaquanickel(II) chlorate and hexaaquacobalt(II) bromate which have been reported recently from this laboratory. PMID- 1786166 TI - Structure and conformation of 5-bromo-2',3'-dideoxyuridine. AB - C9H11BrN2O4, Mr = 291.11, monoclinic, P2(1), a = 11.307 (1), b = 5.954 (1), c = 15.829 (2) A, beta = 93.25 (1) degree, V = 1063.90 A3, Z = 4, Dx = 1.82 g cm-3, lambda(Cu K alpha) = 1.54184 A, mu = 53.58 cm-1, F(000) = 584, T = 295 K, R = 0.034 for 1927 observed reflections [I greater than 3 sigma(I)]. The crystal structure contains two independent molecules forming a dimer linked by a pair of N3--H...O2 hydrogen bonds; the crystal structure is stabilized by four additional hydrogen bonds. Two of these are internal C6--H6...O5' hydrogen bonds, one in molecule A and another in molecule B. These two molecules exhibit two different conformations; their sugar ring puckers are 2'-endo-3'-exo for molecule A and 3' endo-2'-exo for molecule B. The Cl'--N1 distance, the chi CN torsion angle and the glycosidic conformation are 1.464 (8) A, -130.0 degrees and -anticlinal for molecule A and 1.506 (8) A, -168.9 degrees and -antiperiplanar for molecule B, respectively. PMID- 1786167 TI - [Non-invasive evaluation of a population with WPW syndrome]. AB - OBJECTIVE: Evaluation of a WPW Syndrome population by non invasive methods; identification of the sudden death risk; results of treatment and patient selection for Electrophysiologic Studies (EPS). DESIGN: Retrospective study. SETTING: Arrhythmology Outpatients Clinic from a Cardiac Department. PATIENTS: Successive patients older than 12 years with a WPW pattern on the ECG and history of paroxysmal tachycardia followed-up for a period of 46 +/- 29 months. MATERIAL AND METHODS: The clinical, ECG, Holter, stress test and echocardiographic data from 32 patients, were analysed. A study evaluating clinical follow up and the results of treatment was done. RESULTS: The group of patients was very symptomatic. The main complaint was a feeling of tachycardia (84.4%). Orthodromic tachycardia was documented in 7 cases and atrial fibrillation with rapid ventricular rate in five. Intermittent delta wave pattern was found in 21 patients, with 11 cases identified by Holter and 4 by stress test. A predominant left accessory pathway was found (47%), but the anteroseptal location was frequent too (25%). The echocardiogram was not useful in any case. Eighty per cent of the patients became asymptomatic with medical treatment. Beta blockers and amiodarone (the last chance) were the most useful drugs. No mortality was found in the study group. EPS was considered for the 5 patients with paroxysmal atrial fibrillation and the 7 cases resistant to medical treatment. CONCLUSIONS: The difficulty to define the risk of a population with WPW Syndrome by non invasive methods was demonstrated. Eighteen one cases were included in a low risk group, due to the intermittent WPW pattern in the ECG. A high risk group was considered for the 5 patients with atrial fibrillation with fast ventricular rate. The risk was not established in 9 cases. Most of the patients became asymptomatic by medical treatment. PMID- 1786168 TI - [Arterial pressure and race. A study in pauper children attending schools in an urban strip in Lisbon]. AB - OBJECTIVE: To determine whether race is a factor of blood pressure levels in school-age children of similar social status, and to investigate other potential determinants of the levels of blood pressure. DESIGN: Inquiry in schools of the suburbs of Lisbon. SETTING: Three schools, four medical observers (general practitioners with school-health functions). SUBJECTS: Three hundred ninety seven children, aged 6-14 years, both sexes, 296 being white and 101 non-white. INTERVENTIONS: Inquiry to the following individual characteristics--sex, age, race, birthplace, type of housing, house availability of water, electricity and waste water, type of transportation to school, number of cohabitans, family income, school marks. Individual determination of systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), weight and height. MEASUREMENTS AND MAIN RESULTS: Blood pressure values were cross-analyzed with all the determined variables, and the virtual correlations were checked. Main results as follows: Race does not influence either SBP or DBP. In this age group, sex does not influence blood pressure values. The used markers of socioeconomical status have equally no influence on blood pressure. Age has only a significant repercussion on SBP. No significant correlation was found between height and blood pressure. Body weight, however, influence either SBP or DBP. SBP was found to be lower in the second of two successive measurements, and the difference increases with age. CONCLUSIONS: In this school-aged biracial population, body weight seems to be the major factor of blood pressure levels, in the sense-bigger weight, higher SBP and DBP. PMID- 1786169 TI - [Visualization of thrombi in the left auricular appendix using transesophageal echocardiography. Apropos of a clinical case]. AB - A case of Transesophageal Echocardiography (T.E.E.) Assessment of "Rheumatic Mitral Stenosis" is presented. T.E.E. has been recently referred as having superior resolution than transthoracic Echocardiography on the detection of thrombi. In the presented case a thrombi was detected in the left atrial appendage. This fact has allowed a better planning of surgery. PMID- 1786170 TI - [Therapy of cardiac insufficiency with angiotensin converting enzyme inhibitors. New concepts-new strategies]. AB - The treatment of heart failure has two main objectives: the improvement of the quality of life and the decrease of cardiac mortality. The first has been proved on several open studies and placebo controlled studies, using converting enzyme inhibitors. Mortality of these patients is very high and half is by sudden death. It has been proved, by several important studies, that these drugs can reduce the cardiac mortality probably acting on the arrhythmogenic mechanisms and on the structural deterioration of the heart. PMID- 1786171 TI - [Therapy with antiarrhythmic agents in cardiac insufficiency]. AB - The antiarrhythmic drugs characteristics are generally inadequate for the treatment of arrhythmics in heart failure. The pharmacokinetics and pharmaco dynamics of these drugs on heart failure are also altered conditioning its clinical use with a need for tayloring of therapeutics doses. Drug interaction and pro arrhythmic effects are also possible cause of difficulties. That must be considered according with the information about the pro arrhythmic effect of each drug. There is no consensus about how choose these drugs. The published therapeutic antiarrhythmic regimens are variable: monotherapy with amiodarone or propafenone and drug association regimens with type 1 drugs sometimes with beta blockers. The efficacy of invasive or non invasive oriented drug therapy for the suppression of ventricular arrhythmics and reduction of mortality is generally accepted. When there is a great decrease of ejection fraction mexiletine and amiodarone are generally recommended. More recent information considers that treatment of "potentially malignant arrhythmias" are not justifiable. PMID- 1786172 TI - [Nursing and its changes in the preparation of psychiatric patients for non institutional care in the residential home ward at Oulunsuu Hospital in 1977 1988]. AB - The purpose of the study was to describe nursing and its changes in the residential home ward of Oulunsuu Hospital in 1977-1988 from a cultural viewpoint. The aim was to find out new information about the nature of nursing. The principal approach was the 'ethnonursing method' based on the ethnographic research tradition. The data was collected by interviewing the twenty patients and eleven members of the staff who had been in the residential home ward in 1977 1988. The four stages in the development of the ward were: formation, reformation, fragmentation and clarification. The values on which the nursing was based moved towards more individual ones in the course of the process. Man was seen as an acting, communicating subject at first and later as a rationally acting subject capable of learning. The aim of nursing shifted from that of "helping the patients to get out of the hospital" to that of recognizing the symptoms of a disease and the problems of living with it. The nursing first emphasized working, collective activities and spontaneous social interaction, later also guidance in practical skills and teaching in small groups. Finally, nursing was interpreted as a multidimensional system of assistance and support, including the finding of meaningful pastimes and the teaching of the skills needed for independent life. PMID- 1786173 TI - [Opinions on health and integrating health processes--in theoretical and in psychiatric care context]. AB - This study is a part of the research project "Multidimensional Health" and consists of a theoretical and on empirical part. The theoretical part analyzes the concepts of health and processes of health, taking as its theoretical frame of reference the theories of Eriksson. The empirical part is a study of the processes of health of fourteen patients in psychiatric health care and is a hermeneutical study. The aim is to describe and to understand multidimensional health, integrating processes of health and the factors guiding or directing them. The premise that health is relative is verified by the results. The dominating pattern of the processes of health suggests that they are integrating. Man's consciousness of his own potential wholeness, the experience of being accepted in relation to the concrete and the abstract other, and the experience of his own place are essential parts of integrating processes of health. PMID- 1786174 TI - [Ethical decision making and the beginning of terminal care in various nursing units]. AB - This article reviews the ethical decision making in moving to terminal care in different nursing unites from viewpoint of nurses. The research results presented in this article are part of the larger study, which dealt with the terminal care of an elderly patient (Kuuppelomaki 1991). Nurses, special nurses and head nurses (N = 191) working in local hospitals, in central hospitals and in radiotherapy clinics participated in the study. The research material was collected by questionnaires during august and september in year 1989. In the processing of the research material cross-tabulations were used. The statistical significance of the differences in results of groups was tested by the Chi-Square. It was found out that the decision of terminal care is often left unmade both in local hospitals, in central hospitals and in radiotherapy clinics. According to the nurses patients and relatives didn't take part very much in decision making process. The participation of nurses were also more less than the willingness of them. Most often the decision was made by the doctor alone, especially in central hospital. Almost every patient in radiotherapy clinics knew about the decision of terminal care but in local hospitals and in central hospitals less than half of them knew about the thing. PMID- 1786175 TI - [Nursing students and the phenomenon of suicide. Research of students' experience and concept of the suicide phenomenon in Turku and Salo nursing schools]. AB - The aim of the study was to find out nursing students opinions and knowledge of suicide phenomenon. Altogether 132 students from Turku and Salo nursing schools participated and they were specialized in surgical & internal, psychiatric and public health. Their basic education also varied, but the purpose was to find students who were near to graduate. The data was collected with an inquire (eleven non-structured questions) and was analyzed with content analysis. Students had relatively short working life experience and according to their own experience too little knowledge and capability to face suicide phenomenon. Majority of the respondents thought that a person who commits suicide is weak, doesn't talk and is a heavy drinker and the reasons to commit suicide are personal. These reasons are among other things weak self-confidence, speechless and personal problems. Suicide prevention has place in every level of the society and specially in health care, among mental health care personnel and in social work. PMID- 1786176 TI - [Primary nursing care. The abilities of nursing staff]. AB - The purpose of this study was to examine the requirements of primary nursing and to find out whether the test group had the abilities to meet these requirements. Questionnaires were delivered in order to find out how informed on primary nursing the group was and what was the nursing philosophy of its members. As a test group was used a clinic of internal disease of a university hospital. The group included all nurses (N = 177). Only 118 (67%) nurses returned the questionnaires. The questionnaire that was used to collect data consisted of multiple-choice questions as well as open ones. The results of the study indicate that the test group has knowledge of primary nursing. In addition the members of the group are familiar with the concept of fields of responsibility, decision making and reporting in writing. Their nursing philosophy contains elements that are identical with the philosophy of primary nursing. Since the results are relatively affirmative and homogeneous, it is possible, that the clinic could implement primary nursing. PMID- 1786177 TI - A contemporary look at the imaging issues of sinusitis: sinonasal anatomy, physiology, and computed tomography techniques. PMID- 1786178 TI - The major obstructive inflammatory patterns of the sinonasal region seen on screening sinus computed tomography. AB - In conclusion, inflammatory sinonasal disease can be conveniently grouped into five distinct radiological patterns, each with a different therapeutic course and surgical options. A more precise interpretation of SSCT scans is rendered when inflammatory sinonasal disease is categorized into these distinct radiological patterns. The three obstructive patterns occur due to dysfunction of the mucociliary drainage routes of the paranasal sinuses and result in specific diagnostic patterns that are recognizable on coronal SSCT examinations. When one of the three obstructive patterns is identified, detailed attention can be directed to the likely site of occlusion, with possible definition of a specific etiology. A detailed road map of relevant surgical anatomy and pathology is then available for the endoscopic surgeon. This road map can then be used for a more directed and specific functional endoscopic sinonasal surgery. This results in improved patient care and surgical result. PMID- 1786179 TI - Sinonasal polyposis. AB - The SSCT findings of the SNP pattern are nearly diagnostic for this entity. SNP is characterized by the major findings of nasal polypoid masses and infundibular enlargement. Patients may also show individual sinus involvement with polypoid masses and/or opacification of the paranasal sinuses without visualization of polypoid masses. The presence of polypoid masses within the sinuses also can be inferred if the major findings are present, especially if there are the minor findings of nasal septal and sinus trabeculae attenuation and bulging of the lateral ethmoid sinus walls. Air/fluid levels are frequent in SNP but do not always indicate acute sinusitis. Patients typically present with nasal stuffiness and rhinorrhea. They often have facial pain and less often headaches. Common associations exist between SNP and atopy (either allergic or nonallergic), asthma, infection, cystic fibrosis, and aspirin intolerance. Therapy may be either medical or surgical, with steroids being the mainstay of the medical treatment. FESS provides a relatively atraumatic means of removing polyps and creating better sinus drainage. Regardless of the type of therapy, recurrences are common, requiring repeated bursts of systemic steroids, nasal steroid maintenance, and frequent additional surgical procedures. Identification of the SNP pattern on SSCT helps the otolaryngologist to institute an appropriate therapy aimed at alleviating symptoms. The SSCT is adequate for evaluation of SNP in the vast majority of cases and serves as a detailed road map for the treating endoscopic surgeon. PMID- 1786180 TI - The sporadic pattern of inflammatory sinonasal disease including postsurgical changes. PMID- 1786181 TI - The nose and nasal vault. AB - In this article we have reviewed the anatomy of the nose and nasal vault, with emphasis on specific features that are imaged with the SSCT. Important areas of the lateral wall anatomy include the OMU and SER, areas that are key to understanding the obstructive patterns of inflammatory sinonasal disease. Lesions that result in these specific obstructive patterns include anatomic variants and other focal pathological lesions, such as polyps. Other types of sinonasal inflammatory disease include sinonasal polyposis and granulomatous and fungal disease. Congenital lesions of the nose may be understood through a knowledge of the relevant developmental anatomy. These lesions include nasal dermoids and epidermoids, cephaloceles, gliomas, and choanal atresia. Important benign masses include antrochoanal polyps, inverting papillomas, angiomatous polyps, JNAs, and osteomas. Benign nasal masses have characteristic features that distinguish them from malignant lesions. Malignant nasal tumors, such as SSCa, esthesioneuroblastoma, and others, are characterized by their more aggressive and destructive behavior. PMID- 1786182 TI - [Postoperative gastritis due to alkaline reflux. Our results]. AB - We present the results of a retrospective study carried out on 23 patients with alkaline gastric reflux (AGR) verified through endoscopy, biopsies and Tc99m HIDA, which were operated on in our department with Y of Roux, Braun, Henley as the correction techniques of this pathology. The criteria of surgical indications were evaluated in these patients as also the results obtained in reference to residual symptoms and changes in the histologic and gammagraphic patterns. PMID- 1786183 TI - [The endoscopic polypectomy of colonic polyps with invasive adenocarcinoma. A series of 19 cases]. AB - We review the endoscopic polypectomies done at the "Juan Canalejo" Hospital in the last 6 years (1984-1989). Out of a 509 adenomatous polyps, 19 showed invasive adenocarcinoma seen in 18 patients (there were two carcinomatous polyps in one single patient), 11 men and 7 women. The median age was 67 years and all of them were located in the left side of the colon or the rectum. The average size was 3 cm and the most frequent histologic type was villoglandular (58%) followed by the villous (26%) and adenomatous (16%). The endoscopic resection was curative in all but one patient that presented vascular invasion in the resected polyp. PMID- 1786184 TI - [The current treatment of nonvaricose upper digestive hemorrhage. The moderator's introduction]. AB - Incidence of peptic ulcer is about 2-3/1000 and its prevalence 17/1000. Hospitalizations for ulcer are stable at 30-40/100,000 inhabitants. About 70% of patients hospitalized for peptic ulcer complications are over 60 years of age and 80% of deaths occur in individuals aged more than 65. The main association for ulcer and bleeding is the intake of NSAIDS. This symposium analyzes various diagnostic and therapeutic aspects of peptic ulcer bleeding. PMID- 1786185 TI - [The prognostic signs of digestive hemorrhage due to peptic ulcer]. AB - A series of clinical and endoscopic signs have been described, which have predictive value in the evolution and mortality of peptic ulcer hemorrhage. Accepted clinical parameters of severity are: age above 60, associated severe disease, hypovolemic shock at admission. Endoscopic prognostic signs for persistence or recurrence of hemorrhage are: active bleeding, either spurting or oozing, a visible vessel. Other endoscopic signs such as the presence of a dark clot, black dots, red spots over the ulcer, do not have prognostic value. IN CONCLUSION: The presence of active bleeding or a visible vessel in a patient with peptic ulcer bleeding, especially when aged more than 60 and with associated severe disease is indicative of recurrence or persistence of the hemorrhage and of greater mortality. In this group of patients therapeutic endoscopy is mandatory. PMID- 1786186 TI - [Therapy in nonvaricose upper digestive hemorrhages]. AB - In the Central Endoscopy Service of the "San Carlos" University Hospital 218 therapeutic endoscopy procedures have been performed during 1988-1989 in patients with non-variceal upper digestive hemorrhage. Ages of patients were between 6 and 95. Bleeding was more frequent in men over 50. The majority of procedures were done in the first 12 hours (48%), Type IIa Forrest lesions were identified in 57% of cases and gastric and duodenal locations were about the same. Melena was seen in 40%, hematemesis in 28% and both in 32% of patients. In 53% adrenalin and absolute alcohol were injected and in 24% BICAP techniques, in the remaining patients combined procedures were used. Procedures were successful in 93% of cases. No complications were recorded. PMID- 1786187 TI - [The cost effectiveness of hemorrhage units]. AB - Gastrointestinal bleeding units appear as an alternative to intensive care units in the management of patients with gastrointestinal bleeding. Their hospitalization advantages and economic impact, however, are poorly evaluated. A survey was done among 176 Spanish general hospitals over 100 beds. Forty-four percent of the 176 hospitals answering the questionnaire had a protocol for the management of patients with gastrointestinal bleeding. Results from our survey show that gastrointestinal bleeding units are regarded as either useful (53%) or necessary (41%) by most hospitals, and should be equipped to provide intermediate type care (88%). To the vast majority of hospitals, patient care is paramount to evaluate the yield of gastrointestinal bleeding units; in contrast, cost efficiency analysis is relevant to only 31%, whereas the combination of cost efficiency and research is relevant to 61% of hospitals. Mean hospital charges for patients in our gastrointestinal bleeding unit, which has an occupancy rate of 95%, are 53% higher than those for regular inpatients, and 64% lower than those for patients in the intensive care unit. PMID- 1786188 TI - [Surgery in the treatment of nonvaricose upper digestive hemorrhages]. AB - The surgical treatment in 154 patients with upper gastrointestinal hemorrhage, was analyzed retrospectively. One hundred and twenty-two were males (79.2%) and 20.7% were females. Mean age was 58.3 years. Surgery was performed immediately or on a wait and see fashion, according to the evolution of the bleeding, during 1985-1989. Survivals were analyzed with the chi-square test with 95% confidence limits. Overall mortality was 11.68% (18 patients), 12.69% after immediate surgery and 9.1% after deferred surgery. Resections had a higher mortality than simple suture in patients with associated severe risk and urgent surgical indication. In patients with less risk, a vagotomy procedure is added if no intercurrent diseases are present. Gastrectomy should be performed only out of necessity. PMID- 1786189 TI - [Necrosis of the greater curvature following acute dilatation of the stomach]. AB - We present a case of gastric greater curvature necrosis after acute gastric dilatation. The lesion was treated by vertical resection of the greater curvature and the distal end of the gastric fundus. This is the first case described in the Spanish medical literature. PMID- 1786190 TI - [Nonamyloid light-chain deposit disease. A report of 2 cases]. AB - Two cases of non-amyloid light chain deposit disease (EDCL) which were diagnosed by liver biopsy are presented, and the recent literature is reviewed. This disease is a dysproteinemia which shares numerous clinical and pathological features with amyloidosis. A commentary is made on the differential diagnosis between both diseases. This disease must be suspected when the conventional histochemical and immunohistochemical stains for amyloid are negative. Immunohistochemical assays for kappa and lambda chains should then be performed. PMID- 1786191 TI - [Biliary ileus diagnosed by ultrasound]. PMID- 1786192 TI - [Mirizzi's syndrome associated with a cholecystoduodenal fistula]. PMID- 1786193 TI - [Noncalculous giant gallbladder due to infundibulo-cystic muscular hyperplasia]. PMID- 1786194 TI - Alternating immunochemotherapy of advanced gastric carcinoma: a randomized comparison of carbazilquinone and PSK to carbazilquinone in patients with curative gastric resection. AB - A total of 103 patients with advanced gastric carcinoma were randomized after curative surgery to receive an alternate administration of carbazilquinone (CQ) and PSK (Krestin) or carbazilquinone alone. Each course of therapies started 1 week after the surgical operation and therapy schedules consisted of 9 courses. In each course of 6 weeks, CQ (2 mg/m2/week) was administered on day 0, 8, and 15. In combined immunochemotherapy group, PSK was given orally in 3-divided doses of 2 g/m2/day from the day of the third CQ administration for consecutive 4 weeks. Estimated survival rate and cumulative survival curve were compared utilizing the data up to 7 years after the operation. There was no overall significant difference in survival rates between the CQ plus PSK group and the CQ alone group, but a group of patients whose disease was classified as S1 + S2(N1 2) survived significantly longer when treated with the combination of CQ and PSK. Neither in more advanced cases (greater than S3 or greater than N3) nor in cancers of early stages, the addition of PSK provided an additive effect. The favorable result obtained in one subgroup treated with PSK, suggests that the use of this agent in treating gastric cancers should be carefully evaluated in terms of serosal infiltration and nodal metastasis. PMID- 1786195 TI - Transfer of long-lasting tumor immunity by immune T cells from MHC congenic mice: migration, survival and tumor-protectivity of cytotoxic donor cells. AB - Immunocompetent B10.D2 (H-2d) mice are able to reject the highly malignant lymphoma ESb of DBA/2 (H-2d) origin very effectively. Seven days after intravenous injection of the ESb tumor cells, B10.D2 mice developed a strong tumor-rejection response which was associated with the generation of anti-tumor T cells in their spleens with direct cytotoxic activity. Most of the cytotoxic potential was directed against the minor histocompatibility differences as demonstrated by the lysis of unrelated DBA/2 derived Eb tumor cells and normal DBA/2 but no B10.D2 derived ConA lymphoblasts. A previously performed clonal analysis, however, revealed a minority population of CTL clones which specifically recognized the ESb specific transplantation antigen (ESb-TATA). When transferred systemically into DBA/2 mice, the B10.D2 anti-ESb immune spleen cells could delay the outgrowth of s.c. transplanted ESb tumor cells. When the ESb tumor cells were experimentally distributed in a s.c. implanted sponge-matrix, the i.v. injected B10.D2 immune cells could confer complete protective immunity against the metastatic tumor, provided the recipients were pre-treated with 5 Gy to allow a better take of the allogeneic cells. The distribution of intravenously injected B10.D2 donor spleen cells was assessed in the recipients up to 50 days by cytotoxicity testing and assaying for the expression of the beta 2 microglobulin allelic form b (beta 2mb). These tests revealed a high propensity of donor cells to populate the spleen and lymph nodes of the DBA/2 recipients. Again this was particularly marked in sublethally irradiated mice where a long lasting lymphoid chimerism was established. PMID- 1786196 TI - Antitumor action of an acidic glycoprotein (SAGP) from Streptococcus pyogenes in mice. AB - We have shown that an acidic glycoprotein (SAGP) isolated from a cell-free extract of Streptococcus pyogenes (Su strain) prolonged the life-span of Ehrlich ascites carcinoma (EAC)-bearing mice. The present study shows that the life-span prolonging effect of SAGP in EAC-bearing mice was reduced by whole body X irradiation before EAC inoculation. SAGP (500 micrograms protein/mouse/day X 4, i.p.) also showed a life-span prolonging effect (T/C (%) = 169) on Meth A fibrosarcoma (Meth A)-bearing mice, but the effect of SAGP was abrogated by an i.p. pretreatment of the host with carrageenan, an antimacrophage agent. The spleen cells from the Meth A-inoculated and SAGP-treated mice were found to have a considerable cytostatic activity by a 3H-thymidine incorporation assay. But the activity disappeared in the presence of carrageenan. These results suggest that the in vivo antitumor effects of SAGP are mediated through its immunomodulating action. PMID- 1786198 TI - Intrapleural application of recombinant interleukin-2 in patients with malignant pleurisy due to lung cancer. A multi-institutional cooperative study. AB - Forty-three patients with malignant pleurisy due to lung cancer were entered into the trial to evaluate clinical efficacy of intrapleural instillation of recombinant interleukin-2 (RIL-2). Among 35 evaluable patients, serial cytological examinations of pleural effusion following the start of the treatment revealed disappearance of malignant cells in 26 (74%). Malignant cells were detected again in 7 of the 26, however, cytology remained negative in the other 19 patients for longer than 4 weeks. Pleural effusion disappeared roentgenographically in 13 of 35 evaluable patients. Additional 8 patients demonstrated marked decrease of pleural effusion. Complete response (CR) which means disappearance of both malignant cells and pleural effusion for longer than 4 weeks was obtained in 13 of the 35 patients (37%). No serious side effects were experienced in this trial. These results indicate that intrapleural RIL-2 is one of candidates to control intractable malignant pleurisy due to lung cancer. PMID- 1786197 TI - In vivo effects of human recombinant tumor necrosis factor alone and in combination with other biological response modifiers on human digestive organ cancer xenografts transplanted in nude mice. AB - The present study was designed to evaluate the effect of rTNF alone or in combination with other BRMs on human digestive organ cancers. Six kinds of human digestive organ cancer xenografts (esophageal, stomach, colonic, pancreatic, bile duct, and liver cancers: EC-YO, GC-YN, CC-KK, PC-HN, BDC-SN and Li-7, respectively) were transplanted in nude mice, and rTNF was administered at 10(3), 5 x 10(3), or 10(4)U/head directly into the tumor 3 times a week for 2 weeks. EC YO was the most sensitive to rTNF, and intratumoral administration of rTNF at 10(3) U/head caused tumor regression. PC-HN, CC-KK and GC-YN were relatively sensitive to rTNF, and their growth was significantly inhibited by rTNF at 5 x 10(3) U/head, however, the tumors regrew after treatment. Li-7 and BDC-SN were resistant to rTNF. The effects of rTNF in combination with recombinant interferon gamma (rIFN-gamma), recombinant interleukin-2 (rIL-2), or streptococcal preparation OK-432 were assessed in mice transplanted with GC-YN. All combinations of rTNF at 5 x 10(3) U/head and other BRMs were more effective than rTNF alone, and GC-YN tumors were completely regressed after treatment with a combination of rTNF and rIFN-gamma or rTNF and OK-432. However in all cases, the combination of rTNF at 10(3) U/head and any other BRM did not improve the effect. Furthermore, the adverse effects of the combinations were more serious than those of rTNF alone. TNF may still be a useful cytokine, because it can induce the regression of tumors. However, for its clinical application, a method should be developed to reduce its side effects. PMID- 1786199 TI - Growth inhibitory effect of bestatin on choriocarcinoma cell lines in vitro. AB - Bestatin, one of the biological response modifiers (BRMs), is an inhibitor of aminopeptidase B (AP-B), leucine aminopeptidase (LAP) and aminopeptidase M (AP M). In this report, we investigated the direct effect of bestatin on the growth of cancer cells in vitro using established four choriocarcinoma cell lines. In vitro chemosensitivity was evaluated by the succinate dehydrogenase inhibition (SDI) test. Bestatin showed the growth-inhibitory effect on all the choriocarcinoma cell lines dose-dependently, especially on NaUCC-4 cells. Both an isomer of bestatin with no inhibitory activity against aminopeptidases, (2R, 3S) AHPA-(R)-Leu, and another isomer with stronger inhibitory activity against AP-B than bestatin, (2S, 3S)-AHPA-(R)-Leu, did not show growth inhibition on NaUCC-4 cells. So it is suggested that one of the possible mechanisms responsible for the direct action of bestatin on the choriocarcinoma cells may be related to the inhibition of activity of LAP or AP-M rather than that of AP-B. Furthermore, cytotoxicity of actinomycin D on the choriocarcinoma cells was significantly enhanced by combination with bestatin. These results suggest that bestatin has not only an indirect host-mediated anti-tumor activity, but also a direct growth inhibitory effect on some kinds of cancer cell lines. PMID- 1786200 TI - The augmentative effect of a protein-bound polysaccharide (PSK) on tumoricidal activity of the soluble factor produced by a streptococcal preparation (OK-432) activated macrophages. AB - The enhancement of antitumor activities of the tumoricidal soluble factor (SF) from a streptococcal preparation (OK-432)-activated macrophages by the pretreatment with a protein-bound polysaccharide (PSK) was investigated in tumor bearing mice. Two-step stimulations with OK-432 at in vivo priming and in vitro eliciting were required for the production of the tumoricidal SF by macrophages, and the tumoricidal activity of the SF apparently correlated with the uptake of OK-432 by macrophages at priming phase. Tumoricidal activity of the SF from OK 432-activated macrophages in proteose-peptone (P-P)-pretreated mice significantly decreased with the development of the tumor, whereas in PSK-pretreated mice did not. Pretreatment of tumor-bearing mice with PSK saved a decrease in the macrophages carrying Iak or asialo GM1 antigens and an increase in wheat germ agglutinin (WGA) receptors. Furthermore, the uptake of OK-432 by macrophages at priming phase was enhanced. The tumoricidal activity of the SF from OK-432 activated macrophages was augmented. Thus, PSK may restore the depressed functions of macrophages, and the combination therapy with PSK and OK-432 may be effective to enhance the production of tumoricidal SF in tumor-bearing mice. PMID- 1786201 TI - A possible clinical application of multicytokine-producing cytotoxic mononuclear cell (MCCM) therapy. AB - When peripheral blood mononuclear cells (PBMC) were incubated with a streptococcal preparation, OK-432, for 24 h, PBMC acquired cytolytic activity against cultured and fresh human tumor cells. Such PBMC were called OK-432 activated mononuclear cells (OK-MC). OK-MC produce several kinds of cytokines such as interferon alpha (IFN alpha), IFN gamma, and tumor growth inhibitory factor (TGIF) both in vitro and in vivo. OK-MC-produced cytokines also inhibited the growth of cultured and fresh human tumor cells. The growth inhibition was examined by human tumor clonogenic assay using a double-layer agar technique. The results indicate that two pathways of anti-tumor activity are induced in OK-MC, i.e., cell-mediated and cytokine-mediated. PMID- 1786202 TI - GTP binding proteins and growth factor signal transduction. AB - There is a large body of evidence supporting a role for GTP-binding proteins in signal transduction by growth factors. In certain cells, ligands which activate or inhibit the production of cAMP via heterotrimeric G proteins promote replication of the target cell. These mechanisms play an important role in a limited number of tumours. Ligands which activate PI hydrolysis through heterotrimeric G proteins may also promote growth in certain systems, but the precise role for PI hydrolysis remains to be determined. Receptors with intrinsic tyrosine kinases may also interact with the heterotrimeric G proteins, but it is not known if these interactions represent side reactions, or whether they are central in the responses of certain cell types. Lastly, p21ras and other small molecular weight G proteins appear to be profoundly important in growth control. The tyrosine kinase growth factor receptors may interact indirectly with these GTP binding proteins via GAP proteins. The molecular detail of this process is emerging rapidly and is likely to be worked out in the near future. PMID- 1786203 TI - In vitro, insulin receptor catalyses phosphorylation of clathrin heavy chain and a plasma membrane 180,000 molecular weight protein. AB - Insulin receptor mutation studies indicate that the receptor tyrosine kinase activity is necessary for receptor endocytosis, and several insulin receptor containing tissues have a plasma membrane-associated protein (Mr congruent to 180,000, p180) whose tyrosine phosphorylation is receptor catalysed. Since clathrin heavy chain (Mr congruent to 180,000 in dodecyl sulphate gel electrophoresis) is a major component of coated vesicles, the latter functioning in receptor endocytosis, we investigated whether insulin receptors can catalyse clathrin phosphorylation and whether p180 is clathrin. Bovine brain triskelion or coated vesicles and 32P-ATP were added to prephosphorylated insulin receptor preparations (wheat germ agglutinin-purified human placenta membrane proteins). Antiphosphotyrosine immunoprecipitated a phosphorylated 180,000 molecular weight protein. Insulin (10(-7) M) increased the rate of phosphorylation. Monoclonal anti-clathrin antibody immunoprecipitated the phosphorylated 180,000 molecular weight protein, whereas monoclonal anti-insulin receptor antibodies (alpha-IR1, MA10) immunoprecipitated both insulin receptors and the phosphorylated 180,000 molecular weight protein. In the absence of added clathrin, anticlathrin immunoprecipitated no proteins, and alpha-IR1 immunoprecipitated only the insulin receptor. Density gradient (glycerol 7.5-30%, w/v) centrifugation separated human placenta microsomal membrane proteins into endosomal, plasma membrane, cytoplasmic and coated vesicle fractions. Antiphosphotyrosine immunoprecipitated phosphorylated-microsomal proteins that centrifugated into endosomal and plasma membrane fractions. Addition of glycerol gradient fractions to a prephosphorylated insulin receptor preparation, however, gave a tyrosine phosphorylated 180,000 molecular weight protein when cytoplasmic and coated vesicle fractions were added. Taken together these results suggest: (1) that, in vitro, human placenta insulin receptors can phosphorylate bovine brain and human placenta clathrin heavy chain; (2) that both assembled and unassembled clathrin can be phosphorylated; and (3) that p180, the plasma membrane-associated insulin receptor substrate, is not clathrin heavy chain. PMID- 1786204 TI - Mechanisms involved in platelet activation induced by a monoclonal antibody anti glycoprotein IIb-IIIa: inositol phosphate production is not the primary event. AB - The mechanisms involved in platelet aggregation by a monoclonal antibody (mAb) P256 specific for the GPIIb-IIIa complex was investigated following metabolic 32P labelling of platelets. When compared with thrombin, inositol phosphates (InsP) production during P256-induced activation was delayed and no apparent peak, but a small and sustained production of [32P]-Ins(1,4,5)P3 and [32P]-Ins(1,3,4,5)P4, was observed between 20 and 90 s. [32P]-Ins(1,3,4)P3 was also produced with a maximum after 90 s. Addition of the ADP scavenger creatinine phosphate/creatine phosphokinase (CP/CPK) and of the cyclooxygenase inhibitor aspirin together with P256 almost totally abolished InsP formation, whereas platelet aggregation and protein phosphorylation were partially inhibited. F(ab')2 fragments of P256 also aggregated platelets but to a smaller extent than IgG, and without any measurable InsPs. To characterize further P256-induced activation, the phosphorylation of p43, the main substrate of protein kinase C (PKC) and the phosphorylation of tyrosine protein (P-Tyr) was also studied. PKC activation was smaller with P256 IgG than with thrombin but both thrombin and P265-IgG induced a similar profile of P-Tyr involving seven major bands, whereas P256-F(ab')2 only occasionally activated PKC but always significantly phosphorylated a 64,000 molecular weight P Tyr. The data indicate that the binding of P256 to GPIIb-IIIa, in contrast with thrombin, does not initially lead directly to the activation of the phosphoinositide phospholipase C to produce InsP's but rather involves the activation of protein kinases and also both fragments F(ab')2 and Fc play a specific role in the platelet responses to the mAb. Only the crosstalk between the two pathways evoked by F(ab')2 and Fc respectively allows the activation of all platelet activation systems. PMID- 1786205 TI - Dual coupling of the cloned 5-HT1A receptor to both adenylyl cyclase and phospholipase C is mediated via the same Gi protein. AB - The cloned 5-HT1A receptor, stably expressed in HeLa cells, has been shown to mediate the effects of 5-hydroxytryptamine (5-HT) to inhibit cAMP formation and to stimulate the hydrolysis of phosphatidylinositol. Both responses were found to be pertussis toxin sensitive. We have examined these two responses in membranes derived from these cells and show that the 5-HT1A receptor can directly regulate the activity of adenylyl cyclase and phospholipase C in response to agonist. In order to examine whether the same or distinct guanine nucleotide-binding regulatory protein(s) (G protein) are involved in these two signal transduction pathways, we used anti-peptide antibodies recognizing the alpha-subunits of Gi1, Gi2, Gi3 as specific tools, since these pertussis toxin substrates are expressed in HeLa cells. These antibodies have previously been shown to prevent receptor-G protein coupling by binding to the regions of G proteins which are putatively involved in interaction with receptors. Our results indicate that the Gi proteins, but preferentially Gi3, mediate the effects of 5-HT both to inhibit adenylyl cyclase and to stimulate phospholipase C. These findings demonstrate that the same receptor interacting with the same G protein can regulate several distinct effector molecules. PMID- 1786206 TI - Oxysterol activation of arachidonic acid release and prostaglandin E2 biosynthesis in NRK 49F cells is partially dependent on protein kinase C activity [corrected]. AB - We previously demonstrated that the oxysterol potentiation of arachidonic acid release and prostaglandin biosynthesis induced by foetal calf serum activation of normal rat kidney (NRK) cells (fibroblastic clone 49F) was not related to a direct effect of oxysterols on cell free Ca2+ level. Since both Ca2+ variations and protein kinase C are involved in arachidonic acid release in some models, we looked for a possible modulation by protein kinase C in the oxysterol effect on arachidonic acid release. We show that when the phorbol ester 12-O-tetradecanoyl phorbol-13-acetate (TPA), a protein kinase C activator, was added to the culture medium, the oxysterol effect on arachidonic acid release and prostaglandin synthesis clearly increased. Moreover, the effect of TPA was dose-dependent and TPA EC50 (4 x 10(-9) M) was unchanged in the presence of the oxysterol. Preincubation of cells with TPA for 24 h prevented the arachidonic acid release induced by TPA alone, whereas the oxysterol effect was decreased but not abolished. In the absence of serum, TPA and ionomycin added together induced the same noticeable (arachidonic acid) release and PGE2 synthesis as serum alone. Nevertheless, the potentiating effect of cholest-5-ene-3 beta, 25-diol was much higher when serum itself was used to activate NRK cells than it was in the present serum-mimicking experimental conditions. Thus, the presence of growth factors is probably required to obtain a full oxysterol effect. We conclude that the oxysterol effect was synergistic with, but not fully dependent on, protein kinase C and Ca2+ ion fluxes, therefore oxysterols could affect earlier events triggered by serum growth factor binding to their cell membrane receptors. PMID- 1786207 TI - Evidence for the simultaneous translocation of muscarinic acetylcholine receptor and G protein by carbachol. AB - Interactions between guanine nucleotide regulatory proteins (G proteins) and muscarinic acetylcholine receptors (mAChRs) were studied in vivo following carbachol treatment. Rat brain homogenates were separated by high speed ultracentrifugation into heavy and light membrane and 300,000 g supernate fractions. The G proteins were partially purified by Sephadex-G200 and heptylamine-Sepharose and the mAChRs by (3,2'-aminobenzhydryloxy)-tropane-(ABT) affinity chromatographies. Radioligand binding assays showed that acute carbachol induced a biphasic translocation of the mAChRs and G proteins into the light membrane fraction with an initial release at 5-10 min and a second phase at 60 min. Portions of the released mAChRs and the G proteins, were found in the 300,000 g supernates and light membranes and were eluted in the same peak fractions from a Sephadex G-200 column. This dually labelled peak dissociated in the presence of digitonin, suggesting close association between the mAChR and G protein. ABT-affinity chromatography yielded dually labelled mAChR-G protein fractions which eluted as a single radioactive peak on a second ABT column. The partially purified G proteins from these fractions were photoaffinity labelled with 8-azidoguanosine-5'-triphosphate, [gamma-32P]. SDS-PAGE autoradiography revealed the presence of Go alpha and Gi alpha which may be released simultaneously with the mAChRs from the plasma membrane. In addition, 110,000 molecular weight polypeptide was dually labelled by [3H]-PrBCM and [gamma-32P]-8 azido-GTP suggesting the presence of a "mAChR-G protein complex." These findings provide direct evidence for the release of mAChRs and G proteins and a mAChR-G protein complex by agonist occupation of the mAChRs. PMID- 1786209 TI - Release of azurophilic granule contents in fMLP-stimulated neutrophils requires two activation signals, one of which is a rise in cytosolic free Ca2+. AB - We have used a continuous spectrofluorimetric method to analyse the role of cytosolic free Ca2+ ([Ca2+]i) in the lysosomal enzyme release from the azurophilic granules in human neutrophils stimulated with f-Met-Leu-Phe (fMLP) in the presence of cytochalasin B. Measurements were performed with the beta glucuronidase substrate 4-methylumbelliferyl-beta-D-glucuronide. We found that the transient rise in [Ca2+]i induced by fMLP is a necessary signal to obtain maximal degranulation. When this Ca2+ transient is prevented by the Ca2+ chelator BAPTA, degranulation can still be induced by a stimulated Ca2+ influx, albeit to a lower extent. We also studied the degranulation process in the neutrophils of a patient with a generalized chemotactic defect. Release of beta-glucuronidase from the patient's neutrophils could not be induced despite the occurrence of a normal Ca2+ response and normal degranulation of specific granules. We conclude that, besides an increase in [Ca2+]i, an additional signal is required for the fusion of azurophilic granules with the plasma membrane in human neutrophils. PMID- 1786208 TI - Diabetes decreases sensitivity of adipocyte lipolysis to inhibition by Gi-linked receptor agonists. AB - (1) Streptozotocin-diabetes decreased the responsiveness of noradrenaline- or forskolin-stimulated lipolysis to inhibition by phenylisopropyladenosine (PIA), prostaglandin E1 (PGE1) and nicotinate in rat adipocytes. (2) Diabetes had no effect on high affinity binding of [3H]PIA to adipocyte plasma membranes. (3) Plasma membranes from diabetic animals had increased abundance of alpha-subunits of Gi1 and Gi2. The effect of pertussis toxin in overcoming inhibition of lipolysis by PIA was delayed in adipocytes from diabetic rats. (4) Diabetes decreased the GTP-dependent right-wards shift in the dose-curve for displacement of the antagonist [3H]DPCPX by PIA in adipocyte plasma membranes. (5) It is concluded that, despite increased abundance of Gi in diabetic adipocytes, less of this is functional. This may contribute to reduced sensitivity to PIA, PGE1 and nicotinate and explains some of the loss of control of lipolysis in insulin dependent diabetes. PMID- 1786210 TI - Priming of calcium mobilization in human neutrophils by granulocyte-macrophage colony-stimulating factor: evidence for an involvement of phospholipase D-derived phosphatidic acid. AB - Human neutrophils pre-incubated with granulocyte-macrophage-colony-stimulating factor (GM-CSF) exhibit an enhanced mobilization of calcium in response to secondary stimuli such as chemotactic factors. The mechanisms underlying this priming effect of GM-CSF were examined. It was first demonstrated that the additional calcium mobilized by chemotactic factors in GM-CSF-treated cells was derived from intracellular stores and was associated neither with an increased permeability to calcium nor with production of inositol 1,4,5-trisphosphate. These results indicated that GM-CSF called upon a novel mechanism in order to enhance the mobilization of calcium in human neutrophils. The growth factor has recently been shown to prime phospholipase D leading to an enhanced activation by chemotactic factors and an augmented production of phosphatidic acid. Furthermore the ability of exogenous phosphatidic acid to mobilize calcium in cell types other than neutrophils has been previously demonstrated. Therefore, we examined the potential involvement of phospholipase D in the priming of the calcium response by GM-CSF in human neutrophils. Inhibition of the production of the fMet Leu-Phe-stimulated production of phosphatidic acid by ethanol or wortmannin had only marginal effects on the concurrent mobilization of calcium. However, the priming of the mobilization of calcium by GM-CSF was greatly decreased in cells treated with either ethanol or wortmannin. These results provide strong support for the hypothesis that the production of phosphatidic acid, which is enhanced in GM-CSF-treated cells, is linked to an increased mobilization of intracellular calcium. These results may have relevance to the mechanism of action of GM-CSF in mature haematopoeitic cells as well to the mitogenic activity of other growth factors. PMID- 1786211 TI - Statistics and mathematics anxiety in social science students: some interesting parallels. AB - This study illuminates some interesting parallels between statistics anxiety and mathematics anxiety in social science students. Parallel to what is confirmed for mathematics anxiety, two factors were observed to underly statistics anxiety scores, namely, statistics test anxiety and content anxiety. The study revealed modest though significant correlations between student attributes and the two confirmed dimensions of statistics anxiety. Furthermore, parallel to the inverse correlation reported for mathematics anxiety and maths course performance, statistics anxiety correlated negatively with high school matriculation scores in maths as well as self perceptions of maths abilities. These data lend support to the hypothesis that aversive prior experiences with mathematics, prior poor achievement in maths, and a low sense of maths self-efficacy are meaningful antecedent correlates of statistics anxiety and thus lend some credence to the "deficit" interpretation of statistics anxiety. PMID- 1786212 TI - The assessment of movement skill problems in 7- and 9-year-old children. AB - This paper is part of a project examining movement skill problems in an educational setting, and aims to provide guidelines for the assessment and management of movement problems within the primary school. The first part of the project reported here involves teachers assessing children on tasks they perform in day to day school life. A Motor Competence Checklist (MCC) was developed and tested on 350 seven- and nine-year-old children. Developmental differences were shown on every section of the MCC, and in the bottom 10 per cent of scores boys outnumbered girls by a ratio between 2 and 3 to 1. The nature of movement problems was examined by analysing profiles of children identified by the MCC, and the resulting profiles suggest there is a need to move away from viewing children with movement problems as an homogeneous group. PMID- 1786213 TI - Acceptability of alternative treatments for school refusal: evaluations by students, caregivers, and professionals. AB - School refusal is a debilitating condition that may be treated in various ways. This study examined the acceptability and perceived effectiveness of alternative treatments for school refusal. A total of 376 people comprising students, parents, and professionals, were required to evaluate several treatment options in relation to a vignette. Despite its potential aversiveness, behavioural management was the most acceptable treatment approach followed, in order, by home tuition with psychotherapy, hospitalisation, and medication. A strong positive relationship was found between acceptability and perceived effectiveness. PMID- 1786215 TI - [Pain in children--the nurse's observations]. PMID- 1786214 TI - Children with mild learning difficulties in an integrated and in a special school: comparisons of behaviour, teasing and teachers' attitudes. AB - Comparisons were made between children and teachers in two schools, one a mainstream school with an integrated resource unit for children with mild learning difficulties, the other a special school. Seventeen children with mild learning difficulties from the special school and ten children with mild learning difficulties from the mainstream school, matched with ten mainstream children for age and sex, took part in the study. Observations were made on children in the playground and their social proximity and positive and negative behaviours were categorised. Self-reports on teasing, bullying and friendships were also collected from children in the mainstream school. Teachers from both schools completed a questionnaire on their attitudes to integration. There was no difference in amount of social contact children with mild learning difficulties had in the mainstream and special school nor were there significant differences in total positive and negative behaviours. Mainstream children, however, played significantly less frequently with children with mild learning difficulties and this was more marked in the older than the younger children. Self-reports from children in the integrated school indicated that the children with mild learning difficulties were teased/bullied more and made fewer friends than the mainstream children. Teachers in the mainstream were more positive and teachers in the special school were more negative towards integration. The special school teachers' expectations fitted more with the findings of the study than did those of the mainstream teachers. PMID- 1786216 TI - [The myth of togetherness--outmoded forms of relationships between medical and nursing personnel]. PMID- 1786217 TI - [Job descriptions as guiding tools]. PMID- 1786218 TI - [Epidemics return and new ones are added]. PMID- 1786219 TI - [Only half-day nursery schools can be regular nursery schools on the discussion about the legal claim for a place in a nursery school]. PMID- 1786220 TI - [Experiences with day nurseries in former East Germany]. PMID- 1786221 TI - [Etiology, variety of form and clinical aspects of neural tube defects]. PMID- 1786222 TI - [Bo Vahlquist (1909-1978)]. PMID- 1786223 TI - [The Pediatricians' Orchestra]. PMID- 1786224 TI - Object relations theory and activity theory: a proposed link by way of the procedural sequence model. AB - An account of object relations theory (ORT), represented in terms of the procedural sequence model (PSM), is compared to the ideas of Vygotsky and activity theory (AT). The two models are seen to be compatible and complementary and their combination offers a satisfactory account of human psychology, appropriate for the understanding and integration of psychotherapy. PMID- 1786225 TI - Predisposition to emotional distress and psychiatric illness amongst doctors: the role of unconscious and experiential factors. AB - This paper explores the contribution of unconscious and experiential factors in accounting for the high rates of depression, alcohol and drug abuse and suicide within the medical profession. The first part of the paper reviews the literature on motivations to study medicine and proposes that, for some doctors, a component of their decision is a response to unconscious drives to compensate for childhood experiences of parental impotence, or emotional neglect. The second part of the paper utilizes the theoretical framework of Kohut to argue that these childhood experiences may also result in the development of a narcissistic disturbance, and a vulnerable self-esteem. A model is outlined of how this may contribute to the development of emotional distress and psychiatric illness through the creation of a state of dependence on patients, emotional detachment and the denial of personal vulnerability. It is proposed that preventative strategies will need to include changing the emotionally 'abusive' nature of medical education, which tends to exacerbate this process. PMID- 1786226 TI - Change or homeostasis? A systems theory approach to depression. AB - Looking at the onset of depressive states in linear terms, there is often a problem of distinguishing cause and effect: did the adverse life-events cause the depression, or did the depression cause the adverse life-events? If we abandon linear thinking and look at depression in systemic terms, the problem of cause and effect disappears, but it is replaced by another problem: is the patient/environment system characterized by homeostasis or change? Some depressed patients seem to be spiralling down towards disaster. Others seem to be stuck in a rut. In systems terms, can depression be at the same time an agent of change and an agent of stasis (or even homeostasis)? The paradox can be resolved if we postulate that the function of depression is to reconcile the individual to an involuntarily subordinate social role; depression which reconciles to a pre existing subordinate position has static properties; depression which mediates a switch to a subordinate position from a previously dominant position has properties of systemic change. PMID- 1786227 TI - Attribution and intervention in self-poisoning. AB - This paper discusses factors which have affected progress in the primary and secondary prevention of suicidal behaviour. An attributional model of helping and coping described by Brickman and his colleagues (1982) is used to suggest that the match or mismatch between attitudes and attributions of helpers and helped is critical in determining (a) whether or not people seek help when in a crisis, and (b) whether or not people respond to help when they receive it. The evidence for the efficacy of cognitive-behavioural problem-solving therapies is reviewed in the light of their ability to take account of matches or mismatches in attitudes towards helping and being helped. PMID- 1786228 TI - A questionnaire designed to assess roles and goals: a preliminary study. AB - Social-cognitive theories of depression predict that an individual is at more risk of becoming depressed if the individual's only dominant role or goal is disrupted by a life-event. This paper reports the development of an instrument which assesses the individual's important roles and goals; preliminary data are presented from two samples (sample 1 of elderly people, sample 2 of younger adults) taken from the age-sex registers of GP practices. The overall reliability of the questionnaire is good, and evidence was obtained for the predicted pattern of an overvalued role or goal being more likely to be correlated with depressive symptomatology. PMID- 1786229 TI - Issues of methodology, design and analytic procedure in psychological research on stress. AB - The research literature on stress has grown disproportionately to actual advances in the field. The authors review issues that may underlie this lack of progress within four general domains: (1) conceptualization and operationalization; (2) measurement; (3) design; and (4) analysis. PMID- 1786230 TI - Is alexithymia a non-neurotic personality dimension? AB - The basic hypothesis of the literature on alexithymia, i.e. that alexithymia has a higher prevalence in psychosomatic than in neurotic (and delusional) patients, was empirically tested by means of the well-validated Toronto Alexithymia Scale (TAS). Surprisingly, neurotic and delusional patients (N = 71) had significantly higher mean total scores on the TAS, compared with the psychosomatic group (N = 150); the normal control sample (N = 224) was, as predicted, the lowest scorer. This hierarchical distribution was confirmed for the first two factors of alexithymia: (1) difficulty in distinguishing between feelings and bodily sensations, and (2) difficulty in expressing feelings. The psychiatric group was, instead, the lowest scorer on the third factor (lack of fantasy life). A substantial cross-validation of the above findings was achieved by comparing on the TAS three subgroups of the normal sample (symptom-free, somatizing and 'neurotic' normal controls). The postulate of the non-neurotic nature of alexithymia, along with its many psychopathological and technical corollaries, is completely contradicted by the present findings. PMID- 1786231 TI - Fatty acids in plasma phospholipids and cholesterol esters from identical twins concordant and discordant for schizophrenia. AB - The fatty acid compositions of plasma phospholipids and cholesterol esters were measured in 18 pairs of twins discordant for schizophrenia and 20 pairs concordant for schizophrenia. In the twins discordant for schizophrenia the only significant abnormalities were elevations of adrenic (22:4n-6) and docosapentaenoic (22:5n-6) acids in the schizophrenic twins. These fatty acids have also recently been reported to be elevated in brains from schizophrenics. The twins concordant for schizophrenia showed many differences from the normal discordant twins. 22:4n-6 and 22:5n-6 were even more abnormal than in the schizophrenic discordant twins. In addition, linoleic acid was significantly reduced, an abnormality which has been found consistently in other schizophrenic populations. These observations are consistent with the concept that unsaturated fat metabolism may be abnormal in schizophrenia. PMID- 1786232 TI - CEEG mapping in drug-free schizophrenics. Differences from healthy subjects and changes induced by haloperidol treatment. AB - A topographic CEEG investigation was carried out in 20 drug-free, DSM-IIIR diagnosed schizophrenics and in a group of matched healthy controls. The effects of acute and chronic haloperidol treatment were then assessed in the patient group. On the baseline recording, schizophrenics showed a widespread increase in delta, theta 1 and beta 3 amplitude. Acute haloperidol administration produced a decrease in delta and an increase in slow beta amplitude. After 28 days of treatment, delta and fast beta were reduced while theta 2 and alpha 1 were increased. CEEG abnormalities in schizophrenic subjects appear, therefore, to be reduced by chronic neuroleptic treatment. PMID- 1786233 TI - Neurological soft signs in schizophrenia. AB - A new scale for neurological soft signs (NSS) was constructed and consists of 17 items compiled from the literature. The scale was found to have a high internal reliability (Cronbach's alpha 0.83) and a high interrater reliability (0.88). According to the results of a factor analysis, NSS are covered by five factors: 'motor coordination', 'integrative functions', 'complex motor tasks', 'righ/left and spatial orientation' and 'hard signs'. Using this scale, the associations of NSS with clinical course and brain alterations were investigated. NSS varied with the clinical course and were significantly correlated with some BPRS subscales, in particular 'thought disorder'. In addition, the 'motor coordination' soft signs were found to correlate with morphological alterations in the basal ganglia. PMID- 1786234 TI - Neuropsychological probes of fronto-limbic system dysfunction in schizophrenia. Olfactory identification and Wisconsin Card Sorting performance. AB - Schizophrenic patients and normal control subjects took the University of Pennsylvania Smell Identification Test (UPSIT) and Wisconsin Card Sorting Test (WCST) as dual neuropsychological 'probes' of orbitofrontal (OF) and dorsolateral (DL) prefrontal function respectively. Patients were significantly impaired on both tasks compared to controls. UPSIT and WCST performance were uncorrelated in patients but were positively correlated in controls. The lack of correlation found in the patients suggests that the tasks may be tapping independent dysfunctions in schizophrenia reflecting differential impairment in fronto-limbic brain systems. Individual profiles of preserved and impaired performance on the UPSIT and WCST suggested that three schizophrenic patients had OF dysfunction, five had DL dysfunction and seven had a generalized (OF and DL) frontal system dysfunction. The reduced ability of schizophrenic patients to identify odors was largely independent of many deficits or confounds typically associated with schizophrenia and did not appear to be simply a function of generalized deficit. These data are preliminary and require replication with larger samples and validation with other measures of fronto-limbic system dysfunction. PMID- 1786235 TI - The role of head movement and pinnae in auditory localization in schizophrenia and psychosis. AB - This experiment examined the hypothesis that schizophrenics are less able than normals to make use of information concerning self movement when performing auditory localization tasks, and, therefore apply an alternative localization strategy, probably involving use of the pinnae. In this study three groups (healthy controls, schizophreniform patients and chronic schizophrenics) were compared in four experimental conditions: (1) head-movement and free pinnae; (2) static head and free pinnae; (3) head movement and covered pinnae; and (4) static head and covered pinnae. All subjects perform better with head movement than without it, with pinnae than with covered ones. Schizophreniform patients were affected more than normals by pinnae covering. This difference did not reach significance when normals were compared with chronic schizophrenics. A pronounced susceptibility to pinnae manipulation, correlated with medication level, appeared in the combined patient group in the moving condition. It was suggested that schizophreniform subjects, as compared to healthy controls are more depended on pinnae generated information for auditory localization and less able to compensate for its absence with movement generated information. The possibility that the effect is related to psychosis as such, rather than to schizophrenia in particular, was considered. PMID- 1786236 TI - The assessment of schizotypal features over two points in time. AB - The expression of schizotypal personality traits was assessed in mid-adolescence and again in young adulthood for three groups of offspring defined by the psychiatric diagnosis of their parents. Parental diagnoses included schizophrenic disorder (47 offspring), affective disorder (39 offspring), and 'no psychiatric disorder', or normal controls (82 offspring). Initially, schizotypal traits were assessed from video-taped semi-structured psychiatric interviews, subsequently rated by trained psychiatrists blind to the parental psychiatric status of the subjects, and/or direct clinical interviews (Schedule for Affective Disorders Lifetime Version (SADS-L)). The second assessment was conducted by trained social workers and psychologists by means of a semi-structured interview specifically for DSM-III-R personality disorders (Personality Disorder Examination) and sections of the SDS-L where indicated. These interviewers were blind to the parental status and to previous psychiatric assessments of the offspring. The rates of stability of features or the rates of progression to axis I psychotic disorders (Schizophrenia, Schizoaffective Disorder, and Unspecified Functional Psychosis) were evaluated. Concordance of assessments over time is reported as a function of threshold for expression of traits at initial evaluation, i.e., two or more, three or more, or four or more features present. Concordance increases as the threshold for expression increases, as expected. The effect of comorbid clinical status, e.g., the coexistence of schizotypal traits and anxiety and/or depressive features on the concordance pattern, is also examined by parental diagnostic group status. The offspring of affective disorder parents exhibited higher rates of anxiety and/or depressive features at both points in time, exhibited higher concordance for anxiety and/or depressive features, and exhibited higher rates of 'transformation' of initial schizotypal features to anxiety and/or depressive features at the second assessment. PMID- 1786237 TI - Coping style of schizophrenic patients in the recovery from acute psychotic state. PMID- 1786238 TI - P300 in first degree relatives of schizophrenics. AB - It has been reported that the amplitude of P300 is low in schizophrenic patients and high risk children. We recorded P300 components of the event-related potentials in first degree relatives of schizophrenic propositi who were considered to be over the age limit of the risk period for manifestation of schizophrenia and compared them with those of schizophrenic patients and controls. Both the first degree relatives and the schizophrenic patients showed lower P300 amplitude than the controls. There was no significant difference between the first degree relatives and schizophrenic patients in the P300 amplitude. These results would indicate that a low P300 amplitude is a trait marker for schizophrenia. PMID- 1786239 TI - Festschrift in honor of the 75th birthday of Dr. Leo Vroman: Part 2. PMID- 1786240 TI - One more world of Leo Vroman. PMID- 1786241 TI - Off into a thinning fog. PMID- 1786242 TI - Vessel wall proteins adhesive for platelets. AB - Platelet adhesion to the vessel wall is the first step in the development of a haemostatic plug or thrombus. In vitro studies of platelet adhesion in flowing blood have become possible due to the development of suitable perfusion chambers. With the use of such chambers, adhesion to subendothelium and to isolated connective tissue components from the vessel wall has been realized. Such studies have begun to shed light on the molecular basis of the adhesion process. Von Willebrand factor (vWF), fibronectin, and collagen types I and III have been shown to be the most important adhesive proteins. The functional domains involved in vWF and fibronectin are being identified and the platelet receptors for these ligands have been established. A complicated picture of multiple mutually supportive ligand-receptor interactions has emerged. These insights are critical for the development of thrombo-resistant biomaterials. PMID- 1786243 TI - Measurement of fibrinogen adsorption from blood plasma using 125I-fibrinogen and a direct ELISA technique. AB - A direct enzyme-linked immunosorbent assay (ELISA), using a polyclonal anti fibrinogen conjugated to horseradish peroxidase, was used to detect fibrinogen adsorption from blood plasma to ten different materials. Adsorption was also measured with [125I]-fibrinogen. The materials studied included glass, Biomer, Immulon I, and a series of hydroxyethylmethacrylate (HEMA) and ethylmethacrylate (EMA) co-polymers. For all the materials studied, the results from the ELISA technique closely paralleled those obtained using [125I]-fibrinogen. The cross reactivity of the antibody with proteins other than fibrinogen was generally small. Both experimental methods detected the presence of a maximum in fibrinogen adsorption (as a function of the plasma dilution) to the more hydrophobic materials. For all but two HEMA/EMA co-polymers, a linear correlation between the ELISA and [125I]-fibronogen measurements was indicated by inspection of cross plots as well as by a statistical test. PMID- 1786244 TI - Protein adsorption from plasma onto poly(n-alkyl methacrylate) surfaces. AB - Protein adsorption of human serum albumin (HSA), human fibrinogen (Fg), human immunoglobulin G (IgG), high density lipoprotein (HDL) and high molecular weight kininogen (HMWK) from plasma onto poly (n-alkyl methacrylate) (PAMA) surfaces was measured using a semi-quantitative enzyme-immunoassay. Adsorption was investigated for PAMA(n = 1) (n is the number of C-atoms in the n-alkyl side chain), PAMA(n = 8) and PAMA(n = 18). PAMA(n = 1) has a relatively hydrophilic surface as compared to the more hydrophobic PAMA(n = 8) surface. Both polymers have surface chains which do not reorient after contact with water. The PAMA(n = 18) surface is relatively hydrophobic but in this case polymer surface chains and segments are able to reorient after contact with water. Protein adsorption was measured both as a function of time and as a function of the plasma dilution. If adsorption from plasma was measured as a function of time no exchange of proteins could be observed. The amount of adsorbed protein was always larger in the case of the hydrophobic PAMA(n = 8) as compared to PAMAS(n = 1 and 18), probably due to hydrophobic interactions between the proteins and the PAMA(n = 8) surface. At high plasma concentration relatively large amounts of HDL adsorb onto PAMA(n = 8), indicating that this lipoprotein preferentially adsorbs onto this surface. PMID- 1786245 TI - 'Lens-on-surface': a versatile method for the investigation of plasma protein exchange reactions on solid surfaces. AB - The exchange sequence of plasma proteins in narrow spaces on solid surfaces was studied by means of a modified 'lens-on-surface' method as originally described by Vroman and Adams. In our studies, lateral scanning ellipsometry was used as the detection method. With the use of antibodies it was demonstrated and confirmed that immunologically detectable plasma protein antigens appear and disappear in a time- and concentration-dependent sequence [IgG followed by fibrinogen followed by high-molecular weight kininogen (HMWK)] on silica surfaces. Plasma protein exchange reactions were also studied on hydrophilic titanium (Ti), vanadium (V), and silver (Ag) surfaces. Atypical exchange patterns were found on V and Ag surfaces as compared with hydrophilic silica (adsorbed fibrinogen was not removed). PMID- 1786246 TI - Analogies in the two-dimensional spatial arrangement of adsorbed proteins and adhering bacteria: bovine serum albumin and Streptococcus sanguis 12. AB - Neither proteins nor bacteria adsorb or adhere homogeneously to a substratum surface. The final two-dimensional spatial arrangement depends on a complicated interplay between protein-protein (bacterium-bacterium) and protein (bacterium) substratum interactions and the prevailing hydrodynamic conditions. In this paper, results are presented of two separate experiments in which bovine serum albumin (BSA) was adsorbed to, or Streptococcus sanguis 12 was deposited on substrata with different wettabilities in a search for analogies in the two dimensional spatial arrangement of the absorbed proteins and adhering bacteria. The spatial arrangement of adsorbed BSA, visualized by transmission electron microscopy on replicas of the surface, was island-like on substrata with a low wettability and well distributed on substrata with a high wettability. The spatial arrangement of adhering S. sanguis 12 was observed directly by light microscopy during the experiment and showed a relatively large collection of near neighbour sites on the low wettability substrata compared with the high wettability substrata. Thus, it seems that the occurrence of island-like structures in protein adsorption is concurrent with a large collection of near neighbour sites in bacterial adhesion. As a possible explanation for the above analogy, it is suggested that proteins or bacteria are insufficiently immobilized on low wettability substrata owing to weak interaction forces, and they can move over the substratum surface to yield the two-dimensional spatial arrangements observed. PMID- 1786247 TI - Is the Vroman effect of importance in the interaction of blood with artificial materials? AB - The successive displacement of plasma proteins adsorbed to artificial surfaces (biomaterials) is well documented, mostly by specially designed experiments that stretch out the effect in time and space. Analysis of displacement has been focused principally on molecular events on the adsorbing surface. In this paper attention is directed rather to the antecedent transport phenomena necessary to deliver successive proteins to a surface. The different limitations on protein arrival fixed by the total quantity present and by the rates of transport of super-sufficient quantities are distinguished. The transport perspective is then used to ask, and partly answer, the question: Can protein displacement be responsible for patterns of thrombus formation and cellular adhesion that are seen on the blood-wetted surfaces of devices found in medical practice: artificial organs and vascular prostheses? Calculations and a small amount of preliminary data suggest that such patterns may form when blood is introduced into these devices, particularly in the neighborhood of boundary shapes that cause separated flows. PMID- 1786248 TI - Three morphological types of the genus Metagonimus encysted in the dace, Tribolodon taczanowskii, caught from the Sumjin River. AB - Three morphological types of the genus Metagonimus were found encysted in the dace, Tribolodon taczanowskii, caught from the Sumjin River, Korea. They include Metagonimus Yokogawa type (M. yokogawai), Miyata type, and Koga type according to Saito's classification. The metacercariae were experimentally fed to rats and hamsters and a total of 1,624 Metagonimus worms were recovered from their small intestine. The number of each type was 820 for Yokogawa type, 688 for Miyata type, 46 for Koga type, and 70 undetermined. The major differential keys between Yokogawa and Miyata types were in the position of two testes, distribution of uterine tubules, and size of the eggs, and the keys between Miyata and Koga types were in the position of two testes, distribution of vitelline follicles, and size of the eggs. The validity of Miyata type as a specific level should be retained until more convincing evidences are obtained. Koga type is regarded as a synonym of M. takahashii. The present results reveal that there are 3 morphological types of Metagonimus whose larvae are encysted in the dace, T. taczanowskii, from the Sumjin River. PMID- 1786249 TI - [Trematode infections in the small intestine of Egretta alba modesta in Kangwon do]. AB - We surveyed 12 migrating large egrets, Egretta alba modesta, for their infection status with intestinal trematodes, from June to September, 1990. All of them were infected with one or more flukes. Total 5 species were identified. Their infection rates and total numbers of worms were Metagonimus sp. 67% and 1,412, Centrocestus armatus 67% and 2,306, Echinochasmus japonicus 50% and 99, Strigea falconis 83% and 635, and a diplostomid fluke 33% and 36. The number of worms in a bird was in the range from 6 to 896. This is the first record that the egret is a reservoir host of Metagonimus sp., C. armatus, E. japonicus, and S. falconis. S. falconis is a new parasite fauna in Korea. Migrating birds must play an important role in the transmission and spreading of these intestinal trematodes in Korea. PMID- 1786250 TI - [Prevalence of Enterobius vermicularis infection and preventive effects of mass treatment among children in rural and urban areas, and children in orphanages]. AB - An epidemiological study and mass treatments of Enterobius vermicularis infection among children near Wonju area of Kangwon province were carried out. The children were divided into 4 groups according to their residing localities; children in the mountainous area, rural area, urban area and in orphanage. They were examined by adhesive cellotape anal swab technique, and egg positive rates were obtained. The rates of egg reduction and re-infection rates after repeated mass treatments were also observed. The results obtained were as follows: 1. The overall egg positive rate of E. vermicularis in the first screening was 19.9% (251 out of 1,262 examinees; 19.7% in males and 20.1% in females). The positive rates were 13.0% in the mountainous area, 11.9% in the rural area, 15.1% in the urban (medium-sized) area and 61.9% in orphanages. 2. The highest positive rates were observed in the kindergarten children, and 1st and 2nd grade children of primary schools (26.2-32.2%), and the lowest rate (13.6%) in 6-year grade children of primary schools. 3. Cumulative detection rates from 3 repeated anal swabs at 4-5 days interval were higher (70.8%) than those from single anal swabs (50.0-59.2%). 4. Out of the examinees who showed the highest cumulative positive rate (70.8%), about 39.2% were consecutively positive in 3 anal swabs. Among different groups of children, the higher the total egg detection rates (87.5%), the higher the consecutive positive rates (71.9%). 5. A total of 2,609 (male: female = 1:12.4) worms were collected from 17 egg-positive cases treated with anthelmintics. The mean number of worms per child was 153 (range: 4-824).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786252 TI - Purification and characterization of a Cu, Zn-superoxide dismutase from adult Paragonimus westermani. AB - In cytosolic fraction of adult Paragonimus westermani, superoxide dismutase activity was identified (4.3 units/mg of specific activity) using a xanthine xanthine oxidase system. The enzyme was purified 150 fold in its activity using the ammonium sulfate precipitation, DEAE-Trisacryl M anion-exchange chromatography and Sephadex G-100 molecular sieve chromatography. The enzyme exhibited the enhanced activity at pH 10.0. The enzyme activity totally disappeared in 1.0mM cyanide while it remained 77.8% even in 10 mM azide. These findings indicated that the enzyme was Cu, Zn-SOD type. Molecular mass of the enzyme was estimated to be 34 kDa by gel filtration and 17 kDa on reducing SDS polyacrylamide gel electrophoresis which indicated a dimer protein. PMID- 1786253 TI - [Natural killer cell activity in Naegleria fowleri infected mice]. AB - The natural killer (NK) cell activity of splenocytes and recycling capacity of NK cells were observed by combining the 51Cr-release cytotoxicity assay and single cell cytotoxicity assay against YAC-1. The ICR mice were infected intranasally with Naegleria fowleri, that is a pathogenic free-living amoeba. The mice infected with 1 x 10(5) trophozoites showed mortality rate of 76.7% and mean survival time of 12.9 days. The cytotoxic activity of NK cells in infected mice was significantly higher than that of non-infected mice during the period between 12 hours and day 3 after infection, and highest on day 1. The target-binding capacity of NK cells in infected mice was not different from that of non-infected ones. Maximal killing potential and maximal recycling capacity were remarkably increased in infected mice as compared with the control. The results obtained in this observation indicated that elevated NK cell activity in mice infected with N. fowleri was not due to target-binding capacity of NK cells but due to the increased activity of NK cells and increased recycling capacity of individual NK cells. PMID- 1786251 TI - [Antigenic localities in the tissues of Metagonimus yokogawai observed by immunogoldlabeling method]. AB - In order to determine the antigenic localization in the tissues of the adult Metagonimus yokogawai, immunogoldlabeling method was applied using serum immunoglobulins(IgG) of cats which were infected with isolated metacercariae from Plecoglossus altivelis. The sectioned worm tissue was embedded in Lowicryl HM 20 medium and stained with infected serum IgG and protein A gold complex(particle size: 12 nm). It was observed by electron microscopy at each tissue of the worm. The gold particles were observed on the tegumental syncytium as well as cytoplasm of tegumental cells and epithelial lamella of the caecum. The gold particles were not observed on the basal lamina of the tegument, interstitial matrix of the parenchyma, the muscle tissue and mitochondria of the tegument. The gold particles were specifically labeled in the secretory granules in the vitelline cells. They were also labeled on the lumen of bladder and egg shell. The above findings showed that antigenic materials in the tissue of adult worms were specifically concentrated on the tegumental syncytium as well as cytoplasm of tegumental cells and epithelial lamella of the caecum. PMID- 1786254 TI - [Effects of immunoactivity on Ascaris suum infection in mice]. AB - The immune response to sheep red blood cell (sRBC) was monitored in the mice infected with Ascaris suum or Trichinella spiralis. The effects of the infection with T. spiralis or the injection with cyclophosphamide(CY) as an immunosuppression agent prior to challenge infection with the embryonated eggs of A. suum were monitored in mice by means of the level of infection with A. suum and cellular and humoral immune response to sRBC. Following the oral administration of 1,000 eggs of A. suum to mice, delayed-type hypersensitivity (DTH) and rosette-forming rate were gradually decreased and reached to the lowest levels at the 5th week and 6th week postinfection, respectively, and then returned to normal at the 10th week. The hemagglutinin(HA) and hemolysin(HE) titers were gradually elevated and reached to peak at the 3rd week postinfection, and then returned to normal level. The appearance ratios of the eosinophils and mast cells were in peak at the 4th week and the 2nd week postinfection, respectively. Meanwhile the harvest ratio of A. suum larvae from the liver and lungs was 21.97% at the 1st week postinfection. Following the oral administration of 300 T. spiralis infective larvae, DTH and rosette-forming rate were gradually decreased with the lapse of time and reached the lowest values in the 30th and 21st day of postinfection, and then slightly increased and transiently decreased in the 70th and 80th day of postinfection, respectively. HA and HE titers were the lowest in the 21st and 90th day, whereas the ratios of eosinophils and mast cells were the highest on the 40th and 14th day postinfection, respectively. Following the intraperitoneal injection of CY, the body weight, the spleen weight, DTH, rosette-forming ratio, HA and HE titers, the number of WBC and the ratio of the mast cell were predominantly decreased in the 5th day, and then returned to the same value of the 1st day postinjection. The ratio of eosinophils was gradually decreased following to advance of days. At the 1st, 5th and 10th days after intraperitoneal injection of CY of 400 mg/kg, a dose with 1,000 eggs of A. suum was administered orally to mice, and harvest rate of the larvae at the 7th day postadministration was 7.07% in the 1st day, 14.94% in the 5th day, 10.1% in the 10th day, 8.02% in control group. The effect of prior infection with infective larvae of T. spiralis upon immunological sequelae of a challenge infection of mice with embryonated eggs of A. suum in 30 or 70 days interval was checked.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1786255 TI - Analysis of Clonorchis sinensis antigens and diagnosis of clonorchiasis using monoclonal antibodies. AB - Clonorchis sinensis is a common parasite of man in Korea. Researches on the specific antigens of C. sinensis would be valuable not only because those elucidate the molecular characteristics of this fluke but also because it is applicable to immunodiagnosis. Although many monoclonal antibodies have been used in the field of parasite immunology, few articles on monoclonal antibodies against C. sinensis have been published so far. The aim of this study was to analyze C. sinensis antigens recognized by monoclonal antibodies, and to set up ELISA-inhibition test using C. sinensis specific monoclonal antibodies for improved specificity of immunodiagnostic tests. By fusion between spleen cells of the mice immunized with C. sinensis water-soluble crude adult worm antigens and plasmacytoma cells of mouse origin, 29 hybridoma clones secreting anti-C. sinensis monoclonal antibodies were made, and 8 clones among those were found specific. After cell cloning, isotypes of 6 selected specific monoclonal antibodies were determined to be IgG1, IgG2b and IgA. Four exposed antigenic determinants of natural infection were recognized by different specific monoclonal antibodies. By enzyme-immunoelectrotransfer blot, 10 KD, 34 KD antigenic determinants were found to be reacted with CsHyb 0714-20, CsHyb 0605-10 monoclonal antibodies, respectively. The antigenic determinant recognized by CsHyb 0714-20 monoclonal antibody was revealed to be located at the surface and parenchyme of a parasite by indirect immunofluorescent antibody technique, and those reacted with CsHyb 0605-10, CsHyb 0714-25 monoclonal antibodies were found at the parenchyme and intestine. The antigenic determinant reacted with CsHyb 0605-23 monoclonal antibody was found mainly around the uterine eggs. Four antigenic determinants recognized by specific monoclonal antibodies were all found to be present in the early eluted fractions of C. sinensis antigens separated by Sephadex G-200 gel filtration. By conventional ELISA, 75% of clonorchiasis cases were found positive, but 7.1% of normal controls and 37.5% of paragonimiasis cases showed false positives. However, by ELISA-inhibition test using C. sinensis specific monoclonal antibody (CsHyb 0605-23), 77.1% of clonorchiasis cases were found positive, and there were no false positives in normal controls or paragonimiasis cases, indicating 100% specificity.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1786256 TI - [Infection status of Pseudorasbora parva collected from the Sunam stream with metacercariae of Metorchis orientalis]. AB - This study revealed the infection status of P. parva with the metacercariae of M. orientalis in the Sunam stream of the Nakdong River, a well-known focus of Clonorchis sinensis. A total of 60 P. parva were divided into 4 groups by the size (80-90, 70-79, 60-69 and 50-59 mm) and were digested by pepsin-HCl solution in a 36 degrees C incubator. The metacercariae of M. orientalis were collected and counted under a stereomicroscope. A total of 3,885 metacercariae were found, and average number/fish in each group were 143, 54, 23 and 40. They were 175.3 x 155.4 microns in average size and had thick cyst wall(13.1 microns in average). By the results, it is proved that the life cycle of M. orientalis is actively maintained in the Sunam stream of the Nakdong River. PMID- 1786257 TI - Chronic pain in the aged: possible relation between neurogenesis, involution and pathophysiology in adult sensory ganglia. AB - Certain neuropathic pain states, including postherpetic neuralgia and trigeminal neuralgia, show a dramatically increased incidence in the aged. Two recent experimental observations, unrelated a priori, might provide insight into why this is so. The first observation appeared unexpectedly during the course of a quantitative morphometric study aimed at determining the kinetics of retrograde cell death in dorsal root ganglia (DRGs) of adult male rats after nerve injury. Although the expected falloff in the ratio of neurons on the operated side versus the contralateral intact side was confirmed, much of the change resulted from an increase in the number of cells on the intact side. DRG cell counts were then carried out in intact, unoperated rats of various ages, and an increase in neuronal populations with age and size was confirmed. However, as the rats entered "old age" (greater than 400 days of age), proliferation ceased and there was an indication of secondary cell loss (involution). This is consistent with other data on DRG involution in the aged. The second observation is that regressive changes in DRGs following nerve injury are associated with enhanced generation of ectopic impulse discharge in the DRG, and potentiated cross excitation among neighboring DRG neurons. It is likely that these post-injury changes in DRG electrogenesis contribute to the neuropathic sensory abnormalities, including chronic pain, that are associated with traumatic nerve injury. Considering both observations together, it is possible that DRG involution in the aged triggers electrical changes in the DRG resembling those associated with DRG involution following nerve injury. If so, this process could account for the special susceptibility of elderly patients to certain neuropathic pain states. PMID- 1786258 TI - Superoxide dismutase activity is not affected by closed head injury in rats. AB - Superoxide anion radicals are generated in association with prostaglandin production, and are implied in the mediation of secondary brain damage following cerebral ischemia or injury. In a model of closed head injury in rats we have demonstrated the activation of phospholipase A2 (PLA2) and the increased production of eicosanoids in the post-trauma period. In the present study we investigated the role of superoxide dismutase (SOD) in this model. Head trauma was induced over the left cerebral hemisphere of ether anesthetized rats by a calibrated weight drop device. Cortical tissue samples were taken 15 min, 4 and 24 h later. SOD activity was assayed by its ability to inhibit the xanthine oxidase-cytochrome c reduction. There was no significant change in SOD activity in any of the regions studied - the site of injury, and contralateral region as well as the remote frontal lobes of both hemispheres. Although intense PLA2 activity and production of eicosanoids was previously found in some of these regions, activity of SOD was unaffected. These results do not support an important role for endogenous SOD up to 24 h after head injury. PMID- 1786259 TI - Sympathetically-maintained causalgiform disorders in a model for neuropathic pain: a review. AB - Partial nerve injury is the main cause of sympathetically maintained causalgiform pain disorders in humans. We present here an animal model of this condition, produced in rats by a unilateral ligation of about half of the sciatic nerve. Starting hours after the operation and for several months thereafter, the rats developed signs of spontaneous pain, touch-evoked allodynia and hyperesthesia, and mechanical and thermal hyperalgesia in the partially denervated as well as the intact contralateral foot. These disorders were maintained by the sympathetic outflow and disappeared following postoperative sympathectomy. In neonatally capsaicinated rats we found that touch-evoked allodynia and hyperesthesia were mediated by A-fibers whereas thermal hyperalgesia was mediated by C-fibers. These disorders were not due to receptor sensitization of remaining afferent fibers by prostaglandins. We found strain differences and genetic inheritance of these causalgiform disorders which were correlated with the expression of autotomy to hind-paw denervation. PMID- 1786260 TI - Discrimination of complex electrical stimulation through a multichannel intracochlear implant. AB - A model has been developed to describe the electric fields generated in the inner ear when electrical stimuli are presented through a multichannel implant in the scala tympani of the cochlea. The model relies on the hypothesis that stimuli which excite the largest number of neural elements provide the greatest probability of successful discrimination by the implanted subject. It suggests that the effective stimulus is determined by the linear combination of electrical fields produced by the individual channels, and that excitation takes place in a spatially restricted area of the auditory nerve in the vicinity of the stimulating electrodes. The model was tested by biophysical measurements of the potential developed in the stimulated cochlea, and by a psychophysical study of the ability of a monkey to discriminate complex electrical signals using dual channel stimulation. The experimental findings are in agreement with the computer simulations. PMID- 1786261 TI - Clinical use of CT and MR scans in psychiatric patients. AB - During a three-year period, 337 CT or MR scans were ordered for psychiatric patients in a teaching hospital. Scans were normal in 185 instances, equivocal in 34, and abnormal in 118 instances. When a history of neurologic disorder and/or the presence of abnormal neurologic/organic mental signs was positive, scans were abnormal in 74% of cases; when these indicators were negative, scans were normal in 72% of cases. In all, only 4 new diagnoses were made. Two patients, both with markedly abnormal neurological findings, were shown to have brain tumors, which changed their management. Two others showed abnormalities which would have been missed, both of which were of no clinical consequence. The following are suggested as sound indications for ordering CT or MR brain imaging among psychiatric patients: 1) positive history of head injury, stroke or other neurologic disease, as well as suspected Alzheimer disease or multi-infarct dementia; 2) presence of abnormal neurologic signs or organic mental signs, such as confusion or cognitive decline; and, 3) a first psychotic break or personality change after the age of 50 years. PMID- 1786262 TI - Clonidine as a sensitizing agent in the forced swimming test for revealing antidepressant activity. AB - The forced swimming test (FST) in mice has failed to predict antidepressant activity for drugs having beta adrenoreceptor agonist activity and for serotonin uptake inhibitors. We investigated the potential for clonidine to render the FST sensitive to antidepressants by using a behaviorally inactive dose of this agent (0.1 mg/kg). All antidepressants studied (tricyclics, 5-HT uptake inhibitors, iprindole, mianserin, viloxazine, trazodone) showed either activity at lower doses or activity at previously inactive doses. The effect appeared specific because it did not appear with drugs other than antidepressants (diazepam, chlorpromazine, sulpiride, atropine), except for amphetamine and apomorphine which have a strong effect on the dopaminergic system. The use of behaviorally subactive doses of clonidine may thus provide an important means of increasing the sensitivity of the forced swimming test. PMID- 1786263 TI - Eating disorder symptoms in affective disorder. AB - Patients with Major Affective Disorder (MAD), Secondary Depression, Panic Disorder, and bulimia with and without MAD, were given the Eating Disorder Inventory, the Beck Depression Inventory, and the General Behavior Inventory at presentation. It was found that patients with MAD have a triad of eating disorder symptoms: a disturbance in interoceptive awareness, the sense of ineffectiveness, and a tendency toward bulimia. The data supported the concept that the sense of ineffectiveness is secondary to major depression. A disturbance in interoceptive awareness exists independently in bulimia nervosa and in MAD providing a common diathesis from which bulimia may arise given family and social pressure. Bulimics with MAD do not respond to treatment as readily as those without MAD. It is recomended that these two groups be treated separately. PMID- 1786264 TI - Auditory evoked potentials in panic disorder. AB - Neuroimaging studies of behavioral-induced anxiety in non-patients and of lactate induced anxiety in panic disorder patients have indicated that normal and pathological anxiety may share a common pathway involving the temporal poles. As panic-related anxiety may reflect faulty temporopolar evaluative processing of input, the objective of this study was to examine sensory reactivity in panic disorder patients via scalp recordings of the late auditory evoked 'vertex' potential (LAEP) which appears to have a predominantly temporal lobe origin. Twelve patients diagnosed according to DSM-III criteria as panic disorder and ten normal controls served as subjects in this study. EEG was recorded from 16 scalp sites using a monopolar fronto-occipital derivation and LAEPs were separately averaged in response to four acoustic intensities. Analysis focused on group and electrode-site differences in the negative (N1) and positive (P2) component amplitudes of the LAEPs. Panic disorder patients were found to exhibit significantly larger N1 amplitudes across all stimulus intensities and across all recording sites. No significant group differences were observed with P2. Although the results provide indirect support for a temporal focus, other modulating influences must be considered in data interpretation. PMID- 1786265 TI - Comparison between cholinergically and naturally induced ultrasonic vocalization in the rat. AB - Ultrasonic vocalization in rats accompanying stressful situations or induced by direct brain stimulation may be used as a measure of emotionality and as a potential response model for testing anti-anxiety agents. The aim of the present study was to compare physical features of pharmacologically-induced ultrasonic vocalization with naturally triggered vocalization. Ultrasonic calls induced by hand touch, footshock, or by direct intracerebral injection of carbachol in adult rats were compared. Ultrasonic calls obtained in all these situations were described as '22 kHz' vocalization. Average frequencies of vocalization were 24.1 +/- 0.78 kHz, 26.0 +/- 2.64 kHz and 25.0 +/- 1.87 (SD) kHz for handled, footshocked and carbachol injected rats, respectively, and they did not differ significantly from each other. Histograms of single call duration showed similar distribution patterns for all groups with a predominance of long calls, although carbachol-induced calls were shorter than calls induced by touch or footshock. Histograms for inter-call intervals showed one major peak at 100-150 ms for all groups. Sonograms and power spectra showed similar characteristics both for calls induced by intracerebral carbachol and by hand touch or footshock. The results indicate that physical features of ultrasonic vocalization induced by intracerebral carbachol are comparable with those for naturally induced vocalization and fall into the category of '22 kHz' calls. PMID- 1786266 TI - Rabbit syndrome, antidepressant use, and cerebral perfusion SPECT scan findings. AB - The rabbit syndrome is an extrapyramidal side effect associated with chronic neuroleptic therapy. Its occurrence in a patient being treated with imipramine is described, representing the first reported case of this syndrome in conjunction with antidepressants. Repeated cerebral perfusion SPECT scans revealed decreased basal ganglia perfusion while the movement disorder was present, and a return to normal perfusion when the rabbit syndrome resolved. PMID- 1786267 TI - HIV/AIDS risks, alcohol and illicit drug use among young adults in areas of high and low rates of HIV infection. AB - The results are presented of a survey of HIV/AIDS related risks amongst young adults in two urban areas in Scotland. This exercise elicited data from random samples of those aged 16-30 in Muirhouse and Easterhouse. Muirhouse has a high rate of HIV infection, mainly related to intravenous drug use. Easterhouse has a much lower rate of recorded HIV infection. A total of 1,378 individuals were successfully interviewed. Levels of knowledge about risks of HIV infection were relatively high. Even so levels of condom use were low. Respondents in Muirhouse reported high levels of personal knowledge of HIV infected people. In addition 8% of those in Muirhouse and 3% of those in Easterhouse reported having had sex with a person who was HIV infected. Few of such encounters had involved condom use. The combination of alcohol consumption and sexual activity was reported by 82% of respondents. Twelve per cent had combined sexual activity and illicit drug use. Overall patterns of self-reported HIV/AIDS related risks in the two study areas were very similar. PMID- 1786268 TI - Age and injecting drug use in Perth, Western Australia: the Australian national AIDS and injecting drug use study. AB - Young injecting drug users (IDUs) in Australia are a group about whom little is known. It is suggested, however, that their drug using behaviours and life styles put them at particular risk for HIV/AIDS. Data collected in Perth from 195 respondents in the Australian National AIDS and Injecting Drug Use Study was analyzed with emphasis on the distinctions between young and older injecting drug users. It was found that, relative to those aged 23 or over, IDUs under 23 used more stimulants and LSD and fewer opiates and benzodiazepines; were more likely to inject all or most of their drugs; were less likely to have been in treatment; had more sex partners; were less likely to have changed their drug taking behaviour because of AIDS; were less likely to use alone; shared needles less frequently but shared at least some of the time; and had less knowledge of AIDS and were more pessimistic about the long term outcomes of AIDS. Such characteristics need to be taken into account if effective intervention and prevention strategies for this group are planned. PMID- 1786270 TI - AIDS in Africa. PMID- 1786269 TI - HIV-1 associated cognitive/motor complex in an injecting drug user. AB - The clinical and social consequences of AIDS dementia complex/HIV-1 associated cognitive/motor complex (ADC/HACC) in drug users have not been well documented. The value of prospective serial neuropsychological, neuroradiological and neurophysiological measurements to assist diagnosis of ADC/HACC in patients with premorbid personality disorder and intercurrent drug use is demonstrated. The psychosocial problems resulting from ADC/HACC with respect to community care and the location of hospitalization is considered. The relevance of the 1984 Mental Health Act (Scotland) with regard to drug users with ADC/HACC is discussed. PMID- 1786271 TI - AIDS in Asia. PMID- 1786272 TI - AIDS as a development issue. PMID- 1786273 TI - Health care workers. PMID- 1786274 TI - Efficacy of psychological therapies for people with HIV disease. PMID- 1786275 TI - Psychosocial aspects of HIV infection. PMID- 1786276 TI - HIV testing, counselling and partner notification. PMID- 1786278 TI - Studies of behaviour in relation to HIV infection. PMID- 1786277 TI - Factors affecting information and education, and behaviour change. PMID- 1786279 TI - HIV infection in injecting drug users. PMID- 1786280 TI - AIDS: refugees and the homeless. PMID- 1786281 TI - AIDS and the popular media: a new perspective at Florence. PMID- 1786282 TI - Obstetric and gynaecological abstracts: a review. PMID- 1786283 TI - Clinical care and management. PMID- 1786284 TI - Neuroscience of HIV infection: basic and clinical frontiers. AB - Whilst this conference presented no new or exciting breakthroughs in our understanding of the psychosocial or neuropsychological aspects of HIV disease, there were some useful contributions to our knowledge in these areas. Previous work suggesting that HIV seropositive individuals with HIV are no more likely to suffer poor psychosocial adjustment than matched HIV-controls. However, where psychiatric disorders are seen, the most common are adjustment disorders followed by drug and alcohol abuse. Mania, whilst quite rare, may be more commonly seen with HIV than should be expected. People with asymptomatic HIV infection appear to be no more likely to show a cognitive deficit than matched HIV-individuals and this appears to be equally true for gay men, intra-venous drug users and people with haemophilia. However, as the disease progresses, neuropsychological impairment, or even dementia, may be seen and when this occurs the pattern of decline appears to be precipitous rather than insidious. PMID- 1786285 TI - World Health Organization Global AIDS Statistics. PMID- 1786286 TI - Functional and morphological changes in the hypothalamo-pituitary-gonadal axis of aged female rats. AB - Age-related functional and morphological alterations in the hypothalamo-pituitary gonadal axis were investigated in old recurrently pseudopregnant (RPP) female rats, and these alterations were compared with those in young diestrous rats. LHRH in the median eminence (ME) and mediobasal hypothalamus (MBH) as well as plasma FSH, LH, and progesterone were measured by RIA. LHRH in the lateral ME (LME) and pituitary FSH and LH were evaluated by morphometry and densitometrical immunocytochemistry. Furthermore, by light microscopy, we classified and counted the number of ovarian follicles and corpora lutea. LHRH concentrations in the ME and MBH were similar in old and young rats, whereas in old rats, plasma FSH was markedly increased, LH was moderately increased, and plasma progesterone was unchanged. The number and the total area and immunoreactivity of LHRH-labeled axon cross sections in the LME were reduced in old rats. The number of nucleated FSH-labeled cells and total FSH area and immunoreactivity were almost twice in old compared with young animals. The measurements of LH-labeled cells were not different between the two groups. In old rats, the numbers of ovarian follicles and corpora lutea were reduced and that of atretic follicles increased. In conclusion, age-related morphological impairments of LHRH axons associated with an increased number of FSH gonadotropes and higher plasma FSH in our old RPP rats suggest hypothalamic and pituitary disturbances, which may largely contribute to the complex hormonal disarrangement responsible for the decline of reproductive functions in old female rats. PMID- 1786287 TI - Expression of major histocompatibility complex antigens on the bovine corpus luteum during the estrous cycle, luteolysis, and early pregnancy. AB - Treatment of cultured bovine luteal cells with the cytokine, interferon-gamma, induces the expression of Class II major histocompatibility complex antigens (MHC Ags). To determine if Class II MHC Ags are present on the CL in vivo and if the degree of Ag expression changes during luteal life span, bovine corpora lutea were obtained on Day 6, Days 10-12, and Day 18 of the estrous cycle and MHC Ag expression was evaluated via indirect immunofluorescence. Flow cytometry was used to determine the percentage of MHC Ag-positive cells on cell populations distinguished by cell size and intracellular density. Minimal Class II MHC Ag expression was detected on Day 6 CL (approximately 25%), which consisted primarily of smaller cells. The midcycle and late CL consisted of these small cells (SC) and two populations of large cells that differed in intracellular density, or right-angle light scatter. In midcycle CL, few (less than 25%) SC or large, dense cells (LDC) expressed the Class II MHC Ag whereas a high percentage (75%) of the large, less-dense cells (LLDC) were Class II MHC Ag-positive. Class II MHC Ag expression remained negligible on the LDC of the Day 18 CL; however, there was an elevation in the percentage of SC and LLDC expressing Class II Ag (p less than 0.05). To determine if Class II MHC Ag expression also varied with different functional states of the CL, bovine CL were collected after prostaglandin (PG) F2 alpha-induced regression and on Day 18 of early pregnancy. When luteolysis was allowed to progress in vivo, the percentage of Class II MHC Ag-positive cells was increased in all cell populations (p less than 0.05). Class II MHC Ag expression was significantly lower (p less than 0.05) on the three cell populations comprising the CL of pregnancy as compared to the Day 18 cyclic CL. It is hypothesized that enhanced expression of Class II MHC Ags on the late CL and during PGF2 alpha-induced regression may potentiate immune response mechanisms for luteolysis. PMID- 1786288 TI - Stage-synchronized seminiferous epithelium in rats after manipulation of retinol levels. AB - Optimal conditions for obtaining stage-synchronization of the seminiferous epithelium were investigated. In this study, 147 rats were subjected to protocols in which vitamin A deficiency was induced by feeding a diet without retinol (R ol) or retinoic acid (RA), followed by maintenance on a diet containing RA and supplementation of R-ol by injection and diet. An acceptable degree of stage synchronization and recovery of the seminiferous epithelium was observed in 90 (61%) of the 147 rats. The effects on synchrony of variations in the protocol, including the degree of deficiency before RA maintenance, the dose and duration of RA maintenance, and the manner of injection of R-ol, were tested. Initiation of maintenance on RA when a medium degree of deficiency was achieved (4-12 g of weight loss, 3-6 days without growth) resulted in a more reliable (80% of the rats) induction of synchrony than did initiation of maintenance on RA at either a less (70% synchronized rats) or more severe (50-60% synchronized rats) deficiency. Maintenance on food containing 10 mg/kg RA gave better and more reliable synchrony (70%) than maintenance on food containing 5 mg/kg RA (less than 40%). Although the duration of this maintenance did not influence the degree of synchrony, the reliability was lower when maintenance was continued for a month or more (54%). During the interval from 33 to 128 days after resupplementation, the degree of synchronization decreased, as did the predictability of the stages, while the restoration of spermatogenesis increased. Linear regression, performed on the location of the median point of synchronization, indicated that spermatogenesis progressed at a rate of 12.4 days per cycle. The median stage of synchronization, predicted by this regression line, differed by an average of 8% of the cycle from the actual location in individual rats. Extrapolation of the regression line indicated that spermatogenesis was reinitiated in mid-to-late stage VII. PMID- 1786289 TI - Overcoming the 2-cell block by modifying standard components in a mouse embryo culture medium. AB - The 2-cell block may be caused by inappropriate concentrations of commonly used constituents of embryo culture media. Almost all zygotes obtained by fertilizing CF1 ova with hybrid B6D2F1/CrlBR sperm did not develop beyond the 2-cell stage when cultured in Whittingham's medium M16. This 2-cell block was overcome by lowering the concentrations of NaCl, KCl, KH2PO4, glucose, and pyruvate, either individually or in combination. The effects of changing the concentration of either NaCl or KCl depend on the concentration of NaHCO3 in the medium. Although a high percentage of embryos grew to the 4-cell stage in several media with lowered concentrations of certain components, the media are not optimal for complete preimplantation embryo development since the yield of blastocysts is low. PMID- 1786290 TI - Langerhans cells phagocytose vaginal epithelial cells undergoing apoptosis during the murine estrous cycle. AB - Langerhans' cells (LCs) have been studied extensively in the epidermis, where they function as antigen-presenting cells. LCs are also present in the stratified epithelia of the murine vagina and cervix, but their function at these sites is not known. Recent reports noted the association of LCs with vaginal epithelial cells undergoing apoptosis and suggested that LCs might be involved in phagocytosis of dead cells. The present study describes the ultrastructural details of this process. The results demonstrate that LCs in murine vaginal epithelium during late metestrus and early diestrus phagocytose apoptotic epithelial cells and may thereby contribute to the normal turnover of the vaginal epithelium during the estrous cycle. PMID- 1786291 TI - Antigen recognition in the female reproductive tract. II. Endocytosis of horseradish peroxidase by Langerhans cells in murine vaginal epithelium. AB - Previous studies have shown that dendritic cells in the murine vaginal epithelium at diestrus and metestrus can endocytose intravaginally administered soluble protein tracers, but the identity of the dendritic cells was not established. In the investigation reported here, we used a combination of histochemistry and transmission electron microscopy to study the endocytosis of exogenous horseradish peroxidase by vaginal dendritic cells and to identify these cells as Langerhans' cells on the basis of their cellular associations, ultrastructural morphology, and the presence of Langerhans' cell granules. PMID- 1786292 TI - Comparison of the steroidogenic response of luteinized granulosa cells from rhesus monkeys to luteinizing hormone and chorionic gonadotropin. AB - The dynamics of the steroidogenic response of nonprimate gonadal cells to gonadotropins suggests that the biologic action of pituitary LH differs from that of placental CG. To compare the response to LH and CG in primate species, luteinized granulosa cells (LGCs) obtained from rhesus monkeys following follicle stimulation were cultured in vitro. The pattern and levels of progesterone (P) produced during culture was influenced by the concentration (0-10%) and type (fetal bovine or macaque) of serum in the medium and whether LGCs were plated on plastic or extracellular matrix from bovine corneal endothelial cells. After 2-3 days of culture, LGCs were exposed acutely (15-30 min) or chronically (6 h) to 1 or 100 ng/ml human LH (hLH, NIH 1-2) or hCG (CR123), 50 micrograms/ml ovine LH (oLH, NIH-oLH-25), or incubated in the absence of gonadotropins (controls). After the first 15-30 min, the media were changed at 30-min intervals. Both acute and chronic exposure to hLH, hCG, and oLH increased (p less than 0.05) P concentrations above control levels within 15-30 min. There were no differences in the patterns or levels of P elicited by hLH or hCG over time for each treatment condition. Chronic exposure to 1 and 100 ng/ml hLH or hCG and 50 micrograms/ml oLH sustained P levels above that of controls for the 6-h interval. Acute exposure to 1 ng/ml hLH or hCG failed to maintain elevated P levels throughout the experiment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786293 TI - In vitro effects of progesterone and estradiol on uterine prostaglandin production in the pregnant rat. AB - Uterine prostaglandin (PG) levels increase markedly at the end of pregnancy in the rat and steroid hormones appear to be important regulators of this augmentation. The purpose of the present study was to examine the in vitro effects of progesterone (P) and estradiol (E2) on uterine PGE and PGF production in the pregnant rat. Uterine tissue was removed at Days 19 and 21 of pregnancy and incubated with P or E2 (0.1, 1, 10, 100, and 1,000 ng/ml) for 48 h in Ham's F 10 medium at 37 degrees C. P significantly (p less than 0.05) inhibited PGE and PGF production in a dose-dependent manner at Day 19, but not at Day 21 of pregnancy. In contrast, E2 had no effect (p greater than 0.05) at either day of pregnancy. In a second study, P was found to inhibit uterine PGE production at Days 15 and 19, but not at Day 21 or at delivery. A third study determined that the levels of P were greatly reduced in media containing uterine tissue from delivery when compared to media containing tissue from day 15 of pregnancy (p less than 0.05). In a fourth experiment, no difference in tritium-labeled P uptake was detected between media containing uterine tissue from Day 15 of pregnancy and media containing uterine tissue removed at delivery. This observation in association with data from the literature suggests that the disappearance of P from the media in experiment 3 might be due to enhanced P metabolism rather than to differential uptake of P by the tissue.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786294 TI - Changes in serum immunoreactive inhibin and follicle-stimulating hormone during gonadal development in male and female rats. AB - We have measured serum and ovarian immunoreactive inhibin alpha (irI alpha) and serum FSH in fetal and neonatal rats from 20 days of gestation until 40 days of age. For animals aged 10 days or older, serum measurements were made on intact and gonadectomized animals. Serum irI alpha was detectable in intact male and female rats at all ages studied. In females, irI alpha levels were low until Day 5 and then increased steadily to peak at Day 25. Thereafter they declined until Day 35 to reach levels typical of adult females. There was a significant decrease in irI alpha levels 24 h after ovariectomy at all ages. Serum FSH levels in females were low until Day 7, then increased rapidly to plateau from Days 10-15. The levels then declined until Day 25 and were generally unchanged after that time. There was a significant increase in FSH 24 h after ovariectomy in rats aged 20 days and older, and in younger rats by 48 h after ovariectomy. In male rats, serum irI alpha levels were significantly higher than females until Day 7. The levels increased at Day 7 and then remained relatively constant until Day 20, after which they declined to reach typical adult male levels. Serum irI alpha levels were significantly lower in males than females from Days 25-40. There was a significant decrease in serum irI alpha 24 h after castration at all ages studied. Serum FSH levels in males were low until Day 20, increased at Day 25, and thereafter remained relatively unchanged.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786295 TI - Preovulatory changes in glycosaminoglycans and collagen content in the stigma region of the follicle of the domestic hen. AB - The present study determined the amount and types of glycosaminoglycans and collagen concentrations in follicles of the domestic hen. The stigma (S; the area of follicular rupture) and nonstigma (NS) regions of the theca layer were isolated from the preovulatory follicle (F1) and an immature follicle (F2) that were to ovulate 30 min and 26 h later, respectively. Glycosaminoglycan density, which was estimated by measuring follicular uronic acid concentration (micrograms/mg dry wt), was lower (p less than 0.01) in F1S (2.6 +/- 0.1) compared to F1NS (3.4 +/- 0.2), F2S (3.4 +/- 0.1), and F2NS (3.4 +/- 0.1). Theca glycosaminoglycans consisted of approximately 58% dermatan sulfate, 20% heparan sulfate, and 22% hyaluronic acid. The F1S contained lower (p less than 0.05) amounts of dermatan sulfate and hyaluronic acid compared to F1NS, F2S, and F2NS. There was no significant difference in amounts of heparan sulfate in the F1S, F1NS, F2S, and F2NS. Collagen density, which was estimated by measuring follicular hydroxyproline concentrations (micrograms/mg dry wt), were lower (p less than 0.01) in F1S (20.3 +/- 1.4) and F2S (19.8 +/- 1.4) compared to F1NS (28.9 +/- 1.9) and F2NS (29.9 +/- 2.7). However, there was not a further decrease in collagen concentration in the F1S compared to F2S. We suggest that glycosaminoglycans may be degraded specifically in the stigma region of the preovulatory follicle prior to ovulation. The lower amount of collagen in the stigma region may decrease the tensile strength in the stigma compared to the nonstigma region regardless of maturational stage. PMID- 1786296 TI - Morphological and functional heterogeneity in the rat prostatic gland. AB - Ductal morphogenesis and adult ductal branching patterns were examined in the rat prostate by a microdissection method. The rat prostate consists of paired (right and left) subdivisions which correspond in large part to the classically defined lobes: ventral prostate, lateral prostate, dorsal prostate, and coagulating gland. Of particular interest was the finding that the lateral prostate consists of two different ductal zones: (1) lateral type 1 prostate with 5-7 long main ducts (resembling miniature palm trees) that extend cranially towards both the seminal vesicle and dorsal prostate to arborize near the bladder neck, and (2) lateral type 2 prostate with 5-6 short main ducts that arborize caudal to the bladder neck and give rise to compact bushy glands. Both lateral prostatic groups had a ductal-acinar organization. The adult structure of the other rat prostatic lobes was also examined, and closely resembled their mouse counterparts. The ventral prostate, which had 2-3 pairs of slender main ducts per side, and the coagulating gland, which had 1 main duct per side, was completely ductal in structure. In contrast, the dorsal prostate, which had 5-6 pairs of main ducts per side, had a ductal-acinar structure. Ductal branching morphogenesis occurred at different rates in different lobes and was essentially complete in the prostate at the 30 days. Immunocytochemical studies with an antibody to DP-1, a major secretory protein of the rat dorsal prostate, revealed that secretory function was initiated at approximately 30 days after birth in the coagulating gland, the dorsal prostate, and lateral type 1 prostate. A consistent feature of the lateral type 2 prostate was the absence of DP-1. On Western blots, DP-1 was detected in the secretion of the coagulating gland, lateral type 1 and dorsal prostate, but not in the ventral and lateral type 2 prostate. Polyacrylamide gel electrophoresis confirmed this result and demonstrated that the lateral type 2 prostate expressed several low-molecular weight secretory proteins not found in the other lobes of the prostate. On the whole, the rat prostate exhibited considerable heterogeneity both between and within lobes in developmental processes, ductal patterning, histology, and functional expression. PMID- 1786297 TI - Immunohistochemical localization of prostaglandin H synthase in the sheep placenta from early pregnancy to term. AB - Prostaglandin H synthase (PGHS) activity within intrauterine tissues is considered to catalyze a critical step in prostaglandin (PG) biosynthesis at parturition. In sheep, the placenta is a major site of PG production throughout pregnancy, but little information is available concerning the cells that are responsible. Therefore we determined the distribution of immunoreactive (IR-) PGHS in ovine placental tissue obtained at different times of pregnancy using immunohistochemical techniques. In placentomes from early pregnancy (Days 30-54), IR-PGHS was present in maternal epithelial syncytium, but was not detectable in trophoblast cells. Between Day 54 and Day 100, the number of cells that stained positive for PGHS declined in the maternal epithelial layer in the body of the placenta, but IR-PGHS was present in maternal epithelial cells overlying the vascular cones of the placental hemophagous zone. It was also present in the chorionic fibroblasts, but remained undetectable from all classes of trophoblast cells. IR-PGHS was first detectable in the trophoblastic epithelium by Day 114. Between Day 119 and term the trophoblast mononuclear epithelial cells were intensely immunopositive for PGHS, although immunonegative binucleate cells were present. The maternal epithelium was immunonegative except during the last 7-10 days of pregnancy when PGHS immunostaining appeared in both basal and apical regions of the placenta. Thus, the cellular localization of IR-PGHS changes during ovine pregnancy, from predominantly maternal during the first half of gestation to undetectable and then to predominantly trophoblastic between Day 114 and term, suggesting a gestation-dependent change in sites of PG production during ovine pregnancy. Appearance of IR-PGHS in the trophoblast precedes activation of the fetal hypothalamic-pituitary-adrenal axis, generally considered to provide the trigger to the onset of parturition in sheep, and would therefore appear to be regulated through alternative pathways or mechanisms. PMID- 1786298 TI - Protein secretion by the mouse blastocyst: differences in the polypeptide composition secreted into the blastocoel and medium. AB - To initiate studies on the protein microenvironment of the mouse blastocoel, we examined the electrophoretic profile of newly synthesized proteins secreted into the blastocoel, as well as those secreted into the medium. Although most polypeptides reveal no relative enrichment, some proteins (e.g., proteins of Mr = 155,000 and 33,000) are enriched in the blastocoel relative to those secreted apically into the medium. In addition, some proteins (e.g., proteins of Mr = 102,000 and 40,000) are enriched in the medium relative to the blastocoel. The relative amount of newly synthesized protein secreted into the blastocoel is about 2.5% of total protein synthesis. In addition, the trophectoderm and inner cell mass contribute to these proteins. Results of these studies suggest a potential function for these blastocoel-enriched proteins in inner cell mass development. PMID- 1786299 TI - Biological and immunoactive substances resembling chorionic gonadotropin are present in full-term horse and zebra placentas. AB - This study describes the presence of immunoactive and bioactive eCG-like material in full-term placentas of both domestic horses and zebras. Term placental extracts were immunoreactive in an LH monoclonal antibody RIA, and methods successfully used previously for the purification of eCG and eLH were employed to further concentrate the immunoreactive materials to the point where additional characterization studies could be performed. Sufficient equine material was obtained to perform a final fractionation on a concanavalin A Sepharose column yielding an unadsorbed fraction, e17A, and an adsorbed fraction, e17B. There was insufficient zebra material, z5D, for this step. HPLC gel filtration coupled with LH immunoassays of the column eluates showed all the final placental fractions to be highly heterogeneous, but a discrete peak of immunoactivity was found in one of the two equine fractions (e17B) and in the zebra fraction (z5D). The HPLC gel filtration elution volumes for e17B and z5D suggest that they have a smaller molecular size than either eCG or eLH but almost the same size as ovine LH. Both e17B and z5D were bioactive in the rat Leydig cell assay for LH but low in potency compared to eCG or eLH; e17A was inactive at very high doses (5 micrograms). This latter fraction, however, cross-reacted in an eCG alpha RIA to a much greater extent (6 times) than e17B, suggesting that it may be an incompletely formed or degraded alpha subunit. RIAs for LH, eCG, and eCG beta suggest that epitopes distinctive for these molecules are also present or similar to those in the term placental materials.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786300 TI - Different mechanisms are responsible for 3H-androgen movement across the rat seminiferous and epididymal epithelia in vivo. AB - Mechanisms involved in the maintenance of the microenvironment of the seminiferous and epididymal tubules were examined in a series of experiments utilizing in vivo microperifusion, microperfusion, and micropuncture. Intraluminal 3H-androgen concentrations in seminiferous tubules increased linearly as interstitial 3H-androgen concentrations increased from 10 nM to 2,000 nM, but in caput epididymidal tubules, intraluminal 3H-androgen concentrations increased hyperbolically across the same range of peritubular 3H-androgen concentrations. Intraluminal 3H-androgen concentrations in the caput epididymidis did not rise above approximately 340 nM even if peritibular 3H-androgen concentrations exceeded 2,000 nM. Perifusion of caput tubules with 0.1 mM dinitrophenol or potassium cyanide or 100 micrograms/ml cyclohexamide significantly reduced proluminal 3H-androgen movement, but tubules perifused with control medium would not support antigrade 3H-androgen movement in the absence of native lumen fluids which contain androgen-binding protein. Antigrade proluminal 3H-androgen movement was not inhibited by competition with estradiol at ten-times 3H-androgen concentrations. Thus, energy-requiring protein synthesis is necessary for antigrade 3H-androgen movement in the caput epididymidis, but the mechanism for the interaction of intracellular protein(s) and 3H-androgen movement remains undetermined. PMID- 1786301 TI - Catecholamines and uterine activity rhythms in the pregnant rhesus macaque. AB - This study was designed to examine the relationship between uterine contractile rhythms with maternal plasma and amniotic fluid catecholamine concentrations in the pregnant rhesus macaque. Six chronically catheterized rhesus macaques were maintained in a vest and tether system and exposed to a 12L:12D cycle. Continuous uterine activity recordings demonstrated a contractile pattern with peak activity at 2200 h (p less than 0.05). Paired maternal plasma and amniotic fluid samples were collected at 3-h intervals for 24 h between Days 131 and 148 of gestation. Samples were analyzed for norepinephrine, epinephrine, and dopamine by HPLC. Maximum plasma concentrations across the 24-h periods for norepinephrine (633 +/- 230; mean pg/ml +/- SEM) and dopamine (378 +/- 110) were observed at 2100 h and epinephrine (408 +/- 95) at 1200 h, but these values were not significant. The maximum amniotic fluid values were 378 +/- 126, 267 +/- 190, and 556 +/- 87 pg/ml for norepinephrine, epinephrine and dopamine, respectively. However, concentrations across 24 h did not differ. Neither maternal plasma nor amniotic fluid catecholamine concentrations were correlated with uterine activity rhythms. Therefore, we conclude that the nocturnal uterine activity in the rhesus macaque is not related to maternal arterial or amniotic fluid catecholamine concentrations. PMID- 1786302 TI - [Malignant hyperthermia--a systemic disease?]. PMID- 1786303 TI - [Malignant hyperthermia today]. AB - Besides offering a concise recapitulation of known facts, experiences and related viewpoints concerning malignant hyperthermia (MH), the present article offers a review of the most relevant new aspects in this field. Special emphasis is on genetics and pathogenesis of MH. The contents of the review are as follows: History; Definition of MH; Epidemiological aspects; Inheritance; Molecular genetics; Pathogenesis; Triggering agents; Awake Triggering; Sympathetic nervous system; Serotoninergic system; Involvement of other organs and cell systems; Clinical symptoms and diagnosis; MH and myopathies; Associated disorders; Treatment; Prophylaxis; Identification of susceptibility; MH testing centres in the FRG; Hot-line for MH emergencies PMID- 1786304 TI - [Malignant hyperthermia and inositol phosphate metabolism in the heart and skeletal musculature]. AB - There are recent reports that inositol phosphate metabolism is involved in the development of malignant hyperthermia (MH). Consequently, we investigated the basal concentration of inositol phosphate products in skeletal and heart muscles of malignant hyperthermia-susceptible (MHS) and healthy control (MHN) swine. Different inositol phosphates were measured by high pressure liquid chromatography, including inositol trisphosphate, tetrakisphosphate, pentakisphosphate and hexakisphosphate. All inositol phosphate products measured had a higher concentration in MHS than MHN in skeletal (304-1330%) as well as heart muscles (134-440%). An activation of the inositol phosphate metabolism has been shown to mobilise intracellular calcium from the sarcoplasmic reticulum. It is therefore concluded that, firstly, besides involvement of the skeletal muscles a primary myocardial abnormality in MHS is possible; and secondly, the idea that the inositol phosphate metabolism could be involved in the development of MH is additionally supported. PMID- 1786305 TI - [A new emphasis on the diagnosis of malignant hyperthermia using the in vitro contracture test?]. AB - In accordance with the protocol of the European Malignant Hyperpyrexia Group, an account is given of the experience regarding establishment of the "in vitro contracture test" for diagnosis and exclusion of malignant hyperpyrexia disposition at the University Clinic of Leipzig. Since its commencement in 1986 these diagnostic possibilities are being increasingly utilized, and--basing on 76 MH manifestations and suspected cases--324 persons have been examined until now. Besides the representation of the methodical features (e.g. performance of biopsy in tranquanalgesia in children), emphasis was on the safety of executing this test (attaining higher specificity, total absence of MH manifestations). The epidemiological study of the results shows the varying knowledge of physicians and the interference by insufficient investigation alternatives in individual areas. On the basis of the results, the use of the in vitro contracture test is recommended in all MH suspected cases by the authorized and qualified regional centres. PMID- 1786306 TI - [Ryanodine-induced contractures for the diagnosis of malignant hyperthermia susceptibility]. AB - The halothane-caffeine contracture test is presently the most well-established method for identification of malignant hyperthermia susceptibility (MHS) or non susceptibility (MHN). However, 10-20% of the patients tested are classified as equivocal (MHE), i.e. their susceptibility remains uncertain. A genetic disorder of the calcium releasing ryanodine receptor has been postulated recently. Therefore, 12 patients were tested in addition to the protocol of the European Malignant Hyperthermia Group (EMHG) for dose- and time-dependent contracture after ryanodine application. In this study, contracture of 0.2g appeared significantly earlier in MHS patients (17.5 +/- 1.7 min; n = 5) during cumulative ryanodine exposition (0.4-0.8-1.6-10.0 mumol/l) than in MHN (38.2 +/- 5.4 min; n = 5). A significant difference between MHS (10.0 +/- 1.7 min; n = 6) and MHN (19.8 +/- 0.6 min; n = 3) was also seen after bolus application of ryanodine (10.0 mumol/l). One patient classified as MHE according to the EMHG protocol, manifested as MHN after the ryanodine contracture test. This study supports previous work suggesting the ryanodine contracture test as an improvement in the in-vitro diagnosis of MH susceptibility. PMID- 1786307 TI - [An attempt to reconcile differences of opinion in the field of malignant hyperthermia]. AB - Two of the persisting controversies concerning malignant hyperthermia (MH) are discussed: storing and dosage of dantrolene and preoperative tactics to be followed with patients who are MH-susceptible. Reasons are presented for the obligation to store sufficient amounts of dantrolene in every operating suite. The second part discusses the question of pretreatment of MH-susceptible patients with dantrolene. PMID- 1786308 TI - [The early diagnosis of malignant hyperthermia--the place of end-expiratory CO2 monitoring]. AB - The authors report on the course of a fulminant malignant hyperthermia (MH) associated with laminectomy in a 29-year-old man who had been healthy up to that time. Succinylcholine and isoflurane were considered to be the causative triggering agents. Progression could be prevented due to an early suspicion raised by end-expiratory CO2 measurement: treatment was instituted immediately (Dantrolene 2mg/kg body weight, oxygen hyperventilation, external cooling, etc.) Serum creatine kinase increased up to almost 50,000 U/l associated with massive myoglobinuria. Residue-free restitution was achieved within a few days. Decisive for an early detection of MH is the routine performance of end-expiratory CO2 measurement which is definitely superior to temperature control and significantly reduces the time that elapses before treatment is initiated. PMID- 1786309 TI - [Diagnosis of malignant hyperthermia. The platelet test versus the in vitro contracture test]. AB - An eight-year-old boy was scheduled for an orthopaedic operation with a clinically abortive reaction of malignant hyperthermia and a positive platelet test result. Since there has been no validation for this platelet test, we performed a muscle biopsy and the caffeine- halothane-contracture test (CHCT). The young patient was found to be negative (MHN) in CHCT. Furthermore, the valence and the validity of the used platelet test are discussed for diagnostic purposes. With regard to resulting consequences, first of all in respect of possibly false negative results, we suggest to investigate all patients classified by this platelet test with the accepted and established CHCT. PMID- 1786310 TI - [Fulminant malignant hyperthermia during the 6th general anesthesia using volatile anesthetics]. AB - We report on the fulminant crisis of malignant hyperthermia occurring in a 30 year-old female during kidney transplantation. In the past, she had been anaesthetised repeatedly without complications. Anaesthesia was induced with thiopental and vecuronium and continued with isoflurane/N2O/O2. After an initially normal course of anaesthesia, the patient developed symptoms of a fulminant malignant hyperthermia (MH) including excessive increase in end expiratory CO2, hyperkalaemia, tachycardia and hyperpyrexia. The patient was saved by the timely administration of dantrolene. A surgical revision required the next day because of bleeding was done under dantrolene cover and took an uncomplicated course. The patient was extubated 7.5 hours after the second intervention and transferred to a normal ward after 4 days. A subsequently performed in vitro contracture test clearly revealed susceptibility to malignant hyperthermia. PMID- 1786311 TI - [Intraoperative monitoring of respiratory function. Introduction]. PMID- 1786312 TI - [Intraoperative respiratory monitoring: combined monitoring of oxygen supply and carbon dioxide output using pulse oximetry and capnometry]. PMID- 1786313 TI - [Specific monitoring requirements during low-flow anesthesia]. PMID- 1786314 TI - [Friedrich Wilhelm Adam Serturner-the discoverer of morphine]. AB - Friedrich Wilhelm Adam Serturner (1783-1841) was one of the most outstanding pharmacists who significantly influenced the transformation of pharmaceutical chemistry from a state of alchemistry to an acknowledged branch of science at the end of the 18th century. At the age of twenty-one, Serturner was the first to report on some results concerning the substance which was thought to be responsible as the "sleeping-agent". This substance had been isolated by him from the poppy-plant. Since this first report remained unnoticed, he repeated his analysis and described once more on the "crystallizable" properties of the agent in 1817, which he now named morphine. To have an idea of the effects of the drug, Serturner was able to confirm the hypnotic as well as the analgesic properties of morphine that were well-known to him since the had performed animal tests. Since he could demonstrate the alkaline qualities of morphine, something absolutely new at that time, Serturner became the co-founder and promoter of a new type of chemistry now known as alkaloid chemistry. PMID- 1786315 TI - Practical implications of modes of statistical inference for causal effects and the critical role of the assignment mechanism. AB - Causal inference in an important topic and one that is now attracting serious attention of statisticians. Although there exist recent discussions concerning the general definition of causal effects and a substantial literature on specific techniques for the analysis of data in randomized and nonrandomized studies, there has been relatively little discussion of modes of statistical inference for causal effects. This presentation briefly describes and contrasts four basic modes of statistical inference for causal effects, emphasizes the common underlying causal framework with a posited assignment mechanism, and describes practical implications in the context of an example involving the effects of switching from a name-band to a generic drug. A fundamental conclusion is that in such nonrandomized studies, sensitivity of inference to the assignment mechanism is the dominant issue, and it cannot be avoided by changing modes of inference, for instance, by changing from randomization-based to Bayesian methods. PMID- 1786316 TI - Estimation of relative potency with sequential dilution errors in radioimmunoassay. AB - Sequential dilution is a very common procedure in radioimmunoassay, in which the dilution error will be accumulated from the highest to the lowest concentration. A simulated example in relative potency determination is used to demonstrate the potentially wrong conclusion that can be drawn, when the dilution error is not properly included in the model. A Bayesian method is used and an alternative approximation via maximum likelihood is proposed. An alternative experimental design is recommended to increase the precision of the inference. PMID- 1786317 TI - Attributable risk estimation from case-control data via logistic regression. AB - By fitting an unconditional logistic regression model to unmatched case-control data, an estimate of the joint population attributable risk for the factor included is obtained. This estimate and its asymptotic variance can easily be computed from the intercept parameter and its asymptotic variance. A generalization to the analysis of stratified data with large strata enables the calculation of stratum-specific attributable risks and their variances via stratum-specific intercept parameters. If sampling of cases is independent of strata, an estimate of the summary attributable risk and its asymptotic variance may be obtained as a weighted sum of the stratum-specific attributable risks. PMID- 1786318 TI - Logistic regression for clustered binary data in proband studies with application to familial aggregation of sleep disorders. AB - Estimation is considered for the class of conditional logistic regression models for clustered binary data proposed by Qu et al. (Communications in Statistics, Series A 16, 3447-3476, 1987) when clusters are sampled on the basis of the outcome for one or more cluster members. The problem is suggested by data from a study designed to investigate familial aggregation of sleep disorders. After appropriate consideration of the mode of ascertainment of "cases" and "controls," it is shown that the model is preserved under this form of sampling, and a method of estimation is presented. The inconsistency of two alternative methods is demonstrated, and an example is provided. PMID- 1786319 TI - Local full likelihood estimation for the proportional hazards model. AB - In this paper a new approach to local likelihood estimation for censored data is proposed. This method employs the full likelihood and alternates between estimating the baseline hazard and estimating the covariate effect. The proposed methodology incorporates multidimensional data via additive models. Some results regarding inference for the covariate effect are also presented. PMID- 1786320 TI - Applications of multiple imputation to the analysis of censored regression data. AB - The first part of the article reviews the Data Augmentation algorithm and presents two approximations to the Data Augmentation algorithm for the analysis of missing-data problems: the Poor Man's Data Augmentation algorithm and the Asymptotic Data Augmentation algorithm. These two algorithms are then implemented in the context of censored regression data to obtain semiparametric methodology. The performances of the censored regression algorithms are examined in a simulation study. It is found, up to the precision of the study, that the bias of both the Poor Man's and Asymptotic Data Augmentation estimators, as well as the Buckley-James estimator, does not appear to differ from zero. However, with regard to mean squared error, over a wide range of settings examined in this simulation study, the two Data Augmentation estimators have a smaller mean squared error than does the Buckley-James estimator. In addition, associated with the two Data Augmentation estimators is a natural device for estimating the standard error of the estimated regression parameters. It is shown how this device can be used to estimate the standard error of either Data Augmentation estimate of any parameter (e.g., the correlation coefficient) associated with the model. In the simulation study, the estimated standard error of the Asymptotic Data Augmentation estimate of the regression parameter is found to be congruent with the Monte Carlo standard deviation of the corresponding parameter estimate. The algorithms are illustrated using the updated Stanford heart transplant data set. PMID- 1786321 TI - Evaluation of exact and asymptotic interval estimators in logistic analysis of matched case-control studies. AB - We compare six methods for constructing confidence intervals for a single parameter in stratified logistic regression. Three of these are based on inversion of standard asymptotic tests--namely, the Wald, the score, and the likelihood ratio tests. The other three are based on the exact distribution of the sufficient statistic for the parameter of interest. These include the traditional exact method of constructing confidence intervals, and two others, the mid-P and mean-P methods, which are modifications of this procedure that aim at reducing the conservative bias of the exact method. Using efficient algorithms, the six methods are compared by determination of their exact coverage levels in a series of conditional sample spaces. An incident case-control study of lung cancer in women is used to further illustrate the differences among the various methods. Computation of coverage functions is seen as a useful graphical diagnostic tool for assessing the appropriateness of different methods. The mid-P and the score methods are seen to have better coverage properties than the other four. PMID- 1786322 TI - Using replicate observations in observer agreement studies with binary assessments. AB - By introducing replicate observations into observer agreement studies, one can obtain better measures of observer agreement than heretofore possible. New methodology based on the analysis of latent variables allows a separation of within- and between-observer variation for binary measures of assessment among pairs of observers. Maximum likelihood estimation and hypothesis testing are discussed. The methodology is illustrated using data on the assessment of dysplasia by pathologists. PMID- 1786323 TI - Analysis of longitudinal data with unmeasured confounders. AB - Confounding in longitudinal or clustered data creates special problems and opportunities because the relationship between the confounder and covariate of interest may differ across and within individuals or clusters. A well-known example of such confounding in longitudinal data is the presence of cohort and period effects in models of aging in epidemiologic research. We first formulate a data-generating model with confounding and derive the distribution of the response variable unconditional on the confounder. We then examine the properties of the regression coefficient for some analytic approaches when the confounder is omitted from the fitted model. The expected value of the regression coefficient differs in across- and within-individual regression. In the multivariate case, within- and between-individual information is combined and weighted according to the assumed covariance structure. We assume compound symmetry in the fitted covariance matrix and derive the variance, bias, and mean squared error of the slope estimate as a function of the fitted within-individual correlation. We find that even in this simplest multivariate case, the trade-off between bias and variance depends on a large number of parameters. It is generally preferable to fit correlations somewhat above the true correlation to minimize the effect of between-individual confounders or cohort effects. Period effects can lead to situations where it is advantageous to fit correlations that are below the true correlation. The results highlight the trade-offs inherent in the choice of method for analysis of longitudinal data, and show that an appropriate choice can be made only after determining whether within- or between-individual confounding is the major concern. PMID- 1786324 TI - A two-state Markov mixture model for a time series of epileptic seizure counts. AB - This paper discusses a model for a time series of epileptic seizure counts in which the mean of a Poisson distribution changes according to an underlying two state Markov chain. The EM algorithm (Dempster, Laird, and Rubin, 1977, Journal of the Royal Statistical Society, Series B 39, 1-38) is used to compute maximum likelihood estimators for the parameters of this two-state mixture model and extensions are made allowing for nonstationarity. The model is illustrated using daily seizure counts for patients with intractable epilepsy and results are compared with a simple Poisson distribution and Poisson regressions. Some simulation results are also presented to demonstrate the feasibility of this model. PMID- 1786325 TI - Exact statistical inference for group sequential trials. AB - This paper considers clinical trials comparing two treatments with dichotomous responses where the data are examined periodically for early evidence of treatment difference. The existing group sequential methods for such trials are based on the large-sample normal approximation to the joint distribution of the estimators of treatment difference over interim analyses. We demonstrate through extensive numerical studies that, for small and even moderate-sized trials, these approximate procedures may lead to tests with supranominal size (mainly when unpooled estimators of variance are used) and confidence intervals with under nominal coverage probability. We then study exact methods for group sequential testing, repeated interval estimation, and interval estimation following sequential testing. The new procedures can accommodate any treatment allocation rules. An example using real data is provided. PMID- 1786326 TI - Modelling digit preference in fecundability studies. AB - Retrospective studies of fecundability, in which women are asked how many cycles they required to become pregnant, are often affected by problems of digit preference. A probability model for such digit preference is proposed in which misreporting favours 6 or 12 (and possibly also 3) cycles. It is assumed that in the absence of misreporting the number of cycles follows a beta-geometric distribution. The model is applied to two data sets, with clear-cut results: The inclusion of additional parameters to model the misreporting can lead to substantial improvements in fit, but causes little change to the estimated parameters of the underlying beta-geometric distribution. In some cases misreporting parameters may be regarded as nuisance parameters, while in others they may be of interest. We have found estimates of these parameters to vary between different categories of women in an interpretable manner. The models may also be used to estimate the percentage of couples in any study that misreport their conception waiting time. PMID- 1786327 TI - Mixture models for continuous data in dose-response studies when some animals are unaffected by treatment. AB - A mixture model is described for dose-response studies where measurements on a continuous variable suggest that some animals are not affected by treatment. The model combines a logistic regression on dose for the probability an animal will "respond" to treatment with a linear regression on dose for the mean of the responders. Maximum likelihood estimation via the EM algorithm is described and likelihood ratio tests are used to distinguish between the full model and meaningful reduced-parameter versions. Use of the model is illustrated with three real-data examples. PMID- 1786328 TI - A new index of aggregation for animal counts. AB - A new index is described that is especially appropriate for measuring the aggregation of entomological data in the form of counts per sample unit and that can make use of spatial information when it is available. Calculation of the index is based on a comparison of the effort required of individuals in a sample to achieve complete crowding with that to achieve complete randomness. The power of tests of randomness based on this index is found to be greater than those based on the index of dispersion, especially when spatial information is available. PMID- 1786329 TI - Efficiency of cohort sampling designs: some surprising results. AB - Cohort sampling designs are proposed which one would intuitively expect to be more efficient than nested case-control sampling. Two of these designs start with a nested case-control sample and distribute controls to sampled risk sets other than those for which they were picked. The third design has the goal of maximizing the number of distinct persons in a nested case-control sample. Simulation results show surprisingly little gain, and more often a loss in efficiency of these new designs relative to nested case-control sampling. This is due to the sampling-induced covariance between score terms. We conclude that the often stated intuition that nested case-control sampling does not make good use of sampled individuals' covariate histories is false. PMID- 1786330 TI - A note on the conditional approach to interval estimation in the calibration problem. AB - In the calibration problem, the need to construct a confidence interval to estimate the unknown chi 0 arises when the null hypothesis of zero slope is rejected. Otherwise, the resulting confidence interval will be infinite to reflect the fact that the slope of the regression line may be zero. Under the condition of rejecting the hypothesis of zero slope, we study the properties of the conditional coverage rate of the calibration confidence interval. The conditional coverage rate (P1) is a function of the slope, distance between chi 0 and the mean of the trailing sample means, the sum of squares of chi, and n. When the true slope is close to 0 and chi 0 is away from means, P1 can go down to 0. On the other hand, as the power of testing zero slope reaches 1, with or without chi 0 close to means, P1 will tend to the desired nominal coverage rate. In summary, one should choose a reasonably small alpha in testing zero slope to avoid constructing a confidence interval for chi 0 when the true slope is 0. In addition, it is desirable to have high power in testing zero slope so that the resulting confidence interval will maintain the desired coverage rate when using the conditional approach in the calibration problem. PMID- 1786331 TI - A statistical model for in-vitro assessment of patient sensitivity to cytotoxic drugs. AB - Formation of colonies in semisolid medium is an assay used for the study of stem cell characteristics in hematopoietic and solid tumors. Previous experience with leukemia patients failed to show an association between the reduction in colony formation observed when patient blast cells were exposed to increased concentrations of an anticancer agent, and the subsequent patient response to the agent. By introducing a model that takes into account the possibility of a resistant subpopulation of clonogenic cells, the paper demonstrates that the null result was due to an inadequate summarization of the dose-response curve, and in fact a statistically and biologically significant association exists between one of the parameters of the model and patient response. The properties, implementation, and interpretation of the model are discussed. PMID- 1786332 TI - The interpretation of a regression coefficient. AB - Zeger, Liang, and Albert (1988, Biometrics 44, 1049-1060) discuss population averaged and subject-specific models for the analysis of longitudinal data. In their example on respiratory disease in the child and the mother's smoking status, they give an incorrect interpretation to the regression coefficient for the subject-specific model. PMID- 1786333 TI - Confidence intervals and sample sizes. AB - In a recent paper, Beal (1989, Biometrics 45, 969-977) considers the problem of determining the appropriate sample size when inference about a parameter theta is to be made on the basis of a confidence interval (CI). He suggests that the sample size should be chosen so that the probability that the length of the CI is less than a given value, conditional on the interval including the true theta, is greater than a specified level. In this note, in which we concentrate on two sided intervals, this suggestion is examined, as is the effect of uncertainty in our knowledge of the population variance sigma 2 on estimates of sample size. PMID- 1786334 TI - Generalized linear models for enzyme-kinetic data. PMID- 1786335 TI - Testing for random dropouts in repeated measurement data. AB - Diggle (1989, Biometrics 45, 1255-1258) proposes a test for random dropouts in repeated measurement data when the experiment has a completely randomized design. It is argued here that logistic regression is a comparable but more flexible technique for studying the occurrence of dropouts. PMID- 1786336 TI - Fraudulent statistical methods. PMID- 1786337 TI - On testing for threshold values. PMID- 1786338 TI - Effects of limited input distance constraints upon the distance geometry algorithm. AB - In this paper we examine the distance geometry (DG) algorithm in the form used to determine the structure of proteins. We focus on three aspects of the algorithm: bound smoothing with the triangle inequality, the random selection of distances within the bounds, and the number of distances needed to specify a structure. Computational experiments are performed using simulated and real data for basic pancreatic trypsin inhibitor (BPTI) from nmr and crystallographic measurements. We find that the upper bounds determined by bound smoothing to be a linear function of the true crystal distance. A simple model that describes the results obtained with randomly selected trial distances is proposed. Using this representation of the trial distances, we show that BPTI DG structures are more compact than the true crystal structure. We also show that the DG-generated structures no longer resemble test structures when the number of these interresidue distance constraints is less than the number of degrees of freedom of the protein backbone. While the actual model will be sensitive the way distances are chosen, our conclusions are likely to apply to other versions of the DG algorithm. PMID- 1786339 TI - Mass-weighted molecular dynamics simulation of cyclic polypeptides. AB - A modified molecular dynamics (MD) method in which atomic masses are weighted was developed previously for studying the conformational flexibility of neuroregulating tetrapeptide Phe-Met-Arg-Phe-amide (FMRF-amide). The method has now been applied to longer and constrained molecules, namely a disulfide-linked cyclic hexapeptide, c[CYFQNC], and its linear and "pseudo-cyclic" analogues. The sampling of dehedral conformational space of teh linear hexapeptide in mass weighted MD simulations was found to be improved significantly over conventional MD simulations, as in the case of the shorter FMRF-amide molecule studied previously. In the cyclic hexapeptide, the internal constraint of the molecule due to the intramolecular disulfide bond (hence the absence of free terminals in the molecule) does not adversely affect the significant improvement of conformational sampling in mass-weighted MD simulations over normal MD simulations. The pseudo-cyclic polypeptide is identical to the linear CYFQNC molecule in amino acid sequence (i.e., side chains of the cysteine residues are reduced), but the positions of its two terminal heavy atoms were held fixed in space such that the molecule has a nearly cyclic conformation. For this molecule, the mass-weighted MD simulation generated a wide range of polypeptide backbone conformations covering the internal dihedral degrees of freedom; moreover, the physical space of the pseudo-cyclic structure was also sampled in a complete revolution of the entire molecular fragment about the two fixed termini during the simulation. These characteristics suggest that mass-weighted MD can also be an extremely useful method for conformational analyses of constrained molecules and, in particular, for modeling loops on protein surfaces. PMID- 1786340 TI - A stable antiparallel cytosine-thymine base pair occurring only at the end of a duplex. AB - Ultraviolet hyperchromicity experiments indicate that in DNA duplex formation, a C-T mismatch is destabilizing in the center of a duplex, but behaves as a stable base pair at the terminus of a duplex. The C-T base pair is thought to contain two hydrogen bonds, but has thermodynamic parameters (delta Ho and delta Go of dissociation) that are similar to a G-C base pair. AMBER molecular mechanics calculations were performed to study the possible structural properties of DNA duplexes with central and terminal C-T combinations. These calculations also indicate that a central C-T pair destabilizes a duplex, while terminal C-T forms a stable base pair. Hydrogen bonding between cytosine and thymine occurs only in the energy-minimized structures when the helix diameter decreases and the propeller twist angle between the bases increases. These changes are found to occur only at the end of a duplex in the calculations, which may explain the experimental results. PMID- 1786341 TI - Electric birefringence imaging of electrokinetic agarose orientation. AB - Time-resolved and steady-state electric birefringence imaging with a slow-scan video camera is used to study orientation during DNA agarose gel electrophoresis. The hydrodynamically induced gel distortion is shown to be the major source of birefringence under electrophoresis running conditions and to generate a birefringence image that approximates the image of the DNA concentration gradient in the electric field direction. A fluid kinematic model is presented to describe the spatial distribution of steady-state birefringence and is verified with fluorescence measurements of DNA distribution. The stress-optic coefficient of 1% agarose gel is measured by mechanical compression and used to evaluate the magnitude of the induced strain on the gel during electrophoresis. PMID- 1786342 TI - A molecular dynamics simulation of polyalanine: an analysis of equilibrium motions and helix-coil transitions. AB - An understanding of helix dynamics can aid in interpreting the motions of proteins. The conformational transitions that occur also appear to play a role in protein folding. Structural studies of isolated peptides in solution are just becoming available. However, detailed analysis of the helix-coil transition is still not available and will be difficult to obtain experimentally. For these reasons, we performed a long molecular dynamics simulation of polyalanine at high temperature. Using this approach, we obtain a description of the overall structure and inherent flexibility of the chain as well as a structural picture of the conformational changes that occur. In this way, we can address both equilibrium properties of the peptide and the dynamics and mechanisms of the structural transitions. Our results correlate fairly well with the available experimental data and previous simulations aimed at addressing alpha-helix dynamics. The peptide spends the bulk of its time fluctuating between different conformations with intermediate helix contents. Transitions between highly ordered and highly disordered structures were rare, but they occurred rapidly. Our distribution of conformations favored collapsed states. Hence, our transitions to structures with high helical content were from fluctuating compact structures. The conversion between helix and coil occurred sequentially on a residue-by-residue basis. However, there was local cooperativity; the transition of a residue to the coil state was facilitated after a neighboring group became nonhelical. The relevance of our results to protein folding is also discussed. PMID- 1786343 TI - Prion diseases in man. AB - Human spongiform encephalopathies (HSE) are uncommon neurodegenerative diseases of unknown etiology. Whilst numerous observations provide arguments for an infectious disorder mediated by an unconventional agent of the so-called prion type, the recent discovery of predisposing allelic variants suggests that HSE might be considered as genetically linked diseases. PMID- 1786344 TI - Cystic fibrosis: production of high levels of uromodulin-like protein by HLA-DR blood monocytes differentiating towards a fibroblastic phenotype. AB - We report here the spontaneous in vitro transformation of blood monocytes into fibroblasts, in a patient suffering from cystic fibrosis (CF). The blood monocytes with this capacity express HLA-DR specificity. Monocytes were identified by non-specific esterase activity and by immunofluorescence using monoclonal antibodies against monocytes/macrophages antigens. Neo-fibroblasts were identified by electron microscopy and immunofluorescence using monoclonal antibodies against a cytoplasmic enzyme specifically involved in the synthesis of collagen. The secretion of collagen was evidenced using antibodies against type I collagen. Both monocytes/macrophages and neo-fibroblasts express the monocytic and the fibroblastic markers and synthesize type I collagen. This transformation observed in vitro might mimick the process of fibrosis development which takes place in vivo, particularly in pancreatic acini, lungs and intestine of patients with CF. Interestingly, the whole process in vitro is inhibited when T lymphocytes are properly stimulated by IL2. In addition, both monocytes and neo fibroblasts secrete high quantities of uromodulin-like glycoprotein. The significance of this finding is discussed in relation to the thick mucus secretion which characterizes the disease. In addition, from a fundamental point of view, it confirmed in a large series of patients that this observation may have significant implications, since CF mutation impairs the gene coding for cAMP regulated Cl- channel and that it has been proposed that uromodulin might be implicated in Cl- transport. Therefore the question of the relationships between uromodulin and the cAMP-regulated Cl- channel arises. PMID- 1786345 TI - Effect of corticosteroid treatment on hemopoiesis in vivo and in vitro in a patient with Felty's syndrome. AB - We have studied the CFU-GM and BFU-E in vitro growth in a neutropenic and anemic patient with Felty's syndrome, either before or one and three months after steroid therapy when neutrophils and erythrocytes returned to normal. Both CFU-GM growth and CSA production were found to be low before therapy, and prednisone was shown to raise them to normal levels. The in vitro growth of BFU-E and the production of BPA by T lymphocytes of the patient were significantly lower than normal when studied before therapy. However, the T lymphocytes incubated in vitro with hydrocortisone regained their ability to stimulate the BFU-E growth. After prednisone therapy both BFU-E growth and BPA production by T lymphocytes returned to normal. Possible pathogenetic mechanisms of impaired granulo- and erythropoiesis in Felty's syndrome are discussed. The in vitro study with hydrocortisone can help to identify steroid-sensitive patients. PMID- 1786346 TI - Dermatoglyphics: Science in transition. PMID- 1786347 TI - Introduction: dermatoglyphics--back to the future. PMID- 1786348 TI - Embryologic development of flexion creases. AB - Scientific interest in the palmar, plantar, and digital flexion creases has been related mainly to their aberrations in numerous congenital malformations and other medical disorders. Understanding of crease embryonal development is a prerequisite to the estimation of their potential significance in medical practice. While the timing of development of the flexion creases has now been established, their origin is less well understood. Both primary genetic determination and development secondary to flexion function have been suggested as the mechanisms underlying the crease development. The evidence offered has been mostly indirect, related to the timing of the onset of the fetal hand movement and the crease aberrations in malformed hands and fingers. More detailed studies, preferably including experimental designs in nonhuman fetuses, will be necessary to resolve the question of the origin of the flexion creases. In the meantime, it seems reasonable to assume that the flexion creases develop under genetic influences, in close morphologic relationship to the fetal volar pads. Early genetic and environmental factors causing hand malformations and alterations of the form or function of the hand, and occurring prior to the fetal crease development, may affect the developing flexion creases. The close correspondence between the appearance of the flexion creases and hand and digital movement (which, in turn, is associated with joint formation and muscular function) suggests that the same earlier factors are responsible for both crease development and flexion movement. PMID- 1786349 TI - Nonprimate mammalian dermatoglyphics as models for genetic and embryologic studies: comparative and methodologic aspects. PMID- 1786350 TI - The role of heredity and environment on dermatoglyphic traits. PMID- 1786351 TI - Commentatio de examine physiologico organi visus et systematis cutanei. Purkinje's observations (1823) on finger prints and other skin features. 1940. PMID- 1786352 TI - Clinical aspects of dermatoglyphics. AB - As demonstrated above, considerable progress has been made in the understanding of the associations between dermatoglyphics and various medical disorders, as a result of which dermatoglyphic analysis has been established as a useful diagnostic and research tool in medicine, providing important insights into the inheritance and embryologic development of many studied clinical disorders. Many unanswered questions and misconceptions still remain, though. Further well designed investigations, avoiding the pitfalls of many earlier studies, will be needed to reevaluate some of the existing claims and to determine the real value of dermatoglyphics in medicine. The benefits of a dermatoglyphic examination in individual patients in clinical genetic practice are clear; a more widespread application of this tool by clinical geneticists and pediatricians should be encouraged. Embryologic and experimental dermatoglyphic studies clearly hold a considerable potential for a better understanding of the factors influencing the development of the epidermal ridge patterns. Utilized together with newly developed methods and insights gained in recent studies of other aspects of dermatoglyphics, they should significantly advance the studies of the relationship between dermatoglyphic variation and medical disorders. PMID- 1786353 TI - Palmar, plantar, and digital flexion creases: morphologic and clinical considerations. AB - The above overview illustrates the areas of interest in flexion creases in human biology studies in general and in studies of medical disorders in particular. Clearly, flexion creases have a significance of their own rather than only as appendices of the dermatoglyphic analysis and should, therefore, be approached appropriately. In some instances, they may be of more interest than the dermatoglyphics. Our understanding of the creases and their value is, however, as yet incomplete and the gaps in our insight limit the possible interpretations and practical applications of the knowledge gained from studies of various aspects of the flexion creases. Creases provide important clues of the early fetal development and thus may be of practical value in clinical medicine. So far, most of these studies have been carried out in relation to specific disorders, often without a clear reasoning why flexion creases should be altered in the given disorder. The examples of aberrant flexion creases discussed above illustrate the general lack of specificity of crease anomalies in association with a particular syndrome or disorder that does not include malformations or malfunctions of the limbs. Instead, the anomalous flexion creases reflect the altered shape and function of hand and foot, which, in turn, are determined during early fetal development and affected by factors interfering with normal embryogenesis. A more promising approach to studying flexion creases in medical disorders, therefore, is to explore the developmental correlations between the creases and the structure and function of hands and feet. This does not mean that information gained from the case reports of individuals with various congenital defects is of no value. On the contrary, it should be collected systematically to determine the variety of crease aberrations and their frequencies in a given disorder, which would help elucidate the presence and timing of the developmental factors involved in the origin of the defect. The usefulness and limitations of the flexion creases are to a large degree parallel to those of dermatoglyphics. Altered flexion creases are indicative of intrauterine disturbances occurring early in pregnancy. As such, they may be of a predictive value in otherwise apparently normal infants in whom cryptic damage may be manifested later. They may serve to alert the physician to perform careful or more detailed examinations or to reexamine already obtained (and possibly inaccurate) test results. A better understanding of the crease embryology, both normal and abnormal, is a prerequisite for progress in studies of flexion creases.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1786354 TI - Applications of dermatoglyphics to anthropologic populations. PMID- 1786355 TI - The dermatoglyphics of nonhuman primates: a neglected resource. PMID- 1786356 TI - Issues of sampling and of methodologies in dermatoglyphics. AB - In summary, we are left with the conclusion that some innovative work has been done in the past two decades but that the bulk of the world literature in dermatoglyphics still reflects an almost total reliance on Cummins and Midlo, who, we must remember, were summing up the work of scholars prior to the time their book first appeared in 1943. We need to clearly understand biocultural implications of breeding populations from which we wish to draw a sample, and we must ask ourselves before we start new studies exactly what we wish to achieve. If the current methodologies have not been able to provide us with satisfactory answers, the time has surely come for scholars to devise new ways of critically looking at the enormous complexity of dermal ridges. The encouraging news is that our knowledge of human embryology is growing, molecular genetics is soaring forward, and our understanding of the complexities of patterns on the human skin may be greatly improved from what we learn about the embryology of dermal and epidermal tissue. PMID- 1786357 TI - Impact of changes in medical genetics on teaching and disseminating information on dermatoglyphics. PMID- 1786358 TI - Epilogue: dermatoglyphics--the next generation. PMID- 1786359 TI - Dermatoglyphic investigations: expanding prospects. PMID- 1786360 TI - Fingerprints, palms, and soles: historical transitions. PMID- 1786361 TI - Embryologic development of epidermal ridges and their configurations. PMID- 1786362 TI - [Effects of oxymethacil on microcirculation and neuronal impulse activity in the cat cerebral cortex in acute fosfakol poisoning]. AB - By using the methods of vital microscopy and extracellular registration of the neuronal activity the effect of oxymethacil (OM) on microcirculation and NSA in cat brain cortex was studied after grave poisoning by organophosphate paraoxon. The rapid depression of NSA together with the pronounced disturbances of microcirculation in cortical vessels were showed after intravenous injection of paraoxon (0.8 mg/kg). The prophylactic injection of OM (5 mg/kg) induced protective effect on the studied parameters. This effect was more pronounced when OM injection was combined with the M-cholinolytic amyzyl. The present data show the reasonableness of antioxidants using for the correction of a brain functional condition damaged by organophosphates. PMID- 1786363 TI - [Disorders of cerebral blood flow in ischemia and correction by leu-enkephalin]. AB - The cortical blood flow of the rat brain was decreased at 44% by the bilateral occlusion of common carotid artery. The intraperitoneal injection of the leu enkephalin before and after ischemia restored the blood flow and increased the volume of the lymph in ductus thoracicus. Cerebrovascular action of leu enkephalin was connected with its lymphostimulating activity and vasodilation. PMID- 1786364 TI - [Trigeminal neuralgia of neuropathic origin]. PMID- 1786365 TI - [Increased sensitivity of the cardiovascular system to captopril after microsphere embolization of the coronary vessels]. AB - Changes in captopril sensitivity as a result of coronary embolization by 15 um microspheres were studied in rats. Selective coronary embolization was produced by injection of microspheres into the left ventricle during ascending aorta occlusion. The hemodynamic data were examined in conscious rats 21 days after embolization or sham operation before and after captopril bolus injection (1 mg/kg) by using microspheres method. Captopril injection caused a significant increase of the blood flow in the heart, kidneys, skin and some intestinal organs. PMID- 1786366 TI - [Adaptation of the body to stress effects increases resistance of nuclear DNA of cardiac cells due to accumulation of heat shock proteins in the nucleus]. AB - It was shown that adaptation to stress exposure increased the resistance of nuclear DNA in myocardial cells to the damaging action of exogenous one-chain DNA (50 micrograms/ml). This protective effect was accompanied by a pronounced accumulation of heat shock proteins (hsp) 70 in nucleoplasm of myocardial cells from adapted animals. Possible mechanism of the DNA protective effect of adaptation and the role of hsp 70 are under discussion. PMID- 1786367 TI - [Effects of cardiac denervation on its function in asphyxia]. AB - It has been established in 23 experiments on dogs that during asphyxia the reactions of denervated heart which were directed toward compensation of hypoxia in the whole organism and towards preservation of myocardium from hypoxia damages were slower than that in the norm. All these processes led to the overloading of myocardium. PMID- 1786368 TI - [Effects of dalargin on the proliferative processes of the gastric epithelium under repeated action of different stressors]. AB - Using radiography with H-thymidine method we studied the synthesis of DNA process in pyloric parts of stomach epithelium in white rats, which have been five-fold effected by different kinds of stressors against a background of dalargin injections. In the first hour after animals were stressed, DNA synthesis was depressed. Dalargin injections caused DNA synthesis normalization in the first hour after hypoxia and hyperthermia. Since 24 hours after hyperthermia and immobilization against a background of dalargin injections the normalization of DNA synthesis took place, and after hypoxia the post-stressing IMN activation was growing week. One of the mechanisms of dalargin correction of DNA synthesis breach under the influence of stressors is a stabilization of noradrenaline and histamine concentration in tissue of the stomach. PMID- 1786370 TI - [Effects of lipid additions on oxygen supply of skeletal muscles]. AB - The experiment was done on rabbits which were fed for 4-5 weeks a diet with sunflower oil or butter (0.2 gm/100 gm of weight). It was shown that oxygen supply of skeletal muscle could change due to structural of functional modifications of hepato-parenchymatous barrier caused by dietary factors. PMID- 1786369 TI - [Effects of antibodies to dopamine-beta-monooxygenase on the level of catecholamines in the brain]. PMID- 1786371 TI - [Bile lipids in experimental extrahepatic cholestasis]. PMID- 1786372 TI - [Effects of etafon on calcium ion contents in smooth muscle cells of the aorta]. AB - Aethaphonium (dialicor) in 5-20 microM concentrations causes the dose dependent Ca decreasing in resting smooth muscle cells of rabbit aorta. In dose of 0.5-2.0 microM dialicor decreases the extent of transient in cytosolic-free calcium induced by application acetylcholine (10 microM) and high extracellular K (119 microM). This effect of dialicor is most expressed in attitude to the myocytes, containing the hyper K medium. PMID- 1786373 TI - [Characteristics of ultrastructure of the myocardium of rats with different resistance to oxygen deficiency after acute and periodic effects of hypoxia]. AB - In experiments on rats with different resistance to oxygen deficiency (high resistant--HR, and low-resistant LR animals) the myocardium ultrastructure of nonadapted and adapted rats was studied. It was shown that there were more glycogen granules and lipid drops initially in cardiomyocytes of nonadapted HR animals in comparison with LR ones. After a long-term adaptation to hypoxia the hypertrophia and hyperplasia of mitochondria, the nucleus and endoplasmatic reticulum hypertrophy were observed. Moreover, the increase of glycogen and lipids content was more pronounced in the myocardium of LR rats. Besides, the activation of protein-synthesizing processes was observed not only as a result of long-term adaptation, but also after single acute hypoxic effect. The results of submicroscopic cardiomyocyte studies of HR and LR rats are in good correlation with the peculiarities of energetic metabolism. PMID- 1786374 TI - [Effects of the removal of the epiphysis on the hypnogenic action of hexanal in rats]. AB - After pinealectomy a potentiation of the hypnogenic effect of hexobarbital sodium was observed in rats, which was particularly expressed during night hours. Melatonin (0.1 mg/kg, i.p.) attenuated but not fully eliminate this effect. As suggested pineal compounds have an antihypnogenic activity which can be of a pharmacokinetic and pharmacodynamic origin. PMID- 1786375 TI - [Effects of antidepressive agents on tolerance of hypoxia and physical exercise]. AB - In experiments on mice and rats we studied the influence of antidepressants on hypoxic and physical tolerance. The antidepressants pyrazidol, azaphen, imipramine and moclobemide as well as the nootropic drug piracetam prolonged the life of animals in conditions of hypoxic and hemic hypoxia and increased the survival rate of rats in circulatory hypoxia. In experiments on mice antidepressants increased also the time of swimming. PMID- 1786376 TI - [Structural-functional changes in the peripheral nerves after administration of several drugs]. AB - Structural and functional changes in the sciatic nerve induced by some drugs were studied using morphological and electrophysiological methods. It was stated that the application of this drug on the nerve causes different degenerating changes. Electrophysiological data, using the regeneration of action potential, proved the presence of structural changes in the nerve after application of mentioned drugs and showed partly preserved conduction of the nerve trunks. PMID- 1786377 TI - [State of the Krebs cycle in the kidneys of rats with chronic phosphorus intoxication]. PMID- 1786378 TI - [Uptake of adrenaline by rat brain synaptosomes. Effects of several psychotropic drugs]. AB - Comparative study of the uptake of 3H-epinephrine (3H-EN) and 3H-norepinephrine (3H-NE) into rat brain crude synaptosomes and effect of psychotropic drugs of different classes on this process showed that isolated nerve terminals had their own transport system for EN. The crude synaptosomal fraction had two transport system's for EN; high-specific active uptake with high affinity (KM = 3.7 + 0.21 microM) and low-affinity uptake (KM2 = 98.0 + 47.5 microM). En accumulation was saturable, stereo-specific and inhibited by ouabain (3 X 10(-3) M), protoveratrine A and B (10(-4) M), NaN3 (2 X 10(-3) M), 2,4-dinitrophenol (2 X 10(-3) M), p-chloromercuribenzoate (10(-4) M). Actinomycin D had no effect on the uptake of 3H-EN. 3H-HE was accumulated by two uptake system: 1-high affinity uptake system with KM values of 0.49 + 0.13 microM, 2-low affinity uptake system with KM values of 21.1 + 7.71 microM. Amphetamine, mesocarb, chlorpromazine, fluphenazine and haloperidol were equally effective inhibitors of 3H-EN and 2H-HE uptake. Imipramine, phenazepam, diazepam and carbamazepine (5 X 10(-5) M) had no effect on the uptake of 3H-NE. Imipramine, zimelidine, norzimelidine and viloxazine (5 X 10(-5) M) were more potent inhibitors of the 3H-EN uptake than that of 3H-NE. PMID- 1786379 TI - [An electrophysiological study of the anti-arrhythmia effect of antioxidant ionol]. AB - The paper describes the study of anti-arrhythmia effects of ionol. In isolated rabbit papillary muscle, ionol (a) had no effect on the depolarization-induced automaticity; (b) did not influence early afterdepolarizations: (c) delayed the onset of post-depolarizations initiated by Ca-overload and therefore inhibited the ectopic focal activity in myocardium. In isolated left auricles of rabbit, ionol suppressed the shortening of the excitation wavelength induced with adrenaline and thus protected the heart of reentry and consequent rhythm disturbances. PMID- 1786380 TI - [Variability of immune response in mice immunized at different time intervals after total or partial removal of organs with different reparative capacity]. AB - The antibody response on sheep erythrocytes in the murine spleen at different time intervals after has been studied in one of the following operations: liver resection (70%), unilateral nephrectomy or sialadenectomy, or castration and bilateral sialadenectomy or castration. It was shown, that the liver and kidney surgery enhance the immune response if immunization was performed immediately or 24 h after the operation. Analogous changes of the immune response were observed under the immunization during 3 days after unilateral nephrectomy. The unilateral sialadenectomy evokes the contrary changes in immune response: immunization immediately or 24 h after the operation is accompanied by decrease of the above, the immunization on 3-7 days after the operation gets the increase of antibody genesis. Unilateral and bilateral castration as well as bilateral sialadenectomy evoke no changes of the immune response. PMID- 1786381 TI - [Effects of anti-cholinoceptor antibodies on the frog heart]. AB - Research on isolated hearts of Rana temporaria has shown that upon treating them with anti-cholinoreceptor antibodies, there occurs a considerable reduction of inhibition effect on cardiac activity of acetylcholine or carbacholine. A reduction of inhibition effect was noticed after incubation of frog's heart with antibodies against cholinoreceptors obtained from motor-denervated muscles of frogs as well as from muscles of mice Balb/c. Cholinoreceptor protein was obtained and purified by A. Sobel's method. Control tests were made with serum of non-immunized rabbits and rabbits immunized with material obtained from non denervated muscles of frogs. It was concluded that acetylcholinoreceptor antibodies are capable of provoking atropine-like effect on frog's heart. According to our data, anti-cholinoreceptor antibodies as well as cholinoreceptors are relatively non-specific to species. PMID- 1786382 TI - [Regulatory effects of human mononuclear cells treated with diucifon may be dependent on membrane-associated form of interleukin-2]. AB - The immunomodulating activity of diucifon--activated and glutaraldehyde fixed human mononuclear cells (MNC-DGA) was studied in the test--system of autologous and allogenic mononuclear cells proliferative response. It was shown that MNC-DGA had the same stimulating activity as the diucifon treated unfixed cells. The immunomodulating capacity of MNC-DGA was fully abolished in the case MNC-DGA. So, the interaction between interleukin 2 receptor (Tac--antigen) and the membrane form of the mediator, expressed on MNC after diucifon treatment may play an important role in MNC-DGA immunomodulating activity. The regulating activity of MNC-DGA was revealed both in autologous and allogenic systems. The speculation is that construction of new immunomodulating drugs as complexes of cell-like carrier and immunomodulators fixed on their surface may be perspective. PMID- 1786383 TI - [Comparative analysis of the effects of the unpurified preparations of murine erythropoietin and human recombinant erythropoietin on erythroid and granulocyte macrophage progenitor cells in semi-solid mouse bone marrow cultures]. AB - Effects of unpurified murine erythropoietin and unpurified human recombinant erythropoietin on the growth of erythroid--BFU-E and granulocyte--macrophage progenitor cells--CFU--GM from the mouse bone marrow were compared using a methylcellulose culture system. Average erythropoietin titers for murine serum and supernatant human recombinant erythropoietin were 16 U/ml and 33 U/ml, respectively. The maximal stimulation was observed at 1-2 U/ml culture recombinant erythropoietin and 0.5 U/ml culture murine erythropoietin. Murine erythropoietin was more effective then human one. Murine and human recombinant erythropoietin had no significant effect on the number of CFU-GM colonies. But human recombinant erythropoietin could be preferentially used when studying the mechanism of erythropoiesis in man and animals because there were erythropoiesis inhibitors in mouse serum. PMID- 1786384 TI - [Preparation and characterization of monoclonal antibodies to human apolipoprotein E]. AB - Monoclonal antibodies to human apolipoprotein E (apoE) were prepared and characterized. Antibodies of 3D12F11 clone were shown to be specific to apoE and belong to IgG1 subclass. Dissociation constant of antigen-antibody complex in solution was determined as 3.5 +/- 0.5 nM. The antibodies interacted neither heparin- nor lipid-binding sites of human apoE molecule. The obtained antibodies may be useful for metabolic and structural investigations of apoE as well as for clinical studies. PMID- 1786385 TI - [Use of tuftsin in experimental leprosy]. AB - The effect of tuftsin was studied in vivo using CBA mice infected with M. leprae by Shepard's technique and in vitro using macrophage-like cell line P. 388 (Co cultivated with M. leprae) and the cultivated leproma tissue. It was found out that tuftsin acted as a stimulator of M. leprae multiplication in foot-pads of mice and as a prolongator of M. leprae survival in the cells of macrophage-like cell line P .388. It is concluded that using tuftsin might be useful in view of studying different aspects of experimental leprosy. PMID- 1786386 TI - [Contents of CFUf in the unit of the spongiosa from various parts of human skeleton]. PMID- 1786387 TI - [Changes in glutathione-S-transferase activity during induction of resistance of leukemia P 388 and Ehrlich ascitic tumor cells to doxorubicin]. AB - We have studied by uridine short term test the level of resistance of murine leukemia cell lines P 388/Dx and ELD/Dx carcinoma cells with induced resistance to doxorubicin, P 388/Fp + Dx cells with induced resistance to combination of finoptOFF++ and doxorubicin in vivo. It was shown that the level of resistance was 6 fold for P 388/Dx cells, 4.5 fold for ELD/Dx cells and 2 fold for P 388/Fp + Dx cells. It was shown that the P 388/Dx cells and P 388/Fr + Dx cells had a 3.5 and 4.4 fold increase level of glutathione-S-transferase activity than P 388 cells. No increase in the activity of glutathione-S-transferase was detected in ELD/Dx cells. We conclude that increase of cellular glutathione-S-transferase activity is not associated with the development of resistance to doxorubicin. PMID- 1786388 TI - [Sensitivity of human glial tumor cells of different grade of anaplasia to lysis due to natural killers depending on some characteristics of the glycoprotein structure of tumor cell membranes]. AB - A study is presented of the sensitivity of freshly isolated cells (13 cases) to lysis due to natural killers (NK) depending on their malignancy grade and degree of their membrane sialization. The diagnoses were verified histologically (I-II grade gliomas-4 cases, grade III gliomas-3 cases, grade IV gliomas-6 cases). It was established that grade IV gliomas were most sensitive to NK-lysis. Treatment of tumor cells with neuraminidase increased the sensitivity to NK-lysis of grade I-III glioma cells and did not influence the sensitivity of grade IV gliomas. It is suggested that glycoprotein oligosaccharides of glial tumour cell membranes may play the role of target structures for lymphocytes-killers. PMID- 1786389 TI - [In vitro selection of cell variants resistant to macrophage and hydrogen peroxide cytotoxic activity in spontaneous transformed cells of the STHE strain]. AB - The new cell variants were selected in vitro from the low-malignant Syrian hamster embryo cells (STHE strain) spontaneously transformed in vitro. Ten cycles of in vitro co-cultivation of the parental STHE cells with the normal Syrian hamsters peritoneal exudate cells (PEC) (resident and LPS-activated PEC) used as a selecting agents (PERr, PECa) were performed. The susceptibilities of thus selected STHE cell variants as well as parental STHE cells to macrophage cytotoxicity and H2O2 dagame were tested with 3H-TdR assays. It has been demonstrated that all five STHE cell variants selected in vitro with PECa, in contrast to the parental STHE cells and three STHE cell variants selected with the use of PECr, were significantly more resistant to H2O2-mediated cytotoxicity. The increased resistance was acquired already after the 1-st cycle of the selection procedure. In contrast, only one STHE cell variant selected with PECr appeared to be semiresistant (demonstrated in 4 out of 6 experiments) to H2O2 damage after 10th cycle of in vitro co-cultivation. PMID- 1786390 TI - [Benzo(a)pyrene pretreatment of Drosophila simulans mutant strain results in the induction of aberrant isoform of cytochrome P-450 with increased capacity to metabolize benzo(a)pyrene]. AB - The basal level of benzo(a)pyrene monooxygenase, epoxide hydrolase and glutathione S-transferase activity as well as the content of cytochrome P-450 were found the same in both compared benzo(a)pyrene (BP) sensitive D. simulans strain 364yv and BP-resistant wild one (Turku). Phenobarbital pretreatment resulted in the same increase level of these enzyme activities in both strains. BP-pretreatment of 364yv flies decreased the amount of the cytochrome P-450 but raised up the turnover of BP per molecule of cytochrome P-450. SDS-polyacrylamide gel electrophoresis of the microsomal proteins from BP-pretreated 364yv flies (but not from Turku) showed an increased hemoprotein content in the 56000 band. The relationship between BP-sensitivity of the strain 364yv and BP-induced aberrant isoform of the cytochrome P-450 has been discussed. PMID- 1786391 TI - [Determination of the role of DNA cytosine methylation in human genetic individuality]. AB - By the restriction analysis method we established that methylation of the 5'-end cytosine in 5'-m5CC-3' duplexes had individual specific features. This genetic peculiarity did not change even in DNA from human stomach carcinomas. PMID- 1786392 TI - [Interrelations of the severity of manifestations of experimental food anaphylaxis and content of cytochrome P-450 W and P-450 L]. PMID- 1786393 TI - [Blood microvascular bed of the fascia propria of the rat leg in normal conditions and under the effects of gamma rays]. PMID- 1786394 TI - [Morpho-functional changes in the lymph nodes during fever reaction]. AB - Lymph nodes (mesenteric, popliteal, cervical) of rabbits in fever reaction of different duration have been studied in our work. As a whole morpho-functional changes in lymph nodes in fever reaction indicate the increase of their functional activity: hyperplasia of lymphatic substance with the growth of lymphocytes number and slightly differentiated lymphoid cells in follicles and paracortical zone, hyperplasia of pulposus bands, the signs of macrophagal reaction and plasmatization of lymph nodes are to be observed and all these create prerequisites for the increase of tensity of cellular and humoral immunity. Simultaneously the signs of destruction of cellular elements- lymphocytolysis in the porta tract and the growth of number of PAS-positive cells in the parenchyma of the nodes take place. PMID- 1786395 TI - [Cytoplasmic maturation of cow oocytes cultured in vitro and their dehydrogenase activity]. AB - Approximately in 80% of cow oocytes (n = 632) ended cytoplasmatic and nucleus maturation to the state of metaphase II in the conditions of 24 hours in vitro cultivation. In 300 oocytes cytochemically we have determined the activity of enzymes--the succinate dehydrogenase (SDH, EC 1.3.99.1.), alpha-glycerophosphate dehydrogenase (GPDH, EC 1.1.1.8.) and glucose-6-phosphate dehydrogenase (G6PDH, EC 1.1.1.49.). The reaction intensity of the observed dehydrogenases increased in cow oocytes which were cultivated in vitro for 24 hours. Dehydrogenases are located in the mitochondria which are laid out regularly in the cytoplasm of oocytes. Part of oocytes showed polarization in the lay out of reaction and part of oocytes gave extramitochondrial reaction. PMID- 1786396 TI - [Reorganization of skin scars on the back of rats]. AB - The method of dosed mechanical injuries (DMI) when applied repeatedly to the mature skin scars in the rat's backs leads to their reduction and transformation into the regenerates having the structure resembling that of the normal skin. The more is the number of applications of DMI--the more is the amount of transformed scars. PMID- 1786397 TI - [Computer-assisted analysis in morphometric studies of pathologic-anatomic characteristics of the liver]. PMID- 1786398 TI - Green tea extract inhibits nucleoside transport and potentiates the antitumor effect of antimetabolites. AB - The present study provides evidence that green tea extract (GTE), consisting of polyphenol components, is a highly active nucleoside transport inhibitor. GTE markedly inhibited radiolabeled thymidine and uridine transport in mouse leukemia L1210 cells, with IC50 values of 3.2 and 8.0 mumol/L, respectively. GTE blocked the rescue effect of exogenous nucleosides and enhanced the cytotoxicity of AraC and MTX to L1210 cells and human hepatoma BEL-7402 cells. GTE markedly potentiated the inhibitory effect of AraC on leukemia L1210 and P388 in mice. These results indicate that GTE is potentially useful when combined with antimetabolites in cancer chemotherapy. PMID- 1786399 TI - Vaginal reconstruction using perineal-thigh flaps with subcutaneous pedicle. AB - A technique of vaginal reconstruction using bilateral, perineal-thigh flaps with subcutaneous pedicle is described. In this procedure, the flaps were raised bilaterally and introduced into an artificial space between the urinary bladder and rectum. The blood supply for the flaps flows from the perineal artery through anastomotic branches to the external pudendal artery. The authors used the technique on four patients, and all the flaps survived entirely. There was no complication. According to a more than two-year follow-up survey, the reconstructed vaginas are expansible and contract little. No stent is needed. There is good sensitivity in the wall of the artificial vagina because sensory nerves run through the flaps. PMID- 1786400 TI - Phorbol myristate acetate and calcium ionophore A23187 modulate the accessory cell function of mouse dendritic cells. AB - Dendritic cells (DC) comprise a small subpopulation of lymphoid cells, with distinct morphologic features, surface phenotypes and a potent accessory function in T cell-dependent immune responses. In the present study, we investigated the in vitro effects of a tumor promoter, phorbol myristate acetate (PMA), and calcium ionophore A23187 on the accessory cell function of mouse spleen DCs in the primary mixed lymphocyte reaction (1 degree MLR) and oxidative mitogenesis (OM). A multi-step purification procedure was used to procure a highly enriched DC population from mouse spleen. The accessory cell activity of the DCs so obtained was much stronger than that of M phi s in both MLR and OM. The effects of PMA, a protein kinase C (PKC) activator, on DC were dose-dependent. If pretreated with 50 ng/ml of PMA for 3 h, DC activity was enhanced by about two fold; whereas 200 ng/ml decreased DC activity with an inhibition rate of about 50%. However, in the latter situation, a moderate increase in DC activity was seen in the early phase of the response. When pretreated with 0.5-1.0 mumol/L A23187 for 6-8 h, the accessory cell activity of DCs was twice as potent as that of the control, and the enhancing effect was sustained in both MLR and OM. Our results indicate that the function of DCs, a cell type with constitutively high accessory cell activity, can be further promoted by A23187 or a low dose of PMA. This is also circumstantial evidence of an up-regulation of DC activity via PKC activation and/or an increase in cytoplasmic calcium.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786401 TI - Establishment and preliminary application of spermidine radioimmunoassay with 125I-labelled monoclonal antibody and solid phase antigen. AB - Purified anti-spermidine monoclonal antibody was labelled with radioactive iodine by the Iodogen method and spermidine-bovine serum albumin (SPD-BSA) conjugate was used to coat polystyrene beads as solid phase antigen. The new solid phase 125I labelled spermidine radioimmunoassay (RIA) depends on the competition between spermidine in the sample and the solid phase antigen for the limited amount of 125I-labelled monoclonal antibody. The sensitivity of this assay was 10 ng/ml higher than that of liquid RIA for spermidine with 14C-labelled spermidine. The coefficients of variation (CV) within and among batches were 4% and 13% respectively. The sample-batch capacity was increased from 20 (liquid RIA with 14C-labelled spermidine) to 150-200 by using this method. Because of its simplicity, the solid phase RIA kit is very convenient for population survey. This RIA could be used to determine spermidine in saliva for the diagnosis of precancerous lesions. In a preliminary study saliva spermidine levels in different populations were measured among 130 normal subjects, 202 esophageal epithelial hyperplasia cases treated with anti-tumor B for 5 years, 207 esophageal epithelial hyperplasia cases as control, and 55 esophageal cancer patients. The levels were 1,795 +/- 1,481, 3,470 +/- 6,981, 9,753 +/- 17,641 and 18,090 +/- 21,509 ng/ml, respectively, with the saliva spermidine levels in precancerous and cancer patients being significantly higher than that of normal subjects (P less than 0.001); the level in patients treated with anti-tumor B was significantly lower than that of controls (P less than 0.001). This decreased saliva spermidine content was coincident with the 47.3% reduction of canceration rate seen in precancerous patients after a 5-year treatment with anti-tumor B. PMID- 1786402 TI - Hemodynamic response to BMI model PIAB catheter. AB - Using the BMI model PIAB catheter designed and produced by our laboratory, we carried out serial animal experiments to evaluate its hemodynamic effects in goats. The animal experiments and comparison tests indicated that BAPDP = 24, PSP = 22; BAEDP = 8, EDP = 14; BAPSP = 20, PSP = 22. The various hemodynamic parameters of our PIAB catheter are equivalent to or better than those of imported products. But the price of our PIAB catheter is much lower than that of foreign products. It has been used in some hospitals, showing satisfactory results. PMID- 1786403 TI - Production of interleukin I during the course of inflammation and its biological significance. AB - In order to shed some light on the mechanism by which inflammation modulates the immune response, the kinetics of IL-1 production and of the cells producing it as well as the control mechanisms involved were studied in a variety of animal models. In the case of casein-induced peritoneal inflammation in rabbits, IL-1 beta mRNA expression was found to be limited to the early stage--peaking at 2 h and lasting for only 5 h, a period corresponding to that in which new antigen introduction induces an enhanced immune response. This suggests that IL-1 beta is an inflammation-induced immune potentiation factor. Among 5-h peritoneal exudate cells (PEC) staining with anti-rabbit-IL-1 beta goat antibody, 99% were PMNs. Surprisingly, 9-h and 16-h PECs, which display negative IL-1 activity, also stained for IL-1 beta antigen. This seemingly contradictory data can be explained by the existence of a hypothetical processing protease subject to limited activation, and by a newly isolated 13 kD IL-1 antagonist produced during the later stages of inflammation. PMID- 1786404 TI - A modified electrode plate for low energy electric conversion of atrial fibrillation. AB - Fifty-six patients with atrial fibrillation associated with heart disease were treated with a modified electrode plate for low energy electric conversion. Fifty four (96%) of these cases were successfully converted into sinus rhythm using the modified electrode plates, a new site and low energy discharge (an average of about 50 J). To construct the new-style electrode plates, a 2 cm arc segment was cut from each of two electrodes (10 cm in diameter each). As for the site of application, the cut-edge of the anterior chest electrode, which has a concave diameter of 150 cm, is placed close to the right of the sterum over the fourth to sixth intercostal spaces, and the cut-edge of the other electrode is placed to the left of the spinal column at the level of the seventh to ninth thoracic vertebrae. The safe-effective period for the appearance of the first post discharge QRS complex was found to be 1.4-5.0 s. PMID- 1786405 TI - Effects of hyperlipidemic sera and lipoproteins on prostacyclin synthesis by rabbit aortic smooth muscle cells. AB - The effects of various hyperlipidemic sera and serum high density lipoproteins (HDL) and low density lipoproteins (LDL) on the synthesis of prostacyclin (PGI2) by rabbit aortic smooth muscle cells in culture were studied. Data show that HDL induces a dose-dependent increase in the synthesis of PGI2 in smooth muscle cells. Although LDL at comparable cholesterol concentrations to HDL also results in an increase of PGI2 synthesis in a dose-dependent pattern, the extent of this increase is much less than that induced by HDL. Smooth muscle cells incubated with hyperlipidemic serum and hyperlipidemic + aspirin-treated sera synthesize less PGI2 as compared to normal serum, but cells incubated with hyperlipidemic + 8501-treated serum generate an amount of PGI2 similar to that seen with normal serum. We suggest that 8501 may directly stimulate PGI2 synthetase in smooth muscle cells. PMID- 1786406 TI - Antioxidant action of certain simple phenolic compounds derived from Chinese herbs. AB - H2O2 and hydroxyl free radical active oxygen generation systems were utilized to define the antioxidant activities of simple phenolic compounds derived from Chinese herbs. Although the antioxidant activities of compounds differed when assessed in the two systems, all compounds tested were found to be effective at preventing red blood cell membrane lipid peroxidation, with the propyl and butyl esters of gallic acid being especially potent. No compound was able to prevent hemoglobin oxidation. All compounds but salicylic acid were found to interact dose-dependently with H2O2 and hydroxyl free radical as determined by a chemiluminescence method. PMID- 1786407 TI - Use of MG series monoclonal antibodies in the diagnosis and experimental targeting therapy of gastric cancer. AB - In order to facilitate early diagnosis and improve the treatment of gastric cancer, 12 murine hybridoma cell lines capable of producing monoclonal antibodies (mAb) against gastric cancer were established. These monoclonal antibodies were used in histopathological diagnosis, cytological and serological diagnosis, and radioimmunoimaging (RII). Also, immunoconjugates and immunoliposomes were produced by linking these antibodies with various anticancer agents. In vitro and in vivo studies in mice were carried out to investigate the possible uses of these antibodies in experimental targeting therapy of gastric cancer. This paper presents a review of these studies. PMID- 1786408 TI - Experimental studies on the elimination of minimal residual leukemia in vivo by alternative half-body irradiation. PMID- 1786409 TI - Enzymatic diagnosis of Morquio A syndrome with a new fluorimetric substrate. AB - We synthesized a new fluorimetric substrate for the enzymatic assay of galactose 6-sulphate sulphatase (Gal-6S), an enzyme which is deficient in Morquio A syndrome. Our synthetic 4-methylumbelliferyl-galactoside 6-sulphate (4Mu-Gal-6S) proved highly effective and sensitive in the postnatal, prenatal and retrospective diagnosis of Morquio A syndrome as compared to the commonly used radiolabelled substrate. With 4Mu-Gal-6S as substrate and dialyzed supernatant as the enzyme source, we defined the optimal assay conditions for Gal-6S, determined the normal control values for all available materials, and successfully performed postnatal and prenatal diagnosis of Morquio A syndrome. PMID- 1786410 TI - Proteolytic control of protein topogenesis. AB - The data on proteolytic control of protein topogenesis and of cell organelles assembly are critically reviewed. There are grounds to suggest that the slow conformational maturation of polypeptide chains, the defects in their modification (i. e., glycosylation) and the delay in some subcellular compartments on the exocytic pathway are responsible for the enhanced proteolytic degradation of proteins. The same holds true for the miscompartmentalized proteins. Another aspect of proteolytic control is the assembly of the multisubunit protein complexes in a cell. The cases of nonstoichiometric subunits synthesis, followed by the degradation of unassembled subunits, are summarized. Stoichiometric ratios of subunits in a cell are supposed to be established by this means. Such a mechanism is especially important when these subunits are synthesized asynchronously or when they are encoded by different genomes and are produced by different protein-synthesizing systems. Most probably, proteolytic control is operative at all stages of the respiratory competent mitochondria formation: (i) when protein precursors are imported from the cytosol, (ii) when the individual polypeptides are assembled into complexes, and (iii) when functioning multienzyme ensembles are formed. From this point of view, a pleiotropic character of mutations in individual proteins of mitochondria and chloroplasts is considered. Thus proteolytic systems of a cell play an important role in protein topogenesis and in the biogenes of cell organelles. PMID- 1786411 TI - Pollen cultures as a tool to study plant development. AB - In in vitro cultures, isolated microspores and pollen grains can undergo two fundamentally different types of development. In conditions that simulate the tapetum they continue normal gametophytic development to produce functional pollen. Under stress conditions, they are induced to form haploid embryos and plants (sporophytes). In vitro matured pollen is a "minimal" pollen that lacks substances to enhance its reproductive success. In vitro pollen maturation is presented as an experimental system to study pollen development and its interaction with the tapetum. For young binucleate pollen grains, a starvation treatment is sufficient to induce sporophytic development, for microspores a heat shock treatment is required. During the stress treatments, transcription of specific mRNAs is activated. An important aspect of embryogenic induction of binucleate pollen is the derepression of the cell cycle in the G1-arrested vegetative cell. PMID- 1786412 TI - Transendothelial transport of macromolecules: the concept of tissue-blood barriers. AB - In addition to its many functions in biosynthesis, growth, coagulation and rheology, vascular endothelium is anatomically interposed between the vascular space and the tissue fluid. Recent evidence indicates that it mediates cellular and molecular exchange between these compartments. The exchange can occur through differentiated microdomains of endothelium such as fenestrae. These areas are differentiated with regard to surface charge, protein distribution within the lipid bilayer, membrane fluidity and other features. The exchange is also affected by certain characteristics of the molecule to be transported: molecular size, charge, shape and its carbohydrate content. Proportionately, the largest volume of exchange occurs across the endothelial cytoplasm by vesicular transport systems. Two systems are particularly in evidence; (a) receptor-mediated transcytosis which is specific, and (b) fluid-phase endocytosis. The molecule may become modified in transit and the modification may be of essence in determining its target point and its subsequent metabolism. While most of these modifications involve the carbohydrate moiety of the glycoproteins, glycosylation of non glycoproteins such as albumin, may also be of physiological significance in transendothelial transport. By virtue of its transport potential, albumin can thus affect the transport of other substances. Recent advances in the molecular transport function of endothelium have been reviewed in the context of its physiological and clinical significance. The basis for the concept of a generalized tissue-blood barrier has been offered. PMID- 1786413 TI - The volume and characteristics of insanity defense pleas: an eight-state study. AB - The authors document the very complex process involved in identifying insanity defense pleas in eight states. Each state and each study county in each state required an individual approach. Most often, county court dockets were hand searched to identify those pleading insanity, although numerous other methodologies were used. The frequency and rate of insanity pleas and acquittals are presented for the study states as well as descriptive data on the characteristics of persons pleading and acquitted NGRI. Overall, the insanity defense was raised in one percent of all felony cases. Further, only 26 percent of those raising the insanity defense were actually acquitted NGRI. The necessity of obtaining data on insanity pleas to adequately understand and ultimately inform future directions of insanity defense research is discussed. PMID- 1786414 TI - Recent developments in the transracial adoption debate. AB - This article places the controversy over transracial adoption (TRA) in its historical context and analyzes recent developments in the law governing TRA policy. Because unfounded "authority" from the field of mental health infuses current debate, the authors alert psychiatrists to two powerful forces that improperly influence today's legal arena: community preference for same-race families and biased professional norms of mental health professionals. PMID- 1786415 TI - Court based civil commitment of alcoholics and substance abusers. AB - Problem. To study court ordered substance abuse commitment (SAC) in one jurisdiction. We investigated who was evaluated, by whom, and with what outcome. Is SAC primarily a purely civil procedure as originally intended? Are men and women being treated equally? METHOD: Questionnaire survey of court clinicians to determine demographic and clinical status of persons evaluated, the process of evaluation, and the disposition. RESULTS: SAC is common and more frequent in criminal cases than in purely civil ones. SAC of women is clearly influenced by the restricted choices for disposition: either state prison or an unlocked facility. CONCLUSIONS: SAC is an important public health procedure, which courts are using in highly variable and at times unintended ways. SAC has emerged as an alternative to other dispositions in criminal cases involving substance-abusing defendants. PMID- 1786416 TI - Competency to stand trial: description and initial evaluation of a new computer assisted assessment tool (CADCOMP). AB - The authors describe a Computer-Assisted Determination of Competency to Proceed (CADCOMP), a new instrument that collects data directly from the defendant through an interactive computer program and renders a report covering relevant historical, psychopathological, and legal information. The comprehensive report could be utilized by the clinician to focus the clinician's interview with the defendant on areas requiring further probing, thus reducing the time required to assess competency. Preliminary reliability and validity assessment studies are reported. The results support the predictive validity of CADCOMP used as a screening instrument and found the CADCOMP to be sufficiently reliable to be used for screening purposes. PMID- 1786417 TI - Beyond cognition: the role of disordered affective states in impairing competence to consent to treatment. AB - Most of the criteria for competence in current use emphasize cognitive rather than affective dimensions. Our clinical experience indicates that affective disorders may impair competence in a detectable and identifiable way. In particular, patients with major affective disorders can retain the cognitive capacity to understand the risks and benefits of a medication, yet fail to appreciate its benefits. A case study of a pathologic grief reaction is introduced to illustrate how cognitive and affective impairments may coexist and require separate remedial strategies for restoration. Further empirical work on the role of affective disorder in impairing competence is warranted and planned. PMID- 1786418 TI - Mentally disordered offenders in Sweden. AB - This article reviews the laws in Sweden concerning mentally disordered offenders. It also contains some figures on the relationship between mentally disordered offenders and other offenders sentenced to prison. The rules in Sweden are very different from other countries in that the responsibility concept has been abolished and thus there is no acquittal on a psychiatric basis. PMID- 1786419 TI - Informed consent in the electroconvulsive treatment of geriatric patients. AB - The past 15 years have been marked by an increasingly stringent regulatory atmosphere regarding the administration of ECT, leading to delays in treatment and declines in usage. Regulatory changes requiring judicial intervention in clinical decisions are driven by the notion that only the courts can provide adequate due process protections when legal rights and clinical need conflict. We retrospectively reviewed the documentation of the informed consent process for 62 geriatric patients receiving ECT to assess the degree to which clinicians conformed to the spirit of the informed consent doctrine in a state that allows significant clinical discretion in decisions to administer ECT to patients lacking decisional capacity. In the eight cases in which the patient's decisional capacity was questioned, we found appropriate documentation of the patient's failure to comprehend his condition or the proposed treatment, evidence of a high degree of family involvement in decision making, and extensive use of outside consultants to document decisional incapacity and the need for treatment. Evidence of family participation in decision making was present for a high percentage of cases in which decisional capacity was unquestioned. Our review demonstrated high compliance with the procedural safeguards contained in the state regulation and with the spirit of the informed consent doctrine. PMID- 1786420 TI - Forensic psychiatric inpatients served in the United States: regional and system differences. AB - This research note presents data about regional and system variations in psychiatric inpatient services for forensic patients provided in state operated psychiatric inpatient programs in the United States in 1986. Patient census by legal status and service provision information were collected from state forensic directors. In 1986, about 5,400 patients found not guilty by reason of insanity (NGRI) and 3,200 patients found incompetent to stand trial (IST) were being served in state operated inpatient units. About 70 percent of both groups were being served in designated forensic beds. There were wide differences among the states in the volume and rates for NGRI, IST, forensic exams, and dangerous civil patients (DCP). The regional analyses revealed large variability among states within each region. PMID- 1786421 TI - [The Cancerology Forum in 1991]. PMID- 1786422 TI - [Anticancer chemotherapy: transfer of biological concepts to clinical research]. PMID- 1786423 TI - The NCI program of therapeutic research. PMID- 1786424 TI - [Metastatic enhancement: biological mechanisms and therapeutic implications]. AB - In experimental models chemotherapeutic agents enhance spontaneous metastases. Vascular toxicity and myelotoxicity may account for this phenomenon. However, drugs may act directly on tumor cells. Clonogenic resistant cells are involved in the metastatic process facilitation. Fundamental biological mechanisms are evoked to explain these observations. Mutagenicity and its consequences on gene expression or regulation are another hypothesis. Clinical investigations are necessary to confirm the results obtained from animal models. PMID- 1786425 TI - [Study of vinorelbine (V) combined with hexamethylmelamine (H) (combination V-H) in adenocarcinoma of the ovary: results a phase I-IIA trial, NHO-88, of ARTAC "ovarian" group]. AB - The lack of decisive progress in ovarian cancer chemotherapy in recent years led the ARTAC "Ovary" group to initiate a study based on the hypothesis of collateral sensitivities. In this phase I-II trial, NHO-88, the V-H combination (associating vinorelbine (VNB) and hexamethylmelamine (HMM) was studied in patients with advanced ovarian adenocarcinomas, most of which had become resistant to previous chemotherapy. The aim of the study was to find an active combination without complete cross resistance with first-line platinum salt based combinations, such as CAP, FAP or CACb-300. A pilot feasibility study was first carried out to determine the maximum tolerated weekly dose (MTWD) of VNB (20 mg/m2/week), HMM being administered per os on days 1-14 of every 28-day cycle at a standard dose of 250 mg/m2/day. An open phase II-A study was further carried out according to a 2-step sequential analysis method for phase II clinical trials. We observed: 1), a good tolerance of the V-H combination apart from frequent neutropenia; 2), a response rate of 35% (95% confidence interval: 23-47%); 3), a median response duration of 4 months (range: 1-7 months); 4), in some cases, the absence of a complete cross-resistance between the V-H regimen and the previously administered platinum-based combinations. These results, which are currently being validated (phase II-B ongoing), constitute the first step in the search for active systems of sequential or alternate chemotherapeutic regimens for the treatment of advanced carcinomas. PMID- 1786426 TI - [Study of high doses of carboplatin as a first choice in the therapy of advanced ovarian cancers]. AB - Thirty female patients with ovarian cancer of poor prognosis were included in a chemotherapy trial using high dose IV carboplatin--800 mg/m2 every 5 weeks. The subjects had three to six cycles prior to second laparotomy. Twenty-eight patients were assessable. There was no neurological, auditory or renal toxicity. Limiting toxicity was haematological, the mean neutrophil count was less than 650 mm3 and the mean platelet count less than 30,000/mm3. No death occurred from toxicity. The clinical response rate was 67%, and the surgical response rate 53.5%, with 15% complete histological responses. Survival at 18 months is 36%. A trial concerning 36 patients treated with an association of carboplatin at the same dose combined with cyclophosphamide has just been completed and the results are being analyzed. PMID- 1786427 TI - [Acute cardiac toxicity of 5-fluorouracil: pharmacokinetic correlation]. AB - High-dose 5-fluorouracil (5-FU) continuous infusion over a 4-day period seems to dramatically increase the frequency of cardiac complications, which were however extremely rare in the past when it was injected in bolus form (1.6%). In order to evaluate their real incidence we looked for a relation between cardiac toxicity and clinical or 5 FU pharmacokinetic parameters. One hundred and thirty-three patients were followed up from January 1989 to March 1990, treated for head and neck, breast and colorectal cancers by high-dose 5-FU infusion (1,000 mg/sqm/d x 4 d) and cis-platinum (20 mg/sqm/d x 4 d). During each treatment course, daily electrocardiogram and 5 FU plasma assays were performed by high performance liquid chromatography, at 8 am and 8 pm. Twenty-eight patients presented 36 ischemic cardiac manifestations which were sometimes severe. Of these, 29 were asymptomatic. Cardiac toxicity frequency was not increased in the group treated for head and neck cancers. Pharmacokinetic analysis showed wide variations in 5 FU plasma levels in the 133 patients under study (from 20 to 1,200 ng/ml). Cardiac manifestations always appeared during the hours following very high 5-FU plasma levels (greater than 450 ng/ml). Cardiotoxicity seems to be linked to 5-FU plasma levels. Cis-platinum probably increases toxicity in this regimen. These findings indicate the advisability of a close follow-up by daily ECG when 5-FU is administered at high doses in continuous infusion and associated with cis platinum. We are continuing to study 5 FU cardiac toxicity, especially in other regimens containing 5 FU and aim to evaluate the contribution of cardiac isotopic exams. PMID- 1786428 TI - Recombinant human GM-CSF: present clinical results and potential use in oncologic and hematologic disorders. AB - The human recombinant GM-CSF (hrGM-CSF) is a glycosylated hematopoietic growth factor, derived from CHO cells (Schering Plough/Sandoz) used in these studies. The hrGM-CSF can be given intravenously (i.v.) in 4- to 24-h infusions or subcutaneously (scx) once or twice a day. Many patients (more than a thousand) have been treated with the hrGM-CSF in various pathologies, in association with anti-cancer chemotherapy, after bone marrow transplants or for myelodysplasias, refractory anemias, some neutropenias and infections. The reversion of neutropenia is dose-dependent with either a sc or i.v. administration. Recommended doses are from 5.0 to 10.0 micrograms/kg/per day. When the product is given sc the effect is delayed by one day but is more prolonged than with the i.v. route. The treatment duration has been investigated in different studies: a minimal duration of 5 days seems appropriate. When given in association with high doses of cytotoxic chemotherapeutic agents 10 to 14 days are required. In bone marrow transplants (autologous or allogenic with T-cell depletion), the hrGM-CSF has been shown to significantly reduce the time necessary for engraftment. Contrary to some fears, it was not shown that hrGM-CSF increased the risk of blastic transformation in myelodysplastic syndromes. In association with cytosine arabinoside a certain number of partial and complete responses have been obtained. The toxic effects of the product are also dose-dependent. At doses greater than 11 micrograms/kg per day, there is a risk of stimulating inflammatory phenomena whereas at lower doses, more moderate side effects (myalgia, fever, injection site reaction) occur in only 30% of the cases. The GM CSF will certainly be important in the future in haematology, oncology and for the treatment of infectious diseases. PMID- 1786429 TI - [Breast cancer: treatments and perspectives. Lyon, 7 September 1991]. PMID- 1786430 TI - Fallout 131I in western Nevada cattle thyroid glands: 1962-early 1969. PMID- 1786431 TI - Coplanar PCBs in human milk in the province of Quebec, Canada: are they more toxic than dioxin for breast fed infants? PMID- 1786432 TI - Detection limits of organochlorine pesticides and related compounds in blood serum. PMID- 1786433 TI - PCB residues in the adipose tissue of the population of Barcelona (Spain). PMID- 1786434 TI - Fluoride accumulation in different earthworm species near an industrial emission source in southern Germany. PMID- 1786435 TI - Simulated field ingestion of carbofuran-contaminated feedstuffs by pheasants. PMID- 1786436 TI - Protective apparel survey of agricultural workers in cotton growing regions. PMID- 1786437 TI - Removal of fenitrothion and cypermethrin from contaminated fabrics by handwashing. PMID- 1786438 TI - Evaluation of the "reference toxicant" addition procedure for testing the toxicity of environmental samples. PMID- 1786439 TI - Influence of suspended sediment on the biodegradation of alkyl esters of p aminobenzoic acid. PMID- 1786440 TI - Pollution by petroleum hydrocarbons in sediments from continental shelf of Tabasco State, Mexico. PMID- 1786441 TI - Distribution of 1,3-dichloropropene and 1,2-dichloropropane in Big Creek watershed. PMID- 1786442 TI - Behavior and fate of chloronitrobenzenes in a fluvial environment. PMID- 1786443 TI - Infiltration of organic pollutants into groundwater: field studies in the alluvial aquifer of the Sava River. PMID- 1786444 TI - Field chamber technique for measuring pendimethalin airborne loss from turfgrass. PMID- 1786445 TI - Lead levels among various deciduous tooth types. PMID- 1786446 TI - Increase of urinary and serum hydroxyproline in subjects exposed to cadmium. PMID- 1786447 TI - Qualitative assessment of the mutagenicity of road coating asphalt. PMID- 1786448 TI - Hemopathological changes associated with experimental aldicarb poisoning in fish (Puntius conchonius Hamilton). PMID- 1786449 TI - Acute toxicity of parathion and 2,4-D to larval and juvenile stages of Chasmagnathus granulata (Decapoda, Brachyura). PMID- 1786450 TI - Simple method for determination of methanol in blood and its application in occupational health. PMID- 1786451 TI - On-line DDT determination in blood serum: experimental parameters. PMID- 1786452 TI - Determination of petroleum hydrocarbon toxicity with Microtox. PMID- 1786453 TI - Levels of 3,3',4,4'-tetrachloroazobenzene in propanil herbicide. PMID- 1786454 TI - Red blood cell glucose metabolism in human chronic fluoride toxicity. PMID- 1786455 TI - Nickel interactions with glutathione and related enzyme in 11-day embryo and yolk sac in rat. PMID- 1786456 TI - Dietary heavy metal uptake by the least shrew, Cryptotis parva. PMID- 1786457 TI - Tolerance to aluminum toxicity: certain basic biochemical aspects. PMID- 1786458 TI - Long-term trends of DDTs and PCBs in sediment samples collected from the eastern Adriatic coastal waters. PMID- 1786459 TI - SEM study on the effects of crude oil on the gills and air breathing organs of climbing perch, Anabas testudineus. PMID- 1786460 TI - Inhibitory effect of petroleum oil on photosynthetic electron transport system in the cyanobacterium Anabaena doliolum. PMID- 1786461 TI - Accumulation and tissue distribution of radioiodine (131I) from algal phytoplankton by the freshwater clam Corbicula manilensis. PMID- 1786462 TI - Seasonal changes of superoxide dismutase activity in erythrocytes of Abramis brama from two different types of Poland lakes. PMID- 1786463 TI - Acute and chronic toxicity of endosulfan to crab: effect on lipid metabolism. PMID- 1786464 TI - Methylparathion induced alterations in the tissue carbohydrate catabolism of marine prawn, Metapenaeus monoceros. PMID- 1786465 TI - Effect of cadmium on the biochemical composition of the freshwater crayfish Procambarus clarkii (Girard, 1852). PMID- 1786466 TI - Biotechnology of blood. PMID- 1786467 TI - Chemically modified and recombinant hemoglobin blood substitutes. AB - Several intramolecularly cross-linked hemoglobins having properties useful as blood substitutes have been developed. At least one of these, HbXL99 alpha, is amenable to large-scale production. This hemoglobin, and perhaps other cross linked derivatives as well, is sufficiently heat stable to achieve complete viral inactivation. This makes it possible to use human blood as a starting material. Preliminary studies on the use of HbXL99 alpha to perfuse the heart during coronary angioplasty appear promising (Rossen et al. 1987). For large-volume blood replacement, a derivative having a longer intravascular retention time would be desirable. The development of more selective cross-linking agents for the polymerization of hemoglobin would be useful for this purpose. The expression of human hemoglobin in E. coli (Nagai and Thogersen 1984, 1987; Hoffman et al. 1989) and in transgenic mice (Behringer et al. 1989; Ryan et al. 1990) has been achieved. The E. coli system should prove useful for the design of hemoglobin mutants having specifically tailored properties for use as blood substitutes. Adequate supplies of donated blood will likely be available for at least the next decade for the production of chemically modified hemoglobin derivatives. If the supply of human blood later becomes limiting, large-scale production of human hemoglobin should be feasible in transgenic pigs or cows. The economics of this process could be enhanced by producing other blood proteins of commercial value, e.g., human albumin and factor VIII, in the same animal. PMID- 1786468 TI - Liposome-encapsulated hemoglobin: historical development of a blood substitute. PMID- 1786470 TI - Current approaches to the preparation of plasma fractions. PMID- 1786469 TI - Medical oxygen transport using perfluorochemicals. PMID- 1786471 TI - Recombinant antihemophilic factors. PMID- 1786472 TI - Recombinant tissue-type plasminogen activator. PMID- 1786473 TI - Biotechnology, economics, and the business of blood. PMID- 1786474 TI - Long-term storage and preservation of red blood cells. PMID- 1786475 TI - Erythropoietin: its role in the regulation of erythropoiesis and as a therapeutic in humans. AB - The application of recombinant DNA technology to the field of hematology has contributed greatly to our understanding of Epo gene structure and regulation, cellular expression and regulation of hormone production, pharmacokinetics, receptor biology, and ultimately, the value of this hormone as a therapeutic treatment. Areas that will undoubtedly prove fruitful for future research include the mechanisms by which hypoxia influences gene expression, structure/function relationships of the Epo molecule, mechanisms of transmembrane signaling and nuclear activation, and the application of rHuEpo in the treatment of other anemias. Epo is but one example of the contribution that modern biology has made to the understanding of hematopoietic regulation and to the availability of these regulators for the treatment of human disease. PMID- 1786476 TI - Inactivation of viruses found with plasma proteins. AB - Plasma protein solutions such as albumin and intramuscular immune globulin have long histories of viral safety. Coagulation factor concentrates as traditionally manufactured frequently transmitted HBV, HCV, and HIV. Indeed, it is probable that every vial of concentrate contained infectious HCV. Modern coagulation factor concentrates have a greatly improved safety record arising, principally, from the implementation of virucidal procedures. It is interesting to note that the same methods that failed to substantially reduce NANBHV transmission in clinical studies are those that were found to inactivate less than 10(4) ID50 of HIV, HBV, and/or HCV in preclinical studies (Table 17-5). Implementation even of these methods nearly eliminated the transmission of HIV by coagulation factor concentrates. A summary of the results of the most successful procedures is given in Table 17-10. The results show 0/564 patients had evidence of HIV transmission, 6/151 patients had evidence of HBV transmission, and 2/301 patients had evidence of HCV transmission. As compared with those procedures described in Table 17-5, the greater kill of HIV, HBV, and NANBHV demonstrated preclinically, and the improved clinical results, are most notable. The data, examined in terms of units transfused, are presented in Figure 17-1. Since the average adult hemophiliac in the United States receives 80,000 units of clotting factor per year, the best of the concentrates show safety over the equivalent of at least 10-human-years of treatment. Are the best of today's coagulation factor concentrates safe from the transmission of HBV, NANBHV (including HCV), and HIV. Given the limited number of patients eligible for clinical studies, and the length, difficulty, and expense of such studies, the best answer comes from a knowledge of the initial virus load coupled with information regarding virus removal, serendipitous inactivation, and intentional sterilization. A recently completed analysis of these factors (Horowitz 1990) indicates that the best of the modern coagulation factor concentrates are likely to be as safe as albumin (Figure 17-2). PMID- 1786477 TI - Inactivation of viruses found with cellular components. PMID- 1786478 TI - Autologous blood salvage procedures. AB - Autologous transfusion is not a luxury. Some states have passed legislation mandating that surgical patients be informed of the alternatives to homologous blood administration as well as the risks and benefits of transfusion. Technological advances have made autologous blood salvage in surgery, the postoperative period, and certain trauma situations a safe and relatively inexpensive procedure. While there is minimal data documenting the quality of blood which is administered without processing, extensive clinical experience attests to the safety of the procedure. Ample clinical and laboratory data support the safety of reinfusing processed blood. PMID- 1786480 TI - Clinical testing of drug abuse liability. PMID- 1786479 TI - Human drug abuse liability: testing times ahead. PMID- 1786481 TI - Barcelona meeting on clinical testing of drug abuse liability: consensus statement and recommendations. PMID- 1786482 TI - Perspectives and future on testing for abuse liability in humans. AB - Testing of drugs for abuse liability can benefit public health. By encouraging proper therapeutic use, appropriate regulation, and development of safer and more effective drugs, such testing can benefit both consumers and pharmaceutical manufacturers. Many factors influence actual abuse; animal and human drug abuse liability testing procedures are useful, though imperfect, predictors of abuse. Three suggestions are made concerning human drug abuse liability testing: (1) that more research is needed on differences between individuals and between different subpopulations tested with these procedures (2) that actual epidemiological experience concerning abuse should be the 'gold standard' for assessing the validity and utility of drug abuse liability testing methods; and (3) that methods for drug abuse liability testing in humans should be introduced and used systematically to guide appropriate development, regulation, and marketing of drugs. PMID- 1786483 TI - Regulation and abuse liability testing of medicines in Europe beyond 1992. AB - The procedures for approving medicines have been progressively harmonized within the European Community. The authorization of medicinal products beyond 1992 will be based on a more centralized procedure, with important safeguards to ensure that there is no dilution of strict standards of quality, safety, and efficacy. Although some efforts have been attempted to coordinate the procedures for approving medicines with Japan and the United States, some important problems still remain. An example of this lack of coordination is the lack of agreement about applying abuse liability testing to psychotropic drugs. In the United States, abuse liability data are routinely used for scheduling and labeling new drugs under the supervision of the Food and Drug Administration (FDA). This agency has codified the requirements for clinical studies of potential abuse of psychotropic drugs and requires pharmaceutical sponsors to submit specific data. However, requirements within the European Community in this matter are minimal. Clinical trials on subjective effects, drug discrimination or drug preference are not requested. This situation demands more scientific interchange between officials and scientists from the FDA and their counterparts from Europe. The Committee for Proprietary Medicinal Products (CPMP) must play a major role in this coordination and interchange. PMID- 1786484 TI - The necessity and utility of abuse liability evaluations in human subjects. AB - Assessments of the abuse potential of psychoactive drugs in preclinical and clinical studies are used in regulatory decision making process in the United States under the Controlled Substance Act (CSA) and the Federal Food, Drug, and Cosmetic Act (FD & C Act). Two types of drugs are evaluated in abuse potential studies, those being developed for a therapeutic indication by the pharmaceutical industry and illicitly manufactured 'street drugs' of abuse. Only the former will be considered here. In the case of drugs being pursued for marketing or are amendable to study in human subjects and are of scientific, medical, or regulatory interest, preclinical data may be inadequate for drug scheduling and marketing decisions. Preclinical data assessment can suggest hypotheses which must be validated in clinical studies. Moreover, there are limitations to the feasibility of evaluating certain drugs/dosage forms in preclinical studies. Thus, clinical studies are needed for the following scientific reasons: to validate preclinical hypotheses; to assess the time-course of subjective effects as a function of dose and route of administration; to evaluate the generalizability of drug liking in different human subject populations; and to evaluate the effects of drugs on cognitive and affective processes. Clinical studies are also needed if a claim is made regarding reduced or no abuse potential; and lack of additive or potentiative effects with alcohol. PMID- 1786485 TI - Protection of participants and experimental design in clinical abuse liability testing. AB - The protection of participants in clinical abuse liability testing requires adherence to the basic practices of respect for persons, beneficence and justice. Informed consent procedures must ensure protection of confidentiality, specification of potential risk and benefits, and careful explanation of the nature of the research project and the procedures of the study. All participants should be assured that their participation is voluntary, and that they may freely decline or withdraw from the study. The selection of subjects for participation in clinical abuse liability testing should involve consideration of social and behavioral factors which may co-vary with risk for substance abuse. Protection of participants also involves attempts to achieve excellence in the design and conduct of the research in order to enhance the contribution of such studies to science and humanity. PMID- 1786486 TI - Drug abuse potential evaluation in animals. AB - Animal laboratory studies can provide useful information concerning the potential of drugs for abuse. Over the past 50 years, methods have been developed for use with animal subjects which allow the evaluation of pharmacological properties of drugs which are particularly relevant to their abuse. The methods for preclinical drug abuse liability testing are reviewed under six heading: (1) establishment of the degree of pharmacological equivalence to known drugs of abuse, (2) drug discrimination studies, (3) tests of tolerance and cross-tolerance, (4) tests of physical dependence capacity, (5) drug self-administration tests of reinforcing effects, and (6) evaluation of toxicity and performance impairment at self administered doses. Preclinical studies can be helpful early in drug development to select lead compounds with low abuse potential for further study. In the case of new or already marketed medications, animal testing can often compliment and extend abuse liability evaluation in human subjects. The results of abuse potential evaluation studies can be useful in making decisions about the possible need for regulation under national and international drug laws, and thus play an important role in drug abuse prevention. PMID- 1786487 TI - History of abuse liability testing in humans. AB - Clinical testing for drug abuse liability began as part of a collaborative effort to develop non-addicting substitutes for morphine. Physical dependence capacity and euphorigenic potential were identified as the potent effects of morphine leading to abuse; quantitative measures were developed for these effects. Drugs were evaluated for morphine-like effects using principles of bioassay. In recent years, the alterations in mood, feeling, thinking, and perception induced by drugs (subjective effects) are viewed as the effects leading to reinforcement of drug-taking behavior and to abuse. The same procedures and methods developed for assessing these effects with opioids have subsequently been applied to other classes of drugs. At present, human drug abuse liability testing methods exist for opioids, stimulants, sedative hypnotics, serotonin agonist and antagonists, nicotine, alcohol, and caffeine. PMID- 1786488 TI - Utility of subjective-effects measurements in assessing abuse liability of drugs in humans. AB - Estimates of the likelihood that a drug will be abused have generally been based on the subjective effects engendered by that drug. With the development of standardized subjective effects questionnaires in the 1960s and 1970s, researchers have been able to carefully evaluate self-reported effects of drugs, generally making measures before and repeatedly after administration of a single dose of drug. The use of multiple doses under controlled laboratory conditions in which physiological measures are also taken, and both the investigator and the subject are blind to the dose administered, has been suggested as most likely to yield useful data about the abuse liability of a test compound. Although questions remain about the specific subjective effects measures to be used, there has been general agreement among researchers in this area that scores on scales from the Profile of Mood States, Addiction Research Center Inventory, and Visual Analog Scales which include measures of 'high' or 'liking' all provide predictive utility. The addition of a measure of actual drug-taking to this predictive model appears to provide important information about the conditions under which these two behaviors (self-reported effects and drug self-administration) vary, and strengthens the model substantially. PMID- 1786489 TI - Drug self-administration methods in abuse liability evaluation. AB - The human drug self-administration paradigm is an extension of the animal model developed in the 1960s. The paradigm can be used to investigate the determinants and correlates of drug-seeking and drug-taking behavior and has proven useful in the development of medications for treating drug dependence. This paper describes the basic components of the human self-administration model and discusses studies that illustrate some of its applications, including assessment of the reinforcing effects of drugs, analysis of behavioral and pharmacological mechanisms of drug self-administration and measurement of the abuse liability, behavioral toxicity, and aversive effects of drugs. Some of the strengths and limitations of using the paradigm with human research subjects are also presented. It is concluded that the drug self-administration model should not replace other measures of abuse liability testing in humans, but should be incorporated into comprehensive programs of drug abuse assessment wherever possible. PMID- 1786490 TI - Preference procedures for testing the abuse liability of drugs in humans. AB - Drug preference procedures may be used to assess the abuse liability of drugs in human volunteers. These procedures usually measure subjects' choice of a drug versus a placebo, under controlled, double-blind conditions. Depending upon the conditions of the studies (e.g. subject population, environmental conditions of testing), drugs that are known to be abused are also preferred in these laboratory procedures. To assess the abuse liability of an unknown test drug, the frequency of choice of the test drug is compared to choice of a standard drug with known abuse potential: preference for the test drug, relative to the standard, is then taken as an indicator of its relative potential for abuse. A number of methodological variables must be considered when designing and interpreting choice studies, including the characteristics of the subjects, the range of doses tested, whether choices were spaced widely apart (e.g. one a day) or closely together (e.g. one immediately after another), and whether the study was conducted under controlled laboratory conditions or in the subjects' normal daily environments. The conditions for testing the abuse liability of an unknown compound must be selected based on the existing literature with similar, known drugs of abuse. PMID- 1786491 TI - Drug discrimination methods in human drug abuse liability evaluation. AB - The drug discrimination paradigm, which is sometimes considered to provide an animal model of human subjective effects, has been adapted for use with human subjects. This procedure provides a direct measure of stimulus similarity between the test drug and a known standard drug, information that may be of value in predicting abuse liability of novel compounds. The present paper reviews the general methods used in human drug discrimination studies, some of the drugs that have been tested, factors to consider in designing drug discrimination studies in humans, and evidence concerning the utility of the procedure in abuse liability assessment. Further research is needed to validate this procedure and to determine the conditions under which it has the greatest value in abuse liability assessment. PMID- 1786492 TI - Performance and physiological measures in abuse liability evaluation. AB - Abuse liability testing involves an evaluation of the likelihood of drug self-use and also an evaluation of the harmful effects of drug use. This paper reviews the rationale and utility of examining performance and physiological measures in clinical abuse liability evaluation. It is concluded that there are three important reasons to employ such measures in abuse liability studies: (1) to serve as a reference point to allow for between drug and across measure comparisons; (2) to directly quantify dose-response functions on multiple dimensions of drug effect and thus evaluate the overall profile of effects; and (3) to provide information on the likelihood that drug use will produce harmful effects. The review illustrates each of these purposes and briefly summarizes conclusions from previous studies employing performance and physiological measures in the abuse liability evaluation of sedatives, stimulants, and opioids. PMID- 1786493 TI - Pharmacokinetic considerations in abuse liability evaluation. AB - The behavioral effects of a drug are related to three factors: its intrinsic pharmacological activity, its physicochemical properties, and its pharmacokinetic parameters. In many cases differences in absorption, distribution, metabolism, and elimination may explain the different abuse liability profiles of drugs from within the same pharmacological class. Rapid absorption rate and high lipid solubility are the most important factors contributing to early drug concentrations in the brain. Differences in drug metabolism may be related to dose-dependent kinetics, first-pass metabolism, and variations in genetic traits (e.g. poor or extensive metabolizers). Metabolic pathways may produce active metabolites with similar or greater pharmacological activity than the parent substance. Drugs with a rapid elimination rate have been associated with greater self-administration and with early emergence of withdrawal symptoms. More pharmacokinetic studies are needed in human drug abuse liability evaluations. Knowledge of the plasma concentrations of drugs and their pharmacokinetic parameters can be essential to interpret differences among similar drugs in human abuse liability assessments. PMID- 1786494 TI - Drug metabolism and interactions in abuse liability assessment. AB - The interpretation of acute abuse liability studies and drug interaction studies would be importantly strengthened by the routine inclusion of drug concentration measurements at appropriate sampling times. Reliance on mean kinetic data misrepresents the variation in drug kinetics and fails to take experimental advantage of the natural differences in the population which may represent the extremes of abuse risk. Pharmacokinetic-pharmacodynamic studies to better understand the relationship of plasma drug concentration, drug concentration in the receptor biophase and specific drug reinforced behaviour will ensure proper study design and yield useful theoretic information. Multi- and poly-drug abuse (including heavy smoking and heavy ethanol use) are very common. Such patterns of use can have quite large effects on drug kinetics. Because of the potentially large qualitative and quantitative differences in drug metabolism and kinetics between pre-clinical species and the human, data should be gathered at the earliest possible time with respect to human metabolic rates, patterns, and identification of inhibitors. The availability of human liver microsomes facilitates such studies. PMID- 1786495 TI - Drug abstinence effects: opioids. AB - The capacity to produce physical dependence is an important factor in the abuse liability of the opioids, contributing both to their reinforcing efficacy and to the negative public health consequences of abuse. Validated methods for measuring the physical dependence capacity of opioids in humans are the Direct Addiction and Substitution/Suppression tests; however, both methods require that subjects be made physically dependent on morphine or on high doses of investigational drugs. New methods need to be developed. Possibilities include assessment of acute physical dependence and the modification of existing substitution test methods for use with subjects already dependent on therapeutic agents. PMID- 1786496 TI - Head injury in children. PMID- 1786497 TI - The effects of head injury in children on neuropsychological and behavioural functioning. AB - In a prospective study 76 children were divided into three groups on the basis of severity of head injury as defined by the Glasgow Coma Scale and duration of increased intracranial pressure. The children were administered a neuropsychological test battery and behavioural ratings were made by parents and teachers at three intervals: time of hospital discharge and 3 and 9 months post initial testing. There were cognitive deficits related to severity of injury with the greatest difference in abilities observed between the severe and the other two groups. The greatest differences in skills were on the Performance IQ and timed tests of visual-motor speed and co-ordination. The greatest improvement in skills occurred in the first 3 months post-injury. Several children in coma for up to 4 weeks were able to obtain normal IQ scores. In the mild and moderate injury groups very few had behavioural change while in the severe group approximately 90% had one learning or adjustment difficulty and 40% had three or more problems. PMID- 1786498 TI - Cognitive rehabilitation: a neuropsychological speciality comes of age. AB - In its first decade cognitive rehabilitation has emerged from infancy with the energy and much of the turmoil of youth. It has become an established speciality in brain-injury rehabilitation and has inspired many neuropsychologists to broaden their expertise beyond diagnosis and address their efforts to intervention. Restoration, although controversial, is an important and valid goal at the outset of cognitive rehabilitation, whereas the substitution of other means of goal achievement and environmental redesign are significant components of a comprehensive neuro-rehabilitative treatment programme. Efficacy is being demonstrated in many ways, ranging from increased patterns of use to controlled empirical studies. Few continue to raise the naive issue of whether there is any scientific basis for this neuropsychological speciality; instead, questions have become more focused on understanding the process of change to best serve human needs. In the next decade the refinement of current approaches can be anticipated, as well as the breaking of new ground. Neuropsychologists specializing in cognitive rehabilitation are likely to be turning their attention to underserved populations, such as those emerging from protracted coma, individuals suffering from 'progressive' neurological conditions, and persons whose brains were injured early in development. Scientific (theoretical, methodological and empirical) developments in cognitive psychology will help to delve more precisely into the underlying basic processes, including the sensory substrate. We will be challenged to address specific applications, such as advising people with known or suspected cognitive deficits who wish to drive. PMID- 1786499 TI - Assessing and treating non-compliance in brain-injured clients. AB - Assessment of non-compliance has been discussed. This included exploration of reinforcement contingencies, age appropriateness, cultural background and social background. Several perspectives on this have been addressed. Memory deficits are also critical when assessing non-compliance. Specifically, when the TBI person has severe memory deficits. Consequence management and antecedent control techniques have shown to be highly effective in promoting participation. Additionally, non-compliance should not necessarily be viewed as non-desirable, in fact, the client may be communicating preferred and non-preferred interests. It is important to recognize individual talents, interests and preferences. This is a significant point when you consider that TBI survivors had pre-injury lifestyles, i.e. full-time employment, a working social network, and preferred interests and activities. PMID- 1786500 TI - Placebo-controlled study of pramiracetam in young males with memory and cognitive problems resulting from head injury and anoxia. AB - The current study evaluated under double-blind placebo-controlled conditions, the safety and efficacy of 400 mg pramiracetam sulphate TID in treating memory and other cognitive problems of males who have sustained brain injuries. The results of the study indicate that subject performance in measures of memory, especially delayed recall, evidenced clinically significant improvements after the administration of pramiracetam sulphate as compared to placebo. This improvement was maintained during an 18-month open-trial period on the medication as well as during a 1-month follow-up period after the pramiracetam was discontinued. PMID- 1786501 TI - The use of discourse analyses for the evaluation of higher level traumatically brain-injured adults. AB - Higher level traumatically brain-injured (TBI) adults often present a challenge in assessment as well as in the measurement of recovery. Traditional clinical measures of language abilities have not been adequate to identify and describe precisely what is deviant about their communication. Assessment has generally consisted of aphasia tests and measures of general cognitive abilities. Although such measures may be sensitive to deficits in lower level TBI patients or those in the early stages of recovery, their usefulness with higher functioning patients is questionable due to the often subtle nature of their residual communication problems. An overview of discourse analyses is presented and recent applications of these procedures with TBI patients reviewed. PMID- 1786502 TI - Sensory stimulation in prolonged coma: four single case studies. AB - Patients diagnosed as being in prolonged coma (vegetative state) in this hospital are routinely treated according to a sensory stimulation protocol. This paper reports an evaluation of the efficacy of this procedure using the comparison of behavioural measures taken immediately prior to and post-stimulation. Four single cases produced significant behavioural changes suggesting increased arousal as a result of stimulation. The results and implications for further evaluation studies are discussed. PMID- 1786503 TI - Critical analysis of the concept of sensory stimulation for patients in vegetative states. AB - The practice of coma arousal and sensory stimulation is becoming the focus of heated debate. There is no theory on which patients may benefit, at what time in their recovery, or how the 'arousal' or 'stimulation' procedures should be applied. This paper considers some of the information processing mechanisms that are important mediators of arousal and awareness, pointing to some of the weaknesses in current practices and suggesting alternative approaches. Recommendations for a conceptual model of sensory stimulation are given that might provide a more scientific perspective to those who use such methods. PMID- 1786504 TI - Functional status, referral and cost of treatment for persons with traumatic head injury. AB - This study was conducted to examine functional status, costs of treatment, and how function and costs are related to the referral process of persons with traumatic head injury (THI). The study attempted to answer questions such as: what portion of the THI population is not referred on for subsequent treatment? Is referral dependent upon level of function at time of discharge from acute care? What are the costs associated with different levels of treatment by different facilities? Information was gathered from medical record reviews. Data were gathered from 101 persons with traumatic head injury (PWTHI) using a survey form, a functional assessment inventory, and a performance status scale. Per subject cost statements were obtained from the treatment/service facilities. Results indicate that the factors in the referral process for further treatment and rehabilitation do not appear to be consistent. Acute care referral at discharge is dependent upon severity of residual dysfunction including other factors than THI, while referral at discharge from a rehabilitation centre is dependent upon less obvious factors; one of which may be age at time of injury. Acute care and rehabilitation centre per patient average costs are quite similar and significantly higher than average per client costs. PMID- 1786505 TI - 'The ten pound note test': suggestions for eliciting improved responses in the severely brain-injured patient. AB - The severely brain-injured patient may demonstrate a limited repertoire of responses. Anecdotal accounts suggest that stimuli of personal relevance, or of an unusual or innovatory nature, may sometimes elicit more meaningful responses. Two cases of severe acquired brain injury are described, in whom overall levels of responsiveness had been very low since coma ended. The use of stimuli with personal relevance provoked strong responses and presaged further behavioural change. The implications are discussed. PMID- 1786506 TI - The role of the L-arginine-nitric oxide pathway in relaxation of the opossum lower oesophageal sphincter. AB - 1. The role of the L-arginine-nitric oxide pathway in lower oesophageal sphincter (LOS) relaxation and oesophageal peristalsis was investigated. 2. Twenty four adult opossums were anaesthetized and the right vagus nerve was isolated in the neck and sectioned. Electrical stimulation, applied to the peripheral end of the nerve, resulted in a frequency-dependent relaxation of the LOS, and peristaltic and non-peristaltic contractions in the oesophageal body. 3. N omega-nitro-L arginine (L-NNA, 10(-8)-10(-5) mol kg-1), an inhibitor of the L-arginine-nitric oxide pathway, inhibited LOS relaxation in a dose-dependent manner, but did not affect resting LOS pressure. At the highest dose of L-NNA no relaxation of the LOS was elicited in response to vagal stimulation. The effect of L-NNA, (10(-5) mol kg-1) was fully reversed by infusion of 10(-4) mol kg-1 L-arginine. Peristaltic velocity and amplitude of contractions in the oesophageal body were unaffected by L-NNA. 4. Infusion of sodium nitroprusside reduced LOS pressure to zero, and the drug was equally potent in control animals (-log ED50:8.1 +/- 0.2 mol kg-1) and in animals pretreated with L-NNA (-log ED50:8.2 +/- 0.3 mol kg-1). This suggests that the effect of L-NNA was not directly on guanylate cyclase. 5. A significant elevation of blood pressure was recorded after administration of L NNA (10(-5) mol kg-1). 6. It is suggested that the L-arginine-nitric oxide pathway plays an important functional role for relaxation of the LOS, but not for oesophageal peristalsis. Whether the active substance is nitric oxide or a related nitroso-compound remains to be settled. PMID- 1786507 TI - Ca2+ ion sequestration by guinea-pig tracheal cartilage: its influence on trachealis reactivity to KCl. AB - 1. The contractile response of guinea-pig isolated trachealis to KCl has been studied in the presence and absence of cartilage. 2. Dissection of cartilage from the trachealis resulted in both a rightward displacement of the concentration response curve to KCl (EC50 value: intact strip, 26.9 +/- 3.7 mM n = 5; dissected strip, 38.7 +/- 2.6 mM n = 5; P less than 0.05), and a reduction in the contractile response to KCl (30 mM) observed in a nominally Ca(2+)-free medium. 3. Removal of cartilage from the trachealis did not alter the responsiveness of the tissue to CaCl2 (2.5 mM) when added to K+ depolarized tissues. 4. Muscle denuded cartilage rings were prepared by surgical removal of the trachealis muscle. Autoradiographic studies, and a direct comparison of Ca2+ (2.5 mM) uptake with that of sorbitol (2.5 mM) showed that cartilage per se had a high capacity to accumulate Ca2+ ions by a process which was resistant to iodoacetate (100 microM), diflunisal (100 microM) and boiling. 5. The uptake of 45Ca into isolated cartilage was unaltered by the addition of orthovanadate (500 microM), verapamil (10 microM), diltiazem (10 microM) or Bay K 8644 (10 microM), but was significantly reduced (P less than 0.05) in the presence of LaCl3 (1-10 mM). 6. We conclude, like previous studies, that cartilage may supply a pool of Ca2+ ions to airway smooth muscle during the generation of tension in a noninally Ca(2+) free medium, and that LaCl3 may provide an experimental tool to elucidate further the role of non-muscle Ca(2+)-depots in smooth muscle contraction. PMID- 1786508 TI - Pharmacological analysis of agonist-antagonist interactions at acetylcholine muscarinic receptors in a new urinary bladder assay. AB - 1. Agonist-antagonist interactions at acetylcholine (ACh) muscarinic receptors have been analysed by use of an improved urinary bladder assay, isolated and intact, from the mouse. With 5-methylfurmethide as agonist, validated cumulative concentration-effect curves were obtained in less than 7 min by re-dosing before the response plateaux began to fade. 2. The pKB value estimated for pirenzepine was 6.76. The pKB values estimated for atropine and N-methylatropine from data obtained at concentrations which produced dose-ratios greater than 20 and 60 were 8.90 and 9.58, respectively. 3. The deviation from simple competitive behaviour at low dose-ratios with atropine and N-methylatropine was consistent with the operation of saturable antagonist removal processes. The deviation observed with atropine was corrected by pre-incubation with methylbutyrate, an alternative substrate for 'atropine esterase'. 4. The simple competitive behaviour of N methylatropine was restored following pre-incubation with the neuronal choline uptake blocker hemicholinium-3 (HC-3). However, the pKB estimated for N methylatropine under these conditions was low. This latter result could be accounted for by the observed behaviour of HC-3 as a competitive antagonist of ACh muscarinic receptors (pKB = 4.01). 5. We conclude that the modified mouse urinary bladder assay is suitable for the quantitative analysis of muscarinic receptor interactions. In addition, we postulate the existence of a previously undescribed uptake mechanism for quaternary muscarinic receptor antagonists. PMID- 1786509 TI - Factors affecting the regional haemodynamic responses to glyceryl trinitrate and molsidomine in conscious rats. AB - 1. A series of experiments was performed in conscious, unrestrained, male, Long Evans rats, chronically instrumented for the measurement of regional haemodynamics. 2. Infusion of glyceryl trinitrate (GTN, 0.1 mg kg-1 min-1, i.v.) for 10 min elicited tachycardia, but no sustained change in mean arterial blood pressure. Renal haemodynamics were unaffected, but there were reductions in hindquarters flow and vascular conductance together with substantial increases in flow and conductance in the mesenteric vascular bed. 3. In the presence of captopril (2 mg kg-1 bolus, and 1 mg kg-1 h-1 infusion, i.v.) GTN elicited significant hypotension and increases in renal blood flow and vascular conductance, indicating that activation of the renin-angiotension system opposed the dilator effects of GTN in this vascular bed. However, the mesenteric and hindquarters haemodynamic effects of GTN were not affected by captopril. In contrast, in the presence of enalaprilat (2 mg kg-1 bolus, and 1 mg kg-1 h-1 infusion, i.v.) there was significant enhancement of the mesenteric, as well as renal, haemodynamic effects of GTN. Hence, these results provide no evidence for the sulphydryl groups in captopril exerting a specific effect to enhance the haemodynamic actions of GTN in our experimental protocols. 4. Administration of molsidomine alone (1 mg kg-1, i.v. bolus) elicited tachycardia and hypotension; there were no changes in mesenteric or hindquarters haemodynamics, but renal flow and vascular conductance fell. Thus, the hypotensive effect of molsidomine was probably due to a reduction in cardiac output, consequent upon venodilatation. 5. In the presence of captopril or enalaprilat, molsidomine evoked renal and mesenteric vasodilatations in association with hypotension, indicating that activation of the renin-angiotensin system contributed to the lack of vasodilator responses to administration of molsidomine alone. However, since the effects of enalaprilat were more marked than those of captopril (in spite of the dose of both drugs being supramaximal for inhibition of angiotensin-converting enzyme), other factors must have been involved. 6. In a separate experiment, pretreatment with the nitric oxide synthesis inhibitor, N0-nitro-L-arginine methyl ester (1 mg kg- 1 h-1, i.v.), enhanced the mesenteric vasodilator effect of molsidomine. Collectively, these results are consistent with in vitro data showing that endogenous nitric oxide can inhibit the vasodilator effects of nitric oxide derived from molsidomine, and that the sulphydryl groups of captopril can protect endogenous nitric oxide from inactivation by oxygen-derived free radicals, thereby enhancing the inhibitory effect of endogenous nitric oxide on the vasodilator responses to exogenous nitric oxide derived from molsidomine (or GTN). PMID- 1786510 TI - Effects of paracetamol and aspirin on neural activity of joint mechanonociceptors in adjuvant arthritis. AB - 1. The effects of paracetamol and lysine acetylsalicylate (L-AS) on high threshold mechanonociceptors have been investigated by recording neural activity from the inflamed ankle joint in anaesthetized rats with mild adjuvant-induced monoarthritis. 2. Paracetamol (50 mg kg-1, i.v.) and L-AS (100 mg kg-1, i.v., equivalent to 50 mg kg-1 aspirin) both caused a maximal reduction of about 40% in mechanically-evoked discharge and of 30% in ongoing (spontaneous) activity by about 15 min after the injection: a second dose of either drug did not have any significant additional effect on discharge. 3. The prostanoid IP receptor agonist, cicaprost (0.1-0.5 micrograms), increased both mechanically-evoked and ongoing discharge to pre-paracetamol levels when injected close-arterially 30-50 min after paracetamol, whereas prostaglandin E2 (PGE2) was relatively ineffective at restoring activity. 4. The results suggest that prostacyclin (PGI2) contributes to the sensitization of high-threshold joint mechanonociceptors in adjuvant-induced monoarthritis, and that paracetamol and L-AS both act to reduce discharge by inhibiting the synthesis of prostacyclin in the joint capsule. 5. Paracetamol has a direct peripheral action affecting joint capsule mechanonociceptors in rat adjuvant-induced arthritis which is very similar to that of the soluble aspirin preparation, L-AS. These findings, together with the existing literature concerning the anti-arthritic effects of paracetamol, are relevant to the treatment of chronic inflammatory disorders such as rheumatoid arthritis. PMID- 1786511 TI - Inositol 1,4,5-triphosphate-stimulated calcium release from permeabilized cerebellar granule cells. AB - 1. Muscarinic cholinoceptor stimulation of phosphoinositide hydrolysis in rat cultured cerebellar granule cells results in a rapid, transient accumulation of inositol 1,4,5-trisphosphate (Ins(1,4,5)P3), which has been implicated in the release of non-mitochondrial intracellular Ca2+ stores. In the present study, the release of Ca2+ from intracellular stores and the Ins(1,4,5)P3 receptor responsible for this process have been investigated. 2. Monolayers of saponin permeabilized granule cells accumulate 45Ca2+ in an ATP-dependent manner and the sequestered 45Ca2+ can be concentration-dependently released by Ins(1,4,5)P3 by a stereospecific and heparin-sensitive mechanism. The EC50 for Ins(1,4,5)P3 stimulated 45Ca2+ release was 80 +/- 3 nM. 3. Radioligand binding studies performed on a crude granule cell membrane fraction indicated the presence of an apparently homogeneous population of stereo-specific Ins(1,4,5)P3 receptors (KD 54.7 +/- 2.0 nM; Bmax 1.37 +/- 0.29 pmol mg-1 protein). 4. This study provides evidence for Ins(1,4,5)P3-sensitive intracellular Ca2+ stores in primary cultures of cerebellar granule cells and suggest that these cells provide an excellent model neuronal system in which to study the relative functional roles of Ca2+ release from intracellular stores and Ca(2+)-entry in neuronal Ca2+ homeostasis. PMID- 1786512 TI - Effects of lemakalim on changes in Ca2+ concentration and mechanical activity induced by noradrenaline in the rabbit mesenteric artery. AB - 1. Effects of (-)-cromakalim (lemakalim) on tension and Ca2+ mobilization induced by noradrenaline (NA) were investigated by measuring intracellular Ca2+ concentration ([Ca2+]i) isometric tension and production of inositol-1,4,5 trisphosphate (IP3) in smooth muscle strips of the rabbit mesenteric artery. 2. In thin smooth muscle strips, 10 microM NA produced a large phasic, followed by a small tonic increase in [Ca2+]i, which correlated well with the evoked phasic and tonic contractions, respectively. Lemakalim (0.1-10 microM) lowered the resting [Ca2+]i without a decrease in the resting tension, and also inhibited the increased [Ca2+]i and tension induced by 10 microM NA, all in a concentration dependent manner. Glibenclamide (1 microM) inhibited these actions of lemakalim. 3. In Ca(2+)-free solution containing 2 mM EGTA, NA (10 microM) transiently increased [Ca2+]i, tension and synthesis of IP3. Lemakalim (over 0.01 microM) inhibited these actions of NA in Ca(2+)-free solution containing 5.9 mM K+, but not in Ca(2+)-free solution containing 128 mM K+. These actions of lemakalim were prevented by glibenclamide (1 microM). Lemakalim (1 microM) did not modify the increases in [Ca2+]i and tension induced by 10 mM caffeine. 4. In beta-escin skinned strips, 10 microM NA increased [Ca2+]i in Ca(2+)-free solution containing 50 microM EGTA, 3 microM guanosine triphosphate (GTP) and 2 microM Fura 2 after the storage sites were loaded by application of 0.3 microM Ca2+ for 2 min, suggesting that Ca2+ is released from intracellular storage sites following activation of the alpha-adrenoceptor. Lemakalim (1 microM) did not inhibit the Ca2+ release from storage sites induced by NA. 5. We conclude that lemakalim inhibits NA-induced Ca2 + release due to inhibition of NA-induced 'P3 production in a manner dependent on the membrane potential and causes inhibition of the phasic contraction induced by NA. PMID- 1786513 TI - Muscarinic antagonists attenuate the increase in accumbens and striatum dopamine metabolism produced by clozapine but not by haloperidol. AB - 1. The effect of the muscarinic antagonists, scopolamine and atropine, were examined on the increase in extracellular 3,4-dihydroxyphenylacetic acid (DOPAC) in the nucleus accumbens and the striatum induced by haloperidol and clozapine by use of in vivo differential pulse voltammetry with carbon fibre electrodes in anaesthetized rats. 2. Animals received saline (1 ml kg-1, s.c.), scopolamine (1 mg kg-1, o.p.) or atropine (20 micrograms, i.c.v.) followed 15 min later by saline (10 microliters, i.c.v.), haloperidol (1 mg kg-1, s.c.) or clozapine (30 mg kg-1, i.p.) and extracellular DOPAC was simultaneously recorded in the nucleus accumbens and the striatum every 5 min for 60 min after drug administration. 3. Scopolamine or atropine alone had no effect on the DOPAC peak height but attenuated the increase in extracellular DOPAC induced by clozapine in both brain regions. Neither scopolamine nor atropine altered the haloperidol-induced increase in accumbens or striatal extracellular DOPAC. 4. The present results demonstrate that muscarinic antagonists attenuate the increase in accumbens and striatal dopamine metabolism in vivo produced by the atypical neuroleptic clozapine but not the haloperidol-induced increase in dopamine metabolism. The results indicate that central muscarinic receptors are involved in the actions on dopaminergic function of clozapine but not haloperidol. PMID- 1786514 TI - Mechanism of action of platelet activating factor in the pulmonary circulation: an investigation using a novel isotopic system in rabbit isolated lung. AB - 1. Rabbit isolated lungs were perfused via the pulmonary artery with Tyrode solution containing 4.5% Ficoll and 0.1% bovine serum albumin at a constant rate of 20 ml min-1. Lung perfusate was drawn for alternating 5 min periods from two reservoirs, one containing 125I-albumin and the other unlabelled albumin to wash out the intravascular label. Microvascular 125I-albumin leakage was determined from the count remaining at the end of the washout phase with an external gamma scintillation probe. In addition, perfusion pressure was monitored continuously. Each experiment comprised 6 cycles over a total period of 60 min. 2. Infusion of platelet activating factor (PAF, 3 nmol min-1 for 10 min) resulted in microvascular 125I-albumin leakage, whereas lyso-PAF was without effect. During PAF infusions there was also an increase in perfusion pressure. Both the permeability and pressor effects of PAF were inhibited by the PAF antagonist L 652731. 3. Infusion of the thromboxane analogue U-46619 (0.6 nmol min-1 for 10 min) caused an increase in perfusion pressure but protein accumulation was not significantly different from that observed with control infusions. 4. Bolus injections of PAF (1 nmol) caused increases in perfusion pressure which were reduced by indomethacin, dazmegrel and BW 755C. Bolus injections of PAF, repeated at 30 min intervals caused reproducible pressor responses; however, repeated injections at 60 min intervals resulted in augmented responses. This augmentation did not occur in the presence of indomethacin. 5. Retrograde perfusion of PAF via the pulmonary vein induced increased perfusion pressure and microvascular 125I albumin leakage. The observed increase in leakage when compared with forward perfusion suggests that PAF produces predominantly arteriolar constriction i.e. proximal to the site of leakage during forward perfusion. 6. These results indicate that PAF is a vasoconstrictor in the rabbit pulmonary circulation and augmented responses occur with repeated injections at 60 min intervals. Cyclo oxygenase inhibition abolished this vascular hyperresponsiveness induced by PAF. PAF also caused protein accumulation in the lungs. Both these actions of PAF appear to be receptor-mediated because they were inhibited by PAF antagonists. Another pulmonary vasoconstrictor, U-46619 did not cause protein accumulation suggesting that the extravasation of protein with PAF is not merely secondary to changes in vascular tone. PMID- 1786515 TI - Inhibition of the release of endothelium-derived relaxing factor in vitro and in vivo by dipeptides containing NG-nitro-L-arginine. AB - 1. We have shown that dipeptides containing NG-nitro-L-arginine (NO2Arg) inhibit the biosynthesis of endothelium-derived relaxing factor (EDRF) in vitro and in vivo. 2. In anaesthetized rats, intravenous administration at 1-30 mg kg-1 of the methyl ester of NO2Arg, NO2-Arg-L-phenylalanine (NO2Arg-Phe), L-alanyl-NO2Arg (Ala-NO2Arg) or NO2Arg-L-arginine (NO2Arg-Arg) produced dose-related increases in mean arterial blood pressure (MABP) which were unaffected by D-arginine (D-Arg; 20 mg kg-1 min-1 for 15 min), but prevented by co-infusions of L-arginine (L-Arg; 20 mg kg-1 min-1 for 15 min) or by their parent dipeptides. 3. NO2Arg methyl ester, NO2Arg-Phe methyl ester or Ala-NO2Arg methyl ester (10 mg kg-1, i.v.) also inhibited the reduction in MABP caused by the endothelium-dependent vasodilator, acetylcholine (30 micrograms kg-1 min-1 for 3 min), but not those induced by glycerly trinitrate (20 micrograms kg-1 min-1 for 3 min) or iloprost (6 micrograms kg-1 min-1 for 3 min) which act directly on the vascular smooth muscle. 4. Moreover, NO2Arg methyl ester, NO2Arg-Phe methyl ester or NO2Arg-Arg methyl ester (100 microM) inhibited the acetylcholine-induced relaxation of rabbit aortic strips, and NO2Arg-Phe methyl ester (30 microM) blocked the stimulated (bradykinin, 30 pmol) release of EDRF from bovine aortic endothelial cells grown on microcarrier beads. 5. In endothelial cells grown in L-Arg deficient medium, L-Arg-containing dipeptides such as L-Arg-LPhe, L-Ala-L-Arg or L-Arg-L-Arg increased both the basal and stimulated release of EDRF. Moreover, the L-Arg containing dipeptides, but not their NO2Arg analogues, were rapidly cleaved by these cells. 6. Thus, dipeptides containing NO2Arg can directly interfere with the biosynthesis of EDRF in vitro and in vivo. Moreover, the potentiation of EDRF release from endothelial cells deprived of L-Arg by dipeptides containing L-Arg suggests that such peptides may serve as an additional or alternative substrate for the biosynthesis of EDRF. PMID- 1786516 TI - Pharmacology of the putative M4 muscarinic receptor mediating Ca-current inhibition in neuroblastoma x glioma hybrid (NG 108-15) cells. AB - 1. We have assessed the potency of a range of agonists and antagonists on the muscarinic receptor responsible for inhibiting the Ca-current (ICa) in NG 108-15 hybrid cells. 2. Acetylcholine (ACh), oxotremorine-M and carbachol were potent 'full' agonists (EC50 values were 0.11 microM, 0.14 microM and 2 microM, respectively). Maximum inhibition of peak high-threshold ICa by these agonists was 39.5%. (+/-)-Muscarine, methylfurmethide and arecaidine propargyl ester (APE) were 'partial' agonists, with EC50 values of 0.54 microM, 0.84 microM and 0.1 microM, respectively. 3. Atropine, pirenzepine and himbacine were potent antagonists of muscarinic inhibition of ICa, with apparent pKB values of 9.8, 7.74 and 8.83, respectively. Methoctramine was relatively weak (pKB = 7.63). Atropine and pirenzepine depressed maximum responses to agonists, probably because these antagonists have relatively slow dissociation rates. 4. The characteristic pharmacological profile found for the M4 receptors in these functional experiments (himbacine high affinity, pirenzepine moderate to high affinity, methoctramine low affinity) corresponds well with data from earlier binding experiments (Lazareno et al., 1990). Since mRNA hybridising to probes for the m4 receptor genotype can be detected in these cells, it is suggested that these pharmacological characteristics identify the equivalent expressed receptor subtype M4. PMID- 1786517 TI - The antimigraine drugs ergotamine and dihydroergotamine are potent 5-HT1C receptor agonists in piglet choroid plexus. AB - 1. Fozard & Gray (1989) proposed that migraine is mediated by stimulation of 5 HT1C receptors. We have examined the interaction of two effective anti-migraine agents, ergotamine and dihydroergotamine (DHE), with these receptors. Binding (inhibition of labelling by [3H]-mesulergine) and agonist activity (phosphoinositide hydrolysis) were measured in piglet choroid plexus, a tissue rich in 5-HT1C receptors. 2. The pKD for [3H]-mesulergine binding was 8.4. Ergotamine and DHE both inhibited [3H]-mesulergine binding with a pKD of 7.1. This was similar to the potency of m-chlorophenylpiperazine (m-CPP) (pKD 7.4) and rather less than that of 5-hydroxytryptamine (5-HT) (pKD 8.1). 3. Both ergotamine and DHE were full agonists (pEC50S 7.5 and 7.6 respectively) with potencies similar to that of 5-HT (pEC50 7.7) and greater than that of m-CPP (pEC50 7.1). Mesulergine 10(-7) M produced near-parallel rightward shifts of the concentration response curves for all these agents of 1.8-2.2 log units, consistent with an action of the agonists at the same receptor. 4. There was no effect of prazosin, spiperone, mepyramine or atropine on the phosphoinositide hydrolysis induced by ergotamine, ruling out an action via alpha 1-adrenoceptors, 5-HT2, histamine H1, or muscarinic receptors. 5. It is concluded that, together with 5-HT, ergotamine and DHE are the most potent 5-HT1C agonists reported so far. These findings do not support the theory that 5-HT1C receptor activation causes migraine. PMID- 1786518 TI - Effects of NG-substituted analogues of L-arginine on NANC relaxation of the rat anococcygeus and bovine retractor penis muscles and the bovine penile artery. AB - 1. The effects of two inhibitors of nitric oxide synthase, NG-monomethyl L arginine (L-NMMA) and NG-nitro L-arginine (L-NOARG), were examined on non adrenergic non-cholinergic (NANC) inhibitory transmission in the rat anococcygeus, bovine retractor penis (BRP) and bovine penile artery. 2. In the rat anococcygeus, L-NMMA (10-1000 microM) produced a concentration-dependent augmentation of guanethidine (30 microM)-induced tone and inhibited NANC relaxation at all frequencies tested (0.1-20 Hz): the maximum inhibition obtained was 56 +/- 6% (n = 6). L-NOARG (0.3-30 microM) also augmented tone and inhibited NANC relaxation in a concentration-dependent manner, but unlike L-NMMA the maximum inhibition was 100%. 3. In the BRP, L-NMMA (10-100 microM) had no effect on tone or NANC-induced relaxation, but at 1000 microM tone was increased and NANC relaxation inhibited by 25 +/- 7% (n = 6). L-NOARG (0.3-30 microM) produced a concentration-dependent increase in tone and inhibition of NANC relaxation. As in the rat anococcygeus, inhibition of NANC relaxation was complete. 4. The effects of L-NMMA and L-NOARG were stereospecific since D-NMMA (10-1000 microM) and D-NOARG (1-1000 microM) had no effect on tone or NANC relaxation of the rat anococcygeus or BRP. 5. L-Arginine (10-300 microM) had no effect by itself on NANC-induced relaxation of the rat anococcygeus or BRP. It did, however, reverse the ability of L-NMMA (10-1000 microM) to augment tone and inhibit NANC relaxation in the rat anococcygeus and BRP. 6. On the bovine penile artery, both L-NMMA (100 microM) and L-NOARG (30 microM) augmented the tone induced by guanethidine (30 microM) and 5-hydroxytryptamine (0.2 microM) in an endothelium dependent manner. L-NMMA had no effect on NANC-induced relaxation, but inhibited acetylcholine-induced endotheliumdependent relaxation. L-NOARG abolished NANC relaxation at all frequencies tested and inhibited acetylcholine-induced relaxation. D-NOARG (30 microM) had no effect on NANC or acetylcholine-induced relaxation. 7. The ability of L-NOARG to abolish NANC-induced relaxation in the rat anococcygeus, BRP and bovine penile artery suggests that the L-arginine nitric oxide pathway mediates neurotransmission in all three tissues. The effectiveness of L-NMMA in blocking NANC relaxation-in the rat anococcygeus but not the BRP and bovine penile artery suggests a species difference in the neuronal nitric oxide synthase. The neuronal and endothelial nitric oxide synthases in the penile artery also appear to differ. PMID- 1786519 TI - Regional coronary haemodynamic effects of two inhibitors of nitric oxide synthesis in anaesthetized, open-chest dogs. AB - 1. The role of endothelial nitric oxide synthesis from L-arginine in the regulation of coronary vascular tone and myocardial tissue perfusion was evaluated in anaesthetized, open-chest dogs. Coronary blood flow was measured with an electromagnetic flow probe placed around the left circumflex coronary artery. Coronary vascular resistance was calculated from mean arterial blood pressure and mean coronary blood flow, whereas regional myocardial tissue flow was determined by use of the radioactive microspheres technique. 2. NG-monomethyl L-arginine (L-NMMA) and NG-nitro-L-arginine methyl ester (L-NAME), administered directly into the left circumflex artery, induced a small increase in arterial blood pressure and an increase in coronary vascular resistance. However, myocardial tissue perfusion, assessed by the microspheres technique (whether subendocardial, subepicardial, or transmural), was unaffected by L-NMMA or L NAME. 3. Acetylcholine, administered intracoronarily, induced an increase in left circumflex coronary blood flow and a decrease in coronary vascular resistance, without affecting systemic haemodynamics. This coronary vasodilator effect of acetylcholine was markedly inhibited by L-NMMA and L-NAME, the latter being a more potent antagonist than the former. 4. These results indicate that the endothelial L-arginine pathway is largely responsible for the coronary vasodilator effect of acetylcholine. However, although basal release of nitric oxide from L-arginine apparently contributes to the regulation of resting coronary vascular tone, blockade of this pathway does not affect myocardial tissue perfusion, possibly because of compensatory mechanisms occurring at the level of small arterioles and/or capillaries. PMID- 1786520 TI - Fenoverine inhibition of calcium channel currents in single smooth muscle cells from rat portal vein and myometrium. AB - 1. The effects of fenoverine, an antispasmodic drug, have been studied on the Ca2+ channel currents of isolated cells from rat portal vein and pregnant myometrium by the patch-clamp technique (whole-cell configuration). 2. Fenoverine inhibited both fast and slow Ca2+ channel currents in a concentration-dependent manner. Half-inhibition of fast Ca2+ channel current (holding potential of -70 mV) and slow Ca2+ channel current (holding potential of -40 mV) in portal vein smooth muscle were obtained at concentrations of 7.5 and 1.9 microM, respectively. In myometrium, the fenoverine concentration which blocked 50% of the slow Ca2+ channel current (holding potential of -70 mV) was 2.3 microM. 3. Administration of fenoverine at rest reduced both Ca2+ channel currents. Currents activated repetitively, at a rate between 0.05 and 0.1 Hz, were inhibited equally which indicates an absence of use-dependent inhibition. 4. When cells held at depolarized membrane potentials at which fast or slow Ca2+ channel currents were strongly inactivated, the inhibitory effects of fenoverine were enhanced on both Ca2+ channel currents which indicates that the fenoverine-induced inhibition was voltage-dependent. The fenoverine concentrations which blocked the inactivated Ca2+ channels were 5-7 times lower than those which blocked the resting Ca2+ channels. 5. Our results show that fenoverine depresses inward currents through fast and slow Ca2+ channels. This effect may be explained by the preferential binding of fenoverine to resting Ca2+ channels. In addition, fenoverine has a higher affinity for inactivated Ca2+ channels than for resting channels. PMID- 1786521 TI - Cardiovascular profile of 5 novel nitrate-esters: a comparative study with nitroglycerin in pigs with and without left ventricular dysfunction. AB - 1. Four cumulative 10 min intravenous infusions of 0.05, 0.2, 0.5 and 2.0 mg min 1 were used to compare the cardiovascular profile of 5 novel nitrate-esters dissolved in Intralipid 10% to that of nitroglycerin (GTN) in conscious pigs. 2. Infusion of Intralipid 10% alone had no effect on any of the systemic haemodynamic parameters. GTN infusions decreased mean arterial blood pressure dose-dependently from 94 +/- 2 mmHg to 79 +/- 3 mmHg (P less than 0.05) and raised cardiac output from 2.74 +/- 0.09 l min-1 to 3.40 +/- 0.18 l min-1 (P less than 0.05) due to an increase in heart rate (by up to 43 +/- 3%), as stroke volume decreased slightly. Systemic vascular resistance decreased (by 32 +/- 3%) and left ventricular end-diastolic pressure fell from 5.2 +/- 0.4 mmHg to 2.2 +/- 0.5 mmHg (both P less than 0.05). 3. The novel compounds CEDO 8811, CEDO 8834 and CEDO 8901 increased cardiac output only at the highest dose (7%, 8% and 9%, respectively). There was no change in mean arterial blood pressure as the increase in cardiac output was counterbalanced by arterial vasodilatation. All three compounds reduced left ventricular end-diastolic pressure slightly. 4. CEDO 8816 was a more potent arterial and venodilator than the aforementioned CEDO compounds, as the decreases in systemic vascular resistance and left ventricular end-diastolic pressure were already significant at lower doses. The fall in stroke volume was fully compensated by the increase in heart rate and as a result cardiac output increased by 11 +/- 3% (P less than 0.05) at the highest dose. 5. CEDO 8956 was the most potent vasodilator of the novel compounds and exhibited a cardiovascular profile similar to that of GTN. Left ventricular end-diastolic pressure decreased significantly during infusion of 0.2mgmin-'. Mean arterial blood pressure decreased by 11 +/- 2% (P < 0.05) in spite of an increase in cardiac output by up to 20 +/- 2% (P < 0.05), due to a decrease (by 27 +/- 1%, P <0.05) in systemic vascular resistance. The increases in heart rate (20 +/- 5%, P < 0.05) and LVdP/dtmax (38 +/- 4%, P < 0.05) were, however, considerably less after CEDO 8956 than after GTN. 6. The potential of CEDO 8956 in the treatment of chronic left ventricular dysfunction was evaluated during administration to conscious pigs (21-23 kg), in which the left circumflex coronary artery was ligated 4 weeks earlier. In these animals, baseline values for cardiac output and LVdP/dtx were lower and those of systemic vascular resistance and left ventricular end-diastolic pressure were higher than in the first group of experiments. 7. Both GTN and CEDO 8956 in doses of 0.05 to 2.0 mg inm increased cardiac output dosedependently (by up to 34% and 19%, respectively). The decrease in systemic vascular resistance was larger with GTN (35%) than with CEDO 8956 (17%), which resulted in a 13% decrease in mean arterial pressure during infusion of GTN, whereas there was no change in mean arterial pressure during infusion of CEDO 8956. Both compounds increased LVdP/dt,,,,X (by 48% and 30%, respectively) and lowered left ventricular end-diastolic pressure to normal levels. 8. At a dose of 1.0Omg min- 1, both GTN and CEDO 8956 increased left ventricular blood flow parallel to the increase in myocardial oxygen demand. At this dose, GTN also caused vasodilatation in the vascular beds of the brain, kidneys and adrenals. With CEDO 8956 no significant changes were achieved. 9. We conclude that the cardiovascular profile of CEDO 8956 in both normal animals and in animals with chronic left ventricular dysfunction warrants further study on its usefulness in the treatment of a number of cardiovascular disorders. PMID- 1786522 TI - Cross tachyphylaxis to endothelin isopeptide-induced hypotension: a phenomenon not seen with proendothelin. AB - 1. In anaesthetized rats, an i.v. injection of endothelin-1 (0.25 nmol kg-1) evoked a rapidly appearing (maximal effect within 15 s) and short lasting (3 min) fall in blood pressure with tachyphylaxis occurring so that it was reduced by 50% by the last of 4 injections given 10 min apart. This property was also shared by endothelin-2, endothelin-3 and vasoactive intestinal contractor (VIC). 2. Cross tachyphylaxis between the isopeptides occurred. However, under the same experimental conditions the hypotensive effects of acetylcholine, adenosine, atrial natriuretic peptide (ANP) and substance P were reproducible and not modified in animals in which endothelin-1 no longer lowered blood pressure. Thus, the mechanism of the hypotensive action of endothelin peptides is different from that of acetylcholine, adenosine, ANP, and substance P. 3. In pithed rats, endothelin-1 (0.25 nmol kg-1) and its precursor human proendothelin (h proendothelin) (0.5 nmol kg-1) induced pressor responses of a similar magnitude, which for h-proendothelin (up to 5.0 nmol kg-1) were not preceded by a hypotensive phase. The pressor effects of endothelin-1, like those of vasopressin, were reproducible upon repeated i.v. injections. 4. Rats given a 10 min infusion (0.1 nmol kg-1 min-1) of endothelin-1 showed no hypotensive response to an i.v. bolus injection of endothelin-1, whereas animals pretreated with an equipressor infusion of h-proendothelin did not develop tachyphylaxis to endothelin-1. 5. In pitched rats, endothelin-1, at a dose inducing the same maximal increase in blood pressure as h-proendothelin, was approximately 3 fold more potent as a mesenteric vasoconstrictor than h-proendothelin. These results suggest that if h-proendothelin is processed to endothelin-1, this transformation is not uniform throughout the vascular system. 6. The pressor response of h proendothelin in pithed rats was dose-dependently inhibited by phosphoramidon (2.5-5.0mgkg '). However, this compound did not antagonize the effects of endothelin-1(0.25 nmol kg- ) or those of h-proendothelin (0.5 nmol kg- ) once developed. 7. Although some of these results may suggest that h-proendothelin does not undergo in vivo conversion to endothelin-1, the results obtained with phosphoramidon suggest that h-proendothelin is converted into endothelin-1. Therefore, the amount of endothelin-1 so produced can elicit pressor responses or regional vasoconstriction, but is insufficient to lower blood pressure and to inhibit endothelin-1-induced hypotension. 8. The mechanism of the tachyphylaxis does not appear to be depletion of endothelium-derived relaxing factor, since agents coupled to the latter endogenous vasorelaxant substance do not exhibit crosstachyphylaxis with endothelin-1. It is suggested that upon repeated or sustained exposure to endothelin-1, the endothelin-1 receptors mediating hypotension decrease in number and/or undergo conformational changes making them refractory to activation. Alternatively, the depletion of a blood-borne agent responsible for the hypotension could be involved. PMID- 1786523 TI - Analgesia for formalin-induced pain by lateral hypothalamic stimulation. AB - Few studies of analgesia induced by electrical brain stimulation have examined the effects of brain stimulation on responses to tonic pain stimuli. Recent evidence suggests that analgesia for tonic and phasic pain may involve different neural substrates. The present study examined the effects of lateral hypothalamic (LH) stimulation on responses to tonic pain induced by subcutaneous formalin. Our findings demonstrate that LH stimulation produced analgesia for tonic pain and that the effect is primary and not related to stress-induced analgesia. The results are discussed in relation to hypotheses regarding the different neural substrates involved in analgesia for tonic and phasic pain. PMID- 1786524 TI - Effects of the autoimmune uterine/maternal environment upon cortical ectopias, behavior and autoimmunity. AB - NZB and BXSB mice develop autoimmune disease and learn poorly on avoidance tasks. In addition, many of these mice have ectopic collections of neurons, which occur prenatally, in layer I of the cerebral neocortex. The purpose of these experiments was to evaluate the contribution of the uterine/maternal environment upon these variables by transferring fertilized ova to an autoimmune or a non autoimmune maternal host. In Experiment 1 fertilized DBA ova were transferred into the uteri of BXSB maternal recipients. Later, these animals and conventionally reared DBAs were tested for paw preference, swimming rotation, water escape learning, and shuttlebox avoidance learning. Blood was taken for measurement of immune parameters, and their brains were examined for cortical ectopias. As compared to conventional DBAs, the ova transfer mice had greater amounts of anti-dsDNA autoantibodies, poorer avoidance learning, and poorer water escape learning; in addition, the females had greater paw asymmetry. There was only 1 ectopia in the 81 ova transfer animals, and none in the 78 control mice. In Experiment 2 fertilized NZB ova were transferred into the uteri of non autoimmune hybrid females and the same procedures were followed as in Experiment 1. Ova transfer mice had lesser amounts of anti-dsDNA autoantibodies, better avoidance learning scores, and females had less paw asymmetry; in addition, within the ova transfer group males were clockwise swimmers whereas females swam counterclockwise. There were 4 ectopics out of 17 ova transfer mice (23.5%), which did not differ from the 40.5% of the control group. In both experiments the uterine environment did not affect the occurrence of ectopias.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786525 TI - Chronic opiate agonists down-regulate prodynorphin gene expression in rat brain. AB - The effects of long-term administration of opioid agonists on the regulation of prodynorphin gene expression in rat brain were investigated. Chronic intracerebroventricular treatment with the synthetic opioid agonist acting on the kappa receptor, U-50,488H, and the classic mu agonist morphine markedly decreased prodynorphin mRNA levels in hypothalamus, hippocampus and striatum of tolerant rats. Levels of ir-Dynorphin A remained unchanged except in two cases. Chronic exposure to opiates thus appears to induce modifications of the endogenous opioid system, as regards gene expression regulation. PMID- 1786526 TI - Angiotensin II-induced noradrenaline release from anterior hypothalamus in conscious rats: a brain microdialysis study. AB - Interaction with aminergic transmitter substances has been implicated in the central actions of angiotensin II (ANG II). We used the novel technique of brain microdialysis in conscious rats to investigate whether ANG II influences the release of endogenous catecholamines (CA) from the anterior hypothalamus (AH). Intracerebroventricular (i.c.v.) administration of ANG II (1 ng and 100 ng) increased mean arterial pressure. ANG II at 1 ng had no effect on the release of noradrenaline (NA) from the AH but ANG II at 100 ng significantly increased NA release. Intracerebroventricular pretreatment with the ANG II-receptor antagonist sarilesin (Sar1, Ile8-ANG II; 3 micrograms) prevented the ANG II-induced NA release. The release of the intraneuronal NA and dopamine (DA) metabolites 3,4 dihydroxyphenylethyl glycol (DOPEG) and 3,4-dihydroxyphenylacetic acid (DOPAC) from the AH was not altered by i.c.v. ANG II. Our results provide the first in vivo evidence for NA release from the hypothalamus induced by periventricular ANG II receptor stimulation. They support the hypothesis that hypothalamic noradrenergic mechanisms are involved in the central actions of this peptide. PMID- 1786527 TI - Gadolinium block of calcium channels: influence of bicarbonate. AB - The selectivity of block of voltage-activated barium (Ba2+) currents by lanthanide ions was studied in a rat dorsal root ganglion (DRG) cell line (F11 B9), rat and frog peripheral neurons, and rat cardiac myocytes using the whole cell patch clamp technique. Gadolinium (Gd3+) produced a dose-dependent and complete inhibition of whole-cell Ba2+ current in all cells studied, including cells expressing identified dihydropyridine-sensitive L-type currents and omega conotoxin-sensitive N-type currents. Like Gd3+, lutetium (Lu3+) and lanthanum (La3+) blocked all Ba2+ current with little selectivity for different components of the whole-cell current. Gd3+ block of Ba2+ currents was incomplete, however, when sodium bicarbonate (5-22.6 mM) was added to the standard HEPES-buffered external Ba2+ solution. In rat DRG neurons and F11-B9 cells, a fraction of the whole-cell Ba2+ current recorded in the presence of bicarbonate was resistant to block by saturating concentrations of Gd3+ (50-100 microM). The resistant current inactivated more rapidly than the original current giving the appearance that, under these conditions, Gd3+ block is more selective for the slowly inactivating component of the whole-cell current. Bicarbonate modification of Gd3+ block occurred both before and after omega-conotoxin block of N-type currents in rat DRG neurons, suggesting that even in the presence of bicarbonate, Gd3+ block was not selective for N-type currents. PMID- 1786528 TI - Cellular mapping of m2 muscarinic receptors in rat olfactory bulb using an antiserum raised against a cytoplasmic loop peptide. AB - An antiserum that recognizes a sequence from the putative third cytoplasmic loop of the m2 subtype of muscarinic receptors (mAchR) has been raised and used to map the cellular distribution of this subtype in rat olfactory bulb. The antiserum was obtained by injecting BALB/C mice with a BSA-conjugated synthetic peptide whose sequence corresponded to amino acids 240-259 of the porcine cardiac m2 mAChR gene. Antibodies recognized the synthetic peptide in ELISA screening and labelled a single band corresponding to the peak of [3H]PrBCM-labelled heart mAchRs in immunoblots. Immunostaining of olfactory bulb, a region of the brain enriched in this muscarinic receptor subtype, showed that the antibodies labelled cell bodies and multiple dendritic processes. Broad fluorescent labelling throughout cell bodies was consistent with binding to the cytoplasmic face of the surface membrane, in support of the predicted cytoplasmic loop structure. m2 Positive cells throughout the bulb were sparsely distributed in different layers representing small subpopulations of the cells in each region: glomeruli, 6%; external plexiform layer, 16%; inner plexiform and granule cell layer, 3%. The results show that antibodies against specific sequences of different muscarinic receptor subtypes can be used to localize subtypes in situ, that the m2 subtype within the rat olfactory bulb is broadly distributed, and that the m2 subtype can occur postsynaptically in this central nervous system (CNS) region. The mapping of m2-positive cells in olfactory bulb may be of particular interest because loss of this subtype and degeneration of the olfactory system have been observed in Alzheimer's disease. PMID- 1786529 TI - Identification and characterization of specific binding sites of [3H]spermidine in synaptic membranes of rat brain. AB - Synaptic membranes of rat brain contained specific binding sites of [3H]spermidine (SPD) that exhibited an inverse temperature dependency, structure selectivity, reversibility, saturability, low affinity and high density with an uneven distribution profile. The affinities were not significantly different from each other in the rodent brain, while the highest density was found in the medulla-pons among the central structures examined with progressively lower densities in the midbrain, striatum, cerebellum, hypothalamus, hippocampus and cerebral cortex. The binding was insensitive to digestion by various proteases and glycosidases but sensitive to potentiation by phospholipases. A clear correlation was seen between the abilities of several natural and synthetic polyamines to displace [3H]SPD binding and to potentiate [3H] (+)-5-methyl-10,11 dihydro-5H-dibenzo[a,d]cyclohepten-5,10-imine binding to open cation channels associated with an N-methyl-D-aspartate (NMDA)-sensitive subclass of brain excitatory amino acid receptors. Treatment of brain membranes with deoxycholic acid resulted in a significant solubilization of [3H]SPD binding sites. Furthermore, [3H]SPD markedly associated with the acidic phospholipid phosphatidylserine irrespective of the presence of synaptic membranes in a manner sensitive to inhibition by a variety of calmodulin antagonists. These results suggest that endogenous polyamines may play a stimulatory role in neuronal responses mediated by the NMDA receptor ionophore complex through an interaction between their positive charges and negative charges of membranous phosphatidylserine in rat brain. PMID- 1786530 TI - Prolactin response to morphine in intact and adrenalectomized lactating rats. AB - To examine the hypothesis that the increased adrenocortical activity during lactation induced the loss of the prolactin (PRL) -releasing effect of morphine, we studied the effect of morphine in adrenalectomized (ADX) and sham-operated primiparous lactating Wistar rats. Animals were adrenalectomized 4 days after delivery. On day 11 of lactation (7 days after ADX), pups were separated from their mother 2 h before morphine or haloperidol injection. Intravenous injection of 5 mg/kg morphine did not change plasma PRL levels in the sham-operated lactating rats, but it resulted in a significant increase of plasma PRL levels in ADX lactating animals, with or without corticosterone replacement. Catalepsy following 10 mg/kg i.v. morphine was also markedly enhanced in ADX lactating animals. The PRL response to 0.5 mg/kg haloperidol was higher in ADX lactating animals than that in the controls. Morphine given 2 h after haloperidol treatment resulted in a further increase of plasma PRL in ADX, but not in the sham-operated lactating animals. These results suggest that adrenal hyperfunction may lead to a loss of sensitivity to morphine during lactation. PMID- 1786531 TI - Convergence of multi-modal sensory signals at thoracic interneurons of the escape system of the cockroach, Periplaneta americana. AB - Research on the escape system of the cockroach has focused upon the role of giant interneurons in conveying information on wind stimulation from the cerci located on the abdomen to motor control centers in the thoracic ganglia. In the thoracic ganglia the ventral giant interneurons connect to a population of interganglionic interneurons referred to as type A thoracic interneurons. In this paper we have tested the type A interneurons for additional sensory inputs in the absence of ventral giant interneuron activity. We find that the cells that receive ventral giant interneuron activity are also influenced by a variety of additional sensory inputs; wind mediated activity in a pathway that descends from the head, tactile inputs from several loci, auditory stimuli and light responses. Moreover, behavioral observations indicate that at least some of these activities can alter the escape movements. The results suggest that these interneurons serve as a site of convergence for numerous types of sensory activity. They further suggest that the escape system is capable of responding to directional wind information encoded in the ventral giant interneurons in the context of a wealth of additional information. PMID- 1786532 TI - Localization of Alzheimer beta A4 amyloid precursor protein at central and peripheral synaptic sites. AB - We have recently shown that the amyloid beta A4 precursor protein (APP) is synthesized in neurons and undergoes fast axonal transport to synaptic sites [Koo et al., Proc. Natl. Acad. Sci. U.S.A., 87 (1990) 1561-1565]. Using immunofluorescence, laser confocal microscopy and immunoelectron microscopy with simultaneous detection of APP and synaptophysin, we now report a preferential localization of APP at synaptic sites of human and rat brain and at neuromuscular junctions. APP is further found on vesicular elements of neuronal perikarya, dendrites and axons. The synaptic localization of APP implies (1) a role of APP in physiological synaptic activity and (2) a potential and early impairment of central synapses when synaptic APP is converted to beta A4 amyloid during the pathological evolution of Alzheimer's disease and Down's syndrome. PMID- 1786533 TI - Recovery of denervated muscle receptors following treatments to accelerate nerve regeneration. AB - Nerve regeneration promoters offer the possibility of enhancing recovery following nerve injury by increasing the numbers of regenerating axons and decreasing the period of tissue denervation. To date, recent studies have concentrated on evaluating the action of such promoters on the nerve itself and on the restoration of motor function. This study examines afferent regeneration by evaluating the recovery of muscle spindles and tendon organs after nerve injury and treatment with alpha-melanocyte stimulating hormone or nerve stimulation. Treatment was found to be effective in enhancing short-term recovery after nerve-crush injury in terms of increasing the rate of functional and morphological recovery. Following nerve section, there was an increase in the number of reinnervating axons compared with control values. PMID- 1786534 TI - Regional changes in central monoamine and metabolite levels during the hibernation cycle in the golden-mantled ground squirrel. AB - We assayed various brain regions for levels of monoamines and their metabolites throughout the hibernation cycle of the golden-mantled ground squirrel Spermophilus lateralis. The tissue concentrations of serotonin, dopamine, norepinephrine and their metabolites were determined in the parietal cortex, striatum, midbrain, hippocampus, hypothalamus, and pons. Telencephalic regions exhibited the most significant variations in biogenic amine content. Cortical serotonin (5-HT) levels increased significantly at entrance (P less than 0.0001) relative to other periods of the hibernation cycle, suggesting a role for 5-HT in the initiation of hibernation. Among striatal dopamine (DA) metabolites, 3 methoxytyramine was detectable only during euthermia and arousal; from entrance through arousal, homovanillic acid (HVA) levels were half that found during euthermia (P = 0.0001); and dihydroxyphenylacetic acid (DOPAC) levels increased during day 1 of hibernation (P less than 0.0005). Midbrain DA (P = 0.0295) and hippocampal HVA (P = 0.0194) levels also changed significantly across the hibernation bout. The absence of a consistent change in any monoamine or metabolite throughout the brain precludes the possibility of preferential temperature-dependent impairment of an enzyme involved in biogenic amine synthesis or degradation and suggests that the levels observed reflect changes in neural activity specific to each brain region. Together with previous studies of brain 2-deoxyglucose uptake throughout the hibernation cycle, these data indicate that a transient change in afferent monoaminergic metabolism and neurotransmission in the forebrain is a necessary component for the entrance to hibernation. PMID- 1786535 TI - Streptomycin blocks the postsynaptic effects of excitatory amino acids on the vestibular system primary afferents. AB - It has been suggested that streptomycin might be an antagonist of the glutamate receptors, and that it selectively blocks quisqualic acid receptors. We studied whether streptomycin blocks the responses to excitatory amino acid agonists on the vestibular system primary afferents, and if it allows us to differentiate between kainate (KA) and quisqualate (QA) receptor mediated responses. The experiments were performed in the axolotl (Ambystoma tigrinum). Intra- and extracellular records of the electrical activity of semicircular canal afferent fibers were obtained. Drugs were applied by pressure ejection in volumes of 20 microliters in a 10 ml bath. Streptomycin (0.01-10 mM), induced a dose dependent reversible inhibition of the basal spike discharge of the afferent fibers. This coincided with a reduction in the amplitude of excitatory postsynaptic potentials (EPSP) recorded intracellularly in the afferent fibers. Streptomycin also blocked the excitatory action produced by KA and QA; increasing concentrations of streptomycin produced a rightward shift in the concentration-response curves for both KA and QA. This action persisted even in a high Mg2+ (10 mM), low Ca2+ (0.09 mM) Ringer solution, indicating its postsynaptic nature. These results show that streptomycin might be a non-selective excitatory amino acid (EAA) receptor antagonist. PMID- 1786536 TI - Effects of soman-induced seizures on different extracellular amino acid levels and on glutamate uptake in rat hippocampus. AB - Extracellular amino acid levels in CA3 and CA1 fields of rat hippocampus, an area highly sensitive to seizures, were determined by intracranial microdialysis during seizures induced by systemic administration of soman (o-1,2,2 trimethylpropyl methylphosphonofluoridate), a potent inhibitor of acetylcholinesterase. The glutamate uptake level was determined on another series of animals in hippocampus homogenates. An early and transient increase in the extracellular glutamate level occurred in CA3 within 30 min of seizures, with correlated brief elevations of taurine, glycine and glutamine levels. The glutamate level increased early in CA1, declined and then became more sustained (after 50 min of seizures). Apparent elevations of taurine, glycine and glutamine levels in CA1 accompanied changes in glutamate concentrations. Changes of glutamate level correlated with an increase in the glutamate uptake which rapidly declined after 40 min of seizures. The role of the transient release of glutamate in CA3 and of the sustained release in CA1 in prolonged soman-induced seizures is considered. The correlation between glutamate and other amino acid release is studied. PMID- 1786537 TI - Drastic changes of ventromedial medulla neuronal properties induced by barbiturate anesthesia. I. Comparison of the single-unit types in the same awake and pentobarbital-treated rats. AB - By means of single-unit recordings, as we have already performed in other studies, we have found that in the awake, drug-free, freely moving rat, there is only one neuronal class potentially involved in nociception and its control at the ventromedial medulla level (VMM, a structure involved in the spinal descending control systems of nociception): the 'multireceptive multimodal' units. These neurons are always activated by very light mechanical (air puff, light touch) and mechanical (pinch, pin-prick) or thermal noxious stimuli, in addition to an auditory stimulus. During identical VMM penetrations, performed in the same animals tested first awake and then anesthetized a few days later with 30 mg/kg of i.p. pentobarbital, we once again found the 'multireceptive multimodal' units, but this time with physiological properties that were strongly modified: in particular, we noted a disappearance of the nociceptive responses consecutive to a strong noxious heat pulse application (36-51 degrees C), associated sometimes with a reduction of the responses due to innocuous stimulation. This is in agreement with the classical effects of barbiturates. In light of previous observations reported in the literature devoted to the VMM physiology in the anesthetized rat, the most important observation in our study was that, with pentobarbital anesthesia, we recorded 'new' neuronal classes as compared to the awake condition. In these classes, which appeared to be qualitatively similar to those already reported under anesthesia, we found the units exclusively driven by innocuous stimulation (excited for the majority), the units specifically driven by noxious stimulation (half excited, half inhibited) and a 'multireceptive multimodal' group inhibited or excited-inhibited by non noxious and noxious stimuli (half of the multireceptive group). All these data demonstrate that barbiturate anesthesia strongly modifies the VMM physiology in relation to nociception. Furthermore, since our results, that were obtained in anesthetized rats, were qualitatively identical to those described in the literature under similar experimental conditions, they raise the question of the appropriateness of using a barbiturate anesthetic in order to study the cellular mechanisms related to nociception at this level. In addition, these findings indicate that the obtention of only one neuronal class in the awake, drug-free, freely moving rat (the excited 'multireceptive' neurons) is not due to an experimental bias, which strongly emphasizes the reliability of using awake animals. However, it remains to be determined by which mechanisms pentobarbital 'distorts' the VMM physiology as compared to the normal, standard physiological conditions of the awake animal. PMID- 1786538 TI - Drastic changes of ventromedial medulla neuronal properties induced by barbiturate anesthesia. II. Modifications of the single-unit activity produced by Brevital, a short-acting barbiturate in the awake, freely moving rat. AB - In the preceding study, we have found that pentobarbital, a powerful barbiturate substance, strongly modified the ventromedial medulla (VMM) physiology in relation to nociception: indeed, in the same rats, during time-separated similar VMM penetrations, we have recorded, under pentobarbital, 'new' neuronal groups as compared to the awake state, such as the units exclusively driven (excited or inhibited) by cutaneous innocuous or noxious stimulations and the multimodal multireceptive neurons inhibited by non-noxious and noxious stimuli. Still under pentobarbital, we have also recorded the same units found as the rats were awake, i.e., the multimodal multireceptive neurons exclusively excited by various innocuous and noxious stimuli. However, the spontaneous and nociceptive activities of these units were strongly modified as compared to awake animals. Using Brevital (a short-acting barbiturate substance) administration, we have, in the present study, tried to understand the mechanisms underlying these drastic modifications. In particular, one of the questions was whether or not the 'new' neuronal classes recorded under anesthesia resulted from a modification of the physiological properties of the unique VMM neuronal group potentially involved in nociception in awake animals: the multimodal multireceptive units. By following the VMM neuronal activities either before and after or after Brevital administration until recovery from anesthesia, we have determined that the units exclusively driven by innocuous stimulation might result from a modification of the multimodal multireceptive neurons. Alternatively, the multireceptive units inhibited by peripheral stimulations are possibly totally different neurons, silent when the animals are awake. PMID- 1786539 TI - Mesencephalic sites of action of an enkephalin analogue (D-Met2, Pro5) enkephalinamide and naloxone on the anterior pituitary of male rats. AB - (D-Met2, Pro5)-Enkephalinamide and naloxone injected into the dorsal raphe nucleus affected luteinizing hormone (LH) and prolactin (PRL) release. Drugs given into the reticular tegmental nucleus and dorsal part of the periaqueductal gray matter induced a PRL response and their administration into the central superior midbrain raphe nucleus caused changes in growth hormone (GH) secretion. The inferior colliculus and the lateral part of the periaqueductal gray matter were ineffective sites. PMID- 1786540 TI - Focal elevations in neocortical interstitial K+ produced by stimulation of the fastigial nucleus in rat. AB - We studied whether K+, a potent cerebrovasodilator released by active neurons, participates in the increase in cortical cerebral blood flow (CBF) elicited by stimulation of the cerebellar fastigial nucleus (FN). Rats were anesthetized by continuous administration of halothane (1-3%), paralyzed and artificially ventilated. FN was stimulated electrically (8 s trains, 50 Hz, 5-10 V) through microelectrodes positioned stereotaxically. K+o (mM) was measured in sensory cortex by K(+)-sensitive micropipettes. In some experiments neocortical CBF was monitored continuously by laser-doppler flowmetry. Stimulation of the FN produced significant increases in K+o that averaged 0.91 +/- 0.16 mM (range 0.5-2.9 mM; n = 19) and were confined to sites corresponding to the intermediate cortical laminae (P less than 0.05, ANOVA). To determine whether such K+o elevations were able to produce increases in CBF comparable to those elicited by FN stimulation, cortical K+o was increased by superfusing the sensory cortex with 20-30 mM K+ in Ringer. K+o elevations of 2.8 +/- 0.6 mM increased CBF by 17 +/- 2% (n = 5), an increase considerably smaller than that elicited by FN stimulation in cerebral cortex. We conclude that K+ is unlikely to mediate the cortical cerebrovasodilation. Furthermore, the restricted spatial distribution of the K+o increase indicates that the cortical neural activity evoked by FN stimulation is highly focal. Thus the findings support the hypothesis that, in cortex, the vasodilation is mediated by activation of a restricted group of neural elements, perhaps neurons in laminae III-IV. PMID- 1786542 TI - Cultured astrocytes release proenkephalin. AB - Astrocytes as well as neurons express the mRNA encoding the opioid peptide precursor, proenkephalin. In neurons proenkephalin is cleaved intracellularly to yield smaller, bioactive peptides such as Met-enkephalin and Leu-enkephalin. By contrast, utilizing a combination of radioimmunoassay and chromatographic analysis, we report here that astrocytes cultured from neonatal rat brain contain primarily unprocessed proenkephalin and only small amounts of Met-enkephalin. Further, similar experiments with and without the inclusion of several peptidase inhibitors indicate that cultured astrocytes release proenkephalin itself into the medium where it may be subsequently cleaved to smaller peptide products. The release of intact proenkephalin by astrocytes suggests that the glial propeptide subserves a different function than neuronal proenkephalin and that opioid peptides may play novel roles in the central nervous system. PMID- 1786541 TI - Further investigations into the pathophysiology of MPTP-induced parkinsonism in the primate: an intracerebral microdialysis study of gamma-aminobutyric acid in the lateral segment of the globus pallidus. AB - The technique of intracerebral microdialysis has been employed to examine the extracellular level of gamma-aminobutyric acid (GABA) within the lateral segment of the globus pallidus of two cynomolgus monkeys, before and after the induction of parkinsonism with N-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP). Microdialysis probes were acutely implanted through indwelling cannulae positioned at several sites above the lentiform nuclei in the conscious primates, and the basal and potassium (100 mM) evoked amino acid levels were monitored for 3 h. These procedures were repeated at fresh sites within the lateral globus pallidus following the induction of parkinsonism with MPTP. The levels of a number of amino acids, including Asn, Ala, Gln, Ser, and Tau were unchanged following MPTP treatment, whereas both the basal and K(+)-evoked release of GABA was consistently increased. This observation represents further corroboration of the evidence for increased GABAergic input to the lateral globus pallidus in MPTP induced parkinsonism. PMID- 1786543 TI - The cytoarchitectonic boundaries of the monocular and binocular areas of the rat primary visual cortex. AB - We describe the cytoarchitectonic characteristics of the monocular (Oc1M) and the binocular (Oc1B) areas of the rat visual cortex and their boundaries in Nissl stained sections. This formulation, which draws upon the computer image analysis of these areas by Zilles et al. (J. Comp. Neurol., 226 (1984) 391-402), can aid in the delineation of Oc1M from Oc1B in quantitative studies requiring a volumetric analysis of both subfields. PMID- 1786544 TI - The effects of noradrenergic neurotoxin, DSP-4, on the performance of young and aged rats in spatial navigation task. AB - The present study investigated whether an overactive noradrenergic system is related to the impairment in learning/memory in aged subjects. The effects of partial noradrenaline depletion (using the noradrenergic neurotoxin DSP-4) on the acquisition of a water maze task was investigated in young and aged rats, and hippocampal noradrenaline content was correlated with spatial learning performance in similar rats. DSP-4 treatment impaired markedly the acquisition of the water maze task in aged rats, but improved it slightly in young rats. DSP-4 treatment decreased swimming speed, and this effect tended to be more marked in young rats. In the group of control rats, hippocampal noradrenaline tended to correlate positively with spatial bias in aged rats (the rats with the highest noradrenaline content in the hippocampus tended to have the best spatial learning/memory), but negatively in young rats. These results do not support the hypothesis that spatial learning/memory impairment is due to an overactive noradrenergic system in aged rats. Further studies are needed to clarify the reasons of the marked age-related difference in the effects of DSP-4 on the performance of water maze task in rats. PMID- 1786545 TI - In vitro aging of beta-amyloid protein causes peptide aggregation and neurotoxicity. AB - beta-Amyloid peptide forms the senile plaques of Alzheimer's disease and has been previously demonstrated to have both trophic and toxic effects on neurons in vitro. We report here that synthetic beta-amyloid peptide shows both aggregation and neurotoxicity after a 2-4 day incubation period, but is neurite-promoting and not toxic in its initially solubilized state. SDS-PAGE characterization shows that newly solubilized beta-amyloid is predominantly monomeric whereas incubated peptide has several high molecular weight species. PMID- 1786546 TI - Ultrastructural analysis of noradrenergic nerve terminals in the cat lumbosacral spinal dorsal horn: a dopamine-beta-hydroxylase immunocytochemical study. AB - Noradrenaline-containing nerve terminals within the cat spinal dorsal horn were studied by immunocytochemical localization of dopamine-beta-hydroxylase. Immunoreactive terminals formed symmetrical (Gray type II) synaptic specializations with dendrites and somata throughout laminae I-IV, but no junctions were formed with other axons. These findings suggest that noradrenaline regulates sensory transmission through the dorsal horn via a postsynaptic action. PMID- 1786547 TI - Therapeutic window of halothane anesthesia for reversal of delayed neuronal injury in gerbils: relationship to postischemic motor hyperactivity. AB - The effect of postischemic halothane anesthesia on locomotor activity and delayed neuronal injury in the hippocampal CA1 sector was examined in gerbils subjected to 5-min forebrain ischemia. Locomotor activity was assessed for 48 h after ischemia using an animal activity monitor, and CA1 injury was evaluated by counting the number of surviving neurons following 7 days of recirculation. Sham treated animals exhibited a slight decrease of motor activity for about 1 day after surgery. Gerbils subjected to ischemia without postischemic halothane anesthesia developed significant motor hyperactivity (18 times higher than control activity) between 1.7 h and 6.7 h of recirculation. Surviving CA1 neurons in this group amounted to only 17% of those in the control animals. Postischemic halothane anesthesia during the initial 1.7 h of recirculation abolished subsequent motor hyperactivity and protected 84% of all CA1 neurons. Postischemic halothane anesthesia during 1.7 h-3.3 h of recirculation and 3.3-5 h of recirculation did not abolish motor hyperactivity except during the period of anesthesia, and did not protect hippocampal CA1 neurons (only 24% and 10% neuronal survival, respectively). These results demonstrate that the therapeutic window of halothane anesthesia for protection of hippocampal injury precedes the phase of locomotor hyperactivity, and that the appearance of the latter predicts delayed neuronal death. PMID- 1786548 TI - Expression of APP in the early stage of brain damage. AB - We immunocytochemically studied the expression of various epitopes of amyloid beta/A4 protein precursor (APP) after brain damage by kainic acid injection. After 3 h, APP695 rapidly accumulated in dystrophic neurites near the damaged site. After 3 days, APP with Kunitz-type protease inhibitor domain was expressed in reactive astrocytes in the lesion and ipsilateral hippocampus. APP rapidly accumulated in dystrophic neurites, and different types of APP were expressed in different cell types in the damaged brain. PMID- 1786549 TI - Effects of daytime and nighttime stress on Fos-like immunoreactivity in the paraventricular nucleus of the hypothalamus, the habenula, and the posterior paraventricular nucleus of the thalamus. AB - Circadian effects on basal and stress-induced Fos-like immunoreactivity (IR) in the paraventricular nucleus of the hypothalamus (PVN), the habenula (Hab) and the posterior paraventricular nucleus of the thalamus (PVN-Thal) were examined. Stress induced a significant increase in the number of Fos-like IR cells within all 3 brain regions. In the Hab, expression was localized specifically to the medial region of the lateral Hab. No differences between the effects of daytime vs nighttime stress on numbers of Fos-like IR cells in the PVN and PVP-Thal were observed. Significantly fewer Fos-like IR cells were observed, however, in the lateral habenula of nighttime vs daytime non-stressed controls, resulting in a significantly greater percentage increase in Fos-like IR in the lateral habenula following nighttime vs daytime stress. PMID- 1786550 TI - Regional catecholamine levels in brains of normal and ethanol-tolerant long-sleep and short-sleep mice. AB - The objective of this study was to further investigate neurochemicals which might modulate congenital differences in sensitivity to the acute and chronic effects of ethanol. Catecholamine levels were measured in the cortex, hippocampus, midbrain and cerebellum of long-sleep (LS) and short-sleep (SS) mice. These measurements revealed that norepinephrine (NE) levels were equivalent in all these brain regions of both strains except for a significantly greater concentration in the midbrain of LS mice. The hippocampus, cortex and cerebellum of SS mice contained more epinephrine (E) than for LS mice. Likewise, the hippocampus and cerebellum of SS mice had higher levels of dopamine (DA), while in the midbrain this amine was more abundant in LS mice. Following 7-10 days of ethanol ingestion, both LS and SS mice exhibited a significant reduction in the duration of ethanol-induced loss of righting reflex. This tolerant state was associated with a depletion of NE in the hippocampus and cortex of both strains. NE was also significantly reduced in the midbrain of LS and the cerebellum of SS mice. On the other hand, E levels were unaltered except for a reduction in the hippocampus of tolerant SS mice. DA levels declined in all brain regions of tolerant mice except for the cerebellum of LS mice and the midbrain of SS mice where a significant increase and no change in DA concentration was detected, respectively. Interestingly, the brain levels of 3-methoxy-4-hydroxyphenylglycol were uniformly increased during the tolerant state for both strains.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786551 TI - Exo-focal postischemic neuronal damage in the rat brain: alteration of [3H]forskolin binding using in vitro autoradiography. AB - We studied the alteration of intracellular signal transduction using quantitative autoradiography of the second messenger system in order to clarify the mechanisms of delayed neuronal damage in the remote areas of rat brain after transient focal ischemia. Chronological changes of [3H]forskolin binding sites were measured to demonstrate the striatal-nigral pathway after 90 min of right middle cerebral artery (MCA) occlusion and after such occlusion followed by 3 h, 6 h, 1 day, 3 days, 1 week, 2 weeks and 4 weeks of recirculation. [3H]Forskolin binding sites were found to be markedly decreased in the lateral segment of the caudate putamen supplied by the occluded MCA after 90 min of ischemia with no recirculation. On the contrary, there was no alteration on day 1, but 3 days after ischemic insult, marked reduction of [3H]forskolin binding sites was observed in the ipsilateral substantial nigra which lay outside the ischemic areas. This postischemic delayed phenomenon observed in the substantia nigra developed concurrently with 45Ca accumulation, which was detected there in our previous study. The delayed reduction of [3H]forskolin binding sites in the substantia nigra observed in the present study indicates that striatonigral terminal degeneration at presynaptic sites is caused by precedent ischemic damage of the ipsilateral caudate putamen and that exo-focal postischemic neuronal death is caused by a transsynaptic process associated with the ischemic foci. PMID- 1786552 TI - Retinally perceived light can entrain the pineal melatonin rhythm in Japanese quail. AB - The avian pineal organ contains a circadian oscillator that can drive a daily rhythm of melatonin synthesis. In some avian species the pineal organ may act, via the cyclic release of melatonin, as a pacemaker within a multioscillator circadian system. The routes by which light entrains the pineal melatonin rhythm were investigated in the Japanese quail. A 'patching' protocol was used to expose directly either the eyes or the pineal to a light-dark cycle while the rest of the bird was exposed to constant light. The results show that the pineal melatonin rhythm can be entrained (1) by light perceived directly or (2) by light perceived by the eyes. Furthermore, the pathway by which light entrains the pineal melatonin rhythm includes the optic nerves because transection of the optic nerve eliminates the ability of ocularly perceived light to entrain the pineal melatonin rhythm. PMID- 1786553 TI - Both arachidonic acid and 1-oleoyl-2-acetyl glycerol in low magnesium solution induce long-term potentiation in hippocampal CA1 neurons in vitro. AB - The effects of phospholipase blockers on tetanus-induced long-term potentiation (LTP) and of diacylglycerol (DG) and arachidonic acid (AA) on synaptic transmission were studied in CA1 neurons of guinea pig hippocampal slices to evaluate the role of protein kinase C (PKC) and AA on the maintenance of LTP. Tetanus-induced LTP was suppressed by perfusion with neomycin (1 mM) or 2-nitro-4 carboxyphenyl-N,N-diphenylcarbamate (NCDC, 0.1 mM), blockers of phospholipase. 1 Oleoyl-2-acetyl-glycerol (OAG, 100 micrograms/ml) and AA (100 microM) produced a temporal increase in both the amplitude of the population spike (PS) and the slope of the field excitatory postsynaptic potentials (EPSPs) but failed to produce LTP. Application of OAG or AA in low-Mg2+ (0.1 mM) solution induced LTP. OAG- and AA-induced LTP was blocked by DL-2-amino-phosphopentanoic acid (AP5; 50 microM). The administration of a potent activator of PKC, phorbol-12,13 dibutyrate (PDBu), in low-Mg2+ (0.1 mM) solution enhanced the PS and EPSPs for 2 or 3 h but this enhancement did not persist. These results suggest that PKC activation is not as important as AA for the maintenance of LTP and that OAG and AA play important roles in the maintenance of LTP in synergy with the influx of Ca2+ through NMDA receptor-coupled channels. PMID- 1786554 TI - Autoradiographic analysis of second-messenger systems in the gerbil hippocampus following repeated brief ischemic insults. AB - Using [3H]inositol 1,4,5-triphosphate (IP3), [3H]phorbol 12,13-dibutyrate (PDBu) and [3H]forskolin, we performed quantitative autoradiography to determine sequential alterations in second-messenger systems in the gerbil hippocampus following repeated brief ischemic insults. Changes following three 2-min ischemic insults were compared with those following single 2- or 6-min ischemia. [3H]IP3 binding was extremely sensitive to ischemic insult, and more than 80% of the binding sites were lost after destruction of CA1 pyramidal cells following 6-min ischemia and three 2-min ischemic insults. Furthermore, a 30% reduction was observed after 2-min ischemia which leads to no neuronal loss. [3H]PDBu binding in the CA1 subfield decreased by 1 day after three 2-min ischemic insults and by 4 days after 6-min ischemia, and 40-50% reductions were observed at 1 month. In contrast, [3H]forskolin binding was relatively preserved. [3H]PDBu and [3H]forskolin binding transiently increased early in the reperfusion period. We also observed a difference in the pattern and severity of alterations between repeated ischemic insults and single ischemia. PMID- 1786555 TI - Sensitization of mesolimbic brain stimulation reward after electrical kindling of the amygdala. AB - The effects of partial kindling of the central amygdaloid nucleus on brain stimulation reward were evaluated. Intracranial self-stimulation (ICSS) rate intensity functions were determined using a two-hole nose-poke discrimination paradigm in rats implanted with electrodes in the A10 dopamine (DA) neuronal region of the ventral tegmental area (VTA), and in the medial forebrain bundle (MFB) at the level of the lateral hypothalamus. The kindling process did not influence ICSS baseline rates from either site. However, following stage 4 kindling, a low dose amphetamine challenge increased ICSS, resulted in a significant shift to the left of the rate intensity functions, and decreased reward thresholds. Analysis of the error scores which consisted of nonreinforced responses made during ICSS testing revealed that the interaction between kindling and amphetamine on ICSS was specific to changes in central reward processes, and could not be attributed to the influence of rate-enhancing performance variables. The kindling-elicited sensitization of mesolimbic DA reward functioning seen after amphetamine challenge was discussed in relation to the role of the central amygdala in the integration of stimulus-reward associations, and in the conditioning of affective emotional states. PMID- 1786556 TI - Parabrachial nucleus: neuronal evoked responses to gastric vagal and greater splanchnic nerve stimulation. AB - Unitary responses were recorded extracellularly in the parabrachial nucleus (PBN) in anesthetized cats during electrical stimulation of the 1) gastric branches of the ventral and dorsal vagal trunks which serve the proximal stomach, and 2) left greater splanchnic nerve. The gastric vagally evoked parabrachial responses consisted of phasic single and multiple spike orthodromic discharges, which were bilaterally distributed, with a mean latency of 349 ms (S.D. +/- 38.5). The parabrachial-evoked splanchnic unitary responses had a much shorter latency with a bimodal distribution (mean latencies, 53 and 128 ms, respectively). Convergence of gastric vagal input from the proximal stomach and the left greater splanchnic nerve upon single neurons in the PBN was electrophysiologically demonstrated in 132 units. Eighty-seven percent of the gastric vagally evoked parabrachial unitary responses were inhibited by simultaneous electrical stimulation of the splanchnic nerve. The condition-test paradigm was used to evaluate the time course of the splanchnic inhibition of the gastric vagally evoked parabrachial response. Reciprocal connections between neuronal populations in the nucleus tractus solitarius (NTS) which received gastric vagal input and the PBN were also identified electrophysiologically by direct microstimulation of the former structure. The density and characteristics of the gastric vagal and greater splanchnic input to the PBN suggested that this nucleus receives and processes a substantial amount of visceral afferent input. The PBN may serve as an important site for integrating visceral information governing the proximal stomach and ingestive processes. PMID- 1786557 TI - Localization of preproenkephalin A mRNA in the neonatal rat retina. AB - An opioid growth factor, [Met5]-enkephalin, is known to regulate developmental events in the neonatal rat retina. This growth factor interacts with the zeta (zeta) opioid receptor to modulate retinal ontogeny. Both peptide and receptor are present in developing retina, but not in adult retina. We have used in situ hybridization histochemistry to identify and localize preproenkephalin A mRNA in the neonatal rat retina. Preproenkephalin mRNA was localized to the ganglion cell layer, with some radiolabeling found in the neuroblast layer. This result indicates that 1) the mRNA to preproenkephalin A is present during the critical stage of development in the neonatal retina that coincides with the presence of the growth-regulating peptide, [Met5]-enkephalin, and 2) that the source of the opioid growth factor controlling the production of retinal cells appears to be autocrine (i.e., retinal neuroblasts) and paracrine (i.e., ganglion cells) in nature. PMID- 1786558 TI - Prenatal protein malnutrition and hippocampal function: partial reinforcement extinction effect. AB - Developing rats were either malnourished or well-nourished during the prenatal period by feeding their dams diets of low (6% casein) or adequate (25% casein) protein content 5 weeks prior to mating and throughout pregnancy. All pups were well-nourished from the day of birth onwards. Male offspring aged 107 days were gradually reduced to 80% of their free-feeding weight. When weights were stable they were trained to run in an alley for food rewards given on every trial (continuous reinforcement, CR) or on a random 50% of trials (partial reinforcement, PR), then the running response was extinguished. A very clear and similar partial reinforcement extinction effect (PREE) was demonstrated in the previously malnourished and control rats when reward was discontinued. That is, PR groups showed greater persistence as compared with CR groups. During acquisition, however, differences in running speed were observed in the goal section between 6-25 PR and 25-25 PR groups, and between 6-25 CR and 25-25 CR groups. The latter may be due to differences between the nutritional groups in food motivation. PMID- 1786559 TI - Prenatal protein malnutrition and hippocampal function: rapid kindling. AB - A stimulation paradigm evoking rapidly recurring seizure activity from the hippocampal dentate gyrus was used to examine perforant path kindling in prenatally protein malnourished adult rats. Biphasic electrical stimulations (50 Hz) of five s duration were applied to the perforant path every five min for one hour over five consecutive days. Behavioral manifestations of seizure activity were assessed using the standard 0-5 scale. Prenatally malnourished rats exhibited significantly fewer convulsive seizures (stage 5) and required significantly more stimulations to attain the first stage 5 seizure than controls. Animals of the malnourished group also exhibited significantly more stage 1 seizures than control animals, indicating a significant retardation in the kindling rate of these animals. Additionally, 3 of the 11 malnourished animals failed to exhibit a single stage 5 seizure during the 60 stimulation test period. These findings parallel previous results reported for prenatally protein malnourished rats using the traditional one stimulation-per-day kindling paradigm and indicate that this rapid kindling paradigm can be effectively used to study the impact of various insults on seizure susceptibility and development in a shortened time frame. PMID- 1786560 TI - Lack of saturable transport across the blood-brain barrier in either direction for beta-amyloid1-28 (Alzheimer's disease protein). AB - beta-Amyloid and related peptides are components of the neurofibrillary tangles found in the brains of patients with Alzheimer's disease and have been suggested to be directly involved in the pathophysiology of that condition. It is unclear whether the amyloid deposited in the brain arises from the peripheral circulation, which would require passage across the blood-brain barrier (BBB), or whether it is produced within the brain itself. We examined the ability of beta amyloid1-28 (beta Am), a commercially available, biologically active fragment, radioactively labeled with 125I (I-beta Am), to cross the BBB. After IV injection of I-beta Am, radioactivity entered the brain slowly, but to a greater extent than could be attributed to its being trapped in the vascular space of the brain. Entry was not inhibited by an excess of unlabeled beta Am or by pretreatment with aluminum, indicating that entry was by the nonsaturable mechanism of transmembrane diffusion. After intraventricular injection of I-beta Am, radioactivity was cleared slowly from the brain and was not affected by excess unlabeled beta Am or by pretreatment with aluminum, indicating that clearance probably occurred with reabsorption of cerebrospinal fluid. The excess beta Am did not alter the brain/blood ratio or the clearance rate of radioactively labeled albumin, indicating that under the conditions of this experiment beta Am did not have measurable effects on BBB integrity or on the rate of reabsorption of cerebrospinal fluid. High performance liquid chromatography (HPLC) showed that I-beta Am was rapidly degraded, especially by the brain, to smaller peptide fragments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786561 TI - Single unit response of neurons within the hamster suprachiasmatic nucleus to neuropeptide Y. AB - The effect of neuropeptide Y (NPY) on the spontaneous discharge of neurons within the hamster (Mesocricetus auratus) suprachiasmatic nucleus (SCN) (N = 83) was determined using the hypothalamic slice preparation. The discharge of neurons within the ventral SCN recorded during the day was either excited (6/42), immediately inhibited (17/42), or transiently excited and then inhibited (10/42) by NPY 10(-7). During the night, NPY produced excitatory effects in 2/23 neurons, inhibition in 7/23 and excitation followed by inhibition in 4/23. A higher percentage of neurons was found to be unresponsive to NPY during the night than during the day. This difference approached but did not reach statistical significance. In the 18 neurons recorded within the dorsal SCN, NPY had little effect on spontaneous discharge during the day or night. These data indicate that bath application of NPY predominately inhibits the spontaneous discharge of SCN neurons recorded in the hypothalamic slice preparation. PMID- 1786562 TI - Ischemia contributes to adverse effects of cocaine on brain development: suppression of ornithine decarboxylase activity in neonatal rat. AB - Exposure to cocaine during development has been shown to cause structural and functional alterations in the nervous system. In the current study, the mechanisms underlying these effects were examined in neonatal rats through measurement of ornithine decarboxylase activity, a key regulatory enzyme in the control of neural cell differentiation. Animals were given cocaine (30 mg/kg SC) and ornithine decarboxylase measured 1 and 4 h later in midbrain + brainstem, cerebral cortex and cerebellum. Cocaine caused inhibition of ornithine decarboxylase activity that was not secondary to local anesthesia, as lidocaine was ineffective. The effect of cocaine was independent of direct central actions, as introduction of the drug into the central compartment via intracisternal injection failed to inhibit ornithine decarboxylase. In contrast, prevention of cocaine-induced ischemia by peripheral alpha-adrenergic blockade (phenoxybenzamine) reversed the ornithine decarboxylase inhibition caused by cocaine, and actually unmasked potential stimulatory actions. These data indicate that cocaine-induced ischemia is a major contributor to the net effect of the drug on central nervous system cellular development. PMID- 1786563 TI - MK-801 prevents the decrease in 35S-TBPS binding in the rat cerebral cortex induced by pentylenetetrazol kindling. AB - Chemical kindling was induced in the rat by chronic treatment with pentylenetetrazol (PTZ, 30 mg/kg, IP, three times a week for eight weeks). PTZ kindling was associated with a reduction in central GABAergic function, as reflected by a significant decrease in the density of 35S-t butylbicyclophosphorothionate (35S-TBPS) binding sites in the cerebral cortex. The pretreatment with the noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist MK-801 (1 mg/kg, IP, 40 min before each PTZ injection) prevented the development of kindling as well as the reduction in 35S-TBPS binding. The results suggest that NMDA receptors may play a role in the alterations of GABAergic function observed in PTZ-kindled rats. PMID- 1786564 TI - Behavioral sensitization to cocaine is not associated with changes in serotonin (5-HT) fiber immunoreactivity in rat forebrain. AB - We investigated whether cocaine-induced behavioral sensitization is associated with changes in serotonin (5-HT) immunoreactivity. Male Sprague-Dawley rats were injected with either cocaine (15 mg/kg, IP) or saline twice daily for seven days. Their behavior was observed and rated for locomotor activation and stereotypy. One day after the final injection, the brains were processed for 5-HT immunohistochemistry. The intensity of 5-HT immunoreactive staining of 5-HT axons and terminal varicosities was blindly rated in cocaine-sensitized rats and found not to differ from saline-treated rats. The results support the hypothesis that unlike some amphetamine derivatives, repeated cocaine administration which results in behavioral sensitization is not neurotoxic to 5-HT axons and terminals in the forebrain. PMID- 1786565 TI - Comparisons of cocaine receptors in brain regions from WKY and SHR. AB - Both high- and low-affinity sites for [3H]cocaine binding were present in the striatum, hippocampus, olfactory tubercle, and hypothalamus of WKY and SHR. In the striatum, Kd values of both sites and the Bmax value of the high-affinity site were lower in SHR than in WKY rats. In the hippocampus, only the Kd value of the high-affinity site was lower in SHR than in WKY rats. However, there were no differences in Kd or Bmax values between strains in the olfactory tubercle or hypothalamus. The differences in characteristics of [3H]cocaine binding in WKY and SHR may provide a neurochemical basis for the different responses of the two strains to cocaine administration. PMID- 1786566 TI - Increased apomorphine-induced hypothermia precedes development of hypertension in SHRs. AB - Apomorphine produced a greater hypothermic response in spontaneously hypertensive rats (SHRs) than in normotensive Wistar-Kyoto rats (WKYs). Experiments were conducted in SHRs and WKYs of three age groups to determine whether the increased hypothermic responsiveness to apomorphine occurs prior to the development of hypertension. The mean systolic blood pressures (SBPs) of SHRs and WKYs were comparable at 4-6 weeks of age. The mean SBP of SHRs were significantly greater than that of WKYs at both 8-10 and 12-15 weeks of age. Yet SHRs responded to apomorphine with significantly greater hypothermia than WKYs at all three ages. These findings indicate that the hyperresponsiveness of SHRs to apomorphine induced hypothermia precedes the development of hypertension. This sequence of events is consistent with the hypothesis that central DA systems play a role in development of hypertension in SHRs. PMID- 1786567 TI - Influence of temperature, dietary energy, nutrient concentration and self selection feeding on the retention of dietary energy, protein and calcium by sexually-maturing egg-laying pullets. AB - 1. On a daily temperature cycle of 25 to 35 degrees C and during the onset of lay, gross energy in droppings were increased significantly by 3 to 5%. There were no changes in energy metabolisability. Overall, less energy was excreted and energy metabolisability was improved on higher energy diets. 2. Crude protein and calcium losses decreased and their retention efficiencies increased with the onset of lay. Less protein and calcium were lost at the high temperature with corresponding increases in retention. Less protein and more calcium were lost on the higher energy diet. 3. Crude protein excretion was increased and calcium excretion reduced with self-selection feeding. Energy metabolisability and crude protein retention efficiency were reduced by this feeding practice. PMID- 1786568 TI - Analysis of growth curves of fowl. I. Chickens. AB - 1. The Richards function was used to describe the growth curves (n = 989) of 9 broiler lines. Chickens were fed ad libitum and body weight was recorded every second week from hatching to 26 weeks of age. 2. The accuracy of curve fit measured by the coefficient of determination (R2) was better for males than for females (0.9986-0.9995 vs 0.9972-0.9988, respectively). 3. The estimation of the asymptotic final weight (A) for different lines enabled the degree of maturity (ut = yt/A) to be determined at any fixed point of the curve. At the age of 7 weeks this had a value of 0.318-0.369 for cockerels and 0.325-0.377 for pullets and represented the slaughter maturity of individual lines. The ratio of inflection/asymptotic weight (y+/A = 0.370-0.388) indicated that in some cases chicken growth can be described approximately by the Gompertz function (y+/A = 0.368). 4. It was found that the age at the inflection point of curves (t+ 48.2 55.7 d for cockerels and t+ = 47.8-52.8 d for pullets) roughly corresponds to the slaughter age of the chickens. 5. The interline differences in the parameters of maturation rate for weight (y+/A, k, t+, u7) are low in comparison with the differences in body weight (A, y+, y7) and absolute growth rate (v, v+). 6. The intragroup phenotypic correlation among growth parameters and the importance of the mathematical models are discussed. PMID- 1786569 TI - Analysis of growth curves of fowl. II. Ducks. AB - 1. Growth curves of nine selected lines and one random-bred control population (in total, n = 1070) were evaluated by the Richards function. The ducks were weighed at 7-d intervals and, after the tenth week, every second week (up to 18 weeks). Food and water were supplied ad libitum. 2. The predicted curves closely fitted the weight data points (R2 = 0.9991-0.9997). 3. The ducks are characterized by early maturity rate. The peak of the absolute growth rate (the inflection point of the curve) occurred at 24.1-27.6 d of age (t+). A higher ratio of the inflection to the asymptotic weights (y+/A = 0.380-0.424) was found in comparison to those from the Gompertz-type function of growth (y+/A = 0.368). 4. In the selected lines the degree of maturity at a slaughter age of 7 weeks (u7 = y7/A) ranged from 0.784 to 0.835 for males and from 0.819 to 0.889 for females. 5. Ducks within the non-selected control line had a significantly lower maturing rate than the selected lines. 6. Sexual dimorphism was recorded for all growth parameters analysed. Females have faster maturation rate than males (higher values of y+/A, u7, k and a shorter auto-acceleration phase of growth). 7. High interline differences were found for body weight (A, y+, y7) and for absolute growth rate (v, v+) and smaller ones for parameters of the maturation rate (y+/A, u7, k and t+). 8. The intragroup phenotype correlation between growth parameters and the use of weight data only up to 7 weeks of age for the estimation of parameters of the Richards function are discussed. PMID- 1786570 TI - The response of broiler breeder hens to dietary lysine and methionine. AB - 1. Broiler breeder hens were used in an experiment lasting 10 weeks (29 to 38 weeks of age) to measure the responses to dietary lysine and methionine, the main objective being to determine whether the coefficients of response to these amino acids were the same for broiler breeders and for laying pullets. 2. The hens were offered 150 g/d of one of 20 dietary treatments, 10 being lysine-limiting and 10 being methionine-limiting. The diets were mixed by diluting one of two concentrate (summit) mixes with a protein-free dilution mixture. The lysine limiting summit diet was designed to supply approximately 1300 mg lysine/bird d, while the other supplied 520 mg methionine/bird d, when fed at 150 g/bird d. 3. Birds on the 5 lowest concentrations of both lysine and methionine did not consume the allotted amount of food, the amount decreasing, in a curvilinear fashion, to approximately 105 g/bird d. 4. The minimum egg weight recorded was 0.8 of the maximum, whereas the rate of lay of birds fed on the diets with the lowest amino acid concentrations was 0.2 of the maximum. 5. Using the Reading Model, the coefficients of response were calculated to be (for lysine) 16.88 E and 11.2 W, and for methionine, 7.03 E and 1.52 W, where E = egg output, g/bird d, and W = body mass, kg/bird. An average, individual, broiler breeder of 3 kg, producing 45 g of egg output per day, would need 793 mg of lysine and 321 mg of methionine daily. This intake of methionine is similar to that estimated by means of coefficients used for laying pullets, but the lysine requirement would be underestimated by 0.18 if the coefficients for laying pullets were used. 6. The coefficients for maintenance for both lysine and methionine, determined in this experiment, are considerably lower than values published previously, whilst the coefficients for egg output are, in both cases, higher. The resultant flock response curves therefore differed significantly from those in which the coefficients of response for for laying pullets were used.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1786571 TI - Effects of feeding by crop intubation on energy metabolism and physical activity in domestic cockerels. AB - 1. Heat production and physical activity were measured in cockerels given the same amount of food either conventionally or by direct intubation into the crop. 2. The thermogenic effect of feeding (heat increment per unit weight of food) was about 30% less with tube-feeding. 3. The difference in heat increment of feeding, and therefore in efficiency of energy utilisation, was entirely attributable to the circumvention of feeding activity by intubation. PMID- 1786572 TI - Hydrogenated oil decreases tissue concentrations of n-6 polyunsaturated fatty acids and may contribute to dyschondroplasia in broilers. AB - 1. In a factorial design of dietary treatments, male Ross broilers were given diets containing soyabean oil, hydrogenated soyabean oil (as a source of trans fatty acids) or feed fat with either 0 or 300 micrograms of added D-biotin/kg. 2. Growth to 28 d was not influenced by the dietary treatments. 3. Length of tibiotarsal bones was reduced (P less than 0.05) and severity of leg bone cartilage lesions, characteristic of dyschondroplasia, was highest (P less than 0.05) in broilers fed on diets containing hydrogenated soyabean oil. 4. Feeding hydrogenated soyabean oil lowered (P less than 0.05) the concentrations of C20:4n6 and the ratios of C20:4n6/C18:2n6 in liver and growth plate cartilage. 5. Growth plate cartilage from birds affected with dyschondroplasia contained lower proportions of prostaglandin precursor fatty acids compared with normal growth plate. 6. It is speculated that an inhibition of prostaglandin biosynthesis brought about by the presence of trans-fatty acids might contribute to the occurrence of lesions similar to dyschondroplasia. PMID- 1786573 TI - Temporal secretory patterns of growth hormone in male meat-type chickens of lines selected for body weight gain or food conversion. AB - 1. The pronounced episodic release of chicken growth hormone (cGH) in male broiler chicks, as well as its peak interval of about 90 min was confirmed in this study. 2. Lines selected for 6-week body weight (GL line) or for food conversion between 3 and 6 weeks of age (FC line) not only differ in the selection criteria but also in percentage abdominal fat. 3. The overall mean plasma GH concentration was higher in the FC line in both experiments, and this was only caused by peak amplitudes which were almost twice as high as in the FC line. Peak intervals were identical in both selected lines. 4. These observations suggest that decreased abdominal fat and increased protein efficiency may be genetically linked to increased plasma GH peak amplitude. This, and earlier observations on the effectiveness of pulsatile administration of cGH on the growth of broilers suggest that the biological function of GH may depend on its secretory pattern rather than its mean concentration in plasma. PMID- 1786574 TI - Thermal preferences of chicks brooded at different air temperatures. AB - 1. The thermal preferences of small flocks of 400 chicks brooded under radiant heaters were determined at air temperatures of 21, 24 and 27 degrees C from observations of behavioural thermoregulation. 2. At 1 d of age the upper limits of the preferred black bulb temperature increased with air temperature. Preferences for radiant temperature declined with air temperature. 3. Compensation for cold air temperature was imperfect because the chicks avoided zones of high radiant flux. The maximum tolerable radiant temperature was approximately 50 degrees C. 4. Radiant heaters are preferable to convectors in poultry husbandry because the inherent lack of spatial homogeneity in thermal environments ensures that chicks can satisfy their individual thermal preferences. PMID- 1786575 TI - Interaction of operant behaviour and autonomic thermoregulation in the domestic fowl. AB - 1. Domestic fowls were trained to peck a disc in order to receive a limited thermal reinforcement. 2. When subsequently tested, their use of the operant response was a function of ambient temperature, decreasing from 0 to 24 degrees C and rising again steeply from 28 to 42 degrees C. 3. Under cool conditions changes in rate of heat production were of major significance in maintaining homeothermy, whilst in the heat the operant response was used in preference to, or in addition to, thermal panting. 4. Data from the behavioural studies, together with those on autonomic effector mechanisms, indicate that optimal thermal conditions for the fowl are likely to be attained at 22 to 24 degrees C. PMID- 1786576 TI - Determination of furosine in biomedical samples employing an improved hydrolysis and high-performance liquid chromatographic technique. AB - Traditionally, the most sensitive and specific determination of non-enzymatic protein glycation has involved an 18-24-h acid hydrolysis in order to generate the compound furosine, which has been detected employing reversed-phase h.p.l.c. In this study, we have reported that significant quantities of furosine can be generated with much shorter hydrolysis times employing a 90-min vapor-phase acid hydrolysis procedure. The furosine generated by vapor-phase hydrolysis is then quantitated by pulsed amperometric detection using anion-exchange high performance liquid chromatography. Employing this method, we were able to show that furosine generated from acid hydrolysis of purified hepatic membranes in a diabetic and non-diabetic animal model agreed with traditional methods assessing total glycated protein (i.e., boronate affinity methods). PMID- 1786577 TI - Characterization of five isomers of branched cyclomaltoheptaose (beta CD) having degree of polymerization (d.p.) = 9: Reinvestigation of three positional isomers of diglucosyl-beta CD. AB - It has been confirmed by methylation analyses and chemical syntheses that three isomers of branched cyclomaltoheptaose (beta CD) isolated from the mother liquors of a large-scale preparation of beta CD with Bacillus ohbensis cyclomaltodextrin glucanotransferase are 6(1),6(4)-di-O-(alpha-D-glucopyranosyl)-cyclomaltoheptaose (1), 6(1),6(3)-di-O-(alpha-D-glucopyranosyl)-cyclomaltoheptaose (2), and 6-O (alpha-isomaltosyl)-cyclomaltoheptaose (4) instead of 6(1),6(2)-di-O-(alpha-D glucopyranosyl)-cyclomaltoheptaose (3), which was erroneously characterized in an earlier paper. Compound 3 has been newly isolated from a glucosyl-beta CD mixture prepared by hydrolysis with glucoamylase of a maltosyl-beta CD mixture, synthesized from maltose and beta CD through the reverse action of pullulanase. Chromatographic behavior and spectral data (13C-n.m.r. and f.a.b.-m.s.) of these isomers of branched beta CD (1-4), as well as those of another isomer prepared by the reverse action of hydrolytic enzymes, 6-O-(alpha-maltosyl)-cyclomaltoheptaose (5), were compared. PMID- 1786578 TI - Separation of high-mannose isomers from yeast and mammalian sources using high-pH anion-exchange chromatography. PMID- 1786579 TI - High-performance reversed-phase chromatographic mapping of 2-pyridylamino derivatives of xyloglucan oligosaccharides. AB - Xyloglucan oligosaccharides from cotton cell walls and tamarind seeds were derivatized with 2-aminopyridine and subsequently separated by reversed-phase chromatography (r.p.c.) using an octadecylsilyl silica stationary phase and aqueous-organic eluents with 0.01% (v/v) trifluoroacetic acid. The chromatographic behavior of the 2-pyridylamino derivatives of xyloglucan oligosaccharides was examined under a wide range of elution conditions, including gradient steepness and shape, initial acetonitrile concentration in the eluent, and pore size of the r.p.c. packings. Relatively steep acetonitrile gradients resulted in poor resolution of the different xyloglucan fragments, which is believed to be the result of acetonitrile-induced conformational changes. Under these circumstances the elution order of the derivatized xyloglucan oligosaccharides was such that the smaller fragments eluted from the column before the larger ones. R.p.c. packing with a 70-A pore size necessitated relatively high acetonitrile concentration in the eluent when compared with 300-A stationary phase. The r.p.c. mapping of 2-pyridylamino derivatives of xyloglucan oligosaccharides was best achieved when both a wide-pore octadecyl-silyl silica stationary phase and a shallow gradient with consecutive linear segments of increasing acetonitrile concentration in the eluent were employed. This combination yielded rapid r.p.c. maps of the xyloglucan fragments from different sources with high separation efficiencies and concomitantly high resolution. The effects of the nature of the sugar residues in the xyloglucan oligomers and their degree of branching on r.p.c. retention and selectivity are also highlighted. PMID- 1786580 TI - An h.p.l.c. method for determining chain-length distribution in some glycogens. AB - Human, oyster, Streptococcus mitis, and phyto-glycogen samples were debranched using Pseudomonas amylodermosa isoamylase (EC 3.2.1.68). The distribution of chain lengths was studied by high-performance liquid chromatography on reversed phase columns, with water as eluent. Quantitative data was obtained over the degree of polymerisation range three to eighteen (d.p. 3-18), and oligosaccharides up to d.p. 26 were detected. No single column was found suitable for the resolution of the complete range of oligosaccharides, two columns being necessary for the quantitative analysis. The resulting "fingerprints" of chain lengths are characteristic of the glycogen source and should be useful for both comparison purposes among glycogens and for monitoring procedures of glycogen isolation. PMID- 1786581 TI - [The role of calcium in the effect of stress hormones]. AB - During administration of stressogenic substances an increased shift of calcium ions into smooth muscles of the aorta and heart muscle takes place. Administration of a high-fat diet supplemented by cholesterol enhances this process. The calcium blood level does not change significantly during this procedure. The amount of calcium in bones declined after administration of stresso-genic hormones although the values were not statistically significant. It may be assumed that calcium ions shifted into the cardiovascular system originate from osseous tissue. Calcium accumulation during repeated or prolonged stress contributes towards the interpretation of the mechanism of action of stressogenic substances on the cardiovascular system. The increased supply of calcium ions into the heart muscle and coronary arteries may influence also the development of ischaemic heart disease and cardiomyopathies. The increased amount of calcium ions in smooth muscles of the aorta after prolonged administration of stressogenic substances indicates a higher content of calcium ions also in smooth muscle cells of arterioles which leads to a higher peripheral vascular tension. Stress alone does not lead to the development of atherosclerosis but creates favourable conditions for its development. PMID- 1786582 TI - [The effect of calcium channel blockers on experimental hypercholesteremia in rabbits. Biochemical and histochemical study]. AB - Calcium ions act as intracellular messengers in numerous cellular functions and participate also in the development of the atherosclerotic process. Calcium homeostasis could be an important factor in the development of atherosclerosis. One of the drugs which interferes with calcium homeostasis are calcium channel blockers. A number of studies have investigated the possibility whether these drugs may be also useful for prevention of atherosclerosis. However, other investigators have reported that calcium channel blockers did not suppress the atherosclerotic process. In our work we assumed the direct influence of calcium channel blockers on transendothelial transport mechanisms. Therefore we decided to investigate the influence of verapamil, diltiazem and isradipine on the development of experimental atherosclerosis in rabbits. Verapamil administered twice daily, 0.125 mg per kg s. c., reduced the size of atheromatous plaques in the thoracic aorta and the level of total cholesterol and triglycerides in serum. This above effect was not present after administration of diltiazem in doses of 1.0 mg per kg and isradipine 1.25 mg per kg twice daily subcutaneously. Our conclusion is that the anti-atherosclerotic effect of calcium channel blockers is dose-dependent. It is not clear whether this effect takes place in the plasma compartment and/or in the intracellular compartment. PMID- 1786583 TI - [Computer tomography in functional stereotactic neurosurgery]. AB - The authors describe their own modification of visualization and construction of coordinates of a stereotactic object for functional stereotaxis controlled by computed tomography (CT). This method was applied so far in four functional stereotactic operations (twice for parkinsonian tremor, once for retrocollis and once for epilepsy). In three patients where coagulation of the surgical objective was made, on the 4th or 5th day after operation there was a check-up CT examination and the size and character of the lesion was evaluated. Based on their own experience and reports in the literature, the authors emphasize the advantages of CT as compared with formerly used ventriculography in the control of functional stereotactic operations. PMID- 1786584 TI - [Helicopters for the transportation of casualties. Analysis of injured persons transferred to the Traumatology and Special Surgery Research Institute in Brno from 1 July 1988 to 12 December 1990]. AB - The author analyzes a group of casualties who were brought to the Institute of Traumatology and Special Surgery in Brno by helicopter, when the latter was introduced among the equipment of the emergency service, between July 1, 1988 and December 31, 1990. A total of 80 casualties were transported by helicopter. The tables provide accurate data on the numbers of casualties in different years, the mechanism of their injury and summary of injuries they suffered. One of the tables offers orientation on the activities of the Institute during the period of investigation. From an analysis of the group it is apparent that the helicopter is used for transport of patients in an expedient way. Its use is optimal in various large scale events, in the control of accidents on highways and for transport of casualties from remote places. Perspectively casualties should be transferred from the site of accident directly to the centre which will provide definite treatment regardless of the distance in order to avoid incompetent stages of treatment. On the other hand, the use of helicopters in urban areas is of minor importance and the possibilities of their use are limited. In future it will be necessary to build landing sites at specialized centres which are the destination of the casualties. PMID- 1786585 TI - [Dose equivalents of exposure to radon and its breakdown products in workers at the Jachymov Spa]. AB - The author presents an account on the trend of exposure of staff to radon breakdown products when administering radon baths since 1962. The contemporary values of annual dosage equivalents of bath attending staff are less than 1/20th than originally. The author estimates also the exposure of other workers in the spa caused by exhalations from the footwall of the buildings. The author mentions the results of assessment of potential energy of alpha-radiation of radon fission products in the atmosphere obtained by different methods of assessment. PMID- 1786586 TI - [Comparison of the immunomodulating properties of the cyclosporin Sandimmune (Sandoz) with the newly developed Consupren (Galena)]. AB - An experimental comparative investigation provided evidence of identical immunomodulating properties of the Swiss cyclosporin A of Sandoz Company (Sandimmune) and the Czechoslovak cyclosporin of Galena Company (Consupren). Both preparations administered by the oral route to mice in low doses stimulated the reaction of the late hypersensitivity and in higher doses they inhibited markedly this reaction. Immunostimulation was also observed when influencing the host's reaction against the graft by low doses of the substance. The systemic reaction of the graft against the host was markedly suppressed by repeated doses. The development of antibody-producing cells in the spleen was markedly inhibited by high as well as small doses of the preparations. Inhibition of the formation of total antibodies is caused by inhibition of IgG formation, while IgM formation is enhanced and persists longer. This phenomenon is due to a block of the shift from IgM to IgG formation. In the allogenic tumour model both preparations caused a dose-dependent temporary immunosuppression. PMID- 1786587 TI - [Personal experience with the hypolipidemic agent Olbetam-Acipimox in hyperlipoproteinemia associated with type II diabetes]. AB - The objective of this work was to test in type II diabetics with hyperlipoproteinaemia the action of a new analogue of nicotinic acid--Acipimox (Olbetam, Farmitalia Carlo Erba). The investigation comprised 24 patients of whom 16 took for three months Olbetam (250 mg 3 x per day by the oral route) and 8 patients were given placebo. The investigated biochemical parameters were examined before administration of the preparation was started and 4 and 12 weeks following its administration. Contrary to the group taking placebo, in the group taking Olbetam a significant decline of the triglyceride serum level occurred and a slight decline of total serum cholesterol levels and increase of HDL cholesterol and the atherogenic risk indexes were thus more favourable. The results indicate that Olbetam is a satisfactory hypolipidemic agent for the treatment of diabetic hyperlipoproteinaemia. PMID- 1786588 TI - [Computer selection of thrombocyte donors based on the HLA system]. AB - Thrombocyte concentrates are vitally important in thrombocytopenic types of haemorrhage. If repeated transfusions are necessary, they are associated with immunological reactions, which cause side-effects in the recipient and the transfusion is ineffective. Donors should be selected according to the HLA system. The authors prepared a programme in the Redap language for selection of donors according to HLA antigens (loci A and B) which respects cross reactions and split antigens. The donor is selected by the grade of agreement with the recipient. The authors differentiate between nine possibilities from complete agreement to complete disagreement between donor and recipient. The initial experience revealed that the programme is feasible for the user and is sufficiently quick. PMID- 1786589 TI - [E. Albert writing on K. Maydl]. PMID- 1786590 TI - The secretion of two sperm maturation-related glycoproteins in BALB/c mouse epididymis. AB - A well-developed Golgi apparatus and rough and smooth endoplasmic reticulum in the principal cells of the mouse epididymis indicate active protein synthesis. Studies have shown that epididymal secretions are essential for sperm maturation. In a previous study, two wheat-germ agglutinin (WGA)-binding glycoproteins, GP-49 and GP-83, were identified on the surface of mature mouse sperm. In this study, synthesis and secretion of these two glycoproteins were investigated. Apparent WGA-binding was found on the stereocilia and in the apical region of principal cells in the corpus and cauda of epididymis. Post-fixation and pre-embedding cytochemical localization revealed that WGA-binding sites were situated in the Golgi apparatus, multivesicular bodies and stereocilia of principal cells. GP-49 and GP-83 were identified in the Nonidet P-40 homogenates of corpus and cauda epididymidis. In the epididymides of which ductuli efferentes had been ligated for more than 4 weeks, no sperm were found in the lumina of epididymal tubules. WGA-binding sites were present in the corpus and cauda; GP-49 and GP-83 were identified in tissue homogenates of the corpus and cauda as well. These findings suggest that GP-49 and GP-83 of mature sperm may be secreted by the principal cells of the corpus and cauda. These two molecules apparently conjugate to sperm whilst sperm transit through the epididymis. PMID- 1786591 TI - Distribution of acetylated alpha-tubulin in brain. In situ localization and biochemical characterization. AB - We studied the solubility properties of brain acetylated alpha-tubulin, as well as the localization of this tubulin in brain tissue. Endogenous unpolymerized tubulin and cytoskeletal tubulin were fractionated after brain Triton solubilization. Using the immunoblotting technique, we found that acetylated alpha-tubulin was recovered in the cytoskeletal fraction, and that most (92%) of the acetylated microtubules of this fraction were depolymerized by cold/Ca2+ treatment. In another set of experiments, axonal and soma-dendritic preparations were found to have equivalent amounts of acetylated alpha-tubulin. By immunogold electron microscopy, we established that acetylated microtubules are widely distributed in dendrites of the central nervous system. PMID- 1786592 TI - An ultrastructural analysis of the ecdysoneless (l(3)ecd1ts) ring gland during the third larval instar of Drosophila melanogaster. AB - In the late third larval instar of Drosophila melanogaster, the prothoracic gland, an endocrine portion of the ring gland, synthesizes ecdysteroids at an accelerated rate. The resultant ecdysteroid titer peak initiates the events associated with metamorphosis. The normal prothoracic gland displays several ultrastructural features at this developmental stage that reflect increased steroidogenic activity, including extensive infoldings of the plasma membrane (membrane invaginations) and an increase in both the concentration of smooth endoplasmic reticulum (SER) (or transitional ER) and elongated mitochondria. By contrast, the prothoracic glands of larvae homozygous for a conditional larval lethal mutation, l(3)ecd1ts, not only fail to produce ecdysteroids at normal levels at the restrictive temperature (29 degrees C), but also acquire abnormal morphological features that reflect the disruptive effects of the mutation. These abnormalities include an accumulation of lipid droplets presumed to contain sterol precursors of ecdysteroids, a disappearance of SER and a drastic reduction of membrane invaginations in the peripheral area of the cell. These morphological defects are observed in prothoracic glands dissected from larvae transferred from 18 degrees C to 29 degrees C approximately 24 h before observation and also within 4 h of an in vitro transfer to 29 degrees C following dissection from wandering third instar larvae reared at 18 degrees C. No ultrastructural abnormalities were noted in the corpus allatum portion of mutant ring glands. These observations further indicate the direct involvement of the ecd gene product in ecdysteroid synthesis and suggest a role for the gene in the proper transport of precursors to the site where they can be utilized in ecdysteroid biosynthesis. PMID- 1786593 TI - The distribution of actin immunoreactivity in rhabdomeres of tipulid flies in relation to extracellular membrane shedding. AB - Rhabdomeres of tipulid flies lose membrane during turnover from a 'shedding zone' composed of microvillar tips. These distal domains lack intramicrovillar cytoskeletons and appear to be empty sacs of membrane. Recent concerns about the role of ninaC mechano-enzymes in the architecture of dipteran rhabdomeral microvilli and the dynamic role that they may play in the creation of shedding zones demand an examination of the distribution of actin in tipulid rhabdomeres. We compared rhabdomeres from tipulid retinae incubated before fixation for immunocytochemistry in a buffer without additives and a stabilising buffer that contained a cocktail of cysteine protease inhibitors; both were challenged by an anti-actin antibody for immunogold labelling after embedding in LR White Resin. Shedding zones thus processed collapse to structureless detritus. Stabilised and unstabilized shedding zones were immunonegative to anti-actin. To ensure that the negative results were not consequent upon conformational changes generated by the processing protocol, we examined microvilli of degenerating rhabdomeres of the Drosophila light-dependent retinal degeneration mutant rdgBKS222 (which separate and collapse without creating a shedding zone) and found the detritus they generate to be immunopositive to anti-actin. Stabilised and unstabilized regions of basal regions of tipulid rhabdomeres were equally immunopositive. We infer that (a) actin is absent from shedding zones; (b) actin is not degraded by microvillar cysteine proteases. The implications of these conclusions are discussed in relation to some functional models of arthropod photoreceptor microvilli. PMID- 1786594 TI - Structural features of the lateral walls in mammalian cochlear outer hair cells. AB - Freeze-fracture, freeze-etching and thin sections have been used to determine features of the structural organisation of the lateral walls in cochlear outer hair cells. The presence of an organised meshwork of filaments in the lateral cortex of the cell is confirmed in intact unfixed cells. This meshwork showed morphological features similar to the cytoskeletal lattice. The lateral plasma membrane is shown to be protein-rich and to contain cholesterol. The membranes of the subplasmalemmal lateral cisternae contain much less protein, and little cholesterol as judged by their responses to filipin and tomatin. These findings indicate differences in the physical properties of the two membrane systems. On the fracture faces of the plasma membrane there is a high density of intramembrane particles and this particle population is heterogeneous. Some particles show morphological features consistent with those of transmembrane channels. Regularly spaced pillars crossing the space between the plasma and cisternal membranes were identified both in thin sections and in freeze-etched preparations, but neither the plasma nor cisternal membrane fracture faces showed any feature corresponding directly to the pillar. This suggests the pillars do not insert directly into either membrane. Freeze-fracture and freeze-etching of unfixed cells indicated that the pillar is indirectly associated with the cytoplasmic surface of the plasma membrane, and, at its inner end, linked to the cortical cytoskeletal lattice on the outer surface of the cisternal membrane. PMID- 1786595 TI - Ornithine decarboxylase activity during development of the mouse inner ear in vivo and in vitro. AB - Ornithine decarboxylase activity was determined during the development of the peripheral auditory system in the murine otocyst with the goal of understanding the role of this enzyme in the morphological and functional maturation of the inner ear. At gestational days 11 and 12 enzyme activity was more than 10-fold higher than adult levels. A sharp decline occurred between day 12 and 13 after which activity rose to a peak around day 15. Activity then dropped continuously until near-adult levels were reached at birth. A lower specific activity of ODC but a similar time-course was seen in otocysts explanted at gestational day 13 and subsequently cultured for 6 days. For two stages of development, enzyme activity and binding of 3H-alpha-difluoromethylornithine were compared. The four fold difference in enzymatic activity on gestational days 15 and 17 was paralleled by a similar difference in binding. Ornithine decarboxylase activity during inner ear development therefore seems primarily regulated at the level of protein synthesis. Ornithine decarboxylase activity correlates with major inductive events in the morphogenesis of the cartilagenous otic capsule that serves as a template for the formation of the bony labyrinth. The pattern of activity may reflect the changes in the head mesenchyme that is recruited by the otocyst to aggregate and form its protective otic capsule. PMID- 1786596 TI - In-vitro proliferation of germ cells and supporting cells in the neonatal mouse testis. AB - Testicular cells were prepared from neonatal (48 h after birth) mice by enzymatic dissociation and were cultured in serum-supplemented medium to investigate cell proliferation in vitro. The cultured cells were composed mostly of germ cells, identified by immunocytochemistry using a germ cell-specific antiserum, and supporting (immature Sertoli) cells. After 36 h in culture, the cells were pulse labeled with 3H-thymidine and fixed at 2-h intervals for 36 h after labeling. Numbers of labeled and unlabeled metaphases of germ cells and supporting cells were counted, and percent labeled metaphases for both cell types were determined for cell-cycle analysis. The results indicate that germ cells, as well as supporting cells, incorporate 3H-thymidine and progress through the cell cycle in vitro. From the curve of the percent labeled metaphases for the supporting cells, the total cell cycle and intervals of DNA synthesis were estimated to be 27.2 h and 13.2 h, respectively. PMID- 1786597 TI - Isolation of arteriolar microvessels and culture of smooth muscle cells from cerebral cortex of guinea pig. AB - Published methods for the isolation of cerebral microvessels primarily yield terminal resistance vessels and capillary networks, not the more proximal, subpial penetrating arterioles desired for certain studies. We report a novel method for isolating microvessels from the cerebral cortex of a single guinea-pig brain that yields large arteriolar complexes that are up to 50% intact. Instead of using homogenization to disperse brain parenchyma, we digested cortical fragments with trypsin, gently dispersed the parenchyma mechanically, and recovered microvascular complexes by sieving. Phase-contrast and electron microscopy showed primary (penetrating) arterioles, secondary arterioles, and capillary networks that frequently were in continuity as intact microvascular units. Culture of microvascular cells was carried out by enzymatic dissociation followed by an overnight incubation in a recovery medium at 4 degrees C before plating onto fibronectin-modified surfaces. Viability of isolated cells was demonstrated by good cell attachment and prompt proliferation that resulted in confluent cultures after 10 days. Confluent secondary cultures demonstrated characteristic features of smooth muscle cells, including a "hill-and-valley" growth pattern and expression of alpha-actin. Less than 1% of cells were endothelial or astrocytic cells by immunocytochemical and morphologic criteria. Ultrastructural studies demonstrated evidence of a synthetic phenotype of smooth muscle cell and absence of a significant number of fibroblasts. This method demonstrates that viable smooth muscle cells from the cerebral parenchymal microvasculature can be isolated in bulk quantities for study in vitro. PMID- 1786598 TI - Immunocytochemical evidence of a met-enkephalin-like substance in the dense-core granules of mouse Merkel cells. AB - The electron-microscopic immunogold method was applied to Merkel cells of adult mice to demonstrate the subcellular localization of met-enkephalin-like immunoreactivity. Post-embedding incubation with metenkephalin antisera showed that the gold particles were associated with the dense-core granules of the Merkel cells. The majority, but not all, of the dense-core granules were strongly labelled. Osmication caused a significant reduction in the number of gold particles on these granules. The nerve terminal associated with the Merkel cell did not show met-enkephalin-like immunoreactivity. To the best of our knowledge, this is the first report of the ultrastructural localization of a positive met enkephalin immunoreactivity in the dense-core granules of Merkel cells in mice. PMID- 1786599 TI - [Bronchial hyperreactivity in pediatric and adolescent asthmatics and healthy children]. AB - The investigation of bronchial hyperreactivity (b.h.) represents the basic diagnostic test in asthmatics. In 515 asymptomatic pediatric and adolescent asthmatics (age 6-23 years) divided into various subgroups according to the study purposes, b.h. as an induced airway obstruction was assessed after inhalations of a single dose of acetylcholine (3 mg), histamine (3 mg), hypotonic and hypertonic solutions with jet nebulizer. B.h. was also studied following inhalations of distilled and mineral water, physiologic solution with ultrasonic nebulizer, and 5 min. free running outdoors. The induced airway obstruction was assessed by parameters measured from maximum expiratory flow-volume curve. The most potent stimuli were the inhaled acetylcholine (3 mg) and 5 min. free running outdoors. By the latter two tests similar incidence and magnitude of b.h. were revealed in our asthmatics without airway obstruction as well as with a mild obstruction (MEF50 and MEF25 below lower limits of predicted before both tests). For both tests (acetylcholine and 5 min. free running), recommended in practice, were given the expected limits of lung function parameters before starting the tests. The values of the parameters before the onset of provocation tests were unreliable predictors of the induced airway obstruction in our asthmatics. B. h. was also assessed in 426 healthy 9-years old children by inhalation of 1% carbachol (mean dose: 2.57 +/- 0.7 mg). Various lung function parameters showed different incidence of b.h. in the latter children. Both values of one- second vital capacity and respiratory resistance (interruption technique) revealed b.h. in 46% of our healthy children (decline of parameters more than 20%). Other parameters measured, except peak expiratory flow, proved b.h. more frequently. In the article the problems of respiratory resistance measured by interruption technique and higher incidence of b.h. in the studied healthy children are outlined. PMID- 1786600 TI - [Hearing disorders associated with vision disorders in children]. AB - Hearing and eye-sight are very important for the development in children. Early diagnosis of disorders of these organs is therefore essential to ensure the development of affected children from early age, or to provide a correction (hearing aid, glasses) or to enlist these children in special schools. The authors found that in schools for children with impaired eye-sight and schools for children with impaired hearing there were 6.7% children with impairment of both sense organs. The most frequent cause of disorders of both sense organs was intrauterine damage (45.7%), in 25.7% of the investigated children the cause was unknown, in 20% it was genetically conditioned and in 8.6% the cause was postnatal. Therefore when a disorder of one sense organ is revealed, it is necessary to examine on a preventive basis also the other sense organ. PMID- 1786601 TI - [Development of attention in early childhood]. AB - Based on observations of a group of 16 healthy newborn mature babies the authors describe the development of attention during the first six months of life. Analysis of data revealed the importance of age and individual differences. We investigated an interrupted attention (lasting half a minute or longer) focused on the face of adults and a suspended toy, and interrupted attention (lasting for a period less than half a minute with an interruption not longer than half a minute). The curve of uninterrupted attention paid to the face of an adult had the shape of an inverted letter "U". As regards uninterrupted attention devoted to toys this type of curve was less expressed. Interrupted attention increased continuously with age. Individual differences between children throughout the investigation period displayed considerable stability. PMID- 1786602 TI - [Clinical experience with treatment of childhood infections using sultamicillin- Unasyn (Pfizer)]. AB - The authors treated 24 children, the majority with respiratory infections and infections of the urinary tract, with sultamicillin, incl. 22 where an oral suspension was used and in two children therapy was started with i.v. administration of Unasyn, followed by administration of the suspension. The children tolerated the drug very well and the therapeutic results were good. PMID- 1786603 TI - [Netherton's syndrome]. PMID- 1786604 TI - [The Fitz-Hugh-Curtis syndrome in a 15-year-old girl]. AB - The authors describe the development of the disease in a 15-year-old girl hospitalized on account of temperatures and vague pain in the right hypogastrium. Within a short time the pain shifted to the right epigastrium, became more intensive (with deterioration during inspiration) and concurrently the patient developed marked muscular tension in the whole right upper abdominal quadrant. The condition was associated with leucocytosis and a high red cell sedimentation rate. Marked tenderness and muscular tension persisted for cca 48 hours, afterwards, following symptomatic treatment, relatively rapid regression of the complaints and clinical picture occurred. Auxiliary examinations did not reveal any marked pathological changes of the abdominal and thoracic organs. Only during the post-acute phase of the disease gonococcal infection of the sex organs was revealed and adequate treatment was started. The authors evaluated the disease as gonococcal perihepatitis, known in the literature as Fitz-Hugh-Curtis syndrome. PMID- 1786605 TI - [Albright's syndrome]. PMID- 1786606 TI - [Salicylates--review of pharmacokinetics and basic effects]. PMID- 1786607 TI - [Polychlorobiphenyls (PCB) and health. What should the pediatrician know?]. PMID- 1786608 TI - [Adolescent medicine. Introduction to problems in a phase in childhood]. PMID- 1786609 TI - [Epiglottitis and subglottic laryngitis]. AB - Account of the course and conclusions of a working session of the Paediatric Society devoted to laryngeal obstruction in children. The participants discussed in particular the differential diagnosis of subglottic laryngitis and epiglottitis in children. PMID- 1786610 TI - [An offer to examine serum autoantibodies in patients with type I diabetes mellitus]. PMID- 1786611 TI - [Prospective study of health status in children]. PMID- 1786612 TI - [The glucometer or the child's eye in blood glucose readings?]. PMID- 1786613 TI - [Vaccination against mumps--one possibility of preventing damage in the solitary testis]. PMID- 1786614 TI - [Recent history of care of premature children in Ostrava]. PMID- 1786615 TI - Diabetes in adults is now a Third World problem. The WHO Ad Hoc Diabetes Reporting Group. AB - Since 1988, WHO has been collecting standardized information on the prevalence of diabetes mellitus and impaired glucose tolerance (IGT) in adult communities worldwide. Within the age range 30-64 years, diabetes and IGT were found to be absent or rare in some traditional communities in Melanesia, East Africa and South America. In communities of European origin, the prevalences of diabetes and IGT were in the range of 3-10% and 3-15% respectively, but migrant Indian, Chinese and Hispanic American groups were at higher risk (15-20%). The highest risk was found in the Pima Indians of Arizona and in the urbanized Micronesians of Nauru, where up to one-half of the population in the age range 30-64 years had diabetes. The prevalence of total glucose intolerance (diabetes and IGT combined) was greater than 10% in almost all populations, and was within the range 11-20% for European and U. S. white populations. However, the prevalence of total glucose intolerance reached almost 30% in Arab Omanis and in U. S. blacks and affected one-third of all adult Chinese Mauritians, migrant Indians, urban Micronesians and lower-income urban U. S. Hispanics. In Nauruans and Pima Indians, approximately two-thirds of all adults in the age range were affected. These results lead to three important conclusions. (1) An apparent epidemic of diabetes has occurred--or is occurring--in adult people throughout the world. (2) This trend appears to be strongly related to life-style and socioeconomic change. (3) It is the populations in developing countries, and the minority or disadvantaged communities in the industrialized countries who now face the greatest risk.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786616 TI - Use of intraocular lenses in cataract surgery in developing countries: memorandum from a WHO meeting. AB - Visual loss or disability from cataract represents a massive public health and socioeconomic problem in most developing countries. At present, some 13.5 million cases require treatment and this number will increase, as most countries in the Third World are unable to cope with both the backlog and new cases. Cataract extraction with intraocular lens (IOL) implantation is now the established and preferred method in industrialized countries. The introduction of IOLs in developing countries, however, depends on their having adequately trained manpower and facilities (equipment and supplies, including IOLs) for surgery. This will inevitably increase the cost per operated case which, despite the scarce resources for cataract surgery in many developing countries, may be justified by the improved restoration of the patient's vision. Experience has led to the following generic designs for IOLs: the one-piece or three-piece C-loop polymethylmethacrylate (PMMA) posterior chamber lens, which is the current favourite; and, the flexible or rigid one-piece all-PMMA anterior chamber lens, which is a valid alternative in many situations. Further scientific evaluation of the use of these lenses in a wide variety of settings in developing countries is required. Operations research is also needed in order better to define and standardize the various steps and procedures in the surgical and post-operative management of IOL implantation in Third World settings. Meanwhile, the following should be available to ensure safe and good quality cataract surgery using IOLs in developing countries: properly trained surgeons; the needed facilities and equipment with regular supplies; a good quality lens of appropriate design; and the necessary means for careful follow-up of operated patients. PMID- 1786617 TI - Onchocerciasis distribution and severity in five West African countries. AB - The Onchocerciasis Control Programme in West Africa recently extended its operation to Guinea, Guinea-Bissau, the western part of Mali, Senegal and Sierra Leone. To estimate the number of people infected and blinded by the disease and to determine its distribution and severity in the extension area, 215 villages were selected, using a stratified random sampling procedure, and surveyed. All the relevant entomological information available at the time was used in the sampling procedure and in the selection of 92 non-representative villages that were surveyed to confirm the findings. In addition, the populations of 608 villages were examined to map out in detail the distribution of onchocerciasis in the areas at a high risk of onchocercal blindness. The study estimated that 1,475,367 people were infected and 23,728 were blinded from onchocerciasis out of a rural population of 4,464,183. The northern and western part of the study area and the lower Niger basin presented a low or no risk of onchocercal blindness. The upper Niger basin, the south-central part of Sierra Leone, and three small foci in the Gambia, Bakoye, and lower Niger river basins were areas with a high risk of onchocercal blindness. The other parts of the study area presented a medium risk of onchocercal blindness. By detecting the communities at risk of onchocercal disease this study permits the selection of populations for disease control based on mass distribution of ivermectin, a microfilaricide. PMID- 1786618 TI - ZOOM: a generic personal computer-based teaching program for public health and its application in schistosomiasis control. AB - Schistosomiasis, a group of parasitic diseases caused by Schistosoma parasites, is associated with water resources development and affects more than 200 million people in 76 countries. Depending on the species of parasite involved, disease of the liver, spleen, gastrointestinal or urinary tract, or kidneys may result. A computer-assisted teaching package has been developed by WHO for use in the training of public health workers involved in schistosomiasis control. The package consists of the software, ZOOM, and a schistosomiasis information file, Dr Schisto, and uses hypermedia technology to link pictures and text. ZOOM runs on the IBM-PC and IBM-compatible computers, is user-friendly, requires a minimal hardware configuration, and can interact with the user in English, French, Spanish or Portuguese. The information files for ZOOM can be created or modified by the instructor using a word processor, and thus can be designed to suit the need of students. No programming knowledge is required to create the stacks. PMID- 1786619 TI - In vitro sensitivity of southern African reference isolates of Plasmodium falciparum to chloroquine and pyrimethamine. AB - The in vitro sensitivity to chloroquine and pyrimethamine of 19 culture-adapted southern African reference isolates of Plasmodium falciparum was determined using a 48-hour assay. Four isolates collected in KwaZulu, Natal, were sensitive to chloroquine, and one of these was sensitive to the drug in vivo. Eight isolates from KwaZulu or Mozambique were resistant to chloroquine in vitro. Six of these isolates were chloroquine-resistant in varying degrees in vivo. Four of five isolates from north-eastern Transvaal and two clinically chloroquine-resistant Malawian isolates were resistant to chloroquine in vitro. A wide range of pyrimethamine susceptibilities was detected (0.01 mumol/l to greater than 3.0 mumol/l), although most isolates were inhibited at 0.1 mumol/l, indicating a low level of resistance. These results confirm the presence of both chloroquine and pyrimethamine resistance in the endemic areas of South Africa. This has serious implications for the prophylaxis and treatment of P. falciparum malaria in South Africa. PMID- 1786620 TI - [Seroepidemiological study of malaria in the Algerian Sahara]. AB - On the basis of geoclimatic characteristics, the Saharan region of Algeria (area, 2 million km2) is made up of several subregions; analysis of the historical data on malaria in this region seems to show that the epidemiological situation is closely linked to climatic and hydrographic conditions. A longitudinal sero epidemiological study was conducted in this vast region from September 1983 to April 1985. The general findings do not appear to support the existence of active foci of transmission, but analysis of the data for certain oases and localities leads to a quite different assessment of the epidemiological situation. At Ouargla, for example, the serological results obtained by indirect immunofluorescence show prevalence of under 5% in the four successive surveys, whereas in Heiha oasis over 50% of subjects over 30 years of age were found to be seropositive. The results of the longitudinal seroepidemiological surveys conducted in a number of localities and oases in the Saharan region reflect the diversity of epidemiological settings and provide evidence that there is low level malaria transmission in some oases such as Heiha, Yakou, Iherir and probably in In-Salah. These surveys confirm that malaria transmission has been halted in the former foci such as Ouargla and Timimoune. Finally, the longitudinal sero-epidemiological study shows there are movements of potential parasite carriers from countries south of the Sahara and therefore that oases associated with trans-Saharan trade are vulnerable. PMID- 1786621 TI - A mathematical model for Plasmodium vivax malaria transmission: estimation of the impact of transmission-blocking immunity in an endemic area. AB - We have developed a multi-state mathematical model to describe the transmission of Plasmodium vivax malaria; the model accommodates variable transmission blocking/enhancing immunity during the course of a blood infection, a short memory for boosting immunity, and relapses. Using the model, we simulated the incidence of human malaria, sporozoite rates in the vector population, and the level of transmission-blocking immunity for the infected population over a period of time. Field data from an epidemiological study conducted in Kataragama in the south of Sri Lanka were used to test the results obtained. The incidence of malaria during the study period was simulated satisfactorily. The impact of naturally-acquired transmission-blocking immunity on malaria transmission under different vectorial capacities was also simulated. The results show that at low vectorial capacities, e.g., just above the threshold for transmission, the effect of transmission-blocking immunity is very significant; however, the effect is lower at higher vectorial capacities. PMID- 1786622 TI - Influence of deltamethrin treatment of bed nets on malaria transmission in the Kou valley, Burkina Faso. AB - A 3-year entomological study was carried out on the transmission of malaria in a village of 900 inhabitants in a rice-growing area of Burkina Faso. In the study area inhabitants use bed nets to protect themselves from mosquito bites. In the first year of the study, baseline data were collected; in the second year, the village was divided in two parts and all the bed nets in the southern part were sprayed with deltamethrin (25 mg/m2); and in the third year, all the bed nets in both parts of the village were sprayed. The inoculation rate was estimated by hand collection of mosquitos on human volunteers who were not protected by bed nets. The overall inoculation rate in the first year was 55 infected bites per person and was higher in the southern than in the northern part of the village. During the second year the rate increased to 70 bites per person on average (but was slightly lower than this in the southern part of the village). During the third year, the inoculation rate fell to three infected bites per year, i.e., a reduction of 94% compared with the first year. This reduction arose primarily because of a marked decrease in the sporozoitic index and a lower density of vectors. Thus, use of pyrethroid-impregnated bed nets by all members of the community appears to be a major tool in preventing transmission of malaria. PMID- 1786623 TI - Dot enzyme immunoassay: an alternative diagnostic aid for dengue fever and dengue haemorrhagic fever. AB - A dot enzyme immunoassay (DEIA) for the detection of antibodies to dengue virus was tested for use as a tool in the presumptive diagnosis of dengue fever and dengue haemorrhagic fever. Paired sera from the following groups of patients were tested using the DEIA and the haemagglutination inhibition (HI) test: those with primary dengue fever; those experiencing a second dengue infection; and febrile patients who did not have dengue. The data obtained show that the DEIA can be effectively used at a serum dilution of 1:1000 to confirm presumptive recent dengue in patients with a second dengue infection. However, demonstration of seroconversion proved necessary for patients with primary dengue. At a serum dilution of 1:1000 the DEIA has a specificity of 97.3%. The role of this simple and rapid test in improving the effectivity of programmes for the control of dengue virus infection is discussed. PMID- 1786624 TI - Simplified and less expensive confirmatory HIV testing. AB - The conventional approach to human immunodeficiency virus (HIV) antibody testing, which relies on confirmation of all initially positive screening results using a Western blot assay, is expensive. In an alternative approach, we retested sera that were positive in an initial screening assay using a second screening assay, which differed from the first, and limited the use of Western blot to those sera that gave discrepant results in the two screening assays. This resulted in 100% sensitivity and specificity at a cost that was, on average, 6.1 times less than that of the conventional approach. This level of sensitivity and specificity was also achieved at a cost that was 9.0 times less than the conventional approach if the Western blot was replaced by a third screening assay that differed from the previous two. Retesting positive sera using the same assay did not increase the accuracy of the results obtained by testing the sera only once. PMID- 1786625 TI - Comparative evaluation of 36 commercial assays for detecting antibodies to HIV. AB - Summarized are the results of an assessment of the major operational characteristics of 36 commercially available assays for detection of antibodies to human immunodeficiency virus type 1 (HIV-1) and/or type 2 (HIV-2). For this purpose, 20 enzyme-linked immunosorbent assays (ELISAs), 11 simple immunoassays with visual reading, four supplemental assays, and one discriminatory assay were assessed using a panel of 537 sera (65% of which were of African, 26% of European, and 9% of South American origin); the prevalence of HIV-1 was 39.1% and of HIV-2, 15.7%. The following operational parameters of the assays were investigated: ease of performance; suitability for use in small blood collection centres; sensitivity and specificity; positive predictive values at different prevalences; inter-reader variability for simple assays whose results were read visually; the proportion of indeterminate results; and, for some of the ELISA assays, delta-values, as quantitative measures of sensitivity and specificity. The results will be of use to health policy decision-makers, managers of national AIDS prevention and control programmes, directors of blood banks, and laboratory specialists in the selection of appropriate HIV antibody assays. PMID- 1786626 TI - Counting the stunted children in a population: a criticism of old and new approaches and a conciliatory proposal. AB - Two methods for estimating the prevalence of growth retardation in a population are evaluated: the classical method, which is based on the proportion of children whose height is more than 2 standard deviations below the expected mean of a reference population; and a new method recently proposed by Mora, which is based on the whole height distribution of observed and reference populations. Application of the classical method to several simulated populations leads to the conclusion that in most situations in developing countries the prevalence of growth retardation is grossly underestimated, and reflects only the presence of severe growth deficits. A second constraint with this method is a marked reduction of the relative differentials between more and less exposed strata. Application of Mora's method to the same simulated populations reduced but did not eliminate these constraints. A novel method for estimating the prevalence of growth retardation, which is based also on the whole height distribution of observed and reference populations, is also described and evaluated. This method produces better estimates of the true prevalence of growth retardation with no reduction in relative differentials. PMID- 1786627 TI - Familial insulin-dependent diabetes mellitus (IDDM) epidemiology: standardization of data for the DIAMOND Project. The WHO Multinational Project for Childhood Diabetes Group. AB - The WHO Multinational Project for Childhood Diabetes, known as the DIAMOND Project, has been responsible for establishing insulin-dependent diabetes mellitus (IDDM) registries and for carrying out diabetes incidence studies, descriptive epidemiological research, and analytical investigations which are being used to test specific hypotheses regarding the etiology of the disease. Standardized epidemiological data are being collected from countries around the world, permitting international comparisons between registries. Multinational studies are also beginning to investigate the potential genetic determinants of the disease, and are contributing to the development of familial IDDM epidemiology worldwide. The development of standards for data collection of IDDM family histories is important for multinational studies of IDDM recurrence risks in families, descriptive analyses of patterns of familial aggregation, and comparative analytical investigations of specific etiological determinants of IDDM in relatives. These activities are being implemented through the DIAMOND Project. PMID- 1786628 TI - Prevention of mental handicaps in children in primary health care. AB - Some 5-15% of children aged 3 to 15 years in both developing and developed countries suffer from mental handicaps. There may be as many as 10-30 million severely and about 60-80 million mildly or moderately mentally retarded children in the world. The conditions causing mental handicaps are largely preventable through primary health care measures in developing countries. Birth asphyxia and birth trauma are the leading causes of mental handicaps in developing countries where over 1.2 million newborns die each year from moderate or severe asphyxia and an equal number survive with severe morbidity due to brain damage. The other preventable or manageable conditions are: infections such as tuberculous and pyogenic meningitides and encephalopathies associated with measles and whooping cough; severe malnutrition in infancy; hyperbilirubinaemia in the newborn; iodine deficiency; and iron deficiency anaemia in infancy and early childhood. In addition, recent demographic and socioeconomic changes and an increase in the number of working mothers tend to deprive both infants and young children of stimulation for normal development. To improve this situation, the primary health care approach involving families and communities and instilling the spirit of self-care and self-help is indispensable. Mothers and other family members, traditional birth attendants, community health workers, as well as nurse midwives and physicians should be involved in prevention and intervention activities, for which they should be trained and given knowledge and skills about appropriate technologies such as the risk approach, home-based maternal record, partograph, mobilogram (kick count), home-risk card, icterometer, and mouth-to-mask or bag and mask resuscitation of the newborn. Most of these have been field-tested by WHO and can be used in the home, the health centre or day care centres to detect and prevent the above-mentioned conditions which can cause mental handicap. PMID- 1786629 TI - Genes associated with tumor suppression and growth control in the human nervous system. AB - Cancer, the uncontrolled proliferation of a population of somatic cells, is fundamentally a genetic disorder. Although the specific array of genetic changes causing individual tumor types remains largely obscure, the past two decades have witnessed a tremendous increase in our understanding of the specific genes regulating cell differentiation, proliferation, and senescence. There appear to be two distinct fundamental genetic mechanisms of tumorigenesis. One mechanism is associated with the activation of growth-promoting factors such as proto oncogenes. Alternatively, tumor formation may be induced as the result of the loss or inactivation of genes which normally regulate or suppress cell growth. These genes have been termed 'tumor suppressor' genes or 'anti-oncogenes'. This review focuses on the role of 'tumor suppressor' genes in tumor formation and growth control of the human nervous system. PMID- 1786630 TI - Genetic alterations in glioma and medulloblastoma. AB - Multiple genetic changes take place during tumor development and progression. These genetic changes result in inactivation of tumor suppressor genes and activation of proto-oncogenes. Frequent genetic changes observed in gliomas are losses of chromosomal regions on 9p, 10q, 13q, 17p and on 22. Loss of 10q is seen in more than 80% of the glioblastoma multiforme (GBM) tumors suggesting the presence of a gene critical for GBM formation on this chromosome. Amplification of epidermal growth factor receptor gene and expression of platelet derived growth factor and fibroblast growth factor genes are also common among gliomas. The most common genetic abnormality found in medulloblastomas is loss of 17p. The C-myc gene is amplified in a few primary tumors, but the incidence of amplification is higher in medulloblastoma derived cell lines. These findings suggest that the same two genetic processes, gene amplification and regional chromosomal loss, which characterize other primitive childhood neuroectodermal tumors such as retinoblastoma and neuroblastoma are also important in medulloblastomas. PMID- 1786631 TI - Neurofibromatosis type 1 (NF1) gene: implication in neuroectodermal differentiation and genesis of brain tumors. AB - The gene responsible for neurofibromatosis type 1 (NF1), a common autosomal dominantly inherited disease, has been isolated. A region of NF1 gene product has been demonstrated to share structural and functional similarities with the mammalian GTPase activating protein (GAP) and the yeast IRA proteins. Thus, the NF1 protein is thought to play a role in signal transduction by stimulating the conversion of the Ras protein from a GTP-bound active form to a GDP-bound inactive form. The increased risk of malignant tumors in neuroectodermal tissues of NF1 patients may be caused by disruption of growth and differentiation regulatory functions of the NF1 gene. A second type of the NF1-GAP related domain (NF1-GRD) transcript, which has an extra 21-amino-acid insert in the center of the previously reported first type transcript, has been described. This insert significantly changes the hydrophilicity and secondary structure of the central region of NF1-GRD, therefore, suggesting it also changes its function. Alternative splicing is the most likely mechanism by which these two types of transcripts arise. The NF1-GRD alternative splicing has been shown to be intimately involved in differentiation of neuroectodermal tissues. Aberrant regulation of the alternative splicing may contribute to tumor formation in neuroectodermal tissue. PMID- 1786632 TI - Biology of pediatric peripheral neuroectodermal tumors. AB - The pediatric peripheral neuroectodermal tumors which include neuroblastoma, peripheral neuroepithelioma and Ewing's sarcoma may correspond to distinct neural crest cell lineages or tumors arrested at different stages of neural crest development. Besides a brief commentary on the salient clinical features of these tumors, this review examines how cell and molecular biological studies have contributed to a re-classification of these tumors. The differentiation of these tumors is reviewed with a particular emphasis on retinoic acid induced differentiation of neuroblastoma as a model to identify genes important in controlling cell growth, suppression of tumorigenicity and induction of differentiation. PMID- 1786633 TI - Biology of tumors of the peripheral nervous system. AB - Tumors of the peripheral nervous system include neuroblastomas, pheochromocytomas, and neuroepitheliomas. Neuroblastomas and pheochromocytomas are adrenergic in origin and share certain genetic features, whereas neuroepitheliomas are thought to be cholinergic and are characterized by distinct genetic features. Neuroblastomas are characterized by deletion of the short arm of chromosome 1 (1p), amplification of the MYCN proto-oncogene, and hyperdiploidy in subsets of tumors. All three of these genetic features have prognostic value in subsets of patients. Allelic loss of 14q also occurs with increased frequency, but the prognostic importance of this abnormality is not known yet. Pheochromocytomas have not been studied as extensively, but allelic loss for 1p appears to be a frequent change, and no clear examples of oncogene activation have been identified to date. Neuroepitheliomas are characterized by translocation between chromosomes 11 and 22. Although they have a characteristic pattern of proto-oncogene expression, it is not clear that any of these oncogenes are activated specifically, and no sites of allelic loss have been identified to date. Thus, cytogenetic and molecular analysis of neuroblastomas, pheochromocytomas, and neuroepitheliomas are useful in distinguishing them from each other and from other tumors in selected cases. Furthermore, certain genetic markers are useful in predicting clinical behavior, especially for neuroblastoma. PMID- 1786634 TI - The role of chemotherapy in the treatment of patients with brain metastases from solid tumors. AB - Chemotherapy for brain metastases has been considered ineffective because the drugs do not penetrate the intact blood brain barrier. Alternate explanations for past failures of chemotherapy include observations that 1) many solid tumors which metastasize to brain are drug-resistant regardless of location, 2) brain metastases often occur following failure of primary chemotherapeutic regimens to control systemic metastases, and 3) previous trials of chemotherapy employed agents other than those known to be most effective against the primary malignancy. Furthermore, laboratory studies have demonstrated that cytotoxic levels of many drugs can be measured in tumor tissue from primary and metastatic brain tumors. These clinical and pharmacologic observations suggest that chemotherapy would be expected to have limited value unless known effective combination regimens are employed as first-line therapy in chemosensitive malignancies. Recent reports of chemotherapy for patients with brain metastases from small cell lung carcinoma, gestational choriocarcinoma, germ cell malignancies, and breast carcinoma do describe response rates in the brain similar to those in other organ sites. In conclusion, chemotherapy for cerebral metastases can be expected to be effective only when effective drugs for systemic metastases are available. While the blood-brain barrier may be an additional detriment to successful treatment, other factors may be more important. PMID- 1786635 TI - Ontogeny of cholecystokinin-like immunoreactivity in the Brazilian opossum brain. AB - We have studied the anatomical distribution of cholecystokinin-like immunoreactive (CCK-IR) somata and fibers in the brain of the adult and developing Brazilian short-tailed opossum, Monodelphis domestica. Animals ranged in age from the day of birth (1PN) to young adulthood (180PN). A nickel enhanced, avidin-biotin, indirect immunohistochemical technique was used to identify CCK-IR structures. Somata containing CCK immunoreactivity were observed in the cerebral cortex, hippocampus, hypothalamus, thalamus, midbrain, and brainstem in the adult. Cholecystokinin immunoreactive fibers had a wide distribution in the adult Monodelphis brain. The only major region of the brain that did not contain CCK-IR fibers was the cerebellum. The earliest expression of CCK immunoreactivity was found in fibers in the dorsal brainstem of 5-day-old opossum pups. It is possible that the CCK-IR fibers in the brainstem at 5PN are of vagal origin. Cholecystokinin immunoreactive somata were observed in the brainstem on 10PN. The CCK-IR cell bodies observed in the brainstem at 10PN may mark the first expression of CCK-IR elements intrinsic to the brain. A broad spectrum of patterns of onset of CCK expression was observed in the opossum brain. The early occurrence and varied ontogenesis of CCK-IR structures indicates CCK may be involved in the function of a variety of circuits from the brainstem to the cerebral cortex. The early expression of CCK-IR structures in the dorsal brainstem suggests that CCK may modulate feeding behavior in the Monodelphis neonate. Cholecystokinin immunoreactivity in forebrain structures such as the suprachiasmatic nucleus, medial preoptic area, thalamus and cortical structures indicates that CCK may also be involved in circadian rhythmicity, reproductive functions, as well as the state of arousal of the Brazilian opossum. The ontogenic timing of CCK immunoreactivity in specific circuitry also indicates that CCK expression does not occur simultaneously throughout the brain. This pattern of CCK onset may relate to the temporal need for CCK in specific circuits of the central nervous system (CNS) during development. PMID- 1786636 TI - Intra- and extracellular changes of amino acids in the cerebral cortex of the neonatal rat during hypoxic-ischemia. AB - Excitatory amino acids (EAAs) have been implicated to play a part in the development of hypoxic-ischemic brain injury in the neonate. The aim of the present study was to follow changes of intra- and extracellular (microdialysis) amino acids in the cerebral cortex in a model where cortical hypoxic-ischemic damage is produced consistently. Hypoxic-ischemia (unilateral ligation of the carotid artery + 2 h of exposure to 7.8% oxygen) caused a depletion of tissue ATP, phosphocreatine and glucose with a concomittant accumulation of AMP and lactic acid in cortical tissue. These changes were accompanied by a decrease of tissue aspartate and glutamine whereas the contents of gamma-aminobutyric acid (GABA), phenylalanine, leucine, isoleucine, valine and alanine increased. In the extracellular fluid GABA, glutamate, aspartate, taurine, glycine and alanine all increased multi-fold during hypoxic-ischemia. Aspartate and glutamate returned to near initial levels 2 h after the end of the insult, whereas the elevation of glycine persisted during recovery. In conclusion, the high extracellular levels of EAAs and glycine may exert injurious effects during and after hypoxic ischemia. PMID- 1786637 TI - A quantitative analysis of synaptogenesis in the molecular layer of the dentate gyrus in the rhesus monkey. AB - Quantitative electron microscopy was used to study synapse formation in the molecular layer of the dentate gyrus in rhesus monkeys ranging in age from embryonic day 62 to adult. Four to eight radial probes, consisting of a series of overlapping electronmicrographs and extending across the full thickness of the molecular layer were made in each specimen. Synaptic density (normalized to volume of neuropil) increased significantly during the last half of gestation, reaching adult levels at the time of birth. However, new synapses were added during infancy, resulting in an apparent peak in density at between 4 and 5 months of age. This increase was followed by a decline in the synaptic density over the next 5 months, to levels comparable to that of the newborn. In addition to synaptic density, synapse type (symmetric, asymmetric), location (on dendritic shafts or spines), and laminar distribution in the developing molecular layer was determined. The decrease in synaptic density is unlikely to be due to 'dilution' caused by an increase in molecular layer volume since no increase in the volume of the dentate gyrus could be detected during this period. Our calculations suggest that a selective overproduction of asymmetrical, axo-spinous synapses occurs during infancy. Finally, synaptic density was significantly greater in the middle third of the molecular layer suggesting that synaptic exuberance may be related to entorhinal input. PMID- 1786638 TI - Postnatal developmental changes in the responses of mouse primary vestibular neurons to externally applied galvanic currents. AB - The ontogenesis of vestibular primary neuron sensitivity to depolarisation produced by galvanic current stimulations was studied in mouse inner ear explants maintained in vitro. Cathodal galvanic stimulations, which elicit an increase of the discharge frequencies, are assumed to act on the spike initiation site by depolarizing the neuron. The responses of neurons to galvanic currents at various developmental stages were recorded. The pattern of responses reflected the sensitivities of the neurons to depolarization. At birth, about 75% of the vestibular neurons responded weakly to high intensity galvanic currents thus indicating that they were able to generate action potentials. However, the very low gain of the response to the stimulation revealed the immaturity of the neurons at the spike generation site. Between the day of birth and the ninth postnatal day, an increase in the gain of the responses was observed, indicating the enhancement of the sensitivity of the vestibular neurons to the galvanic currents. This increase in sensitivity was more pronounced from the fourth postnatal day. The response of the neurons to galvanic stimulation increased gradually during postnatal development without reaching a plateau at postnatal day 9 indicating that a further physiological maturation occurs after this stage. These results are consistent with the morphological maturation of the vestibular primary afferents and with previous studies showing that the physiological maturation parallels myelination of the afferent fibers. PMID- 1786639 TI - Fetal dexamethasone exposure sensitizes neonatal rat brain to hypoxia: effects on protein and DNA synthesis. AB - Fetal exposure to glucocorticoids is known to produce long-term alterations in cell development within the central nervous system. The current study examines whether some of the adverse effects of prenatal dexamethasone treatment on brain development represent sensitization to hypoxia-induced damage. Pregnant rats were given 0.2 or 0.8 mg/kg of dexamethasone on gestational days 17, 18 and 19 and their offspring were challenged by exposure to 7% O2 on postnatal days 1 and 8. In control rats at 1 day of age, hypoxia evoked an acute decrease in protein synthesis, assessed by [3H]leucine incorporation, in both the midbrain + brainstem and forebrain. The decrease was also seen in animals receiving the low dose of dexamethasone, but was of smaller magnitude in the midbrain + brainstem than in the control cohort. At the higher dose of dexamethasone, hypoxia failed to evoke a decrease in protein synthesis; instead, protein synthesis was significantly increased. By 8 days of age, the animals receiving the lower dose of dexamethasone also displayed the anomalous increment in [3H]leucine incorporation during hypoxic challenge, whereas the effect in the high dose group was less notable. Similarly, parallel examination of incorporation of [3H]thymidine into DNA on postnatal day 1 indicated that control animals would reduce their macromolecule synthetic rate in a hypoxic environment, but that animals exposed to the high dose of dexamethasone would not; unlike the case with protein synthesis, however, the dexamethasone group never showed an increase in DNA synthesis during hypoxia. By 8 days of age, the interaction between the high dose of dexamethasone and hypoxia was no longer apparent for DNA synthesis.2 PMID- 1786640 TI - Developmental regulation of a neurite-promoting factor influencing statoacoustic neurons. AB - The present study investigated a target-derived, neurite-promoting factor (NPF) released by the developing chick otocyst and its effects on statoacoustic ganglia (SAG). SAG explants cultured in the absence of otocysts produced little neurite outgrowth at all stages of development examined (E4-E13). However, extensive neurite outgrowth was seen when E4-E6 SAG were cultured in the presence of otocysts of the same age. The amount of neurite outgrowth observed in cocultures steadily decreased at later developmental stages. E7-E9 cocultures produced less outgrowth and E10-E13 cocultures produced the least outgrowth compared to E4-E6 cocultures. Additionally, otocysts from older stages were unable to promote outgrowth of E4 SAG. Thus, the level of the factor released by the otocysts declined during development. In contrast, neurite outgrowth was promoted when E10 E15 SAG were cocultured in the presence of younger stage otocysts. Our data indicate that the release of NPF from chick otocysts decreased from E6 to E13, although the ability of SAG neurons to respond to the NPF was maintained throughout development. PMID- 1786641 TI - Nodal spacing in the developing, young adult and aging rat inferior alveolar nerve. AB - This study examines the nodal spacing (L) in teased preparations of developing, young adult and aging rat inferior alveolar nerves. In nerves from rats aged 1-2 weeks, most internodes show L-values, which increase from 150 microns to 400 microns, as fiber diameter (D) increases. Other internodes are very short (L = 20 150 microns), and exhibit distorted or fragmented myelin sheaths. In nerves from 2-3 week old rats such very short internodes are rare. By 3-4 weeks, and in young adult animals, very short internodes are lacking. The young adult relation L/D is regular and rectilinear. While D ranges from 2 microns to 10 microns, L ranges from 200 microns to 700-800 microns. In nerves from 1-2.5 year old adult rats some internodes are greater than 1000 microns long. These old nerves show signs of of nodal widening and segmental de- and remyelination. Some newly formed internodes are very short. We suggest that the occurrence of very short internodes in the developing rat inferior alveolar nerve reflects a myelin sheath remodelling, that allows the growing sheaths to elongate more than the nerve. Similarly, a scattered segmental de- and remyelination or a contraction of some internodes might enable other internodes in the old adult IAN to elongate, although the animal is fully grown. PMID- 1786642 TI - Prenatal exposure to methadone affects central cholinergic neuronal activity in the weanling rat. AB - The effect of prenatal exposure to methadone via maternal osmotic minipumps was studied on brain regional acetylcholine (ACh) turnover and dopamine (DA), norepinephrine (NE), serotonin (5-hydroxytryptamine, 5-HT) and their metabolites in 21-day-old female and male rats. ACh content was not affected in any region studied. However, the turnover rate of ACh (TRAch) was increased significantly in the striata and parietal cortices of both sexes. Two gender-specific changes were observed: a profound decrease in hypothalamic TRACh in the females and an increase in hippocampal TRACh in the males. No changes were observed in TRACh in the medulla-pons or the frontal cortex of either sex. The reduction in TRACh was accompanied by a threefold increase in DA content in the hypothalamus of the methadone-exposed females. No other changes were observed in DA, NE, or 5-HT, save for increased 5-HT content in the medulla-pons of the male methadone-exposed rats. Thus, prenatal methadone exposure produces several lingering changes in cholinergic function, many of which were not apparent in the immediate postnatal period. Although striatal ACh content was no longer reduced in methadone-exposed rats, striatal cholinergic function remains disrupted. It remains to be proven whether these differences are a direct effect of methadone exposure or are a consequence of neonatal withdrawal. PMID- 1786643 TI - Abnormalities of foliation and neuronal position in the cerebellum of NZB/BINJ mouse. AB - To analyze developmental abnormalities related to neural migration in the NZB/BINJ mouse, the pattern of cerebellar foliation and neural position were compared with that of a normal mouse (C57BL/6J). Three abnormalities of cerebellar foliation--(1) lobe isolated from other cerebellar lobes, (2) lobes imbalanced in relative amounts or ratio of granular cell layer and molecular layer, (3) lobes in which some Purkinje cells and the molecular layer was embedded in the granular cell layer--were observed in NZB/BINJ mice. These morphological abnormalities were not limited to a specific lobe. On the other hand, abnormalities of neural position were observed in both granule and Purkinje cells. The pattern of ectopically-situated granule cells, in general, could be divided into 3 types: (1) large cell clusters extending from granular cell layer to the pia mater or middle part of the molecular layer, (2) clusters of various sizes scattered within the white matter and (3) clusters formed by combination of granule cells extending from two opposed granular cell layers to the molecular layer. The pattern of ectopically-situated Purkinje cells could be divided into 4 types: (1) ectopia of a group of cells from one part of the Purkinje cell layer, (2) ectopia of a single Purkinje cell observed in the molecular layer, (3) single Purkinje cell scattered within the white matter accompanied by clusters of ectopic granule cells and (4) ectopic Purkinje cells embedded in the granular cell layer. The abnormalities in position of both granule cells and Purkinje cells was not limited to a particular cerebellar lobe.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786644 TI - GABA immunoreactive axons and growth cones in the developing chicken optic nerve and tract. AB - Immunohistochemical studies of the chicken embryo optic tract using an antibody to gamma-aminobutyric acid (GABA) reveal that the tract is initially free of GABA immunoreactive axons. During the second week of incubation, GABA+ axons appear in the tract, chiasm, and optic nerve. The number of GABA+ axons in the optic nerve increases through E18, although few are recognizable after hatching. Detailed staining of GABA+ growth cones confirmed that virtually all the GABA+ axons in the optic nerve were growing toward the retina. Taken together, the findings suggest that the GABA+ axons in the chiasm and nerve are largely a transient extension of the GABA+ optic tract cells, the tectogeniculate projection, or both. PMID- 1786645 TI - Fiber outgrowth from fetal vasopressin neurons of the suprachiasmatic nucleus, bed nucleus of the stria terminalis, and medial amygdaloid nucleus transplanted into adult Brattleboro rats. AB - Outgrowth of fibers from different types of vasopressin (AVP) neurons was compared in the brains of AVP-deficient Brattleboro rats. Fetal grafts of the suprachiasmatic nucleus (SCN), the bed nucleus of the stria terminalis (BST), and the medial amygdaloid nucleus (MA) were implanted into the lateral ventricle. AVP immunoreactive fibers from all grafts entered the host tissue in the lateral septum. SCN fibers were confined to the lateral margin of the septum. In contrast, MA and BST fibers formed equally dense networks spanning the width of the lateral septum. The data suggest that these transplanted neurons show specific outgrowth, and that the phylogenetically related BST and MA neurons follow similar cues to reach their targets. PMID- 1786646 TI - Spectral analysis of the electroencephalogram in neonatal rats chronically treated with the NMDA antagonist MK-801. AB - In order to study the involvement of NMDA-receptor activation in brain development, rat pups were chronically treated with the non-competitive NMDA antagonist MK-801 during the neonatal period. We recorded the cortical EEG at various vigilance states throughout the treatment period. Spectral analysis of the EEG showed reduced power in the delta (delta) frequency range (1.5-4 Hz) during quiet sleep and less power in the theta (theta) range (4-7 Hz) during REM sleep in MK-801 animals than in controls. No significant differences were found for the total time spent in each of the different vigilance states. We conclude that chronic MK-801 treatment probably causes a developmental retardation in state-related brain activities. PMID- 1786647 TI - Neurobehavioral responses of neonatal rats to previously experienced odors of different concentrations. AB - Neonatal rats acquire an olfactory preference following daily exposure to an odor that is accompanied by tactile stimulation. In the present study, we determined the neurobehavioral responses of pups trained and tested with odors of either the same or different concentration. On postnatal day (PND) 1-18, all animals were exposed for 10 min/day to either peppermint or air while receiving perineal tactile stimulation. On PND 19, pups trained with a low odor concentration preferred that odor to air, regardless of its concentration and showed equal preference between odor concentrations. These results suggest both that pups can learn to prefer a specific odor concentration and that they can learn to recognize odor quality across concentrations. To determine the neural responses to such stimuli, trained and control pups were exposed to either low or high peppermint odor concentrations following an injection of 14C-labelled 2 deoxyglucose (2-DG). Early experience with the high odor concentration resulted in the 2-DG uptake response to both test odor concentrations which was higher than that of pups that had previous experience with either the low odor concentration or with clean air. Though the 2-DG density did not increase with test odor concentration, the size of the 2-DG foci did, regardless of previous experience. The 2-DG response to odor concentration is, therefore, influenced by both previous experience and immediate odor stimulus characteristics that are revealed in parallel responses within the olfactory bulb. PMID- 1786648 TI - Effect of neural transplants on seizure frequency and kindling in immature rats following kainic acid. AB - To study the hypothesis that neural transplantations can alter seizure susceptibility in a chronic animal model of epilepsy 260 immature rats (30- to 32 days-old) were administered a convulsant dosage of kainic acid (KA). Ten days later rats that had severe seizures following KA received either bilateral intracerebroventricular transplants of hippocampal (n = 27), neocortical (n = 29), cerebellar (n = 30), or locus ceruleus (n = 32) tissue, or underwent sham transplantation (n = 66). Spontaneous seizure frequency was assessed for 230 days following which the rats underwent entorhinal kindling. The percentage of rats developing spontaneous recurrent seizures was similar in the 4 transplant groups and the sham-operated controls. Rats receiving hippocampal and locus ceruleus transplants had fewer spontaneous seizures than the sham-operated controls or other transplant groups. However, there were no differences in afterdischarge thresholds or kindling rates in the 5 groups. This study demonstrates that the anticonvulsant effects of neural transplants, using this animal model are mild. Tissue type of the graft appears to be an important variable in the alteration of seizure frequency. PMID- 1786649 TI - The development of stimulation-produced analgesia (SPA) in the rat. AB - The present study studied the development of stimulation produced analgesia (SPA) from the periaqueductal gray (PAG) in rats. A monopolar stimulating electrode was lowered into the dorsal or ventral PAG of animals aged 7, 14, 21, or 90-120 days. Constant current cathodal pulses (100 Hz, 100 microseconds) were delivered, starting 10 s before analgesia was tested by the tail-flick (TF) test and continuing throughout each TF trial or until cut-off (7 s). Current intensity was increased stepwise (3-200 microA). It was found that SPA can be elicited starting at 21 days, but not earlier. However, supraspinal modulation of nociception is still immature at 3 weeks after birth. First, stimulation intensities needed to produce SPA are higher in 21-day-old pups than in adult animals. Second, in 21 day-old pups, but not in adults effective current intensities in the dorsal PAG are higher than in the ventral PAG. Third, naltrexone decreases SPA from the ventral PAG in 21-day-old pups, but not in adult animals. These findings indicate that supraspinal modulation of nociception develops only 3 weeks after birth, with the ventral PAG maturing prior to the dorsal PAG, and that the contribution of endogenous opioids to SPA does not remain constant throughout the ontogeny of rats. PMID- 1786650 TI - Central patterning of inspiratory activity in the neonatal period. AB - We hypothesized that synchronization of neonatal inspiratory motoneurons is achieved by common inputs from one or more central pattern generators. Such inputs are manifested in neural discharges as medium-frequency (less than 50 Hz) and/or high-frequency (greater than or equal to 50 Hz) oscillations. Furthermore, if both oscillations appeared, one or both might be gated, i.e. present only in the first or second half of inspiration. The spontaneous discharges of phrenic (C5 and C6) roots and hypoglossal nerves were recorded in anesthetized or decerebrated, vagotomized, paralyzed and artificially ventilated neonatal swine. Autopower spectral analyses showed that phrenic discharges had peaks in the medium- and/or the high-frequency band. Phrenic spectra, derived from either half of inspiration, demonstrated that, while both types of oscillation were present throughout inspiration, their amplitudes were larger during the second half of inspiration. However, comparisons of the relative distributions of power in each half of inspiration showed that the increase of high-frequency power was much larger than that of medium-frequency power during the second half of inspiration. In contrast to phrenic spectra, hypoglossal spectra had peaks only at medium frequencies; consequently, correlated frequencies (indicative of common inputs) in phrenic-hypoglossal coherence spectra were present at those frequencies. The presence of highly correlated frequencies provided strong evidence of a medium frequency pattern generator which may remain operative beyond the neonatal period. PMID- 1786651 TI - Cerebellar Purkinje cells provide target support over a limited spatial range: evidence from lurcher chimeric mice. AB - The distribution of Purkinje cells, granule cells, and olivary neurons was quantitatively analyzed in a lurcher +/Lc in equilibrium C3H/HeJ chimera in which the surviving wild type Purkinje cells were unilaterally distributed in the left hemicerebella. The left hemisphere of this mouse contains 7600 Purkinje cells, approximately 10% of the number of Purkinje cells in inbred C3H/HeJ mice. The right hemisphere contains 300 Purkinje cells, all of which are found within 200 microns of the midline. As in other +/Lc in equilibrium wild type chimeras, the ratio of granule cells to Purkinje cells is increased in the left hemisphere, reflecting increased granule cell survival. In the right hemisphere, however, the number of granule cells is reduced to that found in +/Lc mutants. In the inferior olive, almost twice as many neurons are found in the right nucleus as opposed to the left nucleus. As the projections of olivary neurons are crossed, the number of olivary neurons is increased in the nuclei that project to the cerebellar hemisphere containing Purkinje cells compared to the olivary nuclei that project to the cerebellar hemisphere with almost no Purkinje cells. The preferential survival of granule cells and olivary neurons that either occupy or project to the hemicerebellum containing Purkinje cells suggests that the availability of trophic support from target Purkinje cell neurons is spatially restricted. PMID- 1786652 TI - Early dendritic development of Purkinje cells in the rat cerebellum. A light and electron microscopic study using axonal tracing in 'in vitro' slices. AB - The early stages in the formation of Purkinje cell dendritic arbors have been analyzed using the horseradish peroxidase (HRP) 'in vitro' axonal tracing method, from embryonic day 19 (E19) to postnatal day 6 (P6). These stages comprise the transition from the bipolar Purkinje cell, at the end of its migration, to the phase of stellate cell with disoriented dendrites. Postmigratory Purkinje cells in the cortical plate exhibit poorly elaborated bipolar shapes, here named 'simple-fusiform' cells. They constitute the vast majority of labeled cells up to P0, and thereafter they decrease in number until P4. As a result of continuous outgrowth of new primary dendrites emerging from the apical pole but also from the basal and lateral aspects of the cell bodies, the Purkinje cells enter the 'complex-fusiform' phase, which peaks by P1 and slowly disappears by P6. The disappearance of 'complex-fusiform' cells is the result of an intense regressive process with resorption or retraction of the long dendrites that reaches a maximum by P3. We have called this stage: the Purkinje cell with 'regressive atrophic' dendrites. This regression marks the initiation of the phase of the stellate cell, characterized by the explosive outgrowth of shorter perisomatic protrusions emerging in all directions. By P6, almost all the labeled Purkinje cells have attained this phase. The ultrastructural study of the labeled Purkinje cells has revealed that the transient dendrites of the fusiform cells have all the cytologic features of mature dendrites, particularly cytoskeletal elements (microtubules) and free polyribosomes. More importantly, axon terminals of unknown origin establish a few, constantly present, mature-like synaptic contacts on the dendritic shafts and spinous protrusions from P0, the earliest studied age. Their frequency increases on the Purkinje cells which enter the phase of stellate cell. Our results emphasize that the transformation of bipolar postmigratory Purkinje cells into the stellate cell stage results from a complex cascade of alternating creative and destructive processes, taking place in parallel with the formation and regression of mature synaptic contacts, between the remodelling dendritic arbors and unidentified afferent inputs. Purkinje cells, in all the different transitional stages, are present side by side in the same folial regions, at least until P4, and receive a similar contingent of synaptic input. This indicates that the dendritic remodelling is not driven by the synaptic inputs, but obeys either neural interactions that lead Purkinje cells to assume their monocellular layer configuration, or an internal clock depending on the Purkinje cell birthdate, or an interplay between these two kinds of mechanisms. PMID- 1786653 TI - [Intelligence and language of individuals who incurred left hemisphere injury at no later than 3 years of age]. AB - It is generally considered that damage to the brain during infancy and young childhood results in milder or different syndromes than does brain injury incurred during adulthood. However, only several past studies employed CT scans to confirm that lesions are confined to one of the two cerebral hemispheres. We examined intelligence and language skills of 5 cases, which sustained nonprogressive damage exclusively to the left cerebral hemisphere before 1 year of age, and 1 case, which incurred nonprogressive left hemisphere injury at 3 years of age. These cases were tested at 9 to 25 years of age, or 8 to 22 years after inflicting injuries. The following scales and tests, all of which are Japanese versions, were employed: the Wechsler Intelligence Scale for Children Revised (WISC-R) to measure intelligence of 3 cases at 15 years of age or younger, the Wechsler Adult Intelligence Scale (WAIS) for 3 cases older than 15 years of age, the Western Aphasia Bettery (WAB) to measure language skills, and the shortened version of the Token Test to assess auditory comprehension skills. Upon administration of the tests, we obtained the following results: 1) Although 1 case had a large lesion in the left hemisphere, she exhibited a high IQ of 111, and was adapted well as a college student. The result suggested that large lesions, if incurred at no later than 1 year of age, may affect intelligence to only a little or negligible extent. 2) Verbal IQ generally declines from left hemisphere damage in adults. In all of our subjects, however, verbal IQ was similar to performance IQ.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786654 TI - [A case of transverse myelopathy caused by acupuncture]. AB - A 54-year-old man received insertion of an acupuncture needle into the region extending from the posterior neck to the back on two occasions for the treatment of shoulder stiffness. Two weeks after the second acupuncture, he developed fever, dysarthria and mictionary disturbance, finally reaching the condition of tetraplegia. He was immediately admitted to an emergency room in our hospital, and was diagnosed as sepsis with DIC, ARDS, heart failure, renal failure, liver failure, and myelitis. After one month, he recovered with transverse myelopathy as a residual deficit. Neurological findings showed transverse myelopathy below the level of Th2 at that time. Cervical CT revealed an irregular low density at the periphery of the cervical vertebra from the C2 to C4 level. Cervical MRI revealed an irregular swelling of his spinal cord from the C2 to C7 level. We explained the mechanism of transverse myelopathy in this case as follows. After the acupuncture, he suffered a focal infection of the region of needle insertion, and then the infection expanded to the cervical vertebra, thus causing osteomyelitis, sepsis, and finally cervical myelitis. Direct injury of the spinal cord and nerve roots as a complication of acupuncture was previously reported, but indirect injury of the spinal cord due to myelitis had not been reported except our present case. Careful attentions should be paid to the complications of acupuncture. PMID- 1786655 TI - [Cervical myelopathy due to hypertrophy of the posterior longitudinal ligament (HPLL)--a case report]. AB - We reported a case of cervical myelopathy due to hypertrophy of the posterior longitudinal ligament (HPLL). A 56-year-old man who developed spastic gait and urinary disturbance was admitted to our hospital. Neurological examination disclosed muscle weakness and hyperreflexia in all extremities, and superficial sensory disturbance below Th 4. Neither plain films nor tomograms of the neck showed ossification of the posterior longitudinal ligament (OPLL). However, myelography, myelo-CT and MR scan revealed HPLL and anterior compression of the cervical cord at C2-C6. From these findings, we diagnosed this case as cervical myelopathy due to HPLL. Clinical symptoms were relieved by posterior decompressive laminoplasty. HPLL has been preserved. During the following four years, ossification has not emerged into the hypertrophic region of posterior longitudinal ligament. This case suggests that HPLL may be a novel clinical category of compression myelopathy. Further observation will be needed. PMID- 1786656 TI - [A case of lead neuropathy--importance of subclinical entrapment of nerves in lead neuropathy]. AB - The patient was a left handed 25-year-old man who had worked in a vinyl chloride resin factory since July 1987 using lead stearate as a stabilizer. During the two years preceding hospitalization, he had been admitted three times for colicky abdominal pain with constipation and nausea. Anemia and proteinuria without causative diseases were pointed out. Because of progressive muscle weakness of hands which began since January 1989, he was admitted to our neurologic clinic on October 2 1989. Neurological examination showed severe atrophy of both small hand muscles without sensory disturbances. Left hand was predominantly affected, especially in interossei muscles. Laboratory findings are as follows; RBC 3.25 million/cu.mm: Hb 9.7 g/dl:blood lead concentration 100 micrograms/dl: urinary coproporphyrin 4503 micrograms/l: urinary delta-ALA 138 mg/l: and urinary lead excretion after 1 g CaEDTA infusion: 3938 micrograms/day. Electromyography of extensor carpi radialis, flexor carpi ulnaris and opponens showed increased polyphasic, long duration MUPs. Electromyography of dorsal interossei showed fibrillation. Nerve conduction study showed mildly decreased motor and sensory conduction velocities and markedly reduced amplitude of compound muscle action potentials (CAMPs). Investigation by inching method revealed conduction block of left ulnar nerve across elbow. After CaEDTA chelating therapy, 1 g once a week, steady improvement of muscular weakness was observed within a few months. Serial nerve condition studies revealed constant recovery of nerve conduction velocities, amplitude of CMAPs and diminution of conduction block across the left elbow. Conduction block across left elbow without sensory disturbances implies that subclinical cubital tunnel syndrome might have existed in this patients.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786657 TI - [A case of Crow-Fukase syndrome with increased serum interleukin-6]. AB - We experienced a 47-year-old Japanese female with polyneuropathy, edema, hypertrichosis, hyperpigmentation, and white nail, which were diagnostic as having Crow-Fukase syndrome. Laboratory and radiological evaluation showed neither plasma cell dyscrasia nor monoclonal gammopathy. Increased factor VIII activity and thrombocytosis, which suggested thrombotic tendency, were observed at the exacerbation of clinical symptoms. In her third exacerbation, she presented marked cyanosis in her right foot, and angiography confirmed narrowing of arteries at the ankle. Increased serum interleukin-6 was also observed, and the production of interleukin-6 by endothelial cells of cutaneous angioma was shown. Possible role of interleukin-6 in Crow-Fukase syndrome was discussed. PMID- 1786658 TI - [A case of spinal cord sarcoidosis with interesting MRI findings]. AB - A case of spinal cord sarcoidosis was reported with special reference to MRI findings. A 15-year-old man was admitted to our hospital because of gait disturbance for last six months. Neurological examination on admission showed spastic paraparesis and posterior column signs. MRI of the cervical spinal cord revealed diffuse swelling and low intensity signal in T1-weighted sequences, diffuse high intensity signal in T2-weighted, and multiple micro-nodular lesion in Gd-DTPA enhanced T1-weighted. At first multiple sclerosis was suspected, although the data of cerebrospinal fluid was not suggestive. Four weeks after admission general fatigue, fever, cough, and headache appeared and the neurological symptoms got worse. Chest film and CT revealed diffuse small nodular shadows in the lung field. Abdominal ultrasonography and CT showed hepatosplenomegaly. The general condition became worse in spite of antibiotic and antituberculotic drug therapy, but remitted spontaneously in four weeks. MRI findings also exacerbated and improved during the same period, being compatible with neurological manifestations. The diagnosis of sarcoidosis was made by transbronchial lung biopsy which revealed sarcoid granuloma. Multiple small nodules on Gd-DTPA enhanced T1-weighted MRI had not been reported in patient with spinal cord sarcoidosis. PMID- 1786659 TI - [Hyperkinesie volitionnelle following head injury]. AB - A 13-year-old girl was struck by a car while riding her bicycle. She was comatose on her arrival at the hospital. Neurological examination revealed no focal sign except for right oculo-motor palsy. She became alert 15 days after the head injury when she first experienced a coarse tremor-like movement on the right arm. Neurological examination showed persistent oculo-motor palsy on the right side, decreased sensation of pain and touch on the left. There was no pyramidal deficit. Her gait and speech were normal and joint sensation was intact. A coarse tremor of the right arm was induced by volitional movements especially such as maintaining the arm in certain posture. It was not present at rest. Trajectory of finger-to-nose test was fairly well. However, the tremor became worse when the patient kept her finger near the target. Occasionally myoclonic-jerk and movement oppositionniste were mixed. Superficial EMG recordings of the tremor revealed 4 c/s rhythmic reciprocal grouping discharges, alternating flexor and extensor muscles. From these features, the abnormal movement should better be called tremor type of hyperkinesie volitionnelle (HV). The HV subsided spontaneously 4 months later. MRI of T2-weighted image showed high-intensity areas corresponding anatomically to the caudal part of right red nucleus and the right superior cerebellar peduncle just before its decussation. It is widely believed that lesions in cerebellar outflow pathway (i.e. dentate, red nucleus and thalamus) can cause HV.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786660 TI - [HTLV-I associated myelopathy (HAM) and sarcoid myopathy]. AB - A 65-year-old house-wife developed dirty erythematous rash on her face in April, 1989. Almost simultaneously, she complained of muscle soreness and weakness on both lower extremities. Pathological findings of the skin biopsy at that time was consistent with those of sarcoidosis with moderate inflammatory cell infiltration. In December, 1989, when she was admitted to our hospital, her lower extremities were paretic with marked spasticity, and mild bladder dysfunction was noted. HTLV-I antibody titers in serum and cerebrospinal fluid were significantly elevated. Biopsied limb skeletal muscle revealed the findings of the sarcoid myopathy with small inflammatory cell infiltration in endomysium. HLA haplotypes showed A24, B7, BW61, CW7, CW8, DR1 and DR4 which show relatively common types of those in HAM. Corticosteroid treatments including the methylprednisolone pulse therapy healed the skin lesion, but did not improve her neurological signs. Paraplegia and urinary disturbance were progressive. It is concluded that the inflammatory sarcoid myopathy with HAM in this patient may be caused by a common abnormal immunological background. PMID- 1786661 TI - [A case of upper brainstem infarction developing symptomatic narcolepsy after the administration of anti-convulsant drugs]. AB - A 52-year-old woman, who had ischemic infarction in the ventral upper brainstem due to subarachnoid hemorrhage in October 1986, had recurrent sleep and cataplexy attacks from May 1987. She was receiving valproate and phenytoin daily since 1986. The diagnosis of narcolepsy was made based on the clinical symptoms and EEG findings showing REM sleep during a sleep attack. Both sleep and cataplexy attack increased in parallel with an increase of the dose of anti-convulsant drugs and disappeared immediately after the discontinuation of the treatment. The findings that suggest that the administration of anti-convulsant drug as well as the brainstem vascular lesion was deeply involved in the development of narcolepsy in this case. PMID- 1786662 TI - [Neuro-Behcet disease with bilateral cheiro-oral syndrome following simultaneous multiple brain hemorrhage]. AB - A 34-year-old man with neuro-Behcet disease showed bilateral cheiro-oral syndrome following simultaneous multiple brain hemorrhage. The patient suddenly developed fever, headache, right-sided heminumbness, and gait disturbance after ciclosporin therapy was instituted. Bilateral uveitis, oral aphthous ulcers and follicular skin eruptions were observed. Neurologically, apathetic state, horizontal gaze palsy, spastic paraparesis with right Babinski sign, gait difficulty, and painful dysesthesia of perioral regions, right upper and lower extremities and left hand were revealed as main symptoms. Erythrocyte sedimentation rate was elevated and C reactive protein was positive. Cerebrospinal fluid examination showed lymphocytic pleocytosis. A brain CT scan demonstrated focal high density areas with slight contrast enhancement in the median region of the tegmentum of pons, and in the subcortex of right superior parietal lobe. T1, T2 and proton density images of MRI taken 50 days after the onset disclosed small irregular low signal intensities in the lesions that correspond to the CT findings. Corticosteroid was administered immediately after admission, which resulted in a rapid improvement of clinical symptoms and a complete disappearance of laboratory abnormalities and CT changes. As dysesthesia was attenuated, bilateral typical symptoms of cheiro oral syndrome were found. These results suggest that the intracerebral hemorrhage was caused by angitis related to Behcet disease. MRI findings implicate that the involvement of bilateral paramedian areas including medial parts of both the medial leminiscus and the ventral secondary ascending tract of the trigeminal nerve is responsible for bilateral cheiro-oral syndrome.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786663 TI - [A case of whole visual field visuomotor ataxia of bilateral hands associated with bilateral parietooccipital lesions in the white matter]. AB - A 29-year-old male with visuomotor ataxia was reported. Visuomotor ataxia of bilateral upper extremities was noted in whole visual field including central visual field (optische Ataxie). Neither contraction nor depression of visual field was detected by the test using kinetic or static perimeter, respectively. Magnetic resonance imaging and computed tomography of the brain revealed bilateral parietooccipital lesions in the white matter, and pathological examination of brain biopsy specimen demonstrated demyelination. We considered that bilateral parietooccipital lesions in the white matter were responsible for visuomotor ataxia in this case. PMID- 1786664 TI - [The correlation of consciousness level and the concentration of CSF ammonia in a patient with adult-type citrullinemia]. AB - A 29-year-old man who had a taste for peanuts frequently showed abnormal behaviors. Physical examination revealed consciousness disturbance associated with flapping tremor, hypotonus in the extremities, and hypoactive deep tendon reflexes. Laboratory examination showed hyperammonemia with mild liver injury. A level of serum citrulline was 14 times higher than the upper limit of normal. A diagnosis of type 2 citrullinemia (Seheki et al) was established by the decreased argininosuccinate synthetase (ASS) in liver with low amount of ASS protein and normal kinetic properties. Diurnal fluctuation of consciousness level in this patient was not correlated with the concentration of ammonia in serum, but with that in cerebrospinal fluid. Main metabolic pathway of ammonia in brain is considered to be localized in astrocytes which have receptors for glucocorticoids. Glucocorticoids induce additional glutamine synthetase activity. Circadian rhythm of cortisol level might play a role in diurnal fluctuation of consciousness level in patients with citrullinemia. PMID- 1786665 TI - [Two cases of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) associated with Graves' disease]. AB - We have reported two cases of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) associated with Graves' disease. Case 1: a 45-year old woman noticed a diffuse goiter, palpitation and emaciation in 1977. Laboratory studies confirmed that she had Graves' disease, and she was treated with antithyroid drug. In 1986, when the hyperthyroidism was subsided, she showed progressive symmetrical weakness and numbness in her limbs, and she was almost in tetraplegia at 1987. Markedly slowed motor and sensory nerve conductions and elevated CSF proteins as well as clinical manifestations confirmed the diagnosis of CIDP. Following corticosteroid-pulse therapy and plasmapheresis resulted in good recovery in both motor and sensory impairment, though two-times of relapses were observed. Case 2: a 33-year-old man first noticed weakness in his legs in 1977, motor and sensory disturbances progressed for 12 years. Slowed nerve conduction, high CSF proteins and two-times of relapses in early phase indicated that the CIDP was the diagnosis. In 1989 he complained general fatigue, hyperhidrosis and body-weight loss. The serum thyroid hormone levels were high, and other laboratory studies confirmed the presence of Graves' disease. The cases with both CIDP and Graves' disease has rarely been reported. The background mechanism of this association is not well understood, but the susceptibility to CIDP and Graves' disease may be related to the HLA antigens and immunoglobulin Gm allotypes of which are the genes linked to the major histocompatibility complex and controlling immune responses. The present two cases commonly shared several HLA-DR antigens, but their significance should be confirmed by examining many cases. PMID- 1786666 TI - [Superior vena cava syndrome and compression neuropathy of the right brachial plexus following cardiac pacemaker implantation]. AB - We reported a case with the superior vena cava syndrome and compression neuropathy of the right brachial plexus after pacemaker implantation. A 27-year old man with the second degree atrio-ventricular block had underwent pacemaker implantation via the right subclavian vein at the age of 19. Since the age of 25, he occasionally experienced paresthesia and swelling in his right arm after excessive work. These symptoms gradually resolved within a few days by rest. On June 2, 1990, he noticed swelling and paresthesia of his right face, arm and upper trunk after excessive labor. A few days later, weakness of right hand developed. On examination on June 8, the right arm was edematous, but not cyanotic. There were weakness and hypoactive muscle stretch responses in the right upper extremity with hypesthesia of all modalities in the neck, arm and upper trunk of the right side. Venous angiography showed total occlusion of the right brachiocephalic vein and superior vena cava and well-developed collateral channels. We speculate that swelling of the right upper extremity, which became overt when arterial blood supply to that limb outbalanced impaired venous drainage, finally compressed the right brachial plexus. PMID- 1786667 TI - [A case of adult-onset tethered cord syndrome accompanied with slowly progressive muscular atrophy in the lower limbs]. AB - A 70-year-old man developed slowly progressive muscular atrophy in the lower limbs from age 28, followed by urinary disturbance from age 40. Neurological examination revealed bilateral severe muscular atrophy in the lower limbs with hypesthesia and hypalgesia, mild muscle wasting of both hands, urinary incontinence, and constipation. A sacral dimple was also recognized. A diagnosis of tethered cord syndrome with thick filum terminale was made by spinal magnetic resonance imaging (MRI). After the operation for untethering, urinary disturbance has been slightly improved. Although the adult-onset tethered cord syndrome with the thick filum terminale was extremely rare, the presence of congenital dermal abnormality and segmental distribution of the muscular involvement is often helpful for the clinical diagnosis of this disease. Spinal MRI is one of the most diagnostic method for this disease. PMID- 1786668 TI - [A case of idiopathic, symmetrical non-arteriosclerotic, intracerebral calcification (Fahr's disease) associated with M-proteinemia, followed by multiple myeloma]. AB - We described a 41-year-old woman with idiopathic, symmetrical, non arteriosclerotic, intracerebral calcification (Fahr's disease), associated with multiple myeloma. CT scans revealed severe calcification in the basal ganglia, floors of cortices, subcortical white matter, brainstem and cerebellum without calcification in the spinal cord. Cerebral angiography showed no evidence of arteriosclerosis. The cerebral blood flow measured by SPECT, parathyroid function and calcium metabolism were within normal range. The initial symptom was dystonia and spasticity in the left leg, when she was 30 years old, followed by gait disturbance, speech impairment, micrographia and dementia. M-proteinemia was pointed out when she 32 years old. M-proteinemia, which was due to primary benign monoclonal immunoglobulinemia (PBMI), made progress slowly, followed by multiple myeloma when she was 40 years old. Periodical CT scans revealed that the intracerebral calcification had worsened gradually through 8 years. Neurological abnormality had also progressed slowly. In literature, there has not been any report about Fahr's disease associated with PBMI and multiple myeloma. Our present study is the first to radiologically prove that the intracerebral calcification in Fahr's disease progresses gradually through its course. PMID- 1786669 TI - Diagnosis and management of glaucoma. AB - The first Clinical Symposia on glaucoma (Volume 28, Number 2), by Drs. Paton and Craig, was published in 1976 and updated in 1981. The impact of this disease on public health and the advances in diagnosis and treatment have prompted this revision. The text has been completely rewritten by Drs. Danyluk and Paton and is illustrated with all new plates by Dr. Craig. PMID- 1786670 TI - Newborns' preferential tracking of face-like stimuli and its subsequent decline. AB - Goren, Sarty, and Wu (1975) claimed that newborn infants will follow a slowly moving schematic face stimulus with their head and eyes further than they will follow scrambled faces or blank stimuli. Despite the far-reaching theoretical importance of this finding, it has remained controversial and been largely ignored. In Experiment 1 we replicate the basic findings of the study. In Experiment 2 we attempt a second replication in a different maternity hospital, and extend the original findings with evidence suggesting that both the particular configuration of features, and some aspects of the features themselves, are important for preferential tracking in the first hour of life. In Experiment 3 we use a different technique to trace the preferential tracking of faces over the first five months of life. The preferential tracking of faces declines during the second month. The possible causes and consequences of this observation are discussed. PMID- 1786671 TI - Implementations are not conceptualizations: revising the verb learning model. AB - In a recent issue of this journal, Pinker and Prince (1988) and Lachter and Bever (1988) presented detailed critiques of Rumelhart and McClelland's (1986) connectionist model of the child's learning of the phonological form of the English past tense. In order to address these criticisms, a new connectionist model was constructed using the back-propagation algorithm, a larger input corpus, a fuller paradigm, and a new phonological representation. This new implementation successfully addressed the criticisms of the phonological representation used by Rumelhart and McClelland. It did a much better job of learning the past tense using a fuller input set with realistic frequencies of occurrence. Ancillary simulations using the same network were able to deal with the homonymy problem and the generation of forms like "ated" from "ate". The one feature not provided by the new model was a way of modeling early correct production of irregular forms. The success of the new model can be used to help clarify the extent to which the published critiques apply to a particular connectionist implementation as opposed to fundamental principles underlying the broader connectionist conceptualization. PMID- 1786672 TI - Syntactic subjects in the early speech of American and Italian children. AB - Why do young children leave out sentential subjects? Two competence-deficit hypotheses and a performance-limitation account are evaluated in the present set of studies. American children appear to understand that English requires subjects before mean length of utterance (MLU) 2.0. On balance, performance factors account for the data best. Natural conversations between 21 American children (ranging in age from 1;10 to 2;8 and in MLU from 1.53 to 4.38) and their mothers were taped, transcribed, and analyzed to determine when American children understand that English requires subjects. We measured the frequency of subjects (Study 1); types of pronominal subjects, including expletives (Study 2); frequency of modals and semi-auxiliaries (Study 3); frequency of infinitival to, past tense, third person singular, and subordinate clauses (Study 4); length of verb phrase, frequency of different types of verbs, and frequency of direct objects (Study 5). For Studies 1 and 3 we also used, for comparative purposes, transcripts of 5 Italian children, taped monthly for a year. Even our lowest-MLU American group (5 children between 1.5 and 1.99) used subjects and pronominal subjects more than twice as often as the Italian children, and correctly case marked their subjects. The American children also produced examples of all the sentence elements measured. PMID- 1786673 TI - Causes versus enabling conditions. AB - People distinguish between a cause (e.g., a malfunctioning component in an airplane causing it to crash) and a condition (e.g., gravity) that merely enables the cause to yield its effect. This distinction cannot be explained by accounts of reasoning formulated purely in terms of necessity and sufficiency, because causes and enabling conditions hold the same logical relationship to the effect in those terms. Proposals to account for this apparent deviation from accounts based on necessity and sufficiency may be classified into three types. One approach explains the distinction in terms of an inferential rule based on the normality of the potential causal factors. Another approach explains the distinction in terms of the conversational principle of being informative to the inquirer given assumptions about his or her state of knowledge. The present paper evaluates variants of these two approaches, and presents our probabilistic contrast model, which takes a third approach. This approach explains the distinction between causes and enabling conditions by the covariation between potential causes and the effect in question over a focal set--a set of events implied by the context. Covariation is defined probabilistically, with necessity and sufficiency as extreme cases of the components defining contrasts. We report two experiments testing our model against variants of the normality and conversational views. PMID- 1786674 TI - The evolution of the critical period for language acquisition. AB - Evidence suggests that there is a critical, or at least a sensitive, period for language acquisition, which ends around puberty. The existence of this period is explained by an evolutionary model which assumes that (a) linguistic ability is in principle (if not in practice) measurable, and (b) the amount of language controlled by an individual conferred selective advantage on it. In this model, the language faculty is seen as adaptive, favoured by natural selection, while the critical period for language acquisition itself is not an adaptation, but arises from the interplay of genetic factors influencing life-history characters in relation to language acquisition. The evolutionary model is implemented on a computer and simulations of populations evolving under various plausible, if idealized, conditions result in clear critical period effects, which end around puberty. PMID- 1786675 TI - Does the autistic child have a metarepresentational deficit? AB - This study examines the claim that autistic children lack a "theory of mind" because of an inability to metarepresent. We argue that if autistic children have a "metarepresentational" deficit in Leslie's (1987, 1988) sense of the term, then they should have difficulty not only with mental representations such as false beliefs, but also with external representations such as photographs. Autistic children's understanding of photographic representations was tested using Zaitchik's (1990) task. This task is modelled on the false belief task (Baron Cohen, Leslie, & Frith, 1985; Wimmer & Perner, 1983) but involves "false" photographs where a photographic representation does not conform with the current state of the real world. Like Zaitchik (1990) we found that normal 3 and 4-year olds found this task as difficult as the false belief task. In sharp contrast, however, the autistic children in our study passed the photograph task but failed the false belief task. As both tasks require the ability to decouple, this evidence challenges the view that autistic children lack "metarepresentational" ability in Leslie's sense. However, the results leave open the question of whether autistic children have a metarepresentational ability in the different sense of the term intended by Pylyshyn (1978), that is, representing the relationship between a representation and what it represents. PMID- 1786676 TI - The relationship of phonemic awareness to reading acquisition: more consequence than precondition but still important. AB - Three studies examined the presence of phonemic awareness among Austrian children before reading instruction and its relationship to concurrent and later reading. These children were about 6-7 years of age but in the majority of cases unable to read when they entered school. Testing phonemic awareness with a newly developed, rather simple and natural vowel substitution task revealed that many children showed not a single correct response or little success. In contrast, the few readers at the beginning of grade one exhibited high phonemic awareness and after a few months of reading instruction most of the children scored at least close to perfect in the vowel substitution task. Despite this apparent effect of reading on phonemic awareness there was a specific predictive relationship between initial phonemic awareness differences and success in learning to read and to spell. In agreement with other studies it was found that phonemic awareness differences before instruction predicted the accuracy of alphabetic reading and spelling at the end of grade one independent from IQ and initial differences in letter knowledge and reading. However, closer examination of the relationship between phonemic awareness before instruction and later success in learning to read revealed a specific pattern. Children with high phonemic awareness at the beginning of grade one showed uniformly high reading and spelling achievement at the end of grade one. Such good progress in learning to read and to spell was also evident in the majority of children who showed no phonemic awareness at the beginning of reading instruction, but some of the many children with low phonemic awareness before instruction experienced difficulties in learning to read and to spell. This specific pattern suggests that individual differences in the ease or difficulty with which phonemic awareness can be induced by preschool experiences or by reading instruction is the critical variable underlying the observed correlations between phonemic awareness measures before reading instruction and progress in learning to read. PMID- 1786677 TI - Organizational aspects of IMAC introduction. Nordic model of radiological/clinical conference. AB - The organization of radiological practices differs in Scandinavian countries from that of many other countries. Regular formal meetings take place daily in the radiology department where the senior radiologist demonstrates findings from the imaging procedures of the previous day for the clinicians at the hospital. This procedure which is considered very valuable, should become even more effective with the planned IMAC installations. The article describes routines common to Nordic radiological departments that hopefully can be implemented in future IMAC. PMID- 1786678 TI - PACS and patient data management systems. AB - It is important for a PACS to have access to the patient data, as well as to the images themselves, for the purpose of sophisticated image archiving, retrieving, viewing and interpretation. There are many kinds of patient data concerning image examinations (i.e., patient name, ID, age, examination date and time, examined regions, methods, findings on images, diagnoses or diagnostic impressions, etc.). Some of them are acquired from image examination apparatus, some are supplied by diagnostic radiologists, while some need be retrieved from the radiology and hospital information systems. To facilitate this data exchange, a PACS-RIS-HIS coupling is required. The author has constructed at Tokyo University Hospital a small PACS called TRACS, which adopts one of the possible PACS-RIS-HIS coupling configurations. PMID- 1786679 TI - Independent double reading system. Application of digital image management database. AB - The most important role in a radiologist's work is communicating his findings to the attending physician. This is difficult when the radiologic examinations are performed with portable X-ray units because the attending physician wishes to read the images as soon as possible. To resolve this problem, we have developed an independent double reading system. The hardware consists of a magnetic card reader, a display station, a personal computer and a mouse, all linked with the digital image database and a communication network between HIS and RIS. We also present the software of this system and evaluate the results of the implementation to establish the accuracy of the technique. It was concluded that this system could expand the contribution of the radiologist to portable radiographic examinations and to improve the quality of the RIS database. PMID- 1786680 TI - Practical mini-PACS based on a hybrid video and digital network. AB - The Department of Radiology of the Shinshu University Hospital is presently in the process of developing a new type of mini-PACS with a hybrid architecture consisting of a video and a digital image archiving network. The video block consists of a server station with a video write-once optical disk (LD) and three workstations which are connected to two ultrasound imaging devices and an MRI device. The video images from any of these imaging devices are transferred immediately onto an LD. The examiner can observe the archived images immediately without any interruption of the examination. The image transmission time, including the record and play-back, is within 3 s. The digital block consists of a personal computer server and various workstations linked to the ETHERNET. This digital system supports database management, and archives digital images. This prototype system was used for daily clinical examinations from February 1989 to January 1990 and 31,366 images from 1561 patients were stored on the video disk. This one year experience suggests that a hybrid mini-PACS system is practical for total image archiving when the image matrix is less than 512 x 512 and selected digital image archiving. PMID- 1786681 TI - Clinical application of a magneto-optical disk image filing system/image save and carry (ISAC) system. AB - We propose the utilization of portable magneto optical disks for image filing. The main problems in PACS are the need for a high-speed local area network (LAN) and a large mass storage device. An image filing system--image save and carry (ISAC)--is one solution for these problems in present PACS and requires minimal additional hardware and cost for the installation. Whenever a patient is examined, the clerk carries the medical record and the ISAC magneto-optical disk for recording image data, and after inspection records the image data into the magneto-optical disk. We investigated the number of image retrievals done for inpatients and outpatients in 1988 at our radiation therapy department. The data storage requirements were on the average 18.5 MB for outpatients and 173.9 MB for inpatients. An ISAC display console needs also an easy-to-use man/machine interface for specifying images and image display characteristics in order to realize the ISAC system. PMID- 1786682 TI - Functional and user requirements for IMACS. AB - An Image Management, Archiving and Communication System (IMACS) should integrate all imaging modalities in a diagnostic radiology department. In order to obtain this integration, manufacturers of diagnostic imaging modalities must follow the established standards for communication protocols and image formats. To gain acceptance, IMACS must result in one or more of the following: cost savings, improved efficiency or added diagnostic information. The increased possibilities for image processing should result in a reduced number of rejects and an improved and more uniform image quality. The IMACS should be interconnectable with a range of different Hospital Information Systems (HIS) and Radiological Information Systems (RIS). Interconnections with the HIS and the RIS are mandatory in order to fulfil the specified requirements with regard to access times and functionality. PMID- 1786683 TI - User requirements for IMACS. AB - User requirements of an IMACS are briefly reviewed with special reference to image matrix, number of simultaneous images for review, and connection to the hospital information system. In addition, the problems of information transmission between clinicians and radiologists are discussed--an aspect which varies between different medical communities. Methods of limiting the amount of archived data are also briefly commented upon. PMID- 1786684 TI - Computed radiography and image workstation from the radiologist's point of view. AB - A computed radiography system (Digiscan, Siemens) connected to an image workstation (Siemens) has been used for 1 1/2 years in our department. The image quality is good and it has been possible to reduce radiation dose by about 30% without any appreciable loss of image quality. The image workstation has been used in cases where image postprocessing is considered to be useful. For routine reporting of X-ray images the workstation is too slow although the image quality is comparable to that of the computed radiography film. PMID- 1786685 TI - The goal of PACS in Nagoya University Hospital. AB - In Nagoya University Hospital, a Radiology Intelligent Information System (RIIS) is under construction which will be linked with the Hospital Intelligent Information System (HIIS). RIIS is composed of the radiation oncology information system and the diagnostic radiology information system which is named Imaging Diagnosis Intelligent Information System (IDIIS). IDIIS consists of three parts: (a) the Imaging Diagnosis Management System (IDMS); (b) the Picture Archiving and Communication System (PACS); (c) the Report Generation Support System for Imaging Diagnosis (RGSS-ID). Artificial intelligence methodology is applied to RGSS-ID and IDMS which includes the ordering and scheduling system of diagnostic imaging. IDIIS has an important role to improve the quality of patient care and medical education as well as image management and is an essential component for the implementation of HIIS. PMID- 1786686 TI - Planning for PACS at Osaka University Hospital. AB - We have a plan to adopt PACS as a medical image information system in the new hospital. In order to construct PACS suitable for our hospital, a preliminary survey was carried out to determine how PACS should be introduced and what are the physicians requirements for a new medical image system. The most important requirement of the physicians was a good quality workstation. Our plan of a new medical image information system is as follows. A primary database will be constructed according to each of modalities in the Department of Radiology. In the Department of Medical Information Science, we will make a secondary database according to the patient. Although it may be difficult for us to obtain a sufficient budget digitalizing all medical images by our move to the new hospital, our goal is to establish total PACS throughout the new hospital in 1995. PMID- 1786687 TI - Telephone line transfer using a local filing system in Hokkaido. AB - An image-data transfer system using a public telephone line has been constructed between Hokkaido University Hospital (HUH) and Nakashibetsu Town Hospital (NTH). The latter is situated about 420 km from Sapporo and does not have full-time radiologists. A local filing system coupled with a film reader and an optical disk had been installed in HUH in 1986, and in NTH in 1988. Both systems were connected by a public telephone line along which the transfer speed is 9600 bps. Images originating at NTH, mostly CT, were digitized by the film reader and sent to HUH after compression at a ratio of about 5:1 to 10:1. Clinical information concerning a patient was also sent to HUH using facsimile. Radiologists interpreted the transferred data (12 CT images on a film) on the CRT and sent back a written report to NTH using facsimile. The system and its image quality are largely acceptable, especially in an emergency case for brain and abdomen, although the transfer of a film takes about 7 to 20 min. PMID- 1786688 TI - Diagnostic performance of a teleradiology system in primary health care. AB - Open health care needs proper basic radiological services. Teleradiology makes it possible to get the radiologist's consultation in rural and remote areas and allows the transmission of images between hospitals. A microcomputer-based teleradiology system using a 512 x 512 x 8 bit image matrix with image-processing capabilities and obtainable at a cost of US$ 20,000 was evaluated in daily practice. Images from 372 conventional roentgen examinations were digitized and transmitted via a 64 Kbits/s telephone line from a rural health center to a university hospital, where they were interpreted by two radiologists. The original radiographs were interpreted later and the two reports compared to evaluate the diagnostic performance of system. Slight deterioration of image quality was noticed, though the images were non-diagnostic only in a few cases. The image-processing capability of the system was assessed as useful. Major discrepancies between CRT and film readings were noted in 3.9% of the cases interpreted. The accuracy of CRT readings was about 2% poorer in chest examinations and 5% poorer in bone examinations than in film readings. The teleradiology system proved sufficient for consultation in most conventional radiographs in daily practice, although a system based on a 1024 x 1024 matrix is desirable. PMID- 1786689 TI - PACS in Japan and the Nordic Countries. First Japan-Nordic PACS symposium. AB - The ingredients seem to exist for switching from film-based radiology to digital radiology utilizing the concept Picture Archiving and Communication System (PACS). Why has this not happened? What are the barriers limiting the diffusion of PACS into health care? This was the theme of the 1st Japan-Nordic Symposium in PACS, which was held in Tokyo, March 29-30, 1990. Over 40 radiologists and technical specialists in PACS participated. The topics discussed ranged from the present status of PACS in Japan and the Nordic Countries, to functional specifications and user requirements for PACS, to organizational and other changes brought about by PACS and to teleradiology as a solution for communication of images over wide distances. The symposium was quite successful and will be followed by a 2nd symposium in Finland in the summer of 1991. PMID- 1786690 TI - HU-PACS. 10 months experience. AB - An outline of the Hokkaido University PACS (HU-PACS) and 10 months experience of its clinical use are reported. It is concluded that HU-PACS is a useful clinical tool, even though some points still remain to be improved. PMID- 1786691 TI - Present status and performance of PACS at Kyoto University Hospital. AB - A pilot PACS project, named KIDS, has been running in Kyoto University Hospital. The purpose of the system is to establish a small PACS that includes all digital imaging modalities and to evaluate it. The project has been continued from the first phase (KIDS-1) to the second phase (KIDS-2). In the first phase, a small scale PACS was developed. In the second phase, the expansion of coverage of modalities and completion of the image database was intended. At present, the database contains image data of 16264 patients amounting to 150 Gbytes. Simulation of the retrieval process to the database shows that 154.3 s per patient is required for retrieving his/her entire image data. This calculated value is close to the actual time. PMID- 1786692 TI - PACS in Kochi Medical School Hospital. AB - We have evaluated clinically CRT-based diagnosis and the performance of a picture Archiving and Communication System (PACS) in the Department of Radiology, Kochi Medical School. The important requirements of PACS are a good human interface with the diagnostic workstation and a long-term image archiving device. Because the style of image management varies from hospital to hospital, an analysis of the image management policies of each hospital is also important for the configuration of PACS. PMID- 1786693 TI - PACS and the reporting system. Present status of PACS in the University of Tsukuba. AB - In the University of Tsukuba, PACS research is being carried out with a special emphasis on the reporting system. The radiological diagnostic system in Japan is not sufficiently developed and the number of diagnostic radiologists in Japan is not as large as in many European countries (M. Akisada, Present status of PACS activities in Japan. Med. Inform. 13 (1988) 289-293). With recognition of this fact, PACS research in Japan should also focus on the reporting system. Recently, the first PACS workstation was installed in the Department of Radiology of the University Hospital, but it has not yet been put to clinical use. Reports can be made on this workstation while viewing the properly provided digital images of MR and CT. As to the concepts of the reporting system, there are three important points. The first one is the double check system to maintain the standard quality of diagnostic performance. This system is expected to provide proper training and education to students and young doctors (S.E. Selzer, S.J. Hessel, P.G. Herman et al., Resident film interpretations and staff review. Am. J. Radiol. 137 (1981) 129-133). The second one is to develop a transcriber workstation, through which reports are easily handled as routine work. The last point is to provide a well organized diagnostic coding system. For this purpose, a modified IRD (Index for Radiological Diagnosis, by the American College of Radiology) is assumed to be one of the best choices. PMID- 1786694 TI - Radiology in the Nordic Countries. AB - NEMT, Nordic Evaluation of Medical Technology, conducted a study in 1988-89 on the use and diffusion of diagnostic radiology technologies in Denmark, Finland, Iceland, Norway and Sweden, i.e. the Nordic Countries. The study analysed the responses to a questionnaire sent to all Nordic radiology departments. Our findings show a variation from about 500 to nearly 900 radiology examinations per 1000 inhabitants among the Nordic Countries. Some of the differences are explained by unique structural factors of the health care system in each country, even if they all provide comparable public health services. Other differences are explained by variations in medical practice, accessibility to new imaging modalities, and replacement policies. This paper summarizes the results of the study. PMID- 1786695 TI - Finnish PACS project. AB - A Finnish PACS project has been set up with the participation and financing of 13 university and central hospitals, the Medical Board of Finland, the Hospital League of Finland, the Post and Teleoffice of Finland and the Helsinki Telephone Company with the Medical Engineering Laboratory of the Technical Research Centre of Finland as the principal investigator. The project started in December 1988 and ended in December 1990. The project focused on the functional needs for PACS. The image production, archive sizes, network capacity and workstation requirements have been studied in a big university hospital. The results show that without compression the image archive size needs to be at least 10 TB. The network capacity requirement depends very much on the interactivity requirements. In normal situations less than 1 Mbit/s is needed, if the network is configured in an efficient way. In some cases, however, the speed requirement can be of the order of 100 Mbit/s. A proposal for a hospital-wide PACS network was made. Simple calculation rules to estimate the needed capacities were also developed. PMID- 1786696 TI - Circulating concentrations of 17-estradiol influence pattern of LH in circulation of cows. AB - The objective of the research was to determine the relationship between circulating 17 beta-estradiol (E2) and secretion of luteinizing hormone (LH) in cows. A second objective was to determine if response to E2 was influenced by interval between ovariectomy and the start of E2 treatment. Thirty-one nulliparous cows 3 yr of age were randomly assigned to a 2 x 4 factorial arrangement of treatments. Sixteen cows were ovariectomized at 18 mo of age (long term), and the other 15 cows were ovariectomized at 36 mo of age (short term). At the time of ovariectomy of cows in the short term group, 11 cows in the short term group and 12 cows in the long term group were implanted subcutaneously with 1, 2 or 4 polydimethylsiloxane capsules containing E2. The other eight cows served as non-implanted controls (n = 4-short term, n = 4-long term). All cows were fitted with jugular vein catheters on day 29 of treatment, and on day 30 blood samples were collected at 12-min intervals for 6 hr. At the end of 6 hr, luteinizing hormone-releasing hormone (LHRH) was administered and blood sampling continued at 12-min intervals for an additional hour. Serum was analyzed for LH and E2. Variables of LH secretion analyzed were mean concentration, frequency of pulses, amplitude of pulses and maximum concentration after LHRH. There were no significant interactions for any of the variables of LH among cows ovariectomized for the long and short term. There was a significant linear increase in mean concentration of LH with increased circulating concentration of E2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786697 TI - Secretory patterns of growth hormone and insulin-like growth factor-I during peripubertal period in intact and castrate male cattle. AB - Fifteen Angus bulls and 15 Angus steers 9 months of age and 275 kg of body weight were bled at 20-min intervals over a 6-hr period and serum GH and IGF-I concentrations were measured by RIA. There were no differences between bulls and steers in the mean GH concentration, pulse frequency and amplitude when analyzed by the computer program PULSAR. Mean IGF-I concentration was not different between the two sex phenotypes, nor was there a significant correlation between the integrated IGF-I and GH concentrations. Subsequently, five bulls and five steers were selected from the 30 animals, full-fed a diet for growth in individual pens for 3 months and bled at 15-min intervals over a 24-hr period. Bulls tended to show a greater weight gain and feed conversion efficiency (P less than .10) than steers during the 3-month period. Serum GH concentrations had a pulsatile pattern in all animals with no apparent diurnal rhythm during the 24-hr bleeding. Although mean GH concentration was not different between the two sex phenotypes, bulls tended to have lower baseline levels (P less than .10) and greater peak amplitudes than steers. Serum IGF-I concentrations fluctuated within a two-fold concentration range, with no obvious pulsatility similar to that of GH. Mean IGF-I concentrations of each of the 10 animals were correlated with mean peak GH amplitudes (r = .79), but not with mean GH. These results suggest that gonadal hormone(s) modulates the GH secretory pattern and increases IGF-I secretion which may be related to the greater growth rate of bulls compared with steers. PMID- 1786698 TI - Opioid and 17 beta-estradiol regulation of LH and FSH secretion during sexual maturation in heifers. AB - The objective of the present study was to examine the involvement of opioid neuropeptides and E2 in regulating circulating concentrations of gonadotropins during sexual maturation in the bovine female. Prepubertal (immature) and postpubertal (mature) bovine females were used. Mean concentrations of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in circulation before and after administration of naloxone were determined in ovariectomized heifers administered E2 and ovariectomized heifers not administered E2. A linear decline (P less than 0.01) in opioid suppression of LH and FSH occurred during the experimental period in immature heifers receiving E2. This decline in opioid suppression of LH and FSH occurred during the same period of time that intact control heifers were initiating estrous cycles at puberty. Little change of opioid suppression of LH and FSH occurred during the experimental period in immature heifers not receiving E2 and mature heifers receiving E2. Our research indicates that opioid neuropeptides and E2 act together to regulate LH and FSH secretion during sexual maturation in the bovine female. PMID- 1786699 TI - Effects of transforming growth factor-alpha on parathyroid hormone- and parathyroid hormone-related protein-mediated bone resorption and adenylate cyclase stimulation in vitro. AB - The effects of transforming growth factor-alpha (TGF alpha) were determined on the ability of parathyroid hormone (PTH) or parathyroid hormone-related protein (PTHrP) to stimulate bone resorption and adenylate cyclase in vitro. Bovine PTH (1-34) and human PTHrP-(1-34) were equipotent in their ability to stimulate bone resorption in neonatal mouse calvaria with maximal stimulation (2.9 and 2.8-fold increases in 45Ca release, respectively) at a concentration of 10 nM. Combinations of TGF alpha with bPTH-(1-34) or hPTHrP-(1-34) had additive effects on their ability to stimulate bone resorption when submaximal concentrations of the agonists were used. There was no evidence of synergism between TGF alpha bPTH (1-34) or hPTHrP-(1-34) in their ability to stimulate bone resorption in vitro, nor was TGF alpha able to increase bone resorption induced by maximal concentrations of bPTH-(1-34) or hPTHrP-(1-34). TGF alpha potentiated the effects of either bPTH-(1-34) or hPTHrP-(1-34) on the stimulation of adenylate cyclase in osteoblast-like ROS 17/2.8 cells. These data indicate that TGF alpha has additive effects with submaximal concentrations of PTH or PTHrP on their ability to stimulate bone resorption which may be important in the pathogenesis of humoral hypercalcemia of malignancy. PMID- 1786700 TI - Characterization of and radioimmunoassay for canine thyroglobulin. AB - Canine thyroglobulin (cTg) has been isolated and purified. It has similar electrophoretic patterns as Tg from other mammalian species. The main fraction had a MW of 660,000, whereas also fractions of a MW of approximately 1,300,000 (dimer) and 330,000 (subunit) were present. The iodine content was 0.8 to 1.0% (w/w). cTg did not cross-react with antibodies against human Tg to a degree that would allow the use of a radioimmunoassay for human Tg for the determination of cTg in serum or plasma. Therefore a polyclonal antiserum was raised against cTg and a homologous radioimmunoassay was developed, which was sensitive (0.4 micrograms/l) and specific (cross-reactivity in cTg assay of human Tg, goat Tg, T4, T3, and DIT less than 0.01%). Plasma Tg levels in normal dogs of both sexes and aged 3-15 years amounted to 192 +/- 73 micrograms/l (mean +/- SD, n = 30). There was no relation between plasma Tg and T4 levels. PMID- 1786701 TI - Plasma 13,14-dihydro-15-keto-prostaglandin F2 alpha concentrations in prepubertal dairy heifers challenged with oxytocin. AB - Twenty-nine prepubertal Holstein heifers were assigned by age to one of three age groups to determine if the prepubertal bovine uterus could respond to an oxytocin stimulus. Group 1 heifers were 6 to 7 months of age (AGE1; n = 11), group 2 heifers were 8 to 9 months of age (AGE2; n = 11) and group 3 heifers were 10 to 11 months of age (AGE3; n = 7). Blood samples were collected via an indwelling jugular catheter. Four samples were collected at 15-min intervals prior to oxytocin administration to determine basal 13,14-dihydro-15-keto-prostaglandin F2 alpha (PGFM) concentrations. Each heifer received 100 IU of oxytocin i.v., blood sampling continued at 5 min intervals for the next 30 min and for an additional 90 min at 15-min intervals. Heifers were considered responders to oxytocin if mean PGFM concentrations increased at least 1.5 times the SD of their basal PGFM concentration. Age of the heifer (P less than .0001) and responder status (P less than .05) affected plasma PGFM. Plasma PGFM was higher in AGE1 and AGE3 heifers than AGE2 (P less than .0001). The number of responders was greatest at AGE3 (P less than .03) with AGE1 and AGE2 being similar. Mean basal PGFM was lower (P less than .04) at AGE2 than AGE1 with AGE3 being intermediate. In addition, basal PGFM at AGE1 tended to be lower (P less than .08) in the responders than in the non-responders, while AGE2 basal PGFM did not differ between responders and non responders (P greater than .10).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786702 TI - Neuroendocrine regulation of growth hormone secretion in sheep. IV. Central and peripheral cholecystokinin. AB - The result of alterations in the levels of CCK, in the blood and in the cerebrospinal fluid, on the functioning of the growth hormone axis has been examined in sheep. Male Coopworth sheep of about 40 kg liveweight were given various doses of CCK either intracerebroventricularly (icv) or intravenously (iv). Other similar sheep were given various doses of a CCK antagonist (loxiglumide) by the same routes. Bolus iv administration of either 35 micrograms or 200 micrograms of CCK had no effect on plasma GH levels. When given icv, however, CCK resulted in a marked (P less than 0.01) prolonged depression in plasma GH levels. The decrease in GH secretion could be partially attenuated by concurrent administration of loxiglumide, but was completely unaffected by concurrent administration of antisomatostatin serum icv. Loxiglumide alone had no effect on plasma GH levels when given at up to 200 micrograms icv, but intravenous administration of 8 mg of the CCK antagonist resulted in an increase in plasma GH concentrations (P less than 0.05). Plasma levels of somatostatin, glucose and cortisol were unaffected by both icv and iv administration of CCK. These results show that CCK can have a strong GH-inhibiting effect in the brain. Furthermore, this effect seems to be independent of hypothalamic somatostatin, suggesting another GH-inhibiting system exists. PMID- 1786703 TI - The effect of insulin and relaxin upon mitosis (in vitro) in mammary tissue from pregnant and lactating pigs. AB - The rate of cellular proliferation in the mammary glands of pigs during late gestation and lactation was assessed by measuring the incorporation of 3H thymidine (T1) into the DNA of mammary gland explants in vitro. The T1 showed a linear response over the first 9 hr in vitro, and was not affected by the addition of 500 ng insulin/ml medium. From day 100 to parturition the T1 rose, reached a peak at 2 d after parturition and declined during lactation to the lowest levels seen at day 21 of lactation. The inclusion of 0-1000 ng relaxin/ml medium on T1 at 24-72 hr in vitro had no effect in stimulating T1 in mammary tissue explants taken from either pregnant or lactating pigs. PMID- 1786704 TI - Effect of constant infusion of oxytocin on luteal lifespan and oxytocin-induced release of prostaglandin F2 alpha in heifers. AB - Two experiments were conducted to determine whether constant infusion of oxytocin would prolong the luteal phase and inhibit uterine prostaglandin F2 alpha (PGF2 alpha) secretion in heifers. In Experiment 1, twelve heifers, treated with saline (SAL) or oxytocin (OXY) via jugular cannulae infusions (INF) or osmotic minipumps (OMP), were allotted at estrus into four treatment groups (n = 3). Treatments were: SAL-INF, SAL-OMP, OXY-INF and OXY-OMP. Physiological saline or oxytocin was given from Days 10 to 23 (Day 0 = estrus) of the estrous cycle. Method of treatment (jugular cannula infusion or osmotic minipump) had no effect (P greater than 0.05) on estrous cycle length or pattern of secretion of progesterone; therefore, data were pooled. Estrous cycle lengths were extended (P less than 0.01) for heifers which received oxytocin (25.3 +/- 0.4 d) compared to saline (20.5 +/- 0.4 d). Luteolysis did not occur in oxytocin-treated heifers until after treatment ceased. Experiment 2 was designed and conducted identically to Experiment 1 with the addition of a "challenge" injection of oxytocin (100 IU oxytocin, i.v.) given on Day 16 of the estrous cycle. Treatment of heifers with oxytocin extended (P less than 0.05) estrous cycle length by an average of 3 d compared to heifers treated with saline. The "challenge" injection induced (P less than 0.05) secretion of PGF2 alpha (as measured by the stable PGF2 alpha metabolite, 15-keto-13,14-dihydro-PGF2 alpha) in saline-treated but not oxytocin treated heifers. In both Experiment 1 and 2, serum concentrations of FSH were elevated (P less than 0.05) in oxytocin-treated heifers. No increase was observed for LH or prolactin. The rise in estradiol-17 beta at luteolysis was not affected (P greater than 0.10) by treatment. In summary, constant infusion of oxytocin extended luteal lifespan, prolonged secretion of progesterone, and inhibited oxytocin-induced secretion of PGF2 alpha. Constant infusion of oxytocin did not affect serum concentrations of estradiol-17 beta, LH or prolactin; however, serum concentrations of FSH were elevated during the oxytocin treatment period. PMID- 1786705 TI - Immunolocalization of steroidogenic cells in small follicles of the chicken ovary: anatomical arrangement and location of steroidogenic cells change during follicular development. AB - Previous anatomical and histochemical studies suggested that interstitial cells were the only steroidogenic cells in the theca layer of small follicles of the chicken ovary. However, the precise cellular site of steroid production in the small follicles is not certain. Therefore, our goal was to identify steroidogenic cells in small follicles (less than 10 mm in diameter) of the chicken ovary which have not entered the follicular hierarchy by localizing steroidogenic enzymes with immunocytochemistry. Polyclonal antisera used were anti-cholesterol side chain-cleavage cytochrome P450 (P450scc), anti-17 alpha-hydroxylase cytochrome P450 (P450c17), and anti-aromatase cytochrome P450 (P450arom) for pregnenolone-, androgen-, and estrogen-producing cells, respectively. Ovaries were collected 2 hr after oviposition and embedded in Paraplast after fixation with 4% paraformaldehyde, 10% formaldehyde, or Bouin's solution. Tissues were sectioned (4-6 microns) and sections were mounted on poly-L-lysine coated slides. Sections were incubated overnight at room temperature with each specific antiserum raised in rabbits against cytochrome P450 steroidogenic enzymes or normal rabbit serum as a control and were immunostained with an avidin-biotin-peroxidase complex. Immunoreactivity for the P450 enzymes was absent in the granulosa layer but was present in the theca layer of the small follicles (less than 10 mm in diameter). Interstitial cells in the single theca layer of cortical follicles embedded in the ovarian cortex (less than 1 mm in diameter) contained P450scc and P450c17. Cells which contained P450arom, identified as aromatase cells, surrounded the interstitial cells in the theca layer.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786706 TI - Relationship of thyroid status to growth hormone and insulin-like growth factor-I (IGF-I) in plasma and IGF-I mRNA in liver and skeletal muscle of cattle. AB - Steers were made hyperthyroid or hypothyroid to study the effects of physiological alterations in thyroid hormone status on plasma growth hormone (GH) profiles, plasma insulin-like growth factor-I (IGF-I) concentrations, and relative abundance of IGF-I mRNA in skeletal muscle and liver. Eighteen yearling crossbred steers (360 to 420 kg) were randomly allotted to hyperthyroid (subcutaneous injection 0.6 microgram/kg BW L-thyroxine for 10 d), hypothyroid (oral thiouracil; 0.25% diet plus 12.5 g capsule/d for 17 d), or control (subcutaneous injection 0.9% NaCl) treatment groups. Blood samples were taken for measurement of GH, IGF-I, thyroxine (T4) and triiodothyronine (T3) by RIA. Samples of liver and skeletal muscle were taken by biopsy for measurement of IGF I mRNA by solution hybridization. Steers receiving thiouracil had 57 and 53% (P less than .05) lower T4 and T3, respectively, than control steers (84.1 and 1.7 ng/ml). The hyperthyroid steers had 228 and 65% greater (P less than .05) T4 and T3 than control steers. Neither increased nor decreased thyroid status had any significant effects on plasma GH profiles, liver IGF-I mRNA, or plasma concentration of IGF-I. There was no effect of thyroid hormone alteration on skeletal muscle IGF-I mRNA concentrations. The results of this study suggest that short-term changes in thyroid status of cattle had no major impact on the GH-IGF I axis or skeletal muscle IGF-I mRNA. PMID- 1786707 TI - Effect of exogenous thyrotropin-releasing hormone (TRH) administration on plasma levels of triiodothyronine (T3), thyroxine (T4) and growth hormone (GH) in chronically catheterized suckling piglets. AB - The purpose of the present study was to determine experimental conditions to stimulate secretion of thyroid hormones (T3 and T4) with thyrotropin-releasing hormone (TRH) injections in suckling piglets during the first weeks of postnatal life. Three consecutive experiments were conducted. Four 10-20 d old piglets were i.m. injected with 0, 20, 100, 500 micrograms (experiment 1) or 0, 4, 20, 100 micrograms TRH/kg BW (experiment 2) according to a 4 X 4 latin square design involving different litters in each experiment. Blood samples were taken -15, -1, 15, 30, 45, 60, 90, 120 180 and 300 min after TRH injection in experiment 1, and .25, -.08, .25, .5, 1, 2, 4, 6, 8, 12, 24, 30, 36, 48, 60 and 72 hr after TRH injection in experiment 2. T3 and T4 levels were significantly (P less than .01) increased as soon as 30 and 45 min after TRH injection, respectively. Maximal levels of T3 and T4 were obtained 2 and 4 hr after the injection of 100 micrograms TRH. T3 and T4 returned to basal levels within 6 and 8 hr post injection, respectively. Plasma pGH levels were significantly (P less than .001) increased 15 min after TRH injection in piglets injected with 500 micrograms. In experiment 3, 100 micrograms TRH/kg BW were injected i.m. either daily or every other day from 10 to 23 days of age. Results showed that T4 response to TRH did not decrease after repeated injections. These results indicate that daily i.m. injections of 100 micrograms TRH/kg BW can be used to increase thyroid hormone levels for at least 13 d in the young suckling piglet. PMID- 1786708 TI - Response of young broiler chickens to chronic injection of recombinant-derived human insulin-like growth factor-I. AB - The purpose of this study was to determine if exogenous insulin-like growth factor-I (IGF-I) would improve growth rate or body composition of young broiler chickens. Broiler cockerels were given a daily intramuscular (im) injection of sodium acetate buffer (buffer control), 100 or 200 micrograms recombinant-derived human IGF-I (rhIGF-I) per kg body weight from 11 to 24 days of age. Exogenous IGF I did not affect the average daily gain, average daily feed consumption, or the gain-to-feed ratio of broiler chickens. Although daily injection of 200 micrograms/kg of rhIGF-I reduced (P less than 0.05) body ash content, there was no significant effect of IGF-I treatment on either body fat or protein content. Plasma GH levels were depressed (P less than 0.05) by chronic treatment with rhIGF-I. In contrast, plasma levels of T3 and T4 were not affected by rhIGF-I treatment. The half-life of rhIGF-I in plasma was determined at 25 days of age in naive control or chronically-injected chickens after a single intravenous dose of 50 micrograms rhIGF-I/kg. We found a single compartment, first-order disappearance pattern of rhIGF-I from chicken plasma. The half-life (t1/2) of rhIGF-I in plasma was similar (t1/2 = 32.5 min) for naive controls (injected once) or chronically-treated chickens which had received a daily injection of rhIGF-I (100 or 200 micrograms/kg) for 14 d. These data indicate that daily injection of IGF-I cannot be used to enhance growth performance or body composition of broiler chickens when given during the early growth period. The depression of plasma GH levels in rhIGF-I-injected chickens supports a negative feedback role of IGF-I on pituitary GH secretion. PMID- 1786709 TI - X-ray computed tomography of the cardiovascular system. AB - X-ray CT of the heart is an evolving field. The ultrafast CT scanner provides a practical method of applying the high spatial resolution, high density resolution, and tomographic capabilities of conventional CT scanning, permitting an evaluation of the cardiovascular system. Multiple reports demonstrate that the basic ultrafast technology, while in an evolving state, permits comprehensive evaluation of cardiac structure and function. Recent studies suggest that with further modification ultrafast CT may ultimately be able to delineate the anatomy of the proximal coronary arteries and bypass grafts and to quantitate perfusion. If all these are possible, x-ray CT will have an expanded role in the evaluation of patients with known or suspected heart disease. PMID- 1786710 TI - Pediatric injury prevention for the practitioner. PMID- 1786711 TI - Sound localization and sensitivity to interaural time differences in human infants. AB - The role of interaural time differences in infants' sound localization was investigated. One experiment on free-field sound localization corroborated previous findings that the minimum audible angle changes substantially toward the end of the first half year after birth, and 3 experiments explored interaural time discrimination in that age range. The first of these 3 experiments used an adaptive psychophysical procedure, showing that infants responded appropriately in a sound lateralization task that provides a direct measure of interaural time discrimination. The other 2 experiments improved on the psychophysical procedure by taking into account the ceiling level on performance in the task. Infants aged 16, 20, and 28 weeks had thresholds in the range of 50 to 75 microsec, with no apparent age difference. These thresholds were much lower than would be predicted from studies of free-field sound localization, indicating that sensitivity to interaural time differences is not a limiting factor for the precision of sound localization in this age range. Instead, age-related changes in free-field sound localization may reflect the need to integrate across different localization cues and to calibrate the changing values of cues due to head growth. PMID- 1786712 TI - Object permanence in young infants: further evidence. AB - Recent evidence suggests that 4.5- and even 3.5-month-old infants realize that objects continue to exist when hidden. The goal of the present experiments was to obtain converging evidence of object permanence in young infants. Experiments were conducted using paradigms previously used to demonstrate object permanence in 5.5-month-old infants and 6.5-month-old infants. In one experiment, 3.5-month old infants watched a short or a tall carrot slide along a track. The track's center was hidden by a screen with a large window in its upper half. The short carrot was shorter than the window's lower edge and so did not appear in the window when passing behind the screen; the tall carrot was taller than the window's lower edge and hence should have appeared in the window but did not. The infants looked reliably longer at the tall than at the short carrot event, suggesting that they (a) represented the existence, height, and trajectory of each carrot behind the screen and (b) expected the tall carrot to appear in the screen window and were surprised that it did not. Control trials supported this interpretation. In another experiment, 4.0-month-old infants saw a toy car roll along a track that was partly hidden by a screen. A large toy mouse was placed behind the screen, either on top or in back of the track. The female infants looked reliably longer when the mouse stood on top as opposed to in back of the track, suggesting that they (a) represented the existence and trajectory of the car behind the screen, (b) represented the existence and location of the mouse behind the screen, and (c) were surprised to see the car reappear from behind the screen when the mouse stood in its path. A second experiment supported this interpretation. The results of these experiments provide further evidence that infants aged 3.5 months and older are able to represent and to reason about hidden objects. PMID- 1786713 TI - Individual differences in infant visual attention: are short lookers faster processors or feature processors? AB - Individual differences in the duration of infants' visual fixations are reliable and stable and have been linked to differential cognitive performance; short looking infants typically perform better than long-looking infants. 4 experiments tested the possibility of whether short lookers' superiority on perceptual cognitive tasks is attributable to attention to the featural details of visual stimuli, or simply to differences in the speed or efficiency of visual processing. To do this, the performance of long- and short-looking 4-month-olds was examined on separate discrimination tasks that could be solved only by processing either featural or global information. The global task was easier than the featural task, but as the amount of time allotted for infants to solve either type of task was decreased, short lookers' performance was superior to that of long lookers. These results thus lend support to a speed or efficiency of stimulus processing interpretation of infant fixation duration. PMID- 1786714 TI - Global-local processing in preschool children. AB - The tendency of young children to attend to global and/or local levels of hierarchically structured patterns was examined using an orientation judgment task. 3- and 4-year-old children and adults were asked to judge which way an equilateral triangle was pointing under different contextual conditions. In Experiment 1, contextual variations included overall pattern orientation, configuration alignment type, presence or absence of an immediate frame of reference, and type of local element context. The results showed that, contrary to previous reports in the literature, young children, like adults, attend to both global and local levels of a pattern. Both pattern orientation and the introduction of contextual cues affected children's judgments, and the magnitude of that effect varied with the particular contextual cue present in the stimulus array. In Experiment 2, contextual variations included overall pattern orientation and presence or absence of an internal local level element. Consistent with the results of Experiment 1, young children's orientation judgements were influenced by the addition of local level factors. PMID- 1786715 TI - Postural sway of human infants while standing in light and dark. AB - Postural sway was measured in 12-14-month-old human infants and in adults while they were standing in the light and dark. Spectral density analyses conducted on all frequencies, at specific frequencies, and for individual subjects showed that infants generally did not sway significantly more in the dark than in the light, whereas adults did. For example, infants' dark/light sway proportions were 1.12 and 1.21 for the anterior-posterior and lateral dimensions, respectively, compared to adult values of 2.23 and 3.43 for one-footed stance, and 1.43 and 2.13 for two-footed stance. A statistical power analysis indicated that if the dark/light proportions for infants had been comparable to those for adults, significant differences could have been detected. These findings indicate that the early regulation of standing posture does not depend on the continuous availability of visual information. PMID- 1786716 TI - Young children's disambiguation of object name reference. AB - Children show a disambiguation effect--a tendency to select unfamiliar rather than familiar things as the referents of new names. In previous studies, this effect has been reversed in young 2-year-olds, but not older children, by preexposing the unfamiliar objects, suggesting that attraction to novelty controls 2-years-olds' choices of referents for new names, but a mutual exclusivity and/or lexical gap-filling principle determines preschoolers' selections. Both the disambiguation effect and its reversal by preexposure were replicated in the present study; however, 24-month-olds' rate of selecting unfamiliar over familiar kinds was less when they were simply asked to choose between the items than when they were asked to identify the referents of unfamiliar names. Thus, some young children may have both an attraction to novel tokens and a tendency to honor an abstract lexical principle. Referent selections were also affected by object typicality and word similarity. Correlations between the tendency to acknowledge a new name's unfamiliarity and to treat it like a similar-sounding familiar name suggested that youngsters' phonological matching skills affect their interpretation of new names. Also, 4-year-olds who most often mapped distinctive-sounding new names to unfamiliar kinds tended to admit their unfamiliarity with these names most frequently, suggesting that children's increasing awareness of their own knowledge begins to affect their lexical processing during the preschool years. PMID- 1786718 TI - The development of the subconcepts of death in young children: a short-term longitudinal study. AB - A short-term longitudinal design and the probabilistic latent class method of analysis were used to study the development of young children's understanding of death. 99 first and second graders were interviewed individually in the fall and spring. The results support the notion that the subconcepts of death- irreversibility, cessation, causality, and inevitability--need to be studied separately and in relation to one another. Children first understand the subconcepts of irreversibility and inevitability. Development of these subconcepts does not seem to be conditional on each other. However, at least one of these subconcepts must be understood before the child understands the subconcepts of cessation or causality. The pattern of development of these subconcepts is different when the referent object is human versus animal. The overall methodology offers promise in understanding the development of these concepts in young children. PMID- 1786717 TI - As time goes by: children's early understanding of growth in animals. AB - Beliefs about naturally occurring transformations were examined in children aged 3 to 6 years in 4 experiments. Experiment 1 tested children's understanding that animals (but not artifacts) predictably get larger over time. Experiment 1a examined whether the results obtained in the first experiment could be attributed to an added memory component on the artifact task. Experiment 2 further examined beliefs about the aging of artifacts. In Experiment 3, color and shape (metamorphosis) changes of animals were investigated. At all ages, children appeared to understand that animals get larger and not smaller with age. While older children and adults allowed for rather dramatic changes in the size and shape of animals over the life span if the alternative involved decreasing in size with age, preschool children were less willing to accept these changes. Taken together, the results of these studies suggest that even young preschool children have 2 conceptual insights about natural transformations: that they are lawful and nonrandom, and that they are domain and mechanism specific. Further, children as young as age 3 are able to go beyond the perceptual appearance of animals in making judgments about transformations caused by growth. Implications for children's understanding of personal and species identity are discussed. PMID- 1786719 TI - Perspective taking and theory of mind: do children predict interpretive diversity as a function of differences in observers' knowledge? AB - In 3 experiments, children's ability to vary their responses on perspective taking tasks as a function of the other person's age was examined. In Experiment 1,4- and 5-year-olds were shown to be accurate in their judgments about the knowledge of a 6-month-old baby, a 4-year-old child, and an adult. In Experiment 2, 4-year-olds were asked to determine if a baby, child, and adult would be able to identify an object from a restricted view showing either an identifiable part, a small nondescript part, or no part of the object. Children tended to report that the observer would be able to identify the object from an identifiable or nondescript part. Their judgments were not affected by the age of the observer. Experiment 3 replicated the asymmetry in performance on the general knowledge task and the restricted view task and extended these results by testing 4-year olds, 6-year-olds, and adults using a within-subjects design. PMID- 1786720 TI - Young children's understanding of other people's feelings and beliefs: individual differences and their antecedents. AB - Individual differences in young children's understanding of others' feelings and in their ability to explain human action in terms of beliefs, and the earlier correlates of these differences, were studied with 50 children observed at home with mother and sibling at 33 months, then tested at 40 months on affective labeling, perspective-taking, and false-belief tasks. Individual differences in social understanding were marked; a third of the children offered explanations of actions in terms of false belief, though few predicted actions on the basis of beliefs. These differences were associated with participation in family discourse about feelings and causality 7 months earlier, verbal fluency of mother and child, and cooperative interaction with the sibling. Differences in understanding feelings were also associated with the discourse measures, the quality of mother sibling interaction, SES, and gender, with girls more successful than boys. The results support the view that discourse about the social world may in part mediate the key conceptual advances reflected in the social cognition tasks; interaction between child and sibling and the relationships between other family members are also implicated in the growth of social understanding. PMID- 1786721 TI - The development of distributive justice orientations: contextual influences on children's resource allocations. AB - Previous research on the development of distributive justice decisions, by centering largely on situations in which rewards for work productivity are to be allocated, has shed little light on the child's developing ability to select the justice norm most appropriate to the situation. Children 5, 9, and 13 years of age were asked to allocate resources and judge the fairness of alternative decision rules in situations to which either equity, equality, or need norms were especially applicable. As predicted, young children were insensitive to contextual information, generally preferring to allocate resources equally, whereas older children tailored their decisions appropriately to the situation. The fact that developmental trends differed from situation to situation points to the importance of adopting a contextual perspective on the development of distributive justice orientations. PMID- 1786722 TI - Socialization and temperament in the development of guilt and conscience. AB - Toddlerhood antecedents of conscience were examined in 58 8-10-year-old children. The measures of conscience, such as general affective/moral orientation, the extent of reparation, and the intensity of guilt feelings, were assessed from children's narratives produced in response to semiprojective stories involving transgressions, distress, and conflict. Maternal endorsed socialization orientations and observed rearing behaviors that deemphasized the use of power were associated with the children's internalized conscience 6 years later. However, these findings were significant only for children who were relatively prone to fearful arousal. The capacity for self-regulation, indexed by early compliance and noncompliance to maternal socialization, predicted children's internalized conscience 6 years later. There was preliminary evidence that compliance obtained in a rearing context that deemphasized power assertion was most conducive to the development of conscience. The findings are discussed in view of the interplay of socialization and temperament in moral development. PMID- 1786723 TI - The relations of parental characteristics and practices to children's vicarious emotional responding. AB - We examined the relation of parental empathy-related characteristics and emotion related child-rearing practices to third and sixth graders' vicarious emotional responding. Children's heart rate, skin conductance, facial, and self-reported reactions to a sympathy-inducing film were assessed, as were their dispositional sympathy, empathy, and self-monitoring. Parental sympathy was positively related to low levels of personal distress in same-sex children and, for both parents, with sons' dispositional sympathy or empathy. Parental emphasis on problem focused coping strategies when their sons were anxious was positively correlated with indexes of sons' situational and dispositional sympathy. Same-sex parental restrictiveness in regard to the control of inappropriate, hurtful emotional displays was associated with sons' and daughters' dispositional and situational sympathy, whereas maternal restrictiveness in regard to emotions that are unlikely to hurt others was correlated with nonverbal indexes of personal distress and self reports of low distress. Parental emphasis on control of the child's own negative emotion was associated with children's self-monitoring. PMID- 1786724 TI - Television and families: what do young children watch with their parents? AB - A sample of 271 3- and 5-year-olds and their families participated in a 2-year longitudinal study of television viewing patterns. 5 1-week diaries for all family members were collected at 6-month intervals. Programs were categorized as: (1) child informative, (2) child entertainment, (3) news and informative, (4) sports, (5) comedy, (6) drama, (7) action-adventure, and (8) variety-game. The majority of child programs were viewed without parents, while the majority of adult programs were watched with parents. Coviewing patterns of adult programs were predicted from parents' individual viewing habits, but not from the child's. Coviewing declined with age. Parental encouragement and regulation of viewing were orthogonal. Children whose parents encouraged viewing watched more child informative programming; children of restrictive parents watched less entertainment programming. Encouraging parents coviewed more than nonencouraging parents. Results support the assertion that parental viewing preferences, habits, and orientations toward television influence children's viewing, both with and without parents. PMID- 1786725 TI - Marital adjustment, parental disagreements about child rearing, and behavior problems in boys: increasing the specificity of the marital assessment. AB - 2 studies were conducted to illustrate how measuring a specific aspect of marriage, namely, child-rearing disagreements, provides a better understanding of the link between marriage and boys' behavior. In Study 1, 200 mothers of 3-year old boys completed unstandardized measures of marital functioning and child behavior. An index of child-rearing disagreements: (1) correlated with a greater variety of behavior problems than nonchild disagreements, and (2) improved upon the prediction of behavior problems after accounting for nonchild disagreements as well as after accounting for boys' exposure to marital conflict. In Study 2, 87 mothers with 4-6-year-old sons completed the index of child-rearing disagreements used in Study 1 as well as standard measures of marital functioning and child behavior. Child-rearing disagreements: (1) predicted a greater variety of behavior problems than global marital adjustment, and (2) improved upon the prediction of internalizing problems after controlling for global marital adjustment as well as after controlling for boys' exposure to marital conflict. PMID- 1786726 TI - Marriage and the parenting partnership: perceptions and interactions of parents with mentally retarded and typically developing children. AB - The quality of the parents' marital bond and their ability to work together in the parenting role were examined for the parents of school-aged children (ages 6 18) with mild and moderate mental retardation (n = 38) and a comparable group of parents of typically developing children (n = 34). Significantly more negative functioning for the parents of mentally retarded children was observed during marital interactions, and parent-child interactions but was not reflected in their self-reports of marriage and parenting, suggesting that expectations about marital and parenting strains may modulate negative sentiments for these parents. Across both groups, marital quality and the parenting partnership, together with child behavior problems, accounted for 23% to 53% of the variance in parenting confidence and in aversive parent-child exchanges. Negative marital interaction was a particularly important predictor of aversive parent-child exchanges. PMID- 1786727 TI - Maternal autonomy granting: predictors of normal and depressed mothers' compliance and noncompliance with the requests of five-year-olds. AB - Maternal compliance and noncompliance to child requests, thought to represent an autonomy-granting aspect of socialization, were studied in 24 well mothers and 26 mothers with a history of depression and their 5-year-old children. Mothers continued to retain substantially more power than children in the control process. There were no differences between normal and depressed mothers in the extent to which they granted or denied their children's requests, but the determinants of maternal autonomy granting differed in the 2 groups. Depressed, but not well, mothers' responses to child requests could be predicted from their self-reported mood prior to the interaction and from the concurrent child's behavior. Depressed mothers who reported negative mood and whose children were uncooperative most often denied their requests. Depressed mothers' noncompliance to their children's requests was determined by the quantity rather than quality of their children's behavior: they did not discriminate between skillful and unskillful forms of the children's autonomy expressions. PMID- 1786728 TI - Development of inhibited children's coping with unfamiliarity. AB - In a longitudinal study, 87 children were observed in dyadic free-play sessions with unfamiliar peers at 4, 6, and 8 years of age and were judged by their parents for inhibition. Correlational analyses showed that observed inhibited behavior as well as parental judgments of inhibition became increasingly associated with solitary-passive activity and lost an initial negative correlation with parallel play. Extreme group analyses of the time structure of the behavior of continuously inhibited and control children indicated that with increasing age, many inhibited children spend longer periods in solitary-passive activity, whereas many controls spend longer periods in social behavior. These findings suggest that dispositional inhibition toward strangers becomes increasingly associated with unsociable behavior, which makes it difficult to distinguish between the dispositions of inhibition and unsociability at the empirical level. PMID- 1786729 TI - Relations between attachment, gender, and behavior with peers in preschool. AB - 40 4-year-old children and their mothers participated in a study investigating concurrent links between attachment and peer interactions. Security of attachment was assessed in the laboratory from reunion episodes following a 10-min separation. Focal child observations were carried out during indoor free play in preschool. Relations between insecure attachment and peer interactions were different for boys and girls. Insecure boys showed more aggressive, disruptive, assertive, controlling, and attention-seeking behavior than secure children. Insecure girls showed more dependent behavior than secure children but less assertive and controlling behavior, and more positive expressive behavior and compliance. Secure girls and secure boys did not differ significantly. Gender differences in social behavior may be accounted for by a subgroup of children, those classified as insecure, and the same attachment classification may lead to different predictions depending on whether the child is a boy or a girl. PMID- 1786730 TI - The nonreciprocating robot: effects on verbal discourse, social play, and social referencing at two years of age. AB - 2-year-old children interacted with a robot in a large playroom while their mother sat quietly in the corner. Identical vocalizations from the robot had very different effects on 3 dimensions of the children's behavior when the vocalizations were embedded in reciprocating and nonreciprocating social structures. The reciprocating robot produced (1) more topic-maintaining verbal dialogue, (2) less physical and more linguistically mediated social play, and (3) gender-specific effects on the children's tendency to visually reference their mother during the play session. The data are discussed with reference to the frequently encountered assumption that reciprocal social structures have an impact on children's behavior when the quantity and other qualitative dimensions of social stimulation are held constant, and with reference to the children's attributions about the robot as a social partner. PMID- 1786731 TI - Sibling-directed internal state language, perspective taking, and affective behavior. AB - This study examined relations among preschoolers' sibling-directed internal state language, perspective-taking abilities, and sibling-directed affective behaviors in 32 sibling dyads (aged 14 months and 3-4 years) during naturalistic home observations. Preschooler references about internal states (emotions, wants, abilities) were significantly more likely to be (a) about the toddler than the self, and (b) made in the mother's absence and during sibling conflict and play. Relative to poor perspective takers, skillful perspective takers (a) engaged in more instances of internal state discourse and (b) talked more frequently about both the toddler and themselves. Preschoolers engaging in high levels of positive affective behavior also spoke more frequently about internal states than children engaging in low levels of positive affective behavior. Discussion of results highlights the notion that internal state language may be one way of regulating sibling interaction and also a potential means for siblings to construct shared meanings about their world. PMID- 1786732 TI - Conflict and its resolution in small groups of one- and two-year-olds. AB - 48 1- and 48 2-year-olds were observed in groups of 3 for 25 min on 2 consecutive days, once with ample resources and once with scarce resources. The triads were composed of either 2 girls and a boy or 2 boys and a girl, and duplicate copies of toys were available for half the groups. Their conflicts contained interpersonal features and were more affected by social influences than by the availability of resources. Contrary to expectations, scarcity of resources did not result in increased conflict. In fact, 2-year-olds were more likely to resolve conflict by sharing when toys were scarce. The provision of duplicates decreased the probability of conflict, but many conflicts occurred even when a duplicate was easily accessible. The form of conflict depended on the children's age and the gender composition of the group. Older children and groups dominated by boys, relative to younger children and groups dominated by girls, were less likely to use force and more likely to resolve disputes in prosocial ways. Taken together, these findings provide further evidence for the social nature of conflict in the first few years of life. PMID- 1786733 TI - Conditions of continuity and discontinuity in infant negative emotionality: newborn to five months. AB - This study investigated infant and caregiving-environment variables associated with continuity and discontinuity in infant negative emotionality between the newborn period and 5 months of age. Comparisons were made between groups of infants who evidenced similar levels of crying as neonates but differed by 5 months of age. For initially high-crying infants, mother personality traits, marital quality, and infant variables measured neonatally discriminated stable from changing infants. Ratings of mother sensitivity and infant responsiveness made at 5 months of age also related to continuity and discontinuity in negative emotionality over the first 5 months. PMID- 1786734 TI - [Training of microsurgery in the laboratory of the Hopitaux de Paris]. AB - The Microsurgical Laboratory of Paris Hospitals' Anatomy Amphitheater has been organizing an initiation into microsurgery since 1976 and the University Diploma of Microsurgical Techniques of Paris VI University since 1977. Since this time, 1,426 surgeons have been trained in the laboratory. The geographic origin of the students is worldwide, but predominantly European. The success rate at the final examinations is relatively constant and averages 60%. The results have been compared to the number of sessions in which the candidates had taken part, and a correlation between a number of sessions exceeding 30 and results above 90% at the examinations was established; A minimum number of sessions of vascular microsurgery was therefore laid down in order to ensure the serious training of the students. PMID- 1786735 TI - [Severe multiple injuries. Strategy and results. Experience at the Hopital de la Pitie in 1988 and 1989]. AB - In our series of 97 patients with multiple in juries observed in 2 consecutive years (1988-1989), we have selected only the most severe injuries, of which the patients died within 48 hours, and those that required a long stay in the intensive care department. On admission, we recorded 49 cases of stage II or more severe coma, and 67% of patients under respiratory assistance with an instable hemodynamic state. Out of the 44 deaths recorded, 30 subjects were comatose from the beginning. The justifies the confrontation of 3 specialist teams in 2/3 of cases. The specific recruitment of the hospital and the selection of the most severe cases of these "people under a death sentence" for the study shows a heavy toll of mortality (45,4%), including 60% on the first day. The main cause of death is head injuries (81%). The multivisceral and infectious consequences of long-lasting, heavy intensive care and pulmonary or myocardial contusions account fort secondary deaths in 25% of the patients who had survived. Emergent neurosurgical operations are exceptional, but a neurosurgeon's opinion is always essential. Orthopedic surgical issues are not specific, but the frequency of spinal lesions must be emphasized (27,2%). In this series, 85% of the patients with multiple trauma presented with a lesion of the locomotive apparatus and underwent emergent surgery in every second case in satisfactory conditions. Severe thoracic and maxillofacial lesions requiring surgery are rare. Abdominal lesions are more frequent (17%) and must be dealt with in priority, but they rarely cause death. On the contrary, lesions to the major blood vessels and retroperitoneal compound lesions have a very poor prognosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786737 TI - [Suture, cicatrization and scars]. AB - A suture must comply with precise rules in order to produce an acceptable scar. A distinction must be drawn for "malhealing" between defective and pathological scars. The study of the intimate processes of healing allows understanding genesis and guiding their treatment. PMID- 1786736 TI - [Role of a "watch and wait" policy in the treatment of blunt traumatic lesions of the spleen in adults]. AB - Modern imaging has considerably modified our therapeutic indications, as it allows appreciating the nature of traumatic lesion s of the spleen. We now know that part of the damage sustained by this organ does not evolve towards major internal hemorrhages. In addition, it is advisable to avoid splenectomy, which entails its own complications. It is therefore justified, not only to preserve the spleen, but also to perform no laparotomy whenever this is possible. A series of 22 injured patients, following several isolate cases of "watch and wait policy", confirms the validity of our attitude. PMID- 1786738 TI - [Heterotopic hepatic transplantation. Apropos of a case treated in the terminal stage of decompensated alcoholic cirrhosis]. AB - Heterotopic liver transplantation is an exceptional indication for acute or chronic liver disease. The authors report a case of auxiliary liver transplantation performed for end-stage alcoholic cirrhosis. The patient was contra-indicated for orthotopic transplantation because of poor general and nutritional status. The HLT was indicated because of intractable ascites, liver insufficiency and chronic encephalopathy. The operation was performed according to the technique described by Fortner. Liver function tests returned to normal within 3 days and the only postoperative complication were gastro-intestinal bleeding due to CMV viral infection. Liver function was assessed by HIDA scintigram which showed blood intake by the graft and atrophy of the native liver. The patient was discharged after 3 months. The follow-up is 17 months. At the 15th month control, liver CT showed multiple hypodense nodules biopsied and corresponding to metastasis from a probable pancreatic carcinoma. ERCP and morphologic explorations did not show the primary tumor. The authors discuss the indications of HLT, the rules of successful performance of HLT and the problem of the graft involvement by metastases. PMID- 1786739 TI - [Progress in the surgery of abdominal aortic aneurysm]. AB - Between 1960 and 1989, 609 patients were operated on for abdominal aortic aneurysms. They were 38 females and 571 males from 45 to 87 years old (mean 69). The series has been divided into three consecutive periods: From 1960 to 1973, 135 patients (30 ruptures); from 1974 to 1981, 176 patients (55 ruptures) and from 1982 to 1989, 298 patients (49 ruptures). Perioperative mortality for elective surgery was 8.5% during the first period and 3.2% during the last one. For ruptured aneurysms mortality decreased from 66% to 34%. In the same way, the incidence of rupture decreased from 31.2% to 16.4%. Progresses making possible improvements of the results are related to an early detection with ultrasounds and CT scan, a more precise evaluation of associated pathologies, simplification of surgical techniques, evolution of anesthesia and supportive measures (monitoring, autologous transfusion). On the other hand, rupture is still lethal due to delay in diagnosis and surgery, site of the rupture and multiorgans consequences of hemorrhagic shock. It is only by an echographic screening of people at risk (age, cardiovascular diseases) that frequency can be reduced. PMID- 1786740 TI - [Free-flap coverage technique with double vascular bypass in the lower limb]. AB - In thirteen patients, the repair of a soft tissue defect of the lower limb required a free tissue transfer revascularized by microvascular grafts. The indication of vascular grafting was either the absence of vessels or inadequate recipient vessels. Proximal anastomoses were performed on the femoral artery and the femoral vein or the long saphenous vein. All the transfers were done in one stage procedure. In two cases, a transitory arteriovenous shunt was established. Three flaps out of thirteen have been lost by thrombosis. The discussion concerns the causes of the failures and the indication of the establishment of a transitory or a temporary arterioveinous shunt prior to free flap transfer. PMID- 1786741 TI - [Inguinal herniorrhaphy under local anesthesia with short hospitalization]. AB - This prospective study gives short-term results of 208 inguinal herniorrhaphy performed under local anaesthesia. The median age of the 201 patients (186 M, 15 F) was 57 years (17-87). Local anaesthesia could not be achieved in 1 (0.5%) patient because he was panic-stricken. No serious complications occurred. Peroperative systemic hypotension with bradycardia occurred in 6 (3%) cases. Two (1%) benign postoperative sepsis and 9 (4%) hematoma occurred. The median postoperative hospital stay was 2.8 days (1-10). Twenty seven (13%) patients were discharged on the first postoperative day, 93 (46%) in a period of time less than or equal to 2 days, 147 (73%) in a period less than or equal to 3 days and 184 (91%) in a period less than or equal to 4 days. PMID- 1786742 TI - Artificial feeding and successful reproduction in Ornithodoros moubata moubata (Murray, 1877) (Acarina: Argasidae). AB - The increasing demand for laboratory-reared argasid and ixodid ticks for research and control purposes makes it necessary to develop effective and standardized tick feeding methods without using live animals as hosts. The in vitro maintenance technique, described in this paper, has been used successfully for rearing Ornithodoros moubata moubata by feeding all nymphal and adult instars through Parafilm 'M' sealing film on heparinized bovine blood (fresh standard). The technique is based on a specially designed tick feeding apparatus with a capacity to feed 2000 first nymphal instars (N 1) or up to 200 adults at one time. For different 1-month-old instars feeding rates were between 80-100%. Using this feeding technique the subsequent egg production of female ticks was remarkably high, producing an average of 210.2 eggs per tick with a hatch rate of 96.72%. There was no overall difference in the reproductive capacity of 1-month old female O. M. moubata fed on heparinized and haemolyzed bovine blood (kept deep-frozen), heparinized rat blood and defibrinated ovine blood when compared with those fed on heparinized bovine blood (fresh standard). PMID- 1786743 TI - The life cycle of Amblyomma parvum Aragao, 1908 (Acari: Ixodidae) under laboratory conditions. AB - A colony of Amblyomma parvum was started with engorged females collected from cattle in the Province of Salta (25 degrees 01' S, 63 degrees 56' W), Argentina. The progeny of those ticks were fed on rabbits and the non-parasitic stages maintained at 27 +/- 1 degrees C, 83-86% RH in darkness. The life cycle (prefeeding period not evaluated) had a mean duration of 99.6 days. The mean time (days) for the different phases of the cycle were as follows: feeding period of females, 8.0; pre-oviposition period, 5.7; oviposition period, 17.5; minimum incubation period of the eggs, 31.8; feeding period of larvae, 3.2; premoult period to nymphs, 10.9; feeding period of nymphs, 4.7; premoult period to adults, 17.8. The oviposition pattern was typical of an ixodid tick, including a linear relationship between weights of engorged females and the number of eggs laid (r = 0.8659). The males increased 18% in weight after feeding on hosts (P less than 0.01). The mean recovery rates of larvae, nymphs and females were 28.2%, 95.3% and 90.7%, respectively. The nymphs moulting to females were heavier (6.8 +/- 0.69 mg) than those moulting to males (3.2 +/- 0.29 mg) (P less than 0.01). A comparison of biological values of A. parvum with American and non-American Amblyomma species is presented. PMID- 1786744 TI - Susceptibilities of northern fowl mite, Ornithonyssus sylviarum (Acarina: Macronyssidae), and chicken mite, Dermanyssus gallinae (Acarina: Dermanyssidae), to selected acaricides. AB - The relative toxicities of ten acaricides to northern fowl mite, Ornithonyssus sylviarum (Canestrini and Fanzago), and the chicken mite, Dermanyssus gallinae (De Geer), were determined simultaneously by holding the mites inside disposable glass Pasteur pipettes previously immersed in acetone solutions of various concentrations (w/v) of technical grade acaricides. The LC90s (parts per million) of the acaricides after 24 h exposure for the northern fowl mite and the chicken mite, respectively, were: bendiocarb (13.1, 0.18), tetrachlorvinphos (14.5, 4.07), carbaryl (15.0, 0.83), pirimiphos methyl (18.3, 2.03), permethrin (23.1, 8.46), lambda cyhalothrin (80.7, 11.4), dichlorvos (252.8, 3.75), malathion (238.4, 6.59), amitraz (6741, 9430) and fenvalerate (greater than 10,000, 60.2). After 48 h exposure there were only slight increases in mortalities of both species except for increased mortalities for the northern fowl mite with lambda cyhalothrin, amitraz and fenvalerate, and for the chicken mite with amitraz. PMID- 1786745 TI - Comparison of known and suspected pheromonal constituents in males of African ticks, Amblyomma hebraeum Koch and Amblyomma variegatum (Fabricius). AB - Three low molecular weight compounds were found in hexane:diethyl ether extracts of fed males of the African ticks, Amblyomma variegatum (tropical bont tick) and A. hebraeum (bont tick), namely, o-nitrophenol, methyl salicylate and 2,6 dichlorophenol. These same compounds were also fond in a rinse of fed A. variegatum males, but were absent or present in only trace amounts in a rinse of fed A. hebraeum males, o-Nitrophenol and methyl salicylate were present in much higher concentrations (i.e., amounts/tick) in A. variegatum than in A. hebraeum. 2,6-Dichlorophenol was also more abundant in A. variegatum than in A. hebraeum, but the differences were not as great as with the former two compounds. Extraction in hexane over a 3-week period revealed four additional compounds, benzaldehyde, benzyl alcohol, benzothiazole and nonanoic acid. The first three compounds were found in males of both species; nonanoic acid was found only in A. hebraeum males. Published reports consistently show strong attraction by o nitrophenol and methyl salicylate for both sexes of the two bont tick species; 2,6-dichlorophenol and benzaldehyde have been reported to be attractive to both sexes of A. hebraeum. The possible roles of these compounds, as well as others occasionally reported from A. hebraeum and A. variegatum, as components of the aggregation/attachment pheromone or other pheromones is discussed. PMID- 1786746 TI - Immunocytochemical localization of an insulin-like substance in the synganglion of the tick Ornithodoros parkeri (Acari: Argasidae). AB - Immunocytochemical staining based on the peroxidase-antiperoxidase method has shown that some neurosecretory cells (NSC) in the synganglion of the adult female tick Ornithodoros parkeri react with an antibody to bovine insulin. There are 18 regions of paraldehyde fuchsin-positive NSC of which three regions showed specific insulin-like immunoreactivity: anterolateral cheliceral, anteromedial stomodeal and posterior opisthosomal. Immunoreactivity can also be found in the extracellular surface of the neurilemma of the synganglion. This suggests a possible neurohemal site and release of neurohormone in a diffuse manner. PMID- 1786748 TI - [A preliminary study on the anti-mutagenic effect of seleno-malt]. AB - Seleno-malt is an organic selenium product recently developed in China. Seleno malt itself is not genotoxic. It antagonized the mutagenic effect of aflatoxin B1. Its antagonistic activity was 10-15 times higher then seleno-yeast. Seleno malt may be used as a food additive in areas with low selenium level for the prevention of Ke-shan disease and cancer. PMID- 1786747 TI - Seasonal occurrence of the bont tick (Amblyomma hebraeum) in the southern lowveld of Zimbabwe. AB - The seasonal occurrence of the bont tick Amblyomma hebraeum was recorded over 2 years on 20 Brahman cattle held in a 240-ha paddock at Mbizi in southeastern Zimbabwe. The cattle were infested with all life cycle stages throughout the study period, and no clearly defined seasonal patterns were recorded. Males remained attached for up to about 6 months, and consequently accumulated on the cattle and outnumbered females considerably. The cattle did not acquire resistance to A. hebraeum and the abundance of the adults increased steadily over the 2 years of sampling. The occurrence of adults and nymphs on hosts appeared to be largely independent of weather, and these stages were active over the entire range of temperature and relative humidity recorded during the study period. It was concluded that unfed adults and nymphs are able to engage in host-seeking irrespective of weather conditions as they do not await hosts on the vegetation but emerge from protected microhabitats in response to specific stimuli from hosts, notably, carbon dioxide and the aggregation-attachment pheromone emitted by attached males. This behavior may explain the reported absence of a consistent pattern of seasonal occurrence of A. hebraeum at different locations in southeastern Africa. PMID- 1786749 TI - [Expression of blood group antigens(BGA) in esophageal carcinoma and its prognostic significance]. AB - Five monoclonal antibodies directed against BGA of ABH and Lewis systems and sensitive immunohistochemical SABC method were used to study the expression of these antigens and analyze its significance in prognosis. The results showed: 1. The normal esophageal mucosa in most cases expressed positive BGA; 2. BGA were deleted or lost in most esophageal carcinomas, and the incompatibility of antigens and precursor accumulation were also found. 3. Expression of three or more BGA simultaneously in the same specimen might indicate better prognosis than those which expressed less than two BGA. Incompatibility of antigens also had prognostic significance. PMID- 1786750 TI - [Expression of c-myc and HER-1 genes in the development of human esophageal cancer]. AB - To understand the possible role of oncogenes in the development of human esophageal cancer, the expression of c-myc and HER-1 genes was studied by in situ hybridization. The results showed that: (a) The c-myc and HER-1 protooncogenes were transcriptionally activated (b) Activation of c-myc gene was observed in hyperplastic cells and carcinoma cells. (c) The degree of pathological changes of the esophageal epithelium was related to the level of c-myc transcription, the highest level of c-myc expression was seen in invasive carcinoma cells. (d) Expression of HER-1 gene in carcinoma cells is higher than that in normal and adjacent non-tumor cells, but its frequency is lower than that of c-myc gene. PMID- 1786751 TI - [Short-term assay of colon carcinogen--induction of micronuclei and apoptosis by dimethylhydrazine in the mouse colon crypt cells]. AB - The frequencies of micronuclei and apoptosis in the colon crypt cells of mice treated with colon carcinogen were studied. Two strains of mice, inbred C57BL and close colony Kun-ming mice were used in this experiment. The mice were killed at 24 hr after intraperitoneal injection of dimethylhydrazine (DMH) at doses of 10, 20 and 40 mg/kg body weight. The results indicated that the frequencies of micronuclei and apoptosis in the colon crypt cells of both C57BL and Kun-ming mice were positively correlated quantitatively with the doses of DMH. Our results are similar to that of Heddle obtained in C57BL mice. We propose that the assay of micronuclei and apoptosis in mouse colon crypt cells might be a rapid and sensitive test and useful as a screening method for potential colon carcinogens. Kun-ming mice may be used as the test animal for detecting nuclear anomalies in this assay in lieu of C57BL mice. PMID- 1786752 TI - [Non-volatile nitrosamines in some foods from Linxian County]. AB - For the incidence of non-volatile nitrosamines in the staple foods and vegetables, corn, millet, turnip and turnip chips collected from Linxian County Henan Province, a high incidence area of esophageal cancer, were collected, analyzed and compared with the foods from Huairou County Beijing, a low risk area. Nitrososarcosine (NSAR), nitrosoproline (NPRO) and two unknown non-volatile compounds were found in the food samples from Linxian, and the levels of NSAR in corn ranged 0.7-1.1 ppb and in turnip chips ranged 20.5-962.5 ppb. NSAR level detected in corn samples from Huairou County was not significantly different from that of Linxian. The possibility that the high content of nitrosamines in turnip chips is due to microbial infections is discussed. PMID- 1786753 TI - [DNA ploidy in gastric precancerous lesions]. AB - A study on DNA ploidy by flow cytometry was carried out on human gastric tissues with normal mucosa, chronic atrophic gastritis, varying grades of gastric dysplasia or early carcinoma. The results showed that no DNA aneuploidy was found in all 8 cases with normal mucosa, 13 cases with chronic atrophic gastritis, and 18 cases with grade I gastric dysplasia. DNA aneuploidy was found in 2 among 19 cases with grade II gastric dysplasia, in 8 among 14 cases with grade III gastric dysplasia, and in all 12 cases with early gastric cancer. There was significant differences in DNA index and S% phase cells from cases with gastric dysplasia of varying grades. The findings indicate that DNA aneuploidy might be a marker of malignant change of gastric precancerous lesions. PMID- 1786754 TI - [Haemorheological observation during the process of tumor development after subcutaneous transplantation of non-metastatic mouse lung adenocarcinoma P615]. AB - The haemorheological changes during tumor development in mice with transplanted non-metastatic lung adenocarcinoma (P615) were studied. The tumor cells were injected subcutaneously into 615-strain inbred mice. Animals were sacrificed at days 5, 10, 20, 30 and 35. Each mouse was examined histologically and by haemorheological tests, including plasma viscosity, blood viscosity, haematocrit and aggregation of erythrocytes. The development of subcutaneous tumor was divided into 4 stages after transplantation according to the histological changes, namely, latent stage, proliferative stage, stage of cyst-formation and stage with central necrosis. The haemorheological investigation showed that, compared with the normal animals, plasma viscosity was elevated on days 5, 10, 20, and 35, but was normal at on days 30. The aggregation of erythrocytes showed no change in the whole process of tumor development. The haematocrit and blood viscosity decreased on days 30 and 35 (stage with central necrosis). The significance of the results were discussed. PMID- 1786755 TI - [Cytotoxic and transforming activities of salted fish stocks on C3H 10T 1/2 CL8 cells]. AB - Epidemiological case-control study had shown that consumption of salted fish might be a causative factor for human nasopharyngeal carcinoma. In order to test this hypothesis, salted fish extract was studied by C3H 10T 1/2 CL8 cell transformation system. Neither cytotoxicity nor transformation effect was found in the solvent control, but a definite dose-response relation was obtained using relative transformation index when the cells were treated with 0.025-2.000 micrograms/ml 3-methylcholanthrene in the positive control. Current study showed that in the salted fish extract, dose-response relation in cytotoxicity was present in twelve fractions and transformation index significantly increased in five fractions. The maximum relative transformation indices in dichloromethane methanol, hexane and acetone extract fractions from Murihura croaker were 15.38, 7.69 and 4.29, respectively; and those of dichloromethane-methanol and hexane extract fractions from Sudyoke croaker were 21.69 and 7.69, respectively. In addition, one type-III-focus of cell transformation was found in dichloromethane methanol fraction and another in acetone fraction of Murihura croaker. In conclusion, there must be more than one carcinogen in the salted fish. PMID- 1786756 TI - [Comparative study on the inhibitory effect of green tea, coffee and levamisole on the hepatocarcinogenic action of diethylnitrosamine]. AB - The present study aimed at clarifying whether Chinese green tea, coffee and levamisole (LMS) have similar inhibitory effect on hepatocarcinogenesis induced by diethylnitrosamine (DEN) as they had been proved in our previous aflatoxin B1 (AFB1) experiments. Male Wistar rats were divided into control (A), Green tea (B), coffee (C) and levamisole (D) groups. All rats received the same basic DEN treatment according to the program originally designed by Solt and Farber. During the two weeks before and one week after i.p. injection of DEN, the Groups B, C and D were given 2.5% green tea, 5% coffee and 0.1% LMS diet, respectively. The results demonstrated that coffee, LMS and, in particular, green tea showed inhibitory effect against DEN-induced hepatocarcinogenesis, indicating that green tea can be used as chemopreventive agent for DEN-, as well as for AFB1-induced hepatocarcinogenesis. PMID- 1786757 TI - [Imaging diagnosis of renal tumors]. AB - The imaging findings of 48 cases of renal neoplasms, including excretory urography, ultrasonography, CT and MRI were compared. This series comprised 32 renal cell carcinoma, 5 renal pelvic carcinoma, 4 metastatic renal tumor, 4 renal angiomyolipoma, 2 angioma and 1 lipoma. The comparison of these 4 methods was done with emphasis on their respective merits and disadvantages. Urography remains the major method of detecting the renal tumors. Ultrasound is economic, rapid and sensitive, often used for screening. CT is very useful in the diagnosis and staging of renal tumors, especially for diagnosing small sized renal carcinoma. Its diagnostic accuracy is higher than the others as it offers better spatial and density resolution. MRI may be used in case CT fails to make a diagnosis or the patient is allergic to the contrast media. The diagnostic accuracy may be improved by proper use of the above four methods. PMID- 1786758 TI - [Significance of measurement of serum and cerebrospinal fluid trace elements in the diagnosis of brain tumors]. AB - Cu, Zn, Cd, Mn, Se in serum and Cu, Cd and Mn in cerebrospinal fluid (CSF) of 150 patients were measured by flame, flameless and hydride generation atomic absorption spectrophotometry. The patients were divided into three groups: malignant brain tumor group (MTG), benign brain tumor group (BTG), and non neoplastic neurological disease group (no evidence of brain tumor group, NENG). The results were as follows: 1. Serum Cu, Zn, Cd, Mn, Se levels before operation were higher than those after operation; 2. Cu Cd, Mn serum levels were positively correlated with the CSF in the three groups. The correlation coefficients of serum Cu-CSFCU were 0.8935 (MTG), 0.6074 (BTG), 0.5349 NETG); serum Cd-CSFCd 0.7963, 0.2671, 0.5398; serum Mn- CSF Mn 0.5855, 0.4474, 0.5163, (P less than 0.01). 3. Serum and CSF Cu levels in MTG were significantly higher than in BTG and NETG (P less than 0.01). 4. A group of discrimination function equations was established with stepwise discrimination analysis. The six factors, i. e. serum Cu, Cd, Mn, Se and CSF Cu, Mn were significant in the equations. The conformation rate of diagnosis and discrimination by the equations in the malignant and benign brain tumors with clinical diagnosis was 81 percent. The equations could describe the relationship of coordination and antagonism among trace elements in serum and CSF. The authors believe that discrimination equations may have potential use both in diagnosing and discriminating patients in the 3 groups mentioned above and in following patients after excision of the brain tumor. PMID- 1786759 TI - [Colo-rectal cancer in the elderly]. AB - From September 1981 to December 1988, fiberoptic colonoscopy was performed in 4595 subjects, among whom 476 colorectal cancers were found. Among 692 subjects with ages beyond sixty, 164 (23.7%) colo-rectal cancers were discovered. This study shows that the median age of colo-rectal cancer has increased by 7 years from 45 of the 1950s to the 1970s. The incidence of cancer of the ascending colon is higher (8.5%) in subjects older than 60. It should be noted that 124 out of 164 (75.6%) patients had been misdiagnosed. With prolonging life expectancy in the Chinese population, we strongly advise fibercolonoscopy for the early detection of colo-rectal cancer in the elderly. PMID- 1786760 TI - [Biological behavior of smooth muscle tumors of the alimentary tract--a pathological analysis of 501 cases]. AB - 501 cases with smooth muscle tumors of the alimentary tract are presented with follow up information. 249 leiomyomas and 252 leiomyosarcomas were analyzed in an attempt to evaluate their biological behavior. All patients with leiomyoma survived except 15 who died of other diseases. In the leiomyosarcoma group, 134 survived and 118 died. The 1-2-3-4-5-10-and over 10 year-survival rates were 80.4%, 62.0%, 48.7%, 41.5%, 36.1%, 30.1% and 15.1%, respectively. The following factors were found to be statistically prognostic, arranged in order of their influence on survival; histologic grade, tumor size, mitotic rate and location of the tumor. Leiomyosarcomas were histologically divided into three grades; the higher the grade, the poorer the prognosis. The prognosis was better when the sarcoma was smaller and became worse when larger, especially over 10 centimetres in diameter. The survival rate decreased with increase in mitotic figure. Patients with leiomyosarcoma in the esophagus or stomach had longer survival than those with lesions in the small or large intestines. PMID- 1786761 TI - [Postoperative radiotherapy of renal carcinoma--analysis of 57 patients]. AB - Retrospective analysis of 57 patients with carcinoma of kidney treated by radiotherapy postoperatively from 1970 to 1986 is reported. Thirty-six were male and 21 were female, with ages ranging from 19 to 75. All patients had unilateral nephrectomy followed by radiation therapy after an interval of 3-8 weeks. The kidney area was irradiated using either parallel opposing anterior and posterior portals or two oblique ones. 10-MV photon beam was used to deliver a total dose of 35-60 Gy with daily dose of 1.8 Gy, 5 times a week. The 3- and 5-year survival rates were 62.5% and 58.9%. The authors believe that for extra-capsular extension, tumors larger than 5 cm in diameter, presence of metastatic lymphnodes or local residual lesion, postoperative radiotherapy is indicated. PMID- 1786762 TI - [Comparative gastroscopic and pathologic study on "one point carcinoma" in gastric cancer--analysis of 25 cases. "One Point Carcinoma" National Cooperative Group]. AB - Twenty-five cases of "one point carcinoma" of the stomach, collected from 14 institutes in China, diagnosed by gastroscopic biopsy and proved by regional serial sectioning of the resected specimen as having no more cancerous lesion are presented and studied. The concept, terminology and significance of "one point carcinoma" on the gastric mucosa are put forward by comparative study of the local gross findings and the histopathologic features. The gastroscopic findings showed: mucosal discoloration 3 cases; nodule-like elevation 8 cases; superficial erosion 6 cases; and superficial ulceration 8 cases. Pathologic diagnosis of mucosal biopsy material was: well and moderately differentiated adenocarcinoma 11 cases; poorly differentiated adenocarcinoma 4 cases; signet-ring cell carcinoma 1 case; cancerous change 4 cases; and carcinoma unclassifiable 3 cases. The pathologic changes in the gastric mucosa of the resected specimen were: chronic atrophic gastritis, intestinal metaplasia with superficial erosion and dysplasia 14 cases; superficial gastritis (including partial gastritis verrucosa), intestinal metaplasia with superficial erosion, superficial ulceration and dysplasia 11 cases. The concept of "one point carcinoma", its gross characteristics, biopsy technique and observations as well as other relevant problems discussed are important in the detection of micro-cancerous lesion of gastric carcinoma. PMID- 1786764 TI - [Small experts and internal conflicts in studied neuronal networks]. PMID- 1786763 TI - [Comparison of three different fractionations in radiotherapy for esophageal carcinoma--a prospective randomized trial on 80 patients]. AB - A prospective randomized clinical trial on three different kinds of fractionation in radiotherapy for 80 patients with esophageal carcinoma was carried out from March 1987 to September 1987. The fractionation schemes were: Group A- routine fractionation; Group B- accelerated hyperfractionation with twice-a-day irradiation; and Group C- accelerated hyperfractionation with three-times-a-day irradiation. The 2-year survival rates of the respective groups were: Group A- 18.5% (5/27); Group B- 44.4% (12/27); and Group C- 26.9% (7/26). The difference in survivals was statistically significant between Groups B and C (P less than 0.05) but not between Groups A and C (P greater than 0.05). Though with limited duration of follow-up, the authors prefer the twice-a-day accelerated hyperfractionation scheme for esophageal carcinoma. PMID- 1786765 TI - [The effect of micrococcal nuclease on superhelical DNA molecules forming liquid crystal dispersions]. PMID- 1786766 TI - [Inhibitory analysis of the tissue-specific effect of highly-purified thermostable comuton from rat liver on mitochondrial respiration]. PMID- 1786767 TI - [Participation of calcium and calmodulin in mechanisms of sensitizing Helix snails]. PMID- 1786768 TI - [Hydrated derivatives of naphtho- and anthraquinones--promising psychotropic agents]. PMID- 1786769 TI - [A common approach to studying the nonpolar regions in protein molecules]. PMID- 1786771 TI - [Identification of preganglionic neurons of the dorsal nucleus of the vagus nerve, innervating the stomach wall]. PMID- 1786770 TI - [Adaptation of the body to stress and to altitude hypoxia leads to accumulation of various isoforms of hsp 70 in the myocardium]. PMID- 1786772 TI - [Selection for decreased and increased spontaneous karyotype instability in SP2/0 murine myeloma cell populations]. PMID- 1786773 TI - [Internucleosomal fragmentation of chromatin DNA in human leukemic lymphoblasts, induced by interferon-beta and double-stranded RNA]. PMID- 1786774 TI - [The role of nigroneostriatal dopamine in the transfer of corticofugal pulsation to caudal nuclei neurons in cats]. PMID- 1786775 TI - [Early disruptions in development of pigmented epithelial cell phagocytic function in mutant Campbell mice with hereditary retinal dystrophy]. PMID- 1786776 TI - [Comparative effect of muscle homogenate and suspension on radiation-injured rat skeletal muscle]. PMID- 1786778 TI - [Visual evoked potentials and electroretinography in neurologic diagnosis]. PMID- 1786777 TI - [Structural organization of rat muscle tissue transplants, implanted in Mongolian gerbils after preliminary preparation]. PMID- 1786779 TI - [The spatial frequency limits and the resolving power of the visual system of the pigeon]. AB - The spatial contrast transfer function of the visual system of the pigeon was determined by recording from the optic tectum evoked potentials or extracellular unit activity in response to a pattern stimulus contrast transfer function, determined as a "response function", describes the relationship between the contrast in the pattern--which consisted of vertically oriented stripes of sinusoidally varying luminance--and the amplitude of the response at various spatial frequencies (c/deg). The transfer function yields an estimate of the high frequency limit, which in turn is a measure of visual resolving power. Action potentials were recorded extracellularly using glass microelectrodes; for evoked potentials, stainless steel electrodes were used. Recordings were made from the stratum griseum et fibrosum superficiale of the optic tectum. The highest spatial frequency detectable in a visual system is limited by various factors, including the diffraction of light at the pupil and the anatomical spacing of the photoreceptors. The pupil factor can be controlled in experiments in a suitable way. In this paper, the electrophysiologically determined high-frequency limit was compared with the theoretical resolution limit imposed by the photoreceptor mosaic. The experimental results show that the visual system of the pigeon has a high-frequency limit at a spatial frequency of 15.5 c/deg, corresponding to a visual acuity of 1.9 min of arc. The attempt to relate visual acuity in the pigeon to the anatomical spacing of the photoreceptors shows that the Nyquist frequency of the photoreceptor mosaic, the theoretical upper bound of the spatial resolution, agrees with measurement. PMID- 1786780 TI - [Retinal and cortical electrical activity in man: physiologic bases and clinical applications]. AB - Noninvasive electrophysiological recordings allow to investigate various stages of human visual information processing separately. Luminance and pattern electroretinograms (ERG) contain components originating from anatomically and physiologically different retinal structures while visual evoked potentials (VEP) reflect activity in more central parts of the visual system. Simultaneous recordings of ERGs and VEPs to carefully selected visual stimuli help to relate physiological processes to neural structures, and thus may be employed as an important tool also in clinical investigations. Corresponding experimental data from both basic physiological research as well as from clinical studies are reviewed. PMID- 1786781 TI - [Visually evoked P300 waves]. AB - The event-related potentials after a competitive visual stimulation are presented. The stimulation with target stimuli results in two pronounced positive potentials in the grand-average, the P2 and the P3 component of the ERP, and a long-lasting positivity following the P3 wave. Similar but smaller potential components are elicited by non-target stimuli. Some examples of individual ERP demonstrate the high degree of inter-individual variability, as in the positive components as in the restoration of the poststimulus baseline. Some aspects of a possibly fundamental difference between visually and acoustically elicited P300 waves are demonstrated. PMID- 1786782 TI - [Pattern-reversal visual evoked potentials and electroretinography in the early diagnosis of chronic simple glaucoma]. AB - For differential, therapeutic, and prognostic reasons the recognition of early lesions in glaucoma chronicum simplex is very important. Besides sophisticated ophthalmological investigations optic nerve and retinal functions can be tested by flash and pattern-reversal evoked visual potentials and electroretinograms. 38 glaucomatous eyes were investigated by VEP and ERG applying single and flicker flashes as well as transient pattern-reversal stimuli of different check sizes. The results related to the degree of visual field disturbances show the damage of retinal and neuronal elements in a descending order affecting first of all the macular cones, then the rod system, and later on the elements of the second retinal neuron. The ganglion cells seems to be affected after all. PMID- 1786783 TI - [Flash-evoked visual potentials in the early diagnosis of optic nerve injury due to craniofacial fractures]. AB - Impairment or loss of vision due to optic nerve injury occurs in about 10% of patients with cranio-facial fractures. The assessment of optic nerve function is important for decisions regarding optic nerve decompression. But examination of vision and pupillary reflexes may be difficult, especially in uncooperative patients with reduced consciousness and primary disturbances of pupillary functions. In these cases, optic nerve function can be monitored by means of flash-evoked visual potentials elicited by use of a LED-goggle stimulator. VEPs were recorded in ten patients with head injuries comprising cranio-facial fractures and cerebral concussion with prolonged alteration of consciousness. Recordings were obtained in the acute phase upon admission. Visual acuity and visual fields were examined after regaining consciousness and the clinical findings correlated to the initial VEPs. Upon clinical examinations, four patients with initially normal VEPs had normal vision on both eyes. One patient initially revealed unilateral reduction of the VEP-amplitude of more than 50% and clinically showed a concentric visual field defect. Three patients with unilateral loss of potentials were amaurotic on this side. Perception of light was preserved in one patient in whom VEPs were absent. One patient with bilateral loss of potentials was blind when consciousness was regained. In general, pupillary light reflexes tested at admission corresponded to the VEP-findings. In two cases, however, pupillary reactivity was lost, but VEPs were still present. These patients had normal vision, but exhibited a lesion of the efferent pathways of pupillary reflexes. In two other patients, examination of pupillary reactivity could not be performed due to extreme edema of the eyelids.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786784 TI - [Shape changes in contrast VEP in multiple sclerosis: relation to the type of lesion]. AB - VEP changes in MS patients are due to the demyelinating process which causes conduction alterations as well as inhibitory mechanisms. The pattern-shift VEP can show a delay of the main positivity, a diminished amplitude or/and an altered shape and duration. Concerning to series from the literature and own observations on more than 500 MS patients 4 different types of VEP alterations can be observed: 1. NPN complex with P2 delay; 2. broadening with loss of N2 and P2 delay; 3. bifid P2, P100-P135 complex; 4. deformation and dissociation with loss of P2, N105 dominance and amplitude reduction. PMID- 1786785 TI - [VEP in the determination of multiple lesions in the visual system in patients with multiple sclerosis]. AB - 18 patients with proven multiple sclerosis were examined by pattern reversal visual stimulation. Stimulations were carried out on full fields, foveal areas and horizontal half-fields of single eyes and on half-fields of both eyes. 77% of the patients demonstrated pathological alterations of the potentials in more than one kind of stimulation. In all patients pathological signs could be found, which pointed on the optic nerve. Only the results of three patients suggested a lesion within the central optic pathway. The demonstration of multiple lesions of the optic system in patients with multiple sclerosis is difficult and rarely possible. PMID- 1786786 TI - [Visual evoked potentials in Alzheimer's and Parkinson disease]. AB - Harding et al. suggested at first that an increase of P2 latency in flash VEP without an increase of P2 latency in pattern reversal VEP may be a diagnostic marker of Alzheimer's disease. Up to now there is no convincing evidence for this hypothesis. The purpose of the present study was to examine this hypotheses in an extended group of patients with Alzheimer's disease (n = 36). In addition, a group of patients with Parkinson's disease (n = 8) without dementia syndrome and a group of healthy elderly controls (n = 46) was investigated in order to determine the sensitivity and specificity of these VEP parameters. The results confirmed significant group differences between patients with Alzheimer's disease and healthy controls concerning the increase of Flash P2 latency and unchanged latency of P2 in the pattern reversal VEP. No significant correlations were found between duration of illness and mental test scores. The group differences of P2 latency in the flash VEP for patients with Parkinson's disease and healthy controls were also significant. Therefore, the increase of flash P2 latency in VEP does not seem to be specific for Alzheimer's disease nor for dementia syndrome. The pathological mechanism causing the flash P2 latency increase in a remarkable number of neuropsychiatric patients should be elucidated in further experimental investigations. PMID- 1786787 TI - [Experience with flash-evoked visual potentials in unconscious patients in the neurologic intensive care station]. AB - Evoked potential monitoring has become a widely used procedure in the evaluation of stuporous patients on neurological intensive care units. Currently BAEP and SEP are preferentially employed. VEP monitoring is a relatively uncommon procedure, because late evoked potentials tend to be relatively unstable, varying in amplitude to a moderate extend from changes of temperature, drugs, attention and the level of consciousness. A valuable approach of VEP monitoring on intensive care units are structures of the visual system at risk in vascular disease of the vertebrobasilar system or during evaluated intracranial pressure (EIP). This study uses the data of 20 stuporous patients presenting with either intracranial mass lesions or vascular diseases of the vertebrobasilar system and 20 control persons. Light emitting diode (LED)-VEP are compared with checkerboard stimulation in control persons using the technique of cross-correlation. The comparison of the control group with patients using LED-VEP allows definition of limits for normal variation as a base for identification of significant changes. Despite methodical restrictions of LED-VEP, our results are in favour of serial studies in patients with EIP. There are no corresponding findings in LED-VEP and vascular lesions of the retrochiasmatic visual system. PMID- 1786788 TI - [Neuro-monitoring using visual evoked potentials in comatose neurologic intensive care patients]. AB - The application of visual evoked potentials (VEP) as a monitoring tool was studied in 40 comatose neurological intensive care patients. With increasing depth of coma, the number of detectable VEP components decreased. In deeply comatose patients, VEP were regularly displayed as a negative wave with a latency of app. 100 ms and an amplitude of app. 8 microV (N100). The administration of promethazine or flunitrazepam used as sedatives produced a decrease of amplitude and an increase of latency of N100 that was reversed within 30 or 60 min respectively. In 10 patients, in which intraventricular pressure (IVP) was measured continuously by means of an intraventricular catheter, it was found that increases of IVP produced a considerable decrease of the amplitude and area of N100; after reduction of the increased IVP, both parameters quickly recovered. These observations indicate that VEP may be a useful tool for neuro-monitoring in neurological intensive care patients. PMID- 1786789 TI - [Visual P300 in acute hepatic encephalopathy resulting from non-A-non-B fulminant hepatitis: analysis of the course before and after orthotopic liver transplantation]. AB - The method of Pattern Flash elicited P300 (PFP300) has been applied to evaluate the dynamic alterations in cognitive function of a 58 year old woman (H. C.) presenting with hepatic failure due to fulminant hepatitis Non-A-Non-B. At the time of the first investigation she complained about slight memory deficits and revealed signs of hepatic encephalopathy grade I according to Parson-Smith et al. (bilirubin 26.0 mg/dl, NH3 102 micrograms/dl, electrolytes and blood sugar normal). Psychometric tests: Number connection test (NCT): 54 s (28-53 s, greater than 2sd); Syndrom-Kurz-Test (SKT): total score = 9 (0-4), compatible with a slight "organic brain syndrome". PFP300: N250 latency 343.5 ms (276.4 +/- 14.7 ms, greater than 4sd); PFP300-latency: 442.5 ms (326.9 +/- 14.7, greater than 7sd); PFP300 amplitudes: 16.0 microV (14.4 +/- 8.4, +/- 1sd), indicating severe disturbance in visual discrimination without visual attention deficits. Due to progressive deterioration of liver function the patient had to undergo orthotopic liver transplantation. The patient was reinvestigated four weeks later. The clinical and laboratory status were normal and no signs of hepatic encephalopathy could be detected clinically or by means of the psychometric tests. The parameters of the PFP300 complex had also completely returned to normal: N250 latency: 273.0 ms (less than 1sd); PFP300-latency: 348.0 ms (less than 1sd). This observation suggests that the analysis of P300 can help to detect and follow minor cognitive deficits in cases of acute hepatic encephalopathy. It further underscores the hepatic etiology as well as the potential reversibility of this type of encephalopathy. PMID- 1786790 TI - [Recent additions to the family of dopaminergic receptors]. PMID- 1786791 TI - [Cognitive approach to anticipation in depression]. AB - There is an extensive philosophical and humanistic literature concerning anticipation. Behavioural and cognitive theories have approached the concept of anticipation and have led to therapeutic solutions. The Lewinsohn model enables prediction and restoration of the activities of mastery and pleasure. The social psychology model (Bandura) forms the basis of training in assertiveness, using role-playing in order to be able to produce the relational situations which the patient will encounter. Learned helplessness for action (Seligman), teaches the reattribution of failures or successes, which leads the depressed patient to once again become involved in the action concerned. Exposure to feared situations (Marks) modifies catastrophic anticipations. The social reinforcement model (Liberman) enables prediction by functional analysis of factors involved in the persistence of problems and their modification. The mechanisms of anticipation have been reviewed since Bartlett and Ellis and up to the work of Beck. Structured patterns during existence determine thought processes in face of the circumstances which provoke them. Thus, in the opinion of the authors, our past affects our future in terms of the manner in which these patterns deal with information and determine our thoughts (cognitive events) and our vision of the future. The experimental basis of the cognitive model and the validation of these therapeutic approaches are described. The depressed patient makes negative predictions. Negative cognitions vary in conjunction with mood. Modification of these cognitions changes mood. Numerous studies are presented. They establish the effectiveness of this model, comparable to the action of antidepressant drugs and appearing to have a prolonged effect. The evaluation and cognitive treatment of anticipation are described: cognitive rating scales and analysis are proposed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786792 TI - [Value of sleep and neuroendocrine tests as biological markers of depression in children and adolescents]. AB - In this article, we systematically reviewed the results of application of biological markers of depression to children and adolescents. Concerning sleep EEG, only three studies on a total of twelve among 267 depressed children and adolescents aged 6 to 19 years found the typical sleep abnormalities described in depressed adults (eg, shortened REM latency and decreased sleep efficiency). Most authors insisted on the age-related sleep changes as a major confounding factor. Two studies of the effect of antidepressant therapy on sleep showed a decrease in sleep efficiency but a discrepancy in the evolution of REM latency. Concerning the dexamethasone suppression test, twenty studies including 374 depressed children and adolescents (3-20 years) and 533 psychiatric controls yielded an overall sensitivity of 57% and an overall specificity of 78%. These results may be considered as interesting, despite the lack of agreement among authors on various methodological parameters (dose of dexamethasone, times of blood sampling, method of cortisol assay ...) and the composition of control groups which often comprise subjects presenting disorders very close to major depression (dysthymia, minor depression ...). Among the other tests, the TRH test, used in two studies, showed limited interest. In contrast, the study of growth hormone secretion, performed in one centre, could present diagnostical usefulness. In conclusion, biological markers of depression in children and adolescents should still be considered as research tools and be part of a multidisciplinary approach to depressive illness. PMID- 1786793 TI - [Neuron-glia interactions]. AB - The progress of research in the Central Nervous System (CNS) had led to the consideration of neurons and glia as indissociable functional complexes. Neuron glia interactions are essential for the maturation of the CNS. Glial cells release trophic factors for neurons (NGF) and neurons release trophic factors for glia (GGF). Furthermore, the latter provide a substrate for the migration of neurons and guidance of axons by mean of adhesion molecules. In adults, the interactions between neurons and glial cells serve to maintain homeostasis. Thus, the glial cells perform the restoration of the metabolic equilibrium overthrown by the transmission of the nerve impulse and provide the glucose required for neuronal activity. The nerve impulse provokes increases in the cellular space of CO2, K+, NH3 and neurotransmitters which must be taken up to allow neuronal activity to continue (in normal conditions). Astrocytes perform the uptake of the extracellular K+ by means of passive ionic channels, ionic voltage-dependent channels and a sodium-potassium-ATPase-dependent pump. The oligodendrocytes are involved in the metabolism of CO2 by converting CO2 into carbonic acid by means of carbonic anhydrase. Oligodendrocytes and astrocytes play a role in terminating neural transmission by the uptake of the amino acid neurotransmitters, such as GABA, glutamate and aspartate. The catabolism of glutamate to glutamine by means of glutamine synthetase allows both the conversion of an excitatory amino acid into a neutral amino acid (which can diffuse in the extracellular space without causing neural transmission) and the reduction of cerebral NH3 content.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786794 TI - [Obsessive-compulsive disorder and the study of thyroid function]. AB - We evaluated thyroid function (T3, T4, TSH) and TRH Test in 17 patients with obsessive-compulsive disorder (DSM III criteria and at least 1 year duration) not associated to major depression (absence of DSM III criteria and depression Hamilton scale score, 17 items, below 16). Blood tests were performed following a drug-free period of at least 2 weeks. We accidentally discovered one case of hyperthyroidism with the diagnosis of Graves' disease. In the remaining group (n = 16), basal values of thyroid hormones and TSH were normal. 12.5% (2 cases) showed a blunted delta TSH (less than 5 mUl/l) and 0% a high delta TSH (greater than 20 mUl/l). A significant degree of negative correlation was only noted between delta TSH and age (r = -0.65). Lastly, we report a curious comorbidity between OCD and Graves' disease found in 3 cases within a population of 50 OC patients (or 6%) recruited in our psychiatric unit. The characteristics of these observations will be presented. PMID- 1786795 TI - Cardiovascular and side effects of flesinoxan in conscious hypertensive dogs. Modulation by prazosin. AB - Previous studies on anaesthetized animals indicate that flesinoxan exerts hypotensive effects via stimulation of central 5-HT1A receptors. The purpose of the present study was to investigate the cardiovascular and side effects of flesinoxan in conscious, renal hypertensive dogs at rest and during exercise. Animals were pretreated with prazosin (2.5 or 7.5 nmol/kg) to verify a reduction of dose-dependent side effects, as occurred in normotensive dogs. A decrease in blood pressure without reflex tachycardia was observed only with the lower dose of flesinoxan (0.1 mumol/kg). The higher dose (0.2 mumol/kg) led to an increase in blood pressure and heart rate. The increase in heart rate during exercise was diminished by 0.2 mumol/kg flesinoxan. Pretreatment with prazosin resulted in an additive hypotensive effect at rest. Side effects, occurring primarily after the higher dose of flesinoxan, were not influenced by prazosin. It is concluded that flesinoxan is not likely to be efficacious in antihypertensive therapy. PMID- 1786797 TI - High affinity interleukin-6 binding sites in bovine hypothalamus. AB - The cytokine interleukin-6 (IL-6) has been proposed to interact with the hypothalamic-pituitary axis. The present data provide the first reported evidence of high affinity binding sites for [125I]IL-6 in brain tissue, specifically bovine hypothalamic membranes. Binding was saturable and represented a single site, with a Kd of 316 +/- 49 pM and receptor density of 15.8 +/- 3.2 fmol/mg protein. Other cytokines tested did not interact with this site, but a neutralizing monoclonal anti-IL-6 antibody blocked specific binding. These findings support the proposed involvement of IL-6 in communication between neural and immune systems. PMID- 1786796 TI - Influence of lemakalim on the pulmonary vascular bed of the cat. AB - Pulmonary vascular responses to the K+ATP channel opener, lemakalim, were investigated in the intact-chest cat under constant flow conditions. When tone in the pulmonary vascular bed was elevated, intralobar injections of lemakalim caused dose-related decreases in lobar arterial pressure without changing left atrial pressure. Lemakalim was approximately 3-fold more potent than cromakalim in dilating the pulmonary vascular bed, and pulmonary vasodilator responses to these K+ATP channel openers were blocked by the K+ATP channel blocking agent, glybenclamide. Glybenclamide had no significant effect on pulmonary vasodilator responses to acetylcholine or vasoactive intestinal peptide (VIP) but decreased responses to calcitonin gene-related peptide (CGRP). These data show that lemakalim has potent pulmonary vasodilator activity and suggest that responses are due to activation of a glybenclamide-sensitive K+ATP channel. PMID- 1786798 TI - Pulmonary vasodilator responses to RP 52891 are mediated by activation of a glibenclamide-sensitive K+ATP channel. AB - Pulmonary vasodilator responses to the K+ATP channel opener, RP 52891, were investigated in the intact-chest cat under constant flow conditions. When pulmonary vascular tone was increased with U46619, intralobar injections of RP 52891 caused dose-related decreases in lobar arterial and systemic arterial pressures without altering left atrial pressure. RP 52891 was more potent than pinacidil but less potent than cromakalim in dilating the pulmonary vascular bed. Pulmonary vasodilator responses to RP 52891, cromakalim and pinacidil, but not to acetylcholine, nitroprusside or isoproterenol, were blocked by glibenclamide. These data demonstrate that RP 52891 has potent pulmonary vasodilator activity in the cat and suggest that responses are due to opening of a glibenclamide sensitive K+ATP channel. PMID- 1786799 TI - Chronic desipramine enhances the effect of locally applied amphetamine on interstitial concentrations of dopamine in the nucleus accumbens. AB - In vivo microdialysis was used to study the effect of chronic desipramine (DMI, 5 mg/kg, twice daily for 21 days) on increases in interstitial dopamine (DA) produced by local administration of d-amphetamine (1.0, 3.3 and 10.0 microM) in the nucleus accumbens. Locally applied amphetamine increased interstitial DA in a dose-dependent manner. The amphetamine-induced increase was significantly greater in the DMI treated animals. These data suggest that chronic DMI may directly influence the functional status of the DA terminals in the nucleus accumbens. PMID- 1786800 TI - Inhibition of platelet aggregation by capsaicin. An effect unrelated to actions on sensory afferent neurons. AB - The effects of capsaicin on the ability of platelets to aggregate in response to thrombin, platelet-activating factor or calcium ionophore (A23187) were examined. At concentrations previously shown to activate sensory afferent neurons, capsaicin markedly inhibited the responsiveness of platelets to the three agonists. The effects of capsaicin on platelet aggregation were reversible, and could be observed if capsaicin was added after platelets had begun to aggregate in response to the agonist. Capsaicin did not affect the shape change which occurs in response to the agonists, a process which is calcium-independent. These results demonstrate that capsaicin, at concentrations which are frequently used to 'selectively' activate sensory afferent neurons, is also capable of affecting the function of the platelet. Such non-specific effects of capsaicin must be considered when this substance is used as a pharmacological probe of sensory afferent nerve function. PMID- 1786801 TI - Effects of a phorbol ester and staurosporine on electro- and pharmacomechanical coupling in a resistance artery. AB - We examined the role of protein kinase-C in contractile responses of small arteries of the rat by stimulating and inhibiting protein kinase-C with phorbol myristate acetate and staurosporine, respectively. The experiments were performed in isolated mesenteric resistance arteries that had been sympathectomized and mounted for recording of isometric force development. Phorbol myristate acetate (i) at concentrations lower than 3 nM increased sensitivity for the contractile effect of potassium, but not for the effect of noradrenaline or BAY-K8644, (ii) at concentrations higher than 30 nM increased the sensitivity of depolarized vessels to extracellular calcium and (iii) at concentrations higher than 30 nM induced a contractile effect that depended on the presence of extracellular calcium and that was reduced by the calcium antagonist felodipine. Neither the phorbol ester nor staurosporine affected contractile responses to caffeine in calcium-free solution. Staurosporine (10 nM) reduced the response of resistance arteries to potassium but not to noradrenaline. These results are in agreement with direct observations by others that protein kinase-C plays a role in the activation of voltage-operated calcium channels. Protein kinase-C could participate in this way in electro-mechanical coupling in resistance arterial smooth muscle and, when strongly activated, sensitize the contractile apparatus to calcium. PMID- 1786802 TI - Homogeneous 5-HT1D recognition sites in the human substantia nigra identified with a new iodinated radioligand. AB - The novel iodinated radioligand, serotonin-5-O-carboxymethyl-glycyl[125I] tyrosinamide, was used for binding studies with membranes of human substantia nigra. Evidence is provided for the existence in this tissue of a homogeneous population of recognition sites with the pharmacological profile of the 5-HT1D site. PMID- 1786803 TI - M3 cholinoceptors and P2y purinoceptors mediating relaxation of arteries in spontaneously hypertensive rats at prehypertensive stages. AB - Muscarinic cholinoceptor and purinoceptor subtypes were determined in femoral and mesenteric artery strips from spontaneously hypertensive rats (SHR) at prehypertensive stages. Acetylcholine (ACh), carbachol and oxotremorine induced endothelium-dependent relaxations during contractions evoked by 5 hydroxytryptamine. The order of relative potency of the agonists was ACh greater than carbachol = oxotremorine in the prehypertensive SHR and Wistar Kyoto rats (WKY). Schild plot data for muscarinic cholinoceptor antagonists obtained with carbachol or oxotremorine as agonist indicated that the arteries of prehypertensive SHR and WKY possessed M3 cholinoceptors mediating relaxation. The relaxation responses of the prehypertensive SHR and WKY arteries to ATP were inhibited by reactive blue 2 but not altered after P2x purinoceptors had been desensitized by alpha,beta-methylene ATP, which suggests that the arteries possessed P2y purinoceptors mediating relaxation. The responses of the femoral and mesenteric arteries from prehypertensive SHR to ACh, carbachol and ATP were similar to those of WKY arteries, although the response of the prehypertensive SHR artery to oxotremorine was significantly increased compared to that of the WKY artery. The results suggest that M3 cholinoceptor- and P2y purinoceptor mediated relaxations are not changed in prehypertensive SHR arteries as compared to those in WKY arteries. PMID- 1786804 TI - Inhibition by glibenclamide of the effects of cromakalim on responses of rat vas deferens to naphazoline. AB - Cromakalim has been shown to inhibit naphazoline-induced contractions and spontaneous activity induced by exposure to naphazoline in the rat isolated vas deferens. Glibenclamide 10(-6) M blocked both these effects of cromakalim. Our data add to the list of data derived mainly from experiments on vascular smooth muscle; they suggest that the same glibenclamide-sensitive K+ channel is present in vascular and non-vascular smooth muscle and that it may be involved in the relaxant actions of cromakalim. PMID- 1786805 TI - The accessibility of abortion services in the United States. AB - Abortion services are provided in hospitals, doctors' offices and various types of clinics, but about two-thirds of procedures are performed in specialized abortion clinics. While this system appears to work well for most women, some women seeking abortion face obstacles related to distance, cost, harassment and special medical conditions. Nine percent of nonhospital abortion patients must travel more than 100 miles and 18 percent travel 50 to 100 miles for services. The average woman having a first-trimester nonhospital abortion paid $251 in 1989. Fees were higher in facilities with small abortion caseloads. An abortion at 10 weeks' gestation in a hospital cost an average of $1,757. Charges for abortions at 16 weeks averaged $509 in abortion clinics, compared with $1,539 in hospitals for curettage and $2,246 for instillation procedures. Some women face other barriers: Only 43 percent of all abortion facilities offer services past 12 weeks, and 27-37 percent of nonhospital facilities say they do not treat patients who test positive for the human immunodeficiency virus (HIV), the virus that causes AIDS. Women who need special services such as an administration of Rh immunoglobulin, general anesthesia or HIV testing usually pay extra for these services. In addition, 85 percent of nonhospital facilities that serve 400 or more abortion patients a year reported some form of antiabortion harassment in 1988, most commonly picketing; there was virtually no change in this proportion between 1985 and 1988. PMID- 1786806 TI - Reducing the risk: impact of a new curriculum on sexual risk-taking. AB - Reducing the Risk is a new sexuality education curriculum, based on social learning theory, social inoculation theory and cognitive-behavioral theory and employing explicit norms against unprotected sexual intercourse. In a quasi experimental evaluation, this curriculum was implemented at 13 California high schools; 758 high school students assigned to treatment and control groups were surveyed before their exposure to the curriculum, immediately afterwards, six months later, and 18 months later. Among all participants, the program significantly increased participants' knowledge and parent-child communication about abstinence and contraception. Among students who had not initiated intercourse prior to the pretest, the curriculum significantly reduced the likelihood that they would have had intercourse by 18 months later. Reducing the Risk did not significantly affect frequency of sexual intercourse or use of birth control among sexually experienced students. Among all lower risk youths and among all students who had not initiated intercourse prior to their exposure to the curriculum, the curriculum appears to have significantly reduced unprotected intercourse, either by delaying the onset of intercourse, either by delaying the onset of intercourse or by increasing the use of contraceptives. Among the students not sexually active before participation in the program, effects seem to have extended across a variety of subgroups, including both whites and Latinos and lower risk and higher risk youths, but were particularly strong among lower risk youths and females. PMID- 1786807 TI - Barriers to family planning services among patients in drug treatment programs. AB - In July 1989, family planning services were integrated into 13 drug treatment programs in Philadelphia. To obtain information on the family planning needs of women in drug treatment programs, baseline interviews were conducted with 599 women. Three-quarters of these women had had a sexually transmitted disease, and although they were in a drug treatment program, 41 percent had injected drugs in the previous month. In addition, 62 percent of the women who were sexually active in the previous month had not used a contraceptive. Twelve months into the program, seven focus groups were conducted with 65 women and men to learn more about their opinions and attitudes related to contraceptives and family planning services in general. The discussions revealed that many of the participants were unsure what family planning services included, saw no need for such services or had had prior negative experiences with health care providers. There was also a great deal of misinformation about contraceptives and the effects they have on health. PMID- 1786808 TI - Number of siblings and personality. PMID- 1786809 TI - Antiprogestins and the abortion controversy: a progress report. PMID- 1786810 TI - Clandestine abortions are not necessarily illegal. PMID- 1786811 TI - [The anticonvulsant activity of digoxin in rats of different ages and in mice]. AB - The anticonvulsant activity of digoxin was studied on rats of different ages and mice. Cramps were simulated by using electroshock or a subcutaneous administration of bemegrid or corasol. The effect of digoxin (in the doses amounting to 1/10 or 1/2 of LD50) on the time of the onset of cramps, the duration of tonic and clonic phases as well as the number of the deceased animals was evaluated. The detected anticonvulsant effect of digoxin is explained by its influence on the activity of the membrane Na+, K+, ATP-ase and K+ conductivity. PMID- 1786812 TI - [The antihyperalgesic and selective analgesic effects of neurotropin]. AB - In experiments of albino rats neurotropin injection was shown to increase the latency of the tail-flick test in response to the nociceptive thermal stimulus and didn't change the threshold of the test in response to the nociceptive electroskin stimulus. The administration of the antiserum to beta-endorphin lowered the threshold and the latency of the tail-flick test in response to both stimuli. The preliminary administration of neurotropin reduced the hyperalgesic effect of the antiserum on both nociceptive stimuli. PMID- 1786813 TI - [Neurotropin suppression of the manifestations of the naloxone-provoked withdrawal syndrome in morphine-dependent rats]. AB - Neurotropin was developed by Nippon Zoki Pharmaceutical Co. Ltd. It is produced by inoculating vaccine virus into rabbits and the effective substances are extracted from neuro-immuno inflamed cutaneous tissue. In the present study it was found that intraperitoneally administered neurotropin potently inhibits naloxone-precipitated withdrawal syndrome in morphine-dependent rats. Also we get the experimental evidence that neurotropin increases morphine action but has no positive-reinforcing properties. These data indicate the possibility of testing neurotropin as a medicine for treating opiate-abused patients. PMID- 1786814 TI - [A comparative evaluation of the anti-ischemic action of verapamil in different models of myocardial ischemia]. AB - The effectiveness of the anti-ischemic effect of verapamil was studied on models of coronary spasm (the test with dihydroergotamine) and microthrombosis of the coronary arteries (the test with ADP). The results of the performed studies showed that verapamil exerts the anti-ischemic effect at administration of dihydroergotamine and ADP. The most pronounced effect of verapamil was demonstrated on the model of myocardial ischemia due to coronary spasm. PMID- 1786815 TI - [The antiacidotic and cardioprotective effects of fructose-1,6-diphosphate and dehydroascorbic acid]. AB - The antiacidotic and cardioprotective effects of dehydro-L-ascorbic acid and fructose-1,6-diphosphate were compared in experiments of rats. It was found that the both compounds exhibit the antiacidotic effect on the model of metabolic acidosis in the isolated hypoxic heart, decrease the excess-lactate degree, increase ATP level in the myocardium and reduce the size of the necrosis area 4 hours after the modelling of myocardial infarction. The significance of the antiacidotic component in the mechanism of the cardioprotective action of the energy-supplying agents is concluded. PMID- 1786816 TI - [The effect of pharmacological agents on the rate of lymph outflow and on blood and lymph toxicity in acute myocardial infarct]. AB - In experiments on rabbits it was found that acute myocardial infarction (AMI) was associated with a disorder of the drainage function the lymphatic system and a drastic increase of the lymph toxicity. The administration of propranolol (obsidan), amiodaron (cordaron), lidocaine (xycaine), trimecaine (mesocaine), nitroglycerin, panangin and heparin exerted the pronounced stimulating action on the lymph outflow rate. Strophanthin-K, corglycon and digo in possessed the moderate lymphogenic effect. Novocainamide (procainamide), verapamil (isoptine) and panangin exerted no influence on the lymph outflow rate. The administration of the above mentioned drugs in the initial period of AMI sharply increased the toxic properties of the lymph; subsequently the lymph toxicity gradually decreased and was less than in control (in AMI treated with drugs). PMID- 1786817 TI - [The effect of the flesinoxan subtype of serotonin C1a receptor agonist on the arterial pressure in rats]. AB - The effect of a high-affinity C1A serotonin receptor agonist flesinoxan on the arterial blood pressure and the heart rate in normotensive Wistar rats, spontaneously hypertensive rats and inherited stress-induced arterial hypertension rats was studied. It was shown that both peripheral and central administration of flesinoxan produces a decrease of blood pressure and heart rate. However, a reduction of heart rate was more pronounced at the drug peripheral administration. The sensitivity to flesinoxan in the hypertensive rats was greater than in the normotensive rats. PMID- 1786818 TI - [The effect of a combination of N-propylajmaline bromide and trimecaine on heart arrhythmias of different origins and on the electrophysiological parameters of the myocardium]. AB - In experiments on dogs and cats with disorders of the atrial and ventricular rhythms of various genesis the combination of N-propylaymalinebromide and trimecaine (the antiarrhythmic drugs of classes IA and IB) was found to potentiate the antiarrhythmic action. This effect was studied in electrophysiological experiments by using the microelectrode technique or on the dog and rat myocardium tissue. The combination of the antiarrhythmic drugs was shown to exert a more significant effect on some electrophysiological parameters determining the arrhythmic readiness of the myocardium. PMID- 1786819 TI - [The effect of ethacrynic acid on the functions of the gastrointestinal tract]. AB - During in vitro and in situ experiments ethacrynic acid was shown to reduce the gastric secretion in rats, motility of the small intestine in rats and mice, contractions of the ileum of guinea pigs in response to histamine and acetylcholine. The intestinal water and electrolyte absorption in rats decreased too. All these effects of ethacrynic acid are extrarenal. PMID- 1786820 TI - [The effect of microsomal enzyme inducers on the renal transport of iodamide]. AB - On the 3rd day after the last administration of phenobarbital (50 mg/kg orally, 4 days), benzonal (35 mg/kg orally, 4 days), zixorine (200 mg/kg orally, 4 days) and 3-methylcholanthrene (20 mg/kg subcutaneously, 2 days) the rats exhibited a decrease of iodamide secretion in the kidneys. The administration of zixorine to the dog (200 mg orally, 6 days) led to a significant decrease of iodamide transport in the first two weeks after discontinuation of the drug administration. PMID- 1786821 TI - [The mechanism of the thymolytic action of anabolic steroids]. AB - The administration of testosterone and metandrostenolone to male rats in doses of 10 and 20 mg/kg for 10 days produced a decrease of the thymus mass and a reduction of the thymic serum factor content. A phytoecdisteroid ecdisterone not possessing the androgenic activity fails to influence the thymus mass and the content of the thymic serum factor. PMID- 1786822 TI - [The effect of the adamantylamides of 1,3-diphenylpyrazole-4-carboxylic acids on the cytochrome P-450 system of the liver]. AB - The effect of adamanthylamides of 1,3-diphenylptrazol-4-carbonic acids on the system of the liver microsomal monoxygenases was studied. A potent induction of the liver cytochrome P-450 by 1,3-diphenylpyrazol-5-methyl-4-carbonic acid, N methyl-N-(adamant-1-il)amide was found. As a consequence of the induction of the liver cytochrome P-450, the compound reduced by 40% the degree of the delayed type hypersensitivity in mice. PMID- 1786823 TI - [Pentosephosphate cycle metabolites as energy-supplying anti-ischemic agents]. AB - A brief review of the experimental data on the energy-yielding effects of pentose phosphate cycle metabolites is presented. The cardiotropic effects of NADP, fructose-1,6-diphosphate, fructose-6-phosphate, D-ribose and ribose-5-phosphate were analysed with relation to their influence on viability of the ischemic myocardium. PMID- 1786824 TI - [The effect of mildronate on carnitine-dependent and carnitine-independent ketogenesis in rats]. AB - Mildronate of 3-(2,2,2-trimethylhydrozinium)propionate, a novel anti-ischemic drug, inhibits the biosynthesis of carnitine from Y-butyrobetaine. Continuous administration of mildronate (200, 400 mg/kg for 10 days orally) to rats exerted a marked antiketogenic action on the animals deprived of food for 48 hours. In the fed rats receiving sodium octanoate a course treatment with mildronate elevated to concentration of ketone bodies in blood serum. Selective regulation of carnitine-independent and carnitine-dependent metabolism appears justified for the treatment of such pathological states as ischemic heart disease, diabetes and obesity. PMID- 1786825 TI - [The anti-inflammatory activity of structural analogs of the platelet-activating factor]. AB - The pro- and anti-inflammatory activity of new structural analogues of the platelet-activating factor (PAF) was studied. It was found that three PAF analogues inhibit PAF-induced rat paw edema in a dose-dependent manner. The anti inflammatory activity of one of the PAF analogues upon PAF- or carrageenan induced inflammation was comparable or in some extent exceeded that of dexamethasone. PMID- 1786826 TI - [The effect of antibiotics on the function of type-II and -III glucocorticoid receptors]. AB - The effects of antibiotics on functioning glucocorticoid receptors of types II and III of male Wistar rat liver cytosol were studied. All the studied antibiotics at the concentration of 10(-3) M increased 1.6-2.4 times the function of glucocorticoid receptors of type III. At the concentration of 10(-4) M, except cephazolin and kanamycin, all antibiotics also enhanced the function of glucocorticoid receptors of types III, although to a lesser degree than at the concentration of 10(-3) M. The influence of antibiotics on the function of glucocorticoid receptors of type II is diverse. If antibiotics of penicillin and cephalosporin group increased, antibiotics of streptomycin, rifamycin, aminoglycosides and levomicetine group, on the contrary, decreased the function of type II glucocorticoid receptors. The practical importance of the agents regulating the function of glucocorticoid receptors is discussed. PMID- 1786827 TI - [The pharmacokinetic characteristics of the new psychotropic preparation with nootropic action ONK-10 in the progeny of alcoholized animals]. AB - There were found significant differences in the pharmacokinetics of a new psychotropic drug with nootropic action ONC-10 following a long-term administration to the offspring of the intact animals as compared with the pharmacokinetics after a single administration: an increase of the drug content in plasma with a simultaneous decrease of clearance and the volume of distribution. A long-term administration of ONC-10 to the offspring of the alcoholized animals led to a decrease of the plasma drug level that was related to not only an increase of the constant of elimination and clearance of the drug but also an enhancement of the processes of its biotransformation and the appearance of the main metabolite. PMID- 1786828 TI - [The dynamics of prednisolone and dexamethasone distribution and metabolism in the body of white rats]. AB - The processes of elimination and distribution of the synthetic steroidal drugs prednisolone and dexamethasone in the internal organs of Wistar rats were studied by the method of radioisotopes and high performance liquid chromatography. It was shown that the main route of excretion is the elimination with the urine. Prednisolone does not undergo conjugation and dexamethasone is glucuronidated by approximately 20%. The conclusion is made about the dependence of the main pharmacokinetic parameters on the concrete route of metabolism of each drug. PMID- 1786829 TI - [The characteristics of gentamycin distribution when administered endolymphatically in an experiment]. AB - Gentamicin distribution in some tissues of the abdominal cavity one hour after the intralymphovasal and intranodular administration to 32 rabbits was studied. The experiments were performed under conditions of the blocking and external drainage of the thoracic lymphatic duct. It was found that the optimal bacteriostatic concentrations were reached at both intralymphovasal and intranodular administration. PMID- 1786830 TI - [Therapeutic monitoring in the individualized monotherapy with benzonal of epilepsy patients]. PMID- 1786831 TI - [The lithium concentration of the blood plasma in combined therapy with lithium carbonate and carbamazepine]. AB - In view of the fact that therapy of affective psychoses with the combination of lithium carbonate with carbamazepine has been becoming ever common, the question arises about the influence of carbamazepine on plasma lithium concentration. On the material of 125 blood samples by using the method of dispersion analysis it was shown that carbamazepine exerts no effect on this parameter. Therefore when carbamazepine is added to lithium therapy it is not advisable to decrease lithium dose as it can result in a reduction of the therapeutic effect. PMID- 1786832 TI - [The dynamics of the cerebral circulation and of brain functional activity in patients with initial atherosclerotic encephalopathy under the influence of a single intravenous administration of sermion]. AB - The efficacy of sermion was studied in 41 patients of the middle and elderly ages. The reactive changes in the parameters of the cerebral circulation (the frontomastoidal RhEG), total hemodynamics, frequency-integration characteristics of EEG and visual evoked potentials at the administration of 2 mg and 4 mg of sermion were shown. There are given recommendations for the differential approach to the choice of the drug doses in the elderly persons taking into consideration the parameters of the background reactivity of the CNS and the state of vascular regulation. PMID- 1786833 TI - [Sublingual nitroglycerin: the pharmacokinetic changes following long-term treatment with trinitrolong and nitroderm-TTS]. AB - The effect of the long-term use of prolonged medicinal forms containing nitroglycerin (NG)--trinitrolong and nitroderm-TTS on the pharmacokinetics of sublingual NG was studied. A significant change of the pharmacokinetic parameters at the sublingual use of NG both after the long-term treatment with trinitrolong and after therapy with nitroderm was observed: in both cases the time of half release of NG from plasma and the average time of retention increased, the area under the curve of concentration-time significantly increased and the drug clearance decreased (for trinitrolong the difference in the clearance parameter is significant). While combining the data on both drugs the difference in the last two parameters also becomes significant. The observed slowing of elimination is probably the cause of the development of tolerance to NH at the long-term treatment, since according to the modern notions the degree of the effect is determined by the rate of NG metabolism. PMID- 1786834 TI - [A case of sustonit poisoning]. PMID- 1786835 TI - [Diethylnicotinamid (cordiamine) stabilization of the liver hydroxylating function in rabbits with CCl4 poisoning]. AB - Three and ten days after the administration of CCl4 (subcutaneously, once, 4 ml/kg of 50% oil solution) there were found a decrease of the rate of antipyrine elimination (intravenously, 50 mg/kg) from the blood plasma, an increase of the total bilirubin content, ALT activity and stimulation of lipid peroxidation processes. Cordiamine administration (subcutaneously, twice a day, 3 and 10 days) exerts the normalizing effect. PMID- 1786836 TI - [The subject of pharmacokinetics and its methodological problems]. AB - Recently the article by V. A. Gor'kov and Iu. F. Krylov has been published (Farmakol. i. Toksikol.--1989.--No. 6.--p. 19-25) in which some methodical problems of pharmacokinetics were considered as well as the question of the subject of the discipline. The alternative viewpoint of some of the covered problems is presented. In particular, the opinion of the priority of the applied trend in pharmacokinetics over the fundamental one is contested. PMID- 1786837 TI - [The mechanism of the anti-ischemic protection of the kidneys by diuretics]. AB - The review presents the literature data on the mechanism of the protective action of diuretics in ischemic damage of the kidneys. The role of changes in the renal blood flow, glomerular filtration, oxidative metabolism of the kidney epithelium in the increase of resistance of the kidneys to circulatory hypoxia is analyzed. Great importance of sodium excretion and the corresponding change in hydrodynamics of nephrons in prevention of the damage of the specialized structures of the kidney cells, nephrons, in normalization of the kidney function in the postischemic period is emphasized. PMID- 1786838 TI - [The influence of melatonin, epiphysectomy and anaprilin on the cataleptogenic effect of haloperidol and its time dynamics]. AB - The acute administration of the pineal hormone melatonin (1 mg/kg) to rats was shown to increase, and the chronic use to decrease intensity of haloperidol induced catalepsy with the reorganization of the rhythmic pattern of the neuroleptic effect. The direct opposite shifts were observed after pinealectomy or propranolol chronic administration (1 mg/kg). It is suggested that owing to its own adaptive properties the pineal gland can participate in the formation of drug tolerance. PMID- 1786839 TI - [Immunodepressants used in immune system pathology. I. Cyclosporin, cyclophosphane, azathioprine and mercaptopurine]. AB - The data on immunodepressants most commonly used in the Soviet Union in the diseases caused by disorders in normal function of the immune system are presented. Such drugs as cyclosporine A, cyclophosphan, azatioprine, 6 mercaptopurine are considered. Emphasis is given to the mechanism of the primary pharmacological response of the drugs to the immunocompetent cells, the grounding of their clinical use, dosage and mechanisms of possible side effects. PMID- 1786840 TI - Wegener's granulomatosis. PMID- 1786841 TI - The differential diagnosis of erythema nodosum. AB - Erythema nodosum is an uncommonly seen skin eruption which may be a marker of underlying systemic or infectious disease. It may also occur as a reaction to a variety of medications. The diagnosis of erythema nodosum should prompt a thorough investigation of possible causes or associated conditions which may be treatable. This paper presents a case of erythema nodosum and reviews the differential diagnosis of its causes and of similar appearing skin lesions. PMID- 1786842 TI - Influenza immunization recommendations for Delaware. PMID- 1786843 TI - Advance directives. PMID- 1786844 TI - Ovine trophoblast protein-one: evidence for possible glycosylation. AB - 1. The polymerase chain reaction has been used to amplify specifically the cDNA coding for the secreted form of ovine trophoblast protein-one from a preparation of total cellular RNA extracted from sheep embryos removed from ewes 16 days after mating. 2. Cloning and sequencing of the amplified cDNA revealed two new sequence variants: SPW49 having 93% similarity with deduced amino acid sequences from published cDNA data, and SPW27 a variant coding for a deleted form of ovine trophoblast protein-one. 3. The gene for ovine trophoblast protein-one is intronless. 4. This study provides further evidence for the existence of an ovine trophoblast protein-one gene family. 5. Both variants contain a potential N glycosylation site not apparent in published sequences for ovine trophoblast protein-one. PMID- 1786845 TI - Different porphobilinogen-deaminase forms in wild and mutant strains of Saccharomyces cerevisiae. A possible correlation with its segregants behaviour. AB - 1. Different porphobilinogen-deaminase (PBG-D) enzyme forms were found for D 27 and D 27/C6 (HEM R+) strains of Saccharomyces cerevisiae. 2. PBG-D was partially purified and chromatographed on Sephadex G-100 in either the presence or absence of a protease inhibitor. For D 27 only one active peak was observed while for D 27/C6 strain two active peaks were found. 3. A correlation between this differential behaviour and the presence of HEM R+ gene was looked for employing two segregants of one tetrad from D 27 and D 27/C6 mating. PMID- 1786846 TI - The response of rat liver lipid peroxidation, antioxidant enzyme activities and glutathione concentration to the thyroid hormone. AB - 1. In liver microsomes from hyperthyroid rats NADPH-dependent lipid peroxidation induces a hydroperoxide formation 56% higher than that in euthyroid ones. 2. The addition of 5 microM Fe2+ (or Fe3+) strongly decreases the hydroperoxide level in favour of that of TBA-reactive substances. Higher iron concentrations (30 microM) have no significant effect. 3. In hepatocytes from hyperthyroid rats CCl4-induced lipid peroxidation produces an amount of TBA-reactive substances four times higher than that in those from euthyroid rats. 4. In the liver of hyperthyroid rats a GSH concentration decrease (by about 35%) is found while the opposite occurs in the blood of the same animals where GSH increases 2.5 times. 5. It is shown that in the liver of hyperthyroid rats, besides higher lipid peroxidation, a more active defense mechanism is operating since both glutathione peroxidase and glutathione reductase specific activities are higher than in euthyroid rats. PMID- 1786847 TI - Inhibition of nuclear T3 binding by fatty acids liberated from nuclear membranes via phospholipase C. AB - 1. We have investigated whether phospholipase C (PLC) might act on phospholipids in the nuclear membrane of rat liver, resulting in inhibition of nuclear T3 binding (INB activity). 2. Incubation of intact nuclei with PLC caused a time- and dose-dependent increase of INB activity; this was correlated with a rise of the free fatty acid concentration in the nuclear ether extract. 3. Removal of the nuclear membrane resulted in a loss of INB activity of the nuclei. 4. Other compounds liberated by the action of PLC (such as diacylglycerols, IP3 and phosphoalcohols), had no INB activity. 5. We conclude that PLC can liberate fatty acids from the rat liver-nuclear membrane via further degradation of the direct product diacylglycerol. 6. These fatty acids display inhibition of nuclear T3 binding in vitro. PMID- 1786848 TI - Effect of glutathione manipulation on prostaglandin synthesis in renal medullary homogenates. AB - 1. The effect of glutathione (GSH) manipulation on arachidonic acid (AA) metabolism in renal medullary (RM) homogenates was investigated. 2. Diethyl maleate (DEM) depleted GSH initially by 50% (P less than 0.05) and produced a general suppression (P less than 0.05) of all PGs with the exception of TXB2. GSH was further depleted during homogenization and a 30-min incubation period (P less than 0.01). 3. Adding glutathione monoethyl ester (GSH-MEE) (0, 0.8, 1.6 or 3.2 mmol/ml) to RM homogenates increased GSH (P less than 0.01) and decreased RM homogenates' PGs-synthesizing capability (P less than 0.05), with the exception of PGE2 and TXB2 at the highest concentration. 4. The results indicate that homogenization has a significant impact (P less than 0.05) on GSH concentration of the media and alterations in GSH concentration affect the profile and quantity of AA metabolites in renal medullary homogenates. PMID- 1786849 TI - Purification and characterization of recombinant cell surface protein antigen A of Streptococcus sobrinus B13N. AB - 1. It has been reported that immunization of rhesus monkeys with the surface protein antigen I/II from Streptococcus mutans significantly reduced dental caries. 2. The surface protein antigen A (SpaA) from Streptococcus sobrinus is known to correspond antigenically to I/II. MD51 is an Escherichia coli host containing pMD51, a plasmid encoding the SpaA gene from Streptococcus sobrinus B13N. 3. The recombinant SpaA (rSpaA) was purified from cell extracts of Escherichia coli clone MD51. 4. The purified recombinant SpaA was homogeneous with a molecular weight of 210 kDa according to SDS-PAGE and had an isoelectric point of 4.2 based on isoelectric focusing. 5. Amino acid composition of rSpaA showed a relatively high amount of hydrophobic amino acids (39.7%). PMID- 1786850 TI - AMP deaminase from equine muscle: purification and determination of regulatory properties. AB - 1. AMP deaminase from thoroughbred horse muscle was purified to apparent homogeneity and its regulatory properties were determined at pH 6.5 and 7.4. 2. The results are discussed in relation to the potential role of muscle AMP deaminase during exercise and the existence of two molecular forms depending on the pH. PMID- 1786851 TI - A steady-state kinetic analysis of the reaction between arginine esterase E-I from Bitis gabonica venom and synthetic arginine substrates and the influence of pH, temperature and solvent deuterium isotope. AB - 1. Using synthetic arginines as substrates, steady-state kinetic studies showed a deviation from Michaelis-Menten kinetics for esterase E-I purified from the venom of Bitis gabonica. Graphical analysis indicated a rate equation of at least a degree of 3:3. 2. pH variation of the kinetic parameters indicated the involvement of groups with pK values of approximately 7 and approximately 9 which had to be in the ionic form for activity. 3. Solvent isotope studies suggested transition states where proton transfer or reorganization was the rate-limiting step of proteolytic catalysis. A single protogenic site was postulated. 4. Temperature effects on the enzymic reaction showed a significant reduction in entropy loss upon formation of the transition state with both esters and extended tail polypeptide-anilides in comparison with the activation entropy for benzoyl-L arginine p-nitroanilide. PMID- 1786852 TI - Inactivation of arginine esterase E-I of Bitis gabonica venom by irreversible inhibitors including a water-soluble carbodiimide, a chloromethyl ketone and isatoic anhydride. AB - 1. Esterase E-I from Bitis gabonica was inactivated with irreversible inhibitors which included studies with a water-soluble carbodiimide, an affinity labelling peptide and a mechanism-based inactivator. 2. The reaction with 1-ethyl-3(3 dimethylaminopropyl)-carbodiimide was biphasic and the dominant part followed saturation kinetics. At pH 5.5 a rate constant of 0.4 min-1 for inactive enzyme formation was calculated and a dissociation constant (Ki) of 0.2 M for the enzyme inhibitor complex. 3. Inactivation with D-Phe-Pro-Arg-chloromethyl ketone indicated a two-step mechanism, for which the reaction parameters at pH 8.0 were determined. The Ki value was 0.2 microM and the inactivation rate was 2.5 min-1. 4. With isatoic anhydride pseudo-first-order kinetics was observed. At pH 8.0 a rate constant of 0.9 min-1 and a Ki of 2.0 mM were obtained. The inactivation of the enzyme was found to be governed by a group in the enzyme showing a pK value of 7.3. PMID- 1786853 TI - Acid phosphatases in the frog (Rana esculenta) skeletal muscle. Purification and some properties of the low molecular weight enzyme. AB - 1. The presence of high-Mr and low-Mr acid phosphatases [orthophosphoric monoester phosphohydrolase, (acid optimum), EC 3.1.3.2] in the skeletal muscle of frog Rana esculenta was reported. 2. The subcellular localization and some characteristics of both enzymes were also described. 3. The low-Mr AcPase was purified to homogeneity. The enzyme did not absorb on Concanavalin A-Sepharose 4B indicating that this was not a glycoprotein. 4. The enzyme is homogeneous on polyacrylamide gel electrophoresis and moves as a single band of Mr 13.7 +/- 0.8 kDa in the presence of sodium dodecyl sulphate. 5. The Mr of the native enzyme was 14.0 +/- 1.1 kDa as determined by gel filtration on a Sephadex G-100 column. The isoelectric point was 6.02. 6. The enzyme was strongly inhibited by 1 mM Ag+, Hg2+, Sn2+ and Cu2+ while other cations both at 10(-2) and 10(-3) M showed little or no effect. 7. The enzyme was insensitive to NaF and tartrate but was strongly deactivated by formaldehyde, PMB, Iodoacetamide and Triton X-100. Phosphate was a competitive inhibitor (k1 = 0.83 mM). 8. The best substrate for the enzyme was p nitrophenylphosphate but phenylphosphate, flavin mononucleotide and o-P-tyrosine were also hydrolyzed, though at different rates. 9. The enzyme activity was enhanced in the presence of methanol, ethanol, acetone and glycerol indicating a phosphotransferase activity. PMID- 1786854 TI - A comparison of the properties of 5'-nucleotidase purified from the cytosolic and synaptic plasma membrane fractions of rat forebrain. AB - 1. 5'-Nucleotidase was purified 1247-fold from the post-microsomal supernatant (I) and 3862-fold from the synaptic plasma membrane (II) of rat brain homogenates. 2. The apparent molecular masses of I and II were 131 and 72 kDa respectively by polyacrylamide gel electrophoresis in the presence of sodium dodecylsulphate and 268 and 286 kDa respectively by Sephacryl S-300 chromatography. 3. The activities of both I and II were strongly inhibited by concanavalin A but were affected differently by digestion with glycosidases. for II, these were 0.083 and 0.056 mM respectively. 5. Activities of both I and II were strongly inhibited by ATP and ADP. PMID- 1786855 TI - Ethanol-acetylcholinesterase-inhibitor interactions: inhibitor hydrophobicity and site specificity dependence. AB - 1. Depending on the hydrophobicity and the site specificity of an inhibitor, striking differences were found in ethanol-acetylcholinesterase (AChE)-inhibitor interactions. 2. AChE used was from electric eel and was purified by affinity chromatography. 3. Ethanol at 10-200 mM reduced the inhibitory ability of tetrabutylammonium bromide (Bu4NBr). 4. The observed reduction might be a result of Bu4NBr inhibition being partially compensated for by an ethanol activation effect. 5. In contrast to Bu4NBr, propidium and edrophonium are not involved in hydrophobic interaction with AChE. 6. Their abilities to inhibit AChE activity were enhanced by ethanol. 7. Such an enhancement could not result from combining individual perturbations from ethanol and propidium or edrophonium, since ethanol itself increased the AChE activity. 8. In the presence of ethanol, propidium which binds to the peripheral site of the enzyme remained as an uncompetitive inhibitor, while edrophonium which binds to the active site was changed from a competitive inhibitor to a mixed one. 9. The effect of ethanol was therefore greater in the inhibitor which is involved with the active-site binding. 10. Fluorescence quenching studies of propidium-bound enzyme and edrophonium-bound enzyme revealed that ethanol in the concentration less than or equal to 400 mM did not cause significant conformational change at both the peripheral and the active sites of the enzyme. PMID- 1786856 TI - A new purification procedure for bovine C-reactive protein and serum amyloid P component. AB - 1. A new purification procedure was started with salting-out fractionation of serum proteins at 45-75% saturated ammonium sulfate concentration, followed by HE agarose affinity chromatography by which calcium-dependently bound CRP and SAP were purely eluted with EDTA-containing buffer. 2. Pure CRP and SAP were finally separated by DEAE-5PW HPLC. 3. This procedure gave recovery of 15 and 26%, and fold purification of 2650 and 2400 for CRP and SAP, respectively. 4. Each subunit of CRP and SAP had one intrasubunit disulfide bond, determined by reduction and carboxymethylation. PMID- 1786857 TI - Regulatory properties of AMP deaminases from rat tissues. AB - 1. Phosphocellulose column chromatography under double gradient conditions (phosphate and KCl) revealed two forms of AMP deaminase in rat heart and brain and a single form in the liver and skeletal muscle. 2. Kinetically all purified AMP deaminases were classified into two categories: those, which elute from the column at lower KCl and Pi concentrations, display low S0.5 value are only moderately affected by MgATP, MgGTP and Pi; and those which elute at higher KCl and Pi concentrations, display high S0.5 values and are strongly regulated by allosteric effectors. 3. Physiological significance of the occurrence of two kinetic forms of AMP deaminase in some tissues is discussed. PMID- 1786858 TI - Specific antibodies against the stress-inducible 72-kDa protein, a member of the heat-shock protein hsp70, in healthy human subjects. AB - 1. On Western blot analysis, serum IgG from a healthy human subject reacted with a stress-induced protein, having an apparent molecular mass of 70 kDa, from PC12 cells. 2. This serum IgG also reacted with hsp70 (70-kDa heat-shock protein) purified from the bovine brain. 3. In 5 out of 34 healthy human subjects, IgG antibodies against hsp70 were detected. 4. These antibodies were directed against the stress-inducible 72-kDa protein, but did not cross-react with the constitutive 73-kDa protein. PMID- 1786859 TI - Two new extracellular serine proteases from Streptomyces fradiae. AB - 1. Two new extracellular serine proteases have been purified to homogeneity from Streptomyces fradiae. 2. On amino acid sequencing, striking homology is observed between the first enzyme and Streptomyces griseus Protease A, and the second enzyme and S. griseus trypsin. 3. The sequence information shows for the first time that structurally and enzymatically related serine proteases are extracellularly expressed by different Streptomycetes. 4. Differential keratinolytic substrate specificity among these two microbes are probable due to a difference in disulfide reduction capacity. PMID- 1786860 TI - Differences in the arginase activity produced by resident and stimulated murine and rat peritoneal macrophages. AB - 1. Murine macrophages showed a considerably higher in vitro arginase production in short time cultures than rat peritoneal cells. 2. The in vivo stimulation with casein or thioglycollate resulted in an enhanced in vitro enzyme production in mice. 3. The adherence is not the condition of the enzyme production. 4. The difference between the two species cannot be explained by the lack of bivalent ions, the absence of energy supply, proteolysis, the low number of macrophages or by the different cell types of the peritoneal exudate of mouse and rat. 5. The lysozyme production of murine and rat peritoneal macrophages was also investigated and no difference was observed between the two species. PMID- 1786861 TI - [Individual features of the response of the human cardiovascular system during adaptation to high altitude]. PMID- 1786862 TI - [Effect of bemitil on metabolic processes and work capacity at high altitude]. PMID- 1786863 TI - [A method for integral assessment of the effect of the industrial environment on miners' bodies]. PMID- 1786864 TI - [Zone of thermal neutrality during seasonal adaptation of man to high temperature]. PMID- 1786865 TI - [Correlations between blood flow in brain, skeletal muscles and skin]. PMID- 1786866 TI - [Principles of functioning of human body systems and their application in practical medicine. Part I]. PMID- 1786867 TI - [Assessment of immune reactivity of the body on the basis of analysis of intersystem interrelationships]. PMID- 1786868 TI - [Change in the functional activity of the immune system in coal miners as a function of length of service]. PMID- 1786869 TI - [Psychological features of patients after acute radiation sickness caused by the accident at the Chernobyl nuclear power station]. PMID- 1786870 TI - [Role of oscillation synchronization in the regulatory mechanisms of cardiovascular system]. PMID- 1786871 TI - [Review of V. I. Pronin's article "Role of oscillation synchronization in the regulatory mechanisms of the cardiovascular system]. PMID- 1786872 TI - [Dependence of functional parameters on hemolytic stability of erythrocytes in the assessment of the adaptation state]. PMID- 1786873 TI - [Relationship between alveolar and pleural pressures during forced expiration]. PMID- 1786874 TI - [Early symptoms of decreased resistance to passive orthostatic load]. PMID- 1786875 TI - [Effect of prolonged hypokinesia and weightlessness on the functional state of human skeletal muscles: use of the "electromechanical effectiveness" criterion]. PMID- 1786876 TI - [Redistribution of circulating blood during a change in the position of the human body as a function of the level of hydration]. PMID- 1786877 TI - [Auditory evoked potentials and perception of a moving auditory image in patients with epileptic damage in the temporal lobe of the brain]. PMID- 1786878 TI - [Wide-band multi-channel electrogastrography and periodic motility of the gastro intestinal tract]. PMID- 1786879 TI - [Study of food dominants by means of a verbal test]. PMID- 1786880 TI - [Circadian rhythm of arterial pressure: chronobiological criteria for normotension and hypertension]. PMID- 1786881 TI - [Medical historiography at the time of the Revolution: the French and Italian experience]. AB - After a brief hint at the history of medical historiography from Hippocrates to the age of the French Revolution, the author compares the Italian and French contributions published at the end of the XVIIIth century. In that century, history of medicine shows annalistical, bibliographical and methodological trends. In France, with Pinel and Cabanis, it has a predominantly methodological character, as thought by Cullen. Also in Italy, where the interest for this discipline arises somewhat later than in other European countries, the French methodological model is accepted. PMID- 1786882 TI - [The mentally ill artist in the work of E. T. A. Hoffmann in relation to psychological theories at that time]. AB - The work of one of the greatest writers of German Romanticism, E.T.A. Hoffmann, incorporates a great deal of current medical knowledge, which Hoffmann used in a skillful and detailed manner in the portrayal of his characters and their motives. Immersed as he was in contemporary medical practice, an interest fuelled by his own deep-seated hypochondria, he was particularly taken with the works of Philippe Pinel, Johann Christoph Reil, Carl A.F. Kluge, and Gotthelf Heinrich Schubert, who were all interested in the working of the mind. This article demonstrates how attention to Hoffmans's medical reading list offers insights useful for critical understanding of his work, using as an example the analysis of the mad goldsmith Cardillac in one of Hoffmann's most famous stories, 'Das Fraulein von Scuderi'. PMID- 1786883 TI - [Census of mentally ill and founding of psychiatric clinics in the 19th century. Bern as the example for other Swiss cantons]. AB - Psychiatry developed into an independent branch of medicine during the last century also in Switzerland. In most cantons statistics of the mentally abnormal were set up. In this way, responsible physicians proved to the authorities and to their fellow citizens the need for State lunatic asylums. In this respect, the medical practitioners in the Canton of Berne were pioneers. PMID- 1786884 TI - [Alfred Graefe and antisepsis in ophthalmology]. PMID- 1786885 TI - [Resection prosthetics for free bone transplantation. Prerequisites for establishing a bone transplantation concept of the mandible]. AB - The present paper examines the development of dental and surgical methods for the reconstruction of bone defects in the lower jaw. Starting with the resection prosthesis we highlight important stages of bone transplantation in the lower jaw. Until 1914, actually no concept existed for reconstruction of continuity in the lower jaw. Only when dentists and surgeons started working together in the First World War, a bone-transplantation concept for the lower jaw could be elaborated. PMID- 1786886 TI - [Psychopathology in Ethiopian Jewish immigrants]. AB - In 87 of 352 adult Ethiopian Jews living in Natanya who immigrated recently, psychopathological symptoms were evaluated and their relationships to conditions of immigration and absorption were determined. They were interviewed by Ethiopians who had immigrated previously and who had been trained to help them complete questionnaires at home. The subjects were rated by the interviewers according to the Physician's Outpatient Psychopathology Scale (211-O.P.S.), as well as by 3 other self-rating scales with regard to satisfaction with their life in Israel, events that had occurred while en route to Israel, and frequency of visits to their clinic family physician. The results showed a high incidence of psychopathological symptoms which had persisted even after 5 years in Israel. The main causes of dissatisfaction (found in more than 60% of the sample), in order of severity were: achievement in learning Hebrew, financial situation, attitude of the Israeli religious institutions towards the Ethiopian community, and the degree of nonobservance of religious customs by other Israeli Jews. There was a high degree of correlation between psychopathological symptoms and suffering on the journey to Israel, with the symptoms usually becoming less severe with length of stay in Israel. A high incidence of symptoms was also related to increased age and to low levels of education. Those living in apartments dispersed among the general population suffered less from psychopathological symptoms than those living in buildings largely occupied by other Ethiopian immigrants. PMID- 1786887 TI - [Complications of third stage labor and the puerperium in preterm and term deliveries]. AB - Preterm delivery is the leading cause of perinatal morbidity and mortality worldwide. The purpose of the present study was to determine whether preterm delivery is associated with complications of the third stage of labor and of the puerperium. Retained placentas occurred more frequently in 99 women with preterm vaginal delivery than in 97 with term vaginal delivery (13.1% vs 1%, p = 0.003). There was a higher rate of endometritis in women delivering before term than in those delivering at term (10.1% vs 0%, p = 0.004). This study indicated that preterm labor and delivery is associated with higher rates of perinatal morbidity and mortality and with an increased risk of maternal complications. PMID- 1786888 TI - [Heat stroke associated with massive hepatic necrosis]. AB - Heat stroke in a 21-year-old soldier was complicated by acute renal failure with rhabdomyolysis, hypophosphatemia, hypocalcemia, sinus bradycardia and massive liver necrosis. Treatment included general supportive measures, forced alkaline diuresis and IV fresh frozen plasma and cryoprecipitate and was followed by complete recovery. PMID- 1786889 TI - [Lithium carbonate augmentation in tricyclic antidepressant-resistant depression]. AB - Combinations of lithium carbonate and tricyclic antidepressants are effective in the treatment of resistant unipolar depression. We present a case in which addition of lithium carbonate to a maximal dose of desipramine provided rapid and sustained improvement in a severely depressed 57-year-old woman. She had previously failed to respond to maximum doses of antidepressant drugs of 2 different classes. Although the lithium-tricyclic combination was successful in our case, we caution against its routine use. PMID- 1786890 TI - [Splenic subcapsular hematoma and long-term hemodialysis]. AB - Uremic patients, or those on maintenance hemodialysis, are at increased risk for spontaneous bleeding. Manifestations include retroperitoneal, costal, hepatic, renal, pericardial, mediastinal and subdural hemorrhages. We describe 2 patients on chronic hemodialysis, a 45-year-old man and a 50-year-old woman. Each developed a subcapsular hematoma of the spleen, diagnosed by sonography and CT scan. They were conservatively managed by low-dose heparin, bed rest and careful monitoring. Frequently repeated ultrasound and CT scans demonstrated complete resolution of the hematomas after 2 and 4 months, respectively. PMID- 1786892 TI - [Computed tomography in the diagnosis of popliteal artery entrapment syndrome]. AB - Popliteal artery entrapment syndrome (PAES), a rare cause of lower limb ischemia, is due to an anomalous relationship between the popliteal artery and the gastrocnemius muscle in the popliteal fossa. Hypertrophy of the muscle, or its anomalous insertion, can displace or compress the artery, leading to stenosis or obstruction. It is clinically manifested by intermittent claudication and most often occurs in young, healthy men. Arteriography is the method of choice to demonstrate vascular lesions, but it can only visualize change in the course of vessels or intrinsic lesions. Due to its high spatial and density resolution, CT scan can differentiate between bony structures, vessels, muscles, and fatty tissue in the popliteal fossa. It is therefore a very useful supporting examination in PAES and can demonstrate whether or not stenosis or occlusion of the artery results from causes outside the artery itself. PMID- 1786891 TI - [Tuberculosis of the middle ear]. AB - Tuberculosis is rare in Israel, especially that of the middle ear. Its rarity leads to both underdiagnosis and misdiagnosis. Since tuberculosis is treatable, diagnosis is of the utmost importance. The recent wave of immigration from countries in which tuberculosis is endemic may confront us with more cases of tuberculosis of this type. PMID- 1786893 TI - [Growth hormone reserve in infertile anovulatory women and its correlation with sensitivity to gonadotropins]. PMID- 1786894 TI - [Sudden death in the young]. PMID- 1786895 TI - [Neutrophil function in hematologic disorders]. PMID- 1786896 TI - [Classical dilemmas in choosing reliable indices for early identification of neurodevelopmental risk in newborns after intrauterine growth retardation]. PMID- 1786897 TI - [Primary pulmonary hypertension: new attitudes to an old disease]. PMID- 1786898 TI - [Breast developmental disorders and masses in childhood and adolescence]. PMID- 1786899 TI - [Renal involvement in glycogen storage disease type I]. PMID- 1786900 TI - [Partial and re-partial splenectomies in Gaucher disease. The rational surgical approach]. PMID- 1786901 TI - [Botulinum toxin as a powerful new tool in the treatment of focal dystonia]. PMID- 1786902 TI - [Importance of dust-mites in the pathophysiology of bronchial asthma]. PMID- 1786903 TI - [An approach to hypertension based on age and mortality rates]. PMID- 1786904 TI - Field observations of Goeldi's monkey, Callimico goeldii, in northern Bolivia. PMID- 1786905 TI - Occurrence of enamel hypoplasia in the dentitions of simian primates. PMID- 1786906 TI - Stability of wild callitrichid groups. PMID- 1786907 TI - Early Eocene Pelycodus danielsae: largest adapid in the oldest lemuriform adaptive radiation. PMID- 1786908 TI - Reproductive parameters of captive grey-cheeked mangabeys. AB - This paper reports reproductive parameters for 9 female grey-cheeked mangabeys kept in a captive colony over a 17-year period. Birth seasonality has shown a consistent trend towards an autumn peak. Oestrous cycles had an average length of 31.2 days: however 'short-cycle' (29.9 days) and 'long-cycle' (37.7 days) groups could be discriminated. Gestation was 175 days, with little variability. Variability in interbirth interval is mainly due to varying length of the cycling phase preceding the next gestation, suggesting influences of social factors. All these reproductive parameters are compared to those of baboons and macaques. Some conclusions about mangabey breeding colony management are drawn. PMID- 1786909 TI - Field methods for capture and measurement of three monkey species in Costa Rica. AB - A total of 54 free-ranging monkeys were captured and marked in Santa Rosa National Park, Costa Rica, during May 1985, and an additional 17 were captured during March 1986. The animals were darted using a blowpipe or a CO2 gun. The drugs used were Ketaset, Sernylan and Telazol. Ketaset was effective for Cebus capucinus but unsuccessful for Alouatta palliata and Ateles geoffroyi. Sernylan was successful for A. geoffroyi and A. palliata but is no longer commercially available. Telazol proved to be an excellent alternative capture drug for both A. palliata and A. geoffroyi. PMID- 1786910 TI - Social relationships between immigrant and resident bonobo (Pan paniscus) females at Wamba. AB - Social relations and behaviours of adolescent female pygmy chimpanzees (Pan paniscus) that migrated between unit groups were studied at Wamba, Zaire. Each immigrant female selected one particular resident female, a 'specific senior female' (SSF) and frequently approached and followed her. Affinitive behaviours (e.g. grooming, genitogenital rubbing) were frequently performed between the immigrant and her SSF. Most affinitive behaviours were more likely to be initiated by the immigrant than by her SSF. The immigrant's relationship with her SSF seemed to facilitate the immigrant's integration into the new unit group. Resident males actively approached and mated with the immigrant females. Copulation also appeared to further the immigrant's stable relationship with the resident males. PMID- 1786911 TI - Sexual selection, natural selection and copulatory patterns in male primates. AB - Complex copulatory patterns, involving multiple brief intromissions or prolonged single intromissions (PI) occur most frequently among primate species in which females mate with a number of partners (multimale and dispersed mating systems). However, the PI pattern is also confined almost exclusively to arboreal primates to either smaller-bodied, cryptic, nocturnal species or much larger diurnal forms. Predation pressures may have limited the evolution of the PI pattern, particularly where small-bodied diurnal primates or terrestrial forms are concerned. The available evidence indicates that both sexual selection and natural selection may have influenced the evolution of copulatory patterns. PMID- 1786912 TI - [Rheologic findings in patients with diabetic retinopathy]. AB - The rheological parameters hematocrit, plasma viscosity, red blood cell aggregation and blood cell rigidity were measured in 256 adult-onset (type II) diabetics. The stage of diabetic retinopathy was graded by means of ophthalmoscopy and videofluorescein angiography. The mean values of hematocrit (men 45 +/- 5%, women 42 +/- 5%) and red blood cell rigidity (1.01 +/- 0.08) were equal to those in normal subjects. Plasma viscosity (1.40 +/- 0.10) mPas, normals: 1.24 +/- 0.05 mPas) and red blood cell aggregation (16.0 +/- 4.2, normals: 14.6 +/- 3.2) were increased over the values in normals. The groups with different stages of diabetic retinopathy showed no difference in all rheological parameters. Plasma viscosity and red blood cell aggregation were determined partly by the levels of the large plasma proteins. In the type II diabetics fibrinogen was the most markedly elevated large plasma protein (4.1 +/- 1.2 g/l, normals: 3.2 +/- 0.6 g/l). Significant correlations were found between plasma viscosity and fibrinogen (0.49); plasma viscosity and alpha-2-macroglobulin (0.33); red blood cell aggregation and alpha-2-macroglobulin (0.28); and red blood cell aggregation and immunoglobulin M (0.25). The elevation of red blood cell aggregation and plasma viscosity may be one of the reasons for disturbed microcirculation and fundus changes in diabetic retinopathy. PMID- 1786913 TI - [Statistical evaluation of macular reflection spectra in normal and diabetic patients]. AB - The Jena ophthalmospectrometer was used to investigate type I and II diabetics with and without retinopathy and normal persons. Discriminant analysis allows separation of normals and diabetics with a high degree of sensitivity and specificity. In diabetics, spectrometric changes precede ophthalmoscopically visible changes. PMID- 1786914 TI - [Treatment of diffuse diabetic maculopathy with "grid pattern argon laser coagulation"]. AB - Sixty eyes of 42 patients with diffuse diabetic macula edema were treated with argon laser in a "grid pattern" mode. The eyes were divided into three groups according to the preoperative visual acuity. In the first group with a preoperative visual acuity of below 0.1 (23 eyes), after 6 months of follow-up, 5 eyes improved in function by at least two lines on a Snellen chart. In the second group with an initial visual acuity of 0.2-0.4 (20 eyes) 5 eyes showed improvement and in the group with a pretreatment visual acuity of 0.5 or more (17 eyes) 6 eyes improved in function. In the first group, the visual acuity did not worsen; in the second group it worsened in 4 eyes. Two eyes in the third group showed a worse visual acuity after treatment. Similar results were found after 1 year of follow-up (27 eyes). After a 2-year follow-up (13 eyes) 9 eyes had a stable visual acuity compared to the preoperative visual acuity. Even though the number of cases with a long follow-up was relatively small, our results show clearly that early application of argon laser coagulation for diffuse macular edema allows stabilization to be achieved and, in some cases, even improvement in the visual acuity. PMID- 1786915 TI - [Retinal photocoagulation in hemorrhagic retinal branch vein thrombosis. A new treatment technique]. AB - In branch vein occlusions involving the macula, the loss of macular function cannot be due to hypoperfusion of the involved capillaries, because if this were so the uninvolved part of the macula would presumably be unimpaired. The impairment of the macula is explained as follows. Congestion of the blood caused by the thrombosis means that the capillaries are exposed to high blood pressure. In the border zone of the thrombotic area capillaries that are normally drained are exposed to capillary hypertension. For this reason, the border zone of a retinal thrombosis is also affected. The perifoveal capillary network is usually in this border zone. We treated branch vein occlusions by perimacular photocoagulations on the blood in the inner retinal layer within the zone of the thrombosis. Our explanation for the gain in visual acuity following this procedure is that we occlude the retinal capillaries that are, passing on the high pressure into the perifoveal capillaries. Our proposed photocoagulation procedure is restricted to cases in which hemorrhage has led to enough blood in the inner retinal layer to coagulate. The destruction of the nerve fiber layer by this kind of photocoagulation has to be taken into account. The possible gain of visual acuity has to be balanced against the loss of function caused by destruction of parts of the nerve fiber layer. PMID- 1786916 TI - [Thrombospondin and its importance in proliferative retinal diseases]. AB - Thrombospondin (TSP), a platelet-derived protein of the integrin-binding family with adhesive and mitogenic properties was localized in surgically obtained epiretinal traction membranes from patients with traumatic (7/8) and idiopathic (8/8) proliferative vitreoretinopathy (PVR) and proliferative diabetic retinopathy (PDR) (6/8). Using double-label immunofluorescence techniques, we demonstrated co-localization of TSP with the endothelial cell marker, von Willebrand factor, in PDR; however, only a minority of labeled macrophages showed simultaneous staining for TSP. Therefore, macrophages are probably not a major source of TSP in PVR. We demonstrated co-distribution of blood coagulation factor XIII and two of its cross-linking substrates, fibronectin and TSP, in epiretinal membranes, as well as the detection of plasmin and presumably plasmin-induced TSP breakdown products in physiologic and pathologic vitreous. These results suggest that the coagulation system has a functional role in proliferative retinal disorders and imply that the application of inhibitors of the coagulation cascade like heparin may be a potential therapeutic approach. PMID- 1786917 TI - [Glial and neuronal cellular changes in the glaucomatous human retina]. AB - The purpose of the present study was analysis of the cellular response to glaucoma in the human retina. Retinal strips obtained from two enucleated eyes with therapy-resistant, absolute glaucoma were explanted and cultured in vitro. The morphology of the remaining cell populations was assessed with the DiI method in non-cultured, formalin-fixed retinal tissue from both retinas. We found immunohistochemically identifiable glia cells migrating out from the explants and glial processes formed on the substrate. Labelling of representative retinal areas with the fluorescent dye DiI applied to the nerve fiber layer resulted in delineation of growth cone-bearing glial processes, of occasional non-atrophied ganglion cells, and of amacrines and horizontal cells in deeper layers of the retina. The results demonstrate that glaucoma leads both to selective damage of ganglion cells and to a glial proliferation characterized by the formation of processes both in the retina and following explantation. PMID- 1786918 TI - [Serous retinal detachment in O2 therapy of primary pulmonary hypertension]. AB - Primary pulmonary hypertension (PPH) is a rare disease, which almost inevitably leads to right-sided heart failure and death. This is to our knowledge the first report of ophthalmological complications. A 43-year-old woman in the late stage of PPH who had been continuously treated with oxygen developed an uveal effusion syndrome, which manifested as bilateral central serous retinal detachment and ciliochoroidal swelling. The serous detachment improved promptly after interruption of the oxygen therapy and again worsened when it was resumed because of massive dyspnea. Systemic blood pressure was 115/95. Right-sided cardiac catheterization revealed a systolic pulmonary arterial pressure of 110 mmHg. Pulmonary function tests showed a normal PO2 with oxygen and a light hypoxia without therapy. We came to the following conclusions: First, the central serous retinal detachment and peripheral choroidal swelling were induced by the striking increase in pulmonary arterial pressure, which almost equaled the systemic arterial pressure. Although the same ophthalmological findings have been reported in experimental animals after exposure to pure oxygen, pulmonary function tests disproved high oxygen concentration as the causative agent in our patient. Second, the improvement of pigment epithelial function after the interruption of oxygen therapy could be explained by the following hypotheses. Hypoxia induced a dilation of the choroidal arteries, followed by an improved supply of nutritive material for the pigment epithelium. There is experimental evidence that glucose might be the limiting metabolite of pigment epithelial function. PMID- 1786919 TI - [Perfluorodecalin as a hydrokinetic substance in complicated retinal detachment]. AB - Perfluorodecalin is a clear colourless fluid with high specific gravity. It is immiscible with gas, blood, water, or any other fluid used in vitrectomy. The low viscosity permits easy injection and removal with microsurgical equipment. The high weight displaces subretinal fluid anteriorly through retinal breaks back into the vitreous space. Posterior retinotomies can be avoided. A large bubble of perfluorodecalin in the vitreous cavity stabilizes the retina mechanically during dissection and peeling of epiretinal membranes. Before the procedure is ended the fluid must be completely removed from the eye and replaced by BSS, air, gas, or silicon oil. We present the surgical technique and preliminary results. PMID- 1786920 TI - [Delayed resorption of subretinal fluid after pneumatic retinopexy]. AB - Delayed resorption of pooled subretinal fluid has been reported to cause impaired visual acuity due to involvement of the macula in up to 10% of all case. In our series of 60 eyes treated consecutively with pneumatic retinopexy for retinal detachment, 9 eyes experienced delayed absorption of subretinal fluid. Only 6 eyes showed the phenomenon of pooled, localized subretinal fluid without peripheral extension to the ora serrata. The time for complete absorption of these circumscribed subretinal bullae ranged from 8 to 52 weeks (mean 22.7 weeks). Impaired visual acuity could not be detected in any of these cases. This may be due to the location of these bullae, which never involved the macula. Therefore, we do not consider the occurrence of this phenomenon to be a reason not to carry out pneumatic retinopexy. PMID- 1786921 TI - [Pathology of retinal involvement in pseudophakia]. AB - An eye with clinically successful anterior chamberlens implantation following cataract surgery was removed at autopsy after death in accordance with the wishes of a grateful patient. It was offered for corneal transplantation, and rejected for this purpose. The eye was examined pathologically. In addition to diffuse loss of corneal endothelium, a diffuse uveitis, and a reactive membrane with macrophages on the implant, a special granulomatous surface-cyclitis associated with reactive shrinkage of the vitreous, a peripheral break of the retina, and an early stage of pseudophakic macular edema were also found. PMID- 1786922 TI - [Keratoplasty in infancy and early childhood with special reference to the auto rotation technique]. AB - Between January 1987 and August 1990, a total of 20 keratoplasties were performed in infants and children in the University Eye Hospital, Dusseldorf, accounting for 4% of all keratoplasties during this period. The indications included malformations of the anterior segment and central corneal opacities, mostly of herpetic or microbial etiology. The ages of the patients varied from 2 weeks to 6 years, and the cases were followed up for an average of 2 years. Five (25%) were treated with the autorotation technique. Visual acuity after surgery was satisfactory, although an irregular astigmatism was found in three cases and one child eventually had to have a contact lens fitted. In view of our encouraging results we recommend that ipsilateral rotational autokeratoplasties should be considered more often for suitable forms of central corneal opacyty, particularly for infants and children. PMID- 1786924 TI - [Effect of postmortem time on survival of corneal endothelium after cryopreservation]. AB - In corneal cryopreservation and other preservation techniques, the donor tissue post-mortem time is believed to affect endothelial cell survival. In this study, porcine eyes were stored in a moist chamber at 4 degrees C for 2, 4, 8, 32, and 72 h. Then the corneas were subjected to cryopreservation. After thawing, a 24-h interval of organ culture was used as a viability test. The cell density of the central cornea and the percentage of Descemet's membrane denuded of endothelium were determined with vital staining and morphometric methods. Corneas stored 2-32 h before cryopreservation showed no difference in necrotic areas or cell density of surviving endothelium. Corneas stored 72 h before cryopreservation revealed no endothelial cell survival. We conclude that a post-mortem time of up to 32 h before corneal cryopreservation has no influence on endothelial cell survival. PMID- 1786923 TI - [Damage to the corneal endothelium caused by radial keratotomy]. AB - In our experimental study on 53 rabbits we compared the amount of corneal endothelial damage caused by radial keratotomy (RK) referred to (1) the number of incisions (4, 8, or 16), (2) the postoperative interval (0 h, 48 h) and (3) the direction of the incision [centripetal (cp), centrifugal (cf)]. The endothelial damage was quantified by means of the Janus green photometry technique. Morphological changes were evaluated by scanning electron microscopy (SEM). Depending on the group examined, we found endothelial damage extending over 3-7% of an analysed surface of 64 mm2. One perforation caused endothelial damage of up to 17% of the surface examined. Increasing the number of incisions from 4 to 8 or 16 resulted in a statistically significant increase in the amount of endothelial damage (4.2%, 5.1%, 5.8%; P less than 0.05). At 0 h it was significantly higher than after 48 h (5.5%, 4.6%; P less than 0.05). The direction of the incision had no statistically significant influence in our study (zp: 5.2%, zf: 4.9%). The morphological changes in the rabbit corneal endothelium examined directly after the RK procedure were ruptures in the cell membranes, loss of cells, and posterior corneal protrusions beneath the incisions. After 48 h, we found fewer damaged cells and no denuded Descemet's membranes, but larger polymorphy of the cells and a numerical increase in the microvilli of the cells surrounding the damaged cells. Our results support the crucial argument against RK: the alteration and destabilization of healthy corneal tissue up to the endothelium. PMID- 1786925 TI - [Induction of chromosome aberrations in human lymphocytes as a model for evaluating the mutagenic effect of excimer laser irradiation in ophthalmology]. AB - A model for testing the mutagenicity of excimer laser radiation in ophthalmology is presented. In contrast to other studies using cell monolayers, in our study with this model human peripheral lymphocytes (heparinized whole blood) are exposed to laser irradiation at different conditions. The possible mutagenicity of secondary radiation after exposure of the cornea is also considered. The heparinized blood is either injected into the anterior chamber of an enucleated bovine eye or filled into a quartz chamber (positive control). After irradiation the lymphocytes are stimulated and fixed during metaphase, after which the metaphases are scored for chromatid and chromosome aberrations. In the positive control group, exposure to 248 nm excimer laser radiation (500 J, 277 mJ/cm2, 10 and 20 Hz) was followed by a highly significant increase in the yield of chromatid aberrations (chromatid breaks and achromatic lesions). PMID- 1786926 TI - [Wound healing of the cornea of New World monkeys after surface keratectomy: Er:YAG-excimer laser]. AB - Corneal wound healing was studied after photoablation with an excimer laser (193 nm, 43 pulses at 180 mJ/cm2 [symbol: see text] 11 microns ablation depth, optical zone 2.0 mm) and with an erbium-YAG laser (2.94 microns, 5 pulses at 2.5 J/cm2 [symbol: see text] 50 microns ablation depth, optical zone 1.6 mm). The corneas of marmosets (Callithrix jacchus) were prepared 5 and 10 days and 4 and 25 weeks after photoablation. The sections were investigated by conventional light microscopy or exposed to antibodies against collagen types I, III, IV, VII and laminin and stained by indirect immunofluorescence. Macroscopically, the time course of wound healing was comparable to that seen, after laser keratomileusis for correction of myopia in humans (epithelium closure after 24-48 h, subepithelial haze: erbium-YAG less than or equal to excimer). Histologically the time-course of wound healing could be schematically divided into three phases: (1) epithelial hyperplasia, inhomogeneous new synthesis of collagen fibrils subepithelially; (2) reorganization of the epithelium, hyperplasia of keratocytes, incipient reorganization of the collagen fibrils, increase in subepithelial haze; (3) reorganization of the collagen fibrils, decrease in subepithelial haze. The distribution of collagen type VII during the corneal wound healing suggests that the subepithelial haze observed during the healing process after laser keratomileusis for correction of myopia is based on the anchoring fibrils of the basement membrane. PMID- 1786927 TI - [Lens epithelium necrosis factor for prevention lens opacity]. AB - Posterior capsule opacification is a common postoperative complication after extracapsular cataract extraction and lens implantation. If the patient's visual acuity is reduced markedly, a capsulotomy with a Nd-YAG laser may become necessary. Various attempts have been made with the aim of developing an injectable solution capable of damaging the epithelial cells of the capsule bag irreversibly and thereby avoiding posterior capsule opacification. This solution should be applied for a short time during the operation. In tissue culture we tested the influence of two injectable solutions [lens epithelial necrosis factor (LENF)] and aqua bidest. on cellular growth. Balanced salt solution served as control. We used human epithelial carcinoma cells, type HEp-2. The results were evaluated by vital staining (ethidium bromide and acridin orange), hemotoxylin staining, autoradiography and measurement of protein and DNA synthesis. The results showed that LENF is capable of damaging 100% of the epithelial cells irreversibly if it is applied for 20 s or longer. The influence of each of these solutions was tested on 20 human capsular flaps, which were excised during the operation. The flaps were immersed for 30 s in the different solutions. Vital staining of these flaps led to the following results: LENF causes a 100% cell damage of all epithelial cells of the capsular flaps. No vital cells remained. On the other hand Aqua bidest. cannot guarantee 100% cell damage of the capsular flap epithelia. Sixty percent of the capsular flaps treated with aqua bidest, showed differing amounts of remaining vital cells. PMID- 1786928 TI - [Sclera fixation of posterior chamber lenses. Indications, technique and results]. AB - Over 18 months we implanted posterior chamber lenses in 40 eyes using transscleral suturing. The indication for this technique was the absence of capsular support, in most cases due to previous cataract surgery and/or trauma. A uniform procedure was used. After a medium follow-up of 9 months the major complications were as follows: immediately after the operation transient keratopathia was present in a third of the cases; 6 eyes showed iritis, which persisted in 4 eyes. Other late complications were cystoid macular edema in 2 cases and central vein occlusion, retinal detachment and recurrent iritis in single cases. Despite these complications the functional results were favorable in 32 eyes with a best corrected vision of 6/12 or better. Poor visual outcome could be related to the operative procedure in 2 eyes and to pre-existing pathology in the remaining 6 cases. We conclude that the operative technique should be improved to reduce complications. PMID- 1786929 TI - [Inhibition of cholesterol synthesis and cataract]. AB - The cholesterol requirements of the lens for the formation of plasma membranes are met by self-synthesis only until early postnatal life. This ability subsequently decreases with increasing age and probably ceases altogether. The cholesterol supply then has to come from exogenous sources. These findings are of great importance for the qualitative assessment of extrahepatic side effects of HMG-CoA-reductase inhibitors given for disturbances of lens transparency. The observation of cataracts in chronic toxicity tests with high doses in beagle dogs suggested that the lens enzyme was also affected by the inhibitor, thus causing cataracts. In contrast to other workers' results, we did not find any activity of HMG-CoA-reductase in our experiments with calf, bovine, dog and rat lenses. Preliminary studies with bovine eyes demonstrate a direct correlation between the cholesterol serum level and the content of the aqueous humor. This shows the importance of the exogenous supply for the lens requirements. A further strong argument is that the use of HMG-CoA-reductase inhibitors in patients with pathologically increased cholesterol level is safe as far as the lens transparency is concerned, as demonstrated in clinical trials. PMID- 1786930 TI - [Chronic recurrent polychondritis. The spectrum of eye involvement]. AB - Chronic relapsing polychondritis is a rare connective tissue disease of presumed autoimmunologic pathogenesis. It may involve multiple organ systems. The most characteristic signs are: relapsing inflammation of the cartilage of the outer ear, non-erosive polyarthritis, chondritis of the nasal cartilage, inflammation of different ocular tissues, inflammation of tracheal and bronchial cartilages and lesions of the inner ear. The wide range of ocular tissue involvement is discussed on the basis of two new cases with emphasis on scleritis, episcleritis, keratitis and chorioretinal involvement. Ocular disease complications that have not been published before are the massive development of subretinal stands following multiple intra- and subretinal infiltrates in the posterior pole connecting areas of chorioretinal scars. The importance of high-dose, long-term steroid therapy is stressed. In addition to steroids, immunosuppressive agents such as azathioprine and cyclophosphamide are sometimes mandatory to cope with severe multi-organ disease. Another option in very severe relapses may be plasma separation to improve the condition rapidly until drug therapy can be effective. PMID- 1786931 TI - [The retinal nerve fiber layer in retrobulbar neuritis]. AB - In the course of 1 year we investigated 32 patients suffering from retrobulbar neuritis, using photographs of the retinal nerve fiber layer (RNFL). All photographs revealed defects of the RNFL in the area of the papillomacular bundle. These observations were compared with photographs of eyes not affected by any ophthalmological diseases. No loss of retinal nerve fiber bundles was found in any of these cases. One remarkable finding of this study was that 90% of the patients with retrobulbar neuritis also had defects in the RNFL of the contralateral eye. PMID- 1786932 TI - [Amyloidosis of the vitreous body. Possibilities of diagnosis]. AB - Vitreous amyloidosis is often the presenting clinical manifestation of type I, type II or Jewish-type familial amyloid polyneuropathy (FAP). FAP is an autosomal dominant inherited disorder. It is caused by systemic deposition of variants of transthyretin (TTR), formerly called prealbumin. TTR is a tetrameric protein with beta pleated sheets (mol wt = 56,000 dalton). In two cases we were able to confirm the clinical diagnosis of vitreous amyloidosis. Immunohistochemistry revealed TTR in vitreous samples after therapeutic pp vitrectomy for vitreous opacity. The same result was found in samples of rectal mucosa. Amyloid was not found in skin. Isoelectrical focusing disclosed that TTR in the serum was the Portuguese (TTR-Met 30) variant. Together with polyneuropathy of the lower limbs, a diagnosis of FAB type I was made. In the second generation of the first patient's family the normal variant was found (the pathologic gene was not inherited). In the second case the pathologic variant was detected in the second generation, but without any pathologic clinical features. The third generation showed the normal variant. The disorder was detectable before any clinical signs were present. These findings are also important for genetic counseling. PMID- 1786933 TI - [Changes in the blink reflex in patients with essential blepharospasm and hemifacial spasm]. AB - Electrophysiological investigations have been carried out in 46 patients with essential blepharospasm and 41 with hemifacial spasm. In both diseases reproducible pathologic alterations in the blink reflex were found. In essential blepharospasm a direct R1/R2 transition and a contralateral early component with and without direct transition into the R2C component were recorded. In patients with hemifacial spasm there was a loss of the R1 component in addition. In repeated treatments with botulinum toxin the amplitude (R1,R2) of the blink reflex was reduced in some cases, although in some cases the intensity of spasm was as high as before treatment once the effect had faded. PMID- 1786934 TI - [Results of basal cell carcinoma surgery of the eyelids]. AB - In the treatment of basal cell carcinoma there are still diagnostic and therapeutic problems. The wrong diagnosis resulting in inadequate treatment can lead to loss of the bulbus. In the following study 226 patients were operated on for basal cell carcinoma between 1980 and 1990. In 179 patients a primary eyelid tumor was removed and the rate of recurrence was 5.0%. In 47 patients with secondary eyelid tumors (recurrent tumors) a recurrence rate of 14.8% was found. The examination methods, surgical treatment and results are presented. PMID- 1786935 TI - Recently characterized vascular tumours of skin and soft tissues. AB - This review summarizes the clinicopathological features of a number of vascular tumours that have been characterized only in recent years. These include: glomeruloid haemangioma, a multifocal vascular lesion associated with POEMS syndrome: Kaposi-like infantile haemangioendothelioma, a borderline malignant tumour occurring in the retroperitoneum of infants, mimicking Kaposi's sarcoma histologically; giant cell angioblastoma, characterized by proliferated vessels with a granuloma-like appearance; benign lymphangioendothelioma (progressive lymphangioma), slowly-growing macule or plaque over the trunk or limb, mimicking low-grade angiosarcoma histologically; targetoid haemosiderotic haemangioma, a benign lesion with a distinctive annular appearance and histologically overlapping with benign lymphangioendothelioma; spindle cell haemangioendothelioma, a lesion located mostly in the distal extremities, characterized by cavernous vascular spaces, spindle cells with interspersed narrow vascular channels and scattered plump vacuolated endothelial cells; acquired tufted angioma, characterized by 'cannon-ball' involvement of the dermis by lobules of pericyte-rich capillaries; sinusoidal haemangioma, a distinctive variant of cavernous haemangioma which may be confused with angiosarcoma; and epithelioid angiosarcoma, a highly aggressive tumour of deep soft tissue mimicking metastatic carcinoma and co-expressing endothelial and epithelial markers. PMID- 1786936 TI - Solitary fibrous tumour arising at unusual sites: analysis of a series. AB - Solitary fibrous tumours ('pleural fibromas') are well-recognized in the pleura, but their rare occurrence at other sites has only become appreciated in recent years, as a consequence of which extrapleural examples often go unrecognized or misdiagnosed. Eight cases (three peritoneal, two retroperitoneal, two intrapulmonary and one mediastinal) are presented herein. All but one presented in adulthood, and three were asymptomatic chance findings. Size ranged from 0.8 to 26 cm in maximum diameter. To date, none has behaved in an aggressive fashion. Histologically, these lesions are entirely comparable to their pleural counterparts, and accurate diagnosis is largely dependent on appreciation of their potential extrapleural location. Immunohistochemistry in seven cases favoured myofibroblastic/fibroblastic differentiation, in keeping with the putative submesothelial origin of these lesions. PMID- 1786937 TI - Calcium pyrophosphate dihydrate deposition disease: morphological and microanalytical features. AB - The light microscopic and polarization appearances of calcium pyrophosphate dihydrate crystal deposits in tissues are reviewed. In routine sections haematoxylinophilic crystalline deposits with a feathery or brush-like pattern are typical of calcium pyrophosphate dihydrate. Short rhomboidal crystals showing positive birefringence are seen on polarization; X-ray microanalytical and infrared spectroscopic data support the specificity of these appearances. The appearances of the crystal deposits in decalcified specimens are also described. We include six cases of calcium pyrophosphate dihydrate deposition within periarticular bone; to the best of our knowledge this has not previously been described. PMID- 1786938 TI - Evaluation of endothelial markers in detecting blood and lymphatic channel invasion in pT1 transitional carcinoma of bladder. AB - In a study of 40 patients with high-grade (G2 and G3) transitional cell carcinoma of bladder invading the lamina propria--stage pT1, retraction artifact was often misdiagnosed as vascular/lymphatic tumour invasion. Vascular/lymphatic infiltration was diagnosed in five cases based on haematoxylin and eosin stained sections, but confirmed in only two of these using immunohistochemical techniques to demonstrate endothelial markers. Of the latter, these preparations demonstrating von-Willebrand factor and binding the monoclonal antibody QBEND/10 were technically superior to those in which Ulex europaeus agglutinin 1 was used. It is unlikely that the demonstration of vascular/lymphatic infiltration, a rare feature, will prove of value in defining prognostic groups for treatment. PMID- 1786939 TI - Intra-abdominal desmoplastic small cell tumour with divergent differentiation. PMID- 1786940 TI - Generalized lymphadenopathy due to herpes simplex virus type I. PMID- 1786941 TI - Plexiform xanthoma: an unusual variant. AB - We present a 35-year-old male patient with a recurrent xanthoma within the dermis of the elbow. There was no clinical evidence of hyperlipidaemia. The very unusual feature in this case was the presence of a plexiform growth pattern, not to our knowledge previously described in xanthomata. This necessitated distinction from a true neoplasm, most particularly of neural type. PMID- 1786942 TI - Pulmonary vasculature in Fabry's disease. PMID- 1786943 TI - Rhabdomyosarcoma presenting as 'acute leukaemia'. PMID- 1786944 TI - Immunohistochemistry in sweat gland tumours. PMID- 1786945 TI - The use of Vernier scales. PMID- 1786946 TI - [Preliminary studies of notoginsenoside R1-induced differentiation of HL-60 cell lines in vitro]. AB - Our experiments have proved that human promyelocytic leukemia cells (HL-60) could be induced to differentiate in vitro by notoginsenoside R1 into mature neutrophils. The morphological results showed that 68% of HL-60 cells were differentiated in 80 microgram/ml inducer for 5 days, in which metamyelocytes were 32%, banded neutrophils 30% and segmented neutrophils 6% 3H-TdR and 3H-UR incorporate assay showed that notoginsenoside R1 effected synthesis of DNA and RNA while it induced differentiation of HL-60 cell. At 48 h, percent of incorporate inhibition was 26.32% with 3H-TdR and 18.57% with 3H-UR; at 72 h, 17.46% and 21.76%, respectively. PMID- 1786947 TI - [An analysis of chemical oxygen demand, carbohydrate, IgG and IgA in extracellular fluid of bacterial plaque]. AB - The chemical oxygen demand (COD) of extracellular plaque fluid was measured by potassium dichromate method. Micro-anthrone method and high performance liquid chromatography were used for measuring the carbohydrate content in the fluid. Immunochemistry system was used for measuring IgG and IgA contents in it. The results showed: (1) a high value of COD was found in the extracellular fluid, and it further increased with sugar-intake; (2) during resting stage, the content of carbohydrate measured by microanthrone method or high performance chromatography was very low, and there was no free glucose, fructose or sucrose; (3) no difference of IgG and IgA contents in plaque fluid between caries active (CA) and caries free (CF) subjects was found. PMID- 1786948 TI - [Influences of new synthetic drug vesnarinone on circulatory and respiratory function of dogs]. AB - The purpose of this study was to investigate the influences of vesnarinone, newly synthesized in the School of Pharmacy, West China University of Medical Sciences in 1985, on the circulatory and respiratory functions of dogs. Eight dogs were anesthetized with 3% sodium pentobarbital. Vesnarinone (2 mg/kg), dimethyl sulphoxide (the solvent which was needed to prepare solution of OPC-8212), and 0.9% NaCl (normal control) was given separately according to the arrangement of Latin square. The ECG, blood flow, blood pressure and respiration were measured and recorded for 1-15 minutes. Vesnarinone increased the blood flow in the common carotid artery with no significant changes in blood pressure, heart rate, or respiration. These results suggest that OPC-8212 has positive inotropic effect but no effect on the heart rate in anesthetized dogs. PMID- 1786949 TI - [Studies on the mutagenicity of vesnarinone]. AB - The mutagenicity of domestic Vesnarinone (OPC-8212) was studied by Ames test, micronucleus test of NIH mouse bone marrow and chromosome aberration assay in CHL cells. Negative results were obtained, which suggested that OPC-8212 did not induce prokaryotic cell gene mutation or chromosome damage both in vitro and in vivo. PMID- 1786950 TI - [Role of nucleus parabrachialis medialis in the "renzhong" induced pressor response in rabbits]. AB - Experiments were performed on 18 rabbits, bivagotomized, gallamine triethiodide immobilized and artificially ventilated. The effects of electrical stimulation of "renzhong" (Du 26) area and NPBM, separately and simultaneously, on arterial blood pressure and heart rate were observed before and after electrolytic or chemical lesion of NPBM. Electrical stimulation of "renzhong" area or NPBM, separately could elicit an increase in arterial blood pressure; when both "renzhong" and NPBM were stimulated, the pressor response to NPBM stimulation could affect that of "renzhong" area's. But after electrolytic or chemical lesion of NPBM, stimulation of NPBM could no longer elicit pressor response. On the other hand, the pressor response induced by electrical stimulation of "renzhong" area decreased obviously, after lesion of NPBM or transection of brain stem between NPBM and Nucleus trigemini principalis. These results suggest that NPBM might take part in the pressor response of "renzhong" area stimulation. PMID- 1786951 TI - [The changes of viscoelastic properties of whole blood in patients with chronic cor pulmonale]. AB - The changes of blood viscoelasticity and apparent viscosities at low shear rate (0.512 S-1) and high shear rate (51.2 S-1) were studied in 61 patients with various severity of chronic cor pulmonale (CCP). The relation between blood viscoelasticity and apparent viscosities and PaO2 and PaCO2 was investigated and the data were collected before and after treatment. Grouped data: Group 1. A total of 61 patients with CCP were studied, 10 of them died during hospitalization. Sixty-one patients at the acute stage were divided into mild, severe and dead sub groups. Twenty-nine patients were improved after treatment. Group 2. Control group (74 normal people) matched group 1 in sex and age. The results demonstrated that eta 0.512, eta 51.2 and eta' were slightly increased in the mild group, but HCT, eta 0.512, eta 51.2, AI, eta' and eta" were elevated more significantly in the severe group. All variables mentioned above of died patients were elevated more remarked than that of the mild group. HCT, eta" in dead patients were slightly higher than those in severe group (P less than 0.05 0.01). It was clear that the more severe the patient, the more increased the hematocrit and RBC aggregation, the less the RBC deformability. HCT would be elevated when PaO2 was below 8 kPa (60 mmHg) and the HCT, eta 0.512, eta', eta" increased significantly (P less than 0.05-0.01) when PaCO2 was over 6.65 kPa (50 mmHg). There was a positive linear correlation between eta 0.512 and PaCO2.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786952 TI - [The role of transmission electron microscopy played in diagnosis of knotty tumors]. AB - Eight cases were reported in order to elucidate the important role of electron microscopy (EM) played in diagnosis of knotty tumors. The diagnosis of tumors made by light microscopy (LM) could be confirmed, corrected or eliminated with EM, and the types and histogenesis of tumors could be decided more accurately with EM than with LM. But EM has its inherent limitations, so it is emphasized that diagnosis made by EM must rest on solid basis of LM, and sometimes EM should be combined with other methods, such as histochemistry and immunohistochemistry. PMID- 1786953 TI - [Study on the bias axis stress-strain relationship of the human mandible]. AB - This paper presents our study on the bias axis elastic properties of the human mandible. The elastic coefficients were determined by the composite materials mechanical testing methods. From these values the "technical constants" were calculated to be: EL = 18.823GPa, ET = 12.777GPa, GLT = 5.564GPa, vLT = 0.302, vTL = 0.205. Variation of elastic constants of the human mandible with the orientation to its long axis was investigated. A brief description of the variation law is given. The bias axis stress-strain relationship of the human mandible is established. The data indicate that the human mandible is a living, anisotropic and nonhomogeneous composite biomaterial. Its mechanical properties have a close relation to its location, orientation and structure. PMID- 1786954 TI - [Clinical study of superoxide dismutase in recurrent aphthous ulceration]. AB - Activity of superoxide dismutase (SOD) was determined in erythrocytes obtained from 74 patients with recurrent aphthous ulcerations (RAU) and 100 healthy individuals. The results showed that activity level of SOD in RAU was significantly lower as compared with that in the controls (P less than 0.01). The activity of SOD in 30 cases of RAU at interval period was elevated on reexamination, but it was still lower than that in the controls (P less than 0.01). There is evidence that damage of superoxide radicals (O.2) and decrease of activity of SOD may play important roles in the pathogenesis of RAU. A random double-blind, placebo-controlled, cross-over trial on membrane SOD was carried out in 40 patients with RAU. The results demonstrated that the effective rate of SOD was 90%, being markedly higher than that of placebo. It is suggested that membrane SOD, as a topical medicine, could increase the concentration of SOD on the ulcerous surfaces, prevent O.2-induced injury, decrease capillary permeability, relieve inflammation and improve cure of ulcer. PMID- 1786955 TI - [The preparation of highly purified insulin and its clinical use. Insulin Cooperative Study Group]. AB - Antigenicity of insulin preparations is obviously related to their purity. The average contents of proinsulin, glucagon and pancreatic polypeptide in highly purified insulin (HP-I) produced by us are 76.0, 2.11 and 0.11 ppm respectively. These results are superior to those for domestic conventional crystalline insulin and single peak insulin (SP-I). The antibodies to insulin, proinsulin and pancreatic polypeptide in serum were examined in 24 diabetic patients treated with HP-I for more than 6 months. The positive rates for the above three antibodies were 37.5%, 0% and 0% respectively. The results showed that the antigenicity of HP-I was much lower than that of domestic conventional crystalline insulin and almost the same as that of MC-I from Nordisk, Denmark. PMID- 1786956 TI - [Pathological observation of experimental asbestosis treated by hydroxy piperquin phosphate in dogs]. AB - The paper presents experimental asbestosis treated with hydroxy piperquin phosphate (HPQP) in dogs. Results showed that the total cell number of bronchoalveolar lavage fluid, the viability of alveolar macrophages and the enzyme activities of lactate dehydrogenase, acid phosphatase and beta glucuronidase of alveolar macrophages in treated dogs were higher than those in exposed dogs, asbestos fibers contents in the lungs and the mean scores of lung lesions in the treated dogs were markedly less than those in the exposed dogs. These findings support that HPQP may play a role in protecting alveolar macrophages from damage and inhibiting the progression of lung fibrosis, and that the clinical application of HPQP is somehow evidenced by this study. PMID- 1786957 TI - [The value of residual volume testing in determining degree of emphysema in patients with pneumoconiosis]. AB - A comparative study of chest roentgenograms and the value of RV/TLC% in determining degree of emphysema of patients with pneumoconiosis and workers exposed to dust was made in 400 cases. Accordance rate of RV/TLC% with roentgenograms in determining emphysema in the same subjects was 61.1% and that in the patients group, 67.7%. Moreover, the accordance rate increased with grade of pneumoconiosis diagnosed. The results showed that RV/TLC% was valuable in determining emphysema of patients with pneumoconiosis. The classes of degree of emphysema were proposed according to the testing value of RV/TLC%. PMID- 1786958 TI - [Aluminum and fluorine absorption in a perfusion system of rat small intestine in vivo]. AB - Mixtures of aluminum an fluorine in two different ratios in tris-hydroxy-methyl aminomethane buffered media of pH 7.0 were perfused respectively through the small intestine of the in vivo rat over a period of 40 min. The contents of aluminum and fluorine in the portal vein blood obtained from different perfusion periods were detected and determined simultaneously. The results showed that fluorine absorption was not significant in the mixtures. An obviously large amount of aluminum was absorbed in the mixture with a higher proportion of aluminum (4660 micrograms/ml Al + 200 micrograms/ml F/L), while in the mixture with a lower dose of aluminum (860 micrograms/ml Al + 200 micrograms F/L), a small quantity of aluminum was absorbed. It is evident that the mechanism by which aluminum inhibits fluorine toxicity is that aluminum decreases the intestinal fluorine absorption by the formation of aluminum fluoride complex. PMID- 1786959 TI - [A study on developmental toxicity of vanadium pentoxide in NIH mice]. AB - There is no general agreement yet about the teratogenic effects or developmental toxicity of vanadium in animal studies. This is a report on developmental toxicity in NIH mice following injection of vanadium pentoxide (V2O5, 5 mg/kg body weight, i.p.) at different times of gestation (on days 1-5, 6-15, 7, 8, 9, 10, 11, 14-17 of gestation). No adverse effects of V2O5 on pre-implantation and implantation were noted, and neither were teratogenicity and premature birth. However, there was toxic effect on embryofetus. Increased frequency of resorption or fetal death on days 6-15, 7, 14-17 of gestation were observed. Delayed ossification of bones was noted on days 6-15, 8, 10, 14-17 of gestation. These results suggest that V2O5 may be a weak developmental toxicant but not a teratogen in NIH mice. In addition, this paper reports the developmental toxicity, especially teratogenicity of N, N'-methylene-bis (2-amino-1, 3, 4 thiadiazole) which was used as the positive control in NIH mice. PMID- 1786961 TI - [A micromethod for determination of serum zinc and copper concentration in infants aged 1-3 months in Chengdu]. AB - A micromethod for the measurement of serum zinc and copper concentration of peripheral blood by wave-oscillopolarography is introduced in this article. The method is superior to the commonly used flame atomic absorption spectrophotometry (AAS) in its simplicity in sampling and operating and in its inexpensiveness. Yet the results are identical with those obtained by ASS, the method is good enough to replace ASS in clinical work, especially in the field of pediatrics. Serum zinc and copper concentrations in 243 infants aged 1-3 months in Chengdu were detected by this method. The data were found to be slowly distributed without age and sex differences. For the infants of 1-3 months in Chengdu, the reference values of serum zinc and copper concentration are 6.69-25.46 mumol/L and 8.70 28.07 mumol/L respectively. PMID- 1786960 TI - [Distribution of vanadium in tissues of nonpregnant and pregnant Wistar rats]. AB - This paper reports tissue distribution of vanadium in nonpregnant and pregnant Wistar rats. The experimental results showed that vanadium concentrations in nonpregnant rats were respectively from high to low: I. no treatment: ovary greater than uterus greater than kidney greater than lung greater than heart muscle greater than spleen greater than brain greater than liver greater than blood; II. 4h after single i.p. injection of V2O5 (5 mg/kg): kidney greater than ovary greater than liver greater than bone greater than uterus greater than lung greater than heart muscle greater than spleen greater than brain greater than blood. The results suggest that female genital organs are important organs in distribution of vanadium. The kidney is a main excretory organ. After 24h of treatment, a larger amount of vanadium in body has been excreted. Vanadium can pass through blood-brain barrier. Distribution of vanadium on gestation days 12 after 4h single i.p. injection of V2O5 (5 mg/kg) is: kidney greater than ovary greater than uterus greater than placenta greater than liver greater than fetus greater than bone greater than heart muscle greater than lung greater than brain greater than spleen greater than blood; on gestation days 16-18 after 4h single i.p. injection of V2O5 (5 mg/kg) is: kidney ovary greater than placenta greater than lung greater than bone greater than uterus greater than heart muscle greater than spleen greater than fetus greater than liver greater than brain greater than blood; after 24h (on gestation days 16-18) is: kidney greater than ovary greater than placenta greater than spleen greater than bone greater than lung greater than liver greater than fetus heart muscle greater than brain blood.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1786962 TI - [Determination of trace chloride and sulfate in drugs by ion chromatography]. AB - Chloride and sulfate in magnesium trisilicate, activated charcoal, vesnarinone and bendazac were determined by the IC conductimetric detection. Analysis were performed by using a separating column (100 x 6 mm i.d.) packed with anion exchanger and with a stripper column (100 x 6 mm i.d.); 1.4 mmol/L Na2CO3 and 1.4 mmol/L Na2CO3-0.75 mmol/L NaHCO3 were used as eluents respectively. The peak height was linear with concentration from 10(-6) to 10(-3) mol/L for Cl- and from 10(-5) to 10(-3) mol/L for SO4(2-). Results showed no significant difference as compared with those determined by the CHP (1985) and CHP (1990) appendices methods. The IC method is specific, sensitive, simple and rapid. PMID- 1786963 TI - [Polarographic determination of sulfide in water]. AB - Sulfide has a sensitive polarographic wave in the system of NaOH-EDTA triethanolamine. The addition of triethanolamine to the system improved the shape of the wave and increased the sensitivity. The peak current was directly proportional to the concentration of sulfide in the range of 0.002-5.000 ppm. The detection limit for water sample was 2 ppb, and the relative standard deviation and recovery were 2.3-7.2% and 94.0-102.0%, respectively. The proposed method is simple, accurate, sensitive and reproducible. PMID- 1786964 TI - [Determination and comparison of beta-glucuronidase activity among strains of B. fragilis and E. coli]. AB - We determined and compared the beta-glucuronidase (beta-G) activity among strains of B. fragilis and E. coli under the optimum condition. Results showed that the mean beta-G activity of strain B. fragilis ATCC25285 was 94.7u. B. fragilis ATCC25285 strain was selected as the model strain to establish the animal model of bilirubin gallstones because its beta-G activity was obviously higher than that of B. fragilis CDC14462 and E. coli 3362 (O157K88) strain. PMID- 1786965 TI - Glucocorticoid actions and biomodulators: an integrated biological control. PMID- 1786966 TI - Alpha-1-antitrypsin-structure, function and genetic variants. PMID- 1786967 TI - Protein stability from denaturation transition curves. PMID- 1786968 TI - Protein adsorption at solid-liquid interfaces: Part III--Adsorption from ternary protein mixture. AB - Simultaneous adsorption of bovine serum albumin (BSA), beta-lactoglobulin and gelatin from aqueous solutions of their ternary mixture to the alumina-water interface has been studied as a function of protein concentration at different values of pH, ionic strength, temperature and weight fraction ratios of proteins. At a fixed weight fraction of beta-lactoglobulin, preferential adsorption (gamma w(lac)) of this protein significantly depends on the amounts of BSA and gelatin present in the solution before adsorption. At higher ranges of protein concentrations, extent of adsorption (gamma w(ser)) of BSA decreases sharply with increase of gamma w(lac) until gamma w(ser) becomes significantly negative, thereby indicating that beta-lactoglobulin and water preferentially adsorbed at the interface are responsible for complete displacement of BSA from the surface. On the other hand, adsorption (gamma w(gel)) of gelatin under similar situation increases mutually with increase in the values of gamma w(lac) in many systems. In few systems, gamma w(gel) also decreases with increase of gamma w(lac) depending upon solution parameters. At pH 5.2, increase of ionic strength and temperature, respectively, increases the extent of adsorption of each protein in the mixture considerably. Extents of adsorption of all proteins are observed to increase when pH is changed from 5.2 to 6.4. The affinities of different proteins in the mixture are expressed in unified scales either in terms of maximum extents of total adsorption or in terms of standard free energies of adsorption of protein mixtures with respect to surface saturation. PMID- 1786969 TI - Studies on the induction of cinnamic acid 4-hydroxylase in potato tuber. AB - The change in activity of cinnamic acid 4-hydroxylase (CA4H) in potato parenchyma tissue exposed to various conditions has been examined. Maximum induction of CA4H activity was obtained at 18 hr of incubation. Though CA4H induction can occur in dark, over 100% increase in enzyme activity was obtained on exposure of the tissue to light. Actinomycin D and cycloheximide inhibited the induction process. Mn2+, though known to cause an induction of CA4H in Jerusalem Artichoke, strongly inhibited potato CA4H induction. Dithiothreitol enhanced the CA4H activity due to either activation or protection of the enzyme. CA4H induction was significantly regulated at very low concentrations of trans-cinnamate and paracoumarate. PMID- 1786970 TI - Biochemical characterization of serum thyroglobulin from patients with bone metastases from follicular carcinoma of the thyroid. AB - The biochemical properties of serum thyroglobulin obtained from six patients with follicular carcinoma of the thyroid and distant metastases to bone(s) have been studied. Since it is difficult to isolate sufficient thyroglobulin from serum samples, in vivo radioiodinated serum thyroglobulin obtained after radioiodine administration was used. In contrast to a sharp salting-out pattern observed with native thyroglobulin isolated from normal thyroid tissue, a broad salting-out curve was seen with metastatic serum thyroglobulin. The metastatic serum thyroglobulin eluted with low ionic strength from ion-exchange column. More than 95% of metastatic serum thyroglobulin could be bound to concanavalin-A sepharose and be eluted with 0.5 M alpha-methyl mannoside. The reactivity of metastatic serum thyroglobulin and native thyroglobulin towards concanavalin-A was comparable. Both types of thyroglobulins showed identical mobilities on sucrose linear density gradient centrifugation. The metastatic serum thyroglobulin from follicular carcinoma of the thyroid thus appears to be 19 S thyroglobulin with near normal concanavalin-A binding sugars but altered surface charges. PMID- 1786971 TI - Effects of gamma-rays and glucose analogs on the energy metabolism of a cell line derived from human cerebral glioma. AB - Effects of gamma-rays and glucose analogs, 2-deoxy-D-glucose (2-DG), 5-thio-D glucose (5-TG) and 3-O-methyl glucose (3-O-MG) on cellular energy metabolism have been studied in a cell line, derived from a human cerebral glioma, by analysing intermediates of glycolysis and some important nucleotides (ATP, NAD etc.) using the technique of isotachophoresis. Gamma-irradiation induced a transient decrease in the nucleotide levels accompanied by an accumulation of sugar phosphates, the nucleotide levels recovering in a few hours post-irradiation. 2-DG inhibited glycolysis and reduced the nucleotide levels of irradiated as well as unirradiated cells in a concentration-dependent manner both in presence and absence of respiration, whereas 5-TG and 3-O-MG did not show significant effects in the presence of respiration. Reduced energy status observed with 2-DG under respiratory proficient conditions was completely reversed in 2 hr following its removal, whereas such a recovery was not observed in the absence of respiration. These results have important implications in the energy-linked modifications of tumour radiation response using glucose analogs. PMID- 1786972 TI - Effect of lignocaine on blood lipid in relation to partition coefficient and biological activity. AB - To correlate lipophilicity of lignocaine with changes in lipid composition of blood as a result of in vitro incubation with the drug, phosphorus content and fatty acid compositions of blood lipids before and after lignocaine treatment have been compared with those of a standard phospholipid, lecithin, under similar conditions of drug treatment. The change in fatty acid constituents has been correlated with the biological activity (both therapeutic and toxic) of lignocaine. PMID- 1786973 TI - Corticosterone administration and lipid metabolism in brain regions during development. AB - Effect of corticosterone on lipid contents of different brain regions and the effect of age on the sensitivity of these regions to corticosterone have been studied. Corticosterone administration (40 mg/kg body wt, sc) to 17-day-old rat for 3 days led to significant decrease in phospholipid content of cerebellum and increase in cholesterol contents of hippocampus and striatum. However, there was no effect on cerebral cortex and brain stem lipids. This alteration in lipids was associated with decrease in [U-14C] glucose incorporation into cholesterol and phospholipids, decrease in plasma beta-hydroxy butyrate levels and increase in beta-hydroxy butyrate dehydrogenase activity in hippocampus and striatum, thereby suggesting that suppression of glucose utilization by corticosterone was compensated by higher utilization of ketone bodies for lipid synthesis in these regions. The sensitivity to corticosterone appears to be age-specific as, at 20 day, cerebellum, hippocampus and striatum were susceptible, at 10-day only hippocampus and at 40- and 90-day none of these regions responded to the treatment. PMID- 1786974 TI - Electroporation of red blood cell membrane and its use as a drug carrier system. AB - Application of external electric field to cell suspension maintained at ice temperature induces pores in the cell membrane. At this stage, a drug added to the cell suspension equilibrates across the membrane. On raising the temperature to 37 degrees C, the pores appear to be sealed as the drug is retained in the cells. This method was used for encapsulation of Co-57 labelled cynocobalamin in rabbit erythrocytes. It was seen from the in vivo biokinetic study of the drug loaded erythrocytes that the rate of elimination of the drug was considerably reduced as compared to that of the free drug, indicating that drug delivery by electroencapsulation can give a sustained release of the drug. PMID- 1786975 TI - Chemical studies on purified exopolysaccharide from a virulent strain, ICMP 9758 of Pseudomonas solanacearum. PMID- 1786976 TI - Liver antioxidant defence and lipid peroxidation in vitamin D-deprived rats. PMID- 1786977 TI - Ovarian and testicular damage by cytotoxic drugs. AB - The use of cytotoxic drugs has improved the survival figures in malignancies. These drugs exert harmful effects on the tumour cell and normal cells as well. The detrimental effects on gonads were studied in 36 patients who had cytotoxic chemotherapy for various malignancies. In Group I (20 adults in clinical remission after chemotherapy), sterility was noted in 93.7% of men and hundred percent of women experienced irregularly mensus during treatment, 50% of them subsequently developing persistent amenorrhoea. In Group II, (16 adults undergoing chemotherapy) 100% of men had oligospermia, with 75% of them developing azoospermia after 2-3 cycles of treatment. Women also showed similar effect, but were less vulnerable than men. PMID- 1786978 TI - Differences in oestrogen receptor status and histological grade of breast cancer in different religious communities in Bombay. AB - The various religious communities in India viz.Hindu, Muslim, Christian, Parsi have different breast cancer incidence rate. It is not known whether there might also exist differences in biological properties of breast cancer between these communities. To investigate this possibility we have studied the distribution of oestrogen receptor (ER) status and histological grade of tumour in these four communities. Significant differences were observed in the overall distribution of ER positivity and histological grade between the communities P less than for both parameters). Christians had the highest incidence of ER +ve (65.2%) and grade I + II tumours (16.0%), while Muslims had the lowest incidence of ER +ve (35.8%) and Grade I + II tumours (4.7%). In general, we found a significant positive relationship between ER status and age of the patient (p less than 0.0.1). The mean age of the christians was slightly but significantly higher than that of the Hindus and Muslim. The difference ER positivity between the communities might, therefore, be partly (but probably not wholly) explained by difference in age of the patients. However, the difference with respect to grade of tumour cannot be explained as a function of age since no significant association was found between grade of the tumour and age of the patient. Further investigation with respect to difference in the biology of the breast cancer between the communities are warranted. PMID- 1786979 TI - Carcinoma of the hypopharynx: results of combined therapy. AB - Hypopharyngeal carcinoma is an aggressive cancer with a guarded prognosis. Results of 64 patients with-hypopharyngeal cancer, 59 of whom were in stage III or IV, undergoing curative therapy during a six-year period were analysed. A combined modality resulted in a 62% and 38.4% 2-year disease free survival incases with pyriform sinus and postcricoid tumours respectively. Results of radiotherapy failed salvage surgery were much poorer for either site. PMID- 1786980 TI - Tobacco usage in school children in Bombay, India. A study of knowledge, attitude and practise. AB - A study of knowledge, attitude and practice with regard to tobacco usage was conducted in 1278 boys and 353 girls studying in the final year in various schools in Bombay. The proportion of boys given to one or the other form of tobacco usage (including experimenters/triers) was significantly higher in private English median schools (22.5%) compared to private Indian language schools (6.9%) or municipal Indian language schools (13.8%). There was also a significant difference between the two types of Indian schools. Girls from only Indian language schools were entered into the study and the proportion of tobacco users in them was very low (1.1%). Most (86%) boys who used tobacco were smokers. Hence the detailed analysis is restricted to smokers. Several probable factors influencing smoking behavior were studied. It was found that significantly higher proportion of boys smoked if their father or best friend smoked. Generally boys were more sensitive to best friend's or elder brother's disapproval than to parental. They were well informed about harmfulness of smoking but knowledge about specific health hazards was limited. Most of them had a positive attitude towards nonsmoking and smoking control programmes. Tobacco use has been proven to be a major health hazard. Although its use in adults in India is common, prevalence in adolescents in urban schools is not yet high. Before the situation changes we need to mount anti-tobacco educational programmes and work towards a non-tobacco generation to contain the harmful consequences of tobacco usage. PMID- 1786981 TI - Prognostic factors and outcome of therapy in adult acute lymphoblastic leukemia. AB - We conducted a ten-year review of our patients of adult acute lymphoblastic leukemia. Most patients received vincristine and prednisone for induction. Twenty four patients additionally received doxorubicin. Serious pretreatment morbidity included intracerebral haemorrhage (8 patients), septicaemia (22 patients), pneumonia (8 patients) and CNS leukemia (3 patients). Our complete remission (CR) rate was 41%, predicted median duration of remission was 20.8 months and predicted median duration of overall survival was 10.4 months. Significantly higher CR rates were observed for lower age, female sex and lesser degrees of haemorrhage and infection. High initial WBC count was the only adverse prognostic factor for remission duration. Survival was significantly inferior for nonresponders, age greater than 20 years, and severe haemorrhage and infection. Remission attainment remains the chief obstacle to enhancing overall survival in adult acute lymphoblastic leukemia. However responders often experience years of good quality life. PMID- 1786982 TI - Hairy cell leukaemia. A review of nine cases. AB - Nine consecutive patients with HCL seen over a period of five years were reviewed. Male: Female ratio was 8:1. Median age at diagnosis was 49 years. Weakness and fatigue (66%) were the commonest presenting symptoms and splenomegaly (66%) was the commonest physical findings. Varying degrees of pancytopenia was the consistent feature in majority of cases. Diagnosis was made on the basis of bone marrow biopsy and characteristic EM picture. Forty-four percent of cases developed serious infection during their clinical course. Gram negative bacilli and fungi were the most frequently isolated organisms. Major sites of infections were pneumonia and septicemia. Splenectomy was carried out in four cases. Rapid recovery of haematological parameters without any significant complication was observed in all these cases. Two patients were treated with alfa interferon. In both the cases recovery of haematological parameters was slow compared to those under going splenectomy. One patient treated with alfa interferon died due to infection related complications while the other went into remission. PMID- 1786983 TI - Retropharyngeal lipoma. AB - Lipomata in retropharyngeal region are extremely rare. Accurate preoperative diagnosis is very important to assess invasion of muscles and to prevent local recurrence. A case of retropharyngeal lipoma is being discussed along with review of its clinical, radiological and surgical aspects. The role of CT scan in its definitive diagnosis is also discussed. PMID- 1786984 TI - Choroidal metastases as a presenting sign after 24 years of a primary breast cancer. AB - A case of relapsing breast carcinoma presenting with acute visual loss secondary to choroidal metastases is described. Relapse occurred 24 years after surgery and radiotherapy for primary lesion and spared the loco-regional area. Such a long remission period is unusual. PMID- 1786985 TI - Macrophage tumor cell interaction is enhanced by C3 fragments. AB - We tested the capacity of Lewis Lung carcinoma cells (3LL) to activate the alternative pathway of complement and to bind the C3 fragments on the plasma membrane. C3 fragments were detected by cytofluorometry and by immunoblotting. In time, the fixed C3b molecules were further cleaved into iC3b. The presence of C3b/iC3b on the target enhanced the formation of conjugates with macrophages. In spite of increased contacts, macrophages from tumor bearing mice were not cytotoxic. Only preactivated macrophages, by in vivo treatment with Corynebacterium parvum, were shown to be cytotoxic; this function was potentiated when the target cells were opsonized with C3b/iC3b. PMID- 1786986 TI - Model experiments for immunomagnetic elimination of leukemic cells from human bone marrow. Presentation of a novel magnetic separation system. AB - Optimal conditions for removing leukemic cells from human bone marrow with monoclonal antibodies (mAb) and magnetic immunobeads were investigated. Monodisperse 3 microns polystyrene microspheres containing magnetite were coated with affinity-purified rabbit antimouse IgG at 4 degrees C, pH 9.6 for 18 h. SKW 3 cells (T-CLL cell line) were marked with the supravital DNA stain Hoechst 33342, seeded into normal human bone marrow, and then incubated with the mAb CD1, CD6, and CD8 at 4 degrees C for 30 min. In preliminary experiments REH cells (cALL cells) and mouse anti-REH cell antibodies were used to find the most favorable conditions for the binding of magnetic beads to tumor cells. Optimal formation of cell-bead rosettes was achieved by rotating beads and tumor cells together at room temperature at a concentration of 1 x 10(7) cells/ml, a bead: tumor cell ratio of 100:1 and an incubation time of one hour. The novel magnetic separation apparatus consists of three polystyrene chambers connected by silicone rubber tubing. The chambers contain four steel inserts each equipped with 32 nickel wires, which are magnetized by permanent magnets in such a way that the inhomogeneous high gradient magnetic field could be established within the cell suspension containing the cells to be depleted. The fluid flow was established by a peristaltic pump. At a flow rate of 1.5 ml/min and a field strength of 160 kA/m, no beads could be detected in the purged marrow. A cocktail of the three mAb was more effective than any single antibody in forming bead-cell rosettes. Two sequential purging cycles were superior to one. The marrow recovered was highly viable as assessed by trypan blue dye exclusion and by growth of CFU-GM. PMID- 1786987 TI - The fatty acid composition of the lymphocyte cell membrane. Influence on interactions with high endothelium and the expression of homing receptors. AB - By incubating mouse lymphocytes in vitro with various fatty acids in an otherwise lipid-free medium, the lipid composition of the cell membrane was varied. These changes resulted in an altered adhesion pattern on High Endothelial Venules (HEV) using an in vitro adherence assay. Incubation with linoleic acid (18:2) resulted in an increased adherence of T and B lymphocytes, linolenic acid (18:3) had no influence and both arachidonic acid (20:4) and arachidic acid (20:0) resulted in a decreased adherence of the two cell types when the adherence assay was performed using HEV from peripheral lymph nodes. Using HEV from mucosa associated Peyer's patches, T and B cells incubated with arachidic acid or arachidonic acid were less able to adhere this type of HEV. After incubation with linoleic acid, T lymphocytes adhere better to the Peyer's patches HEV whereas B cells showed a decrease in adherence and linolenic acid resulted in a decreased adherence of only B lymphocytes. FACS analysis revealed that MEL-14 expression as well as the expression of LFA-1 was somewhat elevated in intensity on T and B lymphocytes after incubation with linoleic acid. In contrast, the intensity for MEL-14 had decreased after arachidic acid or arachidonic acid. In case of arachidic acid the LFA-1 expression had also decreased. No changes were found after incubation with linolenic acid. The results suggest a role for the lipid composition of the membrane in recirculation patterns of lymphocytes. PMID- 1786988 TI - Localization of class II molecules in storage vesicles, endosomes and lysosomes in human dendritic cells. AB - Class II molecules are a prerequisite for antigen presentation. We studied whether class II molecules can be found in the endocytic and/or lysosomal route of dendritic cells (DC), which are very potent antigen-presenting cells. Therefore first immunolabelling for HLA-DR alpha chain was applied on ultrathin cryosections of cells of which plasma membrane HLA-DR/DQ molecules were labelled in suspension, followed by incubation with the endocytic marker BSA-gold. Second, immunolabelling for HLA-DR alpha chains was applied on ultrathin cryosections of cells on which enzyme cytochemistry for acid phosphatase (APh) was performed to see whether the class II positive vesicles belong to the lysosomal compartment. Third, this immunolabelling was applied on cryosections of cells pretreated with the protein synthesis inhibitor cycloheximide (CHX) to see whether the class II positive vesicles are derived from biosynthesis. We found limited uptake of BSA gold into endosomes and lysosomes, some of which also contained endocytozed HLA DR/DQ. APh and HLA-DR were observed in the same vesicles but also vesicles containing either HLA-DR or APh were found. However, many class II positive vesicles were found, which were apparently not accessible to exogenous molecules. Moreover, the amount of class II positive vesicles decreased after treatment of the cells with CHX, suggesting that these vesicles form part of the biosynthetic route. These results imply that there is a cluster of class II positive vesicles, probably a storage compartment, that has connections with the lysosomal system. The concentration of lysosomes and class II positive vesicles in the juxtanuclear area of DC is probably of crucial importance in the processing of antigens. PMID- 1786989 TI - A possible site of in vivo action of cyclosporin A for transplantation immunity: comparative study with cyclophosphamide. AB - The immunosuppressive mechanisms of cyclosporin A (CsA) and cyclophosphamide (CPM) in vivo were studied by measuring the transplantation immunity for second set rejection of an allogeneic ascites tumor. The transplantation immunity in our assay system was mediated primarily by allospecific cytotoxic T lymphocytes (CTL). Our results showed that both CsA and CPM did not affect the process of inducing the immunity, but they inhibited the effector phase of that transplant immunity. The experiments using 51Cr-release assay in vitro on peritoneal exudate cells as effector cells showed that the effector phase of the transplantation immunity in vivo involved the maturation from immunological memory CTL-precursor cells to effector CTL with clonal expansion. Further, adoptive cell transfer experiments showed that CsA did not eliminate the immunological memory CTL nor induce the suppressor cells in donor mice. All the data suggested that the maturation of memory CTL precursor cells to effector CTL was inhibited by CsA which would block lymphokine production even in vivo, whereas CPM eliminated the CPM-sensitive memory CTL precursor cells. The findings that CsA and CPM act on the different sites of CTL maturation support the possibility of effectiveness of the combination therapy of the two agents for controlling the transplantation immunity. PMID- 1786990 TI - Characterization of the C5a receptor on guinea pig platelets. AB - Guinea pig (gp) platelets react to nanomolar doses of the complement-derived anaphylatoxin C5a with a shape change, aggregation and release of biogenic amines and nucleotides from their granules. We have investigated the specific receptor for C5a on gp platelets which mediates these biological effects. Competitive binding studies with 125I-labeled guinea pig C5a (125I-gpC5a) revealed approx. 4000 binding sites/cell with Kd = 6 x 10(-9) M. The more than 60-fold higher biological activity (ATP-release from gp platelets) of gpC5a versus recombinant human C5a (rhuC5a) and the different binding behavior of gpC5a and rhuC5a point to a species restriction in the gp platelet system. Cross-linking of 125I-gpC5a to gp platelets (250 microM DSS) and analysis by SDS-PAGE under reducing conditions resulted in labeling of a single band with a molecular mass of 32 kDa (ligand-receptor complex). Because of these characteristics, the C5a receptor on gp platelets clearly differs from all previously described C5a receptors. PMID- 1786991 TI - Crosslinked staphylococcal enterotoxin B stimulates CD8+ T cells only in the presence of unlinked costimulator signals. AB - The superantigen staphylococcal enterotoxin B (SEB) binds to class II MHC expressing cells and subsequently causes selective activation of T cells carrying appropriate T cell receptor (TCR) V beta chains. Apparently SEB acts as a bifunctional molecule by bridging class II MHC structures with the appropriate TCR-V beta chains. This assumption predicts that immobilized SEB ought to stimulate purified, class II MHC negative murine T cells. We show here that immobilized SEB lacks the ability to trigger murine CD8 T cells. Responsiveness obtained at a high T cell concentration is due to contaminating class II MHC positive lymphocytes. Complementation of the culture system with syngeneic irradiated B cells blasts effectively restores responsiveness. The proliferating cells exhibit SEB specific cytotoxicity and a bias for V beta 8 expression. Since no evidence for leakiness of SEB covalently bound to sephadex beads was obtained, the data imply that immobilized SEB in fact binds to the TCR of T cells expressing the appropriate V beta chains. However, for primary activation additional costimulatory signals are required which can be provided in an unlinked fashion by activated B cells. Resting B cells are activated by immobilized SEB to cells expressing high costimulator activity. As such, the data point out a third function of SEB. PMID- 1786992 TI - Proliferation of germinal center B lymphocytes in vitro by direct membrane contact with follicular dendritic cells. AB - In secondary lymphoid organs, follicular dendritic cells (FDC) are located within B cell follicles and germinal centers. Through their cytoplasmic extensions they come into contact with a large number of neighboring lymphocytes. Using an enzyme cocktail to digest human tonsils followed by ultracentrifugation on bovine serum albumin gradients, single cell suspensions were obtained. Immunocytochemistry revealed that 7% of the cells were FDC, 5% T cells, and 5% macrophages. The remaining population were B cells with greater than 95% being of the germinal center phenotype (i.e. CD19-positive, CD39/sIgD negative). After 24 h of culture up to 44% of the lymphocytes were found in clusters centered around FDC. At the start of the culture as well as 24 and 72 h later, between 31 and 55% of the B cells within FDC associated clusters were in late G1 to M phase of the cell cycle. In contrast, less than 10% of the B cells not in contact with FDC (i.e. outside the clusters) were in an activated state. Autoradiography revealed that after three days of incubation the rate of proliferation was 26.2 times higher for the lymphocytes involved in cluster formation as compared to those cells not associated with FDC. Furthermore, the number of viable B cells after a 72 h mitogen-free culture period was determined. By adding FDC to these preparations, 31.9% of the lymphocytes were rescued from dying. These data show that FDC provide a microenvironment which can maintain the viability, activation and proliferation of germinal center B cells in vitro. PMID- 1786993 TI - Interleukin-2 and phytohaemagglutinin stimulate the proliferation of tunicate cells. AB - Proliferative responses of cells in tunicate pharyngeal explants to human interleukins and mitogenic lectins were tested. Increased tritiated-thymidine [( 3H]-TdR) uptake was detected among pharyngeal cells incubated with recombinant human interleukin-2 (IL-2), and phytohaemagglutinin-P (PHA-P). Responses to IL-2 were dose-dependent and affected lymphocyte-like cells. Enhanced proliferation was stimulated by IL-2 in the absence of co-stimulants and was not synergized by co-incubation with human interleukin-1 (IL-1) or PHA-P. Anti-IL-2 polyclonal antibody inhibited the stimulatory activity of recombinant human interleukin-2 (rhIL-2). Of three lectins tested (concanavalin-A [Con-A], pokeweed mitogen [PWM] and PHA-P), only PHA-P proved to be mitogenic. Con-A and PWM did not significantly increase proliferative activity even though both lectins were capable of binding pharyngeal cells as revealed by flow cytometry and fluorescence microscopy. Similarly, human IL-1 had no effect on [3H]-TdR uptake either alone or in combination with IL-2 and PHA-P. These data suggest that the functions of some interleukin-like cytokines have been conserved during evolution. PMID- 1786994 TI - In vitro activation of rGM-CSF derived bone marrow macrophages by cisplatin and lipopolysaccharide. AB - Treatment of fresh non-adherent bone marrow cells (NABMC) with cisplatin or lipopolysaccharide (LPS) did not render them tumoricidal. NABMC incubated in medium alone or medium containing recombinant granulocyte macrophage colony stimulating factor (rGM-CSF) for 4 days matured to macrophages that were positive for non-specific esterase staining. Bone marrow-derived macrophages cultured with medium alone did not respond to cisplatin or LPS by the induction of tumoricidal activity, whereas rGM-CSF derived bone macrophages showed significantly enhanced cytotoxicity after treatment with cisplatin or LPS. Culturing of NABMC with rGM CSF enhanced cell survival compared to the cells incubated in medium alone. These results suggest that bone marrow cells not only mature in rGM-CSF, but are also primed by rGM-CSF for induction of tumoricidal activity. PMID- 1786995 TI - Temporal variations in the fine specificity of IgM anti-fluorescyl antibodies. AB - This study compares the fine specificities of the primary and secondary fluorescein (FITC)-specific immunoglobulin M (IgM) repertoires in BALB/c mouse serum and monoclonal antibodies (MoAb) and has found reproducible, immunization dependent differences. FITC and four of its homologues; iodoacetamido fluorescein (IAF), dichlorotriazinyl aminofluorescein (DTAF), substituted rhodamine isothiocyanate (XRITC) and tetramethyl rhodamine isothiocyanate (TRITC), each conjugated to bovine serum albumin (BSA), were used to determine reactivity patterns of serum IgM from mice immunized once or twice with FITC-haemocyanin (FITC-Hy). Reactivity patterns were also obtained for 20 IgM MoAb, eight of which were produced by fusions of SP2/0 myeloma cells with splenocytes from mice immunized once (primary) and 12 from mice immunized twice (secondary) with FITC Hy. Each MoAb exhibited a unique fine specificity pattern, evidence of extensive heterogeneity in the FITC-specific repertoire. Reactivities of IgM MoAb with certain homologues were found to be more characteristic of either the primary or secondary response. Polyclonal serum IgM also showed reproducible immunization dependent variations in fine specificity. Such a pattern could result from idiotypic suppression of primary antibodies, from the expansion of subsets of IgM memory cells utilizing novel genes and/or from somatic mutation absent in primary IgM antibodies. PMID- 1786996 TI - Molecular cloning, expression and characterization of ovine TNF alpha. AB - Tumour necrosis factor alpha (TNF alpha) is a cytokine with a wide range of effects on both lymphoid and non-lymphoid cell types. By hybridization with a human TNF alpha cDNA probe the corresponding ovine cDNA was isolated from a lipopolysaccharide (LPS) stimulated alveolar macrophage cDNA library. The sequence of the cDNA clone showed that ovine TNF alpha encodes a polypeptide of 234 amino acids that, based on analysis of human TNF alpha, is processed to a protein of 157 amino acids. The nucleotide and amino acid sequences showed a high degree of homology to the equivalent human and mouse molecules. In a mammalian COS cell expression system the ovine cDNA was found to encode a protein which was able to lyse actinomycin-D treated WEHI-164 cells and induce COS cells to produce and secrete interleukin 6 (IL-6). Further experiments demonstrated the importance of sequences within the 3' untranslated region of the cDNA in determining the level of expression of ovine TNF alpha. Northern blot analysis was used to analyse the kinetics of induction of ovine TNF alpha mRNA in alveolar macrophages stimulated with a variety of mitogens. Addition of LPS increased mRNA encoding TNF alpha at 1 h and 5 h but not 24 h post stimulation. In contrast, addition of phorbol myristic acid (PMA) led to increased TNF alpha mRNA at 5 h while the combination of PMA and ionomycin increased the level of specific mRNA detected at 1 h, 5 h and 24 h. From genomic analysis ovine TNF alpha appears to exist as a single copy. PMID- 1786997 TI - The 'Burnet era' of immunology: origins and influence. PMID- 1786998 TI - The early history of the Australian Society for Immunology. PMID- 1786999 TI - Australian Society for Immunology: the 1970s. PMID- 1787000 TI - Some highs of cellular immunology in the late 1960s, early 1970s: personal reflections. PMID- 1787001 TI - Australian Society for Immunology in the 1980s. PMID- 1787002 TI - The Australian Society for Immunology in the 1990s and beyond. PMID- 1787003 TI - Some landmarks in Australian immunology. PMID- 1787004 TI - Preferential binding of Chlamydia trachomatis to subsets of human lymphocytes and induction of interleukin-6 and interferon-gamma. AB - The interactions between Chlamydia trachomatis and human blood mononuclear leukocytes were studied using flow cytometry, immunofluorescence, electron microscopy and cytokine assays. Under serum-free conditions, elementary bodies (EB) of C. trachomatis were found to bind to human T lymphocytes as well as to B cells and monocytes/macrophages (M phi). For all cell types the binding was saturable, rapid, temperature-independent and independent of the chlamydia specific serological status of the donor. Similar proportions of T and B cells bound EB at similar levels. In the T cell population, proportionally less CD8+ cells bound EB. Whereas M phi phagocytosed and destroyed the bound micro organisms for lymphocytes, the Chlamydia remained at the surface, adherent to morphologically featureless membrane areas and showed no evidence of uptake even after long periods at 37 degrees C. Host molecules modulated these basic binding patterns: a heat-stable serum factor inhibited EB binding to T cells and a heat labile serum factor enhanced binding to B cells. Stimulation with C. trachomatis EB rapidly elicited cytokine production by lymphocytes including interleukin-6 from B cells and interferon-gamma (IFN-gamma) from T and/or nonT/nonB cells. The responses were irrespective of the serological status of the donor. The findings suggest that C. trachomatis-leucocyte interactions may differ from the interactions of other bacteria and human leucocytes. The possible relationship between leucocyte-binding, cytokine induction, and the pathognomonic development of lymphoid follicles during mucosal C. trachomatis infections is discussed. PMID- 1787005 TI - Susceptibility of multipotent haemopoietic stem cell deficient W/Wv mice to Plasmodium berghei-infection. AB - The susceptibility of haemopoietic stem cell deficient W/Wv mice to infection with Plasmodium berghei was examined. The mean survival time of W/Wv mice after the infection was shorter than that of the +/+ mice. Splenomegaly, a characteristic pathological change of the host after infection with malaria parasites was not observed in W/Wv mice. When haemopoietic activity of the infected mice was examined, a substantial increase in number of multipotent haemopoietic stem cells (CFU-S) and the committed stem cells for granulocytes and macrophages (CFU-GM) or for erythrocytes (CFU-E) was observed in the bone marrow and spleen of +/+ but not of W/Wv mice. CFU-S were not detected in W/Wv mice before or after infection. The number of CFU-GM and CFU-E in bone marrow and spleen of W/Wv mice decreased after infection. Bone marrow grafting from +/+ to W/Wv mice 8 weeks before infection prolonged the mean survival time of the mice and effectively restored the number of CFU-S in the spleen of W/Wv mice. These results indicate that multi-potent haemopoietic stem cells play an important role in the host's defence mechanisms against P. berghei-infection. PMID- 1787006 TI - Radiology of the esophagus. AB - Plain films, esophagrams, and cross-sectional imaging studies have important roles in evaluating patients with suspected esophageal disease. The strengths and weaknesses of each technique are described in this article. The salient radiographic features of various inflammatory and neoplastic conditions of the esophagus are also described, with emphasis on the value of high-quality triphasic esophagography. PMID- 1787007 TI - Mucosal diseases of the esophagus. PMID- 1787008 TI - Esophageal ultrasonography. AB - Esophageal ultrasonography (EUS) is the most sophisticated noninvasive technique for characterizing esophageal mucosal detail. Many pathologic states can be defined more accurately with the use of EUS, resulting in better patient management decisions. Technical and practical aspects of EUS are discussed in this article. PMID- 1787009 TI - Benign structural lesions of the esophagus. AB - This article discusses a wide spectrum of intrinsic benign structural lesions of the esophagus. Additionally discussed are extrinsic benign structural lesions that may cause esophageal symptoms. Because any congenital anomaly or disease of a structure that normally impinges on the esophagus, or is adjacent to it, may distort the esophagus, we review disorders from several different organ systems. PMID- 1787010 TI - Esophageal foreign bodies. AB - Foreign body ingestion is a common occurrence in children and in specific high risk groups of adults such as those with underlying esophageal disease, prisoners, the mentally retarded, and those with psychiatric illnesses. Although most foreign bodies pass through the gastrointestinal tract without difficulty, sharp, pointed, and elongated foreign bodies are associated with a greater risk of perforation, vascular penetration, and other complications. Foreign body ingestion is usually diagnosed based on a history of ingestion given by the patient or an observer. However, children and impaired adults may be unable to give an accurate history, and a high index of suspicion must be maintained in these groups. Dysphagia and odynophagia are the usual symptoms of foreign body impaction in the esophagus. Respiratory symptoms due to compression of the adjacent trachea are also common in younger children and are occasionally the presenting symptom in adults. The preferred method of removal of esophageal foreign bodies is extraction with the flexible endoscope. This may be accomplished in both adults and children with the use of conscious sedation rather than general anesthesia. The availability of grasping instruments specifically designed for foreign body removal and snares greatly facilitates endoscopic extraction. An overtube conveys all of the advantages of the rigid esophagoscope to the flexible endoscope, enabling extraction of sharp and pointed foreign bodies while protecting the mucosa from injury. Adherence to the general principles of foreign body removal and proper preparation result in successful removal rates as high as 98%, with minimal or no complications. Nonendoscopic methods of removal are associated with increased risks of perforation and aspiration and generally should be avoided, with the exception of a trial of intravenous glucagon. Surgical removal is rarely indicated except in the event of perforation or other foreign body complications. PMID- 1787011 TI - Squamous cell carcinoma of the esophagus. Natural history, incidence, etiology, and complications. AB - In an attempt to improve the dismal outcome of patients with esophageal squamous cell carcinoma, attention has recently focused on suspected causes and other known influences on the course of this disease. This article reviews recent literature regarding the natural history, incidence, etiology, and complications of squamous cell cancer of the esophagus. PMID- 1787012 TI - Radiation and chemotherapy in the treatment of esophageal cancer. AB - Patients with esophageal cancer present with a cancer that is locally aggressive in a critical area and that readily metastasizes. Neither surgery nor radiotherapy alone can control local disease, and chemotherapy alone cannot control local or disseminated disease. Combined modalities yield better results. Surgery or radiotherapy is the standard primary treatment. Chemotherapy may help to control local disease and microscopic metastatic disease. Prospective randomized trials indicate that chemotherapy added to surgery and radiotherapy and chemotherapy added to radiotherapy prolong survival. PMID- 1787013 TI - Benign and metastatic tumors of the esophagus. AB - With the widespread use of fiberoptic endoscopy, benign esophageal tumors are being identified with increasing frequency. It is important to be familiar with the radiologic, endoscopic, and histologic features of these tumors so that appropriate therapy may be facilitated. Overall, the prognosis of patients with benign esophageal tumors is excellent. These tumors must not be confused with the much more common malignant tumors, which carry a dismal prognosis. Metastatic tumors may involve the esophagus, and esophageal symptoms may be the presenting symptoms of an extraesophageal malignancy. Endoscopic biopsy specimens frequently show a normal mucosa. The endoscopist should be aware of this and pursue further workup to exclude extraesophageal malignancy when indicated. As endoscopic ultrasonography becomes routinely available, it will improve the characterization of these lesions and allow more benign esophageal lesions to be safely removed using endoscopic methods. PMID- 1787014 TI - Barrett's esophagus. Natural history, incidence, etiology, and complications. AB - This article reviews the natural history of Barrett's esophagus. The pathology and etiopathogenesis are considered in detail, as are the symptoms and complications of this condition. The indication and efficacy of medical and surgical therapy are reviewed, and the question "Does regression of Barrett's metaplasia occur?" is posed. PMID- 1787015 TI - Barrett's esophagus and esophageal adenocarcinoma. AB - Barrett's esophagus is a condition in which the normal stratified squamous epithelium is replaced by a specialized metaplastic columnar epithelium. It develops as a consequence of chronic gastroesophageal reflux and predisposes to the development of esophageal adenocarcinoma. Adenocarcinoma develops in Barrett's esophagus by a multistep process in which specialized metaplasia progresses to dysplasia, then to early adenocarcinoma, and eventually to deeply invasive and metastatic disease. This neoplastic progression is associated with a process of genomic instability that generates abnormal clones of cells, some of which have aneuploid or increased G2/tetraploid DNA content. A systematic protocol of endoscopic biopsy can detect Barrett's adenocarcinomas at an early stage, when they may be curable. PMID- 1787016 TI - Pill-induced esophageal injury. AB - Delay in esophageal transit of caustic medicinal pills may precipitate esophageal ulceration. The injury is usually mild, producing only self-limited pain. More serious injury may result in esophageal hemorrhage, perforation, or stricture. Injury is more likely if pills are taken without water or while lying down. Patients with esophageal compression from left atrial enlargement are at increased risk, especially if they have had cardiac surgery. PMID- 1787017 TI - Caustic ingestion injuries. AB - Ingestion of caustic agents causes more than 5000 injuries yearly. There is little that the physician can do acutely to attenuate the severity of the internal injuries, but the physician must intensively monitor the patient and react quickly to treat laryngeal burns or transmural penetration of esophageal or gastric burns. Esophageal strictures may appear at any time after the second week. No therapy has been shown to reduce the incidence of strictures. A policy of vigilant anticipation and early dilatation of developing strictures is recommended. PMID- 1787018 TI - Complications of esophageal variceal sclerotherapy. AB - The authors of this article provide a review of complications of esophageal variceal sclerotherapy, including their recognition, management, and prevention. They also discuss the safest possible performance of the procedure. PMID- 1787019 TI - Drug-use profiles, race, age, and risk of HIV infection among intravenous drug users in San Francisco. AB - We examined the relationship of HIV serostatus to drug use profile, high risk behavior, drug treatment status, and demographic characteristics of 505 intravenous drug users (IVDUs) in San Francisco. We found five identifiable drug injection profiles described as Omnijector, Primarily Heroin, Primarily Heroin/Cocaine, Primarily Cocaine, and Primarily Speed which fell into "higher risk" and "lower risk" categories in relation to HIV seroprevalence of members (17.0 and 9.8%), respectively. This difference was not significant when effects of race were held constant (adjusted OR = 1.66, 95% CI = 0.91, 3.01). In logistic regression analysis, only Black race and age under 30 were significant predictors of HIV seropositivity (OR = 2.95, 95% CI = 1.57, 5.52 and OR = 2.05, 95% CI = 1.01, 4.13, respectively). Neither membership in higher risk profile nor frequency of injection (including daily or greater injection of cocaine) contributed to the model. We conclude that Black IVDUs under 30 are at greatest risk of HIV infection, that multiple patterns of drug use injection and habituation require additional resources to treat, and that the heterogeneous distribution of HIV weakens the predictive power of known behavioral risk factors in this population. PMID- 1787020 TI - HIV, drugs, and public health in England: new worlds, old tunes. AB - Since 1986 there has been a major reconceptualization of drugs policy in England in response to HIV and AIDS with new ideas about risk behavior and risk reduction, and health behavior and harm minimization. The debate appears to have a new public health emphasis, but historical examination shows public health concerns have emerged in earlier periods. We examine three models of public health and their influence on drugs policy. The current drugs debate is informed by late twentieth century concern for the individual body and life-style choices. While drug policy has been given new purpose by these developments, this model of public health is essentially individualistic in focus and limited in practice. PMID- 1787021 TI - The next problem: maintenance of AIDS risk reduction among intravenous drug users. AB - Intravenous drug users have surprised many policymakers and researchers by exhibiting large-scale AIDS risk reduction. Relapse from desired behavior change has been a traditional problem in treatment for drug misuse/dependence. Failure to maintain AIDS risk reduction was examined in a study of 399 intravenous drug users from New York City. Over 80% of the subjects reported initiating risk reduction, but 36% of those also reported that they did not fully maintain the risk reduction. Factors associated with initiating risk reduction were not necessarily associated with maintenance, indicating that different types of change processes may be occurring. At the policy level, one needs to think of long-term efforts to reduce the spread of HIV among drug users; "quick fix" programs are not likely to be effective. PMID- 1787022 TI - Syringe exchange for prevention of HIV infection in Sweden: practical experiences and community reactions. AB - An HIV prevention project, including syringe exchange, among intravenous drug users was started in Lund, Sweden, in November 1986. The program has been effective in reaching local addicts. Practical problems have been few. The educational and epidemiological effects on HIV infection are promising, and local drug treatment programs have benefited from the project in that previously untreated users have been attracted to treatment. The syringe exchange has been much debated. In general, the medical society, local authorities, and mass media have been supportive, while many politicians and social workers, especially in other parts of the country, have been strongly opposed. At present, the existence of the project is threatened. PMID- 1787023 TI - Effects of Amsterdam needle and syringe exchange. AB - The needle and syringe exchange in Amsterdam was initiated in 1984 by the Junky Union. To date, ample data are available to support the role of the needle exchange in facilitating drug injectors to use drugs in a safer way: no increase in drug use could be validated, participants of the exchange schemes were less involved in needle sharing, the supply of large quantities of needles to drug users did not lead to an increase in needle stick accidents by the general public, and, finally, the HIV prevalence among drug injectors has remained stable since 1986, while the incidence of acute hepatitis B has gone down. PMID- 1787024 TI - A controlled trial of methadone maintenance in a population of intravenous drug users in Bangkok: implications for prevention of HIV. AB - This study represents the first controlled trial of methadone maintenance and 45 day methadone detoxification in Thailand. We randomly assigned 240 male heroin addicts with at least six prior detoxification treatment episodes to 45-day detoxification or to methadone maintenance treatment conditions. We found that methadone maintenance clients were more likely to complete 45 days of treatment (p less than .00001), were less likely to have used heroin during treatment (p less than .0002), and were less likely to have used heroin on the 45th day of treatment (p less than .000007). These findings are consistent with the results of other studies in the United States, and we conclude that methadone maintenance could be a significant adjunct to AIDS prevention efforts for intravenous drug users in Thailand. PMID- 1787025 TI - HIV prevention among IVDUs in the Federal Republic of Germany: stability and change. AB - These comments on German drug and AIDS policy are based on the author's two decades of experience in the field of drug user treatment, on recent studies about the epidemiology and etiology of HIV among IVDUs, and on evaluative studies on demonstration projects. German drug use/user policy did not change much in the face of AIDS: no large maintenance or needle-exchange programs were initiated. This is because a well-prepared system of low-threshold methods targeted at IVDUs not ready to undergo treatment was in place before the epidemic. This system has been modified to integrate the aims of HIV prevention among IVDUs and is free of charge and available throughout the country. PMID- 1787026 TI - AIDS beliefs and behaviors among intravenous drug users in Bangkok. AB - Prompted by an explosive epidemic of HIV-1 in early 1988 among Thai IVDUs under treatment for heroin use, a series of focus group discussions were conducted at six Bangkok detoxification clinics. In developing qualitative information on knowledge of and attitudes toward AIDS, and on drug use and sexual behavior, our objectives were to identify intervention measures, develop culturally-appropriate educational material, strengthen counseling, and sharpen the focus of needed quantitative research. An abundant store of diverse anecdotal responses and reactions emerged. We discuss the reliability and the policy and research implications of these findings. PMID- 1787027 TI - The regulation of mortality and fecundity in Schistosoma mattheei following a single experimental infection in sheep. AB - The regulation of mortality and fecundity of Schistosoma mattheei in sheep was examined using a series of mathematical models applied to data culled from the literature. Parasite mortality (mu) was found to be an increasing linear function of the magnitude of the initial infection over the ranges of doses examined (200 91,000 cercariae) where mu = 9.78 x 10(-3) + 3.476 x 10(-7) infection dose. Parasite fecundity (lambda) was found to be inversely related to the duration of the infection. The best fit model for parasite fecundity was one in which fecundity decreased exponentially with time since initial infection, lambda = lambda 0e-delta(t-tau). There was no evidence for density-dependent regulation of fecundity. PMID- 1787028 TI - The effect of specific immunization or infection with Trichostrongylus colubriformis on production of eosinophil differentiation factors in guinea pigs. AB - The cultivation of bone marrow was used to quantitate the levels of eosinophil differentiation factors (EDF) produced in conditioned medium (CM) by incubation of mesenteric lymph node cells (MLNC) with mitogens or specific antigens from the intestinal nematode parasite, Trichostrongylus colubriformis. In liquid cultures with 20 units ml-1 recombinant murine interleukin-5 (IL-5), bone marrow cells (BMC) from either normal or infected donors contained less than 5% eosinophils and differentiated to greater than 50% eosinophils over 2-3 weeks. Conditioned medium from 3-4 week infected donors produced between 20 and 50% eosinophils when donor MLNC were stimulated with the specific antigen preparation SP3, but macrophages predominated when using CM from MLNC incubated with Concanavalin A (ConA). CM from MLNC of challenged donors incubated with SP3 produced 30-70% eosinophils in BMC assays, with highest levels induced by CM from high responder (HR) donors. Marrow from parasitized or normal donors gave rise to comparable proportions of eosinophils. CM was also produced from LNC of donors given protein or parasite antigens in adjuvant where between 28 and 35% eosinophils were produced in culture. There were no differences between activities attributable to the antigen, but Freund's complete adjuvant induced earlier differentiation of BMC than alum-induced CM. The results confirm that high levels of EDF activity are specifically induced by parasitic infection, and can also be produced by intraperitoneal and subcutaneous inoculation of adjuvanted antigens. Consistent with the greater eosinophilia exhibited by HR guinea pigs to infection with T.colubriformis L3, their MLNC also produced the highest levels of EDF activity. PMID- 1787029 TI - Murine T cell clones specific for Hymenolepis nana: generation and functional analysis in vivo and in vitro. AB - To examine the role of the T cell in protective immunity to Hymenolepis nana, H. nana-specific clonal lymphocytes were generated from mesenteric lymph nodes of BALB/c mice infected with H. nana, and some of their functions were analyzed in vitro and in vivo. Following limiting dilution techniques, five clones were generated from mesenteric lymph node cell populations. All of these clones expressed the L3T4+, Lyt-2.2- phenotype and proliferated in vitro in response to soluble egg antigen of H. nana. Of five clones, three secreted interleukin 2 (IL 2) and interferon-gamma (IFN-gamma) after stimulation with egg antigen. Furthermore, these three clones conferred local delayed-type hypersensitivity to egg antigen. The remaining two clones produced interleukin 4 (IL-4) in response to egg antigen, and could not mediate local delayed-type hypersensitivity. Adoptive transfer experiments using clonal lymphocytes were also undertaken in an attempt to define cell types involved in protective immunity. Clonal lymphocytes secreting both IL-2 and IFN-gamma transferred protective immunity, equivalent to that obtained by non-cultured-sensitized mesenteric lymph node cells. They were effective in very small numbers. However, clonal lymphocytes that secreted IL-4 did not transfer protective immunity. These results suggest that helper T lymphocytes, especially the Th1 subtype, are involved in protective immunity against H. nana. PMID- 1787030 TI - Ultrastructural and histochemical observations on the tegument of Gastrodiscoides hominis (Paramphistoma: Digenea). AB - The tegument of the paramphistome, Gastrodiscoides hominis, is basically similar to that of other digeneans. It is folded into concentrically arranged furrows and ridges bearing numerous tightly packed tubercules, and extends into the oral cavity. An area of specialized tegument is present on the ventral surface, anterior to the disc region. Mitochondria are absent from the tegumental syncytium and underlying tegumental cells, suggesting that the tegument may serve principally as a protective layer rather than in active uptake phenomena. However, extensions of the lymph and parenchyma systems are closely associated with the base of the tegumental syncytium and may provide ATP for active processes. Ciliated and non-ciliated sensory papillae are present, particularly around the oral opening. Numerous lymph channels are present in the sub-tegument and may be involved in osmoregulation. PMID- 1787031 TI - A comparison of the reproductive parameters of females of two reptile tick species. AB - In comparisons of females of two reptile tick species Aponomma hydrosauri and Amblyomma limbatum, Ap. hydrosauri was initially larger, and after mating on the host engorged faster and remained attached for a shorter time before completing engorgement and detaching. Amb. limbatum had a longer period of engorgement, and achieved a greater engorged weight. Engorged Amb. limbatum females laid significantly more eggs than equivalent sized Ap. hydrosauri. Although the two species are ecologically similar and were collected from the same site for this study, their reproductive differences probably reflect adaptations to different conditions in their largely allopatric ranges. PMID- 1787032 TI - Identification of tubulin isoforms in different tissues of Ascaris suum using anti-tubulin monoclonal antibodies. AB - Three monoclonal antibodies specific to alpha- and beta-tubulin were used to examine the expression of tubulin isoforms in the intestine, reproductive tract and body wall muscle of A. suum. The tubulins were found to be different in their isoelectric points, number of isoforms and peptide maps with Western blot analysis of one-dimensional polyacrylamide gel confirming the presence of alpha-, beta 1- and beta 2-tubulin. Commercial cross-reactive anti-alpha and anti-beta MAbs 356 and 357 recognized tubulin from A. suum tissues as well as from pig brain, whereas anti-A. suum beta-tubulin specific MAb P3D6 recognized tubulin from the A. suum tissues only. Two-dimensional gel analysis showed different isoform patterns in different A. suum tissues with anti-A. suum beta-tubulin MAb P3D6 and cross-reactive beta-tubulin MAb 357 recognizing 2-4 beta-tubulin isoforms and anti-alpha-tubulin MAb 356 recognizing 1-6 alpha-tubulin isoforms. Different peptide maps of tubulin were observed in the three tissues, when subjected to limited proteolysis followed by SDS-PAGE. The data indicate that different tubulins are found in different tissues of adult A. suum. PMID- 1787033 TI - Oltipraz-induced decrease in the activity of cytosolic glutathione S-transferase in Schistosoma mansoni. AB - The activity of glutathione S-transferase (GST) decreased progressively in Schistosoma mansoni from mice treated with oltipraz (OPZ). However, the peroxidase activity of GST (selenium-independent) and selenium-dependent glutathione peroxidase was not affected by OPZ treatment. Purification and quantification of GST from worms after OPZ treatment indicated that the decrease in enzyme activity was greater than could be accounted for by the decrease in GST protein content. SDS-polyacrylamide gel electrophoresis followed by Western blot analysis with GST isoenzyme specific antisera revealed a slight decrease in the quantity of both 26 and 28 kDa GSTs. Fractionation of cytosolic GSTs from male S. mansoni by chromatofocusing resolved three major isoenzymes (SmI, II and III) and a minor form which eluted first from the column. SmI, II and III all had a molecular weight of about 28 kDa on SDS-polyacrylamide gel electrophoresis. However, on electrophoresis in the absence of SDS, the three GST forms exhibited different mobilities. The pattern of SmI, II and III was similar in untreated and OPZ-treated worms, but the activities of the isoenzymes from treated worms were lower. The results suggest that OPZ interacts with the GST isoenzymes SmI, II and III in a similar manner; thus, the effects are not isoenzyme specific. Taken together, these results suggest that OPZ and/or its metabolites interact directly with GST resulting in inhibition of activity and reduction in total enzyme protein. This mechanism may be important in the antischistosomal action of OPZ. PMID- 1787034 TI - Temperature dependent binding of mebendazole to tubulin in benzimidazole susceptible and -resistant strains of Trichostrongylus colubriformis and Caenorhabditis elegans. AB - The binding of [3H]mebendazole ([3H]MBZ) to tubulin in benzimidazole-susceptible (BZ-S) and benzimidazole-resistant (BZ-R) strains of Trichostrongylus colubriformis and Caenorhabditis elegans was examined in order to investigate the biochemical changes to tubulin that result in BZ resistance in parasitic and free living nematodes. In both species the extent of [3H]MBZ binding to tubulin was significantly reduced in the BZ-R strain compared with the BZ-S strain. The decrease in [3H]MBZ binding in the BZ-R strain of each species was the result of a significant reduction in the amount of charcoal stable [3H]MBZ-tubulin complexes and was not related to a change in the association constant of the [3H]MBZ-tubulin interaction. [3H]MBZ binding to tubulin was temperature dependent, reaching maximum levels at 37 degrees C in BZ-S T. colubriformis and 10 degrees C in BZ-R T. colubriformis. Both the BZ-S and BZ-R strains of C. elegans displayed maximum [3H]MBZ binding at 4 degrees C. Resistance ratios derived from the amount of [3H]MBZ binding in the BZ-S and BZ-R strains and in vitro development assays demonstrated that the temperature dependence and extent of drug binding was indicative of BZ resistance status and was species specific in the BZ-S isolates. These results indicate that biochemical differences exist in the binding of benzimidazole carbamates to tubulin in nematode species, and suggest that the susceptibility of the parasitic nematodes to the benzimidazole anthelmintics is the result of a unique high affinity and/or high capacity interaction of benzimidazole carbamates with tubulin. PMID- 1787035 TI - Effect of acute versus chronic Trichinella pseudospiralis infections on systemic cell-mediated immunity. AB - Infection of the mouse with Trichinella pseudospiralis is accompanied by pronounced suppression of host inflammatory response. This study examines the effects of infection with this parasite on several key elements in cell-mediated immunity. Early down-regulation of host granulomatous response to subcutaneously implanted cotton string and delayed-type hypersensitivity (DTH) response to trinitrochlorobenzene (TNCB) was followed later during infection by normalization of these parameters compared to that seen in uninfected mice. Cytotoxic T lymphocyte responses to tumor-specific antigens expressed on the syngeneic P91 mastocytoma were depressed early following infection with T. pseudospiralis relative to that seen in uninfected mice but were similar in these two groups during the later stages of infection. Down-regulation of the components of cell mediated reaction examined herein accompanied the presence of migratory larvae in the host. PMID- 1787036 TI - A cytopathic effect of Trichomonas vaginalis probably mediated by a mannose/N acetyl-glucosamine binding lectin. AB - The pathogenic effect of a highly pathogenic strain of Trichomonas vaginalis on McCoy cell monolayers was investigated. Specific inhibition of the cytopathic effect by monosaccharides, such as N-acetyl-glucosamine (GlcNAc) and mannose (Man), was observed. Our preliminary results suggest that the pathogenicity of T. vaginalis depends on a lectin specifically sensitive to GlcNAc and to a lesser extent to Man. Although N-acetyl-mannosamine was found to be the most efficient inhibitor, this effect seems to be unrelated to the natural biological behaviour of the infested host. PMID- 1787037 TI - The geographic distribution and host range of Capillaria hepatica (Bancroft) (Nematoda) in Australia. AB - The geographic distribution, host range and prevalence of Capillaria hepatica were recorded in 4629 house mice, Mus domesticus, 263 black rats, Rattus rattus, and 58 Norway rats, R. norvegicus. The parasite was found at five localities, all in or near large towns along the coast. The two Rattus species appeared to be the primary hosts of C. hepatica in Australia. Published and unpublished data on helminth infections of Australian native mammals from 1162 murids (26 species), 3018 marsupials (67 species) and 99 monotremes (two species) were compiled. Only seven animals from three murid species were infected with C. hepatica; all were from the same rainforest in northern Queensland. C. hepatica was distributed widely, occurring in the house mouse, black rat and Norway rat on a 10,850 ha farm but there was no infection in cattle, sheep or goats (abattoir records). Also, 52 rabbits, four cats and one fox (shot samples) and 27 marsupial mice, Sminthopsis crassicaudata (museum specimens), had no sign of C. hepatica infection. Overall, the results indicate that transmission of C. hepatica to native, domestic and feral mammals is rare, presumably because of ecological constraints on egg embryonation and survival. In the light of these findings, the potential use of C. hepatica as a biological agent to control mouse plagues in Australia is discussed. PMID- 1787038 TI - The origin of a new focus of infection with Echinococcus granulosus in Tasmania. AB - Hydatid cysts were discovered in cattle on King Island, north of Tasmania, where Echinococcus granulosus was thought to have been eradicated. Using enzyme electrophoresis, isolates from King Island were compared genetically with isolates from Tasmania and the mainland of Australia. The genetic distinctness of the King Island isolates make it unlikely that they originated from a recent introduction from either Tasmania or mainland Australia. Alternative possibilities, that the infection resulted from a recent introduction from another source or from previously undetected persistence of E. granulosus on King Island, could not be distinguished from available data. PMID- 1787039 TI - A cell-free culture system for development of large numbers of Brugia pahangi larvae. AB - Techniques used in the in vitro culture of massive numbers of Brugia pahangi third-stage larvae (L3) are described. Procedures for larval preparation and four culture conditions, with or without animal cell co-cultures, were studied, resulting in the adoption of a relatively simple cell-free culture system for routine harvesting of larval moulting excretory/secretory product. PMID- 1787040 TI - The response of intact Strongyloides ratti infective (L3) larvae to substrates and inhibitors of respiratory electron transport. AB - Live, intact third-stage larvae (L3s) of Strongyloides ratti in the absence of exogenous substrates consumed oxygen at a rate (E-QO2) of 181.8 +/- 12.4 ng atoms min-1 mg dry weight-1 at 35 degrees C. Respiratory electron transport (RET) Complex I inhibitor rotenone (2 microM) produced 33 +/- 6.5% inhibition of the E QO2. Unusually the rotenone-induced inhibition was not relieved by 5 mM succinate. The E-QO2 of intact L3s was refractory to RET Complex III inhibitor antimycin A at 2 microM; 4 microM-antimycin inhibited less than or equal to 10% of the E-QO2. The electron donor couple ascorbate/TMPD augmented the E-QO2 in the presence of rotenone (2 microM) and antimycin A (4 microM) by 110%. Azide (1 mM) stimulated the antimycin A refractory QO2 by 36.6 +/- 7.2% which was only partially inhibited by 1.0 mM-KCN (IC50 = 0.8 mM). The data suggest the presence of classical (CPW) and alternate (APW) electron transport pathways in S. ratti L3s. PMID- 1787041 TI - Specific monoclonal antibodies to Opisthorchis viverrini. AB - A Balb/c mouse was immunized with a crude soluble antigen of Opisthorchis viverrini adult worms (OVAA) over a period of 7 months. Spleen cells from the immune mouse were fused with Sp2/0 myeloma cells. Among the 264 tissue culture wells containing the fused cells, cells of 96 wells (36%) produced antibodies to the immunizing agent. Antibodies produced by cells in several wells reacted with antigens from other species of parasite. Cells of 17 wells produced antibodies specific only to OVAA, thus cells from three representative wells were cloned by limiting dilution. Hybrids obtained produced antibodies which could be classified according to their tissue specificities into three groups. The first group of antibodies reacted strongly to the worm integument and weakly with the muscles while those belonging to the second group reacted only to muscles of the worms. The monoclonal antibodies of the third group gave a positive reaction to both muscles and tegument. PMID- 1787042 TI - Toxicity of aldehyde products of lipid peroxidation to adult Schistosoma intercalatum in vitro. AB - The host's immune response results in oxidative damage to parasite membranes. Known aldehyde breakdown products from lipid peroxidation have been investigated for their in vitro toxicity to Schistosoma intercalatum. Saturated and monounsaturated aldehydes were found to be relatively non-toxic, whilst dienal and hydroxyenal aldehydes had LD50 values in the range of 10-20 microM. Conversion of the toxic aldehydes to their corresponding alcohols or glutathione conjugates reduced toxicity to S. intercalatum by one or two orders of magnitude. This suggests that parasite detoxification enzymes might be useful targets for chemotherapy and raises the possibility of combining chemo- and immunotherapy. PMID- 1787043 TI - The effect of cyclosporin A on the development of Eimeria in non-specific hosts. AB - The role of T lymphocytes on the development of turkey coccidia in chickens was investigated to further document the involvement of immune mechanisms in the reactions of non-specific hosts to infections with species of Eimeria. All chickens treated with the T cell-specific immunosuppressive drug, cyclosporin A (CsA), 1, 2 or 3 days before or for 3 consecutive days immediately before inoculation with sporulated oocysts of Eimeria from the turkey, shed oocysts in their feces 7-12 days after inoculation. Those chickens treated with CsA after inoculation produced no oocysts although in one experiment a small number of oocysts were discharged by birds injected with CsA 1 day after inoculation. High serum levels of CsA were maintained in the CsA-treated chickens for at least 24 h post-inoculation with the oocysts. Immunosuppressive activity of the drug was determined by measuring lymphocyte blastogenesis in response to concanavalin A. These results demonstrate that the suppression of T lymphocyte activity in a non specific host early during an infection with a heterologous species of Eimeria permits the complete intracellular development of the parasite. Our findings are suggestive of a role for T lymphocytes in preventing the development of Eimeria in non-specific hosts possibly via a lymphokine-mediated mechanism. PMID- 1787044 TI - Certitude versus certainty: magnetic treatment of seizures and the rights of authors to publish. PMID- 1787045 TI - Magnetic stimulation in the treatment of partial seizures. AB - We have recently demonstrated that Magnetoencephalographic (MEG) brain measurements in patients with seizure disorders show significant MEG activity often in the absence of conventional EEG abnormalities. We localized foci of seizure activity using the mapping technique characterized by the ISO-Spectral Amplitude (ISO-SA) on the scalp distribution of specified spectral components or frequency bands of the emitted MEG Fourier power spectrum. In addition, using an electronic device, we utilized the above recorded activity to emit back the same intensity and frequency of magnetic field to the presumed epileptic foci. Using this method we were able, over the past two years, successfully to attenuate seizure activity in a cohort of over 100 patients with various forms of epilepsy. We now present in more detail three randomly selected patients with partial seizures in whom application of an external artificial magnetic field of low intensity produced a substantial attenuation of seizure frequency during an observation period extending from 10 to 14 months. All patients had previously obtained only partial response to conventional anticonvulsant therapy. Attenuation in seizure frequency was associated with normalization of the MEG activity. These cases demonstrate that artificial magnetic treatment may be a valuable adjunctive procedure in the management of partial seizures. The possible mechanisms underlying the anticonvulsant properties of magnetic stimulation at both cellular and systemic levels are discussed. Specifically, since the pineal gland has been shown to be a magnetosensitive organ which forms part of a combined compass-solar clock system, and since it exerts an inhibitory action on seizure activity in both experimental animals and humans, we discuss the potential pivotal role of the pineal gland in the long term anticonvulsant effects of external artificial magnetic stimulation. PMID- 1787046 TI - Pineal calcification and anticonvulsant responsiveness to artificial magnetic stimulation in epileptic patients. PMID- 1787047 TI - Lateralization of facial processing: a spatial frequency model. AB - Faces, filtered for either high or low spatial frequency components, were presented tachistoscopically to either the right or left visual fields. The right visual field presentations yielded more errors in a face matching task and this difference was greatest for low spatial frequency stimuli. Left visual field, low spatial frequency stimuli resulted in the fastest reaction times and the lowest error rates. These processing differences may reflect mechanisms underlying a wide range of hemispheric lateralization phenomena. PMID- 1787048 TI - Behavioral and motor mechanisms of dorsomedial frontal cortex of macaca monkey. AB - The activity of 249 neurons in the dorsomedial frontal cortex was recorded in two macaca monkeys. The animals had been trained for saccades and fixation tasks in an unrestrained condition. We found 51 burst neurons that showed a double-firing discharge. We observed two different patterns of discharge. In one case the first burst occurred before the arm movement, the second before the related eye movement. In the second case, the first discharge took place before a neck contraction followed by a second burst before eye movement. Some cells showed two discharges, one that preceded the bar-press and the other the saccade. With other cells the discharges preceded the bar-release and then saccade. Still other cells discharged three times: first before the bar-press, second before release and third before the orienting saccade. Some cells were active for the bar-press and for the first orienting saccades. These cells were active also for a large range of movement tested at the presentation of natural stimuli. Electrical stimulation failed to evoke either arm or eye movement. Neck-eye cells are related to movement of the eye and to an increase of EMG activity independent of eye position. The electrical stimulation evoked eye movements and EMG increases at low threshold. The activity of arm-eye cells related to purposeful movement with the ineffectiveness of electrical stimulation may be ascribed to a motor reactivation or an ordering signal. The neck-eye cells may be considered trigger commands for neck-eye coordination.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787049 TI - Parallel distributed processing and neural networks: origins, methodology and cognitive functions. AB - Parallel Distributed Processing (PDP), a computational methodology with origins in Associationism, is used to provide empirical information regarding neurobiological systems. Recently, supercomputers have enabled neuroscientists to model brain behavior-relationships. An overview of supercomputer architecture demonstrates the advantages of parallel over serial processing. Histological data provide physical evidence of the parallel distributed nature of certain aspects of the human brain, as do corresponding computer simulations. Whereas sensory networks follow more sequential neural network pathways, in vivo brain imaging studies of attention and rudimentary language tasks appear to involve multiple cortical and subcortical areas. Controversy remains as to whether associative models or Artificial Intelligence symbolic models better reflect neural networks of cognitive functions; however, considerable interest has shifted towards associative models. PMID- 1787050 TI - P300 in freely moving cats with intracranial electrodes. AB - Nine chronically implanted cats were used in order to study the event related potentials (ERPs) of the brain with the "omitted stimulus" paradigm. The cats were not restrained and not conditioned, could behave freely in a soundfree room. Due to a selective averaging method a P300 like of response component could be detected in the hippocampus, auditory cortex and reticular formation. The most robust and ample component was the N200-P300 wave complex of the hippocampus. The results are interpreted as follows: the P300 component in the cat brain has probably distributed generators with various frequency selectivities. The hippocampal ERP has a strong theta response component, whereas the auditory cortex and reticular formation have more marked 10 Hz responses. PMID- 1787051 TI - A compound P300-40 Hz response of the cat hippocampus. AB - In companion reports (Basar-Eroglu et al., in press a,b) it was shown that the hippocampal P300 response had a frequency content with prominent theta enhancement, especially near CA3 region. Moreover, frequency analysis revealed a marked component in the 40 Hz frequency range. In the present study, a detailed account about "40 Hz response accompanied by the N200-P300 compound response" is given. These results were obtained by use of digital adaptive filtering method described in previous studies (Basar et al., 1987, Basar, 1980). The physiological interpretation of the visual 40 Hz component gained tremendous importance since the discovery of Gray and Singer (1987, 1989) of 40 Hz oscillations in the visual cortex. Our analysis shows clearly that the 40 Hz response component is not only a cortical response pattern. Moreover, the 40 Hz response is accompanied by a P300 response and we discuss that it is also a universal building block of brain responsiveness. The 40 Hz response should be correlated with multimodal sensory and cognitive function. PMID- 1787052 TI - P300 response of hippocampus analyzed by means of multielectrodes in cats. AB - Event-related potentials (ERPs) of the cat hippocampus were investigated by means of multielectrodes in various layers of the hippocampus. The experimental and mathematical procedures were the same as those in the companion report (Basar Eroglu et al., in press a). It is shown that the most ample N200-P300 complex was recorded close to the CA3 region of the hippocampus. PMID- 1787053 TI - Association of serum testosterone levels with latencies of somatosensory evoked potentials from right and left posterior tibial nerves in right-handed young male and female subjects. AB - The relationships between serum testosterone levels and somatosensory evoked potential (SEPs) latencies from the right and left posterior tibial nerves (PTNs) were studied in right-handed young men and women. The corrected P1 (P39) and N1 (N49) latencies from the right PTN (left hemisphere) were found to be significantly longer in females than males. The corrected P2 and N2 latencies from both PTNs were longer in females than males. Testosterone was not associated with N1 latencies. In females, there was a negative linear correlation between testosterone and latencies from the right and left PTNs. These relationships were complex in males depending upon foot and eye preferences. The following results were obtained from males: no correlation with P1, N1, and P2, but a direct relation with P2 from left PTN in total sample; in males with right eye and right foot preference, a direct correlation only with P1 from right and left PTNs; in mixed- and left-eyed males, inverse correlations with P1, N1, and P2 latencies especially from right PTN; in right-eyed males, direct correlation with P1, inverse correlation with P2 from left PTN; in right-footed males, direct correlation with P1 and N2 waves from right and left PTNs. The interpeak latencies also showed sex-related differences. The overall results suggested that the left brain would be the main target for testosterone effects in both sexes, which may be beneficial for females but mainly disadvantageous for males. PMID- 1787054 TI - A sensitive enzyme-linked immunosorbent assay for dihydrofolate reductase. AB - A competitive enzyme-linked immunosorbent assay (ELISA) has been developed for the enzyme, dihydrofolate reductase. The sensitivity of the assay system approximates 3 ng of immunoreactive enzyme protein which is comparable to the sensitivity achieved in the radioimmunoassay (RIA) for this enzyme. The mean coefficient of variation for within--and between--assay precision was less than 13%. The assay appears to be specific and valid as the concentration of the enzyme is the same whether measured by ELISA or [3H]-methotrexate binding. Since this method, like the RIA, measures the mass concentration of enzyme protein, in conjunction with a [3H]-methotrexate binding assay it will be useful for quantitating functional as well as non-functional immunoreactive forms of the enzyme. PMID- 1787055 TI - Oxidative deamination of S-aminopropylcysteine and S-aminoethylhomocysteine. AB - S-aminopropylcysteine and S-aminoethylhomocysteine are oxidized by snake venom L amino acid oxidase in the presence of catalase with formation of the respective ketoderivatives. Only the ketoderivative of S-aminopropylcysteine cyclizes to give a seven membered ring (ketimine) absorbing at 296 nm. In the absence of catalase both ketoderivatives are oxidatively decarboxylated. PMID- 1787056 TI - Reactions of oxygen radicals with the quinone ring of coenzyme Q. AB - Coenzyme Q, besides its role in electron transfer reactions, may act as a radical scavenger. The effect of oxygen radicals produced by ultrasonic irradiation on the quinone ring was investigated. Aqueous solutions of a Q homologue, completely lacking the side chain, were irradiated and the modifications were spectrophotometrically followed. The experimental results show that both degradation and reduction of the benzoquinone ring took place when the irradiation was performed in water. Data obtained when ultrasonic irradiation was carried out in the presence of OH. scavengers, as formate, organic and inorganic buffers, suggest: a) the responsible species for most the ubiquinol generated by sonication appeared to be the superoxide radical b) addition reactions of OH. radicals with the aromatic ring led probably to the degradation of Coenzyme Q molecules. PMID- 1787057 TI - National meeting of the Nucleotides and Nucleic Acids Group of the Italian Biochemical Society. June 8-10, 1990. Abstracts. PMID- 1787058 TI - Surgery trends change nursing care: operating room nurses share new procedures that will affect home healthcare. AB - The word "surgery" does not mean what is used to. Community nursing care means something different now, too. PMID- 1787059 TI - On certification in home healthcare nurse. PMID- 1787060 TI - Self-care for patients experiencing cancer chemotherapy side effects: a concern for home care nurses. AB - Home care nurses may care for patients experiencing chemotherapy for cancer treatment. These nurses may be called on to evaluate chemotherapy-related toxicities, to identify emergent situations, and to support patient self-care, and thus they must understand chemotherapy procedures and the resultant side effects. PMID- 1787061 TI - Home care nurses' perception of standardized nursing diagnosis. AB - Visiting nurse association staff nurses were surveyed to determine whether perceived use of nursing diagnosis had changed since the establishment of diagnosis-related groups and the extent to which diagnostic labeling was valued as part of home care practice. Little change in labeling was perceived, although the acuity level of patients in home care has increased during this time. Nurses found that they were comfortable, however, with their knowledge of the diagnostic process and believed nursing diagnosis provided an added dimension to care not provided by medical labels. PMID- 1787062 TI - Treatment objectives in chronic wound care. AB - Decision making in topical management of chronic wounds is complex and requires ongoing evaluation of the wound. Here are some useful approaches to managing simple and complex situations. PMID- 1787063 TI - Corneal transplants: the final gift. PMID- 1787064 TI - Putting it together: care and documentation. PMID- 1787065 TI - A case for universal access. PMID- 1787066 TI - Home healthcare agencies can be instrumental in helping family members place patients in treatment facilities. PMID- 1787067 TI - The revised survey process. AB - The implementation of the requirements of OBRA 87 has resulted in many changes for HHAs and home healthcare nurses. These include the patient bill of rights, training and competency evaluation of home healthcare aides, and the revised certification/recertification process. It is important that sound structural and process criteria be in place in an HHA. These will provide the foundation for successful site visits during which patient-focused outcomes can be identified. Increased knowledge should also decrease the nurses' apprehension about the revised process. PMID- 1787068 TI - SFC-364 safety syringe. PMID- 1787069 TI - AIDS protection for healthcare workers. PMID- 1787070 TI - Facsimile systems revised: focus on confidentiality and privacy. PMID- 1787071 TI - Referral by facsimile: new legal headache for home health care. PMID- 1787072 TI - Reimbursement warfare: who loses? AB - The challenge facing healthcare providers is to maximize available reimbursement to cover home care and outpatient management for a growing number of oncology patients who no longer meet inpatient criteria. PMID- 1787073 TI - The status of radiopharmaceutical research. PMID- 1787074 TI - Hepatic uptake of [99mTc]galactosyl-neoglycoalbumin is sensitive to receptor quantity. AB - [Technetium-99m]galactosyl-neoglycoalbumin (TcNGA) is a synthetic radioligand specific to the receptor, hepatic binding protein (HBP), which resides exclusively at the cell surface of hepatocytes. If the TcNGA time-activity data are to provide valid estimates of receptor biochemistry via pharmacokinetic modeling, the shape of the hepatic uptake curve must change with alterations in receptor concentration or affinity. An index of TcNGA hepatic uptake, T90, was obtained by calculating the time at which the liver time-activity curve reached 90% of its maximum. Receptor quantity was measured by Scatchard binding assay of liver biopsy samples obtained prior to each TcNGA study. The range of T90 was 3.7 16.8 min; HBP quantity ranged from 0.022 to 0.100 mumol. Significant correlation (r) and slope (b) was observed between T90 and HBP quantity (r = 0.82, P = 0.003; tb = 3.98, P = 0.003). We concluded that the hepatic uptake of TcNGA is sensitive to HBP quantity. PMID- 1787075 TI - Direct labeling of proteins with 99mTc. AB - The direct labeling of antibodies and antibody fragments to form a highly stable bond between technetium and the sulfide groups of proteins is now well established. To optimize this reaction, the antibody protein must have sufficient reactive sulfides available to accept that technetium metal ions that are formed by the reduction of pertechnetate in the presence of a weak complexing agent. The reactive sulfide groups are provided by first reducing a small fraction of the disulfide bridges in the antibody protein or by starting with Fab' fragments, which already have reactive sulfide groups. When the antibody protein has been appropriately reduced, and the reactive sulfide groups protected by a metal ion with a lower binding affinity than technetium, such as tin or zinc, very high labeling yields of high-affinity-bonded 99mTc can be achieved. This can be accomplished without loss of immunoreactivity, measured as either affinity or immunoreactive fraction. Side reactions can produce radiochemical impurities such as low-affinity, bound 99mTc; 99mTc colloids; 99mTc peptides or antibody aggregates; or 99mTc-complexes. Also, pertechnetate ions may be an impurity if the sodium pertechnetate solution added to the reduced antibodies is not completely reduced. The specifics of minimizing these side reactions have not been extensively discussed in the prior literature; however, it is clear that appropriate reduction of the protein prior to labeling and complete removal of the reducing agent, particularly if it contains reactive sulfide groups or is toxic, are critical. One- or two-step 99mTc-labeling kits for preparing 99mTc labeled antibody or antibody fragments are rapidly being introduced for use in clinical nuclear medicine studies. These direct labeling methods employ a common sequence of chemical reactions, although the reducing agents for both the antibody and the [99mTc]pertechnetate may vary. Different 99mTc transfer agents may be used, but all transfer agents have the common feature of quickly forming weak to moderately strong complexes with reduced technetium. Most use Sn(II) to reduce the pertechnetate, although other reducing agents can be used. PMID- 1787076 TI - Imaging of systemic Candida albicans infections with a radioiodinated monoclonal antibody: experimental study in the guinea pig. AB - Guinea pigs intravenously infected with Candida albicans were scanned to evaluate the use of radioiodinated monoclonal antibodies (MAb) to fungal antigens for detecting tissue infection sites. A total of 18 infected and 8 uninfected animals were used. MAb and F(ab')2 fragments directed against cell wall glycoproteins of C. albicans were labeled with 131I. Another MAb directed against a Schistosoma mansoni glycoprotein was labeled with 125I and used as a nonspecific control. Radiolabeled MAbs were injected at a dose of 12.5 micrograms (500 kBq) per animal. Images were acquired 24 h later. Animals were then killed and the dissected organs were separately gamma-counted. The number of C. albicans colony forming units (cfu) per gram was determined in each organ. A clear relationship was found between the anatomic distributions of C. albicans and 131I. The biodistribution of 131I radioactivity associated with anti-Candida MAb was greater in infected animals than in healthy animals and increased with the number of cfu per g in each organ. The distribution was highly specific in animals with Candida endophthalmitis, a pathognomic feature of organ involvement during hematogenous dissemination. In contrast, the distribution of 125I radioactivity associated with the nonspecific MAb was similar in healthy and infected animals. In infected animals, it was totally independent of the intensity of fungal infection. PMID- 1787077 TI - Development of radiolabelled albumin microspheres: a comparison of gamma-emitting radioisotopes of iodine (131I) and indium (111In/113mIn). AB - Biodegradable albumin microspheres have been prepared incorporating either 131I or 111In/111In. Using cDTPAA/albumin molar ratios of 1, 3 and 10, approx. 0.7, 2.1 and 7 molecules of DTPA could be coupled to an albumin molecule, labelling efficiency being constant over this range. Because 131I microspheres were more stable in plasma than the system labelled with radionuclides of indium it was selected for clinical evaluation: potential uses of this radiopharmaceutical are illustrated. PMID- 1787078 TI - Direct 99mTc labeling of monoclonal antibodies: radiolabeling and in vitro stability. AB - Direct labeling involves 99mTc binding to different donor groups on the protein, giving multiple binding sites of various affinities resulting in an in vivo instability. The stability has been considerably improved by activating the antibody using a controlled reduction reaction (using 2-aminoethanethiol). This reaction generates sulfhydryl groups, which are known to strongly bind 99mTc. The direct 99mTc antibody labeling method was explored using whole antibodies and fragments. Analytical methods were developed for routine evaluation of radiolabeling yield and in vitro stability. Stable direct antibody labeling with 99mTc requires the generation of sulfhydryl groups, which show high affinity binding sites for 99mTc. Such groups are obtained with 2-aminoethanethiol (AET), which induces the reduction of the intrachain or interchain disulfide bond, with no structural deterioration or any loss of immunobiological activity of the antibody. The development of fast, reliable analytical methods has made possible the qualitative and quantitative assessment of technetium species generated by the radiolabeling process. Labeling stability is determined by competition of the 99mTc-antibody bond with three ligands, Chelex 100 (a metal chelate-type resin), free DTPA solution and 1% HSA solution. Very good 99mTc-antibody stability is obtained with activated IgG (IgGa) and Fab' fragment, which makes these substances possible candidates for immunoscintigraphy use. PMID- 1787079 TI - Detection of hepatic metastases from colorectal carcinoma using indium-111 (111In) labeled monoclonal antibody (mAb): MSKCC experience with mAb 111In-C110. AB - Sixteen patients with colorectal carcinoma and a rising serum carcinoembryonic antigen (CEA) level and no evidence of extra-abdominal disease were administered 5 mg of an anti-CEA monoclonal antibody (mAb), C110, labeled with approx. 5 mCi of 111In. All patients subsequently underwent exploratory laparotomy, and samples of tumor and normal tissue were obtained. Hepatic lesions (confirmed by histopathology) were visualized as areas of increased radiotracer uptake in 13 of 16 patients. Single photon emission computed tomography (SPECT) considerably aided detection, being positive in two patients with normal planar images. Ten of the 16 patients had positive x-ray computed tomographic (CT) images. The radioimmunodiagnostic study was falsely negative in 3 of 16 patients with subsequently proven hepatic disease, in one of whom CT was also normal. The antibody study was positive in 80% of lesions, thus being, in this small series, significantly more sensitive (P less than 0.01) than CT. 111In-C110 is a promising monoclonal antibody for the detection of hepatic metastases from colorectal carcinoma; this is the first study to show consistently greater concentration of 111In-labeled antibody in hepatic lesions than in surrounding normal hepatic parenchyma. PMID- 1787080 TI - New indium-111 labeled biotin derivatives for improved immunotargeting. AB - Investigations into the use of streptavidin-conjugated antibodies and labeled biotin to improve radioimmunotargeting have shown background levels drastically reduced over the conventional approach. Nevertheless, accumulation of 111In biotin in normal tissue as well as streptavidin-independent accumulation in tumor, was observed. In this work, the effect of altering the biotin molecule to reduce this nonspecific uptake without decreasing specific localization has been investigated. Three EDTA and DTPA derivatives of biotin have been synthesized and investigated along with a commercial biotin derivative (DTPA-B2). The labeled biotin chelates were administered i.p. to normal mice implanted with avidin beads in one thigh. A wide variation in biodistribution was seen among the biotin derivatives. The most favorable results were obtained with biotinyl-hydrazino EDTA (EDTA-B1), which showed the lowest accumulation in normal tissues but equivalent uptake in the target with respect to the other compounds. Averaged over 8 tissues sampled, the target-to-nontarget ratio was 140 vs 9 for EDTA-B1 vs DTPA-B2 (N = 6) at 24 h post administration. Similar observations have been made in culture with two tumor cell lines: positive accumulation of both DTPA-B2 and EDTA-B1 was measured in tumor cells independent of streptavidin-antibody conjugate, however in the case of the latter derivative, this accumulation was 3 5 fold lower. These studies show that modification of the biotin species can alter accumulation in normal tissues as well as the antibody-streptavidin independent accumulation in tumor tissue. PMID- 1787081 TI - Evaluation of two 111In-oxinate formulations for labelling of white blood cells. AB - This study compares the cell labelling characteristics of two 111In-oxinate formulations. The two preparations differ by the solubilizing agent of the chelate and the total amount of oxine. White blood cell suspensions were obtained by standard separation techniques and were labelled with either of these formulations. The labelling efficiency was higher for 111In-oxinate in aqueous solution (compound B) compared to the preparation where an organic solubilizer was added (compound A) (79.2 +/- 7.7 vs 68.6 +/- 17.6%, respectively, P = 0.03). Red blood cells contaminating the cell suspensions incorporated a higher fraction of 111In if the cells were incubated with the aqueous 111In-oxinate preparation (22.6 +/- 4.6 vs 4.8 +/- 4.6%, respectively, P less than 0.0001). The uptake of activity by polymorphonuclear cells was reduced with compound B (46.1 +/- 12.8 vs 63.8 +/- 15.8%, respectively, P = 0.0002) whereas the fraction retained by mononuclear cells and platelets was similar (31.3 +/- 13.9 vs 31.4 +/- 15.0%, respectively). The recovery from the vial was higher for 111In-oxinate in an organic solution (86.6 +/- 1.82 vs 60.3 +/- 14.3%, respectively, P less than 0.0001). Twenty four hours after administration of the labelled cells, the vascular compartment was less frequently visualized if cells were labelled with compound A (8% of the scintigrams vs 62.5% respectively, P less than 0.0001). High quality images were more often recorded after the administration of cells labelled with compound A (60.0% of the images vs 23.5%, respectively, P less than 0.02). The image quality of scintigrams was not related to any of the other cell labelling parameters.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787082 TI - Chloro----hydroxy substitution on technetium BATO [TcCl(dioxime)3 BR] complexes. AB - The neutral, seven coordinate complexes of technetium known as the BATO (Boronic acid Adducts of Technetium diOximes) complexes have shown their utility as myocardial and cerebral perfusion agents. The axial chloride ligand of the BATO complexes [99mTcCl(dioxime)3 BR] is labile to substitution by a competitive anion; under physiological conditions, the axial chloride ligand can be replaced by a hydroxy group. The chloro and hydroxy analogs have different biodistributions and single-pass cerebral extraction efficiencies. The influence of structure on the rate of the in vitro chloro/hydroxy exchange process has been studied. The mechanism of axial ligand exchange was found to be SN1-CB, which proceeds by way of a transient, neutral six coordinate complex. Evidence is presented which indicates that chloro/hydroxy exchange is not the mechanism by which BATO complexes are retained in the brain. PMID- 1787083 TI - 4-Borono-2-[18F]fluoro-D,L-phenylalanine as a target compound for boron neutron capture therapy: tumor imaging potential with positron emission tomography. AB - We studied the tumor uptake and metabolism of 4-borono-2-[18F]fluoro-D,L phenylalanine ([18F]FBPA), an 18F-labeled target compound for boron neutron capture therapy. In mice bearing FM3A mammary carcinoma, the accumulation of [18F]FBPA in the FM3A for the first 2 h, and its decrease in all other tissues, resulted in high FM3A-to-tissue uptake ratios. In the FM3A, the tracer was stable for metabolic alteration, which was in contrast to the gradual increase of protein-bound radioactivity in plasma. Imaging of FM3A was demonstrated by whole body autoradiography. [18F]FBPA has potential for use as a PET tracer for tumor imaging with high contrast, even in the pancreas. PMID- 1787084 TI - The effect of antigen concentration, antibody valency and size, and tumor architecture on antibody binding in multicell spheroids. AB - Intact IgG1 and F(ab')2 anti-carcinoembryonic antigen antibodies penetrate human colon adenocarcinoma multicell spheroids much more slowly than Fab fragments and the molecular weight and the binding site valency appear to be the most important factor in determining the rate of penetration. The rate is also influenced considerably by the number of antigen binding sites per cell, with a high antigen concentration slowing penetration appreciably. The tumor cell architecture appears to have a minor effect on antibody penetration when compared to antibody size or antigen concentration. PMID- 1787085 TI - Phagocytosis by macrophages in zinc-deficient rats. AB - Phagocytosis by polymorphonuclear cells has been found to be significantly reduced in zinc-deficient patients and this finding was confirmed in animal experiments. In order to find out whether phagocytosis by macrophages is similarly altered, experiments were conducted in three groups of 18 rats. Control, zinc-deficient and pair-fed rats were given 99mTc nanocolloid intravenously. In ten other experiments (5 experimental and 5 control rats) 99mTc sulfur colloid was injected intravenously. The biodistribution was determined by a well-type gamma counter and the results were evaluated statistically. The greatest amount of radioactivity was taken up by the liver, followed by the spleen, lung and kidney. In both series of experiments however the zinc-deficient animals appeared to take up a greater amount of the radiotracer (P less than 0.05). PMID- 1787086 TI - Synthesis, purification and stability of no carrier added radioiodinated 1,1 bis(4-hydroxyphenyl)-2-iodo-2-phenylethylene (IBHPE), a prototype triphenylethylene estrogen-receptor binding radiopharmaceutical. AB - A triphenylethylene compound [1,1-bis(4-hydroxyphenyl)-2-iodo-2-phenylethylene; IBHPE] has been labeled by halodestannylation with 123I at a specific radioactivity of 13,200 Ci/mmol (by in vitro receptor assay) after HPLC purification. The corresponding 80mBr-labeled compound (BrBHPE), which has a 3 fold higher affinity for the estrogen receptor, was previously prepared and examined as a potential therapeutic radiopharmaceutical exploiting Auger electron toxicity. Stability of IBHPE was a concern because free iodide was generated when HPLC solvents were removed with a stream of nitrogen in a glass vial; however, decomposition was minimal when polypropylene vials were used, and ethanol solutions of [123I]IBHPE were stable for several days at 0-4 degrees C. Tissue distribution studies of IBHPE after intraperitoneal injection to mature female rats showed highest estradiol-inhibitable uptake in the peritoneal estrogen receptor rich tissues (uterus, ovaries and vagina) at 30 min. Specific uptake (percent dose per gram) in the pituitary, and peritoneal target tissue-to-blood ratios were greater at 2 h than 30 min. In immature female rats, uterus-to-blood ratios of greater than 50, progressively lowered by increasing diethylstilbestrol levels, were obtained. These data demonstrate good binding of IBHPE to the estrogen receptor in vivo, in spite of extensive non specific binding in in vitro estrogen receptor assays. Most of the label in the uterus at 1 h after injection was still unchanged IBHPE. Our results suggest that IBHPE or related 123I-labeled iodovinyl triphenylethylenes could have diagnostic or therapeutic radiopharmaceutical utility. PMID- 1787087 TI - Biodistribution and tumor uptake of [67Ga]chlorogallium-tetraoctadecyloxy phthalocyanine and its sulfonation products in tumor bearing C3H mice. AB - To evaluate the biodistribution and tumor uptake of chlorogallium tetraoctadecycloxy phthalocyanine, a potential new drug for the photodynamic therapy of cancer, we prepared the radioactive 67Ga-labeled complex and its water soluble sulfonated derivative. The non-sulfonated dye was obtained by condensation of octadecyloxyphthalonitrile in the presence of a mixture of 67Ga and 69Ga chloride. The sulfonated derivative was obtained by treatment of the condensation product with oleum. As singlet molecular oxygen has been implicated in the photodynamic action of phthalocyanines (Pcs), the quantum yield of singlet oxygen (phi delta) was evaluated for chlorogallium tetraoctadecyloxy Pc, and also its zinc, aluminum and metal free analogues. After intraperitoneal administration of the non-sulfonated dye into RIF tumor bearing C3H mice, a very high 67Ga uptake was observed in the spleen, while tumor radioactivity remained low during the 3 day study. The in vivo stability of the 67Ga-phthalocyanine complex was confirmed by comparing the distribution pattern with that of 67Ga-citrate, which proved to be significantly different. Intravenous injection of the sulfonated dye resulted in an overall lowering of 67Ga-uptake by most tissues, particularly in the spleen, while tumor radioactivities were slightly higher. These data suggest that amphiphilic photosensitizers, containing both polar sulfonate groups and long aliphatic substituents, exhibit the best distribution pattern for both imaging and photodynamic therapy of tumors. PMID- 1787088 TI - 166Holmium-containing glass for internal radiotherapy of tumors. AB - Aluminosilicate glass containing the beta-emitter 166Ho was tested for tumor cell killing effectiveness with the BT-20 human mammary carcinoma cell line as a model. Incubation of BT-20 cells with 166Ho glass partially inhibited DNA replication and completely blocked growth in cells located within 1.0 mm of the radioactive fiber. Growth of BT-20 tumor xenografts in nude mice was dramatically inhibited by injection of 2-5 microns fragments of 166Ho glass (200 microCi/tumor). The results suggest that 166Ho glass would be an effective modality for deposition of intense beta- radiation for localized internal radiotherapy of tumors. PMID- 1787089 TI - Radiosynthesis and evaluation of N-(3-[18F]fluoropropyl)paroxetine as a radiotracer for in vivo labeling of serotonin uptake sites by PET. AB - To visualize serotonin uptake sites by positron emission tomography (PET), N-(3 [18F]fluoropropyl)-paroxetine ([18F]FPP), a derivative of the selective serotonin uptake blocker paroxetine, was synthesized from 3-[18F]fluoropropyltosylate and paroxetine via a one-pot procedure. The rate of formation of [18F]FPP was a function of the ratio of the initial amount of paroxetine to that of 1,3 propanediol bistosylate with which [18F]fluoropropyltosylate was synthesized. When the reaction mixture contained an excess amount of paroxetine over that of the propyl-bistosylate, the radiosynthesis followed by HPLC purification, which took approx. 90 min, gave [18F]FPP in a radiochemical yield of approx. 8%, and in high radiochemical and chemical purity. The specific activity was 2640 +/- 360 mCi/mumol. The brain biodistribution of [18F]FPP showed no distinguishable localization in regions with high density of serotonin uptake sites such as hypothalamus or olfactory tubercles. In vitro binding assays revealed that N fluoropropylation of paroxetine reduced the affinity for the serotonin uptake site by three orders of magnitude. PMID- 1787090 TI - The hexachlorotechnetate reagent in the synthesis, characterization and biodistribution of two novel lipophilic complexes. AB - The hexachlorotechnetate reagent has been used to synthesize lipophilic complexes of technetium-99m with polydentate ligands, using ligand exchange reactions and acetonitrile as an aprotic solvent. The complexes isolated were partially characterized by chromatographic (paper and HPLC) and electrophoretic methods. Preliminary data on biodistribution studies, carried out in rabbits, are also presented. This work documents that the hexachlorotechnetate reagent is a suitable intermediate for the rapid synthesis of new lipophilic complexes of technetium-99m. PMID- 1787091 TI - In vivo binding of the dopamine uptake inhibitor [18F]GBR 13119 in MPTP-treated C57BL/6 mice. AB - The in vivo regional distribution of [18F]GBR 13119 (1-[(4 [18F]fluorophenyl(phenyl)methoxy)ethyl]-4-(3-phenylpropyl) piperazine), a specific dopamine reuptake inhibitor, was examined in brains of C57BL/6 mice after MPTP treatment. At 2 weeks post MPTP the in vivo specific binding of [18F]GBR 13119 in striatum was decreased 63% relative to age and sex-matched controls. Animals studied at 6 and 8 weeks after MPTP treatment showed a gradual recovery of specific [18F]GBR 13119 binding in the striatum. No significant changes were observed in binding of radiotracer to cerebellum or cortex after MPTP treatment, nor were age-related changes observed in control mice. In vivo radiotracer studies thus appear useful for following gradual changes in the dopamine uptake system of mouse brain after neurotoxin treatment. PMID- 1787092 TI - Investigation of copper-PTSM as a PET tracer for tumor blood flow. AB - Copper-PTSM has been shown in previous studies to act as a fluid microsphere and to be useful in quantitating blood flow in brain, myocardium, and kidneys. In this study we have evaluated this agent as a PET tumor blood flow agent. 64Cu- or 67Cu-labeled Cu-PTSM was administered (i.v.) to Golden Syrian hamsters with colorectal carcinoma cell implants (GW39). One minute prior to sacrifice (10-60 min after Cu-PTSM was administered) 125I-iodoantipyrine (125I-IAP), an agent known to measure tumor blood flow, was administered intravenously by a 3-stage, 1 min ramp infusion. Following sacrifice, samples of tumor and brain were removed (within 40s) and the tumor and brain levels of Cu-PTSM and iodoantipyrine determined. Since the brain uptake of both Cu-PTSM and IAP is perfusion rate limited, the brain was used as a reference organ to normalize tumor levels of the two tracers. The plot of Cu-PTSM versus 125I-IAP tumor/brain ratios showed a good linear correlation (r value of 0.97), suggesting that Cu-PTSM could be used to quantify tumor blood flow. Since the mechanism of Cu-PTSM trapping is likely to be due to glutathione levels in the tissue, and because tumor tissue glutathione levels might vary, the temporal uptake of Cu-PTSM was investigated by PET imaging both the tumor-bearing hamsters and approximately 300 g Copenhagen rats bearing R3227 prostate tumors. The tumors were clearly visualized and the retained copper radioactivity in the tumor was constant over the 30 min imaging period. PMID- 1787093 TI - Antibody fragments labeled with fluorine-18 and gallium-68: in vivo comparison with indium-111 and iodine-125-labeled fragments. AB - Although monoclonal antibodies have been radiolabeled with many different radionuclides, the application of positron emission tomography (PET) to the imaging of radiolabeled antibodies has been limited to the investigation of a small number of long-lived radionuclides. In this study, we labeled F(ab')2 fragments of a mouse monoclonal antibody (BB5-G1) specific for a human parathyroid surface antigen with the positron emitting radionuclides, gallium-68 and fluorine-18. The biodistribution of the fragments was evaluated in a nude mice model and the results were compared to those obtained with fragments labeled with iodine-125 and indium-111 using conventional labeling techniques. All labeled fragments bound to human parathyroid tissue implanted in nude mice, with parathyroid-to-muscle ratios reaching as high as 10:1, 4 h after administration. A major difference was observed in the uptake and clearance of the various labeled fragments through the kidney. The halogen activity cleared, but the metal radioactivity was retained in the kidney. The results indicate that the fluorine 18 or gallium-68 labeled fragment may be useful for parathyroid imaging with positron emission tomography. PMID- 1787094 TI - Effect of size fractionation on the distribution of an albumin colloid in the reticuloendothelial system of the mouse. AB - To study if by varying the particle size of a 99mTc albumin colloid preparation its relative bone marrow accumulation could be increased, it was separated by gel filtration and different fractions were injected into mice. Particles around and smaller than the peak size of the colloid, 31 nm, exhibited a higher bone marrow/liver-spleen uptake ratio than larger particles but the uptake ratio was similar to that of the unseparated colloid. An antimony sulphide colloid showed a similar particle size distribution, but the corresponding uptake ratio was half of the albumin colloid. This indicates that characteristics other than size determine the distribution of a colloid in the reticuloendothelial system. PMID- 1787095 TI - Inhibition of intestinal absorption and decorporation of radiocaesium in humans by hexacyanoferrates(II). AB - The effect of hexacyanoferrate(II) preparations, KFe[Fe(CN)6], (KFeHCF) anol Fe4[Fe(CN)6]3, (FeHCF) on intestinal radiocaesium absorption was studied in two male volunteers. The 134Cs absorption was decreased from 100 to 3-10% when 500 1000 mg KFeHCF or FeHCF were administered 10 min before the 134Cs-labelled test meal. However, when HCF was administered simultaneously with the test meal, the 134Cs absorption was decreased to only 38-63%. The biological half-time of previously absorbed 134Cs was reduced from 106 (73) to 44 (46) days by daily administration of 3 times 0.5 g KFeHCF. The 134Cs dose conversion factors lie below the values recommended by IRCP 30, indicating that the IRCP model represents a cautious description of the Cs biokinetics in our study. PMID- 1787096 TI - Hb Cleveland or alpha 2 beta 2(93)(F9)Cys----Arg;121(GH4)Glu----Gln. AB - Hb Cleveland is characterized by two amino acid substitutions, namely beta 121(GH4)Glu----Gln as in Hb D-Los Angeles and beta 93(F9)Cys----Arg as in Hb Okazaki, and shares with Hb Okazaki a decreased stability, an increase in oxygen affinity, and decreases in Bohr effect and heme-heme interaction. It is the 13th beta chain variant with two substitutions that has been described thus far. PMID- 1787097 TI - Hb Isehara (or Hb Redondo) [beta 92 (F8) His----Asn]: an unstable variant with a proximal histidine substitution at the heme contact. AB - A 50-year-old Japanese female patient was found to have hemolytic anemia. Isoelectrofocusing of her hemolysate revealed two abnormal hemoglobin bands, one of which was very close to the Hb A2 band, and the other between the Hb A2 and Hb F bands. CM-cellulose column chromatography of the globin prepared from the abnormal hemoglobin showed that the abnormal chain eluted faster than the normal beta and delta chains; the beta X chain, however, did not separate from the normal beta chain in urea cellulose acetate electrophoresis. An instability test of the patient's hemolysate revealed the presence of an unstable component. Structural analysis of the abnormal beta chain indicated that the histidine residue at beta 92(F8) was replaced by an asparagine or aspartic acid residue. DNA amplified by polymerase chain reaction was sequenced by the dideoxy method. The nucleotide sequence of the beta 92 codon was AAC instead of CAC, suggesting that the amino acid substitution corresponded to His----Asn, which is the same as is found in Hb Redondo or beta 92(F8)His----Asn----Asp. PMID- 1787098 TI - Hb Westmead [alpha 122(H5)His----Gln], Hb E [beta 26(B8)Glu----Lys], and alpha thalassemia-2 (3.7 Kb deletion) in a Laotian family. PMID- 1787099 TI - Hb J-Camaguey [alpha 141(HC3)Arg----Gly] associated with alpha-thalassemia-1 in an Australian family. PMID- 1787100 TI - Detection of the most frequent beta-thalassemic defect in Southeast Asia by PCR. PMID- 1787101 TI - A mild thalassemia major resulting from a compound heterozygosity for the IVS-II 1 (G----A) mutation and the rare T----C mutation at the polyadenylation site. PMID- 1787102 TI - Hb Fukuyama or alpha 2 beta(2)77(EF1)His----Tyr observed in an Indonesian female. PMID- 1787103 TI - Hb A2-Niigata [delta 1(NA1)Val----Ala]: a new delta chain variant found in the Japanese population. PMID- 1787104 TI - Malaria and the sickle cell gene in the Tramba district of Tanzania. PMID- 1787105 TI - Compound heterozygosity for Hb E-Saskatoon and beta-thalassemia. PMID- 1787106 TI - Hb Strumica [alpha(2)112(G19)His----Arg beta 2] in a Turkish family. PMID- 1787107 TI - Calcitonin gene-related peptide and its mRNA in pulmonary neuroendocrine cells and ganglia. AB - The occurrence of calcitonin gene-related peptide (CGRP) and it's mRNA was studied in lungs of rats and piglets using in situ hybridization with two synthetic oligonucleotide probes followed by immunocytochemistry (ICC). CGRP mRNA was present in pulmonary neuroendocrine cells (PNEC) of both the solitary type and cluster type (neuroepithelial body; NEB) at all levels of the airway epithelium from bronchi to alveoli. The distribution of labelled cells was similar to that previously described with ICC. The 44-mer probe provided stronger hybridization signal than the 34-mer and the two combined increased labelling slightly. Formalin fixation reduced labelling and tended to increase background. Labelling for CGRP mRNA was evenly distributed over the cytoplasm, whereas CGRP like immunoreactivity (LI) usually was of highest intensity toward the base of the PNEC, suggesting basal accumulation of synthesized peptide. CGRP-LI was also observed in occasional rat ganglia and in some, but not all, piglet ganglia. These local neurons may contribute to the CGRP fibers of airways and vasculature, and could theoretically bridge their dendrites and axons between NEB and the effector organ (e.g. artery or arteriole) thus accomplishing a function similar to the postulated axon reflex. PMID- 1787108 TI - Localization of GAD-like immunoreactivity in the pancreas and stomach of the rat and mouse. AB - The aim of this study was to localize cells immunoreactive for glutamate decarboxylase (GAD), the enzyme of GABA synthesis, in pyloric and oxyntic regions of the rat stomach as well as in the rat and mouse pancreas. GAD immunocytochemistry was carried out on polyethylene glycol or cryostat sections of alkaline paraformaldehyde fixed tissue, with simultaneous immunolabelling of various gastro-pancreatic hormones for topographical comparison. In the rat stomach, nerve fibers displaying intense GAD-like immunoreactivity were seen in the myenteric plexus, the circular muscular layer, the submucosa and the lamina propria of the mucosa. But, they were absent from the submucous plexus. Colchicine treatment of the rats allowed to detect some labelled perikarya in the myenteric plexus suggesting that the GABAergic innervation is at least partly intrinsic to the stomach. In the oxyntic and pyloric mucosa, endocrine cells appeared immunostained for GAD. However, the nature of their hormones remained unknown since double immunodetections revealed that they were immunoreactive neither for gastrin nor for somatostatin. In the rat and mouse pancreas, GAD-like immunoreactivity was found in islet cells which corresponded only to insulin secreting cells. Somatostatin-, glucagon- and pancreatic polypeptide immunopositive cells were devoid of GAD immunolabelling. No GAD-like immunoreactivity was detected in the exocrine tissue and innervation. These results strenghten the hypothesis that GABA is not only a neurotransmitter in the stomach but that it could also be an endocrine or paracrine factor in the stomach and pancreas. PMID- 1787109 TI - Expression of enhancing factor gene and its localization in mouse tissues. AB - Enhancing factor (EF), a 14 kDa protein, isolated from mouse small intestines, has been reported from this laboratory. Based on our earlier studies EF has been implicated in cell proliferation. Preliminary immunohistochemical studies have shown EF to be localized in the Paneth cells of small intestines. In this paper we report the tissue distribution of EF using conditions optimized for immunohistochemical staining. In addition, the data are supported by northern blot analysis using a nick translated cDNA probe specific for EF. The results indicate that EF gene is actively transcribed mainly in the intestines. The chief source of synthesis of EF appears to be the Paneth cells located at the base of the crypts of Lieberkuhn. PMID- 1787110 TI - Mutagens formed during cooking may be carcinogenic. PMID- 1787111 TI - New medium for food pathogens simplifies tests for processed meats. PMID- 1787112 TI - Common law nuisance actions involving veterinarians. PMID- 1787113 TI - Moral orientations of justice and care among veterinarians entering veterinary practice. PMID- 1787114 TI - Pride. PMID- 1787115 TI - Improved nasogastric intubation technique for administration of nutritional support in dogs. AB - Established procedures for nasogastric intubation are difficult to perform in dogs because of anatomic variation of nasal passages and turbinate structures. Twenty-five clinically normal dogs were used to improve and refine the technique of nasogastric tube placement, and 13 clinical patients at our teaching hospital were evaluated for malnutrition and were considered candidates for nutritional support by nasogastric tube feeding. An improved method for the placement of nasogastric tubes in dogs was used. By pushing the external nares dorsally while advancing the tube in a caudoventral, medial direction, the tube passed through the ventral meatus and into the oropharynx and esophagus easily. The procedure does not require chemical restraint, and the complication of epistaxis was not observed in any dog. Materials required to perform this technique are inexpensive, and the method can be used for the administration of nutritional support, fluids, drugs, or contrast material. PMID- 1787116 TI - Pulmonary aspergillosis associated with acute enteritis in a horse. AB - Invasive pulmonary aspergillosis was detected at postmortem examination of an 8 year-old Quarter Horse mare that had a history of diarrhea, laminitis, and bilateral nasal discharge. A diagnosis of Ehrlichia risticii infection was made on the basis of clinical signs of diarrhea and pyrexia, high serum antibody titer to E risticii (1:2,560), and multiple Salmonella-negative cultures obtained from fecal and colonic specimens. Possible pathogenic mechanisms contributing to the development of pulmonary aspergillosis secondary to enteric disease include mycotic invasion of the intestinal tract or immunocompromise and tissue devitalization secondary to severe enterocolitis. Exposure of the mare to large numbers of Aspergillus organisms may have been important in this case. PMID- 1787117 TI - Azathioprine for treatment of immune-mediated thrombocytopenia in two horses. AB - Azathioprine, a thiopurine antimetabolite used in the treatment of immune mediated thrombocytopenia in human beings and dogs, was used in 2 cases of immune mediated thrombocytopenia in horses that failed to respond to corticosteroid therapy alone. Platelet counts were increased to acceptable values in both horses. One horse returned to a successful racing career, and the other was euthanatized after developing renal disease and mild laminitis. PMID- 1787118 TI - Subchondral bone cysts with fractures of the extensor processes in a horse. AB - Probable cause of fracture in a Paint gelding was a congenital bone defect involving the extensor process area of the right and left forelimb distal phalanges. Radiographically and histologically, subchondral bone cysts at the fracture lines were suspected. These cysts were thought to have developed in association with abnormal ossification centers at the extensor process areas of the third phalanx. Partial avulsion of weak extensor processes would then occur from natural forces exerted on these weakened bony prominences via the common digital extensor tendon. Support for osteochondrosis as a cause of this bone cyst formation was seen in histologic examination of fragments removed. Within the bony trabeculae, a dysplastic focus of cartilage with mineralized plaques and osseous tissues was observed. Findings supported a diagnosis of osteochondrosis, to the extent that the disease is presently understood in horses. Surgical correction by fragment removal was performed to circumvent progression of degenerative joint disease, which was evident as partial cartilage erosion of the distal dorsal articular surface of the second phalanx and fracture fragments. Recovery from surgery was rapid, and several months after surgery, the horse was sound for pleasure riding. PMID- 1787119 TI - Use of a flexed dorsoplantar radiographic view of the talocrural joint to evaluate lameness in two dogs. AB - A flexed dorsoplantar radiographic view of the talocrural joint was a useful additional view to diagnose abnormalities of the lateral trochlear ridge of the talus of 2 dogs. This view outlined the subchondral bone of both trochlear ridges of the talus and the apposing cochlea tibiae of the distal portion of the tibia. The tarsus was flexed at the level of the talocrural joint, and an x-ray beam was centered on the joint. With this additional view, fractures of the lateral trochlear ridge were readily diagnosed. This view would help to demonstrate osteochondral lesions of the lateral trochlear ridge. PMID- 1787120 TI - Hemolytic anemia caused by Babesia gibsoni infection in dogs. AB - Babesia gibsoni caused severe hemolytic anemia in 11 dogs from southern California. The most common clinical signs of B gibsoni infection were lethargy, anorexia, anemia, and thrombocytopenia. Acute infection with B gibsoni may be misdiagnosed as autoimmune hemolytic anemia. Diagnosis was most reliably determined by identification of the intraerythrocytic parasites on Giemsa-stained blood smears. The pathogenicity of B gibsoni, difficulties in diagnosis, the parasite's resistance to treatment with available drugs, and frequent interstate movement of dogs indicate that this disease may be a serious threat to dogs throughout the United States. PMID- 1787121 TI - Lag screw and cancellous bone graft fixation of transverse proximal sesamoid bone fractures in horses: 25 cases (1983-1989). AB - Case records of 25 horses with transverse fractures of the proximal sesamoid bone were reviewed to evaluate the success of treatment. All fractures were repaired by use of lag screw fixation and an autogenous cancellous bone graft because the fracture fragments were considered too large for surgical removal and reconstruction of the suspensory apparatus was necessary. Radiography was performed in all cases, and the fractures were classified into 3 types: (1) proximal midbody fractures, which included all fractures in the proximal aspect of the sesamoid bone that resulted in fragments involving greater than one third but less than one half of the total mass of the sesamoid bone; (2) midbody fractures that divided the bone into 2 equal portions; and (3) distal midbody fractures, which included transverse fractures in the distal aspect of the sesamoid bone that resulted in fragments involving greater than one third but less than one half of the total mass of the sesamoid bone. Of these cases, race records were obtained for 9 Standardbreds and 5 Thoroughbreds. Postoperative performance criteria evaluated were the ability to train and start 1 race, ability to maintain preinjury class of racing, earnings per start, and the number of starts following surgery. In Thoroughbreds, fractures occurred most commonly in the right forelimb; in Standardbreds, the left hind limb was most commonly involved. The midbody fracture was the most common type in both breeds, and the distribution of fracture location within the sesamoid bone was similar for both breeds.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787122 TI - Prevalence of nephrotoxicosis associated with a short-term saline solution diuresis protocol for the administration of cisplatin to dogs with malignant tumors: 61 cases (1987-1989). AB - The study reported here was undertaken to determine the nephrotoxicosis associated with the administration of cisplatin, an antineoplastic agent, to dogs when administered during 6-hour saline solution diuresis. Cisplatin (70 mg/m2 of body surface, IV, every 21 days) was given to 61 dogs with malignant neoplasia with a total of 185 doses in 1 (n = 9 dogs), 2 (n = 26 dogs), 3 (n = 4 dogs), 4 (n = 9 dogs), 5 (n = 2 dogs), and 6 (n = 11 dogs) treatments. The cisplatin was given over a 20-minute period after 0.9% NaCl solution (saline solution) was administered IV for 4 hours at a rate of 18.3 ml/kg of body weight/h. After the cisplatin infusion, saline solution diuresis was continued at the same rate for 2 hours. Before each treatment with cisplatin, dogs were evaluated with at least a physical examination, CBC, determination of serum urea nitrogen concentration, and in most cases, determination of serum creatinine concentration and urine specific gravity. Four of the 61 dogs (6.6%) developed clinically evident renal disease after 2 (1 dog), 3 (2 dogs), and 4 (1 dog) doses of cisplatin were administered. Three of the 4 dogs had preexisting disease of the urinary tract prior to the start of treatment. The survival time in dogs that developed renal disease (median, 145 days; range, 15 to 150 days) was similar to that of all dogs in this study (median, 154 days; range, 30 to 500 days), with 13 dogs still alive at the conclusion of the study.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787123 TI - Computed tomography of thoracic diseases in dogs. PMID- 1787124 TI - What is your diagnosis? Collapsed trachea from the level of C5 to C7. PMID- 1787125 TI - What is your diagnosis? Polycystic osteolytic lesion of the rostral portion of the mandible. PMID- 1787126 TI - Impact of chemical structure on quinolone potency, spectrum and side effects. AB - Following the discovery of nalidixic acid in 1962, numerous structural modifications have been made to the quinolone nucleus to increase antimicrobial activity and improve pharmacokinetic performance. A major advance occurred during the 1980s with the discovery that a fluorine at position 6 conferred broad and potent antimicrobial activity, (e.g. norfloxacin) but still with relatively less activity for Gram-positive and anaerobic organisms than Gram-negative bacteria. Subsequent developments produced quinolones with further improvements, predominantly in either solubility (e.g. ofloxacin), antimicrobial activity (e.g. ciprofloxacin) or prolonged serum half-life (e.g. pefloxacin). Recent modifications have attempted to achieve an optimal blend of favourable properties together with minimal potential for undesirable side-effects. An example is temafloxacin with comparatively enhanced activity against Gram-positive pathogens, a balanced pharmacokinetic profile, minimal CNS penetration, and without interaction with theophylline elimination. Improvements in antimicrobial activity combined with adequate blood and tissue concentrations do offer expectancy of enhanced therapeutic efficacy for new derivatives in those infections by organisms which are 'marginally' sensitive to currently used quinolones. The possibility of resistance emerging in these organisms during treatment, should also be reduced. PMID- 1787127 TI - A review of antibiotic resistance patterns of Streptococcus pneumoniae in Europe. AB - Streptococcus pneumoniae no longer has predictable antibiotic susceptibility. There are two areas of high prevalence of resistance (over 25%) to beta-lactam antibiotics in the South-West and North-East of Europe. In Spain, a close relationship has been found between the yearly rate of aminopenicillin consumption and penicillin resistance. High level resistance (MIC greater than or equal to 1 mg/L) has developed against a previous background of low level resistance. The serotypes involved in penicillin resistance in Spain are widespread in other countries. Macrolide resistance is high in France (over 15%) and is also increasing in other countries. All these resistant isolates remain susceptible to the most recent fluoroquinolones, such as temafloxacin. Prospective surveillance, more rational use of antibiotics and a diversification of antibiotic use in respiratory tract infections may serve to limit the threat of antibiotic resistance in S. pneumoniae. PMID- 1787128 TI - Review of quinolones in the treatment of infections of the skin and skin structure. AB - The oral fluoroquinolones ciprofloxacin, ofloxacin and temafloxacin are active against staphylococci, Enterobacteriaceae and Pseudomonas aeruginosa. Ciprofloxacin has been extensively studied, and is as effective as parenteral third-generation cephalosporins in many difficult infections of the skin and skin structure. Ofloxacin has been less extensively studied, yet is probably more effective than ciprofloxacin against Staphylococcus aureus, while less effective against P. aeruginosa. Temafloxacin is an oral quinolone, and appears to be a promising agent for skin and soft tissue infections due to its extended spectrum of activity, including anaerobic pathogens. Oral fluoroquinolone monotherapy, when combined with surgical debridement and local management, may be effective in many difficult infections of the skin and skin structure previously treated with parenteral antibiotics. PMID- 1787129 TI - Concentration of bone marrow mononuclear cells using a programmable blood cell separator. AB - Bone marrow was collected from adult patients with various solid tumors who consented to participate in a study of myelo-ablative chemotherapy followed by autologous bone marrow rescue. Twenty marrow suspensions were processed by using standard Procedure 3 (PRO-3) for lymphocytapheresis without modification. A modified Procedure 1 (M-PRO-1) for plateletpheresis was employed for processing 34 marrow suspensions. For PRO-3, mononuclear cell (MNC) recovery was 68 +/- 22% of the starting marrow suspension (baseline), in a concentrate volume of 234 +/- 53 ml. MNC represented 59 +/- 27% of the total WBC count of the concentrate. The residual volume of RBC was 49 +/- 47 ml. For M-PRO-1, MNC recovery was 63 +/- 22% of the baseline in a concentrate volume of 200 +/- 8 ml. MNC comprised 94 +/- 7% of the total WBC count of the concentrate. RBC contamination was 7 +/- 3 ml. Hematopoietic recovery, defined as the post-transplant days when a sustained granulocyte count of 500/microL and a platelet count of 50,000/microL were achieved, was similar in the two groups and comparable to other reports utilizing other methods and equipment for bone marrow concentration. Personnel time was significantly reduced compared to other procedures for bone marrow concentration due to increased automation. Although there was no significant difference in MNC recovery between the two groups (P greater than 0.5), M-PRO-1 was clearly superior to PRO-3 because of the consistently high degree of purity of the MNC in the concentrate and minimal RBC contamination.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787130 TI - Preparation and storage of "leukocyte-depleted single donor" platelet concentrate: a step forward in effective haemotherapy. AB - "Leukocyte-depleted" platelet concentrates (LD-SDPC) were prepared by cotton-wool and by polyester filtration of "leukocyte-poor" PC collected by the elutriation technique. The storage characteristics of LD-SDPC were comparable to those of the filtered pools of multiple donor platelet concentrates (LD-MDPC). However, LD SDPC were less activated and less damaged than LD-MDPC over a 7-day storage period, as evidenced by beta-thromboglobin percent release and lactic dehydrogenase percent leakage in both products. LD-SDPC were prophylactically transfused to 12 thrombocytopenic patients; the mean bleeding time was shortened from 12 min 20 sec to 4 min 39 sec. Corrected count increment (CCI) was 22.8 at 1 hr and 14.1 at 24 hr compared to 15.5 and 10.0, respectively, with standard PCs. PMID- 1787131 TI - Hemolytic uremic syndrome/thrombotic thrombocytopenic purpura: outcome with plasma exchange. AB - A retrospective analysis was made of 14 consecutive adults with hemolytic uremic syndrome/thrombotic thrombocytopenic purpura (HUS/TTP) who were treated with plasma exchange (PE). In six patients the disease was primary, whilst in eight HUS/TTP was considered secondary to an associated condition. Thirteen patients had renal involvement, six had central nervous system symptoms or signs, three had fever, and one had myocardial damage. Twelve patients (86%) recovered. Four of these relapsed, but responded to further treatment. Two patients failed to respond and died. Hematological response occurred rapidly in survivors: thrombocytopenia resolved after a median of four exchanges, and hemolysis after a median of six. Four patients had a complete recovery, seven had residual mild end organ damage, and one had severe renal impairment. PE was an effective treatment for both primary and secondary HUS/TTP. The platelet count proved to be the earliest indicator of clinical outcome. Continuing follow-up of survivors is required because of the risk of relapse and the high incidence of end organ damage. PMID- 1787132 TI - Zidovudine removal during plasma exchange. AB - Pharmacokinetics of zidovudine (azidothymidine, AZT) were investigated after oral administration (300 mg every 8 hours) in a human immunodeficiency virus seropositive patient who was also treated with plasma exchange (60 ml/kg). Plasma AZT concentrations were measured using high performance liquid chromatography assay. Plasma exchange clearances reached 1-3.8% of the total clearance. The fraction of AZT removed from separated plasma accounted for only 1% of the administered dose. The contribution of plasma exchange to the elimination of AZT appears to be negligible. Solely on the basis of AZT pharmacokinetic data, no particular dose adjustment appears to be necessary in patients treated with multiple plasma exchanges. PMID- 1787133 TI - Cyclosporin-induced hypertriglyceridemia with prompt response to plasma exchange therapy. AB - A case of severe cyclosporin-induced hypertriglyceridemia that prompted plasma exchange therapy is reported. Hyperlipemic retinitis, headache, stupor, and peripheral paresthesias became apparent when the level of triglycerides exceeded the 1,500 mg/dL level. Two plasma exchanges were required to halt disease progression. This is the second time that plasma exchange was used in a bone marrow transplanted patient on cyclosporin-A therapy. In both cases hypertriglyceridemia became apparent and symptomatic after approximately 7 months of therapy with cyclosporin. PMID- 1787135 TI - Abstracts of the twelfth annual meeting of the American Society for Apheresis. New Orleans, Louisiana, March 20-23, 1991. PMID- 1787134 TI - Immediate gross hemolysis due to hypotonic fluid administration during plasma exchange: a case report. PMID- 1787136 TI - Annotation: strategies for helping families with conduct disordered children. PMID- 1787137 TI - Comorbidity in child psychopathology: concepts, issues and research strategies. AB - Epidemiological data show that the co-occurrence of two or more supposedly separate child (and adult) psychiatric conditions far exceeds that expected by chance (clinic data cannot be used for this determination). The importance of comorbidity is shown and it is noted that it is not dealt with optimally in either DSM-III-R or ICD-9. Artifacts in the detection of comorbidity are considered in terms of referral and screening/surveillance biases. Apparent comorbidity may also arise from various nosological considerations; these include the use of categories where dimensions might be more appropriate, overlapping diagnostic criteria, artificial subdivision of syndromes, one disorder representing an early manifestation of the other, and one disorder being part of the other. Possible explanations of true comorbidity are discussed with respect to shared and overlapping risk factors, the comorbid pattern constituting a distinct meaningful syndrome, and one disorder creating an increased risk for the other. Some possible means of investigating each of these possibilities are noted. PMID- 1787138 TI - Executive function deficits in high-functioning autistic individuals: relationship to theory of mind. AB - A group of high-functioning autistic individuals was compared to a clinical control group matched on VIQ, age, sex and SES. Significant group differences were found on executive function, theory of mind, emotion perception and verbal memory tests, but not on spatial or other control measures. Second-order theory of mind and executive function deficits were widespread among the autistic group, while first-order theory of mind deficits were found in only a subset of the sample. The relationship of executive function and theory of mind deficits to each other, and their primacy to autism, are discussed. PMID- 1787139 TI - Asperger's syndrome: evidence of an empirical distinction from high-functioning autism. AB - This study compared the neuropsychological profiles of individuals with high functioning autism (HFA) and Asperger's syndrome (AS). In comparison with matched controls, both groups were impaired on executive function tests. Only the HFA group demonstrated deficits in theory of mind and verbal memory, performing more poorly than both controls and AS subjects. These results suggest that: (1) HFA and AS are empirically distinguishable on measures independent of diagnostic criteria, and (2) impairment on theory of mind measures is not universally found among individuals with autistic spectrum conditions. The primacy of executive function and theory of mind deficits to autism is discussed. PMID- 1787140 TI - Methodological issues for experiments on autistic individuals' perception and understanding of emotion. AB - The purpose of this paper is to consider problems that arise in designing and interpreting experimental investigations of autistic children's capacities for perceiving and understanding emotion, and to offer a review of published studies. Attention is drawn to some strengths and limitations of the experimental approach in this domain. PMID- 1787141 TI - Identity patterns and self- and teacher-perceptions of problems for deaf adolescents: a research note. AB - The present study investigated self- and teacher-perceptions of deaf adolescents in relation to cultural identity. Fifty-one deaf adolescents completed the Porteous Checklist and Deaf Identity Scale presented in British Sign Language. Subjects were assigned to deaf, hearing or dual identity groups. Results suggest that deaf adolescents' self-perceived concerns are not dissimilar in content or severity to those of their hearing peers, although certain issues may assume a particular significance in the presence of deafness. The hypothesis that the hearing identity group would report most problems was not supported. Teachers rated the dual identity group as having the fewest difficulties. PMID- 1787143 TI - Debate and argument: is autism a pervasive developmental disorder? PMID- 1787142 TI - Debate and argument: how useful is the "PDD" label? PMID- 1787144 TI - Debate and argument: the utility of the term pervasive developmental disorder. PMID- 1787145 TI - High-performance liquid chromatography post-column derivatization with fluorescence detection to study the influence of ambroxol on dipalmitoylphosphatidylcholine levels in rabbit eustachian tube washings. AB - In this work an appropriate high-performance liquid chromatography method was set up to guarantee specificity, sensitivity, precision and accuracy in analyzing dipalmitoylphosphatidylcholine (DPPC) in rabbit eustachian tube washings, as well as to determine its varying levels after administration of ambroxol chloride. The procedure is based on a post-column derivatization with fluorescence detection using 1,6-diphenyl-1,3,5-hexatriene which exhibits increased fluorescence in a lipid environment. DPPC was chromatographed on a Hypersil C18. The mobile phase for the isocratic elution consisted of 40 mmol/l choline chloride in methanol tetrahydrofuran (97:3). Ambroxol was given to a group of New Zealand white rabbits at a dose of 30 mg/kg. A second group receiving vehicle only acted as controls. PMID- 1787146 TI - Recent advances in liquid chromatography-mass spectrometry and capillary zone electrophoresis-mass spectrometry for protein analysis. AB - The utility of the combination of separations techniques, such as liquid chromatography and capillary zone electrophoresis, with mass spectrometry in applications involving protein analysis is discussed. The use of continuous-flow fast atom bombardment and electrospray ionization mass spectrometry is compared for the analysis of tryptic digests. For liquid chromatography, both microbore and slurry-packed capillary bore columns were used to separate peptides from proteolytic digests. PMID- 1787147 TI - Purification of canine prolactin and growth hormone by fast protein liquid chromatography. AB - Prolactin and growth hormone are two peptide hormone with a very similar structure. A simple method is described for the simultaneous purification of these two peptides from canine pituitary extract by fast protein liquid chromatography. After extraction at pH 5.0 and 9.6 and anion-exchange chromatography on a MonoQ column, prolactin and growth hormone are then separated by gel filtration chromatography on two Superose columns coupled in series. The different fractions of the purification scheme are checked for the presence of the peptide hormones by sodium dodecyl sulphate gel electrophoresis in the Pharmacia PhastSystem. Each hormone is also characterized by its behaviour in a Western Blotting Detection System. PMID- 1787148 TI - Comparison of high-performance liquid chromatographic detection methods for thyronine and tyrosine residues in toxicological studies of the thyroid. AB - Four high-performance liquid chromatographic methods for the detection of thyroid hormones (iodinated thyronines) and precursors (iodinated tyrosines) have been developed and evaluated. Two methods consist of direct determination of the parent compounds with detection at ultraviolet wavelength (230 nm) and with electrochemical detection. The two other methods consist of a pre-column derivatization (with fluorenylmethyl chloroformate and dabsyl chloride) prior to high-performance liquid chromatographic analysis. The various methods were evaluated based on their practical use and sensitivity. The method with direct ultraviolet detection turned out to be the most practical method. With this method analyses of thyroid homogenates have been performed from rats from a toxicological experiment. PMID- 1787149 TI - Rapid and sensitive high-performance liquid chromatographic method for the analysis of tryptophan, tyrosine and phenylalanine in biological samples. AB - In order to overcome problems related to the determination of free tryptophan in biological fluids using conventional methods, we have developed an accurate and reliable procedure based on a specific pretreatment of samples followed by a very rapid and sensitive reversed-phase high-performance liquid chromatographic analysis. The pretreatment consists of adding to the samples of a very low amount of 3 M phosphate buffer to maintain pH in the physiological range followed by ultrafiltration. The precision, reproducibility and sensitivity of our method were also evaluated. The recovery of each amino acid was greater than 92%. The use of a microbore column allows the detection of up to 0.2 pmol/microliter of amino acid. The method has been applied to the analysis of samples obtained from 25 normal and 10 phenylketonuric subjects. PMID- 1787150 TI - Anion-exchange chromatographic properties of alpha-lactalbumin eluted from quaternized polyvinylimidazole. Study of the role of the polymer coating. AB - The anion-exchange elution behaviour of alpha-lactalbumin was studied on cross linked and quaternized polyvinylimidazole, deposited on various high-performance liquid chromatographic supports (porous silica and diol silica). The influence of the nature and thickness of the coating layer on the retention and band-width properties of the protein elution peak was examined by isocratic elution. The retention properties of alpha-lactalbumin were studied from the plot of log k' vs. log([NaCl]), where k' is the capacity factor and [NaCl] the displacer salt concentration in the aqueous phase. The retention depends on the amount of stationary phase deposited on the support, but an increased hydrophobic effect is found when the polymer films do not coat the chromatographic support uniformly. Band broadening of the elution peaks was studied in terms of plots of plate height vs. mobile phase velocity. An important mass-transfer contribution is found, which decreases with increasing k' and increases with the thickness of the coating layer. These effects reveal that the diffusion into the polymer layer is the controlling step of the ion-exchange process with non-uniform polymer layers of large mean thickness. PMID- 1787151 TI - Determination of several retinoids, carotenoids and E vitamers by high performance liquid chromatography. Application to plasma and tissues of rats fed a diet rich in either beta-carotene or canthaxanthin. AB - A method, using two different systems, is described for the high-performance liquid chromatographic analysis of retinol, retinal, retinoic acid, retinyl acetate, retinyl palmitate, alpha-, beta- and gamma-carotene, beta-apo-6'-, beta apo-8', beta-apo-10'- and beta-apo-12'-carotenal, ethyl beta-apo-8'-carotenoate, alpha-tocopherol and alpha-tocopheryl acetate. The first system consists of a laboratory-packed Hypersil-ODS 3-microns column and a mobile phase of acetonitrile-methylene chloride-methanol-water (70:10:15:5, v/v). The second system consists of a laboratory-packed Hypersil-ODS 3-microns column and a mobile phase of acetonitrile-methylene chloride-methanol-water (70:10:15:5, v/v). The second system consists of a laboratory-packed Nucleosil C18 3-microns column and a mobile phase of acetonitrile-0.1 M ammonium acetate (80:20, v/v). The detection limits in standard solutions were 10 ng/ml for retinoids and carotenoids and 60 ng/ml for the E vitamers. Analysis of the tissues and plasma of rats, after 2 weeks on a diet supplemented with either beta-carotene or canthaxanthin (both 2 mg/g), led to the conclusion that the rats were able both to transport and store beta-carotene and canthaxanthin and to convert beta-carotene to retinol. Incubation of cytosol preparations from the mucosa of the small intestine of rat with 1 microgram of beta-carotene resulted in the formation of 10-20 ng of retinal within 1 h. PMID- 1787152 TI - Determination of the ultraviolet absorbance and radioactivity of purine compounds separated by high-performance liquid chromatography. Application to metabolic flux rate analysis. AB - A double detection system for the determination of adenine metabolism in biological tissues using isocratic ion-pair reversed-phase chromatography is presented. Two isocratic ion-pair separations were used: (i) 10 mM NH4H2PO4, 2 mM tetrabutylammonium phosphate (PIC reagent A) and 18% acetonitrile for the determination of nucleotides and (ii) 50 mM KH2PO4, 1 mM PIC reagent A and 1% acetonitrile for the determination of monophosphorylated nucleotides, nucleosides and nucleobases. The parallel detection of ultraviolet absorbance at 254 nm and the radioactivity of separated purine compounds allows the detection of pool sizes and of the specific radioactivities in tracer kinetic experiments. The high performance liquid chromatography methods were applied to the determination of flux rates during adenine nucleotide metabolism in suspensions of Ehrlich mouse ascites tumour cells. The pathways of adenine metabolism in cells during the proliferation and plateau phases of tumour growth were compared. PMID- 1787153 TI - Hypertensive congenital adrenal enzymatic defects detected by high-performance liquid chromatography of corticosteroids. AB - The simultaneous measurement of the adrenal deoxycorticosterone (DOC), 18-OH-DOC, corticosterone (B), 18-OH-B, 11-deoxycortisol (S) and cortisol (F) present in human plasma in cases of adrenal dysfunction was accomplished using a high performance liquid chromatographic (HPLC) system with a UV detector and with a radioimmunoassay (RIA). After a solid-phase extraction, plasma samples were separated by HPLC using a gradient of water-acetonitrile-ethanol on a radial compressed reversed-phase column. In a 70-min cycle, a complete separation of adrenal steroids was accomplished. The UV detector allowed direct measurement of F in each plasma sample while in selected cases B and S were directly determined. It was therefore possible quickly to identify patients with hypertensive congenital adrenal enzymatic defects with this method: the 17-alpha-hydroxylase deficiency characterized by the absence of measurable levels of F with an evident peak corresponding to B and the 11-beta-hydroxylase deficiency in which high levels of S without F are detected. The RIA of DOC, B, 18-OH-DOC and 18-OH-B complete the characterization of the adrenal defect. Therefore, with this HPLC method it is possible to recognize the major hypertensive adrenal enzymatic deficiencies such as the defect of 17-alpha-hydroxylase or 11-beta-hydroxylase. With "RIA" detectors an almost complete spectrum of adrenal steroid secretion can be obtained. PMID- 1787154 TI - Purine and pyrimidine compounds in murine peritoneal macrophages cultured in vitro. AB - Extracts of murine peritoneal macrophages were analysed by ion-pair reversed phase high-performance liquid chromatography during incubation at 37 degrees C in vitro. Four-step gradient elution was applied to an ODS column (250 x 4.6 mm I.D.) at a flow-rate of 1.3 ml/min, allowing the separation of hypoxanthine, inosine, guanosine, adenosine, IMP, CDP, AMP, GDP, UDP, ADP, CTP, GTP, UTP and ATP within 50 min. Samples of 0.4 . 10(6)-0.5 . 10(6) cells were washed twice with RPMI 1640 medium and extracted with perchloric acid. Nucleotide concentrations of murine peritoneal macrophages did not change during incubation for 4 days in vitro. PMID- 1787155 TI - Clean-up of plasma extracts by gel permeation chromatography during analysis of isosorbide nitrates by capillary gas chromatography. AB - This work describes how gel permeation chromatography (GPC) can be used for sample clean-up to reduce the fouling of the column in an automated on-column injector. The analytes were isolated from plasma together with the internal standard (isomannide dinitrate) by liquid-liquid extraction on Extrelut silica columns. The extracts were evaporated and reconstituted in tetrahydrofuran for separation of the analytes from non-volatile plasma components by GPC on a styrene-divinylbenzene column with 100 A pore size. A programmable autosampler with an additional three-way valve was used for injection and fraction collection. The molecular weight fraction between 100 and 700 a.m.u. was collected and transferred to the on-column autosampler for capillary gas chromatography on a 30-m column butt-connected to a 0.2-m pre-column. The pre column was replaced after 50 sample injections. When the GPC purification was excluded from the work-up procedure a deposit of non-volatile components was formed at the injection zone of the pre-column which resulted in excessive peak tailing after only five or six injections of plasma extract. The limit of determination was 0.2 ng/ml plasma for isosorbide dinitrate and 0.4 ng/ml for the mononitrates. PMID- 1787156 TI - Measurement of enzyme activities of cytochrome P-450 isoenzymes by high performance liquid chromatographic analysis of products. AB - A method is described for the qualitative and quantitative determination of the isoenzymes of cytochrome P-450 from rat liver microsomes. Microsomes are incubated with the endogenous steroid 17 beta-testosterone, which results in the formation of a number of stereo-specific hydroxylation products of testosterone. The hydroxylated products were identified using standards or by comparison with data from the literature. The products can be analysed by reversed-phase gradient high-performance liquid chromatography. The assay has been optimised for pH, linearity and time of incubation. An evaluation of the assay was performed for different kinds of microsomes, microsomal dilution and specificity for particular cytochrome P-450 isoenzymes. PMID- 1787157 TI - High-performance liquid chromatographic determination of acetone in blood and urine in the clinical diagnostic laboratory. AB - A method for the determination of acetone in plasma or urine by high-performance liquid chromatography (HPLC) was developed. Plasma specimens are deproteinized with acetonitrile (1:1, v/v) 2,4-dinitrophenylhydrazine (DNPH) is added to the supernatant or to filtered urine samples, similarly treated with acetonitrile (2:1, v/v) to prevent crystallization of the synthesized phenylhydrazone. An aliquot (20 microliters) of the reaction mixture was subjected to HPLC at ambient temperature using a reversed-phase Pecosphere 3 x 3 C18 column with acetonitrile water (45:55, v/v) as eluent at a flow-rate of 1 ml/min and detection at 365 nm. Hydroxyacetone and acetoacetate phenylhydrazone derivatives do not interfere. The identification of acetone by its retention time was confirmed by comparison with a laboratory-synthesized acetone DNPH derivative. The concentration of acetone, eluted within 3 min, was determined by the peak-height method. The detection limit was 0.034 mmol/l; the relative standard deviations were less than 5% within run (n = 20) and less than 10% between run (n = 20). PMID- 1787158 TI - Determination of free DOPA and 3-O-methyl-DOPA in human plasma by high performance liquid chromatography with electrochemical detection. AB - A procedure was devised for the determination of the unconjugated non-protein bound fraction of 3,4-dihydroxyphenylalanine (DOPA) and 3-O-methyl-DOPA (3-OMD) in plasma using a reversed-phase liquid chromatographic system coupled with electrochemical detection. Sample preparation involves rapid isolation of the unbound drugs from the drug-protein complex by ultrafiltration through a membrane with a molecular weight cut-off of 10,000 dalton. One chromatographic run requires less than 10 min. The relative standard deviation is less than 3% for the within-assay imprecision and less than 4% for the between-assay imprecision. The detection limits for DOPA and 3-OMD are 0.2 and 1.3 ng/ml, respectively. PMID- 1787159 TI - High-performance liquid chromatographic method for the determination of RGH-5702 in plasma samples. AB - A quick and selective high-performance liquid chromatographic method has been developed for the determination of RGH-5702 in plasma samples. A simple one-step extraction is used followed by reversed-phase chromatography and UV detection. This method allowed the separation of the compound and internal standard within 7 minutes. Validation of the method was performed prior to the assay of samples and continued throughout the study. Acceptable accuracy and precision was achieved at all concentrations investigated. The quantitation limit was 20 ng/ml using 1 ml of plasma. The method has been applied to the analysis of plasma samples from toxicokinetic studies in dogs. PMID- 1787160 TI - Rapid determination of abamectin in lettuce and cucumber by high-performance liquid chromatography. AB - A rapid, sensitive and reliable method is presented for the determination of trace amounts of abamectin in lettuce and cucumber. Abamectin consists of greater than or equal to 80% avermectin B1a and less than or equal to 20% avermectin Bb. Vegetables were extracted with ethyl acetate and the extract was purified by solid-phase extraction using Sep-Pak silica cartridges. The purified extracts were analysed by high-performance liquid chromatography with a 5 microm Zorbax ODS column and UV detection under isocratic conditions. The method yields recoveries for avermectin B1a and B1b of 76-109% in the 0.054-0.54 ng/kg range. The limit of detection of the method is 40 microgram/kg each of avermectin B1a and B1b in vegetables. PMID- 1787161 TI - Screening for coumatetralyl in soft drinks by solid-matrix extraction and high performance liquid chromatography with diode-array detection. AB - A method was developed for the rapid determination coumatetralyl in cola- and orange-type soft drinks, which includes extraction using solid-matrix column, clean-up by silica cartridge chromatography and reversed-phase high-performance liquid chromatography with diode-array detection. The recovery of coumatetralyl from 50 ml of soft drinks was better than 80% at spiking levels down to 50 micrograms/kg (ppb). PMID- 1787162 TI - Evaluation of eluents in thermospray liquid chromatography-mass spectrometry for identification and determination of pesticides in environmental samples. AB - The influence of different eluents in positive and negative ion mode thermospray liquid chromatography-mass spectrometry was studied with several groups of pesticides, including carbamates, chlorotriazines, phenylureas, phenoxy acids and organophosphorus and quaternary ammonium compounds, and the corresponding degradation products. Using the positive ion mode in combination with reversed phase eluents the base peaks generally corresponded either to [M + H]+ for the chlorotriazines and their hydroxy metabolites or to [M + NH4]+ for the carbamates, the phenylureas, the organophosphorus pesticides and their oxygen analogues. In the negative ion mode different processes such as (dissociative) electron-capture and anion attachment mechanisms occurred. Fragment ions such as [M - CONHCH3]- for the carbamates, [M - H]- for the chlorotriazines, phenylureas and chlorinated phenoxy acids and [M].-, [M - R]- (R being a methyl or ethyl group) for organophosphorus pesticides were usually formed. Depending on the eluent additive used (ammonium acetate, ammonium formate and/or chloroacetonitrile), three different adduct ions were formed: [M + CH3COO]-, [M + HCOO]- and [M + Cl]-. Normal-phase eluents with cyclohexane, n-hexane and/or dichloromethane provided more structural information and enhanced the response of several compounds. The positive ion mode was useful for the detection of chlorinated phenoxy acids and chlorophenols which could not be detected in the positive ion mode using reversed-phase systems. The base peaks generally corresponded to [M].+, [M + H]+ or [M - Cl]+. For the characterization of difenzoquat, a quaternary ammonium pesticide of which trace level analysis is troublesome, a post-column ion-pair extraction system was used. An aqueous mobile phase with a sulphonate-type counter ion was applied and an extraction solvent containing cyclohexane-dichloromethane-n-butanol (45:45:10) was used in thermospray liquid chromatography-mass spectrometry. Illustrative examples of the determination of residue levels of pesticides in soil matrices are shown. PMID- 1787163 TI - High-performance liquid chromatographic determination of rifapentine and its metabolite in human plasma by direct injection into a shielded hydrophobic phase column. AB - A simple high-performance liquid chromatographic method for determination of rifapentine, a cyclopentyl semisynthetic analogue of rifamycin belonging to the class of piperazinyl hydrazone derivatives of 3-formylrifamycin SV, and its metabolite, 25-desacetylrifapentine, in human plasma was developed using direct injection of the sample onto a Supelco LC HISEP column. The mean recovery was 100.3% for rifapentine and 99.7% for the metabolite and the precision of the assays was 3% and 7%, respectively. The limit of determination was 0.2 micrograms/ml and the method was validated for concentrations up to 64 micrograms/ml for rifapentine and 32 micrograms/ml for the metabolite. The results correlated well with those of the microbiological assay with Sarcina lutea as test organism. PMID- 1787164 TI - Reversed-phase and chiral high-performance liquid chromatographic assay of bupivacaine and its enantiomers in clinical samples after continuous extraplural infusion. AB - A previously unreported coupled achiral-chiral high-performance liquid chromatographic method has been developed to assay the levels of bupivacaine and its enantiomers in plasma samples, after the local anaesthetic had been given as a continuous extrapleural intercostal nerve block for 4 days, to relieve postoperative pain following thoracotomy. The method has been used to determine maximum, individual enantiomer and steady state levels in conjunction with an assessment of whether accumulation of bupivacaine occurs. An off-line extraction sample preparation is involved before determination of the "total" levels and final sample clean-up on a cyanopropyl silica column prior to "heart cutting" of the bupivacaine peak to a Chiral-AGP column for assay of the enantiomeric ratio. For an initial 5 patient number the mean maximum level was 5.43 micrograms/ml against a reported toxic level of around 5 micrograms/ml, which was reached in 72 h and the S-enantiomer gave slightly increased concentrations over the R enantiomer for which there is some evidence of higher toxicity. PMID- 1787165 TI - Liquid chromatographic separation of the enantiomers of metoprolol and its alpha hydroxy metabolite on Chiralcel OD for determination in plasma and urine. AB - The two enantiomers of metoprolol and the four enantiomeric forms of alpha hydroxymetoprolol were separated by liquid chromatography on a Chiralcel OD column containing a cellulose tris(3,5-dimethyl-phenylcarbamate) chiral stationary phase. The column efficiency was strongly dependent on the flow-rate and the enantioselectivity was influenced by temperature. Of utmost importance for the chiral separation was the water content of the mobile organic phase. The separation system was used for the separation and determination of the enantiomers in plasma and urine samples. The metoprolol enantiomers could be determined by fluorescence down to 10 nmol/l of each in plasma with a relative standard deviation of less than 15%. PMID- 1787166 TI - Micro-liquid chromatography method for the determination of ciclopiroxolamine after pre-column derivatization in topical formulations. AB - Ciclopiroxolamine is a broad-spectrum antimycotic drug. Neither the free acid (ciclopirox) nor its salt with ethanolamine (ciclopiroxolamine) can directly be quantified by liquid chromatography (LC) on both normal and reversed phases. This is due to the chelating function of the N-hydroxypyridone group that interacts strongly with stationary phases. Derivatization by alkylation forms a 1 alkyloxypirydone with regular chromatographic behaviour. A micro-LC method based on an isocratic elution reversed-phase system for quantification of ciclopiroxolamine in topical formulations is described. Chromatography was carried out using an LC Packings fused-silica capillary column (15 cm x 330 microns I.D.; Delta Pak, RP-18, 5 microns, 300 A) coupled to a Kontron 433 UV capillary detector. Data with respect to the derivatization reaction, recovery, reproducibility and limits of detection of the proposed method are reported and discussed. PMID- 1787167 TI - High-performance liquid chromatographic determination of vinblastine, 4-O deacetylvinblastine and the potential metabolite 4-O-deacetylvinblastine-3-oic acid in biological fluids. AB - Procedures for the determination of vinblastine (VBL), 4-O-deacetylvinblastine (DVBL) and 4-O-deacetylvinblastine-3-oic acid (DVBLA) in biological samples using high-performance liquid chromatography (HPLC) combined with selective sample clean-up are presented. VBL and DVBL were determined in plasma and urine using ion-exchange normal-phase HPLC with fluorescence detection. The limit of detection was 1 microgram/l for both compounds using a 500-microliter sample. Successful chromatographic analyses of DVBLA were achieved by using a glass column packed with 5-microns Hypersil ODS and acetonitrile-0.05 M phosphate buffer (pH 2.7) (23:77, v/v). Positive identification was supported by the use of diode-array detection. The limit of detection (at 270 nm) was 10 micrograms/l using 1-ml samples. PMID- 1787168 TI - Application of high-performance thin-layer chromatography and automated multiple development for the identification and determination of pesticides in water. AB - The combination of high-performance thin-layer chromatography (HPTLC) with automated multiple development (AMD) allows full automation of the separation step. This provides both a separation efficiency that is considerably better than that in conventional TLC and reproducible gradient elution on the thin layer. Reliable identification of trace amounts of pesticides (e.g., 28 ppt of atrazine) in subsoil, surface and drinking water is clearly demonstrated by AMD-HPTLC using a polarity gradient based on dichloromethane. A second universal elution gradient with changed selectivity on which the substances have different relative migration distances, identification by the multi-wavelength response correlation and the option of recording UV spectra in situ constitute three independent methods for reliable and rapid verification. Using 100- instead of 200-microns HPTLC silica gel layers and reducing the running distance increments from 3 to 2 or 1 mm increase the sensitivity, the linearity and the speed of the method. PMID- 1787169 TI - Two-dimensional high-performance liquid chromatography at low ng/ml levels of the anti-proliferative agent B859-35 in serum with automated sample clean-up, solid phase trapping and ultraviolet detection. AB - An automated non-chiral high-performance liquid chromatographic method is described for the determination of the new anti-proliferative agent B859-35 in serum. This method employs sample clean-up of 1 ml of biofluid by liquid-solid extraction with the AASP (Advanced Automatic Sample Preparation) system. First separation is achieved on a LiChrospher-60-RP-Select-B column. A fraction of this elute is then collected by solid-phase trapping. Thereafter, the final chromatogram is developed on a narrow-bore Hypers1-CPS column and quantified with ultraviolet detection at 230 nm. The limit of quantitation of the assay is 250 ng/ml. Linearity was proven in the range 0.25-100 ng/ml. Typical figures for precision at these concentrations are 7.4 and 3.3%, and for accuracy 8.0 and 1.3%, respectively. An application of this method to the study of pharmacokinetics of B859-35 in serum samples of cancer patients is given. PMID- 1787170 TI - Sensitive determination of the phosphodiesterase III/IV inhibitor zardaverine in human serum by direct sample injection, automated precolumn clean-up and high performance liquid chromatography. AB - A high-performance liquid chromatographic method is described for the determination of the phosphodiesterase III/IV inhibitor zardaverine in serum by using fully automated clean-up of large-volume serum samples on a semi preparative-scale precolumn followed by chromatography on two analytical columns operated with two different solvent systems. The switching of the analytical columns provides the necessary specificity and sufficient sensitivity for UV detection is obtained by the sample volume. The method was shown to give nearly quantitative recovery, allowing the use of external standard quantification. Good precision and linearity within the concentration range 1-50 ng/ml could be demonstrated. The method is suitable for routine measurements in support of kinetic studies of zardaverine in man. PMID- 1787171 TI - Supercritical fluid chromatography in the routine stability control of antipruritic preparations. AB - A recently developed system for supercritical fluid chromatography (SFC), based on independent flow and pressure control and suitable for packed and capillary columns, was tested on a routine level for the reliable, accurate and precise determination of active pharmaceutical substances in stability control. Only packed columns were used for this analysis. The chromatographic figures of merit and the validation data of the active substance alone and in two different dosage forms (accuracy, 98.8-99.2%; precision, 0.6%; linearity of response, 0.998-0.999) are comparable with the former liquid chromatographic methods. Economical (reduction of analysis time, fewer experimental steps and less sample pre separation) and ecological (carbon dioxide of organic solvents) advantages make SFC an attractive alternative to liquid chromatography in the determination of crotamiton. PMID- 1787172 TI - High-performance liquid chromatographic evaluation of Med 15 and its metabolites Med 5 and tolmetin in rat plasma. AB - A simple and reliable high-performance liquid chromatographic method is described for the quantitative analysis of the new non-steroidal anti-inflammatory agent Med 15 and its metabolites Med 5 and tolmetin in rat plasma. After selective extraction the three analytes and an internal standard (p-phenyl-phenol) were separated on a reversed-phase Ultrasphere 5 micron column using potassium dihydrogenphosphate (0.05 M)-acetonitrile (52:48) (pH 4.7) as the mobile phase. The analytes were detected at 313 nm; the sensitivity of the method proved to be 0.05 microgram/ml for all three compounds. The method has been applied to investigate Med 15 pharmacokinetics in rats. PMID- 1787173 TI - Separation of elastin cross-links as phenylisothiocyanate derivatives. AB - A method has been developed for the separation and quantitation of desmosines in tissue samples. The tissue is treated with cold 10% trichloroacetic acid to remove collagen and hydrolysed in HCl vapours in sealed vials. Preseparation of desmosines from tissue acid hydrolysates is performed on a cellulose column, first eluted with n-butanol-acetic acid-water to wash out other amino acids and then with water to recover desmosines. Separated desmosines are then derivatized with phenylisothiocyanate and determined by reversed-phase high-performance liquid chromatography using a gradient system with sodium acetate pH 6.4 and acetonitrile. Desmosines were detected spectrophotometrically at 254 nm. The method was applied to the determination of desmosine in elastin, rat aorta and bovine ligamentum nuchae. PMID- 1787174 TI - Molecular milestones that signal axonal maturation and the commitment of human spinal cord precursor cells to the neuronal or glial phenotype in development. AB - Insights into the programmatic induction of neuronal and glial genes during human embryogenesis have depended largely on extrapolations of data derived from experimental mammals. However, the assumptions upon which these extrapolations are based have not been rigorously tested. Indeed, practically no information is available even on the human counterparts of the relatively small subset of well characterized, developmentally regulated neuron and glial specific genes of the mammalian CNS. Thus, the developmental programs upon which human neural embryogenesis are based remain largely undeciphered. We have addressed this problem in immunohistochemical studies conducted on 22 human fetal spinal cords with gestational ages (GAs) that ranged from 6 to 40 weeks by using monoclonal antibodies to several classes of neuron or glial specific polypeptides. These polypeptides included: representatives of four different types (Types I-IV) of intermediate filament proteins, i.e., vimentin filament protein (VFP), glial fibrillary acidic protein (GFAP), different phospho-isoforms of the high (NF-H), middle (NF-M), and low (NF-L) molecular weight (Mr) neurofilament (NF) subunits, both acidic and basic cytokeratin (CK) proteins; three different microtubule associated proteins (MAPs), i.e., MAP2, MAP5, and tau; two different synaptic or coated vesicle proteins, i.e., synaptophysin (SYP) and clathrin light chain B (LCb); an oligodendroglial specific protein, i.e., myelin basic protein (MBP); and a receptor for a CNS trophic factor, i.e., the nerve growth factor receptor (NGFR).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1787175 TI - Postnatal ontogeny of cells expressing prepro-neurotensin/neuromedin N mRNA in the rat forebrain and midbrain: a hybridization histochemical study involving isotope-labeled and enzyme-labeled probes. AB - The postnatal ontogeny of cells expressing prepro-neurotensin/neuromedin N messenger RNA (prepro-NT/NN mRNA) in the rat forebrain and midbrain was investigated by in situ hybridization histochemistry. According to the pattern of expression during development, the cells which express prepro-NT/NN mRNA can be roughly divided into 2 groups. In type I cells, prepro-NT/NN mRNA expression reaches a maximum in terms of content during the postnatal period. After this early peak, cells of this type express the same or less prepro-NT/NN mRNA, reaching a plateau at an adult level that still contains a high level of expression. In type II cells, prepro-NT/NN mRNA appears during the postnatal period, and the expression decreases dramatically after the first postnatal week, being almost undetectable by a few weeks after birth. Type I cells were observed in the following areas: the piriform cortex, field CA1 of Ammon's horn, subiculum, vertical, and horizontal limbs of the diagonal band of Broca, intermediate part of the lateral septal nucleus, bed nucleus of the stria terminalis, medial preoptic area, lateral hypothalamus, caudal part of the caudate putamen, medial, cortical, and central amygdaloid nuclei, ventral tegmental area, deep mesencephalic nucleus, cuneiform nucleus, dorsal raphe nucleus, laterodorsal tegmental nucleus, parabrachial nucleus, and oral part of the pontine reticular nucleus. Cells of type II were observed in the following areas: the mitral cell layer of the olfactory bulb, rostral part of the caudate putamen, (anterior) cingulate cortex, and retrosplenial cortex (posterior cingulate cortex). PMID- 1787176 TI - Ecdysteroid receptors in the central nervous system of Manduca sexta: their changes in distribution and quantity during larval-pupal development. AB - Ecdysteroids act initially by binding to nuclear and possibly also extranuclear receptors. The presence and expression of these receptors in the insect brain was investigated in the present study as a means of defining these neurons involved in ecdysteroid-regulated processes at different developmental stages. Early in the fifth larval stadium of Manduca sexta, when endogenous ecdysteroid levels are low, receptors for ecdysteroids in cerebral neurons are either absent or present at low levels. Receptors can be reliably detected only on day 0 and are not found again until day 3.5, at the beginning of the commitment peak in the ecdysteroid titer, when they occur in a small stage-specific population of cells. At this time, ecdysteroid receptors are found mainly in nuclei but are also observed at low levels in cytoplasm. By day 4.8, ecdysteroid receptors are exclusively nuclear, and the number of target cells has increased dramatically in several brain regions, including those with known neurosecretory cell groups. This population and organization of ecdysteroid target cells is constant up to day 6, after which time the number of target neurons declines. By day 7.8, only 10% of the number of labelled neurons seen on days 4.8-6.8 remain in peripheral areas. In the pupal brains, ecdysteroid receptors reappear in a new population of neurons. The results indicate changes in the genomic regulation of a varying neuron population by ecdysteroids during fifth stadium development. PMID- 1787177 TI - Effects of prenatal protein deprivation on postnatal development of granule cells in the fascia dentata. AB - The effect of prenatal protein deprivation on the postnatal development of granule cells in the fascia dentata in the rat was studied at 15, 30, 90, and 220 days of age. The granule cells showed a significant reduction in cell size, decreased number of synaptic spines throughout their dendritic extent, and reduced complexity of dendritic branching in the outer two-thirds of the molecular layer. All of these deficits were present at 15 days and persisted throughout the study (220 days). The least deficits in synaptic spine density occurred at 90 days and in dendritic branching at 30 days. Partial restitution of earlier, more severe deficits was associated primarily with maturational events occurring in the protein deprived rats, whereas later increases in deficits were related primarily to a failure of the protein deprived rats to keep pace with neuronal development occurring in the controls. The present results are similar to those noted in our previous study in this journal of the effect of a low protein diet (8% casein) on these neurons that extended from pregnancy until the time of sacrifice at 30, 90, and 220 days of age (Cintra et al., '90; 532:271 277). Taken together, these two studies suggest that the postnatal adaptation of the granule cells to prenatal protein deprivation is primarily due to events that occur during pregnancy and that the site of predilection for the deficit is their dendrites in the outer two-thirds of the molecular layer of the fascia dentata. PMID- 1787178 TI - Major differences in CNS sulfonylurea receptor distribution between the rat (newborn, adult) and turtle. AB - Our previous results have shown that KATP channels play an important role in K+ efflux and extracellular K+ accumulation in the rat brain, and this role was quantitatively more important in the adult than in the newborn brain. The purpose of this study was to localize by autoradiographic techniques the binding sites of glibenclamide, a potent sulfonylurea ligand that targets KATP channels, in the adult and newborn rat central nervous system (CNS). Since the adult turtle is resistant to anoxia, we also compared the rat to the turtle brain sulfonylurea receptor distribution. In all three animal groups (newborn rat, adult rat, adult turtle), specific glibenclamide binding was saturable. Scatchard plots were curvilinear in the rat, thus suggesting that glibenclamide binds to two types of sites, i.e., high and low affinity sites. Scatchard analysis on turtle brain tissue showed evidence of one binding site only. We also found that the distribution of glibenclamide binding sites was heterogeneous in the adult rat CNS with a higher density in rostral than in caudal regions. The highest binding densities were seen in the cortex, hippocampus, cerebellum, substantia nigra, and a few thalamic nuclei; intermediate densities were observed in the basal ganglia, septum, thalamus, and the hypoglossal nucleus. There was a low density in most areas of the hypothalamus, midbrain, brainstem, and spinal cord. Compared with the adult rat, the newborn had a very homogeneous distribution of binding sites and densities were very low throughout the CNS; the level of binding density was even lower in some regions undetectable in the adult turtle. Our results indicate that (1) there are high and low affinity sulfonylurea receptors in the rat CNS, (2) there is a striking heterogeneity in the distribution and density of sulfonylurea receptors in the adult rat CNS and this is in sharp contrast to the homogeneous distribution and low density in both newborn rat and adult turtle; (3) sulfonylurea receptors increase in number postnatally in the rat since binding density increases and the Kd in the newborn rat is similar to that in the adult rat. We speculate that KATP channels and sulfonylurea receptors are poorly developed in the turtle and develop mostly after birth in the rat, reaching highest density in adulthood. PMID- 1787179 TI - Synaptic inputs to physiologically identified retinal X-cells in the cat. AB - The cat retina contains a number of different classes of ganglion cells, each of which has a unique set of receptive field properties. The mechanisms that underlie the functional differences among classes, however, are not well understood. All of the afferent input to retinal ganglion cells are from bipolar and amacrine cell terminals in the inner plexiform layer, suggesting that the physiological differences among cat retinal ganglion cells might be due to differences in the proportion of input that they receive from these cell types. In this study, we have combined in vivo intracellular recording and labeling with subsequent ultrastructural analysis to determine directly the patterns of synaptic input to physiologically identified X-cells in the cat retina. Our primary aim in these analyses was to determine whether retinal X-cells receive a characteristic pattern of bipolar and amacrine cell input, and further, whether the functional properties of this cell type can be related to identifiable patterns of synaptic input in the inner plexiform layer. We reconstructed the entire dendritic arbor of an OFF-center X-cell and greater than 75% of the dendritic tree of an ON-center X-cell and found that 1) both ON- and OFF-center X cells are contacted with approximately the same frequency by bipolar and amacrine cell terminals, 2) each of these input types is distributed widely over their dendritic fields, and 3) there is no significant difference in the pattern of distribution of bipolar and amacrine cell synapses onto the dendrites of either cell type. Comparisons of the inputs to the ON- and the OFF-center cell, however, did reveal differences in the complexity of the synaptic arrangements found in association with the two neurons; a number of complex synaptic arrangements, including serial amacrine cell synapses, were found exclusively in association with the dendrites of the OFF-center X-cell. Most models of retinal X-cell receptive fields, because their visual responses share a number of features with those of bipolar cells, have attributed X-cell receptive field properties to their bipolar cell inputs. The data presented here, the first obtained from analyzing the inputs to the entire dendritic arbors of retinal X-cells, demonstrate that these retinal ganglion cells receive nearly one-half of their input from amacrine cells. These results clearly indicate that further data concerning the functional consequences of amacrine cell input are needed to understand more fully visual processing in the X-cell pathway. PMID- 1787180 TI - The sensory epithelium and its innervation in the mole rat cochlea. AB - The mole rat (Spalax ehrenbergi) burrows throughout its life in subterranean tunnels. Several structural and functional features which adapt the mole rat to its habitat have been discerned. The goal of this study was to elucidate the structural basis for adaptation of the auditory end-organ to an environment where low-frequency acoustical signals prevail. For this purpose, cochleae of adult mole rats were studied with light and electron microscopy. Inner hair cells throughout the cochlea, and outer hair cells in the basal (high-frequency) portion of the cochlea, were similar in structure to those seen in other mammals. In contrast, outer hair cells in the apical (low-frequency) portion displayed unique structural features. These features resembled the structure of inner hair cells or immature outer hair cells. The innervation of outer hair cells was most uncommon, in that classical medial efferent innervation was not found throughout the cochlear spiral. PMID- 1787181 TI - Postnatal development of cholinergic markers in the rat olfactory bulb: a histochemical and immunocytochemical study. AB - The present study has defined the developmental time course and the distribution patterns of neuronal fibers and cell bodies displaying acetylcholinesterase (AChE) activity or choline acetyltransferase (ChAT) immunoreactivity in the rat olfactory bulb. The results indicate that the deployment of centrifugal AChE containing fibers is essentially postnatal. The subset of atypical glomeruli, including the modified glomerular complex, is innervated as early as the first postnatal day while the normal ones are not reached by this type of afferent before postnatal day 6. The comparison of AChE labelling with ChAT immunoreactivity strongly supports the assumption that AChE-containing fibers represent mainly, if not exclusively, the cholinergic bulbopetal innervation emanating from the basal forebrain. A quantitative study has confirmed that the density of labelled fibers increases gradually in the postnatal period and spreads heterogeneously among the bulbar layers. The selective precocious innervation of atypical glomeruli is in favor of their involvement in the early processing of olfactory information in the olfactory bulb. Acetylcholinesterase is also expressed within a subset of ChAT-negative interneurons of the developing olfactory bulb. The number of neurons expressing AChE increases from birth to postnatal day 15 and then decreases to reach the adult value on about postnatal day 30. This neuronal population could constitute a cholinoceptive subset mediating the effects of cholinergic afferents on the bulbar neuronal network. PMID- 1787182 TI - Serotoninergic innervation of the ferret cerebral cortex. I. Adult pattern. AB - We have investigated the serotoninergic innervation of the adult ferret cerebral cortex with immunohistochemical techniques. Distribution pattern of serotoninergic fibers in the ferret neocortex is characterized by a decrease in the density of fibers as one moves from the pial surface towards the white matter. Throughout the entire cerebral cortex, the serotoninergic fibers are very dense within the supragranular layers, especially within layer 1. In contrast, granular and infragranular layers exhibit only a sparse innervation. Although this general pattern of innervation is roughly the same in all cortical areas, significant variations in the fiber density are apparent in different regions. Areas 17, 1, 6, and 8 (primary visual cortex, presumptive somatosensory cortex, presumptive motor cortex, and prefrontal cortex, respectively) are described in more detail to illustrate the diversity of the serotoninergic innervation patterns. The density of innervation is highest in areas 1 and 6, intermediate in area 8, and lowest in area 17. It is noteworthy that while areas 1, 6, and 8 show a marked decrease in fiber density at the boundary between layer 3 and 4, the less strongly innervated area 17 shows a change in density in the transition from layer 2 to layer 3. The types of fibers found within the ferret cortex are similar to those described in other mammalian species. The bulk of the innervation is made by very fine fusiform axons with small ovoid varicosities. In addition to this fiber type, axons with thick round varicosities and some smooth nonvaricose axons were found. The latter types occur in very small numbers within the supragranular layers and mostly in more anterior cortical regions. While the general innervation pattern and the fiber types are similar to those described in the cat cerebral cortex, the pericellular baskets found in the cat cortex (Mulligan and Tork, J Comp Neurol 270:86-110, 1988) are not seen in the ferret. PMID- 1787183 TI - Serotoninergic innervation of the ferret cerebral cortex. II. Postnatal development. AB - We have investigated the serotoninergic innervation of the ferret cortex from the day of birth to adulthood with immunohistochemical techniques. Due to the premature birth of ferrets, this period spans the entire generation of cells located within the upper cortical layers and their subsequent migration to their final positions. Already at birth, serotoninergic fibers innervate the developing cortex. This innervation is most dense within the marginal zone, the subplate region, and the lower portion of the cortical plate. As long as cell migration continues, serotoninergic fibers enter the expanding portions of the cortex. Only the region just below the marginal zone where newly arriving cells are added to the cortical plate is not innervated by the ingrowing fibers. When the bulk of cell migration ceases, during the third postnatal week, this gap disappears and the fibers gradually form a continuous innervation from the pia to the ventricle. As the cortex matures, the serotoninergic fibers become successively confined to the upper layers, to generate the adult pattern. In the adult ferret cortex, the highest innervation density is found within layers 1, 2, and 3, with a much sparser innervation within the lower layers (Voigt and de Lima, J. Comp. Neurol. 314:403-414, 1991). The dense innervation in the deep cortical layers is only transient, virtually disappearing toward adulthood. These results suggest that serotoninergic axons innervate cortical layers as soon as newly arriving cells reach their final positions within the cortex. This early innervation lends support to the idea that serotonin may play a role during development of the cerebral cortex. PMID- 1787184 TI - Purification and characterization of an extracellular protease produced by Pseudomonas fluorescens M3/6. AB - Pseudomonas fluorescens strain M3/6 was inoculated into reconstituted NDM and incubated at 7 degrees C for 46 d. A significant amount of extracellular protease was produced, mainly during the latter part of the culture's life cycle. The protease was purified using ammonium sulfate fractionation, ion-exchange chromatography, and gel filtration. The isolated protease had activity on azocasein, alpha-, beta-, and kappa-caseins and a plasmin substrate but did not have plasminogen activator activity. The protease had a molecular weight of 45 kDa, an isoelectric point of pH 8.25, a broad temperature and pH range for activity, and was less heat stable in the isolated form than in the cell-free extract. PMID- 1787185 TI - Potent antibacterial peptides generated by pepsin digestion of bovine lactoferrin. AB - The antibacterial properties of enzymatic hydrolysates of bovine lactoferrin were examined to determine whether active peptides are produced from this protein. Hydrolysates prepared by cleavage of lactoferrin with porcine pepsin, cod pepsin, or acid protease from Penicillium duponti showed strong activity against Escherichia coli O111, whereas hydrolysates produced by trypsin, papain, or other neutral proteases were much less active. Low molecular weight peptides generated by porcine pepsin cleavage of lactoferrin showed broad-spectrum antibacterial activity, inhibiting the growth of a number of Gram-negative and Gram-positive species, including strains that were resistant to native lactoferrin. The antibacterial potency of the hydrolysate was at least eightfold greater than that of undigested lactoferrin with all strains tested. The active peptides retained their activity in the presence of added iron, unlike native lactoferrin. The effect of the hydrolysate was bactericidal as indicated by a rapid loss of viability of E. coli O111. The lactoferrin hydrolysate described in the present study has commercial value as a natural preservative agent for use in foods and cosmetics, and as a functional component of new clinical foods for prevention or treatment of gastrointestinal disease. PMID- 1787186 TI - Rabbit whey acidic protein concentration in milk, serum, mammary gland extract, and culture medium. AB - Rabbit whey acidic protein has been purified from whey using an AcA54 column. The purified whey acidic protein had an amino acid composition in agreement with the previously defined cDNA sequence. An antibody against whey acidic protein was raised in guinea pig. This antibody did not crossreact with mouse or cow milk or with rabbit alpha s1-casein and beta-casein. Whey acidic protein concentration was measured in rabbit milk using the antibody with a radioimmunoassay. The concentration of whey acidic protein in rabbit milk was 15 mg/ml, whereas the concentrations of alpha s1-casein and beta-casein were 16 and 45 mg/ml, respectively. The concentration of the three proteins was also evaluated in culture medium of rabbit primary mammary cells. The three proteins were induced by prolactin alone. Glucocorticoids amplified the prolactin effect on whey acidic protein more intensively than on caseins. The three proteins were present in mammary extract from virgin rabbit. The concentration of these proteins was lower at d 8 and 14 of pregnancy, and it was very high at d 25 of pregnancy. Whey acidic protein was undetectable in blood of virgin, weaned, and midpregnant females and of males. Whey acidic protein was present in blood of lactating rabbits, but alpha s1-casein and beta-casein were not detectably present in rabbit blood at the examined physiological states. PMID- 1787187 TI - Pathological changes in bovine mammary glands following intramammary infusion of recombinant interleukin-2. AB - Eighteen lactating dairy cows were used to evaluate the physiological response of mammary glands to increasing doses of recombinant bovine interleukin-2. Right front and rear quarters were intramammarily infused with five different doses (.1 to 100 micrograms per quarter) of interleukin-2 as either a single or multiple treatment. Left front and rear quarters were intramammarily infused with a saline placebo and served as within-animal controls. Milk secretion samples for compositional analysis were collected from each quarter prior to infusion and at 12, 24, 36, and 48 h following infusion. Animals were slaughtered by exsanguination immediately following the 48-h sampling period, and mammary gland tissue was obtained for morphometric analysis. No changes in milk composition were observed between control quarters and those infused with up to 10 micrograms of interleukin-2 per quarter, administered as either a single or multiple treatment. Quarters infused with a single 100-micrograms dose of interleukin-2 or three consecutive doses of 25 and 100 micrograms of interleukin-2 had significantly lower lactose concentrations; there was a concomitant increase in bovine serum albumin, pH, and SCC compared with preinfusion concentrations or with control quarters. Morphometric analysis of tissue demonstrated an increase in stroma, a decrease in lumenal area, and a marked increase in the number of infiltrating leukocytes in those quarters infused with the higher doses of interleukin-2. Results suggest that interleukin-2 can be intrammammarily infused at doses as high as 10 micrograms per quarter without adversely affecting milk quality or normal mammary gland function. PMID- 1787188 TI - Lysostaphin: use of a recombinant bactericidal enzyme as a mastitis therapeutic. AB - A recombinant mucolytic protein, lysostaphin, was evaluated as a potential intramammary therapeutic for Staphylococcus aureus mastitis in dairy cattle. Lysostaphin, a product of Staphylococcus simulans, enzymatically degrades the cell wall of Staphylococcus aureus and is bactericidal. Thirty Holstein-Freisian dairy cattle in their first lactation were infected with Staphylococcus aureus (Newbould 305, ATCC 29740) in all quarters. Infections were established and monitored for somatic cell counts and Staphylococcus aureus colony-forming units 3 wk prior to subsequent treatment. Infected animals were injected through the teat canal with a single dose of recombinant lysostaphin (dose response 1 to 500 mg) or after three successive p.m. milkings with 100 mg of recombinant lysostaphin in 60 ml of sterile phosphate-buffered saline. Animals were considered cured if the milk remained free of Staphylococcus aureus for a total of 28 milkings after last treatment. Kinetic analysis of immunologically active recombinant lysostaphin demonstrated that a minimum bactericidal concentration was maintained in the milk for up to 36 to 48 h after a single infusion of 100 mg of recombinant lysostaphin. The cure rate of quarters receiving recombinant lysostaphin (100 mg in sterile phosphate-buffered saline, administered over three consecutive p.m. milkings) was 20% compared with 29% for sodium cephapirin in saline and 57% for a commercial antibiotic formulation, respectively. An improved formulation of recombinant lysostaphin may prove to be an effective alternative to antibiotic therapy for bovine mastitis. PMID- 1787189 TI - Microbiological results from milk samples obtained premilking and postmilking for the diagnosis of bovine intramammary infections. AB - Bacteriological culture results were compared between 336 pairs of quarter milk samples collected premilking and postmilking. Using a positive result on either premilking or postmilking samples as the definitive diagnosis, premilking sampling sensitivity was 91% for Staphylococcus aureus, 91% for coagulase negative staphylococci, and 97% for Streptococcus other than agalactiae. Postmilking sampling sensitivities were 81, 45, and 58%, respectively, for the same pathogens. Requiring both premilking and postmilking samples for the definitive diagnosis, specificities were 92, 86, and 95% for premilking sampling alone and 96, 98, and 99% for postmilking sampling alone. Such differences in specificity would result in major differences in predictive value of a positive culture for herds with a low prevalence. Multiple isolates were significantly more common from premilking samples. PMID- 1787190 TI - Relationship among udder and teat morphology and milking characteristics. AB - Teat cup liner slips, manual milking machine adjustments, milk yields, and milking times were recorded during both morning and evening milkings for 8 d on 97 Holstein cows in The Pennsylvania State University dairy herd. Fore and rear udder heights (distance from floor to udder), udder levelness, distances between teats (before and after milking), teat lengths, teat diameters, and teat end shapes were measured on the same cows. Product-moment correlations among the morphological characteristics, linear slips, manual adjustments, milk yields, and milking times were determined. Residual correlations from a model including lactation number and DIM (linear and quadratic) were also calculated. The variation among cows in machine liner slips and manual adjustments within and across lactation number and DIM can be partially explained by udder and teat morphology. Wider teats were associated with increased linear slips and increased manual adjustments. More tilted udders (rear quarters lower than front quarters) were associated with increased liner slips and tended to be associated with increased manual adjustments. In addition, larger teat diameters and longer teats tended to be associated with increased liner slips. PMID- 1787191 TI - Milk yield of dairy cows receiving somatotropin (somavubove) daily with periodic 14-day interruption. AB - Thirty multiparous (cows) and 15 primiparous (heifers) lactating Holstein cattle were used in a 112-d study to examine the effects of pattern of administration of recombinantly derived bST on 3.5% FCM yield. Ten cows and 5 heifers each received either no injection (controls), 14 mg of bST daily, or four repetitions of 14 mg of bST/d for 14 d followed by 14 d of no injection (intermittent bST). Because there was an interaction between treatment groups and parity, analyses were performed separately for cows and heifers. All cows and heifers produced more FCM when given bST than controls. Comparing FCM only during the last 7 d of each period of injection for the intermittent bST group with contemporary daily injected cattle indicated that cows produced equivalent amounts of milk at those times, whereas heifers given daily bST produced 3.4 kg/d more than intermittently injected animals. Furthermore, over each of the four repetitive periods, cows and heifers given daily or intermittent bST responded similarly, although heifers given continuous bST produced more FCM than the intermittent group during each of periods 2 through 4. We conclude that daily administration of bST lends itself to dosing termination during established lactation with concomitant decline of FCM; resumption of bST allows milk yields of cows to achieve levels comparable with those prior to short-term interruption. PMID- 1787192 TI - Effects of various dietary cation-anion balances on response to experimentally induced hypocalcemia in sheep. AB - We examined the effect of dietary cation-anion balance on bone Ca mobilization, measured by challenging wethers with a 5.6% EDTA infusion at a rate of 1.4 ml kg of BW-1. Dietary cation-anion balance was calculated as milliequivalents [(Na + K) - (Cl + S)]. Six crossbred wethers (average BW, 67.8 kg) were fed rations with high Ca (.74% dry basis) or normal Ca (.45%) and three different dietary cation anion treatments, which differed in their mineral supplementation. Dietary cation anion balances were 354, 125, and 32 meq kg of DM-1 for control and two treatments. A 6 x 4 incomplete Latin square design (six treatments, four periods) was used with five 15-d periods of 14 d of adaptation followed by 1 d of EDTA infusion. Concentrations of total and EDTA titratable plasma Ca were not affected by the level of dietary Ca or treatments. The decrease in plasma EDTA titratable Ca at conclusion of EDTA infusion (120 min) was least in wethers fed the lowest cation-anion balance within high Ca, and recovery of plasma EDTA titratable Ca during the 240-min postinfusion period was faster for sheep fed this diet than for the control. The amount of Ca mobilized and its rate of mobilization during the EDTA infusion period tended to be higher for diets with reduced cation-anion balances than for the control. Thus, reducing cation-anion balance increased the sheep's ability to mobilize Ca during hypocalcemia. PMID- 1787193 TI - Effects of reducing dietary cation-anion balance on calcium kinetics in sheep. AB - A Ca kinetic study with a four-compartment model being fitted to radioisotope and balance data using the CONSAM (conversational, simulation, analysis, and modeling) computer program was conducted to examine the effects of dietary cation anion balance, calculated as milliequivalents [(Na + K] - (Cl + S)]. Twelve crossbred wethers were used as eucalcemic control (period 1); then Ca loss during lactation was simulated by continuous infusion of ethylene glycol tetraacetate (period 2). Dietary cation-anion balance was manipulated by supplementation of various mineral salts and was +339, +35, and -127 meq of kg DM-1 during period 1 and +429, +68, and -147 meq of kg DM-1 during period 2 for control and two treatments, respectively. Animals responded to the simulated lactational Ca loss (period 2) by increasing true intestinal absorption of Ca and bone resorption and by reducing Ca accretion by bone. No difference was observed in concentration of total Ca in plasma, but treatments produced increased concentration of plasma ionized Ca during both periods. Both treatments produced hypercalciuria during both periods, and the lowest cation-anion balance increased true intestinal absorption of Ca and reduced bone accretion during period 2. The size of total exchangeable Ca pool did not differ between treatments or periods, but amount of Ca movement between the pools increased with the intermediate cation-anion balance during period 1 and with both treatments during period 2 compared with control. These results indicated that feeding reduced cation-anion balance diets increased Ca flux through the exchangeable Ca pool with no changes in the size of the pool, particularly when Ca demand was increased. PMID- 1787194 TI - Metabolic changes in blood and liver during development and early treatment of experimental fatty liver and ketosis in cows. AB - Eighteen cows were assigned in equal numbers to three groups: control, ketosis induction by using feed restriction plus dietary 1,3-butanediol to provide ketone bodies, and glucose treatment with 484 g/d of glucose infused intraduodenally starting 7 d after beginning ketosis induction. Ketosis induction, begun at d 15 postpartum, caused ketonemia and gradual development of clinical ketosis by d 40 to 45. None of the cows in the control or glucose-treated groups became ketotic. Concentrations of NEFA in plasma of cows that became ketotic increased 3.0-, 2.6 , and 1.9-fold at 3 wk before, 2 wk before, and at ketosis, respectively, but increased nonsignificantly for glucose-treated cows. Concurrently, beta hydroxybutyrate increased 3.5-, 5.8- and 8.4-fold for cows that became ketotic but 1.6-fold or less for glucose-treated cows. Plasma acetate increased dramatically 2 wk before ketosis. Liver glycogen content decreased to nearly 0 by 2 wk before ketosis occurred, but it increased to prepartal values in glucose treated cows. Liver triglycerides averaged 2.0% of wet weight at d 5 for all cows but increased to 8 to 10% for about 2 wk before ketosis occurred. Microscopy of liver samples demonstrated progressive accumulation of lipid globules, which began in hepatocytes near the central vein and progressed toward the portal triad. Visible lipid content reached a peak 2 wk before ketosis. Hepatic in vitro gluconeogenic capacity decreased significantly for ketosis induction protocol cows when clinical ketosis was detected. Results indicate that experimental ketosis was preceded by metabolic abnormalities up to 2 wk before clinical ketosis occurred. The key events for onset of clinical ketosis, however, were not elucidated. PMID- 1787195 TI - Metabolic changes in blood and liver of dairy cows during either feed restriction or administration of 1,3-butanediol. AB - Previous research has shown that a combination of feed restriction and dietary 1,3-butanediol starting at 14 d post-partum resulted in fatty liver and ketosis. Sixteen multiparous Holstein cows were used to determine effects of feed restriction or 1,3-butanediol as separate treatments. Treatments during d 14 to 42 postpartum were 1) control (ad libitum intake), 2) 20% feed restriction, or 3) control plus dietary 1,3-butanediol (5.5% of DM). From d 43 to 56, cows assigned to treatments 2 and 3 received a combination of feed restriction and butanediol. One cow on treatment 2 developed ketosis, but not fatty liver, after only 4 d of feed restriction. No other cows developed fatty liver or ketosis. Both treatments decreased milk production compared with controls. Feed restriction increased the extent of negative energy balance and caused transient increases in concentrations of NEFA, acetate, and beta-hydroxybutyrate in plasma. Concentrations of beta-hydroxybutyrate and insulin in plasma were increased by butanediol, which is a potent ketone body precursor. Concentration of glycogen in liver was less in feed-restricted cows, whereas glycogen and total lipid were greater in cows given butanediol separately. Gluconeogenic capacity of liver slices was not different among groups. Addition of 1,3-butanediol to in vitro incubation media decreased oxidation of propionate to CO2. Neither feed restriction nor dietary 1,3-butanediol as separate treatments induced the fatty liver and ketosis observed in earlier experiments in which the two treatments were given together. PMID- 1787196 TI - Effect of dietary energy and previous bovine somatotropin on milk yield, mastitis, and reproduction in dairy cows. AB - Thirty multiparous lactating Holstein cows were blocked according to time of calving and assigned to a 2 x 3 factorial arrangement of treatments in a randomized complete block design to evaluate the effects of two dietary energy concentrations either without or with bST (20.6 mg/d per cow) administered to cows that had not or had received bST during the preceding lactation. Subcutaneous injection of bST began 28 to 35 d postpartum and continued for 39 wk. The dietary energy concentration x bST interaction was not significant for any response variable. Compared with DMI of control cows, DMI was higher for cows receiving bST, being 1.6 and 2.4 kg/d higher for cows receiving bST for one and two lactations, respectively. Milk, fat, and protein yields were higher for cows receiving bST than for controls. Those receiving bST for a second lactation also produced more milk than controls until wk 20; thereafter, milk yields were similar to those of controls. Somatotropin administration had no adverse effect on udder health. Cows receiving bST tended to ovulate less regularly than controls, which may be attributed to their higher milk yield. However, BW gains during lactation were similar for all treatments, indicating that bST-treated cows built energy reserves for the subsequent lactation. Although energy concentrations of the diets had no significant impact on yield, the higher energy diet tended to depress milk fat concentration. Administration of bST to dairy cows for a second, consecutive lactation yielded responses similar for the first 20 wk of the study to those receiving bST for the first time. However, after wk 20, milk yield was less than that by cows receiving bST for the first lactation but similar to that of control cows. PMID- 1787197 TI - Effect of forage source on retention of digesta markers applied to corn gluten meal and brewers grains for heifers. AB - Effect of forage source on retention time of dietary protein supplements in the rumen was measured, and solid and liquid markers of digesta passage were compared. Two markers for liquid, two for each of the forages, and two for each of the supplemental proteins were compared for estimating retention time. Eight Holstein heifers were allocated to a single-reversal design with two periods of 29 d each. Heifers were fed either alfalfa hay or corn husks and leaves combined with one of two resistant protein sources: corn gluten meal or wet brewers grains. Average rumen liquid retention times, measured with Co-EDTA or Cr-EDTA, were similar (16.2 to 16.9 h). Liquid retention times differed when alfalfa or corn residue was fed (14.1 and 18.9 h, respectively). Rumen retention times were similar for Sm and Ce (24.9 to 26.3 h) and across markers for forage sources (25.1 to 26.1 h). Total tract mean retention time was higher for corn residue than for hay (57.8 vs. 48.8 h). Rumen retention times for La and Yb (27.1 and 26.0 h) applied to protein sources were similar and were not different when applied to corn gluten meal or brewers grains (26.3 and 26.8 h). Forage source did not have an effect on the retention time of protein supplements. Low daily DMI of 2.22 and 1.91% of BW for hay and corn residue diets explain the rather long retention times of the protein supplements. Both Co-EDTA and Cr-EDTA were effective as liquid phase markers. PMID- 1787198 TI - Effects of gossypol content of cottonseed cake on blood constituents in growing fattening lambs. AB - The effect of gossypol content of cottonseed cake given as a source of CP in lamb (n = 8) rations was examined on the following blood parameters: plasma total protein, albumin, globulins, urea, glucose, hematocrit, hemoglobin, and mean corpuscular hemoglobin concentrations. The diets were isonitrogenous and isocaloric and contained 0, 15, and 30% cottonseed cake for 62 d. Blood samples were taken at the beginning, middle, and end of the experiment. Plasma total protein and globulins were higher at d 30 of the experimental period, but plasma albumin concentration, hematocrit, and hemoglobin were higher at the beginning of the experiment; plasma urea concentration was higher at d 60, and plasma glucose concentration was lower at d 30 of the experiment. The highest fraction in all treatments was albumin, followed by alpha 2-globulin and beta-globulin fractions, and there was no gamma 1-globulin fraction at d 30 and 60 of the experimental period. Liver examination showed significant differences in free gossypol content and accumulation, total N, and total protein percentage among the three treatments. Gossypol toxicity was not observed. The absence of gossypol toxicity in these animals has been attributed to detoxification of free gossypol by the formation of gossypol-protein complex in the rumen. PMID- 1787199 TI - Effects of sometribove on zinc metabolism and tissue mineral concentration in dairy calves. AB - The metabolism of Zn and tissue mineral concentrations were studied after a single oral 65Zn dose in 10 6-wk-old Holstein calves injected subcutaneously daily with 0 (control) or 10 mg of sometribove (recombinant methionyl bST) for 6 wk. Zinc-65 absorption was not significantly affected by bST; its concentration in the semitendinosus muscle was reduced by 32% in the bST calves, but concentrations in liver, pancreas, spleen, kidney, heart, small intestine, testicle, and rib were not different from controls. Manganese content was reduced by 27% in liver, 60% in kidney, 99% in spleen, 92% in testicles, and 33% in rib. Iron content of pancreas, spleen, and testicle and Zn content of rib were increased in the bST calves. The data indicate that Zn metabolism was not affected adversely by bST. Manganese content of several tissues was significantly reduced in the bST calves; however, no clinical signs of an Mn deficiency were evident. PMID- 1787200 TI - Insulin in bovine colostrum and milk: evolution throughout lactation and binding to caseins. AB - The changes in insulin concentration in bovine milk in the first period of lactation and its association with other milk proteins were studied. Highest concentration was found in the first milking (327 ng/ml). This concentration fell within the first 24 h postpartum to about 50% of its initial value. By d 3, the level was about 25%, and, on d 7, a stable concentration was reached at approximately 46 ng/ml (about 14% of its initial value). This concentration is about 100 times higher than that in serum, which suggests a specific mechanism of transfer from blood to milk. Colostral whey obtained by ultrafiltration or ultracentrifugation contains much less insulin than colostrum. When colostrum or milk was incubated with [125I]insulin and whey and casein fractions were separated by precipitation, it was observed that most insulin remained with the casein. However, when colostrum was incubated with [125I]insulin and subjected to gel filtration, most of the radioactivity corresponded to free insulin, indicating that insulin is associated with the precipitated casein but not with the casein micelles in solution. PMID- 1787201 TI - Performance and ruminal function development of young calves fed diets with Aspergillus oryzae fermentation extract. AB - Neonatal Holstein heifer (n = 72) and bull (n = 40) calves were used to study the effects of Aspergillus oryzae fermentation extract (Amaferm) on their performance and on rumen development. The starter diets were formulated to achieve Amaferm consumption of 0, .5, 1, or 3 g per calf daily. Calves were fed milk daily and allowed to consume starter and a mixture of alfalfa and bromegrass hay ad libitum. Weaning was when calves consumed 550 g of starter on 2 consecutive d. Weight gain and feed consumption were recorded weekly. Forty of the heifer calves, 10 from each treatment, were selected randomly to study the effects of Amaferm on ruminal fermentative development. Ruminal fluid samples were collected for pH, ruminal fermentation products, and for bacterial enumerations. Overall, Amaferm-supplemented calves were weaned 1 wk earlier than unsupplemented calves. They had higher total VFA, propionate, and acetate concentrations in the rumen than unsupplemented calves. Total anaerobic, hemicellulolytic, and pectinolytic bacterial counts were higher; cellulolytic bacterial counts tended to be higher for the Amaferm-supplemented calves than for controls. In general, Amaferm supplemented calves had greater ruminal microbial activity than those not fed Amaferm. PMID- 1787202 TI - Derivative-free restricted maximum likelihood estimation in animal models with a sparse matrix solver. AB - Estimation of (co)variance components by derivative-free REML requires repeated evaluation of the log-likelihood function of the data. Gaussian elimination of the augmented mixed model coefficient matrix is often used to evaluate the likelihood function, but it can be costly for animal models with large coefficient matrices. This study investigated the use of a direct sparse matrix solver to obtain the log-likelihood function. The sparse matrix package SPARSPAK was used to reorder the mixed model equations once and then repeatedly to solve the equations by Cholesky factorization to generate the terms required to calculate the likelihood. The animal model used for comparison contained 19 fixed levels, 470 maternal permanent environmental effects, and 1586 direct and 1586 maternal genetic effects, resulting in a coefficient matrix of order 3661 with .3% nonzero elements after including numerator relationships. Compared with estimation via Gaussian elimination of the unordered system, utilization of SPARSPAK required 605 and 240 times less central processing unit time on mainframes and personal computers, respectively. The SPARSPAK package also required less memory and provided solutions for all effects in the model. PMID- 1787203 TI - Expansion of projected lactation yield to stabilize genetic variance. AB - Information on partial lactations often is included in genetic evaluations by predicting the cow's eventual 305-d yield. Such projected yields have less phenotypic and genetic variation than completed yields but were modeled as having greater or equal variation in evaluations. Analysis of first lactations from 48,424 daughters of 844 Holstein sires indicated that yields predicted early (46 to 75 d) in lactation had less than one-half as much additive genetic variance as completed yields. Multiple-trait REML estimates of genetic correlations of predicted and completed yields were all above .92, indicating that early lactation information is valuable if modeled appropriately. Expanded records with genetic variances equal to those of completed yields and new lactation length weights were derived. Expanded records have larger error variances than either projected or completed yields and, thus, are given less weight when included in animal model evaluations. Genetic gains are expected to increase only .2 to .3%, but more stable genetic evaluations should result from use of expanded records, particularly for animals evaluated primarily from first lactation records in progress. PMID- 1787204 TI - Method and effect of adjustment for heterogeneous variance. AB - Lactation records were standardized for differing genetic and error variances across herds and over time based on phenotypic variance for each herd-year-parity group. Each herd-year-parity phenotypic variance estimate was combined with those of adjacent years and regressed toward a region-year-parity variance. Heritability was assumed to be .25 at mean variance within year and to range from .2 for herds with smallest phenotypic SD to .3 for herds with largest phenotypic SD. Lactation deviations from management group mean were adjusted by ratio of base genetic SD to genetic SD estimated from heritability and phenotypic SD. The base was defined as 1987 calvings for first parity and 1988 calvings for later parities. Records were weighted according to heritability by multiplying lactation length weight by herd error weight defined as ratio of base error variance to error variance in the adjusted record. Estimated genetic trend for milk increased by nearly 5 kg/yr for Holsteins with this adjustment, which caused predicted breeding values of oldest animals to be lower by about 100 kg. Most correlations of parent and progeny information were slightly higher with adjusted data. Cows in high variance herds were most likely to have large reductions in their evaluations. Adjustment for heterogeneous variance was implemented in July 1991 for national evaluations for yield traits. PMID- 1787205 TI - Estimated genetic correlations between disease and yield traits in dairy cattle. AB - Data included observations on more than 200,000 first lactations of Norwegian cattle. Milk yield, fat and protein percentages, and observations on mastitis, ketosis, and presence of disease (binary coding of 0 or 1) were analyzed. Following Bayesian principles and applying the threshold concept, dispersion parameters for the binary traits (on the underlying scale) with continuous production traits were estimated. Heritabilities were .27, .34, and .43 for milk yield, fat percentage, and protein percentage, respectively. Heritabilities for the disease traits were .05 to .13 but may be inconsistent because of methodology problems with small sire by herd-year-season subclass size. Genetic correlations between milk yield and all three disease traits were above .5, indicating an undesirable relationship. Genetic correlations between ketosis and the content traits were -.38 to -.65; low component percentages were associated with high ketosis frequencies. Ignoring diseases in breeding programs may lead to undesirable correlated selection responses when selecting on milk yield. PMID- 1787206 TI - Reproductive performance in genetic lines selected for high or average milk yield. AB - Genetic lines were created by selection of service sires differing by approximately 450 kg of milk for estimated transmitting ability. High line sires were selected from the best available proven sires. Selection continued over 24 yr with up to eight generations of selection. Records from 708 nulliparous, 575 first parity, and 437 second parity animals were analyzed. High milk yield was associated with longer days open and calving intervals in both first and second parities. A 1000-kg increase in 305-d milk production was associated with average increases in both days open and calving interval of around 7 d in first parity and 13 d in second parity and with average increases in days to first detected estrus of 4.5 d in first parity. Difference between genetic lines for milk yield was 804 kg in first parity and 772 kg in second parity. Days open and calving interval were less for the average line in both parities and differed by 10 d in second parity. Other reproductive differences were small or insignificant. Selection for yield has affected reproductive fitness modestly. PMID- 1787207 TI - Measurement methods used for the determination of dimensional accuracy and stability of denture base materials. AB - The literature relating to methods of measurement of dimensional accuracy and stability of denture base materials is reviewed. The papers are presented chronologically together with information on the measurement technique used and the reported level of accuracy. Most authors utilized optical measuring apparatus, with the use of calipers being the second most popular method. PMID- 1787208 TI - Trends in the selection of dental filling materials. AB - In 1983 and 1988 a questionnaire was sent to a random sample of Belgian dentists to compare the selection of filling materials such as amalgam and gold with the tooth-coloured filling materials, composites and glass polyalkenoate (ionomer) cements, for the restoration of Class II lesions in premolar and permanent molar teeth. Despite the increasing demand for aesthetics to be considered, the use of composite resins in the posterior region only increased moderately over the assessment period, while amalgam maintained its leading position as the restorative material of choice in premolar and molar teeth. Only in situations where aesthetics played a primary role did composite resins gain over silver based fillings. There was no change in the use of gold as an indirect restorative material. Finally, the selection rate of glass ionomers increased slightly. PMID- 1787209 TI - Five-year clinical study of u.v.-polymerized posterior composites. AB - Four u.v.-polymerized composites (Estilux, Nuva-Fil, Nuva-Fil P.A. and Uvio-Fil) were clinically evaluated in Class I and II cavity preparations in permanent teeth. The restorations were evaluated at baseline, 1, 2, 3, 4 and 5 years using USPHS criteria for direct evaluation and at 3, 4 and 5 years using the Leinfelder method for indirect evaluation of wear. The wear measured by the USPHS method showed increasing wear rates in earlier reports, apparently due to the limited sensitivity of the scale to early wear. The wear by the Leinfelder method showed gradually decreasing wear rates. There were no statistically significant differences among the wear values for the four u.v.-cured materials or between these materials and the self-cured and visible light-cured controls. PMID- 1787210 TI - Performance of 400 adhesive bridges fitted in a restorative dentistry department. AB - The purpose was to present a descriptive report of the clinical performance of adhesive bridges fitted in a university department of restorative dentistry. The case records of 400 consecutive adhesive bridges fitted between November 1984 and June 1989 in the School of Clinical Dentistry, Queen's University, Belfast were reviewed. The majority of the bridges (66 per cent) were of a fixed-fixed Maryland design; the remainder were Maryland cantilevers (18 per cent), hybrids, i.e. Maryland cantilevers which slotted into conventional units (8 per cent), and Rochette bridges (6 per cent). The mean duration of clinical service at review was 2.7 years. One hundred (25 per cent) of the bridges debonded on at least one occasion. Of the bridges which debonded the average number of debonds was 1.7, with the first debond happening on average 10.7 months after placement (range 1 42 months). Fifty-seven (14 per cent) debonded on one occasion only; 25 (6 per cent) debonded twice and 18 (5 per cent) debonded on three or four occasions. The length of clinical service was a significant factor in relation to debonding. A lower proportion of posterior than anterior bridges debonded and cantilevered and hybrid designs performed well. It is concluded that this investigation confirms the efficacy of resin-bonded bridgework used to replace both anterior and posterior teeth. PMID- 1787211 TI - Properties of a titanium nitride coating for dental instruments. AB - Adhesion of tooth-coloured restorative materials to the instruments used to place them is a clinical problem. This paper examines the low-stick properties and the durability of a 5 micron coating of titanium nitride on stainless steel when used with two composites (a hybrid and a microfilled) and a glass polyalkenoate (ionomer) cement. Titanium nitride-coated dies were compared to polished stainless steel for adhesion to the unset restorative material before and after a period of wear, and also for properties of surface hardness, contact angle with unfilled resin and frictional coefficient. The results demonstrated that, while the coated instruments were significantly harder and showed a lower coefficient of friction and a higher contact angle with resin, they were slightly 'stickier' than highly polished stainless steel, and this difference persisted even after wear. However, the material is very hard, resistant to damage, and appears to have little potential to discolour the restorative materials with which it is used. It is concluded that a titanium nitride coating confers no additional advantage as regards low-stick properties, over clean, polished stainless steel used for dental instruments. PMID- 1787212 TI - Acid-etched enamel surfaces after 24 h exposure to calcifying media in vitro and in vivo. AB - The remineralization of acid-etched enamel lesions is investigated in this study both in vitro and in vivo over periods of 24 h. In an initial study, samples of etched bovine enamel were subjected in vitro to treatment with synthetic calcifying solutions, or were exposed to saliva by means of an intraoral appliance. Alterations in hardness of the enamel surface were measured by indentation techniques. In a second study the suitability of an impression technique for investigating the surface relief induced by an acid-etch procedure was investigated. Extracted human incisors were used to make SEM observations of eteched areas and corresponding sections of impressions. Subsequently, six subjects were selected for a clinical evaluation of the impression technique. Although a significant decrease in indentation length (increase in hardness) was observed for etched enamel lesions treated with calcifying solutions in vitro, no evidence for any such change was observed in samples exposed to the influence of saliva when investigated by the indentation and impression techniques. PMID- 1787213 TI - Cardiohaemodynamic and plasma level responses to intraoral submucosal injection of adrenaline. AB - Since knowledge of the bioavailability of adrenaline from the intraoral submucosal depot is a prerequisite for its safe use in dentistry, the time dependent effects of adrenaline on the plasma adrenaline level and cardiohaemodynamic parameters were studied with invasive methods in adrenalectomized, anaesthetized rats after injection of adrenaline (4.0 micrograms/kg body wt) into the mucobuccal fold lateral to the upper right incisor. The absolute bioavailability of adrenaline from this intraoral submucosal depot was 16.8 per cent. Peak values for arterial plasma adrenaline and arterial blood pressure, maximal rate of rise of pressure in the left ventricle and heart rate were measured as early as 5 s after an injection period of 10 s. The different velocities at which the individual parameters returned to the basal state showed that the measurement of heart rate is an insensitive indicator of systemic adrenaline. Due to the absorption kinetics of adrenaline from intraoral tissue it may be concluded that the method of injection has a decisive influence on arterial adrenaline concentration and thus on cardiovascular response. PMID- 1787214 TI - Effect of the curing cycle on acrylic denture base glass transition temperatures. AB - Glass transition temperature of a polymer is an important physical property which may have a major effect on the dimensional stability of denture base materials. Thermomechanical analysis has been used to determine the glass transition temperature of specimens of denture base materials which had been produced by various selected curing cycles. It was found that different curing cycles produced variations in glass transition temperature of up to 20 degrees C. PMID- 1787215 TI - Repairability of type II glass polyalkenoate (ionomer) cements. AB - Two Type II glass polyalkenoate (ionomer) cements were evaluated for their repairability by measuring tensile bond strength of new material added to previously placed cement. Variables included time of repair (20 min vs. 24 h) and surface condition prior to repair (smooth and unetched, smooth and etched, rough and unetched, rough and etched). Failures were evaluated using light microscopy and categorized as cohesive, adhesive, or mixed. Scanning electron microscopy was employed to view the cement surfaces following each of the four pretreatments. Surface pretreatment was found to significantly affect both materials when repaired at 20 min (P less than 0.05). The highest bond strength was achieved when bonding to the smooth, unetched surface. Surface pretreatment did not significantly affect bond strength when the cements were repaired at 24 h (P greater than 0.05). Tensile bond strengths were greater for repairs made at 20 min than for those made at 24 h, but the differences were not always statistically significant. PMID- 1787216 TI - Disinfection of alginate impression material using disinfectants as mixing and soak solutions. AB - Disinfectant solutions were used as water substitutes in the preparation of specimens of alginate impression material. Chlorhexidine gluconate and sodium peroxysulphate solutions were tested. The alginate specimens were infected by sucking, subsequently disinfected in the solution used in the alginate preparation, and then tested for infectivity by 24-h incubation in thioglycollate broth. Bacterial growth was measured by changes in turbidity using a turbidimeter. The results indicate that chlorhexidine gluconate is an effective alginate disinfectant, when it is used as the liquid for alginate preparation and post-setting disinfection solution. PMID- 1787217 TI - Studies on the resistance to various insecticides of a house fly strain (Diptera: Muscidae) selected with azamethiphos. AB - A colony of azamethiphos-resistant house flies, Musca domestica (L.), was obtained from Denmark and further selected in the laboratory with azamethiphos for four generations. LD50s for various insecticides were determined and compared with those of a susceptible house fly strain. The selected flies showed cross resistance to all insecticides evaluated. The flies were highly resistant to most organophosphorus, carbamate, and chlorinated hydrocarbon insecticides except prothiophos, p,p'-DDT, and the pyrethroids. We conclude that the main mechanisms responsible for resistance are presumed to be factors other than acetylcholinesterase sensitivity and nerve sensitivity due to knockdown resistance. PMID- 1787218 TI - Seasonality of peridomestic cockroaches (Blattoidea: Blattidae): mobility, winter reduction, and effect of traps and baits. AB - Populations of smokybrown cockroaches, Periplaneta fuliginosa (Serville), and Eurycotis floridana (Walker) were studied to compare mobility and population size between fall 1985 and spring 1986 seasons at site A, and to assess the effect of a combination of traps and baits at site B in northcentral Florida. Adult smokybrown cockroaches were more mobile in the spring than in the fall; a similar trend for E. floridana adults was not significant. Overall population levels were reduced after winter by approximately 73%. No significant shift in spatial distributions of nymphs occurred, but adult distribution changed from a predominance in palms (fall) to hardwood trees with tree holes (spring), suggesting that this habitat offers better survival during winter. Removal of cockroaches by trapping at site B, followed by a single application of dry distiller's grain containing 0.5 chlorpyrifos, reduced expected population levels (based on site A data) by 90% measured at 6 mo after treatment. These data refute the hypothesis that an increase in numbers of cockroaches infesting homes in the fall is due to an increase in mobility. Instead, the results suggest that population size and proximity of principal habitats to the home are probably responsible for domestic infestations in the fall. Use of traps, baits, or both at these foci significantly reduce populations over an extended period. PMID- 1787219 TI - Toxicity of abamectin to cockroaches (Dictyoptera: Blattellidae, Blattidae). AB - Abamectin was fed to German cockroaches, Blattella germanica (L.), in non-choice tests. LT50s and LC50s were estimated by probit analysis. The LT50s for the German cockroach ranged from 4.4 to 1.7 d for males, from 9.0 to 2.4 d for females, and from 4.4 to 1.6 d for nymphs for bait concentrations of abamectin between 0.0025 and 0.0500%. The LC50s of abamectin were 0.0110 and 0.0040% from males, 0.0240 and 0.0090% for females, and 0.0200 and 0.0080% for nymphs at 3 and 6 d, respectively. The LT50 values of 0.0550% abamectin bait were 3.4, 3.4, 2.4, 7.5, 2.9, and 4.5 d for Periplaneta americana (L.), P. fuliginosa (Serville), P. brunnea Burmeister, P. australasiae (F.), Blatta orientalis L., and Supella longipalpa (Serville). Although the bait was effective against various cockroach species, time to death for the larger species was longer than for the German cockroach. In preference tests in which male German cockroaches were allowed to feed on rat chow or abamectin bait, all died within 5 d of exposure to abamectin bait. Abamectin bait consumption was not significantly lower than that of untreated rat chow. Arena tests with 0.0550% abamectin bait resulted in 31-75% mortality of German cockroaches after 9 d, with most control being achieved by treating harborages with the bait. The hydramethylnon standard resulted in 65% mortality after 9 d. PMID- 1787220 TI - Immunolocalization of desmoglein I ("band 3" polypeptide) on acantholytic cells in pemphigus vulgaris, Darier's disease, and Hailey-Hailey's disease. AB - Acantholysis is defined as loss of coherence between epithelial cells and is histologically shown in several bullous diseases. It was postulated that desmoglein I, one of the major transmembrane glycoproteins of the desmosome, may adhere to the attachment plaque inside the cell and contribute to desmoglea outside the cell. In this study we used a well characterized antibody against desmoglein I for immunofluorescence and immunoelectron microscopic techniques on 2 cases each of pemphigus vulgaris and Darier's disease and one case of Hailey Hailey's disease. In the normal epidermis desmosomes were demonstrated in dotted or rim-like patterns along cell periphery on immunofluorescence study. In pemphigus vulgaris dotted or rim-like patterns were still identified in many acantholytic cells, particularly in early phase of acantholysis. In Darier's disease and Hailey-Hailey's disease, dotted or rim-like patterns were already lost in early acantholysis and immunoreactive desmoglein I proteins were observed diffusely in the cytoplasm. Immunoelectron microscopy confirmed these immunofluorescence observations. It was suggested that in pemphigus vulgaris desmoglein I is unlikely to be the primary site of acantholysis because dotted or rim-like patterns of immunoreactive desmoglein I are relatively preserved on lesional cells, whereas in genodermatoses such as Darier's disease and Hailey Hailey's disease primary abnormalities of desmosomes may be involved in their acantholysis. PMID- 1787221 TI - Morphological characterization of hemangiomatous tumors derived from a novel murine vascular endothelial cell line (F-2). AB - Hemangiomatous tumors were induced in Balb/c nude mice by inoculating F-2 cells (5 x 10(6)) from a novel tumorigenic murine endothelial cell line which had been established and maintained in our laboratories. These tumors were morphologically investigated in the course of development. Subcutaneous hemorrhage was observed at the inoculation site within 12 hours after the injection of F-2 cells, followed by development of skin tumors of various sizes at the same sites. They were dome-shaped, glossy surfaced, black, soft tumors. Mice finally died of massive blood loss due to internal and/or external hemorrhage (on day 10-77). Light microscopically, F-2 cells formed aggregates immediately after inoculation and then branched into a network of channels and cysts containing erythrocytes. Thereafter, spongiform structures composed of various sizes of cysts appeared with subsequent formation of a single large blood-filled cyst lined by one or two layers of thin cells. Under an electron microscope, F-2 cells, possessing large amounts of cytoplasm, formed narrow spaces which were occasionally incomplete with ambiguous basal lamina at the early stages. However, later, in large cysts, they became attenuated, tightly connected, and produced complete lumen surrounded by a basal lamina. Immunohistological demonstration of H-2 K, D antigen showed that tumors induced by F-2 cells mainly consisted of the inoculated F-2 cells. These results indicate that F-2 presents a good experimental system for investigation of vascular endothelial cell tumorigenesis and differentiation. PMID- 1787222 TI - Penetration of lysophosphatidylcholine into the dermis. AB - The ability of Lysophosphatidylcholine (LPC) to penetrate into the dermis and its degradation were investigated in vivo using hairless rats. Phosphatidylcholine (PC) was used as a control. Radioactively labelled LPC and PC were applied on the surface of skin, and the radioactivities of the epidermis and dermis were measured at 8, 24, and 48 hours. The recoveries of radioactive materials of LPC and PC within the area of epidermis and dermis at 8 hours were 0.21% and 0.25%; at 24 hours, 0.68% and 0.31%; and at 48 hours, 0.42% and 0.92%. No radioactivity was detected in serum. The radioactive substances which had penetrated were identified as LPC, PC, diglycerides, and free fatty acids. It was also found that topical application of LPC did not change the structure of skin as seen by microscopical examination. These findings indicate that a small amount of LPC can penetrate without the damaging skin structure and is enzymatically degraded into several lipids. Since LPC has bactericidal and antiviral activity, this substance could be an useful agent for dermatological use. PMID- 1787223 TI - A case of atypical inter-muscular lipoma (Evans). AB - A case of a 51-year-old woman with a lipoma-like tumor on the right arm which showed rapid recurrence after the first simple excision is reported. On the second surgical operation, a lipoma-like tumor with extensive growth between the biceps muscle and brachialis muscle of the right arm was noted. Histological examination revealed almost mature fat cells and scattered atypical lipoblast like cells. For the treatment of an atypical inter-muscular lipoma, complete excision is necessary, although very extensive treatment is not recommended. PMID- 1787224 TI - Eruptive steatocystoma multiplex on the scalp. AB - We report a 71-year-old Japanese woman who noticed approximately 120 small yellowish cysts on the scalp from nine months before her first visit. An incision made into the cysts discharged oily yellow material. Biopsy of a lesion disclosed that the cysts had typical features of steatocystoma multiplex histologically. This case was a unique eruptive variety of steatocystoma multiplex on the scalp. PMID- 1787225 TI - Squamous-cell carcinoma arising in solar keratosis of a leprosy patient: relationship with positive skin smear examination. AB - A 70-year-old Japanese female with lepromatous leprosy developed squamous-cell carcinoma within a long standing area showing solar keratoses on her head. Alopecia had been present at least for the preceding 34 years on her forehead and frontal area of the head, and solar keratoses had existed at least for the previous 9 years. Skin smear examination for acid-fast bacilli which had continually been negative for the previous 2 years (during which 8 examinations were done) became positive. We assume that there may be some relationship between the onset of the tumor and the positive skin smear examination, although the exact connection remains unclarified. PMID- 1787226 TI - Experimental production of DLE lesion with a single exposure to UVB (2.7 MEDs) radiation. AB - Keratotic erythematous lesions developed on the face, ears, neck, and upper back of a 38-year-old man. The patient had a history of photosensitivity to sunlight manifested by the development of new lesions. One week after an MED (2.7 mJ/cm2) was determined using UV-B light, persistent erythema with fine scales were observed at test sites irradiated over 72 mJ/cm2. These lasted for at least 2 months. A biopsy specimen obtained from the test site irradiated at 72 mJ/cm2 showed liquefaction degeneration of the basal cell layer. Within the upper part of the dermis, perivascular and disseminated lymphocytic infiltrates were seen. However, when irradiated again under the same conditions 7 and 12 months after the initial phototest, no persistent erythema was observed. PMID- 1787227 TI - [The stem cells of animal tissues]. AB - A brief historical review of concepts on stem cells is given with a stress made on the role of Russian scientists A. A. Maksimov and A. A. Zavarzin who have formulated key problems in biology of stem cells and cell renewal. Principal stages in current studies of stem cells are considered. An outline is given of traditional and recent trends in the investigations: comparative studies of tissue systems with stem cells; molecular genetic mechanisms of the self maintainance and the differentiation of stem cells; stem cells as a subject of gene engineering. PMID- 1787228 TI - [An analysis of the possible mechanism of the ulcerostatic action of 1 ethoxysilatrane]. AB - Stimulating effect of 1-ethoxysilatrane on healing processes of experimental stomach ulcers was studied in rats. 1-ethoxysilatrane inhibited lipid peroxidation in blood and stomach wall tissues, interacted with artificial membranes, and affected the rate of mitochondrial respiration in liver. A hypothesis is put forward on the membranotropic effect of 1-ethoxysilatrane which underlies its ulcerostatic effect. PMID- 1787229 TI - [The physical work capacity of the body in experiments with the combined action of hypokinesia and radiation]. AB - After combined exposures to hypokinesia and radiation, hybrid CBA x C57BL mice of the first generation showed a drop in their working capacity as estimated by the rate of swimming through a limited distance. It was found that hypokinesia was a sufficiently strong stressor, no less affecting the working capacity than ionizing radiation in LD50. There was no summation in effects of these irritants with respect to the drop in working capacity. PMID- 1787230 TI - [The aggregative stability of human oxyhemoglobin in aqueous media in the presence of mercury(II) compounds]. AB - An analytical review of studies on human oxyhemoglobin coagulation has been performed by the author jointly with V. S. Koniaeva and L. D. Bogdanova within a period from 1985 to 1990. It was shown that the oxyhemoglobin coagulation modified by mercurials proceeded without any essential alteration of native protein conformation. A hypothesis is discussed that the oxyhemoglobin coagulation results from the primary polyaggregation of dimer fragments and that hydrophobic sites which provide for dimer-to-dimer contacts in native tetrameric oxyhemoglobin, participate in this process. PMID- 1787231 TI - [The possible effect of amino acids forming a loop in the surface layer of subunits on the electrophoretic mobility of enzymes in the alcohol/polyol dehydrogenase family]. AB - Relative electrophoretic mobility (REM) of alcohol dehydrogenases from equine hepatocyte cytoplasm was low probably due to the presence of a loop which consisted of 21 amino acid residues in the surface layer of the enzyme subunits. The REM of multiple molecular forms of alcohol dehydrogenases from yeast cell cytoplasm was higher as consistent with the absence of this loop in the surface layer of the enzyme subunits. Possible role of amino acid residues comprising the loop, in the formation of total charge and their effect on REM values of enzymes from the alcohol/polyol dehydrogenase family are discussed. PMID- 1787232 TI - [The blood anticoagulant system in rats perorally administered a heparin acetylsalicylic acid complex]. AB - Heparin/acetylsalicylate complexes (1:9 and 10:1) were obtained in vitro. Single or chronic (7-8 days) per os administration to white rats of 0.1% solution of the heparin/acetylsalicylate complex (0.3 ml/200 g body weight) enhanced anticoagulative properties of blood plasma, increased the fibrinolytic activity in respect of stabilized fibrin, and diminished the thrombin-induced platelet aggregation. PMID- 1787233 TI - [Nonspecific photophysiological immunization]. AB - A hypothesis is suggested on the positive effect of light radiation on the formation of protective immune mechanism related to the photophysiological destruction of porphyrins. References to experimental data are given which illustrate the possibility for existence of such a mechanism. PMID- 1787234 TI - [The effect of a parietal meningoencephalocele on the morphogenesis of the neuroepithelium of the human brain]. AB - Meningoencephalic hernia was studied in human embryo at the 5th week (stage 15) of the development. The analysis of parietal hernia showed that the anomalous development of cerebral tissue was related with disturbed shape-forming processes in the nerve tube. The medullar toruli were not closed at the stage of nerve plate to form a free edge of neuroepithelial layer. Its relaxation resulted in a spontaneous foldness and an enhanced proliferation of neuroepithelial cells. The proliferative activity induced hyperplasia of the layer end zones a disproportionately rapid growth of the brain disturbed the integrity of cephalic ectoderm and elicited formation of external cerebral hernias. It was suggested that disturbances of tangential mechanical tensions which control the proliferative activity in the neuroepithelium underlie the overgrowth of nervous tissue. PMID- 1787235 TI - Intrinsic echolocation capability of Hector's dolphin, Cephalorhynchus hectori. AB - A sonar system's echolocation capabilities can be inferred from the ambiguity distribution (defined here in terms of the conventional signal response function) of each of its transmitted signals. Several records of sounds emitted by Hector's dolphin are analyzed. The computed ambiguity distributions indicate that the sonar clicks of Hector's dolphins should be capable of resolving the ranges of targets as close together as 2 cm apart, but that target velocities cannot be resolved to any useful degree from a single echo. PMID- 1787236 TI - Central, auditory mechanisms of perceptual compensation for spectral-envelope distortion. AB - The spectral envelope is a major determinant of the perceptual identity of many classes of sound including speech. When sounds are transmitted from the source to the listener, the spectral envelope is invariably and diversely distorted, by factors such as room reverberation. Perceptual compensation for spectral-envelope distortion was investigated here. Carrier sounds were distorted by spectral envelope difference filters whose frequency response is the spectral envelope of one vowel minus the spectral envelope of another. The filter /I/ minus /e/ and its inverse were used. Subjects identified a test sound that followed the carrier. The test sound was drawn from an /Itch/ to /etch/ continuum. Perceptual compensation produces a phoneme boundary difference between /I/ minus /e/ and its inverse. Carriers were the phrase "the next word is" spoken by the same (male) speaker as the test sounds, signal-correlated noise derived from this phrase, the same phrase spoken by a female speaker, male and female versions played backwards, and a repeated end-point vowel. The carrier and test were presented to the same ear, to different ears, and from different apparent directions (by varying interaural time delay). The results show that compensation is unlike peripheral phenomena, such as adaptation, and unlike phonetic perceptual phenomena. The evidence favors a central, auditory mechanism. PMID- 1787237 TI - The use of prosody in syntactic disambiguation. AB - Prosodic structure and syntactic structure are not identical; neither are they unrelated. Knowing when and how the two correspond could yield better quality speech synthesis, could aid in the disambiguation of competing syntactic hypotheses in speech understanding, and could lead to a more comprehensive view of human speech processing. In a set of experiments involving 35 pairs of phonetically similar sentences representing seven types of structural contrasts, the perceptual evidence shows that some, but not all, of the pairs can be disambiguated on the basis of prosodic differences. The phonological evidence relates the disambiguation primarily to boundary phenomena, although prominences sometimes play a role. Finally, phonetic analyses describing the attributes of these phonological markers indicate the importance of both absolute and relative measures. PMID- 1787238 TI - The effect of linguistic entropy on speech perception in noise in young and elderly listeners. AB - The rationale for a method to quantify the information content of linguistic stimuli, i.e., the linguistic entropy, is developed. The method is an adapted version of the letter-guessing procedure originally devised by Shannon [Bell Syst. Tech. J. 30, 50-64 (1951)]. It is applied to sentences included in a widely used test to measure speech-reception thresholds and originally selected to be approximately equally redundant. Results of a first experiment reveal that this method enables one to detect subtle differences between sentences and sentence lists with respect to linguistic entropy. Results of a second experiment show that (1) in young listeners and with the sentences employed, manipulating linguistic entropy can result in an effect on SRT of approximately 4 dB in terms of signal-to-noise ratio; (2) the range of this effect is approximately the same in elderly listeners. PMID- 1787239 TI - The effects of auditory feedback on the regulation of intraoral air pressure during speech. AB - Previous experimental evidence has been interpreted as support for regulation of both acoustics and aerodynamics during speech production. One recent perspective is that although speech acoustics may be manipulated, regulation of aerodynamics is a central component of the processes that produce speech. From this perspective, it has been suggested that aerodynamic regulation is given priority over perceptual accuracy. The experiment attempted to test this hypothesis by forcing speakers into a choice between aerodynamic and acoustic regulation. The intensity level of frication (embedded in a carrier phrase) was selectively amplified or attenuated and fed back to the speaker on line. Intraoral air pressure was recorded in order to assess whether or not perturbed auditory feedback would result in aerodynamic compensation. Although compensatory changes in peak intraoral air pressure, pressure duration, and pressure curve area were seen in response to 30-dB alterations of frication, no systematic effects were seen for smaller auditory manipulations. Further, the compensations were less than what one might expect from a system controlling auditory output. Explanations of these findings and their implications for the control of speech production are offered. PMID- 1787240 TI - Different phase-stable relationships of the upper lip and jaw for production of vowels and diphthongs. AB - Relational invariants have been reported in the timing of articulatory gestures across suprasegmental changes, such as rate and stress. In the current study, the relative timing of the upper lip and jaw was investigated across changes in both suprasegmental and segmental characteristics of speech. The onset of upper lip movement relative to the vowel-to-vowel jaw cycle during intervocalic bilabial production was represented as a phase angle, and analyzed across changes in stress, vowel height, and vowel/diphthong identity. Results indicated that the relative timing of the upper lip and jaw varied systematically with changes in stress and vowel/diphthong identity, while remaining constant across changes in vowel height. It appears that modifications in relative timing may be due to adjustments in the jaw cycle as a result of the compound nature of jaw movement for diphthongs as compared to vowels, with further modifications due to the effect of stress on these compound movements. PMID- 1787241 TI - Reiterant speech as a test of non-native speakers' mastery of the timing of French. AB - The reiterant speech of ten native speakers of French was analyzed to develop baseline measures for syllable and consonant/vowel timing for a series of two-, three-, four-, and five-syllable French words spoken in isolation. Ten native speakers of English, who learned French as a second language, produced reiterant versions of both the French words and a comparable set of English words. The native speakers of English were divided into two groups on the basis of their second language experience. The first group consisted of four university-level teachers, who were relatively experienced learners of French, and the second group of six less experienced learners of French. The French reiterant imitations of the two groups of native speakers of English were compared to the native French speakers' productions. The timing patterns of the experienced group of non native speakers did not differ significantly from those of the native French speakers, whereas there was a significant difference between these two groups and the group of six less experienced second-language learners. Deviations from the French baseline measures produced by the less experienced group are discussed in terms of the influence of the timing patterns of English and the literature on a sensitive period for second language acquisition. PMID- 1787242 TI - Some effects of auditory grouping factors on modulation detection interference (MDI). AB - The ability to detect the existence of amplitude modulation at a target frequency is reduced when amplitude modulation exists at a flanking frequency. This effect has been termed modulation detection interference (MDI) [Yost and Sheft, J. Acoust. Soc. Am. 85, 848-857 (1989)]. One explanation for MDI holds that the masking and target frequencies are grouped together by the auditory system such that it is difficult to analyze the modulation at each frequency separately. The present study investigated conditions where the asynchrony of temporal gating of the target and flanking frequencies was manipulated in order to make the frequencies more or less likely to be grouped together by the auditory system and perceived as originating from a single putative source. A second experimental manipulation attempted to perceptually segregate the masking and target frequencies on the basis of harmonicity or spectral proximity. The results of the experiments indicated that manipulations that were intended to enhance the segregation of the masking and target frequencies reduced the magnitude of MDI effects. This generally supported an interpretation that MDI is related in some way to auditory grouping. A final experiment was performed in which the subject had to detect the presence of amplitude modulation, but also had to identify which of two frequency components carried the modulation. Subjects were often poor in discriminating which of two frequencies was amplitude modulated, even when the modulation itself was clearly audible. It was concluded that part of the MDI effect might be due to the poor ability of the auditory system to associate modulation with the carrier of the modulation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787243 TI - Perception of acoustic source characteristics: walking sounds. AB - The current study investigated the ability of subjects to perceive source characteristics (the gender of a human walker) of a naturally occurring auditory event (human walking). A number of acoustic properties were measured and subjected to statistical analyses in order to identify those properties that differentiate male and female walking footsteps. A principal component analysis on the statistical properties of the spectral energy distributions then identified two classes of information that were important in determining subject perception of the gender of a walker: (1) the spectral peak which integrates the information about the spectral central tendency of frequency and shape of the spectral peak; and (2) the contribution of high-frequency spectral components. A follow-up experiment then manipulated these spectral properties to verify their contributions in the perceptual classification of walker gender. Additionally, the effect of shoe on the gender judgement in walking sequences was assessed by having both male and female walkers wear male's shoes. PMID- 1787244 TI - Gap detection in multiple narrow bands of noise as a function of spectral configuration. AB - This study sought to differentiate between the effect of stimulus bandwidth and the effect of number of activated auditory channels on gap detection in narrow bands of noise. The aim was to clarify the role of across-frequency analysis in temporal processing. Experiment 1 established that when total noise bandwidth is held constant at 100 Hz, gap detection improves as stimulus energy is distributed to both lower and higher frequencies. Experiment 2a showed that the effect was smaller, or was absent, when the cumulative stimulus bandwidth was increased from 100 to 200 Hz. Experiment 2b confirmed that the benefit of spectral dispersion for the narrower cumulative bandwidth also held for a higher frequency region. The results suggest that in conditions where the cumulative stimulus bandwidth is relatively narrow and, concomitantly, gap detection is relatively poor, there is an advantage in dispersing the stimulus across a number of auditory channels. The advantage for the distribution of energy across a range of auditory channels may be offset when the spectral spacing of bands exceeds a critical value. PMID- 1787245 TI - Decrement detection in normal and impaired ears. AB - The smallest detectable duration of a brief decrement in the intensity of wideband noise was measured as a function of the depth of the decrement. In the first experiment, conditions were tested in which the noise before the decrement was more intense than the noise after the decrement, and vice-versa. These data were used to estimate the shape of an intensity-weighting function, or temporal window, describing the temporal resolution of the ear. The equivalent rectangular durations (ERDs) of the temporal windows measured in this way had values of about 5.5, 4.6, and 6.6 ms for noise spectrum levels of 10, 30, and 50 dB, respectively. In a second experiment, decrement detection was measured in subjects with unilateral sensorineural hearing loss. One set of thresholds was measured in the impaired ear, and two sets of thresholds were measured in the normal ear; one with the noise level at equal SPL to the level in the impaired ear, and one with the noise at equal SL. Temporal window shapes were also estimated from these data. Only one of the subjects showed reduced temporal resolution in the impaired ear, the other two subjects having similar ERD values for all three conditions. PMID- 1787246 TI - Lateralization of low-frequency tones: relative potency of gating and ongoing interaural delays. AB - Several types of interaural delay can affect the lateral position of binaural signals. Delays can occur within the gating (onset and/or offset) or ongoing portions of the signal, or both. Extent of laterality produced by each of these delays was measured for low-frequency tones with an acoustic pointing task. Relative potency was assessed by presenting the delays singly or in combinations (where the types of delay were consistent or in opposition). Rise/decay time, duration, and frequency of the tonal targets were also varied. The major finding was that ongoing delays were much more potent than gating delays in determining extent of laterality. Gating delays were most effective when the interaural phase of the ongoing portion of the tones was more or less ambiguous with respect to which ear was leading. Many of our findings are qualitatively well described by considering properties of patterns of activity produced within a cross correlation network by such interaurally delayed signals. PMID- 1787247 TI - Risk factors for hearing loss at different frequencies in a population of 47,388 noise-exposed workers. AB - Weighted regression analysis was applied to determine the dependence of the hearing thresholds of 47,388 noise-exposed workers on age, sex, noise immission level, ear disease, head injury, tinnitus, hearing protector usage, and audiometric frequency in the range from 0.5 to 6 kHz. It could be shown that the hearing thresholds at any frequency are dominated by the age of the worker and that women, after equivalent exposure conditions, hear better than men. The relative effects of sex, noise immission level, ear diseases, tinnitus, and hearing protector usage are related to the audiometric frequency. Users of hearing protectors at the last audiometric investigation hear worse than nonusers. Hearing protector usage is strongly related with the hearing threshold in the low-frequency range. The noise immission level does not noticeably affect the hearing threshold below 3 kHz. The most important frequency of the noise immission level is as expected 4 kHz. For 4 kHz, it was shown that the variables age, noise immission level, tinnitus, head injuries, and ear diseases act in a good approximation additively on the pure-tone hearing threshold. PMID- 1787248 TI - Nonparametric estimation of phase variance in auditory-nerve fiber's responses to tonal stimuli. AB - Statistical estimation of the phase variance from the auditory-nerve fiber's action potential timing data is studied in this paper. A detailed derivation of the sample-based estimation formulas, which deals specifically with the circularity of the phase variable, is given. The development of the estimator is based on nonparametric statistical inference techniques, making no assumptions on the parametric form of the phase distribution (i.e., shape of period histogram). Some desirable properties of the estimator are demonstrated through numerical examples and applications of the estimator in auditory research are discussed. PMID- 1787249 TI - Simulations of cochlear nucleus neural circuitry: excitatory-inhibitory response area types I-IV. AB - Several circuitry schemes have been explored among model stellate and fusiform cochlear nucleus neurons in an effort to reproduce excitatory-inhibitory response area (EIRA scheme) types I-IV. Single cell models incorporated known nonlinear membrane properties and spike-discharge characteristics, as described in previous modeling and intracellular recording. In addition, a unique method of implementing dendritic electrotonic distance processing was developed that provides greater computational efficiency, but with results similar to compartmental models. As an initial simple case, results were examined for a kHz pure tone. Auditory nerve (AN) population responses across characteristic frequencies from 200 Hz to 50 kHz based on actual single unit recordings were incorporated into the model as input. The findings and conclusions are (1) relatively simple inhibitory connections among stellate and fusiform cells, all of which receive AN excitatory inputs, can account for the salient features of EIRA-scheme types I-IV; (2) both types III and IV may be obtained using fusiform cells with small adjustments in the anatomical connections; (3) if stellate cells laterally inhibit their own neighbors, they can create inhibitory sidebands, but may have difficulty avoiding multiple sidebands; (4) in the model, type II cells are not responsive to broadband noise but rather to pure tones, and the reason for this was partly because the type II cells were inhibited by other CN units, and partly because the simulated AN fiber response to broadband noise was near their threshold; and (5) the type IV complex response areas may actually arise not necessarily because of elaborate circuitry, but as a result of a complex AN fiber population profile at high stimulus levels in conjunction with the type II inhibitory input to the type IV cells. PMID- 1787250 TI - Responses of "lower-spontaneous-rate" auditory-nerve fibers to speech syllables presented in noise. I: General characteristics. AB - Responses of auditory-nerve fibers in anesthetized cats to nine different spoken stop- and nasal-consonant/vowel syllables presented at 70 dB SPL in various levels of speech-shaped noise [signal-to-noise (S/N) ratios of 30, 20, 10, and 0 dB] are reported. The temporal aspects of speech encoding were analyzed using spectrograms. The responses of the "lower-spontaneous-rate" fibers (less than 20/s) were found to be more limited than those of the high-spontaneous-rate fibers. The lower-spontaneous-rate fibers did not encode noise-only portions of the stimulus at the lowest noise level (S/N = 30 dB) and only responded to the consonant if there was a formant or major spectral peak near its characteristic frequency. The fibers' responses at the higher noise levels were compared to those obtained at the lowest noise level using the covariance as a quantitative measure of signal degradation. The lower-spontaneous-rate fibers were found to preserve more of their initial temporal encoding than high-spontaneous-rate fibers of the same characteristic frequency. The auditory-nerve fibers' responses were also analyzed for rate-place encoding of the stimuli. The results are similar to those found for temporal encoding. PMID- 1787251 TI - Responses of "lower-spontaneous-rate" auditory-nerve fibers to speech syllables presented in noise. II: Glottal-pulse periodicities. AB - The responses of single cat auditory-nerve fibers to naturally spoken voiced sounds (the vowels [a, i, u] and the murmur [m]) presented at normal intensity (70 dB SPL) in various levels of speech-shaped noise were analyzed for the encoding of the glottal-pulse (fundamental) period. To quantify the strength of this fundamental-period encoding, selected segments of the response histograms were autocorrelated, rectified, and fitted with the best-fitting sinusoid of the fundamental frequency. The magnitude of this best-fitting sinusoid was taken as the magnitude of synchronization. In most cases, it was found that the "lower-SR" fibers (those with spontaneous discharge rates less than 20/s) encoded the fundamental periodicity more strongly and more robustly than did the "high-SR" fibers (those with spontaneous discharge rates greater than 20/s). When either a single strong spectral peak or a relatively "flat" spectrum excited a fiber, it showed poor synchronization to the fundamental period, regardless of its spontaneous-rate class. Judging from a few examples, the glottal-pulse synchronization appears to be intensity dependent, with the relative performance of the high-SR fibers improving at lower intensities. A conceptual model is given which accounts for the general characteristics of the data. PMID- 1787252 TI - Effects of a single reflection with varied horizontal angle and time delay on speech intelligibility. AB - Previously, almost all physical measures for estimating speech intelligibility in a room have been derived from only temporal-monaural criteria. This paper shows that speech intelligibility for a sound field with a single reflection depends not only on the temporal-monaural factor but also on the spatial-binaural factor of the sound field. Articulation tests for sound fields simulated with a single reflection of delay time delta t1 after the direct sound were conducted changing the horizontal incident angle xi of the reflection. Remarkable findings are as followings: (1) speech intelligibility (SI) decreases with increasing delay time delta t1, (2) SI increases when xi approaches 90 degrees; the horizontal angle of the reflection causes a significant effect on SI, and (3) the analysis of variance for articulation test scores clearly demonstrated that the effects of both delta t1 and xi on SI are fully independent. Concerning result (2), if listeners get a spatial separation of signals at the two ears, then the listener's capability for speech perception is assumed to be improved due to "adding" further information to the temporal pattern recognition. PMID- 1787253 TI - Hearing loss from gun and railroad noise--relations with ISO standard 1999. AB - Pure-tone hearing thresholds and anamnestic data pertaining to nosocusis and exposure to gun noise were analyzed for 9778 male railroad train-crew workers. A major portion of losses in hearing sensitivity due to railroad noise are obscured in comparisons of hearing levels of trainmen with the hearing levels of the unscreened samples of United States males given in Annex B, ISO 1999 [ISO 1999 (1990), "Acoustics--Determination of occupational noise exposure and estimation of noise-induced hearing impairment" (International Organization for Standardization, Geneva)]. Comparisons of the hearing levels, adjusted for nosocusis, of trainmen who had used no guns, with the hearing levels of otologically and noise screened males (Annex A, ISO 1999) reveal significant losses due to railroad noise. Additional losses were found at high frequencies in trainmen who had used guns. It appears that the effective Leq8h exposure level of trainmen to railroad noise is about 92 dBA, and 87-89 dBA to gun noise. These results are in general agreement with those of study of railway workers by Prosser et al. [Br. J. Audiol. 22, 85-91 (1988)]. Asymmetries in losses between the two ears, effects of ear protection, losses from nosocusis, and losses from sport, as compared to military, gun noise exposures, are examined. PMID- 1787254 TI - Effects of nosocusis, and industrial and gun noise on hearing of U.S. adults. AB - Hearing losses estimated for exposure to industrial and gun noise and for "typical" nosocusis are applied to the distributions of the hearing levels of adult males and females of the general population of an industrialized society unscreened for exposure to noise or ear disease. Noise exposure and demographic data applicable to the United States, and procedures for predicting noise-induced permanent threshold shift (NIPTS) and nosocusis, were used to account for some 8.7 dB of the 13.4 dB average difference between the hearing levels at high frequencies for otologically and noise screened versus unscreened male ears; (this average difference is for the average of the hearing levels at 3000, 4000, and 6000 Hz, average for the 10th, 50th, and 90th percentiles, and ages 20-65 years). According to the present calculations, this difference is due, in order of importance, to (1) nosocusis, (2) exposure to gun noise, and (3) exposure of workers to industrial noise. For these same frequencies and overall average, adjustments for nosocusis accounts for 2 dB of the 5.9-dB difference between the hearing levels of screened and unscreened female ears. For the average at 500, 1000, and 2000 Hz, the overall differences between the screened and unscreened populations is but 3.4 dB for males and 2.9 dB for females. The adjustment procedures reduced these differences to -0.5 and 0.9 dB, respectively. PMID- 1787255 TI - F0 stylization in speech: straight lines versus parabolas. AB - This is a brief report on an experiment, intended to show that a piecewise linear approximation of an F0 curve in speech is, perceptually, not inferior to an approximation by means of fragments of parabolas, which gives--visually at least- a better fit to the original F0 curve than does the rectilinear approximation. (More details can be read in IPO Rep. no. 816, available on request). Stimuli consisted of two pairs of linearly or parabolically frequency modulated pulse trains, one of which contained identical, the other different members. The subjects had to indicate whether it was the first, or the second pair that contained different members. The results showed that even the best performers were hardly ever able to distinguish the parabolic from the rectilinear shapes, provided the latter contained a flattened peak. PMID- 1787256 TI - Chemosensitive ventrolateral medulla in the cat: the fine structure and GABA induced cardiovascular effects. AB - These studies were designed to provide information on both GABA influences on the neuronal structures within the rostral ventrolateral medulla (RVLM) involved in the cardiovascular control, and fine structure of the GABA-sensitive RVLM in cats. By electron microscopy, the S-type asymmetric junctions (believed to mediate excitation) as well as F-type symmetric junctions (thought to provide inhibition) were identified within the RVLM area examined. The axonal terminals thick with spherical electron-transparent synaptic vesicles, measuring about 50 nm in diameter and forming S-type synapses, were distributed within the entire area. Large numbers of axonal terminals forming the F-type synapses and filled with flattened synaptic vesicles with a longitudinal axis of around 60-80 nm were found at the site located 5-6 mm caudal to the trapezoid bodies. Both spherical electron-transparent and flattened synaptic vesicles could be found together with electron-dense vesicles averaging 80-160 nm in diameter. No axonal terminals containing only the latter type of vesicles were found within the area studied. Some axo-axo-dendritic F-S-type synapses were identified within the RVLM. Unilateral injection of GABA into the RVLM site located 2-5 mm caudal to the trapezoid bodies induced a dose-related fall in the systemic arterial pressure and inhibition of the renal nerve sympathetic activity, the most marked responses being found at the site 4-5 mm caudal to the trapezoid bodies. It also resulted in decrease of heart rate and myocardial contractility when injected into a distinct site, located 0-1.5 mm rostral to the outflow of the 12th cranial nerve roots. There was some laterality in GABA effects on heart rate and myocardial contractility following its injections into the RVLM on the left and right side. Injections of bicuculline into the GABA-sensitive RVLM site resulted in an increase in cardio-haemodynamic responses together with the enhancement of renal nerve sympathetic activity in a dose-related fashion. These results suggest that, in cats, GABA-sensitive sympathoexcitatory neuronal structures in the RVLM alter peripheral sympathetic vasomotor and cardiac nerve background activities through GABA action on the bicuculline-sensitive GABAa-receptors. PMID- 1787257 TI - The effects of interleukin-1 beta on the activity of adrenal, splenic and renal sympathetic nerves in the rat. AB - The effects of intravenous (i.v.) administration of recombinant human interleukin 1 beta (rhIL-1 beta) on the activity of adrenal, splenic and renal sympathetic nerves were observed in urethane-anesthetized rats. An i.v. injection of IL-1 beta in doses of 10 pg-20 ng per animal (300-400 g, b.w.) resulted in a dose dependent increase in the activity of the adrenal and splenic nerves, which lasted for more than 2-6 h. On the other hand, the activity of renal nerves showed a transient increase which was followed by a long-lasting suppression after injection of rhIL-1 beta (100 pg, i.v.). An i.v. injection of cyclooxygenase inhibitors (6 mg ibuprofen or 20 mg sodium salicylate) suppressed almost completely the rhIL-1 beta (100 pg)-induced activity in adrenal and splenic nerves. Although rhIL-1 beta (100 pg, i.v.) produced a fall in arterial blood pressure, baroreceptor denervation did not affect the excitatory responses of the adrenal and splenic nerves to rhIL-1 beta. The results suggest the regional differentiation of activity in the visceral sympathetic nerves in response to rhIL-1 beta. The rhIL-1 beta-induced activation of splenic sympathetic nerves implicates their involvement in the modulation of immunity by brain. PMID- 1787258 TI - Variability in cardiovascular and plasma norepinephrine responses to head-up tilt in healthy human subjects. AB - Eight healthy, young adult males underwent three separate, 10-min 70 degrees head up tilts (HUT) over a period of nine days, in order to assess the intra- and inter-individual variability of cardiovascular and plasma norepinephrine (NE) responses to the manoeuvre. Cardiovascular parameters and plasma NE were measured in the basal state and at 2-min intervals during the HUT. The results indicate that: (1) the intra-individual variability is a smaller component of the total variability of both cardiovascular and plasma NE responses to HUT; (2) the variability in cardiovascular parameters is smaller than that in plasma NE levels, both basal and in response to postural stress; (3) there does not appear to be any difference in variability when expressed either as the maximal or the mean response to HUT; and (4) there does not appear to be an increase in the variability of the measured parameters over the duration of the HUT. PMID- 1787259 TI - Anesthesia affects respiratory and sympathetic nerve activities differentially. AB - Phrenic and cervical sympathetic nerve responses to hypercapnia were examined before and after anesthesia in twelve midcollicularly decerebrated, vagotomized, glomectomized, paralyzed and ventilated cats. We measured responses of integrated phrenic and cervical sympathetic nerve activities to increases in end-tidal PCO2 (PETCO2) from apneic threshold to approximately 30 torr above threshold. All cats were studied first in the unanesthetized state. Six cats were then restudied after a quarter of a usual dose of chloralose/urethane (10 mg/kg and 62.5 mg/kg, respectively) and then after half the usual dose of chloralose/urethane (20 mg/kg and 125 mg/kg). The other six animals were restudied after quarter of a standard dose of pentobarbital (9 mg/kg), after half the standard dose (18 mg/kg) and then after the full (35 mg/kg) dose. Both anesthetic agents led to significant increases in apneic thresholds for both phrenic and sympathetic nerve activities. These agents also caused dose-dependent decreases in peak, tonic and respiratory related sympathetic nerve activities. Peak (tidal) phrenic nerve activities, in comparison, were much less affected by the anesthetic agents. CO2 response curves showed that both of these anesthetic agents depressed, at any given level of PETCO2, respiratory-related sympathetic nerve responses more than the responses found in the phrenic nerve. We conclude that the relations between peak, tonic (i.e. between phasic bursts) and respiratory-related sympathetic nerve activities and phrenic nerve activity can be altered by anesthesia. PMID- 1787260 TI - Pharmacologic responses and spectral analyses of spontaneous fluctuations in heart rate and blood pressure in SHR rats. AB - The aim of this experiment was to characterize patterns of autonomic control in spontaneously hypertensive (SHR) and normotensive Wistar-Kyoto (WKY) rats by measuring effects of pharmacologic blockers and using power spectral analysis of heart rate variability (HRV) and blood pressure variability (BPV). Resting HRs and BPs were recorded during a 20-min baseline period and over two 20-min periods of sequential autonomic blockade. On one day, animals received atropine followed by atenolol and on the following day, the drug order was reversed. Power spectrum analyses were performed on 30-s blocks of data throughout each of the three 20 min treatment periods (baseline, single blocker, combined blockade) and HRV and BPV were computed over low and high frequency bands. Increases in HR after atropine were significantly (approx. 40%) smaller in SHR rats than in WKYs. This held true even when animals were pretreated with atenolol. In contrast, decreases in HR following atenolol were similar in the two strains. These results indicate that SHRs have reduced vagal tone, but similar cardiac sympathetic tone compared to WKY rats. Virtually all HRV, over both low and high frequency bands, and in both strains, was inhibited by atropine. SHRs had significantly less high frequency HRV which is consistent with the conclusion that they have reduced cardiac vagal activity when compared with WKYs. BPV was not affected by atropine or atenolol but was inhibited by an alpha-receptor (phentolamine). BPV within both the low and high frequency bands was significantly greater in SHRs, suggesting that sympathetic tone to the vasculature is greater in SHR rats. PMID- 1787261 TI - Trapping efficiency of selected adsorbents for various airborne pesticides. AB - A study was conducted to compare the efficiency of five adsorbents used by government and private laboratories to collect airborne pesticides. Six pesticides, acephate, chlordane, chlorpyrifos, diazinon, heptachlor, and propoxur, were vaporized in a closed system and collected on each of the adsorbents, Chromosorb 102, ORBO 42, ORBO 44 (chlordane and heptachlor only), polyurethane foam (PUF) or Tenax GC, by drawing 250 L of air through the adsorbent. There were no differences in collection efficiency of the five pesticides on Chromosorb 102, ORBO's 42/44, and PUF. The efficiency with Tenax was somewhat less with several of the pesticides. PMID- 1787262 TI - [Formation and degradation of triademinol after the use of triadimefon in a wheat monoculture]. AB - During two vegetation periods, the behaviour of the triadimefon metabolite, triadimenol, in different plant parts of winter wheat and in soil was investigated. The fungicide Bayleton DF (triadimefon + captafol) was applied at the beginning of earing. Different ratios of triadimenol-A/-B were found in individual plant parts. Triadimenol-A predominated in the two uppermost leaves, and triadimenol-B in the roots and in the soil. No residues of triadimenol were found in grain at harvest time (detection limit 0.01 mg/kg). PMID- 1787263 TI - Chronic toxicity of Thiodan (endosulfan) insecticide to Louisiana crayfish, Procambarus clarkii. AB - The major objective of this work was to assess the possible long-term effects of Thiodan insecticide on the growth-rate, fecundity and hatching potential of Louisiana crayfish, Procambarus clarkii. Adult males and females were collected from an Experiment Station, and were exposed to 600 ppb Thiodan. Since the aqueous solubility of endosulfan (active ingredient of Thiodan) is very low, the actual concentration of 2, 10, 15 and 600 ppb Thiodan in tap water was determined by electron-capture gas chromatography. The amount of endosulfan I and II in 2 ppb Thiodan was 0.8 and 0.32 ppb, respectively; 10 ppb = 3.8 and 1.52; 15 ppb = 6.3 and 2.52; and 600 ppb = 284 and 113.6 endosulfan I and II, respectively. Male and female crayfish were exposed to 600 ppb Thiodan for 20 weeks during which mating occurred. The mean number of eggs produced by control crayfish (N = 10) was 288 and by treated crayfish (N = 10) was 225, which did not differ significantly. Hatchlings from unexposed crayfish were used to determine the effects of Thiodan on weight, length and molting frequency. Sixty hatchlings were exposed to 2, 10 and 15 ppb Thiodan for a period of 9, 23 and 27 weeks during which they achieved a mean weight (gain) of 0.64, 0.19 and 0.17 g, respectively. Control hatchling gained 0.82, 0.30 and 0.19 g during the same period. These differences were also insignificant statistically. The length (gain) by these hatchlings (control and treated) over the same time period did not differ significantly. There was a slight increase (insignificant) in the molting frequencies of treated hatchlings. Comparative data on the chronic effects of Thiodan for crayfish are not available. Based on the reported LC50 values for grass shrimp, mysid shrimp and Korean shrimp, we conclude that Louisiana crayfish, P. clarkii is more tolerant to this insecticide than the other decapod crustaceans. PMID- 1787264 TI - In vitro brain acetylcholinesterase response among three inbred strains of mice to monocrotophos. AB - The strain differences in the neurotoxic potential of monocrotophos (MCP) were assessed by determining the inhibition of brain acetylcholinesterase (AChE) in BALB/cAnN, DBA/2J and C57BL/6J in vitro. MCP being a competitive inhibitor for AChE, alters the Km values widely among these inbred strains. Comparatively least alterations in Km were found in BALB/cAnN and maximum in DBA/2J. Based on the Ki values DBA/2J was found to be the most sensitive strain to MCP inhibition followed by C57BL/6J and BALB/cAnN. PMID- 1787265 TI - Compliances of the liquid-filled lungs and chest wall during development in fetal sheep. AB - Our aim was to measure the compliance of the liquid-filled lungs (CL), and the compliance of the chest wall (CW) in fetal sheep in utero. CL and CW were measured in 6 fetuses. The compliance of the lungs and chest wall combined (respiratory system, Crs) was measured in 9 fetuses. Pressure differences across the lungs (PL), chest wall (PW) and respiratory system (Prs) were measured while the lungs were deflated and inflated with liquid from their resting lung liquid volume (V1). V1 was measured using an indicator dilution technique. Specific compliance values were obtained by normalizing the values of CL, CW and Crs with respect to values of V1. From values obtained during stepwise inflation from V1, specific compliances (ml/cm H2O/ml of lung liquid) were: lungs, 0.22 +/- 0.02; chest wall, 0.41 +/- 0.07; respiratory system, 0.13 +/- 0.01. Specific compliances of the lungs, chest wall and respiratory system did not change significantly with advancing gestational age from 120 to 143 days. Our baseline data will be valuable in assessing the in utero progress of the structural development of the lungs following manipulations known to cause altered lung growth. PMID- 1787266 TI - Effect of a melatonin implant on the circadian variation of plasma prolactin and rectal temperature in newborn sheep. AB - Plasma prolactin and rectal temperature show a circadian rhythm in newborn sheep raised under continuous light. Melatonin lowers the concentration of plasma prolactin but it is not known if it affects its circadian rhythm. To detect whether melatonin acts on the circadian system we studied the effect of a subcutaneous melatonin implant in the circadian rhythms of prolactin and rectal temperature in newborn lambs raised under continuous light. We placed catheters in the pedal artery and vein in 9 newborn lambs (2-5 days of age). A subcutaneous melatonin implant was placed in 4 of the lambs at 9-12 days of age. Blood samples and rectal temperature measurements were obtained hourly for a period of 24 h, 11 15 days after the implant, at 20-27 days of age. To avoid interferences of heparin in our melatonin assay, serum melatonin concentration was measured before and during the implant in three additional newborns. Prolactin and melatonin were measured by RIA. Melatonin concentrations were 52.8 +/- 45.9 pg/ml (day) and 315.5 +/- 77.0 pg/ml (night) before treatment (SEM, P less than 0.001), and increased to 594.1 +/- 54.5 pg/ml after placing the implant (there was no difference in melatonin concentration between day and night during the time that the implant was in place). Melatonin had no effect on rectal temperature or its rhythm, but decreased basal plasma prolactin concentration (control: 97.5 +/- 11.3 ng/ml; treated: 25.1 +/- 2.4 ng/ml, P less than 0.001) and abolished the prolactin circadian rhythm, (Cosinor analysis): control: log prolactin (ng/ml) = 1.8 + 0.26 cos 15 (t - 11.16), p = 0.05; treated: log prolactin (ng/ml) = 1.2 + 0.14 cos 15 (t - 9.43), P = 0.36. PMID- 1787267 TI - Cortisol induces perinatal hepatic gluconeogenesis in the lamb. AB - To examine the influence of a prenatal increase in plasma cortisol concentration on perinatal initiation of hepatic gluconeogenesis, we infused cortisol into seven fetal sheep at 137-140 days gestation. 14C-Lactate provided tracer substrate for estimation of gluconeogenesis. We measured hepatic blood flow using radionuclide-labeled microspheres. After delivery, fetal arterial blood glucose concentration (1.33 +/- 0.4 mmol/l) increased transiently, but returned to fetal levels within 1 h after delivery. Substantial hepatic gluconeogenesis was induced in the fetus after cortisol infusion, averaging 23.4 +/- 12.2 mumol/min/100 g liver (7.8 +/- 4.4 mumol/min/kg fetal weight). Fetal hepatic glucose output was 44.4 +/- 17.7 mumol/min/100 g liver. Hepatic glucose output did not change after delivery; estimated gluconeogenesis decreased immediately, then increased by 6 h after delivery. Lactate supply to the liver fell substantially, from 1.1 +/- 0.4 mmol/min/100 g in the fetus to 0.24 +/- 0.09 at 1 h after delivery. Lactate flux across the liver decreased from 75.3 +/- 23 mumol/min/100 g in the fetus to 20.2 +/- 15.7 at 1 h after delivery. Hepatic lactate flux was significantly related to gluconeogenesis (r = 0.734, P = 0.0001). We conclude that cortisol induces substantial hepatic gluconeogenesis in fetal sheep near term. After delivery, there appears to be a transient decline in gluconeogenesis from lactate, which may be secondary to limited hepatic oxygen and substrate supply. Onset of gluconeogenesis in the fetus fails to sustain increases in either fetal or postnatal blood glucose concentrations. PMID- 1787268 TI - Role of plasma adenosine in breathing responses to hypoxia in fetal sheep. AB - The importance of plasma adenosine in hypoxic inhibition of breathing movements was determined in chronically catheterized fetal sheep (greater than 0.8 term). Preductal arterial blood for adenosine measurements was withdrawn using a double lumen catheter to mix blood entering the catheter with a solution to stop adenosine metabolism. In 6 fetuses, isocapnic hypoxia (delta PaO2 congruent to 10 Torr) increased the average plasma adenosine concentration from 1.1 +/- 0.2 (SEM) to 2.0 to +/- 0.4 microM. During hypoxia, plasma levels of adenosine were inversely related to preductal arterial O2 content (CaO2) with values ranging between 1.6 and 4.0 microM when CaO2 was less than 3 ml/dl. Hypoxia also significantly reduced the incidence of fetal breathing and rapid eye movements. In other experiments, adenosine (0.36 +/- 0.03 mg/min/kg) was infused for one hour into the inferior vena cava of 5 fetuses. During this infusion, mean plasma concentration of adenosine was 2.8 +/- 0.3 microM, a value about 2.5 times the control average. Adenosine also significantly reduced the incidence of low voltage electrocortical activity, rapid eye movements and breathing activity. We conclude that hypoxic inhibition of fetal breathing most likely arises from an increase in central adenosine production, although during severe O2 deprivation (CaO2 less than 3 ml/dl) blood-borne adenosine could also contribute. PMID- 1787269 TI - Relationships between body movements and phase of respiratory cycle in newborns. AB - To determine the relationships between body movements and phase of the respiratory cycle, we performed polygraphic recordings during daytime sleep in 12 normal newborns: 6 premature infants of 31 to 36 weeks conceptional age and 6 full-term infants of 39-41 weeks conceptional age. Chin and eye movements, movements detected during sighs and body movements not related to sighs were analysed separately. We analysed 1838 chin and body movements with a clearly defined beginning. Data obtained were similar in both premature and full-term infants, without statistically significant differences when active and quiet sleep states were compared. We found that: (a) The 96 movements concomitant with sighs all started during inspiratory diaphragmatic bursts. (b) The 1270 body movements unrelated to sighs started predominantly (78.6% in premature infants, 81.3% in full-term infants) during expiration, after the end of diaphragmatic contraction (P less than 0.002). (c) The 472 chin movements and eye movements occurred randomly with respect to phases of respiration. In conclusion, our data show that central motor command level determines relationships between movement initiation and respiratory phase. They suggest inhibition of trunk and limb movements (under pyramidal control) during diaphragmatic contraction as early as 31 weeks CA. This inhibition is absent during sighs, which involve the inspiratory augmenting reflex, and does not apply to chin and eye movements, which are mediated by cranial nerves. PMID- 1787270 TI - Combating childhood diarrhoea through international collaborative research. PMID- 1787271 TI - Appropriate use of human and non-human milk for the dietary management of children with diarrhoea. AB - The nutritional benefit of milk consumption during diarrhoea must be balanced against its potential to produce increased severity or duration of illness. Continued breastfeeding during diarrhoea results in decreased stool output and is generally recommended. However, continued feeding of non-human milk may cause increased faecal excretion, prolonged diarrhoeal duration, and a greater number of treatment failures among young patients with relatively severe diarrhoea. Although most children can safely continue receiving milk during acute diarrhoea, the possibility of serious complications dictates that they be carefully observed. Acceptable alternatives to exclusive non-human milk feeding during diarrhoea include milk-free formulas, milk-cereal mixtures, and possibly fermented milks. This paper reviews the results of published clinical trials of milk feeding and discusses their implications for the appropriate dietary management of childhood diarrhoea. PMID- 1787272 TI - Transmission factors and socioeconomic status as determinants of diarrhoeal incidence in Lima, Peru. AB - As part of a longitudinal, community-based study of diarrhoeal morbidity in a peri-urban community in Lima, Peru, a household survey was administered to ascertain possible risk factors, based on transmission routes, for diarrhoeal incidence. Socioeconomic information was also obtained in the survey and a composite socioeconomic status (SES) indicator was created based on four variables: income (wealth), ownership of 4 functioning electrical household appliances, community participation, and house construction. Both transmission factors and the SES indicator were analysed for their effects on diarrhoeal incidence using both bivariate and multivariate methods. The SES indicator, method of water storage, if the child was seen eating faeces or soil were all significantly associated with diarrhoeal incidence. In a final logistic model, water storage, location of defecation for children, child eating soil or faeces, and age, demonstrated significant results. Children in households with water stored in containers without a faucet were twice as likely to have a high incidence of diarrhoea (greater than 7 episodes/child/year). The SES indicator was not significant in the logistic model, but high SES was associated with whether or not the child was reported as having been seen eating faeces or soil and with non-use of latrines by adults. Also low SES households were more likely to have better water storage methods. Therefore, it would seem that (SES) does not independently determine diarrhoeal incidence, but rather may be functioning through these transmission factors to affect diarrhoeal incidence. PMID- 1787273 TI - Physicians' prescribing practice for treatment of acute diarrhoea in young children in Jakarta. AB - Prescribing practices of physicians who treat acute childhood diarrhoea in Penjaringan, an urban district of Jakarta, were investigated utilising observations of clinical practice and interviews with physicians. One hundred thirty-four physicians registered in Penjaringan district in their practices; 122 physicians (91%) participated in the survey and 73 (55%) were included in the observational study. Reported and observed practices are compared. Results show that 78% of the physicians reported that they frequently prescribe Oralit, a solution for oral rehydration therapy (ORT). However, observation of clinical cases indicates that Oralit was prescribed less frequently than reported. Although most physicians believed viral infections were a common cause of diarrhoea, antibiotics were prescribed for children in 94 percent of observed cases. Antispasmodic drugs were also commonly prescribed. Factors associated with physicians' prescribing behaviour and practices regarding diarrhoeal diseases include type of practice, concepts about aetiology, perceptions about ORT and parental expectations. The observed discrepancy between knowledge and practice suggests the need for new ways to encourage physicians to prescribe Oralit and to limit use of antibiotics and antidiarrhoeals of doubtful efficacy. PMID- 1787274 TI - Home treatment of acute diarrhoea in Bali, Indonesia. AB - To determine how acute diarrhoea is managed at home, 75 structured interviews were conducted with mothers of children under two years of age who were admitted to hospitals or health centres in Denpasar district, Bali. Most mothers did not follow the guidelines for home case management established by the World Health Organization (WHO) Control of Diarrhoeal Diseases (CDD) Programme. Sixty eight percent of the mothers reported giving oral rehydration therapy (ORT) to their children with diarrhoea, and over half of these children were given home made salt-sugar-solutions (SSS). However, only 12% of the mothers were able to properly make the SSS. Over two thirds of the mothers reduced or stopped the intake of bottled milk and solid food during the episode. Forty-five percent of breast-feeding mothers increased the frequency of feeding. Over half of the mothers gave drugs to their children, 90% of which were obtained from the physicians or health post personnel. These results indicate that more effective ways to implement the proper home-case management of diarrhoea are needed. PMID- 1787275 TI - Cultural study of diarrhoeal illnesses in central Thailand and its practical implications. AB - A cultural study of diarrhoeal illness was conducted using the Explanatory Model Interview for Cultural Assessment (EMIC) to compare two socioeconomically distinct subdistricts of central Thailand and to determine the practical implications of illness-related perceptions, beliefs and practices. Subjects specified 12 terms for diarrhoeal illnesses that were grouped into four locally meaningful groups, namely, tong-sia, a non-specific term for diarrhoea, bid, associated with colicky abdominal pain, ahiwa, referring to severe illness, often cholera; and taae-tua, diarrhoea associated with milestones of growth and development. To compare pre-existing beliefs and practices with the experience of caretakers when actually confronted with an episode of illness, we inquired about each of the terms and about index cases in subsequent interviews over the course of a six-month surveillance period. Patterns of distress, perceived causes, and preferences for help seeking and treatment elicited by the EMIC identified cultural features of the four groups of diarrhoeal illness. Perceived causes of diarrhoea associated with sanitation, hygiene and infection, which most respondents considered preventable, were prominent explanations for three of the four categories, and the fourth was viewed as a normal feature of growth and development, rather than medical illness. We discuss these and other findings with reference to use of ORS and other issues related to the prevention and control of diarrhoeal illness, concluding with recommendations for public health policy and research. PMID- 1787276 TI - Feeding practices for young Pakistani children: usual diet and diet during diarrhoea. AB - Diarrhoea is among the foremost disorders responsible for high mortality and morbidity in children of third world countries. In addition, improper feeding during diarrhoea leads to a vicious cycle of frequent episodes of diarrhoea and malnutrition in these children. In this study 595 households (200 urban and 395 rural) with 741 children who met the age criteria of 36 months or less were randomly selected for assessing the feeding practices during diarrhoea. Out of these, 276 (37%) were infants and 465 (63%) were toddlers. The majority of both breastfed and non breastfed children were also receiving solids and liquid foods. Animal milk was used by 89% of non-breastfed children. Forty six percent of breastfed and 78% of non-breastfed children were given "Khitchri" (rice cooked with lentils) as a solid diet. During diarrhoeal episodes, most mothers (70%) continued breast feeding their children. Whereas, 53% children also received solid and semi-solid diet which was either "Khitchri" or banana as mentioned by more than half of the respondents. The majority of mothers (97%) considered breast-feeding to be a good practice during childhood diarrhoea. PMID- 1787277 TI - Food hygiene behaviour and childhood diarrhoea in Lagos, Nigeria: a case-control study. AB - We investigated food hygiene-related behaviour as well as other risk factors for diarrhoea in children 6-36 months of age in Iwaya community in Lagos, Nigeria. Between April and July 1989, a bi-weekly diarrhoea surveillance was maintained in 672 households. Following the surveillance, 273 (case = 67 and control = 206) families were visited twice, each visit lasting for 3-4 hours. Detailed observations on food hygiene, water sanitation, and sanitary conditions of the home were made. There was no significant association between any of the observed food hygiene behaviours and the occurrence of diarrhoea. The presence of faeces in and around the toilet area (RR = 1.79), habit of defecating and urinating in chamber pots in dwelling units (RR = 1.80), indiscriminate disposal of waste (RR = 2.48), and source of domestic water (RR = 2.94) were the main factors significantly associated with the occurrence of diarrhoea in this community. These findings imply that diarrhoea might be reduced through an education programme which focuses on the proper care, handling and storage of defecation pots and proper disposal of waste. PMID- 1787278 TI - Evaluation of clinical management training programme for diarrhoea. AB - We report the evaluation of a training programme on clinical management of infantile diarrhoea. The training programme was delivered through a series of on site clinical courses offered to a selected group of physicians and nurses from 16 health units in Peru and a series of local workshops conducted in their own health units. The outcome of this training programme was assessed by pre- and post-tests, knowledge, attitude, and practice (KAP) questionnaires, and observational surveys. A significant improvement in medical knowledge about diarrhoea, in particular about the use of ORT and drug therapy, was observed. Although the observational surveys showed significant improvement in the use of ORT at health facilities (2.9% to 23.6%, p = 0.007) the rate observed was still low compared to the high level of knowledge on ORT that was demonstrated by the KAP questionnaires. A reduction of antibiotic prescription for inpatients with diarrhoea (85.7% to 64.8%, p = 0.025) was observed. The training programme was also effective in promoting the establishment of Oral Rehydration Units in the participants' health facilities. PMID- 1787279 TI - Mothers' perceptions about childhood diarrhoea in rural Mexico. AB - Diarrhoea is a common illness and can be life-threatening. Mothers are used to dealing with diarrhoea and have an ample repertoire of home-based practices, traditional treatments, and western-style medicine to manage diarrhoeal episodes. However, programme planners often overlook and/or underestimate this knowledge, and by so doing they constrain the possible impact of educational messages and intervention programmes designed to treat diarrhoea and to promote oral rehydration therapy. This study addresses the "popular epidemiology" of diarrhoea, in an effort to highlight data that may prove useful for planners of diarrhoea-management programmes. We found that when mothers assess the severity of diarrhoea they consider an increase in the usual number of stools passed per day, as well as the colour, smell and liquid content of the stools. However, they also place special consideration on how much the episode of diarrhoea interfered with their daily activities. When considering the worsening or improvement of their child during the episode, they rely on symptoms related to changes in the child's usual wellbeing, while the more important signs that they recognise are focused on the child's eyes. In relation to fluid and food, we found that herbal tea and rice-based beverages were most commonly used, and that during diarrhoea, mothers were more prone to modify the usual diet fed to the child than to withhold food. PMID- 1787280 TI - Childhood diarrhoea in a low-income urban community in Bangkok: incidence, clinical features, and child caretaker's behaviours. AB - A one-year surveillance study of childhood diarrhoea in a low-income urban community in Bangkok revealed an annual incidence of 2.2 episodes per child among infants, and that the overall annual incidence among children under five years of age was 0.9 per child. Rotavirus, Salmonella and Campylobacter jejuni were common aetiologic agents. In children less than one year, diarrhoea was caused mostly by rotavirus and Salmonella. In 1-2 year old children, the major causative agent was rotavirus while E. coli, Campylobacter jejuni and Shigella were subsequent aetiologic agents. In grown up children (aged 2-5 years), the more common diarrhoeal pathogens were Shigella and E. coli. The clinical characteristics of diarrhoeal illness due to different pathogens were shown. The sources of drugs and the usage of available facilities in treating diarrhoea are also described. Caretakers treated childhood diarrhoea with ORS (53%), antibiotics (10%), and a combination of these in 15% of cases. These findings imply that the available facilities in this community can be better utilised to obtain more effective control of diarrhoeal morbidity and mortality. PMID- 1787281 TI - Diarrhoeal disease morbidity, risk factors and treatments in a low socioeconomic area of Ilorin, Kwara State, Nigeria. AB - A 12-month diarrhoeal disease surveillance was carried out in a sample of 351 children under 3 years of age in a low-income traditional area of Ilorin, Nigeria to determine whether sociodemographic characteristics, including age of the child, sex, parity, mother's education, occupation, mother's age and household kitchen, were associated with the incidence of acute diarrhoea. Bivariate and multivariate analyses were used to determine association. Results indicated that only the age of the child and the type of kitchen used by the household had a significant association with diarrhoea. Diarrhoeal incidence decreases with the child's age while households with a private kitchen had a significantly lower incidence rate than those without a kitchen. This finding emphasises the importance of good hygiene in reducing the risk of having diarrhoea. Three common treatments applied by mothers are ORS (used in 14.8% of diarrhoea days), antibiotics (54.5%) and local herbs (27.7%). The younger a child is the more likely that ORS and antibiotics will be administered during diarrhoea. About 53% of the antibiotic use was by self medication while 40% were prescribed by the clinics. The need for educational campaigns to discourage the inappropriate use of antibiotics was emphasised. PMID- 1787282 TI - A traditional diet as part of oral rehydration therapy in severe acute diarrhoea in young children. AB - Recently, the role of feeding as treatment of acute diarrhoea has received increasing attention. To assess the efficacy of early feeding in acute diarrhoea, we conducted a randomised, clinical trial of a traditional legume-based weaning diet khitchri in boys 9 to 48 months old with moderate to severe dehydration. Khitchri is composed of rice and lentils cooked with cottonseed oil. Children were randomly allocated to 2 groups: group A received only WHO ORS but no food for the first 24 hours and then khitchri and half-strength cow's milk formula freely; group B received khitchri and the half-strength formula in addition to ORS after the initial rehydration period of 4 to 6 hours. The mean period of evaluation was 3 days. 69 patients were admitted into the study, 33 in group A and 36 in group B. The initial mean purging rate for the children was greater than 200 g/kg/day. Six children did not complete the study because they developed intercurrent infections or were removed by their parents for non-medical reasons. Of the 63 patients who were evaluated, 44 (70%) were successfully treated, 21 in group A and 23 in group B. There were no significant differences in the 2 groups in mean stool output, number of stools, or weight gain, although a trend toward earlier improvement was seen in group B. These data indicate that early feeding of khitchri and WHO/ORS may be as well tolerated as WHO/ORS alone in the first 24 hours treatment of severe acute diarrhoea in young children. PMID- 1787283 TI - Bibliography on diarrhoeal diseases. PMID- 1787284 TI - Organ and tissue donation from the emergency department. AB - Despite mandatory request legislation, the lack of available donor organs and tissues continues to limit transplant efforts. The potential contribution from emergency department (ED) patients remains undefined. We reviewed the charts of patients dying in our ED for organs and tissues potentially suitable for transplantation, age, cause of death, and physician documentation of donation inquiry. Of 155 charts reviewed, potential donors were identified for corneas (99), bones (61), heart valves (42), and kidneys (3). Of the 155 charts, 130 (84%) made no mention of donation, and of 37 charts containing a donor request form, 34 (92%) were incorrectly filled out or left blank. Four charts (2.6%) mentioned donation in the narrative section, two (1.3%) documented discussion with family, and one patient was referred to our Organ Procurement Organization, with recovery of one kidney and heart valves. We conclude that physicians rarely document consideration of donation for patients dying in the ED; the number of potential donors far exceeds the number referred or recovered. Future efforts should focus on methods to increase recognition and referral of organ and tissue donors from the ED. PMID- 1787285 TI - Emergency department workload--a transatlantic comparison. AB - This paper compares the workload of the emergency department of a Level One trauma center in the United States and a large city hospital in the United Kingdom. The referral pattern and diagnostic classification of 5,000 patients presenting to both departments were compared, as were the transportation systems at the two sites. It was shown that similarities existed in many areas. Major trauma formed only a small proportion of the overall workload of both departments. The conclusion is that although the two emergency care systems have fundamental differences in terms of organization and finance, the workloads are remarkably similar. Interesting differences arose in areas such as use of helicopter transport, psychiatric and drug and alcohol related admissions, and in the number of patients brought to hospital under police escort. PMID- 1787286 TI - Acute transverse myelitis in the emergency department: a case report and review of the literature. AB - Acute transverse myelitis (ATM) is a neurologic condition that presents with bilateral lower extremity weakness and sensory loss associated with bowel and bladder dysfunction. Whereas the time of onset may be hours to days, the time to either partial or complete recovery may require months. The etiology is varied and may be idiopathic. Laboratory and radiographic evaluation may be nonrevealing. Corticosteroids have been used for treatment, but their efficacy is controversial. As illustrated by this case report, the essential aspect of the initial management of ATM is the elimination of potentially treatable causes. PMID- 1787287 TI - Lingual artery hematoma resulting in upper airway obstruction. AB - A case of upper airway obstruction from a lingual artery hematoma after suturing of a puncture wound to the tongue is reported. The anatomy of the tongue and upper airway is reviewed to better understand the mechanism of obstruction. The emergency physician should be aware of this rare and potentially lethal complication to what might initially seem to be a trivial injury. PMID- 1787288 TI - Neurocysticercosis presenting to the emergency department as a pure motor hemiparesis. AB - We report the case of a 23-year-old male who presented to the emergency department (ED) with an isolated right-sided pure motor hemiparesis (PMH). An unenhanced computed tomography (CT scan) revealed a hypodensity in the area of the left parasagittal motor strip. The patient then experienced a Jacksonian type of seizure involving his right leg and was treated with intravenous phenytoin and dexamethasone. A second CT scan performed with contrast was thought to be consistent with a cerebral abscess with surrounding white matter edema. Surgical findings were consistent with neurocysticercosis. The patient was treated with praziquantel with nearly full recovery. Worldwide, cysticercosis is the most common CNS parasite. Because of immigration from endemic areas, cysticercosis has become more common in the United States. Patients with neurocysticercosis may arrive in the ED with a wide variety of unusual presentations. In this case, the PMH syndrome was caused by a solitary lesion in the motor strip. This report describes a case of PMH due to neurocysticercosis secondary to local mass affect alone. The literature of neurocysticercosis and PMH is reviewed and the pathogenesis, clinical presentation, and therapy are discussed. PMID- 1787289 TI - Nontraumatic gas gangrene: case report and review of emergency therapeutics. AB - Gas gangrene is a well-recognized serious life and limb threatening emergency. In certain patients the source of this infection may be nontraumatic. We present an illustrative case of nontraumatic gas gangrene caused by Clostridium Septicum and review the literature regarding its emergency management. Early recognition of nontraumatic gas gangrene is crucial to reduction of mortality and morbidity. Emergent therapy requires resuscitation, surgical consultation, pharmacological therapy, and consideration of hyperbaric oxygen therapy. Early institution of a multifactorial approach to treatment may significantly reduce the mortality and morbidity of this life threatening disease. PMID- 1787290 TI - Esophageal apoplexy: case report, review, and comparison with other esophageal disorders. AB - Esophageal injuries are potentially serious disorders requiring prompt recognition and management. In addition to the well-recognized Mallory-Weiss and Boerhaave's syndromes, there exists a condition of spontaneous intramural esophageal hemorrhage: esophageal apoplexy. A case of esophageal apoplexy is presented as well as an evaluation of clinical presentations based on a collected review of the 66 cases previously reported. In addition, esophageal apoplexy is contrasted with the Mallory-Weiss and Boerhaave's syndromes, focusing on distinguishing attributes of utility to the emergency practitioner. PMID- 1787291 TI - Emergency department analgesia without narcotics for adults with acute sickle cell pain crisis: case reports and review of crisis management. AB - Vaso-occlusive crises are one of the most debilitating features of sickle cell disease. There appears to be no standardization of care for adults with pain crisis, and some commonly utilized regimens, such as those employing intramuscular meperidine, are pharmacologically unsound. Parenteral narcotic use may be associated with respiratory compromise acutely and with dependence over the long term, but nonopioid preparations are often unsatisfactory in relieving pain. We have recently enjoyed success with a combination of a parenteral nonsteroidal anti-inflammatory medication and an oral tricyclic antidepressant. We report four representative cases and review the salient points of the management of pain crisis in adult patients in the emergency department. PMID- 1787292 TI - Reversal of orphenadrine-induced ventricular tachycardia with physostigmine. AB - A 3-year-old boy developed confusion, generalized tonic-clonic seizures, and sustained ventricular tachycardia following ingestion of an unknown quantity of orphenadrine (Norflex). Although refractory to precordial thump, synchronous cardioversion, and lidocaine, the ventricular tachycardia was reversed by intravenous administration of the tertiary acetylcholinesterase inhibitor physostigmine. We discuss the underlying physiology and manifestations of anticholinergic overdose, the specific manifestations of orphenadrine overdose, and the current recommendations regarding the utilization and toxicity of physostigmine in the treatment of anticholinergic syndromes and orphenadrine intoxication. PMID- 1787293 TI - The crash of Continental 1713: the impact on hospital-based personnel. AB - Psychological morbidity is a common finding in rescue personnel following a disaster. However, no serious attention has been given to the possibility that hospital-based personnel are also at risk. Therefore, 12 to 16 months after the crash of Continental 1713, 15 subjects who had worked with crash victims and their families only while in the hospital, were given a structured interview. Eight of 15 said they developed at least one symptom in each domain of Post Traumatic Stress Disorder within 2 weeks of the crash; of the remaining 7 subjects, all endorsed at least one re-experiencing symptom. Half also reported serious disruptions at home and in their work with other patients. Thirteen subjects also experienced significant worries about flying and 4 actually changed travel plans. Subjects were still symptomatic at 12 to 18 months, though to a lesser degree. We conclude that the emotional effects of disasters on hospital based personnel are not trivial. PMID- 1787294 TI - Resuscitation fluid for a patient with head injury and hypovolemic shock. AB - The resuscitation of a patient with severe closed head injury and hypovolemic shock is a commonly encountered clinical scenario. The optimal resuscitation formula remains controversial. Aggressive use of crystalloid solutions may worsen brain injury. Early use of mannitol or hypertonic agents may worsen hemorrhage and shock. The optimal approach to the resuscitation of a patient with head trauma and hypovolemic shock is reviewed and discussed. Recent experimental evidence suggests that the early inclusion of an agent such as mannitol in the resuscitation formula may be appropriate despite the evidence of shock. However, the controversy remains unresolved. PMID- 1787295 TI - Resuscitation from prolonged cardiac arrest with high-dose intravenous magnesium sulfate. AB - We present evidence of resuscitation from prolonged (70-min) cardiac arrest, temporally associated with administration of 8 g intravenous (IV) magnesium sulfate (MgSO4). A patient undergoing liposuction surgery developed bradycardia and a fall in oxygen tension after reversal of general anesthesia with physostigmine. The electrocardiogram (ECG) rhythm degenerated to ventricular asystole, which was refractory to standard therapy, including multiple boluses of epinephrine, atropine, wide-open dopamine, and attempts at right heart pacing. External cardiopulmonary resuscitation (CPR) was continuously maintained with the patient intubated on 100% oxygen. Multiple electric countershocks (x7) and lidocaine were also administered when ventricular tachycardia/ventricular fibrillation (VT/VF) occurred, but without clinical success. Approximately one hour into the resuscitation, after all of the above occurred, 8 g IV MgSO4 was given and countershock repeated. Whereas the 7 previous countershocks had resulted in unsuccessful conversion of VT/VF to a pulseless rhythm (EMD), the 8th countershock (applied immediately after two 4 g boluses of IV MgSO4) resulted in a stable pulse and normal sinus rhythm developing within 4 minutes. The patient recovered without neurologic deficit. PMID- 1787296 TI - Biomechanics of a new atraumatic surgical needle holder. AB - It is the purpose of this report to design, develop, and evaluate a needle holder whose jaws improve needle-holding security without altering the geometry of the curved surgical needle. The configuration of the jaws of this new needle holder is curved, conforming to the curvature of the surgical needle. A biomechanical study of this curved surgical needle holder demonstrates that it holds the curved needle securely without needle deformation. PMID- 1787297 TI - Epinephrine in cardiopulmonary resuscitation. AB - This review assesses the role of epinephrine in cardiopulmonary resuscitation from the perspective of mechanisms of action, cardiac and cerebral effects, and use in human beings. We reviewed the literature from 1966 onward, using a Medline Search of the National Library of Medicine with the key words: "heart arrest," "resuscitation," and "epinephrine." Pertinent articles that represented original research were critically appraised by at least two authors. We concluded that the Advanced Cardiac Life Support recommended dose of epinephrine (1 mg or 0.007 to 0.014 mg/kg) has little scientific basis. Evidence from animal studies demonstrates that doses of 0.1 to 0.2 mg/kg are required to significantly improve myocardial and cerebral blood flow and resuscitation rates. Limited human data confirm the dose-dependent vasopressor response to epinephrine and the potential for improved immediate survival with higher doses. We suggest that randomized controlled human trials are needed to document the usefulness of higher doses of epinephrine in cardiopulmonary resuscitation. PMID- 1787298 TI - Marine envenomations; Part 1: Vertebrates. AB - As more people travel to the oceans for sport diving and other marine related activities, the incidence of marine envenomations has risen. This article is designed to give the emergency physician an overview of varying marine envenomations, their clinical presentation, and recommended treatment. Part 1 of this article addresses general wound management and vertebrate envenomations. Part 2 will concentrate on invertebrate envenomations. PMID- 1787299 TI - Cardiopulmonary resuscitation: lessons from the past. AB - One of the most startling ideas of modern medicine is that "sudden death" may be reversed; however, this idea was not reached easily. In its earliest forms, cardiopulmonary resuscitation (CPR) is probably as old as the human being. The evolution of CPR represents, as does the evolution of medicine as a whole, a history of human error and human discovery. Although it is common to ascribe the development of CPR to Kouwenhoven and colleagues at Johns Hopkins Hospital, in fact they refined and popularized a method that had been evolving over several millennia. This paper reviews the most important advances in resuscitation prior to the 20th century. PMID- 1787300 TI - Requiring consent to practice and teach using the recently dead. PMID- 1787301 TI - Electric wheelchair precautions. PMID- 1787302 TI - A couple of sternal fractures. PMID- 1787303 TI - Physical examination in acute myocardial ischemic syndromes. PMID- 1787304 TI - The practice of teaching endotracheal intubation on recently deceased patients. AB - There are few data available regarding the emergency department practice of using recently dead patients (RDP) for practice and training in endotracheal intubation (ETI/RDP). We investigated several aspects of practice by means of a survey sent to all 5,397 emergency departments in the country. Of the 992 (18.3%) responses, 537 (54.1%) did practice ETI/RDP; 455 (45.8%) did not (P less than 0.005). ETI/RDP was used significantly more commonly for instruction of paramedics (411 institutions [77%]), than for other classes of health providers (P less than 0.0001). Overall, only 69 emergency departments (7%) had any written policy governing ETI/RDP; even among those actually practicing ETI/RDP, 84% had no written policy. Likewise, patients and families were rarely informed of the practice. In institutions where ETI/RDP does occur, only 15 (3%) of emergency departments have a policy which mandates such notification. There was widespread agreement as to the educational value of the practice, although it was more favored in hospitals practicing ETI/RDP than those that do not: 411 of 418 (98%) hospitals practicing ETI/RDP agreed that it was an important component of medical education, as did 240 (80%) of institutions not practicing it (P less than 0.0001). Nearly equal percentages of teaching hospitals (53.8%) and nonteaching facilities (57.9%) engage in ETI/RDP (P = 0.35). Objections to ETI/RDP had been noted in 25% of the institutions where it was practiced. PMID- 1787305 TI - Objectives to direct the training of emergency medicine residents on off-service rotations: ophthalmology. AB - This is the ninth article in a continuing series for emergency medicine education. Ophthalmology is the topic. Since ophthalmologic problems are common in the emergency department and have obvious importance in clinical care, the time spent on an ophthalmology rotation can be very valuable in emergency medicine training. This experience is often limited to a 2-week rotation. Therefore, clear goals and objectives take on a greater significance for the resident-in-training. PMID- 1787306 TI - Once may be enough. PMID- 1787307 TI - Single preoperative bladder instillation of povidone-iodine for the prevention of postprostatectomy bacteriuria and wound infection. AB - OBJECTIVE: To study the effectiveness of preoperative bladder washing with povidone-iodine to prevent postprostatectomy wound infection. DESIGN: Patients with an indwelling catheter and scheduled for prostatectomy were divided into two groups. In patients in group 1 (n = 76) the indwelling catheter was simply removed without bladder irrigation. Patients in group 2 (n = 80) had their bladder washed with a nondiluted solution of povidone-iodine before surgery. PATIENTS: One hundred fifty-six consecutive patients with an indwelling catheter and bacteriuria. Mean age was 64 years. All patients had an open prostatectomy during the 12-month study period. Patients undergoing open prostatectomy during the first 6 months of the study had no bladder irrigation and served as the control group. Patients undergoing open prostatectomy during the following 6 months had a bladder instillation with povidone-iodine. RESULTS: Wound infection appeared in 17 of 76 patients (22.4%) without bladder washing and in 4 of 80 patients (5%) when 50 to 60 ml of the solution was retained in the bladder for 10 to 13 minutes (p = .001). The incidence of postoperative bacteriuria remained unchanged in the control group (100%) but was reduced to 22.5% in the treated group (p = .001). Statistical comparisons of incidence were done using the chi square test. CONCLUSIONS: It has been demonstrated that the use of preoperative bladder instillation of povidone-iodine may be highly effective in the prevention of postprostatectomy wound infection and in reducing the incidence of bacteriuria in patients with an indwelling catheter and urine colonization. PMID- 1787309 TI - Surveillance of surgical wound infections following open heart surgery. AB - OBJECTIVE: To define accurate wound infection rates for the cardiac surgery service based on site of infection and characterization as "deep" or "incisional" and to determine whether a correctable cause for an apparent increase in deep wound infection rates existed. DESIGN: Observational. SETTING: Tertiary-care teaching hospital. PARTICIPANTS: All adults undergoing open heart surgery in 1988 and 1989. INTERVENTIONS: Changed from razor to clipper preoperative hair removal in January 1989. RESULTS: Deep sternotomy wound infections decreased significantly from 1.2% in 1988 to 0.2% in 1989 (p = .010) and deep venectomy (vein donor site) wound infections declined from 1.6% to 0.4% (p = .014) during the same time period. Incisional wound infection rates did not change. Patients with deep infections more likely required readmission or operation to treat their infection than those with incisional wound infections. The percentage of gram negative organisms causing wound infections decreased from 56.3% in 1988 to 34.7% in 1989 (p = .017). CONCLUSIONS: Preoperative hair removal using a clipper appears to have decreased the risk of deep wound infection compared with razor preparation. The dichotomous wound classification of "deep" and "incisional" distinguished between patients who required additional interventions for treatment of wound infections. PMID- 1787308 TI - An analysis of blood and body fluid exposures sustained by house officers, medical students, and nursing personnel on acute-care general medical wards: a prospective study. AB - OBJECTIVE: To prospectively examine the epidemiology of blood and body fluid exposures sustained by medicine housestaff, medical school students, registered nurses (RNs), licensed practical nurses (LPNs), and nurses' aides (NAs) on general medicine wards and to define problem areas that may be amenable to change. DESIGN: Daily data collection during 9 months using a self-reporting questionnaire. SETTING: General medical wards in 2 tertiary referral hospitals. PARTICIPANTS: Medicine housestaff/students and nursing personnel. RESULTS: Physicians reported 644 exposures, of which 98 (15.2%), 296 (46.0%), and 250 (38.8%) were sustained by medicine residents, interns, and students, respectively. Blood contact occurred with 591 (91.8%) exposures. For physicians, 575 (89.3%) exposures occurred during venipuncture, intravenous catheter manipulation, and arterial punctures. Interns and students most commonly incurred exposures during venipunctures and intravenous manipulations; residents commonly were exposed during emergent intravenous catheter placements. Five-hundred-twenty two (81%) exposures occurred between 7 A.M. and 7 P.M. During 524 (81.4%) exposures, physicians were not using barrier devices. Nurses reported 235 exposures, of which 140 (59.6%), 23 (9.8%), and 72 (30.6%) were sustained by RNs, LPNs, and NAs, respectively. RN exposures commonly occurred during intravenous manipulations and glucometer fingersticks. LPNs and NAs incurred a higher percentage of exposures during nonprocedural patient care. Blood contact and wound drainage accounted for 167 (71.1%) and 31 (13.2%) exposures, respectively. CONCLUSIONS: Exposures to blood and body fluids frequently are incurred by healthcare workers on general medical wards. Efforts to reduce these exposures should be directed not only at improving procedural skills of healthcare workers for venipunctures, intravenous catheter insertions, and glucometer fingersticks, but also in increasing barrier use during procedural and nonprocedural tasks. PMID- 1787310 TI - Monitoring universal precautions: a new assessment tool. AB - OBJECTIVES: Two pilot studies were conducted to produce efficacy data on an observational tool designed to assess the use of Universal Precautions (UP) in patient care settings. The instrument addresses barrier precautions, hand washing, handling of sharps, and avoidance of unprotected mouth to mouth resuscitation. DESIGN: The Universal Precautions Assessment Tool was submitted to a panel of 3 experts to establish consensual validity. It was pilot tested by 2 simultaneous observers to establish interrater reliability. SETTING: Pilot Study I was conducted in 3 different units within a 100-bed U.S. Army hospital. Pilot Study II was conducted in the emergency department of a large university-based hospital. PARTICIPANTS: Subjects observed were registered nurses providing acute patient care. RESULTS: Two simultaneous raters calculated UP compliance rates of 76.4% and 78.6%, respectively, for 9 nurses in Pilot Study I, and 62% and 65%, respectively, for 5 nurses in Pilot Study II. The intraclass correlation coefficient for the raters' scores in Pilot Study I was 0.992 with a 95% confidence interval (0.979, 0.997). Consensual validity was established. CONCLUSIONS: The instrument has acceptable interrater reliability under the conditions used. Limitations to use include the possibility of a Hawthorne effect and the fact that assessing proper implementation of UP occasionally relies on a "judgment call" by the observer. With test conditions adjusted to minimize these limitations and with proper consideration of sample size, the tool can be used by researchers and by monitors of hospital quality control to measure UP compliance of caregivers individually or collectively. PMID- 1787311 TI - Validation of new tests. PMID- 1787312 TI - Management of the healthcare worker infected with human immunodeficiency virus: lessons from nosocomial transmission of hepatitis B virus. PMID- 1787313 TI - SHEA, AIDS, and public policy. PMID- 1787314 TI - AIDS prevention: what are we talking about? PMID- 1787315 TI - Medical manpower requirements of basic doctors. PMID- 1787316 TI - Observation on serum prolactin in hepatic cirrhosis. AB - Serum prolactin assays in patients of hepatic cirrhosis were analysed. Patients with cirrhosis had higher values of serum prolactin (27.2 +/- 5.1 ng/ml in males and 38.4 +/- 4.1 ng/ml in females) as compared to control subjects (p less than 0.05). Majority of patients of cirrhosis with suspected portal-systemic encephalopathy had significantly higher serum prolactin than those without encephalopathy (p less than 0.05). Significantly higher values of serum prolactin on admission had positive correlation with mortality (p less than 0.01). Clinico biochemical severity of hepatic dysfunction was directly correlated with level of serum prolactin. The present study reveals the possibility of diagnostic and prognostic values of serum prolactin in cirrhosis, specially in clinical/sub clinical subsets of portal-systemic encephalopathy. PMID- 1787317 TI - Midtrimester termination of pregnancy--search for a better method continues. AB - Every day a new method of termination of second trimester pregnancy clearly indicates that we have still not found a simple, safe, effective and economic method of termination of pregnancy in second trimester. Present study of 855 cases aims at searching out something better from available modalities. Age old hypertonic saline and ethacridine lactate were used with adjuvants like hyaluronidase and a preparation containing isapgol husk to reduce injection abortion interval and failures. Life threatening dangers of hypertonic saline are known. Ethacridine lactate seems to be safe. By giving it intra-amniotically with these adjuvants its major disadvantages could be minimised. There was no mortality. However, there was morbidity in the series. PMID- 1787318 TI - Effects of age, sex and alcoholic habit of patients on liver enzymes during antituberculosis chemotherapy. PMID- 1787319 TI - Surgical treatment of hydatid cyst of liver. AB - Results of surgery in 52 cases of hepatic hydatid disease are described. Ultrasound examination proved to be the most useful and accurate diagnostic tool. All the patients were treated by enucleation of cyst and closed suction drainage of the cavity lined by pericyst. Mebendazole was given routinely pre-operatively for 15-30 days and postoperatively for 3 months. This mode of treatment had greatly reduced the morbidity and mortality as compared to conventional hydatid cyst surgery. PMID- 1787320 TI - Soft tissue chondroma in an infant. PMID- 1787321 TI - Spontaneous bacterial peritonitis in nephrotic syndrome. PMID- 1787322 TI - Consumer Protection Act and doctors. PMID- 1787323 TI - Current status of thrombolytic therapy in acute myocardial infarction. PMID- 1787324 TI - Plasmid stability in Bacillus sphaericus 2362 during recycling in mosquito larvae. AB - Bacillus sphaericus 2362 strains transformed with the plasmid pUB110 (4.5 kb) and plasmids derived from it, pLDT103 (7.6 kb) and pLDT117 (9.3 kb), were able to recycle (spore germination, vegetative growth, sporulation) in larvae of Culex quinquefasciatus. During the course of recycling, the pUB110 vector and the recombinant plasmid pLDT103 were stable (100 and 99.2%, respectively). However, the recombinant plasmid pLDT117 exhibited 23% segregational instability. Isolates which lost pLDT117 during recycling retained the one large plasmid native to B. sphaericus 2362. PMID- 1787325 TI - Haplosporidiosis of the Pacific oyster, Crassostrea gigas. AB - Haplosporidan parasites were observed in 10/100 spat and 1/171 adult Pacific oysters, Crassostrea gigas, reared in Matsushima Bay, Japan. Eight of the infected spat contained mild to severe plasmodial infections. The multinucleated plasmodia were 6-12 microm x 7-15 microm and were associated with an infiltration of hemocytes that occurred throughout the vesicular connective tissues of all infected oysters. Two oysters, one adult and one spat, contained advanced sporogonic infections. These were characterized by the presence of sporocysts and immature and mature operculated spores that measured 5.6-6.0 microm x 6.0-8.0 microm and were found exclusively within the digestive tubule epithelium. Electron microscopic examination revealed that mature spores contained a hinge operculum, striated and layered wall, spherule, single nucleus, and haplosporosome formative regions. Parasite morphology and infection pattern closely resemble that of Haplosporidium nelsoni, a pathogen of American oysters (C. virginica). PMID- 1787326 TI - Chlamydia-like organisms in digestive and duct cells of mussels from the Basque coast. AB - Chlamydia-like organisms have been detected in digestive cells and duct cells of the digestive gland of mussels, Mytilus galloprovincialis, collected from the Basque coast. The organisms appeared as basophilic inclusion bodies within digestive cells and consisted of elongate initial reticulate bodies and previously undescribed condensed forms, interpreted as intermediate bodies. Of the 414 mussels examined by light microscopy, 5.31% showed this type of infection. A second type of chlamydia-like organism was found in nonciliated duct cells. The microorganisms were found mostly free in duct cells and large elongate reticulate bodies, intermediate condensing forms, and fully condensed elementary bodies were clearly distinguished. No serious histopathological or ultrastructural changes were observed in host cells but evidences of a possible localized metabolic damage within infected digestive cells is presented. PMID- 1787327 TI - Fate of Bacillus sphaericus 2362 spores following ingestion by nontarget invertebrates. AB - Elimination of Bacillus sphaericus spores ingested by midge larvae, snails, and oysters was most rapid among midge larvae. Spores remained in oysters up to 21 days and in snails up to 49 days. Viable spores were recovered in snail and oyster feces for these same periods. There was no indication of actively growing B. sphaericus in the animals. Passage through oyster gut detoxified the B. sphaericus mosquito larval toxin, but there was a 33% retention of toxicity following snail gut passage. Midge larvae reared to adults in spore-containing water carried spores in/on the adult body. This suggests that these animals could carry the bacteria to sites beyond the application area. PMID- 1787328 TI - Cytoplasmic incompatibility in Drosophila populations: influence of assortative mating on symbiont distribution. AB - Cytoplasmic incompatibility is known to occur between strains of both Drosophila simulans and D. melanogaster. Incompatibility is associated with the infection of Drosophila with microorganismal endosymbionts. This paper reports survey work conducted on strains of D. simulans and D. melanogaster from diverse geographical locations finding that infected populations are relatively rare and scattered in their distribution. The distribution of infected populations of D. simulans appears to be at odds with deterministic models predicting the rapid spread of the infection through uninfected populations. Examination of isofemale lines from four localities in California where populations appear to be polymorphic for the infection failed to find evidence for consistent assortative mating preferences between infected and uninfected populations that may explain the basis for the observed polymorphism. PMID- 1787329 TI - Mosquitocidal activity of Bacillus laterosporus. PMID- 1787330 TI - Bioencapsulation and delivery to mosquito larvae of Bacillus thuringiensis H14 toxicity by Tetrahymena pyriformis. PMID- 1787331 TI - Frass failure and pupation failure as quantal measurements of Bacillus thuringiensis toxicity to Lepidoptera. PMID- 1787332 TI - Groove pancreatitis. AB - Groove pancreatitis is characterized by the formation of a scar plate between the head of the pancreas and the duodenum, and is by no means a rare entity. In our material comprising surgical specimens, it was found to be present in 19.5% of the cases. This form of pancreatitis is "special" only on account of the topography of the scar tissue. Scarring of the groove leads to complications that are also determined by the topography: disturbance of the motility of the duodenum, stenosis of the duodenum, and tubular stenosis of the common bile duct, which occasionally extends to obstructive jaundice. In the "pure" forms of groove pancreatitis the main pancreatic duct is not involved, and this fact has a certain significance in the differential diagnosis vis-a-vis carcinoma of the head of the pancreas, since signs of stenosis with no involvement of the rest of the pancreas are, in the first instance, suspicious for carcinoma and provide the indication for surgery. A knowledge of the existence of groove pancreatitis suggests a differential-diagnostic alternative. In terms of etiology, pathogenesis, and the pathological/anatomical picture, groove pancreatitis is "special" only on account of its topographic aspects. PMID- 1787333 TI - Reported family aggregation of pancreatic cancer within a population-based case control study in the Francophone community in Montreal, Canada. AB - As part of the SEARCH Collaborating Study Group of the International Agency for Research on Cancer (IARC), a population-based case-control study of cancer of the pancreas was conducted in Montreal, interviewing 179 patients and 179 controls matched for age, sex, and language (French) and selected by a modified random digit dialing method. Results showed a positive and strong association between cigaret smoking and pancreatic cancer. Total fat, particularly saturated fat, and cholesterol consumption and excess energy derived from fat were associated with positive risk; dietary fiber intake, retinol equivalent, beta-carotene, vitamin C, and calcium showed inverse association with risk. History of such medical conditions as constipation, gallbladder problems, and diabetes was also found to be associated with risk. More important, 7.8% of the pancreatic cancer patients reported a positive family history of the same disease, as compared with 0.6% among controls, a 13-fold difference between cases and controls. Within the original case-control study a further study of patients with instances of familial pancreatic cancer was conducted, based on 14 cases and 56 matched controls. The results support the finding of the main study, and there were no apparent differences in environmental-risk-factor profile in familial and nonfamilial cases. This unusual aggregation of familial pancreatic cancer among French Canadians cannot be explained by environmental factors alone. Some familial predisposition (hereditary factors) may play an important role in the etiology of this cancer, at least in this study region. The findings suggest the potential importance of conducting genetic studies of pancreatic cancer. PMID- 1787334 TI - Hepatic and pancreatic metabolism and biliary excretion of the protease inhibitor camostat mesilate. AB - The hepatic metabolism and biliary and pancreatic excretion of the serine protease inhibitor camostat mesilate and its metabolites FOY-251 and GBA were studied in rats in vivo and in in sutu liver-perfusion experiments. After oral feeding (100 mg/kg) and iv infusion (5 mg/kg.h) of camostat mesilate, the original compound and both metabolites appeared in bile, but could not be detected in pancreatic juice. In plasma, only FOY-251 and GBA were detected. In the perfused rat liver, camostat mesilate (10 microM) was eliminated by 33.8% and its molar rate of degradation to FOY-251 was 25.1%. During the study period about 0.1% of camostat mesilate and FOY-251 appeared in bile. The liver perfusion of FOY-251 or GBA revealed very low hepatic extraction rates of 10.3 and 2.4%, respectively. In conclusion, the low hepatic extraction rate of camostat mesilate and its metabolites leads to high concentrations of the active metabolite FOY-251 in plasma. Camostat mesilate and its metabolites are effectively excreted into bile, but not in rat pancreatic juice. PMID- 1787335 TI - Contribution of adrenergic nerves and the adrenals to 2-deoxy-D-glucose-induced insulin and glucagon secretion in the mouse. AB - The contribution of the adrenergic nerves and the adrenals to the increase in plasma levels of insulin, glucagon, and glucose that occurs in response to 2 deoxy-D-glucose (2-DG) was investigated in the mouse. Chemical sympathectomy by 6 hydroxydopamine or adrenalectomy was performed 48 h before intravenous injection of 2-DG (500 mg/kg). In controls, 2-DG increased the plasma levels of insulin, glucagon, and glucose (p less than 0.001). The insulin response to 2-DG was potentiated by adrenalectomy (p less than 0.01), but not affected by chemical sympathectomy. This indicates that the adrenals, but not the adrenergic nerves, restrain the insulin response to 2-DG. In contrast, 2-DG-induced glucagon secretion was partially inhibited by both chemical sympathectomy and adrenalectomy (p less than 0.001). This suggests contribution of both the adrenals and the adrenergic nerves to the glucagon response to 2-DG. Similarly, 2 DG-induced hyperglycemia was inhibited by both adrenalectomy (p less than 0.001) and by chemical sympathectomy (p less than 0.01). We conclude that, in the mouse, 2-DG activates the sympathetic nerves and the adrenals. This activation induces an inhibitory action on insulin secretion, exerted by the adrenals, and a stimulatory action on glucagon secretion, exerted by both the adrenergic nerves and the adrenals. PMID- 1787336 TI - Obesity as a predictor of severity in acute pancreatitis. AB - In order to determine whether the presence of obesity, defined as increased body mass index, would serve as a predictor of severity in acute pancreatitis, we have reviewed the medical records of 27 patients with severe acute pancreatitis. All patients had at least four positive Ranson's signs; all but three patients had at least five Ranson's signs. When the 13 patients with a fatal outcome were compared with the 14 who lived, neither obesity nor respiratory failure was an independent predictor of death. However, when the 27 patients were analyzed on the basis of whether they were obese (15 patients) or not obese (12 patients), obesity was an independent predictor of respiratory failure. Obesity was not a predictor of renal failure, pancreatic necrosis, or need for surgery. We suggest that obese patients with severe acute pancreatitis require close monitoring for the development of respiratory failure. PMID- 1787337 TI - Hyperlipidemia in acute pancreatitis. Relationship with etiology, onset, and severity of the disease. AB - Serum lipid (triglycerides and cholesterol) concentrations were studied in 49 patients with acute pancreatitis (AP). The aims of the study were to investigate the prevalence of hyperlipidemia (HL) in patients with AP according to etiology and to evaluate whether HL precedes or is a consequence of AP. Moreover, we analyzed the relationship between HL and the development of pancreatic necrosis. At admission, 23 patients (47%) had HL: 9 of 19 patients with alcoholic pancreatitis, 5 of 18 patients with biliary pancreatitis, and 9 of 12 patients with AP of miscellaneous etiologies (p less than 0.05). Severe HL (serum triglycerides greater than 20 mmol/L) was observed in five patients. Serum lipid levels in patients with AP and HL decreased markedly during the first 72 h of evolution, but remained slightly above the upper normal limit in most of them after 15 d. The prevalence of HL was similar in edematous and necrotizing pancreatitis. Necrotizing pancreatitis was significantly associated with the presence of hypertriglyceridemia in conjunction with hypercholesterolemia (p less than 0.05). The observations that a) hyperlipidemia is an early event in acute pancreatitis, (b) serum lipid values decrease during the acute phase of the disease, (c) hyperlipidemia has a different prevalence in different etiologies, and (d) high serum lipid levels are not always associated to pancreatic necrosis suggest that HL is a preexistent metabolic abnormality with respect to AP. On the other hand, HL may play a role in aggravating AP. PMID- 1787338 TI - Three cases of solid and cystic tumor of the pancreas. Analysis comparing the histopathological findings and DNA histograms. AB - The pathological findings in three cases of solid and cystic tumor (SCT) of the pancreas were compared with the nuclear DNA histogram obtained by flow cytometry. One case involved malignant SCT with liver metastases. Two of the cases were benign SCT. In the malignant SCT, cellular atypia and mitotic figures were extensively observed. The proliferation index (PI) was 25, and the DNA index (DI) was 1.65. In the benign SCT, cellular atypia and mitotic figures were rarely observed. The PI was 8 and 13, respectively, and the DI was 1.0 in both cases. The proliferative activity and the biological malignant potential of the malignant SCT were thought to be higher than those of the benign SCT. PMID- 1787339 TI - Elevation of serum phospholipase A2 in patients at an intensive care unit. AB - To evaluate the organ specificity of pancreatic phospholipase A2 (PLA2) and the diagnostic value of the elevation of serum PLA2 levels in patients with serious diseases not involving the pancreas, we studied the organ distribution of PLA2 in autopsy specimens and serum level of PLA2 in patients who required admission to an intensive care unit (ICU). PLA2 was measured by a specific radioimmunoassay (RIA), using monoclonal antibody against human pancreatic PLA2. Organ distribution of PLA2 revealed that the pancreas showed a much higher content of pancreatic PLA2 immunoreactivity than any other organ. An abnormally high value of serum PLA2 was observed in 18 of 30 patients (60%) at ICU. Both serum PLA2 and pancreatic isoamylase were elevated in 11 patients (37%). Of 11 patients with hyperphospholipasemia and hyperamylasemia, serum creatinine was elevated in five patients and blood urea nitrogen in nine patients. Serum PLA2 levels did not always rise comparably to serum creatinine and blood urea nitrogen levels. Serum PLA2 values showed the best correlation with serum lactate dehydrogenase levels among routine blood-chemistry tests. The elevation of serum PLA2 was ascribable to renal dysfunction or ischemic pancreatic damage secondary to circulatory collapse with multiple organ failure. PMID- 1787340 TI - Expression of the human mucin gene, Muc 1, in normal tissues and metastatic pancreatic tumors. AB - Expression of Muc 1 mRNA was evaluated in normal and metastatic-tumor tissues obtained from a patient who died from extensive metastasis of a well differentiated pancreatic adenocarcinoma. Northern blot analysis of total RNA from these tissues revealed that Muc 1 mRNA was detectable and unaltered in size in all metastatic tumor samples tested, including those from lymph node, liver, colon, and stomach. Southern blot analysis indicated that two forms of Muc 1 gene alleles were present in all normal and metastatic tissues of this patient with no evidence for gross rearrangement, deletion, or duplication. PMID- 1787341 TI - Antibacterial and mezlocillin-enhancing activity of pure human pancreatic fluid. AB - The majority of deaths in severe pancreatitis are the result of superinfection of necrotic tissue. The pathogen most commonly responsible for such infections is Escherichia coli. Antibiotic prophylaxis would appear a logical precaution. The antibacterial drugs of choice should possess two basic characteristics: they must be active against the flora responsible for the infections and must be capable of penetrating into the pancreas at adequate minimum inhibitory concentrations (MICs). Mezlocillin--which is active against E. coli--has been shown to possess the latter requisite, but achieving therapeutic concentrations requires administration at high doses. In the present study, pure human pancreatic fluid showed properties similar to those observed in the dog against E. coli (bacterial colony growth 100 times lower than in a control culture) and produced a 75% reduction in mezlocillin MICs against this organism. These enhancing characteristics might make the commonly used doses sufficient for prophylactic purposes. PMID- 1787342 TI - [Long-term follow-up results of anterior discectomy and interbody fusion for lumbar disc herniation]. AB - The long-term postoperative clinical courses were evaluated in 40 patients who underwent trans-peritoneal anterior discectomy and interbody fusion at our institution from 1955 through 1959. Thirty-four out of forty patients were followed up by physical and radiological examinations, and six by telephone interview. All subjects have been evaluated at least every 10 years after surgery. The results were as follows: 1) Thirty-four of forty (85%) patients were rated as satisfactory after a minimum 30-year follow-up. 2) Deterioration of the clinical course was probably attributable to age-related physical weakness. 3) The clinical results in the one-level fusion group were better than those in the two-level fusion group. 4) In the L4/5 fusion group, the adjacent disc degeneration was noted especially at the L3/4 level. Narrowing of the L3/4 disc was observed around 15 years after surgery irrespective of the patient ages at the time of follow-up examination. 5) In the L4/5 fusion group, the clinically significant X-ray findings included disc space narrowing, posterior olisthy, and horizontal displacement at the adjacent cranial level. PMID- 1787343 TI - [The cytotoxic mechanism of tumor necrosis factor (TNF) in human osteosarcoma cell line TE85--(1). Implication of phospholipase A2 activity in cytotoxicity]. AB - The cytotoxic mechanism of recombinant human tumor necrosis factor (TNF) in human osteosarcoma cells (TE85) was studied from the point of view of phospholipid metabolism. The TNF-induced cytotoxicity, determined by using the dye uptake method, was dose-dependent in the range of 100-10,000 U/ml. Phospholipid metabolism was analyzed in the cells labelled with [3H] arachidonic acid or [3H] glycerol. TNF stimulated the release of arachidonic acid and its metabolites from the cells in a dose-dependent manner. After TNF stimulation, the level of phosphatidylcholine (PC) decreased. Concomitantly, phospholipase A2 (PLA2) hydrolyzed PC producing a transiently increased level of lysophosphatidylcholine. ONO-RS-082, a potent PLA2 inhibitor, reduced the TNF-induced cytotoxicity and the release of arachidonic acid. These observations suggest that PLA2 may play a role in the cytotoxic effect of TNF on human osteosarcoma cells. PMID- 1787344 TI - [Experimental study on hydroxyapatite soaked in sodium fluoride--with special reference to bone formation]. AB - An experimental comparative study on bone formation regarding surface implantation was performed on thirty three adult mongrel dogs; using either a hydroxyapatite soaked in sodium fluoride (F-HAP) or a hydroxyapatite (HAP). F-HAP was made as follows: the HAP was soaked in 100ml of sodium fluoride solution of 5ppm., 10ppm. and 100ppm. concentration for an hour under vacuum deaeration+. Under general anesthesia, specimens were implanted into the bone immediately inferior to tibial tubercle by opening a window using a 3.5mm drill. Postoperative course was observed periodically (radiologically, macroscopically and histopathologically) from one to twelve weeks. There were no marked differences on X-rays or macroscopic findings between HAP and F-HAP. Histopathologically, there was significant new bone formation in the F-HAP specimens up until four weeks postoperatively. The 5ppm specimen especially indicated the most significant bone formation. The results of this study suggested that F-HAP was a better biomaterial (concerning new bone formation on the implant's surface) and that 5ppm was at optimal concentration for early new bone formation. PMID- 1787345 TI - [Alteration of leukotriene C4 levels in experimental spinal cord injury]. AB - Leukotriene C4 (LTC4) production in the guinea pig spinal cord following compression injury was determined by radioimmunoassay, in the same way thromboxane B2 (TXB2), a stable metabolite of thromboxane A2 (TXA2), was also measured. When the spinal cords were compressed under a 20 gram weight for 10 minutes, LTC4 levels reached peak values (2.2 +/- 0.4 pmol/g cord) 10 minutes after release, then gradually decreased until being undetectable 60 minutes later. TXB2 levels reached peak values (146.8 +/- 6.2 pmol/g cord) 5 minutes after the release from compression, the TXB2 level then gradually decreased, but remained at about 1/2 of the peak level even 60 minutes after the release. When the spinal cords were compressed with various weights, TXB2 production depended on the degree of compression, while LTC4 production was not affected by the compression injury. The LTC4 production confirmed in the injured spinal cords is suggestive of its relation to secondary disorders after spinal cord injury, spinal edema, in particular. PMID- 1787346 TI - [Immunohistochemistry of musculoskeletal tumors--the significance and evaluation]. PMID- 1787347 TI - [Pathology and etiology of pyogenic arthritis]. PMID- 1787348 TI - Kentucky mental illness awareness survey: attitudes and opinions. PMID- 1787349 TI - Posterior fossa vestibular neurectomy. AB - Many procedures have been devised to deal with intractable vertigo and conserve hearing, but despite this selective vestibular nerve section remains by far the most effective treatment. A series of 14 patients who underwent posterior fossa vestibular neurectomy is reported. The results are reported for vertigo control, hearing and tinnitus. All of the patients achieved vertigo control according to the AAOO (1972) reporting system. A simple and reliable system for the classification of the disability in these patients has yet to be devised. This problem is addressed and a disability grading system proposed, and discussed. PMID- 1787350 TI - A safer transnasal technique for the management of bilateral choanal atresia. AB - A study was undertaken on a 3.2 kilogram fresh stillborn neonate, to determine ways and means of preventing damage to the skull base. Gruber and Rosen aural specula were inserted separately into the right nostril, to determine the degree of exposure of the choana with each. The position of the surgeon was varied (septoplasty versus tonsillectomy position), to determine on which anatomical site of the choana the surgeon's field of vision was focused. The Gruber aural speculum, gave a completely, uninterrupted view of the choana. In the tonsillectomy position, the entire field of vision was focused on the choana itself, whilst in the septoplasty position, one half was focused on the choana and the other half on the roof. Since the roof is part of the skull base, damage to this area can result in serious intracranial complications, such as CSF leak and meningitis. These complications can be avoided if the surgeon uses the Gruber aural speculum for exposure and operates from a tonsillectomy position. PMID- 1787351 TI - Ultrastructure of nasal mast cells in normal subjects and patients with perennial allergic rhinitis. AB - The ultrastructure of mast cells from the nine normal inferior turbinates were compared with those found in eight patients with perennial allergic rhinitis due to house dust mite allergy. Forty-six mast cells from normal patients were found in forty blocks and eighty cells were found in thirty-three blocks in patients with perennial allergy suggesting an increase of mast cell numbers in perennial allergy. There were no basophils outside the blood vessels and whole mast cells were found only in the submucosa. There was no difference in the morphology of cells of different sizes. Mast cells were more degranulated in the allergic mucosa. Degranulation, irrespective of cell size was found at all depths of the mucosa. A review of the literature covered the in vivo and in vitro descriptions of the ultrastructural morphology of human mast cells in the respiratory tract. PMID- 1787352 TI - Fibre-optic endoscopy in atrophic rhinitis. AB - Primary atrophic rhinitis seems to have a high prevalence in the arid regions bordering the great deserts of Saudi-Arabia. Fibre-optic endoscopy was performed on 42 patients treated surgically. Fibre-optic endoscopy demonstrated the presence of crusts in the nasal cavities and their subsequent reduction following surgery. It also demonstrated ulceration of the cartilaginous nasal septum in some cases and this may explain the pathogenesis of septal perforation noted in a high number of our patients. Fibre-optic nasendoscopy was also helpful in demonstrating the reappearance of free mucus in the nasal cavity and helped to determine the optimal time for reversing Young's procedure. Fibre-optic nasendoscopy is a reliable tool for verifying the results of surgery and comparing the efficacy of various treatment modalities. PMID- 1787353 TI - Calvarial bone grafts for augmentation rhinoplasty. AB - A large variety of graft materials have been used for augmentation rhinoplasty. To date there has been no graft material which can be regarded as completely satisfactory. The modern trend is to prefer autologous material to new biological material. The membranous bones of the calvarium are extremely suitable for augmenting moderate to severe saddle nose deformities. Calvarial bone grafts can be harvested easily, with minimum donor site morbidity and disfigurement. Our experience with calvarial bone grafts for augmentation rhinoplasty is presented. PMID- 1787354 TI - An assessment of the incidence of iron deficiency in paediatric otolaryngology inpatients. AB - The aims of this study were: to determine whether there is an increased incidence of iron deficiency in paediatric otolaryngology inpatients compared with other surgical controls; and to establish whether preoperative screening of haemoglobin level is warranted in such patients. Children aged 1-10 years admitted electively for ENT surgery or for general surgical procedures had blood taken for haemoglobin level, mean cell volume and serum ferritin. Their age, weight, socioeconomic class and ethnic background were recorded. A total of 100 patients entered the study, in a six-month period. The mean ages and weights for the two groups were statistically different, so allowance was made for this in calculations. Social class was not significantly different. No relationship could be established between haemoglobin level and ferritin level for individual patients. Multiple regression analysis for haemoglobin level, mean cell volume and for ferritin level showed that allowing for the age and weight differences these variables were not significantly different for the two groups. This study has therefore shown no increased incidence of iron deficiency in paediatric ENT inpatients. Each Department should formulate its own policy on pre-operative haemoglobin screening, based on local considerations. PMID- 1787355 TI - Parapharyngeal abscesses. AB - Fifty-five patients with deep neck infections treated consecutively over a period of six and a half years between January 1983 and July 1989 were reviewed. Nine of these patients had abscesses localized to the pharapharyngeal space and form the basis of this study. The aetiology of the parapharyngeal abscess was odontogenic in two patients and remained unknown in the other seven. Five patients had associated systemic disease; four were diabetics and one patient had non Hodgkin's Lymphoma. High dosage intravenous antibiotics directed towards the causative micro-organisms, airway control and early surgical intervention was the mainstay of treatment. All patients underwent open surgical drainage of the parapharyngeal abscess within 24 h of admission. Bacteriology results showed Klebsiella sp. to be the dominant micro-organism cultured in four patients. Morbidity was low; seven patients had no post-operative complications and were discharged from the hospital between 7-24 d (mean 12.9 d). There were two deaths. Early open surgical drainage remains the most appropriate method of treating parapharyngeal space infections; it avoids life threatening complications with rapid recovery. PMID- 1787356 TI - Serum cotinine as an objective marker for smoking habit in head and neck malignancy. AB - Cigarette-smoking is a well-established aetiological factor in squamous cell carcinoma of the larynx. In Great Britain the majority of patients with laryngeal cancer are treated by radiotherapy with salvage surgery if necessary. A troublesome side effect of radiotherapy is mucositis which may exacerbate hoarseness, dysphagia, airway obstruction or pain. Although it is a common belief that continued smoking and alcohol consumption during radiotherapy may increase the frequency and severity of these side effects this has not been demonstrated objectively. This study confirms and illustrates the relationship between such radiotherapy reactions to continued smoke exposure by using an objective biochemical marker of smoking status. PMID- 1787357 TI - Surgical treatment of laryngomalacia. AB - Laryngomalacia is the commonest cause of congenital stridor. The majority of cases are mild and do not require surgical intervention. However in approximately 10 per cent of these infants the condition is life-threatening. The standard treatment for these patients has been to perform a tracheostomy. Recent reports have shown encouraging results following endoscopic surgery to the supraglottic structures. We report a series of twelve patients in whom a tracheostomy was avoided by performing an aryepiglottic fold trim--'aryepiglottoplasty'. Dramatic improvements were seen in the respiratory obstruction and failure to thrive following surgery. PMID- 1787358 TI - A guide to the selection of paediatric tracheostomy tubes. AB - A large range of tracheostomy tube types and sizes are available for use in children. Regional preference, rather than individual patient assessment, tends to determine selection. We present a table designed to assist with appropriate size selection, and discuss the relative merits and shortcomings of the tubes currently available. PMID- 1787359 TI - Nutritional support in patients with low volume chylous fistula following radical neck dissection. AB - One of the well known complications of radical neck dissection is a chylous fistula, which results from injury to the thoracic duct as it enters the left subclavian vein. Such fistulae may cause considerable increased morbidity to a patient who is already debilitated by malignancy and by the increased catabolic response to surgery. Further surgery may be appropriate for those with a high fistula output but conservative therapy is normally advocated for the remainder. Nutritional and electrolyte support for these patients is essential and poses potential problems in management. We present three such patients. One was fed parenterally and two enterally and in all cases the fistulae closed spontaneously. We examine the known physiological stimuli to chyle production and conclude that the enteral feedings of these patients with fat or an isomolar enteral feed does not, contrary to current belief, increase chyle flow or delay the healing of these fistulae. PMID- 1787360 TI - Primary mucosal malignant melanoma of the middle ear. AB - Only one case of primary malignant melanoma of the middle ear has been reported in the literature to date. We report a case of middle ear and nasopharyngeal malignant melanoma where the primary is likely to have arisen in the middle ear and discuss the relevant literature. PMID- 1787361 TI - Atypical leiomyoma of the choana. AB - Leiomyomas of the nose, nasopharynx and paranasal sinuses are rare. So far only two atypical leiomyomas at these sites have been reported in the English literature. A new case is presented and the literature on the subject is reviewed. PMID- 1787362 TI - Post-irradiation leiomyosarcoma of the maxilla. AB - Primary malignant smooth muscle tumours of the maxilla are extremely rare. A case of leiomyosarcoma of the maxilla associated with previous irradiation is presented. The aetiology, pathology and clinical aspects of this tumour are reviewed. PMID- 1787363 TI - Acute isolated sphenoid sinusitis: a disease with complications. AB - A case of acute isolated sphenoid sinusitis is described in a twelve year old boy who presented with ophthalmic complications. The literature is reviewed to emphasize the potential dangers of this condition. PMID- 1787364 TI - Metastatic seminoma of the sphenoid sinus. AB - Metastatic tumour of the sphenoid sinus from distant primary sites are rare. If sphenoid involvement from adjacent structures is excluded there have been 26 reported cases of metastatic sphenoid sinus tumours. Seminoma metastatizing to other paranasal sinuses has been reported but a careful literature search did not reveal this occurring previously in the sphenoid sinus. PMID- 1787365 TI - Cervical cord compression complicating tracheo-oesophageal puncture. AB - Tracheo-oesophageal puncture for voice restoration is now established as a common procedure in the postlaryngectomy patient. We present what we believe to be the first recorded case of osteomyelitic cervical cord compression following this technique. This is a potentially fatal complication, but diagnosis and active surgical intervention can result in recovery of full neurological function. PMID- 1787366 TI - Chronic bone abscess as an unusual cause of dysphagia. AB - Chronic infections following cervical spine surgery are rare. Here we describe an unusual case presenting five years after anterior spinal fusion. PMID- 1787367 TI - C.T. demonstration of metastatic anaerobic orbital abscess. AB - Orbital abscess of rhinosinogenic origin may develop, either by contiguous spread of the infection or by a thrombophlebitic process. While destruction of the bony walls of the paranasal sinus occurs in propagation of the infection by tissue continuity, haematogenous spread may take place through intact bone. Computed tomography demonstrates the status of the bony partitions shared by the orbit and paranasal sinuses, and the source of the orbital sepsis, thereby influencing the therapeutic approach. PMID- 1787368 TI - Hamartomatous tonsillar polyp. AB - A 41-year-old male Egyptian patient presented with difficulty in swallowing, snoring, and the sensation of a lump in his throat over a long period of time. On examination, a left tonsillar polyp was seen (4 x 2 x 1 cm) which was pedunculated, bilobulate, with an intact surface. The polyp was excised under local anaesthesia and histopathological examination revealed an haemangiomatous hamartomatous polyp. PMID- 1787369 TI - The limited accuracy of bone conduction audiometry. PMID- 1787370 TI - A case of tinnitus and vertigo treated by division of the auditory nerve. 1904. PMID- 1787371 TI - A case of attempted division of the eighth nerve within the skull for the relief of tinnitus. Clinical Society of London. 1904. PMID- 1787372 TI - A case of attempted division of the eighth nerve within the skull for the relief of tinnitus. 1904. PMID- 1787373 TI - A case of division of the auditory nerve for painful tinnitus. 1908. PMID- 1787374 TI - The saccus endolymphaticus and an operation for draining the same for the relief of vertigo. 1927. PMID- 1787375 TI - Ear surgery camps in Nepal and the work of the Britain Nepal Otology Service (BRINOS). AB - The Britain Nepal Otology Service (BRINOS), founded as a registered charity in 1988, has so far held four ear surgery camps in Nepal, sponsored and organised a nationwide survey of the prevalence and causes of ear disease and deafness and is sponsoring a pilot scheme of primary care for ear disease. Seven thousand outpatients have been seen, 270 major and 170 minor ear operations have been performed in the four ear surgery camps. PMID- 1787376 TI - An unusual case of traumatic haematoma of soft palate. AB - Ingestion of small bones often causes oropharyngeal trauma. I present an unusual case of a potentially life-threatening haematoma of the soft palate caused by a chicken bone. To my knowledge, this is the only case reported in the English literature. PMID- 1787377 TI - An unusual oronasal foreign body. AB - An unusual case of oronasal foreign body in a child is reported. A plain lateral X-ray of the head was carried out to show the shape and position of the foreign body; it was also useful in planning removal. Ribbon gauze impregnated with vaseline was packed around the sharp end of the metal in the nostril to protect the nasal mucosa from further trauma while removing it. We recommend this technique. PMID- 1787378 TI - Photographs of a case of rapid destruction of the nose and face. 1897. PMID- 1787379 TI - Effect of middle ear effusion on the vestibular labyrinth. AB - Although middle ear effusion was once described as the most common cause of vestibular disturbance in children, the association between glue ear and symptoms of dysequilibrium has never been quantified objectively. In this study the effect of middle ear effusion on the vestibular system of the inner ear was studied in a select group of children suffering from long lasting effusion in the middle ear with no evidence of infection at least one year prior to the study. The results were compared with results obtained from otitis free children, as well as from examinations of children after the insertion of ventilating tubes. The results of this study confirm the assumption that middle ear effusion has an adverse effect on the vestibular system, which can be resolved following the insertion of ventilation tubes. This effect may also contribute to the adverse effect that otitis media has on a child's development. PMID- 1787380 TI - The value of CT scanning in chronic suppurative otitis media. AB - High definition CT has been advocated for the evaluation of chronic suppurative otitis media (CSOM) either generally or in selected cases. It is said to be capable of producing the fine detail needed to detect lateral canal fistulae, exposed dura and facial canal dehiscences, and to demonstrate the ossicular chain. At present there is no agreement on either the indications for CT scanning in CSOM or the most appropriate scanning plane. To determine the value of high definition CT in CSOM and to decide a unit policy for its application, 36 cases of CSOM underwent pre-operative CT scanning and their scans were compared with the operative findings. Our results show CT to be highly sensitive to the presence of soft tissue disease and bone erosion, moderately sensitive to the presence of lateral canal fistulae but less sensitive to the presence of small areas of exposed dura, ossicular continuity and facial canal dehiscence. Axial scans were better able to demonstrate the lateral canal but otherwise coronal scans were superior; ideally patients should be scanned in both planes. The principle value of CT in CSOM is its ability to demonstrate disease which is not clinically apparent. PMID- 1787381 TI - Congenital cholesteatoma. AB - We present a British series of eleven patients with primary cholesteatoma, including one patient with bilateral disease. Eight children presented with a history of hearing loss, while one child had had recurrent otitis media and another had had earache. Operative findings were: in five ears, cholesteatoma confined to the antero-superior segment with intact ossicles, in a further four, cholesteatomas extending throughout the mesotympanum with ossicular erosion in one, and in two ears posterior disease throughout the middle ear and mastoid, which had eroded the ossicles in both cases. The five cases of antero-superior cholesteatoma lend most support to Michaels' concept of epidermoid formation as a possible source of congenital cholesteatoma. With a greater awareness of the problem and careful examination of the antero-superior quadrant of the tympanic membrane, earlier diagnosis may be possible enabling removal of small intact cholesteatoma sacs and preserving the structures of the middle ear and therefore the hearing. A screening programme for infants included as part of their routine examination which would be undertaken by examiners who are trained to be more aware of the problem and skilled at otoscopy, would help in the earlier detection of such cases as is shown by reports from the U.S.A. PMID- 1787382 TI - Gentamicin administration via peritoneal dialysis fluid: the risk of ototoxicity. AB - In a prospective study on 47 patients, 16 mg of gentamicin per two litres dialysate was administered intraperitoneally at every cycle of intermittent peritoneal dialysis, carried out over the course of several days. Serum gentamicin sampling, pure tone audiometry and caloric tests were performed before and during the treatment. The gentamicin levels reached at the end of the thirtieth cycle were observed to be low. In view of this, the risk of acute ototoxicity was considered to be minimal. This was confirmed by the absence of clinical audiometric or vestibulometric evidence of toxicity. PMID- 1787383 TI - Thrombosis and hemorrhage in thrombocytosis: evaluation of a large cohort of patients (357 cases). AB - We report clinical and laboratory findings in a large cohort of patients with thrombocytosis (357 cases). At the time of study, the patients showed a platelet number greater than 500 x 10(9)/L. The follow-up of patients ranged between 3 and 16 years. 123 patients were affected by polycythemia vera (PV), 97 by essential thrombocythemia (ET), 13 by chronic myeloid leukemia (CML) and 31 by myelofibrosis (MF). In 93 subjects, the thrombocytosis was reactive (ST). We found the highest incidence of thrombosis in PV patients, especially concerning the cerebro-vascular system; thrombosis, but in a lower percentage, was recognized in MF patients. Also, ET patients showed a number of thrombosis in peripheral arteries. Thrombosis of the coronary arteries were quite rare while 25% of MPD subjects showed peripheral vein thrombosis. We take into account that many patients showed thrombocytosis associated to one or more atherosclerotic risk factors. Hemorrhages were present especially in CML and in ET, but were not as frequent as thrombosis. The most common bleeding manifestations affected skin and mucosa. Hemorrhages after surgical procedures were also frequent. Gastro intestinal bleeding was not strictly related to anti-aggregating therapy and occurred not only in PV but also in ET patients. PMID- 1787384 TI - T-zone lymphoma in association with systemic lupus erythematosus. AB - Two patients with systemic lupus erythematosus (SLE) and T-zone lymphoma are described. On admission, both showed arthralgia, generalized lymphadenopathy, hypergammaglobulinemia and positive antinuclear antibody. Lymph node biopsies revealed diffuse infiltration of atypical T-lymphocytes in the expanded interfollicular area (T-zone), a finding characteristic for the T-zone lymphoma. Renal biopsy showed lupus nephritis and neoplastic lymphoid cell infiltration in the glomeruli of one patient, but only diffuse infiltration of neoplastic lymphoid cells and mature plasma cells were observed in the interstitium of the other patient. Both patients responded remarkably well to prednisolone (1 mg/kg/day). PMID- 1787385 TI - The effect of in vitro irradiation on human NK cell activity. A preliminary report. AB - Natural killer activity of peripheral blood cells was evaluated after in vitro irradiation at doses ranging between 100 and 1600 cGy. Natural killer (NK) cells from normal donors exhibited a trend towards increased cytotoxicity peaking at about 600 cGy and then gradually decreasing. NK cells isolated from peripheral blood of cancer patients showed a lower baseline of activity, which was less affected by the same doses of in vitro irradiation. A distinction could be made between patients with early disease and those with advanced cancers; patients with early cancers showing NK activity close to that of normal donors. PMID- 1787386 TI - A comparison of the nutritional status of elderly Chinese living in different types of non-acute care institutions in Hong Kong. AB - The nutritional status of 191 elderly subjects living in three types of non-acute care institutions was studied by estimating nutrient intake and biochemical status. The dietary intake of women in the long-stay institution was similar to that of free-living elderly subjects. Dietary consumption of subjects living in a private nursing home and a convalescent unit were poorer than for elderly free living subjects. Elderly women in all institutions had a poorer protein nutritional status, a poorer biochemical status of vitamin B12, folate, ascorbic acid, and vitamin D, and lower plasma potassium levels when compared with free living elderly women. Those in the private nursing home and the convalescent unit had the poorest protein nutritional status. Among men, institutionalized subjects were observed to have poorer thiamine and riboflavine status, in addition to the above findings. The greater prevalence of chronic diseases and disability in the convalescent unit and the private nursing home may partly account for the poorer nutritional status of residents in these two institutions. PMID- 1787387 TI - An unusual case of chronic lymphocytic leukemia. AB - The degree of involvement of the bone marrow in chronic lymphocytic leukemia (CLL) is shown to closely correlate to the clinical stage of the disease. A patient with CLL who has been on chronic steroid therapy is described, with marrow findings inconsistent with his clinical presentation. PMID- 1787388 TI - Germ-line gene therapy: back to basics. PMID- 1787389 TI - Human germ-line therapy: the case for its development and use. AB - The rationale for pursuing the development and use of germ-line selection and modification techniques is examined in this essay. The argument is put forth that it is the moral obligation of the medical profession to make available to the public any technology that can cure or prevent pathology leading to death and disability, in both the present and future generations. Society should pursue the development of strategies for preventing or correcting, at the germ-line level, genetic features that will lead to, or enhance, pathological conditions. Because prenatal screening and even early embryo screening and selection can prevent only a subset of known genetic disorders, direct genetic intervention is the only way in which certain couples can exercise their rights to reproductive health. Finally, the arguments most often raised against the pursuit of and use of methods for germ-line intervention shall be discussed. PMID- 1787390 TI - Commentary: how do we think about the ethics of human germ-line genetic therapy? AB - The line between germ-line genetic therapy and somatic cell is more and more difficult to discern. With new abilities to effect germ-line genetic therapy it is less clear why such therapy should not be undertaken. Nonetheless, questions persist as to who is the patient in such therapy and about the extent of discretion that should be allowed prospective parents and the physician/researcher. PMID- 1787391 TI - Ethical issues in manipulating the human germ line. AB - This essay examines the arguments for and against working towards the objective of human germ line engineering for medical purposes. Germ line changes which result as a secondary consequence of other well designed and ethically acceptable manipulations of somatic cells to cure an otherwise fatal disease can be seen as acceptable. More serious objections apply to intentional germ line interventions because of the unacceptability of using a person solely as a vehicle for creating uncertain genetic change in his descendants. It is also morally unacceptable to use the promise of future benefit to experiment on fetuses or embryos when other more effective technologies exist to help parents have healthy children. Using new genetic technologies to select desirable genotypes among gametes is less problematic and affords a promising new technique for avoiding intergenerational harms. PMID- 1787392 TI - Commentary: maintaining the somatic/germ-line distinction: some ethical drawbacks. AB - Determinations of the ethical acceptability of genetic therapy have relied on several distinctions in attempts to separate ethically acceptable genetic therapy from those possible therapies that could lead to genetic modifications of future human beings. One distinction that has been proposed is that genetic modifications of human somatic cells is ethically acceptable but that germ-line genetics modifications would be ethically objectionable. This paper examines several serious difficulties which call into question the ethical relevance of a somatic/germ-line distinction. PMID- 1787393 TI - Germ-line engineering: a few European voices. AB - We have surveyed various recent European opinions on germ-line engineering. The majority express more or less severe reservations about any interventions on the human germ-line, including therapeutic ones. However, they are divided over the pragmatic, or categorical-ethical nature of the relevant arguments. This split reflects two competing views of technology. The 'pessimistic' one is deeply concerned by the slippery slope leading from bona fide therapeutic applications of genetic engineering to eugenic practices. It insists that, if anything can defend us against these evils, it must be a set of strong, ethically-based prohibitions. The other, 'optimist' view is more confident in the discriminating powers of societal regulation. We argue for the latter view and suggest that the pragmatic arguments brought to this debate are less problematic than the ethical ones. PMID- 1787394 TI - Genetic disorders and the ethical status of germ-line gene therapy. AB - Recombinant DNA technology will soon allow physicians an opportunity to carry out both somatic cell- and germ-line gene therapy. While somatic cell gene therapy raises no new ethical problems, gene therapy of gametes, fertilized eggs or early embryos does raise several novel concerns. The first issue discussed here relates to making a distinction between negative and positive eugenics; the second issue deals with the evolutionary consequences of lost genetic diversity. In distinguishing between positive and negative eugenics, the concept of malady is applied as a definitional criterion for identifying genetic disorders that could qualify for germ-line therapy. Because gene replacement techniques are currently unavailable for humans, and because even if they were possible the number of people involved would be quite small, the loss of diversity concern seems moot. Finally, we discuss the issue of iatrogenic disorders associated with gene therapy and discuss several 'real world considerations.' PMID- 1787395 TI - Human tecodic allaxis: an essay in terminology. AB - What kinds of new terminology might be useful in discussions of human germline engineering and the bioethics thereof? There are two different schools of thought about how best to devise new terminology for molecular biology: the 'common-usage school', and the 'classicist school'. The relative advantages and disadvantages of each are examined. Finally, several new terms are proposed and discussed. PMID- 1787396 TI - Permethrin and dimethyl phthalate as tent fabric treatments against Aedes aegypti. AB - Tests were conducted to determine the persistence of compounds applied to tents to protect against mosquitoes. Interiors of 2 camping tents were treated by the manufacturer--one with the repellent dimethyl phthalate (DMP) and one with the insecticide permethrin. A third tent was untreated. Tents were set up outdoors and exposed to weathering for one year. Weekly tests were conducted by releasing Aedes aegypti into the tents, then recording knockdown (KD) and biting behavior during a 3-h period. Weather data were collected 24 h/day during the study. Year long mean KD of mosquitoes exposed in the tent to permethrin was 58.6%, to DMP 2.7% and the control 0.9%. Mean biting was 11.9, 43.8 and 58%, respectively. Under constant exposure to weathering, the permethrin-treated tent gave best results with average protection from bites greater than 96% for 9 months (DMP was less than 31%). Although preliminary, the data suggest permethrin would be effective as a tent treatment to reduce annoyance of mosquitoes. PMID- 1787397 TI - Potential use of bendiocarb (Ficam VC) for malaria control in an area of Zimbabwe. AB - Ficam (bendiocarb) was tested for its residual efficacy and irritation in malaria vector control by using a laboratory bred colony of Anopheles arabiensis. In the study area, the insecticide remained active for up to 8 wk (96% mortality) on thatch. In similar, especially constructed huts, 74% mortality was achieved up to 20 wk on mud compared with up to 100% on thatch. In the special huts, release/capture studies indicated that the lethal effect of Ficam on the insects was more pronounced than its irritant effect. This was shown by the low recapture numbers in exit traps as compared with the hut-floor mortalities. The implications of these findings in relation to studies elsewhere and the potential of Ficam use in malaria control are discussed. PMID- 1787398 TI - Heat-shock mortality and induced thermotolerance in larvae of the mosquito Anopheles albimanus. AB - Temperature effects on Anopheles albimanus larval survival were investigated. Larvae were exposed to 30 min heat shocks at various temperatures. Almost no mortality was observed at 40 degrees C, but was complete at 43 degrees C. Increased larval thermotolerance could be induced by higher rearing temperature or by a 30 min exposure to 37 degrees C. PMID- 1787399 TI - Development and survival of Anopheles pharoensis and An. multicolor from Faiyum, Egypt. AB - Adults of Anopheles pharoensis and An. multicolor were held under cycling environmental conditions in the laboratory to examine the duration of the gonotrophic cycles, survival and life expectancy, and to examine the life table characteristics of F1 larvae. The first gonotrophic cycle took 6.14 and 7.37 days for An. pharoensis and An. multicolor, respectively. Subsequent gonotrophic cycles for the 2 species were shorter. Daily survival rates of An. pharoensis and An. multicolor in the laboratory were 0.95 and 0.93, respectively. The parity rate of field-collected females and estimates of the duration of the gonotrophic cycle yielded daily survivorship estimates of 0.89 and 0.80 for An. pharoensis and An. multicolor, respectively. Mean life expectancy at emergence was 19.0 days for An. pharoensis compared with 17.9 days for An. multicolor. Survivorship from egg eclosion to adult emergence and development time were similar for both species. Both the duration of gonotrophic cycles and mean life expectancies indicated that An. pharoensis had a greater potential to serve as a malaria vector than An. multicolor. PMID- 1787400 TI - Evaluation of a microgel droplet formulation of Bacillus sphaericus 1593 M (Biocide-S) for control of mosquito larvae in rice fields in southern India. AB - A new microgel droplet formulation of Bacillus sphaericus 1593 M (Biocide-S) was tested at 2 rates against culicine vectors of Japanese encephalitis and Anopheles subpictus. A single application just after transplantation of rice seedlings prevented the buildup of anopheline as well as culicine populations, and gave 83 100% reduction of pupal density at the lower rate (2.2 kg/ha) and 87-100% reduction at the higher dosage (4.3 kg/ha) for at least 5 weeks. During the last 3 wk before harvest, density was naturally very low and the efficacy of the treatment could not be assessed. This formulation has a potential for control of riceland mosquitoes, but a suitable delivery system is required before it can be considered for practical control. PMID- 1787401 TI - Sustained release pellets for control of Culex larvae with Bacillus sphaericus. AB - Bacillus sphaericus was formulated in pellets with partially hydrogenated vegetable oil, talc and a starch-based superabsorbent polymer. This formulation increased the residual activity against Culex spp. larvae in large and small plots, including polluted water. When the pellets were applied to dry artificial larval habitats 5 days prior to flooding, the Psorophora columbiae that hatched at the time of flooding were eliminated. After the pools were dried and reflooded, 611 Bacillus colony-forming units/ml were present in the surface water. An equivalent amount of primary powder suspension was ineffective as a preflood treatment, apparently due to solar inactivation of the toxin. PMID- 1787402 TI - Anopheles gambiae as a host for geographic isolates of Plasmodium vivax. AB - The G-3 strain of Anopheles gambiae was compared with 2 other strains of An. gambiae and An. freeborni, An. stephensi, and An. dirus for susceptibility to infection with 7 different geographic strains of Plasmodium vivax. Ratios of infection varied, indicating that certain strains of P. vivax were more infectious to the G-3 strain of An. gambiae than to other anopheline species/strains. Based on the comparative number of oocysts per mosquito, the relationships between the 3 strains of An. gambiae were closer than between the G 3 strain of An. gambiae and the 3 other species of Anopheles. Anopheles gambiae appears to be a very useful host for laboratory studies with P. vivax from different geographic origins. PMID- 1787403 TI - Potential for dengue in South Africa: mosquito ecology with particular reference to Aedes aegypti. AB - Observations on prevalence, geographical distribution, utilization of artificial larval habitats and anthropophilism were made on diurnal mosquitoes at selected localities along the coast of Natal and inland in the Transvaal to identify potential vectors of dengue in South Africa. Larval collections made in artificial containers on the ground, the exposure of bamboo pots as ovitraps in trees and collection of mosquitoes biting man showed the following species as the most likely candidates for vectors: Aedes aegypti, Ae. demeilloni, Ae. simpsoni, Ae. strelitziae, Ae. furcifer, Ae. cordellieri and Eretmapodites quinquevittatus. The bamboo pots showed that Ae. aegypti and Ae. simpsoni were the most widespread species, occurring at 11 of 12 localities. Aedes aegypti was the most prevalent species with mean pot index of 60.3 +/- 9.8% (SE) and abundance index of 0.43 +/- 0.15 (SE). Aedes aegypti was frequently present as larvae in artificial containers at indices of 11-83% (mean 56.8 +/- 5.6%, SE) and was the most anthropophilic species with average biting rates of 10-29 per man-hour at 7 localities. Although Ae. aegypti was abundant in the pots at Ndumu (northern Natal) and at Skukuza (eastern Transvaal), the local populations were poorly anthropophilic at these localities. At some localities, populations of Ae. demeilloni, Ae. simpsoni and Ae. strelitziae had average biting rates of 5.4-9.6 per man-hour. Aedes furcifer was collected for the first time at Durban, extending its distribution southward to latitude 29 degrees 53' S. PMID- 1787404 TI - Temperature effects on the gonotrophic cycle of Culicoides variipennis (Diptera: Ceratopogonidae). AB - The duration of oogenesis and time to oviposition after blood feeding was studied in Culicoides variipennis held at constant laboratory temperatures. As assessed by daily dissection of ovaries, the time required for greater than or equal to 80% of females to complete egg development at 13, 17, 21, 27, 30 and 34 degrees C was 10, 5, 4, 3, 2 and 2 days, respectively. Mean times to oviposition at these temperatures were 13.8, 8.2, 4.9, 3.6, 3.0, and 2.6 days, while modal values were 13, 6, 4, 3, 3 and 3 days, respectively. Allowing 7 days after onset of oviposition in groups of 100-150 females, cumulative eggs laid/live female were 4.4, 62.6, 68.9, 63.5, 66.5 and 62.4, respectively. These data should prove helpful in estimating the duration of the gonotrophic cycle and deriving daily survivorship estimates from seasonal parity studies in the field. PMID- 1787405 TI - Gel diffusion analysis of Anopheles bloodmeals from 12 malarious study villages of Orissa State, India. AB - In Orissa State, India, the double gel diffusion technique was used to analyze 97,405 bloodmeals of all fed anophelines that were caught during standardized monthly surveys in 12 malarious study villages, from 1982 through 1988. Anopheles culicifacies contributed the highest number of smears from the 19 Anopheles species recovered. It was observed that a pronounced predilection to take mixed bloodmeals attenuates the vector potential of the species concerned. Consequently, prevalences based only upon "pure" (unmixed) primate bloodmeals provide the most accurate way to assess the intensity of feeding contact that actually occurs between a given species and man. By this method, the ranking order is Anopheles fluviatilis, An. culicifacies and An. annularis (N); a sequence which concurs with current knowledge on the vector status of malaria mosquitoes in Orissa. PMID- 1787406 TI - Field evaluation of an insect growth regulator, pyriproxyfen, against Anopheles punctulatus on north Guadalcanal, Solomon Islands. AB - Five pools containing immature stages of Anopheles punctulatus were treated with pyriproxyfen at 4 different dosages. Inhibition of adult emergence was observed in pupae collected from the test pools and/or those obtained by rearing of the 4th instar larvae. Adult emergence was inhibited completely for 2 months at a dosage of 0.1 ppm, for one month at 0.05 ppm and 0.01 ppm, and for 20 days at 0.02 ppm. Death of test insects were observed at the pupal stage and at adult emergence. The mortality rate at adult emergence increased with the duration of larval rearing and with the elapse of time after application. PMID- 1787407 TI - Activity of new formulations of methoprene against midges (Diptera: Chironomidae) in experimental ponds. AB - The IGR, methoprene, in 3 solid (Altosid Pellet, Altosid XR Briquet and a granular) and a liquid formulation (A.L.L.) was evaluated against chironomid midges in experimental ponds. The A.L.L. was applied at 0.293 liters/ha (0.015 kg AI/ha) and at 5.86 liters/ha (0.28 kg AI/ha). The granules, pellets and briquets were applied at 13 kg/ha (0.17 kg AI/ha), 5.6 kg/ha (0.22 kg AI/ha) and one briquet/8m2 (0.82 kg AI/ha), respectively. The low rate of A.L.L. was ineffective, but the high rate produced 84-100% control of Tanytarsini and 30 100% of Chironomini during 2 wk posttreatment. The granular formulation gave 61 87% control of total midges in 2 wk posttreatment. Altosid Pellets gave initial and prolonged good control of Tanytarsini (64-99% for 7 wk), Chironomini (79-94% for 5 wk) and total midges (64-98% for 7 wk). The briquets at almost 4x the rate of pellets, yielded 38-98% control of midges for 7 wk posttreatment. Altosid Pellets have an excellent potential for midge control. PMID- 1787408 TI - Impact of stressful conditions on the survival of Culex pipiens exposed to Rift Valley fever virus. AB - Several groups of Rift Valley fever (RVF) virus-exposed and unexposed Culex pipiens were allowed differential access to a carbohydrate food source and their survival monitored. When stressed by deprivation of a carbohydrate source, mean survival times of RVF virus-exposed mosquitoes were consistently higher than those of unexposed mosquitoes in each of the carbohydrate-deficient experiments. These differences were statistically significant when mosquitoes were provided 5% sucrose for 24 hours. Mosquitoes that were provided access to a carbohydrate source for 24 h after a bloodmeal and then were denied access survived significantly longer than did those mosquitoes denied access, regardless of their exposure to RVF virus. When not stressed, RVF virus-exposed individuals had slightly higher daily survival rates than did unexposed individuals. PMID- 1787409 TI - Tree hole Culicoides (Diptera: Ceratopogonidae) of the Central Plains in the United States. AB - Three-hundred eleven tree holes were sampled for Culicoides at 27 localities in Colorado, Kansas, Nebraska, Oklahoma and South Dakota. Of the 311 samples taken, 170 produced specimens, and 2,899 Culicoides were collected including 12 species. The 5 most common species (number collected) were C. guttipennis (1,468), C. arboricola (355), C. paraensis (292), C. elemae (186) and C. footei (159). Other species collected were C. villosipennis, C. nanus, C. hinmani, C. oklahomensis, C. snowi, C. lahillei and C. byersi. New state records include C. byersi and C. arboricola for Colorado; C. arboricola for Wyoming; and C. lahillei, C. elemae, C. nanus and C. paraensis for Oklahoma. Culicoides byersi, whose larval habitat was previously unknown, was reared from a cottonwood tree hole. PMID- 1787410 TI - Efficacy and persistence of sustained-release methoprene pellets against Aedes mosquitoes in an irrigated pasture. AB - The efficacy and persistence of sustained-release methoprene (Altosid) pellets were evaluated at rates of 3.4 and 9.0 kg/ha against Aedes mosquitoes through 7 flood cycles (126 days) in an irrigated pasture. At both rates, the pellets provided greater than 98% control through 2 flood cycles, or 20 days posttreatment, and greater than 80% control through 5 flood cycles, or 69 days posttreatment. PMID- 1787411 TI - A new method for monitoring mosquito oviposition in artificial and natural containers. AB - A new method is described for the direct measurement of Aedes albopictus, Ae. atropalpus, Ae. triseriatus and Orthopodomyia signifera oviposition in artificial and natural containers. Seed germination papers were mounted on the insides of can-traps, tree holes and discarded tires to obtain a direct measure of mosquito oviposition. This durable paper substrate was removed weekly while minimizing the disruption of the oviposition habitat. After the germination papers were dried, the aforementioned mosquito eggs were hatched successfully and reared in the laboratory through the adult stage. PMID- 1787412 TI - Antibodies to La Crosse virus in eastern chipmunks in Indiana near an Aedes albopictus population. AB - Blood samples of 34 Eastern chipmunks trapped in the vicinity of an Aedes albopictus population near New Alsace, IN, were tested for neutralizing antibodies to La Crosse (LAC) virus and other California group viruses. Two samples were positive for LAC antibodies. Analysis of mosquito bloodmeals demonstrated that both Ae. albopictus and Ae. triseriatus from the site fed on chipmunks. This note documents the first record of LAC antibodies in sylvan rodents from Indiana, the presence of LAC virus in the vicinity of Ae. albopictus and that wild Ae. albopictus feed on Eastern chipmunks. PMID- 1787413 TI - Design for a canopy trap for collecting horse flies (Diptera: Tabanidae). AB - A design for a canopy trap for collecting horse flies is described. The collecting heads can easily be changed since the collar is fixed in place and supports the trap. The collar allows an unobstructed pathway to the collecting head. The center pole has a sliding steel rod that allows adjustment of canopy height upon installation in one operation. PMID- 1787414 TI - Oral infection of Aedes polynesiensis by Wuchereria bancrofti by using parafilm membrane feeding. AB - In order to construct a cDNA library from third-stage larvae (L3) of Wuchereria bancrofti var. pacifica, the Parafilm membrane feeding method is proposed for the oral infection of Aedes polynesiensis. Heparinized blood supplemented with 5.10( 3) M ATP was put in the feeder with carbon dioxide provided as additional phagostimulant. The results of this artificial infection feeding method were compared with those obtained when mosquitoes fed directly on the forearm of a microfilaremic patient. The number of females feeding through the artificial membrane was smaller than on the patient's forearm (32.1 vs. 84.8%). The mean number of L3s obtained per female was not statistically different between the 2 feeding methods; however, the total number of L3s obtained from 100 females allowed to feed in each group was twice as high in the natural feeding method. PMID- 1787415 TI - 25Mg NMR studies of magnesium binding to erythrocyte constituents. AB - The binding of Mg2+ ion to ATP, ADP, AMP, 2,3-bisphosphyoglycerate (DPG), and hemoglobin has been studied by 25Mg NMR spectroscopy at 9.4 T. Addition of any of these ligands to a solution of 2 mM 25MgCl2 at pH 7.2 caused a progressive increase in linewidth, with no discernible chemical shift. ATP and ADP, which form tight 1:1 complexes with Mg2+, did not cause maximal broadening until present in several-fold excess, implying that bis(nucleotide) complexes also form. The studies showed progressively weaker Mg2+ binding to ATP, ADP, DPG, and AMP, consistent with published binding constants. Hemoglobin cause fairly little broadening, consistent with its known weak affinity for Mg2+. Competition studies determined ATP affinities for Ca2+ and H+ that were also in good agreement with published values. 25Mg NMR spectra of 2 mM bound 25Mg2+ were obtained with good signal to noise in less than 1 hr. The technique may now be a practical means for studying the binding of Mg2+ within erythrocytes and other cells. PMID- 1787416 TI - Effects of fasting on saliva composition. AB - The concentrations of calcium, phosphate, protein and nitrite in whole unstimulated saliva, and the salivary flow rate under fasting conditions (saliva collected at least after 6 h without food and water) were compared with those under control conditions (saliva collected within 30 min to 1 h after food). The flow rate of fasting saliva was half that of control (0.098 ml/min vs 0.208 ml/min) and no significant differences in the flow rate were observed between sexes. The concentration of nitrite under fasting conditions was 50% higher than that in control saliva (p less than 0.05). The protein concentration was decreased, but not significantly, under fasting conditions. The composition of fasting saliva with regard to calcium and phosphate concentrations was comparable to that of the control. No significant variations in these components between sexes were observed under either condition. PMID- 1787417 TI - The ancient origins of oral pathology. AB - Belief in a golden age has provided mankind with solace in times of despair and with elan during the expansive periods of history. Dreamers imagine the golden age in the remote past, in paradise lost, free from toil and grief. Optimists put their faith in the future and believe that mankind, Prometheus-like, will master the arts of life through power and knowledge. Thus, the golden age means different things to different men, but the very belief in its existence implies the conviction that perfect health and happiness are birthrights of men. Yet, in reality, complete freedom from disease and from struggle is almost incompatible with the process of living. PMID- 1787418 TI - Evidence for regular sporulation by Haplosporidium nelsoni (MSX) (Ascetospora; Haplosporidiidae) in spat of the American oyster, Crassostrea virginica. AB - The spore stage of Haplosporidium nelsoni, the ascetosporan parasite causing multinucleated sphere unknown (MSX) disease in oysters, Crassostrea virginica, has been reported so rarely (less than 0.01% of infected oysters) that a second host has been postulated. However, recent intensive sampling of young (less than 1 year) oysters in Delaware Bay, U.S. suggests that spore formation occurs regularly in this group and that spores are produced in at least 75-85% of all infections reaching the advanced stage. Sporulation was seasonal, occurring over two to three weeks in late June/early July and again in late summer/early fall. Our data indicate that sporulation by H. nelsoni in oysters is more common than previously suspected, occurring in a segment of the host population that may not have been sufficiently sampled in the past, and that a direct life cycle should be reconsidered. PMID- 1787419 TI - PCR amplification of Tetrahymena rDNA segments starting with individual cells. AB - To facilitate studies of rDNA molecular genetics in Tetrahymena thermophila, we attempted the detection of polymorphisms in the nontranscribed spacers (NTSs) using polymerase chain reaction (PCR), starting with minute amounts of DNA. The targeted polymorphic regions are 85% adenine-thymine (AT). We found conditions of efficient and specific in vitro amplification of targeted segments in the replication domain of the 5'NTS and in the subtelomeric segment of the 3'NTS. The identity of the amplified segments was confirmed by restriction enzyme digestion and DNA sequence analysis. Digestion of the template DNA at restriction sites upstream and downstream of the targeted region increased the efficiency of amplification, presumably because the targeted segments are in a palindromic molecule. Starting from total cell DNA corresponding to as little as 0.03 picogram (equivalent to the DNA content of 0.003 cells or about 30 rDNA molecules), we observed the amplified band after agarose gel electrophoresis and ethidium bromide staining. The yield indicated more than 10-billion-fold amplification. Amplification of the subtelomeric fragment yielded homogeneous product of minimum possible length even though the telomeric-specific primer can bind, at least initially, at a multiplicity of GGGGTT repeats. Amplified 5'NTS product also was detected in an ethidium-bromide-stained gel when PCR was started with a single cell. PMID- 1787420 TI - The fine structure of the cinctum of Ellobiophrya conviva (Ciliophora: Peritricha). AB - Ellobiophrya conviva clasps tentacles of the bryozoan Bugula neritina with a ring like structure formed from aboral extensions of its body that taper into two slender arms. The tips of the arms overlap and join to form a unique organelle, the bouton. Each arm contains a massive myoneme that splays out at the bouton. The bouton consists of the cupped tips of the arms and a cavity, which is filled with dense homogeneous material. Long digitations containing longitudinal microtubules at their periphery project from the inner surface of the tip of each arm into the cavity. Deep folds of pellicle with pores opening into their depths line the wall of the cavity. Conventional kinetosomes are not visible in the bouton, but circular or elliptical arrays of microtubules are found at the bases of digitations. The nonfunctional scopula of the adult is in a depression enclosed by pellicular folds. The bouton is distant from the scopula, but its fine structure somewhat resembles it, supporting Chatton and Lwoff's hypothesis that the cinctal arms carry parts of the scopula at their tips. The fine structure of the cinctum supports their suggestion that the cinctal arms are homologous to the spasmonemes of vorticellid peritrichs. PMID- 1787421 TI - Distribution of carbohydrates recognized by the lectins Euonymus europaeus and concanavalin A in monoxenic and heteroxenic trypanosomatids. AB - We observed a wide distribution of the carbohydrate epitopes galactosyl alpha(1 3)galactose (gal alpha1-3 gal), alpha-glucoside and alpha-mannoside in mono- and heteroxenic trypanosomatids by using fluorescein-labelled lectins of Euonymus europaeus (EE) and Concanavalin A (Con A) as well as sera from acute chagasic patients who have very high levels of anti-gal alpha(1-3)gal antibodies. The direct fluorescence test for gal alpha1-3 gal with EE was positive at minimum concentrations of 6 micrograms/ml for heteroxenic trypanosomatids and 0.7 micrograms/ml for monoxenic ones and for the plant parasite, Phytomonas. On the other hand, heteroxenic trypanosomatids that infect vertebrates bound ten-fold more Con A than monoxenic flagellates and Phytomonas. These data were confirmed in ELISA and Western Blot assays carried out with peroxidase-labelled EE and Con A. Euonymus europaeus recognized several glycoproteins in all trypanosomatids that we tested. Con A, however, recognized a glycoprotein cluster in heteroxenic protozoa, which ranging from 60-120 kDa, seemed to lack monoxenic parasites and Phytomonas. These findings suggest that alpha-D-mannose and alpha-D-glucose might play an important role in the interaction between trypanosomatids and vertebrate hosts. PMID- 1787422 TI - Further observations on Cryptobia dahli (Mastigophorea: Kinetoplastida) parasitizing marine fish. AB - Studies were conducted primarily to ascertain the mode of transmission of Cryptobia dahli parasitizing the digestive tract of lumpfish (Cyclopterus lumpus). Another flagellate, morphologically similar to C. dahli, was also observed in the gut of a deepsea fish (Macrourus berglax). Several invertebrates, which are food for lumpfish, were examined for flagellates, but were neither infected nor showed evidence of cystic stages. Parasites were more abundant in the stomach, especially at about pH 5, than in other areas of the digestive tract. Transmission was achieved by pipetting the parasites into the stomach of uninfected fish, by feeding food contaminated with flagellates, and also by holding infected and uninfected fish in the same aquarium. In nature, lumpfish probably acquire parasites during winter when they aggregate and regurgitate into seawater because parasites can survive for short periods outside their host. PMID- 1787423 TI - Revision of the family Lagenophryidae Butschli, 1889 and description of the family Usconophryidae n. fam. (Ciliophora, Peritricha). AB - Ten species of lagenophryid peritrichs in three genera are redescribed or described for the first time. Based on this information, the family Lagenophryidae was found to consist of five genera: Lagenophrys, Paralagenophrys, Clistolagenophrys n. g., Setonophrys, and Operculigera. Lagenophryid genera differ in gross structure of the lorica aperture and the peristomial sphincter associated with it. Shape of the lorica and mode of attachment to the host are not generic characteristics in the Lagenophryidae. Differences in shape evolved within each of the three largest lagenophryid genera merely as adaptations for attachment to different parts of a host. Usconophrys, formerly in the Lagenophryidae, and Cyclodonta are assigned to the family Usconophryidae n. fam., which is characterized by possession of a lorica, lack of a closure apparatus operated by the peristomial sphincter, and possession of an operculariform peristome. Lagenophrys, Setonophrys, and Paralagenophrys appear to have evolved separately and convergently from ancestors within Operculigera. Lagenophryid lorica apertures consisting of opposing lips probably evolved as tight seals to prevent water loss when the host is temporarily out of water. The greater diversity and wider distribution of Lagenophrys compared with other lagenophryid genera may result from an advantage in recolonizing hosts conferred by second type division. PMID- 1787424 TI - Purification and substrate specificity of two cysteine proteinases of Giardia lamblia. AB - The proteinase activity present in homogenates of trophozoites of Giardia lamblia, active on azocasein and urea-denaturated hemoglobin, was separated into two different enzymes by a series of purification procedures. These procedures included gel filtration on Fractogel TSK HW-55 (F), organomercurial agarose affinity chromatography, and ion exchange chromatography on DEAE-cellulose. By chromatography on Sephadex G-100, two purified enzymes exhibited relative molecular weights of Mr = 95,000 and 35,000 +/- 10%, respectively. On the basis of inhibition by thiol reagents and abrogation of this effect by dithiothreitol and cysteine, they were identified as cysteine proteinases. Proteinase I (Mr = 95,000) and proteinase II (Mr = 35,000) were active against the beta-chain of insulin releasing characteristic fragments. However, differences in substrate specificities of the two enzymes could be observed by using synthetic peptides that represent sequences 1-6, 8-18, and 20-30 of the insulin beta-chain. Furthermore, the synthetic tetrapeptides Arg-Gly-Phe-Phe, Arg-Gly-Leu-Hyp, and Arg-Arg-Phe-Phe were hydrolyzed by the two proteinases releasing Phe-Phe and Leu Hyp, respectively. Compared with Arg-Gly-Phe-Phe, the rates of hydrolysis of Arg Gly-Leu-Hyp and Arg-Arg-Phe-Phe at substrate concentrations of 1 mM were 91% and 63% (proteinase I) and 80% and 57% (proteinase II), respectively. PMID- 1787425 TI - Three-dimensional reconstruction of rabbit-derived Pneumocystis carinii from serial-thin sections. I: Trophozoite. AB - The highly complex ultrastructural morphology of the endomembrane system in Pneumocystis carinii led us to perform three-dimensional reconstruction from serial-thin sections using the CATIA (Conception Assistee Tridimensionnelle Inter Active) Dassault system program. The three-dimensional reconstruction of a small trophozoite made it possible to better understand the morphological relationship among organelles and to suggest cytophysiological hypotheses. By reconstructing other parasite stages, we gathered information about the evolution of organelles during the life cycle and about their physiology. PMID- 1787426 TI - Three-dimensional reconstruction of rabbit-derived Pneumocystis carinii from serial-thin sections. II: Intermediate precyst. AB - Three-dimensional reconstruction of a binucleate intermediate precyst of Pneumocystis carinii was performed from serial-thin sections using the CATIA (Conception Assistee Tridimensionnelle Inter Active) Dassault system program. The presence of a mitochondrion, complex well-developed endoplasmic structures, and numerous Golgi vesicles was established. A better understanding of the ultrastructure of rabbit-derived P. carinii stages made it possible to formulate hypotheses on the evolution and physiology of the endomembrane system. Thus, the presence of the well-developed endoplasmic saccular structure and more than 230 Golgi vesicles in its vicinity might be implicated in the differentiation of the parasite surface structures and might also be related to nuclear division and individualization of intracystic bodies. PMID- 1787427 TI - Malaria sporozoites release circumsporozoite protein from their apical end and translocate it along their surface. AB - Plasmodium sporozoites, the causative agents of malaria, release circumsporozoite (CS) protein into medium when under conditions simulating those that the parasites encounter in the bloodstream of the vertebrate host. CS protein of the rodent parasite, Plasmodium berghei, is released as the lower molecular weight form, Pb44. This release is substratum- and antibody-independent. Previous studies show that CS protein is released at the trailing, posterior end of motile sporozoites. Video and electron microscopic studies now demonstrate that CS protein is released at the apical end of cytochalasin b-immobilized sporozoites. We propose that CS protein released from the apical end, the leading end of gliding sporozoites, adheres to the sporozoite surface and is translocated posteriorly by a cytochalasin-sensitive and apparently actin-mediated surface motor, which drives gliding motility. This model explains the mechanism of both the circumsporozoite precipitation (CSP) reaction and formation of the CS protein trail by gliding sporozoites. PMID- 1787428 TI - In vitro production of lysine from 2,2'-diaminopimelic acid by rumen protozoa. AB - Rumen protozoa can produce lysine from free 2,2'-diaminopimelic acid (DAP). However, the quantitative importance of this transformation has been disputed; lysine contents of protozoal incubation supernatants reported by Onodera & Kandatsu and Masson & Ling show a 26-fold difference. The in vitro experimental methods of both groups were compared to determine the causes of this difference. Lysine production was proportional to DAP concentration. Results with rumen protozoa from sheep or goats were similar. The incubation medium and deproteinizing procedure of the Welsh group gave a two-fold increase in lysine production compared with Japanese protocols. Omissions of rice starch from protozoal incubations slightly increased lysine production, whereas omissions of antibacterial agents resulted in varying, yet relatively small changes. The greatest cause of the difference was the number of rumen protozoa incubated. When this factor was taken into account, the difference in the maximum rates of lysine production between the Welsh and Japanese groups was only three-fold, namely 4.5 versus 15.0 nmol lysine/10(5) protozoa/h. Adding other amino acids to the incubations suggested that DAP uptake by rumen protozoa may occur via transport system ASC. The importance of DAP metabolism by protozoa as a source of lysine for ruminant host animals is discussed. PMID- 1787429 TI - Glucan synthesis in Pneumocystis carinii. AB - Rat-derived Pneumocystis carinii lysed with sodium deoxycholate catalysed the incorporation of uridine diphosphoglucose into an insoluble polymer. This enzyme activity was present in both the pellet and the supernatant when the P. carinii preparations were centrifuged. The polymer whose production was catalysed by the supernatant was examined by mass spectrometry and found to be an alpha 1----4 glucan, which is either unbranched or has relatively few branches. Polymer formation was completely inhibited by the addition of alpha amyloglucohydrolase to the supernatant. Polymer formation in the pellet of deoxycholate P. carinii preparations, unlike that in the supernatant, was partially resistant to alpha amyloglucohydrolase. The soluble glucan synthase activity in the supernatant was stable for more than 30 h at room temperature and was approximately 50 times more active on a cell-to-cell basis than the supernatant from deoxycholate preparations of the yeast Saccharomyces cerevisae. PMID- 1787430 TI - [Relations between neurinoma of the VIII cranial nerve and the porus of the internal auditory meatus. Apropos of 110 cases]. AB - 110 cases of neurinomas of the VIIIth with APC extension (104 patients) were studied using MRI or CT. Classically, it is said that the tumoral mass is centered on the IAC. In our study, among 110 cases of neurinomas, only 9 were centered along the axis of IAC on axial slices and only 23 on coronal slices. The anterior development of the tumor is never more than 1 cm, except in 3 cases of large and multicystic neurinoma. We suggest that the anterior development of large tumors is limited by the VIIth nerve. PMID- 1787431 TI - [Central nervous system lesions in neurofibromatosis. Clinical, MRI and histopathological correlations. A trial of classification]. AB - The National Institute of Health Consensus Panel on Neurofibromatosis (NF) recently recognized 2 distinct forms of NF (NF-1 and NF-2) and stated that variant forms may exist. We selected 30 patients who fulfilled the criteria of NF 1 or whose condition was consistent with NF-2. All patients showed pathological magnetic resonance images (MRI), and in 19 cases confirmation was obtained from histopathology. We established correlations between the site and nature of the lesions on the one hand and the diagnostic criteria of NF on the other hand, there by hoping to contribute to a better knowledge and classification of neurofibromatosis. Nineteen patients had only intraparenchymatous lesions of the central nervous system (CNS) and fulfilled the criteria of NF-1; histopathological examination demonstrated pilocytic astrocytoma in 8 cases. Eleven patients showed only extra-axial lesions; 8 of them had criteria suggestive of NF-2, except for familial history. Pathological examination revealed either acoustic, pluriradicular of mixed schwannomas (7/8) or pluriradicular ganglioneuromas (1/8). Two patients had unilateral extra-axial pluriradicular cervical lesions and fulfilled the diagnostic criteria of NF-1; pathological examination revealed neurofibroma in both cases. One female patient had both intra- and extra-axial lesions that fulfilled the criteria of NF-1 and NF-2, suggesting the existence of a mixed form (NF-3). PMID- 1787432 TI - [Imaging techniques of the breast in 1991. 1]. AB - Today, there is an increase in breast radiology practise. To realize good investigations with the lowest X ray dose absorbed, the authors accurate the technical specifications of each unit of the mammograph. They insist on the necessary quality control. They definite the technical mammography practice and the ultrasound technology, as a complementary and often indispensable technology after mammography. The association clinical examination-mammography-ultrasound technology, is performed in upper 97% of breast lesion diagnoses. However, other technologies, as complementaries one are sometimes useful to assure the diagnosis. PMID- 1787433 TI - [Ultrasonographic surveillance of treated breast cancer]. AB - Clinical, radiographic (mammograms) and ultrasonographic data were compared retrospectively for 171 patients to evaluate the utility of ultrasound for the follow-up of breast cancer patients treated medically or by conservative surgery. When used to follow-up patients treated medically by induction or exclusive chemotherapy, ultrasonography accurately quantified tumor and nodal regression. After conservative surgery, sonograms are an ideal means to diagnose (and sometimes to treat) early complications (hematoma, lymphocele, abscess). Ultrasonography was more sensitive than mammography for the detection of recurrent disease (95.5% sensitivity for radiography versus 90% for ultrasonography). After radical surgery and breast reconstruction, ultrasonography is the only procedure required to follow-up of patients with breast implants, because it can determine the size and penetration of cutaneous recurrences. The fact that 30% of patients treated by lumpectomy and irradiation ultimately develop malignant or benign abnormalities justifies systematic ultrasonography for the follow-up of treated breast cancers. All sonographically demonstrable abnormalities warrant ultrasound-guided puncture biopsy. PMID- 1787434 TI - [Renal calcium milk. Ultrasonic and x-ray computed tomographic aspects. Review of the literature apropos of a case]. AB - "Milk of calcium" is a rare condition where a diversity of calcium salts are in suspension in a caliceal diverticulum or a renal cyst. This case report details the CT and ultrasound findings of a patient with milk of calcium renal cyst. PMID- 1787435 TI - [Teratogenic effects of ionizing radiations]. PMID- 1787436 TI - [Main phases of the embryo-fetal development and the periods susceptible to the action of teratogenic agents]. PMID- 1787437 TI - [Ionizing radiations and teratovigilance. Experience of Center of Information on teratogenic agents]. PMID- 1787438 TI - [Epidemiological studies. The lessons of Hiroshima and Nagasaki. Other studies]. PMID- 1787439 TI - [Human in utero development. Applications to the radiological protection]. PMID- 1787440 TI - [Radiodiagnostic and teratovigilance]. PMID- 1787441 TI - [In utero irradiation. The gynecologist's point of view]. PMID- 1787442 TI - [Post-script for 1991: in utero radiosensitivity]. PMID- 1787443 TI - [Radiodiagnostic activity in France. Results of a survey 1987]. PMID- 1787444 TI - Proteins and glycosaminoglycans in the intercellular matrix of the human cumulus oophorus and their effect on conversion of proacrosin to acrosin. AB - Human cumuli-oophori were cultured in vitro in the presence of radioactive protein and polysaccharide precursors. The time course of the cumulus cell secretion was traced by histoautoradiography. Matrix solubilization, and sodium dodecyl sulphate polyacrylamide gel electrophoresis and high-performance liquid chromatography showed that proteoglycan (Mr greater than 1,700,000) was the main cumulus cell product that was prevailingly deposited in the cumulus intercellular matrix and partly released into the culture medium. It was capable of accelerating the conversion of proacrosin to acrosin and this activity was abolished by enzymatic removal of chondroitin sulphate, the predominant glycosaminoglycan of this proteoglycan fraction. None of the other fractions, including a proteoglycan of Mr 80,000-90,000, containing heparan sulphate, accelerated the conversion of proacrosin to acrosin under the conditions used. The results suggest that chondroitin sulphate is the active component of the high Mr proacrosin activator of the human cumulus-oophorus. PMID- 1787445 TI - Impact of exogenous progesterone on ovarian follicular dynamics and function in mice. AB - Raising progesterone concentrations in young adult mice by subcutaneous implants resulted in ovulation being blocked and the cessation of oestrous cycles. The effect of this treatment on the numbers and dynamics of preantral follicles during 36 days of treatment was studied using a compartmental model to analyse differential follicle counts. Changes in growth and/or death rates were detected at all stages of follicular development. An increased rate of growth through preantral stages was predicted in the treatment group when compared with the controls, but most of these follicles did not reach the antral stage of development as an increased death rate was observed at large preantral stages (stage IV). Antral follicles were formed in the treatment group, but all succumbed to atresia. Increased atresia in the antral population of follicles in the treatment group was observed directly. PMID- 1787446 TI - Effect of pulse amplitude of luteinizing hormone, duration and rate of change on progesterone secretion from rat corpora lutea. AB - Corpora lutea (CL) were obtained from immature rats primed with pregnant mares' serum gonadotrophin followed by human chorionic gonadotrophin (hCG). Two days after hCG, CL were isolated, placed in perifusion culture and exposed to control medium or specific pulses of luteinizing hormone (LH). In Expt 1, a frequency of 1 pulse LH/h (amplitude 500 pg/ml, duration 40 min, 30 ng/min) increased progesterone secretion compared with control values (P less than 0.05). In Expt 2, LH rate was held constant and the amplitude and duration of a single LH pulse varied; 250 and 500 ng LH/ml initially stimulated progesterone secretion equivalently, but increasing the duration of the LH pulse prolonged high progesterone secretion. These observations suggest that at less than or equal to 500 ng LH/ml, once a stimulatory amplitude is obtained, higher amplitudes do not further increase progesterone secretion, while increasing pulse duration further enhances progesterone secretion. In Expt 3, the LH pulse amplitude was 250 ng/ml and the rate set at 0, 5 or 30 ng LH/min; only 30 ng LH/min resulted in sustained stimulation of progesterone (P less than 0.05). Taken together, these data demonstrate that the characteristics which determine whether an LH pulse will be stimulatory include not only amplitude and duration but also the rate at which an amplitude is obtained. PMID- 1787447 TI - Binding of beta-galactosidase from rat epididymal fluid to the sperm surface by high-affinity sites different from phosphomannosyl receptors. AB - beta-Galactosidase, known to be secreted by epithelial cells lining the rat epididymal duct, binds to the surface of spermatozoa from the caudal region with high affinity and in a saturable form. The binding was not inhibited by mannose-6 phosphate, but was inhibited by fructose phosphate derivatives, a peculiarity previously demonstrated for the membranes of epididymal tissue. Fructose phosphate derivatives released 55% of beta-galactosidase activity from the spermatozoa. These results suggest that in the epididymis there is a special transport system for hydrolases, which could be involved in the secretion of enzymes destined for spermatozoa. This transport would require receptors that recognize sugar ligands other than mannose-6-phosphate. These receptors were present in the epididymal tissue and on the sperm surface. PMID- 1787448 TI - Additive effect of oestradiol-17 beta and serum on synthesis of deoxyribonucleic acid in guinea-pig endometrial cells in culture. AB - Normal guinea-pig endometrial cells, grown in primary culture, were made quiescent by serum depletion. Quiescent cells cultured in the control medium (containing 1% fetal calf serum treated with dextran-coated charcoal, DCC-FCS) showed a steady and weak rate of [3H]thymidine incorporation, but the addition of 15% fetal calf serum (FCS) or 10% DCC-FCS to the control medium induced a significant increase of DNA synthesis, demonstrating the responsiveness of the quiescent cells to stimulation. A lower but significant increase in [3H]thymidine incorporation was elicited by epidermal growth factor (EGF, 100 ng/ml) or insulin (10 micrograms/ml) added to the basal medium. Oestradiol-17 beta added to the control medium at concentrations ranging from 10(-10) to 10(-5) mol/l not only failed to increase but even inhibited [3H]thymidine incorporation at the highest concentrations tested. An additive effect was noticed when quiescent cells were incubated with oestradiol-17 beta (10(-9) mol/l) in the presence of 10% DCC-FCS, but no synergistic effect occurred when 2 x 10(-9) mol oestradiol-17 beta/l was combined with either EGF (100 ng/ml) or insulin (10 micrograms/ml). Oestradiol-17 beta appears unable alone to stimulate DNA synthesis in normal endometrial cells, but requires factor(s) present in fetal calf serum. PMID- 1787449 TI - Distribution of glutathione S-transferase isoenzymes in human ovary. AB - Glutathione S-transferases (GST) are drug-metabolizing and detoxification enzymes involved in the intracellular transport and metabolism of steroid hormones. We studied expression of pi, alpha, mu and microsomal GST by immunohistochemistry in normal human ovaries at different stages of the menstrual cycle and pregnancy and after the menopause. Antibodies were raised in rabbits to purified GST subunits and formalin-fixed, paraffin-embedded sections were studied using the peroxidase antiperoxidase method. Staining density was graded from very strong to negative. All four isoenzymes were identified in the ovary and their distribution was heterogeneous. The staining pattern of follicles varied with the stage of the menstrual cycle for each isoenzyme. All the ovaries contained abundant GST pi in stroma. GST alpha is closely associated with the glutathione-dependent enzyme delta-5,3-ketosteroid isomerase, which catalyses the conversion of pregnenolone to progesterone and dehydroepiandrosterone to androstenedione. GST alpha was localized to the steroid-producing cells and thus may be useful in studying ovaries in conditions where there are assumed alterations in steroid production. PMID- 1787450 TI - Effects of flutamide on testicular involution induced by an antagonist of gonadotrophin-releasing hormone and on stimulation of spermatogenesis by follicle stimulating hormone in rats. AB - The effects of combined treatment with an antagonist of gonadotrophin-releasing hormone (ANT) and the antiandrogen flutamide (FL) on spermatogenesis were studied in the presence and absence of exogenous follicle-stimulating hormone (FSH). After treatment for 2 weeks, the combination of ANT (RS 68439, 450-500 micrograms/kg per day, s.c.) with 10, 20 or 40 mg FL/day, s.c. was as effective as ANT plus the Leydig cell toxin ethane dimethane sulphonate (75 mg/kg per week, i.p.) in terms of reduction in weight of testes, epididymides and seminal vesicles. Thus, a daily dose of 10 mg FL/kg was sufficient to block the androgen action in the testes of ANT-treated rats. In a second experiment, rats received ANT and ANT+FL (10 mg/kg) alone or in combination with a highly purified human FSH preparation (5 or 10 iu, twice a day) for 2 weeks. FSH did not affect testosterone concentration or weight of epididymides and seminal vesicles, but ANT+FL markedly enhanced the ANT-induced reduction of testis weight, seminiferous tubule diameter and numbers of germ cells, as revealed by qualitative and quantitative analysis of testis histology. In the absence of FL, testis size and numbers of germ cells, including elongated spermatids, were increased by FSH. In the presence of FL, the effects of FSH were less pronounced with respect to the germ cells, in terms of both numbers of cells and the effective dose of FSH. Irrespective of treatment with FL, exogenous FSH increased the inhibin concentrations in serum, indicating that Sertoli cells remained responsive to FSH. From the present study it is concluded that (i) FL accelerates ANT-induced testicular involution, (ii) FSH has a role in adult spermatogenesis and (iii) the effects of FSH on advanced germ cells are influenced by androgens. PMID- 1787451 TI - Effect of diabetes mellitus on mouse pre-implantation embryo development. AB - Fifteen spontaneously diabetic, non-obese mice (NOD strain), 17 non-diabetic NOD mice (in which diabetes had not yet developed) and 9 diabetic NOD mice were treated with insulin. All animals were superovulated with 5 iu of pregnant mares' serum gonadotrophin followed 48 h later by 5 iu human chorionic gonadotrophin (hCG) and mated overnight with NOD males of proven fertility. To assess in-vitro and early in-vivo development, 23 NOD mice were killed 72 h after hCG treatment. Embryos were recovered from oviduct flushings and cultured in Ham's F-10 medium with 0.1% bovine serum albumin at 37 degrees C in an atmosphere of 5% O2, 5% CO2, and 90% N2. Development was assessed at intervals of 24 h for 72 h. Compared with embryos from non-diabetic NOD mice (n = 81), embryos from diabetic NOD mice (n = 68) demonstrated marked impairment in growth assessed by distribution of developmental stages at each observation period (24, 48, 72 h, all P less than 0.001) and by overall rates of progression of developmental stages (P less than 0.01). In diabetic NOD mice treated with insulin, embryo development (n = 7) was not significantly different from that of embryos from non-diabetic NOD mice (n = 81), but was significantly faster than in embryos from diabetic NOD mice not treated with insulin (n = 68) (P less than 0.001, for all periods, overall rate P less than 0.01). To assess late in-vivo growth, 18 NOD mice were killed 120 h after hCG.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787452 TI - Effect of rate of change of luteinizing hormone concentration on in-vitro progesterone secretion within rat corpora lutea during differentiation. AB - Immature rats were injected with pregnant mares' serum gonadotrophin followed by human chorionic gonadotrophin (hCG). Ovaries were removed 0, 2, 5 or 8 days after hCG and either prepared for morphometric analysis or perifused with 0, 5 or 30 ng luteinizing hormone (LH)/min. In a second study, ovaries were removed on Day 2 or 8 and perifused with 0.1 mg 8-br-cyclic adenosine 5'-phosphate/ml (8-br-cAMP). On Day 0, the granulosa cells of the preovulatory follicles were small (53 +/- 0.5 microns2) with a cytoplasmic to nuclear (Cy:Nu) ratio less than or equal to 1.5. By Day 2, corpora lutea (CL) were present and composed of 95% small luteal cells (diameter less than 125 microns2, Cy:Nu greater than or equal to 3.0) and 5% large luteal cells (diameter greater than 125 microns2, Cy:Nu ratio greater than or equal to 3.0). The percentage of large luteal cells increased to 36 +/- 7% by Day 5, suggesting that they are derived from a select population of small luteal cells. Basal progesterone secretion increased from 38 +/- 5 on Day 0 to 1010 +/- 48 pg/mg/ml on Day 8. The rate of 5 ng LH/min stimulated progesterone secretion on Days 0, 2 and 8; 30 ng LH/min stimulated progesterone secretion on Days 0, 2 and 8, but not on Day 5; 8-br-cAMP stimulated progesterone secretion on both Days 2 and 8. These data demonstrate that once granulosa cells are induced to luteinize they lose their capacity to secrete progesterone in response to 5 ng LH/min and do not regain their responsiveness to LH rate until they completely differentiate. The loss of this LH responsiveness appears to be due to an inability to stimulate sufficient intracellular cAMP concentrations, since cAMP stimulates progesterone secretion on both Days 2 and 8. PMID- 1787453 TI - Neutrophil migration into the bovine uterine lumen following intrauterine inoculation with killed Haemophilus somnus. AB - Polymorphonuclear neutrophils (PMN) in bovine uterine flushings following intrauterine deposition of killed bacteria were measured and the effect of immune status on the influx of PMN into the uterine lumen during oestrus was determined. Holstein heifers were immunized with a 270-kDa outer-membrane protein (omp-270) from Haemophilus somnus. During oestrus, immunized heifers (n = 21) received an intrauterine inoculum of either a heat-killed suspension of a homologous strain of H. somnus containing omp-270 (n = 7), a heterologous strain of H. somnus lacking omp-270 (n = 7), or phosphate-buffered saline (n = 7). Five additional heifers were inseminated with extended bovine semen. Uterine contents were collected in saline lavage immediately before inoculation (t0) and at 6, 24, 48, 72, 96, and 120 h after inoculation. The semen-inoculated heifers were lavaged only at t120. All groups experienced PMN infiltration which peaked 6 h after inoculation and tended to decline thereafter. Differences were not observed between treatment groups, indicating that neither bacterial inoculation nor immune status was as important in eliciting PMN effusion as the flushing procedure itself. PMID- 1787454 TI - More rapid restoration of pituitary content of follicle-stimulating hormone than of luteinizing hormone after depletion by oestradiol-17 beta in ewes. AB - To test the hypothesis that the synthesis and secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) are differentially regulated after depletion by oestradiol, circulating concentrations of oestradiol were maintained at approximately 30 pg/ml for 16 days in each of 35 ovariectomized ewes. Five other ovariectomized ewes that did not receive oestradiol implants served as controls. After treatment with oestradiol, implants were removed and pituitary glands were collected from each of 5 ewes at 0, 2, 4, 8, 12, 16 and 32 days thereafter and amounts of mRNA for gonadotrophin subunits and contents of LH and FSH were quantified. Before collection of pituitary glands, blood samples were collected at 10-min intervals for 6 h. Treatment with oestradiol reduced (P less than 0.05) steady-state concentrations of LH beta- and FSH beta-subunit mRNAs and pituitary and serum concentrations of these hormones. At the end of treatment the amount of mRNA for FSH beta-subunit was reduced by 52% whereas that for LH beta subunit was reduced by 93%. Steady-state concentrations of mRNA for FSH beta subunit returned to control values within 2 days of removal of oestradiol, but 8 days were required for concentrations of FSH in the pituitary and serum to return to control values. Steady-state concentrations of mRNA for LH beta-subunit and mean serum concentrations of LH returned to control values by Day 8, but pituitary content of LH may require as long as 32 days to return to control levels. Therefore, replenishment of FSH beta-subunit mRNA preceded increases in pituitary and serum concentrations of FSH.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787455 TI - Relationship between early pregnancy factor, mouse embryo-conditioned medium and platelet-activating factor. AB - The effects of synthetic platelet-activating factor (PAF-acether) and mouse embryo-conditioned medium (a source of embryo-derived PAF (EPAF)) on production of early pregnancy factor (EPF) were compared. Embryo-conditioned medium, itself inactive in the EPF bioassay, stimulated ovarian production of EPF in vitro but PAF-acether did not. In vivo, embryo-conditioned medium induced EPF activity in serum of oestrous female, but not in male, mice in contrast to PAF-acether, which induced activity in serum of both male and female mice. This PAF-induced activity was transitory, declining significantly by 2 h and disappearing by 3 h after injection. Activity induced by embryo-conditioned medium was first evident at 2 h after injection, serum concentrations increasing up to 6 h after injection. By discriminating between the behaviour of PAF-acether and EPAF, these studies reinforce the conclusions of other workers that the molecule produced by the embryo is not PAF. Further investigations into the mechanism of action of PAF acether revealed that it is a potent inducer of activity in the EPF bioassay, with an absolute requirement for platelets in the spleen cell suspension used in the assay. This platelet-derived active species was bound specifically by an anti EPF monoclonal antibody, indicating that it is EPF-like. This is consistent with parallel studies showing that platelets are not required for induction of activity by either pregnancy serum or purified EPF. These studies were applied to the PAF-induced leukotriene-like species, which had been found by others to be active in the EPF bioassay. Pregnancy serum induced the appearance of this substance from the spleen cell suspension used in the assay; thus the leukotriene like substance may be regarded as an effector molecule in vitro or mediator of the initiating stimulus of EPF in the bioassay. PMID- 1787456 TI - Induction of the synthesis of the pregnancy-specific protein p70 in the endometrium by intramuscular injection of recombinant bovine interferon-alpha I1 in nonpregnant ewes. AB - We examined the effect of recombinant bovine interferon-alpha I1 (rboIFN-alpha I1) or recombinant bovine trophoblast protein-1 (rbTP-1) on protein synthesis by endometrial explants from Day-13 cyclic ewes and studied the ability of rboIFN alpha I1 injected i.m. to influence subsequent protein secretion by endometrial tissue explants. In Expt 1, ewes were injected with either 2 mg rboIFN-alpha I1 or vehicle alone at 12 h intervals beginning on Day 11 of the oestrous cycle and ending on the morning of Day 13; 8 h after the last injection, ewes were hysterectomized and endometrial explant cultures were prepared. Explants were cultured for 24 h in leucine-deficient medium supplemented with 250 microCi L [3H]leucine per culture. For Expt 2, additional explants were prepared from Expt 1 controls. Explants were cultured in the presence of 0, 20 or 200 ng/ml of either rboIFN-alpha I1 or rbTP-1 for 24 h in leucine-deficient medium supplemented with 250 microCi L-[3H]leucine per culture. Secreted proteins were analysed by two-dimensional electrophoresis and fluorography. There was a marked enhancement of a 70 kDa acidic protein, p70, in explants cultured in the presence of rboIFN-alpha I1 or rbTP-1. This polypeptide is a product of the gravid uterine horn from Day 14 to Day 20 of pregnancy and is a useful marker of the action of interferon-alpha (IFN-alpha) on endometrium. Enhanced production of p70 also occurred in ewes injected i.m. with rboIFN-alpha I1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787457 TI - Alteration of oestrous cycle length, ovarian function and oxytocin-induced release of prostaglandin F-2 alpha by intrauterine and intramuscular administration of recombinant bovine interferon-alpha to cows. AB - An experiment was conducted to (i) determine whether administration of recombinant bovine interferon-alpha I1 (rBoIFN-alpha) attenuates oxytocin-induced release of prostaglandin F-2 alpha and (ii) confirm previous observations that rBoIFN-alpha causes acute changes in body temperature and circulating concentrations of progesterone. Cows were treated twice a day from Day 14 to Day 17 after oestrus with a control regimen (bovine serum albumin (BSA), i.m. + BSA intrauterine (i.u.)), rBoIFN-alpha, i.u. + BSA, i.m. (rBoIFN-IU) or rBoIFN-alpha, i.m. + BSA, i.u. (rBoIFN-IM). On Day 17, plasma concentrations of 13,14 dihydro,15-keto-prostaglandin F-2 alpha (PGFM) were measured after injection of oxytocin. Cows treated with rBoIFN-IU and rBoIFN-IM had longer oestrous cycles and luteal lifespans than control cows. A hyperthermic response and decline in plasma concentrations of progesterone was noticed after administration of rBoIFN alpha on Day 14. On other days, the hyperthermic response was not present and the decline in progesterone was less pronounced. There was no significant effect of rBoIFN-alpha on circulating concentrations of oestradiol between Days 14 and 17. The release of PGFM induced by oxytocin was lower in cows treated with rBoIFN alpha than in control cows. Oxytocin caused increased plasma concentrations of PGFM in four of five control cows, two of five rBoIFN-IU cows and two of five rBoIFN-IM cows. The peak PGF-2 alpha response to oxytocin (peak value after injection minus mean concentration before injection) was 257.8 +/- 61.3 pg/ml for control cows, 100.7 +/- 40.8 pg/ml for rBoIFN-IU and 124.9 +/- 40.4 pg/ml for rBoIFN-IM. It is concluded that rBoIFN-alpha can reduce oxytocin-induced PGFM release and may therefore extend the lifespan of the corpus luteum by interfering with events leading to luteolytic release of PGF from the uterus. Administration of rBoIFN-alpha can cause acute changes in body temperature and circulating concentrations of progesterone that become less severe after repeated exposure to rBoIFN-alpha. PMID- 1787458 TI - Impairment of follicular development by intra-ovarian infusion of gonadotrophin releasing hormone antiserum in prepubertal pigs. AB - Antiserum against gonadotrophin-releasing hormone (GnRH) was infused into one ovary in 4 prepubertal gilts and control porcine serum was infused into one ovary in 4 other gilts. Ovaries were infused for 156 h, after which infused and non infused ovaries were removed surgically and processed for histology. Infusion of GnRH antibodies did not alter (P greater than 0.10) concentrations of luteinizing hormone (LH), follicle-stimulating hormone (FSH) or oestradiol-17 beta, and GnRH titres in peripheral circulation were low, averaging 1:15. Weights of ovaries not infused were similar (P greater than 0.10) between treatment groups. There were fewer (P less than 0.05) follicles greater than 0.5 mm in diameter in the ovaries infused with GnRH antiserum than in the others, but there were no differences (P greater than 0.10) between treatment groups in the number of follicles less than 0.5 mm in diameter. Infusion of GnRH antibodies increased (P less than 0.05) the incidence of atresia in follicles with greater than 4 layers of granulosa cells compared with the other treatment groups. These results provide evidence that a peptide binding to the GnRH antibodies is involved directly in ovarian follicular development. PMID- 1787459 TI - Protein thiols in spermatozoa and epididymal fluid of rats. AB - Thiol (SH) oxidation to disulphides (SS) is thought to be involved in sperm chromatin condensation and tail structure stabilization, which occur during maturation of spermatozoa. Previously developed procedures, using the fluorescent labelling agent monobromobimane (mBBr), enabled us to study the thiol-disulphide status of spermatozoa. Electrophoretic separation of labelled sperm proteins from the caput and cauda regions showed that during maturation thiol oxidation occurs in many protein fractions from the tail and that the magnitude of oxidation differs between proteins. Among the protein bands, one major band (MPB), probably a dense fibre constituent, is quantitatively prominent. N-Ethylmaleimide (NEM) or mBBr alkylation (of intact spermatozoa) changes the mobility of the caput MPB, but not that of the cauda MPB. The results indicated that the altered mobility of MPB is mainly due to a change in its shape, possibly resulting from the alkylation of a few critical SH groups. Epididymal fluid proteins contain both SH and SS. The thiol and disulphide content of the various epididymal proteins appears similar, although some diminution in fluorescence is seen in epididymal fluid proteins from the cauda region as compared with those from the caput region. The prominent changes in thiol status occur in the spermatozoa. PMID- 1787460 TI - Development of radioimmunoassay and enzyme immunoassays for luteinizing hormone in dromedaries (Camelus dromedarius). AB - Polyclonal antibodies against luteinizing hormone in dromedary (camLH) were raised in a rabbit and enabled the development of homologous immunoassays (radioimmunoassay, competitive enzymeimmunoassay (EIA) and sandwich EIA) for the measurement of circulating camLH in plasma. These assays were highly specific for camLH since neither dromedary follicle-stimulating hormone, growth hormone nor prolactin cross-reacted significantly. The lowest detection limit (0.08 ng/ml) was obtained with the sandwich EIA. In addition to its high specificity and sensitivity, this method does not require radiolabelled molecules or expensive laboratory facilities. It can be performed in the field using a portable, battery powered plate reader. PMID- 1787461 TI - Seasonal variation in circulating testosterone and oestrogens of wild-caught California ground squirrels (Spermophilus beecheyi). AB - Blood samples were obtained each month for 18 months in 1984-85 from wild-caught California ground squirrels. Circulating testosterone and total oestrogens were extracted from the plasma, measured by radioimmunoassay and compared with concurrent changes in plasma progesterone and prolactin in the same individuals. Male plasma testosterone concentrations peaked in January, shortly before mating, whereas female testosterone concentrations were low throughout the year. Female plasma oestrogen concentrations peaked in February, during the mating period. Juvenile males exhibited a transient increase in circulating testosterone in September, followed by testis growth, preputial separation, and the appearance of epididymal spermatozoa. Juvenile females exhibited a transient increase in circulating oestrogens in November. By the start of the first mating season after their births, neither juvenile males nor females differed significantly from same sex adults with respect to plasma concentrations of oestrogen or testosterone. Plasma concentrations of progesterone and prolactin in killed individuals were similar to those obtained in previous studies of free-living S. beecheyi. Mean plasma concentrations of all measured hormones varied significantly with reproductive condition in adults of both sexes. PMID- 1787462 TI - Social control of reproduction in breeding and non-breeding male naked mole-rats (Heterocephalus glaber). AB - Eight male naked mole-rats, from three colonies were studied in captivity. When non-breeding male naked mole-rats were removed from their colonies and paired with a non-breeding female, or removed and housed singly for 6 weeks before pairing with a female, concentrations of urinary testosterone and plasma luteinizing hormone (LH) increased significantly (P less than 0.05). Concentration of these hormones were highest while the males were singly housed: urinary testosterone (mean +/- s.e.m.) increased from 8.2 +/- 1.3 ng/mg urinary creatinine (Cr) in a non-breeder in a colony to 49.1 +/- 5.5 ng/mg Cr when singly housed and 21.8 +/- 2.5 ng/mg Cr when paired with a female. Plasma LH concentrations increased from 4.7 +/- 1.0 miu/ml when a non-breeder in a colony to 19.8 +/- 4.0 miu/ml when singly housed and 9.9 +/- 1.1 miu/ml when paired with a female. After pairing with a female, the pattern of urinary testosterone secretion in the male was synchronized with the ovarian cycle of the female mate, such that urinary testosterone concentrations were significantly higher during the early follicular phase of the female's cycle (P less than 0.05). These results suggest that active suppression of reproductive physiology by social cues occurs in non-breeding male naked mole-rats, and that this is readily reversible if social cues are removed and males are housed singly. When a male was subsequently paired with a female, endocrine suppression was partially reimposed on the reproductively active males, such that urinary testosterone concentrations were suppressed to values similar to those in non-breeding males, except for periods prior to mating.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787463 TI - Measurement of oxytocin concentrations in plasma and ovarian extracts during the oestrous cycle of mares. AB - Jugular venous blood samples were collected throughout a complete oestrous cycle from 9 mares for measurement of progesterone and oxytocin by radioimmunoassay. Mean oxytocin concentrations remained at approximately 1 pg/ml throughout, with no evidence of cyclic variation in the release pattern. Extracts of corpus luteum and follicles obtained from a further 33 mares at different stages of the cycle all contained oxytocin concentrations of less than 10 pg/g wet weight of tissue. We conclude that the ovaries are not a source of circulating oxytocin during the oestrous cycle in this species. The plasma oxytocin concentrations reported here are substantially lower than those found by other groups. PMID- 1787464 TI - Repeatability of events during spontaneous and gonadotrophin-induced oestrus in bitches. AB - Oestrus induction using equine chorionic gonadotrophin and human chorionic gonadotrophin was successful in five out of six bitches, although the first day of increased plasma progestagen concentration differed considerably between bitches. Induced oestrous periods differed from spontaneous cycles in the timing of vaginal epithelial cell cornification; plasma oestrogen concentrations were generally greater and progestogen concentrations were less in induced cycles. These results suggest that this schedule of oestrus induction would not be suitable for allowing mating on a predetermined day. PMID- 1787465 TI - Release of arachidonic acid from human endometrial cells in culture mediated by calcium ionophore (A23187) or fluoride. AB - Primary cultures of endometrial glands and stromal cells were labelled with [14C] arachidonic acid for 4 h before exposure to either the calcium ionophore, A23187 (which activates phospholipase A2 (PLA2) by increasing intracellular calcium concentrations) or sodium fluoride (which activates a G-protein). Calcium ionophore (0.5-50 mumol/l) stimulated a dose- and time-dependent release of arachidonic acid from endometrial glands. Incubation with ionophore (10 mumol/l) for 1 h released 22% of the incorporated arachidonic acid. There was a corresponding decrease in phospholipids and no loss from triglycerides. Stromal cells were unresponsive to ionophore. Fluoride (10 mmol/l) stimulated a release of arachidonic acid from stromal cells and endometrial glands (6.5% of the total arachidonic acid incorporated). In stromal cells, arachidonic acid was released from triglycerides in Day-1 cultures and from phospholipids in Day-2 cultures. In both Day-1 and Day-2 cultures of endometrial glands, arachidonic acid was released from phospholipids, but not from triglycerides. Among the phospholipids, phosphatidylcholine was always the major source of arachidonic acid. Arachidonic acid release from endometrial glands and stromal cells may be mediated by activation of PLA2 (or phospholipase C) via a G-protein, but in glands calcium ionophore may have a direct effect on PLA2. The response to calcium ionophore may reflect the differences in calcium requirements of the two endometrial PLA2 isoenzymes. PMID- 1787466 TI - Sequence homology of androgen-regulated epididymal proteins with glutathione peroxidase in mice. AB - The M53 cDNA for Mr 24,000 androgen-regulated secretory proteins of the mouse caput epididymidis previously reported has been sequenced. This clone presents a 5'-incomplete open reading frame of 525 base pairs. The 3'-untranslated region of 946 base pairs contains a repetitive DNA element of the rodent B1 family just between two canonical polyadenylation signals AATAAA, upstream of the poly(A) track. The deduced amino acid sequence for the Mr 24,000 proteins reveals significant homologies of 66.6, 66, 65.2, 63.1 and 64.5% with mouse, rat, man, bull and rabbit cloned selenium-dependent glutathione peroxidases, respectively. The present results emphasize previous studies performed in numerous laboratories suggesting that the major protective system against oxidative damage in mouse spermatozoa could be an enzyme similar to glutathione peroxidase. PMID- 1787467 TI - Fluctuation of histone H1 kinase activity during meiotic maturation in porcine oocytes. AB - Porcine oocytes cultured in follicular fluid for various periods of up to 48 h were stained with Hoechst-33342 and classified according to maturation before assaying. Histone H1 kinase activity at metaphase I was approximately 10 times that at the germinal vesicle stage. An abrupt reduction in activity was observed in oocytes emitting the first polar body; then the activity increased again to the same level as at metaphase I. This pattern is similar to those reported in non-mammalian species and supports the concepts that histone H1 kinase is ubiquitous in eukaryotes and controls the meiotic cell cycle in mammals. PMID- 1787468 TI - Effect of asynchronous transfer and oestrogen administration on survival and development of porcine embryos. AB - Results indicate that recovery of embryos on Days 11 and 13 of pregnancy was reduced for Day 5 embryos transferred to recipients on Day 6 of their oestrous cycle and was greatly reduced when embryos were transferred to recipients on Day 7 of the cycle (P less than 0.01). Administration of oestradiol-17 beta on Day 11 of the recipient's cycle did not appear to affect embryo development on Day 13. Day 6 embryos transferred to recipients on Day 8 of the oestrous cycle deteriorated rapidly within 24 h of transfer; there was no recovery of embryos from the uterus after 36 h. Treatment of pregnant gilts with 1 mg oestradiol-17 beta (i.v.) on Day 10.5 resulted in total embryonic loss by Day 23, but pregnancy rates of gilts treated with oestradiol-17 beta on Day 12 were similar to those of vehicle-treated gilts (60.6 vs. 71.4%). PMID- 1787469 TI - Electrophoretic characterization of the plasminogen activator produced by bovine blastocysts. AB - Sodium dodecyl sulphate-polyacrylamide gel electrophoresis and zymography were used to determine the tissue source and to characterize the types of plasminogen activator (PA) produced by bovine blastocysts. Day 12-14 blastocysts were collected at slaughter from oestrus-synchronized, superovulated and artificially inseminated Holstein cows. In Expt 1, blastocysts were cultured for 24 h in Ham's F-12 in a humidified atmosphere of 5% CO2 in air at 37 degrees C. After culture, blastocysts and medium were recovered and stored separately at -20 degrees C. In Expt 2, embryonic discs were separated from trophoblast by microdissection. Intact blastocysts, embryonic discs and trophoblast were then cultured for 24 h and recovered as in Expt 1. In both experiments, embryonic tissues and media were electrophoresed with PA and molecular mass standards. Polyacrylamide gels were laid onto casein-agar gel plates (zymograms) and incubated at room temperature for 24-48 h. Caseinolytic zones in zymograms containing plasminogen were evidence of PA. In Expt 1, bovine blastocysts contained and secreted light and heavy forms of PA (47.0 +/- 1.0 and 86.1 +/- 0.7 kDa, respectively). In Expt 2, intact blastocysts and trophoblast produced both forms of PA (41.5 +/- 1.5 and 92.2 +/- 2.7 kDa) but PAs were not detected in embryonic discs. The results suggest that Day 12-14 bovine blastocysts produce urokinase-type PA (41.5-47.0 kDa) and a form of high molecular mass (86.1-92.2 kDa) that is either a novel tissue-type PA or a PA inhibitor which complexes with the lighter form. PMID- 1787470 TI - In-vitro penetration of pig oocytes matured in culture by frozen-thawed ejaculated spermatozoa. AB - Pig oocytes matured in culture were inseminated with frozen-thawed ejaculated spermatozoa without preincubation in modified tissue culture medium (TCM) 199. High penetration rates (85-89%) and increased incidence of polyspermy were obtained at 25-100 x 10(6) spermatozoa/ml. Wide variation in penetration rates (16-89%) was observed in oocytes inseminated in medium containing 5mM caffeine and at 25-50 x 10(6) spermatozoa/ml obtained from 6 boars, regardless of sperm motility. At 25-50 x 10(6) spermatozoa/ml, penetration rates of oocytes were dependent upon the concentration of caffeine in the medium: there was no penetration without caffeine, but penetration was highest (89%) with 5mM caffeine. None of the oocytes was penetrated in the medium supplemented with heparin at 5-40 micrograms/ml. When heparin was included in the medium with 5mM caffeine, it inhibited the efficacy of caffeine to promote sperm penetration of oocytes. PMID- 1787471 TI - Seasonal variation in pituitary-gonadal function in free-ranging impala (Aepyceros melampus). AB - Blood, testicular biopsies and electroejaculates were collected from adult male impala, free-ranging in the Kruger National Park (Republic of South Africa), during the breeding (rut; April-May) and nonbreeding (September-October) seasons. Blood samples were collected at 5-min intervals for 120 min from anaesthetized males (n = 7 impala/group) treated intravenously with saline, gonadotrophin releasing hormone (GnRH: 1 microgram/kg body weight) or human chorionic gonadotrophin (hCG: 10 or 30 iu/kg). Semen was collected from six more animals during the breeding season and 12 animals during the nonbreeding season using a standardized electroejaculation protocol. Ejaculates obtained during the nonbreeding season were of inferior quality to those collected during the breeding season, and were characterized by lower sperm concentrations, poorer sperm motility and more morphologically abnormal sperm forms. Within season, there were no differences in testosterone secretion between the two hCG doses, and these responses were similar to those observed after GnRH, but during the rut, testosterone secretion stimulated by both GnRH and hCG was approximately nine times greater than during the nonbreeding season. This seasonal increase in testosterone production was associated with a doubling in testicular volume and concentrations of luteinizing hormone (LH) receptors. Although concentrations of testicular follicle-stimulating hormone (FSH) receptors were similar between seasons, receptor content increased during rut as a result of increased testicular volume. In contrast to testosterone secretion, basal LH and FSH secretions were unaffected by season and GnRH-induced gonadotrophin secretion was reduced during rut.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787472 TI - Production of platelet-activating factor by the pre-implantation sheep embryo. AB - Embryos were collected from superovulated ewes on Day 2 (2-8 cell), Day 4 (8-16 cell) and Day 6 (morula/early blastocyst). Two embryos were cultured in 1 ml of one of four media: (i) Ham's F10 + 4 mg bovine serum albumin (BSA)/ml, (ii) synthetic oviduct fluid medium + 20% human serum, (iii) Quinn's human tubal fluid medium (HTF) + 3 mg BSA/ml or (iv) HTF + 10% acid-treated fetal calf serum for 24 h. They were transferred to fresh media of the same type and their further development was monitored. A quantitative bioassay and radioimmunoassay was used to measure the concentration of platelet-activating factor (PAF, 1-o-alkyl-2 acetyl-sn-glyceryl-3-phosphocholine) produced. Following extraction and partial purification, 21/95 (22.1%) of the embryo-conditioned media samples had PAF concentrations greater than that measured in corresponding control media. This was designated as embryo-derived PAF and the corresponding cultures were termed 'PAF-positive'. PAF was produced by embryos at all three developmental stages examined and in each of the four media used, and the average amount of PAF produced was 60.9 +/- 9.8 pmol/embryo/24 h. However, neither the developmental stage of the embryo, nor the type of media affected the proportion of PAF positive cultures nor the amount of PAF produced during culture. Thus, it is demonstrated for the first time that early ovine embryos can secrete PAF in vitro, and that there is considerable variability in their capacity for PAF secretion. PMID- 1787473 TI - Effect of daylength on the rate of recovery of photosensitivity in male starlings (Sturnus vulgaris). AB - Four groups of castrated photorefractory starlings were transferred from a photoperiod of 18 h light/day (18 L) to photoperiods of 6 L, 8 L, 11 L or 12 L. A control group was kept on 18 L. Plasma concentrations of luteinizing hormone (LH) were low in all groups initially. The first significant increase in LH, which signals the recovery of photosensitivity, occurred after 4 weeks in the groups on 6 L and 8 L, after 8 weeks in the 11 L group and after 13 weeks in the 12 L group. There was no increase in the group on 18 L. The rate of recovery of photosensitivity is therefore inversely proportional to daylength, for daylengths between 8 L and 12 L. PMID- 1787474 TI - Identification of molecules involved in the 'early pregnancy factor' phenomenon. AB - An isolated preparation from ovine placental extracts which was active in the rosette inhibition assay mimicking the activity of the so-called 'early pregnancy factor' (EPF) has been shown to contain a 12 kDa polypeptide which could be partially resolved from low-molecular-weight active moieties. N-terminal amino acid sequence analysis of the polypeptide indicated that it was ovine thioredoxin, an identification confirmed by isolation and complete sequence analysis of the corresponding cDNA. The cDNA for human thioredoxin was expressed in Escherichia coli and the recombinant protein isolated and purified. Pure recombinant thioredoxin alone did not induce the expression of increased rosette inhibition titres (RITs) when tested in the rosette inhibition assay; but, when tested in combination with cell stimuli such as platelet-activating factor (PAF) or serum, it allowed the expression of increased RITs where none was achieved in its absence. Thioredoxin acted in the assay to reverse a refractory state normally induced by these stimuli, allowing lipoxygenase-dependent moieties also induced by the stimuli to exert their effects, resulting in the expression of increased RITs. Antibodies to recombinant thioredoxin removed from pregnancy sera the capacity to induce increased RITs, i.e. to express EPF activity, thus establishing a role for thioredoxin or thioredoxin-like proteins and associated molecules in the mechanisms which allow pregnancy sera to induce increased RITs. Based on a consideration of these and other results, a new model for the study of the EPF phenomenon is presented and discussed. PMID- 1787475 TI - Oestrous cycle of the North American bison (Bison bison) characterized by urinary pregnanediol-3-glucuronide. AB - An enzyme immunoassay for urinary pregnanediol-3 alpha-glucuronide (PdG) was evaluated for the indirect measurement of progesterone metabolites during the oestrous cycle and early pregnancy of uncaptured North American bison. Comparisons between plasma progesterone and urinary PdG, dose-response parallelism between the standard curve and diluted urine samples and high performance liquid cochromatography revealed that PdG was a primary immunoreactive urinary metabolite of progesterone in bison. Urine samples were collected directly from the soil from 29 bison cows during the August rutting season and analysed for PdG. Eight bison cows demonstrated complete oestrous cycles ranging from 19 to 26 days (mean cycle length = 23.12 +/- 0.76 days) and behavioural oestrus among four of these cows correlated with PdG nadirs. Mean PdG nadirs were 63.62 +/- 21.61 ng/mg urinary creatinine (Cr) and mean peak midluteal values were 546.01 +/- 130.73 ng/mg Cr. Seven of eight became pregnant, indicating that bison exhibit a second seasonal oestrus. Eighteen other bison cows were pregnant prior to the beginning of the study and demonstrated non cyclic increased PdG concentrations (greater than 200 ng/mg Cr) during the 30-day course of collection. Three cows ovulated and became pregnant during the 30-day collection period and then exhibited increasing urinary PdG concentrations. This report demonstrates that ovarian function in uncaptured bison can be monitored by means of urinary PdG and that both ovulatory cycles and early pregnancy can be detected. PMID- 1787476 TI - Role of gonadal negative feedback on the gonadotrophin responses to gonadotrophin releasing hormone (GnRH) in ram lambs from two lines of sheep selected for their luteinizing hormone response to GnRH. AB - Divergent selection has resulted in two lines of lambs (high and low) that have a 5-fold difference in their ability to release luteinizing hormone (LH) in response to 5 micrograms of gonadotrophin-releasing hormone (GnRH). Baseline gonadotrophin concentrations, the gonadotrophin responses to a GnRH challenge and the concentrations of testosterone and oestradiol were compared in lambs which were castrated at birth and intact lambs from both selection lines at 2, 6, 10 and 20 weeks of age. The pattern of LH and follicle-stimulating hormone (FSH) secretion was similar in the two lines, but differed between the intact and the castrated lambs. Basal LH and FSH secretion were significantly higher in the castrates than in the intact lambs from both selection lines. The high-line lambs had significantly higher basal FSH concentrations at all ages tested and significantly higher basal LH concentrations during the early postnatal period. The magnitude of the gonadotrophin responses to GnRH differed significantly between the intact and the castrated lambs within each line, the amount of gonadotrophins secreted by the castrated lambs being significantly greater. The removal of gonadal negative feedback by castration did not alter the between-line difference in either LH or the FSH response to the GnRH challenge. Throughout the experimental period, the concentration of testosterone in the intact lambs was significantly greater than in the castrated lambs in both selection lines, but no significant difference was seen in the concentrations of oestradiol. No significant between-line differences were found in the peripheral concentrations of testosterone or oestradiol in the intact lambs from the two selection lines. Therefore, despite similar amounts of gonadal negative feedback in the selection lines, there were significant between-line differences in basal gonadotrophin concentrations, at 2 and 6 weeks of age, and in the LH and FSH responses to an exogenous GnRH challenge, at all ages tested. Removal of gonadal negative feedback did not affect the magnitude of the between-line difference in the response of the lines to GnRH stimulation. The results indicate that the effects of selection on gonadotrophin secretion are primarily at the level of the hypothalamo-pituitary complex. PMID- 1787477 TI - Alterations in pituitary gland sensitivity in ram lambs to physiological doses of gonadotrophin-releasing hormone (GnRH), after divergent selection based on the luteinizing hormone response to a pharmacological GnRH challenge. AB - Divergent selection in 10-week-old Finn-Dorset ram lambs was based on the luteinizing hormone (LH) response to a pharmacological dose of GnRH (5 micrograms). After eight generations of selection, the LH responses of the two lines (low and high) to GnRH differed by a factor of five. This study investigates the pituitary sensitivity of the two lines to exogenous GnRH. Initially, two pilot studies were performed: one to determine the range of doses of GnRH which would stimulate LH pulses of similar amplitude to those seen endogenously, and the other to confirm that sodium pentobarbitone prevents pulsatile LH secretion in prepubertal ram lambs. The results indicated that barbiturate anaesthesia suppressed pulsatile LH secretion in castrated and intact ram lambs. A model system was therefore constructed in 18 10-week-old intact ram lambs (high n = 7, low n = 11), whereby endogenous pulsatile LH secretion was prevented by sodium pentobarbitone anaesthesia and the amplitudes of LH pulses produced in response to different doses of exogenous GnRH could be measured. The GnRH dose-response curves demonstrated that there was a five-fold difference in the sensitivity of the pituitary glands of the two lines to stimulation with GnRH. The projected minimum concentration of GnRH required to produce a measurable pulse of LH was 4.75 ng for the high-line animals and 26.6 ng for the low-line animals. The results indicated that the low-line animals required five times more GnRH than the high-line lambs to stimulate LH pulses of similar amplitude (high line 43.67 ng; low line 206.55 ng). These results demonstrate that selection has produced two lines of sheep which differ in the control of LH secretion at the level of the hypothalamus-pituitary gland. PMID- 1787478 TI - Effect of melittin on prostaglandin production by guinea-pig uterus. AB - Melittin, an activator of phospholipase (PL) A-2, increased the outputs of prostaglandin (PG) F-2 alpha and 6-keto-PGF-1 alpha, but not of PGE-2, from Day-7 guinea-pig uterus superfused in vitro. Reducing the extracellular calcium concentration (by omitting calcium chloride from the superfusing fluid) partially inhibited the stimulatory effect of melittin on uterine PG production. TMB-8 (an intracellular calcium antagonist) completely prevented the stimulation of PGF-2 alpha and 6-keto-PGF-1 alpha output by melittin, although the production of both PGs tended to increase after stopping the melittin and TMB-8 treatments. TMB-8 also inhibited the increases in outputs of PGF-2 alpha, 6-keto-PGF-1 alpha and PGE-2 and prevented contraction of the uterus induced by exogenous PLA-2. Trifluoperazine (a calmodulin antagonist) had no inhibitory effect on the increases in outputs of PGF-2 alpha and 6-keto-PGF-1 alpha produced by melittin; it potentiated the stimulatory effect of melittin on 6-keto-PGF-1 alpha output and allowed melittin to increase PGE-2 output. When melittin was applied twice to the superfused uterus with an interval of 1 h between each treatment, partial refractoriness of the responses to melittin was seen: the magnitudes of the increases in PGF-2 alpha and 6-keto-PGF-1 alpha outputs were 40-50% less after the second treatment than after the first treatment. These results show that melittin stimulates the synthesis of PGF-2 alpha and PGI-2 (measured as 6-keto PGF-1 alpha) in guinea-pig uterus by mechanisms which are calcium dependent.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787479 TI - An ultrastructural study of in-vitro interaction of guinea-pig and mouse blastocysts with extracellular matrices. AB - Guinea-pig (intrusive) and mouse (displacement) blastocysts display different cellular mechanisms of implantation. Blastocysts were placed in CMRL-1066 supplemented with either 10 or 20% fetal calf serum, 0.1M L-glutamine and antibiotics and then transferred to dishes previously coated with either Matrigel or type I collagen. After culture for 48 or 72 h, the dishes were processed for transmission electron microscopy. Blastocysts had attached to both extracellular matrices by 48 h. Matrigel elicited minimal trophoblast cell activity. Trophoblast cell projections were oriented parallel to the Matrigel and displayed little invasive activity, but trophoblast cells displayed active interaction with type I collagen. By 72 h, trophoblast cells exhibited slender, anastomosing projections which extended into the collagen matrix. Bundles of microfilaments running parallel with the long axis of the projections were observed. The morphology of type I collagen was altered in the immediate vicinity of the trophoblast projections. The projections interdigitated and desmosomes developed between processes. Projections appeared to meet, fuse and entrap matrix. These results suggest that trophoblast cells do not significantly interact with Matrigel, but penetrate into type I collagen. PMID- 1787480 TI - Stimulation of 2',5'-oligoadenylate synthetase activity in sheep endometrium during pregnancy, by intrauterine infusion of ovine trophoblast protein-1, and by intramuscular administration of recombinant bovine interferon-alpha I1. AB - In Expt 1, activity of 2',5'-oligoadenylate (2',5'-A) synthetase in endometrium collected on Day 16 (oestrus is Day 0) from the uterine horn ipsilateral to the corpus luteum was greater (P less than 0.001) for pregnant (135.5 +/- 1.72 nmol/mg protein/h) than for cyclic ewes (58.5 +/- 0.99 nmol/mg protein/h). In pregnant ewes, activity of 2',5'-A synthetase in endometrium collected from the contralateral uterine horn (119.5 +/- 1.72 nmol/mg protein/h) did not differ from that of the ipsilateral horn. In Expt 2, three ovariectomized ewes were treated with progesterone for 10 days and then with oestrogen for 2 days. Activity of 2',5'-A synthetase on Day 13 was 18% greater (P less than 0.10) in endometrium collected from the uterine horn receiving infusions of 30 micrograms ovine trophoblast protein-1 (oTP-1) twice a day on Days 10, 11 and 12(57.7 +/- 0.22 nmol/mg protein/h) than from the uterine horn receiving control infusions of serum protein (SP; 48.8 +/- 0.22 nmol/mg protein/h). In Expt 3, activity of 2',5' A synthetase on Day 15 was not significantly greater in endometrium collected from the uterine horn of cyclic ewes receiving infusions of 30 micrograms oTP-1 twice a day on Days 12, 13 and 14 (46.5 +/- 0.37 nmol/mg protein/h) than in endometrium from the uterine horn receiving infusions of SP (38.2 +/- 0.37 nmol/mg protein/h). When results of Expt 2 and Expt 3 were combined, intrauterine infusion of oTP-1 increased (P less than 0.05) activity of 2',5'-A synthetase in endometrium by 20%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787481 TI - Immunoreactive cytochrome P-450(17 alpha) in rat and guinea-pig gonads, adrenal glands and brain. AB - The cytochrome P-450(17 alpha)-hydroxylase, 17----20 lyase (P-450(17 alpha)) is the key enzyme responsible for the biosynthesis of androgens in steroidogenic organs. Its cellular localization has been examined with an immunohistochemical technique. In immature rat ovary, P-450(17 alpha) was first detected in sparse interstitial cells on postnatal Day 8. The number of immunoreactive interstitial cells increased thereafter and the intensity of P-450(17 alpha) staining in these cells was highest at 3 weeks of age. The intensity of staining then started to decline and was very faint at Day 35. From 6 weeks on, the distribution of immunoreactive P-450(17 alpha) was of the adult type: it was detected exclusively in the thecal cells of the large antral, preovulatory, follicles. P-450(17 alpha) was not detectable during pregnancy except on the day of parturition, when thecal cells were transiently immunoreactive. The staining had vanished 24 h after delivery. Human chorionic gonadotrophin (hCG), injected into immature females on Days 24 to 26, induced P-450(17 alpha) prematurely in thecal cells. When injected on Days 12 to 14 of pregnancy, hCG also induced P-450(17 alpha) in the thecal cells surrounding the largest follicles, whereas the interstitial and luteal cells were not immunostained. The antiprogestin RU486, injected on Day 16 of pregnancy, reinstated P-450(17 alpha) (and P-450scc) immunoreactivity in the thecal cells. Oestradiol selectively suppressed P-450(17 alpha) expression in the thecal cells of RU486-treated females. In immature guinea-pig ovary, P-450(17 alpha) was immunostained in thecal cells, not in interstitial cells, although the interstitial cells expressed the delta 5-3 beta-hydroxysteroid dehydrogenase. P 450(17 alpha) was also immunolocalized in the Leydig cells of rat and guinea-pig testes, and in the guinea-pig adrenal cortex (zonae fasciculata and reticularis), but not in the rat adrenal cortex. P-450(17 alpha) was not detectable in the brain of either rat or guinea-pig. PMID- 1787482 TI - Challenges in designing antirheumatic drug trials. PMID- 1787483 TI - The relationship of dermatomyositis/polymyositis to malignancy. PMID- 1787484 TI - What's inside the team care box? Is it the parts, the connections, the attention, or the Gestalt? PMID- 1787485 TI - Prediction of team care effects in outpatients with rheumatoid arthritis. AB - Predictive factors for the outcome of 1-year rheuma-team care were studied in 68 female rheumatoid arthritis (RA) outpatients (mean age 56 years, mean RA duration 15 years). Seventy-three background variables were analyzed in a 4-step statistical model including partial and multivariate correlations in order to disclose the best predictors of change scores of the outcome measures chosen. These concerned disease activity (C-reactive protein, Lansbury articular index), physical joint function (Keitel index), mood (Mood Adjective Check List, MACL), and overall health (Sickness Impact Profile). Between 14 and 47% of the variance of the 1-year outcome change scores was explained by combinations of 2 or 3 predictors out of 12 strong background variables. The lowest value of explained variance was noted for MACL, and the highest for C-reactive protein. Both clinical, social, and self-assessed health data were among the predictors. Our results can provide a guide in the selection of patients with RA for multidisciplinary team care, in the formulation of treatment goals, and the creation of cost-effectiveness schedules. PMID- 1787486 TI - Prolactin deficiency in rheumatoid arthritis. AB - Prolactin and growth hormone were determined from the sera of 48 patients with rheumatoid arthritis (RA) and 23 controls by radioimmunoassay and by the Nb2 lymphoma proliferation bioassay. A highly significant deficiency was found in the bioactivity of circulating prolactin (PRL) in patients with RA, whereas immunoactive PRL was near normal. Only age matched male patients showed significantly lower serum PRL levels by radioimmunoassay. Patients with RA with anemia and high reticulocyte counts had bioactivity of PRL elevated and those with anemia and low reticulocyte counts had a decreased bioactivity of PRL when compared to patients without anemia. Prolactin isolated from the sera of 5 patients with RA showed decreased bioactivity in comparison with PRL separated from 5 sex matched controls. Serum factors capable of enhancing or inhibiting the response of Nb2 cells to ovine PRL were also discovered. Our results indicate that RA is associated with PRL deficiency. PMID- 1787487 TI - An immunohistochemical study of the collagens of rabbit synovial interstitium. AB - The interstitial pathway from joint cavity to synovial transport vessels contains a complex extracellular matrix. Rabbit knee synovial intima contains 3 fibrous elements--banded collagen fibrils, microfibrils and broad banded aggregates. The distribution of 4 types of collagen in rabbit knee synovium was investigated immunohistochemically. Types I and III collagens are both present, although the binding of anti-type I antibody was weak. Type V collagen, which forms thin fibrils, or is copolymerized with type I collagen, and type VI collagen, which forms broad banded aggregates and microfibrils, are widely distributed throughout the intimal and subintimal matrices. PMID- 1787488 TI - Autoantibodies against ribosomal proteins found with high frequency in patients with systemic lupus erythematosus with active disease. AB - Antibodies to ribosomal protein components were examined in sera from 89 patients with active systemic lupus erythematosus (SLE). The anti-P, anti-S10 and anti-L12 antibodies were detected in 37, 28 and 2 patients, respectively. They were not detected in patients with various autoimmune diseases other than SLE or in healthy donors, which indicates that antiribosomal protein antibodies in sera are specific for patients with SLE. These antibodies are prevalent in patients with SLE and should provide good markers for the diagnosis of this disease. PMID- 1787489 TI - Sjogren's syndrome in patients with the CREST variant of progressive systemic scleroderma. AB - Twenty-three patients with the CREST (calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, telangiectasia) variant of progressive systemic sclerosis, were clinically, histopathologically and serologically examined for the presence of Sjogren's syndrome (SS). Fourteen were found to be positive. No significant difference could be demonstrated between them and the remaining 9. Characteristics of patients with CREST were compared with those of 29 randomly chosen patients with primary SS. Parotid gland enlargement was more frequently present (p less than 0.01) in the latter than in the former. Virtually no patients with CREST with SS had antibodies to Ro(SSA)/La(SSB). PMID- 1787490 TI - A reexamination of the relationship between myositis and malignancy. AB - The association between myositis and malignancy has long been appreciated. However, several recent reviews question the validity of this connection and the utility of pursuing an extensive search for occult malignancy in myositis. We report 9 patients fulfilling diagnostic criteria for myositis seen in the past 12 years. In each, a neoplasm was uncovered only in the course of a systematic search or, when initial investigation was deferred, at a later time. Of the 9 patients, 6 had dermatomyositis, 3 polymyositis. In 3 cases, solid tumors were diagnosed concomitantly with the myositis. In the remaining 6 patients, an advanced neoplasm was detected in the course of followup. In retrospect, some of these tumors might have been detected at an earlier and perhaps more treatable stage had a more rigorous initial malignancy search been pursued. Based on this experience, it is imperative that the clinician undertake a more exhaustive search for occult malignancy in patients with myositis than is currently recommended. PMID- 1787491 TI - Magnetic resonance imaging in the idiopathic inflammatory myopathies. AB - We examined the usefulness of magnetic resonance imaging (MRI) in detecting active muscle disease in 40 patients with idiopathic inflammatory myopathies (IIM). Ten patients without evidence of an inflammatory neuromuscular disease were also studied. The fat-suppressive (STIR) image signal intensity correlated with clinical disease activity and, in most cases, with the presence of inflammation on muscle biopsy. Increased STIR signal intensity paralleled disease activity in 3 patients followed serially. MRI provided a detailed anatomic view of the extent of muscle changes in these diseases. Because of inherent limitations of other measures of disease in these disorders, MRI may prove to be a useful complimentary test for assessing disease activity and guiding therapeutic decisions and biopsy in the idiopathic inflammatory myopathies. PMID- 1787492 TI - Ankylosing spondylitis antirheumatic drug trials. I. Effects of standardization procedures on observer dependent outcome measures. AB - We designed a study to assess the effects of standardization procedures on reducing interobserver variability for outcome measures given in the current Food Drug Administration and European League Against Rheumatism guidelines and others selected from the rheumatology literature. Over 2 days, 6 rheumatologists independently examined 7 patients with ankylosing spondylitis (AS) in predetermined order before and after standardizing their examination techniques. An important and beneficial effect of the standardization procedure was observed on the majority of outcome variables. Such reductions in observer variability have the potential to diminish sample size requirements for AS antirheumatic drug studies. PMID- 1787493 TI - Ankylosing spondylitis antirheumatic drug trials. II. Tables for calculating sample size for clinical trials. AB - The calculation of sample size requires knowledge of the standard deviation (SD) of index variables. Unfortunately, there are no published lists of standard deviations and it is exceedingly difficult to locate variance estimates based on relevant populations. We used standardized procedures to determine in 60 patients with ankylosing spondylitis (AS) the SD of key outcome measures recommended in current Food Drug Administration and European League Against Rheumatism guidelines for AS clinical trials. We anticipate that these tables will be useful to clinical researchers in selecting outcome measures as well as for calculating sample size requirements for future clinical studies in AS. PMID- 1787494 TI - Ankylosing spondylitis antirheumatic drug trials. III. Setting the delta for clinical trials of antirheumatic drugs--results of a consensus development (Delphi) exercise. AB - Defining the minimum clinically important difference or delta to be detected in a clinical trial depends on a number of factors including the research hypothesis, patient characteristics, the nature of the intervention and the trial design. In 2 previous studies, we have developed standardized procedures for conducting outcome measurement based on current Food and Drug Administration and European League Against Rheumatism guidelines for clinical trials in ankylosing spondylitis, and thereafter, determined the standard deviation for these outcome measures. In the final component of this series of studies, we have employed a Delphi technique to establish estimates for delta, and calculated the sample size requirements under 2 different conditions of Type I and Type II error probabilities. PMID- 1787495 TI - Hypercalcemia during the resolution of calcinosis universalis in juvenile dermatomyositis. AB - Dystrophic calcification is seen in more than 50% of children with juvenile dermatomyositis and tends to resolve spontaneously in some patients. Calcinosis universalis is the least common type of calcification seen and rarely regresses. We describe a boy with juvenile dermatomyositis and calcinosis universalis who developed hypercalcemia during spontaneous regression of dystrophic calcification. The treatment and possible mechanisms of this complication are discussed. PMID- 1787496 TI - Barrett's esophagus in a young patient with Raynaud's phenomenon. AB - We describe a 12-year-old girl with Raynaud's phenomenon (RP) of 3 years' duration, who developed Barrett's esophagus with severe stricture. Barrett's esophagus complicating progressive systemic sclerosis has been reported in adult patients, but not in childhood. Barrett's esophagus following RP alone has not been reported, to the best of our knowledge, in any age group. PMID- 1787497 TI - Humanized monoclonal antibody treatment in rheumatoid arthritis. AB - A 41-year-old woman with active, seropositive erosive rheumatoid arthritis was treated with the humanized monoclonal antibody Campath 1H. She had not responded or developed side effects to myocrisin, sulfasalazine and penicillamine, and had not responded to inpatient bedrest and physiotherapy. There was a rapid clinical improvement within 24 hours of infusion, which was maintained for about 12-14 weeks after the infusion. The lymphocyte count was suppressed for 7 months after treatment. There were no significant side effects during or after treatment. No anti-Campath 1H response was detected. This preliminary study suggests humanized monoclonal antibody therapy may be of value in the treatment of rheumatoid arthritis. PMID- 1787498 TI - The coexistence of active classic rheumatoid arthritis and AIDS. AB - The lack of previous reports documenting the coexistence of active rheumatoid arthritis (RA) and acquired immunodeficiency syndrome (AIDS) despite an abundance of other HIV associated autoimmune phenomena has generated a hypothesis regarding the necessity of the T4 cell for the development or continued activity of RA. We are the first to describe a patient in whom AIDS did not induce a remission of active synovitis. This observation emphasizes the complexity of the pathogenesis of RA. PMID- 1787499 TI - Lymphoma developing in a patient with rheumatoid arthritis taking low dose weekly methotrexate. AB - We describe the occurrence of a lymphoma in a patient with rheumatoid arthritis (RA) taking weekly oral pulse methotrexate (MTX) in low doses for 33 months. This occurrence may be coincidental. There may be an increased incidence of lymphoma in RA not treated with immunosuppressive medications. However, the increasing use of MTX warrants reporting unusual events, especially malignancy. It is possible that even the mild immunosuppression that occurs with MTX therapy places patients with RA at added risk for developing lymphoproliferative diseases. PMID- 1787500 TI - Peripheral T cell lymphoma with Sjogren's syndrome: a report with immunologic and genotypic studies. AB - We describe an unusual case of peripheral T cell lymphoma, occurring 4 years after the diagnosis of primary Sjogren's syndrome. Immunologic and genotypic studies demonstrated the T cell origin of this lymphoma. PMID- 1787501 TI - Reversal of the vasospastic component of lupus vasculopathy by infusion of prostaglandin E1. AB - The responses of 3 patients with systemic lupus erythematosus (SLE) and progressive digital ischemia to intravenous prostaglandin E1 (PGE1) were studied prospectively in an open 3-day trial. All patients were unresponsive to corticosteroids, one had vasculitis proven by biopsy. Digital ischemia diminished in all 3 patients. In one patient, angiograms documented reappearance of a previously obstructed deep palmar arch. Vasospasm plays a role in the outcome of SLE vasculitis even in the absence of Raynaud's phenomenon. As suggested by animal models of necrotizing and leukocytoclastic vasculitis, and by case reports, intravenous PGE1 may be a relatively nontoxic, adjunctive treatment for vasculitis. PMID- 1787502 TI - Cocaine and scleroderma: is there an association? AB - Scleroderma is a multisystem disease of unknown etiology. A disease predominantly of women, it is distinctly rare in young men. A case of scleroderma in a young male cocaine user is presented, and the possibility that cocaine may play a part in its etiology is explored. PMID- 1787503 TI - Interplay of microbe and major histocompatibility complex: a family study. AB - We describe a 24-year-old man who developed reactive arthritis (ReA) after a dysenteric illness caused by Salmonella hadar. Serologic tests suggested recent exposure of family members to Salmonella. All members of the family were HLA-B27 positive, but no other family member developed acute ReA, although 2 of them had clinical evidence of previously existing B27 associated arthritis. PMID- 1787504 TI - Iliolumbar ligament ossification as a radiologic feature of reactive arthritis. AB - We describe the case of a 21-year-old woman with the clinical picture of HLA-B27+ reactive arthritis (ReA) in whom the ossification of the left iliolumbar ligament was detected. Our case proves that ligament calcifications, which have so far been ascribed to diffuse idiopathic skeletal hyperostosis may also occur in young patients with ReA not primarily affected by metabolic osteoarticular diseases with negative family history. PMID- 1787505 TI - Low dose methotrexate treatment in systemic sclerosis. PMID- 1787506 TI - RS3PE syndrome and polymyalgia rheumatica: distinguishing features. PMID- 1787507 TI - The first case of CRST syndrome associated with collagenous colitis. PMID- 1787508 TI - Polymyositis associated with primary biliary cirrhosis. PMID- 1787509 TI - Arthritis as an unusual presentation of primary biliary cirrhosis. PMID- 1787510 TI - L-tryptophan metabolites and bladder cancer. PMID- 1787511 TI - Destructive arthritis of the temporomandibular joint in a patient with Reiter's syndrome and human immunodeficiency virus infection. PMID- 1787512 TI - Septic arthritis caused by Hemophilus influenza type B in a patient with HIV-1 infection. PMID- 1787513 TI - Philosophy and the teaching of health care ethics. PMID- 1787514 TI - From the patient's point of view: medical ethics and the moral imagination. AB - This paper concerns the difficulties of imagining the subjective point of view of another human being, and the relevance of these difficulties to medical decisions. It explores especially the difficulties of imagining the experience of the mentally impaired, and examines several standards for decision-making: the 'prior expressed wishes standard', the 'substituted judgement standard', and the 'best interests standard'. PMID- 1787515 TI - Resource allocation: idealism, realism, pragmatism, openness. AB - Lewis and Charny have come under siege for suggesting remote questioning to decide appropriate medical care. While the criticisms are theoretically valid, the idea is so important practically that Lewis and Charny should be supported and their approach investigated as a way of making medical treatment at least more open and possibly more fair. PMID- 1787516 TI - The principle of QALY maximisation as the basis for allocating health care resources. AB - This paper presents a case for allocating health care resources so as to maximise Quality Adjusted Life Years (QALYs). Throughout parallels are drawn with the grounds for adopting utilitarianism. QALYs are desirable because they are essential for human flourishing and goal-attainment. In conditions of scarcity the principle of QALY maximisation may involve unequal treatment of different groups of people; and it is argued that this is not objectionable. Doctors in their dealings with patients should not be continually consulting the principle (though it can sometimes be useful); instead by following existing ethical codes more QALYs will be produced overall. In the formulation of policy, however, the principle should be applied in a thoroughgoing way and, if it is, it will not have some of the counterintuitive consequences it may have in interpersonal situations. PMID- 1787517 TI - Unprincipled QALYs: a response to Cubbon. PMID- 1787518 TI - Can compulsory removal ever be justified for adults who are mentally competent? AB - Section 47 of the National Assistance Act is controversial in that it makes provision for the compulsory removal and care of mentally competent adults in certain limited circumstances. A case is described in which it is argued that compulsory management could be justified. This is because the diversity and potentially conflicting nature of the relevant considerations involved in this and a restricted range of other cases, defies their being captured in any wholly rational moral scheme. It follows that if the law is to be both sensitive and just it cannot always provide definitive guidance as to how the community doctor, as the designated decision-maker, should act. The acceptance of his or her judgement is therefore necessary and depends for its proper working on trust, which can only be gained through compassion and respect for the patients concerned. PMID- 1787519 TI - Section 47--assault on or protection of the freedom of the individual? A short response to Greaves. AB - Section 47 of the 1948 National Assistance Act allows incompetent people, usually old people, to be removed from their homes. It can be considered as a repressive tool, designed to infringe personal liberty, but in this article it is argued that it can also be considered as being legislation which governs and controls professional practice and protects the old person from public prejudice. PMID- 1787520 TI - HIV, confidentiality and 'a delicate balance': a reply to Leone Ridsdale. AB - The passing on of information to GPs by genito-urinary doctors is to be encouraged but is not always possible and ultimately the patient's wishes and confidentiality must be respected if sexually transmitted diseases and HIV infection are to be controlled. Infected health-care workers should seek counselling and medical support and clear guidelines from professional organisations which are in existence. However, they will only do so if strict confidentiality is maintained and assurance about future employment can be given. PMID- 1787521 TI - Consent in paediatrics: a complex teaching assignment. AB - The topic of consent in paediatrics is made more difficult, and at the same time more interesting, by the complexity of the issues involved and the consequent diversity of viewpoints. In a teaching session for senior medical students on consent in paediatrics it proved necessary to reinstate previous learning from a range of disciplines. Philosophical medical ethics, developmental psychology, communication skills and the appropriate legal definitions all contributed to a proper understanding of the cases presented. The two most important additional components appeared to be a) a basic knowledge of cognitive development and how to apply it, and b) an awareness of the need to balance an individual child's rights or best interests, with those of the family unit, as well as the wider society. PMID- 1787522 TI - Prolonging dying is the same as prolonging living--one more response to Long. AB - In earlier publications, we had argued that Paul Ramsey is inconsistent because he simultaneously asserts that (i) 'all our days and years are of equal worth' and (ii) 'that it is permissible to refrain from prolonging the lives of some dying patients'. Thomas Long has suggested that we have not shown that Paul Ramsey is inconsistent. Ramsey and we, he holds, start from incommensurable metaphysical views: for Ramsey, the dying process has religious significance--God is calling his servant home. While it is normally a good thing to keep a patient alive, it would, for Ramsey, show deafness to God's call to keep a dying patient alive. It is true we do not share Paul Ramsey's religious views. It is, however, not necessary to rely on any particular metaphysical views to refute Ramsey's position. For Ramsey's view to be internally consistent, Ramsey would have to be able to distinguish between dying and non-dying patients. We examine some of Ramsey's examples and show that his practical judgements do not allow us to draw this distinction. This means that, contra Long, we hold fast to our charge that Ramsey's view is inconsistent. PMID- 1787523 TI - Animal experimentation (but without man at the centre of the universe) PMID- 1787524 TI - Death in Denmark: reply to Lamb. PMID- 1787525 TI - Ethics of preventive medicine: response to McPherson. PMID- 1787526 TI - Ontogeny of monooxygenase activities in the marmoset monkey (Callithrix jacchus). AB - The pre- and postnatal development of monooxygenases in the liver and adrenal gland of marmoset monkeys (Callithrix jacchus) was investigated. Cytochrome P450 was detected in the fetal adrenal gland, but aldrin epoxidase, ethoxycoumarin O deethylase, and ethoxyresorufin O-deethylase activities were below detection limits. Although fetal hepatic cytochrome P450 was not detected, low activities of aldrin epoxidase and ethoxycoumarin O-deethylase, but no ethoxyresorufin O deethylase, could be detected in fetal liver. These enzymes attained adult marmosets activities when the offspring were approximately 2 months of age. PMID- 1787527 TI - Serum insulin-like growth factor 1 concentrations in the developing rhesus monkey. AB - We studied the developmental pattern of serum IGF-1 concentrations in the rhesus monkey in cross-sectional and longitudinal manners. Values were lower in infants with a significant rise at the onset of puberty. Females values were lower than males except for pregnant females. There was a correlation of IGF-1 values with body weight in the males. Longitudinal study of six animals proved this age dependence of IGF-1 values. The rhesus monkey has a pattern of serum IGF-1 concentrations similar to that of the human being. PMID- 1787528 TI - The growth hormone secretory response to growth hormone releasing factor in the developing rhesus monkey. AB - We studied the development of the GH response to growth hormone releasing hormone (GHRH) using two doses of GHRH. The newborns demonstrated higher baseline GH and responses to GHRH than animals of any older age. There was no difference noted between the rise in GH in male and female subjects with 10 mcg/kg vs 1 mcg/kg. Serum cortisol concentrations did not correlate with serum GH concentrations. These developmental patterns of serum GH are similar to those known in the human being. PMID- 1787529 TI - Normal serum biochemical and hematological parameters in Macaca fascicularis. AB - The effects of age, sex, pregnancy, were analyzed and data from fasted and fed animals were compared in a population of cynomolgus macaques. No significant sex effects were observed for biochemical values and no changes were found in male hematological parameters in relation to age. Most values of females during pregnancy were within normal ranges. Comparison between fed and fasted animals showed that several biochemical parameters (e.g., ALT, glucose, CPK, LDH) and several hematological parameters (e.g., monocytes, eosinophils, basophils, hemoglobin, MCV, MCHC, and MCH) were affected by food intake. PMID- 1787530 TI - Anti-human red cell monoclonal antibodies produced by macaque-mouse heterohybridomas. AB - Eight monoclonal antibodies (Mabs) against human red cells were produced by macaque-mouse heterohybridomas. All Mabs uniformly reacted with all human red blood cells tested, but only some agglutinated the red cells of anthropoid apes occasionally detecting intraspecies polymorphisms. None was reactive with blood of Old and New World monkeys. One of the Mabs recognized the Vc antigen of the chimpanzee V-A-B-D system, the homologue of the human M-N blood group system. PMID- 1787531 TI - Possible osteomyelitis of skull causes death of a wild lowland gorilla in the Lope Reserve, Gabon. AB - The remains of a juvenile gorilla, apparently dead for 3-4 days, were found in the Lope Reserve, Gabon. The skull was recovered and showed a chronic lesion involving the insertion of the masseter muscle, consistent with chronic osteomyelitis. PMID- 1787532 TI - The veterinary management of a laryngeal air sac infection in a free-ranging mountain gorilla. AB - A purulent laryngeal air sac infection was diagnosed in a free-ranging adult male mountain gorilla (Gorilla gorilla beringei) in Central Africa. Successful treatment included the administration of antibiotics via blow dart and surgical drainage in the field. This case occurred during an outbreak of respiratory disease of undetermined etiology in this and other gorillas in the population. PMID- 1787533 TI - Protein concentration in urine of normal owl monkeys. AB - The excretion of urinary protein was evaluated in 62 owl monkeys using timed urine collections. The ratio of urine protein to urine creatinine concentrations (Up/c) was determined for each monkey. Linear regression analysis was used to calculate the correlation between that ratio and urine protein (mg/dl) and 24 hour urinary protein loss (mg/kg). The coefficient of determination for Up/c to urine protein and 24-hour urinary protein loss was significant (P less than or equal to 0.0001). Determination of the Up/c in a urine specimen was found to be an acceptable diagnostic technique for detection and quantitative estimation of proteinuria. PMID- 1787534 TI - Twinning in the karyotype I night monkey (Aotus nancymai). AB - A case of successful survival of twins in a Karyotype I (2n = 54) night monkey (Aotus nancymai) is described. Monthly weights of the pregnant female, and of the twins, are compared to those of pregnant females and their single birth offspring of the same sex and karyotype. PMID- 1787535 TI - Role of voltage-dependent ionic currents in coupling glucose stimulation to insulin secretion in canine pancreatic islet B-cells. AB - Glucose-induced electrical activity in canine pancreatic islet B cells is distinct from that in rodent islets, though both display Ca(2+)-dependent insulin secretion. Rodent islet B cells undergo regular bursts of Ca(2+)-dependent action potentials, while canine islet B cells generate isolated Na(+)-dependent action potentials which often give way to a plateau depolarization. Here we present evidence to reconcile the species difference in electrical activity with the similarity of Ca2+ dependence of secretion. (i) In canine B cells increasing glucose concentrations produce membrane depolarization and increasing frequency of Nao-dependent action potentials until a background membrane potential (approximately -40 mV) is reached where Na+ currents are inactivated. (ii) Voltage-dependent Ca2+ currents are present which are activated over the voltage excursion of the action potential (-50 to +20 mV) and inactivate slowly, (over seconds) in the range of the plateau depolarization (-40 to -25 mV). Hence, they are available to contribute to both phases of depolarization. (iii) Tetrodotoxin (TTX) reduces by half an early transient phase of glucose-stimulated insulin secretion but not a subsequent prolonged plateau phase. The transient phase of secretion often corresponds well in time to the period of initial high frequency action potential activity. These latter results suggest that in canine B cells voltage-dependent Na+ and Ca2+ currents mediate biphasic glucose-induced insulin secretion. The early train of Na(+)-dependent action potentials, by transiently activating Ca2+ channels and allowing pulsatile Ca2+ entry, may promote an early transient phase of insulin secretion. The subsequent sustained plateau depolarization, by allowing sustained Ca2+ entry, may permit steady insulin release. PMID- 1787536 TI - Ion fluxes in Acetabularia: vesicular shuttle. AB - Ion flux relations in the unicellular marine alga Acetabularia have been investigated by uptake and washout kinetics of radioactive tracers (22Na+, 42K+, 36Cl- and 86Rb+) in normal cells and in cell segments with altered compartmentation (depleted of vacuole or of cytoplasm). Some flux experiments were supplemented by simultaneous electrophysiological recordings. The main results and conclusions about the steady-state relations are: the plasmalemma is the dominating barrier for translocation of K+ with influx and efflux of about 100 nmol.m-2.sec-1. K+ passes three- to sevenfold more easily than Rb+ does. Under normal conditions, Cl- (the substrate of the electrogenic pump, which dominates the electrical properties of the plasmalemma in the resting state) shows two efflux components of about 17 and 2 mumol.m-2.sec-1, and a cytoplasmic as well as vacuolar [Cl-] of about 420 mM ([Cl-]o = 529 mM). At 4 degrees C, when the pump is inhibited, both influx and efflux, as well as the cellular [Cl-], are significantly reduced. Na+ ([Na+]i: about 70 mM, [Na+]o: 461 mM), which is of minor electrophysiological relevance compared to K+, exhibits rapid and virtually temperature-insensitive (electroneutral) exchange (two components with about 2 and 0.2 mumol.m-2.sec-1 for influx and efflux). Some results with Na+ and Cl- are inconsistent with conventional (noncyclic) compartmentation models: (i) equilibration of the vacuole (with the external medium) can be faster than equilibration of the cytoplasm, (ii) absurd concentration values result when calculated by conventional compartmental analysis, and (iii) large amounts of ions can be released from the cell without changes in the electrical potential of the cytoplasm. These observations can be explained by the particular compartmentation of normal Acetabularia cells (as known by electron micrographs) with about 1 part cytoplasm, 5 parts central vacuole, and 5 parts vacuolar vesicles. These vesicles communicate directly with the central vacuole, with the cytoplasm and with the external medium. PMID- 1787537 TI - Cation transport in vascular endothelial cells and aging. AB - To understand the generation and maintenance of Na and K gradients in cultured vascular endothelial cells, net Na and K movements were studied. Ouabain sensitive (OS) net Na gain and K loss were estimated as the difference between the cation content in the presence of ouabain and that in the control. Ouabain- and furosemide-resistant (OFR) fluxes were determined in the presence of the two inhibitors. When the normal medium bicarbonate and phosphate buffers were replaced by N-2-hydroxyethylpiperazine-N'-2-ethane sulfonic acid both the OS and OFR fluxes decreased more than 50%. Ouabain-sensitive and ouabain- and furosemide resistant fluxes decreased with increasing cellular age (passage number) an effect not observed when the cation movements were studied in the absence of bicarbonate and phosphate. These results suggest that cultured vascular endothelial cells possess bicarbonate- and phosphate-dependent Na and K pathways which account for a significant portion of their passive movements. Furthermore, the behavior of cation permeabilities with passage number suggests that these modulations may be related to the cellular aging process. PMID- 1787538 TI - Induction of anti-myelin antibodies in EAE and their possible role in demyelination. AB - Experimental allergic encephalomyelitis is characterized by invasion of lymphocytes and macrophages into the central nervous system resulting in inflammation, edema, and demyelination. Sera from Lewis rats from 7-95 days after immunization with purified guinea pig CNS myelin were examined with respect to their ability to opsonize myelin. This was correlated with the appearance of antibody components and the relative amounts of antibody to myelin basic protein (MBP) and proteolipid protein (PLP). Sera from rats 10-95 days after immunization preincubated with purified myelin induced phagocytosis of myelin by cultured macrophages with the resulting production of cholesterol ester. This opsonization activity as measured by the percentage of cholesterol esterified reached a peak at 26-27 days after immunization but remained significantly elevated up to 95 days post-immunization compared to the activity of serum from the Freund's adjuvant-injected controls. Immunoblots of the sera revealed a gradual increase in antibody activity against myelin components. ELISA assays for MBP and PLP antibody showed a similar pattern. Antibody to galactocerebroside (GC) was not detected by immunostains nor by the ELISA assay. Areas of demyelination were observed histologically by luxol-fast blue stained spinal cords up to 60 days post-immunization. These results indicate that antibodies to myelin protein when given access to myelin through or within the blood brain barrier could initiate or enhance the phagocytic response by peripheral or resident macrophages. PMID- 1787539 TI - Evidence that protein constituents of postsynaptic membrane specializations are locally synthesized: time course of appearance of recently synthesized proteins in synaptic junctions. AB - Previous studies have led to the hypothesis that some protein constituents of postsynaptic membrane specializations are locally synthesized near postsynaptic sites. The present study focuses on one prediction of this hypothesis, specifically, that if some proteins of the postsynaptic membrane specialization are locally synthesized, then the delay between synthesis and assembly into synaptic junctional membrane could be short. We evaluate the time course of appearance of recently synthesized protein in synaptic junctions by pulse labeling hippocampal slices maintained in vitro with radiolabeled protein precursors, and then isolating subcellular fractions enriched in synaptic plasma membranes (SPM) and synaptic junctional complexes (SJC). We report that there is no evidence of a delay in the appearance of recently synthesized proteins in SPM and SJC fractions. Labeled proteins could be detected as early as 15 min after the initiation of the pulse-labeling period, and the extent of labeling increased monotonically thereafter. The labeling could not be accounted for by contamination of synaptic membrane fractions with other membranes, because the relative specific activity of the SPM and SJC fractions was the same or higher than that of the less pure fractions from which these synaptic fractions were derived. One-dimensional PAGE-fluorography was used to provide an initial characterization of which proteins were labeled in SJC fractions. We found that the most prominent labeled bands were at apparent molecular weights of approximately 43-44, 55-56, and 60 kd, with more lightly labeled bands at about 38 and 116 kd. In some preparations, there was a labeled doublet at about 36-38 kd. There were also other lightly labeled bands at other molecular weights. These bands were much less heavily labeled than the bands at 43-44, 55-56, and 60 kd, however. There was little labeling in the molecular weight range of the "major psd protein" (the alpha subunit of CAM-kinase), although there was diffuse labeling throughout the 45-52 kd region. These results are consistent with the hypothesis that some of the protein constituents of the postsynaptic junctional complex are synthesized by polyribosomes which are selectively localized beneath synaptic junctions. PMID- 1787540 TI - Hyposmolarity-induced taurine release in cerebellar granule cells is associated with diffusion and not with high-affinity transport. AB - The effects of hyposmotic conditions on taurine uptake and release were studied in mice cultured cerebellar granule cells. The effect of DIDS (4,4' diisothiocyanatostilbene-2,2'-disulfonate) and of the divalent cations Mg++ and Mn++ on the hyposmolarity-induced changes in these parameters was investigated. Mg++ (20 mM) and Mn++ (5 mM) inhibited by 25% and 41%, respectively, the release of taurine observed in 30% hyposmolar media. DIDS (100 microM) inhibited this release by 46%. Taurine efflux evoked by 50% hyposmolar solutions was reduced about 40% by Mg++ and 55% by Mn++. Taurine uptake into the granule cells could be resolved into a high-affinity carrier-mediated component plus a nonsaturable diffusion component. The kinetic constants (Km and Vmax) for the high-affinity uptake were unaffected by a 50% decrease in the osmolarity. The diffusion constant for the nonsaturable taurine uptake was increased from 1.5 x 10(-4) in isosmotic media to 4.6 x 10(-4) ml x min-1 x mg-1 in hyposmotic (50%) media. This increase in the diffusional component of taurine uptake elicited by the hyposmotic condition was inhibited approximately 25% by either 100 microM DIDS or 5 mM Mn++. These results strongly suggest that the increase in taurine release induced by swelling under hyposmotic conditions is mediated by a diffusional process and not by a reversal of the high-affinity taurine carrier. PMID- 1787541 TI - Association between vascular basement membrane components and the lesions of Alzheimer's disease. AB - A relationship between the microvasculature and Alzheimer senile plaques has been suggested by several lines of evidence. Besides close anatomic and biochemical relationships, both extrinsic (fibronectin) and intrinsic [heparan sulfate proteoglycan (HSPG)] components of the vascular basement membrane (VBM) have been colonized with amyloid plaques. The present study was designed to examine the association between three intrinsic components of the VBM [HSPG, collagen type IV (CIV), and laminin] and the histopathologic lesions of Alzheimer's disease (AD). Six cases with neuropathologically confirmed AD were immunocytochemically labeled for the presence of HSPG, CIV, laminin, or tau-2 (a marker for degenerating neurites) and examined at the light and electron microscopic levels. For light microscopic analyses, sections were counterstained with a fluorescent marker for amyloid. The present study illustrates an involvement of VBM components in the lesions associated with AD. First, we replicate our previous finding that HSPG antibodies immunolabel a subset of neurons; ultrastructural analyses indicate that at least some of these are actually extracellular neurofibrillary tangles. Second, we report that CIV and laminin immunoreaction product was not associated with neurons but did label several perivascular cells with the morphologic characteristics of microglia. Finally, we demonstrate that all three intrinsic VBM components, CIV and laminin as well as HSPG, are localized to senile plaques. Both light and electron microscopic studies indicate that the VBM components are associated with amyloid rather than degenerating neurites. These findings suggest that the VBM or its components may play a role in the AD pathogenetic cascade. PMID- 1787542 TI - Immunolocalization of Alzheimer beta-amyloid peptide precursor to cellular membranes in baculovirus expression system. AB - One characteristic of Alzheimer's disease (A beta disease) is the accumulation of amyloid deposits within the extracellular space of the brain and meninges. A 40 amino acid peptide called beta-peptide or A4 protein is the subunit of the amyloid fibrils found in these deposits. The sequence of beta-peptide is contained within those of a family of larger proteins called the Alzheimer beta amyloid peptide precursor (APP). These APPs contain, in addition to a signal sequence, a hydrophobic sequence that is believed to span cell membranes. Although biochemical studies indicate that some APPs have properties of integral membrane proteins, morphological confirmation of this has not been reported. We recently described an expression system in which human APP751 cDNA was placed under the transcriptional regulation of the polyhedrin gene promoter in the baculovirus Autographica californica infecting a Spodoptera frugiperda cell line (Ramakrishna et al., Biochem Biophys Res Commun 174:983-989, 1991). As part of a larger biochemical and molecular biological study of APP, we have carried out an immunocytochemical study using antibodies directed against several epitopes within APP to reveal, at both the light and the electron microscopic levels, the cellular localization of APP in the baculovirus expression system. These studies demonstrate that APP751 is abundantly synthesized and inserted into certain of the membrane compartments of the cell. As early as 24 hr postinfection, APP751 is found associated with all membrane compartments excepting mitochondrial membranes. The patterns of immunolabeling are consistent with our biochemical findings that the protein is processed in these cells so as to release the extracellular domain and to retain a transmembrane and intracellular segment. These data provide the first morphological demonstration of the membrane location of APP751, its posttranslational processing to a secreted fragment, and its exclusion from the mitochondrial membranes. This system is especially valuable for identifying conditions under which antibodies raised against APP or appropriate synthetic peptides will react with native APP. PMID- 1787543 TI - Galactocerebroside and sulfatide independently mediate Ca2+ responses in oligodendrocytes. AB - Galactocerebroside (GalC) and sulfated galactocerebroside (sulfatide) are sphingolipids highly enriched in myelin. The binding of antibodies reactive with either sulfatide or GalC to cultured oligodendrocytes causes a Ca2+ influx, followed by microtubule depolymerization; however, antisulfatide is less effective than anti-GalC in altering cytoskeleton. Typical Ca2+ responses are delayed for both antibodies but are transient for sulfatide-reactive antibodies in contrast to the sustained responses previously reported for anti-GalC (Dyer and Benjamins, J Cell Biol 111: 625-633, 1990). Approximately one-half as many oligodendrocytes respond to sulfatide-reactive antibodies (about 39%) as to anti GalC (about 75%). Subpopulations of oligodendrocytes were identified that responded to neither antibody, only one antibody, or both antibodies, indicating that sulfatide and GalC independently mediate Ca2+ responses. These results suggest that sulfatide and GalC have different physiologic roles in regulating elaboration of myelin membrane by oligodendrocytes in vivo and support the possibility that viral or immune attack via GalC or sulfatide on oligodendrocytes may mimic normal signals in a manner that disrupts the sequence of events that coordinates myelination or maintenance of myelin in vivo. PMID- 1787544 TI - Cocaine use by clients in methadone programs: significance, scope, and behavioral interventions. AB - Widespread use of cocaine by methadone clients is undermining the effectiveness of methadone treatment programs in reducing illicit drug use, decreasing criminal behavior, and slowing the spread of the human immunodeficiency virus (HIV). In response, methadone programs are implementing a range of behavioral interventions to manage this growing problem. Many of these interventions, however, have yet to be evaluated for effectiveness for reducing cocaine use among methadone clients. Interventions that are effective for cocaine use in the general population may not be as effective with cocaine users in methadone programs because these clients differ from other cocaine users in ways that are likely to affect how they respond to the interventions. This paper reviews the literature on the significance and scope of the problem of cocaine use by methadone clients and on the behavioral interventions that have been evaluated for these clients. PMID- 1787545 TI - Hidden PTSD in substance abuse inpatients among Vietnam veterans. AB - Alcohol use patterns among Vietnam combat veterans is an area with little research. This study evaluated three groups of Vietnam subjects on a chemical dependency unit who had a current Axis I diagnosis of alcohol abuse. No subject possessed a PTSD diagnosis. Two groups involved in-country veterans divided by presence or absence of PTSD based on the MMPI-PTSD scale (In-country and PTSD). The third group did not experience combat and was below the mean on the MMPI-PTSD scale (Noncombat). These groups were compared on the MMPI and the Alcohol Use Inventory (AUI), a measure of alcohol use patterns. Results showed that the PTSD Group had significantly higher scores on the MMPI and AUI reflective of deteriorated and binge drinking patterns. Discussion focused on the "hidden" dimension of PTSD among chemically dependent Vietnam veteran inpatients. The Relapse Prevention model was endorsed. PMID- 1787546 TI - To surrender drugs: a grief process in its own right. AB - The basic thesis of this article is that addictive substances, because of their need-grafifying and self-medication value, become so central to the life of the addicted person that their absence is associated with a grief reaction. Painful feelings of loss and helplessness accompany drug surrender. This view contrasts with formulations that indicate that mourning experiences observed in recovering persons are specific to and determined by unresolved past losses of loved ones. The author discusses the theoretical underpinnings of the drug-loss grief reaction. Also presented are case vignettes that demonstrate the grief aspects of drug surrender. Finally, the role of brief psychotherapy as a vehicle for helping clients cope with their grief reactions is discussed. PMID- 1787547 TI - Warm turkey: other routes to abstinence. AB - The requirement of immediate and abrupt quitting ("cold turkey") can be an obstacle to the acceptance and accomplishment of abstinence as a long-term outcome. Three alternative "warm turkey" routes to abstinence are discussed: (a) sobriety sampling, (b) tapering down, and (c) trial moderation. Clinical research evidence and case examples are provided in support of these alternative approaches. PMID- 1787548 TI - Condom knowledge, history of use, and attitudes among chemically addicted populations. AB - The need for behavioral change of risky sexual practices has been of the highest priority since the onset of the AIDS epidemic. The major focus of education for safe sex has been emphasis on condom use. We surveyed 124 individuals applying to treatment for various chemical dependencies and 60 individuals applying for non chemical-dependency medical treatment on various aspects of condom knowledge, history of use, and attitudes. Respondents reported that AIDS has motivated them to increase their use of condoms, however, only 13.9% always use them. Education is needed in the areas of increasing protection. Along with the use of a condom, the need for a reservoir tip and the risks associated with multiple sex partners should be stressed. PMID- 1787549 TI - A case of late-onset crack dependence and subsequent psychosis in the elderly. AB - While rapidly spreading "crack" addiction is a major concern in our community, current research in this area is focused mainly on adolescents and young adults. We discuss a case of crack addiction developing for the first time in an elderly person and subsequent complications. We believe no such cases have been previously reported. We hope this will be helpful to practicing clinicians and stimulate research to understand cocaine and crack abuse patterns in the elderly. PMID- 1787550 TI - Experience with clonidine-naltrexone for rapid opiate detoxification. AB - The use of naltrexone results in an accelerated opiate withdrawal. By combining clonidine with naltrexone, severity of the withdrawal is modified. This paper describes the author's experience with use of this protocol in 55 episodes of opiate detoxification. Commercially available naltrexone (Trexan) and clonidine tablets were used in the setting of a medical detoxification unit. Of 55 detoxifications, 51 were successfully completed. Results confirm the clinical utility of this protocol as evidenced by rapid detoxification, minimal dropout, and induction of naltrexone maintenance. PMID- 1787551 TI - Drug addiction in pregnancy: the interface of science, emotion, and social policy. AB - The problem of drug addiction in pregnancy has been posed as a conflict between the rights of women and those of their fetuses. This paper presents a framework that incorporates emotion, identification, scientific research, and ethical issues as components to be used in establishing policy with respect to drug addicted pregnant women. Three approaches--voluntary treatment, involuntary treatment or incarceration, and maintaining of the status quo--are discussed with attention to class and economic aspects of women's lives and society's concern for fetal well-being. A model is proposed that addresses the needs of pregnant drug-addicted women and their fetuses, and that serves as an alternative to forced treatment or criminal prosecution. PMID- 1787552 TI - Infectious diseases and drug abuse. Prevention and treatment in the drug abuse treatment system. AB - Several communicable infectious diseases, including AIDS, hepatitis B infection, gonorrhea, syphilis, and tuberculosis, are increasing among drug abusers. Drug abuse treatment programs may be ideal sites to identify those infections and initiate and maintain appropriate medical management. This paper reviews the epidemiology of those infections among drug abusers in the USA, presents rudimentary aspects of medical management of selected infectious diseases, and discusses the need to integrate infectious diseases, drug abuse treatment, and public health approaches if we are to reverse, or at least stabilize, the trends of those diseases. PMID- 1787553 TI - Chasing the dragon: a wider perspective. PMID- 1787554 TI - Physiological responses to maximal intermittent exercise: differences between endurance-trained runners and games players. AB - Six games players (GP) and six endurance-trained runners (ET) completed a standardized multiple sprint test on a non-motorized treadmill consisting of ten 6-s all-out sprints with 30-s recovery periods. Running speed, power output and oxygen uptake were determined during the test and blood samples were taken for the determination of blood lactate and pH. Games players tended to produce a higher peak power output (GP vs ET: 839 +/- 114 vs 777 +/- 89 W, N.S.) and higher peak speed (GP vs ET: 7.03 +/- 0.3 vs 6.71 +/- 0.3 m s-1, N.S.), but had a greater decrement in mean power output than endurance-trained runners (GP vs ET: 29.3 +/- 8.1% vs 14.2 +/- 11.1%, P less than 0.05). Blood lactate after the test was higher for the games players (GP vs ET: 15.2 +/- 1.9 vs 12.4 +/- 1.7 mM, P less than 0.05), but the decrease in pH was similar for both groups (GP vs ET: 0.31 +/- 0.08 vs 0.28 +/- 0.08, N.S.). Strong correlations were found between peak blood lactate and peak speed (r = 0.90, P less than 0.01) and between peak blood lactate and peak power fatigue (r = 0.92, P less than 0.01). The average increase in oxygen uptake above pre-exercise levels during the sprint test was greater for endurance-trained athletes than for the games players (ET vs GP: 35.0 +/- 2.2 vs 29.6 +/- 3.0 ml kg-1 min-1, P less than 0.05), corresponding to an average oxygen uptake per sprint (6-s sprint and 24 s of subsequent recovery) of 67.5 +/- 2.9% and 63.0 +/- 4.5% VO2 max respectively (N.S.). A modest relationship existed between the average increase in oxygen uptake above pre exercise values during the sprint test and mean speed fatigue (r = -0.68, P less than 0.05). Thus, the greater decrement in performance for the games players may be related to higher glycolytic rates as reflected by higher lactate concentrations and to their lower oxygen uptake during the course of the 10 sprints. PMID- 1787555 TI - Gross efficiency responses to exercise conditioning in adult males of various ages. AB - This study investigated gross efficiency changes in a group of 60 adult males (mean age 39.2 +/- 1.2 years) resulting from endurance training and age-related responses to such training in sub-groups (each n = 20) of younger (30.7 +/- 0.7 years), intermediate (38.3 +/- 0.5 years) and older (48.6 +/- 1.1 years) subjects. Gross efficiency (%) was calculated from work output, oxygen consumption and RER energy equivalents following 10 min standard cycle ergometry exercise at 100 W and 50 rev min-1. Measurements were made at pre-, mid- and post 8 months of training, which involved progressive walking/jogging activities designed to enhance endurance capacity. In the total group, VO2 decreased pre- to post-training from 2.15 +/- 0.02 to 1.93 +/- 0.01 1 min-1 (P less than 0.01). In the sub-groups, both the younger and older subjects showed a significantly reduced VO2, from 2.17 +/- 0.01 to 1.98 +/- 0.04 1 min-1 and 2.05 +/- 0.08 to 1.86 +/- 0.03 1 min-1 respectively (P less than 0.05), but no significant changes were noted at mid-training. In the intermediate age subjects, while there were trends towards a reduced VO2, none was significant. The ANOVA revealed increased mean gross efficiency in the total group from pre- (14.3 +/- 0.1%) to post- (15.5 +/- 0.2%) (P less than 0.05) but not at mid-training (14.8 +/- 0.2%). While similar trends were observed in the sub-groups, gross efficiency increases were not significant, although changes in gross efficiency were reflected in VO2. The findings suggest that during standardized exercise, oxygen cost may be reduced and gross efficiency increased in adult males following endurance training and that such changes may take place over a variety of age ranges. PMID- 1787556 TI - [Gastrointestinal polyp and polyposis]. PMID- 1787557 TI - [Endoscopic polypectomy and local excision--adaptation and limitation in the treatment of colonic polyp]. PMID- 1787558 TI - [Clinical course and prognosis after colo-rectal polypectomy]. PMID- 1787559 TI - [The heat probe in the treatment of gastrointestinal tumors]. PMID- 1787560 TI - [Specimen handling of gastrointestinal polyp--pathological methods]. PMID- 1787561 TI - [The feature and treatment of colorectal polyps in the aged]. PMID- 1787562 TI - [Gastric polyp]. PMID- 1787563 TI - [Polyps of the small intestine]. PMID- 1787564 TI - [Polyps of the colon and rectum]. PMID- 1787565 TI - [Polypoid lesions of the gallbladder]. PMID- 1787566 TI - [Malignant transformation of gastric polyps]. PMID- 1787567 TI - [Polyps of the small intestine--especially malignant changes in duodenal adenoma]. PMID- 1787568 TI - [Adenoma-carcinoma sequence and treatment of colorectal polyps]. PMID- 1787569 TI - [Pathology of gastrointestinal polyp]. PMID- 1787570 TI - [Polyps of the gallbladder: differential diagnosis and treatment referring to malignant potential]. PMID- 1787571 TI - [Juvenile polyps and juvenile polyposis coli]. PMID- 1787572 TI - [Peutz-Jeghers syndrome]. PMID- 1787573 TI - [Cowden's disease]. PMID- 1787574 TI - [Inflammatory polyp and polyposis; benign lymphoid polyp and polyposis]. PMID- 1787575 TI - [Inflammatory fibroid polyp]. PMID- 1787576 TI - [Metaplastic polyp, polyposis]. PMID- 1787577 TI - [Cronkhite-Canada syndrome; observation of 180 cases reported in Japan]. PMID- 1787578 TI - [Multiple lymphomatous polyposis]. PMID- 1787579 TI - [Diagnosis and treatment of rectal carcinoid]. PMID- 1787580 TI - [Gamma unit as a new mode of radiation therapy--its structure and applications to neurosurgery]. PMID- 1787581 TI - [Comparison of incidence of gastrointestinal polyps between Japan and other countries]. PMID- 1787582 TI - [Leukocyte chemotactic and activating cytokines, interleukin 8 and MCAF]. PMID- 1787583 TI - [Diagnostic ability of barium enema examination for the protruded lesions of the large intestine and rectum]. PMID- 1787584 TI - [Study on image processing of magnify type electronic endoscopic pictures of the gastric polyp]. PMID- 1787585 TI - [History and prospects of gastrointestinal polyposis study in Japan]. PMID- 1787586 TI - [The diagnosis of colorectal polyp by endoscopic ultrasonography]. PMID- 1787587 TI - [Progress of electronic endoscopic diagnosis of polyps]. PMID- 1787588 TI - [Enteroscopy for small intestinal polyps]. PMID- 1787589 TI - [Polypectomy and strip biopsy]. PMID- 1787590 TI - [Molecular pathology of oncogenes and anti-oncogenes in diagnosis of colonic polyps]. PMID- 1787591 TI - [Progress in medical imaging and surgery of liver cancer]. PMID- 1787592 TI - [Supper selective hepatic angiography]. PMID- 1787593 TI - [Trans brachial-selective digital subtraction angiography (TB-SDSA)]. PMID- 1787594 TI - [Pharmacoangiography (DPA)]. PMID- 1787595 TI - [Ultrasonic measurement system for tissue characterization]. PMID- 1787596 TI - [31P-MRS and 31P-CSI of hepatic tumors]. PMID- 1787597 TI - [Trend of three-dimensional acquisition and display techniques in imaging diagnosis of hepatoma]. PMID- 1787598 TI - [MR angiography of portal and hepatic venous system in hepatic neoplasms]. PMID- 1787599 TI - [Problems of three-dimensional hepatic imaging and surgical planning system]. PMID- 1787600 TI - [The three-dimensional demonstration of the intrahepatic bile ducts reconstructed from cholangio CT]. PMID- 1787601 TI - [Magnetocardiography using SQUID magnetometer]. PMID- 1787602 TI - [Surgical treatment of liver cancer--advances in operative procedure and its outcome]. PMID- 1787603 TI - [Development of optical absorption computed tomography and its application to imaging diagnosis]. PMID- 1787604 TI - [The 21st Regional Meeting of East and West of Japan, Japanese Society of Nephrology. May 17-18, 1991. Abstracts]. PMID- 1787605 TI - Surgical treatment of abdominal aortic aneurysm in the high-risk patient. AB - In an attempt to define the preoperative risk factors that predictably influence mortality after aneurysmectomy, this study reviews the surgical management of abdominal aortic aneurysms in a series of 110 consecutive patients who underwent elective resection. The preoperative risks to be added to the present study included pulmonary insufficiency, renal dysfunction, advanced age of over 80 years, ischemic heart disease, and associated other diseases such as thoracic aneurysms, atherosclerosis of the limbs and malignant tumors. Forty-six patients had one of these risk factors (one-risk group), 17 had two (two-risk group), and 9 had three (three-risk group). The operative mortality rates were 4.2 per cent for the high-risk patients and 0 per cent for the patients at no risk. As the number of risk factors increased, aneurysm repair was associated with an increased operative mortality; being 2.2 per cent in the one-risk group, 5.9 per cent in the two-risk group and 11.1 per cent in the three-risk group. The common risk factor in patients who died after aneurysmectomy was pulmonary insufficiency which induced prolonged periods of assisted ventilation. Thus, the optimal management of high-risk patients, particularly those with pulmonary insufficiency, may reduce the mortality after aneurysmectomy. PMID- 1787606 TI - Immunohistochemical studies on enterokinase producing cells in the biliary tract. AB - The activation mechanism of pancreatic enzymes refluxing into the biliary tract in the anomalous arrangement of pancreaticobiliary ducts (APBD) remains unclear. In order to elucidate this activation mechanism, an immunohistochemical examination of both bile ducts and gallbladders was carried out on 20 patients with APBD to determine whether or not enterokinase (EK) producing cells exist in the biliary tract, by employing an avidin-biotin-peroxidase complex (ABC) method using a monoclonal antibody, hek-1. Immunoreactive EK was found in the metaplastic epithelium of the bile duct in 2 patients and the gallbladder in one, suggesting that EK production at the metaplastic epithelium is involved in an activation mechanism of pancreatic enzymes refluxing into the biliary tract. The same study was performed on the gallbladders of 62 patients without APBD, which revealed immunoreactive EK in some parts of the metaplastic epithelium of the gallbladder in 2 patients. Thus, in cases of pancreatic juice refluxing into the biliary tract regardless of the presence of APBD, we can not refute the possibility that refluxed pancreatic enzymes may be at least partly activated by EK produced at the metaplastic epithelium. PMID- 1787607 TI - The bacteriology of cholelithiasis--China versus Japan. AB - Cholelithiasis differs considerably from area to area in the world. Calcium bilirubinate stones or brown pigment stones are said to predominate in the Orient, however, this situation may differ within the Orient. In order to compare cases in China and Japan, 102 consecutive cases of cholelithiasis operated on in Shenyang, China were analyzed for the composition of gallstones and bacterial species isolated from bile in relation to the location and composition of gallstones. In Shenyang, calcium bilirubinate stones predominated, occurring in 49.0 per cent of the cholelithiasis cases. This was much higher than in Japan, which had 17.5 per cent. The incidence of bacteria was also very high, ranging from 20 to 96 per cent, with an average of 66.7 per cent depending on the kind of gallstone present. Bacterial species possessing beta-glucuronidase activity were present in nearly all the cases of calcium bilirubinate stones (92.0 per cent). The incidence of bacteria with beta-glucuronidase activity especially of E. coli was much higher than in Japan (50.8 per cent versus 21.8 per cent) in concordance with the higher incidence of calcium bilirubinate stones in China (49.0 versus 17.5 per cent). PMID- 1787608 TI - The clinical pharmacokinetics of two different preparations of intrarectal ketoprofen following spinal or local anesthesia for anal surgery. AB - Two different preparations of commercially available suppositories containing Ketoprofen (KP) were administered to 49 patients immediately following anal surgery. The KP was prepared as either fatty suppositories (FS) or gelatin capsulated suppositories (GCS) and surgery was performed under either spinal (n = 37) or local anesthesia (n = 12). Similar results were observed in the kinetics of KP after both FS and GCS administration. The extent of bioavailability of the two dosage forms in the patient groups and control subjects (n = 10) were essentially equal. When the pharmacokinetic parameters of KP were compared between patient groups under spinal and local anesthesia, significant differences were found in the values of the peak level (C max), peak time (T max), and terminal phase half-life (t 1/2). The C max decreased by one-half, while the T max and t 1/2 increased twice and four times, respectively, in patient operated on under spinal anesthesia compared to those operated on under local anesthesia. The absorption rate constant (Ka) following spinal anesthesia was significantly less than that following local anesthesia or that of the healthy subjects (p less than 0.01). A "flip-flop" phenomena could be seen in the time profiles of plasma KP concentration following spinal anesthesia. PMID- 1787609 TI - Neoadjuvant chemotherapy with cyclophosphamide, doxorubicin and 5-fluorouracil (CAF) or cyclophosphamide, methotrexate and 5-fluorouracil (CMF) in 69 cases of locally advanced (stage IIIb) breast cancer. AB - Sixty nine patients with a median age of 45 years, 62.3 per cent of whom were premenopausal, with locally advanced breast cancer (T 4, N 0-3, M 0; Stage IIIb) were treated with 3 cycles of either neoadjuvant cyclophosphamide, doxorubicin and 5-fluorouracil, being the CAF group: 36 patients, or cyclophosphamide, methotrexate and 5-fluorouracil, being the CMF group: 33 patients. Patients achieving complete response or with residual disease of less than 2 cm in diameter received radical radiotherapy while those with more residual disease underwent radical mastectomy. Nine cycles of adjuvant chemotherapy were administered. Complete responses and disease control by radiotherapy with complete breast preservation were more frequently observed after CAF than CMF, being 25 per cent vs 3 per cent (p = 0.025) and 48.5 per cent vs 12 per cent (p = 0.002), respectively. Overall response rates, adverse effects, disease control following radiotherapy/surgery, local relapses and metastases were similar for both regimes. Relapsing patients were young, with a median age of 38 years, 68.4 per cent of relapses occurred at metastatic sites and 42 per cent of relapses occurred during adjuvant chemotherapy. This study suggests that in locally advanced breast cancer, a greater proportion of patients can be rendered disease free after neoadjuvant CAF and radiotherapy compared to neoadjuvant CMF and radiotherapy. PMID- 1787610 TI - Clinical experience of emergency coronary artery bypass grafting following failed percutaneous transluminal coronary angioplasty. AB - From July, 1981 to December, 1988, 2431 percutaneous transluminal coronary angioplasties were performed on 1901 patients at the Heart Institute of Sao Paulo University Medical School. Seventy-six patients (4.0 per cent) underwent emergency coronary artery bypass grafting for failed angioplasty. The incidence of failed angioplasty was significantly higher in the impending myocardial infarction group (11.5 per cent) than in the angina group (4.8 per cent) and the acute myocardial infarction group (1.3 per cent). The mean age of the seventy-six patients was 54.4 years, and 54 patients were male. The operative mortality was 15.8 per cent, being 9 males and 3 females. Patients who had had a left main trunk dissection during angioplasty and those who were hemodynamically unstable following the failed angioplasty or who had had a cardiac arrest necessitating a cardiac massage during transportation to the operating room, had a higher mortality than patients in whom the failure occurred in other sites and those who were hemodynamically stable. Perioperative myocardial infarction was documented in 50 per cent of the patients. Patients who had had a cardiac arrest during the procedure had a higher rate of perioperative myocardial infarction than those whose preoperative hemodynamic condition was stable. PMID- 1787611 TI - Upper esophagectomy with pharyngolaryngectomy for esophageal carcinoma at the cervicothoracic junction. AB - The choice remains controversial as to which surgical procedure should be selected for carcinomas situated in the esophagus at the cervicothoracic junction involving the trachea. After mediastinal tracheostomy associated with pharyngolaryngoesophagectomy and thoracic esophagectomy, numerous reports have previously described severe postoperative complications, such as tracheal necrosis and rupture of the great vessels in the neck. To prevent such complications, we have developed the procedure called "upper esophagectomy" followed by a free jejunal graft and mediastinal tracheostomy through either manuburectomy or upper median sternotomy. We have established that this procedure maintains the vascular networks between the trachea and the esophagus, avoids an occurrence of tracheal necrosis or great vessel bleeding postoperatively, and obtains an improved prognosis in the surgical treatment of esophageal carcinoma at the cervicothoracic junction. PMID- 1787612 TI - The problems encountered in the surgical management of primary hyperparathyroidism. AB - The problems encountered in the diagnosis and treatment of primary hyperparathyroidism were studied in 69 cases. The accuracy of imaging for hyperplasia was less than that for adenoma or carcinoma and the major causes for multiple operations were a failure to locate the four glands and mediastinal adenoma. The intravenous administration of high doses of calcitonin could reduce the serum calcium level of patients in hypercalcemic crisis. Carcinoma required ipsilateral modified radical neck dissection because of lymph node metastases, and non-medullary thyroid carcinoma was often associated with primary hyperparathyroidism. We found removal of the parathyroid adenoma and biopsy or extirpation of only one macroscopically normal gland to be a fully satisfactory procedure after bilateral neck exploration and attempting to identify at least four glands. PMID- 1787613 TI - Experimental studies on the prediction and prevention of stress ulcers using tonometry, reflectance spectrophotometry and oxygenated perfluorochemicals. AB - The present study investigates whether oxygenated perfluorochemicals protect the gastric mucosa against hemorrhage-induced stress ulceration. The influence of oxygenated perfluorochemicals on both macroscopic and microscopic lesion formation, gastric intramural pH, index of oxygen saturation and index of hemoglobin saturation of the gastric mucosa was studied. To assess the severity of gastric mucosal ischemia, intramural pH was directly measured using a pH sensitive microelectrode and indirectly by utilizing hollow viscus tonometry, and the indices of oxygen saturation and hemoglobin saturation were measured by reflectance spectrophotometry. Oxygenated perfluorochemicals (30 ml/kg/h) significantly protected the gastric mucosa against both gross (lesion index 0.85 +/- 0.2 vs 2.23 +/- 0.31) and microscopic (lesion index 0.52 +/- 0.02 vs 2.04 +/- 0.03) injuries. This protection was associated with a significantly decreased acidification of the mucosa during shock (intramural pH 7.24 +/- 0.02 vs 6.97 +/- 0.02) and significantly increased oxygen saturation of the gastric mucosa (30 +/- 6 vs 5 +/- 2). These data indicate that topical oxygenated perfluorochemicals protect the gastric mucosa against mucosal damage provoked by hemorrhagic shock, and this protection seems to be mediated by an increased oxygen saturation of the gastric mucosa. Tonometry and reflectance spectrophotometry thus are able to predict the critical level of gastric mucosal ischemia. PMID- 1787614 TI - The enhancement of tumor growth after partial hepatectomy and the effect of sera obtained from hepatectomized rats on tumor cell growth. AB - In the process of liver regeneration, the participation of various types of growth stimulators and changes in immune responses have been reported. Here, we examined the growth of subcutaneously transplanted AH130 cells and Walker 256 cells after partial hepatectomy. In the case of tumor cells being transplanted on the same day as partial hepatectomy, the increase in tumor size in hepatectomized rats was significantly greater compared with that in non-treated rats or in those having undergone a simple laparotomy. When the transplantation of tumor cells was done on the 7th day after partial hepatectomy, however, the increase was less marked. We also examined the effect of serum obtained from rats after partial hepatectomy on the in vitro growth of these tumor cells. Growth enhancement was observed with medium containing serum drawn from rats 1 to 4 days after partial hepatectomy. These results suggest that the growth of tumor cells was stimulated during liver regeneration and that some humoral factors participated in the process. Furthermore, as the conditions of the in vitro method appear to mimic those of the in vivo method, the in vitro approach should be very useful for analysis of the factors responsible. PMID- 1787615 TI - Dysphagia resulting from an upper esophageal web--a case report. AB - A circumferential web was located in the proximal portion of the esophagus in a 69 year old female who was admitted to the Iwate Medical University Hospital with severe chronic dysphagia. She had a long history of difficulty in swallowing, intermittently and primarily associated with the ingestion of solid foods. The web was easily ruptured upon endoscopy with subsequent bouginage being performed twice leading to the complete relief of dysphagia. However, dysphagia recurred 6 months postbouginage and the circumferential web, which had regenerated, had less distensibility, making re-dilation impossible. Surgery was elected which revealed esophageal obstruction by a firm circumferential structure. Microscopic examination of the excised web revealed it to consist of a transverse fold of the esophageal mucosa with chronic inflammatory changes and submucosa with marked fibrous tissue proliferation. The patient has remained asymptomatic for the 4 years following her operation. PMID- 1787616 TI - Pharyngoesophageal bypass using a free jejunal graft for corrosive stricture--a case report. AB - The management of corrosive strictures of the esophagus involving the pharynx and/or larynx continues to be a challenge to surgeons. This paper presents a case of a corrosive stricture extending from the hypopharynx to the cervical esophagus associated with complete obstruction of the larynx, which was successfully treated by pharyngoesophageal bypass using a free jejunal graft. Postoperative recovery was smooth without any complications, and swallowing was restored. Three months after the bypass operation, the patient underwent laryngoplasty. Although aspiration occurred immediately after the laryngoplasty, six months later she was again able to tolerate the oral intake of semisolid food without any need for supplementary nutritional support. Reconstruction of a short segment of the pharyngoesophageal stricture by a free jejunal graft restores almost normal swallowing provided that dilatation of the lower esophagus is achieved. PMID- 1787617 TI - Surgical treatment for aspiration following esophageal reconstruction--a report of two cases and the techniques involved. AB - Severe aspiration following esophageal reconstruction is often very difficult to treat while preserving the larynx. However, we have successfully adopted a modified surgical procedure previously employed for aspiration caused by neurological diseases or head and neck cancer surgery. We report herein the use of this modified procedure against aspiration in 2 cases following esophagectomy. In the first case, a combination of cricopharyngeal myotomy, infrahyoid myotomy and laryngeal pull-up, with approximation of the thyroid cartilage against the hyoid bone and that of the hyoid bone against the mandible, were performed simultaneously with the primary esophagectomy. In the second case, cricopharyngeal myotomy, infrahyoid myotomy, laryngeal pull-up and infrafold silicone injection were performed three months after the primary operation. Good results were achieved in both cases. Thus, for any case at risk of aspiration after esophagectomy or for any case with severe aspiration following esophagectomy that does not respond to swallow therapy, these operative rehabilitation procedures should be performed before laryngectomy is considered. PMID- 1787618 TI - Bilateral angiosarcoma of the breast--a case report. AB - A case of a 42 year old multiparous female with bilateral angiosarcoma of the breast without any evidence of dissemination, who later also developed a psammomatous meningioma, is described herein. The world literature on angiosarcoma is reviewed and a discussion presented on the incidence of bilaterality, hormonal stimulation, diagnostic difficulty, prognostic factors and treatment modalities. PMID- 1787619 TI - A case of superior lumbar hernia. AB - A case of a superior lumbar hernia in a 50 year old woman is described herein. She presented with a 7 x 8 cm soft, nontender, smooth-surfaced mass in the left flank, and barium meal with follow through showed herniation of the descending colon. At operation, a 6 x 5 cm defect was found in the transversalis fascia, which was repaired with mattress sutures to the transversalis fascia together with suturing of the external oblique to the latissimus dorsi. This article presents the above case and reviews the published literature relating to this subject. PMID- 1787620 TI - Omental bleeding with spontaneously derotated torsion--a case report. AB - A case of omental torsion seen in a 16 year old male is reported herein. Abdominal pain in the right lower quadrant suddenly developed just after the patient twisted his waist and an emergency laparotomy revealed a hemorrhagic mass at the edge of the right omentum, which was excised. Histological examination of the resected specimen showed hemorrhage without any venous thrombosis or infarction, possibly suggestive of omental torsion with early spontaneous derotation. The patient was successfully treated as a case of omental torsion. PMID- 1787621 TI - A case of empyema developing thirteen years after a pneumonectomy treated using pedicled omentum which was followed by intestinal obstruction. AB - Postpneumonectomy empyema is one of the most difficult complications for the thoracic surgeon to treat. We report herein a case of a 62 year old diabetic man who developed empyema 13 years after a pneumonectomy for cancer, which was successfully treated using an omental pedicle flap. Postoperatively, the chest would healed uneventfully, however, a bowel obstruction developed which was subsequently treated by removing the remnant omentum that had adhered to the bowel. PMID- 1787622 TI - Resection and double ileostomy as an alternative approach for superior mesenteric venous thrombosis in poor risk patients: a case report. AB - An 85-year-old male with a sudden onset of abdominal pain was operated on under the suspicion of intestinal ischemia and was later diagnosed as acute superior mesenteric venous thrombosis (SMVT). The patient was successfully treated by resecting the entire involved bowel and performing a double ileostomy. These procedures are considered to be the preferred method of choice for improving survival in poor risk patients. PMID- 1787623 TI - [The importance of iron prophylaxis in pregnancy]. PMID- 1787624 TI - [Professional continuing education]. PMID- 1787625 TI - [University Hospital Kuopio--modern times: childbirth records]. PMID- 1787626 TI - [Breast feeding--child's choice--child's right]. PMID- 1787627 TI - [Does Cock Gullengamme still watch our maternity care?]. PMID- 1787628 TI - [Midwifery meeting: responsibility of the midwifery profession and the 175th anniversary of midwifery education]. PMID- 1787629 TI - [6 months of waiting]. PMID- 1787630 TI - [Dear midwives!]. PMID- 1787631 TI - [Tomorrow's childbirth]. PMID- 1787632 TI - [Aqua-blisters to eliminate labor pain]. PMID- 1787633 TI - [Waterbath helped me in the delivery]. PMID- 1787635 TI - [Health education needed more than ever--women's position must be strengthened]. PMID- 1787634 TI - [Juuso--my angel child. Born 1-27-1991, died 1-28-1991]. PMID- 1787636 TI - [Dear midwives!]. PMID- 1787637 TI - [Evaluation of students brings development: various points in midwifery education]. PMID- 1787638 TI - [Nursing care of the patient with ovarian cancer]. PMID- 1787639 TI - Primary hyperoxaluria: therapeutic strategies for the 90's. PMID- 1787640 TI - Elimination of Candida albicans from kidneys of mice during short-term systemic infections. AB - The candidacidal activity of kidneys, liver, and spleen's phagocytic systems was studied in mouse. Different strains of mice were inoculated intravenously (i.v.) with 1 to 2.6 x 10(4) viable Candida albicans. Elimination of the microorganisms from the kidneys, liver, and spleen were evaluated by enumeration of colony forming units (C.F.U.) recovered from homogenates of organs dissected within a short period of time (0 to 5 hr). The results indicated that the kidneys possess a capable phagocytic system which was able to eliminate the microorganisms as efficiently as those of liver and spleen. Furthermore, the ability of the liver and spleen phagocytic system as well as that of kidneys were significantly enhanced when animals were treated with Bacillus Calmette-Guerin (BCG) of mycobacterium bovis four weeks prior to induction of systemic infection with C. albicans. PMID- 1787641 TI - Renal functional reserve in treated and untreated hypertensive rats. AB - Renal functional reserve (renal response to protein loading, RFR) has been suggested as a method to verify the presence of hyperfiltration. This study was designed to evaluate the role of RFR as an indicator of increased glomerular capillary hydrostatic pressure in short-term treated and untreated rats with two kidney, one-clip Goldblatt hypertension. One month after placing a silver clip, micropuncture studies were performed on the unclipped kidney. Normal rats and three groups of clipped rats [untreated group (HYP), a group treated with captopril (CEI) and a group treated with verapamil (VER) 5 days before the micropuncture studies] were studied. Glomerular hemodynamics and proximal tubular reabsorption were measured in control period and during intravenous administration of glycine (G). In normal rats, G produced afferent and efferent dilation, increases in single nephron plasma flow (SNPF) and single nephron glomerular filtration rate (SNGFR) of 24%. Systemic hypertension in HYP rats was associated with increases in transcapillary pressure gradient (delta P) and SNGFR. In this hyperfiltration state, infusion of G did not modify SNGFR of SNPF defining loss of RFR. The antihypertensive treatment was equally effective in normalizing MAP and delta P in CEI and VER, but only CEI rats responded to G with a 20% increase in SNGFR due to an increase in delta P. The most striking findings were that loss of RFR in both HYP and VER rats was associated with a significant decrease in absolute and proximal fractional reabsorption.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787642 TI - Impaired potassium-induced insulin secretion in chronic renal failure. AB - Extrarenal disposal of potassium load is impaired in chronic renal failure (CRF). This has been attributed to excess PTH since extrarenal disposition of potassium is normal in CRF-PTX animals. Insulin augments potassium entry into cells and hyperkalemia stimulates insulin secretion. Since glucose-induced insulin secretion is impaired in CRF and normal in CRF-PTX, it is possible that K(+) induced insulin secretion is also impaired in CRF due to excess PTH. Such a defect would contribute to the abnormality in extrarenal disposal of potassium in CRF. We examined K(+)-induced insulin secretion, cytosolic calcium ([Ca2+]i) and the changes in [Ca2+]i in response to 20 mM KCl of islets from normal, CRF, and CRF-PTX rats; and normal and CRF animals treated with verapamil (normal-V and CRF V). K(+)-induced insulin secretion by islets isolated from CRF rats was significantly (P less than 0.01) lower than that from normal, CRF-PTX, CRF-V and normal-V rats. Basal level of [Ca2+]i in islets of CRF rats was significantly (P less than 0.01) higher than in islets of the other four groups of animals. The calcium signal (delta [Ca2+]i) and the delta [Ca2+]i/basal [Ca2+]i ratio in response to 20 mM KCl observed in islets from CRF rats were significantly lower than in the other four groups of animals.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787643 TI - Initiation and evolution of interstitial leukocytic infiltration in experimental glomerulonephritis. AB - Most forms of glomerulonephritis have a significant interstitial leukocytic infiltrate which is associated with disease progression. However, there is little data concerning the timing, initial location, and development of this interstitial component. Therefore, we have addressed these issues in a study of passive accelerated anti-GBM glomerulonephritis in the rat. In this model, interstitial leukocytic infiltration was an early event in the disease process with a significant infiltrate apparent at 12 hours after administration of nephrotoxic serum (NTS). This initial infiltrate was restricted to a perivascular sheath surrounding the hilar arterioles. The sheath infiltrate then spread to include the whole hilar area by day 1, the entire periglomerular area by day 3, and became widespread throughout the cortical tubulointerstitium by day 7. The early sheath infiltrate was composed of macrophages and T cells. Both cell types continued to increase as the infiltrate expanded, and a significant accumulation of activated cells (IL-2R+) was evident from day 7 onwards. There was a highly significant correlation between interstitial macrophage infiltration and renal function impairment, proteinuria, and histologic damage. Interstitial T cell infiltration correlated with proteinuria and histologic damage, while the appearance of immune-activated mononuclear cells (IL-2R+) exhibited a highly significant correlation with all disease parameters. This study demonstrates the importance of the glomerular hilar arteriolar region as a focus for mononuclear leucocytic migration and accumulation which not only affects the structure and function of the glomerulus but subsequently the entire tubulointerstitium. PMID- 1787644 TI - TMB-8 prevents the hydroosmotic response to ADH in rabbit cortical collecting tubules. AB - Both AVP and dDAVP effect a transient increase in cytosolic free calcium (iCa2+) in cortical collecting tubule (CCT) cells. To investigate the physiological role of this increase in iCa2+, we examined the effect of TMB-8, a putative inhibitor of iCa2+ release, on the initial and sustained phase of AVP- and dDAVP-stimulated water permeability (Pf) in isolated, perfused CCTs. Pretreatment of tubules with TMB-8, 50 microM, suppressed the increase in osmotic water permeability (Pf) induced by 10 microU/ml AVP and dDAVP, but had no effect on the sustained phase of the response. When increased to 100 microM. TMB-8 inhibited the sustained phase of AVP action. A similar pattern was observed on AVP-stimulated adenyly cyclase activity in rabbit renal membranes. Pretreatment of tubules with 50 microM TMB-8 attenuated the initial increase in Pf in response to cholera toxin but not to 8-Br-cAMP or forskolin. There was no effect of this concentration of TMB-8 on the sustained phase of these agonists. These studies suggest that, in lower concentrations, TMB-8 inhibits the mobilization of iCa2+, which is important for the interaction of Gs with the catalytic unit of adenylyl cyclase and the initial increase in AVP-stimulated Pf. In higher concentrations, TMB-8 inhibits adenylyl cyclase activity directly. PMID- 1787645 TI - A glomerular permeability factor produced by human T cell hybridomas. AB - A glomerular permeability factor produced by human T cell hybridomas. T cell hybridomas derived from the T cells of a patient with mammal change nephrotic syndrome (MCNS) made a glomerular permeability factor (GPF). Sufficient quantities of GPF were available for further analysis and characterization. We obtained four stable clones of human T cell hybridomas which produced a glomerular permeability factor. When this factor was injected intravenously into rats, significant proteinurias were induced, and in normal human lymphocyte culture, GPF enhanced Concanavalin-A (Con-A) induced lymphocyte blastogenesis by greater than ten fold. GPF was cytotoxic to tumor cell lines of epithelial origin, but only cytostatic to tumor cells of hematopoietic origin. Electron microscopy studies, with polyethyleneimine (PEI) staining, indicated that GPF induced the changes in the arrangement of PEI particles and partial fusion of glomerular epithelial cells in the rats given this factor intravenously. The molecular weight of GPF were estimated to be between 60,000 and 160,000 daltons. The molecular weight of the factor and its TNF like activity, we speculated that the factor was a lymphokine, like lymphotoxins. PMID- 1787646 TI - Role for "uremic toxin" in the progressive loss of intact nephrons in chronic renal failure. AB - We studied the effect on the progression of glomerular sclerosis of two different experimental maneuvers, peritoneal dialysis and oral adsorbent, which remove circulating substances in different fashions. Munich-Wistar rats with established glomerular sclerosis, verified by renal biopsy analysis at seven weeks after subtotal nephrectomy, were treated for four weeks with either peritoneal dialysis (PD) or oral charcoal adsorbent (AST-120). Treatment was initiated at eight weeks. Rats were paired in treatment and control groups according to the similarity in the degree of sclerosis determined at biopsy with a minimum of 50 glomeruli analyzed. Systolic blood pressure and BUN and creatinine clearance, measured at seven to eight weeks, were not different among groups. In Group 2 rats, PD was performed with 1.5% dextrose for eight one-hour cycles, six days per week, while Group 1 control rats had zero indwelling time of the dialysate. Group 4 rats received AST-120, an oral adsorbent charcoal, mixed 5% by weight with standard rat chow and given ad libitum from 8 to 12 weeks after subtotal nephrectomy, while control Group 3 rats received only rat chow. Whole kidney GFR at 12 weeks was significantly higher in Group 2 PD versus Group 1 control (0.50 +/- 0.08 vs. 0.30 +/- 0.05 ml/min, P less than 0.05). There was no statistical difference for BUN and whole kidney creatinine or inulin clearance in Group 4 AST 120 treated versus Group 3 control rats. Light microscopic studies in autopsy specimens revealed that both PD and AST-120 attenuated progression of glomerular sclerosis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787647 TI - Effect of dialysis and renal transplantation on autonomic dysfunction in chronic renal failure. AB - Autonomic functions were evaluated in 25 nondialyzed patients with chronic renal failure and eight controls. Eight patients were reassessed after 6.6 +/- 1.0 weeks of hemodialysis and 12 patients were restudied 24 +/- 4.0 weeks after renal transplantation. In addition, six patients who had been on maintenance hemodialysis for a duration of 21.5 +/- 3.0 weeks were also studied. Autonomic function tests, including blood pressure and heart rate response to sudden loud noise, mental arithmetic, hand immersion in cold water, Valsalva maneuver, change in posture and respiration, were performed using brachial artery cannulation and continuous monitoring by electrocardiogram. Baroreceptor sensitivity slope was determined using bolus injections of phenylephrine. Supine and standing plasma norepinephrine levels were measured. The cold pressor test, response to sudden loud noise and mental arithmetic were normal in nondialyzed patients with chronic renal failure, suggesting an intact efferent sympathetic pathway. The plasma norepinephrine concentration varied widely but the mean value was similar to the control group (P greater than 0.05). Expiration/inspiration ratio, lying/standing ratio, Valsalva ratio and the baroreceptor sensitivity slope were significantly abnormal (P less than 0.001) in nondialyzed patients. This indicates a defective efferent parasympathetic pathway and depressed baroreceptor sensitivity. The blood pressure response to phenylephrine was lower in the uremics, suggesting a reduced end-organ responsiveness to alpha agonists. The presence of hypertension did not affect autonomic function. The heart rate response to standing and the baroreceptor sensitivity were significantly lower (P less than 0.05) in patients who developed hypotension during hemodialysis. Lower baroreflex sensitivity could contribute to hypotension during dialysis. Autonomic functions remained unaltered after short- and long-term dialysis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787648 TI - Histopathologic findings associated with a chronic, progressive decline in renal allograft function. AB - The relationship between specific histopathologic findings of chronic rejection (CR) and the clinical course of renal transplant recipients with a chronic progressive decline in allograft function (CPDAF) is unknown. We used one or two hinged regression lines, fitted by least-squares to serial creatinine clearances, to define the onset and clinical course of CPDAF. Biopsies (N = 100) from patients transplanted from 1978 to 1982 were studied retrospectively. Interstitial fibrosis, tubular atrophy, and fibrointimal arterial narrowing were more pronounced in biopsies obtained after, but not before the onset of CPDAF. Interstitial hemorrhage, an infrequent finding in acute vascular rejection, preceded the onset of CPDAF, but the more common histologic findings of acute cellular rejection did not. The severity of histologic features of CR (as reflected by a score combining fibrointimal arterial narrowing, interstitial fibrosis, tubular atrophy, glomerular sclerosis, glomerular mesangial expansion, and glomerular basement membrane reduplication) correlated with the duration of subsequent allograft survival (r = -0.65, P less than 0.001). Glomerular size increased after transplantation, but was not different in patients with or without CPDAF, suggesting that mechanisms related to compensatory hypertrophy did not play a major role in the pathogenesis of CR. In summary, the histologic findings of CR did not predict the onset of CPDAF, did not distinguish whether the pathogenesis was mediated by immune or nonimmune events, but did correlate with the duration of subsequent allograft survival. PMID- 1787649 TI - Sodium modeling in hemodiafiltration. AB - A computer model was developed to simulate sodium and water kinetics during hemodiafiltration (HDF), acetate-free biofiltration (AFB) and hemodialysis (HD). Multiple regression analysis of the results of 3,240 simulated applications of the model (1,620 HDF, 1,080 AFB, 540 HD) showed that, during HDF and AFB, there is a close correlation (R2 = 0.92 and 0.91) between plasma water sodium concentration [( Na+P]) and a set of three variables: 1) the sodium gradient between plasma water and dialysate, 2) the sodium concentration of the substitution fluid and 3) ultrafiltration (UF) rate. With HD, a close correlation (R2 = 0.94) was found between changes in [Na+P] and combined changes in sodium gradient and the UF rate. On this basis, a regression equation was formulated for each procedure which allowed a reliable prediction of final [Na+P] to be made on the basis of knowledge of the imposed Na gradient, the programmed infusion (during HDF and AFB), and the UF rate. Clinical validation of the model was obtained in 12 patients: predicted final [Na+P] agreed well with the values measured by means of direct potentiometry (141.9 vs. 142.1 mEq/liter; P = NS), with a mean difference (-0.16 mEq/liter) and limits of agreement (+0.8 to -1.03 mEq/liter) fully acceptable for clinical purposes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787650 TI - Elevated urinary excretion of the C5b-9 complex in membranous nephropathy. AB - In experimental membranous nephropathy, antibody binding to glomerular epithelial cell membrane antigens results in complement activation and formation of complement C5b-9 membrane attack complexes in glomeruli. During active disease, the C5b-9 complexes are shed into the urine. To test the hypothesis that a similar mechanism might be operative in human membranous nephropathy, we measured urinary excretion of C5b-9 and C5 in 146 proteinuric patients with biopsy-proven glomerular diseases or diabetes mellitus. Urinary excretion of C5b-9 relative to C5 excretion was higher in 40 patients with membranous nephropathy than in 106 patients with proteinuria due to non-membranous glomerulonephritis when analyzed by covariance analysis (P less than 0.0002). Urinary C5b-9 excretion was higher in membranous nephropathy than in membranoproliferative glomerulonephritis (N = 13, P less than 0.05), minimal change-focal sclerosis (N = 33, P less than 0.001), mesangial proliferative glomerulonephritis (N = 9, P less than 0.02) and IgA nephropathy (N = 7, P less than 0.025). Urinary C5b-9 excretion was also higher in patients with lupus nephritis (N = 18, P less than 0.02) compared to those with non-membranous glomerulonephritis. The lupus patients with the highest excretion had clinical or pathological features of membranous nephropathy. Nine patients with membranous nephropathy and elevated urinary C5b-9 excretion had a shorter duration of disease (P less than 0.05), lower serum creatinine levels (P less than 0.05) and more proteinuria (P less than 0.02) than the 31 membranous nephropathy patients with normal values.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787651 TI - Branched-chain amino acid in chronic renal failure patients: respiratory and sleep effects. AB - Sleep disorders, including a high incidence of sleep apnea, have been recognized as a significant problem in chronic renal failure (CRF) patients. In a preliminary study, we examined CRF patients on maintenance hemodialysis for three nights; one control night, and thereafter randomized to infusion of saline (placebo) for one night and 4% branch-chain amino acid (BCAA) solution for one night. Polysomnographic and respiratory data [respiratory rate, oxygen saturation and end-tidal CO2 (ETCO2)] was recorded continuously throughout the nights and data from each hour compared with baseline (awake) values. The patients studied were characterized by reduced sleep quality and decreased amount of rapid eye movement (REM) sleep. The BCAA infusion was associated with a return of REM sleep to normal and a significant decrease in ETCO2 during both REM and non-REM sleep (P less than 0.05). Our findings demonstrate respiratory stimulation during sleep with infusion of BCAA; this stimulatory effect on respiration (in contrast to many respiratory stimulants) is associated with an increased amount of REM sleep. PMID- 1787652 TI - Pheochromocytoma: new concepts and future trends. PMID- 1787653 TI - [Risk of metastasis in retinoblastoma]. AB - 580 patients with retinoblastoma were analysed retrospectively. Median follow up was 5.5 years. 41 patients developed metastases within 5 years. Clinical and histopathological risk factors were analysed by univariate tests with regard to the occurrence of metastases. Significant variables were then reevaluated using Cox proportional hazards method. Four factors correlated independently with the development of metastases: optic nerve invasion with involvement of the resection line, optic nerve invasion without involvement of the resection line, choroidal invasion and enucleation of an affected eye more than 120 days after initial diagnosis. The regression coefficient beta of the Cox-model was used for a score classification with groups of high, medium and low metastatic risk. The 5-year incidence of metastases was 68%, 43% and 4% respectively. PMID- 1787654 TI - [Hemodynamic findings in patients with retinitis pigmentosa]. AB - The hemodynamic status of 26 patients with retinitis pigmentosa was examined using video fluorescein angiography. The hemorheological parameters hematocrit, plasma viscosity, erythrocyte aggregation and erythrocyte rigidity were determined. The results were compared to a matched pairs-group. Video angiography showed for retinitis pigmentosa patients a normal arm-retina time and a significant increase of the arteriovenous passage time. The rheological parameters for both groups were within the reference range. Interestingly the hemodynamic disturbance of microcirculation could be demonstrated already in early stages with no ophthalmoscopic symptoms and no atrophy of retinal vessels detectable at the time. The results indicate that disturbance of the retinal hemodynamics in early stages of retinitis pigmentosa may play a role in the pathogenesis of the disease. PMID- 1787655 TI - [Differences in the pathogen spectrum of the conjunctival sac before and after irrigation of the lacrimal apparatus]. AB - The microbial flora in the conjunctival sac of 30 patients was investigated. Qualitative and quantitative differences before and after irrigation of the lacrimal system were found. In some cases a quantitative increase was registered. In 12 cases conjunctival samples before and after irrigation changed. Negative results before and bacterial growth of coagulase-negative staphylococci after irrigation were found in 4 cases. In 3 cases unfavourable changes were seen. Pseudomonas, Klebsiella and beta-hemolytic streptococci were isolated after irrigation in these cases. In the other cases differences were insignificant. The sense of preoperative irrigation of the lacrimal system is discussed and questioned. PMID- 1787656 TI - [Pars plana vitrectomy and cerclage after successful glaucoma operation with Molteno implant]. AB - A single or double plate Molteno Implant may control IOP in otherwise desperate cases. Fibrosis of the filtration bleb will lead to failure. We report about 4 patients (age 12 to 77 years--3 neovascular glaucoma, 1 with postinflammatory goniosynechia) who had good IOP after the implantation of a Molteno device. 10 to 26 weeks (mean 18.25) after glaucoma surgery we performed a pars plana vitrectomy because of different reasons: proliferative diabetic retinopathy, proliferative retinopathy due to central venous occlusion, ciliovitreal block mechanism, PVR D3. One aphakic eye was treated with silicone oil and an encircling band. 19 to 30 weeks after posterior segment surgery (mean 24.5) IOP remained controlled. We describe the technique of pars plana approach and putting an encircling band without destroying the preformed filtration bleb. Encircling techniques, pars plana vitrectomy and silicone oil in aphacic eyes seem to bee possible without loss of the filtration effect of the Molteno operation. PMID- 1787657 TI - [Tenotomy of the superior oblique muscle in treatment of A-pattern strabismus and Brown syndrome]. AB - The superior oblique tenotomy and tenectomy is an very effective and predictable surgical method in correcting the A-pattern in strabismus when overaction of one or both superior oblique muscles is present. In this series of 42 patients with an A-pattern an average correction of 86 to 91% was obtained regardless of the degree of the A-pattern. So we didn't observe any case that was converted from an A- to a serious V-pattern as obviously a less reduction is obtained in lesser degrees of A-pattern. In 11 cases of true but atypical Brown's-syndrome the tenotomy of the superior oblique muscle had a very beneficial effect on the limited movement of the affected eye and a co-existing abnormal head posture. PMID- 1787658 TI - [Vertical accommodative vergence]. AB - Five patients showed vertical accommodative vergence during which the strabismic eye deviated either up- or downwards. Additional components of strabismus included intermittent or constant exotropia, dissociated vertical divergence, and various incomitancies. There were no signs of misdirected regeneration after oculomotor palsy. We interpret vertical accommodative vergence as a supranuclear abnormality, most likely congenital. PMID- 1787659 TI - [Ocular circulatory changes in halothane-nitrous oxide intubation anesthesia with special reference to arterial CO2 partial pressure. I. Phenomenology of changes]. AB - In 20 patients (5 with cataract, 15 with strabismus), general anesthesia was performed using halothane (inspiratory concentration: 0.5 vol.%) and nitrous oxide (65 vol.%); thiopental was employed for induction of anesthesia, vecuronium and succinylcholine were used for neuromuscular blockade prior to intubation. In series 1, the patients were slightly hyperventilated (PCO2 33 mmHg, on average). In series 2, the arterial PCO2 was changed in a range between 20 and 45 mmHg. By means of oculo-oscillo-dynamography, we determined the systolic retinal and ciliary perfusion pressures (PPs,ret and PPs,cil) as well as the respective ocular blood pressures (Ps,ret and Ps,cil), the ocular pulsation volume (PVoc) and the pulsatile ocular blood flow (Fp,oc = PVoc x heart rate). The intraocular pressure (Pio) was measured with the Draeger hand-applanation tonometer. Results of series 1: Measured 5 and 15 min after intubation, PPs,ret was reduced by averages of 12.5 and 20.2 mmHg, respectively, corresponding to decreases of 13.1 and 21.2% compared to the initial values. Ps,ret was decreased by 15.4 mmHg (14.2%) 5 min after intubation and by 27.1 mmHg (25.0%) 15 min after intubation. The ciliary pressures (PPs,cil and Ps,cil) were changed by similar amounts. PVoc was reduced by 0.3 microliters (50.8%) during both time periods after intubation. Fp,oc was lowered by 19.5 microliters/min (41.0%) and by 26.4 microliters/min (55.5%), measured 5 and 15 min after intubation, respectively. Pio was decreased by 1.6 mmHg (11.3%) and by 7.6 mmHg (53.5%), respectively. The systolic brachial artery pressure was reduced by 12.6 mmHg (9.5%) 5 min after intubation and by 29.1 mmHg (21.9%) 15 min after intubation. The diastolic branchial artery pressure showed a slight initial increase, followed by a small decrease. All changes were highly significant (P less than 0.001; 1-factor analysis of variance plus Scheffe test). Results of series 2: In a PCO2 range between 40 and 45 mmHg (normo-until slight hypoventilation; determined 5 min after intubation), PVoc and Fp,oc averaged 0.43 microliter and 42.9 microliters/min, respectively. In a PCO2 range between 30 and 35 mmHg (slight hyperventilation), PVoc and Fp,oc averaged 0.38 microliters and 36.1 microliters/min, respectively; and in a PCO2 range between 20 and 25 mmHg (forced hyperventilation), they averaged 0.21 microliter and 22.8 microliters/min, respectively. All other variables were not dependent on the PCO2 level. CONCLUSIONS: The lowering of PVoc and Fp,oc, observed during halothane-nitrous oxide anesthesia--especially with forced hyperventilation-, may be interpreted as reduced pulsatile choroidal blood flow.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1787660 TI - [Entoptic detection of choriocapillaris]. AB - Entopic perception of the central choriocapillaris is documented by personal experience. Seen in this manner, the choriocapillaris appears due to circulatory conditions as a wavy convolute of fresh capillaries whose paths are paralleled by numerous, irregularly distributed, round, black structures. The latter have been presumed to be corpuscles, i.e. erythrocytes, and can be seen entopically as single rows of radial capillaries. Histological studies have shown, however, that these rows of erythrocytes are not always isolated; they have also been found in the choriocapillaris in clusters of rows. Moreover, analogously to the lack of entopic perception of erythrocytes in the retinal vessels in Purkinje's images, the erythrocytes of the choriocapillaris may likewise not be perceived for physical and optical reasons. Therefore the round, black formations are not entoptically perceivable erythrocytes of the choriocapillaries but can only originate in the circular network of the central choriocapillaris. Light directed experimentally into the eye and focussed on the choriocapillaris through a narrow slit positioned nasally leads via reflection to stimulation of the retina from outside to inside and so to entoptic perception of the choriocapillary network. Closer analysis of entoptic perception of the choriocapillaris is significant in view of its heuristic value. PMID- 1787661 TI - [Histiocytosis X (eosinophilic granuloma) of the caruncle]. AB - The lacrimal caruncle of an 11-year-old female patient developed a 2 mm x 3 mm sized growth with the primary appearance of an abscess. The process did not regress under local antibiotic therapy and was excised. Histological examination revealed histiocytosis X (eosinophilic granuloma). PMID- 1787662 TI - [Ocular symptoms in a family with pseudo-Ullrich-Turner syndrome]. AB - We report on a family with some features of the Pseudo-Ullrich-Turner-Syndrome, so-called Noonan-Syndrome. Besides low-set ears, microgenia, short neck, pterygium colli, low-anterior hair line and small stature as well as partial scoliosis, partial cubitus valgus and camptodactylia, retinal detachment, disturbances of the eye motility, keratoconus, unilateral ptosis and antimongoloid slant of the palpebral fissures in different expression are described. The caryotype was normal. Some of the features can be seen within at least 2 generations of the family. It seems to be an autosomal genetic mode of transmission. Differences and common characteristics in comparison to the literature are shown. Differential diagnostic aspects are described. A definite relation to a syndrome already described is not possible. PMID- 1787663 TI - [Bulbar dislocation]. AB - A luxation of the ocular globe can occur spontaneously or due to an adequate trauma. In the older literature several case reports are quoted. The authors report an ocular luxation of a four-year-old girl after a bicycle accident. The reaction of the affected eye's pupil was negative as well as the consensuel reaction of the other eyes's pupil. Three hours after the trauma the bulb was replaced under general anesthesia. There was a macular edema with a central red spot. Nevertheless a control after four weeks proved visus of both eyes and stereopsis to be normal. It is concluded that--as known from the older literature -an ocular luxation does not necessarily mean avulsion of the optic nerve and amaurosis. Thus, a rapid reposition ought to be attempted. PMID- 1787664 TI - [A new contact gel for stabilizing the minus lens in vitrectomy of the posterior eye segment]. AB - A new gel is presented to effect contact between contact lens and cornea during vitrectomy. Mainly it differs from comparable products in terms of higher viscosity. The advantages lie in the stabilisation of the lens and in reduction of air bubbles or blood under the contact lens. PMID- 1787665 TI - [Legal calibration of ocular tonometers]. AB - After a reference to the introduction of the obligitory verification of tonometers in the Federal Republic of Germany in 1970 the legal basis for the verification as well as for the type approval of tonometers are described. A delivery is given of all tonometers which have been approved for verification in the Federal Republic of Germany since 1970. PMID- 1787666 TI - [Meeting of the Berlin Ophthalmologists' Association. 1-2 December 1990, Berlin. Abstracts]. PMID- 1787667 TI - [Therapeutic-prophylactic use of hypoxia]. PMID- 1787668 TI - [Androgen resistance related to receptor disorders]. AB - It is the review of literature data on various phenotypic anomalies consequent to the absent or reduced ability of the target tissues to response to androgens (A) due to defects in receptor A structure and function. Clinical forms of resistance to A, quantitative and qualitative abnormalities in hormone-receptor interaction detectable in relevant patients are described as well as markers of target tissue sensitivity to A action suggested for use in prognosticating the response to A treatment. PMID- 1787669 TI - [Significance of the studies of urinary syndrome in clinical practice]. AB - The study of urinary sediment is essential in laboratory diagnosis. Conventional clinical methods are now used in line with computer-aided techniques and additional microscopy of the sediment elements. The paper provides a brief analysis of clinical situations characterized by appearance in the urine of abnormal numbers of leukocytes, erythrocytes, casts; provides clinical assessment of additional microscopic methods able to accentuate qualitative characteristics of the urinary syndrome; considers possibilities of application of the urinary sediment data in follow-up to improve diagnosis and control on-going treatment. PMID- 1787670 TI - [Current concepts of possibilities of early diagnosis in purulent pleurisy]. PMID- 1787671 TI - [Disorders of respiration and gas exchange during sleep in patients with chronic obstructive lung diseases]. PMID- 1787672 TI - [Campylobacteriosis in clinical practice]. PMID- 1787673 TI - [Ciliary activity of the ciliated epithelium of the airways in patients with acute pneumonia]. AB - A TV unit was employed to study ciliary activity of bronchial ciliated epithelium in 53 patients with acute pneumonia (AP) at its height and in convalescence. Ciliary impairment of the epithelium is independent of AP clinical form (lobular or croupous) or of dissemination of the inflammation though is related to endobronchitis activity. The ciliary dysfunction emerged in all the patients at the height of the disease and in 65.3% of convalescents. Latent dysfunction was revealed by thermal and euphylline tests in 34.7% of the convalescents. Diagnostic criteria of ciliary dysfunction are proposed. PMID- 1787674 TI - [Changes in immune and fibrinolytic systems of patients with atherosclerosis and chronic nonspecific pulmonary diseases]. AB - The study of immune and fibrinolytic systems in 216 atherosclerosis patients with associated chronic obstructions of the lungs revealed a discrete pattern of activity of plasminogen activator which is low in atherosclerosis in contrast to its elevation in combination of atherosclerosis with pulmonary obstructions. The latter cases manifest E-RFC relative number to be reduced in increased number of EAC-RFC. Growing amount of EA-RFM, elevated blood antithrombin III, activation of plasminogen activator in atherosclerosis coexistence with obstructive pulmonary lesions arrest the development of latent DIC syndrome and progression of atherosclerosis. PMID- 1787675 TI - [Pulmonary manifestations of helminth invasion]. PMID- 1787676 TI - [Expiratory stenosis of the trachea and large bronchi and bettolepsy]. PMID- 1787677 TI - [Cough-syncope syndrome]. AB - The paper is concerned with pathogenetic mechanisms of cough syncope, its diagnosis, evaluation of working ability in this disease. Obesity plays a substantial role in the onset of cough syncope. The severity of pulmonary insufficiency or hypotonic dyskinesia of the tracheobronchial free are not essential for the disease course. Treatment of cough syncope should be based on therapy of pulmonary process and its complications. PMID- 1787678 TI - [Assessment of the activity of plasminogen activators in the differential diagnosis of pleural effusion]. AB - The comparison of activator activity of blood, urine and pleural fluid in 55 patients suffering from chronic circulatory insufficiency, tuberculosis, pneumonia and lung cancer helped to determine pathognomonic signs for each of the exudates examined. Cardiac decompensation is associated with high activity of plasminogen activator in the transudate against low activator activity of the blood and urine. In tuberculous pleuritis there is low activator activity of the exudate in normal blood and urine parameters. Reduced activator activity of the blood, urine and pleural fluid is characteristic of parapneumonic pleuritis, while high activity of plasminogen activator in the blood and pleural exudate in its normal activity in the urine is seen in cancer pleuritis. The findings obtained can be used in clinical medicine for verification of pleural fluid nature. PMID- 1787679 TI - [Differential diagnosis of chronic obstructive and asthmatic bronchitis in outpatient clinics]. PMID- 1787680 TI - [Effects of intravascular laser irradiation of blood on the immune status of patients with bronchial obstructive diseases of the lungs]. AB - Thirty-eight patients with infectious-allergic bronchial asthma and thirty-four ones with chronic obstructive bronchitis were exposed to laser irradiation of blood. Control group given standard chemotherapy, consisted of 30 bronchial asthma and 30 chronic obstructive bronchitis patients. The immunity assessed in both groups exhibited the following changes in the study patients: T-lymphocytes count rose as well as their proliferative ability and concentration of immunoglobulins, the activity of oxygen-dependent metabolism inhibited, neutrophil absorptive capacity reduced. Restoration of normal cell function can serve a criteria of on-going laser therapy efficacy. PMID- 1787681 TI - [Evaluation of diagnostic indices of reactivity during treatment of patients with chronic bronchitis and bronchiectatic disease]. AB - Evaluation of neutrophils conditions by glycogen, enzymatic activity (acid and alkaline phosphatases, peroxidase), lymphocyte blast-transformation reaction stimulated by staphylococcal antigen in 113 patients with bronchial pathology on treatment suggested the conclusion of their value in verification of the disease course correction of on-going treatment and definition of its effect. The methods acquire additional significance in objective assessment of the process activity in obscure clinical manifestations and lack of laboratory evidence for aggravation. PMID- 1787682 TI - [Effectiveness of immunomodulators in multimodal treatment of patients with lung cancer]. AB - The analysis of clinical and immunologic findings indicate that retinol and decaris influence functional activity of immune cells at stage II of lung cancer irrespective of histological structure. In stage III, retinol induced changes in proportion of lymphocyte subpopulations, more evident in glandular cancer. Both immunomodulators lowered the number of purulent complications after surgical interventions. It is only retinol that influenced metastatic dissemination in lung cancer stage II-III. PMID- 1787683 TI - [Use of cryo-apheresis in the treatment of patients with cortisol-dependent bronchial asthma]. AB - An attempt of cryo-apheresis treatment of cortisol dependent bronchial asthma demonstrated high efficacy of this method: the majority of the patients could do without glucocorticoid maintenance, recovered working ability. Remission duration considerably increased. PMID- 1787684 TI - [Effectiveness of therapeutic bronchoscopy in patients with deforming bronchitis]. AB - Therapeutic bronchoscopy performed in 94 patients suffering from deforming bronchitis resulted in a clinical response in 94.7% of the cases. Pretreatment pulmonary ventilation was normal in 3 patients only, whereas its after treatment characteristics recovered normal values in 17 and improved in 75 patients. PMID- 1787685 TI - [Mechanisms of chronicity of liver diseases]. PMID- 1787686 TI - [Morbidity and surgical treatment of lung cancer in middle-aged and aged patients in Moscow]. AB - Analysis of lung cancer incidence in Moscow residents shows that of late the rise in the incidence has occurred only in absolute number. Intensive rates remain stable. The number of cases in the age groups 1-59, 60-69 and 70 years and older is approximately the same. Of all the patients who need treatment annually, it is provided to one-third of them and surgical treatment to 16-18%. The percentage of operable cancer patients drops with age. Basing on his own 10-year surgical experience, the author thinks it proper to rise surgical activity in the elderly patients. PMID- 1787687 TI - [Clinical-laboratory parallels in crush syndrome]. AB - Biochemical evaluation of 60 patients with crush syndrome developing after the Armenian earthquake demonstrated informative value of some parameters: total blood protein, aspartate and alanine aminotransferase, myoglobin and middle-mass molecules. An aggravation of the disease accompanied acute renal failure and concomitant injuries. The above parameters proved valuable criteria in diagnosis of the clinical alterations. PMID- 1787688 TI - [Clinico-immunological features of generalized myasthenia in patients with hyperplasia and atrophy of the thymus gland]. PMID- 1787689 TI - [A case of uremic infarct-like lesion of the heart]. PMID- 1787690 TI - [Primary gout with severe lesions of the kidneys]. PMID- 1787691 TI - [A case of pheochromocytoma of the bladder]. PMID- 1787692 TI - [Pulmonary alveolar proteinosis]. PMID- 1787693 TI - [Diagnostic and therapeutic tactics in comatose states]. PMID- 1787694 TI - [Diseases of the gallbladder and biliary tract]. PMID- 1787695 TI - Status of the general health education courses in U.S. colleges and universities. AB - The status of general health education courses was examined in 248 education programs. A general health education course was included in the curriculum of more than 85% of responding institutions. Thirty-five universities indicated the course is a graduation requirement for all undergraduate students. One hundred seventy-eight programs offer a general health education course to meet requirements for various majors including health education, physical education, elementary and secondary education, and athletic training. The average health education course enrolls slightly more than 46 students; more than 108,000 students enroll annually in a general health education course. Part-time faculty teach approximately 23% of the courses. PMID- 1787696 TI - The 1990 ASHA membership survey: members speak up. PMID- 1787697 TI - Effects of a take-home drug prevention program on drug-related communication and beliefs of parents and children. AB - Five hundred and eleven fourth, fifth, and sixth grade students and their parents from six schools in northwest Arkansas participated in this study. Students were blocked on school and grade level, then assigned randomly by class to either the intervention Keep A Clear Mind (KACM) program or a waiting list control. KACM students received four weekly correspondence lessons designed to be completed at home with a parent. KACM students reported significantly less perceived peer use of alcohol, tobacco, and marijuana, as well as significantly less peer pressure susceptibility to experiment with cigarettes. Mothers in the KACM program reported significantly more recent and frequent communication with their children about refusing drugs, and significantly greater discussions with their children regarding how to resist peer pressure to use alcohol, tobacco, and marijuana. Intervention program fathers reported significantly more communication with their children concerning how to resist peer pressure to drink alcohol and use tobacco, and significantly greater motivation to help their children avoid drug use. No significant differences were found between groups on student intentions to use drugs. These data suggest a print medium that emphasizes parent-child activities holds promise for accessing families and enhancing drug prevention communication. PMID- 1787698 TI - Relationship of AIDS education and knowledge to AIDS-related social skills in adolescents. AB - The AIDS Social Assertiveness Scale (ASAS) and a measure of AIDS knowledge were administered to 490 high school students from 10 South Australian schools selected across a range of public/private, rural/urban, and socioeconomic statuses. Age, grade, hours of AIDS education, and sexual experience (and condom use) also were ascertained. Data indicated the factor structure of the ASAS was similar to that obtained in a previous sample. A close association existed between both age and hours of AIDS education, and AIDS knowledge. Students from country and working class area schools were less knowledgeable about AIDS. These data suggest AIDS social assertiveness is measurable and that it is associated with AIDS knowledge, age, and previous sexual experience. AIDS knowledge in high school students differed between country and urban adolescents and between students in working and middle class areas, but AIDS education is associated with the same level of improvement in all schools sampled. PMID- 1787699 TI - School health education and a national curriculum: one disconcerting scenario. PMID- 1787700 TI - Healthy children ready to learn: the Surgeon General's initiative for children. PMID- 1787701 TI - Creating partnerships: a hospital-based newsletter for teachers. PMID- 1787702 TI - Student bereavement: a guide for school personnel. PMID- 1787703 TI - Innovation, peer teaching, and multidisciplinary collaboration: outreach from a school-based clinic. PMID- 1787704 TI - Anticipatory coarticulation in the speech of adults and young children: acoustic, perceptual, and video data. AB - Three experiments investigated anticipatory lingual and labial coarticulation in the [sV] productions of children and adults. Acoustic, perceptual, and video data were used to trace the development of intrasyllabic coarticulation in the speech of adults and children (ages 3, 5, and 8 years). Although children show greater variability in their articulatory patterns than adults, the data do not support claims that young children produce a greater degree of intrasyllabic coarticulation than older children or adults. Rather, the acoustic and video data suggest that young children and adults produce similar patterns of anticipatory coarticulation, and the perceptual data indicate that coarticulatory cues in the speech of 3-year-old children are less perceptible than those of the other age groups. PMID- 1787705 TI - High-level psychophysical tuning curves: forward masking in normal-hearing and hearing-impaired listeners. AB - Forward-masked psychophysical tuning curves (PTCs) were obtained for 1000-Hz probe tones at multiple probe levels from one ear of 26 normal-hearing listeners and from 24 ears of 21 hearing-impaired listeners with cochlear hearing loss. Comparisons between normal-hearing and hearing-impaired PTCs were made at equivalent masker levels near the tips of PTCs. Comparisons were also made of PTC characteristics obtained by fitting each PTC with three straight-line segments using least-squares fitting procedures. Abnormal frequency resolution was revealed only as abnormal downward spread of masking. The low-frequency slopes of PTCs from hearing-impaired listeners were not different from those of normal hearing listeners. That is, hearing-impaired listeners did not demonstrate abnormal upward spread of masking when equivalent masker levels were compared. Ten hearing-impaired ears demonstrated abnormally broad PTCs, due exclusively to reduced high-frequency slopes in their PTCs. This abnormal downward spread of masking was observed only in listeners with hearing losses greater than 40 dB HL. From these results, it would appear that some, but not all, cochlear hearing losses greater than 40 dB HL influence the sharp tuning capabilities usually associated with outer hair cell function. PMID- 1787706 TI - Low-frequency energy deficit in electrolaryngeal speech. AB - The present exploratory project was undertaken (a) to determine the relative strength of low-frequency energy in the output of one widely used electronic artificial larynx (Servox) and (b) to assess the relative strength of low frequency energy in vowels produced by users of this type of artificial larynx. We hypothesized that the outputs of electronic artificial larynges and the vowels produced by laryngectomized users of these devices would be characterized by significant deficits in low-frequency energy level. Five users of electronic larynges and 10 normal speakers (5 female and 5 male) provided the speech samples. Results of spectral analyses indicated that there was a significant deficit in low-frequency energy both in the acoustic signals generated by a Servox electronic larynx and in vowels produced by laryngectomized users of this type of electronic larynx. Based on these findings, a second order filter was designed and implemented digitally to compensate for the observed deficit in low frequency energy. A perceptual experiment was completed to evaluate the effect of low-frequency enhancement on perceived speech quality. Ninety-eight percent (+/- 2%) of the responses of listeners indicated that low-frequency enhanced speech samples had better vocal quality or were more pleasant to listen to than the original speech samples. We conclude that consideration for enhancing low frequency characteristics is warranted in the design of improved prosthetic devices for alaryngeal speakers. PMID- 1787707 TI - Effects of thermal application on dysphagia after stroke. AB - The influence of thermal application on dysphagia for liquid boluses after multiple cerebrovascular accidents was measured. A month-long trial of thermal application organized according to the guidelines of a single-subject withdrawal or ABAB design was replicated across 7 male subjects. After baseline testing, 6 subjects were randomly assigned to begin the study with a week-long period of thermal application (B stage), and 1 subject was randomly assigned to begin the study with a week-long period of no thermal application (A stage). Subsequent week-long A and B stages were then alternated until each subject had completed the 4-week interval of this study. Progress testing occurred at the end of each stage and at follow-up testing 1 month after the study's completion. The influence of thermal application on eight duration and four descriptive measures was determined by three judges using visual inspection of data displays. Two of three judges agreed that 2 of the subjects demonstrated decreased Duration of Stage Transition in the absence of any change in the occurrence of aspiration or penetration. Overall, this study failed to reveal strong evidence that 2 weeks of thermal application alternating with 2 weeks of no thermal application improves dysphagia following multiple strokes. Further replications are needed. PMID- 1787708 TI - Speech deterioration in amyotrophic lateral sclerosis: a case study. AB - Few detailed reports have been published on the nature of speech and voice changes during the course of amyotrophic lateral sclerosis (ALS). The subject of this case study is a woman who was diagnosed as having ALS with bulbar signs at the age of 53. Speech intelligibility, pulmonary function, and selected speech and voice functions were tested during an approximately 2-year course of her disease. Over this period, her speech intelligibility, as measured by a multiple choice word identification test, declined from 98% to 48%. Phonetic features that were most affected during the intelligibility decline included voicing contrast for syllable-initial and syllable-final consonants, place of articulation contrasts for lingual consonants, manner of articulation for lingual consonants, stop versus nasal manner of production, features related to the liquid consonants, and various features related to syllable shape. An acoustic measure, average slope of the second-formant frequency, declined in association with the intelligibility reduction and is thought to reflect the loss of lingual motoneurons. Her pulmonary function also declined over the observation interval, with particularly severe reduction in measures of air flow. Oral diadochokinesis and measures of vocal function (including jitter, shimmer, and signal-to-noise ratio) were highly variable across test sessions. These results are discussed in terms of the challenges they present to sensitive assessment of change and to management of the communication disability in ALS. PMID- 1787709 TI - Anticipatory coarticulation in the speech of profoundly hearing-impaired and normally hearing children. AB - The present study investigated the extent of anticipatory coarticulation in the speech of five 7-year-old and four 10-year-old children with profound prelingual hearing impairment as compared to normally hearing age-matched control subjects. Ten tokens each of the CV syllables [integral of i, integral of u, ti, tu, ki, ku] were elicited from each of the children. Both temporal and spectral (centroid and F2 frequency) analyses were conducted to explore the influence of the following vocalic environment on the initial consonants. The data indicated that the hearing-impaired children displayed evidence of coarticulation on most measures, but they did so to a lesser degree when compared to the normally hearing children. The results are discussed in relation to theories of speech production in the hearing impaired, and their implications for the development of coarticulation are considered. PMID- 1787710 TI - Perseveratory coarticulation in the speech of profoundly hearing-impaired and normally hearing children. AB - This study investigated the extent of perseveratory coarticulation in the VC syllables [i integral of, u integral of, it, ut, ik, uk] as produced by 7- and 10 year-old normally hearing and profoundly hearing-impaired children. Measures of both temporal and spectral (centroid and F2 frequency) parameters were computed. The data revealed that the hearing-impaired speakers exhibited measurable but smaller effects of perseveratory coarticulation relative to the normally hearing speakers. These results are compared with studies of anticipatory coarticulation and are discussed in relation to the claim that perseveratory coarticulation is largely a result of the inertial properties of the speech production mechanism. PMID- 1787711 TI - Following the rules: consistency in sign. AB - The majority of hearing-impaired students in the United States are exposed to at least one, if not several, forms of simultaneously signed and spoken English input (e.g., Seeing Essential English, Signing Exact English, Signed/Manual English, or combinations of these systems). It was the purpose of this study to investigate teachers' and interpreters' consistency with regard to following the rules of three of these systems. Subjects were asked to interpret a carefully designed set of stimuli; their performance was videotaped for later bimodal transcription and analysis. Careful descriptive analysis of the form and content of the data revealed that some professionals who purported to use a particular system frequently do not follow accurately the rules of that system, but many can encode in sign the meaning of what they are saying. Signing Exact English (SEE II) users were able to follow the rules of that system at a significantly higher percentage of time than users of either of the other two systems (p less than .03 and p less than .001). They also were able to encode the meaning in sign of what they were saying an average of 86% of the time--significantly higher than users of Signed/Manual English (p less than .02). However, the average percentage of ability to follow the precise rules of a system was below 57% for even the adults who used SEE-II. It is possible that the acquisition of English is confounded for hearing-impaired children when professionals do not consistently sign the system they purport to use. PMID- 1787712 TI - Social interactions of speech- and language-impaired children. AB - Social interactions among preschool children were classified into four groups according to language ability: normally developing English, specific language impairment (SLI), speech impairment (SI), and English as a second language (ESL). The children were observed in naturalistic classroom interactions on three occasions. Conversational turns were coded according to initiations and responses, and addressee. The results reveal differences across the groups of children. Normal language peers initiate interactions with each other and have a higher percentage of longer responses; normal language peers were the preferred addressee in peer initiations. In contrast, children with limited communication skills were more likely than their normal language peers to initiate with adults and to shorten their responses or use nonverbal responses. ESL children were the least likely to initiate interactions and were the most likely to be avoided as the recipient of an initiation. The findings are interpreted as evidence that preschool children are sensitive to relative communication skills and make adjustments in their social interactions accordingly. Multiple contributing factors are implicated, including intelligibility, limited linguistic flexibility, limited discourse skills, and self-consciousness about communicative competence. PMID- 1787713 TI - Conversational responsiveness of speech- and language-impaired preschoolers. AB - The purpose of this study was to describe preschoolers' conversational responsiveness in an integrated classroom setting. Variables of primary interest were the types of responses as a function of the conversational partner. The children were categorized according to language ability: normally developing, marginal (children previously diagnosed as language or speech impaired, but now functioning within the normal range), language impaired (LI), and speech impaired (SI). They were observed during free play. Differences in response types were apparent between groups with both adult and peer partners. LI and SI children were ignored by their peers and responded less often when a peer initiated to them. Hence, they participated in proportionately fewer peer interactions. These results suggest that peer interaction difficulties may be concomitant consequences of early speech and language impairments. Clinical implications for verbal interactive skill intervention, particularly with peers in classroom settings, are discussed. PMID- 1787714 TI - Stimulability as a factor in the phonological generalization of misarticulating preschool children. AB - The relationship among six functionally misarticulating preschool children's phoneme-specific stimulability skills, the choice of treatment targets (i.e., stimulable or nonstimulable sounds), and generalization of correct sound production was explored in this prospective study. Each subject [age range of 4:11 (years:months) to 5:6] was taught to produce [r] and one other sound that was absent from his or her phonetic inventory using a contrasting-minimal-pairs production approach. A multiple baseline across behaviors single-subject research design provided experimental control. For 86% of the 28 monitored sounds, generalization was consistent with pretreatment stimulability skills; production of stimulable sounds tended to improve regardless of treatment target. These results suggest that nonstimulable sounds are likely to require direct treatment; thus, generalization probe responses may be maximized by treating nonstimulable sounds rather than stimulable sounds. PMID- 1787715 TI - Hypothesis-testing abilities of language-impaired children. AB - Hypothesis-testing abilities were assessed using a modification of the discrimination-learning paradigm employed by Nelson, Kamhi, and Apel (1987) that was designed to minimize the short-term memory demands of the task. Sixteen language-impaired and 16 normal-language children in kindergarten and first and second grades participated in the study. The language-impaired children solved significantly fewer problems than normal-language controls equated on cognitive level, but the two groups used similar hypothesis types to solve the problems. Type of verbal feedback provided during the hypothesis testing task (explicit vs. nonexplicit) did not significantly affect the performance of either group. These results are interpreted as indicating that language-impaired children demonstrate inefficient use of problem-solving strategies that cannot be attributed solely to memory difficulties. Issues surrounding the investigation of language-impaired children's cognitive abilities are discussed. PMID- 1787716 TI - Spontaneous narrative-discourse performance of parents of autistic individuals. AB - The spontaneous narrative-discourse performance of parents of autistic individuals was compared to controls. The narratives of autism parents were similar in length to controls' narratives but were less complex and less coherent. A subgroup of autism parents produced either skeletal or rambling narratives that were not characterized by the type of simplifications that are reported to facilitate comprehension in very young or language-impaired children. The narrative-discourse deficits of this subgroup appeared to be consistent with the hypothesis of a genetic liability for autism that expresses in milder forms and may include impaired language abilities. PMID- 1787717 TI - Pragmatic and linguistic constraints on message formulation: a cross-linguistic study of English and ASL. AB - This study provides a cross-linguistic replication, using American Sign Language (ASL), of the Brown and Dell (1987) finding that when relaying an action involving an instrument, English speakers are more likely to explicitly mention the instrument if it is atypically, rather than typically, used to accomplish that action. Subjects were 20 hearing-impaired users of English and 20 hearing impaired users of ASL. Each subject read and retold, in either English or ASL, 20 short stories. Analyses of the stories revealed production decision differences between ASL and English, but no differences related to hearing status. In ASL, there is more explicitness, and importance seems to play a more pivotal role in instrument specification. The results are related to differences in the typology of English and ASL and are discussed with regard to second-language learning and translation. PMID- 1787718 TI - Profile and stability of sensorineural hearing loss in persistent pulmonary hypertension of the newborn. AB - The purpose of this study was to examine the incidence, profile, and stability of sensorineural hearing loss (SNHL) in infants diagnosed with persistent pulmonary hypertension of the newborn (PPHN). Over a five-year period, 19 of 51 infants (37%) with PPHN were diagnosed with SNHL: 16 with bilateral and 3 with unilateral impairment. This incidence of SNHL is approximately 25 times greater than observed in graduates of our intensive care nursery. The profile of SNHL in the group of 19 children was typically downward sloping. However, there was considerable variation with respect to degree of loss. In addition, progressive SNHL was identified in 5 children whose hearing worsened an average of 55 dB at 2 to 4 kHz. On retrospective analysis, the perinatal variables associated with PPHN were comparable between hearing-impaired and normal-hearing infants. In contrast, the two groups were significantly different when treatment variables, such as the duration of mechanical ventilation or amikacin, were compared. Children with SNHL were treated for longer durations as compared to normal-hearing infants. Children with SNHL were subdivided into two groups, mild and severe, based on degree of loss and treatment variables, and compared again to the normal-hearing group. Two findings emerged from this analysis. First, the duration of hyperventilation was now the only variable significantly different between children with mild SNHL and children with normal hearing. Second, comparison of the mild with the severe SNHL groups showed that the duration of hyperventilation was similar. The pathophysiology and underlying mechanisms resulting in SNHL in PPHN survivors are discussed. PMID- 1787719 TI - Frequency discrimination as a function of signal frequency and level in normal hearing and hearing-impaired listeners. AB - Frequency difference limens (DLFs) for pure tones were obtained over a wide range of frequencies and levels from 7 normal-hearing subjects and 16 ears of 12 listeners with sensorineural hearing losses. The normal data were fitted with a general prediction equation. Variability of the data around the DLFs estimated by the equation was quantified and used to evaluate the DLFs from the hearing impaired listeners. The majority of DLFs from impaired listeners were poorer than one standard deviation above the estimates of the normal equation at all frequencies and sensation levels (SLs). The portion of the equation concerned with sensation level was fitted to each listener's data at each frequency. The slopes of these functions indicated that, on average, the rate of improvement of the DLF with sensation level was similar in the two groups of subjects. These results suggest that it would be reasonable to compare DLFs from normal-hearing and hearing-impaired listeners at equivalent sensation levels. The intercepts of the DLF-intensity functions represent asymptotic values obtained at high SLs. These asymptotic DLFs were abnormal in the majority of hearing-impaired subjects, with more than half the data in excess of two standard deviations above normal. However, among those subjects, the correlation between the DLF deficit and the amount of hearing loss at the test frequency was not strong (r = +.27). PMID- 1787720 TI - Cerebral averaged potentials preceding oral movement. AB - The "readiness potential" is an event-related potential that shows increasing negativity at vertex and motor strip scalp recording sites prior to voluntary, unilateral limb movements. Though speech involves movement on both sides of the midline, recent recordings of prespeech potentials suggest a pattern of bilateral activation that lateralizes to the dominant hemisphere just prior to the onset of articulatory movement. To determine whether this pattern of dominant hemisphere activation is present prior to a stereotyped, nonspeech movement of the mouth, the averaged potentials preceding a lip protrusion task were recorded at the cranial vertex and over the right and left motor cortex. Results were compared to potentials preceding a right finger extension task performed by the same subjects. Both the finger and the lip movements were initially preceded by slow negative potentials. Prior to the finger extension task, the negative amplitude became greatest over the left motor cortex, contralateral to the side of movement. Prior to the lip protrusion task, the amplitude of the potential remained even over the right and left motor cortices. The results suggest that, for this nonspeech movement of a midline structure, bilateral cortical control takes place. Control of lip movement is apparently not necessarily a dominant hemisphere function, though dominance may become part of the motor control strategy for more complex movements such as those used during speech. PMID- 1787721 TI - Consonant-recognition patterns and self-assessment of hearing handicap. AB - Two companion experiments were conducted with normal-hearing subjects and subjects with high-frequency, sensorineural hearing loss. In Experiment 1, the validity of a self-assessment device of hearing handicap was evaluated in two groups of hearing-impaired listeners with significantly different consonant recognition ability. Data for the Hearing Performance Inventory--Revised (Lamb, Owens, & Schubert, 1983) did not reveal differences in self-perceived handicap for the two groups of hearing-impaired listeners; it was sensitive to perceived differences in hearing abilities for listeners who did and did not have a hearing loss. Experiment 2 was aimed at evaluation of consonant error patterns that accounted for observed group differences in consonant-recognition ability. Error patterns on the Nonsense-Syllable Test (NST) across the two subject groups differed in both degree and type of error. Listeners in the group with poorer NST performance always demonstrated greater difficulty with selected low-frequency and high-frequency syllables than did listeners in the group with better NST performance. Overall, the NST was sensitive to differences in consonant recognition ability for normal-hearing and hearing-impaired listeners. PMID- 1787722 TI - Masking-level differences in the elderly: a comparison of antiphasic and time delay dichotic conditions. AB - Four dichotic thresholds (S pi N0, S0 N pi, S0 N tau, and S pi N pi tau) were measured for young and old subjects using both burst and continuous broadband maskers. Masking-level differences (MLDs) were determined by subtracting dichotic thresholds from homophasic thresholds (S0 N0 or S pi N pi). The S0 N0 thresholds for the old subjects did not differ significantly from those for the young subjects in either the continuous or the burst masking noise conditions. The S pi N pi thresholds for the old subjects did not differ significantly from those for the young subjects in the continuous masking noise condition, but there was a significant age effect (3 dB) when burst masking noise was used. Both young and old subjects obtained larger MLDs in continuous masking noise than in burst masking noise. MLDs for old subjects were smaller than MLDs for young subjects by 4.3, 5.0, 2.7, and 1.6 dB in burst masking noise and by 4.9, 3.5, 2.5, and 1.4 dB in continuous masking noise, respectively in the S pi N0, S pi N pi tau, S0 N tau, and S0 N pi conditions. Four young subjects there was a hierarchy in the size of the MLD obtained in the four dichotic conditions, with the MLD being significantly larger in the S pi N0 and S pi N pi tau conditions; however, the size of the MLD was the same in all four conditions for the old subjects. Compared to young subjects, the performance of the old subjects was characterized by decreased ability to use homophasic cues in burst masking noise and decreased ability to use interaural difference cues. These findings were observed at four signal frequencies. PMID- 1787723 TI - Consonant lingual-palatal contacts produced by normal-hearing and hearing impaired children. AB - Ten normal hearing (NH) and 18 profoundly hearing-impaired (HI) children were recorded using palatometry and audiotape while producing the consonants /t,d,k,g,s,z,integral of/ in CV syllables (V = /i, a/). The lingual-palatal contacts produced by the NH subjects for the alveolar stops were undifferentiated across voicing and vowel environment differences. Lingual-palatal contact patterns for the velar stops differed for vowel environment but not for voicing. The /s/ and /z/ sibilants were distinguished by groove width but not anterior place. Groove locations for /s/ and /z/ were more anterior than groove locations for /integral of/. The anterior grove location for the /integral of/ was vowel dependent. The HI subjects produced idiosyncratic lingual-palatal contact patterns. As patterns for individuals became more unique and less variable across the syllable stimuli, listener identifications showed correspondingly incorrect, undifferentiated responses. The atypical contact patterns used by the HI subjects often required interpretation of possible tongue activities during attempts at the various consonants. PMID- 1787724 TI - Enhancement of word-recognition performance with a filtering technique. AB - The NU No. 6 materials spoken by a female speaker were passed through a notch filter centered at 247 Hz with a 34-dB depth. The filtering reduced the amplitude range within the spectrum of the materials by 10 dB that was reflected as a 7.5 vu reduction measured on a true vu meter. Thus, the notch filtering in effect changed the level calibration of the materials. Psychometric functions of the NU No. 6 materials filtered and unfiltered in 60-dB SPL broadband noise were obtained from 12 listeners with normal hearing. Although the slopes of the functions for the two conditions were the same, the functions were displaced by an average of 5.8 dB with the function for the filtered materials located at the lower sound-pressure levels. PMID- 1787725 TI - Survey of emergency medical services in Tennessee. PMID- 1787726 TI - Abdominal gunshot injuries in children. PMID- 1787727 TI - A woman with massive ascites. PMID- 1787728 TI - Chickenpox in a pregnant woman. PMID- 1787729 TI - Platelet-activating factor attenuates muscle amino acid. PMID- 1787730 TI - Radiology case of the month. Schizencephaly with heterotopic gray matter. PMID- 1787731 TI - Good science--bad luck? PMID- 1787732 TI - Health access incentive program in retrospect. PMID- 1787733 TI - Excited hydrogen bonds in the molecular mechanism of muscle contraction. AB - The mechanism of muscle contraction is considered. The hydrolysis of an ATP molecule is assumed to produce the excitation of hydrogen bonds A--H...B between electronegative atoms A and B, which are contained in the myosin head and actin filament. This excitation energy epsilon f depends on the interatomic distance AB = R and generates the tractive force f = -delta epsilon f/delta R, that makes atoms AB approach each other. The swing of the myosin head results in macroscopic mutual displacement of actin and myosin polymers. The motion of the actin filament under the action of this force is studied. The conditions under which a considerable portion of the excitation energy converts into the potential tension energy of the actin filament are analysed, and the probability of higher muscle efficiency existence is discussed. PMID- 1787734 TI - Unequal cell division, growth regulation and colony size of mammalian cells: a mathematical model and analysis of experimental data. AB - This work describes mathematically the dynamics of expansion of cell populations from the initial division of single cells to colonies of several hundred cells. This stage of population growth is strongly influenced by stochastic (random) elements including, among others, cell death and quiescence. This results in a wide distribution of colony sizes. Experimental observations of the NIH3T3 cell line as well as for the NIH3T3 cell line transformed with the ras oncogene were obtained for this study. They include the number of cells in 4-day-old colonies initiated from single cells and measurements of sizes of sister cells after division, recorded in the 4-day-old colonies. The sister cell sizes were recorded in a way which enabled investigation of their interdependence. We developed a mathematical model which includes cell growth and unequal cell division, with three possible outcomes of each cell division: continued cell growth and division, quiescence, and cell death. The model is successful in reproducing experimental observations. It provides good fits to colony size distributions for both NIH3T3 mouse fibroblast cells and the same cells transformed with the rasEJ human cancer gene. The difference in colony size distributions could be fitted by assuming similar cell lifetimes (12-13 hr) and similar probabilities of cell death (q = 0.15), but using different probabilities of quiescence, r = 0 for the ras oncogene transformed cells and r = 0.1 for the non-transformed cells. The model also reproduces the evolution of distributions of sizes of cells in colonies, from a single founder cell of any specified size to the stable limit distribution after eight to ten cell divisions. Application of the model explains in what way both random events and deterministic control mechanisms strongly influence cell proliferation at early stages in the expansion of colonies. PMID- 1787735 TI - A stochastic model for gene induction. AB - Expression levels of individual copies of an inducible gene have been presumed to be identical to the averaged level of many copies and to change in a smooth and predictable way according to the concentration of an inducing molecule. However, our recent experiments using a steroid-inducible system showed that the expression levels of individual copies are very heterogeneous and do not necessarily coincide with the averaged expression level of many copies (Ko et al., 1990, EMBO J. 9, 2835-2842). To explain this result, I present a stochastic model for gene induction here and its analysis using computer simulation. Stochasticity in the model is derived from the randomness corresponding to the random timing of molecular collisions and dissociations between transcription factors and a gene copy, since at any instant each copy is thought to be either "switched on" by having a transcription complex bound to it, or "switched off" by not having a transcription complex bound. This model can produce two types of gene induction that depend on the stability of the transcription complex on the regulatory region of the gene. An unstable transcription complex causes a homogeneous level of gene induction among individual copies, while a stable transcription complex causes a heterogeneous level. Since the recent consensus formed by in vitro transcription experiments is that the transcription complex is generally very stable, the latter case (the non-deterministic one) is highly possible. Since typical eukaryotic cells have just two copies for any gene in a single cell, this possibility of heterogeneous gene induction indicates that the phenotypes of individual cells cannot be precisely determined by just environmental signals, such as inducers. This may prompt us to reconsider many problems related to gene induction, including morphogenesis. PMID- 1787736 TI - Total cell protein concentration as an evolutionary constraint on the metabolic control distribution in cells. AB - Cell protein occupies 15-35% of cell volume. This level is argued to be the maximum compatible with cell function. Because of this constraint, selection pressure during evolution is likely to have maximized pathway fluxes for minimum total protein level. Pathways optimized in this way are shown to have the following characteristics: (1) the "simple" flux control coefficients of all enzymes are equal, (2) the normal flux control coefficients depend on the relative kinetic constants of the enzymes, such that enzymes with low specific activity are present at relatively high levels and have high flux control, (3) the normal flux control coefficients are proportional to enzyme levels. A single rate limiting step located at the first step in a pathway is likely to be inefficient in terms of protein levels, and the major metabolic pathways are therefore expected to have control distributed throughout the pathway. This has important implications for metabolic control. PMID- 1787737 TI - Reconstruction of the antibody affinity distribution from experimental binding data by a minimum cross-entropy procedure. AB - A new solution is presented for the reconstruction of the distribution of association constants of antigen-antibody binding from a finite number of noisy experimental binding data. This ill-posed problem is solved by utilizing an information-theoretic method based on the principle of minimum cross-entropy (MCE) to select, as the solution, that unique antibody binding distribution which minimizes the cross entropy relative to some prior distribution subject to the constraints imposed by the given measurements. The prior distribution is selected to properly encode all the a priori information on the affinity distribution before the measurement of the experimental binding data. The utility of the method is demonstrated by application to synthetic binding data. PMID- 1787738 TI - Levels of selection, evolution of sex in RNA viruses, and the origin of life. AB - Multi-component RNA viruses have genomes that are segmented into two or more RNA molecules. A viral particle carries only one RNA molecule. Reproduction of a particle requires complementation by particles carrying other segments of the genome. Complementation is achieved when a group of particles co-infects the same host cell and forms a co-infection group. I have previously proposed the hypothesis that multi-component reproduction evolved in RNA viruses as a form of sex. Multi-component viruses may need sex because, like all RNA viruses, they have very high mutation rates. On the other hand, Nee (1987, J. molec. Biol. 25, 277-281.) has proposed the hypothesis that multi-component genomes evolved because smaller RNA molecules are favored by selection on RNAs within a host cell. Nee (1989, J. theor. Biol. 138, 407-412.) also claimed that selection on RNAs alone can account for the evolution of multi-component viruses. He criticized the viral sex hypothesis because, in his view, co-infection groups are not units of selection and are too transient to be engaged in sex. These two hypotheses were further examined through population genetic models. Three evolutionary agents are assumed to operate in the models. Selection on co infection groups favors retention of the genome on one large RNA molecule because larger RNAs require less complementation. Selection on RNAs favor segmentation of the viral genome into smaller RNAs, which are replicated and encapsidated more rapidly. Mutation pressure also favors smaller molecules because those molecules are smaller targets for deleterious mutations. Analysis of the models shows that (when parameter values argued to be biologically realistic are used) selection on co-infection groups is necessary for the evolutionary persistence of multi component viruses. Without selection on co-infections groups to oppose mutation pressure and selection on RNAs, a population of multi-component viruses is displaced by a population of parasitic viral RNAs that are replication and encapsidation specialists. These results support arguments that co-infection groups are units of selection in multi-component viruses. Both mutation pressure and selection on RNAs may be responsible for the evolution of genome segmentation in multi-component viruses because there is good evidence documenting the action of both in RNA viruses.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1787739 TI - Adaptation of compartmental schemes for interpreting isotope dilution data on volatile fatty acid metabolism in the rumen to the non-steady state and for single-dose injection. AB - A unifying mathematical analysis of the one-pool and three-pool schemes for estimating acetate, propionate and butyrate production in the rumen from isotope dilution data is presented. Emphasis is given to non-steady-state conditions and to the administration of isotope as a single injection. The single-pool representation is also derived as a special case of the three-pool representation by assuming that the external fluxes are directly proportional to their concentrations in the rumen. PMID- 1787740 TI - A linearized DC lamp controller. AB - The design of a simple and inexpensive battery powered lamp controller for microscope lamps commonly used in patch clamp and other biophysical studies is described. The circuit linearizes the normally exponential voltage-intensity curve of standard 12-V lamps by using an operational amplifier to provide feedback to the drain of a power MOSFET. When the unit is turned off, a charging circuit recharges the battery at a constant potential until the battery voltage reaches a preset level. The charging voltage is then reduced to balance the self discharge rate of the battery. PMID- 1787741 TI - Photoinactivation of neurones axonally filled with the fluorescent dye 5(6) carboxyfluorescein in the pond snail, Lymnaea stagnalis. AB - We describe a new, simple and reliable technique to fill molluscan neurones from their cut axons with sufficient fluorescent dye for photoinactivation experiments. The fluorescent dye 5(6)-carboxyfluorescein (5-CF) travels quickly up the nerves of the gastropod mollusc, Lymnaea stagnalis into the buccal ganglia and fills the cell bodies in 1-3 h. 5-CF filled neurones can be located in the intact ganglia with low intensity blue light. Impalement shows that they are alive and show normal resting, action and synaptic potentials. Intense laser light (wavelength 442 nm, intensity 0.5 MW.m-2) kills all the 5-CF filled cells in less than 5 min in laboratory reared snails. Unstained neurones are not killed. 5-CF fills neurones quicker than Lucifer yellow (LY) when the dye is applied axonally. Neurones stained with Lucifer yellow do not contain sufficient dye to be killed with 5 min laser illumination, but this irradiation reduces the membrane resistance to less than 25%. PMID- 1787742 TI - An in vitro brainstem preparation preserving peripheral auditory function. AB - We describe an in vitro preparation of the brainstem and auditory periphery of the turtle. Properties of cochlear nucleus units recorded from this preparation are consistent with studies of both behavioural responses and auditory nerve fibre activity. A modified preparation for in vitro HRP tracing is also described. PMID- 1787743 TI - Mathematical resolution of mixed in vivo voltammetry signals. Models, equipment, assessment by simultaneous microdialysis sampling. AB - A microcomputer-assisted curve-fitting procedure was developed for the quantitative estimation of the components of the mixed "catechol peak" recorded with differential normal pulse voltammetry (DNPV) at electrochemically pretreated carbon fiber microelectrodes in the living brain. The contribution of each of the relevant electroactive species is fitted by a normal probability function, the parameters of which are previously determined in vitro for each electrode and substance. The voltammogram is thus modeled as a mixture of normal curves corresponding to the individual oxidizable substances plus a low order polynomial approximating the baseline. In a former approach the function was solved by linear least squares techniques. As a further improvement, we now propose a non linear model of the voltammogram and a Gauss-Newton iterative algorithm with stepwise regression for parameter estimation. This report shows the application of the method for the resolution of the dopamine (DA) and dihydroxyphenylacetic acid (DOPAC) components of the DNPV signal recorded from the striatum of freely moving animals in response to amphetamine and pargyline. The method was validated by the chemical assay of contralateral microdialysates collected simultaneously. The changes detected by both methodologies were closely parallel, with highly significant correlation coefficients (0.87 and 0.99 for DA and DOPAC, respectively, P less than 0.001). This study further illustrates that the in vivo voltammetry methodology can be improved substantially by incorporating a suitable mathematical treatment of the electrochemical signals. PMID- 1787744 TI - Measurement of brain tissue specific gravity using pycnometry. AB - In this paper we introduce and characterize pycnometry, a method used to measure fluid density, for determining a tissue's specific gravity. It uses a 2-ml glass pycnometer filled with distilled water to determine a tissue sample's displacement volume. The tissue's density is determined when it's weight is divided by this volume and specific gravity is computed by dividing the tissue density by the density of water. Pycnometry was validated using pre-calibrated glass, specific gravity standards over the range 1.03-1.26, and compared to the density gradient method using rat brain tissue. We observed that the specific gravity values obtained using pycnometry were highly correlated with the specific gravity standards (slope = 1.0107, r = 0.996) and with the density gradient column when tissue volumes larger than 0.120 ml were used with the pycnometer (slope = 1.0707, r = 0.9826). Good correlation was also observed between percent water content values computed using the Nelson equation with pycnometry or density gradient specific gravity values versus the measured percent water content values obtained with the wet weight/dry weight method. Pycnometry is an accurate, reproducible technique to measure tissue specific gravity and brain edema and is best suited for use in a laboratory that engages sporadically in brain edema measurement. PMID- 1787745 TI - A controlled cortical impact model of traumatic brain injury in the rat. AB - Controlled cortical impact models produce brain injury by using a pneumatic impactor to impact exposed brain. This study systematically examined the effects of varying magnitudes of controlled cortical impact to the rat brain on neurological, cardiovascular, and histopathological variables. As the magnitude of injury increased, the duration of suppression of somatomotor reflexes and the duration of chronic vestibular motor deficits increased. The blood pressure response was observed to depend on injury levels; a moderate injury level produced a hypotensive response while a high injury level produced an immediate brief hypertensive response followed by hypotension. Low injury levels produced no significant macroscopic or microscopic change, but higher injury levels produced cortical contusion and intraparenchymal hemorrhage which, with increasing survival time, evolved into necrotic changes and cavitation underlying the injury site. Also with high levels of injury, axonal injury was found throughout the brain-stem with the greatest concentration of injured axons occurring in the cerebellar peduncles and pontomedullary junction. These data demonstrate that controlled cortical impact in the rat reproduces many of the features observed in other experimental animal models. This model allows independent control of many mechanical loading parameters associated with traumatic brain injury. The controlled cortical impact rat model should be an effective experimental tool to investigators of traumatic brain injury. PMID- 1787746 TI - HPLC-EC determination of free primary amino acid concentrations in cat cisternal cerebrospinal fluid. AB - This paper describes an HPLC-EC method for measuring the concentrations of 9 free primary amino acids in cerebrospinal fluid (CSF) withdrawn from the cisterna magna of Nembutal-anesthetized adult cats. Amino acid derivatives were formed with o-phthalaldehyde and beta-mercaptoethanol; subsequently, excess thiol reagent was removed with iodoacetamide. During elution through a C18 5-micron column, the electrochemical detector's sensitivity was switched to accommodate the wide ranges of CSF amino acid concentrations. The analysis was acceptably precise and linear at and above the CSF levels and did not require CSF deproteinization. During the 23 min elution, the concentrations of 8 CSF amino acids were determined: alanine, asparagine, glutamate, glutamine, glycine, serine, taurine, and tyrosine; measurable concentrations were between 1 and 800 microM. The concentration of GABA was below its detection limit (0.5 microM). To assess the ability to detect small concentration increases which might occur due to experimental manipulations, the minimum detectable increments in CSF amino acid concentrations above endogenous levels were determined. PMID- 1787747 TI - A useful programme in BASIC for axonal morphometry with introduction of new cytoskeletal parameters. AB - Interest in the structure of axons and quantification of their components has been growing over the last years. However, the existing literature contains few reports of available computer programmes to facilitate such studies. This paper presents a fully comprehensive BASIC programme for the morphometric analysis of electron micrographs of cross-sectional nerve fibres. From drawings of fibre and axonal contours and dots of the microtubules and neurofilaments, the programme calculates the following parameters: area, diameter and form factor of the fibres and axons, number and density of microtubules and neurofilaments, proportion between microtubules and neurofilaments (R-proportion), myelin thickness and the diameter of the axon relative to its sheath (g-ratio). The programme also introduces three new parameters to analyse the degree of uniformity of microtubule and neurofilament distribution: distances between microtubules and between neurofilaments, equilateral index and cytoskeletal intermingling index. The programme is written in Microsoft BASIC Interpreter for Apple Macintosh (Microsoft Corporation) but can be used on other computers. Although the programme has been tested on adult rat optic nerve fibres, it can be used for different projects concerning axonal morphometry. PMID- 1787748 TI - Electrogastrography: measurement, analysis and prospective applications. AB - Electrogastrography (EGG), the cutaneous recording of the myoelectrical activity of the stomach using surface electrodes, is attractive due to its noninvasiveness and its correlation with gastric motility. Since the first measurement of the EGG, a great deal of research effort has been expended on investigating its relationship with specific activities of the stomach in question. In this review, we discuss how to measure the EGG, what information is available in the EGG, how to extract useful information from the EGG and the prospective applications of the EGG. After a brief historic evolution of the EGG, we first discuss the measurement of the EGG, the importance of localisation of the stomach and the characteristics of the EGG. The most commonly used EGG data-analysis methods, both power spectral analysis and waveform analysis, are then outlined. Some of prospective applications of the EGG in clinical diagnosis and medical research are described, mainly concerning the correlation between EGG amplitude and gastric motility and that between EGG rhythmic variations and motility disorders. Specifically, we present studies on pre- and postprandial EGGs, observation of the propagation direction of the gastric slow wave and gastric electrical dysrhythmias and their correlation with gastric motility. PMID- 1787749 TI - Response of the electric activity in the human stomach to water and a solid meal. AB - The gastric electric activity paces the contractions of the stomach and can be measured noninvasively using surface electrodes placed on the abdomen. In this paper, response of the gastric electric activity to water and a solid meal was investigated using surface electrodes. Applying an improved recording technique, power spectral analysis and statistical analysis methods, the gastric electric activity in preprandial, postwater and postprandial states was measured and analysed from ten healthy volunteers. To more convincingly show the effect of water and the solid meal on the gastric slow wave and gastric motility, simultaneous recordings of the cutaneous EGG and manometric activities in the stomach were performed in three gastroparetic patients. It was found that water does not induce contractions of the stomach, but the gastric slow wave amplitude increases (p less than 0.05) and frequency decreases (p less than 0.05). The solid meal results in an increase in both the amplitude (p less than 0.01) and the frequency (p less than 0.02) of the gastric slow wave. It appears that the postprandial EGG amplitude increases because of a combination of stomach contractions and gastric distension bringing the stomach closer to the recording electrodes. The slow wave frequency, however, correlates well with stomach contractions. PMID- 1787750 TI - Recording fetal breathing movements with a passive transducer based on an inductive principle. AB - A new transducer has been developed, based on an inductive principle, for recording fetal movements and sounds. The compliance of this transducer, the INductive PHOno-sensor (INPHO), can be matched to that of the maternal abdomen to provide an optimal transfer of displacement between maternal abdomen and transducer. In this manner, it is possible to detect fetal breathing movements by digital filtering of the INPHO signal in a frequency band between 0.5 and 2.0 Hz. Singular breathing movements can be detected and this was verified by real time ultrasound imaging. The INPHO transducer shows a flat (+/- 1.5 dB) frequency response between 0.2 and 200 Hz. The signal-to-noise ratio of the transducer system is better than 95 dB, and enables very weak movements and sounds to be detected. Spectral analysis of the processed signal shows that modulation of fetal breathing by maternal breathing takes place. The measuring setup allows for the quantitative assessment of fetal respiratory sinus arrhythmia. PMID- 1787751 TI - Application of the ARMA method to acoustic detection of coronary artery disease. AB - To further explore the application of advanced signal processing techniques to the noninvasive detection of coronary artery disease, 30 patients (10 angioplasty and 20 normal or abnormal) were tested using autoregressive moving average (ARMA) modelling of the diastolic heart sound data. It is during diastole that coronary blood flow is maximum and sounds associated with turbulent blood flow through partially occluded coronary arteries would be loudest. Model parameters (the power spectral density (PSD) functions and the poles of the ARMA method) were used to separate the normal patients from the abnormal patients in the normal/abnormal study, or to decide whether the recordings were made before or after angioplasty in the angioplasty study. The decisions were made 'blind', without knowledge of the actual disease states of the patients for the normal/abnormal study and without prior knowledge of whether a given recording was made before or after angioplasty for the angioplasty study. Results from the angioplasty and the normal/abnormal studies showed that pre- and post-angioplasty records were correctly distinguished in 8 out of 10 cases, and normal and abnormal records were correctly distinguished in 17 of 20 cases. These results also confirmed that high frequency energy above 400 Hz is probably associated with coronary stenosis. PMID- 1787752 TI - Interaction between the aortic valve leaflets and a Millar dual-micromanometer catheter during recording of the aortic component of the second heart sound in dogs. AB - The influence of the closure of the aortic valve leaflets on a dual micromanometer Millar catheter is investigated with respect to the power spectrum of the aortic component (A2) of the second heart sound in dogs. The catheter inserted through the aortic valve is used to simultaneously record A2 in the left ventricle and in the aorta and to study the transmission of A2 up to the body surface. Results indicate that the interaction of the valve leaflets with the Millar dual-micromanometer catheter during the closure and vibration of the aortic valve does not produce a clapping artefact. The main effect is a change in the natural modes of vibration (resonant frequencies) of the aortic valve resulting from a modification of the vibrating structure (combined structure composed of the catheter, the aortic valve and the surrounding blood and tissues) because of the tight mechanical coupling between the aortic valve leaflets and the catheter. In addition, this modification of the natural modes of resonance does not invalidate the estimation of the frequency response of the transfer function between the aortic root and the thoracic recording site, even if the mean gain of the transfer function is affected and the phase slightly increased with frequency. On the contrary, the interaction of the aortic valve leaflets with the catheter seems to slightly increase the spectral contribution (coherence) of the intra-aortic A2 to the thoracic A2. PMID- 1787753 TI - Acoustic transmission of the aortic component of the second heart sound within the ascending aorta of dogs. AB - The spectral characteristics of the acoustic transmission of the aortic component of the second heart sound within the ascending aorta was studied using a Millar dual-micromanometer catheter. The tip micromanometer was located close to the aortic valve leaflets while the second micromanometer was located 3 cm above the aortic valve. The frequency response of the transmission properties (amplitude and phase) of the blood and the aortic wall was modelled by an equivalent acoustic transmission system. The signal recorded by the tip micromanometer located near the aortic valve was considered to be the input signal of the equivalent system and the signal recorded by the second micromanometer was used as the output signal. Results of the spectral analysis of the input and output signals show that the acoustic transmissibility of blood in the ascending aorta is high at 20 Hz (the attenuation is negligible). Between 20 and 60 Hz, the transmissibility decreases at a rate of -3 dB per octave while between 60 and 120 Hz it decreases at a rate of -14 dB per octave. Above 120 Hz the transmissibility is low and the resulting attenuation is greater than 20 dB. The phase of the transfer function is shifted by -60 degrees at 20 Hz and decreases at a mean rate of -2.0 degrees Hz-1 between 20 and 100 Hz and -0.75 degrees Hz-1 up to 400 Hz. The phase velocity of the sound transmission is relatively constant (5.5 ms-1) between 40 and 100 Hz and increases up to 9 ms-1 at 300 Hz. PMID- 1787754 TI - Discrimination of capillary and arterio-venular blood flow in skin by laser Doppler flowmetry. AB - The scattering and absorption of light by tissue and blood is wavelength dependent; the tissue penetration of green light (lambda = 543.5 nm) is about 60 per cent of that of red light (lambda = 632.8 nm) but the absorption of green light by blood is about 20 times greater than for red light. The effect of this difference has been studied by observing the responses of skin blood flow to heat and weal, measured by laser Doppler flowmetry at the two wavelengths. By using time autocorrelation function analysis (ACF) of the scattered light measured, low and high frequency components have been associated with capillary and larger vessel flow, respectively. The comparison of ACF from scattered green and red light has shown that measurements cannot be interpreted by only considering light penetration depth through a homogeneous tissue. Light absorption and multiple scattering by blood at the individual microvessel level, blood rheology and vessel morphology are parameters which are considered for greater attention. PMID- 1787755 TI - Cardiogenic ballistograms of chicken eggs: comparison of measurements. AB - In the incubated avian egg, minute movements occur that are synchronised with embryonic cardiac contractions. We previously developed two systems to noninvasively record this cardiogenic ballistic movement of the egg (referred to as the ballistocardiogram, BCG); one was based on applying an audiocartridge and the other a laser speckle phenomenon. A third system, which detects the ballistic movement as the measurement of displacement (referred to as displacement BCG), is applied in the present study, together with the previous two systems, to the ballistocardiography of the egg. The BCG is measured with three systems simultaneously for comparison. The differentiation of the displacement BCG produces a pattern identical to the BCG recorded by the cartridge method, and the integrated pattern of the latter BCG is identical to the displacement BCG. This indicates that the cartridge system detects the cardiogenic movement as the measure of velocity and it may be referred to as velocity BCG. The BCG by the laser speckle method is not related to that recorded by the other two systems, which may be referred to as movement BCG. PMID- 1787756 TI - Study of cardiac arrhythmia using the Kalman filter. AB - It has been known for some time that the variability of the R-R intervals in the electrocardiogram signal yields valuable information concerning the various types of arrhythmia that might be present. It has recently been suggested that the identification of cardiac arrhythmia might be possible by applying spectral analysis techniques to the data. An investigation is made into the possible application of the Kalman filter identifier in the calculation of time varying spectra of the data, with a view to studying the onset of arrhythmia and also short bursts of arrhythmia. To this end, data from the MIT-BIH database are analysed; in particular, cases of bigenimy, trigenimy, second degree block and ventricular flutter have been looked at. It is found that this technique can, in many cases, detect the onset of arrhythmia and sometimes actually identify the arrhythmia that is present. It is suggested that the Kalman filter identifier could have a general application in studying both the normal and arrhythmic segments of data to yield valuable medical information concerning the subject under study. PMID- 1787757 TI - Method to evaluate the skill level in fast locomotion through myoelectric and kinetic signal analysis. AB - The paper describes a method aimed at providing objective diagnostic testing of skilled locomotor stereotypes. Bioelectric muscle activity indices and ground reaction force data are used to represent a movement structure, in a schematized way, using discrete states in time. Athletes were asked to perform one specific movement structure: a backward somersault from the standing position. Mathematical analyses of measured signals reveal the significance, for the skill level evaluation, of parameters reflecting the impulsive take-off force waveform and the symmetry in EMG activity of ankle extensor muscles, which therefore might be used as diagnostic criteria. Within technical limitations, this approach may also be applied to other locomotor patterns and possibly to monitor the progress in motorics in pathological locomotion. EMG telemetry could significantly enhance the method's scope. PMID- 1787758 TI - Static dynamometer for the measurement of multidirectional forces exerted by the thumb. AB - The functioning of a static dynamometer designed to measure simultaneous forces exerted by the thumb in the vertical and horizontal axes is described. The analysis of the output signals by a desktop computer program provides information regarding the forces generated in eight directions covering a plane transverse to the thumb by 45 degree increments. In 12 normal female subjects, the maximum voluntary torques exerted at the trapezo-metacarpal joint of the thumb were examined and the muscle activation patterns of the interosseus, flexor pollicis brevis and adductor pollicis brevis muscles were recorded in one subject. Torques and muscle activation patterns were depicted using polar plots. Dynamometric data indicate that strength varies with direction and that higher torques are obtained in directions that bring the thumb towards the palm, i.e. flexion, adduction, combined flexion-adduction and extension-adduction. Patterns of muscle activity vary according to the direction evaluated suggesting that strength depends on the number of activated muscles as well as the relative force contribution of each muscle. PMID- 1787759 TI - Impedance plethysmography in human limbs. Part 1. On electrodes and electrode geometry. AB - Electrode design and electrode positioning are important factors in blood flow measurements using impedance plethysmography. Optimal electrode type and accurate positioning will decrease measurement errors and improve the signal-to-noise ratio. Disk electrodes were found to be superior to tape electrodes because of their better skin-electrode stability and because they prevent limb compression. The distance between current electrodes and potential electrodes should be greater than 2.3 R (disk electrodes) and 1.5 R (tape electrodes) to avoid the influence of the so-called diffusion resistance (R is the radius of the limb at the electrode site). PMID- 1787760 TI - Computer simulation of electronic interactions during excitation and repolarisation of myocardial tissue. AB - A three-dimensional model of myocardial tissue has been developed which incorporates electrotonic interactions between neighbouring myocytes. The algorithms of the model are based on asynchronous planning of discrete events. Each cellular element is described in a logical way and traces a predefined action potential which is dynamically modified depending on the electrotonic interactions. The model has a low computational complexity and has been implemented on personal workstations even for experiments investigating arrhythmogenic processes and simulating several tens of cycles in blocks composed of several thousand elements. The paper describes the algorithmic implementation of the model and presents three series of experiments examining the dependence of the accuracy of the model on the size of the modelled tissue, changes of the shape of simulated T-waves due to electrotonic interactions and arrhythmogenic processes caused by lowering the threshold of the electric flow which excites individual cells. PMID- 1787761 TI - High-quality recording of bioelectric events. Part 2. Low-noise, low-power multichannel amplifier design. AB - A multichannel instrumentation amplifier, developed to be used in a miniature universal eight-channel amplifier module, is described. After discussing the specific properties of a bioelectric recording, the difficulties of meeting the demanded specifications with a design based on operational amplifiers are reviewed. Because it proved impossible to achieve the demanded combination of low noise and low power consumption using commercially available operational amplifiers, an amplifier equipped with an input stage with discrete transistors was developed. A new design concept was used to expand the design to a multichannel version with an equivalent input noise voltage of 0.35 microV RMS in a bandwidth of 0.1-100 Hz and a power consumption of 0.6 mW per channel. The results of this study are applied to miniature, universal, eight-channel amplifier modules, manufactured with thick-film production techniques. The modules can be coupled to satisfy the demand for a multiple of eight channels. The low power consumption enables the modules to be used in all kinds of portable and telemetry measurement systems and simplifies the power supply in stationary measurement systems. PMID- 1787762 TI - Variation of the electric properties along the diaphysis of bovine femoral bone. AB - A preliminary study is presented of the variability of the electric properties, in the axial, tangential and radial directions, as a function of position in the diaphysis of a femoral bovine bone. The measurements were carried out at three frequencies: 100 Hz, 10 kHz and 1 MHz. It is shown that both the conductivity and the permittivity exhibit significant variations along the diaphysis, and increase in magnitude towards the epiphyses. From this study, the variation of the electric properties cannot be clearly and directly ascribed to the longitudinal variability of the total volumetric fluid content of the bone. The results reflect the orthotropic nature of the electric properties, at any given location, and indicate a position-dependent tendency towards axis symmetry. PMID- 1787763 TI - Precision of the time-domain correlation ultrasonic flowmeter. PMID- 1787764 TI - Acoustic method for assessment of urethral obstruction: a model study. PMID- 1787765 TI - Effects of drugs acting on platelet and neutrophil aggregation depending on their interaction. AB - In vitro it was confirmed that direct interactions between platelets and neutrophils enhanced the process of the formation of cell aggregates. The interaction decreased the ability of prostacyclin, aspirin, propranolol and nifedipine to reduce platelet and neutrophil aggregation. This decrease was more marked for aspirin and prostacyclin but antiaggregation effects of propranolol and nifedipine were more stable to the influence of platelet-neutrophil interaction. It was assumed that the cell interactions might cause the decrease in the efficiency of antiaggregant therapy in patients with cardiovascular disorders. PMID- 1787766 TI - Growth medium for the evaluation of antiestrogenic compounds in MCF-7 cell culture. AB - The primary aim of the present study was to define a set of cell culture conditions that would be optimal for the evaluation of antiestrogens using estrogen dependent MCF-7 human breast cancer cells in culture. Therefore, the present study examined for the influence of media supplements which are known to alter the growth rate and estrogen receptor content of MCF-7 cells in culture. In this study, MCF-7 cell proliferation was evaluated using the hemocytometric trypan blue exclusion method. The results of this study clearly indicate that 1) charcoal-dextran stripped serum offers no advantage over low estradiol (less than 100 fM) calf serum which is available commercially, and 2) calf serum is as effective as fetal calf serum, in the presence or absence of insulin, in time dependent growth of MCF-7 cells. Thus, growth media containing 5% non-stripped low estradiol (less than 100 fM) calf serum without insulin supplementation was found to be optimal for the evaluation of the antitumor activity of antiestrogenic compounds using MCF-7 cells in culture. PMID- 1787767 TI - The interaction of antioxidants and structurally related compounds with mitochondrial oxidative phosphorylation. AB - The antioxidants, butylated hydroxyanisole (BHA) and butylated hydroxytoluene (BHT), interact with mitochondrial oxidative phosphorylation in two ways. They uncouple phosphorylation from oxidation by making the mitochondrial inner membrane more permeable to protons. They also inhibit respiration by a direct interaction with the electron transport chain. Here we separated out these two properties of BHA and BHT by determining their effects on respiration in coupled and uncoupled mitochondria. Similar experiments were carried out with compounds structurally related to BHA and BHT. Most of these compounds had uncoupling and inhibitory properties essentially similar to BHA and BHT. In contrast, the dimer of BHA had no inhibitory effects on uncoupled respiration and little uncoupling activity. The implications of these results for the interactions of BHA and BHT with mitochondrial oxidative phosphorylation and the design of antioxidants are discussed. PMID- 1787768 TI - Assessment of acute behavioral toxicity of low doses of diisopropylfluorophosphate (DFP) in rats. AB - The effect on behavior of single subtoxic doses (100 and 600 micrograms/kg i.p., i.e. 1/77 and 1/13 of LD50, respectively) of an organophosphorous compound, diisopropylfluorophosphate (DFP), was studied in male Wistar rats. In the open field test, the lower dose of DFP tended to increase ambulation, while the higher dose showed a trend towards a decrease in ambulation, rearing and frequency of defecation. In the elevated plus-maze, rotarod, elevated bridges and hot plate tests, DFP-treated rats did not differ significantly from the olive oil-treated controls. DFP significantly impaired the performance of rats in the one-trial passive avoidance task and dose-dependently decreased spontaneous locomotor activity for 4 hours after administration. At the doses used DFP only slightly inhibited acetylcholinesterase activity in the blood and different brain areas. The results show that the higher dose of DFP had an inactivating effect on the behavior of rats, while the lower dose did not markedly change their behavioral pattern. Our findings indicate that anticholinesterase compounds, such as DFP, can alter behavior even after single small subtoxic doses. PMID- 1787769 TI - Importance of the sympathetic nervous system in blood pressure elevation by subpressor intraventricular NaCl and angiotensin II in the rat. AB - The present study was performed to examine the effect of chemical sympathectomy with guanethidine on the BP change and humoral factors in rats which received continuous and concomitant infusion of i.c.v. hypertonic NaCl with i.v. Ang II, both at subpressor doses for 7 days. Male rats were divided into 3 groups which received the following infusions using an osmotic minipump at a rate of 1 microliter/min: Group 1 (n = 11), 0.15 M NaCl i.c.v. and Ang II (5.4 pmol/kg/min) i.v.; Group 2 (n = 9), 0.8 M NaCl i.c.v. and Ang II i.v.; Group 3 (n = 5), 0.8 M NaCl i.c.v. and Ang II i.v. with daily i.p. injection of guanethidine (40 mg/kg). Significant increase in BP was observed only in Group 2 (from 103 +/- 3 mmHg to 132 +/- 5 mmHg on day 7, p less than 0.001). Addition of i.p. guanethidine to i.c.v. infusion of 0.8 M NaCl and the subpressor dose of Ang II completely prevented increase in the BP, suggesting that the presence of the intact sympathetic nervous system is necessary for the development of BP elevation in response to i.c.v. hypertonic NaCl plus i.v. Ang II. Thus, the sodium status in the central nervous system is important in the regulation of BP and is closely related to the activity of the sympathetic nervous system. PMID- 1787770 TI - Biopharmaceutic evaluation of furosemide as a potential candidate for a modified release peroral dosage form. AB - An attempt was made to evaluate some of the criteria for developing a modified release peroral dosage form for furosemide which has a poor bioavailability when given in the conventional peroral dosage forms. The pathway of absorption for furosemide was studied ex vivo employing the Wilson-Wiseman test. Passive absorption was found to be the predominant mechanism of transport across the ileum of the guinea pig followed by active transport to the extent of about 17%. The in situ procedure to study the extent of absorption of furosemide from the various sites in the lumen of the gastrointestinal tract of the rat indicated the stomach to be the major site of absorption followed by the duodenum. It is hence postulated that due to the site-specificity and mechanism of absorption a peroral modified release dosage form having a longer gastric residence time could possibly increase the bioavailability of furosemide. PMID- 1787771 TI - Comparison of continuous, constant rate enteral tube feeding in supine patients to bolus food intake in ambulatory, healthy subjects regarding bioavailability of perorally administered cefroxadine. AB - Stabilized, bedridden, inactive trauma patients on enteral nutrition via continuous, constant rate tube feeding (2 different formulas) were given a single dose of cefroxadine p.o. There were no differences in the pharmacokinetic parameters between the groups on different enteral nutrition. These patients were compared to cefroxadine absorption in ambulatory healthy subjects after a standardized meal (bolus-fed). The mean residence time was significantly longer in the patients, and the extent of absorption was slightly reduced with one enteral nutrition formulation and significantly reduced with the other. The other pharmacokinetic parameters were not significantly different. The difference is believed to be caused by reduction in splanchnic blood flow in the immobilized patients, weakening of migrating motor complex due to tube feeding and the lower temperature (4 degrees C) of enteral nutrition. PMID- 1787772 TI - Early detection of lower respiratory tract infection: the value of the gram stained sputum smear. AB - In some clinical laboratories the routine examination of sputum includes a Gram stained smear. Of specimens examined in this study the Gram-stained smear was found to be useful, but fallible in predicting bacterial culture results. Smear results requested urgently by clinicians should be relayed with caution. However, the predictive negative value of the Gram stain was encouraging. PMID- 1787773 TI - Detection of micro-organisms using a two bottle blood culture system: a twelve month study. AB - Over a twelve month period the isolation rate of pathogens, frequency of isolation of non-significant organisms, and time taken to detect positive cultures from a two-bottle blood culture system were analysed. Of 6916 blood cultures collected, 978 organisms were isolated from 863 cultures, 540 organisms being considered clinically significant and the majority (81%) being isolated within 48 h. Our results showed that use of more than one bottle increased the general isolation rate, with both bottles facilitating growth independently. This situation was particularly apparent in the cases of Haemophilus influenzae and Neisseria meningitidis, which showed that using the system alone only 76% and 33% (respectively) of the total number of strains would have been isolated. The results of this study reinforce the need for a second bottle containing a suitable culture medium. PMID- 1787774 TI - The Limulus amoebocyte lysate assay for prediction of chlamydial infection in males with non-gonococcal urethritis: an evaluation. AB - Chlamydia trachomatis produces small amounts of an endotoxin-like material. The Limulus amoebocyte lysate assay was used to evaluate chlamydial cell cultures and also the exudates from adult male patients with non-gonococcal urethritis, as a possible method to subdivide this condition into chlamydial and nonchlamydial urethritis. In vitro endotoxin assays were conducted in McCoy cell media using the Limulus assay, and endotoxin levels were consistently 10-fold less at 24 h than at 0, 48, 72, and 96 h, which may be accounted for by the unique growth cycle of chlamydia. In 75 males with non-gonococcal urethritis, urethral exudates were collected, serially diluted and assayed for endotoxin content. Of these, 27 (36%) had positive chlamydial cultures and 48 were negative. There was no statistically significant correlation between the level of endotoxin present and a positive or a negative culture for C. trachomatis (P greater than 0.05). Sensitivity and specificity of the assay were only 59% and 56%, respectively, at a 1 in 8 dilution; it was not useful in predicting chlamydial culture results in male patients with non-gonococcal urethritis. PMID- 1787775 TI - Microwave ovens: mapping the electrical field distribution. AB - Uniformity of electric field intensity of microwaves within the microwave oven cavity is necessary to ensure even load-heating, and is particularly important in pathology procedures where small volume irradiation is carried out. A simple and rapid method for mapping electric field distribution, using reversible thermographic paint, is described. Spatial heating patterns for various positions, and the effects of introducing dummy loads to modify heating distributions, have been obtained for a dedicated microwave processor, and comparison made with a domestic microwave oven. PMID- 1787776 TI - Serum 25-hydroxyvitamin D in Wistar rats fed vitamin D deficient or normal diet: effect of ultraviolet irradiation and temperature. AB - Weanling Wistar rats were studied to examine the effects of vitamin D deficient diet, lack of ultraviolet irradiation, and lowering of environmental temperature, on the production of serum levels of 25-hydroxyvitamin D. Results suggest that dietary vitamin D, sunlight, and ambient temperature may also be contributory factors in the maintenance of adequate levels of vitamin D. PMID- 1787777 TI - The immunological status in Parkinson's disease. AB - It has been suggested that patients with idiopathic Parkinson's disease have altered functions of the immune system. We determined certain immunological parameters in groups of Parkinson's disease patients who have been i) treated and ii) not been treated, with levodopa. Changes in the immune functions were observed to be more profound in Parkinson's disease patients than in age-matched controls. Treatment with levodopa induced an increase in interleukin-1 synthesis, and in IgM and IgA levels in plasma, which suggest a possible selective action on cells of the immune system. PMID- 1787778 TI - C-reactive protein levels in serum: a rapid enzyme immunoassay. AB - A simple and rapid competitive-inhibition enzyme linked immunoassay for serum C reactive protein (C-RP) is described. The assay has a working range of 4.4-700 mg/l of C-RP, uses two serum dilutions and requires only 90 min to perform. Comparisons are presented between this assay and three commercially-available kits. The assay performs as well as the best of these kits but with added advantages of speed, ease of use and increased working range. PMID- 1787779 TI - Malaria screening to prevent transmission by transfusion: an evaluation of techniques. AB - Transfusion-associated malaria is often severe or even fatal, because diagnosis is frequently delayed and it complicates an already serious underlying disorder. Detection of infected donors is difficult in endemic areas due to the lack of a suitable donor screening test. Blood smear staining techniques show poor results due to the low parasite concentration in many infected persons, and the antibody detection test is not helpful due to the universal presence of antibody in healthy donors in these areas. For comparative evaluation of various screening tests, 9131 blood smears from voluntary donors and a group of patients were screened by Giemsa staining. Ten (0.10%) subjects showed parasitaemia, whereas Acridine Orange fluorescence staining showed 13 (0.14%) parasitaemia in almost the same number of smears screened on the same samples. Significantly high levels of malarial antibody were detected in 12.6% and 19.86% of subjects by indirect fluorescent antibody and enzyme-linked immunoassay tests, respectively. Malarial antigen detection by monoclonal antibody showed positive results in 9.48% of subjects, demonstrating excellent results and showing direct evidence of infection. We recommend that this should be adopted as a screening technique by transfusion services in endemic areas in order to prevent post transfusion malaria. PMID- 1787780 TI - Blood group chimaerism: a possible further example. AB - A blood group chimaera is described whose red blood cells exhibit a dual population of group A1 and O, in the proportions 20% and 80% respectively. These results could also indicate a blood group mosaic of the Amos type, but family studies, secretor and transferase investigations on this patient suggest that blood group chimaerism of unestablished type is more likely. There was no further evidence of chimaerism found during cytogenetic investigations, immunoglobulin allotyping or studies of red cell enzyme systems. Blood group chimaeras were previously thought to be rare, as dual red cell populations and the resulting mixed-field agglutination patterns are not always easy to recognise. This case is the second example of chimaerism found within two years in a single routine laboratory, appearing to confirm the view that chimaerism is not as uncommon as previously thought. PMID- 1787781 TI - A computerised spreadsheet for audit of a microbiology laboratory. AB - The use of a microcomputer and spreadsheet software is described, to assist in the audit of a clinical microbiology laboratory. The costs of consumables for specimen types and their workload values were calculated. Together with knowledge of the annual number of requests, these were used as a basis for determining the minimum budget and staffing establishment required. PMID- 1787782 TI - Breast cancer. AB - This Biomedical Update contains summaries of a personal selection of articles which have appeared over the last year or so on the subject of breast cancer. The issues addressed are related to breast cancer risk and the use of oral contraceptives and hormone replacement therapy, breast screening, the diagnosis of breast cancer, and various prognostic indicators. PMID- 1787783 TI - Platelet separation from the blood of severely thrombocytopaenic patients. AB - An efficient method is described for the isolation of platelets from the blood of severely thrombocytopaenic patients. The method, based on centrifugation over a density medium, was compared with platelet-rich plasma obtained by conventional differential centrifugation at a relative centrifugal force of 200 x g. With samples from thrombocytopaenic patients (n = 10, platelet counts between 7 and 22 x 10(9)/l), the density barrier method gave significantly improved platelet recoveries (82.1% +/- 6.2%) compared with differential centrifugation (61.6 +/- 4.6%) (P less than 0.001). Platelets isolated by the density barrier method showed no tendency to aggregate and were suitable for use in tests to detect platelet-associated immunoglobulin. PMID- 1787784 TI - Pneumocystis carinii pneumonia: detection of parasites by immunofluorescence based on a monoclonal antibody. AB - A monoclonal antibody-based immunofluorescence test for the detection of Pneumocystis carinii was evaluated in comparison with the conventional direct staining by Grocott's silver methenamine technique. A total of 254 respiratory samples from HIV positive and other immunocompromised patients were examined. Cysts were detected in 30 (12%) of samples using the monoclonal test, but only 15 (6%) positives were found using the Grocott method. There is need for a speedy and efficient test for detection of these organisms, and the monoclonal test was found to be more reliable, quicker and more sensitive than the Grocott technique. PMID- 1787785 TI - Menstrual immunisation. PMID- 1787786 TI - The RecA protein as a recombinational repair system. AB - The Escherichia coli RecA protein plays a central role in homologous genetic recombination, recombinational repair, and several other processes in bacteria. In vitro, an extended filament involving thousands of RecA monomers promotes a reaction in which individual DNA strands switch pairing partners (DNA strand exchange). This reaction has been extensively studied as a paradigm for the central steps in recombination. Because the strand-exchange reaction is relatively simple and isoenergetic, the complexity of the RecA system that carries it out has led to controversy about the functional significance of many fundamental properties of RecA. Filamentous protein structures involving thousands of RecA monomers, which hydrolyse 100 ATPs per base pair of heteroduplex DNA formed, are hard to rationalize in the context of recombination between two homologous DNAs. The thermodynamic barriers to strand exchange are much too small. These molecular features of the system can be easily rationalized, however, by shifting the focus to DNA repair. PMID- 1787787 TI - Cassette mutagenesis implicates a helix-turn-helix motif in promoter recognition by the novel RNA polymerase sigma factor sigma 54. AB - Cassette mutagenesis has been used to study the role of a helix-turn-helix (HTH) motif in the novel RNA polymerase sigma factor sigma 54 of Klebsiella pneumoniae. Of the four residues which are predicted to be solvent-exposed in the second helix, the first (Glu-378) tolerated all substitutions, and some mutations of this residue increased expression from sigma 54-dependent promoters. Certain substitutions in the third exposed residue (Ser-382) produced a promoter-specific phenotype and all substitutions in the fourth residue (Arg-383) inactivated the protein, identifying this residue as being likely to be involved in base-specific interactions with the promoter. In vivo footprinting indicated that the inactive HTH mutants of sigma 54 were defective in interaction with both the -24 and -12 regions of the glnAp2 promoter. PMID- 1787788 TI - Genetic analysis of the Erwinia chrysanthemi 3937 chrysobactin iron-transport system: characterization of a gene cluster involved in uptake and biosynthetic pathways. AB - Twenty of the twenty-two MudII1734 insertions impairing the chrysobactin iron assimilation system of Erwinia chrysanthemi 3937 were localized to a 50 kbp genomic insert contained in the R-prime plasmid, R'4 (Enard et al., 1988). Using the conjugative plasmid pULB110 (RP4::mini-Mu) and the generalized transducing phage phi EC2, we located this iron-transport region and the two unlinked mutations on the chromosome linkage map. Chrysobactin is a catechol-type siderophore and, as we have previously observed with the entA locus of Escherichia coli, the E. chrysanthemi-derived R'4 was found to complement E. coli entB and entE mutations. A 2.9 kb EcoRi and a 4.8 kb BamHI fragment in the R'4 sharing homology with the E. coli entCEBAP15 operon DNA were subcloned. These fragments were used as DNA/DNA hybridization probes to screen a wild-type gene library, yielding a recombinant cosmid (pEC7) able to complement mutations disrupting the 2,3-dihydroxybenzoic acid biosynthetic pathway in both Erwinia and Escherichia spp. as well as the E. coli entE mutation. Physical mapping of the genomic MudII1734 insertions corresponding to these mutations led to the identification of a cluster of genes confined to a DNA sequence of about 10 kb required for both biosynthetic and receptor functions. PMID- 1787789 TI - Analysis of an anaerobically induced promoter for the cobalamin biosynthetic genes in Salmonella typhimurium. AB - We have identified an anaerobically induced promoter for the cobalamin biosynthetic (cob) genes. In a plasmid the Cob promoter showed two of the three types of control of the intact chromosomal Cob operon: anaerobic induction and cAMP stimulation. Cobalamin repression was observed only in promoter fragments which included sequences far downstream of the transcription start site, suggesting that this control is post-transcriptional. One anaerobically induced transcript was identified and its 5' end was determined. Deletion mapping showed that 60 nucleotides upstream of the start site were sufficient for anaerobic synthesis of this transcript. Upstream of the transcription start site a putative sigma 70-dependent -10 recognition sequence was identified; however, no consensus -35 region was observed. PMID- 1787790 TI - Characterization of a polygalacturonase gene of Aspergillus niger RH5344. AB - We have cloned a gene encoding a polygalacturonase (PG) in the filamentous fungus Aspergillus niger RH5344. The structural gene comprises 1141 bp coding for 362 amino acids and the open reading frame is disrupted by one intron of 52 bp. Eukaryotic consensus sequences for transcription regulation are found only in deviated forms. The biological functionality of the isolated PG gene was established by retransformation in A. niger and Aspergillus awamori. In addition, we have found that the PG protein of A. niger shares significant similarities with PG proteins from tomato and Erwinia carotovora. Comparison of the three enzymes revealed a highly conserved region in their C-terminal region probably comprising the elements of substrate binding and the catalytic centre. PMID- 1787791 TI - Sequential activation of dual promoters by different sigma factors maintains spoVJ expression during successive developmental stages of Bacillus subtilis. AB - The spoVJ gene of Bacillus subtilis encodes a 36 kDa protein and is expressed only in the mother cell. spoVJ has an interesting pattern of regulation during sporulation because it is expressed from sequentially activated promoters. These promoters, designated P1 and P2, are under the control of different sigma factors, sigma E and sigma K, which become active at separate times during sporulation. Removal of promoter P1, leaving promoter P2 active, resulted in about a 30-minute delay in the formation of heat-resistant spores and demonstrated that the expression of spoVJ from both promoters is essential for normal sporulation. A comparison is made between the sequences of the spoVJ promoters and the promoters of other genes dependent upon sigma E and sigma K. PMID- 1787792 TI - A chimeric nucleotide-binding protein, encoded by a hisP-malK hybrid gene, is functional in maltose transport in Salmonella typhimurium. AB - We have isolated a hybrid gene, composed of the first 455 nucleotides of hisP and nucleotides 275-1107 of malK, the genes coding for the nucleotide-binding components of the high-affinity transport systems for histidine and maltose in Salmonella typhimurium, respectively. The fusion had occurred by recombination within 11 homologous base pairs located between the two DNA fragments. In the chimeric protein peptidic motifs A and B, proposed to be part of the nucleotide binding fold, originate from HisP and MalK, respectively. Plasmid pES42-39, harbouring the hybrid gene, was shown to complement only a malK mutation but failed to complement a hisP deletion mutation. The chimeric protein was identified by immunoblotting as a protein with an apparent molecular mass of 49kDa. Removal of the C-terminal 77 amino acid residues from the chimeric protein resulted in the loss of function in transport. In contrast, 51 amino acid residues could be removed from the C-terminus of wild-type MalK without any effect. Upon overproduction the chimeric protein, as wild-type MalK, inhibited expression of the malB regulon. However, both truncated proteins, when overproduced, did not exhibit this activity. Based on these results, a tentative model of the functional domains of MalK is presented. PMID- 1787793 TI - Construction and characterization of Bordetella pertussis mutants lacking the vir regulated P.69 outer membrane protein. AB - The Bordetella pertussis P.69 protein is an immunogen with vaccine potential. The role of this protein in pathogenesis is unclear; it has been associated with the toxic adenylate cyclase and adhesion to eukaryotic cells. For further analysis of the role of P.69 in the biology of B. pertussis, we have constructed strains which specifically lack P.69. The cloned P.69 (prn) gene of B. pertussis was insertionally inactivated with a kanamycin-resistance cassette. This inactivated gene was used to construct P.69- mutants of B. pertussis by allelic exchange using plasmid pRTP1. B. pertussis P.69- strains produced normal levels of other vir-regulated factors, including adenylate cyclase. The serotype of B. pertussis, determined by Eldering and Preston typing sera and monoclonal antibodies, was also unaffected by the presence or absence of P.69. The ability of a prn mutant to adhere to and invade HEp2 cells was not significantly different from that of its parent strain. A strain containing a mutation in fhaB was significantly less adhesive and invasive than its parent, and a prn fhaB double mutant exhibited an even greater reduction in adhesiveness and invasiveness down to levels comparable with a Vir- strain. However, strains harbouring mutations in FHA and/or P.69 were able to colonize or multiply in the murine respiratory tract, although a Vir- strain was unable to survive and proliferate in the same infection model. PMID- 1787794 TI - Organization of genes encoding membrane proteins of the Escherichia coli ferrienterobactin permease. AB - Transposon mutagenesis and plasmid complementation studies have identified two genes, fepD and fepG, which are essential for ferrienterobactin transport in Escherichia coli. These genes mapped in the enterobactin gene cluster and genetic evidence indicated that they are transcribed as part of an operon (fepD, fepG, fepC). The nucleotide sequence of fepD was determine; it could encode a hydrophobic 33.8 kDa protein with sequence homologies to other iron and vitamin B12 transport proteins. Also identified, between fepD and fepB, was an open reading frame (ORF43) with no detectable function; its 43 kDa protein product (P43) was seen on polyacrylamide gels. The fepD-C operon and ORF43 were divergently transcribed from a 110bp region containing a binding site for the repressor protein Fur. PMID- 1787795 TI - Characterization of the opa (class 5) gene family of Neisseria meningitidis. AB - Class 5 outer membrane proteins of Neisseria meningitidis show both phase- and antigenic variation of expression. The proteins are encoded by a family of opa genes that share a conserved framework interspersed with three variable regions, designated the semivariable (SV) region and hypervariable regions 1 (HV1) and 2 (HV2). In this study, we determined the number and DNA sequence of all of the opa genes of meningococcal strain FAM18, to assess the structural and antigenic variability in the family of proteins made by one strain. Pulsed field electrophoresis and Southern blotting showed that there are four opa genes in the FAM18 chromosome, and that they are not tightly clustered. DNA sequence analysis of the four cloned genes showed a modest degree of diversity in the SV region and more extensive differences in the HV1 and HV2 regions. There were four versions of HV1 and three versions of HV2 among the four genes. Each of the FAM18 opa loci contained a gene with a unique combination of SV, HV1, and HV2 sequences. We used lambda gt11 cloning and synthetic peptides to demonstrate that HV2 sequences completely encode the epitopes for two monoclonal antibodies specific for different class 5 proteins of FAM18. PMID- 1787796 TI - Organization of the genes coding for the reaction-centre L and M subunits and B870 antenna polypeptides alpha and beta from the aerobic photosynthetic bacterium Erythrobacter species OCH114. AB - In the aerobic photosynthetic bacterium Erythrobacter species OCH114 the structural genes coding for the light-harvesting (LH) complex B870 and the reaction-centre (RC) polypeptides (the gene products of the pufB, pufA, pufL and pufM genes) are mapped on a 2.728 kbp EcoRI fragment. Sequencing of this fragment revealed that the deduced amino acid sequences contain 50 (B870 beta), 52 (B850 alpha), 283 (RCL) and 331 (RCM) residues with the corresponding molecular weights of 5592, 5814, 31364, and 37671, respectively. In the corresponding mRNA a 'hairpin' structure (delta G degrees = -26.6 kcal) is predicted to be located immediately downstream of pufA. The RC and LH polypeptides are highly homologous to those of the purple photosynthetic bacteria Rhodobacter capsulatus, Rhodobacter sphaeroides and Rhodopseudomonas viridis. Directly downstream of pufM there is an open reading frame (ORF) of unknown size. Partial sequencing indicates that this ORF is highly homologous to the cytochrome subunit of the photosynthetic reaction centre from R. viridis. In the puf operon no pufQ or pufX genes could be found, but the bchA gene is located upstream of that operon. Plasmid pESS8.9 containing the 2.728 kbp EcoRI fragment reconstituted a photoinactive mutant of Erythrobacter species OCH114. Comparative analysis of the DNA region upstream of the puf operon and of bacteriochlorophyll (Bchl) synthesis indicated that Bchl synthesis and puf gene expression are regulated differently in Erythrobacter and purple bacteria, respectively. PMID- 1787797 TI - Identification and molecular characterization of a transcriptional regulator from Pseudomonas aeruginosa PAO1 exhibiting structural and functional similarity to the FNR protein of Escherichia coli. AB - A gene library of chromosomal DNA from Pseudomonas aeruginosa contained a DNA fragment which was able to restore anaerobic growth to an Escherichia coli fnr deletion mutant on glycerol/nitrate medium. The cloned gene (termed anr) was sequenced and shown to encode a protein of 244 amino acids with a calculated molecular weight of 27,129. The deduced amino acid sequence of the anr gene product showed considerable similarity to the FNR protein from E. coli. Expression of the anr gene in a T7 promoter/polymerase system identified ANR as a 31 kDa protein. Transcriptional analysis of the anr gene showed that it is monocistronic but apparently lacks the equivalent sites for negative autoregulation which have been shown to be present in the promoter region of the E. coli fnr gene. The ANR protein was shown to activate transcription of the pfl gene in E. coli in response to anaerobiosis, as well as being able to restore the activity of three anaerobically inducible enzymes. A P. aeruginosa mutant incapable of growing anaerobically with nitrate or on arginine was fully complemented by the anr gene, indicating that it probably has a function in controlling anaerobic gene expression in Pseudomonas. Further corroboration for this assumption was provided by S1 nuclease analysis of transcription of the multiple promoters of the E. coli pfl operon in P. aeruginosa. Transcription was induced by oxygen limitation and was completely ANR-dependent in both aerobic and anaerobic cells. Removal of the upstream regulatory sequence of the pfl operon, which includes the sequences required for FNR-dependent regulation in E. coli, removed ANR-dependent transcriptional control of the remaining pfl promoters, irrespective of the cellular oxygen status. These results imply that the mechanisms by which ANR and FNR regulate transcription are fundamentally similar. PMID- 1787798 TI - Anaerobic growth and cyanide synthesis of Pseudomonas aeruginosa depend on anr, a regulatory gene homologous with fnr of Escherichia coli. AB - Anaerobic growth of Pseudomonas aeruginosa on nitrate or arginine requires the anr gene, which codes for a positive control element (ANR) capable of functionally complementing an fnr mutation in Escherichia coli. The anr gene was sequenced; it showed 51% identity with the fnr gene at the amino acid sequence level. Four cysteine residues known to be essential in the FNR protein are conserved in ANR. The anr gene product (deduced Mr 27,129) was visualized by the maxicell method and migrated like a 32 kDa protein in gel electrophoresis under denaturing conditions. An anr mutant of P. aeruginosa constructed by gene replacement was defective in nitrate respiration, arginine deiminase activity, and hydrogen cyanide biosynthesis, underscoring the diverse metabolic functions of ANR during oxygen limitation. Pseudomonas fluorescens, Pseudomonas putida, Pseudomonas syringae, and Pseudomonas mendocina all had a functional analogue of ANR, indicating that similar anaerobic control mechanisms exist in these bacteria. PMID- 1787799 TI - Anthrax toxin protective antigen: low-pH-induced hydrophobicity and channel formation in liposomes. AB - To probe the role of the protective antigen (PA) component of anthrax toxin in toxin entry into animals cells, we examined the membrane channel-forming properties and hydrophobicity of intact and trypsin-cleaved forms of the protein at various pH values. At neutral pH neither form caused release of entrapped K+ from unilamellar lipid vesicles. At pH values below 6.0, however, K+ was rapidly released upon addition of either the nicked PA (PAN) or the 63 kDa tryptic fragment of PA (PA63), which has been implicated in the toxin entry process. Under the same conditions intact PA exhibited only weak channel-forming activity, and PA20, the complementary tryptic fragment, showed no such activity. Both PA and PA63 exhibited enhanced hydrophobicity at acidic pH values, but the enhancement was greater and the pH threshold higher with PA63. Our findings indicate that proteolytic removal of PA20 from intact PA enables the residual protein, PA63, to adopt a conformation at mildly acidic pH values that permits it to insert readily and form channels in membranes. Thus acidic conditions within endocytic vesicles may trigger membrane insertion of PA63, which in turn promotes translocation of ligated effector moieties, edema factor or lethal factor, across the vesicle membrane into the cytosol. PMID- 1787800 TI - The Rhizobium meliloti exoZl exoB fragment of megaplasmid 2: ExoB functions as a UDP-glucose 4-epimerase and ExoZ shows homology to NodX of Rhizobium leguminosarum biovar viciae strain TOM. AB - A 2.6 kb ClaI-BamHI DNA fragment of megaplasmid 2 of Rhizobium meliloti 2011 was found to carry genes involved in exopolysaccharide synthesis and infection of alfalfa nodules. The analysis of the nucleotide sequence of this DNA fragment revealed the existence of two open reading frames (ORFs) running in opposite directions. Plasmid integration mutagenesis showed that these ORFs are organized as two monocistronic transcription units. One of the ORFs represents a new exo gene designated exoZ, which is involved in, but not essential for, the production of acidic exopolysaccharide. However, exoZ is not necessary for nodule formation with alfalfa. The ExoZ protein was found to show homology (23.3%) to the NodX protein of the R. leguminosarum biovar viciae strain TOM, known to be essential for nodulating the primitive Afghanistan pea. The second identified ORF corresponds to the exoB locus. The deduced amino acid sequence of the ExoB protein is homologous (39.6%) to that of the Escherichia coli GalE protein. In R. meliloti, exoB codes for a UDP-glucose 4-epimerase. A deficiency in the activity of this enzyme fully accounts for all the multiple carbohydrate defects that have been observed in exoB mutants. PMID- 1787801 TI - Enhancement of the invasive ability of Neisseria gonorrhoeae by contact with HecIB, an adenocarcinoma endometrial cell line. AB - Since Neisseria gonorrhoeae is an obligate pathogen, there is no animal model for identification of virulence factors for this bacterium. An alternative model for assessment of gonococcal virulence is invasion of the adenocarcinoma endometrial cell line, HecIB. Preincubation of gonococci with glutaraldehyde-fixed HecIB cells eliminated the six- to eight-hour lag in entry of bacteria into a fresh HeIIB monolayer seen with unpreincubated gonococci or gonococci preincubated in tissue-culture medium alone. Gonococci tightly bound to fixed HecIB cells were more invasive than cells free in the tissue-culture medium, suggesting that actual contact with HecIB cells was required for the enhancement of invasive ability. Chloramphenicol addition during the preincubation prevented the enhanced invasion. Preincubated gonococci were not more adherent to HecIB cells, suggesting that a stage in invasion after binding of gonococci to HecIB cells was enhanced. The enhanced invasion occurred only when gonococci were preincubated with HecIB cells and not with HEp-2, HeLa, Chang or CHO cells. This eukaryotic cell specificity for induction of enhanced invasion may indicate a role for invasion in gonococcal infection of the endometrium. PMID- 1787802 TI - A new system for amplifying 2 microns plasmid copy number in Saccharomyces cerevisiae. AB - The yeast 2 microns plasmid is found in the nucleus of almost all Saccharomyces cerevisiae strains. Its replication is very similar to that of chromosomal DNA. Although the plasmid does not encode essential genes it is stably maintained in the yeast population and exhibits only a small, though detectable, loss rate. This stability is achieved by a plasmid-encoded copy-number control system which ensures constant plasmid levels. For the investigation of 2 microns replication, a yeast strain that is absolutely dependent on this plasmid was constructed. This was achieved by disruption of the chromosomal CDC9 gene, coding for DNA ligase and providing this essential gene on a 2 microns-derived plasmid. This plasmid is absolutely stable under all growth conditions tested. Using the temperature sensitive mutant allele cdc9-1 we have developed an artificial control system which allows one to change the copy number of 2 microns-derived plasmids solely by changing the incubation temperature. PMID- 1787803 TI - Transformation of Mycobacterium aurum and Mycobacterium smegmatis with the broad host-range gram-negative cosmid vector pJRD215. AB - The transformation of Mycobacterium aurum and Mycobacterium smegmatis with the Gram-negative RSF1010-derived cosmid pJRD215 is described. The plasmid is stably maintained in both species and the antibiotic resistance determinants for kanamycin and streptomycin are expressed. Southern blot analysis shows that rearrangements take place both in M. aurum and in M. smegmatis. The use of pJRD215 in mycobacterial cloning systems is discussed. PMID- 1787804 TI - A working hypothesis of acute stress-induced hypotension. PMID- 1787805 TI - Nathan Pritikin and atheroma. PMID- 1787806 TI - Sudden infant death syndrome--a valid diagnosis? PMID- 1787807 TI - Innovation vs. quality control: an 'unpublishable' clinical trial of supplemental ascorbate in incurable cancer. AB - A computerized data bank was created recording the details of all cancer patients attending three district general hospitals in West Central Scotland over a 4.5 year period 1978-1982. At the conclusion of the trial, the records of 2804 individual patients were available for study, of whom 1826 had reached an incurable stage. 294 of these incurable cancer patients had received supplemental ascorbate at some stage in their illness, whereas 1532 had not, and served as controls. Analysis showed that the ascorbate-supplemented patients had a median overall survival time (343 days) almost double that of the controls (180 days). Our difficulties in having this simple, but important, observation published are briefly recounted in the introduction. PMID- 1787808 TI - Protocol for the use of vitamin C in the treatment of cancer. AB - A protocol for the use of vitamin C in the treatment of cancer, developed over a number of years in Vale of Leven Hospital, Scotland, is presented. Clinical experience has shown this protocol to be both safe and efficient. It need not be followed 'to the letter', but provides general guidance to physicians unfamiliar with this therapeutic approach. It recommends that all cancer patients treated in this fashion be given an initial course of intravenous ascorbate followed by a maintenance oral dose to be continued indefinitely thereafter. The importance of continuous as opposed to intermittent administration is emphasized. PMID- 1787809 TI - Melatonin supplementation from early morning auto-urine drinking. AB - Drinking one's morning urine ('amaroli') is a traditional practice of the yogic religion still widely performed. The pineal hormone melatonin and its conjugated esters are present in morning urine in significant quantities. Drinking the first morning urine restores plasma night-time melatonin levels due to deconjugation of its esters to melatonin. Exogenous melatonin, by either regulation of the sleep wake cycle or enhancement of the physiological prerequisites for mediation (decreased body awareness (i.e. analgesia) and claimed slowed brain wave activity and heightened visualization ability) may be the mechanism behind the alleged benefits of 'amaroli'. PMID- 1787810 TI - A groundless hypothesis, megaloblastic madness, and the founding of Duke University. AB - In a recent issue of Medical Hypotheses, Dr H L Newbold repeats the assertion that the cause of James B Duke's death in 1925 was pernicious anemia. Dr Newbold postulates that Mr Duke was neurologically impaired as a result of vitamin B-12 deficiency and that he suffered from depression. In an attempt to relieve this depression, Dr Newbold argues that James B Duke donated the money necessary to found Duke University. Had he been properly treated for pernicious anemia, James Duke might have not been depressed nor made his donation. The historical record does not substantiate this hypothesis. Dr George Minot, Novel Laureate for his work on pernicious anemia, was a consultant to Mr Duke's physicians, and felt that the patient did not have pernicious anemia. There is no independently verifiable evidence to demonstrate that Mr Duke ever suffered from depression. Duke made his first donations to Trinity College, later named Duke University, in 1900--25 years before his death. The available data discounts the hypothesis that depression related to pernicious anemia played any role in the founding of Duke University. PMID- 1787811 TI - Sterols, toxins and parasitism. AB - It has been suggested that pathogenic protozoa like Trypanosoma evolved from toxic algae and retained their ancestral algal toxins throughout evolution. These toxins may have enabled them to overcome their host's defense mechanisms and were therefore preserved by the parasites. Implications of this hypothesis are presented. PMID- 1787812 TI - A suggested air standard for lead to protect the public during lead abatement activities. AB - Lead abatement is developing as a new industry in a manner similar to asbestos abatement. Recent standards and guidelines have been established by various governmental agencies to ensure worker and public protection during lead abatement. An air concentration standard of 3.0 ug/m3 for lead is suggested in non-work locations based on hypothetical body burden calculations and sampling results during lead abatement activities. Adverse health effects to the general public resulting from exposure to lead from abatement activities at this concentration should not be observed. PMID- 1787813 TI - On the possible physical foundations of health related effects of crystals. AB - I propose a possible physical mechanism to account for widely claimed health related effects of crystals. The hypothesis relates the mechanism of such action to the isotropic diversity of crystals which leads to an enormous information storage capacity of crystal lattices. Sublattices of particular isotopes form an interactive network similar to simulated neural networks based on spin glass models. PMID- 1787814 TI - The mild hypertension enigma. AB - This study examines the problem of the correlation between mild arterial hypertension and cardiovascular damage. The authors examine the results of the most important trials carried out and, on the basis of their evaluations, suggest the need to review the current clinical policy of considering mild arterial hypertension as an important risk factor directly related to cardiovascular disease. Since the therapeutic trials carried out on mild hypertension did not substantially reduce the total and cardiac mortality rate, it seems to be probable that arterial hypertension is a progression acceleration marker of atheromatous disease. According to this theory, a therapy which aims merely at returning the pressure values to normal limits will probably not change the natural course of the atheromatous process. PMID- 1787815 TI - Mechanism of analgesic effect of clonidine in the treatment of dysmenorrhea. AB - Clonidine substantially reduces the pain and cramping of dysmenorrhea. The mechanisms for this effect may lie in increased release of analgesic opioids. It is suggested that perhaps a thromboxane synthetase inhibitor such as ginger which activates endorphin receptors may also be an effective treatment. PMID- 1787816 TI - Increased bowel permeability in psychiatric disorder: relevance of thromboxane. PMID- 1787817 TI - Physical fitness, dynamic extra-arterial pressures, and the pathogenesis and distribution of atherosclerosis. AB - Medical writings on cardiovascular disease focus on intravascular pressures. Tissue pressure is assumed to be essentially atmospheric. Yet, under dynamic conditions of sitting, standing, walking, breathing, and the beating of the heart, significant pressures, both above and below atmospheric, do develop outside of important arteries. These dynamic extra-arterial pressures either decrease or increase the pressure gradients across arterial walls, i.e. the transmural pressures are changed. Physical fitness may either prevent the development of negative extra-arterial pressure or increase positive extra arterial pressure, thereby protecting important arteries from high effective pressures. Deconditioning, old age, abdominal obesity, and other cardiovascular disease risk factors may do just the opposite, in effect, causing 'localized hypertension' in clinically important arteries. This, in turn, may lead to localized acceleration of atherosclerosis. The correlation of predictions made from this hypothesis with clinical findings is so remarkable that it suggests there is a direct cause and effect relationship between transmural arterial pressure and atherosclerosis. The concept of dynamic extra-arterial pressure seems to solve a number of puzzles and paradoxes in cardiovascular disease, it suggests key measurements that may be predictive of disease, and it offers new ideas for treatment and prevention. PMID- 1787818 TI - An elevated serum cholesterol level is secondary, not causal, in coronary heart disease. PMID- 1787819 TI - A putative approach for cloning 'silent' genes using retroviral vectors. AB - An alternative approach is described for cloning 'silent' or poorly expressed genes that might be activated as a result of proviral DNA integration. Generally, proviral DNA integrates randomly, in a single copy per cell, although some preferred integration sites exist. Thus, each cell infected by a retroviral vector should represent a different clone. These clones would have different phenotypes depending on the site of proviral DNA integration. Those expressing a desired phenotype would be screened for by using an assay system that depends on the gene of interest. The 5' and 3' flanking cellular DNA sequences, responsible for the observed phenotype in such mutants, could be cloned. Screening of these clones should be relatively simple due to the presence of a selectable marker in the proviral DNA. These sequences would then be used to isolate the wild type (wt) copy of the insertionally activated gene. Packaging retroviral vectors could lead to insertional activation of cellular genes and packaging of insertionally activated RNAs into vector particles. RNA extracted from the particles released into the culture medium would greatly facilitate cDNA cloning of 'silent' genes activated as a result of proviral DNA integration. PMID- 1787820 TI - Towards more efficacious chemotherapy of trypanosomiasis: combination of alpha difluoromethylornithine (DFMO) with reactive oxygen generating drugs. AB - Trypanosomiasis (whether African sleeping sickness, or American Chaga's disease) is caused by an infection with a protozoan parasite, i.e. the trypanosome. This carries fatal sequences in the untreated host. Currently available chemotherapeutic drugs (some of which cure by involving reactive oxygen species (ROS] are not optimally adequate. They are toxic as well, and may also be carcinogenic. It is therefore desirable to devise better chemotherapeutic regimens. ROS destroy the parasite, but excess ROS damage host tissue and are potentially carcinogenic. Alpha-difluoromethylornithine (DFMO) inhibits ornithine decarboxylase and so lowers the levels of spermine and spermidine. This singular effect in the parasite inhibits its multiplication, whereas in the host tissue it prevents carcinogenesis by preventing cell proliferation. Thus, combination of ROS-generating drugs with DFMO would be very effective against trypanosomiasis, and would be without cancer risk too. The combination is therefore advocated for chemotherapy of trypanosoma infections. This necessities experimental investigations specifically directed towards establishing the optimally efficacious combination of DFMO with the drugs. PMID- 1787821 TI - Death from bulbar involvement in Friedreich's ataxia. AB - Cheyne-Stokes breathing occurs in patients with Friedreich's ataxia. In some cases, this form of periodic breathing may be caused by degenerative changes at the bulbar level. In view of decreased levels of glycine in the spinal cord in patients with Friedreich's ataxia, though medullary levels have not been measured, it is hypothesized that glycine (and perhaps other inhibitory amino acids) reverses Cheyne-Stokes breathing and could perhaps prolong life expectancy in patients with Friedreich's ataxia. PMID- 1787822 TI - The role of estrogen receptors in the development of gallstones and gallbladder cancer. AB - The preponderance of gallstones in fertile women suggests that female sex hormones play a role in the pathogenesis of cholelithiasis. In a pilot study we found estrogen receptors and high concentrations of estrogen in gallbladders of persons who underwent cholecystectomy for cholelithiasis. This finding, as well as previous reports on estrogen receptors in diverse human tumors, support the hypothesis that estrogen influences the development of gallstone disease and gallbladder carcinoma. PMID- 1787823 TI - Bacterial colonization behaviour: a new virulence strategy in urinary infections? AB - The urinary bladder resists bacterial colonization and infection by a number of mechanisms, one of which involves the sloughing of colonized uroepithelial cells. Pathogens which thus become detached from bladder tissue are rapidly eliminated upon voiding of urine. During a recent study of bacterial colonization by the urinary pathogen, Proteus mirabilis, we noted that it colonized glass surfaces such that organisms became widely and evenly dispersed over the surface. In contrast, Pseudomonas fluorescens, a non-pathogen in the urinary tract, did not disperse over the surface but colonized and grew in such a manner as to form small clumps or microcolonies. Other investigators have also shown that Escherichia coli, a common urinary pathogen, initially colonizes bladders in a random, widely-dispersed fashion. We propose that successful bladder pathogens will predominantly adopt colonization behaviour that enables them to widely disperse over bladder tissue and, in so doing, avoid being cleared by the desquamation of uroepithelial cells. Colonization behaviour would therefore represent a previously uncharacterized virulence strategy. PMID- 1787824 TI - Consciousness and synchronicity. AB - The brain is described as a system whose states are subject to quantum uncertainty. Conscious observation brings individual states into being from the multiple states possible at a given instant. This gives rise to information, which is the content of consciousness. Synchronicity is the principle by which a single state is generated by conscious observation throughout the brain at a given instant. It is the equivalent of the non-local interaction in quantum theory. Both psychodynamic and cognitive applications of the proposed model are described. PMID- 1787825 TI - Amylin and insulin co-replacement therapy for insulin-dependent (type I) diabetes mellitus. AB - Amylin is a proteinaceous hormone secreted form insulin-producing pancreatic beta cells following stimulation by food molecules such as glucose and arginine. Amylin decreases insulin-stimulated glucose uptake in skeletal muscle and counteracts the ability of insulin to suppress output of glucose from the liver. Substantial evidence supports the view that maylin is a second glucoregulatory hormone produced from islet beta-cells, which can modulate a number of metabolic processes also regulated by insulin. The islet beta-cell may therefore transmit a dual message to peripheral tissues through the two hormones, insulin and amylin. Like insulin, amylin is deficient in individuals with autoimmune diabetes mellitus. Since amylin can modulate processes of fuel metabolism in key tissues, amylin deficiency could contribute to the clinical course in patients with autoimmune diabetes. Here, I propose that amylin lack plays a significant role to promote the tendency to hypoglycemia and defective glycemic control characteristic of insulin-treated patients with autoimmune diabetes. Treatment of such diabetics with injections of amylin as well as insulin is being evaluated with the aim of lessening the incidence and severity of hypoglycemia and improving glycemic control. PMID- 1787826 TI - Stress reactions in connective tissues: a molecular hypothesis. AB - The proper qualitative and quantitative stimuli necessary to maintain bone, cartilage, tendon, and ligament ability to bear load has yet to be completely elucidated. Substantially greater investigation of these requirements has been accomplished for muscle than for dense and ordinary connective tissues; inferential proposals from these muscle observations have been made regarding connective tissues. This hypothesis postulates there is a highly structured inter relationship in terms of the homeostatic stimuli which are shared in common by these different tissues as suggested by the close anatomic and functional relationship they have evolved. The evolutionary influence of man's exercise patterns upon these stimuli, their mode of transduction into adaptive cellular response, and the vulnerability to over-use injury their loss creates is hypothesized. PMID- 1787827 TI - Sudden infant death syndrome (SIDS) and disordered blood flow. AB - Naeye (1) has long linked SIDS with low utero-placental blood flow and foetal hypoxia. Gestational hypotension, maternal smoking and disorders of the foetal membranes are considered by Naeye to promote brainstem and neurological abnormalities. Naeye also found that SIDS' victims often showed a growth lag after birth and suggested a reduced oxygen environment after birth which pointed to chronic under-ventilation of the lungs. Another abnormality observed by Naeye was that brown fat was retained for an abnormally long time. Now Mitchell (New Zealand Herald, 27.11.90) has concluded a 3-year study of SIDS' victims in New Zealand and found a combination of stomach sleeping position, mothers' smoking and bottle feeding was implicated in 79% of SIDS' victims. (The sleeping position and maternal smoking may be additive in disordered blood flow). The effect of circulatory shock (cardiogenic) on skeletal muscle mitochondrial activity shows there is a large decrease in the activity of the mitochondrial enzyme cytochrome oxidase during circulatory shock. There is also a reduced capacity to oxidase succinate, pyruvate and palmitoyl carnitine (2). These authors discuss cellular oxidative damage due to severe hypoxia during circulatory shock and the effect on the skeletal muscle mitochondrial electron transport chain (ETC). The reasons for carnitine supplement to these patients are explained. It was concluded that during the course of circulatory shock in humans inactivation or damage to the mitochondrial ETC plays a crucial role in cellular oxidative damage. The activation of brown fat mitochondria via the ETC revolves around elevated blood flow, and the high content of cytochromes which give this tissue its characteristic brownish colour (3]. Other forms of interrupted blood flow, similar to cardiogenic shock disorders in skeletal muscle, will be discussed. PMID- 1787828 TI - Adrenal steroids and the physiopathology of a subset of depressive disorders. AB - Patients suffering from Cushing's disorders (syndrome and disease) are significantly affected by psychological disturbances that overlap with depressive disorders. In turn, a subset of patients with affective disorders present with hypercortisolemia, and non-suppression in the Dexamethasone Suppression Test (DST). We have shown that long-term potentiation (LTP), a putative memory mechanism, is significantly affected by steroids when tested on the hippocampus, a crucial structure for memory processes. We propose that an imbalance of adrenal steroids and their metabolites, interacting at the level of the hippocampus, play a fundamental role in the psychophysiopathology of Cushing's and depressive disorders. By biasing memory mechanisms, the imbalance of these hormones sets both distorted mood, and hence memory contents, and distorted cognition based on recollection and present experiences. PMID- 1787829 TI - Completion of the last half of the structure of the human gene for the Pro alpha 1 (I) chain of type I procollagen (COL1A1). AB - The nucleotide sequences of the 3'-half of the human gene for the pro alpha(I) chain of type I procollagen (COL1A1) is presented. The results provide the nucleotide sequences for 26 introns not previously analyzed. The sequences that are presented, together with those previously published, make it possible to design primers for the polymerase chain reaction for amplifying and sequencing the gene. The availability of such primers will greatly facilitate the current search for mutations that can cause common and rare diseases of connective tissue. PMID- 1787830 TI - Extracellular matrix gene expression by human endothelial and smooth muscle cells. AB - In this study, the expression of extracellular matrix genes by vascular cells from human iliac blood vessels was characterized on the mRNA steady-state level by slot blot and Northern transfer analyses, as well as by in situ hybridization. Endothelial cells were isolated from adult human iliac arteries and veins, as well as from umbilical veins; smooth muscle cells were isolated from adult human iliac arteries and inferior vena cava. The results show that confluent umbilical vein endothelial cells expressed the genes that encode types I, III, IV and VI collagens, as well as fibronectin and laminin. In contrast, the iliac endothelial cells expressed the genes for types IV and V collagens, fibronectin and laminin; mRNA transcripts for types I, III and VI collagens were not detectable. The smooth muscle cells from iliac arteries or inferior vena cava displayed gene expression for types I, III, IV, V and VI collagens, fibronectin and laminin. The results indicate major differences in gene expression for the various types of collagens by human iliac endothelial and smooth muscle cells. Furthermore, the fetal-derived umbilical endothelial cells displayed differential collagen gene expression from that of adult iliac endothelial cells. PMID- 1787831 TI - Effects of mechanical load on cartilage matrix biosynthesis in vitro. AB - Cultured bovine articular cartilage full thickness explants were mechanically loaded, both statically and cyclically, at high frequency (2s of load with 2s intervals of no load) and low frequency (60s of load with 60s intervals of no load), at 1 MPa. Metabolic effects of the load were studied by radiolabeling and compared with non-loaded cartilage explants. High frequency load had a stimulatory effect on protein and proteoglycan synthesis while low frequency and static load showed decreased synthesis. Removing the load from the cultures restored synthesis to non-loaded control culture levels. No major differences in protein biosynthetic pattern were revealed, as determined by SDS-PAGE and fluorography, showing the generalized nature of the response. PMID- 1787832 TI - Xenogeneic osteogenin, a bone morphogenetic protein, and demineralized bone matrices, including human, induce bone differentiation in athymic rats and baboons. AB - Subcutaneous implantation of xenogeneic demineralized bone matrix does not initiate endochondral bone differentiation. Dissociative extraction in 4 M guanidine-HCl or 6 M urea has shown that the apparent species-specificity of intact bone matrix resides in its insoluble immunogenic component, since there is homology in solubilized osteogenic proteins amongst mammals. To further investigate the species-specificity and cross-species reactivity of bone matrix components, baboon and human demineralized bone matrix (DBM) and bovine osteogenin, purified greater than 50,000-fold and with an apparent molecular mass of 28-42 kilodaltons, were implanted in the subcutaneous space of athymic and euthymic rats and into the rectus abdominis of 16 baboons (Papio ursinus). Baboon DBM was also implanted in athymic and euthymic mice. Alkaline phosphatase activity and histology of implants harvested at day 11 and 30 showed that baboon and human DBM induced endochondral bone differentiation both in athymic rats and baboons. Bovine osteogenin in conjunction with baboon insoluble collagenous matrix induced extensive bone differentiation in athymic rats and baboons. Baboon and human DBM did not induce bone differentiation in euthymic rats and, in athymic mice, baboon DBM failed to induce bone differentiation, determining instead the recruitment of multinucleated giant cells. The results indicate that in rodents bone differentiation induced by intact bone matrix is species specific and that T-cell functions are not a requirement for bone induction, although immunologically competent rats block bone differentiation from xenogeneic matrix. Bone differentiation induced by human DBM in baboons suggests that intact bone matrices may not be species-specific amongst primates.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1787833 TI - Generation of a monoclonal antibody against avian small dermatan sulfate proteoglycan: immunolocalization and tissue distribution of PG-II (decorin) in embryonic tissues. AB - Chick embryonic skeletal muscle synthesizes three major types of proteoglycans: large chondroitin sulfate proteoglycans, small dermatan sulfate proteoglycans and small heparan sulfate proteoglycans. A monoclonal antibody has been raised which recognizes the small dermatan sulfate proteoglycan. Immunoblot analysis of a partially purified preparation of skeletal muscle proteoglycans indicates that the antibody reacts with a molecule which migrates with an estimated Mr of 100,000. Prior treatment of the proteoglycans with chondroitinase results in immunostaining of a species of estimated Mr 45,000. These values for the intact proteoglycan and its core protein suggest that the antibody is directed against a proteoglycan of the PG-II or decorin class. Immunohistochemistry indicates a widespread distribution of the proteoglycan, which is localized in connective tissue septa of skeletal and cardiac muscle, dermis, tendon, bone, perichondrium and cornea. Immunoblot analysis of the proteoglycan core proteins from these tissues demonstrates that the antibody recognizes the same 45,000-dalton band in each tissue. The widespread tissue distribution is also consistent with the antibody being directed against an epitope of PG-II. Neither the glycosaminoglycan chains nor N-linked oligosaccharides are required for reactivity and the antibody cross-reacts with other avian material, but not mammalian. This antibody, which has been designated CB-1, reveals developmental stage-specific changes in the deposition of PG-II in embryonic limb bud and skeletal muscle. PMID- 1787834 TI - The extracellular matrix in cartilage organoid culture: biochemical, immunomorphological and electron microscopic studies. AB - Limb bud mesenchymal cells obtained from day-12 mouse embryos were grown at high density on a membrane filter (pore size 0.2 micron) at the medium/air interphase. Chondrogenesis in this so-called cartilage organoid culture was monitored quantitatively by immunological estimation of type I and type II collagen and qualitatively by indirect immunofluorescence and electron microscopy in the course of a 36 days culture period. Three stages of cartilage development could be substantiated: 1. Formation of cartilage between days 2 and 7; 2. maturation of cartilage between days 9 and 13; 3. degeneration of cartilage beginning at day 20. Differentiation in cell aggregates and a loose mesenchymal tissue occurred during the first two days of the culture period. Type II collagen synthesis started in cell aggregates two days after plating and after 6 days in culture distinct cartilage nodules had developed which were embedded in loose connective tissue that contained type I collagen. During this period the type II collagen content increased progressively from 2.3 micrograms (day 3) to nearly 40 micrograms (day 7) per mg dry weight, whereas the type I collagen level increased more linearly from 2.7 to 21.3 micrograms/mg dry weight. The second period was characterized by enlargement and fusion of cartilage nodules and a diminished increase in type II collagen content from 45 to 60 micrograms/mg dry weight. Enlargement and fusion occurred by matrix production as well as by transformation of perichondrial cells into chondroblasts. Type I collagen synthesis enhanced from 29 to 54 micrograms/mg. Hypertrophic chondrocytes could be demonstrated ultrastructurally. At the third stage a nearly continuous layer of cartilage on the membrane filter covered by noncartilagenous tissue had developed. To some extent chondrocytes lost their matrix capsule and changed into fibroblast-like cells accompanied by a switch of collagen synthesis from type II to type I collagen. Quantitative studies yielded a constant level of about 60 micrograms/mg type II collagen and a further increase in type I collagen from 77 to 116 micrograms/mg dry weight. This study reveals an in vitro model of a prolonged, but almost identical image of chondrogenesis in vivo prior to endochondral mineralization which may be useful for investigations on cartilage differentiation, maturation and degeneration. PMID- 1787835 TI - Persistently low natural killer cell activity, age, and environmental stress as predictors of infectious morbidity. AB - In recent studies of 'low natural killer (NK) cell syndrome', low NK activity was measured in individuals who were symptomatic, and therefore a causal relationship between low NK activity and infectious or other disease manifestations could not be concluded. However, preliminary work by members of our collaborative team (S.L. and R.H.) provided some indications for chronic low NK activity preceding and predicting subsequent infectious morbidity. This present study was designed to address this causal question in a larger sample, using a longitudinal design. Subjects were 106 healthy normal volunteers from the community. They were examined medically and psychosocially at baseline, and were then followed over a 6-month interval, with serial monthly assessments over the study period. The results supported our hypothesis that individuals who were currently healthy, but who exhibited a pattern of natural immunity characterized by persistently low NK cytotoxicity would be at risk for development of infectious sequelae over a 6 month follow-up period. The results also showed that younger age and the perception of more severe 'hassles' or stressors also predicted more infectious morbidity during the 6-month study period. Chronological age appeared to have both a direct, as well as indirect (via NK activity) association with illness outcome. Contrary to our expectation, the report of environmental stressors was directly associated with illness outcome, but not indirectly associated with outcome via natural immunity. PMID- 1787836 TI - Adjuvant adoptive immunotherapy with IL2 and lymphocytes from tumor-bearing mice: in vitro tumor-stimulated lymphocytes are more effective than LAK cells. AB - In order to determine whether lymphocytes with therapeutic potential can be obtained from colon carcinoma (C26)-bearing (TB) mice, splenocytes were activated either in mixed lymphocyte-tumor cell (MLTC) cultures in the presence of 5 and 10 U/ml IL2 or 250 and 100 U/ml IL2 (LAK effectors). The therapeutic efficacy, as well as functional and phenotypic features of such lymphocytes, was then compared in an adjuvant immunotherapy setting. Comparisons of the antigenic phenotype, cytotoxic and proliferative activities, and of transcription of different cytokine genes (IFN gamma, TNF alpha, IL4, IL6) between lymphocytes activated in MLTC and LAK failed to reveal major differences. However, the in vitro lysis of C26 by MLTC-activated but not by LAK TB lymphocytes was significantly blocked by anti-T3 and anti-Lyt2 monoclonal antibodies, suggesting that a fraction of specific antitumor effectors was present in the MLTC bulk population. Moreover, the amount of IFN gamma (but not of other cytokines) produced by MLTC-derived lymphocytes after stimulation with C26 cells was shown to be 10-fold higher than that produced by LAKs. When combined with low-dose IL2 administration as an adjuvant treatment in C26-operated mice, MLTC effectors showed a higher therapeutic activity than LAKs obtained from the same pool of lymphocytes from TB donors. In the same setting, MLTC-activated lymphocytes obtained from TB or tumor excised (TE) mice, combined with IL2, were equally effective (76 and 74% survivors, respectively, vs. 27% of the surgery control group and 26% of the group given IL2 only), whereas LAK cells from TE but not from TB animals resulted in the cure of a significant fraction of mice. PMID- 1787837 TI - Relationship between large and small tumor-binding cells in the spleen and bone marrow. AB - By employing a distinctive feature of natural killer (NK) cells, i.e., spontaneous target cell binding, the present study aimed to follow a relatively large cohort of target-binding cells (TBC), subdivided according to size and the presence of the radioautographically labelled nucleotide, tritiated thymidine, incorporated during a 1- or 6-hour exposure period. Labelling among all TBC in the spleen was 5% by 1 h after a single injection of the isotope and this value did not change significantly after 6 h of isotope exposure. There was an insignificant increase in the labelling index of spleen-localized, labelled, large TBC throughout and beyond the isotope exposure period for at least 48 h, concomitant with a significant increase in the labelling index of spleen localized, small TBC during the same period. In the bone marrow, small TBC showed only 2% labelling by 1 h after a single injection of isotope, while 21% of large TBC in that organ were synthesizing DNA during the same period. The results are consistent with a precursor-product relationship between large and small TBC within the bone marrow but not the spleen, and with a bone marrow-to-spleen migration of small (+/- large) TBC. Moreover, a minor population of large TBC was detected in the spleen with kinetic characteristics distinct from those of the bone marrow. PMID- 1787838 TI - The Kurloff cell in estrogenized guinea pigs as a CT7+ 8BE6- CT6- MR-1- CT10- IgM lymphocyte with natural killer activity. AB - The relationship of the Kurloff cell (KC), guinea pig blood mononuclear cell with natural killer (NK) activity, to a known cell lineage was established. Using indirect immunoperoxidase staining and flow cytometric analysis, numerous monoclonal antibodies directed against guinea pig macrophage antigen, Ia antigen or different T lymphocyte markers and a polyclonal anti-IgM serum were tested in unimmunized estrogenized animals. We excluded any relationship between KC and the monocytic macrophage lineage (MR-1-) and between KC and the B lymphocyte lineage (CT10- and IgM-). The KC immunophenotype was pan T CT7 positive but 8BE6 (mature thymocyte) and CT6 (cytotoxic suppressor T lymphocyte) negative. Since KC displays an NK activity, this cell may be classified among the NK effector cells exhibiting some T lymphocyte markers. PMID- 1787839 TI - [Preparation of Saccharomyces cerevisiae strains with regulated MFalpha1 promotor activity]. AB - Two Saccharomyces cerevisiae strains containing integrated copies of the MAT alpha 1 gene fused to the PHO5 promoter have been obtained by transformation of a MAT alpha 1 mutant. The strains differ in length of 5'-uncoding region of the MAT alpha 1 in the integrated constructions. The mating activity and the ability of these strains to express the yeast MF alpha 1 gene and the hyman alpha-N interferon gene under the control of MF alpha 1 promoter was shown to be regulated by the exogenous inorganic phosphate. The level of intracellular alpha N-interferon synthesized in these strains was several fold higher as compared with the wild type alpha mating type strain. At the same time the observed increase in intracellular production is not accompanied by an increase in the level of secreted alpha-N-interferon. On the contrary, one of the strains had a two-fold reduction in the rate of secretion. PMID- 1787840 TI - [Cloning and detailed mapping of the fra-ymt region of the Yersinia pestis pFra plasmid]. AB - The genetical libraries of the pFra plasmid of Yersinia pestis genes were obtained by insertion into the PstI, SalGI, EcoRI, XhoI restriction sites of the cosmid vector pHC79. The immunochemical analysis of the recombinant clones has revealed the clones synthesizing the antigen Fl (fraction I) and mouse toxin (Ymt -Yersinia pestis murine toxin). The restriction analysis of the plasmids from antigen synthesizing clones has permitted to construct the detailed physical map of the fra-ymt region of the pFra plasmid the size of 22 kb. The recombinant F1 positive clones of Escherichia coli are able to form at 37 degrees C the capsule like structure peculiar for Yersinia pestis. The antigen F1 and the mouse toxin were isolated, purified and characterized. The antigen F1 is an 1-2 Md polymer containing a 16 kDa protein subunit. The mouse toxin a 240 kDa protein consisting of 61 kDa subunits. The nucleotide sequence of ymt gene has been defined. PMID- 1787841 TI - [Temperate SM phage from Pseudomonas aeruginosa as a vector for cloning genetic information]. AB - The recombinant bacteriophages with the genomes containing the DNA fragments of bacteria Erwinia chrysanthemi, including the pectatelyase gene, were constructed on the base of Pseudomonas aeruginosa temperate bacteriophage SM. The gene transferred into Pseudomonas aeruginosa PAO1 cells by transfection is expressed in the new bacterial host. The restriction maps of the recombinant bacteriophages are constructed and the position of an insert is defined. Bacteriophage SM was found to be capable of reproducing in Pseudomonas aeruginosa PAO1 cells when its DNA was shortened to 88% or increased to 111% of the normal genome length. Except for bacteriophage SM, the recombinant bacteriophage SM-2 with an unique restriction endonuclease site for XbaI can also be used as a vector for cloning. Bacteriophage SM capacity in cloning of heterological DNA at HindIII sites is not less than 8 Md, capacity of bacteriophage SM-2 is not less than 5 and 8 Md at XbaI and HindIII sites respectively. PMID- 1787842 TI - [The role of a plasmid with a molecular weight of 82 MD in the modulation of the action of Yersinia pseudotuberculosis on the proliferative activity of murine lymphoid cells]. PMID- 1787843 TI - [Genomic polymorphism of bacterial infection pathogens]. PMID- 1787844 TI - Biochemical dynamics and hypocholesterolemic action of Hibiscus sabdariffa (Karkade). AB - Male albino rats were fed on a mixture of cholesterol and cholic acid for 12 weeks to induce hypercholesterolemia, then Karkade was administered at 5 and 10% for 9 weeks to evaluate its hypocholesterolemic and hypolipemic effect. The experimental parameters include total lipids, cholesterol, triglycerides and phospholipids. Liver and kidney functions were also investigated in normal, hypo- and hypercholesterolemic rats administered Karkade. A remarkable progress (lowering effect) in the level of different lipid fractions was noticed in spite of the continued cholesterol and cholic acid loading during the treatment. However, blood phospholipids were increased after Karkade administration. Hypercholesterolemia has resulted in an effect on the activity of liver and kidney functions. Therefore, the measurement of serum enzyme activity has provided a useful tool for hepatic recovery. Although the administration of Karkade at 5 and 10% induced a significant decrease in the activity of serum GOT and serum GPT, alkaline and acid phosphatase as well as total serum protein, the values nearly returned to the initial levels after 9 weeks of Karkade administration. PMID- 1787845 TI - Influence of ouabain of electrolyte and water transport in the rabbit ileum and colon in vitro and in vivo. AB - We studied the influence of the Na(+)-K+ pump inhibitor ouabain on water and electrolyte transport in the rabbit distal ileum and proximal colon in vitro and in vivo. Under in vitro conditions, ouabain markedly reduced the absorption of water, sodium, chloride and bicarbonate, and reduced potassium secretion in both the ileum and the colon. In vivo results were similar but less marked than those obtained in vitro, with significant differences only at the level of the distal ileum. PMID- 1787846 TI - Prediction of total body lipid from total body water in rats. Part 1. Relations between directly measured major body components. AB - Aimed to the construction of a prediction equation for estimations of lipid content from animal water content body composition was determined by whole body analysis of male rats (1) given access, ad libitum, to a commercial standard diet (n = 144; ranging from 60 to 600 g in weight, and from the 4th to the 34th week of age), and (2) showing striking variations with regard to nutritional state, dietary history, enlarged fat deposition, genetic origin, intestinal microbial status, and advanced age (n = 75). It was shown that a unique coefficient of water content in lipid-free body mass does not exist. The results of statistical analysis for the grouped values of percentage body dry matter (x) and percentage body lipid (y) indicate that the latter can be estimated accurately from body water content directly determined by the use of the quadratic regression equation y = -0.2864 x +0.01615 x2 with a standard deviation of the procedure Sy = +/- 1.40. This prediction equation is valid for a wide developmental span even under highly different experimental states. Differences between the calculated body lipid contents vs. analytically determined values are smaller than by using a linear regression equation or coefficient(s) of hydration of lipid-free body mass. PMID- 1787847 TI - Prediction of total body lipid from total body water in rats. Part 2. In vivo estimation of total body lipid by tritium water dilution. AB - Body composition data estimated for normal young, normal adult, and adult obese Wistar rats by a tritiated water (THO) dilution procedure (b. wt. range 119-237 g, n = 31; 305-597 g, n = 43; 274-381 g, n = 6) were compared with the results of whole body analysis. As for the predicted total body lipid (TBL), the content was calculated from the virtual THO-dilution space estimated by a simple micro-method and a regression equation between TBL [%] and DM [%] (dry matter) content (Part 1. Relations between directly measured major body components. Nahrung 35 (1991) 581. Due to different degrees of overestimations in the animal groups examined, the THO-space can be corrected via subtraction of 3.8%, 2.2% and 1.1% in the sequence young, obese, and adult groups. The derived TBL [%] data show a non significant deviation of less than 1 g/100 g b. wt. in comparison to the three group means after direct lipid determinations. In the best case, i. e. after the additional elimination of extremely overestimated values for total body water (outliers) the combined tritium-derived lipid values (y) are correlated with the lipid data obtained analytically (x), both as proportion of the body weight, by the regression equation y = 0.848 + 0.963 x, r = 0.985, Sy.x = 1.77, n = 58. For a group of young rats (n = 14) after a pre-experimental supplementation with a sucrose solution, TBL values, not significantly different from analytically determined ones, could be calculated without any corrections. PMID- 1787848 TI - Factors affecting the production of Saccharomyces cerevisiae from sugar beet pulp. AB - Factors affecting the production of S. cerevisiae from sugar beet pulp after acid hydrolysis were investigated. Maximum yield and economic coefficient were obtained at sugar concentration of 7.15% after an incubation period of 72 h at 30 degrees C and pH 6.0 using a mixture (1:1) of ammonium sulphate and ammonium nitrate (0.2 g/g sugar) as nitrogen source. HPLC analysis of beet pulp hydrolyzate showed that hexoses especially glucose serve as the most suitable sugars with regard to S. cerevisiae activity. PMID- 1787849 TI - [Toxicologic evaluation of sucrose carbonic acid esters in basic subchronic feeding studies in rats. 2. Effect of sucroacetoglycerides]. AB - Groups of male and female rats received a sucroacetoglycerides containing product (SAG) for 3 months at dietary levels of 0, 2.5, 5 and 10%. Food consumption was initially increased in females at all SAG-levels. After two weeks significant increases in food intake were observed in males and females fed 10% SAG throughout the feeding period. The serum analysis revealed significantly elevated activity in serum alkaline phosphatase at the highest SAG-level in males and females after 6 weeks and in females after 13 weeks. Histological changes related to the SAG-feeding were noted in the intestinal lymph nodes of male and female animals fed 10% SAG. The no-adverse effect level established in this subchronic feeding study was 5% SAG in the diet of rats, equivalent to a daily intake of 3.6 g/kg body weight in males and 4.0 g/kg in females. PMID- 1787850 TI - Autoxidation of stored soybean lecithin (short communication). PMID- 1787851 TI - Composition of fatty acids and triglycerides in human adipose tissue--results from north-east Poland (short communication). PMID- 1787852 TI - [Rights: the rights of the patient]. AB - Medical development has made rights a crucial problem. Basic to the question of patient rights is the fundamental principles that a patient maintains his rights in any health service situation. The patient retains the right to be free from any physical harm, privacy and freedom of movement. Because the nurse is continuously involved with the patient and is responsible for monitoring the patient's progress and carrying out the doctors orders, she is the obvious person to give attention to the rights of the patient. The ICN also points out that nurses must not only ensure patient rights during political uprisings, wars and imprisonment but nurses should also react in the everyday work situation where exploitation or mistreatment of patients may take place. Every nurse is obliged to know, understand, support and protect the moral and legal rights of clients. PMID- 1787853 TI - [Cardiac rehabilitation program]. PMID- 1787854 TI - Wound care update. PMID- 1787855 TI - Cultural differences in midwifery practice. PMID- 1787856 TI - Burns. PMID- 1787857 TI - Comprehensive AIDS package launched. PMID- 1787858 TI - Earliest known victim of small pox? PMID- 1787859 TI - Crippling disorders in the Bible. PMID- 1787860 TI - Change! PMID- 1787861 TI - [Electrophysiologic study of influences of the Pulvinar stimulation on the caudate nucleus neurons responding to visual stimulation]. AB - Responses of caudate neurons to electrical stimulation of the afferent input from the thalamic nucleus pulvinar and to visual stimuli of various orientations were studied extracellularly in awake chronic cats. Activation responses dominated among reactions of these neurons. The response latencies have ranged from 4 to 85 ms for units with primary activation and from 20 to 150 ms for inhibited ones, the values are indicative of both rapidly and slowly conducting afferent pathways. A possibility of monosynaptic transmission in the pulvinar-caudate projections is also revealed. Stimulation of pulvinar is found to be efficient for the significant (more than 50%) number of caudate neurons responding to visual stimuli including orientation-selective cells. The mode of influences from other structures of the visual system (optic tract, area 17, the Clare-Bishop area) on caudate neurons, responding to pulvinar stimulation is described. The obtained data are discussed in the aspect of the possible role of cortical and subcortical projections of the visual system in the creation of sensory specific responses of the caudate nucleus. PMID- 1787862 TI - [Excitation and inhibition in parietal associative cortex neurons during stimulation of thalamic associative nuclei]. AB - Responses of the parietal association cortex neurons to stimulation of lateralis dorsalis (LD) and lateralis posterior (LP) thalamic nuclei were investigated. Primary IPSP were observed in 62.5% of cases after stimulation of LD and in 79.6% of cases after LP stimulation. Latent periods of EPSP and IPSP were longer in case of LD stimulation rather than after LP stimulation. EPSP amplitude to association nuclei stimulation increased and decreased gradually, while amplitude of IPSP increased quickly and decreased slowly. Amplitude of EPSP which has appeared during IPSP development was larger than in case of the resting potential. Amplitude and duration of EPSP of the certain neuron after stimulation of different nuclei were rather similar. It is supposed that with stimulation of different association nuclei the same cortical inhibitory interneurons are involved. IPSP duration is shorter as compared to inhibition of the background impulse activity. A supposition is advanced that such a difference in duration is determined primarily by properties of these neurons. PMID- 1787863 TI - [Impulse activity of neurons of the lateral vestibular nucleus in guinea pigs during locomotion]. AB - The influence of spontaneous locomotion on the resting impulse activity of the lateral vestibular nucleus neurons was investigated in the decerebrated guinea pig. Appearance of the rhythmic limb muscle activity was followed by an increase of the frequency of the resting discharge from 10-50 to 100 imp./s. An increase in the frequency of discharges was observed at the beginning of the forelimb extensor muscle activity, i.e. at the end of the swing phase and beginning of the stance phase of the locomotor cycle. It is suggested that the observed changes in the activity of vestibular neurons provide high tonus of antigravitational muscles, which is the base for rhythmic movements of the limbs. PMID- 1787864 TI - [Activity of neurons of the guinea pig lateral vestibular nucleus evoked by tilting about a longitudinal axis during locomotion]. AB - The activity of neurons of the lateral vestibular nucleus evoked by tilting about a longitudinal axis during spontaneous and mesencephalon stimulation-evoked locomotion have been investigated in the decerebrated guinea pig. In the vast majority of the investigated neurons the locomotor activity has led to changes in the responses to adequate vestibular stimulation. The enhancement of the responses is observed in almost all of the vestibulospinal neurons and in two thirds of neurons without descending projections. The diminishing of the responses is registered only in one quarter of neurons that do not projected to the spinal cord. Changes in responses are of the amplitude pattern. The angle lag value of these changes relative to acceleration that appears during the motion is quite constant. It is suggested that the observed enhancement of dynamic reactions of vestibular neurons provides the maintenance of the animal equilibrium during locomotion by different gaits and trajectories. PMID- 1787865 TI - [Ultrastructural characteristics of callosal neurons in deep layers of the primary auditory cortex (AI) in cat]. AB - An electron microscope study of retrogradely labelled nonpyramidal neurons has been carried out in layers V-VI of the primary auditory cortex (AI) after HRP injections into the contralateral AI of cats. From 2 to 9 synapses were usually revealed on somatic profiles of these callosal neurons. Synapses occupied 15.8 +/ 1.7% (on the average) of the somatic surface of these neurons. All of the revealed synapses on the somata of these callosal neurons had symmetric contacts and were formed by axon terminals with small elongated synaptic vesicles. An average length of these synaptic contacts in sections was 1.6 +/- 0.1 mm. HRP labelled axon terminals of callosal fibres in layers V-VI contained round synaptic vesicles and formed asymmetric synapses on spines and dendrites. Possible functional significance of axo-somatic synapses in formation of impulsation patterns of the callosal neurons is discussed. PMID- 1787866 TI - [Epileptiform activity in the rat hippocampal slices isolated after local lesion of the septum by ibotenic acid]. AB - Extra- and intracellular responses were recorded in the CA3 region of hippocampal slices of rats 1-4 weeks after intraseptal injection of ibotenic acid. Then they were compared with those from unoperated controls. In the slices from operated animals spontaneous and evoked synchronous epileptic field discharges were preserved invariably associated with paroxysmal depolarization shifts (PDSs) and bursts of action potentials of the cells. Both the field discharges and PDSs in the CA3 had an "all-or-nothing" character. There were no consistent effects of septal lesion on the mean resting potential or input resistance of the CA3 pyramidal neurons. Histological examination revealed a cell loss in the dorsal septum, whereas cholinergic neurons of the medial septum were not significantly damaged. The results suggest that intrinsic septal circuitry is critically involved in synchronization of CA3 neurons and control of their excitability. PMID- 1787867 TI - [Changes in neuronal responses of area 7 of the cat cerebral cortex to unconditional and conditional stimulation with additional stimuli]. AB - Influence of external stimuli and food motivation on neuronal spike responses (area 7) induced by conditional and unconditional stimulation were studied in the awake cats. The beginning of external stimuli and food motivation inhibited neuronal responses after electro-cutaneous stimulation. During external stimulation after the reflex onset conditional neuronal reactions were later by 50-250 ms, but the latencies of conditional movements did not change. Identical changes of neuronal responses were during variation of food motivation. It is supposed that the reason of the studied phenomenon is variation of the exteroceptive attention level of cats induced by changes in experiment conditions. PMID- 1787868 TI - [Effect of anesthesia on the impulse activity of hypothalamic neurons in rabbits]. AB - Impulse activity of the anterior and posterior hypothalamus neurons was investigated in the unanaesthetised and anaesthetised (urethan and chloralose) rabbits. Anaesthesia is shown to induce a decrease of the mean firing rate, alteration of the impulse activity pattern and a decrease of the quantity of neurons, responding to the skin thermal stimulation. These changes are expressed most of all in the posterior hypothalamic neurons. PMID- 1787869 TI - [Changes in glycine-activated conductivity of membranes of chick embryo neurons in culture]. AB - Glycine-activated whole-cell currents of the chick spinal cord neurons have been investigated in a chicken embryo during different periods in culture. Shifts in the concentration dependence curve of mature and immature cells are shown. Mature cells prove to be motoneurons and die 5-7 days later in vitro. immature cells are neuroblasts differentiating in culture. Glycine sensitivity of low differentiating cells increased more than 10 times by the end of the 14th day in culture. Desensitization kinetics of the glycine-activated currents decelerated with age. A crucial role of spontaneous electric activity was shown for maturation of the agonist-activated conductance. PMID- 1787870 TI - [Quantitative characteristics and reconstruction of the surface topography of histochemical markers on the nerve cell plasmalemma]. AB - An electron microscopic study of topography of colloidal gold-bound lectins conjugating to glycocalix carbohydrate residues on the somatic membrane surface of the cultivated spinal neurons has been carried out. The quantitative procedures are suggested for analyzing the surface pattern of the markers: two stochastic functions are considered to correspond properly to the particle distribution observed in the electron micrograms. The analysis of these functions permits obtaining required numerical characteristics. The Monte Carlo reconstructing model is described, and results of its work (on the basis of the above experimental data) are demonstrated in the form of "averaged" surface topography of the studied markers within the membrane fragments bordered. Possible connection of the obtained data with cooperative properties of the membrane is discussed. PMID- 1787871 TI - [Electrophysiologic properties of red nucleus neurons in the rat brain slices]. AB - Intracellular recordings from the red nucleus (RN) neurons were made in experiments on the rat brain slices. Passive membrane properties (input resistance and membrane time constant) of the RN neurons were evaluated. Phenomena of potential-dependent rebound depolarization and time-dependent inward rectification were revealed by means of passing hyperpolarizing current pulses through the recorded cells. Injections of depolarizing currents caused repetitive firing of neurons with frequencies directly depending on the intensity of injected currents. Repetitive firing was also characterized by a fast frequency adaptation during injections of currents of different intensities. Stimulation of a region of slices presumably corresponding to the decussation of brachium conjunctivum evoked mainly monosynaptic EPSPs with a "fast"-rise time in the RN neurons, which suggests activation of the synaptic input from the cerebellar nucleus interpositus. Stimulation of the same region sometimes evoked EPSP-IPSP mixtures or pure IPSPs in the RN neurons. PMID- 1787872 TI - [Comparative analysis of the dimensions of vestibulo-spinal neurons in the guinea pig]. AB - The comparative analysis of dimensions of horseradish peroxidase labelled vestibulo-spinal neurons and neutral red stained neurons of undifferentiated areas of the vestibular nuclei have been performed in guinea pig. The undifferentiated areas of the vestibular nuclei consisted of small, medium, large and giant cells. A decrease in the relative numbers of small- and medium-diameter neurons and an increase in the relative numbers of large and giant neurons have been observed along the caudo-rostral axis of the vestibular complex. The vestibulo-spinal populations included neurons of medium, large and giant dimensions. The numerical superiority of large and giant neurons have been found. The even distribution of the vestibulo-spinal neurons of different diameters have been revealed along the longitudinal axis of the brainstem. PMID- 1787873 TI - [Neurotrophic control of the ionic regulation mechanisms for intracellular water content in muscle fibers of mammals]. AB - The volume change of the muscle fibres in the hypertonic medium begins with cell shrinkage. Later the cell volume increases up to the normal level because of the furosemide-sensitive CL(-)-influx activation. The property of the Cl(-)-influx to be activated in the hypertonic medium is abolished after denervation. That causes a loss of the ability of muscle fibres to restore their cell volume in the hypertonic medium. PMID- 1787874 TI - [Synaptic responses of spinal cord neurons to rhythmic microstimulation of a stepping strip]. AB - Synaptic responses of neurons at the low thoracic level to microstimulation of a stepping strip in the dorsolateral funiculus with frequency of 20 and 40 pps were recorded in mesencephalic cats. Histograms of latencies of single neurons were usually monomodal, whereas two modes at 2-3 ms and 5-7 ms occurred in composed histograms. The data obtained show that decremental reverberation exists under these experimental conditions. PMID- 1787875 TI - The regulatory role of calmodulin in the proteolysis of individual neurofilament proteins by calpain. AB - The in vitro degradation of individual neurofilament proteins by calpain and the effects of calmodulin on this proteolysis were studied. Two major results are reported. First, in the presence of calcium, calmodulin binds to the 200-kD neurofilament protein, but only weakly associates with the 150-kD neurofilament protein. The 70-kD neurofilament protein shows no specific calmodulin-binding. Second, calmodulin inhibits the calpain-mediated degradation of the 200-kD neurofilament protein, but does not alter the hydrolysis of the 150-kD and 70-kD neurofilament proteins. In addition, calmodulin is able to bind to the 200-kD neurofilament protein in the presence of other neurofilament subunits, indicating that calmodulin may play a role in the regulation of the metabolism of the 200-kD neurofilament protein in vivo. PMID- 1787876 TI - Effects of various experimental manipulations on neostriatal acetylcholine and dopamine release. AB - The release of endogenous acetylcholine and dopamine and the appearance of their metabolites, choline and dihydroxyphenylacetic acid (DOPAC), from neostriatal slices prepared from Fischer 344 rats was examined under various experimental conditions. There was a dose-dependent increase in the amount of neurotransmitter or metabolite as the medium potassium concentration was increased from 5 to 50 mM. Over an eight minute period in Krebs Ringer bicarbonate buffer containing 25 mM potassium, the rate of release of acetylcholine was 6 to 13 times greater than that of dopamine. The dopamine endogenous to the slice preparation appeared to have little effect on the release of endogenous acetylcholine since manipulations that significantly altered dopamine release (depletion with 6-hydroxydopamine or uptake inhibition with nomifensine) had minimal effects on the cholinergic neurons. In contrast, increasing the endogenous acetylcholine in the preparation by inhibiting acetylcholinesterase resulted in a 1.2 to 12 fold increase in dopamine release depending upon the incubation time and the potassium concentration. These studies indicate that within the neostriatal slices there is minimal influence of the endogenous dopamine on the cholinergic neurons, whereas the extracellular acetylcholine can influence dopamine release when its concentration is increased by inhibition of acetylcholinesterase. PMID- 1787877 TI - Inhibitory actions of muscarinic cholinergic receptor agonists on serotonin N acetyltransferase in bovine pineal explants in culture. AB - We have previously identified muscarinic cholinergic receptors in the bovine pineal gland with a KD value of 0.423 +/- 0.01 nM and a Bmax value of 69.75 +/- 20.91 fmol/mg protein. Similarly, we have shown that the bovine pineal gland possesses a specific choline acetyltransferase with an activity of 0.034 +/- 0.004 nmol/mg protein/min. In order to delineate the function of these cholinergic receptor sites, we have studied the effects of muscarinic cholinergic receptor agonists on the activity of serotonin N-acetyltransferase, the melatonin synthesizing enzyme. Cholinergic receptor agonists such as methacholine (10 microM), carbachol (10 microM), and oxotremorine (10 microM) inhibited the activity of serotonin N-acetyltransferase in the bovine pineal explants in culture, from a control value of 5.02 +/- 0.45 to 1.25 +/- 0.25, 1.30 +/- 0.15, and 1.22 +/- 0.20 pmol/mg protein/min, respectively. These inhibitory effects were blocked by muscarinic cholinergic receptor antagonists such as atropine (20 microM) or QNB (20 microM). The presence of high affinity muscarinic cholinergic binding sites, of a specific choline acetyltransferase, along with an inhibitory action of cholinomimetic agents on the activity of serotonin N-acetyltransferase, are interpreted to suggest that muscarinic cholinergic fibers may modulate the synthesis and actions of pineal melatonin. PMID- 1787878 TI - Calpain-mediated proteolysis of microtubule associated proteins MAP1B and MAP2 in developing brain. AB - Microtubule associated proteins MAP1B and MAP2 are important components of the neuronal cytoskeleton. During early development of the brain, MAP1B (340 kDa) is present as two isoforms that differ in their level of phosphorylation, while MAP2 is expressed as a single high molecular weight isoform (MAP2B, 280 kDa) and a low molecular weight form (MAP2C, 70 kDa). In this study we examined and compared the sensitivities of MAP1B and MAP2, obtained from MT preparations and brain homogenates of young rats, to degradation by calcium-activated neutral protease, calpain II. We found that in MAPs prepared from microtubules the two isoforms of MAP1B had comparable sensitivity to calpain-mediated proteolysis. Similarly, the high and low molecular weight forms of MAP2 were equally sensitive to digestion by calpain. However, although both MAPs were very susceptible to calpain-mediated proteolysis, MAP1B was more resistant to degradation by calpain than MAP2. Furthermore, the endogenous degradation of MAPs in neonate brain homogenates was calcium-dependent and inhibited by leupeptin, and the pattern of degradation products for MAP1B and MAP2 was similar to that of calpain-mediated proteolysis. These data suggest that calpain can play a role in the regulation of MAPs levels during brain development, in relation to normal neuronal differentiation and disorders associated with neurodegeneration. PMID- 1787879 TI - High-affinity [3H]inositol uptake by dissociated brain cells and cultured fibroblasts from fetal mice. AB - The accumulation of [3H]inositol by mechanically dissociated brain cells and cultured skin fibroblasts from fetal mice was examined. Uptake by both tissues was strongly dependent on temperature and the presence of sodium ions. Brain and fibroblast uptake also responded similarly to inhibition by inositol isomers and phloridzin. At lower concentrations of inositol, both tissues exhibited high affinity uptake kinetics with apparent Km values near 30 microM, similar to values observed previously in human fibroblasts and other cultured cells. The activity of brain high-affinity uptake was nearly an order of magnitude lower than that of fibroblasts, however, and was in part confounded by the presence of a low-affinity or simple diffusion system operating at inositol concentrations above 100 microM. Brain preparation from adult mice also showed evidence of high affinity, Na+ dependent uptake, but its activity was significantly diminished relative to that of fetal brain preparations. Our results demonstrate that a high affinity inositol transport system closely resembling that found in cultured cells is expressed in the developing mouse brain. PMID- 1787880 TI - Effects of benzodiazepine receptor antagonist, flumazenil, on antinociceptive and behavioural responses to the elevated plus-maze in mice. AB - Brief exposure to an elevated plus-maze has been shown to induce antinociception in male mice, a reaction that is not attenuated by manipulations of opiate receptors but which is fully blocked by diazepam. The present study examined the effects of the benzodiazepine receptor antagonist, flumazenil (5-20 mg/kg), on behavioural and antinociceptive responses to the elevated plus-maze in male DBA/2 mice. The results showed that, in the absence of an effect on total arm entries or rearing, flumazenil increased the time spent on the closed arms of the maze (an anxiogenic profile) and significantly enhanced antinociception induced by the elevated plus-maze. Data are discussed in relation to an "endogenous ligand theory" and it is concluded that the present findings are consistent with the proposed involvement of anxiety in at least certain forms of adaptive inhibition of pain. PMID- 1787881 TI - Antinociceptive activity of eel calcitonin, injected into the inflamed paw in rats. AB - This study examined the possible peripheral activity of eel calcitonin in the modulation of the response to noxious pressure on inflamed paws in rats (Randall and Selitto test). The intraplantar injection of eel calcitonin (20-200 ng/rat) but not the subcutaneous administration (200 ng and 2 micrograms/rat, s.c.), was able to significantly inhibit hyperalgesia induced by intraplantar injection of carrageenin. The development of oedema on the other hand was not inhibited. The intraplantar administration of eel calcitonin (200 ng/rat) in a non-inflamed paw did not modify paw pressure thresholds. Eel calcitonin (200 ng/rat, intraplantar, i.pl.) was also able to elicit an antinociceptive effect on formalin-induced hyperalgesia, both when the peptide was injected before or after (60 min) formalin. This effect, at difference with morphine (80 micrograms/rat, i.pl.), was not blocked by naloxone (10 micrograms/rat, i.pl.). These results demonstrate the local antinociceptive effect of eel calcitonin in inflammatory pain and might indicate a new way of using calcitonin in the control of pain. PMID- 1787882 TI - Specific binding sites for bifemelane in the hippocampus of the guinea pig, relevant to its pharmacological actions. AB - Bifemelane has an anti-amnesic effect, produces the translocation of protein kinase C in the hippocampal CA3 region but not in CA1 and enhances long-term potentiation in the mossy fibre-CA3 system but not in the Schaffer collateral-CA1 system. The present study examined the specific binding of [3H]bifemelane in membrane preparations of guinea pig hippocampus and regional differences in such a binding. The binding of [3H]bifemelane was reversible and greater when incubated at 4 degrees C than at 25 or 37 degrees C. The binding of [3H]bifemelane appeared to be composed of at least 2 different affinity components. Imipramine significantly suppressed the binding of [3H]bifemelane at 1 microM and, in the presence of 1 microM imipramine, the low-affinity component of the binding of [3H]bifemelane was eliminated. The density of specific binding sites for 1 nM [3H]bifemelane was significantly higher in the hippocampal CA3 region than in the CA1. The specific binding of 1 nM [3H]bifemelane was not inhibited by other nootropic drugs, such as idebenone, calcium hopantenate, vinpocetine, indeloxazine and piracetam. The present results suggest that there are specific binding sites for bifemelane in hippocampus, which are different from those for other nootropic drugs tested and that the regional differences in the pharmacological susceptibilities to bifemelane are at least, in part, attributed to those in the density of binding sites for bifemelane. PMID- 1787883 TI - Effects of lithium and desimipramine on second messenger responses in rat hippocampus: relation to G protein effects. AB - The effects of chronic administration of lithium, short-term administration of lithium, chronic administration of DMI and a combination of short-term administration of lithium and chronic administration of DMI on second messenger responses were studied in the hippocampus of the rat. Lithium reduced the ability of carbachol to inhibit forskolin-stimulated activity of adenylate cyclase in hippocampal membranes but had no effect on carbachol-stimulated formation of inositol phosphate in hippocampal slices. Lithium, however, reduced the degree of stimulation of formation of inositol phosphate, induced by noradrenaline. Desimipramine alone did not affect carbachol- or noradrenaline-mediated reactions and a combination of short-term administration of lithium and chronic administration of DMI did not potentiate the action of lithium on adenylate cyclase. Both lithium and DMI abolished the inhibition by 5-HT of carbachol stimulated formation of inositol phosphate a 5-HT1A receptor-mediated response. It is concluded that the chronic effects of administration of lithium may be related to actions at the G protein level and that different modes of coupling of receptors to G proteins may be responsible for the variety of effects observed. PMID- 1787884 TI - Dextromethorphan and levorphanol on dorsal horn nociceptive neurones in the rat. AB - Intrathecal administration of dextromethorphan and levorphanol and intravenous injection of dextromethorphan were tested on the electrophysiological response of deep multireceptive dorsal horn neurones to peripheral stimuli. Both blockade of C-fibre input to the cells and wind-up, the increase in C-fibre firing with repeated stimulus, were recorded. Intrathecal injection of levorphanol (0.25-100 micrograms) had a typical opioid effect, blocking the C-fibre input. Its affect on wind-up was dose-dependent, paralleled precisely the blocking effect on the C fibre input and both effects were reversed by naloxone. Unlike levorphanol and other opiates, intrathecal administration of dextromethorphan (50-500 micrograms) blocked the C-fibre input and A beta response in parallel and was not reversed by naloxone. Wind-up was reduced by a maximum of 56% at the largest dose tested. Intravenous injection of dextromethorphan (5 mg/kg) also produced a reduction in wind-up but not in the C-fibre response. PMID- 1787885 TI - Regulation of noradrenergic coerulean neuronal firing mediated by 5-HT2 receptors: involvement of the prepositus hypoglossal nucleus. AB - Previous studies have indicated a 5-HT2-mediated inhibitory influence on unit activity in the locus coeruleus. In the present work, attempts were made to determine which area(s) of the brain is (are) involved in this effect: (1) Microiontophoretic application of serotoninergic compounds (quipazine, ketanserin, RU 24969 (Roussel Uclaf), 8-hydroxy-2(di-n-propylamino) tetralin (8 OH-DPAT), metergoline, serotonin) in the locus coeruleus, did not alter the coerulean discharge. Local microinjection of quipazine or ketanserin in the area of the locus coeruleus, as well as in one of its major afferents, the prepositus hypoglossi, had no effect on the unit activity in the locus coeruleus. (2) Section of the forebrain, caudal to the frontal cortex (rich in 5-HT2 receptors), did not modify the effects of coerulean activity of quipazine-ketanserin injected systemically: quipazine induced an inhibition which was reversed by ketanserin. In contrast, these effects were significantly reduced after the bilateral or contralateral lesion of the prepositus hypoglossi. It is concluded that the prepositus hypoglossal nucleus is part of the network responsible for the 5-HT2 mediated control of unit activity in the locus coeruleus. PMID- 1787886 TI - Tetrandrine: a novel calcium channel antagonist inhibits type I calcium channels in neuroblastoma cells. AB - Tetrandrine, an alkaloid isolated from the Chinese herb, Radix stephaniae tetrandrae, has been used clinically as a hypotensive agent for a long time. Recently, several studies have demonstrated that tetrandrine behaves like a calcium entry blocker. In the present investigation, the whole cell version of the patch clamp technique was used to study the effect of tetrandrine on the type I (transient inward) calcium current in neuroblastoma cells. These results showed that tetrandrine inhibited the transient inward current, without affecting the channel kinetics. The effects of tetrandrine were dose-dependent and reversible but did not depend on the frequency of stimulation (use-dependence) or the membrane potential. These data clearly demonstrate that tetrandrine is a novel and potent antagonist of the transient inward current in neuroblastoma cells. PMID- 1787888 TI - The imposition of user part-charges: a U-turn is needed. PMID- 1787887 TI - Pyrethroid insecticides indirectly inhibit GABA-dependent 36Cl- influx in synaptoneurosomes from the trout brain. AB - Rainbow trout (Oncorhynchus mykiss) are extremely sensitive to the neurotoxic activity of pyrethroid insecticides. One possible target for pyrethroids is the GABA(A) receptor of brain of the trout, the function of which can be tested by measurement of influx of 36Cl- into synaptoneurosomes, in response to the application of agonists. gamma-Aminobutyric acid produced a time- and concentration-dependent increase in influx of 36Cl- in synaptoneurosomes from the brain of the trout, which exhibited the pharmacology characteristic of a response mediated by activation of a GABAA receptor. Deltamethrin, (1R alpha S)-cis cypermethrin and permethrin produced a dose-dependent increase in the basal uptake and a corresponding decrease in GABA-dependent influx, with a maximum inhibition of 70-82%. This effect of pyrethroid was stereospecific, of high potency and inhibited by tetrodotoxin (TTX) and t-butylbicyclophosphorothionate (TBPS). The sensitivity of the effect of the pyrethroid to TTX suggested an activation by pyrethroid of the voltage-dependent sodium channel. Veratridine, a sodium channel activator, elicited similar changes in the basal uptake of chloride, which were TTX-sensitive. Neither deltamethrin nor veratridine had a measurable effect on the efflux of 36Cl- from synaptoneurosomes. Thus, pyrethroid insecticides may interfere with the function of GABAA receptors indirectly through an interaction with the voltage-dependent sodium channel in the brain of the trout and consequently perturb chloride influx, possibly through a voltage dependent chloride channel. PMID- 1787889 TI - A survey of nurses views on the latest health service 'reforms'. AB - A small survey was carried out to measure nurses views on the latest changes planned by the Government for the health service. Data were collected by questionnaire from a small convenience sample of nurses from throughout New Zealand. The majority of respondents indicated that they oppose the changes overall. All key aspects of the latest reforms are opposed by a clear majority. However, the survey had a number of limitations; in particular a very low return rate. PMID- 1787890 TI - [Botallo's duct with pulmonary hypertension in the adult]. AB - A patent ductus arteriosus in adults is a rare eventuality. After correct diagnosis, an accurate evaluation of pulmonary vascular resistances is necessary with, in case of normality, a straightforward indication to surgery, because the evolution of the disease cannot be predicted. In case of pulmonary hypertension irreversible pulmonary vascular damage must be excluded. Haemodynamic data such as pressures, flows and resistance ratios are not reliable. According to the majority of Authors the value of pulmonary resistances seems to be more accurate, and when more then 8 u/m2 an histological specimen must be obtained. In our experience a comparative study between the Health and Edwards method and the Yamaki et al., one shows, confirmed by postoperative follow-up, a greater reliability of the second one. PMID- 1787891 TI - [Peroperative blood autotransfusion in heart surgery]. AB - A drastic reduction in homologous blood or plasma transfusion becomes necessary to prevent the risks of severe infections disease transmission. The authors studied the possibility of homologous blood save in cardiac surgery by peroperative autotransfusion. This procedure, although it diminished the average blood bank requirements, above all for an unexplained decrease in postoperative bleeding, did not obtain the good results that other authors had with the technique of 2 or 3 preoperative withdrawal, storage and postoperative reinfusion. In future our trend is to associate preoperative and intraoperative withdrawals to take advantage of both techniques. PMID- 1787892 TI - [The early ergometric test after myocardial revascularization]. AB - Ergometric tests (ET) were used to study 900 patients undergoing surgical myocardial revascularisation during the period between January 1983 and December 1989. ET was carried out without medical therapy between the 30th and 35th day post surgery. The test was positive in 193 subjects (21%); in 42 of the latter (5% of the total and 229 of positive subjects) symptoms of effort angina were found to persist. ET was negative in 557 patients (62%); 150 subjects (17%), although not positive, did not attain a sufficient heart rate to enable a 100% negative diagnosis to be made. No major complication was observed. Maximal short term ET is a reliable and safe test for checking the efficacy of myocardial revascularisation and to assess functional recovery. In view of the relatively high percentage of positive tests due to ischemia but with the complete absence of symptoms, the authors affirm that the mere onset of anginous symptoms alone cannot be considered indicative of the success of cardiosurgery. PMID- 1787893 TI - [Angiocardioscintigraphy in the cardiological surveillance of chemotherapy with anthracyclines]. AB - Equilibrium angiocardioscintigraphy is a noninvasive nuclear medical method which allows cardiac function to be assessed. It is widely used in oncology since some clinically important drugs used in antitumor chemotherapy have a marked cardiotoxic effect. Angiocardioscintigraphy enables several parameters characteristic of cardiac function to be assessed, namely the left ventricular ejection fraction whose alterations during chemotherapy allow possible cardiotoxic side effects to be revealed before the development of irreversible heart failure. PMID- 1787894 TI - [A controlled clinical experiment "within subjects" with heparan sulfate in intermittent claudication]. AB - An experimental clinical trial was carried out using heparan sulphate in order to assess its antithrombophilic, profibrinolytic and possibly hemorheological characteristics. Twenty patients with stage 2 obliterating arteriopathy of the lower limbs were enrolled in the study. Patients were fully informed regarding the experimental protocol: a controlled, crossover and double-blind study. The population sample included 20 subjects, male and female, mean age 60.9 years who received heparan sulphate at a dose of 200 mg/die (one 100 mg tablet twice a day): treatment continued for 120 days (60 days of treatment with heparan sulphate and 60 days with placebo). The results obtained were in favour of medical therapy which was significantly more effective than placebo in relation to a number of parameters: compared to basal values, walking parameters were improved, recovery times were more rapid and gait was longer. Significant changes in hemocoagulative and hemorheological parameters were also observed (euglobulin lysis time, fibrin degradation products, erythrocytic filtration, hematic viscosity) and their positive trend may account for peripheral hematic perfusion, as shown by photoplethysmographic tests, velocimetric tests and the modification of the Windsor index. Therapeutic efficacy and the good tolerance (one case of gastralgia, two of pyrosis) as well as broad safety margins offered by the drug justify the use of heparan sulphate in all clinical conditions characterized by thrombophilia and local ischemia, above all those which require long-term treatment. PMID- 1787895 TI - [The physiopathology of dual-chamber cardiac stimulation. Apropos a case with a dual-chamber pacemaker, left atrial standstill and heart decompensation]. AB - The paper describes the clinical case of an elderly patient with heart failure, the possessor of a dual-chamber pacemaker programmed in DDD mode, in whom a complete interatrial block with left atrial standstill was diagnosed. The authors discuss the physiopathological aspect of the case which is a paradigmatic example of the problems related to dual-chamber pacing. In particular, the utility of an echo-Doppler assessment of the mechanical activity of the atria is emphasized together with a careful choice of the optimal atrioventricular delay in programming and the follow-up of dual-chamber pacing. PMID- 1787896 TI - Utilization of the greater omentum in surgery: a historical review. AB - Up to our century, the surgical approach to the greater omentum was mainly confined to resectional techniques of the prolapsed organ following abdominal injuries. The present contribution highlights the early searches for the nature of the greater omentum in the discovery of an organ which has for so long been disregarded, but now attracts increasing consideration as useful plastic material in surgery. This structure, used at various sites of the body to repair defects and provide blood supply, also opened new clinical and experimental fields of both surgical and immunological aspects. PMID- 1787897 TI - The greater omentum: physiology and immunological concepts. AB - In surgery, the omentum is used as a very potent tissue in wound healing. This suggests, besides a good vascularization pattern, an important immunological function in which milky spots might be involved. Therefore, we investigated the characteristics of the milky spots in the omentum of an animal model after several immunization procedures. Our results showed that milky spots must be regarded as strongly reactive structures originating from perivascular effusions in the omentum. Moreover, milky spots can firstly be a local source of potent immune effector cells i.e. peritoneal macrophages and secondly can, after specific immunization, be qualified as a lymphoid organ that is, produce a specific (lymphocyte) mediated response. This may shed new light on the reason why the omentum works so well in wound healing. PMID- 1787898 TI - The pedicled omentoplasty: technical aspects in reconstructive and protective surgery. AB - A pedicled omentoplasty is a simple and safe method to reconstruct soft-tissue defects. A pedicled omentoplasty can also be used as an adjuvant surgical procedure in preventing anastomotic leakage and radiation damage. The way a pedicled omentoplasty should be performed is described in detail with special attention to transposing techniques. PMID- 1787899 TI - The role of the greater omentum in intrathoracic transposition. AB - This review shows that the application of pedicled omental flaps or gastro omental grafts with microvascular connection to the recipient is a reliable and safe means of reconstructing and protecting esophageal, pharyngeal and soft tissue defects and in problems related to sepsis. It has shown its usefulness in those patients who had high-dose radiation with tissue damage, in whom reconstruction otherwise would have required multiple stages or multiple flaps, or in whom other reconstructive options have failed. With the increasing use of radio- and chemotherapy as the treatment for various types of cancer, surgeons and radiotherapists are required to cope with the complications of this therapy. They should become familiar with the usefulness of the omentum in difficult problems. Despite the fact that omental transposition is usually undertaken in risky situations and in patients with poor health conditions, this technique is associated with a remarkably low morbidity and mortality. PMID- 1787900 TI - Transposition of the greater omentum in the prevention and treatment of radiation injury. AB - The greater omentum provides a tissue flap that can readily be transposed for surgical reconstruction both inside and outside the abdominal cavity. To prevent radiation enteritis, an omental sling or envelope can be constructed at the end of an abdominal operation to displace small bowel from the pelvis prior to radiotherapy. The immunological and angiogenic properties of the omentum are particularly useful when reconstruction is required in a region of late radiation injury. Indications for omental transposition in this context include reinforcement of anastomoses, pelvic fistula repair, chest wall and axillary reconstruction, vascular cover, pharyngostoma, bronchopleural fistula and possibly lymphoedema. PMID- 1787901 TI - Revascularised omentum in microvascular surgery. AB - The clinical use of microvascular surgery has developed considerably. Transplantation of skin, muscle, musculocutaneous island flaps, bone or osteocutaneous island flaps are possible for different reconstructive problems. These make the indication for revascularised omentum limited. A short review of the possible indications of revascularised omentum transplants and its complications is given. PMID- 1787902 TI - Complications of the pedicled omentoplasty. AB - A total of 74 patients, additionally treated with a pedicled omentoplasty, were studied retrospectively with regard to the complications. The pedicled omentoplasty was used extra- or intra-abdominally to reconstruct large soft tissue defects, to treat radiation necrosis or to prevent radiation enteritis. Gastro-intestinal complaints were seen in six patients, three developed an ileus and needed a relaparotomy, one patient had herniation of the stomach through a diaphragm defect. Total necrosis of the omental flap was seen in two patients and infection in seven patients with an extra-abdominally used omentoplasty. An abscess in the pelvic cavity occurred five times in an intra-abdominally placed omentoplasty. In seven patients, an operative correction of an incisional hernia was necessary. One patient died of massive pulmonary embolism. This study indicates that the pedicled omentoplasty is a safe procedure and is associated with a moderate number of postoperative complications, which can be reduced if the right surgical technique is used. PMID- 1787903 TI - Aorto-caval fistula after lumbo-sacral disk surgery. AB - A patient with an aorta-caval fistula after intervertebral disk surgery is presented. Deterioration of the condition of the patient, mainly due to a progressive congestive heart failure, was caused by a large aorto-caval fistula; emergency repair of the lesion led to complete recovery. Because of delay in diagnosis, this insidious complication generally causes serious cardiopulmonary disturbances with a high morbidity and a significant mortality. The surgical treatment consists of the reconstruction of the greater veins and arteries involved. PMID- 1787904 TI - Malpositioning of subclavian vein catheters in left and right sided attempts: a prospective study. AB - The purpose of the study performed between 1987 and 1989 was to prospectively collect and analyse the mechanical complications, especially malpositioning in right-sided and left-sided attempts of catheterization of the infraclavicular subclavian vein. The subclavian vein was catheterized in 100 right-sided and 100 left-sided attempts. Catheterisation failed in 24 cases. The success rate on the right side was 84.7 per cent and on the left side 94.3 per cent. The rate of malpositioning in right-sided attempts (23%) was significantly higher than in left-sided attempts (4%) [p less than 0.001]. Minor and major mechanical complications, other than malpositioning, were also more frequent in right attempts (14.4%) than in left-sided attempts (5.6%) [p less than 0.05]. Malpositioning of central venous catheters may lead to serious complications including intravascular knotting, rupture of the heart and great vessels, incorrect central venous pressure readings and thrombosis due to delivery of hyperosmolar solutions. Based on our results a left-sided approach should be preferred in infraclavicular subclavian vein catheterization unless specific contra-indications exist. PMID- 1787905 TI - Carcinoma of the duodenum after trauma, radiotherapy and chemotherapy. AB - The case history is reported of a patient with a carcinoma of the duodenum 30 years after blunt abdominal trauma at the site of the 'scar' in the duodenum. Thirteen years after the trauma the patient was treated with chemotherapy and abdominal irradiation for a relapse of Hodgkin's disease. At follow-up, 25 months after the operation, he had no local recurrence of Hodgkin's disease or duodenal cancer. The possible relation between the cancer and the abdominal trauma, chemotherapy and abdominal irradiation is discussed. PMID- 1787906 TI - Fournier's gangrene: the need for early recognition and radical surgical debridement. AB - Fournier's gangrene, a specific form of necrotizing fasciitis, predominantly affects the male genitals, perineum and perianal region. Most frequently Fournier's gangrene is caused by the synergistic action of aerobic and anaerobic microorganisms and leads to early septicaemia with a high mortality. The case histories of three patients with Fournier's gangrene are presented to illustrate the importance of early recognition and radical surgical debridement as essential objectives for therapeutic success. In the first patient, who died of Fournier's gangrene after a vasectomy, appropriate therapy was significantly delayed due to late recognition of the condition. The second patient presented with a rapidly progressive fasciitis secondary to a perianal abscess; immediate excision of all necrotic tissue was successfully performed. The third patient developed gangrene from an urogenital infectious focus, which was primarily treated by insufficient incisional and drainage therapy. Only after radical debridement his general condition rapidly improved. PMID- 1787907 TI - A rare combination of fractures of the upper extremities: a diagnostic problem. AB - The rare case is reported of fractures concurrently of the bilateral proximal radius and the right proximal carpal row. Initial radiographs of the patient showed only fractures in the bilateral proximal radius and the right triquetral bone. In addition, the bone scan showed focal increased uptake in the right scaphoid bone and lunate bone as well, suggesting fractures. Fractures of the entire right proximal row were confirmed by computer tomography. The patient received functional treatment for the elbows and had a scaphoid plaster-of-Paris cast for the wrist. This resulted in a complete recovery after one year. PMID- 1787908 TI - A future role for loop ileostomy in colorectal surgery? AB - Thirty patients underwent a defunctioning loop ileostomy. Elective ileostomy was performed in 23 patients to protect a potentially vulnerable colorectal anastomosis and in one patient as a permanent faecal diversion for colonic atony. Six emergency loop ileostomies were performed; in four patients after colonic perforations and in two patients as a primary treatment secondary to colonic anastomotic leakage. Peri-operatively, none of the patients with an elective operation died. Four patients with an emergency operation, however, all died of irreversible peritoneal sepsis. Complications were a diversion colitis and an abdominal sepsis after anastomotic leakage in a second patient who required a re operation. During follow-up (up to four years) one patient suffered from an episode of severe dehydration six months after operation. The ileal continuity was, without mortality, restored in 23 patients. Two patients had a wound infection with, in one of them, a late cicatricial hernia. In our experience, a defunctioning loop ileostomy is a relatively safe procedure and is, in our opinion, preferable to loop colostomy for temporary faecal diversion. The high mortality following emergency loop ileostomy reflects the bad prognosis of these patients and indicates the need for resection of the primary disease. PMID- 1787909 TI - Rupture of the distal tendon of the biceps brachii muscle. AB - Rupture of the distal tendon of the biceps brachii muscle is easy to diagnose. For functional and cosmetic reasons the tendon to the radial tuberosity should be re-inserted. Two patients had early treatment, and one was operated upon after four weeks, all three with a good result. After treatment consisted of immobilization in a plaster cast with the arm in flexion and full supination for four weeks. Physical therapy is recommended. Complete functional repair and full recovery of strength can be expected in most cases. PMID- 1787910 TI - Avulsion of profundus tendon insertion with a large bony fragment: misdiagnosis and delayed treatment. PMID- 1787911 TI - Ischaemic colitis after ruptured abdominal aortic aneurysm repair. PMID- 1787912 TI - Distribution of angiotensin II receptor subtypes in rat brain nuclei. AB - Angiotensin II (ANG II) receptor subtypes in rat brain were characterized and quantified by competitive radioligand binding using [125I]Sar1 Ile8 angiotensin II ([125I]sarilesin) as a tracer and ANG II, sarilesin and the subtype selective ligands DuP 753 (AT1) and CGP 42112A (AT2) as competitors. The distribution of AT1 and AT2 receptors was determined in midbrain, brainstem, hypothalamus as well as in individual hypothalamic and periventricular nuclei. Whereas in midbrain and brainstem the AT1: AT2 ratio was 40%: 60% and 70%: 30% respectively, the AT1 receptors were by far predominant in hypothalamus and in the nuclei investigated. Interestingly, we found that approximately 25% of the ANG II receptors in hypothalamus did not bind DuP 753 even at 0.1 mM. These sites which bind CGP 42112A, ANG II and sarilesin may represent a third ANG II receptor subtype. PMID- 1787913 TI - The significance of 3-O-methyldopa concentrations in the cerebrospinal fluid in the pathogenesis of wearing-off phenomenon in Parkinson's disease. AB - We determined concentrations of 3-O-methyldopa (3-OMD), L-3,4 dihydroxyphenylalanine (L-dopa), dopamine (DA) and other related substances in the cerebrospinal fluid in patients with Parkinson's disease (PD) 15 h after L dopa/carbidopa medication, and compared patients with and without the wearing-off phenomenon. Concentrations of 3-OMD significantly increased, and the ratio of DA to 3-OMD was significantly shifted in favor of 3-OMD in patients with the wearing off compared with patients without the wearing-off. However, concentrations of L dopa, DA, and homovanillic acid (HVA) were not different between the groups. These results suggest that even if 3-OMD is related to the pathogenesis of the wearing-off, it is not through competition with L-dopa for uptake into the brain, but through other unknown mechanisms within the brain. PMID- 1787914 TI - IgG from neuropeptide FF antiserum reverses morphine tolerance in the rat. AB - Previous studies suggest that neuropeptide FF (NPFF) plays a role in opiate dependence and subsequent abstinence syndrome. The present study assessed the role of NPFF in opiate tolerance. Third ventricular injection of IgG from NPFF antiserum restored the analgesic response to i.c.v. morphine in morphine-tolerant rats (radiant heat tail flick test). IgG from control serum failed to produce this effect. In opiate-naive rats, however, the same treatment with IgG from NPFF antiserum did not affect the analgesic response to i.c.v. morphine. Thus, immunoneutralization of NPFF appears to selectively restore morphine sensitivity in opiate-tolerant animals. These results support the hypothesis that endogenous NPFF contributes to opiate tolerance. PMID- 1787915 TI - Topography of C1 nerve- and trigeminal-evoked potentials in the ventrobasal complex of the cat thalamus. AB - In order to provide information pertaining to the C1 nerve representation in the thalamus, C1 nerve- and trigeminal-evoked potentials were recorded throughout the ventrobasal complex of the cat thalamus. Contralateral electrical stimulation of the C1 nerve and maxillary division of the trigeminal nerve elicited multiphasic positive-to-negative responses with mean maximum positive peak latencies of 2.2 ms and 2.7 ms, respectively. Ipsilateral stimulation failed to elicit a thalamic response. Construction of isopotential contour maps revealed that the foci of activity elicited by contralateral C1 nerve and trigeminal stimulation were located in the dorsolateral and ventromedial sections of ventroposterior medial nucleus (VPM), respectively. PMID- 1787916 TI - The actions of a conformationally restricted analogue of aspartic acid on mammalian spinal neurones. AB - The effects of the 4 stereoisomers of 1-aminocyclopentane-1,2-dicarboxylic acid (CPA), a conformationally restricted analogue of aspartic acid, have been examined on spinal dorsal horn neurones of the rat in vivo. Unlike the corresponding 1,3-dicarboxylate compounds which are glutamate analogues and markedly excitatory, the CPA isomers had no evident excitatory actions of their own. Three were weak and non-specific antagonists of other amino acid-induced excitations, while the (+)-trans isomer had a slight potentiating effect. PMID- 1787918 TI - Nitric oxide influences ventrolateral medullary mechanisms of vasomotor control in the cat. AB - In acute experiments on cats changes in the background sympathetic activity in the renal nerve, chosen as a model of vaso-constrictor nerve, together with arterial pressure shifts have been found following injections of nitric oxide (NO) containing drugs into the ventrolateral medulla. This is the first report of evidence that both sodium nitroprusside, which produces NO spontaneously and thus mimics endothelium-derived relaxing factor (EDRF), and L-arginine, being a precursor for NO, as well as L-NG-monomethyl-L-arginine (L-NMMA) which inhibits synthesis of NO, induce remarkable changes in the background activity of the renal nerve and systemic arterial pressure (SAP) level shifts, following unilateral injections of drugs examined into the rostral (RVLM) and caudal (CVLM) ventrolateral medulla. These sites are essential for the maintenance of arterial pressure level and vascular tone control. Injections of NO-containing drugs in the RVLM induce attenuation of the renal nerve sympathetic activity and lower the SAP level, while injections in the CVLM reverse these effects. After previous application of Methylene blue on the ventral medullary surface we failed to induce any of the effects following NO injections in the sites examined. Our results raise the possibility that NO influences mechanisms of the neurogenic vasomotor control, realized by neurons within the RVLM and the CVLM via activation of the guanylate cyclase. PMID- 1787917 TI - Effect of aromatic amino acids, pentylenetetrazole and yohimbine on isatin and tribulin activity in rat brain. AB - The effects of i.p. injection of 3 aromatic amino acids and two anxiogenic agents on rat brain isatin concentration and tribulin (endogenous monoamine oxidase inhibitor) activity were investigated. Isatin levels were significantly increased by pentylenetetrazole, confirming the link with 'anxiety', but were unaffected by the other compounds. In contrast, tribulin activity was significantly increased by phenylalanine and tryptophan as well as by both pentylenetetrazole and yohimbine. Whilst these findings shed no light on the mode of synthesis of isatin, they clearly demonstrate the existence of rat brain monoamine oxidase inhibitory activity that is different from it. PMID- 1787919 TI - Protein kinase C beta-subtype-immunoreactive motor and sensory nerves in rat muscle spindle. AB - The localization of protein kinase C beta-subtype-like immunoreactivity (PKC-beta LI) was studied in the muscle spindles of rat neck muscles. In the equatorial regions of muscle spindles PKC-beta-LI was detected in spiral sensory nerve endings surrounding intrafusal muscle fibers. In polar regions single PKC-beta immunoreactive (IR) nerve fibers were found between intrafusal muscle fibers and some PKC-beta-IR motor nerve endings were seen on the surface of intrafusal fibers. These results suggest that PKC-beta may be involved in regulation of muscle contraction and tonus by modulating the sensitivity of afferent and efferent innervation of muscle spindles. PMID- 1787920 TI - Increasing neuron numbers in the vasopressin and oxytocin containing nucleus of the adult female pig hypothalamus. AB - Neuron number and volume of the recently described vasopressin and oxytocin containing nucleus (VON) in the pig hypothalamus have been studied into adulthood. Following a 2.5-fold increase in both sexes around puberty, both neuron number and volume of the VON continued to increase in the female pig between 1 and 2.5 years of age. Since no such increase occurred in the male, the VON exhibits a pronounced sexual dimorphism in adulthood of 260%. PMID- 1787921 TI - Terpenoid phytoalexins. PMID- 1787922 TI - Withanolides and related ergostane-type steroids. PMID- 1787923 TI - [A medication error: not banal]. PMID- 1787924 TI - [Perinatology in Quebec: where are we?]. PMID- 1787925 TI - [The "lead crisis" in Saint-Jean-sur-Richelieu. The major role of nurses in ecological crises]. PMID- 1787926 TI - [Denise Gregoire, the good genie of rehabilitation care]. PMID- 1787927 TI - [Screening of breast cancer: profile of women]. PMID- 1787928 TI - [Mass screening of neuroblastoma]. PMID- 1787929 TI - The Cote reform. Is there still room for hope? PMID- 1787930 TI - [Self help groups in psychiatry: a valuable support for the group]. PMID- 1787931 TI - [The nurse clinician: a luxury or a necessity?]. PMID- 1787932 TI - The damaging effects of regulation and deregulation. PMID- 1787933 TI - Peripheral light focusing by the anterior eye and the ophthalmohelioses. AB - Peripheral focusing of light by the anterior eye may provide a unifying concept to explain the location and etiology of sun-related eye conditions (ophthalmohelioses). Using a bovine eye model, along with computer-assisted ray tracing techniques to model limbal focusing, we demonstrated a correlation between the locations of the foci of scattered incident light (resulting in a 20 fold concentration of light at the limbus) and the usual locations of pterygium and cortical cataract. These findings suggest the need for improved ocular protective devices, particularly ones that provide lateral protection of the eye against the increased ultraviolet insolation resulting from thinning of the ozone layer. PMID- 1787934 TI - Cortex at the 12 o'clock position and the role of peripheral iris opening. AB - Performing a peripheral iridectomy is a safe and effective means of atraumatically removing cortex at the 12 o'clock position. It prevents pupillary block as well as adhesions between the iris and capsule. Also, it serves to position the anterior capsular flap and the superior edge of the intraocular lens. PMID- 1787935 TI - Lamellar corneal autograft for corneal perforation. AB - A corneal perforation developed in the right eye of a 46-year-old man after removal of a corneal foreign body. Two attempts to seal the perforation with cyanoacrylate glue failed. The patient subsequently underwent lamellar corneal autograft, which successfully closed the perforation. To the best of our knowledge, this is the first report of repairing a corneal perforation with lamellar corneal autograft. PMID- 1787936 TI - Tissue plasminogen activator modifies healing of glaucoma filtering surgery in rabbits. AB - The healing response after glaucoma filtering surgery was analyzed immunohistochemically in rabbit eyes that had been treated with tissue plasminogen activator immediately after surgery and in the fellow eyes that had not been so treated. In the untreated eyes, at 1 day after surgery, fibronectin like immunoreactivity was seen in the scleral fistula tract but not in the subconjunctival space of the filtering bleb. At 3 days immunoreactivity for fibronectin, collagen III, and collagen I could be seen in the bleb and fistula tract. By 14 days staining for collagen I and collagen III filled the surgical site, but fibronectin could only be seen in the fistula tract. In the eyes treated with tissue plasminogen activator immediately after surgery, the deposition of fibronectin and collagen III in the subconjunctival space and fistula tract was apparently delayed and diminished. This delayed and reduced deposition was correlated with the delayed clinical failure of surgery in these eyes. These results suggest that alteration of the biochemical changes in the extracellular matrix occurring after filtering surgery may influence the success of this surgery. PMID- 1787937 TI - The effects of postoperative corticosteroids on trabeculectomy and the clinical course of glaucoma: five-year follow-up study. AB - A randomized, prospective study on 68 eyes of 54 patients with progressive, uncontrolled, noninflammatory open-angle glaucoma showed that eyes that received topical prednisolone 1% had a lower intraocular pressure (IOP) 18 months following trabeculectomy than the eyes that received no prednisolone. The addition of systemic prednisone had no definite further effect. In the present study, we reevealuated 58 eyes of 45 of these patients 5 years after the time of initial surgery. The number of cases lost to follow up was similar in the steroid and the nonsteroid-treated groups. Mean IOP of the steroid-treated patients was 14.5 +/- 1.8 mm Hg, and of the nonsteroid-treated patients, 19.3 +/- 2.1 mm Hg. Visual field, optic disc, and IOP were stabilized in 94% of the steroid-treated cases and in 43% of the nonsteroid-treated cases. Thus, postoperative steroids significantly increased the success rate of trabeculectomy in these eyes, and the eyes with lower IOPs had a significantly better prognosis than those with higher IOPs. PMID- 1787938 TI - Modified vitrectomy for impending macular holes. AB - We report a consecutive series of 13 eyes (11 patients) treated with pars plana vitrectomy, in which surgical manipulation of the prefoveal layer of cortical vitreous was avoided, for stage I (eight eyes) and stage II (five eyes) macular hole formation. Average follow up was 8.1 months (range, 2 to 13 months). There was no significant improvement in vision in the patients with stage II macular holes; however, vision in these patients stabilized and did not fall below 20/400. Visual acuity improved in seven of the eight patients with stage I holes. The results for both these groups achieved by our modified vitrectomy, which is relatively easy to perform and involves minimal intraoperative manipulation of the fovea, are consistent with those obtained by methods involving more aggressive cortical vitreous stripping of the fovea. PMID- 1787939 TI - Retinal tolerance of an implantable light source for use during vitrectomy surgery. AB - To assess for the possible development of a phototoxic lesion, we exposed five Dutch belted rabbit retinas to constant illumination with an implantable "chandelier" light source at maximal intensity for 1 hour. No clinically apparent lesion developed in any of the experimentally treated eyes by 48 to 72 hours posttreatment. Light and electron microscopic examination failed to reveal any of the characteristic changes of retinal phototoxicity. A control eye treated with a 20-minute exposure to a standard endoiluminator probe at maximal intensity held 2 mm from the retinal surface demonstrated typical light and electron microscopic phototoxic abnormalities, whereas a retina similarly treated with a 5-minute exposure was normal. We have confirmed that a standard endoilluminator probe can create a phototoxic lesion in the experimental setting. Furthermore, no phototoxicity from the sustained retinal exposure to a fixed, implantable light source for a clinically relevant duration could be demonstrated. PMID- 1787940 TI - Intravitreal U75412E: a new free radical scavenger. AB - Free-radical-mediated tissue damage is thought to be involved in a multitude of ophthalmic pathologies. Therefore, drugs that scavenge free radicals may find wide clinical application. A new chemical class of antiinflammatory agents, the 21-aminosteroids, has been developed as free radical scavengers. These agents are thought to inhibit lipid peroxidation and prevent the release of free arachidonic acid from injured cell membranes. In the present study, we investigated the intraocular toxicity of one of the 21-aminosteroids, U75412E. Intravitreal doses of up to 0.1 mg of U75412E were nontoxic to rabbit ocular tissues. PMID- 1787941 TI - Surface reaction on silicone tubes used in the treatment of nasolacrimal drainage system obstruction. AB - Silicone tubes removed from patients who underwent intubation of the nasolacrimal system for acquired or congenital obstruction were studied to determine the cellular reaction on the tubes and to assess the relationship between the length of intubation and the cellular response. Twenty-one tubes were available for analysis. Length of intubation varied from 39 to 415 days; patient ages varied from 10 months to 75 years. All patients had undergone dacryocystorhinostomy or closed intubation of the nasolacrimal system. No patient had clinical signs of infection at the time of tube removal. All tubes were mounted on glass slides and stained with hematoxylin and eosin. The reactions seen, together with the location and type of cells present, were graded by a masked observer. There were varying numbers of inflammatory cells, predominantly polymorphonuclear leukocytes. As the length of intubation increased, the number of inflammatory cells also increased. The proximal portion of the tubing showed the least amount of cellular reaction at all lengths of intubation. PMID- 1787942 TI - Paralimbal compression suture for Molteno implants. AB - When a Molteno implant is being inserted, the silicone tube occasionally can be misdirected anteriorly, bringing the end of the tube dangerously close to the corneal endothelium. A paralimbal compression suture of 8-0 nylon may redirect the tube more posteriorly, preventing such contact. PMID- 1787943 TI - Balloon catheter dilatation in pediatric patients. AB - Balloon catheter dilatation was performed in five children with nasolacrimal duct obstruction who had failed probing or silicone intubation, or who were 6 years of age or older. A patent lacrimal system was achieved in four of these children. Balloon catheter dilatation may offer an alternative to silicone intubation in children with nasolacrimal duct obstruction who fail probing or who are at least 2 years old. PMID- 1787944 TI - Descemet's membrane detachment treated by penetrating keratoplasty. PMID- 1787945 TI - Systemic absorption of chloramphenicol following ophthalmic use: a cautionary tale. PMID- 1787946 TI - Lacrimal obstruction after medial maxillectomy. AB - Medial maxillectomy can result in lacrimal obstruction and the need for subsequent dacryocystorhinostomy. Computed tomographic dacryocystography is a technique in which radiopaque dye is instilled in the lacrimal sac and computed tomography is subsequently performed. Computed tomographic dacryocystography facilitated the management of a patient with lacrimal obstruction after medial maxillectomy by helping to exclude recurrent tumor and sinusitis, and by providing a surgical "roadmap" in the presence of altered anatomy. PMID- 1787947 TI - A new test for the evaluation of disability glare. AB - We describe a new glare test that uses low contrast letters and a variable surround glare source. The test is easy to administer clinically and all test targets, luminance levels, glare geometry, and viewing conditions are well controlled. We found the most useful index of disability glare to be the difference in visual acuity scores for the low contrast chart in the no-glare and high-glare conditions and refer to this as the disability glare index (DGI). We tested a group of normal subjects who were divided into younger (age 15 to 41 years) and older (age 50 to 82 years) groups. The mean DGI value for the older group (10.2 +/- 4.8) was significantly higher than that for the younger group (2.3 +/- 1.9). The DGI is a better discriminator between the two groups than either high or low contrast visual acuity. We attribute the significantly higher DGI values in the older group to increased intraocular light scatter. We find DGI is poorly correlated with high contrast visual acuity (r = 0.33). Our findings suggest that this test of disability glare is sensitive to relatively modest changes in the ocular media. It is a potentially useful tool in detection and assessment of subtle media disturbances and in monitoring changes in the ocular media over a period of time. PMID- 1787948 TI - Preliminary examination of the reliability and relation to clinical state of a measure of low vision patient functional status. AB - An evaluation of the reliability and relation to clinical state of a measure of low vision patient functional status was conducted. The measure included discrete tasks aggregated into three different areas: identifying objects, reading, and daily/leisure activities. Data were obtained retrospectively from case records of 247 low vision patients and 144 complete cases were used for statistical analyses. Evidence of reliability was found with coefficient alpha scores for the three areas ranging from 0.90 to 0.96. Significant relations between functional status and clinical states (acuity, contrast sensitivity, and visual field) were found with R2 values ranging from 0.39 to 0.58, p less than 0.001. PMID- 1787949 TI - Visual performance at video display terminals--effects of screen color and illuminant type. AB - A limited set of illuminants and phosphor colors are commonly used in video display terminal (VDT) working environments. This study attempts to identify any combinations of such conditions that influence performance on a visually demanding counting task. Experiments were performed to test whether the phosphor color, ambient lighting spectrum, or temporal frequency characteristics of the display and ambient lighting could alter performance. Under conditions where potentially contaminating variables such as reflectance level and screen glare patterns were equalized, no significant differences in performance were produced by the particular sets of stimulus conditions tested. The results suggest that displays and illuminant types that are in common use allow substantially equivalent visual performance. PMID- 1787950 TI - Effects of long-term visual display terminal usage on visual functions. AB - Since their rapid introduction into the workplace visual display terminals (VDT's) have been the source of a number of studies aimed at detecting effects on office workers. The published studies have been either short-term or cross sectional, with one exception. The results have shown varying degrees of relation but by not having a comparable control group all have been limited in their value. We set out to monitor at regular intervals over a 2-year period specific visual functions that have been reported to be affected by VDT usage, and to compare VDT and non-VDT users in the same office environment. By assessing the VDT operators from the time the systems were introduced we have an accurate baseline to work from when assessing change due to the introduction of the VDT. PMID- 1787951 TI - Quantification of metamorphopsia using hyperacuity techniques. AB - We have developed a new technique for quantification of metamorphopsia using a simplified and modified Amsler grid. Furthermore, the technique used is a bisection task, a form of hyperacuity determination. This allows for very fine assessments of metamorphopsia even in the presence of cataracts. PMID- 1787952 TI - Reliability and validity of videokeratoscopic measurements. AB - When a test surface or a cornea is carefully and properly positioned with respect to the Corneal Modeling System (CMS) videokeratoscope, measurements are highly repeatable, but the accuracy of the measurements is dependent on the shape of the surface. For spherical and toroidal surfaces, the CMS provides suitably accurate descriptions of the topography of the surface. For aspheric surfaces the CMS renders less accurate, but still clinically acceptable, topographic descriptions. PMID- 1787953 TI - Ellipsoidal confidence regions for mean refractive status. AB - Confidence regions for mean dioptric power can be represented by ellipsoids in a three-dimensional space called h-space. A convenient graphical representation is provided by stereo-pair drawings that, at a glance, show the estimated accuracy with which the mean power is known. As an example, a sample of autorefractor measurements made on one eye were used to construct a 95% confidence ellipsoid for the mean objective refractive status of that eye. Key dimensions of the ellipsoid are compared with those of another eye. The analysis is of fundamental importance for scientific studies of variation and change of refractive status. Its potential clinical importance is also discussed. PMID- 1787955 TI - Effect of iris displacement on oblique astigmatism in aphakic eyes. AB - Aphakic eyes possess considerably less oblique astigmatism than phakic eyes. The possibility that posterior iris displacement after lens extraction accounts for the observed reduction in oblique astigmatism is tested in this study. Oblique astigmatism was calculated for a phakic and an aphakic schematic eye. With no iris displacement little reduction of oblique astigmatism occurred contrary to experimental findings. However, introduction of varying levels of iris displacement reduced this aberration to values found experimentally. Posterior iris displacement (mean = 1.19 mm) was confirmed in vivo by pre- and postoperative anterior chamber pachometry in eight patients. PMID- 1787954 TI - Sympathetic denervation of the iris dilator in noninsulin-dependent diabetes. AB - Twenty-three subjects with noninsulin-dependent diabetes mellitus (NIDDM) and 23 age- and sex-matched controls were tested for sympathetic denervation of the iris dilator by comparing the mydriatic effect of the combination of 1% phenylephrine and 1% tropicamide with that of 1% tropicamide alone. Most of the diabetic subjects had no clinical signs of severe diabetic complications. Nine diabetics and two controls showed sympathetic denervation, defined as a 1 mm or greater dilation due the addition of 1% phenylephrine. One of those two controls had a recent history of vascular headache. The diabetics with pupillary neuropathy had higher glycosylated hemoglobin percentages and a history of higher fasting blood sugars (FBS's) than the diabetics with normal pupils. Our results show that pupillary neuropathy can develop in persons with diabetes, often before the other complications of diabetes become manifest. PMID- 1787956 TI - Improved method for calculation of corneal topography for any photokeratoscope geometry. AB - Accurate and efficient calculation of the anterior corneal surface topography by photokeratoscopy has become important for the management or surgical treatment of refractive errors. Methods have been published that describe such calculations. The algorithms described here eliminate an assumption made in some of the earlier computational methods without an excessive increase in the computation time or increased sensitivity to measurement errors. This results in an enhanced accuracy for reconstructing corneal topographies. Computer simulation results indicate an improved accuracy in measuring the topography for nonspherical corneas. The equations given here apply to any general photokeratoscope geometry and can easily be used in computer programs. In a notable previous publication concerning the more common flat faceplate keratoscope geometry, several of the equations were presented with errors. These errors are identified as an aid to anyone who had already attempted to use those equations in a computer program. PMID- 1787957 TI - Variability of monocular visual acuity during binocular viewing. AB - Two patients observed changes in the visual acuity of one eye when both eyes were viewing simultaneously in certain directions of gaze. While viewing targets presented during the Turville Infinity Balance (TIB) test, the acuity of the affected or amblyopic eye improved when the nonamblyopic eye was covered and binocular vision suspended. The vision of the amblyopic eye was also improved when an appropriate prism was held in front of either eye. The direction of the prism base was based upon the interrelations of horizontal, vertical, and cyclotorsional anisophoria and the amount of prism was the minimum necessary to improve the vision in the amblyopic eye and neutralize vertical fixation disparity. The correlation of variable monocular acuity, stereopsis, and fixation disparity with oculomotor balance is recorded and discussed. PMID- 1787958 TI - Optokinetic nystagmus testing using personal computers. AB - Optokinetic nystagmus (OKN) testing is a useful tool for visual assessment. It has been used for assessing visual function in infants, hysterical patients, and malingerers. It is also of value in the diagnosis of disorders of the central nervous system. At present the devices used for the clinical testing of OKN are the OKN drum and OKN tape. A method is presented for OKN testing using an IBM personal computer or compatible. This method is compared with the other two standard methods. PMID- 1787959 TI - Magnetic resonance imaging of the human eye in vivo. AB - Because of the broad range of T1 (longitudinal relaxation time), T2 (transverse relaxation time), and proton density of the component tissues in the eye, proton magnetic resonance imaging (MRI) can provide ocular images of high contrast. The use of surface coils further enhances the signal-to-noise (S/N) ratio and shortens the image acquisition time to 1 to 6 min. High-resolution MR images of the eye therefore can be acquired readily and routinely. At present, with conventional spin-echo imaging, the in-plane resolution of MR images can be as high as (but not limited to) 0.3 x 0.3 mm with a 3-mm slice thickness. MRI can be used to detect and differentiate ocular lesions and to determine the ocular shape and measure ocular dimensions such as tissue thickness, curvature, and volume. PMID- 1787960 TI - Statistics notebook: entry III.C: Hypothesis test, and entry III.D: Type I and type II errors. PMID- 1787961 TI - Measurement and management of quality in managed care organizations: alive and improving. AB - Leatherman et al, Schlackman, and McGuirk-Porell et al all provide important examples of how managed care organizations (MCOs) will measure quality in this decade (except for health care status, which none have yet incorporated). All three organizations rely on insurance claims as a data source and quality management as a tool for improving quality; United Health Care and US Health-care use claims data to improve care for the entire membership, a still unrealized potential for MCOs. All three programs, relatively new, can be only minimally evaluated in terms of measurement validity, cost-efficiency, and improvement in the quality of care. The impact of such MCOs depends on policy initiatives, improvements in outcome and process measures, and MCOs' commitment to serve the total population, including the uninsured and Medicaid populations. PMID- 1787962 TI - Quality screening and management using claims data in a managed care setting. AB - Quality screening and management (QSM), developed by United HealthCare Corporation for its own health plans but applicable to other settings, analyzes health care provided to an enrolled population using claims and administrative data supplemented, when necessary, with medical record review. For selected topics/conditions, QSM compares the care received by patients to that recommended by established practice guidelines and also reports and describes quality through incidence rates, condition-specific process and outcome measures, occurrence of adverse events, and use of preventive services. Results of the analyses are linked to appropriate quality management actions and are used to identify strategies for improvement. Data permit health plans to make performance comparisons on individual indicators and longitudinal comparisons on the effectiveness of quality improvement initiatives. PMID- 1787963 TI - The quality care cycle. AB - This paper describes an HMO--US Healthcare--which is based on a philosophy of quality-based managed health care. The paper shows how an individual patient interacts with the cycle of care in terms of risk evaluation, health education and prevention, diagnosis, treatment, referral, case management, and outcome. Other components of the cycle of care include primary certification and recertification of providers, criteria for procedure and site appropriateness, and evaluation of the professional qualifications of providers. PMID- 1787964 TI - A performance-based quality evaluation system for preferred provider organizations. AB - This article describes a performance-based quality evaluation program developed by a partnership of insurers for a nationwide preferred provider organization (PPO) which uses indicators to monitor for practice deviations from PPO standards representing four components of patient care--administrative efficiency, patient satisfaction, medical practice standards, and clinical outcome. Quality improvement efforts to eliminate deviant practices through indirect organizational strategies and direct communication with preferred physicians are also described. The program's strengths are its effective use of available data, its potential application to other organizations with a loosely connected network of providers, and its ability to simultaneously monitor care received over time by individual patients in various settings (hospitals, physician offices). PMID- 1787965 TI - Unilateral sensorineural hearing loss rehabilitation. AB - The Audiant Bone Conductor has been heralded as an aid for use in conductive hearing loss; however, its possible use in unilateral sensorineural hearing loss (SNHL) has also been proposed. Between July 1987 and July 1989, profound unilateral sensorineural hearing loss has been rehabilitated in 43 patients using the Xomed Audiant Bone Conductor. Patients who were willing to participate in this clinical trial and who were felt to be good contralateral routing of signals (CROS) aid candidates were selected preoperatively. Audiometric followup, selection criteria, patient satisfaction, and complications are discussed. PMID- 1787966 TI - Histiocytic non-Hodgkin's lymphoma of Waldeyer's ring. AB - The most common extranodal site for non-Hodgkin's lymphoma in the head and neck is the lymphoid tissue of Waldeyer's ring. Diffuse histiocytic non-Hodgkin's lymphoma is the most frequent type occurring at all head and neck extranodal sites. The rarity of histiocytic lymphoma in the areas comprising Waldeyer's ring tends to make assembly of a large series of patients for retrospective study quite difficult. Of the 804 patients treated for malignancies in Waldeyer's ring during the years 1948 to 1985 at the Charity Hospital of Louisiana, 26 had lesions classified as histiocytic non-Hodgkin's lymphoma. We present, to our knowledge, the largest series of diffuse histiocytic lymphomas involving Waldeyer's ring. PMID- 1787967 TI - Monoclonal antibody-porphyrin conjugate for head and neck cancer: the possible magic bullet. AB - Although photodynamic therapy in the treatment of large head and neck cancers showed some initial promise, the results in the final analysis have been somewhat disappointing. Lack of specificity and nonhomogeneous uptake of the porphyrin by the tumor are only some of the problems. The conjugation of a monoclonal antibody (UCD/AB 6.01) with hematoporphyrin derivative that preferentially binds to tumor cells offers promise as a therapeutic agent that will not only improve specificity, but vastly enhances tumor cell kill when exposed to light in its photodynamic range. The application of the monoclonal antibody-hematoporphyrin conjugate (AB:HPD) to A-431 squamous cell carcinoma cells in vitro, followed by exposure to light in the 630 nm range, increases the kill ratio by a factor of 10(5) times. The active tumor cell binding site on the cell surface has been found to be on the microvilli, a site at which a 52 kDa protein that is very similar to keratin 8 is found. The clearance of the conjugate from nude mice who have grown an A-431 tumor shows a retention of AB:HPD of approximately 15% and less than 1% in skin and internal organs when measured at 48 hours. Direct application of AB:HPD to fresh pathology specimens containing human squamous cell carcinomas shows binding exclusively limited to the tumor. PMID- 1787968 TI - Combined approach for lesions involving the cerebellopontine angle and skull base: experience with 20 cases--preliminary report. AB - Skull base tumors involving the clivus, petrous bone, and adjacent areas can be formidable lesions to successfully remove without causing significant neurologic deficits. At our institution in the last 5 years, twenty patients out of 103 patients with skull base tumors have undergone the supratentorial-infratentorial combined approach for removal of a neoplasm (nine schwannomas, six meningiomas, two epidermoids, one extensive basal cell carcinoma, one pontine cavernous malformation, and one basilar artery aneurysm). The average patient age was 43 years. The combined approaches in conjunction with the subtemporal exposure were retrosigmoid-retrolabyrinthine, retrosigmoid-translabyrinthine, or retrosigmoid transcochlear. The choice depended upon the type and location of the lesion and the deficits noted preoperatively. Basically, the approach allowed communication of the middle fossa and posterior fossa by totally dividing the tentorium as much as necessary for effective surgical manipulations. Both sigmoid and superior petrosal sinuses are divided. There were no deaths. Postoperative neurologic deficits included temporary seventh nerve paralysis, sixth nerve weakness, fifth nerve sensory deficits, cerebrospinal fluid leaks, and hydrocephalus requiring a shunt. Overall, the results were very gratifying, considering the difficulties encountered in the surgical removal of these lesions. PMID- 1787969 TI - Effects of chronic electrical stimulation on patients using a cochlear prosthesis. AB - Eighteen patients using the Nucleus multichannel cochlear prosthesis underwent annual evaluations for electrical thresholds, dynamic range, and speech recognition abilities for a period of 1 to 5 years. Results revealed no correlation between length of usage of a cochlear implant and electrical thresholds. The dynamic range was initially wider in the patients with open-set speech recognition, but narrowed in subsequent years. There was a correlation between length of deafness and postoperative performance. PMID- 1787970 TI - The impact of screening sinus CT on the planning of functional endoscopic sinus surgery. AB - The clinical and radiologic records of 500 sequential patients who underwent screening sinus CT as a prelude to possible functional endoscopic sinus surgery (FESS) were reviewed in order to answer three clinical-radiologic questions: (1) Can distinct radiologic patterns of inflammatory disease be identified on screening sinus CT (SSCT)? (2) If so, what are these radiologic patterns? (3) How do the findings seen on SSCT influence the endoscopic surgical plan? Five basic radiologic patterns of sinonasal inflammatory disease were identified among the 500-member patient population. These were based on known patterns of mucociliary drainage correlated with obstructive patterns observed on the CT scans. These radiologic patterns included: (1) infundibular (129 of 500 or 26%), (2) ostiomeatal unit (126 of 500 or 25%), (3) sphenoethmoidal recess (32 of 500 or 6%), (4) sinonasal polyposis (49 of 500 or 10%), and (5) sporadia (unclassifiable) (121 of 500 or 24%) patterns. Normal SSCT was seen in 133 of the 500 patients (27%). Although the ostiomeatal unit is the central feature in sinonasal inflammatory disease, obstruction of the infundibulum alone or of the sphenoethmoidal recess can cause unique inflammatory patterns of disease that require tailored FESS. The identification of sinonasal polyposis raises a different set of FESS considerations. The sporadic pattern of inflammatory disease, when identified, creates unique FESS challenges, depending on the specific sinus or sinuses involved. Assignment of these patterns to the individual case also assists in patient management by grouping patients into nonsurgical (normal CT), routine (infundibular, ostiomeatal unit, and most sporadic patterns) and complex (sinonasal polyposis and sphenoethmoidal recess) surgical groups. PMID- 1787971 TI - Hearing threshold difference between ears and risk of acoustic tumor. AB - This study addresses the question, what difference in hearing between ears puts a patient at sufficient risk of acoustic tumor to warrant further diagnostic tests? The subjects were 210 patients with surgically confirmed unilateral acoustic tumors and a control group comprised of 112 patients referred for audiometry. Hearing thresholds were determined at octave intervals from 250 Hz to 8 kHz. The threshold in the nonsuspect ear was subtracted from the threshold in the suspect ear. The rank order in effectiveness for threshold difference was: 2 kHz, 4 kHz, 1 kHz, 8 kHz, 500 Hz, and 250 Hz. We found that the most effective diagnostic strategy was to refer patients for magnetic resonance imaging if their average threshold difference at 1 to 8 kHz was 20 dB or greater and refer patients for auditory brainstem response testing if their average threshold was 5 to 20 dB. PMID- 1787972 TI - Functional endoscopic sinus surgery in the immunocompromised child. AB - Fungal sinusitis in the immunocompromised child is an aggressive, invasive process that may result in a fatal outcome if not diagnosed early. As a result of increasing use of bone marrow transplantation and new cytotoxic chemotherapeutic agents resulting in severe agranulocytopenia, more patients have become susceptible to fungal sinus disease. Functional endoscopic sinus surgery has emerged recently as an important surgical modality in the treatment of sinus disease in adults and children. Use of this technique in immunosuppressed children has allowed early diagnosis of fungal sinonasal disease, resulting in earlier surgical intervention. The high-quality fiberoptic capability of nasal endoscopes allows very detailed visualization of the internal anatomy of the nose and detects early mucosal changes as a result of intranasal fungal disease. Our experience using functional endoscopic sinus surgery in immunocompromised children over an 18-month period is reviewed. Our philosophy for diagnosis and management of immunocompromised children with suspected fungal sinonasal disease is discussed. PMID- 1787973 TI - Cricoid quartersection vs. anterior-posterior cricoid split: effect on subglottic growth in rabbits. AB - Five-week-old New Zealand white rabbits were divided into three groups: control, anterior-posterior cricoid split with stent, and cricoid quartersection (anterior posterior-lateral cricoid split) with stent. The stents were removed 2 weeks after placement. The rabbits were allowed to grow for six months, at which time they were killed and the larynges were studied. Average, minimal, and maximal subglottal cross-sectional areas were calculated for each animal and adjusted for weight. The cricoid quartersection group had significantly greater average, minimal, and maximal subglottal cross-sectional areas compared to controls and significantly greater minimal and maximal cross-sectional areas compared to the anterior-posterior cricoid split group. The anterior-posterior cricoid split group and the control group did not significantly differ with respect to any of the three parameters. The results indicate that anterior-posterior cricoid split and cricoid quartersection do not adversely affect subglottic growth. Cricoid quartersectioning was superior to the anterior-posterior cricoid split in its ability to expand subglottic airway dimension. PMID- 1787974 TI - The effects of topical oral clindamycin antibiotic rinses on the bacterial content of saliva on healthy human subjects. AB - The use of systemic antibiotics for major head and neck surgical procedures involving the upper aerodigestive tract is now accepted as an important part of perioperative patient care. Despite knowledge of the high counts of bacteria present in saliva, no preoperative regimen for preparing the mouth has been standardized. Surgical wounds come in contact with saliva during the course of many head and neck procedures. While wound infection rates have been decreased with the use of prophylactic systemic antibiotics, serious morbidity still exists from postoperative wound infections. Reducing the bacterial counts in saliva preoperatively may further decrease wound infection rates. A prospective randomized pilot study of twenty healthy human subjects compared the effects of an oral rinse with clindamycin vs. a placebo rinse of normal saline. There was a statistically significant reduction in both aerobic and anaerobic colony counts in the clindamycin group at 4 hours after treatment. For the group that rinsed with placebo, there was an actual increase in counts 4 hours after treatment. It is concluded that oral rinses with clindamycin can reduce the bacterial content of saliva for a sufficient length of time to be effective as a preoperative prophylactic measure for head and neck surgery involving the upper aerodigestive tract. Future studies are planned to evaluate other potentially effective agents. A logical continuation is a clinical study of preoperative and postoperative rinses. PMID- 1787976 TI - Effect of superior laryngeal nerve on vocal fold function: an in vivo canine model. AB - Assessment of laryngeal framework surgery requires an awareness of the effect of vocal fold mass, stiffness, and position on voice production. The vibratory pattern of vocal folds during phonation depends on the subglottic pressure as well as the mass and stiffness of the folds. To assess the effect of variations in vocal fold tension with contraction of the cricothyroid muscle on phonation, eight mongrel dog larynges were studied in vivo. Photoglottography, electroglottography, and subglottic pressure were simultaneously recorded as airflow rate and superior laryngeal nerve (SLN) stimulation were varied. Stimulation of the SLN was modified by varying the frequency and voltage of the stimulating electrical signal. Multiple regression analysis of the data revealed a direct relationship between the voltage of SLN stimulation and frequency of vibration (p less than 0.001) at constant subglottic pressure. Increases in the stimulating voltage to the SLN also led to an increase in open quotient (p less than 0.001), but no statistically significant change in speed quotient, subglottic pressure, or sound intensity. Changing the frequency of SLN stimulation had only a modest effect on the frequency of vibration. These results are consistent with the reported findings of an increase in frequency and open quotient with increased tension in an in vitro canine model. The glottographic measurement open quotient appears to be an estimator of cricothyroid contraction and longitudinal vocal fold tension, and may be clinically applicable to the assessment of superior laryngeal nerve injuries and laryngeal framework procedures. PMID- 1787975 TI - The porcine model for intratemporal facial nerve trauma studies. AB - Facial nerve anatomy was compared in the rat, rabbit, cat, and pig in an effort to develop a model for facial nerve trauma within the temporal bone. The porcine model was found to have the most suitable anatomy. Landmarks for the nerve were excellent. The pig had a definite facial nerve mastoid segment that was vertical, as in the human, and long enough to allow for performance of sequential procedures on the nerve. It was also large enough for grafting and electrical testing. A detailed description of the advantages of the pig model and the anatomy of the surgical approach to the facial nerve in the porcine model is presented. PMID- 1787977 TI - Inflammatory pseudotumor of the neck. PMID- 1787978 TI - Oncocytic malignancy of the parotid gland. PMID- 1787979 TI - Mastoid pneumatocoele: unusual complication after transmastoid translabyrinthine labyrinthectomy. PMID- 1787980 TI - Dreams. PMID- 1787981 TI - Definition of complete spinal cord injury. AB - Prospective serial neurological examinations were performed on 445 consecutive traumatic spinal cord injury (SCI) patients admitted for rehabilitation on an average of 22.8 +/- 15.6 days after injury. Patients were categorized by both the ASIA and Sacral Sparing (SS) definitions of complete SCI, in order to compare the definitions in terms of consistency and prognostic ability. Recovery during follow-up was determined by sensory scores for light touch, sharp/dull discrimination, proprioception, and the ASIA Motor Index Score. Change in complete status was unidirectional using the SS definition and bidirectional using the ASIA definition. Twelve patients with SS complete injuries on initial examination converted to SS incomplete injuries at follow-up. No patients converted from SS incomplete to SS complete injury. Twenty three patients with ASIA complete injuries upon admission converted to ASIA incomplete status and 6 converted from ASIA incomplete status on admission to ASIA complete status at follow-up. For quadriplegics, the average motor recovery for patients changing complete status according to the ASIA definition was 11.7 +/- 10.3, which was significantly less (p less than .05) than the average recovery using the SS definition (group 1), 17.9 +/- 9.3. For paraplegics, the average motor recovery using the ASIA definition, 8.3 +/- 6.7, did not differ significantly from the value using the SS definition, 6.8 +/- 4.0. PMID- 1787982 TI - Traumatic cervical Brown-Sequard and Brown-Sequard-plus syndromes: the spectrum of presentations and outcomes. AB - Brown-Sequard syndrome (BSS) and Brown-Sequard-plus syndrome (BSPS) are characterised by asymmetrical paresis with hypalgesia more marked on the less paretic side. This study examined the clinical features of 38 patients (30 males and 8 females; mean age = 32 years) with traumatic cervical BSS or BSPS who underwent comprehensive inpatient rehabilitation. Twenty two injuries were caused by road traffic accidents, 8 by penetrating injuries, 5 by diving injuries, and 3 by other causes. After an average of 35 days in acute care and 79 days in rehabilitation, 37 patients had increased muscle strength, all 38 patients improved functional abilities, 29 patients walked independently, 34 had spontaneous bladder emptying, 36 were discharged home, and 14 were employed. Statistically significant increases (p less than 0.001) were made in modified Barthel index functional scores between admission and discharge. Patients with BSPS had a better prognosis than did those with 'pure' BSS. Patients with predominant upper limb weakness had more favourable outcomes than did those with predominant lower limb weakness. Few other potentially predictive demographic, injury, or neurological factors were associated with functional outcome. Patients with BSS or BSPS generally have a good prognosis for neurological and functional improvement. PMID- 1787983 TI - Reversal of adaptive left ventricular atrophy following electrically-stimulated exercise training in human tetraplegics. AB - Left ventricular (LV) myocardial atrophy and diminished cardiac function have been shown to accompany chronic human tetraplegia. These changes are attributable both to physical immobilisation and abnormal autonomic circulatory regulation imposed by a spinal cord injury (SCI). To test whether exercise training increases LV mass following chronic SCI, 8 neurologically complete quadriplegic males at 2 SCI rehabilitation and research centres underwent one month of electrically-stimulated quadriceps strengthening followed by 6 months of electrically-stimulated cycling exercise. Resting M-mode and 2-D echocardiograms were measured before and after exercise training to quantify the interventricular septal and posterior wall thicknesses at end-diastole (IVSTED and PWTED, respectively), and the LV internal dimension at end-diastole (LVIDED). LV mass was computed from these measurements using standard cube function geometry. Results showed a 6.5% increase in LVIDED following exercise training (p less than 0.02), with increases in IVSTED and PWTED of 17.8 (p less than 0.002) and 20.3% (p less than 0.01), respectively. Computed LV mass increased by 35% following exercise training (p = 0.002). These data indicate that myocardial atrophy is reversed in tetraplegics following electrically-stimulated exercise training, and that the changes in cardiac architecture are likely to be the result of both pressure and volume challenge to the heart imposed by exercise. PMID- 1787984 TI - Work status after posterior fixation of unstable but neurologically intact burst fractures of thoracolumbar spine. AB - Thirty nine patients with unstable burst injuries of the thoracolumbar junction who did not suffer neurological injury have been prospectively followed. There were 24 males and 15 females. Five patients were covered under the Workers' Compensation Board (WCB). The average patient age was 34 years (14-66). All patients were stabilised using the AO 'Fixateur Interne' and posterior fusion. The post-operative instrumented sagittal curve averaged six degrees of lordosis ( 20 to +20). The length of follow-up averaged 24 months (range 12-24). Pre operatively 28 patients were employed, 2 were housewives, 6 were students, and 3 were unemployed. At follow-up, all students and housewives had returned to their usual activities. No patient who was initially unemployed had found work. Of the remaining 28 patients who were employed before injury, 23 (82%) had returned to gainful employment, one had returned to school for job retraining, and 5 had not returned to work. Of the 23 patients who had returned to work, 5 returned to lighter duties, and 18 returned to their original occupation. Only 2 of the 5 WCB covered patients did not return to work. Most neurologically intact patients undergoing surgery for unstable bursting injuries of the thoracolumbar spine can return to work. PMID- 1787985 TI - Post-traumatic spinal cord cysts evaluated by magnetic resonance imaging. AB - In order to determine a more accurate prevalence of post-traumatic spinal cord cysts (PTSCC) in spinal cord injured (SCI) patients, we retrospectively reviewed magnetic resonance scans from symptomatic imaging and asymptomatic SCI patients. We found the incidence of PTSCC to be 51% in our patient population. The only symptom that correlated to the presence of a cyst was spasticity. The cyst develops at the site of injury and appears to be a common sequela of SCI. We believe that conservative treatment is indicated in most patients with a PTSCC. PMID- 1787986 TI - Suicide following spinal cord injury. AB - A study of 9135 persons injured between 1973 and 1984 and treated at any of 13 model regional spinal cord injury (SCI) care systems was conducted. Follow-up ended December 31, 1985, by which time 50 persons had committed suicide (6.3% of deaths). Based on age-sex-race-specific rates for the general population, 10.2 suicides were expected to occur. Therefore, the standardized mortality ratio (SMR) for suicide was 4.9. The highest SMR occurred 1 to 5 years after injury. The SMR was also elevated for the first post-injury year, but was not significantly elevated after the fifth year. The SMR was significantly elevated for all neurological groups, but was highest for persons with complete paraplegia. The SMR was highest for persons aged 25 to 54 years, but was also elevated for persons aged less than 25 years. Suicide was the leading cause of death for persons with complete paraplegia and the second leading cause of death for persons with incomplete paraplegia. The most common means of committing suicide was by gunshot. These figures demonstrate the need for increased staff, patient and family awareness of this problem, and improved follow-up assessment and psychosocial support programmes. PMID- 1787987 TI - Non-granulomatous spinal epidural abscess: a rehabilitation perspective. AB - Spinal epidural abscess (SEA) as a cause of back pain, fever, and neurological deficits has been recognised. Reports of this entity have increased in recent years, possibly likely secondary to increasing intravenous drug abuse. Most patients recover without neurological sequelae. Recent reports in fact indicate that those with persistent deficit have a much poorer prognosis for survival. As a result, few patients with SEA are seen in spinal injury rehabilitation programmes. Our 5 years experience with SEA was reviewed. Thirteen patients were admitted with residual neurological deficits following a course of prolonged antibiotic therapy. Of these most had progressive neurological improvement with only 3 of 4 remaining Frankel class A and 3 of 7 Frankel class C. The only mortalities (2) were secondary to the underlying medical problems. Most patients were discharged home. PMID- 1787988 TI - [Somatotropin and estradiol in children with arterial hypertension]. PMID- 1787989 TI - [Value of echocardiography in ambulatory examination of children with a history of primary rheumatic carditis without the development of heart defects]. PMID- 1787990 TI - [Status of the organs of the gastroduodenal region in children with chronic hepatitis]. PMID- 1787991 TI - [Clinico-immunological characteristics of typical and atypical forms of hepatitis A in children]. PMID- 1787992 TI - [Effect of dimephosphon on the clinico-immunological indicators in children with chronic hepatitis]. PMID- 1787993 TI - [Medium-weight molecules and their indicator role in young children with acute pneumonia]. AB - As many as 63 infants with acute pneumonia, 7 children with ARVI (bronchiolitis) and 28 normal children were examined. At the height of the clinical manifestations there was an increase of the level of medium-weight molecules in blood serum, correlating well with the disease gravity determined by the intensity of the toxic syndrome. The highest concentration of serum medium-weight molecules was demonstrable in toxic and purulent complications due to acute pneumonia. Meanwhile the level of medium-weight molecules, equal to or exceeding 0.6 Units extinction may be viewed as an unfavourable predictor. No relationship was discovered between the concentration of serum medium-weight molecules and the type of virus causative agent and respiratory tract inflammation. PMID- 1787994 TI - [Heterogeneity and polymorphism of the thymus hyperplasia syndrome in children in the first 3 years of life]. AB - Sixteen years of observation over a large group of children with the syndrome of the enlarged thymus with the use of up-to-date methods of examining the CNS, immune, endocrine, neuroendocrine systems and the autopsy data allowed the heterogeneity and polymorphism of the given syndrome to be revealed. Both transitory and stable enlargement of the thymus may be observed. The syndrome of the stable-enlarged thymus is likely to be formed in the intrauterine period and postnatally as well. It may be associated and not associated with thymus dependent immunodeficiency. The morphological investigation of the thymus may show an enlargement of the cortical area with enhanced T lymphocyte proliferation in it or formation of lymphoid follicles. In clinical practice, the syndrome of the stable-enlarged thymus should be differentiated with thymic tumor. The working classification of the syndrome and concept of the pathogenesis of the stable-enlarged thymus are offered. PMID- 1787995 TI - ["Falling look" symptom in the structure of the neurological status as a precursor of paroxysmal conditions in young children]. AB - The authors observed children aged 1 to 7 years without any signs of epilepsy in the anamnesis. The children were examined for headaches, memory deterioration, difficulties in the learning, some types of tics, stammering, and psychomotor disinhibition. Among them, a group of 35 children characterized by specific movements of the eye balls as was shown by estimation of oculomotor nerve functions (look anxiety, "falling look") were distinguished. EEG examinations discovered the peak-wave type complexes related to the signs of petit mal of the absence type. The conclusion is a precursor of paroxysmal conditions. It is recommended that adequate anticonvulsive therapy be initiated provided the symptom is identified together with the EEG changes. PMID- 1787996 TI - [Approach to differential diagnosis of clinically related forms of chromosomal pathology using computers]. AB - Multiple congenital developmental abnormalities account for a considerable share in the structure of the childhood morbidity, mortality and disability. Still, the differential diagnosis of the above abnormalities presents considerable difficulties because of the diversity of the forms and genetic pleomorphism. Using the method of rarefied templates of the "case--description term" type tried previously, a study was made of the possibility of differentiating between the clinically related forms of the chromosomal pathology 9p- and 11q- on the basis of phenotypic differences. The template was made up of 40 cases of 9p- and 40 cases of 11q-, accounting for 720 traits altogether. The "phenotypic nuclei"- traits occurring at a rate of over 25% were revealed for each syndrome and compared. Two approaches to the differentiation between these syndromes were used, which may turn out instrumental for diagnosing the clinically related forms of multiple congenital developmental abnormalities of the non-chromosomal genesis. The potentialities and difficulties of the computer-aided differential diagnosis are under discussion. PMID- 1787997 TI - [Characteristics of the course of chronic liver diseases of hepatitis B etiology with delta infection in children]. AB - Overall 120 children with chronic liver diseases of HB-virus etiology were examined. In 78.3% of the patients, RIA was used to reveal anti-delta in blood serum, 33 children were diagnosed to have chronic persistent hepatitis, 44 chronic active hepatitis, and 43 liver cirrhosis. The patients with anti-delta manifested certain characteristic features. There prevailed children from epidemiologically unfavourable regions as regards virus hepatitis B. There also prevailed boys. In one-third of the patients with chronic liver diseases and anti delta, acute hepatitis ran a biphasic course. According to the data obtained, super-addition of delta-infection aggravates the disease; the process becomes chronic more rapidly, exacerbations are more pronounced. 16 out of 23 children showed delta-antigen in liver biopsy specimens; in patients with active disease, the antigen was detected in the nucleus and cytoplasm at a time. As the activity decreases, the antigen becomes mostly detectable in the cytoplasm. PMID- 1787998 TI - [Immunogenetic indicators in protracted hepatitis and their dynamics during the treatment with T-activin]. AB - The authors analyze the course of acute virus hepatitis B in 11 children. Provide results of the treatment with T-activin of K cells in vitro and the clinico immunologic data on 26 patients afflicted with lingering hepatitis B before and after the treatment with T-activin. Show the hereditary predisposition to an unfavourable course of virus hepatitis B. PMID- 1787999 TI - [Effect of splenectomy on the dynamics of allergic symptoms and the level of IgE in the complex treatment of children with liver cirrhosis]. AB - Overall 21 children suffering from active liver cirrhosis were examined for the dynamics of allergic symptoms and IgE before and after splenectomy. The IgE level was measured 2-4 weeks, 3-11 months and 1-5 years after splenectomy. All the children received glucocorticosteroid therapy followed by the administration of maintenance therapy. It has been shown that splenectomy as one of the pathogenetic forms of therapy of active liver cirrhosis produces a decrease in blood IgE and in the incidence of allergic manifestations in addition to the clinical effect and amelioration of liver function. PMID- 1788000 TI - [Improving the quality of professional training of physicians: problems and solutions]. PMID- 1788001 TI - [Correction of hypoxia in acute destructive pneumonia in children by using phospholipid liposomes in a controlled germ-free environment]. PMID- 1788002 TI - [Magnetotherapy of hepatitis A and B in children]. PMID- 1788003 TI - [Vaccinal measles process in children during the manifestations of acute respiratory diseases]. PMID- 1788004 TI - [Gilbert's syndrome in children]. PMID- 1788005 TI - [Characteristics of uric acid metabolism and the activity of various enzymes in the families of patients with interstitial nephritis]. PMID- 1788006 TI - [Analytical review of research studies in pediatrics completed in 1990]. PMID- 1788007 TI - [Transient endocrine and metabolic syndromes in newborn and older infants]. PMID- 1788008 TI - [Celiac disease in children]. PMID- 1788009 TI - [Rehabilitation of children with bronchial asthma in a sanatorium-type pioneer camp]. PMID- 1788010 TI - [Immunoglobulins A, G and M and C3 and C4 components of the complement in pneumonia in infants under 1 year of age]. AB - The findings of 69 autopsies of children of the first year of life who died from pneumonia were examined. The children were found to have a significant lowering of IgA and IgG and an increase of IgM which correlated with the immunomorphological appearance of the organs of immunogenesis. The concentration of components C3 and C4 of complement was reduced. The reduction appeared most remarkable in +viral and bacterial pneumonias. The conclusion is drawn that in children of the first year of life, pneumonias eventuating in lethal outcomes may occur in primary and secondary immunodeficiency states, since the immune mechanisms are also implicated in the pathogenesis of pulmonary tissue lesions. PMID- 1788011 TI - [Problem of long-term subfebrile conditions in children]. PMID- 1788012 TI - [So-called "onanic spasms" in infants]. PMID- 1788013 TI - [Health status of children exposed to low doses of radiation 1 year after the Chernobyl AES accident]. AB - The authors provide data on the health status of children living in radiation polluted regions, obtained 9-11 months after the Chernobyl accident. Study of the demographic characteristics, distribution into health groups and of the hematological parameters did not reveal any significant differences with the exception of a higher anemia incidence (in children under 1 year). PMID- 1788014 TI - [Assessment of the immunohematological status of children exposed to low doses of ionizing radiation in the early and late periods after the Chernobyl AES accident]. AB - The qualitative and quantitative parameters of hemopoiesis and immunocompetent cells were studied in 365 children in the early "iodine" and long-term periods after the accident. In accordance with primary response, a group consisting of 28 subjects with so-called "radiation injury" was distinguished. The early period was marked by unusual qualitative and quantitative hematological changes which, however, did not lead to the development of the hematological syndrome characteristic of acute radiation injury. Certain deviations that corresponded to somatic pathology were detectable at the late periods after the accident. PMID- 1788015 TI - [Peripheral blood of children exposed to radiation as a consequence of the Chernobyl AES accident]. AB - As many as 103 children exposed to minor doses of radiation after the Chernobyl accident were examined for peripheral blood morphology. Statistical and individual analysis did not reveal any pathological alterations on the part of the hemograms of the radiated children. At the same time they manifested certain deviations in the form of leukopenia, lymphopenia and neutropenia, suggesting the action produced by radiation factor. On the whole, these alterations were characterized as adaptation ones of multifactorial genesis. The data obtained support an assumption that the changes in the quantitative composition of blood exposed to radiation in the doses not exceeding the maximal permissible limits were not remarkable, occurring within the physiological boundaries and could be detected only during observations made over time. Emphasis is laid on the necessity of further monitoring of the hemopoietic system of the radiated children according to the current principles of dispensary observation. PMID- 1788016 TI - [Clinical-immunological characteristics of the state of the thyroid gland in children exposed to ionizing radiation because of the Chernobyl AES accident]. AB - Overall 806 children evacuated from the city of Pripyat were examined for the thyroid condition. The children who received a dose of more than 30 rad for the thyroid manifested primary response in the form of euthyroid hyperthyroxinemia, a high risk of the development in future of autoimmune diseases in the lack of hypothyrosis. PMID- 1788017 TI - [Changes in metabolic processes in children from the regions which were affected by the Chernobyl AES accident]. PMID- 1788018 TI - [Certain characteristics of the perinatal development of children whose parents were exposed to the action of uranium fission products]. AB - Analysis was made of the character of the perinatal development of 238 children. In 65 of these, the parents were exposed to the action of uranium fission products in the basin of the river Techa in the Chelyabinsk region. The parents were radiated approximately 5 years before the children's birth. The mean equivalent dose for endocrine glands (including gonads) of the parents amounted to about 12 centiSievert U. As compared to the control group, the basic one manifested a higher incidence of placenta and umbilical cord pathology. In the group of the radiated persons' progeny, the number of small-weight children appeared greater; a larger physiological reduction of the body weight was recorded as were later times of funic residue falling off. PMID- 1788019 TI - [Congenital developmental defects in children and environmental pollution]. AB - In one of the southern regions of the Ukraine, analysis was made over the recent three years of the genetic monitoring data on the incidence and structure of congenital developmental abnormalities in the newborn as related to the status of environmental pollution (the content of dust, carbon black, carbon and nitrogen oxides, nitrogen and sulfur dioxides, hydrogen sulfide, formaldehyde, phenol, fluorine compounds in the atmospheric air; the content of toxic chemicals and pesticides in foods, soil, water and feeds) as well as to the radiation situation. In the region under study, areas with varying degree of environmental pollution were distinguished. That was mainly done in terms of the characteristics of the atmospheric air and (to a less degree) varying annual dose of external radiation on conversion to one inhabitant. Analysis of the genetic monitoring has demonstrated the prevalence of congenital abnormalities, in the genesis of which the mutation component was of paramount importance, to be significantly higher in an ecologically unsafe area. The data obtained can be used in the regional programs aimed at the improvement of the environment, a reduction of the influence of exogenous risk factors implicated in the formation of congenital developmental abnormalities in children. PMID- 1788020 TI - [Prevalence of cardiovascular diseases in the school-child population with regard to the ecological condition of the atmosphere]. PMID- 1788021 TI - [Chemical intoxication syndrome in children with diffuse alopecia]. PMID- 1788022 TI - [Risk factors of thyroid hyperplasia in prepubertal and pubertal periods in the endemic region]. PMID- 1788023 TI - [Myelodysplastic syndromes]. PMID- 1788024 TI - [Emergency care of hemorrhage in children]. PMID- 1788025 TI - [Problems of childhood eco-pathology: immunological aspects]. PMID- 1788026 TI - [Effects of the consequences of the Chernobyl accident on the child's body]. AB - Overall 1580 children from the regions with unsafe radiation situation were examined comprehensively at different times after the accident. The data obtained were correlated to the results of examining 610 children of the control group. The basic group children manifested a higher incidence of diverse alterations on the part of many organs and systems, which was accompanied by an increase of free radical processes signs of destabilization of cellular membranes, activation of blood cell metabolism, suppression of the T cell component of immunity in the presence of vegetovascular dysfunction. A tendency was noted toward normalization of these alterations seen over time after the accident. No clear-cut dose-effect dependence was found. PMID- 1788027 TI - [Certain features of clinical and hormonal status of children of the southwestern areas of the Bryansk region exposed to radiation]. PMID- 1788028 TI - [Diagnosis of fetal and neonatal hypoxia based on indices of lipid peroxidation and antioxidant activity]. PMID- 1788029 TI - Sources of auditory masking in infants: distraction effects. AB - Previous work has demonstrated that infants' thresholds for a pure tone are elevated by a masker more than would be predicted from their critical bandwidths. The present studies explored the nature of this additional masking. In Experiment 1, detection thresholds of 6-month-old infants and of adults for a 1-kHz tone were estimated under three conditions: in quiet, in the presence of a 4- to 10 kHz bandpass noise at 40 dB SPL, and in the presence of the same noise at 50 dB SPL. The noise was gated on at the beginning of each trial. Adult thresholds were the same in all three conditions, indicating that little or no sensory masking took place in the presence of the noise. Infant thresholds were about 10 dB higher in the presence of the noise. We term this effect distraction masking. In Experiment 2, the effect of gating the noise on at trial onset was examined. Thresholds for the same tone were estimated in quiet and in the presence of the band-pass noise at 40 dB SPL, but the noise was presented continuously during the session. Under these conditions, distraction masking was still observed for infants. These findings suggest that a masker can have nonsensory effects on infants' performance in a psychoacoustic task. PMID- 1788030 TI - Detection of symmetry in tachistoscopically presented dot patterns: effects of multiple axes and skewing. AB - We examined the effects of multiple axes and skewing on the detectability of symmetry in tachistoscopically presented (100-msec) dot patterns to test the role of normal grouping processes based on higher order regularities in element positions. In addition to the first-order regularities of orientational uniformity and midpoint collinearity (Jenkins, 1983), bilateral symmetry (BS) gives rise to second-order relations between two pairs of symmetric elements (represented by correlation quadrangles). We suggest that they allow the regularity (i.e., BS) to emerge simply as a result of the position-based grouping that takes place normally, so that no special symmetry-detection mechanism has to be postulated. In combination with previously investigated variables--number and orientation of axes--we introduced skewing (resulting from orthographic projection of BS) to manipulate the kind and number of higher order regularities. In agreement with our predictions, the data show that the effect of skewing angle (varied at three 15 degrees steps, clockwise and counterclockwise) on the preattentive detectability of symmetry (measured with d') increases as the number of axes decreases. On the basis of some more specific findings, we suggest that it is not as much the number of correlation quadrangles that determines the saliency of a regularity as it is the degree to which they facilitate or "bootstrap" each other. PMID- 1788031 TI - Factors influencing perceived angular velocity. AB - The assumption that humans are able to perceive and process angular kinematics is critical to many structure-from-motion and optical flow models. The current studies investigate this sensitivity, and examine several factors likely to influence angular velocity perception. In particular, three factors are considered: (1) the extent to which perceived angular velocity is determined by edge transitions of surface elements, (2) the extent to which angular velocity estimates are influenced by instantaneous linear velocities of surface elements, and (3) whether element-velocity effects are related to three-dimensional (3-D) tangential velocities or to two-dimensional (2-D) image velocities. Edge transition rate biased angular velocity estimates only when edges were highly salient. Element velocities influenced perceived angular velocity; this bias was related to 2-D image velocity rather than 3-D tangential velocity. Despite these biases, however, judgments were most strongly determined by the true angular velocity. Sensitivity to this higher order motion parameter was surprisingly good, for rotations both in depth (y-axis) and parallel to the line of sight (z axis). PMID- 1788032 TI - What has happened to Pragnanz? Coding, stability, or resonance. AB - Three theoretical measures of Pragnanz were compared with four data sets. The theoretical measures were a stimulus-coding one (structural information load, SIL), a measure related to within memory processes (stability), and one based on the interaction of perception and memory (resonance). The four data sets were obtained in two experiments and involved goodness rating, grouping, and immediate and delayed recall. A complete set of seven-element binary serial patterns was used in each experiment. Both SIL and resonance were shown to correlate reliably with the data sets across tasks. The resonance measure, however, performed best. Pragnanz thus appears to be explained better by resonance than by stimulus coding or memory storage. Resonance explained all systematic variance in the recall tasks, but not in the other tasks. Regarding these, partial-correlation analyses showed that the effect of stability could be fully reduced to resonance. SIL could not be similarly reduced. Therefore, additional perceptual constraints, other than resonance, would be needed for a complete account of goodness in the judging or grouping tasks. PMID- 1788033 TI - The syllable-length effect in number processing is task-dependent. AB - Two experiments were run in order to investigate the relationship between syllable length of number names and eye-fixation durations during silent reading of one- and two-digit numbers. In Experiment 1, subjects had to read a series of three numbers and recall them orally; in Experiment 2, subjects had to indicate manually whether the value of the middle number was between the values of the outer numbers. The effect of syllable length was controlled for possible confounding effects of number frequency and number magnitude. Findings indicated that fixation duration depended on syllable length of number names in the first task, but not in the second task. The results call into question the claim that phonological encoding is imperative in visual processing; phonological encoding was used only when the numbers had to be recalled, and not when they were coded for computational purposes. PMID- 1788034 TI - Texture and motion spreading, the aperture problem, and transparency. AB - When a cross of either static or moving texture is inserted in the intersection of an Ehrenstein figure, we find that the texture and its motion appear to spread outside of the cross. We suggest that these phenomena are analogous to neon color spreading, wherein an interpretation of a transparent surface makes the properties of that surface, which are physically visible only inside the cross, appear to spread over its apparent extent. In our experiments, the texture and the motion of the cross are attributed to the transparent surface. In addition, the spreading changes the apparent aperture within which the texture and its motion are seen, leading to a corresponding change in the apparent direction of motion. PMID- 1788035 TI - Perception of three-dimensional angular rotation. AB - In three experiments, difference thresholds (dLs) and points of subjective equality (PSEs) for three-dimensional (3-D) rotation simulations were examined. In the first experiment, observers compared pairs of simulated spheres that rotated in polar projection and that differed in their structure (points plotted in the volume vs. on the surface), axis of rotation (vertical, y, vs. horizontal, x), and magnitude of rotation (20 degrees-70 degrees). DLs were lowest (7%) when points were on the surface and when at least one sphere rotated around the y-axis and varied with changes in the independent variables. PSEs were closest to objective equality when points were on the surface of both spheres and when both spheres rotated about the x-axis. In the second experiment, subjects provided direct estimates of the rotations of the same spheres. Results suggested a reasonable agreement between PSEs for the indirect-scaling and direct-estimate procedures. The third experiment varied sphere diameter (and therefore mean linear velocity of stimulus elements) and showed that although rotation judgments are biased by mean linear velocity, they are not likely to be made solely on the basis of that information. These and past results suggest a model whereby recovery of structure is conducted by low-level motion-detecting mechanisms, whereas rotation (and other) judgments are based on a higher level representation. PMID- 1788036 TI - Duration of visible persistence in relation to stimulus complexity. AB - Visible persistence refers to the phenomenal impression that a stimulus is still present after its offset. A dispute exists whether visible persistence is due to temporal sluggishness in the visual pathway (neural hypothesis) or whether it is a byproduct of information-extraction processes under cognitive control (process hypothesis). This was investigated by manipulating stimulus complexity in five temporal integration experiments and one recognition memory experiment. According to the process hypothesis, complex stimuli should persist longer than simple stimuli because they require more information extraction. This prediction was not confirmed; in all six experiments, complexity was found to have no reliable effect on the duration of visible persistence. By contrast, and in accordance with earlier findings, complexity was shown to have a significant effect on a short-lived, nonvisible form of memory known as schematic persistenc. This pattern of results supports two major conclusions: First, that the effects of complexity reported in earlier research were probably on schematic--rather than visible--persistence; and second, that visible persistence must be regarded as a residual neural trace of an extinguished stimulus, rather than as a byproduct of information-extraction processes. PMID- 1788037 TI - Effects of early common features on form perception. AB - Recognizing forms may involve a contingency in which later processing is modified, depending on the results of early analyses. This hypothesis can be distinguished from feature models, in which features (including early global features) accumulate over time. In four experiments, shape primes were presented briefly, followed immediately and in the same location by a similarly or differently shaped target, and then a mask. Accuracy was measured with a two alternative forced-choice discrimination. The primes facilitated discriminations between a similarly shaped target and differently shaped foil, as would be expected. More important is that the primes also facilitated discriminations between similarly shaped targets and similarly shaped foils, even though the primes contained only features common to the alternatives and thus provided no discrimination-relevant information. The facilitation effect was constant over variations in the size of the target set, the type of mask, and the type of baseline condition. This result is consistent with the idea of early-to-late contingencies in processing but was not predicted by feature models. PMID- 1788038 TI - Poisson signal-detection theory: link between threshold models and the Gaussian assumption. AB - The Gaussian model of signal detection cannot fit asymmetric data as long as the variances of the distributions are kept equal. It is therefore common practice to assume unequal variances in order to fit these data. But this assumption leads to the well-known crossover problem. The present paper provides new arguments for the abandonment of the Gaussian model with unequal variances. In its stead, this paper reevaluates multiple-parallel-threshold models. In particular, the Poisson model turns out to be very useful: it can handle data with any degree of asymmetry, giving a reasonable interpretation of the two parameters of the receiver-operating characteristic. The three-state-threshold model (Krantz, 1969) is given a new interpretation in light of the Poisson model. The slope of Poisson double-probability plots turns out to be much closer to unity than is predicted by the Gaussian approximation. PMID- 1788039 TI - Patient peer orientation groups: an innovative approach. AB - Both clients and staff can benefit from a patient orientation program conducted at a state psychiatric facility by a psychologist and a registered nurse. The program cited by the authors utilized a group format to decrease the stress experienced by clients when transferred from a closed to an open ward, and to increase the social skills of clients residing on an open unit. Informal observation and verbal feedback from clients and staff indicated positive reactions to the program and noticeable behavior changes. Recommendations include replication of this program on a large scale with control group comparisons, formal assessment, and statistical analysis of the results. PMID- 1788040 TI - Rethinking inpatient treatment of borderline clients. AB - A number of clinical and financial advantages exist when clients diagnosed with borderline personality disorder are placed in an unlocked milieu-oriented treatment unit during hospitalization. The author describes the transition from a locked inpatient unit to an unlocked unit, the effects of this change on staff and clients' attitudes toward treatment, and the impact of this transition on client functioning. PMID- 1788041 TI - Transformation into a healing healthcare environment: recovering the possibilities of psychiatric/mental health nursing. AB - The author describes the transformation of an inpatient psychiatric unit into a healing healthcare environment through the application of principles built upon the ARTWorks Paradigm (Acceptance, Responsibility, and Trust). Parallels are drawn among the transformation seen in clients, the growth evidenced in nurses working on the unit, and the changes reflected within the nursing profession as a whole. Paradigm themes and specific program components are shared to demonstrate applicability in a variety of settings. PMID- 1788042 TI - Self-injury concept formation: nursing diagnosis development. AB - Self-inflicted injury, an increasingly common phenomenon in psychiatric settings, often is seen in borderline clients who scratch or burn themselves repeatedly. Their dysfunctional behavioral patterns present special challenges to the psychiatric/mental health nurse who seeks to interrupt such destructive means of coping. Aside from the difficult task of assisting these individuals to deal with their feelings in a constructive way, the psychiatric nurse often struggles with difficult countertransference feelings. The authors review a historical perspective of self-injury behaviors, define the phenomenon through the procedure of concept analysis, propose the creation of a new nursing diagnosis, and outline interventions appropriate for these clients. PMID- 1788044 TI - Desert Storm: waiting for the call. PMID- 1788043 TI - Alternatives to lithium in the treatment of bipolar disorder. AB - Bipolar disorder is a serious mental illness affecting a large number of Americans. While lithium, the treatment of choice for this disorder, is usually effective, a substantial number of individuals with bipolar disorder are not helped by lithium or are intolerant to its side effects. Consequently, investigators are searching for alternative drugs in order to treat lithium resistant patients. Although a number of alternative drug treatments have been discussed in the literature, only the anticonvulsants carbamazepine and valproate appear to warrant serious consideration at this time. Future research will further define their roles as antimanic agents. PMID- 1788045 TI - Aloneness in tenuous self-states. AB - This article describes the inner world of severely impaired clients who operate within a behavioral mode of violence and manipulation. Clients who employ such tactics are attempting to exert control over an internal environment that threatens their sense of self-cohesion. While descriptive labels of "uncooperative" and "manipulative" may be apt, these terms are used pejoratively all too often. This article outlines nursing approaches that assist these clients to achieve greater self-cohesion. PMID- 1788046 TI - Acceptance vs. rejection: nursing students' attitudes about mental illness. AB - The influence of a psychiatric nursing course on BSN students' attitudes toward mental illness was the subject of quasi-experimental research. Attitude theory was the conceptual framework for the study. The Opinion about Mental Illness (OMI) questionnaire was given to a group of nursing students before and after an eight-week course. Half of the students took the course, the other half served as a comparison group. Nursing students taking the course changed more than the control group on authoritarianism and interpersonal etiology but expressed higher stereotypical attitudes. PMID- 1788047 TI - Comparison of three rating scales used with psychiatric patients. AB - Many instruments are available to augment assessment of psychiatric patients. There is little comparative information regarding reliability and validity of these tools on assessing treatment needs, in predicting future behavior, and in classifying psychiatric patients. The purpose of the descriptive study was to provide comparative information on the Nosie-30, Pardue-Dick and the Revised Allen Cognitive Level Test. A significant correlation was found between the total Nosie-30 and the Pardue-Dick and between the Revised ACL and the Nosie-30. The scores on the Pardue-Dick and the R-ACL were not related. PMID- 1788049 TI - The alligators and the swamp. PMID- 1788048 TI - Staff and patients: divergent views of treatment. AB - A patient-staff survey, focusing on the efficacy of treatment and aftercare, showed inconsistencies in the way staff perceived treatment given patients at a large municipal acute care hospital. Primary therapists, psychiatrists, and psychologists saw treatment in a routine, standardized fashion, whereas nurses, social workers, activity therapists, and others viewed treatment in more elaborate, individualized terms. The survey also showed disparities between what staff intended to do and what patients perceived was happening to them. Implications of these findings and recommendations for coordinating staff efforts and clarifying patient understanding of treatment are presented. PMID- 1788050 TI - Working in psychiatric research: answers tomorrow, dilemmas today. AB - Implementing research protocols with critically ill psychiatric patients sometimes creates professional dilemmas. It almost always intensifies countertransference issues. Working through the process assisted staff at this hospital to reaffirm their commitment to clinical research. PMID- 1788051 TI - "I-Thou" in nursing: research supporting Duldt's Theory. AB - One of the difficulties in testing nursing theories through research is inconsistency in publishing a theory and its supporting research. The author synthesizes the research in which aspects of Duldt's Humanistic Nursing Communication Theory have been tested. PMID- 1788052 TI - The effect of hypo-osmolarity upon transepithelial ion transport in cultured renal epithelial layers (MDCK). AB - Regulatory volume decrease after exposure to hypo-osmotic media in MDCK epithelial cells results from activation of both K+ and Cl- conductances. Swelling-stimulated 86Rb(K) losses were observed only across the basal-lateral membrane and were relatively insensitive to 10 mM Ba2+. The effect of hypo osmotic media upon MDCK epithelia mounted in Ussing chambers has been investigated. Exposure of the basal-lateral surfaces to hypo-osmotic media resulted in a transient stimulation of inward short-circuit current (Isc) followed by inhibition of inward Isc in both control layers and in layers where inward current (due to transepithelial Cl- secretion) was first stimulated by 5 microM prostaglandin E1 (PGE1). The transient stimulation of inward current by hypo-osmotic media was not markedly attenuated by 10 mM Ba2+ in PGE1-stimulated layers. After stimulation of inward (Cl(-)-secretory) current to high levels by 10 microM adrenaline, the predominant effect of basal-lateral exposure to hypo osmotic media was an inhibition of the inward current. This inhibition was partially reversed by 40 microM 4,4'-diisothiocyanatostilbene-2,2'-disulphonate (DIDS). The stimulation, then inhibition, of inward Isc is likely to be the result of separate swelling-induced K+ and Cl- conductances (respectively) at the basal-lateral membrane. The swelling-stimulated Cl- conductance is distinct from the apical Cl- conductance regulated by PGE1 or adrenaline. PMID- 1788053 TI - Beta subunits determine the time course of desensitization in rat alpha 3 neuronal nicotinic acetylcholine receptors. AB - Standard two-electrode voltage-clamp techniques were used to investigate some of the pharmacological and functional properties of two types of rat neuronal nicotinic acetylcholine receptors expressed in Xenopus oocytes after pairwise injection of alpha 3 beta 4 or alpha 3 beta 2 mRNAs. Currents of several microA amplitude were elicited by fast application of micromolar concentrations of either acetylcholine (ACh) or 1,1-dimethyl-4-piperazine (DMPP). The activation of either receptor type by DMPP showed cooperativity (Hill coefficient, n greater than or equal to 1.7) with a half-maximal activation concentration (EC50) of 15 30 microM. In alpha 3 beta 4 receptors, ACh displayed cooperativity (n = 1.8) but was less efficacious than DMPP, yet its EC50 was about equal to that of DMPP. Finally, in alpha 3 beta 2 receptors, ACh was much less efficacious and had a much lower EC50. Desensitization induced by either DMPP or ACh was slow in alpha 3 beta 4 nicotinic ACh receptors but was rapid and extensive in alpha 3 beta 2 receptors, causing a significant proportion of the response to wane within the first few seconds of agonist application. PMID- 1788054 TI - Zinc uptake by proximal cells isolated from rabbit kidney: effects of cysteine and histidine. AB - The aim of this study was to characterize the mechanisms of zinc transport in proximal cells isolated from rabbit kidney cortex. Uptakes of 65Zn were assessed under initial rate conditions, after 0.5 min of incubation. The kinetic parameters obtained at 20 degrees C were a Km of 15.0 +/- 1.5 microM, a Jmax of 208.0 +/- 8.4 pmol min-1 (mg protein)-1, and an unsaturable constant of 0.259 +/- 0.104 (n = 8). Cadmium competitively inhibited the zinc uptake, with a Ki value of 13.0 +/- 2.8 microM, while zinc competitively inhibited 109Cd uptake by isolated cells. Cysteine and histidine stimulated zinc transport at an amino acid:zinc molar ratio ranging from 1:1 to 8:1. This stimulation was not observed in the absence of a sodium gradient. At a molar ratio greater than 16:1 (i.e. 400 microM cysteine or histidine and 25 microM Zn), there was evidence of inhibition. These data suggest that zinc enters renal proximal cells (a) as a free ion via a saturable carrier-mediated process or an unsaturable pathway and (b) complexed with cysteine or histidine, by means of a sodium/amino acid cotransport mechanism. PMID- 1788055 TI - Quantitative and sustained suppression of renal sympathetic nerve activity by left atrial distension in conscious dogs. AB - In order to investigate the interrelations between left atrial pressure (Pla) and renal sympathetic nerve activity (RSNA) and heart rate (HR), Pla was increased by a balloon both in conscious sham-operated and cardiac-denervated dogs. RSNA was decreased and HR was increased with increasign Pla in sham-operated dogs. The reflex changes in RSNA and HR induced by the stimulation of atrial receptors persisted for at least 15 min. There was a consistent relationship between Pla and RSNA which could be described by a single exponential equation: % delta RSNA = -80.0(1-e-0.395 delta Pla), or by a linear equation when delta Pla was less than 6 mmHg; % delta RSNA = -13.5 delta Pla-2.25. The relationship between Pla and HR can be described by a single exponential equation: delta HR = 86.5(1-e 0.125 delta Pla). A significant linear relationship between RSNA and HR was obtained during a graded left atrial distention (% delta RSNA = -1.08 delta HR 17.7). In cardiac-denervated dogs, RSNA tended to increase and HR remained constant during the left atrial distention. These results indicate that left atrial receptors regulate RSNA and HR in both a quantitative and sustained manner in conscious sham-operated dogs. PMID- 1788056 TI - Characterization and mechanism of fever induction by interleukin-1 beta. AB - To investigate the relation of arachidonate metabolism to the induction of fever by interleukin-1, indomethacin was administered in either an intracerebroventricular (icv) or a subcutaneous (sc) route in conscious rabbits. Fever induced by icv administration of recombinant human interleukin-1 beta (rhIL 1 beta) was depressed by either icv or sc pretreatment with indomethacin. Fever induced by intravenous (iv) administration of rhIL-1 beta was significantly inhibited, though initial small increase in colonic temperature still remained, and was completely depressed by combination of icv and sc pretreatment with indomethacin. Intracerebroventricularly administered recombinant rabbit IL-1 beta (rrIL-1 beta) induced dose-dependent increases in colonic temperature, which was depressed by sc pretreatment with indomethacin. There is little species specificity between human and rabbit IL-1 beta, in terms of the pyrogenic potency and the inhibitory effect of sc indomethacin on fever induced by icv IL-1 beta. Further, fever caused by icv administration of sodium arachidonate was significantly depressed by sc pretreatment with indomethacin. These results show that the inhibitory effect of indomethacin, administered either icv or sc, on IL 1 beta-induced fever is similar to that of IL-1 alpha-induced fever reported previously. This suggests that the site of arachidonate metabolism significantly involved in the mechanism of fever induction by IL-1 is easily accessible to the brain from the blood. PMID- 1788057 TI - Pressure-flow characteristics in the right and left ventricular perfusion territories of the right coronary artery in swine. AB - Regional pressure-flow relationships within the right coronary artery (RCA) circulation of swine were determined. Enflurane-anaesthetized swine (n = 7) were studied during step-wise reductions of RCA perfusion pressure using an extracorporeal circuit. Regional blood flow was measured using microspheres and contractile function of the right ventricle was measured using sonomicrometry. The RCA perfusion territory was divided into its anatomic components: right ventricular free wall (RV), interventricular septum (with further division in transmural thirds; SEP-LV, SEP-MID and SEP-RV) and right atrium (RA). Pressure flow relations were constructed for each region and autoregulatory capacity assessed through calculation of an autoregulatory index (AI, closed-loop gain). The pressure-flow relationship for the entire RCA exhibited autoregulation down to a pressure of 40 mmHg. The SEP-LV exhibited a similar relationship with loss of autoregulation at approximately 40 mmHg. The pressure-flow relationship of the RV, however, showed autoregulation to a pressure of 30 mmHg with a decrease of blood flow only at a pressure of 20 mmHg. Little autoregulation was observed in the RA. Autoregulatory gain assessed by AI was similar in RV, SEP-LV and SEP-RV as pressure was reduced from 90 to 55 mmHg (RV = 0.54 +/- 0.41; SEP-LV = 0.58 +/- 0.36; SEP-RV = 0.83 +/- 0.36). With further reductions of pressure, AI was highest in the RV, followed by the SEP-RV and then SEP-LV.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1788058 TI - Carbachol induces sustained glucose-dependent oscillations of cytoplasmic Ca2+ in hyperpolarized pancreatic beta cells. AB - The effect of carbachol on the cytoplasmic Ca2+ concentration [( Ca2+]i) was studied in insulin-releasing mouse pancreatic beta cells hyperpolarized by the K(+)-channel-activating agent diazoxide. By mobilizing intracellular Ca2+, carbachol induced an initial [Ca2+]i transient, which was more than tenfold higher after preexposure to 20 mM glucose than in a medium lacking substrate. The transient was followed by a sustained but less pronounced elevation, probably due to activation of the potential-independent entry of Ca2+. In individual beta cells exposed to 20 mM glucose small oscillations with a frequency of 1-4/min were superimposed on the sustained phase. These oscillations were insensitive to methoxyverapamil, and their frequency increased in a Na(+)-deficient medium. However, the oscillations faded away after lowering glucose to 3 mM and reappeared when increasing the sugar concentration. The results indicate that the glucose concentration is an important permissive determinant for sustained oscillations of [Ca2+]i in response to agents stimulating the formation of inositol 1,4,5-trisphosphate. PMID- 1788060 TI - Teaching gerontology: the curriculum imperative. Introduction. PMID- 1788059 TI - Induction of inward rectifiers in mouse skeletal muscle fibres in culture. AB - The whole-cell voltage-clamp technique was used to study the physicochemical nature and regulatory mechanisms of inward rectifier K+ currents in skeletal muscle fibres (flexor digitorum brevis muscle) of newborn mice. The inward rectifier K+ currents were at hardly discernible levels (less than or equal to 15 microA/cm2) in fibres acutely isolated from 1-day-old (P1) mice or P1 fibres cultured without any added reagents for 1-3 days. When A23187 (1 microM), ionomycin (3 microM) or ryanodine (greater than or equal to 0.03 microM) was added to a culture medium, a significant increase of the inward rectifier current (-106 +/- 46 microA/cm2 at a membrane potential of -100 mV and an extracellular K+ concentration of 20 mM for the case of A23187) was observed within 1 day after the addition of the reagents. The inward rectifier current decreased to the level of control cultures within 11 h after a removal of A23187. The increase of the current with A23187 was inhibited with actinomycin D, cycloheximide or colchicine, but not with tunicamycin or cytochalasin B. We suggest that the functional inward rectifiers are induced in skeletal muscle fibres by elevation of the cytosolic Ca2+ concentration in a transcription and protein synthesis dependent manner and that the microtubular system is necessary for this induction. PMID- 1788061 TI - The challenge to faculty. PMID- 1788062 TI - The content domain. PMID- 1788063 TI - Developing and maintaining the learning environment. PMID- 1788064 TI - What and how of student learning activities. PMID- 1788065 TI - The American nursing home. PMID- 1788066 TI - Assessing educational goals: the national movement to outcomes evaluation. PMID- 1788067 TI - Developmental programs and remediation strategies in schools of nursing. PMID- 1788068 TI - The measurement characteristics of computerized clinical simulation tests (CST). PMID- 1788069 TI - Development of an instrument to measure thinking, learning, and creativity: a triangulation process. AB - The process of triangulation was used to develop an instrument to measure thinking, learning, and creativity in the nursing workplace. A TLC instrument consisting of five components was systematically developed as part of this study. In this descriptive correlative study, we investigated nurses' perceptions of their ability to think, learn, and be creative in their work life. The results of the investigation showed that TLC is significantly related to the perceived quality of work life of practicing registered professional nurses supporting Naisbett and Aburdene's (1985) idea that TLC is essential to attract and retain employees in the workplace. PMID- 1788070 TI - Curricula of doctoral programs in nursing. AB - Each doctoral program possesses unique features that reflect the special characteristics of the faculty, the environment, and the students of its respective institution. This study focused more narrowly on the formalized structure of programs of study available in printed literature which does not fully capture the richness of doctoral education. While most doctoral programs in this country appear to possess curricular elements of quality previously identified by AACN with respect to curricular issues in the areas of research, theory construction, and philosophy, there was much more variation in the curricular content focusing on areas of substantive nursing knowledge, and data management, tools, and technology. PMID- 1788071 TI - Assessing the goals of nursing education: issues and approaches to evaluation outcomes. PMID- 1788072 TI - Program evaluation in nursing education: creating a meaningful plan. PMID- 1788073 TI - An outcome assessment of liberal education for the baccalaureate nursing major. PMID- 1788074 TI - Assessment of affective outcomes in RN/BSN programs: advancing toward professionalism. PMID- 1788075 TI - Validation testing: implications for RN/BSN curriculum development. PMID- 1788076 TI - [A comparison of 201Tl and 99mTc-MIBI in the follow-up of differentiated thyroid carcinomas]. AB - 12 patients with suspected recurrence of differentiated thyroid carcinoma following thyroidectomy, radioiodine therapy and, in some cases, external radiation therapy had 201Tl and 99mTc-MIBI scintigraphy. Except in one case, the findings concerning tumor localization and extension were identical. In all cases, locoregional lymph node metastases as well as osseous metastases were imaged by 201Tl and 99mTc-MIBI scintigraphy. MRI images obtained in all patients with suspected lymph node metastases revealed inoperable situations in 2 cases, whereas there was no correlation in 1 patient with positive 201Tl and 99mTc-MIBI scintigraphy. In contrast, the sensitivity of the two methods was relatively low in the detection of pulmonary metastases which were imaged in 1 out of 3 patients only. Discrepancies between 201Tl and 99mTc-MIBI were observed in a case of axillary lymph node metastasis. Although tumor-/background ratios were slightly higher for 201Tl, 99mTc-MIBI SPECT showed a higher imaging quality compared to 201Tl SPECT, especially in deeply situated tumor lesions. In conclusion, 99mTc MIBI seems to be a promising alternative imaging agent in the follow-up of differentiated thyroid carcinomas. PMID- 1788077 TI - Non-invasive detection of reduced regional myocardial perfusion at rest in patients with unstable angina pectoris: increased regional 81mKr deposition following intravenous injection of 81Rb. AB - The present study was to investigate whether combined imaging of 81Rb and 81mKr distributions after i.v. injection of 81Rb at rest might improve the differentiation between ischemic and irreversibly damaged myocardium as compared to 201Tl scintigraphy at rest. In 21 patients who had undergone diagnostic cardiac catheterization for evaluation of chest pain, 148 MBq ultrapure 81Rb were injected i.v. at rest immediately following 201Tl scintigraphy at rest. Of 14 patients with earlier myocardial infarction, 10 patients revealed decreased regional tracer uptake of 81Rb and/or 81mKr, compared to 12 patients with regional 201Tl uptake abnormalities. In 3 patients with unstable angina pectoris, however, an evident mismatch between either the regional 201Tl or 81Rb distributions and the distribution of 81mKr was observed: in contrast to the reduced uptake of 201Tl and/or 81Rb, 81mKr activity was increased in 3 myocardial segments with normal left ventricular performance but supplied by coronary arteries with high-grade stenoses. In patients with contraindications to exercise tests (e.g. unstable angina) 81Rb/81mKr rest scintigraphy may therefore assist the differentiation between malperfused but potentially viable and irreversibly damaged myocardium. PMID- 1788078 TI - Visualization of bone pathologies and lung cancer with 99mTc-glucose phosphate: a comparative study. AB - Glucose phosphate (GP) labelled with 99mTc was used to obtain scintigraphic images of bone lesions in one group of patients (n = 28) and of lung tumors in another (n = 35). All bone lesions detected by 99mTc-MDP were also demonstrated by 99mTc-GP; all lung tumors except 4 were detected by 99mTc-GP, the failure rate being about the same as that for 67Ga. The use of 99mTc-GP is preferable to that of 99mTc-MDP because the former does not accumulate in normal bone; the advantage of 99mTc-GP over 67Ga lies in its better physical characteristics and in the fact that the result of the study is available within a few hours rather than three days. PMID- 1788079 TI - [A preclinical study of the organ distribution and radiation dosage of radioiodinated iodolisuride]. AB - The distribution in rats of 125I-iodo-lisuride was studied. Three rats each were sacrificed at fixed intervals between 5 min and 24 h p.i., and the radioactivity was measured in isolated organs and parts of the body. The organ distribution and biexponential blood disappearance were similar to values for unlabeled lisuride. The radiation dose was estimated for man assuming a 123I label. The resulting doses were comparable to those from other radiopharmaceuticals in clinical use. PMID- 1788080 TI - [Nuclear medicine--personnel exposure and release of radioactivity]. AB - The Nuclear Medicine Division and 30 other groups at the University of Hannover School of Medicine are taken as examples to describe the diagnostic, therapeutic and research uses of radioactivity and the effectiveness of the associated radiation protection. The evolution of radiation exposures of 520 employees followed over the last six years and the methods used for the disposal of radioactive waste are explained. The adaptation of protective measures to individual and, in particular, specific working conditions has led to approximately 90% of all exposures remaining under the detection limit of the personal dosimeters during the entire observation period. Only a few people contributed to the collective radiation dose. In 1990, the average annual dose equivalent among personnel in the Nuclear Medicine Division was 0.12 mSv/person. By the installation of facilities for the storage of isotopes with short half lives and of filters in the air circulation system, environmental contamination could be held much below the legal limits. Combustible and liquid waste containing radionuclides with long half-lives such as tritium and 14C had to be disposed of separately. However, they were a small fraction of the total radioactivity used. PMID- 1788081 TI - 99mTc-labelled anti NCA-95 antibodies in prosthetic heart valve endocarditis. AB - A 54-y old women with earlier replacement of the mitral and aortic valves and clinical signs of localized endocarditis was studied with 99mTc-labelled anti NCA 95 antibody. Whereas echocardiographic findings were negative, increased radionuclide uptake was observed left parasternal over the mitral valve as a sign of prosthetic valve endocarditis. This result could be confirmed by a similar study with leukocytes labelled in vitro with 111In-oxine. PMID- 1788082 TI - Special aides. PMID- 1788083 TI - Home truths. PMID- 1788084 TI - Put into practice. PMID- 1788086 TI - Coping well. PMID- 1788085 TI - Patient abuse. PMID- 1788087 TI - An adventure in normality. PMID- 1788088 TI - Building in health. PMID- 1788090 TI - Mental health. Listen to the real experts. PMID- 1788089 TI - Mental health. Surviving psychiatry. PMID- 1788091 TI - Environment-friendly. PMID- 1788092 TI - Making sense of ... arthroscopy. PMID- 1788093 TI - Nurse education. A helping hand? PMID- 1788094 TI - Nurse education. How to ... use small group work effectively. PMID- 1788095 TI - Left holding the baby. PMID- 1788096 TI - Teamwork in health and social services. PMID- 1788097 TI - Genital herpes at delivery of pregnancy. PMID- 1788098 TI - Food for Asian mothers-to-be. PMID- 1788099 TI - Journal of wound care nursing. Reach for the sky. PMID- 1788100 TI - Journal of wound care nursing. Practice in nursing homes. PMID- 1788101 TI - Journal of wound care nursing. Pressure sore success. PMID- 1788102 TI - [Neurologic follow-up of the premature infant with very low birth weight]. AB - The most recent studies on premature infants with low birth weights (less than 1500 grams) and extremely low birth weights (less than 1000 grams), other than confirming the spectacular drop in mortality in these subjects, have evaluated their neuropsychic development and the extent of the handicaps over the long term. The major handicaps (cerebral paralysis, mental retardation) have considerably decreased in the survivors, if one makes exception for cases with birth weights less than 750 grams (which present sequelae in high percentages, even if reported differently in the few works published). Minor handicaps (neuropsychological and behavioral defects) are maintained on relatively high levels (20-30% of subjects that survive). There is no doubt that the handicaps of these children may in large part be lead back to ischemic cerebral injuries and/or hemorrhages, well documented today in their evolution from neuroradiological technologies. The mechanism of neurological damage is, however, complex, both in its origin and in its development. Other factors contribute to this as well, among which environmental conditions seem to have an importance that can't be ignored. This applies especially for minor handicaps, which clearly predominate in premature infants of less advantaged social classes. At any rate, the neuropsychic development of premature infants with low birth weights is very individualized and difficult to predict, also because there is still much uncertainty about the value of neonatal prognostic indexes. In the course of the first year of life, neuromotor anomalies can be detected that then spontaneously disappear. In other cases, a more delayed recuperation, even if partial, can be obtained with delays in neuromotor development.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1788103 TI - [Child abuse: analysis of the problem and description of some "borderline" aspects]. AB - In the present study, the A. put in evidence some "historical" aspects of the child abuse and neglect, and emphasize "borderline" cases of this problem. The importance of this analysis for the operators of the Public Health System is great. In effect, some "borderline" cases are results of ignorance of child psychology and lack of sanitary paediatric organization in the Paediatric Divisions. PMID- 1788104 TI - [Clinical and epidemiological study of a group of patients with insulin-dependent diabetes mellitus lost to longitudinal follow-up]. AB - The Authors report the results of a retrospective study aimed to assess the clinical and biochemical parameters of a series of patients suffering from insulin-dependent diabetes mellitus (IDDM) who came out their regular follow up. 90 patients (44 males, 46 females; IDDM mean duration 10.51 yrs) who came out follow-up between 1978-1988, were evaluated by a multiple choice questionnaire. The prevalence of the degenerative complications were particularly focused. An increased prevalence of ocular (21%) and renal (12%) damage was found. Moreover this population showed a higher prevalence of degenerative complications in front of another IDDM series in regular follow up with the same mean age of disease (35.8% vs 6.4%). This data underline the role of clinical management of IDDM to prevent its degenerative complications. PMID- 1788105 TI - [Use of computer programs in the education and self-management of patients with insulin-dependent diabetes mellitus]. AB - A computerized program for children and adolescents with insulin dependent diabetes mellitus (IDDM) and their parents has been developed. Our program consists of computed assisted education, of aid to routine insulin dosage self adjustment and of records of home and hospital controls. Technically it has been implemented in DBIII plus: it runs on IBM PC computers (and compatible computers) and MS DOS (version 3.0 and later). Computed assisted education consists of 80 multiples choice questions divided in 2 parts: the first concerns basic informations about diabetes while the second one behavioral attitudes of patient in particular situations. Explanations are displayed after every question, apart from correct of incorrect choice. Help for self-adjustment of routine insulin dosage is offered in the third part. Finally daily home urine and/or blood controls and results of hospital admissions are stored in a database. PMID- 1788106 TI - [Monitoring the treatment of precocious puberty with a GnRH-analog (buserelin): comparison of the GnRH-test with nocturnal pulsatility of LH, testosterone and 17 beta-estradiol]. AB - We studied in 10 children (3 boys and 7 girls), affected by precocious puberty and treated for a period of more than 6 months with the GnRH-analog Buserelin, the efficacy of the GnRH test versus the study of spontaneous nocturnal secretion of LH, testosterone and 17 beta-estradiol as a means of testing the gonadotropin suppression. All the subjects have shown a total suppression of LH during the GnRH test as well as a nocturnal profile of LH, testosterone and 17 beta estradiol of a prepubertal pattern. Clinically all the patients were treated successfully. Considering the effectiveness of both investigations, we conclude that the GnRH test combined with clinical observation is a single and valid means of testing the pharmacological treatment for precocious puberty. PMID- 1788107 TI - [Influence of iron metabolism on the efficacy of r-HuEPO (recombinant human erythropoietin) treatment of anemia in children on hemodialysis]. AB - Recombinant Human Erythropoietin (r-HuEPO) is efficient in the treatment of anaemia in terminal renal failure under dialysis. Five pediatric patients, who were under periodic hemodialysis, were treated and the interaction between the metabolism of iron and the response to r-HuEPO was studied in particular. In two patients it was noticed that a significant reduction of hematic ferritin levels occurred, while an efficient erythropoietic activity was maintained. On the contrary, three patients showed iron deficiency characterized by a reduced percentage of total transferrin saturation in the plasma, in the presence of high levels of ferritin in the blood. Also discovered was a missing increase or even a fall of the hemoglobin values that were obtained till now. In these cases, the increase of the hormone dose didn't lead to an improvement, that could only be obtained by the oral or parenteral administration of iron. The Authors in conclusion affirm that iron deficiency is the first cause to be searched for and to be corrected in the presence of missing hemoglobin increase even with adequate doses of r-HuEPO. PMID- 1788108 TI - [Prevention of acute hypertensive encephalopathy in the course of acute post streptococcal glomerulonephritis in children: considerations in 31 cases]. AB - The authors analysed 31 cases of an acute hypertensive glomerulonephritis. The antihypertensive efficacy of two medicines: a vasodilator (dihidralazine) and a diuretic (Furosemide) was underlibed an these patients. Their efficacy was evident not only in the stabilization of P.A. around normal values on three days, but also on the disappearance of signs of on hypertensive encephalopathy whereas these ones were present. PMID- 1788109 TI - [Radiology of thalassemic syndrome in the transition from the old to the new therapeutic transfusion regimen]. AB - The authors have evaluated the skull, thorax, wrist and hand standard radiographs of 29 patients affected by Cooley's disease who were treated up to 1983 with a low transfusion regimen, rather with a high transfusion regimen (Hb level greater than 9.5 g/dl). The patients have been divided into two groups, according to the prevalence of the first or the second transfusion regimen. Almost all the changes described in the literature have been found in the radiographs, but completely modified; some of these, like rib notchings, in higher percentage than known. In the youngest patients the most significant appearances were ribs and hand changes, that can be considered the most important feature in their radiological monitoring. However this new transitional radiological syndrome will rapidly modify with the establishment "ab initio" of the high transfusional regimen. PMID- 1788110 TI - [Antiendomysium antibodies in the diagnosis and follow-up of celiac disease]. AB - The authors have studied the proceeding of anti endomysium antibodies (AEA-IgA) in a group of coeliac patients, in order to investigate new tests, not intrusive and easy repeatable, to employ in diagnosis and in follow up of coeliac disease. The research was carried out by an indirect immunofluorescent test on 65 sera of patients with age range 1-11 years; of those patients 14 show the coeliac disease at beginning, 16 were on Gluten Free Diet (GFD) from 3-5 months, 28 were on GFD from 1 year and 7 were on challenge with gluten from 2-4 months. We investigated AEA-IgA in sera of 71 gastroenterological and not-gastroenterological patients of analogous age to coeliacs how control subjects. All coeliac patients (14) with disease at beginning were positive for AEA-IgA. For the patients on GFD we observed an evident correlation between the term of diet and presence of AEA-IgA: 12 of 16 patients on GFD from 3-5 months were positive, but after 1 year of GFD all patients were negative; after 2-4 months from reintroduction of gluten in diet with the challenge we observed that all examined patients were positive for AEA-IgA. In 21 coeliac patients on free diet (14 with the disease at beginning and 7 after challenge) any reduction of percentage positivity was noted with the growth. The investigation of AEA-IgA in all examined control subjects was always negative. Our data suggest that the AEA-IgA investigation, for highly sensitivity and specificity, for easy repeatability and absence of intrusivity, is a diagnostic test that can be usefully combined to others (intestinal biopsy, dosage of anti gliadin antibodies) in diagnosis and in follow up of coeliac disease. PMID- 1788111 TI - [Congenital hip dislocation: at what age to screen with ultrasound?]. AB - The Authors report their experience in ultrasound screening for congenital hip dislocation. Goal of this study is to recognize the best age for the screening. PMID- 1788112 TI - [Hospital admissions in a pediatric department]. AB - Admission of 429 children in Pediatric Department were examined. 249 children had been taken to emergency ward by parents, 131 had been hospitalized by other physician. 175 children had been examined before admission by panel doctor who decided admission of 114 in Pediatric Department. Parents decided admission of 30 children. The necessity of admission in Department was only in 33 per cent of children admitted. PMID- 1788113 TI - [Intestinal hemorrhage in a milk-fed infant: a case of laryngo-tracheo-gastric duplication]. AB - An important gut hemorrhage in a breast fed child is not a usual event. If, in addition, the etiology represents a real rarity, even the most sophisticated diagnostic trials can't give any aid and this constitutes a hard diagnostic and therapeutic problem. In this report, the authors describe how, after a long sequence of analysis and exams, no certain diagnosis was possible, till serious anaemia gave indication to an explorative laparatomy. Laparatomy became both diagnostic and therapeutic and allowed to discover a rare malformation: a tracheal-gastric duplication. PMID- 1788114 TI - [William-Beuren syndrome: description of a case]. AB - The Authors describe a case of William-Beuren Syndrome, also know as "Fanconi Schlesinger Syndrome" or "Idiopathic Hypercalcaemia, supravalvular aortic stenosis, elfin facies syndrome". Irritability and chronic constipation are early features. Hypercalcaemia may occur in infancy but rarely after 1 year age. The facies is characteristic. Supravalvular aortic stenosis is the most frequent cardiac abnormality. Other common features are short stature, mental retardation and significant behavioural disorders. In this case report typical facies, short stature, behavioural disorders are associated with epilepsy in early years of life. Hypercalcaemia or cardiovascular malformation were not found. PMID- 1788115 TI - [Non-specific spondylodiscitis in children: report of a case in an infant. Review of the literature]. AB - A case of non-specific spondylitis in an infant has prompted us to an ample review of the literature. The disease is acknowledged as characteristically benign in children. However some publications seem to imply that in the very young child it would display a remarkable seriousness. From our case and half a score of others that we found in the literature, it appears that in the first year of life the nonspecific spondylitis has the same features as in the older children, namely a mild course and a good prognosis. The above publications probably refer to peculiar cases, which give rise to an as yet unsolved nosological problem. The characteristics of the disease, with special emphasis on its clinical and radiological presentation and evolution, are exposed. PMID- 1788116 TI - [Paroxysmal tachycardia in children: analysis of two clinical cases]. AB - Two cases of paroxysmal supraventricular tachycardia in children are reported. Associated congenital heart disease were excluded by color-doppler echocardiogram. Electrocardiogram, holter monitoring and transesophageal study (in one case) suggested associated Wolf-Parkinson-White syndrome. The former case was successfully treated with digitalis, the latter, diagnosed "at risk" by transesophageal recording, was long term treated with propafenone. Clinical evaluation at follow-up confirmed the efficacy of the therapy. PMID- 1788117 TI - [Acute perforated appendicitis in newborns]. AB - The Authors present and discuss a personal case of perforated acute neonatal appendicitis. After a brief review of literature, they delineate the elements that are responsible of rareness of this affection and the causes of frequency of perforation and mortality. Diagnosis is difficult in newborns because clinical and laboratory signs are not specific. They conclude affirming that acute abdomen is an indication for operation even if pre-operating diagnosis of acute neonatal appendicitis is not possible. PMID- 1788118 TI - Haemophilus influenzae type b bacteremia in older children. AB - Haemophilus influenzae type b (HIB) is a well-recognized cause of serious infection in infants and toddlers. However, little information exists regarding HIB infections in older children. This report describes serious HIB infections in 23 children (eight immunocompromised; 15 immunocompetent) older than 59 months of age. Data were collected over an 11-year period. The mean age of the children was 7.6 years (range, 5-15 years), and 14 were male. While three of the eight immunocompromised children had HIB pneumonia, none of the immunocompetent group had this diagnosis. Eleven of the 15 immunocompetent children had epiglottitis or meningitis. HIB bacteremia without focal infection occurred in four children, two immunocompromised and two immunocompetent. This study supports the recommendation of empiric HIB antibiotic therapy for children up to 12 years of age who have serious infections. Antibiotics effective against HIB should be included in the presumptive antibiotic therapy of seriously ill immunocompromised children, regardless of age. PMID- 1788119 TI - Electrocardiographic findings in children with Lyme disease. AB - The incidence of cardiac involvement in Lyme disease (LD) has been estimated to be 4 to 10% in adults, with conduction and rhythm disturbances noted most frequently. To assess the frequency of electrocardiographic abnormalities in children with LD, we prospectively performed 12-lead electrocardiograms in 32 randomly selected children presenting with LD between May and September 1989. No patient had symptoms of cardiac involvement. Using defined diagnostic criteria, combining symptoms, signs, serology, and residence in or travel to an endemic area, 14 patients were classified as having definite LD and 10 were categorized as probable. The incidence of electrocardiographic abnormalities in the definite group was 29% (4/14), including two patients with 1 degree atrioventricular block, one with left axis deviation, and one with ventricular ectopy. Thirty percent (3/10) of the probable group had abnormal ECGs, including one with ST-T wave abnormalities, one with prominent sinus arrhythmia, sinus bradycardia, and wandering atrial pacemaker, and one with ectopic atrial bradycardia. No patient required cardiac therapy. The incidence of abnormal ECG findings in this group of children with either probable or definite LD was thus 29%, with 1 degree atrioventricular block noted most frequently. When the diagnosis of LD is highly suspected, an electrocardiogram may be a useful screening test for cardiac involvement. PMID- 1788120 TI - An approach to the diagnosis and treatment of membranous laryngotracheobronchitis in infants and children. AB - The purpose of this study is to report 18 cases of membranous laryngotracheobronchitis (MLTB) and to review 143 published cases in order to accurately characterize the epidemiology, presentation, clinical course, treatment, and outcome of patients with this disorder. The male:female ratio was 2:1; mean age was four years. Most patients presented with acute onset of respiratory distress with fever, toxicity, and stridor after a prodrome of upper respiratory tract infection lasting a few days. White blood cell counts varied over a wide range, and blood culture results were rarely positive. Respiratory cultures commonly yielded Staphylococcus aureus or Haemophilus influenzae. Diagnosis was usually confirmed by airway radiographs or endoscopy. An artificial airway was required in 83% of patients. Complications included respiratory failure, toxic shock syndrome, anoxic encephalopathy, and death. MLTB is a serious, potentially fatal cause of acute infectious airway obstruction in infants and children that requires an organized approach to diagnosis and management. PMID- 1788121 TI - Percutaneous ethyl alcohol intoxication in a one-month-old infant. AB - A one-month-old child was referred to our hospital for unexplained lethargy. She was found to be intoxicated from ethanol-soaked gauze pads which had been applied to the umbilical stump and contiguous skin for several days for the purpose of promoting umbilical cord detachment. We emphasize the importance of considering the risk of percutaneous alcohol absorption, especially in young infants, and the necessity of toxicology screening in every child with drowsiness of unknown etiology. PMID- 1788122 TI - Hydrofluoric acid burn in a child. PMID- 1788123 TI - The clinical features of children with malrotation of the intestine. AB - A review was performed of the 37 cases of malrotation of the intestine which occurred in previously healthy children during a 12-year period. There were 33 patients (89%) younger than eight weeks of age, with 17 patients (46%) aged less than one week. Symptoms included bilious vomiting in 36 patients (97%) and constipation in 33 patients (89%). On initial examination, 35 patients (95%) appeared to be well (including 23/25 patients [92%] with volvulus of the midgut), and 28 patients (76%) exhibited no abnormal physical findings on abdominal examination (including 15/25 patients [60%] with volvulus of the midgut). In all, 25 cases (68%) of malrotation were accompanied by volvulus of the midgut; in 21 of these cases, torsion of the bowel was greater than or equal to 360 degrees. There were four patients (11%) with gangrenous bowel requiring surgical resection. The mortality rate associated with this disorder was 5%; both patients who died were neonates with volvulus who presented in shock and had extensively gangrenous bowel. Malrotation of the intestine usually presents in the young infant, is almost always associated with bilious vomiting, and is commonly accompanied by few if any abnormal physical findings suggestive of a serious underlying intraabdominal disease process. An emergent radiographic contrast study of the upper gastrointestinal tract should be performed to delineate the anatomy of the proximal bowel in all young infants with bilious vomiting. PMID- 1788124 TI - Paradoxical hypertension in hypovolemic children. PMID- 1788125 TI - The role of footwear in childhood injuries. AB - To assess the influence of footwear on injury, we prospectively studied all injured children presenting to the Emergency Department of The Children's Hospital of Philadelphia during February, May, July, and October 1988. Information was collected concerning the type and characteristics of footwear worn and environmental factors. Comparisons were made between those involving and those not involving loss of footing (LOF) during injury. Of the 3015 children studied, LOF occurred in 1075 (35.8%). Overall, significantly more injuries involved LOF in children whose feet were covered (n = 946, 37.0%) than in those who were barefoot (n = 129, 29.1%) at the time of injury (P less than 0.001). However, children wearing low-top sneakers had the lowest rate of LOF (24.0%) of any group. Children wearing rough-sole footwear had LOF significantly less frequently (24.2%) than those wearing smooth-sole footwear (51.8%; P less than 0.001). Rubber-sole footwear was less frequently associated with LOF (n = 488, 28.6%) than were other sole materials (n = 457, 53.8%; P less than 0.001). Our data suggest a potential injury prevention strategy involving utilization of rough-sole footwear. PMID- 1788126 TI - Universal precautions and safety devices which reduce the risk of occupational exposure to blood-borne pathogens: a review for emergency health care workers. PMID- 1788127 TI - Abdominal pain and mass. PMID- 1788128 TI - Infant incubators. PMID- 1788129 TI - Eye emergencies: acute management in the pediatric ambulatory care setting. AB - Pediatric emergency department visits commonly relate to eye problems. Over 70,000 children under the age of 15 years are treated annually for eye injuries. Ocular examination is also often performed in the ambulatory care setting when the physician is evaluating systemic problems, such as head trauma, to look for abnormalities such as papilledema. For these reasons, it is essential that the acute care physician becomes familiar with the initial evaluation and management of ocular disorders. Unfortunately, this evaluation may be hampered by inadequate instrumentation, an uncooperative patient, or a fear of causing further damage to the eye. However, primary care physicians can perform a wide range of diagnostic and therapeutic interventions with a minimum of technology and a modicum of patience and understanding. PMID- 1788130 TI - Nasotracheal intubation of pediatric patients. PMID- 1788131 TI - Isolation and amino acid sequence of crustacean hyperglycemic hormone precursor related peptides. AB - The crustacean hyperglycemic hormone (CHH) is synthesized as part of a larger preprohormone in which the sequence of CHH is N-terminally flanked by a peptide for which the name CPRP (CHH precursor-related peptide) is proposed. Both CHH and CPRP are present in the sinus gland, the neurohemal organ of neurosecretory cells located in the eyestalk of decapod crustaceans. This paper describes the isolation and sequence analysis of CPRPs isolated from sinus glands of the crab Carcinus maenas, the crayfish Orconectes limosus and the lobster Homarus americanus. The published sequence of "peptide H" isolated from the land crab, Cardisoma carnifex, has now been recognized as a CPRP in this species. Sequence comparison reveals a high level of identity for the N-terminal region (residues 1 13) between all four peptides, while identity in the C-terminal domain is high between lobster and crayfish CPRP on the one hand, and between both crab species on the other. Conserved N-terminal residues include a putative monobasic processing site at position 11, which suggests that CPRP may be a biosynthetic intermediate from which a potentially bioactive decapeptide can be derived. PMID- 1788132 TI - Structure, bioactivity, and cellular localization of myomodulin B: a novel Aplysia peptide. AB - Important insights into mechanisms by which neuromuscular activity can be modulated have been gained by the study of experimentally advantageous preparations such as the ARC neuromuscular system of Aplysia. Previous studies have indicated that one source of modulatory input to the ARC muscle is its own two motor neurons, B15 and B16. Both of these neurons synthesize multiple peptide cotransmitters in addition to their primary neurotransmitter acetylcholine (ACh). Peptides present in the ARC motor neurons include SCPA, SCPB, buccalin A and B, and myomodulin A. We have now purified a novel neuropeptide, myomodulin B, which is structurally similar to myomodulin A. Myomodulin B is present in two identified Aplysia neurons that contain myomodulin A; the ARC motor neuron B16 and the abdominal neuron L10. Ratios of myomodulin A to myomodulin B are approximately 6:1 in both cells. Like myomodulin A, myomodulin B potentiates ARC neuromuscular activity; it acts postsynaptically, and increases the size and relaxation rate of muscle contractions elicited either by motor neuron stimulation or by direct application of ACh to the ARC. When myomodulin A is applied to the ARC in high doses (e.g., at about 10(-7) M), it decreases the size of motor neuron-elicited muscle contractions. This inhibitory effect is never seen with myomodulin B. Thus, despite the structural similarity between the two myomodulins, there exists what may be an important difference in their bioactivity. PMID- 1788133 TI - Pretreatment with caerulein protects against memory impairment induced by protein kinase C inhibitors in the rat. AB - The effect of subcutaneously injected caerulein (CER) on memory impairment induced by protein kinase C (PKC) inhibitors, H-7 and melittin, was examined in rats. Intracerebroventricular injection of PKC inhibitors caused marked memory impairment in one-trial passive avoidance response and Morris water tank tasks. However, when rats were pretreated with CER at a subcutaneous dose of 1 microgram/kg 3 hours before the training trials, the reduced latency of the passive avoidance response was significantly increased, and in the Morris water pool tasks the memory deficit induced by PKC inhibitors completely disappeared. These results indicate that CER can offer protection against the effect of PKC inhibitors at least from the viewpoint of the memory processes. PMID- 1788134 TI - Electrophysiological actions of VIP in rat somatosensory cortex. AB - Electrophysiological and biochemical studies suggest that VIP may exert a facilitating action in the neocortical local circuitry. In the present study, we examined the actions of VIP and VIP + norepinephrine (NE) on somatosensory cortical neuron responses to direct application of the putative transmitters acetylcholine (ACh) and gamma-aminobutyric acid (GABA). Spontaneous and transmitter-induced discharges of cortical neurons from halothane-anesthetized rats were monitored before, during and after VIP, NE and VIP + NE iontophoresis. In 57 VIP-sensitive cells tested, VIP application (5-70 nA) increased (n = 18), decreased (n = 36) or had biphasic actions (n = 3) on background firing rate. In a group of 20 neurons tested for NE + VIP, the combined effect of both peptide and bioamine was predominantly (70%) inhibitory. On the other hand, inhibitory and excitatory responses of cortical neurons to GABA (11 of 15 cases) and ACh (10 of 18 cases), respectively, were enhanced during VIP iontophoresis. Concomitant application of VIP and NE produced additive (n = 2) or more than additive (n = 3) enhancing effects on GABA inhibition. NE administration reversed or enhanced further VIP modulatory actions on ACh-induced excitation. These findings provide electrophysiological evidence that NE and VIP afferents may exert convergent influences on cortical neuronal responses to afferent synaptic inputs such that modulatory actions are anatomically focused within the cortex. PMID- 1788135 TI - Developmental changes in brain angiotensin II receptors in the rat. AB - AII binding and distribution were measured in rat brain during development by autoradiographic techniques using radioiodinated [Sar1,Ile8]AII. At all ages, from 2 days to 7 weeks, binding was present in the circumventricular organs, and areas related to pituitary hormone secretion and modulation of sympathetic activity. At early stages of development, AII binding was transiently expressed in a number of motor- and sensory-related areas. These findings support a role for AII in the control of water intake and autonomic activity at all stages of development, and suggest that the peptide may be involved in the maturation of neuronal function during development. PMID- 1788136 TI - Coerulospinal cells containing neuropeptide Y in the cat. AB - Spinally projecting neuropeptide Y (NPY)-immunoreactive cells were sought in the feline locus coeruleus (LC) nuclear complex after horseradish peroxidase (HRP) injection into the lumbar cord; HRP injection was followed by intracerebroventricular colchicine administration. Our results revealed that a significant number (approximately 20% of all descending cells from the LC complex) of spinally projecting NPY-immunoreactive neurons arise from the LC alpha, the subcoeruleus and the Kolliker-Fuse nuclei. Other nonspinally projecting NPY-containing cells were also evident in the laterodorsal tegmental nucleus and the LCd, in addition to those occurring in the aforementioned LC nuclear complex. PMID- 1788137 TI - Chemical stability and plasma-catalyzed dealkylation of peptidyl-alpha hydroxyglycine derivatives--intermediates in peptide alpha-amidation. AB - The production of alpha-amidated peptides has recently been shown to occur via a two-step process with peptidyl-alpha-hydroxyglycine being an intermediate. In this study the chemical stability and plasma-catalyzed conversion of various peptidyl-alpha-hydroxyglycine derivatives to their parent amide product have been examined. This conversion was shown to be independent of pH in the range pH 1-5 and to be apparently specific base-catalyzed at pH 6-10. At pH 7.4 and 37 degrees C the half-lives of decomposition of the derivatives ranged from 5.8 to 13.3 h. In 80% human plasma solutions (pH 7.4) the half-lives decreased to 1.3-3.9 h, indicating the occurrence of an enzyme activity in plasma catalyzing the dealkylation of peptidyl-alpha-hydroxyglycine derivatives. The best substrate for the plasma catalytic activity was found to be N-benzyloxycarbonyl-L-alanyl-alpha hydroxyglycine. PMID- 1788138 TI - Inhibition of apomorphine-induced yawning and penile erection by neurotensin. AB - The yawns and penile erection elicited in rats by apomorphine (100 micrograms/kg SC) are dose-dependently suppressed by the enkephalinase-resistant analog of NT, [D-Trp11]NT, intracerebroventricularly (ICV) injected (10-120 ng per rat). This antagonistic effect was shared by NT (0.75-3 micrograms per rat) administered ICV. The yawns induced by pilocarpine (2 mg/kg IP) were similarly antagonized by [D-Trp11]NT (30-120 ng per rat). The enkephalinase inhibitor acetorphan (5 mg/kg IV) reduced in a naloxone (2 mg/kg, SC)-resistant manner the apomorphine-induced penile erection or yawning. PMID- 1788139 TI - Effects of fourth ventricle bombesin injection on meal-related parameters and grooming behavior. AB - Injections of bombesin (BN) into the vicinity of the caudal brainstem suppress food intake in rats. In the present study, the food intake parameters [meal size (MS), intermeal interval (IMI), satiety ratio (SR)] affected by 4th ventricle BN injections were determined. Following a 15-h food deprivation, rats were administered 4th ventricle injections of saline (0.15 M) and BN in doses of 1, 5, 10, and 20 ng BN, and were then given access to sweetened milk. The animals' behaviors (feeding, resting, grooming, exploring) were scored every one min and milk intake every five min for 60 min following the injections. Fourth ventricle injections of 5 ng BN and greater reliably suppressed milk. intake. This reduction was reflected in a significant reduction in the MS. The IMI was not affected. As a result, the SR (IMI2/MS1), which is thought to represent the satiating property of food, was reliably greater following BN than following saline administration. The reduced food intake was accompanied by a significant increase in grooming behavior and a corresponding decrease in exploring. The amount of time spent resting (inactive) was similar following saline and all but the highest dose of BN. To demonstrate that the behavioral effects of BN were mediated by specific caudal brainstem BN receptors, 4th ventricle injections of [D-Phe12,Leu14]BN, a BN receptor antagonist, or saline preceded the 4th ventricle injection of 5 ng BN. Pretreatment with [D-Phe12,Leu14]BN reliably blocked the effects of BN on food intake and grooming. PMID- 1788140 TI - Anti-inflammatory activity of alpha-MSH(11-13) analogs: influences of alteration in stereochemistry. AB - D-Amino acid substitutions in the anti-inflammatory/antipyretic Ac-alpha-MSH(11 13)-NH2 tripeptide of Ac-alpha-MSH(1-13)-NH2 were made and the altered peptides were injected in mice treated with picryl chloride. Ear swelling, measured 3 and 6 h after application of the irritant, was reduced by IP injections of Ac-alpha MSH(11-13)-NH2, in confirmation of previous observations. Ac-[D-Lys11]alpha MSH(11-13)-NH2 effected similar anti-inflammatory activity but Ac-[D-Pro12]alpha MSH(11-13)-NH2 was inactive. Ac-[D-Val13]alpha-MSH(11-13)-NH2 and Ac-[D-Lys11,D Val13]alpha-MSH(11-13)-NH2 generally had greater anti-inflammatory activity than the parent tripeptide molecule; the dose-response relations exhibited the bell shaped characteristics seen previously with MSH peptides. The results indicate that the L-Pro12 is essential for the anti-inflammatory activity of Ac-alpha MSH(11-13)-NH2 whereas the L-Lys11 is not. D-Val13 substitution increased anti inflammatory activity approximately four-fold over Ac-alpha-MSH(11-13)-NH2. These results provide new structure-activity relationships of the anti-inflammatory Ac alpha-MSH(11-13)-NH2 molecule. The data support the developing idea that alpha MSH and its COOH-terminal fragments modulate host responses, perhaps by antagonizing the actions of cytokines. PMID- 1788141 TI - In vitro degradation of endothelin-1 by endopeptidase 24.11 (enkephalinase). AB - The breakdown of endothelin-1 by crude membrane preparations of human kidney and choroid plexus was investigated. 125I-labeled endothelin-1 was degraded by both tissues in a phosphoramidon-sensitive way, suggesting a role of endopeptidase 24.11 in the in vitro metabolism of this peptide. Identification of the cleavage sites of purified human renal endopeptidase 24.11 in the sequence of endothelin-1 revealed that bonds involving the amino side of the hydrophobic amino acids (Ser4, Leu6, Val12, Phe14, His16, Leu17, Ile19) were susceptible to cleavage. Endothelin-1 appears thus to be degraded at multiple sites by endopeptidase 24.11 in vitro, producing inactive fragments. PMID- 1788142 TI - Urotensin I-like immunoreactivity in the central nervous system of Aplysia californica. AB - In the present study the occurrence and localization of urotensin I (UI, a corticotropin releasing factor-like peptide) in the CNS of Aplysia californica were investigated by immunocytochemistry and radioimmunoassay. The RIA cross reactivity pattern indicated that the UI antiserum used recognized an epitope in the C-terminal region of the UI, but it did not cross-react with mammalian corticotropin-releasing factor (CRF) and partially recognized sauvagine (SVG, a frog CRF-like peptide). The use of CRF-specific and sauvagine-specific antisera failed to give positive immunostaining. The application of UI antiserum (which does not cross-react with CRF in RIA) gave a positive staining, which was blocked by synthetic sucker (Catostomus commersoni) UI, but not by rat/human CRF (10 microM). On the basis of immunostaining and RIA parallel to fish UI displacement curves of cerebral ganglia extracts, the unknown UI/CRF-like substance in the Aplysia ganglia is likely to have greater homology with sucker UI than with the known CRF peptides. Urotensin I-immunoreactive (UI-ir) neurons were seen mainly in the F neuron clusters, located in the midline and rostrodorsal portion of the cerebral ganglia. Few UI-ir neurons were also found in the C and D neuron clusters of the cerebral ganglia, as well as in the left pleural and abdominal ganglia. In addition, numerous fine and coarse, and beaded UI-ir fibers were found in the cerebral commissure. UI-ir fibers were also seen in the neuropile of the buccal, pedal and pleural ganglia, and abdominal ganglion. A cuff-like arrangement of UI-ir fibers was seen in the supralabial nerves.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1788143 TI - Central administration of the peptide alpha-MSH inhibits inflammation in the skin. AB - Inflammation is generally conceptualized in terms of cells, mediators, and events in the periphery, with no consideration of an influence of the central nervous system (CNS). However, the neuroendocrine peptide alpha-melanocyte stimulating hormone (alpha-MSH) is anti-inflammatory when given systemically and this molecule reaches the brain to exert another effect: fever reduction. Tests on mice indicate that alpha-MSH can act solely within the CNS to inhibit inflammation in the skin. This observation indicates that the central nervous system can inhibit peripheral inflammation via action of alpha-MSH molecules and it further strengthens the idea of neural/endocrine modulation of the host responses. PMID- 1788144 TI - Peptide YY reduces effects of sympathetic nerves and neuropeptide Y on cardiac vagal action. AB - In anesthetized dogs intravenous injection of neuropeptide Y (NPY) or stimulation of the cardiac sympathetic nerve is followed by a period of attenuation of vagal action at the heart lasting from many minutes to over an hour. Peptide YY (PYY), a related peptide (but one not reported to occur in the heart or its autonomic innervation), also inhibits cardiac vagal action but is more powerful and has a longer duration action. In 5 of 9 dogs, cardiac sympathetic nerve stimulation inhibited vagal action on the heart in control conditions, but relieved preexisting inhibition when repeated in the presence of PYY. In 3 dogs, exogenous NPY inhibited cardiac vagal action in control conditions, but failed to augment preexisting inhibition in the presence of PYY. An explanation offered for these results is that when PYY is occupying receptors on vagal nerve terminals, nerve released NPY or exogenous NPY is either unable to produce an effect, because it cannot gain access to the receptors, or displaces PYY from at least some receptors and, being less powerful than PYY in its inhibitory action, lessens the preexisting vagal attenuation. The results reported are consistent with the proposal that the factor released from the sympathetic nerves following their stimulation and which is responsible for cardiac vagal inhibition is NPY. PMID- 1788145 TI - Primary structure and pharmacological activity of a nonapeptide related to neuromedin U isolated from chicken intestine. AB - An extract of chicken intestine contained neuromedin U-like immunoreactivity (36 pmol/g wet tissue weight). The primary structure of the predominant molecular form (NMU-9), comprising 94% of the total immunoreactivity, was established as: Gly-Tyr-Phe-Phe-Phe-Arg-Pro-Arg- Asn-NH2. This sequence differs from that of pig neuromedin U-8 (NMU-8) by the substitution of Leu3 by Phe and, like the corresponding peptide from the guinea pig, is extended from the NH2-terminus by a Gly residue. A minor component of neuromedin U comprised 25 amino acid residues. An extract of chicken whole brain contained much less NMU-like immunoreactivity (1.5 pmol/g) and the nonpeptide was the only molecular form detected. Synthetic chicken NMU-9 produced a concentration-dependent contraction of smooth muscle from the rat uterus and its effect was unchanged in the presence of tetrodotoxin, atropine and indomethacin. The potency of chicken NMU-9 (EC50 360 +/- 60 nM; mean +/- S.E., n = 6) was approximately 8-fold less than that of pig NMU-8 (EC50 46 +/ 8 nM) but the maximum contraction produced by both agonists was not significantly different. PMID- 1788146 TI - Interaction between norepinephrine, NPY and VIP in the ovarian artery. AB - The in vitro effect and the interaction between norepinephrine (NE), neuropeptide Y (NPY) and vasoactive intestinal peptide (VIP) were studied in dissected segments of the rabbit ovarian artery. In addition, the structural requirement of the NPY receptor was investigated using NPY peptide analogs. NE induced a dose dependent vasoconstriction with an Emax of 131.4 +/- 2.9% of K(+)-induced constriction. The vasoconstrictor effect of NPY was less than 5% of K(+)-induced vasoconstriction. Incubation of the artery with 10(-7) M NPY for 4 min induced a significant potentiation of NE-induced contractions. The selective NPY Y1 receptor agonist [Leu31, Pro34]NPY was also able to potentiate the NE response at the half-maximum contraction level, but not NPY(11-36), an NPY peptide fragment predominantly stimulating the NPY Y2 receptor. NPY exerted a dose-dependent vasoconstrictor effect on vessels contracted for 20 min with 10(-6) M NE. VIP induced a dose-dependent relaxation of vessels contracted with 10(-6) M NE. The VIP-induced relaxation could be reversed by NPY. In conclusion, receptors capable of interacting with NPY, presumably of the Y1 type, and VIP are present in the rabbit ovarian artery, and activation of these receptors may profoundly influence the response of the artery to norepinephrine. PMID- 1788147 TI - Calcitonin gene-related peptide in human obesity. AB - We studied plasma calcitonin gene-related peptide (CGRP) levels in obese women before (n = 24) and after (n = 13) weight loss, and in normal weight controls (n = 15). Furthermore, the influence of two isocaloric meals (high carbohydrate vs. high fat) on plasma CGRP concentrations was studied. The CGRP concentration in the obese group (32.26 +/- 2.01 pg/ml) was significantly (p less than 0.0001) higher than in the control group (21.64 +/- 0.15 pg/ml). After weight loss (14.3 +/- 0.72% of original weight) CGRP concentrations remained unchanged. Only the high-fat meal caused a significant (p less than 0.02) rise in CGRP levels. Our results indicate that elevated plasma CGRP levels may constitute a primary phenomenon in obese women, and that fat intake may be associated with increased CGRP secretion. PMID- 1788148 TI - Amylin decreases food intake in mice. AB - The isolation of amylin from pancreatic islets has stimulated interest in its potential role in the pathogenesis of type II diabetes mellitus and in its possible physiological roles. Amylin administered intraperitoneally decreased food intake in non-food-deprived and food-deprived diabetic and nondiabetic mice. Amylin also decreased feeding induced by insulin administration without significantly affecting blood glucose levels. Amylin also decreased food intake following intracerebroventricular administration. It is possible that amylin plays a physiological role in appetite regulation and may play a pathophysiological role in the altered appetites seen in some persons with type II diabetes mellitus. PMID- 1788149 TI - Effects of DDAVP on movement planning and execution processes in the healthy elderly. AB - Effects of DDAVP on speed and consistency of planning and executing simple and complex movements in healthy older adults were studied. A simple reaction time (SRT) task, a single-plane movement task, and two tasks involving multiplane movements of distal upper extremities were performed with and/or without a 0.6 ml intranasal dose (60 micrograms) of DDAVP or placebo. Results indicated that DDAVP had no significant effect on speed or consistency of SRT processes, or the speed with which simple or complex movements were planned or executed. There was also no effect on retention of motor responses. PMID- 1788150 TI - Presence of immunoreactive endothelin in human saliva and rat parotid gland. AB - The presence of immunoreactive endothelin (IR-ET) in human saliva and rat parotid gland was investigated by radioimmunoassay. The IR-ET concentration (mean +/- SEM) in saliva taken from normal volunteers was 2.0 +/- 0.2 pmol/l (n = 15). The IR-ET concentration in rat parotid gland was 19.2 +/- 2.2 fmol/g wet weight (n = 10). Fast protein liquid chromatography (FPLC) of human saliva extract revealed 6 peaks; one peak eluting in the void volume, one in a position between ET-1 and 3, and the other four in the positions of synthetic ET-1, -2, -3 and big ET(1 38), respectively. A similar pattern of rat parotid gland extract was noted with FPLC, except that there was no peak after the void volume. Presence of endothelin, a potent growth factor, in saliva and salivary gland points to a role in maintaining the integrity of the oral and gastrointestinal tract mucosa. PMID- 1788151 TI - Effects of [des-Tyr-D-Phe3]beta-casomorphin (2-5) on sleep pattern in rats. AB - The effects of the antidepressant-like acting peptide [des-Tyr-D-Phe3]beta casomorphin(2-5) (Pro-D-Phe-Pro-Gly, BCH-325) on sleep were studied in rats. The rats received subcutaneous injections of BCH-325 in acute experiments (doses: 4, 20, 100, 500 and 2500 nmol/kg) and in a 10-day chronic experiment (50 nmol/kg/day). Acute administration of 20 and 100 nmol/kg enhanced wakefulness, 500 and 2500 nmol/kg enhanced paradoxical sleep, and 4 nmol/kg had no effect. Chronic administration resulted in an increase of paradoxical sleep during the first 5 days of drug treatment. Thus the sleep effects of BCH-325 differ from those of typical antidepressants and other psychotropic drugs. PMID- 1788152 TI - Liposomes and nanoparticles in the treatment of intracellular bacterial infections. AB - The treatment of infections caused by obligate or facultative intracellular microorganisms is difficult because most of the available antibiotics have either poor intracellular diffusion and retention or reduced activity at the acidic pH of the lysosomes. The need for antibiotics with greater intracellular efficacy led to the development of endocytosable drug carriers, such as liposomes and nanoparticles, which mimic the entry path of the bacteria by penetrating the cells into phagosomes or lysosomes. This Review assesses the potential of liposomes and nanoparticles in the targeted antibiotic therapy of intracellular bacterial infections and diseases and the pharmaceutical advantages and limitations of these submicron delivery systems. PMID- 1788153 TI - Water-soluble, solution-stable, and biolabile N-substituted (aminomethyl)benzoate ester prodrugs of acyclovir. AB - Various N-substituted 3- or 4-(aminomethyl)benzoate esters of acyclovir were synthesized and evaluated as water-soluble prodrug forms with the aim of improving the delivery characteristics of acyclovir, in particular its parenteral administration. The esters showed a high solubility in weakly acidic solutions and, as demonstrated with the 3-(N,N-dipropylaminomethyl)benzoate ester, a high stability in such solutions, allowing storage for several years. The esters combine these properties with a high susceptibility to undergo enzymatic hydrolysis in plasma. The half-lives of hydrolysis in 80% human plasma ranged from 0.8 to 57 min, the rate being highly dependent on the position (3 or 4) of the aminomethyl group relative to the ester moiety. All esters were more lipophilic than acyclovir in terms of octanol-pH 7.4 buffer partition coefficients. These properties make N-substituted (aminomethyl)-benzoate esters a promising new prodrug type for acyclovir to enhance its delivery characteristics. PMID- 1788154 TI - Valerian-derived sedative agents. I. On the structure and spectral assignment of the constituents of valmane using the selective INEPT nuclear magnetic resonance technique. AB - The valepotriates, a group of chemically unstable iridoid triesters possessing sedative activity, contain various ester groups at the C-1, C-7, and C-11 positions. Using the selective INEPT NMR technique and employing a suitable polarization delay for long-range coupling, it was possible to achieve the assignment and location of the ester groups directly, without ambiguity, and without chemical modification. Six valepotriates isolated from Valmane tablets served as examples to demonstrate the utility of this NMR technique. During the course of this work, the "acevaltrate" fraction was shown to be a mixture of 1 alpha-acevaltrate (3) and 7-beta-acevaltrate (4), the structures of valtrate (1) and didrovaltrate (2) were confirmed directly, and two new valepotriates, 5a and 5b, were obtained as an inseparable mixture and characterized. PMID- 1788155 TI - Stability of the thrombolytic protein fibrolase: effect of temperature and pH on activity and conformation. AB - The effect of temperature and pH on the activity and conformation of the thrombolytic protein fibrolase was examined. Fibrolase maintained proteolytic activity over 10 days at room temperature (approximately 22 degrees C). At 37 degrees C, greater than 50% of the proteolytic activity was lost within 2 days and no activity remained after 10 days. Circular dichroism (CD) spectra at elevated temperatures showed that alpha-helical structure was lost in a cooperative transition (Tm of 50 degrees C at pH 8). Structural changes were detected by NMR prior to unfolding which were not observable by CD, and the Tm determined by NMR was 46 degrees C at pD 8. The effect of pH on the proteolytic activity and structure of fibrolase was examined over the pH range from 1 to 10. Activity was maintained at neutral to alkaline pH values from pH 6.5 to pH 10.0 but decreased substantially in acidic media. While CD spectra indicated little variation in secondary structure over the pH range 5 to 9, significant differences were noted at pH 2 to 3. The melting temperature of fibrolase decreased to 43 degrees C at pH 5. Protein concentrations determined over the pH range of 1 to 10 showed an apparent solubility minimum at pH 5.0, which did not correspond to the isoelectric point of 6.5. Explanations for these observations are proposed. PMID- 1788156 TI - Iontophoretic delivery of amino acids and amino acid derivatives across the skin in vitro. AB - The effects of penetrant properties (lipophilicity and charge) and of vehicle pH on the iontophoretically enhanced delivery of amino acids and their N-acetylated derivatives have been examined in vitro. The penetrants were nine amino acids (five were zwitterionic, two positively charged, and two negatively charged) and four N-acetylated amino acids, which carry a net negative charge at pH 7.4. Iontophoresis at constant current (0.36 mA/cm2), using Ag/AgCl electrodes, was conducted across freshly excised hairless mouse skin. Iontophoretic flux of the zwitterions was significantly greater than passive transport. Delivery from the anode was greater than from the cathode for all zwitterions. The level of enhancement was inversely proportional to permeant octanol/pH 7.4 buffer distribution coefficient. Cathodal iontophoresis of the negatively charged amino acids and of the N-acetylated derivatives produced degrees of enhancement which were significantly greater than those measured for the "neutral" zwitterions. Furthermore, the enhanced flux reached a steady-state level within a few hours for the negatively charged species, whereas the transport of the zwitterions continued to increase with time. Anodal iontophoresis of histidine and lysine, the two positively charged amino acids studied, induced substantial enhancement which was sensitive to the pH of the delivery vehicle. For example, the flux of histidine from an applied solution at pH 4 (where the amino acid carries a net positive charge) was significantly greater than that from a vehicle at pH 7.4 (where histidine is essentially neutral). The behavior of lysine was more complex and suggested a certain degree of neutralization of the skin's net negative charge. PMID- 1788157 TI - Iontophoretic delivery of a series of tripeptides across the skin in vitro. AB - The iontophoresis of eight tripeptides, of the general structure alanine-X alanine, has been measured across hairless mouse skin in vitro. The peptides were blocked (a) at the carboxyl terminus using the mixed anhydride reaction with t butylamine and (b) at the amino terminus by acetylation with 14C-acetic anhydride. The nature of the central residue (X) was varied by selecting one of five neutral amino acids, two negatively chargeable moieties (aspartic and glutamic acids), and a positively chargeable species (histidine). Constant current iontophoresis at 0.36 mA/cm2, using Ag/AgCl electrodes, was performed for 24 hr in diffusion cells, which allowed both anode and cathode to be situated on the same (epidermal) side of a single piece of skin. Due to a combination of osmotic and electroosmotic forces, the anodal iontophoretic flux of neutral peptides was significantly greater than passive transport. Steady-state fluxes were not achieved, however, suggesting that time-dependent changes in the properties of the skin barrier may be occurring. Limited, further experiments confirmed that, on a 24-hr time scale, these changes were not fully reversible. The cathodal delivery of anionic permeants was well controlled at a steady and highly enhanced rate by the current flow. This behavior closely paralleled earlier work using simple negatively charged amino acids and N-acetylated amino acid derivatives. It appears that the normalized iontophoretic flux of these anionic species is independent of lipophilicity but may be inversely related to molecular weight. The positively charged peptide, Ac-Ala-His-Ala-NH(But), showed greater anodal iontophoretic enhancement when delivered from a donor solution at pH 4.0 than from a solution at pH 7.4.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1788158 TI - Nuclear magnetic resonance (NMR) spectroscopic investigation of interaction energies of ephedrine stereoisomers in noncrystalline solids and its correlation with thermodynamic data. AB - Equations relating the interaction energies of each of the binary mixtures of ephedrine from linear combinations of the energies of the individual isomers are presented. The interaction energies in the noncrystalline solid mixtures measured from NMR chemical shift data using cross-polarization magic angle spinning nuclear magnetic resonance 13C cross-polarization magic angle spinning nuclear magnetic resonance (13CP/MAS NMR) spectroscopy correlate strongly with interaction energy from thermodynamic data. The summation of changes in relative frequencies for structurally equivalent carbons is used as a measure of differences in electron shielding on mixing. The relative direction of polarization of individual stereoisomers is found to affect association in noncrystalline binary mixtures of solids. NMR chemical shift data of solids may be useful in confirming spectroscopically the interactions of stereoisomers observed thermodynamically. PMID- 1788159 TI - The effect of plasticizers on compatibility, mechanical properties, and adhesion strength of drug-free Eudragit E films. AB - The use of plasticizers to affect the properties of drug-free, self-adhesive Eudragit E-100 films with higher transparency was tested for possible transdermal drug delivery. Triacetin was found to be an effective first plasticizer for Eudragit E-100 polymer. In order to improve the flexibility and adhesiveness of Eudragit E-100 film plasticized with triacetin, a more flexible and adhesive, secondary plasticizer was added. Plasticizer-polymer compatibility was evaluated by measuring transparency, surface topography, and solubility. Secondary plasticizers with a low molecular weight and a solubility parameter similar to that of Eudragit E-100 polymer and triacetin were compatible. Further, a lower molecular weight or higher concentration of the secondary plasticizers might lead to greater plasticizing action, reduce tensile strength, and increase film elongation, independent of the hydrophilicity of the plasticizer. The adhesive strength of Eudragit E-100 film under a 180 degrees peel test was also affected by the molecular weight and solubility parameter of the secondary plasticizers used. The results indicate that PEG 200, propylene glycol, diethyl phthalate, and oleic acid can serve as a secondary plasticizer to improve the transparency, flexibility, and adhesion of Eudragit E-100 film. PMID- 1788160 TI - Cyclodextrin sulfates: characterization as polydisperse and amorphous mixtures. AB - Alpha- and beta-cyclodextrins and their hydroxypropyl derivatives were converted by the reaction with chlorosulfonic acid in pyridine to the corresponding sulfates. Cyclodextrin sulfates were shown by fast-atom bombardment mass spectrometry (negative ion mode, triethanolamine matrix) to be mixtures with nearly symmetrical distributions of degree of substitution by sulfate groups and by powder X-ray diffraction to be amorphous. Thus, in these aspects, cyclodextrin sulfates are similar to the potent drug solubilizers hydroxypropylcyclodextrins. PMID- 1788161 TI - Catalysis of carbaryl hydrolysis in micellar solutions of cetyltrimethylammonium bromide. AB - Carbaryl hydrolysis was studied in micellar solutions of cetyltrimethylammonium bromide (CTAB) at pH 7.5 The hydrolysis followed first-order kinetics with respect to carbaryl concentration. Above the critical micelle concentration (CMC) the rate of hydrolysis increased with increasing CTAB concentration. A plateau was ultimately reached, at which the rate constant was 30 times the rate constant in an equivalent solution without CTAB. Entropies of activation were calculated to prove that the reaction mechanism did not change in the micellar environment. The binding constant of the micelle for carbaryl and the rate constant in the micellar pseudophase were determined from kinetic data using the pseudophase model. To verify this binding constant, a study of the solubility of carbaryl in CTAB solutions was performed. The results were found to be in very good agreement with those from the kinetic studies. PMID- 1788162 TI - Solid-state properties of tobramycin. AB - Tobramycin (I) obtained from two different sources was subjected to powder X-ray diffractometry, thermal analyses, and Karl Fischer titrimetry. It was concluded to be tobramycin monohydrate (C18H37N5O9 . H2O). When heated in the differential scanning calorimeter (DSC), the dehydration of I resulted in the formation of metastable anhydrous tobramycin, which melted at 164 degrees C. This was followed by the crystallization of the stable anhydrous tobramycin, which then melted at 217 degrees C. The polymorphic transition was concluded to be monotropic and the calculated free energy difference between the metastable and the stable forms, at 25 degrees C, was 348 cal.mol-1. Both the heating rate in the DSC and the sample size had a significant influence on the enthalpy values of most of the thermal events. These observations were attributed to the presence of trace amounts of moisture in the sample. No detectable decomposition of I occurred when it was heated up to 224 degrees C. PMID- 1788163 TI - Formulation influence on conjunctival penetration of four beta blockers in the pigmented rabbit: a comparison with corneal penetration. AB - The objective of this study was to compare the influence of pH, tonicity, benzalkonium chloride, and EDTA on the conjunctival and corneal penetration of four beta blockers--atenolol, timolol, levobunolol, and betaxolol. Drug penetration was evaluated using the isolated pigmented rabbit conjunctiva and cornea in the modified Ussing chamber. The conjunctiva was more permeable than the cornea to all four beta blockers. Formulation changes caused larger changes in corneal than in conjunctival drug penetration, especially for the hydrophilic beta blockers, atenolol and timolol. Raising the solution pH to 8.4 caused the largest increase in corneal penetration for all drugs except atenolol. This increase was greater than that obtained by removing the corneal epithelium. The same formulation also increased conjunctival drug penetration, although to a lesser extent. In the case of timolol, the formulation changes evaluated brought about similar changes in its ocular and systemic absorption with good in vitro-in vivo correlations. The above findings indicate that in making formulation changes to maximize corneal drug penetration, it is necessary to evaluate possible changes in conjunctival drug penetration, hence systemic absorption. Moreover, because the conjunctiva plays an active role in the noncorneal route of ocular drug absorption, the relative contribution of the noncorneal to the corneal routes to ocular drug absorption may also be altered by formulation changes. PMID- 1788164 TI - A redox-based chemical delivery system that enhances estradiol distribution to the brain: disposition studies in the rat. AB - The disposition of a chemical delivery system for estradiol (E2-CDS) which is based on a redox dihydropyridine-pyridinium salt conversion was investigated in rats. Tissue and plasma concentrations of E2-CDS and the oxidized metabolite (E2 Q+) were evaluated at times ranging from 1 to 14 days after intravenous administration of E2-CDS formulated as a modified cyclodextrin inclusion complex. While E2-CDS levels were below HPLC assay detection limits for all samples by 1 day postdosing, E2-Q+ was readily quantified. The calculated half-life of E2-Q+ was longest in brain tissue, significantly shorter in heart, lung, and kidney tissues, and shortest in plasma. There was a linear relationship between administered E2-CDS dose and oxidized metabolite measured in brain as well as in other tissues collected 24 hr after drug administration. Coadministration of high doses of a similarly oxidizable dihydropyridine, 1-methyl-1,4-dihydronicotinamide (NMN), in a dimethylsulfoxide (DMSO) vehicle decreased E2-Q+ measured in brain and other tissues without significantly affecting the relative patterns of distribution in these tissues. Brain tissue E2Q+ levels were not detected after dosing with the oxidized metabolite. PMID- 1788165 TI - Stereoselective systemic disposition of ibuprofen enantiomers in the dog. AB - The pharmacokinetics of ibuprofen are complicated by the unidirectional metabolic inversion of the (-)-R- to (+)-S-enantiomer. Chiral inversion is of therapeutic significance since the drug's pharmacologic activity has been shown to depend upon the (+)-S-isomer. As a result, the present study was undertaken to determine if chiral inversion occurs systemically and to elucidate further the kinetics of the inversion process. Experiments were performed in the beagle dog after intravenous bolus injections of ibuprofen enantiomers separately [100 mg (-)-R, n = 4; 100 mg (+)-S, n = 4] and as admixtures of varying proportions [100 mg (-)-R + 100 mg (+)-S, n = 4; 100 mg (-)-R + 200 mg (+)-S, n = 2]. Plasma samples of (-) R- and (+)-S-enantiomers were measured by a stereospecific HPLC assay after all drug administrations. Based on the area under the plasma concentration-time curves for (+)-S after administration of each enantiomer alone, chiral inversion was 70 to 75%. A progressive reduction in total plasma clearance of (-)-R ibuprofen is also observed as increasing amounts of (+)-S-enantiomer are added to the system. The results demonstrate that chiral inversion occurs to a significant extent in the systemic circulation in dog and that R-to-S inversion of ibuprofen may be inhibited by its (+)-S-enantiomer. PMID- 1788166 TI - Operational evaluation of three commercial configurations of atropine/HI-6 wet/dry autoinjectors. AB - Commercially manufactured wet/dry autoinjectors containing atropine in solution and powdered HI-6 were evaluated using HPLC for consistency of drug delivery with various solvation times and stability of drugs postsolvation at a temperature of 40 degrees C. Three configurations of autoinjector were tested. System A (SYS A), with a specified mixing time of 5 sec, delivered a volume of 3.0 ml containing 1.86 mg of atropine sulfate and 443 mg of the bispyridinium oxime HI-6 dichloride. System B1 (SYS B1) and System B2 (SYS B2), with specified mixing times of 40 sec, delivered volumes of 2.3 ml containing 2.13 and 2.06 mg atropine citrate and 424 and 545 mg HI-6 dichloride, respectively. Average coefficients of variation for SYS A were 3.4% for atropine and 5.8% for HI-6 and for SYS B1 and B2 were 5.2% for atropine and 7.0% for HI-6 determinations. Stored from 3 to 14 days at 40 degrees C after the autoinjector contents were mixed, SYS A delivered 1.77 mg atropine sulfate and SYS B1 and B2 delivered 2.02 mg atropine citrate. The delivery of HI-6 dichloride decreased with a half-life of 34 days for SYS A, 39 days for SYS B1, and 32 days for SYS B2. This resulted in a decrease to 90% of the respective day 0 amount after 4 (SYS A) or 5 (SYS B1 or B2) days. PMID- 1788167 TI - Stereospecific high-performance liquid chromatographic assay of sotalol in plasma. AB - A convenient high-performance liquid chromatographic (HPLC) assay was developed for determination of sotalol (STL) enantiomers in plasma. Following addition of the internal standard (IS; racemic atenolol), enantiomers of STL and IS were extracted using ethyl acetate. After evaporation of the organic layer, samples were derivatized with a solution of S-(+)-1-(1-naphthyl)ethyl isocyanate (NEIC). The resulting diastereomers were chromatographed with normal-phase HPLC with chloroform:hexane:methanol [65:33:2 (v/v)] as the mobile phase at a flow rate of 2 ml/min. The fluorescence detection wavelength was set at 220 nm for excitation with no emission filter. The suitability of the assay for pharmacokinetic studies was determined by measuring STL enantiomers in the plasma of a healthy subject after administration of a single 160-mg oral, racemic dose of STL. PMID- 1788168 TI - Permselective characteristics of rabbit buccal mucosa. PMID- 1788169 TI - Solubility of mefenamic acid under simulated fed- and fasted-state conditions. PMID- 1788170 TI - Determination of drug solubility in aerosol propellants. PMID- 1788171 TI - Determination of release limits: a general methodology. AB - Release limits of drug dosage forms are defined as the bounds on the potency at which an individual lot can be released for marketing which will ensure that it remains within registered limits throughout its shelf life. A statistically based method is described for calculating release limits for any type of dosage form and any parameter for which the rate of change with time is predictably uniform and linear. When the mean release assay result for a specific product lot is at or within the calculated release limit bounds, assurance is provided at the specified confidence level that the average assay results obtained at any subsequent time within the shelf life will remain within registered limits. PMID- 1788172 TI - The spontaneous resolution of cystic hygromas and early fetal growth delay in fetuses with trisomy 18. AB - The spontaneous resolution of cystic hygromas in fetuses with trisomy 18 may be due to a delay in lymphatic-vascular anastomosis. The severity of growth delay with trisomy 18 appears to be variable in time of onset and extent. PMID- 1788173 TI - The vanishing twin: an explanation for discordance between chorionic villus karyotype and fetal phenotype. AB - One 'erroneous' diagnosis occurred in 200 first-trimester chorionic villus samples (CVS) analysed. In direct preparations following 24 h incubation as well as in long-term cultures, a 46,XX karyotype was observed in the villi (28 and 25 cells, respectively). At 20 weeks of gestation, labour was induced because of fetal death in utero. An autopsy performed on the fetus revealed a male phenotype. Placenta and fetal tissues were not submitted for cytogenetic studies. The discordant CVS karyotype (46,XX), in view of the male fetal phenotype, prompted further cytogenetic and molecular studies. Chromosome marker studies on the parents' blood and chorionic villi confirmed both maternal and paternal inheritance of chromosomes in the CVS. DNA studies on formalin-fixed skin using a Y-specific probe, DYZ1, confirmed the presence of a Y chromosome in the fetus. The most likely cause of the discrepant CVS karyotype is the presence of an undetected degenerating dizygotic twin. PMID- 1788174 TI - Prenatal diagnosis in advanced maternal age. Amniocentesis or CVS, a patient's choice or lack of information? AB - Ninety-six women of advanced maternal age were interviewed about the way they obtained information on prenatal diagnosis and about how the decision was made as to what procedure was to be performed (transabdominal chorionic villus sampling (TA-CVS) or amniocentesis). In the CVS group, women visited their physician or midwife earlier in pregnancy (mean 7.1 weeks) than those in the amniocentesis group (mean 10.7 weeks). The availability of prenatal diagnosis was not mentioned during the first antenatal visit in 55 per cent of women from the amniocentesis group as opposed to 25 per cent from the TA-CVS group. Approximately 40 per cent of women eligible for prenatal diagnosis did not receive any information from the referring body prior to counselling at our centre. Only 29 per cent of women who underwent amniocentesis had actually chosen this procedure; 71 per cent were too late to undergo TA-CVS at 12 weeks. It is concluded that information to the patient must be improved in order to ensure early referral for prenatal diagnosis. PMID- 1788175 TI - Eleventh week amniocentesis for prenatal diagnosis of some metabolic diseases. AB - We report the results of 23 prenatal diagnoses performed at the 11th or 12th week of gestation by the simultaneous analysis of chorionic villi (for direct or indirect enzymatic analysis) and cell-free amniotic fluid (for search of accumulated catabolites). For six cases of citrullinaemia, four cases of argininosuccinic aciduria, seven cases of propionic acidaemia, and six cases of methylmalonic acidaemia, three discrepancies were observed between the two methods used. The amniotic fluid analysis for accumulated catabolites seems to be a safe method and should always be used in conjunction with the enzymatic assays performed for the prenatal diagnosis of these diseases. PMID- 1788176 TI - Heterochromatin decondensation in chromosomes from chorionic villus samples. AB - The spontaneous decondensation of constitutive heterochromatic regions of chromosomes 1, 9, 16, and Y has been observed in 46.6 per cent of chorionic villus samples. This type of decondensation is occasionally observed in amniotic fluid cells (9 per cent) and has never been found in fetal lymphocytes. The phenomenon is similar to that described in spermatogonial metaphases, in primary and secondary spermatocytes and in human sperm chromosomes, although decondensation of the heterochromatin of chromosome 15 has never been recorded in chorionic villus samples. PMID- 1788177 TI - Prenatal counselling and diagnosis in progressively deforming osteogenesis imperfecta: a case of autosomal dominant transmission. AB - A 21-year-old woman with progressively deforming or type III osteogenesis imperfecta (OI) presented for prenatal counselling and diagnosis at 10 weeks' gestation. Family history was non-contributory. At 14.8 weeks' gestation, ultrasonographic examination revealed fetal skeletal hypomineralization, easily compressible fetal cranium, and thickened long bones, indicating that the fetus was also affected. Confirmation of the prenatal diagnosis of OI type III was made following a Caesarean section birth of a male infant with multiple skeletal deformities and blue sclerae implying, in this case, autosomal dominant inheritance. PMID- 1788178 TI - Sanfilippo D syndrome: correction of glucosamine-6-sulphatase deficiency following fibroblast culture in Chang's media. AB - The de-O-sulphation of alpha-linked glucosamine-6-sulphate residues in heparan sulphate requires a specific sulphatase, glucosamine-6-sulphatase, which has been shown to be deficient in tissues of Sanfilippo D, or mucopolysaccharidosis type IIID (MPS IIID), patients. MPS IIID fibroblasts cultured in Basal Eagle's medium supplemented with either fetal calf serum or heat-inactivated fetal calf serum, MDCB or Ultraserg media had residual glucosamine-6-sulphatase activities towards a heparin-derived trisaccharide substrate, O-(alpha-N-acetylglucosamine-6 sulphate)-(1----4)-L-O-(alpha- iduronic acid-2-sulphate)-(1----4)-D-O-2,5 anhydro[1-3H]mannitol-6- sulphate, GlcNAc6S-IdoA2S-anM6S, which were less than 1 per cent of the normal range for fibroblasts cultured in Basal Eagle's medium supplemented with fetal calf serum. However, the glucosamine-6-sulphatase activities of MPS IIID fibroblasts grown in Chang's medium were similar to the activities in normal control fibroblasts which were cultured in Basal Eagle's medium. These results indicate that caution is required for prenatal diagnosis of MPS IIID patients using chorionic villi or amniotic cells cultured in Chang's medium. PMID- 1788179 TI - First-trimester diagnosis of hypophosphatasia. Importance of gestational age and purity of CV samples. AB - Prenatal diagnosis of hypophosphatasia was made by alkaline phosphatase (ALP) assay on a chorionic villous sample taken in the first trimester. Very low activities of the LBK isoenzymes indicated an affected fetus. Diagnosis was confirmed at 12 weeks of gestation by measurement of LBK isoenzyme activities in fetal bone tissue. In control chorionic villous samples an inverse relation was observed between LBK and placental ALP percentage during gestational age. High LBK ALP activities are observed in decidual tissue. Chorionic villous tissue must not be sampled after 12 weeks of gestation and decidual tissue must be excluded from the sample. PMID- 1788180 TI - First-trimester prenatal diagnosis in quintuplets: a practical approach using step-by-step embryo reduction. AB - A multiple pregnancy of high rank may occur in a couple at risk for a Mendelian disorder. Prenatal diagnosis is hampered by the difficulty of (1) obtaining chorionic villi from each zygote and (2) unequivocally relating each sample to the corresponding embryo. The calculation of the genetic risk according to the number of zygotes led us to propose a diagnostic strategy based on embryo reduction, a technique initially designed to improve the perinatal outcome of multiple pregnancies with normal embryos. We report a case in which this approach allowed rational use of first-trimester chorionic villus sampling in a quintuplet pregnancy at risk for non-ketotic hyperglycinaemia, resulting in the selective birth of unaffected twins. PMID- 1788181 TI - [The therapy of children and adolescents with vascular and immunological disorders in diabetes mellitus]. AB - The paper is concerned with investigation of the state of microcirculation and immune system of 65 children and adolescents with a severe course of diabetes mellitus. The syndrome of marked vasoconstriction in 42.7% of the patients was combined with immunological disorders that required the use of immunomodulators such as andecalin. Due to its simultaneous action on the vascular and immune systems it can be recommended for combined therapy of children and adolescents with diabetes mellitus. PMID- 1788182 TI - [The indices of the lipid peroxidation and desaturation of the blood serum in diabetes mellitus in children]. AB - Comparative investigation of indices of lipid peroxidation and blood lipid unsaturation was carried out in 91 pediatric inpatients (aged 7 to 15) with type I diabetes mellitus and in 10 controls of the same age. Activation of free radical lipid peroxidation was shown to occur in children with diabetes mellitus. A degree of compensation of diabetes did not influence the level of hydroxyperoxides (HP) and final decay products (FP) of lipid peroxidation. In ketoacidotic decompensation HP and FP concentrations in the patients were increased as compared to those in the controls by 284 and 255%, respectively. At the same time children who were admitted in coma, demonstrated low values of blood lipid unsaturation. Insulin therapy (irrespective a drug dose) was accompanied by a 1.8-2-fold increase (p less than 0.05) in a HP level as compared to control values. Change in the level of lipid unsaturation depended upon a daily dose of insulin. In diabetes over 1 year different types of changes in lipid peroxidation and unsaturation were detected, and individual differences in their levels required a differentiated approach to therapeutic tactics. PMID- 1788183 TI - [The development of the reproductive system in children suffering from a severe form of diabetes mellitus]. AB - The levels of estrogen, estrone, estradiol, progesterone, FSH, insulin, and C peptide were investigated in insulin dependent diabetes mellitus of various duration. Secondary sexual characters developed in time though there was no regular menstrual cycle in girls until they were 15. Retarded physical development was noted in early childhood and in disease of 10 year duration. The level of FSH in boys was twice as low in patients as in healthy ones, the level of estrogens was the same as in girls. A decrease in hypophyseal gonadotropic function with the reduced level of hormones was noted in boys and girls with a severe course of disease at the stage of decompensation. A 2-fold decrease of insulin and C-peptide was also noted in these patients. PMID- 1788184 TI - [The transplantation of beta-cell cultures in the treatment of insulin-dependent diabetes mellitus in children]. AB - Over 100 transplantations were performed in 86 children and adolescents with a severe course of insulin dependent diabetes mellitus. A good effect was achieved in 81 +/- 6%, in other cases the effect was uncertain. Therapy resulted in a significantly higher rate of cases of stable compensation with a lesser number of injections and a stable dose of insulin, in stabilization and regression of some complications. Transplantation was followed by an increase in the level of C peptide 3-4 times as compared to the basal one for a period of 6 mos. A better effect was noted in a group of patients with a high residual secretion of C peptide. An assumption was made of simultaneous secretory activity of a graft and residual beta-cell-stimulated endogenous production of insulin. PMID- 1788185 TI - [Acupuncture in the treatment of diabetic angiopathy of the lower extremities]. AB - A course method of acupuncture (10 sessions) using corporal points of general and segmental action and some auricular points was used for therapy of the functional stage of lower limb diabetic angiopathy in 55 patients with insulin-dependent diabetes mellitus. Rheovasography, thermography and ultrasound dopplerography were carried out over time to confirm the diagnosis of insulin dependent DM and to assess therapeutic efficacy. A direct noticeable clinical effect was obtained in 78.2% of cases, determined perhaps by improved elastotonic properties of arteries of average caliber, enhanced blood outflow and regulation of lower limb vascular peripheral resistance. PMID- 1788186 TI - [The content of stable forms of prostacyclin I2 and thromboxane A2 in the blood plasma in diabetic angiopathies]. AB - Altogether 33 patients with insulin-dependent, 51 patients with noninsulin dependent diabetes mellitus, and 17 patients with atherosclerosis with the affected lower limb major vessels were investigated. The levels of stable forms of prostacyclin I2 and thromboxane A2 were studied with relation to the nature and degree of vascular disorders. Diabetes mellitus and progress of diabetic angiopathies were accompanied by a more pronounced increase in the level of thromboxane B2 and a decrease in the level of 6-ketoprostaglandin F1. An increase in the ratio of thromboxane B2/6-ketoprostaglandin F1 could be interpreted as a prognostically unfavorable sign, suggestive of progression of diabetic angiopathy. It was recommended to study the efficacy and potentialities of correction of disorders with concentrates of ethers of unsaturated fatty acids. PMID- 1788187 TI - [The pathological characteristics of the thyroid in autoimmune polyendocrinopathies]. AB - After examination of 18 patients with autoimmune polyendocrinopathies the authors have arrived at a conclusion that thyroid pathology is the most frequent sign of autoimmune polyendocrinopathies and is noted earlier than other endocrine disorders. A course of thyropathies is characterized by resistance to conservative therapy and recurrences after surgical interventions. A high hereditary aggravation of patients with autoimmune polyendocrinopathies requires careful investigation of their relatives for early detection of endocrine pathology. PMID- 1788188 TI - [Malignant apudoma of the pancreas]. PMID- 1788189 TI - [Glycosylated hair proteins in healthy subjects and diabetics]. PMID- 1788190 TI - [Drug preparations used for treating endocrine patients]. PMID- 1788191 TI - [Nutritional control in diabetic patients at home (a lecture)]. PMID- 1788192 TI - [The development of diabetology--the use of new knowledge in practice]. PMID- 1788193 TI - [The effect of testosterone and its metabolite dihydrotestosterone on the hormone level of hypothyroid rats]. AB - The levels of thyroid and sex hormones, TSH and PRL were studied in thyroidectomized (6 weeks) noncastrated rats and in castrated rats receiving testosterone propionate (1 mg/kg) or dehydrotestosterone (0.2 mg/kg) or their mixture to reveal the hormonal nature of disorder of sexual function in hypothyrosis. The results obtained show that all disorders of sex function in hypothyroid rats with a different androgenic status have a different hormonal basis. PMID- 1788194 TI - [The activity of thyroxine conversion to triiodothyronine in the liver and kidneys of rats]. AB - Rat liver and kidney microsomal fractions contain 5'-deiodinase, converting thyroxin into 3,5,3'-triiodothyronine. In control animals a marked decrease in thyroxin concentration takes place when the blood passes through the liver and kidney (triiodothyronine level being preserved). Fasting causes a prominent decrease in blood thyroxin, a small decrease in triiodothyronine as well as a drop of glucose and insulin levels. At the same time a decrease in thyroxin deiodinase activity takes place in the liver; as for the kidney a decrease is less marked. Fasting rats have no gradients in the blood passing through the liver and kidney; triiodothyronine balance remains unchanged. The results show that the rat liver and kidney deiodinase activity regulation (during changes in the body physiological status) helps to maintain triiodothyronine optimum concentration in general circulation. PMID- 1788195 TI - [The effect of estradiol on histamine distribution in the uterine structures of the normal rat and after the experimental administration of the hormone]. AB - Estradiol levels were radioimmunoassayed and histamine levels histochemically measured by Cross', Ewen's, and Rost's methods in intact rats. Estradiol was shown to increase sharply the absorption of exogenous histamine by uterine structures. Estradiol effects were interpreted by the authors as activation of the histamine receptors in uterine structures by the hormone, and an estradiol induced decrease in a histamine level in macrophages was explained by histamine release from macrophages for passing to other structures. PMID- 1788196 TI - [Hormones in milk and their role in the development of newborn infants]. PMID- 1788197 TI - [The effect of ionizing radiation on the thyroid]. PMID- 1788198 TI - [Sensitivity to insulin studied by the clamp method in patients with type-1 diabetes mellitus]. AB - The rate of insulin dependent utilization of glucose by tissues under the conditions of normoglycemia was assessed in 76 patients with insulin dependent diabetes mellitus (their age and period of disease varied) without clinical signs of resistance to insulin. The investigation was performed with the help of the clamp method. A decrease in the sensitivity to insulin was noted even in normal values of carbohydrate and fat metabolism. A decrease in the insulin dependent rate of glucose utilization by tissues depended neither on sex and age of the patients, nor on a period of disease, body mass, daily requirement in insulin, the levels of cholesterol, triglycerides and ketone bodies. A transient increase in the rate of glucose utilization during the 1st year of disease was typical of patients with partial remission. It has been assumed that a decrease in the sensitivity to insulin in insulin dependent diabetes mellitus cannot be the secondary metabolic phenomenon only. PMID- 1788199 TI - [Immunoreactive growth hormone in the urine of patients with acromegaly]. AB - The use of an immunosorbent on the basis of monoclonal antibodies, electrophoresis in polyacrylamide gel and radioimmunoblotting has shown that immunoreactive growth hormone in acromegalic patients' urine is represented mainly by intact hormone with the molecular mass of 22 kD, large molecular products of its limited proteolytic splitting and, probably, by a small amount of an immunoreactive form, corresponding to hormone variant 20 K. The detection of the intact growth hormone in the urine confirms a possibility of characterization of hypophyseal somatotropic function by hormone excretion with urine, however taking into account the presence of immunoreactive products of its proteolysis in urine. A routine radioimmunoassay was shown unfit for the determination of growth hormone levels in urine. Specially adapted very sensitive methods are required for the purpose. PMID- 1788200 TI - [Induced and spontaneous prolactin secretion in young, obese women]. AB - Prolactin reactions in response to insulin hypoglycemia and prolactin levels were examined in 20 obese women of reproductive age at various time of the day. In one group prolactin response to stimulation with insulin hypoglycemia was normal, in another group an increase in the level of prolactin was unnoticed. Both groups were compared with healthy controls. Two types of obesity (upper and lower) were investigated. A conclusion has been made that the absence of prolactin reaction in response to insulin hypoglycemia and an insufficient rise of prolactin at night are noted more frequently in women with upper type of obesity suggesting more profound endocrine derangements in them as compared to women with lower type obesity. PMID- 1788201 TI - [Lymphocyte response of blast transformation and some parameters of hormonal status in patients with type II diabetes mellitus]. AB - Tests were conducted to analyze a blastogenic response of lymphocytes to phytohemagglutinin (PHA) in autoserum and bovine serum and the hormone level of blood of the second-type diabetes patients. The results indicate that there is a positive correlation between a blastogenic response to PHA in the autoserum medium on the one hand and the T4 level and insulin on the other hand. There is a negative correlation between the first factor and the glycemic index and the duration of disease. There is no correlation between a mitogenic response and the examinees' age. The blood insulin level also correlates with a mitogenic response of lymphocytes in bovine serum. The examination of patients in the compensation stage suggests a negative correlation between a cortisol level and the stimulation index logarithm of a mitogenic response in bovine serum. This correlation did not exist in cases of decompensated diabetes. PMID- 1788202 TI - [Use of finoptin in patients with non-insulin-dependent diabetes mellitus with concomitant essential hypertension]. AB - The paper is devoted to a study of the time course of lipid metabolism, analysis of glucose tolerance, change in indices of immunoreactive insulin, glucagon and C peptide before the start of verapamil therapy and 6 mos. after it during monotherapy with this drug. These parameters were investigated in the blood serum using biochemical methods and radioimmunoassays. A marked antihypertensive effect was achieved in patients suffering from noninsulin dependent diabetes mellitus with concomitant essential hypertension of the 2nd degree. No negative effect on the pancreatic hormone secretion was noted. Lipid transport indices were improved. PMID- 1788203 TI - [Causes of development of the diabetic syndrome in patients with diffuse toxic goiter]. AB - Altogether 41 patients with thyrotoxicosis of mean severity at the stage of decompensation were observed. By glucose tolerance they were divided into 3 groups: with normal, flat and disturbed curves. The third group vs. the first group demonstrated higher levels of the thyroid hormones, cortisol and insulin. C peptide/insulin ratio values were significantly lower than in the first group before and in 120 min. after glucose loading. The second group showed average indices. Evaluation of sensitivity to insulin in 35 patients showed a decreased reaction to insulin in 17 patients, belonging mainly to the third and second groups. The blood levels of thyroxine and cortisol in these 17 patients were raised. The authors have arrived at a conclusion that the development of insulin resistance rather than the disturbed insular apparatus is likely to cause disorders in glucose tolerance in some patients with thyrotoxicosis. PMID- 1788204 TI - [Relationship between serum selenium level and lipid spectrum in patients with diabetes mellitus type I]. AB - The purpose of the work was to study correlation between blood Se levels and lipid fractions in patients with severe type I diabetes mellitus. Great individual variations of Se blood concentrations were noted in diabetic patients. There was no statistically significant difference from Se levels in healthy persons. Positive correlation of Se levels with the atherogenic factors and negative correlation with antiatherogenic factors were noted in the control group. PMID- 1788205 TI - [Physical working capacity and myocardial perfusion in patients with diabetes mellitus]. AB - A study was made of the interrelationship of myocardial perfusion with physical working capacity in different types of DM (with the duration of disease from 4 to 8 years without clinical signs of circulatory insufficiency). Rated physical exercise testing in 12 patients with insulin dependent diabetes and 27 patients with noninsulin dependent diabetes as well as in 40 healthy subjects has shown a GTT decrease in diabetes mellitus irrespective of patient's age, sex and body mass to be more marked in noninsulin dependent type and to be closely related to disturbed oxygen supply of the heart and a lowered myocardial reserve. Bicycle ergometric testing combined with 201Tl scintigraphy in 20 patients has shown disorder of perfusion in all the patients irrespective of a diabetes type and duration of disease. Insulin dependent diabetes mellitus was characterized by stable perfusion defects resulting from metabolic derangements, and noninsulin dependent diabetes mellitus was characterized by a decrease in the level of a maximum Tl uptake by the myocardium and transient perfusion defects of ischemic type. PMID- 1788206 TI - [Effect of endovascular laser irradiation of the blood of patients with diabetic angiopathies]. AB - The activity of primary and secondary products of lipid peroxidation and antiperoxide protection enzymes was investigated in 33 patients with diabetes mellitus, complicated by lower limb angiopathies before and after endovascular laser irradiation of blood. Tissue microcirculation was evaluated on the basis of the results of capillaroscopy and thermography of the limbs, and biomicroscopy of the conjunctiva. Blood was irradiated with the help of a light guide for 60 min. Laser therapy led to a decrease in the activity of processes of free radical oxidation, acting probably on antiperoxide protection enzymes. Tissue microcirculation was markedly improved. PMID- 1788207 TI - [Therapeutic action of laser irradiation and immunomodulators in purulent injuries of the soft tissues in diabetic patients]. AB - A study was made of the immune status and results of therapy of 152 diabetic patients with purulent injuries of soft tissues. Low-intensity laser irradiation of wounds and adjuvant active and passive immune therapy were shown to result in rapid stabilization of the immune status, reducing the duration of treatment. PMID- 1788208 TI - [Potential for the clinical use of intranasal rifathyroin for diagnosis and treatment]. AB - It has been shown that stimulated TSH and prolactin levels in intranasal administration of rifathyroin are comparable with the results of i.v. administration of the drug. Intranasal administration can be used for both therapeutic and diagnostic purposes. PMID- 1788209 TI - [A number of parameters of the status of the nervous, neuro-endocrine and immune systems in chronic alcoholism and their response to therapy]. AB - A number of neuromediators, neurohormones and indices of cellular and humoral immunity were investigated in 100 chronic alcoholics before and after the use of appropriate stimulants and blockers of these biological systems. Pathogenetic importance of disorders of interactions of the neuroendocrine and immune systems in chronic alcoholism was determined. Means and methods for therapy of alcoholism were evaluated. PMID- 1788210 TI - [Complicated form of hermaphroditism with symptoms of urgent surgical disease]. PMID- 1788211 TI - [Clinical follow-up of parathyroid cancer]. PMID- 1788212 TI - [Syndrome 46,XX in males]. PMID- 1788213 TI - [Substitution hormonal therapy in congenital adrenocortical hyperplasia, caused by 21-hydroxylase deficiency (lecture)]. PMID- 1788214 TI - [What must a diabetic patient know about proper care of the legs (lecture)]. PMID- 1788215 TI - [Influence of the expression of the human growth hormone releasing factor gene on hormone levels in a transgenic rabbit]. AB - A transgene rabbit with the human growth hormone releasing factor gene was produced by a method of microinjections into fertilized oocytes; a mouse metallothionein I gene was used as a promoter. Gene expression was accompanied by a phenotypical effect, expressed in increasing the rates of development. The maximum difference among the transformant, transplants and control was revealed on the 30-45th day of postnatal development. Analysis of the hormonal status of the transgene animal has shown change in the levels of the majority of hormones: a 6-10-fold increase in insulin; a 2-3-fold increase in the level of triiodothyronine, thyroxin; a reduced somatostatin concentration, a two-fold decrease in the level of progesterone, and a four-fold decrease in the level of testosterone. Activation of the promoter zone with Zn++ salts for 5 weeks resulted in a further increase in the transformant body mass by 10%. However blood hormone levels in the transgene rabbit returned to normal. Proceeding from the above it can be assumed that exogenous gene expression probably increased somatotropin secretion which determined dysfunction of most of the endocrine glands; the effect of somatotropin was probably insulin-mediated. PMID- 1788216 TI - [Effect of glucagon and short-term fasting on the interrelationship of cellular and humoral immune responses]. AB - The effect of subcutaneous administration of 25 micrograms/kg of glucagon and 2 day fasting (as a natural model of hyperglucagonemia) on the accumulation of antibody-forming splenocytes and the expression of a delayed-type hypersensitivity reaction (DTHR) in response to intraperitoneal immunization with sheep erythrocytes at various doses were studied in experiments on random-bred albino mice. A suppressing effect of the hormone on antibody genesis at optimum doses and its stimulating effect at suboptimum doses were revealed. The latter effect took place against a background of DTHR suppression. Glucagon action manifested itself mainly in the effector phase of an immune response and correlated with the effect of two-day fasting on the immune system. A conclusion has been made of a possible competition (at certain doses of antigen) between a cellular and humoral response, whose type can vary during endocrine dysfunction. PMID- 1788217 TI - [Effect of an unbalanced food ration on induction and course of alloxan diabetes in rats]. AB - Wistar rats were kept on a synthetic ration with different percentage of proteins (18, 9 and 50%) for 2 weeks. Then they were given subcutaneous injections of alloxan at a dose of 200 micrograms/kg of body mass. In some animals glycemia was established on the 7th day after the first administration of alloxan, in others- on the 3rd day after repeated administration of alloxan at a dose of 150 micrograms/kg of body mass. The animals were decapitated on the 14th and 30th day after establishing a hyperglycemic condition. Lethality percentage, a degree of glycemia, and at the end of the experiment insulinemia, body mass indices, indices for some organs were evaluated. A ration with an optimum and high content of protein was shown to decrease lethality percentage, reducing risks developing of a hyperglycemic condition, caused by alloxan. A ration with a high content of protein decreased a degree of severity of a diabetic condition, caused by alloxan. PMID- 1788218 TI - [Effect of stress on thyroid morphofunctional features in rats of strains, selected according to excitability of the nervous system]. AB - The authors have shown that rat strains with varied excitability of the nervous system also differ in thyroid morphofunctional features. Selection based on the nervous system excitability threshold resulted in divergence of reactivity of the endocrine system (the thyroid) to prolonged stress. PMID- 1788219 TI - [Regulation of calcium metabolism in the human body]. PMID- 1788220 TI - [Hormones of the hypophyseo-adrenal system and their role in postnatal adaptation of newborns]. AB - The levels of hormones of melatonin (MT), ACTH, aldosterone (AS) and cortisol were investigated in the blood plasma of mature and premature newborns as well as in foremilk and milk of lactating women using a radioimmunoassay. Maximum concentrations of these hormones in mature infants were noted by the 1st-3rd day, decreasing on the 5th-7th day. The same regularity was observed in premature infants (I-II degree of prematurity). Lower concentrations of these hormones were observed in very premature infants. A conclusion has been made that breast milk is an important link between a mother and an infant in terms of supplying infants with lactogenic hormones. PMID- 1788221 TI - [Patterns of occurrence and detection of pulmonary tuberculosis in the cities and rural areas]. AB - The role played by various risk factors in urban and rural areas and the regularities in the occurrence and detection of pulmonary tuberculosis were defined from the analysis of 120 pulmonary tuberculosis contamination cases which were revealed for the first time in the region during 5 years. The study included the patients' age, the pattern of morbidity according to the clinical forms of pulmonary tuberculosis, dependence of morbidity on the number of residents- bacilli excretors, the influence of the risk factors of the disease, the effectiveness of preventive fluorographic screening of the thoracic organs and the diagnosis of pulmonary tuberculosis by general physicians. It was found that the epidemiologic situation for tuberculosis in the rural areas is more unfavourable than that in the urban ones. PMID- 1788222 TI - [Mucociliary transport in patients with pulmonary tuberculosis complicated by bronchial obstruction]. AB - The examination of 98 patients with newly diagnosed destructive pulmonary tuberculosis was undertaken to find the relation between the condition of the bronchial tree, level of obstruction and degree of mucociliary insufficiency. The latter was shown to depend on the condition of the bronchial free and was most manifest in diffuse endobronchitis. At the same time, the degree and level of obstruction of the bronchial tree also had influence on the rate of mucociliary transport. PMID- 1788223 TI - [Value of different indirect methods of diagnosis of pulmonary hypertension]. AB - Dependence of the duration of right-ventricular isometric relaxation phase (IRP) on right ventricular systolic pressure (SP) and heart rate was studied. IRP was measured using echography of the tricuspid valve and SP value was determined according to the data of heart venous catheterization. Examination included 30 patients with chronic inflammatory pulmonary diseases. A low dependence was found between IRP, SP and HR, which is of little use for the indirect establishment of the pressure value in pulmonary circulation. Errors during right-ventricular SP measurement using methods based on the IRP analysis show their unreliability. A method for measuring pressure value in pulmonary circulation has been suggested which is based on the data of echography. Despite the high correlative coefficient of the estimated and actual values, the method makes it possible to obtain only the approximate data. PMID- 1788224 TI - [Differential diagnosis of pleurisy of tuberculous etiology]. AB - A combined ++clinico-roentgenological+ examination of 367 patients with a pleurisy syndrome was aimed at the study of a potential establishment of the etiologic diagnosis of the disease. Examination comprised the routine tests and findings of various types of biopsy, including pleural biopsy performed within the first two months from disease onset. The etiologic diagnosis of tuberculous pleurisy was most difficult in 96% of the patients who exhibited prolonged and stable maintenance of exudation or, on the contrary, very rapid regression of the pleural exudate without residual changes. Simultaneous morphologic and bacteriological examination of a pleural biopsy specimen contributed to the most efficacious and reliable diagnosis of tuberculous etiology of pleurisy. PMID- 1788225 TI - [Hepatitis B and delta infections in patients with tuberculosis]. AB - Clinical variants of the course and outcomes of HBV and delta infections have been studied in pulmonary tuberculosis patients in the general structure of 1465 patients who were treated for hepatitis B. Enzyme immunoassay and radioimmunoassays were used to study the detection rate of contamination markers HBV activity and delta-virus replication in 437 pulmonary tuberculosis patients. Viruses were found to be predisposed to prolonged persistence and wide spread among tuberculosis patients. PMID- 1788226 TI - [HLA antigens in patients with osteoarticular tuberculosis with different disease course]. AB - Examination included 93 Uzbek patients with osteoarticular tuberculosis: 37 had localized and 56 disseminated tuberculosis process. All the patients were typified according to the HLA antigen locuses-A, B, C and DR by the standardized microlymphocytotoxic test. As a control, 135 healthy Uzbeks were typified by antigens of the same HLA locuses (105 subjects were typified by antigens of the HLA-DR locus). The patients with osteoarticular tuberculosis were found to have genetically controlled susceptibility to tuberculosis infection. The frequency of HLA, B7, B27 and DR2 antigens occurrence in tuberculosis patients is increased as compared to that in healthy subjects. In patients with a disseminated tuberculosis process, the frequency of HLA-Cw4 and HLA-DR4 antigens was increased to 33.9% and 44.6%, respectively, as compared to that in patients with a localized process (5.4% and 21.6%, respectively). PMID- 1788227 TI - [Predicting the degree of surgical risk in patients with disseminated forms of tuberculous spondylitis]. AB - It was shown that the basic parameters of respiratory and circulatory disorders are of the most informative value for the prognosis of the severity of the postoperative condition of patients with tuberculous spondylitis. A two dimensional variant of the classification of patients into three groups with a different degree of surgical risk is given. PMID- 1788228 TI - [Mental state of patients with restricted forms of pulmonary tuberculosis]. AB - The procedure of the multimodality personality investigation (MMPI) to examine the mental status and personality traits of 61 patients with newly diagnosed pulmonary tuberculosis of limited extent. The clinical and psychodiagnostic examination has revealed the following general types of a response to the disease: alienation from the people around, depressive reaction (18%), negative attitude to treatment (16.1% of the patients refused treatment and 13.1% refused surgical treatment), social adaptation impairment, neglect of the generally accepted behaviour patterns and schizoid personality traits. Along with this, the individual forms of a response to disease detection were determined. They were manifested by a number of symptom complexes: hypochondriac (13.6%), anxiety depressive (18.4%) and paranoid (9.1%). These mental disorders gravely affected the patients and made treatment of the basic disease more complicated. A long term conservative treatment aggravated depression and hysterical and schizoid personality traits. The mental status and the types of response were shown to differ from the same reactions in somatic patients with other abnormalities. PMID- 1788229 TI - [Recurrences of pulmonary tuberculosis in patients with mental disorders and alcoholism]. PMID- 1788230 TI - [Variants of the course of disseminated pulmonary tuberculosis]. PMID- 1788231 TI - [Single-stage lobectomy and left-sided glomectomy in a patient with fibrous cavernous tuberculosis and concomitant bronchial asthma]. PMID- 1788232 TI - [Pathology of the mediastinum in phthisiological practice]. PMID- 1788233 TI - [Dynamics of specific changes in recurrences of pulmonary tuberculosis in relation to chemotherapy schedules]. PMID- 1788234 TI - [Status of immunity in newborn infants and young children born to mothers with tuberculosis]. AB - The children born to tuberculosis mothers show a decline in T-lymphocyte count and in their functional activity, an increase in specific immunity parameters, which is manifested by a higher level of antituberculosis antibodies and a marked proliferative lymphocyte response to tuberculin. It has been established that the level of specific antibodies in children and their mothers is related to the clinical form of tuberculosis. The discovered features of specific and nonspecific immunity in newborns and infants born to tuberculosis mothers should be considered in the organization of preventive measures in this group of children. PMID- 1788235 TI - [Immunogenetic grounds for the development of local forms of primary tuberculosis in children]. AB - The ++clinico-immunogenetic status of children with local forms of primary tuberculosis was analysed. Examination included 99 children aged 4-14 years with pulmonary tuberculosis. The control group comprised 51 children who has negative tuberculin tests and no intercurrent diseases. The HLA composition was determined by the A, B, C and DR loci. The HLA-DR2 representation is responsible for a high specific process risk and HLA-A11 and HLA-B15 can be characterized as antigens causing a resistance to tuberculosis infection. PMID- 1788236 TI - [Changes in the functional activity of blood lymphocytes in patients with destructive pulmonary tuberculosis during the treatment]. AB - Lymphocyte function was studied by the Rigler method modified by V. A. Kolesnikov et. al. in 118 patients with different forms of pulmonary tuberculosis and 15 healthy subjects. This parameter was found to depend on the nature and dynamics of a tuberculosis process and the predominance of the exudative or productive inflammation phase. A considerable reduction of lymphocyte functional activity (LFA) up to 60% was found in the presence of dissemination in pulmonary tissue. Transition from infiltration to destruction was marked by a average rise of LFA from 67 to 79%. The initial LFA parameters can be taken into account as a prognostic criterion. Prescription of immunity stimulators in destructive pulmonary tuberculosis requires LFA evaluation by the above method. PMID- 1788237 TI - [Serological analysis of blood and cerebrospinal fluid in patients with meningeal tuberculosis]. AB - The results of ++clinico-serological examination of 81 subjects with meningeal diseases are given; among them 53 had tuberculous meningitis. The authors applied complement fixation (CFT) and indirect hemagglutination tests (IHT) with tuberculin. The high diagnostic significance of CFT and low efficiency of IHT were established in tuberculous meningitis detection. It is expedient to determine simultaneously the antituberculous antibodies in the blood serum and cerebrospinal fluid of the examined patients. Simultaneous performance of CFT during the follow-up increases its diagnostic potentialities to 88.6%. Detection of complement-binding antibodies only in CFT is, in most cases, a sign of isolated tuberculous meningitis. Detection of specific antibodies only in the blood serum of tuberculous meningitis patients is an indirect evidence of generalized process. PMID- 1788238 TI - [Inclusion of the immunoenzyme analysis in the complex serological reactions in the diagnosis of pulmonary tuberculosis]. AB - The detection frequency of antituberculous antibodies (AB) was studied by means of the complex of serologic reactions and enzyme immunoassay (EIA) in 254 pulmonary tuberculosis patients. The detection rate of antituberculous AB by EIA was higher than that in a simultaneous application of EIA and the complex of serodiagnosis. In certain cases, however, the antituberculous AB are detected only with the complex of serologic reactions so that simultaneous usage of both the complex of serologic reactions and EIA is required. PMID- 1788239 TI - [Decrease in the intensity of luminol-dependent chemiluminescence of neutrophils in patients with pulmonary tuberculosis]. AB - The ability of neutrophils to generate free oxygen forms, and the activity of glutathione-conjugated enzymes and superoxide dismutase were investigated in 94 patients with pulmonary tuberculosis. A drop in the oxygen-generating ability of the patients' neutrophils was revealed. The interrelation between the decrease of activity of antioxidative enzymes and the drop in the oxygen-generating ability of neutrophils are shown. Clinical and pathophysiological importance of the changes revealed is discussed. PMID- 1788240 TI - [Study of lipid peroxidation in patients with tuberculosis of the female genital organs during subcutaneous tuberculin test]. AB - The level of MDA in erythrocytes and plasma was determined in 71 female patients with a chronic inflammatory process in the genitals before and after subcutaneous tuberculin administration. In patients with active genital tuberculosis the MDA level rose significantly: in erythrocytes 24 hours and in plasma 72 hours after subcutaneous tuberculin administration. The MDA level remained unchanged in the rest of the patients. PMID- 1788241 TI - [Comparative hepatic toxicity of isoniazid, rifampicin and ethambutol]. AB - Isoniazid, rifampicin and ethambutol administered in equimolecular dosages (50, 250 and 100 mg/kg, respectively) for 4 days caused liver affection. This was manifested by elevated activity of serum aminotransferases and alkaline phosphatase, inhibition of lipid peroxidation of hepatocyte membranes and antioxidative system dysfunctions. Isoniazid and rifampicin were proved to be most hepatotoxic. The combined use of antituberculous drugs increases their membrane-damaging action, especially when isoniazid and rifampicin are used together, but mostly when isoniazid in combination with rifampicin and ethambutol is applied. PMID- 1788242 TI - [Intra-dental route of experimental tuberculosis infection]. AB - A total of 13 dogs weighing 13-15 kg were infected by intra-dental route with the tuberculosis mycobacterium strain H37R in a dose of 0.5 ml in the 5th dilution according to a turbidity standard. Two dogs were given intravenously the same dose of tuberculosis mycobacteria and they formed a control group. The observation varied from 10 days to 5 months. It was found tuberculosis development in intradental contamination could be attended by generalized specific affection of the viscera and development of a "minor" tuberculosis inflammation in the peridental tissues. PMID- 1788243 TI - [Optimal measures for early detection and prevention of tuberculosis in adolescents]. AB - Data are given on the examination of 23,507 schoolchildren, students of specialized secondary and technical vocational schools covering 13 regions of the country. It has been found that tuberculosis contamination of adolescents is 30 33%, on average, but it varies considerably depending on the general epidemiologic situation at the place of residence, and the social status of adolescents. As compared to schoolchildren, tuberculosis contamination and the frequency of tuberculin reaction reversion are higher in students of technical vocational schools. The importance of BCG vaccination in adolescents, as the main method for tuberculosis is prevention, is substantiated. About 30% of adolescents, on average, are subject to revaccination. It is concluded that children and adolescents should be revaccinated twice: at 6-7 years (1st form) and 14-15 years (8-9th form). PMID- 1788244 TI - [Causes of erroneous diagnosis of pulmonary tuberculosis]. PMID- 1788245 TI - [Tuberculous meningoencephalitis associated with tuberculosis of the adrenal glands]. PMID- 1788246 TI - [Publications on chemotherapy of pulmonary tuberculosis 1989-1990]. PMID- 1788247 TI - The radiologic assessment of acute pancreatitis and its complications. AB - This review summarizes the role of radiologic tests, especially CT, in the diagnosis and assessment of acute pancreatitis and its complications. Consideration of the underlying pathologic changes of complicated pancreatitis and their radiographic correlates allows identification of the presence, extent, and nature of local complications. This information can be crucial in making appropriate management decisions. Based on these data, general guidelines for the appropriate use of CT in acute pancreatitis can be formulated. Patients with clinically mild pancreatitis in whom the diagnosis is secure probably do not require imaging as long as they respond appropriately to conservative management. In patients with clinically severe pancreatitis, early CT should be performed to evaluate the extent and nature of local complications. If radiographic changes are mild and the patient responds to conservative management, no further imaging is needed. If the patient does not respond appropriately or clinically worsens, follow-up CT should be performed, seeking delayed complications. Patients in whom the initial CT shows severe pancreatitis and peripancreatic inflammatory changes should be followed with serial CT to assess resolution. Initially, serial CT should be performed every 1-2 weeks, or sooner if clinically indicated. If at any time there is clinical suspicion of infection, aggressive use of FNA is indicated. The decision to intervene, whether for infectious or sterile complications of pancreatitis, must still be made on clinical grounds. CT can be helpful in choosing the appropriate means of intervention. PMID- 1788248 TI - Intracellular events in the pathogenesis of acute pancreatitis. PMID- 1788249 TI - Endoscopic intervention in pancreatitis. AB - This overview clearly documents the critical diagnostic and therapeutic role for endoscopic intervention in pancreatitis. Further, although at the forefront of endoscopic development, the new therapeutic techniques discussed offer promise, suggesting cautious optimism. Their ultimate role in treatment of pancreatic disorders must await clarification of appropriate indications, safety, efficacy, and long-term benefit. PMID- 1788250 TI - Pancreatic "abscess": diagnosis and management. PMID- 1788251 TI - Organ failure and multiple organ system failure in pancreatitis. PMID- 1788252 TI - Surgical intervention in acute pancreatitis: when and how. PMID- 1788253 TI - Management of pancreatic pain. AB - Treatment of pancreatic pain remains a very difficult problem. At present, when the main pancreatic duct is dilated, lateral pancreaticojejunostomy remains the treatment of choice for refractory pancreatic pain. When the disease is localized to the head or tail of the pancreas, resection of these segments has also proven to be effective in the majority of patients. It will be important to learn whether medical strategy (such as treatment with oral pancreatic enzymes or somatostatin) and endoscopic techniques (such as insertion of stents or shock wave lithotripsy), compare favorably with surgical techniques. This evaluation will require randomized prospective trials. PMID- 1788254 TI - Pancreas divisum and sphincter of Oddi dysfunction. PMID- 1788255 TI - Surgical management of pancreatic pseudocysts, pancreatic ascites, and pancreaticopleural fistulas. PMID- 1788256 TI - Predictors of severity in acute pancreatitis. AB - Accurate predictors of severity in acute pancreatitis are sorely needed. At present, Ranson's scores provide useful information, some of which is recorded too late to be of maximal usefulness. APACHE-II scores on the day of admission and thereafter appear to provide important prognostic information that may enable the clinician to optimize patient care. CT scans, particularly those with bolus injection of i.v. contrast, help enormously in distinguishing interstitial from necrotizing pancreatitis. Most serum markers have not proven to be reliable in making this distinction. PMID- 1788257 TI - New perspectives in the surgical management of chronic pancreatitis. AB - Although the etiology of pain in chronic pancreatitis remains uncertain, that symptom remains the most common indication for surgery in these patients. Current endoscopic and imaging techniques now permit accurate definition of the morphology of the disease. Thus, surgical intervention can be more selectively applied to address specific abnormalities. Pancreaticojejunostomy should be the first line of surgical therapy if the ductal system is dilated. When, in addition, the head of the pancreas is enlarged and inflamed, the operation should include a localized resection of the head, preserving the stomach and duodenum. If the duct is not dilated, some form of pancreatic resection is indicated. The resection should be limited to the most severely diseased part of the pancreas. Efforts should be made to preserve as much pancreatic tissue as possible, while maintaining normal gastrointestinal continuity. In this way, the nutritional and metabolic consequences of pancreatic resection will be minimized. PMID- 1788258 TI - Cytologic criteria used to diagnose adenocarcinoma in pleural effusions. AB - A stepwise logistic regression analysis was employed to evaluate the usefulness of the following criteria to distinguish adenocarcinoma in pleural effusion from benign pleural effusion: increased size of nucleus, increased nuclear to cytoplasmic ratio, irregular nuclear borders, sharply defined cytoplasmic boundaries, large nucleoli, aggregates with variable size nuclei, aggregates with nuclear overlap, irregular noncentral vacuoles, aggregates with nuclear molding, multinucleation, three-dimensional aggregates, aggregates with large cytoplasmic vacuoles, atypical mitoses, nuclear vacuoles, homogeneous cytoplasm, aggregates with associated lymphocytes and neutrophils, and uniform size aggregates. A total of 223 patients with benign pleural effusion cases and 221 patients with adenocarcinoma in their pleural effusion were scored as to the presence or absence of the above criteria. The resulting data were subjected to a stepwise logistic regression analysis that chose increased nuclear/cytoplasmic ratio, irregular nuclear borders, large nucleoli, sharply defined cytoplasmic boundaries, and three-dimensional aggregates as the best criteria to differentiate adenocarcinoma in pleural effusion from benign pleural effusion. When used together, these five features had a sensitivity of 94% and a specificity of 93% for predicting adenocarcinoma. PMID- 1788259 TI - Adrenoneuropathy: characteristic gross findings and association with Hashimoto's thyroiditis and accelerated atherosclerosis. AB - New understanding in the pathogenesis of adrenoneuropathy (ANP), formerly called adrenoleukodystrophy (ALD) and adrenomyeloneuropathy (AML), has led to greater awareness of the disease with resultant increase in the number of new cases being diagnosed. We report adrenoneuropathy in two siblings, one of whom had associated affective symptoms and died undiagnosed in prison. The other sibling died at the age of eight with severe cerebral demyelination. Affective symptoms have been described in ANP, but the association of Hashimoto's thyroiditis and accelerated atherosclerosis in this case is unique. We would like to stress the characteristic gross appearance of the adrenals in ANP that may help in identifying undiagnosed cases of adrenoneuropathy in surgical and autopsy specimens. Genetic counseling and family-pedigree analysis with diet restriction and diet therapy will be invaluable in such cases. PMID- 1788260 TI - Aneuploidy in benign seminal vesicle epithelium: an example of the paradox of ploidy studies. AB - To evaluate if the nuclear enlargement and irregularity of non-neoplastic seminal vesicle epithelium were associated with an abnormal DNA content, 30 seminal vesicles obtained from radical prostatectomies were analyzed by flow cytometry. Twenty-eight (93.3%) of the seminal vesicles showed characteristic diploid histograms, while two (6.7%) showed histograms characteristic of aneuploidy. These results are discussed and other reported examples of aneuploidy in nonmalignant tissues are reviewed. PMID- 1788261 TI - Serial sectioning and multiple level examination of endomyocardial biopsies for the diagnosis of myocarditis. AB - To determine if serial sectioning and multiple level evaluation increase the sensitivity of endomyocardial biopsy for the detection of myocarditis, we prospectively studied all diagnostic endomyocardial biopsies between 1986 and 1989. Biopsies were embedded in paraffin, serially sectioned, and every 4-microns section was mounted in ribbons on glass slides. Every fifth slide was stained with hematoxylin and eosin and examined for myocarditis by the Dallas criteria (myocyte necrosis and inflammatory cells). Of a total of 153 biopsies, 20 cases (13%) were diagnostic of myocarditis on at least one section. Four biopsies (25%) were positive at slide Level 1, and 15 (75%) by slide Level 5; in five cases (25%), diagnostic foci were present only at or after slide Level 10. Multiple levels should be performed in the histologic evaluation of endomyocardial biopsies to increase the sensitivity of endomyocardial biopsy in the evaluation of myocarditis. PMID- 1788262 TI - Right ventricular dysplasia associated with sudden death in young adults. AB - The frequency of right ventricular dysplasia (RVD) in an autopsy series of young persons with sudden cardiac death in the United States has not been previously reported. We reviewed the autopsies from cases of sudden cardiac deaths in young adults in the state of Maryland and noted three cases of RVD among 547 cardiac deaths (0.55%). These three cases of RVD in young adults and three additional cases from our file are presented. Their ages ranged from 19 to 28 yr, and there were five males and one female. Five deaths occurred during strenuous exercise while the sixth was unwitnessed. Three of these cases had a documented history of arrhythmias and 1 had palpitations. In each case, autopsy revealed right ventricular dilatation with partial absence of the myocardium and extensive fatty infiltrates with and without fibrosis. In four cases, collections of chronic lymphocytic infiltrates were seen, of which two had associated myocyte necrosis. In one patient, the disease was familial, while in the remaining five it was sporadic, suggesting a nongenetic cause. PMID- 1788263 TI - Gastrointestinal cryptococcosis. AB - Cryptococcal infection of the gastrointestinal (GI) tract is rarely reported, either in disseminated disease or as an isolated finding. We report a case of gastric cryptococcal infection diagnosed by endoscopic biopsy as the initial presentation of the acquired immunodeficiency syndrome (AIDS), and an additional seven cases found by reviewing 23 other autopsy cases of disseminated or pulmonary cryptococcal infection. The patient with gastric cryptococcosis was a 38-year-old man who presented with symptoms of gastroesophageal reflux including odynophagia. Upper GI endoscopy showed Candida esophagitis and gastric nodules. Biopsy of the nodules revealed cryptococcal infection and granulomatous inflammation of the fundic mucosa and submucosa. The patient died 3 weeks later despite anti-fungal therapy. Autopsy revealed widespread cryptococcal infection involving the cecum but not the stomach, suggesting that the gastric lesions resolved with therapy. The sites of infection in the seven other cases were esophagus (three), stomach (one), terminal ileum (one), colon (three), gallbladder (one), and in a focus of Kaposi's sarcoma in the wall of the small bowel (one). Esophageal candidiasis was also present in two of the cases of esophageal cryptococcal infection. Predisposing factors were AIDS (3), hematologic malignancy (3), and corticosteroid therapy (1). In summary, we report a case of gastric cryptococcosis and conclude that cryptococcal infection involves the GI tract more commonly than has been previously reported, with 8/24 (33%) cases positive in our autopsy series. Of clinical significance is the observation that GI cryptococcal infection may be the initial presentation of disseminated disease in the immunocompromised patient, and cryptococcal infection of the esophagus may be found in the setting of esophageal candidiasis. PMID- 1788264 TI - Cells from ejaculatory ducts and seminal vesicles and diagnostic difficulties in prostatic aspirates. AB - In some smears from prostatic aspirates we have observed atypical epithelial cells similar to those of seminal vesicles; however, the site of aspiration was nowhere close to the seminal vesicles. We presumed those cells corresponded to ejaculatory duct epithelium. To confirm this assumption, we compared the cytology of seminal vesicles and ejaculatory ducts based on smears obtained from 10 autopsy cases. The aspects analyzed were types and arrangements of the cells, cytoplasmic and nuclear features, presence of pigment, and background of the smear. The only differences observed were the greater amounts of proteinaceous material in smears from seminal vesicles and the presence of transitional epithelial cells in smears from ejaculatory ducts. We would like to make pathologists aware of atypical cells from ejaculatory ducts as a source of diagnostic difficulties in prostatic aspirates. This subject has received no attention in the literature. PMID- 1788265 TI - Serotonin immunoreactivity in pancreatic endocrine neoplasms (carcinoid tumors). AB - Primary serotonin secreting pancreatic endocrine neoplasms (carcinoid tumors) are extremely rare and may be associated with manifestations of the carcinoid syndrome. Two cases of primary carcinoid tumor of the pancreas with liver metastases showed clinical and biochemical features of the carcinoid syndrome. Both cases demonstrated strong positive immunoreactivity for serotonin within the tumor cells. In an attempt to determine the relationship between pancreatic carcinoid tumors and other pancreatic endocrine neoplasms, immunostains for serotonin were performed on 11 additional islet cell tumors and on non-neoplastic pancreatic tissues. These cases showed serotonin immunoreactivity within islet cell tumors (36%). In addition, focal staining for serotonin was present in non neoplastic ducts and ductules (88%), acini (22%), and islets of Langerhans (33%). Based on these observations, specific criteria are suggested for the diagnosis of primary pancreatic carcinoid tumor. PMID- 1788266 TI - Histopathology and doxycycline treatment in a previously healthy non-AIDS patient systemically infected by Mycoplasma fermentans (incognitus strain). AB - The newly recognized human pathogenic mycoplasma M. fermentans (incognitus strain) causes a fatal systemic infection in experimental monkeys, infects patients with AIDS, and apparently is associated with a fatal disease in previously healthy non-AIDS patients. An apparently immunocompetent male who lacked evidence of HIV infection developed fever, malaise, progressive weight loss, and diarrhea and had extensive tissue necrosis involving liver and spleen. M. fermentans (incognitus strain) was centered at the advancing margins of these necrotizing lesions. Following the treatment of 300 mg doxycycline per day for 6 weeks, he recovered fully. He has no fever or diarrhea, and his abnormal liver function tests have returned to normal. He regained all lost strength and 14 kg of lost weight and has remained disease free for more than 1 year. PMID- 1788267 TI - Ultrastructural lesions of ovine GM1 gangliosidosis. AB - Ovine GM1 gangliosidosis, an inherited disease of sheep with deficiencies of beta galactosidase and alpha-neuraminidase, storage of GM1 ganglioside, asialo-GM1 and neutral long chain oligosaccharides in the brain, autosomal recessive inheritance, and histopathologic lesions typical of lysosomal storage diseases, has been described recently. Selected tissues from two sheep with the condition and an age-matched control were examined by transmission electron microscopy to characterize the ultrastructural lesions. In all central and peripheral neurons, the majority of the cytoplasmic space was occupied by membrane-limited enlarged bodies judged to be lysosomes, with a resultant displacement of normal organelles. The neuronal lysosomes usually contained stacks and concentric whorls of lamellae of stored material with a periodicity of 25 to 75 nM. Individual lamellae consisted of fine, multilayered (three to 10, and occasionally more) bands. Less commonly, enlarged neuronal lysosomes contained fibrillogranular or electron dense material. Central nervous system microglia and peripheral nervous system satellite cells had less extensive storage of similar material within enlarged lysosomes, whereas oligodendrocytes, astrocytes, and Schwann cells were relatively unaffected. Hepatocytes and renal epithelial cells also had storage of less quantity than neurons, but within even larger lysosomes. In contrast to neuronal storage material, visceral storage consisted of vesicles containing fibrillogranular or electron dense material within a mostly electron lucent matrix with only occasional lamellae. Kupffer cells and macrophages from bone marrow were affected similarly to but less severely than hepatocytes and renal epithelial cells, whereas hematopoietic cells and chondrocytes were unaffected. Both neuronal and visceral storage were evident, but the neuronal storage was much more extensive.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1788268 TI - Nuclear morphology of prostatic carcinoma: comparison of computerized image analysis (CAS 200) versus video planimetry (DynaCELL). AB - We compared mean nuclear size and mean nuclear shape (nuclear roundness) on Feulgen-stained smears from 113 cases of prostatic carcinoma analyzed by DynaCELL system at x 100 magnification versus CAS system at x 40 where DNA can be assessed simultaneously. Correlation coefficients were 0.67 for size and -0.07 for shape. A subgroup of cases were compared at x 40 versus x 100 on the CAS system by two observers: The correlation for size ranged 0.47 to 0.49, with correlations for shape ranging from -0.19 to 0.54. In this subgroup at x 100 magnification, the correlation between CAS and DynaCELL was 0.32 for size and 0.07 for shape. At x 100 magnification on the CAS system, intraobserver correlation was 0.58 for size and 0.37 for shape with interobserver correlations of 0.36 for size and -0.05 for shape. At x 40 on the CAS system, intraobserver correlation was 0.42 for size and 0.72 for shape, with interobserver correlations of 0.06 for size and 0.45 for shape. This study shows that in comparison to video planimetry of prostatic cancer nuclei, which has been shown to have a high inter- and intraobserver correlation, the CAS 200 system provided accurate measurements of size yet not shape. Intra- and interobserver correlations were suboptimal with CAS, showing better results at x 100 for size and x 40 for shape. These results in part reflect the relative narrow range of size and shape in prostate cancer in comparison to other tumors, and the use of Feulgen smears where nuclear RNA is not stained or measured by the CAS system, potentially leading to artifactually irregular shapes. PMID- 1788269 TI - Correspondence re: J. D. Seidman, J. J. Berman, and G. W. Moore. Basal cell carcinoma: importance of histologic discontinuities in the evaluation of resection margins. Mod Pathol 4:325, 1991. PMID- 1788270 TI - Effects of opiates on blood pressure in pithed and normal anesthetized rats with hypovolemic shock. PMID- 1788271 TI - The anticoagulant effect of beta-asarone in the mouse and the rat. PMID- 1788272 TI - Ethanol effects upon the renal excretion of water and sodium. PMID- 1788273 TI - Effects of perfluorocarbon emulsions on adenine nucleotide and lactate levels in unaerated guinea pig atria. PMID- 1788274 TI - Opioid like effects of cycloheximide and bacitracin. PMID- 1788275 TI - Effects of 2-(5-methoxy-3-indolyl)-3-aminopropanol (TR-3661) on the canine basilar artery. PMID- 1788276 TI - Captopril does not modify endothelial dependent vascular reactivity in spontaneous hypertensive rat (SHR). PMID- 1788277 TI - Dilazep increases plasma adenosine levels during adenosine infusion in the anesthetized cat. PMID- 1788278 TI - The effect of norepinephrine on distribution of portal and arterial blood flow in the liver. PMID- 1788279 TI - Glucagon modulation of vasoconstrictor responses in the hepatic and mesenteric arterial vascular beds of the cat. PMID- 1788280 TI - Vasoconstriction induced by soluble factors derived from human placenta. PMID- 1788281 TI - Potentiation of vascular responses using placental extracts from eclamptic women. PMID- 1788282 TI - Treatment of vitreous hemorrhage with amole infusion administered orally to New Zealand rabbits. PMID- 1788283 TI - Relaxant effect of viguiepinol on smooth muscle in vitro. PMID- 1788284 TI - Differential responses of Ruta chapelensis in small intestine from male and female guinea pigs. PMID- 1788285 TI - Effects of pentobarbital on gap junctions from crayfish lateral axons. PMID- 1788286 TI - Differential effects of gamma-aminobutyric acid, glycine and taurine on central synapses of crustaceans. PMID- 1788287 TI - Amygdaline penicillin focus replicates and modulates electrical amygdaloid kindling in the cat. PMID- 1788288 TI - The GABA-withdrawal syndrome. PMID- 1788289 TI - The importance of selecting the correct index of vascular tone for in vivo pharmacological studies. PMID- 1788290 TI - Pertussis toxin increases sensitivity to the lethal effect of morphine in mice. PMID- 1788291 TI - Chronic hypoxia alters ovine cerebrovascular reactivity and composition. PMID- 1788292 TI - Pregnancy-induced changes in ovine cerebrovascular reactivity and composition. PMID- 1788293 TI - Effects of maturation on ovine cerebrovascular function. PMID- 1788294 TI - Electrophysiological effects of morphine, naloxone and conorphone on cardiac Purkinje fibers. PMID- 1788295 TI - Angiotensin receptors in cultured bovine carotid artery smooth muscle cells: comparison with receptors in other smooth muscle cells/tissues. PMID- 1788296 TI - Acute and chronic administration of cocaine produces hyperthermia in the rat. PMID- 1788297 TI - Structure activity relationship in the in vitro relaxation of uterine muscle induced by 5 alpha and 5 beta alphaxalones. PMID- 1788298 TI - Effects of anticonvulsants on intestinal kindling. PMID- 1788299 TI - Metallothionein and oxidation reactions in Parkinson's disease. PMID- 1788300 TI - Substance abuse in psychiatric patients admitted to the emergency room. PMID- 1788301 TI - Arginine vasopressin induced motor disturbances in the medial amygdala: evidence for the involvement of a V1-type of AVP receptor. PMID- 1788302 TI - Nicardipine and nifedipine in the treatment of essential arterial hypertension. PMID- 1788303 TI - Behavioral and metabolic adverse interactions between diphenhydramine and ethanol. PMID- 1788304 TI - Radiologic contrast material and a vasodilator can produce arterial thrombosis. PMID- 1788305 TI - Comparison of neosynephrine and mechanical nasal dilator in relief of anterior nasal obstruction. PMID- 1788306 TI - Absence of pharmacokinetic interaction between ambroxol and clenbuterol. PMID- 1788307 TI - Clinical pharmacokinetics of praziquantel. PMID- 1788308 TI - The area postrema and the median eminence do not concentrate [Leu]enkephalin following systemic administration. PMID- 1788309 TI - Absorption of local anesthetics via the arterial wall. PMID- 1788310 TI - Pharmacokinetics of lithium in brain regions and plasma. PMID- 1788311 TI - The effect of an isoquinoline analogue on voluntary ethanol ingestion in rats. PMID- 1788312 TI - Effect of ketoconazole on external otitis. PMID- 1788313 TI - Prophylactic antibiotic in shunt surgery. PMID- 1788314 TI - In vitro study of different antiamoebic drugs. PMID- 1788315 TI - In vitro evaluation of gossypol as potential antiamoebic drug. PMID- 1788316 TI - Effect of amikacin on the renal function in the adult rat. PMID- 1788317 TI - Inhibition of E. invadens cysts induced by the addition of rifampicin. PMID- 1788318 TI - Comparison between the efficacy of cefotaxime and cephalothin on several infections by gram (+) and gram(-) bacteria. PMID- 1788319 TI - Effects of prenatal administration of diazepam on the ovary of mice. PMID- 1788320 TI - Increase of bone calcium by prenatal exposure to diazepam in mice. PMID- 1788321 TI - Antagonism by 5-reduced steroids of the tonic and phasic contractions induced by serotonin in the isolated rat uterus. PMID- 1788322 TI - Measurement of the cytosolic Ca2+ mobilization induced by extracellular ATP in AS 30D hepatoma cells using Indo-1. PMID- 1788323 TI - Accumulation of cinnarizine, a calcium entry blocker, following usual dosage regimens. PMID- 1788324 TI - Application of nonlinear regression to the estimation of in vitro antagonist dissociation constants and relative potency problems. PMID- 1788325 TI - Oral and pulmonary toxicology of the surfactant used in roundup herbicide. PMID- 1788326 TI - Serotonergic receptors involved in the hemodynamic changes observed during pulmonary embolism. PMID- 1788327 TI - Anticholinergic effect of quinidine sulfate on guinea pig smooth muscle. PMID- 1788328 TI - The effects of a centrally selective cholecystokinin analog on male, Sprague Dawley rats in the non-fasted food intake model. PMID- 1788329 TI - Effects of serotonergic compounds on associative learning. PMID- 1788330 TI - Effects of the intracerebroventricular administration of indorenate and fenfluramine on spontaneous behavior and food intake in rats. PMID- 1788331 TI - Neonatal monosodium glutamate reduced pentobarbital hypnotic susceptibility in adult mice. PMID- 1788332 TI - Effects of penicillin on rat blood lead levels. PMID- 1788333 TI - Effects of amitriptyline, chlordiazepoxide and amphetamine on the behavior of rats in a linear maze. PMID- 1788335 TI - GABA withdrawal signs in the isolated guinea pig ileum. PMID- 1788334 TI - Antinociceptive and gastrointestinal transit effects of cholecystokinin (CCK-8) and related analogs of CCK-8 in the mouse. PMID- 1788336 TI - Axonal regeneration after neurapraxia and action potential evaluation. PMID- 1788337 TI - Decreased striatal manganese content in MPTP treated mice. PMID- 1788338 TI - Chlorpromazine treatment increases circulating digoxin like immunoreactivity in the rat. PMID- 1788339 TI - The effect of lowering the sodium concentration in the cerebrospinal fluid of the III cerebral ventricle on the renal excretion of sodium and water. PMID- 1788340 TI - The effects of 4-aminopyridine on rabbit spontaneous jejunal contractions are calcium dependent. PMID- 1788341 TI - Genetic regulation of N-acetyltransferase in target organs of arylamine tumors: homologous expression in human and hamster bladder and colon. PMID- 1788342 TI - Efficacy of prussian blue against thallium poisoning: effect of particle size. PMID- 1788343 TI - Acute toxicity of casiopeine, a new type of cytotoxic agent. PMID- 1788344 TI - Preliminary toxicological evaluation of Agave sp. "amole". PMID- 1788345 TI - Toxic effects of parathion on glucose, protein and lipids in the algae Ankistrodesmus falcatus. PMID- 1788346 TI - Effect of melatonin administration on plasma glucose levels. PMID- 1788347 TI - Effect of N-(3-hydroxy-1,3,5,(10)estratrien-17 beta-yl)-3-hydroxypropyl-amine (prolame) and estradiol-17 beta on platelet aggregation. PMID- 1788348 TI - Comparative effect of prolame, a synthetic amino-estrogen, with estradiol and estrone on the contractility of the isolated rat myometrium. PMID- 1788349 TI - Inhibitory effect of 5-reduced androgens and progestins on the uterine contraction induced by acetylcholine. PMID- 1788350 TI - Effects of clofibrate on erythrocyte membranes. PMID- 1788351 TI - Presence of erythrocyte IgG auto-antibodies in clofibrate treated rats. PMID- 1788352 TI - The effects of five new 17 beta-amino-estrogens, buame, endiame, etolame, picae, and procame on blood clotting time. PMID- 1788353 TI - Publishing in peer-reviewed journals. Fundamentals for new investigators. PMID- 1788354 TI - On writing abstracts. PMID- 1788355 TI - APHIS responds to questions from IACUCs about new animal welfare regulations. PMID- 1788356 TI - The team physician. AB - The term "team physician" may refer to the activity of a sports physician in providing medical surveillance and care to a team of athletes, or to activities in coordinating a team of medical and paramedical professionals (the "sports medicine team") in the care of one or more athletes. Frequently, it denotes both activities undertaken by the same physician simultaneously. To be effective, the team physician must have medical knowledge and skill in breadth, as opposed to depth, such as derives from primary care experience. Furthermore, he or she must understand, appreciate, and function comfortably with athletics, athletes, the athlete's milieu, and the other individuals important to athletes' successful pursuit of their chosen sport. Although such service rarely provides significant financial remuneration, the rewards in terms of personal satisfaction, the opportunity for unique interpersonal relationships, and the ability to make a meaningful community contribution are significant and apparently sufficient to encourage a rapidly growing number of physicians to undertake the role. PMID- 1788357 TI - The preparticipation evaluation. AB - The preparticipation evaluation (PPE) is the first step toward meeting the responsibility of maintaining the health and safety of the athlete. The ideal timing for the PPE is 6 weeks prior to the competitive season to allow adequate time for treatment and rehabilitation of problems. It is suggested that a complete screening evaluation be performed prior to entrance into a new level of school with annual limited reevaluations thereafter. The annual reevaluation should focus on the medical history with the physical examination emphasizing the cardiovascular system and interim injuries and medical problems. Currently, there are no data to support routine screening laboratory, radiographic, or cardiovascular testing in the asymptomatic athlete with an unremarkable history and normal examination. Two different methods for performing the PPE can be used (station-type mass screening and office setting), with each having its own distinct advantages and disadvantages. The most important and difficult decision for the physician screening young athletes is determining clearance for activity. Guidelines based on the demands of the sport and specific medical problems have been established; however, the physician's clinical judgement should be used in interpreting these recommendations for each individual athlete. The PPE is an excellent opportunity for the physician to positively influence the health care and safety of a local sports program. Through genuine interest, thorough evaluation, and knowledgeable counseling, the athlete will develop confidence in the evaluating physician. This confidence can translate into a good relationship and hopefully this interaction will encourage the athlete to trust the physician's judgement and seek early evaluation and treatment for problems that arise. PMID- 1788358 TI - Exercise-induced asthma, anaphylaxis, and urticaria. AB - Exercise-induced asthma is a common but frequently undiagnosed problem. The patient may not wheeze, but rather have shortness of breath, chest tightening, and coughing. The coach and the physician must be particularly alert to the signs and symptoms of exercise-induced asthma to recognize this syndrome. Proper conditioning, warming up, inducing refractoriness, participating in sports less likely to provoke exercise-induced asthma, and the aggressive use of appropriate medications allow patients to enjoy sports and compete effectively. A rare but potentially fatal syndrome is exercise-induced anaphylaxis. Accurate diagnosis and differentiation from other exertion-related syndromes are critical, and appropriate precautions are necessary. A third clinical entity, exercise-induced cholinergic urticaria, although not life-threatening, can be quite annoying. Aggravating factors, such as increased heat, compound the problems. In summary, exercise-induced allergic phenomena are common and should be recognized by the practicing physician. PMID- 1788359 TI - Down man on the field. AB - Rapid evaluation and treatment of playing-field injuries can save a patient's life and prevent further injury. These outcomes are possible if trained personnel, who are familiar with athletic injuries, are present. This article presents basic procedures for adequate preparation, step-by-step assessment, and management of emergencies on the field, including cardiovascular emergencies; anaphylaxis; central nervous system injuries; abdominal and pelvic injuries; eye, ear, and nose injuries; and extremity injuries. PMID- 1788360 TI - Overuse injuries. The concept in 1992. AB - Overuse injuries are caused by intrinsic and extrinsic factors. Exercise exposes even the most subtle anatomic imperfections and extrinsic influences. Overuse that is not musculoskeletal in nature and new information pertaining to the role of bursae are discussed. Treatment philosophy is approached with an emphasis on history taking. PMID- 1788361 TI - Medical coverage of endurance events. AB - Supervision of medical coverage at endurance events is a complex undertaking, well suited to family physicians by virtue of their training and enhanced by their flexibility to function as gatekeepers of a wide-ranging support network. Ideally, the medical director is involved from the beginning in the planning of an endurance event and will be primarily responsible for staffing, facilities, equipment and supplies, communications, and transportation. In this article, I have presented an overview of the medical problems encountered in endurance events (Table 6). These events are increasing in popularity, and physicians should be aware of the complexities and responsibilities of medical management to ensure the health and safety of all participants. PMID- 1788362 TI - Sports protective equipment. AB - It is important for the primary care and team physician to become more involved and better informed regarding the athletic equipment process. With the increase in litigation related to sport participation and caused by athletic protective equipment misuse or malfunction, the primary care and team physician can not afford to be an uninformed bystander. Primary care and team physicians serve a very necessary role in the protection of an athlete because they are usually able to serve independently of the school or sponsoring group, thus keeping the athlete's safety and health the primary consideration. Many athletic injuries occur as "unavoidable" accidents, but many others are "preventable." One of the variables involved in preventing injuries is to follow high standards of quality, fitting, use, and maintenance of athletic protective equipment. When we obtain athletic protective equipment, we have made a decision to control the risk of injury. The primary care and team physicians should accept a share of the responsibility in decreasing risk of sports injuries. Diverse public opinion has been generated over catastrophic injuries resulting from sport participation. Most of those injuries involve either the head or neck and may be either permanently disabling or lethal. Any part of the body may be subjected to injury. Sports protective equipment is available for many different sports, with many different injury risks, and for any part of the body. Many involved in the athletic health care delivery system continue to struggle with the "noncompliant" athletic patient. Not surprisingly, the "noncompliant" athletic patient. Not surprisingly, the noncompliant athletes have a higher recurrence rate of injury than do those who are compliant. Anything that the primary care and team physicians can do to decrease the desire of the athletic patient to resist orders for modification of activities to allow an injury to heal is important. PMID- 1788363 TI - Early psychological reaction to the stress of widowhood. AB - As part of an ongoing panel study, we evaluated 350 widows and widowers at 2 and 7 months following the loss of their spouses. In general, no consistent progression of grief resolution was noted. At 7 months, grief-specific feeling states remain remarkably similar to what they were at 2 months. Anxiety levels remain high and change little from 2 to 7 months. When changes do occur, they are not unidirectional. For example, subjects are about as likely to increase as to decrease their drinking or smoking. Furthermore, depression scores at month 2 correlate well with depression and anxiety scores at month 7. Over 50% of the subjects were depressed at some time during the study period, but the depression could initially manifest itself at any time during this period. Despite the presence of psychological distress in a significant minority, most bereaved individuals report good health, satisfactory work performance and good adjustment to widowhood. PMID- 1788364 TI - Bereavement and heightened existential awareness. AB - "Ask not for whom the bells toll; they toll for thee." John Donne's admonition, though written 350 years ago, endures with astonishing freshness; it speaks to something self-evident, to a truth that is well known to many who have experienced bereavement--that the death of a significant other has the potential to hurl the survivor into a confrontation with his/her own death. A confrontation with death--should we seek it? There is evidence in the clinical literature that in terminally ill patients such a confrontation may lead to pronounced positive psychological changes. Research (Yalom 1980) has documented that terminally ill patients may undergo a series of positive personal changes; they communicate more openly with family and close friends, they experience fewer fears, they rearrange their life priorities, they are less preoccupied with the trivialities of life, they live life more immediately rather than postpone experience and pleasure into the future. Does spousal bereavement in our culture confront individuals with their own personal death? Does it cause some widow/widowers to regard their existence in a different manner? If so, might it be possible that those bereaved individuals who examine their life deeply may have a different course of bereavement than those who do not look within? Might it even be possible that bereavement, for some individuals, results in psychological shifts analogous to the positive changes reported by terminally ill patients? These are the basic questions of our research inquiry. We designed a project which would allow us to determine, in a nonclinical sample of bereaved spouses, differences in the degree of existential awareness and the consequences of such awareness on the course of bereavement. We also attempted to determine which subjects were more likely to develop heightened existential awareness. The participants studied were part of an intervention project on bereavement in which we studied a sample of widows and widowers in the first few months of bereavement and then offered them an opportunity to participate in an eight-meeting support group. Reports of the clinical issues emerging in our short-term bereavement groups and of the efficacy of these groups were published elsewhere (Yalom and Vinogradov 1988; Lieberman and Yalom 1991). PMID- 1788365 TI - Role reversal and the self-effacing solution: observations from infant-parent psychotherapy. AB - In our culture, it is widely accepted that one of the central tasks of parenting is the promotion of psychological autonomy in one's children. For parents who have achieved a reasonable measure of psychological autonomy themselves, a flexible response to the child's dual needs for dependence and independence will support the child's need for nurturance without thwarting strivings for independent mastery. In other cases, this balance is not achieved. This paper describes a particular form of relationship disorder between parents and infants in which the major theme of the relationship is an intense and unrelenting interdependence. Parent and child are inextricably bound by a shared belief that each is essential to the other's psychological well-being. The disordered relationship is characterized by mutual anger, disappointment, and/or anxiety that makes the intense closeness mutually dissatisfying. These relationships no doubt exist on a continuum, but at the clinical extreme, which is our focus, they are conflict-ridden and painful for both parent and child. PMID- 1788366 TI - The deficiency model: an exploration of current approaches to late-life disorders. AB - Many of the terms used to describe conditions in elderly individuals, whether medical (deterioration, involution, degeneration) or neurobehavioral (impairment, dysfunction), imply deficiency. The complex of distorted views of real impairment, illness, or disability may be described as the deficiency model. Although developmental theory has expanded explosively and could offer an alternative frame of reference to dispel denigration of the elderly condition, late life continues to be viewed as lacking all redeeming aspects, while mortality is considered an obstacle to prolonging life rather than one of its determinants. Deficiency-model thinking has influenced the conduct of epidemiologic, neurobiologic and clinical research, whose results in turn have often been interpreted to reinforce such thinking. It can also distort clinical approaches to diagnosis and treatment of late-life disorders. This paper offers instead an alternative approach that focuses on late life as a developmental task. PMID- 1788367 TI - A theory of madness. AB - Is there a difference between a person who is sane and that person when he is, in some way, mad? By extension, do the states of affairs we speak of as psychoses, neuroses, personality disorders, and adjustment reactions display any common features? We need adequate and coherent answers to these foundational questions if the persons about whom these judgments are made are to be properly perceived and if psychiatry as a historically emergent institution is to be rendered moderately intelligible. PMID- 1788368 TI - On the advantages of cross-culture psychotherapy: the minority therapist/mainstream patient dyad. AB - The personal quality of the therapist is a key element in therapy. In the case of the minority therapist, the difference in language and cultural background offers the patient unique benefits. Value orientations amongst cultures are similar enough for the minority therapist to acculturate. Through acculturation, the therapist becomes aware of a new set of value orientations. This cultural objectivity better enables the therapist to help the mainstream patient to see alternatives in coping with stresses of life, and to fortify the patient's adaptive skills. Because Western psychiatry and psychotherapy are culture-bound, mainstream therapists may easily be "culturally addicted," whereas a minority therapist can maintain cultural neutrality. Advantages discussed include language independence, culture independence, positive transference and analogous experiences. PMID- 1788369 TI - Mood brighteners, affect tolerance, and the blues. AB - Recently, a colleague challenged me to think seriously about a hypothetical medication--a "mood brightener...[that would] brighten the episodically 'down' moods of those who are not clinically depressed, without causing euphoria or the side effects that have accompanied the mood elevators of abuse." Fluoxetine is a significant step in that direction, he argued, and we would inevitably possess drugs that "reduce the common experiences of drudgery such as going to work on Monday mornings for those who, at present, are not seen as suffering from a mood disorder, without obvious side effects or 'impairment' in judgment." He suggested that we had best begin now to consider the implications of such medicines (R. Aranow, personal communication). PMID- 1788370 TI - The axiological dimension of psychiatric contact. AB - This article is a general reflection on psychiatric contact considered from the metatheoretical standpoint of the philosophy of science and axiology. It is inspired by the axiological dilemma of Polish psychiatry and the possibility that similar problems may arise in other countries, including the United States. The author analyzes the relation between theoretical knowledge about people and the rules of psychiatric contact and emphasizes that this contact has primary ethical components. The professional and personal spheres of psychiatric contact are distinguished and described. In addition, psychiatric contact is differentiated from educational contact--that is, in the sense of influence on development--and from psychological counseling. Finally, the dangers and limitations of psychiatric treatment based on ideology are mentioned. PMID- 1788371 TI - Sexual integration in female adolescence. Anne Frank's diary as a study in healthy development. AB - The growing acceptance of the concept of primary femininity suggests inquiry into the process through which adolescents girls integrate their rapidly developing, specifically female sexual capacities. A review of classic observations makes it apparent that, in heterosexual adolescence, the girl comes to terms with her fertility and increasing sexual excitement and with intensified wishes both to draw the opposite sex to herself and to be penetrated by the male. A discussion of these issues provides an interpretive matrix for an examination of themes of female adolescent sexual development in Anne Frank's The Diary of a Young Girl. PMID- 1788372 TI - The development of time sense in young adulthood. AB - The subjective, intrapsychic experience of time may be traced through life. The development of time sense in young adulthood (ages 20 to 40) is related to the effects of physical aging and important object relationships to spouse, children, parents, and friends. The subjective experience of the temporal modes of past, present, and future are determined by current, phase-specific influences and attitudes toward time from childhood and adolescence. As an individual approaches 40, normal functioning in relation to time implies that he or she has integrated the shift from physical progression in childhood to physical aging in adulthood, begun to deal with the idea of personal death, separated psychologically from parents, and forged new ties that shape current attitudes toward time and give meaning to life. PMID- 1788373 TI - Trauma and war. A fragment of an analysis with a Vietnam veteran. AB - The author examines the impact of the catastrophic trauma of war on symptom formation and development through the detailed, clinical account of a psychoanalysis with a Vietnam veteran. Theoretical dilemmas regarding adult trauma are explicated and a reformulated theory of etiology is proposed. PMID- 1788374 TI - Reflections on the aim of child analysis. AB - Childhood disturbances can best be studied in a developmental frame of reference. Following Anna Freud, the authors distinguish between outcome aims and intermediary aims. They present the analyses of a child and an adolescent to demonstrate how these aims affect the nature and progression of treatment. PMID- 1788375 TI - The homosexual analyst. Clinical considerations. AB - Some aspects of the work of the homosexual analyst with gay and heterosexual patients are discussed. The author examines the reasons most homosexual patients prefer to work with gay therapists, why it is usually beneficial for them to do so, and the related question of the appropriateness of revealing sexual orientation to one's patients. Manifestations and elaborations of transference and countertransference when the gay analyst works with homosexual and heterosexual patients are also discussed. PMID- 1788376 TI - On fantasies of self-creation. AB - The authors present a psychoanalytic study of fantasies of self-creation. These fantasies constitute important mental structures shaping the lives of many individuals. Although hitherto unreported in the clinical literature, artists have made rich use of self-creation fantasies, and we therefore begin our investigation with representative portraits of self-creators by Milton, Goethe, and two modernists, Luigi Pirandello and F. Scott Fitzgerald. We then describe the psychoanalyses of two men whose lives were shaped and organized by self creation fantasies, showing the clinical value of uncovering and analyzing these fantasies. We offer some preliminary observations on the cultural significance of self-creation fantasies and their impact on the analyst and the analytic enterprise. PMID- 1788377 TI - The early abortion of a pseudocyesis. Some observations from the analysis of an adolescent girl. AB - Clinical material relevant to the emergence and resolution of a pseudocyesis during the analysis of an adolescent girl is presented. This case provides evidence that psychodynamic factors can alter human behavior, produce significant mental disturbance, and even alter physiological functions. The data not only validate the psychoanalytic approach but are relevant to its very origins. The importance of the transference neurosis and the interrelationship of oedipal and preoedipal conflicts are emphasized. A brief comment is addressed to the patient's penis envy which appeared as a secondary phenomenon. PMID- 1788378 TI - The little riddle maker. A case presentation. AB - This report describes the intensive psychoanalytic psychotherapy of a 7-year-old girl diagnosed as suffering from childhood schizophrenia. The treatment, lasting for 3 years, took place in an inpatient setting and followed a conflict resolution model. The treatment process revealed an unusually orderly unfolding of a psychosexual zonal configuration: oral, anal, and phallic-oedipal. The child's style of communicating with her therapist by way of riddles is illustrated and examined in relation to her self-other experience in each emerging psychosexual phase. PMID- 1788379 TI - Looking at and looking away. Etiology of preoedipal splitting in a deaf girl. AB - This paper presents the analysis of a profoundly deaf 12-year-old girl. The main referring symptom was a pattern of intense libidinal looking at and aggressive looking away from others, which functioned as a preoedipal splitting to keep apart opposite "all good," life-enhancing and "all bad," deathlike self and object representations. The preoedipal splitting seemed to have its etiology in traumatic experiences in the symbiotic and rapprochement phases. The analysis followed the sequence of separation-individuation, as blocks to development were progressively removed. PMID- 1788380 TI - Exploring internal and external worlds. Reflections on being curious. AB - Curiosity is a complex function that is related to a number of other psychological functions such as motivation, arousal, attention, and novelty preference. This paper presents the thesis that curiosity represents a separate ego function which is closely tied to objects and is centrally organizing in all phases of development. It is an integrative function that regulates arousal, motivation, and affect, begins in infancy, has a neurobiological base, and is channeled by the child's social experience. Psychologically, curiosity may serve both libidinal and aggressive aims. Psychoanalytic views of curiosity are considered in light of data from studies of infants' and young children's exploratory activities and a model is presented for the developmental function of curiosity throughout the life-span. PMID- 1788381 TI - Grandiosity in children with narcissistic and borderline disorders. A comparative analysis. AB - I draw a distinction between two clinical pictures in children, borderline and narcissistic disorders. Both belong to the realm of personality disorder--or, perhaps, disorders in the development of the personality--but only the former has been widely reviewed and thoroughly investigated in the professional literature. I raise the question how and when these disorders emerge, stressing that both derive from the early, preoedipal period, and precede completion of the separation-individuation processes. Both disorders reveal manifestations of grandiosity which I view as a defense against the two underlying emotional experiences of the disorders: the experience of feeling alone in the borderline case, and the experience of "worthlessness" in the narcissistic personality. PMID- 1788382 TI - Narcissism and object love as separate but dependent developmental lines. AB - The literature on the existence of a separate narcissistic line of development is reviewed. In contrast to both extreme points of view--the classical one, not recognizing any separate narcissistic line of development, designed by Freud and sustained by Kernberg, Mahler, and others, and the Kohutian one, claiming the separate independent existence of a narcissistic developmental line--there are various possibilities of intermediate solutions. I suggest that in the frame of reference of Anna Freud's concept of developmental lines, two separate but interdependent lines could be defined, one of object love and the other, rather than termed narcissistic, of introjective-egocentric characteristics. The development and the possible regression in the possible regression in the realm of both lines and dealt with and schematically laid out. PMID- 1788383 TI - "Jointness" as integration of merging and separateness in object relations and narcissism. AB - "Jointness" represents an encounter between mother and infant or any partners experiencing simultaneously mutual satisfaction of surrendering while concomitantly safeguarding separateness. The merging and separateness need to be constantly regulated. This continuous movement creates a "psychic space" between partners and elicits the triangulation in object relations. "Media" is created through the "psychic space" by the mutual investment of the partners in a joint object, phenomenon or idea, cathected and meaningful to both. Such a dynamic process paves the way to a sense of narcissistic restoration and culminates to establish the narcissistic integrity. In contrast, symbiosis is a dyadic pathological process, from the beginning of life, producing narcissistic fragility. PMID- 1788384 TI - Adoption and identity. A case study. AB - A middle-aged adoptee instituted a search for his biological parents. His discoveries enhanced his sense of identity. PMID- 1788385 TI - A note on the nature of prejudice. AB - The psychodynamics of prejudice have been extensively studied and documented. What is less well understood perhaps are the developmental steps that get the process started. This paper argues that to understand prejudice from a developmental point of view, two psychological processes must be understood: (1) the process whereby the mind arrives at its convictions; and (2) group concepts, their uses and abuses. PMID- 1788386 TI - Object loss, aggression, and gender identity. AB - This paper arises from a clinical, observational, longitudinal study of aggression in normal children in the first two years of life. In this study of one of the research children the authors seek to delinate how the emergence and vicissitudes of aggression in a little boy are affected by a variety of strains in the course of his early development and how the aggression affects all the major developmental tasks in his young life. In particular, the authors attempt to follow the interdependent currents of object relations, aggression, and early sexual development. PMID- 1788387 TI - Divorce--a Gordian knot. AB - This paper describes the applications of psychoanalytic and child development theory to the court-ordered visitation study of a 6-year-old child. In this case, the recommendation is for the sole custodial parent to be given the authority to regulate visitation with the noncustodial parent. This recommendation is consistent with the principle of the least detrimental alternative. PMID- 1788388 TI - An analysis of gender differences in separation-individuation. AB - Mahler's description of separation-individuation is examined for evidence of gender-related differences. My analysis suggests that these differences may be seen throughout the four subphases and should not be viewed as stemming primarily from the child's awareness of the anatomical difference. It is argued that mothers do treat daughters differently from sons starting at the earliest moments of life. PMID- 1788389 TI - The maternal representation. A comparison of caregiver- and mother-reared toddlers. AB - Two groups of toddlers and their caregivers were observed at the Margaret S. Mahler Observational Research Nursery on different days. In one group (the caregiver group) the children of full-time employed mothers were cared for at home by paid caregivers. In the other group (the mother group) the children were cared for full-time by their actual mothers. These two groups are compared in terms of the children's expression of affect, interest in peers, identifications, separation protests, signals of communication, and symbolic functioning. Contributions from infant research are used to illustrate how recent conceptualizations about the construction of the maternal representation further understanding about the child's experience of multiple caregivers. PMID- 1788390 TI - Pathogenic factors in the experience of early and late adopted children. AB - This study examines factors contributing to the difficulties of 20 adopted children, including their common posture of rejection toward their adoptive parents and interest in reunification with biological parents. The children adopted at or near birth used the fantasy of reunion as a reparative substitute for an intense but ambivalent relationship with adoptive parents, while children adopted after 2 years were less intimately connected with their adoptive parents. A disturbance in the relationship with the parenting figures with whom these children spent their earliest years appeared to be the most unique factor in determining this later course of events. PMID- 1788391 TI - Endocrine and substrate control of fetal growth: placental and maternal influences and insulin-like growth factors. AB - Fetal growth is largely controlled by the interaction of the genome with the availability of oxygen and glucose and by endocrine responses to variations in their supply. Insulin-like growth factor II (IGF-II), and probably IGF-I, modulate fetal growth. Insulin and thyroid hormones are controlled by the supply of glucose and oxygen, respectively, and they influence fetal growth, partly via IGF-I. Circulating IGF-I and -II are controlled acutely and chronically by glucose availability to the fetus. The transfer of substrates from the mother to the fetus is determined by placental transfer capacity and by placental utilization of those substrates. The fetus controls the latter via its blood concentrations of oxygen and glucose and possibly IGF-I. In the mother, placental hormones and proteins, such as progesterone, placental lactogen, placental growth hormone and proteases, increase circulating IGFs and alter the stability and concentrations of IGF binding proteins. These changes may direct the metabolic and growth adaptation of the mother to pregnancy, which ensures an adequate flow of substrates to the developing fetus. PMID- 1788392 TI - Ovarian follicular dynamics and concentrations of oestradiol-17 beta, progesterone, luteinizing hormone and follicle stimulating hormone during the periovulatory phase of the oestrous cycle in the cow. AB - Changes in the plasma concentration of oestradiol-17 beta, progesterone, luteinizing hormone (LH) and follicle stimulating hormone (FSH) were characterized during the transition from the luteal to the follicular phase, the periovulatory period and the early luteal phase in five cycling cows. The pattern of growth and the regression of follicles and corpora lutea in the ovary of the same animals were also assessed by daily ultrasonographic examinations. Two waves of follicular growth (ovulatory and non-ovulatory) occurred in all animals. The ovulatory follicular wave started from 4 days before the preovulatory surges of LH and FSH and the wave of next growth of a dominant follicle (non-ovulatory follicle) started within one day after ovulation. Changes in plasma levels of oestradiol-17 beta correlated well with the growth of both ovulatory and non ovulatory dominant follicles. Suppression of FSH concentration during the follicular phase was inversely related to the increase in plasma concentration of oestradiol-17 beta. These results suggest that, in the cow, ovulatory dominant follicles suppress FSH secretion by increasing the concentration of oestradiol-17 beta (and probably also inhibin) during the follicular phase. PMID- 1788393 TI - Detection of anti-ovarian antibodies by indirect immunofluorescence in patients with premature ovarian failure. AB - The sera of 30 patients with premature ovarian failure (POF) and a control group of 19 menopausal women were screened for anti-ovarian and other tissue antibodies. Anti-ovarian antibodies were detected by indirect immunofluorescence using monkey ovary substrates from two different commercial sources. Serum anti ovarian antibodies were detected in only one of the patients with POF. This test does not appear to be reliable for the detection of serum anti-ovarian antibodies, and the clinical usefulness of screening patients with POF for anti ovarian antibodies is questionable. PMID- 1788394 TI - Peripheral concentrations of immunoreactive inhibin during pregnancy and parturition in the ewe. AB - The aim of this study was to measure the peripheral concentrations of immunoreactive inhibin (ir-inhibin) and progesterone (P) during pregnancy and parturition in the ewe and to relate the concentrations of ir-inhibin to P and to the number and sex of the fetuses. P increased across pregnancy with higher levels in ewes with 2 fetuses (n = 5) than in those with 1 fetus (n = 6), and concentrations falling before birth. ir-Inhibin concentrations were relatively stable during the first 40 days of pregnancy for example (Day 20, 34.7 +/- 2.9 pmol L-1; mean +/- s.e.m., n = 11). After Day 40, inhibin fell in all ewes to reach less than or equal to 2.5 pmol L-1 after Day 80 (mean on Day 103, 6.3 +/- 1.2 pmol L-1), and remained low until 2 days before parturition when concentrations rose sharply, peaking at or around the day of birth in all ewes (21.5 +/- 2.1 pmol L-1). Thereafter, ir-inhibin fell and remained low or undetectable for up to 10 days in the six ewes still being sampled. ir-Inhibin concentrations in ewes carrying one (n = 6), two (n = 5) or three fetuses (n = 1) did not differ at any stage of pregnancy examined. The sex of the fetus did not appear to influence the peripheral concentrations of ir-inhibin in the ewe. PMID- 1788395 TI - Increased production of sheep embryos following superovulation of Merino ewes with a combination of pregnant mare serum gonadotrophin and follicle stimulating hormone. AB - In a factorially designed experiment (N = 321), 0, 800 or 1600 I.U. pregnant mare serum gonadotrophin (PMSG) were administered in combination with 0, 12 or 18 mg follicle stimulating hormone (FSH-P) to superovulate Merino ewes in autumn and spring. A moderate dose of PMSG (800 I.U.) in conjunction with 12 or 18 mg FSH-P increased the ovulation rate above that observed when FSH-P was used alone. This was accomplished by (i) increasing the proportion of ewes that exhibited a superovulatory response (greater than 3 corpora lutea (CL) or persistent large follicles (LF): 69/70 (99%) v. 55/74 (74%), P less than 0.001), and (ii) in those ewes that exhibited a superovulatory response, by an additive effect of exogenous gonadotrophin (14.8 +/- 0.9 CL (69) v. 11.3 +/- 0.9 CL (55), P less than 0.01) without increasing the incidence of LF. The use of 1600 I.U. PMSG in conjunction with 12 or 18 mg FSH-P was characterized by an increase in the number of LF and, in comparison with 800 I.U. PMSG, a reduction in ovulation rate. Season had no effect on the numbers of CL, but total ovarian response (CL + LF) was higher in autumn than in spring (P less than 0.01), because of a greater incidence of LF (P less than 0.001). The proportion of ewes with regressed CL was higher in autumn than in spring (53/143 (37%) v. 32/156 (21%), P less than 0.01), and increased with increased dose of gonadotrophin. Furthermore, a nutritional component to the incidence of ewes with regressed CL was suggested by the observation that the mean concentration of plasma glucose was higher for ewes with normal CL than for ewes with regressed CL (P less than 0.05). Rates of ova or embryo recovery, fertilization and embryo development generally declined with an increase in the incidence of LF as a result of increases in the dose of gonadotrophin and season of administration. PMID- 1788396 TI - Superovulation of Merino ewes with an ovine pituitary follicle stimulating hormone extract. AB - In order to investigate the effectiveness of ovine FSH as a superovulatory gonadotrophin in sheep, three batches (oFSH-1, oFSH-2 and oFSH-3) of crude follicle stimulating hormone (FSH) extracts were prepared from ovine pituitaries by protein fractionation. The extracts were characterized in radioimmunoassays (RIA), radioreceptor assays (RRA) and bioassays. A FSH:LH (luteinizing hormone) ratio of 1:0.71 and 1:0.18 was calculated from oFSH-1 in RIA and RRA respectively. oFSH-1 was more potent than NIH-oFSH-S12 in RRA, with a potency ratio of 1:0.65 calculated at 50% binding. In mouse bioassay, oFSH-2 was effective in inducing folliculogenesis. The potency of oFSH-3 as an ovarian stimulatory hormone was tested in a field trial on sheep. Thirty-one mature Merino ewes were treated in the breeding season with intravaginal progestagen pessaries and 6, 12 or 24 mg doses of oFSH-3 were injected twice daily for 3 days (n = 10 or 11). Each ewe was inseminated in the uterus with fresh semen 24 h after pessary withdrawal. Ova or embryos were recovered by mid-ventral laparotomy 6 or 7 days after pessary withdrawal. The dose of oFSH-3 had a significant effect on the ovulatory response (P less than 0.01); the mean ovulation rates were 1.5 +/- 0.2, 12.6 +/- 2.8 and 13.1 +/- 2.9 following injection with 6, 12 or 24 mg of the gonadotrophin respectively. The dose of the gonadotrophin injected had no effect on the mean percentages of ova recovered or fertilized. The overall ova recovery and fertilization rates (%) were 67.8 +/- 6.4 and 92.2 +/- 5.1 respectively. (ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1788397 TI - Glucose utilization by sheep embryos derived in vivo and in vitro. AB - Embryos were collected from superovulated donors at various intervals from onset of oestrus, ranging from Day 1.5 to Day 6. In addition, blastocysts obtained from the culture of 1-cell embryos collected in vivo or of oocytes matured and fertilized in vitro were used to assess the effects of in vitro manipulation and culture on glucose utilization. Glycolytic activity was determined by the conversion of [5-3H]glucose to 3H2O, and oxidation of glucose was determined by the conversion of [U-14C]glucose to 14CO2. Glucose utilization increases significantly from the 8-cell stage and during compaction and blastulation. Glucose oxidation was at a relatively low level (5-12% of total utilization) compared with glycolysis. No difference was observed between the glycolytic activity of blastocysts derived from in vivo or in vitro sources. However, glucose oxidation was lower (P less than 0.05) in blastocysts derived from the culture of 1-cell embryos or from oocytes matured and fertilized in vitro. Exogenous tricarboxylic acid cycle substrates (i.e. pyruvate and lactate supplied in the medium) affected the level of glucose oxidation. PMID- 1788398 TI - Relaxin and relaxin c-peptide levels in human reproductive tissues. AB - A radioimmunoassay for a representative portion of the c-peptide of human relaxins (H1 and H2) was developed and validated. Relaxin c-peptide is present in preprorelaxin and prorelaxin, and exists free after the maturation of relaxin is completed. The aim of the study was to identify possible production and storage sites of human relaxin by comparing c-peptide and relaxin levels in various human reproductive tissues. c-Peptide immunoreactivity was present in the corpus luteum, amniochorion, decidua and seminal plasma; this indicates that these tissues may be relaxin production sites. Relaxin was detected in the corpus luteum, amniochorion, decidua, trophoblast, seminal plasma, myometrium and fibroids. This suggests that these tissues are storage and/or target sites for relaxin. The highest concentration of relaxin was detected in decidua at term. This level decreased after labour. The concentrations of c-peptide and relaxin were approximately equimolar in serum during pregnancy. This study lends support to the concept that relaxin is produced and stored at extra-luteal sites; these sites of hormone production support a paracrine role for relaxin during pregnancy. PMID- 1788399 TI - Luteinizing hormone and follicle stimulating hormone induce premature condensation of chromatin in goat (Capra hircus) oocytes. AB - This study tested the hypothesis that premature condensation of chromatin in goat oocytes following superovulation with 1200 i.u. pregnant mare serum gonadotrophin (PMSG) is mediated by the high luteinizing hormone (LH) activity inherent in this gonadotrophin. Goats were treated with either a standard (3.95 mL) or high (7.90 mL) dose of a highly purified follicle-stimulating hormone (FSH) preparation (Ovagen), and different doses of human chorionic gonadotrophin (hCG) were added to increase the level of LH bioactivity during superovulation. The meiotic status of oocytes obtained at sponge withdrawal was compared between different treatments and correlated with profiles of LH bioactivity in peripheral plasma. Injection of 100 i.u. hCG (which gave a plasma LH profile comparable to 1200 i.u. PMSG) or 200 i.u. hCG resulted in significantly more oocytes showing premature condensation of chromatin without germinal vesicle breakdown than with 25 i.u. hCG or treatment with FSH alone. Nevertheless, nuclear maturation was also prematurely activated in a significant number of oocytes with a high dose of FSH alone, even though LH bioactivity was not detected in plasma. It is concluded that high LH bioactivity during superovulation of goats with gonadotrophins activates the initial stages of nuclear maturation in oocytes. However, highly purified FSH preparations in high doses can also induce this apparent abnormality in the timing of oocyte maturation through mechanisms unrelated to any LH contamination. PMID- 1788400 TI - Growth in vitro and acquisition of meiotic competence after the cryopreservation of isolated mouse primary ovarian follicles. AB - The growth and acquisition of meiotic competence of oocytes from fresh and frozen thawed primary follicles collected from 10-day-old mice was compared during culture in collagen gels for 12 days. The oocytes contained in primary follicles have a mean diameter of about 48 microns and do not resume meiosis without further growth and development. During the 12-day culture period the mean diameter of the oocytes increased to over 60 microns. The oocytes were capable of resuming meiosis when isolated from the gel and cultured in the absence of follicular cells in a manner similar to that observed in vivo. Freezing and thawing did not affect oocyte growth or the ability to resume meiosis; this demonstrates the possibility of storing large numbers of female gametes for subsequent development. PMID- 1788401 TI - Oxygen concentration and protein source affect the development of preimplantation goat embryos in vitro. AB - The effect of oxygen concentration and the source of protein in culture medium on the development of 2- to 4-cell goat embryos in vitro was investigated. Embryos were collected from superovulated Angora-Cashmere-cross goats 48 h after ovulation and cultured for 6 days in synthetic oviduct fluid (SOF) medium under one of two oxygen concentrations (20% or 7%) and in the presence of one of five protein sources; Miles bovine serum albumin (Miles BSA), Commonwealth Serum Laboratory bovine serum albumin (CSL BSA), goat serum (GS), fetal calf serum (FCS) and human serum (HS). In the presence of 20% oxygen the percentage of embryos reaching the expanded and/or hatched blastocyst stage in SOF medium containing Miles BSA was 29%, with a mean cell number per embryo of 28.1 +/- 6.0 (+/- s.e.m.). Use of an oxygen concentration of 7% significantly increased the percentage of embryos reaching this stage (80%, P less than 0.01) and the mean number of cells per embryo (65.3 +/- 8.2, P less than 0.01). The mean number of cells of the early-cleavage-stage embryos was significantly lower when the medium contained CSL BSA, GS or FCS (42.7 +/- 5.6, 29.0 +/- 6.1 and 21.3 +/- 3.2, respectively) than with Miles BSA (92.8 +/- 6.4) or HS (104.8 +/- 17.2) (P less than 0.01). Under 7% oxygen and with Miles BSA or HS, embryos were morphologically comparable to those developed in vivo, but the mean cell numbers in vitro were only approximately half those obtained in vivo. PMID- 1788402 TI - Metabolism of fructose-1,6-bisphosphate by mature boar spermatozoa. AB - Mature epididymal boar spermatozoa converted glucose and fructose to carbon dioxide and lactate and maintained high concentrations of ATP. In the presence of (S)-alpha-chlorohydrin these processes were inhibited and there was an accumulation of fructose-1,6-bisphosphate and dihydroxyacetone phosphate. With fructose-1,6-bisphosphate as the substrate, the concentration of ATP was maintained, carbon dioxide was evolved and dihydroxyacetone phosphate accumulated. Cells pre-incubated with (S)-alpha-chlorohydrin did not maintain ATP levels, evolved less carbon dioxide and produced dihydroxyacetone phosphate. Assays of incubates in which fructose-1,6-bisphosphate was used as the substrate showed the presence of equilibrium quantities of fructose-6-phosphate and glucose 6-phosphate which were not detected when either fructose or glucose were used as substrates. [14C]Fructose and [14C]glucose were not produced from [14C]fructose 1,6-bisphosphate in spermatozoal incubates which had or had not been pre incubated with (S)-alpha-chlorohydrin. Evidence is presented that a high concentration of fructose-1,6-bisphosphate leads to the formation of fructose-6 phosphate and glucose-6-phosphate but not of fructose and/or glucose. PMID- 1788403 TI - Is the antiprogestin RU486 luteolytic in rats? AB - Subcutaneous injections of RU486 on Day 1, Day 4 or Days 3 and 4 of pregnancy in rats induced abortion of the embryo and transient vaginal cornification. Nevertheless, most corpora lutea appeared to be functional at autopsy on Day 12. The same treatments in pseudopregnant rats also produced transient vaginal cornification, but did not terminate pseudopregnancy. This suggests that transient antagonism of progesterone by RU486 does not terminate function of the corpus luteum in rats and that positive feedback by progesterone is not essential for continuing luteal function in rats. PMID- 1788404 TI - A simple rapid 4.5 M dimethyl-sulfoxide freezing technique for the cryopreservation of one-cell to blastocyst stage preimplantation mouse embryos. AB - This study applies a 4.5 M dimethyl-sulfoxide freezing procedure, developed for 2 cell mouse embryos, to pronuclear to hatched blastocyst stage mouse embryos. The embryos were plunged into liquid nitrogen after 3 min equilibration at room temperature, or 3-60 min equilibration at 0 degrees C. Equilibration at 0 degrees C gave survival rates as high as or higher than rates after equilibration at room temperature. Optimal blastocyst formation, or re-expansion, rates for embryos frozen after equilibration at 0 degrees C were 76% for pronuclear stage embryos and 96-100% for 2-cell to mid-blastocyst stage embryos. The optimal rates of fetus formation, per embryo frozen, ranged from 62 to 88% for pronuclear to mid blastocyst stage embryos. These results compared favourably with non-frozen control embryos (80-100% blastocyst formation, and 67-78% fetus formation). PMID- 1788405 TI - Telematics in medicine: problems, Italian experiences (TELECOS, cardiophone), perspectives. PMID- 1788406 TI - Health care and telemedicine: the information system in Italy. PMID- 1788407 TI - Telemedicine and telehealth: the situation in Italy and the perspectives in Europe. PMID- 1788408 TI - TELECOS project: the experience of the Friuli Venezia-Giulia Region. PMID- 1788409 TI - TELECOS project: the experience of the Marche Region. PMID- 1788410 TI - The TELECOS project: experience of the Basilicata region. PMID- 1788411 TI - The TELECOS project: experience of the "Istituto di Radiologia, Universita Cattolica del S. Cuore", of Rome. PMID- 1788412 TI - The TELECOS project: the experience of the Istituto Nazionale dei Tumori of Milano. PMID- 1788413 TI - Cardiophone. PMID- 1788414 TI - Technological advance in teleconsultation. PMID- 1788415 TI - Technical aspects of digital processing and transmission of X-ray pictures. PMID- 1788416 TI - Experience with remote transmission of high resolution biomedical imaging. PMID- 1788417 TI - Local access network: state of the art. PMID- 1788418 TI - Advanced technologies in problem-based teaching: reference databases. PMID- 1788419 TI - Advanced technologies in problem-based teaching: author systems. PMID- 1788420 TI - Continuing medical education by the videotex system. PMID- 1788421 TI - Computer and communication in medicine. PMID- 1788422 TI - Multimedia: a new frontier in education. PMID- 1788423 TI - [Characters in search of an author. Thoughts on the paternity of scientific articles]. PMID- 1788424 TI - [A proposal of an original system of "voice-mediated input" in radiological reporting]. AB - The recent introduction of vocal input systems in diagnostic radiology will produce many changes in reporting. Statistical analyses of the texts put in (the so-called "mediated vocal input") are an interesting possibility which allows the radiologist to evaluate both readability and efficacy of his reports. The structure of a vocal input system is also suitable to define standardized vocabularies of commonly used radiological terms. This paper describes the structure of an original system, built by assembling low-cost components, with a self-made software. The aim is the reduction of noise in the communication between the radiologist and the physician, by means of new solutions which will make the radiological report one of the key points of the diagnostic procedure. PMID- 1788425 TI - [The presurgical staging of soft-tissue sarcomas of the extremities: imaging diagnosis]. AB - The authors studied 43 patients affected with soft tissue sarcomas to evaluate the accuracy of different imaging modalities in predicting resectability. Locations included lower (30) and upper (11) limbs, axillary (2) and gluteal (2) regions. MR imaging was performed on 37 patients, CT on 35 and US on 30. All patients were preliminarily subjected to conventional radiographic examination. MR imaging proved to be the most reliable modality because it allowed the lesion site to be correctly determined relative to both anatomical compartments and lesion spread; its relationships to joints and vascular structures were also depicted. Intravenous administration of Gd-DTPA (to 9 patients) allowed important information to be gained as to identifying and quantifying tumoral necrosis, and made it possible to discriminate tumoral component from perilesional edema. In our experience, CT was shown to overstage the T parameter--due to difficult distinction of edemigen component, even with a careful use of angio-CT. On the contrary, CT was the modality of choice in recognizing bone cortical infiltrations, even small ones, and in identifying pulmonary metastases. US played a role in the staging of these neoplasms thanks to its recognizing even small lesions and, in case of suspected vascular involvement, it allowed even small infiltrations of the vascular wall to be demonstrated. PMID- 1788426 TI - [Acute instability of the shoulder in athletes. The role of magnetic resonance in therapy planning]. AB - Magnetic resonance imaging (MRI) of the shoulder was performed to evaluate both the actual role of this technique in the study and staging of acute shoulder instability, and its potentials as diagnostic tool, with particular reference to treatment planning. Seventeen athletes with acute shoulder instability were examined. All MRI examinations, subsequent to plain radiographs, were performed within 48 hours from the traumatic event. After MRI examination, 14 patients underwent physiotherapy (2 cases were subsequently submitted to arthrotomy), and only 3 cases underwent surgical treatment in the acute phase (2 arthrotomies and 1 arthroscopy). These cases, submitted to MRI in the acute phase and subsequently to surgery, showed anterior glenoid labrum involvement with good evidence of associated skeletal lesions (Hill-Sachs lesions in 1); changes in the inferior glenohumeral ligament complex (2 cases) were also observed. In the other examined cases, MRI always provided accurate information on the glenoid labra and the anterior capsular mechanism. When the superior glenohumeral ligament was investigated (9 cases of 17), no alterations were observed. Acting as natural contrast, the presence of joint effusion allows good visualization, on T1 weighted sequences, of the structures involved by the traumatic events. Contrast resolution improvement could be obtained by employing gradient-echo T2 weighted sequences, which proved to be quite valuable for a correct depiction of the lesions involving the inferior glenohumeral ligament complex. In conclusion, MRI can be considered as a valuable diagnostic method for the early evaluation of the acute shoulder instability, since it provides information of the utmost importance for the subsequent therapeutical approach. PMID- 1788427 TI - [The incidence of disk changes in volleyball players. The magnetic resonance findings]. AB - In order to evaluate the to potential hazards related to athletic functional overload on the intervertebral disk we studied with MRI the incidence of intervertebral disk abnormalities in a group of 45 volunteers who had been playing professional volleyball for 3-7 years. As a control group we examined with MRI 30 professional swimmers as well. Among the volley-ball players the incidence of intervertebral disk alterations was 44.4%; they were represented by 8 cases of disk degeneration, 11 cases of bulging and 9 disk herniations (in 8 patients the simultaneous presence of more than one lesion was observed). In the control group the incidence of such lesions was 20%. The obtained results were correlated with the clinical findings and the age of the athletes. Among the 26 athletes with back pain only 13 had positive findings at MRI, while among the 19 asymptomatic athletes 7 showed lesions detectable with MRI. As for age, we observed that the younger athletes (17-19 years) had positive MRI findings in 38.5% of cases, while the players in the age group ranging from 23 to 26 years, had positive MRI findings in 56.2% of cases. The analysis of the different types of training of the volley-ball players and the control group, showed that 19 volley-ball players who followed appropriate training procedures had positive MRI findings in 21.1% of cases (in the control group the percentage was 20%). Among the 26 athletes who were trained with exercises that caused significant functional overload, 16 had intervertebral disk lesions at MRI (61.5%). Moreover, our data showed that the correlation of the incidence of disk lesions with the type of training (and relative varying degree of overload) is definitely more important than the one existing with the age of volley-ball players and the overall period of their athletic activity. MRI proved to be a useful technique for the early assessment of the intervertebral disk damage caused by an incorrect training in young athletes, even when asymptomatic. PMID- 1788428 TI - [The significance of echographic signs in pathology of the rotator cuff]. AB - Fifty-two patients, 17 acute and 35 chronic, underwent US of the shoulder. The first class of patients had clinical history of blunt trauma occurred 2 to 30 days before examination. The second class of patients included 15 patients with history of trauma occurred 3 months (or more) before examination and 20 patients affected with impingement syndrome. As to the US signs of rotator cuff tear reported in the literature, the results of the study, supported by arthrographic (21 cases), MR (2 cases) and surgical (24 cases) findings, indicate that their presence and significance differ in the acute and in the chronic patient and that: 1) Focal discontinuity, appearing as a hypoechoic area, is demonstrable only in the acute patient. The sign is due to a tear filled with blood and/or bursal liquid and holds high diagnostic accuracy. It is rare that an acute lesion appears as a hyperechoic linear density--which has doubtful diagnostic accuracy. 2) Non-visualization of the cuff is observable in both the acute and the chronic patient and indicates rupture in both of them. This sign has high diagnostic accuracy. 3) Thinning of the cuff is also observable both in the acute and in the chronic patient. Nevertheless, while in the former the sign can be regarded with confidence as indicating a tear in almost all cases, in the latter it may be due either to a tear or to degeneration. Arthrography or MR Imaging are therefore advisable in this group of patients, especially if surgical treatment is considered. PMID- 1788429 TI - [Ultrasound in the diagnosis of fragilitas ossium]. AB - Recently, a proposal has been made to evaluate bone fragility in osteoporotic women by measuring ultrasound transmission velocity at the patella. Theoretically, sound transmission velocity depends on both bone mass and other factors which are not mass-dependent--e.g. bone architecture. Ultrasound transmission technique was thus tested for the capability of evaluating bone fragility factors, which are not mass-dependent, in the screening of osteoporotic women. To this purpose, the sound velocity at the patella of 31 healthy women was compared with that of 62 osteoporotic women with spontaneous vertebral fractures having similar bone mineral content. In 31 cases bone mineral content was similar to that of healthy women at the middle radius, and in 31 at the distal radius. Sound transmission velocity was significantly lower in osteoporotic than in healthy women. Fifty-two per cent of healthy women was correctly selected by US, relative to the risk threshold, versus 13% with bone mineral densitometry. This finding suggests that US is capable of distinguishing normal from osteoporotic women having similar bone mineral content, which means that non-mass-dependent factors may affect US velocity in the bone. Since the measurement were taken in various sites, different for US and bone densitometry, our results need confirmation in further studies where measurements are taken in the same sites. PMID- 1788430 TI - [Cranial trauma: the predictability of the presentation symptoms as a screening for radiologic study]. AB - A prospective study was performed on 4,262 consecutive patients who had had skull examinations for recent head trauma. Clinical signs and symptoms and patient history were correlated with skull fractures and intracranial sequelae as identified on CT studies, in order to evaluate the predictive value of each clinical finding and to identify high-yield referral criteria. Ninety-seven skull fractures (3%) and 32 intracranial sequelae (0.7%) were observed. All the intracranial complications were observed in patients with fractures and with altered consciousness of some degrees (Glasgow Coma Scale score less than 13). Most patients were asymptomatic (41%) or showed "low risk" symptoms (29%): among them, neither fractures nor complications were observed. High-risk clinical signs, mainly expressing basilar fractures (as rhinorrhea, otorrhea, focal neurologic signs, retroauricular hematoma) demonstrated high predictive value (100%) for intracranial sequelae. Other "moderate risk" findings for intracranial injury--i.e. loss of consciousness at any time, antegrade or retrograde amnesia, multiple trauma, and possible skull penetration--showed a high correlation with skull fractures and a slightly lower one with intracranial sequelae. The most predictive finding for brain injury was the depressed level of consciousness: brain injuries were never observed in fully conscious patients; in altered consciousness with GCS 15-13 we observed 4% of skull fractures with no sequelae; at GCS values 12-9, 61% of skull fractures and 20% of sequelae were present, whereas at GCS less than 8, 100% of complicated fracture were observed. The finding of skull fracture showed 33% of predictivity for brain damage, which was, however, always associated with "high or moderate risk" clinical signs. Therefore, the authors suggest some guidelines for the management of patients with recent head trauma, including referral criteria for X-rays or CT studies, based on signs and symptoms with high, intermediate and low risk of developing intracranial sequelae. PMID- 1788431 TI - [The echo-guided percutaneous injection of ethanol: a therapeutic alternative in the "autonomous thyroid nodule". Our experience]. AB - The authors report their experience on the therapeutic value, in terms of efficacy and tolerance, of percutaneous ethanol injection (PEI) in the treatment of autonomous thyroid nodules (ATN). A group of 15 patients, 13 in clinical pretoxicity and 2 in initial thyrotoxicosis, were submitted to fine-needle ethanol injection (95%) performed under US guidance. The amount of injected alcohol was measured on the basis of the volume and diffusion of alcohol itself within the nodule, in the whole of 79 injections given. Follow-up lasted 3-15 months. Thyroid scanning demonstrated a complete or partial recovery of extranodular parenchymal function in 80% and 20% of cases, respectively. In all cases a volume reduction greater than 50% was obtained, with an initial sharp fall, already after the first month, thanks to early alcohol cytotoxicity. In the 2 patients with toxic ATN serum, normal values of free hormones have been observed ever since the third weekly injection. Good tolerance to treatment was observed, and no permanent complications. In agreement with other authors, we believe our experience to show that PEI represents a new therapeutic approach in patients with ATN. PEI will certainly play a preferential role, relative to other conventional therapies, in the management of clinical pretoxic ATN, regarding which no uniform treatment protocol exists yet. PMID- 1788432 TI - [Echo-guided needle biopsy of the thyroid. An assessment of 52 thyroid neoplasms found in 1042 consecutive patients]. AB - The authors report on a series of 1,043 fine-needle biopsies of the thyroid performed under US guidance; the patients had been selected for thyroid pathologic conditions. Fifty-two neoplasms were observed (46 papillary carcinomas, 1 medullary carcinoma, 2 follicular carcinomas, and 3 metastases), which had been detected by cytology and confirmed by histology or autopsy. The authors focus on 46 cases of papillary carcinoma: their US features were studied which, through a correlation of variables, allow a quick and "safe" recognition of the type of carcinoma (papillary carcinomas account for nearly 60% of thyroid neoplasms). Tumor echogenicity and outline, and the presence/absence of calcifications were evaluated: in most cases, papillary carcinomas presented as focal lesions (alone or associated with other goiter lesions), with irregular and blurred outline, no hypo/anechoic halo and, in about 1/3 of the cases, with calcifications and colliquative areas. In 17% of papillary neoplasms, metastases to loco-regional nodes were observable at US; in 3 cases the carcinoma did involve a loco-regional node but there were no US signs suggestive of it. The incidence of neoplasms on the total of fine-needle biopsies is 4.9%, while in a previous series of 3,038 fine-needle biopsies, without US guidance, on clinically detectable lesions, the figure was about 2%. PMID- 1788433 TI - [The echographic picture of the breast following quadrantectomy and radiation therapy]. AB - Our experience moved from the clinical relevance of an eventual positive role of US in the follow-up of breast cancers treated with conservative therapy. This trial was suggested by the more and more frequent use of conservative therapy an by the diagnostic difficulties offered by the breasts treated with surgery and radiation therapy. Aim of the study is to analyze the diagnostic value of US in the identification of local relapse in a group of 60 patients with breast carcinoma (stages I and II) treated with conservative therapy. The patients were studied for at least 2 years following treatment, with clinical, US, and mammographic controls at 6, 12, and 24 months. The following clinical problems were considered: 1) study of the US patterns of the morphological and structural changes induced by conservative treatment; 2) observation of US and mammographic agreement in case of local relapse; 3) role of US in the follow-up of this kind of patients. US patterns and results at 6 months follow: cutaneous scar (60/60 cases), skin thickening (55/60), architectural distortion (asymmetry and amputation of the glandular cone, intramammary scar) (52/60), volumetric changes in the treated breast (50/60), skin asymmetry and retraction (50/60), "parenchymal fibrosis" (48/60), mass (8/60) and calcifications (3/60). As for the very few relapses (4 cases), US failed to reveal a ductal carcinoma which presented as microcalcifications. In our experience, US is a complementary exam to clinical and radiologic investigations, especially in the period immediately following therapy and in case of particular clinical problems, such as increased breast volume, mastitis, and appearance of a nodule. PMID- 1788434 TI - [Magnetic resonance: the usefulness of gradient-echo refocusing sequences in the diagnosis of aneurysms of the abdominal aorta]. AB - Sixteen patients bearing aneurysms of the abdominal aorta were studied by means of a 0.5 T MR unit. Spin-echo T1-weighted sequences and gradient-echo refocusing sequences were performed. All patients were previously submitted to US; in 8 cases angio CT was performed, and in 6 patients angiography of the abdominal aorta. A comparative analysis with the US findings showed a high correlation coefficient for the maximum diameters (R = 0.93) while site and size evaluations were not accurate. A very high correlation coefficient for the maximum diameters (0.97) was found at the comparative analysis with CT findings, while in two cases an erroneous suprarenal location was described. Angiographic examination provided valuable information about renal and iliac involvement, but the maximum diameters could not be accurately assessed. Spin-echo MRI allowed good evaluation of the maximum size, of location and extent of the aneurysm, as well as of iliac involvement; this technique, however, was useless in the characterization of the thrombus. Gradient-echo refocusing sequences have proven very useful for the identification of endoluminal contours and for the correct evaluation of the thrombus. Spin-echo sequences, on the contrary, accurately assessed only 7 cases, whereas the diagnosis was uncertain in the remaining 4 patients. PMID- 1788435 TI - [The usefulness of angiographic studies in the vascular complications of liver transplantation. The authors' own experience]. AB - The authors report their experience with angiographic techniques in the diagnosis of vascular complications after liver transplantation. From 1986 to 1990, 78 patients were transplanted in our Hospital; of them, 8 underwent angiographic investigations for vascular complications. Angiography is very important when vascular complications are suspected, in the patients with a rise in cytolytic enzymes and in bilirubine levels, with hyperpyrexia, and with bioptic confirmation of no rejection. Duplex US is useful in the evaluation of portal canalization; if there are any doubts, angiography is performed also in the preoperative phase. PMID- 1788436 TI - [Fungal lesions of the organs of the upper abdomen]. AB - The authors report on 14 cases of fungal parenchymal infections of the abdomen detected with CT and/or US in immunodepressed patients. Image patterns and the capabilities of the two diagnostic techniques are analyzed in the early detection of fungal lesions. CT was the first-choice examination, followed by US, in 9 patients; laboratory tests followed in 3 cases; US was performed first (and CT second) in 1 patient; finally, US alone was performed in 1 patient. The information yielded by CT and that given by US overlapped in 8/9 cases: in the extant patient, US demonstrated multiple fungal microabscesses of liver, while CT was negative, probably due to low liver density. CT patterns were multiple, small and round nonenhanced areas. Since the indiscriminate administration of intravenous contrast medium is unsuitable, CT cannot be performed first. On the other hand, in several patients liver CT with no contrast medium gave the same results for venous and fungal lesions. Compared with CT, US is a safer technique which is easier to perform and to evaluate. Therefore, US should be the exam of choice in immunodepressed patients with suspected fungal lesions. US is likely to demonstrate, in most cases, a pathologic condition (fungal microabscesses) as well as vascular and biliary anatomy. PMID- 1788437 TI - [The hypothesis of a diagnostic-prognostic assessment of intestinal invagination with the aim of treatment by echo-guided pneumatic reduction]. AB - The authors investigated the role of US in the diagnostic-prognostic evaluation of enteric intussusception, for the use of US-guided pneumatic reduction (RPEG). In the last 5 years, 59 young patients were examined; 44 of them had clinically suspected enteric intussusception which was confirmed by US. US allowed site and nature of the condition to be demonstrated (sensitivity and specificity: 100%), while supplying helpful predictive prognostic elements as to the extent of intussuscepted loop involvement (predictive prognostic value: 100%). On the contrary, its etiological screening capabilities were poor (11%) in the identification of secondary forms (5 ileal diverticula). A grading score was introduced to select the patients undergoing RPEG. Six clinical and US parameters were considered, with values increasing according to severity of the condition. The higher the score, the lower the chances of therapeutical success with RPEG. In 3 cases (2 loop necroses and 1 severe intestinal obstruction) with US score greater than 6 [9] and clinical score greater than 11 [15], RPEG, was replaced by surgery. Fourteen patients underwent RPEG: positive results were obtained in 12 cases (85%). In one case, a short-term relapse (within 6 hours) was observed. PMID- 1788438 TI - [The continent perineal colostomy after abdominoperineal resection of the rectum. A digital defecographic study]. AB - For 10 years, in the Surgery Dept. of the University of Pisa, perineal colostomies have been performed on patients who had undergone abdominoperineal rectal amputation. The gracilis muscles of the thighs, transposed to the perineum, are used for building a continent muscular apparatus. Seventeen of 40 patients operated with this procedure have been submitted to defecographic studies, by means of digital fluoroscopic image acquisition. This modality allowed the visualization of anastomotic colon morphology as well as of the functionality of the transposed gracilis muscles during the various phases of defecography. The muscle surrounding the colostomy acts as a sphincter and relaxes only during evacuation; the one positioned as a sling acts as the normal puborectalis muscle. In two patients a perineocele was documented, causing problems in the evacuation phase, which were solved after surgical intervention. PMID- 1788439 TI - [Percutaneous nephrostomy in neoplasm patients: when?]. AB - The management of cancer patients with a lesion in its end stage is a clinical problem a satisfactory solution to which has not been found yet, because of the ethical and legal problems involved. The authors analyzed the survival rates of 218 patients with advanced neoplastic disease and obstructive renal failure who had undergone external/internal urinary diversion. One month after the procedure 20% of the patients were dead. The figure rose to 75% at 6 months and reached 98% at one year. Urinary diversion in cancer patients with renal failure is aimed not only at avoiding death and assuring a prolonged survival, but also at providing a good quality of life. Several clinical criteria are therefore analyzed which are used in the selection of patients to submit to nephrostomy. The most important factors seem to be the actual stage of the tumor, its primary location, the possibility of an effective antineoplastic therapy, and the patient's consent. Randomized long-term studies are still necessary to analyze not only survival rates but also quality of life after urinary diversion for obstructive renal failure. PMID- 1788440 TI - [Salvage radiotherapy in postoperative recurrences of rectal and rectosigmoid carcinomas]. AB - One hundred and twenty-five patients, previously operated for rectal or rectosigmoid cancer, have been submitted to external radiation therapy from 1964 to 1985 on pelvic and/or perineal recurrence (50 perineal, 66 pelvic, 9 both). Fifty-seven per cent received more than 50 Gy, but only 14% more than 60 Gy. Overall survival has been poor (66% at 1 year, 20% at 3 years, 15% at 5 years) whereas better results have been achieved for pain relief: complete remission in 49% and partial remission in 26% of 77 symptomatic patients. Among 94 patients, evaluable for tumor size before and after treatment, radiation significantly decreased the size of the recurrence in 63% (27% CR). Among prognostic factors (recurrence site, radiation dose, age, pain relief and disease-free interval since surgery) only perineal recurrence without pelvic involvement, if treated with high doses (greater than 50 Gy), seems to be related to a significantly improved prognosis. PMID- 1788441 TI - [131I-meta-iodobenzylguanidine scintigraphy in patients with a suspected pheochromocytoma. A comparison with CT and biohumoral parameters]. AB - The results of 131I metaiodobenzylguanidine (MIBG) and Computed Tomography (CT) scans in a group of patients with clinically suspected pheochromocytoma were evaluated and compared with biohumoral parameters. We studied 24 consecutive patients (7 M and 17 F; age range 20-66 years). 131I-MIBG scintigraphy and CT were in agreement in 19 patients (79%): of them 7 cases were true positive, and 12 were true negative. Disagreement between the two imaging techniques was observed in 5 patients (21%). In this group, one patient, with positive CT scan, had false negative MIBG study, while 4 patients with negative MIBG scan, had false positive CT. MIBG showed significantly higher (p less than 0.05) specificity (100%), positive predictive value (100%), and accuracy (96%) than CT (75%, 67%, and 83%, respectively). 131I-MIBG scintigraphy is an accurate, noninvasive technique for localizing pheochromocytoma and providing direct tissue characterization, while CT provides more accurate spatial information. In conclusion, CT and MIBG studies are complementary in the evaluation of patients with suspected pheochromocytoma. PMID- 1788442 TI - [An attachment for performing CT arthrography of the shoulder in the sagittal projection]. PMID- 1788443 TI - Mild I-cell disease, or severe pseudo-Hurler polydystrophy in three siblings: further evidence for intermediate forms of mucolipidosis II and III. Radiological features. PMID- 1788444 TI - [A case of fetal achondrogenesis]. PMID- 1788445 TI - [Sternocostoclavicular hyperostosis. The clinico-radiological aspects of 3 cases]. PMID- 1788446 TI - [Lipoid pulmonitis. The diagnostic usefulness of magnetic resonance]. PMID- 1788447 TI - [Magnetic resonance in the diagnosis of cor triatriatum. A case report]. PMID- 1788448 TI - [Pulmonary carcinoma associated with a bulla. The radiological characteristics]. PMID- 1788449 TI - [A case of bilateral Baker's cysts with endoluminal calcic formations. An integrated echographic-radiographic study]. PMID- 1788450 TI - [A case of the percutaneous treatment of a noncommunicating biliocutaneous fistula]. PMID- 1788451 TI - [Serous microcystic adenoma of the pancreas. A rare case of a double location]. PMID- 1788452 TI - [The limits of mammography of the dense breast]. PMID- 1788453 TI - [The diabetic's diet]. PMID- 1788454 TI - [Acute pyelonephritis. Prospective analysis of 91 cases]. AB - Ninety nine patients suffering of acute pyelonephritis are prospectively analyzed. Mean age was 39.8 +/- 18.2 (mean +/- DE), 72 of them were females and 19 were males. The most frequent clinical manifestations were fever and side pain in 97% of the cases and lower urinary syndrome in 78%. The duration of symptoms previous to the visit was 3.5 +/- 2.9 days. Bacteremia was confirmed in 99% of cases, it affected the oldest patients (p less than 0.001) and provoked the lasting of fever (p less than 0.05). E. coli was the most frequently isolated microorganism with an incidence of 91% in the isolated samples. Gentamicin was the initial treatment and the definitive treatment was prolonged to a total of 14 days. Fifteen percent of patients were classified after the evaluation as carriers of complicated pyelonephritis and had to undergo afterwards a urologic treatment. Follow up over a minimum of 6 weeks showed a treatment failure in 2% of cases and recurrency in 22%. PMID- 1788455 TI - [Hemostasis profiles in thrombotic disease]. AB - It is well known that in thrombotic disease the alteration of biological factors such as antithrombin III, protein C, and protein S deficiency, and congenital disfibrinogenimias and displasminogenemias are determining factors being the acquired alterations not so well known. With this in mind was studied 85 patients with arterial thrombosis and 196 with venous thrombosis, who were again divided into three groups: unique or of repetition, less or more than 35 years and with or without immediate apparent cause. The general clinical-biological profile in patients with thrombosis in whom a congenital deficit is not detected, can help establish prognosis and treatment in these patients. In our patients, together with the importance of factors such as obesity, hyperlipemia, and tabaquism, an increase in fibrinogen (Fg), antigenic Factor VII (vWF:Ag), total protein S is observed as well as a decrease in total fibrinolytic activity related to an increase in the inhibitor of the plasminogen tissue activator (PTA). PMID- 1788456 TI - [Study of blood pressure response to exertion in essential hypertension. Its modification with anti-hypertensive treatment]. AB - We have studied the effect of atenolol, xipamide, and verapamil in the control of effort tensional response in 54 patients suffering essential hypertension. A first effort test without treatment and a second after a one month treatment randomly assigned were performed in all patients, evaluating the tensional response at 30, 60 and 80 Watts of charge, maximum peak, and after five minutes in recovery. Atenolol significantly reduced (p less than 0.05) systolic arterial pressure and diastolic arterial pressure in every intermediate effort stage, maximum peak and post effort recovery, xipamide, also significantly reduced (p less than 0.05) the systolic hypertensive response at all different levels, however, the diastolic one did not reach any statistic significance. Verapamil at used doses did not modify neither systolic nor diastolic hypertensive response. The beneficial effect of beta-blockers is confirmed although we could not confirm the effect pointed out by other authors regarding calcium antagonists. Tensional control using xipamide was striking although there is some evidence to think that it can have a more important effect in the control than thiazide diuretics or amiloride. PMID- 1788457 TI - [Idiopathic retroperitoneal fibrosis. An atypical case of multisystem presentation]. AB - Idiopathic retroperitoneal fibrosis (IRF) is a disease difficult to diagnose. It is considered by different authors of autoimmune origin given its similarity to other connective tissue diseases. We present the case of a female patient diagnosed by a postmortem study, of IRF with multiorgan involvement (lymph nodes, serose tissue, liver, spleen, adrenal glands, thyroid and kidneys) and atypical presentation, not finding other similar cases in the national literature. PMID- 1788458 TI - [Septic pulmonary embolism, bacterial endocarditis and endocavitary pacemaker]. AB - The number of patients carrying an endocavitary pacemaker is increasing every day. The presence of a foreign body in right cavities predisposes to the formation of thrombi that can be over infected from distal septic focci usually silent. When a pulmonary embolism is diagnosed in these patients, the initial study must include an echocardiographic exam in order to rule out the presence of an intracardiac thrombosis as the origin of the emboli. We present the case of a patient with and endocardiac pacemaker who was admitted with fever and repeated episodes of pulmonary embolism. Hemocultures were positive for proteus mirabilis and a electrocatheter thrombosis was demonstrated in bidimensional echocardiography. Proteus mirabilis was positive in cultures from the material obtained by cardiothomy and clinical evolution after surgery was satisfactory. PMID- 1788459 TI - [Polymyositis as the first manifestation of acquired immunodeficiency syndrome]. AB - We present a case of polymyositis (PM) in a patient with no previous relevant medical history, who had received blood transfusion four years ago during surgery. It could be demonstrated that the patient was HIV infected inspite the fact that he did not belong to any other high risk groups. PM was the clinical presentation form of HIV infection, the patient dying five months later due to a Pneumocystis carinii. The main clinical and histologic characteristics of PM in HIV infected patients are described as well as the main myopathies that these patients present. PMID- 1788460 TI - [Early diagnosis of breast cancer]. AB - Breast cancer is the most frequent cancer in Western females. After the controversy sustained over many years in which the rentability of early diagnosis and the secondary potential effects of periodic mammographies was questioned, nowadays there is no question about their value. Performance of these campaigns for the general population is going to permit the detection of smaller tumors and the possibility of cure for a great number of patients. Besides these advantages, early diagnosis will lead to more limited resections and breast reconstructions which are psychologically very important for women. In this article, besides showing the historical evolution of early detection campaigns and the reasons that led to demonstrate its benefit, we expose the indications, limitations, and characteristics of the different diagnosis tests, as well as the most profitable sequence of detection with its viability, sensibility, specificity, and also the frequency at which is nowadays recommended to perform this type of tests. PMID- 1788461 TI - [Chronic asthenia syndrome and viral infections]. PMID- 1788462 TI - [Hashimoto thyroiditis: postpartum course]. PMID- 1788463 TI - [Ramsay-Hunt syndrome in primary care]. PMID- 1788464 TI - [Pseudoperiodic activity and hypercalcemic encephalopathy]. PMID- 1788465 TI - [Infections in systemic lupus erythematosus]. PMID- 1788466 TI - [Bilateral pneumothorax in a patient with AIDS and Pneumocystis carinii pneumonia]. PMID- 1788468 TI - [Coronary risk factors in women with acute myocardial infarction]. PMID- 1788467 TI - [Erythema nodosum as the initial manifestation of hydatidosis]. PMID- 1788469 TI - Effects of vitamin D2 analogs on calcium metabolism in vitamin D-deficient rats and in MC3T3-E1 osteoblastic cells. AB - The effects of 1 alpha-hydroxyvitamin D2 on calcium metabolism in vivo and of 1 alpha, 25-dihydroxyvitamin D2, which is an active metabolite of 1 alpha hydroxyvitamin D2, on bone metabolism in vitro was studied and compared with that of 1 alpha-hydroxyvitamin D3 or 1 alpha,25-dihydroxyvitamin D3. 1 alpha Hydroxyvitamin D2 and 1 alpha-hydroxyvitamin D3 was equally potent in stimulating intestinal calcium transport by using the everted sac method and of calcium mobilization from bone in vitamin D-deficient rats. On the other hand, the hypercalcemic activity of 1 alpha-hydroxyvitamin D2 was much lower than that of 1 alpha-hydroxyvitamin D3 in normal mice and rats. 1 alpha,25-Dihydroxyvitamin D2 and 1 alpha,25-dihydroxyvitamin D3 stimulated alkaline phosphatase activity in osteoblastic MC3T3-E1 cells and bone resorption in newborn mouse calvaria maintained in organ culture. These results show that 1 alpha-hydroxyvitamin D2 as well as 1 alpha-hydroxyvitamin D3 promote calcium absorption and may accelerate bone remodelling via direct action on osteoblasts. In addition, they suggest that 1 alpha-hydroxyvitamin D2 may be more useful than 1 alpha-hydroxyvitamin D3 for the treatment of senile osteoporosis, because hypercalcemia is one of the major side effects of 1 alpha-hydroxyvitamin D3. PMID- 1788470 TI - Insulin secretion and sensitivity after partial hepatectomy in the rat. AB - It is known that following partial hepatectomy in the rat hyperinsulinemia evolves, yet glucose intolerance exists. This pattern could be explained by peripheral insulin insensitivity and a compensatory insulin hypersecretion. In the present study, we examined in vivo insulin secretion and sensitivity in partially hepatectomized rats. We found that the increase in plasma insulin levels during i.v. infusion of glucose (10 mg/min) was exaggerated at 1 and 3 days after partial (68%) hepatectomy (P less than 0.001) compared with that in sham-operated controls. In contrast, at days 7 and 14 the plasma insulin response to glucose was not different from that in controls. To study the in vivo insulin sensitivity, a 3-h i.v. infusion of adrenaline, propranolol, glucose, and variable amounts of insulin were given at 3 days after partial hepatectomy. In this model, the ensuing glycemia, being stable during the 3rd hour of infusion, depends on the plasma insulin levels and insulin sensitivity. It was found that the relation between plasma insulin and plasma glucose levels was not different between partially hepatectomized and sham-operated rats. This indicates the same peripheral sensitivity to insulin in these two groups. We conclude that insulin hypersecretion is already evident even at day 1 after partial hepatectomy, whereas after 7 days this hypersecretion has vanished. Furthermore, the study shows that insulin sensitivity is not altered by partial hepatectomy. PMID- 1788471 TI - Glucose overload and hepatic energy metabolism after resection of the cirrhotic liver in rats. AB - The effect of glucose hyperalimentation on energy metabolism in the cirrhotic rat liver after 70% hepatectomy was studied. After resection, rats received either 30 kcal/kg per day (group I) or 200 kcal/kg per day (group II) of glucose for 48 h. In both groups, hepatic mitochondrial ATP synthesis was accelerated when palmitic acid was used as substrate and suppressed when pyruvate was used. This suggests that the energy substrate of the remnant liver was principally fatty acids rather than glucose. Hepatic energy charge was within normal limits in group I, but decreased significantly in group II after hepatectomy. An abundance of glucose in the early postoperative period, therefore, caused a hepatic energy derangement by suppressing fatty acids utilization; this suppression was corroborated by the findings of lower immunoreactive glucagon and non-esterified fatty-acid concentrations in group II. To determine optimal glucose administration, the predicted value of glucose disposal rate (GDR) was calculated after an intravenous glucose tolerance test. GDR decreased significantly after hepatectomy and did not increase appreciably even with a large dose of insulin administration. These results suggest that glucose administration should be tailored to the GDR values after resection of the cirrhotic liver. PMID- 1788472 TI - Enhanced proliferation of coronary endothelial cells in response to growth factors is synergized by hemodialysate compounds in vitro. AB - Using capillary endothelial cells from the coronary system of guinea pig heart, we have devised an in vitro assay suitable for measuring proliferative and growth promoting effects mediated by drugs and growth factors. In this assay, hemodialysate and fractions isolated from it--consisting exclusively of low molecular-weight compounds from calf blood--stimulate the proliferation of coronary endothelial cells. This effect is not a trivial nutritive one. Furthermore, in respect to the stimulation of proliferation, hemodialysate synergizes with epidermal growth factor, basic fibroblast growth factor, and endothelial cell growth factor, but not with insulin, which shows no proliferative effect in our system. From data obtained by analysis of hemodialysate fractions, it is deduced that the active compounds are strongly negatively charged oligosaccharides with a molecular weight of apparently 3000 Dalton. The synergistic effect of hemodialysate compounds on proliferation of endothelial cells as well as their previously demonstrated insulin-like activity is believed to explain the therapeutic efficacy of hemodialysate in cases of impaired wound healing and occlusive diseases. PMID- 1788473 TI - Simulated weightlessness and bone metabolism: evidence for direct gravitational effect and its related insulin action. AB - The effect of simulated weightlessness on bone metabolism was investigated in skeletal unloading for 4 days. Skeletal unloading was designed using the model of hind-limb hang in rats. In hypokinetic state, rats were fed while the right hind limb was weighed down and the left hind limb was unloaded (a state of weightlessness). Bone metabolism in normal rats did not vary significantly in the femoral diaphysis in right and left hind limb. Alkaline phosphatase activity and DNA content in the femoral diaphysis were not significantly altered by hypokinetic state without skeletal unloading, while the unloading caused an appreciable decrease in the enzyme activity and DNA content. However, femoral diaphyseal zinc content and glucose consumption was significantly decreased by hypokinetic state with and without skeletal unloading. When femoral-diaphyseal tissues were cultured in the presence of insulin (10 nM), the hormone produced a significant increase of alkaline phosphatase activity and decrease of glucose consumption in the femoral-diaphyseal tissues obtained from normal and hypokinetic rats. This hormonal effect was not seen in bone tissues from hypokinetic rats with skeletal unloading. These results suggest that skeletal unloading-induced disorder of bone metabolism is directly related to gravitational effect and that gravitational stimulation may be involved in insulin action. PMID- 1788474 TI - Improvement of impaired mitogen-induced interferon-gamma release of peripheral blood mononuclear cells derived from tumor patients by Factor AF2. AB - Factor AF2, a now standardized extract from liver and spleen of newborn lambs, showed myeloprotective capacity on platelet- and erythrocyte-count as well as on hemoglobinconcentration in patients undergoing aggressive chemotherapy. In addition, a possible influence on prolonged remission duration in patients with mammary carcinoma had been claimed. In this study, the effect of Factor AF2 on mitogen-induced interferon-gamma release by PBMC was tested in 23 healthy humans and in 23 tumor patients. All patients were prior to surgery and had not yet received radio- or chemotherapy at the time of examination. The interferon-gamma concentration of the supernatants was measured using an enzyme-linked immunosorbent assay (ELISA). The cells were stimulated with PHA at 7.5 micrograms/ml. In the reference group, interferon-gamma concentration rose to 26 units/ml and to 15.5 units/ml in the tumor patients. In the reference persons, an addition of Factor AF2 at concentrations from 10(1) micrograms/ml to 10(3) micrograms/ml resulted in a small non-significant decrease of interferon-gamma release. At 10(4) micrograms/ml, neither test group showed measurable interferon gamma concentration. In the tumor patients, cocultivation with Factor AF2 until concentration of 10(2) micrograms/ml resulted in a dose-dependent increase of interferon-gamma release, where 20.5 units/ml interferon-gamma were reached. At 10(3) micrograms/ml, Factor AF2 showed no effect on interferon-gamma release compared with the stimulation with mitogen alone. Flow-cytometry analysis of CD3, CD4, CD8, CD16, CD19, CD56, and HLA-DR expression of the PBMC deriving either from reference persons or from patients revealed an almost identical distribution. A slight difference in CD16-positive and HLA-DR positive cells, respectively, was not significant. PMID- 1788475 TI - Experimental infection of goat fetuses in utero with a stable, rough mutant of Brucella abortus. AB - Fetuses of goats in their last trimester of pregnancy were experimentally infected with Brucella abortus strain RB51, a stable rough mutant deficient in the perosamine O-chain content of its lipopolysaccharide. RB51 maintained its rough phenotype in vivo and did not induce abortion. Infection with RB51 resulted in the production of significant levels of IgG type antibodies specific for B abortus cellular antigens distinct from the perosamine O-chain. These findings suggest that strain RB51 will be useful in the pregnant goat for studying the role of brucella antigens other than the lipopolysaccharide O-chain in the immune response to brucellosis. PMID- 1788476 TI - Effect of weaning on antibody responses and nematode parasitism in Merino lambs. AB - Lambs weaned at eight weeks old were compared with control lambs which remained with their dams; both groups grazed the same pasture. Weaning significantly reduced the growth rate, control lambs being, on average, 6 kg heavier than weaned lambs at 15 weeks old. When contamination of pasture with larval parasites was light, both groups of lambs suffered only modest parasitic infections. When lambs were experimentally infected with 5000 Haemonchus contortus and 10,000 Trichostrongylus colubriformis larvae at eight weeks old, the mean faecal egg count for weaned lambs was twice that for controls at 12 weeks old (P less than 0.001) and weaned lambs suffered a significantly greater decline in packed cell volume than controls over the next four weeks. Antibody responses following immunisation with either ovalbumin or Brucella abortus at four and at eight weeks old, did not differ significantly between control and weaned lambs. In contrast serum antibody responses to H contortus and T colubriformis differed significantly between the two groups, with controls responding earlier and more strongly than weaned lambs. The practical significance of these findings is that up to three months old, suckled lambs, when faced with a substantial parasite challenge, have much better prospects than weaned lambs. PMID- 1788477 TI - Evaluation of total serum bile acid concentrations for the diagnosis of hepatobiliary disease in cattle. AB - Serum bile acid concentrations were measured in 41 clinically healthy cattle of different breeds. There was no diurnal variation in values and age and sex had no effect. There was no significant difference between serum and plasma bile acid concentrations in clinically healthy cattle. Serum bile acids were stable on storage at -20 degrees C. The total serum bile acid concentrations, together with other tests of hepatic disease, were evaluated in cattle with various types of hepatobiliary disease (hepatic lipidosis, hepatic abscessation, leptospirosis, biliary calculi, fascioliasis), respiratory, cardiovascular and infectious diseases, and in various other conditions not affecting the liver. Total serum bile acids were the most specific and sensitive indicators of a wide variety of hepatic diseases and were significantly correlated with the degree of clinical illness. PMID- 1788478 TI - Ethanol euthanasia and its effect on the binding of antibody generated against an immunogenic peptide construct. AB - Mice were immunised with an immunogenic peptide construct CKNNNSTNSGI coupled to diphtheria toxoid as a carrier. This peptide sequence contains the epitope STNS which is the target of inhibitory monoclonal antibodies directed against the second merozoite surface antigen of Plasmodium falciparum. Antisera raised against the peptide construct were taken using an injection of 70 per cent ethanol or sodium pentobarbitone as methods of euthanasia and these methods compared by determining their effects on the binding specificity of the antibody to the antigen using the immunological criteria of immunofluorescence, immunoblotting criteria of immunofluorescence, immunoblotting and ELISA assays. There was no significant decrease in antibody binding with either sodium pentobarbitone, or ethanol with a final concentration of less than 30 per cent in mouse antisera. Antisera with an added ethanol concentration of 40 to 60 per cent relaxed antibody conformation and this raises the possibility of using the differential effects of ethanol as a tool in mapping antigenic fine structure of a range of antibodies directed against defined epitopes. The cross-reactive response of non-specific antibodies in polyclonal antisera was lowered at the suggested dosage for ethanol euthanasia. Ethanol has immense potential as an alternative method of euthanasia when barbiturate drugs, such as sodium pentobarbitone, are unavailable in specific experimental protocols. This may especially aid research workers in developing countries involved in vaccine development, antibody production and subsequent serological analysis. PMID- 1788479 TI - Observations on the action of amperozide: are there social influences on sow litter productivity? AB - The effects of amperozide on sow performance when administered as a single intramuscular injection of 1 mg kg-1 at the time of either farrowing or weaning, or on both occasions were evaluated. Treatments were given during the rearing of two consecutive litters with each individual sow remaining on the same treatment throughout the trial. In total, 64 sows, 16 per treatment group, were used to investigate the effects on weight loss during lactation, mastitis-metritis agalactia (MMA) and duration of the reproductive cycle. Untreated control sows lost more weight (2 to 3 kg) during lactation than sows treated with amperozide at farrowing. No clinical outbreak of MMA was recorded in the amperozide groups dosed at the time of farrowing. The number of empty days was decreased (about three days) in sows treated with amperozide at weaning. Furthermore, pre-weaning mortality decreased (8 per cent) and piglet growth rate improved (6 per cent) when sows were treated with amperozide at farrowing. The results suggest that amperozide improves the health status and productivity of sows by reducing their emotional responses to novel or threatening situations. PMID- 1788480 TI - Plasma alpha-tocopherol profiles in sheep after oral administration of dl-alpha tocopheryl acetate and d-alpha-tocopheryl polyethylene glycol-1000 succinate. AB - Twenty-five yearling wethers, weighing 45 to 50 kg, were used in a trial designed to compare the bioavailability of dl-alpha-tocopheryl acetate (TA) and d-alpha tocopheryl polyethylene glycol-1000 succinate (TPGS). The sheep, five per treatment, were each given a basal diet without vitamin E supplement (control) or with a daily oral supplement of 240 iu TA or TPGS, or of 480 iu TA or TPGS. Blood samples were obtained at zero time, and then twice daily for three weeks. The bioavailability was greater for TA than for TPGS. This was indicated by the significantly higher (P less than 0.01) plasma alpha-tocopherol concentrations during the three-week experimental period in sheep dosed with equivalent units of TA than in those dosed with TPGS. When administered at 480 iu, the TPGS produced plasma profiles similar to those found after administration of the lower (240 iu) dose of the TA. PMID- 1788481 TI - Lack of LH response to oestradiol treatment in cows with cystic ovarian disease and effect of progesterone treatment or manual rupture. AB - The luteinising hormone (LH) surge in response to 1 mg oestradiol benzoate intramuscular injection was studied on 67 occasions in 45 cows with cystic ovarian disease 20 to 150 days post partum. Cows diagnosed as having luteal cysts were given 500 micrograms cloprostenol intramuscularly 24 hours before oestradiol, to induce luteolysis. Oestradiol benzoate was also given to eight post partum acyclic and eight cyclic cows and in all these cases a control LH response was characterised for comparison. Eight of 17 cows with luteal cysts (47 per cent), and 10 of 21 cows with follicular cysts (48 per cent), released LH in response to oestradiol. Some cows with cysts were given one of two treatments. Seven cows with follicular cysts were treated with a progesterone-releasing device (PRID) for seven days: all responded to a second oestradiol treatment given 24 hours after removal of the PRID. Luteal cysts in three cows and follicular cysts in nine cows were ruptured manually: only one cow (a luteal case) responded to the second oestradiol treatment given 24 hours after manual rupture. In eight cows initially diagnosed with luteal cysts, cloprostenol was not given and plasma progesterone concentration at the time of oestradiol treatment was high (over 0.9 ng ml-1): none released LH in response to oestradiol. As manual rupture did not improve the LH response to oestradiol, it is concluded that the defective LH response to oestradiol in cows with cystic ovarian disease was not influenced in the short-term by cyst fluid contents.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1788482 TI - Clinical and serum antibody responses to lambs to infection by Listeria monocytogenes. AB - Oral dosing of lambs with 1 x 10(10) colony forming units of Listeria monocytogenes daily for three days produced no clinical signs but protected the animals against bacteraemia following subsequent homologous subcutaneous challenge. Following the subcutaneous injections, comparison with controls revealed significantly lower rectal temperatures and a significant difference in positive blood cultures. In both groups signs of systemic illness were unremarkable. However, two and 10 days after the subcutaneous challenges neurological signs developed in two lambs. L monocytogenes was isolated from the brain of one lamb and histopathological lesions of listeric encephalomyelitis were demonstrated in both. After oral infection antibodies to L monocytogenes whole cell antigen were detectable in serum agglutination tests and by ELISA. Serological responses to flagellin were examined by ELISA and to listeriolysin O by immunoblotting. The responses of the animals to flagellin were weak and inconsistent, but antibodies to listeriolysin O were detectable after both oral and subcutaneous challenge. The subclass of antibody involved in this response was shown to be predominantly IgG1. PMID- 1788483 TI - Effects of local anesthesia and intravenous naloxone on the changes in behaviour and plasma concentrations of cortisol produced by castration and tail docking with tight rubber rings in young lambs. AB - The reliability of some behavioral and physiological indices used for the recognition and assessment of acute pain in lambs after castration and tail docking has been examined. Changes in the indices were measured after blocking neural activity with local anaesthetic (lignocaine) and after an opioid antagonist (naloxone) was administered. Six lambs, aged less than one week, were allocated randomly to each of six treatments. (i) control handling and blood sampling; (ii) castration plus tail docking with tight rubber rings; (iii) local anaesthesia; (iv) local anaesthesia followed by castration and tail docking; (v) intravenous naloxone only (0.2 mg kg-1); and (vi) intravenous naloxone followed by castration and tail docking. Local anaesthesia eliminated the behavioural and plasma cortisol changes which usually follow castration and tail docking. Naloxone had a limited effect on the increase in cortisol but altered the behaviour. The results support the view that such indices are useful for assessment of the response to acute pain and that, although endogenous opioids do reduce pain in young lambs after castration and tail docking, the effect is small. PMID- 1788484 TI - Effect of depth of immersion in the waterbath on the effectiveness of electrical stunning in chickens. AB - Broiler chickens were electrically stunned either by immersing their heads, necks and upper breast in a waterbath stunner or by immersing their heads only. The time to recovery of muscular activity was assessed, and it was found that the deeper immersion was associated with a slightly (10 second) shorter time to resumption of head righting. When hens which had previously been implanted with electroencephalogram electrodes were electrically stunned it was found that the incidence of somatosensory evoked responses during the first 60 seconds after applying the current was not influenced by the depth of immersion. It was concluded that depth of immersion had little influence on the effectiveness of electrical stunning. PMID- 1788485 TI - Occurrence and diversity of plasmids in ovine isolates of Pasteurella haemolytica. AB - 160 ovine isolates of Pasteurella haemolytica, representing each of the 16 serotypes and also untypable strains, were examined for plasmid content. Plasmid DNA was identified in, and prepared from, strains of serotypes A2, T3, A14 and A16 and also from an untypable strain. The relationship between the plasmids present in the different strains was examined both by restriction fragment profile analysis and by DNA/DNA hybridisation. Both methods gave broadly similar results and showed that each serotype tended to contain either a single plasmid species, or a limited range of species, and that structural similarities could traverse serotype boundaries. None of the plasmid-bearing strains showed any significant level of resistance to a range of antibiotics. PMID- 1788486 TI - A morphological study of the gross and light microscopic lesions of infectious anaemia in Atlantic salmon (Salmo salar). AB - Infectious anaemia in Atlantic salmon (Salmo salar) was studied by recording gross and light microscopic changes, and the development of lesions was studied in relation to haematocrit values. Gross lesions were characterised by ascites formation, congestion and enlargement of liver and spleen, congestion of the foregut and petechiae in the peritoneum. Histologically, lesions were demonstrated in the liver, being characterised by congestion in early stages (that is, haematocrit values around 25), dilatation of the sinusoids, and in later stages (haematocrit values 25 to 15) formation of blood-filled spaces bearing morphological resemblance to peliosis hepatis. At low haematocrit values (around 10), these changes comprised large areas of the liver parenchyma, that is, blood-filled areas coalesced, presenting islets of degenerate and necrotic hepatocytes. At this stage, haemorrhagic necroses were found. Spleen and kidney lesions were characterised by congestion. In the foregut, congestion and bleeding in lamina propria were observed. Liver lesions became more disseminated and severe with decreasing haematocrit values. Hypoxia due to anaemia alone cannot fully explain the development of the liver lesions. PMID- 1788487 TI - Effect of sustained release and pulse release anthelmintic intraruminal devices on development of pathophysiological changes and parasite populations in calves infected with Ostertagia ostertagi and Cooperia oncophora. AB - An experiment was conducted in calves to investigate the effect of sustained release and pulse release anthelmintic intraruminal boli on the development of pathophysiological changes following daily infection with Ostertagia ostertagi and Cooperia oncophora for six weeks. After infection various pathophysiological changes were detected including increases in serum pepsinogen concentration, enteric plasma protein losses and in the catabolic rate of albumin. Such changes developed rapidly in the unprotected calves following patency after 17 days and persisted until the termination of the study. There were indications that the sustained anthelmintic release device was more efficacious than the pulse anthelmintic release device in reducing the worm burdens and early pathophysiological changes associated with infection. It was found at necropsy that the release of anthelmintic by the oxfendazole pulse release bolus had been delayed in several calves. PMID- 1788488 TI - Chromosomal hyperdiploidy in a feline sarcoma. AB - An eight-year-old male cat developed a sarcoma. The cytogenetic evaluation of the tumour cells showed the presence of hyperdiploidy (range 40 to 46 chromosomes). This hyperdiploidy was encountered in all the cells examined. Extra-chromosomes numbers C1, C2, B4, D4 and E3 were mainly responsible for the hyperdiploid chromosomal complements. There was a high incidence of monosomy E3. PMID- 1788489 TI - Changes in alveolar mixing efficiency during exercise. AB - The increased alveolar-arterial oxygen gradient (A-aDO2) occurring at higher levels of exercise may reflect impaired gas mixing. This latter function was investigated using the multiple breath nitrogen washout technique in 30 physical training students (15 M, 15 F). They were examined at rest and at work loads of 50, 100 and 150 W, using a cycle ergometer. Measurements included tidal volume (VT), serial dead space (VDS) and from the washout alveolar dead space (VDA), lung volume as the end-expiratory volume (EEV) and alveolar gas mixing efficiency (AME). There were expected rises in mean V1 from 641 +/- 161 to 1650 +/- 248 ml and in minute ventilation (VE) from 11.1 +/- 3.1 to 47.1 +/- 5.2 L.min-1 at 150 W but EEV changed only slightly from 2555 +/-559 to 2321 +/- 585 ml at the same workload. Despite an increase in VDS from 156 +/- 33 to 258 +/- 35 ml and VDA from 139 +/- 40 to 305 +/- 73 ml, AME rose significantly with exercise from 72.5 +/- 5.0 to 78.3 +/- 3.3%. These results are discussed in relation to the morphology of the lung, and the stationary interface theory. They suggest that gas mixing improves at the onset of exercise only, so that the widening in A-aDO2 with increasing levels of exercise cannot be explained by impaired mixing efficiency alone, and is probably due to other factors such as critically rapid transit time of blood through the pulmonary capillaries as cardiac output increases. PMID- 1788490 TI - Decreased pulmonary distensibility and pulmonary barotrauma in divers. AB - Pulmonary distensibility, lung volume and conductance were measured in 14 men (mean age 22 (SD 3) years) who suffered pulmonary barotrauma (PBT) during shallow water diving. Exponential analysis of static pressure-volume date obtained during deflation of the lungs gave K, and index of distensibility. The pulmonary conductance-recoil pressure (GL-PL) relationship was also obtained during deflation. Total lung capacity (TLC) was measured in a body plethysmograph or by nitrogen washout. The results were compared with 34 male nonsmokers and 10 healthy male divers. Mean lung volumes and FEV1 did not differ significantly in the three groups. In the PBT group K was decreased and recoil pressure was increased; the slope of the regression of GL and PL was decreased indicating stiffer airways. Decreased K reflects a decreased airspace size. Smaller airspaces increase the surface component of recoil pressure which increases the stress in tissue fibres. Relatively stiff airways may magnify the elastic stresses in peribronchial alveolar tissue increasing the possibility of rupture of alveolar walls with interstitial gas dissection. PMID- 1788491 TI - Esophageal and mouth pressure during sniffs with and without nasal occlusion. AB - The sniff maneuver has recently been advocated for assessing inspiratory muscle strength. We characterized the relationship between mouth pressure (Pmo) and esophageal pressure (Pes) during sniffs performed with open, semi-occluded, and occluded nose. In seven normal subjects, pressure was simultaneously measured with a mouthpiece (Pmo) an esophageal balloon (Pes) during high- and low intensity sniffs performed from FRC. With open nose, the mean ratio Pmo/Pes was 0.96 +/- 0.05 (mean +/- SE). The mean ratio Pmo/Pes was not significantly different in high- and low-intensity sniffs. With one nostril occluded, the mean ratio Pmo/Pes was 1.03 +/- 0.04. The ratio Pmo/Pes was significantly higher than with open nose for all sniffs (P less than 0.05) and low-intensity sniffs (P less than 0.01). With both nostrils occluded, the mean ratio Pmo/Pes was 1.06 +/- 0.03, with occasional marked overestimation of Pes by Pmo. We conclude that Pmo generally reflects Pes during sniffs performed with open and semi-occluded nose, but not with complete nasal occlusion. PMID- 1788492 TI - Respiratory muscle recruitment in awake ponies during exercise and CO2 inhalation. AB - We measured respiratory muscle electromyograms (EMG), inspiratory (I) and expiratory (E) airflow patterns and functional residual capacity (FRC) in six ponies at rest, during treadmill walking at 1.8 mph-5, 10, and 15% grades, and during 2, 4, and 6% CO2 inhalation. There were several similarities in the responses to exercise and CO2 inhalation. The shapes of the I and E flow patterns were not changed appreciably from the respective control patterns during either condition. Mean diaphragm EMG increased from control (P less than 0.05) at 1.8 mph-10 and 15% grades, and during 4 and 6% inhalation. However, mean transversus abdominis EMG did not change significantly from control (P greater than 0.10) during either condition. Exercise did not have an effect (P greater than 0.05) on FRC, and there was only a slight (P less than 0.05) increase in FRC (100 ml or 2%) during 6% CO2 inhalation. Based on the fact that we did not find major differences between exercise and CO2 inhalation in mean diaphragm and transversus abdominis EMG, I and E flow patterns, and FRC we conclude that factor(s) other than the ventilatory stimulus and the non-ventilatory functions of the respiratory muscles are important determinants of the pony's respiratory muscle recruitment pattern under these conditions. PMID- 1788493 TI - Renal carbonic anhydrase inhibition reduces high altitude sleep periodic breathing. AB - The efficacy of carbonic anhydrase (CA) inhibitors in amelioration of periodic breathing during sleep at high altitude is not fully understood. Although CA is present in a number of tissues, we hypothesized that selective renal CA inhibition without physiologically important inhibition of other tissue CA, may be sufficient alone by its generation of a mild metabolic acidosis to stimulate ventilation and prevent periodic breathing. We studied benzolamide (3 mg/kg), a selective inhibitor of renal CA, in 4 climbers on ventilation and ventilatory responses at sea level and on arterial O2 saturation (SaO2%) and periodic breathing during sleep at altitude. At sea level, ventilation increased and PaO2 rose accompanied by a mild metabolic acidosis. The isocapnic hypoxic ventilatory response was unchanged but the hyperoxic hypercapnic ventilatory response rose 40%. At high altitude (4400 m), daytime SaO2% improved from 81 to 85 and venous plasma HCO3- fell from 18.9 to 14.8 mM. During sleep, mean SaO2% rose from 76 to 80 and periodic breathing decreased 75%. We conclude that metabolic acidosis occurring with all CA inhibitors is one of the major stimulant actions of these drugs on ventilation while awake and during sleep at high altitude. PMID- 1788494 TI - Ventilatory response to keto-doxapram in intact and carotid body denervated lambs. AB - We aimed to investigate the role of the carotid bodies in the ventilatory response to keto-doxapram, and whether this response was dose-dependent; we studied two group (n = 5 per group) of awake, intact and carotid-body denervated (CBD) lambs, aged 10-15 days. At 20 min intervals, they received 0.5, 1.0, 2.5 and 5.0 m g/kg mg/kg of keto-doxapram as an intravenous bolus infusion. Plasma keto-doxapram was measured (HPLC). Ventilation was recorded via a face mask and a pneumotachograph. In intact lambs, an immediate dose-dependent increase in minute ventilation (V1) was observed. At 2 min, VI increased from baseline by 125 +/- 28, 212 +/- 49, 378 +/- 41 and 637 +/- 92 mol.kg 1.min 1 (mean +/- SE, P less than 0.01) corresponding to the foregoing incremental doses. A significant correlation was observed between the peak VI and the corresponding plasma keto doxapram concentrations (r = 0.73, P less than 0.0003). In CBD lambs, VI increased significantly less than in intact animals. In conclusion, early ventilatory response to keto-doxapram depends mainly on intact carotid bodies, and the effect is dose-dependent. PMID- 1788495 TI - The respiratory activity of the superior laryngeal nerve in the rat. AB - The aim of this study was to characterize the laryngeal afferent activity of the rat. The animals were anesthetized and breathing spontaneously. Laryngeal afferent activity was recorded from both the whole superior laryngeal nerve (SLN) and from single fibers isolated from this nerve. An overall inspiratory augmenting activity was observed in the whole SLN during tracheostomy breathing, tracheal occlusion and upper airway breathing, but an expiratory augmenting activity was present during upper airway occlusion. The inspiratory modulated activity was abolished by bilateral section of the hypoglossal nerves but not the recurrent laryngeal nerves. A great number of receptors (46/80, 58%) were identified as 'drive' receptors, and others as 'pressure' (22/80, 28%) and 'irritant' type receptors (9/80, 11%). Nineteen pressure receptors were stimulated by positive transmural pressure, while only three stimulated by negative pressure. Nine drive receptors were also stimulated by positive pressure and inhibited by negative pressure. Such response to pressure was further evaluated by applying maintained pressures to the functionally isolated upper airway. These results are essentially consistent with findings obtained in the rabbit, but differ from those reported for the dog. PMID- 1788496 TI - High pressure reduces pH sensitivity of respiratory center in isolated rat brainstem. AB - We examined the effect of high pressure (10.1 MPa) on the sensitivity of the respiratory center to alterations in pH (range 5.8-7.6) which were obtained by varying either PCO2 or [HCO3-] in superfused Krebs solution. Isolated rat brainstem-spinal cord preparations were placed in a pressure chamber and respiratory-related motor neuron activity was recorded from severed ventral roots C1 and C5. At atmospheric pressure, respiratory burst frequency in both C1 and C5 varied inversely with pH. Only the time integral of a single C5 response was sensitive to acidification. High helium pressure reduced by 60% the sensitivity of the respiratory frequency to alteration in pH, while the time integral of both C1 and C5 responses became independent of PCO2, causing the relative respiratory drive between the two roots to change. These modifications in the chemoresponse of the respiratory center may contribute to the respiratory difficulties encountered under high pressure conditions. PMID- 1788497 TI - Exercise-entrained breathing and non-invasive determination of anaerobic threshold. AB - Incremental cycle exercise was performed by 17 subjects under two breathing conditions: spontaneous breathing (Non-ENT run) and deliberate entrainment of breathing frequency (f) to cycling rate at preferred coupling ratios up to possibly high work rates (ENT run). The purpose was to investigate the influence of entrainment on two non-invasive determinations of anaerobic threshold (AT): the break points of VE/VO2 (VAT) and VCO2 (V-slope AT) changes against VO2. Compared to the Non-ENT run, VAT in the ENT run was greater in 12 subjects entrained at higher f accompanied by relative hyperventilation at low work rates, while it was similar in five subjects entrained at lower f accompanied by relative hypoventilation. Relative hyperventilation and hypoventilation during the ENT run tended to elicit greater and lower VCO2, respectively, relative to VO2, as compared to the Non-ENT run. These different VCO2, responses between the two runs exerted little influence on the V-slope AT determination. It is concluded that breathing patterns and ventilatory response during incremental work tests can affect the VAT method but not the V-slope method. PMID- 1788498 TI - The ventilatory effects of sustained isocapnic hypoxia during exercise in humans. AB - To investigate how the ventilatory response to isocapnic hypoxia is modified by steady-state exercise, five subjects were studied at rest and performing 70 W bicycle exercise. At rest, isocapnic hypoxia (end-tidal PO2 50 Torr) for 25 min resulted in a biphasic response: an initial increase in ventilation was followed by a subsequent decline (HVD). During exercise, an end-tidal PO2 of 55-60 Torr was used. The magnitude of the initial ventilatory response to isocapnic hypoxia was increased from a mean +/ SE of 1.43 +/- 0.323 L/min per % arterial desaturation at rest to 2.41 +/- 0.424 L/min per % during exercise (P less than 0.05), but the magnitude of the HVD was reduced from 0.851 +/- 0.149 L/min per % at rest to 0.497 +/- 0.082 L/min per % during exercise (P less than 0.05). The ratio of HVD to the acute hypoxia response was reduced from 0.696 +/- 0.124 at rest to 0.202 +/- 0.029 during exercise (P less than 0.01). We conclude that while exercise augments the ventilatory sensitivity to hypoxia, it also has a direct effect on the mechanisms by which sustained hypoxia depresses peripheral chemosensitivity. PMID- 1788499 TI - Pharmacological management of allergic disease. PMID- 1788500 TI - Anaphylaxis, urticaria, and angioedema. PMID- 1788501 TI - Pulmonary diseases of potential allergic origin. PMID- 1788502 TI - Parasitic hypersensitivity. PMID- 1788503 TI - Atopic disease. PMID- 1788504 TI - Ocular allergy. PMID- 1788505 TI - Contact dermatitis in the dog and cat. PMID- 1788506 TI - Food allergy and immunologic diseases of the gastrointestinal tract. PMID- 1788507 TI - [Histamine and tyramine levels in selected food products]. AB - Histamine and tyramine contents were determined in parallel in fish and fish products ripening and processed cheese, yeast, wine, cabbage and sauerkraut, and tomato paste. Histamine was assayed by the colorimetric method of Hardy and Smith, and by TLC. Tyramine was determined by TLC. Levels of histamine and tyramine were found to be low in all products tested. For histamine and tyramine, respectively, they amounted: in raw fish to 0.0-8.0 and 0.0-2.6 mg/100 g, in fish products to 0.0-16.0 and 0.0-10.0 mg/100 g, and in cheeses to 0.0-0.8 and 1.3 20.0 mg/100 g. In the remaining food products (tomato paste, yeast, wine, cabbage and sauerkraut), histamine content was between 0.0-16.6 mg/100 g (highest in tomato paste), and tyramine content fluctuated between 0.0-8.0 mg/100 g (highest in sauerkraut). PMID- 1788508 TI - [Harmful elements versus iron, zinc and copper: their interactions in animals and humans. I. Mercury, tin, nickel, selenium, fluorine and aluminum]. AB - A literature survey was made of the interactions--in the organism--between some food contaminating elements (mercury, tin, nickel, selenium, fluorine, aluminium) and iron, zinc and copper. The harmful elements may disturb the mineral metabolism already at the stage of intestinal absorption. Moreover, they bring about changes in microelement distribution in the tissues and cells. On account of their approximately similar chemical structure, they compete for the sites of binding to some proteins, including enzymic ones. In this respect a special role is played by ++metallothionein, a protein with the ability of regulating free metal contents in the tissues and thus possibly displaying some detoxifying properties. Many mechanisms and relationships determining the interactions between the surveyed food contaminants and iron, zinc and copper remain, however, not elucidated. PMID- 1788509 TI - [Effect of emissions from the Household Glassware Factory (HGF) "Irena" in Inowroclaw on the levels of fluorine and lead in selected vegetables and fruit harvested in 1988]. AB - Fluorine and lead were determined by spectroscopic methods in some vegetables harvested in 1988 in two groups of Employees' Gardens in Inowroclaw ("Transportowiec" and "Irena", distant from the Household Glassworks "Irena" by ca. 500 and 2600 m, respectively). Employees' Gardens "Irena" were divided into 2 belts, in consideration of a vicinal traffic artery. It was found that 42% of the plants harvested in Employees' Gardens "Transportowiec" exhibited excessive contents of fluorine, and 91%--of lead; fluorine contamination of vegetables was, however, slight, except for parsley leaves containing 56.0 mg F per 1 kg dry weight. In the case of Employees' Gardens "Irena", in the I belt (30-40 m from the traffic artery) the level of fluorine was excessive in 8.3% of plants, and that of lead--in 63.6% of plants; in the II belt (80-100 m from the traffic artery) the respective values were 17% for fluorine and 66.6% for lead. PMID- 1788510 TI - [Nutritive value of daily food rations prepared in different regions of the country. III. The levels of calcium, phosphorus, magnesium, iron and potassium]. AB - Studies on the content of macrominerals in daily diets reconstructed in 1988 on the basis of the analysis of family budgets in 1986 carried out by the Central Statistical Bureau were carried on. Two social groups i.e. manual and mental workers with medium income were considered. The diets were prepared for 5 regions (Warszawa, Lublin, Olsztyn, Poznan, Wroclaw). According to the studies the requirements for calcium and magnesium were met in about 70% and those for iron in about 84%. The content of potassium in the diets was in the range of recommended allowances while the phosphorus exceeded the allowances by about 20 30%. The comparison of the presently studied diets with the ones from 1973, 1980, 1981 showed a lower degree of realization of the recommended intake of calcium and magnesium in 1986. The content of studied minerals in the diets was usually similar in all five regions. PMID- 1788511 TI - [Nutrition of men in Poland 1975-1984 (review and analysis of the literature)]. AB - The quality of nutrition of 22,249 men employed in Polish national economy was evaluated on the basis of own results and of literature data, obtained between years 1975-1984 in Poland. Energy content in the daily food ration (weighted mean) of the investigated men was 2879 kcal and was in agreement with the standard (lower level) recommended for men working moderately heavily. In the 14 publications considered, the mean value of energy content in the food ration fluctuated between 2495-3915 kcal/indiv. day. In the daily food ration (weighted mean), total protein content amounted to 93 g, with high participation of animal protein; it exceeded the recommended amount of protein. The amount of fat ingested daily by an average working man was 115 g, and exceeded the recommended fat intake by more than 20%. Evaluation of the daily food ration (weighted mean) from the standpoint of the groups of products showed that the daily intake of: a) meat, sausages and fish, 2) eggs and 3) fats, amounting to 292, 29.5 and 49 g, respectively, greatly exceeded that recommended by food standards, and accounted for 194, 177 and 141%, respectively, of the food allowance. In contrast, the mean daily intake of: 1) milk and its products, and 2) vegetables and fruits, was lowest, and accounted for 44 and 53%, respectively, of the food allowance. PMID- 1788512 TI - [The role of individual segments of the gastrointestinal tract in the elimination of cesium radioisotopes]. AB - The transfer of radiocesium from blood to the lumen of individual sections of the gastro-intestinal tract was quantitatively determined. The water suspension of ion exchange resin was injected to the lumen of the individual sections of the gastro-intestinal tract. The sections were ligated. The highest amount of radiocesium absorbed to the resin in the lumen of gastro-intestinal tract was observed 3 hrs after intravenous administration 137CsCl and reached 17.7% of the administered dose. It was shown that the small intestine and the ileum play the biggest role in absorption and excretion of the radiocesium. The role of the duodenum, the large intestine and the stomach is much smaller in this process. PMID- 1788513 TI - [Effect of acute carbaryl poisoning on various indicators of amino acid metabolism in rats]. AB - Male Wistar rats were orally poisoned with carbaryl in a single dose 474 mg/kg (1/2 LD50). After 2, 4, 24, 72 and sometimes 120 hours from the administration of the insecticide the studied biochemical parameters have been determined. Trials showed an essential effect of carbaryl on the amino acid balance and metabolism. Significant decreases of the most amino acids concentrations in the brain tissue (a maximum decrease in the second hour) and in the liver (at 4-th h of intoxication). Normalization of the amino acid levels occurred more early in the brain than in the liver. Furthermore a decrease of total keto-acids concentration in erythrocytes (at 4-th h) and activity changes of some plasma and liver plasmatic aminotransferases in the reaction with alpha-ketoglutarate and pyruvate was observed. PMID- 1788514 TI - [Determining the level of histamine in canned fish by the fluorometric method using the Spekol-10 apparatus with FK device for fluorescence spectrometry]. AB - The content of histamine in canned fish products was determined by fluorometric method recommended by AOAC with final determination of fluorescence on spectrophotometer Spekol 10 with FKC equipment of wave excitation for maximum of emission: lambda = 365 nm, filter GVK--48). The method makes possible quick, reproducible, and sensitive determination (limit of detection: 1 mg/100 g of product) of histamine in canned fish products, on simple equipment available in every laboratory of count Sanitary Stations. PMID- 1788515 TI - [Effect of Escherichia coli on growth of Bacillus cereus]. AB - The effect of 101 Escherichia coli strains on growth of 90 Bacillus cereus strains on solid media was investigated. Only 9 E. coli strains (in particular the colicin +-generating ones) were antagonistic towards B. cereus, giving distinct growth-inhibition zones around the colonies. PMID- 1788516 TI - [Sensitivity of surface microorganisms to disinfectants]. AB - The influence of humidity and temperature on survival of S. aureus and P. aeruginosa on the surfaces of titles, glass and blanket carriers has been estimated. The number of CFU was examined after exposure time 6 and 24 hours in temperatures of 21 degrees C, 37 degrees C and RH 35%, 95%. It was observed: 1. The important reduction of numbers of both microorganisms at temperature 37 degrees C and RH 95%, 2. The relatively high number of survival cells of P. aeruginosa on the surface of blankets at temp. 21 degrees C and RH 95%. The microorganisms on the carriers were previously kept for 24 h at temp. 21 degrees C, RH 35% and 95% and then exposed to solutions of chloramine, formalin, lysol and Sterinol (QAC). It was observed that there was a great dependence of the disinfecting effect on the degree of dessication of the surfaces. In all cases the resistance of contaminated carriers stored 24 h was higher at 95% RH than at 35% RH. PMID- 1788517 TI - [Effect of different amounts of KNO3 on the quality of "Zulawski" cheese. II. Microbiological and organoleptic values after addition of different amounts of KNO3]. AB - The present paper constitutes an integral part of the studies on "Zulawski" cheese quality that have been presented in the first part: "Changes of nitrates in ripening "Zulawski" cheese". Physico-chemical and microbiological assessment of raw and pasteurized milk assigned to cheese production proved that the milk not always was of the highest quality. It was stated that ++saltpeter addition to cheese-making milk by 0.01% and 0.02% does not have an explicit effect on improvement of microbiological quality and organoleptic values of "Zulawski" cheese. PMID- 1788518 TI - [Effect of chronic nasopharyngeal diseases among 14-year-old students and extra curricular factors on school performance]. AB - On the basis of extended health balances of 3482 14-year old school children, the association between the incidence of chronic diseases of the nasopharynx and some circumstances of their living conditions was evaluated. Nasopharyngeal diseases were identified in 2.3% of children. Their incidence was unrelated to sex; it was similar in urban and rural environments. Some circumstances creating inferior living conditions were associated with higher incidence of these diseases; they included living in poverty, lack of central heating and covering by foot a large distance from home to school. Other circumstances, e.g. numerous family, crowding of the apartment, un-sanitary sleeping conditions, contrary to expectation failed to display such associations. Likewise, health-promoting behaviours (e.g. habit of teeth cleaning, practising sports) did not lead to lower incidence of these diseases. Consideration of the problem from standpoint of physical development showed that the proceeding of the maturation process failed to be paralleled by lower incidence of nasopharyngeal diseases. This incidence amounted in pupils with overweight to 4.1% of cases, and in the remaining ones to 2.0-2.3%. Nasopharyngeal diseases were recorded in 5.4-5.5% of pupils complaining of poor general feeling (headache, sleep disturbances), and in as many as 7.0% of those experiencing difficulties in falling asleep. As concerns the progress in learning, the difficulties between better and worse pupils in the incidence of nasopharyngeal diseases were insignificant. These diseases occurred somewhat more frequently in pupils with up to 14 days of justified non-attendance per semester, as compared with those without any non-attendance or with non-attendance lasting more than 14 days. PMID- 1788519 TI - Microcinematographic analysis of further fate of multinucleate cells arising after polyethylene glycol induced fusions of L cells. AB - Cell fusions were studied in continuous cell line L treated with polyethylene glycol (PEG). The progenies of 152 treated cells were studied by time-lapse microcinematography up to four generations. It was found that all the cells that remained mononucleate after treatment with PEG grew actively and their mitotic divisions were without abnormalities. On the contrary, only 60% of multinucleated (fused) cells divided mitotically during the filming period. We observed many disturbances in mitotic divisions of multinucleated cells. In most cases the multipolar divisions of these cells resulted in mononucleate daughters. In half of these cases the daughter cells fused to form again multinucleate cells. Nevertheless, both the total number of multinucleate cells and the average number of nuclei per cell were lowered after mitoses. PMID- 1788520 TI - Relationship of liver damage and liver regeneration after carbon tetrachloride treatment in rats. AB - Various doses of carbon tetrachloride (0.625 mmol to 10 mmol CCl4/kg body weight) were administered to female Wistar rats. Liver damage after a single treatment was evaluated by serum aminotransferase levels and by the extent of necrotic areas in parenchyma. Liver regeneration was evaluated by 3H-thymidine incorporation into liver DNA and by the number of dividing hepatocytes. Mitotic index of hepatocytes rose in parallel with the specific activity of DNA and with the extent of necrosis. However, the activities of serum aminotransferase AST and ALT increased much more rapidly and did not correlate either with necrosis or with regeneration rate. Increased membrane permeability in morphologically intact cells, increased synthesis of the enzymes by the liver as well as the leakage from necrotic cells are discussed as possible causes of the high aminotransferase activities in serum. PMID- 1788521 TI - Efficacy of various pretreatment and therapy regimens against soman lethality in mice. AB - The efficacy of a number of drug pretreatment combinations in protecting mice against lethal effects of soman was determined. Pyridostigmine peroral pretreatment followed by intramuscular postpoisoning therapy with atropine, obidoxime and/or trimedoxime, and diazepam protected mice against the lethal action of soman. Combination of pyridostigmine with trihexyphenidyl, benactyzine and bis-(4-hydroxyiminomethyl) pyridinium-methane dichloride improved prophylactic action even further. PMID- 1788522 TI - Disappearance of radioactivity from perfusate of isolated rat liver after administration of different doses of tritiated DH-ergotoxine. AB - In ergot alkaloids a disproportion between the size of the peroral dose and the achieved area under the curve concentrations was described. This process can be explained by nonlinearity in the absorption, distribution or elimination of alkaloids. The aim of the present paper is to find whether elimination of tritiated DH-ergotoxine (3HDHE) in the liver is a linear, dose-independent process. Therefore on the model of the isolated rat liver disappearance of radioactivity in perfusate after the administration of two doses of 3HDHE, viz. 60 ng g-1 of the liver and 3030 ng g-1 of the liver, was investigated. The disappearance curves of radioactivity expressed as the percentage of the administered dose did not significantly differ between both groups. No significant changes between the groups were found either in the size of pharmacokinetic parameters, or in the portion of the administered radioactivity excreted in bile. Therefore the present authors think that disappearance of radioactivity in perfusate of the isolated liver after administration of 3HDHE is a linear process following first-order kinetics. PMID- 1788523 TI - Effect of diazepam in circadian rhythm of activity and in novelty induced hyperactivity in the genetically hypertensive rats of Koletsky type and in the normotensive rats of Wistar strain. AB - The experiments were performed in the younger adult normotensive rats of Wistar strain and in the genetically hypertensive rats of Koletsky type. Motor activity was traced under regime 12 h light/12 h dark (light on at 6 A. M., light off at 6 P. M.). The activity was traced from 10 h A. M. during 24 hours by pneumoactograph described by Weggemenn. In the control genetically hypertensive males of Koletsky type phase advance was found when compared with the normotensive rats of Wistar strain. This phase advance in the former animals is missing under acute diazepam treatment (0.5 mg/kg). In control animals the novelty induced hyperactivity shows in the genetically hypertensive males of Koletsky type the lower rate of habituation than in the normotensive males of Wistar strain, i. e., the former animals show "sustained activity" in new environment. Novelty induced hyperactivity was alleviated in both strains of rats by the acute diazepam treatment; the effect of the latter drug was more expressive in the normotensive rats of Wistar strain. PMID- 1788524 TI - Working memory test in the genetically hypertensive rats of Koletsky type and in the normotensive rats of Wistar strain. AB - The experiments were carried out in the adult normotensive rats of Wistar strain and in the genetically hypertensive rats which were developed by Koletsky; the experiments were performed in both sexes. For a testing of the working memory we have used the new session unique test elaborated by Ennaceur and Delacour. This test is based on the differential exploration of familiar and new objects. In the first trial rats are exposed to two identical objects (samples) and in the second trial, to two dissimilar objects, a familiar (the sample) and a new one. Between the trials one minute intertrial interval was used. The working memory test was used in two experimental arrangements. In the first one the animals two days before testing were allowed to explore the testing box (without any objects) two minutes each day. In the second arrangement no adaptation to the testing box was used. The optimal conditions for memory processes in the genetically hypertensive rats are attained after previous adaptation to the testing box. The optimal conditions for memory processes in the normotensive rats of Wistar strain were obtained when no adaptation to the testing box was used. Moreover, it was also found that the more intensive explorations of samples is registered in the first trial, the more intensive novelty preference in the second trial was obtained. The possible role of the level of behavioral activation in the working memory processes is discussed. PMID- 1788525 TI - Influence of chronic lead exposure on hormone levels and organ weights in developing rats. AB - The effect of 5 months' exposure to 0.5% lead acetate in drinking water on the hypothalamo-pituitary-thyroid-adrenal system was evaluated by measuring hypothalamic and striatic noradrenaline (NA), serum thyroxine (T4), 3,5,3' triiodothyronine (T3) and corticosterone (CS) and blood and adrenal catecholamines (CA) levels in developing rats of both sexes. Blood CA were increased and hypothalamic and striatic NA was decreased by exposure in male rats. In female rats, blood and adrenal CA and serum CS were increased and hypothalamic and striatic NA was decreased by exposure. No changes in the two sexes were observed in serum T3 and T4. Exposure induced an increase in spleen and kidney weights in both sexes; the weight of liver was increased only in female rats. Weights of hypothalamus, striatum, adrenals and thyroid glands were not changed. Female but not male rats exposed to lead gained less weight than controls. The results suggest a non-specific stress response in female rats. In male rats only the sympatho-adrenal system seems to be affected by this lead exposure. PMID- 1788526 TI - Stress reaction in developing rats exposed to 1% lead acetate. AB - Effects of a three-month exposure of both male and female rats under their development to lead acetate in drinking water on the hypothalamus-pituitary gland thyroid gland-suprarenals and sympathico-adrenal systems were evaluated by determining noradrenaline (NA) in the hypothalamus and striatum, thyroxine (T4), 3,5,3'-tri-iodothyronine (T3) and corticosterone (CS) in the serum and catecholamines (CA) in both blood and suprarenals. NA in the hypothalamus and striatum was decreased in exposed males. CA in blood and suprarenals and CS in the serum were increased and NA decreased in the hypothalamus and striatum in exposed females. No serum T3 and T4 changes were found in males or females. The exposure to lead resulted in increased weight of spleen and kidneys in both sexes and suprarenals in females only. Weights of hypothalamus, striatum, liver and thyroid gland did not change. Female rats exposed to lead grew more slowly than control animals. Retardation in the growth was not statistically significant in males. The results indicate a specific stress reaction in female rats. In males only the sympathico-adrenal system seems to be affected by such lead exposure. PMID- 1788527 TI - A computer-based approach to education and training in clinical gastroenterology. AB - Computer systems adapted to gastroenterology can effectively assist in organization of knowledge, clinical reasoning and competence, and manual skills. Computer-based methods and tools for medical education comprise systems for computer-assisted instruction (CAI), systems for clinical simulation (CS), and expert systems (ES). Computer-based methods in medical education are now so well defined and assessed that their use should be considered the necessary goal for coming years. PMID- 1788528 TI - The role of terminology in medical education and training. AB - The aims are to present a uniform terminology (terms), which can be suitably used throughout the world for enumeration of characteristics by which an item can be identified and distinguished. Nomenclature is a list of terms classified in a logical system. Description must be as objective as possible and the terms used must be specific for the method. Terminology, definitions, and diagnostic criteria in digestive endoscopy have been published in several languages. PMID- 1788529 TI - Toxicology and occupational hazards of new materials and processes in metal surface treatment, powder metallurgy, technical ceramics, and fiber-reinforced plastics. AB - Many new materials and processes are about to find their way from the research laboratory into industry. The present paper describes some of these processes and provides an overview of possible occupational hazards and a list of chemicals used or produced in the processes. The technological areas that are considered are metal surface treatment (ion implantation, physical and chemical vapor deposition, plasma spraying), powder metallurgy, advanced technical ceramics, and fiber-reinforced plastics. PMID- 1788530 TI - Job strain and ambulatory blood pressure profiles. AB - Occupational characteristics were used to study the role of job stress in the pathogenesis of hypertension. Ambulatory 24-h recordings of blood pressure were made for 161 men with borderline hypertension. From the occupational classification system scores for psychological demands, control, support, physical demands, and occupational hazards were obtained. The results indicated that the ratio between psychological demands and control (strain) was significantly associated with diastolic (but not systolic) blood pressure at night and during work. The association between job strain and diastolic blood pressure at night and during work was greatly strengthened when the subjects with occupations classified as physically demanding were excluded from the analysis. The conclusion was reached that a measure of job strain derived from the occupational classification is useful in predicting variations in diastolic blood pressure levels during sleep and work for men with borderline hypertension. PMID- 1788531 TI - Importance of accurate employment histories of patients admitted to units of internal medicine. AB - A study was undertaken to assess the importance of systematically recording occupational histories of patients admitted to an internal medicine unit of a university hospital. Detailed information on current and past employment was obtained with questionnaires and in personal interviews from 200 inpatients over a 12-month period. Twenty-one patients (10.5%) were considered to have a "primary illness" (condition causing hospital admission) probably (4.5%) or possibly (6%) related to their current or previous occupation. From the 786 primary and secondary illness and medical antecedents diagnosed for the 200 patients examined, 70 illnesses of 55 patients were considered probably or possibly related to current or previous occupation. This pilot study emphasizes the need for accurate occupational records for patients in an internal medicine ward. This task is best performed by an appropriately trained occupational physician. PMID- 1788532 TI - Preemployment medical examinations in a large occupational health service. AB - Several hundreds of thousands of preemployment medical examinations are performed in The Netherlands each year, with the objective of screening for obvious risks for the applicants or others. Neither the efficacy of these examinations nor determinants for rejection are known. Altogether 101,754 preemployment medical examinations of applicants for governmental functions were analyzed. For one fifth of the applicants some medical diagnosis was recorded. The overall rejection percentage was 0.6%, being highest for job categories involving public safety and high physical demands, but never exceeding 4%. Age was positively correlated with rejection percentage. Except for the diagnostic category "disorders of the musculoskeletal system" no relation between diagnostic category and job demands was apparent. Medical diagnoses frequently encountered among rejected applicants were also common among successful applicants. If selection aiming at reducing absenteeism or work disablement is considered to be the only goal of preemployment medical examinations, then their efficacy appears to be low for many job categories. PMID- 1788533 TI - Ocular exposure to solar ultraviolet and visible radiation at high latitudes. AB - Exposure of the eyes to ultraviolet (UV) radiation and short wavelength light, blue light, from the sun was assessed under realistic geometric conditions. A spectroradiometer with a double monochromator was used to determine the spectral irradiance at 1-nm intervals within the wavelength range of 250-800 nm. Biological weighting functions were used to calculate the blue-light radiance and the weighted UV irradiance. In addition, a photometer with a 1 degree angle of view was used to measure the ambient luminance. The results indicate that sizable amounts of UV radiation and blue light can be reflected from different environmental surroundings. Hence various groups of outdoor workers seem to be at risk of chronic ocular overexposure to solar radiation. When occupational exposure limits for UV and visible radiation are revised, the risks of chronic exposure should receive more consideration than to date. PMID- 1788534 TI - Relative risk of mesothelioma associated with different levels of exposure to asbestos. AB - The relative risk of mesothelioma associated with different levels of exposure to asbestos was evaluated. The exposure was assessed from work histories of 51 mesothelioma cases and 51 sarcoidosis referents. The lung fiber concentration of the mesothelioma patients was compared with that of two reference groups (13 random autopsy cases and 43 male lung cancer patients). When the categories definite and probable were used as an estimated probability of occupational exposure, an odds ratio of 17.7 [90% confidence interval (90% CI) 3.4-253] and 3.0 (90% CI 0.9-10.6), respectively, was obtained. A lung fiber concentration of greater than 1 million fibers/g of dry tissue as an indicator of accumulated exposure gave an odds ratio of 14.4 (90% CI 2.5-178) for the men in comparison with the autopsy cases and 3.1 (90% CI, 1.3-7.5) in comparison with the lung cancer patients. Elevated risk of mesothelioma was shown to be associated with a lung fiber concentration of greater than 1 million fibers/g of dry tissue. PMID- 1788535 TI - Symptoms, airway physiology and histology of workers exposed to medium-density fiber board. AB - Medium-density fiber (MDF) board was recently introduced in the furniture industry. In this pilot study health complaints, physiology, and histology of the upper airways were evaluated for two groups of workers, one handling MDF board for at least one-third of their work week (MDF group) and another handling traditional fiber board. Civil servants served as a reference group. The frequency of health complaints concerning the airways was higher, the sense of smell was poorer, and the frequency of nasal obstruction measured with rhinomanometry was higher for the MDF group, while mucociliary activity was lower in the group handling traditional board. In both groups forced vital capacity was low when compared with expected values. Histological specimens from the middle turbinate of the nose showed, in a few cases, nasal epithelial dysplasia in the traditional board group, but histological changes in terms of scoring did not differ significantly between the groups. PMID- 1788536 TI - Monitoring of exposure to cyclohexanone through the analysis of breath and urine. AB - Occupational exposure to cyclohexanone was studied for 59 workers through the analysis of environmental air, alveolar air, and urinary cyclohexanol. Environmental cyclohexanone exposure was measured by personal sampling with a carbon-felt passive dosimeter. Cyclohexanone in alveolar air and cyclohexanol in urine were determined with gas chromatography with a flame ionization detector. The end-of-shift urinary cyclohexanol levels correlated well with the time weighted average environmental cyclohexanone values (r = 0.66). Urinary cyclohexanol corrected for creatinine correlated best with cyclohexanone in air (r = 0.77); when corrected for specific gravity, it gave a similar correlation coefficient (r = 0.73). When the time-weighted average of the exposure was 25 ppm, the corresponding calculated concentration for urinary cyclohexanol was 54.5 mg/1, 23.3 mg/g of creatinine, or 43.5 mg/l at a specific gravity of 1.018. The relationship between cyclohexanone exposure and its concentration in exhaled breath was found to be poorer than that for cyclohexanone exposure and the urinary metabolite (r = 0.51). PMID- 1788537 TI - Determination of exposure to aflatoxins among Danish workers in animal-feed production through the analysis of aflatoxin B1 adducts to serum albumin. AB - Aflatoxin B1 is suspected as an etiologic factor in the increased risk for primary liver cancer among workers in animal-feed processing plants in Denmark. Aflatoxin bound to serum albumin was therefore measured for feed-processing workers. Blood samples were collected immediately after vacation and after four weeks of work, and aflatoxin was quantified by competitive enzyme-linked immunosorbant assay. Seven of 45 individuals with an estimated exposure of 64 ng aflatoxin B1.d-1.kg-1 body weight were positive. Three positive workers had been unloading a cargo with an aflatoxin B1 level of 26 micrograms.kg-1 raw material. The exposure level correlated well with the job titles. Dust samples collected at different sites showed considerable variation in the amount of aflatoxin B1 (nondetectable to 8 micrograms.kg-1 dust). The exposure to aflatoxin B1 may only partially explain the increased risk of liver cancer. PMID- 1788538 TI - Fever and respiratory symptoms after welding on painted steel. AB - Electric-arc welding generates particles and gases that can induce chronic bronchitis and airway obstruction. In this case report two welders are described who had fever, spirometric deterioration, and bronchial hyperreactivity after welding steel painted with chloro-containing polymer lacquer. Pyrolysis of this paint releases many different compounds, for example, hydrogen chloride and complex chlorinated compounds. PMID- 1788539 TI - Marfan syndrome: a review and update. PMID- 1788540 TI - Hyperlipidaemia and coronary risk. PMID- 1788541 TI - The natural history of dilated cardiomyopathy--a community study. AB - The incidence, clinical features and natural history of dilated cardiomyopathy within a clearly defined population of Scotland was studied retrospectively. From 1982 to 1986, 57 cases were recorded in a population of 145,00, representing an annual incidence of 7.9 per 100,000 per year. This incidence rate is higher than that reported from other centres, and the overall survival rates were poorer. PMID- 1788542 TI - An analysis of cases incorrectly coded as inflammatory bowel disease in Scottish Hospital In-Patient Statistics (SHIPS). AB - As part of a large clinical and epidemiological study of inflammatory bowel disease (IBD), we examined the hospital case records of a sample (255) of the 1257 patients aged 0-20 years, recorded in Scottish Hospital In-Patient Statistics (SHIPS) for 1968-1983 as Crohn's disease (CD) or ulcerative colitis (UC). The coded diagnosis was incorrect at the time of coding in 47 instances (18.4% of the sample), for the following reasons: clinical diagnosis wrong (24 cases); IBD correctly diagnosed but wrongly coded as CD for UC or UC for CD (seven cases): various other clerical or computer errors (15 cases). One case that did not meet standard diagnostic criteria for CD at the time of coding was shown to be correctly labelled when confirmatory pathological information became available. In view of the influence of such statistics on the social and clinical management of chronic illnesses such as IBD, and in view of the impact of analysis of these data on the provision of services and allocation of resources, it is suggested that some indication of the degree of confidence in the clinical diagnosis (possible, probable, definite) should be incorporated in the information submitted for coding and should be reflected in the derived data. PMID- 1788543 TI - Review of 18 years' experience of a diagnostic geriatric neurology referral service. AB - From 1971 to 1989, 1446 cases were referred from Glasgow and the West of Scotland to the University Department of Geriatric Medicine for neurological diagnosis. In that time, the number increased from one per week to more than two per week, and the proportion from outside Glasgow from 2% to 24%. Eighty-seven per cent had CT scans and 8% electrophysiological studies. One third of patients stayed three days or less, and one third over a week. Cerebrovascular disease was diagnosed in 637 cases (44%), subdural haematoma or hygroma in 59 (4%), and intracranial tumour in 228 (16%), of which 26 (11%) were benign. In 104 cases (7%) no definite diagnosis was made. Management was changed in 402 of the 1446 cases (28%). In the 635 (44%) in whom a referring diagnosis was documented, this was not confirmed in 63%; diagnosis and/or management was changed in 80%. The proportions of referring diagnoses of subdural haematoma and intracranial tumour that were confirmed rose with time. The value of the service lay in the speed and ease of access to it, and the opportunities for teaching and learning it provided. The problems it posed were those of the transfer of ill patients, the distances sometimes necessary, and the need for high standards of communication. PMID- 1788544 TI - Metastatic pancreatic polypeptide producing tumour presenting with diabetes mellitus. AB - A metastatic pancreatic polypeptide tumour is described which presented clinically with diabetes mellitus. This is the first case to present this way. PMID- 1788545 TI - Pancreatic mediastinal pseudocyst: report of two cases simulating intrathoracic disease. AB - Mediastinal pseudocysts of the pancreas are extremely rare. Intra-thoracic symptoms such as dysphagia or dyspnoea due to compression or associated pleural effusions are common and urgent decompression by percutaneous or internal drainage is often necessary. PMID- 1788546 TI - Concealed rectal opiates presenting as respiratory arrest: the importance of rectal examination in i.v. drug abusers. AB - A case of recurrent respiratory depression due to rectal absorption of concealed opiate drugs in an intravenous drug abuser held in police custody is described. The importance of rectal examination in intravenous drug abusers in police custody is stressed and it is emphasised that drugs may have been concealed in a body cavity at the time of arrest. The use of both the intramuscular and intravenous route for the administration of naloxone in treatment of unconscious intravenous drug abusers suspected of having overdosed on opiates is advocated as these patients frequently discharge themselves from hospital on regaining consciousness and may later present with recurrent respiratory depression. PMID- 1788547 TI - Angiography of cerebral tumour haemorrhage. PMID- 1788548 TI - Caesarean section: historical background. AB - Although caesarean section is probably one of the oldest operations in the history of medicine, its origins are rather obscure. Very few surgical procedures have been the subject of such bitter controversy, and, it is only in relatively recent times that its performance changed from a last minute attempt to save a child from an almost dead mother to a safe, often planned, operation. PMID- 1788549 TI - Microangiopathy with retinopathy, encephalopathy, and deafness (RED-M) and systemic features. AB - The case of a young woman with a rare syndrome of acute encephalopathy followed by deafness and retinopathy developing over 1 year is reported. Unlike previously described similar cases, she had considerable systemic symptoms and signs including polyarthralgia-arthritis, diffuse myalgia, malar rash, livedo reticularis, night sweats, and fatigue suggestive of systemic lupus erythematosus. However, results of most immunological investigations were repeatedly normal, including antinuclear antibodies. Anticardiolipin antibodies were elevated on one occasion. Cyclophosphamide has been the most effective treatment for exacerbations of the disease, which have continued to occur over 6 years. This microangiopathic syndrome more likely relates to an immunologically mediated vasculitis of small blood vessels than to a thromboembolic etiology. PMID- 1788550 TI - Felty's and pseudo-Felty's syndromes. AB - Felty's syndrome, consisting of rheumatoid arthritis, leukopenia, and splenomegaly, has been recognized as a distinct clinical entity for more than 60 years. Clinical and laboratory manifestations of the condition are reviewed. The major sources of morbidity and mortality remain recurrent local and systemic infections. Immunogenetic analysis shows a strong association with HLA-DR4, in addition to DQ beta 3b and C4B null allele. Potential mechanisms of neutropenia are contrasted, including impaired granulopoiesis and neutrophil-immune complex interactions. Lithium carbonate and splenectomy may have a role in the treatment of fulminant disease. Maintenance therapy should be directed at control of the underlying inflammatory arthropathy. A syndrome of proliferation of large granular lymphocytes and neutropenia, associated with rheumatoid arthritis in 23% to 39% of cases, has been described recently. Cases of "pseudo-Felty's" syndrome are often confused with traditional Felty's syndrome, which has twice the prevalence. The clinical and laboratory distinctions between these two conditions are elaborated. PMID- 1788551 TI - Colchicine intoxication: clinical pharmacology, risk factors, features, and management. AB - The use of colchicine for acute gouty arthritis dates to ancient times. In recent years, colchicine also has been used successfully for various other rheumatic and nonrheumatic conditions. Colchicine is a safe drug when used according to established therapeutic guidelines. However, toxicity can be considerable if ingested intentionally or if the recommended doses are exceeded. Colchicine intoxication is characterized by multi-organ involvement and by the poor prognosis associated with administration of large amounts of the drug. Therapy is basically supportive and symptomatic because of the rapid distribution and binding of colchicine to the affected tissues. Use of anticolchicine antibodies is a novel approach that has shown promise in experimental models. Important research questions pertain to the effect of liver and kidney disease on colchicine metabolism, use of colchicine levels in the diagnosis of intoxication and for prognostication, and application of immunotoxicotherapy for colchicine poisoning in humans. PMID- 1788552 TI - Computer-assisted diagnosis of rheumatic disorders. AB - A review of the literature regarding computer-assisted diagnosis of rheumatic diseases is presented. After a general outline of the history and goals of computer programs intended to support physicians in the diagnostic process, 14 systems or projects are described. The scope of seven of these is general internal medicine, and the other seven are intended exclusively for rheumatic problems. The majority of these systems are prototypes. To date, none of them is widely used by physicians. Preliminary evaluation studies and/or independent reviews have been reported for all of the systems. The need for further evaluation studies is recognized, and strategies to carry these out are outlined. Furthermore, the potential usefulness for patient care and education is discussed. It is concluded that a new and interesting field is being developed that deserves more attention among rheumatologists. PMID- 1788553 TI - Ankylosing spondylitis in nonhuman primates: the drill and the siamang. AB - Nonhuman primates are known to be susceptible to many of the arthritides that afflict humans. Psoriatic like spondyloarthropathies have been reported in gorillas and skeletal hyperostosis in gibbons, rhesus monkeys, and gorillas, and additional cases of both of these conditions occurring in drills (baboons) are noted in this report. One western lowland gorilla and two rhesus monkeys with clinical features consistent with ankylosing spondylitis have been documented previously. Two additional nonhuman primate species with radiographic evidence of ankylosing spondylitis are described. A siamang (gibbon) and two drills (baboons) with the classic radiographic features of ankylosing spondylitis, namely a bamboo spine and sacroiliac joint fusion, are reported. PMID- 1788554 TI - The synovial membrane: studies for the 1990s--introduction to papers from the First International Symposium. PMID- 1788555 TI - Physiology of normal and abnormal synovium. AB - Because the synovial lining is a major target organ of rheumatic diseases, it seems logical to seek understanding of those conditions through study of the normal and abnormal physiology of this specialized organ system. This brief review covers some basic principles and recent progress in this area with emphasis on our evolving knowledge of microvascular function. PMID- 1788556 TI - Asymmetrical effects of albumin on transsynovial fluid movement. AB - The effect of intraarticular infusions of albumin solution on transsynovial flow was studied in healthy rabbit knee joints and compared with the effect of albumin solution perfused through the synovial microcirculation. Increasing intravascular albumin levels enhanced fluid absorption from the joint cavity, whereas increasing intraarticular albumin levels reduced the absorption rate. The slope of intraarticular pressure-versus-absorption rate plots was reduced by albumin in proportion to the reduction in fluidity (1/viscosity). When joint pressure was held constant, the transsynovial absorption rate was reduced by albumin in excess of the fluidity reduction and even reversed to filtration into the joint cavity. Thus intraarticular albumin acts by a dual mechanism, namely by increasing synovial interstitial fluid viscosity and by exerting a peri-capillary oncotic pressure. However, the latter effect was much less than that of intravascular albumin. Reasons for this are discussed. PMID- 1788557 TI - [Responses of neurons in lateral parabrachial nucleus to antidromic stimulation of subfornical organ and to orthodromic stimulation of nucleus tractus solitarius in the rat]. AB - Single unit discharges were extracellularly recorded from the neurons in the lateral parabrachial nucleus (LPBN) and responses of the recorded units to antidromic stimulation of the subfornical organ (SFO) and to orthodromic stimulation of the nucleus tractus solitarius (NTS) were observed in urethane anesthetized rats. Following electrical stimulation of the SFO, 9.9% (51/151) of the LPBN units were antidromically activated. After activation of peripheral baroreceptors by raising arterial blood pressure with an intravenous injection of phenylephrine, 40.7% (22/54) of the LPBN units were inhibited and 27.8% (17/54) excited. Following orthodromic stimulation of the depressor area in the NTS, 55.6% (94/169) of the LPBN units showed an increase and 22.5% (38/169) a decrease in firing rates. Among the LPBN neurons antidromically activated by SFO stimulation, 2 units were inhibited by phenylephrine administrated i.v.; of the 8 units tested, when the NTS was stimulated, 6 were excited and 2 inhibited. The results suggest that the LPBN neurons may receive inhibitory or excitatory baroreceptive inputs from the NTS and then relay it directly to SFO. PMID- 1788558 TI - [A quantitative study on the relationship between the specific binding of glucocorticoid receptor and glucocorticoid biopotency in rat thymocytes]. AB - The inhibitory effect of dexamethasone (Dex) on the incorporation of [3H] Urd and specific binding of [3H] Dex with glucocorticoid receptor (GR) were measured in order to quantitatively study the relationship between these two indices in rat thymocytes. The results showed that there existed a close correlation between the two indices in the range of 10(-9)-10(-5) mol/L Dex. When thymocytes were treated with RU486 in the concentration range of 10(-10)-10(-6) mol/L, both [3H] Dex specific binding and inhibitory effect of Dex were blocked with different fractions. The specific binding was linearly related to Dex biopotency. When extrapolated 100% of specific binding corresponded to 100% of biopotency while 20% of specific binding corresponded approximately to 0% of biopotency. It is likely that GR exhibited an occupancy threshold of about 20% total receptors, with only few spare ones in rat thymocytes. PMID- 1788559 TI - [Characteristics of central acute resetting of high threshold baroreflex in rabbit's aortic nerves]. AB - Experiments were performed on 37 urethane-anesthetized rabbits. The aortic nerves, carotid sinus nerves and vagus nerves were cut, MAP and renal sympathetic nerve activity (RSNA) were recorded. The conditional stimulation CSc (0.5 ms, 10 Hz, 4-6V, 5 min) was used to mimic the information of baroreflex non-medullated afferent fibers responding to acute increase of BP. Test stimulation TSa (0.02 ms, 0-80 Hz/30 s, 4-6V) and TSc (0.5 ms, 0-20 Hz/30s, 4-6V) was used to examine the responses of baroreflex A- and C-fibers. After CSc at 1 min the reflex MAP and RSNA of TSc was attenuated at 45.5% (P less than 0.01) and 10.6% (P less than 0.05), the MAP response of TSa was attenuated at 32.1% (P less than 0.05), but the RSNA response was not. From the further investigation it is concluded that the characteristics of central acute resetting are dependent on the components of baroreflex afferent fibers. The reflex responses are attenuated mainly by correspondent afferent components. PMID- 1788560 TI - [Electrophysiological studies of after-depolarizations and arrhythmias in the heart in vivo]. AB - CsCl triggered activities in cat heart in vivo were studied by using floating microelectrode and contact electrode to record transmembrane and monophasic action potentials (TAP and MAP). Ten seconds after CsCl (0.5 m mol/kg, i.v.), early after depolarization (EAD) appeared in the middle-later period of phase 3 in both TAP and MAP. Thirty seconds after CsCl, the amplitude of TAP-EAD was 25.6 +/- 9.3 mV and that of MAP-EAD was 3.4 +/- 1.3 mV. The potential changes of the EADs could be divided into three kinds, i.e. the "tail", the "plateau" and "peak" types. Delayed after depolarization (DADs) could also be induced by CsCl in the phase 4 of the TAP and MAP in two cats. The amplitudes of TAP-DAD and MAP-DAD were 13.0 +/- 5.3 mV and 3.3 +/- 0.6 mV respectively. The types of the afterdepolarizations in MAP were very similar to those in TAP. The ventricular extrasystole and/or tachycardias could be induced by repeated injections of CsCl. According to the occurrence of after depolarization (AD) and the relationship between the coupling interval of the AD and that of the ventricular beat, two kinds of generation of arrhythmias were suggested, i.e. one triggered by AD of the myocardium under the electrode and the other induced by AD originating from the other sites of the myocardium. PMID- 1788561 TI - [The curvilinearity of the end systolic tension-length relation of isolated rat papillary muscles]. AB - A series of isotonic tension, shortening and shortening velocity were obtained in isolated rat papillary muscles by varying the ++set point force against which the muscle shortened at optimal length. It was found that (1) end systolic tension length relation (ESTLR) could be described by an exponential equation. T = ae-bL k, where a and k represent respectively the total tension and the resting tension and b means curved degree and length-axis intercept (L0) represents maximal shortening. There was a greater correlation index R2 when fitted with the equation compared with linear regression (P less than 0.001). (2) High [Ca2+]0 shifted ESTLR leftward and upward, with increased a, b and maximal shortening L0, so did norepinephrine (NE) but significantly less than high [Ca2+]0, whereas the changes in rates of shortening and tension rise were greater during NE infusion than during high [Ca2+]0 infusion. These results indicated that ESTLR was non linear in isolated myocardium and exponential parameters a, b and L0 were sensitive to changes in contractile intensity, but less sensitive to changes in contractile velocity when compared with indexes of myocardial mechanics. PMID- 1788562 TI - [Effect of hypertonic NaCl solution on arterial pressure compensation after hemorrhage in rats]. AB - Rats were bled within 5 min in lowering mean arterial pressure (MAP) to 25 mmHg and were subsequently infused intravenously with hypertonic (7.5% NaCl) or normal saline in a volume equal to 10% of the amount of the lost blood. Intravenous infusion of hypertonic saline significantly facilitated posthemorrhagic recovery of MAP, which was markedly attenuated by 6-hydroxydopamine or Captopril. When these two drugs were used together, the attenuation effect was complete. While hypertonic saline significantly increased plasma Na+ concentration, normal saline only gave rise to a decrease. Intracerebroventricular injection of hypertonic NaCl solution also facilitated the recovery of MAP significantly. These results suggest that after hemorrhage increased plasma Na+ concentration following i.v. of a small amount of hypertonic saline may act on the central nervous system and activate sympathetic nervous system and renin angiotensin system to facilitate a rapid recovery of MAP. PMID- 1788563 TI - [The rapid effect of the iontophoretically applied cortisol on unit activity of neurons in three brain areas in rats]. AB - The present study was undertaken to analyze whether the glucocorticoid (GC) effect was region specific in the brain. Na-cortisol-succinate (HC) was applied iontophoretically to cerebral cortex (CX), hippocampus (HPC) and PVN respectively and the effect on unit discharge rate in these three brain areas were compared. In cerebral cortex, the percentage of responsive neurons was only 8% (4/50), which was significantly lower than those in HPC (10/36, 27.8%) and PVN (9/35, 25.7%). The difference in the occurrence is paralleled with the known distribution of traditional GC cytosolic receptors in the brain. In all the three brain areas studied the main response to GC was inhibitory and the latencies of the responses were 9.6 +/- 6.5, 22.7 +/- 24.0, and 14.5 +/- 11.5 s and the durations of the after-effect were 74.8 +/- 66.5 (n = 4), 24.2 +/- 14.5 (n = 6) and 21.0 +/- 10.5 s (n = 9) respectively. The shortness of the latencies once again suggests that the mechanism involved is non-genomic. It is interest to note that in some HPC neurons the after-effect lasted for 1758 +/- 2148 s (n = 4). The results show that the rapid effect of GC on neurons is different in the three brain areas studied in regarding to the occurrence of responsive neurons and the duration of the after-effects. PMID- 1788564 TI - [Effect of adenosine on carotid chemoreceptor activity in the rabbit]. AB - The response of single carotid chemoreceptor afferent fibers upon adenosine acting on the carotid body (CB) was examined in 39 urethan-anesthetized rabbits. Totally 73 units with spontaneous discharge were recorded in our experiment. The results were as follows: (1) Of 55 units, 51 showed an increase in discharge frequency from 0.76 +/- 0.10 to 1.53 +/- 0.23 imp/s. A few new units were recruited concomitantly in response to intracarotid injection of adenosine (10 micrograms/kg). (2) Adding adenosine in the doses of 0.5, 1.5, 10, 50 and 100 micrograms/kg to the perfusate passing through the isolated carotid sinus led to dose-dependent increase in the discharge from 0.51 +/- 0.06 to 0.58 +/- 0.07, 0.78 +/- 0.13, 0.96 +/- 0.15, 1.11 +/- 0.17, 1.34 +/- 0.21 and 1.38 +/- 0.18 imp/s, respectively (P less than 0.001, n = 9 units). (3) In other 9 units with spontaneous discharge rate of 1.30 +/- 0.40 imp/s, the activity was decreased to 0.56 +/- 0.19 imp/s (P less than 0.01) by intracarotid injection of dopamine (50 micrograms/kg). Intracarotid injection of adenosine to the CB pretreated with dopamine still activated the units with an increase in firing rate to 1.07 +/- 0.28 imp/s (P less than 0.01). However, the increment was less prominent as compared with that of adenosine administration before dopamine injection (P less than 0.001). From the results obtained, it is hypothesized that the exciting effect of adenosine on the CB chemoreceptor may be attributed to its action on the presynaptic component of the chemoreceptor complex in attenuating the release of inhibitory transmitter dopamine, and its direct stimulating action on the chemosensory nerve endings. PMID- 1788565 TI - [Otoacoustic emission cochleogram evoked by bone conducted stimulation]. AB - As bone conducted stimulation, tone bursts of different frequencies were applied through the forehead in 7 normal-hearing subjects. Binaural evoked otoacoustic emissions (EOAE) were then recorded simultaneously, which saved one half of the time required for conventional monaural recording. Analysed with autoregressive modeling, the main echo of EOAE was a narrow-band sound with a stimulus dependent central frequency. It was suggested that the generation site of EOAE was near to that cochlear portion stimulated by the corresponding frequency. The latency of EOAE, although independent of the stimulus intensity, tended to be shorter at higher stimulus frequencies. This was possibly due to the differences in the distances from the generation sites of the otoacoustic emissions to the tympanic membrane. Recordable otoacoustic emissions were evoked by tone bursts of 1.0, 2.0, 3.0 and 4.0 kHz in all the 14 normal ears except one at 4.0 kHz, and 10 and 7 ears by tone bursts of 0.5 and 6.0 kHz, respectively. Emission cochleogram was obtained when the means of EOAE detection thresholds were plotted in an audiogram format. The lowest threshold was found at 1.0 kHz. This might be related to the middle ear resonance frequency of 1100 +/- 230 Hz. The technique of simultaneous recording of binaural EOAE and plotting of emission cochleogram described in this paper is clinically useful as a means of objective evaluation of hearing. PMID- 1788566 TI - Cholesterol and coronary artery disease--issues in the 1990s. PMID- 1788567 TI - Cardiac magnetic resonance imaging. PMID- 1788568 TI - Retarding the progression of chronic renal failure: is it possible? PMID- 1788569 TI - CT-directed stereotactic neurosurgery. PMID- 1788570 TI - Comparison of progression of renal failure in children with hypoplastic dysplastic kidneys and chronic glomerulonephritis. AB - A comparative study was made on two groups of children comprising 20 patients with renal hypoplasia/dysplasia in one group and 12 patients with chronic glomerulonephritis (GN) in the other, presenting with chronic renal failure (CRF) in the Department of Paediatrics, Singapore General Hospital and National University Hospital between 1975 and 1989. The age of onset of CRF, the progression of renal failure and the presence of various clinical complications were analysed and compared. The mean age of onset of CRF was earlier in patients with renal hypoplasia/dysplasia (p less than 0.001) but the progression of renal failure in these patients were slower (p less than 0.005). Hypertension occurred more frequently in the chronic GN group (p less than 0.001) while urinary tract infection (UTI) occurred more frequently in the renal hypoplasia/dysplasia group (p less than 0.004). With the early onset of renal failure and slow deterioration of renal function in patients with renal hypoplasia/dysplasia, the provision of good conservative treatment for renal failure is most important in the management of these patients. In the chronic GN patients however, with the rapidity of deterioration of renal function, early preparation for replacement therapy becomes more imminent. However, renal replacement therapy in end-stage renal failure (ESRF) is costly and not readily available, it is more prudent to delay the onset of ESRF by providing effective conservative treatment of renal failure which includes the early recognition and treatment of hypertension in chronic GN and UTI in renal hypoplasia/dysplasia. PMID- 1788571 TI - CT-directed BRW stereotactic neurosurgery: local experience with 42 cases. AB - Initial experience with the Brown-Roberts-Wells (BRW) computed tomographic (CT) guided stereotactic system is reported. Forty-two procedures were performed over a 22-month period on 21 female and 20 male patients (one patient had a repeat procedure). Their ages ranged from 11 years to 89 years. These included 21 stereotactic biopsy procedures, 2 stereotactic implantations of third ventricular catheters through the foramen of Monro for intraventricular opiate insertion in terminal cancer patients, 2 stereotactic aspirations for brain abscess, 10 stereotactic aspirations of intracerebral haematomas, 3 stereotactic aspirations of cystic brain tumours, 1 stereotactic placement of a fourth ventricle peritoneal shunt and lastly 3 stereotactic craniotomies. Successful targeting was achieved in all cases. There was one operation-related complication which resulted in uncontrollable intracerebral haemorrhage and ultimately led to the patient's demise. PMID- 1788572 TI - The management of ingested foreign bodies in the upper digestive tract: a retrospective study of 49 cases. AB - Forty-nine cases of accidental foreign body ingestion treated in our unit were reviewed. Fish bones were the commonest foreign body ingested by adults while coins and pins accounted for most cases in the paediatric age group. All except one patient had endoscopy performed, majority with flexible endoscope. Foreign bodies were detected and successfully removed endoscopically in 23 patients except one. In another 12 patients, foreign bodies were demonstrated by chest X ray or Barium meal but at the time of endoscopy, they had passed beyond the reach of the endoscope. For the remaining 13 patients, despite having a history of foreign body ingestion and retrosternal pain, subsequent investigation failed to demonstrate the foreign bodies. Barium contrast studies were performed in 31 cases, with 5 false negative and 2 possible false positive findings. There were 2 serious complications related to foreign body ingestion, one had empyema thoracis and another died of massive bleeding due to esophageal carotid fistula. PMID- 1788573 TI - Oriental eyelids--anatomical and surgical considerations. AB - There are subtle anatomical differences between the oriental and occidental eyelids. Creation of upper eyelid crease, otherwise known as "Double Eyelid" has been the single most popular cosmetic surgical procedure among the affluent Asians to enhance the beauty of their eyelids. It is important for the surgeon to be familiar with the anatomical differences in order not to westernise their facial features but to blend his creation with the existing facial features. This is true of any surgical procedure in the lids, be it ptosis correction or blepharoplasty for excess skin and bags in the eyelids, in order to produce good cosmetic results. PMID- 1788574 TI - Health care services for the elderly--a Singapore perspective. AB - Singapore is greying at a phenomenal pace as well as in a markedly disproportionate manner. By the year 2030, the elderly will comprise around 25% of the total population; at the same time the numbers of younger and economically active persons will decline. The reasons for this process are varied and its implications disturbing. An important consequences is the urgent need for careful and comprehensive planning to meet the elderly's needs. The needs are best addressed when the elderly are looked at as either being well or frail. A guiding principle is that most of them prefer and should remain within community (and not be institutionalised). Efficient and appropriate community services must be developed so as to support the elderly's stay in the community. PMID- 1788575 TI - The application of disposable contact lenses in the Navy. AB - With the recent advent of disposable contact lenses, many of the problems which have been hindering the military application of contact lenses have been overcome. Fifty-five myopic naval personnel with no previous contact lens experience were put through a three-week study using these contact lenses. The aim was to test the feasibility of supplying bespectacled myopic seamen with contact lenses at the outset of operational missions. Seven developed conjunctival injection which caused them to discontinue contact lens wear. Of the remaining 48, however, a vast majority showed preference for contact lenses when compared to spectacles in the work environments that they were exposed to. With contact lenses, 95.8% had comparable or better vision during the day and 85.4% during the night. No serious ocular complications were noted and only minor findings were detected in the 96 eyes at the end of three weeks of contact lens wear. PMID- 1788576 TI - Investigation of rectal bleeding. AB - We studied a consecutive series of 115 patients presenting to one gastroenterologist with non-emergency rectal bleeding or positive faecal occult blood studies. When there is a clear history that the bleeding was perianal, 26 out of 33 patients (79%) were found to have haemorrhoids. In the absence of such a history (n = 82), 16 patients (20%) had colonic cancer or polyps, 20 (25%) colitis; 24 (29%) perianal disease while only 15 (18%) had no pathology demonstrated. Our experience coupled with a review of the literature on the investigation of rectal bleeding lead us to the following recommendations: (1) Total colonoscopy or flexible sigmoidoscopy plus double contrast barium enema should normally be performed; (2) when there is a clear history that the bleeding is perianal, flexible sigmoidoscopy may suffice. PMID- 1788577 TI - Is sedation without desaturation possible? AB - The correlation between the depth of sedation and the degree of oxygen desaturation was studied in 52 patients presenting for surgery under regional anaesthesia. After establishing successful regional anaesthesia, patients were sedated with incremental doses of intravenous midazolam. The various levels of sedation were scored from 0 to IV. Continuous pulse oximetry allowed for correlation of sedation and saturation. Each patient's presedation oxygen saturation served as the control value. This was compared with the saturation at sedation levels II, III and IV and was found to be significantly higher (p less than 0.001). There was also a significant drop in saturation as patients progressed from sedation level II to III (p less than 0.02) and from level III to IV (p less than 0.001). The incidence of saturation falling to less than 90% was 4.35%, 14.71% and 40% at sedation scores of II, III and IV respectively. PMID- 1788578 TI - Four patients in Singapore with anti-Golgi antibodies. AB - Serum specimens for anti-nuclear fluorescence tests are routinely received in our laboratory. Four specimens were spotted to be negative for anti-nuclear fluorescence but positive for fluorescence characteristic of that caused by anti golgi antibodies. (a) Patient A had acute glomerulonephritis; (b) Patient B had acute viral hepatitis; (c) Patient C had deep vein thrombosis; and (d) Patient D had non-Hodgkin's lymphoma. The relevance and possible aetiology of anti-golgi antibodies are also discussed. PMID- 1788579 TI - Unusual hepatic manifestations in typhoid fever. AB - This paper deals with two patients with typhoid fever in whom hepatic manifestations were the dominant and presenting features of the illness. The ability of typhoid hepatitis to simulate other common infectious diseases in this region is highlighted. It is recommended that typhoid hepatitis should be included in the differential diagnosis of patients presenting with fever and jaundice particularly in the tropics. PMID- 1788580 TI - The Mentakab Hypertension Study Project. Part III--Detection of hypertension in the outpatient department. AB - Undetected hypertension is an obstacle to effective blood pressure control in the community. A study was done to assess the justification of screening in the outpatient department. Only 13% of all visits to the outpatient department resulted in an attempt to detect hypertension. The common reasons leading to blood pressure measurement were headache and dizziness. Current practice of hypertension detection appeared inadequate and irrational. Nine per cent of all visits to the outpatient department were already accounted for by hypertensives. A screening survey found that 30% of all non-hypertensive patients attending outpatient department aged 30 years or more had blood pressure greater than or equal to 140/90 mmHg. The drop out rate among these newly diagnosed hypertensives was 100%. Existing resources are already inadequate and existing hypertension care has also been shown to be inadequate. Screening can only be expected to considerably increase hypertensive patient load without however any assurance that effective long term care can be delivered. Labelling people as hypertensives in this manner may be harmful. The question of screening cannot be considered individually, separate from the entire problem of hypertension control. Detection must be linked to treatment in a programme designed to promote compliance and capable of delivering adequate care before it can be justified. PMID- 1788581 TI - Nausea and vomiting after termination of pregnancy as day surgery cases: comparison of 3 different doses of droperidol and metoclopramide as anti-emetic prophylaxis. AB - Frequency of nausea and vomiting following day case termination of pregnancy was found to be rather high (42%) without anti-emetic prophylaxis. Droperidol in doses of 2.5 mg, 1.25 mg and 0.25 mg were found to be equally effective as prophylactic anti-emetic, but not metoclopramide 10 mg. This study confirms that low dose droperidol 0.25 mg is effective as a prophylactic anti-emetic, without any delay in immediate recovery and hence suitable for day surgery cases. PMID- 1788582 TI - Anti-toxoplasma antibodies in healthy adults and in different patient categories. AB - This study analyzes the anti-toxoplasma sero-titres and prevalence rates in normal healthy adults and in patients presenting with different symptom complexes. The study was based on sera from 80 normal healthy adults and 2,185 patient sera samples from 2,032 patients (from various clinics and hospitals in Singapore) being investigated for the diagnosis or exclusion of toxoplasmosis, over a 42-month study period. About 15% of the healthy adults were found to have low IgG antibody titres (1:64 to 1:256), while 3.8% had high IgG titres (1:1024 or higher). Interestingly, among the patients investigated for toxoplasmosis: i) more than 20% of those presenting with lymphadenopathy (usually cervical) had antibody titres more than or equal to 1:1024; ii) more than half of all patients with an antibody titre of 1:4096, and more than three-quarters of all patients with a titre exceeding 1:4096 had presented with lymphadenopathy; iii) about 20% of those presenting with ocular symptoms had low antibody titres of 1:64 or 1:256, whereas 7% had higher titres. Malay (p less than 0.01) and Indian (p less than 0.05) patients had significantly higher seropositive rates than the Chinese. In particular, the Malays (p less than 0.00001) and Indians (p less than 0.01) had significantly higher incidence of low-positive titres (1:64, 1:256); conversely the Chinese patients had a significantly higher (p less than 0.01) incidence of high-positive titres (1:4096 or higher). Finally, the epidemiology and clinical profiles of patients presenting with acute toxoplasmic lymphadenitis are contrasted with that of patients presenting with ocular manifestations of congenital toxoplasmosis. PMID- 1788583 TI - Silent myocardial ischaemia: the Tan Tock Seng experience. AB - The results of treadmill exercise stress test (TMX) for ischaemia is based on ST segment depression. Patients with positive test may or may not be symptomatic. This study examines if there are any differences between these two groups of patients. A total of thirty-nine patients with coronary artery disease and positive TMX results in 1988 was studied. There were 16 patients with chest pain and 23 without. They were followed-up for a mean period of 16.9 and 15.2 months respectively. The following factors were found not to be statistically significant between these two groups of patients: age, sex, race, height, weight, history of hypertension, diabetes mellitus or smoking, indication for the test, use of drugs, total and HDL-cholesterol, exercise duration and the initial double product. The difference between the maximal double product of the two groups was statistically significant (p = 0.004). In the follow-up period, in the group of patients with silent myocardial ischaemia, one had a cardiac event and one underwent revascularisation. While in the symptomatic group, two had cardiac events and seven underwent revascularisation. There were no deaths in either group. The difference in overall outcome was significant statistically (p = 0.002). Therefore, patients with silent myocardial ischaemia have a higher maximal double product in TMX; hence a higher maximal workload and a less adverse outcome compared to symptomatic patients. PMID- 1788584 TI - Heart failure in the elderly. AB - Heart failure commonly occurs in the elderly age group. Treatment mainly centres on the use of digoxin and diuretics. In intractable heart failure other agents ie inotropic agents and vasodilators may be considered. Routine maintenance on diuretic and digoxin should not be encouraged. A conscious effort to tail off these medication is needed. PMID- 1788585 TI - Management of stroke in the elderly. AB - Stroke management involves prevention, management of the acute stroke and rehabilitation. Hypertension is probably the most important controllable risk factor in stroke, both ischaemic and haemorrhagic. In the acute stroke, there is as yet no effective medical treatment. Care in the acute phase is mainly supportive with attention to airways, feeding, skin, bowel and bladder care. Rehabilitation aims to maximise the patient's natural recovery and to help him adapt to any residual disability. It involves a multidisciplinary team approach. An accurate and comprehensive assessment of the patient is important to enable the team to set realistic goals. Goals set usually involve functional end-points. The type of community and home support available will influence decision of whether patient could be discharged home. Ideally a patient should be rehabilitated back into his community and support of carers is important if they are to continue with their caring role. PMID- 1788586 TI - Psychiatric problems in the elderly. AB - Psychosocial changes and physical disabilities that occur in the elderly contribute to an increase in the prevalence of psychiatric disorders in the elderly. A comprehensive approach to diagnosis is required. Depression, dementia, delirium and paranoid disorders are common psychiatric disorders seen in the elderly. Underlying treatable causes must be excluded. Treatment requires special considerations such as adverse drug reactions, drug interactions, side effects and concomitant physical illnesses. Management of the elderly should involve the family as well as the patient. PMID- 1788587 TI - Persistent mullerian duct syndrome--a case report. AB - An eighteen month old phenotypically and genotypically normal male child was admitted with a left inguinal hernia and a right undescended testis. At operation, he was found to have a uterus, bilateral fallopian tubes, and a vagina in the left hernial sac. Bilateral orchidopexies and excision of the persistent Mullerian duct structures were carried out. This rare case of persistent Mullerian duct syndrome is due to a defect in Mullerian regression, which is in turn controlled by the Mullerian inhibiting substance (MIS). Orchidopexy with excision of the persistent Mullerian duct structures is usually not possible without damage to the vas deferens which is closely adherent to the wall of the uterus. The alternative of leaving the persistent Mullerian duct structures alone and performing a staged or primary orchidopexy has been suggested. PMID- 1788588 TI - Mandibulo-facial dysostosis--the eye signs of a case study. AB - The mandibulo-facial dysostosis syndrome (Treacher-Collins syndrome) was first described in 1889. It is a syndrome with multiple presentations, the classification for which was devised by Franceschetti and Zwahlen in 1944. The eye signs are an important part of this syndrome. In addition to the main ocular features of colobomata of the lower eyelids and an anti-mongoloid slant, many other eye signs have been reported. An 18-year-old Indian male was found to have features not previously described. These are high myopia, dermolipoma, lens subluxation and secondary glaucoma. PMID- 1788589 TI - Pseudohypopyon--an unusual presenting sign in retinoblastoma. AB - Retinoblastoma is the most common intraocular malignancy of childhood. A case of pseudohypopyon as an unusual first sign of retinoblastoma is presented. More common clinical presentations and diagnosis of this disease are also discussed. As some cases of retinoblastoma can mimic non-malignant disease, it is important that the physician have a high index of suspicion for this tumour. PMID- 1788590 TI - Hyperthyroidism with gynaecomastia, galactorrhoea and periodic paralysis. AB - A 32 year old male thyrotoxic presenting with gynaecomastia, galactorrhoea and later complicated with hypokalaemic periodic paralysis is presented. The gynaecomastia and galactorrhoea resolved with treatment. To the best of the author's knowledge this combination of association in one patient has not been reported previously. PMID- 1788591 TI - Enterococci highly resistant to penicillin: characterizing isolates from Singapore hospitals. PMID- 1788592 TI - Ischaemic necrosis of bone. PMID- 1788593 TI - 1991 SMA Lecture. Singapore and the provision of medical services for the region. PMID- 1788594 TI - Results of total hip replacement in systemic lupus erythematosus. AB - Ten total hip replacements were performed between 1 June 1984 and 31 May 1989 in 6 patients who had systemic lupus erythematosus. All had avascular necrosis of the femoral head. The mean age at operation was 31.2 years with a range of 21 - 41 years. The mean follow-up period was 3.9 years with a range of 1.75 to 6.25 years. Mayo clinical hip ratings were excellent for all but one hip. Complications included transient sciatic nerve palsy in one hip and aseptic loosening of the femoral component in another. PMID- 1788595 TI - Hypertension in the elderly--a review. AB - This report reviews the recent studies on the risks of excess morbidity and mortality from untreated hypertension in the elderly (aged 60 and above), and the possible benefits derived from therapeutic intervention. These studies suggest that the 'young-old' (aged 60-80) have definite measurable risks associated with elevated blood pressure, which are reduced by appropriate treatment, but the benefits of conventional treatment on those above 80 years old are not so clear cut. With these findings the review examines the existing issues, the accompanying risks, criteria and recommendations for evaluating the elderly hypertensive, and the modalities of treatment. PMID- 1788596 TI - Occupational asthma in Singapore--a review of cases from 1983 to 1990. AB - One of the newer occupational diseases in Singapore is occupational asthma. As on 31 December 1990 there were 35 confirmed cases of occupational asthma in the official statistics on occupational disease. We report in this paper our observations and experience based on these cases. The problem of under-reporting and the importance of early diagnosis are discussed. PMID- 1788597 TI - Profile of a homosexual in Singapore. AB - A study was done on 40 homosexual subjects and 47 controls between the ages of 18 19 years, matched for race and age. There was no significant difference in the educational level, and family background of the 2 groups. But homosexuals had a significantly more unhappy childhood than the controls, were more often reprimanded than physically punished and were often teased by their classmates and called names. They were not overprotected or infantilized by their parents and there was no overclose relationship with their mothers. The majority mixed with effeminate boys, admired a senior person in school and about a third had a physical relationship with this person. Almost half had been molested when they were young. Less than a fifth had girlfriends. About three-quarters knew of AIDS and of these less than a fifth felt they would give up their sexual practices because of fear of AIDS. The main problems faced by the subjects were confusion about their identity, their desire to find the right partner, relationship problems and difficulties in controlling their impulses. PMID- 1788598 TI - Malignant axillary lymphadenopathy--a problem for management. AB - Axillary lymph node enlargement can be the first and only manifestation of malignancy. Although lymphoma and metastasis from melanoma, breast and lung cancers are known causes, the primary tumour may remain undetected in some cases despite exhaustive investigations. Therefore, once the diagnosis of malignancy is confirmed by clinical examination followed by histology, further investigations should be limited to a search for treatable malignancies only. Extensive investigations with a hope of discovering the primary is useless and not cost effective. Close follow up may occasionally reveal new clinical signs when further investigations can be justified. This paper reports the clinical approach to diagnosis and management of such cases with examples of illustrative cases. PMID- 1788599 TI - A multimodality approach to endoscopic treatment of bleeding peptic ulcers. AB - The role of endoscopic haemostasis in the treatment of bleeding peptic ulcers is widely studied. Many trials to date have compared one or more modalities against a medical control with variable results. To date, no single modality has been shown conclusively to be superior to others. As such, in this study we have not confined the endoscopist to one modality of treatment but allowed him to customize the method of endoscopic haemostasis according to the configuration, accessibility and rate of bleeding in any particular patient. Seventy-three patients with non-variceal upper gastrointestinal (GI) bleeding were admitted to the National University Hospital in Singapore between May 1, 1988 and April 30, 1989. All were gastroscoped and 48 were found to have chronic peptic ulcer. Twenty-nine (60%) with actively bleeding peptic ulcer or stigmata of recent haemorrhage (SRH) were treated endoscopically. Initial haemostasis was achieved in 27 (93%) patients. Seven patients rebled (26%) of which four underwent repeat endoscopic treatment. Of these four patients only one rebled again and required surgery. Permanent haemostasis was achieved in 23 of 29 patients (79%). The multimodality approach for the treatment of bleeding peptic ulcers gives the endoscopist flexibility in deciding on the best way to deal with a bleeding gastric or duodenal ulcer. Each instrument has its strengths and weaknesses and the right choice of instrument is often a critical factor especially in treating a bleeding ulcer in a situation where access poses a problem. PMID- 1788600 TI - Intravesical chemotherapy for superficial carcinoma of the bladder. AB - Intravesical chemotherapy has been shown to be of value in the treatment of superficial transitional cell carcinoma of the bladder, not only in the prevention of recurrence but possibly progression of the disease to higher stage as well. At the Department of Surgery, National University of Singapore from 1980 to 1986 we had used intravesical chemotherapy for multiple or recurrent superficial carcinoma of bladder in 45 patients. Of these, 21 patients had associated carcinoma in situ. Initially, thiotepa was used as the main intravesical chemotherapeutic agent. Since 1984, mitomycin C was introduced. The schedule used is 30 mg in 30 mg of water, and left in the bladder for 2 hours weekly for 4 weeks. Intermittent courses were given when deemed necessary on follow-up cystoscopy at 3 to 6 months. Patients were deemed to have good response if there was no evidence of tumour on cytology and biopsy at follow-up cystoscopy. Eleven patients had thiotepa only, of these 4 had good response, 4 were stable and 3 had progression of disease to higher stage. Thirty-four patients had mitomycin therapy. Thirteen of them following thiotepa treatment. Twenty-one patients (64%) had good response to therapy. Three patients (9%) had progression of disease, requiring cystectomy. Of those who responded to therapy, none had developed muscle invasive disease so far with mean follow-up of 43 months. Of the group of patients treated with mitomycin, no patient developed myelosuppression.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1788601 TI - Tuberculosis in the elderly. AB - A study of 120 cases of tuberculosis in patients aged 65 years and above revealed that there were more males than females with the disease compared with the younger age group of 15 to 45 years old. The elderly group also had significantly more severe and more had bacteriologically positive disease. The majority of them were born outside Singapore and immigrated more than 30 years ago. Risk factors such as diabetes mellitus, past history of tuberculosis, malignancy and gastrectomy were more common in the elderly group. Standard 6-month regimens were well tolerated and adverse side effects to the drugs were negligible. PMID- 1788602 TI - Tuberculoma of the brain--report of 2 cases and review of literature. AB - Tuberculomas of the brain are relatively uncommon in developed countries nowadays. We report the only two cases that were seen in our Department in the last five years. Both patients presented with seizures and were found to have space occupying lesions on cranial CT scanning. They had no past history of tuberculosis, no evidence of current extracranial tuberculosis and the diagnosis of tuberculoma was made at the time of surgical excision. Underdiagnosis of tuberculoma of the brain is likely to occur in industrialised countries where tuberculosis is rare. The radiological investigation of choice is CT scanning with contrast enhancement and the presence of a target lesion is considered to be pathognomonic of a tuberculoma. Most tuberculomas of the brain can be treated medically with antituberculous chemotherapy. We recommended obtaining a definitive histological diagnosis with CT-guided stereotactic techniques prior to commencing antituberculous therapy. Surgical excision is necessary in patients with raised intracranial pressure secondary to the lesion and not responding to medical therapy. PMID- 1788603 TI - The Mentakab Hypertension Project. Part IV--Hypertension care: is it adequate? A criterion-based audit of hypertension care in a hospital. AB - An audit to assess the adequacy of hypertension care was performed by examining the records and interviewing 55 selected hypertensive patients on treatment and follow-up at the outpatient department of a hospital. The patients selected had no previous record of drop out of treatment and had excellent compliance with drug therapy, so that ineffective blood pressure control cannot be attributable to these two reasons. Adequacy of care was measured by the number of patients whose management as indicated in their records complied with pre-defined criteria of adequate care. Only 18% of patients had achieved adequate blood pressure control. Assessment of patients was inadequate. None of the patients had been screened for secondary causes though 16% of patients had some basic investigations (urinalysis, blood urea and serum potassium), 5% had an assessment of target-organ damage, and 2% had been screened for other cardiovascular risk factors. Only 5% had a surveillance of side-effects from drug-therapy, 45% of the patients demonstrate adequate knowledge concerning complications of hypertension. The use of non-drug treatment was non-existent. The results of this study suggest that there were considerable deficiencies in the management of hypertension. Measures needed to overcome this are discussed. PMID- 1788604 TI - Transrectal ultrasound of the prostate: the early Singapore experience. AB - During a four-month-period 40 patients presenting to the Department of Urology with mainly retention of urine had their prostates scanned ultrasonically. Eight nodules were detected on the ultrasound of which five were not detected on digital rectal examination. Of the five non-palpable nodules two were diagnosed on ultrasound guided transperineal Tru-cut biopsy to be carcinomas. Of the three nodules detected both on ultrasound and digital rectal examination, two were proven to be carcinomas while the other was benign. The transrectal ultrasound was not only found to be easy to use but was also found to be a useful complement to the urologist's index finger with the added advantage of obtaining good quality biopsy material from suspicious lesions. PMID- 1788605 TI - Methicillin-resistant Staphylococcus aureus (MRSA)--phage-typing of Malaysian and international isolates. AB - Twenty-one isolates of methicillin-resistant Staphylococcus aureus (MRSA) from Malaysia (M-MRSA) derived from various sources associated with nosocomial infections were phage-typed and compared with 54 international isolates associated with epidemic and sporadic episodes of infections. It appeared that the majority of M-MRSA were non-typable by the international basic set of phages. Two (9.5%) were typed by phage 85. Phage-typing of MRSA revealed that the strains were almost completely restricted to phage groups III and a lesser portion to phage groups I and III. PMID- 1788606 TI - Approach to joint pains. AB - Aches and pains are common clinical problems. There are many causes of rheumatic pains and a simple classification is given in this article. The approach to the problem should be clinical, and starts with careful history, physical examination and some simple investigations. Most of the common rheumatic problems can be diagnosed easily using the clues to diagnosis given here. Those which are unresolved and problematic can then be referred for further evaluation. PMID- 1788607 TI - Surgical management of arthritis. AB - The progression and manifestations of arthritis can to a large extent be controlled by medical measures. In the instance of inflammatory arthritis surgical synovectomy may have to be undertaken to control the disease. Once the arthritis has resulted in significant damage to the joints surgical intervention may be the only means of providing relief of pain and restoring function to the affected limb. Arthroplasty, arthrodesis, debridement and osteotomy remain the most used surgical procedures to achieve this. PMID- 1788608 TI - Calf hypertrophy in spinal muscular atrophy. AB - Two unusual variants of spinal muscular atrophy with gross calf hypertrophy of adolescent onset were studied clinically, electrophysiologically and histologically. There have been reports of several variants within this group of spinal muscular atrophies. In Singapore we encountered 2 patients who had an unusual variant of spinal muscular atrophy not well recognised previously with only 3 reports recorded to date. Our cases presented with gross calf hypertrophy and a slowly progressive clinical course. Nerve conduction studies were normal but electromyogram and muscle biopsies revealed a chronic denervation problem of probable central origin. PMID- 1788609 TI - Jejunal diverticulosis: case report of a rare cause of mechanical intestinal obstruction. AB - Jejunal diverticulosis is a rare condition and usually discovered incidentally at laparotomy for an unrelated pathology. When inflamed or perforated, jejunal diverticulosis may present with paralytic ileus. In contrast, mechanical bowel obstruction is an unusual presentation. This paper reports the first local case of jejunal diverticulosis presenting with mechanical bowel obstruction due to impaction at the terminal ileum by an enterolith originating from a diverticulum, and reviews the recent literature on the subject. PMID- 1788610 TI - Pulmonary alveolar proteinosis--a case report. AB - Pulmonary alveolar proteinosis is a relatively rare disease. Its etiology is unknown but it has been found associated with various opportunistic infections as well as immunological conditions. The clinical and radiological features may be indistinguishable from other respiratory disorders and diagnosis is often dependent on histology. Its course can vary from progressive deterioration to spontaneous improvement and treatment with bronchopulmonary lavage may not always be necessary. Many theories regarding pathogenesis have been put forward and most of these centre upon the roles of alveolar macrophages. We describe a case of Pulmonary Alveolar Proteinosis in a local Oriental male and reviewed the current understanding of its pathogenesis. PMID- 1788611 TI - [Radiotherapy of malignant tumors of the uterine cervix: results of therapy]. AB - From February 25, 1974 to April 30, 1976 at the Institute for Oncology and Radiology of the University Clinical Center in Belgrade 138 patients with cervical carcinoma stage I, II and III were radical irradiated by Cathetron (HDR Co-60 sources and remote afterloading technique) and 42 MeV Betatron. The 5-year and 10-year survival of these patients was: stage I--90.9% and 81.8%, stage II- 65.1% and 46.0%, stage III--32.8% and 23.0% and III stages--52.5% and 39.1%. Local recurrences, distant metastases and late postirradiation sequelae were: 26.8%, 5.8% and 22.7%. PMID- 1788612 TI - [Microsurgical reconstruction of peripheral nerve injuries]. AB - The results of peripheral nerve repair have been significantly improved since introduction of the operating microscope. Microsurgical repair enables better fascicular orientation and coaptation with diminished fibrotic reaction on the suture line. The ten-year experience in 421 patients with peripheral nerve injuries is analyzed in the paper. Different surgical procedures (interfascicular neurolysis, direct fascicular repair, interfascicular transplantation or brachial plexus reinnervation) have been performed depending on type of injury, the special attention is paid to the cases with the nerve transection and consecutive interfascicular grafting. The results are analyzed in 182 cases depending on the location of injury, the patient's age, the timing of surgery and the length of nerve grafts. PMID- 1788613 TI - [Diagnostic and prognostic criteria in acute non-A, non-B viral hepatitis with a prolonged course]. AB - In a prospective three-year-long study of Non-A, Non-B infections carried out in the Institute of Infectious and Tropical Diseases in Belgrade, by a method of exclusion and in about 30% of patients' liver biopsies, 75 cases of acute viral hepatitis Non-A, Non-B were discovered. It makes only 2.29% of all cases of acute viral hepatitis diagnosed and treated in the same period in this institution. In prolonged forms of the disease (24 cases) the chronicity was shown by epidemiological data (posttransfusion hepatitis), fluctuation of transaminase and rise of gamma globulins in acute phase of the disease. Liver biopsies performed in the first four months of the disease were of no prognostic value. PMID- 1788614 TI - [Multicenter study of the efficacy and tolerance of gemfibrozil and fenofibrate in the treatment of primary hyperlipoproteinemia]. AB - In the primary prevention of atherosclerosis and risk of lipoproteinemia, is of primordial importance. Therefore, adequate food and physical activities are necessary. If no good result is evident thereafter medicinal treatment should be prescribed. In our open random study performed in two different centres, we evaluated the efficiency and tolerance of Gemfibrozile and Phenofibrate in 77 patients with IIa, IIb, and IV stage of hyperlipoproteinaemia. The study included the patients in whom the 8-week diet gave no expected results. The evaluation of Gemfibrosile (900 mg daily) and Phenofibrate (300 m daily) efficiency lasted 12 weeks. During that time 11 patients were excluded from the study because of administration of other relevant drugs or for lack of control examinations. The efficiency was evaluated in 66 patients: 33 to Gemfibrozile and 31 to Phenofibrate. At the end of treatment the following results were obtained: decreased cholesterol level by 17% in Gemfibrozile patients and by 6% in Phenofibrate subjects; LDL-cholesterol by 15% i.e. 3% and triglycerides by 48% in Gemfibrozile cases and by 27% in Phenofibrate individuals. At the end of treatment HDL-cholesterol was increased by 29% in patients treated with Gemfibrozile and by 9% in those treated with Phenofibrate. Apoprotein A-1 was increased after Phenofibrate treatment and decreased after Gemfibrozile administration. Apoprotein B was increased in both groups. No harmful clinical or laboratory effects were observed. On the basis of these results it can be concluded that the effect of Gemfibrozile was more favourable on lipod composition in the plasma then that of Phenofibrate. No significant differences in drug tolerance were observed. PMID- 1788615 TI - [Tables of composition of prepared foods for patients on hemodialysis]. AB - Numerous mutually contradictory conditions in diets for haemodialysis patients require knowledge about the composition of prepared food for each individual patient. The aim of this study was to make appropriate tables of prepared food on the basis of the analysis of patients nutrition. A list of the food way of its preparation was formed after dietary interviews. The most frequent food was prepared in the usual way and its composition was computed with food tables. The tables of prepared food composition facilitate the prescription of dietary daily meals, and make the therapy easier. PMID- 1788616 TI - [Transsexualism and sex change]. AB - The article deals with the psychosexually disturbed identity known as transsexualism. The medical practice is occupied with this problem and phenomenon since the sixth decennium of this century. However, in this country it was not present at that time. In Serbia the treatment of transsexualism began at the beginning of 1989, and there have not yet been published articles on this problem. This paper is the first article dealing with transsexualism in Serbia. It is based on personal authors' experience. The essential characteristic of transsexualism is the existence of such psychical grasp and conduct which do not correspond to bodily sexual characteristics. The difference is so great that the patient must force himself (herself) to accept the existing psychical properties or inborn bodily particularities which do not harmonize. Therefore the patient decides to take psychial things as they are but to alter his (her) body. Psychiatry cannot alter his (her) soul but surgery and endocrinology can alter his (her) body. In that case the patients body is first shaped with hormonal therapy according to his (her) wishes (female or male), and then genital organs are appropriately formed by surgery. The popular nema of this procedure is sex reassignment. The whole problem and the therapeutic procedure are considered as hermaphroditism. In true hermaphroditism ovarian or testicular tissue is present in the same patient; in false hermaphroditism female or male organs predominate; and in transsexualism only one way of alteration is possible i.e. bodily sexual alteration. The latter is the most complex form and physicians finally realized that spiritual feelings can be the property of one sex and bodily characteristics of the other.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1788617 TI - [Causes of mental health disorders during pregnancy and in the postpartum period]. AB - SUMMARY: Pregnancy, delivery and postpartal period are biological phenomena which are influenced by the interaction of numerous physiological, psychological and social factor. The psychological disturbance occurring in pregnancy not only affects the health of the mother, but also it influences the outcome of pregnancy and delivery, as well as the newborn infant. The literature describes various causes of such disturbances. Different schools point out psychodynamic, endocrinologic and psychosomatic causes respectively. PMID- 1788618 TI - [An anaphylactic reaction after administration of Novalgetol in an asthmatic patient]. AB - The article deals with a 16-year old patient who was suffering from bronchial asthma with frequent severe respiratory obstructive crises and decreased values of functional pulmonary tests since his eleventh year. He was on salbutamol and teoline therapy, and since one year and a half on continuous inhalation corticosteroid therapy. During one of the episodes of bronchobstruction when he was on broncholdilatation and oxygen therapy the patient was given novalgetol because of headache. This provoked a grave astmatic attack with loss of consciousness. One and a half year later he was given novalgetol during a dyspneic drisis with headacke. Five minutes later asthatic attack and generalized urticaria appeared as anaphylactic reaction to novalgetol. This is a good example how drugs form the group of amonomethansulphonate (novalgetol), used in analgetic purposes, can induce, like aspirin, asthamtic crisis and anaphylactic reaction. Therefore they should be avoided in asthamtic patients. PMID- 1788619 TI - [Diabetes insipidus as a sequela of metastatic breast carcinoma]. AB - Hypothalamo-hypophyseal metastases are still a relatively unfamiliar entity. Mostly they are confirmed by autopsy. Rear clinical manifestations are presented by diabetes insipidus. In general, patients with endocrine breast carcinoma metastases are young, premenopausal women, with great tumour burden and widely disseminated tumor. We report 54-year-old woman with diabetes insipidus caused by solitary breast carcinoma metastasis, eight years after primary tumour was diagnosed. The operative and radiation therapy were effective. PMID- 1788620 TI - [Diagnosis of ureteral duplication associated with complications]. AB - In three patients (mean age about 3 years) we established excretory tract duplication with obstructed ectopic ureter, a function of the upper pole and ectopic ureterocele. Diagnostic procedure was different in each case. Ultrasonography was the most important diagnostic method in all cases; it usually showed all main morphological details, regardless of functional ability of the kidney. To complete diagnosis, we used additional methods: antegrade pyelography and percutaneous nephrotomy. Excretory urography and voiding cystography gave only indirect signs of a functional part of duplicated excretory tract. The methods we used were complementary and they should rationally be combined in order to complete the diagnosis of ureteral duplication with complications. PMID- 1788621 TI - [Various quantities of sunflower seed oil in the diet, long-term administration of hydrocortisone and liver tissue lipids in rats]. AB - The influence of different quantities of vegetable oil/sunflower oil/and the long term ingestion of hydrocortisone on the total lipid content of the liver in rats and cholesterol was studied. The rats were of Wistar strain, males, 2 months old at the beginning of the experiment. The sunflower oil comprised 5 g%/diet A/ and 20 g%/diet B/ in the diet of rats. Two groups of animals were on diet A or B and took as much water as required. Another two experimental groups were on similar diets A or B, with an additional ingestion of 0.5 mg/kg of hydrocortisone natrium succinate over the whole period of experiment. The experiment lasted 6 months. The study showed that the major participation of the sunflower oil/20 g%/ induced the increase of the total lipid content of the liver, with significant increase of cholesterol. Long-term ingestion of glucocorticosteroids/hydrocortisone natrium-succinate/induced the significant increase of the content of total lipids and cholesterol in the liver tissue in rats, independent of ingestion of sunflower oil in diet. PMID- 1788622 TI - [Intratracheal administration of adrenaline in the treatment of bronchospasm]. AB - The paper deals with a female patient in whom during induction of anesthesia acute obstruction of the lower parts of the respiratory tract caused by bronchospasm appeared. The bronchospasm was successfully treated and almost immediately relieved by intratracheal administration of adrenaline solution of 0.5 mg in 1 ml. It is concluded that intratracheal adrenaline is a highly efficient therapeutic agent in relieving bronchospasm. PMID- 1788623 TI - [Chlormethiazole in the treatment of complex partial epileptic status in childhood]. AB - The authors report on the results of clinical investigations, treatment and follow-up of a 9-year old boy with complex partial status epilepticus (CPSE) which occurred after the first onset of partial secondary generalized epileptic seizures. Electroencephalografic recordings during status epilepticus showed a diffuse, generalized, high-voltage delta dysfunction and bilateral epileptiform activity, with local maximum over the posterior right temporal parietal regions. Parenteral administration of diazepam, phenytoin and phenobarbitone as choice anticonvulsant drugs, failed to stop CPSE in the patient. Only by continuous intravenous infusion of chlormethiazole (Heminevrin) status epilepticus was successfully controlled. Paroxysmal discharges on electroencephalogram disappeared and attenuation of slow wave activity was evident. Memory deficits and the elements of nominal dysphasia and tactile dysgnosia were apparent soon after cessation of CPSE and may be related to the signs of maximal local electroencephalographic dysfunction. Later testings after complete seizure control by chlormethiazole and phenytoin given orally, showed almost normal results. No side effects were encountered. A more common chlormethiazole administration as a useful therapeutic agent in the management of CPSE especially in children with refractory and long-time status, would be mandatory. Since chlormethiazole is free from serious side effects, its earlier use in the control of epileptic status may help to preclude some severe cognitive effects and to evade the use of barbiturate anesthesia as the last therapeutic resort. PMID- 1788624 TI - [Comparative study of nutritional status of school-age children fed at home and in schools]. AB - Comparative study of the nutritional status of schoolchildren fed at home and in schools is a part of a broader study conducted in primary schools in Belgrade which comprised 1083 children, aged 7-11. The aim of investigation was to determine whether the nutritional status of children fed at home was different from the nutritional status of those fed in schools, and to determine the reasons of possible differences. The investigation concerned 756 children. The nutritional status of children was assessed by anthropometric measures (BH,BW,AC,AMC,ST,RBW,BMI)% of fat), haemoglobin concentration in the serum and the value of blood pressure. The quality of nutrition in each child was assessed by a questionnaire and his/her daily energy expenditure calculated on the basis of individual daily physical activities. Other date have also been taken into consideration (economical status of a family, education in nutrition and in general, etc.). Results show that nutrition in schools is not adjusted to RDA and that children fed in schools are worse nourished, in lesser percent obese and have lower level of BP than the coevals fed only at home. The differences are visible and statistically significant among the oldest in this age group. They are the result of differences in the individual whole day nutrition and several other factors which have been taken into account. PMID- 1788625 TI - [Venous insufficiency following lack of a healthy superficial femoral vein and popliteal vein]. AB - Using the superficial femoral yein in ultimate arterial reconstructive surgery we have not found distinct signs of venous insufficiency concerning the clinical status, the strain gauge plethysmography and the measurement of limb circumference. For special indications the use of the superficial femoral vein presents a valuable addition to our armamentarium of arterial substitutes. PMID- 1788626 TI - [Indications for stent implantation in stenoses of the pelvic veins: early results]. PMID- 1788627 TI - [Results of endoscopic perforant vein dissection]. AB - A new endoscopic technique allows insufficient perforating veins to be sectioned under direct visual control with minimal trauma. The endoscopical sectioning of perforating veins was performed on 61 patients in 86 legs. Perforating veins have most frequently been separated in the area of the Cockett group (185), the 24-cm perforating vein (74), and the Boyd group (63). Two patients showed disturbances of wound healing after the operation. By a follow-up examination 2 years postoperatively, insufficient perforating veins were not found in any of the 86 legs operated on. New varices were seen in six legs. With respect to a staging of chronic venous insufficiency, it can be said that in 90% of cases a more favorable stage or complete healing is reached. PMID- 1788628 TI - [Surgical treatment of anastomotic valve insufficiency in predominantly lower leg, main branch and side branch varicose veins of the great saphenous vein]. PMID- 1788629 TI - [Therapy and the natural course of axillary vein thrombosis--review of 765 patients and analysis of our personal patient sample]. AB - Thrombosis of the axillary vein is a rare event. The incidence of 0.5, -1.5% of all venous thromboses makes comparative studies concerning therapy in a single center impossible. 15 own patients and 750 patients with axillary vein thrombosis collected from literature were studied, to compare the different therapeutic modalities. 36% received no therapy (NV), 15% anticoagulation (AG: heparin, warfarin, coumarins), 18% thrombolytic therapy (TL streptokinase, urokinase, locally and systemic) and 31% were treated by surgery (OP). Mean follow up was 32 months in NV, AG: 16, 3, TL: 35, OP: 38 months. RESULTS: NV; No complaints: 12%, PTS I: 29%, PTS II: 25%, PTS III: 33%. CONCLUSION: Untreated axillary vein thrombosis leads to functional disability of the affected extremity in one third. AG reduces this rate to 25%. After surgery and thrombolytic therapy a severe PTS is found only in 12% and 13.7% respectively. Loss of extremity was found in 5 cases (0.6%). A mechanic factor seems to be important in thrombogenesis. Rapid restitution of venous backflow and promotion of collateralisation is important to avoid disability of the patient. The low difference between AG and OP is pointed out indicating that invasive surgery should be restricted to special cases. PMID- 1788630 TI - [Laser sclerosing of intracutaneous varicose veins]. AB - 87 patients with intracutaneous varicosities underwent a percutaneous Neodym-YAG laser therapy. The results of 72 of them were satisfactory. Only in 2 cases complications (Hyperpigmentation, scarification) were found. The laser seems to be an additional tool in the therapy of varicosities, so small calibrated, that intravasal drug application seems to be impossible. PMID- 1788631 TI - [Therapy of varicose veins. Duplex sonography as a decision aid]. AB - Venous aneurysms are rare, but they can be source of pulmonary embolism. In two cases of venous aneurysm of lower extremity we show, that duplex ultrasound is usefull in diagnosis of venous aneurysms and in finding of the best therapy. PMID- 1788632 TI - [Pudendal varicose veins]. PMID- 1788633 TI - Treatment of the venous insufficiency of the lower limbs by vein valve transplantation. PMID- 1788634 TI - [Peripheral local lysis and compression treatment in patients with post thrombotic syndrome--alternative to operation?!]. PMID- 1788635 TI - [Ultra-high dosage lysis of deep venous thrombosis in ipsipedal administration along with compression]. AB - The ipsipedal application of UHSK leads to a decisive increase of recanalisation. The fibrinolyticum will be brought in a greater quantity to the thrombotic region. The adjuvant supramalleolar compression and the increase of volume seems to be beneficial. The promising results of thrombolysis at elder thrombosis justify a late fibrinolysis, which is profitable too, for patients with early postoperative thrombosis at the end of the first wound healing phase. PMID- 1788636 TI - [Results of the North-Baden venous lysis study. Randomized trial of the effect of ultra-high streptokinase versus conventional streptokinase dosage]. AB - We compared the effect between ultra-high-streptoinase therapy and standard fibrinolysis in a prospective randomized multicenter study of deep vein thrombosis. Ultra-high doses group seems to be a better treatment including decreasing the side-effects, but without showing statistical significance. PMID- 1788637 TI - [Incidence of post-thrombotic syndrome following systemic fibrinolysis of deep venous thrombosis]. PMID- 1788638 TI - [Clinical and functional late results following acute pelvic/leg vein thrombosis in relation to method of treatment]. PMID- 1788639 TI - [Locoregional ultrahigh dosage fibrinolysis of deep leg vein thrombosis]. AB - The ultrahigh locoregional fibrinolysis in extracorporal circulation with the Heart-lung-machine allows fibrinolysis in cases of contraindicated systemic fibrinolysis. The early results are promising. PMID- 1788640 TI - [Low dosage fibrinolytic therapy with r-TPA in thromboses of the deep venous system]. PMID- 1788641 TI - [Short-term thrombolytic therapy in pulmonary artery embolism with rt-PA]. PMID- 1788642 TI - [Effectiveness and tolerance of rt-Pa for local lytic therapy of 53 embolic and thrombotic occlusions of the lower extremity]. PMID- 1788643 TI - [Ultra-high systemic lysis in occlusions of the aorta and iliac artery in 14 patients]. PMID- 1788644 TI - [Intra-arterial thrombolysis using rt-PA in peripheral arterial occlusions]]. PMID- 1788645 TI - [Local low dosage thrombolysis with rt-PA. Systemic effects on the fibrinolytic system--data on the assessment of the value and risk of this method]. AB - We investigated 70 patients suffering from peripheral vascular disease for alterations in fibrinolytic parameters before, during and twice after local, low dose thrombolysis with rt-PA (1 - 7.5 mg). Recanalization was achieved in all 10 embolic occlusions and in 87% of 60 thrombotic occlusions. We found no alterations of fibrinogen and plasminogen plasma levels, but significant consumption of antiplasmin 5 min after the end of rt-PA application. Degradation products of fibrinogen and fibrin showed a parallel increase only during the therapy. PAI I concentrations significantly increased until the 2nd day after the therapy. Since we limited the maximum dose of rt-PA to 7.5 mg we never saw systemic bleeding or embolisation in more than 300 cases. PMID- 1788646 TI - [In vitro balloon treatment of coronary plaque material of the human: effect of dilation time on proliferation of smooth muscle cells]. AB - The proliferation of smooth muscle cells (SMC) seems to be an important factor in the development of restenosing events after angioplasty. Primary stenosing plaque material was obtained from human coronary arteries by thrombendarterectomy. Specimens were cut in small pieces and dilated in a flexible tube with a balloon catheter (Medtronic 18K2030E) for 1 min., 5 min. and 10 min. at 3 atm. For the isolation of plaque cells the expant technique was used. The majority of plaque cells was identified as smooth muscle cells by positive reaction with monoclonal antibodies against smooth muscle alpha-actin. For the cultivation of SMC a mixture of Waymouth's MB 752/1 and Ham F-12 (1:1) was used. After 8 weeks cell number was analysed by a cell counter (Casy I, Scharfe System). There was a clear increase of SMC-proliferation in dependence to the duration of angioplasty (1 min. = 100%, 5 min. = 112%, 10 min. = 153%). If these data are confirmed by clinical and experimental studies, the duration of angioplasty has to be considered as a risc factor for the development of restenosis. PMID- 1788647 TI - [Proliferation and migration behavior of coronary primary stenosis cells in the transfilter culture system]. AB - With enzymatically isolated smooth muscle cells from primary stenosing lesions cultured in a transfilterculturesystem it is possible to examine multiple steps (e.g. migration and proliferation) involved in the development of restenosing lesions at the same time. By using human atherosclerotic plaque material the clinical relevance of experiments might be improved. PMID- 1788648 TI - [The transfilter culture system as a model for the study of proliferation and migration of smooth muscle cells of the rabbit and human]. AB - By cultivating smooth muscle cells, isolated from media-pieces of rabbit and human aorta, on microporous filter membranes (transfilter-culture-system), it is possible to examine proliferation and migration of smooth muscle cells at the same time. After addition of Epinephrine to the cultures, an increase in proliferation and migration was observed. PMID- 1788649 TI - [The migration behavior of human vascular myocytes in culture--the screening potential of anti-arteriosclerosis active endogenous and exogenous substances]. AB - Besides proliferation, migration of smooth muscle cells (SMC) is considered to be an essential cellular mechanism involved in plaque formation. Human SMCs were cultured from 14 arteriosclerotic lesions of coronary (n = 5), femoral (n = 7) and aortic (n = 2) arteries. By a semi-automatic standardized video analysis system SMC migratory activity was quantified to be 21.7 +/- 2.1 microns/h (n = 14; x +/- SD). Addition of drugs, such as calcium antagonists (10(-5) - 10(-7) M), heparin (100 micrograms/ml), SIN-1 (10(-5) M) and colchicine (10(-7) M) resulted in a significant decrease of SMC migratory velocity. Exposure to endogenous extracellular matrix proteins (5 micrograms/cm2) showed no effect for collagen I and a significant reduction of SMC migratory activity for fibronectin, respectively. Our results indicate SMC migratory velocity to be a parameter of potential interest to screen various substances for an anti-arteriosclerotic effect. PMID- 1788650 TI - [Ultrastructural and proliferation studies of human, catheter atherectomy extracted plaque material]. AB - Atherectomy with a Simpson catheter enables a detailed characterization of percutaneously removed human atheromatous plaque material. Cell biological investigations (flow-cytometric analyses, cell type-specific antibodies, immunohistological labelling methods of selected extracellular matrix proteins) are aimed at a comparative characterization of excised material from primary lesions and restenoses to yield further insight into the mechanisms of plaque formation. First results on 17 specimens would like to contribute to a better understanding of the structure and composition of the extracellular matrix and their interaction with cells in atherosclerotic plaques. PMID- 1788651 TI - [Changes in the ultrasound power spectrum due to concentric stenoses of the femoral artery of the dog]. AB - An artificial stenosis model consisting of a revolving centric cylinder with six boreholes (10-60% diameter reduction) was implanted in the superficial femoral artery of anaesthezised beagles (n = 10). Range gated pulsed Doppler signals were recorded at 7 sites between three diameters upstream to ten diameters downstream the Angle corrected parameters derived from the contour of spectral lines between 3 and 21dB on both sides of mode frequency were calculated for different time windows. Two groups of dogs could be distinguished. Group A showed marked downstream power spectrum changes which did not correlate to the degree of stenosis. In Group B, in contrast, the degree of power spectral disturbances correlated to the degree of stenosis. It was suggested that partial thrombosis of the stenoses during measurement provides an acceptable explanation for the missing correlation in Group A. PMID- 1788652 TI - [Behavior of arterial vascular contractility in the course of structural vascular changes during a cholesterol diet]. PMID- 1788653 TI - [Long-term correlations of selected trace elements and lipid parameters in arteriosclerosis obliterans]. PMID- 1788654 TI - [Serum endothelin in patients with Raynaud syndrome before and following cold provocation]. AB - To determine wether there is a pathogenetic effect of endothelin (ET) in vasoconstriction in Raynaud's phenomenon, plasma-endothelin and it's association to extent of vasoconstriction was measured before and after digital cooling. Only in cases with massive vasoconstriction ET rose significantly after cooling. In conclusion ET seems to be involved in the pathogenesis of RS, whereas the exact pathomechanism remains unclear. PMID- 1788655 TI - [Value of epidural neurostimulation in treatment of stage III and IV peripheral arterial occlusive disease]. PMID- 1788656 TI - [Measuring regional blood flow in evaluating CT-controlled lumbar sympathetic neurolysis in arterial occlusive disease]. AB - A prospective study was designed to evaluate the effect of CT-guided lumbar sympathectomy in PAOD using the following investigations: 1: laser flowmetry, 2. thermography, 3. plethysmography, 4. thallium scintigraphy. A significant improvement of perfusion was shown. The results of thallium scintigraphy disproved the often claimed steal effect of the muscle perfusion in favor of an increased skin perfusion. 80% of the treated patients experienced relief of their pain. Chemical sympathectomy proved to be as effective as the surgical procedure. PMID- 1788657 TI - [Vascular-induced organic mental disorders in the aged. Long-term therapy with pentoxifylline and psychological training]. PMID- 1788658 TI - [Bacterial colonization and antibiotic therapy of mal perforant]. PMID- 1788659 TI - [Increased acral macro- and microcirculation in functional acral vascular disorders of the upper extremities caused by CO2 forearm baths. Results of a comparison with fresh water]. PMID- 1788660 TI - [Effect of subcutaneous administration of lactobionic acid on coagulation and platelet function]. PMID- 1788661 TI - [Can a reduction of graft failures be achieved by monitoring the femoro-crural bypass using color duplex]. PMID- 1788662 TI - [Therapeutic success in refractory ulcers of the lower extremity in intensive prostavasin therapy]. PMID- 1788663 TI - [The Essen walking training model]. AB - Patients suffering from intermittant claudiation should be treated mainly by walking. Following the example of Weidinger and Bachl, who established in Vienna 1981 for these patients walking groups, we also started with this treatment in Essen. Since 1988 117 patients, 68 men and 49 women took part regularly at least 3 months in one of the walking groups. Only 9% of the patients could not improve their walking distance. PMID- 1788664 TI - [Effect of a 2-year ambulatory vascular sports program on walking distance in claudication patients--a controlled study]. PMID- 1788665 TI - [Walking training as basic therapy of stage II peripheral arterial occlusive disease--success despite advanced age and concomitant diseases]. AB - 64 patients (60 to 83 years old) with intermittent claudication underwent a six months lasting supervised exercise walk training. Most of them suffered from concomitant disease impairing walking performance or just weakness by age. Walking distance was measured in the beginning and after 3 and 6 months. We found an improvement in walking distance in all groups (60-64 years: 273%; 75-83 years: 196.6%) So we recommend to apply walk training to a much more patients even with concomitant disease are of old age. PMID- 1788666 TI - [What is the progress in angiology with calcitonin (CT) and calcitonin-gene related peptide (CGRP)? Relations to vascular tonus?]. PMID- 1788667 TI - [Pulsed color laser: initial experiences with vascular recanalization in patients with peripheral arterial occlusive diseases and in patients with obstructions of the dialysis shunt]. PMID- 1788668 TI - [What is the status of laser angioplasty in the total angiologic-vascular surgery concept?]. PMID- 1788669 TI - [Experiences with color-coded duplex sonography in the diagnosis of extracranial vascular changes]. AB - 72 Patients with occurred transitory ischemie attacks and passed reversible neurologie deficits were duplexsonographically diagnosed. After wards a renewed duplexsonographic investigation with color coding followed in all patients. The patients were angiographically diagnosed within two weeks. As a result in three of ten patients with an unobtrusive angiogramm plaques formations were proved by means of the color codes duplexsonography. PMID- 1788670 TI - [The value of color duplex for sonography of the vertebral artery]. AB - The prognosis of patients with carotid artery disease in combination with symptoms of vertebrobasilar TIA is worse than that of patients with single carotid territory transient ischemic attacks. We investigated 30 patients with stenosis or occlusion of the carotid arteries into two groups. All patients underwent color duplex imaging of the vertebral artery between the transverse processes of the cervical spine (pars costotransversaria). Diameter, systolic and diastolic velocities were measured. Nearly all patients with clinical signs of vertebrobasilar TIA showed a stenosis or a hypoplasia of vertebral artery in addition to carotid artery disease. PMID- 1788671 TI - [Color duplex--control sonography in laser angioplasty]. PMID- 1788672 TI - [The ultrasound image of cystic adventitia degeneration]. PMID- 1788673 TI - [Color-coded duplex sonography of lower leg arteries--imaging for classification of Fontaine stages]. PMID- 1788674 TI - [Contribution of duplex sonography to prediction of pressure drop across iliac artery stenoses]. AB - The present study investigates the validity and accuracy of the simplified Bernoulli equation in the duplex-derived determination of pressure gradients across iliac artery stenoses. Twenty eight patients presenting with iliac artery stenoses could be examined by both duplex and intraarterial catheter pressure measurements. The correlations between mean and maximal-instantaneous pressure gradients assessed by both methods were r = .77 and r = .79, respectively. Duplex scan can be used to predict pressure gradients in patients with iliac artery stenoses. PMID- 1788675 TI - [Diagnostic procedure in threatened dialysis shunt failure]. PMID- 1788676 TI - [Does duplex sonography have value in diagnosis of post-thrombotic syndrome?]. PMID- 1788677 TI - [Conservative therapy of chronic venous insufficiency. The extent of the edema preventive effect of horse chestnut seed extract]. PMID- 1788678 TI - [Kinetic effect characterization of 0-beta-hydroxyethylrutoside (Venoruton) in healthy probands]. PMID- 1788679 TI - [The European 1992 norm: single or dual stretch compression stockings?]. PMID- 1788680 TI - [Vascular problems in transplantation: perioperative problems in kidney transplantation]. PMID- 1788681 TI - [Prevention of thrombosis with anti-thrombosis stockings and intermittent compression]. PMID- 1788682 TI - [Pressure of the compression stocking--gradient and fatal "strangulation"]. PMID- 1788683 TI - [Leg vein hemodynamics in patients with venous diseases before and following treatment in a carbon dioxide mineral thermal exercise bath]. PMID- 1788684 TI - [Effect of several weeks of functional venous training in venous insufficiency: results of a controlled study]. PMID- 1788685 TI - [Effects of hetero-thermal water administration on leg vein hemodynamics, skin microcirculation and O2 tension in chronic venous insufficiency]. PMID- 1788686 TI - [Acute effects of special water gymnastics on the venous system of patients with chronic venous insufficiency]. PMID- 1788687 TI - [Prospective 5-year follow-up study of hemodynamic and clinical parameters following deep leg/pelvic vein thrombosis]. PMID- 1788688 TI - [Mobilization following deep venous thrombosis of the leg]. AB - A simple score for mobilisation of patients with deep venous thrombosis of the leg is proposed. By this score the significantly earlier mobilisation of patients with deep venous thrombosis is possible without risk. PMID- 1788689 TI - [When can a patient with multi-level thrombosis following administration of anticoagulant therapy be mobilized again]. PMID- 1788690 TI - [Life threatening aortobronchial fistula as a late complication following surgical correction of aortic isthmus stenosis]. AB - An aortobronchial fistula is a rare cause of hemoptysis and most commonly occurs in patients with thoracic aneurysms. If undiagnosed, this entity is uniformly fatal. However, with early recognition and surgery, the survival rate exceeds 80%. We present history and outcome of 3 patients with fistulas due to previous surgery of coarctation of the aorta and discuss the value of different diagnostic procedures. PMID- 1788691 TI - [Primary and secondary aorto-intestinal fistula in infrarenal aortic replacement]. AB - During the past 20 years 17 patients with abdominal-aortic-intestinal fistulas have been operated in our department. Hospital-letality accounted till 1986 with 75%. Since then we preferred direct reconstruction by implantation of a vascular graft, covered by omentum in primary fistulas. Hospital letality could be reduced by this management to 0% in primary fistulas by a total survival rate of 67%. PMID- 1788692 TI - [Critical ischemia of the lower leg caused by aneurysm of the popliteal artery]. PMID- 1788693 TI - [Problems and results of treatment of vascular injuries--a 20-year analysis]. AB - From 1.1.1971 until 31.12.1990 we observed and provided 331 patients with 344 acute injuries of arteries. Reasons was iatrogenic and traumatic injuries. In 94% of iatrogenic injuries and in 67.7% of traumatic injuries a full restitutio could be achieved. In 11.9% the extremity was saved with a resting functional deficit, in 11.9% an amputation was required, 9.5% hat a letal outcome. PMID- 1788694 TI - [The role of diabetes mellitus as a risk factor in peripheral arterial occlusive disease]. PMID- 1788695 TI - [Location and morphology of plaque of the carotid artery and femoral artery in the B-scan image in employees of the Dusseldorf public officials: value of screening study]. AB - With the help of high-resolution real-time sonography, we examined the carotid and femoral arteries in 3,500 asymptomatic persons to assess early states of atherosclerosis an to prove the utility of B-Scan-Sonography in this aim. We found 384 people having plaques, totally 769 pl. 68 p.c. of all plaques we were found in the femoral arteries, 32 p.c. in the carotid arteries, in each case with preference of the bifurcation and the pre-bifurcation-region. This seems to confirm earlier studies on this theme. As regards to the morphology, we found 67 p.c. (of all plaques) being faintly-echogenic ("fatty-streaks" or intermediar type). 73 p.c. of all plaques showed a smooth or faintly irregular surface character. More than 75% of all plaques had a volume less than 0.3 ccm. Altogether, the results verify the assessment of mostly early states of atherosclerosis with the help of real-time-ultrasound and underline this method being a good and sufficient non-invasive-technique for screening-examinations on an asymptomatic collective. PMID- 1788696 TI - [Arteriosclerosis vascular changes as an expression of the local effect of mechanical continuous stress--observations of the femoral artery of marathon runners]. AB - The arteries of the thigh of 126 male marathon runners at the age of 41.6 +/- 11.3 years were examined with B-Scan-ultrasound. 32 (62.1%) persons were found with arteriosclerotical plaques. All of them were older than 35 years, so the number of arteriosclerosis in this group increases to 36.4 percent (n = 88). 38 persons were younger than 35 years. Persons with plaques started training about 10.9 years later than those without plaques. Correlations of plaques and age, age of starting training, years of training and km/year were found. The numbers of riskfactors showed significant differences between both groups but the correlation of "having no risk factor" and arteriosclerotical plaques was higher than the correlations of nicotine, hypertension, hypercholesterolemia and plaques. It seems that marathon running itself is a risk factor of developing arteriosclerotical plaques in the femoral arteries particularly if the age of starting training is higher than 30 years. PMID- 1788697 TI - [Angiologic screening in a rehabilitation center for diabetes]. PMID- 1788698 TI - [Early detection and incidence of peripheral arterial occlusive disease in general practice]. PMID- 1788699 TI - [Prevention of arterial and venous vascular diseases, especially the correlation between risk factors and arteriosclerosis]. AB - In a epidemiological study 3840 clerks of state of North Rhein Westfalia were investigated concerning the frequency of atherosklerotic leasions of the carotid and femoral arteries in duplex scanning. 17% of all investigated showed independency to age, sex and risk factors alterations of the vessel walls. Men had twice as much plaques as women and male subjects with multiple risk factors had four times more plaques than those without. PMID- 1788700 TI - [Venous diseases and the population structure]. PMID- 1788701 TI - [Imaging real-time sonography (B-scan) of peripheral veins--possibilities for use with reference to secondary prevention]. AB - In 2400 male and 1400 female persons the proximal femoral and saphenal venous vessels have been monitored and measured with a Ultramark 4, build by ATL, by use of 7.5 megacycle/s. transducer. Moreover, we took the venous calibers at the junction of the saphenous veins into femoral veins. In patients with marked varices or less symptomatic patients as well as clinically asymptomatic persons with positive family history there could be found significantly bigger dilatation of vessel calibers in those patients laying than those standing up, in contrast to healthy persons. B-Scan ultrasound consequently in future offers a new range of diagnostic values in examination of venous vessels, that is to say a non invasive, reproducible and haemodynamically tolerable method which helps to improve secondary prevention. PMID- 1788702 TI - [Vital findings in capillary microscopy in collagen diseases]. AB - Microangiopathic changes in capillary architecture associated with collagen diseases can be visualized by vital capillary microscopy. In our study of 100 patients with collagen disease we found typical capillaroscopic images in 64%. Differentiation in subclasses showed the highest diagnostic value of this method in systemic sclerosis (77%) and rheumatoid arthritis (68%). It was lower in patients with Sharp- and CREST-syndrome (55%) and very low in systemic lupus erythematosus (33%). In summary, vital capillary microscopy is a valid method in non-invasive diagnostic of collagen diseases. PMID- 1788703 TI - [Duplex sonographic assessment of the hemodynamics of transplanted kidneys]. PMID- 1788704 TI - [Scopeman: flexible videomicroscopy--a simplified procedure for capillary microscopy? Method and initial experiences]. PMID- 1788705 TI - [Capillary microscopy controlled nail fold biopsy in the diagnosis of collagen disease and vasculitis]. AB - In cases of suspected microangiopathies morphologic abnormal capillaries were identified and marked by nailfold capillary microscopy (NCM). The marked nailfold areas were precisely biopsied and the biopsies were examined by electronic microscopy and light microscopy (HE and immune-histochemical). Histological findings well correlated with clinical and capillaroscopical findings. It is concluded that NCM-assisted nailfold biopsy helps to achieve histologic proof of microangiopathies and improves diagnostic accuracy in collagen vascular diseases and vasculitides. PMID- 1788706 TI - [Comparative studies of capillary microscopy and retinal changes in diabetic patients]. PMID- 1788707 TI - [Laser Doppler in angiology: clinical relevance or expensive game?]. AB - The analysis of 55 articles about the Laser-Doppler in Angiology with a total of 2425 patients and controls shows very promising results concerning the applicability in daily clinical medicine. However, to establish the method as a basic-test in angiology and vascular surgery, standardized procedures and provocation-tests should be developed in future prospective trials. PMID- 1788708 TI - [Transcutaneous O2 and CO2 measurement with different measuring temperatures of electrodes and brief complete ischemia]. PMID- 1788709 TI - [O2 inhalation and lowering leg position as a provocation test for transcutaneous measurement of partial oxygen pressure (tcpO2) in advanced peripheral arterial occlusive disease]. PMID- 1788710 TI - [Combined transcutaneous measurement of partial O2 and CO2 pressure as a diagnostic supplement in assessing the degree of severity of peripheral arterial occlusive disease]. PMID- 1788711 TI - [Studies of post-occlusion reactive hyperemia with a triple probe for video microscopy, laser Doppler flowmetry and transcutaneous oxygen measurement]. PMID- 1788712 TI - [Pattern of flow movement in healthy probands and patients with peripheral arterial occlusive disease]. PMID- 1788713 TI - [Reflection spectrophotometry determination of cutaneous hemoglobin saturation in patients arterial occlusive diseases]. AB - By a spectrophotometrical method, the oxygenation and relative concentration of hemoglobin in the skin of the forefoot was determined in 40 patients with advanced peripheral arterial occlusive disease. While the Hb-saturation at rest was hardly different from normals, leg elevation provoked a marked decrease of both parameters, especially in patients with critical ischemia. In these patients, reactive hyperemia was markedly delayed and impaired. External heat application failed to cause a hyperemic saturation increase in 14 patients and produced a decrease in 8 patients, 6 of whom experienced an infavourable clinical outcome. The method seems specially suited to assess states of severe ischemia. PMID- 1788714 TI - [Pressure measurement in lymph capillaries of the human skin]. PMID- 1788715 TI - [Paragangliomas of the carotid body--clinical problems and therapy]. AB - 24 carotid body tumors in 21 patients (1970-1990) have been analysed retrospectively. These well vascularized tumors are growing slowly in the carotid bifurcation and often cause failures in diagnostic and therapeutical approach. 66% (14) have been operated on partially 2-3 times with wrong diagnosis (cervical gland, lateral cervical cyst and others) in other hospitals. It is important to come to an early diagnosis by the typical trias according to Fontaine and Kocher by CT-scan and arteriography. The best method of operation is the so-called technique of transsection, which is also applicable in advanced tumor state (type II-III according to Linder). In tumors, which are beyond radical operability, good cosmetic and functional results can be achieved by partial resection. PMID- 1788716 TI - [Spontaneous renal artery dissection--a rare event (angiologic vascular surgery rarities)]. PMID- 1788717 TI - [Super-selective embolization--an alternative to surgery in acute diverticular hemorrhage]. AB - The embolisation (microspirales) of the diverticle-bleeding of the colon is an alternative treatment to the operative colon resection. Advantages for the most older patients are fewer complications and no risk of anaesthesia. An intensive surgical care after embolisatio is necessary to prevent peritonitis in the case of a colon perforation. The risk of an elective colon resection after embolisation if necessary is less than that of resection in cases of emergency. PMID- 1788718 TI - [Salmonella infected aneurysm of the superficial femoral artery--a rarity in angiologic vascular surgery]. PMID- 1788719 TI - [Case report: acute infrarenal aortic occlusion and leg vein thrombosis in heparin-induced thrombocytopenia]. AB - Heparinassociated thrombocytopenia has been reported for over 35 years. This reaction can result in serious thromboembolic complications. The primary mechanism responsible for this reaction is thought to be an immunologic process. The author reports a severe thrombocytopenia, acute thrombotic occlusion of the leg, acute aortal thrombosis, deep-vein thrombosis and pulmonary emboli occurred simultaneously in a 75-year-old woman within 11 days of starting a subcutaneous low-dose heparin prophylaxis. PMID- 1788720 TI - [Diagnosis of transplant renal artery stenosis]. PMID- 1788721 TI - [Traumatic arteriovenous fistula between the hepatic artery and portal vein]. PMID- 1788722 TI - [Contrast medium adverse effects in neuroradiologic studies]. PMID- 1788723 TI - [Determination of the length and site of the occlusion of extremity arteries- color duplex sonography versus angiography]. AB - The aim of the study was to determine the accuracy of colour--coded Doppler sonography (CDS) compared to angiography in detecting the localisation and length of an occlusion in peripheral arteries. 118 legs of 107 patients with clinical suspected occlusion were examined prospectively with CDS before angiography. In 110 cases both methods identify identical localisations. The sensitivity in detecting occlusions was 97%, the exact localisation was diagnosed by CDS in 95% with a high correlation (r = 0, 96) of length measurements. PMID- 1788724 TI - [Examination of peripheral arteries with intravascular ultrasound. The informative value and limits of the method in comparison with angiography]. PMID- 1788725 TI - [Intravascular ultrasound for support in percutaneous interventional treatment]. AB - The potential of intravascular ultrasound (IVUS) as an adjunct to angiography was investigated in 54 interventional procedures (13 venous lesions, 41 arterial lesions: stent placement in 31, atherectomy in 7, balloon dilation in 6, thrombectomy in 5, placement of vena cava filters in 3, foreign body retrieval in 2 cases). IVUS offered additional information to angiography in 30 cases; the therapeutic concept was changed because of IVUS findings in 18 cases. Severity of dissections or stenoses was more accurately depicted by IVUS compared to angiography. IVUS allowed an exact measurement of vessel diameter and a correct positioning of stents and caval filters. PMID- 1788726 TI - [Increasing value of the duplex scan in preoperative diagnosis of the carotid artery--is preoperative carotid angiography still sensible?]. AB - In effort to eliminate morbidity and costs, associated with arteriographic investigation, we increasingly perform Duplex Scan of the extracranial carotid artery prior to endarterectomy. 451 carotid reconstructions between 1986 and April 1991 were evaluated retrospectively. The percentage of patients undergoing carotid endarterectomy without angiography has increased from 21.1% to 92.8%. Angiography was associated with a combined neurologic morbidity rate of 3.0%. Perioperative outcome of patients and stratification by indication did not show any significant differences for both groups undergoing Duplex Scan alone and/or angiography. Diagnostic Carotid angiography should only be used selectively in patients showing distal internal carotid plaque, recurrent stenosis, symptomatic carotid occlusion or aortic arch disease. PMID- 1788727 TI - [Electronic data processing data bank for vascular surgery as a multiple site system with network connection]. AB - A clinical database, using FileMaker Pro and a network of APPLE Macintosh computers, were created for a vascular surgical unit. The databank presented here is based on proven, routine working procedures of the department. An easily learnable entry facility with hands-on, screen-oriented users' guide and help data file provide easy operability and highly efficient databank capability, along with great flexibility. This criterial and user-friendly features make staff acceptance and compliance readily achievable, thus assuring comprehensive data entry. PMID- 1788728 TI - [Introduction of a new image databank for duplex-/color duplex sonography with digital image processing using personal computers]. PMID- 1788729 TI - [D-SGP Duo--a new plethysmography for acral, arterial and venous blood pressure measurement]. AB - This is to present a new portable plethysmograph using modern microprocessor technology, a two-channel digital strain gauge plethysmograph (D-SGP Duo). This system contains two strain gauges and a pressure gauge and has measuring programmes for thrombosis screening (venous occlusion test) and for the acral blood pressure measurement. For the first time it is possible to determine not only the acral systolic arterial pressure but also the acral venous blood pressure. Examples of application are given. PMID- 1788730 TI - [Computer simulation of the dynamics of the arterial system for various cardiovascular situations]. AB - The simulation model describes the basic characteristics of the pulse in a wide range of arterial vessels. By comparison of simulated stenosis with photoplethysmographic registered curves of patients suffering from stenosis, it could be shown, that also pathologic hemodynamics can be adequately described. A new sight of dicrotic pulse generation was derived by the simulated removal of large arteries. This led to the hypothesis of decoupled, autonomous multiple reflections in the arteries of the arm, the leg and the head. PMID- 1788731 TI - [Computer-assisted pulse wave diagnosis--use and results in early diagnosis of arteriosclerotic vascular diseases]. AB - A method for computer-analysis of noninvasive pulse waves for diagnosis of angiologic disease is described. Quantitative analysis of pulse waves using new and significant criteria and allows early diagnosis of arteriosclerotic lesions. PMID- 1788732 TI - [Quantitative flow measurement of the art. dorsalis pedis in normal probands and patients with arterial occlusive disease of a low Fontaine stage]. AB - Quantitative blood flow measurements of the dorsal foot artery were performed with a multichannel digital pulsed Doppler device in normal volunteers and in patients with Fontaine IIa stage peripheral arterial occlusive disease. The measured parameters were: 1. vessel diameter, 2. maximum systolic flow volume, 3. minimum diastolic flow volume, 4. maximum systolic velocity, 5. minimum diastolic velocity. The calculated parameters were: pulsatility index, mean velocity and mean flow volume. Pulsatility index, maximum systolic flow volume and velocity were found to be reduced--although not statistically significant--in patients compared to volunteers. PMID- 1788733 TI - [What does 31 phosphorus magnetic resonance spectroscopy measure?A validation in healthy probands]. AB - With 31P nuclear magnetic resonance spectroscopy skeletal muscle metabolism can be measured noninvasively. Aim of this study was to investigate intraindividual reproducebility, interindividual variability, and the correlation of the NMR parameters PCr, alpha-, beta-, gamma-ATP to graded exercise. Reproducebility and variability of PCr values were comparabel to changes of the pH value. Alpha-, beta-, gamma-ATP did not change during measurements. Correlations between the workload and the changes of the NMR parameters were rare. It was found that the intraindividual reproducebility is low and the interindividual variability is high. No systematic correlation between the NMR parameters and the workload could be seen. The termination of exercise in healthy volunteers is not explained by energy depletion but due to other mechanisms. There is no evidence that 31P NMR spectroscopy presents remarkable advantages for clinical purposes compared to well established diagnostic methods. PMID- 1788734 TI - [The value of 31 P nuclear magnetic resonance spectroscopy in follow up of Fontaine stage IIb peripheral arterial occlusive disease]. AB - The method of nuclear magnetic resonance (NMR) spectroscopy compared to the parameters absolute-, pain-free walking distance and ankle/arm coefficient in Doppler pressure was used for observation of patients with peripheral arterial occlusive disease stage IIb according to Fontaine. While the classic parameters (walking distances, ankle/arm coefficient) described a homogenous group, NMR spectroscopy parameters showed marked inter- and intraindividual variations during exercise. Further studies on high magnetic power fields, exercise patterns and muscle recreation analysis have to be carried out to develop a reliable system of non invasive muscle energy monitoring in vascular diseases. PMID- 1788735 TI - [Significance of quantitatively recorded spectral width in diagnosis of stenoses with less than 60% reduction in vascular diameter]. PMID- 1788736 TI - [Site resolution study of venous outflow velocity and capacity by imaging plethysmography systems]. AB - Two imaging systems designed for plethysmography purposes are used to investigate venous capacity as well as maximum venous outflow. A series of pictures of the extremity are taken during a subsystolic blood obstruction. As a result, capacity as well as maximum outflow can be plotted as locally resolved profiles alongside the axis of the extremity. The advantage of the new method compared to conventional plethysmography is discussed. PMID- 1788737 TI - [Computer-assisted evaluation of the compressive force of antithrombosis stockings]. PMID- 1788738 TI - [Objective assessment of the risk of edema in patients with venous diseases and healthy vein probands using optoelectronic volumetry]. AB - The optoelectronic volumetry is a simple, good reproducable and effective method for measuring leg oedemas in patients with chronic venous insufficiency (CVI). Even in persons without CVI there is a significant increase of lower leg volume from the morning to the afternoon with mean increase of 51.1 ml (1.63%). These increases were not sex related, a five minutes rest played no significant part in volume increase. In patients with chronic venous insufficiency the volume increase from morning to the afternoon is very much higher (158 ml +/- 54 ml = 4.5 +/- 1.5%). Three days measurements showed an intraindividual variation of volume increase of about 20 ml (0.6% of the absolute leg volume). PMID- 1788739 TI - [Arterial occlusive disease and cerebrovascular insufficiency]. PMID- 1788740 TI - [Atherosclerotic vascular changes of the carotid bifurcation in patients with coronary heart disease]. PMID- 1788741 TI - [Detection of silent ischemia for better assessment of the coronary risk profile in patients with peripheral arterial occlusive disease]. PMID- 1788742 TI - [Coronary vasculopathy--a limiting factor following successful heart transplantation]. PMID- 1788743 TI - [Silent myocardial ischemia and arrhythmia in patients with stage II-IV arterial occlusive disease]. AB - Holter-monitoring offers a possibility to detect asymptomatic coronary-heart disease-patients, suffering from peripher-arteric-occlusion stadium II-IV, and introduce them to effective medication. It became evident, that about 30% of all patients with unknown coronary-heart-disease, even as patients who were therapied against coronary-heart-disease, have had silent myocard ischemia. PMID- 1788744 TI - [Incidence of potential hemorrhagic sites of the upper gastrointestinal tract in patients with acute vascular occlusion and indications for systemic fibrinolytic therapy]. PMID- 1788745 TI - [Venous insufficiency in patients with progressive systemic scleroderma]. PMID- 1788746 TI - [Pharmacologic concepts for clinical use of prostaglandin E1]. AB - This presentation reviews pharmacological properties of PGE1 which may be relevant for its clinical use to treat peripheral arterial occlusive diseases. These include inhibition of receptor-mediated stimulation of human PMN and platelets which is caused via cAMP as intracellular second messenger. Further actions are an endothelium-independent vessel relaxation and a yet poorly defined "cytoprotective" action, i.e. an improved organ and tissue preservation without direct relation to cell metabolism or blood flow. Recent evidence suggests that these biological effects of PGE1 may also include one of its metabolite, i.e. PGE0. Details about the biological activities of this compound in comparison to PGE1 will be presented separately at this meeting. It is concluded that the beneficial effects of PGE1 in treatment of peripheral arterial occlusive disease are a multifactorial event and might involve PGE0, in particular at intravenous administration of high doses. PMID- 1788747 TI - [The pharmacology of 13,14-dihydro-PGE1 in comparison with PGE1]. AB - This study investigates the effects of 13,14-Dihydro-PGE1 (PGE0) in comparison to PGE1 on human platelets, human polymorphonuclear granulocytes (PMN) and a number of vessel preparations of different species. The potency of PGE0 in inhibition of platelet and neutrophil activation is similar to PGE1. The vascular action differs. At a comparable molar potency, PGE0 showed stronger contractile and less relaxing effects than PGE1. The biological activities of PGE0 may contribute to the in vivo effects of PGE1 in treatment of peripheral arterial occlusive disease, in particular at high-dose i.v. administration. PMID- 1788748 TI - [Pilot study of the effect of intravenous prostavasin therapy of inpatients with diabetes mellitus and IIb arterial occlusive disease]. PMID- 1788749 TI - [Effect of intra-arterial and intravenous PGE1 infusions on transcutaneous oxygen pressure in patients with critical ischemia of the extremities]. AB - In a randomized cross-over study 20 patients with peripheral arterial occlusive disease stage IV according to Fontaine received one i.a. infusion of 10 micrograms PGE1 in 25 ml saline over 30 min and one i.v. infusion of 40 micrograms PGE1 in 125 ml saline over 60 min. Transcutaneous PO2 was measured continuously (44 degrees C) on the forefoot and dorsum of the foot of the affected leg as well as on the forefoot of the contralateral limb. During i.a. infusion tcPO2 decreased by 73% on the forefoot combined with pain in the infused leg in 8 patients, whereas i.v. infusion induced a 83.1% increase in tcPO2. All in all i.v. PGE1 infusion resulted in a more pronounced increase of tcPO2 without causing side effects. PMID- 1788750 TI - [Placebo controlled study of the effect of intravenous PGE1 on macro- and microcirculation in patients with stage III/IV arterial occlusive disease]. AB - In a randomized double-blind study i.v. PGE1 (60 mcg) leads to a significant increase of femoral blood flow, of tcPO2 and skin temperature. This effect lasts for more than one hour after infusion. Besides a slight decrease of blood pressure no severe side effects could be confirmed. PMID- 1788751 TI - [Double-blind study of the effect of various intra-arterial/intravenous prostaglandin E1 doses on hemodynamics and prostaglandin E1 metabolites]. PMID- 1788752 TI - [Risk-benefit analysis of intra-arterial and intravenous PGE1 infusions in peripheral arterial occlusive disorders]. AB - On the basis of pharmacological and clinical studies this review describes the effects of prostaglandin E1 (PGE1) on the cardiopulmonary system and its profile of adverse reactions taking into account spontaneous reports of side effects. All in all no increased risk of cardiovascular adverse reactions was obvious. PGE1 rather showed some desirable effects on heart and lung. Thus the analysis revealed a positive risk benefit relation for PGE1, provided that dosage and contra-indications are not neglected. PMID- 1788753 TI - [Randomized study comparing the clinical effectiveness of intravenous prostaglandin E1 and intravenous pentoxifylline in patients with Fontaine stage IIb arterial occlusive disease]. PMID- 1788754 TI - [Controlled vascular training in IIb peripheral arterial occlusive disease: additive effect of intravenous PGE1 versus intravenous pentoxifylline during training]. AB - An intensive 4-week vascular training (patients with PAOD IIb) leads to an effective amelioration of painfree walking distance (+120%). Additive i.v. Pentoxifylline was not more effective (+105%) whereas PGE1 showed a remarkable increase (+605%). After one year the results in all groups diminished: training group: +30%, Pentoxifylline group: +30%, PGE1 group: +149%. PMID- 1788755 TI - [Experiences with adjuvant prostaglandin therapy in vascular surgery interventions]. AB - Two prospective randomized trials were referred. In the first study 50 patients with femorotibial greater saphenous vein in situ bypasses were treated intraarterially with 0.2 ng PGE 1/kg body weight/min and 15,000 i.U. of heparine continuously. The control group of 50 patients also got 15,000 i.U. of heparine and 3 x 0.5 g of Aspirin. We observed 2 (4%) immediate occlusions in the PGE 1 group and 7 (14%) immediate occlusions in the control group. This difference proved to be statistically significant. In the second study 83 patients with three level occlusions (ilio-femoro-tibial) in stage III and IV were treated with a profundaplasty. 42 patients received 60 micrograms PGE 1 in 250 ml saline twice daily. The control group of 41 patients only got twice 250 ml saline over a period of three weeks. In the PGE 1 group 26 patients (61%) showed disappearance of rest pain and healing of necrotic lesions, whereas in the control group this could only be achieved in 15 patients (35%). The difference proved to be statistically significant. PMID- 1788756 TI - [Indications for active varicose vein therapy]. PMID- 1788757 TI - [Minisurgery of varicose veins]. PMID- 1788758 TI - [Para-tibial fasciotomy in treatment of chronic venous stasis syndrome]. PMID- 1788759 TI - Valvuloplasty in chronic venous insufficiency: a worthwhile procedure? PMID- 1788760 TI - [Endothelial protection]. PMID- 1788761 TI - [Atheromatous carotid artery changes in familial hypercholesterolemia before and following therapy]. PMID- 1788762 TI - [Approaches to preventive modification of hyperinsulinemia]. PMID- 1788763 TI - [Prevention of bypass occlusion]. PMID- 1788764 TI - [Duplex procedure in prevention of arteriosclerosis]. AB - Early atherosclerosis can be easily dedected in arteries accessable to ultrasound. The main localisations are the carotid and femoral arteries, which can be deseased alone or together. The progression seems to be higher in the femoral vessels. There is the impression that the growth can be influenced by drugs which lower blood cholesterol or are partial inhibitors of serotonin receptors (S 2). PMID- 1788765 TI - [Diagnosis and therapy of acute arterial occlusion of the extracranial cerebral arteries]. PMID- 1788766 TI - [Acute peripheral ischemia]. PMID- 1788767 TI - Shunting is the key to the management of complex lower limb vascular injuries. PMID- 1788768 TI - [Problems in diagnosis and therapy of thrombotic venous diseases]. AB - The sudden occlusion of a vein by thrombosis almost always leads to irreversible damage or loss of function unless early diagnosis, proper primary care, and rapidly initiated surgical or medical treatment succeed in preserving the organ and reestablishing function. There are many uncertainities concerning the optimal way of treatment in preserving the venous valves essential for the venous function but it seems clear that only emergency approach and immediate treatment can be the right way reducing the amount of emerging postthrombotic syndromes and acute and chronic pulmonary disease after dvt. PMID- 1788769 TI - [Syndrome X]. PMID- 1788770 TI - Substances with vasoactive effects mediated by the prostaglandin system. PMID- 1788771 TI - [Drug interactions with oral anticoagulants]. PMID- 1788772 TI - [New methods for detection of interaction of drugs acting on blood coagulation and blood platelets]. PMID- 1788773 TI - [Hemodynamics of the lower extremity following kidney transplantation]. PMID- 1788774 TI - [Use of duplex sonography in kidney transplant patients]. PMID- 1788775 TI - [Vascular surgery problems in kidney transplantation]. PMID- 1788776 TI - [Arterial complications following kidney transplantation--etiology, therapy, results]. PMID- 1788777 TI - [The diagnostic value of quantitative Doppler ultrasound signal analysis in diagnosis of postoperative organ dysfunction following orthotopic liver transplantation]. AB - As hepatic transplantation becomes more successful, there is increasing demand on noninvasive methods for studying graft dysfunction during the postoperative period. Duplexsonography now is a routine investigation with the possibility of quantitative description of changes in hepatic blood flow during graft dysfunction. Serial quantitative doppler measurements of hepatic artery, portal vein and hepatic veins were obtained in 20 adult patients during hospitalisation after transplantation and retrospective correlated to clinical datas. The resistive index of hepatic artery was maximal elevated in the initial period after graft reperfusion. There was no correlation with acute rejection. The angle independent damping index (minimum frequency shift/maximum frequency shift) calculated for portal- and hepatic vein showed significant changes during acute rejection, chronic rejection and cholangitis. PMID- 1788778 TI - [Vascular problems in patients with transplants from the interdisciplinary viewpoint]. AB - From 1979 to 12/1990 795 organ transplants have been performed at our hospital (kidney n:737, liver n:23, heart n:35). Our data reveal vascular problems in 10 percent of the transplanted patients - not concerning the vascular anastomosis. The therapeutic approach should be determined interdisciplinary. Due to the low complication rate of operative or interventionel procedures in this patients, even relative indications--to improve "quality of live"--can be accepted. PMID- 1788779 TI - [A new biological vascular prosthesis]. AB - In an experimental study on sheeps a new biologic vascular graft was implanted, 30 x in carotidal, 30 x in aortal position. Only one early occlusion of the graft, due to technical reasons, could be observed. Without aneurysmatic degeneration all graft were in function at the time of harvesting the samples. Morphologically a "revitalisation" of the grafts could be proved. PMID- 1788780 TI - [Isolated in situ bypass or composite bypass for preserving the upper extremity]. PMID- 1788781 TI - Clinical experience of the use of self-fixing synthetic prostheses for remote endoprosthetics of the thoracic and the abdominal aorta and iliac arteries through the femoral artery and as intraoperative endoprosthesis for aorta reconstruction. PMID- 1788782 TI - [Externa-plasty in symptomatic internal carotid artery occlusion--indications, technique, results]. PMID- 1788783 TI - [Early and late damage in bypass vessels induced by crystalloid and cardioplegic solutions]. AB - Veins and arteries grafted into the aorto-to-coronary position undergo degenerative processes, subintimal fibrous hyperplasia and diffuse atherosclerosis. We examined the influence of various crystalloid and cardioplegic solutions on the endothelium of human saphenous veins and internal mammary arteries, bovine internal mammary veins and arteries and rabbit carotid arteries, using light microscopy, TEM, SEM, immunological techniques and quantitative permeability measuring methods. Immersion or perfusion of vessel segments for various periods of time led to an ultrastructural endothelial cell damage, to an increased endothelial permeability for macromolecules, partly to an endothelial cell loss. Addition of high concentrations of heparin impaired this effect. Under influence of various solutions an increased plaque development under stimulation with atherogenic stimuli was observed. PMID- 1788784 TI - [Plasmapheresis in the therapy of the hyperosmolar syndrome in patients with myelomatous nephropathy]. PMID- 1788785 TI - [The results of the combined chemoradiation treatment of lymphosarcomas corresponding to the degree of its intensity]. AB - The authors describe the results of combined chemoradiotherapy of different intensity in 117 patients. It has been discovered that the differences in the results obtained were dependent on the stage of the treatment at which there ensured remissions rather than on the treatment intensity. The more rapidly complete remissions were attained the better were the long-term results, for the treatment continued during remissions turned out consolidating. PMID- 1788786 TI - [The results of using differentiated programs of therapy in acute lymphoblastic leukemia in adults]. AB - Results of the treatment of 30 adult patients with acute lymphoblastic leukemia are analyzed. Before the treatment was commenced, the patients were distributed into groups with a favourable, intermediate and unfavourable prognosis depending on the signs previously defined by the authors. In the phase of induction and consolidation of a remission, the treatment intensity in these groups varied. The rate of complete remissions (CR) reached 70% in the whole group; provided Ph positive ALLs were excluded from the analysis, it was 75%, the median duration of the CR amounted to 21 months, the projected 4-year relapse-free survival was 41%. In the group of historic control (31 patients treated in accordance with the unified program), these indicators were 58 and 69%, 18 months, and 21%, respectively. All the differences appeared statistically insignificant. In spite of the total treatment intensification, the rate of lethal outcomes did not rise during remission induction. PMID- 1788787 TI - [The effect of enterosorbents on stomach functional activity and the parameters of nitrogen metabolism in patients with nephrogenous gastropathies]. AB - The therapeutic efficacy of the continuous 6-week application of the enterosorbents CKH-4M and CKT-6A was traced in 64 patients with chronic renal diseases and different stages of chronic renal failure (CRF). The treatment was established to be most effective in the early stages of CRF. The morphologically verified manifest nephrogenic gastropathy was often associated with lack of the therapeutic effect and deterioration of the clinico-laboratory characteristics. Enterosorption brought about a decrease of ammonia concentration in gastric juice coupled with a positive time course of changes in dyspeptic disorders in such patients. PMID- 1788788 TI - [The optimization of the transfusion procedure in transfusions of thrombocyte masses in patients with amegakaryocytic thrombocytopenias]. PMID- 1788789 TI - [A case of acute myeloblastic leukemia in brothers over 60]. PMID- 1788790 TI - [Immunological and rheological disorders in multiple myeloma patients]. AB - Overall 30 patients with multiple myeloma (MM) were examined for immunological and rheological parameters. MM was shown to be marked by imbalance of immunobiological reactivity, with the greatest changes being seen in the B cell immunity system. MM is also characterized by marked rheological shifts related to the immunological alterations and underlying the hyperviscosity syndrome and heart failure. Administration of polychemotherapy resulted in a decrease of the count of B lymphocytes, circulating immune complexes; a tendency toward normalization of the rheological blood properties was observed. Introduction of plasmapheresis into the treatment program of the patients noticeably raised the treatment efficacy. PMID- 1788791 TI - [Addison-Biermer anemia: the clinical problems during diagnosis and therapy]. AB - Analysis is made of the diagnostic and therapeutic problems related to Addison Biermer anemia based on studying disease histories of 15 patients afflicted with the disease and placed under the author's observation. Under the outpatient conditions, the disease, in many cases, is not diagnosed accurately whereas the treatment is carried out without any control. The diagnostic role of examining the bone marrow puncture biopsy, reticulocyte and erythrocyte sedimentation crisis, gastric secretion, and the neurological status is outlined. Among rare complications of the treatment with vitamin B12, abacterial feverish reactions, hypertonic crises and cerebral circulatory disorders are recorded. Emphasis is laid on the necessity of oncological apprehension both in the period of the patients' entry into the stage of remission and in long-term dynamic observation. PMID- 1788792 TI - [Enteropathies in the hematology clinic]. PMID- 1788793 TI - [The reaction of active rosette formation as a method for assessing T-lymphocyte function in clinical practice]. PMID- 1788794 TI - [The nonspecific alpha 1-Pi proteinase inhibitor in the clinical picture of glomerulopathies]. PMID- 1788795 TI - [Splenectomy in hematology: indications, hazards and alternatives to surgical intervention]. AB - The author reviews pathological function of the spleen in the development and course of blood system diseases. Provides evidence for indications for that function suppression by means of surgical splenectomy and embolization of the splenic artery. Describes the experience gained with over 2,000 splenectomies and 145 embolizations of the spleen. Depicts an original technique of the removal of the spleen by transthoracic access. Discusses the long-term results of different methods of suppressing pathological function of the spleen. PMID- 1788796 TI - [Pulmonary emphysema]. PMID- 1788797 TI - [Chronic nonspecific lung diseases and gastroduodenal ulcers with a combined course]. PMID- 1788798 TI - [Immunochemical research in oncology (based on materials from the 50th European Congress of Nuclear Medicine, Amsterdam, May 1990 and from the 15th International Cancer Congress, Hamburg, August 1990)]. PMID- 1788799 TI - [Partial x-ray endovascular occlusion of the spleen in pediatric hematological practice]. PMID- 1788800 TI - [The embolization of the splenic artery in hematologic surgery]. AB - The short- and long-term results of embolization of the splenic artery are analyzed in 143 patients with different diseases of the blood system. Two methods of splenic artery occlusion have been examined: one-stage total and staged embolization of the splenic artery. The course of the postembolization period is considered depending on the type of splenic artery occlusion as is the treatment policy for such conditions. The authors hold that transcatheter embolization of the splenic artery required in some diseases of the blood system is, in terms of its clinical effect, an alternative to splenectomy. PMID- 1788801 TI - [Antithrombocyte antibodies in the serum and on the surface of the thrombocytes in patients with chronic lymphoproliferative diseases]. AB - Antiplatelet antibodies were studied in patients with chronic lymphatic leukemia (CLL) using ELISA for detection of serum antibodies and RIA for determination of antibodies associated with platelet surface. Serum antibodies were identified in 1 out of 6 CLL patients with the platelet count 100,000-200,000 per microliter and in 7 out of 54 CLL patients with the platelet count lower than 100,000. Platelet-associated antibodies were not detected in patients with the normal platelet count, but were revealed in 14 out of 25 patients with the platelet count 100,000-200,000 per microliter and in 21 of 27 patients with the platelet count lower than 100,000 per microliter. The presence of a group of thrombocytopenic patients lacking serum or platelet-associated antibodies suggested that the development of thrombocytopenia in CLL could be mediated not only by antibodies but also by other pathogenic mechanisms, i.e. by the depression of megakaryocytes in bone marrow. Increase of the platelet count after steroid and cytostatic treatment in CLL patients correlated with decrease of antiplatelet antibodies. In splenectomized CLL patients, the increase of the platelet count and disappearance of hemorrhage occurred in patients with the low level as well as with the high level of antibodies after the operation. PMID- 1788802 TI - [Colloid osmotic pressure and the total protein level in assessing the safety of therapeutic plasmapheresis]. AB - In 117 plasmapheresis procedures provided to rheumatic arthritis patients, the authors studied the changes in colloid osmotic pressure (COP), proteinemia and systemic arterial pressure depending on the plasma volume removed and on the type and volume of the substituting solution. Plasmapheresis carried out in 3 alternative regimens was not accompanied by dangerous exchange in the protein system. The substitution of the removed plasma by albumin and rheopolyglukin ensures an effective maintenance of COP just after the procedure. Since the elimination of polyglucin from the vascular system proceeds quicker than making up for protein deficiency, there is a potential danger of inadequate reduction of COP several hours after the procedure. Simple mathematic models have been proposed for the description of the COP level and proteinemia after plasmapheresis, which can be used for prognosis. PMID- 1788803 TI - [The parameters of tumor cell proliferation as a prognostic factor in lymphosarcomas]. AB - Cytophotometry of DNA was used to measure cell fractions in the S + G2 phases of the mitotic cycle in imprints of the involved lymph nodes and/or smears of the cells isolated from archival paraffin blocks of 60 patients with lymphosarcoma. Parallel studies have shown that both cell sources permit obtaining similar results (r = 0.98, p less than 0.001). The mean S + G2 values increased with the increment of the histological degree of malignancy, amounting to 1.6 +/- 0.4, 3.4 +/- 0.5 and 7.4 +/- 2.7% for patients with low, intermediate and high degrees, respectively. However, the statistically significant differences in accordance with Wilcoxon's criterion were revealed but for the second and third groups. To estimate the independent prognostic importance of the S + G2 parameter, all the patients were distributed into 2 groups. The first group included patients, in whom the magnitude of S + G2 did not surpass 3%, whereas the second one was made up of patients with the S + G2 values exceeding 3%. In the second group, the mean survival reached 13.8 +/- 4.0 months. At present 45% (9 out of 20) are still alive. In the first group, the mean survival was 25.2 +/- 3.8 months, with 70% of the patients being alive (28 out of 40). The significance of the differences is very high: p less than 0.001. Thus, the S + G2 parameter turned out to be reversely dependent on the survival of lymphosarcoma patients. PMID- 1788804 TI - [Risk factors and survival prognosis in lymphogranulomatosis: a statistical analysis]. AB - To examine risk factors and to design prognostic models for the total, relapse free and after-relapse survival, use was made of the Cox model for unifactorial and multidimensional analysis based on the retrospective estimation of the results of the treatment of 235 patients with lymphogranulomatosis, stages II III. Radiotherapy according to the radical program was carried out in conjunction with polychemotherapy according to the COPP scheme. The number of areas of damage, massiveness of injury to the mediastinum, involvement of the spleen into the process appeared the most informative risk factors for predicting both total and relapse-free survival. The prediction of the after-relapse survival was considerably influenced by the age combined with carrying out of not less than 3 cycles of polychemotherapy given to the patients during initial treatment or with the presence of intoxication symptoms and increased ESR. The tables of the survival probability were calculated. PMID- 1788805 TI - [The problems of modern transfusion science]. PMID- 1788806 TI - [The combined therapy of stage-II lymphogranulomatosis: the effect of splenectomy and the time period for achieving full remission on treatment efficacy]. AB - In 1982-1986, 72 patients with stage II lymphogranulomatosis received combined treatment according to the following program: 3 cycles of polychemotherapy in accordance with the CVPP scheme plus radiation of all the lymphatic collectors above the diaphragm up to the total radiation dose 35 Gy plus 3 cycles according to the CVPP. Splenectomy was provided to 45 patients; spleen impairment was revealed in 13. The median observation period reached 67 months. Both short- and long-term results of the treatment were analyzed. Neither splenectomy nor specific impairment thereof exerted any effect on the treatment results of this patients' group. The predominance of a number of "favourable" prognostic factors in splenectomized patients produced no effect on the treatment efficacy. It is concluded that in this patients' group, splenectomy is not advisable. A significant relationship was discovered between both survival and duration of the relapse-free course and the times of complete remission attainment. In patients, in whom complete remission was ascertained after 3 cycles of polychemotherapy and before radiotherapy onset, the 7-year survival amounted to 100% whereas the 7 year relapse-free course was recorded in 98% of cases, which is significantly higher than in patients, in whom only partial remission was attained by that time -78 and 68%, respectively (p less than 0.05). PMID- 1788807 TI - [Subtotal whole-body irradiation as the 1st phase in the therapy of patients with stage-IIIB and -IV lymphogranulomatosis: the immediate effects]. AB - Systemic radiotherapy in the form of subtotal radiation of the body (STRB) was provided for the first time to 23 patients with lymphogranulomatosis, stages IIIB IVB, as the first stage of anticancer treatment as an alternative to chemotherapy. STRB was established to produce marked immediate and steady anticancer effects manifesting in the removal of intoxication, a reduction of the size of the lymph nodes and specific infiltration in the lungs, and the lowering of the ESR. The duration of STRB was 10.6 days on the average, with the interval till the next treatment stage amounting to 31.2 days. The regularities were established in the time-course of changes in the hematological parameters in the course of and after STRB, permitting one to define them as a subacute radiation syndrome. PMID- 1788808 TI - [The effect of specific transfusion therapy on the level of circulating immune complexes in hemophilia patients]. AB - The level of circulating immune complexes (CIC) was measured in 108 hemophilic patients registered at the Republican Center for Hemophilia Treatment. High levels of CIC were detected in hemophilic patients of different age. The concentrations of CIC were higher in adult patients than in children. Formation of immune complexes in the test groups did not go beyond the framework of the physiological process, for the signs of vasculitis, which is an indispensable component of immunocomplex pathology, could not be identified. Higher levels of CIC in adults were related to a greater number of transfusions made throughout the life, particularly if the annual dose of the preparations infused exceeded 10,000 Units of factor VIII or IX. No significant correlation was established between the rise of CIC levels in the patients' serum and the biochemical alterations in liver function, detected in these patients. Therefore, CIC detected by the authors are not specific and lesions of the liver parenchyma in hemophilic patients are not determined by their presence. PMID- 1788809 TI - [The results of using pseudoplasmapheresis in bronchial asthma (a preliminary report)]. AB - The authors provide the results of the treatment of 15 patients with infectious bronchial asthma by plasmapheresis (PA). All the patients received PA in accordance with the techniques developed by the authors. These techniques simulate standard procedures using a plasticized container and a refrigerator centrifuge. As a result of the studies carried out, it has been concluded that the clinical efficacy of false PA is similar to that of routine PA as regards the clinical manifestations of bronchial asthma. Apparently, the elimination effect and the effect of red blood cells plasma withdrawal are of no material importance in the mechanism by which PA influences bronchial asthma. The psychosomatic causes, effects of temporary blood loss, blood contact with polymeric materials, and the influence of temporary blood cooling may be under discussion. PMID- 1788810 TI - [The characteristics of the postsplenectomy hyperthrombocytic syndrome in patients with chronic myeloleukemia]. AB - One of the clinical features of chronic myeloid leukemia (CML) after splenectomy lies in the development of an unusual hyperthrombocytic syndrome. In the course of a long-term observation, 12 out of 14 patients subjected to splenectomy demonstrated maximum thrombocytosis ranging from 1.008 X 10(9) to 3.053 X 10(9)/l. Hemorrhagic manifestations occurred in 6 patients, no thromboses were recorded. Postsplenectomy hyperthrombocytosis is to a certain measure resistant to cytostatic therapy. Dissociation may occur--good readings of the leukogram with a high hyperthrombocytosis. According to the authors' and reported data, the postsplenectomy hyperthrombocytic syndrome in ALL patients is fraught with the danger of the occurrence of hemorrhagic manifestations and, to a less degree, of thromboses. PMID- 1788811 TI - [The principles of and some experience with component therapy in acute radiation sickness]. AB - The previous experience gained with the treatment of acute radiation sickness supported during the treatment of the victims to the disaster at the Chernobyl NPP has shown the multimodality treatment to be indispensable for the bone marrow syndrome, particularly in terms of correcting postradiation thrombocytopenia and counteracting bleeding sickness. The use of the whole blood was found to be inadvisable because of the low efficacy, with the risk of transfusion complications being fairly high. Adequate replacement therapy with donor's platelets is capable of a complete modifying of the hemorrhagic syndrome. PMID- 1788812 TI - [The effect of different programs of cytostatic therapy on the blood coagulation and rheological properties in multiple myeloma patients]. AB - Three different programs of polychemotherapy (PCT) of multiple myeloma (MM) were compared. The programs included the use of cyclophosphamide (up to 750 mg/m2), vincristine (1.4 mg/m2), rubomycin (40 mg/m2), sarcolysine (7.5 mg/m2), paphencyl (50 mg/day) and prednisolone (from 30 to 60 mg/m2) in different combinations with regard to the hemocoagulation and rheological blood properties. It has been shown that in patients with MM there occur profound hemocoagulation and rheological alterations playing an important part in the genesis of the syndrome of hyperviscosity and circulation failure. The use of the programs of PCT in conjunction with therapeutic plasmapheresis brought about an appreciable improvement of the patients' general health status and correction of hemocoagulation and hemorheological disorders. To control the efficacy of PCT, its individualization, intensity and duration, it is recommended that in addition to the common tests, the activity of the antithrombin-III-heparin complex may be measured and the test for the presence of fibrin monomer in the plasma be made, since these parameters clearly reflect the changes in the system of hemostasis and enable one to discover the early signs of proliferation activation in MM thereby preventing hemorrhages. PMID- 1788813 TI - [The plasmoimmunosorption of low-density lipoproteins in the treatment of patients with hereditary hypercholesterolemia]. AB - The authors describe the experience gained with the use of apheresis of low density lipoproteins with the aid of the Soviet immunosorption columns with polyclonal and monoclonal antibodies in patients with hereditary hypercholesterolemia resistant to the diet and hypolipidemic drug therapy. High specificity of apheresis of low density lipoproteins and high efficacy of the use of the sorption columns to correct hypercholesterolemia have been demonstrated. PMID- 1788814 TI - [The clinical characteristics of the course of hemochromatosis]. AB - Eight patients with hemochromatosis (HC) were followed up. For a long time HC ran a latent course. Throughout many years, the symptoms occurred at varying succession. In many cases, the first manifest symptoms included skin itch, arthropathy, and diabetes mellitus. They may be dominant in the clinical picture for a long time, masking the genuine cause of the disease. The correct diagnosis was established, as a rule, at the pronounced stage of HC. Before that event the patients were followed up and treated by the endocrinologist (3 persons), by the infectionist (2 persons), dermatologist and traumatologist (2 persons), and by the internist (1 person). Appearance of one of the symptoms of the classical triad can be regarded as the onset of HC. The cardinal symptoms that determine the clinical picture progressed for the most part: liver cirrhosis, diabetes mellitus, and melanoderma. The first two require appropriate correction. Melanoderma presents a cosmetic and social and psychological problem. In HC patients, disorders occurring by the type of liver porphyria are recordable. They are of secondary nature, being an unfavourable prognostic sign. Investigation of iron metabolism in patients suffering from chronic liver diseases should be carried out by all means, since it can be regarded a specific enough test in the diagnosis of HC. Emphasis is laid on the importance of early diagnosis of HC. PMID- 1788815 TI - [The heparin prophylaxis of gas exchange disorders in disseminated intravascular blood coagulation]. AB - Altogether 35 patients operated on for gastric carcinoma were examined. In the postoperative period, a study was made of alterations in gas exchange function of the lungs parallel with the parameters of the hemostatic system. It has been established that in the early postoperative period, arterial hypoxemia was associated with the maximum tension of the functioning of the hemocoagulation system. Administration of heparin in a dose of 20,000 Units/day for 10 days led to a decrease of the period of arterial hypoxemia and reduction of its intensity. This is related to the blockade of intravascular blood coagulation. The heparin dose administered does not influence the plasma content of antithrombin-III and blood fibrinolytic activity. PMID- 1788816 TI - [An unusual case of heavy gamma-chain disease with several monoclonal components: IgG kappa, IgM lambda, Bence-Jones proteins kappa and lambda]. PMID- 1788817 TI - [Free-radical processes in iron-deficiency anemias]. PMID- 1788818 TI - [Cardiolipin antibodies and immunoglobulin E in arteriosclerosis obliterans of the peripheral arteries]. PMID- 1788819 TI - [The characteristics of the clinical course of lymphosarcomas in conformity with the morphological variants of the WHO and Working Formulation classifications]. AB - Histological and cytological preparations of the lymph nodes, spleen, bone marrow and other tumors from 140 patients with different variants of lymphosarcomas were subjected to a comparative clinicomorphological analysis. The data obtained were correlated to the WHO classification and the working formulation of non-Hodgkin's lymphomas intended for clinical use. It has been found desirable that the working formulation may be used for predicting the disease course and elaboration of the programs of lymphosarcoma treatment. PMID- 1788821 TI - [Training in heart auscultation]. PMID- 1788820 TI - [A method for clinico-morphological comparisons in chronic glomerulonephritis]. PMID- 1788822 TI - [The topographic localization of pneumonias and its clinical significance]. AB - It has been established that in addition to other factors, the clinico-laboratory manifestations of pneumonias depend on the localization of the inflammatory process in the lungs. Provided pneumonias are localized in the upper lobes, they are characterized by scanty symptomatology, prolonged course and unpronounced changes in the general blood analysis. If pneumonias are localized in the inferior lobes, they are marked by a typical clinico-laboratory appearance. PMID- 1788823 TI - Coevolution of self-fertilization and inbreeding depression. III. Homozygous lethal mutations at multiple loci. AB - We study the evolution of the rate of self-fertilization in response to deleterious mutations at multiple loci. Although partial selfing induces associations among loci even in the absence of linkage, associations among mutations at different loci are of a smaller order of magnitude than the mutation rate. Genotypes that carry homozygous lethal mutations in heterozygous form at i loci occur in frequencies of the order (Ti) mu i, in which T denotes the number of viability loci and mu the mutation rate. While associations between mutations at different loci remain small even under inbreeding, each viability locus develops an association with the modifier of the rate of self-fertilization that substantially affects the evolution of the breeding system. Positive associations between enhancers of selfing and haplotypes carrying multiple wild-type alleles and positive associations in heterozygosity between the modifier locus and the viability loci promote evolutionary increases in the rate of self-fertilization. PMID- 1788824 TI - On the concept of effective number. AB - A generalized conceptual basis for Wright's notion of effective size is presented. The concept is applied to the calculation of effective numbers based on the rate of change of genetic variability. With particular reference to the inbreeding, the eigen value, and the newly introduced "diversity" effective size, the use of the concept as a means for discrimination between and identification of various effective sizes is demonstrated. PMID- 1788825 TI - Phospholipase C-sensitive factor VII complexes in dog plasma. AB - We report the presence of a phospholipase c-sensitive activated factor VII complex in canine plasma after feeding a special diet. Low levels of complex was observed in the fasting state. The response to feeding in terms of activated factor VII varied markedly among the dogs investigated. PMID- 1788826 TI - Visualization of platelet glycoproteins Ib and IIIa by immunoenzymatic stain using avidin-biotin peroxidase complex. AB - A method is described here for the identification and quantitation of antigens by monoclonal antibodies. This method is based upon 1) separation (crossed immunoelectrophoresis) and immunoprecipitation (rocket immunoelectrophoresis and crossed immunoelectrophoresis) of glycoproteins Ib and IIIa with a polyspecific antiserum; 2) binding of the non precipitating monoclonal antibody to glycoproteins precipitated by the rabbit antibody; 3) visualization of the monoclonal antibody with secondary biotinylated antibody and after addition of avidin biotin peroxidase complex, the peroxidase activity is detected by 4-Cl-1 naphtol. By this technique, the agarose gel plate could be stained directly and this allowed us to eliminate electrophoretic transblotting and radioactive compounds. PMID- 1788827 TI - The effect of thrombin inhibition in a rat arterial thrombosis model. AB - The effect of heparin and the synthetic irreversible antithrombin D-phenylalanyl L-prolyl-L-arginyl chloromethyl ketone (FPRCH2Cl) was studied on FeCl3-induced thrombotic occlusion of rat carotid arteries. Thrombocytopenia prevented occlusion in five of 7 rats for the 60 min observation period after FeCl3 injury demonstrating platelet dependence in this model of thrombosis. Intravenous injection of heparin (250 units/kg) followed by continuous infusion (250 units/kg/hr) failed to prevent occlusion in four of 6 rats whereas intravenous FPRCH2Cl infusion prevented occlusion at a dose of 200 nmol/kg/min during infusion in 6/6 rats. These findings indicate that thrombin plays a principle role in the platelet-dependent process of arterial thrombosis in FeCl3-damaged rat carotid arteries. Neutralization of the thrombogenic stimulus in this model by the thrombin inhibitor FPRCH2Cl suggests selective thrombin inhibition may be useful in the treatment of arterial thrombosis. PMID- 1788828 TI - Anticoagulant properties of semisynthetic polysaccharide sulfates. AB - Several naturally occurring polysaccharides were purified and subsequently sulfated by chlorosulfonic acid-pyridine complex. These were isolated as the sodium salt and further purified by ECTEOLA cellulose chromatography. Anticoagulant properties of the sulfated polysaccharides were compared with commercial heparin by measuring their in vitro effects on activated partial thromboplastin time (APTT), prothrombin time (PT) and thrombin time (TT) using pooled normal human plasma. In general, all the compounds exhibited antithrombic (anti-TT) properties similar to heparin but were less effective than heparin in inhibiting APTT or PT. The in vivo anticoagulant properties were also compared with commercial heparin by injecting rats a single intraperitoneal dose and measuring plasma APTT at 2, 4 and 6 hour intervals. All of the compounds including heparin increased APTT significantly at 2 hours and then gradually returned to near normal value after 6 hours. Larchwood xylan sulfate was almost as active as heparin in inhibiting APTT while the rest of the compounds were less active. Toxicological studies using rats showed wide variations in the LD50 of various compounds. Sulfated xylan and heparin were least toxic while sulfated polysaccharide of locust bean was most toxic. For most of the compounds the LD50 was 5-100 fold higher than the effective dosage. PMID- 1788829 TI - Contact activation factors in plasma from women using oral contraceptives- increased levels of factor XII, kinin-free high molecular weight kininogen and acetone-activated kallikrein. AB - The plasma levels of FXII, prekallikrein (PK) and high- and low molecular weight kininogens (HK and LK) were measured in women on low estrogen dose (30-40 micrograms ethinylestradiol) oral contraceptives (OC) and in controls. FXIIa was assayed in acetone-treated citrated plasma (CPL) with PK and the tetrapeptide S 2222 as substrates, and in acetone-treated citrated plasma with benzamidine (BPL) with PK as substrate. The level of FXII was found to be about 20% higher in OC plasma than in control plasma. Kallikrein was assayed in CPL with S-2222 as substrate and in BPL with the tripeptide S-2302 as substrate. No difference in PK level was observed in the CPL-based method, whereas an increase in kallikrein activity of about 30% was registered in BPL. The levels of HK and LK were estimated both in rocket immunoassay and in bioassay of released kinin. No difference in HK-level could be registered in immunoassay, whereas the bioassay revealed a HK-level in OC-plasma of 40% of the control level. Immunoblot studies showed that a substantial part of HK in OC-plasma was present as kinin-free protein (mol. wt. 103 KD), assumed to possess a higher cofactor potency than that of native HK. Both in bioassay and immunoassay the level of LK was found to be 60% higher in OC-plasma than in control plasma. Considered together the observations on contact factors made in this study provide support for the assumption of an increased readiness for contact activation in plasma from women using OC. PMID- 1788830 TI - Poor fibrinolytic response to venous occlusion by different criteria in patients with deep vein thrombosis. AB - Five criteria for poor response to a 20 min venous occlusion test were applied to 58 patients 3 months or more after acute deep vein thrombosis (DVT). The criteria were arbitrarily defined as the last 5 percentiles of response distributions in an age- and sex-matched healthy control group of 51 subjects. The criteria were: 1. euglobulin clot lysis time after venous occlusion greater than or equal to 140 min; 2. t-PA activity after venous occlusion less than or equal to 0.04 IU/ml; 3. increase in t-PA antigen above resting value less than or equal to 2-fold; 4. ratio between t-PA antigen increase and resting PAI activity less than or equal to 0.5 ng/IU; 5. PAI activity after venous occlusion greater than or equal to 6 IU/ml. The last criterion of poor response was the only one that was significantly more frequently reached by patients than by controls: 28% (p less than 0.005) of all DVT patients and 35% (p less than 0.005) of the subgroup with idiopathic DVT (N = 34) were found to be poor responders. The percentage of poor responders according to the other four criteria was 7-11% in all patients and 9 15% in the subgroup with idiopathic DVT and thus was not significantly higher than in controls (5% by definition). It was concluded that residual PAI activity after venous occlusion might be a useful criterion for prospective studies on recurrence of DVT. PMID- 1788831 TI - Studies on fibrin network structure in human plasma. Part One: Methods for clinical application. AB - Methods based on turbidity and permeability, for measurement of mass-length ratio of fibrin fibres developed in pure fibrinogen solution, have been evaluated in respect of their applicability to human plasma. Theoretical assumptions made in the calculation of mass-length ratios in plasma have been critically examined. Methods of handling plasma, reproducibility of technique and the influence of age and sex have been investigated. The anticoagulant used, as well as other factors such as time, venepuncture and effects of calcium and fibrinolytic inhibitors are fully explored. With suitable standardization the methods are acceptable for application to clinical studies and are reproducible. PMID- 1788832 TI - Studies on fibrin network structure in human plasma. Part II--Clinical application: diabetes and antidiabetic drugs. AB - Using measurements of fibrin fibre thickness (microT) derived from turbidity and permeability (tau) of clotted plasma, it has been found that glucose in vitro added to plasma decreases permeability of the network despite unaltered fibrinogen conversion. Fibrin fibre thickness (microT) in uncontrolled diabetes is found significantly reduced. In diabetic plasma the degree of conversion to fibrin is similar to that in age and sex matched plasma from non-diabetics: the effect on fibrin network and fibre thickness probably arises from glycosylation of fibrinogen. Studies with Gliclazide, Metformin, Glibenclamide and insulin have shown that while all other drugs tested have no effect, Gliclazide increases fibrin fibre thickness (microT) significantly, diminishes tensile strength and reduces permeability. In separate experiments lysability of 125I-labelled fibrin networks developed in the presence of all four hypoglycaemic agents by tissue activator was tested. Networks developed in the presence of Metformin were found to lyse more quickly, followed by insulin and Gliclazide. Alterations induced in fibrin networks in diabetes may be nullified by some oral hypoglycaemic agents such as Gliclazide and not by others. Whether nullification of such changes has long-term effects in reducing the incidence of vascular disease in diabetics remains to be established. PMID- 1788833 TI - Circadian variations of platelet aggregability and fibrinolytic activity in patients with ischemic stroke. AB - The purpose of this study was to determine circadian dynamics of platelet aggregability and fibrinolytic activity in patients with ischemic stroke. The study was carried out in 21 male patients, aged from 51 to 65 years in acute phase of severe hemispheric brain infarction diagnosed clinically and radiologically. The examinations showed that circadian variations of platelet aggregability and fibrinolytic activity were persistent, but the intervals and the degree of oscillation differed from those in healthy persons. The significance of these disorders for clinical purposes was discussed. PMID- 1788834 TI - Gemfibrozil predictably lowers triglycerides but does not significantly change plasminogen activator inhibitor activity in hypertriglyceridemic patients with a history of thrombosis. AB - Impaired fibrinolysis due to high plasminogen activator inhibitor levels is present in patients with a variety of thrombotic diseases. Plasminogen activator inhibitor levels correlate with triglyceride levels and are elevated in patients with hypertriglyceridemia. Treatment of asymptomatic hypertriglyceridemic patients with diet or medication results in improvement of fibrinolytic parameters. To determine if similar improvements in fibrinolysis occur during treatment of hypertriglyceridemia in patients with a history of venous thrombosis and impaired fibrinolysis due to high plasminogen activator inhibitor levels, 5 patients were given gemfibrozil. Triglyceride levels and fibrinolytic response to venous occlusion were determined before and after 30 days of treatment. Gemfibrozil therapy resulted in a predictable decrease in triglyceride levels in all patients, a reduction that was statistically significant (p = 0.04). There was no significant change in fibrinolytic variables during gemfibrozil therapy. Independent factors appear to control the plasminogen activator inhibitor and triglyceride levels in patients with a history of venous thrombosis. PMID- 1788835 TI - Temperature-dependence of LDL binding and activation of human platelets. AB - The effect of low density lipoprotein (LDL) on intracellular free calcium ion concentration ([Ca2+]i), taken as an index of the degree of platelet activation, was investigated in normal volunteers. At 37 degrees C LDL, in a dose of 20 micrograms of protein/ml, increased [Ca2+]i in all subjects tested (basal 57 +/- 11 to 113 +/- 19 nM). In contrast, when measurements were performed at 20 degrees C, no effect on [Ca2+]i was seen following LDL. Thrombin (0.2 U/ml) increased [Ca2+]i to 455 +/- 98 nM. When platelets had been exposed to LDL before thrombin stimulation, this increase was less pronounced (to 301 +/- 43 nM). Our finding of a temperature dependence of LDL induced increase in platelet [Ca2+]i supports the concept of a platelet-LDL receptor mediated mechanism. Furthermore, the lower thrombin response following LDL exposure suggests a LDL-thrombin interaction, possibly at the thrombin receptor level and/or calcium recruitment from the same stores. PMID- 1788836 TI - Ovine platelet factor 4: purification, amino acid sequence, radioimmunoassay and comparison with platelet factor 4 of other species. AB - A simple method of purification of ovine platelet factor 4 (PF4) is described. Material released by freezing and thawing suspension of washed sheep platelets was fractionated by heparin-agarose chromatography and reverse phase HPLC. Purified ovine PF4 contained 85 amino acids (Mr 9130) and showed 78% homology with bovine PF4, 76% with porcine PF4, 71% homology with human PF4, and 61% with rat PF4. The heparin binding site of ovine PF4 localized in the C-terminal region of the molecule was identified as LYKKIIKRLL. The content of PF4 determined by radioimmunoassay was 22.6 (+/- 1.6 S.D.) micrograms per 10(9) platelets and 46.8 (+/- 19.6 S.D.) ng per ml platelet poor plasma collected in acid citrate dextrose in the presence of prostaglandin E1. PF4 was rapidly released during stimulation of ovine platelets by collagen. PMID- 1788837 TI - Analyzing contractile responses in demembranized pig papillary muscle fibres: the influence of calcium, resting force, and temperature. AB - The influence of calcium, resting force and temperature on the contractile behaviour in isolated demembranized ("skinned") pig papillary muscle fibers (n = 36) was analysed. Demembranisation excludes the influence of any membrane related processes on the contractile response as the myofilaments are in direct contact with the bathing medium. Resting force (1 mN-9 mN), temperature (22 degrees C or 32 degrees C) and pCa 7.0-4.3 were varied and the contractile response was analyzed by studying the time constant and the extent of post vibration force recovery (PVFR) of the activated preparations (the vibration method). Additional constant-load experiments and detection of sarcomere-length were carried out. There was an inverse-linear relationship between time constants of post vibration force recovery and maximum shortening velocity as estimated by constant load experiments. Resting force affected the extent of force development but not the time constant of post vibration force recovery and modulated the pCa-force relationship without altering the calcium concentration required for half-maximal activation (calcium sensitivity). In contrast lowering the bath temperature from 32 degrees C to 22 degrees C caused a significant leftward shift of the pCa-force relationship potentially due to changes of the contractile filaments' calcium sensitivity. The effect of temperature on the myocardial contractile system is of special interest as hypothermia is frequently used in cardiac surgery. Analysis of alterations of the contractile proteins' calcium sensitivity during the rewarming period of the patient may provide further insight in the pathophysiology of reperfusion.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1788838 TI - Organ preservation for heart-lung and lung transplantation. AB - One of the most important restrictions in the field of heart-lung- and lung transplantation remains the limited ischemic tolerance of the lung. From December 1987 through February 1991, 44 patients underwent either single-, double-, or heart-lung-transplantation. All organs were harvested in multiorgan procedures. For the first 4 patients core cooling of the donor was used. For the rest pulmonary artery flush with modified Euro-Collins solution and prostacyclin was employed. Ischemia time varied from 3-6.5 hours (mean 241; 176-390 minutes). Hearts were arrested with St. Thomas cardioplegia. Oxygenation was satisfactory at 24 hours: p O2 greater than 100 mmHg, FI O2 less than 30% oxygen. It is concluded that for lung preservation modified Euro-Collins solution and prostacyclin for flush perfusion of the pulmonary artery will result in excellent lung function early postoperatively with ischemic times up to 6.5 hours. This method seems advantageous compared to others due to the limited surgical and instrumental needs. PMID- 1788839 TI - Hemodynamic assessment of radial-arterial pressure-wave contours in children. AB - A new classification system for the radial-arterial pressure-wave contour in children is proposed with respect to their hemodynamic parameters. The contour of the radial-arterial pressure wave was analyzed in 45 children who had undergone open heart surgery. Stroke volume and peripheral vascular resistance were calculated from the cardiac output by thermodilution. The arterial pressure-wave contours were classified into type I, II or III, with each wave type having three, two and one shoulders, respectively. Type I denoted a better cardiac index, with a lower heart rate and larger stroke volume than type II. Type III was symptomatic of low cardiac output. Type I was further classified into subgroups Ia and Ib according to the magnitude of the tidal wave, and type II was subdivided into IIa and IIb according to the magnitude of the dicrotic notch. The classification of subgroup types a and b in both types I and II was related to the degree of vascular contraction. It is concluded that monitoring of the arterial pressure-wave contours provides useful information regarding hemodynamics in children. PMID- 1788840 TI - Early and late results after surgery for massive pulmonary embolism. AB - Between 1978 and 1990 emergency pulmonary embolectomy with the aid of extracorporeal circulation (ECC) was performed for massive pulmonary embolism (PE) in 44 patients (19-73 yrs; 49 +/- 15 yrs). Cardiopulmonary circulation was stable in 16/44 patients but unstable in 28/44; of the latter, 15 had undergone previous cardiopulmonary resuscitation due to cardiac arrest. Diagnosis of PE was obtained clinically in 15/44 patients, by angiography in 13/44, by echocardiography in 10/44, and by perfusion scintigraphy of the lung in 6/44 patients. There were 9/44 (20%) postoperative deaths. Early mortality was significantly higher in previously resuscitated patients (p less than 0.05). There were 2/36 (6%) late deaths. Actuarial survival was 75% after 4 yrs and 71% after 8 yrs. 77% or 35 survivors were in NYHA-class I and 23% in NYHA-class II after a mean follow-up of 4.6 yrs. Pulmonary embolectomy is indicated in patients with central PE and shock; it is advisable in patients with embolism of the main pulmonary artery or its major branches or in patients with contraindication to thrombolysis. Intraoperative insertion of a vena cava filter is recommended for prevention of recurrent embolism. Preoperative resuscitation and duration of ECC are predictors for early death. PMID- 1788841 TI - Thrombolytic therapy in fulminant pulmonary thromboembolism. AB - For the treatment of massive pulmonary embolism thrombolytic therapy is efficient in reducing late mortality and complications from chronic pulmonary hypertension. Best results are achieved if treatment is started as soon as possible. Even after days or weeks after pulmonary thromboembolism, however, thrombolytic therapy is beneficial. In life threatening conditions due to right heart failure an initial bolus of 2,000,000 U urokinase should be administered. The number of contraindications can be markedly reduced due to the well controlled thrombolysis with urokinase. PMID- 1788842 TI - Eversion endarteriectomy of the internal carotid artery. AB - Eversion endarteriectomy has been proposed as a reliable and rapid method for operating on an ulcerated or stenosed internal carotid artery. The surgical technique is presented in detail. The perioperative course is appraised in a series of 60 operations. Irrespective of age and other diseases in the patients and the preoperative state of the ipsilateral and contralateral vessels, a perioperative morbidity of 1.6% (a temporary neurological deficit) and no lethal outcomes were found. Indication for operation on the carotid artery depends on the spontaneous prognosis based on the vascular morphology and the rate of perioperative complications. The method of surgery described establishes favorable conditions for endarteriectomy even in the asymptomatic stage as well as in exulcerative lesions of the carotid wall. PMID- 1788843 TI - Adenocarcinoma of the lung: a contribution on prognosis after potentially curative resection. AB - From 1976 to 1989, 166 patients were operated on for primary adenocarcinoma of the lung. For better comparison, all the tumors were categorized retrospectively according to the TNM system of the UICC 4th edition of 1987. One hundred and thirty-eight patients could be potentially curatively operated. The average survival time following incomplete resection was 5 months and after potentially curative resection it was 65 months for stage I, 22 months for stage II and 6.5 months for stage IIIa. The 5-year survival rate was 53.7% for stage I, 18.5% for II and 0% for IIIa. The differences between the tumor stages are statistically significant. At the time of writing a large number of the patients have already died due to either recurrence of the tumor or, as in most cases, secondary metastases distant from the primary growth CI: 32%, II: 66%, IIIa: 79%). Comparison of the results of potentially curative operations in patients with adenocarcinoma and those with squamous cell carcinoma show a better prognosis in the equivalent stages for cases of squamous cell carcinoma. In seven cases there was the situation of ipsilateral pulmonary metastasis which could be subjected to potentially curative resection together with the primary tumor (5 bronchioloalveolar, 2 other adenocarcinomas). The prognosis of these patients was just as good, following resection, as for cases of T2N0 tumors without such metastases. PMID- 1788844 TI - Interventricular septum rupture due to falling from a height. AB - Non-penetrating traumatic interventricular septal rupture of the heart is rare. This lesion can result from blunt injuries, either immediate or delayed, but has never been reported from blunt chest trauma secondary to falling from height. Surgical repair can usually be done as an elective procedure with good results. However, with some patients early repair is necessary as a lifesaving measure. We report on a 15-year-old patient admitted after falling from the fourth floor with multiple bone fractures and blood pressure of 80/0. He soon required mechanical ventilation, but a heart murmur was only detected after some hours. On the fifth day a non-penetrating traumatic interventricular septal rupture became apparent, which was proved by echocardiography and Swan-Ganz catheterization. The patient underwent successful repair of the interventricular septal defect on the 13th day following injury. Two weeks later surgery for his bone fractures was carried out, after which the patient could be discharged uneventfully. PMID- 1788845 TI - Leaflet embolisation from Duromedics valves: a report of two cases. AB - Embolization of parts of mechanical valves has been reported since the inception of prosthetic valve implantation. We report here two cases of embolization of one hemileaflet of a Duromedic bileaflet prosthesis in the mitral position due to a pivot fracture. Both presented with moderately severe mitral regurgitation and pulmonary edema and were successfully managed by replacement of the malfunctioning prostheses. The embolised disc was located in the left common iliac artery by abdominal ultrasound and removed by an inguinal, retroperitoneal approach with low morbidity. Both patients left hospital and are doing well to date. PMID- 1788846 TI - Abdominal aortic aneurysm repair after renal transplantation with extracorporeal bypass. AB - The successful resection of an abdominal aortic aneurysm is presented in a patient who had undergone kidney transplantation 4 years previously. Because the transplanted kidney is more sensitive to ischemia than a normal one, a femoro femoral bypass with a pump oxygenator was used for perfusion of the transplanted kidney during crossclamping. During the clamping time of 40 minutes kidney perfusion was maintained with a perfusion pressure of 60 to 80 mmHg and the flow was 600 to 1000 ml/min. A collagen-seeded Dacron graft (diameter: 18 mm, length: 12 mm) was interposed. The postoperative course was uncomplicated. We believe that performing the femoro-femoral bypass with a pump oxygenator is an effective and simple method for kidney protection in such operations. PMID- 1788847 TI - Bullet pulmonary embolus and the role of surgery. AB - A case report is described of a 33-years-old male who suffered a bullet pulmonary embolus following an abdominal gunshot injury. The literature of this rare occurrence is discussed together with the role of surgery in its treatment. Operative removal is advocated in all cases and the optimal time for removal is 1 2 weeks following the initial embolus to allow pulmonary induration, which can prevent peroperative embolus migration. PMID- 1788848 TI - The arterial switch operation in transposition of the great arteries: anatomic indications and contraindications. AB - 1. The arterial switch procedure is now the operation of choice for typical D transposition of the great arteries at The Children's Hospital, Boston, USA, the operative mortality rate since 1985 being 3%. 2. There are many anatomic considerations suggesting the morphologically left ventricle (LV) may well be a better systemic pump than the morphologically right ventricle (RV) which, if true, would favor the arterial switch procedure as opposed to an atrial switch operation: (1) The LV consists almost entirely of the sinus or pumping portion, and has only a minimal distal infundibular (conal) component. The RV, by contrast, has a relatively much larger infundibular component, the primary function of which is to prevent regurgitation rather than to pump. (2) Phylogenetically, the LV is the ancient "professional" pump. By contrast, the RV is a comparatively recent modification of the bulbus cordis. (3) The LV is a two coronary ventricle, whereas the RV is a one-coronary ventricle. (4) The LV has relatively much more compact myocardium (stratum compactum) than does the RV. (5) The mitral valve leaflets are better designed to occlude a circular systemic atrioventricular orifice than are the tricuspid valve leaflets. (6) The papillary muscles of the LV are large, paired, well balanced, and both arise from the same ventricular wall--the LV free wall. By contrast, the papillary muscles of the RV are comparatively small, numerous, unbalanced, and arise from both ventricular septal and free walls. Hence, dilatation of the LV does not pull the LV papillary muscles apart, whereas dilatation of the RV does pull the RV muscles apart, favoring the development or exacerbation of tricuspid regurgitation. (7) The LV has two conduction system radiations, whereas the RV has only one. 3. The current anatomic contraindications to the arterial switch operation in typical D-TGA include the following: (1) an unprepared LV; (2) an aortic intramural left coronary artery arising from the right coronary sinus of Valsalva; (3) pulmonary outflow tract stenosis (with small annulus and subvalvar obstruction) or atresia; (4) aortic outflow tract stenosis (with small annulus and subvalvar obstruction) with tubular hypoplasia of the aortic arch and preductal coarctation; (5) tricuspid or mitral atresia; (6) marked underdevelopment or absence of either the RV sinus or the LV sinus; and; (7) 2 major anomaly of the systemic and/or pulmonary veins, as in the heterotaxy syndrome with asplenia.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1788849 TI - Arterial switch operation for simple and complex TGA--indication criterias and limitations relevant to surgery. AB - Since 1983, 505 patients underwent the arterial switch operation (ASO). 326 (28 days) had transposition of the great arteries with an intact ventricular septum (TGA/IVS) und 179 had a ventricular septal defect (TGA/VSD). Mean age at ASO was 7 +/- 5 days. Total mortality in the neonatal group was 7%. In the last 150 neonates, there was no operative mortality. Two late deaths were due to coronary obstruction 6 and 7 weeks after ASO. Cardiac catherisation in 106 late survivors revealed a mean gradient form RV to PA of 20 +/- 20 mmHg, and from LV to aorta of 5 +/- 8 mmHg. Mean PA pressure was 13 +/- 4 mmHg; enddiastolic pressure in the left ventricle was 8 +/- 3 mmHg. Cardiac index was 4.0 +/- 1.2 L/min. Sinus node recovery time was normal in 97%. Asymptomatic occlusion of a coronary artery was present in 3 patients. Aortic regurgitation was moderate in 1%. Rapid two-stage ASO (preliminary PA banding and shunt followed by ASO after 7 days) was carried out successfully in 29/30 patients with TGA/IVS, the oldest being 28 months of age. The ASO, as a primary operation, is our treatment of choice for neonates with TGA/IVS and TGA/VSD. The rapid two-stage approach is applicable for older patients with TGA/IVS. PMID- 1788850 TI - Experience with anatomical correction of transposition of the great arteries (TGA). AB - During the past seven years, 102 patients with TGA have been operated on using the switch operation. Overall early mortality was 5.9%, late mortality 2.%. Sixty three newborns had an intact septum and were corrected between the 3th and 35th day after birth, 39 had a ventricular septal defect and/or associated anomalies. All operations were carried out under ECC and deep hypothermia. Myocardial function was recorded intraoperatively by using sonomicrometry. The data demonstrate that adaptation of the left ventricle to the new load conditions should be supported by drugs providing inotropic stimulation and afterload reduction. Mean follow-up time is 32.5 months, no rhythm problems have been recorded during that period, a few children revealed trivial pulmonary or aortic valve stenosis and/or incompetence. The switch operation permits good early results for newborns with TGA and intact septum and TGA with VSD. A decade has to pass in order to judge the long-term results. PMID- 1788851 TI - The arterial switch-operation: early and midterm (6 years) results with particular reference to technical problems. AB - Since February 1985 the arterial switch operation (ASO) has become the surgical treatment of choice for newborns with simple TGA, appropriate forms of complex TGA and double outlet right ventricle (DORV) as well at our institution. Between 1985 and 1990 a total of 87 patients underwent surgery. In 60 patients with simple TGA and 8 patients with complex TGA or DORV, respectively, an arterial switch-operation was performed. Because of coronary artery anomalies (n = 13), dysplastic pulmonary valves (n = 3) or pressure drop in the left ventricle (n = 1), the initially planned arterial switch operation was discarded and a Mustard type procedure was in 17 patient. Finally there were two primarily performed Mustard operations. The hospital mortality after arterial switch for simple TGA was 15% (9/60), 0/8 in patients with complex TGA. Late mortality was calculated to be 12% (1/8) in patients with complex TGA and 3/60 in patients with simple TGA. Within the Mustard group there were 2/19 hospital deaths and one late death. Causes of early death after arterial switch were: intraoperative myocardial infarct (n = 3) low cardiac output syndrome (n = 2), intractable bleeding (n = 2), metabolic acidosis (n = 1), and septicemia (n = 1). Late after surgery there was one death due to chylothorax after thrombotic obstruction of the SVC, and 3 more deaths secondary to intraoperative infarct, progressive LV dysfunction and meningitis, respectively. Among the long-term survivors 2 patients developed a severe supravalvulary pulmonary stenosis. There were no significant arrhythmias, supravalvulary pulmonary aortic stenoses, aortic insufficiency or myocardial perfusion disturbances.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1788852 TI - Follow-up of arterial switch operation. AB - This report describes the experience of the Leiden University Hospital with the arterial switch operation for transposition of the great arteries, with and without ventricular septal defect, and for the Taussig-Bing-anomaly. The longest follow-up was 13 years and 9 months. Follow-up shows good results with almost all surviving patients in functional class I and with a sinus rhythm. Supravalvular pulmonary artery stenosis is noted in some of the patients but is almost always mild and does not show any tendency to progression. Insufficiency of the aortic valve is seen less frequently. Until now it has not caused great concern but, of course, follow-up is still limited. PMID- 1788853 TI - The arterial switch repair and the obstructive right ventricular outflow tract: does it matter? AB - Right ventricular outflow tract obstruction (RVOTO) was resected in 5 of 78 neonates (6.4%) with complete transposition of the great arteries (TGA) and in 10 of 26 neonates and infants (38.5%) with double outlet right ventricle (DORV) or TGA associated with ventricular septal defect (VSD). The early mortality in the combined series was 7.7%. Morphologic indicators for RVOTO in TGA are abnormal spatial relations of the great arteries, abnormal coronary anatomy, small size of the aortic valve ring, hypoplasia or obstruction of the aortic arch and the presence of a malaligned VSD. Sizing of the RVOT and the aortic valve annulus should confirm the diagnosis and establish the indication for resection. Right ventricular outflow tract obstruction is important for the outcome of arterial switch operation (ASO) in neonates and infants with simple and complex TGA: if subaortic obstruction is anticipated and properly dealt with, the surgical risk of anatomic correction is not increased. PMID- 1788854 TI - Early results with the anatomical correction of transposition of the great arteries. AB - From November 1984 to April 1991, 38 children underwent an arterial switch operation for transposition of the great arteries (TGA). In 24 infants (mean age 8 days) TGA with intact ventricular septum was present, in 14 patients (mean age 75 days) TGA was combined with a ventricular septal defect (VSD). There were 11 in-hospital deaths with an overall mortality of 29%, mainly due to technical problems. Whereas the group TGA + VSD showed a mortality rate of 50%, simple TGA and the subgroup simple TGA younger than 14 days had a mortality rate of 16.7% and 17.4%, respectively. Mortality was not influenced by coronary artery morphology and age. In simple TGA, the data presented suggest that this operation can be performed with good short-term clinical results. Most children are asymptomatic and without medication at a mean follow-up time of 2.5 years; but as there are pathological postoperative findings in echocardiography, the long-term benefit remains a matter of concern. Considerable perioperative problems are present in cases of TGA + VSD so surgical management is more differentiated, including other options. PMID- 1788855 TI - Two-dimensional and Doppler echocardiographic follow-up after the arterial switch operation for transposition of the great arteries. AB - An echocardiographic follow-up examination was performed in 20 children who underwent an arterial switch operation from November 1984 to October 1990. The age at the time of operation ranged from 1 to 54 days, the weight ranged from 2.5 to 4.5 kg body weight. The time interval from the day of operation and the examination ranged from 3 to 74 months. M-mode echocardiography showed hypokinetic left ventricular function in 6 patients (30%). Abnormal segmental left ventricular wall motions were found in 6/16 patients (37.5%). Doppler echocardiographic examination at the site of the pulmonary anastomosis revealed an instantaneous gradient less than 20 mmHg in 9 patients (45%), a gradient between 20 and 60 mmHg in 9 patients (45) and a gradient greater than 60 mmHg in two patients (10%). The location of the stenosis was just below the bifurcation in 17 patients (85%) and seemed to be related to stretching of the pulmonary trunk during the Lecompte maneuver. One patient (5%) had a supravalvular aortic stenosis with a gradient of 43 mmHg. Color-flow mapping revealed mild aortic regurgitation in 8 patients (40%) but moderate regurgitation in one patient (5%). Three patients (15%) showed mild mitral regurgitation, all of them also had hypokinetic left ventricular function. PMID- 1788856 TI - Atrial repair for transposition of the great arteries: current approach in Zurich based on 24 years of follow-up. AB - Long-term survival after atrial repair of a transposition of the great arteries between 1964 and 1988 is analyzed in 254 thirty-day survivors. For the complete series, overall survival is 99.6% after one year, 94.9% after 6 years, 89.6% after 12 years, 84.9% after 18 years, and 64.0% after 24 years. Broken down for simple (154/254) versus complex (95/254) transposition survival, it is 99.4% versus 100.0% for one year, 94.7% versus 99.5% for 6 years, 90.8% versus 88.3% for 12 years, 85.1% versus 85.8% for 18 years and 77.7% versus 46.8% at 24 years. Survival for patients without or with VSD is 95.3% versus 96.2% after 6 years, 91.2% versus 87.9% after 12 years, 87.5% versus 84.0% after 18 years, and 83.7% versus 52.5% after 24 years. Cumulative survival as a function of the surgical approach for VSD closure is 94.3% for transatrial versus 92.3% for transventricular at 6 years, 82.2% versus 92.3% after 12 years, 82.2% versus 83.0% after 18 years and 82.2% versus 41.5% after 24 years. Survival for patients operated upon before 1978 is 94.3% versus 96.0% thereafter at 6 years, and 90.7% versus 89.2% at 12 years (NS). Linearized mortality rates are 1.49% per patient year for the complete series, 0.93 for simple transpositions, 2.21% for complex transpositions (including VSD, obstruction of the left ventricular outflow tract, or both), 0.68% for transpositions without VSD, 1.98% for transpositions with VSD, 2.43% for transposition with transventricular repair of a VSD, 1.74% for transposition with transatrial closure of a VSD, and 0.90% for all cases operated upon after 1978.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1788857 TI - Early rhythm disorders after arterial switch and intraatrial repair in infants with simple transposition of the great arteries. AB - Between 1986 and 1990 68 infants with transposition of the great arteries (TGA) have been repaired within their first six months of life. From the 51 simple TGA, forming the study group, 20 underwent intraatrial repair according to Mustard and Brom (group I) and 31 received the arterial switch procedure (group II). We compared the observed rhythm disorders after both surgical methods. There were no deaths in group I and 3 deaths in group II. Group I: 7 cases (35%) had early postoperative arrhythmias, 6 patients received transient therapy. There were 3 cases of supraventricular tachycardia (SVT), 2 cases of frequent supraventricular premature beats (SVPB), 1 infant with temporary AV junctional rhythm and 1 with temporary total AV block. Both needed external pacemaker support for maximal two days. Group II: 14 cases (50%) presented rhythm disorders, 13 patients received transient therapy. There were 4 SVT and 3 SVPB. The time of occurrence was between the first and the sixth postoperative day. 2 cases of temporary AV junctional rhythm and 2 infants with transient total AV block needed external pacemaker support for maximal two days. 3 cases with relative sinus bradycardia (less than 130 beats/min) improved clinically with temporary external pacemaker support for several hours. Finally all patients of both groups were in sinus rhythm and after two months all antiarrhythmic drugs could be stopped. There have not been any ventricular arrhythmias in the early postoperative period. During the whole follow up (mean 28 months, range 4-60 m) no arrhythmias reappeared with two (4%) exceptions. PMID- 1788858 TI - Size and steroid-binding characterization of membrane-associated glucocorticoid receptor in S-49 lymphoma cells. AB - The precise mechanism for glucocorticoid-mediated lymphocytolysis is not understood, although it is presumed to be receptor mediated. We have recently presented evidence that this response is mediated by a specialized form of the glucocorticoid receptor (GR) that resides in the plasma membrane (mGR). Confirmation of the previous receptor identification studies in a population of S 49 cells enriched for mGR is now made using another antibody specific for the rodent GR, BUGR-2. The membrane resident receptor could be labeled competitively with the affinity ligand dexamethasone 21-mesylate, and Scatchard analysis of whole cell binding revealed that receptor number, but not the affinity for hormone, varied between the mGR-enriched and -deficient cell populations. Steroid specificity displacement analyses showed an order of affinities as follows: triamcinolone acetonide greater than progesterone greater than dexamethasone greater than testosterone = estrogen. Studies of mGR by one- and two-dimensional gel electrophoresis, immunoblot, autoradiography, and density gradients revealed a species with an equivalent size to cytosolic receptor as well as multiple higher molecular weight species, confirming earlier studies. To offer a possible explanation for the nucleic acid origins of the mGR, RNA from the mGR-enriched cells was probed with rat GR cDNA; mGR-enriched cells contained higher levels of GR mRNA. Possible molecular etiologies of larger receptor species in membrane are discussed. PMID- 1788859 TI - Studies on the arrangement of glucocorticoid receptors in the plasma membrane of S-49 lymphoma cells. AB - The presence of glucocorticoid receptors is required for glucocorticoid-mediated lymphocytolysis to take place. However, the explicit mechanism of involvement of this receptor continues to be debated. We have recently presented evidence that this response is mediated by a specialized form of the glucocorticoid receptor that resides in the plasma membrane (mGR). Using sequential cell separation techniques ("immunopanning," fluorescent cell sorting, and soft agar cloning), a resultant population of membrane receptor-enriched cells have remained stable and provided material for further analysis. The mGR patching and capping phenomenon originally observed with fluoresceinated monoclonal antibody techniques was verified here with electron micrographic analysis using colloidal gold-conjugated antibody. Using 3H-labeled monoclonal antibody, a radioimmunoassay for membrane receptors was developed. Trypsin treatment removed the membrane receptor antigenic site from the surface of cells. Peptide mapping of receptor purified from plasma membranes reveals several trypsin and alpha-chymotrypsin cleavage sites. Larger fragments resulted from cleavage of the membrane receptor of cells enriched for mGR versus those found in cells depleted of the membrane form, although most of the resulting fragments are shared by the two forms. Confirmation of previous studies correlating membrane receptor with the mechanism of glucocorticoid sensitivity is now extended to include elimination of the lymphocytolysis effect in membrane receptor-stripped (trypsinized) S-49 cells. PMID- 1788860 TI - Clues to the development of mechanism-based inactivators of 3 alpha hydroxysteroid dehydrogenase: comparison of steroidal and nonsteroidal Michael acceptors and epoxides. AB - A series of steroidal and nonsteroidal Michael acceptors that represent reaction products for 3 alpha-hydroxysteroid dehydrogenase were synthesized and evaluated as potential enzyme-generated inactivators. Introduction of exocyclic olefins either at C-2 or C-6 produced inhibitors with high affinity for the enzyme (0.05 to 5.0 microM). However, despite this affinity, none of these compounds produced time-dependent inactivation of the enzyme. By contrast, analogs based on 1-phenyl 2-propen-1-one were stoichiometric inactivators of the enzyme and ease of turnover of the parent latent Michael acceptor depended on the presence of an electron-withdrawing substituent at the para position. A series of steroidal and nonsteroidal epoxides in which the oxiranyl oxygen could be substituted for the 3 ketone (the acceptor carbonyl of a steroid substrate) were also synthesized and evaluated as potential mechanism-based inactivators. Steroidal 2 alpha,3 alpha-, and 3 alpha,4 alpha-epoxides as well as 3 alpha- and 3 beta-spiroepoxides did not bind to the enzyme and were unable to cause enzyme inactivation in either the presence or absence of pyridine nucleotide. In contrast, nitrostyrene oxides produced time-dependent inactivation, the rate of which was governed by the presence of an electron withdrawing group at the para position. These data indicate that the design of mechanism-based inactivators for 3 alpha hydroxysteroid dehydrogenase requires the incorporation of electron-withdrawing groups adjacent to the latent enzyme-activated group and, as a result, the turnover and/or reactivity of these compounds is increased. Moreover, these compounds can be modeled on nonsteroids. PMID- 1788861 TI - Topical anti-androgenicity of a new 4-azasteroid in the hamster. AB - The topical anti-androgenic activity of L-651,580 (methyl 3-oxo-4-methyl-4-aza-5 alpha-androst-1-ene-17 beta-carboxylate) was established in a series of for experiments using castrated male hamsters. During each 21-day experiment, the animals received a daily subcutaneous injection of 40 micrograms testosterone propionate or 20 micrograms dihydrotestosterone propionate. Test compound in 25 microliters of gel was applied daily to the left flank organ. Compounds assayed included L-651,580, WIN 17,665 (17 alpha-propyltestosterone), and SH-434 (17 beta hydroxy-1 alpha-methyl-17 alpha-propyl-5 alpha-androstan-3-one). Endpoints were flank organ area, sebaceous gland area, and prostate weight. Very similar results were obtained with L-651,580 and WIN 17,665. Daily doses of 0.25 mg or more of either compound usually produced a significant reduction in the areas of treated flank organs and sebaceous glands underlying treated flank organs. Neither compound caused significant changes in the area of the contralateral flank organs and sebaceous glands, which indicated they possess little or no systemic activity at topically effective treatment levels. In direct comparisons, SH-434 was less anti-androgenic than L-651,580 or WIN 17,665, although in one experiment, 0.5 mg/d of SH-434 significantly reduced the area of treated flank organs and sebaceous glands. Neither WIN 17,665 nor SH-434 caused a change in prostate weight; however, in one of four tests, a significant decrease was induced by the 0.5 mg/d level of L-651,580. The results of these experiments show that the topical anti-androgenicity of L-651,580 compares very favorably with that of WIN 17,665 and SH-434. They also indicate that the topical administration of effective dosage levels of L-651,580 causes few, if any, systemic effects. PMID- 1788862 TI - Novel soft steroids: effects on cell growth in vitro and on wound healing in the mouse. AB - Evaluation of three "soft" steroids is described. The test compounds were compared with the standard anti-inflammatory steroids betamethasone and prednicarbate in two studies. Soft steroids are designed based on the "inactive metabolite approach" to be rapidly inactivated by predictable metabolism after performing their therapeutic function. Consequently, lower circulating (peripheral) levels of potentially harmful steroids result, and undesirable systemic and local side effects are minimized. The soft and standard steroids behaved similarly in an in vitro cell culture model, whereas in a whole animal study the advantages of the soft steroids were evident. PMID- 1788863 TI - 19-Nordeoxycorticosterone, aldosterone, and corticosterone excretion in sequential urine samples from male and female rats. AB - 19-Nordeoxycorticosterone (19-norDOC) is a powerful mineralocorticoid that has been postulated to play a role in the pathogenesis of some forms of hypertension in the rat. We measured the daily excretion of 19-norDOC, aldosterone, and corticosterone in intact male and female SR/jr rats for 20 consecutive days. The excretion of corticosterone and aldosterone was higher during the first 4 days of collection and remained relatively stable for the rest of the collection period. The excretion of corticosterone and aldosterone was not different between male and female rats. The excretion of 19-norDOC, which, as has been reported previously, was significantly higher in female than male rats, varied over 600% from day to day in some individual rats. The variability in the excretion of 19 norDOC did not correlate with the excretion of aldosterone or corticosterone and did not appear to coincide with an estrous cycle. These studies also indicate that when the urinary excretion of steroids is intended to be used as an indication of steroid production in the basal state, a period of at least 4 days of acclimatization in metabolic cages, even for animals accustomed to handling, is necessary to obtain stable excretions. PMID- 1788864 TI - [Status of liver mitochondria and rat tissue creatine kinase during administration of antivitamin K]. AB - It has been shown that 16-18 days administration of antivitamin K (pelentan) leads to two-fold increase of prothrombin time in adult rats but does not influence the soluble brain, renal, heart, muscle and serum creatine kinase activity. No effect on metabolic function of isolated liver mitochondria has been found in contrast to the vitamin K deficient rats. Mitochondria were characterized by high value of respiration control; substance oxidation rates and internal mitochondrial Ca2+ content do not differ in the level from those of control animals. From the obtained results and data published in literature a conclusion can be drawn about only particular similarity (prothrombin time) between the antivitamin K administration and alimentary vitamin K deficit. PMID- 1788865 TI - [Effect of calcium on lipid peroxidation in plasma membranes]. AB - Process of nonenzymatic peroxidation of lipids in the plasma membranes of thymocytes has been studied as affected by Ca2+. It is established that at calcium concentrations to 900 microM peroxidation gets more intensive; at higher concentrations of the intensity of this process falls. PMID- 1788866 TI - [Status of the free radical oxidation and antioxidant system in rats with toxic liver damage; effect of tocopherol and dimethylsulfoxide]. AB - Carbon tetrachloride injected to white rats during four days in the dose of 2 g/kg drastically activates intensity of free radical lipid oxidation and induces impairment of the antioxidant system inhibition of the activity of superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, a decrease of SH-groups and general plasma ceruloplasmin level and total phospholipids in the liver. The greatest changes are observed by the 7th day. A complex use of tocopherol (30 mg/kg) and dimethyl-sulphoxide produce partial or complete normalization of all the above mentioned values. It is concluded that the optimization of the protective action of the antioxidant system requires a complex use of water and liposoluble antioxidants. PMID- 1788867 TI - [Post-irradiation changes in the content of phospholipids and cyclic nucleotides in the mouse brain]. AB - The effect of ionizing radiation (5, 20, 100, 200 and 400 Gy) on the content of phospholipids and cyclic nucleotides in the brain tissue has been studied in experiments on albino mice. During the development of evident behavioural disturbances in irradiated mice (2 h after irradiation with doses 100-400 Gy), significant changes were observed in the content of phosphatidylinositides and cyclic GMP. These changes may account for disturbances in the function of the central nervous system during cerebral forms of acute radiation injury. PMID- 1788868 TI - [Isolation, purification and immunologic specificity of monoclonal antibodies to antigen p24 of bovine leukosis virus]. AB - The aim of the work is to develop optimal conditions for identification and purification of monoclonal antibodies specific to protein p24 of bovine leukemia virus (p24-BLV). Two schemes of isolation and purification of monoclonal antibodies are compared. Purified monoclonal antibodies contain two subunits with molecular weight of about 22,000 and 50,000 Da as determined by sodium dodecylsulphate polyacrylamide gel electrophoresis. They react with p24-BLV in the immunoblot assay. PMID- 1788869 TI - [Chromatographic analysis and immunobiologic properties of tuberculins]. AB - Immunobiologic activities of tuberculin preparations and their components have been comparatively studied using gel filtration and high-performance liquid chromatography (HPLC) techniques. It is shown that high-molecular weight fraction of protein-purified derivate tuberculin (PPD) had higher activity as compared to nonfractionated preparation in skin tests on guinea pigs sensitized with Mycobacterium bovis BCG as well as in enzyme-linked immunosorbent assay with affinity purified rabbit antibodies against PPD. Using the preparative HPLC technique we failed to isolate a component of PPD having greater tuberculin test potency than nonfractionated preparation. PMID- 1788870 TI - [Antigenic properties of heterogeneous nuclear ribonucleoprotein particles weakly binding nonhistone proteins and proteins binding single-stranded DNA (SSB proteins) from Ehrlich ascites tumor]. AB - Antigenic properties of the proteins of heterogeneous nuclear ribonucleoprotein particles, (hnRNP), weakly bound nonhistone chromatin proteins (WB(N)P) and single-strand DNA-binding proteins (SSB proteins) from chromatin and extrachromatin fraction of the Ehrlich ascites tumor cells have been comparatively studied. The chromatin and extrachromatin SSB proteins displayed similar mobility in the tube and slab SDS/PAGE, had the same ssDNA-binding capacity and similarly stimulated the replicative synthesis in permeable cells. However, the chromatin SSB proteins contained 1.4 times higher phosphate amount than the extrachromatin ones (3.1 and 2. 2. moles phosphorus per 1 mole protein, respectively). The study of four protein groups with the use of a rabbit antiserum to/against extrachromatin SSB proteins (titer 1:13000 by enzyme immunoassay) showed that the chromatin and the extrachromatin SSB proteins have similar antigenic properties. One fraction of the hnRNP proteins was also reactive with the antiserum, whereas the WB(N)P displayed no cross-reactivity. The specificity of the ferm "SSB proteins" as applied to eukaryotic cells, their affinity with hnRNP proteins and differences from the HMG proteins are discussed. PMID- 1788871 TI - [Role of proteolysis in posttranslational modifications of biologically active peptides and polypeptides]. AB - Data from literature about the precursors of biologically active peptides and polypeptides in cells are summarized. Their processing by limited proteolysis and the enzymes which take part in this process are presented. PMID- 1788872 TI - [Enzymatic hydrolysis of gelatin]. AB - The process of gelatin hydrolysis by means of enzymes of the proteolytic action with the aim to determine most effective destructor of gelatin macromolecules for recovering permeability and selective properties of ultrafiltration membranes was investigated. The presence of free alpha-NH2-groups was determined by means of the Lee and Takahashi method. Calculation of the destruction degree of substances in the Lee and Takahashi method during determination of the quantity of free alpha-NH2-groups rose precision of the method by 6-8%. The maximum degree of destruction (48.2% for 1-2 hours) was provided by the enzyme preparation "Pronaz 1" (Str. griseus + Acr. chrysogenum) and by industrial enzymes: alkali proteaze and proteaze C. PMID- 1788874 TI - [Influence of the substrate nature, ethanol and phosphate buffer on the butyrylcholinesterase hydrolysis retardation by reversible inhibitors]. AB - The reversible inhibition of horse blood serum butyrylcholinesterase (Ce 3.1.1.8) hydrolysis of ion substrates of acetyl- and butyrylthiocholines and non-ion substrate of indophenylacetate by N-methyl-4-piperidinylbenzylate and tacrine (1,2,3,4,-tetrahydro-9-aminoacridine) and phosphate buffer and ethanol influence on this process are investigated. The values of competitive Ki, uncompetitive K'i and generalized K sigma inhibitory constants are determined. It is shown that the inhibition effect and reversible inhibition type depend not only on the inhibitor and substrate nature but also on the phosphate buffer concentration and ethanol presence in the reaction mixture. PMID- 1788873 TI - [Hydrophobic interactions of serine proteases with low molecular compounds: role of the S'2-site in substrate activation and interaction with serpines]. AB - An attempt is made to simulate the P1-P'2 site of the reactive centre of protein inhibitors of serine proteases (serpines). On the basis of data from literature structure requirements are formulated and compound 1,5 bis-dibenzyl-aminopentane is synthesized. It may simultaneously interact with S1- and S'2-sites of chymotrypsin and contains no bonds adequate to the hydrolytic centre of proteinase. The compound is studied for its effect on hydrolysis of low-molecular substrates and proteins by chymotrypsin. Results obtained are discussed as well as the possible role of the S'2-binding site in the substrate activation of serine proteinases and their interaction with serpines. PMID- 1788875 TI - [Kinetic properties of rat heart cathepsin D under normal conditions, during emotional-pain stress and in the post-stress period]. AB - Cathepsin D preparations have been isolated from the heart of healthy animals and stress-surviving rats by the method of affine chromatography with the hemoglobin biogel-P300 sorbent. To analysis of the obtained data permits concluding that acute stress stimulates activation of the catalytic function of cathepsin D in the heart. But the period after the stress accompanied by the consecutive proteolysis rate reduction, that can be explained, probably, by a change in enzyme conformation. The concentration of Ca2+ (10(-6), 10(-5) M) and cAMP (10( 7), 10(-6) M) exert a regulating influence on the cathepsin D activity in the heart in acute stress period and after it. PMID- 1788876 TI - [Glutathione defense system in various brain structures during starvation]. AB - Distribution of glutathione reductase (GR) and selenium-dependent glutathione peroxidase (GP) activity and the content of selenium in the cytosolic fraction of the brain stem, hypothalamus and different cortical areas of the rat cerebrum in norm and under starvation was investigated. It was shown that GR activity in all investigated structures was approximately identical, but GP activity in various cortical areas was 1.5-2.0 times higher, than that in the mesencephalon and myeloencepalon. During 2-3 days of starvation GR activity changed insignificantly, whereas GP activity varied within wide limits. Under prolonged starvation a significant decrease in the content of selenium and GP activity was observed. The correlation of these changes was more expressed in the hypothalamus. It was assumed that glutathione and enzymes of its metabolism were involved in the regulatory system of redox processes in the nervous tissues in the primary period of starvation. PMID- 1788877 TI - [Anabolic action of prolactin on phosphatidylcholine metabolism in guinea pig adrenocorticocytes]. AB - Isolated adrenocortical cells of guinea pigs whom injected with prolactin (PRL) during 3 days incorporated [3H] choline into phosphatidylcholine more intensively than those cells of animals in control. Labelling of intracellular pools of choline and phosphorylcholine remained unchanged, though a part of radioactivity represented by the water-soluble precursors decreased due to PRL influence. The rate of disappearance of labelled phosphatidylcholine in adrenocortical cells prelabelled with [3H] choline was lower in cells obtained from PRL-treated animals. The discharge of [3N] choline accumulated during prelabeling accelerated simultaneously. Rate of the phosphorylcholine radioactivity fall remained unchanged. The obtained data showed that prolonged influence of PRL caused a shift of the phosphatidylcholine metabolism to anabolism. That effect might be a part of the mechanism of proliferative PRL action in the adrenal cortex. PMID- 1788878 TI - [Effect of alpha-tocopherol on adrenal cortex functions under stress]. AB - alpha-Tocopherol has been studied for its effect on lipid peroxidation and steroidogenesis in the adrenal cortices of rat and rabbit under stress. The vitamin is shown to exert an inhibitory effect on the lipid peroxidation developing under chronic stress. A biphasic pattern of the alpha-tocopherol effect on the steroidogenesis in the adrenal cortex is established: a decrease in the release of the steroids under the acute stress and maintaining of their levels under the chronic stress. A conclusion is drawn about a potential alpha tocopherol application to correct the adrenal cortex function under stress. PMID- 1788879 TI - [Vitamin E and its structural analogs in tuberculosis]. AB - Efficiency of tocopherol, its analog with a shortened side chain as well as their quinons for tuberculosis was determined. All the studied compounds inhibited peroxide-formation processes in the liver homogenate and mitochondria. The vitamin E amount in the blood is considerably decreased in case of tuberculosis. The studied analogs increased its content and possessed a weak tuberculostatic but expressed antiedemic and antiinflammatory action. Administration of vitamin E in combination with isoniazid to sick animals had a favourable effect on the processes of tissue respiration and oxidative phosphorylation. If taking a sum of characters, tocopherol acetate with a shortened side chain is the most efficient of all the analogs under study for the tuberculosis therapy. PMID- 1788880 TI - [Free amino acids in rat blood serum during A-hypovitaminosis]. AB - A pool of free aminoacids of the blood serum has been studied in growing rats with a decreased retinol content in the liver tissue (to 5 g/g). The study shows a reliable drop in the concentrations of all essential aminoacids, except for phenylalanine. It is determined that the total amount of essential aminoacids decreases by 31%. At the same time concentrations of replaceable aminoacids increase, namely: glutamic acid and arginine--by 15.7%, ornithine and histidine- by 24%-45%, though proline concentration decreases abruptly by 31%. A disturbance in ultrastructural organization of microvilli in the apical membrane cells absorptive epithelium of the small intestine has been found. The results of the study confirm changes in a free aminoacid pool of the blood serum in growing rats and these changes occur first of all due to the disturbance of the absorption processes in the small intestine. PMID- 1788881 TI - [Isolation of a histone-specific proteinase from brain cell nuclei of rats]. AB - A method for isolating histone proteinase of rat brain chromatin is described, including ammonium sulphate fractionation gel filtration on sefacryl 5200, ion exchange chromatography on mono S and affinity chromatography with benzamidine sefarose. The enzyme molecular weight equals 25 kDa. It is purified 15621 times in comparison with initial nuclear extract. PMID- 1788882 TI - [Experimental verification of the use of YAG-neodymium laser in otorhinolaryngology]. AB - In order to verify the applicability of an YAG-neodymium laser to the therapy of various ENT pathologies, an experimental study was performed in which the effect of laser 1.06 microns radiation on the tonsils, polyps and mucosa of the nose was investigated. During exposure tissue temperature and radiation density at different depths were measured. PMID- 1788883 TI - [Use of MR spectroscopy in the study of the nature of paramagnetic complexes of nasal secretion]. AB - New data are presented indicating that the electron paramagnetic resonance technique can be used to study nasal secretion paramagnetic centers. In the study 53 subjects, who were not exposed to industrial aerosols during their professional activities, were examined. It was demonstrated that nasal secretion contained paramagnetic centers bound with iron- and copper-containing proteins in the concentrations which were significantly lower than plasma had. It is postulated that metal-containing complexes may be involved in defence systems of the upper airways. PMID- 1788884 TI - [Hearing impairment in the so-called normal ear during Meniere's disease]. AB - A detailed audiological examination of 84 specially selected patients was performed. They had Meniere's disease without any audiometric changes in the so called normal ear. The hearing function was characterized on the basis of threshold tonic audiometry, ultrasound sensitivity, lower limit of perceived sound frequencies, hearing discomfort level, dynamic range of the hearing field, and intelligibility of low voice speech masked by noise. It was demonstrated that all patients with Meniere's disease on the side of the so-called normal ear, where no symptoms of hearing insufficiency can be detected by routine audiometry, showed hearing impairment: their discriminatory capacity of low voice speech masked by noise significantly decreased giving evidence for bilateral hearing problems involved in Meniere's disease. PMID- 1788885 TI - [State of the hearing function and cerebral hemodynamics in agricultural machine operators]. AB - The hearing function and cerebral hemodynamics were investigated in 96 agricultural machine operators, 14.6% and 23.2% of whom presented complaints about noise in the ear and hearing impairment, respectively. Hearing impairment was diagnosed in 90.6% in terms of tonal thresholds and in 63.3% in terms of speech intelligibility. Threshold increase was often observed at a frequency of 6 kHz. The number of operators with enhanced tone of cerebral vessels, especially in the vertebral area, grew with their work record. As the enhanced tone spread over both cerebral blood flow systems, the number of cases of injury of the sound receiving apparatus increased. PMID- 1788886 TI - [Electromyography in the evaluation of the functional state of the internal neuromuscular apparatus of the larynx in myasthenia]. AB - Using needle transcutaneous electromyography of internal laryngeal muscles and kalymin tests, 40 patients with myasthenia of different forms were examined. It was found that patients with generalized and local pharyngeal-facial forms of the disease developed latent generalization of myasthenic injury. Characteristic changes can be used to determine the degree of disorders in the internal nervous muscular apparatus of the larynx. PMID- 1788887 TI - [Main principles of the study of the formation of ORL-organ pathology during epidemiological surveys]. PMID- 1788888 TI - [Characteristics of postoperative period in surgical treatment of chronic frontal sinusitis]. AB - During the last 5 years 132 patients underwent frontal-ethmoidal trepanation. Recurrences were observed in 27 (20%) patients with nonspecific immune deficiency, frequent respiratory viral infections and microbial virulence. The major cause of recurrences was inadequacy of the frontal-nasal ostium. Recurrences occurred more frequently in patients with orbital and intracranial complications of frontitis, traumatic frontitis, and abnormal anatomic relations of the frontal and ethmoidal sinuses. It is recommended to carry out postoperative conservative therapy including antibacterial, antiedematous, desensitizing drugs as well as drugs stabilizing immunity and microcirculation. It is also recommended to follow-up patients during a year after frontal ethmoidal trepanation because recurrent episodes occur mostly during this time period. PMID- 1788889 TI - [Current status of knowledge concerning allergy]. PMID- 1788890 TI - [Use of rhinomanometry in otorhinolaryngologic examination of patients]. AB - Clinical applicability of anterior passive rhinomanometry to identify nasal breathing disorders during wide-scale physical examinations and therapeutic procedures was investigated. The method proved highly accurate and informative; it was not time consuming and can be performed with the use of available equipment. Therefore, the method can be recommended of wide application in practical otorhinolaryngology. PMID- 1788891 TI - [Herpes zoster oticus]. AB - In 1985-89, 8 patients with Herpes zoster oticus were examined in the ENT department of the First Leningrad Medical Institute named after I.P. Pavlov. All the patients were treated, taking into consideration the severity of injury of cerebrocranial nerves. It is emphasized that the pathology may have many clinical forms and that it deserves special attention in AIDS diagnosis. PMID- 1788892 TI - [Treatment of acute diffuse otitis externa by low-frequency magnetic field]. AB - Patients with acute diffuse external otitis were treated using an alternating and pulsatile low-frequency magnetic field synchronized with the pulse wave propagation across the pathological focus. It was shown that the magnetic exposure should be 30-40 min longer because the beneficial effect of the magnetic field develops as a function of time and because there should be a feedback between the acting magnetic field and hydrostatic pressure in focal capillaries which varies during inflammation. This therapeutic method was applied to 27 patients. The mean time on this method was 4 days shorter when compared to that on UHF and SHF therapy or 3 days shorter when compared to that on continuous magnetic field therapy, the difference being statistically significant. PMID- 1788893 TI - [Pre-hospital diagnosis of nosebleed in children]. AB - Early signs of haemorrhages develop in the childhood, nose bleeding being predominant. Recurrent nose bleeding was observed in 130 (89.0%) patients with thrombocytopathies, 37 patients with nasal pathologies, 13 out of 14 children having willebrand's disease, 3 patients suffering from Rendu-Osler disease, in a boy with a factor XIII deficiency, and in a girl with psoriasis. In the case of haemorrhagic diathesis, nose bleeding was, as a rule, combined with haemorrhages of other types (skin, gum, uterine, etc.) whereas in the case of ENT pathology, nose bleeding was the only haemorrhagic symptom. Medical examinations of patients suffering from recurrent nasal haemorrhages at the prehospital stage should include: study of the history case, ENT-doctor examination, and blood analysis using standard tests (micro-coagulation, prothrombin, hemolysate-aggregation). The battery of blood tests can be performed without costly equipment or reagents. It became routine in the work of a regular polyclinical laboratory and helped identify the causes of nose hemorrhages in 94.6% children. PMID- 1788894 TI - [Role of computerized tomography in the diagnosis of encapsulated cerebellar abscesses in acute otitis media]. AB - Two rare cases of encapsulated cerebellar abscesses that developed 2-2.5 months after acute otitis media are described. In both patients, otitis media was cured using conservative therapy although it was aggravated by mastoiditis in one case and antritis in the other. Abscesses were removed by means of a neurosurgical trans-occipital approach. Computer tomography detected "volume formations" in the cerebellum but failed to differentiate between an abscess and tumor. It is concluded that in such cases antrotomy (mastoidotomy) is not necessary. PMID- 1788895 TI - [Otogenic cerebellar abscesses]. PMID- 1788896 TI - [Improving surgical treatment of children with acquired cicatricial stenosis of the larynx and cervical part of the trachea]. AB - Results of surgical treatment of 144 children with acquired cicatricial stenosis of the larynx and cervical compartment of the trachea were analyzed retrospectively. It was found that a temporizing policy was preferable after the first complaints were voiced. They should be operated no earlier than 18 months after stenosis development. In the case of insignificant cicatricial changes CO2 laser treatment was recommended whereas in the case of concentric large scars plastic surgery with an exterior access was to be used. Therapeutic results also depended on the etiology of the pathology. In children with cicatricial stenosis, that developed after intubation trauma of an intact larynx, the results were better. Repeated surgery of small scars produced a high success rate when CO2 laser was used between months 3 and 7. In the case of concentric scars surgical intervention was indicated during months 7-12 after the first operation, with laryngotracheoplasty being the method of choice. PMID- 1788897 TI - [Laser excision in chondroma of the subvocal cavity of the larynx]. PMID- 1788898 TI - [Impaired mobility of the vocal cords in a patient with hyperexplexia]. PMID- 1788899 TI - [Chondroma of the larynx]. PMID- 1788900 TI - [Neurinoma of the larynx with signs of malignization]. PMID- 1788901 TI - [Fibrosarcoma of the larynx]. PMID- 1788902 TI - [Laryngeal cancer developing in a patient with pemphigus vulgaris]. PMID- 1788903 TI - [Chondro-perichondritis of the larynx and abscess of the lamina cartilaginis cricoideae in a patient with botulism]. PMID- 1788904 TI - [Post-intubation granulomas of the larynx]. PMID- 1788905 TI - [A case of combined laryngocele and features of its removal]. PMID- 1788906 TI - [Pyolaryngocele]. PMID- 1788907 TI - [Bronchial asthma attack after excision of cancerous tumor of the larynx]. PMID- 1788908 TI - [2 cases of epidermoid cyst of the epiglottis]. PMID- 1788909 TI - [Sinusitis--incidental findings during magnetic resonance computer tomography of the head]. PMID- 1788910 TI - [Papilloma of the maxillary sinus extending into the nasal cavity and deforming the face]. PMID- 1788911 TI - [Chronic suppurative otitis media complicated by abscess of the temporal lobe of the brain and purulent ventriculitis]. PMID- 1788912 TI - [A rare case of otogenic thrombosis of the bulb of the internal jugular vein]. PMID- 1788913 TI - [Injury of the concha auriculae]. PMID- 1788914 TI - [Artificial nutrition in multimodal intensive therapy of patients with ORL cancer]. PMID- 1788915 TI - [Otorhinolaryngology classics: biography and main works of Joseph Toinby (1815 1866)]. PMID- 1788916 TI - The control of bovine spongiform encephalopathy in Great Britain. PMID- 1788917 TI - An economic assessment of twin births in British dairy herds. AB - The effect of twinning on the subsequent health, production and reproductive performance of dairy cattle was studied by analysing the data derived from 19,755 calvings which occurred during three years on 37 farms. The data formed part of the database of a veterinary practice operating the DAISY dairy cow recording scheme for its dairy farmer clients. The average twinning rate was 2.5 per cent. For first calf heifers the rate was 0.9 per cent, and the rate increased with increasing parity to over 5 per cent for cows calving for their sixth and subsequent lactations. Although they produced more milk than their contemporaries, twin-bearing cows suffered an increased incidence of retained placenta and vulval discharges and their calving to conception interval was extended by 33 days. Furthermore, 35 per cent of these cows were culled compared with 21 per cent of their contemporaries. The benefit of having more calves for sale was reduced owing to 15 per cent of them being born dead. It is calculated that producing twins resulted in an average loss of income of 74 pounds/cow, a deficit of 15 per cent compared with cows having single calves. PMID- 1788918 TI - Differentiation of Salmonella senftenberg into biogroups. AB - Ninety-six strains of Salmonella senftenberg, isolated between 1984 and 1986 from different parts of England and Wales, were tested for their biochemical reactions and biotyped according to the method of Duguid and others (1975). Nine biogroups were identified on the basis of their metabolism of L-tartrate, D-tartrate, Bitter's xylose and Stern's glycerol. In addition, fumaric, oxalic, succinic, glutaric, malonic, maleic, L-malic, L-aspartic, lactic and formic acids were used but did not increase the discrimination. Three biogroups (7, 2 and 5) accounted for 79 per cent of the cultures examined. PMID- 1788919 TI - Skirrow agar for simultaneous isolation of Brucella and Campylobacter species. species. PMID- 1788920 TI - An assessment of the CITE T4 immunoassay. PMID- 1788921 TI - Enterococcal endocarditis causing heart failure in broilers. PMID- 1788922 TI - Sudden death in a recently calved heifer. PMID- 1788923 TI - Tests for milk screening. PMID- 1788924 TI - Coat colour and copper deficiency in cattle. PMID- 1788925 TI - A survey of the prevalence of Toxoplasma infection in goats in New Zealand and a comparison of the latex agglutination and indirect fluorescence tests. AB - Anti-Toxoplasma antibody titres in 185 sera from clinically normal goats from 14 farms were assayed by both the latex agglutination and the indirect fluorescent antibody tests. The animals were of various breeds including Angora, New Zealand feral, Angora x feral, Saanen and Toggenburg. A high level of agreement between the two tests was obtained with 83.8% of titres corresponding to within one dilution and 96.8% to within two dilutions. In both tests, titres of 1:64 and above were considered positive. A total of 298 goat sera from clinically normal kids (n = 88), yearlings (n = 65) and adults (n = 145) from 17 farms were examined by the latex agglutination test. The prevalence of positive sera was 7% in kids, 23% in yearlings and 37% in adults. There was a significantly higher prevalence of positive sera in dairy than in fibre breeds. PMID- 1788926 TI - Assessment of mean oocyst count in groups of kids: litter, individual randomized and non-randomized fecal samplings. AB - A trial was conducted in six pens of kids visited five times monthly to compare different regimes of fecal sampling in order to assess average coccidial infection at a group level. In addition to individual fecal samplings of all the kids in the pen, giving the actual mean oocyst count, three sampling methods were performed: (i) individual sampling of three, five, seven, ten, 15, 20 or more animals according to the numbers of animals in the pen; (ii) sampling of feces in the litter; (iii) individual sampling of six kids, three with the poorest and three with the highest daily weight gain. Results indicated that drawing a random sample of ten kids was necessary to obtain a good estimation, with an accuracy of 25% in more than 90% of pens. Sampling of feces in the litter and individual sampling of six kids selected on daily weight gain considerations gave accurate estimation of the actual mean oocyst counts except in the case of high levels of infection. Further investigations would be needed to assess the diagnostic value of such sampling techniques whatever the coccidial infection level. PMID- 1788927 TI - Trypanosoma evansi infection in worked and unworked buffaloes (Bubalus bubalis) in Indonesia. AB - The effect of controlled amounts of exercise on the outcome of Trypanosoma evansi infection was studied in groups of swamp buffaloes (Bubalus bubalis) experimentally infected with T. evansi. Daily body temperature, packed cell volume (PCV) and parasitaemia measurements were obtained from each animal for up to 110 days after infection. Exercise did not appear to exacerbate the effect of T. evansi infection in that similar temperature, PCV and parasitaemia profiles were obtained with both exercised and rested animals. Trypanosoma evansi infection, however, had a marked effect on temperature and PCV profiles, both of which could adversely affect an infected animal's work output and work tolerance. PMID- 1788928 TI - The effect of Trypanosoma brucei infection on serum biochemical parameters in boars on different planes of dietary energy. AB - Young boars were placed on diets with either low or high dietary energy and subsequently infected with a virulent stock of Trypanosoma brucei. The effects of dietary energy level and infection on some serum biochemical parameters were evaluated up to 7 weeks post-infection (p.i.). There were no significant changes in serum electrolyte (Na+, K+) concentrations resulting from dietary energy level and/or the infection. Serum total protein and albumin levels significantly decreased in both groups of infected boars, the decline being greater in those on the low-energy diet. Infection was accompanied by a rise in serum transaminase (serum aspartate and alanine aminotransferases) levels which were higher in infected boars on the low-energy diet. The serum testosterone concentration declined in both groups of infected boars with the fall being more pronounced in the group on the low-energy diet. The results indicated that the reproductive efficiency of boars may be modulated by nutrition and that adequate feeding may assist in ameliorating the deleterious effects of trypanosomiasis on production in endemic areas. PMID- 1788929 TI - Partial purification and characterisation of the proteolytic enzymes of Fasciola gigantica adult worms. AB - The proteases of adult Fasciola gigantica whole worm were analysed by preparative isoelectric focusing and by gelatin-substrate gel electrophoresis at acidic and neutral pH (4.5 and 7.0). At least 15 bands of proteases were observed. These proteases had molecular weights ranging from 26 to 193 kDa and isoelectric points of 4.92-7.63. Protease-rich fractions were subsequently separated from whole worm preparation of the parasite by filtration in Sephacryl S-200. The proteases were able to digest bovine immunoglobulin G (IgG) and globin (derived from bovine haemoglobin) in vitro. The sizes of the proteases in these fractions were from 26 to 96 kDa, and they were inhibited by the protease inhibitors phenylmethylsulphonyl fluoride (PMSF), leupeptin and trasylol. PMID- 1788930 TI - Production and characterization of monoclonal antibodies against excretory secretory products of Fasciola hepatica. AB - Four monoclonal antibodies (mAbs) (9.49, 24.27, 46.71 and 179.57) were produced against Fasciola hepatica excretory-secretory products. Isotype analysis revealed the antibodies to be IgM, IgG3, IgG1, and IgM. In immunoblot assays, the mAbs recognized different antigenic polypeptides migrating between 29 and 180 kDa. Specificity of the mAbs was evaluated by ELISA against antigens of Fascioloides magna, Anoplocephala magna, Stichorchis subtriquetrus, Haemonchus contortus, sheep liver extract (SLE), bovine liver extract (BLE), bovine serum albumin (BSA), bovine viral diarrhea virus (BVDV), and Madin-Darby bovine kidney (MDBK) cells. Monoclonals 9.49 and 24.27 were specific, and reacted only with Fasciola hepatica antigens. However, mAb 46.71 cross-reacted with antigens of Fascioloides magna, A. magna, Stichorchis subtriquetrus, and H. contortus but not with SLE, BLE, BSA, BVDV or MDBK cells. Monoclonal antibody 179.57 cross-reacted with Fascioloides magna, A. magna, S. subtriquetrus, H. contortus, SLE, and BLE, but not with BSA, BVDV, or MDBK cells. PMID- 1788931 TI - Hematology and clinical pathology of experimental Fascioloides magna infection in cattle and guinea pigs. AB - The hematologic and clinico-pathologic response to Fascioloides magna infection in cattle and guinea pigs was investigated. Twelve calves (six infected and six controls) were monitored for 26 weeks after inoculation with 1000 metacercariae. All calves remained healthy and there were no significant differences in weight gains between infected and control groups. Flukes (mean = 9.2, range 1-32) were recovered from the liver and abdominal cavity of all infected calves. The only significant response observed in the complete blood counts was an eosinophilia present in the infected calves extending from Weeks 2 to 26 post-infection. There were no significant differences in serum levels of aspartate aminotransferase and only minor increases in the levels of gamma-glutamyl transferase and sorbitol dehydrogenase. A total of 48 infected and 48 control guinea pigs from three separate experiments were monitored for 16 weeks after inoculation with 20 metacercariae of Fascioloides magna. Infected guinea pigs died between 7 and 114 days after infection, and flukes (mean = 2.5, range 0-13) were recovered from the liver, abdominal cavity, lungs, thoracic cavity, skeletal muscle and subcutaneous tissue. There were no differences in weight gains between infected and control guinea pigs. Complete blood counts showed increases in white blood cells, monocyte and neutrophil counts from between the third and fourteenth weeks post infection; however, the differences were not consistently significant. Infected guinea pigs developed a significant eosinophilia and basophilia from 2 to 16 weeks post-infection. There were no significant changes in the serum levels of alanine aminotransferase or gamma-glutamyl transferase. There was an increase in the serum levels of aspartate aminotransferase beginning at 5 weeks post infection. The response observed in the guinea pigs was similar to that reported in sheep, suggesting the suitability of the guinea pig as a model for Fascioloides magna infection in the sheep. PMID- 1788932 TI - Biology and pathophysiology of Toxocara vitulorum infections in a rabbit model. AB - Ten female New Zealand rabbits were infected via stomach intubation with eggs of Toxocara vitulorum at a dosage of 10 embryonated eggs per gram of body weight on Days 0, 35 and 72. Ten or 4% of the administered parasites passed in the feces during the 3 days following the first or second infection, but 32% after the third infection. Many larvae were passed in the third infection, but not in the first or second. Tissue parasite yields were 4.1% on Day 5, 2% on Day 15, 0.8% on Day 30, 0.1% on Day 65 and 0.06% on Day 101. Five hundred and ninety-three larvae were recovered from liver, 243 from lungs and 0 from muscles on Day 5; 282 from liver, 138 from lungs and 21 from muscles on Day 15; 151 from liver, 21 from lungs and 50 from muscles on Day 30; 0 from liver, 26 from lungs and 15 from muscles on Day 65; 0 from liver, 0 from lungs and 9 from muscles on Day 101. No larvae were found in other tissues. The size of the muscle larvae at 30, 65 and 101 days indicated that the parasites did not develop beyond the infective stage and suggested that they were probably hypobiotic organisms. Erythrocytes, packed cell volume and monocytes decreased, but eosinophils and basophils increased, after each infection. Serum enzyme levels indicated that liver damage occurred only after the first infection, but muscle injury occurred after each infection and was increasingly more precocious after each infection. PMID- 1788933 TI - Efficacy of ivermectin against Parafilaria bovicola and lesion resolution in cattle. AB - Thirty-two cattle were included in a study to confirm the efficacy of ivermectin administered at 200 micrograms kg-1 against Parafilaria bovicola and to determine the time required for resolution of the lesions caused by the parasite. Four treated and four control animals were slaughtered over 2 days starting 15, 30, 50 or 70 days after treatment. The number, distribution and surface area of carcass lesions, and the weight of tissue trimmed to render the carcasses aesthetically acceptable, were recorded and parasites were recovered from subcutaneous tissues. Significantly (P less than 0.01) fewer worms were recovered from ivermectin treated cattle slaughtered 50 or 70 days after treatment than from controls. Reductions in the mean number and surface area of lesions, and in the weight of tissue trimmed, were statistically significant (P less than 0.05) for the ivermectin-treated group slaughtered 70 days after treatment and approached significance (P less than 0.1) for the ivermectin group slaughtered 50 days after treatment. PMID- 1788934 TI - Effect of a controlled-release albendazole capsule on parasitism and productivity of sheep. AB - The efficacy of intraruminal albendazole (ABZ) capsules (Profitril-Captec) and the effect of treatment on productivity were studied in 300 ewes infected with gastrointestinal nematodes and the trematode Dicrocoelium dendriticum. Coprological tests revealed that treated animals remained negative for 10 weeks after the administration of capsules. Contamination of pasture with nematode larvae was significantly reduced during the whole experiment. Necropsy of 14 animals (seven treated and seven untreated) showed 96.9-99.2% efficacy against the nematodes Nematodirus spp., Oesophagostomum spp., Cooperia spp., Trichostrongylus spp. and Trichuris ovis, while efficacy was 88.5% against D. dendriticum. During the 6 month pasture season (May-October 1989), treated ewes produced on average 2.56 kg cheese and 0.6 kg wool per ewe more than untreated controls. Our study confirms the reliability of the ABZ slow-release capsules over 90 days and the positive effect of treatment on nematode contamination of pasture and ewe productivity. PMID- 1788935 TI - The effect of parasite control on fertility in beef heifers. AB - The effect of anthelmintic treatment on the growth and conception rate in beef heifers was studied in southwestern Virginia, USA. Forty mixed-breed heifers were divided into two groups at weaning and placed on experimental pastures. Control heifers did not receive anthelmintic treatment, while animals in the treatment group were given ivermectin (200 micrograms kg-1) at the time of allocation to groups in October and again in April the following year. Supplemental feed was provided throughout the winter to ensure adequate weight gains. In May, the heifers were exposed to bulls for natural breeding for a period of 6 weeks. Weight gains, fecal egg counts, serum pepsinogen levels and pasture larvae counts were monitored throughout the experiment. No difference in conception rate was observed between the two groups, although the cumulative weight gain was significantly greater in treated than non-treated animals. Serum pepsinogen levels and fecal egg counts were also generally lower in treated than non-treated heifers. PMID- 1788936 TI - Parasite burdens and host susceptibility of Zebu and N'Dama cattle in village herds in Gambia. AB - Helminth and tick burdens of N'Dama cattle kept in village herds were compared with parasite burdens in Zebu cattle introduced into the same herds. The animals were monitored regularly for tick and helminth burdens, and blood samples were examined for differential white cell counts. The Zebu were found to have significantly higher numbers of endo- and ectoparasites. The N'Dama had significantly higher levels of circulating eosinophils than the Zebu during peak parasite burdens. No difference in antibody levels to Amblyomma variegatum infestation could be detected between the two breeds. It is suggested that observed differences in susceptibility to endo- and ectoparasites between the two breeds cannot be totally attributed to environmental naivety of the Zebu, but must be partially owing to enhanced innate resistance factors in the N'Dama. PMID- 1788937 TI - Survival of larvae of Boophilus annulatus, Boophilus microplus, and Boophilus hybrids (Acari: Ixodidae) in different temperature and humidity regimes in the laboratory. AB - The survival period for larvae of Boophilus annulatus (Say), Boophilus microplus (Canestrini) and hybridized Boophilus ticks was determined by exposure to various combinations of temperature (20, 25, 30 and 35 degrees C) and relative humidity (32, 63, 75, 84 and 97% RH) in the laboratory. Results indicated that within a given temperature and RH regime, there was no difference (P greater than 0.05) in larval survival among the three species tested, indicating that these ticks respond similarly over a wide range of temperature and RH combinations. Larval survival in all three species was longest (P less than 0.05) at 20 degrees C and either 84 or 97% RH. With each increase in temperature at the 84 and 97% RH treatment levels, there was a corresponding significant (P less than 0.05) decrease in larval survival. When the temperature reached 35 degrees C at all humidities or when the RH was 63% or less at all temperatures, the mean larval survival period was 43 days or less in all cases and little difference (P greater than 0.05) was observed among the treatment regimes included. Results suggest that at a RH of 75% and more, the temperature is the determining factor in larval survival, whereas at a RH of 63% and less the RH is the determining factor in larval survival, regardless of temperature. PMID- 1788938 TI - Epidemiology of Oestrus ovis in southwest France. AB - From July 1989 to June 1990, 555 heads of adult sheep obtained from Pamiers slaughterhouse (southwest France) were examined for infestation by Oestrus ovis. Infestation was present in 65% of the heads and the mean larval burden per positive case over the year was 24.8. The monthly prevalence rate varied from 44% in April to 88.2% in November. There are usually three generations of O. ovis each year: the first in March-April, the second in June-July and the last in September-October. There was no fly activity in winter and during the hottest months of summer. On the other hand, nearly all the larvae overwintered as the first stage. This study emphasizes the seriousness of the problem in the region and the authors recommend three strategic treatments per year during periods of high fly activity. PMID- 1788939 TI - Humoral and cellular immune response of rabbits to Psoroptes cuniculi, the rabbit scab mite. AB - Rabbits infested for the first time with Psoroptes cuniculi (Group A) and heavily infested ones with unknown aetiology (Group B) were examined for specific serum antibody activity and responsiveness of their peripheral blood lymphocytes by the enzyme-linked immunosorbent assay and lymphocyte transformation assay methods. These parameters were examined after treatment with ivermectin and after subsequent challenge infestation with P. cuniculi. Group A rabbits developed a small number of mite-caused lesions, and exhibited a significant P. cuniculi antigen-induced T cell response and a high level of specific serum antibody. However, both lymphocyte responsiveness and antibody production were observed to be suppressed in Group B rabbits that were highly susceptible to P. cuniculi. PMID- 1788940 TI - Canine filariasis caused by Dirofilaria repens in southeastern Nigeria. AB - Many species of canine filarial nematodes and their microfilariae have been described in various parts of the world. At the present time, it would appear that in Nigeria, the canine filarial species of importance is Dirofilaria repens. The parasite and its microfilariae appear to produce toxic and immunologic actions which are responsible for many pathological lesions. PMID- 1788941 TI - Anthelmintic activity of paraherquamide in dogs. AB - Paraherquamide, an oxindole alkaloid metabolite of Penicillium paraherquei and Penicillium charlesii, was tested against the common gastrointestinal nematodes of dogs at a single oral dosage of 0.5, 1.0, or 2.0 mg kg-1. Efficacy was poor (less than 85%) against Ancylostoma caninum, Uncinaria stenocephala, Toxascaris leonina, Trichuris vulpis, and Strongyloides stercoralis at the low- and mid dosage levels. At the high dosage level, good efficacy (91%) was observed only against S. stercoralis. Adverse reactions were observed in all dogs at every dosage level and included depression, ataxia, and protrusion of the nictitating membrane. PMID- 1788942 TI - [Our experience in double contrasting of the stomach and duodenum]. PMID- 1788943 TI - [The value of the x-ray study method in the diagnosis of celiac-sprue]. AB - The authors describe some features of x-ray symptoms of Gee-Herter disease with relation to severity and a period of disease. Altogether 106 adult patients with this disease were followed up, of them 78 patients with diagnosis of Gee-Herter disease, confirmed by histology of intestinal biopsy specimens, were selected for analysis. Three groups of patients with different x-ray symptoms were singled out. Some distinctive features of differential diagnosis and complications of Gee Herter disease in adults were noted. PMID- 1788944 TI - [Methodologic aspects of the x-ray endoscopic study of the pancreatobiliary system]. AB - Methodological variants of roentgenoendoscopic investigation of the pancreatobiliary system were worked out on the basis of a combination of various methods of contrast studies of the ducts and fibroduodenoscopy. Possibilities of their use were shown with respect to a clinical situation. Investigations of 240 patients led to the conclusion that the use of the above variants of roentgenoendoscopic investigation increased diagnostic and therapeutic efficacy in diseases of the pancreatobiliary system. PMID- 1788945 TI - [Venography in the evaluation of the results of surgical treatment of varicocele in children]. AB - The paper is concerned with analysis of the results of intraoperative phlebotesticulography, performed in 50 patients with varicocele of degree I-II during Ivanissevich's operation. The effect of surgical intervention was shown to depend upon the quality of ligation of the testicular vein, some parts of which are anastomosed between themselves. The localization of this anastomosis is revealed by means of intraoperative phlebotesticulography, which permits increasing the results of surgical treatment and predicting a course of a postoperative period. PMID- 1788946 TI - [Ultrasonic echography in the diagnosis of urolithiasis]. AB - The paper is concerned with comparison of the results of ultrasound and x-ray investigation in 110 patients with urolithiasis. A possibility was established to diagnose roentgenonegative concrements in the kidneys and pelvicalyceal system with the help of ultrasound echography. The results of x-ray investigation were more reliable for the localization of uretero- and cystoliths. Ultrasound echography in such patients permitted the detection of complications (hydrocalycosis and hydronephrosis) as well as the assessment of the time course of complications in the postoperative period. PMID- 1788947 TI - [Computed tomography in the diagnosis of head and neck diseases]. AB - A total of 106 patients suffering from tumors and inflammatory diseases of the head and neck were investigated. CT was performed in axial and frontal projections using a method of intravenous contrast image enhancement. The purpose of CT was to reveal an abnormal lesion, to detect its initial site, spreading, to make differential diagnosis, and to evaluate therapeutic results. Some limitations of CT in differential diagnosis of small-size tumors were observed. CT can be used for differential diagnosis of tumors and inflammatory processes in the accessory nasal sinuses. CT results were important for a choice of therapeutic methods, radiation therapy design, assessment of efficacy of surgical and radiation therapy, and the detection of tumor recurrences. PMID- 1788948 TI - [Panoramic zonography in the diagnosis of blowout fractures of the orbit]. AB - Altogether 32 patients with blow-out fractures of the orbit were investigated, using an x-ray study that included panoramic zonography. Isolated blow-out fractures and blow-out fractures combined with injured adjacent facial bones, were singled out. X-ray signs were divided into direct ones, characterizing a parietal fracture, and secondary ones, determined by secondary traumatic changes. Fractures of the lower and medial walls of the orbit were considered. PMID- 1788949 TI - [Magnetic resonance tomography of malignant tumors of the maxilla]. AB - The authors discussed their experience in investigating 20 patients with maxillary malignant tumors using routine x-ray studies and MR-tomography, and 13 patients, investigated in the same way plus CT. MRT permitted defining a topical localization of a tumor and its spreading to adjacent anatomical regions (the pterygopalatine and infratemporal fossae, pharynx and peripharyngeal space, orbit, buccal soft tissues, and the cranial cavity). MRT was used to differentiate between tumor tissue and inflammation even within the sinus. As to the detection of osseous destruction, CT seemed much more superior than MRT. It was only in one patient that x-ray findings brought about better results than MRT because of artefacts resulting from metal crowns on the affected side. PMID- 1788950 TI - [Computed tomography in the diagnosis of pathological states of the lumbar diaphragm. 1: general data. Developmental defects and traumatic disorders]. AB - CT was employed for investigation of 94 patients with pathological changes of the diaphragm. Congenital defects and unilateral aplasia of the diaphragm were observed in 5 of them. A new symptom of a pathological line of the diaphragm was recognized, characteristic for this type of patients. Teratodermoid formations with a typical CT picture were found in 3 patients. A tumor growth source was undetectable by CT. The results of investigation of 5 patients with traumatic diaphragmatic hernia have shown no particular advantages of CT over traditional radiation methods. In one case, a traumatic diaphragmatic cyst was correctly diagnosed by CT. CT was shown to be a method of choice in the diagnosis of congenital and traumatic diaphragmatic lesions. PMID- 1788951 TI - [Destructive changes in the joints in juvenile rheumatoid arthritis]. PMID- 1788952 TI - [X-ray diagnosis of injuries to the posterior part of the pelvic ring in children]. AB - Proceeding from morphoroentgenological investigation of 48 isolated pelvic specimens from dead children, a new method for radiodiagnosis of fractures of lateral sacral masses (LSM) and rupture of sacroiliac joints (SIJ), based on quantitative assessment of pelvic ring deformity has been developed. Limitations of the method were established. The introduction of this roentgenometric method into clinical practice for diagnosis of injury of the posterior pelvic semiring permitted an increase in x-ray detection of LSM fractures 10-fold and SIJ ruptures 2.5-fold. PMID- 1788953 TI - [Functional computed tomography in the diagnosis of injuries to the ligamentous apparatus of the upper cervical spine in children and adolescents]. AB - Altogether 40 children and adolescents were investigated after injuries of the upper cervical spine using radiograms through the open mouth, functional radiograms of the cervical spine, and functional CT. Various injuries of the ligamentous apparatus of the upper cervical spine were revealed in 31 patients. PMID- 1788954 TI - [Ultra-low field magnetic resonance tomography in the diagnosis of diseases of the spine and spinal cord]. AB - A total of 309 investigated cases was analyzed with the help of the Magnaview apparatus with field intensity of 0.04 T. The method included obtaining both T1- and T2-suspended tomograms in the sagittal and, if necessary, transverse planes. MRT was shown to be an effective method of diagnosis and differential diagnosis of the compression syndrome of osteochondrosis, the effects of a "spinal" trauma, extra- and intramedullary tumors, metastatic vertebral involvement, postoperative changes, and syringomyelia. PMID- 1788955 TI - [Current aspects of the treatment of cancer of the prostate gland: etiology, diagnosis, radiotherapy (review of the literature)]. PMID- 1788956 TI - [Computed tomography in the differential diagnosis of jaundice]. PMID- 1788957 TI - [Spontaneous intrahepatic anastomosis between the portal and hepatic vein systems in a patient with portal cirrhosis of the liver]. PMID- 1788958 TI - [Ultrasound tomography of inflammatory infiltrates in muscles]. PMID- 1788959 TI - [Metastases of thyroid gland cancer to the cranial bones]. PMID- 1788960 TI - [A case of Wegener's granulomatosis in a 13-year-old child]. PMID- 1788961 TI - [Computed tomography in the diagnosis of pathological states of the lumbar diaphragm. 2: diseases of the diaphragm]. AB - CT potentialities in the diagnosis of diaphragmatic diseases were considered. CT provides valuable information in relaxations of the diaphragm and diaphragmitides, permitting the detection of infiltration of the diaphragm by a tumor, retroperitoneal fibrosis, diaphragmatic cysts, Bochdalek's hernia, and hernias of the esophageal opening. An algorithm for investigation of patients with suspected diaphragmatic pathological conditions was proposed. PMID- 1788962 TI - [A rare case of osteoid-osteoma localization]. PMID- 1788963 TI - [The use of the Elektronika BM-12 video magnetophone in x-ray studies]. PMID- 1788964 TI - [Dynamics of returning the injured and ill to military and work responsibilities in wartime]. AB - Returning of the injured and diseased to military and working duties in war have been trained and tested in the final training of members of the School of Reserve Medical Officers of the Military Medical Academy in the period 1985-1989. The time of returning of the injured and diseased members of the armed forces depends directly on the organization of the military medical and public health service, and especially of the preparedness of health personnel, well equipped military medical units and health institutions and the consistent application of the unique military doctrine. PMID- 1788965 TI - [Risk of infection with Borrelia burgdorferi in an area endemic for Lyme disease]. AB - The results of the study of the prevalence of antibodies against Borrelia burgdorferi in three categories of subjects from the endemic region of Lyme disease in the northeast Croatia are reported. The study comprised 265 subjects: 97 living in the rural region, 51 forest rangers working in this region and 117 members of the Yugoslav People's Army who spent a certain period of time in this region. Positive titer of specific antibodies were found in 11.3% of local inhabitants, 25.5% forest rangers and 6% soldiers. Serologic testing was performed by the direct immunofluorescent method with aspiration and the titer in the dilution of 1:80 was considered significant. Some risk factors causing disease as well as the relationship between inapparent and clinically manifested cases of infection are pointed out. PMID- 1788966 TI - [Spectrophotometric determination of phenol and sodium tosylchloramide]. AB - A possible quantitative analysis of oil injections of phenol and tosylchloramide sodium solution using the spectrophotometric method in the UV field has been examined. The results have been compared with results of official methods, bromometry and iodometry. The proposed spectrophotometric method is suitable due to its speed and simplicity in work giving precise and reproducible results. PMID- 1788967 TI - [Hardness of composite materials used for restoration of front teeth]. AB - The evaluation comprised four anterior two-components composite materials: concise-"B", concise-"T", adaptic and silar and six anterior one-component composite materials: heliosit, visio-dispers, visio-fill, durafill, estilux and prisma-fill. The Amsler press of 600-2000 kg was used for evaluation of hardness on pressure, flexion and extension of 10 composite materials using the original "accessory apparatus" PAC-s and PAC-e. For evaluation of hardness 15 samples of each material were made. On the basis of the results obtained it has been concluded that no evenly regular dependence exists among the evaluated hardness of different composite materials so it is necessary to evaluate all three hardness for their adequate categorization. Taking into account levels of all three hardness, AJKM was recommended as better material than ADKM, while some of them are much better (such as estilux, prisma-fill and visio-fill) for restoration of angular defects of teeth structures of crowns of anterior teeth. PMID- 1788968 TI - [Exposure to selenium in photocopying workers]. AB - The selen concentration was found in the air of 10 photocopy rooms with the mean value of 0.0025 +/- 0.0013 mg Se/m3 of the air which markedly below the maximally permissible concentration. In the same time selen was determined in serum and urine of persons in these photocopy rooms and in 22 control subjects. The mean value of selen in urine of workers in photocopy rooms was 76.50 +/- 12.60 micrograms Se/1, which is statistically significant compared with the control group which indicate that workers are exposed to selen but in a smaller degree. In the exposed subjects selen urine concentrations were higher compared to the control group with the mean value of 19.01 +/- 6.79 micrograms Se/1, but it has not been statistically significant. The selen level in urine and serum of examinees were mainly in the limits given for normal population so that the present selen exposure of workers in the photocopy rooms could not be considered harmful for human health. PMID- 1788969 TI - [Fractures of the scaphoid bone in soldiers]. AB - The conservative treatment and results obtained in the treatment of 30 scaphoid bone fractures in soldiers aging from 18 to 22 years are reported. The immobilization was performed after acute posttraumatic edema, the latest 4 days after injury, first using the plaster splint and then the "plaster gloves." The immobilization lasted two months. The complete healing was achieved in 29 injured and pseudoarthrosis occurred in one case only. PMID- 1788970 TI - [New possibilities for medical and pharmaceutic activities in field conditions]. PMID- 1788971 TI - [Biological effects of laser irradiation and its use in medicine]. PMID- 1788972 TI - [Clinical significance of anticardiolipin antibodies]. PMID- 1788973 TI - [Macrocystic meningiomas]. PMID- 1788974 TI - [Trigeminal neuralgia as a symptom of cerebellopontine epidermoid cyst]. PMID- 1788975 TI - [Possibilities of defibrillation under field conditions]. PMID- 1788976 TI - Evaluation of certain veterinary drug residues in food. Thirty-eighth report of the Joint FAO/WHO Expert Committee on Food Additives. PMID- 1788977 TI - Xenobiotic induction of P-450 PB-4 (IIB1) and P-450c (IA1) and associated monooxygenase activities in primary cultures of adult rat hepatocytes. AB - 1. The long-term maintenance of metabolism of representative drugs and steroid hormone substrates by cytochromes P-450, and their inducibility, was investigated in primary cultures of adult rat hepatocytes. Collagenase-isolated cells were seeded on collagen-coated tissue culture dishes and cultured in Chee's essential media in the presence or absence of phenobarbital (PB, 0.75 mM, 96 h or continuously) and 3-methylcholanthrene (MC, 5 microM, 48 h) for up to 45 days. 2. Hepatic P-450-dependent metabolism of diazepam to its primary oxidized metabolite was inducible by PB both in vivo (monitored in isolated liver microsomes) and in cultured cells (up to 100% and 400% increases in the formation of temazepam and nordiazepam, respectively, after 25 days in culture). Hepatocyte microsomal androstenedione 16 beta-hydroxylase activity was also induced by PB treatment of the hepatocytes (350-650% increase in 20-day-old cells). 3. Western blot analysis revealed that immunoreactive P-450 form PB-4 (IIB1), which catalysed the N demethylation of diazepam to yield nordiazepam as well as androstenedione 16 beta hydroxylation when assayed in a purified enzyme system, was substantially elevated following PB treatment of the cultured cells. Similarly, MC induced 7 ethoxycoumarin O-deethylase activity (up to 2000% increase from 5 to 45 days) as well as immunoreactive P-450c (IA1) in the hepatocyte cultures. 4. These studies demonstrate that cytochrome P-450 activities can be maintained, and also induced, after extended periods of time in hepatocytes cultured using a simple collagen mixture as substrate and a commercially available tissue culture media. This culture system should provide an important tool for further studies of P-450 dependent xenobiotic metabolism in a well-defined, liver-derived cellular system. PMID- 1788978 TI - Methylation of captopril in human liver, kidney and intestine. AB - 1. The methylation of captopril was studied in the microsomal fraction from 20 human liver, 12 kidney, and 14 intestinal mucosa specimens. 2. The hepatic methyltransferase activity (mean +/- SD) was 477 +/- 204 pmol/min per mg. Renal and intestinal methyltransferase activities were 3 and 8 times lower, respectively, than hepatic activity. 3. The kinetics of methyltransferase with captopril as substrate were studied in four specimens of liver, kidney and intestine. The maximum velocities of reaction (mean +/- SD; pmol/min per mg) were 697 +/- 219 (liver), 456 +/- 120 (renal cortex), 264 +/- 77 (renal medulla) and 101 +/- 28 (ileum mucosa). Km values (mean +/- SD; mM) were 5.2 +/- 2.3 (liver) 4.3 +/- 1.7 (renal cortex) 4.1 +/- 1.5 (renal medulla) and 5.3 +/- 2.0 mM (ileum mucosa). Vmax is subjected to a marked tissue dependence whereas Km is similar in all tissues. 4. Liver is the primary site of captopril methylation whereas the intestine plays only a minor role. Kidney may contribute substantially to the hepatic methylation of captopril. PMID- 1788979 TI - Sulphation of hydroxybiphenyls in human tissues. AB - 1. Sulphotransferase is an important detoxication pathway of hydroxybiphenyls and the kinetics of sulphotransferase activity were studied in human liver, ileum and colon mucosae, lung, kidney, urinary bladder mucosa and brain using 0-, m- and p hydroxybiphenyl as substrates. 2. Sulphotransferase activity was detectable in all tissues studied, although it showed marked tissue-dependence. The rate of sulphation ranged greater than 100-fold in different tissues and the highest and lowest activities of sulphotransferase were found in liver and brain, respectively. 3. The Km of sulphotransferase was not tissue-dependent but was dependent on the isomer of hydroxybiphenyl. The Km varied over a 500-fold range and the highest and lowest values of Km were found with p-hydroxybiphenyl and m hydroxybiphenyl, respectively. PMID- 1788980 TI - Sex differences in excretion of zenarestat in rat. AB - 1. Rat shows a marked sex difference in the excretion of 14C-zenarestat: only 1% of the dose was excreted in the urine of males, about 45% of the dose was excreted in the urine of females. 14C in the urine of female rats was almost entirely unchanged drug. 2. Plasma protein binding was similar in both sexes: 99.3-99.5% in males and 99.4-99.6% in females. 3. The type and ratio of metabolites in the faeces and bile were not significantly different between males and females. 4. Renal clearance experiments, and inhibition of urinary excretion by probenecid, indicated that female rats may possess an active secretory mechanism which is lacking or relatively inactive in male rats. PMID- 1788981 TI - N-dealkylation of tertiary amides by cytochrome P-450. AB - 1. N-Methyl-N-alkyl-p-chlorobenzamides (alkyl = Me, Et, nPr, nBu, PhCH2, isoPr and cylcoPr) underwent mono-N-dealkylation exclusively with phenobarbital-induced rat liver microsomes; with each compound both demethylation and dealkylation occurred. 2. The time-courses showed bilinear kinetics, but there was no evidence for general suicide-substrate activity with the cyclopropyl amide, and product ratios did not vary with time. 3. The demethylation/dealkylation ratio varied from 0.3 to 2.0 among the primary alkyl groups but was ca. 40 when the alkyl group was isoPr or cylcoPr. Dealkylation of the benzyl substituent was 2-3 times more favourable than for any other primary alkyl group. Despite wide variations in the demethylation/dealkylation ratios, at near-saturating concentrations of substrates the rates of total oxidation (demethylation plus dealkylation) varied little across the entire series. 4. The results of this study are consistent with a kinetic mechanism involving significant commitment to catalysis, substituent induced metabolic switching at the product-determining step, a non-catalytic step which is partly rate-limiting in turnover, and a chemical mechanism involving H atom abstraction as opposed to electron abstraction. PMID- 1788982 TI - Metabolism of the thiocarbamate herbicide SUTAN in rats. AB - 1. The metabolism of the thiocarbamate herbicide SUTAN (butylate) was studied after administration of single oral doses of [isobutyl-1-14C]SUTAN to male and female rats. 2. The radiolabelled dose was rapidly absorbed and excreted, with 79% of the dose excreted in the urine in 72 h. The small percentages of radioactivity excreted in the faeces and as 14CO2 were significantly higher (P less than or equal to 0.05) in males than in females. 3. SUTAN was extensively metabolized, and no unmetabolized SUTAN was found in the urine. A total of 18 of the 29 urinary metabolites were identified, and identified metabolites represented 83-88% of the urinary radioactivity. 4. Diisobutylamine was the major urinary metabolite in both males and females, averaging 51% of the urinary radioactivity. 5. Other significant urinary metabolites included primary hydroxylated and tertiary hydroxylated diisobutylamines and a series of mercapturic acid pathway metabolites, including an S-glucuronide and several hydroxylated and unhydroxylated mercapturates. 6. Oxidations at the three alkyl groups produced a variety of minor urinary metabolites, and hydroxylation of the primary or tertiary carbon on the isobutyl groups, followed by an intramolecular reaction, generated a series of minor cyclized metabolites. PMID- 1788983 TI - Tissue distribution of mexiletine enantiomers in rats. AB - 1. The kinetics of distribution of the enantiomers of mexiletine were studied in various tissue (heart, brain, lungs, liver, kidneys and fat) in male Sprague Dawley rats after administration of a single i.v. dose (10 mg/kg) of racemic mexiletine. 2. The pharmacokinetic parameters calculated from the serum data showed a 32% greater systemic clearance (162 ml/min per kg vs 123 ml/min per kg) and a 22% greater steady-state volume of distribution (9.0 l/kg vs 7.4 l/kg) for R(-)-mexiletine relative to the S(+)-enantiomer. However, the terminal elimination half-lives of the enantiomers (1.4 and 1.3 h for R(-)- and S(+) mexiletine, respectively) did not exhibit stereoselectivity. 3. Maximum tissue concentrations of the enantiomers were observed at 5 min after dosage in all tissues studied. Stereoselective uptake was evident only in the liver tissue and was 2.4-fold greater for S(+)-mexiletine. High tissue/serum ratios (greater than 20 for both enantiomers) were observed in lungs, brain and kidneys. The cardiac concentrations of R(-)- and S(+)-mexiletine were 8- and 7-fold those of serum, respectively. 4. The results demonstrate that the uptake of mexiletine enantiomers into the target tissue (heart) is not stereoselective. However, the relatively high brain accumulation of the enantiomers may be related to the CNS side-effects commonly associated with mexiletine therapy. PMID- 1788984 TI - Identification of the metabolites of irinotecan, a new derivative of camptothecin, in rat bile and its biliary excretion. AB - 1. To investigate the metabolites and biliary excretion of new camptothecin analogue, irinotecan, the drug was administered i.v. to rats (10 mg/kg) and bile, urine and faeces were collected. 2. In rat bile, unchanged irinotecan, the metabolite 7-ethyl-10-hydroxycamptothecin (EHCPT) and unknown metabolite M-1 were found by t.l.c. and h.p.l.c. From beta-glucuronidase hydrolysis, n.m.r. spectrometry and mass spectrometry, M-1 was identified as EHCPT-glucuronide (EHCPT Glu). Other metabolites in the bile were negligible. 3. The cumulative biliary and urinary excretion of radioactivity after dosage of rats with irinotecan were 62.2% and 33.3% dose, respectively, and 9.0% of the radioactivity was excreted in the faeces. 4. Approx. 55% of the biliary radioactivity excreted in 24 h was unchanged irinotecan, 22% was EHCPT Glu, and 9% was EHCPT. 5. Approx. 18% of the biliary radioactivity was reabsorbed from the intestine. PMID- 1788985 TI - Importance of oxygen functions in the biological hydroxylation of flavonoids by Absidia blackesleeana. AB - 1. The synthesis and microbiological transformation of 2-phenyl-1-tetralone (compound 3, 1-deoxyisoflavanone), 3-phenyl-1-tetralone (compound 4, 1 deoxyflavanone), 2-phenylchroman (compound 7, 4-deoxyflavanone), 3-phenylchroman (compound 8, 4-deoxyisoflavanone) and 1,2-dihydro-3-phenylnaphthalene (compound 10, 1,4-dideoxy-dehydroflavanone) by Absidia blackesleeana are described. 2. Compounds 3, 4, 7 and 8 were hydroxylated at the 4'-position while compound 10 was not utilized as a substrate. The two phenylchroman analogues 7 and 8 gave approximately the same yield (22% and 26%, respectively) of the 4'-hydroxylation products, while the phenyltetralone analogues 3 and 4 showed significant differences in 4'-hydroxylation (2% and 47%, respectively). PMID- 1788986 TI - Metabolism of benzothiazole. I. Identification of ring-cleavage products. AB - 1. The metabolic fate of benzothiazole in guinea pig has been investigated following i.p. administration at a dose of 30 mg/kg. 2. Five ring-cleavage products were identified in urinary extracts by g.l.c.-mass spectra. By reference to authentic compounds the three major metabolites were shown to be 2 methylmercaptoaniline (I), 2-methylsulphinylaniline (II) and 2 methylsulphonylaniline (III). On the basis of the mass spectrometric evidence the remaining two metabolites were postulated to be 2 methylsulphinylphenylhydroxylamine (IV) and 2-methylsulphonylphenylhydroxylamine (V). 3. I, II and III were present in conjugated and unconjugated forms; IV and V were identified only after hydrolysis with sulphatase. PMID- 1788987 TI - Investigations on the metabolic pathways of cyclosporine: I. Excretion of cyclosporine and its metabolites in human bile--isolation of 12 new cyclosporine metabolites. AB - 1. Cyclosporine metabolites of known and unknown structures were isolated, by semi-preparative h.p.l.c., from human bile from the T-tube of liver-grafted patients, who received cyclosporine treatment. Their structures were elucidated by FAB mass spectrometry and 1H-n.m.r. spectroscopy. 2. Twelve of the cyclosporine metabolites, with known chemical structures, were isolated and identified using authentic standard material. 3. Four isolated fractions contained tri-hydroxylated metabolites; two fractions contained di-hydroxylated, demethylated metabolites; one fraction contained a tri-hydroxylated, demethylated metabolite; and one fraction a mono-hydroxylated, demethylated metabolite. The exact metabolism sites were partially defined. 4. Two carboxylated cyclosporine metabolites, of which one was hydroxylated in an unknown position, were isolated. 5. One new metabolite proved to be a glucuronylated phase II metabolite. Deglucuronylation of this metabolite by beta-glururonidase yielded metabolite AM1c. The proposed structure was AM1c-Glc; is a proposed extension of the Hawk's Cay nomenclature of the cyclosporine metabolites for glucuronylated metabolites. 6. One of the unknown metabolites was hydroxylated in two positions of amino acid 1. The proposed nomenclature was 'AM11d', where '1d' indicates hydroxylation at the delta C of amino acid 1. 7. A metabolite with an aldehyde functional group at amino acid 1, which had two isomeric forms, was isolated. I.r.-spectroscopy indicated that isomerism may be caused by conjugation of the aldehyde group with the double bond between C6 and C7 of amino acid 1. PMID- 1788988 TI - Investigations on the metabolic pathways of cyclosporine: II. Elucidation of the metabolic pathways in vitro by human liver microsomes. AB - 1. Cyclosporine and its metabolites, isolated from human bile and identified by FAB mass spectrometry and 1H-n.m.r. spectroscopy, were metabolized by human liver microsomes for the identification of new cyclosporine metabolites. From these data a metabolic pathway for cyclosporine, which includes these new cyclosporine metabolites, has been proposed. The new metabolites were isolated by semi preparative h.p.l.c. and their chemical structures were elucidated by FAB mass spectrometry. These isolated metabolites were further metabolized and the products identified by FAB mass spectrometry. 2. Fourteen metabolites, whose structure has not yet been elucidated, were isolated after metabolism of structurally identified cyclosporine metabolites, and chemical structures for five of these metabolites were proposed. 3. The structures of the new cyclosporine metabolites were: (i) a N-demethylated, carboxylated derivative (AM1A4N), (ii) a di-hydroxylated, N-demethylated derivative (AM14N9), (iii) a hydroxylated and carboxylated derivative (AM1A9), (iv) a di-hydroxylated, cyclized and N-demethylated derivative (AM1c4N9) and (v) a cyclized and carboxylated (AM1cA) derivative. 4. A proposed cyclosporine metabolic pathway comprises a total of 29 metabolites. It consists of four main branches originating from metabolites AM1, AM1c, AM9 and AM4N. PMID- 1788989 TI - The pharmacokinetics of single oral doses of feprazone in healthy volunteers and elderly patients. AB - 1. The pharmacokinetics of feprazone were studied in nine healthy volunteers and 10 elderly patients. 2. The mean elimination half-life of feprazone after a single oral dose in the healthy volunteers was 22.3 h, the mean apparent clearance 0.0051 1/h per kg and the mean volume of distribution 0.1681/kg. Corresponding values for the elderly patients were 22.6 h, 0.00561/h per kg and 0.1651/kg, which are not different from those for the volunteers. Thus, we were unable to detect any changes in feprazone pharmacokinetics which are related to age, or to the concurrent use of chronic medications, such as digoxin, diuretics, or hormones. PMID- 1788990 TI - Do physicians have an ethical obligation to care for patients with AIDS? AB - This paper responds to the question: Do physicians have an ethical obligation to care for patients with acquired immunodeficiency syndrome (AIDS)? First, the social and political milieu in which this question arises is sampled. Here physicians as well as other members of the community are found declaring an unwillingness to be exposed to people with AIDS. Next, laws, regulations, ethical codes and principles, and the history of the practice of medicine are examined, and the literature as it pertains to these areas is reviewed. The obligation to care for patients with AIDS, however, cannot be located in an orientation to morality defined in rules and codes and an appeal to legalistic fairness. By turning to the orientation to morality that emerges naturally from connection and is defined in caring, the physicians' ethical obligation to care for patients with AIDS is found. Through an exploration of the writings of modern medical ethicists, it is clear that the purpose of the practice of medicine is healing, which can only be accomplished in relationship to the patient. It is in relationship to patients that the physician has the opportunity for self realization. In fact, the physician is physician in relationship to patients and only to the extent that he or she acts virtuously by being morally responsible for and to those patients. Not to do so diminishes the physician's ethical ideal, a vision of the physician as good physician, which has consequences for the physician's capacity to care and for the practice of medicine. PMID- 1788991 TI - Pseudohypoaldosteronism: case report and discussion of the syndrome. AB - A 41-year-old man, complaining of leg cramps, was found to have persistent hyperkalemia. Except for mild hypertension, his physical examination and laboratory values to exclude connective tissue diseases and diabetes mellitus were normal. Renal function testing revealed a normal glomerular filtration rate and tubular capacity to acidify and dilute, as well as near-normal ability to concentrate his urine. Hormonal evaluation revealed a normal cortisol, as well as normal resting and stimulated renin and aldosterone levels. A selective defect in tubular potassium secretion was demonstrated. In the absence of aldosterone deficiency or renal dysfunction, it was assumed that the patient had primary renal resistance to aldosterone, known as pseudohypoaldosteronism. Treatment with hydrochlorothiazide controlled his hyperkalemia and hypertension. His case emphasizes the diagnostic and therapeutic factors that should be considered in evaluating and treating a non-hospitalized patient with sustained hyperkalemia. PMID- 1788992 TI - Counseling issues in genetic screening. PMID- 1788993 TI - Nutrient interactions with reference to amino acid and protein metabolism in non ruminants; particular emphasis on protein-energy relations in man. AB - Because the regulation of protein and energy balance is of major research interest in the nutrition and physiology of humans and animals, a selected account of interactions between protein and energy is given here, with particular emphasis on studies in human subjects. The discussion begins with reference to the relations between protein and energy intakes and nitrogen balance; selected aspects of the relations between protein dynamics and energy metabolism among the various mammalian species are then considered. This leads to a brief account of oxidative amino acid catabolism and its relevance to the assessment of amino acid requirements, particularly in adult man. It is concluded that obligatory oxidative losses of amino acids can be used to predict or approximate amino acid requirements in children and adults. The nitrogen-sparing properties of carbohydrate and lipid-derived fuels are then considered. Despite the well-known and profound, yet differential, impacts of dietary protein and energy sources, and their interactions on body protein balance, there remain wide gaps in our understanding of the mechanisms responsible for their effects, such as the quantitative and mechanistic involvement of hormones, including insulin and the counter-regulatory hormones, and the roles played by the major amino acids responsible for the interorgan transport of nitrogen and the regulation of urea production. Additional studies focusing on metabolic nitrogen trafficking would significantly enhance an understanding of how protein and energy interact to achieve the efficient utilization of dietary protein for maintenance and promotion of lean body gain. PMID- 1788994 TI - Effect of diazinon on freeze-fracture images of microvilli of intestinal epithelial cells of Tilapia nilotica. AB - The effect of the organophosphate insecticide, diazinon on the intramembranous particles (IMPs) of the microvilli of the intestinal epithelial cells of Tilapia nilotica fish was studied using freeze-fracture technique. Exposing fish to different repeated concentrations of diazinon (1/2LC50) caused a significant decrease in population density of IMPs in P- and E-faces. IMPs of microvilli found in intestinal epithelial cells are thought to represent many kinds of proteins including enzymes. In the present work, it is suggested that diazinon induced a reduction in enzymatic content of the membrane which was accompanied by a decrease in IMPs density of the microvilli. PMID- 1788995 TI - [The body muscle compartment and its relationship to food absorption and blood chemistry during an extreme endurance performance]. AB - The purpose of the study was to examine the changes of the muscle's fat-free compartment and its relation to the corresponding biochemical and nutritional parameters of 42 men and 13 women, the participants of an ultra long-distance run of 1000 km (20 days of daily running 50 km). The muscle-fractions initially increased, decreased in the middle phase, and remained stable for the rest of the run. Significant changes of the fat-free weight were registered from the 11th day on, the LBM decreasing until the middle of the distance; then the lean body mass enlarged. All the muscle-circumferences were reduced with the exception of the thigh, which grew, paralleling the CK/CKMB-concentrations, this phenomenon being due to the high mechanical stress of the lower extremities. The biochemical parameters exhibit a strain-related reaction of adaptation within the initial 6 days, the hormones and protein-concentration increasing in the beginning and falling from the third day on, uric acid and CK/CKMB-activity decreasing from the 6th day on. The consecutive parallel reduction of both uric acid, urea, and muscle measurements might be seen as a special endurance-related clearance mechanism of potential toxicants. The negative relationship between the changes of muscle measurements and the cumulative protein intake and the catabolic constellation of the clinical-chemical values might suggest that the absolute protein intake of 1.7 g/kg body mass should be increased in order to diminish the loss of musculature during an ultra-long distance run. PMID- 1788996 TI - Fatty acid composition of mature human milk in Nigeria. AB - The fatty acid composition of mature human milk from 10 rural Nigerian women was analyzed by high-resolution capillary gas-liquid chromatography and compared to previously determined results on mature human milk from 15 German mothers. Human milk of the Nigerian group contains significantly higher proportions of saturated fatty acids (median 54.07 vs. 42.76% wt/wt). The difference is primarily caused by high values for lauric (C12:0, 8.34%) and myristic acids (C14:0, 9.57%), but not of medium chain fatty acids (C8:0, C10:0), presumably due to increased de novo fatty acid synthesis in the African women consuming a high carbohydrate and low-fat diet. Markedly lower values of oleic and total cis-monounsaturated (22.82 vs. 37.98%) as well as trans-isomeric fatty acids (1.20 vs. 4.40%) in Nigerian milk appear to result from low dietary intakes of animal and partially hydrogenated fats, respectively. Although percentage contribution of linoleic acid (18:2n-6) is similar, arachidonic acid (C20:4n-6) and total n-6 long-chain polyunsaturates with 20 and 22 carbons (n-6 LCP) are higher in the African samples. N-6 LCP secretion with human milk lipids is not correlated to the precursor linoleic acid and seems not to depend on maternal dietary intake of preformed dietary LCP with animal fats. N-3 LCP are very high in milk of the Nigerian women who obtain a large portion of dietary lipids from sea fish, but even then docosaehexanoic (C22:6n-3) and not eicosapentaenoic (C20: 5n-3) is the predominant n-3 LCP in milk.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1788997 TI - [The effect of increased copper supplements in feed on the development of cadmium residues in swine]. AB - In commercial pig fattening copper is added to the feed at a concentration exceeding the requirement by a factor of more than ten. This improves the weight gain of the pigs during the first three months remarkably. In order to study the influence of copper supplementation on cadmium retention, 4 groups of male castrated weanling crossbred pigs (Deutsche Landrasse x Pietrain) received for 3 months a diet containing 1 mg Cd per kg feed, given as CdCl2, as well as 0, 50, 100 or 200 mg Cu per kg feed, given as CuSO4. The liver, kidney, spleen, pancreas, brain, heart, diaphragm, bile and duodenal mucosa were submitted to wet ashing and analyzed by atomic absorption spectroscopy for cadmium. The Cd retention in all tissues increased in correlation to the Cu content of the feed. When 200 mg Cu per kg were added, Cd rose in the muscle from 10 to 15 micrograms per kg, in the liver from 770 to 1720 micrograms per kg and in the kidney, where the highest Cd concentration occurred, from 4620 to 9320 micrograms per kg. This indicates that in pigs the retention of cadmium in kidney and in liver is promoted by Cu supplementation as used in commercial pig fattening. PMID- 1788998 TI - [Content of available lysine in gamma-irradiated soybean products]. AB - The content in available lysine of soya protein products irradiated in a 60Co gamma cell were investigated. The results indicate that available lysine content and crude protein content at irradiation doses of 1, 3 and 5 kGy were unaffected at the 95% significance level. During 3-month storage the irradiated samples showed no significant (p = 0,05) changes of available lysine content. In samples with high content of lecithin, which were irradiated at 1 kGy as well as non irradiated the content of available lysine was significantly (p = 0,05) reduced after 8-month storage; the other products as well as the at 3 and 5 kGy irradiated samples showed no significant decrease. Immediately after irradiation the microflora was significantly (p = 0,05) reduced. Under the effect of radiation treatment at 3 and 5 kGy the microflora was reduced to nearly 100% after 3-month storage. PMID- 1788999 TI - [Differences in nutrition behavior between weekends and work days: results of the nutrition survey in 1984/85 of the MONICA project in Augsburg]. AB - Seven-day food records of the MONICA project Augsburg dietary survey 1984/85 in 899 men aged 45-64 years were used to compare food and nutrient intake of weekdays and weekends. Differences were found in food intake. The mean intake of energy, macronutrients and especially alcohol was higher on weekends, whereas the dietary constituents independent of total energy intake, as percentage supply of energy from macronutrients, did not show huge differences. PMID- 1789000 TI - Transport of lactic acid in Kluyveromyces marxianus: evidence for a monocarboxylate uniport. AB - Lactic acid-grown cells of a strain of Kluyveromyces marxianus transported D- and L-lactic acid by a saturable mechanism that was partially inducible and subject to glucose repression, with the following kinetic parameters at pH 5.4: Vmax = 1.00 (+/- 0.13) mmol h-1 per g dry weight and Ks = 0.42 (+/- 0.08) mM. Lactic acid transport was competitively inhibited by pyruvic, glycolic, acetic and bromoacetic acids. The latter, a non-metabolizable analogue, was transiently accumulated, the extent depending on the extracellular pH. The pH dependence of the Ks values for undissociated lactic acid and for the lactate anion indicated that the latter was the transported species. Lactate uptake was not accompanied by the simultaneous uptake of protons, potassium ions or sodium ions excluding symport mechanisms. Initial lactic acid uptake led to transient membrane hyperpolarization as measured with a fluorescent dye excluding also an electroneutral anion antiport mechanism. It was concluded that lactate anions use a monocarboxylate uniport and that the counter anion, possibly bicarbonate, uses a separate channel, the coupling being electrical and loose. PMID- 1789001 TI - Four major transcriptional responses in the methionine/threonine biosynthetic pathway of Saccharomyces cerevisiae. AB - Genes encoding enzymes in the threonine/methionine biosynthetic pathway were cloned and used to investigate their transcriptional response to signals known to affect gene expression on the basis of enzyme specific-activities. Four major responses were evident: strong repression by methionine of MET3, MET5 and MET14, as previously described for MET3, MET2 and MET25; weak repression by methionine of MET6; weak stimulation by methionine but no response to threonine was seen for THR1, HOM2 and HOM3; no response to any of the signals tested, for HOM6 and MES1. In a BOR3 mutant, THR1, HOM2 and HOM3 mRNA levels were increased slightly. The stimulation of transcription by methionine for HOM2, HOM3 and THR1 is mediated by the GCN4 gene product and hence these genes are under the general amino acid control. In addition to the strong repression by methionine, MET5 is also regulated by the general control. PMID- 1789002 TI - Selective inactivation of alcohol oxidase in two peroxisome-deficient mutants of the yeast Hansenula polymorpha. AB - We have studied selective inactivation of alcohol oxidase (AO) in two peroxisome deficient (PER) mutants of the yeast Hansenula polymorpha. In these mutants high activities of cytosolic AO are induced by different growth conditions. At enhanced expression rates AO is arranged in large crystalloids in the cytosol, whereas smaller crystalloids are often observed inside the nucleus. Transfer of cells of the PER mutant 125-2E, which completely lacks peroxisomes, to glucose excess conditions did not lead to degradative inactivation of AO and catalase as observed in wild-type (WT) cells used as a control. The gradual decrease in enzyme activities in the PER mutant could be accounted for by dilution of existing enzyme into newly formed cells as a result of growth. Morphologically, degradation of the cytosolic crystalloids was also not observed. Similar results were obtained with a second PER mutant (strain 124-2D), impaired in the import of peroxisomal matrix proteins. This mutant is characterized by the presence of small peroxisomes and large cytosolic AO crystalloids. Upon a shift of cells to glucose-excess conditions only part of the small peroxisomes present in these cells were degraded by mechanisms similar to those observed in WT cells placed under identical conditions. These results indicate that degradative inactivation of AO in H. polymorpha is strictly dependent on the localization of the enzyme inside peroxisomes and furthermore suggests that the mechanisms triggering this process are not directed against AO protein, but instead, to the membrane surrounding the organelle. Transfer of cells to methanol- or ethanol-containing media both resulted in modification inactivation of AO.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789003 TI - Electroporation-stimulated recombination in yeast. AB - Saccharomyces cerevisiae cells treated by high voltage and made transformation competent (electroporation) are also made hyper-recombinational as determined by an assay that measures interchromosomal mitotic recombination between chromosome III homologs, each containing mutant heteroallelic copies of the trp1 and his3 genes. There is a 10-fold stimulation of Trp+ and 21-fold stimulation of His+ prototrophs. Although this stimulation coincides with conditions for maximal transformation competence it is independent of the presence of transforming plasmid DNA. Electroporation does not increase the reversion frequency of these mutations, nor is there a stimulation in Ty transposition. Among the electroporation-stimulated Trp+ and His+ recombinants there is no dramatic difference in the pattern of events: that is to say that, while there is an increase in the number of recombinants, the distribution of gene conversion and cross-over events among the stimulated recombinants is not significantly altered compared to spontaneously arising Trp+ and His+ recombinants. This electroporation-stimulated recombination is abolished in an isogenic rad52 mutant strain consistent with the increase in Trp+ and His+ prototrophs being the result of a stimulation of a RAD52-dependent recombination pathway. PMID- 1789004 TI - The major exoglucanase from Candida albicans: a non-glycosylated secretory monomer related to its counterpart from Saccharomyces cerevisiae. AB - Exoglucanases secreted by two different strains from Candida albicans have been purified to homogeneity. The purified enzyme from each strain behaved as a non glycosylated monomer (molecular weight 38,000) that was identical in terms of sodium dodecyl sulphate/polyacrylamide gel electrophoresis comigration, amino acid analysis and amino terminal sequence. The amino acid composition was similar to that of the major exoglucanase from Saccharomyces cerevisiae. In addition, these two enzymes displayed a 50% homology in the first 35 amino acids of the amino terminus. Antibodies against the deglycosylated exoglucanase (treated with Endo H) from S. cerevisiae were reactive with the exoglucanase from C. albicans and vice versa. Immunoblotting proved to be a semiquantitative method to detect C. albicans antigen in culture fluids. The exoglucanase from C. albicans appears to enter the secretory pathway without undergoing N-glycosylation. PMID- 1789005 TI - Regulation of cystathionine gamma-lyase in Saccharomyces cerevisiae. AB - Regulation of the two enzymes in reverse trans-sulfuration was investigated in Saccharomyces cerevisiae. In wild-type strains, cystathionine gamma-lyase, but not cystathionine beta-synthase, was depressed nearly 15-fold if cells were starved for both inorganic and organic sulfur compounds. In a met17 strain which is defective of O-acetylserine and O-acetylhomoserine sulfhydrylase, the same enzyme was derepressed if organic sulfur compounds were limited; the repressive effect was in the order of glutathione greater than methionine greater than cysteine. The repressive effect of methionine was not observed, however, in a cys2 cys4 strain which is deficient of serine O-acetyltransferase and cystathionine beta-synthase, indicating that methionine itself is not the effector. The weak repressive effect of cysteine was attributed to inefficient uptake of this amino acid. Our observations indicate that cystathionine gamma lyase is the target of regulation in reverse trans-sulfuration and that cysteine is very likely to be the effector of this regulation. PMID- 1789006 TI - The cysteine transport system of Saccharomyces cerevisiae. AB - Although Saccharomyces cerevisiae strains had different cysteine uptake activities, they revealed monophasic uptake kinetics and had the same KT (83.3 microM). The optimal pH of cysteine uptake was between 4.5 and 5.0, but the activity was quickly lost if cells were kept in buffer. When the activity was measured in the growth medium, it increased in the presence of EDTA and greatly decreased in the presence of mercuric chloride. Thioglycol as well as metabolic inhibitors such as dinitrophenol and azide were inhibitory. Homocysteine and methionine were competitive and non-competitive inhibitors, respectively. Cysteamine and cysteic acid were not inhibitory. From these observations, we conclude that the system mediating uptake of cysteine is specific (we thus name it the cysteine transport system) and that the cysteine transport system recognizes not only the SH-group but also amino- and carboxyl-groups. In wild type strains the cysteine transport system was derepressed only when the cells were incubated without any sulfur source. On the other hand, in cysteine dependent mutants, cysteine uptake activity increased with increase of exogenous supply of cysteine, glutathione or methionine. From this result, we suspect that the cellular cysteine level is the limiting factor for biosynthesis of the cysteine transport system in cysteine-dependent strains. PMID- 1789007 TI - Map positions of pet9, pep1 and pdr4 with respect to CEN2. PMID- 1789008 TI - The PHO80/TUP7 locus in Saccharomyces cerevisiae is on the left arm of chromosome XV: mapping by chromosome engineering. AB - The PHO80/TUP7 locus in Saccharomyces cerevisiae is reported to be located on the right arm of chromosome XV close to its centromere. In the present study, the locus has been reassigned to the left arm of the same chromosome by reciprocal recombination between chromosomes V and XV at URA3 (on chromosome V) and PHO80/TUP7 loci by using the site-specific recombination system of the yeast plasmid pSR1. PMID- 1789009 TI - The product of the YCR105 gene located on the chromosome III from Saccharomyces cerevisiae presents homologies to ATP-dependent permeases. AB - During the systematic sequencing of chromosome III from Saccharomyces cerevisiae, carried out by a network of laboratories sponsored by the Commission of the European Community, we have identified the open reading frame YCR105 located on fragment J11D from the circular derivative of chromosome III in strain XJ24-24a (Palzkill et al., 1986). YCR105 is immediately centromere proximal to the PGK gene (opposite strand) on the right arm of chromosome III about 20 kb from the centromere. PMID- 1789010 TI - TDH2 is linked to MET3 on chromosome X of Saccharomyces cerevisiae. AB - The MET3 gene of Saccharomyces cerevisiae was cloned and its restriction map was found to differ in the upstream region from an earlier published map (Cherest et al. Gene 34, 269-281, 1985) and nucleotide sequence (Cherest et al. Mol. Gen. Genet. 210, 307-313, 1987). Southern blot analysis of genomic DNA from strains S288C and FL100 (the genetic backgrounds from which these different copies of the gene had been cloned) showed that our clone from a S288C-based library had the same restriction map as the chromosomal DNA from both of the strains. Comparison of the nucleotide sequence of the two clones indicated that the earlier published clone probably represented a cloning artifact. In our clone, we found upstream of MET3, the nucleotide sequence of the TDH2 gene (Holland and Holland, J. Biol. Chem. 255, 2596-2605, 1980). The chromosomal orientation of the two genes was determined to be MET3-TDH2-CEN10. PMID- 1789011 TI - The MAT locus revisited within a 9.8 kb fragment of chromosome III containing BUD5 and two new open reading frames. AB - This paper reports the DNA sequence of a segment of 9.8 kb of the chromosome III. The sequenced DNA contains the MAT alpha locus. The new sequence of the MAT alpha locus differs from the previously reported sequence by six modifications in the W segment. We have found the same modifications in the HML locus. The corrected sequence contains, in HML, an open reading frame (ORF) of 190 codons which ends at the border between the W segment and the flanking DNA. In the MAT locus, this ORF extends in the flanking DNA up to 538 codons. This ORF corresponds to a gene independently identified as BUD5 (Chant et al., 1991). This gene presents homologies with the exchange factors SDC25 and CDC25. A large ORF of 1399 codons is found on the opposite side of MAT alpha (toward the telomere). This ORF corresponds to a new gene YCR724. Next to this gene is a small ORF, YCR725, of 127 codons. The localization of this fragment on chromosome III, originally supposed to be distal from the MAT locus based on genetic distance, illustrates variation in recombination frequency along the chromosome and suggests the existence of hot spots of recombination between MAT and the THR4 locus. PMID- 1789012 TI - The Seychelles cardiovascular diseases survey 1989. PMID- 1789013 TI - [Kinetics of the inactivation of Salmonella during thermal disinfection of liquid manure]. AB - Technical processes for thermal liquid manure disinfection usually reach temperatures between 50 degrees C and 70 degrees C. The destruction of important infectious micro-organisms can be expected in this temperature range. The purpose of the investigations reported here was to study the thermal resistance of Salmonellae during heat treatment of liquid manure. Salmonella senftenberg 775W survived much longer than each of 12 other strains from 8 different Salmonella serovars. Resulting from a regression analysis kinetics of thermal death were determined for this strain and decimal reduction times were calculated in cases of an exponential die-off. D60-values ranged from 47 to 138 sec depending on the type of slurry used. Further investigations on the inactivation of Salmonella senftenberg 775W at 50 degrees C, 55 degrees C, 60 degrees C, and 65 degrees C were carried out and following D-values were obtained: D50 = 56.7 min, D55 = 11.5 min, D60 = 2.3 min, D65 = 0.47 min. The resulting ZD-value was 7.2 degrees C. Minimum requirements concerning temperature and heating time can be derived from the results of this study. The given recommendations may only be applied, if technical processes work without any functional deficiencies and thermal energy is evenly distributed in the heated slurry. Combinations of temperature and heating time should not fall below the following values: 50 degrees C/15 h, 55 degrees C/3 h, 60 degrees C/30 min, 65 degrees C/5 min. PMID- 1789014 TI - Characterization of 2 groups of Actinomyces-like bacteria isolated from purulent lesions in pigs. AB - Two groups of Actinomyces-like bacteria isolated from purulent lesions in pigs, were characterized and compared with Actinomyces pyogenes of porcine origin. One group showed characteristics which differed in many respects from A. pyogenes but which corresponded more closely to those of the non-official species 'Actinomyces suis'. Certain carbohydrate reactions differed from those given in earlier descriptions. This group was isolated only from purulent vaginal discharge and aborted foeti. The other group resembled the 'A. suis'-like bacteria but differed in its colony morphology, hippurate and to some extent also in its cellobiose and gluconate reactions and in its habitat. It was concluded that 'A. suis' may occur in lesions other than mammary actinomycosis in areas where this disease is extremely rare, and that its natural habitat is the genital tract of pigs. Furthermore a probably related group exists, which is found in purulent lesions located mainly outside the porcine genital tract. These organisms appear to be as frequent in these types of lesions as A. pyogenes, with whom they can easily be confused in routine diagnostic bacteriology. PMID- 1789015 TI - [Comparative studies of the standardization of erysipeloid immune sera "Dessau" from swine using the mouse-protection test and ELISA]. AB - Different serological methods were used in determining the valence of red murrain immune sera. By using a grow test it is possible to accomplish an immunological differentiation of the immune sera. The used ELISA was tested in comparison to the conventional mouse protective test (PRIGGE, 1950) with regard to its valuation of immune sera. Both procedures have been tested on a possible correlation. In almost all cases a correlation between high titres in ELISA and a mouse protective value over 100 I.E. could be proven. The statistical processing of the test results proved an assumed correlation of both procedures. But it is necessary to carry out further research in order to be able to recommend this procedure as an alternative for the mouse protection test. PMID- 1789016 TI - [Taylorella equigenitalis: cell wall proteins, gene fingerprints, plasmids, adhesion and toxicity]. AB - In this study 55 strains of Taylorella equigenitalis isolated from horses of four different studs in Austria, and a comparative strain from the Federal Republic of Germany were investigated by different methods. These investigations were carried out with the help of SDS-PAGE, immunoblotting, the analyses of genomes and by proof of plasmids. Furthermore, pathogenic mechanisms such as adhesion or the formation of toxins were investigated in vitro. On the basis of the results carried out by means of SDS-PAGE and immunoblotting all tested strains of Taylorella equigenitalis were alike, whereas by DNA analyses the strains could be divided into five groups. The comparative strain from the FRG, which clearly differed from the Austrian strains, formed one group all by itself. From three studs, which are related to each other because of an intensive exchange of horses, representatives (n = 53) of three DNA fingerprint groups were isolated. These three fingerprint patterns were very similar to each other, while the hybridisation patterns from the other two Austrian strains were very different. One of these strains, isolated from a diseased mare, could not be distinguished from the other strain isolated from a clinical healthy stallion from the same study by this method. Only 47.3% from the investigated strains showed attachment to HeLa cells, while cell extracts of all of them caused morphological changes of a varying degree of both Y1 and Vero cells. There were no connexions between these adhesion-cytotoxicity-properties and the DNA fingerprint groups as well as the studs, respectively. No plasmids were found in the Taylorella equigenitalis strains used in this study. PMID- 1789017 TI - Genomic distribution of a serotype 1-specific antigen-coding DNA fragment of Pasteurella haemolytica. AB - A genomic fragment of Pasteurella haemolytica biotype A coding for a serotype 1 specific agglutinating antigen was used as a probe in a series of hybridization experiments to determine distribution of the fragment in various P. haemolytica serotypes as well as other bacteria. Results showed presence of the fragment in seven out of the 12 serotypes tested, all of which belonged to biotype A. Two other serotypes belonging to biotype A, all three serotypes belonging to biotype T, two Pasteurella multocida isolates and Escherichia coli did not have the fragment in their genome. Thus the expression of the P. haemolytica biotype A serotype 1-specific agglutinating antigen (PHA1SAA) seems to be due to serotype specific regulation of protein expression rather than to genetic deletion. Differences in methylation of the PHA1SAA-coding fragment was also noted in DpnI and Sau3AI genomic DNA digests from the various serotypes analyzed by Southern blot. However, no apparent correlation was observed between methylation and PHA1SAA expression. E. coli with a recombinant plasmid containing a homologous genomic fragment derived from P. haemolytica serotype 2 also expressed PHA1SAA. PMID- 1789018 TI - [Hemorrhagic septicemia of rabbits (rabbit hemorrhagic disease, RHD)- quantitative antigen detection]. AB - The efficiency of a vaccine of inactivated virus is influenced to a great deal by the mass of antigen per dose of application. Therefore it is essential to known the concentration of the antigen. We tested a physical method for quantification of the RHD-Virus. It implies a centrifugation of the prepurified, if necessary, preconcentrated infectious or inactivated virus in a gentle sucrose gradient. It is followed by analysis in a sensitive UV flow-through photometer with a computer calculated virus mass. The extinction coefficient (optical density) of the virus (175S-component) at 254 nm is 3.9 cm2/mg. The haemagglutination test and the ELISA were used to prove the virus specificity of the optical peak and partial for comparing them with the method mentioned above. PMID- 1789019 TI - Translation of double-stranded RNA segments 1 and 2 of Chuzan virus in rabbit reticulocyte lysates. AB - Coding assignments of genome segments 1 and 2 of Chuzan virus strain K-47 were studied in vitro by using rabbit reticulocyte lysates. The double-stranded RNA segment was extracted from sodium dodecyl sulfate (SDS)-polyacrylamide gels by a modified crushing and eluting technique. Translation products labeled with [35S]methionine were resolved by SDS-polyacrylamide gel electrophoresis. The molecular weights of the products from RNA segments 1 and 2 were estimated to be 98 and 95 kilodaltons, respectively. PMID- 1789020 TI - The occurrence of streptothricosis and its association with Amblyomma variegatum ticks in St. Lucia. AB - Cattle, horses, sheep and goats in all areas of St. Lucia were examined to ascertain the prevalence and distribution of streptothricosis on the island and to investigate its association with the occurrence of Amblyomma variegatum ticks. Although the disease was found to occur throughout St. Lucia it was more prevalent and generally of a more severe form in areas where A. variegatum ticks are present. A tick control programme in the North of the island appeared to have resulted in a dramatic reduction in the prevalence of the disease. PMID- 1789021 TI - The helminth fauna of the common seal (Phoca vitulina vitulina, Linne, 1758) from the Wadden Sea in Lower Saxony. Part 1: Trematodes, cestodes and acanthocephala. AB - Between August 1988 and January 1989 110 common seals found dead along the coast of Lower Saxony were investigated for the occurrence of trematodes, cestodes and acanthocephala. Two fluke species, Cryptocotyle lingua Creplin, 1825 and Phagicola septentrionalis Van Den Broek, 1967, two tapeworm species Diphyllobothrium cordatum Leuckart, 1863 and Diphyllobothrium elegans Krabbe, 1865, and the acanthocephala species Corynosoma strumosum Rudolphi, 1802 were found. Phagicola septentrionalis and the cestodes were always found together with Cryptocotyle lingua. The prevalence of Phagicola septentrionalis, the diphyllobothriids and the acanthocephala increased with increasing age of the pinniped host. The worm counts of all species appeared to increase with increasing age of the host. The adult male seals were more often infested with Phagicola septentrionalis and cestodes than the female adults and the younger pinnipeds. There was no correlation between blubber thickness of the seals and parasitic infection. The prevalence of the diphyllobothriids and the intensity of the infection with acanthocephala were higher in seals found in the eastern part of the Wadden Sea. PMID- 1789022 TI - The helminth fauna from the common seal (Phoca vitulina vitulina, Linne, 1758) of the Wadden Sea in Lower Saxony. Part 2: Nematodes. AB - During the seal epidemic in 1988 and the beginning of 1989, 115 common seals found dead on the shores of the Wadden Sea of Lower Saxony were investigated for the presence of nematodes. The lungworm Otostrongylus circumlitus Railliet 1899 was found in 26.1% of the seals, the lungworm Parafilaroides gymnurus Railliet 1899 in 26.9% and the heartworm Dipetalonema spirocauda Leidy 1858 in 32.2% of the seals. In the digestive tract, two anisakid species were found, Pseudoterranova decipiens Mozgovoi 1951 in 87.8% and Contracaecum osculatum Rudolphi 1802 in 10.4% of the seals. Statistical analysis revealed a negative correlation between age of the seals and prevalence and intensity of infestation with the two lungworm species and the heartworms. Adult seals were found not to be infected with Dipetalonema spirocauda and Parafilaroides gymnurus, whereas the prevalence of the two anisakid species increased with increasing age of the seals. Pseudoterranova decipiens was found more often in autumn and winter than in summer. This parasite was more prevalent and had higher worm counts in the eastern part of the Wadden Sea than in the western part. Parafilaroides gymnurus and Dipetalonema spirocauda were found more often in seals with smaller blubber thickness than in well fed seals. PMID- 1789023 TI - Experimental autoimmune thyroiditis. II. An immunocytochemical and ultrastructural study of the lesion. AB - The early steps of thyroid damage in experimentally induced autoimmune thyroiditis in mice were studied. Mice were immunized with 150 micrograms of rat thyroglobulin followed by 20 micrograms of bacterial LPS 3 h later on day 0 and 7. Thyroid glands were obtained on days 14, 21 and 28 in order to be studied by light microscopy, electron microscopy and immunocytochemical techniques. The initial lesion was a focal inflammatory infiltrate composed of lymphocytes and lymphoblasts, and plasma cells as the damage progressed. In some cases an increase in neutrophils, macrophages and eosinophils was also seen. The infiltrate became multifocal and eventually diffuse and in few cases germinal center-like structures were seen. The cellular infiltrate corresponded to IgG, IgM and IgA bearing B cells and to a lesser degree Thy 1.2, Lyt 1 and Lyt 2 bearing T cells. Follicular alterations corresponded to different degenerative states of the follicular cells that in some cases was seen without the participation of lymphoid cells. Another mechanism observed was the migration of small lymphoid cells and plasma cells between the follicular cells. PMID- 1789024 TI - Assessment of lymphocyte and phagocytic functions in goats treated with glucan. AB - The effect of glucan, a biological response modifier of yeast origin, on different immune functions was studied after the intramuscular application in goats. The simultaneous administration of glucan with human serum albumin or tetanus toxoid significantly stimulated the antibody production to both antigens differing in their thymus dependency. Similarly, the phagocytizing activity of the blood polymorphonuclear leukocytes measured by the reductase colorimetric assay significantly increased one week after the glucan treatment. However, suppression of T-lymphocyte function in experimental animals was determined by the lymphocyte transformation test particularly in response to phytohemagglutinin and concanavalin A. The results of the study indicate that glucan can modulate some elements of the ruminant immune response. PMID- 1789025 TI - Inhibitory effect of sulfamonomethoxine on capsule formation of Bordetella bronchiseptica. AB - Bordetella bronchiseptica phase I organism possesses a capsule and has the ability to agglutinate with K antiserum, although phase III organism lacks both. The present study examines the effect of sulfamonomethoxine (SMMX) on capsule formation of B. bronchiseptica. I also investigated whether or not the organisms possessed a capsule by bacterial agglutination with K antiserum. Three SMMX resistant strains of B. bronchiseptica phase I organisms showed loss of agglutinability with K antiserum by culturing them at a higher concentration of 1.56 micrograms/ml of SMMX. These results indicated that capsule formation of SMMX-resistant B. bronchiseptica is inhibited by SMMX. PMID- 1789026 TI - [Comparison of protein A purification and combined octanoic acid-ammonium sulfate precipitation for the collection of rabbit immunoglobulin]. PMID- 1789027 TI - [The microbial colonization of the skin of newborn infants rooming in with the mother in maternity homes]. AB - The formation of skin biocenosis in children under the conditions of a maternity hospital with the joint care of mother and child was studied with the use of commercial bacteriological imprints manufactured in the USSR. The colonization of newborn infants in maternity hospitals with opportunistic, saprophytic and normal microflora was established. In newborn infants aged up to 5 years low skin resistance to colonization and, as a consequence, frequent colonization of the skin with opportunistic and saprophytic microflora was observed. PMID- 1789028 TI - [The biological properties of Salmonella strains isolated from adult patients at different seasons of the year]. AB - Biological properties of Salmonella strains, isolated in different seasons from patients with the corresponding disease of moderate severity, were compared. Their morphological, biochemical, serologic properties, sensitivity to antibiotics, capacity for synthesizing O-antigen, as well as their virulence for experimental animals, have been studied. Seasonal changes in the virulence of Salmonella strains have been established: the strains isolated in autumn have proved to be more virulent than those isolated in winter. In winter the isolation rate of Salmonella strains resistant to the therapeutic doses of antibiotics is significantly higher than in other seasons. In spring and summer Salmonella O antigen is synthesized more intensively. PMID- 1789029 TI - [The gene identification of bacterial species and serovariants by the polymerase chain reaction with universal oligonucleotides: the reidentification of earlier isolated strains of Yersinia pseudotuberculosis]. AB - Genetic analysis of 19 standard strains belonging to 6 Yersinia species (Y. pestis, Y. pseudotuberculosis, Y. enterocolitica, Y. kirstensenii, Y. frederiksenii, Y. intermedia) revealed that gene typing by the method of polymerase chain reaction (PCR) with the use of universal primers permitted the identification of species in bacterial cultures by PCR patterns and the determination of Y. pseudotuberculosis serovars within 4 hours. By this method 23 Y. pseudotuberculosis strains (serovar 1), earlier isolated in different regions of the USSR from humans and rodents, were studied. The study showed that out of 14 strains of human origin only two strains could actually be classified with serovar 1, while the remaining strains were reidentified as belonging to serovar 5. Among 9 strains isolated from rodents those of serovar 1 prevailed (8 strains). The authors suppose that strains of serovar 5 cause outbreaks and sporadic cases of pseudotuberculosis, occurring considerably more often than it is commonly believed in the USSR. PMID- 1789030 TI - [The cause of the activation of an epidemic process of intestinal infections in the 70s]. AB - In the seventies a considerable rise in dysentery morbidity was observed in all republics of the USSR, in the whole of the USSR, in Bulgaria and in the German Democratic Republic. An increase in cholera morbidity in the world, as well as in the number of countries affected by this infection, was registered. A tendency towards a rise in virus hepatitis incidence was observed in the USSR. The dynamic study of the ozone content in the stratosphere, solar activity, disturbances in the magnetic field of the Earth, air temperature for the period of 1967-1980 was carried out. Strong and moderate correlation between dysentery and air temperature in summer was established. The maximum morbidity level in the USSR in 1972 was probably the consequence of unusually high air temperature in summer. PMID- 1789031 TI - [The characteristics of the epidemic manifestations of plague in the USSR from the period of 1920 through 1989]. PMID- 1789032 TI - [The effect of the synergistic action of enterotoxin on the specific protective complex of Shigella sonnei]. AB - The study has first established that enterotoxin enhances the protective potency of S. sonnei specific protective complex. This effect has been revealed both in experiments of the oral immunization of mice and in experiments of the conjunctival immunization of guinea pigs and depends on the dose of enterotoxin used in the experiment. The increase of protection has a specific character. These observations open prospects for further enhancement for the protective properties of S. sonnei specific protective complex, which should be taken into consideration in developing the vaccinal preparation. PMID- 1789033 TI - [The immunomodulating properties of staphylotoxin]. AB - The action of native staphylotoxin has been tested on T lymphocytes obtained from 21 healthy human donors. As revealed in this investigation, toxic action affects Fc-receptors to IgG, IgM and IgA. The dose-dependent effect of the preparation suggests its direct contacts with Fc-receptors of lymphocytic membranes. High doses of the toxin suppress the expression of Fc-receptors 6- to 12-fold, low doses of the toxin are capable of stimulating the expression of Fc gamma receptors. PMID- 1789034 TI - [The reactogenicity and efficacy of a dried cell-free staphylococcal vaccine in treating chronic bronchitis]. AB - The data obtained in the controlled trial of the immunotherapy of chronic bronchitis (CB) patients with lyophilized acellular staphylococcal vaccine developed at the Mechnikov Research Institute for Vaccines and Sera (USSR Acad. Med. Sci.), Moscow, are presented. The patients were divided at random into two groups; of these, one group received the vaccine and the other, placebo (0.9% sodium chloride solution). The preparations were injected subcutaneously simultaneously with traditional treatment. The vaccine was well tolerated by the patients. In the blood of the patients receiving the vaccine, in contrast to those receiving placebo, a significant increase in the level of specific antibodies determined in the passive hemagglutination test and IgG was noted. When following the remote consequences of the disease for a year after the course of immunotherapy, a significant decrease in the occurrence of aggravations, an increase in the duration of remission and a decrease in the duration of sick leaves were registered. These data indicate that the immunotherapy of CB with lyophilized acellular staphylococcal vaccine is a promising method of preventing relapses. PMID- 1789035 TI - [The response of human lymphocytes to Staphylococcus aureus peptidoglycan in a system of opsonic cooperation]. AB - Interaction of lymphocytes with S. aureus peptidoglycan treated with normal human serum and its fractions was studied on the basis of luminol-dependent chemiluminescent reaction. Treatment with whole serum led to the considerable increase and acceleration of lymphocytic reactions. The opsonic effect mainly depended on antibodies and complement, the contribution of other opsonins (which could be partially attributed to fibronectin) did not exceed 30%. IgG and fibronectin in concentrations, similar to their concentration in normal human plasma, enhanced the reactions 3.4 +/- 0.3 (p less than 0.05) and 1.5 +/- 0.005 (p greater than 0.05) times, respectively. The problem of the intrapopulation profile of opsonic-lymphocytic reactions and their role in the system of cell mediated and humoral interactions is discussed. PMID- 1789036 TI - [The pathogenesis of Q fever in the intratracheal infection of guinea pigs]. AB - The intratracheal introduction of R. burnetii is the method of infection, highly similar to aerogenic infection, the most widespread route of R. burnetii infection in humans under natural conditions. This suggests that the study of the pathogenesis of Q fever resulting from the intratracheal infection of guinea pigs is highly topical. The authors have established that after the penetration of the infective agent generalized infection develops in the animals with rickettsiae accumulating mostly in the lungs and the organs of the reticuloendothelial system being affected; this infection is commonly more pronounced than that developing after the intraperitoneal inoculation of rickettsiae. PMID- 1789037 TI - [The system of international control of infectious diseases]. PMID- 1789038 TI - [Hospital clostridial infections]. PMID- 1789039 TI - [The immunology and serodiagnosis of cryptococcosis]. PMID- 1789040 TI - [The biological characteristics of Pneumocystis carinii]. PMID- 1789041 TI - [Bacterial exotoxins and anatoxins as antigen-nonspecific immunomodulators]. PMID- 1789042 TI - [The effect of interferon preparations on the ultrastructural organization of Legionella pneumophila]. AB - The influence of the preparations of interferon on morphological changes in L. pneumophila on the ultrastructural level has been studied. Disturbances in the ultrastructure of L. pneumophila result from the direct bactericidal action of interferons without any interference of immune mechanisms. These disturbances are manifested by damages in the cell wall, plasma membrane, nuclear and ribosomal apparatuses of microbial cells. Leukinferon exhibits pronounced anti-Legionella activity, both in vitro in a liquid culture medium and in ovo, than reaferon. PMID- 1789043 TI - [The typological characteristics of natural foci of tick-borne encephalitis]. PMID- 1789044 TI - [The culture of discussions and a little bit on the epidemiology of intestinal infections]. PMID- 1789045 TI - ["The modern theoretical and practical concepts of the epidemiology of shigellosis" and the culture of discussions]. PMID- 1789046 TI - Unresolved issues in the thrombolytic treatment of myocardial infarction. AB - Despite enormous advances made in understanding of the biochemistry of fibrinolytic agents and their extensive clinical use in acute myocardial infarction a number of unresolved issues remain. There is an intriguing divergence of left ventricular response and reduction of mortality in patients with acute myocardial infarction treated with thrombolytic drugs. It is also difficult to explain why patients treated late have a reduced mortality after thrombolytic treatment. Uncertainty prevails on the validity of thrombolysis in patients with a low and very high risk of mortality. Resistance of coronary occlusion to any thrombolytic is another unexplained fact. Alteplase and saruplase are more fibrin-specific thrombolytic drugs than anistreplase. These and the thrombolytic drugs of the first generation (streptokinase and urokinase) have shortcomings and limitations. It is being explored whether prolonged intravenous maintenance infusions are more effective if replaced by a bolus injection, accelerated infusion or the combined intravenous administration of thrombolytic agents. PMID- 1789047 TI - Comparison of Q with non-Q myocardial infarction using signal averaged ECG. AB - Forty consecutive patients (pts) with acute myocardial infarction (MI) who survived to be discharged from the hospital were studied with high gain signal averaged electrocardiography (SAECG). 28% of the pts with non-Q MI had an abnormal SAECG as compared to 15% in the Q MI group. It was also found that SAECG showed a significantly longer filtering QRS duration in the non-Q MI group. The results above were considered as indicative of more delayed activation in pts with non-Q MI providing probably a substrate for more frequent reentrant arrhythmias. PMID- 1789048 TI - Late potentials and ejection fraction at hospital discharge: prognostic value in thrombolyzed and non-thrombolyzed patients. A preliminary report. The Belgian Working Group for Signal Averaging. AB - The prognostic value of the use of thrombolytic therapy (TL), the ejection fraction (EF) and the presence of late potentials (LP) in the signal-averaged ECG (filter less than 40 Hz) at the time of hospital discharge was assessed in a multicenter prospective study. This report presents the follow-up at 4 months of the first 263 patients. Thrombolytic therapy was given to 41%. The mean ejection fraction was 45%. The average duration of the high frequency QRS complex (HFQRS) was 104 ms. The mean duration of the terminal signal under 40 microV (D40) was 31 ms. The combination of both HFQRS greater than 110 ms and a D40 greater than 40 ms was considered as presence of LP. The cardiac mortality at 4 months was 5.7% (15 patients). Late ventricular tachycardia or fibrillation occurred in 2.3% (6 patients). The relative risk (RR) for cardiac death or late events was 5.14 with a 95% confidence interval (CI) of 1.2 to 22.0 when no thrombolytic therapy was used. The RR was 3.39 (CI: 1.4 to 8.4) for patients with an EF lower than 30%. The single most important electrocardiographic parameter was a D40 greater than 40 ms (RR: 3.14, CI: 1.3 to 7.8). The presence of LP had a RR of 4.28 (CI: 1.7 to 10.5). With stepwise regression analysis it was evident that cardiac function and information obtained by signal averaging offered independent prognostic information. The presence of LP at hospital discharge after acute infarction offers additional prognostic information to EF for the risk of later cardiac death, especially in patients without thrombolysis. PMID- 1789049 TI - Clinical correlation between diabetic and non diabetic patients with myocardial infarction. AB - We have studied 130 patients with diabetes mellitus and 455 patients without. All the patients were consecutively admitted to our Coronary Care Unit with their first myocardial infarction. We have observed a higher incidence of heart failure, in-hospital mortality, atrial fibrillation, conduction abnormalities, and post-infarction angina among diabetics. Nevertheless, diabetic patients do not show evidence of larger infarcts than those without diabetes. In our patients the higher mortality among diabetics is related to an increased occurrence of left ventricular failure. Moreover, post-infarction ischemic episodes are more common compared with non diabetics. Since infarcts in diabetics do not seem to be more extensive than in non diabetics, we suggest, in accordance with others, that the poorer outcome among diabetic patients with AMI could be related to an underlying cardiac dysfunction of diabetics in addition to coronary artery diseases. PMID- 1789050 TI - A survey of nine years heart transplantation at Erasme Hospital, University of Brussels. AB - Between March 1982 and March 1991, 225 heart transplantations (HTx) have been performed in 220 patients suffering end stage cardiac disease. Thirteen percent were females and 87% were males. Age range was from 5 to 68 years. The underlying cardiac disease was ischemic cardiopathy in 51.5%, congestive dilated cardiomyopathy in 42%, valvular cardiomyopathy in 3.5%, toxic myocarditis (post adriamycin) in 1.5% and chronic rejection in 2.5% (retransplantation). Selection of the recipients was done following the currently well established criteria also taking into account the absolute major contraindications for HTx. Due to the still increasing demand of donor organs, currently donor age has been extended up to 50 years for male and 55 years for female donors. One quarter of the grafts were harvested on site in our institution, two other quarters were harvested somewhere else in Belgium and the last quarter provided by other countries cooperating with Eurotransplant. All patients have undergone orthotopic cardiac transplantation using the standard Lower and Shumway technique. Immunosuppression protocols have changed four times throughout the years. Nevertheless all were based on the use of Ciclosporine variously combined with other current immunosuppressive drugs. Rejection monitoring relied on routine endocardiac biopsy and was diagnosed according to the Billingham criteria. The in-hospital mortality is currently 11%. Infection, early right heart graft failure and acute rejection were the leading causes of death. The major causes of early morbidity were several curable infections, reversible rejection episodes, transient acute renal failure and controllable arterial hypertension. Among the survivors followed for at least one month up to nine years, half of late mortality was caused by chronic rejection followed by infection, sudden death, metabolic disorders, stroke and malignancy. Late morbidity involves cases of mild coronary graft diseases, biological renal insufficiency, some degree of arterial hypertension, dislipidemia. Current actuarial survival rate is 87% at one year, 76% at 5 years up to 9 years. Our experience confirms that HTx represents today and effective therapy for selected patients suffering end stage cardiac disease. PMID- 1789051 TI - Mechanographic assessment of disopyramide in postinfarction patients. AB - The inotropic effect of a per os single dose of 200 mg disopyramide phosphate was studied in 25 patients during the second week after acute myocardial infarction with no signs of heart failure. Systolic time intervals and the indices derived from the uncalibrated differentiated carotidogram and apexcardiogram were used to assess changes in cardiac performance. The results were as follows: a) Reduction by 3.2% of the haemodynamic ratio LVET/PEP. b) Reduction by 20.1% of the maximal relative upstroke velocity in the differentiated carotidogram (B/S2) p less than 0.05). c) Decrease by 13.1% of the ratio, total amplitude/dicrotic deflection (T/S2) in the same tracing (p less than 0.05). d) Decrease by 2.8% of the ratio, early systolic wave/early diastolic complex wave (b/ef) in the differentiated apexcardiogram. e) Increase by 3.2% of the ratio early diastolic complex total amplitude (ef/ZN) in the previous tracing. The above changes were indicative of a slight negative inotropic effect of the drug. PMID- 1789052 TI - Familial idiopathic dilated cardiomyopathy (IDC). AB - A three-generation family is presented in which several relatives died from or are affected by idiopathic dilated cardiomyopathy (IDC). The transmission pattern is autosomal dominant. Although familial instances of IDC have been reported the proportion of familial cases tends to be underestimated. Moreover, different transmission patterns have been associated with IDC. This report adds further evidence to the fact that an autosomal dominant form of IDC clearly exists and that early screening of asymptomatic first degree relatives is mandatory for accurate genetic counselling of patients and their family members. PMID- 1789053 TI - Sudden appearance of echocardiographic changes in a case of acute massive pulmonary embolism. AB - We report a case of a 68-years-old woman who developed during hospitalization a massive pulmonary embolism. Since the patient had undergone routine cardiac examination, comparison between the echo features immediately preceding and following the event allowed to detail the time interval required for the occurrence of the anatomical and functional changes of the heart chambers. PMID- 1789054 TI - Illustration by transesophageal echocardiography of rapid and important pannus formation during infective endocarditis of a prosthetic valve. AB - A 38-year-old man with a Starr-Edwards mitral prosthetic valve presented with a Staphylococcus aureus septicemia. Twenty-four hours later, transthoracic echocardiography did not show obvious vegetations but Doppler examination of the prosthetic valve demonstrated a prolonged half pressure time and an elevated peak transmitral velocity. Seventy-two hours after the first septic event transesophageal echocardiography revealed a large annular pannus floating in the left atrium in systole and protruding in the prosthetic cage during diastole. This case report emphasizes the importance of transesophageal echocardiography in septic patients with prosthetic valves and underlines the possibility of extremely rapid pannus formation in these patients. PMID- 1789055 TI - Increased serum concentrations of type I procollagen C-terminal propeptide and osteocalcin during a short course of calcitriol administration to adult male volunteers. AB - To investigate bone collagen metabolism during vitamin D treatment, 15 healthy males (aged 28-45 years, median 34) were treated orally with calcitriol, 2 micrograms daily for 7 days and followed for a total of 2 weeks. The serum concentration of calcitriol rose markedly (median difference and 95% confidence limits: 49% (5-82), p less than 0.005) during treatment, whereas serum levels of calcidiol, and calcium remained unchanged. The serum level of procollagen type I C-terminal propeptide rose 15% (7-33, p less than 0.003), whereas no alterations were observed concerning serum procollagen type III N-terminal propeptide, and serum hyaluronan. The serum concentration of osteocalcin rose concomitantly (26% (12-45), p less than 0.003). All values returned to baseline levels within seven days after the treatment week. The serum levels of osteocalcin and procollagen type I C-terminal propeptide were positively correlated (rs = 0.71, p less than 0.004) during the study. Serum procollagen type I C-terminal propeptide and serum osteocalcin did not correlate with serum procollagen type III N-terminal propeptide or serum hyaluronan either at baseline or after treatment. It is concluded that a short course of calcitriol administration to healthy males stimulates the biosynthesis of bone-related matrix proteins. By contrast, connective tissue components of predominantly extraosseous origin are not affected. PMID- 1789056 TI - LH pulsatility and in vitro bioactivity in women with anorexia nervosa-related hypothalamic amenorrhea. AB - LH nocturnal pulsatility and bioactivity to immunoreactivity (B/I) ratio were determined in 16 patients with anorexia nervosa-related hypothalamic amenorrhea and low sex steroid levels, and in 12 normal women in the midfollicular phase. The patients were subdivided into 2 groups: IA (N = 7) without, and IB (N = 9) with documented recent weight gain. Blood samples were taken from each subject at 10-min intervals from 00.00 to 06.00 h. Immunoreactive LH data were analysed with cluster analysis algorithm. A pool of aliquots from all the samples was used to evaluate bioactive LH, immunoreactive LH and LH B/I ratio in each subject. LH pulse frequency was lower in Group IA than in controls, whereas it did not differ significantly between Group IB and controls. LH pulse amplitude was lower in Group IA, and higher in Group IB than in controls. LH B/I ratio was below the control range in 3/16 patients. In conclusion, persistent hypothalamic amenorrhea does not require a permanent inhibition of the GnRH pulse generator; transient inhibition of pulsatility and qualitative abnormalities of gonadotropins could be involved in the mechanism, at least in some patients. PMID- 1789057 TI - Basal prolactin and total lactogenic hormone levels by microbioassay and immunoassay in normal human sera. AB - The availability of an improved microbioassay for prolactin measurement has enabled comparison of lactogenic hormone bioactivity and immunoreactivity in normal human serum. Serum was studied from 61 normal females and 15 normal males. The correlation of both assays was very close for all subjects with a mean ratio of bioassay to immunoassay of 1.5 (range 0.8-2.0) for prolactin and 1.4 (range 0.5-1.9) for total lactogenic hormone. There was no significant variation in prolactin or total lactogenic hormone values by microbioassay or immunoassay with sexual or menstrual status. Postmenopausal prolactin levels were lower by both assays compared with premenopausal values with a relative and absolute decrease in prolactin bioactivity with age. These findings indicate that there is a good correlation between prolactin bioactivity and immunoactivity in human serum. PMID- 1789058 TI - In situ hybridization histochemistry of mRNAs for hormones and chromogranins in normal pituitary tissue and pituitary adenoma. AB - In situ hybridization histochemistry was employed to detect mRNAs of pituitary hormones and chromogranins in normal pituitary gland and pituitary adenomas. Oligonucleotide probes specific to the mRNAs for prolactin, growth hormone, proopiomelanocortin, the alpha- and beta-subunits of the glycoprotein hormones and chromogranins A and B were used in the hybridization experiments. The oligonucleotides of 27 to 51 bases were labelled radioactively with dATP[alpha 35S] at the 3'-end using terminal deoxynucleotidyl transferase. Positive hybridization reactions were visualized by autoradiography in the normal pituitary gland with all of the probes. The clinically diagnosed pituitary adenomas (prolactinoma, acromegaly, Cushing's disease, FSH-secreting tumour) showed positive hybridization with the corresponding oligonucleotide probes. In some cases positive hybridization was also obtained with other probes, suggesting multihormone-producing character of the tumour cells. A microprolactinoma was found in a pituitary gland obtained from a patient without any known pituitary disorders. Examination of mRNAs for chromogranin A and B revealed that the normal pituitary gland contains a larger number of cells expressing chromogranin B and a lower number expressing chromogranin A and, moreover, the microprolactinoma lacked the expression of mRNA for chromogranin A but expressed that of chromogranin B. PMID- 1789059 TI - Dynamics of the acute effects of octreotide, bromocriptine and both drugs in combination on growth hormone secretion in acromegaly. AB - The separate and combined GH-lowering effects of single doses of octreotide and bromocriptine were assessed in 51 acromegalic patients on 4 occasions each 2 days apart. Patients received sequentially: placebo sc (N = 51), 50 micrograms octreotide sc (N = 51), 2.5 mg bromocriptine po (N = 40) or a combination of both drugs (N = 25). With octreotide, in 28 patients (55%) GH levels were suppressed to less than 5 micrograms/l and 39 of them (76.5%) had a 50% or greater decrease of their basal GH level from 2 to 6 h. During bromocriptine, GH values were suppressed to below 5 micrograms/l in 11 patients (27.5%) and reduced by 50% or more in 21 (52.5%). The combination of both drugs acutely suppressed GH levels to less than 2 micrograms/l in 32%, to less than 5 micrograms/l in 56%, and by more than 50% in 84% of patients. Octreotide produced a stronger and faster suppression of GH levels than bromocriptine in most patients. The combination of both drugs had an additive effect on the lowering of GH levels, especially between 7 and 10 h after drug administration. These results suggest that chronic therapy with a combination of both drugs may be as effective as therapy with higher doses of either compound alone. Albeit transient, octreotide caused a rapid near total suppression of insulin release in the morning, 15 to 45 min after administration. Postprandial glucose rise, between 2 and 3.5 h after breakfast was significantly higher during octreotide than on the control day. PMID- 1789060 TI - Prediction of relapse in drug-treated Graves' disease using thyroid stimulation indices. AB - Thyroid stimulation indices such as high thyroidal radioactive iodine uptake, increased estimated thyroid weight, presence of TSH-binding inhibitor immunoglobulin or thyroid-stimulating antibody, and elevated serum thyroglobulin level, were evaluated in 148 patients with Graves' disease who had been treated with antithyroid drugs for two years or more before the drugs were withdrawn. In all 19 patients in whom three or more indices were positive, early relapse, within 12 months, occurred after reducing the dosage of antithyroid drugs. Other 129 patients were followed after the drug was withdrawn and in 77 patients with one or two positive indices, early relapse occurred in 65-71% and late relapse, after 12 months or later, occurred in 2-11%. In 52 patients in whom none of the indices were positive, 86% remained in remission, but 10% developed an early relapse, and 4% a late relapse. We conclude that a combined analysis of thyroid stimulation indices is useful in predicting relapse in Graves' disease whereas it remains difficult to predict permanent remission. PMID- 1789061 TI - Prolactin responses to vasoactive intestinal polypeptide and thyrotropin releasing hormone in chronic renal failure. AB - Prolactin response to iv bolus injection of 1 micrograms/kg vasoactive intestinal polypeptide was determined in 8 patients with chronic renal failure undergoing chronic hemodialysis and in 8 normal controls, age- and sex-matched. Plasma prolactin in the patients showed a blunted response following vasoactive intestinal polypeptide injection, whereas the controls showed significantly higher mean peak prolactin value over the baseline value (p less than 0.002). The net rise (peak levels minus basal levels) in plasma prolactin and area under the curve after vasoactive active intestinal polypeptide injection in the controls were significantly greater than those in the patients (p less than 0.001). On a separate day, each individual underwent a TRH (500 micrograms) challenge with the prolactin response determined. The patients had significantly higher peak prolactin values over baseline levels (p less than 0.02) which, however, were not significantly different from those in the control group. In the patients, the peak net prolactin increments and area under the curve were significantly higher following TRH than following vasoactive intestinal polypeptide (p less than 0.05). The net prolactin increments to TRH challenge were significantly higher in the control group than in the patients (p less than 0.001). The results demonstrate the blunted prolactin response to the stimulatory effect of vasoactive intestinal polypeptide and TRH in chronic renal failure. In chronic renal failure prolactin release after vasoactive intestinal polypeptide is more blunted than after TRH. These data suggest that the responsiveness of plasma prolactin to vasoactive intestinal polypeptide is defective in these patients, though the mechanism(s) are yet to be defined. PMID- 1789062 TI - Oral estradiol-17 beta raises the level of plasma high-density lipoprotein in menopausal women by slowing down its clearance rate. AB - Plasma lipoprotein composition, plasma kinetics of autologous [125I]HDL and the metabolism of iv administered radioactively labelled artificial chylomicrons were studied in postmenopausal women during a control period and after 4 months of oral estradiol-17 beta treatment (1 mg/m2 body surface per day). Drug treatment significantly raised plasma HDL-cholesterol levels (19%) in the fasting state and total apolipoprotein A-I (16%), but did not interfere with triglyceride, VLDL, LDL or apolipoprotein-B values. As compared with the control period, estradiol-17 beta administration significantly slowed down plasma [125I]HDL clearance by about 82% and reduced the delipidation index of the injected artificial chylomicrons by 47% as a consequence of impaired plasma lipolytic activity. PMID- 1789063 TI - Course of thyroid iodine concentration during treatment of endemic goitre with iodine and a combination of iodine and levothyroxine. AB - In the treatment of endemic goitre, the concept of giving levothyroxine in combination with iodine offers a promising therapeutic approach by influencing not only TSH secretion but also intrathyroidal iodine content. However, little is known about the doses of iodine necessary to correct intrathyroidal iodine deficiency. To get more information on this important issue, we conducted a prospective, double-blind study on the effect of a monotherapy with 500 micrograms iodide/day and a combined treatment with 100 micrograms levothyroxine and 100 micrograms iodide/day on thyroid iodine concentration as measured by fluorescence scintigraphy. In a group of 12 patients, a 4-month treatment with 100 micrograms levothyroxine and 100 micrograms iodide/day did not significantly affect thyroid iodine concentration (0.35 +/- 0.14 vs 0.37 +/- 0.11 mg/g). The application of 500 micrograms iodide/day in these patients during a second 4 month period resulted in a sharp increase in thyroid iodine concentration from 0.37 +/- 0.11 to 0.61 +/- 0.14 mg/g (p less than 0.01). Another group of 8 patients first treated with 500 micrograms iodide/day also showed a significant increase in iodine concentration from 0.35 +/- 0.14 to 0.65 +/- 0.20 mg/g (p less than 0.01). After switching to the combination regimen during a second 4-month period, thyroid iodine concentration slightly decreased, particularly in those patients with high iodine concentrations after monotherapy with iodide (0.65 +/- 0.20 vs 0.50 +/- 0.12 mg/g, p less than 0.05). In conclusion, treatment with 500 micrograms iodide/day could sharply increase thyroid iodine concentration in patients with endemic goitre. In contrast, a combination of 100 micrograms levothyroxine and 100 micrograms iodide/day had no significant effect on thyroid iodine concentration. PMID- 1789064 TI - Measurement of intact parathyroid hormone in the diagnosis of hyperparathyroidism. AB - Plasma levels of parathyroid hormone were determined pre-operatively in 27 consecutive patients with clinical and biochemical signs of primary hyperparathyroidism, by the use of one assay recognizing the intact PTH molecule and one assay recognizing the mid-portion of PTH. Plasma levels of mid-molecule PTH were normal in 5 of the patients with primary hyperparathyroidism. In 4 of these patients, plasma levels of intact PTH were raised. Conversely, in 6 patients with primary hyperparathyroidism, intact PTH were normal pre operatively. In 5 of these cases, plasma levels of mid-molecule PTH were raised. The EDTA infusion test was performed in 6 patients with normal baseline plasma level of intact PTH pre-operatively. The test correctly predicted all the patients in this group who were found to have primary hyperparathyroidism, as well as a patient with normal parathyroid glands found at operation. We conclude that some patients with primary hyperparathyroidism have normal baseline plasma levels of intact PTH. In these patients, plasma levels of mid-molecule PTH and an EDTA infusion test provide further diagnostic information. PMID- 1789065 TI - Amiodarone and thyroid hormone metabolism in the rat heart. AB - The effect of amiodarone on thyroid hormone metabolism in heart, muscle, liver and kidney was investigated. Rats were treated ip with a high (100 mg.kg-1.day-1) or a low (50 mg.kg-1.day-1) dose of amiodarone for 10 days. Serum T3 was dose dependently depressed (mean 30 and 54% of controls, respectively, p less than 0.01). rT3 was elevated (to 663 and 313% of controls, p less than 0.01 and 0.05, respectively). Serum T4 was depressed only in the high-dose group (to mean 80%, p less than 0.05). Tissue concentrations of T3 in the heart and muscle from treated animals did not differ from controls, whereas liver and kidney T3 contents were markedly reduced in both groups (p less than 0.05). Heart T4 and rT3 were elevated to about 200% of controls (p less than 0.01 and 0.05, respectively). The same pattern was observed in the other tissues. Iodothyronine-5'-monodeiodinase activity was significantly depressed in all tissues; heart: 32 and 28% of controls (p less than 0.05); muscle: 36 and 49% (p less than 0.01); liver: 11 and 13% (p less than 0.01); kidney: 22 and 28% (p less than 0.01), respectively. In conclusion, amiodarone depresses iodothyronine-5'-monodeiodinase activity in the heart, muscle, liver and kidney in a dose-dependent manner, resulting in lowered T3 concentrations in the liver and kidney, whereas no reduction of tissue T3 content is observed in the heart and muscle. This may indicate that T3 from plasma may cross the cardiac sarcolemma without hindrance. PMID- 1789066 TI - A null cell adenoma of the pituitary detected seven years after removal of a prolactinoma. Recurrence or de novo tumourigenesis? AB - We report an extremely unusual case of prolactinoma which emerged at recurrence as a null cell adenoma. A 53-year-old woman sought medical attention for progressive visual loss and headache. A pituitary tumour was detected by a computed tomographic scan, and hyperprolactinemia was noted. The tumour, removed by a transfrontal surgery, was a chromophobe adenoma, and immunohistochemically the adenoma cells were selectively positive for PRL, which indicated a prolactinoma. Postoperatively, her plasma PRL level was normalized. Seven years later, she noted blurred vision and again sought medical attention. A CT scan demonstrated recurrence of a pituitary tumour. On this occasion, however, she was not hyperprolactinemic. She underwent again a transfrontal resection of the pituitary tumour. Its histology was again a chromophobe adenoma, but the adenoma cells showed no positive immunostaining for any anterior pituitary hormone including PRL, which indicated a null cell adenoma. We have no clear explanation of the pathogenesis underlying her very unusual course. However, null cells (assuming that the original tumour was a mixed adenoma) left behind at the first surgery, or unidentified hypothalamic and/or pituitary derangements might possibly have been responsible for the recurrence. We learned from this patient that recurrent pituitary adenomas may not necessarily have the same endocrine features as did the original tumours. This information appears to make a valid clinical point, because if hormone levels alone are followed after pituitary surgery, recurrent pituitary tumours may be overlooked. PMID- 1789067 TI - Recommendations for a revised nomenclature of thyroid autoantigens and autoantibodies. PMID- 1789068 TI - Anesthesia and the surgeon's comfort. PMID- 1789069 TI - HCFA issues final rule on "Medicare payment; Fee Schedule for Physicians' Services". PMID- 1789070 TI - Alfentanil analgesia/sedation for extracorporeal shock wave lithotripsy: a comparison with general and epidural anesthesia. AB - An alfentanil infusion was used to produce analgesia and sedation for patients undergoing extracorporeal shock wave lithotripsy with the Dornier HM-4 lithotripter. This was compared to general and epidural anesthesia in a retrospective review of 197 consecutive patients. Total care time, anesthesia time, and recovery room time were shorter for the alfentanil analgesia/sedation group. The incidence of nausea and vomiting was similar in all three groups. Technical failure (requiring switching to general anesthesia) was not significantly different than when performed with epidural anesthesia. The technique was simple and reliable when performed by a large number of anesthesia practitioners (anesthesiologists, anesthesia residents and CRNAs). PMID- 1789071 TI - Nasoendotracheal tube obstruction secondary to inferior turbinate impaction. AB - This case report discusses one of the unusual complications of nasoendotracheal intubation, amputation of the inferior turbinate with its subsequent impaction of the nasoendotracheal tube. A healthy 19-year-old male underwent surgery for an open reduction and internal fixation of a fractured mandible. Several minutes after nasoendotracheal intubation, airway pressures increased, end-tidal carbon dioxide levels increased, and the patient became difficult to ventilate. The patient was extubated and then reintubated with a smaller-diameter nasoendotracheal tube through the same naris without further sequelae. After examination the tube was found to be occluded with an inferior turbinate. The increased airway pressure and elevated carbon dioxide levels were early signs of partial airway obstruction. Capnography was an important early warning device to provide information prior to changes in other vital signs. It allowed rapid detection of a potentially disastrous obstruction of the airway before the patient experienced severe cardiopulmonary complications. These facts should assist the anesthetist in focusing attention on the possible obstruction of the airway with a foreign body after nasoendotracheal intubation. PMID- 1789072 TI - Postdural puncture headache: a literature review. AB - This is a review of literature from 1943 to mid-1989 on the postdural puncture headache. The article looks at the currently held thoughts on the cause, prevention, and treatments of this second most frequent side effect of spinal anesthesia. Postdural puncture headache (PDPH) is caused by vascular distension within the nondistensible cranium following the leakage of cerebral spinal fluid (CSF) into the epidural space. Prevention of PDPH can be accomplished by using small-gauge needles and possibly by using the lateral approach, as opposed to the midline approach. Luck plays a big part, because if the needle punctures a thicker portion of the dura, there is a reduced chance of PDPH. Epidural saline injection is effective only if it is used as a continuous infusion for 24 hours. The usefulness of caffeine sodium benzoate with a 70-80% success rate and epidural blood patching with a 90%-plus success rate are discussed. PMID- 1789073 TI - Report of the National Commission on Nurse Anesthesia Education. American Association of Nurse Anesthetists Medicare pass-through reimbursement for nurse anesthesia education programs. AB - Medicare pass-through dollars for paramedical education are one way hospitals can still get reimbursed on the basis of their costs under the prospective payment system. To qualify, a hospital must demonstrate that it has some involvement in the operation of the nurse anesthesia program. Establishment of a cost center for school-related expenses can help maximize reimbursement. PMID- 1789074 TI - Report of the National Commission on Nurse Anesthesia Education. Graduate nurse anesthesia education: the university based model. AB - A university based model of a nurse anesthesia educational program is described, with emphasis on its development in a graduate degree framework. Steps in developing a university based program are outlined. PMID- 1789075 TI - Report of the National Commission on Nurse Anesthesia Education. Current and future perspectives regarding the framework for nurse anesthesia education: nurse anesthesia curriculum in the College of Pharmacy and Allied Health Professions, Wayne State University. AB - The nurse anesthesia educational program at Wayne State University, Detroit, is one of four allied health programs that offers a master's degree from the College of Pharmacy and Allied Health Professions. The program itself is housed in a teaching hospital, where CRNAs control and deliver the coursework. Advantages and limitations of this arrangement are analyzed and discussed. PMID- 1789076 TI - Report of the National Commission on Nurse Anesthesia Education. The role of the medical director in nurse anesthesia education. AB - The medical director of a nurse anesthesia educational program in a Veteran's Administration medical center relates his experiences in creating an educational and practice environment where, through cooperation with the CRNA director, the capabilities of all anesthesia providers are respected and utilized. PMID- 1789077 TI - Report of the National Commission on Nurse Anesthesia Education. The impact of the national nursing shortage on applicants for nurse anesthesia educational programs. AB - The serious nursing shortage of the late 1980s is reviewed in relation to the impact it has had on the recruitment and training of nurse anesthetists. A rapid expansion of the nurse anesthesia educational system and improved practice conditions for all nurses are advocated. PMID- 1789078 TI - Report of the National Commission on Nurse Anesthesia Education. An analysis of the cost of nurse anesthesia programs. AB - Cost-benefit questions that require nurse anesthesia education administrators to justify their programs are looked at from the perspective of the director of a large hospital program that entered into a cooperative arrangement with a school of nursing. PMID- 1789079 TI - Cardiovascular collapse following infusion of 5% albumin. AB - The administration of albumin is an excellent volume expander, although its use is not without potentially serious complications. This case report presents a patient who experienced an anaphylactoid reaction resulting in cardiovascular collapse following the administration of 5% albumin. Management and treatment of a patient with an anaphylactoid reaction is discussed. PMID- 1789080 TI - Council on Accreditation of Nurse Anesthesia Educational Programs. PMID- 1789081 TI - Refractive surgery of the cornea. PMID- 1789082 TI - Autosomal dominant stationary night-blindness. A large family rediscovered. AB - In 1909, 2 years after the famous publication by Nettleship, a large family with congenital stationary night-blindness of the 'Nougaret type' was published by the Danish district surgeon, Sigurd Rambusch. In 1990 the 'Rambusch family', still resident in the original area, was sought out and rediscovered, at which time the reconstructed part of the pedigree comprised more than 200 affected persons in 11 generations. Dark adaptometry and electroretinography were performed on a few affected family members, including a descendant with a uniocular affection. The pedigree is presented and recordings of dark adaptation courses and electroretinographical responses from a few family members are demonstrated. PMID- 1789083 TI - Clinical and electroretinographic comparison between Aland Island eye disease and a newly found related disease with X-chromosomal inheritance. AB - Two subjects representing AIED (Aland Island Eye Disease) and a family with 5 males affected with an AIED related X-linked hereditary eye disease were studied clinically and electrophysiologically. The clinical picture of AIED includes myopia and astigmatism, reduced visual acuity, nystagmus, ocular albinism, hemeralopia and dyschromatopsia (No. 300600, McKusick 1990). The subjects with the related disease showed astigmatism with or without myopia, reduced visual acuity, slight hemeralopia, normal color vision in 3/5 subjects, no ocular albinism and nystagmus only in one case. In both diseases the ERG was abnormal showing defective a- and b-waves, but there were also differences. The most notable was the greater reduction of the b-wave amplitude in the mixed (rod and cone) responses for the white stimulus in the ERG of the AIED related disease. With regard to the pathogenesis we propose that in both diseases rod and cone functions are defective but in an AIED related disease a defective cone function inhibits the transmission of the rod signals to the rod bipolars, causing greatly reduced mixed responses. The clinical and ERG findings of this study suggest that the 5 subjects of our family do not represent AIED but another X-linked hereditary eye disease. The investigation to find out the gene locus of this disease is going on. PMID- 1789084 TI - Electroretinograms in patients with achromatopsia. AB - Eleven patients with X-linked and 9 patients with autosomal recessive achromatopsia were examined with full-field electroretinograms. In the standard full-field ERG's, normal rod responses were obtained, but the amplitude of the cone b-waves was not detectable. With computer averaging and narrow bandpass filtering, residual cone b-wave responses could be detected in 10 of the 20 patients. The residual cone b-wave amplitudes were markedly different in the 3 families with X-linked achromatopsia. In two of them, residual cone b-wave responses were seen in all patients examined. In contrast, such responses were seen only in 2 of 7 patients in the third family. There were also differences in other clinical observations (mainly in the visual acuity and refractive error) and we therefore suggest that there are at least two forms of X-linked achromatopsia. The ratios of the cone response amplitudes to 30 Hz flickering orange and blue-green light suggested that the defect in the X-linked achromatopsia patients was of the protanope type, whereas in the autosomal patients, both the protanope and the deutanope type was seen. In conclusion, measurements of the residual cone b-wave amplitude responses are of diagnostic and may possibly be of prognostic value when examining children and other members of families with achromatopsia. PMID- 1789085 TI - Regeneration of the rat corneal epithelium after injury. A cell kinetic study comparing the reaction after abrasions made mechanically and with n-heptanol. AB - Central corneal epithelial defects with diameter 3.5 mm were made with n-heptanol in the right eyes of rats. Erosions of the same size were made by mechanical scraping in the left eyes of the same animals. All the erosions were covered by epithelium after one day. After one day the mitotic rate and the labelling index were higher in the n-heptanol treated corneas compared to the mechanically abraded ones. Both methods produced similar mitotic rates and labelling indexes after 3 and 12 days. The results from wound healing studies using n-heptanol or mechanical scraping are therefore not entirely comparable because of the different regenerative responses after one day. However, the n-heptanol method is easier to perform and to standardize, and is therefore preferable. PMID- 1789086 TI - Outgrowth of cells from human conjunctival explants onto cornea in vitro. AB - The epithelium was removed from human corneas, and samples of conjunctival tissue were cultured as explants on the denuded corneal surface for 1 and 2 weeks. Cells migrating from the conjunctival explants onto the corneal surface produced a multilayer where cells on the surface generally showed a flattened appearance. The apical membrane of these cells demonstrated villi as well as microplicae. Surface projections were also detected on cells in the deeper layers of the epithelium. Neighbouring cells were connected by junctional complexes. After 2 weeks, however, a lack of intercellular junctions in some areas resulted in the formation of intraepithelial cystoid spaces. Basal cells were connected to the underlying basement membrane by hemidesmosomes. Although transdifferentiation of the cells into a corneal epithelium was not observed within the 2 weeks, the present system provides a tool for studies on factors affecting reepithelialization of corneal epithelial defects by conjunctival cells. PMID- 1789087 TI - The swelling of cornea in bank cultivation. The role of barriers and peripheral edge. AB - The swelling of a rabbit cornea in organ culture is caused by influx of fluid via the surface. Data regarding the weight increase rates during the first 4 h of corneal buttons with different diameters, have been used to calculate the net influx per mm2 per h via the anterior + posterior surfaces on one hand, and via the peripheral edge on the other hand. In fresh corneas the contribution to the corneal swelling, of the net fluid uptake via the anterior + the posterior surfaces, is negligible. The influx via the peripheral edge is about the same in fresh and freeze treated buttons. For freeze treated corneas, the resistance for fluid transport via the anterior + posterior surfaces seems to be 4 times higher than the resistance for transport via the peripheral edge. This result indicates that the Descemet's membrane and the Bowman's layer may have some barrier effect. An alternative or supplementary explanation is that, at least in swollen corneas, there may be reduced resistance to fluid flow along the corneal plane as compared with the flow vertical to this plane. PMID- 1789088 TI - Fatty layer of the precorneal film in the 'office eye syndrome'. AB - The thickness of the fatty layer of the precorneal film was estimated by the semiquantitative inteference method in 70 office workers from two town halls in Copenhagen County and compared with that in 110 controls from the general population. There were significant correlations between use of eye make-up and a thin fatty layer (less than or equal to 50 nm, P = 0.023) and between investigation time before 12 h and a thick fatty layer (greater than or equal to 150 nm, P = 0.046). After correction for these confounders, the fatty layer was significantly reduced in the office population compared with the controls (P = 0.0032). Furthermore, absence of biomicroscopically dry eyes (expressed as a combination of premature break-up of the tear film and lissamine green-stained epithelial damage of the bulbar conjunctiva) was significantly correlated to a thick fatty layer (greater than or equal to 150 nm, P = 0.015), indicating that a thick fatty layer may protect the eyes against development of dry eyes. The results indicate that deficiency in available Meibomina oil is involved in the dry eye syndrome we earlier found to be associated with eye irritation in the office environment and termed the 'office eye syndrome'. Together with observation of foam in the eye canthus, estimation of break-up time, and examination for clusters of epithelial damage on the bulbar conjunctiva, measurement of the fatty layer appears to be an easy tool for diagnosing the 'office eye syndrome' or for differentiating this disorder from other conditions with complaints of dryness or irritation. PMID- 1789089 TI - Spectrum of oculomycosis in South India. AB - Ninety-one consecutive cases of proven oculomycosis were studied in relation to clinical features and epidemiological parameters. Mycotic corneal ulcers formed the major group (76%), followed by endophthalmitis (20%). Aspergillus was the common causative fungus (36%) in keratomycosis followed by Penicillium species (29%). Fusarium keratomycosis was not as common as reported in the literature. In endophthalmitis there was preponderance of Penicillium as the causative fungus. These etiological agents are studied in comparison with studies of conjunctival flora of healthy controls and culture studies of common objects of trauma. Mycotic endophthalmitis was seen following cataract surgery in 64% of cases. Contrary to expectations the onset of endophthalmitis was within 2 weeks of surgery in most cases. Trauma with organic matter was an important predisposing factor in keratomycosis. These observations are discussed in relation to the clinical features. Other unusual forms of oculomycosis are also discussed. PMID- 1789090 TI - Epikeratophakia for high myopia. AB - A cryo-technique for production of corneal epi-lenses has been developed. During the manufacturing procedure the anterior surface of the tissue is moulded and the posterior surface cut with a microtome. After cutting, the epi-lenses are stored for days to weeks in an organ culture medium. Twelve eyes in 10 patients have been treated with epikeratophakia for high myopia (greater than -7 D). In all eyes, epithelialization was complete within one week, and at follow-up 3-18 months after the operation all epi-lenses were clear. The average refractive change in spherical equivalents was 9.7 +/- 4.4 D. All eyes obtained better uncorrected visual acuity, and no eyes lost more than one line of the best corrected visual acuity. At the time of follow-up, the patients' native cornea had regained normal hydration, whereas the epi-lenses did not thin as much as expected. PMID- 1789091 TI - One year follow-up study on polymetacrylate and hydrogen intraocular lenses. AB - This study includes two selected groups of patients operated for cataract with implantation of either a polymetacrylate (PMMA, Sinskey J-loop, prolene haptics, Mod.102H, Pharmacia) or a soft hydrogel (IO-gel, Alcon) posterior chamber lens. There were 27 patients in the PMMA group and 32 in the hydrogel lens group. The study concludes that after 1 year of observation a comparison between the two groups disclosed no major difference concerning the visual outcome and influence on the ocular tissue. No substantial observations point towards the hydrogel lens as the more biocompatible of the two lenses. PMID- 1789092 TI - Long-term results of extracapsular cataract extraction with posterior chamber lens implantation: sodium hyaluronate 1% vs hydroxypropyl methylcellulose 2%. AB - We investigated the frequency of surgical complications and the long-term outcome in terms of visual acuity, intraocular pressure and post-operative complications in 206 extracapsular cataract extraction procedures with posterior chamber lens implantation using either sodium hyaluronate 1% (Healon) or hydroxypropyl methylcellulose 2% over a follow-up period of 12 months. We found no significant difference in the results of using either of the two viscoelastic agents. PMID- 1789093 TI - Correlations in series of perimetric performance values. AB - The correlation function for consecutive performance (P) values in a material of simple glaucoma is studied. The outcome of perimetry sessions recorded with about 2 min intervals are significantly correlated, whereas those obtained 2 h apart or more are not so. Partial correlations of the right and left P values as well as IOP and P value are estimated and discussed in connection with a statistical model for the sensitivity fluctuations. A slow trend, a random error component and an irregular undulation of sensitivity are discerned. The cause of the fluctuations as well as procedures for reducing the dispersion of performance values are discussed. PMID- 1789094 TI - Transcleral contact krypton-laser photocoagulation of the retina in rabbits. AB - Transcleral contact retinal krypton laser photocoagulation of the retina was studied in rabbit eyes. The laser application was performed under indirect ophthalmoscope visual control with indentation of the sclera by the laser probe. Retinal lesions were produced with powers ranging from 0.2 to 0.3 W and application times between 1 and 2 sec. The lesions were studied histologically 2, 5, 10, 12, 20, 30 and 70 days after treatment. Histopathological examination of the lesions showed damage of mainly the outer retinal layers in light lesions, and to all layers of the retina in the more intense lesions. No scleral damage was observed in the light lesions, whereas transient oedema of the inner sclera was seen in the intense lesions. Studies with enucleated rabbit eyes showed that indentation of the sclera by the laser probe substantially decreased the power needed to produce a retinal lesion. It is concluded, that when used with scleral indentation, transscleral krypton laser photocoagulation of the retina can be performed with minimal damage to the sclera. PMID- 1789095 TI - The frequency distribution of the glaucoma tolerance limit. AB - The probability of having glaucoma may be expressed by the quotient p = (number of eyes with glaucomatous damage)/(total number of eyes). p has been calculated for different IOP levels, within a total population and also within groups with and without pseudo-exfoliation (PE). The resulting quotients were plotted versus IOP. Random irregularities were reduced by regression analysis, using the equation for the logistic distribution. The resulting sigmoid curves demonstrated that the probability p of having glaucomatous damage at a certain IOP is highest in the PE group. In the total material, the glaucoma probability p was 0.5 at IOP = 27.1 mmHg, and at IOP = 25.3 and 28.0 mmHg in the groups with and without PE, respectively. The frequency distributions of the glaucoma tolerance limit have been computed from the glaucoma probability curves. PMID- 1789096 TI - Astigmatism and school myopia. AB - Changes in astigmatism were followed for a 3-year period among 238 myopic children as part of a clinical trial of myopia treatment. Children with mild myopia and no previous myopic spectacle correction and astigmatism less than or equal to 2 D were included in the study. The prevalence of astigmatism of at least 0.25 D was 55% at the beginning of the follow-up at a mean age of 10.9 years, increasing to 76% during the 3-year period. At the same time the mean astigmatism increased from -0.26 D to -0.45 D. Most of the astigmatism was against the rule; with the rule astigmatism represented 18% of the astigmatism at the beginning and 24% at the end of the study. There was a weak correlation between the spherical equivalent and astigmatism at the beginning of the follow up (r = 0.122, n = 240, P = 0.029) but not at the end of the follow-up. Myopic progression controlled for the spherical equivalent, was not related to degree of astigmatism at the beginning of the study. PMID- 1789097 TI - The correlation between serum progesterone and aqueous dynamics during the menstrual cycle. AB - Exogenously-administered progesterone has been shown to lower intraocular pressure. However, attempts to correlate endogenous progesterone levels and aqueous dynamics have produced inconsistent results. In this study, 20 healthy, non-pregnant women were followed over a 28-day menstrual cycle. Serum progesterone level, intraocular pressure, and aqueous flow rate were measured weekly. We were unable to demonstrate any correlation between progesterone levels and either aqueous flow or intraocular pressure. PMID- 1789098 TI - Prevalence of amblyopia in old people without previous screening and treatment. An evaluation of the present prophylactic procedures among children in Denmark. AB - An epidemiological study of amblyopia was performed among old people without previous screening and treatment. The study revealed a prevalence of 2.9% (strabismic in 2.3%, anisometropic in 0.6%). Present residual amblyopia among Danish school children is about 1% according to literature. The rate of cure of amblyopia by the present Danish system of prophylaxis and treatment is estimated to be 60-70%. PMID- 1789099 TI - Conjunctival hyperaemia in non-contact lens wearers. AB - Conjunctival hyperaemia was assessed in noncontact lens wearers using a photographic reference scale. The study was carried out on a sample of 252 females and 227 males within the age range of 1 to 89 years. The results show increasing levels of hyperaemia with age and higher levels of hyperaemia in males than in females. The differences in hyperaemia level for age and sex, however, were small and were insignificant clinically. PMID- 1789100 TI - A primary intraocular hydatid cyst. AB - Ultrasonography and computerized tomography (CT) of the painful and blind right eye of a 13-year-old girl showed a cystic mass almost filling the vitreous cavity and narrowing the anterior chamber. The histopathologic diagnosis of the enucleated eye was an echinococcus cyst. Abdominal ultrasonography, brain CT and chest X-rays gave no abnormal findings when first examined, nor during the follow up 18 months after surgery. Indirect hemagglutination test was negative at the last control. The case was accepted as a primary hydatid cyst (echinococcosis) of the eyeball. PMID- 1789101 TI - Exudative retinal detachment in familial pulmonary hypertension. AB - In a family with pulmonary hypertension, one woman developed bilateral exudative retinal detachments and her daughter developed a unilateral exudative retinal detachment during pregnancy. Treatment with Acetazolamide provided quick recovery in the bilateral case, whereas the unilateral exudative detachment recovered without treatment after delivery. Exudative retinal detachments have not previously been associated with pulmonary hypertension. PMID- 1789102 TI - Gyrate atrophy of the choroid and retina in a 5-year-old girl. AB - A 5-year-old Asian-Indian female presented with bilateral cobblestone-like peripheral lesions, a single area of chorioretinal atrophy, infero-nasal to the disc, in her right eye and a non-recordable single flash ERG. Serum ornithine level was assayed at 841 mumol/l, ten times normal levels, and a diagnosis of gyrate atrophy, due to ornithine aminotransferase deficiency was made. The patient was refractory to any form of therapy and her clinical lesions spread rapidly in both eyes, showing both centrifugal and centripetal spread in her right eye. A rapid deterioration in her psychophysical tests was also seen over the 28 months follow-up. The presence of cobblestone-like peripheral lesions in a child should alert the clinician to the possibility of gyrate atrophy, and the rapid spread of the chorioretinal lesions coupled with non-recordable single flash ERGs, in a young patient may suggest a much poorer prognosis. PMID- 1789103 TI - Toxicity of topical ophthalmic medications. PMID- 1789104 TI - [Circadian rhythms of toxicity and pharmacokinetics of gentamicin in mice]. AB - The circadian rhythms in the toxicity and the pharmacokinetics of gentamicin were investigated in mice. Male ICR mice were housed in a standardized light-dark cycle (light on: 0700-1900, LD 12: 12) with food and water ad libitum for 2 weeks before experiment. Each animal was given a single dose of gentamicin 290 mg/kg, se. for the toxicity study and 45 mg/kg, sc for the pharmacokinetic study. A definite circadian rhythm was demonstrated for the toxicity and pharmacokinetics of gentamicin depending on the time of administration with the highest toxicity and plasma drug concentration during the light phase and the lowest during the dark phase. The results of the study suggest that there is a correlation between the peak drug levels and toxicity of gentamicin in mice. The circadian rhythm of gentamicin toxicity seems to be, at least in part, due to the circadian rhythm in pharmacokinetics of the drug. PMID- 1789105 TI - [Protection of biomembrane fatty acids by antioxidants studied with gas chromatography]. AB - A gas chromatography method for the determination of degree of lipid peroxidation of polyunsaturated fatty acids (PUFA) in 3 kinds of biomembrane (human red blood cell, human platelet membrane and mitochondrial membrane of rat liver) was established. The method was used to study the inhibiting effect of several antioxidants on OH. radical induced lipid peroxidation reaction in biomembrane. The results showed that several compounds with phenolic hydroxyl groups (catechuicine, sodium ferulate, gallic acid and its derivatives) have significant protective effect on PUFA of the 3 kinds of biomembrane. PMID- 1789106 TI - [Study on porphyrins:synthesis and antitumor activity of porphyrin-fluorouracil compounds]. AB - Three covalently linked porphyrin-fluorouracil compounds were synthesized. Measurement using these compounds for inhibition of mice transplanted tumor growth, cytotoxicity to mice cancer cells and the mice ear index under exposure to a light was performed. The results indicated that all these compounds were phototoxic to the cancer cells, and compound 1 was the most effective among them. PMID- 1789107 TI - [Synthesis of analogues of carbocyclic nucleoside]. AB - The derivatives of 5'-dehydroxymethyl carbocyclic nucleoside were synthesized by condensation of cyclopentenyl chloride and corresponding pyrimidines followed by epoxidation and substitution. All compounds were screened for anticancer and antiviral activities and no activity was found. PMID- 1789108 TI - [Studies on the chemical constituents of Melia azedarach L]. AB - Melianoninol (I), melianol (II), melianone (III), meliandiol (IV), vanillin (V) and vanillic acid (VI) were isolated from the fruits of Melia azedarach L.. The structure of melianoninol, a new compound, was elucidated by IR, MS, 1H NMR, 13CNMR and other spectral evidences. The new compound possesses some anti-feeding properties against the imported cabbage worm (Pieris rarae L.). PMID- 1789109 TI - [Application of 2d NMR techniques in the structure determination of ganosporelactone A and B]. AB - Structure and stereochemistry of ganosporelactone A and B isolated from the spores of Ganoderma lucidum have been elucidated by the use of 1H-1H COSY, 1H-13C COSY, 1H-13C COLOC and NOESY 2D NMR spectroscopy. Ganosporelactone A and B are two novel pentacyclic triterpenoids which may be biogenetically derived from lanostane skeleton through the construction of C16 and C23 bond. PMID- 1789110 TI - [Studies on the structure of gnetifolin A of Gnetum parvifolium (Warb.) C.Y. Cheng]. AB - A new component, gnetifolin A, was isolated from the ethyl acetate fraction of the stem of Gnetum parvifolium (Warb.) C.Y. Cheng together with three known components isorhapontigenin, resveratrol and beta-sitosterol. The structure of gnetifolin A has been established as 2-(3',5'-dihydroxy-4'-methoxyphenyl)-3 methoxy-5-hydroxybenzofuran by spectroscopic methods (UV, IR, MS, 1HNMR, 13CNMR, 2D-NMR). PMID- 1789111 TI - [Phytoecdysteroids of Rhaponticum uniflorum root]. AB - Three phytoecdysteroids I, II and III were isolated from the root of Rhaponticum uniflorum (L.) DC. and their structures were elucidated by chemical and spectroscopic methods (UV, IR, EI-MS, FAB-MS, 1HNMR, 13CNMR, 1H-1H COSY, 1H-1H NOESY, 1H-13CCOSY and CD). Compound II is new and named rhapontisterone, its structure was confirmed as (20R, 22R, 24S)-2 beta, 3 beta, 11 alpha, 14 alpha, 20, 22, 24-heptahydroxy-5 beta cholest-7-en-6-one. The other two, I and III, were identified as ecdysterone and turkesterone, respectively, both are known compounds, but turkesterone was isolated for the first time from the title plant. PMID- 1789112 TI - [The structure of glyeurysaponin]. AB - A species of the genus Glycyrrhiza, G. eurycarpa P.C. Li recently reported as a new species growing in Gansu Province Xinjiang Autonomous Region has rarely been studied before on its chemical constituents. This paper reports the isolation and chemical elucidation of two triterpene glucosides named glyeurysaponin (K-4) and uralsaponin B (K-3) from this species collected in Jinta County, Gansu Province. Their chemical structures were elucidated by means of chemical and spectrometric analysis (UV, IR, MS, 1HNMR and 13CNMR) and were first reported to be present in this plant. Glyeurysaponin (K-4), C42H62O16 was obtained as white crystals, mp 288 degrees C (d), [alpha]18D + 22.5 degrees (c 0.62,60%MeOH). Its structure was found to be be 3 beta-hydroxy-11-oxo-olean-12-en-30-oic acid-3-O-beta-D glucuronopyranosyl-(1----4)-beta-D-glucuronopyr anoside. Glyeurysaponin is a new triterpenoid saponin. The known saponin was identified to be 3 beta-hydroxy-11 oxo-olean-12-en-30-oic acid-3-O-beta-D-glucuronopyranosyl-(1----3)-beta-D glucuronopyr anoside, uralsaponin B. PMID- 1789113 TI - [Determination of chlorphenamine and propantheline bromide in pukeling tablets by differential--linear combination derivative spectrophotometry]. AB - This paper provides the basic principle and experimental technique of differential--linear combination equal value derivative spectrophotometry. Quantitative analysis of three or four component--mixture can be done without separation. This method was investigated to assay the contents of chlorphenamine and propantheline bromide in Pukeling tablets by using UV-210A spectrophotometer. The average recoveries of chlorphenamine and propantheline bromide were 100.2 +/- 1.49% (CV) and 99.89 +/- 1.03% (CV) respectively. The results showed that it not only can effectively remove disturbances from each other, but also give higher sensitivity and accuracy. PMID- 1789114 TI - [Determination of compound preparation containing unknown absorptive background by UV spectrophotometry]. AB - A novel algorithm of target factor analysis has been developed for detection and correction of unknown absorptive background in multicomponent analysis. The algorithm is based on the property that the estimated spectra can gradually approach the true ones by iterative refinements. Paracetamol and antipyrine contained in compound injection of paracetamol were determined by this method without any preliminary chemical separation. The average recoveries were both 100.0% and the coefficients of variation were 1.1% and 1.0% respectively. The results clearly indicate that the proposed method may also provide a new approach to the analysis of traditional Chinese medicine containing some unknown absorptive components. PMID- 1789115 TI - [Study on the Chinese drug beimu. IX. Microscopic identification of the upper epidermis of the scales of Fritillaria bulls]. AB - Beimu, a famous traditional Chinese drug, has been used as an antitussive and expectorant for a long time and it is derived from a number of species of Fritillaria. So it is difficult to identify exactly the botanical origin of the commercial crude drugs by means of macroscopic examination. This paper deals with the microscopic identification of the upper epidermis of the scales of 20 species. The result showed that these species are different from each other in the shape and size of the epidermal cells, the shape, size and arrangement of the cuticular peg. Moreover, it was found that the anticlinal wall of the epidermal cells is not bead--thickened, but cuticular peg formed by cuticle. PMID- 1789116 TI - [Studies on surfactants used for thin layer chromatographic separation of flavones]. AB - The micellar thin layer chromatographic behaviours of rutin, quercetin and morin were studied. The methods of separation and identification were established: Polyamide thin coating was used as the stationary phase and 4% Zeph- acetylacetone--H2O (5:1.5:1.5) used as the mobile phase. The method was applied to the separation and identification of quercetin and rutin in samples of Sophorae flos and satisfactory result was obtained. PMID- 1789117 TI - Determination of 4'-methoxy-puerarin in puerarin by reversed phase HPLC. PMID- 1789118 TI - Vasomotor functions of skin microcirculation in vasospastic Raynaud's phenomena. AB - An overview of our recent studies is given. The following subjects were investigated: Women with primary Raynaud's phenomenon (PRP) and their female controls (FC); vibration exposed workers without (HAV) and with vibration-induced white finger (VWF); men with chemotherapy-induced Raynaud's phenomenon (CRP) and men with similar treatment but without finger symptoms (CVB); and male controls (MC). All three forms of Raynaud's phenomenon (RP) had a vasospastic and not an obstructive disease. The relative capillary blood flow rate in the skin of the finger was measured by the local 133Xenon washout technique during three different postural stimuli before and after hand vibration and furthermore during hand vibration. The main results indicate a hyperreactivity of the central sympathetic nervous system in all three types of vasospastic RP, which may be responsible for episodes of RP; a dysfunction of the peripheral sensory nerve fibers in VWF; a chemotherapy-induced prolonged vascular-toxic effect only on the terminal arterioles regardless of finger symptoms; and an only transitory mechanical effect of hand vibration on the arteriolar vasomotor function. The applied quantitative mapping of the function levels of the different elements involved in sympathetic vasoconstriction may be valuable in the evaluation of the pathophysiological components in other forms of RP. PMID- 1789119 TI - Into the black box: flows, fluxes, distribution volumes, and interstitial diffusion. AB - From considerations of a simple kinetic model and of measurement of blood flow in tissues with inert radioactive gases, a set of practically applicable equations are presented to allow measurement of perfusion coefficients, permeability surface area products, distribution volumes, and interstitial diffusion coefficients for hydrophilic, extracellular indicators. PMID- 1789120 TI - The microvascular haematocrit as a determinant of myocardial oxygenation. AB - Ischaemia of the left ventricular myocardium preferentially threatens the subendocardial layers. The microvascular haematocrit is a main factor for oxygen delivery to the left ventricular wall together with coronary blood flow and perfused capillary area. The influence of coronary perfusion, precapillary flow, haematocrit, the viscosity of the blood, and the viscoelastic properties of red cells are considered with emphasis on their influence on oxygen delivery to the myocardium. The microvascular haematocrit is decreased distal to a coronary artery stenosis, and especially in subendocardial layers, so the oxygenation of the deep layers within the left ventricle is reduced more than could be expected from a decrease in coronary blood flow alone. PMID- 1789121 TI - Presence of nerve fiber collaterals from the sympathetic arteriolar plexus the concomitant venules in dog skeletal muscle. AB - Previous studies with the local 133Xenon washout method of the local regulation of blood flow in peripheral tissues in man gave evidence for a local veno arteriolar sympathetic axon reflex which constricts arterioles when the venous transmural pressure is increased 25 mm Hg or more. The present study with the formaldehyde induced histofluorescence technique applied to skeletal muscle biopsies from dogs showed a dense plexus of noradrenergic sympathetic fibers around arterioles. Venules were generally devoid of these fibers. In certain instances sympathetic fibers left the arteriolar network to innervate the concomitant venule directly. Some of these fibers could be seen returning from the venule back to the arteriolar network. We suggest that the adrenergic fibers derived from the sympathetic plexus around the arterioles who innervate the venules can be the anatomical substrate for the local veno-arteriolar sympathetic axon reflex. PMID- 1789122 TI - Myocardial capillary permeability for small hydrophilic indicators during normal physiological conditions and after ischemia and reperfusion. AB - Myocardial capillary permeability for small hydrophilic solutes (51Cr-EDTA or 99mTc-DTPA) has been measured using intracoronary indicator bolus injection and external radioactivity registration (the single injection, residue detection method). The method is based on kinetic separation of the injected indicator molecules in an extracted and a transmitted fraction of molecules. In open chest dog hearts measurements performed during normal physiological conditions gave mean capillary extraction values of 43.5-47.5% and the corresponding calculated PdS values were 47.1 - 57.5 ml.(100g.min)-1. From these PdS values Pd values between 1.57.10(-5) and 1.92.10(-5) cm.s-1 were calculated, in accordance with values obtained by other methods. Similar data have been obtained in myocardium of patients undergoing coronary angiography. Oxygen derived free radicals seems to participate in reperfusion injury including microvascular alterations. In open chest dogs transitory increases in capillary extraction fraction and PdS for small hydrophilic solutes were seen following 20 minutes of regional myocardial ischemia and reperfusion. This response could be inhibited by treatment directed against superoxide radicals. PMID- 1789123 TI - 133Xenon absorption into rubber-protected portable cadmium telluride (CdTe(Cl)) detectors invalidating the 133Xenon washout method for measurement of cutaneous and subcutaneous blood flow rates in man. AB - The importance of 133Xenon absorption into rubber detector caps during cutaneous and subcutaneous blood flow measurement was investigated in 46 experiments involving 38 persons. 133Xenon was administered atraumatically. Cutaneous and subcutaneous washout rates were registered by portable Cadmium Telluride detectors without rubber caps, with rubber caps, and with rubber caps with Mylar membranes interposed between the rubber and the tissue investigated. No difference in rate constants obtained by means of various detector types was detected. The accumulation of 133Xenon in the rubber caps was found to take place within the first few minutes after the detectors had been brought into position. The 133Xenon then diffused back into the tissue exhibiting a great variation regarding rate constants. The 133Xenon diffused form rubber into air and perfused tissue tracing a monoexponential course; and again the rate constants would vary considerably. No correlation was found between elimination rates obtained with detectors with and without 133Xenon polluted caps, and no way of correcting for the 133Xenon content in the rubber caps was found. Relative changes in rate constants could still be recognized, but absolute values were not obtainable. PMID- 1789124 TI - Measurement of capillary permeability in canine heart determined by the tissue injection, residue detection method. AB - In previous studies the tissue injection, residue detection method failed to provide results of diffusional capillary permeability comparable to those of other methods. For this reason we reconsidered the kinetic theory and found that it is necessary to take into account the apparent (restricted) diffusion coefficient of the indicator within the tissue, D', in order to determine the permeability-surface area product, PdS = Vev.D.D'-1.tev-1 = Vev'.klo where D is the diffusion coefficient in free aqueous solution, Vev is the physical interstitial water volume of distribution, Vev' is the virtual (apparent) interstitial volume of distribution, tev is the mean transit time of the indicator, and klo is the recorded fractional initial washout rate constant. In experiments on open chest dog hearts we examined capillary permeability for 51Cr EDTA and 99mTc-DTPA with the tissue injection, residue detection method and the single injection, residue detection method. Blood flow was measured independently with local 133Xenon washout. D and D' were measured by a true transient diffusion method. We found that the tissue injection, residue detection method gave results for capillary extraction and PdS-product similar to those obtained with a number of other methods based on indicator diffusion, so the tissue injection, residue detection method in its new kinetically correct formulation could prove useful in clinical studies of capillary permeability since it is applicable to determination of relative changes of permeability during interventional procedures. PMID- 1789125 TI - The anatomical basis of a new method for re-innervation of the gluteal region in paraplegics. AB - The surgical treatment of pressure sores in paraplegic patients currently consists of myocutaneous flaps, direct suture and cover with split thickness skin grafts. These surgical methods of closing defects in pressure bearing areas do not normally provide any sensory function unless the skin flaps have intact sensibility or have been re-innervated in a first stage operation. The aim of the present project is to study the feasibility of re-innervating the gluteal region directly by mobilizing intercostal nerves, extending their reach by nerve grafts and neurotization of the required area without involving other skin areas so achieving: 1) re-innervation of skin to gain protective sensibility in the pressure bearing area, 2) re-innervation of the gluteus maximus muscle to gain voluntary muscle contraction to improve blood flow and diminish ischaemia. So far, 10 cadaver dissections have been performed to define anatomical relationships. Different intercostal nerves were dissected to allow for the various levels of spinal cord lesion among the patients. Through an incision in the midgluteal region, the sensory nerve to the skin covering the ischial tuberosity and the motor nerve to the gluteus maximus were located. The technical possibilities of connecting these nerves to intercostal nerves via sural nerve grafts were demonstrated. PMID- 1789126 TI - Mechanisms that determine the transport of substances from capillary blood to myocytes during changes in oxygen metabolism. AB - Transport of substances by convection in myocardium is mainly controlled by autoregulation and metabolic vasodilation. It can be increased by a factor 3-4 during increased oxygen demand and probably even more during pharmacologic coronary vasodilation. Other factors such as the systolic compression, neural and humoral factors, and endothelium may alone or in combination modulate local blood flow rate. Resistance to movement of molecules across the capillary membrane is well known in measurement of capillary permeability, and it seems likely that these phenomena operate in the interstitium as well. The rate of which hydrophilic substances find their way through the interstitial space between matrix fibers depends mainly on molecular size, i.e., the pathways will offer relatively more resistance to the progress of larger molecules as compared with small molecules. Despite the central role played by the microcirculation in supplying the myocytes with oxygen and nutrients, we remain relatively ignorant about many aspect of its functional and morphological responsiveness to ischemia. PMID- 1789127 TI - Sympathetic reflex control of blood flow in human peripheral tissues. AB - Sympathetic vasoconstrictor reflexes are essential for the maintenance of arterial blood pressure in upright position. It has been generally believed that supraspinal sympathetic vasoconstrictor reflexes elicited by changes in baroreceptor activity play an important role. Recent studies on human skeletal muscle, cutaneous and subcutaneous tissues of the limbs indicate that the situation is more complex. Measurements have been carried out during acute as well as chronic sympathetic denervation. Spinal sympathetic reflex mechanisms have been evaluated in tetraplegic patients, where supraspinal sympathetic vasoconstrictor reflexes are blocked. Blood flow has been measure by the local 133Xe-technique. The results indicate the presence of spinal as well as supraspinal sympathetic vasoconstrictor reflexes to human peripheral tissues. Especially is emphasized the presence of a local sympathetic veno-arteriolar axon reflex which is elicited by increase in venous transmural pressure of more than about 25 mm Hg. Finally, centrally elicited vasoconstrictor activity is modified by simultaneously activating the local veno-arteriolar axon reflex or vice versa by means of an intraneuronal impulse inhibition due to collision of normodromically and antidromically conducted impulses in efferent sympathetic vasoconstrictor fibers. The evidence obtained suggests that sympathetic vasoconstrictor reflexes to postural changes are complex and highly differentiated. PMID- 1789128 TI - Skinfold thickness, local subcutaneous blood flow and insulin absorption in diabetic patients. AB - The influence of skinfold thickness on the local subcutaneous blood flow (SBF) and absorption rate of subcutaneously injected and infused soluble insulin was investigated in insulin-dependent diabetic patients. The local 133Xenon washout technique was used for measuring SBF and the disappearance of 125I labelled insulin for measuring insulin absorption. A Harpenden skinfold caliper was used for measuring skinfold thickness. A large variation in skinfold thickness (range 6-40 mm, N = 50) was demonstrated. The SBF was curvilinear related to the skinfold thickness with decreasing SBF for increasing skinfold thickness (N = 50). A similar relationship was found between the SBF and the absorption rate of subcutaneously injected (N = 10) and infused (N = 7) insulin. The large variation in skinfold thickness and thus insulin absorption may partly explain the well known large inter-individual variation in insulin absorption, and the different absorption rates from areas with different skinfold thickness should be taken into account when treating with insulin. PMID- 1789129 TI - Peripheral blood flow control in diabetes mellitus. AB - Long term diabetes has a profound effect on the peripheral circulation. This has been demonstrated to be due to the presence of angiopathy and autonomic neuropathy, affecting autoregulation and distensibility of the vessels as well as local and central reflex regulation of the vascular resistance. Whereas the hemodynamic consequences of vascular denervation are well known (causing blood pressure maladaptation to a number of stimuli such as standing, exercise and agonist infusion) (Hilsted 1985), the consequences of disturbances in autoregulation and distensibility remain to be established. PMID- 1789130 TI - Whole body capillary exchange of albumin. AB - Analyzed versus the large plasma marker of fibrinogen, initial albumin plasma disappearance in man or animals is sharply biphasic. Albumin uptake in skin, muscle and viscera follow the same pattern, suggesting serial barriers to albumin efflux in these tissues, i.e., a capillary membrane barrier and an interstitial barrier. The transport across the membrane is rapid, in both directions and probably mediated by diffusion, while interstitial transport may be slow, mainly unilateral and mainly convective. This implies the interstitial barrier and not the capillary membrane to be the rate limiting step of total plasma to lymph albumin transport. The distribution of efflux indicates whole body plasma disappearance to reflect mainly the uptake in muscle, lung, skin, and gut, while the highly perfused tissues of heart, kidney and sinusoid tissue have smaller influence due to their lower body masses. PMID- 1789131 TI - Skin oxygen tension, skin oxygen consumption, and skin blood flow measured by a tc-pO2 electrode. AB - By use of a combined tc-pO2 skin blood flow sensor E5250 and measurement of cutaneous and subcutaneous blood flows with the 133Xenon washout method it was demonstrated that blood flow in both tissues increases with a factor of 3-4 when the electrode temperature increases from 37 to 45 degrees C. In order to examine the influence of the gas diffusion barrier within the epidermal membrane the stratum corneum of the forearm was removed selectively by stripping with adhesive tape. Stripping increased the oxygen tension values from 10.98 +/- 0.63 kPa to 14.58 +/- 1.03 kPa, and skin oxygen consumption ranged from 0.208 to 0.251 ml O2.(100g.min)-1. The combination of a Clark type electrode with a heat sensor allows determination of oxygen delivery to the skin as well as the oxygen supplying cutaneous blood flow. The distribution of blood flow between nutritional and shunt vessels at various local temperatures remains to be clarified. PMID- 1789132 TI - Effect of regulatory peptides on the blood flow rate in rabbit female genital tract evaluated by the 133Xe technique. AB - The 133Xe washout method has been evaluated and found to be a reliable method for the measurement of myometrial as well as ovarian blood flow rates in the rabbit. Monoexponential washout curves for 133Xe have been demonstrated for the whole washout process, both in the uterus and the ovary. Consequently it is possible to calculate the blood flow rate at any time interval during the whole washout process. This 133Xe washout technique has been used for the evaluation of the biological effect of neuropeptides on the local blood flow within the rabbit uterus and ovary. It has been recognized for years that the intrinsic control of a number of functions, including the blood flow regulation, in the genital tract cannot be attributed to cholinergic and/or adrenergic nerves alone. Evidence from 133Xe experiments suggests that the neuropeptides in the female genital tract may play a functional role in these non cholinergic non adrenergic events. PMID- 1789133 TI - Measurement of cutaneous blood flow by the 133Xenon washout method. Clinical applications in dermatology. AB - Measurement of cutaneous blood flow by the 133Xenon washout method was elaborated by Sejrsen (1971). The method has been applied to evaluate the local regulation of blood flow in normals and in skin diseases. The method can, provided it is used with caution, give quantitative values for cutaneous and subcutaneous blood flow, but has mostly been used to register relative changes in blood flow during various provocation tests. This review details studies with relevance to dermatology performed during two decades. PMID- 1789134 TI - Mucosal/submucosal blood flow in the gut wall determined by local washout of 133Xenon. AB - A 133Xe washout technique for measuring the blood flow in the intestinal mucosa is introduced and evaluated. In 11 anaesthetized pigs a laparotomy was performed and the mucosal blood flow rate in the intestine of the pig was determined by a local epimucosal application of 133Xe. In both the colon and the small intestine the 133Xe washout plotted in a semilogarithmic diagram showed a multiexponential configuration. Histological examination and localization studies showed shunting by diffusion of 133Xe in the intestinal mucosa explaining the multiexponential configuration of the washout curve. Therefore the initial slope of the washout was used for measuring blood flow rate. Blood flow rate was simultaneously measured by microsphere entrapment technique. There was an excellent correlation between the blood flow rate determined by the two techniques the correlation coefficient R being 0.89 in the small intestine and 0.996 in the colon. PMID- 1789135 TI - Transmural pressures and tissue perfusion in man. AB - The relationship between the arterio-venous pressure gradient and blood flow - the Hagen-Poiseuille principle - was reinvestigated. A main theme was to compare transmural pressure changes induced by either changing pressure inside or outside the vessels. Blood flow was measured in subcutaneous and skeletal muscle tissue in the lower limb of man by using the 133Xenon washout technique. Intramural pressure changes were achieved by supine leg elevation or lowering and leg exercise in nearly erect position. Extramural pressure changes were induced by inflation of a leg cuff. The main finding was a cessation of blood flow, when local diastolic arterial pressure was reduced to zero, although a positive pressure head was still present. This phenomenon was believed to be caused by a collapse of the arterio-arteriolar bed with the pulse pressure energy extinguished by the Windkessel effect. Several other hemodynamic topics were examined and discussed such as pulsatile arterial pressure and flow, the Hagen Poiseuille principle, autoregulation of blood flow, postcapillary vessel collapse, vasoconstrictor response, local sympathetic veno-arteriolar axon reflex, the central baroreceptor activity, and the musculo-venous pump in the calf. In conclusion, changes in transmural pressure, whether accomplished by intra- or extramural pressure changes, had the same impact on the arterial and venous sections of the vascular bed. One exception emerged. Blood flow resistance was increased by external compression in supine position due to postcapillary venous collapse even when a low compression force was applied. PMID- 1789136 TI - Sources of variation in 133Xenon washout after subcutaneous injection on the abdomen. AB - The washout of 133Xenon injected locally in three subcutaneous regions on three volunteers was in a repeated latin square design analyzed regarding flow values and initial clearance. Blood flow showed no dependence on injected volumes (.02 .5 ml), but there was a significant day-day variation and regional and personal differences in subcutaneous blood flow. The initial fast washout was related to the injected volumes due to trauma and dilution of the tissue. From these results precautions are described to increase the validity of the local 133Xenon washout method for measurement of subcutaneous blood flow. In repeated clinical studies it remains important even on the same individuals to record sources of variation apart from the variable to be investigated. PMID- 1789137 TI - Role of ascorbic acid in the regulation of proliferation in osteoblast-like MC3T3 E1 cells. AB - Proliferation of osteoblast-like MC3T3-E1 cells was minimal in serum-free Eagle's minimum essential medium (MEM) but was enhanced by about 3.5-fold in serum-free alpha-modification of MEM (alpha-MEM). By adding back each of the extra constituents present in alpha-MEM to MEM, it was found that ascorbic acid was responsible for the sustained proliferation of MC3T3-E1 cells without serum. Ascorbic acid also stimulated the synthesis of collagen and increased the hydroxyproline content of MC3T3-E1 cell cultures markedly. Inhibitors of collagen synthesis, L-azetidine-2-carboxylic acid, cis-4-hydroxyproline, and 3,4 dehydroproline, almost completely eliminated the stimulatory effect of ascorbic acid on DNA synthesis of MC3T3-E1 cells. The dose response of the effect of L azetidine-2-carboxylic acid on the hydroxyproline content closely paralleled that on DNA synthesis of MC3T3-E1 cells. Furthermore, a 10 times higher concentration of proline, which competes with L-azetidine-2-carboxylic acid for the incorporation into procollagen molecules, reversed the inhibition of DNA synthesis by L-azetidine-2-carboxylic acid. These results are consistent with the assumption that the stimulatory effect of ascorbic acid on the proliferation of MC3T3-E1 cells is mediated through its effect on the synthesis of collagen or some related protein. Furthermore, a fibronectin attachment peptide, GRGDTP, that competes with matrix proteins for specific binding to cell surface adhesion receptors also inhibited the stimulation of proliferation by ascorbic acid almost completely.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789138 TI - Inhibition of parathyroid hormone secretion correlates with increased incorporation of 32P into phosphatidylinositol and lysophosphatidylinositol. AB - We have studied the incorporation of radioactive P (32P) into lipids of bovine parathyroid tissue under conditions of stimulated and inhibited hormone secretion. Utilizing low (0.5 mM) and high (3.0 mM) concentrations of calcium to regulate parathyroid hormone secretion, we initially found that the labeling of the cellular phospholipids with 32P was greater in those tissues incubated in high-calcium medium. Thin-layer chromatography of lipid extracts prepared from tissue incubated in either low- or high-calcium media revealed that the increased incorporation of 32P (high or low) was localized primarily to two phospholipids. To determine whether the increases were due directly to the different calcium concentrations, the experiments were performed in media containing normal calcium concentrations (1.25 mM) and low (0.5) or high (3.0) magnesium concentrations to modulate hormone secretion. The results were identical to those obtained using low and high calcium, indicating that the increased 32P incorporation was not an effect of high calcium but rather correlated with the inhibition of hormone secretion. The use of other secretagogues confirmed this correlation. The identity of the two phospholipids was established, by two-dimensional thin-layer chromatography, to be phosphatidylinositol (PI) and lysophosphatidylinositol (LPI). The correlation of increased 32P incorporation with inhibition of secretion led us next to examine isolated secretory granules from tissues exposed to either high-or low-calcium conditions. Thin-layer chromatography of granule lipid extracts yielded chromatograms containing PI and LPI, and the radioactivity of each was greater in the high-calcium sample than in the low-calcium sample.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789139 TI - Relationship between the number of resorbing cells and the amount resorbed in metabolic bone disorders. AB - The relationship between bone-resorbing cells, assessed by the presence of tartrate-resistant acid phosphatases (TRAP) and morphologic indices of bone resorption, was determined in 29 osteoporotic patients (14 postmenopausal females and 15 males) and 15 dialyzed patients. The number of TRAP-positive cells per unit of cancellous bone area (N.Oc/B.Ar) was higher in dialyzed patients than in those with osteoporosis (16.8 +/- 15.3 versus 4.95 +/- 2.86, p less than 0.05). The amount of bone resorbed at the basic multicellular unit level was estimated by calculating eroded area containing TRAP cells per bone area (E.Ar+/BA). This novel parameter was similar in dialyzed and in osteoporotic patients (41,700 +/- 28,400 versus 32,300 +/- 24,600). In contrast, trabecular spacing (Tb.Sp) was identical in both metabolic bone diseases. Trabecular width (169 +/- 38 versus 127 +/- 32 microns, p less than 0.05) and bone area were higher in dialyzed than in osteoporotic patients. N.Oc/B.Ar was significantly related to E.Ar+/BA in dialyzed (r = 0.76, p less than 0.05) but not in osteoporotic patients. Tb.Sp was significantly correlated to N.Oc/B.Ar and to the number of TRAP-positive cell nuclei per B.Ar (r = 0.44, p less than 0.05) in osteoporotic but not in dialyzed patients. This last result shows that in overt osteoporosis with thin trabeculae, trabecular spacing is related to the number of resorbing cells. In contrast, the spacing of thick trabeculae in dialysis osteodystrophy is not dependent on the number of osteoclasts. PMID- 1789140 TI - Iliac trabecular bone formation predicts radial trabecular bone density changes in type 1 osteoporosis. AB - In 28 patients with idiopathic or postmenopausal type 1 (spinal crush fracture) osteoporosis, resorption indices and dynamic measurements of trabecular bone formation based on in vivo tetracycline labeling in 7.5 mm transiliac biopsies have been compared with trends in radial cortical and trabecular bone density measured with computed tomography. Positive correlations were observed between trabecular bone density trends in the radius and indices of bone formation in the ilium. These were improved when one of the two resorption indices was included with a formation index in bivariate regressions. Marked interindividual variations in radial bone density trends were also seen in cortical bone. These correlated poorly with trends in trabecular bone. Weak negative relationships between cortical bone trends and indices relating to bone formation and resorption were observed, but a positive association was seen with single-labeled surfaces on iliac trabeculae. If, as has been suggested, there are periodic variations in bone formation, the results suggest that axial and peripheral trabecular bone density trends are synchronized in osteoporosis, perhaps in response to systemic factors, such as circulating hormones. PMID- 1789141 TI - Effects of fixation and demineralization on the retention of bone phosphoprotein and other matrix components as evaluated by biochemical analyses and quantitative immunocytochemistry. AB - Aqueous tissue processing and demineralization procedures may adversely affect the inorganic mineral phase of a calcified sample and, where mineral and organic constituents interact, may consequently also indirectly alter organic matrix ultrastructure and distribution. In the present work, the effects of demineralization have been investigated on the retention in chicken bone of two phosphoamino acids, O-phosphoserine and O-phosphothreonine, found in bone phosphoproteins proposed to be important in vertebrate mineralization and, more specifically, on the retention and distribution of a 66 kD bone phosphoprotein (66 kD BPP, osteopontin) also implicated in the calcification process. In tibiae fixed initially with 1% glutaraldehyde and then demineralized in 0.5 N HCl, 0.5 N acetic acid, or 0.1 M EDTA (all containing 1% glutaraldehyde), amino acid analyses and quantitative immunocytochemistry revealed that the phosphoamino acid content and the distribution of the 66 kD BPP were essentially the same as in fixed undemineralized controls. However, demineralization slightly altered the ultrastructural appearance of immunolabeled, electron-dense patches of organic material in the bone matrix. In unfixed bone demineralized with any of these acids, there was a substantial loss of phosphoamino acids and the 66 kD BPP from the bone matrix. The relative ability of these acids to extract phosphoproteins from unfixed bone was found to decrease in the order EDTA greater than HCl greater than acetic acid. These results emphasize the differential effects on structural components of various demineralization and extraction procedures for biochemical and immunocytochemical studies of biologic tissues. Furthermore, they demonstrate that initial fixation with glutaraldehyde retains phosphoproteins in bone, with or without demineralization, while being adequate for immunocytochemical localization of certain bone matrix proteins and that an understanding of the action of specimen preparation on organic constituents (as well as inorganic components) is essential for accurately describing ultrastructural matrix-mineral relationships. PMID- 1789142 TI - Parathyroid hormone-related protein inhibits stimulated uterine contraction in vitro. AB - The effect of parathyroid hormone-related protein (PTHrP) fragments 1-34, 38-64, and 67-86 on acetylcholine-stimulated rat uterine contraction was examined in vitro. In addition, the possibility that PTHrP-(38-64) or (67-86) influenced relaxation caused by PTHrP-(1-34) was also investigated. Contraction of uterine horns was stimulated with 10(-6) or 10(-5) M acetylcholine. PTHrP-(1-34) reduced the magnitude of acetylcholine-stimulated uterine contraction. This effect was dose related over a concentration range of 10(-9)-10(-6) M. Neither PTHrP-(38-64) or PTHrP-(67-86) at concentrations of 10(-8)-10(-6) M affected uterine contraction stimulated by 10(-6) M acetylcholine. These fragments did not affect the relaxation caused by 10(-7) M PTHrP-(1-34). These results demonstrate that (1) PTHrP-(1-34) at 10(-6) M influences contraction of the rat myometrium and (2) the muscle relaxant activity of PTHrP is associated with the first 34 N-terminal amino acids. PMID- 1789143 TI - In vivo induction of bone by recombinant human transforming growth factor beta 1. AB - A single application of recombinant human transforming growth factor beta 1 (rhTGF-beta 1) adjacent to cartilage was found to induce bone formation in rabbit ear full-thickness skin wounds. At doses that optimally promote soft tissue healing, 25-100 ng rhTGF-beta 1 per wound caused osseous tissue formation starting 21 days after wounding to reach a peak incidence and area of bone formation at day 42. Bone formation was followed by active remodeling, resulting in lower incidence and area of bone formation at days 56 and 70. The early phase of bone formation was located overlying the cartilage and involved perichondrial cells that appeared to differentiate directly into osteoblasts forming bone matrix without a cartilage precursor. Cartilage was replaced with bone at later time points. rhTGF-beta 1 was able to increase the ratio of osteoblasts to osteoclasts lining the trabecular surface of bone and thus increase the net amount of bone formation. The present studies suggest a potential therapeutic role for rhTGF-beta 1 in hard tissue repair. PMID- 1789144 TI - Precision and sensitivity of dual-energy x-ray absorptiometry in spinal osteoporosis. AB - This study evaluated the performance of dual-energy x-ray absorptiometry (DEXA) with regard to (1) the correlation with dual-photon absorptiometry (DPA), (2) the ability to discriminate between normal and osteoporotic patients, and (3) long term reproducibility. The bone mineral density (BMD) of the spine in 112 subjects, both normal and osteoporotic, was measured with DPA and DEXA (Lunar Corporation, Madison, Wisconsin) of the spine. The femur BMD of 22 cases was also measured with both machines. The results for the two techniques were highly correlated (r greater than 0.9, SEM = 0.02 to 0.04 g/cm2). BMD was measured using DEXA in 80 women (mean age = 61 years) with established spinal osteoporosis and 110 normal age-matched controls. The osteoporotic patients had significantly reduced spine and femur BMDs compared to the controls: -23% for L2-4 BMD (Z score = 2.6) and -13 to -20% for femur BMD (Z score = 1.1-1.3). L2-4 BMD had the best discriminative value, with an area under the ROC curve of 94%; the Ward's triangle BMD had an area of 84%. The precision error in vitro in a phantom over a 1-year period was 0.7%. The measured precision in vivo with young adults was approximately 1% (SD = 0.012 g/cm2) for L2-4 BMD and 1.7-2.3% (SD = 0.015-0.022 g/cm2) for femur over the 1 year period. The reproducibility was not as good for osteoporotic patients (SD = 0.017 g/cm2). PMID- 1789145 TI - Changes of the lung in rheumatoid arthritis--rheumatoid pneumonia. A clinicopathological study. AB - The frequency and patho-histological characteristics of pulmonary changes were studied on the autopsy material of 100 patients with rheumatoid arthritis (RA). The formal pathogenesis and different stages of vasculitis, rheumatoid nodule, interstitial pneumonia, rheumatoid pleuritis, obliterative bronchiolitis, amyloidosis and the so-called rheumatoid pneumonia in the lungs is discussed. The rheumatoid pneumonia is a disseminating inflammatory lobular-sublobular process, not described previously. The frequency of rheumatoid pneumonia was 4%. The rheumatoid pneumonia is characterized by the necrotic vasculitis, fibrinoid necrosis or thrombovasculitis of the pulmonary and bronchial arterioles, and of small arteries. Because of the diminished blood supply distal to the vascular changes inflammatory foci may develop, more or less respecting the anatomic borders of pulmonary tissue. The lobular-sublobular inflammation is basically of non haemorrhagic character. Because of the recurrent nature of vasculitis, foci of inflammation in different stages can be observed in the lungs simultaneously side by side. Clinically the rheumatoid pneumonia was accompanied by severe RA, according to the frequency and severity of acute exacerbations. In all 4 cases of rheumatoid pneumonia the pulmonary process had been proven clinically and radiologically. Rheumatoid pneumonia occurred subsequent to recurrent arthritis following steroid withdrawal, and it was resistant to antibiotics. PMID- 1789146 TI - Adenocarcinoma of ceruminous glands. Ultrastructural, immunohistochemical and lectin histochemical studies. AB - A case of ceruminous adenocarcinoma is reported. The tumor destroyed the right pyramid, widely invaded the base of the skull and caused death shortly after the diagnosis. Distant metastases were not found by autopsy. The tumour cells reacted with epithelial markers and with the antibody against S-100 protein. Heparan sulphate proteoglycan seemed to be a good marker for detecting basement membrane ruptures and concomitant tumour invasion. Among the lectins BS-I and PNA gave the strongest reactions in the stroma. This is the first immunohistochemical and lectin histochemical report on ceruminous adenocarcinoma. PMID- 1789147 TI - Turnover and intranuclear localization of 125I-insulin in Tetrahymena. An autoradiographic study. AB - The unicellular Tetrahymena first internalized, then partly released the labelled insulin. Insulin-pretreated (imprinted) Tetrahymena cells behaved differently from non-pretreated cells, in that they retained a greater part of internalized insulin in the cytoplasm. Additional exposure to excessive non-labelled (cold) insulin caused a decrease in intracellular labelled insulin retention. Internalized insulin also entered the nucleus of Tetrahymena, where it was found in a heterochromatic localization. PMID- 1789148 TI - Translational inhibitors cycloheximide, emetine, and puromycin inhibit cellular autophagy in mouse liver parenchymal and pancreatic acinar cells in vivo. AB - The protein synthesis inhibitor cycloheximide is widely used (in vitro or in vivo) to inhibit the autophagic degradation of endogenous cellular proteins. Circumstantial evidence has been obtained largely from in vitro experiments for a similar effect of other translational inhibitors. In the present study, the in vivo effects of cycloheximide, emetine and puromycin on autophagy in murine exocrine pancreatic and liver cells were tested using electron microscopic morphometry. The experiments were based on the assumption that the autophagic compartment will regress if the formation of the vacuoles is blocked while degradation in the pre-existing vacuoles goes on. To make the measurements easier, autophagic compartment of the cells was greatly enlarged in both cell types by administering vinblastine (10 mg/kg b. wt.) for 2 h when the inhibitors were set on for an additional 30 min. During this half-an-hour, cycloheximide (0.2 mg/g b. wt.), emetine (0.12 mg/g b. wt.) and puromycin (0.2 mg/g b. wt.), respectively caused 58.5, 35.6, and 69.5% regression of the pancreatic and 46.7, 64.2, and 54.2% of the hepatocytic autophagic vacuole compartment. Thus, similarly to cycloheximide, both emetine and puromycin have proved to be inhibitors of autophagy in vivo. The results argue for a possible relationship between the synthesis and degradation of endogenous cellular proteins. PMID- 1789149 TI - Teratogenic effects of nicotine on first molar odontogenesis in the mouse. AB - Fetuses of pregnant CD-1 Swiss albino mice, exposed to 0.1% nicotine sulphate at a dose of 1.67 mg/kg body weight from the 6th to the 15th gestational day, were compared with control fetuses to assess the effects of nicotine on first molar odontogenesis. Mothers were sacrificed on the 18th day of gestation. The 130 nicotine treated fetuses, as well as the 348 control fetuses were embedded in paraffin and sectioned in the frontal plane. The developing molars of the experimental fetuses were retarded, less differentiated, and reduced in breadth in comparison with controls. The developing molars of the control fetuses were in the bell stage of odontogenesis, whereas those of the experimental population were either in the late cap or early cap stage, depending on the absence or presence of palatal cleft, which occurred in 9.6% of the fetuses. It is suggested that nicotine, or its metabolic byproducts, interfere with normal interaction between the epithelial and mesenchymal components of the developing tooth. PMID- 1789150 TI - Phagocytosis of autologous platelets by human neutrophil granulocytes. AB - The phenomenon that the autologous human platelets can be phagocytosed in vitro by neutrophils and monocytes of healthy human donors (being free of antiplatelet autoantibodies) was demonstrated earlier. In this study we have confirmed electron microscopically the phenomenon of phagocytosis. Besides, using flow cytometric analysis, we have shown that a possible way for the bridge-formation between the washed platelets and neutrophils can be the linkage via IgG + C3b complexes bound to the Fc receptors of platelets. This mechanism supposedly may play a role also in the clearance of platelets by peripheral phagocytes in vivo. PMID- 1789151 TI - [Informatics and odonto-stomatology]. PMID- 1789152 TI - [The computer examined or the world of Big Blue and Apple]. PMID- 1789153 TI - [Operating system and software]. PMID- 1789154 TI - [Telematics. A soft therapy for shock medicine]. PMID- 1789155 TI - [The computer in the dental office. 1. Ergonomics and microprocessing]. PMID- 1789156 TI - [The computer in the dental office. 2. Automation and legislation]. PMID- 1789157 TI - [Orthodontic decisions and automation]. PMID- 1789158 TI - [C.A.M.D.M. (Computer-Assisted Medical Decision Making). Why and how?]. PMID- 1789159 TI - [Automation and medical imaging applications in dentistry and stomatology]. PMID- 1789160 TI - [Possibilities for treatment and numerical analysis of dental x-rays]. PMID- 1789161 TI - [Dental CAD-CAM six years after the first presentation at the 1985 A.D.F. Congress]. PMID- 1789162 TI - [Automation and occlusion. From research to clinic]. PMID- 1789163 TI - [Automation and dental education. Reflections on tomorrow]. PMID- 1789164 TI - Adolescence: a literary passage. AB - Using Erikson's and Gilligan's theories of adolescent development, this paper presents a content analysis of the depiction of adolescent development in a sample of Newbery Medal winners and honor books. Some diversity was found among the major characters, but white males were overrepresented. Many of the characters underwent an identity crisis. Some passed through the identity versus role confusion stage; others, especially in the almost prototypical male initiation-rite stories, discovered ways to deal with nature (industry) which engendered a far clearer sense of self (identity). The major female characters experienced the two phases more or less simultaneously, but a similar fusion existed for a number of the male characters. The themes of "separation" and "connection" were paramount in the stories, and what Gilligan has called "the ethic of care" was presented positively. Some main characters matured only when they recognized their responsibility to others. PMID- 1789165 TI - Sexual activity and contraceptive use among low-income urban black adolescent females. AB - A modified form of Nathanson and Becker's (1983) Health Belief Model Questionnaire and other measures designed to assess cognitive processing were administered to low-income black adolescent female clients of an inner-city comprehensive health care clinic. The purpose of the study was to explore determinants of sexual activity and contraceptive use. Subjects were classified as not sexually active (n = 50), sexually active/noncontracepting (n = 20), or sexually active/contracepting (n = 72). Not sexually active subjects tended to be younger, more career motivated, to have a father at home, to be more influenced by family values, and to have more conservative attitudes regarding adolescent sexuality than did sexually active subjects. Sexually active/noncontracepting subjects tended to report fewer benefits and more barriers to the use of contraception. Level of cognitive processing did not differ among the three groups, but was at a lower-than-expected level for age. Finally, inconsistent contraceptive use was common to both sexually active groups. PMID- 1789166 TI - Long-term support and personal adjustment of adolescent and older mothers. AB - Adolescent and older mothers reported the size and quality of social networks and perceptions of family support at 1, 6, and 12 months postpartum. Maternal behavior, general life satisfaction, and parental satisfaction were assessed at 12 months. No significant differences were found in the size of social networks and quality of interactions within those networks, though older mothers had significantly higher scores on perceived family support than did adolescent mothers. Perceived family support and quality of interactions within the social network generally were associated positively with maternal behavior, life satisfaction, and parental satisfaction. This was true in more cases for the adolescent than for older mothers. PMID- 1789167 TI - Adolescents' problems and their relationship to self-esteem. AB - The Mooney Problem Check List and Rosenberg's Self-Esteem Scale were administered to 201 adolescents, ages 14 to 16 years. Sex differences in the number and nature of problems reported, and their relationship to self-esteem, were examined. Results indicated that, overall, girls reported significantly more problems and lower levels of self-esteem than did boys. Girls had more problems with interpersonal relationships, personal adjustment, health, and family issues. There were no significant differences between girls and boys in the areas of educational and vocational future. Surprisingly, neither boys nor girls were particularly concerned about their vocational/educational future. Relative to other areas, adjustment to schoolwork was identified as being of considerable concern for both sexes. There was a significant relationship between self-esteem and reported problems, and different problem areas were related to self-esteem for girls and boys. The findings of this study support previous research and provide further information concerning relationships between self-esteem and problems. PMID- 1789168 TI - Adolescent pregnancy: contributing factors and strategies for prevention. AB - A questionnaire was administered to pregnant adolescents and adolescent mothers to assess both basic needs and factors that may have contributed to their becoming teen parents. Family background and composition, history of sexual abuse, vocational plans and aspirations, and self-esteem were examined. Results and implications for prevention programs and counseling are discussed. PMID- 1789169 TI - Selected risk factors in adolescent suicide attempts. AB - This study examined stress, depression, attempted suicide, and knowledge of common signs of potential suicide in Alabama adolescents. A modified version of the National Adolescent Student Health Survey (NASHS) was administered to 3,803 eighth- and tenth-grade public school students during the fall of 1988. The incidence of stress, depression, and attempted suicide was analyzed by gender, ethnicity, locale (urban vs. rural), and participation in sexual intercourse and use of alcohol. Chi-square tests were used to determine if there were significant differences between groups. Findings indicated that females were at greater risk than were males. Both males and females who engaged in sexual intercourse and alcohol consumption were at greater risk than were abstainers. When analyzed by ethnicity, white adolescents who engaged in these behaviors were at significantly greater risk than were those who abstained; differences were not as pronounced for black youth. Comparisons on the knowledge scale indicated that females scored better than males, whites scored better than blacks, and urban students scored better than rural students. The data suggest that many adolescents are having difficulty coping with stress and depression, and that those who are engaging in various types of risk-taking behavior are at greater risk for depression and suicide. PMID- 1789170 TI - Maternal employment and early adolescent substance use. AB - Research stimulated by increases in maternal employment has focused primarily on children, even though mothers of adolescents are more likely to be employed. It is adolescents who experience developmental changes that promote participation in adult behaviors in advance of their abilities. This study investigated the effects of maternal employment on the use of alcohol, cigarettes, marijuana, and other substances by early adolescents. A sample of ninth-grade students responded to a 48-item survey about their substance use behavior. A comparison of maternal employment patterns (full-time vs. part-time/not employed outside the home) indicated no significant differences in substance use behavior. These results confirmed and extended the growing literature regarding the nonharmful effects of maternal employment on adolescent adjustment and behavior. PMID- 1789171 TI - Schooling without learning: thirty years of cheating in high school. AB - A survey instrument, developed in 1968 and administered to 1,629 high school students in 1969, 1,100 students in 1979, and 1,291 students in 1989, asked them to respond to items regarding the following: (1) the amount of cheating believed going on, (2) who was most guilty, (3) reasons given for cheating, (4) the courses in which most cheating occurred, (5) how to punish cheaters and by whom, (6) beliefs regarding dishonesty in society, and (7) confessions of their own dishonest behaviors in school. Between 1969 and 1989, student responses reflected increasingly pessimistic opinions about dishonesty in school and society. Fear of failure remained the most common reason for cheating. Math and science were the courses in which cheating most often occurred. The home was considered the best place and school the worst place to inculcate honesty. Over the three decades covered by this study, dishonesty was viewed as increasingly necessary, more people believed advertising was suspect, and success in business was attributed to fraudulent activities. More students admitted to cheating on tests and homework. More parents were not aiding and abetting students in avoidance of school rules. Polls, studies, and reports recently published by state, federal, and private agencies appear to confirm these findings. PMID- 1789172 TI - Adolescent perspectives on ways of thinking and believing that promote peace. AB - Qualitative research methodology was used to interpret adolescents' responses to questions about their views on peace. They identified underlying causes and behavioral indications of the potential for war, and provided prescriptions for avoiding it and promoting peace. Skills in interpersonal relations, especially communication and problem solving, were viewed as essential. Responsibility for peace was seen as resting with the individual, the family, society, and world leaders. PMID- 1789173 TI - Sources of sexual information and sexual attitudes and behaviors of Anglo and Hispanic adolescent males. AB - A survey of Anglo and Hispanic adolescent males' sources of sexual information and their attitudes and practices was conducted. A comparison of attitudes and behaviors revealed little difference by ethnicity; however, a more detailed analysis of sources of information resulted in some interesting findings. The relationship between completing a sex education class and condom use was statistically significant in a positive direction. In addition, this relationship was much stronger for Hispanic youth. The important implications of this finding are discussed. PMID- 1789174 TI - Overt and covert parental conflict and adolescent problems: observed marital interaction in clinic and nonclinic families. AB - When adolescents behave in socially unacceptable ways, overt interparental conflict is widely held to be the cause. Empirical studies, however, have been inconsistent in supporting this assumption. Some researchers therefore have speculated that covert conflict also plays a role. In the current observational study, evidence was found that both overt parental conflict and some forms of covert conflict play roles. During problem-solving family discussions, parents of adolescents whom they had brought into an outpatient clinic for treatment overtly disagreed with each other significantly more often than did parents with adolescents who did not require treatment. Families of clinic adolescents also exhibited significantly more silence during their discussions, and mothers spent significantly less time talking than did their nonclinic counterparts. The implications that both the overt and covert conflict may have for adolescent behavior are discussed. PMID- 1789175 TI - A comparison of the family environments of black male and female adolescent alcohol users. AB - The purpose of this study was to examine black American adolescents' use of alcohol and their perceptions of their family environments. Seventy-one participants between the ages of 12 and 20 from a large mid-Atlantic medical facility, who reported using alcohol, were asked to complete the Family Environment Scale (FES). Users were described as those who drank at least once a week and used medium amounts per occasion. Females were hypothesized to have higher scores on the FES than males (higher scores on the FES suggest a more favorable perception of family functioning). A t test was conducted to compare group means on each subscale of the FES. Analyses of the data indicated that females differed significantly from males (p less than .05) on four of the ten subscales. PMID- 1789176 TI - Attempting to change sex role attitudes in adolescents: explorations of reverse effects. AB - Previous interventions designed to reduce sex role stereotypes have been successful with women, but frequently have had no effects, or reverse effects, with men. These interventions have generally used presentations emphasizing women's roles. In the present study, three experiments were conducted using media presentations focusing on men. Two of these produced reverse effects in women. Despite the brevity of the interventions, the effects persisted three or four weeks later, and were intensified, suggesting a sleeper effect. These male focused presentations produced positive effects in the male subjects in all three experiments, though these did not reach statistical significance. The results strongly suggest that current sex differences in sex role attitudes are partially due to situational determinants (as well as developmental factors). Implications of reverse effects for counselors and educators are discussed. PMID- 1789177 TI - Attitudes toward family life education: a survey of Israeli Arab teachers. AB - This paper investigated Israeli Arab teachers' attitudes toward the inclusion of a family life education program in their schools, possible subject areas for instruction, and parent involvement. The results indicated a high degree of support for family life education; however, a narrow range of subject areas was considered appropriate for Arab classes. Parent involvement was considered essential. The findings are compared with attitudes reported in the North American literature on sex education. PMID- 1789178 TI - Similarity between parents' and adolescents' levels of individuation. AB - Intergenerational theories of family functioning and therapy have sparked interest in empirical investigations that test intergenerational relationships. Of particular interest is whether one generation's level of functioning is similar to that of the next generation. This paper presents a test of difference scores that enables researchers to compare related and unrelated dyads, thus creating a comparison group when using only two generations. This procedure is contrasted with correlational findings in testing the hypothesis that adolescents will have a level of individuation similar to that of their parents. PMID- 1789179 TI - Loneliness and alcoholism risk in late adolescence: a comparative study of adults and adolescents. AB - The Short Michigan Alcoholism Screening Test (SMAST) was administered via phone survey to a random sample of subjects 18 years of age and older in a large metropolitan county. Among late adolescents (aged 18 to 20), lonely females had the highest mean score on the SMAST, indicating a higher degree of alcoholism risk than lonely males and nonlonely males and females. Among lonely females, late adolescents scored higher on the SMAST than any other age group. For males, loneliness did not appear to increase alcoholism risk in the late adolescent age group, but did appear to do so during the early and middle adulthood years. The implications of these findings for mental health professionals and adolescent substance abuse treatment personnel are discussed. PMID- 1789180 TI - Interaction dynamics of cooperative learning groups in Trinidad's secondary schools. AB - This study investigated adolescent students' changes in choice of workmates before and after cooperative learning in order to identify relationships between these changes and existing friendship and clique patterns, socioeconomic status, race, and achievement perceptions. Also investigated were students' perceptions of specific preferred or nonpreferred others. From these, four cases were identified and are described. The pattern that emerged was that while actual choices changed, the principle upon which these choices were made remained the same. Therefore males continued to select others using achievement as their criterion, while females used socioeconomic status. Choices based on same race decreased, and the number of friendship groups increased. Additionally, in spite of a general lessening of negative attitudes toward others, specific students remained very popular or very unpopular for reasons that seemed context based. In all cases, however, the unpopular students did not perceive themselves as of equal status to others in the group, a situation that may well affect the interaction dynamics of the group. PMID- 1789181 TI - Hispanic adolescent pregnancy testers: a comparative analysis of negative testers, childbearers and aborters. AB - Fifty-six Hispanic adolescents who requested a pregnancy determination at a municipal outpatient adolescent clinic participated in a comparative study of negative testers, childbearers, and aborters. The study's purposes were to assess differences between negative and positive pregnancy testers and to evaluate the pregnancy resolution decision-making process of positive testers. Data were collected using a two-part structured interview administered prior to and following knowledge of pregnancy test results. Results indicated that negative and positive pregnancy testers were similar in all areas evaluated. However, positive testers were slightly older and had higher self-esteem than negative testers. Of the 36 positive testers, 29 chose to deliver and keep the baby. None of the adolescents chose adoption. Adolescents were consistent in their pregnancy resolution decision before and after knowledge of pregnancy test results. The pregnant adolescents considered themselves to be the most influential person in the decision-making process. There were no significant differences between the childbearers and the aborters, although the former demonstrated higher self esteem and greater religiosity. Most of the teenagers were at risk for unintended pregnancy; therefore, subsequent family planning counseling efforts should be directed at this population. PMID- 1789182 TI - Identity status of black adolescents: an empirical investigation. AB - The purpose of this study was to assess the identity status of a group of 237 black adolescents. The major finding--that the majority of these adolescents were engaged in the identity-searching process rather than experiencing identity foreclosure--differed from previous research on the black adolescent identity process. PMID- 1789183 TI - Areas of concern and sources of advice for Israeli adolescents. AB - This study explored the concerns of Israeli adolescents, who grow up in a socially, politically, and economically highly stressed environment. Ninth- and eleventh-grade students (N = 1,645) completed a questionnaire in which they indicated three important problems they had recently experienced. Content analysis identified six major categories of concerns (listed in descending order of occurrence): studies and career, social "I," personal "I," existential issues, army or national service, and health and drugs. Younger adolescents were found to be more concerned with problems involving studies and career and with issues pertaining to the social "I"; older adolescents were more concerned with existential issues and army or national service. Boys were more concerned with existential issues, army or national service, studies and career, and the social "I." Girls were more concerned with issues pertaining to the personal "I." Three major sources of advice were identified: friends, parents, and brothers/sisters. PMID- 1789184 TI - The effects of family structure on the sexual behavior of adolescents. AB - The effects of two family structures, single- and two-parent homes, on adolescent sexual behavior were studied. The variables of race, age, and gender were controlled. The analysis compared the age at first intercourse, frequency of intercourse in the last four weeks, and virgin/nonvirgin status of adolescents from black single-parent families, white single-parent families, black two-parent families, and white two-parent families. For males, the two-parent family was related to less sexual activity and older age at first intercourse. For females, the two-parent family was not as important as race in influencing sexual behavior. The white females from two-parent families were more likely to be virgins, but once having had sexual intercourse, tended to have a higher level of sexual activity than did black females from two-parent homes. PMID- 1789185 TI - Biochemical approach to new medications. PMID- 1789186 TI - Isolated liver perfusion versus hepatic artery infusion with 5-fluorouracil in a rat model; effects on thymidylate synthase. PMID- 1789187 TI - Changes of purine nucleotide metabolism of Ehrlich ascites cells during transition of tumour growth. PMID- 1789188 TI - Purine nucleotides, nucleosides and nucleobases of liver, skeletal muscle, blood and tumor cells during the growth of Ehrlich ascites tumor in mice. PMID- 1789189 TI - Uridine fluxes in healthy proliferating T-lymphocytes, MOLT-3 T-ALL cell-line cells and differentiated MOLT-3 cells. AB - Incorporation of 14C-uridine into UTP and CTP and fluxes of label through these nucleotide pools to RNA and DNA were greater in MOLT-3 cells compared to T lymphocytes. In growth-arrested, differentiated MOLT-3 cells overall incorporation of radiolabel into nucleotides and nucleic acids was lowered compared to exponentially growing cells. Turnover of UTP and CTP however, retained the profile of exponentially growing MOLT-3 cells, implicating the characteristically higher conversion of UTP to CTP is independent of the MOLT-3 cells proliferative capacities. We conclude that drugs interfering with CTP synthetase activity are good candidates to be used as selective substances in the battle against T-ALL. PMID- 1789190 TI - Metabolism and action of 2',2'-difluorodeoxycytidine: self-potentiation of cytotoxicity. PMID- 1789191 TI - Effect of leucovorin on 5-fluorouracil induced inhibition of thymidylate synthase in patients with colon cancer. PMID- 1789192 TI - A novel xanthine dehydrogenase inhibitor (BOF-4272). PMID- 1789193 TI - Changes caused by ethanol intake on metabolism of hypouricemic agents (combination of allopurinol and benzbromarone). PMID- 1789194 TI - Allopurinol in breast milk. PMID- 1789195 TI - Pharmacokinetics of benzbromarone: evidence for a biliary-intestinal-biliary recirculation. PMID- 1789196 TI - Analysis of uric acid transport in renal tubules using benzbromarone and pyrazinamide. PMID- 1789197 TI - Deficient benzbromarone elimination from plasma: evidence for a new genetically determined polymorphism with an autosomal recessive inheritance. PMID- 1789198 TI - Nucleotide status in erythrocytes of rats infected with Plasmodium berghei. PMID- 1789199 TI - Hypoxanthine depletion induced by xanthine oxidase inhibits malaria parasite growth in vitro. PMID- 1789200 TI - New nucleoside transport pathways induced in the host erythrocyte membrane of malaria and Babesia infected cells. PMID- 1789201 TI - Effect of polyethylene glycol-modified adenosine deaminase (PEG-ADA) therapy in two ADA-deficient children: measurement of erythrocyte deoxyadenosine triphosphate as a useful tool. PMID- 1789202 TI - Urate transport in the proximal tubule of human kidney. PMID- 1789203 TI - The genetics of renal excretion of urate in man. PMID- 1789204 TI - What is the pathogenesis of familial gouty nephropathy? PMID- 1789205 TI - ICI D1694, an inhibitor of thymidylate synthase for clinical study. AB - The TS inhibitor, ICI D1694, is a highly potent inhibitor of tumour growth in vitro and in vivo. Uptake via the RFC and rapid metabolism to polyglutamate forms appear to be responsible for potency. Antiproliferative toxicity in mice was evident although the dose-limiting renal toxicity experienced with CB3717 was not apparent. PMID- 1789206 TI - Renal urate hypoexcretion preceding renal disease in a new kindred with familial juvenile gouty nephropathy (FJGN). PMID- 1789207 TI - Familial nephropathy and gout: which comes first? PMID- 1789208 TI - Does allopurinol affect the progression of familial juvenile gouty nephropathy? PMID- 1789209 TI - Congenital chloride losing enteropathy associated with tophaceous gouty arthritis. PMID- 1789210 TI - The role of lead in gout nephropathy reviewed: pathogenic or associated factor? PMID- 1789211 TI - Lipoprotein metabolism in primary gout--influence of alcohol intake and body weight. PMID- 1789212 TI - Serum urate and uric acid excretion. PMID- 1789213 TI - Gout and main rheumatic diseases in man. PMID- 1789214 TI - Importance of the confounding factors age and sex in the correlation of serum uric acid, cholesterol and triglyceride levels. PMID- 1789215 TI - Changes in urate metabolism after castration of patients suffering from carcinoma of the prostate. AB - 13 patients with carcinoma of the prostate were investigated on a low purine diet before and after surgical castration, performed to slow progression of their disease. A control group of herniorrhaphy patients was similarly studied. The 2 groups were very similar pre-operatively except for urea which was higher pre operatively in patients than controls (p0.004). Testosterone levels fell significantly in patients soon after surgery (W0.002). There was a significant fall in serum uric acid in the early post-operative phase in both patients (W0.004) and controls (W0.01) but the fall only remained significant one month after surgery in castrated patients (W0.007). Urinary uric acid levels in patients fell significantly soon after surgery (W0.04). This is a small study but results suggest that endogenous male hormones are at least partially responsible for serum uric acid levels since castration, with reduction in circulating testosterone, resulted in a fall in these levels. PMID- 1789216 TI - Renal hypouricemia associated with hyperoxypurinemia due to decreased renal excretion of oxypurines: a new defect in renal purine transport. PMID- 1789217 TI - Significance of hypouricemia. PMID- 1789218 TI - Organic distribution and interrelationships of lesions occurring in laying hens suffering from gout and urolithiasis. AB - Gout as a multifactorial syndrome can cause the death of chicken. In this study, the lesions formed were studied macro-, and microscopically in 134 gouty chicken. The gross and microscopic changes were found in all kidneys and renal capsules, though the other internal organs were also involved in many cases. Their serosal surfaces were more severely affected than the parenchymal parts. These organs were liver, lungs, heart, spleen and synovial sacs. Uroliths were found in all cases and were formed in ureters. This finding indicated that the gouty lesions were the results of urolithiasis. Physical characteristics and the chemical composition of the stones were studied, and the results confirmed that they were made up by urates of calcium, ammonium cations. PMID- 1789219 TI - Action and sequence dependent interaction of acivicin and 6-thioguanine in human derived malignant T-ALL and CALLA+ cell lines. PMID- 1789220 TI - A biochemical investigation on chicken gout observed in the Marmara region in Turkey. AB - Poultry breeding has economical importance for the people living in Bursa and surrounding villages. Similar to some sporadic disease, gout can also be reason for production loses and death in laying and broiler chickens. Gout cases have been observed in some pens of a big poultry company. In this study 20 healthy control and 40 sick Studler Iso-Brown chickens were used as research materials. Blood were taken from heart by syringe to plastic tubes with EDTA. Plasma were collected and analyzed for total protein, uric acid, bicarbonate, vitamin A, calcium and orotic acid. The blood levels of healthy and sick groups were; total protein % 4.60-5.98 gr, uric acid % 10.19-38.09 mg, bicarbonate 27.37-35.73 mEq/l, vitamin A % 42.20-35.55 mcg, calcium % 8.38-8.25 mg and orotic acid % 1.42 1.97 mg, respectively. Statistical analysis was done by t test. There were statistical importance for total protein, bicarbonate (p less than 0.01) and for uric acid (p less than 0.001) differences. Feeding program analysis was done and a feeding disturbance was determined. Chicken in gout observed pens have fed with chicken developing feed for two weeks earlier. For this case diet was the reason of gout. PMID- 1789221 TI - Production of uric acid and allantoin in perfused rat liver. PMID- 1789222 TI - Dynamics in the purine nucleotides of liver during various periods of hypoxia/ischaemia and reoxygenation. PMID- 1789223 TI - Adenosine: origin and clinical roles. PMID- 1789224 TI - Oxypurines in extracellular fluids from piglets during hypoxemia and reoxygenation. PMID- 1789225 TI - Regulation of adenosine concentrations by acadesine (AICA-riboside) in human B lymphoblasts. PMID- 1789226 TI - Preservation of adenine nucleotides following ischemia and reperfusion: correlation with functional recovery. PMID- 1789227 TI - An alternative pathway of adenylate and ATP synthesis. PMID- 1789228 TI - Preservation of nucleotide pool during heart transplantation and evaluation of adenylate catabolic pathways in the human heart. PMID- 1789229 TI - The influence of acetate on adenine nucleotides in rat liver. PMID- 1789230 TI - Purine nucleotide catabolism in rat liver after castration. PMID- 1789231 TI - Adenine nucleotide metabolism in liver ischemia: effect of allopurinol. PMID- 1789232 TI - Effects of pulsed electromagnetic fields on the adenine nucleotide pool and energy charge in cells in culture. PMID- 1789233 TI - Mechanisms accounting for changes of adenine nucleotide content in mitochondria at ischemia. PMID- 1789234 TI - Phosphorylation of adenosine by an exchange reaction between AMP and adenosine in anoxic hepatocytes. PMID- 1789235 TI - Hypoxanthine and inosine metabolism in cultured rat cardiomyocytes. PMID- 1789236 TI - The mechanism of conversion of xanthine dehydrogenase to oxidase and the role of the enzyme in reperfusion injury. PMID- 1789237 TI - Purification of xanthine oxidase from human milk. PMID- 1789238 TI - Mechanisms of protection of hepatocytes at anoxia and reoxygenation by the xanthine oxidase inhibitor oxypurinol. PMID- 1789239 TI - Oxypurinol reduces ischemic brain injury in the gerbil and rat. PMID- 1789240 TI - Acadesine (AICA riboside) attenuates reperfusion injury and oxidant-induced damage of the heart. PMID- 1789241 TI - Effects of H2O2 and CHPO on ATP-, CP-content and 14C-HX-uptake by HUVECS. PMID- 1789242 TI - Absence of xanthine oxidoreductase activity in human myocardium. PMID- 1789243 TI - Lower xanthine oxidoreductase activity in isolated perfused hearts if xanthine replaces hypoxanthine as substrate. PMID- 1789244 TI - Evidence from in vitro studies that dihydroorotate dehydrogenase may be a source of toxic oxygen species. PMID- 1789245 TI - Influence of oxypurinol on colitis induced in rat colon by trinitrobenzene sulfonic acid treatment. PMID- 1789246 TI - A xanthinuric family--the proposita having immunologically reactive xanthine oxidase but no xanthine oxidase activity. AB - The antibody was raised against purified human liver xanthine oxidase in a rabbit. In a xanthinuric patient, the double immunodiffusion method demonstrated the existence of an immunologically reactive duodenal mucosa xanthine oxidase which did not possess xanthine oxidase activity. These results indicated that xanthine oxidase protein is abnormal in structure and/or amino acid sequence. PMID- 1789247 TI - Human hepatic peroxisomes with crystalloid cores associated with urate oxidase activity. PMID- 1789248 TI - Structural analysis of the rat uricase gene and evidence that lysine 164 is involved in the substrate-binding site of the enzyme. PMID- 1789249 TI - Study of DNA repair in the peripheral blood lymphocytes of patients with rheumatic diseases under going treatment. PMID- 1789250 TI - Initial rate measurements of cellular nucleoside transport: time course, initial curvature of time curves and metabolism. PMID- 1789251 TI - Relationships between metabolic enzymes and the nucleoside transport. PMID- 1789252 TI - Active transport of adenosine into primary cultures of brain cells and its methodological consequences. PMID- 1789253 TI - Intestinal transport and metabolism of purine and pyrimidine nucleosides. PMID- 1789254 TI - Guanine uptake by human erythrocytes. PMID- 1789255 TI - Biochemical and pharmacological properties of CI-972, a novel 9-deazaguanine analog purine nucleoside phosphorylase (PNP) inhibitor. AB - CI-972 (2,6-diamino-3,5-dihydro-7-(3-thienylmethyl)-4H-pyrrolo[3, 2-d]pyrimidin-4 one monohydrochloride, monohydrate) is a novel inhibitor of PNP (Ki = 0.83 microM) under development as a T cell-selective immunosuppressive agent. CI-972 inhibited proliferation (3H-thymidine uptake) of human MOLT-4 (T cell) but not MGL-8 (B cell) lymphoblasts with respective IC50s of 3.0 and greater than 50 microM when tested with 10 microM 2'-deoxyguanosine. Without addition of exogenous 2'-deoxyguanosine, CI-972 was not inhibitory to any human T or B lymphoblastoid cell line tested. 2'-Deoxycytidine (10 microM), but not hypoxanthine or adenine, restored MOLT-4 cell growth. Inhibition of 3H-thymidine uptake in MOLT-4 cells correlated with accumulation of dGTP, while alterations in guanine nucleotides were not observed. 2'-Deoxycytidine (10 microM) also blocked dGTP accumulation in MOLT-4 cells. CI-972 showed activity in vivo over a broad dose range: At 5-150 mg/kg p.o., CI-972 produced dose-dependent elevation of plasma inosine one hr after administration to rats (mean maximum of 2.62 vs. 0.06 microM in controls). Guanosine was also significantly elevated in a concentration dependent manner, although the effect was not as impressive. Plasma nucleosides remained statistically-significantly elevated for up to four hr following a single oral dose of CI-972. PMID- 1789256 TI - Radioligand binding studies on the nucleoside transport protein. PMID- 1789257 TI - Nucleoside transport in guinea-pig myocardium. PMID- 1789258 TI - Comparison of the existing nucleoside transport inhibitors: in vitro and in vivo data. PMID- 1789259 TI - Effect of membrane lipid composition on the functional activity of a reconstituted nucleoside transporter derived from Ehrlich ascites cells. PMID- 1789260 TI - Antibodies and proteases as probes of the structures of mammalian nucleoside transporters. PMID- 1789261 TI - Control of nucleoside transport in neural cells. Effect of protein kinase C activation. PMID- 1789262 TI - Isolation of nucleoside permeases from Escherichia coli. PMID- 1789263 TI - Murine erythroleukemia cells resistant to periodate-oxidized adenosine have lowered levels of nucleoside transporter. AB - The results above show that mammalian cells, as exemplified by MELC, can be selected to be resistant to Adox, and that the resistant cells have greatly decreased nucleoside transport capacity. Since no mutagen was used prior to the selection process and Adox resistance was genetically stable, it appears that within a population of normal cells there is a genetically controlled range of expression of the nucleoside transporter. On the basis of the present data we cannot determine if the low level of nucleoside transporter in AR MELC is due to an altered form of the protein or a decreased amount of the normal protein. However the similarity of the Kd for NBTI in normal and AR MELC suggests that the latter is the case. Considerable indirect evidence is presented that Adox, with its ribose converted to an acyclic dialdehyde, is a substrate for the nucleoside transporter, adding a new type of compound to this list. PMID- 1789264 TI - Effect of ischaemia on cardiac adenosine binding sites. PMID- 1789265 TI - Pyrrolo[3,2-d]pyrimidines, a new class of purine nucleoside phosphorylase (PNP) inhibitors as potential T-cell selective immunosuppressive agents. AB - Previously, we have described the synthesis and biological activity of 2,8 diamino-1,9-dihydro-9-(2-thienylmethyl)-6H-purin-6-one (PD 119229; Cl-950) as a potent and competitive PNP inhibitor. As a part of our continuing efforts to develop a PNP inhibitor for autoimmune diseases, we have synthesized a series of pyrrolo[3,2-d]pyrimidines as PNP inhibitors. In this series, 2,6-diamino-3,5 dihydro-7-(3- thienylmethyl)-4H-pyrrolo-[3,2-d]pyrimidin-4-one (Cl-972) was found to be a potent, competitive inhibitor of PNP with Ki of 0.83 microM. It was also found to be selectively cytotoxic to human MOLT-4 (T cell) (IC50 = 3.0 microM) but non-toxic to MGL-8 (B cell) lymphoblasts. Cl-972 is under development as a potential T-cell selective immunosuppressive agent. Synthesis and biological activities of the series are discussed. PMID- 1789266 TI - A ferritin-cyclohexyladenosine probe for electron microscope localization of A1 adenosine receptor. PMID- 1789267 TI - Effect of adenosine on the membrane potential changes of human neutrophils triggered by the tripeptide F-Met-Leu-Phe. PMID- 1789268 TI - A2 adenosine receptors in neutrophils from healthy volunteers and patients with rheumatic disease. PMID- 1789269 TI - Acadesine (AICA riboside) inhibits platelet aggregation in human whole blood. PMID- 1789270 TI - Concentration and time dependent growth inhibition and metabolism in vitro by 2',2'-difluoro-deoxycytidine (gemcitabine). PMID- 1789271 TI - Thiopurine methyltransferase activity and efficacy of azathioprine immunosuppression in transplant recipients. PMID- 1789272 TI - Increase in 2',5'-oligoadenylate synthetase caused by deoxycoformycin in hairy cell leukaemia. PMID- 1789273 TI - Antimetabolites in cancer chemotherapy. PMID- 1789274 TI - Purine nucleotide biosynthesis in leukemic promyelocytes treated with retinoids. PMID- 1789275 TI - Synergistic interaction of methotrexate and 6-mercaptopurine in human derived malignant T-ALL and CALLA+ cell lines. PMID- 1789276 TI - 6-Thioguanine metabolism in human erythrocytes. PMID- 1789277 TI - The impact of selected nucleosides on the cytotoxicity of Ara-C in HL60 cells. PMID- 1789278 TI - Association of the Robin sequence with the fragile X syndrome. AB - We report on 4 individuals with the fragile X [fra(X)] syndrome and the Robin sequence (or elements of that sequence). To our knowledge, this association has been described in only one other boy. However, males with the fra(X) syndrome have been reported to have an increased incidence of cleft palate. We recommend that children with a cleft palate or the Robin sequence be assessed for developmental delays and a family history of mental retardation. The fra(X) syndrome may be one of the genetic causes of the Robin sequence and, when indicated, children with the sequence should be tested for fra(X). PMID- 1789279 TI - Chromosome rearrangements among couples with pregnancy losses and other adverse reproductive outcomes. AB - During the years 1975-1987, 1,364 cytogenetic studies were performed in 682 couples with history of adverse pregnancy outcome. Thirty-six balanced translocations were detected, 24 (3.5%) in women and 12 (1.7%) in men. Before 1982, all 234 couples studied had 2 or more spontaneous abortions with unknown pedigrees, with an incidence of 6.8% of balanced translocations. During 1982 1987, complete pedigree analysis was performed on a subset of 448 couples, who were then classified into 3 groups. Group I; 321 couples with 2 or more spontaneous abortions, but no other adverse outcome; group II; 37 couples with at least one or more spontaneous abortions plus a malformed child or stillbirth; and group III; 90 couples with one or more spontaneous abortions plus a sib having at least a malformed child or repetitive spontaneous abortions. The incidence of balanced translocations in these 3 groups was 2.8%, 5.4%, and 10.0%, respectively. When group III was compared with group I, the frequency of translocations was significantly different (P less than 0.02). Robertsonian translocations were predominantly detected in women, raising the possibility that prezygotic failure producing primary sterility may occur in men with such translocations. PMID- 1789280 TI - Duplication (6q) syndrome diagnosed in utero. AB - We report on a case of partial duplication 6q detected ultrasonographically. The clinical picture noted in utero is consistent with the adult phenotype previously reported in the literature. PMID- 1789281 TI - Molecular and cytologic studies of Ehlers-Danlos syndrome type VIII. AB - We present a family with findings of Ehlers-Danlos syndrome type VIII and a presenile appearance due to decreased subcutaneous tissue with drawn skin, defective wound healing, contractures, and thin hair. To investigate this syndrome, we studied collagen production and the growth properties of cultured fibroblasts taken from affected relatives. We could not find evidence of a collagen defect or premature senescence of cultured fibroblasts, although the fibroblasts may have a decreased growth rate. We conclude that this family has findings of EDS VIII and premature aging and propose that this overlapping phenotype is due to a single pathogenetic mechanism. Our studies of collagen production and fibroblast replication did not discern this mechanism. PMID- 1789282 TI - Attitudes toward presymptomatic testing and prenatal diagnosis for adrenoleukodystrophy among affected families. AB - One hundred and thirty-six individuals with a family history of X-linked adrenoleukodystrophy (ALD) or adrenomyeloneuropathy (AMN) were given a questionnaire surveying their sociodemographic characteristics, knowledge of X linked inheritance, and attitudes toward prenatal, presymptomatic, and carrier testing. Of the respondents, 68% indicated that they would use prenatal testing. Of these, 57.1% would terminate a pregnancy of a male fetus hemizygous for the ALD gene and 13.5% would reportedly choose to terminate a heterozygote female fetus. Presymptomatic testing would be used by 88.7% of respondents to test at risk sons and carrier testing would reportedly be used by 95.4% of respondents to test their at-risk daughters. Respondents correctly answered an average of 61% of the questions testing understanding of X-linked inheritance. This indicates a strong interest in prenatal, presymptomatic, and carrier testing and a need for genetic counselors to provide information about these available tests and X linked inheritance. PMID- 1789283 TI - Mitochondrial DNA deletion in a girl with manifestations of Kearns-Sayre and Lowe syndromes: an example of phenotypic mimicry? AB - Lowe oculocerebrorenal syndrome is an X-linked recessive disease whose locus has been assigned to Xp25. However, several reports of affected females without obvious chromosomal abnormalities suggest genetic heterogeneity of the Lowe phenotype. Although the biochemical defect in typical Lowe syndrome is not known, there is evidence suggesting that mitochondrial metabolism may be impaired. We have studied a girl who presented with an oculocerebrorenal syndrome, but later developed symptoms and signs of mitochondrial encephalomyopathy. Molecular genetic analysis of muscle mitochondrial DNA showed the presence of a population of partially deleted mtDNAs (heteroplasmy). The deletion was 7803 bp long and encompassed several genes encoding subunits of the respiratory chain enzymes. Our results suggest that mitochondrial DNA deletions may mimic several symptoms of the Lowe phenotype and reinforce the concept that a defect of mitochondrial metabolism could be involved in the pathogenesis of the X-linked disease. PMID- 1789284 TI - Estimated number of loci for autosomal recessive severe nerve deafness within the Israeli Jewish population, with implications for genetic counseling. AB - Deafness occurs in about 1 per thousand live births, and at least 50% of congenital deafness is hereditary. The aim of this study was to examine the number of loci for recessively inherited severe nerve deafness of early onset within the Israeli population and to compare the results to those obtained in other populations. The Jewish population in Israel originates from many countries and may be divided into Sephardi, Eastern and Ashkenazi Jews, and the matings will be intraethnic or interethnic. Data were obtained on 133 deaf couples who lived in the Tel Aviv area, through the files of the Helen Keller Center. Causes of deafness in the spouses were studied and data on their children were obtained. Among 111 couples who had recessive or possibly recessive deafness and had at least 1 child, there were 12 with only deaf children and 5 with both deaf and hearing children. The number of loci for recessive deafness in the whole group was estimated at 8-9. Intraethnic and interethnic matings gave an estimate of 6.7 and 22.0 loci, respectively, which indicates that within populations fewer loci exist with recessive mutations for deafness than between populations. It could be shown that the sharing of loci between spouses decreased with increasing geographical distance of their origin. The results provide data for genetic counseling in Israel for deaf couples who have no children or have one hearing or one deaf child. PMID- 1789285 TI - Mucolipidosis type IV: clinical manifestations and natural history. AB - The clinical manifestations and psychomotor development of five patients with mucolipidosis IV (MLIV) from three Ashkenazi-Jewish families are reported. The presenting symptoms were hypotonia, developmental delay, corneal clouding, and puffy eyelids. Four of the patients had convergent strabismus and none progressed beyond a developmental age of 15 months. One patient died of aspiration at 17 years while the oldest patient entered puberty at 20 years, developed a coarse face at 30 years, and is now 32 years old. Histopathological studies in four patients showed storage changes characteristic of MLIV. PMID- 1789286 TI - Prenatal ascertainment of an inherited dup(18p) associated with an apparently normal phenotype. AB - Direct two-generation transmission of an unbalanced 18p+ chromosome was discovered after amniocentesis. Neither the mother nor the child exhibited apparent physical malformations or mental impairment. Banding analysis suggested a complete 18p duplication. Molecular studies verified the 18p origin of the duplicated material. Only 14 previous cases of duplication 18p have been reported and these exhibited either a normal phenotype or mild and inconsistent abnormalities. The present cases, as well as the review of literature, indicate that duplication 18p is associated with few or inapparent phenotypic abnormalities. PMID- 1789287 TI - Familial congenital brachial palsy. AB - Eight relatives in a Sicilian family, including a sibship of 5, were affected with severe unilateral congenital brachial palsy (CBP) in a pattern suggesting autosomal dominant inheritance with reduced penetrance (6 cases affected on the right, 2 on the left). X-linked inheritance with expression in heterozygous females cannot be excluded. PMID- 1789288 TI - Early childhood diagnosis of acoustic neuromas in presymptomatic individuals at risk for neurofibromatosis 2. AB - We report on a family in which individuals at risk for NF 2 were investigated with the use of gadolinium-enhanced MRI. This technique has allowed the diagnosis of small (less than 8 mm) acoustic neuromas in two asymptomatic children (age 7 and 11), one of whom had normal audiometric and brainstem-evoked response testing. To our knowledge these are the youngest asymptomatic patients in whom the diagnosis of NF 2 has been demonstrated. It is possible that acoustic neuromas develop at an early age more commonly than recognized previously. The early diagnosis of acoustic neuromas with the use of gadolinium-enhanced MRI may lead to better outcome following surgery. This technique will provide the opportunity to better determine the natural course of this disease. PMID- 1789289 TI - Sporadic, idiopathic MCA syndrome with mandibulofacial dysostosis and tibial hemimelia. AB - We report on a Brazilian woman with mandibulofacial dysostosis, cleft lip/palate, vertebral anomalies, abnormally modeled femora, and bilateral tibial agenesis. The clinical aspects involving this patient strongly suggest an unreported condition. Clinical and genetic aspects are discussed. PMID- 1789290 TI - Neural tube and neural crest: a new view with time-lapse high-definition photomicroscopy. AB - The dynamic process of neural tube formation and neural crest migration in live, unstained cultured avian embryos at Hamburger-Hamilton (H.H.) stages 8-11 was investigated by time-lapse cinematography using a high-definition microscope. These studies have demonstrated that neural tube closure in the trunk region differs from that observed in the head. The cephalic neural folds elevate slowly, then make contact rapidly. Following this initial apposition, they gradually "zip up" in the rostrad and caudad direction. In the trunk region where the neuroepithelium bulges adjacent to the somites, the edges of the folds pulsate and forcefully touch-retract-touch in these bulging regions; the intersomitic epithelia retract, remain open even after more posterior somitic regions have apposed, and then close slowly. Epithelial blebs and N-CAM antibody were observed at the leading edges of the neuroepithelia. Between the open folds only a few bridging cells were seen; they probably represent the sites of initial cell adhesion following epithelial retraction. Focusing into the developing embryo shows that neuroepithelial fusion occurs prior to surface epithelial fusion. A meshwork of synchronously pulsating neural crest cells was identified below the surface epithelium and a preliminary investigation of their initial migration was conducted. PMID- 1789291 TI - Delineation of the Costello syndrome. AB - We present a 15-year-old girl with mental retardation, short stature, coarse face, unusually thick, loose skin of the hands and feet, deep plantar and palmar creases, and nasal papillomata. Her history and physical findings are compared to those of 2 children initially reported by Costello and to 1 child recently reported by Der Kaloustian et al. PMID- 1789292 TI - Pelizaeus-Merzbacher disease: clinical and DNA-linkage study of an extended family. AB - We describe a 5-generation family of 6 individuals with Pelizaeus-Merzbacher disease, Type I. DNA linkage study was done to establish carrier status. Two loci, DXS162 and DXYS1, were informative in this family for carrier determination. The highest lod score is that for PMD-DXYS1 (Z = 1.421 at theta = 0). The carrier probability can only be defined as likely or unlikely in the absence of an established recombination frequency. PMID- 1789293 TI - Angular homeostasis. VIII. Pursuit of a slowly moving target in a plane: relevance to lateralization in cardiovascular ontogeny. AB - We explore the pursuit in a plane of a target moving at constant slow speed in a straight line. Two models of the pursuit are given. In the continuous case, the pursuer is moving at constant speed and is subject to proportionate angular homeostasis with correction constant b. In the discrete version movement occurs at a constant speed in a sequence of straight line segments of constant length (called the step size, s) the end of the segments being called the vertices. The pattern considered is not the absolute position of the pursuer, but its distance and orientation relative to the target. Both the transients and the asymptotic orbit are addressed. A key quantity is r, the speed of the target expressed as a fraction of that of the pursuer. If the speed of the pursuer is defined as unity, r is also the ratio of the speeds. There exists a critical speed fraction, R(b,s), a function of b and s, that defines what the term slow designates. R(b,s), which has to be found numerically, has the following property. For r less than R(b,s), the asymptotic path is a simple closed curve. In the discrete case the vertices converge to a simple closed curve. The larger r, the more the path (or in the discrete analogue its set of vertices) departs from a circle, and the more eccentric the target is with respect to it. Interest centers on two issues. First we address the transient patterns of the path, notably whether or not the sense of any particular path (clockwise or counterclockwise) is the same throughout, or changes at some stage.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789294 TI - Cartilage hair hypoplasia, metaphyseal chondrodysplasia type McKusick: description of seven patients and review of the literature. AB - We describe 7 cases of cartilage hair hypoplasia (CHH) with emphasis on the clinical and immunological aspects. The literature on CHH is reviewed and symptoms in 63 non-Amish cases are summarized. In this autosomal recessive disorder the immunodeficiency, hair abnormalities, and severity of skeletal involvement show extremely variable expressivity, between and within families. Two of the 3 sib-pairs among our cases demonstrate the great difference in expression within one family. At adult age roentgenological abnormalities can be very mild, or even absent. An impairment in cell-mediated immunity is present in all of our cases and seems a consistent manifestation in CHH; however, sometimes it is very subtle and without clinical symptoms. PMID- 1789295 TI - Pallister-Killian syndrome: characterization of the isochromosome 12p by fluorescent in situ hybridization. AB - The isochromosome 12p (i(12p)) in fibroblasts of 3 patients with Pallister Killian syndrome and one decreased prematurely born neonate, was characterized by fluorescent in situ hybridization (FISH) using chromosome 12-specific DNA probes. FISH is a useful technique for rapid and reliable detection and characterization of the i(12p) chromosome in Pallister-Killian patients. Detection was possible also in interphase cells. In addition, the in vitro selection against i(12p) cells at different passages in fibroblast cultures of two patients was monitored. PMID- 1789296 TI - High prenatal lead levels and congenital anomalies. PMID- 1789297 TI - Opposite imbalances of medial 2q in familial insertions. PMID- 1789298 TI - The look north to the Canadian Health Care System: possible implications for otology and neurotology. PMID- 1789299 TI - Class A results in Meniere's disease. AB - A series of 101 patients with Meniere's disease treated surgically with an intramastoid endolymphatic shunt operation and with a minimum follow-up of 2 years is reported. The results included success in 76 percent and failure in 22 percent. Thirteen of these patients maintained a hearing level of 15 dB or better, while 11 patients experienced hearing gains of 25 dB or better. These results are compared to other reports, and the difficulty of making such comparisons is illustrated. A derived "efficacy ratio" is defined, and its use is suggested to aid in making statistical inference. The conclusion is reached that more knowledge is required about the natural history of Meniere's disease so that appropriate staging may be carried out on these study populations. PMID- 1789300 TI - Magnetic resonance angiography: technique and skull-base applications. AB - Cerebral angiography has become essential in the evaluation and management of extensive skull-base lesions. However, with a 2.6 percent incidence of neurologic complications and a 0.3 percent incidence of permanent neurologic deficits associated with cerebral angiography, the procedure is not without risk. Recent advances in magnetic resonance angiography (MRA), allow one to visualize the skull-base vasculature without need of intravenous contrast injection or radiation exposure. Our initial experience in visualizing the normal vascular anatomy and pathology at the base of skull with this new imaging modality is presented. Two different MRA techniques were used: (1) thin-slice two-dimensional gradient echo pulse sequence acquisition with three-dimensional projection reconstruction, and (2) two-dimensional phase contrast angiography. The specifics of these techniques and their usefulness in the evaluation of lesions involving the skull base are discussed and demonstrated. PMID- 1789301 TI - Bilateral Meniere's disease in surgical versus nonsurgical patients. AB - In patients with Meniere's disease, the possibility of developing Meniere's disease in the uninvolved ear is of great concern. In this study, the incidence of bilateral Meniere's disease (BMD) in medically treated patients was found to be 17 percent, while in surgically treated patients it was significantly lower, 5.9 percent (p less than 0.01). The incidence of BMD for each surgical procedure was as follows: 9 percent after endolymphatic subarachnoid shunt (n = 101), 7 percent after cochleovestibular neurectomy (n = 100), 6 percent after cochleosacculotomy (n = 18), and 0 percent after vestibular nerve section (n = 73). The average duration of disease prior to surgery was 6.3 years. Seventy-two percent of the patients who developed BMD did so within 5 years of the onset of their symptoms. Proper patient selection is the most likely explanation for the low incidence of BMD among surgically treated patients. PMID- 1789302 TI - Relative value of diagnostic tests for small acoustic neuromas. AB - Auditory brainstem response is now widely employed as a screening test for acoustic neuromas because it is equally sensitive when standardized against computed tomography. We have detected eight small (less than 10 mm) acoustic neuromas using gadolinium enhanced magnetic resonance imaging. In three of these cases, the auditory brainstem response was falsely negative. In contrast, 19 patients with larger tumors (greater than or equal to 10 mm) were found to have no false negative auditory brainstem responses. Auditory brainstem response appears to be less sensitive for detecting small, symptomatic acoustic neuromas. PMID- 1789303 TI - Practical method of reporting test results in neurotologic disorders. AB - A more practical method of reporting the neurotologic test results became desirable in the course of preparing case reports. This need grew out of the necessity to organize neurotologic tests results in a simple, easily understandable, nonredundant manner. Tests organized in this manner were vestibular and auditory tests. Vestibular tests included electronystagmography, rotational testing, and posturography. Auditory tests included pure-tone testing, speech testing, impedance testing, and auditory brainstem responses. PMID- 1789304 TI - Prediction of auditory nerve survival in humans using the electrical auditory brainstem response. AB - This investigation studied the electrical auditory brainstem response (EABR) input-output functions in three groups of patients: individuals with normal auditory neural systems; patients with acquired, profound sensorineural hearing loss; and patients with congenital, profound sensorineural hearing loss. Each input-output function was obtained in the operating room under general anesthesia and with the patient paralyzed to eliminate myogenic contamination. In contrast to the acoustically elicited ABR, the EABR waveforms were characterized by a dominant early wave corresponding in latency to wave II. This wave was much larger and often appeared at lower stimulus intensities than wave V. The results, plotted according to rate of growth for waves II and V, showed that normal subjects generally had larger, more robust early waves than either hearing impaired group. Little difference was noted in the amplitudes or rates of growth for wave V among the three groups. Based on these observations, we concluded that the EABR demonstrated differences in the way normal and impaired systems respond to electrical stimulation. In addition, the EABR may be useful in providing a qualitative prediction of neural survival into broad categories of many surviving neurons versus a marked reduction in ganglion/neuronal density. PMID- 1789305 TI - Age-related changes in binaural processing: I. Evoked potential findings. AB - Possible age-related effects of speech competition in one ear on the late auditory (LAEP) and P300 event-related potentials recorded at the other ear were investigated with female volunteers. In each of the age categories of 20 to 34, 35 to 49, 50 to 64, and 65 to 80 years, 10 subjects were tested. While contralateral speech competition produced no significant amplitude or latency changes in the earlier auditory brainstem or middle latency responses, several age- and competition-related effects were observed with the later-occurring LAEP and P300 responses. With contralateral competition, the two oldest groups exhibited significantly larger reductions in the N1-P2 peak-to-peak amplitude of the LAEP than did the two youngest groups. While significant decreases in P300 amplitude also occurred with the competition, the magnitude of this effect was not age-related. In addition, small but statistically significant increases in the latency of all three major components, N1 and P2 of the LAEP, and P300, occurred in the presence of contralateral competition. These effects also did not differ among the four age groups. Thus, the LAEP appears to be sensitive to some form of age-related change in binaural processing or attention, although the P300, while sensitive to contralateral competition, did not reflect an age related component in this effect. PMID- 1789306 TI - Age-related changes in binaural processing: II. Behavioral findings. AB - In the preceding report in this journal, the authors presented evidence for an electrophysiologic correlate of impaired binaural processing or attention in elderly listeners. In the present experiment, the subjects tested in the earlier study were administered a Dichotic Digits Recognition task in which they were required, in separate sessions, to repeat all digits heard in both ears (channel capacity measure), or to report the digits in one ear while ignoring the digits in the opposite ear (selective attention measure). With both measures, older subjects performed significantly poorer than did younger subjects. Although similar age-related decrements in performance were observed with the behavioral and electrophysiologic tests, no significant correlations were found in the performances on the two types of tests. This suggests that, while both behavioral and electrophysiologic tests can reveal age-related decrements in binaural processing, they do not necessarily reflect the same underlying neural processes. PMID- 1789307 TI - Cavernous hemangioma of the internal acoustic canal. AB - A case report of a 39-year-old man suffering from left-sided, progressive hearing loss is presented. As well, the patient noted ipsilateral recurrent facial paralysis. MRI succeeded in confirming the presence of a tumor in the internal acoustic canal 18 months after the first MRI. PMID- 1789308 TI - Cerebellopontine angle lipomatous hamartoma of nerve: case report. AB - Cerebellopontine angle lipoma has been previously described in 21 patients and is frequently unresectable. An intracanalicular lipomatous hamartoma in a 60-year old male is presented. MRI enabled a correct preoperative diagnosis to be made. Complete surgical excision, without major neurologic deficit was achieved. A review of the literature reveals that the tumor is frequently infiltrative, especially when vascular elements are prominent. The histologic characteristics and the hamartomatous nature of the lesion are discussed. PMID- 1789309 TI - Ruptured petrous carotid aneurysm presenting with otorrhagia and epistaxis. AB - Aneurysm formation and rupture within the petrous internal carotid artery (ICA) is an extremely rare occurrence with approximately 10 such cases in the literature. Etiologies of petrous ICA aneurysms include atherosclerosis, closed head trauma, iatrogenic injury during mastoid surgery, chronic middle ear infections, and congenital causes. Therapeutic options include carotid artery ligation, aneurysm resection with or without reconstruction, and radiographically controlled vessel occlusion. The case of a patient who presented with otorrhagia, epistaxis, and transient focal neurologic signs due to a ruptured petrous ICA aneurysm is presented. The incidence, etiology, and anatomy of these aneurysms is reviewed, and the various tests for determining adequacy of collateral cerebral blood flow are described. Factors that affect the selection of surgical versus radiologic control of these lesions are also discussed. PMID- 1789310 TI - Cerebrospinal fluid leak from nontumor ear after acoustic neuroma surgery: diagnostic and therapeutic problems. AB - An unusual case of CSF leak from the nontumor ear after removal of a 3-cm acoustic neuroma is presented. Prior to tumor removal a ventricular-peritoneal shunt was established because of increased intracranial pressure. After the shunt was clamped the patient twice developed rhinoliquorrhea and underwent in both instances unsuccessful closure of the leak on the tumor side. Finally the leak was established in the nontumor ear, most likely due to sequelae after a hunting accident 20 years before, where a projectile created a defect in the tegmen tympani. The CSF leak was probably provoked by the pressure changes following tumor removal and shunt treatment. PMID- 1789311 TI - Partitioning of the labyrinth: application in benign paroxysmal positional vertigo. AB - Partitioning of the labyrinth is a new laser technique that creates a fibrous band within the inner ear. The application of this technique to benign paroxysmal positional vertigo (BPPV) is described in the first two patients to undergo this procedure. The partitioning technique involves blue-lining the posterior semicircular canal near its ampulla and lasing the blue-lined area. The technique provides a prompt decrease and the ultimate elimination of BPPV. There is some mild motion sensitivity of 6 to 8 weeks duration, and some transient (3-week) sensorineural hearing loss. The use of immediate postoperative low dose steroids provides marked decrease in the motion sensitivity and elimination of the transient sensorineural hearing loss. Lasing two adjacent areas on the posterior semicircular canal may prevent transient recurrence of the positional vertigo during the healing process. PMID- 1789312 TI - Cholesteatoma and imaging. PMID- 1789313 TI - Management of facial hyperkinesis from a brainstem lesion. PMID- 1789314 TI - A 5-month-old born with a complete facial paralysis. PMID- 1789315 TI - MRI not contraindicated following gold or spring implantation to the upper eyelid for facial reanimation. PMID- 1789316 TI - [Prevention of endometritis after cesarean section]. PMID- 1789317 TI - [Complex evaluation of the feto-placental system in gestosis of different degree of severity]. AB - Comprehensive studies of the fetoplacental system in pregnant women with gestoses of varying severity (n = 260) and in those with normal pregnancy (n = 200), carried out in pregnancy terms of 29 to 41 weeks, have revealed a lowering of the levels of trophoblastic beta-globulin and pregnancy-associated alpha 2 glycoprotein, elevated concentration of pregnancy-associated protein A, a higher incidence of placental types II and III (as evidenced by ultrasonic examination), reduced rate of growth of the fetal biometric parameters and a reduction of fetal systolic output, augmenting with the gestosis severity. A comprehensive assessment of the fetoplacental system permits obtain a more complete picture of the gestosis severity. PMID- 1789318 TI - [Catecholamine levels and their distribution in the uterus during pregnancy and labor]. AB - Catecholaminergic fiber distribution and noradrenaline levels were studied in various sections of the myometrium of a pregnant uterus. Female myometrium preparations obtained during surgery were studied by histochemical and radioenzymic methods. The findings evidence that catecholaminergic innervation of the myometrium is essentially reduced by the end of normal pregnancy and is detectable only in the lower segment of the uterus; in labor this phenomenon is virtually undetectable. Myometrial noradrenaline++ content is reduced by 90% by the end of pregnancy and in labor, the mediator level in the lower segment of the uterus being 2.4 times higher than in the body of the uterus. PMID- 1789319 TI - [Predicting the outcome of labor in women with contracted pelvis]. AB - The authors suggest that the coefficient, representing the ratio between the sizes of the small pelvis section and fetal head section, be used for the prediction of labor outcome for the fetus in women with a contracted pelvis. When the coefficient values K1-K4 were lower than 1.32, 1.35, 0.68, and 0.79, more than 90% of the newborns developed signs of cerebral circulation disorders, this prompting the use of cesarean section for this group of pregnant women. Timely correction of the policy of labor management with due consideration for the anatomical features of the pelvis helped reduce the perinatal mortality in multigravidae to 5/1000, mainly at the expense of carrying out planned cesarean section and monitoring in labor. PMID- 1789320 TI - [Clinical value of Doppler ultrasonographic examination of blood flow in the uterine arteries in physiological and complicated pregnancy]. PMID- 1789321 TI - [Diagnosis and treatment of juvenile uterine hemorrhage]. AB - The authors demonstrate the usefulness of supplementary methods of investigation (echography and hysteroscopy) for the diagnosis and treatment of juvenile uterine bleedings. Hemorrhages developing at the onset of puberty are not associated with noticeable shifts in the hormonal status. Dysfunction of the hypophyseo-ovarian system is detectable at the end of this period; therefore the authors suggest a specific therapeutic approach to such patients. Blood coagulation disorders were revealed in 21.7% of the patients. PMID- 1789322 TI - [Critical periods in the pubertal development of girls]. AB - The authors analyze the results of physical and sexual development of girls at the pubertal period, as well as their blood levels of hormones participating in the growth regulation and characterizing the +hypophyseal-gonadal relations. A staged pattern of pubertal period is emphasized+ and the critical period singled out: the age of menarche onset and establishment of the ovulation cycle (at the age of 14-15). PMID- 1789323 TI - [Doppler monitoring of the treatment of inflammatory diseases of the adnexa uteri]. AB - Twenty-five women with acute inflammations of the uterine tubes were examined using Doppler studies of the internal iliac, uterine, and ovarian arteries over the course of therapy. The systolic/diastolic ratio (A/B) and the Pourcelot resistance index were used in analysis of the spectral curves. The findings evidence that the iliac artery blood flow was unchanged over the course of therapy. Dopplerometric curves of the uterine and ovarian arteries were plotted for various periods of therapy for acute salpingo-oophoritis . The authors come to a conclusion of the usefulness of Doppler studies in clinical practice, and these conclusions are supported by the results of statistical data processing. PMID- 1789324 TI - [Ultrasonic examination of the status of the ovaries and endometrium after the treatment of tubal and peritoneal infertility]. AB - The authors analyze the usefulness of ultrasonic examination for the assessment of ovarian and endometrial status in 84 patients operated on for tubal and peritoneal sterility. After surgery the patients were recommended nootropic agents and cyclic vitamin therapy for 3 months. In cases with concomitant diseases (endometriosis, small pelvis varicose veins) synthetic estrogen-gestagen drugs, anticoagulants, disaggregants were prescribed. If the treatment did not result in pregnancy in 2 months, ovulation stimulants (clostilbegit, choriogonin) were prescribed. Drug therapy had a favorable effect on ovarian and endometrial function. Ultrasonic examination may be recommended for monitoring ovarian and endometrial status. PMID- 1789325 TI - [Clinical characteristics of mental disorders observed in ambulatory-polyclinical gynecological practice]. AB - Concomitant mental disorders were diagnosed in 97 of the 107 gynecologic patients aged 19 to 66. Twenty of these patients were previously consulted by psychiatrists. Five groups of mental conditions were distinguished, most frequently associated, in a certain mode, with gynecologic diseases. The results of our analysis necessitate that gynecologic outpatients be consulted by psychiatrists. PMID- 1789326 TI - [Status of the urinary system in genital endometriosis]. PMID- 1789327 TI - [Characteristics of the functional state of the central nervous system in women during the menstrual cycle and in premenstrual syndrome]. AB - Electroencephalographic examination of the function of the central nervous system in 30 healthy women and in 15 ones suffering from the premenstrual syndrome, carried out over both phases of the menstrual cycle, has revealed clear-cut differences between the two groups. 46% of the patients developed pathologic shifts at the level of the brain stem, 37% of the hypothalamic level, and 17% combined involvement of these portions of the brain. Triggering of the compensatory defense mechanisms already during the follicular phase of the cycle indicates failure of the adaptation mechanisms in the patients with the premenstrual syndrome. PMID- 1789328 TI - [Medium-weight molecules in the blood serum of patients with hyperplastic processes in the endometrium and benign and malignant ovarian tumors]. AB - Measurements of blood serum medium mass molecule (MMM) levels in patients with benign and stages III-IV malignant tumors of the ovaries have shown that MMM levels are significantly elevated in the patients with the hyperplastic processes in the endometrium, malignant and benign ovarian tumors. In health MMM level is 0.238 U, in patients with the endometrial hyperplasia and benign ovarian tumors it has been found to make up 0.358 U, in Stage III malignant epithelial tumors this value has been 0.439 U, and in Stage IV tumors 0.366 U. After therapy, resulting in a prolonged remission, MMM level reduced to 270 U on an average. Therefore MMM measurements in the blood serum may be recommended as a test for monitoring the course of a malignant process and the treatment results. PMID- 1789329 TI - [Corrective effect of reflexotherapy on the hypophyseal-ovarian and sympathetic adrenal systems after ovariectomy]. AB - The time course of LH, FSH, prolactin, estradiol, hydrocortisone, insulin and catecholamine levels in the blood was followed up in 62 patients of a reproductive age after surgical switch-off of the ovaries. Reflex therapy (electroacupuncture, acupuncture, other types of reflex therapy) included in the complex of postoperative treatment was conductive to the maintenance of a favorable level of hormones contributing to compensatory defense reactions to surgical stress and total ovariectomy. PMID- 1789330 TI - [The role of zinc in normal and pathological pregnancy]. PMID- 1789331 TI - [Pain syndrome after gynecological operations]. AB - The structure of the pain syndrome was studied in 110 patients on day 2 after surgery. A total of 76 parameters ware analyzed by 8 signs. Different combinations of the pain parameters, a negligible variability of the parameters of the pain intensity, depth of its site, and type, as well as the subjective sensations of the patients were distinguished, related to the patients' psychologic type. Opiate analgesia was associated with polymorphism of the pain syndrome. Transcutaneous electroanalgesia was sufficiently effective, promoting a narrowing of the range of pain parameters. PMID- 1789332 TI - [Characteristics od preoperative, intraoperative and postoperative care of gynecological patients with von Willebrand's disease]. PMID- 1789333 TI - [Status of tissue mineralization and the periodontium in women with impaired ovarian function]. AB - Examinations of 87 women with various disorders of ovarian function (amenorrhea, ovariectomy, climacteric period) and 26 healthy women with normal ovarian function have revealed reduced mineral content of the osseous tissue and a lowered ultrasound velocity propagation in the mandible and ulnar bones in women with hypoestrogenemia. Periodontal disorders grew in severity in the patients with ovarian dysfunction, being the least severe in those with secondary amenorrhea, augmenting in those with a history of ovariectomy, and the most severe in those in the climacteric period. These findings evidence a correlation between ovarian dysfunction, mineral content of the forearm bone tissue, and severity of the pathologic shifts in periodontal tissue. PMID- 1789334 TI - [Immunological properties of the amniotic fluid in physiological pregnancy and gestoses]. AB - Immunologic analysis of the amniotic fluid included measurements of immunoglobulins A and M, circulating immune complexes, rheumatoid and antinuclear factors, immunophoresis and electrophoresis, and tests for the presence of donor lymphocytes, Changed immunologic parameters of the amniotic fluid indicate a complicated course of pregnancy, development of gestosis among other things. Basing on their findings, the authors suggest that gestosis involve dysfunction of the adaptive mechanisms, that may result from disordered interactions of the immunity system components. PMID- 1789335 TI - [Feto-placental system in diabetes mellitus and hydramnios]. AB - The fetoplacental system of 132 women with diabetes mellitus and 85 healthy women was studied during the third pregnancy trimester. Blood estradiol and urinary estriol levels were found-reduced in the diabetics, particularly in those with insulin-dependent diabetes. Blood progesterone and oxytocinase levels were found unchanged. These parameters lowered in diabetic glomerulosclerosis. If pregnant diabetics develop hydramnion, their blood estradiol, progesterone, prolactin, and oxytocinase levels increased. PMID- 1789336 TI - [Characteristics of enzyme activity of leukocytes in women with history of habitual abortion]. AB - Leukocytic dehydrogenases (succinate and alpha-glucose phosphate dehydrogenases) and acid and alkaline phosphatase hydrolases activities were cytochemically assayed in 20 healthy women with normal menstrual cycles (controls) and 34 ones with habitual abortions. Ovulation in health was associated with a significant elevation of SDH, alpha-GPDH, and alkaline phosphatase activities. The second peak of enzymic activation, less marked, was recorded on days 20-24 of the cycle. Acid phosphatase activity was reduced by the second phase of the cycle. In women with habitual abortions the activities of redox enzymes (SDH and alpha-GPDH) reduced as against the controls (p less than 0.05, less than 0.01, less than 0.001), and no ovulatory peak of enzymic activation was detectable. The curves of enzymic activities were in good correlation with rectal temperature curves of the examinees. Elevated enzymic activities during ovulation and in the second phase of a normal cycle evidenced a sufficiently high energy supply of these processes. The detected reduction of leukocytic enzymic activities in women with habitual abortions may be used for the early diagnosis of an unfavorable pregnancy course and, possibly, for the prediction of placental insufficiency. PMID- 1789337 TI - [Pathogenesis of deceleration in the prenatal period]. AB - Comprehensive examination, making use of cardiotocography, dopplerometry, and doppler echocardiography, was carried out to disclose the contribution of fetal hemodynamic disorders to the pathogenesis of antenatal deceleration in 69 pregnant women. Disorders of both intracardiac fetal hemodynamics and of the fetoplacental circulation were revealed in all the cases with deceleration. Therefore, circulatory disorders underlie the pathogenesis of decelerations. The development of decelerations is related to the progressive deterioration of fetoplacental circulation and, specifically, to marked changes in the intracardiac hemodynamics in conditions of augmenting peripheral vascular resistance and hypoxia of the fetus. PMID- 1789338 TI - [Experience in the use of fetal monitor MKP-01 Nadezhda]. AB - Cardiotocograms were studied in 40 women during timely labor with the use of Nedezhda MKP-01 fetal monitor with real-time automated processing of the following parameters: fetal basal heart beat rate, amplitude and length of decelerated heart beat rate, amplitude and frequency of oscillations of heart beat rate, time of delayed deceleration minimum with respect to the peak of a uterine contraction. Developing acute fetal hypoxia was detected in 3 cases, that permitted timely abdominal deliveries to preserve the fetuses. The described device was found highly informative and valuable. PMID- 1789339 TI - [New data on the role of the fetus in the initiation of labor]. AB - The authors' findings evidence the fetal origin of amniotic fluid myoglobin. Myoglobin was found to activate the arachidonic acid and prostaglandin F2 alpha synthesis by fetal membranes. Possible mechanisms of amniotic fluid myoglobin effect on the initiation of labor are discussed. PMID- 1789340 TI - [Plasma cortisol levels in the newborn infants with hypoxic and traumatic injuries of the spinal cord]. AB - Adrenal glucocorticoid function was studied in 56 newborns with natal injuries of the cervical section of the spine and the contribution of the hypoxic factor to such injuries defined. The babies were examined by the cliniconeurologic and electron-neuromyographic methods in order to specify the level of the injury. Blood serum and umbilical blood hydrocortisone levels were radioimmunoassayed immediately at birth and on days 5-7 of life. Spinal injury at the C1-C4 level was associated with low hydrocortisone levels, that may be regarded as an additional criterion for the differentiation of the level of injury in traumas of the cervical portion of the spine in the newborns. PMID- 1789341 TI - [Factors conducive to the development of pyelonephritis in pregnant women]. PMID- 1789342 TI - [Partial separation of sutures of the uterus after cesarean section (diagnosis and treatment tactics)]. AB - Echography supplemented by hysteroscopy helped detect signs of partial separation of the sutures on the uterus in 12 of 33 patients with grave endometritis following cesarean section. Therapeutic policy in such cases should be based on rational etiotropic antibiotic therapy and active local treatment of the involved focus (surgical treatment of the uterine cavity walls, drainage of the uterus, local multicomponent ointments with a hydrophilic base). The treatment helped preserve the uterus and resulted in complete cure in 11 of the 12 cases. PMID- 1789343 TI - [A new method of the surgical treatment of vaginal (total) hypospadias in girls]. AB - A new method for surgical treatment of girls with vaginal (total) hypospadia is described. Two girls were operated on; the results were good. PMID- 1789344 TI - [Complex drug therapy of patients with juvenile uterine hemorrhage dependent on the status of the hemostasis system]. AB - The authors analyze the results of examinations and treatment of 125 patients, suffering from juvenile uterine bleedings, divided into three age groups and subgroups with different status of the hemostasis. They consider the suggested complex of drug therapy as an additional diagnostic test for the detection of the underlying pathogenetic component of such bleedings and recommend a pathogenetically-based hemostasis and adequate therapy to regulate menstrual function. PMID- 1789345 TI - [Interferon in combined treatment of patients with chronic inflammatory processes of the internal genitalia]. PMID- 1789346 TI - [Features of the adrenal cortex function in patients with hyperandrogenism of various etiology]. AB - ACTH, prolactin, hydrocortisone, 17 OH-progesterone, androstenedione, dehydroepiandrosterone C, and testosterone were measured in the blood of 36 androgenic women and 8 healthy ones before and after adrenal stimulation. The findings evidence that various mechanisms are responsible for the development of androgynism of an adrenal origin. In patients with congenital virilizing adrenocortical hyperplasia and 21 hydroxylase deficiency excessive androgen production results mainly from activation of delta-4 route of androgen synthesis; in patients with adrenal androgynism and insufficiency of enzymic systems of steroidogenesis the androgen production is explained by functional hyperactivity of the bundle and retinal zones of the adrenal cortex and hyperreactivity to stimulating factors. Hyperproduction of androgens is related to ovarian hyperproduction of not only androstenedione and testosterone, but, in some patients, of dehydroepiandrosterone C as well. Elevated basal blood level of this enzyme cannot be regarded as a sufficiently reliable criterion in the differential diagnosis of the adrenal or ovarian origin of androgynism. PMID- 1789347 TI - [Characteristics of the functional state of different sections of the autonomic nervous system and their role in the pathogenesis of oligomenorrhea]. AB - Analysis of the clinical picture of oligomenorrhea and of the results of studies of the function of various sections of the autonomic nervous system (ANS) in 58 patients of a reproductive age has revealed differences in these functions, related to the time of menstrual disorders onset. Oligomenorrhea patients with menarche complained of cardiovascular, respiratory, and emotional-motivational disorders, examinations have revealed in them dysfunctional disorders and reduced reserve potentials of both ANS sections. In oligomenorrhea patients in whom the condition developed at the age of 18-25 after a period of regular menstruations the effects of various stress factors resulted in reduction of the functional activity of the ergotropic (sympathoadrenal) section of the ANS. Differences in the pathogenetic mechanisms of oligomenorrhea development in the two groups of patients are discussed. PMID- 1789348 TI - [Psycho-electroregulation in conservative treatment of patients with uterine myoma]. AB - Basing on the concept of the uterine myoma presenting as a psychosomatic process that manifests in ischemic disease of the uterus, the author has tried psychoelectrostimulation in 76 patients with interstitial and subserous interstitial myomas as a method of psychotherapy and electrotranquilization. Indications for such treatment are the presence of psychoemotional stress syndrome (high anxiety level, pain and hemorrhagic syndromes, dysuria) and a rapid growth of the tumor. The reference group consisted of 73 patients with the same myoma forms, treated by hormonal therapy. Psychoelectroregulation has exerted a regulating effect on the central nervous, cardiovascular, endocrine and reproductive systems, it eliminated or alleviated the neurotic symptoms, and slowed down or arrested the tumor growth. PMID- 1789349 TI - [Possibilities of combined diathermo-cryodestruction in the treatment of hyperplastic processes of the cervix uteri]. AB - The authors analyze the results of two-year follow-up of 82 patients operated on for hypertrophy of the cervix uteri. Traditional cone-shaped diathermo-excision and diathermo-cryodestruction in the authors' modification were used. Good results were achieved in all the cases. PMID- 1789350 TI - [Toxoplasmosis as cause of hydrocephalus (case report of congenital toxoplasmosis)]. PMID- 1789351 TI - [Reproductive function after surgery of the horn of uterus in rats]. AB - A model of tuboplasty with the use of biologic glues (FK) and microsuturing material was created in experiments with 63 rats. Clinically commercial fibrin glue Beriplast FK manufactured by Bering (Germany) and FK-1 (USSR) were used in 15 patients during various gynecologic operations. The patency of uterine horn anastomoses, the formation of adhesions and other changes at the site of anastomosis were assessed, as was the incidence of the resultant pregnancy. Clinically early control laparoscopy was carried out on days 4-5 after surgery. The results evidence the efficacy of FK in reconstructive surgery on the uterine tubes. Preliminary analysis of the clinical data has confirmed the experimental data. PMID- 1789352 TI - [Use of a rating system in the assessment of 4th-year students' knowledge of obstetrics]. AB - The rating system was used to check up students' knowledge in obstetrics at the fourth course of the therapeutic and prophylactic faculty. Comparison of the results of the rating system and the routine one evidence that introduction of the new system has essentially improved the attendance of practical studies by the students, and their mean marks were improved as well. Students' knowledge assessed by the rating system coincided with the assessment made during examinations, thus permitting the use of this system in future without resorting to traditional sessions of examinations. PMID- 1789353 TI - [Morphofunctional features of the cervix uteri in women using hormonal contraception]. PMID- 1789354 TI - [Certification of the physician obstetrician-gynecologist with conferring of the qualification category]. PMID- 1789355 TI - [Hormonal contraception]. PMID- 1789356 TI - [The 150th anniversary of the Obstetrics-Gynecology Department of the Kiev Medical Institute]. PMID- 1789357 TI - [Ultrasonic biometry of the fetal kidney]. AB - Renal biometry of the fetus was carried out on 1200 women when exogenous difference between renal and surrounding tissue became distinct. Three dimensions of the kidney were measured at two mutually performed perpendicular scans. In our study it was established that the ratio between the circumference of the kidney and the abdominal circumference was a constant, preserving itself during the whole pregnancy. Establishment of this process presented diagnostic criteria for fetal hypotrophy as well as for anomalies in the development of the kidney. The three parameters as well as the estimated by them volume of the kidney could be presented as dynamic curves, rather similar in their course with the curves of BPD and the abdominal circumference. Prognosis of the fetal weight was made on the basis of the volume of the kidney by the formula W = 125, 1689 + (0.2008 X V), as the exactness of the method was commensurable with the precision of the popular combined biometric formulas, although only one parameter was used. The ratio the pelvis:kidney was of interest as well, since it differed from that of the grown up persons and it was from 1:3 to 1:4 within the fetal norm. The transverse size of pelvis at least over 15 mm suggested obstructive uropathy and hydronephrosis. There was no statistically significant difference in the biometric parameters of the right and left kidney of the fetus in our study. PMID- 1789358 TI - [The echographic measurement of fetal transverse cerebellar diameter in the second pregnancy trimester--a "nonstandard" method for determining gestational age]. AB - The study was carried out on 192 women with normally progressing pregnancies during the second trimester, in whom the gestational age was determined by 291 echographic measurements of the fetal anatomic parameters-the biparietal diameter, length of the femoral bone and the transverse cerebellar diameter. The coefficients of correlation between each of the indicated parameters and gestational age as high values of correlation--0.96, 0.98, 0.98 were established. A brief literary review is made on the problem for determination of gestational age by measurement of the transverse cerebellar diameter of the fetus. Making more precise some technical details of the method, the authors recommend it for routine usage in the clinical practice. PMID- 1789359 TI - [Prohibited visiting in the maternity hospital and its epidemiological consequences]. AB - Advancement of the obstetric ward in Bulgaria is connected with the organization, forbidding a free contact of parturients with their relatives. The authors carry out an inquiry study, showing that the administrative ban of visits in the obstetric ward is violated a hundred percentage. Concrete data are indicated to show when, with whom, for how much time the parturients are visited. The opinion of the parturients is accepted that it is necessary to fix daily time for their visits with members of their families, and it is recommended that the problem should find contemporary administrative solution. PMID- 1789360 TI - [A comparison between thiopental, midazolam-ketalar and midazolam-ketalar-aneksat for anesthesia during cesarean section]. AB - The effect of dormicum-ketalar and dormicum-ketalar-anexat in comparison with thiopental was studied on 45 parturients at 39-40 weeks' pregnancy, operated electively, divided into three groups as each group consisted of 15 women. The representative groups were compared by the following parameters: duration of the operation, age, weight, duration of induction in anaesthesia-extraction of the fetus, premedication, anaesthesia after the extraction of the fetus. Usage of dormicum ketalar for induction in anaesthesia during cesarean section did not affect the basic metabolic parameters of the parturients, fetus and amniotic fluid. Such a combination of preparations during simultaneous neutralization of the action of dormicum by anexat affects positively the fetal state, transport of O2 and activity of enzymes, in order that the fetus could survive more favourably this critical state. PMID- 1789361 TI - [Spinal opioid anesthesia for cesarean section]. AB - The spinal opioid anaesthesia indicated its onset in 1982 with the report of Mircea et al. on its usage in surgery. Our aim was to study the possibilities for the usage of Petidine as a single drug for anaesthesia in caesarean section as well as its effect on the newborns. Fifty women with elective caesarean section and their infants were investigated in respect to: time of occurrence of anaesthesia, level of sensory block, presence of motor block, duration of anaesthesia and side reactions. The newborns were studied in respect to: clinical state evaluated by Apgar score, acid-base balance (ABB) as well as blood gases in the umbilical artery (UA), umbilical vena (UV) and capillary blood within the first hour after delivery. The authors think that the spinal opioid anesthesia with Petidine can be used in caesarean section. Infants are born with very good clinical state, ABB and gases in blood. capillary blood within the first hour after delivery. PMID- 1789362 TI - [The coagglutination reaction (CoA)--a rapid test for the diagnosis of vaginal candidiasis]. AB - Vaginal candidiasis is frequently encountered disease. The question about quick and exact diagnosis is still a problem for the practice. The method, proposed by us, is the first attempt for diagnosis by the method of co-agglutination. Staphylococci, sensibilized by hyperimmune anti-candidiasis serum, are used. The preparation, proposed by us, is in no way inferior to the well known latex agglutination tests for vaginal candidiasis. PMID- 1789363 TI - [The assessment of the clinical and microbiological status of the lower genital tract in women with sterility]. AB - The study was carried out on 40 randomly selected patients with sterility, in whom microbiological examination of the lower genital tract was performed. Pathogenic microorganisms were isolated in the vaginal secretion of 10 out of 26 patients with primary sterility, but in the cervical secretion in 8 out of 26 women. Similar finding was found in 5 patients out of 14 patients with secondary sterility. The obtained results were compared with the complaints of women and their gynecological examination. Attention is paid again to the necessity of complex evaluation on the character of microbiological flora in view of the frequent usage of invasive methods in diagnosis and treatment of sterility. PMID- 1789364 TI - [Chlamydial infection in women with ectopic pregnancy]. AB - A study was carried out on the presence of antibodies to C. trachomatis in women with ectopic pregnancy, established during laparotomy. Pathohistological examination discovered that ectopic pregnancy occurred due to chronic salpingitis in a larger part of the women. The presence of antibodies to C. trachomatis was found in women with more sexual partners more frequently. Serum data for infection to C. trachomatis did not correlate with inflammatory gynecological diseases, undergone in the past. From the obtained results the authors could conclude that the endured subclinical chlamydial infection has caused damage of the Fallopian tubes, which is the cause for occurrence of ectopic pregnancy. PMID- 1789365 TI - [A method for the repair of the cervix uteri in conization]. AB - The technique for repair of the uterine cervix after circumferential cut and conization is described. The sewing is made by placing two symmetrical sutures, by which invagination is achieved simultaneously at sagittal and lateral sides. The authors have used the method in 400 patients for a period of 12 years as its good hemostatic and plastic effect is established. Attention is also paid to the observation on 18 women, who have became pregnant and delivered after conization and repair of the uterine cervix by the described method--11 out of 18 women have been delivered of infants through natural birth pathways. PMID- 1789366 TI - [Electrolyte studies of the amniotic fluid]. AB - The obstetrician does not pay attention to electrolytes in the amniotic fluid inspite of its great significance in the fetal homeostasis since its disturbance causes quick death of the fetus. In the presented article we aimed not only to describe reference values of sodium potassium, chloride and calcium but to examine their changes in prepathological and pathological states. 135 women with changes in the course of pregnancy of various character were investigated as well as 200 control women with normally progressing pregnancy. The results showed that there was steady state in the concentration of the indicated electrolytes during the whole pregnancy. There were no statistically significant changes in electrolyte concentrations neither in preterm or prolonged pregnancy, nor in acute or chronic fetal asphyxia, in meconial and hematinic mexures samples as well as in oxytocin infusions with a medium of saline. There was only highly significant lowering of the amount of calcium ions in the amniotic fluid of women with pre-eclampsia. Analysis of the results show that the kidney, finding itself in functional correlation with the placenta, is reliable regulator of the internal and external homeostasis of the fetus. PMID- 1789367 TI - [Organ-preserving operations on patients with microinvasive carcinoma of the cervix uteri]. AB - Organ-preserving operative treatment was performed on 29 women with microinvasive operative microinvasive carcinoma of the uterine cervix at lal clinical stages. After conization of the uterine cervix the patients were observed actively by cytology, colposcopy and, when it was necessary, a colposcopic-directed biopsy was made during a period of 3-98 as there was no relapse of the disease in neither case. The authors think that it is possible to perform conization in young women with minimal stromal invasion up to 1000 microns as their reproductive function is preserved without any risk for occurrence of a relapse. PMID- 1789368 TI - [Folliculometry as a method for determining ovulation in insemination with frozen sperm]. AB - The authors carried out studies retrospectively on 57 women, who became pregnant in insemination with donor frozen spermatozoa. Ovulation problems and luteal insufficiency were diagnosed in advance and treated before and during the occurring cycles. Women were divided into two groups. The first group of 25 women were examined by ultrasound transvaginal transducer for follow-up of follicle growth in the ovaries in addition to measurement of body temperature and determination of the cervical factor. The second group of 32 women, in whom follicle-metry was not performed. The frequency of conception was 0.24 in the first group, but 0.26 in the second group. It is concluded that inspite of the significance of follicle-metry for determination of ovulation the traditional methods are still valid criteria for ovulation and can be used as independent methods for determination of the time for insemination with therapeutic donor frozen spermatozoa. PMID- 1789369 TI - [The assessment of the physical work capacity of women with hypertension in the climacteric]. AB - The author studied the hypotensive effect on women with hypertonic disease during climacteric and investigated their physical capacity for a period of one year. The object of the study was 56 women with climacteric syndrome during climacteric as 38 out of 56 women suffered from hypertonic disease (HD). A considerable reduction in the physical working capacity of women suffering from HD during climacteric 326 +/- 20 kgm/min was found. After the performed one-year treatment the physical working capacity was increased considerably to 606 +/- 23 kgm/min at p less than 0.001, to which an increase in the heart output (presented as heart frequency and arterial blood pressure) corresponded. The best manifested effect in recovery of the physical working capacity in patients with HD during climacteric was found after hypotensive therapy, but the combined (hypertensive and sedative) therapy was on the second place and the sedative therapy--on the third place. PMID- 1789370 TI - [The introduction of microcomputerization into the uro- and andrological fields]. AB - Microcomputer systems are used wider and wider in medicine after their incorporation in the diagnosis and treatment of large number of diseases. Computer dispensary of patients with retained testes was used in the chair of urology in 1987 for the first time. Half of the used computer programme was written on the language DBABE. DBABE are 16 beat computers. The functional possibilities for the programme are the following: introduction of data from the first clinical examination, adding new data from the control examinations, correction of the old data, search for data according to a definite criterium, printing of informations in accordance with assigned criterium for seeking in table type, all functional possibilities for generation of informations, printed post communications. The created system for coding data allows their further mathematical processing both with practical and with scientific purposes. PMID- 1789371 TI - [The epidemiological aspects of acute inflammatory processes in the female genitalia]. PMID- 1789372 TI - [The determination of the probable term of delivery]. AB - The full-term infants born during the leap year of 1988 in the obstetric gynecological complex in the town of Dobrich were 2434, but the infants born according to the formula of Negele within the defined term--14 days were 2038. Most women were delivered of infants before the term. Standardization of parturients before and after term is made after estimated term with addition of 5 days to the last menses as the number of deliveries is increased as well. The difference in weight and length of infants before and on term is significant in respect to the infants born on term (with few exceptions) and insignificant between the infants born on term of labour and the infants born after the term. Duration of full-term pregnancy is 280.5-280.7 days. The probable term of delivery is determined more exactly by the formula of Negele with addition of 5 days during leap years and of 6 days during the remaining years to the first day of the last menstruation of pregnant women. PMID- 1789373 TI - [Replacement therapy with Estrofem in the postcastration syndrome]. PMID- 1789374 TI - Neuroendocrine responses in alcoholics to the presentation and consumption of a perceived alcoholic beverage. AB - Eight male alcoholic inpatients in their 2nd week of treatment were presented with, and instructed to consume, a beverage described at one session as containing alcohol and at another as not containing alcohol. The beverage on each occasion did not, in fact, contain alcohol. The results indicated that when subjects believed they had consumed alcohol, the change in insulin from baseline was significantly greater at 10, 20, and 30 min following consumption. The findings suggest that the insulin response of alcoholics following ingestion of a carbohydrate-containing beverage is enhanced by the anticipation of ethanol. PMID- 1789375 TI - Hemoglobin-acetaldehyde adducts are elevated in women carrying alcohol-damaged fetuses. AB - Alcohol use exceeding 3 to 5 daily drinks is associated with a 30% to 50% risk of delivering a child with fetal alcohol effects (FAE). FAE could be prevented if women were counseled and if they decreased their drinking. Therefore, we need sensitive and specific markers to detect alcohol abuse during pregnancy. We investigated whether acetaldehyde-hemoglobin adducts (Hb-Ach) could be such a marker. Using an antiserum specific for acetaldehyde-generated epitopes in proteins, we measured the levels of Hb-Ach from the red cells of 19 women visiting the outpatient department of pregnant alcohol abusers and from 14 nonpregnant controls. The pregnant women were carefully followed to receive personal antenatal care and intensive counseling on alcohol. Nevertheless, eight of the women delivered infants with FAE. The remaining 11 women had healthy infants, although only four of them stopped drinking totally. The highest concentrations of Hb-Ach were found from women who subsequently delivered children with FAE. When compared with the pregnant women abstaining from ethanol the Hb-Ach values were found to be elevated in five of eight (63%) of the women who gave birth to children with FAE, whereas only in two/seven (28%) of the mothers who despite drinking delivered healthy children. Hb-Ach measurements during pregnancy may prove to be useful to monitor the compliance of women withdrawing from alcohol and to distinguish the mothers at risk of affected offspring. The studies also support a pathophysiological role of acetaldehyde in producing ethanol-associated fetal injury. PMID- 1789376 TI - Effect of short-term ethanol feeding on rat testes as assessed by 31P NMR spectroscopy, 1H NMR imaging, and biochemical methods. AB - 31P Nuclear magnetic resonance (NMR) spectroscopy and 1H NMR imaging were used to examine the effect of short-term ethanol feeding on the rat testis. Weanling rats were pair-fed for 10 weeks either on ethanol containing liquid diet (36% ethanol of total calories) or a diet in which dextrimaltose was isocalorically substituted for the ethanol of the alcohol-containing diet. In vivo 31P NMR of the testes was used to determine the intratesticular pH and the relative concentrations of various phosphorus-containing metabolites. The integrity of the blood-testes barrier was evaluated using 1H NMR imaging following a gadolinium diethylene tetramine pentaacetic acid derivative (Gd-DTPA) administration as a vascular contrast agent. After the completion of NMR studies, the testis and the liver were freeze-clamped to allow for the assay of their adenosine-5' triphosphate (ATP) contents. Serum was assayed for its content of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alcohol and testosterone. Ethanol feeding resulted in the following: (a) a reduction in the body weight (p less than 0.05), (b) a reduction in the testicular phosphodiesters (PDE) PDE/ATP ratio (p less than 0.05), (c) an increased change in the testis image intensity difference between pre- and post-iv Gd-DTPA images, (c) a reduction in the testicular and hepatic content of ATP, and (d) increased serum levels of AST and ALT.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789377 TI - Effects of long durations of ethanol treatment during aging on dendritic plasticity in Fischer 344 rats. AB - Twelve-month-old Fischer 344 rats were fed a liquid diet containing 35% ethanol until they were 18 or 24 months old. Pair-fed and chow-fed control rats were matched to each ethanol-fed rat for concurrent treatment. Cerebellar Purkinje cell networks were measured in half of the rats at the end of the ethanol treatment and in the remaining rats after a subsequent 2-month recovery period. Chronic ethanol consumption resulted in significant elongation of terminal segments in the networks, and the unpaired terminal segments were the predominant sites of this growth. An increase in the duration of ethanol consumption from 24 to 48 weeks caused significantly greater segment elongation in the ethanol-fed rats in spite of the fact that circulating blood levels of ethanol declined markedly with the increased duration of treatment. During the same period of time, a pattern of terminal segment regression followed by terminal segment regrowth characterized age-induced changes in these networks. Thus the effects of long-term ethanol consumption were distinct from effects of concurrent aging processes in the Purkinje cell networks. There were significant interactions between the diets and the longer duration of treatment, such that as segments elongated in the ethanol-fed rats, they shortened in the pair-fed rats, and between the diets and the recovery period, such that as segments elongated during recovery in the pair-fed rats, they shortened in the ethanol-fed rats.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789378 TI - Fetal alcohol exposure and effects of LHRH and PMA on LH beta-mRNA expression in the female rat. AB - Fetal alcohol exposure (FAE) is associated with a variety of physiological and behavioral dysfunctions. Effects of FAE on reproduction have been described that include delayed puberty, altered gonadotrophin secretion and steroidogenesis, and altered sexual behavior. Earlier work suggested that pituitary function was compromised in adult fetal alcohol-exposed female rats. This study examined the effects of LHRH and PMA in vitro on LH beta-mRNA expression in pituitary fragments from FAE animals; a separate experiment examined the effects of estradiol-17 beta on LH beta-mRNA under similar conditions. The results indicate that the pituitary glands of FAE females have a reduced ability to respond to these three stimuli. The reason for this reduced responsiveness to LHRH, PMA, and estradiol-17 beta is not clear, but the alterations suggest that LH synthesis is impeded following fetal ethanol exposure. PMID- 1789380 TI - Low density lipoprotein derivatization by acetaldehyde affects lysine residues and the B/E receptor binding affinity. AB - Acetaldehyde (AcA), the first metabolite in ethanol oxidation, forms covalent adducts with the free amino groups of various proteins. In this study, we examined how acetaldehyde modification affects the chemical and biological properties of the atherogenic low density lipoprotein (LDL). AcA modification did not alter the protein and lipid composition of LDL, but the AcA concentration used in the incubation correlated strongly with the electrophoretic mobility of acetaldehyde-treated LDL (AcA-LDL) (r = 0.97, p less than 0.001) and the percentage of the free amino groups in AcA-LDL (r = -0.90, p less than 0.01). Amino acid analysis of AcA-LDL showed that lysine was the predominant residue in LDL modified by AcA. Assays with monoclonal antibodies (MB47, 2b, 4G3, and C1.1) directed against different epitopes of the LDL apoprotein B suggested that AcA modification reduced the immunological recognition of the LDL receptor binding region and its vicinity. Also, the binding affinity of AcA-LDL to B/E receptors correlated negatively with the percentage of modified lysine residues in AcA-LDL (r = -0.96, p less than 0.001). The results suggest that AcA derivatizes the lysine residues of LDL, and thus decreases the B/E receptor binding affinity of LDL. However, major changes in LDL receptor binding were produced only with non physiologically high concentrations of AcA, and, therefore, the role of the present findings in vivo remains uncertain. PMID- 1789379 TI - Behavioral and endocrine interactions between thyrotropin-releasing hormone and ethanol in normal human subjects. AB - Thyrotropin-releasing hormone (TRH) has been shown to antagonize the depressant effects of ethanol in animals, but conflicting findings have been reported in humans. To test whether TRH counteracts any of a variety of ethanol-sensitive behavioral measures in normal human subjects and for an effect of ethanol on TRH induced thyrotropin (TSH) and prolactin (PRL) response, we administered TRH (500 micrograms) or placebo over 1 min intravenously, 30 min after subjects had ingested 0.8 g/kg of ethanol or a placebo drink. Blood samples for TSH and PRL were drawn prior to and 15 and 30 min after injection. Eight male subjects were studied in a balanced, crossover design with each subject receiving placebo placebo, TRH-placebo, placebo-ethanol, and TRH-ethanol. Whereas ethanol had significant and expected effects on subjective measures, memory, disinhibition, reaction time and time perception, TRH failed to counteract any ethanol effect, except for a small effect in one memory task. Similarly, no effect of ethanol on TRH-induced TSH or PRL response was found. Though the behavioral findings could be interpreted to indicate that TRH does not alter ethanol sensitive behaviors in humans it will be necessary to utilize higher dosages of TRH and/or TRH analogues before firmly drawing this conclusion. PMID- 1789381 TI - Suppression of ethanol intake in chickens by fenfluramine and dietary tryptophan. AB - Two groups of 10-week-old White Leghorn cockerels were fed a commercial grower diet with or without an L-tryptophan (0.5%) supplement. After a 24-hr water deprivation and 13 to 14 hr without food, the birds were randomly injected with 0 (saline) 4, 8, or 12 mg of fenfluramine/kg body weight. Thirty minutes after injections, water or a 5% ethanol solution was offered, no choice, to the birds and fluid consumption as well as skin and rectal temperature before and after fluid availability were measured. The ethanol solution in otherwise untreated animals was consumed in similar amounts as water was. Fenfluramine (8 mg/kg) significantly reduced ethanol consumption and tryptophan further significantly reduced ethanol intake. At 12 mg/kg fenfluramine, both water and ethanol intake were sharply reduced. Ethanol decreased body temperature, an effect that was reversed by both tryptophan alone and fenfluramine + tryptophan in a dose dependent manner. These observations are discussed in reference to the effects of central serotonergic manipulations and ethanol consumption. PMID- 1789382 TI - Effect of dietary fat on Ito cell activation by chronic ethanol intake: a long term serial morphometric study on alcohol-fed and control rats. AB - We studied the effects of long-term ethanol ingestion and dietary fat on Ito cell activation morphometrically in rats. Sixteen pairs of Wistar male rats were divided into two groups, one fed tallow and the other fed corn oil as the source of dietary fat. Each group of rats were pair-fed a nutritional adequate liquid diet containing either corn oil (CF) or tallow (TF) as fat as well as protein and carbohydrate. Half of each group received ethanol, the rest were pair-fed isocaloric amounts of dextrose via an implanted gastric tube for up to 5 months. Morphometric analysis of the change in fat and rough endoplasmic reticulum (RER) of Ito cells was performed on electron micrographs obtained from monthly biopsies including baseline. Ito cell activation was assessed by a decrease in the ratio of fat/RER in Ito cells. The ratio of fat/RER in Ito cells of alcoholic rats fed the CF diet (CFA) gradually decreased. The ratio was found to be lower than in the pair-fed control rats (CFC) at 5 months of feeding. CFA: 1.74 +/- 0.57, vs. 7.46 +/- 2.05, respectively, p less than 0.05, mean +/- SE). Ito cell fat also significantly decreased at 5 months of feeding (p less than 0.05). The fat/RER ratio in CFA significantly decreased only subsequent to the development of fatty change, necrosis, and inflammation followed by fibrosis of the liver. In contrast, the TFA rats did not show a significant decrease in the fat/RER ratio in the Ito cells throughout the study, while TFC rats showed an increase in the fat/RER ratio.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789383 TI - Function of isolated hearts from septic, saline-infused, and septic, alcohol infused rats. AB - The aim of the present study was to determine whether hearts that demonstrate depressed myocardial reserves as a result of sustained hypermetabolic sepsis would show a potentiation of the dysfunction after an infusion of high doses of alcohol. We have previously shown that myocardial depression is present in hearts removed from hypermetabolic septic rats. Acute alcohol administration has also been shown to have a negative inotropic effect on the heart. In this study, myocardial function was assessed under in vitro conditions in which preload could be varied and aortic outflow resistance controlled and thus heart function could be determined under both low and high workloads. The alcohol-infused group increased cardiac performance as a function of increasing preload similarly to the controls. Heart rate, however, was significantly elevated compared with control. Isolated hearts from septic, saline-infused animals showed depressed cardiac performance both in terms of stroke volume and myocardial work over a range of preloads. The septic, alcohol-infused animals did not show this depression. Thus, a loss of myocardial reserve was demonstrable in hearts isolated from septic, saline-infused rats but not in septic, alcohol-infused rats. Alcohol, at least acutely, seemed to reverse or ameliorate the loss of myocardial reserve induced by sepsis possibly by increasing the ability of the heart to fill during diastole and thus perform volume work. PMID- 1789384 TI - Effects of chronic ethanol exposure on cardiac receptor-adenylyl cyclase coupling: studies in cultured embryonic chick myocytes and ethanol fed rats. AB - Ethanol effects in the brain appear to be mediated at least in part by an alteration in receptor-effector coupling via guanine nucleotide-binding regulatory proteins (G proteins). To test the hypothesis that a similar pathway participates in the cardiotoxic effects of ethanol, we assessed the effects of chronic ethanol on two commonly used experimental models: embryonic chick myocytes in culture and ventricular myocardium from chronically fed rats. Ethanol had no effect on either the function or quantity of G proteins as assessed by effector-stimulated adenylyl cyclase activity and the levels of ADP-ribosylation substrates. In contrast, effector-stimulated adenylyl cyclase activity was significantly altered in the liver of ethanol-fed rats. These results suggest that receptor-effector coupling via G proteins in our two cardiac models is insensitive to ethanol and that ethanol effects may be species or organ specific. PMID- 1789385 TI - Ethanol and fetal/postnatal growth. PMID- 1789386 TI - Prenatal alcohol exposure and preschool physical growth: a longitudinal analysis. AB - This report examines the effects of fetal alcohol exposure on size and growth in an urban cohort followed prospectively through early childhood. Indices of prenatal drinking were related to measurements of weight, stature (length), and head circumference obtained at birth and during five subsequent in-home assessments. Small but statistically significant relationships were detected between short-term recall estimates of drinking during pregnancy and weight and length at birth. The strength of these relationships diminished during the preschool assessments. However, estimates of catch-up growth associated with alcohol exposure were not statistically significant. With the exception of a single case with a profile of signs characteristic of fetal alcohol syndrome, an adverse effect of prenatal alcohol exposure on head circumference was not indicated. PMID- 1789387 TI - Prenatal alcohol exposure and offspring growth at 18 months of age: the predictive validity of two measures of drinking. AB - This is an analysis of the effect of prenatal alcohol exposure on growth of the offspring at 18 months of age. In this prospective study, a cohort of women was interviewed at the end of each trimester of pregnancy, at delivery, and at 8 and 18 months. Offspring were examined at each follow-up point. Two drinking scales, average daily volume (ADV) and frequent heavy drinking (FHD), were used to explore the effect of different patterns of drinking. We found significant relationships between both prenatal FHD and ADV and offspring growth at 18 months. A significant and inverse relationship was found between ADV during the second and the third trimesters of pregnancy and weight, height, and head circumference at 18 months. Frequent heavy drinking during all three trimesters predicted a significant decrease in head circumference at 18 months. FHD during the second trimester was significantly related to weight and height at 18 months. Analyses demonstrated that ADV was a better predictor of growth deficits than FHD. PMID- 1789388 TI - Postnatal growth deficits in prenatal ethanol-exposed mice: characteristics and critical periods. AB - We previously reported that offspring of C57BL/6 mice maintained on liquid diets containing 20% or 25% ethanol-derived calories throughout pregnancy had birth weights comparable with controls but had weight reductions that became manifest around 23 to 28 days postnatally. Since this pattern of weight reduction may represent an unrecognized condition for human ethanol exposure, we completed a number of experiments to more thoroughly characterize the altered growth of prenatal ethanol exposed C57BL/6 mice. The results of this study indicate that consumption of liquid diets containing either 17% or 25% ethanol-derived calories during pregnancy can reduce growth of male and female offspring. Although attenuated postnatal growth of prenatal ethanol-exposed rodents is not commonly reported, prospective studies in humans suggest that in addition to having lower birth weights, children prenatally exposed to ethanol are postnatally growth retarded. Mice exposed to the low ethanol doses used in the present study had normal birth weights; however, their growth was attenuated between 19 and 28 days of age (preadolescent growth spurt) resulting in a weight reduction for at least 35 days, and which according to our previous report could extend into adulthood. The latter stages of gestation appear to be more sensitive to the postnatal growth retarding effect of prenatal ethanol exposure than early gestation. Caloric deficiency and postnatal maternal factors were eliminated as possible mechanisms for the growth deficit. PMID- 1789389 TI - The role of cirrhosis in memory functioning of alcoholics. AB - The effects of alcoholism and liver disease on memory functioning in alcoholics were studied by comparing four groups: normal healthy controls, alcoholics without liver disease, alcoholics with biopsy-confirmed cirrhosis, and nonalcoholics with postnecrotic cirrhosis. Memory capacity was evaluated employing the Benton Visual Retention Test (BVRT), the Rey-Osterreith Complex Figure Test, Digit Span, and the Brown Peterson four-word short-term memory test. A 2 x 2 ANOVA revealed significant main effects for both alcohol and cirrhosis on Digits Forward and the total score on the Brown Peterson test. Additionally, there were significant main effects for cirrhosis on the BVRT. The Brown Peterson test was analyzed using a repeated measures 2 x 2 ANOVA. Significant effects for cirrhosis were observed at all three interpolation periods. The effects for alcohol approached significance at the 30-sec (most difficult) interpolation period. Analysis of error patterns on the Brown Peterson test indicated that overall omission errors were most commonly made among all groups. Significant effects were found for alcohol on omissions and intrusion, while the cirrhosis factor yielded significant effects for phonemic, perseverative, and omission errors. This study demonstrates the importance of liver disease underlying the etiology of memory impairments in alcoholics. The results confirm our earlier findings that neuropsychologic deficits seen in alcoholics may be the result of the combination of alcohol abuse and liver disease. PMID- 1789390 TI - Effects of alcoholic beverage server liability on traffic crash injuries. AB - We examined effects on the frequency of injuries due to motor vehicle crashes of a sudden change in exposure to legal liability of servers of alcoholic beverages in Texas. A multiple time-series quasi-experimental research design was used, including the Auto-Regressive Integrated Moving Average and intervention-analysis statistical models on injury data from 1978 through 1988. We controlled for the effects of several other policy changes expected to influence injury rates in Texas, and for broader nationwide changes in injury rates in the 1980s. Results revealed 6.5% and 5.3% declines in injurious traffic crashes following the filing of two major liability suits in 1983 and 1984, respectively. Sever liability is one of several important public policy tools in efforts to achieve health objectives regarding reduced injury morbidity, and mortality. PMID- 1789391 TI - Short-term processes of remission and nonremission among late-life problem drinkers. AB - This prospective study compares alcohol use, functioning, life stressors, social resources, and help-seeking among three groups of older adults: remitted problem drinkers, nonremitted problem drinkers, and nonproblem drinkers. At initial assessment, to-be-remitted problem drinkers had several advantages compared with individuals who would continue to have drinking problems. Specifically, they consumed less alcohol, reported fewer drinking problems, had friends who approved less of drinking, and were more likely to seek help from mental health practitioners. Problem drinkers who remitted improved somewhat over time, but they did not attain the level of functioning or type of life contexts shown by nonproblem drinkers. Time of onset of drinking problems influenced the short-term process of remission: Compared with early-onset individuals, late-onset problem drinkers were more likely to remit over the 1-year interval. The predictors of short-term remission suggested that late-onset problem drinkers may be more reactive to physical health stressors and to social influences than are individuals with more long-standing problems with alcohol. PMID- 1789392 TI - Improvement in cognitive functioning of alcoholics following orthotopic liver transplantation. AB - Cognitive functioning in alcoholic cirrhotics before and 1 year following orthotopic liver transplantation was compared with age- and sex-matched normal subjects. The alcoholic group improved significantly following transplantation on tests measuring psychomotor, visuopractic and abstracting abilities whereas the performance of normal controls remained virtually unchanged. In contrast, memory capacity in alcoholics with cirrhosis did not statistically improve following successful transplantation. Further investigation, using more sophisticated measures of memory function, are required to determine whether memory deficits are either associated with alcohol neurotoxicity or an irreversible component of hepatic encephalopathy. These findings suggest that a reversible hepatic encephalopathy underlies many of the neuropsychologic deficits observed in cirrhotic alcoholics and can be ameliorated following successful liver transplantation. PMID- 1789393 TI - Bromocriptine in the treatment of alcohol dependence. AB - A double-blind controlled study of the effects of bromocriptine on drinking behavior and associated symptoms in ambulatory alcoholics showed a marked improvement in both treatment and control groups. However, significant differences in favor of the medication were observed in psychopathological measures, and trends in the same direction in most of the other efficacy parameters. PMID- 1789394 TI - Lithium carbonate and mood disorder in recently detoxified alcoholics: a double blind, placebo-controlled pilot study. AB - The effects of lithium carbonate were assessed in a double-blind, placebo controlled study of a small group of recently detoxified alcoholics. The patients were treated during their 2nd and 3rd week of abstinence. A previous study demonstrated the existence in these patients of a syndrome of mildly elevated psychomotor rate, including irritability, grandiosity, an increased need for social contact, loquaciousness, and sexual preoccupation. The intensity of this syndrome was significantly decreased by treatment with low dose lithium carbonate, with no effect of placebo treatment. PMID- 1789395 TI - Hand movement speed and accuracy in detoxified alcoholics. AB - Detoxified alcoholics (n = 192) were found to be 9.3% slower than age-matched controls (n = 112) with regard to the composite speed (movement time, MT) with which they were able to strike targets of various sizes and distances with a hand held stylus at onset of a light stimulus (Fitts's Task). Females (n = 102) were 8% slower than males (n = 202), and blacks (n = 103) about 15.6% slower than whites (n = 201). Gender was the only significant factor with regard to errors (target misses), with women committing 28% fewer errors than men. Women, in contrast to men, appear to trade speed for accuracy in this task. Favorable socioeconomic/medical status and target misses were directly related to movement speed. Thus, when the MT data were corrected for lifestyle variables, the significance of the alcohol effects on MT disappeared, but gender differences persisted. The alcohol effect became statistically significant, the ethnic group differences remained statistically significant, and the gender effect became insignificant when MT scores were corrected for accuracy of performance (target misses). The slope of the linear function relating MT to target difficulty was similar for all subgroups. Prior knowledge of the direction of movement was found to affect MT performance more in white than in black subjects. With regard to reaction times, ethnic group and alcohol use effects remained statistically significant after corrections for lifestyle and errors were made, with values for blacks about 5% slower than values for whites, and values for alcoholics about 4.6% slower than those for controls. Prior knowledge of the direction of movement significantly improved (shortened) reaction time in all subgroups (14%-19%). PMID- 1789396 TI - Lifestyle effect on total IgE. Lifestyles have a cumulative impact on controlling total IgE levels. AB - Recent studies have demonstrated an increasing number of cases of allergy in economically developed societies. Many of these allergic reactions are mediated by IgE antibodies whose levels are under genetic control. However, this large increase of allergy prevalence cannot be explained by genetic mutations; comprehensive lifestyles may also play roles in determining total IgE levels. Total IgE levels were determined from serum samples taken from 706 hard metal workers who responded to a questionnaire including 17 items related to physical and mental health practices. Five factors tending to normalize IgE upward and three tending to normalize IgE downward when we keep good lifestyles were extracted using MANOVA analysis. We therefore constructed a Health Practice Index in Allergic reactions (HPIA); eight physical and mental health practices were significantly (P less than 0.05) associated with cumulative elevations or suppressions of total IgE levels when sex, age and environmental factors were controlled for. Multivariate analyses demonstrated a dramatic synergism (Relative Risk greater than 2.0, P less than 0.05) of unhealthy lifestyles determining a bipolar high risk for elevated or suppressed IgE levels which in turn may result in allergic diseases or immuno-suppression. Maintenance of healthy lifestyles may prove beneficial for reducing the prevalence of allergic disorders. PMID- 1789397 TI - Association of features of atopy and diagnostic parameters in hymenoptera venom allergy. AB - In a total of 525 patients with hypersensitivity reactions to hymenoptera stings diagnostic parameters of hymenoptera venom (HV) allergy (severity of reactions, skin test threshold and RAST for bee and vespid venoms) were investigated for their relationship to the following indicators of atopy: positive history of atopic diseases, elevated (less than or equal to 100 kU/l) total serum IgE and positive prick test reactions to common inhalant allergens (CIA) (grass pollen, cat epithelium, house dust mite). There was a conclusive history of atopic disease in 25%, a total serum IgE greater than or equal to 100 kU/l in 48%, and at least one positive reaction to CIA in 53%. Total IgE greater than or equal to 100 kU/l correlated with a higher frequency of RAST classes greater than or equal to 2 (P less than 0.01) and with less severe reactions to hymenoptera stings (P less than 0.05). In the presence of at least one positive reaction to CIA, there were more frequently skin test thresholds less than or equal to 10 micrograms/ml (P less than 0.05) and RAST classes greater than or equal to 2 (P less than 0.01) for HV than in CIA prick test negative individuals. There was no significant, relationship between the other pairs of parameters evaluated. Thus, reactivity to HV in diagnostic tests is increased in the presence of certain indicators of atopy. This has to be considered in the interpretation of skin test and RAST results obtained with HV. PMID- 1789398 TI - Specific IgE to reindeer epithelium in Finnish reindeer herders. AB - Reindeer herding is a major source of living for more than 4200 inhabitants in northern Finland. To determine the prevalence of allergic symptoms among reindeer herders clinical examinations and skin prick tests (SPT) with nine inhalant allergens were performed in 211 randomly selected men from 21 to 69 (mean 45) years. Specific IgE antibodies to reindeer epithelium (RE) and total serum IgE were evaluated in 99 herders, five persons who handled reindeer leather indoors, 21 atopic patients with cow allergy and another 20 subjects with specific IgE to other inhalant allergens. Positive SPT to RE was detected in one and specific IgE by using enzyme allergosorbent test (EAST) (greater than or equal to 0.8 PRU/ml) in seven herders. Specific IgE to RE was also demonstrated in one control. Using RAST inhibition a patient with cow allergy did not show cross-reactivity between cow and RE while another patient did. Thus, RE should be included in the allergy test panel when hypersensitivity to RE is suspected. PMID- 1789399 TI - Powder administration of pure budesonide for the treatment of seasonal allergic rhinitis. AB - The objective of this study was to compare the efficacy and safety of a pure powder formulation of budesonide, delivered from a new multi-dose dispenser for nasal drug application, with the commercially available budesonide pressurized aerosol, and with placebo. Of 116 patients with grass pollen-induced allergic rhinitis, 112 finished the study, which comprised a 4-week treatment period, preceded by a 1-week run-in period. The patients were randomized to four parallel treatment groups: budesonide powder 400 micrograms daily; budesonide powder 800 micrograms daily; budesonide aerosol 400 micrograms daily; and placebo powder. Treatment was given once daily in the morning. The study was double-blind regarding comparison between budesonide powder and placebo. Assessment of efficacy, made by comparing mean scores of nasal symptoms and use of rescue medication, showed equal efficacy of all three budesonide groups compared with placebo. There were no differences between budesonide-and placebo-treated groups with regard to side effects. Budesonide treatment had no demonstrable effect on the HPA-axis assessed by measurement of 24-h urine cortisol. We conclude that budesonide, delivered as pure powder from a multi-dose dispenser, is effective and safe for the treatment of seasonal allergic rhinitis. This new formulation is a good alternative to the commercially available preparations, as it does not contain carrier gas, preservatives or lubricants. PMID- 1789400 TI - Existence of exine-free airborne allergen particles of Japanese cedar (Cryptomeria japonica) pollen. AB - We investigated whether exine-free pollen allergen particles exist together with the intact pollen grains of Japanese cedar (Cryptomeria japonica) in the air during the pollen season in Yamagata City. First, we separated the allergen particles in an Andersen multi-stage air-sampler according to their aerodynamic diameters. The amount of major allergen (Cry j I) on each stage of the sampler was determined by a sensitive fluorometric sandwich ELISA, and the pollen count of the same samples was done by light microscopy after Carberla staining. Cry j I was found in stages 1 to 6, whereas most of intact and ruptured pollen grains were microscopically observed only in stages 1 and 2. Second, we suctioned the air through a tandem membrane filter system (the first filter, Nuclepore filter with 5 microns-pores; and the second, Millipore filter with 0.3 micron-pores). None of the pollen grains was detectable on the 0.3 micron-pore filter with light microscopy. However, Cry j I was detectable in the aqueous extract from the second filter. From these results, we concluded that pollen-free Cry j I existed in the air of Yamagata City during the pollen season. PMID- 1789401 TI - Efficacy of an air-cleaning device equipped with a high efficiency particulate air filter in house dust mite respiratory allergy. AB - The efficacy of an air-cleaning device equipped with a high efficiency particulate air (HEPA) filter (without further avoidance measures) was studied in patients allergic to house dust mite. The effects of the air-cleaner on indoor Dermatophagoides sp. levels, symptom score and bronchial hyperresponsiveness in nine mite-allergic patients were assessed using a cross-over controlled study. No significant effect was demonstrated on indoor Dermatophagoides sp. levels when comparing the period of air-cleaner activity (2 months) with the control period (2 months). The Dermatophagoides sp. levels in the houses studied were lower than the risk level for asthmatic attacks, making it difficult to assess any effect on asthma; however, neither bronchial hyperresponsiveness nor rhinitis symptom score were changed by air-cleaner activity. During the trial period, however the mean level of Dermatophagoides sp. allergen in the houses changed spontaneously from 4.4 micrograms/g (mean level in the first 2 trial months) to 1.75 micrograms/g of dust (second 2 months) (P less than 0.05). Owing to this change, the mean rhinitis symptom score also decreased (P less than 0.05), even if no significant correlation was demonstrated (r = 0.4 P = 0.089). HEPA filter air-cleaners appear insufficient as substitutes for standard avoidance measures in mite allergic patients. PMID- 1789402 TI - Immunologic tests of specific antibodies to organic acid anhydrides. AB - The outcome of immunologic tests of antibodies directed against hapten conjugates of organic acid anhydrides and human serum albumin (HSA) has been studied in workers exposed to phthalic anhydride (PA), methyltetrahydrophthalic anhydride (MTHPA), hexahydrophthalic anhydride (HHPA), and methylhexahydrophthalic anhydride (MHHPA). HSA conjugates of PA, MTHPA, HHPA, MHHPA, and maleic anhydride (MA) have been prepared and used in the tests. The hapten densities (HD) of the conjugates were varied by different molar ratios of hapten and macromolecule in the preparative procedure. Skin prick reactions to MTHPA-HSA increased with rising HD over the range 6-13 mol/mol. The achieved HD was tested by spectrometric and gas chromatographic methods. In RAST of IgE antibodies MTHPA HSA with HD six and 25 showed significantly lower bindings than conjugates with intermediate HD. There was a good correlation between skin prick tests and RAST. Of 234 workers tested [MTHPA (n = 145), and HHPA (n = 89)], 45 had a skin prick reaction greater than or equal to 50% of the histamine reaction (1 mg/ml). All but two of these were RAST positive (RAST value greater than 0.3%; 0.3% upper range in 147 controls; MTHPA, n = 63; HHPA, n = 84). Nine RAST positive workers had no obvious skin prick reaction. However, their RAST values were low (less than 0.8%). In exposed workers, the ELISA value of specific IgG antibodies to MTHPA-HSA showed optimal values when tested with the HD 13 conjugate.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789403 TI - Egg protein sensitization in patients with bird feather allergy. AB - We have studied the hypersensitivity to hen's egg protein and chicken meat in 25 adults with a previous diagnosis of bronchial asthma and rhinoconjunctivitis due to bird feather sensitization. Seventeen of the 25 reported good tolerance to the ingestion of egg and chicken meat. The skin tests were negative to both antigens in 15 of them, and positive for egg in two. All 17 patients had negative RAST to chicken meat and egg protein. The remaining eight patients had intolerance to egg, and three of them also to chicken meat ingestion; in seven of the eight cases allergic to egg, the alimentary intolerance began after the clinical symptoms of bird feather sensitization. In all eight cases the skin tests were positive to egg yolk, and in five of them also to egg white and chicken meat. These patients evidenced specific serum IgE antibodies to egg yolk, four of them to egg white, and seven to chicken meat. These results demonstrate the high frequency (32%) of the association of sensitization to egg proteins, particularly egg yolk, in a selected population of patients with known allergy to bird feathers, thus suggesting that in some patients feather sensitization could trigger or somehow facilitate the later sensitization to egg yolk proteins. PMID- 1789404 TI - Allergenicity suppression in natural latex surgical gloves. AB - By a revised manufacturing process we aimed to obtain latex surgical gloves without immediate allergenicity, and also to determine a simple physical technique by which to estimate this allergenicity. Five glove samples were evaluated for allergenicity by physical and biochemical methods and by skin tests at the University Allergy Centre. Three groups of allergic patients with documented anaphylaxis to surgical gloves, positive skin tests to latex extract and specific IgE to latex (RAST Pharmacia greater than or equal to class II), volunteered for the study. The protein content, the in vitro allergenic potency of glove supernatants (RAST inhibition) and the skin test results with glove supernatants were lower in washed gloves than in non-washed samples (P less than 0.02 to P less than 0.009). The supplementary effect of glove sterilization at 120 degrees C (for 1 h in saturated steam) was obvious. The protein content became undetectable in four of the five glove supernatants, and skin tests results with sample supernatants were decreased (M +/- SEM = 0.68 +/- 0.29 mm vs 3.06 +/- 0.61 mm with non-sterilized gloves), P less than 0.009 by Wilcoxon test. With the Spearman test there was a significant correlation (P = 0.029) between the mean wheal size, obtained with supernatants (Groups 1 and 2) and electrical conductivity. Skin tests through pieces of gloves randomly distributed and coded were decreased by sterilization: 0.66 +/- 0.25 mm vs 2.86 +/- 0.45 mm, P less than 0.0001. Thus, it is possible to decrease glove allergenicity by washing them after mould forming and then sterilizing with steam. Electrical conductivity may be a simple parameter for revealing allergenicity. PMID- 1789405 TI - Differences in serum IgE antibody activity to benzylpenicillin and amoxicillin measured by RAST in a group of penicillin allergic patients. AB - To determine the influence of the acyl side chain on the IgE antibody specificity of the two most common penicillins inducing allergic reactions in our community, benzylpenicillin (BP) and amoxicillin (AX), IgE positive sera from a group of 24 patients allergic to penicillin were studied. RAST was determined in parallel to benzyl penicilloyl-polylysine (BPO-PLL) and amoxicilloyl-polylysine (AX-PLL) in each serum, and values greater than an established coefficient of variation of 15% were considered as different for either of the haptens used (BP and AX). 16 sera proved to be more positive to BP (Group A), six to AX (Group B) and in two IgE was positive to both haptens with a similar value (Group C). RAST titration concentration effect curves and RAST inhibition studies with a pool of sera from each group (A, B, C) and individual sera showed that most of them were more specific for either BPO or AX, a minority being of similar value to both. These findings indicate that the side chain structure of penicillins is relevant in the constitution of the antigenic determinant, although in some instances the common chemical structure of betalactam is recognised mainly by the IgE antibodies. The clinical relevance of these data needs to be established. PMID- 1789406 TI - Fungi in carpeting and furniture dust. AB - The qualitative and quantitative species composition of fungi in carpets and upholstered furniture dust found in the living-rooms of nine Dutch dwellings was examined in a pilot study. Numbers of spores of xerophilic fungi did not differ in dust removed from carpeting and upholstery. Spores of hydrophilic species were found to be more predominant on floors (P less than 0.05), whereas meso hygrophilic spores, largely dominated by allergologically relevant Penicillium species, were significantly more abundant in dust taken from regularly used furniture (P less than 0.05). Our results indicate that growth conditions for fungi in the micro-habitats of furniture differ from those in carpeting. No statistically significant differences in number of viable spores have been found in samples taken from ground-floor level compared with those taken from 1st to 3rd floor level of dwellings. From this study, the need for a micro-topographic analysis of the fungal flora in the human environment has become apparent. Efficient allergological home sanitation in dwellings of allergic patients requires detailed data about the colonization of the various micro-habitats by allergenic fungi. PMID- 1789407 TI - Safety of bronchial allergen provocation in a children's out-patient clinic. AB - A total of 137 bronchial provocation tests (BPT) with allergen extracts were performed in an outpatient clinic, 110 were positive, 29 with late reaction and 81 without. The patients were observed for 6-8 h and discharged if they did not develop a late reaction. None of the discharged patients was admitted to hospital later, and the number of patients hospitalized was reduced by 80%. PMID- 1789408 TI - Bronchial asthma due to Cannabis sativa seed. AB - A 51-year-old man with asthmatic attacks due to Cannabis sativa seed inhalation was studied. Specific IgE against this seed was demonstrated by in vivo (skin and bronchial challenge tests) and in vitro methods (reverse enzyme immunoassay and histamine release from basophils), suggesting a Type I immunologic reaction. PMID- 1789409 TI - Development of an acid hydrolysis method with high recoveries of tryptophan and cysteine for microquantities of protein. AB - High recoveries of tryptophan and cysteine were achieved by 12.5 min of hydrolysis with mercaptoethanesulfonic acid vapor. Proteins (1-100 micrograms) were modified by vapor-phase S-pyridylethylation before hydrolysis. The modified proteins were hydrolyzed with the vapor of 2.5 M mercaptoethanesulfonic acid at 176 degrees C. This method promoted efficient hydrolysis of the peptide bonds in proteins and resulted in high recoveries of both tryptophan and cysteine, of 90% or greater, in addition to the other amino acids. PMID- 1789410 TI - A fluorescent substrate for the continuous assay of phosphatidylinositol-specific phospholipase C: synthesis and application of 2-naphthyl myo-inositol-1 phosphate. AB - A fluorescent water-soluble substrate for phosphatidylinositol-specific phospholipase C was synthesized. The diacylglycerol moiety of the natural substrate, phosphatidylinositol, was replaced by the fluorescent moiety, 2 naphthol, resulting in the synthetic substrate, racemic 2-naphthyl myo-inositol-1 phosphate. The synthetic substrate provided a continuous fluorometric assay for the phosphatidylinositol-specific phospholipase C from Bacillus cereus. Initial rates of the cleavage of the 2-naphthyl substrate by the phospholipase measured by fluorometry were linear with time and the amount of enzyme added. The specific enzyme activity at pH 8.5 and 25 degrees C was about 0.04 mumol/min mg protein at an initial substrate concentration of 0.8 mM. 31P NMR experiments suggest that, as with phosphatidylinositol itself, cleavage of the fluorescent substrate proceeds in two steps via a myo-inositol-1,2-cyclic phosphate intermediate, and that only the D-isomer is a substrate for the B. cereus phospholipase. The synthetic substrate was stable during long-term storage as a solid in the dark at -20 degrees C. It was also stable for several weeks when stored in the dark frozen in aqueous solution near neutral pH. PMID- 1789411 TI - Quantitative determination of hydroxy fatty acids as an indicator of in vivo lipid peroxidation: gas chromatography-mass spectrometry methods. AB - A new method has been developed for the quantitation of lipid peroxidation products by gas chromatography-mass spectrometry. An important advantage over existing gas chromatography-mass spectrometry methods is the elimination of autoxidation during sample preparation. The sensitivity is sufficient to permit measurement of lipid peroxidation products under normal physiological conditions on as little as 1 mg of tissue. Lipids from whole tissue samples or cell preparations are reduced by catalytic hydrogenation during extraction. The hydrogenation stabilizes the compounds by saturating the double bonds and reducing the hydroperoxides to hydroxy derivatives. The saturated lipids are then saponified and the resulting fatty acids are converted to pentafluorobenzyl esters. Hydroxy fatty acids are further converted to trimethylsilyl ether derivatives. Quantitation is accomplished by negative ion chemical ionization gas chromatography-mass spectrometry, using deuterated internal standards. Specific products from polyunsaturated fatty acids can be quantitated, and the method differentiates between products produced by free-radical and photooxidation mechanisms. Increased levels of lipid peroxidation products, above normal physiological levels, that result from prooxidant conditions, such as exposure of animals to carbon tetrachloride, can be measured. PMID- 1789412 TI - Binding of antibodies and other proteins to nitrocellulose in acidic, basic, and chaotropic buffers. AB - This report compares the binding of proteins to nitrocellulose membranes in acidic buffers (pH 2 and 3) with binding in neutral buffer (pH 7), basic buffers (pH 12 and 13), 8 M urea (pH 2, 3, and 7), and 6 M guanidine hydrochloride (pH unadjusted). Initially, similar amounts of antibodies and other proteins bound to the nitrocellulose membrane in all of these buffers and solvents. However, the susceptibility of individual proteins to displacement (stripping) from the membrane by the milk blocking agent depended on both the pH and the type of buffer or solvent used to bind the proteins to the membrane. Most proteins that were bound to nitrocellulose in acidic buffers were relatively resistant to milk stripping compared to proteins bound in pH 7 buffer. After correction for the amount of antibody remaining on the membrane after the milk block, it was found that acid-bound antibodies were unchanged in biological activity when compared with the same antibodies bound at neutral pH. These results suggest that acid binding of proteins could increase the sensitivity of nitrocellulose membrane assays using a milk block. PMID- 1789413 TI - Two-dimensional electrophoresis of plant proteins with phastsystem using nonequilibrium pH gradient separation. AB - We have adapted a two-dimensional electrophoretic technique described by P. Z. O'Farrell et al. (Cell 12, 1133-1142, 1977) to Phastsystem, resolving both acidic and basic proteins by using nonequilibrium pH gradient electrophoresis in the first dimension and sodium dodecyl sulfate polyacrylamide gel electrophoresis in the second dimension. Protein separation was optimized for the analysis of plant proteins. The use of the Phastsystem apparatus reduced times of preparation and separation, allowing the rapid screening of plant proteins on a large scale of isoelectric points. This technique was used for the immunodetection and characterization of two stress-induced proteins in irradiated tomato leaves. PMID- 1789414 TI - Fluorometric assay of microsomal aldehyde oxygenase activity: 9-anthraldehyde as a substrate. AB - With regard to hepatic microsomal oxidation of 9-anthraldehyde (9-AA), a fluorometric method for determination of 9-anthracene carboxylic acid (9-ACA) is described. 9-AA was incubated with hepatic microsomes prepared from male ddN mice. 9-ACA formed was fluorometrically (excitation and emission wavelengths of 255 and 458 nm, respectively) quantitated after the separation from 9-AA by an alkali extraction and ethyl acetate reextraction. Hepatic microsomes less than 0.1 mg protein were enough to assay the microsomal aldehyde oxidation. The enzyme in the microsomes that catalyzes the oxidation of 9-AA to 9-ACA has been characterized by this method. PMID- 1789415 TI - Covalent immobilization of DNA onto polystyrene microwells: the molecules are only bound at the 5' end. AB - Carbodiimide-mediated condensation of DNA onto microwells is investigated. DNA is bound onto the microwells by formation of a phosphoramidate bond between the 5' terminal phosphate group and the microwells. Immobilization of 25 to 30 ng DNA per well is obtained. DNA molecules bound covalently at only the 5' end are, ideally, perfect for hybridization. The practicability of DNA molecules bound to microwells for hybridization is investigated. PMID- 1789416 TI - Estimation of flavin-containing monooxygenase activities in crude tissue preparations by thiourea-dependent oxidation of thiocholine. AB - The activity of flavin-containing monooxygenases in microsomes and whole homogenates is readily estimated by following the thiourea-dependent oxidation of thiocholine. NADPH- and oxygen-dependent flavin-containing monooxygenases catalyze the oxidation of thiourea to formamidine sulfenic acid, which oxidizes thiocholine to thiocholine disulfide. The latter reaction is quite rapid and never rate limiting even at concentrations of thiocholine below 30 microM. The loss of thiocholine in deproteinized aliquots of the reaction medium is measured colorimetrically with the thiol reagent, DTNB [5,5'-dithiobis(2-nitrobenzoate)]. In the absence of thiourea, thiocholine is not oxidized and its disulfide is not reduced at a detectable rate even in reactions containing 4-5 mg of liver or kidney homogenate protein per milliliter. In all tissues where both can be measured, rates of thiocholine oxidation and N,N-dimethylaniline N-oxygenation were virtually identical, which suggests that both activities are catalyzed by the same monooxygenase. PMID- 1789417 TI - Measurement of plasma acetate kinetics using high-performance liquid chromatography. AB - Previous studies suggest that plasma acetate may be an important fuel in man, accounting for approximately 10% of energy expenditure. Available methods for the determination of plasma acetate kinetics are difficult and time consuming. We describe here a procedure for the determination of plasma acetate concentration and specific activity using automated high-performance liquid chromatography that is precise and sensitive and accommodates large numbers of samples. The procedure involves extraction from plasma with diethyl ether, derivatization with bromoacetophenone, and separation on a C-18 reversed-phase column. The specific activities of D-beta-hydroxybutyrate and lactate can also be determined. Acetate turnover was measured in four dogs and was similar to that previously reported in sheep and humans. Transport of [14C]acetate into red blood cells was negligible. PMID- 1789418 TI - Radioimmune assay of sialyltransferase and N-acetylgalactosaminyltransferase activities using specific antibodies on a 96-well filtration plate of a multiscreen assay system. AB - A new assay method for glycosphingolipid glycosyl-transferase activities was developed using a 96-well filtration plate of a MultiScreen assay system. An acceptor glycosphingolipid and a donor radioactive nucleotide sugar were incubated with an enzyme source in a well of the filtration plate. After incubation, both identification and quantification of the reaction product were carried out simultaneously using a specific antibody for the product which was trapped on a filtration membrane of the plate as a complex with Staphylococcus aureus protein A (IgGSorb). This assay method was used for determining the activity of cytidine 5'-monophosphate-N-acetylneuraminic acid:Lcn4Cer alpha 2--- 6sialyltransferase and uridine 5'-diphosphate-N-acetyl galactosamine:GM3 N acetylgalactosaminyltransferase. In addition to the simple and rapid identification and quantification of the product, this method proved to be as reliable and sensitive as the previously published assay procedures. Furthermore, this assay method can be used with a high concentration of detergent which should not be used in the other procedures described previously using enzyme-linked immunosorbent assay methods on a 96-well multiplate even if the enzyme reaction might require a certain percentage of the detergent concentration. PMID- 1789419 TI - Comparison of polarographic and chemical measurements of oxygen uptake in complex media: the example of lipoxygenase reaction. AB - A polarographic method using a Clark oxygen electrode was used to assess oxygen concentrations in model and complex media before and during the lipoxygenase catalyzed oxidation of linoleic acid to hydroperoxides. The results were in good agreement with those obtained with the chemical determination of dissolved oxygen. The electrode correctly responded when the dissolved oxygen concentration was decreased by the addition of water activity depressors (sorbitol, sucrose, glucose). The influence of the medium components on the gas solubility was discussed. The linear relationship between partial pressure of oxygen (determined by polarographic method) and the oxygen concentration (determined by chemical method) indicated that the Clark oxygen electrode can be used to study enzyme reactions consuming or evolving oxygen in non-Newtonian media. PMID- 1789420 TI - Synthesis and properties of sulfhydryl-group-specific reagents containing 125I. AB - 125I-containing compounds that react specifically with sulfhydryl groups were prepared in yields of 30 to 40% on the basis of starting 125I quantity. The synthetic precursors were commercially available heterobifunctional crosslinkers and the peptide L-arginyl-L-tyrosine. Two types of sulfhydryl specific reagents were prepared: 3-(2-pyridyldithio)propionylarginyl-[125I]-monoiodotyrosine, which permits reversible incorporation of 125I at sulfhydryl sites, and 3 maleimidopropionylarginyl- [125I]monoiodotyrosine, an irreversible labeling reagent. These products were isolated in a highly radiochemically pure form by C18 HPLC. The second-order rate constants for the reaction of 3-(2 pyridyldithio)propionylarginylmonoiodotyrosine and 3 maleimidopropionylarginylmonoiodotyrosine with N-acetylcysteine were 28 +/- 3 M-1 s-1 and 154 +/- 4 M-1 s-1, respectively, at pH 7.3. Storage of carrier-free 3-(2 pyridyldithio)propionylarginyl-[125I]monoiodotyrosine and 3 maleimidopropionylarginyl-[125I]monoiodotyrosine at -80 degrees C at a radioactive concentration of 0.4 mCi/ml resulted in conversion of 125I to species that did not react covalently with sulfhydryl groups. This process occurred with first-order kinetics and a t1/2 of 5.7 days for the pyridyldithio compound and 7.5 days for the maleimido compound. No conversion was observed during storage at -80 degrees C at radioactive concentrations of 0.02 mCi/ml or less. The labeling properties of these compounds were examined using red blood cell proteins as a test system. 3-(2-Pyridyldithio)propionylarginyl- [125I]monoiodotyrosine and maleimidopropionylarginyl-[125I]monoiodotyrosine reacted preferentially with membrane - associated sulfhydryl groups when incubated with intact red blood cells. PMID- 1789421 TI - Removal of hydroperoxides by immobilized borohydride: a good method for purification of biochemical materials. AB - Borohydride was immobilized on a quaternary ammonium type anion exchange resin, Amberlite IRA-400, by an exchange reaction in N,N-dimethylformamide. The reducing ability of borohydride on the polymer beads was examined; 0.1 g resin was applied for about 30 min to 3 ml solutions of hydrogen peroxide, ethyl hydrogen peroxide, and peracetic acid, at a concentration of approximately 40 mM, m-chloroperbenzoic acid (3.13 mM), and 5-phenyl-4-pentenyl-1-hydroperoxide (1 mM), respectively. The solutions were then assayed for remaining hydroperoxide by use of horseradish peroxidase or prostaglandin H synthase. In addition, the effect of treatment on the ability of 5-phenyl-4-pentenyl-1-hydroperoxide to initiate the cyclooxygenase activity of prostaglandin H synthase was investigated. Results indicated that immobilized borohydride is very efficient in removing hydroperoxides. It can be used in either organic or aqueous media. It is convenient for both large and small scales, particularly important for purification of biochemical materials. PMID- 1789422 TI - Methyl viologen as a preferred electron acceptor in metabolic experiments. AB - Widely used artificial electron acceptors, including dichlorophenol-indophenol, methylene blue, and phenazine ethosulfate, were shown to induce the nonenzymatic decarboxylation of pyruvate. This characteristic rendered these electron acceptors unsuitable for use in metabolic experiments. In contrast, methyl viologen stimulated the pentose phosphate pathway in mouse preimplantation embryos without decarboxylating pyruvate in the process. Furthermore, methyl viologen had no effect on the Embden-Myerhoff pathway and was not overtly toxic to mouse embryos. These features made methyl viologen a preferred artificial electron acceptor for metabolic studies. PMID- 1789423 TI - A comparison of apparent mRNA half-life using kinetic labeling techniques vs decay following administration of transcriptional inhibitors. AB - Several different techniques were used to determine the apparent half-lives of immunoglobulin gamma 2b heavy chain and kappa light chain mRNA's in mouse myeloma 4T001 and a mutant derived from 4T001, i.e., mutant I17. The mutant I17 Ig heavy chain mRNA lacks CH1 and has fused CH2 and CH3 domains resulting in a truncated protein. By all four techniques the Ig heavy chain mRNA from mutant I17 displays a half-life that is approximately 70% the half-life of Ig mRNA in 4T001 cells. However, the absolute values of apparent half-life varied by greater than twofold for both lines among several of the techniques employed. The half-life of Ig gamma 2b mRNA in 4T001 cells was found to be 6.4 h by measuring decay following administration of the adenosine analog DRB to block new mRNA synthesis and 5.7 hr by measuring accumulation in an approach to steady-state labeling protocol. In contrast, the observed Ig mRNA half-lives determined by measuring decay following administration of actinomycin D to block new mRNA synthesis, or in a pulse-chase analysis were 2.9 and 3.8 h, respectively. The apparent half-life for Ig kappa light chain mRNA was the same in the 4T001 and I17 lines using any one technique but the value varied depending on the technique from a high value of 5.9 h following DRB to a low value of 2.4 h with actinomycin decay. Approach to steady state is theoretically the most accurate method to measure mRNA half-life when that value is less than the doubling time of the cells. Pulse-chase analyses are accurate for measuring mRNA half-life when that value is longer than the effective chase period. Measuring preformed message decay following administration of drugs to block new mRNA synthesis is adaptable over a range of half-lives, but the cells must be shown to retain correct RNA metabolism over the time frame of the experiment. Determining a correct half-life for a particular mRNA may not be feasible using only one method and may, in fact, require several different approaches until a consensus value emerges. PMID- 1789424 TI - A membrane blotting method for following the time course of protein radioiodination using Iodobeads. AB - A method for monitoring and optimizing the incorporation of radioiodide into protein is described. The use of immobilized chloramine-T (Iodobeads) combined with timed blots on nitrocellulose forms the basis of an efficient assay system. Results with Iodobeads and with the commonly utilized soluble form of chloramine T are compared. PMID- 1789425 TI - Application of simultaneous determination of 3H, 14C, and 22Na by liquid scintillation counting to the measurement of cellular ion-transport. AB - A liquid scintillation counting method for simultaneous determination of three radioactive nuclides (3H, 14C, and 22Na) of biological interest was studied. By comparing the beta spectra of the three nuclides, their counting energy ranges, A, B, and C, were determined. 22NA was set high enough to avoid any spillover counts from lower-energy nuclides. Region A for 3H was set to maximize the counting efficiency. A good correlation between the counting efficiency for 22Na in region C and the counting efficiency of other nuclides in all regions was obtained. Prior to 3H and 14C dpm calculations, the 22Na counts spilled down in regions A and B were subtracted from the total counts in regions A and B. A simple linear equation was then used to compute 3H and 14C dpm. Findings show that the method presented is adaptable for highly quenched samples up to quenching indices of tSIE = 100. The method is useful for studying the biological transport coupled to Na+. PMID- 1789426 TI - Use of a mutant strain of the cyanobacterium Synechococcus R2 for the determination of nitrate. AB - A sensitive procedure for the determination of nitrate within the 1- to 50-microM range is described. The method is based on the photoreduction of nitrate to nitrite by whole cells of a nitrite reductase-less mutant strain of the unicellular cyanobacterium Synechococcus R2. Cell suspensions of this cyanobacterium retain high levels of nitrate photoreduction activity for at least 2 months when maintained in the presence of dimethyl sulfoxide at -70 degrees C. PMID- 1789427 TI - Collisionally induced dissociation of epoxyeicosatrienoic acids and epoxyeicosatrienoic acid-phospholipid molecular species. AB - Four isomers of epoxyeicosatrienoic acid (EET) can be formed by cytochrome P-450 oxidation of arachidonic acid: 5,6-, 8,9-, 11,12-, and 14,15-epoxyeicosatrienoic acid. The collision-induced dissociation of the [M-H]- anion at m/z 319 from each of these isomers, using negative-ion fast atom bombardment ionization and a triple quadrupole mass spectrometer, resulted in a series of common ions as well as ions characteristic of each isomer. The common ions were m/z 301 [M-H2O]- and 257 [M-(H2O + CO2)]-. Unique ions resulted from cleavages alpha to the epoxide moiety to form either conjugated carbanions or aldehydes. Mechanisms involving charge site transfer are suggested for the origin of these ions. A distonic ion series that may involve a charge-remote fragmentation mechanism was also observed. The epoxyeicosatrienoic acids were also incorporated into cellular phospholipids following incubation of the free acid with murine mast cells in culture. Negative fast atom bombardment mass spectrometry of purified glycerophosphoethanolamine-EET species and glycerophosphocholine-EET species yielded abundant [M-H]- and [M-CH3]- ions, respectively. The collision-induced dissociation of these specific high-mass ions revealed fragment ions characteristic of the epoxyeicosatrienoic acids incorporated (m/z 319, 301, and 257) and the same unique ions as those seen with each isomeric epoxyeicosatrienoic acid. With this direct method of analysis, phospholipids containing the four positional isomers of EET, including the highly labile (5,6 EET), could be identified as unique molecular species in mast cells incubated with EET. PMID- 1789428 TI - Synthesis of N-benzyloxycarbonyl-L-cysteinylglycine 3-dimethylaminopropylamide disulfide: a cheap and convenient new assay for trypanothione reductase. AB - Trypanothione disulfide [N1,N8-bis(glutathionyl)-spermidine], the physiological substrate for the chemotherapeutic target enzyme trypanothione reductase, is difficult to isolate, expensive to buy, and awkward to synthesize. Here we describe the straightforward synthesis of N,N'-bis(benzyloxycarbonyl)-L cysteinylglycyl-3-dimethylaminopropylam ide disulfide, which is shown to be a good alternative substrate for the trypanothione reductases from Crithidia fasciculata and Trypanosoma cruzi. PMID- 1789429 TI - Immunodetection of DNA with biotinylated RNA probes: a study of reactivity of a monoclonal antibody to DNA-RNA hybrids. PMID- 1789430 TI - Conditions for the assay of glutamate semialdehyde aminotransferase that overcome the problem of substrate instability. AB - Investigations into the kinetic properties of glutamate semialdehyde aminotransferase, a key enzyme in the metabolic pathway leading to chlorophyll, are made difficult by the instability of the enzyme's substrate glutamate 1 semialdehyde. The rate of spontaneous disappearance of this compound from solution is shown to vary with the square of its concentration and to be pH dependent. Thus using conditions appropriate to the assay of the enzyme, half of the substrate is lost from solution in a few minutes. Second-order rate constants for the reaction are determined and conditions are selected whereby the effects of the spontaneous reaction are rendered insignificant. The steady-state kinetic properties of the enzyme determined using these conditions are reported. PMID- 1789431 TI - Amplified colorimetric assay of alkaline phosphatase using riboflavin 4' phosphate: a simple method for measuring riboflavin and riboflavin 5'-phosphate. AB - Alkaline phosphatase hydrolyzes riboflavin 4'-phosphate to produce riboflavin. This is converted to riboflavin 5'-phosphate, using riboflavin kinase, which reconstitutes apoglycolate oxidase to give hologlycolate oxidase. This enzyme catalyzes the oxidation of glycolate with simultaneous production of hydrogen peroxide which is detected via the formation of a colored product through the action of peroxidase. The system allows the detection of 4 amol after a 2-h incubation. PMID- 1789432 TI - Determination of thiamin and its phosphate esters in cultured neurons and astrocytes using an ion-pair reversed-phase high-performance liquid chromatographic method. AB - A sensitive method, based on fluorescence detection, for the determination of thiamin derivatives after precolumn derivatization is described. The separation is achieved on a PRP-1 column using ion-pair reversed-phase HPLC. This method is especially well adapted to the detection of thiamin triphosphate in complex mixtures such as tissue extracts. The detection limit for TTP is 50 fmol. The contents of thiamin derivatives were determined in primary cultures of rat cerebellar granule neurons and cerebral astrocytes. The amount of TTP is about five times higher in neurons than in astrocytes. Thus in rat brain TTP seems to be essentially associated with neurons and the intracellular concentration is estimated to be about 0.2 microM. Our results suggest the existence, in nerve cells, of specific regulatory mechanisms not related to the blood-brain barrier and responsible for the maintenance of thiamin homeostasis in brain. PMID- 1789433 TI - Characterization of nuclear matrices prepared without salt extraction. AB - The structure and composition of the nuclear matrices prepared from a mouse mammary adenocarcinoma cell (line 66) by digestion with DNase I and several proteases (PRT-matrices) were characterized by protein and DNA gel electrophoresis, flow cytometry, and scanning electron microscopy. The characteristics of these PRT-matrices were compared with the characteristics of conventionally prepared nuclear matrices that employ a high salt extraction step (HS-matrices) in order to select a preparation that can be used in biochemical and/or biophysical studies where salt extraction compromises either the analysis or the interpretation of the data. Of the characterized PRT-matrices, only those prepared with Type XIV protease (pronase) had most of the characteristics of HS matrices. They, (i) maintained their structural integrity, (ii) had less than or equal to 5% of their nuclear DNA associated with the matrix, (iii) had no evidence of higher-order chromatin structure, and (iv) had a DNA size distribution in the range of 400-1100 bp. The major difference between the PRT matrices and the HS-matrices was a decrease in the protein content of the PRT matrices. Although the PRT-matrices may not be appropriate for studying the unique nuclear matrix associated proteins that are involved in functions such as replication, transcription, and differentiation, they are clearly suitable for studying the properties of the nuclear matrix associated DNA. PMID- 1789434 TI - Preparation of enzyme-conjugated DNA probe and application to the universal probe system. AB - A general procedure for the cross-linking of enzyme to DNA has been developed for use as a nonradioactive probe. In this method, DNA is transaminated with diaminopropane to introduce primary amino groups into the cytosine residues. Then the amino groups are converted to thiol groups using a heterobifunctional cross linker. The thiolated DNA is conjugated with the maleimide-introduced enzyme. With this method, alkaline phosphatase was cross-linked to a single-stranded DNA (sspUCRf1). The conjugate was able to detect 5 pg of target DNA (pUCf1 plasmid, 3.2 kbp) fixed onto the nitrocellulose membrane, using a colorimetric assay. The enzyme-conjugated DNA was applied to "the universal probe system," which consisted of two single-stranded DNA probes (a primary probe and a labeled secondary probe). Using alkaline phosphatase-conjugated sspUCRf1 DNA as the secondary probe, the c-myc gene and HBV DNA were detected effectively on Southern and dot-blot hybridization. PMID- 1789435 TI - Direct analysis of polymerase chain reaction products using enzyme-linked immunosorbent assay techniques. AB - PCR products obtained using primers carrying at their 5' ends biotin and an antigenic group (e.g., fluorescein) can be quantitatively analyzed by immunological techniques. The procedure described here does not require electrophoretic separation and/or hybridization with radioactive probes. It takes advantage of the fact that biotinylated DNA can be immobilized on avidin- or streptavidin-coated microtiter plates and then can be quantitated by an ELISA specific for the antigenic group. The PCR/ELISA procedure is suitable for routine diagnostic purposes and lends itself to automation. The sensitivity of the immunological detection system that employs horseradish peroxidase linked to anti fluorescein antibodies is high: 1 microliter of the PCR mixture obtained after approximately 25 cycles of amplification of 1 ng/microliter genomic template DNA is sufficient for the detection of human single-copy genes. The usefulness of the procedure for the quantitative analysis of the amount of DNA present in a blood or tissue sample is discussed. PMID- 1789436 TI - Amperometric alcohol electrode with extended linearity and reduced interferences. AB - Conventional amperometric alcohol electrodes were constructed with oxygen- and hydrogen peroxide-base sensors and a much improved electrode was designed by placing a hydrophobic, gas-permeable membrane over the conventional hydrogen peroxide-based alcohol electrode. The immobilization of alcohol oxidase with glutaraldehyde was also studied and optimized. The upper linear ranges of the conventional and newly designed alcohol electrodes were 0.02 and 0.5% ethanol, respectively. The hydrophobic membrane of the new design eliminated the classical electrochemical interferences of hydrogen peroxide-based electrodes and the typical pH dependence of enzymatic systems. PMID- 1789437 TI - Electrochemical performance, biocompatibility, and adhesion of new polymer matrices for solid-state ion sensors. AB - Ammonium and potassium ion-selective membranes formulated with PVC/hydroxylated PVC, polyurethane/hydroxylated PVC, and moisture-curable silicone rubber matrices are studied in an effort to extend the lifetime of solid-state ion sensors through improved membrane adhesion. The PVC/membranes exhibit electrochemical performance equivalent to that of conventional PVC membranes in terms of slope, detection limit, and selectivity. The polyurethane- and silicone-rubber-based membranes have better adhesion to silicon nitride than do PVC or hydroxylated PVC matrices. Incorporating a silanizing reagent (silicon tetrachloride) significantly improves the adhesion of the polyurethane matrix. The use of silicon tetrachloride in membrane matrices also enhances the electrochemical stability of the interfacial potential between ion-selective polymer-matrix membranes and silver epoxy inner reference electrodes of solid-state sensors. The biocompatibility of the polymer matrices is examined via radiotracer protein adsorption studies and whole blood clotting time measurements. The polyurethane- and silicone-rubber-based membranes exhibit less overall nonspecific protein adsorption than the PVC or hydroxylated PVC matrices. PMID- 1789438 TI - Principles of stopped-flow sequential injection analysis and its application to the kinetic determination of traces of a proteolytic enzyme. AB - The concept of sequential injection analysis is described, and an application of this novel technique to an assay of traces of a proteolytic enzyme is demonstrated. The automated method is based on a stopped-flow procedure with fluorescence detection. Instead of using the conventional constant flow rate, a sinusoldal flow pattern, as generated by a robust cam-driven piston pump, has been applied. The validation of the novel flow injection system using a nonreactive fluorescent compound yielded highly reproducible results over a concentration range of 3 order of magnitude. The calibration graph for the enzyme activities in the range 5-75 micron mL-1 could be fitted a second-order polynomial. The detection limit is 2.5 micron mL-1, which corresponds to 7.2 ng mL-1 pure active enzyme. PMID- 1789439 TI - Design and in vitro studies of a needle-type glucose sensor for subcutaneous monitoring. AB - A new miniaturized glucose oxidase based needle-type glucose microsensor has been developed for subcutaneous glucose monitoring. The sensor is equivalent in shape and size to a 26-guage needle (0.45-mm o.d.) and can be implanted with ease without any incision. The novel configuration greatly facilitates the deposition of enzyme and polymer films so that sensors with characteristics suitable for in vivo use (upper limit of linear range greater than 15 mM, response time less than 5 min, and sensitivity yielding a 5:1 signal-to-background ratio at normal basal glucose levels) can be prepared in high yield (greater than 60%). The sensor response is largely independent of oxygen tension in the normal physiological range. It also exhibits good selectivity against common interferences except for the exogenous drug acetaminophen. PMID- 1789440 TI - Mass profile monitoring in trace analysis by gas chromatography/mass spectrometry. AB - The advantages of gas chromatography/mass spectrometry (GC/MS) selected-ion monitoring (SIM) in the mass profile (MP) mode at medium mass resolving power were investigated for analyses requiring detection of low-picogram quantities of analytes in complex mixtures. The mass profile monitoring provides a certainty at least 10 times greater than that achieved by conventional GC/MS-SIM in the peak top monitoring mode, and it can be operated at lower mass resolving power to compensate for the loss of sensitivity in the MP mode. The examination of mass profile peak shape, central mass shift, and sequential changes during GC elution not only reveals the presence of interfering compounds but also results in accurate mass measurement for those interferences. The latter feature takes the MP mode beyond the target mass analysis that GC/MS-SIM was originally designed for. This additional dimension of information is particularly useful for those complex and incompletely characterized matrices that are frequently encountered in environmental and biological sample analyses. PMID- 1789441 TI - Electrospray and tandem mass spectrometric characterization of acylglycerol mixtures that are dissolved in nonpolar solvents. AB - This paper presents electrospray mass spectrometric analysis of mixtures containing monoglycerides, diglycerides, and triglycerides. Sample compounds were dissolved in concentrations of 1-50 pmol/microL in chloroform:methanol (70:30, v:v), which was modified by the addition of alkall-metal or ammonium salts or by addition of formic acid to favor the addition of a cationic species to the sample molecules. Electrospray mass spectrometric analysis of acylglycerol standards yielded positive-ion current signals for (M + Na)+ or (M + NH4)+ of all the species that were present at low picomole per microliter concentrations with no fragmentation. For equimolar concentrations of these sample compounds, there was a general decrease in ion current response as the analyte polarity decreased. Therefore, acylglycerols that contained unsaturated fatty acid chains were observed to exhibit a response in the mass spectrum greater than those with saturated chains, and ion signals resulting from the molecular adduct ions of monoglycerides were more abundant than those of diglycerides, which were more abundant than those of triglycerides in the mass spectrum. Electrospray mass spectrometric analysis of an unknown lipid material recovered from a mammalian cell culture reactor revealed a mixture of triglycerides containing mostly C14, C16, and C18 fatty acids with varying degrees of unsaturation. The results obtained by electrospray mass spectrometry compared favorably to those obtained by gas chromatography after saponification and methylation of fatty acid components of the triglycerides. MS/MS fragmentation of sodiated acylglycerols required a dissociation energy significantly greater than that required for fragmentation of ammoniated acylglycerols, so MS/MS characterization of acylglycerols was generally performed on the ammoniated compounds.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789442 TI - Electrospray ionization mass spectrometry of semduramicin and other polyether ionophores. AB - Pneumatically assisted electrospray mass spectrometry of polyether ionophores yields several molecular ions. A single metal adduct molecular ion can be obtained by the addition of a neutral salt to the HPLC mobile phase. This approach may be useful in structural studies of unknown ionophores and in the development of specific methods for their analysis in complex matrices. Collision induced dissociation of the molecular ions provides additional structural information and enhanced specificity for trace analysis. HPLC mobile-phase composition and flow rates have been optimized for on-line analysis. Best response and lowest background noise were obtained at the flow rate of 40 microL/min of a mobile phase containing a 20/80 mixture of water and acetonitrile. The development of a specific confirmatory assay for the new ionophore semduramicin in chicken liver demonstrates the usefulness of on-line HPLC pneumatically assisted electrospray mass spectrometry. PMID- 1789443 TI - Micellar electrokinetic capillary chromatography of acidic solutes: migration behavior and optimization strategies. AB - Micellar electrokinetic capillary chromatography (MECC) is suitable for the separation of mixtures of uncharged and charged solutes. In this paper, the migration behavior of acidic compounds in MECC is quantitatively described in terms of different models. These equations describe the relationships between the two migration parameters in MECC (retention factor and mobility) and the two important experimental parameters (pH and micelle concentration) that have a great influence on the migration behavior and selectivity. Interestingly, the mobility and retention factor of a given solute could behave differently with the variations in pH. This would raise a question of which parameter actually represents the migration behavior of a solute in MECC: retention factor (a chromatographic parameter) or mobility (an electrophoretic parameter). The consequences of micellar-mediated shifts of ionization constants on selectivity and optimization strategies in MECC are discussed. The mathematical models would allow the prediction of migration behavior of solutes based on a limited number of initial experiments. This would greatly facilitate the method development and optimization of separations of ionizable compounds by MECC and, in addition, important physical and chemical characteristics of solutes such as their apparent ionization constants in micellar media and their partition coefficients into micelles (over a wide range pH values) can be determined. The models were verified, as good agreements were observed between the predicted and the experimentally observed migration behavior. Based on the preliminary results, the pH and micelle concentration are likely to be interactive parameters in many situations. As a result, simultaneous optimization of these two parameters would be the most effective strategy to enhance the MECC separation of acidic solutes. PMID- 1789444 TI - Theory for electrostatic interaction chromatography of proteins. AB - A simple theoretical framework for the effect of the eluting salt concentration on the retention factor of proteins in ion-exchange chromatography under conditions of linear elution is described. It is based on the solution of the linearized Poisson-Boltzmann equation for two oppositely charged planar surfaces in contact with a salt solution. The theory predicts a linear relation between the logarithmic retention factor and the reciprocal square root of the ionic strength of the eluent in the salt concentration range used in linear elution chromatography. A large body of retention data obtained in ion-exchange chromatography of proteins over a wide range of experimental conditions was plotted as ln k' vs 1/square root of I, where k' and I are the retention factor and ionic strength, respectively. The plots are linear or nearly so, as predicted for a moderate salt concentration range by the theory. From the slope of such plots the characteristic charges of the proteins were estimated by using only fundamental physicochemical constants. The chromatographically measured protein charges compare well to those obtained from titrimetric experiments at the same pH, although certain deviations are noted. The theoretical approach presented here offers a more realistic treatment of the ion-exchange chromatography of proteins than the stoichiometric displacement model and can serve as a convenient framework for the analysis of retention data. PMID- 1789445 TI - Capillary isotachophoresis with concentration gradient detection. PMID- 1789446 TI - Temperature control of liquid chromatographic columns and enzyme reactors by using a proportional-integral-differential regulator in conjunction with a thermoelectric element. PMID- 1789447 TI - Matrix-assisted laser desorption/ionization mass spectrometry of biopolymers. PMID- 1789448 TI - Integration of mass spectrometry in analytical biotechnology. AB - Mass spectrometry (MS) has become an indispensable tool for peptide and protein structure analysis because of three unique capabilities that enable it to be used to solve structural problems not easily handled by conventional techniques. First, MS is able to provide accurate molecular weight information on low picomole amounts of peptides and proteins independent of covalent modifications that may be present. Second, this information is obtainable for peptides present in complex mixtures such as those that result from a proteolytic digest of a protein. Third, by using tandem MS, partial to complete sequence information may be obtained for peptides containing up to 25 amino acid residues, even if the peptides are present in mixtures. Sensitivity and speed of the MS-based approaches now equal (and in some cases exceed) that of Edman-based sequence analysis. In this perspective we discuss how MS, tandem high-performance MS, and on-line liquid chromatography/MS using fast atom bombardment or electrospray ionization have been integrated with more conventional techniques in order to increase the accuracy and speed of peptide and protein structure characterization. The expanding role of matrix-assisted laser desorption MS in protein analysis is also described. The unique niche that MS occupies for locating and structurally characterizing posttranslational modifications of proteins is emphasized. Examples chosen from the authors' laboratory illustrate how MS is used to sequence blocked proteins, define N- and C-terminal sequence heterogeneity, locate and correct errors in DNA- and cDNA-deduced protein sequences, identify sites of deamidation, isoaspartyl formation, phosphorylation, oxidation, disulfide bond formation, and glycosylation, and define the structural class of carbohydrate at specific attachment sites in glycoproteins. PMID- 1789449 TI - Three DNA sequencing methods using capillary gel electrophoresis and laser induced fluorescence. AB - Capillary gel electrophoresis is demonstrated for the four-spectral-channel sequencing technique of Smith, the two-spectral-channel sequencing technique of Prober, and the one-spectral-channel sequencing technique of Richardson and Tabor. Sequencing rates up to 1000 bases/h are obtained at electric field strengths of 465 V/cm. At lower electric field strengths, capillary electrophoresis produces useful data for fragments greater than 550 nucleotides in length with 2 times better resolution than slab gel electrophoresis. An on column detector produces detection limits of 200 zmol (1 zmol = 10(-21) mol = 600 molecules) for the four-spectral-channel technique. A postcolumn detector, based on the sheath flow cuvette, produces detection limits of 20 and 2 zmol for the two- and one-spectral-channel techniques, respectively. PMID- 1789450 TI - Direct interfacing of high-speed countercurrent chromatography to frit electron ionization, chemical ionization, and fast atom bombardment mass spectrometry. AB - Direct interfacing of analytical high-speed countercurrent chromatography (HSCCC) to mass spectrometry (MS) was demonstrated for the first time, and its performance was evaluated in terms of chromatography and mass spectrometry. HSCCC/MS interface was based upon Frit electron ionization (EI), chemical ionization (CI), and fast atom bombardment (FAB). Separations were conducted by newly developed HSCCC-4000 with a 2.5-cm revolutional radius and 0.3 mm or 0.55 mm i.d. multilayer coiled column which is capable of operating at a maximum speed of 4000 rpm. To demonstrate the potential capability of HSCCC/frit MS, three indole auxin mixtures, two mycinamicin (macrolide antibiotics) mixtures, and a colistin complex (peptide antibiotics) were analyzed under HSCCC/frit EI, CI, and FABMS conditions, respectively. The data obtained indicated that interfacing to frit/MS does not adversely affect the chromatographic resolution and mass spectra provide structural information. The HSCCC system interfaced with a frit-equipped mass spectrometer will offer a new dimension in the separation of biologically important substances. PMID- 1789451 TI - Analysis of illicit drugs in human urine by micellar electrokinetic capillary chromatography with on-column fast scanning polychrome absorption detection. AB - Using micellar electrokinetic capillary chromatography (MECC) with a borate/phosphate buffer containing 75 mM SDS (pH 9.1), common drugs of abuse and/or their metabolites, including opioids, benzoylecgonine, amphetamines, and methaqualone, can easily be analyzed. After solid-phase extraction of 5 mL of urine, drug concentrations down to about 100 ng/mL can be unambiguously monitored with on-column multiwavelength detection. Peak assignment is achieved through comparison of retention times and absorption spectra of eluting peaks with those of computer-stored model runs. The effectiveness of the approach is demonstrated with data obtained from different patient urines which tested positively for one or several drugs using nonisotopic immunoassays. Results suggest that MECC of illicit drugs is a highly specific and sensitive instrumental approach suitable for confirmation testing following a positive response of a toxicological screening procedure. PMID- 1789452 TI - Characterization of the tryptic map of recombinant DNA derived tissue plasminogen activator by high-performance liquid chromatography-electrospray ionization mass spectrometry. AB - A detailed tryptic map is presented for recombinant human tissue plasminogen activator (rt-PA). Electrospray ionization mass spectrometry is utilized as an on line HPLC detector for tryptic mapping of this glycoprotein. The additional dimension provided by mass spectrometry gives considerably more detail about the complex tryptic map and significantly enhances the high-resolution chromatographic separation by distinguishing by mass any coeluting components. Through this improvement, the proline isomers of a tryptic peptide were observed eluting over a broad range of retention times. The glycopeptides of rt-PA are observed as well as any corresponding nonglycosylated peptides. In addition, the carbohydrate heterogeneity is readily observed, allowing analysis of the carbohydrate composition. The characteristic diagonal patterns formed by glycopeptides in a contour plot of the data allow rapid recognition of the glycopeptides. PMID- 1789453 TI - Determination of the relative amounts of free and complexed manganese ions in aqueous solution by nuclear magnetic resonance. AB - The ratio of the transverse relaxation rate to the longitudinal relaxation rate of water protons (T1/T2) at 90 MHz can be used to determine the relative amounts of free Mn2+ ions (the hexaquo ion) and chelated manganese ions when both species are present in the same aqueous solution. This technique is demonstrated for simple aqueous solutions containing known concentrations of both the free Mn2+ ion and a manganese(III) porphyrin. The accuracy of the method is found to be +/- 7.3% for the solutions considered in this report. The determinations of the relative amounts of the free Mn2+ ion and the manganese(III) porphyrin by this T1/T2 method are shown to agree well with those determined by nuclear magnetic resonance dispersion profiles. The theoretical basis of this ratio method as well as the scope and limitations in its application to aqueous solutions containing both free Mn2+ ions and chelated manganese species other than manganese(III) porphyrins are also discussed. This work demonstrates a unique use of NMR as a means for the quantitative analysis of manganese in which the effects of the metal ion on the solvent, and not the metal itself, are observed. PMID- 1789454 TI - Direct measure of the low-density fractions of serum cholesterol. AB - Data on total cholesterol (TC) and its distribution among the three solubilizing lipid fractions in human serum have been obtained from three independent laboratories, and binary linear correlations between TC and each of the various fractions are compared. Two sources used the approved double-enzymatic multistep Allain-Trinder reaction with absorption detection. In the third method, which is entirely new, a nonenzymatic chromogenic reaction and circular dichroism (CD) detection were used. TC results from all three sources are in excellent agreement. HDL-C values measured by both enzymatic methods also agree in their correlations with TC but these are quite different from the correlation observed between HDL-C and TC values obtained by the new nonenzymatic procedure. Reasons are given which suggest that the nonenzymatic method is more accurate for the measurement of the low-density lipid fractions and why health risk determinations that are based upon calculated values for this variable should be deemphasized until a more dependable procedure is approved for use. PMID- 1789455 TI - Enzyme-modified organic conducting salt microelectrode. AB - A miniaturized enzyme-modified electrode has been constructed and evaluated. The tip of a capillary-encased, carbon-fiber electrode is recessed, and tetrathiafulvalene-tetracyanoquinodimethane crystals are electrochemically deposited in the recessed tip. Flavoenzymes are placed in the recess by cross linking with glutaraldehyde. The specific enzymes used are glucose oxidase to form a microbiosensor for glucose, and a combination of acetylcholine esterase and choline oxidase to form a microbiosensor for acetylcholine. The sensor is operated in an amperometric mode with Eapp = 150 mV versus a sodium saturated calomel electrode, and the response appears to be limited by the kinetics of the enzyme reaction. The effective maximum current density for the glucose electrode is greater than 600 microA/cm2. At low concentrations of glucose, oxygen provides a significant interference by attenuating the signal. The device is simple to prepare and has a rapid response time. Interference from ascorbate has been significantly reduced by the design and by addition of a layer of ascorbate oxidase. Although not yet suitable for use in tissue, the biosensors are suitable for detection in situations where oxygen concentrations do not frequently change. PMID- 1789456 TI - Strategies for low detection limit measurements with cyclic voltammetry. AB - Cyclic voltammetry of Nafion-coated, carbon-fiber electrodes is used to detect trace concentrations of dopamine, both in a flow injection apparatus and in the brain of an anaesthetized rat. To improve signal-to-noise ratios, the sources of noise during cyclic voltammetry have been determined and strategies have been developed to decrease the noise. With the potentiostat employed, the measured noise is comparable to that expected for Johnson noise from the feedback resistor of the current transducer. Additional noise arises from the waveform generator employed and, in some cases, line noise. Line noise is discriminated against by starting each cyclic voltammogram either in phase or 180 degrees out of phase with the line frequency. When used in vivo, additional noise also arises from the physiological activity of the animal. Detection limits are found to closely correspond to those predicted on the basis of simulation of the voltammetric shape and the measured noise. Detection limits are improved by the use of appropriate analog and digital filtering, ensemble averaging, and appropriate timing of repetitive cyclic voltammograms. The combined use of these techniques enables the in vivo detection of approximately 100 nM of dopamine with a signal to-noise ratio of 25. PMID- 1789457 TI - Determination of trace iodine in food and biological samples by cathodic stripping voltammetry. AB - This paper describes a sensitive and selective method for the determination of iodine in food and biological samples. The method involves treatment of samples by combustion in an oxygen flask and determination of iodide by cathodic stripping voltammetry of the solid phase formed with the quaternary ammonium salt Zephiramine as the ionic associating agent; Br- is used as the complexing agent in the preconcentration process. We have studied the effect of concentration of Zephiramine, Br-, I-, and some other elements presented, deposition potential, preelectrolysis time, and scan rate, on the stripping curve shape and maximum stripping current. Determinations of trace iodine in table salt, laver, and eggs were demonstrated as practical examples. PMID- 1789458 TI - Gas chromatography/electron capture negative-ion mass spectrometry at the zeptomole level. PMID- 1789459 TI - Immunocomplex-immobilization technique. AB - An immunoassay technique is presented, which works equally well with either a radioactive isotope or an enzyme as the label. It is based on the competition between a labelled antigen of known concentration and an unlabelled antigen (concentration to be determined) for binding to an antibody, which previously has been thiolated by the heterobifunctional reagent N-[3-(2 pyridyldithio)propionyl]succinamide [marketed as N-succinimidyl-3-(2 pyridyldithio)propionate; SPDP)]. The soluble immunocomplex formed is then immobilized onto agarose beads containing reactive disulphide groups. After washing, to remove any unbound and non-specifically adsorbed material, the radioactivity or the enzymic activity on the agarose beads is determined and the concentration of the antigen in the test sample calculated according to the conventional procedure for a competitive immunoassay. In order to demonstrate the applicability of the technique a test procedure for the determination of total serum immunoglobulin E is presented. PMID- 1789460 TI - Immobilized-enzyme electrode for nicotinamide adenine dinucleotide (reduced form) (NADH) sensing and application to the kinetic studies of NADH dependent dehydrogenases. AB - Amperometric determination of nicotinamide adenine dinucleotide (reduced form) (NADH) at an immobilized-diaphorase (Dp) electrode is described. The measurement was conducted using ferrocenylmethanol as a mediator in a stirred solution at 0.20 V versus a saturated calomel electrode. A linear relationship between the steady-state current and the concentration of NADH was found over the range 0.005 0.125 mmol dm-3. The immobilized-Dp electrode showed outstanding stability and the current response reached a steady state within 2-3 seconds upon addition of NADH. The proposed electrode was used to follow the reactions of pig heart lactate dehydrogenase and horse liver alcohol dehydrogenase. The kinetic investigation using the immobilized-Dp electrode gave the kinetic parameters (Michaelis constants, Km values, and maximum velocities, Vm values), which were in satisfactory agreement with those determined by a conventional spectrophotometric method. PMID- 1789461 TI - Voltammetric behaviour of salicylic acid at a glassy carbon electrode and its determination in serum using liquid chromatography with amperometric detection. AB - Cyclic voltammetry was used to investigate the oxidation of salicylic acid at a planar glassy carbon electrode. The electrode reaction was found to be dependent on the pH and ionic strength of the acetate buffer, which contained 35% methanol. Under these conditions the maximum electrochemical signal was obtained with a supporting electrolyte of 0.06 mol dm-3 acetate buffer in 35% methanol (pH 5.0). The peak current value (ip) increased by approximately 10% when the methanol concentration was decreased to 8%. The substance was found to undergo an irreversible reaction involving one electron and possibly two protons in the initial oxidation step with at least one possible quasi-reversible follow-up reaction. The optimum mobile phase for the liquid chromatography, with amperometric detection, of the serum extracts was found to be 0.06 mol dm-3 acetate buffer in 8% methanol (pH 5.0); the acidified serum was extracted with a mixture of chloroform and acetonitrile (60 + 40), prior to injection onto a reversed-phase column. The peak current was measured at +1.35 V and the calibration graph was found to be linear in the range 4-200 ng of sample injected. The average recovery from serum was found to be 60% with a relative standard deviation of 5.8%. A pharmacokinetic study was carried out and the results obtained were comparable to those found in the literature. It was concluded that the method developed had possible application for the measurement of trace levels of salicylic acid in clinical studies. PMID- 1789462 TI - Improvement on the microdiffusion technique for the determination of ionic and ionizable fluoride in cows' milk. AB - Different microdiffusion techniques for the determination of ionic and ionizable fluoride in milk have been evaluated for measurement with a fluoride-selective sensor. This work culminated in a modified version of the hexamethyldisiloxane acid diffusion technique where an increased amount of perchloric acid and sodium hydroxide seemed to be a prerequisite for accurate and precise results. The configuration of the fluoride-selective electrode was also modified by using an adapted microanalytical procedure to determine fluoride in small volumes (50 microliters each) and to avoid contamination between successive milk samples. The resultant procedure is free of interferences and is capable of measuring fluoride in milk at concentrations from 0.02 to 10.00 mg dm-3 with improved accuracy and precision compared with earlier work. PMID- 1789463 TI - Indomethacin ion-selective electrode based on a bis(triphenylphosphoranylidene)ammonium-indomethacin complex. AB - The properties of an ion-selective electrode for indomethacin based on the bis(triphenylphosphoranylidene)ammonium-indomethacin ion-pair complex in a poly(vinyl chloride) membrane are described. The detection limit found for indomethacin at pH 7.0 was 2 x 10(-5) mol l-1 (6.4 micrograms ml-1) and the linear range was determined to be between 5 x 10(-5) and greater than or equal to 10(-3) mol l-1. The selectivity coefficients observed for organic anions of different lipophilicity were 10(-1.1) for naproxenate, 10(-0.75) for salicylate and less than 10(-4) for tartrate. Cationic organic and inorganic ions showed negligible interference with selectivity coefficients of less than 10(-4). A strong electrode response was observed for the inorganic anions IO4-, ClO4- and SCN- with selectivity coefficients of up to 10(+0.9). Very low detection limits, e.g., 6 x 10(-7) mol l-1 (60 ng ml-1) for ClO4- were found. The selectivity for inorganic anions was close to the Hofmeister series. PMID- 1789464 TI - Determination of the insecticide promecarb by fluorogenic labelling with dansyl chloride. AB - The use of spectrofluorimetry to determine the fluorescent derivative of the insecticide promecarb, following hydrolysis to the corresponding phenol in basic media and subsequent coupling with the labelling agent dansyl chloride, is described and discussed. A study of media of different basicity and of different temperatures for both reactions gave optimum conditions of 20 min for the hydrolysis reaction and 10 min for the labelling reaction at 55 degrees C in 0.05 mol dm-3 sodium hydrogen carbonate solution with a reagent to insecticide ratio of 12:1. The effect of the solvent on the formation of the dansyl derivative and on the extraction process was studied using nine and seven solvents, respectively. The use of a mixture of acetone and water (50 + 50, v/v) and an extraction into cyclohexane gave the best results. The minimum detectable concentration of promecarb in the experimental assays was 100 ng ml-1. The error and relative standard deviation at a concentration level of 0.6 micrograms ml-1 were 9.7 and 10.9%, respectively. Air samples containing promecarb at different concentration levels were analysed. PMID- 1789465 TI - Determination of epinephrine, norepinephrine, dopamine and L-dopa in pharmaceuticals by a photokinetic method. AB - A study of the photochemical reaction of the Rose Bengal (RB) ethylenediaminetetraacetic acid system in the presence of epinephrine, norepinephrine, dopamine and L-dopa is presented. The rate of photoreduction of RB is dramatically retarded by small amounts of these catecholamines, which have an inhibitory effect on the excited state of RB, which is the activator of the process. Optimum conditions for the determination of catecholamines in the range of concentration between 5 x 10(-6) and 1 x 10(-4) mol dm-3 are described. The proposed method has been applied with excellent results to the determination of catecholamines in pharmaceuticals. PMID- 1789466 TI - Selective spectrophotometric method for the determination of ascorbic acid in pharmaceutical preparations and fresh fruit juices. PMID- 1789467 TI - Colorimetric method for the determination of captafol (difolatan) in commercial formulations and residues on grains and apples. AB - A simple and rapid colorimetric method for the microdetermination of captafol (difolatan), based on its reaction with a dithiocarbamate, has been developed. The bright yellow colour which develops instantaneously on mixing the fungicide with the reagent is stable for at least 12 h. The method has been successfully adapted to the determination of captafol in its formulated products and residues on grains and apples. PMID- 1789468 TI - Classification of human maxillar sinuses according to their geometric features. AB - 119 casts of maxillary sinuses have been taken out of 60 dry skulls. In these specimens, the volume V, the area of the basal (i.e. corresponding to the nasal cavity) surface S and the height h have been measured. The sinuses are subsequently arranged into 4 classes, according to their similarity to solids of revolution such as: semi-ellipsoid (class a: 15% of specimens); paraboloid (class b: 30%); hyperboloid (class c: 47%) and cone (class d: 8%). As criterion for this classification, the value of the coefficient K, equal to v/Sh has served. Beyond the eventual anatomical and anthropological interest of this classification, a clinical interest may exist in combination with Computed Tomography or eventually with Echography. The asymmetry that exists between maxillary sinuses (56% of our sample comprises pairs of sinuses arranged in different classes) suggests the eventual necessity of separate radiography of each individual sinus. PMID- 1789469 TI - Elements of a general theory of joints. 5. Basic mechanics of the knee. AB - In the sagittal plane the interplay of the knee joints, the patellofemoral and the tibiofemoral joint, are depicted as a closed kinematic chain consisting of 3 dimeric link chains. Kinematically the system is without constraint and possesses 3 (abstract) degrees of freedom. Only the application of external forces fixes the single dimeric link chains in mechanically stable positions and thus determines the momentary functional state of the knee. Without external loads the single links can snarl up like those of a bike's chain. The crucial ligaments play a minor role for knee bending. A qualitative analysis of the force distribution within the knee is presented. In the frontal plane the tibiofemoral joint represents a linkquadrangle with positive drive (one abstract degree of freedom) which also becomes mechanically stable by external compressive forces. PMID- 1789470 TI - [An unusual canal in the apical part of a petrous bone--an emissary canal for the superior petrosus sinus?]. AB - A bone canal was found in the apical part of a Pars petrosa, connecting the Sinus petrosus superior and the "Foramen petrobasilare", which is a Foramen emissarium of the Sinus petrosus inferior. This canal was interpreted as a Canalis emissarius of the Sinus petrosus superior. PMID- 1789471 TI - Human eccrine sweat glands--a histochemical approach. AB - Histogenesis of eccrine sweat glands is incompletely understood. Histochemistry of the human eccrine sweat gland of adult skin by the use of lectins as well as antibodies to neuroglandular antigen (NGA) and urokinase was in favour of a relative independent differentiation from interfollicular epidermis. Expression of NGA by sweat glands is a feature unique among skin appendages. The possible impact of our findings for sweat gland histogenesis is briefly discussed. PMID- 1789472 TI - [Simplification of the production of plastination histologic preparations through the use of a grinding machine]. AB - A new histological method basing on the plastination technique (v. Hagens, Tiedemann, Kriz 1987) has recently been developed and applied to research in human fetal development. This plastination histology shows some evident advantages compared with the classical histological techniques. As the application of this new method has been very time consuming up to now, only some special questions of basic research have been investigated. We here present the use of a grinding-machine, which can be used to partially mechanize the procedure of plastination histology. PMID- 1789473 TI - Os penis of the rat. VI. Scanning electron microscopy of the surfaces of the mature bone. AB - Observations on the ultrastructural appearance of the surfaces of the mature os penis in the rat reveal that a majority of its surfaces may be classified as prolonged resting surfaces on very slow growing surfaces. Although a vast majority of the bone consists of bone tissue types which usually only form a small part of human and laboratory animal bones, their surface appearances resemble to a high degree surface appearances described for ordinary bone tissue types. Thus, surface morphology need not reflect tissue type variance. However, certain minor deviations from usual descriptions of surface appearances were observed. Such deviations are for instance the combination of partly mineralized fiber bundles and a fully mineralized amorphous ground substance on some of the observed surfaces. The combination may be a result of an extremely slow growth or a lost ability of the ageing bone forming cell to produce organized tissue. PMID- 1789474 TI - Effects of autonomic nerve stimulation on the secretory products of the dog submandibular gland. AB - Dog submandibular gland cells store mucins and secretory protein in their secretory granules for the purpose of export. The secretion of these products is under the influence of autonomic innervation to the gland. Acinar cell products are influenced by the parasympathetic division whereas the duct cell secretory proteins are influenced by the sympathetic division of the autonomic nervous system. Demilune cell secretory products are influenced by both divisions of the autonomic nervous system. PMID- 1789475 TI - [Intraoperative monitoring of the EEG in patients with arterial aneurysms of the cerebral vessels]. AB - Visual EEG monitoring and EEG monitoring using a special "Neuro-2" monitor controlling the changes in quantitative EEG parameters (power range and coherence) have been used during surgery in 42 patients with arterial aneurysms of brain vessels performed in conditions of profound controlled arterial hypotension. Computer processing facilitates EEG analysis and reveals the most early signs of the developing cerebral ischemia on the basis of specific changes in power ranges and coherence. PMID- 1789476 TI - [The risk of neurological complications following aortocoronary bypass in patients with multifocal atherosclerosis]. AB - Since January 1988 till June 1990 145 patients with combined coronary and vascular pathology have been operated on. Concomitant damage of aortic arch branches was observed in 54 patients (37.2%), and aortocoronary bypass surgery was performed in 40 patients without correction of the carotid vascular bed pathology. These patients comprised the basic group, which was divided into two subgroups depending on the clinical pattern of the disease: subgroup I--18 asymptomatic patients (45.0%), subgroup II--22 patients (55.0%) with clinical signs of the disease. The basic group comprised 257 patients with CHD alone and no damages of the aortic arch branches. In the postoperative period 10 out of 40 patients of the basic group developed neurological complications: brain hypoxia, delirious syndrome (3 patients); brain hypoxia, pre-comatose condition (3 patients); brain hypoxia, comatose condition (2 patients); transitory ischemic attack (2 patients). No significant differences in the development of complications have been observed in patients of both subgroups. In the control group neurological complications developed in 9 out of 257 patients (3.5%). The comparison of reasons responsible for the onset of complications in both groups has shown that acute heart failure was significantly predominant (10%) in the basic group, as compared to control group (1.9%). It has been concluded that after aortocoronary bypass surgery the risk of neurological complications was higher in patients with the accompanying damage of the aortic arch branches than in patients with CHD alone; the onset of acute heart failure in the early postoperative period increases the risk of neurological complications in such patients. PMID- 1789477 TI - [Central hemodynamics and hormonal homeostasis during surgical stress in young patients with different levels of physical preparation]. AB - Twenty-two patients, aged 16 to 35 years who were to be operated on for varicocele have been examined. It has been established that the degree of shifts in hormonal homeostasis and central hemodynamics depends on the baseline level of physical training. Analysis of central hemodynamic response to operation stress has shown that the prognosis of favourable operation stress tolerance was observed in well trained patients or in those poorly trained without hyperkinetic hemodynamic reaction 1 day before surgery. The above data make it possible to predict the nature of reactions in response to the operation stress by the level of circulation function activation 1 day before surgery. PMID- 1789478 TI - [Potentialities of ATP in sustaining the function of the myocardium]. AB - The effect of ATP on the functional capacities of the isolated heart has been assessed. It has been shown that the drug at a concentration of 24 x 10(-6) M improves myocardial contractility and increases coronary flow volumetric rate. Favourable ATP effects manifested right after its administration into the circulating solution in improvement of all the physiological parameters, but were unstable. Nevertheless, the presence of ATP in the perfusate ensured high functional reserve and guaranteed stability of the isolated heart performance over 60-min observation period. The paper reviews the prospects of exogenous ATP application in cardiosurgical patients and outlines problems of drug administration techniques, as well as possible difficulties of its clinical use. PMID- 1789479 TI - [Metabolic shifts and gas exchange during the working of artificial heart ventricles]. AB - Complete cardiac bypass has been performed in the experiments on 21 random-bred dogs under thiopental-ketamine anesthesia using artificial heart ventricles (AHV), "Kedr" type. In 9 dogs 15 hours after AHV insertion their output was increased by half, as compared to baseline cardiac output values; in the rest of animals AHV worked in the regimen of normal perfusion. The study of acid-base balance parameters has revealed that AHV functioning in the regimen of normal perfusion for 2.5 hours leads to the development of moderate decompensated metabolic acidosis, the degree of which depends on the duration of AHV functioning. Changes in arterial and venous blood pO2 in long-term AHV functioning is indicative of blood flow activation in arteriovenous shunts. Blood flow increase during the first 15-20 min is accompanied by the improvement of blood oxygenation and stabilization of the acid-base balance parameters. AHV functioning in hyperperfusion regimen for 1 hour leads to deterioration of ventilation-perfusion pulmonary ratio and the onset of hypoxemia. PMID- 1789480 TI - [Principles of optimization of infusion therapy in critical conditions]. AB - Hemodynamic and pulmonary gas exchange reactions to albumin test were different in 45 critical patients. Four types of reactions to albumin test have been identified and formed the basis for selection of the infusion therapy. In type 1 colloid-osmotic plasma pressure and pulmonary wedge pressure increased, in type 1B there was a critical increase in pulmonary wedge pressure; in type 2 colloid osmotic pressure always decreased, and in type 2A this decrease was accompanied by a drop in arterial blood pO2. It may be assumed that in patients from group 1 albumin is retained in the vascular bed and thus the protein permeability function of the pulmonary vessels endothelium is not damaged. Colloid-osmotic pressure lowering in patients from group 2 is indicative of increased vascular permeability for protein molecules, which can be combined with lymphatic drainage inhibition in the lung interstitium (type 2B). It is obvious that transfusion of colloid solutions is not indicated in type 2 reactions to albumin test, while in type 1 such transfusions may have a favourable effect on hemodynamics and pulmonary gas exchange. PMID- 1789481 TI - [Characteristics of the pain sensitivity in patients with accompanying allergic diseases prior to stomatologic surgery]. AB - The studies were performed on 161 patients with allergosis, aged 18 to 60 years. The severity of allergosis was the most significant clinical sign affecting the pain sensitivity of the patients under study. All the patients with allergoses were characterized by a higher psychoemotional response to pain stimuli than patients without the accompanying pathology. The patients with severe clinical signs of allergosis in history were characterized by hyperalgesia, while those with moderate allergosis were characterized by hypoalgesia. In patients with severe allergosis afferent signals processing in the central nervous system was disturbed. The differences in pain sensitivity in two groups of patients suggest different approaches to the selection of analgesia technique. PMID- 1789482 TI - [The use of moradol for optimizing the recovery from neuroleptanesthesia]. AB - The study has been performed right after surgery in 20 patients of the test group (subgroups I and II) and 20 control patients. Surgery for urologic cancer has been performed in all the patients by transabdominal approach using general anesthesia based on neuroleptanesthesia (NLA). It has been shown that in patients with hypoventilation moradol, administered intravenously at a dose of 1 mg, restores adequate respiration and gas exchange. Patients with apnea upon administration of 1 mg moradol recovered respiration in hypoventilation regimen. Repeated injection of 1 mg moradol promoted the recovery of adequate respiration and gas exchange in all the patients. The patients of the test group were extubated 12.4 +/- 0.1 min on an average after the operation. Control patients, who had not been administered moradol, were extubated 20.4 +/- 0.7 min on an average after the operation. It is shown that the use of moradol in patients after NLA leads to a drastic decrease in the incidence and degree of postoperative pain syndrome and postanesthesia chill. PMID- 1789483 TI - [Infusion therapy tactics during prolonged reconstructive and plastic surgery using microsurgical techniques]. AB - The impact of various infusion therapy techniques has been studied in 166 patients during microsurgery for posttraumatic tissue defects. It has been established that the achievement of hypervolemic hemodilution is accompanied by the damage of water-electrolyte homeostasis and peripheral circulation during the operation and on the first postoperative day. Normovolemic hemodilution makes it possible to prevent the above disturbances and optimize peripheral blood flow in case the infusion programme is compiled adequately with an obligatory introduction of blood plasma preparations. PMID- 1789484 TI - [Methodology of regional blood stabilization with sodium citrate during hemosorption and the first experience of its clinical application]. AB - The method of blood stabilization using sodium citrate ("Glugicir") has been elaborated. The experimental hemosorptions (HS) have shown that reliable blood stabilization in extracorporeal sorption contour was achieved with Glugicir/blood ratio 1 to 10, no considerable changes in the basic clearance characteristics of the sorbents have been observed. The method elaborated was used in 135 HS sessions performed in 100 patients. It has been shown that sodium citrate causes no changes in the patients' hemostasis. The method of regional blood stabilization with sodium citrate may be recommended for HS in patients with bleeding or high risk of its development. Mild symptoms of citrate intoxication (3.7%) were associated with technical inaccuracy and were easily eliminated either by discontinuation of excessive Glugicir introduction into the contour or by intravenous injection of calcium salts. PMID- 1789485 TI - [The effect of non-inhalation anesthetics on the function of automatism and conductivity of the heart in patients with the sick sinus syndrome]. PMID- 1789486 TI - [Analysis of late potentials of the heart ventricles in patients with respiratory failure]. AB - The ECG signal was studied by the method of Simson in 43 patients with the clinical pattern of respiratory failure of different genesis with the aim in view to detect signs of late ventricular potentials (LVP) in the QRS vector and in separate orthogonal leads X, Y and Z. The signal was averaged by 150 complexes. It has been shown that 53% of the patients examined have signs of LVP, their incidence being much higher in critical patients subjected to controlled lung ventilation. Characteristic differences of the LVP signs analysed in leads X, Y and Z have been detected, as compared to the analogous parameters of the control group. PMID- 1789487 TI - [Characteristics of prolonged epidural anesthesia in surgery of the magistral vessels]. AB - Prolonged epidural anesthesia has been analysed in 288 patients operated on for atherosclerosis and vascular stenosis. To prolong anesthesia the authors have for the first time administered morphilong into the epidural space. The efficacy of anesthesia was assessed by Nanovoltaampere meter P-341 used for the measurement of skin potential, which in the course of anesthesia decreased by 40-50%. The quality of anesthesia was assessed by microcirculation state. It is recommended during surgery on major vessels to extend the area of epidural anesthesia towards the lower extremities. Analgesia with morphilong was effective for 22.3 +/- 4 h. Complications during anesthesia were observed in 31.2% of patients, in 6.2% of cases they required drug therapy. The incidence of postoperative pneumonias after epidural anesthesia reduced from 8 to 1.6% as compared to conventional anesthesia techniques. PMID- 1789488 TI - [The use of galanthamine in epidural anesthesia with trimecaine and fentanyl]. AB - Analgesia and hemodynamic parameters during epidural anesthesia with trimecaine (2% solution) in combination with fentanyl (200 micrograms) have been studied in 56 patients aged 28-84 years. During premedication 34 patients were, in addition to atropine, dimedrol and relanium, administered galanthamine (15 mg); 22 patients were not given galanthamine. Fentanyl was administered with the first doses of the anesthetic. It has been established that premedication with galanthamine reduced the time of anesthesia onset by 19.6% and decreased the initial anesthetic dose by 10.7%. The initial period of anesthesia was characterized by a 23% increase in the number of cases with retained baseline BP level, a 1.6-fold decrease in the value of BP lowering, a 2.4-fold slowing of the time of hypotonic reaction development and a 31% shortening of the time of bradycardia onset. PMID- 1789489 TI - [Changes in the parameters of systemic and pulmonary blood circulation in patients with lung cancer during different types of anesthesia]. AB - Central and pulmonary hemodynamic parameters have been studied by total body and transthoracic plethysmography in 60 patients before surgery, after surgery and on the 2nd, 4th and 9th day of the postoperative period. Neuroleptanalgesia and postoperative intramuscular analgesia with analgesics have been performed to control patients. Test patients during surgery and for 18 hours postoperatively have been subjected to upper thoracic epidural anesthesia with trimecaine and morphine. Marked stress hemodynamic reaction in control patients right after surgery and its following gradual inhibition with signs of right ventricular overload corresponded to a complicated clinical course. Reduced right ventricular afterload in test patients, minimum changes in right-ventricular performance and inotropic properties in combination with uncomplicated clinical course make it possible to consider the use of prolonged epidural anesthesia justified in thoracic cancer surgery. PMID- 1789490 TI - [Evaluation of the effect of different anesthesia techniques on the immune status of pregnant women]. AB - Cellular immunity has been studied in women after surgical delivery. Initial immune deficiency has been found in all the patients. Postoperative changes in the immune status have been compared after standard general anesthesia and after spinal anesthesia. Minimum effect of spinal anesthesia on the immune status, as compared to general anesthesia, has been established. The use of spinal anesthesia is recommended during cesarean section in patients with immune deficiencies. PMID- 1789491 TI - [The expediency of the clinical use of prostaglandin E2 for treating acute renal failure]. AB - The effect of exogenous prostaglandin (PG) E2 ("PROSTENON") on the renal function and some metabolic parameters have been studied in 10 dogs with acute renal failure (ARF) caused by the crush-syndrome. It has been shown that intravenous PGE2 at a dose of 0.25 mg/kg 1 h after relief of soft tissue compression leads to prompt and stable recovery of all the renal functions under study, normalises metabolism and promotes the survival of animals. However, side effects of the drug have been revealed: blood pressure decrease and induction of vomiting effect and diarrhea. Critical analysis of the literature data has shown that, despite positive PGE2 effect on the renal function in ARF, prostenon, because of its immunosuppressive properties, cannot be used in the clinical practice for the treatment of this pathology. It is suggested that PGE2 be widely used in transplantology. PMID- 1789492 TI - [A case of long-term occlusion in craniocerebral hypothermia]. AB - A case of urgent application of craniocerebral hypothermia (CCH) during correction of traumatic mitral insufficiency developing in the course of closed mitral commissurotomy is described. The occlusion duration was 46.5 min, with the temperature in the esophagus 30.2 degrees C. No postoperative neurological disturbances have been observed. Three years after surgery the patient was in a satisfactory condition. It is demonstrated that CCH is associated with a more marked antihypoxic effect, than it has been earlier believed, and that it is possible to use intravenous ketamine anesthesia during CCH in patients with low cardiac output syndrome. PMID- 1789493 TI - [The successful use of auxiliary high-frequency artificial ventilation of the lungs in a patient with shock lung]. PMID- 1789494 TI - [The role of acoustic resonance in realizing the effect of high-frequency artificial ventilation of the lungs]. AB - A new explanation of improved oxygenation during high-frequency jet ventilation has been suggested. The mechanism is based on resonance oscillations generated by oscillation and injection high-frequency jet ventilation and promoting gas penetration into the alveoli, PaO2 elevation in perimembrane layer and O2 concentration gradient increase between the alveolar and convection zones. Alveolar and bronchial fluctuations facilitate their drainage and decrease pulmonary shunting. The suggested mechanism is explained, using facts known from the practical application of high frequency jet ventilation. The advantages of combined volumic-oscillation high-frequency jet ventilation over the jet one are established, except cases of lung ventilation in patients with open bronchus and in patients transmitted to spontaneous respiration after prolonged controlled lung ventilation. PMID- 1789495 TI - [New parameters of the oxygen transport function of arterial blood]. AB - New criteria of the arterial blood oxygen transport function suggested by O. Siggaard-Andersen et al. are reviewed. The examples from clinical practice show the possibility to evaluate the capacity of the arterial blood to transport O2 during general anesthesia and intensive care. PMID- 1789496 TI - [Pharmacologic aspects of the clinical use of clofelin in anesthesiology]. PMID- 1789497 TI - Duplex ultrasonographic insonation and visualization of intracerebral arteries. AB - Until now, clinical, noninvasive interrogation of intracranial vessels has consisted only of insonation via transcranial Doppler. Such devices have utilized a 2.0 MHz, continuous wave probe with Doppler spectral waveform display. Clincial aapplication of these techniques has required precise location of cranial "windows" and has been hampered by the extreme anatomic variability of both cranial bony structures and intracerebral arteries. The lack of simultaneous intracranial arterial visualization has limited the clinical pplicability of transcranial Doppler technology. Recently, the authors have utilized a 2.25 MHz curved phased array probe with a pulsed Doppler to image and insonate simultaneously the intracerebral arteries. Colorflow imaging of both near- and far-field regions is the necessary first step for vessel localization and identification. Once this is accomplished, the image of each artery in turn is amplified and gray scale tuning is employed to permit direct visualization of the arterial walls and lumen. Pulsed Doppler waveform analysis is perfomred simultaneously and along the entire visible artery length. In this manner the arteries of both right and left hemispheres are examined in detail. We have found the duplex technique to be superior to the use of Doppler alone in the examination on intracerebral vessels. The ability to visualize and insonate simultaneously eliminates the uncertainty caused by anatomic variation. These advantages, long applied to the evaluation of peripheral vessels, are now available for use in the diagnosis of intracranial arterial disease. PMID- 1789498 TI - Erythrocyte alloantigen loci Ea-D and Ea-I map to chromosome 1 in the chicken. AB - A test cross was conducted to analyse some linkage relationships in the chicken. Pea comb (P), naked neck (Na), tardy feathering (t), four erythrocyte alloantigen loci (Ea-C, -D, -I, -P), and the rearrangement break point (RB) of the NM 7092 t(Z;1) chromosome translocation were tested. Significant linkages were found between P and Ea-I (32.9 +/- 4.2), the RB and Ea-D (30.7 +/- 4.3), and t and Ea-D (38 +/- 4.8). The data suggest the linear order of t, Ea-D, and the RB, with t closest to the centromere. Significant linkage was also found between Na and Ea-P (32.4 +/- 4.9), confirming earlier reports. PMID- 1789499 TI - Involvement of major histocompatibility complex class I compatibility between dam and calf in the aetiology of bovine retained placenta. AB - The possibility was examined that in cattle compatibility of major histocompatibility complex (MHC) products between dam and calf might negatively influence the placental maturation and expulsion, and therefore increase the risk of retained placenta in healthy, normally calving cattle. Fifteen combinations of a single dam and two offspring were selected; the placenta of the first offspring was normally expelled (control) and the placenta of the second one was retained (case). The MHC class I and class II antigens of the animals were typed by immunoprecipitation and by one-dimensional isoelectric focusing (1D-IEF). Compatibility or incompatibility of class I or class II antigens was established by comparison of the IEF banding patterns of dam and calves. Analysis revealed that MHC class I compatibility between dam and calf increased the risk of retained placenta. In this study, the effect of class II compatibility was not significant, nor was the effect of the interaction of class I and class II. In a subsequent, additional sample the experimental design was extended: induction of tolerance against non-inherited maternal antigens (NIMA) might be implicated in the occurrence of the disorder within the group of class I incompatible cases. In three out of the five class I incompatible retained placenta cases, the banding pattern of the incompatible haplotype of the calf was identical to that of the haplotype of the granddam that was not inherited by the dam (NIMA). Notably, within the nine class I incompatible controls, there were none in which the offspring shared a paternal class I type with the granddam. This might suggest a tolerance-inducing effect of NIMA in cattle in relation to retained placenta.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789500 TI - [High resolution NMR spectroscopy of CSF: methodological issues and perspective clinical applications]. AB - High resolution proton nuclear magnetic resonance (NMR) spectroscopy is a new analytical technique which allows to readily identify and quantitate a variety of key metabolites in cerebrospinal fluid (CSF) in relation to normal and pathological brain activity. Proton NMR spectroscopy can be performed on native CSF, with or without addition of exchange reagent (NH4Cl). The analysis of native CSF provides qualitative information (identification) of metabolites or xenobiotics present in the fluid. Alternately, CSF can be lyophilized and dissolved in deuterated water. This concentration offers 2 advantages: additional compounds are detected and a precise quantification of all CSF metabolites can be obtained. Both protocols require a very small volume of CFS (1-2 ml). The high informational content available on the NMR spectra of CSF, the ease-of-use of NMR spectroscopy and its cost effectiveness concur to predict that this analytical approach will keep developing to completement the array of existing tests which are already routinely performed on CSF. PMID- 1789501 TI - [Value of the study of total alkaline phosphatases and bone isoenzyme in a population of subjects with osteoporosis]. AB - The authors have compared the values of total and bone serum alkaline phosphatases in an osteoporotic population and a control group. The total activity of alkaline phosphatases was determined by a kinetic method at 30 degrees C and alkaline phosphatase isoenzymes were separated by agarose gel electrophoresis in presence or absence of wheat germ lectin. The authors have confirmed reported data concerning the physiological variations of alkaline phosphatases in the control group; they have therefore divided each group in several sub-populations according to age and sex in order to obtain accurate comparisons. Mean values of total and bone alkaline phosphatases were greater in the osteoporotic population than in the control group regardless of age or sex. Nevertheless, significant differences were obtained only with 50 to 75 year-old subjects (men or women) for total alkaline phosphatases and with 50 to 75 year old women for bone alkaline phosphatase. PMID- 1789502 TI - [Intra-leukocyte cystine in cystinosis treated with cysteamine]. AB - Data on cystine leukocyte content are analyzed in cystinotic patients receiving cysteamine as a depleting agent of cellular cystine. During 2 years, 63 measurements of cystine leucocyte content were performed in 15 cystinotic patients, aged 20 months to 22 years, taking daily 40 to 65 mg/kg of cysteamine. An original method was used to measure leukocyte cystine: a binding protein assay with a specific cystine-binding protein from E. coli. Results were taken individually because of various clinical situations in patients. In 8 patients taking cysteamine regularly, 6 hours after a dose, cystine leukocyte content was between 1 and 2 nmol 1/2 cystine/mg protein, about 10 times less than basal values without treatment and 5 to 10 times more than control subjects. In less compliant patients, cystine leukocyte content was close to basal values without treatment (3 to 25 nmol/mg). Some variability was observed between individuals receiving cysteamine: pharmacokinetic parameters may need further investigation. This sensitive and specific assay helped in controlling compliance and adjusting dosage regimen in each patient. The aim was to maintain a minimum effective dosage in order to avoid toxic side effects of cysteamine. PMID- 1789503 TI - International Federation of Clinical Chemistry (IFCC) IFCC recommendation. The Theory of Reference Values. Part 4. Control of analytical variation in the production, transfer and application of reference values. PMID- 1789504 TI - Ultrasonographic examination of the right kidney in cows. AB - To determine the position, dimensions, and structure of the right kidney in cattle by use of ultrasonography, the right kidney of 11 healthy Brown Swiss cows was examined 10 times within 2 weeks. A 3.5- and 5.0-MHz linear and convex transducer was placed on the right side of the cow in the lumbar region, in the paralumbar fossa, and in the last intercostal space. The echogenicity of various renal structures differed. The lobulation of the kidney in cattle could be visualized ultrasonographically; however, the cortex and medulla could not be differentiated. The distance between body surface and the right kidney was almost 3 times larger (5.3 +/- 1.71 cm, mean +/- SD) in the lumbar region than in the paralumbar fossa (1.8 +/- 0.52 cm). The vertical diameter of the kidney was remarkably smaller (5.1 +/- 0.47 cm) than the horizontal diameter (9.4 +/- 0.98 cm). In 7 cows, the thickness of the renal cortex and medulla was between 1.9 and 2.1 cm. The medullary pyramids could be visualized when the transducer was placed in the paralumbar fossa. Fourteen of 19 variables measured had a coefficient of variation between 8 and 14%. It was concluded that the ultrasonographic values determined in this study can be used as references for the diagnosis of morphologic changes in the right kidney of domestic dairy cattle. PMID- 1789505 TI - Comparison of high-performance liquid chromatography with a radiometric assay for determination of the effect of intra-articular administration of corticosteroid and saline solution on synovial fluid hyaluronate concentration in horses. AB - Two recently developed direct methods, radioassay-125I-labeled hyaluronic acid binding protein (125I-HABP)- and high-performance liquid chromatography (HPLC), were used to assess and compare the concentration of hyaluronate (HA) in synovial fluid of horses. Also determined were changes in the HA concentration in an experimental treatment model involving physiologic saline solution (PSS) irrigated or methylprednisolone acetate-injected tarsocrural joints of clinically normal horses. Serum HA concentration was determined simultaneously, using the 125I-HABP assay. Synovial fluid HA concentration values obtained by use of the HPLC method were approximately double the values obtained by use of 125I-HABP assay. Correlation (r = 0.819) between the 2 methods was highly significant (P less than 0.001; linear regression analysis) for all samples studied and for various experimental subgroups. When pure HA standards were used, correlation between the 2 methods was close to 1 (r = 0.965; P less than 0.001), with higher values obtained by use of the 125I-HABP assay. It is suggested that the HA binding protein derived from endogenous cartilage proteoglycan interferes with the 125I-HABP assay on synovial fluid, resulting in excessively low values, compared with those obtained using the HPLC procedure. Intra-articular injection of methylprednisolone acetate significantly (P less than 0.01) increased synovial fluid HA concentration at 24 hours after injection. Increase was also detected after PSS irrigation, but owing to wide intersubject variation, this increase was not significant. The HPLC procedure, which provides simultaneous information about the concentration and degree of polymerization of HA, is recommended for the study of synovial fluid, whereas the 125I-HABP assay is more suitable for serum HA analysis. PMID- 1789506 TI - An ultrasonographic off-set system for examination of equine tendons and ligaments. AB - In a dorsal plane, an improved ultrasonographic off-set system was used to obtain serial ultrasonographic images with enhanced anatomic and pathologic detail of the tendons, ligaments, and associated structures of the limbs of 100 horses. The off-set provided good acoustic coupling between a linear array ultrasonographic transducer and the horse's skin. A water-soluble gel contained within the off-set had acoustic properties similar to those of mammalian soft tissues. PMID- 1789507 TI - Evaluation of atropine, glucagon, and metoclopramide for facilitation of endoscopic intubation of the duodenum in dogs. AB - Modification of gastroduodenal motility has been proposed to aid endoscopic examination of the duodenum in dogs. The objective of this study was to evaluate the use of the following pharmacologic agents for facilitation of endoscopic intubation of the duodenum in 6 clinically normal dogs: metoclopramide HCl (0.2 mg/kg of body weight), atropine sulfate (0.045 mg/kg), glucagon (0.06 mg/kg), and isotonic saline solution. In a randomized, blinded, crossover design, the ease of endoscopic duodenal intubation was qualitatively scored by 3 endoscopists (in random order), using the following scale: 1 - immediate entry; 2 - rapid entry- moderate manipulation; 3 - difficult entry--multiple attempts; and 4 - no entry after 2 minutes [corrected]. Anesthesia was induced with thiopental and maintained with halothane. The 4 agents were diluted to a fixed volume and randomly administered. Duodenal intubation was attempted 2 minutes after IV injection of 1 of the agents. Four endoscopic procedures (1 for each agent) were performed on each dog with a minimum of 5 days between each procedure. In this study, no agent facilitated endoscopic duodenal intubation at the dose used. Instead, atropine and metoclopramide made duodenal intubation significantly more difficult, compared with use of saline solution. Difference between intubation after administration of glucagon and saline solution was not seen. On the basis of our findings, the use of these agents for facilitating endoscopic duodenal intubation is not recommended. In addition, in this study, we found that experience in endoscopic intubation is an important factor in determining the ease of duodenal intubation. PMID- 1789508 TI - In vitro assay of nuclear uptake of doxorubicin hydrochloride in osteosarcoma cells of dogs. AB - A rapid, simple chemosensitivity assay, assessing tumor cell nuclear uptake of doxorubicin hydrochloride, was evaluated in 16 dogs with appendicular osteosarcoma. Doxorubicin was administered to dogs in 5 biweekly treatments, and surgical resection was performed after the second or third treatment. The chemosensitivity assay was performed on biopsy specimens from all dogs before chemotherapy. It was repeated on tissue from resected tumors, and tumors were evaluated histologically to determine the degree of necrosis resulting from chemotherapy. Disease-free and total survival time correlated significantly (P less than 0.05 in both cases) with the degree of postchemotherapy necrosis of the primary tumors. Significant correlation was not apparent between the percentage of tumor cells with nuclear uptake of doxorubicin (in either biopsy or resection samples) and disease-free or total survival time. The percentage of cells with nuclear uptake of doxorubicin in surgically resected tumors correlated significantly (P less than 0.05) with percentage of necrosis. PMID- 1789509 TI - Relationship between urine ammonium ion excretion and urine anion gap in dogs. AB - Acidemia stimulates renal ammonia production and excretion. This adaptive response allows increased H+ secretion and generation of new bicarbonate. To determine whether a relationship existed between urine ammonium (NH4+) concentration and excretion and urine anion gap (Na+ + K(+)- Cl-), ammonium chloride (NH4Cl) was administered per OS for 5 days to induce systemic acidemia in 12 healthy Beagles. During NH4Cl administration, a strong, statistically significant (P less than 0.0001) relationship was apparent between urine NH4+ concentration measured in millimoles per liter and urine anion gap. Regression equation: urine [NH4+] = 8.2 - 0.416 x urine anion gap; r = -0.897. A statistically significant (P = 0.0001) relationship existed between urine NH4+ excretion measured in millimoles per kilogram of body weight per day and urine anion gap. Regression equation: urine NH4+ excretion = 0.74 - 0.38 x urine anion gap; r = -0.768. As urine NH4+ concentration or excretion increased, urine anion gap became more negative. Before NH4Cl administration (no systemic acidemia), a weak, but statistically significant (P = 0.015) relationship was observed between urine NH4+ concentration and urine anion gap. Regression equation: urine [NH4+] = 65.2 - 0.141 x urine anion gap; r = -0.41. However, a relationship was not evident between urine NH4+ excretion and urine anion gap before NH4Cl administration. Hence, urine anion gap is a reliable index of urine NH4+ concentration and excretion only in dogs with metabolic acidosis. In human beings with distal renal tubular acidosis, NH4+ excretion is inappropriately low and results in a positive urine anion gap.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789510 TI - Cutaneous laser-Doppler velocimetry in nine animal species. AB - The assessment of cutaneous microcirculation by laser-Doppler velocimetry (LDV) has been primarily limited to human studies. The purpose of this investigation was to establish normal values in various species and anatomic sites for blood flow, velocity, and volume as determined by LDV. Microcirculation was measured with a laser-Doppler velocimeter in 54 animals, 6 healthy animals from each of 9 species. The standard sites used were the buttocks, convex surface of the ear, metacarpal pad, humeroscapular junction, thoracolumbar junction, ventral portion of the abdomen, dorsal metacarpus (hooved animals), and ventral surface of the tail (horse). Significant differences in blood flow, velocity, and volume were measured between species and sites within species. The ventral portion of the abdomen consistently had the highest relative blood flow across all species except the monkey. Measurements in the canine metacarpal pad had a high SD, possibly indicating the stratum corneum and epidermis to be too thick for LDV. Our findings provide baseline data in several species, with application of LDV in comparative dermatologic research. PMID- 1789512 TI - Platelet function, antithrombin-III activity, and fibrinogen concentration in heartworm-infected and heartworm-negative dogs treated with thiacetarsamide. AB - Platelet aggregation and release, platelet number, mean platelet volume, antithrombin-III activity, and fibrinogen concentration were evaluated in heartworm-negative and heartworm-infected dogs at baseline and on days 3, 10, and 21 after treatment with thiacetarsamide. Platelet reactivity was enhanced in a group of dogs naturally infected with Dirofilaria immitis, compared with 2 groups of heartworm-negative dogs, but platelet reactivity was not further enhanced after treatment with thiacetarsamide. A significant decrease in antithrombin-III activity was detected 21 days after treatment. The platelets from a group of laboratory Beagles implanted with 50 adult D immitis displayed enhanced reactivity 6 months after implantation, but by 18 months, platelet reactivity had returned to near, or less than, baseline. Platelet reactivity was enhanced after thiacetarsamide treatment in this group. Thiacetarsamide-associated changes were not observed in platelet number or size; antithrombin-III activity decreased, but the change was not significant. Fibrinogen concentration was increased significantly (P less than 0.05) on day 10. Enhanced adenosine diphosphate (ADP) induced platelet aggregation was observed on days 3, 10, and 21 after treatment in heartworm-negative dogs. This change was not observed in 6 control Beagles not treated with thiacetarsamide. Although antithrombin-III activity was decreased on day 3 and fibrinogen concentration was increased on day 10, paralleling changes observed in the heartworm-infected dogs, the changes were not statistically significant. In this study, thiacetarsamide was procagulatory in heartworm negative dogs and may be an important contributing factor to the thromboembolism observed with adulticidal therapy. PMID- 1789511 TI - Isolation, characterization, and quantitative analysis of ceruloplasmin from horses. AB - Ceruloplasmin (Cp) was isolated from fresh equine plasma by precipitation, cellulose chromatography, and improved ion-exchange chromatography. Purified equine Cp is a glycoprotein having a molecular weight of approximately 115,000. In electrophoresis, equine Cp migrated to the alpha 1-globulin region, its isoelectric point was about 4.15 and consisted of about 890 amino acid residues. Serum Cp concentration was measured by use of the single radial immunodiffusion method. In clinically normal horses, the mean (+/- SD) serum Cp concentration of newborn foals was 2.87 +/- 0.40 mg/ml and that of 3-month-old foals was 5.02 +/- 0.92 mg/ml, which was similar to the adult value. It reached a peak of 6.06 +/- 0.74 mg/ml in 2-year-old horses. The Cp concentration in mares was not statistically different for the perinatal period, but it decreased immediately before and after delivery. Concentration of Cp increased at 6 days after IM administration of turpentine oil, castration, or jejunojejunostomy in adult horses, and increased to peak values twice as high as baseline values at 7 to 14 days, returning to baseline values at 28 days after treatment. We concluded that equine serum Cp is an acute-phase reactive protein increased in the intermediary or later phase of acute inflammation. PMID- 1789513 TI - Effects of treatment with aspirin or aspirin/dipyridamole combination in heartworm-negative, heartworm-infected, and embolized heartworm-infected dogs. AB - To determine the drug dose required to inhibit platelet reactivity by at least 50%, 2 drug regimens were evaluated in heartworm-negative, heartworm-infected, and heartworm-infected dogs embolized with dead heartworms. Aspirin, or a combination of aspirin and dipyridamole, were administered to 2 groups of Beagles (n = 5 each) for 5 to 9 days; a third group of 5 Beagles served as nontreated controls. For heartworm-negative dogs, mean (+/- SD) aspirin dosage that inhibited collagen-induced platelet reactivity by at least 50% was 6 (+/- 2) mg/kg of body weight given once daily. The aspirin/diphridamole combination dosage was 1 mg of each drug/kg given every 12 hours. All dogs (n = 15) were implanted with 7 adult heartworms each and remedicated (or not treated) beginning at 21 days after heartworm implantation. In heartworm-infected dogs, mean aspirin dosage required to inhibit collagen-induced platelet reactivity greater than or equal to 50% was 10 (+/- 6) mg/kg. Mean dosage of aspirin/dipyridamole combination was 1.6 +/- (0.5) mg of each drug/kg given every 12 hours. When platelet reactivity in response to collagen was determined to be inhibited by at least 50% in all medicated dogs, each dog (n = 15) was embolized with 7 dead adult heartworms to mimic heartworm adulticidal treatment. Platelet reactivity was monitored for 21 days after treatment, and drug dose was adjusted to maintain platelet inhibition by at least 50%. In embolized dogs, mean aspirin dosage was 17 (+/- 14) mg/kg given once daily. Mean dosage of the aspirin/dipyridamole combination was 2.8 (+/- 1.3) mg of each drug/kg given every 12 hours. All dogs (n = 15) were euthanatized 21 days after heartworm embolization. Each lung lobe was evaluated for severity of lesions and presence of organized or fibrinous thrombi. Lesion severity in the aspirin- and aspirin/dipyridamole-treated dogs was not significantly different from that in control dogs. PMID- 1789514 TI - Effects of treatment with ticlopidine in heartworm-negative, heartworm-infected, and embolized heartworm-infected dogs. AB - Ticlopidine hydrochloride was evaluated for its effectiveness in inhibiting platelet aggregation and serotonin release in 5 laboratory Beagles before and after heartworm implantation with 7 adult Dirofilaria immitis, and after embolization with 7 dead heartworms to mimic what happens after heartworm adulticide treatment. Five other laboratory Beagles, similarly implanted and embolized with heartworms, were used as nonmedicated controls. During the heartworm-negative stage, the dosage of ticlopidine that inhibited adenosine diphosphate (ADP)-induced platelet aggregation in 5 dogs by at least 50% after 5 days of treatment was 62 mg/kg of body weight once a day. In the same dogs implanted with 7 adult heartworms 21 days previously, mean (+/- SD) ticlopidine dosage required to obtain similar results was 71 (+/- 13) mg/kg given once daily. During the 21 days after dead heartworms were implanted in heartworm-infected dogs, mean ticlopidine dosage was 108 (+/- 35) mg/kg (range, 62 to 150 mg/kg). Ticlopidine treatment was associated with increased platelet numbers in all 5 dogs during the heartworm-negative stage and in 4 of 5 dogs during the heartworm implantation and heartworm embolization stages. Mean platelet volume tended to decrease as platelet numbers increased. At necropsy, gross and histologic pulmonary lesions were less severe in ticlopidine-treated dogs than in nonmedicated control dogs. PMID- 1789515 TI - Characterization and comparison of antimicrobial susceptibilities and outer membrane protein and plasmid DNA profiles of Pasteurella haemolytica and certain other members of the genus Pasteurella. AB - The outer membrane protein (OMP), plasmid, and antimicrobial resistance profiles of Pasteurella haemolytica serotypes 1 through 12, a bovine isolate of P multocida, a chicken isolate of P multocida, and an unidentified Pasteurella species of bovine origin were examined. Isolates of P haemolytica serotypes belonging to the same biotype possessed similar OMP profiles. Biotype A isolates contained 2 prominent OMP of 43 kilodaltons (kD) and 29 kD, whereas biotype-T serotypes contained 3 major OMP of 43, 36, and 25 kD. The major OMP profiles of the 2 P multocida isolates and the unidentified Pasteurella species were different from each other and from P haemolytica isolates. Plasmid DNA screening indicated both plasmid-containing and plasmid-free P haemolytica and P multocida isolates. Multiple drug resistance was found in pasteurellae isolates with and without plasmids. However, a relationship between drug resistance and plasmid isolation was found in 3 of 4 haemolytica serotype 1 field isolates, all of which contained a 2.51-megadalton plasmid and had multiple drug resistance for benzylpenicillin, ampicillin, streptomycin, and tetracycline. PMID- 1789516 TI - Heterogeneity in phagocytic and nitroblue tetrazolium reductive properties of neutrophils from cows. AB - Phagocytic and nitroblue tetrazolium (NBT) reductive activities of blood neutrophils from 19 Holstein heifers were measured by light microscopic and spectrophotometric methods, respectively. These functional properties of neutrophils correlated well (r = 0.64) and varied significantly (P less than 0.05) among animals studied. Variations in phagocytosis and NBT reductive activities attributable to the source of sera were determined in experiments in which cells from the same cows and zymogen particles opsonized with heat inactivated autologous or homologous sera were used. Variations attributable to the source of cells were determined in experiments in which cells from different cows and particles opsonized with pooled sera from all the cows were used. Most of the variation in phagocytic properties and NBT reductive activities was attributable to the source of cells (ie, each cow). The source of sera contributed slightly to the variation in NBT reductive activities, but not to the phagocytic properties. These results support the concept of functional heterogeneity of neutrophils among cows. PMID- 1789517 TI - Effects of human recombinant interleukin 2 on in vitro tumor cytotoxicity in dogs. AB - In these studies, the effects of recombinant human interleukin 2 (rHuIL-2) were examined on in vitro tumor cytotoxicity by canine blood lymphocytes obtained from peripheral vessels through use of a chromium release microcytotoxicity assay. Cytotoxic activity by lymphokine-activated killer cells was significantly increased, compared with that by untreated lymphocytes in a dose-dependent manner. The maximal effect was attained with 300,000 IU of rHuIL-2/ml. Lymphokine activated killing also was dependent on the duration of incubation with rHuIL-2. After 1 day of rHuIL-2 incubation, cytotoxicity was significantly increased, compared with that of untreated lymphocytes. Of the 3 times examined, cytotoxicity peaked after 3 days of rHuIL-2 incubation. High levels of cytotoxic activity were still present at 7 days of incubation. Numbers of granular lymphocytes increased over the times examined. These results demonstrate functional and morphologic changes in canine peripheral blood lymphocytes obtained from peripheral vessels after incubation with rHuIL-2 in a dose- and time-dependent manner. PMID- 1789518 TI - Pathologic features of dogs inoculated with North American Trypanosoma cruzi isolates. AB - Twenty-three clinically normal Beagles were inoculated with North American Trypanosoma cruzi isolates from an opossum (Tc-O), an armadillo (Tc-A), or a dog (Tc-D). The dogs were grouped according to the clinical outcome of inoculation. Group 1 consisted of 7 dogs inoculated with Tc-O or Tc-A that died or were euthanatized during acute stages of disease. Group 2 consisted of 5 dogs inoculated with Tc-O or Tc-A, that also developed acute disease, but survived to develop chronic disease. Group 3 consisted of 7 dogs inoculated with Tc-D neither developed acute nor chronic disease. Group 4 consisted of 4 dogs and served as noninoculated controls. In group 1, the gross lesions were diffusely pale myocardiums with right ventricular enlargement, hepatomegaly, and a moderate amount of modified transudate in the abdominal cavity. Severe diffuse granulomatous myocarditis with large numbers of pseudocysts and minimal fibrosis characterized the tissues from all cardiac chambers and septum. The lesions were most severe in the right atrium and ventricle. Mild multifocal myositis and pseudocysts were observed in skeletal muscles and smooth muscles of the urinary bladder and small intestine. Multifocal encephalitis and pseudocysts were in the cerebral cortex, cerebellum, and brain stem. In group 2, the gross lesions were biventricular enlargement and thinning of the ventricular free walls. The right ventricle contained the most severe microscopic changes. There were mild multifocal interstitial lymphohistocytic cellular infiltrates, perivasculitis, and marked fibrosis in all areas of the myocardium. Mild myositis and multifocal encephalitis were seen in the skeletal muscles and brains. Pseudocysts were not observed in any tissues.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789519 TI - Chemoprophylactic effects of milbemycin oxime against larvae of Dirofilaria immitis during prepatent development. AB - Three studies were conducted to determine the efficacy of milbemycin oxime in the prevention of Dirofilaria immitis infection in dogs. Dogs were given single or multiple experimental inoculations with infective third-stage D immitis larvae and were treated with milbemycin oxime at a target dosage of 0.5 mg/kg of body weight either once or at monthly intervals at various times after inoculation. The compound was effective in preventing infection when 1 dose was administered 30 or 45 days after inoculation. Significant, but incomplete, protection was achieved when single treatments were administered 60 or 90 days after inoculation. Multiple monthly treatments beginning 60 days after inoculation appeared to provide additive effects that resulted in restoration of complete efficacy. PMID- 1789520 TI - Prevalence of pigment gallstones in sheep. AB - In a survey of 666 sheep at a slaughterhouse, gallstones (concretions with a diameter greater than or equal to 1 mm) were found in the gallbladder of 50 sheep (7.5%), sludge (concretions with a diameter less than 1 mm) was found in 9 sheep (1.4%), and sludge plus gallstones were found in 7 sheep (1.1%). Gallstones and sludge were associated, and were more frequent in lambs and females, compared with adults and males. Qualitative analysis of the stones revealed all to be pigment (bilirubin) stones. There was a statistically significant increase of biliary bilirubin (total and indirect quota) only in sheep with gallstones plus sludge, compared with control sheep without sludge or gallstones. Concentrations of bilirubin, cholesterol, phospholipids, total and single bile aids, and total and ionized calcium were similar in the bile of sheep with gallstones, sludge, or both and control sheep. Bacteriologic analysis of the bile in 10 sheep with gallstones and 10 controls revealed bacteria in 50% of the first group and in 75% of the second group (Escherichia coli in all sheep and Salmonella spp also in 1 sheep with gallstones). These findings confirm our earlier findings of a high prevalence of black pigment gallstones in sheep. On that basis, we suggest that gallstones are associated with high total bilirubin concentration in the bile, and deconjugating bacteria are common in the biliary tract of these animals. PMID- 1789521 TI - Abnormal structure of the canine oncogene, related to the human c-yes-1 oncogene, in canine mammary tumor tissue. AB - Cellular oncogenes of genomic DNA in 6 canine primary mammary tumors were screened by Southern blot analysis, using 7 oncogene probes. A canine genomic oncogene related to the human c-yes-1 oncogene was detected as abnormal bands in solid carcinoma genomic DNA digested with EcoRI, HindIII, HindIII-EcoRI, or HindIII-BamHI. Comparison was made between other tumor specimens and control specimens obtained from 4 clinically normal dogs--1 mixed breed and 3 Shiba Inu dogs (the same breed as the dog from which the solid carcinoma was obtained). These abnormal bands were 0.1 to 1 kilobase shorter than the normal gene. However, digestion of genomic DNA obtained from normal WBC of this dog also produced all of the abnormal bands as observed in digested DNA from the solid carcinoma tissue. Therefore, in this dog, the genomic DNA of all somatic cells from the ontogenic stage still had the abnormal sequences related to the human c yes-1 oncogene, and it is possible that this abnormal structure may have some role (eg, as an initiator) in tumorigenesis or the progression of this tumor. PMID- 1789522 TI - Effects of superoxide dismutase on injury induced by anoxia and reoxygenation in equine small intestine in vitro. AB - Sheets of mucosa from the jejunum of healthy horses were mounted in incubation chambers and bathed with Krebs-Ringer bicarbonate solution. Changes in tissue function and histologic appearance were compared after the following conditions: (1) control conditions for 30 minutes with 95% O2/5% CO2 in the gas phase; (2) same conditions as control, except incubation with superoxide dismutase (300 U/ml) during the last 18 minutes; (3) anoxia for 15 minutes with 95% N2/5% CO2, followed by reoxygenation for 15 minutes; (4) same conditions as 3, except incubation with superoxide dismutase during reoxygenation; and (5) anoxia for 30 minutes. Anoxia reduced the accumulation of radiolabeled L-alanine and caused cell swelling, as indicated by an increase in tissue water and tissue Na contents. Reoxygenation improved the tissue's ability to accumulate L-alanine, but tissue swelling continued after this treatment. Tissue Na content and L alanine accumulation were restored to control values by reoxygenation with superoxide dismutase in the bathing medium. The grade of structural damage, as indicated by separation of epithelial cells from villi, was equally severe after all, but control, conditions. Superoxide dismutase had no effect on the tissue control conditions. Results of this study suggest that superoxide radicals are involved in the pathogenesis of reperfusion injury in equine jejunal mucosa and that this may be of clinical importance in cases of small intestinal strangulation obstruction. PMID- 1789523 TI - Measurement of estrogen receptors in normal and neoplastic lymph node tissue from dogs. AB - Estrogen receptors were measured in normal canine lymph nodes and neoplastic tissue from dogs with lymphoma, using a commercially available [3H]estradiol dextran-coated charcoal assay. Using the same assay, estrogen receptors were detected in the positive-control tissues--dog uterus, rat uterus, and lyophilized bovine uterus. Specific binding of [3H]estradiol was not detected in rat skeletal muscle or in any of the canine lymphoid tissues, indicating that the specimens did not contain estrogen receptors. PMID- 1789524 TI - Evaluation of a topically administered carbonic anhydrase inhibitor (MK-927) in normotensive and glaucomatous beagles. AB - A new topically administered anhydrase inhibitor, MK-927, was evaluated for its ocular hypotensive activity in normotensive and glaucomatous Beagles. Single- and multiple-dose studies were performed. Six concentrations of the drug were evaluated in the single-dose study and the 2% solution was used for multiple-dose evaluation. The decrease in intraocular pressure (IOP) was greater in glaucomatous Beagles at the higher concentrations of the drug. The 2 and 4% solutions of MK-927 significantly lowered IOP (mean, 5 mm of Hg; SEM +/- 1.6 and SEM +/- 1.2, respectively) in normotensive and glaucomatous Beagles. In the multiple-dose study, IOP was significantly decreased in the normotensive (mean, 4 mm of Hg; SEM +/- 0.74) and glaucomatous Beagles (mean, 9 mm of Hg; SEM +/- 1.2). The maximal effect was observed by day 4. A contralateral effect was found in glaucomatous Beagles, with the maximal effect on day 4. PMID- 1789525 TI - Effects of the fungal endophyte Acremonium coenophialum in fescue on pregnant mares and foal viability. AB - Effects of the endophyte Acremonium coenophialum in tall fescue on pregnant mares and foal viability were evaluated. Twenty-two mature pregnant mares were randomly chosen to graze either Kentucky-31 tall fescue that was free from A coenophialum (endophyte-free, EF) or tall fescue infected with A coenophialum (endophyte present, EP) after the first 90 days of pregnancy through parturition. Concentrations of pyrrolizidine and ergopeptine alkaloids were significantly greater in EP grass, compared with EF pasture. Ten of 11 mares grazing EP pasture had obvious dystocia. Mean duration of gestation was significantly greater for the EP group, compared with the EF group. Foal survivability was severely reduced among mares grazing EP fescue with only 1 foal surviving the natal period. Udder development and lactation were low in mares grazing EP grass. The absence of clinical problems in mares grazing EF grass implicated the endophyte as the causative agent of reproductive problems and perinatal foal mortality in pregnant mares grazing endophyte-infected fescue grass. Caution should be exercised in allowing pregnant mares to graze pastures infected with the endophyte A coenophialum. PMID- 1789526 TI - Changes in the bovine teat canal during the nonlactating period and early lactation, as measured by teat canal impressions. AB - Changes in dimensions of impressions of the lumen of the teat canals of 13 cows were examined at 17 intervals during the nonlactating period and early lactation. Impressions were made of teats of 2 diagonally opposed quarters of each cow, using dental impression material. Impression length was measured and cross sections of the impressions at the proximal (distal to Furstenburg rosette), distal (proximal to the teat orifice), and middle (midway between the 2), portions of the teat canal were prepared. Cross sections were photographed and enlarged, and circumference and area were determined by use of planimetry. Effects of making repeated impressions during the nonlactating period and early lactation on new infection rates and somatic cell counts were also assessed. Mean length of teat canal impressions decreased between days 0 and 3 of involution and during the prepartum periods. Depending on the level from which they were taken, cross-sectional areas of impressions tended to increase or increased significantly during the period of involution and again in the prepartum period. Significant changes in cross-sectional area were not observed during early lactation. Changes in circumference of proximal, middle, and distal cross sections followed trends similar to area measurements, but were more variable and differences were less statistically significant. On the basis of our findings, we suggest that heightened susceptibility to new infection during mammary involution and the prepartum period may be attributable, in part, to changes in the patency of the teat canal. Making impressions repeatedly throughout the nonlactating period and early lactation did not affect the number of new intramammary infections. PMID- 1789527 TI - [Vasculitis and neoplasms. 14 cases]. AB - Fourteen cases of vasculitis associated with a neoplasm are reported. The vasculitides were classified as: leukocytolytic vasculitis 7, periarteritis nodosa 4, purpura rheumatica 1, cutaneous granulomatous vasculitis 1, microvasculitis nervosa 1. The neoplasms were diagnosed as: 10 hemopathies (including 4 cases of refractory anemia) and 5 solid tumors (1 patient had 2 tumors). The cutaneous manifestations (purpura, papules, subcutaneous nodules, etc.) and fever were the most common, while joint and neurological involvement were the rarest. The evolution of the vasculitis was usually corticosensitive and independent of the underlying neoplasm. A review of the literature revealed that these vasculitides (primarily leukocytolytic) were frequently associated with dysplastic myelogenous syndromes and hairy cell leukemia, while bronchopulmonary and colonic neoplasms were the most common solid tumors. The mechanisms giving rise to these vasculitides are discussed. PMID- 1789528 TI - [Comparison about the efficacy and tolerability between simvastatin and bezafibrate in the treatment of hypercholesterolemia]. AB - Simvastatin and bezafibrate actions on blood lipids and their side effects were compared in a double-blind trial involving 24 adults with severe type IIa or IIb primary hypercholesterolemia (mean plasma cholesterol = 4.35 g/l). During a 12 week period, the patients received either bezafibrate, 600 mg 3 times a day, or simvastatin, 10 or 20 mg once a day, with a doubling of the dosage at week 6 if the LDL-cholesterol level remained above 1.40 g/l. Simvastatin significantly reduced LDL-cholesterol by -39.5% (p less than 0.001), total cholesterol by 33.9% (p less than 0.005) and apoprotein B by -28% (p less than 0.001). Bezafibrate significantly reduced LDL-cholesterol (-19.8%, p less than 0.001) and total cholesterol (-17.5%, p less than 0.002), but not apoprotein B. Bezafibrate also reduced triglycerides by -26.6% and raised HDL-cholesterol by +27.6%. Simvastatin was more effective than bezafibrate in lowering LDL-cholesterol (p less than 0.002), total cholesterol (p less than 0.005) and apoprotein B (p less than 0.05). Tolerance of both drugs was considered excellent. PMID- 1789529 TI - [Constitutional differences in the risk of hypersensitivity to cats in children]. AB - Several risk factors for allergy to cats were studied in children and teenagers who had respiratory symptoms possibly of allergic origin and were chronically exposed to a cat. It appears that: atopic dermatitis significantly increases the risk, independently of the other parameters examined; a family history of presumed allergic respiratory disease without atopic dermatitis significantly increases the risk in boys carrying the rhesus phenotype cc; passive smoking significantly increases the risk for allergy to cats in rhesus CC antigen-bearing subjects, independently of all other parameters (family history or atopic dermatitis). These factors aggravating risk, which can easily be determined by each physician, may prove useful, once personalized, in strengthening the general recommendations given to parents but routinely disregarded due to the lack of readily identifiable constitutional markers to establish the undeniable risk of hypersensitivity to cats. PMID- 1789530 TI - [Biological diagnosis of systemic lupus erythematosus]. PMID- 1789531 TI - [Repeated vascular complications, anti-phospholipid antibodies and systemic lupus erythematosus]. PMID- 1789532 TI - [Pulmonary artery aneurysm and multiple pulmonary infarctions disclosing Behcet's disease]. PMID- 1789533 TI - [Malignant non-Hodgkin's lymphoma disclosed by erythema nodosum. 2 cases]. PMID- 1789534 TI - [Hypercalcemia in chronic lymphoid leukemia. 2 new cases]. PMID- 1789535 TI - [Flaccid paraplegia after injection of methotrexate and aracytine by the intraspinal route]. PMID- 1789536 TI - [Rhabdomyolysis with acute renal insufficiency caused by fenoverine]. PMID- 1789537 TI - [Acute renal insufficiency caused by tubulo-interstitial nephropathy after treatment with ciprofloxacin]. PMID- 1789538 TI - [Another etiology of intermittent claudication of the jaw: Mac Ardle's disease (muscular glycogenosis type V)]. PMID- 1789539 TI - [Mc Ardle's disease and the elderly]. PMID- 1789540 TI - John Treherne (1929-1989): an appreciation. PMID- 1789541 TI - Cell surface recognition and neuron-glia interactions. PMID- 1789542 TI - Molecular mechanisms of glial-guided neuronal migration. AB - The migration of young neurons from their site of origin in proliferative zones out into neuronal layers is a hallmark of cortical development. Neuroanatomic studies show that astroglial fibers provide the primary substrate for neuronal migration. In vitro studies on living cells provide evidence that migrating neurons express distinguishing cytologic features including the formation of a specialized junction at the site of neuron-glia contact and the extension of an active leading process in the direction of migration. Our in vitro functional assays point to a critical role for astrotactin in neuron-glia binding during the developmental periods of glial-guided cell migration and assembly in brain. Other receptor systems, including neural cell adhesion systems, cadherins, and integrins are expressed by granule cells but do not appear to contribute to neuron-glia binding or to glial-guided neuronal migration. A role for astrotactin in glial-guided migration and assembly is supported by our observation that astrotactin is expressed by neurons and not glial cells and by restricted spatiotemporal expression of astrotactin in vivo, wherein astrotactin is expressed by migrating neurons and by neurons during periods of assembly into neuronal layers in developing brain. Understanding the regulation of astrotactin expression and its role in migration will provide fundamental insights into the role of glial-guided migration in the histogenesis of the brain. PMID- 1789543 TI - Boundaries and wounds, glia and glycoconjugates. Cellular and molecular analyses of developmental partitions and adult brain lesions. AB - During brain development, transient partitions of glia and glycoconjugates (glycoproteins, glycolipids, and glycosaminoglycans) surround forming functional units (e.g., nuclear divisions, whisker-related barrels, and neostriatal striosomes). These partitions, which we think of as boundaries, consist of dense aggregates of glial fibrillary acidic protein (GFAP)-positive radial glia, young astrocytes and their processes, and developmentally regulated glycoconjugates (e.g., J1/tenascin and the 473 proteoglycan) that can be thought of as recognition molecules present on membranes or perhaps within the extracellular matrix. When functional patterns have formed and appear to be stabilized, these boundaries are no longer detectable. Lesions of the developing brain show the existence of a more global astrocytic distribution suggestive of biochemically distinct subsets of astrocytes that reside within boundary versus nonboundary positions. Lesions of the adult brain, in addition to showing gliosis, reveal a reexpression of some of the same macromolecules present in transient brain boundaries during development. It is postulated that developmental boundaries and wounds in the adult brain possess some of the same inhibitory and possibly alluring molecular substrates for neuritic expansion. PMID- 1789544 TI - Role of the midline glia and neurons in the formation of the axon commissures in the central nervous system of the Drosophila embryo. AB - A row of midline precursor cells separates the two lateral neurogenic regions that give rise to most of the Drosophila CNS. From these midline precursors arises a discrete set of special glia and neurons. The growth cones of many CNS neurons initially head straight towards the midline and change their behavior after traversing it, leading to the hypothesis that these midline cells play a key role in the formation of the axon commissures. We have used a variety of cellular and molecular genetic techniques to elucidate the cells and interactions, including specific cell migrations, that are important for the normal formation of the two major commissures in each segment. This cellular analysis has led to a model that proposes a series of sequential cell interactions controlling the three stages in commissure development: (1) formation of the posterior commissure, (2) formation of the anterior commissure, and (3) separation of the two commissures. An initial genetic test of this model has used a number of mutations that, by either eliminating or altering the differentiation of various midline cells, perturb the development of the axon commissures in a predictable manner. PMID- 1789545 TI - Myelin structure and demyelination in multiple sclerosis. PMID- 1789546 TI - Vertebrate glial classification, lineage, and heterogeneity. PMID- 1789547 TI - Immune-mediated oligodendrocyte injury. PMID- 1789548 TI - Glia, neurons, and plasticity. PMID- 1789549 TI - Neuronal and nonneuronal influences on retinal ganglion cell survival, axonal regrowth, and connectivity after axotomy. AB - In contrast to the abortive regrowth that occurs when axons are interrupted in the adult mammalian CNS, exposure of injured CNS axons to the nonneuronal milieu of a peripheral nerve can lead to extensive axonal elongation. With the application of this experimental approach to the retinocollicular pathway in adult rodents, it has been possible to investigate the influences of neuron-glia and other interactions on the capacity of axotomized CNS neurons to survive injury, to elongate the distances necessary to reach specific targets, and to form connections in the CNS in adult rodents. The results of these investigations indicate that the changed glial environment provided by peripheral nerve grafts permits the guided regeneration of RGC axons to their CNS targets. Back in the CNS glial environment, regenerated axons penetrate their targets for short distances and re-form normal appearing synapses that can excite or inhibit postsynaptic neurons. Further studies will require a better understanding of intrinsic neuronal properties and of the interactions of these neurons with other neurons and with the cellular and noncellular components of the extraneural milieu. PMID- 1789550 TI - Schwann cells in central regeneration. PMID- 1789551 TI - Myelin-associated inhibitors of neurite outgrowth and their role in CNS regeneration. PMID- 1789552 TI - Is functional repair in the CNS a realistic possibility? PMID- 1789553 TI - Glial cells in the rat optic nerve. The search for the type-2 astrocyte. PMID- 1789554 TI - Glial K+ permeability and CNS K+ clearance by diffusion and spatial buffering. PMID- 1789555 TI - Glial ion transport and volume control. AB - K(+)-induced glial swelling results from an intricate interaction of transport and diffusion processes and metabolic stimulation, with many open questions remaining. Our concept of the major mechanisms involved can be summarized as follows: high extracellular K+ causes a burst-like stimulation of Na+/K+ ATPase and, hence, increases the metabolic demands. Lactate is produced; the cell is slightly acidified. To maintain a normal intracellular pH, the Na+/K+ antiporter extrudes protons and supplies Na+ for further Na+/K+ exchange. In addition, K+ ions enter the cell via membrane channels or furosemide-inhibitable transport. K+, Cl-, and lactate- ions accumulate as the osmotic basis for cell swelling. Later, cell volume normalizes slowly, a process involving lactate export and other, so far unidentified mechanisms. Taken together, the temporary swelling of glia at high K+ concentrations is the result of a homeostatic function, for the maintenance of a constant extracellular potassium concentration. Ion control ranges over volume control. In pathophysiologic states the loss of cell volume regulation may become a clinical problem, if cerebral swelling leads to an increase in intracranial pressure. It should be kept in mind, however, that elevation of the extracellular K+ concentration is not the only cause of glial swelling. Tissue acidosis, the release of neurotransmitters, especially glutamate, or free fatty acids are other mediator mechanisms initiating the swelling of glial elements. Only under controlled in vitro conditions can the individual significance of these factors be evaluated on a quantitative basis. Therapeutic approaches should be selected very carefully in order to maintain homeostatic mechanisms that are of utmost importance, especially after an insult to the brain. PMID- 1789556 TI - Axon-glia exchange of macromolecules. AB - The periaxonal and perineurial glia of crayfish and squid are strategically situated to regulate the neuronal microenvironment. Diverse molecules rapidly traverse the periaxonal sheath and a fraction of them enters the axons from glia or the glia from axons. The significance of these intercellular exchanges has not been tested directly. However, recent reports suggest that stress proteins, which probably are synthesized by both types of glia and transferred to axons, may be essential components by which the glia directly and indirectly assist neurons in tolerating ambient stress. PMID- 1789557 TI - Implication of astroglia in the blood-brain barrier. PMID- 1789558 TI - Morphology of glial blood-brain barriers. AB - Glial cells, in certain situations in the CNS, may become modified to form the structural basis of the blood-brain barrier. This occurs in more primitive vertebrates, such as the elasmobranch fish, and in some higher invertebrates. In the latter, the outermost glial sheath, often called the perineurium in avascular ganglia, substitutes functionally for the vascular endothelium of higher organisms. The intercellular junctions between the lateral borders of these modified glial or perineurial cells may be of several types. In nearly all cases, adhesive and communicating (gap) junctions are found together with an occluding junctional structure. The latter is assumed to be the morphologic basis of the observed blood-brain barrier. It varies in nature and may be one in which the adjacent cell membranes fuse, partially or completely, to form a classical tight junction, or it may be one in which the cell membranes remain separated by a distinct intercellular cleft. If the latter, the cleft may be straddled by columns or septal ribbons, between which a charged matrix substance may be found. Restrictive linker junctions, recently found to be the basis of the interglial barrier in cephalopod CNS, as well as that of myriapods, are characterized by cross-striations or columns which, in combination with charged residues, inherent either in them or in the associated extracellular matrix, slow down the entry of exogenous molecules. Septate junctions, which occur between glial cells in certain other invertebrates, exhibit intercellular septal ribbons, which do not prohibit paracellular transport of all substances but may slow down the passage of some by virtue of charged moieties. There is an association of cytoskeletal components with these septate, linker, and tight junctions; the role of the cytoskeleton in tight junctions, which can be seen by freeze fracture to be based on simple ridges in insects or a more complex network of them in arachnids, may also be important in the regulation of paracellular permeability. The structural details of the junctions in different groups are summarized and their physiologic implications discussed. PMID- 1789559 TI - Development, regeneration, and neoplasia of glial cells in the central nervous system. PMID- 1789560 TI - Modulation of a glial blood-brain barrier. AB - CNS interstitial fluid homeostasis by the glial perineurial blood-brain barrier in the crayfish and cockroach is dependent on glial uptake mechanisms, low paracellular permeability, and the cation-binding properties of the extracellular matrix. Potassium selective permeability of the crayfish perineurium is modulated by a Ca(2+)-dependent mechanism at the basolateral membranes of the glial barrier and is ion and voltage dependent. In addition, extracellular charged sites are significant in perineurial K+ and Ca2+ homeostasis and may be modified by changes in pH. In the cockroach, and probably the crayfish, perineurial K+ transport may also be modulated by receptor-mediated changes in glial membrane permeability. The factors acting at the crayfish and cockroach blood-brain barrier are summarized in FIGURE 8 and would be well suited for providing efficient K+ spatial buffering of the CNS. Analogous processes have been described in vertebrate glial cells and in the endothelial blood-brain barrier, which implies a common primary function. The CNS is protected from large fluctuations in the body fluids by the blood-brain barrier, whereas glial uptake mechanisms control the composition of the brain interstitial fluid, and modulation of both barrier permeability and glial transport by the altered chemical environment following neuronal activity allows precise adjustment of the brain extracellular fluids to the changing needs of the CNS. The insect and crustacean ventral nerve cord and perineurial blood-brain barrier provide an excellent preparation in which the interactions between these factors can be investigated in intact CNS tissue. PMID- 1789561 TI - Permeability and transport of glial blood-brain barriers. PMID- 1789562 TI - Astrocytic induction of endothelial tight junctions. PMID- 1789563 TI - Induction of blood-brain barrier endothelial cell differentiation. PMID- 1789564 TI - Astrocytes, cerebral endothelium, and cell culture. The pursuit of an in vitro blood-brain barrier. PMID- 1789565 TI - Glia as targets for neuroactive substances. PMID- 1789566 TI - Lineage and differentiation of oligodendrocytes in the brain. PMID- 1789567 TI - Origin, growth factor responses, and ultrastructural characteristics of an adult specific glial progenitor cell. PMID- 1789568 TI - Studies relating differentiation to a mechanism that measures time in O-2A progenitor cells. PMID- 1789569 TI - Expression of myelin glycolipids and proteins in mitotic and postmitotic murine oligodendrocytes. PMID- 1789570 TI - Protein kinase C in astrocytes. Phosphorylation and the regulation of cell morphology. PMID- 1789571 TI - Regulation of glial development by cell line derived factors. PMID- 1789572 TI - Differentiation of aminergic neurons in vitro is not paralleled by glial maturation. PMID- 1789573 TI - Astrocytes and O-2A progenitors migrate toward distinct molecules in a microchemotaxis chamber. PMID- 1789574 TI - Influence of grafted neurons on glial enzyme expression. PMID- 1789575 TI - Adhesion-induced differentiation of oligodendrocytes signals the synthesis and polarization of heparan sulfate proteoglycans and sulfated glycoproteins. PMID- 1789576 TI - Effect of EGF on DNA labeling in rat cerebellar immature astrocytes maintained under different culture conditions. Presence or absence of polylysine, serum, or both. PMID- 1789577 TI - Differential regulation of nerve growth factor and brain-derived neurotrophic factor expression in the peripheral nervous system. PMID- 1789578 TI - Expression of the 14E antigen in glial cells in human normal and pathological central nervous system tissues. PMID- 1789579 TI - Isolation and characterization of the myelin-like membranes ensheathing giant axons in the earthworm nerve cord. PMID- 1789580 TI - Analysis of cell lineage in the rat cerebral cortex. PMID- 1789581 TI - A growth cone collapsing activity in chicken gray matter. PMID- 1789582 TI - Transplantation of normal and genetically engineered glia into areas of demyelination. PMID- 1789583 TI - Glial cells transplanted to the rat optic tract. Influence on the regrowth of retinal axons. PMID- 1789584 TI - Nerve regeneration in vivo. A blind-ended tube model for studying environmental effects. PMID- 1789585 TI - Induction of blood-brain barrier characteristics in bovine brain endothelial cells by rat astroglial cells in transfilter coculture. PMID- 1789586 TI - Ultrastructure and voltage-dependent sodium currents at the glia limitans of the frog optic nerve before and after the axons degenerate. PMID- 1789587 TI - Accumulation of intracellular bicarbonate accounts for the missing anion during potassium-evoked swelling of cortical type-1-like astrocytes. PMID- 1789588 TI - Cell coupling is restricted to subpopulations of astrocytes cultured from rat hippocampus and optic nerve. PMID- 1789589 TI - Endothelin increases rubidium uptake through calcium-activated potassium channels in C6 glioma cells. PMID- 1789590 TI - Electrophysiological properties of squid giant axon Schwann cells. Relevance to K+ clearance. PMID- 1789591 TI - The inducible blood-brain barrier endothelium-specific antigen HT7, a novel immunoglobulin-like membrane glycoprotein. PMID- 1789592 TI - Blood-brain barrier function in central demyelinating lesions repaired by Schwann cell remyelination. PMID- 1789593 TI - Development of nonneural elements in the central nervous system of Drosophila. PMID- 1789594 TI - Inhibition of potassium-activated release of D-aspartate from astrocytes by an anion transport inhibitor. PMID- 1789595 TI - Peptidylglycine amidating monooxygenase (PAM), an enzyme required for neuropeptide biosynthesis, is present in Schwann cells and some glia. PMID- 1789596 TI - Fluoroacetate, a selective inhibitor of the glia tricarboxylic acid cycle, attenuated the release of luteinizing hormone-releasing hormone from the hypothalamus of ovariectomized rats. PMID- 1789597 TI - Macroglial cell types, lineage, and morphology in the CNS. AB - The characterization of macroglial antigenic phenotypes has provided considerable information on the classification of glial subtypes and lineage, but the picture in vivo appears to more complex than originally surmised from in vitro systems. Whether type-2 astrocytes and O-2A progenitors play a significant part in vivo remains controversial, but these questions have generated a valuable reassessment of inferences made from in vitro studies. It is not known whether disparate regions of the nervous system have different glial cell types with distinct cell lineages, but results in peripheral nerve and the cortex (see Price and colleagues, and Jessen and colleagues, this volume) suggest that this is likely the case. The heterogeneity of astrocytic form and the implied divergence of function in vivo parallel but have yet to be equated with the wide range of antigenic and electrophysiologic characteristics that can be induced in glia under certain culture conditions in vitro. Whether similar conditions prevail within the developing nervous system is not clear. The continued development of immunocytochemical markers and the use of retroviral vectors, combined with morphologic and electrophysiologic studies in vivo and in vitro, will undoubtedly answer these and other questions. PMID- 1789598 TI - Glial cells in development. In vivo and in vitro approaches. PMID- 1789599 TI - [Threefold intraoperative electrophysiological monitoring of vestibular neurectomy]. AB - A threefold intraoperative monitoring of facial nerve, auditory nerve and vestibular nerve function was performed in 14 cases of retrosigmoidal neurectomy. The facial nerve was monitoring with a pressure transducer placed against the cheek (Opalarm system). The auditory nerve was monitored with acoustically (click) evoked early potentials and the vestibular nerve was monitored with electrically evoked vestibular potentials obtained by direct stimulation (biphasic current pulses of 0.75-mA p-p, 100 us, 20/s) of the exposed vestibular nerve in the cerebellopontine angle before, during and after neurectomy. A characteristic vertex negative peak having a latency of approximately 2 ms and approximately 0.5 uV amplitude was obtained between a forehead and an ipsilateral ear lobe electrode (2 x 1,000 averaged responses over 10 ms) before the neurectomy. This response disappeared after selective vestibular nerve section proximal to the stimulation site. A diminished response amplitude was measured after incomplete nerve section. Simultaneous acoustic masking had no influence on the vestibular potential. The 14 operated patients became all free of vertiginous spells and drop-attacks except one patient who developed a contralateral Meniere's. Facial nerve function remained normal in all. Hearing preservation was obtained in 12 patients (86%). The threefold intraoperative monitoring has turned out to be an additional safety factor for facial and auditory nerve preservation and, thanks to the recording of vestibular potentials, it increased the efficiency of vestibular neurectomy. PMID- 1789600 TI - [Malignant external otitis. When and which imaging]. AB - Malignant external otitis (MEO) is a severe infection of the external auditory canal (EAC), most often caused by Pseudomonas aeruginosa, although a few cases are caused by an Aspergillus (4). Mortality remains high (20%) in spite of an early general antibiotic treatment. This infection of the soft tissue of the EAC causes cellulitis, chondritis and osteomyelitis, and there are risks of diffusion into the base of the skull. Our work is aimed at placing computed tomography and magnetic resonance imaging into the context of exploration of this infection, in relation to radionuclide scanning, owing to our experience with 10 patients. Imaging appreciates the anatomical extension of the infection beyond the EAC and towards the base of the skull and the infratemporal fossa, this being a key element for prognosis. It assesses the efficiency and duration of treatment, although the criteria of healing are still difficult to appreciate and late recurrence is frequent. Exceptionally, it is useful for diagnosis in some particular clinical forms. PMID- 1789601 TI - [Parotid metastases: value of imaging. Review of the literature, apropos of 4 cases]. AB - Parotid gland is a very unusual site of metastasis. Four proven cases are described. The tumor was occult in three cases out of four. In one case, an extra neck primitive tumor was suspected. Two kinds of metastases are described: firstly, metastases within the salivary gland with look like pleomorphic adenoma and are secondary to hematogenous spread; secondly, lymph node metastasis (two cases). Their diagnosis appear easier as they are not usually completely surrounded by parenchyma. They can reveal either occult head and neck tumor or visceral tumor. PMID- 1789602 TI - [Parotid carcinoma in children. Apropos of 3 cases]. AB - Three pediatric cases of parotid carcinoma are reported two are acinic cell carcinoma of relatively good prognosis. The third case is a cystic variety of salivary duct carcinoma, more exceptional, which prognosis remains uncertain. A review of the parotid tumors of this age range is done. PMID- 1789603 TI - [Abnormalities of the intrapetrous internal carotid artery]. AB - The abnormalities of the internal carotid artery along its intrapetrosal course are infrequent, but they are interesting because of the etiological hypotheses that must be put forward and because they sometimes have extremely serious consequences if middle ear surgery is performed without a preliminary study of the anatomy and vasculature of this region. No statistics likely to produce accurate guidelines are available at present, as the literature has reported too few cases. After attempting to explain these aberrant variations on the basis of anatomical and embryological considerations, we describe one case encountered in the ENT department of Brest University Hospital, then discuss it according to the data provided by the literature. PMID- 1789604 TI - [Dural fistula of the lateral sinus. Apropos of 2 recent cases]. AB - On the basis of two recent cases of dural fistula of the lateral sinus, the authors review the literature relating to this type of arteriovenous fistulae. The development of selective arteriographic techniques has allowed better knowing them, ensurgin the diagnosis and also treating them with embolization techniques. The role of the ENT specialist is no less important: during the clinical stage, it for him to recognize the pulsatile character of a tinnitus and to demonstrate it in order to establish the diagnosis. PMID- 1789605 TI - [Mucocele of the maxillary sinus. Apropos of 3 cases]. AB - Mucocele of the maxillary sinus is a rare affection his pathogenesis is still discussed, with a prevalence of the injury's and inflammatory's theories. The diagnosis being confirmed by computed tomography imaging ... We report in this study, 3 cases of maxillary sinus mucocele, with a review of literature. PMID- 1789606 TI - [Efficacy and tolerability of tiaprofenic acid (Surgam) in acute sinusitis in adults. Results of a randomized study versus paracetamol and placebo]. AB - Tiaprofenic acid (Surgam) is a non steroidal anti-inflammatory drug used for acute inflammation during episode of upper respiratory tract infection in adults. Its efficacy in association was already demonstrated in tonsillitis. The efficacy and tolerance of tiaprofenic acid for the treatment of inflammation occurring in the course of adult acute sinusitis were evaluated by a randomized study versus paracetamol and placebo. 139 patients were included in the study. 134 patients were evaluated for efficacy. They received either tiaprofenic acid or paracetamol or placebo during seven days together with amoxicillin. We used evaluation criterion taking into consideration inflammatory physical indications of sinusitis and opinions of investigators and patients. After 7 days of treatment the efficacy of tiaprofenic acid (Surgam) was significantly superior to placebo on all principal criterion studied. Amelioration with paracetamol was lower, but no statistical difference was found between paracetamol and tiaprofenic acid (Surgam) groups. Tolerance was good in every group. PMID- 1789607 TI - [Pharyngolaryngeal fibroscopy under general anesthesia in children. Technique and indications in sleep apnea and hypopnea]. AB - The frequency of obstructive sleep apnea syndromes in children is not negligible. The diagnosis is based on the parents' answers and on sleep recordings. Radiographs sometimes help defining the site of obstruction. However, except when there is a considerable, clinically obvious tonsillar hypertrophy (which is fortunately the most frequent case), the exact location of the obstruction may be difficult to assess. In fact, it is far less obvious and more often multiple than in adults, especially in cases of craniofacial malformation. A pharyngolaryngeal exploration technique with a flexible endoscope under general anesthesia (GA) has been developed in our department. With natural ventilation, when a GA is induced with halothane through a mask, muscular relaxation similar to that of natural sleep is obtained. A thin flexible endoscope is then inserted through the mask to observe the obstructive structures at the nasal, rhino/oropharyngeal or pharyngolaryngeal levels. During the past two years, 17 children were examined with this technique, which allows an extremely accurate diagnosis of the site of the obstruction. Four children had a craniofacial malformation. The examination evidenced 9 cases of adenotonsillar hypertrophy, 4 cases of dynamic laryngeal obstruction, 3 cases of basilingual obstruction and one case of circular collapse of the oropharynx. The evolution under treatment confirm the merits of this endoscopic examination technique for the etiological diagnosis of respiratory obstruction. PMID- 1789608 TI - [Subtotal laryngectomy in the treatment of extensive tumors of the larynx]. AB - The authors assess the possibility to perform subtotal laryngectomy for extensive tumors of the endolarynx. They describe a particular variety of T3/T4 tumor extending anteriorly to the thyroid cartilage or to the pre-epiglottic space. Such tumors do not affect the arytenoid cartilages posteriorly, which makes functional subtotal laryngectomy with CHP or CHEP possible. This surgery was performed in 28 patients from 1972 to 1985, with 20 patients still living after 5 years, ie. 72% of all cases. PMID- 1789609 TI - [New concepts of the course of cholesteatoma from the immunohistological study of 96 samples]. AB - The immunohistological characteristics of retraction pockets, cholesteatoma matrix and granulomatous tissue have been compared. Langerhans cells, epidemic folds and sub-epithelial tissue were labelled with specific markers (HLA II, adhesion receptors, KI 67). The junction between epidermis and sub-epithelial tissue of middle ear mucosa appeared as the most inflammatory area, displaying characteristics of delayed type hypersensitivity phenomenon. CD1+ Langerhans cells appear to express class II molecules only in the vicinity of polymorphonuclear infiltrates. Epidemic proliferation seems to able place mainly in the deepest recesses of the epidermis. PMID- 1789610 TI - [Changes of the properties of provoked oto-emissions in tubal dysfunctions]. AB - The authors have studied the induced acoustic otoemissions in 53 children with tubal malfunction. Otoemissions were present in 29% of all ears. In cases of retraction of the eardrum, the otoemissions were present in 2 of 23 ears. Some ears had no induced oteomission, with hypoacousia ranging from 10 to 15 dB only. Conversely, there were induced otoemissions in some ears while hypoacousia was as high as 25 dB. PMID- 1789611 TI - [Value of collagen type IV in tympanoplasties. Animal experimentation in rats]. AB - The authors recall the importance of collagen in the ultrastructure of the lamina propria and the properties of the type IV collagen concerning epidermic healing. Tympanomeatic graft composed of reticulated type IV collagen was used as a graft in rats. This experimental study demonstrated a good stability of the graft 40 days after operating. A new non toxic cross linking technique has been developed to stabilise of the biomaterial. The type IV collagen film shows good properties for the growth and the differentiation of epithelial cell like keratinocytes. PMID- 1789612 TI - [Facial motricity of trigeminal origin. Apropos of a typical case and review of the literature]. AB - The authors report the case of a patient who underwent the neurosurgical exeresis of an acoustic neuroma 14 years ago, and subsequently presented with a total facial palsy in spite of a spinofacial anastomosis. This patient had to be reoperated because of tumoral recurrence compressing the trigeminal nerve (V). This operation, through atranslabyrinthic that also emptied the entire internal auditory canal of its neural elements, allowed removing the neuroma. Once the facial nerve had been resected, the patient recovered some facial motricity and his masticatory function improved on the day following the operation. Since the contralateral facial nerve was not involved and the spinofacial anastomosis was absolutely not functional, only motor reinnervation from the trigeminal nerve was possible. The anatomy of the facial and trigeminal nerves in summarized, and their central connexions and peripheral anastomoses are studied. Out of the 27 cases of spontaneous motor reinnervation following the resection of the facial nerve described in the literature, only one similar case of recovery of motricity after a major nerve resection in the cerebellopontine angle is reported. Such a phenomenon can be explained only by the transformation of some sensory fibers of the 5th cranial nerve into motor fibers, which are activated by the resection of the 7th nerve and receive their nervous influx from the motor nucleus of the 5th or 7th nerve through protuberantial communications. PMID- 1789613 TI - [Diagnostic and surgical strategy in sporadic primary hyperparathyroidism]. AB - The generalized use of phosphocalcic biological assays makes the discovery of sporadic primary hyperparathyroidism increasingly common. In 1989-1990, first intention surgery was performed in 26 female patients. In all cases, an exploratory cervicotomy under cervical peridural anesthesia allowed discovering and treating a parathyroid lesion: adenoma, asymmetric or symmetric hyperplasia, cancer. We discuss: the circumstances of the clinical diagnosis and the biological criteria, the timeliness of preoperative radiological assessment, the surgical strategy advocated. In more than 90% of all cases, a cervicotomy for the exploration of all areas of parathyroid migration should allow curing primary hyperparathyroidism. PMID- 1789614 TI - [Balloon dilatation of tracheobronchial stenoses in children. Apropos of 4 cases]. AB - Long-lasting tracheal tubing in newborns and infants, associated with repeated tracheobronchial aspiration, is sometimes complicated by tracheal and/or bronchial stenoses. Many therapeutic methods have been described to treat this condition: use of dilatators, laser, surgery, insertion of prosthetic material. Dilatation with an angioplasty balloon has been recently described for the treatment of various stenoses. The authors report about 3 cases of acquired tracheobronchial stenosis which were successfully treated with this method, and 1 case of complex tracheal stenosis (with a double inflammatory and congenital nature) which required both dilatation and surgery. The technique is described. There is no morbidity and no mortality in this non-randomized series. Balloon dilatation is a simple and effective method, which may be proposed as a first intention treatment for acquired tracheobronchial stenosis in newborns and infants. PMID- 1789615 TI - [Evaluation of voice quality. Experimental approach and modeling of the prosthetic voice of laryngectomized patients]. AB - The authors describe their initial results with the parametric assessment of voice quality, which still is mainly subjective. This analysis will be used both in audiology and phonology. A first approach is made on the experimental model of a laryngectomee with a Bordeaux-type phonatory implant. Such patients allow a simpler analysis of voice production both incoustics and with an electromyographic control. The analysis of the data and their statistical validation is based on the use of original computer software. PMID- 1789616 TI - [Acoustic distortion products. Clinical values and limitations in the study of low frequencies]. AB - Distortion products are otoemissions produced when the cochlea is stimulated by two pure, continuous sounds f1 and f2. The most ample distortion product in Man corresponds to a frequency of 2f1-f2. The aim of our work is to appreciate the possibilities to study the distortion products for the exploration of low frequencies in Man. Three populations of subjects have been studied: young subjects have been studied: young subjects with a normal hearing, subjects with pathological otoscopic findings in spite of a normal hearing, subjects with pathological otoscopic findings in spite of a normal audiometric study, and subjects with endocochlear perceptive deafness. The major result of this study was to demonstrate that the lowest frequency that can be explored with distortion products is 750 Hertz. PMID- 1789617 TI - [Peroperative monitoring of the facial nerve in surgery for acoustic neuroma]. AB - This paper reports our experience about intraoperative facial nerve monitoring carried out in 97 patients operated on by a retrosigmoid approach. Intra operative facial nerve monitoring was performed using a pneumatic sensor which transforms into acoustic signals contractions of facial muscles elicited by mechanical, electrical or thermal stimulations of facial nerve. Long term results showed that a normal facial function (grade I) was achieved in 90.5% of patients, 4 patients were grade II, 2 patients grade III, a total paralysis (grades V and VI) was persistent in 3 patients. Our experience with facial nerve monitoring suggests a modification of the strategy of dissection based upon a preservation of the arachnoid veil and a medial to lateral direction of dissection. PMID- 1789618 TI - [Perilymphatic fistula]. AB - Perilymphatic fistulae are the first cause of perceptive deafness that may be amenable to surgical treatment. After a complete study of the literature, we have made a retrospective analysis of 48 ear explorations in 37 children. These children presented with a variable degree of progressive or fluctuating perceptive deafness without any obvious etiology. Computed tomography, especially aimed at detecting an abnormality in the patency of the aqueduct of the cochlea, seems to be the most efficient criterion of selection to establish an indication for surgical exploration. The extent of the perilymphatic fistulae and their location, mainly at the level of the fissura ante fenestram, call to our mind the possibility of an arrest in the differentiation of the otic capsule, with a persistent anomalous patency of the aqueduct of the cochlea. The results of this study mainly demonstrate stabilizations of hearing, while spectacular improvements still are anecdotal. On the other hand, morbidity is very low and mainly results from insufficient surgery to fill in the fistula. Further studies are needed, especially to better understand the pathophysiology of the perilymphatic fistulae, and their results must certainly be appreciated in the longer term. PMID- 1789619 TI - [HMPAO radionuclide of temporal cortex in the study of deafness]. AB - A new method of dynamic exploration of central auditory pathway is presented, using measurement of cortical temporal perfusion variations, during auditory stimulation (tonal stimulation in normal hearing patients, electrical stimulation with promontory test in profoundly deaf patients). This study shows a perfusion increment in normal hearing and deaf patients with positive promontory test, which doesn't exist in a patient with negative promontory test. Further development of this study could help for optimization of post implantation auditory results. PMID- 1789620 TI - [Nasosinusal polyposis. Indications. Results. Apropos of 222 ethmoidectomies]. AB - From 1984 to 1990, we carried out 222 endonasal ethmoidectomies in 116 patients with invalidating nasosinusal polyposis who had undergone multiple treatments. Out of these, 49 suffered from asthma and 17 from Widal's disease. We were able to follow up 109 patients with an average time lapse of 14.2 months, the extreme values being 3 months and 6 years. Complete ethmoidectomy was performed in all case, using a combination of surgical microscope and 30% rigid optics. The low number of complications, the high percentage of good results and the absence of respiratory functional aggravation currently give endonasal ethmoidectomy a place of choice for the management of patients with polyposis, in the absence of any true etiological treatment. We associate non-intolerant asthmatics, for whom we have obtained the best results, to the conventional indication. Conversely, Widal's disease is a more disputable indication, and its high percentage of failures justifies the continuation of basic research. PMID- 1789621 TI - [Chronic maxillary sinusitis of dental origin and nasosinusal aspergillosis. How to manage intrasinusal foreign bodies?]. AB - About a series of 33 patients operated in the ENT Depart. Prof. Soudant-La Pitie Salpetriere Hospital-Paris. Any emphasis was put on 11 cases of aspergillosis sinusitis. Most of the time, clinical signs are non specific. But X rays studies are of great help for the diagnosis. Treatment of chronic sinusitis of dental origin, particularly aspergillosis, remains surgical: caldwell-luc operation or endonasal approach. As a conclusion, the authors suggest systematic removal of all intrasinusal foreign body. PMID- 1789622 TI - [Cholesteatoma of the maxillary sinus. Apropos of a case]. PMID- 1789623 TI - [Evaluation of the fundamental voice frequency during the day]. AB - As know by the singers, the possibilities of the voice vary during the day. The study aims to determine whether the mean pich of the voice can be a valuable chronobiological index of this variability. PMID- 1789624 TI - [Treatment of spasmodic dysphonia with botulinum toxin]. AB - Spasmodic dysphonia is a focal laryngeal dystonia, a rare form of dystonia. Videostroboscopy, acoustic analysis, computerized voice analysis and over all electrophysiological analysis allow for the study of the different muscles involved in this dysphonia. There are two types of spasmodic dysphonia: adductor spasmodic dysphonia and abductor spasmodic dysphonia. The most efficient therapy nowadays is the injection of botulinum toxin into the thyroarytenoid muscle under fiberoptic visualization. We report 6 patient's cases of spasmodic dysphonia that we have been treating for about 2 years by direct injection of botulinum toxin in the vocal cords. PMID- 1789625 TI - [Laryngeal papillomatosis in Cameroon (Central Africa). Anatomical aspects]. AB - 52 cases of laryngeal papillomatosis are found in Cameroun during a 6 1/2 year period (1st January 84-30th June 90). The 52 patients are 27 men and 25 women aged 10 months to 65 years. 40 patients (77%) are less than 15 years and present with the juvenile form of laryngeal papillomatosis. Clinically, all the patients have dysphonia and 30% of them complain of dyspnoea. Less frequent symptoms are cough, foreign body sensation in the throat, dysphagia. Endoscopic and histologic aspects of the disease are those classically described. PMID- 1789626 TI - [Cherubism: 2 familial cases]. PMID- 1789627 TI - [Congenital atrichia. Follicular ichthyosis. Palmoplantar keratoderma. Total proximal leukonychia. Facial dysmorphism. A new entity?]. PMID- 1789628 TI - [X-linked chondrodysplasia punctata: neonatal manifestations]. PMID- 1789629 TI - [CFC syndrome in mother and daughter: a syndrome distinct from Noonan syndrome]. PMID- 1789630 TI - [Kabuki make-up syndrome: abnormalities of the fingertips and cutaneous hyperelasticity]. PMID- 1789631 TI - [Common aspects of connective hyperplasia of Proteus syndrome and collagenoma]. PMID- 1789632 TI - [Happle-type Conradi-Hunerman syndrome. A sporadic case]. PMID- 1789633 TI - [Dubowitz syndrome]. PMID- 1789634 TI - [Nevus or Starink hamartoma (acantholytic and dyskeratotic epidermal nevus). Apropos of a case in an infant]. PMID- 1789635 TI - [Diffuse hamartoma of the arrector muscles and congenital hypertrichosis lanuginosa]. PMID- 1789636 TI - [Neonatal lupus]. PMID- 1789637 TI - [Dysmorphism in Stiff Skin syndrome]. PMID- 1789638 TI - [A new case of Stiff Skin syndrome]. PMID- 1789639 TI - [Acrodermatitis enteropathica aspect caused by group B vitamin deficiency]. PMID- 1789640 TI - [Cold paroxysmal hemoglobinuria and treponemal infection]. PMID- 1789641 TI - [Relapsing polychondritis and psoriatic arthritis]. PMID- 1789642 TI - [Systemic mastocytosis of the telangiectasia macularis eruptiva perstans type with poikilodermal aspect]. PMID- 1789643 TI - [Systemic mastocytosis with digestive involvement]. PMID- 1789644 TI - [Mucocutaneous xanthomatosis of Montgomery and monoclonal gammopathy]. PMID- 1789645 TI - [Hemi-atrophy and chronic hyperlymphocytosis]. PMID- 1789646 TI - [Amicrobial pustulosis and systemic lupus erythematosus]. PMID- 1789647 TI - [Partial lipodystrophy, glomerulonephritis and hypocomplementemia]. PMID- 1789648 TI - [Gingival hypertrophy disclosing sarcoidosis]. PMID- 1789649 TI - [Cutaneous sarcoidosis (lupus pernio) with neuroendocrine involvement]. PMID- 1789650 TI - [Testicular tumor during the initial evaluation of cutaneo-mucous sarcoidosis]. PMID- 1789651 TI - [Sarcoidosis in husband and wife]. PMID- 1789652 TI - [Ecthyma gangrenosum caused by pseudomonas septicemia disclosing agammaglobulinemia]. PMID- 1789653 TI - [Inflammatory tinea capitis caused by Trichophyton erinacei in a 3 year-old child]. PMID- 1789654 TI - [Disseminated actinomycosis caused by Actinomyces meyeri. 3 cases with multiple cutaneous localizations]. PMID- 1789655 TI - [Post-traumatic ulcerated nodules of the ankle caused by Mycobacterium smegmatis]. PMID- 1789656 TI - [Epidermodysplasia verruciformis (EV) after bone marrow transplantation for the treatment of severe combined immunodeficiency: a model to understand the specific immunodeficiency of EV?]. PMID- 1789657 TI - [Cutaneous leishmaniasis with 48 years development]. PMID- 1789658 TI - [Type II mixed cryoglobulinemia with cutaneo-nervous vasculitis during chronic hepatitis C]. PMID- 1789659 TI - [Recurrent panniculitis associated with chronic active hepatitis C. Efficacy of Introna (a case)]. PMID- 1789660 TI - [Neonatal pustulosis induced by Malassezia furfur]. PMID- 1789661 TI - [Cutaneo-mucous leishmaniasis in HIV infection]. PMID- 1789662 TI - [Pityriasis rubra pilaris in a patient with acquired immunodeficiency syndrome]. PMID- 1789663 TI - [Kaposi's sarcoma in after heart transplantation]. PMID- 1789664 TI - [Vegetant intravascular hemangioendothelioma of the skin (cutaneous intravascular papillary endothelial hyperplasia)]. PMID- 1789665 TI - [Fast developing melanoma arising on a nevus excision scar]. PMID- 1789666 TI - [Meyerson's nevus on congenital pigmented nevus]. PMID- 1789667 TI - [Sus-clavicular cutaneous bronchogenic cyst]. PMID- 1789668 TI - [Value of magnetic resonance imaging (MRI) in prognostic and therapeutic approaches of breast hemangioma in the little girl]. PMID- 1789669 TI - [Systemic capillary leak syndrome disclosing mixed diffuse T lymphoma]. PMID- 1789670 TI - [Hypereosinophilic syndrome with pachyderma preceding lymphoma. Treatment with interferon alpha]. PMID- 1789671 TI - [Palmoplantar pustulosis disclosing acute monocytic leukemia]. PMID- 1789672 TI - [Specific cutaneous localizations of myeloma]. PMID- 1789673 TI - [Ulcerative lichen planus: treatment by graft of total skin]. PMID- 1789674 TI - [Erythema gyratum repens type eruption]. PMID- 1789675 TI - [Erosive pustular dermatitis of the scalp]. PMID- 1789676 TI - [Erythema multiforme after topical administration of bufexamac (3 cases)]. PMID- 1789677 TI - Comparison of resistance level and circulating IgG response in chickens experimentally inoculated with a multiple or single immunizing doses of Eimeria acervulina. AB - Two immunizing methods (Trickle or single immunizing doses) against E. acervulina were tested in chickens. The effects of immunization and challenge upon growth, oocyst output and circulating antibodies response (IgG) were compared. Neither immunization method produced pathogenic effects, similar numbers of oocysts were produced, and the levels of IgG in serum were similar and low in each case. After the challenge, immunized birds showed a high level of resistance but susceptible controls produced very large number of oocysts and showed a marked reduction in the growth. Birds immunized by a trickle infection produced oocysts on two days only and the total number of oocysts per bird was very low, whereas those immunized by a single infection produced oocysts over a period of nine days and the total number of oocysts was higher. Susceptible and birds immunized by a single inoculation showed similar IgG concentration and these were statistically higher than birds immunized by a trickle infection. In susceptible birds the kinetic of IgG was delayed about 4 days. PMID- 1789678 TI - [Atypical forms of Plasmodium vivax. Apropos of a case]. AB - In one case of human malaria imported from Gabon, abnormal forms of Plasmodium vivax are described; severe multiple infections of the host erythrocytes are noticed (up to 6 amoeboid trophozoites in a single red blood cell). Attention is drawn to the numerous morphologically abnormal intra-erythrocytic stages of P. vivax: severe multiple infections of red cells, parasites "ressembling" P. ovale, mature schizonts of small size, with reduced number of merozoites... The geographical distribution of P. vivax in Central Africa is discussed, with reflections on the factors allowing the importation of few P. vivax cases from this area. PMID- 1789679 TI - [Antibody levels against circumsporozoitic protein of Plasmodium falciparum and their use as epidemiological indicators of malaria transmission in FIR of Comoros]. AB - Epidemiological survey on prevalence of Plasmodium falciparum anti circumsporozoite antibodies (Ab-CS) was carried out in 21 villages of Comoros FIR, at the beginning of 1988 rainy season. Evaluation of anopheline indoor resting densities was also carried out at the same time. Frequencies of antibody positive subjects vary considerably in the different villages, according to the Anopheles gambiae and A. funestus densities per room, which are determined by ecological factors. Ab-CS prevalence varies in the sample population from 5.5% in 3-4 years children to 40% in those of 5 years. Starting from 6-7 years group, prevalence increased steadily reaching a plateau by 30 years of age. The detection of Ab-CS levels in a sample population is a good tool to evaluate malaria transmission levels, especially where the epidemiological situation does not allow a reliable entomological evaluation. PMID- 1789680 TI - Stroke prevention in nonvalvular atrial fibrillation: a review of prospective randomized trials. AB - Patients with atrial fibrillation are at risk for cerebral embolism; however, the roles of chronic anticoagulation or antiplatelet therapy for stroke prevention in patients with nonvalvular atrial fibrillation have been controversial. Recently, the results of three large prospective randomized trials that examined the risks and benefits of warfarin or aspirin for stroke prophylaxis in patients with nonvalvular atrial fibrillation were reported. All three studies revealed a reduction in the stroke rate for patients treated with warfarin and a small incidence of major bleeding. One of the studies also reported a reduced stroke rate in aspirin-treated patients. The reduction of thromboembolic events associated with chronic warfarin therapy appears to outweigh the risks of significant bleeding for most patients with nonvalvular atrial fibrillation. Aspirin may offer an alternative for subgroups of patients who are at low risk for stroke or those who are not good candidates for anticoagulation. PMID- 1789681 TI - Etiology of motor or sensory stroke: a prospective study of the predictive value of clinical and radiological features. AB - The diagnostic utility of clinical and radiological features for distinguishing penetrating artery disease from other causes of stroke has been questioned. To address this issue, we prospectively evaluated more than 40 features in 85 patients with pure motor, sensorimotor, or pure sensory syndromes. Nonischemic causes were present in 4 patients. The causes of ischemic stroke in the other 81 patients were penetrating artery disease (32 patients), large artery occlusive disease (17), cardioembolism (12), other causes (8), and undetermined (12). Of the features evaluated, frequent transient ischemic attacks (greater than or equal to 1/day), transient ischemic attacks occurring only within 1 week of stroke, pure motor hemiparesis (similar involvement of face, arm, and leg), pure sensory stroke, and round or oval infarction were associated (p less than 0.05) with penetrating artery disease. However, only pure sensory stroke involving two or more regions of the body and pure motor hemiparesis associated with subcortical infarction of less than 1.5 cm had positive predictive values exceeding 90% for penetrating artery disease. Carotid bruit ipsilateral to an anterior circulation infarction, monoparesis, and striatocapsular infarction had positive predictive values exceeding 90% for causes other than penetrating artery disease; however, half of the striatocapsular infarctions were of undetermined cause. These data suggest that certain clinical and radiological features are useful for distinguishing penetrating artery disease from other causes of stroke. PMID- 1789682 TI - Predictive value of intraoperative electrocorticograms in resective epilepsy surgery. AB - The preresection and postresection intraoperative electrocorticograms of 76 consecutive patients undergoing resective surgery for intractable epilepsy were analyzed to see if location, configuration, and discharge rate of epileptiform activity correlated with type and location of pathology of the resected specimens and outcome in regard to seizure control. The location of the predominant spike focus did not correlate with either type of location of pathology or with seizure outcome from temporal lobe surgery (n = 58). The presence of spontaneous or activated spikes outside the resected area did not correlate with outcome from any surgery type. Positive spikes recorded from the amygdala and anterior hippocampus (n = 37) were not associated with type or location of pathology, but bursts of fast repetitive spikes on these needle recordings tended to associate with mesiotemporal pathology (p = less than 0.02) and with mesial temporal sclerosis (p = less than 0.04). A preresection spike discharge rate of 1 per 4 minutes or less was associated with a poor outcome in 5 of 6 patients (p = 0.03), whereas a rate of 18 or more per minute was associated with a good outcome in 15 of 18 patients (p less than 0.06). Persistence of 50% or more of the preresection epileptiform activity in the postresection electrocorticogram after temporal lobectomy correlated with poor outcome in 80% (p = less than 0.03), although the absolute amount of epileptiform activity remaining in the postresection electrocorticogram did not correlate with outcome. Further studies are needed to define the role of intraoperative electrocorticograms in resective epilepsy surgery. PMID- 1789683 TI - The serotonin antagonist mianserin improves functional recovery following experimental spinal trauma. AB - The ability of the serotonin antagonist mianserin to improve neurological recovery after graded impact trauma to the thoracic region of the spinal cord was compared to that of cyproheptadine and ketanserin in pentobarbital-anesthetized rats. Spinal cord injury was produced at T-10 by the weight-drop method and confirmed by the disappearance of the somatosensory-evoked response during the subsequent 15 minutes. In all experiments, drug or vehicle treatments were randomly administered as a single intravenous bolus 15 minutes after injury. Functional outcome was blindly assessed for 2 weeks after injury using a modified Tarlov scale, and in some cases, the Rivlin-Tator angleboard test. The survival of descending raphe-spinal axons was determined by the measurement of serotonin in postmortem spinal tissues located above and below the site of injury. In separate acute experiments, the physiological and hemodynamic correlates of a 50 gm cm injury and either mianserin or vehicle injection were examined, as were the effects on serotonin content and metabolism in spinal tissues harvested 30 minutes after injury. All doses of mianserin were associated with some index of improved recovery following a 50 gm cm injury, with a 1-mg/kg dose being clearly superior. Both ketanserin (0.1 mg/kg) and cyproheptadine (2 mg/kg) displayed marginal therapeutic actions for 50 gm cm injuries. In acute studies, mianserin at 1 mg/kg was associated with the preservation of posttraumatic spinal cord blood flow at T-12 as well as a pronounced alteration in postmortem spinal serotonin content and metabolism, in contrast to vehicle control treatments.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789684 TI - Physical basis of cognitive alterations in Alzheimer's disease: synapse loss is the major correlate of cognitive impairment. AB - We present here both linear regressions and multivariate analyses correlating three global neuropsychological tests with a number of structural and neurochemical measurements performed on a prospective series of 15 patients with Alzheimer's disease and 9 neuropathologically normal subjects. The statistical data show only weak correlations between psychometric indices and plaques and tangles, but the density of neocortical synapses measured by a new immunocytochemical/densitometric technique reveals very powerful correlations with all three psychological assays. Multivariate analysis by stepwise regression produced a model including midfrontal and inferior parietal synapse density, plus inferior parietal plaque counts with a correlation coefficient of 0.96 for Mattis's Dementia Rating Scale. Plaque density contributed only 26% of that strength. PMID- 1789685 TI - Quantitative measurements of capillary transport in human brain tumors by computed tomography. AB - The rate at which water-soluble chemotherapeutic drugs enter brain tumors can be extremely variable. The ability to measure or predict the rate of drug entry may have an important role in treatment. We have developed a method that uses information from contrast-enhanced computed tomographic scans to measure quantitatively the rate of transcapillary transport of iodinated compounds in brain tumors. In a group of 10 patients with brain tumors, we obtained serial measurements of tissue (Am) and arterial plasma (Cp) iodine concentration from timed computed tomographic scans done over 30 minutes, after intravenous infusion of meglumine iothalamate (Conray-60). These measurements were analyzed with a two compartment pharmacokinetic model and nonlinear least-squares regression methods to obtain K1, a blood-to-tissue transfer constant; k2, a tissue-to-blood rate constant; and Vp, tissue plasma vascular volume. Images of K1, k2, and Vp were reconstructed after calculating these values for each 0.8 x 0.8 x 5-mm volume element of the original data. Mean whole tumor K1 values varied from 2.0 mu 1 gm 1 min-1 in a thalamic astrocytoma to 33.9 mu 1 gm-1 min-1 in a glioblastoma multiforme. The value of k2 varied from 0.034 to 0.108 min-1, and Vp varied from 2.4 to 7.9 ml 100 gm-1. In tumor-free brain, the K1 of meglumine iothalamate was 2.9 mu 1 gm-1 min-1; k2 was 0.058 min-1; and Vp was 2.1 ml 100 gm-1.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789686 TI - Is the carboxyl-terminus of dystrophin required for membrane association? A novel, severe case of Duchenne muscular dystrophy. AB - Duchenne muscular dystrophy is a lethal X-linked recessive disorder caused by the deficiency of a component of the muscle fiber membrane cytoskeleton called dystrophin. Becker muscular dystrophy, a clinically milder disorder, results from dystrophin abnormalities rather than deficiency. We identified the first patient who is clearly an exception to these established clinical and biochemical correlates. The patient described clinically had particularly severe Duchenne dystrophy. Biochemically, his muscle contained substantial amounts of abnormal dystrophin (Becker-like). Characterization of the dystrophin protein and gene revealed a unique intragenic gene deletion resulting in a dystrophin protein missing the carboxyl-terminal domain. This patient's dystrophin seemed to have a deleterious "dominant" effect on his muscle: The presence of this abnormal protein was more damaging to the myofibers than the absence of dystrophin would have been. This patient challenges the current hypothesis that dystrophin associates with the plasma membrane solely via its carboxyl-terminus, yet supports the hypothesis that an intact carboxyl-terminus is crucial for correct dystrophin function. PMID- 1789687 TI - Somatostatin replacement therapy for Alzheimer dementia. AB - Somatostatin is consistently diminished in brains of patients with Alzheimer's disease. To evaluate whether pharmacological restoration of this transmitter deficit has therapeutic value, the synthetic analogue octreotide was administered intravenously to 14 Alzheimer patients under double-blind, placebo-controlled conditions. At the highest dose administered, spinal fluid concentrations approximated those found in brains of experimental animals receiving behaviorally effective amounts of the drug. Neuropsychological testing, however, showed no clinically significant improvement. Coadministration of octreotide and physostigmine to 1 patient also failed to improve cognition. Positron emission tomographic studies in 6 patients revealed a generalized decrease in glucose metabolism as a result of octreotide infusion. These findings suggest that stimulation of the somatostatin system has no value in the symptomatic treatment of Alzheimer dementia. PMID- 1789688 TI - Nighttime levodopa infusions to treat motor fluctuations in advanced Parkinson's disease: preliminary observations. AB - We report the clinical response of a parkinsonian patient with severe motor fluctuations who was begun on continuous, nighttime-only levodopa infusions accompanied by oral carbidopa/levodopa use during the day. Sleep disturbances improved immediately. There was a gradual reduction in "off" time and severity of dyskinesias during the waking day. Nighttime-only levodopa infusions have a carryover benefit to the waking hours and may be suitable for long-term therapy to reduce daily motor fluctuations in some patients with Parkinson's disease. PMID- 1789689 TI - The use of hospital discharge data for public health surveillance of Guillain Barre syndrome. AB - The sensitivity of passive reporting of Guillain-Barre syndrome (GBS) to the Vermont Department of Health from 1980 to 1985 was compared to that of computerized hospital discharge abstract data. Written hospital discharge summaries were reviewed for clinical data to validate the computerized abstracts. In all, 51 definite and probable cases of GBS were identified from hospital data during a period when only 4 cases (8%) had been reported to the health department through passive physician reporting. Based on the hospital data, the incidence of this syndrome in Vermont was 1.6/100,000 population/year. The incidence rate for males was 1.5 times that for females. No geographical or seasonal clustering of cases was found. These epidemiological features are consistent with previously published data on the syndrome and suggest that the incidence has not changed significantly in the past 10 years. Incidence rates for GBS based on passively reported cases markedly underestimate the true incidence rate. Although limited by the lack of timeliness for public health surveillance, computerized hospital discharge data are readily available in many states and may be more sensitive in detecting cases, compared to passive surveillance. They may be a useful tool for establishing baseline rates and examining long-term trends for selected acute diseases like GBS for which there are well-established diagnostic criteria and that usually result in hospitalization. PMID- 1789690 TI - T-cell receptor biology and multiple sclerosis. PMID- 1789691 TI - Focal neuronal migration disorders and intractable partial epilepsy: a study of 30 patients. AB - We studied 30 patients with partial epilepsy and a radiological or pathological diagnosis of localized neuronal migration disorders, with a view to surgical treatment. Eight patients had identifiable prenatal etiological factors. The frequency of complex partial, partial motor, and secondarily generalized seizures was approximately 70% each. Drop attacks were present in 27%: Their presence usually correlated with a lesion involving the central region. Partial motor or generalized convulsive status epilepticus occurred in 30%, and was most frequently associated with extensive structural abnormalities involving two or more lobes. A full-scale intelligence quotient of less than 80 was found in 44%. Magnetic resonance imaging (MRI) was superior to computed tomography for identification of the dysplastic cortical lesions. In one third, MRI showed only subcortical abnormalities. It did not allow distinction between true pachygyria, focal cortical dysplasia, or the forme fruste of tuberous sclerosis. The epileptogenic area was usually more extensive than the lesion; it was multilobar in more than 70% of patients. Of 26 surgically treated patients, a histological diagnosis of the type of neuronal migration disorder was possible in 22: 12 had focal cortical dysplasia and 10 the forme fruste of tuberous sclerosis. In the remaining 4, no definite histological diagnosis was made, since the maximally abnormal tissue could not be examined. In the latter, and in the 4 nonoperated patients, the diagnosis of neuronal migration disorder was based on imaging findings. The presence of the forme fruste of tuberous sclerosis correlated with delayed psychomotor development and more extensive epileptogenic areas. PMID- 1789692 TI - Focal neuronal migration disorders and intractable partial epilepsy: results of surgical treatment. AB - Twenty-six patients with focal or lateralized neuronal migration disorders and intractable partial epilepsy were treated surgically. Twenty-four had reliable follow-up ranging from 1 to 15 years (mean, 5.0). Pathologically, they fell into two categories: focal cortical dysplasia (12 patients) and forme fruste of tuberous sclerosis (8 patients). In the remaining 4 patients, the material was inadequate for histological analysis. Outcome regarding seizure control was assessed according to a classification most sensitive to variations in frequency of major attacks. Ten (42%) of the 24 patients achieved good or excellent outcome, 6 (25%) had a worthwhile decrease in seizure frequency, and 8 (33%) had only discrete improvement. The variable most strongly correlated with surgical outcome was the amount of lesion removed. Seventy-seven percent of patients in whom a complete excision or excision of 50% or more of the lesion was accomplished achieved excellent or good surgical outcome. Conversely, no patient with less than 50% of the lesion removed attained the same result. There was no correlation between other clinical, radiological, or electrographic variables and outcome regarding seizure control. Specifically there was no significant correlation between the amount of excision of the epileptogenic area as judged by scalp electroencephalography and electrocorticography studies, and surgical outcome. In patients with neuronal migration disorders and intractable partial epilepsy, removal of the structural abnormality takes precedence over removal of epileptogenic tissue as the main surgical strategy to achieve seizure control. PMID- 1789693 TI - Reflex activity and muscle tone during elbow movements in patients with spastic paresis. AB - Reflex behavior and tension development in upper limb muscles were analyzed and comparisons made between the unaffected and spastic sides of patients with spastic hemiparesis. During sinusoidal (0.3-Hz) isometric or isotonic elbow tracking, with a control either of joint position or of torque, randomly timed displacements were induced (at one of three velocities) stretching either the activated flexor or the extensor muscles. On the spastic side, exaggerated short latency reflexes were apparent, but in contrast, the amplitude of long-latency electromyography (EMG) responses was reduced. The latter responses were differentially modulated on the unaffected side, predominantly by the acceleration signal during control of position and more by the velocity signal during control of torque, while the mode of muscle contraction (isometric or isotonic) had little influence on this behavior. This difference in reflex modulation was lost on the spastic side. The functional consequence of this reduced EMG modulation could be difficulty in performing finely controlled arm movements. The ratio of torque to EMG activity during displacements was higher for both background and reflex-induced EMG on the spastic limb than on the unaffected side. This effect was more pronounced for the flexor than for the extensor muscles. Consequently, the development of spastic muscle hypertonia cannot be attributed to an increase in EMG activity. It is suggested that secondary to a supraspinal lesion, mechanical muscle properties change in such a way that the activated spastic muscle develops more tension when it is stretched. PMID- 1789694 TI - Hypertension in the elderly is associated with white matter lesions and cognitive decline. AB - Forty-two elderly patients (mean age, 66.2 +/- 5.1 yr) with hypertension, treated for an average of 17.3 years (standard deviation, 10.3), and 42 control subjects (mean age, 66.5 +/- 4.8 yr), matched for age, sex, and level of education, were studied with regard to the detection of lesions in the cerebral white matter with magnetic resonance imaging (MRI), particularly with axial T2-weighted images. The assessment of the MRI scans was blinded. Ten hypertensive patients showed confluent lesions in the white matter, versus only 1 control subject (Chi-square test, p = 0.01). The presence of diffuse lesions of the white matter was related to age but not to the known duration of hypertension, nor to the presence of any other cardiovascular risk factors. Cognitive function was measured in 34 hypertensive patients and in 18 control subjects. Results of the Mini-Mental State Examination, the Stroop color-word test, Trailmaking test, and the visual subtest of the Wechsler Memory Scale were worse in patients with confluent lesions of the white matter; there was no difference in mental functioning between hypertensive patients and control subjects with normal white matter or with only small focal lesions. Our findings suggest that long-standing hypertension in some patients may cause not only strokes but also chronic end organ damage of the brain in the form of demyelination of the white matter, with cognitive decline. PMID- 1789695 TI - Human nerve growth factor prevents degeneration of basal forebrain cholinergic neurons in primates. AB - Basal forebrain cholinergic neurons respond to nerve growth factor (NGF), and it has been suggested that the administration of NGF might prevent their degeneration in patients with Alzheimer's disease. One major prerequisite to be fulfilled before the consideration of clinical trials of NGF in patients with Alzheimer's disease is the demonstration that human NGF affects basal forebrain cholinergic neurons in primates. In the present study, we used a recombinant human nerve growth factor (rhNGF), which we previously showed to be active on rat basal forebrain cholinergic neurons, in nonhuman primates with a unilateral transection of the fornix (a well-established model for the induction of retrograde degenerative changes in septal cholinergic neurons). After the lesion, one group of animals received rhNGF and a second group received vehicle solution for 2 weeks. In animals receiving vehicle, the medial septal nucleus ipsilateral to the lesion showed reductions in number (55%) and size of cell bodies immunoreactive for NGF receptor and choline acetyltransferase. In Nissl stains, many cells showed reduced size and basophilia. The rhNGF completely prevented alterations in the number and size of NGF receptor- and choline acetyltransferase immunoreactive neurons in the medial septal nucleus and reversed atrophy in a subpopulation of large, basophilic medial septal nucleus neurons, as identified by Nissl stains. The effects of rhNGF were identical to those of mouse NGF, which we have previously used in the same primate lesion paradigm. The restoration of the phenotype of injured cholinergic septal neurons by rhNGF in the monkey raises the possibility that this factor may be used to ameliorate acetylcholine dependent memory impairments that occur in aged nonhuman primates. In concert, results of the present investigation provide critical information for the future use of NGF in patients with neurological disorders that affect NGF-responsive cells in the peripheral and central nervous systems. PMID- 1789696 TI - Inter- and intra-examiner reliability of nerve conduction measurements in normal subjects. AB - Nerve conduction studies are widely employed in evaluating patients with peripheral nerve disease and are often used serially to measure disease progression or to assess a therapeutic intervention. We determined the inter- and intra-examiner reliability of electrophysiological data by performing serial nerve conduction studies on 7 normal subjects. A high degree of intra-examiner reliability was present, but significant inter-examiner differences were found. Our results suggest that if nerve conduction studies are to be used longitudinally, they should optimally be performed by a single examiner to minimize the degree of variability associated with different examiners. PMID- 1789697 TI - Thrombotic microangiopathy isolated to the central nervous system. AB - A man with plasma cell dyscrasia and bone marrow infiltration presented with rapidly progressive encephalopathy. Magnetic resonance imaging revealed multiple small areas of abnormal signal that correlated with the autopsy findings of thrombotic microangiopathy isolated to the central nervous system. PMID- 1789698 TI - Changes of muscarinic cholinergic binding by lymphocytes in Parkinson's disease with and without dementia. AB - We compared the muscarinic cholinergic binding in lymphocytes of 44 patients with idiopathic Parkinson's disease with 23 age-matched normal volunteers, using [3H]quinuclidinyl benzilate. In 24 patients with Parkinson's disease without dementia, binding was normal in 12, below control values in 6, whereas the remaining 6 (all on anticholinergic medication) showed very high binding. In all 20 patients with Parkinson's disease and with dementia, the binding was below control levels, indicating that in these patients, as in patients with Alzheimer's dementia, the cholinergic muscarinic binding by lymphocytes is reduced. PMID- 1789699 TI - Current diagnostic criteria for Guillain-Barre syndrome. PMID- 1789700 TI - An alternative apnea test for the evaluation of brain death. PMID- 1789701 TI - [Methods and expenses for protection against mosquitoes in households in Kinshasa, Zaire]. AB - An investigation on the knowledge, behaviour and practices regarding the protection against mosquitoes was carried out in June 1990 among 420 households in six districts of urban Kinshasa. Most of the surveyed families (92.4%) consider mosquitoes as a nuisance and 83.8% say to do something about it. Among the latter, 43.5% spend money for their protection: incense coils (85.6%), insecticide sprays (55.5%), bednets (38.6%). In May 1990, families have spent a median sum of US$ 5.00, which was at that time about the price of an impregnated bednet. 89.5% of the surveyed families said they would agree to buy an impregnated bednet if the price was acceptable (median sum of US$ 4.00 is judged as acceptable). Impregnated bednets being an efficient method of malaria control, financially accessible and acceptable, their utilization should be further encouraged by the national programme of malaria control and primary health care. PMID- 1789702 TI - An experimental latex agglutination test for antibody detection in human African trypanosomiasis. AB - A latex card agglutination test for detection of antibodies in human African trypanosomiasis is presented. The latex was covalently coated with semipurified surface glycoprotein of Variable Antigen Type LiTat 1.6 of Trypanosoma brucei gambiense. Sera from 100 patients infected with T.b. gambiense, 26 patients infected with T.b. rhodesiense and 707 individuals without trypanosomiasis, including 132 malaria seropositives, have been tested. At serum dilution 1:16, sensitivity of the test was 91% for the T.b. gambiense and 42.3% for the T.b. rhodesiense group. Specificity was over 99%. The reagent remained stable at +/- 6 degrees C for at least 3 months. Reagent kept at 37 degrees C for 3 months retained its sensitivity and showed a slight decrease in specificity. PMID- 1789703 TI - A simplified and less expensive strategy for confirming anti HIV-1 screening results in a diagnostic laboratory in Lubumbashi, Zaire. AB - The conventional algorithm for HIV testing based on the confirmation of all positive anti-HIV screening reactions by Western blot (WB) is too expensive for developing countries. We investigated the validity of confirming positive screening assay reactions by a second screening test, limiting the use of the supplemental assay to the discrepant test results (algorithm 3), or screening all sera with 2 different assays and retesting all discrepant results by a supplemental assay (algorithm 4) on a panel of 519 sera in a regional reference laboratory in Lubumbashi, Zaire. Combining the Vironostika anti-HTLV-III ELISA with HIV Chek 1 + 2 or Clonatec Rapid HIV 1/2 Ab on all samples and retesting the discrepant results in WB or a line immunoassay (INNO-LIA) (algorithm 4), yielded a sensitivity of 100% and specificities of 98.4% and 99.0% respectively, at costs of 7.3 US $ and 9.3 US $ per test, respectively, for a 40% prevalence of HIV antibody positive samples. The conventional algorithm scored a sensitivity of 97.1% and a specificity of 100% for 11.3 US $ per test. The testing strategy of combining HIV Chek 1 + 2 and Clonatec Rapid HIV 1/2 Ab, an interesting option for small isolated centra, had a 96.6% sensitivity, but yielded only a slightly better specificity of 99.0%, as compared to 97.8% for HIV Chek alone. The price of combining the two simple assays using algorithm 3 was 6.8 US $ per test, using algorithm 4 was 10.6 US $. HIV testing strategies based on ELISA and a simple HIV test are a valuable alternative for reference laboratories faced with a high prevalence of HIV positive samples. PMID- 1789704 TI - [Population dynamics and infestation with Bulinus globosus in a Sudan-Sahelien zone of Cameroon]. AB - The population dynamics of Bulinus globosus was followed at seasonal and perennial habitats in three villages in the Extreme North Province, Cameroon, known to have high prevalences of Schistosoma haematobium. The study covered 2 rainy and 1 dry season between June 1987 to November 1988. Of several environmental factors monitored, only rainfall and the resulting changes in water level were strongly correlated with changes in snail density, and even then only when values were at their extremes. In seasonal pools, adult snails emerge from estivation and begin laying eggs shortly after the first rains. A decline in the number of larger snails 3 to 6 weeks later suggests a die off of the founding population. In general, the population density increases modestly during the rainy season and then rapidly declines after torrential rains have ended in September or October. Adults are again dominate just before the habitats dry up. In seasonal streams, population densities fluctuate dramatically in association with rainfall and subsequent flooding, and populations stabilize only after the torrential rains have ceased. Unlike populations in temporary ponds, young snails constituted a large percentage of the population very late in the season. In perennial habitats, seasonal fluctuations in population density were related to manipulation of water levels in a rice irrigation scheme. The lowest densities occurred when the water levels were at their most extreme levels, between November and April. But declines in the population densities often preceded significant changes in the water level, indicating that this factor alone is not responsible for these declines. Of the B. globosus shedding schistosome cercariae, more than 90% were infected with S. haematobium and the remainder with S. bovis. Of 153 infected B. globosus, 87% were found in seasonal habitats. In those sites the first infected snails were found in July but the large numbers were not present until late August and September. Infected snails declined rapidly before the final decline in the general population of B. globosus in November and December. In perennial habitats, infected snails were most common in May and June, just before and early in the rainy season. These findings may prove useful in developing more effective schistosomiasis control measures in sahelian climates. PMID- 1789705 TI - [Perinatal mortality in Burkina Faso: risk factors in an urban environment of Bobo-Dioulasso]. AB - A total of 96 mothers of stillborn babies (cases) and 402 mothers of live-born babies (controls) were studied between the 1st November 1988 and the 31st July 1989 in an attempt to identify the risk factors for the high number of stillbirths in the Maternity wing of the Hopital National Souro SANON in Bobo Dioulasso, Burkina Faso. From a stratified analysis, eight risk factors emerged as significant predictors of mortality: mother older than 35 years, high parity (five or more), previous history of stillbirth, lack of medical supervision of pregnancy, interval between last consultation and birth longer than 30 days, complications during delivery and birth weight less than 2,500 g. Polygamy was associated with a 51% reduction in the risk of stillbirth. The problem of selection bias which affects the validity of hospital based case-control studies is discussed. Techniques for reducing selection bias in hospital based case control studies are proposed. Improvements in antenatal care in Bobo-Dioulasso are suggested. PMID- 1789706 TI - Prevalence and type of infertility in Gabon. AB - The prevalence and type of infertility based on the WHO criteria were determined in a rural and semi-rural population in south-eastern Gabon. The prevalence rate of infertility in the rural population was 5.7% for primary infertility and 20.0% for secondary infertility. In the semi-rural area, 3.0% suffered from primary infertility and 22.4% from secondary infertility. Pregnancy wastage and home delivery were risk factors for secondary infertility. An evaluation of the WHO criteria for fertility surveys was made. PMID- 1789707 TI - [Value of the quantitative buffy coat test (QBC) as a method in the microscopic diagnosis of malaria]. PMID- 1789708 TI - [Development of chloroquine resistance in an urban area. Results of surveys in Dakar and Pikine]. PMID- 1789709 TI - Influence of methylene blue and oxyhemoglobin on mammalian vascular responses to sodium nitroprusside and nitroglycerin. AB - Vasodilatory responses to sodium nitroprusside were compared with those to nitroglycerin in helical strips of blood vessels isolated from dogs, humans, monkeys, rats and guinea-pigs. Sodium nitroprusside relaxed arterial and venous strips contracted with prostaglandin F2 alpha in a dose-related manner, as did nitroglycerin. Relaxant responses to sodium nitroprusside and nitroglycerin were significantly greater in dog coronary arteries than in the mesenteric arteries. Tachyphylaxis developed upon repeated applications of nitroglycerin but not of sodium nitroprusside. In rat and guinea-pig aortae, relaxant responses to sodium nitroprusside and nitroglycerin were markedly suppressed by treatment with methylene blue or oxyhemoglobin. In dog arteries and veins, treatment with oxyhemoglobin significantly inhibited relaxant responses to sodium nitroprusside and nitroglycerin. On the other hand, treatment with methylene blue did not inhibit responses to sodium nitroprusside but markedly suppressed those to nitroglycerin in dog blood vessels as well as in human gastroepiploic and monkey mesenteric arteries. It is concluded that dog and primate blood vessels do not develop tolerance to repeated applications of sodium nitroprusside and that sensitivity of soluble guanylate cyclase to methylene blue may differ in blood vessels from different mammals (dog and primate vs rat and guinea-pig). PMID- 1789710 TI - Alterations of the endothelial function of isolated aortae in rats with adjuvant arthritis. AB - Adjuvant arthritis was induced in 30 male Wistar rats by injection into the tail of heat-killed Mycobacterium butyricum. Three weeks later, 14 of these rats exhibited severe arthritic lesions. Their thoracic aortae were studied in parallel with those isolated from a control group. On rings precontracted with phenylephrine (0.1 microM), the endothelium-dependent relaxations produced by acetylcholine and histamine were significantly diminished in the arthritic group as compared to the control group. Moreover, the increase in tone induced by incubation with methylene blue (10 microM) (a nonspecific inhibitor of endothelium-derived relaxing factor) was significantly less pronounced in preparations isolated from the arthritic group. On the other hand, relaxations produced by the endothelium-independent vasodilators verapamil and nitroprusside were similar in both groups. It is concluded that adjuvant arthritis modifies the endothelium-derived relaxing factor-mediated responses of rat aorta. PMID- 1789711 TI - Effect of caffeine on tone and intracellular Ca++ release in guinea-pig and human trachealis. AB - High concentrations of methylxanthines induce contraction in many smooth muscle types, but relax guinea-pig trachealis. We examined this discrepancy by studying the interaction of caffeine and spasmogens in the isolated guinea-pig trachealis. We extended our observations to the isolated human trachealis. In the guinea-pig trachealis, 25 mM but not 2.5 mM caffeine totally blocked any contractile effect of methacholine or histamine, but not of KCl, whose contractile effect relies on extracellular Ca++. The beta-adrenergic agent isoprenaline (10(-3)M) only partially blocked the spasmodic effect of methacholine and histamine. In the human trachealis, 25 mM but not 2.5 mM caffeine induced an initial contraction followed by a relaxation. After this latter relaxation, methacholine (10(-5) M) and histamine (10(-5) M) were without effect, while KCl caused a contraction. In the guinea-pig, a contractile effect of 25 mM but not 2.5 mM caffeine was uncovered by switching to a high K+, Ca(++)-free solution prior to adding the caffeine. The source of the Ca++ promoting the contraction thus must be intracellular stores. Accordingly, ryanodine, an inhibitor of Ca++ storage, blocked this contraction. Similarly histamine (10(-5) M) and methacholine (10(-5) M) in the Ca(++)-free solution induced a contraction. The histamine contraction was completely blocked by ryanodine, the methacholine contraction, 79% blocked. We conclude that caffeine appears to surpass the antispasmodic effects of beta adrenergic stimulation, at least in part, by depleting intracellular stores of Ca++. PMID- 1789712 TI - Validation of spontaneous morphine withdrawal symptoms in rats. AB - Spontaneous morphine withdrawal has been studied in rats after induction of dependence using administration of morphine via the food (+/- 160 mg/kg/day on the basis of body weight). In the present paper, the decrease of the nocturnal locomotor activity and of food intake were validated as real morphine withdrawal symptoms. During the withdrawal phase, morphine was readministered either by subcutaneous injection of morphine or admixed in the food. Subcutaneous administration resulted in short-lasting enhancements (of 50%) of the locomotor activity (peak effects) followed by a decrease of 50%, while food intake and loss of body weight were hardly affected. Administration via the food resulted in a dose-dependent reduction of the decrease of the nocturnal locomotor activity, the decrease in food intake and the loss of body weight. Chronic naloxone infusion (0.03 or 0.1 mg/kg/hr) via osmotic minipumps appeared to have similar effects on locomotor activity, food intake and body weight, compared with spontaneous withdrawal of morphine. However, the recovery to normal values appeared to occur faster after naloxone infusion. It is concluded that the observed withdrawal symptoms, i.e. decrease of the locomotor activity, decrease of food intake and loss of body weight, can be interpreted as real withdrawal symptoms not caused by additional manipulations occurring in the course of the experiments. PMID- 1789713 TI - Effect of hypoxia and catecholamine stimulation on cardiac performance in the isolated working hyperthyroid rat heart. AB - The hyperthyroid heart has a greater oxygen demand due to its enhanced contractile state and higher basal metabolic rate. Consequently, it may be more sensitive to conditions of decreased oxygen supply or increased oxygen use. We, therefore, investigated the effect of a restricted oxygen supply (hypoxia) and enhanced oxygen demand (catecholamine stimulation) on cardiac function in the isolated working hyperthyroid heart. Hypoxia was induced by substituting 20% of the oxygen in the perfusate with nitrogen, while catecholamine stimulation was with isoproterenol. Hypoxia caused a 37% drop in cardiac output in the hyperthyroid heart and a 10% decrease in euthyroid hearts. In response to isoproterenol, a dose-dependent increase in heart rate was found in both groups which was greatly augmented in the hyperthyroid hearts by hypoxia. With isoproterenol stimulation under normoxic conditions, euthyroid hearts showed a moderate increase in contractile performance (cardiac output and dP/dtmax), while in hyperthyroid hearts contractile performance declined. Hypoxia exacerbated the decrease in function of the hyperthyroid heart. In conclusion, our results indicate that the hyperthyroid heart is very sensitive to imbalances in the myocardial oxygen supply/demand ratio, especially when demand is increased in the presence of decreased supply. PMID- 1789714 TI - Mechanisms of inhibition of nitric oxide production in a murine model of splanchnic artery occlusion shock. AB - Nitric oxide has been thought to be a major endothelium-derived relaxing factor which is synthesized from L-arginine and can be selectively inhibited by L-NG monomethyl arginine. On the other hand, another endothelium-derived vasorelaxant, defined as endothelium-derived hyperpolarizing factor, has been reported. We compared their role in regulating the splanchnic vascular tone in splanchnic artery occlusion shock in the rat. Administration of L-NG-monomethyl arginine (100 mg/kg) given 5 min prior to reperfusion of splanchnic arteries which were occluded for 45 min, produced a significant increase in mean arterial blood pressure. However, the indices of the severity of shock status, including survival time, survival rate and increases in hematocrit, plasma cathepsin D and myocardial depressant factor activity following splanchnic artery occlusion shock were not exacerbated by administration of L-NG-monomethyl arginine. Addition of L NG-monomethyl arginine (1 mg/ml) induced a small but significant increase in basal vascular tone of superior mesenteric artery rings, but it failed to totally block acetylcholine-induced vasorelaxation (48 +/- 4% relaxation). Although there were no significant changes in basal vascular tone after administration of glibenclamide (30 micrograms/ml), acetylcholine-induced vasorelaxation was significantly attenuated (58 +/- 4% relaxation). When L-NG-monomethyl arginine and glibenclamide were added together, acetylcholine-induced vasorelaxation was almost totally abolished (18 +/- 2% relaxation). Our results indicate that rat splanchnic artery endothelial cells may produce both endothelium-derived relaxing and hyperpolarizing factor. Endothelium-derived relaxing factor plays an important role in the regulation of basal vascular tone of the splanchnic circulation, while endothelium-derived hyperpolarizing factor may be important in modulating the mesenteric blood flow following splanchnic artery occlusion shock. PMID- 1789716 TI - Effects of peripheral inputs from hindlimb on the monosynaptic reflex of motoneurons innervating tail muscles. AB - The effects of group II muscle (PBSt, GS) and cutaneous afferent (Sur, SPc, Tib) inputs from the hindlimb on the monosynaptic reflexes of motoneurons innervating tail muscles were studied in lower spinalized cats. Stimulation of the cutaneous nerves at the conditioning-test stimulus interval of about 10-20 ms facilitated and inhibited the monosynaptic reflexes of ipsilateral and contralateral tail muscles, respectively. The effects of the muscle nerve stimulation were not so prominent as those elicited by cutaneous nerve stimulation. The monosynaptic reflex was also inhibited by muscle nerve stimulation at 10-50 ms intervals. The effects of conditioning stimulation of the hindlimb peripheral nerves at short intervals were depressed or blocked by section of the ipsilateral lateral funiculus at S1 spinal segment. These findings show that the neuronal pathway from hindlimb afferents to tail muscle motoneurons passed the lateral funiculus of the spinal cord and modulates the motoneuronal activity of tail muscles. PMID- 1789715 TI - The contribution of diffusion to the termination of penicillin-induced convulsive activity in the awake rat. AB - 1. Experiments were performed to investigate the contribution of diffusion to the termination of PCN induced convulsive (epileptiform) activity in the awake rat. The basic question was whether convulsive activity terminates at the same critical concentration Ct of PCN independently of the concentration Co of PCN injected into the superficial layer of the foreleg field of the right motor cortex. Different concentrations Co were used, the lowest being 16 IU PCN/0.5 microliters saline, the largest 1000 IU PCN/0.5 microliters saline. The convulsive activity was recorded by means of the electroencephalogram (EEG). 2. Mathematical calculations concerning the diffusion of the substances were performed by using the diffusion equation with a PCN diffusion coefficient D = 3.52 x 10(-4) mm2/s and the tortuosity factor lambda = 1.62. 3. The lowest dose of PCN used was considered as a threshold dose for acute induction of convulsive activity because only 4 out of 9 rats treated with 16 IU PCN developed epileptiform activity. For the range of doses between 16 and 32 IU, the median frequency of convulsive potentials was dose-dependent, and increased from 7.9 to 13.8 pot./min, respectively. For higher doses covering the range between 63 and 1000 IU, there was only an insignificant increase from 19.2 to 22.7 pot./min, respectively. 4. The median period of convulsive activity increased significantly (p less than 0.05 or less than 0.01) and monotonically from 19.5 min in rats treated with 16 IU PCN to 267 min after treatment with 1000 IU PCN. 5. At the end of the convulsive activity, the median critical concentration Ct within the artificial focus ranged from 1.75 to 1.31 IU/0.5 microliters saline in rats treated with 16 to 125 IU PCN, while after induction of convulsive activity with doses of 250, 500 or 1000 IU PCN, Ct gradually increased to 2.01, 2.83, and 3.75 IU/0.5 microliters, respectively. This means that the brain became less sensitive for PCN the longer the epileptiform activity lasted. 6. It is concluded that during long-lasting convulsive activity, the brain takes advantage of its plastic properties by eliciting counteracting mechanisms. These self-protective factors may utilize neuronal networks which needs some time to become effective in the control of the cortical activity. PMID- 1789717 TI - Effects of butorphanol on luteinizing hormone and follicle stimulating hormone levels in ovariectomized rats--comparative study with morphine sulphate. AB - Studies were conducted into the effects on pituitary gonadotrophic hormones in ovariectomized rats of butorphanol, a synthetic morphine derivative which was claimed to be a potent analgesic with few side-effects, in comparison to effects of the naturally occurring alkaloid morphine. For this purpose, 3 groups of ovariectomized rats were used. Rats of the 1st group were injected butorphanol at 2 dose levels (1 or 2 mg/kg body weight [b.w.]. Those of the 2nd group were injected morphine sulphate (10 or 20 mg/kg b.w.). The 3rd group was injected saline and served as control. Blood samples were collected by orbital sinus punctures, just before treatment and 1 hour post injection. Luteinizing hormone (LH) and follicle-stimulation hormone levels were determined in the sera of rats by radio-immuno-assay. The results revealed that morphine, at the 2 dose levels used, produced more than 90% decrease in serum LH concentration, whereas butorphanol produced more than 70% decrease in serum LH levels. Both morphine and butorphanol, at the 2 doses used, produced more than 76% decrease in serum follicle stimulating hormone concentration. It is concluded that butorphanol, the morphinic derivative, has a depressive effect on the synthesis and/or release of gonadotrophic hormones. This inhibitory effect, however, was nearly as potent as that produced by morphine sulphate. PMID- 1789719 TI - Effect of pregnancy on body weight and pelvic conformation in crossbred cows (Friesian x Gir and Jersey x Gir). AB - Studies were conducted into 80 pregnant crossbred cows belonging in equal numbers to 1/2Friesian (F) 1/2Gir (G) and 1/2Jersey (J) 1/2G genetic groups to determine the effect of pregnancy on body weight (B.W.) and pelvic conformation of the dam. Mean B.W. started to increase in 1/2F1/2G/1/2J1/2G genetic groups from 406.08 +/- 6.16/375.45 +/- 7.73 kg on the 120th day of pregnancy and reached its maximum of 470.42 +/- 7.22/428.05 +/- 8.36 kg on the day of calving. A significant increase in weight occured in both groups between the 240th and 270th days of pregnancy. Total weight gain in both groups during pregnancy was 63.34/52.60 kg. There was a steep fall (P less than 0.01) in B.W. in both groups, within 1 month after calving. Weight became stable 60 days after calving in both groups. The cows in the 1/2F1/2G group were significantly heavier (P less than 0.01) than the 1/2J1/2G group, all the time. The mean pelvic outlet area started to increase in 1/2F1/2G/1/2J1/2G groups from 278.28 +/- 4.03/249.29 +/- 5.02 cm2 by the 120th day of pregnancy. Like B.W., the pelvic area, too, increased significantly (P less than 0.01) between the 240th and 270th days of pregnancy and dropped within 1 month post partum in both groups. Total increase in pelvic area was 49.15/39.76 cm2 in both groups, between the 120th day of pregnancy and calving. The area became stable 60 days after calving in both groups. The pelvic area in the 1/2F1/2G group was always significantly larger (P less than 0.01) than that in the 1/2J1/2G group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789718 TI - [Comparison of pharmacokinetic parameters of tetracyclines which are most frequently used in veterinary medicine]. AB - 40 adult White Californian rabbits were monitored for serum levels, soft tissue concentrations, and biological half-life of technical chlorotetracycline (Aureovit 12 C40 -- SPOFA), chlorotetracycline chloride (Farmitalia substance), tetracycline chloride (tetramyocine tablets for veterinary use -- SPOFA), and oxytetracycline chloride (oxymycoine in powder form for solution for veterinary use -- SPOFA), following application of 20 micrograms.kg-1. All tetracyclines tested were orally administered by gavage, following dissolution or suspension (Aureovit 12 C40). Statistically significant differences were found to exist among serum levels of various tetracyclines, with the 1st to 11th hours from administration, whereafter differences turned minimal between the 11th and 24th hours. Differences were found to exist also among concentrations in various organs. PMID- 1789720 TI - Effects of dietary protein deficiency on hepatic carbohydrate metabolism in geese. AB - This paper was aimed at following up the course of glucose in the liver of protein underfed geese. Compared to normally fed geese, liver carbohydrate metabolism in protein underfed animals can be characterised by lowering of free glucose content of in vitro glucose uptake and glycogen synthesis and reduction of carbohydrates in total oxidation. Glycogen content of the liver and rate of glucose oxidation were also lowered, but these differences were not statistically significant. Summing up our results and taking into consideration some literature data, an overall reduction of hepatic carbohydrate metabolism in protein underfed birds may be assumed. PMID- 1789721 TI - [Orienting toxicologic studies in Wistar rats for the evaluation of knotgrass- (Polygonum convolvulus)--seed]. AB - Black bindweed seed (Polygonum convolvulus) from the 1987 harvest was tested for possible toxicity in a 38-day range-finding test with Wistar rats which received feed rations on the basis of VDT-1 standard feedstuff and components of 5 or 20%. Histological liver findings as well as parameters recorded from laboratory diagnosis (plasma activities of ALAT, ASAT, and gamma GT as well as total protein and albumin levels in plasma) were indicative of incipient impairment of liver metabolism. More detailed and comprehensive chemico-analytical investigations are recommended, with due consideration of the unity between high-value primary components, on the one hand, and possibly toxic secondary constituent substances, on the other. PMID- 1789722 TI - Thio-urea and methionine effects on glucose and leucine absorption in chicken jejunum. AB - Administration to broiler chickens of one single dose of thio-urea (7 mg/kg body weight) on the 7th day of age affects in different ways jejunal absorption of glucose and of leucine. Methionine supplementation of feedstuff (1.5 g/kg) through 40 days affects, in an age-dependent manner, glucose absorption, but not that of leucine. PMID- 1789723 TI - [The occurrence and the importance of enterotoxins from strains of Escherichia coli from bovine mastitis]. AB - Baby mouse and Y1 cell culturing tests were conducted into 117 Escherichia (E.) coli strains from mastitis of cattle to clear up enterotoxin formation. The rate of the latter was found to be relatively low, with enterotoxins recorded from only 7 strains (6%). No correlations were established between enterotoxin formation, on the one hand, and antibiotic resistance as well as biochemical activities of E. coli isolates, on the other. The question still remains open, if enterotoxin-forming strains derive their udder pathogenicity from endotoxins or with support by enterotoxins. PMID- 1789724 TI - [Histologic studies of the postnatal development of the uterus of dwarf goats]. AB - Thirty-four Syrian goats were investigated for postnatal uterus development, from the first day after parturition to the age of six months. Structures were found to undergo conspicuously early differentiation. Full morphological uterus development was established at the age of three to four months. Syrian goat thus is sexually mature at that early age. This is considered to be essential to good suitability of Syrian goat as experimental animal. PMID- 1789725 TI - Response of testes, epididymis, and seminal vesicle of rabbits to zinc deficiency. AB - It is the purpose of this study to determine the effects of Zn deficiency on the biochemical composition of testes, epididymis, and seminal vesicle of rabbits. An attempt is made to evaluate previous physiological studies and to correlate them with biochemical changes. 30 mature male Balady rabbits were used in this study. 1 group was fed a Zn-deficient diet, and 2 control groups were pair-fed or fed ad libitum a Zn-sufficient diet, all for a period of 120 d. There was significant reduction in the levels of hyaluronidase, alkaline phosphatase, acid phosphatase, lactic dehydrogenase, sialic acid, protein, and Zn of both testes and epididymis of Zn-deficient rabbits. Reduction in the level of glyceryl-phosphoryl choline in the epididymis of Zn-deficient rabbits was the best indicator of inhibition of epididymal secretory activity. In contrast, the cholesterol and glycogen contents of the testes were elevated. The results also showed in Zn-deficient rabbits significant reduction in androgen-sensitive parameters, namely fructose and citric acid in the seminal vesicle. Zn levels were decreased in the seminal vesicle. The results indicated that Zn deficiency caused inhibition of testicular, epididymal, and seminal vesicle function and, consequently, caused reductions in the biochemical composition of these organs. PMID- 1789726 TI - Haemophilus somnus as a bacterial cause of pneumonia in buffalo calves in Egypt. AB - Haemophilus (H.) somnus strains were isolated from nasopharyngeal swabs collected from buffalo calves showing respiratory symptoms as well from pneumonic lung tissue samples, the incidence being 4.7% and 10.4%, respectively. The organism was not recovered from samples obtained from apparently healthy buffalo calves. All isolated strains were highly virulent to mice, causing acute septicaemia and death within 3-5 days from intraperitoneal inoculation with 7.5 x 10(6) viable organisms. All tested strains were resistant to tetracycline and sulphafurazole, but most strains were highly sensitive to gentamicin, ampicillin, penicillin G, and colistin sulphate. H. somnus must not be neglected as a causative agent of respiratory disorders in buffalo calves, in addition to other incriminated organisms. PMID- 1789727 TI - [Methods and results of electrocardiography and arterial blood pressure determination with remote recording and drug administration in cattle]. AB - An account is given in this paper of catheterisation of the common carotid artery and external jugular vein of cattle by means of silicone rubber hoses together with a method of wireconnected remote recording of blood pressure and cardiac potentials, using strong subcutaneously placed electrodes. Also described are techniques for recording of respiration through one simple, intranasally applied thermo-couple as well as for remote application of pharmaceuticals, using infusion pumps or syringes with extension tubes. Electrocardiograms (ECG) and shapes of blood curves recorded from non-medicated animals were analysed. Cattle ECG usually exhibited a small positive P-spike, one ventricular complex usually made up of one small positive R-spike and one large negative S-spike as well as one large positive T-spike. The pericardial arterial blood-pressure curve was found to rise, without preliminary waves, to two main waves separated from one another by a clear incisure, before it dropped steeply, later on more smoothly and oscillating to the enddiastolic pressure point. PMID- 1789728 TI - [Direct electron microscopic virus detection in diseases of goslings and Moscovy ducks (Cairina moschata)]. AB - Various organs of goslings and Muscovy duck chickens were investigated by electron microscopy, with the negative contrast technique being used in a routine diagnosis programme. Investigations were extended over several years and were, more specifically, applied to 1,148 samples obtained from 525 goslings and 429 samples which had been collected from 139 Muscovy duck chickens. Viruses were directly detected in 132 or 76 samples. Parvoviruses were predominant in geese and Muscovy ducks and accounted for 83.3 or 94.7%. Rotaviruses, reoviruses, and adenoviruses were sporadically diagnosed. Most of all positive findings were recorded from intestinal matter, liver, and heart. Parvovirus-related diseases were practically removed from among goslings, owing to efficient immunoprophylaxis on all larger goose units. Small privately owned flocks were found to play a role as pathogen reservoirs for both goslings and Muscovy ducks. PMID- 1789729 TI - Hemato-clinical changes in phenylhydrazine-induced acute hemolytic anaemia in calves. AB - Acute anaemia was induced in calves aged 1 week, using the oxidant chemical phenylhydrazine-hydrochloride (PHH). The hematoclinical responses to graded doses were evaluated. Mild anaemia was observed with the 60 mg/kg body weight (B.W.) dose. The 100 mg/kg B.W. dose was too toxic. The sublethal 80 mg/kg B.W. dose produced the desired type of hemolytic anaemia, the peak of which being observed on d 4 post-injection (p.i.). Hemolytic anaemia was evidenced by hemoglobinaemia and hemoglobinuria. The acute toxicity symptoms lasted for about 30 min. Thereafter, the animals appeared to overcome the stress. In general, increases in pulse and respiration coincided with progress of the hemolytic syndrome. Peak response occurred 48 to 60 h p.i. PMID- 1789730 TI - Pathomorphological changes in calf erythrocytes during phenylhydrazine-induced acute hemolytic anaemia. AB - In acute hemolytic anaemia of calves induced with phenylhydrazine-hydrochloride, accentuated degenerative changes in circulating erythrocytes occurred on the 5th d post-injection. Marked anisocytosis and poikilocytosis were observed. Crenated cells, acanthocytes (star-shaped cells), dacrocytes (tear drop cells), bite cells, and schistocytes predominated. Heinz bodies were the cytoplasmic hallmark of hemolytic anaemia. The regenerative nature of anaemia was evidenced by early appearance of reticulocytes in peripheral blood. PMID- 1789731 TI - [The acrosin system of bull, boar and ram sperm]. AB - Described in this paper is a technique by which to separate the components of the sperma acrosin system. Included in the method are extraction of all components by means of acetic acid, separation of acrosin inhibitors on Sephadex G 100 as well as biochemical determination of proacrosin and acrosin. While species-related peculiarities were of minor importance, alterations were found to occur to the acrosin system in response to deep-freeze preservation of bull, boar, and ram sperma. Those alterations grew manifest primarily through decline in total acrosin activity and shifting of the proacrosin-acrosin ratio in the direction of proacrosin activation. Detachability of membrane-bound acrosin inhibitors was increased with significance, following in-vitro capacitation of bull sperma under heparin action. PMID- 1789732 TI - [Concentrations of prolactin, LH, estradiol-17 beta and progesterone in swine after biotechnical stimulation with PMSG, HCG and suidor]. AB - Concentrations of estradiol-17 beta, progesterone, luteinising hormone (LH), and prolactin were recorded from 9 gilts, following cycle blocking by means of Suisynchron(R)-Pramix and application of PMSG, HCG, and Suidor(R). A radio-immuno assay which for its quality criteria enabled safe determination of the hormone in peripheral blood had been worked out specifically for prolactin appraisal. HCG application led to blockage of pre-ovulatory LH release in 7 of 9 animals. Possible causes are discussed. Prolactin concentrations during oestrus were differentiated and, for example, were characterised by strong oscillatory variations. With the experimental arrangement used, the boar pheromone Suidor(R) was not found to have any impact upon hormone profiles. PMID- 1789733 TI - [Estrus and ovulation synchronization in Merino meat sheep. 1. Effect of Gonavet "Berlin Chemie" after estrus synchronization with prostaglandin F2 alpha in Merino meat sheep]. AB - Oestrus synchronisation by means of PGF2 alpha analogues was followed by injection of Gonavet "Berlin-Chemie" which triggered off an LH peak, 2 to 3 hours from injection. Injection of Gonavet "Berlin-Chemie", 44 hours after PGF2 alpha application, caused synchronisation of all LH peaks. The interval between injection of Gonavet "Berlin-Chemie" and onset of ovulation amounted to 22 hours. The length of ovulation was not accurately determinable. Ovulation was successfully induced to all sheep by application of Gonavet "Berlin-Chemie", 44 or 48 hours after PGF2 alpha injection. Ovulation rates were 1.75 or 1.54. Luteolytic action on sheep of Cloprostenol "Jenapharm", a PGF2 alpha analogue, proved to be just as good as that of Oestrophan (SPOFA). PMID- 1789734 TI - [Estrus and ovulation synchronization in Merino meat sheep. 2. Fertility outcome after estrus and ovulation synchronization with Cloprostenol "Jenapharm" and Gonovet "Berlin-Chemie" and term-oriented artificial insemination]. AB - 49 of 102 sheep of one production herd, which had returned to oestrus once or twice within the 1985 breeding season, were treated twice in a nine-day interval with the PGF2 alpha analogue Cloprostenol "Jenapharm". 53 animals received an additional dose of 10 micrograms of Gonavet "Berlin-Chemie". A lambing rate of merely 15% was achieved by subsequent term-oriented artificial insemination. 31 sheep still in oestrus one day after term-oriented artificial insemination were served, bringing the lambing rate from synchronisation of oestrus and ovulation to 26% and the lambing result to 154%. Serving of the remaining sheep in 2 subsequent oestric cycles, on balance, yielded lambing rates and results of the remaining sheep in 2 subsequent oestric cycles, on balance, yielded lambing rates and results which were higher with significance than those recorded from untreated sheep in the same herd. PMID- 1789735 TI - [Selected factors influencing the in vitro maturation of oocytes of cattle]. AB - Studies were conducted into hormonal additives to medium and culturing time and their effects on in vitro maturation of bovine oocytes. The best maturation results were ensured in vitro by substitution of TCM-199 with FSH, HCG, and 17 beta-oestradiol: The stage of fertilisation capability (telophase I or metaphase II) was reached by 86% of all oocytes (115 of 134). The rate of maturation was worse with significance in FSH-free medium (62% or 101 of 163), and the amount of degenerated oocytes was twice as high (18%). Maturation in hormone-substituted medium for 28 to 30 hours is recommended under the condition that immature oocytes were cultured from juvenile antral follicles (2--5 mm in diameter). PMID- 1789736 TI - [The influence of follicular factors on the in vitro maturation of bovine oocytes]. AB - Immature oocytes from antral follicles of cattle were tested for the effect of follicular factors on maturation. In vitro maturation was accomplished by use of follicular fluid from small (2--5 mm) and large (above 15 mm) follicles and by addition to the medium of a granulose factor (GF) which had been isolated from the surface of granulosa cells. The parent material, with 84% (72/86) of oocytes at the germinal vesicle stage (GV-S) at the beginning of culturing, could be rated immature. 46% of all oocytes (41/89) had reached telophase I or metaphase II (full maturation) after 24 hours of maturation in hormone-free control medium (TCM 199 + 10% of foetal calf serum). 36% of oocytes (53/84), on the other hand, stayed between GV breakdown (GVBD) and anaphase I (incipient maturation). Full maturation was reached by as little as 14%. GF and follicular fluid from small antral follicles were found to inhibit GVBD in the oocytes. 59% (36/61) or 48% (61/127) of oocytes were blocked at GV stage. Positive determination of maturation inhibiting action of the above follicular components may provide a chance for their target-oriented use in control of the maturation process. The pool of immature oocytes of the ovaries, under such circumstances, might be more systematically utilised for in vitro manipulations. PMID- 1789737 TI - [The effectiveness of oral and parenteral vitamin A doses in growing cattle with different vitamin A supplies]. AB - The effect of one single oral or parenterally administered dose of 1 million IU vitamin A on the vitamin A depot in the liver and on blood plasma vitamin A concentrations was investigated in 3 individual feeding experiments with involvement of 18 and 24 calves or 24 fattening bulls. 50% of all animals in each of the 3 experiments received feed without any vitamin A through 108 or 112 or 209 days, prior to vitamin A administration, or received 10.000 IU/100 kg live weight and day. Parenteral vitamin A administration in either group yielded rise in blood plasma from 0.06--0.35 to 26.2--30.2 mumol/l, after 1 or 2 days. The maximum value measured after oral administration was 1.9 mumol/l. Most of the plasma values had returned to normal (0.6--12. mumol/l) within 14 days from administration. Oral and parenteral vitamin A doses, after 14 days, caused significant rise in vitamin A concentrations in the liver (from 15.5 to 82.5), with the increase resulting from parenteral administration (from 13.7 to 99.1) being clearly higher than that resulting from oral administration (from 17.3 to 65.9 mumol/kg fresh liver tissue). The same trends were recorded from recovery of vitamin A from the liver (26.8% after parenteral administration versus 15.0% in the wake of oral doses). Storage in and recovery from vitamin-A depleted animals were below values recorded from young cattle with sufficient vitamin A supply. These findings are likely to confirm that one single parenteral vitamin A administration was of clearly higher effectiveness, as compared to oral application. PMID- 1789738 TI - [ATP in the metabolism of ruminants]. AB - The ATP yield from the carbohydrates of anaerobically living microorganisms in the rumen amounts to only 5-10% of the ATP yield of the intermediary metabolism in the presence of oxygen. Vital functions and thus microbial protein synthesis are due to protein degradation in the rumen. The ATP yield in the intermediary metabolism of ruminants is mainly achieved from propionate and microbial protein by means of gluconeogenesis because the absorption of glucose from digested starch is very low. The relationships between ATP yield in the rumen and the processes of glucose provision for the production of lactose as well as the protein content of the milk are shown. As important processes of ATP production in microorganisms from easily soluble carbohydrates take place in silage preparations before feed intake, the corresponding consequences for the metabolism of high-performance cows fed with silage are shown. PMID- 1789739 TI - [Determination of bacterial N portions in feces and differently collected ileum chymus from swine]. AB - In faeces and ileal digesta samples of 31 intact (INT) as well as 73 surgically differently prepared pigs bacterial fractionations and 2.6-diaminopimelic acid (DAP) estimations were carried out in order to calculate the bacterial N proportion in faeces N and digesta N after feeding various diets. Because of a high individual variability and the analytical variation width of the DAP/N ratios no distinct influences of the fed diets could be found. The average DAP/N values in the faeces (0.224) of INT pigs ranged in the same magnitude as in the digesta (0.0272) of ileorectostomized (IRA) pigs with open colon descendens (IRAo), where a digesta backflow is possible. Distinct lower DAP/N-ratios (0.0125 resp. 0.0043), however, were found in the digesta of pigs with ileo-caecal cannulae (IZB) or IRA pigs with closed colon (IRAg). On the base of various premises (N of the "bacterial fraction" C is only bacterial N; the DAP found in fraction A originates from intestinal bacteria adhering to feed particles) conducted calculations of the bacterial N proportions (in per cent of total N) led to the following data: Faeces of INT pigs: 43.0 ... 68.2 vs. 69.6 ... 89.0; digesta of operated pigs (except protein free diet) IRAo: 22.3 ... 57.0 vs. 46.2 ... 73.8; IZB: 17.0 ... 35.7 vs. 25.2 ... 53.6; IRAg (only 3 pigs): 23.6 vs. 24.2. The proportion of bacterial N in the digesta N of protein free fed IRAo pigs was 22.0 vs. 22.6%. PMID- 1789740 TI - Sulphur availability and microbial fermentation in the fauna-free rumen. AB - The concentration of H2S and rate of feed digestion, VFA and methane production in the rumen were measured in sulphur deficient (-S) and S supplemented (+S) sheep while fauna-free (-P) and after refaunation (+P). The concentration of rumen H2S was increased by S supplementation but was not affected by the presence of protozoa. When fauna-free, -S sheep had reduced rates of feed digestion (30 v 48%/d), acetate synthesis (35 v 115 g/d) and methane synthesis (0.4 v 7.4 g C/d) compared to +S sheep and up to 36% (v/v) of total rumen gas was H2. When these sheep were given a single dose of 8.8 g Na2SO4, the proportion of methane increased and the proportion of H2 in rumen gas decreased. After refaunation of sheep, their rates of feed digestion, VFA production and methane production were higher and were not affected by the level of S. From this differential response to S deficiency by -P and +P sheep, it is concluded rumen protozoa increase the availability of S to other rumen microbes. This is probably because they degrade protein through to peptides and amino acids. PMID- 1789741 TI - Effect on catfish (Clarias lazera) composition of ingestion rearing water contaminated with lead or aluminum compounds. AB - To study the effect of contaminated rearing water of catfish (Clarias lazera) with lead acetate, lead chloride or aluminum chloride, 3 level of concentrations (10, 50 and 100 ppm) of each salt were added in the rearing water for 6 weeks. The results of this experiment confirmed the followings: Existence of deaths among fishes reared in water contaminated with the inorganic pollutants (PbCl2 and AlCl3) but not with the organic lead. The treatments led to pathological findings e.g. haemorrhages and congestion of the gastrointestinal tract and kidneys. Protein content was decreased insignificantly (P greater than or equal to 0.05) than for the control. The decrease was accompanied with the elevation of contamination level, especially in the lead acetate treatment. The ether extract increased in the treated fish than in the control. The increase was related to the pollutant level especially in the PbCl2 and AlCl3 treatments (P less than or equal to 0.01). Gross energy, generally, increased slightly by the application of the pollutants than in the control fishes. Muscular contents of ash, calcium, magnesium, and lead were increased significantly than the control. The contents of Na, K (P less than or equal to 0.01) and P (P less than or equal to 0.05) decreased in the treated fishes. PMID- 1789742 TI - [Detection of microbial protein synthesis in the small intestine of sheep using an intraduodenal 15N-urea infusion]. AB - Sheep (3 animals, 50 kg LW) with reentrant cannulas in duodenum and at the end of the ileum received 700 g hay and 800 g alfalfa pellets per animal and day. In a previous 1st period of three days duodenal digesta and in a 2nd period of four days ileal digesta were collected and stored deep frozen. In the main period the digesta flow was interrupted for 28 hours. The duodenal and ileal digesta were collected quantitatively. The previously collected duodenal and ileal digesta portions were introduced hourly. The duodenal digesta was supplemented with 15N labelled urea for a 24 hour period. 4.5% of the introduced 15N-excess were detected at the end of the ileum in the 24 hour period. 5.6% of the 15N-excess at the end of the ileum were incorporated in bacterial protein. It was measured that the ileal digesta contained 4.62 g N in the TCE precipitable fraction and 24.4% of the TCE precipitable N-fraction was bacterial nitrogen. PMID- 1789743 TI - [Effect of infrared impulse laser irradiation on the development of albino rat embryos]. AB - Development of the white rat embryos has been studied under effect of infrared laser beams (wave length--0.89 mcm, impulse frequency--300 Hz) during various periods of pregnancy. Exposure of the female rats for 256 and 128 sec produces an increased preimplantational death of embryos and certain disturbances in formation of the osseous skeleton in some embryos. PMID- 1789744 TI - [Metabolic reactions in sensory and motor neurons after exposure to various physical factors]. AB - A course of radiation of biologically active points of the guinea pig lumbosacral area has been performed by means of focused frequency-modulated and a continuous beam of the helium-neon laser, having various power density, as well as by means of an impulsive magnetic field. A comparative histoenzymatic analysis of sensitive neurons of the lumbar spinal nodes and of the caudal-mesenteric motor neurons has been carried out. The response of the metabolic processes in the sensitive neurons depends not so much on the type of action, as on adequacy of the parameters applied. The power density, frequency of impulse generation and time of application are important for characterization of the adequacy of the laser radiation. Peculiarities of the metabolic reactions in the sensitive and sympathetic neurons in response to the actions studied are discussed. PMID- 1789745 TI - [Reactive changes in adrenergic innervation of the cerebral arteries after activation of the cholinergic mechanisms]. AB - Magistral arteries of the brain and pia mater have been studied in cats 24-72 h after administration of the cholinesterase inhibitor (phosphacol, 600 mcg/kg). Cholinesterase activity in blood has been checked by means of the potentiometric titration method, and acetylcholinesterase (AChE) content in varicosities of the perivascular nervous fibers--cytophotometrically in preparations treated after Karnovsky--Roots histochemical method. Cholinesterase activity of blood homogenates in test animals is 42 +/- 10%, and acetylcholinesterase content in varicosities of the perivascular nervous fibers--23.5 +/- 2.3% in comparison to the norm. Catecholamines in adrenergic nervous elements are revealed treating them with glyoxylic acid. Distribution density (DD) of histochemically active nervous elements is determined, as well as their specific content of the mediator according to luminescent intensity (LI) of varicosities of nervous fibers. The data obtained in intact animals serve as the control. In the experiment DD and LI reach 127 +/- 9% and 154 +/- 15%, respectively, as compared to the control. Signs of the adrenergic nervous apparatus activation in the experiment reflect a compensatory reaction in response to increase of dilatatory cholinergic influences to vessels under conditions of AChE activity. PMID- 1789746 TI - [The neural apparatus of the small intestine of piglets after administration of a growth stimulator kormogrisein]. AB - By means of classical neurohistological techniques, phase contrast microscopy and morphometry, a comparative investigation has been performed concerning the development of the intramural nervous apparatus in the small intestine, normal and at application of cormogrisine. The structural peculiarities of morphogenesis are considered together with signs of activation and inhibition of the neurons growth in tissue culture. A number of morphological criteria, demonstrating an increased extrusive activity and enhancing potensity of the neurons growth have been revealed. The number of nervous processes becomes greater; degree of their ramification increases; a part of neurons of Dogiel II type turns into multiprocessive neurons with some signs of Dogiel I type cells; growth cones and arcadian structures are present; giant processes appear; thick nervous fasciculi are formed; volume of the neuron bodies increases more intensively. After application of cormogrisine for 2 months a definite neurostimulatory effect is revealed; it demonstrates a more intensive morphogenesis of the small intestine nervous of Physiology, USSR, Academy of Medical Sciences, Leningrad. PMID- 1789747 TI - [Extra-organic sources of innervation of the sigmoid]. AB - By means of horseradish peroxidase administration into the wall of the sigmoid colon central part, localization, relative amount, body forms and size of the neurons, dealing with innervation of the given part of the colon have been determined. Labelled neurons are present in the colon wall, in ganglia of the caudal mesenteric artery nervous plexus, in the caudal and cranial mesenteric ganglia in the celiac plexus ganglia, in nodes and internodal branches of the lumbar part of the sympathetic trunk (the left one predominantly) and in the spinal ganglia from TXIII up to LVII. In the grey substance of the spinal cord labelled neurons are not revealed. The main part of the postganglionar sympathetic neurons, projecting their axons to the sigmoid colon, are situated in the caudal mesenteric ganglion. In the spinal ganglia the most part of the labelled neurons are to the left at the level of LII-LVI, to the right--at the level of LII-LV. The optimal time for revealing the greatest number of the labelled neurons are the 1st-3d days after administration of the enzyme. Capture of the lable takes place later in the neurons of those ganglia, which are situated more further from the place of peroxidase administration. PMID- 1789748 TI - [Surgical anatomy of subaortic conus of the normal heart]. AB - One hundred and fourty-three normal hearts have been studied. The conoid septum, supraventricular crest, bulboventricular fold, area of the fibrous tissue between the aortal and mitral valves and the anterior interventricular septum make the walls (frontal view, in the direction of the hour hand) of the left ventricular cone. In the normal heart there is no real contact between the fibrous rings of the aortal and mitral valves. They are connected by means of a strip of the fibrous tissue, its size varies. The subaortal cone and deferent part of the left ventricular axes make an obtuse angle; the axes of the subpulmonary and subaortal cones have a cross direction. The geometrically definitive left ventricular cone is seen as obliquely-sectioned overturned isosceles cone, with its big base directed upward, right and back, and the small one forward and left. PMID- 1789750 TI - [Subendocardial vascular plexus of the human ventricular myocardium in ontogenesis studied by scanning electron microscopy]. AB - By means of scanning electron microscopy of native and corrosive preparations peculiarities of endocardium of the papillary-trabecular apparatus of the human heart ventricle and its vessels have been studied in ontogenesis. Folds of the endocardium increase its contact area with blood and also increase reserve of its elasticity at diastole. The subendocardial vascular plexus is formed by capillary like venous sinusoids. They situate in the direction to the compact myocardium at the depth of 300-500 mcm. They are supposed to perform resorptive functions of nutritive substances and oxygen from blood, which is in the ventricular cavities and to smooth blood pressure between blood in the ventricular cavities and vessels of the compact myocardium. PMID- 1789749 TI - [Evaluation of the effectiveness of organ-preserving solutions]. AB - In the experiments performed on 61 dogs dynamics of changes of morphometrical parameters of mitochondria of brush-border and cuboid cells have been studied at conservation of the kidneys for 120 h in solutions of intracellular type. Stages of structural reorganization of the mitochondria have been determined depending on duration of conservation and the solution composition. A morphometrical index of viability (Im) has been worked out, correlated with survivability of the transplant and the recipient. In every specific case it allows to estimate quantitatively whether the conserved kidney is suitable for transplantation. At Im less than 50% from the control level, the kidney is not viable, at 50% less than or equal to Im less than or equal to 60%--it is conditionally suitable for transplantation, at Im greater than 60%--it is viable. The index elaborated is practically used for a comparative estimation of the protective action of the four organ-preserving solutions of the intracellular type. The morphometrical index of viability of the conserved kidneys can be used in experimental transplantology for approbation of new solutions before their application in clinical practice. PMID- 1789751 TI - [Ultrastructure of the thymus gland in rabbits during hyperthermia and fever]. PMID- 1789752 TI - [Effect of dipyridamole on the interrelations of the stromal and hematopoietic tissues of the bone marrow in experimental studies]. AB - By means of heterotopic transplantation of the bone marrow interrelations of the stromal and hemopoietic tissues of the mice bone marrow have been studied at administration of dipiridamol. Effect of the drug to the hemopoiesis is realized via stem stromal cells of the bone marrow. Under the influence of dipiridamol a focus of heterotopic hemopoiesis the osteogenic component in it is present only in 30% of cases in comparison with the control. Inhibition of the stromal component proliferation is accompanied with increasing mitotic activity of the hemopoietic elements against the background of the bone marrow cellularity decrease both in the femoral bone and in the focus of heterotopic hemopoiesis. At administration of dipiridamol a phenomenon of noneffective megakaryocytopoiesis with the intrabone marrow destruction of megakaryocytes, resulting in local release of thrombocyte growth factor, which has a compensatory character. PMID- 1789753 TI - [Structure of skeletal muscles in combined conditions of denervation, physical load and laser acupuncture]. AB - An experimental investigation of the skeletal muscles denervation with a subsequent histological, electron microscopical and morphometrical study of their structural state has been carried out on 77 Wistar male rats. Structure of the muscles in the animals, subjected to laseropuncture and also to its combination with physical load after denervation, is disturbed to an essentially less degree than after denervation only. Combination of laseropuncture and physical load ensures activation of regeneration and reinnervation processes of the skeletal muscles. PMID- 1789755 TI - [Measuring cell density in the differentiating tissues as a method of the study of embryonal histogenesis]. PMID- 1789754 TI - [Lectin histochemistry of human placenta in the normal state and in uterine inertia]. AB - The lectin-peroxidase technique has been used. The peanut lectin is able to label selectively Kashchenko--Hofbauer cells, villi of the chorion; the soya lectin- decidual cells in the maternal part of the placenta. Prolonged labour development is connected with disappearance of Kashchenko--Hofbauer cells, with a reduced binding of the Laburnum anagyroides lectin in combination with an intensified peanut lectin and concanavalin A binding with glycopolymeres of the villi of the chorion. PMID- 1789756 TI - [110th anniversary of the birth of E. P. Konova]. PMID- 1789757 TI - [Life and activities of the Russian histologist K.Z. Kuchin]. PMID- 1789758 TI - Connective tissues of the periodontium. Research and clinical implications. AB - The periodontium is a complex anatomical site composed of a variety of hard and soft connective tissues. The site is subjected to enormous daily chemical and mechanical abuse, yet, for the most part remains relatively intact. Nonetheless, when breakdown does occur, the ability of the periodontium to regenerate is sometimes limited. This review considers the various components of the periodontium and how they might be involved in not only the pathology of periodontal diseases but also the various reparative and regenerative processes required during wound healing. In addition, the importance of external factors such as a variety of commonly prescribed medications on these events is discussed. PMID- 1789759 TI - Limitations of rotational panoramic radiographs in the diagnosis of maxillary lesions. Case report. AB - This case report clearly demonstrates that misdiagnosis may result from failure to recognize the limitations dictated by the width of the focal trough in rotational panoramic radiographs. The patient's clinical signs and symptoms were at variance with the findings from the rotational panoramic radiograph. A subsequent radiographic view by the occipito-mental (Water's) projection showed the extent and malignant features of the lesion. PMID- 1789760 TI - An infected dentigerous cyst complicated by periostitis ossificans. Case report. AB - Periostitis ossificans is a rare condition which has not been previously reported arising from an infected dentigerous cyst. This paper reports such a case in a twelve-year-old boy, and reviews the literature concerning periostitis ossificans. PMID- 1789761 TI - The oral health of the elderly in Melbourne. AB - A survey of 303 subjects over the age of 60 years collected demographic and oral health status data for analysis. The majority of the sample (64.2 per cent) were edentulous. Over 90 per cent of the dentate subjects required scaling and the removal of plaque (CPITN score of TN2); however, just less than half of the sextants examined were excluded because they contained fewer than two functional teeth. About one-third of the dentate subjects required no treatment for dental caries. Of those who required treatment, most needed only one restoration of any particular type. Total tooth loss was associated with gender, level of education, previous occupation, and birthplace. The need for complex periodontal treatment (TN3) was not high, nor was there a high prevalence of root or cervical dental caries. PMID- 1789762 TI - The role of oral bacteria in the pathogenesis of infective endocarditis. AB - Various micro-organisms have been implicated as causative agents for bacterial endocarditis, including lactobacilli and in particular the viridans streptococci which are more commonly associated with dental caries. Of these, the most frequently isolated one has the descriptive name Streptococcus sanguis. The disease is characterized by growth of micro-organisms within a platelet-fibrin thrombus protruding from a valve leaflet. An understanding of the pathogenesis involves knowledge of the mechanisms of conversion of the normal vascular surface to a thrombogenic one and the adhesion of micro-organisms to such surfaces. Model systems to study this interaction include experimental animals, mammalian epithelial cells and platelets, and proteins such as fibronectin and fibrinogen. Microbial protein surface components (adhesins) and lipoteichoic acid have also been implicated. Capsular polysaccharides may be involved, but the role of dextrans formed from sucrose has been over-emphasized as the polymers are not formed in situ. Antibiotic prophylaxis for patients at risk is based on bacteriostatic or bactericidal action. However, bacterial cell surface components involved in adhesion may also be affected, and knowledge of such reactions could provide a more rational basis for antibiotic prophylaxis. PMID- 1789763 TI - Valiant-PhD and Lojic N amalgam alloys: four-year clinical results. AB - From 1984 to 1986, 97 similar pairs of Valiant-PhD and Lojic N amalgam restorations were placed at random by one dentist in Class II cavities prepared in 105 molar and 89 premolar permanent teeth of 73 patients treated in a private practice. Assessments were made of the different handling properties of the two alloys and of the effects of polishing, or otherwise, on the clinical behaviour of the restorations. Valiant-PhD alloy had more 'body' for condensing and was easier to carve and polish than was Lojic N alloy. After periods of up to four years, there was only one restoration failure (from bulk fracture) for each alloy although both materials deteriorated over time. Both the polished and the unpolished restorations showed similar deterioration for marginal fracture and staining, and for surface tarnish, and their initially-different surface textures became more similar during the study. Statistically, Lojic N restorations showed significantly more surface tarnish, but less marginal fracture than did Valiant PhD restorations, and the tarnishing did not appear to be related to the effects of corrosion. PMID- 1789764 TI - Three-year clinical evaluation of dentine bonding agents. AB - Eighty Class V non-undercut cervical abrasion lesions were restored using four dentine bonding agents and composite resin. The restorations were examined over a three-year period, and the cumulative loss rate calculated each year. Marginal staining at each year was assessed using a standardized photographic method. The loss rate of restorations increased generally over the three-year period, reaching 30 to 60 per cent for the four products. Marginal staining also increased for all four products over the three-year period. PMID- 1789765 TI - Dimensional accuracy of small gold alloy castings. Part 1. A brief history and the behaviour of inlay waxes. AB - Part 1 reviews published studies which relate to materials and techniques contributing to the dimensional accuracy of small dental castings. A brief history of the cire perdue or lost-wax method of casting alloys and the development of modern dental casting materials and techniques are presented. Data on the behaviour of inlay wax, in particular its contraction and distortion, are reviewed as is the extensive literature about the casting shrinkage of gold alloys (Part 2) and the setting and thermal expansion of investments under both laboratory and practical conditions (Part 3). Part 4 discusses the role of the casting ring and its asbestos liner. Asbestos as a liner has now largely been replaced by two alternative materials, one based on cellulose and the other on ceramic fibres. The limited literature on the effect of these newer materials on casting accuracy is also reviewed, as their introduction may require significant changes in the traditional technology of dental casting. PMID- 1789766 TI - The use of theatre in dental health education. AB - This report describes the use of theatre as a strategy for school dental health education. A play with messages relating to dental disease and its prevention was staged by school dental personnel for middle level primary schoolchildren. Feedback from the school staff indicated that the performance was well received and understood by the majority of the pupils. School dental personnel found that the awareness of dental disease and its prevention among their patients was generally more positive after the play. It thus appears that theatre is a useful medium for dental health education of young people. PMID- 1789767 TI - Maxillary nerve block anaesthesia. PMID- 1789768 TI - The sorcerer and his apprentices: contributions of Professor R.H.T. Bates to the physical sciences and engineering in medicine. AB - The late Professor R. H.T. Bates (Richard) left an enormous legacy of published research and launched many young researchers and engineers into their careers. In doing so he established an international network of information engineering/scientists that is in itself a laudable contribution to the global multidisciplinary scientific community. In this paper are reviewed the contributions that Professor Bates and his students made over the last two decades in the physical sciences applied to medicine. Where appropriate (i.e. where it doesn't overlap with other contributions to this issue) brief descriptions are given of current research projects in the Department of Electrical and Electronic Engineering at Canterbury, (where Professor Bates carried out most of his research, and where the authors are now ensconced) which in some way relate to the work of "the sorcerer" and his former "apprentices" (as Professor Bates liked to refer to the group). PMID- 1789769 TI - From radio-astronomy to medical imaging. AB - A common thread in much of the medical imaging that has developed over the past 20 years has been the Fourier transform. It was Richard Bates' interest in radio interferometry, as well as his fascination with problems of medical imaging that prompted an initial interest in applying Fourier techniques to medical imaging in general and to Computed Tomography in particular. This resulted 20 years ago in one of the earliest technical papers advocating Fourier techniques for reconstructing cross-sections from radiographic projections (Bates and Peters, NZ J Science 14:883-896, 1971). Since those early days, medical imaging has explored into a multi-billion dollar industry. The CT scanner has become the workhorse imaging modality in the radiology department, while its more recent relative, the MR scanner, is rapidly gaining ground as a technique of even greater importance. Richard Bates, with his team of "Medical Imagers" was a very significant force in the development of the field of Medical Imaging as we know it today. This paper attempts to chronicle the genesis of this process from the personal perspective of the author. PMID- 1789770 TI - Non invasive measurement of myocardial motion using magnetic resonance tagging. AB - Magnetic resonance imaging has become a key modality within the modern radiology department. In addition to the conventional slice images, three dimensional angiographic images, and quantitative flow measurements can be obtained. More recently methods have been developed which enable one to visualize the motion of objects through the application of magnetic resonance markers or tags. Generally the myocardium appears homogeneous with respect to magnetic resonance imaging. Thus at best the displacement of the myocardial surfaces can be observed, but rotational and shear motions are not discernable. With magnetic resonance tagging this all changing. Tagging involves modifying the ability of the tissue to produce a nuclear magnetic resonance signal, in a spatially dependent manner. Typically the pattern is a grid of reduced signal intensity. The tagging grid is applied prior to the heart contraction. Then images are made during systole and diastole. The rotation and shear of the myocardium can be inferred from the distortions of the tagging grid. Here our work in this field is reviewed. PMID- 1789771 TI - Lung mechanics--the inverse problem. AB - The mechanical properties of the lung are important determinants of its efficacy as a gas exchanging organ. These properties are reflected to a precise degree in the relationships between pressure and flow measured at the mouth. Together with oesophageal pressure, which reflects the pressure in the pleural space, these quantities allow one to usefully indulge in inverse modelling of the lung - that is, identify mathematical models of lung mechanics that give insight into its structure and may be diagnostic of certain diseases. The complexity of such models, however, is limited by the number of distinct components that can be unambiguously resolved from the measured signals. The development of more detailed models requires the availability of experimental methods for obtaining additional input-output information from the lungs. One such method is the so called alveolar capsule technique which allows alveolar pressures at several sites on the lung surface to be measured directly. This technique has been used in animals to show that the mechanical behaviour of normal lungs in the breathing frequency range is well described by a homogeneously ventilated compartment surrounded by viscoelastic tissue. During bronchoconstriction, however, the lungs can become markedly inhomogeneous resulting from differences in regional resistive and elastic properties. Model ambiguity problems again appear as it becomes impossible to distinguish changes in local resistance from changes in elastance using only the information obtained from alveolar capsules. To push the inverse modelling of the lung one step further, we have recently developed a new technique for quantifying changes in local resistance and elastance by applying broad-band oscillations in flow to the lung through a small hole in the pleura, thereby obtaining an alveolar input impedance. PMID- 1789772 TI - Simulation of current flow in piecewise constant media. AB - A boundary method is presented and is used to calculate the electric potential throughout two-dimensional regions which represent cross-sections of the human body. The method differs from the usual boundary element method by representing both the boundaries and the voltages supported on them as smooth (i.e. infinitely differentiable). Examples are given which show the flow of current through the chest due to electrodes placed on its surface, and that throughout the brain due to a dipole source within the grey matter. PMID- 1789773 TI - A model of atrioventricular nodal conduction. AB - A model of cardiac impulse propagation through the atrioventricular node is described. The model is based on a synthesis of various experimentally determined characteristics of atrioventricular nodal conduction. The model can be set up to mimic a particular patient's atrioventricular node, by using data collected during routine electrophysiological studies. It can also be used as a component in a larger model of the cardiac conduction system, to simulate cardiac arrhythmias. PMID- 1789774 TI - Fourier coefficient description of left ventricular shape. AB - A method of quantifying the shape of the left ventricle of the heart as seen in 2D echocardiograms was developed. It is based on describing the shape in terms of the coefficients a fifth-order trigonometric Fourier series. Such a series has eleven Fourier coefficients which is too large a number for clinical application so pairs of coefficients are combined to give six coefficients (alpha 0, alpha 1, ... , alpha 5). A trial was conducted to test the ability of the coefficient description to classify subjects as having normal right ventricles or ventricles with an apical abnormality. The tests showed that one of the coefficients (alpha 2) was higher for the subjects with an apical abnormality and that this difference increased with exercise. This is as was expected. However, it was found to be difficult to get a reliable estimate of alpha 2 from a single scan of a patient and that it is therefore probably necessary to average data from several scans to obtain a reliable alpha 2 value for a single patient. PMID- 1789775 TI - A mathematical study of simple exponential modelling in biochemical processes. AB - This paper discusses the application of simple exponential functions for analyses of complex biochemical processes such as transport phenomena in a mammalian system. The main aim is to identify these exponential function models using various curve fitting techniques. The experimental data used is based on transport of a radio-active tracer 32P (Radio-phosphorus) from a central compartment of blood plasma to subsidiary organ compartments in insulin-treated diabetic rats. The data has been analysed with a view to fitting exponential functions. A graphical method of exponential peeling and six (I to VI) computer programs based on iterative methods for solving single, as well as, multiple exponential functions have been used. The method of exponential peeling has also been compared with the least squares method for simple linear regression. The sum of two exponential functions has been found to be the most preferred Goodness of Fit by the computer programs. This model indicates that the transport of 32P in blood plasma in rats is governed by two major metabolic parameters. Further interpretations of the fitted equations are discussed. PMID- 1789776 TI - Slice selection axis motion artifact correction in MRI. AB - In magnetic resonance imaging using two-dimensional Fourier transform techniques, motion causes ghosting in the phase-encoded direction and loss of image resolution. Although numerous techniques have been proposed to suppress these motion artifacts, they are a continuing problem. In this paper a new technique is presented to reduce the artifact from motion along the slice selection axis. It is shown that such motion causes an amplitude modulation of the data, and an iterative algorithm is developed to reduce this modulation by post-processing the data using signal processing techniques. The algorithm is tested on simulated data, and shown to perform well, even with significant levels of noise added to the data. PMID- 1789777 TI - Ultrasonic beam-plotting with very small spheres. AB - A method of pulse-echo ultrasonic beam plotting is described. It differs from traditional pulse-echo beam plotting in that the ultrasonic pulses are scattered off a totally isolated sphere rather than a sphere suspended on a wire. The method also allows extremely small spheres to be used thus providing greater resolution. It is demonstrated that pulse-echo beam plotting using spheres of different size produces different iso-echo amplitude curves. PMID- 1789778 TI - Quality assurance (QA) in mammography. PMID- 1789779 TI - Specification of cell fate in the developing eye of Drosophila. AB - Determination of cell fate in the developing eye of Drosophila depends on a precise sequence of cellular interactions which generate the stereotypic array of ommatidia. In the eye imaginal disc, an initially unpatterned epithelial sheath of cells, the first step in this process may be the specification of R8 photoreceptor cells at regular intervals. Genes such as Notch and scabrous, known to be involved in bristle development, also participate in this process, suggesting that the specification of ommatidial founder cells and the formation of sensory organs in the adult epidermis may involve a similar mechanism, that of lateral inhibition. The subsequent steps of ommatidial assembly, following R8 assignment, involve a different mechanism: Undetermined cells read their position based on the contacts they make with neighbors that have already begun to differentiate. The development of the R7 photoreceptor cell, one of the eight photoreceptor cells in the ommatidium, is best understood. An important role seems to be played by sevenless, a receptor tyrosine kinase on the surface of the R7 precursor. It transmits the positional information--most likely encoded by the boss protein on the neighboring R8 cell membrane--into the cell via its tyrosine kinase, which activates a signal transduction cascade. Constitutive activation of the sevenless kinase by overexpression of an N-terminally truncated form results in the diversion of other ommatidial cells into the R7 pathway suggesting that activation of the sevenless signalling pathway is sufficient to specify R7 development. Genetic dissection of this pathway should therefore identify components of a signalling cascade activated by a tyrosine kinase. PMID- 1789780 TI - Bristle patterning in Drosophila. AB - The 5000 bristles that protrude from the cuticle of a Drosophila adult function as either mechanosensors or chemosensors, and they are arranged in surprisingly intricate patterns. Development of the patterns appears to involve five stages: (1) establishment of a coordinate system of 'positional information'; (2) partitioning of the epidermis into areas where bristles either can or cannot originate; (3) selection of one or more bristle mother cells within each permissible area; (4) suppression of bristle development in the neighborhood of each mother cell; and (5) differentiation of the mother cell to produce four or more descendant cells, each of which forms part of the bristle apparatus. Some of the genes that control these events participate in more than one stage, and others play key roles in seemingly unrelated developmental pathways, including embryonic neurogenesis, body segmentation, and sex determination. PMID- 1789781 TI - The role of DNA double strand breaks in ionizing radiation-induced killing of eukaryotic cells. AB - A widely accepted assumption in radiobiology is that ionizing radiation kills cells by inducing forms of damage in DNA structures that lead to the formation of lethal chromosome aberrations. One goal of radiation biology research is the identification of these forms of DNA damage, the characterization of the mechanisms involved in their repair and the elucidation of the processes involved in their transformation to chromosome damage. In recent years, evidence has accumulated implicating DNA double stranded breaks as lesions relevant for cell killing. Here, the available information on this topic is reviewed together with the methods most commonly used to quantitate induction and repair of this type of lesion. The presentation concludes with an outline of present research directions and future goals. PMID- 1789782 TI - Gene targeting and gene trap screens using embryonic stem cells: new approaches to mammalian development. AB - Mouse embryonic stem cell lines offer an attractive route for introducing rare genetic alternations into the gene pool since the cells can be pre-screened in culture and the mutations then transmitted into the germline through chimera production. Two applications of this technique that seem ideally suited for a genetic analysis of development are enhancer and gene trap screens for loci expressed during gastrulation and production of targeted mutations using homologous recombination. These approaches should greatly increase the number of mouse developmental mutants available and help to elucidate the genetic hierarchy controlling embryogenesis. PMID- 1789783 TI - Insect antibacterial proteins: not just for insects and against bacteria. AB - In response to a bacterial infection, insects launch an array of countermeasures. Among these are the antibacterial proteins, which effectively lyse bacteria or are bacteriostatic. These proteins were generally assumed to be restricted to insects, yet recent information has shown some homologous counterparts in vertebrates, including humans. Recent data have revealed that at least some of these proteins can also act against eukaryotic cells, including human infectious parasites. The latter activities have opened up new possibilities for disease control. PMID- 1789784 TI - The kinetics of mammalian gene expression. AB - When rates of transcription from specific genes change, delays of variable length intervene before the corresponding mRNAs and proteins attain new levels. For most mammalian genes, the time required to complete transcription, processing, and transport of mRNA is much shorter than the period needed to achieve a new, steady state level of protein. Studies of inducible genes have shown that the period required to attain new levels of individual mRNAs and proteins is related to their unique half-lives. The basis for this is a physical principle that predicts rates of accumulation of particles in compartmental systems. The minimum period required to achieve a new level is directly proportional to product half-lives because rates of decay control the ratio between the rate of synthesis and the concentration of gene products at steady state. This kinetic model suggests that sensitivity of gene products to degradation by ribonucleases and proteinases is an important determinant of the time scale of gene expression. PMID- 1789785 TI - Chromosomes, kinetochores and the microtubule connection. PMID- 1789786 TI - Transgenic Drosophila as an in vivo model for studying mammalian drug metabolism. PMID- 1789787 TI - Two-dimensional nuclear magnetic resonance study of brain natriuretic peptide in aqueous solution. AB - Two dimensional NMR spectra of porcine brain natriuretic peptide have been recorded at 400 MHz. Peak assignments have been made and the combined information from chemical shifts, coupling constants, temperature coefficients, exchange studies and nuclear Overhauser effects has been used to determine the conformation of pBNP in aqueous media. Overall the peptide appears to be conformationally averaged with the possibility of some restricted flexibility in localized regions. The conformation of porcine brain natriuretic peptide in water is compared to previous studies in d6-DMSO and to studies of atrial natriuretic peptide and some closely related analogues in H2O and d6-DMSO. PMID- 1789788 TI - Effect of radical treatment on erythrocyte lipid peroxidation in Plasmodium vivax infected malaria patients. AB - Elevated levels of thiobarbituric acid reactive substances and increased in vitro Heinz body formation in erythrocytes of Plasmodium vivax-infected malarial patients were observed. Radical treatment with chloroquine and primaquine increased the per cent maximal release of thiobarbituric acid reactive substances. Antioxidant enzymes, superoxide dismutase and catalase were decreased significantly in vivax malaria. Superoxide dismutase showed restoration of enzyme activity while catalase activity was increased significantly following therapy, suggesting an active involvement of free radical mechanism. PMID- 1789789 TI - Characterization of polyclonal antibodies to cell-surface antigens from ovine adipose tissue. AB - High titres of polyclonal antibodies to specific proteins of ovine adipose tissue plasma membranes were raised in horses and chickens following repeated injections of purified plasma membranes. Horse antiserum was highly species specific, reacting only weakly with rat adipose tissue plasma membranes. A protein of molecular weight 68,000 was most antigenic in that it was readily precipitated; however proteins of 25,000, 82,000 and 94,000 were also precipitated when the reaction was performed for longer with a higher antiserum concentration. Chicken egg yolk IgY reacted strongly with ovine adipose tissue plasma membranes as did those preparations from horse, but IgY was ineffective in immunoprecipitating solubilized membrane proteins and exhibited no cytotoxic reaction when incubated with intact ovine adipocytes. However, horse antiserum produced a strong complement-dependent cytotoxic reaction with ovine adipocytes, as measured by leakage of lactate dehydrogenase. This work suggests that the membrane protein of molecular weight 68,000 is likely to be an important antigenic marker for ovine adipocytes. PMID- 1789790 TI - Amplification and activation of c-Ki-ras oncogene in cell line developed from human pancreas explants. AB - Amplification and activation of c-Ki-ras gene was studied in normal human pancreas and a cell line (T-3) derived from normal pancreas explants exposed to methylnitrosourea (MNU) for 26 weeks. Normal genomic DNAs from pancreas and derived cell lines showed no transforming activity in NIH 3T3 cells. However, DNAs isolated from tumorigenic cell line derived from MNU treated human pancreas explants transformed NIH 3T3 cells. The hybridization profiles showed that the c Ki-ras gene was amplified 5 fold in the tumorigenic cells (T-3). The level of mRNA specific to the c-Ki-ras gene was found to be 50-60 fold higher in the malignant cells than in normal human pancreas. These results suggest that higher expression of ras genes is due to gene amplification and/or activation, which is an important step in carcinogenesis. PMID- 1789791 TI - Skeletal muscle oxygenation monitoring by near infrared spectroscopy. AB - The oxygenation of human forearm muscle tissue was studied using an optic fiber fast scanning spectrophotometer. We investigated near infrared (700-1100 nm) hemoglobin (Hb) and myoglobin (Mb) spectral changes in flow and/or oxygen-limited conditions. The superimposition of deoxy Hb and deoxy Mb spectra was confirmed "in vivo" on perfluorocarbon-blood exchanged transfused rats. Oxygenation changes were evaluated in 15 volunteers during 10 min forearm arterial occlusion. Rapid desaturation occurred until a plateau was reached after about 4 min, suggesting rapid anaerobic glycolytic activation. PMID- 1789792 TI - In vitro studies on mild alkali induced lesions in DNA. AB - S1 nuclease hydrolysis, benzoylated naphthoylated DEAE cellulose (BND-cellulose) chromatography as well as certain immunological and genetic techniques have been used to evaluate the effect of mild alkali (pH10.0) on the DNA molecule. Native calf thymus DNA after exposure to alkaline pH10.0 when subjected to S1 nuclease hydrolysis released significant amount of acid soluble nucleotides as compared to the untreated control. With pBR322 DNA, the population of linear DNA species increased on S1 digestion with concomitant reduction in the supercoiled form. BND cellulose chromatographic studies also suggested the formation of single strandedness and/or distortions in the alkali treated DNA molecule. Antisera raised against the alkali treated DNA exhibited high cross-reactivity with both single stranded and Z DNA. Moreover, a significant reduction in transformation frequency of the treated DNA molecule compared with the untreated control further ascertained the structural alterations in DNA as a result of exposure to mild alkali. PMID- 1789793 TI - Effect of iodination on the activity of cytotoxin P4 of Naja nigricollis nigricollis. AB - Iodination of cytotoxin P4, isolated from the venom of Naja nigricollis nigricollis, develops gradually and depends on the molar ratio between the free iodine and the cytotoxin reaching a maximum of two equivalents at a molar ratio of 250 or higher. The cytotoxic activity was also gradually decreased and was totally abolished when one equivalent of iodination was achieved. However, antigenic properties of the cytotoxin were preserved in the iodinated form. When the iodination of the cytotoxin was carried out with a carrier free radiolabeled iodide, the molar ratio was 0.05 resulting in labelling of only 2% of the cytotoxin molecules, which explains the cytotoxicity of the radiolabeled mixture. PMID- 1789794 TI - Carbon-phosphorus bond cleavage activity in cell-free extracts of Enterobacter aerogenes ATCC 15038 and Pseudomonas sp. 4ASW. AB - Carbon-phosphorus bond cleavage activity was investigated in cell-free extracts of Enterobacter aerogenes ATCC 15038 (IFO 12010) and Pseudomonas sp. 4ASW, strains known to utilize a range of phosphonates as sole phosphorus source. In vitro phosphonatase activity was detected in extracts of both organisms; however extensive analysis failed to detect any organic product from phosphonates other than phosphonoacetal dehyde. Non-specific liberation of phosphate was observed in Pseudomonas sp. 4ASW, associated with a single fraction of FPLC-purified extract, and is believed to result from the activity of cellular phosphatases. PMID- 1789795 TI - Effects of different types of polyunsaturated fatty acids on cholesterol esterification in human fibroblasts. AB - We have enriched human fibroblasts with oleic acid, with linoleic acid and with eicosapentaenoic acid. The accumulation of cholesteryl esters in the cells and the rate of esterification of cholesterol by microsomal acyl-CoA:cholesterol acyltransferase (ACAT) were measured in these cells. Cholesteryl ester levels were lower in cells enriched with eicosapentaenoic acid compared with cells enriched with oleate or linoleate. We also observed significantly lower ACAT activities in the microsomes from fibroblasts enriched with the n-3 polyunsaturated fatty acids relative to cells enriched with oleic acid or linoleic acid. We suggest that the presence of n-3 polyunsaturated fatty acids might suppress cholesteryl ester accumulation and inhibit atherogenesis. PMID- 1789796 TI - Regulation of glycogen synthesis in human skeletal muscle: does cellular glycogen control glycogen synthase phosphatase activity? AB - Contrary to the accepted feedback control mechanism of glycogen biosynthesis in skeletal muscle, evidence is presented here leading to the conclusion that glycogen does not control the activity of glycogen synthase phosphatase in intact human skeletal muscle tissue. PMID- 1789797 TI - Identification of a 38-kDa protein (p38) in HL-60 leukemic cells as a truncated actin. AB - Exposure of human leukemic HL-60 cells to monocyte-inducing compounds is accompanied by numerous newly synthesized protein changes in subfractions of the cell. Two proteins with molecular weights of 42,000 and 38,000 (p42, p38), present in the ribosomal salt wash (RSW) of proliferating cells, were markedly elevated and suppressed, in PMA-induced differentiated cells. Actin was identified as a component of p42. P38 cross-reacted with an actin-specific monoclonal antibody in Western blot analysis. Sequencing of gel-purified p38 showed that it was not N-terminally blocked and represented a truncated actin cleaved between val 43 and met 44. The reduction of p38 accompanying proliferating to differentiated cell transition may be indicative of proteolytic differences between the two cellular phenotypes. PMID- 1789798 TI - Damage of rat liver microsomal mixed function oxidase system by carbon tetrachloride. In vivo study with selective inhibitor of lipid peroxidation. AB - Pretreatment of rats with 4-[4-N-sodium-N-(5-ethyl-1-thia-3,4-diazol-2 yl)sulfophenylamin o]-5- methoxy-1,2-benzoquinone (Q) before carbon tetrachloride intoxication inhibited lipid peroxidation by 85% but did not prevent cytochrome P 450 destruction, decrease of hydroxylase activity, and loss of the capability to bioactivate carbon tetrachloride in rat liver microsomes. Also no influence of Q on 10-day lethality was found. We conclude that covalent binding of free radical products of metabolic cleavage to various cellular structures is apparently the main damage factor of carbon tetrachloride hepatotoxicity rather than lipid peroxidation. PMID- 1789799 TI - Bending of a highly repetitive component in rat nuclear DNA. AB - A highly repetitive component in rat nuclear DNA was isolated by HindIII digestion and cloned. A 370-bp cloned component was highly AT-rich (68.3%) in about one third of the region from the 3'-terminus and showed an anomalously slow gel electrophoretic mobility (k-factor = 1.19). These results indicated that a sequence-directed bending of the helix axis occurs in the component. Accordingly, a subclone containing a tandem dimer of the component was isolated and subjected to a circular permutation analysis for exploring the bend center (1). In consequence, the center was shown to be present in the sequence ranging from position near 270 to the 3'-terminus and estimated to be located around position 340. PMID- 1789800 TI - Changes observed in antioxidant system in the blood of postmenopausal women with breast cancer. AB - From experimental studies and epidemiological data, it can be inferred that lipid peroxidation is increased in cancer patients. Cases of post-menopausal, untreated women with benign and malignant breast tumours, were compared with their age matched controls in their serum lipid peroxides, antioxidant vitamins (E and C), serum selenium and serum ceruloplasmin. Erythrocyte and its membrane lipid peroxidation and antioxidant enzymes (catalase, superoxide dismutase, glutathione peroxidase and glutathione-S-transferase) levels were also analyzed. Significant increase in circulating lipid peroxides, ceruloplasmin and significant decrease in antioxidant vitamins and selenium were observed in breast cancer women. The erythrocyte and its membrane lipid peroxidation was increased significantly and severe impairment of antioxidant potential was observed in breast cancer women. PMID- 1789801 TI - Structural analysis of phospholipase A2 by near-IR Fourier transform Raman spectroscopy. AB - Venom toxins were isolated from Formosan cobra (Naja naja atra) by cation exchange chromatography. Most toxin components could be obtained in relatively pure forms by single-step ion-exchange chromatography whereas an extra step of gel permeation was needed for the separation of phospholipase A2 (PLA2) from the major neurotoxic component, i.e. cobrotoxin. The newer near-IR FT-Raman analytical method has been applied to the characterization of PLA2 in their lyophilized forms. Structural analysis of PLA2 and correlation of Raman spectroscopic data with amino acid compositions were made. The results indicate that phospholipase A2 showed the Raman peak at 1659 cm-1 which is characteristic of the alpha-helical structure in this enzyme. It is also found that the relative Raman signal intensities of Tyr, Phe, Trp and Met residues in purified toxins correlate very well with the structural data obtained from amino acid analysis. The application of near-IR FT-Raman techniques in the detection of the microenvironments of the aromatic amino acids such as Tyr and Trp in the native toxins may prove useful in the investigation of the functional properties of various venom toxins. PMID- 1789802 TI - Plasma high density lipoprotein particle size alteration by simvastatin treatment in patients with hypercholesterolaemia. AB - Twenty-two patients with pronounced hypercholesterolaemia were treated with simvastatin in increasing doses, i.e. 10, 20 and 40 mg O.D. Each treatment regimen had a duration of 6 weeks. In addition to the expected low density lipoprotein (LDL)-lowering effect, simvastatin altered the plasma HDL particle size spectrum by selective elevation of the plasma HDL2b and HDL3a levels, as defined by polyacrylamide gradient gel electrophoresis (gge). While the reduction in LDL cholesterol by simvastatin was dose dependent, the effect on HDL was maximal already at 10 mg daily. On treatment with simvastatin 10 mg O.D., the plasma HDL2b and HDL3a concentrations increased by 30% (P less than 0.001) and 12% (P less than 0.01) respectively. On the corresponding treatment with simvastatin LDL cholesterol decreased by 31% (P less than 0.001). The very low density lipoprotein (VLDL) cholesterol to triglyceride ratio was significantly lowered by treatment with 10 mg simvastatin O.D. suggesting a compositional change in VLDL. Positive univariate correlations between treatment-induced decreases in plasma HDL3b/3c levels and VLDL triglyceride concentration were seen. It is suggested that inhibition of cholesterol synthesis in hypercholesterolaemic subjects by simvastatin treatment alters the composition of VLDL, which may affect the close relation between HDL and VLDL, in turn producing selective elevations of the plasma HDL2b and HDL3a levels. PMID- 1789803 TI - Evaluation of elastin metabolism in children from families with high risk of atherosclerosis. AB - Markers of elastin metabolism were estimated in sera of children from families with a high risk of atherosclerosis (ATH). There was no statistically significant difference in the serum elastase-like activity between the groups studied. The concentration of elastin-derived peptides was statistically significantly elevated in the ATH group. Anti-elastin antibodies were found to be present in 73% of ATH children, while they circulated in 5% of control subjects only. Antibodies observed in the youngest ATH children were of the IgM type, suggesting the initial stage of the autoimmunization to elastin. The data obtained in this study may indicate an enhanced metabolism of elastin in ATH children. PMID- 1789804 TI - Population correlates of plasma fibrinogen and factor VII, putative cardiovascular risk factors. AB - Recent prospective investigations have reported that higher plasma fibrinogen concentrations and higher factor VII coagulant activity are associated with greater risk of cardiovascular disease. To discover what characteristics may influence fibrinogen and factor VII, we analyzed data from the Atherosclerosis Risk in Communities Study obtained from over 12,000 men and women, aged 45-64 years, from four communities in December 1986 to June 1989. Fibrinogen was higher in blacks than whites and in women than men; in general, it increased with age, smoking, body size, diabetes, fasting serum insulin, LDL cholesterol, lipoprotein(a), leukocyte count, and menopause, and it decreased with ethanol intake, physical activity, HDL cholesterol, and female hormone use. Factor VII was higher in women than men and, in women, increased with age; in both sexes, it increased with body size, triglycerides, LDL cholesterol, and HDL cholesterol, and it decreased with ethanol intake. These findings indicate that elevations in fibrinogen and factor VII may be modifiable through appropriate lifestyle changes. PMID- 1789805 TI - Proteoglycans produced by cholesterol-enriched macrophages bind plasma low density lipoprotein. AB - Proteoglycans (PG) produced by [35S]sulfate and [3H]serine labeled cultures of cholesterol-enriched macrophages obtained from atherosclerosis-susceptible White Carneau (WC) and -resistant Show Racer (SR) pigeons were characterized and assessed for their capacity to bind low density lipoprotein (LDL). The majority of 35S-labeled PG was released into the culture media in both WC and SR macrophage cultures and consisted of large and small size PG as determined by Sepharose CL-4B chromatography. Large PG were identified as chondroitin sulfate PG comprised of 4-sulfated disaccharides whereas small PG consisted of primarily 4-sulfated chondroitin sulfate-PG and lesser amounts of heparin sulfate-PG. Experiments demonstrated that 32-34% of 35S-labeled large PG and 86-93% of small PG bound to LDL-substituted Sepharose. Interactions between PG and LDL substituted Sepharose were inhibited in the presence of heparin or soluble LDL. Glycosaminoglycans derived from macrophage PG had a decreased binding affinity demonstrating the importance of an intact PG. The results suggest that macrophage PG may facilitate trapping of LDL in the intimal intima and promote foam cell formation through a mechanism involving the uptake of PG-LDL complexes. PMID- 1789806 TI - Effect of nifedipine on renal microvascular cholesterol accumulation and prostacyclin biosynthesis in cholesterol-fed rabbits. AB - Studies, performed in rabbits, examined the effect of feeding a high cholesterol diet and/or a calcium antagonist, nifedipine, on renal microvascular prostacyclin biosynthesis and cholesterol accumulation. After 30 days, cholesterol-fed rabbits had elevated serum and tissue cholesterol levels associated with decreased microvascular prostacyclin biosynthesis and histologic evidence of microvascular and glomerular lipid accumulation. Nifedipine reduced tissue cholesterol levels, enhanced prostacyclin biosynthesis, and reduced the histologic evidence for lipid accumulation in renal microvessels and glomeruli. These studies suggest that calcium antagonists may have a beneficial effect in preventing the tissue cholesterol accumulation associated with a high-cholesterol diet and further suggest that these agents may have beneficial effects in the treatment of renal diseases associated with microvascular or glomerular lipid accumulation. PMID- 1789807 TI - Venous occlusion and chronic cigarette smoking: dose-dependent decrease in the measurable release of tissue-type plasminogen activator and von Willebrand factor. AB - This study was aimed at examining the effect of chronic cigarette smoking on a venous occlusion test. Two groups of young healthy men, a control group of 20 non smoking subjects and a group of 21 smoking subjects having an average consumption of 17.6 packages.day-1.years (SD 8.6) were studied. Venous occlusion performed in smokers did not induce a significant measurable release of von Willebrand factor (vWF). The release of tissue-type plasminogen activator (t-PA) was significantly weaker for the smokers than for the control group (P less than 0.02). An inverse correlation was found between the cumulative parameter of tobacco consumption and the measurable amount of t-PA Ag or vWF Ag released during venous occlusion (r' = -0.994 and r' = -0.889). Cigarette smoking is thus associated with disturbances of the biological response to this venous occlusion test. PMID- 1789808 TI - Inhibition of HMG-CoA reductase in mononuclear cells during gemfibrozil treatment. AB - The effect of gemfibrozil treatment (900 mg/day) on serum levels of total cholesterol, HDL-cholesterol, triglyceride, apoproteins A-I, A-II and B as well as HMG-CoA reductase in mononuclear cells was studied in patients with hyperlipoproteinemia types IIa and IIb. After 4 weeks of treatment gemfibrozil reduced total serum cholesterol (IIa: -17%, IIb: -26%), triglyceride (IIa: -39%, IIb: -47%) and apoprotein B (IIa: -22%, IIb: -15%). HDL cholesterol was increased by 20-22% and apoproteins A-I and A-II by 4-11%. Concomitantly, HMG-CoA reductase activity in freshly isolated mononuclear cells was suppressed by 78% in type IIa and 51% in type IIb patients. Continuation of treatment for up to 16 weeks prompted a further decline to 8 and 5% of the initial values, respectively. However, gemfibrozil failed to affect HMG-CoA reductase directly in homogenized or cultured mononuclear cells and did not further promote the suppressive action of LDL when added to the culture medium. Similarly, preincubation with the drug did not significantly modulate the binding or degradation of LDL in the cultured cells. However, LDL from patients with hyperlipoproteinemia types IIa and IIb exhibited enhanced binding and more potent HMG-CoA reductase suppression when isolated after compared to before gemfibrozil treatment. It is suggested that the HMG-CoA reductase inhibition observed in mononuclear cells during gemfibrozil treatment is due to changes in LDL structure affecting LDL receptor binding rather than direct effects of the drug on cellular cholesterol metabolism. PMID- 1789809 TI - Apolipoprotein B gene polymorphisms are associated with lipid levels in men of South Asian descent. AB - Three polymorphic sites of the apolipoprotein B gene - the insertion/deletion signal peptide, XbaI and EcoRI sites - were examined in a sample of 107 healthy men and in 46 men with evidence of coronary heart disease selected from a large population survey of South Asians aged 40-69 in London, U.K. There were no significant differences in allele frequencies between cases and controls. Frequencies of the ins (insertion) and X- (absence of XbaI cutting site) alleles were higher in South Asians than in Europeans studied previously (South Asians versus Europeans ins: 0.80 vs. 0.68, P less than 0.025; X-: 0.71 vs. 0.47-0.56, P less than 0.001). The del allele was associated with higher levels of total cholesterol (P less than 0.05) and the X+ allele with lower levels of HDL cholesterol (P less than 0.05), and thus both polymorphisms were associated with differences in the ratio of HDL cholesterol to total cholesterol (ins/del, P less than 0.01; XbaI, P less than 0.001). Mean waist-hip girth ratio was lower in the 10 men homozygous for the X+ allele than in the 42 men with X-/X+ and 55 men with X-/X- genotypes; the means (+/- SEM) were 0.92 +/- 0.02, 0.97 +/- 0.01 and 0.96 +/- 0.01 respectively (P = 0.03). These data suggest that genetic variation in linkage disequilibrium with the XbaI and ins/del polymorphisms of the apo B gene contributes to the determination of total cholesterol and HDL cholesterol levels and possibly to obesity in South Asians. PMID- 1789810 TI - Insulin resistance observed in WHHL rabbits. PMID- 1789811 TI - Lipid-lowering drugs: focus on HMG-CoA reductase inhibitors. Introduction. PMID- 1789812 TI - Significant increase of high-density lipoprotein2-cholesterol under prolonged simvastatin treatment. AB - In a contribution to a prolonged multicenter study 15 patients with primary hypercholesterolemia were treated with simvastatin, a competitive inhibitor of HMG-CoA reductase. The first part of the study was done in a double-blind fashion comparing the effect of this new drug with that of gemfibrozil during 12 weeks, and after this period on open-label treatment was started with the administration to all the patients of simvastatin in doses ranging from 2.5 to 40 mg q.p.m. Persistent and significant reductions (P less than 0.001) were achieved for total serum cholesterol (TC), LDL-cholesterol (LDL-C), apo B and triglycerides: by 38, 49, 44 and 33%, respectively, after 40 weeks of the open-label extension. From week 12, LDL-C levels were maintained at a cut point less than or equal to 140 mg/dl in every patient throughout the study. At week 40, cholesterol values of HDL subfractions showed a significant increase in HDL2-C (28%, P less than 0.01) and a concomitant reduction in HDL3-C (12%, P less than 0.01) in spite of a nonsignificant elevation of total HDL-C (by 6%). The HDL2-C/HDL3-C ratio rose by 47% (P less than 0.001) and the TC/HDL-C ratio was significantly reduced by 43%: from 6.1 +/- 1.2 to 3.5 +/- 0.7 (mean +/- SD, P less than 0.001). No adverse effects were detected. Our results suggest a conversion of HDL3 into HDL2, which could imply a beneficial effect of simvastatin upon the so-called reverse cholesterol transport, in addition to the striking reduction in atherogenic lipoproteins. PMID- 1789813 TI - Long-term efficacy and safety of simvastatin alone and in combination therapy in treatment of hypercholesterolaemia. AB - The 3-years efficacy and safety of the 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor simvastatin (S) (previously called synvinolin or MK-733) has been studied in single and combined therapy with cholestyramine (C) in 48 hypercholesterolaemic patients. Plasma lipids, lipoproteins and apolipoproteins A I and B, and blood safety tests (haematology, liver function, creatine phosphokinase (CPK), creatinine, blood glucose and thyroid function) were determined regularly throughout the study. Extensive ophthalmological examinations with particular focus on the lens were done before initiation of therapy and at every 6 months during drug treatment. Maximal reductions of mean plasma total cholesterol concentration (34% with S; 47% with S + C) and low density lipoprotein (LDL)-cholesterol concentration (42% with S; 56% with S + C) were achieved after 4 weeks on full-dose therapy. During continued treatment, years 1 through 3, the reduction of mean plasma total cholesterol was 26-29% with S alone, and 31-41% with S + C. Significant reductions of plasma triglycerides (15-27%) and very low density lipoprotein (VLDL) triglycerides (10-27%) were achieved in the group treated with S as single therapy. In this group there was also a significant increase (10-14%) of high-density lipoprotein (HDL) cholesterol. In liver aspartate (AST) and alanine (ALT) aminotransferases, as well as alkaline phosphatase (ALP), minor and variable, but usually transient, increases were seen. Repeated ophthalmological examinations did not demonstrate any drug-related side effects. It is concluded that simvastatin is a safe and efficient cholesterol-lowering drug for long-term therapy, both as a single drug and in combination with cholestyramine. PMID- 1789814 TI - Lipoprotein particle analysis comparing simvastatin and fenofibrate. AB - This study compares the effects of fenofibrate and simvastatin in primary hypercholesterolemia, with particular regard to lipoprotein particles, as defined by their apolipoprotein composition: LpAI, LpAII: AI, LpE:B, LpCIII:B. This was a double-blind study in which patients were randomized to 2 groups, one receiving simvastatin 20 mg once daily and the other receiving fenofibrate 200 mg b.i.d., if their total cholesterol and their LDL cholesterol remained above 7.60 mmol/l (300 mg/dl) and 4.95 mmol/l (195 mg/dl) after a 4-week placebo period. Simvastatin dosage was doubled at the end of 6 weeks of therapy if the LDL cholesterol level remained above 3.55 mmol/l (140 mg/dl). Analyses were done after 6 and 10 weeks of therapy. Apolipoprotein AI was increased significantly only at week 10 with fenofibrate (+7.4%). Simvastatin had a more pronounced effect than fenofibrate on apolipoprotein B. There was a significant difference between drugs at weeks 6 and 10. No change was observed in the LpAII:AI level with simvastatin, whereas fenofibrate increased these particles quite significantly (+13.9 and +22.3%). The drugs had opposite effects on LpAI (+2.5 and +5.6% with simvastatin; -12.8 and -15.1% with fenofibrate). LP E:B (-33.0 and -40.8% with simvastatin; -53.8 and -52.2% with fenofibrate) and LpCIII:B (-23.8 and -31.8% with simvastatin; -35.1 and -43.5% with fenofibrate) were decreased by both drugs, but fenofibrate was significantly more effective in reducing these particles than simvastatin at week 6. This study suggests that both drugs led to different structural modifications of the lipoproteins, which would not be revealed by total apolipoprotein analysis. These differences are probably related to the mechanisms of action of these drugs. PMID- 1789815 TI - A multicenter double-blind study comparing lovastatin and gemfibrozil in the treatment of primary hypercholesterolemia. AB - The efficacy and tolerability of lovastatin and gemfibrozil were compared in a randomized double-blind 12-week study including 182 patients with primary hypercholesterolemia, from 7 hospitals in Spain. Inclusion criteria were total cholesterol of at least 250 mg/dl and triglycerides less than 350 mg/dl. Patients were stratified in two groups: group 1, cholesterol less than 300 mg/dl, and group II, cholesterol equal to or more than 300 mg/dl. Patients were randomized to gemfibrozil (600 mg b.i.d.) or lovastatin (20 mg q.p.m., group I and 40 mg q.p.m., group II). If after 6 weeks of treatment cholesterol remained above 200 mg/dl, lovastatin does were doubled. In group I, lovastatin decreased cholesterol by 20%, LDL-C by 28%, and triglycerides by 17%, and increased HDL-C by 8%. In group II the results were: -26%, -33%, -19% and +6% respectively. The corresponding results with gemfibrozil were: -8%, -9%, -28% and +14% (group I); and -13%, -14%, -33% and +9% (group II). In both groups, lovastatin was more effective in reducing cholesterol and LDL-C (P less than 0.001) and gemfibrozil in reducing triglycerides (P less than 0.05 group I and P less than 0.01 group II). Both drugs were well tolerated. Thus, lovastatin and gemfibrozil are effective lipid-lowering agents; lovastatin has more pronounced effects in patients with hypercholesterolemia. PMID- 1789816 TI - Clinical considerations regarding treatment of hypercholesterolemia in the elderly. AB - Therapy for hypercholesterolemia has been shown to reduce the risk for coronary heart disease in middle-aged men. Current guidelines for detecting and treating hypercholesterolemia in adults render large numbers of elderly patients eligible for medical intervention. The elderly are a heterogeneous group of individuals who differ widely in their ability to function physically, behaviorally, cognitively and emotionally. Not all elderly patients qualify for cholesterol lowering therapy. Decisions regarding diagnostic and therapeutic interventions should be based on the physiological age of the patient rather than the chronological age, and on the presence and severity of concomitant disease, mental status and cognitive ability, as well as on the patient's expectations from medical care. Suggestions for dietary therapy and drug therapy in the elderly are provided. The objectives and potential benefits of therapy are described. Based on the information currently available, it is concluded that the elderly are likely to benefit from cardiovascular risk factor modification and should not be denied cholesterol-lowering therapy simply on the basis of their chronological age. PMID- 1789817 TI - Does cholesterol screening result in negative labeling effects? Results of the Massachusetts Model Systems for Blood Cholesterol Screening Project. AB - Several previous studies that looked at the effects of labeling individuals as hypertensive found increases in psychosocial distress, diminished feelings of well-being, or absenteeism. Other studies found no such effects. Thus far, similar studies relating to labeling for high blood cholesterol levels have not been published. The Massachusetts Model Systems for Blood Cholesterol Screening Project investigated whether labeling effects occurred as a result of the community-based screening, education, and referral programs it conducted in Worcester and Lowell. Nine questions concerning perceptions of physical and psychological well-being were asked on a questionnaire given to screening participants. The same questions were asked as part of a follow-up questionnaire given to all individuals identified as having high blood cholesterol levels at one of the screenings. Comparison of the baseline and follow-up results did not demonstrate significant overall negative effects among any age, sex, racial, income, or educational groups. On the contrary, responses to many of the questions revealed small but statistically significant improvements in perceptions of physical and psychological well-being. The absence of negative labeling effects may be attributable to the positive, supportive approach to participant counseling taken by the project. PMID- 1789818 TI - Alcohol abuse in adolescents. AB - Alcohol abuse among teenagers is an increasing problem with serious physical and social consequences. Early diagnosis of adolescent alcoholism may be delayed for two reasons: the physical indicators of alcohol abuse seen in adults are often not identifiable in teenagers, and alcoholism is generally believed to be an adult problem. If the history is taken carefully, with respect and confidentiality, it can help the family physician determine the extent of a young person's alcohol abuse and begin the process of treatment for both the adolescent patient and the family. PMID- 1789819 TI - Plasma cell granuloma of the nasal cavity treated by radiation therapy. AB - Plasma cell granuloma is a rare, benign tumor most commonly found in the lungs in patients younger than 30 years. Although presentation has been reported at a number of other anatomic sites, this report is the first of plasma cell granuloma of the nasal cavity. The tumor was initially resected, but progression was seen at 1-month follow-up. Because further surgery to completely eradicate the tumor would have been extensive and disfiguring, 40-Gy external beam radiation was given in 20 fractions using a three-field wedge technique. Most recent clinical follow-up at 27 months showed local control. Surgery remains the treatment of choice for plasma cell granuloma when the disease can be completely resected. However, irradiation can also be effective in patients with recurrent or inoperable local disease. PMID- 1789820 TI - A standard heparin nomogram for the management of heparin therapy. AB - A nomogram for the adjustment of heparin dosage was developed to standardize heparin therapy and to reduce delays in achieving and maintaining a therapeutic activated partial thromboplastin time (APTT) result. Fifty consecutive patients with acute venous thromboembolism had their continuous intravenous heparin therapy adjusted according to this heparin nomogram. The effect of the nomogram on heparin therapy in these patients was compared with data from 53 historical control patients. The proportion of patients in the nomogram group who reached a therapeutic APTT at 24 hours after the start of heparin therapy was 66%, which increased to 81% at 48 hours. In contrast, 37% and 58% of the control patients reached a therapeutic APTT at 24 and 48 hours, respectively. The percentage of therapeutic APTT results of the total number of APTT determinations was greater in the nomogram patients than controls. The use of this heparin nomogram resulted in (1) achieving a therapeutic APTT at 24 and 48 hours in a large proportion of patients and (2) reduced periods of inadequate anticoagulation and overanticoagulation during heparin therapy. PMID- 1789821 TI - The ritual abuse of children: clinical features and diagnostic reasoning. AB - A case of alleged ritual sexual abuse is presented. Clinical recognition and diagnostic reasoning are discussed. After a brief account of modern satanism, it is concluded that, although the evidence for the occurrence of ritual abuse is sketchy, a high index of suspicion is appropriate. PMID- 1789822 TI - Anaphylaxis. PMID- 1789823 TI - Enhanced tumor growth of both primary and established human and murine tumor cells in athymic mice after coinjection with Matrigel. AB - Previously we found that the reconstituted basement membrane matrix Matrigel, when premixed with human small-cell lung carcinoma cells and injected subcutaneously into athymic mice, permitted tumor growth, whereas cells injected in the absence of Matrigel did not form tumors. In the present study, we examined additional cell types and determined some of the underlying mechanisms involved in the promotion of tumor formation by Matrigel. The tumor cell lines that we studied included transformed mouse Englebreth-Holm-Swarm tumor cells (T-EHS), human submandibular carcinoma A253 cells, mouse melanoma B16F10 cells, human epidermoid carcinoma KB cells, and human primary renal cell carcinoma cells. When coinjected subcutaneously with Matrigel, these cell lines formed rapidly proliferating tumors. Primary biopsy specimens of human colon carcinoma, when dispersed and coinjected with Matrigel, also formed tumors. Only A253, KB, and B16F10 cells formed small tumors in the absence of Martrigel, but a fivefold to tenfold increase in tumor size was observed in the presence of Matrigel. These data demonstrate a useful method for improving the growth of human tumors in athymic mice. PMID- 1789824 TI - Do we have the infant mortality rate we desire? PMID- 1789825 TI - The oral health status, dental needs and factors affecting utilisation of dental services in Asians aged 55 years and over, resident in Southampton. AB - A socio-dental investigation was carried out in Southampton among 195 Asians of Indian, Pakistani or Bangladeshi origin, aged 55 years and over, in order to assess their oral health status and identify factors which might affect their uptake of dental services. The majority of subjects (70%) were dentate; 69% were in need of periodontal treatment and 29% required extractions due to advanced periodontal involvement. Despite the fact that many subjects held positive attitudes towards dental health, less than 15% attended the dentist on a regular basis. The remaining subjects felt that it was not necessary to do so unless they were in pain or required new dentures. PMID- 1789826 TI - Management in the NHS. PMID- 1789827 TI - Ocular injuries due to exploding bottles of carbonated drinks. PMID- 1789828 TI - Examination without interview. Learning about the physical examination as a diagnostic tool. PMID- 1789829 TI - Is rheumatoid arthritis an infectious disease? PMID- 1789830 TI - Randomised controlled trial comparing oral and intravenous rehydration therapy in children with diarrhoea. AB - OBJECTIVE: To determine the effectiveness of oral rehydration in children with moderate dehydration caused by gastroenteritis, and to compare the complications of oral and intravenous treatment. DESIGN: Randomised controlled trial. SETTING: Emergency department and infectious diseases ward in a large urban teaching hospital. PATIENTS: 111 children aged 3-36 months who had been previously healthy, had had diarrhoea for seven days or less, had clinical signs of dehydration, and were not in shock. Six children were withdrawn because the diagnosis was incorrect (four in oral group, two in intravenous group) and one (oral group) was withdrawn at her parents' request. INTERVENTIONS: Oral rehydration fluid was given by mouth or nasogastric tube, or both to 52 children. The remaining 52 received intravenous rehydration fluids but were allowed to drink. MAIN OUTCOME MEASURES: Success or failure of rehydration. Number of times child vomited or passed stool after starting treatment. Time taken to rehydrate. RESULTS: Oral treatment failed in two children (failure rate 3.8%, upper 95% confidence limit 11.6%) and intravenous treatment in none. Vomiting was more common in the oral group (p less than 0.01): 26 of 50 children (52%) in the oral group and 11 of 50 (22%) in the intravenous group vomited during rehydration. There was no significant difference between the two treatment groups in the number of stools passed during rehydration (p = 0.09). None of the children had serious complications of treatment. CONCLUSION: Rehydration by mouth or nasogastric tube is a safe and effective treatment for moderately dehydrated children with gastroenteritis. PMID- 1789831 TI - A 28-year-old man with weakness, dizziness, and sensation of bounding heart rate. PMID- 1789832 TI - Three-dimensional imaging. PMID- 1789833 TI - Comparison of plasmid profile analysis, antibiogram testing, resistotyping and biotyping in the identification of Escherichia coli isolates from poultry. AB - Twenty isolates of Escherichia coli from poultry, predominantly from birds with colibacillosis, were collected and plasmid profile analysis, antibiogram testing, resistotyping and biotyping were compared as epidemiological tools for the differentiation and identification of the isolates. Plasmid profile analysis, in conjunction with any one of the other three tests, was found to be more valuable as an epidemiological tool than one test alone. PMID- 1789834 TI - Epidural diamorphine for the obstetric patient. PMID- 1789835 TI - Lumbar plexus block after total knee replacement. PMID- 1789836 TI - Another set of twins. PMID- 1789837 TI - Who should hold the medical record--provider, parents, or both? PMID- 1789838 TI - An evaluation of assumptions underlying the single-patient-only position in neuropsychological research: a reply. AB - This note challenges the position adopted by A. Caramazza and W. Badecker (1989, Brain and Cognition 10, 256-295) that, since the a priori classification of patients can only be theoretically arbitrary, the basic unit of analysis in cognitive neuropsychology must be the individual patient. We argue that even if there is no prior theory to justify patient classification, this does not preclude group studies; syndromes are what the world gives us--they constrain theory, permitting groups to be formed for research purposes. We also reexamine a particular example of group-based research that was extensively criticized by Caramazza and Badecker. We confront each of their criticisms, and, again, demonstrate the validity of group-based research. PMID- 1789839 TI - Comparative study between the gastroepiploic and the internal thoracic artery as a coronary bypass graft. PMID- 1789840 TI - 'The efficacy of comprehensive dental care for children under general anaesthesia'. PMID- 1789842 TI - Systolic arterial pressure as a monitor of depth of anaesthesia. PMID- 1789841 TI - Antagonism of benzodiazepine sedation with flumazenil. PMID- 1789843 TI - Improving survival after large bowel cancer. PMID- 1789844 TI - Routine testing for HIV at infertility clinics. PMID- 1789845 TI - Computers in audit: servants or sirens. PMID- 1789846 TI - Garlic. PMID- 1789847 TI - Editing medical records. PMID- 1789848 TI - From audit to quality and beyond. PMID- 1789849 TI - Oral rehydration in gastroenteritis. PMID- 1789850 TI - Set menus and clinical freedom. PMID- 1789851 TI - Improving survival after large bowel cancer. PMID- 1789852 TI - No consensus yet on the management of liver metastases. PMID- 1789853 TI - Effects of adenosine on human coronary arterial circulation. PMID- 1789854 TI - Alclometasone dipropionate allergy. PMID- 1789855 TI - High-tech research in the '90s. PMID- 1789856 TI - Anorexia and family dynamics. PMID- 1789857 TI - Fine needle aspiration cytology in lymphadenitis. PMID- 1789858 TI - Smoking and hypertension. PMID- 1789859 TI - "Silicone synovitis" in endosteal region. PMID- 1789860 TI - Neuropsychological assessment in patients with multiple sclerosis and mild functional impairment. PMID- 1789861 TI - Sensitivity and specificity of a diagnostic test determined by repeated observations in the absence of an external standard. AB - Traditionally, the sensitivity and specificity of a new diagnostic test are derived from its application to two groups of individuals known to have or not to have met the criterion to be detected as judged by means of a "gold standard", some external time-honored test. In this study, a test with unknown accuracy parameters was used to detect an end-point criterion in an ongoing ophthalmological clinical trial. Since no external test method was available to assess the accuracy of this test, equations were derived relating the unknown sensitivity and specificity of the test to data frequencies based on replicate measurements. The solutions to these equations also provided estimates of the incidence rate of the criterion under investigation in the group tested, and of the predictive values of the test. The validity of this method of estimation is discussed, and applications to other situations are suggested. PMID- 1789862 TI - Characteristics of a radionuclide monitoring of cardiac function and ST-segment. PMID- 1789863 TI - Halothane hepatitis in children. PMID- 1789864 TI - Treating burns. PMID- 1789865 TI - Ethical medical practice and the NHS. PMID- 1789866 TI - "Sonographic sliding". PMID- 1789867 TI - Bad debt and uncompensated care. PMID- 1789868 TI - The concept and definition of an "intermediate form" of atrioventricular septal defect. PMID- 1789870 TI - Eye-wash. PMID- 1789869 TI - Nonsteroidal antiinflammatory drugs--differences and similarities. PMID- 1789871 TI - Blood alcohol concentration. PMID- 1789872 TI - Readership comment on sutures and cylinder editorial. PMID- 1789873 TI - Intraocular pressure peaks. PMID- 1789874 TI - Chronic fatigue controversy. PMID- 1789875 TI - Procedure questioned. PMID- 1789876 TI - Determination of blood lead levels. PMID- 1789877 TI - Pneumoperitoneum on supine abdominal radiographs. PMID- 1789878 TI - Gadopentetate dimeglumine-enhanced MR imaging of spinal dermal sinus tract. PMID- 1789879 TI - Alcohol abuse in adolescents. PMID- 1789880 TI - Treatment of a deaf multiple personality disorder. PMID- 1789881 TI - Postnatal outcome depends on prenatal history. PMID- 1789882 TI - Aminophylline in the emergency department. PMID- 1789883 TI - Prevalence of Helicobacter pylori in nonulcer dyspepsia. PMID- 1789884 TI - Change: a professional challenge. PMID- 1789885 TI - Cost-efficient study designs for binary response data with Gaussian covariate measurement error. AB - When mismeasurement of the exposure variable is anticipated, epidemiologic cohort studies may be augmented to include a validation study, where a small sample of data relating the imperfect exposure measurement method to the better method is collected. Optimal study designs (i.e., least expensive subject to specified power constraints) are developed that give the overall sample size and proportion of the overall sample size allocated to the validation study. If better exposure measurements can be collected on a sample of subjects, an optimal design can be suggested that conforms to realistic budgetary constraints. The properties of three designs--those that include an internal validation study, those where the validated subsample is derived from subjects external to the primary investigation, and those that use the better method of exposure assessment on all subjects--are compared. The proportion of overall study resources allocated to the validation substudy increases with increasing sample disease frequency, decreasing unit cost of the superior exposure measurement relative to the imperfect one, increasing unit cost of outcome ascertainment, increasing distance between two alternative values of the relative risk between which the study is designed to discriminate, and increasing magnitude of hypothesized values. This proportion also depends in a nonlinear fashion on the severity of measurement error, and when the validation study is internal, measurement error reaches a point after which the optimal design is the smaller, fully validated one. PMID- 1789886 TI - Gender differences in creative achievement: a survey of explanations. AB - Thus far, in most fields of endeavor, the majority of seminal achievements have come from men. In this article, we have considered some possible explanations for this phenomenon, and for each of these explanations, some theories of creativity that would stress it. We have emphasized that creative achievement depends on both biological and environmental factors and that inborn talents establish a potential whose fulfillment depends on appropriate experiences. Because men and women differ in both factors, either or both could have produced the achievement difference. Moreover, achievement can occur in fields requiring different abilities. Talent may not be wide ranging but directed toward specific endeavors, with men and women differing not in amount of talent but in the fields preferred. Changes in women's roles and cross-cultural studies may shed further light on the gender difference, but environmental explanations alone are premature. PMID- 1789887 TI - Profile of pediatric admissions with diagnosis of asthma at the San Pablo Hospital. AB - Bronchial Asthma morbidity and mortality appear to be increasing. In our continuing endeavor to investigate the asthma problem in Puerto Rico, we describe the profile or group of pediatric patients admitted with asthma during a three month period of time to a community hospital. This is intended to be an initial step in developing a more detailed study to evaluate risk factors for hospitalization and need for acute care management of children with asthma in Puerto Rico. We evaluated a group of patients admitted with the diagnosis of asthma (ICD-9 code 493). One hundred and nineteen admissions between August 22 and November 21, 1990 (ninety days) were reviewed retrospectively. Data extracted from the records included demographic, laboratory and physiological variables. Results were similar for both sexes. Asthma admissions represented 29 percent of the total admissions with a hospital stay of 4.07 +/- 1.09 days and age of 4.62 +/- 4.29 years (mean +/- SD). No pulmonary function tests were performed as criteria for admission. In conclusion, this study suggests that the need for hospitalization in children with asthma in a community hospital is based on clinical evaluation. The use of pulmonary function tests, peak expiratory flow measurement or both may not be suitable for the majority of children admitted with asthma due to age. Other criteria for younger children with asthma need to be developed. PMID- 1789888 TI - Supraglottitis: the need of a standardized protocol. AB - Supraglottitis is an acute airway emergency requiring prompt medical intervention. Ten cases of epiglottitis treated at San Pablo Hospital are reviewed retrospectively. The controversies regarding this diagnosis are discussed. Due to a wide range of opinions concerning the proper management and treatment of epiglottitis, and the need of a standardized protocol, a simple and flexible protocol to be used by all physicians is proposed. PMID- 1789889 TI - Essential thrombocythemia: a hypercoagulable state. AB - Essential thrombocythemia is an entity characterized by clonal proliferation of megakaryocytes and thrombocytosis. We have analyzed the presenting manifestation of 13 patients with Essential Thrombocythemia diagnosed in the last three years. The major findings include the frequent presence of symptomatology of a hypercoagulable state with prompt improvement of these symptoms once the thrombocytosis is controlled. Constitutional symptoms, organomegaly, modest Leukocytosis and eosinophilia were also often seen. No catastrophic events were detected with a mean follow up period of 17.5 months. PMID- 1789890 TI - Cardiac surgery at the San Pablo Heart Institute: an update of statistics on surgical mortality and morbidity. AB - We performed 1,739 cardiac surgery procedures between August 1988 and July 1991 at the San Pablo Heart Institute. The statistics for mortality and morbidity are among the best in the nation and they showed an overall mortality for the entire period of 1.8%, a mortality for coronary artery bypass graft of 1.5% no patient has died as a result of mitral valve replacement, and a mortality of 1.1% for aortic valve replacement. We have demonstrated that our cardiac surgery team is capable of performing a high volume of these procedures with good results. PMID- 1789891 TI - Joubert syndrome. Respiratory failure requiring home mechanical ventilation. AB - A case of Joubert's Syndrome with respiratory insufficiency requiring mechanical ventilatory support is presented. The case illustrates the complex clinical, ethical and technical aspects in the management of patients with this syndrome and the feasibility of extending mechanical ventilatory support to the home setting. A caring, knowledgeable care team and a loving supportive family are required to properly continue treatment in the home in cases of this rare syndrome. PMID- 1789892 TI - Administrative and legal aspects of a smoke free policy in hospitals. PMID- 1789893 TI - ["Papanicolaou." Outmoded, isn't it?]. AB - The quality of cytopathology services in the United States has recently come under public scrutiny. While numerous studies have demonstrated remarkable success of the PAPANICOLAOU test in the reduction of cervical cancer, problems that include inadequacies in obtaining the sample, processing the sample screening and interpretation based on the PAPANICOLAOU Classification have been questioned. The recommendations of expert consultants attending a workshop sponsored by the Division of Cancer Prevention and Control, National Institutes regarding utilization of the Pap Smear have been made and published as the Bethesda System. In general terms, the recommendations are: 1. The cytopathology report is a medical consultation 2. The PAPANICOLAOU classification for reporting consultations is not acceptable in the modern practice of diagnostic cytopathology. 3. The recommendations made by participant and here published, should serve as a guideline for reports. 4. All reports should include: a. A statement regarding adequacy b. A designation of normal or otherwise. c. A descriptive diagnosis. PMID- 1789894 TI - [Pediatric asthma: update]. PMID- 1789895 TI - A modified procedure for the identification of anaerobic bacteria by high performance liquid chromatography--quantitative analysis of short-chain fatty acids. AB - We have developed a new rapid method for analysing volatile and non-volatile short-chain fatty acids using high-performance liquid chromatography. Within 50 min, 22 fatty acids in a standard mixture could be detected in a single chromatographic run. The fatty acids released by anaerobic bacteria in the culture media were ether-extracted and analysed with an Aminex HPX-87H column. Using a microprocessor-controlled chromatography unit, a quantitative analysis of the fatty acids produced in bacterial cultures was possible. Resolution, rapidity and sensitivity were improved as compared to previous methods by using an eluent of 5% acetonitrile in 0.01 N H2SO4 and changing the column temperature to 35 degrees C. PMID- 1789896 TI - Restriction site mapping of subgenus D adenoviruses, prototypes 42-47, intermediate and atypical strains. AB - Restriction site maps with the endonucleases BamHI, BgIII, and HindIII were elaborated for 19 adenovirus strains of subgenus D, namely candidates AV42 to 47, 6 intermediate and 7 atypical strains. On the basis of several types mapped by biochemical methods, the physical maps for the 19 strains were constructed by adapting restriction fragments of defined molecular weight to the known maps, as the homology among strains within this subgenus is considerable. Other prototypes mapped by adaptation were also used for reference. The localization of the restriction sites on the genome was analyzed for all mapped types or strains of subgenus D (except AV8). The sites appeared to be randomly distributed; only one site was common to all strains. PMID- 1789897 TI - The discovery of melanin production in Cryptococcus neoformans and its impact on diagnosis and the study of virulence. PMID- 1789898 TI - [Isolation and identification of bacteria of the genera Campylobacter and Helicobacter]. PMID- 1789899 TI - Evidence for degradation of synthetic polyurethanes by Staphylococcus epidermidis. AB - The survival of Staphylococcus epidermidis strain KH 11 in the presence of synthetic high molecular polyurethanes was prolonged in comparison to control experiments performed in the absence of any nutrients. Investigations of the bacteria after contact with the polymers revealed changes in their surface properties and metabolism, in particular a marked induction of urease activity. ESCA (Electron Spectroscopy for Chemical Analysis) measurements detected a decrease in elementary nitrogen in the polyurethane surfaces after incubation with the bacteria. The alterations observed indicate an urease-induced degradation of synthetic polymers by Staphylococcus epidermidis KH 11. PMID- 1789900 TI - Comparative evaluation of five agglutination techniques and a new miniaturized system for rapid identification of methicillin-resistant strains of Staphylococcus aureus. AB - The speciation of methicillin-resistant Staphylococcus aureus (MRSA) poses a significant diagnostic problem when rapid identification methods such as slide agglutination tests, are used, because of the high proportion of false-negative reactions. 150 perfectly identified MRSA strains were tested on 5 commonly used agglutination reagents ("Bacto staph latex test", "Monostaph", "Pastorex staph", "Staphaurex", and "Staphyslide test") in comparison with a new micromethod ("RAPIDEC staph") which detects a type of staphylocoagulase within 2 hours by a fluorescence test. The "RAPIDEC staph" reagent enabled identification of all the MRSA while the agglutination tests gave poorer results: "Monostaph" correctly identified 64.6% of strains, "Staphyslide", 59.3%, "Bacto staph latex test", 44.6%, "Pastorex staph", 38.6% and "Staphaurex", 28.6%. These results show that agglutination slide tests are not reliable enough for the identification of MRSA which are more and more encountered in hospital wards. The authors recommend not to use slide agglutination methods. They suggest the tube test for coagulase which is the reference technique, although it is time-consuming and not well standardized. The results of this evaluation encourage the use of the "RAPIDEC staph" reagent since it is an easy-to-use, reliable technique for the rapid identification of Staphylococcus aureus. PMID- 1789901 TI - In vitro activity and cross resistance studies with cefpodoxime. AB - On the basis of MIC determinations and appropriate MIC breakpoints, 370 pathogens showed complete cross resistance between cefpodoxime and cefuroxime axetil, cefotiam hexetil, cefixime and cefotaxime in 69.7%, 80.3%, 92.2% and 87% of the strains, respectively. Cefpodoxime was superior to cefuroxime axetil in 28.7%, to cefotiam hexetil in 17.6%, to cefixime in 7% of strains and to cefotaxime not at all. On the other hand, we found cefpodoxime to be inferior to the cephalosporins mentioned in 1.6%, 2.1%, 0.8% and 13%, respectively. PMID- 1789902 TI - Susceptibility to aminoglycosides of 63 strains of Stomatococcus mucilaginosus isolated from sputum. AB - The MIC of 63 Stomatococcus mucilaginosus for 7 aminoglycosides was determined. Most of the strains were resistant to these antibiotics except to streptomycin. A natural resistance due to impermeability may be involved. One single strain was resistant to all these aminoglycosides where the concentration level of streptomycin was greater than 1000 mg/l. A chromosomal mutation is probably involved. PMID- 1789903 TI - Staphylococcal lipoteichoic acid exerts growth factor-like activity towards human and murine cells. AB - Lipoteichoic acid (LTA) was extracted from Staphylococcus saprophyticus strain S1 and tested for the capacity to induce hematopoietic and lymphatic cell proliferation. As compared to nontreated cells, the number of human bone marrow cells significantly increased in the presence of low LTA concentrations. Optimal growth was observed on the fifth day of in vitro incubation. After exposure to LTA, the lymphocyte proliferation rate also increased in a dose and time dependent manner. On the other hand, human epithelial cells and fibroblasts did not show enhanced growth activities in the presence of LTA. PMID- 1789904 TI - Diversity of Mobiluncus strains as demonstrated by their electrophoretic protein patterns. AB - The analysis of electrophoretic protein profiles of 21 Mobiluncus curtisii, 11 Mobiluncus mulieris and 3 reference strains (Mobiluncus curtisii subsp. curtisii ATCC 35241, Mobiluncus curtisii subsp. holmesii ATCC 35242 and Mobiluncus mulieris BV 64-5) demonstrated species-related patterns. A highly variable region appeared at 70-85 kDa for Mobiluncus curtisii and at 75-95 kDa for Mobiluncus mulieris, which was likely to correspond to cell surface located proteins. When performed under standardized conditions, PAGE-protein analysis allowed to define intraspecies clusters, from which some strains appeared identical. Thus, the method seemed to provide a useful additive to identify a strain at the species level and might be of epidemiological interest. PMID- 1789905 TI - Scarlet fever and types of erythrogenic toxins produced by the infecting streptococcal strains. AB - Group A streptococcal strains were isolated from the throats of 46 children suffering from scarlet fever. For detection of erythrogenic toxins (ETs), the culture supernatants were concentrated 100 times by ethanol precipitation and solubilisation in acetate buffer. ELISA was used to identify ETA and double immunodiffusion to identify ETB and ETC. The presence of the ETA gene was detected by a specific DNA probe. ETA (alone or in combination with ETB and/or ETC) was found in 51.9% of the strains, ETB (alone or in combination with ETA and/or ETC) in 76.9% and ETC (in combination with ETA and ETB) in 28.9%. Only 5.8% of strains did not produce any detectable ET. In SDS-PAGE, supernatants of ETB-producing strains showed a pronounced band in either the region of the proteinase zymogen or the active proteinase. There was no correlation between the type of erythrogenic toxin and the serological M or T type of the producing strain. The mitogenic potency of culture supernatants did not differ significantly irrespective of the toxin type(s) present. Culture supernatants of strains without a detectable amount of the known ETs were highly mitogenic, indicating the production of other streptococcal mitogens. A correlation with clinical symptoms was determined with regard to exanthema and fever. Strains producing two or three toxins caused a more intense exanthema. Patient temperature was higher (greater than or equal to 38 degrees C) when the infecting strain produced ETB. The toxin-producing patterns of the strains of this study were compared with those isolated during the last epidemic outbreak of scarlet fever in East Germany. PMID- 1789906 TI - Impaired insight in Alzheimer's disease. AB - We studied insight into illness in 41 patients with probable Alzheimer's disease. An impaired insight score was developed by measuring discrepancies between patient report and caregiver report on standard instruments of activities of daily living. Insight was more impaired in subjects with greater dementia severity and subjects with paranoid delusions. In a multivariate analysis, the best neuropsychological predictors of impaired insight were the Continuous Performance Test and the Visual Reproduction Test. We speculate that the impaired insight of Alzheimer's disease has two components: confabulation reflecting prefrontal dysfunction and anosognosia reflecting right-hemisphere dysfunction. PMID- 1789907 TI - Cerebral blood flow and dementia in Parkinson's disease. AB - Regional cerebral blood flow (CBF) was examined in 27 patients with Parkinson's disease using single-photon emission computed tomography and N-isopropyl-p [123I]iodoamphetamine as a tracer. Their CBF pattern was compared with that of seven patients with Alzheimer's disease and nine age-matched neurologically normal controls. Tracer activity was determined in seven bilateral cerebellar, cortical, and subcortical regions and was expressed as the ratio of activity in each region to the mean tracer activity in the cerebellar region. Nineteen patients with nondemented Parkinson's disease showed significantly decreased tracer activity ratio in the frontal and temporal cortices, basal ganglia, and thalamus compared with that in controls. The eight demented Parkinson's disease patients showed significantly decreased tracer activity ratio in the temporal and parietal cortices compared with the patients without dementia, and demonstrated CBF pattern similar to that of patients with Alzheimer's disease. These findings suggest that in patients with Parkinson's disease, the mechanism of CBF reduction of the frontal cortical region differs from that in the temporoparietal cortical region and support the concept that Parkinson's disease and Alzheimer's disease may overlap in some patients. PMID- 1789908 TI - Sleep problems and institutionalization of the elderly. AB - This study examined the role of sleep problems in the decisions of families to institutionalize elderly relatives. Previous work on institutionalization of the elderly has given little attention to the contribution of nocturnal, sleep related problems. Seventy-three primary caregivers of elders recently admitted to a nursing home or psychiatric hospital were asked to identify the problems the elder was having during the night and day and rate the degree to which these influenced their decision to institutionalize the elder. Seventy percent of the caregivers in each sample cited nocturnal problems in their decision to institutionalize, often because their own sleep was disrupted. The most frequent disruptive nocturnal events were micturition, pain, and complaints of sleeplessness. Sleep problems of the elderly contribute heavily to the decision to institutionalize an elder and thus to the social and economic cost of institutional care. They appear to do this largely by interfering with the sleep of caregivers. The nature, prevalence, and treatability of the sleeping problems of both elders and their caregivers need further study. PMID- 1789909 TI - A new assessment tool for neuropsychopharmacologic research: the Computerized Neuropsychological Test Battery. AB - The Computerized Neuropsychological Test Battery (CNTB), a new assessment tool for neuropsychopharmacologic research, is based on a neuropsychological approach. While it is based on tests previously shown to be sensitive to subtle changes in neuropsychological functioning, it differs from currently available tools for measuring central nervous system effects of new compounds. It has sensitivity to a broader range of cognitive functioning and is more comprehensive than other measurements in its sampling of neuropsychological functions, providing wider application to diverse clinical populations. The CNTB is valid, reliable, and has two alternative forms. Use of the computer as an expert system maximizes standardization and ease of CNTB administration and data analysis. Using this assessment tool, three groups of subjects were compared: young and elderly neurologically normal subjects and elderly subjects with the dementia syndrome of Alzheimer's disease (AD). The AD subjects' summary score on the CNTB correlated significantly with the Blessed Information Memory Concentration Test score. The CNTB summary score was significantly higher in young subjects than in neurologically normal elderly subjects, demonstrating sensitivity to the effects of aging. The CNTB summary score also was significantly higher in neurologically normal elderly subjects than in elderly subjects with AD dementia. PMID- 1789910 TI - Screening a skilled nursing home population for depression. AB - The population resident in the skilled nursing home of a Veterans Administration Hospital on the 27th of June 1988 was screened for the presence of depression. Only 74% of the patients (59 of 80) were able to complete most of the screening battery: the Folstein Mini-Mental State Examination, the 15-item Geriatric Depression Scale, and the Hamilton Depression Scale. Thirty-four percent of the sample (20 of 59) met the criteria for a DSM-III-R psychiatric diagnosis; 22% (13 patients) had a major depressive disorder, and 12% (seven patients) had an adjustment disorder with depressed mood. The 15-item version of the Geriatric Depression Scale was more effective than the Hamilton Depression Scale as a screening instrument in this population of frail elderly veterans who had multiple and severe medical problems (end-stage cardiac disease, progressive myasthenia gravis, terminal pulmonary disease, and multiple cerebrovascular accidents) that limited verbal and nonverbal communication, as well as physical endurance. PMID- 1789911 TI - Longitudinal analysis of nortriptyline side effects in elderly depressed patients. AB - Forty-five depressed elderly patients were closely monitored in a research setting during treatment with nortriptyline and interpersonal psychotherapy for 7 consecutive months of acute and continuation treatment. Overall, nortriptyline was efficacious and well tolerated in this group. The frequency of somatic complaints measured by the Rating Scale for Side Effects declined by 50% during the acute phase of treatment, suggesting that many somatic complaints that may be attributed to side effects of nortriptyline are actually somatic symptoms of depression. The authors discuss the implications of these findings and offer practical advice for the treating clinician. PMID- 1789912 TI - Quantitative assessment of ALZ-50 immunoreactivity in Alzheimer's disease. AB - A quantitative assay for ALZ-50 immunoreactivity was evaluated in samples of superior temporal gyrus taken at autopsy from 13 Alzheimer patients and 11 controls. The assayable immunoreactivity appears to be stable for at least 24 hours postmortem but was lost with formalin fixation. The mean value of the Alzheimer patients was tenfold higher than that of the controls (P less than .002). The values of four Alzheimer samples overlapped with the low levels seen in controls, but no controls had elevated levels. In this sample population, therefore, the assay had a sensitivity of 69% and specificity of 100%. PMID- 1789913 TI - Progressive nonfluent aphasia with dementia: a case report. AB - We report a patient with progressive nonfluent aphasia and mild dementia. On 9 month follow-up evaluation, there was significant deterioration in both language and cognition. Unlike in Alzheimer's disease, the aphasia was of the Broca's type. In contrast with primary progressive aphasia, a dementia was present and the cognitive and language decline showed a rather rapid course. PMID- 1789914 TI - Ontogeny of human lymphocytes. Two-color fluorescence analysis of circulating lymphocyte subsets in fetuses in the second trimester of pregnancy. AB - By using monoclonal antibodies, two-color immunofluorescence techniques and flow cytometry, we evaluated the surface marker phenotypes of lymphocyte subsets in cord blood samples from fetuses in the second trimester of pregnancy. The results indicate that cells of the T-, B- and NK-cell lineages as well as precursor cells can be detected in fetal blood at 18-20 weeks of gestation. At this stage of development, variable proportions of T and B lymphocytes express surface molecules, such as the CD1, CD10, CD38, CD45RA, indicative of a precursor or 'naive' state; on the other hand, the CD57 molecule is not detectable on the membrane of NK and T cells, and the RO isoform of the CD45 leukocyte antigen is synthesized by a low percentage of T cells. We suggest that the observed phenotypic peculiarities of the lymphoid cells might be related to the easy induction of tolerance that occurs in the early ontogenetic stages of the immune system. PMID- 1789915 TI - Intra-uterine starvation and fetal leucocyte count. AB - In 104 severely growth-retarded fetuses, the mean white blood cell count (WBC), as well as neutrophil, lymphocyte and monocyte counts were reduced. Furthermore, the severity of the leucopenia was significantly related to the degree of fetal 'smallness' and anaemia. These findings suggest that leucopenia observed in growth-retarded neonates may be a consequence of intra-uterine starvation due to deficiency of haematinics. PMID- 1789916 TI - Standard curves of cerebral Doppler flow velocity waveforms and predictive values for intrauterine growth retardation and fetal acidosis. AB - Cerebral Doppler measurements seem to be a future method to evaluate the degree of fetal hypoxemia. The aim of this study was (1) to elaborate standard curves for the different cerebral vessels in our own population, and (2) to describe the predictive value of Doppler measurements for intrauterine growth retardation (IUGR) and fetal acidosis. We recorded cerebral flow velocity waveforms from 71 normal pregnancies to establish standard curves for the following vessels: proximal middle cerebral artery, distal middle cerebral artery and posterior cerebral artery. Finally, we calculated the cerebroplacentar index (CPI) for each case. The predictive values from the different vessels were determined in 24 patients with IUGR and 17 cases with fetal acidosis. The poor sensitivity and the low positive predictive value of each cerebral vessel is probably explained by the rather long interval between the last Doppler assessment and delivery (22 +/- 23 days). Reducing the interval to less than 7 days, the distal middle cerebral artery and the CPI were pathological in 4 cases out of 5 fetuses that underwent cesarean section for fetal distress. These latter results have encouraged us to use cerebral Doppler flow velocity to detect fetal hypoxemia. In conclusion, the middle cerebral artery blood flow in its distal part seems to be the finest parameter to predict fetal acidosis, and this vessel should be used to optimize obstetrical management of high-risk pregnancies. PMID- 1789917 TI - Pregnancy-associated idiopathic intrahepatic cholestasis. Hypotheses of physiopathology: a therapeutic case report. AB - By modification of the circulating pool of biliary acids, the administration of ursodesoxycholic acid has permitted the restoration of normal maternal hepatic function during a triple pregnancy complicated by the precocious onset of an intrahepatic cholestasis. The marked regression in clinical and biological markers of the disease confirms the role of biliary acids in the aggravation of hepatic abnormalities. PMID- 1789918 TI - Stuck twin with cotwin nonimmune hydrops: successful treatment by amniocentesis. AB - Until the recent introduction of therapeutic amniocentesis, pregnancies complicated by the stuck twin phenomenon usually suffered poor outcomes. We report the first case in which a single amniocentesis of the cotwin was followed by equalization of amniotic fluid volume in both sacs, resolution of nonimmune hydrops in the cotwin, and delivery of 2 healthy infants. The cause of the phenomenon in this was most likely severe twin-twin transfusion, based on a negative hematologic and serologic immune and nonimmune hydrops evaluation, and placental histology revealing a superficial large-caliber arteriovenous anastomosis joining the twins' circulations without an intervening capillary bed. The mechanism proposed for the physiologic response in this case to therapeutic amniocentesis is based on the correction of abnormal amniotic fluid volumes and pressures. This contention is supported by histologic evaluation of the placenta and the intrapartum fetal heart rate tracing. PMID- 1789919 TI - Report of the Council on Scientific Affairs of the American Medical Association: ultrasound evaluation of the fetus. AB - Ultrasound evaluation of the fetus has become a vital part of prenatal care not only to detect abnormalities of fetal growth, but to diagnose congenital anomalies, hydatidiform mole and ectopic pregnancy, to assess fetal well-being, and finally to provide ultrasound guidance for invasive procedures. This article will discuss the role of fetal ultrasonography as we head into the 1990s, the changing concepts of indications for ultrasound scanning, the increasing sophistication of the technique, and the types of anomalies detected by this imaging method. PMID- 1789920 TI - Lung function following first-trimester amniocentesis or chorion villus sampling. AB - Functional residual capacity (FRC) was measured at 2-8 (median 4) weeks of age in 100 infants whose mothers had entered a randomized trial of amniocentesis versus chorion villus sampling (CVS) at 10-13 weeks gestation. At measurement all of the infants were well and none had respiratory problems. No significant difference was found in the FRC of infants whose mothers had undergone amniocentesis (n = 49) compared to those who had undergone CVS (n = 51). The 95% confidence intervals of the difference of the means of the amniocentesis group (29.7 ml/kg) and the CVS group (30.4 ml/kg) were -1.17 and 2.52 ml/kg. Three patients in the amniocentesis group and 2 in the CVS group had an FRC less than 24 ml/kg, which is below the 2.5th centile of the reference range. These preliminary results suggest that there is no difference in the effect on antenatal lung growth of these two first-trimester antenatal diagnostic procedures. PMID- 1789921 TI - Neonatal anoxia induces transitory hyperactivity, permanent spatial memory deficits and CA1 cell density reduction in developing rats. AB - Physical and reflex development, spontaneous behavior in open field and spatial memory abilities have been studied in rats after neonatal anoxia. Histological analysis of the hippocampal fields have been carried out in selected animals at the end of the testing period. No differences between control and anoxic rats were recorded in the physical and reflex development. Hyperactivity in open field was present in anoxic animals only transiently between P20 and P45. Spatial memory abilities, tested at two developmental stages by means of a maze and a water maze, appeared to be defectual not only during the hyperactivity period but also in adulthood. The histological analysis of the different hippocampal fields demonstrated a significant difference between anoxic and control rats in the cell density of the CA1 field. The present data demonstrate that neonatal anoxia, besides determining only transitory defects in open field behavior, profoundly affects cognitive abilities and cell density in CA1 hippocampal field. These results might be of relevance in the interpretation of the substrate of the cognitive impairment seen in hyperactive children that are exposed to hypoxia at birth. PMID- 1789922 TI - A computer-controlled Y-maze for the analysis of vibrissotactile discrimination learning in mice. AB - An automatized, computer-controlled Y-maze is described in which mice are trained to discriminate between two vibrissotactile, and/or visual stimuli, other modalities or combinations of modalities being testable as well. Movements of the mouse are recorded by photocells and monitored on a computer screen. Forward passage of the mouse is ensured by movable gates, and, if necessary, by brief air blows. Wrong choices are punished by air blows as well. The controller is a Hewlett-Packard Series 80 microcomputer with a 16 channel parallel input/output interface; programs are in BASIC. The program analyzes start latency, decision and homing time, side preference, inspections and ultimate choice, as well as choice strategies based on discrimination, left/right habits and short-term memory. Thus we can determine the nature of discrimination errors, and establish individual behavioral profiles of the animals. Results are both printed alphanumerically and plotted. The apparatus may be used for studying sensory physiology as well as cerebral lateralization, and drug or gene effects on memory and learning. PMID- 1789923 TI - Dissociable roles of the ventral, medial and lateral striatum on the acquisition and performance of a complex visual stimulus-response habit. AB - The effects of discrete bilateral ibotenic acid lesions to 3 areas of striatum were examined on a conditional visual discrimination task involving temporal frequency (SLOW vs FAST flashes) that had previously been shown to be sensitive to the effects of dorsal striatal dopamine depletion. Two of the groups, namely, those with nucleus accumbens (ACC) and lateral caudate-putamen (LCP) lesions, were very disrupted in the acquisition of the task. The nature of the respective impairments of the 2 groups was dissociable, however. The performance of the ACC group could be improved either by manipulations of stimulus duration or inter stimulus interval, implying an attentional deficit. In contrast, the rats with lesions of the LCP were not significantly improved by any of the behavioural challenges. Their performance was characterised by a bias to respond to the SLOW discriminandum. Under conditions of non-reward, the LCP group extinguished their responding at a similar rate to control rats whereas the ACC group were very much more persistent. Lesions of the medial caudate-putamen failed to affect any index of performance significantly. These data suggest that the LCP is necessary for the acquisition of arbitrary stimulus-response rules and that damage to an equivalent area in humans, such as in Huntington's disease, may explain deficits of procedural memory. The second part of the experiment investigated the effects of ACC lesions on established performance of the schedule. The lesioned group behaved identically to the ACC group that had been lesioned prior to acquisition, both in terms of accuracy and degree of persistence in extinction, further implying the role of attentional factors and inflexibility in the lesion-induced deficit. PMID- 1789924 TI - Localization of brainstem motoneurons involved in dewlap extension in the lizard, Anolis equestris. AB - Dewlap extension is a characteristic component of inter- and intraspecific displays of Anolis lizards. Dewlap extension is accomplished by the contraction of ceratohyoid muscles associated with the hyoid apparatus. Retrograde transport of horseradish peroxidase (HRP) was used to investigate the brainstem origins of efferent fibers to the ceratohyoid muscles in Anolis equestris. Following application of HRP to the ceratohyoid muscle or to its nerve supply on one side of the throat, large polygonal motoneurons were found ipsilaterally in the vagal (Amb X) and glossopharyngeal (Amb IX) parts of nucleus ambiguus. Labelled neurons were more abundant and more heavily labelled in Amb X than in Amb IX. In addition, small spindle-shaped cells were labelled ipsilaterally in three parasympathetic nuclei that innervate glandular structures in the pharyngeal floor. HRP injections of the larynx labelled cells in many of the same locations, including Amb X and Amb IX. Thus, the nucleus ambiguus in Anolis contains motoneurons for supply of striated muscles in the hyoid (i.e. ceratohyoid muscles) and the larynx. PMID- 1789925 TI - A comparison between the effect of intentional modulations and the action of L dopa on gait in Parkinson's disease. AB - The aims of the present study were to analyze how L-Dopa allows parkinsonian patients to increase their gait velocity and to compare these L-Dopa-induced modifications with those achieved by consciously attempting to walk as fast as possible (intentional modulations). The 'intentional modulations' of velocity were also compared with those of healthy elderly subjects. The results showed that parkinsonian patients walked more slowly, with shorter strides and shorter durations of swing phase, and longer durations of stance and double support phases, although no differences were observed for cycle duration. The mechanisms involved in increasing gait velocity were found to differ according to whether this was achieved through the action of L-Dopa, or by intentional increases in velocity. Intentional increases in velocity were greater than those caused by the effect of L-Dopa. The patients, however, used efficient strategies to increase their velocity when under the influence of L-Dopa. As L-Dopa leads to a ceiling effect on stride length, the patients can increase their velocity by modifying the cycle to such an extent that it compensates for the limitation in stride length. This strategy effectively increases velocity, despite the L-Dopa ceiling effect. The effects of L-Dopa on locomotion and, more generally, on motor control aspects are discussed. PMID- 1789926 TI - Air righting without the cervical righting reflex in adult rats. AB - The current explanation of air righting in animals is that when falling supine in the air, labyrinthine stimulation triggers head rotation. The head rotation involves neck rotation which, via the cervical righting reflex, triggers rotation of the body. (In cats and monkeys, when the labyrinths are absent, visual stimulation when falling supine can also trigger this righting sequence.) In the present paper, a descriptive analysis of air righting in the rat shows that the shoulders rotate, carrying the unmoving head and neck passively along. Thus, for this species, labyrinthine input appears to trigger shoulder rotation directly, independently of the cervical righting reflex. This suggests that at least two physiological mechanisms exist for labyrinthine control of head rotation during air righting, one via the neck and the other via the shoulder girdle. PMID- 1789927 TI - Acute phorbol ester treatment improves spatial learning performance in rats. AB - Recent findings have lead researchers to speculate that hippocampal protein kinase C (PKC) in rodents is involved in spatial learning and memory. The purpose of this study was to determine if treating rats with a compound known to increase PKC activity would improve performance in a task that requires spatial learning processes. Rats were treated with a single intracerebroventricular injection of a phorbol ester, phorbol 12,13-dibutyrate (PDBu) that is known to increase PKC activity and then tested on the hidden-platform version of the Morris water taks. Results showed that PDBu-treated subjects' ability to learn to locate the escape platform was better than controls. In addition, PDBu-treated subjects showed signs of having remembered the location of the platform better than controls when tested 24 h later. These results support a role of brain PKC in processes required to learn the Morris water task. PMID- 1789928 TI - Kinetic measurements of T----R structural transitions in insulin. AB - The T6----T3R3 and T3R3----R6-structural transitions of cobalt insulin hexamers as induced by SCN ions or m-cresol were studied in stopped-flow experiments using the absorption in the visible for monitoring their time course. The T6----T3R3 transition induced by either SCN or limited concentrations of m-cresol is mono exponential with a rate constant of 0.1 s-1 and 0.4 s-1, respectively. A mono exponential time course is also encountered for the m-cresol-induced T3R3----R6 transition when starting from the T3R3 state preestablished by either SCN or m cresol. The corresponding rate constants are 1.3 s-1 and 0.49 s-1, respectively. If m-cresol is used beyond the concentration range where transformation is limited to one trimer, two exponentials are required for fitting the time course. The second exponential corresponds to the T3R3----R6 step with a concentration independent rate constant of 0.4 s-1. The rate constant for the faster T6----T3R3 transition, however, increases with increasing excess of m-cresol. PMID- 1789929 TI - delta 4-3-Oxosteroid 5 beta-reductase. Structure and function. AB - delta 4-3-Oxosteroid 5 beta-reductase catalysing reduction of delta 4-3 oxosteroids to give A/B cis-conformation was intraperitoneally injected into BALB/c strain mice with Ribi adjuvant. Monoclonal antibody specific for this enzyme was prepared from their spleen cells. Using this monoclonal antibody as a probe the enzyme was further purified using reversed phase liquid chromatography to determine amino-acid sequence protein-chemically. Attempts to determine the N terminal amino acid failed, indicating that the N-terminal amino acid is blocked. The protein was therefore subjected to digestion with lysyl endopeptidase after alkylating with iodoacetate. The peptides thus formed were isolated and purified by reversed-phase high-performance liquid chromatography and their amino-acid sequences were determined. Using antibodies and oligonucleotides as probes a cDNA which contained a 978 bp long open reading frame encoding 326 amino-acid residues (Mr 37376) was isolated from rat liver cDNA libraries and the entire sequence of the protein was deciphered from its nucleotide sequence. The COS cells transfected with this cDNA revealed a versatile activity to reduce varied kinds of delta 4-3-oxosteroids, i.e. 7 alpha-hydroxy-4-cholesten-3-one, androstenedione and cortisone as postulated by Okuda and Okuda (1984, J. Biol. Chem. 259, 7519 7524) and Furuebisu et al. (1987, Biochim. Biophys. Acta 912, 110-114. With a newly established immunoblotting assay method several tissues and organs were surveyed and it was found that the enzyme exists only in the liver and there is an apparent difference between sexes as to the content of this enzyme. However, there was little if any difference in the amount of mRNAs between both sexes, which may indicates that the sexual difference of rat liver cytosol 5 beta reductase is due to a posttranslational modification and/or degradation. PMID- 1789930 TI - Characterization of metalloelastase-like activity from the plasma of a patient with Tangier disease. AB - An enzymatic activity with releases p-nitroaniline from 3-carboxypropionyl trialanine p-nitroanilide (Suc[Ala]3NA) was characterized in blood plasma of patients with Tangier disease. This activity results from the sequential action of a metalloendopeptidase (MP) and an aminopeptidase (AP). These proteases were purified 134- (MP) and 82-fold (AP) from low density and very low density lipoproteins (LDL and VLDL) depleted Tangier plasma by DEAE-Trisacryl chromatography and gel filtration. MP and AP could be separated by polyacrylamide gel electrophoresis. MP shares some analogy with neutral endopeptidase (membrane metalloendopeptidase, EC 3.4.24.11) and is able to degrade human plasma fibronectin (mainly to fragments of 185, 168 and 128 kDa) as evidenced on Western blots. It cannot hydrolyse 3H-labelled insoluble elastin and apolipoprotein AII, but did cleave a dinitrophenyl-octapeptide as well as apolipoprotein AI to 25-kDa and 24-kDa fragments formed sequentially. It may therefore be partially responsible for the in vivo degradation of apoAI observed in Tangier disease. PMID- 1789931 TI - Cloning, sequencing and expression of the sialidase gene from Actinomyces viscosus DSM 43798. AB - Chromosomal DNA from Actinomyces viscosus was digested with restriction endonucleases and the fragments ligated with pUC-vectors were used to transform Escherichia coli cells. Clones bearing the required sialidase gene were detected by spraying the colonies with the fluorogenic sialidase substrate MU-Neu5Ac. The identity of the cloned sialidase was confirmed after the 5700-fold enrichment and comparison with the purified enzyme of A. viscosus. Both sialidases were identical with regard to molecular mass, substrate specificity tested with sialyllactoses, and the inhibition of their activity by heterologous antisialidase antibodies. The sequenced insert (EMBL accession number X62276) revealed a mol% G + C of 68.2, typical for A. viscosus. An open reading frame of 2739 bp follows a sequence with dyad symmetry and an AG-rich region, and codes for 913 amino acids representing a molecular mass of 113 kDa. The conserved amino acid sequence [Ser-X-Asp-X-Gly-X-Thr-Trp] typical for bacterial sialidases was found at five positions in the predicted amino acid sequence. The gene of this enzyme is expressed by E. coli, despite the low relatedness of both species. PMID- 1789932 TI - Distribution and DNA methylation of a repetitive promoter sequence cloned from mouse embryonal carcinoma cells. AB - A 203 bp HpaII fragment (X9) cloned from F9 embryonal carcinoma cell DNA showed multiple bands on Southern hybridization towards mouse DNA digested with various restriction enzymes. No tandem repeats were evident. A 200 bp MspI band corresponded to several copies of the cloned fragment and many elements appeared each associated with a 12-kb PvuII fragment. X9 is therefore a member of a moderately repetitive family probably dispersed in the mouse genome. X9 displayed polymorphisms between different Mus species, whereas multiple hybridizing bands were detected neither in DNA from rodent species outside the Mus genus nor in DNA from man. Therefore, X9 provides a useful probe for studies of murine evolution. X9 contains a TATA box and a CCAAT box as well as several homologies to known transcription factor binding sites. When cloned in front of a reporter gene, it acted as a strong promoter in several different cell types. Most genomic sequences detected by X9 were highly methylated. A single copy appeared hypomethylated in adult mouse tissues, whereas several copies were hypomethylated in F9 and embryonic stem cells. It is speculated that X9 might represent the promoter of a murine gene family whose activity is regulated by DNA methylation. PMID- 1789933 TI - Microbial metabolism of quinoline and related compounds. XII. Isolation and characterization of the quinoline oxidoreductase from Rhodococcus spec. B1 compared with the quinoline oxidoreductase from Pseudomonas putida 86. AB - Quinoline oxidoreductase from Rhodococcus spec. B1 was purified 39-fold to apparent homogeneity in a 5-step procedure with a recovery of 26%. The Mr of the native enzyme as determined by gel chromatography was 300,000. SDS polyacrylamide gel electrophoresis of the enzyme revealed 3 protein bands corresponding to Mr 82,000, 32,000, and 18,000. The enzyme contains 1.3 atoms of molybdenum, 8 atoms of iron, 8 atoms of acid-labile sulphur, 2 molecules of FAD and 2 molecules of molybdopterin cytosine dinucleotide. Cyanide, 4-hydroxymercuribenzoate and methanol were effective as inhibitors. The amino-terminal protein sequences of the 3 subunits of quinoline oxidoreductase from Rhodococcus B1 compared to those of quinoline oxidoreductase from Pseudomonas putida 86 revealed no difference among 71 amino acids examined. PMID- 1789935 TI - Predictors of hypertension. Proceedings of a workshop. June 5-6, 1989, Bethesda, Maryland. PMID- 1789934 TI - The primary structure of the hemoglobin from the Australian ghost bat (Macroderma gigas, Microchiroptera). AB - The Australian ghost bat (Macroderma gigas, Microchiroptera) has two hemoglobin components in the ratio 3:2. They share identical beta-chains and differ by three replacements in the alpha-chains. The primary structures of all three chains are presented. They could be separated by high-performance liquid chromatography. The sequences were determined by automatic liquid and gas phase Edman degradation of the chains and their tryptic peptides. The two alpha-chains show 18 and 19 and the beta-chains 15 exchanges compared to human alpha- and beta-chains, respectively. The divergent evolution of Macroderma gigas and Megaderma lyra, two representatives of the family Megadermatidae, is discussed. An influence of replacements at functionally important positions on the hemoglobin oxygen affinity seems unlikely. PMID- 1789936 TI - Predictors of hypertension. Population studies. AB - A genetic influence on the variability of blood pressure in populations has been established. This effect has been demonstrated repeatedly by the presence of familial aggregation of blood pressure; however, a unique bimodal distribution in populations has not been established. About one-third to one-half of the blood pressure variance is explained by heredity with the remainder due to environmental or unknown factors. Direct associations of blood pressure with genetic markers in populations have been described infrequently. However, an association between haptoglobin 1 and increased blood pressure has been reported. This relationship is possibly secondary to increased sodium sensitivity in this genetic subgroup. The familial aggregation of urinary kallikrein as well as sodium-lithium countertransport and hypertension represents a successful attempt by investigators to identify correlates of intermediate phenotypes of hypertension. The association between restriction fragment length polymorphisms and elevated blood pressure represents an unmet potential. It should be emphasized that any genetic predictive factor will be affected by environmental factors. This interaction provides the opportunity for possible modification or prevention of hypertension by hygienic means. PMID- 1789937 TI - Key concepts regarding the genetics of hypertension in humans. AB - More and more, genetic research is being used to investigate the problem of hypertension, especially as hypertension appears to be a population-wide phenomenon. This article discusses such key concepts as phenotypic variation within the hypertensive subpopulation, the importance of a family history for hypertension in predicting hypertension, the development of hypertension in youth, environmental considerations (nature v nurture), and gene linkage. PMID- 1789938 TI - Genetic markers in human hypertension. AB - A rapidly increasing abundance of genetic markers which can be characterized on a large scale makes an application of the genetic linkage strategy, so successful with Mendelian diseases, ever more attractive for genetic investigations of common diseases such as essential hypertension. Variability in expression, lack of phenotypic specificity and multiple causation create unique challenges when approaches originally designed for single gene inheritance are applied to disorders with complex determination. PMID- 1789939 TI - Predictors of blood pressure and hypertension. General principles. AB - Early intervention in the treatment of hypertension can reduce the detrimental effects of high blood pressure. Therefore it is important to be able to predict the development of hypertension in individuals. A number of factors can be used as predictors of hypertension, but only childhood high blood pressure (especially in combination with obesity) is a potent predictor of future hypertension. A family history of hypertension is a contributory risk factor, as is tachycardia, but neither is as strong a predictor as a youthful elevated pressure. PMID- 1789940 TI - Childhood predictors of high blood pressure. AB - Longitudinal studies in children have tracked blood pressure through childhood and from childhood into adult life. However, many children do not maintain their rank during these periods of observation. Several of the factors contributing to maintenance of rank order are reviewed, such as initial level of blood pressure, body size, sexual maturation, and family history of high blood pressure. Children with initially high level of blood pressure are more likely to become adults with high blood pressure, particularly if they are obese as children or become obese as young adults, and if they have a positive family history for hypertension. PMID- 1789941 TI - Challenge response predictors. General principles. AB - Environmental challenges offer a potential method for predicting hypertension. They could be nutritional (eg, an increased salt load), behavioral (eg, a mental arithmetic task), or physical (eg, an exercise test) in nature. An ideal challenge test should be simple to administer, easily standardized, and with a response that can be precisely quantified. The response is best expressed as a change score from the baseline level, and should be reproducible over time. For the prediction of hypertension, blood pressure is the usual response measure, although others, such as heart rate, are possible. The response should have predictive value independently of other known predictors, including the baseline level. The dependent variables might be future blood pressure, target organ damage, or morbid events. PMID- 1789942 TI - Salt sensitivity as a predictor of hypertension. AB - Salt sensitivity of blood pressure can be identified in half of the hypertensive population and one-fourth of normotensive subjects. Salt sensitivity of blood pressure is especially frequent in normotensives from subpopulations known to have a higher frequency of hypertension, such as blacks, older subjects, and first-degree relatives of hypertensives, suggesting a link between salt and the subsequent development of hypertension. A variety of associated markers of salt sensitivity has been described. Recent studies also link calcium and salt sensitivity of blood pressure. PMID- 1789943 TI - Blood pressure response to exercise. A marker for future hypertension? AB - Whether or not an exaggerated blood pressure response to exercise in childhood predicts adult-onset essential hypertension is not known. While peak systolic blood pressure during exercise can indicate future hypertension, left ventricular mass (measured echocardiographically) and resting systolic blood pressure seem to be much better predictors. However, the blood pressure response to exercise in groups of normotensive individuals, such as those with a family history of hypertension, may identify physiologic changes associated with the early hypertensive state. PMID- 1789944 TI - Blood pressure response to mental stress. AB - In a series of studies to explore the relationship of mental stress with blood pressure regulation, we have found that offspring of hypertensive parents exhibit a greater cardiovascular response to the stress of mental arithmetic compared to offspring of normotensive parents. The response is also greater in both adolescents and adults with borderline hypertension. However, there are racial differences in the stress-response pattern. In studying the interaction of sodium sensitivity with stress-reactivity, our data indicates that the cardiovascular response to central stress is not altered by sodium balance. The response to mental stress may be a useful marker for essential hypertension (EH), but does not appear to represent an isolated mechanism in the pathogenesis of EH. PMID- 1789945 TI - Blood pressure reactivity and sympathetic hyperactivity. Predictors of hypertension. AB - Raised sympathetic nerve activity appears to be a predictor and factor in primary hypertension. Sympathetic activation alone does not appear to be a sufficient cause of sustained hypertension, however. Over the past two decades we have studied several populations of primary hypertensive patients and found neural hyperactivity in 25 to 30% of them. Metaanalyses of other studies have supported these findings. PMID- 1789946 TI - Biochemical predictors of hypertension. Utility in prevention and treatment. AB - Several biochemical markers have been reported to be useful in the investigation of patients with hypertension. These markers can be divided into three broad categories: those related to sodium homeostasis (eg, renin, converting enzyme, aldosterone, and the kallikrein-kinin system); those related to sodium homeostasis and vascular reactivity (eg, cytosolic calcium, sodium transporters, insulin resistance, and nonmodulation); those related to vascular reactivity (eg, catecholamines). These biochemical factors may be useful in defining which treatment modality to use, in increasing our understanding of the pathophysiology of the disease, and in evaluating end-organ damage and/or familial risk. Further information, however, is required before one can verify these hypotheses. PMID- 1789947 TI - Cation transport markers as predictors of hypertension. AB - Of the abnormalities of cation transport described in human essential hypertension, an increased maximal activity for red blood cell lithium-sodium (RBC Li(+)-Na+) countertransport is the most appealing candidate for a genetically mediated marker for risk of future hypertension. Population studies have demonstrated that the distribution of values for countertransport can be modelled statistically as a mixture of two overlapping subpopulations. These two modes could result from the action of a single principal determinant, and pedigree-based studies of the genetic transmission of RBC Li(+)-Na+ intertransport activity have suggested that factor may represent the effect of a major monogenic influence segregating in a Mendelian recessive fashion. Although the molecular nature of the proposed genetic lesion underlying high RBC Li(+)-Na+ countertransport is not yet known, a recent linkage study suggests it may be localized to chromosome 4. A preliminary report of a prospective analysis of the predictive value of high RBC Li(+)-Na+ countertransport for future hypertension supports its utility as a premorbid marker for genetic risk of future hypertension. Allelic differences at a genetic locus controlling RBC Li(+)-Na+ countertransport activity may contribute directly to interdividual blood pressure differences or may be linked to other genes that do. PMID- 1789948 TI - Glucose, insulin, and insulin resistance as biochemical predictors of hypertension. AB - Obesity, essential hypertension, and diabetes mellitus share certain metabolic disturbances. The predictive value of disordered glucose metabolism and insulin action for hypertension are discussed. Several studies have examined the relationship between hypertension and glucose metabolism in diverse populations, and tend to indicate a predictive role for insulin and glucose metabolism disturbances in the development of hypertension. PMID- 1789949 TI - Blood pressure and renal blood flow responses to dietary calcium and sodium intake in humans. AB - This study was designed to determine the interaction between salt and calcium intake on blood pressure (BP) and renal blood flow (RBF) in a predominantly white population. We measured BP and RBF (P-aminohippurate [PAH] clearance) in hypertensive patients after 7 days on a low salt/low calcium diet and again after either a high salt/high calcium diet (HS/HC) or a high salt/low calcium (HS/LC) diet for another 7 days. Compared to low salt BP, both high salt diets increased BP, but the increase with high salt/low calcium was significantly greater than with high salt/high calcium (+14.6 +/- 3.9/+8.2 +/- 1.7 mm Hg v +7.5 +/- 1.9/+2.5 +/- 1.4 mm Hg; systolic/diastolic, both P less than or equal to .05). PAH clearance increased 26 +/- 13 mL/min/1.73 m2 on the HS/HC diet but only 10 +/- 17 mL/min/1.73 m2 on HS/LC (P = .05 between groups). These data suggest that a low calcium diet may contribute to the phenomenon of salt sensitivity in a white population. The low calcium intake appears to affect both the systemic and renal vasculature. PMID- 1789950 TI - Research opportunities and directions on the blood pressure problem. Combining predictors. AB - While only a small percentage of the population has high blood pressure, a much larger segment of the US population has a high-normal (above optimal) blood pressure, and is at increased risk for hypertension and its cardiovascular sequelae. Hypertension is thus a population-wide problem and must be approached in much the manner of other epidemic diseases. This paper examines some recent population studies and proposes directions for future research. PMID- 1789951 TI - Influence of nonhemodynamic factors on the microcirculation in moderate arterial essential hypertension. AB - This study is aimed at examining the role of non-hemodynamic factors on the impaired microcirculation in patients with moderate essential hypertension. In a series of 31 patients (mean age, 47.8 +/- 1.1 years) with newly diagnosed untreated moderate essential hypertension (mean systolic blood pressure 161.7 +/- 2.0 mm Hg, mean diastolic blood pressure 102.4 +/- 1.5 mm Hg), parameters of the capillaroscopic examination of the finger microcirculation (mean number of capillaries, NRCAP), length of the capillaries (LECAP, microns), diameter micron) of the efferent (EFDI) and afferent (AFDI) apillaries, and mean red blood cell velocity (RBCV, microns/sec), which was measured by the flying spot technique, were correlated with a number of hormones (sampled after an overnight fast) including: plasma renin activity, aldosterone, and parathyroid hormone (PTH). A significant correlation (P less than .05) could be obtained between several parameters of the microcirculation and PTH:PTH (23.8 +/- 1.4 pg/mL)-NRCAP (14.9 +/- 0.5): r = -0.440, P = .013; PTH-AFDI (4.0 +/- 0.5 microns): r = 0.442, P = .012; PTH-EFDI (2.8 +/- 0.5 microns): r = 0.416, P = .019; PTH-RBCV (711 +/- 69 microns/sec): r = -0.351, P = .05. Furthermore, 24-h urinary norepinephrine (U NOR) and afferent and efferent diameter of the capillaries intercorrelated significantly: U-NOR (46.0 +/- 6.2 micrograms/24 h)-AFDI: r = 0.439, P = .034; U NOR-EFDI; r = 0.462, P = .025. This study shows that in patients with moderate essential arterial hypertension nonhemodynamic factors have an influence at the level of the microcirculation. PMID- 1789952 TI - A multicenter evaluation of the A&D TM-2420 ambulatory blood pressure recorder. AB - The A&D TM-2420 (A&D Engineering, Milpitas, CA) is an automatic, portable, noninvasive blood pressure (BP) recorder which uses a dual microphone system for the detection of Korotkoff sounds. Its accuracy and clinical performance were assessed in a multicenter study that also addressed issues such as observer agreement and the effects of age, arm circumference, heart rate, posture, and blood pressure level on the observer-device differences. We compared 906 simultaneous, same-arm BP measurements in 151 subjects using the TM-2420 versus two skilled clinicians per site using a teaching stethoscope. The agreement between the TM-2420 and mercury column determinations were within 10 mm Hg for 86 to 91% of systolic readings and 91 to 94% of diastolic readings, depending on the posture; a level of agreement which would receive a 'B+' grade from the recent British Hypertension Society guidelines. The limits of agreement (2 standard deviations about the mean difference) for systolic BP between observers and the TM-2420 tended to be greater for the standing position (-20 to 15 mm Hg) compared to supine (-14 to 12 mm Hg) and seated (-13 to 8 mm Hg) positions. Limits of agreement between the observers and device were not dependent upon age, heart rate, arm size, or blood pressure level. Twenty-four-hour blood pressure monitoring in two of the four centers demonstrated an error code rate of 3.4%, excluding 'retries' that are one of the device's features. These data demonstrate an acceptable level of accuracy and performance of the sixth generation of the TM 2420 for use in clinical practice and research.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789953 TI - Communicating the risk from radon. AB - A prominent television station developed a special series of newscasts and public service announcements about radon. This was combined with their advertising of the availability of reduced-price radon test kits in a local supermarket chain. The large number of test kits sold was a success from a marketing perspective, but not from a public health perspective--especially because of the very small share of high readings that were mitigated. In contrast, a study of housing sales showed a much higher testing rate and corresponding mitigation when risk communication accompanied the housing transaction, rather than being directed toward the general public. This paper examines the relative effectiveness of these alternative approaches to radon risk communication, emphasizing the implications for developing and implementing radon programs. PMID- 1789954 TI - How clean is clean? Cleanup criteria for contaminated soil and groundwater. AB - An international specialty conference cosponsored by the Air & Waste Management Association's New England Section and the WF-2, EE-5 and EP-1 technical committees was held in Boston, Massachusetts on November 7-9, 1990. The technical program consisted of 39 presentations, held in eight technical sessions, exploring a wide range of topics related to the development of cleanup criteria for contaminated soil and groundwater. Supported by 11 exhibitors, the conference was attended by more than 350 professionals from the United States and other countries. This overview by the Technical Program Chair highlights a selection of the technical presentations. PMID- 1789955 TI - Development and evaluation of a method to determine indicator microorganisms in air emissions and residue from medical waste incinerators. AB - To allow testing of microbial destruction in medical waste incinerators, methods were developed to determine indicator microorganisms (Bacillus Stearothermophilus spores) in incinerator air emissions and residue. The emission trapping train consisted of a water cooled glass probe and impingers containing a neutral phosphate buffer. In field tests, spores were injected directly into the probe, and results showed that approximately 60 percent of the spores were recovered. Spores were analyzed with adequate precision using a microbial membrane filter unit. Lab experiments indicated that spores were stable in neutral pH phosphate buffer for up to 20 days, and heat shocking samples (heating to 80 degrees C for 20 minutes) reduced spore numbers in acidic or basic buffer. Laboratory tests also showed that 60 to 70 percent of spores initially added to ash were recovered up to 22 days after addition of the spores. In addition, lab tests showed that spores can be effectively recovered from residue test pipes spiked with indicator spores. PMID- 1789956 TI - A short-term diffusive sampler for nitrogen dioxide monitoring in epidemiology. AB - An automated timed exposure diffusive sampler (TEDS) for sampling nitrogen dioxide (NO2) was developed for use in epidemiological studies. The TEDS sequentially exposes four passive sampling devices (PSD) by microprocessor controlled valves while a pump and air flow guide prevent sampler "starvation." Two TEDS units and two portable, real-time NO2 monitors were tested for accuracy, precision, sensitivity, and linearity of response. The accuracy of the TEDS was within 10 percent of the calibrated NO2 values, and precision was within 10 percent of the means of the measured values. The TEDS sensitivity was 20 to 30 ppb-hour for NO2. Co-location of the TEDS with a chemiluminescent NOx monitor (EPA reference method) showed similar responses to ambient NO2 (R2 = 0.9991). TEDS allows better time resolution than traditional diffusive samplers (i.e., Palmes tube) while sharing their ability to sample a variety of gases. PMID- 1789957 TI - U.S. EPA SITE demonstration of AWD Technologies' AquaDetox/SVE system. AB - Under the Superfund Innovative Technology Evaluation (SITE) Program, a technology developed by AWD Technologies, Inc. was demonstrated in September 1990. This paper presents the major results of the SITE demonstration of AWD Technologies' AquaDetox/SVE treatment system designed for simultaneous on-site treatment of contaminated groundwater and soil-gas. The groundwater and soil at the demonstration site were contaminated with trichloroethylene (TCE) and tetrachloroethylene (PCE). The AWD technology was evaluated on the basis of the removal efficiencies of TCE and PCE from the contaminated groundwater and soil gas. The conclusions drawn from these evaluations are: (1) the system achieved removal efficiencies as high as 99.99 percent for groundwater and 99.9 percent for soil-gas; (2) the effluent groundwater was in compliance with the regulatory discharge requirements of 5 micrograms/L each for TCE and PCE for all test runs; (3) the demonstrated 1,000 gpm system has an estimated capital cost of $4.3 million and annual operating and maintenance cost of approximately $820,000. PMID- 1789958 TI - Do we need the subspecialty of paediatric ophthalmology? PMID- 1789959 TI - Rubella immunisation and embryopathy. PMID- 1789960 TI - Gregg and congenital rubella: lessons from history and clinical research. PMID- 1789961 TI - Diode laser trabeculoplasty--what's in a name? PMID- 1789962 TI - Changing patterns of blindness in Australia. PMID- 1789963 TI - Congenital cataract following German measles in the mother. 1941. PMID- 1789964 TI - Problems in the diagnosis and management of unilateral retinoblastoma. AB - The improved prognosis for life in retinoblastoma challenges us to readdress the severe morbidity associated with late presentation and treatment, particularly in unilateral disease. Three cases of unilateral sporadic retinoblastoma are presented to illustrate the range of therapeutic options that need to be considered in management and to show that early recognition of the tumour and local treatment have the potential to minimise morbidity and to enable binocular vision to be retained. PMID- 1789965 TI - Enlisting the eccentric photoscreener in a public hospital eye department. AB - We analysed retrospectively non-acute new referrals of children to Waikato Hospital over one year. It was found that children were required to wait unacceptably long to be seen. Almost half the children with established amblyopia were not seen until after the age of five years (42% were not referred until after that age). On the other hand, half the children seen had no significant pathology, and the high level of non-attendance also wasted clinic time. An attempt was made to address these problems by holding regular screening clinics using a photoscreener, assessing all children within three weeks of referral so that children with pathology could be examined and treated promptly. Preliminary investigations into mass community photoscreening produced an average recall rate of 11% (54% of whom fell into our definition of pathological). We feel that enlisting the photoscreener has provided a much more efficient paediatric service, which it is hoped will lead to a reduction in visual loss due to amblyopia. PMID- 1789966 TI - Congenital rubella infection from reinfection of previously immunised mothers. AB - Two children developed congenital rubella infection when their mothers had been proven to be satisfactorily immunised against rubella before the affected pregnancy. One child was severely affected with heart lesions, brain damage, severe deafness, physical retardation, cataracts and rubella retinopathy. The other child had moderately severe sensorineural deafness and a mild reduction in visual acuity due to rubella retinopathy. PMID- 1789967 TI - A case of progressive hemifacial atrophy with uveitis and retinal vasculitis. AB - Parry Romberg syndrome is a rare disorder characterised by progressive hemifacial atrophy that is usually unilateral, involving the skin, subcutaneous tissue, and subsequently the muscle, cartilage and bone. Previous cases with various ocular manifestations have been reported. A case of Parry Romberg syndrome with retinal vasculitis is reported. PMID- 1789968 TI - Cytokines, fibrosis and the failure of glaucoma filtration surgery. AB - Current therapies for the prevention of fibrosis after glaucoma filtering surgery can be effective but often produce unwanted side effects. An understanding of the cellular basis of the fibrotic reaction may lead to better treatments. Wound repair revolves around angiogenesis and the activation of fibroblasts by cytokines. These peptides, a number of which have been described, act together in intricately complicated networks to encourage fibroblast chemotaxis, proliferation and contractility, as well as to stimulate the production of glycosaminoglycans and collagen. Since interferons seem to inhibit many of these responses, they deserve further evaluation in the treatment of ocular fibrosis. PMID- 1789969 TI - Diode laser trabeculoplasty. AB - Diode laser is a solid state Gallium Aluminium Arsenide (Ga AlAs) laser with a wavelength of approximately 800 nm (near infrared radiation). It has a similar penetration to, and absorption within the ocular tissues as, Krypton red. Diode laser trabeculoplasty (DLT) was carried out on 20 glaucomatous eyes resulting in a mean fall in intraocular pressure of 6.35 mmHg at one month and 6.45 mmHg at three months. Over this early period DLT has an effect similar to argon laser trabeculoplasty (ALT) in the management of open-angle glaucoma. PMID- 1789970 TI - The expression of adhesion molecules in the human retina and choroid. AB - This study examines the expression of some selected adhesion molecules likely to be important in the migration of leucocytes across the blood-retinal and blood aqueous barriers in samples of normal human retina and choroid by immunoperoxidase staining. ICAM-1, LFA-3 and ELAM-1 were expressed on retinal endothelium and ICAM-1, ELAM-1 and CD44 in the region of the external limiting membrane. VLA-2 was found around the retinal ganglion cells and in the inner and outer fibre layers and is likely to be important in maintaining the structural integrity of the retina. The endothelium on the choriocapillaris showed moderate staining of ICAM-1, and slight staining of LFA-3 and ELAM-1. These molecules may have an important functional role in the pathogenesis of many immunological ocular conditions, including uveoretinitis and corneal allograft rejection. PMID- 1789971 TI - Corneal ulceration due to Nocardia asteroides. AB - A case of corneal ulceration due to infection with Nocardia asteroides is described. Microbiological examination of corneal scrapings permitted accurate diagnosis and suggested appropriate therapy. Nineteen other cases that have been described in the world literature are reviewed. PMID- 1789972 TI - Visual disability and major causes of blindness in NSW: a study of people aged 50 and over attending the Royal Blind Society 1984 to 1989. AB - Visual disability in individuals aged 50 years and over seeking services of the Royal Blind Society in the years 1984 to 1989, was studied with respect to changes in frequency of major causes together with age and sex of those affected. The results mirror statistics in the UK. Age-related macular degeneration (AMD) accounts for an increasing proportion of visual disability (34% in 1984 to 43% in 1989). Of particular interest was the frequency of disability attributed to cataract. While decreasing (24% in 1984 to 19% in 1989), cataract still represents a significant cause of potentially treatable disability. The authors conclude that there is a changing prevalence of visual disability caused mainly by an increase in AMD and a subgroup of patients attending for services who appear to have a potentially remediable disability. These conclusions affirm the need for close liaison between ophthalmological practitioners and agencies for the blind. PMID- 1789973 TI - Volume measurement of intraocular tumours by cross-sectional ultrasonographic scans. AB - The volume of intraocular tumours can be calculated from tumour height and cross sectional areas measured in maximal orthogonal B-mode ultrasonograms, on the assumption that the tumour morphology is hemi-ellipsoidal. Comparison of this method with an accurate but more complex computer-aided B-mode ultrasonic tomographic method demonstrated a highly linear relationship with a correlation coefficient of 0.93. Furthermore, the comparison of cross-sectional areas measured from B-scan images and histological cross-sections in a small series of enucleated eyes demonstrated that tumour cross-sectional area measured from ultrasound images provides an accurate representation of the true physical size of the tumour in the globe. This method can be easily implemented with readily available B-mode ultrasound equipment. Unlike previously reported volume measurement methods, customised hardware or software is not required. The method is rapid and easy to perform, and may offer a useful standard method of measuring and monitoring intraocular tumours. PMID- 1789974 TI - Computer-assisted analysis of the electro-oculogram. AB - A method of acquiring and analysing electro-oculogram signals was developed using computer-aided techniques. The repetitive nature, characteristic shape and spectral properties of the electro-oculogram are used in the automated analysis, enabling the retinal resting potential to be investigated. Online computer-aided automatic analysis of the electro-oculogram is efficient, reliable and accurate. Automated analysis produced results that have a highly significant degree of correlation (P less than 0.001) with the results obtained manually from strip chart recording of the electro-oculogram signals. The increased accuracy of the automatic analysis system demonstrates a significantly reduced (McNemar's Test) false positive rate in classifying abnormal results on the basis of Arden ratio. The computer-aided analysis system offers a useful clinical means of measuring the electro-oculogram for diagnostic and research purposes. PMID- 1789975 TI - Moving muscles with microchips, mathematics and models: an update on the 'reverse' model. AB - This paper reviews the current status of our computer model for the management of strabismus and its future direction. Vector analysis was first used in the 1950s for the assessment of strabismus. Robinson's model was the first computer simulation of ocular motility. Using physiological principles and anatomical approximations, Robinson's model sought to predict the strabismic pattern to be expected from a given injury. The Kault/Stark 'reverse' model works in the opposite direction, to first simulate the given strabismic pattern and then advise the surgery required to restore orthophoria. The surgeon is able to 'trial' various operations and compare the expected postoperative results. An automated system is currently being developed to ease the difficulty in measuring the position of the eyes in all nine positions of gaze. This paper includes three illustrative case reports. PMID- 1789976 TI - Steroid sensitive Acanthamoeba keratitis. AB - A 44-year-old woman with proven Acanthamoeba keratitis was successfully treated medically with resultant 6/9 vision. During the treatment, repeated attempts to titrate the patient off topical corticosteroids resulted in recurrent flare-up of inflammatory keratitis from which Acanthamoeba could not be recultured. It is suggested that steroid administration during the course of Acanthamoeba keratitis may need to be withdrawn extremely slowly to avoid the recurrence of what appears to be an immunological corneal reaction. PMID- 1789977 TI - The incidence and progression of lens opacities. AB - Selected clinic patients were entered into a prospective longitudinal study to assess the incidence and rate of progression of lens opacities. Ninety-seven patients aged 15 to 88 years (median 63 years) were followed for two to 35 months (median 16 months). Lenses were photographed on a photo slit lamp and retroillumination cataract camera. Photographs were graded independently and then assessed in a side-by-side comparison. The incidence rate of cortical opacity was found to be 4% and for nuclear cataract between 11% and 20%. The rates of progression were 18% to 21% for cortical opacity, 14% to 16% for nuclear opacity, and 39% to 40% for posterior subcapsular opacities. These data suggest that these simple photographic means are sufficiently sensitive to detect changes in lens clarity. PMID- 1789978 TI - Management of eyelid trauma. AB - The management of eyelid trauma presents some frustrating challenges to the general ophthalmologist. Because each case is unique, adaptation of general principles is essential for optimal ophthalmic treatment. This review includes the essentials of approaches to the evaluation and treatment of eyelid margin and canalicular lacerations. Specific attention is directed towards avoidance of complications. PMID- 1789979 TI - Larva tick bite of the conjunctiva. PMID- 1789980 TI - Congenital rubella in a mother and son. PMID- 1789981 TI - Nasolacrimal duct obstruction. PMID- 1789982 TI - Paper-clip technique for upper eyelid skin crease assessment. PMID- 1789983 TI - Unnecessary surgery in fully refractive accommodative esotropia. PMID- 1789984 TI - Percutaneous penetration of methyl nicotinate at three anatomic sites: evidence for an appendageal contribution to transport? AB - Percutaneous absorption of the vasodilator methyl nicotinate (MN) was evaluated in human volunteers at three anatomic sites (forehead, forearm and palm) using the technique of laser Doppler flowmetry (LDF). The experiments were designed to test the hypothesis that the kinetics and extent of skin penetration are dependent upon the appendageal density at the site of application. The LDF technique measured the increase in skin blood flow elicited by topically applied MN once the chemical had penetrated to the microvasculature. Significant differences in the measured LDF responses at the three sites were found, and further analysis of the data suggested that MN penetration was greatest through forehead skin, least through the palm and intermediate across the skin of the forearm. A correlation therefore existed between apparent MN absorption and appendageal density. PMID- 1789985 TI - Development of an intracutaneous depot for drugs. Binding, drug accumulation and retention studies, and mechanism of depot. AB - In previous studies we reported that the permeation of dexamethasone and hydrocortisone across the skin was decreased and penetration into the skin was increased in the presence of Transcutol (TC) when compared to water as a solvent. The objective of this investigation was to study the effect of TC on the binding of dexamethasone and hydrocortisone to the skin, and on the accumulation and retention in the skin. Adsorption and desorption studies were conducted for dexamethasone and hydrocortisone with full thickness skin (FTS), and epidermis. The amount of dexamethasone and hydrocortisone adsorbed and desorbed with FTS and epidermis was essentially the same. In the presence of TC the amount of dexamethasone and hydrocortisone adsorbed was increased by 100% with both FTS and epidermis, whereas there was no difference in the amount of dexamethasone and hydrocortisone desorbed. A topical delivery system was developed with and without TC and was evaluated in vivo using the rat as an animal model for hydrocortisone accumulation after multiple dosing. The systemic body burden was reduced by 70% and skin retention of hydrocortisone was increased by 100% in all the layers of the skin. The detection of hydrocortisone accumulation and retention were studied by autoradiography and electron microscopy, and the results support the hydrocortisone depot in the skin due to TC. PMID- 1789986 TI - Synthetic retinoids affect differently the epidermal synthesis of 3,4 didehydroretinol. AB - For unknown reasons, the epidermal concentrations of retinol and its metabolite 3,4-didehydroretinol become characteristically changed during treatment with certain synthetic retinoids. In the present study we investigated [3H]retinol uptake and conversion to 3,4-[3H]didehydroretinol in cultured human skin exposed to six different retinoids. The tissue accumulation of [3H]retinol increased by 50-130% following addition of 1.3 microM of all-trans-retinoic acid, 13-cis retinoic acid, or 3,4-didehydroretinoic acid (putative metabolites of retinol), and by 13-55% after addition of acitretin, arotenoid Ro 13-7410, or 4-(N hydroxyphenyl)retinamide. The formation of 3,4-[3H]didehydroretinol was markedly inhibited (minus 80-90%) by the three putative retinol metabolites, moderately inhibited (minus 60-70%) by the aromatic retinoic acid analogues acitretin and arotinoid, and only slightly inhibited (minus 25%) by 4-(N hydroxyphenyl)retinamide. Addition of citral and ketoconazole, substances known to interfere with the oxidative metabolism of vitamin A, diminished the formation of 3,4-didehydroretinol by 70 and 95%, respectively, but only marginally affected the retinol values. We conclude that the increase in retinol and marked reduction in 3,4-didehydroretinol concentrations in epidermis especially during treatment with 13-cis-retinoic acid are most likely due to diminished conversion of retinol to 3,4-didehydroretinol, but whether or not this reflects feedback inhibition of retinol metabolism or direct inhibition of a specific enzyme remains to be established. Nonetheless, in vitro analysis of 3,4-didehydroretinol biosynthesis appears to be a sensitive means for screening compounds for their ability to interfere with the cutaneous vitamin A metabolism. PMID- 1789987 TI - Mouse skin inflammation induced by multiple topical applications of 12-O tetradecanoylphorbol-13-acetate. AB - It is well known that applications of a single dose of 12-O-tetradecanoylphorbol 13-acetate (TPA) to mouse ears induces an acute inflammatory reaction consisting of erythema, edema and polymorphonuclear leukocyte (PMN) infiltration. We report here that multiple topical applications of TPA to mouse ears produce a prolonged inflammatory reaction characterized by increases in ear weight, inflammatory cell infiltration and epidermal hyperplasia. TPA was applied 5 times over 10 days to mouse ears. Epidermal thickness and PMN infiltration (myeloperoxidase content) increased 3- and 160-fold, respectively, by day 3 and remained elevated over control values throughout the test period. Ear weight was elevated from day 1 and remained high. Hydrocortisone 17-valerate and betamethasone dipropionate significantly reduced all three parameters of inflammation. Indomethacin and two other cyclo-oxygenase inhibitors, and an antihistamine had little or no effect on any of the parameters. This chronic skin inflammation model may be more relevant for evaluating anti-inflammatory compounds than the acute TPA model because the test compounds are applied after the inflammatory lesion is established, which mirrors the use of clinical anti-inflammatory drugs. Also this model may be more selective than the acute TPA model for compounds which affect leukotriene production since other pharmacological agents which are active in the acute model are not active in the multiple-application model. PMID- 1789988 TI - Effect of ciclosporin on epidermal 12(S)-hydroxyeicosatetraenoic acid binding sites. AB - 12-Hydroxyeicosatetraenoic acid (12-HETE) is assumed to play an important role in the pathogenesis of inflammatory skin diseases. Recently, high-affinity binding sites for this eicosanoid have been identified on human keratinocytes by our group. Since ciclosporin exerts therapeutic effects in chronic inflammatory dermatoses such as psoriasis or atopic eczema, the influence of the drug on 12(S) HETE binding to human keratinocytes was studied. No competitive inhibition of 12(S)-HETE binding was observed in ciclosporin concentrations between 10(-10) and 10(-6) M. In contrast, pretreatment of epidermal cells for 24 h resulted in a dose-dependent decrease of specific 12(S)-HETE binding. The analysis of saturation curves showed that the inhibition of 12(S)-HETE binding by ciclosporin was due to the decrease of 12-HETE binding sites, while receptor affinity remained unchanged. In addition, ciclosporin blocked the interferon-gamma-induced increase in epidermal 12(S)-HETE binding. These findings suggest that the effects of ciclosporin in cutaneous disorders could be partly mediated via an influence on epidermal 12(S)-HETE binding. PMID- 1789989 TI - Xanthines inhibit 3T3 fibroblast proliferation. AB - It is believed that xanthines can inhibit cell proliferation by elevating intracellular cAMP. Therefore, these compounds can be useful in hyperproliferative disorders. Our aim was to assess the efficacy of theophylline, caffeine and dyphylline on 3T3 fibroblast proliferation. 3T3 subconfluent cultures were incubated for 3 days with the xanthine derivatives (1 mM-1 microM). At 1 and 0.1 mM the three derivatives exhibited marked inhibition of fibroblast proliferation. Theophylline and caffeine were more potent than dyphylline. At a concentration of 1 mM, the three xanthine derivatives also inhibited proliferation of psoriatic dermal fibroblast, albeit to a lower extent. Caffeine was the most active compound followed by theophylline and dyphylline. We conclude that xanthine derivatives are good candidates for use as fibroblast antiproliferative drugs. We also conclude that 3T3 fibroblasts appear to be a valid system for the pharmacological screening of fibroblast antiproliferative drugs. PMID- 1789990 TI - Genetic polymorphism of IgG in the mink. 7. Expression of the C gamma-allotypes in domestic mink infected with the Aleutian disease virus. AB - The Aleutian disease (AD), i.e., viral plasmocytosis in mink can be used as a model of the natural development of immune complex pathology in man. The immunogenetic aspect of AD was studied with the help of genetic markers of the constant region of the mink immunoglobulin gamma-heavy chain (the C gamma allotypes H2, H3, H4, H6, H7 and H8). The frequencies of 2 of the 6 allotypes, H3 and H4, were significantly higher in the AD-infected than in normal minks from the same population. This supports and extends the data in the literature indicating that the frequencies of certain human Gm allotypes are significantly higher among patients with multiple sclerosis, some oncological and other diseases compared with normal humans. Individual testing of 110 adult Standard minks before and after artificial inoculation with the AD virus demonstrated that change in allotype frequencies results from the activation of the expression of H3 and/or H4 in many individuals. The obtained results make it possible to consider the regulation of the expression of the two CH genes of immunoglobulins as allotype-specific. PMID- 1789991 TI - Human monocyte antigens in a random sample from Japan. AB - We studied a random sample of Japanese and compared both Japanese and German monocyte antigen frequencies and performed a segregation analysis in Japanese families. In Japanese, the following gene frequencies were established: 0.1033 for HMA-A1; 0.0299 for HMA-A3; 0.0033 for HMA-A6; 0.1521 for HMA-B2. Data on the gene frequency in Germans were presented by Rose. In this comparison, the frequency for HMA-B2 in Japanese is more than two times higher; for antigen HMA A6, the Japanese is a fifth of the German quantity. The antigen HMA-B4 was not found in Japanese. The results we obtained from family analysis confirmed an unambiguous autosomal, codominant inheritance of the examined HMA antigens. PMID- 1789992 TI - Regulation of immunoglobulin transcription. AB - B lymphocytes express membrane-bound immunoglobulin molecules as antigen specific, clonally distributed, cell surface receptors. Molecules with the same fine specificity can be secreted in large amounts into the body fluids by progeny of the clone, subsequent to antigenic challenge and appropriate stimulation into terminal differentiation. While this review is limited to the regulation of immunoglobulin transcription, it should be noted that immunoglobulin expression is regulated at the level of DNA, RNA and protein. A DNA recombination process determines the specificity of the antibody to be expressed, the immunoglobulin RNA level is regulated qualitatively and quantitatively, as is the mature immunoglobulin protein. PMID- 1789993 TI - Immunoglobulin heavy-chain allotypes play a role in the clinical history of celiac disease. AB - We studied the role of the immunoglobulin heavy-chain allotypes in the evolution of celiac disease. Particularly the Gm(fb) phenotype was investigated since this phenotype is able to determine the breadth of immune response against alpha gliadin antigen. The results show that weight percentiles and intestinal absorption as assessed by xylose test are influenced by Gm(fb) phenotype suggesting that Gm(fb) genes contribute to the determination of clinical aspects and evolution of celiac disease. PMID- 1789994 TI - Determination of allotypes G1m(f) and G1m(z) at the genomic level by subclass specific amplification of DNA and use of allele-specific probes. AB - Two oligonucleotide primers were used for selective enzymatic amplification of a DNA segment encoding a major portion of the first constant region domain (CH1) of the human IgG1 heavy chain. The selective amplification was confirmed by use of subclass-specific oligonucleotide probes. Two 15-mer oligonucleotides, hybridizing with the alleles for the allotypes G1m(f) and (z), respectively, could then be used for determination at the genomic level of these two truly allelic allotypes. Serum and DNA samples from 12 individuals, one of them with a considerable amount of anti-Gm(f) antibodies, were used for allotype assignment by classical serological methods and by the new method operating at the genomic level. The resulting classifications agreed completely, demonstrating the reliability of the new method. PMID- 1789995 TI - Biosynthesis and interaction of endothelium-derived vasoactive mediators. AB - The vascular endothelium, which envelopes the circulating blood in a continuous monolayer, is not only a physical barrier between blood and vessel wall, but a highly complex "organ" which is involved in the regulation of blood vessel tone and permeability, blood coagulation, angiogenesis, leukocyte and platelet reactivity, phagocytosis of bacteria and the metabolism of many vascular mediators. This article focuses on the biosynthesis, biological actions and interactions of endothelium-derived vasoactive mediators, namely, prostacyclin, endothelium-derived relaxing factor--now characterized as nitric oxide--and endothelin, in the regulation of blood vessel tone under physiological and pathophysiological conditions. The formation of these highly vasoactive substances in modulated by changes in intracellular messengers (cyclic adenosine monophosphate, cyclic guanosine monophosphate, calcium), by interactions of endothelium with blood-borne cells and plasma constituents and finally by the interaction of these mediators themselves. The current evidence supports the view that nitric oxide plays a pivotal role for the regulation of blood vessel tone under physiological conditions, while the generation of prostacyclin is primarily an important defense mechanism to maintain a sufficient blood vessel patency and tissue viability under conditions of a compromised blood supply. Although the physiological role of the endothelium-derived vasoconstrictor peptide endothelin 1 is less well defined, it is apparent that any potential harmful vasoconstrictor effects resulting from an enhanced formation of endothelin under pathophysiological conditions are modulated by the simultaneous generation of prostacyclin, nitric oxide and tissue-plasminogen activator, thus preventing excessive vasoconstriction and thrombotic occlusion of the vascular bed concerned. PMID- 1789996 TI - Differences of metabolism of prostaglandin E2 and F2 alpha by decidual stromal cells and macrophages in culture. AB - Intact decidual stromal cells and macrophages metabolized 3H-prostaglandins E2 and F2 alpha although the rate of metabolism of both prostaglandins was higher in the decidual macrophages than in decidual stromal cells. PGE2 was metabolised mainly to 13,14-dihydro-15-keto-PGE2 together with smaller quantities for PGB2 and 13,14-dihydro-15-keto-PGA2, whereas PGF2 alpha was metabolised to 13,14 dihydro-15-keto-PGF2 alpha, PGE2 and PGB2, and it seems that similar metabolic pathways were present in both cell types. The half-lives of both prostaglandins (8.8 +/- 3.4 h for PGE2 and 15.0 +/- 8.2 h for PGF2 alpha sigma in the presence of decidual stromal cells show that during incubations lasting more than a few hours significant metabolism of prostaglandins, especially PGE2, will occur, and that this must be allowed for in any assessment of total prostaglandin production by cultured decidual cells. One of the 6 tissue samples examined metabolised both prostaglandins very rapidly, such that the half-lives were less than 2 h. This may be the result of the presence of very high levels of metabolic enzymes, since the overall pattern of metabolites was similar to that from the other 5 samples. PMID- 1789997 TI - Effects of defibrotide on prostacyclin release from isolated rabbit kidneys and protection from post-ischemic acute renal failure in vivo. AB - We evaluated whether defibrotide, a single-stranded polydeoxyribonucleotide that enhances prostacyclin (PGI2) release from various isolated organs, could also release PGI2 from the rabbit kidney and prove effective against renal ischemic injury. Isolated perfused kidneys responded to defibrotide (100, 250 and 500 micrograms ml-1 min-1) with a dose-dependent release of immunoreactive 6-keto PGF1 alpha (4-fold increase at highest dose), which was prevented by indomethacin pre-treatment. In vivo, venous blood withdrawn from heparinized rabbits (and representative of renal outflow) was conveyed over a collagen matrix, onto which platelets adhered and aggregated. Recording the weight increase of the matrix was used as a bioassay to follow the time-course of released PGI2. We observed that renal outflowing blood from defibrotide treated animals (50 mgKg-1 i.v.) displayed lower (P less than 0.05 versus controls) platelet activation, consistent with enhanced PGI2 release from the kidneys. Furthermore, the duration of this effect was longer lasting than that predicted from the known plasma half life of the drug. After transient (30 min) occlusion of the renal arteries, glomerular filtration rate (GFR) dropped by about 50% (P less than 0.01) during the first reperfusion hour in control animals, with only mild recovery having occurred 4 h later. Defibrotide (16 mgKg-1 bolus + 16 mgKg-1h-1, i.v.) could not antagonize the initial impairment (40% GFR reduction), but allowed full recovery at the end of the observation period (P less than 0.05 vs controls). Indomethacin, instead, caused a dramatic reduction of GFR (70%) during early reperfusion, with no subsequent recovery.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789998 TI - Omega-3 polyunsaturated fatty acids augment endothelium-dependent vasorelaxation by enhanced release of EDRF and vasodilator prostaglandins. AB - Dietary supplementation with fish oil results in augmentation of endothelium dependent vasorelaxation in experimental animals. The present study was designed to evaluate the direct in vitro effects of omega-3 polyunsaturated fatty acids (omega-3 PUFAs) on vascular reactivity in isolated rat aortic rings. Aortic rings were incubated with the omega-6PUFA arachidonic acid (AA, 10(-7) M) or the omega 3 PUFAs eicosapentaenoic acid (EPA, 10(-7) M) and docosahexaenoic acid (DHA, 10( 7) M) in an organ bath at 37 degrees C. Following contraction with norepinephrine, changes in isometric force were measured in response to the endothelium-dependent vasodilators acetylcholine (ACh, 10(-10) to 10(-5) M) or the calcium ionophore A23187 (10(-10) to 10(-5) M). Parallel sets of vascular rings were pretreated with the cyclooxygenase inhibitor indomethacin (10(-5) M) or the inhibitor of nitric oxide synthesis NG-monomethyl L-arginine (L-NMMA 5 x 10(-5) M) prior to treatment with AA or EPA. Treatment of rings with EPA resulted in an increase (P less than 0.05) in ACh-mediated vasorelaxation compared both to AA-treated and buffer-treated rings (maximum relaxation 83 +/- 5% vs 46 +/- 5% and 63 +/- 4%, respectively). A similar augmentation was observed in DHA-treated rings. Pretreatment of rings with indomethacin or I-NMMA decreased (P less than 0.05) the ACh-mediated vasorelaxation, although EPA-treated rings showed less (P less than 0.05) attenuation of ACh response compared to AA-treated or untreated control rings.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1789999 TI - 13,14-dihydro-PGE1, an in-vivo metabolite of PGE1, decreases mitotic activity induced by corticosteroid administration. AB - PGE1 has antimitotic activity by virtue of its effect in increasing cAMP in vascular smooth muscle cells. The present study compares the effect of 13,14 dihydro-PGE1 (13,14-DH-PGE1) with PGE1 in an experimental model of stress induced by desoxycorticosterone in the rabbit. 13,14-DH-PGE1 significantly inhibited the stress-induced increase in mitotic activity, measured by autoradiography as percentage of 3H-thymidine positive cells, in all 3 abdominal aortic wall layers. Administration prior to stress was more effective than after stress, while combined administration was most effective. 13,14-DH-PGE1 exerts approximately 90% of the antimitotic activity of PGE1. It seems possible that the antimitotic activity observed after administration of intravenous PGE1 is attributable in part to 13,14-DH-PGE1. PMID- 1790000 TI - Membranes exert indirect negative control on phospholipase A2 in human placenta. AB - Phospholipase A2 (PLA2) activity of human term placenta is distributed about equally between cytosol and membranes. The latter activity was detached by treating membranes with EGTA, but this extraction also released inhibitory protein, which complicated the assay and has probably often led to underestimation of such PLA2. Varying the substrate concentration, we found that large amounts of liposome substrate relieve PLA2 suppression in the extract. This suggests substrate depletion by the inhibitory protein as the mechanism by which PLA2 enzymes are negatively controlled in placenta. Membrane-bound PLA2 was purified about 700-fold and appeared to be one enzyme species (PLA2-M). By contrast, cytosolic PLA2 activity could be fractionated into four separate fractions, one of which was further purified (PLA2-S1). As judged on the basis of a variety of biochemical properties, PLA2-M and PLA2-S1 seem to be identical enzyme forms. They are distinct from the class of pancreas/venom-type phospholipases A2. PMID- 1790001 TI - [XLIII Annual Meeting of Spanish Society of Neurology, Barcelona, December 9-14, 1991. Abstracts]. PMID- 1790002 TI - [Organization of neurological care in Spain]. PMID- 1790003 TI - [The multiple sleep latency test in the diagnosis of narcolepsy and idiopathic hypersomnia]. AB - The diagnostic differential between narcolepsy and idiopathic hypersomnia may be difficult in those cases which clinically manifest only hypersomnia and the nocturnal polygraphic study does not show any differences between both diseases, particularly when the beginning of REM sleep is not presented in narcoleptic patients. The multiple sleep latency test is an objective test of daytime hypersomnia in both diseases. Moreover, if 2 or more REM periods are registered altogether in the 4 or 5 siestas studied, the test is highly suggestive of narcolepsy and permits sure differentiation with idiopathic hypersomnia. In the present study, the multiple sleep latency test permitted the diagnosis of the cases of oligosymptomatic narcolepsy and absence of the beginning of REM sleep. PMID- 1790004 TI - [Congenital fiber-type disproportion: analysis of a series of 11 cases]. AB - We present 11 patients with congenital fiber type disproportion suggesting the existence of two different clinical groups. The first group not associated with other diseases, presents a uniform clinical picture and a generally good prognosis, although the patients with severe respiratory involvement can die. The second group includes the cases in which CFTD is associated with other congenital diseases such as Lowe's Syndrome, Mobius' Syndrome, hypothyroidism and hydrocephalus. In this group the clinical presentation and prognosis is that of the associated disease added to that of CFTD. The frequent association of CFTD with other congenital diseases suggests that CFTD may not be a specific myopathy but a histological abnormality due to different pathogenic insults which interfere with the normal growth and maturation of the muscle fibres. PMID- 1790005 TI - [Parkinsonism induced by MPTP as an experimental model of Parkinson disease: similarities and differences]. AB - MPTP administration, preferably to mice and primates, induces a selective damage of substantia nigra dopaminergic cells. Intrinsic mechanisms mediating MPTP induced toxicity, remain still under evaluation. There are very few semiological differences between Parkinson's disease (PD) and MPTP parkinsonism, but significant biochemical and neuropathological differences have been reported between these two entities. However, at the moment it represents the best model of Parkinson's disease available for the study of the basal ganglia function. In addition it could be a useful tool for a better understanding of mechanisms involved in neuronal death and regeneration. The present paper, summarize the real knowledge about the mechanism by which MPTP induces neuronal toxicity, the differences reported between PD and MPTP parkinsonism and finally its application for research. PMID- 1790006 TI - [Meningitis caused by Candida albicans in a male patient infected by HIV and failure of treatment with amphotericin B]. AB - We report a case of Candida albicans meningitis in a male with human immunodeficiency virus (HIV) infection. This finding has seldom been reported, both in this group of patients and in those with other causes of immunosuppression or other underlying diseases. We discuss the clinical presentation and the features of cerebrospinal fluid, which showed only a mild inflammatory reaction as found in other fungal meningitis (basically cryptococcal) in AIDS patients. Finally, we emphasize the ineffectiveness of amphotericin therapy to achieve a complete microbiological cure and to prevent the relapse of meningitis in this patient. We also stress the need to make an early diagnosis in cases of fungal meningitis in patients with VIH infection, so that appropriate therapy is begun as soon as possible. PMID- 1790007 TI - [Neuralgiform paroxysmal migraine]. AB - A 23-year-old woman presented with episodic, strictly unilateral, left-sided headaches of excruciating severity. Pain was referred to the eye, lasted from seconds to a minute and was accompanied by homolateral ptosis, redness of the eye, increased lacrimation and nasal discharge. The attacks of pain repeated up to seven times over 24 hours and clustered around ovulation for seven days a month. After she became pregnant, the attacks increased in frequency and appeared every five to ten minutes during night and day. Different medical treatments including indomethacin, were without effect. Two months later pregnancy was interrupted and the pain immediately subsided. After carotid angiography the pain reappeared for two months, but it finally disappeared and she has been free of pain without treatment for the last nine months. This syndrome can be related to episodic paroxysmal hemicrania. PMID- 1790008 TI - [Molecular genetics in neurology (II). Analysis of the human genome]. PMID- 1790009 TI - [Cerebral embolism and atrial septum aneurysm. Diagnoses using transesophageal echocardiography]. PMID- 1790010 TI - [Topography of the pyramidal fibers in the internal capsule]. PMID- 1790011 TI - [Unilateral Creutzfeldt-Jakob disease with periodic lateralized epileptiform discharges]. PMID- 1790012 TI - [Nursing staff's viewpoint of the self-determination of a long-term psychiatric patient]. AB - The purpose of the study was to describe the views of the nursing staff working with long-term psychiatric patients about the patient's right of self determination. The information obtained was used for clarifying the concept of self-determination and the patient's right of self-determination during hospital care. The research material was collected from the trained personnel (n = 127) working in the long-term or rehabilitation wards of four psychiatric hospitals in the province of south-western Finland. The main method used for collecting the information was a questionnaire containing open questions. The material was processed by analysing the contents with both qualitative and quantitative methods. The nursing staff was able to define the concept of long-term psychiatric patient's right of self-determination quite clearly. On the other hand, the nursing staff did not have a clear idea of how the self-determination was carried out in practice. More than half of the nursing staff consider the self-determination important. Many of them were of the opinion that a patient in a psychiatric hospital has rather little self-determination. The main reason for this is the nature of the patient's illness. Self-determinations is promoted by details connected to the treatment given and the recent development in the treatment. PMID- 1790013 TI - [Ethical decision making of nurses associated with the feeding of demented patients and terminally ill elderly cancer patients in 7 countries]. AB - This article clarify the results of the international study, carried out in seven countries. The purpose of the study was to clarify the ethical decision making of the nurses working with demented patients and with elderly cancer patients in terminal state, who refused to eat. In the structured interview a different kind of case study was presented to the nurses (N = 300) working with demented patients and to the nurses working with cancer patients. Nurses were asked to make a decision to feed or not to feed the patient. Justifications to the decision were also demanded. The subjects were also asked under what conditions they would change their decision. The most part of the nurses working with cancer patients made a decision not to feed the patient. Nurses from China and quite many from Israel chose however to feed the patient. The half of the nurses working with demented patients made a decision to feed the patient and an other half prefer not to feed the patient. Nurses from China, Israel, Finland and Kalifornia did prefer feeding and nurses from Australian, Sweden and Canada chose mostly not to feed the patient. The majority who chose not to feed the patient used the principle of autonomy as justification. Nurses who made a decision to feed the patient stressed mostly the principle of sanctity of life. Nurses changed their decision mostly when a doctor, nursing staff or patient's husband had different kind of opinion of the strategy to nurse the patient. Nurses from Sweden and China changed mostly their attitude because of the order of the doctor. The opinion of the staff was most important to australian nurses and the opinion of the husband had most influence to finnish nurses. PMID- 1790014 TI - [Quality of perioperative nursing care: viewpoint of the patient with back surgery]. AB - The purpose of the study was to explore and describe the views of back-operated patients on good perioperative nursing care. The study forms part of a major research project. The data consists of theme interviews with 30 (= N) back operated patients. The data were analysed by using the method of content analysis. As a general rule all back-operated patients were satisfied with the nursing care they had received. At the preoperative phase, the patients show a very obvious need for information, but the structure and amount of desired information varied. At the intraoperative phase the most important thing is that a friendly, competent staff explain to the patient what is going on and why. At the postoperative phase patients wanted someone at their bedside all the time monitoring the patient's condition. Because this study represents a basic research of nursing care, the results provide a useful basis for the further research. PMID- 1790015 TI - [Responsive student evaluation in Finnish nursing education]. AB - In the middle of 1980s in Finland the evaluation of the quality of learning was developed according the principles of the responsive student evaluation. These principles consist of goal orientation and critical attitude of one's own and others' action. In this article the realization of the principles is described, from the perspective of nursing students (N = 379) and based on a questionnaire. The students answered to the questionnaire before their graduation in the autumn term 1990. The main part of the students was during their education aware of the goals in curriculum and stated the goals also themselves. Between the goal orientation and grades in certification there was, however, no correlation. In clinical practice the students evaluated the action of their own and supervisors. In the evaluation of more theoretical learning (e.g. in class-room) the role of the students was very limited. Based on the questionnaire it is presumable that the principles of responsive student-evaluation realize only partly in the Finnish professional nursing education. PMID- 1790016 TI - [Effectiveness of group physiotherapy on motor function in elderly stroke patients]. AB - The purpose of this study was to assess the effectiveness of group physiotherapy with special emphasis on motor function of the elderly stroke patients. The sample comprised sixteen persons who had survived a stroke and who lived at home. The sample was treated by using group physiotherapy weekly and ten times altogether. The patients' motor function were assessed before and after the intervention programme with a chart for assessing motor capacity. In addition, each patient was interviewed regarding his or her usual activity, health and life situation. Mainly descriptive statistical methods were used, e.g medians, lower and upper quartiles. The outcome of the study shows that group physiotherapy has effectiveness to maintain and in some respects also to improve basic motor function. It seems that survivors need and also get different kind of rehabilitation and care to minimize their motor impairment and to maintain their functional capacity. PMID- 1790017 TI - The problem of defining good nursing. PMID- 1790018 TI - Good nursing care--under what conditions and at what price? PMID- 1790019 TI - Good nursing care--the relationship between client and nurse. AB - The patient-nurse relationship, its definition and evaluation, are central to the quality of nursing care. Analysis of this relationship requires a stronger epistemological and philosophical emphasis and also more practical research. At least the following dimensions must be included in: 1) the health management strategies of the patients and population; these form the content of the client nurse relationship; and 2) the dominance factors of the relationships, which form the structure of the relationship. PMID- 1790020 TI - Good nursing care--related to nursing action. PMID- 1790021 TI - Foundations of nursing's perspectives on health education. AB - Nursing is one of the many diverse disciplines on which health education draws for theoretical perspectives, research, and practice tools. It brings more than a 130 year heritage of practice with individuals, groups, institutions, and communities toward the goals of restoring, promoting, and maintaining health. Nursing's more recent history of theory development and research, in which relationships are examined between persons, their environment and health, is especially germane to the art and science of health education. In nursing, health education is one of a large repertoire of intervention actions nurses take to support healing, caring, and health with individuals, families, groups, organizations, and communities. The theoretical foundations of these actions characterize the nursing domain and guide research and practice. In this paper, several theoretical frameworks from nursing and health education are examined to bring their perspectives more clearly into focus for the mutual advance of both fields. PMID- 1790022 TI - Balanced chromosome rearrangements and abnormal phenotype. AB - Analysis of the results of 3411 routine cytogenetic examinations initiated by abnormal phenotype or family history revealed that out of 44 cases with balanced structural aberration 12 patients had an abnormal phenotype. Of the 12 cases, there were four reciprocal translocations, three Robertsonian translocations, and five pericentric inversions. Eight rearrangements were inherited, one had occurred de novo, and three were of unknown origin. Each carrier parent was apparently healthy. In all of the four cases with reciprocal translocation the rearrangements were of paternal origin. None of the clinical abnormalities could be assigned specifically to the breakpoints. Explaining the association of balanced chromosomal rearrangement and clinical abnormalities, possibilities of causal relationship and by chance coincidence are discussed. PMID- 1790023 TI - Short clinical report: a new case with de novo partial 9p monosomy. AB - A female patient is described with a karyotype 46,XX,del (9) (p22) showing characteristic dysmorphic phenotype: trigonocephaly, prominent forehead, long philtrum, small mouth, high arched palate, low set ears, short neck, widely spaced nipples, long fingers and toes, omphalocele. The first Hungarian case of 9p monosomy syndrome is reported here. PMID- 1790024 TI - The influence of metoclopramide on the composition of human breast milk. AB - The breast milk prolactin (PRL) has been claimed to play a role in the control of electrolyte composition of the milk. Since metoclopramide has been shown to increase milk production in humans, we have made an attempt to investigate the production, the PRL and sodium concentrations in milk with (group I) and without (group II) maternal metoclopramide treatment (5 days, 30 mg/day). Both groups consisted of 11 mothers and their full-term newborn infants. The daily milk production was significantly higher in the treated group (276.4 +/- 36.6 vs 150.9 +/- 25.3 ml/day, p less than 0.01). The PRL measured by RIA was similar in the milk samples of the metoclopramide treated and control groups (80.5 +/- 17.7 vs 90.7 +/- 27.3 ng/ml). The sodium concentration in the milk of mothers taking metoclopramide was 22.1 +/- 1.6 mmol/l and 24.3 +/- 3.2 mmol/l in the control group (p = 0.59). On the 5th postnatal day the plasma PRL of the newborns of mothers treated with metoclopramide does not differ from the values of the control babies (29.8 +/- 2.6 vs 30.7 +/- 2.4 ng/ml) indicating that the amount of metoclopramide transferred into the milk has no apparent influence on the hypothalamo-hypophyseal axis of the neonate. IN CONCLUSION: the maternal metoclopramide treatment augments the milk production without having any effect on the PRL and sodium concentration of human "mature" milk. PMID- 1790025 TI - Biochemical and ultrastructural diagnostic problems in mucolipidoses. AB - Biochemical and ultrastructural investigations were made in 2 children suffering from mucolipidosis type III. Among the lysosomal hydrolases the activity of beta galactosidase and alfa-fucosidase diminished in the homogenate of the peripheral leukocytes in case I. The activity of serum and leukocyte arylsulfatase was normal. By electron microscopy typical storage organellums for mucolipidosis were detected in different biopsy materials--liver, skin, conjunctival ones--and in the cytoplasm of the peripheral lymphocytes and leukocytes. Definitive diagnosis was given by the specific electron microscopic investigations detecting the typical storage patterns for mucolipidosis. PMID- 1790026 TI - Ultrastructural investigations in late infantile type of ceroid lipofuscinosis (Jansky-Bielschowsky). AB - Ultrastructural findings of biopsy materials of four gipsy first cousin infants suffering from late infantile type of ceroid lipofuscinosis (Jansky-Bielschowsky) were investigated. The diagnostic significance of the conjunctival biopsy is emphasized. The pericytes and the vascular smooth muscle cells of the arterioles proved to be the main inclusion storing cells. PMID- 1790027 TI - Surgical management of pulmonary atresia with intact ventricular septum. Right ventricular size as a guideline for surgical intervention. AB - 61 infants with critical valvular pulmonary stenosis (21 cases) or pulmonary atresia with intact ventricular septum (40 cases) were operated on between 1975 1989 in the Semmelweis University Medical School. Right ventricular volume, area, outflow tract dimension and tricuspid anulus diameter was measured by angiocardiography and echocardiography to evaluate right ventricular size, and to predict the operative outcome using these data. Our results suggested, that if the normalized right ventricular volume was less than 3 ml/m2, the normalized right ventricular area was less than 2.5 cm2/m2, and the normalized right ventricular area was less than 2.5 cm2/m2 and the normalized tricuspid anulus diameter was less than 1.2 cm2/m2/3 only a systemopulmonary shunt procedure is needed. In all other cases pulmonary valvotomy is necessary to decompress the right ventric and to help increase the right ventricular size. Where a different part of the right ventricle is hypoplastic a systemopulmonary shunt procedure is needed too. In the follow up period the right ventricular dimension and tricuspid valve diameter was measured by echocardiography. This noninvasive assessment can predict the preoperative diagnosis, postoperative outcome and demonstrates an adequate growth of the right ventricle after pulmonary valvotomy. PMID- 1790028 TI - Acute head injuries in children--a review of 100 consecutive patients. AB - Head injuries of children between 4-16 years in the first hour after the trauma have been studied. The neurological examination was completed by CT-scan. Glasgow Coma Score (GCS) as well as Glasgow Outcome Scale (GOS) were also applied and proved to be very helpful. Our findings show a significantly frequent occurrence of epidural haematomas. Their treatment in patients with GCS above 8 was in 90% successful. PMID- 1790029 TI - Screening for the detection of coronary artery disease by using the exercise tolerance test in a preventive medicine population. AB - We designed this study to identify patients with coronary artery disease (CAD), employing the exercise tolerance test, and to develop further criteria for ordering the exercise tolerance test in the preventive medicine population of the Cleveland Clinic Foundation. During 1987-1988 1,930 patients not known to have CAD were referred from the Department of Preventive Medicine for exercise tolerance tests as part of their periodic physical exams. We hypothesized that age was a major risk factor and ordered most (86.4%) tests on this basis: at age 40 and every two years after age 50. Twenty-five cases of CAD (25/1,930 or 1.3%) were found. One of 297 women was found to have CAD (0.3%). Seventeen patients were treated surgically and eight medically. Using age as an indication for testing detected 23 of 25 cases (92%). We compared the group with normal or nondiagnostic exercise tolerance tests and presumed not to have CAD (1,905 patients, median age 48) with the group with CAD (25 patients, median age 59). Age greater than 40, a total cholesterol level over 240 mg/dL, triglyceride level over 250 mg/dL, a total cholesterol to high-density lipoprotein ratio greater than 4.5, and a history of chest pain of any type were all significantly related to the presence of CAD. Testing men older than forty with two or more CAD risk factors, as has been recommended, would have resulted in finding five of the 25 cases (20%). Testing only patients who complained of any type of chest discomfort would have resulted in detecting 14 of the 25 cases (56%).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790030 TI - Screening for coronary heart disease risk in the elderly: total cholesterol versus high-density lipoprotein-cholesterol. AB - Despite recent national recommendations to use total cholesterol (TC) measures to screen patients for hyperlipidemia and coronary heart disease (CHD) risk, it is unclear how predictive this approach is for older adults, who tend to have higher high-density lipoprotein-cholesterol (HDL-C) values and therefore higher TC. We looked at lipid profiles of 190 adults with a mean age of 70.8 years (range 51 to 86 years) to determine the value of TC in predicting risk states based on HDL-C. One hundred sixty-two did not have a diagnosis of CHD; 28 had a diagnosis of CHD. Of those subjects without CHD, 13 (8.0%) with a TC under 200 mg/dL were "underscreened" since they had a low HDL-C value under 40 mg/dL. Men were three times more likely to be underscreened on the basis of TC alone. Thirty (18.5%) of the subjects were "overscreened" since they had a TC greater than or equal to 240 mg/dL and a normal HDL-C value greater than 50 mg/dL. Only women were overscreened. For those 28 subjects with CHD, TC values alone also "underscreened" 3 (10.7%) of this cohort, and "overscreened" 3 (10.7%). If a provider decides to screen for hyperlipidemia and CHD risk in older patients, a lipid profile rather than a nonfasting TC test should be ordered. Over 26% of the patients in this study would have been misclassified and inappropriately advised regarding their risk for CHD based on a TC value alone. PMID- 1790031 TI - The impact of public cholesterol screening on diet, general well-being, and physician referral. AB - Public cholesterol screenings have become common. To evaluate the public health impact of such events, we conducted a public cholesterol screening and, three months later, invited participants between the ages of 18 and 72 to return for follow-up. More than 77% (N = 143) returned. We collected information on diet and general well-being at baseline and follow-up, and we obtained information on further medical evaluation of the initial cholesterol value at follow-up. Diet improved regardless of baseline cholesterol level (overall diet score 2.10 baseline, 1.75 follow-up, P less than .001). There were no adverse psychosocial ("labeling") effects in persons told of elevated cholesterol levels. About one third of individuals referred to their physicians for elevated cholesterol values discussed the cholesterol issue with their physicians, as did a similar proportion of those told of a desirable cholesterol level. Total cholesterol decreased from 218.5 to 211.6 mg/dL (P = 0.18, 95% CI for the change, -18.5 to +4.7 mg/dL). Public cholesterol screening did not appear to have any adverse effects and may lead to beneficial changes in diet in persons screened. PMID- 1790032 TI - Patterns of physicians' treatments for referral patients from public cholesterol screening. AB - Current interest in high blood cholesterol and attendance at public cholesterol screening programs has raised the issue of whether physicians are responding to referrals according to existing national assessment and treatment recommendations. This study assessed the relationship of characteristics of referrals from a series of public blood cholesterol screenings to physicians' treatment practices. For this analysis, the sample was restricted to 1,324 subjects, from the 2,109 referred, who reported seeking physician care. At five months after screening, 75% of subjects reported their physician prescribed a diet; 16% of physicians prescribed medication. Multiple logistic regression, adjusted for sociodemographic characteristics and other coronary heart disease (CHD) risk factors, indicated that screening cholesterol risk level, prior history of high blood cholesterol levels, and type of medical contact were consistently related to receipt of diet and medication treatment, but other CHD risk factors were underutilized. "Moderate" risk subjects with no history of high blood cholesterol were less likely to have received dietary advice, but a screening-risk level interaction did not occur for medication. The results imply that current treatment guidelines may not be working and suggest the need for continued physician education in the management of hypercholesterolemia. PMID- 1790033 TI - Prevalence of hypercholesterolemia in a national worksite sample. AB - We conducted a screening for serum cholesterol levels at 41 locations of a large manufacturing company to determine baseline serum cholesterol levels in a workplace population. Locations were based on volunteerism. We conducted screenings at the worksite with individuals voluntarily participating on company time. Fifty percent of eligible employees participated in the screening. Using National Cholesterol Education Program guidelines, we identified 17.6% of employees as hypercholesterolemic (greater than or equal to 240 mg/dL), and another 30.2% were at borderline high risk. Total serum cholesterol increased with age and was higher in men than in women. Total cholesterol was significantly associated with age, sex, marital status, and education, but not with occupational status. PMID- 1790034 TI - Increasing women's compliance with opportunistic cervical cancer screening: a randomized trial. AB - Our objective was to evaluate the efficacy and acceptability of two interventions designed to increase opportunistic cervical cancer screening. We designed a randomized trial of two interventions additional to usual care. We recruited 17 male general practitioners selected at random from the inner metropolitan region of Sydney, Australia. The patients were 202 women, between 20 and 65 years of age, eligible for a Pap smear. We allocated minimal and maximal interactional interventions to obtain consent for a Pap smear. Our main outcome measure was women's having a Pap smear during the consultation or within one month. We also measured acceptability of interventions to practitioners and women. These were our results: minimal: 55% of women had a Pap smear; maximal: 67% of women had a Pap smear; total when both approaches are combined: 61%. We conclude that brief advice is as effective as maximal persuasion in increasing women's compliance with opportunistic screening in routine consultations. Both interventions were acceptable to women. Practitioners preferred the minimal intervention. We demonstrate opportunistic screening is an effective and acceptable way to encourage women at risk to have a Pap smear. PMID- 1790035 TI - Evaluation of an intervention program in the control of an urban outbreak of shigellosis. AB - Community-wide outbreaks of shigellosis are a persistent public health problem. We evaluated the effect of a household-based intervention program on the control of an urban outbreak of S. sonnei gastroenteritis. During the intervention we attempted to contact all households with culture-confirmed S. sonnei and provide education in methods to prevent spread of Shigella. Subsequently we conducted a survey of intervention (n = 43) and nonintervention (n = 33) households. We also conducted a serosurvey of children three to five years of age. The number of new cases of S. sonnei infection declined steadily over several months after the intervention began. Members of the intervention households were more knowledgeable about handwashing (rate ratio [RR] 4.7, 95% confidence interval [CI] = 2.1-10.8) and others methods of S. sonnei transmission and control than members of nonintervention households. However, intervention households had higher attack rates of Shigella-associated diarrhea in susceptible household members (RR 1.4, 95% CI = 1.0-2.0). During the intervention we were able to contact only 25% of households by the eighth day after onset of diarrhea in the index case, when 90% of intrahousehold transmission of Shigella had already occurred. Two months after the outbreak ended, 42% of children in the outbreak community had elevated antibody titers against S. sonnei; an additional 19% had borderline elevated titers. The intervention program improved knowledge but may have occurred too late to prevent intrahousehold transmission of Shigella. Exhaustion of susceptible hosts, rather than the education program, likely accounted for the decline in shigellosis cases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790036 TI - Physical fitness gains following simple environmental change. AB - Inactivity is the risk factor with potentially the greatest public health impact, according to the 1989 U.S. Preventive Services Task Force report. Our study reports changes in subjects' physical fitness level after simple changes aimed at enabling community members to adopt more easily active lifestyles. Simple environmental and social alterations occurred at a San Diego Naval air station. We administered to a cohort of active-duty personnel from within this community (n = 1,609) both a physical readiness test (PRT) and a lifestyle questionnaire at baseline and at one year. The PRT consisted of a 1.5-mile timed run, sit-ups, push-ups, and percentage body fat components, and the questionnaire addressed demographics, current exercise behavior, and attitudes toward exercise. We took similar measures within a comparison community cohort (n = 217) and within a Navy wide sample cohort (n = 546). Both overall PRT category and 1.5-mile run time improved significantly (P less than .05) over time in the intervention community (0.3 category points and 18 seconds, respectively). The increase was significantly greater (P less than .01) than in either the control community or the Navy-wide sample. Subgroup analysis showed that, in the intervention community, 12.4% failed the overall fitness test in 1987, but only 5.1% failed in 1988. Similarly, the 1.5-mile run failures decreased from 8.4% to 4%. Reported leisure time kilocalorie expenditure showed no significant improvement. This simple program successfully improved fitness performance. The improvement was distributed throughout the community and included those who were substandard at baseline. Similar programs could easily be adopted in a variety of communities. PMID- 1790037 TI - Description of a computerized health maintenance tracking system for primary care practice. AB - This article describes the development of a computerized health maintenance tracking system for primary care practice and its features. Research has shown existing computerized health maintenance tracking systems are unsatisfactory for the average practitioner for these reasons: (1) Data entry is slow or requires duplication of entries for billing purposes; (2) the system is linked to a totally computerized medical record that is expensive and complex to maintain; (3) health maintenance status options are limited to "YES/NO" and do not inform the practitioner of the full range of possible situations; (4) physician reminders are created only for patients with an appointment; (5) patient reminders are not generated on a regular basis regardless of appointment status; (6) it is difficult to change individual and global health maintenance schedules. The system described here downloads demographic and health maintenance data from the practice's billing system. Six health maintenance status options are available: D = done and normal, X = done but abnormal, N = not indicated, R = patient refused, E = done elsewhere, I = abnormal but inactive. A health maintenance status report is created for both the patient and provider once a year, in the month of the patient's birth unless an alternate month has been designated, regardless of the patient's appointment status. Patients are encouraged to make an appointment for overdue health maintenance procedures, unless already scheduled. PMID- 1790038 TI - Dietary changes among husbands of participants in a low-fat dietary intervention. AB - A dietary intervention delivered to one family member with a beneficial impact on other members could provide a cost-effective approach to public health dietary intervention programs. The Women's Health Trial (WHT) was a study in which women were randomized to be trained in adopting a low-fat diet or to continue their normal diet. The intervention women consumed 21% of total calories from fat versus 38% for control women at six months postrandomization. Husbands of women in the Seattle Clinical Center of the WHT were surveyed between 1985 and 1988 to determine whether and to what extent the husbands' diets changed at six months. Ninety-one intervention men and 162 control men, 79% of those eligible, participated. Intervention men reported an average weight loss of 2.4 pounds, compared to an average 0.7-lb loss among controls (P = .03). Based on self reported change of specific foods, we found that intervention men more often reduced butter, margarine, eggs, and red meat over the six months than did control men (P less than .001). Based on nutrient consumption estimated by a food frequency questionnaire, intervention husbands consumed 34% of total calories from fat versus 36% for controls (P = 0.04). The number of meals shared with wives per week modified the effect of the intervention: among the intervention group, for every three meals shared, an accompanying one percentage point reduction in percentage of calories from fat occurred in the husband's diet. Thus, we suggest that dietary intervention programs attended by one spouse appear to exert a small beneficial effect on the other spouse. PMID- 1790039 TI - The Expert Panel on Preventive Services: continuing the work of the U.S. Preventive Services Task Force. PMID- 1790040 TI - Evaluation of referral completion after a workplace cholesterol screening program. AB - We designed a randomized clinical trial to examine effectiveness of a follow-up educational mailing to improve referral completion following a workplace cholesterol screening program. Of 836 employees who participated in a cholesterol screening program at Blue Cross and Blue Shield of Maryland, 313 (37%) had a total cholesterol greater than or equal to 200 mg/dL and were referred to their physician for remeasurement and evaluation. Individuals with elevated cholesterol who agreed to a telephone interview two months after screening (n = 272) were randomized to a control or intervention group. The intervention consisted of a booster mailing two weeks after screening designed to encourage further physician follow-up and to increase knowledge about cholesterol and its dietary control and about risk factors for coronary heart disease (CHD). No statistically significant differences appeared between the control and intervention groups in rate of referral completion. However, a blood cholesterol level of greater than or equal to 240 mg/dL at the time of screening was the most significant predictor of referral completion (P less than .0001). Of those randomized, the association between the number of other additional risk factors for CHD and referral completion was not statistically significant. There was, however, a trend toward reported changes in lifestyle behavior as a result of screening, particularly in diet modification. PMID- 1790041 TI - The effect of duration of intervention and locus of control on dietary change. AB - Scientific evidence supports a relationship between diet and the incidence of cancer. This finding has resulted in dietary recommendations that have been disseminated to the public. To reduce actual cancer incidence, these recommendations must lead to dietary changes among the population. We compared two brief dietary interventions with a longer term intervention and found that all three interventions produced significant reductions of calories, fat, fiber intake, and weight. The duration of the intervention did not significantly affect the magnitude of these reductions. We also found that health locus of control did not affect dietary change. Participants who initially were found to have an internal locus of control, or who subsequently internalized their locus of control during the period of observation, did not demonstrate a significant change in their intake of any of the nutrients measured when compared to participants with an external locus of control. Thus, we suggest a brief dietary intervention as a feasible and effective mechanism to produce progressive incremental dietary changes in a large population. PMID- 1790042 TI - Occupational exposure in lung cancer patients: contribution of remote past work. AB - Occupational exposures have been recognized for a number of years as contributing to disease risk for certain cancers. Although disease risk may be attributed to personal behaviors, such as cigarette smoking, occupational exposure may enhance the risk. Obtaining occupational histories is therefore important to the study of the etiology of cancer. However, the availability of occupational information in the medical record and vital registries can be incomplete or of poor quality and is often restricted to current, most recent, or usual occupation. This article reports the contribution of remote past work, data not ordinarily collected in the medical record, as an exposure source to potential lung carcinogens in a group of lung cancer patients. Twenty-six of the 114 lung cancer patients interviewed (23%) reported remote work consistent with past exposure to lung carcinogens. This occupational risk would have been undetected by usual history taking methods and highlights the significant limitations of occupational data collection methods by vital registries. PMID- 1790043 TI - Health effects of hazardous chemical waste disposal sites in New Jersey and in the United States: a review. AB - The hazardous chemical waste disposal issue is a widespread problem. Large quantities of chemical wastes have been produced by the chemical industries in the past forty years. Estimates now number disposal sites in the United States at least 30,000. The public and scientists have grown increasingly concerned about the effects of these waste disposal sites not only on the environment, but also on the human body. In this article, we review the number of hazardous chemical waste disposal sites (HCWDS), their construction, difficulties in defining their contents, and the establishment of the Superfund Act. We then discuss various studies in the literature that have attempted to define adverse health effects of HCWDS, particularly those examining Love Canal and sites in New Jersey. In our conclusions, we note the difficulties in establishing direct causal links between HCWDS and dangerous health effects. We suggest that more epidemiological studies are needed, with improved methodology for gathering complete data and studying large samples. Both positive and negative findings of epidemiological studies are important. Positive results will substantiate an association of health effects with HCWDS. Negative results may reduce the concerns of people living near HCWDS. Future investigators need sufficient information about HCWDS materials, possible routes of exposure, and measurements of exposure, as well as sufficient statistical power to detect even modest associations of health effects with HCWDS exposure. PMID- 1790044 TI - Sexual violence against women: prevalence, consequences, societal factors, and prevention. AB - Sexual assault of women in the United States may have a prevalence rate of 25% or more. Moreover, the majority of survivors of sexual assault know their assailants. Consequences of assault may be severe and long-term, including fear and anxiety, depression, suicide attempts, difficulties with daily functioning and interpersonal relationships, sexual dysfunction, and a whole range of somatic complaints. Recent evidence implicates societal factors, such as acceptance of rape myths, rigid sex role stereotyping beliefs, and acceptance of violence as a legitimate means for obtaining compliance in interpersonal relationships, in the etiology of sexual violence against women. I present a model for primary, secondary, and tertiary prevention of rape. Primary prevention represents a program of anticipatory guidance in a developmental framework. Secondary prevention entails identification of and early intervention in dysfunctional families. Tertiary prevention consists of the appropriate treatment of the survivor of sexual assault to prevent or minimize subsequent physical and psychological problems. This preventive framework may be incorporated into the practice of clinical preventive medicine and primary care. PMID- 1790045 TI - Impact of cost problems on morbidity in a hypertensive population. AB - Researchers disagree about the extent to which limited access to health services negatively affects health. In this study, we investigated the association of health status with access to high blood pressure medication among hypertensive respondents drawn from two random household surveys conducted in the state of Georgia during 1981 and 1983. We compared hypertensive respondents reporting difficulties in paying for medication (n = 616) with hypertensive respondents not reporting cost problems (n = 616) who were matched on race, sex, age (+/- 3 years), and per capita family income (+/- $3,000). Because questions were not identical in the 1981 and 1983 surveys, we compared responses of the matched groups separately for each year in the analysis. In the 1981 comparison, a significantly higher (P less than .05) percentage of hypertensive individuals experiencing cost problems reported being in fair or poor health (60.5%) and having had a stroke (11.4%) than those without cost problems (39% for fair or poor health status and 5% for occurrence of stroke). Those with cost problems also reported a higher frequency of cardiac problems (24.6%) than those without cost problems (18.1%), although these differences are not statistically significant (P greater than .05). In the 1983 survey, a significantly larger number of those with cost problems (57.4%) reported being in fair or poor health than those without cost problems (43.1%, P less than .05). PMID- 1790046 TI - Comparative uptake of calcium from milk and a calcium-rich mineral water in lactose intolerant adults: implications for treatment of osteoporosis. AB - Despite the links between low calcium (Ca) intake and age-related bone loss, hypertension, and colon cancer, the majority of Western populations have average daily Ca intakes substantially below recommended daily allowances. Although dietary products are widely known as a rich and valuable source of Ca in the diet, consumption of diary products is low and has been decreasing because of perceptions of excess calories and fat in the diet, as well as taste aversions. During the last decade, a marked increase in the consumption of bottled waters has occurred. Since some of these waters are characterized by high concentrations of Ca, we have studied Ca bioavailability from a Ca-rich water, using 15 lactose intolerant male individuals as subjects, and compared such bioavailability to that from milk. We report herein that the bioavailability of Ca from the water was generally as good as or better than that from milk, a food product well known for its very high Ca bioavailability. Indeed, in eight of 15 subjects, there was a higher level of Ca absorption from mineral water than from milk; bioavailability was equal in five of 15 subjects; in contrast, in two of 15 subjects, the bioavailability of Ca absorption from milk was greater than that from the mineral water. The potential implications of this observation for the prevention and management of age-related bone loss are important for preventive medicine and indicate a new, important source of dietary Ca for lactose intolerant individuals. PMID- 1790047 TI - Results of a national survey of physicians' knowledge and application of prevention capabilities. AB - We used the Comprehensive Prevention Knowledge and Applications Survey Instrument to study health promotion and disease prevention activities of a national sample of 777 family physicians. The study demonstrated active counseling in some areas, such as smoking cessation, but lesser efforts in other aspects, including counseling about smokeless tobacco cessation, seat belt use, sunlight exposure, prevention of AIDS and other sexually transmitted diseases, and preconceptual counseling. Although respondents thought themselves prepared to counsel about prevention efforts, they reported limited success in changing patients' behavior. The physicians documented frequent application of many prevention techniques, and they noted much more frequent use of mammography than has been reported in prior studies. The survey results indicate the need for modification of medical education programs and for enhancement of ability to change behavior to reduce health risks. PMID- 1790048 TI - Effect of coffee on cholesterol and apolipoproteins, corroborated by caffeine levels. AB - The possibility that coffee may increase cholesterol levels has created uncertainty among physicians. The confusion arose from cross-sectional studies, in which female coffee drinkers appeared to show a positive association more frequently than men. To clarify this relationship, we designed an intervention trial to reduce caffeine and coffee intake sequentially while measuring total cholesterol and the apolipoprotein A-I and B levels. We conducted the study among women who were coffee drinkers (n = 35) or not coffee drinkers (n = 28). The trial spanned seven months with caffeine-free and coffee-free intervals. Serum caffeine levels corroborated compliance with the dietary protocol. Analysis of the apolipoprotein levels confirms the absence of any influence of coffee on lipoproteins in normocholesterolemic persons. We observed no apparent causal association of coffee or caffeine consumption and cholesterol and apolipoproteins. PMID- 1790049 TI - Reflotron performance in a community screening program: results of the Massachusetts Model Systems for Blood Cholesterol Screening Project. AB - We evaluated the precision, accuracy, and durability of the Reflotron portable analyzer as part of the National Heart, Lung, and Blood Institute's Model Systems for Blood Cholesterol Screening Program. We conducted screenings in a wide variety of settings in four Massachusetts communities over a 16-month period. Fingerstick samples from 10,428 individuals were tested on the Reflotron at the screening sites. For comparison, we drew venous samples from 972 participants and analyzed them in a reference laboratory, which had met the requirements of the Centers for Disease Control's Lipid Standardization Program. All four Reflotrons tested met the 1988 guidelines for precision and accuracy established by the Laboratory Standardization Panel (LSP) of the National Cholesterol Education Program (NCEP). None of the analyzers consistently met the 1992 LSP standards for precision, although two met the 1992 standards for accuracy. More than 40% of Reflotron values differed from the reference laboratory values by more than 5%. As a consequence, more than 16% of individuals were misclassified in terms of the NCEP risk category into which their Reflotron readings fell. All four instruments malfunctioned at some point during the project, precluding their further usage. We recommend improvements in the precision, accuracy, and durability of this analyzer. PMID- 1790050 TI - Variability in cholesterol measurements in a worksite cholesterol screening program. AB - Worksite cholesterol screening programs are becoming increasingly prevalent. Variability in cholesterol measurements frequently renders the interpretation of single or repeated cholesterol determinations problematic, complicating employee counseling within screening programs. In the setting of a corporate cholesterol screening program, this study quantifies variability in cholesterol measurements and calculates a 90% confidence interval (CI) for cholesterol measurements. We chose 15 men and 15 women to represent a broad range of cholesterol values. We obtained duplicate samples of blood from each subject at one-week intervals for a total of three weeks. We performed total cholesterol measurements in duplicate twice weekly on each blood sample for three weeks, yielding a total of 36 measurements per subject. Components of variability were estimated using a hierarchical random effects analysis of variance (ANOVA) model. The coefficients of variation for biologic and analytic variation were 5.2% and 3.4% for men and 4.7% and 3.2% for women. CIs were +/- 10.2% for men and +/- 9.3% for women. As a result of this variation, we recommend the routine use of CIs when discussing cholesterol measurements with patients. PMID- 1790051 TI - Physicians and exercise promotion. AB - Regular exercise has been associated with numerous health benefits. In response, the promotion of regular exercise for patients has become a recommended component of preventive health care. The extent to which primary care physicians encourage their patients to exercise and the factors associated with exercise promotion are not well elucidated. We surveyed the attitudes and practices of 63 family physicians and 63 internists regarding exercise promotion to patients. We evaluated the associations between demography, cognition, belief, and behavior with exercise promotion. Several factors were associated with physicians' recommending exercise to their patients. A logistic regression model suggests that physicians who have a follow-up plan, who have been in practice over 10 years, who exercise themselves, and who estimate that more than 10% of their patients exercise encourage exercise in greater than or equal to 50% of their patients. PMID- 1790052 TI - AIDS risk behaviors of minority youth living in Detroit. AB - During summer 1989, 30 Hispanic (15 men, 15 women) and 34 African American (17 men, 17 women) adolescents and young adults from Detroit participated in face-to face interviews designed to provide preliminary descriptive data of this population's AIDS and condom knowledge, sexual behavior, and condom and needle use behavior. Results suggest almost all knew that AIDS could be transmitted sexually or by needle sharing, and most participants knew condoms protect against AIDS. Although many sexually active participants reported using condoms, the majority reported engaging in unprotected vaginal intercourse. More Hispanic women reported episodes of unprotected intercourse than any other group. The following results may be useful in designing AIDS prevention strategies. Many participants seemed unaware of the ineffectiveness of nonlatex condoms. Hispanic female participants seemed to have a low level of knowledge concerning their own reproductive health. Small numbers of Hispanic and African American participants reported that people in their neighborhood used needles to self-administer steroids or vitamins. PMID- 1790053 TI - Tuberculosis incidence and the seroprevalence of HIV infection in the United States. AB - Unlike other available studies, this article not only recognizes a human immunodeficiency virus-tuberculosis (HIV-TB) correlation but also shows its strength, statistical significance, and the method of calculation. These results increase comparability of the data on the HIV-TB relationship and allow more accurate analysis for developing better control of the two diseases. This population-based study compares data by states on HIV seroprevalence among 1,799,771 military recruits and the incidence of TB in the general population of the United States in 1987. The corresponding correlation coefficient was 0.8 (P less than .001). Although military recruits do not constitute a random sampling of the population at risk for TB, the high correlation suggests that HIV infection contributes substantially to population-based rates of TB. PMID- 1790054 TI - Personal health habits and mental health in a national probability sample. AB - This investigation examined the relationship between six of seven Alameda County health habits and four dietary practices and three indices of mental health in a probability sample of 2,436 adults 20 to 64 years of age, residing in the coterminous United States. The sample consisted of all respondents to Wave 2 of the National Survey of Personal Health Practices and Consequences conducted in 1980. I found a strong relationship between poor health habits and risk of depressed mood and "nervous breakdown." The magnitude and direction of the association varied by sex, age group, the specific habit examined, and the measure of mental health used. For women, infrequent participation in active sports consistently predicted mental health problems, but was not important for men. In young men, I found no association between health habits and mental health. Dietary practices and mental health generally showed a negative association, especially among men, for whom those reporting good practices had a significantly higher risk of nervous breakdown than those reporting poor practices. PMID- 1790055 TI - Racial and socioeconomic aspects of myocardial infarction recovery: studying confounds. AB - Cardiovascular disease rates illustrate the excess morbidity and mortality associated with race and social class. However, while prevalence and deaths from heart disease are greater among black and lower socioeconomic status (SES) populations, researchers rarely consider possible confounds between race and SES. In a longitudinal study of 246 older myocardial infarction (MI) patients, differences appeared in both morbid events and death for black and lower SES patients. Simultaneous comparison of race and SES showed significantly different outcomes among black low SES, black high SES, white low SES, and white high SES patients that confirmed the predicted ranking of these groups. Low SES black subjects ranked last in physical functioning and cardiac symptomatology, whereas high SES white subjects ranked first in preventive health opportunities. We also considered the potential race-SES confound as an interaction term in multiple regression analysis, and three recovery outcomes were significantly predicted by the joint effects of these variables. These findings demonstrate that failure to consider SES of black and white patients jointly, as well as individually, can lead to erroneous conclusions about health. PMID- 1790056 TI - Preventive medicine residents: a national survey. AB - Little is known about those physicians who pursue graduate medical education in preventive medicine, including aerospace medicine, general preventive medicine and public health, and occupational medicine. We surveyed resident physicians about their academic background, financial environment, clinical activities, and professional goals. A total of 147 residents (30%) responded from a population of 498 residents. The data suggest a lack of available information about preventive medicine training and careers among medical students who subsequently pursue such training. Their economic environment is extremely diverse, with a wide range of salary, "moonlighting" hours, educational loans, and service obligations. Although the median annual salary ($24,700) is similar to the national average resident salary, 32% of respondents earned less than $20,000, and 95% have educational debts averaging $30,900. Sixty-two percent of respondents perform clinical work in their residency, whereas 76% desire future clinical work as part of their practice. This gap is most pronounced in general preventive medicine and public health. The residents express a wide range of interests in future practice of preventive medicine; 54% are interested in government work, and 33% desire academic careers. PMID- 1790057 TI - Cumulative AIDS incidence and altered pneumonia mortality. AB - We grouped New Jersey residents according to age, sex, race, and residence specific cumulative incidence of AIDS since the onset of the AIDS epidemic: less than 15, 15-99, 100-499, and greater than or equal to 500 cases per 100,000 people, respectively. We determined mortality from bacterial and viral pneumonias (International Classification of Diseases [ICD] 480.0-486.9) from underlying cause of death files. Between 1980 and 1986, pneumonia mortality increased from 15.1 deaths per 100,000 per year (95% confidence interval [CI] 10.4, 19.7) to 25.0 deaths per 100,000 per year (95% CI 19.2, 30.8), an increase of 10.0 deaths per 100,000 per year (95% CI 2.6, 17.3), among those 25-44 years of age in the highest cumulative incidence group for AIDS. Increases in other population subgroups were approximately proportional to each subgroup's AIDS cumulative incidence. In particular, pneumonia mortality did not increase among those 25-44 years of age in groups with low cumulative incidence of AIDS. Deficiency of cell mediated immunity, a diagnosis commonly applied in AIDS cases, was listed as a secondary diagnosis in 14% of the pneumonia deaths of persons 25-44 years of age in 1986 and in none of those in 1980. PMID- 1790059 TI - Caring for the victim of sexual assault. PMID- 1790058 TI - AIDS and changing patterns of mortality. AB - We compared changes in all-causes mortality rates, 1986 versus 1980, among members 25 to 44 years of age of demographically defined groups with high AIDS cumulative incidence to the changes among same-age, same-sex members of groups with low AIDS cumulative incidence. Among nonwhite men ages 25-44 residing in northeastern New Jersey (NJ) counties, AIDS cumulative incidence was 1,409 cases per 100,000; all-causes mortality was 413.8 deaths per 100,000 per year in 1980 and increased 74% to 726.6 deaths per 100,000 per year by 1986. In contrast, among white men ages 25-44 residing in other NJ counties, AIDS cumulative incidence was 75 cases per 100,000; all-causes mortality fell slightly from 192.6 deaths per 100,000 per year in 1980 to 189.2 deaths per 100,000 per year in 1986. Among nonwhite women ages 25-44 residing in northeastern NJ counties, AIDS cumulative incidence was 435 cases per 100,000; all-causes mortality was 162.07 deaths per 100,000 per year in 1980 and increased 70% to 276.3 deaths per 100,000 per year by 1986. Among white women ages 25-44 residing in other NJ counties, AIDS cumulative incidence was 9.1 cases per 100,000; all-causes mortality was 90.5 deaths per 100,000 per year in 1980 and fell slightly to 83.0 deaths per 100,000 per year in 1986. A substantial portion of the increased mortality of the groups with high AIDS cumulative incidence resulted from causes that have not been associated with HIV infection. PMID- 1790060 TI - AIDS in communities of color. PMID- 1790061 TI - [How to write and present a scientific work]. AB - The goal of a scientific work is to give to the reader clear information in the shortest time. To achieve this goal depends on the writer's technique and experience. In this article we will review the essential ingredients of a scientific paper, and which is the role of each one. We will also make some comments on lecture presentation and on paper preparation for journal submission. PMID- 1790062 TI - [Morphological evaluation of the organ of Corti of guinea pigs submitted to acoustic trauma. II. Correlations of depth and surface lesions]. AB - Adult guinea pigs (250-500 g) were exposed to a chronic wide-band noise, at intensities ranging from 117 to 133 dB(A) at different times. While the first part of this paper concentrated on the surface study of the lesions produced by noise, this second part describes to correlating deep structural damage, based on the study of semi-thin and ultra-thin sections in the same specimen. Finally, a general discussion is presented with respect to the lesions described, both in so far as their specific characteristics as well as the possible mechanisms of damage which determine their formation. PMID- 1790063 TI - [Primary neuroendocrine carcinoma of the pavilion of the ear]. AB - We present a case of primary neuroendocrine carcinoma (Merkel cell carcinoma) of the external ear and its treatment. This paper also deals with histogenesis, pathology, clinical findings, diagnosis and treatment of this tumor. PMID- 1790064 TI - [Trial of amitriptyline versus flunarizine as treatment of vestibular diseases. A preliminary study]. AB - 109 patients with vestibular disease were included in two different treatments with amitriptyline (Group A:53 patients with depressive symptoms), or flunarizine (Group B: 56 patients). Vertiginous symptoms, basic vestibular exploration, depressive disorder, cochlear symptoms, vegetative disorders and headache were evaluated. Among the patients treated with amitriptyline a significant decrease in the vertiginous symptoms were observed. The possible mechanism of action were analyzed too. PMID- 1790065 TI - [Brain stem auditory evoked potentials in rabbits with hereditary glaucoma associated with hearing loss: morphofunctional correlations]. AB - 32 rabbits suffering from simple hereditary glaucoma were studied from the ophthalmological, otological and histopathological point of view. Gonioscopy, tonometry, ophthalmo- and retinography, otoscopy, tympanometry, ABR and the corresponding histopathological studies of the eye and of the cochlea were performed. The simple hereditary glaucoma seems to be causally related with concomitant hearing loss due to congenital endolymphatic hydrops. Further studies are planed. PMID- 1790066 TI - [Study of histological preparations of laryngeal epidermoid carcinoma using image analysis]. AB - At the present application of quantitative techniques in anatomopathologic studies is becoming more and more frequent, adding the possibility of numeric and quantitative evaluation. In this study the authors make a first attempt with one of these methods, the image analysis using conventional slides of epidermoid carcinomas from larynx. PMID- 1790067 TI - [A comparative study of the efficacy of josamycin versus oral penicillin in the treatment of acute tonsillitis]. AB - We have compared the efficacy josamycin (750 mg/12 h/orally) versus penicillin V (500 mg/8 h) for the treatment of acute tonsillitis in a prospective randomized study. Of the 82 eligible patients, 18 were diagnosed of infectious mononucleosis and excluded and the remaining 64 could be evaluated. The duration of the fever and the clinical evolution was similar away the 31 randomized to receive josamycin and the 27 treated with penicillin. In conclusion, josamycin seems to be a useful alternative to penicillin for the treatment of acute tonsillitis. PMID- 1790068 TI - [Nasal mucociliary function in children with recurrent infections of the airways]. AB - Nasal mucociliary function has been studied in 21 children suffering recurrent airway infections. Previously, cystic fibrosis, immune deficits and allergy were discharged. 38 per cent of these patients had alterations in the mucociliary transport and in this group, it was observed an increase of bronchiectasis, permanent rhinorrhea and serous otitis media. PMID- 1790069 TI - [Solitary extramedullary plasmocytoma of the nasal fossa and paranasal sinuses]. AB - The clinical and morphological features of two patients with solitary extramedullary plasmacytomas of paranasal sinus and nasal cavity are presented. Patients only developed local symptomatology without features of multiple myeloma. They were treated with surgical excision and local radiotherapy. This is the treatment of choice recommended for these localized tumors. Microscopically, one tumor contained a well-differentiated plasma cell population, and the other was made up immature cells. Cytoplasmic staining for IgG was showed in both tumors for immunoperoxidase studies. However, no serum monoclone was detected at the time of diagnosis nor later. Currently, they are alive without evidence of disease 20 and 16 months, respectively, after treatment. PMID- 1790070 TI - [Study of relations between the peripheral organ of olfaction and the olfactory bulb using anterograde and retrograde axon transport of horseradish peroxidase (HRP)]. AB - Utilizing 26 Wistar albino rats, an anterograde and retrograde study has been performed on the connections between the first neuron of the olfactory pathway located in the olfactory epithelium and the second neuron in the glomeruli of the bulb. In the experiment we used horse radish peroxidase (HRP) in free form and combined with wheat lectin. In anterograde transport (epithelium-bulb), the HRP is deposited in preestablished sites in the olfactory epithelium of the nasal fossa. In retrograde transport (bulb-epithelium), HRP combined with wheat lectin is injected by means of a Hamilton microsyringe, glass micropipette and stereotaxic apparatus, in foreseen sites of the glomerular layer of the bulb. PMID- 1790071 TI - [Laryngeal hemangioma]. AB - We present a case of a 59 years-old man with a five months history of hoarseness. The diagnosis was laryngeal hemangioma and the treatment by microsurgery. We expose the different types of laryngeal hemangiomas and the various therapeutic modalities for those unusual tumors in adults. PMID- 1790072 TI - [Histoplasmosis of the oral cavity]. AB - Here is presented a case of a patient with histoplasmosis in the oral cavity a rare disease in our country and whose diagnosis is based upon epidemiological history, serological tests, cultures and hystological study of lymphatic nodes and the hard plate of the palate. Here we will expound upon clinical, diagnostical and therapeutic aspects as applied to our patient. PMID- 1790073 TI - [Incidence and clinical manifestations of arterial complications of liver transplantation. Personal experience with 57 transplants]. AB - The vascular complication remains one of the main cause of graft failure after orthotopic liver transplantation (OLT). Its incidence has been documented between 5-18%. Due to its lethal evolution, the early diagnosis and emergency treatment are crucial: early retransplantation, arterial reconstruction. Seven out of 57 OLT (12.2%) performed in 53 patients developed arterial complications: 4 arterial thrombosis (7.0%),--3 were retransplanted--; 3 ruptured arterial aneurysms and 1 child who developed hemobilia secondary to an arterio-biliary fistula. The clinical presentation of hepatic artery thrombosis was related with the post transplant time. Due to the variability in the clinical presentation of this complication, angiographic study should be performed in any episode of unexplained graft dysfunction. PMID- 1790074 TI - [Jaundices in pregnancy]. AB - There are three types of disorders which may produce jaundice during pregnancy: 1) acute or chronic coexistent or pre-existent liver disease (acute and chronic hepatitis, liver cirrhosis etc.), 2) acute and chronic hemolytic disorders, 3) jaundice directly or indirectly related to pregnancy. Among the later group, intrahepatic cholostasis, gravidic hyperemesis with jaundice represent exacerbations of physiologic gravidic cholostasis. Hepatic steatoses of pregnancy are the result of toxic metabolites or drugs on the liver parenchyma. Severe forms of eclampsia may induce jaundice of hemolytic and parenchymal origin. Hypercoagulability may also induce, in the first post-partum days Budd-Chiari's syndrome with accompanying jaundice. PMID- 1790075 TI - [Gigantic diverticulum of the colon. A complication of diverticulosis?]. AB - We present a patient affected of diverticular disease of the colon, with diverticulosis and two giant diverticula of the sigma, both located at the mesenteric edge. We would like to stress the low incidence of reports about this entity in the medical literature, its uncommon location and the fact of a double lesion coinciding in a single patient. We discuss the most important nosocomial aspects and the different diagnoses. Finally, we support the idea of distinguishing three different entities that in the medical literature are usually unified as a single "giant diverticulum of the colon". We reaffirm ourselves on the importance of an early diagnosis and a correct indication for surgery. PMID- 1790076 TI - [Amyloid colitis]. AB - A patient is reported who had urolithiasis and pyonephrosis of the right kidney. In the terminal phase of his disease he developed chronic diarrhea and hematochezia. Sigmoidoscopy showed changes in the colo-rectal mucosa compatible with ulcerative colitis with moderate activity. Histology demonstrated large amyloid deposits of the AA type in the lamina propia around the vessels and with atrophy and ulceration if the epithelium. PMID- 1790077 TI - [Renal amyloidosis in a case of Crohn disease with colonic and rectal involvement]. AB - A clinical case characterized by renal amyloidosis, Crohn's disease of the colon and rectum, multiple chronic anal fistulae and ankylosing spondylitis is reported. This association has been infrequently recognized. In this patient Crohn's disease became manifest at 20 years of age and underwent a chronic and relapsing course. Proteinuria and renal amyloidosis were detected after eight years of evolution. Panproctocolectomy was performed. The patient progressed satisfactorily and six months later he remains asymptomatic, free from medication and with normal creatinine clearance. The authors recommend early surgical treatment on the diseased intestinal segment once the association has been diagnosed and before serious impairment of renal function has occurred. PMID- 1790078 TI - [Multilocular peritoneal inclusion cysts in puerperium]. AB - We report the case of a 26 year old female with low abdominal pain occurring post partum. Ultrasonography revealed the existence of pelvic cysts. Laparotomy allowed the resection of the cysts interpreted at that time as hydatic cysts. Four months later the patient was readmitted because of a recurrence of the cysts. Pathological examination made the final diagnosis of multilocular peritoneal inclusion cysts. The literature on this rare condition, previously denominated cystic benign mesothelioma, is reviewed. Recurrence may be prevented by the use of sclerosing agents during the surgical intervention. PMID- 1790079 TI - [Monoctanoin for the dissolution of biliary calculi. Report of a case]. AB - The authors present a case report of a cholecystostomized high surgical-risk patient with gallstones in gallbladder and biliary duct treated with continuous monoctanoin infusion through a Pezzer's tube. They analyze the biological characters of such substance as solvent agent, its management and the results of treatment. PMID- 1790080 TI - [The anatomic description of the pelvic floor muscles from Galeno through Holl]. PMID- 1790081 TI - [Free ileal perforation as first symptom of Crohn disease]. PMID- 1790082 TI - [Massive lower digestive hemorrhage caused by cavernous hemangioma of the jejunum]. PMID- 1790083 TI - [Leiomyosarcoma of the duodenal bulb. Presentation of a case with digestive hemorrhage and abdominal mass]. PMID- 1790084 TI - [Infrequent cause of upper digestive hemorrhage: systemic mastocytosis]. PMID- 1790085 TI - [Barrett esophagus as precancerous lesion]. AB - The incidence of Barrett's esophagus is still little known. Our objective has been to study the incidence of this lesion in our environment as well as the frequency of malignant degeneration in our endoscopic material. Among 12,450 upper digestive endoscopies done in the past 7 years, 945 instances of peptic esophagitis have been diagnosed (7.59%). Among them, 172 cases of endobrachiesophagus (Barrett's esophagus) were detected (1.38% of the entire endoscopy series and 18.2% of all cases of esophagitis). Twenty two of th 172 patients with Barrett's esophagus were diagnosed as having carcinoma (12.79%). Barrett's esophagus is a frequent complication of peptic esophagitis and as the possibilities of malignant changes are as high as 12.79 it should be considered as a precancerous lesion and monitored as such. PMID- 1790086 TI - [Comparative study of sucralfate and ranitidine in the treatment of bleeding duodenal ulcer]. AB - Sixty patients with bleeding duodenal ulcers were randomized to treatment with sucralfate or ranitidine. Endoscopy was performed in all patients within 24 hours from admission. Acute phase outcome was similar in both groups. Four patients in the sucralfate group and 1 patient in the ranitidine group rebled and required surgical treatment (NS). Healing rate at 6 weeks was 88% with sucralfate and 96.6% with ranitidine. Relapsing rate without maintenance therapy at 6 and 12 months was 21.1% and 42.1% for sucralfate-treated patients and 33.3% and 56.5% for ranitidine-treated patients (NS). Sucralfate-treated patients had a significantly lesser relapsing rate at 12 months compared to ranitidine treated patients, in the smokers group. PMID- 1790087 TI - [Comparative study of 3 drugs (aceglutamide aluminum, zinc acexamate, and magaldrate) in the long-term maintenance treatment (1 year) of peptic ulcer]. AB - In a multicentre study, 146 peptic ulcer patients who had recently healed with H2 antagonists (38 gastric, 108 duodenal ulcers) received randomly for a year one of the following mucosal protecting antiulcer drugs: aceglutamide aluminium salt (AAL), zinc acexamate (ZAC) and magaldrate (MAG). Forty six patients received AAL (700 mg bid), 50 patients received ZAC (300 mg at single nocturnal dose) and 50 patients received MAG (800 mg bid). An endoscopic examination was performed at the beginning of the study and 12 months later. Clinical examinations where performed on months 3, 6 and 9, advancing the endoscopical control in case of ulcer symptoms. ZAC showed to be superior to MAG (p less than 0.05, chi-square test) in preventing relapses, with a favourable tendence in front of AAL, but without reaching statistical significance. Its important to mention the high number of withdrawals and the good tolerance of the treatments. PMID- 1790088 TI - [Retrospective study of Crohn disease at a hospital in Andalucia (1978-1988)]. AB - We reviewed 46 cases of Crohn's disease diagnosed during the period between 1978 1988, with the intention to analyse the age, sex, presentation, evolution, complications and diagnosis. The majority of patients were women, with a mean age of 39. In the last years we have seen an increment in our number of cases. The mean time to diagnosis was about 3.5 years. The main symptoms were abdominal pain, diarrhoea and loss of weight. The complications was of 40% in colonic disease and 75% when the affection was in ileum and colon. During the evolution 4 patients died, 2 of them from their Crohn's disease. One patient had a colonic carcinoma. In 15% of the cases there was a previous appendectomy. The most frequent radiological findings were in the small intestine: lack of haustration and cobblestone appearance. In the colon: lack of haustration and ulceration. The most frequent endoscopical findings were ulcers and a cobblestone appearance. PMID- 1790089 TI - The international scene: the nurse practitioner in the United Kingdom. PMID- 1790090 TI - Professionalism of nurse practitioners. AB - Little information is presently available about the professionalism of nurse practitioners (NPs). Nor do we know what degree of professionalism is actually exhibited by NPs. Nurse practitioners in this study scored moderately professional. The highest level of education attained had no relationship to degree of professionalism. With increasing age and number of years in practice, NPs expressed a greater degree of professionalism. Nurse practitioners need to continue their development of professionalism, both as individuals and as members of groups and/or organizations. Recommendations for practice, education, and research are discussed. PMID- 1790091 TI - Venous ulcers: a nursing challenge. AB - The prevalence of individuals with venous ulcers is estimated to be over 500,000 in the United States. Management should be based on an understanding of the pathophysiology of venous insufficiency and venous ulcers. This article presents a review of the anatomy venous system of the lower leg and the pathophysiology of venous insufficiency. In addition, a current theory of the etiology of venous ulcers, their complications, and management options are discussed. Emphasis is placed on patient education, compression therapy, and dressing choices. PMID- 1790092 TI - Maternal concerns during the early postpartum. AB - The trend toward shortened, postpartum hospitalization has greatly reduced the time available to teach child care and parenting techniques to new mothers. This study surveyed 120, low-risk mothers during the early postpartum period to identify their concerns and learning needs. During home interviews, a card-sort tool and questionnaire were used to gather information. Frequencies for family, mother, and infant items are listed. Participants were worried about family finances, meeting the needs of everyone at home, and being a good mother. They were also interested in learning more about their infant. PMID- 1790093 TI - Predictors of a health-promoting life-style among well adult clients in a nursing practice. AB - The self-reported health-promoting life-style (HPL) of 130 well adults in a primary care clinical population was examined in relation to the cognitive/perceptual and sociodemographic factors hypothesized in Pender's Health Promotion Model (1987) to predict this behavior. Subjects were randomly drawn from the clients of a group nurse practitioner practice emphasizing health maintenance. Data were collected by mailed survey (response rate, 59%) with one telephone prompt. The mean age of the subjects was 39.7 years; 72.3% were female; 51.2% were married; 47.7% had college degrees; and 67.4% were white. Blacks were underrepresented in the sample compared to the practice population (chi = 7.56, p = .006). Using multiple regression, the definition of health, importance of health, health locus of control, age, gender, marital status, race, education, income, and rural/urban residence were studied to determine their effects on health-promoting behavior. Results generally supported the Pender Model. Defining health eudiamonistically, that is, as exuberant well-being (rather than adaptive, functional, or absence of disease), predicted HPL. Ranking health above other values such as achievement and harmony had no effect; chance health locus of control had a negative relationship. In the final regression model, predictors of HPL were eudiamonistic conception of health and college education (p = .0001, R2 = 17). Based on this data, considerations of a clients' health conception when framing health-promotion messages is warranted in this population. PMID- 1790094 TI - Battering in a population of adolescent females. AB - The purpose of this study was to assess the prevalence of battering in a population of adolescent females, to gain information regarding the impact of battering on their health, and to test a portion of the Campbell and Humphreys (1984) framework, which states that our patriarchal society and the resulting machismo attitudes toward women are the cause of battering. If the framework is correct, partners who batter would possess characteristics indicative of machismo. The sample for this descriptive study consisted of a convenience sample of 59 females from a shelter for displaced teens. The subjects provided information on themselves and 92 male partners via interviews. Of 59 subjects, 69% had been battered before the age of 18 and 41.5% had been battered during pregnancy. Health care problems were frequent in all the subjects, especially depression and suicidal ideation. The nonbattered and battered subjects as well as their partners were compared with respect to several demographic variables. There was a statistically significant higher rate of reported qualities of machismo among batterers when compared with nonbatterers. Recommendations include suggestions for further research. PMID- 1790095 TI - Polymyalgia rheumatica. PMID- 1790096 TI - Comprehensive health care reform: how close are we? PMID- 1790097 TI - The doll hospital. PMID- 1790098 TI - The Council of Clinical Nurse Specialists (CNS) and the Council of Primary Health Care Nurse Practitioners (PHCNP) merge to form the Council of Nurses in Advanced Practice. PMID- 1790099 TI - The University of Rochester Pain Center's Second Annual Hugh Cumming Memorial Teaching Day on Cancer Pain. The war on drugs versus the war on cancer pain. PMID- 1790100 TI - Evaluation of the cancer patient in pain. PMID- 1790101 TI - Listeria monocytogenes. Recommendations by The National Advisory Committee on Microbiological Criteria for Foods. PMID- 1790102 TI - Borrelia burgdorferi: another cause of foodborne illness? AB - Borrelia burgdorferi was identified as the etiological agent of Lyme disease in 1982. This Gram-negative spirochete is classified in the order Spirochaetales and the family Spirochaetaceae. The pathogen is fastidious, microaerophilic, mesophilic and metabolises glucose through the Embden-Meyerhof pathway. A generation time of 11 to 12 h at 37 degrees C in Barbour-Stoenner-Kelly medium has been reported. Lyme disease, named after Lyme in Connecticut, is distributed globally. It is the most commonly reported vector-borne disease in the United States, where the incidence is highest in the eastern and midwestern states. Since establishment of national surveillance in 1982, there has been a nine-fold increase in the number of cases reported to the U.S. Centers for Disease Control. The deer tick of the genus Ixodes is the primary vector of Lyme borreliosis. The tick may become infected with B. burgdorferi, by feeding on an infected host, at any point in its 2-year life cycle which involves larval, nymphal and adult stages. The infection rate in deer ticks may be as high as 40% in endemic areas. The primary vertebrate reservoirs for Ixodes are the white-footed mouse (Peromyscus leucopus) and the white-tailed deer (Odocopileus virginianus). Dairy cattle and other food animals can be infected with B. burgdorferi and hence some raw foods of animal origin might be contaminated with the pathogen. Recent findings indicate that the pathogen may be transmitted orally to laboratory animals, without an arthropod vector. Thus, the possibility exists that Lyme disease can be a food infection. In humans, the symptoms of Lyme disease, which manifest themselves days to years after the onset of infection, may involve the skin, cardiac, nervous and/or muscular systems, and so misdiagnosis can occur. PMID- 1790103 TI - An investigation of the effects of four variables on the growth of Salmonella typhimurium using two types of gradient gel plates. AB - The effect of four variables (pH, temperature, sodium chloride concentration and sodium nitrite concentration) on the growth of Salmonella typhimurium CRA663 was investigated using a two-dimensional gradient gel technique. Two methods were used. In the first method the gradients comprised NaCl and pH and in the second method a temperature gradient incubator was used to produce a temperature-pH gradient. Using image analysis, the growth on the plates was depicted as three dimensional wire frame graphs. At neutral pH and in conditions of low salt, growth was observed over the temperature gradient range of 14-41 degrees C. The optimum growth range was reduced to 21-29 degrees C in conditions of acid pH and/or increased NaCl concentration. The growth on the temperature-pH gradient plates had an irregular surface appearance suggesting that changes in growth rate were occurring at different points of temperature and pH. The effects of increased salt concentration together with acidic pH increased the inhibitory effect of the sodium nitrite. The gradient gel plate technique may be a means of rapidly screening the effect of multiple variables on the growth on microorganisms that may be found in food. PMID- 1790104 TI - Nutritional quality of lupine (Lupinus albus cv. Multolupa) as affected by lactic acid fermentation. AB - The effects of selected NRRL strains of Lactobacillus acidophilus, L. buchneri, L. cellobiosus and L. fermentum upon oligosaccharide, phytate and alkaloid contents, as well as on the nutritive value of lupine, were investigated. Lupine was processed to a 12% total solids suspension, inoculated with 1% (v/v) cultures and fermented until a final desired pH of 4.5. L. acidophilus B-2092 and L. buchneri B-1837 growth was related to a significant sucrose breakdown and decreases of phytates, whereas L. acidophilus B-1910 and L. fermentum B-585 reduced the content of flatulence oligosaccharides. The activity of L. acidophilus B-1910 was particularly associated with lowering of alkaloids and increase of riboflavin. Lactic acid fermentation produced slight changes in lysine and methionine contents. No significant differences in net protein ratio values and protein digestibility were found between fermented and unfermented lupine (P less than 0.05). A 1:1 ratio mixture of B-1910 and B-2092 strains of L. acidophilus lead to a final fermented lupine with nutritional advantages to those given by the individual cultures. PMID- 1790105 TI - Growth inhibition of Listeria spp. on Camembert cheese by bacteria producing inhibitory substances. AB - Bacterial strains exhibiting antimicrobial activity towards other bacteria are quite common in nature. During the past few years several genera have been shown to exert inhibitory action against Listeria. spp. In the present work strains of Enterococcus, Lactobacillus and Lactococcus were tested for their influence on the development of Listeria spp. on Camembert cheese. Partial or complete inhibition of growth of Listeria spp. was observed using various inhibitory bacteria. Complete inhibition occurred when the inhibitory strain was used as a starter culture and there was a low level of contamination with Listeria spp. during the first stage of ripening. Very little inhibition occurred if the inhibitory strain was added together with the starter culture. PMID- 1790106 TI - Use of pulsed field gel electrophoresis to compare large DNA-restriction fragments of Listeria monocytogenes strains belonging to serogroups 1/2 and 3. AB - Thirty-five Listeria monocytogenes strains belonging to serogroups 1/2 and 3 and isolated from various origins were characterized by whole cellular DNA restriction patterns using low-frequency cleavage enzymes and pulsed field gel electrophoresis. Seventeen restriction profiles were detected with ApaI, 18 with SmaI and 15 with NotI, the combination of these patterns allowing one to define at least 24 distinct groups within the 35 strains. The significant genomic diversity pointed out by this method can be of value in the epidemiological fingerprinting of L. monocytogenes. PMID- 1790107 TI - Comparison of four kits for the detection of staphylococcal enterotoxin in foods from outbreaks of food poisoning. AB - Four commercial kits, three based on sandwich ELISA techniques and one on latex agglutination were compared for the detection of staphylococcal enterotoxins in foods from outbreaks of food poisoning. Enterotoxin was detected in 14 of 18 foods with the Swiss SET-EIA and in 9 or 10 with the Unipath SET-RPLA and two ELISAs from Transia. The advantages and disadvantages of the four methods are discussed. PMID- 1790108 TI - Fate of unirradiated Salmonella in irradiated mechanically deboned chicken meat. AB - Mechanically deboned chicken meat was irradiated at 0, 1.25 and 2.50 kGy (Cesium 137) and inoculated with Salmonella dublin ATCC 15480, Salmonella enteritidis ATCC 9186 or Salmonella typhimurium ATCC 14028. Samples were then stored at 5 degrees C and 10 degrees C and were subjected to microbiological analysis directly after irradiation and inoculation (time 0), and after 24, 72, 120, 168 and 216 h of storage. Samples stored at 20 degrees C were examined at time 0 and after 6, 12 and 24 h of storage. Irradiation at 1.25 and 2.50 kGy caused an average reduction in bacterial levels of 2.23 and 3.44 logs, respectively. S. dublin, S. enteritidis and S. typhimurium showed very small, insignificant changes in numbers, during storage of meat for 9 days at 5 degrees C. The final populations of S. dublin and S. typhimurium in samples irradiated before inoculation and stored at 10 degrees C or 20 degrees C were greater than the equivalent populations in samples which had not been irradiated before inoculation. Reduction of indigenous microflora in mechanically deboned chicken meat by irradiation may create better conditions for the growth of salmonellae and may thus increase the risk of salmonellosis when accidental contamination and temperature abuse occur after a radiation treatment. Therefore, irradiated mechanically deboned chicken meat should be properly refrigerated and protected against contamination. PMID- 1790109 TI - Feasibility of a reference material for staphylococcal enterotoxin A. AB - A reference material for staphylococcal enterotoxin A (SEA), was produced by spray-drying the toxin in milk. With this procedure the SEA was distributed homogeneously in the material. For ease of handling the reference material was encased in gelatin capsules, each containing 405 ng of SEA. Simply dissolving the milk powder in distilled water resulted in a 100% recovery of the SEA present. The reference material would appear suitable for testing laboratory performance, comparison of detection methods and to validation of extraction procedures. PMID- 1790110 TI - Minimal water activity for growth of Listeria monocytogenes as affected by solute and temperature. AB - Two strains of Listeria monocytogenes, Scott A (serotype 4b) and Brie 1 (serotype 1b) were characterized in terms of minimum aw requirements for growth at 4 and 30 degrees C, using NaCl, glycerol and sucrose as test solutes. Both strains grew well at 30 degrees C in glycerol-supplemented tryptic soy broth (TSB), but not in NaCl- and sucrose-supplemented TSB at aw 0.90. Sucrose was more inhibitory than NaCl and glycerol. The Brie 1 strain was less tolerant to sucrose compared to the strain Scott A at both 4 and 30 degrees C. The effects of all three solutes were magnified at 4 degrees C, where tolerance to low aw was markedly less than at 30 degrees C. Results confirm that the type of solute as well as the osmotic conditions created by the solute affects the ability of Listeria monocytogenes to grow at 4 and 30 degrees C. PMID- 1790111 TI - Phase contrast cine magnetic resonance imaging. AB - Phase contrast cine magnetic resonance imaging (MRI) combines the flow-dependent contrast of phase contrast MRI with the ability of cardiac cine imaging to produce images throughout the cardiac cycle. Two pulse sequence types are used for sensitivity to flow in one direction, whereas four are needed for sensitivity in all directions. Several alternatives for synchronization of the data to the cardiac cycle exist. Retrospectively interpolated methods can image the entire cardiac cycle efficiently. Rapid interleaving of the various sequence types ensures immunity to motion misregistration. The technique produces images in which contrast is related to flow velocity as well as magnitude images such as those of conventional cine MRI. The data can be interpreted qualitatively to demonstrate the presence, magnitude, and direction of flow, and quantitatively to provide estimates of flow velocity, volume flow rate, and displaced volumes. Phase contrast cine MRI is helpful in the diagnosis of aortic dissections, in the study of flow distributions in large vessels such as pulmonary arteries, as well as in smaller vessels such as carotid and basilar arteries, and in the evaluation of complex anatomical variants. Future developments are expected to reduce imaging time and expand the quantitative applications. PMID- 1790112 TI - Magnetic resonance imaging for assessment of myocardial function. AB - It is likely that, as the field progresses, cardiac magnetic resonance imaging (MRI) will become the definitive reference imaging method for evaluation of myocardial function. The first phase of development in the field has emphasized replication and improvement of commonly used methods for analysis of global ventricular pump function, global ventricular mechanics, and regional myocardial performance. Thus, validated MRI methods exist for assessment of ventricular end diastolic and end-systolic volume and ejection fraction. Similarly, standard methods for evaluation of myocardial mean wall stress can be applied to evaluation of afterload as a determinant of ventricular performance. Regional function of myocardium can be evaluated using either regional endocardial motion or regional wall thickening. In addition, recent development of novel methods for assessment of local myocardial motion by tracking motion at fixed points in the tissue over the cardiac cycle has attracted interest from the cardiovascular research community. These methods, such as radial stripe myocardial tagging and spatial modulation of magnetization, have already provided unique and incisive new information on segmental myocardial performance in normal and diseased hearts in experimental models and in man. The most important limitation of cardiac MRI for assessment of cardiac function continues to be long image acquisition times. The advent of real time methods, with further development, should address this problem. PMID- 1790113 TI - Differential diagnosis of hepatic neoplasms: spin echo versus gadolinium diethylenetriaminepentaacetate-enhanced gradient echo imaging. AB - Early results are reported of hepatic neoplasms studied with dynamic gadolinium diethylenetriaminepentaacetate (Gd-DTPA)-enhanced magnetic resonance imaging (MRI). The purpose of this study was to evaluate the potential of the Gd enhancement pattern for characterizing these neoplasms and to compare the performance of spin-echo (SE) to SE plus dynamic Gd-enhanced gradient-echo (GRE) pulse sequences. Forty-two patients with hepatic neoplasms were examined at 1.5 T field strength. In each patient, short and long repetition time/echo time (TR/TE) SE images were obtained, followed by pre- and post-Gd-DTPA (0.1 mmol/kg body wt), single-slice, breath-hold (13 s/scan) GRE images, which were serially acquired less than or equal to 12 min postinjection. The patterns of contrast enhancement of the various hepatic lesions were documented and analyzed. The time to peak Gd signal enhancement-to-noise ratio (SE/N), contrast-to-noise ratio (C/N), contrast (defined as the signal intensity ratio [SIR]), as well as the peak values of these quantities, were determined. The C/N and SIR values on the short and long TR/TE SE and pre-Gd GRE images for all hepatic neoplasms were also obtained. The discriminating abilities (hemangiomas vs. malignant neoplasms) of these quantities were analyzed statistically. In addition, the impact of lesion characterization on the SE versus the SE plus the Gd-enhanced GRE scans was assessed by means of a blinded reader study. Malignant hepatic neoplasms could be differentiated from hemangiomas by visual inspection of their enhancement patterns (p = 0.0009), by the time to peak C/N on Gd-enhanced images (p = 0.0002), and by the magnitude of such peak (p = 0.02). Combined SE + Gd-enhanced GRE scans afforded minor, though statistically significant (p less than 0.01), improvement of the accuracy in differentiating benign from malignant hepatic neoplasms. Late scans (12 min post-Gd) may be particularly useful in identifying hemangiomas that, unlike other neoplasms, have a significant high signal of their enhancing portions on such images. PMID- 1790114 TI - [Paul Giroud (1898-1989)]. PMID- 1790115 TI - [New pathogenetic aspects of the relations between viral and microbial infections and peripheral vasculopathies]. AB - The immunofluorescence technique using antisera against some viruses and inframicrobes allowed the detection of pathogens in altered vascular tissues (arteritis and phlebitis-phlebectasia). Pathomorphological aspects and some dehydrogenase activities in these patients were also investigated. PMID- 1790116 TI - [Differences in the susceptibility to HIV infection in children as a function of sex and ethnicity]. AB - The study was conducted on 114 children (87 Romanians and 27 Turks) from an orphanage in Romania, where an AIDS outbreak was recorded due to parenteral contamination through blood transfusion or injection. The average age of the 53.5% seropositive children was of 27.63 +/- 7.88 months, versus 37.03 +/- 10.01 months in seronegative ones. The seropositivity rate was higher in Romanian children and among girls. The antibody profile in Western Blot showed that gag and pol genes specified stripes were less frequent in Turkish children. PMID- 1790117 TI - [The involvement of microbes in the etiology of respiratory diseases in infants 0 to 12 months old]. AB - A study was worked out on the etiopathogenic relations and a more exact evaluation of the incidence of some agents: viruses, chlamydiae, mycoplasmas and rickettsiae, in the respiratory diseases of 0- to 12-month-old children. Serological analysis and immunofluorescence examination of pharyngeal cells were done. Results showed that parainfluenzae and respiratory syncytial viruses, chlamydiae, rickettsiae and mycoplasmas had an important part in the outbreak and maintaining of severe respiratory diseases in the 0- to 12-month-old children population. PMID- 1790118 TI - The control of some viral epidemics by antiepidemic programmes elaborated by an expert system. AB - A base of data for viral epidemiological studies is presented containing correlation between outer symptoms (observable characteristics of the mass morbid phenomena), inner symptoms (characteristics of intensity of elementary processes implied in the virosis propagation) and influencing factors (risk or protective ones). A resolutive nucleus of processing these is divided in to three parts: an inductive one (specification of the mentioned correlations, of the mathematical model and its equation solutions); a deductive one (explaining or prognosing the epidemiological evolution); a decisional one (specifying the antiepidemic services, necessary for a possible or desired reduction of the morbidity). PMID- 1790119 TI - [The incidence of anti-HIV antibodies in hospitalized patients in a tuberculosis clinic]. AB - HIV antibody prevalence was studied in 1274 patients, including 150 children, hospitalized in phthisiology services. The sixteen EIA positive samples were confirmed by the Western blot test (1.25%). The other seventeen EIA positive samples gave undetermined results in W.B. In children, antibody incidence was 7.33% versus 0.45% only in adults: this ratio seems to be characteristic for AIDS endemia in Romania, where parenteral transmission is the quasi unique way of HIV infection dissemination in children. The presence of nonspecific multiple bands in the gp 41 region was noted on seven of the seventeen undetermined samples, which is to confirm the reports about the presence of W.B. detectable anti-HIV antibodies cross-reacting with anti-mycobacterial antibodies. PMID- 1790120 TI - [Serological studies for the presence of arboviruses in the forest-steppe region of Tulcea]. PMID- 1790121 TI - [Biotin-T-(G). Its synthesis and use in virology]. PMID- 1790122 TI - Laboratory diagnosis of sporadic cases of acute respiratory virus diseases. PMID- 1790123 TI - Potential antiviral activity of copper complexes, derived from symmetrical triazines hydrazones. PMID- 1790124 TI - [Viruses and pathology of the buccal mucosa]. PMID- 1790125 TI - [The buccal lesions during the evolution to HIV]. PMID- 1790126 TI - [Tumor necrosis factor or cachectin]. PMID- 1790127 TI - Electroencephalographic abnormalities in 351 Nigerians with epilepsy. AB - A review of the electroencephalographs of 351 epileptic patients admitted to the Ahmadu Bello University Teaching Hospital, Kaduna from March, 1982 to November, 1984 is presented. Those under 20 years age group predominated in the cohort studied. The frequencies of generalised epilepsy and partial epilepsy were almost equal. Partial epilepsy with complex symptomatology was common and petit mal was relatively rare. The inter-ictal EEG record was normal in 35.6% who were usually young and presumably suffered from idiopathic epilepsy. Differences existing in the EEG records reported and those reported in Nigeria and elsewhere are discussed. The need for an epidemiological study of the general population in the Northern Nigeria is emphasized. PMID- 1790128 TI - Priapism: experience with the caverno glandular shunt. AB - Twenty cases of Priapism were managed surgically over a 3-year period with the A1 Ghorab modification of the caverno-glandular shunt. The procedure was simple and short. Except for post-operative bleeding in 2 patients, no major complications were encountered. Post-operative potency rate of 39 per cent was achieved. Late presentation and repeated previous episodes may have contributed to this low potency rate. PMID- 1790129 TI - Human retinol-binding protein: its relationship to renal function in renal diseases. AB - Human Retinol-binding protein (RBP) was measured in serum and urine of 30 healthy volunteers and 66 renal disease patients with varying degrees of renal insufficiency in order to establish its clinical relevance in evaluating renal function. 24-hour creatinine clearance (Ccr) was used to assess renal dysfunction in all cases, and the serum RBP related to Ccr. There was a good correlation between serum RBP and creatinine (r = 0.80, n = 96, p less than 0.001) and, on logarithmic scale, between serum RBP and Ccr(r = 0.77, n = 80, P less than 0.001). Serum RBP was more sensitive in detecting early changes in glomerular filtration than serum creatinine and it is suggested that RBP may be useful in predicting glomerular filtration rate without the need for a 24 hour or time urine collection. Urinary excretion levels of RBP may also be useful in monitoring renal tubular function. It is concluded that RBP is useful in assessing renal function for the purposes of diagnosis and monitoring the course of progression of renal disease. PMID- 1790130 TI - Pterygium in Ibadan. AB - This is a retrospective study of 500 eyes of 400 patients with pterygium seen over a 3 year period to determine the clinical presentations and outcome of surgery. The study showed that it was a fairly common eye condition in the south western part of Nigeria. It formed 9% of all new cases seen in the eye clinic of the University College Hospital, Ibadan and 20% of all planned ocular surgery in the same hospital. 70% of patients studied came to hospital because of the growth in their eyes. 80% of the pterygia were large, fleshy type in the nasal position. 65% of patients were outdoor workers. Surgical excision was by the 'Bare sclera' method. 40% of these patients had a recurrence of the growth. There is need to modify the available surgical method commonly performed at the University College Hospital and introduce B irradiation treatment to reduce the recurrence rate. PMID- 1790131 TI - Epidemiologic survey of menstrual patterns amongst adolescents in Nigeria. AB - Nine hundred and fifty secondary school girls aged between 10 and 18 years were randomly selected and surveyed. Information on their age at menarche, regularity of menstruation at onset and the time of survey and length of period of irregularity were sought using a well structured questionnaire. Estimation of blood loss per period premenstrual symptoms and signs, prevalence and severity of dysmenorrhoea were also inquired about. This study demonstrated a secular trend in the age at menarche when compared with other similar studies conducted in the previous decade in Nigeria. A higher prevalence of 71.8% of any grade of dysmenorrhoea was found in this study when compared with figures from developed countries, this and the short mean duration of irregular menstruation (3.7 months after menarche) were taken to be evidence of early establishment of regular ovular menstruation. PMID- 1790132 TI - Glucose tolerance during experimental tetanus toxicity in rabbits. AB - Tetanus was induced in rabbits by injection of high doses of purified tetanus toxin. After the induction of tetanus, the fasting blood glucose level was significantly elevated in the rabbits with tetanus--blood glucose level being 137.5 mg% compared with 114.8 mg% in controls. The Glucose tolerance showed the expected curve in control rabbits while in the rabbits with tetanus, there was a continuous rise in blood glucose levels even after 3 hours. Histological studies show degranulation of the beta cells of the pancreas in the tetanus rabbits. Thus, the high fasting blood sugar level and the diabetic pattern of Glucose tolerance observed in the tetanus animals are suggestive of reduced insulin production during tetanus, as part of the mechanism involved. PMID- 1790133 TI - Lung function in young Nigerian adults. AB - Static and dynamic long volumes have been measured in 181 (123 males and 58 females) apparently healthy Nigerian adults. The age range in both sexes was between 17 and 34 years (22.0 +/- 3.2 years in males and 21.3 +/- 3.2 years in females). In the male subjects mean height, weight and body surface area were 170.0 +/- 6.0 cm, 62.0 +/- 8.5 kg and 1.72 +/- 0.19 m2 respectively. In the female subjects mean height, was 162.3 +/- 15.3 cm, mean weight was 57.2 +/- 8.4 kg and mean body surface area was 1.60 +/- 0.12 m2. In both sexes, caucasian prediction formulae overestimated the TLC, FVC and RV/TLC% of the subjects. Observed FEV % in our subjects was higher than in the caucasians. The elevated FEV1 % and reduced FVC, RV/TLC % and TLC in Nigerian subjects may suggest and increased elastic recoil of the lungs and chestwall in them. Regression coefficients and constants for predicting TLC, FVC, FEV1, IC, ERV and RV in Nigerian subjects are presented. PMID- 1790134 TI - Typhoid fever masquerading as functional psychosis. AB - While acute confusional states are frequently encountered in typhoid fever, initial manifestation of this illness as "functional psychosis" is very rarely encountered. We describe our experience of three patients seen within a 15-month period, who initially presented as various forms of psychiatric disorders with little evidence of impairment of consciousness, well before the appearance of pyrexia which led to the correct diagnosis. The possible role of less severe or self limiting organic conditions in the genesis of "functional" psychosis in the African population is discussed. The importance of a high index of suspicion in the functional-type psychosis, that might be due to typhoid fever and the need to institute therapy for typhoid fever while investigating (the late appearing fever) in such cases are emphasized. PMID- 1790135 TI - An orbital teratoma operated on the 2nd day after birth--a case report. AB - This is a case report of an intraorbital tumour found soon after delivery in otherwise normal girl. The clinical manifestation were so intensive that the operation was performed within 24 hours after birth. Histologically a benign teratoma presenting almost all possible tissues was diagnosed. In the follow up the girl's bilateral eye-function was satisfactory and she was doing well. PMID- 1790137 TI - Immunological effects of levamisole in vitro. AB - Levamisole, an anthelminthic drug with immunological properties, has recently been reported to have antitumor activity when administered with 5-fluorouracil in patients with Duke's C colorectal carcinoma. The mechanism of this antitumor effect is unknown, but has been postulated to be related to levamisole's immunomodulatory properties. To define further the immunomodulatory activities of levamisole, we studied the in vitro effects of levamisole on monocyte and lymphocyte cytotoxicity, activation, and proliferation; induction of cytokine induced proteins; and expression of tumor-associated antigens. Experiments utilized peripheral blood mononuclear cells from normal donors incubated in the presence of increasing concentrations of levamisole (0.1 to 100 micrograms/ml). Levamisole had no consistent effect on induction of 2',5'-oligoadenylate synthetase activity or indoleamine-2,3-dioxygenase activity, or production of tumor necrosis factor. Levamisole had no effect on monocyte cytotoxicity or expression of HLA-DR, HLA-DQ, HLA-DP, and the Fc receptor. Similarly, levamisole had no significant effect on NK or LAK cytotoxicity or the immunological activation of T-lymphocytes, assessed by expression of CD3, CD4, CD8, CD16, CD25, and CD56. Proliferation of lymphocytes from normal donors, patients with benign polyps, and patients with malignancies, with or without IL-2 or irradiated LS174T cells, was not significantly increased overall. No significant enhancement in the expression of three tumor-associated antigens (880364, NRCO-4, and ING-1) and the intercellular adhesion molecule-1 (ICAM-1) antigen on four human cancer cell lines was observed following in vitro exposure to levamisole. We conclude that levamisole is not a potent modulator of the immune parameters we examined, and that the mechanism behind the unique clinical interaction between levamisole and 5-fluorouracil in colorectal carcinoma remains to be identified. PMID- 1790136 TI - Expert opinion on presumptive treatment with halofantrine (Halfan). AB - According to the new strategy of the WHO for malaria prophylaxis, the use of stand-by drugs should be recommended when feasible. Because of its favourable safety/efficacy profile, I recommend Halofantrine to be used as the drug for stand-by treatment with the precautions expressed here. PMID- 1790138 TI - Augmentation of natural killer cell activity in mice by Bru-Pel. AB - The immunomodulatory and anti-tumor activity of Bru-Pel, an aqueous-ether extracted residue of Brucella abortus (strain 456), was investigated. Bru-Pel was administered to C57BL/6 mice intraperitoneally (i.p.) and tested for its effect on natural killer (NK) cell activity in spleen cells, liver, and peritoneal cavity. Three days after injecting 100 micrograms of Bru-Pel i.p., the cytotoxicity of spleen cells against YAC-1 target cells, assessed by LU20 increased by approximately two-fold and nonparenchymal cells of liver by greater than six-fold. The highest stimulatory effect of Bru-Pel was seen with peritoneal exudate cells, and 47-fold augmentation of NK cell activity was observed. Bru-Pel treatment made spleen, liver, and peritoneal exudate cells capable of lysing P815 mastocytoma cells, a tumor cell line highly resistant to lysis by unstimulated NK cells. In vivo, Bru-Pel inhibited the formation of experimental BL6 melanoma metastases; however, there was no significant effect on the eradication of established pulmonary metastatic lesions. These results demonstrate that in addition to its previously described macrophage-activating ability, Bru-Pel is highly efficient in stimulation of NK cell-mediated cytotoxicity in mice. PMID- 1790139 TI - Study of tumor-infiltrating lymphocytes for adoptive therapy of renal cell carcinoma (RCC) and metastatic melanoma: sequential proliferation of cytotoxic natural killer and noncytotoxic T cells in RCC. AB - We investigated the immunological properties of interleukin-2 (IL-2)-activated tumor-infiltrating lymphocytes (TIL), which were used for adoptive therapy of renal cell carcinoma (RCC) (seven patients) by focusing on natural killer (NK) cells, and metastatic melanoma (six patients) by focusing on cytotoxic T lymphocytes. TIL from five of seven cases proliferated well in culture with AIM-V serum-free medium and 1000 U/ml rIL-2 in 3-L gas permeable bags, whereas TIL from two RCCs exhibited delayed proliferation. Proliferation of CD3-CD56+ NK cells with major histocompatibility complex-nonrestricted cytotoxicity in RCC-TIL (n = 6, mean = 651-fold, ranging from 39- to 3450-fold) for the first 2-4 weeks was 63 times higher than that of noncytotoxic CD3+ T cells (n = 6, 10.3-fold ranging from 0.8 to 35-fold). Thereafter, CD3+ T cells predominantly proliferated, and proliferation of CD3+ T cells (n = 5, 743-fold) for 5-6 weeks were 24 times higher than that of CD3-CD56+ NK cells (n = 5, 31-fold). Significant numbers of RCC-TIL became adherent to the surfaces of the bags several weeks after initiation of culture. These adherent TIL consisted of more CD3-CD56+ NK cells and exhibited higher cytotoxicity than did nonadherent TIL. Adherent RCC-TIL produced interferon (IFN)-gamma, while nonadherent TIL did not. These results suggest that initially cytotoxic CD3-CD56+ NK cells and, later, noncytotoxic CD3+ T cells proliferated in culture of RCC-TIL for adoptive therapy. These noncytotoxic TIL were primarily transferred to RCC patients, who also received cyclophosphamide, IL-2, and IFN-alpha. In contrast to RCC-TIL, IL-2-activated melanoma TIL consisting of all CD3+ T cells displayed modest levels of cytotoxicity, primarily restricted to autologous melanoma cells in all cases tested. The cytotoxic melanoma TIL were adoptively transferred to melanoma patients. Three of seven RCC patients responded to the adoptive therapy. PMID- 1790140 TI - Phenotype and cytolytic activity of mouse tumor-bearer splenocytes and tumor infiltrating lymphocytes from K-1735 melanoma metastases following anti-CD3, interleukin-2, and tumor necrosis factor-alpha combination immunotherapy. AB - We studied the phenotype and antitumor cytolytic activity of splenocytes from mice with K-1735 pulmonary metastases and tumor-infiltrating lymphocytes (TILs) from these metastases following treatment with anti-CD3, IL-2, and TNF combination immunotherapy. Mice were injected with 5 x 10(4) tumor cells and received a single 5 micrograms i.p. dose of anti-CD3 on day 3, followed by either IL-2 alone or fourfold less IL-2 with TNF (25,000 U/day) given at 3-day intervals. A single dose of anti-CD3 followed by low-dose IL-2 and TNF caused the greatest reduction in metastases compared to anti-CD3 alone, higher doses of IL-2 alone, or IL-2 + TNF. Reduction in metastases (greater than 80%) using the three agents was equal to or exceeded that achieved by ninefold higher concentrations of IL-2 alone. Treatment with anti-CD3 + IL-2 and TNF significantly prolonged survival, and resulted in 60% of mice achieving long-term survival greater than 120 days. This was superior to single agents or other combinations with the three agents causing a synergistic rather than additive effect. The anti-CD3-activated splenocytes were a heterogeneous population of T cells, with an increased number of CD8+ cells compared to splenocytes from mice treated with high doses of IL-2 alone. Analysis of TILs showed a greater proportion of CD8+ cells in anti-CD3 treated mice compared to IL-2 alone, but a lower proportion of CD4+ cells. Lymphokine-activated killer (LAK) and natural killer (NK) activities of both splenocytes and TILs in vitro increased following anti-CD3/IL-2 + TNF treatment, and were consistently greater than that generated with four times more IL-2 alone. TNF appeared to potentiate cytolytic activity rather than affect phenotypic changes. These results indicate that the sequential use of anti-CD3, IL-2, and TNF for LAK induction and maintenance potentiates antitumor activity, and suggests novel strategies for combination immunotherapy. PMID- 1790141 TI - Depressed ability of patients with melanoma or renal cell carcinoma to generate adherent lymphokine-activated killer cells. AB - Adherent lymphokine-activated killer (A-LAK) cells, selected from peripheral blood lymphocytes (PBL) of normal human donors by adherence to plastic, and cultured in the presence of interleukin 2 (IL-2), are highly enriched in CD3 CD56+ natural killer (NK) cells. These IL-2-activated NK cells proliferate extensively upon further culture in conditioned medium containing IL-2. In contrast, we previously found that with PBL of some patients with advanced cancer, the same procedure often failed to yield high enrichment of NK cells or substantial expansion in the numbers of these effector cells. To obtain sufficient numbers of A-LAK cells for adoptive immunotherapy in cancer patients, an improved method for generation of human A-LAK cells with irradiated mitogen stimulated allogeneic PBL- or Epstein-Barr virus-transformed lymphoblastoid cell lines was introduced. In paired experiments, A-LAK cultures with feeder cells showed significantly enhanced IL-2-driven proliferation of A-LAK cells obtained from normal donors or patients with metastatic melanoma, renal cell carcinoma, and other types of solid cancers. The growth-promoting effect of feeders for A LAK cells resulted in significantly improved expansion of CD3-CD56+ (NK) effector cells in A-LAK cultures established from normal donors. Cells in these cultures also had significantly higher levels of antitumor cytotoxicity against K562 and Daudi targets than did A-LAK cells grown in the absence of feeder cells. Enrichment in CD3-CD56+ cells and antitumor activity also occurred in patient A LAK cultures supplemented with mitogen-stimulated feeder cells, but was not statistically significant. Overall, despite improved proliferation and CD3-CD56+ cell content of A-LAK cultures established in the presence of mitogen-activated feeder cells, only 39% (21/54) of patients tested generated A-LAK cells that would be judged acceptable for large-scale therapeutic use by criteria based on fold expansion and purity of A-LAK cells. These results suggest that in comparison to normal individuals, NK cells of many patients with advanced solid tumors are defective in their ability to respond by proliferation to IL-2 even in the presence of exogenously supplied growth factors. PMID- 1790142 TI - Autologous tumor-specific cytotoxicity of tumor-infiltrating lymphocytes derived from human renal cell carcinoma. AB - Conditions for generating and expanding cytotoxic tumor-specific, tumor infiltrating lymphocytes (TIL) were studied to improve the efficacy of adoptive cancer immunotherapy. Thus, we have examined the growth and cytolytic patterns of bulk culture TIL from human renal cell carcinoma (RCC) cultured in low (20 U/ml) or high (1,000 U/ml) dose interleukin (IL)-2, with or without irradiated autologous tumor stimulation. By 55 days in culture, TIL grown in the presence of IL-2 without tumor stimulation lost their lytic activity, whereas those exposed to tumor stimulation maintained high levels of cytotoxicity against autologous and/or nonautologous tumor targets. Only TIL grown with low dose IL-2 and autologous tumor maintained long-term (over 4 months in culture) specific cytotoxicity against the autologous tumor, even upon cryopreservation and regrowth. These TIL were 88-97% and 80% positive for CD3 and CD8, with a persistent subset exhibiting CD4+ CD8+ double positive staining. Their specific cytotoxic activity was major histocompatibility complex Class I-restricted and inhibited by pretreating the TIL with anti-CD3 monoclonal antibody. TIL exposed to the four types of culture conditions, low or high dose IL-2, with or without irradiated autologous tumors, and exhibiting different lytic specificities, all expressed mRNA for interferon-gamma and tumor necrosis factor (TNF)-alpha, but not for IL-1-beta, IL-4, IL-6, and granulocyte-macrophage colony stimulating factor. The degree of TNF-alpha mRNA expression correlated with the degree of autologous tumor-specific cytotoxicity of these TIL. This initial report demonstrates that antigen-specific cytotoxicity against the autologous tumor does, in fact, exist within the RCC tumors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790143 TI - Phase I evaluation of recombinant tumor necrosis factor given in combination with recombinant interferon-gamma. AB - In light of in vitro and preclinical animal model data suggesting potential additive or synergistic antitumor effects from the combined use of interferon gamma (IFN-gamma) and tumor necrosis factor-alpha (TNF-alpha), we conducted a phase I study employing escalating doses of each agent in 36 patients with solid tumors to determine the maximum tolerated dose (MTD). Patients were given an intramuscular (i.m.) injection of IFN-gamma, followed 5 min later by an i.m. injection of TNF-alpha, each agent in different sites, every other day for ten doses over 20 days. Patients received 10, 50, or 100 micrograms/m2 of each agent throughout the treatment course. No dose modifications were made. Patients suffering serious toxicity had therapy stopped and were considered to be off study. All patients experienced fatigue, and 36% spent over half their time in bed on treatment days. Fever and chills were nearly universal. Mild to moderate elevations in serum transaminase levels were noted in 44% of patients, and 44% developed transient microscopic hematuria. Although 81% of patients had anorexia, only 17% of patients lost more than 3 kg of body wt during the 3 weeks of therapy. Because two of three patients receiving 100 micrograms/m2 of both agents developed serious toxicity (one fever greater than 105 degrees F, one thrombocytopenia 43,000/mm3), the MTD was established to be 100 micrograms/m2 of IFN-gamma plus 50 micrograms/m2 of TNF-alpha. The use of aspirin did not significantly alter the toxic effects of the agents. One patient with melanoma had a mixed response and one patient with mesothelioma transiently cleared his ascites of malignant cells. PMID- 1790144 TI - Alterations of platelet function induced by interleukin-2. AB - We recently reported that thrombocytopenia and bleeding are often limiting effects of immunotherapy with interleukin-2 (IL-2). In order to understand the mechanisms that lead to this unexpected clinical toxicity, we studied the effects of IL-2 on in vitro platelet function. When platelet aggregation was studied using whole blood (impedance, electrical) aggregometry, inhibition of aggregation was detected within 1 min of the addition of exogenous IL-2 to whole blood. IL-2 induced platelet secretion was quantified by radioimmunoassay (RIA) of PF4, BTG, and TXB2 independent of the addition of an aggregating agonist (ADP). Platelet secretion and inhibition of aggregation were an indirect consequence of a cellular effect of IL-2 on mononuclear cells, since aggregation was normal when whole blood was depleted of mononuclear cells and its reconstitution with autologous mononuclear cells led to a cell concentration-dependent inhibitory effect of aggregation and release of alpha-granule components in the presence of IL-2. In order to understand the mechanism of platelet secretion mediated by IL-2 activated mononuclear cells, we quantified the release of eicosanoid products from cultures of mononuclear cells exposed to IL-2 and found a significant increase in TXB2. Our results indicate that platelet secretion, indirectly initiated by IL-2-activated cells, is followed by inhibition of aggregation. These findings may not only have important implications for the planning of clinical immunotherapy trials with IL-2, but may also provide a novel link for a better understanding of the relationships between the hemostatic and the immune systems. PMID- 1790145 TI - Relapse after response to interleukin-2-based immunotherapy: patterns of progression and response to retreatment. AB - The initial site of disease relapse was identified for 79 patients with metastatic renal cell cancer (RCC), melanoma, colon cancer, or non-Hodgkin's lymphoma (NHL), who had achieved partial or complete responses to one of five IL 2-based immunotherapy regimens. The initial site of relapse was evenly distributed between pre-existing sites of disease (33%), new sites of disease (38%), or both (29%). There was no difference in the distribution of recurrences between patients with partial or complete responses. Fifty-one patients with prior complete or partial responses were retreated with additional IL-2-based therapy following tumor progression. Five of 51 patients retreated following relapse developed new partial responses. There were no complete responses. Three patients with NHL were retreated with IL-2 and LAK cells and all achieved a second response, while only 2 of 48 patients with other histologic diagnoses reresponded. It is concluded that after a partial or complete response to IL-2 based immunotherapy, patients who relapse do so equally at new and pre-existing sites of disease. A response to retreatment following tumor progression may be attained in patients with NHL, while a new response is unlikely for patients with melanoma and RCC. PMID- 1790146 TI - A phase II trial of recombinant tumor necrosis factor in patients with adenocarcinoma of the pancreas: a Southwest Oncology Group study. AB - Twenty-two evaluable patients with advanced adenocarcinoma of the pancreas, but without prior chemotherapy or immunotherapy, received recombinant tumor necrosis factor (rTNF). rTNF was given as an intravenous infusion over 30 min daily x 5, every 14 days, at a starting dose of 150 micrograms/m2/day. Toxicities included fevers/rigors, nausea/vomiting/anorexia, flu-like symptoms, hypotension, hyperglycemia, anemia, coagulopathy, hepatotoxicity, and hypertriglyceridemia. Laboratory evidence of disseminated intravascular coagulopathy occurred in 11 patients, with only 3 of these patients having clinical manifestations. Two patients suffered from pulmonary emboli. The high incidence of coagulopathy was felt to be, at least in part, disease related. No objective responses were observed with a 95% confidence interval of 0-15%. PMID- 1790147 TI - Phase II trial of recombinant DNA gamma-interferon in advanced colorectal cancer: a Southwest Oncology Group study. AB - Fifty evaluable patients with advanced colorectal cancer, but without prior chemotherapy or immunotherapy, were randomized to one of two schedules of recombinant gamma-interferon (rGIFN). Twenty-four evaluable patients received rGIFN as a 2-h intravenous infusion daily x 5 every other week at a starting dose of 4.0 x 10(6) IU/m2/day (arm I). Twenty-six evaluable patients received rGIFN as a 24-h continuous intravenous infusion daily x 5 every month at a starting dose of 2.6 x 10(6) IU/m2/day (arm II). Toxicities on both schedules included flu-like symptoms, fevers/rigors, nausea/vomiting, hypotension, leukopenia, hepatotoxicity, nephrotoxicity, diarrhea, anemia, confusion, and ileus. Toxicity appeared to be more severe on arm I. No antitumor responses were observed, with 95% confidence intervals of 0 to 14% for arm I and 0 to 13% for arm II. PMID- 1790148 TI - Health and substance use behavior: the longitudinal Harlem Health Study. AB - Described here is a 22 year prospective study of adolescents focusing on health problems, substance use and other health behaviors, and treatment needs of urban African Americans. The study panel was drawn from a probability sample of households in Central Harlem (NYC). Accordingly, it is a community representative sample comprised about equally of males and females. Data from the study have been used for planning the local municipal hospital's adolescent service and for informing drug policy and community education activities regarding trajectories in and out of drug use. Given the timing of the research, the latter has focused chiefly on heroin and polydrug use. Current investigation focuses on drug use and sexual practice as risk behavior in HIV infection. In the report which follows, requirements and procedures in sample retention are emphasized, since epidemiological research is valid only to the extent its population representativeness is maintained. Major findings regarding health and substance use trajectories over three data collection time points are discussed. PMID- 1790149 TI - The epidemiology of substance abuse. PMID- 1790150 TI - Surveys that work and what they show in Mexico. AB - The drug abuse epidemiologic research program in Mexico does not differ from programs in other countries. At the same time some special features of the problem in Mexico influence the type of research undertaken, especially studies which help orient official policy. These features are related to the prevailing conceptions of drug abuse, the characteristics of the problem, the infrastructure available for conducting research, and human and economic resources. This paper includes a discussion of the conceptions of drug abuse and a description of the research strategies that have been used in Mexico over the past 15 years, their advantages, disadvantages and perspectives for the future, which are again linked to the characteristics of the problem and the available resources. PMID- 1790151 TI - Epidemiological approaches to drug misuse in Britain. AB - Most surveys in Britain are carried out at local level, though some indicators are monitored at national level. An example of a successful multi-source and multiple method model used in local studies is described. The importance of integrating both quantitative and qualitative approaches is stressed. The emphasis is on the value of local research, and of comparative studies between localities (e.g., cities). National surveys offer a useful baseline against which to set local studies. They are also used to inform broad policies, though it is argued that they are often misused and that their contribution at national policy level is overrated. Most service delivery and prevention activities occur at local level. It is here that research can be interpreted in the local context, thus giving richer and more relevant insights. It is important that a range of methods and sources are used, since any one approach is partial and can easily lead to bias. The strengths and weaknesses of different methods are discussed. PMID- 1790152 TI - What works in drug abuse epidemiology in Europe. AB - This paper discusses what works and what does not work in drug abuse epidemiology in Europe. Given the tradition in European countries of defining the drug abuse problem in terms of social and medical interventions, epidemiological research is also tied to these interventions, and consequently to community-based research. What seems not to work, and what is generally suspect are grand legal designs to solve the drug problem. Promising initiatives are going towards a compromise between a relaxation of legal sanctions but a tendency away from legalization. What is recommended is striving towards a more analytic and multidisciplinary epidemiology that can help society critically evaluate the truth-value of its moral prerogatives. PMID- 1790153 TI - National substance abuse epidemiology initiatives in the United States: what works for what. AB - Data concerning the epidemiology of drug abuse in the United States are presented in this paper. The paper includes an integrating approach from various data sources: national, state, and local level; surveillance systems; and outbreak investigations. An analysis of trends and patterns of drug abuse are discussed, both from the perspective of historical development and the current situation. Analyses focus on changes in levels of use for different drugs as well as changes in user characteristics and consequences of use. Current studies concerning the epidemiology of drug abuse in special populations and findings from recent field investigations are presented. Future research directions in the field of epidemiology from a national perspective are outlined. PMID- 1790154 TI - The barefoot epidemiologist: "what works" in drug abuse prevalence estimation. AB - This paper proposes that the problem of estimating drug abuse prevalence may be approached effectively through inexpensive means and without the need of experts. A situation is hypothesized in the city of "Metropolis" whereby a junior staffer is able to make reasonable and compelling estimates of the problem using information gathered from various city agencies and knowledgeable individuals over a two-week period. Each day's information-gathering is described, with the thought processes that sort out and coalesce the findings. In the matter of weeks the information is used to justify expenditures for treatment and prevention programs. PMID- 1790155 TI - Stalking the elusive designer drugs: techniques for monitoring new problems in drug abuse. AB - In the 1980s, the clandestine synthesis, distribution, and use of analogs of controlled substances became popular in the United States. These designer drugs comprise analogs of many different classes of psychoactive drugs and present a spectrum of adverse health effects ranging from mood changes to severe neurologic disease. Although there has been no unified program of surveillance for these drugs, a number of articles describing their presence in North American communities have appeared in a variety of publications. This paper summarizes the evidence of designer drug production and use, and recommends effective surveillance efforts that might be adopted by drug abuse prevention and public health agencies. PMID- 1790156 TI - Street studies that work and what they show in New York City. AB - The New York State Division of Substance Abuse Services (DSAS) maintains a street research unit that monitors drug activity on the streets of New York City. The Street Research Unit consists of a supervisor and several carefully selected researchers who have had a history of drug abuse. The team includes males and females, and whites, blacks and Hispanics. Their supervisor has trained them in social science methods and ethnographic techniques. The researchers' own knowledge of street language and drug behavior has enabled them to capture information that would escape most observers and even some participants. Despite the risks involved, the Street Research Unit has become a vital and indispensable part of the research capability of the agency. There is no better way to gather current information on drug activity on the streets of New York City. The paper traces the history of the Unit, discusses some methods that are used, describes the studies that have been conducted, and summarizes what works, what does not work in this type of ethnography, and the plans for the future. PMID- 1790157 TI - A typology based on measures of substance abuse and mental disorder. AB - The data of this study were derived from comprehensive interviews of 311 women and 949 men residing in the New York City public shelters for homeless adults during the summer of 1987. Interviews, guided by a 57 page interview protocol, were conducted by thoroughly trained interviewers who had worked in agencies and service systems focused on mental disorders, child abuse, substance abuse and problems of homeless people. Included in the content of the interview were seven dichotomous measures of substance use, substance abuse and mental disorder. A typology of ten groups comprised of individuals with similar profiles on the seven measures served as the independent variable. Three pairs of dependent variables were suicide attempts and current thoughts of suicide, a need for medical services reported by shelter residents and by their interviewers, and disclosure of a drug problem and a need for help in treating it. Consistently meaningful associations between group memberships and the 3 pairs of dependent variables, and 16 measures of health status in previous work, were interpreted as evidence for predictive validity of the typology. PMID- 1790158 TI - Short-term memory performance with magnetic stimulation of the motor cortex. AB - Whether transcranial magnetic stimulation of the motor cortex has an influence on memory was investigated. In a first experiment with 21 healthy volunteers six pronounceable nonsense words were visually presented, immediately followed by a magnetic stimulus. There were three blocks of stimulation with field intensities of 60, 80 and 100% (referring to a maximal intensity of 2 Tesla), each block comprising six magnetic stimuli and six nonsense words. After each block there was a free recall test and at the end another free recall trial as well as a multiple-choice recognition test for all 18 words. Eighteen subjects served as controls, undergoing the same procedure, except that the field intensity was zero. A significant but small reduction of short-term memory performance was observed only for 100% field intensity. In a second experiment with 16 subjects who had not participated in experiment I, the effect of 100% intensity cortical magnetic stimulation was compared with a control stimulation over the cervical spine. There was no difference in free recall or in the multiple-choice test between the sites of stimulation, suggesting that the difference in the 100% intensity block in experiment I was not due to a specific cortical effect of the magnetic field on memory function. With respect to the effect on memory functions, transcranial magnetic stimulation of the motor cortex is thought to be a safe method. PMID- 1790159 TI - Brain gamma-aminobutyrate transaminase and monoamine oxidase activities in suicide victims. AB - The activity of gamma-aminobutyrate amino-transferase (GABA-T) and monoamine oxidase (MAO-A and -B) was measured in 42 postmortem human brains. Three brain regions (frontal cortex, cingulate cortex and hypothalamus) from 23 controls without known neurological or psychiatric disorder and from 19 suicide victims were analysed. The suicide victims were classified according to the use of violent and non-violent methods and to the presence or absence of a known history of depressive disorder. No difference was found between the series of suicide victims and the control subjects with regard to GABA-T activity. Carbon monoxide poisoning and death by drug overdose, however, were found to reduce the activity. The MAO-B activity did not differ between the groups. With MAO-A, however, a significant elevation (t = 2.01; P less than 0.05) was found in the hypothalamic region of the suicide victims. The difference seemed to be confined to the subgroup of suicides with a record of depressive disorder. PMID- 1790160 TI - Avoidance behaviour: a predictor of the efficacy of pharmacotherapy in panic disorder? AB - The impact of the avoidance behaviour on the psychopharmacological treatment of panic disorder was explored in the Cross National Collaborative Panic Study (n = 1134 patients); in this double blind randomized trial alprazolam, imipramine and placebo were compared during an 8-week treatment period. Patients with extensive avoidance behaviour (agoraphobia) had the most profit from the active drugs. Counter expectancy these specific drug effects were most pronounced in avoidance behaviour. Active drugs (in particular imipramine) were especially more effective than placebo if the patients presented with associated avoidance behaviour. The results suggest that agoraphobia defines more a particular type of anxiety disorder overlapping with panic disorder than merely a severe state of panic disorder. PMID- 1790161 TI - Senile dementia of the Alzheimer type in the Lundby Study. I. A prospective, epidemiological study of incidence and risk during the 15 years 1957-1972. AB - In spite of the great impact of senile dementia of the Alzheimer type (SDAT) on society, far too little is known about its epidemiology. In this study of a total, normal population from a geographically delimited area in Sweden, Lundby, 2612 persons were examined in 1957 by one psychiatrist (Hagnell). In 1972 the same population was reexamined irrespective of domicile. The incidence and risk of contracting SDAT during the 15 years were calculated. No cases of SDAT were diagnosed before the age of 60 years. The lifetime risk was for men 25.7% and for women 26.2%. When only the very severely impaired were taken into account, the figures were 14.5% in men and 14.6% in women. PMID- 1790162 TI - The reliability of the SADS-LA in a family study setting. AB - The joint-rater and test-retest reliability study of two translated versions of the SADS-LA (Schedule for Affective Disorders and Schizophrenia--Lifetime version -modified for the study of anxiety disorders), one in French and the other in German, have been tested in family study settings, in a sample of patients and first-degree relatives. The test-retest reliability study demonstrated that identification of major affective disorders and schizophrenia was performed with sufficient reliability; however, diagnoses of subtypes of major disorders (e.g. bipolar II disorder) and identification of minor disorders was less reliable. The implications of these findings in phenotype identification during family studies in psychiatry are discussed. PMID- 1790163 TI - Psychiatric aspects of writer's cramp. AB - Although its aetiopathogenesis is still unknown, writer's cramp is meanwhile regarded essentially an organically induced disorder. However, as shown by this interdisciplinary study, psychodynamic factors should not be neglected. Special attention should be given to the patients' experience of the syndrome and secondary psychoreactive processes. PMID- 1790164 TI - The heart in muscular dystrophy: an electrocardiographic and ultrasound study of 20 patients. AB - Twenty patients with different types of muscular dystrophy (MD) were included in a cross-sectional study by means of electrocardiography and ultrasound cardiography. A manifest cardiomyopathy was detected in 8 patients; a latent cardiomyopathy was found in 4. A hypertrophic cardiomyopathy was especially frequent in facioscapulohumeral MD, a congestive cardiomyopathy in Becker-Kiener MD. The ECG showed a reduction in the QT interval and frequent block formers in the X-chromosomal inherited forms and the trunc-girdle form. Bradycardia and a prolonged QT interval were frequent in myotonic dystrophy and facioscapulohumeral MD. Signs of cardiac infarction in the ECG were most frequent in the trunc-girdle forms. A high cardiac output per minute in conjunction with increased left ventricular volume was frequent in Becker-Kiener and Landouzy MD. A left ventricular dysfunction with reduced ejection was characteristic of myotonic dystrophy and trunc-girdle MD. A mitral valve prolapse was more frequent with increasing severity of the muscle disease and was particularly frequent in myotonic dystrophic and Landouzy MD. The cardiac output per minute and the stroke volume were significantly lower (P less than or equal to 0.03) where a mitral valve prolapse was present. PMID- 1790165 TI - Stability of diagnoses in affective, schizoaffective and schizophrenic disorders. Cross-sectional versus longitudinal diagnosis. AB - The present study investigated the syndrome shift during the course of disease in 355 patients with functional psychoses. The mean observation time was 25.2 years. Every episode was diagnosed cross-sectionally as schizophrenic, melancholic, manic, manic-depressive mixed, schizodepressive, schizomanic or schizomanic depressive mixed. With regard to the whole course, 148 patients fulfilled the diagnostic criteria of schizophrenic, 106 of affective and 101 of schizoaffective disorders. Patients with a schizophrenic initial episode showed the greatest stability: 90% had no other type of episode. The majority of patients who suffered a melancholic initial episode remained unipolar melancholics or developed manic symptomatology, and only a few suffered schizoaffective or schizophrenic episodes. Patients with a manic symptomatology at the beginning had a very unstable and changeable course. The stability of patients with initial schizodepressive episodes lay between that of patients with melancholic initial episodes and that of those with manic initial episodes. The findings demonstrate the relevance of longitudinal considerations in making the final diagnosis. PMID- 1790166 TI - The lack of relationship between DST nonsuppression in the dexamethasone suppression test and EEG abnormalities. AB - As a recent study suggested a relationship between cortisol escape following dexamethasone suppression test (DST) and electroencephalogram (EEG) abnormalities, we tried to replicate these findings in 52 major depressive inpatients. A total of 23 patients exhibited DST nonsuppression (44%) and 18 patients had EEG abnormalities (35%). No relationship existed between DST and EEG results. PMID- 1790167 TI - Enhancement of the thrombolytic potency of plasminogen activators by conjugation with clot-specific monoclonal antibodies. PMID- 1790168 TI - Conjugation of plasminogen activators and fibrin-specific antibodies to improve thrombolytic therapeutic agents. AB - Here we have reviewed chemical and recombinant approaches to the construction of hybrid molecules that combine a "targeting" antibody and an "effector" enzyme activity. There are advantages and disadvantages to both chemical and recombinant methods, and one goal of this review has been to elucidate these so that the appropriate method can be used by those interested in using hybrid molecules to study questions of basic or therapeutic importance. The system studied in greatest detail has as its goal the targeting of a plasminogen activator to an occlusive intravascular thrombus. We have, therefore, used this system as an example of currently available approaches. Now that these methodologies have been studied and put into use, it is anticipated that this principle will be generalized both to other therapeutic applications, as well as to the design and construction of molecules that will allow more basic questions to be addressed. PMID- 1790169 TI - Catalytic activity and thermostability of dehydrogenase conjugates with cortisol and progesterone. AB - The conjugates of glucose-6-phosphate dehydrogenase, lactate dehydrogenase, and malate dehydrogenase with progesterone and cortisol, containing 1-40 steroid molecules per enzyme molecule, were obtained by the reactions of N-succinimide esters of the 3-[O-(carboxymethyl)oximes)] of cortisol and progesterone with a protein in a water-DMFA (10%) medium. The catalytic activity and thermostability of dehydrogenases and their steroid conjugates were kinetically studied. The effects of the modification degree on the activity and thermostability of dehydrogenases by their hydrophobization were studied and discussed. Practical recommendations for using the dehydrogenase-steroid conjugates in enzyme immunoassay are given. PMID- 1790170 TI - o-acetamidophenylboronate esters stabilized toward hydrolysis by an intramolecular O-B interaction: potential linkers for selective bioconjugation via vicinal diol moieties of carbohydrates. AB - The synthesis and properties of o-acetamidophenylboronic acid 8 and the corresponding 1,2-diol cyclic boronates 13 and 16 are reported. The presence of an O-B interaction in 8 and 13 has been established by 11B and 1H NMR spectroscopy. The O-B interaction stabilizes boronate 13 toward hydrolysis and accelerates esterification of acid 8 in contrast to the non-ortho-substituted boronate 10 and acid 3. The enhanced stability of o-acetamidophenylboronate esters toward hydrolysis suggests their application as vicinal diol protecting groups in carbohydrate synthesis. Through the incorporation of an amino group as a second site for a coupling reaction (e.g. via isothiocyanate 22), o acetamidophenylboronic acids may serve as novel agents for bioconjugation reactions involving carbohydrate moieties. PMID- 1790171 TI - Rapid synthesis and introduction of a protected EDTA-like group during the solid phase assembly of peptides. AB - A simple two-step procedure is reported for the synthesis of a tert-butyl ester protected form of an EDTA-like bifunctional chelating agent. This reagent can be easily introduced on any available amino group during the assembly of peptides on solid-phase supports. Using the model tetradecapeptide OVA(323-336), we have introduced an EDTA group at the N-terminus of this T-cell epitope and confirmed that the EDTA group is present on the molecule, can chelate metals, and does not affect the biological activity of the peptide. PMID- 1790172 TI - Comparison of ELISA with activity and ligand-binding methods for the determination of thymidylate synthase concentration. AB - The determination of enzyme levels in cellular extracts by active site titrations or by catalytic activity measurements is relevant in both science and medicine. However, these techniques assume that enzymes exhibit the same response in crude sample matrices as they do in the purified state. We report here an example of how an enzyme-linked immunosorbent assay (ELISA) was used to determine the true enzyme concentration which was compared to the effective enzyme concentration obtained by ligand binding and catalytic assay methods in a crude bacterial cell extract. Rabbit antibodies specific for Lactobacillus casei thymidylate synthase (TS) were used to develop a highly specific and sensitive heterogeneous noncompetitive ELISA assay with a typical detection limit of 1.4 fmol of TS (100 pg) and a dynamic working range of 3 orders of magnitude. The antibodies showed identical responses for TS, its inhibitory binary complex with 5-fluoro-2' deoxyuridylate, and its inhibitory ternary complex with 5-fluoro-2' deoxyuridylate and 5,10-methylenetetrahydrofolate in the immunoassay. L. casei cell-free extracts were subjected to extraction with CM-Sephadex and the various fractions were analyzed by ELISA, active-site titrations, and catalytic assays which demonstrated that assays which assumed full catalytic or ligand-binding competence underestimated the true enzyme level. PMID- 1790173 TI - Photolysis of 3-aryl-3-(trifluoromethyl)diazirines: a caveat regarding their use in photoaffinity probes. AB - The photolysis of 3-(4-tolyl)-3-(trifluoromethyl)diazirine in the presence of benzene, methanol, carbon tetrachloride, cyclohexane, triethylsilane, or diethylamine led to photoproducts consistent with the intermediacy of a singlet carbene. In the case of diethylamine, the photoinsertion into the N-H bond of diethylamine produced the expected adduct, 1-(diethylamino)-2,2,2-trifluoro-1-(4 tolyl)ethane. However, the base-catalyzed elimination of hydrogen fluoride from this adduct afforded an enamine, alpha-(diethylamino)-beta,beta-difluoro-4 methylstyrene, and the subsequent hydrolysis of this enamine furnished diethylamine and 2,2-difluoro-1-(4-tolyl)ethanone. This elimination and hydrolysis sequence effectively reversed the photoinsertion process. A similar photoinsertion and hydrolysis process using 3-(4-n-octylphenyl)-3 (trifluoromethyl)diazirine also produced 2,2-difluoro-1-(4-n-octylphenyl)ethanone in modest yield. These results suggest that the photoinsertion products from 3 aryl-3-(trifluoromethyl)-diazirines in biological systems may suffer similar fates limiting, in part, their utility in obtaining primary sequence data. PMID- 1790174 TI - Terminal-modified polylysine-based chelating polymers: highly efficient coupling to antibody with minimal loss in immunoreactivity. AB - A method is suggested for the preparation of chelating polymers containing a single terminal reactive group capable of interaction with proteins. These polymers were synthesized from N-CBZ-polylysine and DTPA and contain a terminal SH or pyridyldisulfide group. A polymer molecule with MW 13,500 is able to carry up to 40 DTPA residues. Polymers easily and quantitatively bind with antibodies (Fab fragments of antimyosin antibodies R11D10) with minimal effect on antibody immunoreactivity as revealed in ELISA assay and in direct immunoanalysis. Conjugates prepared can chelate radioactive metal ions reaching very high specific radioactivity (greater than 1 mCi 111In/10 micrograms of protein). Perspectives for their application are discussed. PMID- 1790175 TI - In vitro and in vivo activities of monoclonal antibody-alkaline phosphatase conjugates in combination with phenol mustard phosphate. AB - The prodrug p-[N,N-bis(2-chloroethyl)amino]phenyl phosphate (phenol mustard phosphate, POMP) was prepared from p-[N,N-bis(2-chloroethyl)amino]phenol (phenol mustard, POM) by phosphorylation with phosphoryl chloride, followed by aqueous hydrolysis. It was found that POMP was much less cytotoxic than POM when tested against H2981 human lung and H3396 human breast carcinoma cells in vitro. Pretreatment of the H2981 cells with L6-alkaline phosphatase (L6-AP), a monoclonal antibody conjugate that could bind to cell surface antigens, greatly enhanced the cytotoxic effects of POMP in an immunologically specific manner. Owing to its reduced toxicity in nude mice, larger amounts of POMP compared to POM could be administered. Neither agent exhibited significant in vivo antitumor activity when tested against subcutaneous H2981 tumors in nude mice. However, antitumor activity was observed in animals receiving L6-AP 48 h prior to POMP administration. This level of activity was greater than with the drugs alone, or a combination of 1F5-AP (nonbinding control) with POMP. PMID- 1790177 TI - Reversed-phase high-pressure liquid chromatographic tryptic peptide mapping for the comparison and study of monoclonal antibodies. AB - We have examined and optimized several parameters to generate efficient, high resolution, high-information tryptic peptide maps of monoclonal antibodies and their Fab fragments, without separating the H and L chains, using reversed-phase high-pressure liquid chromatography. Use of a high protease-to-substrate ratio with optimized digestion time and HPLC gradient conditions led to a reproducible mapping of the reduced, carboxymethylated Fab fragments of two antibodies. The technique was then used to screen Fab lots for batch-to-batch consistency, and for examining the effect of 10 mM cysteine on papain cleavage of whole antibody. The technique was modified by labeling cysteine with chromophoric analogues of iodoacetamide instead of radiolabeled iodoacetamide, resulting in a three dimensional peptide map. With multiwavelength detection, this consisted of simultaneous observation of all chromophores at 214 nm, those with aromatic residues at 280 nm, and those with cysteine at 422 nm, without collecting and counting each peak to identify cysteine-containing peptides. PMID- 1790176 TI - Progestin-rhenium complexes: metal-labeled steroids with high receptor binding affinity, potential receptor-directed agents for diagnostic imaging or therapy. AB - In order to investigate the possibility of developing diagnostic imaging agents for steroid-positive tumors that are labeled with the readily available radionuclide technetium-99m, we prepared four conjugate systems in which a progestin is linked to a metal chelate system. Three of these are bis-amino bis thiol (BAT or N2S2) systems and are linked through carbon-21 of progesterone or the 17 alpha- or 11 beta-position of a nortestosterone type progestin. The fourth, an amino-amido-thiol-alcohol chelate (N2OS) system, is linked at the 16 alpha,17 alpha-positions of a dihydroprogesterone. As a model for technetium labeled complexes, all four chelate systems were converted to their oxo-rhenium complexes. Of the four possible diastereomers in the 16 alpha,17 alpha-system, only one was isolated, while of the four possible diastereomers in the other systems, a syn pair and an anti pair (linker methylene vs rhenium-oxo, relative to the N2S2 plane) were separated in the 17 alpha-substituted series, a syn pair was isolated in the 21-substituted series, and a syn pair and the two individual anti diastereomers were separated in the 11 beta-substituted series. In competitive radiometric receptor binding assays, the 21-, 17 alpha-, and 16 alpha,17 alpha-linked systems had low affinity for the progesterone receptor (less than 0.3% that of promegestone (R5020) or 2% that of progesterone). By contrast, the two anti diastereomers of the 11 beta-linked system had affinities that were 10% and 44% that of R5020 (or 64% and 283% that of progesterone) and the syn pair had an affinity 25% that of R5020 (or 161% that of progesterone). The latter finding indicates that it is possible to prepare metal-labeled steroids that retain high affinity for steroid receptors. These and related systems, when complexed with radioactive metals, may be useful in vivo as receptor-directed agents for diagnostic imaging or therapy of steroid receptor positive tumors. PMID- 1790178 TI - Chemometrics, why, what and where to next? AB - The advantages of the application of chemometrics in pharmaceutical and biomedical analysis are discussed. Some chemometric approaches are described and the requirement for validation emphasized. Finally, possible future developments of chemometrics are assessed. PMID- 1790179 TI - Chemometrics in pharmaceutical analysis. AB - Pharmaceutical analysis is undergoing a slow revolution as chemometric principles become increasingly incorporated. This paper reviews some of the more recent advances, with particular focus on spectrophotometry, chromatography and expert systems. PMID- 1790180 TI - Use of experimental design in the pharmaceutical industry. AB - Statistical modelling and experimental design (SMED) are essential tools for the development and understanding of complicated products and processes. SMED allows efficient experimentation in which all or a large subset of factors are together varied over a set of experiments, in contrast to the traditional approach of varying only one at a time. An overview of the SMED methodology and the generalization of statistical design to multivariate design is presented. The following examples illustrating the use of these methods are discussed: (1) use of factorial designs to improve drug solubility; (2) testing the robustness of an analytical method; and (3) use of multivariate design to select the solvent in analytical method development. PMID- 1790181 TI - The use of a computer to select optimized conditions for high-performance liquid chromatography separation. AB - Computer simulation allows the convenient prediction and optimization of HPLC separation as a function of various separation conditions. The use of retention and bandwidth relationships that have been validated for a broad range of chromatographic systems minimizes the number of experimental runs needed, especially for the new technique of restricted multi-parameter optimization. The chromatographer is free to use these procedures in a trial-and-error mode, or alternatively use can be made of resolution maps and other data summaries. "Gridding" experiments, based on the automated collection of chromatographic data, can be used to supplement predictions obtained from computer simulation. PMID- 1790182 TI - Extended multiplicative signal correction and spectral interference subtraction: new preprocessing methods for near infrared spectroscopy. AB - Near infrared (NIR) spectroscopy spectra can be converted mathematically to precise quantitative information of chemical and physical nature by multivariate calibration. This makes NIR analysis useful for a variety of "difficult" sample types (powders, slurries), more or less without any sample preparation. The paper emphasizes the importance of using prior knowledge for spectral preprocessing of spectral data prior to the linear multivariate calibration modelling. Two new preprocessing methods are presented: extended multiplicative signal correction (EMSC) for elimination of uncontrollable path length or scattering effects, and spectral interference subtraction (SIS) for elimination of known spectral interferences. Determination of toluene in mixtures with benzene and xylene from NIR spectra with gross simulated light scattering effects is used for illustration. PMID- 1790183 TI - Mathematical isolation of component spectra in HPLC/UV-vis and GC-MS. How unique are the resolved spectra? AB - The resolution of overlapping spectra in GC-MS and HPLC/UV-vis is fundamentally limited by the quality of the experimental data. The narrowness of the solution range depends on the degree of overlap between components. If the components are dissimilar, the solutions obtained by all mathematical methods are robust. Small perturbations in the observations do not change the calculated solution very much. Alternating regression (AR) is a useful tool in the analysis of overlapping spectra because AR can be calculated very rapidly. The robustness of the solution can be easily checked with AR. The mathematical analysis is repeated several times after adding different sets of noise. Each time different random spectra are used as a starting point. The range of solutions thus obtained reflects the quality of the data for resolution purposes. PMID- 1790184 TI - Multicomponent analysis: a case report. AB - Three cases are described. Case 1: kinetic studies often need high time resolution measurements in order to follow the pattern of reactions taking place during the experiment. This is often laborious to achieve with the collection of fractions for chromatographic separation. Some tool for separation is, however, necessary in order to decompose the concentrations of reactants, products and intermediate species. The spectra of the intermediates may not be known at the time when the kinetic studies are needed. With unknown spectra there are still possibilities to use spectroscopy and multivariate techniques to obtain qualitative information. Case 2: it is possible to use Partial Least Squares (PLS) in order to describe the chromatographic profiles for the species even if the separation is insufficient for traditional peak measurement methods. This requires that mixtures are available with known concentrations of the species to be determined. Case 3: with modern diode array liquid chromatography detectors there is the possibility to capture the chromatogram and the spectra at the same time. The ability to reproduce the chromatographic profile between samples makes it possible to use the Generalized Rank Annihilation Method (GRAM) possible. Whereas PLS only treats one spectrum at a time, this method treats the full two dimensional chromatogram as an entity. The GRAM calibration is claimed to be insensitive to interfering species which are not present in the calibration. Limitations are that GRAM requires a linear detector response and very good repeatability of the retention time. The use of GRAM for calibration with real samples is demonstrated. PMID- 1790185 TI - Multivariate data analysis of NMR data. AB - Multivariate methods based on principal components (PCA and PLS) have been used to reduce NMR spectral information, to predict NMR parameters of complicated structures, and to relate shift data sets to dependent descriptors of biological significance. Noise reduction and elimination of instrumental artifacts are easily performed on 2D NMR data. Configurational classification of triterpenes and shift predictions in disubstituted benzenes can be obtained using PCA and PLS analysis. Finally, the shift predictions of tripeptides from descriptors of amino acids open the possibility of automatic analysis of multidimensional data of complex structures. PMID- 1790186 TI - The selection of laboratory tests for organ dysfunctions using multivariate statistics. AB - There is a need for selecting good combinations of laboratory tests for various medical decision situations. Multivariate statistical methods are better tools for this type of selection than multiple univariate comparisons of candidate tests. Linear discriminant analysis is a suitable method. The best selection strategies are stepwise selection and evaluation of all possible subsets. Guiding criteria in the selection process may be measures of statistical separation between the clinical groups or empirical probabilities of correct reallocation. The latter criterion has the advantage that an optimum subset size may be identified. PMID- 1790187 TI - Interpreting complicated chromatographic patterns. AB - GC-MS, HPLC, automatic amino acid analysis, high-resolution two-dimensional electrophoresis and capillary electrophoresis are suitable for the multicomponent analysis of body fluids and tissues. Manual interpretation of the complex metabolite and protein profiles thereby obtained is usually difficult, except in the case of metabolic disorders, where major deviations from the normal profiles often are observed. Implementation of multivariate data analysis makes it possible to retrieve diagnostic information that otherwise may be overlooked, as shown in this report where patients with leprosy have been examined. Urine samples were analysed by ion-exchange chromatography and by GC-MS to obtain profiles of amino acids and organic acids. Qualitative and quantitative information on 68 metabolites were then analysed by principal components analysis (PCA) and by partial least square models (PLS). Three different PLS dimensions were found (cross-validation) corresponding to controls (persons without leprosy), paucibacillary and multibacillary leprosy. PMID- 1790188 TI - Relating multivariate time-series by linear three-way decomposition (LTD) and partial least squares (PLS) analysis. AB - The problem of relating multivariate time-series which is common in drug development is considered. The mathematical and statistical problems involve relating two three-way tables. These tables have objects and time-points in common while the variables to be related are unique for each table. A modification is presented of the linear three-way decomposition (LTD) algorithm which directly incorporates the information that both objects and time-points are common to the two tables. A comparison is made with partial least squares (PLS) analysis both at the theoretical level and in their application to three sets of real data. Limitations of LTD are discussed, in particular the constraint imposed by the trilinearity requirement, and areas for future development are proposed. PMID- 1790189 TI - Epidemiology and premenstrual syndrome: theories abound but where is the supporting evidence? PMID- 1790190 TI - The value of an indirect index in selecting groups for a health education message. PMID- 1790191 TI - Do women with premenstrual symptoms self-medicate with caffeine? AB - Recent investigations have suggested that caffeine consumption is related to the occurrence and severity of premenstrual symptoms. Phillis has proposed that not only the total amount of caffeine consumed but also the pattern of consumption over the menstrual cycle may be important. This study explored whether women who experience moderate or severe premenstrual symptoms differ from other women in their pattern of caffeine intake throughout the menstrual cycle. Analysis of data for 96 complete menstrual cycles from 47 women demonstrated that caffeine intake during the menstrual cycle differed between women who experience moderate or severe premenstrual symptoms and other women. Furthermore, the monthly pattern of caffeine consumption for women with moderate or severe premenstrual symptoms, but not for other women, differed substantially from Phillis's proposed beneficial pattern. Women with premenstrual symptoms may self-mediate with caffeine in response to premenstrual symptoms, thereby exacerbating their symptoms. PMID- 1790192 TI - Caffeine and spontaneous abortion of known karyotype. AB - We tested associations of caffeine from beverages with spontaneous abortions of known karyotype. Spontaneous abortions (cases) were classified as chromosomally normal (n = 510) or chromosomally aberrant (n = 389) and, within the latter category, by type of aberration (237 trisomies, 54 monosomies X, 49 triploidies, 49 others). Controls registered for prenatal care before 22 weeks gestation and delivered at 28 weeks or later (n = 1,423). Caffeine intake in the perifertilization period did not differ among case groups and controls. For the highest category, 225+ mg/day, odds ratios (OR), adjusted for payment group and maternal age, were 1.0 for chromosomally normal cases, 0.9 for trisomies, 1.6 for monosomies X, and 0.8 for triploidies. Caffeine intake during pregnancy was tested for associations with chromosomally normal loss using the chromosomally aberrant cases to provide a robust comparison group. Although the proportion of subjects with intake of 225+ mg/day of caffeine intake in the perifertilization period does not influence the risk of chromosomally normal loss or trisomy. For monosomy X and triploidy, no strong associations were observed, but numbers were insufficient to rule out moderate effects. For caffeine intake during pregnancy, we found little evidence to support an influence on chromosomally normal loss. PMID- 1790193 TI - The importance of employment status in occupational cohort mortality studies. AB - Person-years at risk in occupational cohort mortality studies may be defined as "active" (when a person is working) or "inactive" (after a person has left employment at the plant under study). To investigate the effects of employment status (active/inactive) both across studies and within them, we have analyzed ten large cohort studies conducted by the National Institute for Occupational Safety and Health in which no occupational risk had been observed. These ten data sets included 89,376 workers, 1,984,505 person-years, and 18,840 deaths. In these ten studies, the SMR for all causes was positively correlated with the percentage of inactive person-years in the study (r = 0.57, p = 0.08). Considering only inactive person-years, the all-causes SMR was 1.12 (approximately 1.25 before age 65, dropping to 1.00 after age 65). Stratification of inactive person-years by time-since-last-employment showed markedly increased mortality during the first year following employment. The all-causes SMR during active person-years was 0.40 and was fairly constant across age categories. With active and inactive person years combined, a strong negative trend in SMRs with duration of employment was observed for all causes and for heart disease. These trends were not apparent when person-years were stratified by employment status. These results indicate that investigators should evaluate the effects of employment status when comparing SMRs between multiple cohorts or when interpreting trends in rate ratios within cohorts. PMID- 1790194 TI - The effect of recall bias on the association of calorie-providing nutrients and breast cancer. AB - This nested case-control study conducted within a large dietary cohort study examined whether recall bias could explain the inconsistent results obtained in case-control and cohort studies of the association between dietary fat and breast cancer. Cases were defined as women diagnosed with breast cancer between 1982 and 1987 who had completed a self-administered food frequency questionnaire on enrollment in the cohort study between 1982 and 1985. They were matched to two controls each, and the study subjects were asked in 1988 to complete a second diet questionnaire addressing their diets at the time of enrollment. The mean nutrient intakes for 325 cases who completed the first diet questionnaire six months or more before breast cancer diagnosis and their 628 matched controls were very similar for the prospectively and retrospectively collected diet questionnaires. There was little difference in the magnitude of the odds ratios estimated from the two questionnaires for the association between breast cancer risk and these nutrients. These data do not provide evidence for recall bias in retrospectively collected nutrient data from breast cancer cases compared with their matched controls. PMID- 1790195 TI - Mailed dietary surveys: response rates, error rates, and the effect of omitted food items on nutrient values. AB - Mailed surveys may be a cost-effective way to collect dietary information in large populations. We sent a brief quantified food frequency survey to a random sample of 2,000 prepaid health plan members between the ages of 20 and 65 years for two consecutive years. Logistic regression was used to predict the probability of: (1) responding to the questionnaire, (2) completing all 60 items in the questionnaire correctly so that all information could be used (responding entirely correctly), and (3) completing all 60 items in the questionnaire incorrectly so that no information was usable (responding entirely incorrectly). In a follow-up survey of a subsample of respondents, Spearman correlation coefficients were used to compare nutrient intakes calculated from questionnaires that had omitted data with those from the same questionnaires after the missing information was completed by telephone interview. About 50% of all persons surveyed returned the questionnaire. Response rates were highest among persons who had taken a voluntary multiphasic health examination, among women, and among older persons. Only 22.9% of the respondents in year 1 and 27.7% of the respondents in year 2 responded entirely correctly; a small percentage of respondents (12.1%) omitted more than 10 food items. Responding entirely correctly was inversely related to age and related to race. Most correlations between nutrient intakes calculated from questionnaires with omitted data and those from the same questionnaire subsequently completed by telephone interview were greater than 0.90 and increased as the number of omitted items decreased. If a relatively low overall response rate is acceptable, food frequencies collected through the mail can be an effective way to gather dietary information. PMID- 1790196 TI - The raw oyster consumer--a risk taker? Use of the Behavioral Risk Factor Surveillance System. AB - We used the 1988 Behavioral Risk Factor Surveillance System in Florida to determine the prevalence of consumption of raw oysters, a vehicle implicated in the transmission of several pathogens. One-third of survey respondents reported ever eating raw oysters. The prevalence was higher for persons 18-49 years old and for males, and, when controlled for age and sex, for persons who reported being cigarette smokers or acute or chronic alcohol drinkers, and driving while intoxicated. PMID- 1790197 TI - HIV seroconversion and disinfection of injection equipment among intravenous drug users, Baltimore, Maryland. AB - To examine the putative protective effect of disinfectant use on HIV seroconversion among intravenous drug users, we conducted a nested case-control study comparing 22 black heterosexual HIV seroconverters with 95 persistent seronegatives matched on gender, use of cocaine, date of study entry, and duration of follow-up. For intravenous drug users who reported using disinfectant all the time, the odds of seroconversion was 0.77 (95% CI: 0.25-2.38) compared with those who reported no use of disinfectants; for those who used disinfectants some of the time, the corresponding odds ratio was 0.91 (95% CI: 0.26-3.31). The odds ratio for use of disinfectant all the time was 0.63 (95% CI: 0.10-3.91) for those injecting at galleries and 1.08 (95% CI: 0.35-3.11) for those not injecting at galleries. These data suggest a limited protective effect of disinfectant use in the field which may be more beneficial to those injecting in shooting galleries. PMID- 1790198 TI - Age and sex differences in variation of nutrient intakes among U.S. adults. AB - Studies assessing associations of diet with health frequently use multi-day dietary records to estimate usual dietary intakes. We examined variation in intakes of 13 nutrients for 13,388 U.S. adults using 3 days of dietary data from the 1977-1978 Nationwide Food Consumption Survey. Ratios of within-person variability to between-person variability in intakes were large and would result in attenuated linear regression estimates of diet-health associations. For many nutrients, the magnitude of the attenuation decreased with age for both sexes but particularly for men, implying that fewer days of dietary intake per person would correctly assess diet-health associations among older adults than have been suggested for younger adults. PMID- 1790199 TI - Chronic hypertension, cigarette smoking, and abruptio placentae. AB - We investigated the importance of maternal hypertension and cigarette smoking, and their interaction, as risk factors for abruptio placentae, using Massachusetts birth certificate data for 1987-1988. We used multiple logistic regression procedures to model data from 943 abruptio placentae cases and 10,648 randomly selected births. Risk of abruption was associated with a history of chronic hypertension (adjusted OR = 2.3, 95% CI: 1.5-3.5) and cigarette smoking during pregnancy (adjusted OR = 1.7, 95% CI: 1.5-2.0). There was also evidence of interaction between chronic hypertension and cigarette smoking. The hypoxemia that results from exposure to cigarette smoke and the alterations in uterine blood flow that result from hypertension may lead to placental lesions that cause abruption. PMID- 1790200 TI - Severe vomiting during pregnancy: antenatal correlates and fetal outcomes. AB - Neither the cause nor the effect of severe vomiting during pregnancy is well understood. This study examines possible causes of severe vomiting and associations between this disorder and fetal outcomes. One thousand eight hundred sixty-seven women with normal singleton live births were included in the analysis. The cumulative incidence of severe vomiting during pregnancy was 10.8%. Women with chronic liver disease had a threefold increased risk of severe vomiting during pregnancy. Paternal smoking was associated with a twofold increased risk of maternal vomiting. A modest association between severe vomiting and fetal growth retardation was identified (OR = 1.4, 95% CI: 0.9-2.3). Severe vomiting was also found to be associated with preeclampsia (OR = 1.5, 95% CI: 1.0 2.4). Our study indicates that passive smoking is a risk factor for vomiting during pregnancy, which may, in turn, increase the risk of fetal growth retardation. PMID- 1790201 TI - Light exposure and breast cancer. PMID- 1790202 TI - Chlorinated water exposures and congenital cardiac anomalies. PMID- 1790203 TI - [Use of the rendez-vous technique in endoscopic insertion of biliary prosthesis in malignant obstructive jaundice]. AB - The paper describes the Authors' personal experience of the use of the rendez vous technique (using a combined endoscopic-transhepatic route) for the endoscopic insertion of biliary prosthesis in cases of malignant obstructive jaundice. Having illustrated the series of cases, the paper proposes the use of this technique in the event of endoscopic failure due to the smaller incidence of complications compared the use of a wholly transhepatic route. PMID- 1790204 TI - [Endoscopic therapy of giant choledochal calculosis]. AB - The paper reports the results of conventional endoscopic treatment in 100 consecutive cases of giant lithiasis of the common bile duct. A giant calculus is one whose dimensions exceed 2 cm. Endoscopic therapy proved successful in 73% of cases, with an 8% incidence of complications. The success of endoscopic treatment is related to the anatomical conditions of the biliary tract and the diameter of calculi. Mechanical lithotripsy has proved efficacious in all cases where it was used, whereas poor results were obtained using MTBE infusion through a naso biliary tube. ESWL provided encouraging results. Cases which were not resolved using endoscopic methods were treated using intervention radiology or surgery, or both. PMID- 1790205 TI - [Diagnosis of bacterial contamination of the small intestine using the 1 g [14C] xylose breath test in various gastrointestinal diseases]. AB - The prevalence of the small intestine bacterial overgrowth syndrome has been assessed in 109 in-patients affected by various gastrointestinal disorders using the 1 g [14C]-xylose breath test; 18 healthy subjects acted as a control group: none of them showed abnormal results (100% specificity). None of 14 patients with colonic disease had abnormal results, whereas in 44 patients with ileal diseases the test was positive in 12% to 39% of the cases. Abnormal results were found in 46% of patients who underwent partial gastric resection greater than 20 years before, 29% of patients with irritable bowel syndrome without diarrhoea (faecal wet weight less than or equal to 600 g/72 h), 56% of those with diarrhoea of obscure origin, and 25% of celiac patients. Eight out of 8 patients with altered results showed normalization of the test after antibiotic therapy. Despite its high diagnostic value in the setting of clinical research, the 1 g [14C]-xylose breath test cannot as yet be proposed as a routine investigation. PMID- 1790206 TI - [Preservation of the liver with the University of Wisconsin solution. Clinical and experimental aspects]. AB - The University of Wisconsin solution discovered in 1987 by Belzer and associates, has dramatically changed the logistics associated with liver transplantation. The extension of hypothermic preservation time has mode at possible: a) to operate in a semi-elective situation, rather than urgent; b) to improve patient selection and to be able to admit them from distant locations, and c) to reduce postoperative complications with a better quality of organ preservation. In the present work we illustrate the pathophysiological background and the rationale behind the various chemical constituents included in the new solution, emphasizing the antiedemogenic effect. Furthermore we report some experimental data on the role of energy level (ATP) and intracellular pH in the monitoring of liver preservation. Together with the improvements of surgical technique and immunosuppression, the new solution of the University of Wisconsin represents a fundamental step in the development of organ transplantation. PMID- 1790207 TI - [Adenocarcinoma of the distal esophagus treated with external and intracavitary radiotherapy. Description of a clinical case and review of the literature]. AB - The prognosis of esophageal adenocarcinoma is extremely poor. Despite recent improvements in diagnostic and therapeutic techniques, the 5-years survival rate remains below 10%. Management is primarily surgical or radiotherapeutical, although pre- or postoperative radiation or chemotherapy are often employed. Chemotherapy alone, however, has not demonstrated great therapeutic efficacy in the management of this neoplasm. As most patients with cancer of the lower esophagus have an advanced stage of the disease and a very poor prognosis, the main aim of treatment should be to improve the quality of life. Intracavitary radiation (high dose rate) is a well recognised method of treatment alone or in combination with external radiotherapy. Its simplicity, the convenience of short treatment time and radiation safety provided by the remote after loading system make this the ideal palliative treatment in esophageal cancer. Endoscopic techniques, like dilation and endoprosthesis placement, laser therapy or BI-CAP probe, provide good palliation for dysphagia, with a low morbidity rate. The paper describes a case of lower esophageal adenocarcinoma treated with combined external and intracavitary radiation and endoscopic palliative techniques. Good control of the disease was achieved and the patient is alive 26 months after treatment with a good quality of life. PMID- 1790208 TI - Exercise-induced phospholipid degradation in the equine skeletal muscle and erythrocytes. AB - To understand the pathogenesis of equine exercise-induced myopathies and hemolysis, changes of phospholipid peroxidation products in the equine middle gluteal muscle and erythrocytes following the high-speed treadmill exercise were studied. In the skeletal muscle, the peroxidized phosphatidylethanolamine (PE) were increased at 24 hours after the exercise. The malondialdehydes (MDAs) were also increased as the protein-bound MDAs following exercise. In the erythrocytes, the peroxidized PE were significantly decreased at 24 hours after the exercise. The protein-bound MDAs were significantly increased at 5 min after the exercise and returned to the base values at 24 hours after the exercise. These findings indicate that the PE is more susceptible to in vivo oxidative effects than the other phospholipid classes, and the accumulation of the protein-bound MDAs is considered to play some cytotoxic roles in the equine skeletal muscle and erythrocytes following exercise. PMID- 1790209 TI - Medullary bone of piglets. AB - The bone marrow is commonly present in the medullary cavity of long bones in most mammals at birth. In the present study, the persistence of the osseous tissue was examined in the medullary cavities of piglet bones at and after birth. Immediately after birth, medullary cavities of long bones were almost completely filled with the spongy bone. The persisted spongy bone, i.e., medullary bone was prominent in younger pigs but decreased with advance in age. By 90 days of age, the medullary bone almost disappeared to form the extended medullary cavity. During the disappearing process of the medullary bone, osteoclasts showed significant increase in size and number (p less than 0.05). In irregular and flat bones, osseous trabeculae of the medullary bone became slender with age. The extramedullary hematopoiesis in the liver and spleen was very active till 30 days of age. This may suggest that the persistence of the medullary bone narrows the medullary cavity to cause poor medullary hematopoiesis and is compensated by extramedullary hematopoiesis. The relationship among the medullary bone, extramedullary hematopoiesis and piglet anemia was discussed. PMID- 1790210 TI - Serum C-reactive protein (CRP) in horses: the effect of aging, sex, delivery and inflammations on its concentration. AB - The serum concentration of C-reactive protein (CRP) in horses was measured by single radial immunodiffusion (SRID) using rabbit anti-equine CRP serum to evaluate the significance of CRP as an acute-phase reactive protein. In serum samples of clinically normal newborn thoroughbred foals before being given colostrum, serum CRP was not detectable (less than or equal to 1 microgram/ml). The serum CRP concentration was found to increase quickly and reach a peak level of approximately 14.1 micrograms/ml in 12-month-old horses. Then, it decreased gradually to reach a low value of 5.4 micrograms/ml in the 4-year-old. In horses over 5-year-old, serum CRP concentration was stable at values of 7 to 8 micrograms/ml. In mares during the peri-natal period, serum CRP concentration decreased at 2 months before delivery, showed moderate changes just before and after delivery, and then increased to relatively high level by 2 months after delivery. The concentration of serum CRP was found to be increased at 24 hours after experimentally inflammatory stimuli in adult horses, and reached peak values of 3 to 6 times as high as the base line values at 3 to 5 days. Serum CRP concentration returned to base line values by 2 to 3 weeks after treatments. It is clear from these data that CRP is one of the acute-phase reactive proteins in horses. PMID- 1790211 TI - Determination of the source of relaxin immunoreactivity during pregnancy in the dog. AB - We investigated the source of immunoreactive relaxin (IR) in the dog during pregnancy using the following: (1) controls, (2) dogs ovariectomized during pregnancy and maintained on progesterone, (3) dogs hysterectomized during pregnancy or immediately postpartum, (4) corpora lutea, uteri, and placentas collected at various times during pregnancy for determination of IR, and (5) maternal (overian and uterine vein) and fetal (cardiac) blood and amniotic and allantoic fluid. Plasma IR patterns remained unchanged in animals subjected to ovariectomy, whereas in the controls IR was first detected at about Day 20 of pregnancy, peaked on Day 35, and was then remained at the same level until parturition. Hysterectomy, on the other hand, resulted in IR values becoming undetectable within 2 to 3 days. The highest tissue concentrations of IR were found in the placenta. These findings indicate that the source of relaxin in the pregnant dog is the placenta. PMID- 1790212 TI - Distributions of extracellular matrix and carbonic anhydrase-III during bovine palatine ridge development. AB - The present study describes histological alterations and immunohistochemical distributions of extracellular matrices (ECMs) and the carbonic anhydrase isozyme III (CA-III) during the period of bovine palatine ridge formation. Morphogenesis of bovine palatine ridges was preceded by epidermal placodes and the mesenchymal condensation (MC). During the early stages of less than 44 cm crown rump length (CRL), fibronectin (FN) was distributed densely in the MC. Strong reactions against type I collagen (C-1) were detected outer to the FN positive site. In the stages of more than 44 cm CRL, FN and C-1 were distributed diffusely in subepithelial mesenchyme. Laminin (LN) and type IV collagen were distributed in the epithelial and endothelial basement membranes (BMs) in all of the stages examined, except in the stage of 7 cm CRL, where LN was not detected only in the BM just beneath the epidermal placode. CA-III was detected in basal epithelial cells except for palatine ridge rudiments in the stages of more than 21 cm CRL. It is suggested that the expressions of LN and CA-III might play a role in the spatial determination of rudiments of bovine fetal palatine ridges. PMID- 1790213 TI - Pathological studies on cerebral amyloid angiopathy, senile plaques and amyloid deposition in visceral organs in aged dogs. AB - The relationship between cerebral lesions such as amyloid angiopathy or senile plaques and amyloid deposition in the visceral organs were studied in 90 autopsy cases of dogs, 0 to 19-year-old. Cerebral amyloid angiopathy was detected in 28 aged dogs (mean age: 13.7-year-old) and was found mostly in or around the wall of cerebral meningeal arterioles and capillaries of the neocortex. That condition was often accompanied by cerebral hemorrhage in dogs more than 9 years of age. Senile plaques were detected in the neocortex of the brain of 12 dogs (mean age: 13.2-year-old) and classified into 3 subtypes, i.e., "diffuse plaque", "primitive plaque" and "classical plaque". Among those 3 subtypes of senile plaques, amyloid containing plaques were small in number. In the visceral organs of dogs with cerebral amyloid angiopathy, amyloid deposition was found in the vascular walls or connective tissues of small intestines at a high frequency and sometimes in the vascular walls of the heart, lung, liver and thyroid gland as well as in atrioventricular valves. Amyloid in both cerebral and visceral organs was congophilic and showed green birefringence under poralized light even after potassium permanganate oxidation. PMID- 1790214 TI - Experimental infections of mice and pigs with Streptococcus suis type 2. AB - Five inbred strains of mice were tested for their susceptibility to Streptococcus suis type 2 including the type strain, two isolates from meningitis in pigs and two isolates from tonsils of clinically healthy pigs. C57BL/6, ICR and ddY strain mice showed lower susceptibility to all strains of S. suis type 2 than BALB/c and SS strain mice. The type strain and the isolates from diseased pigs produced septicaemia and meningitis in BALB/c and SS mice inoculated with 10(8) colony forming unit of the bacteria and 60 to 100% of these infected mice died. On the other hand, mice inoculated with the isolates from healthy pigs showed mild clinical signs but none of them died. In BALB/c mice which died or developed nervous signs, the purulent meningo-encephalitis, myocarditis, ophthalmitis, labyrinthitis and otitis media were observed. S. suis type 2 antigen was demonstrated in these lesions by immunoperoxidase staining using rabbit S. suis type 2 antiserum. These results were similar to those in the experimentally infected pigs with these virulent and avirulent strains against mice. These results indicate that BALB/c and SS strains of mice are useful as an experimental model of S. suis type 2 infections in pigs, and that there are virulent and avirulent strains against mice and pigs among the strains of S. suis type 2. PMID- 1790215 TI - Pathological studies on systemic mycoses in calves. AB - Systemic mycoses were found in 19 (4.7%) of 406 calves less than 6 months old which were autopsied during the past 10 years. Alimentary mycosis occurred in 12 (63.2%) of 19 cases. In alimentary mycosis, mucormycosis showed the highest rate of occurrence (91.7%, 11/12 calves) followed by aspergillosis 41.7% and candidiasis was 9.3%. Mucormycosis and aspergillosis were characterized by focal hemorrhagic necroses with hyphal proliferation and thrombi in the mucosa and muscular layers of the forestomach, abomasum, and small intestine. Candidiasis was characterized by hyperkeratosis with pseudohyphae and microconidia in the mucosa of the omasum. Four of 12 calves (33.3%) had mixed infections of the alimentary tract consisting of Mucorales and Aspergillus species. Pulmonary aspergillosis was found in 10 (52.6%) of 19 calves. There were micro-abscesses with hyphal proliferation or asteroid bodies in the lungs. Infections involving both the alimentary tract and respiratory organs were noted in 3 (10.5%) of 19 calves. Disseminated mycosis was found only in one calf. In alimentary mycosis, administration of antibiotics for the treatment of diarrhea and early weaning were thought to be an important predisposing factor. PMID- 1790216 TI - Immunoelectron microscopy of chicken anemia agent. PMID- 1790217 TI - Antiprogesterone compound, RU486 administration to terminate pregnancy in dogs and cats. PMID- 1790218 TI - Erythrocyte sickling in sika deer (Cervus nippon). PMID- 1790219 TI - Epidemiology of equine rotavirus infection among foals in the breeding region. PMID- 1790220 TI - Use of laryngeal mask airway in small animals. PMID- 1790221 TI - Detection of aflatoxin B1 in plasma of fowl receiving feed naturally contaminated with aflatoxin B1. PMID- 1790222 TI - Chromatographic analysis of glycosaminoglycans in epiphyseal cartilage of congenital osteochondrodysplasia (ocd/ocd) rat. PMID- 1790223 TI - Detection of staphylococcal enterotoxin A by sandwich enzyme-linked immunosorbent assay with monoclonal antibodies. PMID- 1790224 TI - First case of Hepatozoon canis infection of a dog in Japan. PMID- 1790225 TI - Enzyme variation of Eimeria acervulina and E. tenella isolated from poultry farms in Japan. PMID- 1790226 TI - Preparation of monoclonal antibodies against dog erythrocyte antigen D1 (DEA-3). PMID- 1790227 TI - An epidemiological survey of Brucella canis infection of dogs in the Towada area of Aomori prefecture. PMID- 1790228 TI - Evaluation of pulse oximetry in anesthetized dogs. PMID- 1790229 TI - Delay of closure of the ductus arteriosus at low temperatures in newborn rats. PMID- 1790230 TI - Anatomical findings of apodia in a calf. PMID- 1790231 TI - Analysis of various antigens in golden hamster testis by monoclonal antibodies. AB - A total of 38 hybridomas producing monoclonal antibodies (mAbs) was established by immunizing BALB/c mice with extracts of the golden hamster testis. Six mAbs stained the acrosome of developing spermatids by immunofluorescence. Two mAbs (1A11 and 4D8) reacted with spermatid components other than acrosome. The mAbs 1C9 and 4D3 recognized a 103 kilodalton (kDa) protein on immunoblots, and were reactive to spermatocytes and early spermatids, but not to late spermatids and spermatozoa. This finding suggests that the protein functions for meiosis or early spermiogenesis. Four mAbs (3G2, 2E5, 2G3, and 3F10) stained all stages of spermatogenic cells. The remaining 24 mAbs showed a positive reaction to the basement membrane of the seminiferous tubule. Two of them, 3D6 and 3E5, recognized approximately 150 kDa major proteins, indicating that the antigen is an extracellular matrix. PMID- 1790232 TI - Increased nuclear type II estradiol receptor concentrations in rat spleen during the course of pregnancy. AB - Estradiol receptors are classified into type I and type II receptors by their affinity and capacity for estradiol binding. The type II receptors are thought to be significant in the suppression of immune response, such as in the pregnancy associated immunosuppression. The present study was undertaken to show the presence of type II receptors in rat spleen and to examine the change of receptor distribution after estradiol administration and during pregnancy. Scatchard analysis revealed that the type II receptors were present in rat spleen, and dissociation constants were estimated to be 3.23 x 10(-9) M for cytosol and 4.29 x 10(-9) M for nuclei. The receptors possessed specificity for estradiol and diethylstilbestrol, but not for promegestone, methyltrienolone and dexamethasone. Administration of estradiol to rats resulted in the increase of nuclear receptor concentrations with concomitant decrease of cytosolic concentrations. During pregnancy, the receptor concentrations were increased in the nuclear fraction, but were not significantly changed in the cytosolic fraction. The dissociation constants of the receptors in pregnant rat spleen (4.77 x 10(-9) M for cytosol and 7.20 x 10(-9) M for nuclei) were similar to those in the non-pregnant control, suggesting the quantitative change of the receptors during pregnancy. PMID- 1790233 TI - Epidemiological and pathological studies on congenital diffuse hyperplastic goiter in calves. AB - Perinatal diseases such as weak calf, stillbirth, or abortion were found in 86 calves from about 600 cows in a farm (A Farm) in 1987 and 1988. Such perinatal diseases were decreased to 36 calves in 1989 and 1990 after an additional supply of seaweed was made to the maternal feeds. From these cases, 23 stillborn and weak calves were pathologically examined. The mean weight with standard deviation of the 18 thyroid glands was 36.3 +/- 28.6 g before feeding of the seaweed supplement, and 12 (67%) of the glands showed moderate to marked degree of diffuse hyperplastic goiter in histological criteria. On the other hand, 5 glands weighed 12.0 +/- 3.4 g and revealed no such histological lesions after the additional supply. These results suggest that the goiter had been associated with birth of weak calves. Further study was performed on 37 newborn calves affected with Akabane disease in 1986 in A Farm and the neighbouring B Farm located. Seven (54%) of 13 thyroid glands from A Farm and 1 (4%) of 24 glands from B Farm showed histologically moderate to marked goitrous lesions. There were dotted "Inugarashi", Rorippa indica, family Cruciferae in both pastures. The mean iodine contents of the orchard grasses were 87 and 121 micrograms/kg on dry basis in A and B Farms. Marginal deficiency or lower limit of iodine and possible thiocyanate content of "Inugarashi" may have been responsible for the goiter in the farms. PMID- 1790234 TI - Interleukin 1 alpha mRNA-expressing cells on the local inflammatory response in feline infectious peritonitis. AB - By in situ hybridization with biotinylated human interleukin 1 alpha (IL-1 alpha) cDNA probe, distribution of feline IL-1 alpha mRNA-expressing cells was examined in the tissues from 49 cases diagnosed as feline infectious peritonitis (FIP) by pathological examination. IL-1 alpha mRNA-expressing cells were found in visceral peritoneum, lymphoid organs, liver, kidney, pancreas, digestive tract, lung, pleura, brain, palpebral conjunctiva, and bone marrow. Hybridization signals for IL-1 alpha mRNA were mostly located in the local inflammatory lesions on the serosal surface of various organs and omentum, which were frequently involved in the lesions of FIP (27.8 +/- 5.1 cells/mm2). Morphological examination suggested that they were infiltrated macrophages. However, few IL-1 alpha mRNA-expressing macrophages were in the lesions of other organs. These data suggested that IL-1 alpha produced from macrophages in the local inflammatory sites might participate in the initiation and development of the lesions on the visceral peritoneum in FIP. PMID- 1790235 TI - Starch removal from potato tuber sections. AB - Heating plant sections at 90 C with 0.5% aqueous ammonium oxalate is required to remove pectins. When applied to tissues rich in starch such as potato, this step produces heavy dextrinization of the starch which hinders subsequent evaluation of the extinction values of the cell walls. To overcome this a method has been devised to brush away the starch granules from the sections with a thin paint brush, just after paraffin removal by xylene. The slide is then processed as usual: pectins are removed by heat treatment, cell walls are stained with PAS and the stain intensity can be evaluated by photometry. PMID- 1790236 TI - A new imprinting material for scanning electron microscopic studies. AB - A new imprinting material, "Thermocool", has been used for preparing negative replicas of plant as well as metal surfaces for SEM study. The technique has wide application and gives very good results. PMID- 1790237 TI - Quantification of tartrate resistant acid phosphatase activity using a computerized image analysis system. AB - Tartrate resistant acid phosphatase (TRAP) has been accepted as a marker for identification of osteoclasts. A method is reported here for quantitating TRAP using an image analysis system. The amount of the enzyme specific to osteoclasts can be used to differentiate osteoclasts from other cells capable of TRAP expression. TRAP expression characteristic of the osteoclast was compared with that of multi-nucleated giant cells (MNGC)s recruited to the site of subcutaneously implanted mineralized bone matrix. Two weeks post-implantation, the pellets were removed and processed for the demonstration of TRAP along with rat proximal tibiae. A large amount of TRAP was consistently expressed by the in situ osteoclasts. The MNGCs associated with the mineralized bone implants expressed little if any TRAP reaction product. Using this system, the amount of TRAP reaction product or any other enzyme reaction product expressed can be objectively and reproducibly quantitated. PMID- 1790238 TI - Ammonium thiocyanate for detaching antibodies from histological specimens. AB - When different antigens must be demonstrated in the same structure, the permanence of former antibodies can lead to false identification of another antigen. The peroxidase-antiperoxidase method was used, followed by the oxygen acceptor ethyl-carbazole. After staining the sections, they were destained with xylene and the antibodies detached with 3 M ammonium thiocyanate; then the specimens were treated for the demonstration of the other antigen. The procedure could be repeated and thus as many as four antigens could be demonstrated without damaging the tissues. Antigens participating in the immunohistochemical staining were well-preserved after destaining and detaching the antibodies as demonstrated by their ability to react again in a second staining. PMID- 1790239 TI - A rapid method for macerating phloem. AB - Sieve cells and sieve tube members can be macerated from the phloem of various organs of woody and herbaceous species by autoclaving the tissue in a mild macerating medium. This treatment does not digest the primary walls or the callose deposits on the sieve areas and sieve plates of the sieve elements. These cells can then be recognized by the fluorescence of their callose after staining with aniline blue. Sometimes adjacent sieve elements fail to separate and one can observe details of their junctures. PMID- 1790240 TI - Pituitary secretory granule topography: influence of different electron microscopic preparation procedures on the surface of Epon sections. AB - Human, rat and mouse pituitary tissues have been examined electron microscopically in transmission (TEM), scanning-transmission (STEM) and scanning (SEM) modes for the surface appearance of the secretory granules in tissue sections. Cryofixed and cryosectioned tissue showed only slightly protruding granule profiles which had a smooth surface. Cryofixed, freeze-dried and Epon embedded pituitaries, on the other hand, demonstrated swollen and furrowed surfaces over the granules after contact with water. This topography could also be seen after glutaraldehyde fixation but less after post-fixation in OsO4. The surface alterations in the sections of pituitary secretory granules are thought to be due to differences in the homogeneity of the resin infiltration, leaving resin-free openings where water can enter. It also seems probable that the Epon resin is more influenced by water than has been previously assumed, based on the findings of efficient elimination of osmium from the granules after incubation of tissue sections in water for only 10 min. PMID- 1790241 TI - Avoiding gas bubble formation during freeze substitution. AB - Gas bubbles frequently are formed during freeze substitution, especially when tissues are warmed to room temperature. The problem arises largely from the extreme solubility of CO2 in the freeze substitution solvent. Gas bubbles may be minimized by briefly transferring the tissue to freshly chilled solvent before warming to room temperature. PMID- 1790242 TI - In situ embedding of cell monolayers cultured on plastic surfaces for electron microscopy. AB - Various procedures suitable for routine in situ embedding of cell monolayers were tested including: (1) the use of different Epon substitutes, (2) the use of different types of plasticware obtained from different sources, and (3) different methods of preparing capsules for sectioning. Different resins reacted differently with different plastics and type of preparation. Merck Epon substitute bound to most of the plastics tested. Ladd Epon substitute released cleanly from all plastics tested when a suitable method of preparation was used. The results show that for routine embedding of cell monolayers it is necessary to select an appropriate Epon substitute and method of preparation of capsules for the type of plasticware used. A routine method is described, with various alternative steps which can be applied when particular difficulties are encountered. PMID- 1790243 TI - Thin histological sections prepared from large thick sections: a new technique. AB - A method is described for obtaining thin (1 microm) sections for light microscopy from large area thick (100 microm) sections of low viscosity nitrocellulose embedded specimens of human spinal osteoligamentous material. PMID- 1790244 TI - [The antioxidative activity of drugs in the liver microsomal system of rats]. AB - The antioxidative properties of drugs--diethylcarbamazine citrate--DECC, dipyridamole-DP, levamisole and labinzarit--have been investigated in various microsomal lipid peroxidation (LPO) models: NADPH-, ascorbate- and CCl4 dependent. The most strong antioxidant of direct action turned out to be DP, DECC exhibited the antioxidative properties as a result of metabolic activity in monooxygenases system of rat liver microsomes. Levamisole and labinzarit turned out to be weak antioxidants. The control of microsomal membrane stability against Fe(2+)-ADP, NADPH-induced LPO, after being isolated from rat liver after the action of CCl4 without and with DECC, showed that DECC protected microsomal membranes from CCl4 in vivo and they remained stable against LPO in vitro. PMID- 1790245 TI - [The cytochrome P-450 content and catalytic activity in rat liver microsomes during hyperbaric oxygenation]. AB - The effect of different conditions of hyperbaric oxygenation (HBO) on content and catalytic activity of cytochrome P-450 in rat liver cytochrome has been studied. The intensity of lipid peroxidation in microsomal membranes has been determined by the content of dien conjugates and Schiff's bases. The rate of amidopyrine demethylation has been shown not to change, but the rate of aniline hydroxylation decreases on 34, 57 and 64% under increase of oxygen pressure up to 0.3, 0.5 and 0.7 MPa correspondingly. The level of dien conjugates increase on 66-87% under all studied conditions of HBO. Cytochrome P-450 content decreases on 45% under the action of 0.7 MPa, but content of Schiff's bases increases on 210% as compared with control. PMID- 1790247 TI - [An enzyme from the fungus Aspergillus niger that hydrolyzes choline ethers]. AB - The acetylthiocholine-hydrolyzing enzymatic activity inhibited by the neostigmine and partly physostigmine has been found in extracts from mycelium of fungus Aspergillus niger. The enzyme has been isolated and 15-20 fold purified. The cholinesterase activity of the protein (Kmu 7.10-7 M) is comparable with known for analogous enzymes from higher plants, for its inhibition high concentrations of substrate (greater than 10-3M) are required. The enzyme hydrolyzes acetylthiocholine with rate approximately 1.5 times higher than butyrylthiocholine. Molecular mass of native protein is approximately 600 kDa, subunits -63 and 44 kDa. PMID- 1790246 TI - [The effect of copper and insulin on nucleic acid and protein synthesis in Tetrahymena pyriformis cells under different functional conditions]. AB - The effect of copper ions and insulin on the rate of DNA, RNA and protein synthesis, and on the growth dynamics of Tetrahymena pyriformis cells, and also joint action of Cu2+ and insulin on these processes has been investigated. The effect of Cu2+ after 6-fold action of heat shock (34 degrees C) on the cell culture has been studied. The results obtained indicate that significant reconstructions of the infusoria cell functioning conditions caused by various reasons re of great importance in the adaptation mechanisms to such stress factors as heavy metals. PMID- 1790248 TI - [The structural equivalents of the functions in the nervous system]. AB - The article is devoted to the analysis of multiaspect manifestation of morphofunctional interrelation in the nervous system. Significance of morphological data on subcellular, cellular and systemic levels for the creation of physiological conceptions is considered. PMID- 1790249 TI - [Conditioned-reflex food selection in mongrel white rats exposed to high temperature]. AB - Under condition of normal temperature the conditioned reflectory runnings of rats on the audible irritants were developed more quickly during dry food than damp one. Daily influence of high temperature during two hours and partially water deprivation resulted in reduction of the conditioned reflex which had been developed before during dry food. The reproduction of the conditioned reflexes during dry food failed. The essential changings in the conditioned reflexes during damp and dry food were not found when animals had become overheating without restriction of water consumption. During daily heat affecting at the end of the second week animals adapted to high temperature. This statement is confirmed by lowering the rectal temperature, decrease of the breath rate, daily water consumption and restoration of the activity of conditioned reflexes. PMID- 1790250 TI - [The effect of an insulin load on rat mast cells]. AB - The increase of heparin secretion by mast cells of kidney capsule and subcutaneous fat has been noted in rats after 30 min intravenous insulin administration in a dose 0.3 U/200 g (by this time the blood sugar concentration lowers by 40%). The index of mast cells saturation with heparin drops by 2.3 and 1.9 times correspondingly. After preliminary administration of protamine sulphate (2 mg/200 g that provokes in rats the status of temporary resistance to the hypoglycemic action of insulin the stimulatory effect of insulin on the function of mast cells does not occur. PMID- 1790251 TI - Symptomatic patent ductus arteriosus following prophylactic indomethacin. A clinical and biochemical appraisal. AB - Seven of 36 premature infants with birth weight less than 1,250 g who had been randomly assigned to either high-frequency ventilatory ventilation or conventional mechanical ventilation developed symptomatic patent ductus arteriosus (PDA) after receiving prophylactic indomethacin, 0.2 mg/kg, i.v. 24 h after birth. Infants who developed symptomatic PDA were more likely to be white and male and have more severe pulmonary insufficiency than infants who did not develop symptomatic PDA. Serum indomethacin levels were similar in both groups of patients. There was no difference in the degree of suppression or subsequent recovery of endogenous eicosanoid biosynthesis between infants who did and did not develop symptomatic PDA. Compared to conventional mechanical ventilation, high-frequency oscillatory ventilation had no significant effect on endogenous eicosanoid biosynthesis. The susceptibility of white male infants to symptomatic PDA following prophylactic indomethacin may represent the influence of maturational factors on ductus patency. Cyclooxygenase products do not appear to be involved in mediating ductus patency when symptomatic PDA occurs immediately following administration of prophylactic indomethacin. PMID- 1790252 TI - Ductal shunting and effective systemic blood flow following single dose surfactant treatment in the premature baboon with hyaline membrane disease. AB - We studied the hemodynamic effects of using natural surfactant in premature baboons with hyaline membrane disease (HMD). Study animals (n = 5) received a single dose of surfactant immediately after delivery and control animals (n = 8) did not. Using microspheres at 3, 8, and 23 h we found no significant differences in left ventricular output, effective systemic flow, systemic-to-pulmonary patent ductus arteriosus (PDA) shunting, or in cerebral or renal organ blood flow. However, both groups had large PDA shunts (fraction of LVO to lungs greater than 0.40-0.55 at 3 and 8 h) resulting in low systemic perfusion (less than 80 ml/min/kg). Single dose surfactant did not improve the myocardial dysfunction and low cerebral and renal blood flow which occur during treatment for HMD. PMID- 1790253 TI - Autoradiographic localization and effects of exogenous radioactively labelled surfactant in the lung of the prematurely delivered fetal rabbit. AB - Adult rabbit lung surfactant was radioactively labelled with [3H]palmitate and isolated by centrifugation. This material was instilled into the trachea of fetal rabbits prematurely delivered on the 27th gestational day. A similar preparation of unlabelled surfactant was used to measure the effects on pressure-volume characteristics in lungs of 27th day fetuses. Tissue sections were prepared from the lungs of all animals and morphometric and autoradiographic determinations made. Surfactant instillation improved pressure-volume relationships in fetal rabbit lungs. Histologically, although only the middle right lobe seemed to show significant qualitative improvement in expansion after surfactant treatment, quantitative assessment indicated that the surfactant preparation had significantly increased the mean alveolar cross-sectional areas in all three lobes of right lungs. In addition, distribution of autoradiographic grains indicated that 8-25% were located over the alveolar spaces while approximately half this percentage was present over tissue at the level of the alveolus. These results indicate that intratracheal instillation of surfactant supplements the endogenous surfactant at the level of the alveolus. PMID- 1790254 TI - Relationship between newborn and maternal iron status and haematological indices. AB - The haemoglobin, mean corpuscular volume, mean corpuscular haemoglobin, haematocrit, serum iron and total iron binding capacity, and serum ferritin concentrations in umbilical cord blood samples taken from 96 appropriate-for gestational age infants delivered at term were measured and compared to the respective maternal values measured at 36 weeks' gestation. All the values were higher in cord blood. Only maternal mean corpuscular volume and mean corpuscular haemoglobin were correlated with cord serum iron. Cord blood haematological indices were not correlated with either gestation at delivery or birth weight. However, newborn serum ferritin was positively correlated with gestation at delivery, while the maternal:newborn ferritin ratio was inversely correlated with gestation and birth weight. The results suggest that maternal haematological and iron indices are not predictive of the haemoglobin or iron status of the newborn, and that the fetus continues to take up iron from the mother until delivery. PMID- 1790255 TI - Influence of albumin-bound bilirubin on the antibody-dependent cellular cytotoxicity of human cells in vitro. AB - In neonatal hyperbilirubinaemia the distribution of unconjugated bilirubin (BR) between albumin and cellular binding determines its toxicity. The relationship between the ratio of BR/albumin and the impairment of cellular functions was studied employing a system of antibody-dependent cellular cytotoxicity (ADCC) with erythrocytes as target cells. The cytotoxic activity of peripheral blood monocytes, lymphocytes and granulocytes is inhibited in a concentration-related manner depending on the molar ratio BR/albumin. The occupation of albumin binding sites by BR is related to the extent of inhibition of ADCC activity suggesting that there is a competition between albumin and cellular binding sites for free bilirubin. This competition is governed by the respective affinity and concentration of the binding sites. Bilirubin binding to the cellular (silent) membrane receptors leads to the chain of events resulting in impairment of cellular functions, i.e. ADCC. PMID- 1790256 TI - Initial response of serum bilirubin levels to phototherapy. AB - We demonstrated the phenomenon of transiently increasing total serum bilirubin within 4 h of phototherapy. We attempted to resolve the mechanism of this phenomenon in 29 hyperbilirubinemic full-term newborn infants who received continuous phototherapy for 24 h. Our present study suggests that this phenomenon may in part be bilirubin load (photobilirubin, photoisomers) from skin and subcutaneous bilirubin and/or peripheral capillary wall bilirubin into the blood stream pool, rather than delayed clearance of bilirubin and photoisomers from the blood stream to bile or urine. Further study is needed to determine these bilirubin compounds for safe and more effective phototherapy. PMID- 1790257 TI - Bilirubin as an antioxidant: effect on group B streptococci-induced pulmonary hypertension in infant piglets. AB - Bilirubin scavenges toxic oxygen radicals in vitro, but it is not known whether this potential salutary effect can be extended to the intact animal. Accordingly, the present experiments tested the hypothesis that bilirubin protects against oxygen radical-dependent pulmonary hypertension and arterial hypoxemia in piglets infected with group B streptococci (GBS). Piglets ranging in age and weight from 7 to 14 days and 1.5 to 2.0 kg, respectively, were infused for 60 min with 108 cfu GBS/kg/min. One group of 7 animals was pretreated with a bolus infusion of 15 mg/kg of bilirubin followed by a continuous bilirubin infusion. A second group of 7 animals was given the vehicle. While plasma bilirubin levels in control animals were negligible, administration of exogenous bilirubin was associated with plasma levels of 13.0 +/- 0.74 mg%. Piglets treated with exogenous bilirubin exhibited GBS-induced increases in pulmonary arterial pressure and decreases in PaO2 of 16.1 +/- 2.0 and 46.5 +/- 4.3 torr, respectively. In control animals, GBS increased pulmonary arterial pressure and decreased PaO2 by 17.5 +/- 1.6 and 47.9 +/- 3.2 torr, respectively. Neither the peak changes in pulmonary arterial pressure or PaO2 nor the time courses of these alterations differed between treatment groups. These observations indicate that bilirubin fails to prevent GBS induced pulmonary hypertension and arterial hypoxemia in infant piglets and suggests that in this particular model bilirubin does not exhibit appreciable oxygen radical scavenging activity. PMID- 1790258 TI - Ascorbic acid concentration in amniotic fluid in late pregnancy. AB - Amniotic fluid and venous blood specimens were obtained from 34 pregnant women and analyzed for the ascorbic acid concentration. The mean amniotic ascorbic acid concentration of smoking pregnant women was less than 50% of that of non-smoking women. Pregnant women who smoked had a significantly lower serum and amniotic fluid ascorbic acid concentration than those who did not smoke. No differences were observed between the groups with or without premature rupture of the fetal membrane. The results suggest that ascorbic acid in the amniotic fluid reflects the ascorbic acid status in the blood of pregnant women and smoking had a greater effect in decreasing the ascorbic acid concentration in amniotic fluid than in serum. PMID- 1790259 TI - Nonlinear kinetics of lactate uptake across blood-brain barrier. PMID- 1790260 TI - How about something practical? PMID- 1790261 TI - Lack of association between HLA-DR antigens and sleep-onset REM periods in major depression. AB - Narcolepsy is the disease disclosing the strongest association with the HLA system. Almost 100% of cases are associated with HLA-DR2 antigen. Moreover, narcolepsy is often characterized by the occurrence of sleep-onset REM (SOREM) periods. SOREM has also been demonstrated in major depression. To further investigate the relationship between SOREM and HLA-DR2, HLA-DR and HLA-DQ antigens were assessed in 50 research diagnostic criteria (RDC) major depressed patients. Depressed patients were elected for HLA typing on the basis of the presence of at least one SOREM period (n = 29) or three REM latencies above 50 min (n = 21) during three consecutives EEG nights recording. No significant differences were observed in the frequency of HLA-DR or HLA-DQ antigens between patients and controls. These results demonstrate a lack of association between SOREM and HLA-DR2 in major depression, and also do not confirm the presence of an association between antigens encoded by the HLA region of the chromosome 6 and major depressive illness. PMID- 1790262 TI - Mood state in unilateral temporal lobe epilepsy. AB - The purpose of this investigation was to reexamine the relationship between self reported depression and laterality of temporal lobe epilepsy and to determine the contribution of associated frontal lobe dysfunction in predisposing patients to depression. Sixty-four patients with complex partial seizures of left (n = 26) or right (n = 38) temporal lobe origin were administered several self-report measures of mood state (Beck Depression Inventory, Center for Epidemiological Studies-Depression scale, Beck Anxiety Inventory), and a test of frontal lobe function [Wisconsin Card Sorting Test (WCST)]. There were no overall differences between the left and right temporal lobe groups on the measures of depression and anxiety. However, the left temporal lobe group exhibited a significant relationship between the degree of associated frontal lobe dysfunction (as indicated by increased perseverative responding on the WCST) and dysphoric mood state. For the right temporal lobe group there was a nonsignificant inverse relationship between mood state and indices of frontal lobe dysfunction. These results (1) are consistent with the broader psychiatric literature, which has implicated a relationship between depression and left frontal lobe dysfunction, (2) suggest that previous conflicting reports of depression/left temporal lobe epilepsy relationships are due in part to variations in the intactness of frontal lobe function, and (3) suggest that the presence of associated frontal lobe dysfunction may be a consideration in understanding interictal psychopathology in epilepsy. PMID- 1790263 TI - Increased insulin levels after OGTT load in peripheral blood and cerebrospinal fluid of patients with dementia of Alzheimer type. AB - An investigation was carried out to determine whether a disturbance of glycometabolism is associated with dementia of Alzheimer type (AD). The first part of the study was carried out on 108 AD patients and 57 normal controls (NCs). Neither the plasma level of insulin nor that of glucose differed significantly between the two groups before the oral glucose tolerance test (OGTT), whereas there was a significantly greater increase of the plasma insulin in the AD group than in the NC group after the OGTT. The second part of the study was carried out on 54 AD patients, 44 patients with vascular dementia (VD), and 26 NCs. Early in the morning after overnight fasting, there was no significant difference in the fasting plasma level of either glucose or insulin, or the cerebrospinal fluid (CSF) level of glucose, among the three groups, However, the CSF level of insulin was significantly higher in the AD group than in the other two groups. These results suggest that an abnormally high level of insulin, not only in the peripheral blood after OGTT load but also in the CSF after fasting, may be associated with the pathology of AD. PMID- 1790264 TI - Late onset argininosuccinic aciduria in a paranoid retardate. PMID- 1790265 TI - Active and passive attention in schizophrenia: an ERP study of information processing in a linguistic task. AB - Attentional dysfunctions in schizophrenia were investigated using a sentence priming task. Schizophrenic patients and healthy control subjects were presented with sentences to which they were required to make a response based on either semantic or physical stimulus features. Schizophrenics' behavioural responses were slower than those of controls, particularly when attending to semantic relationships, but their performance was no less accurate. Both the P300 and the N400 components of the event-related potentials (ERPs) recorded to the sentence completions were attenuated in the schizophrenic sample. The results are interpreted in terms of a deficit in the active maintenance of semantic information in memory and the integration of new information with this representation. PMID- 1790266 TI - Event-related potential correlates of non-motor anticipation. AB - A slow negative shift called "stimulus-preceding negativity" (SPN) has been observed preceding feedback. The aim of the present study is to investigate whether the SPN is related to perceptual or conceptual anticipation. Event related potentials (ERPs) were recorded in an S1-S2-S3 sequence with intervals of 3 s. S1 was an auditory warning signal; the task stimulus presented at S2 consisted of two digits on which subjects (n = 8) performed an arithmetic task. They had to match their solution with a probe stimulus presented at S3. Perceptual anticipation was manipulated by varying the discriminability of S2 (intact vs. degraded). Conceptual anticipation was manipulated by varying the amount of information processing required at S2 (easy vs. difficult arithmetic). Motor preparation was varied by requiring a speeded versus a delayed response. No negativity was found before the task stimulus (S2), whereas the probe stimulus (S3) was always preceded by a negative shift. The amplitude of this negative shift was larger under the speed than under the delayed instruction. Its amplitude showed a left-hemisphere preponderance and was larger for the difficult than for the easy condition. ERPs preceding task stimuli seem to reflect functionally different processes from ERPs preceding probe and feedback stimuli. The difference is explained in terms of motivational factors that come into play with feedback and probably play a role in the anticipation of the probe stimulus. PMID- 1790267 TI - Changes in the palmar sweat index during mental arithmetic. AB - This study investigated the influence of activation on the number of active sweat glands (palmar sweat index, PSI), as assessed by the plastic impression method. Subjects were 50 male students, assigned to two groups. The experiment involved 5 phases: an initial adaptation for 6 min in both groups (Phase I), 3 relaxation periods for 10 min (Phases II, IV and V in Group 1, Phases II, III and V in Group 2), and 10 min of mental arithmetic (Phase III in Group 1, Phase IV in Group 2). Prints were taken every 2.5 min from the left middle and forefinger, and skin conductance level (SCL), number of spontaneous fluctuations (SF) and heart rate (HR) were recorded for the corresponding intervals. PSI rose significantly during activation conditions and decreased afterwards. Accordingly, during Phase III values were higher in Group 1, whereas during Phase IV they were higher in Group 2. Decrease of PSI during the first measurements indicated that subjects probably react to the assessment procedure itself and that interpretable baseline values can only be obtained after several initial assessments. Correlations between PSI and electrodermal variables proved to be high within subjects, whereas correlations across subjects were lower. PMID- 1790268 TI - Discovery of the P300: a tribute. AB - The significant and enduring contributions made to cognitive psychophysiology by Samuel Sutton and his colleagues in the first two papers on the P300 component of the event-related brain potential are discussed. The remarkable quality of these contributions is revealed in the fact that the issues that motivated the series of experiments reported by these investigators continue to be of core importance to the field. PMID- 1790269 TI - P300 seasonal variation. AB - The P300 (P3) event-related brain potential (ERP) was elicited with auditory stimuli in four different groups of normal, young adult subjects (n = 20 in each group) whose ERPs were obtained at different times of the year. P3 amplitude was largest during spring and summer and smaller for the subjects who were assessed during fall and winter. P3 latency was not affected reliably by changes in the seasons. Measurement of the daily sunshine present when each subject was recorded indicated that P3 amplitude is influenced by seasonal variation in the available amount of sunshine. These findings suggest that comparison of P3 amplitude across subject groups must take seasonal differences into account. PMID- 1790270 TI - Morningness-eveningness and early-morning salivary cortisol levels. AB - The purposes of this exploratory study were: (1) to describe a 2-h segment of the early-morning salivary cortisol levels of morning (M) and evening (E) types of healthy, day-active adults on one morning; and (2) to compare selected demographic and sleep characteristics. The sample consisted of 20 subjects, aged 23-39 years, 10 of each type. Measures included: morningness-eveningness questionnaire score, demographic information, self-report sleep characteristics, and self-report of well-being. Beginning with time of arising, seven salivary samples were collected at approximately 20-min intervals. Among the sleep variables, bedtime (p = 0.005), time of mid-sleep (p = 0.002), and arising time (p = 0.043) were later in the E group as compared to the M group. Six M and one E subject awoke spontaneously on the morning of sampling without an awakening aid (p = 0.018). Even though total hours of sleep were comparable between groups, E subjects reported feeling less rested in the morning (p = 0.019). Although mean M group salivary cortisol levels were greater than mean E group levels for each sampling time, there were no significant group differences. Eight M subjects reached a sampling period salivary cortisol peak by 50 min after arising, contrasted with six E subjects who reached their peak at that time. These preliminary findings suggest that E types demonstrate lower morning arousal and a delay in their early-morning peak of salivary cortisol relative to M types. Further study is needed to explore the relationship between M and E types, their sleep-wake patterns, and cortisol secretion patterns. PMID- 1790271 TI - Extending the Rescorla-Wagner theory to account for transswitching. AB - This article is a brief response to commentaries made by Bond and Siddle (1988) and Lovibond (1988) to our article (Kimmel & Lachnit, 1988) outlining some of the difficulties encountered by the Rescorla-Wagner theory in predicting the outcome of transswitching experiments. We show that Bond and Siddle's assertion that increasing the value of beta would "bring the model into line with the empirical data" (p. 186) is incorrect. Increasing beta in simulated transswitching experiments causes the theory to predict a more rapid increase in associative values, to higher levels, but does not change the degree of predicted phasic switching. We agree with Lovibond's observation that the Rescorla-Wagner theory can predict phasic switching more effectively if it is assumed that an unobserved additional stimulus is present whenever the phasic stimulus occurs in positive tonic segments and a different unobserved additional stimulus is present whenever the phasic stimulus occurs in negative tonic segments. But this kind of usage of the "unique cue hypothesis" does little more then immunize a theory against problematic empirical findings. When the salience of the unique cue is increased relative to that of the stimuli that are actually physically present, simulated transswitching experiments show greater and greater phasic switching. But, unless there is a good a priori reason to postulate such unique cues, or unless the unique cue hypothesis leads to empirically testable new hypotheses, it does not provide a scientifically useful solution to the theory's problem with transswitching. PMID- 1790273 TI - Reply to: Lachnit, H. and Kimmel, H.D.: "Extending the Rescorla-Wagner theory to account for transswitching. PMID- 1790272 TI - On testing current cognitive theories of Pavlovian conditioning in the human Pavlovian autonomic transswitching preparation. AB - The Rescorla-Wagner theory, which Lachnit and Kimmel's transswitching evidence has apparently contradicted, is fundamentally cognitive, inasmuch as it views Pavlovian conditioning as "the learning of relations among events". Kimmel and Lachnit's criticism that Lovibond's theory-saving defence "does little more than immunize a theory against problematic empirical findings" is analogous to the charge of circularity in explanation that cognitive, Tolmanian researchers used to bring against their S-R, Hullian opponents. A way out of the circle in human autonomic transswitching is to measure the cognitive process of relational conditional stimulus-unconditional stimulus contingency learning throughout the experiment, as has been done in simple Pavlovian human autonomic conditioning, although it may also be desirable to check whether such continuous measurement changes the basic transswitching phenomenon itself. The other issue briefly commented on is the relation between animal and human experiments and theoretical formulations, where the more basic distinction may be not between animals and humans, but between conditional stimulus-instrumental response and conditional stimulus-conditional response preparations. The latter preparations (of which human electrodermal transswitching is an instance) appear to be sensitive to S-R as well as (cognitive) S-S factors. PMID- 1790274 TI - "Extending the Rescorla-Wagner theory to account for transswitching" by H. Lachnit and H.D. Kimmel. PMID- 1790275 TI - On extension of Rescorla-Wagner model. PMID- 1790276 TI - [Cardiac arrhythmia in patients with chronic obstructive pulmonary disease]. AB - A retrospective study of all patients diagnosed as having obstructive pulmonary disease (POD), who were admitted to our department during 1989, was carried out. The presence of cardiac arrhythmia (CA) in standard ECG having been correlated to clinical and laboratory parameters on admission. Out ot 101 admissions, 67.3% had a type of CA, the most frequent being sinus tachycardia (54.4%). 71.9% of the patients who had cardio-respiratory decompensation, 72.8% of those admitted in basal situation III/IV and 86% who were regularly taking theophylline (p less than 0.01), had a type of CA. Our data suggests that patients with worst functional situation and those with cardiorespiratory decompensation had a higher incidence of CA and that regular theophylline intake can play a role in the etiopathogenesis of CA. PMID- 1790277 TI - [Primary empty sella turcica: clinical aspects and hormonal study of 15 cases]. AB - The goal pursued has been to analyze clinical observations and hormonal studies of patients with empty sella turcica (EST), in order to review this disorder and determine if it can be considered a real syndrome. Fifteen patients with EST (3 men and 12 women) and mean age of 45.6 +/- 17.9 years have been prospectively studied. In the hypothalamus-hypophysis study, reserves of thyrotropin (TSH), prolactin (PRL), gonadotropins (FSH and LH), growth hormone (GH), adrenocorticotropin (ACTH) and cortisol were assessed. In addition, thyroid hormones and, for men, testosterone, were determined. The pathogenic mechanism was explained in two cases (13.3%). We registered headache in 10 patients, obesity in 8, arterial hypertension in 2 and diabetes mellitus in 2. Multiparity antecedent was found in 2 cases. The hormonal study was abnormal in two cases (40%). Most common abnormalities were hyperprolactinemia (3 cases), deficit of gonadotropins (3 cases), without coexisting both of them in any case, and deficit of GH (2 cases). EST is frequently associated with endocrine disfunction, although clinical implications are rare. The absence of common clinical manifestations in most cases questions the EST as a real syndrome. PMID- 1790278 TI - [Cerebrovascular accident: study of risk factors and development in 154 cases]. AB - A retrospective study of 194 patients is carried out. Patients were divided into two groups: 154 patients with acute cerebrovascular accident (ACA) and 40 patients without vascular pathology, hospitalized for other causes. A descriptive analysis of these patients is made with respect to age, sex, type of ACA, previous ACA and potential relationship between the type of this first ACA and the one motivating current hospitalization. In addition, ACA is related to risk factors (hypertension, dyslipemia, diabetes, cardiopathy). In our series, variables that can be considered as risk factors, with significant differences between both groups, are: HTA, tobacco consumption, cardiopathy, dyslipemia (hypercholesterolemia and hypertriglycemia, hyperuricemia and diabetes. Alcoholism, anticoagulation, antiaggregation or polyglobulia were not risk factors. In 33.2% of patients with current ACAs, there were antecedent of clinically documented cerebrovascular pathology; one thing of them were transitory cerebral ischemias and more than half of them, cerebral infarcts. In conclusion, we stressed the role of primary and secondary prevention acting against risk factors, given the recurrence of this pathology and the irreversibility of the injuries once happened. PMID- 1790279 TI - [Infectivity by HIV of different blood products used in Aragon]. AB - In our region, prevalence of anti-HIV antibodies among hemophiliacs B (83.3%) is higher than among hemophiliacs A (47%), as reported in other spanish communities and contrary to other countries, were the opposite phenomenon has been observed. This seems to be due to the volume of hemo-derivatives received, rather than to their different infectivity, as it has been suggested sometimes. In order to assess this infectivity, independently of doses, we have studied two groups of patients, hemophiliacs A transfused with factor III and non-hemophiliacs who had received concentrate of prothrombinic complex factors (CPCF), in doses lower than 10,000 units. Both groups were transfused during the period when seroconversions were observed in our area (1981-1985) and we demonstrated that the difference between their prevalences of anti-HIV antibodies was not statistically significant. PMID- 1790280 TI - [Sister Mary Joseph's nodule: metastatic umbilical carcinoma]. AB - Maria Jose's Sister's lump (metastatic umbilical carcinoma) is a metastasis of more than one malignant tumor (frequently abdominal), but on occasions it is the first sign of disease. A case of a female patient diagnosed as having "umbilical hernia" with peritoneal carcinomatosis, liver metastasis and "frozen pelvis", who died 6 months later, is presented, demonstrating the bad prognosis of this sign. PMID- 1790281 TI - [Pulmonary tumorlets in POEMS syndrome]. AB - POEMS syndrome is a systemic disease characterized by severe chronic polyneuropathy, organomegaly (adenopathy, and liver enlargement) endocrinopathy, monoclonal peak, sclerotic bone lesions and skin changes. We report on a case of complete POEMS syndrome with peripheral arterial thrombosis and multiple lung tumorlets. No antibodies were found against human nervous tissues or Rhesus monkey on patient serum. This case is the first association described of POEMS syndrome and lung tumorlets. PMID- 1790282 TI - [Pseudotumoral hepatic tuberculosis]. AB - Liver infection as a result of tuberculosis is well known; there are several histological lesions, the most important being epithelioid cell granuloma. There are 3 anatomo-clinic variants: military or micronodular type, macronodular or pseudotumoral and pericanalicular of cholestatic. A case of a 66 year old male with a diagnosis of hepatic pseudotumoral tuberculosis, confirmed by means of a laparoscopy, is presented. The rareness of this particular presentation is discussed, as well as the difficult diagnosis due to confusion with primary or metastatic tumors of the liver. PMID- 1790283 TI - [Etiologic considerations regarding superior vena cava syndrome]. AB - Literature review indicates a change in the etiological trends of the Superior Cava Syndrome. While during the first half of the twentieth century, aortic aneurysms, malignant tumors and mediastinitis were its main causes, nowadays talking about obstruction of the superior cava is the same than talking about obstruction secondary to a malignant cause (85-90%). Benign affections account for 10-15% and, among them, intravenous iatrogenic foreign bodies constitute a new chapter as cause of thrombosis. Given that small cells simplex carcinoma is the most common cause of SCS and given that benign processes or other chemosensitive tumors can be present, it is currently necessary to secure the histologic diagnosis before starting the treatment. PMID- 1790284 TI - [The role of BCG in the prevention of tuberculosis]. AB - Tuberculosis is still a major international public health problem. The role of vaccination with BCG in the prophylaxis of the tuberculosis has been a source of controversy almost since ist introduction in the thirties, because of the disparity of the results regarding efficacy and protection of the several studies that have been done. Currently, everybody seems to agree that in countries with annual infection risk lower than 1%, a massive vaccination campaign with BGC is not profitable. On the other hand, BCG interferes the lecture of the Mantoux intra-dermo-reaction and, thus, it invalidates the most effective test that we have for the diagnosis of the tuberculosis infection. In our country, the battle against tuberculosis is currently focused on the identification and treatment of the tuberculous patient, chemoprophylaxis with contacts of these patients and avoidance of the development of the tuberculosis infection to tuberculosis disease. PMID- 1790285 TI - [The teaching of medical humanism]. PMID- 1790286 TI - [Acute rhabdomyolysis associated with cocaine intoxication]. PMID- 1790287 TI - [Massive pleural effusion caused by Legionella pneumophila]. PMID- 1790288 TI - [Residual masses after treatment of non-Hodgkin's lymphoma: interpretation of a case of gastric lymphoma]. PMID- 1790289 TI - [Hodgkin's disease, Kaposi's sarcoma and infection by the human immunodeficiency virus]. PMID- 1790290 TI - [Diabetic microangiopathy and serum laminin]. PMID- 1790291 TI - [Cardiac tamponade as a presentation of extracardiac carcinoma]. PMID- 1790292 TI - [Efficacy and operating simplicity of the Turbuhaler system for dry powder terbutaline inhalation]. PMID- 1790293 TI - [Stress angina, spontaneous rupture of the spleen and almost normal leukocyte values, a rare form of presentation of chronic myeloid leukosis]. PMID- 1790294 TI - [Anxiolytic effect of magnesium]. PMID- 1790295 TI - Electrostatic interactions in protein solution--a comparison between Poisson Boltzmann and Monte Carlo calculations. AB - The accuracy of the Poisson-Boltzmann (PB) approximation and its linearized version is investigated by comparison to results obtained from Monte Carlo simulations. The dependence of the calcium binding constant of the protein calbindin as a function of salt concentration and mutation is used as a test case. The protein is modeled as a collection of charged and neutral spheres immersed in the electrolyte solution. The PB equation is solved using a finite difference technique on a grid in a spherical polar coordinate system, which is the preferred choice for a globular protein like calbindin. Both MC and PB give quantitative agreement with experimental results. The linearized PB equation is almost as accurate, but it becomes less reliable in systems with divalent ions. However, the linearized PB equation fails to describe the concentration profiles for cations and anions outside the protein even in a 1:1 salt solution. PMID- 1790296 TI - On the mechanism of dielectric relaxation in aqueous DNA solutions. AB - The complex dielectric response of calf thymus DNA in aqueous saline solutions has been measured from 1 MHz to 1 GHz. The results are presented in terms of the relaxation of the incremental contributions to the permittivity and conductivity from the condensed counterions surrounding the DNA molecules. Measurements of the low-frequency conductivity of the samples also lends support to the condensed counterion interpretation. PMID- 1790297 TI - beta-Alanyl-beta-alanine in cyclic beta-turned peptides. AB - In the present paper we describe the synthesis, purification, and single crystal x-ray analysis of the cyclic pentapeptide cyclo-(L-Pro-L-Pro-L-Phe-beta-Ala-beta Ala). The peptide was synthesized by classical solution methods and the cyclization of the free pentapeptide was accomplished in good yields in diluted methylene-chloride solution using N,N-dicyclohexylcarbodiimide. The compound crystallizes in the monoclinic space group P21 from hot water with five solvent molecules. The Pro1-Pro2 peptide bond is cis and the molecular conformation is stabilized by an intramolecular hydrogen bond between the CO group of the beta Ala5 and the NH of the Phe3 residue. The Pro1-Pro2 segment occupies the relative positions 2 and 3 of a type VIa beta-turn, while the L-phenylalanyl-beta-alanyl beta-alanine segment is incorporated in a C13-like ring structure. The crystal packing is characterized by a network of 11 intermolecular hydrogen bonds involving all the remaining CO, NH, and the water molecules. PMID- 1790298 TI - Valinomycin and its interaction with ions in organic solvents, detergents, and lipids studied by Fourier transform IR spectroscopy. AB - The structure of valinomycin in a range of organic solvents of varying polarity and in detergent and lipid dispersions has been studied by Fourier transform ir spectroscopy. In solvents of low polarity such as chloroform, ir spectra of valinomycin are fully consistent with the bracelet structure proposed on the basis of nmr spectroscopy, showing a single narrow amide I component attributable to the presence of beta-turns and a single band arising from nonhydrogen-bonded ester C = O groups. K+ complexation results in a downward shift in the amide I band frequency, indicating an increase in the strength of the amide hydrogen bonds, along with a shift to lower frequencies of the ester C = O absorption due to a reduction in electron density in these bonds upon complexation. Identical results were obtained with NH4+, a finding not previously reported. In solvents of both medium (CHCl3/DMSO 3:1) and high (pure DMSO) polarity, we find evidence of significant disruption of the internal hydrogen-bonding network of the peptide and the appearance of a band suggesting the presence of free amide C = O groups. In such solvents, complexation with K+ and NH4+ was not observed. The structure of valinomycin in detergent micelles resembles that in nonpolar organic solvents. However, changes were found in the amide I and ester carbonyl maxima as 2H2O penetrated the micelle which suggest significant interaction between the solvent and peptide. Complexation with K+ was reduced in cationic detergent micelles as a result of a decrease in the effective K+ concentration due to charge repulsion at the micelle surface.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790299 TI - Structural properties of polydisperse biopolymer solutions: a light scattering study of bovine alpha-crystallin. AB - We have measured mean value of RHz, mean value of R2G1/2z, and mean value of Mw for individual fractions of the protein alpha-crystallin obtained by gel filtration of bovine lens nuclear extracts. A strong and monotonic decrease of mean value of RHz and mean value of Mw with increasing elution volume could be observed, indicating a broad size distribution. The experimental results are quantitatively consistent with a polymerization of monomeric units into linear chains, which may have a certain degree of flexibility. Using theoretical expressions for mean value of R2G and mean value of RH originally derived for semiflexible polymers in solution, we can self-consistently analyse the data from static and dynamic light scattering, and from electron microscopy experiments. We thus obtain detailed information on the molecular weight distribution and the quaternary structure of alpha-crystallin in these solutions. PMID- 1790300 TI - Reaction of colchicine with peptide amino groups. PMID- 1790301 TI - Cytokine regulation of human immunodeficiency virus expression. PMID- 1790303 TI - Development of immunoassays for human interleukin 3 and interleukin 4, some of which discriminate between different recombinant DNA-derived molecules. AB - Two panels of hybridomas were produced that secreted monoclonal antibodies (MAbs) against recombinant DNA-derived human interleukin 3 and interleukin 4 (rhIL-3 and rhIL-4). From each panel, sensitive immunoradiometric assays (IRMAs) were developed which were capable of detecting the recombinant molecule used as the immunogen but were unable to recognize natural or other recombinant forms of the same cytokine. Subsequent studies using the MAbs from each panel showed that a number of the MAbs appeared only to recognize that particular recombinant molecule used as immunogen, with little or no binding to other recombinant forms of the molecule. By using MAbs that were found to be unrestricted in their recognition for different recombinant forms of the cytokines, it was possible to develop an IRMA for IL-4 that was capable of detecting natural IL-4 as well as all the recombinant forms equally. An IRMA was also developed for IL-3 but was not of equivalent sensitivity in detecting the different recombinant forms of IL 3 used in the study. The recombinant DNA-derived cytokine molecules used to raise the two panels of MAbs contained amino acid substitutions relative to the natural sequences, and these findings indicate that caution should be exercised when using immunoassays to estimate natural sequence molecules if antibodies raised to modified rDNA-derived molecules are used. PMID- 1790302 TI - Transforming growth factor-beta enhances secretory component and major histocompatibility complex class I antigen expression on rat IEC-6 intestinal epithelial cells. AB - Transforming growth factor-beta (TGF-beta) has been implicated as having a role in inflammatory responses by inducing cellular infiltration and the release of inflammatory cytokines. In this study, the IEC-6 rat intestinal epithelial cell line was used as a model to assess the effect of TGF-beta 1 on the expression of various plasma membrane determinants. TGF-beta 1 induced a dose-dependent increase in the percentage of cells expressing surface secretory component (SC) and class I major histocompatibility (MHC) antigens. However, the expression of class II MHC was unaffected. In contrast, epidermal growth factor had no effect on any of the surface proteins studied. The TGF-beta 1-enhanced expression of SC was accompanied by an enhanced binding of polymeric, but not monomeric, immunoglobulin A (IgA). Preincubation of the TGF-beta 1-treated cells with an anti-human beta-galactosyltransferase (beta-GT) antiserum did not block the binding of the anti-SC antibody, indicating that the TGF-beta-induced increase in SC staining was due to SC expression and not the polymeric immunoglobulin-binding enzyme, beta-GT. These results indicate that TGF-beta 1 may be important in immune functions involving intestinal epithelial cells by enhancing the expression of surface class I MHC antigens and SC, a protein responsible for the transport of polymeric IgA into the intestinal lumen. PMID- 1790304 TI - Taurolidine, an analogue of the amino acid taurine, suppresses interleukin 1 and tumor necrosis factor synthesis in human peripheral blood mononuclear cells. AB - Taurolidine (Geistlich Pharm, AG, Wolhusen, Switzerland), a derivative of the amino acid taurine, is commonly used in some parts of the world as an adjunctive therapy for various infections. Its mechanism of action is thought to be related to its antimicrobial properties, including its ability to interfere with some of the biological activities of endotoxin (lipopolysaccharide, LPS). For example, taurolidine has been shown to protect animals against endotoxic shock and death. In this study we examined the ability of taurolidine to block LPS-induced tumor necrosis factor (TNF) and interleukin 1 (IL-1) synthesis in human peripheral blood mononuclear cells (PBMC) from 27 donors. We observed a dose-dependent reduction in the synthesis of these two cytokines when taurolidine was preincubated with LPS before being added to PBMC. This reduction was independent of the molar ratio of taurolidine to LPS but was related to the concentration of taurolidine present in the PBMC cultures. There was a 80 to 90% reduction in total IL-1 and TNF synthesis induced by LPS at concentrations of taurolidine of 40 to 100 micrograms/mL; the vehicle was without effect. Following a 30-min preincubation with PBMC, taurolidine could be washed from the cells and still suppress cytokine synthesis induced by LPS. Using release of lactic acid dehydrogenase, 100 micrograms/mL of taurolidine was not toxic for PBMC. Taurolidine also reduced IL-1 and TNF synthesis induced by the Staphylococcus aureus-derived toxic shock syndrome toxin-1 as well as that induced by nontoxic heat-killed Staphylococcus epidermidis organisms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790305 TI - Tumor necrosis factor release from lipopolysaccharide-stimulated human monocytes: lipopolysaccharide tolerance in vitro. AB - Human peripheral blood monocytes secrete tumor necrosis factor (TNF) in response to stimulation with bacterial lipopolysaccharide (LPS). We have shown that isolated human monocytes pretreated with LPS for 24 h secrete lower levels of TNF on a second stimulation with LPS than monocytes that have been stimulated with a single dose of LPS either immediately after isolation or 24 h after isolation. The levels of TNF released by monocytes after the second stimulation with LPS are proportional to the LPS concentration over a range from 1 ng/mL to 10 micrograms/mL. Increasing concentrations of LPS used during the first 24-h stimulation induce greater suppression of TNF release after a second stimulation with LPS. After an initial stimulus of 10 micrograms/mL LPS, a second stimulation of monocytes even with 10 micrograms/mL LPS will result in TNF secretion similar to that of unstimulated cells. This in vitro tolerance apparently can be overcome by stimulating previously activated cells with phorbol myristate acetate. We have also shown that neither prostaglandin E2 nor dexamethasone added during the initial stimulation with LPS had an effect on the subsequent reduction in TNF release on a second stimulation of monocytes with LPS. PMID- 1790306 TI - Interleukin 5 up-regulates high-affinity interleukin 2 receptor expression by human resting peripheral T cells: a comparison with the effect of interleukin 4 on B cells. AB - The separate regulation mechanisms of cytokines on two classes of interleukin 2 receptors (IL-2R) on human peripheral T and B cells were analyzed by a flow cytometer using a double stain with IL-2R alpha (55 kilodalton Tac) and IL-2R beta (75 kilodalton mik beta 1, mik beta 3). Although the expression of IL-2R alpha by T cells was slightly enhanced by IL-2 and IL-4, expression of the beta chain was diminished by both cytokines. IL-5 by itself did not alter the expression of either IL-2R alpha or beta, but preculturing with IL-2 for 24 h followed by IL-5 for another 24 h induced an increase in IL-2R alpha expression and in simultaneous alpha/beta chain expression. Increased numbers of high affinity IL-2R were confirmed by 125I binding assays. On B cells, IL-4 increased alpha, beta, and simultaneous alpha/beta chain expression, but IL-4-treated B cells did not show an increased number of high-affinity IL-2R. PMID- 1790308 TI - Why is too little TNF bad? PMID- 1790307 TI - Regulation of lymphocyte blastogenesis and antibody production by soluble factor released by a human B-lymphoblastoid cell line. AB - Yam 1B, a human B lymphoblastoid cell line, spontaneously produced an immunoregulatory factor, which suppresses blastogenesis and antibody formation by human lymphocytes. The Yam 1B cells, which were derived from the peripheral blood of an adult T-cell leukemia patient, have been established and maintained in our laboratory since 1985. This cell line expressed mature B-cell surface antigens including surface immunoglobulin M (IgM), CD23, and HLA-DR; had cytoplasmic IgM; and secreted small amounts of IgM in the culture supernatants. Yam 1B was positive for Epstein-Barr virus-associated antigen (EBNA) but negative for adult T-cell-associated antigen (ATLA). The serum-free Yam 1B culture supernatants (SN) inhibited the expression of transferrin R, but neither the expression of interleukin 2 (IL-2) R(CD25) nor the production of IL-2 in the lymphocytes stimulated with phytohemagglutin. Yam 1B SN also inhibited DNA synthesis by human T and B lymphocytes and immunoglobulin generation by normal B cells as well as by Epstein-Barr virus-transformed human B lymphoblastoid cell lines. The inhibitory activity of Yam 1B SN was inactivated at 56 degrees C and at pH 10 but was relatively stable at pH 2. It was abrogated by digestion with pronase and was partially stable by digestion with trypsin. Fractions collected from a Sephacryl S-300 gel filtration column (Pharmacia Fine Chemicals, Uppsala, Sweden) were found to have a peak of inhibitory activity of cell proliferation associated with molecules of apparent MWr of 43,000 to 67,000. The inhibitory activity of Yam 1B SN was not blocked by the anti-transforming growth factor beta antibody.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790309 TI - Factors influencing the protein binding of vancomycin. AB - Various factors influencing the protein binding of vancomycin were examined using equilibrium dialysis method. Four per cent human serum albumin (HSA) and/or 0.08 per cent alpha-1-acid glycoprotein (AAG), dissolved in isotonic phosphate buffer, were dialyzed against isotonic phosphate buffer of pH 7.4 using Spectrapor 2 membrane. The protein binding of vancomycin to 0.08 per cent AAG was dependent on vancomycin concentrations; the values ranged from 21.1 per cent at the vancomycin concentration of 20 micrograms ml-1 to 5.30 per cent at 2400 micrograms ml-1. However, binding to 4 per cent HSA was relatively constant, 8.79 +/- 2.43 per cent over a vancomycin concentration range of 20-2400 micrograms ml-1. The values to 4 per cent HSA alone and 0.08 per cent AAG alone did not predict the greater binding of vancomycin in the presence of both proteins, especially at higher concentrations of vancomycin; the values to 4 per cent HSA with 0.08 per cent AAG were constant, 26.3 +/- 3.74 per cent, at the vancomycin concentration range of 20-2400 micrograms ml-1. This suggested an interaction between the proteins, which resulted in enhanced binding of vancomycin. The protein binding of vancomycin to 4 per cent HSA with 0.08 per cent AAG was not influenced by the different incubation temperatures (4 degrees, 22 degrees, and 37 degrees), quantities of heparin (up to 40 units ml-1) or AAG (up to 0.16 per cent), or buffers (isotonic phosphate buffer of pH 7.4, phosphate buffer of pH 7.4 and 0.9 per cent NaCl solution) at the vancomycin concentration of 80 micrograms ml-1. Vancomycin was found to be stable in human serum albumin or in isotonic phosphate buffer of pH 7.4. PMID- 1790310 TI - Partially competitive inhibition of intestinal baclofen absorption by beta alanine, a nonessential dietary aminoacid. AB - In situ intestinal absorption of baclofen in the rat in the presence of beta alanine has been investigated. Through the perfusion of 0.50 mM baclofen solutions containing variable concentrations of the aminoacid (from 5 to 100 mM), a partially competitive inhibition of baclofen absorption was characterized: absorption rate pseudoconstants of the spasmolytic drug decrease as beta-alanine concentration increases, until a limiting value is obtained (36.8 per cent of that found for baclofen alone). A computer method was developed in order to calculate parameters governing baclofen absorption in the presence of beta aminoacid, with the following results: Vm = 11.22 mM h-1; Km = 7.42 mM; Ki = 2.45 mM; alpha = 2.78; r = 0.998. Kinetic absorption parameters for beta-alanine in the presence of 0.50 mM baclofen were also assessed: Vm = 49.88 mM h-1; Km = 12.16 mM; r = 0.998, which, as can be expected, do not significantly differ from those previously found in the absence of the spasmolytic. It is concluded that baclofen and beta-alanine compete for the same intestinal carrier system, although the values of the interaction parameters, particularly Ki, can be more or less biased due to the limitations of the procedure and/or to the existence of some other carrier system for absorption. Possible practical implications of this phenomenon are briefly discussed. PMID- 1790311 TI - A combined single and multiple dose pharmacokinetic study of oral isosorbide-5 mononitrate in healthy volunteers. AB - Pharmacokinetics of 20 mg isosorbide-5-mononitrate (IS-5-MN) after single and multiple administration of two different tablet formulations were investigated in twelve healthy human subjects using an open, randomized, two-way crossover experimental design. Pentacard 20 mg tablets were compared with Ismo 20 mg tablets. After single-dose administration, both preparations caused a rapid increase in IS-5-MN plasma levels with the peak plasma concentration occurring between 0.5 and 1.5 h. For both formulations, the mean plasma half-life was found to be approximately 5 h after a single dose. In steady state during multiple dosing (t.i.d. at 8 h dosing intervals), a reduced elimination rate was observed. In line with this observation, the area under the plasma concentration-time curve (AUC) for one 8 h dosing interval during multiple dosing was higher than the extrapolated AUC after a single dose. Based on statistical evaluation of the various relevant pharmacokinetic parameters calculated from the plasma concentrations occurring after single and multiple dosing, the tablet formulations are judged to be bioequivalent. PMID- 1790312 TI - Isomazole disposition in man as a function of dose and route of administration. AB - The disposition of a new cardiotonic agent (isomazole (ISO] was evaluated in healthy volunteers after various single oral (p.o.), intravenous (i.v.), and multiple p.o. doses. Blood samples were collected after dosing in all studies, with urine collected in the single i.v. and multiple dose studies. All biological samples were measured for ISO. In the multiple dose study, samples were collected for analysis after the first and last doses administered. In addition to ISO, several known metabolites (hydroxyisomazole (OHISO), sulfone (SULF), and hydroxysulfone (OHSULF) analogs) were measured after the first and last doses given in the multiple dose study. Pharmacokinetic values compared between doses suggested no saturable processes existed over the entire dose range. The single i.v. dose data showed ISO experienced some extravascular distribution (mean V beta = 1.82 l kg-1), with a high clearance (mean Cls = 18.8 ml min-1 kg-1) and a short half-life (mean t 1/2 = 1.1 h). Elimination was primarily nonrenal (Clr = 3.5 ml min-1 kg-1). Single p.o. data supported these findings and further suggested rapid absorption. ISO data from the first dose of the multiple dose study was in agreement with these data; however, the last dose showed a higher Cls (33.0 ml min-1 kg-1) (p = 0.055). Although not statistically significant, metabolite plasma data and and urinary excretion patterns changed. An increase was observed in plasma AUC and metabolite excretion of SULF and OHSULF, while a decrease was observed in the same parameters for OHISO. These results suggest that multiple dosing of ISO produces autoinduction of ISO metabolism through selective metabolic routes. PMID- 1790313 TI - Bioavailability study of a freeze-dried sodium phenytoin-milk formulation. AB - The problematic bioavailability of phenytoin's (5,5-diphenylhydantoin) oral formulations serves as a stimulus for examining new formulations and/or administration conditions that may provide more predictable absorption. Attempts to achieve more consistent peroral phenytoin bioavailability from conventional solid dosage forms include changes of binder and crystal size, use of salt form, and inclusion of the drug in cyclodextrins. In addition, various factors which may affect the environment and/or the physiology of the upper gastrointestinal tract can profoundly affect the absorption of phenytoin. Among other approaches, the use of drug-milk freeze-dried formulations has been proposed to overcome problems associated with dissolution-limited bioavailability. The effect has been attributed to the formation of an amorphous precipitate during the drying process which facilitates the re-dissolution of the drug during the regeneration of the milk solution. In this work, we report comparative bioavailability studies utilizing a freeze-dried sodium phenytoin-milk formulation and a capsule formulation administered with either water or milk. In addition, the interaction of the drug with milk components was evaluated in vitro through binding and solubility studies. PMID- 1790314 TI - Regulation of liver base-exchange activity by acidic phospholipids. AB - Liver microsomes were enriched in liposomal acidic lipids by Ca(2+)-dependent fusion of liposomes at pH 7.0. The extent of fusion was monitored by the transfer of radioactive cholesteryl oleate. The enrichment of membranes in phosphatidylserine inhibited ethanolamine base-exchange, whereas the fusion with phosphatidylinositol inhibited both ethanolamine and serine base-exchange reactions. In contrast, these two phospholipids had scarce effects on choline base-exchange. Phosphatidic acid did not suppress any of the three base-exchange activities. Possible functional implications are discussed. PMID- 1790315 TI - A high-affinity folate binding protein in human semen. AB - The presence of a folate binding protein of high-affinity type (affinity constant 3.10(10) M-1, maximum folate binding 1.4 nM) in human semen was demonstrated in equilibrium dialysis experiments (37 degrees C, pH 7.4) with the radioligand 3H folate. Radioligand dissociation from the binding protein was slow at pH 7.4, but rapid at pH 3.5. By use of rabbit antibodies against 25 kDa human milk folate binding protein we determined the concentration of folate binding protein in 16 specimens of human semen in an enzyme-linked immunosorbent assay. The concentration of immunoreactive folate binding protein was independent of the number of spermatozoa in individual specimens. Gel filtration showed that immunoreactive and radioligand bound folate binding protein coeluted in two peaks: a major one of 100 kDa and a minor one of 25 kDa. PMID- 1790316 TI - Chick hepatic lectins: an electron microscopic study on isolated hepatocytes during development. AB - We studied the carbohydrate recognition systems of hepatocytes isolated from 16 day-old embryos, 19-day-old embryos and chicks within 24 h of hatching. We localized and quantified at the ultrastructural level the binding sites for glycoproteins exposing terminal N-acetylglucosamine (GlcNAc), mannose and N acetylgalactosamine (GalNAc) residues by means of protein-gold complexes. Binding sites specific for GlcNAc and mannose residues are present on hepatocytes from embryos and chicks. On the contrary GalNAc specific binding sites are exclusively observed on cells from 16-day-old embryos. The number and distribution of gold particles on hepatocyte cell surfaces depend on the binding sites and the age considered. We describe a modulation in the number of GlcNAc, and mannose specific receptors present on the cell surface between the embryonal stage and neonatal life. PMID- 1790317 TI - Binding of doxorubicin to cardiolipin as compared to other anionic phospholipids- an evaluation of electrostatic effects. AB - The binding of doxorubicin to large unilamellar vesicles consisting of cardiolipin or other anionic phospholipids was analyzed in terms of the local drug concentration at the membrane surface, according to the Gouy-Chapman theory. The analysis suggests strong positive binding cooperativity. Part of the drug binds in the uncharged form. The affinity for cardiolipin and other anionic phospholipids is comparable. A binding level of 0.5 doxorubicin per lipid phosphorus is reached when the local concentration of free doxorubicin monomer equivalents at the membrane surface is about 0.2-0.7 mM. This contrasts with earlier findings indicating a 300-1000 fold higher affinity for cardiolipin. The present analysis provides an explanation for this apparent discrepancy. PMID- 1790319 TI - Improving appropriate use of surgical services. AB - The aspects of surgical services being addressed from the point of view of appropriateness in Australia at the present time are the use of the surgical bed, the maintenance of standards by the surgeon and the need for and outcome of the surgical procedures performed. There are growing waiting lists now for the 70% of acute hospital beds which are public. Whilst these waiting lists are inaccurate and require regular review their existence has led to a greater interest in reducing length of stay. This has hitherto not been of concern, with hernia patients for example staying five days or more. With regard to the surgeon it has been felt that the long training period (six years) guaranteed a high standard which was maintained. The Royal Australasian College of Surgeons is however, now to introduce a system of re-certification which will involve a demonstration of continuing education, the maintenance of an audit and a periodic physical examination. Delineation of privileges has until now only been in the broad traditional categories but consideration is being given to delineation of privileges for sophisticated surgery and particularly for new procedures (e.g. percutaneous cholecystectomy). Systems for assessing the quality of the surgery itself have been slow to develop, particularly in the smaller and private hospitals. Government bodies have been concerned in the private sphere with over servicing and a number of studies have been done showing regional variations in numbers of operations performed. Over servicing is, however, difficult to detect.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790318 TI - Glucose handling by hepatocytes from obese Zucker rats. AB - Hepatocytes isolated from obese Zucker rats showed a significantly higher rate of both [U-14C]glucose and [U-14C]lactate incorporation into [14C]lipid than those from their lean counterparts. This was associated with a marked increase in the lipogenic rate measured by the incorporation of 3H2O into the cell esterified fatty acids. Although there were no changes in the incorporation of the tracer into either [14C]glycogen or 14CO2, the [14C] total uptake was significantly higher in the obese animals. The high rate of [14C]lipid synthesis from glucose was observed both at 15 and 30 mM substrate concentrations and was linked to an enhanced uptake of the tracer into the cell as measured using the decarboxilation of [1-14C]glucose in the presence of phenazine methosulphate. The presence of insulin in the incubation medium had no effect on the uptake of glucose by the liver cells. However, the large uptake of glucose by the hepatocytes from the obese animals was not related to an enhanced rate of transport as measured using 3-O-methyl[U-14C]glucose. The activity of glucose-6-phosphate dehydrogenase together with a higher [1-14C]glucose/[U-14C]glucose descarboxylation ratio indicate a predominant very active pentose phosphate pathway which may be responsible for the enhanced glucose uptake observed in the hepatocytes from the obese animals. PMID- 1790320 TI - Appropriateness of admission in an emergency department: reliability of assessment and causes of failure. AB - The validity of a modified version of the appropriateness evaluation protocol was assessed in a sample of patients aged 15 and over admitted by means of the emergency department of one of the Paris hospitals. As measured among 371 patients, the reliability of the indicator was high. The prevalence of inappropriate admissions (IA) was found to be 20% using the expert opinions and 25% the instrument. Homelessness was associated with a higher prevalence of IA (34%). Other social factors and age were not related to IA. According to the experts' opinions, difficulties in organizing the continuity of care for patients examined in the emergency room were one of the main causes for IA. PMID- 1790321 TI - A quality control method in cardiac surgical outcome: experience in 462 patients. AB - The aim of our study is to verify the reliability, reproductiveness and simplicity of a method to control cardiac surgical results. We divided 462 adult patients, operated on for acquired heart disease from October 1989 to January 1991, into five classes according to an individual score which was predictive for their operative mortality risk. The score resulted from 15 different risk factors tested with univariate and multivariate analysis against one event: operative death. The total number of deaths was 12: 2, 2, 1, 2, 5 for each class respectively. When comparing the predicted versus our observed mortality, we found no statistically significant difference, using the chi-squared test. The method we used is highly predictive for surgical mortality risk: it makes the results objectively comparable among different institutions; it is useful as a self-controlled quality method for cardiac surgical activity in any single institution. PMID- 1790322 TI - A complementary approach to outcome analysis in the parturient. AB - As part of routine Quality Assurance (QA) activity in our Department, a quarterly audit of patient outcome after obstetric anaesthetic care is completed. Previously this consisted of a technical (criteria-based) audit and some assessment of patient satisfaction. The most recent audit was carried out by a volunteer providing a cost-effective and flexible means of data collection. In addition, the focus of this audit has shifted to emphasize the importance of 'Patient Described Outcome' (PDO). These data are gathered by means of an interview by the volunteer and a patient questionnaire (PDO factors) and a chart audit (technical details). Simple analysis of data is done to assess both technical and PDO information. Technical details allow comparison to internal and published standards. PDO data provide a complementary means of assessing Structure, Process and Outcome. Thus, the audit permits internal and external evaluation of departmental activities and feedback of QA information necessary to a comprehensive QA program. PMID- 1790323 TI - Program evaluation as a measure of the quality of a new approach to community psychiatric care. AB - The effectiveness of a new approach to providing psychiatric rehabilitation services in community settings will be assessed using a combination of quality assurance principles and program evaluation techniques. A new Assertive Community Rehabilitation Program (ACRP) is evaluated and compared with existing hospital rehabilitation programs. Measures of service efficiency, admission, discharge and readmission rates, and service costs are made for 100 new referrals, 99 inpatients and 117 outpatients. Follow-up interviews use standardized measures of clients' quality of life, clinical status, client and staff satisfaction, and community resource utilization. After 19 weeks of operation, the ACRP has prevented more admissions, and discharged more inpatients than the comparison programs. Readmission rates have not differed. Results at the end of the one-year project using this program-based quality assurance approach will facilitate managerial decisions about the future of rehabilitation services. PMID- 1790324 TI - Acquired conditions: an improvement to hospital discharge abstracts. AB - Selected secondary diagnoses (e.g. pulmonary embolism) may provide an efficient and inexpensive source of data for quality assurance (QA) monitoring if their absence at admission were known. In June 1990 we modified our hospital abstracting methods to classify each diagnosis into categories: (1) present on admission, (2) acquired during hospitalization, or (3) uncertain. Our experience has confirmed the identification and elimination from QA reports of the majority of pre-existing secondary diagnoses. Examples of secondary diagnosis codes acquired or uncertain were acute myocardial infarction 48%, pneumonias 25%, pulmonary emoboli 54% and cerebral vascular accident/hemorrhage 35%. Abstracting time has increased less than 2 min per discharge. A reabstraction study showed 87% agreement (kappa = 0.733, p less than 0.001) between initial collection and blinded reabstraction. The separation of secondary diagnoses into preexisting or acquired can: (1) be reliably undertaken by discharge abstracters; (2) be efficient in adding minimal time; and (3) enhance the validity and usefulness of data and increase physician acceptance. PMID- 1790325 TI - Discharge report accuracy. AB - The clinical report is one of the most useful ways of cooperation between the hospital doctors and general practitioners. This paper is aimed at checking the accuracy of clinical reports in an Italian children's hospital. The authors examined 200 clinical reports after establishing some criteria to be fulfilled in order to write a good clinical report. Only 18 reports were considered good; the results were discussed with the physicians who had written the reports. At a second evaluation, the authors checked the efficacy of the proposed changes: 97 clinical reports were considered good. PMID- 1790326 TI - Using billing data to improve hospital drug use. AB - All hospitals, both in the United States and abroad, have a critical need to ensure the appropriateness and safety of the drugs prescribed and administered to their patients. The sources of data to support this effort are typically patient charts or automated pharmacy information data bases. Patient charts allow the capture of all information relevant to the patient, but are laborious to review in detail. Pharmacy information systems provide much information on drugs prescribed, but lack information on laboratory values and patient diseases. A third source of data, namely billing data, is a byproduct of the automated order entry process in US hospitals, but is seldom used for research or quality management. By standardizing the individual charge codes used by the hospitals for billing for drugs, the billing data becomes more accessible, comparable to other institutions, and more valuable as a source of research, quality assurance and quality improvement. PMID- 1790327 TI - Comparative analysis between clinical requests and magnetic resonance imaging results in neurological diseases. AB - In order to rationalize the use of MR, which is a high cost technology and not widely available, we analysed comparatively the reasons of test requests and MR diagnosis. We selected three groups of motivations for requests: diagnosis, symptoms and aspecific symptoms: they all were related with MR results classifying concordance, negativity and discordance groups. The results were evaluated also considering whether the patients were hospitalized or outpatients and in relation to the brain, the cervical, thoracic and lumbar regions. Within the general group we found a negativity of 36%, which increases to 52.5% if the motivation of the exam was a symptom and to 88% if the symptom was aspecific, whereas it fell to 26% with the request belonging to the group diagnosis. Concordance was higher in the brain and in the cervical spine (62% and 61%) whereas it was 46% in thoracic and lumbar spine and higher, even if not statistically significative, in the group of hospitalized patients compared to the outpatients. PMID- 1790328 TI - Applications for risk-adjusted outcome measures. AB - This paper reports on the development and application of multiple risk-adjusted measures of hospital performance (mortality, readmission, complications). The indices are based on patient-level data so they can be aggregated at any level (hospital, specialty, physician), are easy to use and interpret by hospitals, and provide an inexpensive method for evaluating hospital performance using existing databases. This paper focuses on the development of practical applications of these measures in the quality improvement process. PMID- 1790329 TI - An interdistrict audit of vascular surgery. AB - The Interdistrict Audit of Vascular Surgery project entails the compilation of data on all new vascular patients who are referred, investigated and/or treated in three UK health authorities. The main aim is to create an accurate database containing process/outcome criteria, which can be interpreted as quality measures and which facilitates review of current practices. Data collection, which began in June 1990 and is scheduled to continue until March 1992, is by a series of proformas. Currently 503 patients are registered on the database, and preliminary results have shown that 28% of initial assessment patients go on to have an arteriogram, 9% are admitted to the hospital immediately and 7% are discharged back to the care of their general practitioner. At follow-up consultation, the patient's main presenting symptom had been cured in 38% of cases, but remained unchanged in 27% and had worsened in 5%. The paper concludes by examining the project against some success criteria and recounting some of the practical difficulties of data collection encountered so far. PMID- 1790330 TI - Quality assurance in an acute geriatric ward. AB - A multi-disciplinary problem oriented patient record was introduced on to a 24 bed geriatric ward, replacing separate professional records. A Clinical Psychologist and Quality Assurance Consultants assisted with implementation. A Master Problem List with care plans consisting of goal setting and goal achievement analysis were used. Doctors justified use of medications and radiological investigations. Audit indicators were developed for completion of documentation, goal achievement, functional status at discharge, medication and radiology usage. Thirty four per cent of patients' records showed at least one goal not achieved and 45% not reached by review date. Twenty per cent of patients had lower functional status on discharge. Medication cost per patient fell by 10.8% compared with the year prior to introduction. On a similar ward, medication cost rose by 6.7%. This problem resolution approach helped to assure safer discharge and improved team communication. Prescribing behaviour was modified. PMID- 1790331 TI - Results of a comparative study of in-patient satisfaction in eight hospitals in the Paris region. AB - Using the method of self-administered questionnaires, patient satisfaction was measured in eight hospitals for both in-patient stays and out-patient visits, excluding emergency departments for which this method is not appropriate. According to the size of the ward, the in-patient satisfaction was assessed for a period of time, ranging from one to three months in order to obtain 110 questionnaires; for outpatients, the satisfaction was assessed for one week. On the whole, the study showed high satisfaction with the care provided by physicians and nurses (81% and 74% of patients were "very satisfied"), satisfaction with cleanliness and comfort (respectively 64% and 61%), and low satisfaction for quietness and for the time schedule and the quality of meals (respectively 48%, 52% and 40%). As far as comparisons between hospitals and between wards within a given specialty were made, a major result of the study was to point out the very great range of dispersion of satisfaction scores. For example, if the mean value of the satisfaction about comfort is 61% of patients "very satisfied", the extreme values for the set of eight hospitals are 35% and 70%. Another example may be given in general surgery specialty: if the mean value of the satisfaction for medical care is 78%, the extreme values for the set of seven wards are 68% and 86%. These results make clear that however encouraging the scores may be, the evidence of the variability is a powerful incentive to organize corrective actions. PMID- 1790332 TI - Structure-activity studies on adipokinetic hormones in Manduca sexta. AB - Structure-activity studies were performed for adipokinetic hormone (AKH) in Manduca sexta. Seven naturally occurring and four synthetic peptides of the red pigment concentrating hormone (RPCH)/AKH family were tested in larvae of M. sexta for activation of glycogen phosphorylase in fat body. pGlu at the N-terminal was found to be important for activity of peptides; however, Manduca AcGly1AKH is partially active. The amino acids at all positions appear to be of importance for activity, with the possible exception of the two serine residues in positions six and seven. Generally, the more amino acids are exchanged, the less the peptide will bind to the receptor. In M. sexta a beta-bend appears not to be important for the binding of peptides. Peptides ten amino acids long appear to be more active than shorter ones. PMID- 1790333 TI - Bacteria-induced protein P4 (hemolin) from Manduca sexta: a member of the immunoglobulin superfamily which can inhibit hemocyte aggregation. AB - The synthesis of a number of hemolymph proteins is induced in insects in response to bacterial infections. The major induced hemolymph protein in larvae of Manduca sexta is a glycoprotein of Mr = 48,000 known as P4. We have isolated a clone for P4 from a fat body cDNA library constructed from RNA isolated from larvae injected with bacteria. The cDNA has an open reading frame encoding a 411 residue polypeptide with a hydrophobic NH2-terminal sequence, which appears to be a signal peptide. Analysis of the deduced amino acid sequence shows that P4 is a member of the immunoglobulin (Ig) gene superfamily, and is composed largely of four C2 type Ig domains. The M. sexta P4 amino acid sequence is 60% identical with hemolin (P4) from Hyalophora cecropia. The name "hemolin" has also been adopted for the M. sexta P4 protein. Hemolin mRNA levels in fat body begin to increase within 1 h after injection of bacteria into fifth instar larvae and within 4 h after injection of adults. Hemolin associates with the surface of hemocytes and inhibits hemocyte aggregation responses, suggesting a role for the protein in modulating hemocyte adhesion during recognition and response to bacterial infections in insects. PMID- 1790334 TI - Histology and histochemistry of the stomach and intestinal bulb of three hillstream losches. AB - The presence of a stomach and an intestinal bulb in three hillstream teleosts is correlated with their ecological niche and feeding habits. The intestinal bulb of G. lamta and L. guntea displays structural, enzymological and physiological features indicative of ist involvement in absorption. Evidence of an intracellular protein-digesting mechanism extending below the mucosa throughout the whole length of the intestine was also obtained in G. lamta and L. guntea. The stomach of N. savona shows gastric glands of an archaic type, without any acid-secreting parietal cells. PMID- 1790335 TI - Ultrastructural changes in the gonadotrophic and prolactin cells of Myotis myotis under experimental conditions. AB - The adenohypophyseal cells of the pregnant female Myotis myotis present as very active elements organized in anastomosing cords in which several secretory cell types appear to intermingle. The prolactin granules are of variable shape, electron density and diameter (180 to 510 nm). The granules of the gonadotrophic cells are columnar or cuboidal and are of medium electron density; the majority are smaller than the prolactin granules. The adenohypophysis of pregnant females kept under experimental conditions shows disorganization of the cell cords and degranulation of the prolactin and gonadotrophic cells, which display greatly increased development of the rough endoplasmic reticulum and Golgi apparatus, a large number of lysosomes and a large amount of degraded material. PMID- 1790336 TI - The retrocerebral endocrine complex in Diptera. AB - The retrocerebral endocrine glands were studied in 20 insects belonging to the three suborders of Diptera. The CC-CA complex either takes the form of a ring gland, or consists of paired CC and CA. In the suborders Nematocera and Brachycera, both types of organization are to be seen, but only ring gland organization is present in members of the suborder Cyclorrhapha. NCC I and NCC II are found only in insects with paired CC and CA. The histology of the CC and CA is described. NCA1 is clearly discernible in species with paired organization. NCA2 was seen in only one species (Tabanus speciosus), but no swelling was observed on this nerve. NAA and NAO were not present in any of the 20 species studied. PMID- 1790337 TI - Origin of the v. portae and variability of its tributaries in laboratory animals. V. The golden (Syrian) hamster (Mesocricetus auratus). AB - The authors studied the origin and variability of the v. portae in 30 adult golden hamsters (Mesocricetus auratus) of both sexes after injecting blue-dyed latex into their portal bed. In 16 cases (53.3%) the v. portae was formed from three tributaries and in 11 cases (36.7%) from four. The v. mesenterica cranialis was the only constant tributary, the v. lienalis was a tributary in 28 cases (93.3%) and the other most frequent tributaries were the v. gastroduodenalis and the v. pancreaticoduodenalis cranialis. In one case there was an anastomosis between the v. portae and the v. cava caudalis. In 25 cases (83.3%) the v. gastrica sinistra joined the v. lienalis, in four (13.3%) it was an independent tributary of the v. portae and in one case (3.3%) it was duplicated. A v. cardiaca was found in 25 cases (83.3%), when it was most frequently a tributary of the v. gastroepiploica sinistra and v. gastrica sinistra. In one case only it was an independent tributary of the v. portae. A v. pylorica was observed in 29 cases (96.7%), usually (in 17 cases--56.7%) as a tributary of the v. gastroepiploica dextra; in three cases it was an independent tributary of the v. portae (10.0%). A v. pancreaticoduodenalis cranialis was formed in 28 cases (93.3%). In 12 cases (40.0%), together with the v. gastroepiploica dextra, it was a tributary of the v. gastroduodenalis and in eight cases (26.7%) it was an independent tributary of the v. portae. In two cases (6.7%) the two vv. pancreaticoduodenales united to form v. pancreaticoduodenalis communis. In three cases (10.0%) this vein was duplicated and in one case it was triplicated. A v. gastroepiploica dextra was found in 26 cases (86.7%) and a v. gastroepiploica sinistra in 22 (73.3%). Both veins occurred simultaneously in 19 cases (63.3%). In no case, however, was there a continuous venous arc along the curvatura major ventriculi. A v. lienalis was present in 28 cases (93.3%). It was absent in two cases (6.7%), in which it was replaced by inter-organ anastomoses with the stomach and pancreas. In 19 cases (63.3%), the v. gastroepiploica sinistra and v. gastrica sinistra were both its main tributaries and in five cases (16.7%) its main tributary was the v. gastrica sinistra. In one case the v. lienalis was duplicated. Inter-organ anastomoses were formed in all 30 cases (100%). They occurred between the spleen and the stomach in 27 cases (90%) and between the spleen and the pancreas in 28 cases (93.3%).(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1790338 TI - Developmental toxicity of cadmium in mice. I. Embryotoxic effects. AB - Embryotoxic effects of CdCl2 administered in a single dose of 2.0, 4.0 or 6.0 mg/kg body weight to randombred ICR mice (Velaz) on the 8th, 9th, 10th, 11th, 12th, 13th or 14th day of pregnancy were studied. The embryolethal effect, being highest after treatment with 6.0 mg/kg CdCl2 on the 12th and 13th day of pregnancy (50.0 and 61.3%) was not significantly correlated to the day of treatment. Among survivors, foetuses with haemorrhagic bullae, limb malformations, exencephaly, cleft palate, open eyelids and tail deformities occurred. Mainly the right-sided limbs were malformed. The administration of 2.0 and 4.0 mg/kg CdCl2 on the 10th day of pregnancy induced fore limb polydactylies, whereas with the dose of 6.0 mg also oligodactylies were induced. The foetal body weight was reduced only by a dose of 6.0 mg CdCl2 administered on the 12th day of pregnancy. Reduction of the thymus weight was a constant effect of treatment with the higher doses of cadmium from the 9th to the 14th day of pregnancy. PMID- 1790339 TI - Ramification of the a. mesenterica cranialis and its variability in the guinea pig (Cavia aperea f. porcellus). AB - The authors studied ramification of the a. mesenterica cranialis and its variability in 30 guinea pigs (Cavia aperea f. porcellus) after injecting red dyed latex into their arterial bed. In every case, this artery arose from the truncus hepato-mesentericus, which in turn was a branch of a thick arterial truncus coeliaco-mesentericus. After leaving its site of origin, the a. mesenterica cranialis formed a long arc whose convexity was directed leftwards and caudally. Its first branch was most frequently (18 cases-60%) the a. colica media. In seven cases (23.3%) this artery arose together with the a. pancreaticoduodenalis caudalis from the same site. The a. pancreaticoduodenalis caudalis was the first branch of the a. mesenterica cranialis in two cases only (6.7%). In 18 cases (69%) the a. pancreaticoduodenalis caudalis was the second branch of the a. mesenterica cranialis and in seven cases (23.3%) it arose from the same site as the a. colica media. It supplied the caudal part of the pancreas and the duodenum as far as the flexura duodenojejunalis, where it formed an anastomosis with the first a. jejunalis. In every case, the ileum, caecum and colon were supplied by a thick a. ileocaecocolica, which after giving off the last a. jejunalis, formed a continuation of the trunk of the a. mesenterica cranialis. Near the ileocaecal junction it divided into a r. ileacus, rr. caecales, a r. prae--and retrocaecalis and a r. colicus. The caecum was further fed by thick r1. caecales which usually branched from the middle segment of the a. mesenterica cranialis.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790340 TI - Changes in cell proliferation kinetics during organogenesis and differentiation of the brain and optic cup in the chick embryo. AB - The kinetics of cell proliferation on during early ontogenesis of the brain and formation of the eye was studied in the chick embryo. Kinetic parameters--the mitotic index (MI), proliferative activity (P), the duration of mitosis (tm) and the generation time (T)--were measured in various regions of the brain and eye cup, using colchicine as a stathmokinetic agent. It was found that MI could be taken as an indicator of P during early development. In stage 11 it is also clear that the shortest T occurs in areas of rapid proliferation. By stage 12, although the generation time in the various regions studied differs, P and MI are approximately the same. A short tm is not always restricted to areas with a high P. P is affected by variation of T rather than by tm or time of any other parameter of the cycle. With increasing age, tm values decrease and T increase, probably owing to the progress of differentiation during embryonic development. PMID- 1790341 TI - Cholinergic nerves in the lacrimal gland of the desert rat. AB - The histochemical localization of acetylcholinesterase activity in the lacrimal gland was investigated in intact (control) and chemically sympathectomized desert rats. An intensely positive specific cholinesterase reaction was found in the thick nerve bundles distributed throughout the interlobular connective tissue septa. Thick and fine nerves were present in the vicinity of the intra- and interlobular ducts and round the glandular acini and the blood vessels. The finding that this distribution pattern did not alter in the lacrimal gland of chemically sympathectomized animals suggest that the nerves are of a parasympathetic nature. PMID- 1790342 TI - Studies on the corpuscles of Stannius of Botia lohachata. AB - The corpuscles of Stannius of Botia lohachata are made up of numerous large lobules, each of which is bounded by a septum and contains two types of cells. The secretory granules are PAS- and AF-positive, indicating that 1,2 glycol groups and non-sulphated mucoid substances are present. Detached cells in the lobule lumen are suggestive of holocrine secretion. The possibility of the existence of more than one secretory product is discussed. PMID- 1790343 TI - Morphology and structural characteristic of the thoracic vertebrae in the zebu (Bos indicus). AB - The thoracic vertebrae and the course of the ligamentum nuchae were investigated in the East African zebu (Bos indicus) from birth to the age of four years. The results were compared with the findings in 28 specimens of Bos taurus aged 1-4 years. In Bos indicus, at all ages, the apices of the spinous processes of the 7th to 13th thoracic vertebrae are forked. The terminal arms are covered with cartilage, which provides attachment for the funicular part of the ligamentum nuchae. The tips of the spinous processes of the 3rd, 4th and 6th thoracic vertebrae which point dorsad and slightly caudad, are bordered by the two lateral portions of the funicular ligamentum nuchae. At its dorsal insertion, the nuchal ligament lies between the terminal branches, thereby creating a concavity. In Bos taurus, however, there is a convexity, because the spinous processes are not forked. Towards the lumbar spine, the spinous processes become shorter and flat sided. PMID- 1790344 TI - Reappraisal of age-related morphological changes in the rat thymus--morphometric study. AB - A quantitative morphometric study, using a routine histological technique, was carried out with 72 rats aged 7 and 15 days, 1, 4 and 9 months and 1 1/2 years. A micrometric eyepiece, calibrated by means of a stage micrometer, was employed for measurement. Change due to aging included loss of septa, increased fatty infiltration, diminished demarcation of the cortex from the medulla and a decrease in the number of Hassall's corpuscles. The thymus of rats aged 1-4 months was considered to be active; it had well-developed septa, the largest lobules, with complete demarcation of the cortex and medulla, and the maximum number of Hassall's corpuscles. Differences between some of these parameters in males and females were observed. PMID- 1790345 TI - The nasal apparatus of the red squirrel (Sciurus vulgaris L.) embryo at the stage of the fully formed chondrocranium. AB - The nasal apparatus of the squirrel embryo at the optimum stage of the chondrocranium displays simple (though not always primitive) features and individual structures developed largely as in other rodents and even in insectivores. Primitive features include the presence of a cartilago paraseptalis communis and probably the simplicity of the olfactory labyrinth, whose main support in the region as a whole is ethmoturbinale I, whose dorsal and ventral lamella divide off the basic recesses; anterior (frontalis), maxillaris and frontoturbinalis. Completely caudally we find ethmoturbinale I, the frontoturbinalia and the relevant secondary (greatly reduced) recesses. The zona annularis is interrupted by failure of the rostral processes of the lamina transversalis anterior (corresponding to the processes laterales ventrales) to fuse with the capsula nasi ant. or with the anlage of the septum nasi. We did find a fenestra nasi superior (lateralis). The atrioturbinale is well developed, the maxilloturbinale only as a trace, but we have a very striking nasoturbinale. In the rostral region of the olfactory segment, the cartilaginous capsule has a very conspicuous thickening, which in this part is formed of paranasal cartilage. The thickening presents outwardly as the prominentia anterior; cavity of the recessus anterior (frontalis) is formed inside it. The rest of the dorsal and caudal wall of this cavity forms the crista semicircularis, which further caudally circumscribes the foramen olfactorium. A foramen epiphaniale is present. The vestibular region of the epithelial nasal tube is interestingly formed. In cross section it is crescent-shaped; the nasal tube itself opens into the convexity, but the lamina transversalis ant. sends a turbinale into the concavity. A cartilago alaris superior, which develops independently in situ, is present; in our stage it is associated with the wall of the capsule, but ventrolaterally it terminates freely and is not joined to any other element. The morphological interpretation of particular elements is discussed. PMID- 1790346 TI - [Micro-mesoscopic study of fibro-muscular structures of the venous nephro-adrenal transition in humans]. AB - The purpose of this work has been to study the disposition of the fiber and muscular tissues of the wall of the supra-renal left vein, and of its transition to the renal vein. We analysed the disposition of the bundles of muscular, collagenic, elastic and myoelastic fibers, and how they integrate from a morpho functional point of view. In a general way, we evidence the presence of strong longitudinal musculature in the venous wall, and condensations of the collagenic tissue at the level of the ostium of the mouth which constitutes real pillars of sustain of the bundles of the muscular fibers. In relation to the venous transition we concluded that, the morpho-functional architecture of the region, do not suggest the existence of a morphological sphincter but, in fact of the physiological sphincter. PMID- 1790347 TI - Ultrastructural, immunocytochemical and morphometric studies of pituitary prolactin cells after chronic administration of met-enkephalin. AB - The effects of chronic administration of met-enkephalin (40 micrograms/day, for 20 days) on the pituitary prolactin cells of Wistar male rats were studied at the light (PAP-immunohistochemical for PRL demonstration technique) and electron microscopy levels. The D. CIRCLE (mean diameter), D. MAX (maximum diameter) and FORM PE (circular factor of form; irregularity degree) form secretory granules, as well as their percent distribution, were also evaluated. The cellular alterations were variable. Most prolactin cells showed an increase in immunohistochemical reaction. At the electron microscope level the prolactin cells showed an enlargement and swelling of the RER and Golgi apparatus. The secretory granules were bigger and more spherical in experimental than in untreated and control animals. A number of cells showed a variable number of cytoplasmic vacuoles or a large central vacuole formed from dilated RER cisternae. The authors discuss the possible mechanism whereby met-enkephalin exerts a control on prolactin cells. PMID- 1790348 TI - [Quantification of the diameter of muscular fibres in the course of the development of the quadriceps]. AB - Muscle biopsies were taken from the medium portion of the vastus lateralis of a hundred fetuses (aged between 10 and 40 weeks), children, adolescents and adults without any neuro-muscular disease. Diameters of the muscle fibers were measured with a Leitz ASM 68K on frozen sections which had been stained for myofibrillar ATPase. The results have been expressed as average diameters and histograms. The results demonstrated a gradual increase in diameter of the fibers during fetal development. At the birth, the average diameter of the type I and II fibers is 10 15 microns. Growth continues during postnatal development up until puberty, when the fibers reach their final diameter of 60-65 microns. Analysis of the histograms shows that before 18 weeks of gestation, there is a large dispersion in the diameter of the fibers. The first type I fibers are larger than the others and correspond to Wohlfart type b fibers. This is followed by the appearance of a second population of smaller type I fibers. These fibers gradually increase in diameter and one observes a homogenous population of type I fibers at the birth. PMID- 1790349 TI - [Otoneurologic functional examination on the olivo-cochlear efferent pathway]. AB - The authors report their exploration's test of efferent pathway through the BERA with the wave one's surface... Thirty one subjects have been tested. If we can deduce through this study the interaction of the two cochlea by efferent pathway. PMID- 1790350 TI - [Incidence of the morphological aspect on the rate of implantation of embryos obtained by fertilization in vitro]. AB - 1350 embryos obtained by In Vitro Fertilization (IVF) have been examined with the reverse microscope before their transfer in utero. Some embryos are "morphologically normal" (34.7%); some others are atypical. It is difficult to determinate the implantation rate by embryo according to morphological aspect because, most of the time we transfer several embryos to only one patient and we do not know, in case of pregnancy, which one or which ones have developed. Nevertheless, we have tried to appreciate, for 500 embryos transfers after IVF, the incidence of morphological aspect according to the presence or absence of "morphologically normal" embryos. The implantation rate is significantly higher in the groups in which you find "morphological normal" embryos than in the group where they are missing. (19.7% and 19.2% vs 10.2%). It seems that the aspect of the embryo when it is transferred, has an incidence on its future development. PMID- 1790351 TI - [Stratified cylindrical epithelium of the human urethra. Apropos of various cytological observations on urocytograms]. AB - The stratified columnar cells of the human urethra were studied by the filtering membrane technique in urocytograms usually effected, or in smears made after a cytoscopy or after an ejaculation. The cells were present in 61% of systematic filters without inflammation, in 82% of inflammatory filters, and in the urine of 90% of persons after a cytoscopy. The mean number of columnar cells did not exceed 1% in usual filters without inflammation; the percentage varied with the donor sex, but it did not show a significant variation with the donor age. The presence of an inflammation in filters is followed by an increase of the number of columnar cells (until 6%) and of clumps. The columnar cells were numerous in the bladder-washing liquid postcytoscopy (until 40%); their number rapidly decreased in further filters and became to nil between days 7 and 9 after the cytoscopy. The cell clumps showed the same evolution, but they disappeared in filters more rapidly. The significance of these results is discussed. PMID- 1790352 TI - [End of embryonic somite period in the rat and a comparison with the corresponding embryonic period in humans]. AB - The end of the embryonic somite period--stage 12 according of the Carnegie Institution--was identified in the rat. The series was composed of 23 embryos taken out from uterus on day 11/4H, day 11/5H and day 11/10H post fertilization. The specimens were submitted to external macroscopic examinations and to histological sections. The rat development of this stage was characterized by the closure of the caudal neuropore, the evidence of 3 pharyngeal archs, the closure of the otic vesicle, the presence of the fore limb buds, the beginning of the cardiac septa. This stage, being similar to this of human embryos, the authors concluded that rat could be an excellent comparative model for experimental Teratology. PMID- 1790353 TI - [Parameters of the facial bones in the fetus. Anthropology and medico-legal application for the determination of the fetal age]. AB - From 93 skulls and 23 foeto-skeletals we give a glimpse of the rhythme of the human foetuse's facial bones growth and the main variations for facial measurements rating during foetal period. The best correlation between foetal age and facial measurements was obtained with facial height (correlation coefficient: 0.96). Evolution of cranio-facial rating, during foetal stages shows essentially: the increase of the height/width facial rating, the same rhythme of growth for frontal and facial width, the rapidly growth of biparietal diameter up to 30 amenorrhea weeks comparatively to the facial and frontal growth in width. PMID- 1790354 TI - Biochemistry and molecular genetics of Rh antigens. PMID- 1790355 TI - Molecular genetic aspects of human platelet antigen systems. AB - Recent advances in molecular and cellular biology have made it possible to build upon previous serological and biochemical studies of human platelet alloantigen systems in important and exciting ways. In addition to providing a detailed basic understanding of the polymorphisms that are responsible for eliciting an alloimmune response, the molecular characterization of platelet membrane glycoprotein polymorphisms is expected to have an increasingly large clinical impact. As the molecular basis of the remaining platelet antigen systems becomes known, our ability to design novel diagnostic and therapeutic approaches for the care and management of patients with PTP and NATP should improve. PMID- 1790356 TI - Fc-gamma receptors: mediators, targets and markers of disease. PMID- 1790357 TI - Complement. AB - The complement system mediates a wide range of important biological functions. The use of modern techniques in protein chemistry and molecular biology has greatly facilitated our understanding of the interactions between the fluid phase and cell-bound components of the system. Structural and genetic analysis has shown that while many of these components are polymorphic, there are major similarities between many of the proteins serving enzymatic and regulatory roles in both the alternative and classical pathways. The regulation of complement activation and Class III genes, on chromosomes 1 and 6 respectively, encode nine of the major proteins in the system. The genetic basis of C4 and C3 polymorphisms is now well established, and further study may reveal functional differences between polymorphic variants of other components. The study of individuals with either genetic or acquired deficiencies of complement proteins and receptors has provided insight into the function of these components, leukocyte adherence deficiency (LAD) providing the best example. An appreciation of the genetics, structure and functions of the regulatory proteins decay-accelerating factor (DAF) and homologous restriction factor has enhanced our understanding of the pathogenesis of paroxysmal nocturnal haemoglobinuria. The full importance of CD59 glycoprotein, the newest member of the complement family, remains to be determined. PMID- 1790358 TI - Immunochemical and molecular genetic basis of the histo-blood group ABO(H) and related antigen system. PMID- 1790359 TI - Molecular biology of the HLA system and its relevance for immunohaematology. PMID- 1790360 TI - MR imaging of the abdomen: are we there yet? PMID- 1790361 TI - Simultaneous acquisition of phase-contrast angiograms and stationary-tissue images with Hadamard encoding of flow-induced phase shifts. AB - A technique for the simultaneous acquisition of three-dimensional phase-contrast angiograms and stationary-tissue images is described. Hadamard multiplexed encoding of flow information permits image acquisition times that are a third shorter than those of previous phase-contrast methods. The encoding scheme described also enables differentiation of flow-induced phase shifts from phase shifts due to resonance offset conditions such as field inhomogeneities and chemical shift. Display strategies that combine this phase information with the flow image are described. PMID- 1790362 TI - Encoding strategies for three-direction phase-contrast MR imaging of flow. AB - Three encoding strategies for the measurement of flow velocities in arbitrary directions with phase-contrast magnetic resonance imaging are presented; their noise and dynamic range performance are compared by means of theoretical analysis and computer simulation. A six-point measurement strategy is shown to be quite inefficient in terms of velocity variance per unit time. A simple four-point method exhibits equal dynamic range; its noise depends on flow direction but on average is equal to that of the six-point method. An alternate, balanced four point method has noise that is direction independent and has, depending on implementation, possibly lower noise levels. Either four-point method is more efficient and is preferred over the six-point approach. PMID- 1790363 TI - Phase-contrast MR angiography with reduced acquisition time: new concepts in sequence design. AB - A new acquisition scheme for three-dimensional (3D) phase-contrast MR angiography reduces by 33% the measurement time for a data set sensitive to flow in all three orthogonal directions. Background suppression is achieved by acquiring a flow compensated data set and three data sets flow encoded in the three orthogonal directions, with subsequent complex subtraction. The data are acquired in an interleaved fashion, eliminating misregistration artifacts due to patient motion between measurements sensitive to different flow directions. A standard maximum intensity-projection algorithm is applied to the combined 3D data set to obtain angiographic projections sensitive to all three orthogonal flow directions. The theory and implementation of the method are described and examples of its application to the intracranial and abdominal circulation are provided. PMID- 1790364 TI - Application of a connected-voxel algorithm to MR angiographic data. AB - A connected-voxel algorithm (CVA) that improves the contrast and conspicuity of blood vessels in maximum-intensity-projection (MIP) magnetic resonance (MR) angiography is described. Images from a variety of anatomic regions in healthy volunteers were calculated with either an MIP procedure alone or with data that had first been processed with the CVA. A low-signal-intensity threshold is first applied to separate groups of voxels associated with different vessels from one another and to eliminate the contribution from low-intensity stationary material. The remaining voxels are grouped by a connectivity criterion into discrete "objects." Vessels are represented by extended objects, and small objects are discarded. The CVA, therefore, reduces the full three-dimensional data set into a small number of discrete objects. It is a powerful technique that can be used to remove signal from vessels overlying the vessel of interest, to separate objects representing arterial flow from those representing venous flow, to eliminate flow artifact from projection images, and to more completely retain signal within the vascular lumen. This technique has been successfully demonstrated with MR angiography in healthy volunteers. PMID- 1790365 TI - Use of magnetic particles for sensitizing MR images to blood flow. AB - Magnetic resonance (MR) images made with the IVIM (intravoxel incoherent motion) technique for demonstrating tissue microcirculation are limited in sensitivity because of the small volume of blood involved. This limitation may be overcome by incorporating magnetic particles into the flow. The magnetic perturbation caused by the particles extends beyond the walls of the capillary and affects a much larger volume than that of the flowing material. Imaging experiments conducted with an artificial capillary system for renal dialysis, containing large magnetic particles, showed that signal intensity decreased with increasing flow rate through the dialysis bundle and with increasing particle concentration. Predictions of the effect based on a theoretical model of spin dephasing in the field of a magnetic dipole agreed with the experimental data. The results hold promise for development of the technique in vivo. PMID- 1790366 TI - Muscle edema in musculoskeletal tumors: MR imaging characteristics and clinical significance. AB - To determine the frequency and clinical significance of tumor-associated muscle edema, magnetic resonance (MR) imaging findings in 46 consecutive patients with benign or malignant musculoskeletal lesions were reviewed. Increased muscle signal intensity on T2-weighted, STIR (short-inversion-time inversion-recovery), and gadopentetate dimeglumine-enhanced T1-weighted images was present in 41 cases, with the clearest delineation of tumor margins seen on T2-weighted images. Typical peri/paratumoral edema (PTE) was present in equal proportions of malignant (25 of 37) and benign lesions (six of nine). Massive edema involving the entirety of at least one contiguous muscle--to the authors' knowledge, a previously undescribed finding--was identified on MR images of eight malignant and two benign lesions (22% of both groups). All cases of massive edema had a substantial soft-tissue component and involved muscles disrupted by tumor at the point of attachment to bone. Malignant tumors associated with massive edema were larger than those with typical or no PTE, showed a poorer response to initial chemotherapy, and had a higher frequency of metastases at diagnosis. Thus, the presence of massive muscle edema appears to be an ominous clinical finding in patients with malignant musculoskeletal lesions. PMID- 1790367 TI - MR image contrast at high field strength. AB - The T1 of soft tissues increases with magnetic field strength. Some tissue contrast may be diminished on high-field-strength magnetic resonance (MR) images when conventional TRs are used, because of altered T1 effects on the MR signals. This necessitates longer TRs in techniques that use long TRs, which prolongs the examination excessively. Behavior of macroscopic magnetization is governed by the Bloch equations. Therefore, T1 contributions to the MR signal can be modulated by means of both timing intervals and radio-frequency pulses. The analytic solution to the Block equations allowed calculation of white matter/gray matter and gray matter/cerebrospinal fluid contrast in both spin-echo and inversion-recovery (IR) imaging. Rabbit brains (normal and tumor-containing) were then imaged in vivo at 1.5 and 4.7 T. In addition, MR images of a human head were obtained at 4.0 T. Experimental results supported the theoretical predictions that brain contrast on long TR spin-echo or IR images increases with field strength. However, varying the excitation flip angle allowed optimization of the T1 contribution to the MR signals, improving image contrast and/or reducing examination time. Thus, the dependence of T1 on field strength determines the optimum choice of imaging techniques and parameters in a predictable fashion. PMID- 1790368 TI - Phase-offset multiplanar (POMP) volume imaging: a new technique. AB - Phase-offset multiplanar (POMP) imaging is a technique that excites several sections simultaneously for improved imaging efficiency. The centers of the reconstructed images from each of the POMP sections are offset from each other in the phase-encoding direction by means of view-dependent phase modulation of the radio-frequency (RF) excitation pulses and are placed adjacent to each other in the reconstruction. With a suitable reconstruction matrix size, the images can be made nonoverlapping and stored separately. At constant imaging time, signal-to noise ratio (S/N), and resolution, POMP imaging produces a factor NP more sections than a conventional sequence but with a reduced field of view. Alternatively, imaging time may be increased by the factor NP to retain the same field of view but with the expected S/N advantage. The average RF power deposited by the 90 degrees composite RF pulse is greater by the factor Np, but the power for the 180 degrees pulse is unchanged. The POMP method is discussed and compared with three-dimensional and Hadamard techniques. PMID- 1790369 TI - Polymeric gastrointestinal MR contrast agents. AB - Combining either paramagnetic (gadolinium chelates) or superparamagnetic (ferrite) contrast agents with polymers such as polyethylene glycol or cellulose, or with simple sugars such as dextrose, results in mixtures that exhibit improved T1 and/or T2 relaxivity compared with that of the contrast agent alone. It is suggested that the addition of such inexpensive and nontoxic polymers or saccharides may improve the effectiveness and decrease the cost of enteric contrast agents. PMID- 1790371 TI - Right-side aortic arch with aneurysm of aberrant left subclavian artery: MR imaging appearance. AB - Reports of aneurysms of the subclavian artery in both normal and anomalous aortic arches have been rare. The authors describe a patient with a right-side aortic arch and an aneurysm of the aberrant left subclavian artery, which, to the authors' knowledge, is a previously unreported association. At presentation, the aneurysm appeared as a calcified left superior mediastinal mass. Magnetic resonance imaging enabled preoperative diagnosis and guided surgical planning. PMID- 1790370 TI - MR imaging of Hippel-Lindau disease: value of gadopentetate dimeglumine. AB - Hippel-Lindau disease is an autosomal dominant disorder characterized by tumors of the central nervous system and abdominal viscera. Frequent multisystem radiologic evaluation of persons at risk is desirable. Twenty-seven patients with Hippel-Lindau disease or a family history of the disease were examined with both unenhanced and gadopentetate dimeglumine-enhanced magnetic resonance (MR) imaging to study the usefulness of the contrast medium in the evaluation of these patients. The MR studies were correlated with computed tomographic (CT) scans in seven patients and cerebral angiograms in five. Twelve patients had hemangioblastomas in the brain, and eight of these patients also had spinal cord lesions (most were multiple), well demonstrated with gadopentetate dimeglumine. Contrast-enhanced MR imaging enabled detection of more central nervous system lesions and provided better delineation than unenhanced MR imaging, CT, or angiography. In addition, four patients with multiple renal cysts seen on CT scans and unenhanced MR images had enhancing lesions that were later proved to be renal cell carcinoma at angiography and/or surgery. Four patients had cystic lesions in the pancreas that did not enhance and were later proved to be pancreatic cysts. The authors conclude that gadopentetate dimeglumine-enhanced MR imaging appears to be a useful method for evaluating and following up patients with Hippel-Lindau disease. PMID- 1790372 TI - Evaluation of a simple method for reconstructing asymmetrically sampled echo data. AB - A simple method for reconstructing echo data with a large degree of sampling asymmetry was investigated. The method is based on the application of an optimized data sampling window before standard Fourier transform magnitude reconstruction. The performance of this "windowed direct" reconstruction was evaluated with theoretical simulations and experimental measurements and compared with that of the half-Fourier method. With the proper selection of data sampling window parameters, highly asymmetric echo data reconstructed with standard Fourier transform magnitude algorithms produced images similar in quality to those reconstructed with the half-Fourier method. Windowed direct reconstruction provides a simple and computationally fast alternative to more sophisticated algorithms and may be particularly applicable for specialized or developmental applications. PMID- 1790373 TI - Clinical comparison of three-dimensional MP-RAGE and FLASH techniques for MR imaging of the head. AB - Three-dimensional (3D) MP-RAGE (magnetization-prepared rapid gradient-echo) imaging was evaluated as a high-resolution 3D T1-weighted brain imaging technique for patients with suspected neurologic disease. Fourteen patients were studied. In five, 3D MP-RAGE images were compared with 3D FLASH (fast low-angle shot) images. Signal difference--to-noise ratios and T1 contrast were not statistically different for 3D MP-RAGE images as opposed to 3D FLASH images. Advantages intrinsic to the application of 3D MP-RAGE sequences include decreased imaging time and decreased motion artifact. With this technique, it is possible to perform a relatively motion-insensitive, T1-weighted screening brain study with voxel resolution of 1.0 x 1.4 x 2.0 mm or smaller, in an imaging time of 5.9 minutes or less--permitting offline (poststudy) reconstruction of high-resolution images in any desired plane. PMID- 1790374 TI - Prostate and seminal vesicles after irradiation: MR appearance. AB - Familiarity with the morphologic changes in the prostate and seminal vesicles (SV) after pelvic irradiation is important to the correct interpretation of follow-up magnetic resonance (MR) studies. A retrospective study of 38 patients with prostatic or other pelvic tumors treated with radiation showed that 31.6% had a normal prostatic zonal pattern (peripheral zone hyperintense to central gland) on T2-weighted images, and 7.9% showed reversal of the zonal pattern; among the rest, the entire gland was diffusely isointense to fat in 42.1%, hypointense to fat in 10.5%, and hyperintense to fat in 7.9%. Sixty-three percent of the SV had a normal appearance, 21% had fewer tubules but normal signal intensity (SI), 8% had diffuse loss of SI (hypointense to fat), and 8% were hypointense to muscle. Quantitative measurements of SI of the prostate and SV demonstrated a statistically significant lower mean value for the irradiated patients relative to 10 control patients. A decrease in the size of both the prostate and SV was observed in 33% of patients with baseline studies. Use of additional treatment modalities in patients with prostatic carcinoma appeared to correlate with increased likelihood of developing abnormal changes. The authors conclude that in the irradiated patient, the prostate and SV can develop several patterns of SI abnormalities; in particular, diffuse low SI in the prostate and SV should establish radiation fibrosis as an important differential diagnosis to consider. PMID- 1790375 TI - Interventricular differences in myocardial T2 measurements: experimental and clinical studies. AB - The goal of this study was to determine the accuracy, the reproducibility, and some of the tissue determinants of image-based myocardial T2 measurements. Image based T2 calculations for the free walls of the right ventricle (RV) and left ventricle (LV), in vitro T2 determination (at 0.47 T), and water, fat, and collagen content analyses were performed in ex vivo hog hearts. T2 values of the RV and LV free walls were also determined from spin-echo images of 14 healthy human subjects. Preliminary reproducibility studies were performed with 10 sets of images acquired from a single subject. For both in vitro and image-based T2 values of hog hearts, RV T2 was significantly longer than LV T2. Water content was the only tissue factor to significantly correlate with in vitro and image based T2 values. For the 14 human subjects studied, image-based T2 values calculated from the first- and third-echo images demonstrated a significant difference between LV and RV. The difference was not significant when the first- and second-echo images were used. Image-based T2 measurements of a single subject showed a coefficient of variation of 6.8% for the LV and 9.1% for the RV. The authors conclude that image-based T2 measurements of normal myocardium can be made with sufficient precision to identify differences of the magnitude of those found between RV and LV T2 values. Image-based T2 values of myocardium may provide useful data to aid in patient treatment. PMID- 1790376 TI - Multipoint Dixon technique for water and fat proton and susceptibility imaging. AB - Extensions to a previously described three-point Dixon magnetic resonance imaging technique are presented that use alternative water/fat phase-encoding strategies. The technique is generalized to phase encoding of (-theta, O, theta) or (O, theta, 2 theta) radians, and the signal-to-noise ratio (S/N) performance is evaluated. It was found that a theta of 2 pi/3 radians has optimal S/N but that a theta of pi radians is a good compromise and that phase encoding of (O, pi, 2 pi) radians offer an advantage over the previous method, which used (-pi, O, pi) increments, in that a T2' (intravoxel susceptibility dephasing) image may be obtained in addition to the usual water, fat, and Bo images. A new four-point method with phase encoding of (O, pi, 2 pi, 3 pi) radians that can also provide a measure of the spectral width of the fat resonance is suggested. The disadvantages of the method are the extra imaging time and low S/N efficiency. PMID- 1790377 TI - TE interleaving: new multisection imaging technique. AB - A new pulse sequence that increases the number of sections that can be acquired with a T2-weighted multisection imaging prescription is presented. The sequence achieves a higher efficiency in section acquisition per unit time by interleaving excitation and data collection for up to three separate sections during the long TE (greater than or equal to 80 msec) of a T2-weighted spin-echo pulse sequence. The necessary modifications of the section-select and readout gradient waveforms for the implementation of TE-interleaved (TEI) sequences, with and without flow compensation, are described. Secondary- and stimulated-echo artifacts are present on some TEI images, but these can be controlled with appropriate spoiler gradients. The signal-to-noise ratio for contiguous sections is slightly reduced compared with that of a standard multisection pulse sequence. These observations indicate that the effects of radio-frequency section interference are enhanced by the TEI sequence. PMID- 1790378 TI - Visualization of MR angiographic data with segmentation and volume-rendering techniques. AB - Novel image processing and computer graphics techniques were developed to create three-dimensional (3D) models of vasculature from magnetic resonance (MR) angiographic images of the head or neck. Region growing was used to produce a mask that isolated the vascular signal in the MR angiographic data. The masked images were subjected to gradient-shaded volume rendering to create 3D views of the vasculature. The computer-derived model of intracranial vasculature was then merged with a 3D model of brain parenchyma derived from a set of MR images. The combined display of vascular and gyral anatomy may be useful for neurosurgical planning. PMID- 1790379 TI - Diagnostic value of gadopentetate dimeglumine for 1.5-T MR imaging of musculoskeletal masses: comparison with unenhanced T1- and T2-weighted imaging. AB - Three magnetic resonance (MR) imaging techniques (T1-weighted, T2-weighted, and T1-weighted gadopentetate dimeglumine--enhanced) were compared in 32 consecutive MR imaging studies of 26 patients with suspected musculoskeletal masses. T2 weighted images were superior to T1-weighted enhanced images with respect to detection and definition of lesions in 12% of cases (n = 4) and were equal in 88% of cases (n = 28). T2-weighted images were also superior to T1-weighted images in 38% of cases (n = 12). In no cases were T1-weighted enhanced images superior to T2-weighted images. In two cases, T1-weighted images were superior to both T1 weighted enhanced and T2-weighted images. The authors conclude that gadopentetate dimeglumine did not provide much value in lesion detection above that obtained with T2-weighted images. They also conclude that T1-weighted images were occasionally superior to T1-weighted enhanced images and T2-weighted images because of loss of definition between fat and lesion on the latter. PMID- 1790380 TI - MR imaging-guided interstitial Nd:YAG laser phototherapy: dosimetry study of acute tissue damage in an in vivo model. AB - A dosimetry study of acute tissue damage induced by interstitial application of the neodymium-yttrium-aluminum-garnet (Nd:YAG) laser was performed with magnetic resonance (MR) imaging. The MR appearance of the lesion was correlated with gross and histopathologic findings. Seventy-six lesions were induced in rabbit muscle with laser power outputs of 5-20 W and exposure times of 20-600 seconds. MR imaging was performed immediately after laser exposure. T2-weighted spin-echo images clearly showed the acute thermal injuries caused by laser energy deposition and correlated best with histopathologic findings. These images showed three distinct layers, corresponding to central ablation, coagulative necrosis, and interstitial edema, respectively, in the pathologic findings. Lesion diameters measured on MR images showed a linear correlation with those in gross sections. Lesion volume increased not only with increasing total energy delivered but with increasing power output for a fixed total energy delivered. MR imaging is an accurate modality for dosimetry studies of laser-induced acute lesions. PMID- 1790381 TI - Rapid three-dimensional T1-weighted MR imaging with the MP-RAGE sequence. AB - The authors investigated the application of three-dimensional (3D) magnetization prepared rapid gradient-echo (MP-RAGE) imaging to the acquisition of small (32 x 128 x 256) T1-weighted 3D data sets with imaging times of approximately 1 minute. A theoretical model was used to study the contrast behavior of brain tissue. On the basis of these theoretical results, 3D MP-RAGE sequences were implemented on a 1.5-T whole-body imager. Thirty-two-section 3D data sets demonstrating good signal-to-noise ratios and resolution and strong T1-weighted contrast were obtained in 1 minute. Compared with standard short TR/TE spin-echo sequences with the same imaging times and comparable sequence parameters, the 3D MP-RAGE sequence delivered increases of more than 50% in the white matter/gray matter signal difference-to-noise and white matter signal-to-noise ratios, and provided almost twice as many sections. These sequences may find a clinical role in 3D scout imaging and screening and in patients with claustrophobia or trauma. PMID- 1790382 TI - Significance of the point of expansion in interpretation of gradient moments and motion sensitivity. AB - The relationship between magnetic field gradient waveform moments and the motion sensitivity of magnetic resonance imaging was explored analytically and by computer simulation. The analysis and simulations revealed several key points. In general, waveform time moments define sensitivity to the time derivatives of position of moving material only at a single time point: the time about which the moments are computed. A Taylor series description of instantaneous position is expanded about this same time point to compute the phase acquired due to specific derivatives of position. A moment is proportional to phase sensitivity to a particular derivative of position throughout the waveform only when sensitivity to all lower-order derivatives is zero. Under restricted conditions of waveform symmetry and motion characteristics, the phase due to motion may be expressed in terms of the average value of a derivative of position over the duration of the waveform. The choice of the moment center, or point of expansion, adds a degree of freedom that may be used advantageously in the design of motion-compensating and motion phase-encoding gradient waveforms. These results facilitate a more complete understanding of the effects of motion through a magnetic field gradient. PMID- 1790383 TI - MR imaging of head and neck vascular malformations. AB - Between 1980 and 1990, 150 patients with cervicofacial vascular malformations were studied at the authors' institution with computed tomography, plain radiography, and angiography. Since 1989, 34 of these patients have also undergone magnetic resonance (MR) imaging. Capillary-venous hemangiomas seem to be the best indication for the adjunctive use of MR imaging. The venous pouches, characteristic of this type of lesion, cause elevated signal intensity, well seen on the T2-weighted images. Excellent fat and muscle differentiation with MR imaging allows appreciation of the depth of extension of these lesions and their delimitation from normal tissue. Arteriovenous malformations (AVMs) are characterized by serpentine signal voids, indicative of the high flow rate of these lesions. Delimitation of the AVM nidus in the midst of the afferent and efferent dilated vessels is often difficult. Study of immature angiomas with MR imaging should be restricted to lesions in specific locations (eg, orbital, laryngeal). Lymphatic malformations showed either tissular or cystic signal intensity changes. MR imaging does not replace other studies but represents an important complementary study for the delineation and diagnosis of deep extensions of vascular malformations, allowing better planning of therapy. PMID- 1790384 TI - MR imaging of poststenotic flow phenomena: experimental studies. AB - Poststenotic flow patterns were analyzed in a flow phantom with a 1.5-T magnetic resonance (MR) imager, with use of different MR imaging and MR angiographic pulse sequences. Spin-echo, fast field-echo, two-dimensional inflow (multiple single section technique), and flow-adjusted-gradient sequences were applied. For the spin-echo sequences, modulus and phase images were reconstructed from each data set. The length of the region of poststenotic changes in signal amplitude and phase measured at a constant flow rate increased with stenosis grade. Likewise, the length of the region of poststenotic changes measured at a constant stenosis grade increased with flow rate. Moreover, the results depended on the alignment of the flow direction with the readout gradient. Comparison of modulus and phase images allowed discrimination of turbulent and nonturbulent flow, which yields additional information on stenosis grade in clinical MR angiography. PMID- 1790385 TI - Ineffectiveness of averaging for reducing motion artifacts in half-Fourier MR imaging. AB - Two data sets for half-Fourier imaging (HFI) can be collected in the same time as one data set for conventional full Fourier imaging (FFI). The hypothesis is that averaging twice as much data in HFI does not make ghost artifacts caused by motion have less signal intensity than in FFI. This hypothesis was tested with images of a human subject by measuring the standard deviation within regions of interest containing ghosts. The control experiment involved measuring the standard deviation on images from the same data reconstructed with FFI. The images were formed after averaging of one to eight data sets from a collection of nine data sets acquired sequentially. Background ghosts or those in other regions of low intensity were less intense on images from HFI after twice as much averaging as in FFI, but this was not the case for ghosts superimposed on anatomic structures. This observation is explained by showing that an image obtained by means of FFI can be expressed in terms of two images obtained by means of HFI applied to the top and bottom halves of the data. The use of HFI to allow twice as much averaging without prolonging data acquisition time is not advantageous for reducing ghost artifacts caused by motion. PMID- 1790386 TI - Primary nasal amelanotic melanoma: MR appearance. AB - The appearance on magnetic resonance (MR) images of a primary amelanotic malignant melanoma of the nasopharynx is reported. The factors affecting the MR appearance of melanomas of the head and neck are reviewed. The case is compared with a previously reported case of primary nasopharyngeal melanotic melanoma, and the importance of considering the tumor in all nasopharyngeal neoplasms is emphasized. PMID- 1790387 TI - Rectal barium in pelvic MR imaging: initial results. AB - Pelvic magnetic resonance (MR) imaging is limited by lack of an effective bowel contrast agent. This study was performed to evaluate the efficacy of rectally administered barium sulfate as a contrast agent in pelvic MR imaging. Thirty-two patients were studied retrospectively to evaluate anatomic definition of the rectosigmoid colon. A commercially available barium sulfate suspension was administered rectally in 19 patients. Thirteen patients were imaged without barium. In the latter patients, anatomic definition of the rectum and sigmoid colon was poor to fair with all pulse sequences. Delineation of the rectum and sigmoid colon improved in patients who received rectal barium, owing to distention and marking of the bowel by the predominantly low-signal-intensity barium. Barium is a safe, inexpensive negative contrast agent for bowel that may improve pelvic MR imaging. PMID- 1790388 TI - Acoustic pressure wave generation within an MR imaging system: potential medical applications. AB - The static magnetic field of a magnetic resonance (MR) imaging system was used as a component of an electromagnetic transducer for generating acoustic pressure waves. To permit limited focusing, the transducer was constructed from a conductive thin plate shaped like a section of a sphere. The plate was placed within the static field of the MR unit (B0 = 1.5 T), and current pulses with a rise time of 73 nsec and amplitude of 1.0 kA were applied to it. Hydrophonic recording demonstrated a shock wave with a peak pressure of 4.8 MPa at the approximated focal point. MR guidance of lithotripsy would be particularly useful to limit undesirable soft-tissue damage. It is also suggested that the integration of an acoustic pressure wave generator with MR imaging and control provides a novel technology for the treatment of solid soft-tissue tumors. PMID- 1790389 TI - The dilemma of health care quality, access, and cost and its effect on MR imaging. PMID- 1790390 TI - Fluoride therapy in postmenopausal osteopenic women: effect on vertebral and femoral bone density and prediction of bone response. AB - Fifty-two postmenopausal women (mean age 60 +/- 5 years) with low BMD (less than 2SD of young adult values) but who had not experienced previous crush fracture were treated with 50 mg of sodium fluoride (NaF), 1 g of calcium and 400 IU of vitamin D2 per day for 2 years. Repeated vertebral and femoral BMD measurements were made and compared with those of a control group consisting of 16 untreated women. Serum alkaline phosphatase and osteocalcin, blood and urinary fluoride levels were measured regularly to determine their predictive value on bone response. 18 of 52 (35%) of the treated patients experienced side effects (29% gastric, 4% lower extremity pain syndrome) but only in 6 cases (12%) was it necessary to discontinue treatment. In neither of the two groups was any fracture recorded (vertebral or otherwise). Among the 43 women who were treated for at least 2 years, 21 (49%) were considered to have responded (i.e., with an increase of vertebral BMD greater than 0.043 g/cm2). There was a mean linear increase in BMD in this group of 0.0041 g/cm2 per month (i.e., 5.5% per year). On the other hand in the non-responder group and in the control group, vertebral BMD either remained stable or decreased. However no difference was detected between the two groups (treated and controls) at the femoral site after 2 years; both groups showed a significant decrease in BMD. The responders had a lower initial osteocalcin level and treatment led to a relatively greater increase in osteocalcin.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790391 TI - Broadband ultrasound attenuation of the calcaneus predicts lumbar and femoral neck density in Caucasian women: a preliminary study. AB - Recent studies have demonstrated the ability of ultrasound techniques to differentiate normal and osteoporotic women. To define the ability of broadband ultrasound attenuation (BUA) of the calcaneus to predict axial bone mass, the ultrasound value was correlated with lumbar vertebral and femoral neck density in 22 Caucasian women. The three measures of bone mass inversely correlated with age: lumbar density (r = 0.54), femoral neck density (r = 0.65), and BUA (r = 0.73). BUA correlated with lumbar (r = 0.83) and femoral neck (r = 0.87) density. Lumbar vertebral density predicted femoral neck density with a standard error of estimate (SEE) of 0.07 g/cm2, and femoral neck density predicted lumbar density with a SEE of 0.09 g/cm2. BUA of the calcaneus was as effective as either axial bone mass measure in predicting the other value: the SEE for lumbar density was 0.09 g/cm2 while that for femoral neck density was only 0.06 g/cm2. The results of this preliminary study indicate that this rapid, radiation-free technique can accurately predict axial bone mass, and may be of value as an initial procedure to discriminate those women warranting more extensive radiologic evaluations. PMID- 1790392 TI - Consensus development conference: prophylaxis and treatment of osteoporosis. PMID- 1790393 TI - Consensus Development Conference, 19-20 October 1990, Copenhagen, Denmark. Abstracts. PMID- 1790394 TI - Calcium supplements: practical considerations. AB - The preferable source of calcium is a balanced diet, but medicinal supplements are sometimes necessary if patients are to reach desired intakes. A divided dose regimen (4x/d; i.e., with meals and at bedtime) results in substantially greater absorption of a supplement than does 1x/d dosing. However, differences in chemical solubility between supplement preparations are of little importance, with calcium carbonate preparations, for example, being absorbed as well or better than some much more highly soluble salts. Gastric acid is not necessary for absorption of even poorly soluble preparations, so long as they are taken with meals. Because typical patients exhibit a wide range of absorption efficiencies, it is desirable to assess absorption fraction before beginning a supplement regimen. (Some patients will need three times as large a dose as others to absorb the same amount of calcium.) Calcium intakes up to at least 62.5 mmol (2500 mg) are safe for virtually all patients. PMID- 1790396 TI - Localization of regional forearm bone loss from high resolution computed tomographic images. AB - The precise site of bone loss was evaluated in early postmenopausal women using high resolution computed tomographic (CT) images of forearm measurements. A procedure was devised to quantitate trabecular and subcortical bone density of the distal radius, cortical bone density of the diaphyseal radius, and cortical wall thickness at both measuring sites. Twenty women (mean age 52 years, time since menopause 1 to 4 years) were examined twice at one-year intervals to determine the yearly change of the above mentioned bone parameters. Trabecular bone and subcortical bone showed the same density reduction of 7 mg/cm3 per year. Cortical bone density remains unchanged and no increase in porosity can be seen. For early postmenopausal women the reduction of bone mass (BMC) in the diaphysis of the radius is, therefore, due to a thinning of the cortical wall. This is in accordance with the observed average loss of wall thickness of 0.04 mm per year. The non-invasive determination of the precise localization of bone changes in individual patients should be of value in the assessment of the severity of osteoporosis. Furthermore it has potential in the evaluation of the efficacy of therapeutic procedures in the various disease states. PMID- 1790395 TI - Formation of neutralizing antibodies during intranasal synthetic salmon calcitonin treatment of postmenopausal osteoporosis. AB - Nineteen patients with postmenopausal osteoporosis were treated with 200 u (15 nmol) synthetic salmon calcitonin (sCT) intranasally per day for 15 months. Six months after the start of the nasal administration of sCT, antibodies were recognized in 7, and after 15 months in 10 of the 19 patients studied. The half maximal dilution of serum binding to 60 pmol/l [125I]sCT (dilution-50) ranged from 2 to 490, and half-maximal inhibition of [125I]sCT binding (60 pmol/l) from 91 to 221 pmol/l sCT. In a cultured breast cancer cell line (T47D) cAMP production was stimulated by sCT (EC50 70 pmol/l). Stimulated cAMP production by sCT (50 pmol/l) was reduced to between 4% and 23% in the presence of serum from patients with antibody dilution-50 of [125I]sCT binding exceeding 32. In patients with lower titer antibodies cAMP production was only marginally suppressed. The values of patients with postmenopausal osteoporosis were in the range of those of earlier studied patients with Paget's disease and clinical resistance to sCT. There was a linear relation between the antibody dilution-50 and the serum dilution required for half-maximal inhibition of cAMP production (P less than 0.01). In conclusion, neutralizing antibodies to sCT may contribute to the decreased responsiveness of bone mineral loss during prolonged treatment with sCT. PMID- 1790397 TI - Bone mineral density in patients with cervical and trochanteric fractures of the proximal femur. AB - The bone mineral density (BMD) of the proximal femur, spine and radius shaft was determined in 75 women with atraumatic fractures of the proximal femur (FXf) (average age: 70.1 +/- 9.6 years) and 51 controls of similar age. Fractures were classified as either cervical (n = 36) or trochanteric (n = 39) on the basis of radiographic and surgical finding. The BMD of spine and proximal femur was determined by dual-photon absorptiometry (Lunar DP3) and the BMD of the radius shaft by single photon absorptiometry. The BMD of patients with FXf was significantly decreased over all skeletal sites compared to controls of similar age. No significant correlation was found between age and the BMD of the femoral neck in patients with FXf. Patients with trochanteric FXf were older and thinner (average: age, 72.9 +/- 9.4 years; weight, 53.1 +/- 7.8 kg) compared with patients with cervical fractures (age, 67.2 +/- 8.9 years; weight, 59.3 +/- 8.3 kg). Likewise the BMD of trochanteric FXf was lower at all measured sites: femoral neck, 0.548 +/- 0.066 g/cm2 vs 0.624 +/- 0.055 g/cm2 (P less than 0.001); L2-L4, 0.799 +/- 0.115 g/cm2 vs 0.925 +/- 0.106 g/cm2 (P less than 0.001); radius shaft, 0.454 +/- 0.057 g/cm2 vs 0.502 +/- 0.083 g/cm2 (P less than 0.05). Of the patients with trochanteric fractures 66% had concomitant vertebral fractures, while this occurred in only 28% of the patients with cervical fractures (P (Fisher) = 0.0007). In summary, females with trochanteric FXf are older, thinner, have less bone mass in all measured sites and suffer with a significantly greater frequency of vertebral fractures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790398 TI - Rapid postmenopausal loss of total body and regional bone mass in normal southern Chinese females in Hong Kong. AB - Osteoporosis is a major health problem in Hong Kong, affecting about 200,000 patients among a population of 6 million. To evaluate the rate of bone loss and determinants of low bone mass among the Southern Chinese, we measured the total body and regional bone mass with the XR-26 dual-energy X-ray absorptiometry in 90 normal females. The results show that the total and regional bone densities were stable before menopause, with a change of around 0.5% every year. After menopause, a rapid loss is evident for total body and regional bone mass. The rate of bone loss varies from 1.2% for the pelvis to 3.1% for the Ward's triangle per year. Thus, by the age of 70, most Southern Chinese females would have lost at least 25% of their bone. Age, body weight, and skeletal area are important determinants for the total body bone mass. Bone densities in weight-bearing regions, including hip, pelvis, spine and legs correlate strongly with each other (r = 0.68, P less than 0.001). Correlation is poor among unrelated regions, such as between head and arms (r = 0.39, P greater than 0.5). To conclude, normal Chinese women in Hong Kong lose bone rapidly after menopause at a rate of about 2% per year. This may account for the major incidence of osteoporosis-related complications in Hong Kong. PMID- 1790399 TI - Potential risk factors for development of postmenopausal osteoporosis--examined over a 12-year period. AB - In a longitudinal study, we investigated the influence of risk factors on bone mass at menopause and postmenopausal bone loss in 121 healthy postmenopausal women. These women had completed a 2-year prospective study in 1979 and a follow up examination in 1989. Measurements of the bone mineral content in the distal forearm (single photon absorptiometry) were performed 9 times during the initial study and once at the follow-up examination. Bone mass at menopause (initial measurement), rate of early postmenopausal bone loss, and the subsequent rate of bone loss over 10 years were thus determined. In addition, the bone mineral density of the lumbar spine and proximal femur was measured by dual-energy X-ray absorptiometry (DXA) in 1989. Information about risk factors was assessed by standardized questionnaires and included reproductive history and lifestyle factors (intake of calcium and vitamin D supplements, consumption of alcohol and caffeine, smoking habits, and physical activity). Lactation, oral contraceptive use, and dietary calcium intake above 1500 mg per day was associated with significantly increased bone mass at menopause. The number of pregnancies reduced the rate of early postmenopausal bone loss, whereas moderate alcohol consumption reduced the subsequent rate of bone loss. Smoking significantly reduced femoral bone mineral density. In conclusion, the present prospective study showed that some of the examined putative risk factors positively influenced bone mass at menopause, especially calcium intake, whereas the postmenopausal bone loss was virtually unaffected. Assessment of risk factors in postmenopausal women thus seems to have limited value for reducing future risk of osteoporosis. PMID- 1790400 TI - Differential action of pamidronate on trabecular and cortical bone in women with involutional osteoporosis. AB - Since osteoporotic fractures are mainly related to the diminution of the bone mineral density (BMD), the effect of pamidronate (3-amino-1-hydroxy-propylidene) 1,1-bisphosphonate on the BMD of the spine, proximal femur and radius shaft was evaluated in an initial cohort of 35 postmenopausal women with at least one vertebral fracture due to involutional osteoporosis. Pamidronate was given continuously during 18 months in a daily oral dose of 4.8 to 6.0 mg/kg supplemented with calcium (1 g/day). BMD--measured by dual photon absorptiometry- increased after one year 5.3 +/- 1.0% (P less than 0.001) in lumbar spine and 5.3 +/- 1.5% (P less than 0.001) over trochanter. However no significant changes were observed in the BMD of the femoral neck, Ward's triangle or in the cortical bone of the radius shaft measured by single photon absorptiometry. Pamidronate also decreased significantly urinary hydroxyproline-creatinine excretion after 6 months and thereafter maintained a plateau. After 18 months of treatment the diminution was 42.6 +/- 4.9% (P less than 0.001). The differing effects of pamidronate on the BMD of lumbar spine and proximal femur might be ascribed to dissimilarities between the proportions of trabecular and cortical bone in these. These results suggest that pamidronate may be prescribed to prevent fractures in cases of involutional osteoporosis with a significant decrease of BMD in lumbar spine and/or trochanter. PMID- 1790401 TI - In vivo and in vitro precision for bone density measured by dual-energy X-ray absorption. AB - An investigation was made into some of the major sources of error influencing the bone mineral density (BMD) measurements of the lumbar vertebrae, the femoral neck and the greater trochanter. The effect on accuracy and reproducibility of the following parameters was investigated: influence of patient positioning, patient size, scan speed, the technique of scan analysis and the temporal variation in instrument performance. The in vitro precision, both long-term and short-term, was assessed using aluminium phantoms supplied by the manufacturer. For the spine phantom, the precision expressed as a percentage coefficient of variation (%CV) was found to be 0.4% (10 scans) in the short term and 0.55% (15 scans) in the long term. Measured precision (short-term) for the three regions of the femur phantom analysed by the software was 1.3% for the neck of femur, 1.7% for Ward's triangle and 0.6% for the trochanter. Long-term precision was 1.0%, 1.9% and 1.1% respectively. No statistically significant difference was found between long- and short-term results. Short-term in vitro precision on a low density anthropological phantom was 4.1%, 4.2%, 2.4% and 0.61% for neck of femur, Ward's triangle, trochanter and spine respectively. In vivo short-term precision for the lumbar spine (L2-L4), measured by scanning four normal volunteers five times in one session, was found to be 0.8 +/- 0.25%. In vivo precision for the femur, measured on seven volunteers was 1.6 +/- 0.8% for the neck of femur, 3.2 +/- 1.7% for Ward's triangle and 2.2 +/- 1.1% for the trochanter.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790402 TI - Preferential low bone mineral density of the femoral neck in patients with a recent fracture of the proximal femur. AB - Bone mass is an important determinant of resistance to fractures. Whether bone mineral density (BMD) in subjects with a fracture of the proximal femur (hip fracture) is different from that of age-matched controls is still debated. We measured BMD of the femoral neck (FN) on the opposite side to the fracture, as well as femoral shaft (FS) and lumbar spine (LS) BMD by dual-photon absorptiometry in 68 patients (57 women and 11 men, mean age 78.8 +/- 1.0) 12.4 +/- 0.8 days after hip fracture following a moderate trauma. These values were compared with BMD of 93 non-fractured elderly control subjects (82 women and 11 men), measured during the same period. As compared with the controls, FN BMD was significantly lower in fractured women (0.592 +/- 0.013 v. 0.728 +/- 0.014 g/cm2, P less than 0.001) and in fractured men (0.697 +/- 0.029 v. 0.840 +/- 0.052, P less than 0.05). Expressed as standard deviations above or below the mean BMD of age and sex-matched normal subjects (Z-score), the difference in FN BMD between fractured women and controls was highly significant (-0.6 +/- 0.1 v. +0.1 +/- 0.1, P less than 0.001). As compared with mean BMD of young normal subjects, BMD was decreased by 36.9 +/- 1.4 and 22.4 +/- 1.5% (P less than 0.001) in fractured and control women, respectively. There was no significant difference between FN BMD of 33 women with cervical and 24 with trochanteric hip fractures (0.603 +/- 0.017 v. 0.577 +/- 0.020). FN BMD was lower than 0.705 g/cm2 in 90% of fractured women.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790403 TI - A randomized trial of sodium fluoride as a treatment for postmenopausal osteoporosis. AB - The anti-fracture efficacy of sodium fluoride (NaF) was evaluated in 84 postmenopausal white women with spinal osteoporosis. The dose of NaF used was 75 mg/day and all patients in this prospective, randomized, double-blind, placebo controlled clinical trial received calcium supplements (carbonate salt) 1500 mg/day in addition to participating in a structured physical therapy program. For each of the outcome measures (change in stature, change in cortical bone mass in the forearm and development of new vertebral fractures determined by change in vertebral morphometry and by scintigraphy) there was no significant difference between the fluoride or placebo treated groups. Side effects, predominantly gastrointestinal symptoms and the development of the painful lower extremity syndrome, occurred significantly more frequently in the fluoride group (P less than 0.05). Peripheral fractures were not more frequent in the fluoride group. We conclude that, in the dose and manner used in this study, NaF is no more effective than placebo in retarding the progression of spinal osteoporosis. There is no role for NaF in the treatment of osteoporosis outside the confines of clinical research. PMID- 1790404 TI - hPTH 1-34 treatment of osteoporosis with added hormone replacement therapy: biochemical, kinetic and histological responses. AB - Twelve patients with vertebral fracture osteoporosis were recruited into a trial of treatment with hPTH 1-34 by daily injection for 1 year combined (from the 5th month) with an anti-resorptive agent (oestrogen, n = 9; nandrolone, n = 3). Treatment outcomes were monitored by biochemical and radiotracer measurements together with histomorphometry of transiliac biopsies before and at the end of treatment following double in vivo pre-labelling with demethylchlortetracycline. Indices of whole body bone formation, obtained from the analysis of 85Sr data, showed substantial increases (P less than 0.005) for all three indices measured) while biochemical (hydroxyproline) and kinetic measurements of bone resorption showed modest and equivocal changes only. As a result calcium balance improved. Gastrointestinal calcium absorption showed a tendency to improve, while urine calcium decreased; but these changes were statistically not significant except for radiocalcium absorption in the oestrogen treated subgroup. Histomorphometry revealed substantial increases in cancellous bone volume as reported previously with hPTH 1-34 given alone. However, iliac (as distinct from whole body) indices related to bone formation and resorption appeared to have returned towards pre treatment values by the time of the second biopsy under the influence of the anti resorptive agent given with the hPTH 1-34. It is confirmed that hPTH 1-34 therapy can increase iliac cancellous bone mass (as well as spinal cancellous bone mass as reported earlier) without a long-term increment in whole body bone resorption, providing the hPTH is combined with an anti-resorptive agent. PMID- 1790405 TI - Effect of cyclical therapy with phosphorus and etidronate on axial bone mineral density in postmenopausal osteoporotic women. AB - Forty seven women with postmenopausal osteoporosis and at least one but no more than four vertebral compression fractures received sequential and cyclical therapy with phosphorus and etidronate (p/etid). During the same 2-year period of observation, three other groups of patients received either sodium fluoride (n = 12), estrogen replacement therapy (n = 12), or vitamin D and calcium (Ca++) alone (n = 15). Axial bone mineral density (BMD) was measured by means of dual-photon absorptiometry. Lateral thoracic and lumbar spine radiographs were taken to assess fractures. Bone mineral density increased from baseline during p/etid therapy: Mean 15.7 +/- 1.6% (SD) (P less than 0.001). During the same time, the patients in the sodium fluoride group showed a comparable increase in their BMD from baseline: mean 15.7 +/- 1.1% (P less than 0.001). During the first year of therapy, patients in the estrogen replacement group had an increase in their BMD from baseline: mean: 4.6% +/- 1.1% (P less than 0.05). No change in BMD was seen in the control group that received vitamin D and Ca++ alone. No patient who received p/etid, sodium fluoride, or estrogen replacement therapy had any new vertebral compression fractures or height loss, whereas in the control group that received vitamin D and Ca++ alone 6 out of 15 had height loss and at least one new vertebral fracture (P less than 0.01). p/etid therapy increases BMD in women with postmenopausal osteoporosis comparable to sodium fluoride but without side effects or toxicity and stabilizes vertebral compression fractures. PMID- 1790407 TI - Guidelines for clinical trials in osteoporosis. A position paper of the European Foundation for Osteoporosis and Bone Disease. PMID- 1790406 TI - Secondary hyperparathyroidism and osteopenia in women following gastric exclusion surgery for obesity. AB - Gastric exclusion has been introduced as a surgical treatment for morbid obesity. We describe two women who had undergone gastric bypass for obesity with metabolic bone disease and secondary hyperparathyroidism. In one patient transiliac bone biopsy after double tetracycline labelling demonstrated histologic evidence of hyperparathyroidism with osteitis fibrosa cystica. Six additional women who had undergone gastric exclusion were evaluated. Serum phosphorus, calcium, and creatinine were normal in all but one patient who had hypocalcemia. Serum immunoreactive parathyroid hormone was elevated in seven of eight patients and urinary calcium was less than or equal to 2 mmol/d (80 mg/24 h) in 6 patients. Lumbar spine bone mineral density was 86 +/- 7 (mean +/- SE) per cent of predicted and femoral neck bone mineral density was 89 +/- 6 per cent of predicted. Women who have had gastric exclusion for obesity may develop secondary hyperparathyroidism which could result in loss of bone mass. PMID- 1790408 TI - How can we tell if a treatment works? Further thoughts on the randomized controlled trial. PMID- 1790409 TI - The pathogenesis and treatment of hip fractures. PMID- 1790410 TI - Incidence of hip fractures in the elderly: a cross-national analysis. AB - This paper reviews international data on incidence rates of hip fracture in persons 50 years of age and older, based on a bibliographic search of articles published since 1960. Incidence rates are higher in white populations than in black, Asian, and Hispanic populations. In both sexes and in all ethnic groups and geographic areas, incidence rates increase markedly with age. The steep increase with age, however, occurs later in black, Asiatic and Hispanic populations than in whites. The ratio of female to male incidence rates is higher than 1.0 in whites, while in blacks and Asians it has often been the reverse, with higher rates among men. In recent years in Hong Kong incidence rates in females have increased more rapidly than incidence rates in males, so that now the incidence rates in females are higher than those in males. In addition to the study in Hong Kong, most studies in Northern Europe and North America show an increase in age-adjusted hip fracture incidence rates over time over the past few decades. Methodological differences among the various studies (including differences in the definition of hip fracture, in case ascertainment, and in the selection and sample size of the study population) necessitate cautious interpretation of the findings of this report. PMID- 1790411 TI - Bone mineral density of the hip measured with dual-energy X-ray absorptiometry in normal elderly women and in patients with hip fracture. AB - Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DEXA) in 133 normal females on five regions of the femoral site: neck, trochanteric, intertrochanteric, Ward's triangle, and total area of the proximal femur. One hundred and twenty-five women (56 older than 65, range 65-97, and 69 with an age range of 21-65) were also examined for spinal bone mineral density. The mean in vivo precision (CV%) of the measurements with repositioning assessed on five young and eight elderly patients was ranged from 0.7% to 1.7% but lower for Ward's triangle (CV = 2.95% and 3.87%). Between 30 and 90 years, a linear age related bone mineral decrease was found at all sites with a similar magnitude of bone loss for the femoral neck, total or intertrochanteric regions (-33% to 39%). A greater decrease was found for the Ward's triangle region (-61%). In the subgroup of elderly women (65-97 years old), the lumbar BMD measured with an anteroposterior incidence did not decrease significantly with age, contrasting with an average 27% decrease of the BMD of the hip between 65 and 90 years of age. In addition, 31 patients suffering either from a cervical (n = 12) or pertrochanteric (n = 19) fracture were measured on their contralateral femur 15 to 30 days after the fracture event. The mean calculated BMD values were, depending on the measured area, from 14% to 21% lower than those reported for age matched controls (z-score from -1.11 to -0.65). A fracture threshold was determined for each site from this population and the elderly controls.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790412 TI - The impact of measurement errors on the diagnostic value of bone mass measurements: theoretical considerations. AB - It has become clear over the last decade that correlations between measurements of forearm bone mineral content (BMCarm) by single-photon absorptiometry (SPA) and measurements of spinal bone mineral density (BMDspine) by dual-photon absorptiometry (DPA) in healthy subjects and patients with spinal fractures are invariably significant, but not very powerful (i.e. r = 0.5-0.7). Nonetheless, several recent studies have shown that appendicular bone mass measurements discriminate between spinal fracture and non-fracture at least as well as do spinal DPA measurements. Correlations of a given parameter with measured BMDspine are less important than those with true BMDspine. To establish the latter we made the following assumptions: (1) accuracy errors or SPA BMCarm and DPA BMDspine measurements of 2%-4% and 8%-10%, respectively; and (2) a measured biological variation of SD = 14% for both BMCarm and BMDspine, corresponding to that of healthy women at the menopause. On these assumptions, we found that a correlation between true BMCarm and true BMDspine at about r = 0.8-0.9 yields a correlation between measured BMCarm and measured BMDspine at about r = 0.6--corresponding to experimental data in healthy women at the menopause. Furthermore, we found that the correlation between DPA measured BMDspine and true BMDspine is about the same as that between the SPA measured BMCarm and the true BMDspine. Thus, with the assumptions given above, spinal (DPA) and fore-arm (SPA) measurements appears to predict equally the true BMDspine in healthy perimenopausal women. PMID- 1790413 TI - Age-related changes in resorption cavity characteristics in human trabecular bone. AB - The depth of resorption cavities in trabecular bone is an important determinant of bone structure and has implications relevant to the cellular pathophysiology of bone loss in osteoporosis. However, assessment of resorption depth has proved difficult and few data are available; in this study we report age-related changes in iliac crest trabecular bone obtained from 41 normal healthy subjects (21 female, 20 male) aged 22-80 years. Using 8-microns undecalcified sections stained with toluidine blue, resorption cavities were quantitatively assessed by a computerized technique in which the eroded bone surface is reconstructed and measurements made interactively. Maximum and mean cavity depth showed no significant correlation with age in either sex. The absolute length of eroded surface was unrelated to age but the eroded surface/BS (%) and the number of cavities/BS (/mm) showed a significant positive correlation with age (r = 0.384 and 0.386 respectively, p less than 0.05). No significant correlation was found between age and either cavity area or density. These results suggest that increased resorption depth does not contribute to age-related bone loss, although the possibility that deeper resorption cavities occur which result in trabecular penetration and are therefore unrecognizable cannot be discounted. The age related increase in eroded surface/BS (%) reflects a decreased available trabecular surface and/or increased number of cavities rather than a greater surface length of individual cavities; alternatively it may indicate an increased resorption period. No evidence of increased resorption depth at the time of the menopause was found in this study. PMID- 1790414 TI - Bisphosphonates and vertebral fracture: an epidemiological perspective. PMID- 1790415 TI - Toward a cure for osteoporosis: reversal of excessive bone fragility. AB - While estrogen replacement therapy and calcium supplementation appear to be effective at preventing postmenopausal osteoporosis, therapy for established osteoporosis is far less effective. The reduction of bone fragility should be a goal of a treatment for established osteoporosis. To this end, increases in cortical bone mass by subperiosteal new bone formation may produce the greatest mechanical advantage. Anti-resorptive drugs, such as etidronate, have shown potential for reducing the incidence of osteoporotic fracture in the short term, but their ability to produce a long-term benefit may be limited. An alternative approach might be to develop drug therapies that substantially increase cortical bone strength, namely by stimulating periosteal bone formation. Although sodium fluoride has proved to be problematic, there are several other potential osteoporosis therapies. They include treatment with anabolic hormones (e.g. growth hormone and anabolic steroids) and targeted delivery of growth factors. Also, anti-resorptive and formation-stimulating drugs might be combined in a new form of ADFR (coherence) therapy where the new acronym means: Activate-Depress Formation stimulation-Repeat. PMID- 1790416 TI - Minerals and osteoporosis. PMID- 1790417 TI - Fluoride-induced bone changes in lambs during and after exposure to sodium fluoride. AB - The evolution of bone changes induced by fluoride after the end of exposure was investigated in lambs. Sodium fluoride (NaF) was given orally at a dose of 3.5 mg/kg per day to 14 animals for 120 days. A group of 7 control and 7 treated lambs was slaughtered at the end of NaF administration (T120) and another group 120 days after the end of NaF exposure (T240). At T120, the bone fluoride content (BFC) was very significantly increased in treated animals. The histomorphometric analysis confirmed that fluoride induces an increase in bone formation (the osteoid perimeter and area were 3-fold and 4.5-fold higher respectively in treated than in control animals). The number of osteoblasts was significantly augmented. Serum osteocalcin level was twice as high in treated animals compared with controls. The bone formation rate at the tissue level (BFR) doubled after treatment, but the apposition rate (Aj.AR) was half that in the control group. The mineralization lag time (Mlt) was 120 days in treated animals compared with 42 days in controls. At T240, BFC had decreased by 50% compared with the level at T120, but it was still significantly higher than in controls. The osteoid and osteoblastic parameters were 2 and 1.3 times higher than in control animals. BFR remained significantly increased in treated animals, but Aj.AR and Mlt were similar in control and treated animals. In conclusion, after 4 months of NaF exposure fluoride induced an increase in osteoblast natality and bone formation at the tissue level, associated with a toxic effect at the individual cell level.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790418 TI - Radiographic absorptiometry: a simple method for determination of bone mass. AB - Bone mass measurements have been shown to be useful determinants of the risk of development of osteoporotic fractures and may help identify individuals who are most likely to benefit from both primary and secondary prevention of osteoporosis. As standard bone density measurements are not available to all physicians, there is a need for a fast, inexpensive, and widely available technique to measure bone mass. Radiographic absorptiometry of the phalanges requires only routine radiography with processing of the films done at a special off-site laboratory. We performed a preliminary investigation to see whether this simple technique could be used to predict a low bone mass as defined by dual- and single-photon absorptiometry. Correlations between radiographic absorptiometry. Correlations between radiographic absorptiometry and the standard techniques were as good as those among the standard techniques themselves (r = 0.58-0.9). Radiographic absorptiometry measurements predicted low bone mass of the lumbar spine and femoral neck with 90% and 82% sensitivity respectively. If further evaluation supports these initial conclusions, radiographic absorptiometry may be useful as a screening technique for primary care physicians and in research settings where dual-photon or dual-energy X-ray absorptiometry are impossible. PMID- 1790419 TI - Apparent beneficial effects of tamoxifen on bone mineral content in patients with breast cancer: preliminary study. AB - Eight postmenopausal women undergoing adjuvant treatment with tamoxifen (20 mg/day) for breast cancer had baseline pretreatment, and 6- and 12-month post treatment dual-photon determinations of vertebral bone mineral content (BMC). BMC measured at 6 and 12 months increased over baseline in all subjects. These observations imply that women treated with tamoxifen may retain rather than surrender the protective effect of estrogen against osteoporosis. PMID- 1790420 TI - Epidemiology of fractures of the proximal femur in Geneva: incidence, clinical and social aspects. AB - Fracture of the proximal femur (hip fracture) as a consequence of osteoporosis is an important public health problem. Its incidence, which rises with age, varies according to geographical location and race. There is no information concerning hip fracture in Switzerland, which is a Western country with a particularly aged population. During 1987, 361 patients with hip fracture were recorded in the University of Geneva Hospital, which is the main referral center for a population of about 376,000 inhabitants. This represented 94% of all hip fractures occurring in the region. A moderate trauma was reported in 329 cases (91.1%). The overall annual incidence was 96.1 per 100,000 population (146.9 for women and 39.8 for men). When only hip fractures following moderate trauma were considered, the incidence was 87.6 per 100,000 population (138.8 for women and 30.8 for men). Rare under the age of 65, hip fracture incidence increased exponentially in older subjects. The mean age of patients with hip fracture was 82.0 years in women and 75.7 years in men. The ratio of cervical to trochanteric fracture was 1.03 and 1.12 in women and men, respectively. The mean length of stay in the orthopaedic ward was 30.5 days, and the total costs amounted to 8.8 million Swiss francs for hip fracture associated with moderate trauma. Forty-seven percent of subjects were transferred to another hospital for recovery or rehabilitation. During the stay in the orthopaedic ward, the mortality rate was 8.2%. These results emphasize the high incidence and cost of hip fractures in a region of Switzerland where the population is particularly old.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790421 TI - Screening for vertebral osteoporosis using individual risk factors. The Multicentre Vertebral Fracture Study Group. AB - Osteoporosis is a major cause of ill health in postmenopausal women. Several risk factors for osteoporosis have been identified, and they have been widely recommended as a means of identifying subgroups of postmenopausal women who might benefit from prophylaxis and therapy. Evidence to support this use of risk factors is currently lacking, however. We have constructed and evaluated a profile of putative risk factors as a means of identifying women attending general practitioners who have sustained vertebral fractures. The overall prevalence of vertebral fractures in the 1012 women (mean age 64.4 years) studied was 7.8%. Women who had sustained vertebral fractures in this population were significantly (p less than 0.05) older and shorter than those without fractures. They reported a significantly (p less than 0.05) earlier menopause, lower parity and a greater prevalence of hyperthyroidism. However, the best screening instrument devised was not sufficiently predictive to warrant widespread use. PMID- 1790422 TI - Extraskeletal effects of estrogen and the prevention of atherosclerosis. AB - A cumulative effect has been calculated by Henderson et al. concerning the estimated changes in mortality with estrogen therapy. Even assuming a twofold increase in the risk of breast cancer, the benefits derived from reduction of osteoporotic fractures and the decreased risk of heart disease, demonstrate a 41% decrease in mortality in women who receive estrogen therapy. Since cardiovascular disease is the major cause of morbidity and mortality in postmenopausal women, and since the beneficial effects of estrogen outweigh the documented and perceived risk of estrogen use, estrogen ought to be considered as prophylactic therapy, particularly in women at risk of heart disease. PMID- 1790423 TI - The definition of remission in acute leukemia with immunologic techniques. AB - In acute leukemia residual disease is usually monitored by morphology. The precision of this approach can be improved by several methods including the investigation of chromosomal abnormalities by conventional cytogenetics, flow karyotyping, in situ hybridization and polymerase chain reaction (PCR), and the analysis of immunoglobulin and T cell receptor genes by Southern blotting and PCR. Immunologic methods represent a reliable option for studying residual disease in approximately half of the patients with acute leukemia. This strategy is based on the observation that some marker combinations are expressed on leukemic blasts but are absent or rarely present in normal peripheral blood (PB), bone marrow (BM) or cerebrospinal fluid cells. In patients with T cell-acute lymphoblastic leukemia, even one cell simultaneously expressing terminal deoxynucleotidyl transferase and CD3, CD5 or CD1 amongst 10(5) PB or BM cells indicates residual disease. Some cases of B lineage and myeloid acute leukemias also exhibit phenotypes potentially useful for monitoring response to treatment. Such phenotypes are identified by double or triple color staining techniques using fluorescence microscopy or flow cytometry. Independent studies have demonstrated that detection of cells with leukemia-associated phenotypes in BM samples of patients in clinic and morphologic remission heralds the recurrence of leukemia. It is likely that a combination of techniques will be needed to monitor the majority of patients with acute leukemia. Advantages and disadvantages of individual methods should be determined in comparative preclinic investigations. These studies should yield sufficient information to initiate the testing of therapeutic strategies planned according to the data provided by use of modern sensitive techniques. PMID- 1790424 TI - Supernatant cell counts from long-term bone marrow culture correlate with the speed of engraftment following autologous bone marrow transplantation. AB - This study evaluates the relationship between bone marrow growth in a long-term bone marrow culture (LTBMC) system and speed of engraftment of the same marrow following autologous bone marrow transplantation (ABMT). Bone marrow from 21 patients transplanted with unmanipulated, non-cryopreserved autologous marrow was cultured. Samples from 21 normal donors were cultured to establish the normal supernatant cell count range. Supernatant counts from LTBMCs established from marrow taken from patients at the time of bone marrow harvest were compared with the time to neutrophil and platelet engraftment. Supernatant counts, particularly after 1 week in culture, showed close correlation with time to neutrophil and platelet engraftment following ABMT (r = 0.733, p less than 0.01; r = 0.735, p less than 0.01 respectively). Where supernatant cell counts were within the normal range rapid engraftment was predicted (neutrophils greater than 0.5 x 10(9)/l within 21 days, platelets greater than 50 x 10(9)/l within 28 days) and if supernatant counts were below this range, engraftment was predicted to be delayed. After 1 week in culture, the speed of neutrophil and platelet engraftment were correctly predicted in 19 and 18 cases respectively. Preliminary data suggest that LTBMC of marrow obtained 2-6 weeks before harvesting provides similar data, thus allowing the opportunity to intervene, for example with growth factors, in selected patients. PMID- 1790425 TI - Long-term results of bone marrow transplantation for patients with AML, ALL and CML prepared with single dose total body irradiation of 500 cGy delivered with a high dose rate. AB - One hundred and sixty-six patients between the ages of 12 and 48 years with acute myelogenous leukemia (AML), acute lymphoblastic leukemia (ALL) or chronic myelogenous leukemia (CML) underwent allogeneic bone marrow transplantation following single fraction total body irradiation (TBI) of 500 cGy from a cobalt source. Patients also received one of three chemotherapeutic regimens according to their diagnosis or disease status at time of transplant. The median follow-up was 67 months with a range of 33-120 months. The actuarial 5-year event-free survival (EFS) for the subgroup of patients with good risk disease (first complete remission AML and ALL or first chronic phase CML) was 43% with an actuarial relapse rate at 5 years of 26%. Patients with poor risk disease (other than first remission AML and ALL or other than first chronic phase CML) had an EFS at 5 years of 15% with a relapse rate of 62%. Disease status at the time of transplantation was the most important factor predicting outcome in this patient population. We conclude that preparation of good risk patients with chemotherapy and single fraction TBI of 500 cGy at a dose rate of 42-91 cGy/min resulted in EFS and relapse rates similar to those observed by centers using fractionated radiotherapy schedules, without a concomitant increase in toxicity, in particular interstitial pneumonitis and cataracts. PMID- 1790426 TI - High-dose chemotherapy containing busulfan followed by bone marrow transplantation in 24 children with refractory or relapsed non-Hodgkin's lymphoma. AB - Twenty-four children with relapsed or refractory non-Hodgkin's lymphoma underwent high-dose chemotherapy (HDC) with bone marrow transplantation (BMT). HDC comprised in all cases busulfan (16 mg/kg or 600 mg/m2), with either cyclophosphamide (200 mg/kg or 4.4 g/m2) and/or melphalan (140 mg/m2). Twenty three of these children had received second-line therapy before receiving HDC. There were 16 B cell and eight T cell lymphomas. Twenty-three patients were evaluable at day 30 post-BMT; 19 were in complete remission, four did not respond. Eight patients are long-term survivors between 62 and 296 weeks after BMT. Among the seven children with resistant disease before HDC, only one is a long-term survivor. No toxic deaths occurred. The main adverse side effect was hepatic veno-occlusive disease which occurred in four patients, but resolved completely in all cases. Comparisons with other classic HDC regimens in relapsed childhood lymphomas show that HDC containing busulfan with BMT appears reasonably safe and is effective in refractory or relapsed lymphomas, even in these highly previously treated patients. PMID- 1790427 TI - ABO-incompatible pediatric bone marrow transplantation: a simple method to remove red blood cells from small volume marrow grafts. AB - A simple and reliable technique for removal of ABO incompatible marrow red cells is described. This method requires a blood cell processor and third party red cells are used as a shelf. Using this technique, nine children age 0.5-11.5 years received allogeneic bone marrow transplantation from ABO incompatible donors. A median of 4.8 ml of incompatible red cells were transfused. There was no evidence of a hemolytic transfusion reaction in any patient. A median of 75% of nucleated marrow cells were recovered and used for transplantation. Engraftment occurred at the same time as with ABO compatible transplants. Autologous marrow red cells were reinfused into four young donors. This 'shelf' technique for red cell depletion is an acceptable method for processing small volume, ABO incompatible marrow harvests from pediatric donors. PMID- 1790428 TI - Allogeneic bone marrow transplantation using unrelated donors: a pilot study of the Canadian Bone Marrow Transplant Group. AB - Between February 1988 and January 1990, 35 patients underwent allogeneic bone marrow transplantation (BMT) from unrelated donors using measures routinely employed for matched related donors. Median patient age was 34 years (range 2 49). Thirty-two patients had hematologic malignancies, including chronic myelogenous leukemia (CML) in 16; three patients had severe aplastic anemia. Donor-patient pairs were matched at the HLA loci tested serologically (HLA-A, -B, -DR) in 29 cases; mixed leukocyte culture results were variable but often reactive. Five patients died prior to day +28 without evidence of myeloid engraftment, and one patient developed fatal graft failure several months after initial engraftment. Acute graft-versus-host disease (GVHD) occurred in 77% (95% confidence interval [CI] 60-90%) of all patients, and GVHD contributed to the death of 10 patients. Fatal regimen-related toxicity occurred in four patients and another died due to neurologic complications of a process that resembled the hemolytic-uremic syndrome. Two acute leukemia patients relapsed, and a CML patient was found to have a localized non-Hodgkin's lymphoma at necropsy. As of 1 June 1991, 14 patients are alive and in remission at a median follow-up of 1.9 years (range 1.5-3.3); all except one have normal performance scores. The 2-year actuarial event-free survival for all patients is 40% (95% CI 24-56%). Proportional hazards analysis revealed favorable significance for female patient sex, less advanced disease status and shorter interval from diagnosis to BMT. While unrelated-donor transplants need not necessarily duplicate the results of related-donor transplants to be of benefit, the event-free survival in this series was roughly similar to that expected in the related-donor situation, with the high transplant-related mortality somewhat offset by a low recurrence rate. Further studies using unrelated donors, employing new methods of preventing transplant-related complications, are indicated. PMID- 1790429 TI - Improved results of allogeneic bone marrow transplantation for advanced hematologic malignancy using busulfan, cyclophosphamide and etoposide as cytoreductive and immunosuppressive therapy. AB - Twenty-four patients between the ages of 8 and 48 years (median 27.5) with high risk for relapse hematologic malignancy received a marrow transplant from an HLA and MLC compatible sibling donor after chemotherapy with busulfan, 4 mg/kg/day for 4 days by mouth, cyclophosphamide 60 mg/kg/day i.v. for 2 days, and etoposide 60 mg/kg i.v. over 4 h on the first day of cyclophosphamide treatment (BU/CY/VP). Toxicity consisted of mucositis, skin rash, and nausea and vomiting in all patients, transient fever thought to be due to etoposide administration in 16/24 (67%) patients, and clinical veno-occlusive disease (VOD) of the liver in 4/24 (17%). There were nine deaths from causes other than recurrent disease in the first 100 days after transplant and two deaths after day 100, a total transplant mortality of 11/24 (46%). Three patients relapsed, but 10/24 (40%) remain alive and disease free 26-182 weeks (median 60 weeks) from transplant. These results compare favorably with results in a group of 12 similar risk patients treated with total body irradiation (TBI) containing regimens during an overlapping time period. Six of the TBI patients have had persistent or recurrent disease and only two (17%) are currently alive and disease free. The probability of disease persistence or relapse is 67% in the TBI group and 20% in the BU/CY/VP group (p less than 0.02). PMID- 1790430 TI - High frequency of antithrombin 3 and protein C deficiency following autologous bone marrow transplantation for lymphoma. AB - To investigate the possibility that a hypercoagulable state develops during autologous bone marrow transplantation (BMT), we measured levels of circulating natural anticoagulants and fibrinolytic proteins before and weekly during the hospital course of 18 patients undergoing autologous BMT for Hodgkin's and non Hodgkin's lymphoma. Patients received either weekly (standard dose group) or daily (high dose group) vitamin K supplements with their total parenteral nutrition. By day 14 there had been a significant drop in protein C activity (mean of 95% of normal to 52%), protein C antigen (mean of 105% of normal to 70%), and antithrombin 3 activity (111% of normal to 83%), and an increase in fibrinogen (471-621 mg/dl) and tissue plasminogen activator (6.9-13.8 ng/ml). No changes were seen in free or total protein S, plasminogen activator inhibitor, prothrombin time or partial thromboplastin time. The decreases in protein C and antithrombin 3 persisted through day 28 after transplantation. The drop in protein C correlated strongly with decrease in serum albumin, suggesting impaired synthesis of these proteins by the liver. No differences were seen in any of these parameters between the standard and high dose groups. Deficiencies in anticoagulant proteins antithrombin 3 and protein C and a rise in fibrinogen without a concomitant improvement in fibrinolytic variables create a potentially hypercoagulable state which may contribute to the thrombotic complications of autologous BMT. PMID- 1790431 TI - High-dose chemotherapy and autologous bone marrow transplantation in relapsing angioimmunoblastic lymphadenopathy with dysproteinemia (AILD). AB - Angioimmunoblastic lymphadenopathy with dysproteinemia (AILD) or lymphogranulomatosis X is a lymphoproliferative disorder with a histological picture resembling that of reactive lesions but with frequent cytogenetic and molecular abnormalities characteristic of malignant T cell lymphoma. Clinically, the disease runs a fatal course in the majority of patients although occasional spontaneous remissions have been observed. Median survival approaches only 1 year even with the most effective treatment protocols implemented so far. Fewer than 20% of patients survive 5 years after diagnosis and cure seems exceedingly rare. High-dose chemotherapy (HDCT) followed by autologous bone marrow transplantation (ABMT) represents a promising new treatment modality for patients with advanced lymphoma conceivably including AILD. We report the first patient with relapsed AILD successfully treated by HDCT and ABMT. This 21-year-old male is alive and free of disease 27 months after ABMT with a Karnofsky score of 100%. PMID- 1790432 TI - Transmission of rotavirus diarrhea in a bone marrow transplantation unit by a hospital worker. PMID- 1790433 TI - Serotonergic innervation of the cerebral vasculature: relevance to migraine and ischaemia. AB - Multiple and complex interactions exist between the cerebral circulation and a potent vasoactive (and neurotransmitter) agent, serotonin. The nature and bases of the real and potential relationships are often hotly contested, for example, the serotonergic innervation of brain conducting and resistance vessels. In this review, an attempt is made to reconcile the available literature and to indicate future and possibly fruitful research directions. It appears that, by its very nature, the pattern of the serotonergic innervation is singular to blood vessels of the brain and could provide a neuronal link (or coupling) between functional events within the central nervous system and its perfusion which subserves changes in brain function. Finally, there are sufficient data to suggest an involvement of 5-hydroxytryptamine in different cerebrovascular pathologies. PMID- 1790434 TI - The neurobiology of stress ulcers. AB - We have reviewed the neurobiology of stress ulcers from animal models to potential pharmacotherapeutic mechanisms. The evidence strongly supports the hypothesis that certain stress-related gastric lesions are 'brain-driven' events which may be more effectively managed through central manipulations than by altering local, gastric factors. Recent advances in the use of anxiolytic and antidepressant drugs in the management of stress-related gastric mucosal injury further supports the contention that a brain-gut axis, which may have nervous, peptidergic and classic monoaminergic components, modulates the intricate and complicated pattern of communication between the brain and the stomach. Delineation of the precise pathways which make up this communication as well as their manipulation by various pharmacological agents will be the focus of future research endeavour. PMID- 1790435 TI - Survey of reproductive health in young adults, greater Santiago, 1988. AB - This article reports the results of an interview survey with 1,665 residents of Metropolitan Santiago 15-24 years old. The survey, which dealt with various aspects of reproductive health, indicated that the sex education received by 75% of the subjects generally failed to convey an accurate knowledge of the basic concepts of sexuality; that use of contraceptive methods was very limited; that approximately 25% of the 865 women interviewed had been pregnant at some time; and that 40% of all the pregnancies were unplanned. These findings demonstrate a need to begin effective sex education programs and to provide adolescent services commensurate with the circumstances of modern life. PMID- 1790436 TI - Sexual behavior and frequency of antibodies to type 1 human immunodeficiency virus (HIV-1) in a group of Peruvian male homosexuals. AB - The most important risk factor for HIV infection in North America and Western Europe is homosexual behavior. This article describes a 1988 survey of active male homosexuals in Lima, Peru, that investigated patterns of homosexual behavior and HIV seropositivity. PMID- 1790437 TI - Breast-feeding patterns of Montserratian women. AB - This article describes the breast-feeding patterns found on Montserrat by a survey that interviewed 69 mothers who delivered infants over a 13-month period, from March 1989 through March 1990. The results indicated that 94% of the women breast-fed these children for at least two weeks after delivery; that 70% were still breast-feeding at the time of the interview in March or April 1990; and that principal factors influencing early termination of breast-feeding were the age at which supplementary feeding was commenced and lack of maternal information about why babies appear to reject the breast. PMID- 1790438 TI - Decanting geriatric institutions: development of a patient assessment methodology. AB - Many elderly people in both developing and developed countries are institutionalized--often irrespective of whether their ability to function requires it. Increased attention is now being given to prospects for decanting geriatric institutions and planning new forms of care. However, methodologic difficulties exist, it being hard to determine how much of the institutionalized elderly population could be effectively accommodated by alternate forms of care requiring certain levels of social, physical, and mental capacity. The procedure described in this article, based on work performed in Barbados, seeks to assess the eligibility of an existing institutionalized geriatric population for alternate types of care, thereby laying the groundwork for future planning. PMID- 1790439 TI - Epidemiology and control of malaria in Suriname. AB - Malaria is endemic in the interior of Suriname. However, epidemiologic data indicate that as of 1985 the only permanent malaria focus was located in an area along the Upper Marowijne River. The existence of this focal area can be accounted for partly by relatively high and stable numbers of the local malaria vector, Anopheles darlingi, in the region and also by frequent travels of local inhabitants within the Upper Marowijne region. Government workers from this area appear to have played a significant role in spreading malaria to other parts of the country. PMID- 1790440 TI - Toward a taxonomy of technical cooperation in health. PMID- 1790441 TI - AIDS among women in Latin America and the Caribbean. PMID- 1790442 TI - The age of aging: implications for nursing. PMID- 1790443 TI - Drug-related lupus. PMID- 1790444 TI - Lecture by HRH The Prince of Wales, as Patron, to the Royal College of Psychiatrists, Brighton, Friday 5 July 1991. PMID- 1790445 TI - Treatment issues in child sexual abuse. AB - Child sexual abuse is a commonly encountered and often emotionally damaging experience, maintained by secrecy and followed by denial after disclosure. Treatment in this field involves both the child and the family in a variety of treatment settings and modalities, often proceeding in parallel. Child developmental considerations dictate that treatment often proceeds in phases. It aims to protect the child from further abuse and the consequences of disclosure, and address the trauma and context of the abuse. Careful planning and co operation is required by the many professionals working in this stressful area in order to avoid confusion, conflicts, and splits which may mirror relationships in the family. The heterogeneity of the problem is reflected in the fact that treatment cannot be offered in a uniform programme. Legal issues may influence the treatment process. Evaluation of treatment modalities, the identification of protective factors and achieving long-term adjustment in the least detrimental manner offer challenges in this newly developing field. PMID- 1790446 TI - The incidence of operationally defined schizophrenia in Camberwell, 1965-84. AB - We established first-contact rates of schizophrenia in the defined area of Camberwell between 1965 and 1984. The rate of schizophrenia, whether defined by ICD, RDC, or DSM-III criteria, rose over the period under study. This finding is at odds with reports of an overall decline in first-admission rates for schizophrenia in England, over the same period. The discrepancy was largely accounted for by the influx into Camberwell of individuals of Afro-Caribbean origin, who showed rates of schizophrenia between four and eight times that of their Caucasian counterparts. PMID- 1790447 TI - Schizophrenia and Afro-Caribbeans. A case-control study. AB - A case-control study was performed using 90% of all first-contact patients with a clinical diagnosis of schizophrenia residing in the London borough of Camberwell between 1965 and 1984. Cases and controls were obtained from the Camberwell psychiatric case register. Controls were those presenting with first episodes of non-psychotic disorders, matched for age, sex and period. The risk of schizophrenia was greater in those of Afro-Caribbean ethnicity, irrespective of age, gender or place of birth. This risk increased over the study period. The results cannot be explained by changes in the age, gender or ethnic structure of the local population. Effects of misdiagnosis or change in diagnostic practice were reduced by using uniform operational criteria. Possible explanations include maternal exposure to unfamiliar infective agents, a differential fall in the age at onset of illness, or worsening social adversity. PMID- 1790448 TI - Epidemiology of schizophrenia in Salford, 1974-84. Changes in an urban community over ten years. AB - The prevalence and inception rates of treated schizophrenia in the population of inner-city Salford were compared with those from a similar survey, ten years earlier. Data were obtained from a computerised case register and a postal questionnaire sent to GPs, and case notes rated on the SCL and screened using ICD 9. The point-prevalence rate of 6.26 per 1000 adult population was higher than that previously reported (4.56), despite decreases in total inception rate and in the general population. Changes in rates are presumed to be related primarily to population movements and ageing of the schizophrenic sample. Compared with 1974, the numbers of in-patient days and long-stay in-patients had fallen substantially by 1984, although annual admissions increased over the decade; day-patient and out-patient attendances, and extramural contacts with psychiatrists, community psychiatric nurses, and social workers had also increased. Almost 62% of cases were maintained on depot injections as out-patients in 1984. Over 75% of identified schizophrenic patients were in contact with psychiatrists, but only 7 out of 557 were solely in contact with their GP. In spite of the emphasis on community care, responsibility for schizophrenic patients was still carried overwhelmingly by hospital psychiatric services. PMID- 1790449 TI - Changes in the administrative incidence of schizophrenia. AB - First-admission rates to psychiatric hospitals, and data from certain psychiatric case registers suggest that there may have been a substantial decline in the administrative incidence of schizophrenia in recent years. However, data from the Nottingham case register show that rates for first-onset schizophrenia remained stable between 1975 and 1987. It is suggested that variations in trends between different parts of the UK may be partly explained by differences in the proportion of migrants and their children in the population at risk. PMID- 1790450 TI - Psychiatric hospital admission rates in Jamaica, 1971 and 1988. AB - The overall psychiatric hospital admission rates in Jamaica were 136 per 100,000 in 1971 and 69 per 100,000 in 1988. The admission rate for schizophrenia was 69 per 100,000 in 1971 and 35 per 100,000 in 1988. The 49% reduction in admission rates over these 17 years is attributed to the introduction of an island-wide community mental health service with psychiatric admission to general parish hospitals in 1972. This admission rate for schizophrenia is five to six times lower than the rate reported for Afro-Caribbeans in the UK by a number of studies, and is more in keeping with the admission rate for schizophrenia reported for the general population in England. PMID- 1790451 TI - Psychopathology of people with mental handicap and epilepsy. I: Maladaptive behaviour. AB - One hundred and fifty mentally handicapped people (100 from hospital and 50 from the community) with epilepsy were studied along with an individually matched control group of 150 (100 from hospital and 50 from the community) non-epileptic mentally handicapped people. Behaviour was studied using the Profile of Abilities and Adjustment Schedule. Of the total population, 55.3% showed some type of severe behaviour problem. Although the epileptics showed slightly more severe behaviour problems than the non-epileptic group, there was no statistically significant difference between the two groups. Some differences emerged between the groups when subgroups of epileptics were studied. PMID- 1790452 TI - Psychopathology of people with mental handicap and epilepsy. II: Psychiatric illness. AB - The prevalence of psychiatric illness was studied in 150 epileptic mentally handicapped people (both hospital in-patients and living in the community) and a matched group of 150 non-epileptic controls. The Profile of Abilities and Adjustment (PAA) scale was used for the initial screening of psychiatric illness. Mildly to moderately handicapped individuals who had good communication skills and scored positively on the PAA schedule for psychiatric illness were interviewed using the PSE interview schedule. Severely mentally handicapped individuals who scored positively on the PAA's psychiatric illness subscale were observed and information was gathered from their medical notes and carers. A psychiatric diagnosis was made using DSM-III-R criteria. The non-epileptic group showed significantly more psychiatric illness than the epileptic group. Psychiatric illness was diagnosed in 25% of the cohort. PMID- 1790453 TI - Psychopathology of people with mental handicap and epilepsy. III: Personality disorder. AB - A group of 75 mildly to moderately mentally handicapped people with epilepsy, resident in both a hospital and the community, were studied together with an individually matched control group of non-epileptic patients. Their carers were interviewed to gather information for two observer-rated personality questionnaires, the Standardised Assessment of Personality (SAP) and the T-L Personality Behaviour Inventory. The two groups were compared with respect to the prevalence rates of various personalities. An abnormal personality score according to the SAP schedule was reported in 26% (n = 39) of the cohort, of which 28 (18.6% of the cohort) were personality disorders. A diagnosis of SAP abnormal personality was made in 46% of the in-patients and 6.5% of the community based population. Of the cohort, 15% had an abnormal personality score according to the T-L schedule. No statistically significant difference emerged between the epileptic and the non-epileptic groups in the prevalence of either the SAP or T-L personality. PMID- 1790454 TI - Parental representations of patients with panic disorder and generalised anxiety disorder. AB - Previous studies using the Parental Bonding Instrument have shown a general trend for neurotic subjects to score their parents as less caring and more protective. Such a finding was broadly replicated in a study of 80 clinically anxious subjects and age- and sex-matched controls. Although direct comparisons of PBI scores failed to reveal clear-cut differences between generalised anxiety (GA) and panic disorder (PD) subgroups, logistic regression analyses revealed higher odds ratios for parental assignment to aberrant categories in the GA group, with PD patients reporting a more limited pattern of overprotective parenting only. Our findings suggest that adverse parental behaviour may be relevant to the pathogenesis of GA, while parental 'affectionate constraint' may be a parental response to early manifestations of PD. PMID- 1790455 TI - Value of the Fear Questionnaire in differentiating agoraphobia and social phobia. AB - The present study examined responses on the Fear Questionnaire (FQ) of 68 patients suffering panic disorder with agoraphobia, 50 social phobics, 75 subjects with 'non-clinical' panic attacks, and 188 non-panicking controls. The FQ agoraphobia and social subscales had satisfactory internal consistency and were accurate (82%) in correctly differentiating the patients. In general, the patient and control groups differed as expected. The highest level of social fear was reported by social phobics and the highest level of agoraphobic fear was reported by patients with panic disorder and agoraphobia. Five items from these two subscales significantly differentiated social phobia from panic disorder with agoraphobia. The results support the reliability and validity of the FQ. PMID- 1790456 TI - The prediction of treatment response in bulimia nervosa. A study of patient variables. AB - To investigate the predictive value of a wide range of variables for distinguishing subjects who demonstrate a favourable treatment response from those who do not, 86 women with a DSM-III-R diagnosis of bulimia nervosa who completed a group treatment programme for eating disorders were studied. Discriminant-function analysis of demographic variables, weight history, specific eating-disorder psychopathology, mood status and social adjustment before treatment was performed; five factors (depression and core symptoms of eating disorder) best discriminated 'positive' from 'poor' treatment responders, accounting for 44% of the variance. PMID- 1790457 TI - The idealisation of therapy: fantasy versus reality in clinical practice. AB - In this paper, object-relations theory is used to illuminate problems encountered in the psychotherapeutic management of severely disturbed psychiatric patients. The hazards of idealisation of the psychiatrist by the patient are reported in four case histories. Attention is drawn to the subsequent breakthrough of negative feelings where idealisation had been unrecognised or unwittingly encouraged. Some implications for the more successful management of the transference in patients such as these are discussed. PMID- 1790458 TI - A psychophysical method for assessing visual and acoustic hyperaesthesia in patients with mild head injury. AB - Although it is well known that patients with mild head injury (MHI) are less able to endure intense light and sound stimuli than normal people, there are few psychophysical studies that have objectively measured this type of hyperaesthesia. In the present study, using a computerised rating scale technique, both the maximal and submaximal levels of reduced tolerance to light and sound were assessed for a wide range of stimuli. Three to six days after the trauma, 40 MHI patients were significantly less tolerant to stimuli of intensities over 71 dB and 500 lux levels than controls. These intensities are common, and MHI patients may suffer as a consequence. PMID- 1790459 TI - Seasonal affective disorder in adolescence. AB - Two adolescent girls with seasonal affective disorder (SAD) are described. It is suggested that the classic symptom profile seen in adults is not characteristic in younger subjects. Although hypersomnia is prominent, increased appetite and carbohydrate craving are rarely reported. Local meteorological data link the course of the disorder in one case to the hours of sunshine and ambient temperature during the winter months. PMID- 1790460 TI - Thyroid hormone supplementation of fluoxetine in the treatment of major depression. PMID- 1790461 TI - Continuation electroconvulsive therapy: preliminary guidelines and an illustrative case report. AB - Despite renewed interest in ECT as a continuation treatment after an episode of depressive illness, few guidelines for its use are available. Meaningful research findings are few, although the potential benefits and risks of modern continuation ECT merit study. We suggest preliminary guidelines and provide an illustrative clinical example. PMID- 1790462 TI - Adrenocortical suppression presenting with agitated depression, morbid jealousy, and a dementia-like state. AB - A 66-year-old woman showed profound neuropsychiatric disturbance after withdrawal from prolonged corticosteroid treatment. Reintroduction of an alternative corticosteroid, at low dose, produced a return to premorbid mental state. PMID- 1790463 TI - Reflex tics in two patients with Gilles de la Tourette syndrome. AB - Two patients with Gilles de la Tourette syndrome (GTS) showed tics triggered by external stimuli. This unusual feature is of significance to the aetiology of GTS and in particular the relationship between GTS and the startle response. PMID- 1790464 TI - Capgras syndrome in association with lithium toxicity. AB - Capgras syndrome in association with lithium toxicity is described in a 74-year old woman. Lithium toxicity should be considered when new delusions occur during lithium therapy. PMID- 1790465 TI - Sibling sex and bulimia nervosa. PMID- 1790466 TI - The future of psychotherapy. PMID- 1790467 TI - Evaluation of motor disorder in mentally handicapped people. PMID- 1790468 TI - Fitness to plead. PMID- 1790469 TI - Obsessive slowness revisited. PMID- 1790470 TI - Musical hallucinations triggered by clomipramine? PMID- 1790471 TI - Crossover reaction between haloperidol and amoxapine for NMS. PMID- 1790472 TI - Neuroscience. PMID- 1790473 TI - Family health services authorities and primary dental care. PMID- 1790474 TI - The effect of the price of dental services on their demand and utilisation in Norway. AB - The aim of the present study was to examine the effect of the price of dental services on their demand and utilisation. These effects cannot be examined in cross-sectional studies when prices are fixed, as they are in Norway, but they can be studied over a period of time, as the price for dental services has changed relative to the prices for other goods. The analyses were performed on 7 sets of data, collected every second year, over the period 1977 to 1989. The samples were representative of the non-institutionalised Norwegian population aged 20 years and over. Price had a different effect on demand than on utilisation. There was no statistically significant association between price and demand. Utilisation decreased with increasing price, and this can be explained in two ways. First, it may express patients' response to reduced prices, and second, it may express the dentists' response to reduced prices. If the latter explanation is correct, this means that the dental care market is rather special. Consumers are not dominant. Dentists, as providers, can, to a certain extent, influence the uptake of the services they provide. PMID- 1790475 TI - Dental disease and health behaviour: the development of an interactional model. AB - This paper describes the development of an interactional model in which both the clinical and the socio-psychological aspects of dental disease and its prevention are considered. Clinical and social data were collected from two separate samples, and the interrelationships between antecedent, motivational and preventive health behaviour variables and their influences on each other and on dental health outcomes were measured by regression analyses. A complex pattern of significant interrelationships was revealed, in which direct and indirect influences on dental health and behaviour operated at different levels of intensity and in different combinations, sometimes reinforcing each other but sometimes in conflict. The model could have relevance to a multifactorial approach in health research and, by incorporating additional causal influences, it could be developed into a more effective analytical tool as well as an aid the promotion of dental health. PMID- 1790476 TI - Periodontal treatment needs among Saudi Arabian adults and their relationship to the use of the Miswak. AB - The main aims of this study were, first, to estimate the need for periodontal care among adult residents of Saudi Arabia using the community periodontal index of treatment need (CPITN) and, second, to quantify the relationship between the frequency of using the 'Miswak' and the need for periodontal care. The Miswak is a stick made from the roots of the Arak tree (Salvadora persica) and is used for oral hygiene purposes by many cultures. A total sample of 480 adults aged 35 to 44 years and 65 years and older from the cities of Mecca and Jeddah was included in the study. The findings indicate that the level of need for periodontal care in the sample chosen is low when compared with the findings of similar studies undertaken in other countries. The frequent use of the 'Miswak' was associated with a lower need for treatment. PMID- 1790477 TI - Oral hygiene, gingivitis and periodontal status of Libyan school children. AB - There is relatively little information about the dental health of Libyan children, so this study was initiated to assess the level of oral hygiene and the gingival and periodontal status in children living in urban and rural parts of Libya. Two thousands and fifteen children aged 7-16 years were examined during 1987 using World Health Organization criteria. The oral hygiene was found to be good (mean oral hygiene index = 0.12); boys demonstrated significantly worse oral hygiene than girls (P less than 0.001). Overall, gingival inflammation was categorised as mild (mean gingival index = 0.05). Boys had more gingivitis than girls (P less than 0.001). Periodontal pockets of more than 3.5 mm were found in 4.1 per cent of 15-16-year-old children. PMID- 1790478 TI - Dental health of young insulin dependent diabetic subjects in Northern Ireland. AB - The present study was undertaken to establish the dental disease and treatment levels in 101 young insulin dependent diabetic patients in Northern Ireland. There was a significantly greater proportion of children from the higher social classes in the diabetic group. Their dental caries experience was lower than that reported for the general population and the restorative indices were high. However, those whose diabetes was diagnosed at a late stage had a higher caries experience. There was significantly more gingivitis detected in older diabetic patients, but oral hygiene status did not significantly differ with age. There was a pattern of regular dental attendance in the majority of diabetic subjects. PMID- 1790479 TI - Increment of caries in diabetic adults. A two-year longitudinal study. AB - The increment of caries was monitored for two years in 30 adult diabetic and 30 healthy subjects, who received regular preventive and reparative treatment during this time. No significant differences in caries increment were found between the diabetic and control subjects, but there was a tendency for a greater increment on lingual surfaces of the teeth in the diabetic group than in the healthy subjects (P less than 0.09). PMID- 1790481 TI - Dental attendance in a sample of pregnant women in Birmingham, UK. AB - One of the broader aims of antenatal care is to enhance the general health of the mother, and free dental treatment during pregnancy gives an opportunity for the mother's dental health to be improved. In this study, 500 mothers at the Birmingham Maternity Hospital were interviewed, using a questionnaire, during their first three days postpartum. The object was to investigate the receipt of dental care during pregnancy. Only 304 (61 per cent) mothers had visited the dentist in the antenatal period and 196 (39 per cent) had not. Although the majority of mothers (95.5 per cent) were aware that dental care was free, the high non-attendance rate was because mothers 'did not feel it necessary' to visit. Therefore the removal of the financial deterrent does little to promote dental attendance. Previous patterns of dental attendance strongly influenced attendance behaviour during pregnancy. Non-attenders tended to be Muslims, mothers who were previously irregular attenders, those of lower socio-economic groups, and those having their first baby. Efforts to improve the uptake of dental care should be directed towards these groups, and all the health agencies involved in antenatal care can contribute to the promotion of better maternal health. PMID- 1790480 TI - An analysis of the community periodontal index of treatment needs. Studies on adults in France. V. Presentation of CPITN data in cross-tabulations. AB - A total of 1005 subjects were examined using the CPITN and DFT indices. CPITN data were modified in their presentation in order to be suitable for cross tabulation. Two different methods were considered. One, described previously by Roland et al. (1984), classified subjects according to the combination of their highest CPITN score and the mean of the highest scores of every nonedentulous sextant. The other consisted of multiplying the above mentioned mean by the individual's highest CPITN score. A critical analysis of the methodology showed that the two number system developed by Roland et al. (1984) was impractical. The new method provides a linear array of values from 0 to 16. Very little overlapping of values was observed, which means that a relatively precise periodontal condition is characterised by each value. With this transformation the CPITN can be used as an index that quantifies periodontal conditions instead of treatment needs. PMID- 1790482 TI - Teeth, tea and Tibetans. PMID- 1790483 TI - A quantitative study of cardiac ventricular mass in dogs. AB - This study was undertaken to determine the correlations between heart weight, ventricular weight and body weight in adult dogs. A total of 130 dogs was selected for the study after necropsy and histological examination. The body weights (BW) were obtained and a standardized dissection technique was used to obtain the total heart weight (HW), total ventricular mass (VW), right ventricular mass (RvW) and the left ventricular plus the interventricular septum mass (Lv + SW). A strong and significant correlation was found between all variables (BW, HW, VW, Lv + SW and RvW). The following ratios were calculated: HW/BW, RvW/BW, Lv + SW/BW, RvW/VW, Lv + SW/VW, RvW/HW, Lv + SW/HW and Lv + SW/RvW. No sex effect was observed on any ratios. A straight linear relationship was observed between HW and Lv + SW or RvW and between Lv + SW and RvW. The ratios Lv + SW/HW, RvW/HW and Lv + SW/RvW could then be used to predict a normal value of Lv + SW or RvW from a known HW value, or a normal value of Lv + SW from a known RvW value. The relations between BW and HW, Lv + SW or RvW were best described by second order equations. Such equations should be utilized to predict a normal value of HW, Lv + SW or RvW from a known BW value. PMID- 1790484 TI - Xanthine oxidase formation during experimental ischemia of the equine small intestine. AB - We hypothesized that xanthine oxidase plays a role in the postischemic reperfusion injury in the equine small intestine. Under anesthesia, four horses and two ponies underwent ischemic strangulating obstructions of segments of the proximal jejunum, mid-jejunum and ileum. Prior to vascular occlusion, and at 1 h and 2 h of ischemia, full-thickness intestinal biopsies were collected for histopathological evaluation and for determination of combined xanthine dehydrogenase (XDH) plus xanthine oxidase (XO) activity, and XO activity alone. The level of XO activity was expressed in percentage according to the ratio of XO/(XDH + XO). We found a nearly threefold increase in the combined level of XDH plus XO activity from ileum to duodenum (p less than 0.04). However, the preischemic level of % XO activity did not vary significantly (p = 0.61) between segments of jejuno-ileum. Likewise, no significant difference was noted between intestinal segments after ischemia. Therefore, the data from all intestinal segments were pooled for each time and analyzed using Wilcoxon's signed rank test (one-tailed). Compared to the pre-ischemic level of % XO activity (median 27%), the % XO activity increased after 1 h of ischemia (median 37.0%), reaching statistical significance (p = 0.016). There were no statistical differences between the preischemic % XO activity and the % XO activity in non-ischemic bowel at the end of the anesthetic period. During ischemia, % XO activity increased, which lends credence to the importance of xanthine oxidase in previously documented reperfusion injury in the equine small intestine. PMID- 1790485 TI - Use of scintigraphy for the determination of mucociliary clearance rates in normal, sedated, diseased and exercised horses. AB - Mucociliary clearance rates from the trachea were determined in normal, sedated, diseased and exercised horses from scintigraphs obtained after an injection of technetium-99m sulphide colloid into the tracheal lumen. The group mean tracheal clearance rate of eight clinically normal horses during 42 trials was 2.06 +/- 0.38 cm/min. Significant between horse differences were found (p less than 0.05). When six and seven of these horses were given xylazine and detomidine hydrochloride, respectively, mean group tracheal clearance rates dropped significantly (p less than 0.05). The decreases from each normal horse's mean tracheal clearance rate ranged from 18 to 54%. There did not appear to be a difference between the tracheal clearance rates (TCRs) of the normal horses and those with chronic respiratory disease. Postexercise evaluations were not significantly different from the pre-exercise TCRs in three clinically normal horses and three horses with chronic obstructive pulmonary disease (p greater than 0.05). This minimally invasive scintigraphic technique for determining TCRs has proved to be useful and reliable. PMID- 1790486 TI - Examination of chemotactic properties of bovine mammary macrophages. AB - An in vitro model system in which polymorphonuclear leukocytes (PMN) migration under agarose was employed to examine the ability of mammary macrophages to release chemoattractants for PMN. Mammary macrophages were incubated in Hanks' balanced salt solution for up to 12 h in the presence of Staphylococcus aureus. The possibility that the chemotactic activity is mediated through release of interleukin 1 (IL-1) and prostaglandins (PGs) by mammary macrophages was investigated. The data showed that release of chemotactic activity peaked 6 h following addition of S. aureus in the culture medium of mammary macrophages. Very low levels of IL-1 were detected in the same culture medium. Addition of indomethacin, a PGs synthesis inhibitor, was ineffective in altering the chemotactic activity detected in the culture medium of macrophages. These data suggest that it is highly unlikely that the chemotactic activity is mediated through the production of IL-1 and PGs by the mammary macrophages. PMID- 1790487 TI - Evaluation of a guarded bronchoscopic method for microbial sampling of the lower airways in foals. AB - A novel method to reduce contamination of the bronchoscope during microbial sampling of the lower airways of foals was evaluated. Methylene blue (MB) was used as a nasopharyngeal dye marker to assess the relative contamination from the upper airways of bronchoalveolar lavage (BAL) specimens obtained by standard bronchoscopy (SB) and a "guarded" bronchoscopic method (GB). For GB, a clear sterile cellulose sheath was fitted over the bronchoscope in an effort to protect the endoscope tip and channel from contamination. Methylene blue was detected visually in seven of eight BAL samples from foals following SB, but in none of the samples recovered by GB (p less than 0.001). Significantly less MB was detected in BAL by spectrophotometry in the GB group as well (p less than 0.02). The GB was next employed to study the microbial flora in the lower airways of healthy weaned foals (n = 30). Bacteria were isolated from 29 of 30 (97%) BAL samples, and in moderate or large numbers from 26 of 30 (87%) of the foals. Potential pathogens, including Bordetella bronchiseptica, Streptococcus zooepidemicus, Staphylococcus aureus, Mycoplasma felis and Streptococcus pneumoniae, were cultured from the lower airways of foals. In conclusion, the bronchoscope and bronchoalveolar lavage specimens were readily contaminated by a dye marker placed in the nasopharynx of foals, and the degree of contamination was significantly reduced by sheathing the endoscope. This contamination during bronchoscopy may obscure the interpretation of isolates from BAL specimens from foals, which may possess a bacterial flora in the lower airways without cytological evidence of inflammation. PMID- 1790488 TI - Purification and properties of cholesterol oxidase and choline phosphohydrolase from Rhodococcus equi. AB - Cholesterol oxidase (CO) and choline phosphohydrolase (CPH) exoenzymes were isolated from culture supernatants of Rhodococcus equi ATCC 33701 and their hemolytic and cytotoxic activities examined. The purifications involved differential ammonium sulphate precipitation, ion exchange and gel filtration chromatography. A purification of 32.8-fold and a yield of 0.3% of CO were determined by synergistic hemolysis of sheep red blood cells (SRBC) presensitized with Staphylococcus aureus beta toxin. The enzymatic activity of CO was also demonstrated by oxidation of aqueous cholesterol suspensions. The activity of CO was reversibly inhibited by concentration. A purification of 412.4-fold and a yield of 1.7% of CPH were determined by hydrolysis of p nitrophenyphosphorylcholine. Purity of both exoenzymes was confirmed by immunoblotting. On sodium dodecyl sulphate polyacrylamide gel electrophoresis, the CO had a molecular mass (Mr) of 60 kd and the CPH a Mr of 65 kd. Choline phosphohydrolase did not hydrolyse sphingomyelin. Sphingomyelinase C (SMC) activity was however demonstrated in concentrated culture supernatants. This dissociation of SMC from CPH activity indicates that R. equi produces two distinct phospholipase C exoenzymes, a CPH and a SMC. Both CO and CPH combined, or individually, did not lyse native SRBC even with subsequent chilling of the cells at 4 degrees C ("hot-cold" treatment). Purified CO lysed beta toxin sensitized SRBC. The CPH showed only minor hemolytic activity against such sensitized SRBC even at high concentrations. Combination of CO and CPH in lysis of beta toxin sensitized SRBC showed only minor additive rather than synergistic effects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790489 TI - The microbial flora of the respiratory tract in feedlot calves: associations between nasopharyngeal and bronchoalveolar lavage cultures. AB - The upper and lower respiratory tracts of 59 feedlot calves with clinical signs of naturally occurring respiratory disease (cases) and 60 comparison (control) animals were cultured before treatment, using nasopharyngeal swabs (NPS) and bronchoalveolar lavage (BAL). The most prevalent organisms were Pasteurella multocida and Mycoplasma bovis. Isolations of P. multocida from NPS and BAL fluid were found to be significantly associated with morbidity (p less than or equal to 0.05), but the frequency with which other organisms were isolated from the nasopharynx and lungs was similar in cases and controls. There was evidence of moderate agreement between NPS and BAL isolates at the individual calf level using the kappa statistic, (range of kappa values = 0.47-0.61) but the variability of the kappa statistics was large. Therefore, in an individual calf NPS cultures did not accurately predict BAL cultures. The NPS and BAL culture results were quite similar at the group level, however. PMID- 1790490 TI - Epidemiological associations between Mycoplasma hyopneumoniae and Actinobacillus pleuropneumoniae antibody titers and lung lesions in Prince Edward Island swine herds. AB - A survey of anteroventral (AV) lung lesions, pleuritis and serology for Mycoplasma hyopneumoniae (MH) and Actinobacillus pleuropneumoniae (AP) was conducted on a minimum of 25 slaughter hogs from each of 18 randomly sampled Prince Edward Island farms (producing over 1,000 market hogs per year). The data were analyzed to evaluate the potential role of these two agents as risk factors for the two conditions, using crude and multivariable techniques, as well as individual and herd data. Anteroventral lung lesions were present in 50.5% of hogs at slaughter, and pleuritis was present in 15.4% of the hogs. Least squares multivariable regression was used to analyze the simultaneous ability of MH, AP and MH/AP interaction to predict the herd prevalence of AV lung lesions. Only MH was associated with AV lung lesions (p = 0.035). In spite of this statistical significance, MH accounted for only 53% of the herd variation in prevalence of lung lesions (R2 = 0.529). As well, some herds maintained very low levels of lung lesions despite moderate (up to 30%) prevalence of MH. Discrepancies between the analytic techniques suggested herd-level factors play an important role in the development of lung lesions. Pleuritis did not appear to be associated with either of the agents studied (p = 0.478). PMID- 1790491 TI - A serological survey of leptospirosis in Prince Edward Island swine herds and its association with infertility. AB - A serological survey was undertaken to determine the prevalence of leptospirosis, and to investigate associations between leptospiral antibody titers, and herd measures of reproduction. Production records and leptospirosis serology were analyzed for 25 slaughter hogs from each of eleven randomly sampled farrow-finish operations on Prince Edward Island. The effect of selected leptospiral serovars on nonproductive sow days per parity (NPSD/P) and the proportion of pigs born dead was evaluated. The four most common serovars to which antibodies were detected were Leptospira icterohaemorrhagiae, L. bratislava, L. autumnalis and L. pomona, with respective prevalences of 57.1%, 35.1%, 3.4% and 1.5% of PEI slaughter hogs. None of these serovars was associated with increased frequency of stillbirths (p greater than 0.05). However, farms with a higher prevalence of L. bratislava antibody titers tended to have more infertility, as measured by NPSD/P (r = 0.738, p = 0.036 with Bonferroni adjustment). Also, farms with L. pomona antibody titers had higher NPSD/P than farms without L. pomona antibody titers (p = 0.0008 with Bonferroni adjustment). There was no association between NPSD/P and antibodies to either L. autumnalis or L. icterohaemorrhagiae (p greater than 0.05). PMID- 1790492 TI - Associations between dairy production indices and lipoarabinomannan enzyme immunoassay results for paratuberculosis. AB - Data from an epidemiological study in Ontario, involving 304 dairy herds, were used to identify associations between selected production indices and lipoarabinomannan antigen serological test results for paratuberculosis (LAM ELISA). Analyses were conducted at both the herd and individual cow levels of organization. After analytically controlling for management and cow factors in the respective regression models, positive serological paratuberculosis status (as defined by the LAM-ELISA test), was associated with higher milk somatic cell counts at both the herd average (p less than 0.01), and individual cow levels of organization (p less than 0.0001). In contrast, LAM-ELISA test results were consistently not associated with calving intervals in either the herd average or individual cow level analyses. Associations between LAM-ELISA results and milk production were inconsistent. No associations were found at the herd level of organization, and LAM-ELISA results were not associated with a change in breed class average (BCA) for milk, between the previous and the most recent lactations of individual cattle. However, at the individual cow level, LAM-ELISA results were positively associated with higher milk production as measured by the current BCA (p less than 0.05), and individual cow average kg of milk produced per year of life since two years of age (p less than 0.0001). PMID- 1790494 TI - Effects of continuous stray voltage on health, growth and welfare of fattening pigs. AB - The effects of continuous stray voltage were evaluated on growing-finishing pigs between the ages of 8 and 21 weeks. Seventy-two pigs were assigned to six blocks of 12 animals each. The following treatments were randomly distributed in each block according to a 2 x 3 factorial design: feeding level (restricted or ad libitum) and voltage level (0, 2 or 5 volts (V) as a difference of potential between feeder or drinker and the metallic floor). During daytime, stray voltage at 5 V decreased (p less than 0.05) the eating frequency in both feeding groups and the drinking frequency in restricted-fed pigs. The mean duration of drinking bouts and the total time spent at the drinker were also lower (p less than 0.05) in this last group during the hour following meal distribution. Daily feed intake and average daily gain were lower (p less than 0.05 and less than or equal to 0.08, respectively) in the 5 V group than in the 2 V and the control groups from 17 to 21 weeks of age. Finally, gastric lesions, hematological and biochemical variables were not affected (p greater than 0.05) by stray voltage. PMID- 1790493 TI - A field trial to evaluate a whole cell vaccine for the prevention of caseous lymphadenitis in sheep and goat flocks. AB - A field trial to evaluate a whole cell vaccine for the prevention of caseous lymphadenitis (CLA) in sheep and goats was performed in one goat herd and one sheep flock over a period of three years. In goats, there was a nonstatistically significant trend for fewer cases of CLA in the vaccinated animals compared to the controls. In sheep, from six months to 36 months postinitial vaccination, the proportion of vaccinated sheep that developed CLA was significantly less (p less than 0.05) than in the control sheep. The antibody titers to Corynebacterium pseudotuberculosis as detected by microagglutination assay were significantly different (p less than 0.0001) at all times except at the initial vaccination. Swellings occurred at the vaccination site at an incidence level of 29.6% in goats and 34.1% in sheep. The vaccine appeared to be efficacious in reducing the proportion of sheep that developed CLA when challenged naturally in a field situation. PMID- 1790495 TI - Seroprevalence of anti-Toxoplasma IgG in Canadian swine. AB - In 1990, 1443 sera randomly selected by computer generated random numbers from a bank of greater than 15,000 sera collected earlier from sows at slaughter in various geographic regions of Canada were tested for anti-Toxoplasma immunoglobin G (IgG) by the modified direct agglutination test. One hundred and thirty-six (9.4%) samples were positive for anti-Toxoplasma IgG while 36 (2.5%) of the sera gave borderline reactions. The highest prevalence of anti-Toxoplasma IgG was in swine originating in the Atlantic provinces and Ontario while the lowest was in swine from Manitoba and Saskatchewan. PMID- 1790496 TI - [A new method for the approach to the lateral cerebral ventricle of the ewe (Ovis aries)]. AB - The proposed technique consists of placing a catheter in the olfactory recess of the lateral ventricle of the brain of a sheep. Twenty adult ewes were used in the study. The olfactory recess is in the frontal region 25 +/- 3 mm below the skin, just caudal to the line joining the supraorbital foramen and approximately 8-10 mm from the median plane. The approach is relatively easy under normal experimental conditions. The wall of the olfactory bulb, however, is fragile, and the animals must not have been injured by Oestrus ovis. PMID- 1790498 TI - Regulation or contagion? Measles vaccination policy in Quebec. PMID- 1790497 TI - Building the knowledge base on HIV/AIDS in Canada. PMID- 1790499 TI - Apparent nutrient intakes of Canadians: continuing nutritional challenges for public health professionals. AB - The apparent nutrient intake patterns of 4774 households in 15 urban areas across Canada were analyzed using the first public use data tape of Statistics Canada's Family Food Expenditure Survey of 1984. This study addresses the paucity of population-based information about the nutritional adequacy of Canadian eating patterns. Considerable nutrient deficits were identified. The particularly vulnerable population groups were the poor, female-headed households, and male headed households with spouses working outside the home or with no spouses. Controlling for income, senior households were less vulnerable. PMID- 1790500 TI - Nutritional status of single male government-sponsored refugees from Ethiopia. AB - Single male Ethiopian refugees living in Ottawa were interviewed to determine their dietary intakes, anthropometric status, and the factors associated with nutritional status. Of 58 eligible subjects, 39 (67%) participated. Dietary intakes, measured by three 24-hour recalls, revealed that protein, iron and Vitamin C generally met or exceeded the Nutrition Recommendations for age. The mean percentages of total energy consumption from protein and fats were 17.2% and 33.4% respectively. The mean energy intake of the group was 81.5% +/- 23.9 of the level recommended. 21% had a body mass index (BMI) below 20, and 55% of arm circumference measurements fell at or below the tenth percentile of the National Center for Health Statistics standards for black males. Participants with higher domestic skill scores, measured by the questionnaire, had significantly higher energy intakes (p less than 0.02). Lack of domestic skill was the dietary problem most commonly identified by participants. PMID- 1790501 TI - Childhood lead exposure in Trail revisited. AB - We sought to identify modifiable determinants of elevated blood lead levels in preschool children; to compare the current situation with past information; to determine historical trends in environmental lead contamination in Trail; and to find a basis for identifying appropriate precautions and protection against future lead exposure. In Phase 1, blood samples were drawn from all children aged 2 to 5. In Phase 2, children in the highest and lowest quartile of blood leads were surveyed by questionnaire. Environmental samples of drinking water, paint, housedust, soil and vegetables were taken from their residences, and soil samples were collected from nearby parks. The average blood lead level was 13.8 micrograms/dl, range 4 to 30 micrograms/dl. This is approximately 40% lower than in 1975, when a previous survey was done, but is high compared to other places in Canada. The study of environmental determinants of lead revealed that soil lead levels and, secondarily, housedust lead levels are the principal determinants of high blood lead. Children with high blood leads also tended to concentrate in neighbourhoods near the lead-zinc smelter. PMID- 1790502 TI - Perceived barriers to physical activity by older adults. AB - The purpose of this study was to investigate the perceived barriers to physical activity by older adults. 199 volunteers responded to the Perceived Barriers Questionnaire (PBQ). The subjects resided in apartment residences for independent, healthy, older adults. Older adults perceived as many as 17 barriers to physical activity. The number of barriers per subject was significantly related to age and illness or handicap. The remaining factors, gender, income, activity and educational levels, were not related to the number of barriers. There was a significant difference among four specific types of barriers (i.e. Psychological, Administrative, Physical/Health, Knowledge) with barriers of the knowledge dimension being most often identified. PMID- 1790503 TI - The benefits of HIV antibody testing of saliva in field research. PMID- 1790504 TI - Evaluation of the British Columbia AIDS Information Line. AB - We evaluated implementation of the British Columbia AIDS Information Line during its initial 15 weeks of operation. Data collected during daily operation of the line included call frequency, caller characteristics, response patterns, caller concerns and community referrals. Information on activities and resources required to implement the AIDS Line was also assembled. The study concluded that the advertising campaign sponsored by the provincial government and other AIDS related media events had a strong impact on the frequency of calls made to the AIDS Line. However, the effect of both advertising and media events was of relatively short duration, suggesting that utilization of an AIDS information line is dependent on continuing promotional activities. The evaluation results demonstrate the importance of continuous collection of data online utilization, to track public awareness of and response to AIDS-related issues, and to facilitate planning of public education. PMID- 1790505 TI - HIV: the debate over isolation as a measure of personal control. AB - In the biomedical ethical debates over HIV/AIDS, the issue of personal control measures, including isolation and detention, should be addressed critically. Taking account of historical experience with epidemics and current legislation, several major policy options are identified, each of which has drawbacks. A sliding scale of personal control measures culminating in limited detention may offer a balance between private responsibility and public health to ensure responsible behaviour. Any measure of personal control must be linked to fully implemented, positive programmes in education and counselling within a coherent strategy for which there is no coercitive substitute. PMID- 1790506 TI - The knowledge, attitudes and concerns of hospital staff about AIDS. AB - Staff from 3 Toronto hospitals were surveyed for knowledge, attitudes and concerns about AIDS. 70% of the 1,366 respondents had direct clinical experience with persons with AIDS. Data were analyzed according to hospital setting and professional group: physicians, nurses, technologists and supervisory staff. No setting difference was observed and although statistically significant differences (at the .001 level) were observed between professional groups, these differences are small and have little practical importance. In general, subjects answered 68% of the knowledge questions correctly. All attitudes and concerns were inversely associated to knowledge (Pearson r range was -.31 to -.20). Multivariate analysis demonstrated that knowledge and concern about contagion are important mediating variables (multiple r = .40) for other attitudes and concerns. PMID- 1790507 TI - Long-term survival rates among patients with cancer in Saskatchewan, 1967-1986. AB - We calculated relative survival rates from 5 to 15 years after diagnosis for cancer cases diagnosed in Saskatchewan, Canada, between 1967 and 1986. Cancers with high 15-year relative survival (greater than 60%) included lip, melanoma among women, other male genital sites, and corpus uteri. As anticipated, relative survival rates declined with increasing length of follow-up, with the largest relative declines noted among those in the oldest age group (65+ years). Only small declines in relative survival were noted for cancers of the colon and cervix with increasing length of follow-up. Improved survival of cases diagnosed in the period 1980-1984 compared to 1970-1974 was observed for all sites combined, as well as the following sites: colon, lung, prostate, brain, ill defined sites, non-Hodgkin's lymphoma, and lymphoid leukemia. For colorectal cancer, stage at diagnosis was a more important independent predictor of survival than age. PMID- 1790508 TI - Tuberculosis surveillance in northeastern Ontario health care institutions: what are we doing? AB - The purpose of this study was to describe the current tuberculosis (TB) surveillance practices in health care facilities in accordance with the Ontario Hospital Act. Data for this survey were collected by means of a mailed questionnaire received from 51 health care facilities and schools of nursing in Northeastern Ontario. With some minor changes, most institutions followed standard TB surveillance practices based on the Ministry of Health legislation. Alterations in surveillance practices generally reflected the literature update in terms of cost-effectiveness. It was also discovered that some institutions (33.3%) failed to account for the relative risk for pregnant employees/students with skin testing and X-Ray screening. PMID- 1790509 TI - [Screening for a frequent cardiac disorder: mitral valve prolapse]. AB - Mitral valve prolapse (MVP) screening using bidimensional echocardiography was performed on 171 healthy subjects from Lorraine of both sexes, aged 20 to 60 years. Six men and seven women presented this valvular disease. In the Lorraine population, the estimated prevalence of MVP was 7.6% (95% confidence interval: 3.6-11.6%). In this study, only seven cases of MVP had a cardiac auscultation suggestive of MVP. As compared with echocardiography, clinical screening of MVP had a low validity (sensibility 54%, specificity 69%) and a poor positive predictive value (12.5%). Because MVP has severe complications, and because clinical screening has a low performance, a strategy of screening with bidimensional echocardiography could be interesting. PMID- 1790511 TI - The effect of cigarette smoking on trabecular bone density in premenopausal women, aged 20-35 years. PMID- 1790510 TI - Health knowledge of Native Indian youth in central Alberta. AB - This paper is the first report of health knowledge among Native Indian youth in central Alberta and, in the absence of comparable information for Native youth in other regions of Canada, provides a unique basis for comparison of the health knowledge of Native youth attending junior high school with that of non-Native young Canadians included in the Canada Health Knowledge Survey. The results of our survey of 229 Native Indian youth from seven different reserves in central Alberta indicate that a higher proportion of the Native youth were more knowledgeable about dental health, fire safety, and the effects of smoking, alcohol and drugs. However, they generally scored lower on items related to knowledge of first aid for burns, nutrition, communicable diseases, and personal health. Factors contributing to these differences and suggestions for future action are suggested on the basis that accurate information of this kind is essential for health promotion efforts directed toward reducing risky health behaviours and promoting healthier lifestyles among youth of Native Indian communities. PMID- 1790512 TI - A health centre survey of childhood injury in Edmonton. PMID- 1790513 TI - Sexual behaviour changes due to HIV. PMID- 1790514 TI - Psychiatric disorder and substance use in adolescence. AB - This article examines the relationship between psychiatric disorder and the use of tobacco, alcohol, marijuana and hard drugs during adolescence. The sample of 1,302 adolescents aged 12 to 16 came from households selected by stratified, cluster and random sampling of the 1981 Canada Census. Symptom checklists were used to approximate diagnoses of conduct disorder, attention deficit disorder and emotional disorder. Logistic regression analyses indicated that conduct disorder was strongly related to all types of substance use and that emotional disorder was related to the use of tobacco, alcohol and hard drugs. These relationships were true for the adolescents' self-assessments only; the parents' assessments of psychiatric disorder were not related to the adolescents' reports of substance use. PMID- 1790515 TI - Behaviour problems of the mentally retarded. AB - The behaviour profiles of 176 mentally retarded individuals from two reception centres and nine group homes were assessed. The correlations between behaviour and age, sex, degree of mental retardation, etiology of mental retardation and medical diagnosis were assessed using the Revised Child Behaviour Profile. The severity of behaviour disturbance did not vary with age or medical diagnosis. The moderately retarded subjects presented with more severe behaviour problems, such as aggression, than the severely mentally retarded subjects. The variable most predictive of behavioural problems was etiology of the disorder. Individuals with Down's syndrome had significantly fewer behaviour disturbances and those with autism and pervasive developmental disorder had significantly more behaviour disturbances than other subjects. A psychiatric disorder was found in 10.2% of the sample. The implications of these findings are discussed with respect to public policy. PMID- 1790516 TI - Fluoxetine treatment of obsessive-compulsive disorder. AB - Two patients suffering from severe obsessive-compulsive disorder which had proven refractory to clomipramine and/or phenelzine treatment were successfully treated with fluoxetine, a new drug with a strong serotonin uptake inhibiting action. Outcome of treatment was measured on psychometric tests including the Leyton Obsessive Inventory, Hopkins Symptom Checklist-90, Beck Depression Inventory, and daily self-reports of the duration and degree of discomfort of their most severe obsessions. The delay in responding to fluoxetine, the continuing improvement even after one year on the drug, and the prompt relapse with abrupt withdrawal of treatment were noted. PMID- 1790517 TI - Validity of the computerized DIS for diagnosing psychiatric inpatients. AB - The validity of a self-administered, computerized version of the National Institute of Mental Health Diagnostic Interview Schedule (DIS) was evaluated with a group of 41 psychiatric inpatients. Each patient was administered the computerized DIS (C-DIS) and a semi-structured clinical interview using the symptom checklist developed by Helzer et al. The concordance between the C-DIS and symptom checklist was comparable to that found in earlier studies of the original DIS. The overall distribution of kappas was also similar to those of previous studies. Overall, the results suggest that computerized administration may be a feasible alternative to face-to-face administration of the DIS. PMID- 1790518 TI - Prevalence estimates of pathological gambling in Quebec. AB - Pathological gambling was officially defined and recognized as a psychiatric illness by the American Psychiatric Association in 1980. This survey reports the results of a province-wide study in Quebec based on telephone interviews using standardized assessment instruments with 1,002 subjects. The current prevalence of pathological gambling is 1.2%. The results also show that 88% of the respondents have gambled at least once in their life. The implications of these results for the prevention and treatment of this debilitating disorder are discussed. PMID- 1790519 TI - Psychiatric and neurological effects of chronic solvent abuse. AB - This study is a review of the psychiatric and neurological effects of solvent inhalation on a group of 22 patients with chronic histories of solvent abuse, primarily toluene-based solvents. The findings suggest that the chronic inhalation of toluene-based adhesives can produce a paranoid psychosis which may persist. Other findings were a high incidence of temporal lobe epilepsy and decrease in IQ. We suggest that the psychiatric and neurological sequelae of chronic solvent abuse are serious and potentially irreversible. Toluene is felt to be a major factor in the morbidity associated with chronic solvent abuse, and attention is drawn to the necessity for educational programs in this area. The burden caused by the resulting psychiatric problems resulting from solvent abuse may have implications for health care budgets. PMID- 1790520 TI - Repeated use of psychiatric emergency services by children. AB - In this study, the repeat utilization of child psychiatric emergency services was examined. There are patients who use psychiatric emergency services repeatedly, and these patients represent a significant proportion of child psychiatric emergencies seen in emergency rooms. Repeat patients were more likely to threaten to harm others, have a diagnosis of adjustment disorder, conduct or oppositional disorder and be under the care of a child welfare agency. They were significantly more likely than the one-time patients to be less compliant with outpatient follow-up, admitted to hospital more often, needed more social support and had greater difficulty remaining in a residential treatment setting. Intervention in the emergency room did not appear to change the way they used emergency services. PMID- 1790521 TI - Salivary cortisol in children: correlations with serum values and effect of psychotropic drug administration. AB - This study compares the paired serum and salivary cortisol levels of 60 children and adolescents, obtained while performing a routine Dexamethasone Suppression Test. The results reveal significant correlations between serum and salivary cortisol levels in both drug-free (r = 0.90, p less than .001) and medicated patients (r = 0.81, p less than .001). Multiple regression analysis suggests that, while the slopes of the two regression curves are parallel (0.15 less than p less than 0.20), the intercepts are significantly different (p less than 0.05). This study supports the use of salivary measures of cortisol for children and adolescents. The authors suggest care in the use these measures while the patient is taking psychotropic medication. PMID- 1790522 TI - Fluoxetine potentiation by buspirone: three case histories. AB - The potentiation of fluoxetine by buspirone is described in three cases of treatment-resistant depression. All three patients improved markedly with very few side-effects from the medication. The possibility of synergy between drugs that affect serotonin reuptake inhibition, 5HT1A receptors and 5HT2 receptors is discussed. PMID- 1790523 TI - [Isolation and restraints: review of the literature and focus on their impact and normative component]. AB - Despite recent developments in psychopharmacology and a better understanding of agitation patterns in psychiatric patients, the use of isolation and restraint procedures remains a matter of daily practice. Little or no time is spent on its teaching in a formal way. There is almost no literatureton these issues, and it has grown only since legal procedures initiated by patients, which forced practitioners to spend some time analysing these methods. The article gives a succinct reflection of the literature of recent years which focuses more on the normative component, which should govern these procedures and a short analysis of their systemic impact. The review or awareness of certain variables may give clinicians a better perspective on the use of procedures which, unfortunately, continue to be the cause of deaths in psychiatric practice. PMID- 1790524 TI - Mania in the elderly. PMID- 1790525 TI - Ischemic and hemorrhagic cerebral lesions of the newborn. Current concepts. AB - Neonatal pathology comprises a large array of cerebral lesions due to ischemic and/or hemorrhagic mechanisms. Pathogenesis, neuropathology, clinical settings in the acute stages as well as short and long-term outcome are discussed. PMID- 1790526 TI - Multifocal dural arteriovenous shunts in children. AB - The authors present four consecutive cases of multiple dural arteriovenous (AV) shunts in children. This entity represents a rare but severe clinical situation. The etiology of the shunts is not known. There is clinical and radiological evidence that they are evolutionary lesions. The clinical presentation in this series was usually by cardiac manifestations (one case), cerebrospinal fluid disorders (two cases), neurological symptoms (three cases), including intracranial hemorrhage (two cases), and cranial bruits (four cases). No radical treatment leading to anatomical cure of all dural AV shunts was thought to be possible using current methods, including modern endovascular and surgical techniques, in any of the four cases. Therefore, treatment was only symptomatic and directed at some of the AV shunts. Targeted arterial embolization with permanent embolic agents represents the most rational technique for symptomatic relief in these patients. However, clinical recurrence often happens without evidence of recanalization. Secondary multifocal pial AV shunts opening into the abnormal sinus occurred in two of the cases; they may have been induced by venous sump from the sinus draining the dural AV shunts. Mechanical occlusion (or excision) in multiple dural AV shunts in children does not represent a satisfactory goal, as the shunts can be the expression of a more complex and yet unknown disease. PMID- 1790527 TI - Choroid plexus tumors in childhood. Histopathologic study and clinico pathological correlation. AB - Choroid plexus tumors are rare and account for only 2.3% (8/352) of primary childhood intracranial neoplasms in our series. Most of our patients were under 2 years of age. The tumors had a predilection for the lateral ventricle. Calcification was found in half of these tumors, and ossification was seen in 1 case. Histological features of malignancy including invasion, loss of differentiation, and severe nuclear pleomorphism pointed to a poor prognosis. Such features were found in 2 cases. Neither a large number of mitoses nor necrosis was a constant feature in cases of malignancy. Transthyretin, a marker for choroid plexus tumors, was positive in all cases. However, negative S-100 or positive carcinoembryonic antigen was not necessarily associated with a more aggressive histological pattern. All the papillomas could be totally resected without recurrence, and all the patients with carcinoma died within a few months. PMID- 1790528 TI - Serotonergic effects on carbonic anhydrase activity in the choroid plexus. AB - The carbonic anhydrase (CA) activities in the choroid plexus of dogs were investigated by electron microscopy, and the effects of 5-hydroxytryptophan (5 HTP) on them were examined to elucidate the participation of serotonin in the production of cerebrospinal fluid. The reaction products yielded by the method employed proved to be CA activity by elimination tests using acetazolamide (Diamox). Following administration of 5-HTP, the CA activities fell to 43.3% of the control value, that is, approximately 56% of the CA activities in the choroid plexus were affected by serotonin. When tetrabenazine (TBZ) was administered, the CA activities in the choroid plexus decreased to 22.4% of the control value. These results suggest that the CA activity in the choroid plexus is remarkably suppressed when nervous control of the choroid plexus is disturbed by the administration of a monoamine denervator such as TBZ. The present data indicate that the serotonergic inhibitory effect on the CA activity in the choroid plexus may be less predominant than that of TBZ and acetazolamide. PMID- 1790529 TI - Solitary eosinophilic granuloma of the pediatric skull and spine. The role of surgery. AB - Nine pediatric cases of solitary eosinophilic granuloma (EG) are reported. Six children harbored cranial lesions and three had spinal involvement. Plain radiographs and computed tomography scan were not always sufficient for diagnosis. Isotopic bone scan was useful to rule out multiple lesions. The authors' opinion is that surgical excision is the treatment of choice for cranial lesions, leaving radiotherapy for possible relapse. Management of EG of the spine should start with needle biopsy, followed by radiation therapy, surgery being indicated in selected patients with immediate risk of neural compression. Mean follow-up time was 4.4 years (longer than several reported series). At the time of revision all children were asymptomatic, and only one case presented a local recurrence that was managed by radiotherapy. PMID- 1790530 TI - Cerebral blood flow velocity changes after ventricular taps and ventriculoperitoneal shunting. AB - Transcranial Doppler ultrasonography (TCD) was performed on 14 patients with hydrocephalus (age range 1 day to 12 years old) before and after ventriculoperitoneal shunting. TCD was also performed with simultaneous intracranial pressure (ICP) measurements during ventricular taps through a reservoir in 7 patients. Measurements of the resistance index (RI) = (S-D)/S, peak systolic (S), enddiastolic (D) and time-averaged mean flow velocities were made. After ventricular taps and ventriculoperitoneal shunting there was a significant decrease in RI in all patients. This was due to a greater increase in D compared to S, which suggests a decreased distal cerebrovascular resistance. There was a significant correlation between RI and ICP in the older infants and children and in individual neonates. Successful cerebrospinal fluid diversion reduces ICP and cerebrovascular resistance, thus improving cerebral perfusion. The RI is a reliable index for serial monitoring of cerebrohaemodynamic change in patients with hydrocephalus. PMID- 1790531 TI - Optic chiasm glioma associated with inappropriate secretion of antidiuretic hormone, cerebral ischemia, nonobstructive hydrocephalus and chronic ascites following ventriculoperitoneal shunting. AB - An optic chiasm glioma may cause loss of vision, endocrine disturbances, hydrocephalus and cerebral ischemia due to its proximity to the pituitary, hypothalamus, III ventricle and internal carotids. A 3-month-old infant with optic chiasm glioma developed hypopituitarism and inappropriate secretion of antidiuretic hormone with plasma hypo-osmolality. The cerebrospinal fluid (CSF) protein concentration was markedly elevated. The impairment of fluid absorption via arachnoid villi and peritoneum by the high protein content, and reversed osmotic gradient between protein-rich CSF and hypo-osmolar plasma may have contributed to both nonobstructive hydrocephalus and recurrent ascites following ventriculoperitoneal shunting. Cerebral ischemia from carotid compression may have led to cerebral atrophy. PMID- 1790532 TI - Gelastic seizures treated by resection of a hypothalamic hamartoma. AB - A 7-year-old girl presented for evaluation of a peculiar kind of epilepsy. Her seizures began before 1 year of age and consisted of episodes of brief, uncontrolled and unprovoked laughter than with time progressed to include cursive, complex partial and generalized tonic-clonic seizures. Progressive impairment of cognitive functions was noted as well as precocious puberty. Neuroimaging examination disclosed a hypothalamic hamartoma. It was excised by a pterional approach, and no further seizures were noted. The authors propose direct surgery for the hypothalamic hamartoma as a treatment for this progressive syndrome. PMID- 1790533 TI - Hemifacial spasm in a child. AB - Hemifacial spasm in a 10-year-old child is herein reported. Computed tomography and angiography were normal. Magnetic resonance imaging showed an anomalous vascular structure, probably a redundant loop arising from AICA or PICA, which was identified at surgery. The spasm, presumably due to vascular compression at the root entry zone of the right facial nerve, promptly and completely remitted after surgical decompression, without functional deficits. Atypical clinical features, as well as pre- and postoperative neurophysiological findings supporting the microvascular compression theory, are discussed. PMID- 1790534 TI - [Changes in pulmonary vascular reactivity to adrenergic stimuli in congestive heart failure]. AB - Heart failure is associated with increased activity of sympathetic nervous system. As to the latter's effector organs, attention has been mainly drawn by heart and systemic circulation. In this study we investigated whether and how the neurogenic vasomotility of the lesser circulation is modified. Therefore, we compared 12 patients with heart failure in III NYHA functional class, with 10 subjects, undergoing hemodynamic study for diagnostic reasons and found to be normal. The neurogenic reactivity of pulmonary vessels was assayed by means of 2 sympathetic stimuli: arithmetic test (AT) and cold pressor test (CPT), performed both with and without obstruction to right heart venous return. This was obtained by expanding a balloon in inferior vena cava, in order to rid the neurogenic component of pulmonary vasomotility of the interference of the normally prevailing mechanical component (consisting in adaptations to flow variations). AT caused pulmonary vasodilation in normal subjects, as a passive consequence of the increase of cardiac output and, therefore, of pulmonary flow. Caval obstruction, by simply restraining this increase, induced a clearly neurogenic vasoconstrictor response. On the contrary, in failing patients, a slight vasodilation, independently from the condition of venous return, was observed. This took place in spite of the constant absence of any variations of cardiac output, which both indicates the reduction of myocardial function and helps to show the diminished nervous influence on pulmonary circulation. On the other hand, CPT had a vasoconstrictor effect in both groups, though potentiated by the reduction of transpulmonary flow in normal subjects only.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790535 TI - [The inhibitory effect of magnesium on mitochondrial calcium uptake in ischemic and reperfused rat hearts]. AB - Several studies suggest that the protection exerted by Mg2+ on the reperfused myocardium may be mostly due to its competitive effect with respect to Ca2+. The aim of this research was to evaluate the inhibitory action of Mg2+ on mitochondrial Ca2+ uptake in the reperfused myocardium. Hearts of male Wistar rats (250-300 g) were isolated and perfused by the Langendorff technique. Aerobic control hearts (n = 6) were perfused with a constant flow of 10 ml/min/g for 65 min. In a second group (n = 6) the hearts were aerobically equilibrated for 20 min, then subjected to 30 min of ischemia (98% reduction of coronary flow) and subsequently reperfused for 15 min at the same preischemic flow. The hearts of both groups were electrically stimulated at 300 b/min. Then, the hearts were pooled in groups of 2 each and homogenized for the isolation of mitochondria. One part of mitochondrial suspension was used to evaluate the respiratory function by a polarographic technique. The remaining part was incubated with fura-2/AM for 10 min at 30 degrees C in order to determine the kinetics of Ca2+ transport within mitochondria in the presence of succinate as substrate. Ca2+ uptake was reduced in the mitochondria of reperfused hearts with respect to control, particularly in the presence of elevated extramitochondrial Ca2+ concentrations (greater than 10 nM). On the contrary the initial rate of Ca2+ uptake was increased in the reperfused mitochondria.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790536 TI - [The structural organization of the human myocardium: the interrelation between myocardial fibers and interstitial connective tissue]. AB - The complex tridimensional structure of the human ventricular myocardium has rarely been studied in the past. In the normal heart, in the lapse of time of few weeks of the embryonic life, a radical transformation from a chaotic plexiform organization to a complex tridimensional structure occurs. From then on, the ulterior growth of the myocardial fibres will only be dimensional and quantitative, because the spatial geometry is to be considered definitive. The role of the interstitial connective tissue in following the development of the myocardium, possibly inducing or influencing it, is still unclear. We have performed an histologic study on serial sections of the ventricular mass of 7 human embryos and fetuses, from 5 to 20 weeks of gestational age. The sections have been evaluated for their morphologic characteristics as evidentiated by histochemical (PAS, trichrome, Gomori silver technique) and immunohistochemical (myosin, actin, desmin, myoglobin, vimentin, fibronectin, smooth muscle cell, endothelial factor VIII) stainings. The results show that myocardial growth is mantellar, proceeding from the epicardium toward the endocardium, with progressive structural organization in strata, variably related one to the other depending upon the considered site of the ventricular mass. The interstitium grows in parallel to the myocardial growth, beginning with a thin network surrounding each fibre that progressively in time is transformed in a complexly arranged and more densely packed structure. The collagen fibres appear initially at epicardial level, particularly around the coronary vessels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790537 TI - [Verification of the prognostic significance of a left-ventricular aneurysm after a first myocardial infarct]. AB - The prognostic implication of a left ventricular aneurysm after a first myocardial infarction has been assessed on a series of 64 patients (mean age 65 +/- 10 years; 55 males and 9 females) having a diagnosis of a left ventricular aneurysms made by the equilibrium gated radionuclide angiocardiography. The control group was composed by 80 patients (mean age 63 +/- 10 years; 65 males and 15 females) with first myocardial infarction and comparable clinical characteristics but without left ventricular aneurysm. Aneurysm was defined as a ventricular segment in phase with atria in the phase parametric imaging. A left ventricular ejection fraction less than 52% was diagnosed in 83% and in 49% of the patients with and without aneurysm respectively (p less than 0.0005). The study group also showed a higher use of digoxin (39% vs 21%; p less than 0.05) and a higher prevalence of ventricular arrhythmias (31% vs 12%; p less than 0.05). After 36 months, mortality was 34% and 17% in patients with and without left ventricular aneurysm, respectively (p less than 0.05). According to the logistic regression analysis, mortality was predicted by a left ventricular ejection fraction less than 52% (odd ratio = 1.91; confidence limits = 1.03-3.48) while neither left ventricular aneurysm nor any of the remaining variables (age, sex, site of the myocardial infarction, peak filling rate, congestive heart failure, ventricular arrhythmias and their Lown class) could affect survival. In conclusion, a left ventricular aneurysm has no prognostic implication after a first myocardial infarction provided that the patients are stratified for the left ventricular ejection fraction. PMID- 1790538 TI - [The clinical and prognostic significance of the infarct size in patients discharged after a myocardial infarct]. AB - The authors report their experience in the determination of the infarct size (IS) by means of enzymatic analysis in a series of 281 consecutive patients (230 males, 51 females) admitted to the CCU because of myocardial infarction (MI), who did not benefit from thrombolytic therapy in the acute phase. To obtain the enzymatic IS, the serum activity of creatine kinase (CK) is determined every 4 hours for 48 hours and after 72 hours; Sobel's formula is used and results are expressed as CK-g-Eq of tissue. The enzymatic IS was compared to the degree of left ventricular dysfunction (assessed by echocardiography); to the electrocardiographic extension of necrosis; to the severity of ventricular arrhythmias (expressed as Lown's class) on 24-hour Holter monitoring; to cardiac mortality at 2 years. Mean estimated enzymatic IS of the population under study was 129 +/- 101 g-Eq. Patients with extensive MI (216 +/- 144 g-Eq) had significantly (p less than 0.05) higher IS compared to patients with inferior (131 +/- 93 g-Eq), anterior (105 +/- 65 g-Eq) and non-Q wave MI (73 +/- 54 g-Eq); also, a statistically significant difference (p less than 0.05) was found between inferior and non-Q wave MI. Patients with severely compromised left ventricular function (defined as an echocardiographic ejection fraction less than 30%), had significantly higher values of IS compared to patients with preserved left ventricular function (171 +/- 130 vs 120 +/- 93 g-Eq; p less than 0.05). A poor correlation was found between enzymatic IS and ventricular arrhythmias documented at pre-discharge 24-hour Holter monitoring.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790539 TI - The CASTEL project (CArdiovascular STudy in the ELderly): protocol, study design, and preliminary results of the initial survey. AB - The CASTEL (CArdiovascular STudy in the ELderly) has been performed in order to evaluate the prevalence of hypertension of people aged 65 years or more, to evaluate the cardiovascular risk of elderly subjects from a general population, to verify the feasibility and effectiveness of a systematic continuous community based hypertension control program in the elderly, and finally to evaluate whether a population-based therapeutic intervention was able to extend to a great number of elderly hypertensive patients the benefits of a better control of hypertension. Only the preliminary results of the initial survey are described in this paper, since the final data collection will be available at the end of 1991. The prevalence of hypertension in elderly subjects of the CASTEL was 51.2% (44.6% for males, 52.2% for females), that of isolated systolic hypertension was 8.8% among the whole population sample (2254 subjects) and 23.4% among the subgroup of 850 hypertensives screened following the WHO criteria; 8 visits were performed during the initial screening and prevalence of hypertension regularly decreased from the first visit to the last one. Taking into consideration the mean of the last 2 blood pressure measurements performed during visit 8, average systolic blood pressure was 175.5 +/- 25.9 mmHg and diastolic 93.5 +/- 13.0 mmHg. Some correlations between blood pressure and other biological parameters are also discussed. PMID- 1790540 TI - [Nifedipine and gingival hypertrophy]. AB - Nifedipine-induced gingival hypertrophy is a rare side effect reported by the producers of this drug but, surely, not well known in all its aspects. In the present case report this pathology is studied in a patient treated with nifedipine for 30 months for cardiac angina, analyzing the histologic features, the therapy plain conducted for the hypertrophy and the most important pathogenetic theories formulated till now. PMID- 1790541 TI - Detection and assessment of insomnia. AB - Insomnia is one of the most common complaints encountered by the primary care physician. Yet, in many cases, physicians treat the symptom of insomnia rather than evaluating and treating the underlying causes of insomnia. Because the subjective complaint of insomnia does not always correlate with evidence of objective sleep disruption, a careful history and evaluation are required. Assessment of the duration of insomnia and quantification of the impact of nocturnal sleep disruption on daytime functioning provide the most reliable indices of severity. Primary insomnia may be due to a number of different causes, such as poor sleep hygiene or circadian rhythm disruption. Insomnia may also be the presenting symptom of other primary sleep disorders, such as sleep apnea syndrome or nocturnal myoclonus, or of a variety of medical or psychiatric illnesses. The treatment of the patient with insomnia should address the underlying cause, when identifiable. When the cause cannot be identified, treatment should be conservative; nonpharmacologic therapies should be used whenever possible. When pharmacologic approaches are indicated, short-acting benzodiazepines should be administered in concordance with strict prescribing guidelines. Frequent follow-up is necessary to ensure continued therapeutic efficacy of the prescribed therapy. PMID- 1790542 TI - Acute and short-term effects of nitrendipine and diltiazem at rest and during exercise in hypertensive patients. AB - The subjects were 30 patients with mild-to-moderate hypertension randomly assigned to receive 10 mg of nitrendipine twice daily or 60 mg of diltiazem thrice daily for 14 days. On days 1 and 14 the patients performed an effort test (to a maximum of 100 W) before and after drug administration. Both nitrendipine and diltiazem reduced systolic and diastolic blood pressure; after 14 days of treatment, the reductions in blood pressure were significantly greater in the nitrendipine-treated patients than in the diltiazem-treated patients. Blood pressures were reduced at maximum effort in both treatment groups before drug administration on day 14 compared with day 1. Two hours after drug administration on days 1 and 14, the reductions in effort blood pressures were significantly greater after nitrendipine than after diltiazem. No side effects were noted in either group. It is concluded that nitrendipine is safe and effective in patients with mild-to-moderate hypertension at rest and during exercise. PMID- 1790543 TI - Assessing equivalence of innovator and generic formulations of betamethasone dipropionate cream and ointment. AB - A series of tests was used to compare two formulations of the topical steroid beta-methasone dipropionate, Diprolene (manufactured by the innovator, Schering Corp.) and Topilene (a generic formulation, manufactured by Technilab). Cream and ointment formulations produced by both manufacturers were compared with respect to physicochemical characteristics, skin sensitivity in rabbits, and a vasconstrictor assay indicative of topical availability in man. The physicochemical tests revealed no differences between innovator and generic ointment formulations, whereas excipients varied widely for the cream products. Similarly, the ointment formulations were comparable on the skin sensitivity tests in rabbits, whereas the generic cream product was much more irritating than the innovator cream in this test. On the vasoconstrictor assay in man the ointments were comparable, while the activity of the generic cream was much lower (approximately 30%) than that of the innovator cream; this difference was highly statistically significant. The difference in vasoconstrictor activity of the two cream products is discussed in relation to the differences in their physicochemical properties. It is concluded that the generic Topilene cream is not interchangeable with the innovator Diprolene cream, and that both pharmacists and physicians should be very careful when substituting one topical steroid formulation for another. PMID- 1790544 TI - Metabolic effects of nitrendipine. AB - A randomized, double-blind, placebo-controlled study was conducted to evaluate the safety and clinical efficacy of nitrendipine in the treatment of isolated systolic hypertension in elderly patients. The subjects were 20 elderly patients with isolated systolic hypertension who received 20 mg of nitrendipine or placebo daily for 60 days. In the nitrendipine-treated patients, both systolic and diastolic blood pressures were reduced significantly during treatment (from a mean of 180 to 155 mmHg and 92 to 80 mmHg); heart rate did not change significantly. Standard laboratory test results did not change in either group during treatment and results of a posttreatment oral glucose tolerance test were similar in the two treatment groups. PMID- 1790545 TI - Treatment of presumed bacterial pneumonia in ambulatory children. AB - In a prospective, randomized, open study, a combination of trimethoprim and rifampin (TMP/R) 20 mg/kg/day was compared with ampicillin (AMP) 150 mg/kg/day, both given orally twice daily for 10 days, for the treatment of 60 children who had mild community-acquired pneumonia. The control group comprised 112 healthy children. The overall duration of the disease was 8.5 +/- 3.6 days in the TMP/R group vs 6.0 +/- 1.1 days in the AMP group. Fever persisted for 7.0 +/- 1.8 days in the TMP/R-treated patients vs 5.2 +/- 1.0 days in the AMP-treated patients. At the end of the 10 days, nasopharyngeal cultures were negative in all patients in the AMP group and in 25 of the 30 patients in the TMP/R group. These five patients were clinical and microbiologic failures. We conclude that in infants and children with mild community-acquired pneumonia, treatment with AMP for 10 days is more effective than treatment with a combination of TMP/R for clinical cure and eradication of bacterial pathogens. PMID- 1790546 TI - Ampicillin/sulbactam in lower respiratory tract infections: a review. AB - The pathophysiology and microbiology of lower respiratory tract infections are outlined and diagnostic and therapeutic problems considered. The use of sulbactam/ampicillin in the treatment of these infections is evaluated. The two drugs have similar pharmacokinetic characteristics; predictable and dose dependent peak serum concentrations of both agents are achieved after parenteral administration. More than 90% of strains of Staphylococcus aureus, Haemophilus influenzae, Moraxella catarrhalis, Klebsiella sp, Escherichia coli, and Acinetobacter sp were inhibited by ampicillin/sulbactam concentrations of 16/8 micrograms/ml. Serum concentrations of ampicillin and sulbactam were 18 to 28 micrograms/ml and 13 micrograms/ml, respectively, after intramuscular administration of 1 gm/0.5 gm of ampicillin/sulbactam and 58 micrograms/ml and 30 micrograms/ml, respectively, after intravenous administration of the same dose. Good distribution of ampicillin/sulbactam into lung tissue, sputum, and bronchial fluid has been demonstrated. In over 2,250 patients treated with ampicillin/sulbactam, the rate of discontinuance of treatment because of side effects was less than 1%. Satisfactory clinical and bacteriologic outcome has been reported in over 80% of patients treated with ampicillin/sulbactam. The cost of ampicillin/sulbactam treatment is generally lower than that of other comparable antibiotic regimens. PMID- 1790547 TI - Ofloxacin versus cephalexin in the treatment of skin, skin structure, and soft tissue infections in adults. AB - A multicenter study was conducted to compare the safety and efficacy of oral ofloxacin with that of cephalexin in microbiologic eradication of skin and skin structure pathogens and the clinical treatment of skin and skin-structure infections. The subjects, 335 adult patients with acute localized infections of the skin, skin structure, or soft tissue, were randomly assigned to receive 400 mg of ofloxacin orally every 12 hours or 500 mg of cephalexin orally every six hours for 10 days. At admission, 398 aerobic pathogens were isolated, the most common being Staphylococcus aureus (160 isolates), Streptococcus pyogenes (49), coagulase-negative staphylococci (30), Staphylococcus epidermidis (25), and Pseudomonas aeruginosa (10). Of 317 isolates tested against ofloxacin, 96% were susceptible, and of 325 tested against cephalexin, 85% were susceptible (P less than 0.001). Microbiologic and clinical outcome were evaluated in 73 ofloxacin treated patients and in 65 cephalexin-treated patients. The causative pathogens were eradicated in 95% of the ofloxacin group and in 92% of the cephalexin group. In the ofloxacin group, 75% were clinically cured and 23% improved, and in the cephalexin group, 74% and 23%, respectively. Drug-related adverse experiences were reported by 14% of the 161 ofloxacin-treated patients and by 11% of the 162 cephalexin-treated patients; gastrointestinal disturbances were reported by 8% and 7% and nervous system effects by 6% and 1%, respectively (P less than 0.05). It is concluded that both ofloxacin and cephalexin are safe and effective in the treatment of skin and soft-tissue infections. PMID- 1790548 TI - Efficacy and tolerability of enalapril (20 mg)/hydrochlorothiazide (12.5 mg) combination therapy in essential hypertension. AB - The efficacy and tolerability of a preconstituted formulation combining enalapril (20 mg) and hydrochlorothiazide (12.5 mg) were evaluated in patients with essential hypertension unresponsive to enalapril monotherapy (20 mg/day). The duration of this open-lable, multicenter, noncomparative trial was 12 weeks: a two-week washout period followed by ten weeks of active treatment. During the active treatment period, patients received enalapril alone (up to 20 mg/day) for six weeks. At the end of week 6, patients with supine diastolic blood pressure greater than 90 mmHg were treated with the enalapril/hydrochlorothiazide combination therapy (EN/HCTZ). Of the 147 patients who were entered into the study, 81 were not normalized with enalapril alone. At the end of the study period, blood pressure was normalized (supine diastolic blood pressure less than or equal to 90 mmHg) in 60 (74%) of the 81 patients who had received the EN/HCTZ combination. Overall, 86% of the patients achieved satisfactory blood pressure control with this therapeutic regimen. Adverse reactions were mild and transient. Six patients experienced undesirable effects, the most frequent of which was coughing (2 cases). Neither enalapril (20 mg/day) alone nor the EN/HCTZ combination had any significant influence on any of the metabolic parameters evaluated. No hypokalemia and no significant changes in serum lipids occurred in the course of the study. PMID- 1790549 TI - Differential effects of propentofylline on the production of cytokines by peripheral blood mononuclear cells in vitro. AB - The effects of the xanthine derivative propentofylline on the production of interleukin-6 (IL-6), interleukin-1 beta (IL-1 beta), and tumor necrosis factor alpha (TNF-alpha) by human peripheral blood mononuclear cells (PBMCs) were studied. When PBMCs were cultured with propentofylline in vitro, the production of IL-6 was markedly increased at concentrations of 0.1 to 3.0 mmol/L of propentofylline and the production of IL-1 beta was slightly increased at concentrations of 1.0 to 3.0 mmol/L. However, an insignificant increase in TNF alpha production was observed. When the effects of propentofylline on the production of IL-6, IL-1 beta, and TNF-alpha by OK-432-stimulated PBMCs were examined, IL-6 secretion was not significantly increased, whereas production of IL-1 beta and TNF-alpha were significantly suppressed in a dose-dependent manner. The results demonstrate that propentofylline has a differential effect on the production of IL-6, IL-1 beta, and TNF-alpha by PBMCs, and it is proposed that propentofylline may exert pharmacologic actions on the regulation of the production of cytokines in the central nervous system. PMID- 1790550 TI - Effects of ubidecarenone in an exercise training program for patients with chronic obstructive pulmonary diseases. AB - A study was undertaken to determine the usefulness of ubidecarenone in pulmonary rehabilitation in exercise training programs in the management of chronic obstructive pulmonary disease (COPD). The subjects were 20 patients with COPD who had been participating in an exercise training program for at least four weeks. The patients were randomly assigned either to receive 50 mg of oral ubidecarenone daily or to enter a control group during the program. Oxygen consumption, expired volume, and heart rate were measured during exercise tests before and after training. Maximum oxygen consumption increased 13% in the ubidecarenone-treated patients and 7% in the controls, and maximum expired volume increased 10% in each group. The increases were significant in the ubidecarenone group but not in the controls. Heart rate increased 2% in both groups. It is concluded that ubidecarenone deserves further evaluation in exercise training programs for patients with COPD. PMID- 1790551 TI - Milestones in clinical pharmacology. The adrenal gland. PMID- 1790552 TI - Perinatal mortality statistics in Harare 1980-1989. AB - Perinatal and neonatal mortality rates, in the Greater Harare Maternity Unit, which showed a modest decline from 1980 to 1985, have rise dramatically since then. Half of the rise in neonatal mortality rate is due to increased numbers and an increased mortality rate in babies of birth weight less than 1001g. There is also an increase in the numbers of deaths of large babies. There is a strong case for a broad-based on-going enquiry into the reasons for such changes. PMID- 1790553 TI - Residues of organochlorine pesticides in human milk from mothers living in the greater Harare area of Zimbabwe. AB - Residue levels of the chlorinated hydrocarbons p,p -DDT, p,p, -DDE, p,p TDE, p,p DDT, alpha-beta-gamma-hexachlorocyclohexane (HCH), heptachlor epoxide, dieldrin and polychlorinated biphenyls (PCBs) were determined in human milk of 40 Zimbabwean mothers living in the greater Harare area. Three municipal clinics and one main hospital were randomly selected as collecting points. The main organochlorine contaminants found in all the samples analysed were p,p -DDT and p,p -DDE and the mean levels of sum DDT and DDT/DDE ratio were 6 mg/kg milk fat and 0.74 respectively. In general, relatively low residue levels of alpha-beta ,gamma-HCH, heptachlorepoxide and dieldrin were detected in 58,100,63,13 and 65pc, respectively of all the milk samples analysed. Trace of the PCB congener 2,2,4,5,5'-pentachlorobiphenyl (PCB 101) were found in 15 samples and only one sample contained traces of 2,3',4,4',5-pentachlorobiphenyl (PCB 118). The results were examined with regard to health ad living condition of the mothers. From the small population observed around the greater Harare area--social status, educational background an living conditions could be described as important demographic variables influencing the frequency distribution of residual levels of sum DDT in the mother's milk. PMID- 1790554 TI - Effect of methanol extract from Monadenium Lugardiae on contractile activity of guinea-pig ileum. AB - A methanol extract from Monadenium Lugardiae was tested for contractile activity on the guinea-pig ileum using the transmural stimulation method. Results obtained showed that the extract exhibited notable activity on the guinea-pig ileum contraction. Higher concentrations, however, showed inhibitory effect on the guinea-pig ileum contraction as well as its response to transmural stimulation. PMID- 1790555 TI - Comparative study of glycosylated haemoglobin and serum fructosamine values in children with protein-energy malnutrition. AB - Serum fructosamine, glycosylated haemoglobin (HbAic), fasting blood glucose and serum proteins were determined in 50 malnourished children aged 1-5 years and in 25 healthy and nutritionally normal children of the same age group. It was observed that both HbAic and fructosamine values correlated well with the blood glucose values of the patients. It was also observed that the patients had significantly elevated values of HbAic, indicating the existence of glucose intolerance in them. In contrast, the fructosamine values were significantly reduced in the patients and this was attributed to the hypoproteinaemia in such patients. It was concluded that while both HbAic frustosamine correlate well with blood glucose values, HbAic gives a better reflection of the glycaemic status of malnourished children because its level is not significantly altered by hypoproteinaemia. HbAic measurement may, therefore, be a more reliable indicator of glucose status than serum fructosamine in children with protein-energy malnutrition. PMID- 1790556 TI - Renal function in non-insulin dependent--diabetes mellitus. AB - Creatinine clearance, urinary specific gravity after water deprivation and fractional excretion of sodium, potassium and phosphate were measured in 28 patients with uncomplicated non-insulin dependent diabetes mellitus. Defective concentrating capacity was found in 46pc of the patients and 21pc had decreased glomerular filtration rate. Renal handling of sodium was normal in the patients but they showed a tendency for renal retention of potassium. Glycosuric patients showed marked phosphaturia. PMID- 1790557 TI - The prognostic value of serum immunoglobulin G and immune complex levels in acute lymphoblastic leukaemia. AB - Twenty-five newly diagnosed patients with acute lymphablastic leukaemia and an equal number of controls matched for age and sex were admitted to this study. Serum immunoglobulin G concentration was determined by single radial immunodiffusion and immune complex level by polyethylene glycol precipitation. The patients had significantly higher immune complex and lower immunoglobulin G levels than the controls. No significant correlation was observed between length of survival and serum concentrations of immunoglobulin G or immune complexes in patients who died during the period of study. Decreased immunoglobulin G and raised immune complex levels reduce the ability to mount an immune response and imply bad prognosis. However, their practical value for estimating the length of survival in acute lymphoblastic leukaemia is limited. PMID- 1790558 TI - Dystrophic epidermolysis bullosa with toe nail deformities--report of a case in Benin City, Nigeria. AB - We report the first case of Dystrophic epidermolysis bullosa with toe nail deformities in a Nigerian child in Benin City. The patient had characteristic dermolytic bullae on the skin and upper gastrointestinal tract mucosa with conjunctivities, dystrophic lesions of the toe nails and dysplastic teeth. PMID- 1790559 TI - Drug utilisation, supply and expenditure at Chitungwiza, Gweru, Mpilo, Parirenyatwa and United Bulawayo Hospitals in one year (1987-1988). AB - From 1987 to 1988 a total of 759,602 items were supplied to the five hospitals at a cost of Z$4,603,256.17. Over that period 373,203 (49.13pc) were supplied by the Government Medical Stores (GMS) at a cost of Z$1,341,675.32 while 386,399 (50.87pc) of the items were supplied by the Private Sector (PS) at a cost of Z$3,261,580.85. The disease pattern in hospitals' main causes of admission was used as a parameter to indicate the rationality of drug use and expenditure. The defined daily dose (DD), was used as a standard of comparison on drug usage at the five hospitals. Anti-infectives ranked highest in both use and expenditure in most hospitals while cytotoxics and vitamins respectively accounted for the highest expenditures and usage at Parirenyatwa hospital. The source of drug supplies to the hospitals was mainly the PS. Foreign currency shortages and the ineffective distribution system in the GMS seem to play an important factor in the provision and the utilisation of drugs in the public sector. In the public sector, physicians often prescribe expensive brand name products rather than the corresponding generic drugs. PMID- 1790560 TI - Epidemiology of household medications in urban Gweru and Harare. AB - A questionnaire to evaluate the epidemiology of household medications was verbally administered to 498 households in urban Gweru and Harare. Self medication was common in 95pc of the households. The average number of drugs per household was four. The commonest items encountered were analgesics, cough, cold and sore throat preparations, dermatologicals, gastrointestinals and antimalarials. The majority of the respondents usually chose an appropriate drug for a particular symptom. The sources of the medications found in the households were chemist/pharmacy, shop/supermarket, hospital/clinic, friends and relatives. PMID- 1790561 TI - A cross-sectional study on the prevalence and intensity of schistosomiasis among sugar cane cutters in Zimbabwe. AB - A schistosomiasis prevalence and intensity survey was carried out among sugar cane cutters of Hippo Valley and Triangle, the two largest irrigated sugar estates in Zimbabwe. Urine and stool specimens were collected for determination of schistosomiasis infection from 1995 cane cutters. A total of 315 (15.8pc) cutters were found to be infected with Schistosoma mansoni while 163 (8.2pc) were found to be positive for S. haematobium. The arithmetic mean egg count (AMEC) and geometric mean egg count (GMEC) for the different age groups into which the cane cutters were divided was calculated. The prevalence and intensity of S. mansoni increased with age while the opposite was true for S. haematobium. The factors contributing to this observation are discussed. PMID- 1790562 TI - Health for all--interpretation of meaning by newly qualified general and staff certified nurses. AB - Zimbabwe adopted P.H.C. approach in 1980 in order to provide equitable distribution of health services and to achieve H.F.A. In 1985 new Nursing education curriculae were introduced to orient student nurses and their teachers to this approach. Between 1986 and 1990 a study was conducted in which 416 newly qualified General and State Certified Nurses answered a comprehensive questionnaire relating to how the nurse training programme prepared them for their work. One question from the self administered questionnaire required them to state their interpretation of H.F.A. and indicate whether they believed that such a goal was achievable by the year 2000. Over 50 pc of respondents from the new curriculae interpreted H.F.A. as physical and financial accessibility of health services and that this goal was not achievable by the year 2000. The interpretation by candidates from the old curriculae was divided among four concepts and over 50% of the respondents believed that the goal was achievable by the target date. PMID- 1790563 TI - New trends in chloroquine efficacy in the treatment of malaria: chloroquine resistant Plasmodium falciparum in Anambra and Benue States of Nigeria. AB - Increasing malaria treatment failures with chloroquine (C25) and reports of chloroquine resistant Plasmodium falciparum (CRPF) led to the field survey of two sites (Agbani and Jato-Aka) both in Primary Health Zone A, using WHO--in vivo seven-day test, modified to 14-day follow-up period. Of the 922 children studied, high transmission rates of 40 pc and 59.2 pc were found in Agbani and Jato-Aka respectively. Varying degrees of parasitologic failures (CRPF), 52 pc in Agbani and 60 pc in Jato-Aka were confirmed. However, chemotherapy with C25 significantly reduced the clinical symptoms of malaria infection, even in the CRPF-cases. The clinical success in the two study sites were 69 pc ad 94 pc respectively. PMID- 1790564 TI - Serotype variation in vibrio cholerae el tor diarrhoea in northern Nigeria. AB - Serotyping of Vibrio cholerae organisms causing epidemics in Zaria and environs since 1975 to 1986 shows that Hikojima serotype was prevalent from 1976-1978, but Ogawa became prevalent from 1984 till 1986. The internal and external pressures responsible for these selections are unclear. PMID- 1790565 TI - The case of a salesman with recurrent chest infection and a loud cough. PMID- 1790566 TI - WHO statement on the oil spill in the Gulf. PMID- 1790567 TI - Is intravenous lidocaine clinically effective in acute migraine? AB - We performed a prospective, randomized, double-blind, placebo-controlled trial of intravenous lidocaine (1 mg/kg) in the treatment of acute migraine. Thirteen subjects were randomly allocated to receive intravenous lidocaine and 12 received intravenous normal saline. Subjects scored the intensity of headache and nausea on separate visual analogue scales before the injection and at 10 and 20 min after injection. At 20 min, the mean pain intensity score was 80% of initial intensity in the lidocaine group and 82% in the placebo group. The difference was not statistically significant; at 20 min, the 95% confidence interval for the difference between the two groups in mean percentage of initial pain score was 2 +/- 29%. At the dose studied, intravenous lidocaine has, at best, only a modest effect in acute migraine. PMID- 1790568 TI - Elevation of plasma vasopressin in spontaneous migraine. AB - Vasopressin is a vasoactive hormone secreted from the posterior pituitary. At low concentration its role is in regulating renal water excretion, but at higher concentrations it has a number of extrarenal actions, including effects on blood flow. To investigate the role of vasopressin in spontaneous migraine, paired samples were collected from 14 subjects (a) during an acute attack of spontaneous migraine, and (b) when symptom-free for at least seven days. During an attack, vasopressin was consistently raised (median (range) 3.5 (1.2-9.6) pg/ml v 0.5 (0.5-1.1) pg/ml, p less than 0.001). The highest vasopressin concentration occurred in the only patient who vomited. The results suggest vasopressin rises during an attack of spontaneous migraine, and this may, in part, be related to emesis. In the majority, vasopressin levels only rose sufficiently to have some renal antidiuretic effect, although in some these levels could have been sufficient to cause alteration in peripheral blood flow. Release of vasopressin may be responsible for the facial pallor and antidiuresis observed in migraine. PMID- 1790569 TI - Long-term results of migraine prophylaxis with flunarizine and beta-blockers. AB - We followed-up 64 migraine patients after discontinuation of successful interval prophylaxis with flunarizine, propranolol or metoprolol, to investigate how long the therapeutic success would last, if further prophylaxis would be successful again, and what factors would influence the prognosis. We found that 16 out of 64 patients experienced a lasting reduction of migraine frequency, whereas 48 patients did improve initially, but later experienced a relapse. Further prophylaxis was effective in 29, poorly effective in 11, and ineffective in 8 of these patients; in 7 of the 8 non-responders prophylaxis was not changed. Negative prognostic factors were frequent attacks, a history of analgesic abuse and/or analgesic withdrawal therapy and ineffective previous prophylaxis. In conclusion, the therapeutic success decreases dramatically in the majority of patients several months after discontinuation of prophylaxis; further prophylaxis is more effective if the substance class is changed; increased analgesic intake is the most important prognostic factor. As a strategy for migraine prophylaxis we propose sequential changing of interval prophylaxis or--in patients with negative prognostic factors--long-term prophylaxis. PMID- 1790570 TI - Cerebrovascular risk factors in migraine with prolonged aura and without aura. AB - The role of cerebrovascular risk factors such as mitral valve prolapse, platelet aggregation, platelet activation and cardiac arrythmias in migraine was investigated in a total of 44 migraineurs (32 migraineurs without aura and 12 with prolonged aura) and 32 controls. Comparing the total of migraineurs and the two subgroups with controls, mitral valve prolapse, a raised thromboxane B2 level, at least one platelet aggregation dysfunction or an abnormality in 24-h ECG was statistically seen no more often than in the control group. Neither did combinations of the variables occur more frequently. Altogether, this study showed no increased coincidence of migraine with prolonged aura and migraine without aura with the above parameters. The absence of cardiac and haematological abnormalities in migraine with prolonged aura focuses attention on the control of the cortical microcirculation. PMID- 1790571 TI - MMPI personality profiles in patients with primary headache syndromes. AB - The role of psychological factors in the course of primary headache syndromes is still controversial. Using the Minnesota Multiphasic Personality Inventory (MMPI) we investigated the personality profiles of 434 headache patients (160 migraineurs, 95 with tension type headache, 30 with cluster headache and 149 with combination headache) in accordance with the IHS criteria. In the first three MMPI scales (hypochondria, depression, hysteria) there was a slight increase in T mean values to over 60, but still in the range of two standard deviations of the normal population. There were no statistically significant differences between the four headache groups and between patients with and without analgesic abuse. It was impossible to distinguish headache groups on the basis of their personality profiles by means of reclassification with discriminant analysis. In a cluster analysis, patients with cluster headache showed the highest number (20%) of abnormalities, but also the highest percentage (13%) of completely normal results. Our findings--a cross section analysis of personality profiles- contradict many other MMPI-based studies. PMID- 1790572 TI - Meningeal enhancement and low CSF pressure headache. An MRI study. AB - A 34-year-old woman developed severe and incapacitating positional headaches two weeks following a minor head trauma. Lumbar punctures demonstrated unmeasurable or very low CSF pressures. Gadolinium-enhanced cranial MRI showed diffuse enhancement of thickened meninges, suggesting inflammation. One year later, MRI was normal. PMID- 1790573 TI - Brainstem auditory evoked potentials in migraine after Rausedyl provocation. AB - Brainstem auditory evoked potentials were recorded in 34 migraine patients (21 F and 13 M, mean age 37.4 +/- 8.1 years) after Rausedyl (2.5 mg reserpine) provocation. Intramuscular injection of reserpine induces a typical headache in migrainous controls. The findings were compared with those of 40 healthy controls (25 F and 15 M with a mean age of 40 +/- 8.9 years). We evaluated I, III, V and I III, III-V, I-V peak and interpeak latencies. We did not find significant differences after provocation in the control group. In the migraine group, V waves were delayed significantly and consecutively I-V interpeak latencies were increased. Our results indicate an impairment of the rostral brainstem function after reserpine provocation in migraine patients. PMID- 1790574 TI - Migraine in patients with history of centro-temporal epilepsy in childhood: a Hm PAO SPECT study. AB - The authors report the results of a retrospective controlled study on the incidence of migraine in centro-temporal epilepsy compared to absence epilepsy, partial epilepsy and a group of patients with cranial trauma without epilepsy. The following observations from this series of 129 patients were made. Migraine was present in 63% of the patients with centro-temporal epilepsy (rolandic epilepsy), in 33% with absence epilepsy, in 7% with partial epilepsy and in 9% of the cranial trauma group. These results suggest that the association of centro temporal epilepsy and migraine is non-fortuitous and also to a lesser degree in absence epilepsy. The role of neurotransmitters in this association is discussed. No decrease in cerebral blood flow was observed in 12 patients with rolandic epilepsy on a Hm-PAO SPECT study. PMID- 1790575 TI - Measles outbreak--Baffin region, Northwest Territories. PMID- 1790576 TI - Measles outbreak--Ungava region, Quebec. PMID- 1790577 TI - On the effect of lysophosphatidylcholine, platelet activating factor and other surfactants on calcium permeability in sarcoplasmic reticulum vesicles. AB - The effect of low concentrations of lysophosphatidylcholine (LPC), platelet activating factor (PAF) and other surfactants (Triton X-100, C12E8, sodium dodecyl sulfate, sodium cholate and sodium deoxycholate) on membrane permeability of native sarcoplasmic reticulum vesicles and sarcoplasmic reticulum lipid vesicles, has been studied. Triton X-100, C12E8, sodium dodecyl sulfate, sodium cholate and sodium deoxycholate were all able to permeabilize membranes at concentrations of surfactants below their critical micellar concentration (CMC) in both lipid and native vesicles, being the K0.5 of calcium release from native vesicles lower than that from lipid vesicles. The values of these K0.5 were well correlated with the corresponding CMC values for each type of membrane. However, both LPC and PAF behaved in a different way since, although they induced permeabilization of the native vesicles at values of K0.5 close to their CMC, their K0.5 values for permeabilizing vesicles, prepared by using lipids extracted from sarcoplasmic reticulum, were much higher than their corresponding CMC. PMID- 1790578 TI - Fluorescence properties of methyl 8-(2-anthroyl) octanoate, a solvatochromic lipophilic probe. AB - Fluorescence excitation and emission spectra, relative fluorescence quantum yield phi r and fluorescence lifetime tau of methyl 8-(2-anthroyl)-octanoate have been studied in a set of organic solvents covering a large scale of polarity and in the presence of water. In this probe, the 2-anthroyl chromophore exhibits quite remarkable and unique fluorescence properties. Thus, when going from n-hexane to methanol, the maximum emission wavelength lambda em max shifts from 404 nm to 492 nm while phi r and tau increase from 1 to 17.7 and from 0.91 ns to 13.5 ns, respectively. These increments are still more accentuated in the presence of water with estimated values of 526 nm for lambda em max, 27 for phi r and 20 ns for tau in this solvent. Because of the presence of a keto group which is a hydrogen bond acceptor and which can conjugate with the aromatic ring so as to provide the chromophore with a high dipole moment, the fluorescence properties of the probe strongly depend on the polarity of the surrounding medium. They can be accounted for in terms of general solvent effects (dipolar solute/solvent interactions) in the presence of aprotic solvents and in terms of specific solvent effects (hydrogen bonding) in protic solvents. Such properties of solvatochromism make the 2-anthroyl chromophore, after 8-(2-anthroyl)octanoic acid has been attached to phospholipids (E. Perochon and J.F. Tocanne (1991) Chem. Phys. Lipids 58, 7-17) a potential tool for studying microenvironmental polarity in biological membranes. PMID- 1790579 TI - Purification of surfactant protein A from dog lung by reconstitution with surfactant lipids. AB - We have developed a simple method for purification of surfactant major apoprotein (SP-A, MW 34-38 kD) from dog lungs with high yield and purity. Lipids and proteins of partially purified surfactant were dissociated by sodium deoxycholate (DOC, 100 mM, 37 degrees C, 30 min), diluted 1:10 with borate buffer containing 3 mM CaCl2, and dialysate in the same buffer to reconstitute the lipids and proteins (4 degrees C, 48 h). The reconstituent and the partially purified surfactant were purified by ultracentrifugation on a discontinuous sucrose density gradient. Protein was isolated from the reconstituent and from the purified surfactant by delipidation, and the yields and purities were assessed by one-dimensional SDS-PAGE and 2-dimensional electrophoresis (isoelectric focusing, SDS-PAGE). We found that the surface pressure-time adsorption isotherm, minimum surface tension, and the yield and composition of lipids of the reconstituent were identical with those from the purified surfactant. Only about 0.25% of the DOC used for dissociation remained with the reconstituent and it did not affect surface properties of the reconstituent. The yield of SP-A in the reconstituent was almost the same as that in the purified surfactant, but the former contained no plasma protein whereas the latter contained significant amounts. The amino acid composition and the partial N-terminal amino acid sequence of SP-A were the same as those from the purified surfactant. Reconstituent prepared from surfactant lipids and SP-A adsorbed more rapidly and reached a higher final surface pressure than did the surfactant lipids alone. These results demonstrate that large quantities of SP-A can be purified by reconstitution with surfactant lipids, and that the purified protein is biophysically active. PMID- 1790580 TI - A continuous fluorometric assay for phospholipase C from Clostridium perfringens. AB - A fluorescent assay for Clostridium perfringens phospholipase C is described using 1-palmitoyl-2-[6(pyren-1-yl)hexanoyl]-sn-glycero-3- phospho-N (trinitrophenyl)aminoethanol (PPHTE) as the substrate. This method is based on the decrease of the quenching of pyrene monomer fluorescence when phospholipase C hydrolyzes PPHTE into pyrenediglyceride and phospho(trinitrophenyl)-aminoethanol. The hydrolysis of egg lecithin/PPHTE (25:1 molar ratio) substrate by C. perfringens phospholipase C was linear with time for at least 2 min. Optimal conditions for the hydrolysis by phospholipase C were 50 mM Tris-HCl pH 7.0-30 mM CaCl2/63 microM egg lecithin and 2.5 microM PPHTE. The Km and Vmax values for the hydrolysis of egg lecithin/PPHTE vesicles were 28 microM and 280 pmol min-1, respectively. The detection limit of the assay was 40 microU of C. perfringens phospholipase C. When diglyceride was included into egg lecithin/PPHTE vesicles up to 30 mol% the reaction velocity increased 13-fold. Higher molar proportions of diglyceride were inhibitory. When the hydrolysis of mixtures of different naturally occurring phospholipids and PPHTE was studied egg lecithin was found to be the best substrate. When dipalmitoylphospholipids with different polar head groups were used the reaction velocity decreased in the order egg lecithin greater than or equal to dipalmitoylphosphatidylserine greater than dipalmitoylphosphatidic acid greater than dipalmitoylphosphatidylcholine greater than dipalmitoylphosphatidylglycerol. PMID- 1790581 TI - The use of microwave oven for the rapid hydrolysis of bile acid methyl esters. AB - An efficient and convenient procedure for the hydrolysis of bile acid methyl esters is described. This is achieved by the addition of aqueous lithium hydroxide in methanol/dioxane/tetrahydrofuran (or dimethylformamide) in the microwave oven. Under these conditions the formates as well as the acetate derivatives prepared under microwave irradiation conditions were also hydrolyzed, and the desired bile acids were isolated in 86-94% yield. All these reactions were completed in the microwave oven within 45-60 s. PMID- 1790582 TI - A preschool child psychiatric service: referral patterns and service uptake. AB - A study of referrals to a preschool child psychiatric service found that, although the commonest problem behaviours were similar to those found in community surveys of under-five-year-olds, the levels of child disturbance, maternal mood disorder and atypical family structure were much higher than in the community. It therefore seemed that the service was being used appropriately to seek help for families with multiple, severe and/or persistent problems. A quarter of the sample failed to attend the initial appointment, of whom over a third refused home assessment. There were no clear differences between those attending or failing to attend for assessment, but some suggestion of lower symptom levels in the latter. PMID- 1790583 TI - Developmental and social factors in Nigerian children's accidents. AB - Accidents to children are discussed in terms of developmental and social factors in Nigeria. The types of accidents involving children and age trends in accident incidence are reported. Physical, perceptual, cognitive and social development are discussed. Social factors identified are family variables, the physical environment, and attitudes and folk beliefs. PMID- 1790584 TI - Occupational therapy intervention guidelines for children and adolescents with spina bifida. AB - Children and adolescents with spina bifida present with a number of characteristics that affect functional performance and developmental skills. The focus of this paper will be to share information about spina bifida and the overall approach to care within the Glenrose Rehabilitation Hospital Spina Bifida Clinic and, more specifically, the role of the occupational therapist. PMID- 1790585 TI - Developmental changes in the presence of ecdysteroid receptors in the central nervous system of third instar larvae of Sarcophaga bullata. AB - Radiolabeled ponasterone A, a high affinity ligand for ecdysteroid receptors which agonises the effects of 20-hydroxyecdysone, was used in combination with thaw-mount autoradiography to study the stage-specific presence of ecdysteroid receptors in the central nervous system of Sarcophaga bullata. In third instar larvae, nuclear high affinity binding of tritiated or iodinated ponasterone A occurs in the same target cells and both radioligands were displaced by an 100 fold excess of unlabeled ponasterone A or an 500-fold excess of 20 hydroxyecdysone. Target neurons for ponasterone A appear first in the third instar larvae on day 4.0 (early wandering stage) where many cells of the perineurium, ring gland, lateral neurosecretory cells in the brain and certain neurons in abdominal ganglia exhibit nuclear high-affinity binding for ponasterone A. At day 5.5 after larviposition, less binding is present in the perineurium but many neurons, including certain neurosecretory cells in the pars intercerebralis, pars lateralis, tritocerebrum, and neurosecretory cell groups 7, 8, 9, and 10 of the dipteran suboesophageal and abdominal ganglia show increased nuclear ecdysteroid binding. At this stage nuclear binding also occurs in the ring gland except in the central corpus allatum and for the first time in the neurons of the inner optic lobes. The results show that ecdysteroid receptors are present in distinct cerebral neurons and that their expression or ecdysteroid binding capability is under developmental control. PMID- 1790586 TI - Developmental neuron-glia interaction: role of the serotonin innervation upon the onset of GABA uptake into the ependymocytes of the rat subcommissural organ. AB - The subcommissural organ (SCO) of the rat allows the analysis of neuron-glia interactions, in vivo, during the maturation of the brain. The SCO contains a single glial cell type which receives a homogeneous serotonin (5-HT) innervation. The onset of gamma-aminobutyric acid (GABA) uptake transport into the SCO ependymocytes is dependent on the 5-HT innervation since destruction of this innervation, at birth, or transplantation of newborn rat SCO ependymocytes to the fourth ventricle of adult host rats prevented the appearance of [3H]GABA uptake as visualized by autoradiography. PMID- 1790587 TI - Intraretinal pathfinding of ganglion cell axons is perturbed by a monoclonal antibody specific for a G4/Ng-CAM-like cell adhesion molecule. AB - To identify molecular components involved in directed axonal outgrowth and in neural pattern formation, hybridoma technology was employed using the visual system of the chicken as a model system. Using cell surface protein fractions as immunogens, we obtained the monoclonal antibody mAb C4, which binds to a 135 kDa cell surface glycoprotein of the high-mannose or complex type. Within the retina, the C4 antigen is found exclusively in the optic fiber layer. Immuno-double labeling of retinal whole mounts with a glial marker and mAb C4 suggests that the C4 antigen is restricted to ganglion cell axons but not found on Muller glial endfeet. Biochemical and histological data reveal similarities between the C4 antigen and G4/NgCAM. Addition of mAb C4 to retina explants cultured on a striped carpet of tectal cell membranes leads to defasciculation of outgrowing axons, suggesting that the C4 antigen serves as an axon cell adhesion molecule (Ax-CAM). Axon elongation on neighboring axons can be also inhibited by the application of mAb C4 to embryonic retina whole mounts in vitro. The aberrant axon growth into incorrect retina layers observed under these conditions suggests that the C4 antigen functions as a guiding cue for the generation of the retinal optic fiber layer. PMID- 1790588 TI - Transneuronal degeneration of thalamic neurons following deafferentation: quantitative studies using [3H]thymidine autoradiography. AB - Transneuronal degeneration of thalamic neurons following partial deafferentation was studied using [3H]thymidine autoradiography. Timed-pregnant female Sprague Dawley rats received systemic injections of [3H]thymidine on embryonic day (E) 13, 14 and/or 15. On the day of birth, pups were anesthetized by hypothermia and subjected to unilateral enucleation, unilateral removal of the inferior colliculus or sham lesion. Animals were sacrificed on postnatal day 10 or 30 and the brains processed for autoradiography. Material from sham-lesioned animals demonstrates that neurons destined for the dorsal lateral geniculate nucleus (LGd) undergo final mitoses on E13, 14 and 15. Neurons in the ventral medial geniculate nucleus (MGv) undergo final mitoses on E13 and 14. Thirty days following neonatal unilateral eye removal, the contralateral LGd displays a loss of approximately 30-35% of [3H]thymidine labeled neurons. Neonatal unilateral removal of the inferior colliculus results in a loss of approximately 30-40% of labeled neurons in MGv. For both LGd and MGv, shorter survival times reveal less severe cell loss. Late generated (E15) LGd neurons show less severe loss following enucleation than do earlier generated neurons. These results document the degree of cell loss in sensory thalamic nuclei following deafferentation and demonstrate that [3H]thymidine autoradiography provides a useful quantitative method for assessing anterograde transneuronal cell loss in targeted populations of neurons in the developing central nervous system. PMID- 1790589 TI - Neonatal nicotine exposure induces permanent changes in brain nicotinic receptors and behaviour in adult mice. AB - The effects of neonatal nicotine exposure on spontaneous and nicotine-induced behaviour in 4-month-old mice and on the development of brain nicotinic receptors were studied. The behaviour study showed that mice treated with nicotine 66 micrograms (-)nicotine base/kg body weight (bw) s.c. twice daily between 10 and 16 days postnatally displayed a hypoactive condition, whereas mice treated with saline displayed a hyperactive condition. When the nicotinic receptors in the brain cortex were analyzed, the displacement curves for [3H]nicotine(-)nicotine revealed an almost equal proportion of high- and low-affinity binding sites in 17 day-old mice, while the high-affinity sites predominated in 4-month-old mice, with affinity constants for both high- and low-affinity binding sites 10 times higher in 4-month-old mice than in 17-day-old-mice. A decrease in the number of nicotinic receptors was observed from day 17 to 4 months, mainly of the low affinity nicotinic type. Interestingly, the displacement curves in neonatally nicotine-treated mice showed only one population of high-affinity binding sites in 17-day- and 4-month-old mice though the total binding sites in 4-month-old mice were the same for the neonatally nicotine-treated and saline-treated mice. These results indicate that neonatal nicotine treatment prevents the development of low-affinity nicotinic sites in the brain and this earlier exposure to nicotine induces a different behaviour response in adult animals to a test dose of nicotine. Days 10-16 postnatally appear to be a critical period for the effects of nicotine on the brain. PMID- 1790590 TI - Ontogeny of cells containing estrogen receptor-like immunoreactivity in the Brazilian opossum brain. AB - In this study, we have used the Brazilian short-tailed opossum (Monodelphis domestica) as a model to study the ontogeny of estrogen receptors in the mammalian brain. Monodelphis is a small, pouchless marsupial which breeds well under laboratory conditions and whose young are born in an immature sexually undifferentiated state. The Abbott H222 monoclonal rat estrogen receptor antibody (gift of Abbott Laboratories) was utilized in an indirect immunohistochemical procedure to detect estrogen receptors in developing opossum brains. Estrogen receptors were first expressed in the dorsomedial and ventromedial hypothalamus of the opossum 10 days after birth (10PN). Most regions that contained estrogen receptor-like immunoreactivity (ER LI) in the adult opossum contained ER LI at 15 PN. These areas include the lateral septum, medial preoptic area, bed nucleus of the stria terminalis, periventricular preoptic area and hypothalamus, amygdala, dorsomedial and ventromedial hypothalamic nuclei, arcuate nucleus, ventral premammillary nucleus, and the midbrain central grey. The number of cells that contain ER LI increased through 60PN in all regions that will contain ER LI in the adult opossum. These results indicate that estrogen receptors are present in early development of the Monodelphis brain and may mark the beginning of a critical period for sexual differentiation of the opossum brain. PMID- 1790591 TI - Spatial-temporal appearance of developing immunoreactive TRH neurons in the neuroepithelial wall of the diencephalon. AB - Using an anti-pro-thyrotrophic hormone-releasing hormone (TRH) serum for immunohistochemical analysis, we examined the ontogenesis of TRH-producing neurons in the rat diencephalon, and distinguished three waves in the neurogenesis corresponding to the time and place of their origin. The first wave started on day 12.5 of embryonic age (E12.5); the neurons appeared within the neuroepithelium in both the anterior and posterior walls of the optic recess. These cells then migrated anteriorly into the marginal layer of the developing preoptic area (group 1 cells) and posteriorly into the hypothalamus (group 2 cells). The second and third waves occurred on E13.5-14.5 and E16.5-17.5, respectively. We named the cells that appeared in the neuroepithelium of the anterior portion of the hypothalamus as group 3 and 5 cells, and those in the posterior portion as group 4 and 6 cells. Group 1 and 3 cells generated the lateral and medial preoptic TRH neurons, and group 2 and 4 cells generated the cells in the lateral hypothalamic nucleus. Group 6 cells were involved in the development of the dorso-medial hypothalamic nucleus. Group 5 cells gave rise to the hypophysiotrophic secretory neurons in the parvocellular paraventricular nucleus. The cells derived from each cell group showed distinct morphological characteristics. These findings suggest that the ventricular wall of the hypothalamus is protomapped in a spatial-temporal manner to generate TRH neurons with distinct functional properties. PMID- 1790592 TI - Arachidonic acid cycloxygenase and lipoxygenase pathways are differently activated by platelet activating factor and the calcium-ionophore A23187 in a primary culture of astroglial cells. AB - The aim of our study has been to investigate the metabolism of endogenous arachidonic acid or that of radiolabeled arachidonate in astroglial cells, stimulated with platelet activating factor (PAF) and with the calcium-ionphore A23187. Primary cultures of astroglial cells were obtained from brain cortex of one-day-old rats and were characterized by immunofluorescent staining vs glial fibrillary acidic protein. In labeled cells, diacylglycerol was formed after stimulation with platelet activating factor, whereas mainly the release of labeled arachidonic acid from phospholipids was observed after stimulation with calcium-ionophore. Both PAF and the calcium-ionophore A23187 actively stimulated the formation of the cycloxygenase products PGD2, TXB2 and 6-keto-PGF1 alpha, measured by radio- or enzyme-immunoassay. Differences were observed, instead, in the formation of the lipoxygenase metabolites, the hydroxyeicosateraenoic acids, which were measured by high pressure liquid chromatography (HPLC) with on line radiodetection for the labeled products, and Leukotriene C4, measured by radioimmunoassay. The formation of hydroxyacids by stimulated cells was confirmed by gas chromatography-mass spectrometry (GC-MS). In labeled cells, both agonists induced the formation of 12- and 15-hydroxyeicosatetraenoic acids, whereas stimulation of unlabeled cells with calcium ionophore resulted in formation of 12 hydroxyeicosatetraenoic acid and Leukotriene C4. Our results suggest that in astroglial cells, PAF, a compound which is produced in several tissues including brain, mobilizes a selected arachidonic acid pool, possibly associated with diacylglycerol production, from phospholipids, thus activating the conversion of the released fatty acid via the cyclo and the 12-lipoxygenase pathways. PMID- 1790593 TI - An in vivo study of the ontogeny of long-term potentiation (LTP) in the CA1 region and in the dentate gyrus of the rat hippocampal formation. AB - The influences of stimulus intensity, intratrain frequency, and number of trains were studied for their effects on the development of long-term potentiation (LTP) in the hippocampal formation. LTP was analyzed with full input-output curves for population spike (PS) amplitudes (PS-LTP) calculated from responses elicited in the CA1 region and in the dentate gyrus by monosynaptic activation. A standardized protocol employing a sequence of stimuli was devised to systematically compare LTP in the dentate gyrus to that in the CA1 region in rats of various ages ranging from postnatal day (PN) 6 to adults (PN 60). In adult animals, the degrees of LTP were comparable in the dentate gyrus and CA1 region for the 3 stimulus strengths studied (intensity just subthreshold for PS, intensity giving 1/4 maximal PS, and intensity giving 1/2 maximal PS). LTP developed at different rates in the two regions, reaching adult values about two weeks after birth in CA1 but about 3 weeks after birth in the dentate gyrus. We postulate that differences in the rate of development in CA1 and in the dentate gyrus are related to the later neurogenesis of dentate granule cells and also possibly to a later functional maturation of N-methyl-D-aspartate (NMDA) receptor channel complexes on these cells. PMID- 1790594 TI - Quantitative in situ hybridization analysis of glutamic acid decarboxylase messenger RNA in developing rat cerebellum. AB - The appearance and relative amounts of GAD mRNA in rat cerebellar neurons during postnatal development was studied by in situ hybridization. GAD mRNA content within all GABAergic neurons increased during the first month of postnatal development, but the degree and time course of the increase varied among different neuronal types. In newborn rats, GAD mRNA was present only in the prenatally-formed Purkinje and Golgi cells. GAD mRNA in Golgi cells had reached adult levels by postnatal day 14, while GAD mRNA levels in Purkinje cells reached adult levels one week later. Most basket cells expressed GAD mRNA by postnatal day 14, and final levels were attained one week later. Stellate cells in the bottom two-thirds of the molecular layer attained their final GAD mRNA content by postnatal day 21 whereas stellate cells in close proximity to the pial surface were not yet mature at this age. No GAD mRNA was detected within the external granular layer at any time during development. In adult rat, approximately 40% of cerebellar GAD mRNA was contained within the Purkinje cell population, 38% within the stellate cells, 17% within the basket cells, and only 5% within the Golgi cells. Increases in GAD mRNA within GABAergic neurons during cerebellar development correlated with the timing of neuronal maturation and synaptogenesis in these cell populations, suggesting that synaptic activity affects GAD gene expression in developing cerebellum. PMID- 1790595 TI - Postnatal maturation of cholinergic markers in forebrain regions of C57BL/6 mice. AB - The maturation of some neurochemical markers linked to cholinergic function (choline acetyltransferase, acetylcholinesterase, muscarinic binding sites) has been studied from 10 to 150 days of age in mice belonging to C57BL/6 strain. Previous studies had suggested that part of the cholinergic neurons of the basal forebrain undergo degeneration during juvenile stages of life in these rodents. Our data showed a delayed maturation of the cholinergic levels in the cortex and hippocampus, the main targets of the forebrain cholinergic neurons, but not in the striatum and superior colliculus. In none of these regions was any clear trend towards a decrement of cholinergic levels observed during the lifespan considered. In the medial septum-diagonal band area, an actual decrease of cholinergic levels was observed between 60 and 150 days of age. A side experiment based on daily administration of GM1 ganglioside during juvenile life, showed no effect of this treatment on the maturation of cholinergic markers. PMID- 1790596 TI - Effect of treatment with difluoromethylornithine on polyamine and spectrin breakdown levels in neonatal rat brain. AB - Impairment of polyamine synthesis by treatment with difluoromehtylornithine (DFMO), an irreversible inhibitor of ornithine decarboxylase, has been shown to alter normal brain development. In the present study we determined the effect of DFMO treatment during a discrete developmental period on polyamine levels and on the in situ activity of calpain, as reflected by the level of degradation of spectrin, in various brain regions of rat pups. DFMO treatment from postnatal days 5 to 10 produced a marked decrease in putrescine levels in every brain structure and a significant decrease in spectrin breakdown levels in hippocampus and cortex but not in cerebellum. The results indicate that the ODC/polyamine pathway partly regulates the in situ activity of calpain and that polyamines may play a role in both growth and degeneration phenomena. PMID- 1790597 TI - Adrenergic and 5-HT2 receptors on the same astroglial cell. A microspectrofluorimetric study on cytosolic Ca2+ responses in single cells in primary culture. AB - Noradrenaline (NA) or 5-hydroxytryptamine (5-HT) evoked cytosolic Ca2+ mobilization in single type 1 astrocytes in primary culture from the cerebral cortex of newborn rat. The Ca2+ indicator dye fura-2/AM was used in a microspectrofluorimetric system to visualize fluctuations in the intracellular Ca2+ concentration. Activation of the adrenergic receptors alpha 1, alpha 2 and beta, or activation of the 5-HT2 receptors elicited different responses of Ca2+ mobilization with different types of Ca2+ spikes or oscillations. Principally, 4 different types of Ca2+ responses could be obtained: a sharp spike, which declined back to baseline; an initial sharp spike, which declined to a smaller but sustained Ca2+ elevation; an initial sharp spike which declined and showed low amplitude oscillations; and a sharp spike which declined back to baseline with baseline oscillations. Applications of the alpha 2 adrenoceptor agonist clonidine to individual astroglial cells evoked Ca2+ transients mostly in young cultures (cultivated for 7-10 days), while applications of the alpha 1 adrenoceptor agonist phenylephrine evoked Ca2+ transients mostly in older cultures (17-21 days of cultivation). Applications of the beta adrenoceptor agonist isoproterenol evoked Ca2+ transients in both young and older cultures, however, more frequent in older cultures. The alpha 2 and beta receptor responses were dependent on external Ca2+ levels. The NA-evoked Ca2+ responses were seen in cultivated cells at all ages, but were more frequent in older cultures. Approximately 50% of the astroglial cells in 8 day old cultures responded to 5-HT with a cytosolic Ca2+ mobilization and 80% of the cells in 21 day old cultures responded.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790598 TI - Development of intracellular calcium responses to depolarization and to kainate and N-methyl-D-aspartate in cultured mouse hippocampal neurons. AB - We have investigated the initial appearance of voltage-gated Ca channels and kainate- and NMDA-type glutamate receptors in cultured embryonic mouse hippocampal neurons. The Ca-dependent fluorescence change of the dye fura-2 was used as a sensitive assay for the presence of functional channels and receptors. Expression of functional NMDA receptors was observed on some hippocampal neurons as early as E14. By the equivalent of E15-16, 40-50% of cells responded to Ko depolarization (50 mM), indicating the presence of functional voltage-gated Ca channels, approximately 20% of cells responded to kainate (50 microM), and just under 20% responded to NMDA (50 microM; in the presence of glycine and strychnine). By the equivalent of the end of the embryonic period 70-80% of cells responded to all 3 stimuli. As approximately 20% of cells in these cultures are glia, these data indicate that by the time of birth close to 100% of neurons express functioning kainate and NMDA receptors, and voltage-gated Ca channels. Increases in [Ca2+]i in embryonic neurons after application of NMDA were sensitive to APV and to external Mg, as are responses in mature neurons. The IC50 for block by external Mg of the [Ca2+]i increase induced by NMDA was 130 microM, and there was a slight positive correlation between the amplitude of the response to NMDA and sensitivity to external Mg. PMID- 1790599 TI - Expression of proenkephalin mRNA in developing cerebellar cortex of the rat: expression levels coincide with maturational gradients in Purkinje cells. AB - The cellular localization of proenkephalin (PE) mRNA expression was systematically examined in midsagittal (vermal) sections of the developing rat cerebellar cortex by in situ hybridization. PE mRNA was initially detected in Golgi cells of postnatal day 7 (PND 7) rats and in each group thereafter. Moreover, PND 7 rats also displayed an intense layer of PE mRNA hybridization signal over the Purkinje cell layer. By PND 14, distinct cellular labeling was observed in a subpopulation of Purkinje cells in all lobules of the vermis except lobule III. At PND 7 and 14, the area and level of intensity of Purkinje cell associated PE mRNA hybridization signal followed a gradient that was most intense caudally but then decreased rostrally. At PND 21, the proportion of labeled Purkinje cells and the intensity of PE hybridization signal was evenly dispersed between the anterior and posterior lobules of the cerebellar vermis. PE hybridization signal was not detected in the developing neural cells of the external granular layer or the interneurons of the molecular layer in the vermis. These results indicate that the ontogeny of PE mRNA expression in Purkinje cells is developmentally regulated since levels of expression closely follow the chronological order of settling and maturation of these neurons. Based on prior evidence that endogenous opioids inhibit the growth of Purkinje cell dendrites and dendritic spines, PE expression is likely to be important for Purkinje cell maturation. PMID- 1790600 TI - Acute stimulation of ornithine decarboxylase in neonatal rat brain regions by nicotine: a central receptor-mediated process? AB - Nicotine exposure during development alters central nervous system structure and function. In the current study, we examined the acute effects of nicotine (3 mg/kg) on developing rat brain by monitoring ornithine decarboxylase (ODC), a marker for perturbed cell development; ODC controls polyamine biosynthesis and thus regulates cell differentiation. Three brain regions were selected that differ both in their timetables for maturation and in nicotinic receptor concentrations: midbrain + brainstem (earliest development, highest receptor concentration), forebrain (intermediate profiles) and cerebellum (latest development and lowest receptor concentration). Nicotine caused stimulation of ODC within 1 h after drug administration, an effect that displayed both age- and region-dependence corresponding to the development of central nicotinic receptors: effects appeared earliest and were largest in magnitude in midbrain + brainstem and forebrain, and appeared last and with smaller magnitude in the cerebellum. Central receptor involvement was confirmed at 8 days postpartum by demonstrating desensitization of the response after repeated nicotine administration, and by evoking equivalent effects with direct introduction of a small dose of nicotine into the central nervous system. Later in development, acute stimulation of ODC by nicotine became less selective, reflecting secondary actions mediated through systemic hypoxia caused by the drug; this conclusion was confirmed by the absence of desensitization after repeated nicotine administration, and by the failure of centrally administered nicotine to evoke a full stimulatory response. Nicotine-induced ischemia did not contribute to stimulation of ODC seen at the 1 h time point: pretreatment with chlorisondamine, a ganglionic nicotinic antagonist, failed to alter the central stimulatory response.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790601 TI - A randomized comparative study for the clinical evaluation of hormone replacement by transdermal and oral routes. AB - During a six-month randomized study involving 460 post-menopausal women, transdermal estradiol has proved to be as effective as oral conjugated equine estrogens in the control of menopausal symptoms and to produce similar estrogenic effects on the endometrium. The group of patients treated with transdermal estradiol showed better compliance and had fewer drop-outs. Moreover, the quality and duration of menstrual bleeding were considered more physiological in the transdermal estradiol group than in the orally treated patients. The trial was carried out with the co-operation of 17 Italian University Centres, under the supervision of Ciba-Geigy Italy S.p.A. Medical Department. PMID- 1790602 TI - Human chorionic gonadotropin and free beta subunit secretion in three events of pregnancy. AB - Serum hCG and free beta hCG subunit were measured in intrauterine pregnancies (n = 21), ectopic pregnancies (n = 20) and spontaneous abortions (n = 19) matched for gestational age. Significantly higher concentrations of both dimer and free beta subunit hCG were detected in normal pregnancies (86,336 IU/L) and 21.02 IU/L respectively) compared to abortions (10,460 IU/L and 3.73 IU/L) and ectopic pregnancies (3,900 IU/L and 3.73 IU/L) (p less than .05). When the ratio of free beta hCG/intact hCG (%) was studied, however, EP had significantly higher ratios (0.09 +/- 0.09) than IUP (p less than .05). Assessment of the relative distributions of these ratios revealed that 100% of IUP and AB and 65% of EP had ratios less than 0.10. Most notably, 35% of EP were uniquely characterized by ratios greater than 0.10. This ratio was sufficiently higher in 35% of EP to define a profile completely unique to EP. These data suggest that an increased free beta to dimer hCG ratio of greater than 0.10 may assist in the differentiation of ectopic from intrauterine pregnancies of spontaneous abortions and provide insight into a possible trophoblastic mechanics in these clinical events. PMID- 1790603 TI - Serial monitoring of human chorionic gonadotropin and free beta subunit secretion in ectopic pregnancy. AB - The diagnosis of ectopic pregnancy (EP) has relied primarily on serial serum sampling for human chorionic gonadotropin (hCG) and timely pelvic ultrasound examinations. We recently described the applicability of free beta hCG, intact hCG ratio (%) to distinguish EP from spontaneous abortion or intrauterine pregnancy and found that 35% of EP were uniquely characterized by ratios greater than 0.10. In the present study, we sought to determine if this altered pattern of free beta subunit and intact hCG secretion when present persisted as the EP progressed and whether this ratio was influenced by estradiol (E2) and progesterone (P4) secretion. Twelve patients with histologically-confirmed EP and ratios greater than 0.10 were studied longitudinally from initial presentation to surgical intervention. Ratios (%) ranged from .10 to .52 and persisted at levels greater than 0.10 throughout the period of monitoring in all patients. Intact hCG, free beta hCG and ratios (%) showed no correlation to E2 or P4 concentrations. These data suggest that ratios greater than 0.10 when present persist throughout gestation in EP and may serve as a marker for early diagnosis of EP. Such patterns of hCG secretion in EP may be secondary to altered placental histology with persistence of histologic patterns characteristic of early gestation. PMID- 1790604 TI - Silksutures in the bladder causing recurrent urinary tract infection. PMID- 1790605 TI - Gram(+) anaerobic intestinal cocci in healthy adults and neonates. AB - Anaerobic gram(+) cocci were found to be part of the normal indigenous flora of the intestinal tract in healthy adults (19.6%) but they were rarely isolated from healthy neonates (6.1%). A larger variation of species was also present in adults. Their installation in the newborn's intestine seems to be partially inhibited by factors that are not at present very clear. PMID- 1790606 TI - 5-year survival of endometrial carcinoma in the experience of the Gynaecological Clinic of Padua University: quality of life. AB - We have considered 414 cases of endometrial carcinoma from 1963 to 1990, with particular attention to 5-year survival and quality of life. The results show an increase of survival rate and of patients always NED- rate, from the first decades (63-70) to the last period (81-90). Similarly, the percentage of patients treated just with surgical therapies increases too, showing the effectiveness of personalized therapeutical strategies. PMID- 1790607 TI - Plasma and amniotic fluid concentrations of fibronectin during normal and post term pregnancy. AB - Fibronectin is a plasma glycoprotein which is involved in coagulation, platelet function, tissue repair and the vascular endothelial basement membrane. Increase of plasma fibronectin levels in pre-eclamptic patients have been previously reported. There have been no reports however regarding plasma fibronectin levels during post term pregnancy. A significant decrease of maternal plasma concentration of fibronectin was noticed during third trimester, at the time of delivery, and the third post partum day in post term pregnancies as compared to the concentrations found in normal pregnancies. PMID- 1790608 TI - Uterine motility and cervical ripening in second trimester elective abortion by two different PGE analogues. AB - The clinical effects were studied of two different PGE analogues on the uterine motility and cervical ripening of eighty pregnant women asking for a second trimester elective abortion for fetal abnormalities. Forty women received vaginal suppositories each containing 1 milligram of 16, 16-dimethyl-trans-s2-PGE1 (Gemeprost) every 3 hours (5 mg max). Intramuscular injections of 500 micrograms of 16-phenoxy-w 17, 18, 19, 20 tetranor PGE2 methyl-sulphonylamide (Sulprostone) were administered every four hours (2000 mcg max.) to the remaining forty patients. Thirty-three Gemeprost treated patients (82.5%) and 34 Sulprostone treated patients (85%) experienced a complete abortion in the mean of 12.92 +/- 6.95 hours and 11.88 +/- 6.8 hours respectively. The histological and ultrastructural findings of cervical ripening were similar in both groups, while the tocographic patterns showed different characteristics. Side effects occurred in 16 Sulprostone (40%), but only in 9 (22.5%) Gemeprost treated patients, demonstrating that Gemeprost, although equally effective, is better tolerated. PMID- 1790609 TI - Foetal blood sampling, a point of technique. A case report. PMID- 1790610 TI - Conservative approach to massive haemoperitoneum of ovarian origin during anticoagulant therapy. AB - Recurrent massive haemoperitoneum of ovarian origin during anticoagulant therapy in a patient with mitral valve prosthesis is described. The patient was treated conservatively on both occasions. The authors suggest that a trial of conservative approach may be considered in such patients. PMID- 1790611 TI - An overview of adolescents breast disorders. AB - Our investigation has confirmed the low incidence of mammarian pathology in adolescents and the near absence of malignant neoplastic pathology. Programs of breast control in this age can be valid only by aiming at health education prevention and correction of eventual risk factors. The group of adolescents studied by us has allowed us to define the most frequent pathology as the functional one, that is, mastodinia, and among the organic cases single or multiple fibroadenomas are the most frequent lesions. An exact diagnostic profile is necessary in order to reassure the patient in cases of absence of pathology, or to schedule a follow-up or to program an eventual surgical and/or medical treatment. PMID- 1790612 TI - Fibrocystic condition and "at risk" lesions in asymptomatic breasts: a morphologic study of postmenopausal women. AB - A series of postmenopausal women who had died without noticing any clinical breast disease in their anamnesis (100 cases, age range 46-90 years, average age 62 years) were submitted to bilateral subcutaneous mastectomy during autopsy in order to evaluate the morphologic profile of asymptomatic mammary glands, at different ages. Submacroscopic changes were found and removed to be processed for histology. Results were as follows: a) 46% of cases did not show any change; b) 54% of cases showed benign changes, namely a fibrocystic condition; c) 14% of cases had in addition epithelial lobular hyperplasia with low grade atypia and d) 3% of cases showed atypical borderline lobules (ABL), i.e., terminal ductal lobular units characterized by severe epithelial atypia. Such lesions cannot be easily distinguished from "in situ" carcinoma, and are currently considered at morphologic risk for subsequent cancer when found in breast biopsies. Our data show that: 1) ABL do not represent a common finding in women who never complained of breast pathology during life; 2) ABL are not related to older age; 3) Fibrocystic condition is quite frequent at subclinical levels also in asymptomatic aging women. The latter statement confirms the opinion that fibrocystic condition should be considered as a common "functional" change. On the contrary, the rarity of ABL gives us a further indirect evidence of their possible precancerous significance. The risk of subsequent development of cancer from the collateral mammary gland could be theoretically higher when ABL are found in breast biopsies of fertile and premenopausal women, who have a longer period of life expectation. PMID- 1790613 TI - Neopterin in clinical practice. PMID- 1790614 TI - Detection of an eosinophil derived neurotoxin in the urine of a patient with idiopathic chronic eosinophilic pneumonia. PMID- 1790615 TI - The common finding of covert hypothyroidism at initial clinical evaluation for hyperlipoproteinemia. PMID- 1790616 TI - Hyperornithinemia, hyperammonemia and homocitrullinuria--a case report and study of ornithine metabolism using in vivo deuterium labelling. PMID- 1790617 TI - Nomenclature of hormones used as drugs for biochemical function tests. PMID- 1790618 TI - Instability of fecal lysozyme. PMID- 1790619 TI - Serum beta-2-microglobulin levels and cognitive function in chronic dialysis patients. PMID- 1790620 TI - Measurement of intact parathormone in hyperthyroidism. PMID- 1790621 TI - Diagnosis of organic acidemia in developing countries. PMID- 1790622 TI - Aminopeptidases in the soluble fraction of human placenta. PMID- 1790623 TI - Analysis of bismuth in serum and blood by electrothermal atomic absorption spectrometry using platinum as matrix modifier. AB - Bismuth-containing medicines have been used for years, but there is a lack of clinically applicable methods for measuring bismuth in body fluids. We describe a sensitive, accurate and precise method for analysis of bismuth in blood and serum, which is suitable both for monitoring purposes and for further investigations into the biokinetics and safety of bismuth. Bismuth was quantitated with electrothermal atomic absorption spectrometry with Zeeman background correction. In the furnace programme a cool-down step was introduced and platinum was used as a matrix modifier. Recovery for 40 micrograms/l is 93.7 +/- 4.6% (mean +/- SD) from serum and 92.8 +/- 5.4% from blood; within-day precision (n = 10) at 40 micrograms/l is 3.2% for serum and 4.2% for blood. Day to-day precision at 40 micrograms/l (n = 10) was 4.5% for serum and 4.0% for blood. The detection limit is 0.7 microgram/l for serum and 1.0 microgram/l for blood. Blood samples have to be collected in glass tubes and stored at -20 degrees C. PMID- 1790624 TI - Bone-alkaline phosphatase as indicator of bone formation. AB - Bone-alkaline phosphatase was determined in patients at risk of osteoporosis due to treatment with oral corticosteroids, and in patients at risk of increased bone synthesis because of treatment with cyclosporin. Both a significant decrease of bone-alkaline phosphatase during corticosteroid treatment, and a significant increase of bone-alkaline phosphatase during cyclosporin treatment could be demonstrated. It is concluded that bone-alkaline phosphatase is a useful parameter for monitoring changes in bone formation. PMID- 1790625 TI - Clinical analysis in intact erythrocytes using 1H spin echo NMR. AB - A new method of clinical analysis based on 1H spin echo NMR spectroscopy is presented. It is capable of providing information on six metabolites within viable erythrocytes, directly and without any preparative procedures prior to analysis except for cell separation and washing. Erythrocytes from patients with rheumatoid arthritis and Graves' disease are compared with cells obtained from healthy volunteers. The NMR detectable species in the cytosol of the cells are glutathione, ergothioneine, choline, creatine, glycine, lactate and to a lesser extent alanine and valine. Significant differences are observed between the ergothioneine pools in the rheumatoid group (P less than 0.01) compared to the control group. The glutathione: di-glutathione ratio can be assessed from the ratio, g2 to g4, taken from different signals in the glutathione molecule. The total concentration of glutathione present is easily assessed qualitatively but is more difficult to quantitate. PMID- 1790626 TI - Changes in fucose metabolism associated with heavy drinking and smoking: a preliminary report. PMID- 1790627 TI - Differential low density lipoprotein hydrated density distribution in female and male patients with familial hypercholesterolemia. AB - The low density lipoprotein (LDL) hydrated density distribution and composition was studied by using density gradient ultracentrifugation in 26 heterozygous familial hypercholesterolemia patients (FH) (13 females and 13 males) and 28 normolipidemic subjects (14 females and 14 males). The average peak hydrated density of LDL mass in female FH patients was 1.0301 g/ml as compared with 1.0333 g/ml in male FH patients (P less than 0.01) indicating less dense LDL particles in females. A similar difference in the average peak density was observed between normolipidemic females and males (1.0315 g/ml and 1.0342 g/ml, respectively; P less than 0.001). The FH males had a significantly lower mean triglyceride (Tg) content in their LDL (4.8%), lower Tg to apolipoprotein B (Apo B) weight ratio (0.24) and higher cholesteryl ester (CE) to triglyceride weight ratio (9.11) in comparison to FH females (Tg 6.2%; Tg/Apo B 0.31; CE/Tg 5.99), P less than 0.05 in all. Similar LDL composition differences were also observed between normolipidemic males and females. PMID- 1790628 TI - Reference values for free gamma-aminobutyric acid determined by ion-exchange chromatography and fluorescence detection in the cerebrospinal fluid of children. PMID- 1790629 TI - Pitfalls in the determination of diamine oxidase activity. PMID- 1790630 TI - Enzymatic phenylalanine estimation for the management of patients with phenylketonuria. PMID- 1790631 TI - HbA1C and serum fructosamine in diabetic patients: relationship to age, clotting and fibrinolysis parameters and urinary microalbumin excretion. PMID- 1790632 TI - Juvenile psoriatic arthritis. AB - Among 664 juvenile chronic arthritis patients cared for in the Outpatient Clinic of the Pediatric Rheumatology Unit of the National Institute of Rheumatology and Physiotherapy 11 were found with juvenile psoriatic arthritis, and their data regarding skin, joint, ophthalmological, laboratory and radiological manifestations were analysed. These patients were categorised according to the four subgroups suggested by Truckenbrodt et al. Considering that the occurrence of the disease is rare, the small number of patients investigated in this study can provide additional data to the study of Truckenbrodt. The higher number of patients with JPA thus studied can give more information for a multicentric evaluation. PMID- 1790634 TI - Clinical and serological spectrum of systemic lupus erythematosus in Greek children. AB - In the present study 19 Greek Caucasian children with systemic lupus erythematosus (SLE), onset before the age of 16, were followed up for 1-12 years (mean 5.6 yrs.). Diagnosis was determined early in 14 patients and delayed by 2 to 6 years in 5. The clinical manifestations and laboratory findings did not differ significantly from those reported in adults with lupus. The major organ system involvement at onset and early course were skin and joints (80%) followed by kidneys (42%). During the course of the disease 26% of the children developed central nervous system (CNS) involvement. All the patients were treated with steroids and/or cytotoxic drugs in severe uncontrolled progressive disease. At the mean 5.6 years follow-up most patients were in remission on small doses of steroids; one patient still presents signs of active lupus nephritis and one patient died from sepsis. All the patients with CNS involvement recovered without permanent CNS residue. PMID- 1790633 TI - Acquired hyperostosis syndrome: spectrum of manifestations at the sternocostoclavicular region. Radiologic evaluation of 34 cases. AB - Thirty-four patients with chest wall hyperostosis, a condition which has been designated by various terms in the literature were evaluated radiologically. We prefer the name acquired hyperostosis syndrome (AHS), which we categorize into the complete, incomplete and possible form. In complete AHS, sternocostoclavicular hyperostosis is associated with axial and/or peripheral (endosteal, periosteal, enthesopathic, metaplastic) hyperostosis and with psoriasiform or acneform dermatosis. In addition, these three manifestations are accompanied by erosive or non-erosive peripheral and/or axial arthritis to a variable degree. Sometimes, concomitant findings which are consistent with ankylosing spondylitis are also to be found in the axial skeleton. AHS is manifested at 11 different sites on the anterior chest wall. Ossification forms of the costal cartilage, inflammatory enthesopathies (three different insertions) and focal hyperostoses as well as processes of remodelling of the ribs, clavicles and sternum which are described in detail have particular diagnostic significance. AHS can start simultaneously at one, two or several sites on the anterior chest wall. Conventional tomography (possibly supplemented by CT) is necessary for early diagnosis and for analysis of the various findings on the anterior chest wall. PMID- 1790635 TI - The rheumatic manifestations of leprosy. AB - We investigated the rheumatic and laboratory features in 25 patients with Hansen's disease. Sixteen (64%) developed a broad range of rheumatic manifestations, the most common being a distinctive syndrome of swollen hands observed in 10 patients (66.5%). These manifestations were more frequent in patients with lepromatous leprosy. There was no correlation between articular clinical findings and X-ray or laboratory abnormalities. A careful clinical history and the recognition of rheumatic features will help to differentiate patients with leprosy and rheumatic manifestations from those with a primary rheumatic disease. PMID- 1790636 TI - Effects of colony-stimulating factors on proliferation and activation of synovial cells. AB - Joint synovium of patients with rheumatoid arthritis plays an important role in initiation and progress of joint diseases. Proliferation and activation of synovial cells, including macrophages, are modulated by various cytokines and arachidoic acid metabolites. Two kinds of cytokines; granulocyte/macrophage colony-stimulating factors (GM-CSF), and monocyte/macrophage colony-stimulating factor (M-CSF) induce the proliferation or activation of monocyte/macrophages, and their progenitor cells or other stromal cells in bone marrow. We investigated the effects of GM-CSF and M-CSF on synovial cells. GM-CSF stimulated the proliferation of synovial cells and its effect was enhanced by the presence of indomethacin, like that of a potent stimulator of synovial cells, interleukin-1 beta (IL-1 beta). But GM-CSF did not induce the production of IL-1 beta. M-CSF neither stimulated the proliferation of synovial cells nor induced production of IL-1 beta by synovial cells. It was suggested that GM-CSF played some role in the proliferation of synovial cells of the joints. PMID- 1790637 TI - The actual survival rate in systemic lupus erythematosus: study of a 1976 cohort. AB - The purpose of this study was to establish the actual survival rate of a cohort of 51 patients with systemic lupus erythematosus (SLE) all of whom were followed during 12 years from 1976 to 1988 and to evaluate the prognostic significance of the severe complications of the disease. Forty-eight were females. The mean age was 28.5 at onset, 36.2 at diagnosis and 42 at entry; 80% had four or more 1982 ARA criteria at diagnosis and 96% in 1988. Survival rates were: 96% at two years, 86.3% at five years and 74.5% at twelve years. The main cause of death was infection (62%); SLE was directly responsible in only one case. Manifestations considered as severe occurred in almost two-thirds of the cases without any concordance in the time sufficient to recognize different severe forms of the disease. PMID- 1790638 TI - Prevalence and clinical associations of anticardiolipin antibodies in systemic lupus erythematosus: a prospective study. AB - The main objectives of the present study were to determine the prevalence of IgG and IgM anticardiolipin antibody (aCL) isotypes in systemic lupus erythematosus (SLE) in order to analyze their possible association with the clinical manifestations of the disease. Clinical features of 64 consecutive and unselected SLE patients were prospectively studied. Sera from the same patients taken during each clinical manifestation were tested for the presence of aCL. The prevalence of aCL was 43.75% for the IgG isotype and 9.4% for the IgM isotype. A strong linkage between the presence of these antibodies and the occurrence of both thrombosis and abortions was found: a weaker association with neurological events and thrombocytopenia was also demonstrated. The titre of aCL appeared to be linked with the probability of having the clinical manifestations associated with these autoantibodies. Our results suggest that thrombosis and abortion, and possibly thrombocytopenia and central nervous system involvement, may be associated with the presence of aCL at the time when these clinical events develop in SLE patients. PMID- 1790639 TI - Liver scan abnormalities in polymyalgia rheumatica/giant cell arteritis. AB - Liver involvement in polymyalgia rheumatica/giant cell arteritis (PMR/GCA) before treatment and during follow-up of up to 3 1/2 years was assessed in 74 patients clinically, with liver function tests, isotope scans and blood flow studies. Twenty-seven patients had elevated alkaline phosphatase levels which fell to normal after 2.6 weeks treatment. Both PMR and GCA patients were affected, the latter more commonly. Isotope scans were abnormal in 7 of 29 patients and remained abnormal on follow-up. The arterial fraction of hepatic flow was significantly reduced in GCA patients in comparison with those having PMR only; values became normal after treatment. These abnormalities may be due to hepatic arteritis. PMID- 1790640 TI - The value of bone scintigraphy in the follow-up of vertebral osteoporosis. AB - In an open study, we have assessed the bone/soft tissue uptake index in recent osteoporotic vertebral collapse using scintigraphy. The evolution of these cases was followed-up at 6 months in 22 patients treated with 100 IU of salmon calcitonin plus 500 mg of elemental calcium/10 days per month and in 18 patients treated with 500 mg of elemental calcium only on a daily basis. There were no index differences between groups prior to treatment. At six months, the group treated with calcitonin plus calcium showed a significant decrease from 10.2 +/- 6.4 to 3.2 +/- 1.1 (p less than 0.001), while the calcium only group did not show any significant changes (12.1 +/- 6.6 vs 9.2 +/- 4.6), considering that there were significant differences between groups (p less than 0.001). On a mid-term basis, these results have shown the values of the bone/soft tissue index in the follow-up of osteoporotic vertebral collapse. PMID- 1790641 TI - Is the benign joint hypermobility syndrome benign? AB - Over a period of two years, joint hypermobility was identified in 95 female and 19 male patients who attended rheumatology and rehabilitation units in Ismailia city. Pauciarticular pains referring to large and medium-sized joints was their most frequent complaint. Clinical diagnosis of carpal and/or tarsal tunnel syndromes was made in 45.6% of patients, and various forms of soft tissue rheumatism were evident in 73% of them. On radiologic evaluation of the involved joints, 60.5% of the examined patients showed significant degenerative lesions. The most prominent finding in the study, however, was the aggregation of varieties of articular and extra-articular abnormalities in the same patient. Extra-articular features included high frequencies of occurrence of varicose veins, piles and uterine prolapse among other abnormalities. Thus, results of the study lend support to the view that joint hypermobility predisposes to several articular and nonarticular lesions raise serious questions about the reputable benignity of the syndrome. PMID- 1790642 TI - The measurement of osteoporosis in clinical practice. AB - It has been reported that metacarpal morphometry does not correlate with iliac crest histomorphometry in patients with hip fractures. Such disagreement led us to study the correlation between both types of measurements on 35 patients who had suffered hip fracture. We observed a significant correlation between metacarpal morphometry and iliac crest cortical width (p less than 0.001), and to a lesser degree with the trabecular bone volume (p less than 0.01). The same was also true if we assessed separately the patients with cervical or trochanteric hip fractures. PMID- 1790643 TI - The effects of peripheral cold exposure on oesophageal motility in patients with autoimmune rheumatic diseases and Raynaud's phenomenon. AB - The effects of peripheral cold exposure on oesophageal motility were studied in 14 patients with autoimmune rheumatic diseases. They were divided into two groups: 9 with and 5 without Raynaud's phenomenon. The statistical comparison of these two groups did not reveal any difference in the way they manometrically reacted during and after the cold exposure. We conclude that the oesophageal dysfunction in Raynaud's phenomenon may not be of neurogenic origin. PMID- 1790644 TI - Primary pulmonary hypertension associated with systemic lupus erythematosus. AB - A 24-year-old West Indian woman with a four-year history of systemic lupus erythematosus presented with progressive dypsnoea due to primary pulmonary hypertension. Despite showing a response to vasodilators, these failed to control the condition. Her pulmonary hypertension increased in severity, eventually resulting in her death. We believe primary pulmonary hypertension to be an unusual complication of systemic lupus erythematosus. We suggest that this diagnosis should be considered in all patients with systemic lupus erythematosus and progressive dypsnoea, as optimum benefit can only be obtained by early institution of vasodilator therapy. PMID- 1790645 TI - Sarcoidosis in a patient with myasthenia gravis. Case report and review of the literature. AB - The case of a 38-year-old white female, with a long history of myasthenia gravis, who developed sarcoidosis is presented. The diagnosis of myasthenia gravis had been established on the basis of typical clinical symptoms with severe myastenic crises necessitating respiratory support, characteristic electromyographic findings, positive anti-acetylcholine receptor antibodies and response to appropriate medications. After 9 years of disease and while in apparent remission, she presented with ankle arthritis and bilateral hilar adenopathy. A transbronchial lung biopsy showed noncaseating granuloma, typical of sarcoidosis. To our knowledge, the combination of myasthenia gravis and sarcoidosis is extremely rare and emphasizes the intriguing tendency of some immunologic disorders to appear together in certain individuals. PMID- 1790646 TI - Adult-onset Still's disease associated to toxoplasma gondii infection. AB - Adult-onset Still's disease is characterized by high spiking fever, evanescent maculopapular rash and arthritis. Several recent reports have associated its development with a variety of infectious agents. We describe the case of a 25 year old woman presenting high fever, maculopapular rash and seronegative polyarthritis associated with lymphoadenopathy, splenomegaly and neutrophil leucocytosis together with acute acquired toxoplasmosis. Other causes of systemic illness were excluded by appropriate laboratory, radiological and histological investigations. Clinical, radiological and laboratory findings as well as possible etiopathogenetic correlations among both pathological conditions are discussed. Toxoplasma gondii should be considered as a further possible triggering agent associated with the development of adult-onset Still's disease. PMID- 1790647 TI - Aminohydroxypropylidene bisphosphonate (AHPrBP) treatment of severe immobilization hypercalcaemia in a young patient. AB - We report a case of severe hypercalcaemia in a 16-year-old patient, 24 weeks after immobilization for quadriplegia. The biochemical and histomorphometric parameters showed increased osteoclastic resorption and decreased osteoblastic formation. Hydration, chair sitting, salmon and porcine calcitonin, sodium etidronate were unable to normalize the hypercalcaemia. The new antiosteoclastic agent, 3-amino-1 hydroxypropylidene-1, 1-bisphosphonate (AHPrBP), was effective in normalizing serum calcium and biochemical parameters of osteoclastic activity within five days. Bone histomorphometry showed a marked reduction in osteoclastic activity after AHPrBP treatment, as well as a drastic depression of osteoblastic activity, presumably due to the reduction of bone turnover. This case represents to our knowledge, the first successful use of AHPrBP in the treatment of immobilization hypercalcaemia. PMID- 1790648 TI - Focal myositis: a pseudotumoral form of polymyositis. AB - The authors report a case of pseudotumoral focal myositis found in a 55 year-old man, in the anteroexternal area of the right leg. The diagnosis was based on the pathological findings, the absence of any further clinical signs or laboratory findings, and no further development over time. They compare their patient's characteristics with cases found in the literature (24 cases during the past 20 years). Diagnostic certainty confirms the benign character of this pathology, which contrasts with the gravity of the classical form of polymyositis. PMID- 1790650 TI - Cutaneous manifestation of ruptured popliteal cyst. PMID- 1790649 TI - Are gallstones less prevalent in rheumatoid arthritis? PMID- 1790651 TI - Introduction to special issue of Cognition on lexical and conceptual semantics. AB - It is the fate of those who dwell at the lower employments of life, to be rather driven by the fear of evil, than attracted by the prospect of good; to be exposed to censure, without hope of praise; to be disgraced by miscarriage, or punished for neglect, where success would have been without applause, and diligence without reward. Among these unhappy mortals is the writer of dictionaries ... (Preface, Samuel Johnson's Dictionary, 1755). PMID- 1790652 TI - Wiping the slate clean: a lexical semantic exploration. AB - This paper presents a case study in lexical semantic analysis aimed at uncovering syntactically relevant components of verb meaning. Our strategy is to investigate the nature of the lexical knowledge that a speaker of English possesses with respect to certain apparently semantically related verbs: a set of verbs that might as a first approximation be classed as verbs of removal. However, a closer examination of these apparently semantically related verbs reveals that their syntactic properties diverge. An exploration of the patterns of behavior of the verbs suggests that the initial class includes three linguistically significant subclasses. The components of meaning that are relevant to characterizing each subclass are identified by isolating those components of meaning that the members of each subclass share. The conclusion considers the implications of the meaning components identified in this study for a lexical semantic representation. PMID- 1790653 TI - Affectedness and direct objects: the role of lexical semantics in the acquisition of verb argument structure. AB - How do speakers predict the syntax of a verb from its meaning? Traditional theories posit that syntactically relevant information about semantic arguments consists of a list of thematic roles like "agent", "theme", and "goal", which are linked onto a hierarchy of grammatical positions like subject, object and oblique object. For verbs involving motion, the entity caused to move is defined as the "theme" or "patient" and linked to the object. However, this fails for many common verbs, as in fill water into the glass and cover a sheet onto the bed. In more recent theories verbs' meanings are multidimensional structures in which the motions, changes, and other events can be represented in separate but connected substructures; linking rules are sensitive to the position of an argument in a particular configuration. The verb's object would be linked not to the moving entity but to the argument specified as "affected" or caused to change as the main event in the verb's meaning. The change can either be one of location, resulting from motion in a particular manner, or of state, resulting from accommodating or reacting to a substance. For example, pour specifies how a substance moves (downward in a stream), so its substance argument is the object (pour the water/glass); fill specifies how a container changes (from not full to full), so its stationary container argument is the object (fill the glass/water). The newer theory was tested in three experiments. Children aged 3;4-9;4 and adults were taught made-up verbs, presented in a neutral syntactic context (this is mooping), referring to a transfer of items to a surface or container. Subjects were tested on their willingness to encode the moving items or the surface as the verb's object. For verbs where the items moved in a particular manner (e.g., zig zagging), people were more likely to express the moving items as the object; for verbs where the surface changed state (e.g., shape, color, or fullness), people were more likely to express the surface as the object. This confirms that speakers are not confined to labeling moving entities as "themes" or "patients" and linking them to the grammatical object; when a stationary entity undergoes a state change as the result of a motion, it can be represented as the main affected argument and thereby linked to the grammatical object instead. PMID- 1790654 TI - Semantic networks of English. AB - Principles of lexical semantics developed in the course of building an on-line lexical database are discussed. The approach is relational rather than componential. The fundamental semantic relation is synonymy, which is required in order to define the lexicalized concepts that words can be used to express. Other semantic relations between these concepts are then described. No single set of semantic relations or organizational structure is adequate for the entire lexicon: nouns, adjectives, and verbs each have their own semantic relations and their own organization determined by the role they must play in the construction of linguistic messages. PMID- 1790655 TI - The syntax of event structure. AB - In this paper we examine the role of events within a theory of lexical semantics. We propose a configurational theory of event structure and examine how it contributes to a lexical semantic theory for natural language. In particular, we argue that an event structure can provide a distinct and useful level of representation for linguistic analysis involving the aspectual properties of verbs, adverbial scope, the role of argument structure, and the mapping from the lexicon to syntax. PMID- 1790657 TI - Parts and boundaries. AB - Within the framework of Conceptual Semantics, a family of conceptual features and functions is developed that accounts for phenomena in the semantics of noun phrases such as the mass-count distinction, plurality, the partitive construction (a leg of the table), the constitutive construction (a house of wood), the "Universal Packager" (three coffees), and boundary words such as end, edge, and crust. Using the strong formal parallelism between noun phrase semantics and event structure that is a hallmark of the Conceptual Semantics approach, the features and functions of the NP system are applied to a wide range of problems in event structure, for example the analysis of the Vendler classes, the meaning of the progressive, the "imperfective paradox", and "aktionsarten" such as the syntactically unexpressed sense of repetition in The light flashed until dawn. Crucial to the analysis is that these features and functions can be expressed in syntactic structure either by being part of lexical conceptual structure, or by use of a morphological affix, or by being associated with the meaning of a construction such as N of NP or nominal compounding. Alternatively, they may remain unexpressed altogether, being introduced into the conceptual structure of a phrase by "rules of construal". This shows that lexical semantics and phrasal semantics interpenetrate deeply, and that there is no strict one-to-one correspondence between syntactic and semantic structures. In addition, the analysis provides further evidence that natural language semantics must be based on a psychological view of meaning--it must be concerned with how language users are constructed to understand and schematize the world. PMID- 1790656 TI - Learning to express motion events in English and Korean: the influence of language-specific lexicalization patterns. AB - English and Korean differ in how they lexicalize the components of motion events. English characteristically conflates Motion with Manner, Cause, or Deixis, and expresses Path separately. Korean, in contrast, conflates Motion with Path and elements of Figure and Ground in transitive clauses for caused Motion, but conflates motion with Deixis and spells out Path and Manner separately in intransitive clauses for spontaneous motion. Children learning English and Korean show sensitivity to language-specific patterns in the way they talk about motion from as early as 17-20 months. For example, learners of English quickly generalize their earliest spatial words--Path particles like up, down, and in--to both spontaneous and caused changes of location and, for up and down, to posture changes, while learners of Korean keep words for spontaneous and caused motion strictly separate and use different words for vertical changes of location and posture changes. These findings challenge the widespread view that children initially map spatial words directly to nonlinguistic spatial concepts, and suggest that they are influenced by the semantic organization of their language virtually from the beginning. We discuss how input and cognition may interact in the early phases of learning to talk about space. PMID- 1790658 TI - Prognostic factors and management of axillary node negative breast cancer. AB - Axillary node negative breast cancer has become the most frequently occurring stage of breast cancer among American women. Even in spite of early diagnosis and optimal local management, 20-30 percent of all women diagnosed with Stage I breast cancer will recur and succumb to the disease. Standard management approaches to treatment as well as prognostic determinants are in a state of rapid evolution. Entry of patients to appropriate clinical trials is highly recommended. However, if this option is not available to the physician or is not desired by the patient, further therapeutic approaches must be guided by the prognostic variables. For patients with small (less than 1 cm) tumors, low nuclear grade and/or low proliferation rate with diploid DNA characteristics, no further therapy may be a reasonable option. However, patients with tumors equal or greater than 2 cm, high or poor nuclear grade, with a high proliferation rate and aneuploid tumor should be considered candidates for adjuvant chemotherapy if the tumor is ER negative, or treatment with tamoxifen if the tumor is ER positive. PMID- 1790659 TI - Diagnosis and management of skin cancer. PMID- 1790660 TI - Complicated problems in osteogenic sarcoma including pulmonary metastasis, second bone involvement and cure rates. AB - A desirable goal in the treatment of osteogenic sarcoma is preservation of a limb, without sacrificing the principles of cancer surgery. This study describes the author's experience at the Memorial Sloan-Kettering Cancer Center in New York with limb salvage surgery for osteogenic sarcoma. One hundred ninety two patients are included in this study. The study shows that pre-operative chemotherapy is successful as demonstrated by the improved cure rates of each resection group. It was also found that limb sparing surgery is successful with or without chemotherapy as long as the surgical margins are adequate. Pulmonary resection surgery has also been shown to be successful as has surgery for a second bone involvement. PMID- 1790661 TI - New approaches to cancer treatment. AB - New approaches to cancer treatment include methods that improve the ability of the patient to tolerate the administration of aggressive chemotherapy. The use of bone marrow transplantation, hematopoietic growth factors, biologic response modifiers and toxicity-specific protective agents have potential for improving the response rates of several cancers and of improving patient survival. Further study of these treatment strategies, coupled with advances related to the clinical application of mechanisms for reversing chemotherapy drug resistance have important relevance for the future. PMID- 1790662 TI - Biological response modifiers in breast cancer. PMID- 1790663 TI - Therapy of desmoid tumors and related neoplasms. PMID- 1790664 TI - Interleukin-2 for anti-cancer therapy. PMID- 1790665 TI - Nausea and vomiting induced by chemotherapeutic agents. PMID- 1790666 TI - Current status of tumor imaging with monoclonal antibodies. AB - Although the full potential of MoAb imaging has yet to be realized, technologic advances continue with great intensity at a number of academic and industrial research institutions. Continuous production of MoAbs will eventually yield a variety of highly specific antibodies and novel approaches for improving cancer detection. As new diagnostic and therapeutic methods continue to be developed, MoAbs will begin to play a major role as targeted carriers, provided adequate funding from industry and government can be readily obtained. At present, the future of monoclonal antibodies in diagnosis and therapy for cancer patients appears promising. PMID- 1790667 TI - Gene expression, adaptation and evolution in higher organisms. Evidence from studies of Drosophila alcohol dehydrogenases. PMID- 1790668 TI - Cooperativity and allosteric regulation in non-mammalian vertebrate haemoglobins. AB - 1. This review illustrates the vast range of molecular functions expressed in non mammalian vertebrate haemoglobins; with particular reference to the degree of aggregation of haemoglobin subunits and their interactions with allosteric effectors. 2. In at least the broadest sense, these properties suggest that haemoglobin function in non-mammalian vertebrates can be viewed against the evolutionary hierarchy of organisms rather than from a purely adaptive perspective. PMID- 1790669 TI - Identification and structural characterization of Lyt-1 glycoproteins from tunicate hemocytes and mouse thymocytes. AB - 1. A panel of monoclonal antibodies specific to murine Lyt-1 allotypic and framework determinants was used to investigate the possible occurrence of a Lyt-1 homolog in tunicate (protochoradte) hemocytes. 2. In immunoprecipitation experiments, antigenic activities were associated with a major 67 kDa component on tunicate hemocytes and C57Bl/6 mouse thymocytes. 3. Tunicate and mouse Lyt-1 molecules were compared, in terms of glycosylation, by their sensitivity to glycosidases and analyses on one- and two-dimensional gel electrophoresis. 4. Each of the two molecules appeared to bear two N-linked oligosaccharides, one high-mannose and one complex-type glycan. 5. Both molecules revealed charge microheterogeneity with differences in sialic acid content accounting for the charge difference between each other. 6. However, the difference in the glycans did not account for the microheterogeneity within each molecule, suggesting that other post-translational modifications might be responsible. 7. At the polypeptide level, comparisons of chymotryptic and endoproteinase-Arg-C peptide maps, as well as CNBr-cleavage products, suggested that tunicate and mouse Lyt-1 molecules are structurally similar and that each may contain at least one intra chain disulfide bridge. 8. The significance of these findings is discussed in terms of the possible biological role of Lyt-1 glycoproteins at different levels of evolution. PMID- 1790670 TI - Comparative studies on heart and skeletal muscle AMP-deaminase from rainbow trout (Salmo gairdneri). AB - 1. AMP-deaminases from fish heart and skeletal muscle have been isolated, and their kinetic and regulatory properties compared. 2. The results obtained indicate that the enzyme variants present in fish heart and skeletal muscle, in contrast to their mammalian counterparts, show very similar chromatographic, kinetic and regulatory characteristics. 3. The above may reflect evolutionary programmed differences in AMP-deaminase gene(s) organization. PMID- 1790671 TI - Biosynthetic studies of marine lipids. 35. The demonstration of de novo sterol biosynthesis in sponges using radiolabeled isoprenoid precursors. AB - 1. De novo sterol biosynthesis in the sponges Tethya aurantia and Aplysina fistularis was investigated, using sodium [5,5-3H]-mevalonate, [1-3H]-farnesol and [3-3H]-squalene. [3-3H]-Squalene was found to be the best precursor for demonstrating de novo sterol biosynthesis in a wider range of sponges. 2. By feeding [3-3H]-squalene and using cell-free techniques, the de novo sterol biosynthesis was established in 18 sponges belonging to nine orders. Among these sponges were Axinella polypoides and Axinella verrucosa which had previously been thought to be incapable of de novo sterol biosynthesis based on work with radiolabeled lanosterol, cycloartenol, mevalonate, and acetate. 3. In contrast to earlier assumptions, it is likely that all sponges are capable of de novo sterol biosynthesis. PMID- 1790672 TI - Purification and partial characterization of stonustoxin (lethal factor) from Synanceja horrida venom. AB - 1. The lethal factor of the stonefish (Synanceja horrida) venom, designated as the stonustoxin, was purified to homogeneity by a two-step procedure on Sephacryl S-200 High Resolution (HR) gel permeation and DEAE Bio-Gel A anion exchange chromatography. 2. Stonustoxin has a native mol. wt of 148,000 and an isoelectric point of 6.9. 3. SDS-polyacrylamide gel electrophoresis revealed two subunits (designated alpha and beta) with mol. wts of 71,000 and 79,000, respectively. 4. The amino acid composition of both subunits and the N-terminal amino acid sequence of the beta subunit were also determined. 5. Purified stonustoxin had an LD50 of 0.017 microgram/g which is 22-fold more potent than that of the crude venom. 6. The toxin exhibited potent haemolytic activity in vitro and edema inducing activity with a minimum edema dose (MED) of 0.15 micrograms in mouse paw. The edema effect was not antagonized by diphenhydramine. PMID- 1790673 TI - Structural studies on the major milk gland protein of the tsetse fly, Glossina morsitans morsitans. AB - 1. The major protein in the milk gland secretions of the tsetse fly, Glossina morsitans morsitans, was isolated by a combination of gel permeation chromatography and crystallization. 2. It has a native Mr approximately 47,000 and is composed of two identical polypeptide chains (Mr approximately 21,000) as determined by chemical cross-linking studies. The protein has no covalently-bound carbohydrates or lipids. Amino acid analysis of the protein revealed relatively high amounts of the aromatic amino acids, tyrosine (9.1 mol.%) and phenylalanine (8.5 mol.%). Immunoblotting experiments using antiserum against the protein revealed no cross-reactivity with any other milk proteins. 3. Quantitation of the protein during the pregnancy cycle showed that synthesis of the protein by the milk glands of adult female flies starts as the larva moults into second instar and rapidly declines as it matures into third instar. 4. It is proposed that the major milk gland protein could provide essential amino acids needed for the puparium formation. PMID- 1790674 TI - Lipophorin from the tsetse fly, Glossina morsitans morsitans. AB - 1. Lipophorin was isolated from the haemolymph of adult tsetse fly, Glossina morsitans morsitans, by ultracentrifugation in a potassium bromide density gradient. 2. The tsetse fly lipophorin (Mr congruent to 600,000) has a density of congruent to 1.11 g/ml and consists of two apoproteins, apolipophorin-I (apoLp-I, Mr congruent to 250,000) and apolipophorin-II (apoLp-II, Mr congruent to 80,000), both of which are glycosylated as shown by staining with periodate-Schiff reagent. The protein complex is composed of 49% protein and 51% lipids. 3. The finding of lipophorin in tsetse fly haemolymph suggests that, although these flies primarily utilize proline for their energy needs, there is an active transport mechanism for the supply of lipid requirements. PMID- 1790675 TI - Morphometric and metabolic indices of disuse in muscles of hibernating ground squirrels. AB - 1. Morphological, biochemical and metabolic characteristics of hindlimb muscles from summer-active (SA), winter-active (WA) and hibernating (H) golden-mantled ground squirrels (Spermophilus lateralis) were examined to identify alterations resulting from seasonal periods of inactivity. 2. Cross-sectional areas of fibers from the soleus were reduced in both WA and H, although only significantly (P less than 0.05) in WA. Fibers in the EDL exhibited significant reductions in cross-sectional areas in both H and WA groups. Muscle fiber and capillary densities were altered in quantitative agreement with changes in cross-sectional areas. 3. Protein content was reduced 20% (P less than 0.05) in EDL from H and WA groups, but reductions (10%) in the soleus were not statistically significant. RNA content in WA and H groups was significantly decreased in soleus (20%) and EDL (35%) compared with SA, but DNA content was unchanged. 4. In the plantaris, triglyceride content was unchanged, but citrate synthase activity in H (210 +/- 13 mumol min-1 g-1) was significantly greater than in SA (177 +/- 10). In contrast, LDH activity in H was reduced by 25% (P less than 0.05) compared with SA. 5. These results demonstrate atrophic effects associated with seasonal inactivity in hibernating ground squirrels, but suggest the existence of natural mechanisms which limit the response. PMID- 1790676 TI - Unmasking of GDP binding sites on hamster brown adipose tissue mitochondria and uncoupling protein. AB - 1. A rapid unmasking of GDP binding sites on brown adipose tissue (BAT) mitochondria was observed when hamsters acclimatized to 28 degrees C were exposed to a temperature of 4 degrees C for 2 hr. 2. No rapid unmasking of GDP binding sites was observed when hamsters housed at 22 degrees C were briefly exposed to 4 degrees C. 3. The amount of GDP bound to BAT mitochondria from hamsters increased during 2 weeks of exposure to 4 degrees C, but did not change between 2 weeks and 30 days of cold exposure. 4. Incubation of mitochondria with 10 mM Mg2+ prior to the GDP binding assay increased the subsequent GDP binding to BAT mitochondria from hamsters housed at 28, 22 or 4 degrees C, albeit to different degrees. 5. The amount of GDP bound to uncoupling proteins isolated from untreated and Mg(2+) treated mitochondria of hamsters and rats was measured. Scatchard analyses of the binding of GDP to purified uncoupling protein indicate that increases in the number of binding sites due to Mg2+ treatment of mitochondria do not change the affinity of the protein for GDP. PMID- 1790677 TI - Polylysine activates membrane-bound adenylyl cyclase from Xenopus laevis oocytes through the Gs transducing protein. AB - 1. The activity of the adenylyl cyclase found in the membranes of Xenopus laevis can be affected by polylysine and other polycations. 2. The activity of the catalytic subunit measured with forskolin is inhibited by polylysine and polyarginine at concentrations above 10 microM and by spermine above 3 mM. 3. The adenylyl cyclase activity stimulated by GTP-gamma-S or F- through the stimulatory G protein (Gs) can be increased by polylysine, polyornithine and spermine but not by polyarginine. 4. Polylysine stimulation of Gs dependent activity is due to the increase in the apparent affinity for GTP-gamma-S and to a lowering of the requirement for Mg2+ concentration. PMID- 1790678 TI - Effect of phorbol ester on protein phosphorylation in the central nervous system of the leech Hirudo medicinalis: a two-dimensional electrophoretical analysis. AB - 1. Proteins of different regions of the Hirudo medicinalis central nervous system have been analyzed by means of two-dimensional electrophoresis. 2. Subcellular distribution of phosphoproteins has been studied in leech segmental ganglia. 3. Phorbol 12,13-dibutyrate, a protein kinase C activator, stimulates the phosphorylation of a number of proteins whose isoelectric points and mol. wts are presented. 4. Putative roles for these phosphoproteins are discussed. PMID- 1790679 TI - Methyl farnesoate in the prawn Macrobrachium rosenbergii: synthesis by the mandibular organ in vitro, and titers in the hemolymph. AB - 1. The mandibular organ of Macrobrachium rosenbergii was identified and cultured in the presence of [methyl-3H]-methionine. 2. Radiolabelled methyl farnesoate was extracted and quantitated from cultured glands and culture media of both males and females: variation in synthesis rates was observed (1558-52,652 DPM/hr per gland) between individual prawns. 3. No significant incorporation of isotope into hexane-extractable material was observed in any other tissue cultured. 4. The concentration of methyl farnesoate in the hemolymph of M. rosenbergii was determined using normal phase HPLC with cis-trans (non-biological isomer) as an internal standard. 5. Hemolymph from males contained 17.3 +/- 9.5 ng/ml methyl farnesoate. 6. Female hemolymph contained 24 +/- 13.1 ng/ml methyl farnesoate. PMID- 1790680 TI - DNA reassociation kinetics and genome complexity of a fish (Psetta maxima: Teleostei) and its gut parasite (Bothriocephalus gregarius: Cestoda). AB - 1. The genomic structure of a fish (Psetta maxima) and of a Tapeworm (Bothriocephalus), who form a close host-parasite association, was determined by reassociation kinetics experiments. 2. Spectrophotometric readings of single stranded versus double-stranded DNA separated on hydroxylapatite columns after reassociation at Cot values ranging from 0.0001 to 10(5) allowed the drawing of the reassociation curves of both genomes. 3. Different fractions according to their degree of repetitivity were evidenced, and the relative amounts of repetitive versus single-copy sequences, as well as their complexity, were calculated. 4. It appears that the amount of non-repetitive DNA is lower in the Tapeworm than in its vertebrate host, although the complexity of these single copy sequences is the same. PMID- 1790681 TI - Evidence for the presence of two different beta-globin chains in the hemoglobin of the river buffalo (Bubalus bubalis L.). AB - 1. Hemoglobin (Hb) of the river buffalo (Bubalus bubalis L.) was studied by employing isoelectric focusing (IEF) in the 6.7-7.7 pH range and by IEF in ultra narrow immobilized pH gradient (IPG) 7.1-7.5. 2. Three Hb BB phenotypes were identified which were characterized by sets of two or four Hbs with different isoelectric points. 3. These type were called BB, BsBs and BBs, the Bs phenotype showing Hbs with slightly slower mobility. 4. Analysis of constituent globin chains by acid urea polyacrylamide gel electrophoresis in the presence of Triton X-100, provided clear evidence of a novel polymorphism at the beta-globin level. 5. Titration curves of beta-globins from heterozygous Hb BBs indicated a single curve thus suggesting the absence of a net charge in all the pH field. 6. A neutral-to-neutral amino acid replacement probably differentiates the two beta globins. PMID- 1790682 TI - Identification of alpha-lactalbumin and beta-lactoglobulin in cynomolgus monkey (Macaca fascicularis) milk. AB - 1. An electrophoretic analysis of whey protein from cynomolgus monkey milk revealed that its constituents are more similar to bovine milk than human milk, i.e. cynomolgus monkey milk whey contains, besides alpha-lactalbumin-like protein (LaP), another predominant component similar to bovine beta-lactoglobulin (LgP), in its electrophoretic behavior on both disc- and SDS-polyacrylamide gel electrophoreses. 2. The amino acid composition of LaP shows close similarity to that of human alpha-lactalbumin, and LaP forms an immunoprecipitin line with anti human alpha-lactalbumin rabbit antiserum. The homology between LaP and alpha lactalbumin was further confirmed by an analysis of the N-terminal amino acid sequence. 3. LgP is not immunologically identical to bovine beta-lactoglobulin, but its amino acid composition is similar. The result of the N-terminal amino acid sequence analysis of LgP (up to the 26th residue) strongly suggests homology between this protein and beta-lactoglobulin. PMID- 1790683 TI - A computer simulation of muscle-tendon mechanics. AB - A computer simulation program was developed to study and illustrate the complex interactions that exist between muscle structure, neural activation, and mechanical characteristics. The software incorporates equations inherent in a comprehensive muscle-tendon model. The software provides a multi-menu interface allowing the user to easily alter quantities related to muscle architecture, kinematics, and activation level. Five different simulations may be performed and graphically displayed including: force-length, force-velocity, force-activation, force-time, and muscle vs tendon length. Up to three different muscle design/contraction condition combinations can be displayed simultaneously for each simulation. Sample simulation results illustrating the mechanical behavior of muscles with different structures are presented. PMID- 1790684 TI - Computer-assisted diagnosis of acute azotaemia: diagnostic strategy and diagnostic criteria. AB - This report describes the diagnostic strategy, cost-effectiveness and diagnostic accuracy of a rule-based, backward chaining diagnostic expert system designed to assist in diagnosing the cause(s) of acute azotaemia. The diagnostic strategy of the expert system seems to be cost-effective compared with that of a renal unit and the diagnostic criteria of the expert system accurately imitate the diagnoses of the renal unit. It is suggested that the expert system is diagnostically reliable and may reduce cost in the diagnostic work-up of patients with acute azotaemia. PMID- 1790685 TI - Use of a personal computer for fast acquisition of cardiovascular data over an extended period. AB - This paper describes data collection during open chest cardiovascular research based on an IBM compatible personal computer. Data from eight analogue data channels are collected at a rate of 500 Hz per channel for a period of more than 40 sec per run. General analysis functions include the integration of the data obtained from any channel as well as an exponential curve fitting routine. Special functions are available for the calculation of cardiac parameters. This includes the automatic determination of end-diastole and end-systole, as well as maximum and minimum values of all curves for both the systolic and diastolic phases of contraction. PMID- 1790686 TI - A comparison of islet transplantation and subcutaneous insulin injections for the treatment of diabetes mellitus. AB - Transplantation of the islets of Langerhans has received considerable attention as a means of treating insulin-dependent diabetes mellitus. However, the number of islets needed and the level of plasma glucose control that results from this treatment method still needs to be defined. A pharmacokinetic model of glucose and insulin dynamics which includes the islet insulin response to plasma glucose is used to compare the effectiveness of subcutaneous insulin injections and transplanted islets of Langerhans for the treatment of a hypothetical patient with insulin dependent diabetes mellitus. For a patient receiving 60 U of insulin per day the results show that 500,000 human islets would be needed to obtain glucose control comparable to that obtained with insulin injections and at least 1.5 million human islets are needed to obtain normoglycemia. PMID- 1790687 TI - Voice-activated dictation for autopsy pathology. AB - Dictation with report preparation using computer-aided voice recognition software and hardware is described for use in autopsy pathology. The system utilizes standardized modular fill-in forms that automatically generate preprogrammed text when key descriptive phrases or words are spoken, and it can be trained to recognize the voice of individual operators. The system has the potential for reducing personnel time in dictation and transcription, increasing accuracy of reports, and encouraging uniformity with completeness through adherence to built in standard forms. PMID- 1790688 TI - Computerized acquisition and evaluation of whole blood aggregometry data. AB - A special-purpose software package has been developed to acquire and analyze analog signals from a whole blood aggregometer. Up to four independent blood samples can be analyzed simultaneously or with arbitrary delays in time. The user menu ensures proper calibration prior to each measurement and provides a real time graphic display of the signals. From analog/digital converted data, several "derived diagnostic quantities" are calculated. They are constructed with the aim to mimic the process of visual inspection of aggregometry curves and thus place the intuitive diagnostics of blood platelet function on a quantitative basis. PMID- 1790689 TI - A microcomputer program to analyze the CD spectrum of proteins and nucleic acids- use of LOTUS 1-2-3 spread sheet. AB - A user friendly interactive computer program, CIRDIC, is developed which calculates the molar ellipticity and molar circular dichroic absorption coefficients from the CD spectrum. This, in combination with LOTUS 1-2-3 spread sheet, will give the spectra of above parameters vs wavelength. The code is implemented in MicroSoft FORTRAN 77 which runs on any IBM compatible PC under MSDOS environment. PMID- 1790690 TI - 3-D computer model of subcortical structures of human brain. AB - Three-dimensional computer model of thalamus and adjacent formations of human brain has been elaborated on the basis of sagittal slices from the Schaltenbrand Bailey stereotactic atlas. The model includes 120 morphologically distinguishable structures and consists of more than 16 million points (volume elements) each of them being associated with the particular structure in the brain. The model is stored in the long-term computer memory. A special software has been developed to facilitate utilizing the model obtained. The software facilitates synthesizing arbitrary cross-sections through the brain and provides the correspondence between the stereotactic coordinates of any point and its position on the screen of monitor. The coordinates of the point in the system of stereotactic atlas and the name of the structure, the point belongs to, are also supplied. It is also possible to get magnified images of cross-sections and to get isometrical images. The system enables the neurosurgeon to improve the planning and execution of stereotactic operations, and will also be helpful for education. PMID- 1790691 TI - Least-squares estimation of enzyme parameters. AB - The estimation of the enzyme parameters Km and Vmax from initial velocity data, or of analogous parameters in binding or transport experiments may be accomplished by transformation of the data, or by a direct weighted least-squares fit. Although the latter makes better use of the data, the method is complex and may be sensitive to initial parameter estimates. We develop a method which reduces the problem to finding the zero of a continuous function of a single variable. PMID- 1790692 TI - Diabetes. PMID- 1790693 TI - Diagnosis and classification of diabetes mellitus. AB - The diagnosis of diabetes mellitus is established by history, physical examination, and measurements of serum or plasma glucose concentrations under specific conditions. This disorder represents the final common expression of diverse etiologies which are incompletely understood. The treatable causes of diabetes should be identified, and the appropriate therapy initiated. Distinguishing Type I and Type II diabetes is often useful, but not a necessary prerequisite for initiating therapy. As we begin to understand the underlying causes of diabetes, our emphasis is likely to shift from a diagnosis based on metabolic characteristics to a diagnosis based on etiology. PMID- 1790694 TI - Standards of medical care for patients with diabetes mellitus. Diabetes care. American Diabetes Association. PMID- 1790695 TI - Combination sulfonylurea-insulin therapy in the treatment of noninsulin-dependent diabetes mellitus. PMID- 1790696 TI - The clinical utility of capillary blood glucose monitoring in the 1990s. AB - The purpose of this article is to explore the clinical utility of capillary blood glucose monitoring (BGM) in providing data for management decisions by persons with diabetes and by clinicians in acute and chronic care facilities, as well as in the private practice setting. Issues that affect clinical utility include: quality assurance for the BGM procedure, knowledge and beliefs regarding BGM of both the patient and the clinician, and communication patterns. Counseling patients regarding the frequency of their self-monitoring should be individualized and based on the type of treatment for managing the patients' blood glucose, their resources, and their motivation for making dietary, medication, or exercise changes based on the BGM results. Thus, the clinical utility of BGM is dependent on the quality of data generated and the utilization of these data for management decisions by informed and motivated patients and clinicians. PMID- 1790697 TI - Nutritional management for patients with diabetes. PMID- 1790698 TI - Weight loss strategies in diabetes. PMID- 1790699 TI - The diabetes health care team: spotlight on the nurse educator. PMID- 1790700 TI - Chronic complications of diabetes mellitus: practical issues for primary care providers. PMID- 1790702 TI - HIV partner notification in Connecticut. PMID- 1790701 TI - On opposing the use of the pacifier. PMID- 1790703 TI - Euthanasia. PMID- 1790704 TI - Malpractice reform: the no-fault options. PMID- 1790705 TI - Lifetime psychiatric illness and premenstrual syndromes. AB - The frequency of affective symptoms in most descriptions of premenstrual syndromes (PMS) suggests a potential etiologic link between menstrually-related mood changes and specific psychiatric disorders. The purpose of this study is to assess women presenting with "PMS" for lifetime psychiatric illness and PMS, according to rigorous diagnostic criteria comparable to those for "late luteal phase disorder," a proposed DSM-III-R diagnosis requiring further study. The women were interviewed with the Schedule for Affective Disorders and Schizophrenia Lifetime Version (SADS-L) and they kept prospective records of menstrual symptoms with the Moos Menstrual Distress Questionnaire - Form T (Moos MDQ-T). Of the 20 women evaluated, 85% had lifetime psychiatric illness and 30% had PMS. Careful psychiatric assessment is recommended in patients presenting with "PMS" as their chief complaint. PMID- 1790706 TI - Replacing an old drug with a new one. AB - One of the constants facing the individual who practices clinical medicine is the evaluation of the continuing flow of new pharmaceutical products. It is a formidable challenge to use the most up-to-date therapeutic agents judiciously and with proper monitoring. This commentary will discuss issues for the practitioner to consider when faced with the prospect of replacing an old drug with a new one. It will attempt to develop a framework to facilitate rational decision-making in this context. PMID- 1790707 TI - Antibiotic prophylaxis of Lyme disease following recognized tick bite. Bacterial Zoonoses Branch, Division of Vector-Borne Infectious Diseases National Center for Infectious Diseases, Centers for Disease Control. PMID- 1790708 TI - The art long, judgment difficult. PMID- 1790709 TI - Narcotic analgesics in renal failure. PMID- 1790710 TI - Final Medicare anti-fraud and abuse safe harbor regulations. PMID- 1790711 TI - Comparison of lectin reactivity in the vessel beds of the rat eye. AB - The capillary beds of the eye are lined by two types of endothelia, fenestrated in the choriocapillaris and ciliary body, and continuous in the retina and iris. In this study, we wished to find a marker for each of these types of vessel beds using lectin histochemistry. Sections of glutaraldehyde fixed rat eyes embedded in epoxy resin were extracted with sodium ethoxide and rehydrated. Binding of 15 different lectins was visualized using the avidin-biotin peroxidase technique. We found WGA, WGA-s, LFA and PHA-E to strongly bind retinal vessels. In addition to the above lectins, iris vessels bound GSL-I. Choriocapillaris reacted variably only with WGA and not at all with other lectins tested. Vessels of ciliary body processes did not react with any lectin studied. The less fenestrated vessels of the base of the ciliary process bound lectins similar to the retina. We speculate that the differential lectin staining of the various vessel beds of the eye may reflect the degree of fenestration of the endothelium. This reactivity may be influenced by variations in the surrounding milieu including cells and extracellular matrix. PMID- 1790712 TI - The influence of epidermal growth factor on cat corneal endothelial wound healing. AB - Using standardized freeze wounds in cat corneas, we tested the efficacy of human recombinant Epidermal Growth Factor (EGF) to promote endothelial healing when solubilized in either phosphate buffered saline (PBS), 1% methylcellulose (MC), or sodium hyaluronate (NaHA), in final intraocular doses ranging from 2 micrograms to 100 micrograms of EGF. After 6 or 7 days' healing, animals were humanely sacrificed and corneal tissues were fixed and stained for light microscopy and computation of remaining wound areas. EGF in NaHA in final intraocular doses of 2 and 10 micrograms prompted significantly more complete healing of transcorneal freeze wounds to endothelium compared with endothelium of eyes treated with NaHA control solution alone. EGF in PBS or in MC in doses ranging from 2-100 micrograms/eye did not promote more complete wound healing than that seen in eyes treated with their respective vehicle solutions alone. All vehicle solutions were associated with similar degrees of wound healing, implying that they have no intrinsic healing properties. PMID- 1790713 TI - Hydrogen peroxide in the eye lens: radioisotopic determination. AB - Lenses from normal rabbits, mice, rats, cattle, guinea pigs, lambs, chicken, cats, baboons, blue acara (fish) and dogs were examined for the presence of H2O2. No previous reports exist on the presence and levels of H2O2 in normal eye lenses. Freshly isolated lenses of these animals were extracted with trichloroacetic acid and the extract neutralized with Tris. H2O2 was assayed in these extracts by reacting them with 1-14C-alpha-ketoglutarate and measuring the 14CO2 produced by peroxide-dependent decarboxylation. Peroxide of the order of 10(-4)M was detected in most of the lenses except in baboons wherein it exists between 10(-4) and 10(-5)M. Culture experiments with rat lenses demonstrated that GSH may make a major contribution to the formation of H2O2 in the intact lens in vivo. PMID- 1790714 TI - Calmodulin interacts with a C-terminus peptide from the lens membrane protein MIP26. AB - Lens fiber cells are coupled by communicating junctions that comprise over 50% of their appositional surfaces. The main intrinsic protein (MIP26) of lens fibers is a 28.2 kDa protein that forms large gap junction-like channels in reconstituted systems. Previously, we have shown that Ca(++)-activated calmodulin (CaM) regulates the permeability of reconstituted MIP26 channels and changes the conformation of MIP26, as measured by intrinsic fluorescence and circular dichroism spectroscopy. Examination of the MIP26 amino acid sequence has revealed a basic amphiphilic alpha-helical segment (Pep C) on the C-terminus with residue distribution similar to that found in other CaM binding proteins. To test the interaction between the amphiphilic segment and CaM, both a 20-mer peptide and trp-substituted fluorescent analog have been synthesized and purified by HPLC. Evidence from spectrofluorometric titration shows that the Pep C binds with CaM in 1:1 stoichiometry and with a kd of approximately 10 nM. Neither Ca++ nor H+ alone affects the conformation of the Pep C. However, when mixed with CaM the Pep C undergoes both a dramatic blue-shift in tryptophan fluorescence emission, indicative of strong hydrophobic interaction, and an increase in circular dichroism absorption in the alpha-helical region. Additional fluorescence blue shift and alpha-helical content occur when Ca++ is added to the CaM:Pep C complex. PMID- 1790715 TI - Growing human corneal epithelium on collagen shield and subsequent transfer to denuded cornea in vitro. AB - Three fundamental in vitro experiments have been done in the present report: 1) comparison of three different nutrient media on their abilities to culture and passage the human corneal epithelial cells; 2) evaluation of the ability of extracellular matrix material to promote the growth of cultured human corneal epithelium on collagen corneal shields; and 3) determination of the feasibility of the shield to serve as a carrier for the transfer of cultured cells to allogeneic, denuded corneal surface in vitro. Primary cultures of human corneal epithelium were established from explants which were obtained from limbal and peripheral corneal tissue by three different nutrient media respectively: KGM (Keratinocyte Growth Medium), SHEM (Supplemental Hormonal Epithelial Medium), and one combination of the two media (KGM/SHEM). We found the KGM/SHEM combination to be more favorable because morphology was better preserved, the proliferation rate increased five-fold over the 14 days observed time course, and we were able to subculture the tissue for at least three passages. With this combined medium, a suspension of cultured corneal epithelial cells (5 x 10(5)/ml) was seeded onto either the concave surface of collagen corneal shields or onto shields which had been coated with extracellular matrix materials (Matrigel or type IV collagen). The cells attached readily to all the coated shields (20/20) but to only a few of the uncoated shields (3/10), and formed a stratified tissue (2 to 3 layers) within seven days once the cells attached. However, the cells on the shields coated with Matrigel failed to become confluent under these conditions. The stratified tissue on type IV collagen coated shields could then be subsequently transferred to denuded human corneal stroma in organ culture by placing them together and incubating for 2-7 days. After that, histologic examinations showed that the epithelial cells had attached tightly to the recipient stromal surface, even after the removal of the collagen shield. PMID- 1790716 TI - Age-dependent deamidation of the major intrinsic polypeptide from lens membranes. AB - The Major Intrinsic Polypeptide (MP26) of lens membranes contains an -asn-gly- sequence, which has been shown in other proteins to be particularly susceptible to spontaneous deamidation. To determine if the asparagine residue of this sequence undergoes age-dependent deamidation in vivo, antiserum to a synthetic peptide containing the sequence was used to monitor purification of a tryptic peptide containing this sequence from fetal versus mature bovine lenses. The peptide from fetal lenses contained the -asn-gly- sequence, while the peptide from mature lenses contained an -asp-gly- sequence, demonstrating that age dependent deamidation of this asparagine residue was occurring in the lens. PMID- 1790717 TI - Conserved N-terminal sequences in homologous subunits of the multicatalytic proteinase complex (proteasome). AB - The bovine lens multicatalytic proteinase complex (MPC) (MW 700 kDa) comprises at least twelve subunits in the molecular mass range 22-35 kDa. Three of the subunits, L1 (27 kDa), L2 (24 kDa) and L3 (29 kDa), were purified by reverse phase HPLC. Their amino acid composition and N-terminal sequences indicate that they are not identical. L1 and L2 subunits show very high (greater than 90%) sequence homology with specific subunits of rat liver and human reticulocyte MPC and these are considered to be homologous components of the MPC which are highly conserved in evolution. PMID- 1790718 TI - Quantitative study of collagen and elastin of the optic nerve head and sclera in human and experimental monkey glaucoma. AB - Quantitative studies of collagen density and fibril size distribution as well as elastin density were carried out in the optic nerve head and sclera of human and experimental monkey glaucoma eyes. The collagen fibrils of the normal lamina cribrosa are smaller and more uniform in size than those of the sclera. This feature may be an adaptation to maximize either elasticity or resistance to mechanical stress. In glaucomatous nerve heads, there is a major disruption of the structure of the lamina cribrosa beam structure, including a decrease in collagen density. The peripapillary sclera undergoes similar collagen density changes to those in the nerve head in human glaucoma eyes. Elastin fiber density is unchanged in the glaucomatous nerve heads that we studied. PMID- 1790719 TI - Class I disparate corneal grafts enjoy afferent but not efferent blockade of the immune response. AB - Class I antigens are normally expressed on cells in all three layers of the cornea. In congenic rats that differ only at the single Class I locus RT1 A, central orthotopic corneal grafts were rejected 18% of the time with a mean survival time (MST) of 11.5 days. Pre-immunized recipients always rejected Class I disparate corneal grafts (100%, MST = 13.3 days). Surprisingly, the presence of donor Langerhans cells in the cornea at the time of grafting did not increase the rejection of grafts (20%, MST = 14.0 days). To determine if long term surviving grafts enjoyed immune priviledged in the form of efferent blockade, the recipients were challenged with skin grafts 4 to 6 weeks following corneal transplantation. All of the corneal grafts underwent rejection (100%, MST = 14.7 days). A number of important conclusions may be drawn from these studies. A single Class I mismatch is a weak barrier to successful engraftment of corneal grafts. However if the recipient has previously been exposed to donor antigens, a single Class I disparity is sufficient to provoke rejection of all subsequent corneal grafts. The susceptibility of long term surviving grafts to rejection induced by skin grafts indicates the orthotopic corneal grafts are antigenic but not immunogenic. PMID- 1790720 TI - Penetration of ciprofloxacin and metabolites into human lung, bronchial and pleural tissue after 250 and 500 mg oral ciprofloxacin. AB - Ciprofloxacin (CIP) and metabolite concentrations in lung tissue, parietal pleura and bronchial tissue were assessed in 43 adult patients who underwent lung surgery. A single oral dose of CIP was given for prophylaxis of bacterial infections. Two to 6 h prior to tissues sampling, 23 patients received 250 mg and 20 subjects 500 mg of the substance. Blood plasma samples were obtained at the same time as the lung tissue samples. CIP and its metabolites were assayed chemically by high-pressure liquid chromatography (HPLC). After 250 mg CIP, the individual lung tissue CIP concentrations during the 2- to 6-hour post-dose period ranged from 0.5 to 4.8 mg/kg. In 20 of the 23 lung samples, the CIP concentrations were above 1 mg/kg. After 500 mg CIP, the corresponding lung CIP concentrations ranged from 1.6 to 6.0 mg/kg. The CIP lung concentrations were, irrespective of the dose size, between 2 and 7 times higher than the simultaneous blood plasma concentrations. This indicates an excellent penetration of CIP and its metabolites into lung tissue. Bronchial tissue was obtained in 9 cases. Penetration into bronchial mucosa tissue was good as well, as indicated by tissue/plasma ratio values between 1.5 and 4.4. Individual CIP concentrations in the patients given 250 mg CIP, ranged from 1.0 to 1.6 mg/kg. In the patients who received 500 mg, the range was from 1.7 to 3.4 mg/kg. Tissue/plasma ratio values between 0.8 and 2.1 indicated that penetration to pleural tissues was good as well. Metabolite concentrations in all of the tissues assayed (lung, bronchial mucosa, pleural tissue) were low when compared to the concentrations of CIP. The concentrations in lung, pleural and bronchial tissue will probably permit low doses in the treatment of most respiratory tract infections. The broad spectrum of antibacterial activity, the good tissue penetration, chemical stability and the good safety record of the substance means that the drug is potentially a useful agent for perioperative antibiotic prophylaxis. PMID- 1790721 TI - Aminoglycoside resistance in Pseudomonas aeruginosa due to outer membrane stabilization. AB - Pseudomonas aeruginosa PAO1 released a significant amount of a cytoplasmic enzyme, glucose-6-phosphate dehydrogenase, in the presence of aminoglycoside and lysozyme. The extent of the enzyme release was inversely related to the MICs of the aminoglycoside. However, the aminoglycoside-resistant strain F3721, treated in the same way; released a less enzyme. The F3721 LPS was extracted in the phenol phase instead of the water phase in which PAO1 LPS was easily extracted. Electrophoretic analysis of the F3721 LPS showed the ladder bands at the high Mr position, suggesting that the LPS of the aminoglycoside-resistant cells has a structural modification(s) which somehow protects the outer membrane from aminoglycoside-mediated damage. PMID- 1790722 TI - Antibiotic susceptibility and outer membrane proteins of clinical Xanthomonas maltophilia isolates. AB - Twenty clinical Xanthomonas maltophilia isolates were studied for their susceptibility to various antibiotics and for their outer membrane protein profiles and compared to Pseudomonas aeruginosa isolates. Among the antibiotics studied, fleroxacin and ciprofloxacin exhibited the greatest activity (MIC90 4 micrograms/ml). All the X. maltophilia isolates exhibited similar outer membrane protein profiles with 40, 23 and 21 major proteins, whereas the outer membrane of P. aeruginosa revealed at least 7 major outer membrane proteins, as is known from the literature. Thus, it is assumed that the outer membrane profile of X. maltophilia contributes to the resistance of this nosocomial pathogen to most antibiotics. PMID- 1790723 TI - The effects of ions on antibacterial activity of ofloxacin and ceftriaxone. AB - MIC and MBC values of ofloxacin and ceftriaxone were investigated against Staphylococcus aureus in MHB and MHB containing additional Mg2+, Al3+, Fe3+, Ca2+, Zn2+, Cu2+. The addition of Mg2+, Al3+, Fe3+ increased the MIC and MBC of ofloxacin and the MBC of ceftriaxone. However, the addition of these cations did not change the MIC of ceftriaxone. Our findings suggest that these interactions might be due to the formation of chelates between metal ions and antibiotics. These results also indicate that some cations may have an important role in the antibacterial activity of antibiotics. PMID- 1790724 TI - In vitro susceptibility of Ureaplasma urealyticum clinical isolates to new macrolides. AB - Nine antimicrobial agents, the new macrolides, rokitamycin and midecamycin acetate, and seven other antibiotics, tetracycline, minocycline, doxycycline, josamycin, erythromycin, spiramycin, and norfloxacin, were studied for their antimicrobial activity against 100 strains of Ureaplasma urealyticum, using a microtiter broth dilution technique. The new macrolides, rokitamycin and midecamycin acetate, had the highest activity, with the MIC against 90% of isolates tested (MIC90) being less than or equal to 0.05 microgram/ml. MICs90 of erythromycin, josamycin, doxycycline, minocycline and tetracycline ranged from 0.1 to 0.78 micrograms/ml. Norfloxacin was least active, with a MIC90 of 12.5 micrograms/ml. Five of 100 strains tested were resistant (MIC greater than or equal to 12.5 micrograms/ml) to tetracycline, and two were resistant to minocycline and doxycycline; all of these were susceptible to rokitamycin and midecamycin acetate. PMID- 1790725 TI - In vitro activity of LY281389 and comparison with erythromycin and oral beta lactams. AB - LY281389 is a new 14-member ring macrolide which is presently being developed for possible clinical use against bacterial infections. We compared the in vitro activity of LY281389 with erythromycin, ampicillin, augmentin and cephalexin against 610 clinical isolates. The new drug inhibited 97 and 11% of methicillin sensitive and methicillin-resistant Staphylococcus aureus isolates, respectively, 59% of coagulase-negative staphylococci, 63% of enterococci and 74% of Haemophilus influenzae. All the 171 isolates of Streptococcus Lancefield group A, group B and Streptococcus pneumoniae were susceptible to LY281389 at MIC values ranging between 0.03 and 0.24 micrograms/ml. In vitro activity of LY281389 against the bacteria tested was comparable to that of erythromycin. PMID- 1790726 TI - Imipenem/gentamicin and imipenem/rifampin against methicillin-resistant Staphylococcus aureus. AB - The combinations of imipenem with gentamicin and imipenem with rifampin were studied by the time-kill method against 20 strains of methicillin-resistant Staphylococcus aureus. Twelve strains were resistant to imipenem, 18 resistant to gentamicin, 5 resistant to both imipenem and gentamicin and 5 resistant to imipenem, gentamicin and rifampin. Imipenem/gentamicin was synergistic against 1 strain and antagonistic against another strain. Imipenem/rifampin was synergistic against 4 strains and antagonistic against 3 other strains. PMID- 1790727 TI - Nephrotoxicity of aminoglycosides, polypeptides and cephalosporins in cancer patients. AB - The nephrotoxicity of various combinations of antibiotics--aminoglycosides, cephalosporins, vancomycin, amphotericin B--in 171 oncologic patients is described. The most nephrotoxic combination seems to be cefotaxime plus gentamicin, ceftriaxone plus amikacin and amphotericin B with cephalosporin, vancomycin or aminoglycoside. Less toxic was netilmicin with penicillin or cephalosporin, and vancomycin. PMID- 1790728 TI - Treatment of acute pyelonephritis in women with intramuscular ceftriaxone: an out patient study. AB - Ceftriaxone, a third-generation cephalosporin with a long half-life, was administered intramuscularly to 30 adult women suffering from acute pyelonephritis. Standard bacteriologic methods were used to identify the pathogens and their susceptibilities before treatment and at intervals during and after treatment. Overall cure was achieved in 25 (85%) of the patients 6 weeks after completion of therapy. The results demonstrate that ceftriaxone is an effective drug when given once a day intramuscularly to out-patients with acute pyelonephritis. PMID- 1790729 TI - Assigning functions to nucleolar structures. AB - Nucleoli provide the fascinating possibility of linking morphologically distinct structures such as those seen in the electron microscope with biochemical features of the formation and stepwise maturation of ribosomes. Localization of proteins by immunocytochemistry and of rRNA genes and their transcripts by in situ hybridization has greatly improved our understanding of the structural functional relationships of the nucleolus. The present review describes some recent results obtained by electron microscopic in situ hybridization and argues that this approach has the potential to correlate each step of the complex pre rRNA maturation pathway with nucleolar structures. Evidence is accumulating that the nucleolus-specific U3 snRNPs (small nuclear ribonucleoprotein particles) participate in rRNA processing events, similar to the role played by the nucleoplasmic snRNPs in mRNA maturation. The intranucleolar distribution of U3 snRNA is consistent with the view that it is involved in both early and late stages of pre-rRNA processing. PMID- 1790730 TI - Integration site preferences of endogenous retroviruses. AB - Retroviruses have the ability to integrate into the genome of their host, in many cases with little apparent sequence or site specificity. However, relatively few studies have addressed more general features of chromosomal integration. In this study we directly visualized the chromosomal organization of three representative endogenous retroviruses by in situ hybridization. Because there are 50-1000 copies of each of these retroviruses in the genome, it was possible to evaluate repeated integration events. Each retroviral sequence exhibited a unique and markedly different integration pattern. In order to characterize more precisely the chromosomal domains targeted by each retrovirus, later replicating domains were differentially labeled. Additionally, prototypic SINES and LINES (short and long interspersed reiterated sequences), which are inhomogeneously distributed on chromosome arms, were simultaneously detected. Retroviral copies of greater than or equal to 2 kb were found (i) exclusively in a discrete set of later replicating domains, most of which have the staining characteristics of constitutive heterochromatin, (ii) widely represented in disparate types of chromosome domains, or (iii) almost completely confined to CpG Alu-rich regions that are known to be early replicating. Retroviral elements in Alu-rich domains would be expected to be actively transcribed in all cells. Surprisingly, hybridization to blots of brain RNA showed an approximately 25 fold lower level of transcripts from these Alu associated elements than from retroviral sequences restricted to later replicating, heterochromatic domains. Retroviral insertions may subvert more typical transcriptional characteristics of a domain. The present results indicate that there are highly specific integration patterns for each endogenous retrovirus that do not readily relate to their sequence or particle classification. Each host genome may utilize these elements for contrary, and possibly beneficial functions. PMID- 1790731 TI - Microdissection and cloning of DNA from landmark loops of amphibian lampbrush chromosomes. AB - Microdissection of the "globular" and "granular" landmark loops of Pleurodeles lampbrush chromosomes and subsequent cloning of their DNA yielded several recombinant clones. The 6.6-kb insert of one of them was subcloned and the 600 bp of one subclone was characterized by Southern and slot hybridizations as well as by sequencing. This sequence, designated p130B, was shown to belong to a class of moderately repetitive DNA. RNA expression of this sequence was investigated by in situ hybridization of p130B to the nascent transcripts of lateral loops. Results showed that: (1) the same transcripts were not always found in matrices of landmarks exhibiting the same morphological features; (2) the same transcripts were expressed in loops of different morphological types. Based on these results we suggest that even if there is a morphological similarity of landmark loops, this does not reflect total similarity of their transcripts. PMID- 1790733 TI - Alternating hyperphoria. Dissociated vertical deviation (DVD) 'occlusion hyperphoria'. AB - Alternating hyperphoria (synonyms: dissociated vertical deviation (DVD) or occlusion hyperphoria) and variants like 'unilateral patching hyperphoria' ('periodic vertical squint') and monocular vertical nystagmus, which may arise after strabismus operations or loss of the function of one of the eyes, have dynamic properties which differ from those of the vertical vergences or fusional movements in normal binocular vision. Alternating hyperphoria is the result of an early intense disturbance of binocular vision, leading to the absence of vertical fusional vergence or the detection of disparity necessary for this. Vertical disparity vergence is essentially a stabilizing and adaptive system. PMID- 1790732 TI - Analysis of centromere function in Saccharomyces cerevisiae using synthetic centromere mutants. AB - We constructed Saccharomyces cerevisiae centromere DNA mutants by annealing and ligating synthetic oligonucleotides, a novel approach to centromere DNA mutagenesis that allowed us to change only one structural parameter at a time. Using this method, we confirmed that CDE I, II, and III alone are sufficient for centromere function and that A + T-rich sequences in CDE II play important roles in mitosis and meiosis. Analysis of mutants also showed that a bend in the centromere DNA could be important for proper mitotic and meiotic chromosome segregation. In addition we demonstrated that the wild-type orientation of the CDE III sequence, but not the CDE I sequence, is critical for wild-type mitotic segregation. Surprisingly, we found that one mutant centromere affected the segregation of plasmids and chromosomes differently. The implications of these results for centromere function and chromosome structure are discussed. PMID- 1790734 TI - Covering one eye in fixation-disparity measurement causes slight movement of fellow eye. AB - In the subjective measurement of fixation disparity (FD), the subject fuses contours presented in the peripheral macular areas of both eyes (fusion lock). The position of the eyes relative to each other is monitored by means of two haploscopically seen vertical lines presented in the central macular area, one above and one below a binocularly seen horizontal line. The subject is instructed to shift one of the vertical lines horizontally until the two are aligned, while fixating their intersection with the horizontal line. It has recently been questioned whether the foveolae really are pointed towards the perceived intersection. In this study, we monitored the position of one eye while intermittently covering the fellow eye, while the subject maintained fixation of the intersection of the remaining vertical line and the horizontal line. We found slight differences in position of the measured eye, depending on whether the other eye was covered or not, i.e. depending on the presence or absence of fusion in the macular periphery. These differences were more pronounced in the non dominant eye. PMID- 1790736 TI - Retinal contrast loss with non-monofocal IOLs. AB - Non-monofocal IOLs are designed to give simultaneously sharp images of distant and near objects. This is achieved by means of different focal distances for various portions of the light reaching the eye. As a result, for any given object, one part of the light will be properly focused, while another part is out of focus. This results in a sharp image superposed on a blurred image, causing contrast loss. The retinal contrast loss as a function of spatial frequency is derived in this paper. PMID- 1790735 TI - The effects of an aldose reductase inhibitor on the progression of diabetic retinopathy. AB - The polyol pathway has long been associated with diabetic retinopathy. Glucose is converted to sorbitol with the aid of the enzyme aldose reductase. Aldose reductase inhibitors can prevent changes induced by diabetes. A total of 30 patients with minimal background retinopathy were randomly divided into a ponalrestat-taking group and a placebo-taking group. All were followed for 6 months and twenty-three were followed for 12 months. The baseline microaneurysm count was 2.6 +/- 1.9 (mean +/- SD) for the ponalrestat group and 3.5 +/- 2.9 for the placebo group. At 6 months the counts were 3.1 +/- 3.5 and 2.9 +/- 3.6 and after 12 months 3.0 +/- 4.1 and 2.9 +/- 3.4. There is no statistically significant difference between the groups at 0, 6 or 12 months of study. The change in retinopathy severity level did not significantly differ between the two groups at either 6 or 12 months. Ponalrestat administration at a dosage of 600 mg daily for 12 months has no significant effect on the course of minimal retinopathy in diabetic patients. PMID- 1790737 TI - Unusual deposits in the superficial corneal stroma following combined use of topical corticosteroid and beta-blocking medication. AB - Clinical observation of eight patients with superficial stromal precipitation of calcium phosphate is presented. In all cases the predisposing factors for the formation of these depositions were: epithelial defects and the combined use of topical dexamethasone phosphate or prednisolone phosphate with topical beta blocking agents. In two patients the medication that gave rise to these precipitates was used without preservatives, suggesting that the medication itself and not the preservatives contribute to the deposits. Discontinuance of simultaneous administration of the steroids and beta-blocking agents prevented further formation of precipitates. The authors suggest an interaction between simultaneously given steroid and beta-blocking agents, giving rise to calcium phosphate precipitates when an epithelial defect is present which allows easy access to the superficial corneal stroma. PMID- 1790738 TI - On the relation between glare and straylight. AB - An overview is given of the basic phenomena that may lead to glare complaints in patients. Prominent among them is increased intraocular straylight; this can be measured. Other causes may include: increased sensitivity to normal straylight, the length of (increased) light and dark adaptation times, (small angle) neuronal lateral interaction. Distinction must be made between disability glare and discomfort glare. Tests have been proposed to determine glare-induced loss of various visual functions. Often the test results are thought to be directly related to straylight but this may be untrue. PMID- 1790739 TI - Xenon arch photocoagulator used for transpupillary hyperthermia. AB - The technique of near-infrared irradiation to obtain tumour necrosis in experimental pigmented melanomas is described. The xenon arch photocoagulator was modified and adapted for hyperthermia treatment. The adaptations included: filtering the light and changing the electronics, the aiming beam and the diameter of the beam. PMID- 1790740 TI - Pattern electroretinography in senile macular degeneration. AB - The value of pattern electroretinography (PERG) for the detection and differentiation of senile macular degeneration (SMD) was assessed. A group of patients with atrophic SMD and a group with exudative SMD were compared with an age-matched reference group. Differences were only found in visual acuity and in the amplitude of the negative peak N95. No statistical differences between the atrophic and exudative groups were found. Conclusions may be drawn from these results with regard to the use of PERG in senile macular degeneration. PMID- 1790741 TI - Illumination research as part of a visual assessment of visually impaired individuals. AB - In this paper we describe a method for the preliminary assessment of the illumination needs of partially sighted individuals. The method is based on determining the smallest readable lettersize under different levels of illumination. Half of the partially sighted in our population had a performance that was dependent upon the level of illumination. At the same time, most of those for whom no improvement in performance was found, did express a preference for a certain level of illumination. Therefore, there remain discrepancies between the objectively determined optimal level and the preference for a certain level. We conclude that the current method is a useful but insufficient method of determining the illumination needs of partially sighted individuals. PMID- 1790742 TI - Results obtained with low vision aids. A retrospective study. AB - In this retrospective study of 261 patients (181 female and 80 male) the results obtained in a special low vision clinic are described. The mean age of the patients was 73.5 years (range 16-95 years). Visual acuity of the best eye was less than or equal to 0.08 in 26 patients (10.0%); better than 0.08 but less than or equal to 0.25 in 130 (50%); 0.30 in 62 (23.8%) and better than 0.30 in 42 patients (16.1%). Persons with a visual acuity better than 0.30 either could not read normal print or had restricted visual fields. Main causes of visual impairment were macular degeneration (38.9%), diabetic retinopathy (16.1%), glaucoma (8.4%) and cataract (7.4%). Low vision aids could be prescribed for 208 persons (79.7%). Follow-up of an average of 12 months (range, 3-22 months) was carried out in 250 cases (96%). In this period 24 patients (9%) died. At least 161 persons (62%) used their aids regularly, i.e. 77% of the patients who were given a low vision aid. PMID- 1790743 TI - Uveal melanomas diagnosed in the 6 months after lens-implant surgery. AB - During a five-year period uveal melanoma was diagnosed in 11 patients in the 6 months after lens-implant surgery. Pre-operatively all but one of the patients had bilateral senile cataract. The tumours were remarkably large and localised in the periphery rather than in the posterior pole (mean maximum tumour diameter 12.5 mm); they were therefore present at the time of surgery. An adequate pre operative diagnostic ultrasound examination had not been performed in any of the patients. A plea is therefore made for the performance of an echographic examination in all eyes with opaque media in order to exclude solid lesions or other pathology in the vitreous cavity. PMID- 1790744 TI - The determination of the central static visual acuity, presentation of a modified Landolt C chart. AB - The circumstances which can influence the determination of the static central visual acuity are enumerated. The TNO Landolt C chart can be improved. A modified Landolt C letter chart is introduced on which the optotype is presented in 8 different positions, in vertical rows of ten per visual step above visual acuity 0.3. PMID- 1790745 TI - Clinical analysis of Fuchs' heterochromic cyclitis. AB - Fuchs' heterochromic cyclitis (FHC) is an important diagnosis to make. Not only for the patient, because incorrect diagnosis may lead to unnecessary therapy and the failure to detect secondary glaucoma, but also for the comparison of studies on the etiology of FHC, which is still unknown. No clinical criteria for establishing the diagnosis of FHC have been internationally accepted yet. By means of clinical analyses of FHC patients in different parts of the world, predominant clinical features may be distinguished and combined to form (internationally accepted) diagnostic criteria. We report a clinical analysis of 51 FHC patients in the Netherlands. Acute symptoms (severe redness, pain or photophobia) were never (100%) encountered. Characteristic keratic precipitates (88%) and/or minimal aqueous cells and flare (60%) and/or vitreous opacities (84%) were major signs, indicating a chronic inflammatory activity, in which no synechiae (100%) were present. Heterochromia (82%) was not a constant sign, but iris stromal atrophy, which causes the heterochromia, was always present (100%). Cataract was present in 82% as a result of the chronic iridocyclitis. Secondary glaucoma was present in 22%. Based on the predominant clinical findings obtained from this analysis of FHC patients, and on data in the literature, we propose clinical diagnostic criteria for FHC. Future studies, also including other uveitis groups, are necessary to confirm these diagnostic criteria. PMID- 1790746 TI - Lens reflectometry with a CCD video camera and computer image analysis. AB - Lens reflectometry is a useful method of determining the back scatter of light from the cataractous lens. Making use of normal programmes, the personal computer can be used for the quantitative determination of the lens reflex, as seen in the slit-lamp image. If three different images of the same eye are compared, it appears that the mean variation in the back-scatter readings made by our method is 8.3%. PMID- 1790747 TI - Prolonged electro-retinal response suppression (PERRS) in patients with stationary subnormal visual acuity and photophobia. AB - Neural adaptation to light stimulation in the dark-adapted retina can be demonstrated by double-flash electroretinography. The first flash is a conditioning flash, the second flash is the test flash. Interstimulus intervals are in the range of 0.2 to 30 seconds. Suppression of the response to the test flash is assumed not to be related to photopigment regeneration, as in normal human subjects the recovery after strong conditioning flashes is completed in about 2 seconds. In this paper we demonstrate the results of double-flash electroretinography on four patients, two of whom are brother and sister. Each of them showed a five- to ten-fold prolonged suppression time compared to normal measurements. Clinical aspects of all the patients were a stationary, though fluctuating, subnormal visual acuity of about 0.5, some photophobia, and difficulties in adaptation to changes in luminance levels. We assume that the PERRS indicates changes in the restorative reactions to phototransduction in the photoreceptors, or in the neural transmission mechanism, either in the rod-driven lateral inhibitory neural processes or in the cone-driven rod inhibitory processes, caused by a cone dysfunction. PMID- 1790749 TI - Clinical evaluation of two non-contact tonometers. AB - The precision and speed of two non-contact tonometers were examined and compared. The Goldmann applanation tonometer was used as the standard for precision. On the average the results obtained with the non-contact tonometers were not significantly different from those obtained with the Goldmann tonometer. The variation in the values obtained with the non-contact tonometers was greater. The speed of measurement differed between the two non-contact tonometers. PMID- 1790748 TI - Concentration of timolol in aqueous humour. AB - Two groups of twenty patients who were to undergo a routine e.c.c.e. applied eye drops containing timolol 0.1% or 0.5% twice daily during the week preceding their operation. A third group of twenty patients, using placebo drops, served as control. During the cataract surgery a sample of aqueous was collected. The samples from the timolol 0.1% patient group contained a significantly lower concentration of timolol than those from the timolol 0.5% patient group, but there was considerable overlap. PMID- 1790750 TI - Conjunctival xerosis, arcus lipoides and Rieger's disease. AB - Three generations of a family with conjunctival xerosis, Rieger's anomaly (complete or incomplete) and arcus lipoides are described. The xerosis was found always to be accompanied by a Rieger anomaly, which had sometimes, but not always, been detected before. Independent heredity was not observed. In a number of cases the xerosis was bilateral and localised both temporally and nasally. The combination appears to be a stigma malformationis oculi. Correlation with a temporary vitamin A deficiency in early youth appears possible. At this age in such families caution is advisable in the administration of vitamin A inhibiting medicines such as steroids and neomycine. PMID- 1790752 TI - Scotopization and the Nagel-II anomaloscope. AB - The term scotopization refers to the intrusion of rod activity in colour vision when assessed under photopic observation conditions. Scotopization is an important symptom of cone dystrophies. The detection of scotopization is not easy. With the Nagel-II anomaloscope scotopization can be detected in two ways. One method is new and this method is described in the present paper. PMID- 1790751 TI - Effect of donor cornea preservation in tissue culture and in McCarey-Kaufmann medium on corneal graft rejection and visual acuity. AB - In a retrospective study the rate of rejection and clouding of the donor cornea for other reasons was investigated in 230 penetrating keratoplasties performed between 1984-1986. Donor corneas were stored in McCarey-Kaufmann Medium (MK) at 4 degrees C or in a modified Minimal Essential Medium (MEM) at 31 degrees C. No statistical differences in rejection rate, cloudiness due to other causes or visual acuity was found between MEM- and MK-stored donor corneas. PMID- 1790753 TI - Points of action in the campaign against blindness in developing countries. AB - This article provides a survey of the problems of prevention of blindness in developing countries. The World Health Organization estimates that 31 million people are blind and 15 million people partially-sighted. The main cause of blindness is cataract. Other causes are trachoma, glaucoma, xerophthalmia, river blindness, corneal scars and leprosy. Prevention or treatment of these causes is possible in more than 80% of cases. The number of blind persons, however, is still increasing due to the increase in population and the immense shortage of all kinds of ophthalmological equipment and personnel. An effective strategy for the prevention of blindness in developing countries should focus on: more cheap cataract operations, increasing teaching facilities for ophthalmic personnel, integration of ophthalmic care into the general health system and the promotion of blindness prevention in political organizations. PMID- 1790754 TI - Cell-ingrowth in a silicone plombe. Interactions between biomaterial and scleral tissue after 8 years in situ: a SEM and TEM investigation. AB - A male patients (42 years) who had been treated for retinal detachment by the implantation of a silicone plombe into the sclera, returned to the clinic 8 years after implantation because of inflammation of the tissue and partial protrusion from the sclera. After removal of the plombe this was processed for TEM and SEM and examination of the plombe material after 8 years in situ could be carried out in order to get information about the cell-biomaterial interface. A large proportion of the silicone pores was filled with cellular material, including macrophages, giant cells and erythrocytes thus indicating a foreign body granuloma. The external surface of the pores showed a granular osmiophilic dense amorphous layer including extracellular debris. Engulfing of silicone particles by macrophages and the evidence of long-term tissue response suggest partial biodegradation of the silicone and certainly not complete inertness as was formerly claimed. PMID- 1790755 TI - A combined scanning and transmission electronmicroscopic investigation of human (secondary) cataract material. AB - Cataract lenses from patients of advanced age were processed for SEM by standard pre-fixation followed by treatment by the Tannin-Arginine-Osmium-tetroxide (TAO) method and critical point drying, and for TEM by standard pre-fixation followed by vibratomation, standard post-fixation, ultramicrotome sectioning and staining with uranyl acetate/lead citrate. Secondary cataract material was brought onto a Millipore filter, fixed by standard methods, dried in air and sputter-coated with Au. Both SEM and TEM images revealed degeneration processes in lensfibre material, such as swelling of the lensfibre, protrusion of the cytoplasm, fibrillation of the cell membrane, loss of the nucleus, spherical bodies of various sizes between 0.5-1.5 microns, sometimes surrounded by a (double) membrane with different contrast but without cellular evidence, and small and large vacuoles partly filled with granular material both in and at the periphery of the lensfibre-body. The secondary cataract material on the Millipore filter revealed erythrocytes and more or less spherical bodies with high contrast, measuring between 0.5-1.5 microns, often referred to as Elschnig's pearls, besides non-definable organic material. The SEM and TEM micrographs of the cataract lens material strongly suggest that the spherical bodies with sizes of approximately 0.5-1.5 micrometer and high contrast without cellular evidence, are similar to the more or less spherical bodies found in the secondary cataract material on the filter, referred to as Elschnig's pearls. PMID- 1790756 TI - Retinal folds through the macula. AB - In a series of 137 consecutive conventional primary retinal detachment repairs we postoperatively found retinal folds through the macula in four cases (2.8%). All four patients had presented with an acute, bullous, superior detachment, and had been treated with an encircling band, drainage of subretinal fluid, injection of an air/gas mixture, cryocoagulation, and a radial buckle to close the largest retinal tear. Redundant retina (created by the encircling band and possibly by stretching in the bullous detachment) became folded either by compression by the gas-bubble in the recumbent patient, or by a steam roller action of the bubble when the patient sat up. In acute bullous detachments, we try to avoid this complication by using an air/gas bubble which is not greater than necessary to tampon the retinal break, and by positioning the patient in such a way that residual subretinal fluid is pressed away from the posterior pole. PMID- 1790757 TI - Routine use of potassium-sparing diuretics. PMID- 1790758 TI - Measuring peak flow at home. PMID- 1790759 TI - Local applications to wounds--II. Dressings for wounds and ulcers. PMID- 1790760 TI - Botulinum toxin and dystonias. PMID- 1790761 TI - Cilest--a combined OC. PMID- 1790762 TI - [Bovine leukocyte adhesion deficiency (BLAD = Hagemoser-Takahashi syndrome): clinical aspects, pathologico-anatomic and histologic findings]. PMID- 1790763 TI - [Characterization of strains of Bordetella bronchiseptica isolated from animal housing air and of the airborne infection pressure proceeding from them]. AB - Strains of B. bronchiseptica were isolated from the air in farrowing and weaned piglet houses within the framework of follow-up investigations in an intensive pig breeding and fattening farm with 2600 productive sows. The strains were tested for their biological properties. The results show that virulent B. bronchiseptica-strains have been present as an aerosol in the air of both husbandry systems which refers to the infectious pressure of the animal house air. The number of isolated strains of B. bronchiseptica increases during both rearing phases of piglets. The toxin-forming ability of the strains from weaned piglet houses is higher in comparison with such from farrowing houses. This is a proof for the increasing infectious pressure during the rearing period. One has to take the transmission of virulent strains from animal houses with older pigs to such with younger one into account in case of a common air space. This could result in a lower impact of disinfection during the servicing period. The morbidity rate of atrophic rhinitis could be reduced by 60% in consequence of the application of a B. bronchiseptica-live vaccine. P. multocida couldn't be found neither on nasal mucous membrane nor in animal house air over the whole investigation period. All results as a whole point out that within the framework of the elaboration of a strategy for atrophic rhinitis control in pig houses with a high animal density one has to pay more attention to virulent B. bronchiseptica strains in addition to toxinogenous strains of P. multocida. PMID- 1790764 TI - Disposition of tylosin in goats. AB - The disposition kinetics of tylosin was studied in goats after intravenous or intramuscular injection of 15 mg/kg b. wt. Following i.v. injection, tylosin was rapidly and widely distributed in goats (half life of distribution: 0.2 h and volume of distribution: 1.7 l/kg). It was slowly eliminated with a mean elimination half life of 3.04 h and a total body clearance rate of 6.8 ml/kg/min. Following i.m. injection, tylosin was slowly absorbed (T1/2ab of 1.82 h). Tylosin concentration in serum was greater than 1 microgram/ml after 1 h and persisted up to 12 h post-injection. The peak concentration (Cmax, 2.38 micrograms/ml) was obtained after 4.19 h. The systemic bioavailability of tylosin injected intramuscularly was 72.6% and the serum protein bound fraction was 37.6% of the total drug. Tylosin was excreted in milk and urine at concentrations much higher than that in serum. Low concentrations of tylosin were reported in ruminal juice of goats. In conclusion tylosin should be injected every 15 hours to obtain an appreciable concentration in serum, milk and urine. PMID- 1790765 TI - Incorporation of tritiated thymidine, leucine and histidine in murine tail epidermis after skin irritation (histoautoradiography). AB - Thymidine incorporation into epidermal DNA as well as leucine and histidine incorporation into epidermal protein were studied by histoautoradiography in female mice tail epidermis. Prior to in vitro incubation of skin samples with labelled precursors, tail skin was irritated mechanically by rubbing with fine sand paper, chemically by repeated topical administration of n-hexadecane and by feeding an essential fatty acid deficient diet. After these skin irritations, an increased thymidine labelling index and skin thickening were found. Leucine was shown to be incorporated into protein predominantly in basal epidermal cell layers, while histidine was incorporated predominantly in the granular layer. Especially after mechanical skin irritation, this difference was obvious. PMID- 1790766 TI - [Diagnosis of teat stenosis in cattle using ultrasonic tomography (literature review)]. AB - This review deals with the relevant literature about the application of ultrasonography in udder diagnosis especially in stenosis of the teat in cattle. Ultrasonic devices, frequencies and ultrasonic techniques are discussed. It seems that under practical conditions, a 5 MHz linear scanner might be sufficient. Compared with radiography, ultrasonography gave better results in high and medium stenoses of the teat. The results of these first investigations demonstrated that with the development of suitable devices and techniques, ultrasonography might be of high importance as an additional and supporting technique for the diagnosis of stenoses of the teat. PMID- 1790767 TI - [The struggle toward a unified Europe in the area of veterinary medical education]. AB - The recent years have been conspicuous by an unusually dynamic arrangement of political, social and economic relations among all European countries. Scientific community of nations on our continent concerns also our discipline-veterinary medicine-giving numerous examples of common aims, beginning from the 1st Veterinary Congress in 1863, Hamburg. The present changes occurring in Europe give priority to individual scientific, professional and productive integration also in our veterinary science and practice. It must be said, too, that international exchange of goods stimulates not only their standardization as for production conditions and assessment methods, but also the level of consciousness and objective knowledge of the parties warranting the quality of the product. This concerns particularly the food products as for which the parties interested take into account the technical and sanitary norms concerning the products at all stages of their production. Hence the tendency to unification of veterinary studies in all Europe has been approved by all four facilities in Poland. Accession of our faculties to the European Association of Veterinary Medicine Faculties direct by Prof. TOMA, as well as of Czechoslovak and Hungarian faculties, is a clear example of these countries being ready to integration. Similarly, the resolutions of the Association concerning standardization of diplomas and professional specializations of veterinary surgeons in European Community would inspire the veterinary education centres to comparing and following unified organization and programmes of studies.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790768 TI - [The effect of ultraviolet rays and climatic conditions (solar radiation and temperature) on the calcinogenic activity of Trisetum flavescens and Nierembergia veitchii]. AB - Cholecalciferol (Vitamin D3) and its metabolites participate in the regulation of Ca and P metabolism in vertebrates. The intermediate (6,7-cis-precalciferol) is formed by a photoreaction at wave length of 250-310 nm from 7 dehydrocholecalciferol in skin tissues. Vitamin D3, 1,25(OH)2 D3 and other metabolites, previously known to be synthesized only in mammalians and avians, have been detected also in plants. The influence of the UV light (6 hrs radiation with 254 nm) in the calcinogenic activity of T. flavescens and N. veitchii was tested. The extracts of the plants were administered to rachitic chicks in two research models: "Alimentation without Vitamin D" and "Strontium added Alimentation". After 25 days the extracts were administered (per os) and the serum was analyzed to determine the level of Ca, P and alkaline phosphatase. The results were compared with those obtained in chicks with standards of vitamin D3, 1,25(OH)2 D3, T. flavescens and N. veitchii not irradiated and also with T. flavescens that has grown in Rio Grande do Sul/Brazil. PMID- 1790769 TI - [Fertility disorders in dairy cows in northern Greece]. AB - Housing conditions, parameters of fertility and occurrence of different types of infertility in a group of 1641 breeding cattle are described. Biochemical parameters of blood serum from 150 infertile cows suffering from endometritis and treatment results regarding a possible relation between nutrition and infertility of the animals are reported, as well as results of treatment of endometritis using several methods in 147 infertile cows. The results show that hormonal disorders are the most common reasons of infertility and low concentrations of beta-Carotene are the most common reasons of nutrition deficiency resulting from an insufficient quantity of fresh fodder. It can be suggested that low concentration of beta-Carotene may be related to hormonal disorders. PMID- 1790770 TI - The role of excitatory amino acid toxicity in epilepsy. Proceedings of a meeting. 14-16 September 1990, Geneva. PMID- 1790771 TI - Seizure-like activity in cell culture. AB - I will describe experiments with neurons in long-term culture that display seizure-like electrical activity. The neurons are dissociated from the hippocampal formation of newborn rats and then chronically exposed to agents that block synaptic transmission, especially glutamatergic transmission. Seizure-like behavior of the neurons develops as the cultures mature and is revealed when the blocking agents are withdrawn. This spontaneous electrical behavior of the culture has many of the characteristics of seizure activity in intact cortex. It can be very intense and can lead to the death of many neurons. This system allows the familiar experimental advantages of dissociated-cell culture to be applied to the study of seizure-like activities. The experiments to be described were all done with mass cultures containing hundreds or thousands of neurons. However, many of the seizure-like events observed in mass cultures can also be seen in microcultures containing only a few neurons. PMID- 1790772 TI - The relationship between electrographic seizure activity and neuronal injury. PMID- 1790773 TI - Excitotoxicity and epileptic brain damage. AB - The two forms of epileptic brain damage, that found in patients with chronic epilepsy (post-mortem or in an anterior temporal lobectomy specimen) and that occurring acutely after status epilepticus, have much in common but are not identical. Hippocampal lesions occurring acutely after status epilepticus show a high degree of selectivity for hilar interneurones, CA1 pyramidal neurones and CA3 pyramidal neurones. Hippocampal lesions in anterior temporal lobectomy specimens tend to involve the subfields less selectively with CA1 being only slightly more severely affected than dentate granule cells, CA3 and CA2 pyramidal neurones. The most severely damaged hippocampi may result from a combination of acute damage early in life (commonly from prolonged febrile convulsions) and cumulative damage associated with seizures. Less severe degrees of damage are probably a consequence of repeated seizures. The abnormal patterns of firing associated with epileptic activity are almost certainly responsible for cell death occurring acutely after status epilepticus; they may contribute to the progressive cell loss occurring in chronic epilepsy. PMID- 1790774 TI - Reactive changes in epilepsy: cell death and axon sprouting induced by kindling. PMID- 1790775 TI - Epilepsy and behaviour. PMID- 1790776 TI - Neuronal damage and epilepsy: basic and clinical interface. PMID- 1790777 TI - Clinical aspects of epilepsy. PMID- 1790778 TI - Endogenous and therapeutic nitric oxide donors: pathophysiology and clinical implications. 24 April 1991, Geneva, Switzerland. PMID- 1790779 TI - Cellular mechanisms of action of therapeutic nitric oxide donors. AB - A survey of the available literature leads to the conclusion that the most probable mechanism by which nitrovasodilators act, is by nitric oxide (NO) formation. This by itself or by formation of a nitrosothiol (e.g. nitroscocysteine) activates guanylyl cyclase which increases the production of cyclic guanosine monophosphate (cGMP). Endothelium-derived relaxing factor (EDRF), which later turned out to be or to form NO, relaxes smooth muscle by stimulating cGMP formation. The effect of cGMP is mediated by a cGMP-dependent protein kinase and causes a reduction in the intracellular concentration of free Ca2+ ions in the smooth muscle cell. The precise mechanism of this effect is not completely clear but sequestration into sarcoplasmatic reticulum seems to play a major role. In order to identify the nature of the endogenous stimulator of guanylyl cyclase, i.e. to decide whether it is a nitrosothiol or the free radical NO, we compared the effects of NO, nitrosocysteine and nitrosoglutathione on vascular relaxation and increases in cGMP levels in isolated bovine circular strips and on guanylyl cyclase activity in vitro. Induction of tolerance and of cross-tolerance between various NO donors was also investigated. Nitrosodium and nitrosoglutathione augmented cGMP and relaxed vascular smooth muscle slightly more powerfully than NO. The three agents induced slight tolerance after repeated administration without affecting cGMP rises or desensitizing guanylyl cyclase. Pretreatment of coronary strips with nitrosoglutathione caused largely similar cross-tolerance as did NO against nitroglycerin, SIN-1 and sodium nitroprusside. The similarities to NO characterize nitrosocysteine as its most likely precursor, e.g. as EDRF.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1790780 TI - Endothelium-derived nitric oxide: the endogenous nitrovasodilator in the human cardiovascular system. AB - The L-arginine pathway within endothelial cells in the blood vessel wall is the source of production of the endogenous nitrovasodilator, nitric oxide (NO). NO is released under basal conditions and in response to various stimuli such as shear stress and in response to platelet-derived products, coagulation factors and hormones. NO is the mediator of endothelium-dependent relaxation in the circulation and exerts its effects by activating soluble guanylyl cyclase in vascular smooth muscle, which in turn leads to the formation of cyclic guanosine monophosphate (cGMP) and to relaxation. In addition to its effects on vascular smooth muscle, NO is also released abluminally to interact with circulating platelets. Increases in cGMP in platelets are associated with a decreased adhesion and aggregation of cells. Thus, endothelium-derived NO, through its vasodilator and anti-aggregatory properties, prevents vasospasm and thrombus formation in the circulation and thereby helps to maintain blood flow to vital organs such as the heart. Therapeutic nitrates also exert their effects by releasing NO from their molecules and activating soluble guanylyl cyclase. Their effects are particularly pronounced in arteries without endothelium and are reduced in the presence of the basal formation of endothelium-derived NO in intact arteries. The lower basal formation of endothelium-derived NO in veins, as compared to arteries, contributes to the greater sensitivity of venous circulation to nitrates. Thus, the endothelial L-arginine pathway plays an important protective role in the local regulation of blood flow and through its vasodilator and antiplatelet properties. PMID- 1790781 TI - Hypercholesterolaemia, atherosclerosis and release of endothelium-derived relaxing factor by aggregating platelets. AB - In pig coronary arteries atherosclerosis developed progressively after an experimental mechanical injury to the endothelium, despite its regeneration. The atherosclerotic process can be considerably accelerated by a high cholesterol diet. In arteries with regenerated endothelium, there is a reduction of endothelium-dependent relaxations mediated by (a) pertussis toxin-sensitive G protein(s). As this includes the response to platelet-derived serotonin, the ability of the regenerated endothelium to prevent abnormal vasoconstrictions (and presumably to feedback on platelet aggregation) in response to aggregating platelets is seriously curtailed. These changes are exacerbated in atherosclerotic arteries. Bioassay studies demonstrate that reduced endothelium dependent relaxations are due mainly to a reduced release of endothelium-derived relaxing factor. Thus, endothelial dysfunction, in particular the reduced ability to release endothelium-derived relaxing factor, is a key factor in determining the abnormal responsiveness of the atherosclerotic blood vessel wall. PMID- 1790782 TI - Clinical comparison of nitrates and sydnonimines. AB - Organic nitrates and the sydnominine-derivative, molsidomine, exhibit similar pharmacodynamic actions. Venous vasodilatation leads to a decrease in ventricular pressures and volumes and, consequently, to a reduction in myocardial oxygen requirement; coronary vasodilatation enhances myocardial oxygen supply to hypoperfused poststenotic regions. At the molecular level, relaxation of vascular smooth muscle is due to nitric oxide (NO) delivery; with nitrates, this is coupled to the presence of thiol groups, the depletion of which is considered the cause of nitrate tolerance. At least one further site in the nitrate bioconversion cascade, possibly at the level of NO generation appears to be involved in tolerance development, which may also affect the non-nitrate vasodilator SIN-1. Nitrate tolerance is a clinically relevant problem incurred with multiple daily doses or continuous nitrate administration which lead to nearly constant, high plasma concentrations. Effective long-term therapy with nitrates can only be carried out with an interval treatment which is associated with relatively low and substantially fluctuating plasma concentrations. In contrast, during long-term treatment with molsidomine, tolerance development is not a clinically-relevant problem, so that with multiple daily doses, an effect can be provided over 24 h. With regard to maximal anti-ischaemic and haemodynamic effects, organic nitrates and molsidomine are similar. Molsidomine represents an alternative to nitrate interval treatment, or, respectively can be used as an adjunct to interval treatment should it be necessary to bridge the therapeutic gap. PMID- 1790783 TI - Clinical aspects of nitrate tolerance. AB - Tolerance to the organic nitrates is a vexing problem. Tolerance is clearly avoidable with the employment of appropriate and well-designed dosing regimes, utilizing fewer doses and/or a nitrate-free interval. The emerging story of thiol donors and ACE inhibition to prevent tolerance is as yet incomplete. Hopefully, future research will provide the clinician with additional modalities to eliminate the threat of nitrate attenuation. The organic nitrates are superb drugs whose potential usefulness in cardiovascular medicine is clearly limited by nitrate tolerance. While the mechanisms involved in producing vascular smooth muscle attenuation are complex and multiple, it appears that we will be able to resolve this problem in the future, increasing the remarkable benefits of these drugs for patients around the world. PMID- 1790784 TI - The origins of fatherhood: an ancient family process. AB - Despite appearances to the contrary (fostered by anthropocentric nursery stories), a distinct role for male parents does not exist in nature. Fatherhood was invented by humans during the agricultural revolution about six thousand years ago. Symbolized by the new god-king, it incorporated the mother's originally superior role in primate families--the control or ownership of children. The male deity could even make his own offspring without female help. This inflated political figure was designed to compensate for the male's modest role in procreation, once the facts of life were known. Patriarchy was born out of an envious attack on mothers. PMID- 1790785 TI - Migrants and their therapists: a trans-context approach. AB - In this article, I examine how changes in technology, social organization, and economic opportunity are fundamentally altering the encounter between therapists and migrant clients. Approaches are required that take into account the recursive nature of the newly emerging two-home, trans-context lifestyle. I outline a second-order position and lines of questioning that may help migrants and therapists to situate problems in historical-geographical context, examine structural constraints on choice, and co-develop options for the future. To illustrate and enlarge upon hypotheses about the life experience of migrants, I analyze a particular Caribbean-Canadian immigrant story. PMID- 1790786 TI - Parenting behaviors of women who were sexually abused as children in their families of origin. AB - This research explored links between a childhood history of family sexual abuse and current parenting behaviors of mothers of school-age children, using observations of family interaction and interviews with the mothers. Videotaped family interaction tasks, analyzed with Benjamin's Structural Analysis of Social Behavior, showed that women who had been sexually abused in their childhood families were more self-focused, rather than child-focused, compared to nonabused women. In interviews, the women who had been abused gave strong evidence of greater reliance on their children for emotional support. These findings lend support to theoretical and clinical impressions of highly permeable intergenerational boundaries, including parent-child role reversal, in family systems marked by child sexual abuse, even when the abuse occurred in the previous generation. PMID- 1790787 TI - Rethinking levels of abstraction in family systems theories. AB - This article is an attempt to improve the way we conceptualize "levels" in family systems. The first section reframes thinking about levels by identifying an array of different ways of thinking about levels. The next section suggests a parsimonious frame-work for thinking about levels of abstraction in systemic processes. The proposed framework integrates several earlier ways of conceptualizing levels, and helps eliminate some of the confusion, inconsistencies, fragmentation, and limitations of some earlier models. The new framework has three categories that are called Levels I, II, and III. The most abstract level (III) includes phenomena such as family paradigms and values. The intermediate level includes processes such as second-order change, regime, and "meta" processes such as metacommunication and meta-rules. The least abstract level refers to specific processes such as transformation processes and rules. The article concludes with an attempt to demonstrate the usefulness of the proposed framework by showing how it can be used to eliminate a number of conceptual problems in earlier models, improve conceptual clarity, help generate new theoretical insights, and help deal with several controversies in the field. PMID- 1790788 TI - Family-of-origin work and family therapy skills training: both-and. AB - Since the inception of field, theoreticians and teachers of family therapy have advocated for either problem-solving, skill-based training, or transgenerational training that emphasizes the therapist's own family-of-origin work. This article proposes an end to these polarized positions and argues for both-and, that is, a model of training that integrates the trainee's own family-of-origin work with live supervision and skills training. A family-of-origin curriculum designed for this purpose is described. PMID- 1790790 TI - [The polycystic ovary syndrome]. PMID- 1790789 TI - [The diagnosis and treatment of uterine inertia]. PMID- 1790791 TI - [Esophagitis in children]. PMID- 1790792 TI - [Tumorous diseases of the breasts in children]. PMID- 1790793 TI - [Neck tumors]. PMID- 1790794 TI - [The modern principles of diagnosis and treatment in duodenal peptic ulcer]. PMID- 1790795 TI - [The use of fiction in antiabortion propaganda]. PMID- 1790796 TI - [The clinical picture and ambulatory treatment of drug-induced anaphylactic shock with a favorable course]. PMID- 1790797 TI - [The problems of supplying water to the rural population in developing countries]. PMID- 1790798 TI - [Uterine myoma and pregnancy]. PMID- 1790799 TI - [The primary pulmonary form of plague]. PMID- 1790800 TI - [Health centers at the stage of the development of a market economy]. PMID- 1790801 TI - [Acute glomerulonephritis]. PMID- 1790802 TI - [Genital tuberculosis]. PMID- 1790803 TI - [The past destiny of our native land (A. P. Borodin and M. P. Musorgskii)]. PMID- 1790804 TI - [Psychophysiological and personality factors of the accident rate at power plants]. AB - Psychophysiological and personality factors of accident rate are revealed. It is substantiated as inexpedient to professionally train and to employ in operator positions the persons with predisposition to create accident as well as necessary to allow for individual-psychophysiological peculiarities of operators while investigating the causes of accidents. PMID- 1790805 TI - [Effect of exogenous heparin on secretory status of rat mast cells under immobilization stress]. AB - The significant increase of heparin release from mast cells was observed in rats under stress conditions induced by 60 min immobilization. The index of its saturation with heparin became 4 times lower. The highest secretory activity of mast cells was observed during the first 30 min of immobilization. It was shown that at that time the heparin release from mast cells occurred by granulolysis (merocrine type of secretion). In the rats received heparin (15 or 150 u/200 g) during the first 15 min of immobilization the mast cells released heparin with the same intensity as in a 4 control animals. But then in rats with high heparin blood concentration the heparin release from mast cells ceased and mast cells began to accumulate heparin from blood. By the 30th min of immobilization the heparin content in the mast cells has become normal. PMID- 1790806 TI - [Protective effect of malonic acid in hypoxic hypoxia]. AB - Malonic acid injection causes an increase in the survival of rats with acute hypoxic hypoxia. Endogenic malonic acid is supposed to be of great importance in stimulating tissue resistance to hypoxia. PMID- 1790807 TI - [Humoral factors of the spleen in the regulation of the calcium content in blood plasma of rats]. AB - Introduction of protein-free peptides-enriched spleen extract increases the calcium content in blood plasma of rats. After the effect of stress factor (long swimming) it falls. The value of the index under study increases in the splenectomized rats and remains unchanged after stress and introduction of the spleen factors. The most pronounced increase of the calcium concentration is observed in the case of experimental hypersplenism induced by methylcellulose introduction. The calcium-regulating effects of introduction of the enriched protein-free spleen extract and pharmacopoeial splenin preparation are compared. It is supposed that spleen contains two humoral factors of different chemical nature which are able to influence somewhat differently the calcium content in blood plasma. PMID- 1790808 TI - [Gastroprotective effect of luminal gastrin]. AB - Experiments on mongrel rats have revealed that ulceration of mucous membrane of the stomach achieved by vinculum of pylorus is formed only in 47% of animals. In this case luminal secretion of gastrin in the rats with unaffected mucous membrane was higher, while the serum secretion--lower than in the rats with injured one. A conclusion is made on the gastroprotective effect of serum gastrin. PMID- 1790809 TI - [Hyperbaric oxygenation and drug therapy in treatment of nonspecific ulcerative colitis and Crohn's disease]. AB - Patients with nonspecific ulcerative colitis and Crohn's disease were treated with drug therapy (prednisolone, sulphasalazine, metronidazole per os and hydrocortisone per rectum) and subjected to 12 sessions of HBO. Every 10-14 months the HBO course was repeated. After 7 years of such a treatment a gradual partial recovery of large intestine mucosa and in some cases even its absolute recovery were observed. It was most difficult to get good results when treating lesion of distal colon segments. HBO produced a good effect when the disease was diagnosed at the early stage, when the intestine injury was accompanied by hepatobiliary system disease and in teenagers. PMID- 1790810 TI - [Age-related features of tocopherol vitamer content in the heart and liver of rats of different ages in health and in ischemia of these organs in vitro]. AB - The experiments on the heat and liver of 1-, 3-, 12- and 24-month-old rats were conducted to study the effect of ischemia for 1 h on the content of tocopherol vitamers in these tissues. The parameters under study were shown to reliably decrease in all the cases. In the liver the content of all the tocopherol vitamers decreased most rapidly in 1-month-old rats. In the heart the most rapid decrease in the content of vitamers was observed in 3-month-old rats. The results observed permit estimating contribution of certain vitamers to remedy injuries caused by ischemia. PMID- 1790811 TI - [Role of functional interrelationships of the adrenoreactive structures of the amygdalar complex and vascular walls in the regulation of blood coagulation]. AB - The chronic experiments on 24 male cats were carried out to study the influence of changes in functional interrelations between alpha- and beta-adrenoreactive amygdalar structures and corresponding receptors of vascular wall upon haemostatic system. It is shown that activation of alpha-adrenoreactive structures causes the hypercoagulative effect and that of beta-adrenoreactive receptors--the hypocoagulation activation. The central adrenoreactive structures realize their regulative influences through corresponding peripheral adrenoreceptors of the vascular wall. PMID- 1790812 TI - [Analysis of the effect of the alpha 1-adrenostimulator mezaton on plasma renin activity in healthy people of varying age]. AB - 30 healthy people aged 20-34, 60-74 and 75-89 (10 subjects in each group) were examined to study the changes in plasma renin activity (PRA), the sympathetic nervous system tone, indices of central and renal haemodynamics after intramuscular injections of alpha 1-adrenostimulator mezaton (phenylephrine) in dose of 0.15 mg/kg of body mass. The pharmacological activity of postsynaptic alpha 1-adrenoreceptors was found to induce more considerable and prolonged increase of PRA in older persons. The increase of PRA was reliably correlated with a decrease of renal blood flow indices and was combined with an increase of sympathetic tone. As to the authors' opinion a more pronounced constrictor response of afferent renal arterioles to alpha 1-adrenoreceptors activation of vessels is the cause of more considerable changes of PRA in older age groups. PMID- 1790813 TI - [Types of circulation in people with varying physical training]. AB - In 125 young healthy males the cardiac output was estimated by means of tetrapolar rheoplethysmography. The marked differences were found in indices of central hemodynamics and specific peripheral resistance between the groups of sportsmen and non-sportsmen in spite of almost equal systemic arterial pressure in both groups. These differences are greatly due to the types of hemodynamics and in lesser degree--to the level of physical training and trend of sporting training. PMID- 1790814 TI - [Continuous noninvasive recording of circulatory parameters while performing the Valsalva test under elevated ambient pressure]. AB - The results are presented which confirm applicability of the Valsalva test as a functional exercise for the cardiovascular system while studying changes of the circulation regulation under high ambient pressure. Methods of transthoracic tetrapolar impedance plethysmography, electro- and intervalocardiography and mean arterial pressure measurement by means of the oscillometric servosystem are shown as adequate and highly informative under these conditions. PMID- 1790815 TI - [Ultrastructural alterations in rat brain tissues under the direct action of Escherichia coli endotoxin]. AB - The experiments on the rats with intracisternal injection of endotoxin have revealed essential differences in the mechanisms of its permeability through cerebrospinal fluid-brain and blood-cerebrospinal fluid barriers. As for ependymal cells, endotoxin shunts through the cytoplasm in the areas of tight junctions and then it reaches perineuronal spaces. The mechanism of endotoxin penetration through the epithelium of choroid plexi is associated with receptor mediated endocytosis. PMID- 1790816 TI - [Compensatory reactions of the oxygen-transport systems of the body with hemic hypoxia (studies on a mathematical model]. AB - The mathematical model suggested by the authors and results of experiments have been used to study the significance of basic oxygen-transport systems in regulation of oxygen conditions of the organism with acute and chronic hemic hypoxia of different seriousness, to determine a relative contribution of each of them to compensation of this hypoxic state, to estimate specific weight of proper "hypoxic" (induced by the effect on oxygen-transport blood function) and "toxic" (caused by the total toxic effect) action of sodium nitrite in the development of hemic hypoxia. PMID- 1790817 TI - [Effect of electromagnetic EUHF-radiation of non-thermal intensity on the function of the respiratory and cardiovascular system and some parameters of the cell immunity in respiratory pathology]. AB - The electromagnetic radiation of mm-range and 3 mW/cm2-flow density has been studied for its effect on the function of the respiratory-hemodynamic system in some parameters of the cell immunity and on the sensory sphere of patients with chronic obstructive diseases of the lungs. The therapeutic exposure was performed by the method of cascade EUHF-reflexotherapy. It is shown that such a radiation promotes stabilization of the chronic broncho-obstructive process. The exposure features revealed allow recommending the cascade EUHF-reflexotherapy for a routine use in the complex rehabilitation of patients with chronic obstructive diseases of the lungs. PMID- 1790818 TI - [Possibility of directed changes in the surface activity of rat pulmonary surfactants by means of exposure to antibodies specific to them]. AB - The experiments were performed on Wistar rats with weight of 150-200 g. Antibodies were prepared by immunization of rabbits with pure surfactants of rat lungs and were intravenously injected into rats three times within 3 days intervals. These antibodies were shown to influence the superficial activity of lung surfactants and the alveolar lung cells activity. The low doses of antibodies (0.06 micrograms of protein per 100 g of body mass) stimulated the superficial activity of lung surfactants, while higher doses (3 mg of protein per 100 g of body mass) inhibited it. PMID- 1790819 TI - [Effect of inhalation of an air mixture with hydrogen sulfide-containing industrial natural gas on glycolysis and lipid peroxidation in rats]. AB - It is shown that inhalation of gas with increased hydrogen sulphide content causes an inhibition of lipid peroxidation, an increase of blood lactate concentration and lactate/pyruvate ratio. Inhalation of hydrogen sulphide leads to inhibition of lipid peroxidation and anaerobic glycolysis. PMID- 1790820 TI - [Two types of gas exchange disorders in children with bronchial asthma]. AB - The main parameters of gas exchange, respiration and hemodynamics have been studied in children aged 9-14 during the acute period of bronchial asthma. Two types of gas exchange disturbances (hyperreactive type characterized by O2 consumption increase, and hyporeactive one--by O2 consumption decrease) have been revealed in the beginning of the acute period. It is shown that by the end of this period the O2 consumption has normalized in children of both groups and has become the same as in in healthy ones. The main pathogenetic mechanisms of hypoxic state development in these two types of gas exchange disturbances are discussed. PMID- 1790821 TI - [Effect of splenectomy on the development of neonatal lymphoid organs transplanted to animals of varying age]. AB - The effect of splenectomy on the development of newborn thymus and spleen grafted under the kidney capsule of young and old mice has been investigated. Preliminary splenectomy is shown to increase cell counts in grafted spleen that is more conspicuous in young recipients as compared with old ones. This result suggests a decrease with age in the inhibitory effect of the host spleen on the maturation of spleen grafted from newborn donor. Combined transplantation of newborn thymus and spleen has revealed a decrease of cell counts in the donor spleen grafted to the young splenectomized recipients and, on the contrary, increase of this parameter in old ones. Immune response in donor spleen with combined transplantation of the thymus to the old splenectomized recipients is much higher as compared with the same parameter in recipient without splenectomy. It is concluded that partial destruction of the old immune system is essential for its correction. PMID- 1790822 TI - [Experimental study of polyvalent proteus antigen immunogenicity]. AB - The experiments on 52 rabbits have been carried out to show the possibility to use Proteus antigen with high content of H-component (H1; H2; H3 Proteus antigens are most frequently found) for active immunization to make highly specific humoral immunity. The optimal scheme of immunization consists of 3 subcutaneous injections in doses of 0.25-0.25-0.5 mg of antigen within 7 days intervals and 0.25 mg dose of single revaccination. The duration of cycle immunization is 14 days. PMID- 1790823 TI - [Activity, hexokinase isoenzyme spectrum and various factors of their regulation in liver and skeletal muscles of young piglets]. AB - Hexokinase in the liver of 1- and 5-day-old piglets is presented by four isoforms and in the skeletal muscles--by two ones. The enzyme activity in the liver and skeletal muscles of 5-day-old piglets is much higher than in 1-day-old ones. The increased hexokinase activity in the tissues of piglets during the first days of life appears to be due to the changes in their isoenzyme spectrum. The hexokinase activity and isoenzyme spectrum in the investigated tissue were affected by insulin, cortisol and 24 hours long starvation. These changes depended upon the age of the animals and differed in various organs and tissues: in 1-day-old piglets they were more pronounced in the skeletal muscles, while in 5-days-old animals--in the liver. PMID- 1790824 TI - [Adaptive potential of operators with various dynamics of fitness for work during a transition from day to night shift]. AB - While transferring from day to night shifts 3 categories of changes in the working ability are revealed among the operators. It is stated that the working ability in 19% of operators decreases, in 62%--remains practically unchanged, in 19%--improves. The higher levels of arterial pressure, vascular peripheral resistance (in both shifts), the heart systole rate (day shift) are found in the first group of operators. The structure of correlations between the physiological functions is characterized by harder intrasystemic relations in the day shift as against that of other operators and by the increasing effects of the intersystemic interactions while decreasing intrasystemic relations in the night shift. The adaptive potentialities were higher in the second group and particularly in the third group of operators. PMID- 1790825 TI - [Osborn wave in normothermic patients?]. AB - Four cases of normothermic patients exhibiting transient changes of the repolarization resembling the Osborn wave, are herein reported. The ecg changes seem to be the result of the elevation of the ST segment in presence of an S wave: the S wave merges in it and disappears until the elevation persists. Whether we are dealing with true Osborn waves is unclear. PMID- 1790826 TI - [ Bacterial endocarditis of the pulmonary valve damaged by thoracic radiotherapy (in Hodgkin's disease)]. AB - It is well known that radiation therapy to the anterior mediastinum may induce lesions of all cardiac structures. The pericardium is most frequently involved, but atrioventricular conduction disorders, cardiomyopathy, coronary stenosis may also be produced. Aortic, mitral and tricuspid lesions have been described. However, clinical evidence of pulmonic valve involvement has not been reported. Only at necropsy has fibrotic thickening of the pulmonic cusps occasionally been found. We report a case of infective endocarditis of the pulmonic valve in a 53 year-old patient who had undergone thoracic radiation therapy for Hodgkin's disease 31 years previously. Four years prior to the endocarditis he had also been submitted to myocardial revascularisation for critical lesions of the left main and right coronary ostia, and to aortic valve replacement because of stenosis and insufficiency. At that time, the pulmonic valve was fibrotic on echo examination. It is noteworthy that, of all the cardiac valves, the infective process involved only the pulmonic one, which is seldom the target of an infection. To our knowledge this is the first case of bacterial endocarditis of a heart valve that had been previously damaged by radiation therapy. PMID- 1790827 TI - [Evaluation of the left ventricular function in ischemic heart disease: an old problem with new solutions]. PMID- 1790828 TI - [The cholesterol question. Disinformed information]. PMID- 1790829 TI - [The Giornale Italiano di Cardiologia and the Italian language]. PMID- 1790830 TI - [Dissection and aortic insufficiency]. PMID- 1790831 TI - [Immediate results of percutaneous mitral valvuloplasty using Inoue catheter. Personal experience in the first 15 cases]. AB - Mitral valvuloplasty with an Inoue balloon catheter was performed at our institution in 15 patients affected by mitral stenosis. All were severely symptomatic (class NYHA III or IV). Transthoracic and transesophageal echocardiography showed a mitral score less than 10 (Wilkins criteria). Patients with thrombi in the left atrium and those with important mitral regurgitation were excluded. The mitral valve area increased from 0.98 +/- 0.2 to 1.89 +/- 0.4 cm2 and the transvalvular gradient decreased from 18.2 +/- 7.5 to 6.7 +/- 3.7 mmHg. There was a small increase of the mitral regurgitation. Two complications occurred during the procedure: the first was a haemopericardium, which was percutaneously drained, and the other a rupture of the anterior mitral leaflet with acute, severe mitral regurgitation necessitating urgent surgical correction. Applying the criteria of Herrmann, the results were optimal in 11 and suboptimal in 3 cases. PMID- 1790832 TI - [Comparison of exercise thallium-201 perfusion scintigraphy and coronarography in the prognostic stratification of patients with post-infarction residual ischemia]. AB - The goals of this study were: 1) to determine and compare the prognostic utility of exercise 201Thallium scintigraphy with coronary angiography in patients with residual ischemia at the symptom limited bicycle exercise testing performed at hospital discharge after a first uncomplicated acute myocardial infarction 2) to verify the ability of perfusion scintigraphy to identify better than coronary angiography a subset of these patients at low risk for future events, despite the ischemic response at the exercise stress testing. Accordingly, follow-up data were obtained prospectively for 72 consecutive patients with adequate left ventricular rest systolic function, and with exercise induced greater than or equal to 1 mm ST-segment depression and/or typical angina pectoris. A planar 201Thallium scintigraphy and coronary angiography were performed within 2 months after acute myocardial infarction. By 31 +/- 29 months 38 patients had no events, while 34 experienced a cardiac event: 3 died of cardiac causes, 2 had nonfatal recurrent myocardial infarction, 29 were rehospitalized for severe class III or IV angina pectoris (4 were treated medically, 25 were revascularized: 20 had coronary bypass surgery, 5 coronary angioplasty). Each of the 3 angiographic classification of coronary artery disease (number of vessels with greater than or equal to 70% reduction of luminal diameter, jeopardy score and Gensini score) accurately identified patients with subsequent cardiac event by Mantel and Cox analysis (respectively p = 0.01, p = 0.0000, p = 0.002). Among 201Thallium variables, the number of segments demonstrating redistribution on delayed images (p = 0.0000), the number of segments with persistent defect (p = 0.0003) and increased 201Thallium uptake by the lungs (p = 0.0100) effectively stratified the probability of survival by the same analysis. Furthermore, the number of perfusion defects, either transient or persistent, with exercise 201Thallium scintigraphy provide additive prognostic information to any of the 3 angiographic coronary artery disease classifications considered. On the contrary, when 201Thallium stress findings are known, coronary angiography data in general are not additive in risk stratification. 17 patients with no reversible perfusion defect remained stable at follow up (52 +/- 28 months) despite development of typical angina pectoris (11/17) and/or ischemic ST segment depression (12/17) during exercise testing.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1790833 TI - [Hemodynamic benefits of sequential atrioventricular pacing]. AB - The purpose of this study was to evaluate the hemodynamic benefits of atrioventricular (A-V) sequential pacing. 30 pts implanted with DDD pacemakers underwent M-mode, B-mode and Doppler echocardiography. In each patient, left ventricular (LV) stroke volume was assessed by measuring the time-velocity integral of mitral inflow in the following modes and rates: VOO at 70 ppm or at the minimum stimulation rate and at 120 ppm; DOO at the same rates with different A-V delay (100, 150, 200, 250 and, whenever possible, 300 msec). The increase in stroke volume obtained with dual chamber pacing at the optimal A-V delay was 45 +/- 25% at 75 ppm and 29 +/- 14% at 120 ppm (p less than 0.05 75 vs 120 ppm). This increase was significantly higher in pts with than in pts without LV hypertrophy (respectively: 51.9 +/- 20.4 vs 36.9 +/- 20.8% at 75 ppm, p less than 0.05 and 33 +/- 13.4 vs 25.4 +/- 14.5% at 120 ppm, p = 0.08). Concerning the A-V delay, we noted that at 75 ppm stroke volume was significantly higher in DOO than in VOO with any A-V delay ranging +/- 100 msec from the optimal one; at 120 ppm the hemodynamic benefit of DOO pacing was observed only when the programmed A-V delay was the optimal one or very near to it. In conclusion, atrio-ventricular sequential pacing allows a significant increase in LV stroke volume over single chamber ventricular pacing both at 75 and 120 ppm. Programming the optimal A-V delay is absolutely necessary to obtain this hemodynamic benefit at the higher stimulation rate. PMID- 1790834 TI - [Ventricular-infundibular morphology in visceral heterotaxia with left isomerism. An echocardiographic-angiocardiographic study]. AB - We report 2D-echocardiographic and angiocardiographic assessment of 28 cases of visceral heterotaxia with left atrial isomerism, with particular emphasis on infundibular ventricular morphology. Ventricular D-loop was present in 15 cases (52.6%), and ventricular L-loop in 13 (46.4%); 25/48 patients had concordant ventricular loop and cardiac position (89.3%). In 18 patients (64.3%) there were 2 balanced ventricles; of the other 10 patients, 9 (32.1%) presented right and 1 (3.6%) left ventricular dominance. Ventricular septal defect was present in 12 cases (42.8%). Ventriculo-arterial connections were concordant, with "normally related" great arteries in 9/15 cases with ventricular D-loop (60%). In these cases, ventricular morphology, connections and relations of the great arteries were typical of situs solitus. In the remaining 6 patients there was double outlet right ventricle, also with normally related great arteries. In 12/13 cases (92.3%) with ventricular L-loop ventriculo-arterial connections were concordant with "mirror image normally related" great arteries. In these cases, ventricular morphology, connections and relations of the great arteries were typical of situs inversus. In one patient there was double-outlet right ventricle, also with mirror image normally related great arteries. Twelve patients (42.8%) had pulmonary stenosis and 5 had a systemic outflow obstruction (17.8%). From these observations we conclude that ventriculo-infundibular morphology, either of situs solitus-type or of situs inversus-type, is a typical anatomical feature of left atrial isomerism. These results may have important implications in the diagnosis and in the surgical management of patients with left atrial isomerism. PMID- 1790835 TI - [Nonpharmacological therapy of supraventricular and ventricular arrhythmias: role of intracavitary ablation]. PMID- 1790836 TI - [The etiology of purulent meningoencephalitis in pediatrics. The therapeutic implications]. AB - In order to know the etiology of purulent meningitis in infant and children, a retrospective study was done; 709 cases of a pediatric infectious disease service were analyzed. Diagnosis was established either by antigen detection (coagglutination) or bacterial culture. In 334/709 (48%) the bacterial agent was identifies. Haemophilus influenzae type b (70%), Streptococcus pneumoniae (14%), Enterobacteriaceae (8%) and Streptococcus sp (6.5%) were the most frequent. According to our results the epidemiologic pattern of purulent meningitis has not changed. A therapeutic approach is suggested. PMID- 1790837 TI - [Hepatosplenomegaly of unknown origin. A study of 63 cases]. AB - We have reviewed sixty three cases of patients with hepatosplenomegaly admitted at the internal medicine service at the Hospital Infantil del Estado de Sonora over a period of the ten years. We didn't found differences in the number of male and female children. The larger groups were from 1 month to 6 years old age. The nutrition status were normal in more of 80% of the patients. The time that children spent at the hospital for diagnosis was less than 15 days in more than half of the cases. The symptoms predominating and clinical features were paleness fever and adenomegalies. Basic laboratory and other studies were made in a initial period, phase I (CBS, urinalysis serum, urea serum creatinine, serum glutamic oxalacetic and piruvic transaminases, and coccidioidine skin test, monotest, ASL, cytomegalovirus and rubella antibodies, Sabin-Feldman test, VDRL and chest, abdominal and paranasal sinus x-Ray) we reached a definitive diagnosis with this laboratory methods in 41.2% of the cases. A percutaneous hepatic biopsy was a rewarding accurate diagnostic procedure in 19 of 21 patients. The diagnosis that we established in general groups were: infections diseases, oncologic disease, metabolic disturbances, primary unknown hepatic disease, hematologic disorders and congestive diseases. In this letter we want to show our experience in a second level pediatric hospital in a mexican province so that this work can be reviewed by other Physicians and they can offer a better attention for this patients. PMID- 1790838 TI - [The prognosis for the immunocompromised host in an intensive care unit. A report of 80 cases]. AB - An analysis of 80 immunocompromised patients who were admitted to the intensive care unit (ICU) was made. It was 3 different groups: those treated chronically with more than 20 mg of prednisone or it's equivalent, patients with severe neutropenia (-500 PMN'S/mm3) and patients with AIDS. The reasons for admittance to the ICU were: pneumonia (51.2%), postoperative care (30%) extrapulmonary sepsis (8.7%) and other causes in 10%. Mortality was 62.5%. It was statistically higher in those that were admitted for pneumonia, developed respiratory failure, and required postoperative care after emergency surgery (80%, 89.5% and 70% respectively). Also in patients with multiple organic failure (3.2 +/- 1.6 vs 0.9 +/- 1.2 in survivors) and with higher APACHE II score (24 +/- 7 vs 15.4 +/- 6 in survivors). The mortality for acute respiratory failure, the principal organic failure observed, according to the primary diagnosis was: AIDS 100%, severe neutropenia 85.7% and chronic use of steroids in 85.7% of the patients. PMID- 1790839 TI - [Thallium poisoning which stimulated systemic lupus erythematosus in a child]. AB - We report the case of a preschool boy who, without knowledge of his relatives, ingested thallium sulfate in a dose calculated in 30 mg/kg. He presented a systemic lupus erythematosus-like syndrome and only further alopecia oriented the diagnosis of thallium toxicosis; thallium blood levels were; 37.2 micrograms/dl and in urine: 2330 micrograms/L. Treatment with the chelating agent D. penicillamine was effective, the clinical picture disappeared and the decrease of the thallium levels was observed. Thallium intoxication should be considered in the differential diagnosis of connective tissue disease as the above mentioned. PMID- 1790840 TI - [Laryngeal papillomatosis]. PMID- 1790841 TI - [Electroconvulsive treatment]. PMID- 1790842 TI - [Mercury poisoning in children]. PMID- 1790843 TI - [The clinical importance of pharmacokinetics]. AB - An overall review about the main concepts of pharmacokinetics and its importance in the clinical arena is presented. The goal of this manuscript is the comprehension of this matter, described with a clear language, without mathematical formulas, considering that they are widely explained in the publications of the well-known journals of clinical pharmacology. PMID- 1790844 TI - [The mechanisms of neutrophilic oxygen damage in ischemic and reperfusion lesions. Pharmacological manipulations]. AB - This work studies the ischemic/reperfusion injury (I/R) in relationship to the production of free radicals from activated neutrophils. It is well known, that biochemical and physiopathological alterations participate in the tissue lesion produced by the interaction oxygen/leukocyte. Pharmacological manipulations, oriented to eliminate the harmful effect of the free radicals, remain as the most significant event in the management of the I/R injury. Compounds such as allopurinol, adenosine, naloxone, corticosteroids, methylurea, and others, have demonstrated a protective effect during the I/R injury. Although, the mechanism of action of these compounds is unknown, it is possible that the free radical scavenging effect, could be the most important protective mechanism. The better understanding of the I/R injury would allow for a better protection of the damaged organ. PMID- 1790845 TI - [Order and disorder in medical care during the siege of Queretaro in 1867. History made by the winners?]. PMID- 1790846 TI - [The history of intensive care units. 2 Mexican antecedents]. PMID- 1790847 TI - [Cholera, plaga rediviva]. PMID- 1790848 TI - [Hepatitis B and delta: the prevalence of seroepidemiological markers in volunteer blood donors and their families]. AB - 41 volunteer blood donors and his relatives were studied in order to know about the prevalence of hepatitis B and D virus infections in selected groups. Frequency of HBsAg+ carriers was 0.34 per cent in the Centro Nacional de la Transfusion Sanguinea and 0.15 per cent in the Banco Central de Sangre, IMSS. Most of the HBsAg+ blood donors were 21 to 40 years old (87.8%); 21.9 per cent had IgM antibodies against HBc and just 2.4 per cent were HBeAg positive. Forty one (26.9%) of 152 relatives had one or more of the HBV markers, 3.9 per cent were HBsAg carriers and 1.3 per cent were HBeAg positive. In the infected relatives group 36.6 per cent were ancestory or brothers and just 14.6 per cent of wives were infected. None of the HBsAg+ blood donors or his relatives had antibodies against delta agent. These results support the fact that the frequency of asymptomatic carriers of HBsAg in the volunteer blood donors group is similar to he frequency in the general population and identifies the group of relatives as those with the highest risk to acquire HBV infection. PMID- 1790849 TI - [The evolution of immunological markers in acute viral hepatitis B. A study in 177 patients]. AB - This is a report about 177 patients suffering acute viral hepatitis type B; 135 (76%) men and 42 (24%) women. Sequential monitoring was carried out of HBe Ag, HBs Ag and their corresponding antibodies until negativitation or positivitation. Even though the immune response was adequate, there were three kinds of response: a) Simultaneous, disappearance of antigens and appearance of antibodies at the same time; 46% for antigen e and 39% for s. b) Late the elimination of antigens preceded the appearance of the antibodies; 37% for antigen e and 34% for antigen s. c) Early, the antibodies anticipated negativitation of antibodies which enables both markers to be detected simultaneously; 17% for antigen e and 27% for antigen s. PMID- 1790850 TI - [Sarcoidosis (intra- and extrathoracic): apropos a Mexican case]. AB - In this paper, we report a case of sarcoidosis, in a 15-years-old boy. Clinical picture has cutaneous findings as only manifestation. Clinical approach was oriented by reticulosis. Diagnosis of sarcoidosis, was based in scans that shows pulmonary involvement. Lastly, granulomatoses disorders most common in our country, like tuberculosis and leprosy, were excluded. PMID- 1790851 TI - [Cholera]. PMID- 1790852 TI - [Visual damage due to the observation of a solar eclipse]. PMID- 1790853 TI - [The African bee]. PMID- 1790854 TI - [The panorama of coccidioidomycosis in Nuevo Leon from 1978 to 1988]. AB - The coccidioidomycosis is an endemic illness in the southern United States and the Northern of Mexico, the state of Texas and Nuevo Leon are included in this area. In the city of Monterrey from 1978 to 1988 the hospitals have reported one hundred and fifty cases. One hundred eleven of them from the state of Nuevo Leon and the remaining from the neighboring states. The main clinical presentation was in the pulmonary form with one hundred and twelve cases, followed by the cutaneous with thirty-three in the later the most common presentation was the ulcerated form. Therapeutically two new medication have been tried a with encouraging results, the itraconazole and the fluconazole the differential diagnosis is made mainly with tuberculosis and deep mycosis. PMID- 1790855 TI - [Tinea manuum. Epidemiological and mycological data on 366 cases]. AB - Epidemiological an mycological data of a 30 years long study on 366 cases of tinea manuum. A sudden raise on the last five years (249 cases). The mycosis is caused by T. rubrum (86%), mostly affects men (70%) among 11 and 40 years of age, on one hand (61%) and seldom both (21%). The course last 2 years in average. The KOH examination confirms the diagnosis (93.5%). PMID- 1790856 TI - [New aspects of the biology of Entamoeba histolytica]. AB - To determine the mechanism of mitosis in E. histolytica, a study was carried out with axenic cultures of trophozoites in Coplin jars with glass slides to stain them in situ with Giemsa and fluorescent antibodies for actin. Tobuline and myosin. Sedimented amoeba of cultures were used also for ultrastructural studies after glutaraldehyde fixation, and inclusion in spon-araldite. Giemsa stained trophozoites showed duplication by budding or fission with production of polykaryons, mononuclei, micronuclei and apparent polyploidy and DNA reduction. Tubuline was present in nuclei and cytoplasm, actin and myosin had a peripheral distribution with low contents of the latter in large amoeba, resulting in polynucleated cells. The findings are suggestive of endomeiosis with chromosomal recombination which would render virulent and non virulent strains producing either invasive or asymptomatic amoebiasis. PMID- 1790857 TI - [Health and social communication]. PMID- 1790858 TI - [The interaction of the medical researcher with other scientists]. AB - A brief review of nonmedical scientists contributions to medicine is done. Information on morphology, physiology, biochemistry obtained with high technology has been increasingly used in the clinical work. Therefore broad knowledge and skills have turned to be necessary, though almost impossible to get by one person alone. The answer to this problem is the interdisciplinary team work on basic problems: diagnosis, prognosis, treatment, epidemiology, public health, management of health services, etc. By these work the physician must use models and "black boxes". Both concepts are reviewed. Some proposals to improve the relationships among physicians and other scientist are made. PMID- 1790859 TI - [Biotesting in hygienic assessment of water quality]. PMID- 1790860 TI - [Problems of individual-typological variations of the body]. PMID- 1790861 TI - [Metrological certification of the method of testing materials for toxicity of burning products]. PMID- 1790862 TI - [Effectiveness of preventive measures in lowering pollution of water reservoirs of the Irtysh River basin]. PMID- 1790863 TI - [Hygienic assessment and sanitary measures in mining and processing of potassium ore]. AB - Study of labour conditions in mining and processing of polymineral potassium ore was conducted. It was shown, that air and lighting conditions and vibrations are more severe under mining, than under processing of potassium ore. PMID- 1790864 TI - [Embryotoxic effects of industrial environment pollutants: formaldehyde and gasoline]. AB - Prenatal and postnatal effects of formaldehyde and gasoline were studied. Delay of skeleton development and other prenatal negative effects at levels 0.5 mg/m3 for formaldehyde and 300 mg/m3 for gasoline were noted. Slow-down of motor reflexes and physical development in postnatal time were demonstrated. Embryotoxic tests of environmental pollutants offered to do both as in prenatal so as postnatal periods. PMID- 1790865 TI - [Work capacity of man when using individual respiratory protective devices]. AB - Gas-mask decreased the ability to work by 20-50%. It was caused by decreasing skin and respiratory evaporation. Ventilation of the under mask interspace (90 1/min) was recommended. PMID- 1790866 TI - [Physiologic-hygienic characteristics of work conditions of women workers in hot houses during harvesting]. PMID- 1790867 TI - [State of the monooxygenase system of the rat liver during ontogenesis under the action of polychlorinated diphenyls]. AB - Perinatal action of polychlorinated diphenyls on rat liver monooxygenase system in ontogenesis was studied. Significant modifications in the development of cytochrome P-450 system were noted. PMID- 1790868 TI - [Assessment of the effectiveness of radiation protection of dietary calcium in relation to cesium-137 administered alone or in combination with iodine-131]. AB - New fish product with addition of food calcium had radioprotective properties, resulted in decreased cesium-137 content in organs and tissues of animals by 40 60% and lesser changes in differential blood count and biochemical indexes of blood serum. PMID- 1790869 TI - [Differential assessment of the health status of preschool children in risk groups]. AB - Health status of the underschool children from the second health group, which with having some morphofunctional changes, (503 persons) was studied. The key changes were postural, cardiovascular, neuropsychic changes. The lysozyme level in saliva is the informative index related to the health status of underschool children. PMID- 1790870 TI - [Hygienic assessment of the organization of teaching of lower classes during a 5 day school week]. AB - Hygienic assessment of teaching conditions and ability to work of pupils in primary school under five day a week education were studied. Significant "physiological cost" of teaching and difficulties in adaptation of pupils were noted. PMID- 1790871 TI - [Biological effects of small quantities of nuclear fission products]. PMID- 1790872 TI - [Current problems of sanitary protection of water resources and soil]. AB - Chemical pollution of water reservoirs and rivers in Ukrainian SSR was noted. Anthropogenic soil pollution is also discussed, and sanitary measures for reservoirs and soil protection suggested. PMID- 1790873 TI - [Radiation situation in Moscow and Moscow region in 1985-1988]. PMID- 1790874 TI - [Morbidity of respiratory organs in children in relation to radiation factors in housing]. PMID- 1790875 TI - [Combined effects of vibration and continuous wide-range noise on the nervous system]. AB - Influence of vibration and broad band noise on the nervous system of guinea pigs was studied. Changes in all parts of the nervous system were noted. The changes connected with disruption of metabolism, caused by disruption of microcirculation. In cases of prolonged treatment the death of neurones with subsequent widening of micro-and macroglia was noted. PMID- 1790876 TI - [Methodological approaches to the morphological assessment of the skin under slight toxic effects]. AB - One-fold treatment of rat skin with 3% water solution of potassium bichromate resulted in slight toxic effects in epidermocytes, sebaceous gland cells and epithelial follicles. System of indexes for the slight toxic effects to assess was worked up. PMID- 1790877 TI - [Endocrinology in the training of physicians in "medical prophylactic work" specialty]. PMID- 1790878 TI - [Rapid control of commercially produced disposable syringes]. PMID- 1790879 TI - [Criteria for the assessment of nutritional hygiene units in sanitary epidemiological stations]. PMID- 1790880 TI - [Work satisfaction and health]. PMID- 1790881 TI - [Questionnaire as a method of studying the level of hygienic knowledge of milk factory workers]. PMID- 1790882 TI - [Optimization of laboratory control in state sanitary inspection]. PMID- 1790883 TI - [Photometric detection of 3,5-dinitrosalicylic acid in the air]. PMID- 1790884 TI - [Gas chromatographic vapor-phase detection of organic solvents in the water and model systems]. PMID- 1790885 TI - [Identification of volatile phenols in drinking and raw water]. PMID- 1790886 TI - [General approaches to the determination of ecological hazards of anthropogenic environmental factors]. PMID- 1790888 TI - [Annual meeting of the Bavarian Society of Obstetrics and Gynecology and of the Austrian Society of Gynecology and Obstetrics. Munich, May- June 1991]. PMID- 1790887 TI - [Determination of methyl benzoate and isoamyl benzoate in the environmental air using high performance liquid chromatography]. PMID- 1790889 TI - [Preventive tocolysis in premature rupture of fetal membranes]. PMID- 1790890 TI - [Induction of lung maturation in the early stage of premature rupture of fetal membranes]. PMID- 1790891 TI - [The diagnostic reliability of neuraminic acid/protein quotients in amniotic fluid as an indicator of fetal maturity]. PMID- 1790892 TI - [Bed rest for the prevention of threatened premature labor]. PMID- 1790893 TI - [Effect of streptococci on the uterine activity]. PMID- 1790894 TI - [The support pessary--a therapeutic possibility in premature opening of the uterine cervix]. PMID- 1790895 TI - [Obstetric parameters and morbidity of very small newborn infants less than 1,500 g]. PMID- 1790896 TI - [Oxycardiotocography. A new procedure for measuring fetal oxygen saturation sub partu. Use of the method]. PMID- 1790897 TI - [New and established methods for labor monitoring in comparison with their predictive value for fetal risk status]. PMID- 1790898 TI - [Different dosage intervals in oxytocin-induced uterine contraction--a retrospective study]. PMID- 1790899 TI - [Optimizing the time of delivery with prostin E2]. PMID- 1790900 TI - [Patient-controlled lumbar catheter peridural anesthesia versus continuous perfusor catheter peridural anesthesia--initial results]. PMID- 1790901 TI - [Severe growth retardation: results of a study of fetal blood samples (cordocentesis)]. PMID- 1790902 TI - [Prospective randomized study of the clinical value of Doppler sonography as a screening procedure]. PMID- 1790903 TI - [Discriminant analysis of Doppler sonographic data for assessment of obstetric risk]. PMID- 1790904 TI - [Doppler sonography versus current monitoring methods--comparison of test validity]. PMID- 1790905 TI - [The clinical value of Doppler sonography]. PMID- 1790906 TI - [Differential diagnosis of the biometrically small infant using Doppler sonography]. PMID- 1790907 TI - [The value of Doppler in evaluation and prognosis of fetuses with non-immunologic hydrops fetalis]. PMID- 1790908 TI - [Effect of TNS on sonographic functional parameters in placental insufficiency]. PMID- 1790909 TI - [Vaginal sonographic assessment of placenta praevia]. PMID- 1790910 TI - [Prenatal diagnosis and Doppler sonographic monitoring of twin pregnancy with acardius]. PMID- 1790911 TI - [Caudal regression syndrome in the fetus of a type I diabetic patient: case report]. PMID- 1790912 TI - [Pregnancy in mucoviscidosis]. PMID- 1790913 TI - [Accident in pregnancy]. PMID- 1790914 TI - [Maternal death in Austria 1975-1989]. PMID- 1790915 TI - [Analysis of Doppler sonographic findings in diabetic pregnancies]. PMID- 1790916 TI - [Predictive value of hemolysis for fetomaternal outcome in patients with pregnancy-induced hypertension]. PMID- 1790917 TI - [Four years experience with individual quality assurance in obstetrics]. PMID- 1790918 TI - [Tubular changes in normal pregnancy and EPH gestosis. Diagnosis by N-acetyl-beta D-glucosaminidase]. PMID- 1790919 TI - [Hypertension in pregnancy: possibilities for differentiating various kinds of hypertension based on serum and urine parameters]. PMID- 1790920 TI - [Prognostic value of peripartal thrombopenia]. PMID- 1790921 TI - [Predictive value of selected examination parameters in anamnestic risk for premature labor]. PMID- 1790922 TI - [Experience with the roll-over test in gestosis screening]. PMID- 1790923 TI - [Initial experiences with a new catheter-controlled chorionic villi sampling technique]. PMID- 1790924 TI - [Amniocentesis in the 12th - 14th week of pregnancy: initial experiences with 107 interventions]. PMID- 1790925 TI - [Amniocentesis in the first trimester of pregnancy]. PMID- 1790926 TI - [Experiences with 7,127 early amniocentesis in 6,924 pregnancies at the I. Munich University Gynecologic Clinic 1976-1989]. PMID- 1790927 TI - [Significance of cervical chlamydia infections in pregnancy for mother and child]. PMID- 1790928 TI - [Intrauterine fetal death--where does prenatal care fail?]. PMID- 1790929 TI - [Predictability of fetal risk by ultrasonographic screening]. PMID- 1790930 TI - [Glucose tolerance--only a burden for personnel? The oral glucose tolerance test in puerperium]. PMID- 1790931 TI - [Is the transfer rate of newborn infants a quality criterion in peri-neonatal monitoring?]. PMID- 1790932 TI - [Isolated skin manifestations of amniotic band syndrome and their clinical significance]. PMID- 1790933 TI - [Comparison of perinatal data from 1989 between Bavaria and South Tyrol]. PMID- 1790934 TI - [Diagnosis and therapy of vulvar dystrophy]. PMID- 1790935 TI - [Routine use of the CO2 laser in a large gynecologic department]. PMID- 1790936 TI - [Primary cytostatic treatment of vaginal cancer]. PMID- 1790938 TI - [Magnetic resonance staging as a decision aid in therapy of cervix cancer]. PMID- 1790937 TI - [Initial results of adjuvant chemotherapy of operated cervix cancer]. PMID- 1790939 TI - [Cervix cancers in young women]. PMID- 1790940 TI - [Effect of histomorphologic parameters on the formation of lymphoceles after radical operation of gynecologic malignancies]. PMID- 1790941 TI - [Radical surgery of blind vaginal sac]. PMID- 1790942 TI - [Immune lymphoscintigraphy in gynecologic oncology]. PMID- 1790943 TI - [Effect of radiation therapy on urodynamic parameters in cervix cancer patients]. PMID- 1790944 TI - [Vaginal sonography of the endometrium in postmenopause. Initial results of a prospective study]. PMID- 1790945 TI - [Endometrial cancer: diagnostic validity of vaginal ultrasound screening]. PMID- 1790946 TI - [The significance of prognostic factors in patients with endometrial cancer and lymph node excision]. PMID- 1790947 TI - [Secondary surgical interventions in ovarian cancer]. PMID- 1790948 TI - [Is in adenomatous hyperplasia of the endometrium a control curettage indicated?]. PMID- 1790949 TI - [Lymph node status in corpus and cervix cancer]. PMID- 1790950 TI - [Corpus cancer in after care]. PMID- 1790951 TI - [Therapy of atrophic colpitis--is a reduction of estrogen dosage in local administration possible?]. PMID- 1790952 TI - [Pretherapeutic scalenus biopsy in ovarian cancer]. PMID- 1790953 TI - [Surgical treatment of ovarian cancer: comparison of primary and secondary tumor reduction interventions]. PMID- 1790954 TI - [Ototoxicity of cisplatin chemotherapy in patients with ovarian cancer]. PMID- 1790955 TI - [The value of preventive ovariectomy at the time of hysterectomy for prevention of ovarian cancer]. PMID- 1790956 TI - [Supportive enteral nutrition therapy in cytostatic drug treatment despite decreased absorptive ability of the small intestine]. PMID- 1790957 TI - [Comparative study of optimizing drainage after axillary lymph node excision]. PMID- 1790958 TI - [Flow cytometry DNA analysis of pure cell nuclei from formalin fixed paraffin sections in primary breast cancer: correlation with other prognostic factors]. PMID- 1790959 TI - [DNA image cytometry in breast cancer: comparison with other prognostic criteria]. PMID- 1790960 TI - [Mitoxantrone monotherapy in metastatic breast cancer--initial results of a prospective randomized study in "low risk" patients]. PMID- 1790961 TI - [Nuclear magnetic resonance of the pelvic floor--an expansion of the anatomic image]. PMID- 1790962 TI - [Urodynamic studies after surgery, radiation treatment and cytostatic therapy of gynecologic cancers]. PMID- 1790963 TI - [Endoscopic bladder neck suspension--clinical, urodynamic and radiologic results]. PMID- 1790964 TI - [Surgical therapy of stress incontinence after radical hysterectomy]. PMID- 1790965 TI - [Ureteral lesions in radical hysterectomy with pelvic lymph node excision]. PMID- 1790966 TI - [Urologic complications in gynecologic tumor interventions]. PMID- 1790967 TI - [Abdominal surgery for gynecologic malignancy: sequelae and complications]. PMID- 1790968 TI - [Intravesical administration of estriol as a possible form of therapy of sensory urge incontinence]. PMID- 1790969 TI - [Is increased secretion of LH after LHRH administration a reliable indicator of polycystic ovary syndrome?]. PMID- 1790970 TI - [The value of the GnRH double stimulation test in differentiation of oligo amenorrhea]. PMID- 1790971 TI - [Endocrine effects of laser vaporization of the ovaries in women with polycystic ovary syndrome]. PMID- 1790972 TI - [Sterility therapy in patients with polycystic ovaries]. PMID- 1790973 TI - [Spectrophotometry analysis of follicle fluids in an in-vitro fertilization program]. PMID- 1790974 TI - [Initial experiences with hysteroscopic catheter technique for recanalization of proximal tubal occlusions]. PMID- 1790975 TI - [Therapy of tubal pregnancy by hysteroscopic administration of prostaglandin]. PMID- 1790976 TI - [The importance of preoperative diagnosis for prevention of postoperative complications of the efferent urinary tract]. PMID- 1790977 TI - [Coping with illness by patients with genital cancers]. PMID- 1790978 TI - [Hyperemesis as an individuation attempt--a case report]. PMID- 1790979 TI - [Psychological factors in the development of breast cancer]. PMID- 1790980 TI - [Who needs preparation for labor?]. PMID- 1790981 TI - [Psychological short term psychotherapy in vaginism]. PMID- 1790982 TI - [Prognostic importance of tumor cell detection in exudates and peritoneal lavage fluid by monolayer cultures]. PMID- 1790983 TI - [Immunohistochemical differentiation of granulosa cell tumors and ovarian cancers]. PMID- 1790984 TI - [Modification of the EGF receptor by cytostatic treatment]. PMID- 1790985 TI - [Effect of hormonal contraceptives on eicosanoid content of menstrual blood]. PMID- 1790986 TI - [Evaluating an integrated obstetric data processing program for the personal computer]. PMID- 1790987 TI - [Fetal and maternal risk in 782 deliveries after previous cesarean section]. PMID- 1790988 TI - [Effects of severe EPH gestosis on the neonatal blood picture]. PMID- 1790989 TI - [Therapy of vaginal infections in postmenopausal patients]. PMID- 1790990 TI - [Does lumbar epidural analgesia improve hemodynamics and kidney dysfunction in EPH gestosis?]. PMID- 1790991 TI - [Lumbar epidural analgesia in EPH gestosis: fetal and maternal risk]. PMID- 1790992 TI - [Comparison of the estrogen and progesterone receptor content of primary breast cancers without skeletal or visceral metastasis with tumor marker MCA, CEA and CA 15-3 serum concentration at the time of surgery]. PMID- 1790993 TI - [Hysteroscopic balloon catheter-plasty]. PMID- 1790994 TI - [In vitro studies of the regulation of secretion and synthesis of human chorionic gonadotropin (hCG) by prolactin in the human placenta at term]. PMID- 1790995 TI - [Effect of radical surgery on development of postoperative urologic complications]. PMID- 1790996 TI - [Therapy of functional disorders of the lower urinary tract after radical surgery of the pelvis]. PMID- 1790997 TI - [Isotope nephrography in follow-up of cervix cancer patients after radical surgery]. PMID- 1790998 TI - [Androgenization. An overview]. PMID- 1790999 TI - [Androgenization and androgen insensitivity]. PMID- 1791000 TI - [The incidence of hyperandrogenemia]. PMID- 1791001 TI - [Predictability of fetal risk and predictive value of results of perinatal studies: a challenge for the obstetrician]. PMID- 1791002 TI - [The value of prepathologic and pathologic Doppler findings in comparison with cardiotocography, hormone and asphyxia parameters]. PMID- 1791003 TI - [Validity of Doppler findings with reference to fetal outcome]. PMID- 1791004 TI - The use of night splints for treatment of recalcitrant plantar fasciitis. AB - This study reports the results of the use of molded ankle foot orthosis night splints for the treatment of recalcitrant plantar fasciitis on 14 patients with a total of 18 symptomatic feet. All patients had symptoms for greater than 1 year and had previously undergone treatment with non-steroidal anti-inflammatory medicines, cortisone injections, shoe modifications, and physical therapy without resolution. All patients were provided with custom-molded polypropylene ankle foot orthoses in 5 degrees of dorsiflexion to be used as a night splint. With continued use of nonsteroidal anti-inflammatory medication, Tuli heel cups, Spenco liners, and general stretching exercises, successful resolution occurred in 11 patients in less than 4 months. There were three failures. It is felt that the use of night splints provides a useful, cost-effective adjunct to current therapeutic regimens of plantar fasciitis. PMID- 1791005 TI - Analysis of the forefoot on pointe in the ballet dancer. AB - The forefoot positions of nine ballet dancers standing on pointe were determined using a mold technique. These molds revealed three positions of the toes: (1) no crossing of the three medial toes; (2) crossing of the third toe behind the second; and (3) crossing of the hallux partially in front of the second. Almost half of all the toes seen on the molds had some deformation of the toenails. These molds also indicated a wide variability in the amount and location of contact between the shoes and toes. PMID- 1791006 TI - The use of a grommet bone liner for flexible hinge implant arthroplasty of the great toe. AB - Press-fit titanium grommets were developed to shield flexible hinged silicone implants used for arthroplasty of the radiocarpal, metacarpophalangeal, and metatarsophalangeal joints. Since 1985, 179 titanium circumferential grommets were used in 90 first metatarsophalangeal joints with excellent, pain-free, functional results and favorable bone response around the implant stems and at the bone-grommet interface. There were no complications due to particulate reactivity, implant fracture, or grommet fracture. The use of circumferential titanium grommets appears to be a safe and effective method to improve the long term durability of flexible hinge implant arthroplasty of the first metatarsophalangeal joint. PMID- 1791007 TI - Results of arthrodesis of the tarsus: talocalcaneal, midtarsal, and subtalar joints. AB - A 10-year prospective study was carried out on arthrodesis surgery of the major tarsal joints of the foot. The guiding principle of the study was that foot symmetry would be preserved, except where both feet were deformed. Correction in the frontal, coronal, and sagittal planes would be used to restore normal talocalcaneal relationships. In patients with normal relationships, triple, subtalar (talocalcaneal), and isolated tarsal arthrodesis would be carried out by iliac-crest-inlay grafting to preserve tarsal relationships. In 41 patients, 47 arthrodeses were carried out. There were 31 triple arthrodeses, 10 talocalcaneal fusions, four talonavicular fusions, and two naviculocuneiform fusions. In patients with deformity, significant improvement in the angles of anteroposterior talocalcaneal divergence and lateral talocalcaneal convergence was recorded. There were 27 good results, 15 fair results, and five poor results. Supplementary bone grafting and the use of internal fixation improved the rate of arthrodesis. PMID- 1791008 TI - Longitudinal splitting of the peroneus brevis tendon: an anatomic and histologic study of cadaveric material. AB - Gross and microscopic examinations of 21 split and 10 intact cadaveric peroneus brevis tendons were performed in an effort to determine the pathogenesis of longitudinal splitting of this tendon. The split regions were centered over the posterior margin of the distal fibula and were characterized by splaying of the collagen bundles with accompanying proliferation of blood vessels and fibrovascular connective tissue. Inflammatory infiltrates were not present. Regions of the tendons that were not altered had normal cellularity and orientation of the collagen. The findings of this study suggest that the splitting of the tendon develops through a mechanical mechanism. PMID- 1791009 TI - Distal oblique osteotomy for tailor's bunion. AB - Thirty-six patients with a total of 50 symptomatic tailor's bunions were evaluated clinically, radiographically, and subjectively, both before and after a distal oblique osteotomy procedure was performed. Thirty-four of 36 patients were satisfied with pain relief. Radiographic measurements derived from this study were consistent with those of other studies. Avascular necrosis, nonunions, or neuroma formation were not encountered in this study. The significant advantages of this procedure are its simplicity, safety, and predictability. The procedure does not require internal fixation or postoperative immobilization. PMID- 1791010 TI - Acute rupture of the tibialis anterior tendon: a case report. AB - Acute rupture of tendons on the dorsum of the foot is rare and the diagnosis can be difficult. We present the case of a 51-year-old man who sustained an acute rupture of the tibialis anterior tendon. Pain about the medial aspect of the midfoot and ambulation with a steppage gait were the keys to formulating a correct diagnosis. The tendon was repaired primarily 10 days after injury. At his final follow-up examination 6 months after surgery, the patient was asymptomatic and ambulated with a normal gait. PMID- 1791011 TI - Squamous cell carcinoma complicating chronic osteomyelitis in a toe: a case report and review of the literature. AB - Squamous cell carcinoma arising from chronic osteomyelitis is uncommon. Although the majority of cases occur in the lower extremity, incidence in the foot is relatively rare, and in the toe, exceptional. This report illustrates a particularly unusual incidence of squamous cell carcinoma complicating chronic osteomyelitis of the hallux. Guidelines for early diagnosis, recommendations for treatment, and prognostic data are included. PMID- 1791012 TI - Chronic lateral ankle instability. AB - Chronic lateral ankle instability may be present in as many as 10% to 30% of people suffering from acute lateral ankle ligament injuries. Ankle instability has been referred to as either functional instability or mechanical instability. Management options consist of either nonoperative or operative treatment, with the majority of the literature emphasizing operative management for chronic instability. Long-term studies assessing the different types of available operative repairs have now been published. This review article discusses chronic lateral ankle ligament instability from a functional, anatomical point of view. The indications for treatment, nonoperative and operative treatment, as well as the biomechanical information available regarding these methods of treatment are considered. The major emphasis of this review is discussion and analysis of the many different surgical treatment options. Following this review, we presently recommend anatomical repair to the bone of both the anterior talofibular ligament and the calcaneofibular ligament, together with imbrication of the ligaments. In patients with hypermobility, long-standing instability, or arthritis, reconstruction using the Chrisman-Snook technique is recommended. PMID- 1791013 TI - Loading of the contralateral foot in peripheral vascular insufficiency below-knee amputees. PMID- 1791014 TI - My experience as a courier. PMID- 1791015 TI - Pharmacokinetics of sustained release and conventional tablets of theophylline plus hydroxyethyltheophylline and its comparison with tablet aminophylline. AB - Pharmacokinetics of a sustained release (SR) and conventional formulations of theophylline plus hydroxyethyltheophylline was compared with tablet aminophylline. Time concentration curve of serum theophylline with the three formulations after single and multiple dosage schedules revealed significantly retarded absorption with the SR preparation. SR tablet was also seen to produce uniform steady state levels with fluctuation of serum concentrations within the therapeutic range for a duration of over 12 hours. In comparison, aminophylline and conventional theophylline hydroxyethyltheophylline tablets produced sharp swings in steady state levels with trough levels dipping to subtherapeutic concentrations within 4-6 hours. SR formulation, therefore, is likely provide consistent serum levels and better therapeutic control in comparison to the other two conventional tablets. PMID- 1791017 TI - Brush cytology as a diagnostic aid for bronchogenic carcinoma. AB - The results of 125 bronchoscopies were reviewed and analysed with particular emphasis on bronchial brushing. In the patients with a visible endobronchial growth, yield for malignancy was 76.6%, while 2.9% each showed evidence of adenoma and dysplasia. In the patients with no visible growth, the yield was 25% without fluoroscopic guidance. There were no major complications. PMID- 1791016 TI - Fiberoptic bronchoscopy in patients with haemoptysis and normal chest roentgenograms. AB - Over the last 10 years, 53 patients with hemoptysis, but with a normal chest radiograph underwent diagnostic fiberoptic bronchoscopy. Forty-three patients did not show any abnormal findings, the site of bleeding could be localised in five and non-specific mucosal changes were seen in the remaining five patients. Thirty two patients were followed up clinically for a 3-18 months period. One patient on follow-up developed tubercular pleural effusion. Bronchogenic carcinoma was not detected in any of these patients during the procedure or at follow up. A review of literature revealed a 3 per cent incidence of bronchogenic carcinoma and the risk factors associated with higher incidence were age above 40 years, cigarette smoking and a longer duration of hemoptysis. We conclude that fiberoptic bronchoscopy has little role in this relatively benign condition (hemoptysis) especially when the risk factors are absent. PMID- 1791018 TI - Clindamycin in the treatment of anaerobic lung abscess. AB - A case of anaerobic lung abscess who had treatment failure after 4 weeks of supervised parenteral penicillin and oral metronidazole is described. Anaerobic pathogens resistant to one or the other of the above drugs were isolated. The patient had a striking clinical response to subsequent therapy with oral clindamycin. Failure of therapy should alert physicians to the possibility of infection with resistant anaerobic pathogens and in such situations, clindamycin is considered as an effective alternative. PMID- 1791019 TI - Tracheo-oesophageal fistula in an adult. PMID- 1791020 TI - Primary mediastinal embryonal cell carcinoma. AB - It is now widely accepted that germinal cell tumors can arise primarily in the mediastinum. Primary extragenital seminoma has been documented arising in the mediastinum but very few reports are available about primary mediastinal embryonal cell carcinoma. We report a case of this rare condition with radiological and CT features. PMID- 1791021 TI - Correlation of smoking behaviour and blood carboxyhaemoglobin in bidi and cigarette smokers. AB - Effects of different variables (amount, number of puffs, depth of inhalation, length and timing of sampling) of smoking on the blood carboxyhaemoglobin (COHb) levels were studied. There were 27 bidi smokers, 25 cigarette smokers, 25 mixed smokers (all asymptomatic) and 20 symptomatic cigarette smokers. Fifty-eight healthy non-smokers served as controls. The mean COHb levels in all the smokers were nearly 5-7 times higher than that in non-smokers. The blood COHb levels correlated well with the self assessed degree of inhalation by the individual smokers in each of the groups. There was no significant correlation between the COHb levels and number smoked on the test day, number of puffs per cigarette or bidi, and the length of smoking material. There was a good inverse correlation between the time interval and COHb level. The smoking index (amount smoked) did not bear any relationship with blood COHb levels. PMID- 1791022 TI - Pulmonary effects of formaldehyde exposure--an environmental-epidemiological study. AB - A comparative study of effects of formaldehyde on respiratory system was carried out among systematically selected anatomy and histopathology department workers of three medical colleges of Vidarbha. A group of persons, not exposed to formaldehyde served as control group. Analysis of air samples revealed that the concentration of formaldehyde at study group work places was significantly more than the control group work places. The respiratory symptoms such as productive cough, breathlessness and tightness of chest were significantly more frequent among formaldehyde exposed persons. The lung function parameters showed a significant decrease among exposed as compared to non-exposed group. PMID- 1791024 TI - Multiple bilateral pulmonary hydatids. PMID- 1791023 TI - Hypoplastic lung with Hodgkin's disease. AB - A case of Hodgkin's disease who was found to have a hypoplastic lung on investigation is presented here. This co-incidence has not been reported earlier in the literature. PMID- 1791025 TI - Reproducibility of histamine inhalation bronchial challenge test. AB - Broncho-provocation tests with inhaled histamine were performed in 61 asthmatics twice at a gap of 4 weeks. Ten of them also underwent a third test after 16 weeks. More than 80% of the patients had a reproducibility of response within 1 to 2-fold concentration difference. It is concluded that under carefully controlled conditions broncho-provocation tests with histamine are reproducible. PMID- 1791026 TI - Effect of drugs used in pulmonary edema (frusemide and combination of etofylline and theophylline) on surfactant system of lung. AB - Pulmonary surfactant activity of healthy male albino rats was estimated in terms of the maximum and minimum surface tension values of alveolar washings and the phospholipid content of the extract. The results obtained in these (control) animals were compared with those in two groups of animals treated with therapeutic doses of frusemide and a combination of etofylline and theophylline. A significant increase in surfactant activity in terms of surface tension values and phospholipid content was observed with frusemide, whereas a significant increase in phospholipid content without a change in surface tension values was observed in the case of combination of etofylline and theophylline. These findings suggest that frusemide in addition to its diuretic action, increases the surfactant activity of lung. This might be another mechanism by which it provides relief in pulmonary edema patients. The study also indicates that phospholipid concentration need not always reflect surfactant activity of lung. PMID- 1791027 TI - Role of serial pleural biopsies in the diagnosis of pleural effusions. AB - One hundred fifty-five cases of pleural effusion underwent a percutaneous pleural biopsy by the Cope needle. In the face of an inconclusive result in the first attempt, biopsy was repeated for upto three times. Diagnostic yields of biopsy in tuberculous and malignant effusion were 93.5 per cent and 66.7 per cent, respectively. When combined with pleural fluid cytology, a definite diagnosis of malignancy could be established in 80.95 per cent cases. Serial pleural biopsies significantly increased the diagnostic yield. PMID- 1791028 TI - Sputum production during recovery from acute asthma--effect of adrenal corticosteroids. AB - The effect of corticosteroid drugs on sputum production was studied in 74 patients of asthma. They were alternatively allotted to two different treatment schedules-conventional bronchodilator drugs alone and bronchodilators plus corticosteroids. All the subjects recovered, bringing out sputum in the process. However, the steroid treated group produced significantly less sputum than the other group. It is concluded that (a) sputum expectoration is a regular accompaniment of recovery from acute asthma and (b) steroids inhibit sputum production in acute asthma. PMID- 1791029 TI - Effect of exercise on pulmonary function tests in normal first degree relations of asthmatic subjects. AB - The prevalence of exercise-induced asthma (EIA) after six minutes of standard exercise test on bicycle ergometer was studied in thirty healthy first degree relations of asthmatic subjects (group II) and was compared with that in thirty healthy controls (group I). Pulmonary function tests (PFT) measuring FVC, FEV1, FEF25-75% and PEFR were performed on each subject prior of exercise, immediately following exercise period and serially at 5 minute interval for 25 minutes thereafter. Bronchial lability was noted in 7% and 27% of the subjects in groups I and II respectively. Of all the parameters measured, FEF25-75% exhibited most striking changes when expressed as % of the baseline value. PMID- 1791031 TI - Unusual rib destruction in pleuro-pulmonary tuberculosis. PMID- 1791030 TI - Recurrent pneumothorax in a child. PMID- 1791032 TI - Atypical radiological presentation of tropical pulmonary eosinophilia. PMID- 1791033 TI - Autoantibodies to serum proteins in women with recurrent spontaneous abortion: subsequent pregnancy outcome. AB - Sera from 130 first trimester pregnant women were tested for their serum antibody level against a naturally occurring serum antigen purified from non-pregnancy sera. IgG and IgM antibody level was measured using enzyme linked immunosorbent assay. Results indicate that patients with multiple abortion (n = 26) have significantly (p = 0.0029) lower level of IgG antibody and significantly (p = 0.0001) higher level of IgM antibodies against the serum antigen as compared to the patients with successful pregnancies with no history of miscarriage (n = 63). Western blot analysis identified the serum antigen recognized by the IgM antibody as a 24 kDa molecular mass component. These IgG and IgM antibodies may play an important role in the outcome of pregnancy. PMID- 1791034 TI - Zone electrophoresis of anti-human sperm antibodies in concentration gradients of sucrose. AB - Zone electrophoresis of anti-human sperm antibodies elicited in chickens and isolated from the yolks of eggs laid by the birds were subjected to zone electrophoresis in sucrose concentration gradients. Because of its very low migration rate in the electric field it was possible to isolate the specific IgY antibody component in a virtually pure state. In zone electrophoresis experiments on human "auto" anti-sperm antibodies the presence of both IgA and IgG types was shown in human Ig. The IgA agglutinating antibody was 1/6 that of the IgG component. The mobility in the electric field of the IgG-type antibody was very low, similar to the IgY-type human sperm antibody. PMID- 1791035 TI - Two distinct P70 interleukin-2 receptors on a murine large granular lymphocyte clone Y479. AB - A continuous cloned cell line (Y479) was established by culturing normal mouse spleen cells in a high concentration of interleukin-2 (IL-2). Y479 cells showed morphological characteristics of large granular lymphocyte with the phenotypes of Thy-1.2+, T3+, Lyt-1-, Lyt-2-, L3T4-, B220-, AsGM1+, LFA-1+, and TcRV beta 8-. The Y479 cells required a high concentration of IL-2 for their growth but did not express detectable p55 IL-2 receptor (IL-2R) although they bound IL-2 with high and low affinities. Analysis of the IL-2 binding proteins on the Y479 cells revealed that both the high and low affinity receptors consisted only of 70 kDa protein. Analysis of the 70 kDa protein was performed using five monoclonal antibodies (L15, L20, L23, L34, and L61) against human recombinant IL-2. Although they recognized different epitopes, all monoclonal antibodies immunoprecipitated 70 kDa IL-2R that was cross-linked with radioiodinated IL-2. The supernatant after immunoprecipitation with L61 still contained IL-2/IL-2R complex that was L23-reactive, and the supernatant after immunoprecipitation with L23 contained L61-reactive IL-2/IL-2R complex, whereas L15 immunoprecipitated almost all the complex. Limited digestion of IL-2-cross-linked Y479 cells with trypsin caused the liberation of 45 kDa IL-2R fragment cross-linked with IL-2. This complex was immunoprecipitated by L15 or L61 but not by L23. These results suggest that there are at least two distinct 70 kDa IL-2R on the surface of Y479 cells. PMID- 1791036 TI - Size, CD4 and CD8 marker profiles and functions of lymphocyte subpopulations in mucosal-associated lymph nodes. AB - We analyzed phenotypic and functional characteristics of T cell populations in mucosal-associated supramammary and mesenteric lymph nodes in goats. Here we demonstrate, by flow cytometry, quantitative differences in CD4 and CD8 T cell subsets among large and small mucosal-associated lymphocyte populations and their differential regulatory activities on resident lymph node B cells stimulated with Staphylococcus aureus Cowan I or pokeweed mitogen. The CD4/CD8 T cell ratio was lower in mesenteric lymph nodes (1.46) when compared to that of supramammary lymph nodes (2.18). Analysis of large and small lymphocyte subpopulations from lymph nodes showed nearly 62% of the lymphocytes from mesenteric lymph nodes being of large cell phenotype with CD4/CD8 ratios of 1.34. In contrast, large cell subpopulations in supramammary lymph nodes showed a significantly lower number (50%) with a higher CD4/CD8 ratio of 2.05. Functionally, mesenteric lymph node T cells, isolated by nylon wool, showed heightened suppressive activity in mitogen-driven B cell proliferation responses, whereas T cells from supramammary lymph nodes were stimulatory. These findings clearly demonstrate distinctive functional properties between resident T cell populations of supramammary and mesenteric lymph nodes, suggesting that different proportions of T cell subsets in these nodes are activated and thus regulate regional immune responses via different pathways. PMID- 1791037 TI - The effect of anti-tuftsin antibody on the phagocytosis of bacteria by human neutrophils. AB - Tuftsin (Thr-Lys-Pro-Arg) is a naturally occurring tetrapeptide which stimulates most known functions of the polymorphonuclear and mononuclear phagocytic cell lines. Although tuftsin is a well characterized bioactive peptide, the exact physiological role tuftsin plays remains unclear. Specific mouse anti-tuftsin antiserum generated in our laboratory, is now available for phagocytosis inhibition studies. Monolayers of human neutrophils were prepared on glass coverslips from a few drops of finger prick blood obtained from a single healthy donor. The monolayers were treated with and without mouse anti-tuftsin antiserum at dilutions of 1:1000 or 1:2000. Exogenous tuftsin (1 microgram/ml) was also added with and without antibody. Treated and untreated neutrophils were subsequently incubated with unopsonized Staphylococcus aureus. The proportion of cells accomplishing phagocytosis (phagocytic index) and the number of bacteria engulfed per cell (avidity index) were recorded. The results showed that exogenous tuftsin increased phagocytosis while the addition of mouse anti-tuftsin antiserum at a 1:1000 dilution inhibited phagocytosis both with and without exogenous tuftsin. This effect was diminished by the antiserum at the 1:2000 dilution. This study reaffirms that tuftsin plays an important physiological role in phagocytosis. PMID- 1791038 TI - Human T lymphocytes require lipid as either lipoprotein or nonesterified fatty acid for in vitro activation. AB - Serum, which is required for activation of T cells in vitro, was fractionated to isolate and identify major supportive components. The serum activity concentrated exclusively with the lipoprotein fractions LDL and HDL. Furthermore, oleic and linoleic acids were equally active supplements, suggesting that resting T cells may require exogenous lipid because they are incapable of synthesizing fatty acid. A survey of fatty acids disclosed that all were capable of some degree of support. Titration delineated the narrow concentration range of lipid supplements successful in supporting T cell proliferation and demonstrated that concentrations must be rigidly controlled to optimize cell proliferation. PMID- 1791039 TI - Age-dependent difference in susceptibility to IgE antibody- and IgG1 antibody mediated passive anaphylactic shock in the mouse. AB - The age dependence of the susceptibility to passive anaphylactic shock was studied in the mouse. Anti-BPO IgE monoclonal antibody produced potent systemic sensitization sufficient for provocation of lethal shock in most aged (6 to 10 months) CTS, DS and C57BL/6J mice but only in a very few young (1.5 to 2.5 months) mice. A similar trend was found in the NOD strain, though it was not as definite as in the above three strains. Age-dependent potentiation of the IgE antibody-mediated anaphylactic shock was not found in both sexes of five other strains, C3H/He, DBA/2, NON, BALB/c and B6D2F1. However, the potentiation became obvious even in these strains, when they were treated with Bordetella pertussis before the antigen challenge. Age-dependent potentiation was also clear with IgG1 antibody-mediated anaphylactic shock in DS females and NON males. In contrast, no age-dependent difference was seen for the shock induced by PAF which is estimated to be the main mediator for anaphylactic shock in the mouse. This suggests that the age-dependent potentiation of anaphylactic shock does not seem to be due to elevated susceptibility to the mediator but to its increased release. The sex dependent differences was also studied and found to be particularly clear in the case of IgG1 antibody-mediated anaphylactic shock in young DS and aged NON mice. PMID- 1791040 TI - Synthetic antigens as immunogens: Part IV. Specificity of antisera developed to Gal beta 1-3(GlcNAc beta 1-6)GalNAc and GlcNAc beta 1-6GalNAc. AB - Antisera to the chemically synthesized trisaccharide, Gal beta 1-3(GlcNAc beta 1 6)GalNAc, and disaccharide, GlcNAc beta 1-6GalNAc, were developed using the diazophenyl bovine serum albumin derivatives. The binding specificity of the antisera were analyzed by enzyme immunoassays with structurally related, chemically synthesized oligosaccharides. The anti-trisaccharide antibody showed no reactivity to T antigenic structures which bear the Gal beta 1-3GalNAc moiety. The immunodominant area of the Gal beta 1-3(GlcNAc beta 1-6)GalNAc was contained in the GlcNAc beta 1-6GalNAc region of the molecule. The reactivity pattern of the anti-trisaccharide antibody, although directed to the disaccharide, did not exactly duplicate the reactivity pattern of the anti-disaccharide. PMID- 1791041 TI - Laboratory decontamination and destruction of carcinogens in laboratory wastes: some mycotoxins. PMID- 1791042 TI - Laboratory decontamination and destruction of carcinogens in laboratory wastes: some polycyclic heterocyclic hydrocarbons. PMID- 1791043 TI - The impact of early undernutrition on voluntary food consumption in later life of rats. AB - Food consumption patterns were studied during ad-libitum feeding of rats undernourished for 21 or 60 days after birth. Rats undernourished for 21 days consumed less food than the controls on a whole animal basis. But the food intake was higher during the early part of ad-libitum feeding when expressed on a unit body weight or metabolic body weight basis, and subsequently became comparable to that of the controls. Male rats undernourished for 60 days showed either comparable (for the whole animal) or higher (in other terms) food consumption, whereas the female rats undernourished for 60 days consumed more food at the beginning of ad-libitum feeding but less food during the latter part, when compared to their respective controls. The results thus indicate that no single mechanism can completely explain the food intake of undernourished rats during nutritional rehabilitation. PMID- 1791044 TI - Taste sensitivity in pregnancy. AB - Taste sensitivity to Phenyl-thio-Carbamide (PTC) and glucose were studied in 150 females during the 3 trimesters of their pregnancy periods. The taste sensitivity to PTC was determined by Harris and Kalmus method. For taste intensity and hedonic evaluation, 7 concentrations of glucose solutions were used. Taste sensitivity to both PTC and glucose increases during the 1st trimester of pregnancy. In comparison to non-pregnant females (from previous study) taste thresholds and hedonics decreases in pregnancy. PMID- 1791045 TI - Morphine-induced modulation of sciatic nerve stimulation evoked blood pressure responses. AB - Effect of i.v. morphine (1-2 mg/kg) on blood pressure changes evoked by sciatic nerve stimulation (SNS) were studied in chloralose anaesthetised cats. SNS gave a depressor, pressor or a biphasic BP response generally linked to the parameters of stimulation. Morphine produced marked attenuation of depressor and some facilitation of pressor response, suggesting a possible reciprocal relationship between depressor and pressor responses. Depressor response has been correlated with deep tissue or visceral pain mediated through A delta fibres and pressor response to cutaneous nociception involving C fibres or non nociceptive input via group II fibres. Involvement of medullary regions in differential modulation of these depressor and pressor response has been suggested. PMID- 1791046 TI - A study on bioavailability of theophylline in rabbits as influenced by fatty diet. AB - The influence of fatty diet and standard diet on the bioavailability and plasma half life of conventional theophylline was studied in the rabbit. It was found that standard diet had significantly reduced the extent of oral bioavailability (AUC0-alpha) of theophylline compared to the fasting state. The fatty diet resulted in a significantly increased extent of oral bioavailability (AUC0-alpha and Cmax) and significantly decreased rate of bioavailability (tmax and t1/2a) of theophylline compared to the standard diet group. The plasma half life was unaffected by either standard diet or the fatty diet. Therefore, dietary composition should be actively considered while titrating the dose of theophylline since theophylline is a drug of narrow therapeutic range and requires close monitoring of therapeutic plasma level. PMID- 1791047 TI - Estimation of body composition by whole body volumetry in human subjects. PMID- 1791048 TI - Blood cholesterol and HDL cholesterol in cigarette smokers. AB - 24 cigarette smokers were investigated for their blood cholesterol and HDL cholesterol. They had elevated total cholesterol compared to age and sex matched controls. 21 smokers out of 24 had significant decrease of HDL cholesterol. It is suggested that smoking, which is a major risk factor for coronary heart disease, might act through its effect on total cholesterol and HDL cholesterol. PMID- 1791049 TI - Effect of nifedipine on carbohydrate metabolism in rats. PMID- 1791050 TI - Yoga and medical sciences. PMID- 1791051 TI - Gastric cytoprotection. AB - The term 'cytoprotection' means protection against gastric mucosal injury by a mechanism other than inhibition or neutralisation of gastric acid. Several mechanisms of gastric cytoprotection have been proposed like increased mucus and bicarbonate secretion, strengthening of gastric mucosal barrier, increased gastric mucosal blood flow, decreased gastric motility, increased formation of prostaglandins and sulfhydryls, scavenging of free radicals, stimulation of cellular growth and repair, decreased release of leukotrienes etc. Some of the drugs widely used in therapy of peptic ulcer are cytoprotective e.g. sucralfate, colloidal bismuth and aluminium containing antacids. As the concept of gastric cytoprotection is becoming widely accepted, the list of drugs which have shown a cytoprotective action in animal experiments is growing rapidly. This list includes zinc sulphate, meciadanol, propranolol, dipyridamole etc. PMID- 1791052 TI - Sir Frederick Grant Banting (1891-1941) PMID- 1791053 TI - Hypoglycemic and antihyperglycemic effect of leaves of Vinca rosea linn. AB - Oral administration of water fraction of alcoholic extract of leaves of Vinca rosea (fam. apocynaeceae) led to marked lowering of blood glucose level in normal and streptozotocin induced diabetic rats. The hypoglycemic effect of the fraction was comparable with that of tolbutamide. PMID- 1791054 TI - Taste disorder in hypo and hyperthyroidism. AB - Gustatory responses to the basic taste substances (sweet, salty, sour and bitter) were studied in hypothyroid and hyperthyroid subjects. The intensity and hedonic responses were evaluated using "category scaling" for 7 concentrations of glucose, sodium chloride, citric acid and quinine sulphate. The intensity and hedonic values decrease in hyperthyroidism for salt and bitter solution, and sourness is perceived as more unpleasant. In hypothyroid subjects intensity and hedonic value decreases for sweetness, the pleasant responses to salt and bitter increase, though intensity perception decreases for bitter solutions. PMID- 1791055 TI - Role of vagal and sinoaortic baroreflexes in restoration of arterial pressure after acute mild haemorrhage in rabbits. AB - To evaluate the contribution of vagal and sinoaortic baroreflexes (SBR) in circulatory adjustments, anaesthetized rabbits were subjected to acute mild haemorrhage and the extent of recovery produced after haemorrhage was estimated. The recovery of arterial pressure after acute mild haemorrhage with reflexes intact was 96.19%, after elimination of SBR it was 79.20%, after bilateral vagotomy 87.38%, and after eliminating both reflex systems it was 75.66%. The results suggest that vagally mediated baroreflexes from cardiopulmonary baroreceptors contribute significantly in restoring the arterial pressure in response to haemorrhage while the sinoaortic baroreflexes play the major role. PMID- 1791056 TI - Visual evoked responses to pattern reversal in children. AB - Pattern reversal evoked potentials (PREPs) were studied in school going children 4-15 years of age (mean 9.9 +/- 2.6 yrs), using Ag/AgCl electrodes anchored on 01 A1 and 02-A2 scalp sites. Two sets of 256 pattern reversal stimuli with check sizes 32' and alternation rate 1 Hz were applied to each eye and evoked responses thus obtained were averaged and analysed by the inbuilt computer of the evoked potential recorder. The latency of various components of visual evoked potentials along with P1 amplitudes were recorded for the right and the left eye separately in boys and girls. The normative data are being reported and these do not show eye and gender differences in children. PMID- 1791057 TI - Effect of histamine on wound healing. AB - Using incision, excision and dead space wound models in rats, a study was conducted on the effect of histamine on wound healing. Exogenous histamine given either ip or locally was without any effect. Semicarbazide as (histamine synthesis inhibitor) suppressed healing process (breaking strength of skin incision wound), decreased breaking strength and hydroxyproline content of granulation tissue and delay in period of epithelization. On the other hand compound 48/80 (a promoter of histamine forming capacity) was found to promote wound healing. Exogenous histamine (topical) reversed the anti-healing effect of semicarbazide on incision and excision wounds. PMID- 1791058 TI - Effects of undernutrition on transit time and body weight of rats. AB - Rats given 50% and 25% of their ad lib food intake were taken as undernourished, while those on ad lib intake served as controls. Water was given ad lib for all rats. Body weight of all rats was measured daily. It showed decrease in undernourished groups but not to the extent expected from calorie intake. Fifty tiny (1-2 mm) orange coloured plastic markers mixed with food were given to all rats, at 11.00 p.m., and were collected from faeces at regular intervals of 1 h each till 80% of markers were obtained. Period (hrs) for collection of 80% markers was taken as total transit time. It showed increase with increased undernutrition (ad lib 38.9 +/- 2.1 hrs, 50% cal 68.2 +/- 5.3 hrs, 25% cal 105.00 +/- 3.3 hrs). Delayed transit time in the undernourished by prolonging contact period between food and absorptive surface of intestine probably caused increase in absorption of nutrients and thus counteracted against the loss in body weight of underfed rats. PMID- 1791059 TI - A study on the chronopharmacokinetics of theophylline in rabbits. AB - The Chronopharmacokinetics of a single oral dose of theophylline was studied in rabbits. It was observed that morning (06.00 hr) dosing was characterized by significantly low rate of absorption (t 1/2a and Tmax) but higher extent of absorption (AUC0-alpha) compared to that after nocturnal dosing (22.00 hr). The plasma half life (t1/2el) was significantly less at night compared to that in daytime. The data may have considerable clinical relevance. PMID- 1791060 TI - A comparative study of the driving effects of dextroamphetamine and yogic meditation on muscle control for the performance of balance on balance board. AB - The work is aimed to compare the relative strength of dextroamphetamine and yogic meditation on the performance of 3 different groups of medical students to concentrate on the task to balance on a balance board. Group A subjects were mediators, group B subjects were given orally 5 and 10 mg of dextroamphetamine in a capsule, 1 hr prior to the test. Group C subjects were given same capsule but with lactose in place of the drug (placebo). This last groups served as control for the study. The balance index calculated taking into account their balance time and error score at each trial of 5 min duration showed that the performance of the group B (drug) had declined with overall percentile fall of 40.6% as compared to the performance of the controls (placebo) whereas, the performance of Group A (meditators) went on steadily and progressively increasing throughout the period of 10 trial days with overall percentile rise of 27.8%. The results were conclusive to confirm earlier reports that amphetamine is not of use for improvement of task rather, it deteriorates the task performance. Contrary to that, yogic meditation is of merit to achieve concentration for mental as well as physical task. PMID- 1791061 TI - Leukocyte lipid profile in chronic alcoholics. AB - Polymorphonuclear leukocytic (PNML) lipid content was studied in chronic alcoholic and normal control subjects. Chronic alcoholic subjects showed abnormal liver function and abnormal serum lipid profile. PMNL obtained from chronic alcoholic subjects exhibited decreased free cholesterol and phospholipid contents, with a significant increase in cholesterol to phospholipid ratio. Although, there was no change in the free fatty acids, the levels of triglycerides were significantly elevated. PMID- 1791062 TI - Early indicators of deteriorating renal efficiency in elderly subjects. AB - Renal functions decline with age. Only after considerable renal reserves are lost, the traditional clinical tests of urine, blood or clearance levels reveal the defect. The urine quantity & contents passed in 24 hrs both by young and elderly, show little differences between the two groups. Their creatinine clearances are also comparable. Earlier Studies on water dilution test had shown significant differences between the performance of the young and elderly subjects, indicating decrease in renal efficiency on ageing. In the present study 4 hourly collections of urine showed that the night collections in elderly subjects were comparatively larger in volume, electrolytes and other components as compared with younger subjects. The kidneys of the elderly seem to compensate by labouring at night, while the young have their restful phase. Thus in addition to water dilution test, comparison of day/night outputs of urine can be taken as an early indicator of renal deterioration in elderly. PMID- 1791063 TI - Age dependent changes in human serum lipid peroxide levels in rural population around Ambajogai. AB - Serum lipid peroxide levels were estimated in 205 healthy human subjects. The serum lipid peroxide levels in terms of malondialdehyde/ml was 1.47 nmol in male subjects with 11-20 years and which rose to a peak 2.97 in subjects with 51-60 years. Male subjects exhibited significantly higher (P less than 0.01) values as compared to female subjects in whom this increase with age was not observed. PMID- 1791064 TI - Precautionary note on use of polyethylene glycol as a drug solvent. PMID- 1791065 TI - Effect of some non-steroidal anti-inflammatory agents on blood sugar level and on insulin-induced hypoglycaemia in albino rats. PMID- 1791066 TI - Effect of peppermint oil on gastric emptying in man: a preliminary study using a radiolabelled solid test meal. PMID- 1791067 TI - Assessment of knowledge and attitudes in human nutrition among nurses of Delhi. AB - The present study revealed that the majority of nurses had adequate knowledge about dietary practices during the antenatal and post-natal period. However, their knowledge about nutritive value of foods and nutrition advice during disease conditions was inadequate. It is recommended that to make the training more meaningful, the identification of the incorrect dietary beliefs of trainees should be done at the beginning of the training course. Each incorrect belief should be explained in detail for better comprehension of the correct knowledge in nutrition. PMID- 1791068 TI - An exploratory study on infant feeding and weaning practices of a Muslim community settled at Calcutta. PMID- 1791069 TI - Salinity tolerance of Gambusia affinis--a larvivorous fish. PMID- 1791070 TI - Family planning, immunisation and nutritional status of brick kiln workers in some areas of rural Punjab. PMID- 1791071 TI - Immunisation status of under fives: completion of primary immunisation--an immunisation clinic base study. PMID- 1791072 TI - Drinking water supply and sanitation decade (1981-90) PMID- 1791073 TI - Study of prevalence of chronic illness in a semiurban community in Pune Cantonment by household interview method. AB - A household interview survey of 200 households in a semiurban community in Pune Cantonment carried out during 1979 revealed a prevalence rate (persons, 109/1000 of chronic illness. Prevalence rate (No. of illnesses) was 140/1000. Multiple illnesses were found among 23.5 percent of ill persons. The present survey has been found to bring out the nature and extent of the problem of chronic illness as perceived by the community and relationship of chronic illness to social factors. The information, can be useful for public health and further research. PMID- 1791074 TI - [Clinical evaluation of a permethol mouthwash for gingivorrhagia]. PMID- 1791075 TI - Cephalosporins--cefotaxime 10 years later, a major drug with continued use. AB - Cefotaxime has in the past decade proved to be a most useful agent. It has established the efficacy and safety suggested in the early in vitro, pharmacological and clinical papers. It remains an excellent agent to treat many community and hospital-acquired respiratory infections, urinary tract infections, meningitis, particularly in pediatrics, spontaneous bacterial peritonitis and selected abdominal and gynecological infections. PMID- 1791076 TI - Anti-infective therapy in intensive care units. AB - In intensive care units, treatment is primarily directed at the suspected pathogen. However, the risk of interaction with other concomitantly administered drugs, the possible accumulation when renal and, in particular, hepatic function are impaired, and the possible development of resistance play major roles when selecting a therapeutic regimen. Studies of interactions between the different antimicrobial substances and, in particular, interactions between the antibiotics and other drugs are urgently called for in the future. PMID- 1791077 TI - Nosocomial pneumonia: comparative multicentre trial between monotherapy with cefotaxime and treatment with antibiotic combinations. AB - In a multicentre clinical trial involving 32 hospitals, 588 adult patients diagnosed with nosocomial pneumonia and not receiving mechanical ventilation were treated randomly with monotherapy with cefotaxime or the antibiotic combination routinely used in each particular hospital. Both groups of patients were similar regarding demographic data, concurrent diseases, additional therapies and causative organism. Protocol violations were recorded in 40 patients, and these patients were excluded from the evaluation of treatment efficacy. The cure rate was 79% in the cefotaxime group and 71% in the group receiving antibiotic combinations; this difference is statistically significant (p = 0.03, Fisher's two-tailed test). In the patients receiving combinations of cephalosporins having activity predominantly against gram-positive organisms plus aminoglycosides, the cure rate obtained was very low. The frequency of serious adverse reactions was significantly higher in the group treated with antibiotic combinations. It is concluded that monotherapy with cefotaxime is the regimen that offers better results for the empirical treatment of nosocomial pneumonia. PMID- 1791078 TI - Empiric treatment of serious infections in patients with cancer: randomised comparison of two combinations. AB - Infection is the immediate cause of death in many patients with cancer. Traditionally, combinations of modern beta-lactam antibiotics and aminoglycosides are empirically used in the treatment of patients with neutropenia and presumed infection. However, the new quinolones appear to have become potent combination partners for beta-lactams. Eighty-seven patients with presumed serious infection were blindly randomised to receive either 2 g cefotaxime i.v. plus 200 mg ofloxacin twice daily (group 1) or 2 g cefotaxime i.v. twice daily plus tobramycin i.v. three times daily with dosage adjustment according to renal function and body weight (group 2). The response rate was significantly higher in group 1 (71%) compared to group 2 (47%). The cefotaxime/ofloxacin combination proved to be safe and represented a considerable reduction of workload on the nursing staff. PMID- 1791079 TI - Efficacy and safety of cefotaxime in the management of pediatric infections. AB - The utilization of cephalosporins in serious bacterial infections in children has become more widely accepted by pediatric infectious disease specialists over the past five years. The use of cephalosporins has become increasingly popular in empiric antibiotic regimens. The recognition that age-specific bacterial pathogens in neonates, older infants and children can be effectively treated with cephalosporins alone, or in combination with ampicillin, has led to this increasing popularity. This review will discuss the use of cephalosporins in empiric antibiotic regimens and relate the efficacy and safety of specific cephalosporins in the treatment of serious bacterial infections in children. PMID- 1791080 TI - Prophylaxis of postoperative infections. AB - The antibiotic most appropriate for prophylaxis of postoperative infections depends on the nature of the operation. In aseptic (clean) operations, gram positive postoperative infections are the primary concern, and cefazolin is recommended because of its excellent pharmacokinetics and good activity against gram-positive pathogens, including staphylococci. In those operations where violation of the digestive tract creates a contaminated field, a cefotaxime generation cephalosporin is the agent of choice because of the excellent safety profiles and the capability of agents of this class to kill essentially all pathogenic gram-negative aerobes as well as a substantial portion of anaerobes. Selection of resistant bacteria has not been significant and is unlikely to become so with single-dose prophylaxis. Occasionally, if there is a high probability that the operative field may be heavily contaminated by anaerobes, metronidazole should be added. Dosing should be sufficient to cover the operative period. Only a single prophylactic dose is necessary, given at the time of induction of anesthesia. For particularly long operations, a second dose of those antibiotics with half-lives shorter than 60 min is required two hours after the first. Single-injection prophylaxis is effective, inexpensive, has no side effects and does not induce bacterial resistance. PMID- 1791081 TI - Calculated empiric antimicrobial therapy for mixed surgical infections. AB - In acute life-threatening surgical infections requiring immediate institution of antimicrobial therapy before bacteriological results are available, antibiotic treatment must be empiric. For best efficacy a more sophisticated form of empiric therapy is offered, termed calculated antibiotic therapy (CAT). Calculated antibiotic therapy requires consideration of a) typical bacterial spectrum; b) bacterial pathogenicity and synergism; c) antibacterial concentrations at the site of infection; d) toxicity and adverse effects; e) interaction with immune response; and f) results of properly conducted trials. Intraabdominal infections are used as an example here to assess the efficacy of clinically used cephalosporins and penicillins for determination of calculated antibiotic therapy. CAT identifies Escherichia coli and Bacteroides fragilis as the most important pathogens for intraabdominal infections and determines the most effective antibiotics at the tissue breakpoint, which is defined as the minimal concentration maintained for more than 90% of the dosage interval period at the infected tissues. At the tissue breakpoint calculated antibiotic therapy identifies cefotaxime-generation cephalosporins to be fully (100%) active against the most important aerobic pathogen E. coli and metronidazole as fully active against the important obligate anaerobe B. fragilis. Calculated antibiotic therapy becomes relatively important, since impeccably controlled clinical therapeutic trials as a foundation for therapy are rarely published. PMID- 1791082 TI - Current surgery/drug combination treatment of diabetic gangrene of the foot. AB - Twenty-eight patients, 20 females and eight males (age 45-85 years) were treated for diabetic gangrene of the foot using a combination of surgery and intraarterial administration of prostaglandin F and cefotaxime. In 64% of the patients treated it was possible for the leg in question to be saved. We therefore consider intraarterial administration of cefotaxime in conjunction with prostaglandin E, and with simultaneous local surgery of the focal infection, to be a promising concept. Further studies, however, are necessary in order to establish whether the initial success can be consistently reproduced. PMID- 1791083 TI - The effects of Trolox, a water-soluble vitamin E analogue, in regionally ischemic, reperfused porcine hearts. AB - Myocardial protection by the water-soluble vitamin E analogue, Trolox, was investigated in 18 regionally ischemic, reperfused porcine hearts. The left anterior descending coronary artery was distally ligated for 45 min and was reperfused for three days. Five grams of Trolox (n = 9) were infused intravenously before coronary occlusion. Treatment was continued with an intravenous dose of 5 grams Trolox/24 hours until the end of the experiment. Infarct size was determined as the ratio of infarcted (tetrazolium stain) to ischemic myocardium (dye technique). Regional systolic shortening was assessed by sonomicrometry. Generation of free radicals by stimulated neutrophils was evaluated by luminol-enhanced chemiluminescence. Plasma concentrations of Trolox were measured by high-performance liquid chromatography. Aside from heart rate before ischemia, global hemodynamic values including calculated left ventricular oxygen consumption did not differ significantly between the two groups. Plasma concentrations of Trolox measured 1.8 +/- 0.3 mmol/l (before ischemia), 0.96 +/- 0.13 mmol/l (before reperfusion), 0.77 +/- 0.1 mmol/l (40 min of reperfusion), and 0.08 mmol/l (end of the experiment). Generation of free radicals by stimulated neutrophils was reduced by about 30% in the treatment group before ischemia and immediately before reperfusion, but was not reduced at the end of the experiment. Risk regions (control group 19.4 +/- 6 g, treatment group 19.3 +/ 7 g) and infarct sizes (control group 69.3 +/- 8%, treatment group 69.3 +/- 12%) were almost identical. Regional systolic shortening of a control segment and of the risk region were similar in both groups before ischemia, before reperfusion, and after 45 min of reperfusion. After 3 days of reperfusion, regional systolic shortening of the reperfused myocardium of the treated group had recovered to a significantly greater extent (P = 0.027). This parameter amounted to 9 +/- 6% in the treated group and to 3 +/- 3% in the control group. Improved functional recovery was not accompanied by higher tissue concentrations of adenosine triphosphate. It is concluded that the chosen treatment with Trolox does not reduce infarct size but accelerates functional recovery. This finding suggests that the mechanisms resulting in myocardial necrosis during ischemia/reperfusion and in post-ischemic myocardial dysfunction may differ. PMID- 1791085 TI - Value of exercise vectorcardiography and exercise radionuclide ventriculography in identification of coronary arterial disease in patients with left bundle branch block. AB - Twelve patients (8 male and 4 female, age ranged 39-60 years) with suspected coronary arterial disease with left bundle branch block were evaluated for ischemia by simultaneous exercise vectorcardiography and radionuclide ventriculography. Selective coronary angiography revealed normal coronary arteries in 5 and significant coronary arterial disease in 7 patients. Radionuclide ventriculography revealed no significant difference in resting left ventricular ejection fraction in patients with normal coronary arteries (44.0 +/- 13.9%) and coronary arterial disease (45.7 +/- 11.9%). Exercise radionuclide ventriculography showed positive response suggestive of ischemia in 11 patients (11/12), including all 5 with normal coronary arteries and 6/7 with coronary arterial disease. The magnitude of spatial 'R' maximum cardiac vector in both groups at rest (normal coronary arteries: 1.61 +/- 0.22 mV, coronary arterial disease: 1.63 +/- 0.35 mV) did not show any significant difference. On exercise, the magnitude of spatial 'R' maximum cardiac vector uniformly increased in patients with normal coronary arteries (1.61 +/- 0.22 to 1.75 +/- 0.25 mV, P less than 0.01) and decreased in 6 and remained unchanged in 1 patient with coronary arterial disease (1.63 +/- 0.35 to 1.34 +/- 0.46 mV, P less than 0.01). There was no change in rotational characteristics of QRS and T loops at end exercise in either group. Our preliminary observations indicate that exercise induced alteration of the magnitude of the maximal spatial 'R' cardiac vector appears to be an useful parameter to diagnose underlying coronary arterial disease in patients with left bundle branch block. Having a high false positive response, exercise radionuclide ventriculography appears to be of limited value in these patients. PMID- 1791084 TI - Segmental analysis of coronary arterial stenoses in patients presenting with angina or first myocardial infarction. AB - The segmental distribution of stenoses within the coronary arteries was analysed in a population of 258 patients with a first myocardial infarction undergoing coronary angiography to evaluate the effect of thrombolytic therapy, and in a population of 466 patients undergoing elective coronary angiography for stable angina. Mean ages were 53.7 and 56.7 years respectively (P = NS). As judged angiographically, coronary arterial disease was more extensive in the group suffering angina, with a greater proportion of patients with two- or three-vessel disease (odds ratio 2.56, 95% confidence interval 1.87 to 3.52) and more patients having stenoses in two or more coronary arterial segments (odds ratio 1.52, 95% confidence interval 1.12 to 2.08). For each coronary vessel, the probability of finding a stenosis greater than 50% in an individual segment was greater in the group presenting with angina. There was a relative deficiency of stenoses within the main stem of the left coronary artery or its proximal left anterior descending branch among the patients suffering myocardial infarction. Within those having angina, subgroups were identified with "isolated" and "diffuse" coronary arterial disease: the latter patients tended to have a lower concentration of total cholesterol in the serum, but an increased prevalence of diabetes mellitus. Patients presenting clinically with a first myocardial infarction, and patients with severe angina, constitute distinct populations selected by different mechanisms from the overall pool of patients with atheromatous coronary arterial disease. PMID- 1791086 TI - Differences in response to single dose and steady-state therapy with verapamil in stable angina. AB - Ten patients with stable effort angina were studied in a randomized double-blind and placebo-controlled trial to compare the antianginal efficacy of "acute" and "chronic" (after reaching a steady-state level) treatment with verapamil. Efficacy was assessed by exercise testing after a 120 mg single-dose and at the end of a seven-dose course of 120 mg of verapamil given thrice daily. Three daily exercise tests were performed the first, second and fifth day of the study protocol at 8, 12 and 16 hours. Eight hours after the last dose was given, exercise time increased by 54 +/- 30 sec after a single-dose of verapamil and by 156 +/- 31 sec after seven-doses of verapamil (P less than 0.05 as compared to single-dose verapamil). The time to 1 mm depression of the ST segment increased by 30 +/- 20 sec after a single-dose of verapamil and by 66 +/- 28 sec after seven-doses of verapamil (P less than 0.01 as compared to single dose verapamil). Six of the ten patients became free from angina on treadmill exercise after a seven-dose course of verapamil, but only one patient became free from angina after acute testing with a single-dose of verapamil. It is concluded that several doses of verapamil are required to achieve an optimal anti-ischemic effect, as suggested by the pharmacodynamic properties of this drug. Once steady-state is achieved, the effects of verapamil remain for at least 8 hours, so that an administration schedule of three times daily protects the patient for a 24-hour period. PMID- 1791087 TI - Snoring and risk of cardiovascular disease. AB - In order to evaluate the possible role played by snoring as a risk factor for cardiovascular disease, we studied 400 patients aged 30-80 years, divided into 4 groups matched for age, sex and body mass index. The first group consisted of 100 patients who snored, having risk factors (hypertension, diabetes, obesity, smoking, high serum cholesterol level) for cardiovascular disease. The second group consisted of 100 non-snoring patients with risk factors. The third and fourth groups were formed by 100 snoring and 100 non-snoring patients without risk factors. We investigated the morbidity and the mortality from cardiovascular disease over a period of five years (1982-1987). An increase in morbidity and mortality was found for snorers with risk factors (36 and 17 respectively) compared to non-snorers with risk factors (10 and 4, P less than 0.001), and also to both snorers and non-snorers without risk factors (7 and 3, P less than 0.001; 3 and 1, P less than 0.001 respectively). No difference was noted between snorers and non-snorers without risk factors. A higher morbidity and mortality for cardiovascular disease was found in snorers with risk factors as compared with non-snorers having risk factors. Furthermore, the morbidity and mortality in patients without risk factors was found to be lower compared with that found in snorers with risk factors. In conclusion, snoring worsened the prognosis of patients with risk factors for cardiovascular disease, but did not represent an independent or predictive risk factor in itself. PMID- 1791088 TI - Responses of serum insulin and blood pressure to cold and handgrip in obese patients. AB - A close correlation between body weight and blood pressure has been frequently observed in both clinical and epidemiological studies. The aim of this clinical trial was to evaluate whether, in obese patients, there is any relationship between blood pressure, at rest or during sympathetic stimulation, and blood glucose and serum insulin, both while fasting and during an oral glucose challenge. Twenty obese patients (age 26-65 years, body weight 97 +/- 16 kg, 11 normotensive and 9 hypertensive) entered the study. After a 4-week run-in period on an isocaloric diet with normal intake of sodium, blood pressure and heart rate were measured at rest and during sympathetic stimulation induced by cold and isometric testing. Responses of glucose and insulin to a standardized 75 g oral glucose tolerance test were also evaluated. The responses of glucose and insulin to glucose challenge were not statistically different in normotensive and hypertensive obese patients. Levels of insulin in the serum in the serum in the fasting state and during glucose load were significantly correlated with the response of blood pressure to cold and isometric exercise, but not to blood pressure at rest. The response of heart rate to cold was closely related to insulin only in the subgroup of normotensives. The present findings support the hypothesis that the sympathetic nervous system, which influences secretion of insulin and regulation of blood pressure, is involved in the pathophysiology of the association of obesity and hypertension. PMID- 1791089 TI - Anti-streptokinase levels in Indian patients. AB - Levels of anti-streptokinase antibodies were measured in 75 Indian patients who were divided into three groups. The first group consisted of 25 healthy blood donors; the second group of 25 patients with ischaemic heart disease with stable angina; and the third group of 25 patients with acute myocardial infarction. The mean level of anti-streptokinase for the entire group was 0.37 SD 0.20 million international units (IU) (range 0.09 to 1.15 million IU). There was no significant difference in the anti-streptokinase levels among the three groups. In order to neutralise the anti-streptokinase levels in 90% of the study population, 0.57 million IU of streptokinase was necessary. These levels are more than twice the current Western levels. In the light of this study, it may be necessary to reconsider the adequacy of the conventional dosage of streptokinase while treating acute infarctions in India and, possibly, other tropical countries where prevalence of prior streptococcal infection is high. PMID- 1791090 TI - Acute heart failure: determinants of outcome. AB - We prospectively studied 69 consecutive patients hospitalized with a primary diagnosis of acute left ventricular failure so as to assess the impact of vasodilators on incidence and morbidity of acute symptomatic left ventricular failure. The determinants of duration of hospitalization, in-hospital mortality and symptomatic status 2 months after discharge were examined. There were 9 in hospital deaths (13%), and survival at 60 days was 77%. Median duration of hospitalization was 9 days, and 33% of the surviving patients remained in New York Heart Association functional class III-IV 60 days subsequent to discharge. Of the patients, 49 (76%) had previously received treatment for left ventricular failure: 30 (61%) of these had received vasodilators, most commonly angiotensin converting enzyme inhibitors and nitrates. Ischaemic chest pain was present in 34 (49%) of the patients. Acute utilization of vasodilators (45% of patients) was largely limited to nitrate therapy associated with ischaemic chest pain (P less than 0.01). Multiple logistic regression revealed previous left ventricular failure, advanced age and hypokalaemia as significant correlates of prolonged hospitalization (greater than 9 days). Previous left ventricular failure was also predictive of persistent severe disability two months subsequent to discharge. No factor was a significant predictor of in-hospital death. Although preceding treatment with digoxin and incremental angiotensin converting enzyme inhibitor therapy tended to predict brief hospitalization, the parameter of acute ischaemia, other biochemical anomalies and modes of acute or chronic therapy were not significant correlates of any end point. We conclude that preceding disability, rather than mode of treatment, predicts an adverse outcome in acute left ventricular failure. PMID- 1791091 TI - One-year mortality rate after discharge from hospital in relation to whether or not a confirmed myocardial infarction was developed. AB - Consecutive patients admitted to our hospital with suspected acute myocardial infarction during 21 months were prospectively evaluated. One-year mortality after discharge from hospital was related to whether or not an infarction developed (infarct versus non-infarct patients). Of patients discharged alive after developing an infarct, there was a mortality of 17% (n = 777) versus 12% (n = 1830) (P less than 0.001) for all patients not developing infarction. In a high risk group (any of the following: age greater than or equal to 75 years, previous history of myocardial infarction, diabetes mellitus or congestive heart failure) patients developing infarction had a mortality of 24% (n = 457) versus 17% (n = 1221) for those who did not (P less than 0.001). In a low risk group (none of the high risk criteria), the corresponding mortality was 8% (n = 316) for patients suffering infarction and 3% (n = 603) for those not having infarction (P less than 0.001). The difference in mortality between patients with and without infarction was most marked in women (21% vs 11%; P less than 0.01) and in hypertensives (25% vs 12%; P less than 0.001), but less marked in men (16% vs 13%; NS) and in patients without hypertension (13% vs 12%; NS). Among patients not suffering infarction, mortality was particularly high in those with previous congestive heart failure (23%) and diabetes mellitus (21%). PMID- 1791092 TI - Assessment of mitral valvar stenosis by echocardiography: utility of various methods before and after mitral valvotomy. AB - Cross-sectional and Doppler echocardiography are currently the most important non invasive tests for the evaluation of mitral stenosis. Recent experience has, however, shown that parameters that are reliable before mitral valvotomy may not be valid after the procedure. We have studied the validity of estimation of the area of the mitral valve by echo-planimetry, by Doppler pressure half time and the transmitral end-diastolic pressure gradient calculated by continuous wave Doppler in 100 patients (aged 10-30 years) before and after balloon mitral valvoplasty (n = 70) or surgical closed mitral valvotomy (n = 30). These patients underwent cardiac catheterisation and echocardiographic studies before, immediately after and 8-12 (9.3 +/- 2.2) weeks following balloon valvoplasty or closed valvotomy. The area as estimated echocardiographically correlated well with that obtained by the Gorlin formula before (r = 0.80), but not immediately after (r = 0.67) or on follow up after mitral valvotomy. There was good correlation between Doppler pressure half time and the area as estimated by the Gorlin formula before (r = 0.89) and on follow up after valvotomy (r = 0.82), but the correlation was not as good in the immediate period after valvotomy (r = 0.60). The end-diastolic pressure gradients obtained by Doppler examination and at cardiac catheterisation correlated well with each other before (r = 0.94), immediately after valvotomy (r = 0.92) and on follow up (r = 0.94). Hence, the reliability of estimation of the area of the mitral valve by echo-planimetry and by Doppler pressure half time varies according to the time at which the examination is performed following commissurotomy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791093 TI - Regional sympathetic denervation in von Recklinghausen's disease with coronary spasm and myocarditis. AB - Two patients with von Recklinghausen's disease presented with coronary artery spasm, transient high concentrations of norepinephrine, catecholamine-induced myocarditis, and regional sympathetic denervation of the heart that was assessed by I-123 metaiodobenzylguanidine scintigram. It is postulated that regional sympathetic denervation of the heart may precipitate both coronary artery spasm and catecholamine-induced myocarditis in susceptible patients with von Recklinghausen's disease. PMID- 1791094 TI - Extreme axis deviation in a Nigerian with severe congestive cardiac failure: an unusual manifestation. AB - A case of severe congestive cardiac failure of unidentified etiology demonstrating an extreme electrical QRS axis is presented. The axis is about -120 degrees. This electrocardiographic manifestation is rare, and, to the best of our knowledge, there have been no previously reported cases in congestive cardiac failure in our environment. This finding, in view of the clinical state of our patient, may be indicative of extreme severity resulting in widespread patchy myocardial fibrosis. PMID- 1791096 TI - Hypertrophic cardiomyopathy: disorder to be rechristened? PMID- 1791095 TI - Pheochromocytoma with asymmetric septal hypertrophy and Wolff-Parkinson-White syndrome. AB - A 24-year-old woman with pheochromocytoma associated with asymmetric septal hypertrophy, Wolff-Parkinson-White syndrome and pigmentation was operated on and the tumor was excised. The asymmetric hypertrophy and the pre-excitation disappeared after the operation, but the pigmentation increased. We discuss the relation between excessive catecholamines and these findings. PMID- 1791097 TI - The Caerphilly study. PMID- 1791098 TI - Vincenzo Gallucci, 1935-1991. PMID- 1791099 TI - Economic aspects of law and psychiatry. PMID- 1791100 TI - The impact of vendorship legislation and interprofessional competition in the market for social workers' services. AB - The results of this article suggest that, in the short run, vendorship legislation will not result in a large shift of social workers from organized settings into private practice. However, vendorship legislation appears to increase the number of social workers in private practice in areas that have not attracted as many psychiatrists. Thus, vendorship may have a favorable impact on the geographic distribution of mental health providers. Vendorship legislation may result in increases in private practice social workers in underserved areas. The results also suggest that social workers and psychiatrists compete in the market for mental health services. In counties with higher psychiatrist-to population ratios, fees for social workers' services are lower. Further, in counties with higher psychiatrist-to-population ratios, the number of social workers in private practice decreased after vendorship. Finally, there is a large range of optimal practice size for social workers. Social workers with 20 or more clients per month can provide mental health services at the lowest average cost per client. Thus social workers operating either full-time or part-time practices with more than 20 clients per month can provide mental health services efficiently. PMID- 1791101 TI - Determinants of stringency of psychologist licensure. PMID- 1791102 TI - Psychiatric malpractice claims in Maryland. PMID- 1791103 TI - Reimbursement systems and the behavior of mental health providers. PMID- 1791104 TI - Differences in mental health service utilization among ethnic subpopulations. PMID- 1791105 TI - Mental health and marital stability. PMID- 1791106 TI - State purchase of mental health care: models and motivations for maintaining accountability. PMID- 1791108 TI - Legislative process is an eye-opener for young physician. PMID- 1791107 TI - Health care issues will be overshadowed in 1992. PMID- 1791109 TI - Pericardial patch angioplasty. AB - The authors describe the case of a man with severe left coronary ostial stenosis who was treated with direct left main angioplasty with a pericardial patch. This approach may be superior to artery bypass grafting in certain patients. PMID- 1791110 TI - Sticks, stones and words. PMID- 1791111 TI - Incomplete documentation in ambulatory settings. PMID- 1791113 TI - Defusing a bomb. PMID- 1791112 TI - Medical waste--perceived risk. PMID- 1791114 TI - Study skills instruction in medical school. AB - Effective study skills are an essential component of medical education. Following analysis of current study habits of students attending the Royal College of Surgeons in Ireland (RCSI) a brief study skills course was developed for premedical students. Course evaluation indicated that instructed students reported more positive study habits one year later than did those without such instruction: a greater number of instructed students reported taking detailed notes during lectures (56 vs 32%) and starting to revise early in term (28% vs 11%) while fewer of these students routinely used the notes of other students after lectures (2 vs 10%) or as study material (0 vs 6%). A study skills course is now routinely provided in conjunction with individual student counselling, where necessary, to facilitate student success in this Medical School. PMID- 1791115 TI - Apex beat. PMID- 1791116 TI - Lyme disease and skeletal tuberculosis. PMID- 1791117 TI - Haemophilus influenzae type b vaccine. PMID- 1791118 TI - Nutrition in the elderly. PMID- 1791119 TI - Promoting health in young people. PMID- 1791120 TI - Cervical screening: a time for reappraisal? PMID- 1791121 TI - Examining lymph nodes. PMID- 1791122 TI - Mitempfindung. Do you get it? PMID- 1791123 TI - Childhood poisoning in Dublin. AB - A prospective survey was carried out over a three month period to assess the incidence of accidental poisoning in children. The survey also examined the role of child resistant closures (CRC) and other form of packaging in the prevention of poisoning. Two hundred and six children with suspected poisoning attended the casualty departments of the three Dublin children's hospitals surveyed. Ninety three percent of the children were less than five years old. Medications were thought to have been ingested by 65%, household or gardening products by 34% and plants by 1%. Most children had no symptoms and received no treatment except emesis or oral fluid and demulcents. Twenty five percent required admission to hospital. There were no fatalities during the study period. Only 8.5% of the medications involved had been in containers with CRC's. Twenty percent were in blister packs or strips. A substantial number of poisonings occurred at a time when medicines were not in their normal place although in most cases they were still in the original container. We propose a two-phase approach to poisoning prevention--more widespread use of CRC's and public education on safe storage of medicines. PMID- 1791124 TI - Consultation-liaison referrals to the north Dublin old age psychiatry service. AB - 107 elderly acute hospital in-patients were referred to the North Dublin Old Age Psychiatry Service during an eighteen month period. Cognitive impairment was present in 54%, 25% had functional psychiatric disorders and 19% had no psychiatric diagnosis. The main reason for referral in 47% of cases was advice on placement. This reflects the deficiency in residential care in North Dublin and supports other recently compiled data. The implications of this situation for both elderly people and the acute hospitals are discussed. PMID- 1791125 TI - Rehabilitation of the elderly amputee. AB - A rehabilitation service based in a department of geriatric medicine and dealing exclusively with amputees aged 65 years or over, is described. Provision of prostheses has been expedited, and the multi-disciplinary approach of the department has been beneficial in rehabilitation especially of the amputee with multiple pathology. The experience of the first 146 patients with an average age of 74.1 years is reviewed. Discharge home was achieved in 77.6% of the patients provided with a prosthesis and in a small multi-centre study of the post discharge status of 20 elderly amputees it was found that over 90% used their prosthesis regularly and the great majority were independent in the activities of daily living. Although BKA (Below knee amputation) is preferable to AKA (Above knee amputation), the functional benefit in this age group is not always as significant as traditional attitudes would suggest whereas a failed BKA has serious consequences in terms of psychological impact, morbidity and length of hospital stay. In order to minimise the number of BKA's requiring revision or re amputation every effort should be made to ensure that the initial procedure is carried out by a surgeon with experience of amputation in this age group. Limb provision is cost effective and the frequent difficulty with regard to the financing of prostheses for elderly amputees is counter-productive. PMID- 1791126 TI - Employee attitudes to involuntary smoking at the workplace. AB - The Dublin Healthy Cities Project carried out this survey to establish employees' attitudes to involuntary smoking. A self administered questionnaire was sent to 750 randomly selected employees from the organisations involved with the Project. A response rate of 77% was achieved. 70% were non-smokers. 80% (Non-smokers 92%, smokers 50%) are bothered by involuntary smoking and 78% (non-smokers 85%, smokers 59%) were aware that it was harmful. 93% (non-smokers 99%, smokers 84%) felt that involuntary smoking should be restricted in the workplace and 99% (non smokers 99%, smokers 97%) felt that it should be restricted in the canteens. 77% of smokers expressed a desire to quit the habit. This survey shows that employees are bothered by involuntary smoking in the workplace, they see it as being harmful to their health and they think it should be restricted. PMID- 1791127 TI - Erythema induratum (Bazin's disease). AB - Four patients with erythema induratum (EI) have been diagnosed at the Dermatology Department within the past two years. All four patients had a history of recurrent painful nodules on their calves for at least three years before diagnosis. Three of the patients, all with positive Mantoux reaction to tuberculin skin tests, had neither a personal or family history of tuberculosis. The other patient who had a six year history of recurrent painful leg nodules developed a tuberculous breast abscess. There was a dramatic response to anti tuberculous chemotherapy in all four patients but one subsequently had recurrent nodules which spontaneously subsided without further chemotherapy. PMID- 1791128 TI - Vocal cord dysfunction presenting as asthma. AB - A 14 year old boy presented with deteriorating asthma and marked stridor. Neither asthma nor stridor responded to an increase in anti-asthma medication, including high dose oral steroids. Indirect laryngoscopy revealed adduction of the vocal cords throughout the respiratory cycle, a phenomenon previously identified as a psychosomatic conversion reaction. When gently confronted with these findings and offered psychological assistance the boy's symptoms abated totally. After two sessions of hypnotherapy he has had better control of both his physical (asthma) and psychological problems. PMID- 1791129 TI - EMG evaluation of motor neuron sprouting in amyotrophic lateral sclerosis. AB - Collateral sprouting has been evaluated in amyotrophic lateral sclerosis (ALS) patients on the basis of: 1) Motor Unit action potential (M.U.A.P.) parameters evaluated by simultaneous EMG recordings using concentric needle electrodes and surface electrodes and 2) Motor Action Potential (M.A.P.) activated by graded electrical stimulation of nerve and recorded with the same electrodes. Mean values of duration and amplitude were calculated in 40 normal age-matched controls, 42 ALS patients in the early phase of the disease and in 5 muscles of three ALS patients during the whole course of the disease including the last paralytic phase. Percentage of M.U.A.P.s with linked potentials and highest amplitude was also calculated. The study confirms previous suggestions on collateral sprouting occurring in the early, middle and advanced phases of the disease and it shows, at variance with some recent claims, that it fails in the latest phase of paralysis. PMID- 1791130 TI - Stenosis of the spinal canal in achondroplasia. AB - Stenosis of the spinal canal is a very frequent finding in achondroplastic patients. It is secondary to abnormalities of endochondrial ossification, which is responsible for formation of the vertebral bone structures, and, subsequently, to bone degeneration. Cervical stenosis (most frequently involving the first metameres and the craniospinal junction) is more common in children while thoraco lumbar stenosis favors adults. The surgical indications for cervical stenosis depend mainly on the clinical evolution but also on neurophysiological data. In thoraco lumbar stenosis too, clinical data determine the surgical indications and the route of attack depends on the type of anatomical alteration affecting the spine. PMID- 1791131 TI - Comparative evaluation of SPECT, CT and CW Doppler data in patients with ischemic lesions of the brain. AB - We report the SPECT, CT and CW Doppler findings in a series of 117 patients with cerebral ischemic lesions and correlate them with the clinical findings. SPECT PAO proved to be more sensitive in localizing focal lesions than CT, which in 50% of the cases was normal or yielded an image of cerebral atrophy. In the latter cases CW Doppler ultrasound on the supraaortic trunks showed changes, circumscribed or diffuse. On the CW Doppler and SPECT evidence we consider that the CT image of cerebral atrophy may denote an alteration of the cerebral blood flow and metabolism and should be assessed in this light in the diagnosis and prognosis of cerebral ischemic lesions. PMID- 1791132 TI - CBF side-to-side asymmetries in stenosis-occlusion of internal carotid artery. Relevance of CT findings and collateral supply. AB - Cerebral blood flow (CBF) was studied at rest by 133-Xenon inhalation method in 15 normal subjects, in 10 patients with cerebral infarction and normal angiograms of major cerebral arteries and in 28 patients with unilateral stenosis-occlusion of the internal carotid artery (ICA), with or without cerebral infarction. All the normals and 20 patients with ICA stenosis-occlusion were tested again after cerebral vasodilatation induced by an intravenous bolus of acetazolamide. At rest the patients with cerebral infarction, irrespective of whether ICa stenosis occlusion was present or not, showed abnormal side-to-side CBF asymmetry. After cerebral vasodilation variations in side-to-side asymmetry were shown to depend on the inefficiency of the collaterals and not on the degree of ICA obstruction or on the presence of cerebral infarction. These data indicate that at rest side to-side CBF distribution is influenced more by the presence of an ischemic zone than by a ICA stenosis-occlusion and that under these circumstances the hemodynamic effect of the vascular stenosis cannot be assessed. After cerebral vasodilatation a subset of patients--irrespective of the degree of ICA obstruction and of whether or not cerebral infarction is present--with true cerebrovascular insufficiency can be isolated. PMID- 1791133 TI - Saccadic eye movements analysis in the early diagnosis of myasthenia gravis. AB - Saccadic eye movements were examined by electro-oculography in 21 patients with suspected myasthenia gravis. The presence of dissociated nystagmus and quiver eye movements was also assessed. The aim of the study was to assess the diagnostic value of saccadic abnormalities in the early stage of the disease. Pathological oculographic findings consisted of intra and post saccadic disorders and intersaccadic variability. A fatigue test was useful in detecting latent disorders in most patients. A Tensilon test was positive in 11 out of 16 patients with oculographic abnormalities. Diagnostic problems, apparently paradoxical findings and differential involvement of extraocular muscle fibers are discussed. PMID- 1791134 TI - Analysis of diagnostic procedure costs for cerebrovascular disease admission to a highly specialized hospital. AB - Length of stay and hospital costs for cerebrovascular disease admissions depend on several hospital-, patient- and disease-related factors. To determine the incidence of each of these factors we studied 240 admissions for cerebrovascular diseases in a neurology division and in two medical divisions of a highly specialized hospital. Statistical analysis of the data collected from the case records revealed the effect of several factors. Some increased only the length of stay (severe neurological sequels on discharge; stay in general medicine, diagnosis of hemorrhage, arterial hypertension). Others increased investigation costs (length of stay, marital status), and costs were higher in a specialists ward. Length of stay was shorter where the nurse/bed ratio was higher. Old age and male sex were associated with a lower cost of diagnostic procedures. PMID- 1791135 TI - Steroid myopathy: clinical and immunohistochemical study of a case. AB - A 42 year old woman with foot process disease, was treated with corticosteroids for 6 years. She had been suffering, for about 3 years from progressive muscle weakness of the limbs, accompanied by general paresthesia, cramps of the calves and burning muscle pain both at rest and an effort. The clinical, neurophysiological and histochemical examination indicated noninflammatory myopathic damage. The progressive reduction of corticosteroid dosage led rapidly to a distinct improvement, but not to a remission, of symptoms. Clinical and laboratory findings were consistent with those observed in most cases of steroid myopathy described in literature. We discuss the possible pathogenetic role of corticosteroids in this affection. PMID- 1791136 TI - Demyelinating polyradiculoneuritis following Coxiella burnetti infection (Q fever). AB - Neurological complications of Coxiella burnetii infection (Q fever) are rare, although the occurrence of headache, paresthesias, and transient focal deficits has been reported. We report the case of a patient with a relapsing demyelinating polyradiculoneuritis as an aftermath of C. burnetti endocarditis and pneumonia. PMID- 1791137 TI - Labio-glosso-pharyngo-laryngeal paralysis caused by two brain lesions: cortical and subcortical. AB - We report a case of labio-glosso-pharyngo-laryngeal paralysis with some peculiar features. CT and MRI yielded the diagnosis of acute pseudobulbar syndrome by demonstrating the existence of two lesions of the corticobulbar tract: one subcortical (recent) and the other opercular cortical (old) on the opposite side. PMID- 1791138 TI - Leuko-araiosis. PMID- 1791139 TI - High amounts of beta-endorphin in peripheral blood mononuclear cells from HANE patients. AB - We measured peripheral blood mononuclear cells (PBMC) beta-endorphin (BE) in patients suffering from hereditary angioneurotic edema (HANE), a disease attributed to C1-esterase inhibitor (C1INH) deficiency inherited as an autosomal dominant trait. Two orders of considerations prompted us to undertake the study reported herein: the presence of elevated plasma BE concentrations in HANE and the demonstration of BE-immunoreactivity in human unstimulated peripheral blood leukocytes obtained from healthy volunteers. Our results show that patients suffering from HANE have a very high BE presence in uncultured, unstimulated PBMC and in unstimulated PBMC cultured for 48 h. At this time high BE concentrations are detected in the culture supernatants. These observations suggest that in HANE patients the same factor(s) involved in causing increased secretion and release of BE from the pituitary (and, in turn, increased plasma BE levels) can play a relevant role also in the determination of high BE presence in PBMC and BE release from the cells. PMID- 1791140 TI - Transcriptional changes in macrophage TNF-alpha expression following dimethylnitrosamine exposure in vivo. AB - DMN exposure has been shown to increase macrophage cytotoxic activity against tumor targets both in vitro and in vivo. Since the production and expression of the macrophage-derived cytokine tumor necrosis factor-alpha (TNF-alpha) is associated with such anti-tumor activity, studies were performed to determine whether changes in TNF-alpha gene transcription and biosynthesis resulted following DMN exposure. Thioglycollate-elicited macrophages obtained from DMN exposed animals displayed enhanced levels of constitutively expressed TNF-alpha transcripts compared to vehicle controls. Northern blot analysis of the time course expression of TNF-alpha following endotoxin (1 microgram/ml) stimulation in vitro showed a significantly greater induction of TNF-alpha transcripts in macrophages from DMN-exposed than control animals, with peak levels detected between 30 and 120 min. Maximum endotoxin-induced TNF-alpha secretion occurred later than the accumulation of the transcripts, with greater secretion observed between 120 and 360 min. In contrast to endotoxin, stimulation with IFN-gamma (100 U/ml) produced no changes in the level of TNF-alpha transcripts. However, stimulation of macrophages with IFN-gamma did greatly enhance the surface expression of membrane-bound TNF-alpha in cells from the DMN-treated animals. Supernatants from media and endotoxin stimulated macrophage were tested for TNF alpha activity against WEHI-164 cells. In media alone, a five-fold increase in TNF-alpha activity was observed at 6 h in supernatants from macrophage obtained from DMN-exposed animals compared to the vehicle group. Treatment of supernatants with either superoxide dismutase (SOD) or catalase to remove reactive oxygen products did not alter their lytic capacity. However, addition of a neutralizing murine-anti-TNF-alpha antibody reduced the lytic capacity of the supernatants by 90% in both treatment groups. Accumulation of IL-1 beta transcripts gradually increased over the 6 h with a concomitant increase in secreted IL-1 beta that was identical in both DMN and vehicle groups. These results demonstrate that DMN exposure: (1) enhances the expression of TNF-alpha in peripheral macrophages by transcriptional regulatory mechanism(s) and, (2) does not alter the expression or secretion of IL-1 beta. PMID- 1791141 TI - Effects of the ether phospholipid AMG-PC on mast cells are similar to that of the ether lipid AMG but different from that of the analogue hexadecylphosphocholine. AB - The ether lipid AMG (1-O-hexadecyl-2-O-methylglycerol) has previously been shown to have both enhancing and inhibitory effects on histamine release from isolated rat mast cells. In addition, a synergistic interaction with the phorbol ester TPA indicated protein kinase C activation. In the present investigation the effects of the related ether phospholipid AMG-PC (1-O-hexadecyl-2-O-methylglycero-3 phosphocholine) and the analogue hexadecylphosphocholine (miltefosine (HPC) are compared with those of AMG. HPC had only inhibitory effects, in contrast to AMG PC which acted similarly on histamine release induced by compound 48/80, but had dual influence on responses to antigen and the ionophore A23187 and mainly exhibited a synergistic interaction with combinations of the ionophore and TPA. The influence of AMG-PC differed from that of AMG in some aspects whereas the character of its synergistic interaction with A23187 resembled that of AMG, in particular after pre-incubation with TPA. The results show that HPC does not share all biological activities of the antineoplastic ether lipids. They indicate that the effects of AMG-PC under appropriate conditions may be due to activation of protein kinase C but do not permit a distinction between direct effects and indirect through metabolic conversion to AMG. PMID- 1791142 TI - Analysis of retinoid-mediated immunosuppression in vivo. Effects of Ro23-6457 on cellular alloimmune responses. AB - We have investigated the immunosuppressive effects of a synthetic retinoid, Ro23 6457, on the in vivo development of cellular alloimmunity. We initially observed that treatment of C57B1/6 mice with 10 mg/kg/day Ro23-6457 drug could prolong the survival of DBA/2 cardiac allografts, thus verifying its immunosuppressive potential in murine experimental models. We next used the sponge matrix model of allograft rejection and limiting dilution analysis (LDA) of cytotoxic T lymphocyte (CTL) frequency to dissect this phenomenon further. In this experimental system we observed the following effects of Ro23-6457: (1) dose dependent decrease in the number of LDA-detectable, donor-reactive CTL accumulating in sponge matrix allografts; (2) failure to interfere with in vitro assays of cellular alloimmunity, including LDA; and (3) antigen non-specific depression of LDA-detectable CTL in lymph nodes, spleen and especially in peripheral blood. For peripheral blood CTL, the drug eliminated LDA-detectable CTL, an effect that was reversible and could not be attributed to the activation of suppressor cells. Since Ro23-6457 has little effect on the number of peripheral blood Thy1.2+ cells, it appears that this drug does not physically eliminate CTL, but makes them temporarily hyporesponsive to antigen stimulation, and thus undetectable in functional assays like LDA. PMID- 1791144 TI - Laryngeal precancer: a review of the literature, commentary, and comparison with oral leukoplakia. AB - Laryngeal keratosis (LK) is a precancerous mucosal change with great similarity to oral leukoplakia. Its malignant transformation rate varies from 1% to 40%, with the highest rates being found in patients microscopically diagnosed as "keratosis with atypia" (KWA). Recent evidence indicates that even cases with only mild or moderate epithelial dysplasias are at increased risk for malignant transformation, with the highest rates occurring in patients with more severe dysplasia or carcinoma in situ. Approximately 81% of LK patients are men and the average age at diagnosis is 50 years, a decade younger than that for laryngeal carcinoma patients. A high proportion of LK patients are tobacco smokers (84%) and alcohol abusers (at least 35%). LK is almost always found on the true vocal cords and is usually bilateral (67%). Clinical signs of high risk include, in decreasing order of importance: erythroplakia, surface granularity, increased keratin thickness, increased size, recurrence after conservative removal, and long duration. The annual incidence of LK in the United States is 10.2 and 2.1 lesions per 100,000 males and females, respectively. PMID- 1791143 TI - Prognostic factors in head and neck cancer: histologic grading, DNA ploidy, and nodal status. AB - Histopathologic malignancy score and DNA ploidy were investigated as prognostic factors for 72 cases of squamous cell carcinoma of the head and neck (HNSCC). The malignancy grading was based upon four different morphologic characteristics for the tumor cell population and four characteristics for the tumor-host relationship. DNA ploidy was determined through flow cytometry on fresh-frozen tumor samples. The median malignancy score was 20, with 71% of the tumors scoring less than 20 being diploid and 68% of the tumors scoring greater than or equal to 20 being nondiploid (p = 0.003). Univariate analysis revealed that tumors scoring less than 20 and diploid tumors had a significantly higher proportion of complete response and better survival as compared to tumors scoring greater than or equal to 20 and nondiploid tumors, respectively. There was a tendency toward better survival among patients without regional metastasis (N0) as compared with patients with regional spread (N+), whereas the other single factors, patient age, clinical stage, histologic grade, and tumor size did not correlate with prognosis. In N+ patients both malignancy score and DNA ploidy were predictive for survival, whereas in N0 patients only malignancy score was related to prognosis. A multivariate analysis showed that the combination of malignancy score and nodal status were the strongest predictors for survival. DNA ploidy did not contribute further information in this test, due to its close relation with the histopathologic malignancy score. PMID- 1791145 TI - Oral hairy leukoplakia: clinical aspects, histologic morphology and differential diagnosis. AB - Clinical and histologic morphology of oral hairy leukoplakia in 85 HIV-positive patients were studied. Differential diagnosis of oral hairy leukoplakia in comparison with the normal lingual and buccal epithelium from both HIV-positive and HIV-negative patients, and with other tongue conditions was also examined. Oral hairy leukoplakia lesions were located on the lateral borders of the tongue and showed a corrugated/hairy aspect in the majority of cases. Hyperparakeratosis, hyperplasia/acanthosis, and a papillated epithelial surface were common findings. A parakeratin band and ballooning cells were present in 60% and 99% of the cases, respectively. Some of the histologic features of oral hairy leukoplakia were present in the normal lingual epithelium of both HIV-negative and HIV-positive patients as well as in other tongue conditions. Thus, many histologic features of oral hairy leukoplakia appear not to be specific. PMID- 1791146 TI - Parapharyngeal soft-tissue infection with Aeromonas hydrophila. AB - Parapharyngeal soft tissue infections may be rapidly progressive and life threatening. Prompt institution of appropriate antimicrobial therapy is of paramount importance. This report highlights the potential virulence of Aeromonas hydrophila in infection of the head and neck and the need to consider this organism in selected patients. PMID- 1791147 TI - Sphenoid mucocele with intracranial invasion secondary to nasopharyngeal acinic cell carcinoma. AB - We present a case of sphenoid mucocele with large invasion of the middle cranial fossa, secondary to a nasopharyngeal acinic cell carcinoma, occurring in a 52 year-old man. To the best of our knowledge, this association has not been reported so far. We discuss the importance of imaging techniques in delineating the relationship between the two lesions, as long as the clinical and therapeutic problems related both to sphenoid mucocele and acinic cell carcinoma. PMID- 1791148 TI - Anaplastic large cell lymphoma. AB - Anaplastic large cell lymphoma (ALCL) or Ki-1 lymphoma is a recently described and distinctive non-Hodgkin's lymphoma. Cervicofacial adenopathy caused by ALCL may mimic involvement by metastatic carcinoma or other malignancies common to the head and neck. A case in which ALCL was originally interpreted as metastatic nasopharyngeal carcinoma is presented. The clinicopathologic features of this uncommon entity are discussed. PMID- 1791149 TI - Recurrent squamous cell carcinoma of the true vocal cord. AB - None of the consultants disagree with the initial plan to treat this T1N0 squamous cell carcinoma of the true vocal cord with radiotherapy. The consensus is that 10% to 20% of these lesions can fail conventional treatment. Dr. Rice cites incorrect radiotherapy ports, understaging, and extension into muscle or cartilage as the likely reasons for failure. He also believes that a patient who continues to smoke is at risk for persistent or recurrent disease. Drs. Wetmore and Singer add that some tumors are radioresistant for indefinable reasons. Although all the consultants agree that the differentiation between severe atypia and carcinoma in situ can be very difficult, Dr. Singer warns that the surgeon should not play a role in the histologic decision-making. He does not make a distinction between the two and suggests treating a lesion on the basis of its clinical behavior. Dr. Rice draws the line at treating T3 glottic carcinomas with radiotherapy. He states that the greater the tumor bulk the less well the lesion will do with radiotherapy. All the experts caution that involvement of cartilage at the anterior commissure and arytenoid is also a reason for failure. Dr. Wetmore adds that subglottic extension and verrucous carcinoma also contribute to radiotherapy failure. The real controversy lay with how to proceed in this case. Dr. Rice suggests excision of the lesion with the laser or microsurgical stripping. If the margins were positive he would proceed with a vertical hemilaryngectomy. Dr. Wetmore would excise the lesion with a CO2 laser and would follow the patient closely thereafter. He would only plan a hemilaryngectomy if the lesion recurred again.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791150 TI - Cervical metastatic squamous carcinoma. PMID- 1791151 TI - Life after treatment--quality of life. PMID- 1791152 TI - Neck-node biopsy before radiotherapy. PMID- 1791153 TI - Rechargeable, deep-cycle, lead-acid batteries for powered wheelchair and scooter users. PMID- 1791154 TI - Electric beds: do not use in psychiatric wards. PMID- 1791155 TI - Stryker surgical microsurgical drills: activation by ESUs. PMID- 1791156 TI - Internal defibrillator paddles. PMID- 1791157 TI - Type III collagen in the intervertebral disc. AB - Several collagen types have now been isolated from the intervertebral disc, although type III collagen has previously only been extracted from human pathological disc. In this study, type III collagen has been isolated from normal human and bovine intervertebral disc and immunolocalized in sections of rat, sheep, bovine and 'normal' human intervertebral disc of various ages. Staining with antisera to type III collagen is localized primarily around the cells. Results indicate that cells of the disc sit in 'chondrons', similar to those seen in the deep and mid zones of articular cartilage. We suggest that type III collagen is present in the intervertebral disc and hypothesize that it may be involved in the organization of the pericellular environment, perhaps linking the chondron capsule to the interterritorial matrix. PMID- 1791158 TI - Ultrastructural localization of human kidney antigens using monoclonal antibodies. AB - A highly sensitive method of ultrastructural-immunoperoxidase staining was developed for use with monoclonal antibodies which have been raised in this laboratory to a variety of antigens of the human kidney. Because of the susceptibility of the antigens to fixation and processing, a four layer, pre embedding method of staining was used. Results confirmed and clarified previously reported light microscopy results, indicating that an antigen recognized by the PHM5 antibody was found on the podocyte cell membrane within the glomerulus and was not present within the glomerular basement membrane. The antigen was also present on the extraglomerular endothelial cell membrane. The study also demonstrated the presence of an antigen specific to endothelial cells throughout the renal cortex, and gave further insight into the precise localization of glomerular basement membrane components including fibronectin. The method of staining is now being used together with detailed ultrastructural studies to identify the cells produced from isolated glomeruli in tissue culture. PMID- 1791159 TI - Ultrastructural immunoperoxidase investigations of HCG binding to isolated testicular intertubular cells. AB - The binding and processing of human chorionic gonadotrophin (HCG) on isolated rat testicular intertubular cells was investigated using an ultrastructural immunoperoxidase technique. Following incubation of isolated cells with HCG at a range of temperatures and time intervals, cells were fixed and the presence of HCG demonstrated using monoclonal and polyclonal antibodies to HCG and its alpha and beta subunits. Results indicated that HCG binds to the surface of the Leydig cells where it is rapidly split into its component subunits. Internalization of the HCG molecule was not demonstrated. The testicular macrophages also bound HCG. In contrast to the Leydig cells they were able to internalize the molecule into lysosomes in the cytoplasm. The complete molecule and the alpha and beta subunits were found within the cells. The study suggests that results of previous studies using mixed populations of isolated cells may be due to the combined effects of the different mechanisms present in the two cell types. It is postulated that Leydig cells bind HCG on the surface and cyclic AMP is activated prior to breakdown and loss of the hormone from the surface of the cells. It is postulated that the macrophages play a role in the breakdown of excess trophic hormone and act in concert with the Leydig cells in the local control of testicular function. PMID- 1791160 TI - New possibilities for bacterial cytochemistry: light microscopical demonstration of beta-galactosidase in unfixed immobilized bacteria. AB - The possibility of applying light microscope cytochemical techniques in order to determine the identity and physiological state of microbes, particularly bacteria, has received little attention in recent years. The technical obstacles have perhaps been thought too great and the potential rewards too small. In order to demonstrate the feasibility of the cytochemical approach to problems in microbiology, an indoxyl method was developed for the demonstration of beta galactosidase activity in unfixed bacteria. Cells were immobilized on 3 aminopropyltriethoxysilane-treated glass, permeabilized by air drying, then incubated in an indoxyl beta-D-galactopyranoside substrate plus a ferri ferrocyanide reaction mix. Specific enzyme activity was demonstrated in Escherichia coli and a strain of Bacillus subtilis containing the LacZ gene. In the former, activity was inducible both before and after immobilization. These findings indicate that the basic prerequisites for light microscopical demonstration of bacterial intracellular activities, i.e. immobilization without disruption and reagent access without loss of localization, can now be fulfilled. Further development of this approach is desirable because it allows rapid demonstration of specific microbial activities without an intervening period of in vitro cultivation, thus avoiding the time delays and adaptive changes associated with propagation on laboratory media. PMID- 1791162 TI - Abstracts of the annual symposium of the Czechoslovak Society of Histochemistry and Cytochemistry. Prague, Czechoslovakia, 2-5 October, 1990. Abstracts. PMID- 1791161 TI - DNA fluorescence induced by polymethine cation pyrvinium binding. AB - Pyrvinium is a polymethine cation which shows interesting fluorescence emission and DNA binding properties. In diluted aqueous solution, pyrvinium pamoate induced a bright yellow fluorescence in kinetoplast DNA from Trypanosoma cruzi epimastigotes as well as in chicken erythrocyte nuclei under a wide range of excitations. No fading was observed after mounting in suitable media. Spectroscopic studies on pyrvinium solutions revealed bathochromic and hypochromic shifts in the absorption spectrum of its complex with DNA. A striking enhancement of pyrvinium fluorescence was found in solvents of high viscosity or after binding to DNA. Experimental results and the chemical structure of pyrvinium allow us to suggest that the minor groove of adenine-thymine DNA regions could be the specific binding site for this new DNA fluorochrome. PMID- 1791163 TI - Concentration of antimicrobial proteins in human saliva. The effect of six months use of an antiplaque dentifrice on levels of antimicrobial proteins in unstimulated saliva from 102 adults. AB - Student nurses (aged 20-26 years) were assigned to two groups that were matched for plaque levels and gingival health. For six months, one group used a standard fluoride dentifrice while the other used an identical dentifrice to which zinc citrate (1%, w/w) and Triclosan (0.2%, w/w) had been added. Levels of natural antimicrobial proteins (lysozyme, lactoferrin, salivary peroxidase and Immunoglobulin A) in whole, unstimulated saliva taken from the students at the start and on completion of the six months were measured. No statistically significant differences were found in the levels of antimicrobial proteins in saliva between the test and placebo groups. PMID- 1791164 TI - Bacterial invasion of periodontal tissues after experimental immunosuppression in rats. AB - A moderate gingivitis was produced in 3 groups of 10 adult Wistar rats with diet 2000 of Keyes and Jordan (1964) delivered for 30 days with a controlled feeding unit. The first group served as untreated control. The second group received 5 intraperitoneal injections of cyclosporine A (15 mg/kg body weight) from day 20 to 30 to interfere with the activation of T lymphocytes and interleukin synthesis. The third group received 2 intraperitoneal injections of cyclophosphamide (100 mg/kg on day 20 and 25) which induced a severe neutropenia. The gingival areas between the upper molar regions were prepared for light and transmission electron microscopy. In the untreated control group, a layer of polymorphonuclear neutrophils (PMN) was observed between the dental plaque and the junctional epithelium with a round cell infiltration in the superficial connective tissue. No bacterial invasion was observed. In the cyclosporine group, despite the action on T lymphocytes, no bacterial invasion occurred, but a differentiated PMN layer was present between the apical dental plaque and the junctional epithelium. In the cyclophosphamide group an important bacterial invasion was observed in the interdental epithelium as well as in the underlying connective tissue. In the local absence of PMNs, a mixed flora of Gram positive and negative bacteria of various shapes invaded epithelial as well as connective tissue cells and came in contact with the alveolar crestal bone. Resorption of the alveolar crestal bone scored according to the Keyes and Gold method (1955) was significantly more important in the cyclosporine and the cyclophosphamide group when compared to the controls (p less than 0.05). No statistical difference in bone resorption was noted between the cyclosporine and the cyclophosphamide groups. It can be concluded that the PMN layer constitutes the first line of defense opposed to bacterial invasion of the periodontal tissues. PMID- 1791165 TI - A new method for locating anterior skeletal landmarks from soft tissue measurements. AB - Clinical examination of human profiles provides some idea of the localization of hard tissue landmarks, but is unreliable because of large variability in thickness of the soft tissues. In this investigation an instrument was developed to measure the thickness of the lips. Linear regression was applied to estimate cephalometric hard tissue landmarks from those in the soft tissues. By adding information from direct clinical measurements to the model for estimating hard tissue landmarks from soft tissue landmarks, the correlation between the digitized (actual) and estimated or calculated landmarks was significantly improved. PMID- 1791166 TI - [Dental delay and microdontia in children with somatotropin hormone deficiency]. AB - The clinical effects of growth hormone deficiency on dental development were studied in 27 young people aged 3.5-17.5 years, suffering from pituitary dwarfism. They presented with either a late selective eruption of premolars whose roots appeared normal or partial eruption of the whole permanent dentition. Premolar crowns were statistically significantly smaller while the other teeth were of normal size. The hormonal deficiency produced a decrease in the level of circulating growth factors and especially of EGF which may explain the anomalies of eruption and dental morphogenesis. PMID- 1791167 TI - Age reference charts of tooth length in Dutch children. AB - The lengths of molar, premolar and canine teeth were determined from orthopantomograms collected in the Nymegen Growth Study. In this Mixed Longitudinal Interdisciplinary Investigation orthopantomograms were taken every six months from 486 children, covering the age range 4-14 years. A statistically relevant number of mixed-longitudinal data were found for the canines and premolars in the maxilla and for the canines, premolars and molars (except third molars) in the mandible. These data on tooth formation expressed in age reference charts provide useful information for research purposes as well as for orthodontic diagnosis and treatment planning. PMID- 1791168 TI - In vitro penetration of 125I-amelogenin into the enamel and enamel organ of rat incisors. AB - This work attempted to introduce pre-labelled intact amelogenins into developing rat enamel in vitro. The intention was ultimately to trace the fate of such proteins in the developing enamel matrix and to examine the effect of these and other molecules on ameloblast behavior. The penetration of 125I-amelogenin (25 KDa) directly into the young enamel of rat incisors, in vitro, keeping the enamel organ intact is described. The enamel (an extension approximately 8 mm from the apical end of the tooth) together with the enamel organ, was separated from the underlying dentine and placed over a strip of filter paper covering a well of micro-culture slide filled with Eagle's medium containing 125I labelled amelogenin and incubated at 37 degrees C. The enamel faced the strip of filter paper and so was adjacent to the medium. After 1 h pieces were either washed in cold medium, fixed and embedded in Epoxy-resin, or incubated in cold medium for another 1 to 10 h at 37 degrees C before embedding. One-micron thick sections were processed for autoradiography and the results showed a decreasing gradient of silver grain concentration from the dentino-enamel junction towards the enamel organ. It is expected that by determining the nature of the labelled material incorporated into the enamel and enamel organ the fate of amelogenins could be better understood. PMID- 1791169 TI - A scanning electron microscopic study of the enamel of neonatal teeth. AB - Neonatal teeth, two mandibulars incisors and one maxillary central incisor, from two separate patients were examined, by SEM. Besides typical enamel anomalies, the incisors exhibited partial or total absence of root formation. These findings suggest that the early eruption of natal and neonatal teeth is dependent on osteoblastic activity within the area of the tooth germ. The reported cases show that teeth may erupt without root formation and without periodontal ligament which correlate with the role of the dental follicle during tooth eruption. PMID- 1791170 TI - Chlorhexidine and thymol release from a varnish system. AB - The release of chlorhexidine and/or thymol from an antimicrobial containing varnish in an in vitro model was investigated. Four varnishes with the same polymer base were studied; one with chlorhexidine only, one with thymol only, one with both agents and a placebo varnish without the active agents. Microscope glass slides were covered with the varnishes and stored in water. During the following three months liquid samples were regularly withdrawn and analysed for chlorhexidine and thymol content. The released amounts of chlorhexidine and/or thymol were determined by means of U.V. spectrophotometry. The results showed that chlorhexidine was released slowly from the chlorhexidine-only varnish compared with the thymol release from the thymol-only varnish. In the case of the clinically tested varnish (containing both active ingredients chlorhexidine and thymol) the amounts of thymol and chlorhexidine released were comparable. Most important, however, was the observation that in the last mentioned case both agents continued to be released after 3 months. PMID- 1791171 TI - Modulation of osteogenesis in fetal bone rudiments by mechanical stress in vitro. AB - Studies of organ cultures of developing bone subjected to intermittent mechanical stress are reviewed. Mineral metabolism in these bones is modulated by exposure to dynamic stress of physiological magnitude. Finite element stress analysis of long bone rudiments shows that hydrostatic pressure during organ culture produces significant shear stresses at mineralized/non-mineralized tissue interfaces, in addition to dilatational stress. Both matrix producing cells (chondrocytes, osteoblasts) and matrix resorbing cells (osteoclasts) are affected by mechanical stress in vitro. The organ culture model offers certain opportunities for studying effects of mechanical stress on skeletal tissue at the cell and tissue level. PMID- 1791172 TI - The determinants of skeletal muscle force and power: their adaptability with changes in activity pattern. AB - A kinetic model of the cross-bridge cycle in skeletal muscle is presented with special reference to the rate limiting steps regulating the peak rate of force development (dP/dt), peak force (P0), and the maximal shortening speed (Vmax). Force production in skeletal muscle is dependent on the number of cross-bridges in the strongly bound, high-force state (AM'-ADP), and during a peak isometric contraction this state is the dominant cross-bridge form. The peak force and power output of a muscle depends upon numerous factors to include: (1) muscle and fiber size and length; (2) architecture, such as the angle and physical properties of the fiber-tendon attachment, and the fiber to muscle length ratio; (3) fiber type; (4) number of cross-bridges in parallel; (5) force per cross bridge; (6) peak dP/dt; (7) force-velocity relationship; (8) fiber Vmax; (9) force-pCa2+ relationship: and (10) the force-frequency (action potential Hz) relationship. In this paper, we discuss these determinants of force and power output, and consider how they adapt to both muscle unloading (induced by hindlimb suspension) and programs of regular endurance exercise. Slow- and fast-twitch fibers have similar capacities to generate specific tension (kg cm-2). However, fast fibers show a considerably higher peak dP/dt, Vmax, and power output. The high Vmax of the fast-twitch fiber is likely due to the high myofibrillar ATPase activity of the fast myosin isozyme. Both hindlimb suspension and regular endurance exercise have been shown to induce fiber type specific changes in single fiber function. For example, fiber size and the peak tetanic tension of the slow oxidative (SO), fast oxidative glycolytic (FOG), and fast glycolytic (FG) fiber types were generally unaltered by endurance exercise-training. In contrast, hindlimb suspension produced cell atrophy in all fiber types and a reduced specific tension in the SO but not the FOG or FG fiber types. Both exercise-training and HS shifted the force-pCa curve to the right, and increased the Vmax of the SO fiber type. From the standpoint of work capacity or the ability to move a load, the important functional property is power output. Peak power is obtained at loads considerably below 50% of PO, and it is correlated with the percentage of fast-twitch fibers. Peak power can be increased by both dynamic and isometric programs of exercise-training.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1791173 TI - Regulation of skeletal muscle fiber size, shape and function. AB - There is convincing evidence that the cross-sectional area, the type of myosin expressed, the potential for oxidative phosphorylation and the number of myonuclei of a skeletal muscle fiber are closely interdependent. Each of these variables, as well as the shape of the fiber, has identifiable physiological consequences. Further, it is suggested that the cytoplasmic to myonucleus ratio is a function of the myosin type and the amount and/or rate of protein synthesis and degradation. Although the neuromuscular activity (electromyographic activity) as well as the associated mechanical and metabolic events have significant regulatory influences on protein metabolism, there are other important regulatory factors independent of these activity-related events. Both the activity and non activity related regulatory mechanisms probably occur via a cascade of cellular events. The specific combinations of cellular responses that occur may define the nature of the modulatory effects on specific proteins. In spite of the complexity of the regulatory mechanisms of protein modulation and how these responses are structurally integrated into or removed from functional fibers, it is suggested that controlled studies of human neuromuscular function can be more accurately defined and interpreted when fiber and muscle size and shape are considered. PMID- 1791174 TI - Trabecular bone remodeling: an experimental model. AB - An experimental model, capable of inducing controlled stress fields to the distal femoral metaphyses of large dogs, is presented. This model utilized an implantable hydraulic device incorporating five loading cylinders and platens in direct contact with an exposed plane of trabecular bone. A microprocessor controls the loading characteristics, and finite element models were created to calculate the induced stress and strain fields. The trabecular remodeling response is measured using serial in vivo computed tomography, in vitro microcomputed tomography, and histologic analysis. The results of the experiment indicate that significant remodeling can be induced by the activated implant. An increase in trabecular orientation toward the loaded platens was observed, and a statistically significant decrease in connectivity was documented. The greatest effect was associated with a change in the loading rate. A fast rise time (70 ms) loading waveform induced significant bone ingrowth at the implant interface when compared to a slow rise time waveform (700 ms), and demonstrated high correlations with the calculated stress fields as remodeling approached an equilibrium state. PMID- 1791175 TI - Noninvasive measurements of activity-induced changes in muscle metabolism. AB - Two noninvasive measurement techniques were used to monitor activity-induced changes in skeletal muscle in humans. Phosphorus magnetic resonance spectroscopy (P-MRS) was used to measure changes in energy metabolism by measuring the ratio of inorganic phosphate to phosphocreatine (Pi/PCr) during steady level work in the wrist flexor muscles in a 30 cm bore, 1.9 Telsa magnet, and the rate of PCr recovery from exercise in the calf muscles in a 76 cm bore, 1.8 Tesla magnet. Near red spectroscopy (NRS) was used to measure changes in oxygen saturation of hemoglobin and myoglobin during and after exercise. Fourteen days of wrist flexion exercise resulted in significant improvement in muscle metabolism as measured by MRS. This improvement disappeared after 35 days of inactivity. Indications of muscle stress during training such as muscle soreness and decreased maximum strength were associated with increases in resting Pi/PCr. A similar training protocol using plantar flexion exercise resulted in an improved rate of PCr resynthesis, which returned to control values 42 days after training stopped. NRS measurements of the wrist flexor muscles during a ramp exercise protocol demonstrated a decrease in the oxygen saturation of hemoglobin-myoglobin from 60% at rest to 15% at the highest work levels. The half time of recovery of oxygen saturation was faster than that of PCr in both young and old subjects, supporting the hypothesis that oxygen delivery is not rate limiting in submaximal exercise in healthy individuals. PMID- 1791176 TI - Fluid movement in bone: theoretical and empirical. AB - Evidence from the literature and from our laboratory demonstrates a pronounced and rapid flow of fluids and associated solutes through the extravascular spaces in bone. Minutes after injection, large molecules such as ferritin and horseradish peroxidase (HRP) have been localized throughout the osteocytic lacunae and canaliculi of cortical bone in the chick, rat and dog. Patterns of marker movement preclude diffusion as the mechanism for solute movement and suggest a centrifugal bulk flow of fluids. We have developed a computer model of bone fluid flow that has led to the conclusion that the pattern and rate of fluid movement is governed by the pressure differential across the bone, the vascular architecture, and the porosity of the mineralized matrix. The validity of simulations in which a substance is injected and monitored over time has been tested by comparisons with actual injections of markers in the rat. Evidence is presented for a relationship between blood flow and bone dynamics in growth, repair and pathology of bone. We employed the tail suspension model of weightlessness in the rat to test the effect of posture on the perfusion of cortical bone using injections of HRP. Data indicated that perfusion of the femur was reduced by this treatment. We propose a "rheostat" mechanism, which suggests that bone perfusion may set limits for bone growth and remodeling. Therefore, bone mass reflects the ability of the vasculature to supply oxygen and nutrients to the cells on and within the mineralized matrix. PMID- 1791177 TI - Musculoskeletal design in relation to body size. AB - Irrespective of body size and phylogenetic diversity, the skeletal systems of terrestrial mammals are built of tissue components having similar mechanical properties and material organization. Because of scale effects on skeletal form, therefore, larger mammals increase the effective mechanical advantage of their limbs to decrease mass-specific forces associated with the support of gravitational loads imposed during locomotion to maintain a similar safety factor. Larger animals accomplish this by adopting a more upright posture while running, which aligns their limb joints more closely with the resultant ground reaction force, thereby decreasing the mass-specific force that their muscles must generate to support externally applied joint moments. As a result, peak (compressive) bone stresses determined from in vivo bone strain recordings and force platform and kinematic analyses of the limb generally range from -40 to -80 MPa (mean: -55 +/- 23 MPa), corresponding to a safety factor to compressive bone failure of about three to four. The decrease in mass-specific muscle force indicates that the maximum stresses developed in limb muscles of different sized species are also similar at equivalent levels of performance. Stresses developed in the midshafts of most long bones are primarily the result of bending, often engendered by axial forces transmitted about the bone's longitudinal curvature. The consistency of bending-induced skeletal strain over a range of physical activity and the associated expense of increased strain magnitude that this form of loading incurs suggest that functional strain patterns developed through bending may be a desirable architectural objective of most long bones. Alteration of a bone's normal functional strain distribution, therefore, is likely a key factor underlying adaptive remodeling in response to changes in mechanical loading. PMID- 1791179 TI - The influence of gravity and activity on muscle and bone. Proceedings of the NASA Symposium. Moffett Field, California, January 29-30, 1990. PMID- 1791178 TI - Musculoskeletal ontogeny, phylogeny, and functional adaptation. AB - Physical forces applied to connective tissues may cause significant changes in cell metabolism and gene expression. Theoretical investigations indicate that mechanical loading histories beginning very early in skeletal development may guide endochondral ossification patterns and the initial architectural construction of bones. Developmental patterns and structures of bones can be emulated using mathematical algorithms or "rules of construction" which relate developmental processes to tissue stress (or strain) histories. Skeletal forms and tissues are well-designed for their mechanical function primarily because their histomorphological construction has been guided by mechanical loading during growth and development. Construction rules of developmental mechanics can also be used to describe many of the histological and morphological adaptations of mature skeletal tissues to changes in customary physical activity. Over many generations, changes in the heritable genetic information occurs by mutation and genetic variability. The range of skeletal forms that are possible in evolution due to such variations, however, is constrained by the developmental rules of construction that reflect biophysical processes associated with the tissue mechanical loading. PMID- 1791180 TI - Validation of optimization models that estimate the forces exerted by synergistic muscles. AB - The purpose of this study was to validate the mathematical predictions of individual muscle forces obtained using optimization models. Mathematical muscle force predictions were made using linear and nonlinear optimization models proposed in the literature. Actual muscle forces were measured experimentally from soleus, gastrocnemius and plantaris muscles of an adult male cat during a variety of locomotor tasks. Mathematically predicted muscle forces did not agree well with the experimentally determined muscle forces, because changes in force sharing during given step cycles and for different locomotor speeds were largely ignored in the theoretical models tested. It is suggested that changes in force sharing during given step cycles may be caused by differences in force-velocity characteristics or small time delays of onset of activation between muscles; whereas changes in force sharing associated with different speeds of locomotion may be caused by corresponding changes in the magnitude of centrally controlled activation. Theoretical simulations testing the feasibility of these suggestions were encouraging. In view of the findings of this study, it is suggested that future models should be developed and validated based on experimental findings. PMID- 1791181 TI - Force transmission across muscle cell membranes. AB - Myotendinous junctions (MTJs) display both morphological and molecular specializations for force transmission from contractile, cytoskeletal proteins to extracellular, structural proteins. MTJ membrane folding may be a mechanically important feature in junction structure in that it reduces membrane stress and situates the junction for loading primarily under shear. Force is likely to be transmitted, at least in part, by a chain of proteins including vinculin, talin, integrin, fibronectin and collagen. However, the concentration at MTJs of other structural proteins and of proteins involved in cell adhesion indicate that additional, force transmitting mechanisms also exist. Myonexin and dystrophin, muscle-specific proteins found at MTJs, may also be associated with MTJ force transmission. Periodic structures at non-MTJ membrane, called costameres, have molecular compositions similar to MTJs and may therefore also be involved in force transmission across the muscle cell membrane. Muscle tears occurring during muscle use following periods of disuse occur at or near MTJs. Disuse atrophy is associated with decreased MTJ folding and, therefore, an increase in MTJ stress during loading. This decrease in membrane folding may be the basis of increased tears in atrophied muscle. PMID- 1791182 TI - Muscle architecture in relation to function. AB - Animal muscles generate forces and induce movements at desirable rates. These roles are interactive and must be considered together. Performance of the organism and survival of the species also involve potential optimization of control and of energy consumption. Further, individual variability arising partly via ontogeny and partly from phylogenetic history often has pronounced and sometime conflicting effects on structures and their uses. Hence, animal bodies are generally adequate for their tasks rather than being elegantly matched to them. For muscle, matching to role is reflected at all levels of muscular organization, from the nature of the sarcoplasm and contractile filaments to architectural arrangements of the parts and whole of organs. Vertebrate muscles are often analyzed by mapping their placement and then "explaining" this on the basis of currently observed roles. A recent alternative asks the obverse; given a mass of tissue that may be developed and maintained at a particular cost, what predictions do physical principles permit about its placement. Three architectural patterns that deserve discussion are the classical arrangement of fibers in pinnate patterns, the more recent assumption of sarcomere equivalence, and the issue of compartmentation. All have potential functional implications. 1. The assumption of equivalence of the sarcomeres of motor units allows predictions of the fiber length between sites of origin and insertion. In musculoskeletal systems that induce rotation, the observed (but not the pinnation-associated) insertion angle will differ with the radial lines on which the fibers insert. In a dynamic contraction inducing rotation, a shift of moment arm has no effect for muscles of equal mass. 2. Classical pinnate muscles contain many relatively short fibers positioned in parallel but at an angle to the whole muscle, reducing the per fiber force contribution. However, the total physiological cross-section and total muscle force are thus increased relative to arrangements with fibers parallel to the whole muscle. Equivalent muscles may be placed in various volumetric configurations matching other demands of the organism. The loss of fiber force due to (pinnate, not equivalent) angulation is compensated for by the reduced shortening of fibers in multipinnate arrays. 3. Compartmentation, i.e., the subdivision of muscles into independently controlled, spatially discrete volumes, is likely ubiquitous. Differential activation of the columns of radial arrays may facilitate change of vector and with this of function. Compartmentation is apt to be particularly important in strap muscles with short fiber architecture; their motor units generally occupy columnar, rather than transversely stacked, subdivisions; this may affect recovery from fiber atrophy and degeneration.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1791183 TI - On the adaptive structures of the collagen fibrils of bone and cartilage. AB - In order to investigate how bone and cartilage respond at the molecular level to changing demands of the skeleton, the influence of endogenous and external chemical stresses on collagen fibrillar structure as a function of locale in the femoral articular cartilage from 2 to 14 year old cows has been studied by x-ray diffraction. The fibrils were found to be osmotically compressed by vicinal proteoglycans. For most locales, the molecular packing density was less at the articular surface and increased to a maximum adjacent to the bone. This gradient in structure became more accentuated with animal age. For all ages, the packing density gradients could be almost completely eliminated upon enzymatic removal of the proteoglycans. However, in the regions of cartilage which had experienced the greatest stress in locomotion, the fibrils had a hyperswollen structure. This tendency towards hyperswelling increased with animal age. We have concluded that the collagen fibrils in articular cartilage adapt a structure that is in response to their respective mechanico-chemical histories. PMID- 1791184 TI - Mechanically induced alterations in cultured skeletal muscle growth. AB - Model systems are available for mechanically stimulating cultured skeletal muscle cells by passive tensile forces which simulate those found in vivo. When applied to embryonic muscle cells in vitro these forces induce tissue organogenesis, metabolic adaptations, and muscle cell growth. The mechanical stimulation of muscle cell growth correlates with stretch-induced increases in the efflux of prostaglandins PGE2 and PGF2 alpha in a time and frequency dependent manner. These prostaglandins act as mechanical "second messengers" regulating skeletal muscle protein turnover rates. Since they also effect bone remodelling in response to tissue loading and unloading, secreted prostaglandins may serve as paracrine growth factors, coordinating the growth rates of muscle and bone in response to external mechanical forces. Cell culture model systems will supplement other models in understanding mechanical transduction processes at the molecular level. PMID- 1791185 TI - The vascular endothelial growth factor family of polypeptides. AB - Vascular endothelial growth factor (VEGF) was identified as a heparin-binding polypeptide mitogen with a target cell specificity restricted to vascular endothelial cells. Molecular cloning reveals the existence of four species of VEGF having 121, 165, 189, and 206 amino acids. These have strikingly different secretion patterns, which suggests multiple physiological roles for this family of polypeptides. The two shorter forms are efficiently secreted, while the longer ones are mostly cell-associated. Alternative splicing of mRNA, rather that transcription from different genes, is the mechanism for their generation. In situ hybridization reveals that the VEGF mRNA is widely distributed in most tissues and organs and expressed at particularly high levels in areas of active vascular proliferation, like the ovarian corpus luteum. Ligand autoradiography on rat tissue sections demonstrates that VEGF binding sites are associated with vascular endothelial cells of both fenestrated and non-fenestrated capillaries and with the endothelium of large vessels, while no displaceable binding is evident on non-endothelial cell types. These findings support the hypothesis that VEGF plays a highly specific role in the maintenance and in the induction of growth of vascular endothelial cells. PMID- 1791186 TI - Vascular permeability factor: a unique regulator of blood vessel function. AB - Vascular permeability factor (VPF), also known as vascular endothelial growth factor (VEGF), is a potent polypeptide regulator of blood vessel function. VPF promotes an array of responses in endothelium, including hyperpermeability, endothelial cell growth, angiogenesis, and enhanced glucose transport. VPF regulates the expression of tissue factor and the glucose transporter. All of the endothelial cell responses to VPF are evidently mediated by high affinity cell surface receptors. Thus, endothelial cells have a unique and specific spectrum of responses to VPF. Since each of the responses of endothelial cells to VPF are also elicited by agonists, such as bFGF, TNF, histamine and others, it remains a major challenge to determine how post-receptor signalling pathways maintain both specificity and redundancy in cellular responses to various agonists. PMID- 1791187 TI - Effect of monensin on ricin and fluid phase transport in polarized MDCK cells. AB - The effect of monensin on endocytosis, transcytosis, recycling and transport to the Golgi apparatus in filter-grown Madin-Darby canine kidney (MDCK) cells was investigated using 125I-labeled ricin as a marker for membrane transport, and horseradish peroxidase (HRP) as a marker for fluid phase transport. Monensin (10 microM) stimulated transcytosis of both markers about 3-fold in the basolateral to apical direction. Transcytosis of HRP in the opposite direction, apical to basolateral, was reduced to approximately 50% of the control by monensin, whereas that of ricin was slightly increased. Recycling of markers endocytosed from the apical surface was reduced in the presence of monensin and there was an increased accumulation of both ricin and HRP in the cells. Transport of ricin to the Golgi apparatus increased to the same extent as the increase in intracellular accumulation. No change in recycling or accumulation was observed with monensin when the markers were added basolaterally, but transport of ricin to the Golgi apparatus increased almost 3-fold. Our results indicate that basolateral to apical transcytosis is increased in the absence of low endosomal pH, and they suggest that apical to basolateral transcytosis of a membrane-bound marker (ricin) is affected by monensin differently from that of a fluid phase marker (HRP). PMID- 1791188 TI - Lung-derived growth factor that stimulates the growth of lung-metastasizing tumor cells: identification as transferrin. AB - We have previously shown that culture medium conditioned by lung fragments contains mitogenic activity for lung-metastasizing tumor cells but not for their non-metastatic counterparts. The growth-promoting component from media conditioned by rat and porcine lungs has been purified and partially characterized as a Mr approximately 66,000 (unreduced) or Mr approximately 72,000 (reduced) glycoprotein [Cancer Res 49:3928, 1989; J Cell Biochem 43:127, 1990]. Here we report that this factor is the iron transport protein transferrin. Migration distances in sodium dodecyl sulfate and native gel polyacrylamide electrophoresis systems were similar, as were the specific activities and spectrum of mitogenic activities of the lung-derived growth factor and transferrin. Electrophoretically separated holo-rat transferrin and rat lung derived growth factor displayed similar positive stains for iron. A polyclonal antibody generated against the lung-derived growth factor cross-reacted with human and rat transferrin in Western blots, and anti-human transferrin cross reacted with rat lung-derived growth factor. All of the mitogenic activity contained in crude lung conditioned media could be removed by antibody-mediated transferrin depletion. The putative cell receptor molecular weights for the lung derived growth factor and transferrin were similar as were the molecular weights of polypeptides produced by partial trypsin cleavage of the two. Finally, the amino acid sequence of certain regions of rat lung-derived growth factor demonstrated a high degree of homology to human transferrin. The physical and biochemical properties, antigenicity, and mitogenic activity of a previously unidentified lung-derived growth factor for lung-metastasizing tumor cells indicate that it is transferrin. PMID- 1791189 TI - Effect of phospholipases and proteases on the [3H]N6-(R)-phenylisopropyladenosine ([3H]R-PIA) binding to A1 adenosine receptors from pig cerebral cortex. AB - The effect of phospholipases and proteases on the membrane-bound and solubilized A1 adenosine receptor has been studied. Phospholipids modulate the [3H]N6-(R) phenylisopropyladenosine binding to A1 adenosine receptors in crude membranes and in soluble preparations, because changes in the phospholipid environment decrease both the binding capacity and the affinity for the ligand. It has become clear that 1) there is co-solubilization of receptor and phospholipids; 2) the phospholipid requirements are different for the coupled and the uncoupled receptor; 3) a net charge in the polar head produced by phospholipase D prevents the agonist binding to the receptor-G protein complex; alternatively, when the whole polar head is removed by phospholipase C the uncoupled receptor is altered; and 4) the protease action upon the receptor suggests that receptor coupled to G protein is more protected by the membrane than the uncoupled receptor. In kinetic experiments performed on membranes it was demonstrated that phospholipase C and trypsin increased the Kd value of the high-affinity state by modifying both k1 and k-1. In contrast they only modified the dissociation constant of the low affinity state. In conclusion it should be noted that phospholipids play a key role for the binding of R-PIA to A1 adenosine receptor. Also, a different disposition within the membrane of the coupled and uncoupled receptor is encountered. PMID- 1791190 TI - Involvement of weak binding crossbridges in force production in muscle. PMID- 1791191 TI - Relaxation from rigor by photolysis of caged-ATP in different types of muscle fibres from Xenopus laevis. AB - Using chemically skinned fast and slow fibres from the iliofibularis muscle of Xenopus laevis, we measured the force changes following laser pulse photolysis of caged-ATP at 4 degrees C in the presence and absence of added calcium. The time course of the early force change in the absence of calcium was used to derive an apparent second order rate constant for crossbridge detachment. These values were compared with previous model-dependent estimates stemming from force-velocity experiments. For fast muscle fibres, the value obtained here was equal to that obtained in the previous study, namely 4 x 10(5) M-1 S-1. For slow fibres, the value obtained from caged-ATP experiments was 1.5 x 10(4) M-1 S-1, whereas the value from force-velocity experiments was 20 times greater (2.9 x 10(5) M-1 S-1). The different values for slow fibres indicate that the model assumptions inherent in the analysis of the force-velocity experiments may not hold for all muscle types. For example, the process of dissociation of the actomyosin complex of slow myosins may be different from that of fast myosins. All observed or calculated kinetic transitions for the crossbridge cycle were slower in slow muscle fibres than in fast muscle fibres. These include the forward and backward rate constants for crossbridge attachment which were lower by a factor of three in slow fibres compared with fast fibres. PMID- 1791192 TI - Four aspects of creep phenomena in striated muscle. AB - Four aspects of the slow creep of tension and sarcomere lengths observed during fixed-end tetani are studied with computer simulations, using the instantaneous steady-state (adiabatic) approximation. (1) Most aspects of fixed-end creep phenomena can be simulated in the presence of the passive forces which correctly produce initially shortened end sarcomeres. However, the very large maximum tensions observed with fibres of low resting force for sarcomere lengths greater than 3.0 microns cannot be simulated within the adiabatic approximation. (2) Random variations in the passive tension-length curve between different sarcomeres can predict the reported incidence of contracting sarcomeres in the middle of the fibre, while avoiding significant tension creep when a central segment is length-clamped. They can also reverse the velocity of these sarcomeres during creep in fibres with high resting tension, as observed by Altringham and Bottinelli (1985). At sarcomere lengths of greater than or equal to 3.4 microns we find that spatial variations in passive tension strength also contribute to tension creep. (3) Crossbridge fluctuations in active tension have been estimated from the sliding-filament model, and do not contribute significantly to tension creep. (4) The need for inter-sarcomere stiffness or other mechanisms to produce an additional slow rise in tension at long times, and to smooth the sarcomere length distribution, is assessed. PMID- 1791193 TI - Functional characterization of the two isoforms of troponin C from the arthropod Balanus nubilus. AB - Two isoforms of troponin C (BTnC1 and BTnC2) from the striated muscle of the arthropod Balanus nubilus Darwin (giant barnacle) have been purified (Potter et al., 1987; Collins et al., 1991). Both isoforms were present in all of the white striated muscle fibres studied but not in the red fibres. The ratio of BTnC2 to BTnC1 in different fibre types varied between 3:1 and 1:1. Both forms of TnC could be readily extracted from myofibrillar bundles of barnacle muscle in low ionic strength EDTA solutions, reducing force activation to less than 10%. Both forms either separately or together reassociated with the TnC-depleted fibres in a relaxing (LR) solution (pCa greater than 8.0, [Mg2+] free = 1 mM, I = 0.15 M), and the reconstituted fibres could be subsequently activated in contraction (LA) solution (pCa = less than 3.8, [Mg2+] free = 1 mM, I = 0.15 M). The dissociation of BTnC 1 + 2 is blocked in low ionic strength solutions containing Mg2+ (greater than or equal to 10 mM). The two isoforms of crayfish TnC (CrTnC1 and CrTnC2) were also found to be equivalent to the barnacle TnCs in their ability to reactivate TnC-depleted barnacle myofibrillar bundles. Similar experiments using rabbit skeletal muscle TnC (STnC) (I = 0.15 M) in BTnC-depleted myofibrillar bundles of barnacle showed considerable variability. STnC could associate, although weakly, with the depleted bundles in either LR or LA, and force could be partially restored. In neither situation was it as effective as either BTnC or CrTnC. Interestingly, bovine cardiac TnC (CTnC), although it did not associate at pCa greater than 7.0, did associate and effectively activate force at pCa less than 3.8, but dissociated on return to pCa greater than 7.0 (LR). Neither barnacle TnC isoform associated with TnC-depleted skinned fibres from rabbit skeletal muscle at pCa greater than 7.0, but did associate and activate these fibres at pCa less than 3.8. Once these fibres were returned to LR and then placed in LA at pCa 3.8 all BTnC-restored force was lost, indicating a dissociation of BTnC once the Ca2+ is lowered, as observed with CTnC in barnacle myofibrillar bundles. Finally, the inhibitory effect of BTnI on force and the absence of an effect of calmodulin, trifluoperazine or ATP-gamma-S on force were all taken as evidence for a thin filament regulated Ca2+ control system. PMID- 1791194 TI - Functional implications of the unusual amino acid sequence of the regulatory light chain of Acanthamoeba castellanii myosin-II. AB - We have determined by protein chemistry methods the amino acid sequence of light chain 2 from Acanthamoeba castellanii myosin-II (ALC2). This is the first reported sequence for any protozoan myosin light chain. ALC2 consists of 154 amino acid residues, including a single residue of His and two residues each of Pro and Tyr, and lacks Cys and Trp. The N-terminus is blocked, and if an N terminal acetyl group is assumed. ALC2 has a calculated molecular weight of 17,657. ALC2 is an acidic protein, with a calculated net charge of -7 at pH 7. The sequence of ALC2 is most similar to those of the calmodulins (identity approximately 35%), followed by myosin regulatory light chains. ALC2 appears to lack the potential N-terminal phosphorylation site and single Ca(2+)-binding site in region I which are characteristic of most myosin regulatory light chains. Instead, ALC2, unlike any other myosin light chain characterized to date, may have a functional Ca(2+)-binding site only in region II, suggesting a novel role of ALC2 in the Ca2+ regulation of the activity of Acanthamoeba myosin-II. PMID- 1791195 TI - Complete coding sequences of cDNAs of four variants of rabbit skeletal muscle troponin T. AB - Four variants of troponin T (TnT) cDNAs have been isolated and sequenced. These cDNAs have been derived from rabbit skeletal muscle, the most widely studied source of troponin, of a 11-day-old animal. One variant (TnT-1) contains the complete coding sequence, while in three variants the coding sequences are truncated at the 5' termini. The previously published amino acid sequence differs from the present cDNA-derived sequences at three locations. At least two, possibly all, of them are probably accounted for by errors in peptide sequencing. The present results are consistent with the two types of alternative splicing of TnT genes, both being first reported on the rat gene. (1) Highly variable sequences in the amino-terminal region are accounted for by the alternative splicing of exons 4-8 in an interchangeable but not mutually exclusive manner. (2) In the carboxyl-terminal region, the alternative splicing of two exons 17 (beta-type) or 16 (alpha-type) in mutually exclusive manner is consistent with the difference between all the four cDNAs, which express exon 17, and the previously published peptide sequence (derived from the adult muscle) in which exon 16 is present. This variation also corresponds to the finding in chicken skeletal muscle that the choice of exon 16 or 17 may be dependent on developmental stages. Finally, a sequence is observed corresponding to an extra exon or exons between exons 5 and 6. This sequence is shorter than that of the chicken skeletal muscle gene and is not detected in the rat skeletal muscle gene. PMID- 1791196 TI - Calcium transients in skeletal muscle fibres under isometric conditions and during and after a quick stretch. AB - The transient change in the sarcoplasmic concentration of Ca2+ was measured in intact fibres isolated from the anterior tibial muscle of the frog Litoria moorei. The fibres had been injected with the calcium-sensitive dye arsenazo III and the change of the calcium concentration was calculated from the changes in light absorbance at 570, 600 and 720 nm wavelengths. Absorbance and force were measured under three different conditions: (1) during a normal isometric twitch, (2) when a quick ramp-and-hold stretch had been applied to the fibre during onset of the contraction, and (3) when the fibre was allowed to contract isometrically at a length corresponding to the final length of the stretch. A method was devised to neutralize most of the movement artefacts encountered in such measurements. While the quick stretch caused substantial increase in the level and the duration of the contractile force such as originally described in whole muscle by A. V. Hill, the calcium transients appeared basically unaffected. It thus seems that the mechanism behind the phenomenon of the force enhancement lies at a step in the excitation-contraction coupling subsequent to the calcium release. From the present results, however, it is not clear whether the phenomenon is caused by an increase in the level of activation of the calcium dependent regulatory system, or whether it is to be found in the acto-myosin interaction itself. The latter alternative would be consistent with the stiffness measurements published earlier. PMID- 1791197 TI - Binding of alpha-actinin to F-actin or to tropomyosin F-actin is a function of both alpha-actinin concentration and gel structure. AB - We have studied by electron microscopy as well as by measurements of low shear viscosity, rigidity and binding, the effect of alpha-actinin on the gel formed at 37 degrees C with F-actin and with tropomyosin-decorated F-actin. Contrary to previous reports in the literature, alpha-actinin at nanomolar concentrations is an efficient actin gelling protein, even at 37 degrees C, provided that the concentration of actin (or of tropomyosin-decorated F-actin) is low (1.2-2.4 microM). The binding of alpha-actinin to F-actin, as a function of actin concentration, is anomalous. The amount of bound alpha-actinin increases when actin concentration increases from 0 to 1.2 microM but does not change significantly when actin concentration is further increased up to 48 microM. A similar result is obtained with tropomyosin-decorated F-actin. These observations can be explained by an hypothesis that binding is a function of the alpha-actinin - F-actin association constant as well as of the rigidity of the gel. When the concentration of actin increases, the rigidity of the gel also increases and more work is required to bring two actin filaments to the reaction distance with alpha actinin and, consequently, a larger alpha-actinin concentration is required to attain the same ratio of bound alpha-actinin to actin monomers in the filaments. PMID- 1791198 TI - Mechanical properties of normal and mdx mouse sarcolemma: bearing on function of dystrophin. AB - The tensile strength of the muscle fibre surface membrane was estimated (1) from the suction required to burst membrane patches and (2) by aspiration of sarcolemmal vesicles into micropipettes of uniform bore. Each method gave an average value close to 60 microN cm-1 for the maximum tension sustainable by normal mouse sarcolemma and only slightly lower values for sarcolemma from mdx mice which lack dystrophin. The elastic modulus of area expansion, as measurable by pipette aspiration of sarcolemmal vesicles, was found to have an average value of 3160 microN cm-1 for normal and 2770 microN cm-1 for mdx mouse sarcolemma. The tensile strength of the sarcolemma is much too small for any differences in it to be the basis for the different osmotic behaviour of normal and mdx muscle fibres reported recently (Menke & Jockusch, 1991). By analogy with the better understood origin of the osmotic fragility of different types of red blood cells, the higher osmotic fragility of mdx muscle fibres is suggested to be of morphological origin. We postulate that dystrophin functions as an element of the submembrane cytoskeleton so as to maintain the normal folding which safeguards the sarcolemma against mechanical damage. PMID- 1791199 TI - Lung mast cells in plexogenic pulmonary arteriopathy. AB - The numbers of mast cells/mm2 of lung parenchyma were counted in four controls, 15 cases of primary plexogenic pulmonary arteriopathy (PPA), and 17 cases in which the arteriopathy was secondary to congenital heart disease, to determine if increased numbers occur in PPA and with what stage of disease they might be associated. Considerable accumulations of lung mast cells may occur in this disease, but these are not closely related to any particular histological stage in the development of the arteriopathy. It is postulated that while mast cells could conceivably exert a vasodilatory effect on constricted small pulmonary arteries, it seems more likely that they are part of the parenchymal changes that commonly develop in this disease. PMID- 1791200 TI - New automated technique for assessing emphysema on histological sections. AB - The assessment of emphysema in human lungs has traditionally been based on observations made on whole lung slices. These methods are inappropriate for the study of early emphysema, because as much as 75% of the alveolar wall surface area may have been lost by the time airspaces are visible to the naked eye. A new, automated image analysis system, the Fast Interval Processor (FIP), was used to measure airspace wall surface area per unit volume of lung tissue (AWUV). AWUV was measured on histological sections of lung tissue and expressed in mm2/mm3. The study sample consisted of resection specimens from 40 patients (32 men and 8 women whose ages ranged from 23-74 years). Histological sections from the inflated specimens were scanned using the FIP, and a mean AWUV value was calculated for each. The intra- and interobserver reproducibility of this method of measuring AWUV were examined. The results obtained using the FIP were also compared with those from an established image analysis system. The FIP is a fast, efficient technique which gave highly reproducible results comparable with those obtained with an established and much more time consuming measuring technique. PMID- 1791201 TI - Mnemonic coding system for clinical data entry into laboratory computers: its effect on quality and efficiency. AB - A simplified coding method for entering the clinical details found on pathology request cards was developed. The method uses a basic four letter code, derived from the initial character of the first four words in a clinical detail, being expanded to four characters with letters from the final word if the number of words is less than four. Rules were devised to cope with common medical terminology. In excess of 90% of clinical details on request cards are readily input by clerical staff using our coding system, and 8% of clinical details are used intelligently by the computer in scheduling further tests or automatically commenting on results. A carefully designed coding system such as the one outlined above could greatly facilitate input of clinical detail without the penalty of reduced throughput. PMID- 1791202 TI - Molecular specificity of two commercial enzyme linked immunosorbent assays for human immunodeficiency virus antigens. AB - Only "fair" agreement has been shown between the Abbott and DuPont enzyme linked immunosorbent assays when used for the detection of human immunodeficiency virus (HIV) antigen in serum samples from asymptomatic HIV antibody positive homosexual men. To investigate the discrepancies between the two ELISA results, further experiments were performed. The rabbit detector antibody solutions of both tests were western blotted and showed that the DuPont test was specific for p24; the Abbott detector antibody had bands for p18, p41-43, gp120 as well as p24. By using dilutions of a known amount of HIV antigen, the Abbott test could detect 20 pg/ml p24; the DuPont test could detect 30 pg/ml p24. The DuPont test was also more sensitive than the Abbott test at detecting a synthetic 104mer peptide of p24. Within the 104mer sequence two regions (294-318, 334-348 amino acids) inhibited the binding of the DuPont detector antibody, but no blocking was observed with the Abbott antibody. Although the Abbott test was slightly more sensitive at detecting HIV protein than the DuPont test, the major difference between the tests was in the molecular specificity, in that the Abbott test detected proteins other than p24. This may not be important for detecting antigen in cell culture, but it may affect the detection of antigenaemia in patients' sera. PMID- 1791203 TI - Rapid screening for toxigenic Corynebacterium diphtheriae by the polymerase chain reaction. AB - The polymerase chain reaction (PCR) was used to discriminate between toxigenic and non-toxigenic isolates of Corynebacterium diphtheriae. Primers specific to the diphtheria toxin gene were used to amplify a toxin gene fragment from simple boiled-cell preparations. Eight recent clinical isolates and four reference strains were tested. The result of the PCR agreed with the traditional toxigenicity assays (the Elek test and guinea pig inoculation) in all cases. PCR has several advantages over the Elek test: it gives a same-day result, it works on colonies taken from selective media, and it detects the toxin gene in mixed cultures. One potential drawback is that the PCR might give a false positive result with the occasional isolate carrying an inactive toxin gene. The good predictive value of a negative PCR result, however, should make it a valuable screening test. PMID- 1791204 TI - Demonstration of Chlamydia trachomatis in colposcopic cervical biopsy specimens by an immunoperoxidase method. AB - A total of 31 cervical biopsy specimens were taken from 29 women attending a genitourinary medicine clinic, nine women (11 biopsy specimens) were known to have Chlamydia trachomatis cervicitis and 20 women were known to be free of chlamydial infection. The specimens were routinely processed to paraffin wax and stained by an anti-Chlamydia immunoperoxidase technique to localise the organisms. Of the 11 positive biopsy specimens three showed positive staining of elementary/reticulate bodies. In one case the surface endocervical cells showed large inclusions which were packed with chlamydial bodies. The diagnosis of chlamydial infection is difficult to make clinically and in routine cytological and histological specimens but immunoperoxidase staining can clearly identify C trachomatis inclusions in cervical biopsy specimens provided infection is severe. PMID- 1791205 TI - Evaluation of a screening test for detecting urinary tract infection in newborns and infants. AB - The results of a study of a screening test for urinary tract infection (UTI) in infants under 18 months is reported. Two hundred and forty three urine specimens were tested in the laboratory using AMES Multistix 8SG reagent strips read by photometer. The strips included three potential markers for urinary tract infection: leucocyte esterase, nitrite, and protein. The predictive value of a positive result (PPV) was low. The predictive value of negative test (NPV) when combining the screen of leucocyte esterase, nitrite, and protein was 99.4% with no difference between boys and girls. The test for leucocyte esterase had a 97.6% negative predictive value. An examination of the results by age confirms the good NPV in all age groups. Paediatricians should find Multistix 8SG strips a useful aid in the diagnosis of urinary tract infection in infants, and that costly culture of samples with negative strip tests can be avoided. PMID- 1791206 TI - Oncocytic metaplasia of the nasopharynx or extra-parotid Warthin's tumour? AB - A case of oncocytic metaplasia obstructing the Eustachian tube in an elderly patient is described. Histologically, it was similar to Warthin's tumour of the parotid gland. The lymphocytes were predominantly T cell, unlike those of Warthin's tumour which are predominantly B cell. It is proposed that oncocytic metaplasia represents an early stage in the evolution of Warthin's tumour. PMID- 1791207 TI - Atypical Ph negative chronic myeloid leukaemia presenting as sudden profound deafness. AB - A patient with atypical Ph negative chronic myeloid leukaemia presented with the sudden onset of profound deafness. He survived only eight months. Detailed histological investigation performed at necropsy showed loss of ganglion cells and afferent nerve fibres in the cochlea and vestibule associated with extensive fibrosis and new bone formation in the labyrinthine spaces. Both leucophoresis and high dose chemotherapy capable of rapid cytoreduction are recommended in patients with chronic myeloid leukaemia with profound hearing loss, as conventional chemotherapy is rarely followed by recovery. PMID- 1791208 TI - Pulmonary infarction, myocardial infarction, and acute disseminated intravascular coagulation. AB - Pulmonary and myocardial damage are frequently cited as manifestations of disseminated intravascular coagulation (DIC), but rarely as causes. Three elderly cases of severe DIC due to pulmonary and myocardial infarction are reported. All three patients died. Necropsy showed extensive pulmonary emboli in each case with large pulmonary infarcts in cases 1 and 2 and a ventricular aneurysm containing thrombus in cases 2 and 3. Early diagnosis and treatment of pulmonary embolism requires a high degree of clinical suspicion but may prevent progression to the irreversible stage of severe DIC. PMID- 1791209 TI - Use of polymerase chain reaction to detect Toxoplasma. PMID- 1791210 TI - Blood and bone marrow cultures in enteric fever. PMID- 1791211 TI - Diagnosis of acute hepatitis B by qualitative assay of specific IgM antibody. PMID- 1791212 TI - Current views on cervical intraepithelial neoplasia. PMID- 1791213 TI - Wiskott-Aldrich syndrome: a multidisciplinary disease. PMID- 1791215 TI - Language skills of delinquent and nondelinquent adolescent males. AB - A comparison of language skills between adolescent juvenile delinquent males and matched nondelinquent peers was made using an informal language sample analysis (a modified Clinical Discourse Analysis) and the TOAL-2 measure. Twenty-four institutionalized delinquents and 24 nondelinquents ranging in age from 14.4 to 17.9 years were subjects. Their respective mean full scale intelligence quotients were 99.75 and 101.25 and they had no known verified handicapping conditions. Two one-way ANOVAs showed that there were significant differences for language skills on the dependent measures between the two groups. Differences between the groups also were observed from descriptive statistics for academic performance. Implications for assessment and treatment of "at-risk" populations are addressed. PMID- 1791214 TI - Quantitative interrelations of Lewis antigens in normal mucosa and transitional cell bladder carcinomas. AB - The factors regulating the expression of the Lewis blood group related antigens in tissues have yet to be clarified. In an attempt to resolve some of the existing controversies the quantitative interrelationship of the Le(a), Le(b), X and Y antigens in normal urothelium and transitional cell carcinomas (TCC) was studied using biopsy specimens derived from 22 patients whose ABO and Lewis red blood cell phenotype was known. A quantitative scale was devised to encompass both the extent and intensity of the immunohistochemical reactivity in one numerical value (score). The expression of these four antigens in the normal urothelium followed a characteristic pattern that is related to but not identical with the red blood cell phenotype. An excess of Le(b) and Y in the urothelium correlated with the Le(a-b+) red blood cell phenotype, while a relative increase in Le(a) and X (at the expense of Le(b) and Y) was associated with the Le(a+b-) red blood cell phenotype. This pattern can be accounted for by the combined effects of differential gene expression and substrate availability. The quantitative comparison of the antigenic make-up of TCCs with the corresponding normal tissue phenotype shows consistent trends, suggesting that the changes associated with neoplasia derive primarily from the suppression of specific gene products and, secondarily, from altered competitive substrate utilisation. PMID- 1791216 TI - Adolescents' perceptions of normal and voice-disordered children. AB - The purpose of this investigation was to compare adolescents' perceptions of the nonspeech characteristics of voice-disordered and normal speakers. Recordings of six three-word phrases produced by 16 speakers, eight voice-disordered and eight normal-speaking children, were presented to 19 adolescent students for judgments of nonspeech characteristics on a semantic differential scale containing 22 bipolar adjective pairs. Results of their ratings indicated that for 15 of the 22 pairs (68.2%) the normal speakers were judged more positively than the voice disordered speakers. Moreover, for 9 of the 22 pairs (40.9%) the differences in listeners' ratings between the two speaker groups were statistically significant. Implications of these findings concerning developmental trends in the perception of voice disorders and their potential impact on mainstreaming in schools are discussed. PMID- 1791217 TI - Perceptual and acoustical analyses of phonemic paraphasias in nonfluent and fluent dysphasia. AB - Phonemic paraphasias produced by nonfluent and fluent dysphasic adults during connected speech elicitations were examined using four perceptual and two acoustical variables. Results revealed important findings for each of the examined variables. The acoustical variables, however, were more helpful for differentiating the two dysphasic categories. The findings obtained also relate to factors such as phoneme frequency, suprasegmental feature of stress placement, anatomicophysiological characteristics of phonemes, and the interaction between the linguistic parameters of phonology and semantics. These factors have implications for the treatment of verbal dyspraxia in nonfluent and fluent dysphasia. PMID- 1791218 TI - Lichen planus. AB - Lichen planus, a papulosquamous disease, in its classical presentation is characterized by pruritic violaceous papules most commonly on the extremities of middle-aged adults. It may or may not be accompanied by oral and genital mucous membrane involvement. Its course is generally self-limited for a period of several months to years, but it may last indefinitely. There are many clinical variants described, ranging from lichenoid drug eruptions to association with other diseases such as diabetes mellitus, autoimmune disease, and the graft versus-host reaction. The relationship of these, if any, to classical lichen planus is questionable. Multiple therapeutic options exist including corticosteroids, retinoids, griseofulvin, PUVA, and cyclosporine. PMID- 1791219 TI - Detection of undegraded fibrin and tumor necrosis factor-alpha in venous leg ulcers. AB - The pathogenesis of venous leg ulcers is based on the leakage of fibrinogen leading to pericapillary fibrin cuff and plugging of capillaries by white blood cells. Eight patients with venous leg ulcers have been studied with a panel of antibodies reactive for fibrinogen, fibrin, fibrin degradation products, and various cell-associated markers for polymorphonuclear cells, monocytes, and B and T lymphocytes. Our results showed that pericapillary fibrin cuff was mainly composed of undegraded fibrin and that, in the granulation tissue, tumor necrosis factor-alpha and elastase activities were detectable in monocytes and polymorphonuclear cells, respectively. Only few activated lymphocytes were present. On the basis of these results, it is assumed that inflammation generated by activated white blood cells that accumulate under unrelieved pressure is the key event. Tumor necrosis factor-alpha synthesized by activated monocytes may therefore induce the formation of pericapillary fibrin cuffs. Pericapillary fibrin cuffs and toxic metabolites released by polymorphonuclear cells may explain the absence of wound repair. PMID- 1791221 TI - Lichen striatus: a Blaschko linear acquired inflammatory skin eruption. AB - An illustrative case report and a series of 18 well-documented cases of lichen striatus are presented. The mean age at diagnosis was 3 years (6 months to 14 years; median 2 years). The lesions were predominantly distributed on the trunk in 33% of cases and on the limbs in the remaining two thirds (upper limb: 48%; lower limb: 19%). Pruritus was noted in only 1 of 18 cases. Six cases were associated with clinical features of atopy and/or minor signs of atopic dermatitis (e.g., pityriasis alba). Two cases were considered to be clinically associated with lesions consistent with psoriasis. The mean duration was 9.5 months (4 weeks to 3 years; median 6 months). In one patient, two relapses occurred in 4 years. Hypochromic sequelae were noted in 50% of cases. Lichen striatus is the most common acquired self-limited linear eruption in childhood that follows Blaschko's lines. A new acronym is proposed to emphasize the developmental background of the disease: BLAISE for Blaschko linear acquired inflammatory skin eruption. PMID- 1791220 TI - Laugier-Hunziker syndrome: a clinical, histopathologic, and ultrastructural study of four cases and review of the literature. AB - Four cases of Laugier-Hunziker syndrome are described. In all patients (two men and two women between 39 and 57 years of age) pigmentation of the lower lip and hard palate was found. in addition, two patients had involvement of the buccal mucosa; another patient also had pigmentation of the upper lip, the gums, the soft palate, and the fingers of both hands. Histopathologic examination demonstrated an accumulation of melanin in the basal layer keratinocytes and an increase in the number of melanophages in the papillary dermis. Ultrastructural study showed the presence of numerous mature melanosomes in the cytoplasm of the keratinocytes of the basal layer and of the melanophages in the papillary dermis. Alterations of the melanocytes were not observed. PMID- 1791222 TI - Purpura simplex (inflammatory purpura without vasculitis): a clinicopathologic study of 174 cases. AB - Purpura simplex manifests clinically as macular purpuric and petechial pigmented, golden, annular, or lichenoid lesions. These subtypes have been termed Schamberg's purpura, lichen aureus, Majocchi's purpura, and Gougerot-Blum purpura. Histologically, there is inflammation and hemorrhage without fibrinoid necrosis of vessels. One hundred seventy-four cases were retrospectively reviewed. In some patients, the eruption was related to medications. Treatment was usually of limited benefit. Fifty-eight of 87 patients (67%) who had follow up data did eventually have clearing of lesions. Because of the clinical and histologic similarities among the subtypes, the inclusive term purpura simplex is favored. PMID- 1791223 TI - Hypertriglyceridemia in patients with psoriasis treated with cyclosporine. AB - Eight patients received cyclosporine at doses of 2.0 to 7.5 mg/kg/day. Seven of these patients had increased fasting plasma triglyceride levels with cyclosporine therapy compared with pretreatment values, which peaked after 1 month of therapy. Four patients experienced elevations in fasting triglycerides, over the upper limits for age- and sex-matched controls, which were at least two times higher than their baseline values. It was striking that all four of these patients had previously had hypertriglyceridemia while using etretinate and three of these patients had preexisting hypertriglyceridemia before both etretinate and cyclosporine therapy. Triglyceride elevation did not correlate with cyclosporine levels. Thus cyclosporine, similar to etretinate, unmasks a latent tendency for mild to moderate hypertriglyceridemia. Fasting triglyceride levels should be monitored during cyclosporine therapy, especially after 1 to 2 months of use, and in patients with preexisting increased triglycerides and/or a history of etretinate use. PMID- 1791224 TI - Peptide T improves psoriasis when infused into lesions in nanogram amounts. AB - In each of 14 patients, two small but comparable psoriatic lesions were infused for 2 weeks with either saline or a saline solution of peptide T (as its analog D ala1-peptide T amide) at 10(-7) mol/L with Alzet osmotic pumps worn extracorporeally. During infusion, lesions were photographed and scored for clinical features of psoriasis on a 9-point scale. After another 7 days, biopsy specimens were taken from the infused sites, and sections were scored for features of psoriasis on a 19-point scale. The differences between means for data from saline- and peptide T-infused lesions were evaluated statistically. Peptide T-infused lesions improved clinically; scores decreased from a mean of 4.35 initially to 1.57 at biopsy, whereas control lesions changed from 4.43 to 3.57 (p less than 0.01 for 1.57 vs 3.57). Histologic scores were also significantly different (5.28 for peptide T vs 10.00 for controls, 0.05 greater than p greater than 0.02). This study provides evidence that intralesionally infused peptide T demonstrates some clearing effect in psoriasis. PMID- 1791225 TI - Weekly pulse dosing: effective and comfortable topical 5-fluorouracil treatment of multiple facial actinic keratoses. AB - Ten patients completed a weekly pulse dosing regimen for topical 5-fluorouracil therapy for multiple facial actinic keratoses. The method cleared an average of 98% of the lesions, without the severe irritation usually caused by the conventional, daily dosing regimen. Nine patients described the therapy as comfortable. Local irritation was limited to erythema. None of the patients suffered disruption in their social or business lives because of altered appearance. Patients had an average of 6.7 weeks of treatment and applied the medication 1 to 2 days per week; significant remissions were achieved. The longest available follow-up is with six patients who at 9 months remained 86% clear of lesions. This new method offers a significant advance in topical 5 fluorouracil therapy by reducing irritation to an acceptable level while maintaining efficacy. PMID- 1791226 TI - Basal cell, squamous cell, and sebaceous gland carcinomas of the periorbital region. AB - It is important that clinicians suspect malignancy in patients who have persistent or nonhealing periorbital lesions. Basal cell carcinoma, squamous cell carcinoma, and sebaceous gland carcinoma of the eyelids are frequently misdiagnosed clinically and, in the case of squamous cell and sebaceous gland carcinomas, histologically as well. Prompt and adequate biopsy can facilitate early diagnosis and thus avoid unnecessary metastatic spread in the case of squamous cell carcinoma and sebaceous gland carcinoma, as well as the extensive local destruction that basal cell carcinoma may produce. PMID- 1791227 TI - The tetracyclines in dermatology. AB - Tetracycline is one of the most widely used antibiotics. It may share some properties with conventional immunosuppressive drugs and act as an anti inflammatory agent in the treatment of inflammatory disease. This article reviews cutaneous diseases that have been treated with tetracyclines and their antiinflammatory and immunosuppressive properties. PMID- 1791228 TI - Cutaneous malignant melanoma. PMID- 1791229 TI - Extracorporeal photochemotherapy: a potentially useful treatment for scleromyxedema. PMID- 1791230 TI - Topical griseofulvin in tinea versicolor: a double-blind study. PMID- 1791231 TI - Lyme disease in Israel. PMID- 1791232 TI - Treatment of periungual warts. PMID- 1791233 TI - Sezary cell counts in treatment of the Sezary syndrome. PMID- 1791234 TI - Reproducibility of patch tests. PMID- 1791235 TI - Dermatology and the history of ideas. PMID- 1791236 TI - Dohi Memorial Lecture. The past, present and future of dermatology in the United States. PMID- 1791237 TI - Differential oxygen sensitivities in G6PDH activities of cultured keloid and normal skin dermis single cells. AB - Cell cultures of excised keloids and biopsied normal skin were established from patients of the Plastic Surgery Department of Singapore General Hospital and their single cells quantitated for glucose-6-phosphate dehydrogenase (G6PDH) activity using microspectrophometry. G6PDH has been cited as a transformation linked discriminant. Analysis of variance shows no difference in overall activity between skin and keloid cells, but under oxygen saturation conditions, keloid G6PDH activity was significantly higher than skin G6PDH activity, although they were almost identical under nitrogen saturation conditions. Differential oxygen sensitivity in G6PDH activities between malignant and non-malignant cells have been reported, but its occurrence between keloid and normal skin cells is novel, especially as the keloid is regarded as a benign tumor with a zero carcinogenicity rate. PMID- 1791238 TI - Immunohistochemical differential diagnosis between lymphocytoma cutis and malignant lymphoma in paraffin-embedded sections. AB - A panel of monoclonal antibodies (Leucocyte Common Antigen [CD45], LN-1 [CDw75], LN-2 [CD74], LN-3, L-26, UCHL-1 [CD45RO] and MT-1) which identify B and T cell surface markers were applied to benign lymphocytoma cutis and malignant lymphoma of the skin in paraffin-embedded sections. In five cases of lymphocytoma cutis, both B and T cell markers were positive, consistent with the polyclonality of the proliferative lymphocytes. In contrast, in two cases of B cell lymphoma, only the B cell markers were positive, consistent with the monoclonality. Furthermore, the immunohistochemistry clarified lymph follicle structures of lymphocytoma cutis. These were occasionally not evident in routine hematoxylin and eosin stained sections. Thus an immunologic phenotyping study combined with other appropriate criteria for histologic evaluation and clonal gene rearrangement analysis appears to be useful in distinguishing reactive from neoplastic lymphoid lesions of the skin. PMID- 1791239 TI - Clinical evaluation of cutaneous malignant melanoma with histologically involved lymph node metastases. AB - Thirty-six cases of cutaneous malignant melanoma with histologically involved lymph nodes were studied during a 2-10 year study period, and the characteristics of the metastasized nodes and the associated prognosis were compared. The results were as follows: 1) the survival rate in cases with 3 or fewer (n = 16) metastasized nodes was significantly higher than in cases with 4 or more positive nodes (n = 20); 2) the survival rate in cases in which metastasized nodes were limited to one regional lymph node section (n = 12) was significantly higher than in cases where metastasis extended to two or more intra-regional sections of nodes (n = 24); 3) cases which had nodes measuring 3.00 cm or less (n = 25) had significantly higher survival rates than those with nodes of 3.01 cm or more (n = 11). Therefore, the results indicate that the number of metastasized lymph nodes, the extension into regional lymph node sections, and the size of the metastasized lymph node(s) can be considered as important prognostic factors for melanoma patients. PMID- 1791240 TI - A case report of EMO syndrome showing localized hyperhidrosis in pretibial myxedema. AB - We describe here a case of EMO syndrome, which is defined as a combination of exophthalmos, pretibial or localized myxedema, and hypertrophic osteoarthropathy. A 34-year-old Japanese man with Graves' disease developed the characteristic eye changes. He showed 22 mm protrusion of both eyes and hypertrophy of the right lateral rectus muscle as well as both superior rectus muscles by computerized tomography. He subsequently developed lightly erythematous, indurated, nonpitting, peau d'orange plaques and nodules on his lower legs. Finally, he developed Graves' acropathy with hypertrophic osteoarthropathy in the metacarpal bones. Histological examination of myxedematous skin showed typical deposition of mucin accompanied by changes in the amount and distribution of elastic fibers. In addition, the lesional skin showed localized hyperhidrosis, a rarely reported complication of pretibial myxedema. We speculate that this hyperhidrosis of the lesional skin was brought about by stimulation of peripheral sympathetic nerves by surrounding mucin deposition, in the setting of poorly controlled hyperthyroidism. PMID- 1791241 TI - Transepidermal elimination of thrombi in three cases of thrombotic angiokeratoma: an incidental histopathologic finding of angiokeratoma. AB - Transepidermal elimination (TEE) is a well known phenomenon by which foreign or altered constituents are removed from the dermis. A thrombosis in the dilated dermal blood vessels of angiokeratoma is not unusual, hence the term thrombotic angiokeratoma. We recently reviewed the histopathologic findings of previously diagnosed cases of angiokeratoma and found that multiple histologic sections of surgical biopsy materials disclosed changes indicating TEE of thrombi in three cases. Special stains searching for an altered substance in those thrombi failed. In this report of three cases, we suggest that this phenomenon could be an incidental and long missed histopathologic finding of angiokeratoma which might explain the fate of these thrombi. PMID- 1791242 TI - A case of erythropoietic protoporphyria with severe liver dysfunction suggesting a close relationship between erythrocyte protoporphyrin levels and those of gamma GTP. AB - A case of erythropoietic protoporphyria (EPP) with severe acute abdominal pain and jaundice was reported. Erythrocyte protoporphyrin (PP) levels were constantly high, and liver histology showed a slight fibrosis with inflammatory infiltration. During the investigation period of 18 months, erythrocyte PP levels closely paralleled those of serum gamma-GTP. PMID- 1791243 TI - Trigeminal trophic syndrome--a report of three patients. AB - Three Japanese patients with trigeminal trophic syndrome, a rare dermatosis in Japan, were reported. Cutaneous lesions were a long-standing ulcer and destruction of the right ala nasi in case 1, a persistent deep ulceration on the forehead after a small trauma in case 2, and development of small, discrete ulcers on the right forehead during the treatment of a postherpetic neuralgia in case 3. A protective device was very effective in one patient. PMID- 1791244 TI - A case of cutaneous metastases of gastric carcinoma showing peculiar clinical features. AB - A 52-year-old male patient presented with multiple cutaneous nodules on the face, trunk, and upper extremities. Examination of a skin biopsy specimen disclosed numerous signet ring cells throughout the dermis. Histopathologic examination of the stomach, along with gastroscopy, revealed that the cutaneous metastases were of gastric origin. The metastatic skin lesion on the shoulder and the back of the patient grew relatively rapidly, showing an erysipelas-like lesion followed by prominently large tumor masses. The clinical appearance seen in our case is thought to be rare. Radiotherapy and chemotherapy appeared to be effective in reducing some tumors and the swelling on the anterior of the neck, and in prolonging life. PMID- 1791245 TI - Cutaneous T-cell lymphoma in Colorado 1974-1991. PMID- 1791246 TI - Pigmented macules on the palms and/or soles of Japanese subjects: influences of clinical severity and duration of illness. AB - We have suggested that pigmented macules on the palms and/or soles occur in response to various systemic diseases. In the present paper, we evaluated the influences of clinical severity and duration of illness in Japanese subjects. In males, cases who suffered from cerebral vascular accident (CVA) for long periods and/or severely tended to have numerous pigmented macules. In females, cases with CVA did not show any similar tendency. As the result of our prior and present studies, we conclude that underlying systemic disease itself can play a pivotal role in the development of pigmented macules on the palms and/or soles of Japanese subjects. We emphasize that such a pigmented macular eruption with characteristic clinical features is an important sign of internal disorders, including malignancy. PMID- 1791247 TI - Pigmented contact dermatitis due to musk moskene. AB - Musk moskene is a soft, sweet fragrance resembling musk ambrette which introduces a very desirable creamy powder note for cosmetic fragrance. Because of its advantages, which include low cost, oil solubility, and less sensitive to sunlight, musk moskene has recently increased its share of the market. In this paper, we reported a case with pigmented contact dermatitis from musk moskene in cheek rouges. Patch test positive reactions to cheek rouges resulted in hyperpigmentation. Both the perfume used in the cheek rouges and musk moskene, which was a component of that perfume, showed strongly positive reactions. Residual hyperpigmentation was seen on the regions of the perfume and musk moskene patch testings. Hyperpigmentation on cheeks of the patient gradually diminished after discontinuing use of the causative cheek rouge. PMID- 1791248 TI - Canadian nurses succeed again! The launch of Canada's first doctoral degree in nursing. PMID- 1791249 TI - Body-image disturbance: cognitive behavioural formulation and intervention. AB - An account of the genesis and maintenance of disturbed body image is presented, drawing on cognitive-behavioural concepts of human experience, and emphasizing the central importance of fear and avoidance in mediating such difficulties. Intervention strategies, extrapolated from work in dysmorphophobia and in anxiety disorders, are described, together with a clinical example. Difficulties with the cognitive-behavioural approach to disturbed body image are discussed, and possible applications of the formulation to client care are suggested. PMID- 1791250 TI - Demographical, sociomedical and physical characteristics in relation to malnutrition in geriatric patients. AB - The purpose of this study was to describe and compare demographical, sociomedical and physical characteristics between protein-energy malnourished and non malnourished geriatric patients on admission. According to the International Statistical Classification of Diseases, 104 malnourished patients were age-, gender- and diagnosis-matched with 104 non-malnourished patients. Data were collected from patients' medical records. The patient's condition was assessed by a modified Norton scale on admission. No differences were seen in marital status, type of dwelling, previous need for help service, residence before admission, and dependence on assistance with ADL function. The malnourished patients had a greater consumption of diuretics (47%; P less than 0.05) and a lower consumption of analgesics (29%; P less than 0.05) than the non-malnourished patients (33% and 42% respectively). In the malnourished group, impaired conditions in activity (83%; P less than 0.05), and general physical condition (78%; P less than 0.01) were observed compared to the non-malnourished group (69% and 60% respectively). The malnourished patients had less sufficient food intake (41% vs 21%; P less than 0.01) and fluid intake (25% vs 10%; P less than 0.01) than non-malnourished patients. This study indicates that demographical characteristics and primary ADL functions are of minor importance for the development of protein-energy malnutrition in geriatric patients. Observation of the patients' physical condition and drug consumption seemed more important on admission. PMID- 1791251 TI - An evaluation of a paediatric home care scheme. AB - The policy background of paediatric home care schemes is reviewed and an evaluation of such a scheme is described. The home care scheme is shown to be a worthwhile service provision. However, it is suggested that this service development can only represent an improved use of resources when there is a complementary reduction in hospital provision. PMID- 1791252 TI - Sleep medication in Dutch hospitals. AB - Insomnia is an important nursing problem in hospitals. Although sleep medication is often criticized, it is one of the commonest interventions with regard to sleep problems. In this study, the prescription and provision of sleep medication in three Dutch general hospitals is investigated. Results show that on a random day 47% of all patients (n = 1076) of the surgical and medical wards were prescribed medication. Thirty-four per cent actually received sleep medication that evening or night. The prescription and provision of sleep medication was higher on medical than on surgical wards. Furthermore, hospitals were shown to differ regarding the prescription and provision of as-needed sleep medication. The study also explores whether attitudes of nurses are related to the provision of as-needed sleep medication. Although their influence does not seem to be great, it is concluded that more attention has to be paid to possible effective nursing interventions in educational programmes. PMID- 1791253 TI - An evaluation of the Ulster Cancer Foundation's Nurses and Smoking Package and its impact on student nurses. AB - The Ulster Cancer Foundation's teaching package Nurses and Smoking was evaluated by testing nurses' knowledge and skills in the area of smoking-related health education. As smoking is still a major cause of mortality and morbidity, does the nurses' training equip them with an adequate knowledge of its consequences? Questionnaire data, together with material from in-depth interviews, were analysed and pre- and post-package results produced significant differences (P less than 0.001) between the experimental and control groups, suggesting that a teaching package significantly improves a nurse's knowledge and expertise with regard to smoking and its effect on both patients and their environment. PMID- 1791254 TI - Home pass assessment in neurorehabilitation practice. AB - The patient undergoing in-patient neurorehabilitation is often encouraged to go home with a family member or other carer for a short period when fit to do so. This home pass is helpful to both the family and the rehabilitation nursing staff in gauging how well the patient will function when discharged, but valuable feedback information can be lost. This study describes the experience of using a home pass assessment form to document the patients' performance and discusses the nursing staff and relative's perceptions of the usefulness of this instrument and the possible reasons for discrepancies between the nurses' assessment of the patient's abilities and the carers' reports. PMID- 1791255 TI - The recognition and non-recognition of problem-solving stages in nursing practice. AB - A requirement for high-quality individualized nursing care is that nurses must recognize and attempt to solve patients' health problems. In this study, it was decided to investigate problem solving using a model similar to the nursing process derived from the general literature. Insight into nurses' perceptions and understanding of problem solving was gained by interviewing 116 nurses using vignettes of clinical problem solving. Data analysis revealed that many informants failed to discuss some problem-solving stages, in particular planning and evaluation. Conversely, problem assessment and implementation attracted more comment. The implications for these variations in nurses' problem-solving behaviour are examined in relation to contemporary nursing issues. PMID- 1791256 TI - The concept of hope revisited for nursing. AB - The development of nursing knowledge and interventions involve understanding human responses and needs. The human response of hope was identified as a concept in need of further clarification. The purpose of this paper was to review definitions and contextual usage of the word 'hope' from the literature and answer the conceptual question 'What is hope?' Literature from theology, philosophy, psychology and nursing was reviewed for contextual usage of the word 'hope'. In the literature, hope was viewed as part of human development, a process, a theory and a source of meaning in life. In addition, antecedents, attributes and outcomes of hope were identified from the literature that contributed to a clearer understanding of the concept. PMID- 1791257 TI - Sociological issues in the conceptualization of mental illness. AB - This paper explores the conceptual knowledge base underpinning 'mental illness type behaviour' and offers a sociological and philosophical perspective. The role of values in concepts of health and illness is presented as widespread not only within psychiatry, but also in regard to general/physical health. The controversial nature of the psychiatric enterprise is believed to be due to the lack of consensus regarding notions of mental health and mental illness. Psychiatry is presented as a form of social control, akin to the legal system, dictated by moral norms. These are presented as value-loaded and maintained in accordance with the dictates of particular interest groups. Social control concepts are explored and Freud's psychodynamic model is presented as a legitimate model that incorporates a meaningful concept of 'illness'. No theory, though, is presented as value-free. Psychiatry is thus presented as being socially and politically constructed. The implication for health care professionals is presented as that of trying to liberate professional work from the narrow responsibility of the 'individual', whilst also trying to create a more democratic enterprise. PMID- 1791258 TI - Nurse socialization: issues and problems. AB - A comparative study was conducted of the professional socialization process of student nurses in three nurse education centres in South Wales. Patterns and problem areas can be identified of relevance to issues in role theory and with practical implications for the more effective implementation of Project 2000. Three cohorts of students were interviewed using a semi-structured interview schedule whilst in the introductory block and at the end of the first year. The teaching and ward staff directly involved in the socialization process were also interviewed so that their views could be compared with those of the students. There were differences between the types of ward in the opportunities they offered for role modelling. It was doubtful whether the three categories of students, teaching staff and ward staff were all employing a single conception of 'the good nurse'. The student has to find her own pathway through the divergent and often conflicting values and philosophies of the teaching staff and those in authority on the wards. It is recommended that a more unified approach be adopted to reduce the conflict which learners experience. In accordance with Project 2000, the teaching staff should act as practitioners and thereby be perceived as a professional role model with clinical credibility. PMID- 1791259 TI - The idea of revolution in the development of nursing theory. AB - This paper examines Thomas Kuhn's notion that theory develops by means of revolution and its pervasion within nursing theory. Initially, the traditional, cumulative model of theory development is examined and then Kuhn's idea is explored. The extent of its pervasion in nursing theory is outlined. Finally, the value of Kuhn's model of theory development in nursing is evaluated. It is argued that while Kuhn's model has set nursing theory free from logical empiricism, it needs to be understood in conjunction with the traditional cumulative model. PMID- 1791260 TI - Why do we need sleep? Relating theory to nursing practice. AB - By reviewing the literature, this paper explores the nature and function of sleep. Most of the evidence for the functional theories of sleep has been obtained as a result of examining the effects of sleep deprivation, the physiological, emotional and behavioural effects of which are discussed. There is a discussion on how an awareness of the theoretical knowledge may help in the nursing care of patients with advanced cancer and other chronic diseases, as well as their carers. The physiological effects of stress, and the possible relationship to patients and their carers, leads the author to highlight the need for further research, and possible benefit of proactive intervention for the bereaved. The effects of poor nutrition and common symptoms such as pain and dyspnoea on sleep, and the iatrogenic causes of sleep disturbances, are discussed. The importance of individualized patient care is stressed. The conclusion is drawn that although researchers do not seem to have been able to prove conclusively any essential function of sleep, the nurse is in a unique position to facilitate and enable patients and their carers to cope during the waking hours, without the added stress that sleep disruption and deprivation bring. PMID- 1791261 TI - Childhood experiences of loss and suicide attempts: significance in depressive states of major depressed and dysthymic or adjustment disordered patients. AB - Three hundred and twenty-eight patients aged 45 years and over with major depression, dysthymic disorder or adjustment disorder with depressed mood (according to DSM-III) were asked about childhood loss experiences (death of one or both parents or at least 1 year's separation) and their current state of health. No statistically significant relationships were found between experiences of loss in childhood and type of depression, sex and age at first episode. However, there was an increased incidence of suicide attempts in patients with experiences of loss in childhood, both by separation and by death of parents. The increased suicidal tendency could mainly be attributed to loss of the father. PMID- 1791262 TI - Contrasts between symptoms of summer depression and winter depression. AB - Epidemiological studies and studies of clinical populations suggest that there are primarily two opposite patterns of seasonally recurring depressions: summer depression and winter depression. In addition, there is preliminary evidence that the two seasonal types of depression may have opposite types of vegetative symptoms. In the present study, we prospectively monitored symptoms of depression in 30 patients with recurrent summer depression and 30 sex-matched patients with recurrent winter depression and compared the symptom profiles of the two groups. Consistent with predictions based on the earlier reports, we found that winter depressives were more likely to have atypical vegetative symptoms, with increased appetite, carbohydrate craving, weight gain and hypersomnia, and that summer depressives were more likely to have endogenous vegetative symptoms, with decreased appetite and insomnia. A cluster analysis performed on the patients' symptom profiles without reference to season of occurrence of their episodes separated 78% of the summer depressives and winter depressives from each other on the basis of their symptoms (chi 2 = 19.29, P less than 0.001). PMID- 1791263 TI - Atypical depressive symptoms possibly predict responsiveness to phototherapy in seasonal affective disorder. AB - Phototherapy was administered to 24 depressed patients with seasonal affective disorder (SAD), of which 62%, 24%, and 14%, respectively, showed improvements of greater than or equal to 50%, 25-50%, and less than 25% based on the Hamilton rating scale for depression for SAD (HAMSAD). No patients showed aggravation or side effects. Although the improvement rate in HAMSAD correlated significantly with the pretreatment severity of atypical symptoms of depression, it did not correlate with that of typical symptoms. This suggests that phototherapy is a useful treatment in SAD and that responsiveness to phototherapy in SAD can possibly be predicted by the atypical depressive symptoms before treatment. PMID- 1791264 TI - Effects of ECT course on TSH and prolactin responses to TRH in depressed patients. AB - The thyrotropin (TSH) and prolactin (PRL) responses to TRH were studied in 15 female depressed patients with melancholia (nine unipolar, six bipolar) during an electroconvulsive therapeutic course. The test was performed before initiation of treatment, 5 days after the final ECT session, and 1 month later, when the patients were on medication with heterocyclic antidepressants (HCAs). The maximal hormonal responses were not altered 5 days after the final ECT but both increased significantly 1 month later. Responders (n = 8) and non-responders (n = 7) to ECT did not differ significantly as regards changes in delta max TSH and PRL. The seven non-responders to ECT improved markedly after 1 month's treatment with HCAs. Three out of four patients with blunted TSH response (less than 5 mu IU/ml) continued to exhibit a blunted response in both post-ECT TRH tests. The rank order of magnitude of delta max TSH remained remarkably stable throughout the assessment period as shown by the highly significant correlations between the values in the three time points. PMID- 1791265 TI - Mood variability in adolescents: a study of depressed, nondepressed and comorbid patients. AB - In a study to examine the variability of mood in psychiatrically disturbed adolescents, 30 inpatients aged 13-17 reported on current depressive symptoms three times a day for seven consecutive days, using a set of visual analog scales (the Adolescent Mood Scale: AMS) to record DSM-IIIR and other depressive symptoms. Ten of the patients had no depressive diagnosis; 11 had both a depressive and an 'externalizing' diagnosis (mainly conduct disorders and substance abuse disorders), and nine had depressive diagnoses but no externalizing disorder. Variability was defined in terms of (1) range of AMS scores; (2) amount of change from one test point to the next; (3) rhythmicity, measured by the autocorrelation function across 21 test points. All three groups had high levels of depressive symptoms throughout the week. On all measures of severity of depression, the depressed girls were more depressed than the depressed boys, irrespective of comorbidity. Measures of variability, however, showed no effect of sex, but comorbid patients were more likely to have a wide range of mood scores, and reported a 45% greater amount of mood change. Only five subjects had a significant lag1 autocorrelation function, and there was no indication of diurnal rhythmicity. Implications for research and diagnosis are discussed. PMID- 1791266 TI - Prediction of efficacy of antidepressant by 1-week test therapy in depression. AB - Forty patients suffering from depression were treated with fixed doses of clomipramine for 4 weeks. The most effective predictor of efficacy during the 4 weeks was the percentage improvement in the Hamilton rating scale for depression during the first week. Baseline severity did not show any predictive ability. The Beck depression rating scale had only low predictive ability, and the dexamethasone suppression test did not predict the outcome at all. These results suggest the benefit of 1-week test therapy for predicting the efficacy of antidepressants. PMID- 1791267 TI - PDQ-R personality disorders in bipolar patients. AB - The prevalence of personality traits and disorders in bipolar patients as reported in the literature varies widely. The Personality Diagnostic Questionnaire-Revised (PDQ-R) is a self-report instrument for DSM-IIIR personality disorders found to have validity, but with high sensitivity and moderate specificity. This study was designed to assess personality disorders in bipolar patients using the PDQ-R. Fifty bipolar patients in a long-term lithium treatment program completed the PDQ-R. Over one half the patients (58%) scored for one or more personality disorders. A total of 71 diagnoses was made among the 50 patients, or a mean of 1.42 per patient. The majority of the axis II diagnoses were from cluster B, with borderline the most prevalent, followed by histrionic. The PDQ-R has high sensitivity but moderate specificity and may overdiagnose personality disorders in bipolar patients. The PDQ-R may register subclinical aspects of affective disorder as personality. PMID- 1791268 TI - Does learned resourcefulness predict response to cognitive therapy in depressed outpatients? AB - Thirty-seven unipolar, nonpsychotic, outpatients with major depression were treated with cognitive therapy in an ongoing study designed to identify which depressions respond to cognitive therapy. Pretreatment levels of learned resourcefulness, assessed by Rosenbaum's (1980) Self Control Schedule (SCS), were used to predict response to cognitive therapy (according to the 17-item Hamilton Rating Scale for Depression and the 21-item Beck Depression Inventory). Pretreatment SCS scores did not predict response to cognitive therapy according to either measure. PMID- 1791269 TI - Effects of phototherapy on non-seasonal unipolar and bipolar depressive spectrum disorders. AB - In a group of 17 patients with non-SAD depressive disorders we compared the response of bipolar spectrum versus unipolar patients to treatment with light therapy. The main hypothesis was that bipolar spectrum depressed patients would preferentially respond to bright light therapy as compared to unipolar depressed patients. All patients were treated with either 400 or 2500 lux phototherapy for 2 h on seven consecutive days. All outcome measures, which included the SIGH-SAD, CGI, and the Anxiety and Depressive Factors of the SCL-90, showed significant improvement in the bipolar vs. the unipolar spectrum patients. Unexpected this occurred regardless of the intensity of the light. These changes were judged to be quite clinically significant. All patients showing response were noted to have maintained their response at a 3-month follow-up. PMID- 1791270 TI - The effects of marital disharmony on prepubertal children. AB - The study investigated the association between marital disharmony and childhood behavior problems in a sample of families drawn from a general population. Eighty three families where the marital relationship had previously been rated as disharmonious were matched with an equivalent number of families where the marriage was rated harmonious. Mothers, fathers, and children were interviewed, using a semistructured interview format. Children living in disharmonious homes had significantly more problems than children from harmonious homes, and control for confounding variables, such as the mothers' mental health, did not alter this relationship. The main effects found were in antisocial symptomatology. Gender differences and differences according to the accounts of different respondents were found. One possible interpretation is that mothers perceived their sons as more affected by marital disharmony, while evidence from children suggested that boys and girls were equally affected. PMID- 1791271 TI - Children's attributions for peers' positive behaviors: social status differences. AB - The purpose of this study was to investigate differences between aggressive rejected and nonaggressive-cooperative boys in their attributions for peers' positive behaviors. In individual interviews, 27 aggressive-rejected and 27 nonaggressive-accepted boys were presented with 10 vignettes and a real-life situation in which a peer's action resulted in a favorable outcome for another peer or for the subject. Subject's attributions for the peer's behavior were elicited with open-ended probes. Analysis of variance indicated that the groups did not differ in their tendency to infer positive intentions in the hypothetical story condition. In the real-life situation, aggressive-rejected boys were less likely to infer positive intentionality than were the nonaggressive-accepted boys. Boys' responses across the two conditions (hypothetical and real life) were moderately consistent. PMID- 1791272 TI - Somatic complaints in anxious children. AB - Although stomachaches and headaches are considered characteristic of children with anxiety disorders, there is converging evidence that a broader range of somatic symptoms may be associated with children's expressions of anxiety. The purpose of this study was to determine the prevalence of somatic complaints in anxious children. The results indicated that children with anxiety disorders endorsed the presence of many different somatic complaints, and that contrary to clinical intuition, stomaches and headaches were not among the most commonly reported symptoms. In addition, the anxious children endorsed significantly more somatic complaints when compared to normal controls. Furthermore, the symptom pattern reported by anxious children indicated the presence of both the somatic and cognitive components usually associated with panic attacks, although none of the children met diagnostic criteria for panic disorder. The results are discussed in terms of the contribution of somatic symptoms to the understanding of anxiety disorders in children. PMID- 1791273 TI - Study strategies and story recall in attention deficit disorder and reading disability. AB - The role of metacognition and executive processes in mediating use of study skills was examined in groups of attention deficit disorder with hyperactivity (ADD-H), normal, and non-ADD-H reading-disabled (RD) boys, matched on age and verbal IQ. On a story recall task, ADD-H boys did not differ from normals in their immediate gist recall of a story or in their recall following a study period. RD boys demonstrated inferior recall in both conditions. Study skills of the ADD-H boys were poorer than those of normal boys on all measures. They spent less time studying, expended less effort, and employed more superficial strategies. However, their poor strategies did not appear to reflect a lack of metacognitive awareness. Results are discussed in terms of the impact of motivational variables in modulating strategy use in ADD-H boys and the impact of verbal processing problems in reading disabilities. Implications for treatment and the relationship between ADD-H and RD are discussed. PMID- 1791274 TI - Maternal depression: effects on social cognition and behavior in parent-child interactions. AB - The social interactions of depressed and nondepressed mothers and their preschool age children were observed and mothers' perceptions of child behavior assessed. Depressed mothers, as a group, exhibited more negative behavior than controls; however, no differences were found for maternal positive behavior or contingent responding. There was a high degree of reciprocity between child and mother behavior in both groups and there was a trend for children of the depressed mothers to be more negative than the control children. The results with cognitive measures were consistent with depressive realism in perception of social interactions: Depressed mothers recalled more negative child behavior than nondepressed mothers; however, these perceptions paralleled the observed interactions. Overall, the results suggest that maternal depression is associated with negative parent-child interactions and more negative, albeit fairly accurate, perceptions of child behavior. PMID- 1791275 TI - [Extracapsular cataract extraction and implantation in the capsular sac during vitrectomy in diabetics]. AB - Removal of the lens is often performed during pars plana vitrectomy for complications of proliferative diabetic retinopathy, but correction of aphakia often remains unsatisfactory. Some authors have reported posterior chamber intraocular lens implantation during pars plana vitrectomy in diabetic patients who presented with coexisting cataract and vitreoretinal complications from proliferative diabetic retinopathy. Some patients were operated by pars plana lensectomy and vitrectomy followed by posterior chamber intraocular lens implantation in the ciliary sulcus, others by extracapsular extraction, posterior chamber intraocular lens implantation in the ciliary sulcus, and pars plana vitrectomy. Other authors have described phacoemulsification through the limbus, pars plana vitrectomy and implantation in the capsular bag in one operation in various indications, including complications of proliferative diabetic retinopathy. We inserted a posterior chamber intraocular lens into the capsular bag in 18 eyes of 16 patients with complications of proliferative diabetic retinopathy after extracapsular cataract extraction and pars plana vitrectomy in a single session. A standard extracapsular cataract extraction was performed before pars plana vitrectomy. Sufficient anterior capsule was left in place in order to facilitate implantation in the capsular bag after pars plana vitrectomy. The anterior chamber was filled with sodium hyaluronate in order to maintain anterior chamber depth, corneal clarity, and good mydriasis during the continuation of the procedure. A standard three port pars plana vitrectomy was performed in all cases. After closure of superior sclerotomies, superior corneal incision was partially reopened, an intraocular lens specifically designed for the capsular bag with an optic size of 7 mm was inserted, and the corneal incision was closed with interrupted 10/0 sutures.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791276 TI - [Papillary hyperfluorescence caused by traction of the vitreous body]. AB - We present 4 clinical cases showing late dye leakage on the optic disc related to vitreous traction. Optic disc dye leakage disappeared following posterior vitreous detachment in one patient, delamination of the posterior hyaloid in two patients and segmentation of the posterior vitreous surface in one patient. Vitreous traction should be added to the previously described causes of optic disc dye leakage. PMID- 1791277 TI - [Preventive chemo-antibiotic treatment of postoperative endophthalmitis in planned open eyeball surgery. Apropos of 2,337 cases]. AB - A protocol combining chemoprophylaxis and antibioprophylaxis has been used since January 1st, 1990 for all patients (2,337 cases) undergoing planned open eyeball surgery (except emergencies). The chemoprophylaxis is local, by eyedrops (picloxidin) during the days before surgery, and by eyewash of the conjunctival cul-de-sac with iodized polyvidone immediately before surgery. The systemic antibioprophylaxis associates two bactericidal antibiotics with a wide spectrum and good intraocular penetration, active on 89 to 90% of the bacteria incriminated in postoperative endophthalmitis: a ureidopenicillin, piperacillin, and a fluoroquinolone, ciprofloxacin; the adverse effects are minimal. Although the sample size does not allow statistical, analysis the results of this study (the absence of any endophthalmitis) are very encouraging in comparison with those of the literature, those of the same department during the years before the protocol, and those of the other departments in the same hospital which carry out the same surgery under the same conditions. PMID- 1791278 TI - [Fresh corneal lenticule in the treatment of keratoconus. Histological study of a case]. AB - The aim of this study was to examine the histology of a freshly removed kerato lens lenticule (for keratoconus). The lenticule was obtained one year after refractive keratoplasty. It was removed by penetrating keratoplasty. The histological and transmission electron microscopic studies were performed. PMID- 1791279 TI - [Direct detection of toxoplasma in the aqueous humor by gene amplification]. AB - For immunocompetent patients, ocular toxoplasmosis is the most frequent infectious cause of chorioretinal inflammation. Nowadays, the laboratory diagnosis of ocular toxoplasmosis requires serological tests and anterior chamber puncture to detect the local production of specific antibodies. The authors describe a new technique to detect toxoplasma in aqueous humor by a polymerase chain reaction in which the target is a 88 bp specific rDNA fragment. 31 patients were concerned (23 highly suspect of ocular toxoplasmosis and 8 controls). The presence of the parasite in aqueous humor was found in 7 cases. No false positive was detected. The sensitivity of the test is reduced by the poor volume of the sample. The combination of this technique with Desmont's coefficient gives a better positive predictive value. We emphasize the pathophysiological value of this technique by suggesting the presence of tachizoites in the anterior chamber. According to our knowledge, this finding has never been demonstrated. In the future, this should be a very promising technique for the diagnosis of ocular toxoplasmosis. PMID- 1791280 TI - [Retinal toxicity caused by intravitreous injection of an aminoglycoside. Apropos of a case]. AB - The authors present a case of severe retinal ischemia associated with Dibekacin intraocular injection. This aminoglycoside was used, at an inadvertent dose, for the treatment of a postoperative endophthalmitis. The prominent finding at ocular ophthalmoscopy was oedematous retina with hemorrhages in the macular area. Fluorescein angiography revealed severe retinal vascular non perfusion. The eye subsequently developed neovascular glaucoma. Precautions are necessary to prevent such a catastrophic event; the injectable solution must be prepared on the surgical field, the injection should be performed slowly in the anterior vitreous without exceeding 0.2 mg when Gentamicin is used. PMID- 1791281 TI - [Extension of lesion in congenital hypertrophy of retinal pigment epithelium]. PMID- 1791282 TI - [Argon laser trabeculoplasty]. AB - There is currently a general consensus to perform argon laser trabeculoplasty (ALT) onto the 360 degrees of the trabecular ring to obtain the best long term results; but in two sessions a month apart with, during each session, 50 burns of a true 50 mu laser spot on 180 degrees, a 0.1 sec exposure time and a power high enough to create a tiny but visible trabecular reaction on the anterior edge of the posterior trabecular meshwork. During the first three hours after treatment, the main complication is raised intraocular pressure (IOP) which occurs in between 14% and 33% of the cases with a 10 mmHg rise above the initial IOP. In end stage glaucomas, a very close monitoring is mandatory during these first hours. Pretreatment with apraclonidine drops can dramatically reduce this complication. Our results and those of the literature with the same follow-up show that ALT seems effective in phakic chronic open-angle glaucomas (COAG) in half of the cases for about five years with a 10% new failure rate per year. The youngest patients, the aphakic patients and all the cases with trabecular severe disorganisation display the worst results. ALT must be considered to be a physical treatment - initially powerful but with decreasing efficacy in the long term. It should be used in presurgical glaucomas when IOP does not exceed 30 mmHg with intensive medical treatment and in intermediate stages of the disease where it is more effective. PMID- 1791283 TI - [Value of the Teller's cards in the evaluation of visual acuity in young children]. PMID- 1791284 TI - [Maternal mortality in France. Frequency and reasons for its under-estimation in the statistics of medical cause of death. Group of Experts on Maternal Mortality]. AB - All deaths of women of reproductive age notified in France over four months were the subject of an enquiry carried out through the post to the doctors who had written the certificates of death. The objective was to try to evaluate the true maternal mortality on a national scale. This enquiry was carried out on 4,102 female deaths and showed that 68 of these (1.6%) were in pregnant or puerperal women. 45 of these deaths were classified as maternal which was twice the number that showed up on the official statistics of the causes of death. On one hand the under notification--due to failure to realise that the patient was pregnant at the time of certification, and on the other hand the under registration because of the complexity of the pathological states explain this under estimation. The frequency of maternal mortality has been evaluated at 18 per 100,000 live births and 60% of these deaths are considered as due to a direct obstetric cause. The most frequent causes are embolisms, then haemorrhages and hypertension of pregnancy. PMID- 1791285 TI - [System of decision support in obstetrics. The computerization of prenatal consultations]. AB - The aim of this study was to realize a prototype of a computer-aided decision support for prenatal visits. He has been developped on a microcomputer. We used procedural programming to represent the medical knowledge. This prototype has several interfaced units: a computerized prenatal record, the computing of quantitative variables (term, fetal biometry, uterine height) and the two computer-aided units (preterm births and modelization of weight gain during pregnancy). The next step will be the medical evaluation of this computer-aided decision support in obstetrics. PMID- 1791286 TI - [Ovulation disturbances in athletes and their mechanisms]. AB - Delayed menarche, amenorrhea or at least luteal insufficiency are frequent in athletic women, when in intense athletic training. The origin of these disturbances seems to be plurifactorial. The main responsible parameters seem to be: the physical and psychological stresses; nutritional factors often associated with reduced food intake (specially reduced protein and increased vegetable fibers intake), and in some cases with loss of body fat; and affective problems responsible for eating disorders. The paper describes the acute effects of training upon hormones, and the hormonal profile of athletes when in intense training. The reduced or suppressed LH pulsatile secretion determines the ovulatory disturbances. Among the responsible factors, the rise of opioids, as beta-endorphin, and the corticotropin hyperactivity, which probably play an important role, even if other mechanisms will be demonstrated later. PMID- 1791287 TI - [Curietherapy-surgery for epidermoid carcinomas of the uterine cervix T1]. AB - Between 1975 and 1985, we have treated 157 patients with carcinoma of the cervix T1. The size of the tumor was always equal or less than 30 mm. Our patient underwent Cesium 137 brachytherapy with Fletchers applicators followed by a modified radical hysterectomy and pelvic lymphadenectomy 4 to 6 weeks later. Intracavitary brachytherapy was performed within three days (low dose rate 0.8-1 Gy/h). The median 60 Gy Isodose was: 65 mm height, 58 mm width and 29 mm thickness. At surgical time we mentioned that vaginal cut out was 2-3 cm and pelvic lymphadenectomy limited to external iliac nodes. The 5 and 10 disease Free Survival was respectively 91.6 and 89.4%. We observed 14 relapses, five were distant metastases only. The tumor size and pelvic node involvement were the main prognostic factors in our data. The sterilization of the cervix wasn't of prognostic value. Complications occurred in 22 patients, 2 (1.3%) were severe urinary injury. PMID- 1791288 TI - [Absence of peritonization after pelvic cancer surgery. Results in 157 cases]. AB - Pelvic lymphadenectomy for genital cancer can lead to complications: particularly lymphoceles, post-operative fever, thromboembolism and lymphoedema. We compared two groups in a series of 157 patients treated by extended lymphadeno-colpo hysterectomy for cancer of the uterine cervix, of the endometrium, of the ovary, of the vagina: Group I: 108/157 patients: visceral peritonization: lymphoceles: 23.1%, post-operative fever: 35.2%. Group II: 49/157 patients: visceral non peritonization, lymphoceles: 6.1%, post-operative fever: 16.3%. PMID- 1791289 TI - [Prenatal echographic study of esophageal duplication. A case report]. AB - We report a case of abdomino-thoracic oesophageal duplication revealed by prenatal ultrasonography as a liquid mass in the posterior mediastinum, responsible for a major chylothorax. Tow our knowledge, this is the first thoroughly documented case occurring in the prenatal period. The various possible ultrasonographic diagnoses and the possibility of therapeutic drainage of pleural effusions are discussed in the light of anatomy, embryogenesis and ultrasonographic images of the lesion. PMID- 1791290 TI - [Q fever and fetal death in utero. Two cases]. AB - Some cases of late abortion occurring after a Coxiella burneti infection, more often with a chronic evolution, have already been mentioned in the literature. We reported here two cases of early abortion, contemporaneous of an acute infection due to C. burneti. Two patients, after a contact, before and at the beginning of the pregnancy, with an animal susceptible to contaminate human beings by C. burneti, presented no clinical symptom characteristic of Q fever. The fetal death for the two cases was found out at the 17th week of amenorrhoea. All the investigations in order to search for an abortion etiology remained negative. Only, the specific serologies showed an acute infection due to C. burneti. PMID- 1791291 TI - [Limb-girdle dystrophy and pregnancy: a case report]. AB - A case of pregnancy with Limb-girdle dystrophy is presented. The course of pregnancy remained uncomplicated, the patient has been delivered at 42 week's gestation by cesarean section, performed for dystocia and fetal distress. Histological and immunohistochemical examinations of the myometrium were unable to show its involvement in the muscular disease. The influence of the muscular disease and the route of delivery for such patients are discussed. PMID- 1791292 TI - [Late postpartum eclampsia, myth or reality?]. AB - It has never been formally established whether eclampsia can come on more than 48 hours after delivery. We report a case of a patient who had convulsions together with transitory raised blood pressure coming on 14 days after her delivery. MRI was carried out 24 hours after the attack and showed pathological sub-cortical images and there was a hyper signal at T2. This is now a well known feature and has been described in the course of typical eclampsia fits. On the other hand MRI is able to eliminate a certain number of differential diagnoses such as cerebral thrombophlebitis, cerebral vascular accidents and tumours. A cerebral blood flow study and a trans-cranial Doppler flow study showed (as far as we know for the first time) a lessening in perfusion and in speed of flow giving rise to lowered blood circulation in that part of the brain and suggestive of vascular spasm. This observation makes it very likely that eclamptic crises can occur two weeks after delivery and favours a vascular spasm being the origin of these crises. PMID- 1791293 TI - [Use of mifepristone (RU 486) in pregnancy (excluding abortion on demand). The first clinical trials]. AB - The use of RH 486 in terminating missed abortions, in inducing labour for therapeutic abortions and in cases of fetal death in utero. Mifepristone (RU 486) is an anti-progesterone steroid and it is known to be effective in terminating early pregnancies. The authors report 34 cases of evacuation of the uterus after pregnancy has ceased to progress (because of an empty sac or the loss of fetal heart beat) using Mifepristone, after prostaglandins had been inserted. In eleven out of 18 cases Mifepristone by itself was adequate to empty the uterus with the preliminary administration of prostaglandin analogues. In 5 cases the uterus had to be curetted. In 3 cases this was not necessary. Mifepristone given 48-72 hours before prostaglandin is first administered in order to procure a termination of pregnancy makes it possible to empty the uterus within 6 to 15 hours after first giving the prostaglandins. It lessens the dose of prostaglandins needed and shortens the labour. There was no haemorrhage or obstetric complication in our cases. We cannot make any conclusion about fetal death in utero because our series is too small, but it does seem to confirm the works of Cabroll et al. PMID- 1791294 TI - [The effect of sunshine on the vitamin status of pregnant women in France]. PMID- 1791295 TI - Ultrastructure of axons in stereotaxically placed ibotenic acid-induced lesions of the hippocampus in the adult rat. Evidence for demyelination and degeneration of dispersed axons of passage. AB - The fate of axons in lesions following stereotaxic injections of ibotenic acid into the rat hippocampus was studied on the ultrastructural level. Myelinated and unmyelinated axons were examined in the, presumably, axon sparing lesions induced by circumscribed in vivo injections of ibotenic acid. In lesions placed in the dentate gyrus or parts of the Ammon's horn a considerable amount of dispersed myelinated axons of passage were affected, showing a characteristic pattern of demyelination and suggesting the involvement of oligodendroglia processes. However, the structural integrity of unmyelinated axons of passage, studied with the example of the mossy fiber system, was completely unaffected after exposure to ibotenic acid. Thus, at least in the hippocampus, in situ injections of ibotenic acid cannot be looked upon as being completely axon sparing as frequently proposed. PMID- 1791296 TI - [Neuronal structure abnormality in the orbito-frontal cortex of schizophrenics]. AB - Changes were described in the neuronal structure of neurones, impregnated after the method of Golgi-Bubenaite in schizophrenic patients. Investigations were done in area 11 (Brodmann 1909) of patients with paranoid-hallucinatory schizophrenia. Control cases were patients without any clinical or morphological brain diseases and patients with catatonic schizophrenia. 1.1 We investigated numerous typical triangle cells in lamina VI of patients with paranoid-hallucinatory schizophrenia. Only few were seen in the controls. 1.2 In the paranoid hallucinatory schizophrenia brains there are lamina VI pyramidal cells with ramified apical dendrites reaching lamina II. 2. In lamina V there are many pyramidal cells with two to five apical dendrites, such cells were never seen in controls, these pyramids have only one main apical dendrite. 3. A small group of L III pyramids have atypical long spines. A lot of these spines have splitted spine heads. The spine number is significantly increased. 4. There is an atypical simplified angioarchitecture in paranoid hallucinatory schizophrenia-patients and no normal arborization of the brain vessels in three planes, like in controls. We think that the abnormal findings in paranoid-hallucinatory schizophrenia are not the consequence of specific therapeutics. We interpret our findings as possible variabilities of a normal brain structure. PMID- 1791297 TI - Some considerations on the fine structure of rhabdomeric photoreceptors in the amphioxus, Branchiostoma lanceolatum (Cephalochordata). AB - This study confirms the close relationship of two of the photoreceptive cells of the amphioxus central nervous system, the Hesse and Joseph cells. Both cells have rhbdoms located at the cell surface and possess 9 + 0 cilia that are not related to the rhabdom structure. The rhabdom of Joseph cells is enclosed by thin glial lamellae containing gliofilaments, whereas that of Hesse cells is associated with a pigmentary cell, the two cell types forming an eyecup. The pigment cell is mostly filled of pigment granules and has a 9 + 2 cilium. A third photoreceptive cell of the lancelet, the lamellate cell, is of ciliary type. The significance of the presence of rhabdomeric and ciliary photoreceptors in the lancelet brain is discussed. PMID- 1791298 TI - The effects of prostacyclin on early ultrastructural changes in the cytoplasm and nuclei of neuroglial cells following complete cerebral ischemia. AB - Twelve rabbits were submitted to 20-min global cerebral ischemia. Half of them were treated continuously with prostacyclin (PGI2) for 3 min before and during ischemia, and for 15 min after it. Untreated animals were not given PGI2 medication. The cases treated with PGI2 were found to have recovered bioelectric activity of the brain in half the time that its return took in the untreated cases. In the group that received PGI2, the ischemic ultrastructural changes in the cytoplasm of neuroglial cells were abolished, however, PGI2 did numerous vesicular structures, nuclear inclusions and chromatin clumping and margination. The vesicular structures were enclosed in a single smooth membrane without contact with the nuclear envelope. It is suggested that the vesicular structures may form as the result of disturbances in the water-electrolyte exchange between the cytoplasm and karyoplasm of neuroglial cells. The inclusions consisted of filaments and/or membranes. The amassing in the karyoplasm of vesicular structures and intranuclear inclusions with chromatin clumping and margination probably leads later to the death of the neuroglial cells after total cerebral ischemia. Hence, the described data indicate that the curative effects of PGI2 are directed only to early changes in the neuroglial cells cytoplasm and reflect a transient facilitation of functional recovery and/or metabolism rather then permanent brain protection after complete cerebral ischemia. PMID- 1791299 TI - Differential vulnerability of neurons toward local injection of ibotenic acid in the hippocampus of the adult rat. An electron microscopic study. AB - The ultrastructural changes of neurons following in situ injection of biotenic acid into the adult rat hippocampus were investigated. Independent from the localization of the injection site, swelling and subsequent vacuolar degeneration was seen in the center of the induced lesion, in the periphery the nerve cells degenerated electrondense and shrunk. In the center of the lesion all perikarya degenerated, whereas a considerable amount of different hippocampal interneurons survived in the lesion's periphery. Furthermore, the extent of the lesion sites suggested that CA1 pyramids were more sensitive than CA3 perikarya and the granule cells of the dentate gyrus. The different vulnerability of the various hippocampal neurons to the in situ exposure of ibotenic acid can tentatively be interpreted by their differing receptor equipment. PMID- 1791300 TI - A comparative study of the tangential-oculomotor projection. AB - Most of the neurons of the tangential vestibular nucleus of birds project to the controlateral oculomotor complex, but it is not known whether there is a homologous projection in mammals. In this study, horseradish peroxidase (HRP) was injected into the oculomotor nucleus of chicks and rabbits, and the distributions of labelled neurons in the target region of the vestibular complex in the two species were compared. In chicks, a large number of labelled neurons formed a continuous band of neurons located in the contralateral tangential, descending and medial nuclei. In rabbits a similar band of labelled neurons was found in the contralateral descending and medial vestibular nuclei, but most of the neurons were caudal to the incoming vestibular nerve fibers, and only a few rostral neurons were located among these fibers. Our results suggest that the tangential nucleus neurons projecting to the oculomotor nucleus may be homologous to the most lateral neurons of the neuronal band of rabbits. PMID- 1791301 TI - A morphogenetic quantitative approach to species-typical behaviour. AB - The numerical ratio of the allocortical, late-myelinized infra-temporal sector (Flechsig) to the neocortical convexity of the temporal lobe in the human brain is proposed as a quantitative invariant of the human species, called "Neocorticalisation Index NI". Its morphogenetic nature derives from (1) the dual, that is the reptilian-palaeomammalian origin of the primate cortex (Kappers 1909, Vogt 1910. Kuhlenbeck 1924, Filimonoff 1947, Northcutt 1967, Stephan 1975). The two layers differentiate at independent rates forming a transitional belt, called "periallocortex" (limbic) and "mesocortex" (insular). They approach the most the general cyto- and myeloarchitectonic scheme of Brodmann (1909) and C. and O. Vogt (1919), and in the human brain are the latest to reach maturity (Flechsig 1920, Kahle 1969, Sanides 1975); (2) measurements in fossilized human brain endocasts (Taung, Rhodesian man) reported earlier (Irsigler 1984a and b); (3) clinico-pathological evidence gained from cases of the Pick-type of presenile dementia confirming the anthropogenetic character of the frontotemporal "basal forebrain" (Spatz and his school since 1937, Luers 1947, Jakob 1979). The latter is considered to be in the mammals the major counterpart of the hormonally and reciprocally controlled reptilian forebrain (Schepers 1948, Sanides 1970, MacLean 1978). The results of NI measurements in 128 human brains are tabulated and interpreted in the light of species-typical behaviour. It turns out that the left hemisphere is the one possessing the greater share of allocorticity showing precocious development in the non-European (Negro) infant. There are gender related differences of the NI parameters. The Indo-Europeans (Caucasians) undergo, in their ontogeny, a kind of "secondary" allocorticalisation in both hemispheres which, hypothetically, may be correlated with the "substantializing" (reifying) property inherent in their languages. PMID- 1791302 TI - Quantitative morphological analysis of hippocampal structures in DBA1 and DBA2 inbred mice strains with genetically determined different shuttle box behavior: the mossy fiber system with reference data to the C3H strain. AB - The present work deals with morphological aspects which are likely related to a genetically determined learning behavior in the shuttle box paradigm. Subregions of the hippocampal mossy fiber system in two closely related inbred mice strains, DBA1 as a bad active avoider and DBA2 as a good one, are compared. Additionally, data derived from C3H (bad active avoider) studies are analyzed. Beside of certain structural similarities in DBA1 and DBA2 such as the elongation of infrapyramidal mossy fibers along the CA3 neurons this study pays attention to the topography of hilus and basal CA3 mossy fiber innervation. PMID- 1791303 TI - Changes in GABA-immunoreactivity and GABA-transaminase activity in rat amygdaloid complex in aging. AB - The distribution of gamma-aminobutyric acid (GABA), gamma-aminobutyric acid transaminase (GABA-T) and glial fibrillary acid protein (GFAP) in the amygdaloid complex of young adult (3-month old) and aged (26-month old) Wistar rats was compared by using histo- and immunohistochemical techniques. The study revealed a heterogeneous distribution of GABA-immunoreactive and GABA-T positive nerve cells, fibers and terminals in various amygdaloid nuclei of young adult rats. A significant reduction in the density of GABA-immunoreactive neurons was demonstrated in the amygdala of aged rats. Reduced density and staining of GABA- and GABA-T-positive fibers and terminals were also seen in aged rat amygdala. Heavily GABA- and GABA-T-stained aberrant fibers and coarse puncta were clustered around blood vessels as well as under the pial and ependymal surfaces. GFAP immunostaining demonstrated numerous hypertrophic astrocytes in these areas. PMID- 1791304 TI - [Electron microscopic studies on the medial septal nucleus of the rat: neuronal somata and axosomatic contact]. AB - At least 4 categories of neurons were found in this region, whose somata differ in ultrastructural features. 1. Large cells with a broad rim of cytoplasm (nucleus cytoplasm-index; 3.07 +/- 0.67), RER is densely arranged throughout the whole perikaryon. The nuclear invagination index (1.34 +/- 0.19) is low. Few axosomatic contacts are present. 2. Large to medium-sized cells with a broad rim of cytoplasm (nucleus/cytoplasm-index 2.58 +/- 0.36 and 2.08 +/- 0.42). The RER is clustered in voluminious staples. There are differences in the nuclear invagination indices between subpopulations. In large cells it is low (1.36 +/- 0.24), but it is high in medium-sized cells (1.70 +/- 0.5). Axo-somatic contacts are more numerous in this type than in others. 3. Large, medium-sized and small cells with a broad rim of cytoplasm (nucleus/cytoplasm-index; 2.50 +/- 0.32, in large and medium-sized 2.25 +/- 0.5 and 2.24 +/- 0.48 in small cells). Single RER elements tends to be arranged in loops. The cells are characterized by a high nuclear invagination index. It is 1.68 +/- 0.38, in the large cells, 1.56 +/- 0.44 in the medium-sized and 1.55 +/- 0.34 in the small ones. In this neuron category the number of axo-somatic contacts is very low. 4. Medium-sized to small cells with a narrow cytoplasmic rim (nucleus/cytoplasm-index; 1.78 +/- 0.23 and 1.89 +/- 0.39). RER is nearly absent. The nuclear invagination index of medium sized cells (1.11 +/- 0.07) and of small cells (1.14 +/- 0.12) is lower than in other categories. These cells exhibit a very low number of axo-somatic contacts. Comparison with findings of immunostained cells lead to the conclusion that category 2 corresponds to GABA-ergic and category 3 to cholinergic neurons of the medial septal region. PMID- 1791305 TI - Phylogenetic evolution of intermediate filament associated proteins in ependymal cells of several adult poikilotherm vertebrates. AB - The cytoskeletal proteins are phylogenetically well preserved in Vertebrates. However, unlike the case of Mammals, comparatively little is known about the immunocytochemical characterization of the intermediate filaments (IF) of the ependymal epithelium cells in the lower Vertebrates. The immunohistochemical response of the ependymal epithelium of the spinal cord has been examined in several poikilotherm Vertebrates. The latter were selected on the basis of the high degree of variation in adult spinal cord plasticity, a property due to the ependymal cells and probably related to different IF-associated proteins contained in them. In Triturus (Urodele Amphibian) the presence of cells having an exclusively vimentine positive cytoskeleton, apparently not organized into filamentous structures, was observed throughout ependymal epithelium. In Rana (Anuran Amphibian) the ependymal epithelium cells were found to be comparatively positive with respect to both vimentine, which was structured into cytoskeletal filaments, and glial fibrillary acidic protein (GFAP), detected using monoclonal anti-chicken-GFAP antibodies. In Lacerta (Scaly Reptile) the ependymal epithelium cells only rarely had a vimentine positive cytoskeleton and mostly appeared to stain intensely with polyclonal anti-bovine-GFAP. The different immunocytochemical response of the cytoskeleton of the ependymal epithelium cells in the poikilotherm Vertebrates examined can be explained in terms of the varying plasticity of the spinal cord. In adult animals, this plasticity is still high in the Urodeles, lower in the Anurans, much weaker in the Reptiles and disappears completely in the homeotherm Vertebrates. PMID- 1791306 TI - FMRF-amide-like immunoreactivity (FMRF-amide-LIR) in the vegetative areas and dorsal horn of the spinal cord of some rodents. AB - A dorsal horn fiber system is revealed along the entire length of the spinal cord of guinea pig, rat and wild hamster by means of FMRF-amide immunocytochemistry. Additionally by the same method are revealed two IR networks in the intermediate zone of the thoracic and sacral spinal cord which are identical with the described earlier by us (Galabov and Davidoff, 1976; Galabov 1980; Davidoff et al. 1985) vegetative networks. The dorsal horn fiber system on transversal sections possesses five main components identical with the components of such system described earlier by Davidoff et al. (1986) by means of SP immunocytochemistry. On horizontal sections it is composed of two FMRF-amide LIR networks: One is localized in the superficial layers of the dorsal horn (Laminae I and II) and the second in laminae IV and V, in the borders of nucleus proprius. Both networks are interconnected and in the thoracic and sacral spinal cord are connected with the vegetative networks. It is suggested that some fibers of the dorsal horn fiber system originate from dorsal-root ganglia and may represent primary sensory or visceral afferents. It is likely that this system together with the vegetative networks may represent the morphological basis for the integration of 1) the central and peripheral vegetative nervous systems and 2) the somatic and vegetative nervous system. The presence of different neuropeptides in the dorsal horn fiber system gives ground to term it as a Peptidergic Dorsal Horn Fiber System (pDHFS). PMID- 1791307 TI - CA 549 as a marker in breast cancer. AB - CA 549 is one of several carcinoma associated mucin antigens proposed as a breast cancer tumor marker. In this study, the performance characteristics of the CA 549 assay were validated and the clinical utility of the test was compared with that of other breast cancer markers including CA 15-3, CA M26, CA M29 and carcinoembryonic antigen. The upper limit of normal was established as 15.5 U/ml based on data for 250 control subjects apparently free of disease. Overall, CA 549 had a low negative predictive value (0.51) due to a low sensitivity in the detection of early breast cancer. However, the test had a high positive predictive value (0.93) reflecting a high specificity for the disease. In 56 patients with advanced breast cancer, the sensitivity was 0.71 for CA 549 alone and 0.79-0.84 for CA 549 combined with any of the other markers studied. PMID- 1791308 TI - Estrogen, progesterone receptors and proliferating activity evaluated by immunocytochemistry in breast cancer. AB - The correlation of the most important prognostic indicators was evaluated in 75 breast cancer cases. Estrogen-progesterone receptors and proliferating activity were analyzed by immunocytochemical methods (ER-ICA, PR-ICA, Ki-67). Both steroid receptors were inversely correlated with the proliferating activity (ER-ICA vs Ki 67, p less than 0.003; PR-ICA vs. Ki-67, p less than 0.0001). No correlation was found between steroid receptors or cell kinetics and tumor size or lymph node status. These findings confirm the relevance of biochemical and kinetic parameters as independent markers in breast cancer and suggest a routine use of the simple immunocytochemical methods in assessing the biological behavior of tumors. PMID- 1791309 TI - Evaluation of a radioreceptor assay to assess exogenous estrogen activity in serum of patients with breast cancer. AB - A radioreceptor assay (RRA) for the determination of total estrogen activity, was set up and used to assess the possible presence of exogenous molecules with estrogen activity in serum; a comparison was made with the specific radioimmunoassay (RIA) for the endogenous estrogen 17-B estradiol (17-B-E2). The assay was first performed on sera from healthy people taking estrogens in the form of oral contraceptives or lotions for local application whose total estrogenic activity in the blood was assumed to be abnormal. The assay was then performed on serum from 98 patients with early breast cancer and 20 patients with metastasis, not undergoing hormone therapy. A higher estrogen activity was found in 2.5% of sera compared to the activity found using the RIA method which is specific for endogenous estrogen 17-B-E2, the RRA/17-B-E2 ratio being higher than 3. Increased estrogen activity was found in 10% serum samples from digoxin treated cardiopathic patients, with an RRA/17-B-E2 ratio ranging from 4.4 to 20. The RRA assay could prove useful for showing up exogenous estrogen activity from various sources (drugs, food) in sera of people in whom estrogen stimulation could be potentially dangerous (i.e. in patients with hormone-sensitive tumors). This exogenous activity could support a certain degree of neoplastic stimulation and, therefore, unfavourably condition the patients' therapeutic response. PMID- 1791310 TI - Demonstration of mucinous-like carcinoma-associated antigen in bone marrow and lymph node biopsies from patients with breast carcinoma. AB - Two hundred and fifty bone marrow and 140 lymph nodal biopsies were analyzed immunocytochemically, using a mouse monoclonal antibody b-12 (M Ab b-12), which reacts with MCA (mucinous-like carcinoma-associated antigen). The presence of MCA in bone marrow specimens was demonstrated in 102 out of 105 (97.1%) breast cancer metastases, 5 out of 8 (62.5%) gastric cancers, 5 out of 6 (83.3%) colon cancers, 3 out of 5 (60%) prostate cancers, 11 out of 26 (42.3%) lung cancers and 25 out of 30 (83.3%) unknown primary cancers, while no positivity to anti-MCA antibody was found in 30 cases of normal bone marrow biopsies, 5 cases of non epithelial malignancies and 30 cases of hemolymphoproliferative disease. Normal lymph nodes and non-epithelial lymph node metastases did not show any reaction to M Ab b-12; on the contrary MCA positive staining was observed in 75 out of 75 (100%) lymph nodal metastases in breast cancer. These results suggest that application of M Ab b-12 in immunohistochemistry is valid for the detection of bone marrow and lymph nodal micrometastases of epithelial origin. PMID- 1791311 TI - Tumor markers in leukemia: evaluation of serum levels of different forms of sialic acid, Regan isoenzyme and lactate dehydrogenase. AB - A sensitive and specific serum marker can greatly help in the early diagnosis of malignancy as well as in monitoring the treatment of cancer patients. The present work was initiated for determining serum levels of Total Sialic Acid (TSA), Lipid Bound Sialic Acid (LSA), Free Sialic Acid (FSA). Regan Isoenzyme (RI) and Lactate Dehydrogenase (LDH), so as to evaluate their value as potential tumor markers. Fifty patients with anemia and 78 patients with leukemia were studied. The leukemia group consisted of 32 cases of Acute Myeloid Leukemia (AML), 29 cases of Chronic Myeloid Leukemia (CML) and 17 cases of Acute Lymphatic Leukemia (ALL). The levels were compared with the values obtained from 88 healthy individuals. Compared to the healthy controls, all the biomarkers were significantly elevated in patients with anemia as well as in those with leukemia. However, in leukemia patients significantly higher levels of TSA, LSA, FSA and LDH were observed compared to anemia patients. TSA levels were significantly higher in AML patients compared to CML and ALL patients. LSA levels were also significantly higher in AML patients compared to ALL patients. LSA was the most sensitive (84.6%) while FSA and RI levels were the most specific (78.0%) markers for leukemia. The combined use of the markers showed increased sensitivity and specificity (100.0% and 98.0%, respectively). The study suggested that the biomarkers investigated might be used for differentiating anemic from leukemic conditions, however, more in-depth studies are indicated to assess their utility in classifying various leukemias. PMID- 1791312 TI - Serum levels of ceruloplasmin, properdin factor B and copper in lymphoma patients. AB - The serum levels of Ceruloplasmin (CER), Properdin Factor B (PFB) and Copper (CU) were evaluated in a series of 40 patients with Hodgkin's Disease and 46 patients with non-Hodgkin's lymphoma. Concentrations of CER and PFB were determined by rate nephelometry and CU concentrations by the bathocuproine colorimetric method. The results obtained demonstrated that CER, together with the well documented CU, can be used for monitoring Hodgkin's Disease. PMID- 1791313 TI - CA 15.3 in nonmalignant liver diseases. AB - CA 15.3 is a recent tumor marker for a wide range of cancers that is usually used for monitoring breast carcinoma patients. This study was performed to evaluate CA 15.3 behaviour in 161 patients with benign diffuse hepatic diseases who underwent thorough clinical and biochemical evaluation. Abnormal serum levels of this antigen were found in 8.7% of the 161 patients, 11.6% of the 86 cirrhotics, and 5.3% of the 75 noncirrhotic patients. The correlation between CA 15.3 and certain parameters characteristic of liver diseases was checked. IgA showed the most relevant correlation (r = 0.39, p less than 0.00001) and in our series a normal level of IgA was practically determinant of normal CA 15.3 levels. Our results also support the role played by hepatocellular dysfunction in increasing levels of this antigen in spite of the low number of false-positive results. CA 15.3 can be used as a tumor marker in these patients at levels used for healthy subjects. PMID- 1791314 TI - Placental alkaline phosphatase in the cerebrospinal fluid of patients affected by pineal region neoplasms. PMID- 1791315 TI - High TAG-72 serum levels, defined by MoAb B72.3, in premenopausal women with benign breast disease, are associated with type I gross cystic disease. PMID- 1791316 TI - Different immunoreactivity between cyst fluid and serum prolactin in women with cystic breast disease. PMID- 1791318 TI - Lung injury in acute experimental pancreatitis in rats. II. Functional studies. AB - In this study we report the functional changes in isolated perfused lungs from rats with cerulein-induced experimental pancreatitis. Rat lungs isolated immediately after the cerulein infusion demonstrated decreased pressor responses to angiotensin II (A II) and acute hypoxia (FIO2: 0.0). The lung wet- to dry weight ratio was increased, as was the lung-leak index, consistent with high permeability edema formation in the lung. Neither saline-solution infusion for 12 h nor perfusion with cerulein of rat lungs isolated from untreated animals caused lung injury or functional alterations. The changes in pulmonary vascular reactivity were normalized 48-72 h after induction of pancreatitis. In conclusion, we describe an animal model of pancreatitis and reversible, ARDS-like lung injury. PMID- 1791317 TI - Lung injury in acute experimental pancreatitis in rats. I. Morphological studies. AB - The pathogenesis of pancreatitis-related pulmonary injury was studied at the light- and electronmicroscopic level. Experimental pancreatitis was induced in rats by infusion of supramaximal doses of cerulein for 12 h. Investigations were carried out 3, 6, and 12 h after the start of infusion and 12, 48, and 72 h after the end of pancreatitis induction. Initial manifestations of pancreatitis associated lung injury revealed a pronounced clustering of polymorphonuclear leukocytes in pulmonary microvessels, followed by severe damage of alveolar endothelial cells. Consecutively, the increase in vascular permeability of the lung resulted in interstitial edema formation. Structural changes were maximal after 12 h and reversed completely after 84 h. In conclusion, the structural appearance of pulmonary injury in cerulein-induced pancreatitis was similar to that reported in early stages of the adult respiratory distress syndrome (ARDS). It is suggested that polymorphonuclear granulocytes play a crucial role in the pathogenesis of pancreatitis-related lung injury. PMID- 1791319 TI - Evaluation of CEA, CA 19-9, CA-50, CA-195, and TATI with special reference to pancreatic disorders. AB - The tumor markers CEA, CA 19-9, CA-50, CA-195, and TATI were analyzed in patients with pancreatic diseases as well as disorders in the upper quadrant of the abdomen. Two different methods for CA-50, namely CA-50 IRMA and CA-50 DELFIA, which are based on the same monoclonal antibody, were used. The sensitivities, specificities, and predictive values of positive and negative results were calculated at one, three, and ten multiples of the upper reference value ("cutoff") for each method. All the tumor markers except TATI had sensitivities exceeding 90% at one cutoff level, but CEA had low specificity. Poor sensitivities were observed for CEA and TATI at three cutoff levels, whereas CA 19-9, CA-50, and CA-195 had sensitivities and specificities greater than 80%. The sensitivities of these tumor markers decreased at 10 cutoff levels, although the specificities exceeded 95%. The predictive values of positive and negative results were also evaluated at these three cutoff levels. High scores were observed at three cutoff levels. Examined together with the sensitivity and specificity, the evaluation at three cutoff levels indicated that CA 19-9, CA-50, and CA-195 can be used in the diagnostic arsenal for the detection of cancer of the exocrine pancreas in symptomatic patients, and in the differential diagnosis between pancreatic cancer and chronic pancreatitis. Although CA-50 IRMA and CA-50 DELFIA are based on the same monoclonal antibody, there were substantial differences in the levels of CA-50 in a lot of the patients when samples were analyzed by the two methods. These differences were shown to be methodological, and they affected the test evaluations to some extent. PMID- 1791320 TI - Early graft injuries after pancreatic transplantation in syngeneic rats. Cytoprotective effects of gabexate-mesilate. AB - Failures in experimental and human pancreatic transplantation are mainly attributable to rejection, graft thrombosis, and technical problems. There are, however, problems related to other causes, such as preservation injuries, which we found to exhibit, at least within the first 6 h, the same histological patterns seen in experimental acute pancreatitis. We performed pancreatic transplantation in 110 syngeneic rats under different preservation techniques and administration of gabexate mesilate, a synthetic protease inhibitor. The results showed that antiprotease treatment reduces graft preservation injuries significantly. PMID- 1791321 TI - Is there a duodenum-pancreas negative feedback? Views: pro and con. PMID- 1791322 TI - Clinical regression of infected pancreatic necrosis. Case report. AB - Infected pancreatic necrosis was diagnosed clinically and radiologically in a patient admitted for acute pancreatitis. As free gas in the pancreatic area was recognized, antibiotic therapy (ceftriaxone) was empirically introduced, while surgical drainage was being planned. After the second week, the patient rapidly started to improve, to the point that he could be discharged home without operation. Control CT-scans and general laboratory tests, at this phase and later on, confirmed a still enlarged gland but free of infection or ongoing inflammation. Cholelithiasis, which had been identified in an early ultrasound scan, was electively treated by cholecystectomy 2 mo after the onset of pancreatitis, in the absence of sepsis, and with uneventful recovery. This case illustrates the rare possibility of spontaneous regression of infected necrotic pancreatitis, without any type of operation or nonoperative drainage. PMID- 1791323 TI - [Immunization of healthy children with mumps-rubella bivalent live vaccine and simultaneous vaccination with mumps-rubella and varicella vaccines]. AB - Bivalent virus vaccine, containing rubella TCRB-19 strain and mumps NK-M46 strain (MR vaccine), was administered to a total of 95 healthy children who had already received measles vaccine or had been infected with wild measles virus. The seroconversion rates for rubella and mumps viruses in subjects having no antibody to rubella or to mumps virus were 99% (75/76) and 97% (63/65), respectively, at 6 8 weeks after vaccination. The seroconversion rates for both rubella and mumps in vaccinees initially seronegative to both viruses were 95% (56/59). Immune responses after MR vaccine injection were comparable to those after administration of monovalent rubella or mumps vaccine. Clinical reactions observed in some subjects who received MR vaccine were mild fever (3.6%), exanthem (8%), lymphadenopathy (1.8%), and swelling of the parotis region (1.8%). MR vaccine could be simultaneously injected with varicella vaccine at the opposite site producing no adverse effect on immune response. Our results indicate that MR vaccine is a safe and effective vaccine, especially for children who have had wild measles or who have received measles vaccine. PMID- 1791324 TI - [Early diagnosis of Mycoplasma pneumoniae pneumonia by antigen detection using immunobinding assay]. AB - The possibility of rapid diagnosis of Mycoplasma pneumoniae infection by immunobinding assay is described. Immunobinding assay which was developed by Kotani and McGarrity is a simple and rapid method for identification of mycoplasmas. Small amounts of antigen were spotted onto the nitrocellulose membrane. It was treated with a specific rabbit antisera against M. pneumoniae. The antigen-antibody complex was visualised with the avidin-biotin horseradish peroxidase method. Cross reaction was seen between M. pneumoniae and M. genitalium. Throat swabs from hamsters infected with M. pneumoniae were positive on 7th and 14th day after infection. Although the cross reaction was seen between M. pneumoniae and M. genitalium, this method could be useful for rapid diagnosis of M. pneumoniae infection. PMID- 1791325 TI - [Application of trichloroacetic acid-treated antigen for serodiagnosis of Q fever by indirect immunofluorescence technique]. AB - It is well known that the etiologic agent, Coxiella burnetii, exhibits an antigenic phase variation (phase I to phase II), and the diagnostic significance of the relative antibody titers against phase I and phase II antigens is pointed out. Therefore both phase I and phase II antigens are necessary for the serological examination of Q fever. But it is not so easy to prepare and maintain the phase II antigen by the conventional method. In the present study we tried to prepare the phase II antigen for immunofluorescence test by chemical treatment of the phase I antigen. As a result, treatment of the TK-1 strain of C. burnetii (phase I) with 10% trichloroacetic acid for 4 hr at 4 degrees C modified the antigenicity. The modified antigen reacted strongly with anti-phase II antibody. PMID- 1791326 TI - Disseminated mycobacteriosis in patients with severe hematologic disorders. AB - During a 20-year period disseminated mycobacteriosis occurred in 11 (1.1%) of a total of 1006 patients with severe hematologic disorders, with the frequency remaining almost unchanged. The diagnosis in three patients (27%) was made only at autopsy. Tuberculosis accounted for 64% of all cases. Female preponderance was seen with a male-to-female ratio of 3:8. The major factors associated with dissemination included immunosuppression, weight loss, old age, and diabetes mellitus. Fever was the most common clinical symptom. Chest X-ray abnormalities, hypoproteinemia, liver dysfunction, and hypoxemia were noted in most cases. The prognosis of tuberculosis depended mainly on early diagnosis and treatment, while that for the nontuberculous variety was largely influenced by the underlying disease. Thus, our findings indicated that clinicians must suspect disseminated mycobacteriosis especially in any febrile patient with recent pulmonary pathology on chest X-ray, so that an adequate trial of therapy can be provided. PMID- 1791327 TI - [Spheroplast formation in clinical isolates of gram-negative bacteria by beta lactam antibiotic in the presence of Ca2+ or Mg2+]. AB - Induction to cell wall-deficient bacteria has been suggested to be a cause of intractable and opportunistic infection after chemotherapy. Spheroplast formation by beta-lactam antibiotic in not so high osmotic pressure was investigated in six species of gram-negative bacteria. Some species of gram-negative bacteria were induced to form spheroplast at a high rate by 1:10 concentration of ceftizoxime in the presence of Ca2+ or Mg2+. Especially in 38% of Proteus mirabilis and P. vulgaris, more than 40% of the original cells were induced to form spheroplast by ceftizoxime in a medium supplemented with 40 mM Ca2+. The same formation rate was also found in 22% of Serratia marcescens. Formation rates in the drug sensitive strains of S. marcescens were enhanced as the drug concentration increased. Ca2+ was more effective in spheroplast formation than Mg2+. PMID- 1791328 TI - [Epidemiological study on Chlamydia trachomatis infection in obstetrics and gynecology field in Tokyo]. AB - In conjunction with the Tokyo Branch of Japan Association for Maternal Welfare, we have been carrying out examinations of Chlamydial infection on women, especially pregnant women, living in Tokyo. Specimens were collected from 212 gyneco-obstetric clinics in Tokyo during 4 years from January 1987-December 1990. A total of 13,925 swab specimens from patients who were suspected of sexually transmitted diseases from clinical findings and pregnant women who requested the examination were tested for the presence of antigen to C. trachomatis with EIA (Chlamydiazyme). Epidemiological analysis based on the results and case cards that were described sex, age, occupation and clinical findings were conducted. The results obtained are briefly summarized as follows. 1) C. trachomatis antigen was detected in 12.8% (1,237/9,657) of the female patients, 31.0% (124/400) of the male patients and 6.8% (10/168) of the infants. The detection rates of C. trachomatis antigen in the male patients was significantly higher than that in the female and the infants patients. C. trachomatis antigen was detected in 6.1% (226/3,683) of pregnant women. 2) The detection rates of C. trachomatis antigen were compared by occupation of female patients. Most high rate was 26.6% (53/199) in bar hostess , subsequently 20.1% (102/508) in students, 19.8% (59/298) in prostitutes, 13.6% (455/3,348) in office girls and 7.2% (471/6,573) in house wives. It was noteworthy that the detection rates of C. trachomatis antigen in students was as similarly high as that in prostitutes. 3) The detection rates of C. trachomatis antigen was also compared by age groups. The detection rate had a tendency to be high in younger people.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791329 TI - [Fundamental studies on "M. TB probe assay kit" for the identification of Mycobacterium tuberculosis]. AB - DNA probe assay kit for the identification of Mycobacterium tuberculosis was evaluated. This kit is based on beads capture method and using a 20 well assay tray. The culture isolate is suspended with 0.5 ml sterilized water in the tube containing phi 3 mm glass beads for dispersion, transferred to a well of the assay tray. After lysation and adsorption of the nucleic acids to the capture bead, 125I-DNA probe specific for the M. tuberculosis is added to the sample and hybridized for 1 hour at 65 degrees C. Hybridized probe trapped on the capture bead is quantitated using a gamma counter. This hybridization assay kit can detect more than 1 x 10(5) bacteria per assay. Using the control DNA (synthesized oligonucleotide complementary to the probe sequences) and suspension of the culture isolates, the intra assay C.V. value was 4.3% and 5.2% respectively. To compare this probe assay kit with the conventional culture identification method, a total of 144 culture isolates were examined. This test for the M. tuberculosis had 99.3% agreement with the conventional identification procedures, and demonstrated 100% sensitivity and 98.2% specificity. The suspension of culture isolates can be stocked by freezing, the samples can be assayed together when they have accumulated instead of every day. As shown in the above, this assay kit demonstrates a high level of specificity and sensitivity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791330 TI - [In vitro antimicrobial activity of rokitamycin, a macrolide antibacterial agent, against clinically isolated strains of Campylobacter and other enteritis-causing bacteria]. AB - We determined the minimum inhibitory concentrations (MICs) of rokitamycin (TMS-19 Q, RKM), a macrolide antimicrobial agent, against strains of various bacterial species isolated from enteritis patients, and compared them with those of josamycin (JM), erythromycin (EM) and ofloxacin (OFLX). MIC90 of RKM against 147 strains of Campylobacter jejuni, and each 25 strains of Shigella spp., Salmonella spp. and diarrheagenic Escherichia coli were 1.56, 200, 800 and 200 micrograms/ml, respectively. There was only one RKM resistant (MIC greater than 100 micrograms/ml) C. jejuni strain, while most of the strains of the other species were resistant to RKM. MIC values of the other drugs were all similar to those of RKM. MIC90 of OFLX against 147 strains of C. jejuni was 0.78 micrograms/ml, lower than other drugs. PMID- 1791331 TI - [Detection of human immunodeficiency virus type-1 (HIV-1) DNA by polymerase chain reaction using nonradioactive probe and virus isolation]. AB - We compared the results obtained with the polymerase chain reaction (PCR) and virus isolation from peripheral blood mononuclear cells (PBMC) in HIV seropositive and seronegative persons. Three primer pairs of SK38/39 (gag). SK29/30 (LTR) and SK68/69 (env) were used in the amplification of the HIV DNA sequences, and KM29/38 (beta-globin) was used as the inner control. The PCR positive rate among the virus-isolation-positive persons was SK38/39:100% (22/22), SK29/30:95.5% (21/22) and SK68/69:90.0% (20/22). The PCR-positive rate among the virus-isolation-negative persons was SK38/39:60% (6/10), SK29/30:60% (6/10) and SK68/69:80% (8/10), and two subjects were PCR-negative with all primer pairs. We could not detect HIV DNA from seronegative samples, and all subjects were positive with the inner control. Each primer pair expressed a different PCR positive rate. There are possible explanations for the low PCR-negative rate on virus-isolation negative-subjects that the number of infected cell was rare or infected HIV contained genetic variations or deletions. We considered that the results of PCR correlated with the character of HIV as infectivity. PMID- 1791332 TI - [Bacteriological examination of infections in the field of oral surgery]. AB - Etiology of bacterial infections in the field of oral surgery was studied. A total of 270 samples collected from patients with encapsulated abscess in their oral cavities was examined and bacteria were isolated from the 244 samples (90.4%). The following results were found; 1) Organisms more than one from one sample were frequently isolated from cases with parodontitis, pericoronitis and gnathitis. Isolation of anaerobic bacteria was common (54.2%). 2) Streptococcus milleri and Streptococcus sanguis and Capnocytophaga species were the most common isolates among aerobic gram-positive and gram-negative bacteria, respectively. 3) Peptostreptococcus micros and Eubacterium lentum were most frequent isolates among gram-negative anaerobic bacteria. Among gram-negative bacteria, Oral Group Bacteroides, especially Bacteroides gingivalis, Bacteroides intermedius, Bacteroides buccae and Bacteroides oralis were most prominent. 4) Isolation frequency of bacteria (both species and strains) was high from samples obtained from patients before antibiotic chemotherapy. 5) Most strains were sensitive to Midecamycin acetate and Josamycin. Minimum inhibitory concentration of 80% isolates (MIC80) against these antibiotics was 0.39 microgram/ml. PMID- 1791333 TI - [A study of Ureaplasma urealyticum pathogenicity in human genitourinary tract]. AB - Ureaplasma urealyticum was investigated in urine from 765 outpatients who visited Jikei University Affiliated Hospital and Tokyo Metropolitan Taito Hospital from June, 1988 to December, 1989 in order to clarify the pathogenicity of U. urealyticum in human genitourinary tract. U. urealyticum in urine was detected by means of Taylor-Robinson's method. The positive rates of U. urealyticum were 31.5% in 146 patients with gonococcal urethritis, 33.8% in 334 patients with non gonococcal urethritis, 17.5% in non-bacterial chronic prostatitis and 27.5% in the other patients without infectious diseases, respectively; no significant difference was seen among these groups. U. urealyticum was detected in the urine from 32.1% of the 28% patients who were younger than 12. However, U. urealyticum was detected in the urine from 5.6% of the 18 patients who were older than 70. Therefore, there was no relationship between the age and U. urealyticum-positive rate in urine. Furthermore, there was no relationship between the detection of U. urealyticum and the subjective and objective findings in the patients with urethritis before and after the treatment. From these results, it is presumed that U. urealyticum has no pathogenicity in human genitourinary tract. PMID- 1791334 TI - [Ofloxacin in the treatment of infection caused by Salmonella paratyphi A]. AB - We reported a case of salmonellosis treated with ofloxacin (OFLX) which showed excellent clinical and bacteriological effect in a 22 year-old Japanese male with Salmonellosis paratyphi A. He had stayed in India from Sept. 6, 1990 to Oct. 13, 1990. On Oct. 25, 1990, he complained of a high fever and headache. On Oct. 29, he was admitted to our hospital and was diagnosed as Salmonellosis paratyphi A by the blood culture. He was treated with 2.0 g/day of chloramphenicol (CP) for 7 days, but the clinical efficacy was not sufficient. Therefore, we added 900 mg/day of OFLX for 10 days. He was treated successfully with them, the temperature became on the 2nd day. No side effect and no changes of laboratory data were observed and no recurrence was observed clinically and bacteriologically for three months after his discharge. PMID- 1791335 TI - [A case of Pasteurella multocida subsp. multocida complicated with diabetes mellitus]. AB - We report a case of sepsis who died caused by Pasteurella multocida subsp. multocide sepsis. A 68-year-old male was admitted to Azusawa Hospital because of disturbance of consciousness. He had been suffering from diabetes mellitus combined with gangrene, but received no treatment. The patient died 24 h after hospitalization, and Pasteurella multocida subsp. multocida was isolated from his blood. Laboratory tests showed that CRP; 5+ WBC; 15,400/microliters, TP; 5.2 g/dl. Although Pasteurella multicida subsp. multocida seemed to cause mild infection in healthy subjects, it can cause severe systemic illnesses such as sepsis and meningitis in compromised hosts. It should be considered that the contact with pets will increase the incidence of systemic severe infection with this agents. PMID- 1791336 TI - [A case of remarkable effect of clindamycin in nasal septum abscess caused by Streptococcus milleri]. AB - We encountered a 14-year-old male patient with a destructive abscess of nasal septum, caused by Streptococcus milleri. He was successfully treated with Clindamycin in combination with surgical intervention. We emphasized the significance of Streptococcus milleri as a causative agent for abscess formation, and clindamycin should be considered as a first choice of antibiotics against Streptococcus milleri infection. PMID- 1791337 TI - [Acute upper respiratory tract infections associated with Chlamydia pneumoniae]. AB - From March 1990 to January 1991, a total of 46 outpatients with acute upper respiratory infections (URTI) were studied to determine the etiological role of Chlamydia pneumoniae. Sera from 40 patients were tested by micro-IF method for evidence of recent or past infections of this organism, and swab specimens from tonsilar crypt from 26 were cultured. Sera from 20 patients without any evidence of acute infectious disease were selected as controls. The seroprevalence of antibodies to C. pneumoniae was 52.5% in patients group and 30.0% in the control group. No statistical difference was found in seroprevalence between patients and controls. Serological evidence of acute infections with C. pneumoniae was found in 7 (17.5%) patients with acute URTI, but was not found in any of the control group. Of 26 patients, three (11.5%) had C. pneumoniae isolated from a tonsilar crypt swab specimen. Therefore ten of the 46 patients with acute URTI were associated with C. pneumoniae. It is suggested that C. pneumoniae is a common pathogen in acute upper respiratory infections without any evidence of lower respiratory tract symptoms. PMID- 1791338 TI - Susceptibility to active oxygen species of protective and nonprotective strains on the challenge of Salmonella enteritidis by immunization with culture filtrate. AB - Protective ability against the challenge of different strains by immunization with culture filtrate (CF) obtained from Salmonella enteritidis was investigated. It was shown that the different strains of S. enteritidis can be separated into two distinct groups of protective (2547, 116M, 116-54, SR-98G, and 3775) and nonprotective strains (2822, 3975, and IID-604). Using a cell-free microbicidal system, the susceptibilities of these strains to active oxygen species was evaluated. S. enteritidis was found to be susceptible to these active oxygen species, however no differences between the protective and nonprotective strains were observed. Both catalase (H2O2 scavenger) and histidine (1O2 scavenger) inhibited the bactericidal activity of the xanthine-xanthine oxidase system. Therefore, among the various oxygen intermediates, H2O2 and 1O2 appears to be necessary for killing of S. enteritidis. In tests for the ability to trigger an oxidative burst in murine peritoneal macrophages, strain 2547 triggered O2 generation at levels as high as those observed with strain 2822. These studies indicate that the difference between the protective and nonprotective strains is not attributed to susceptibility against active oxygen species nor to the ability to trigger an oxidative burst. From these observations, it is suggested that the difference is not due to differences in resistance to the killing of different strains within macrophages. PMID- 1791340 TI - [Clinical and pathological study of 34 patients with isolation of methicillin resistant Staphylococcus aureus in stool culture]. AB - Clinical and pathological findings of 34 patients with isolation of methicillin resistant Staphylococcus aureus (MRSA) from stools during the past one and half a year were studied. Twenty-three patients (68%) had internal diseases and the remaining were postoperative patients (32%). Thirty-three patients (97%) had diarrhea, and properties of the stools were watery in twenty-four and mushy in nine. The degrees of fever, leukocytosis and increase of serum C-reactive protein as inflammatory signs were various, and these had no relation with severity of diarrhea. Diarrhea preceded MRSA infection of organs except for the digestive tract in 7 patients (21%) and appeared alone in 14 patients (41%). These results indicate that closed observation of the stool was very important for early diagnosis of MRSA enterocolitis. C. difficile were isolated in 17 patients (50%) and there were many patients whom C. difficile took part in diarrhea. We should take notice of this organism on stool culture and therapy of diarrhea. Twenty seven patients (79%) improved and 7 patients (21%) died. Three patients who did had MRSA enterocolitis as one of the cause of death. This shows that early diagnosis and therapy are important and fundamental therapy are the attempt of improvement of the general condition and appropriate use of antibiotics. Pathologically most the common finding was edema of the colon, which was found in 4 of five autopsied patients, and specific findings were not observed. As other findings, edema and bleeding of ileum and multiple erosion of the colon were found in one, bleeding of the colon in one, and neutrophil infiltration and pseudomembrane of the colon in one with isolation of C. difficile. PMID- 1791339 TI - [Herpes zoster in connective tissue diseases: II. Rheumatoid arthritis and mixed connective tissue disease in comparison with systemic lupus erythematosus]. AB - We investigated the incidence of herpes zoster (HZ) and the immunological state to HZ in patients with rheumatoid arthritis (RA) and mixed connective tissue disease (MCTD) in comparison with systemic lupus erythematosus (SLE). HZ occurred in 6 (25%) out of 24 patients with RA and 4 (22%) out of 18 patients with MCTD. One patient had had HZ before the diagnosis of RA. On the other hand, all 4 patients with MCTD had had HZ before the diagnosis of MCTD. The patients with RA and MCTD showed normal or higher antibody titers to varicella zoster virus (VZV) than normal subjects as assayed by both complement fixation technique and neutralization test. However, the antibody levels were not very high compared to those in patients with SLE. On the other hand, only 7 (50%) of 14 patients with RA and 4 (40%) of 10 patients with MCTD showed positive skin reactions to VZV antigen, whereas all 15 normal subjects had positive reactions. Thus, cellular immunity to VZV was thought to be impaired in these diseases. In the patients who were receiving less than 10 mg/day of prednisolone, 7 (64%) of 11 had positive skin reactions in RA patients and 3 (60%) out of 5 patients with MCTD, whereas none (0%) out of 3 patients with RA and 1 (20%) out of 5 patients with MCTD who were receiving 10 mg/day or more prednisolone showed positive skin reactions. These results suggest that the high incidence of HZ in patients with RA and MCTD is probably due to an impaired cellular immunity as in the case of SLE. PMID- 1791341 TI - [Characteristic features of children subjected to vaccination against influenza- in view of the state of their absence from school during a non-prevalence period]. AB - Characteristic features of children subjected to vaccination against influenza were analyzed in view of the state of their absence from school during a non prevalence period of this disease. A total of 31,902 children were divided broadly into those with a history of asthma, allergy or cardiac disease [disease history group, 1,048 (3.3%) children] and those without such a history [non disease history group, 30,854 (96.7%) children]. Each group was further divided into three subgroups according to the number of inoculations (0, 1, 2 inoculations) given during the period between October and November 1988. The three subgroups in each group were compared statistically with regard to the state of absence from school during the non-prevalence period of influenza between April and July 1988, and the following results were obtained. 1. Disease history groups. There was no significant difference among the three subgroups with regard to the rate of absenteeism or mean number of days of absence. Also, no significant difference among them was found in the overall or segmental distribution of days of absence. These findings indicate that the three subgroups of children with a history of disease were almost homogeneous. However, the overall rate of absenteeism was significantly high among children who received one inoculation (p less than 0.001). In this subgroup, the number of children who were absent from school for 21-30 days was greater than that of children who were absent for fewer days. This contributed to the highest overall rate of absenteeism in this subgroup.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791342 TI - Difference in the protection against infection with different challenge strains of Salmonella enteritidis by killed vaccine. AB - Differences in protection against the challenge of different strains of formalin killed cells obtained from Salmonella enteritidis were investigated. When strains 2547, 116M, 116-54, SR-98G, and 3775 were used as the challenge strain, protective effects were apparent in groups of mice immunized with formalin-killed cells from S. enteritidis strains (protective strains). Conversely, no protective effects were observed with the challenge of strains 2822, 3975, and IID-604 (nonprotective strains). Electrophoretic banding patterns of lipopolysaccharides in SDS-PAGE were similar between the LPS obtained from the various strains used in this study. Additionally, no differences in sensitivity to macrophage intracellular killing were observed between the protective and nonprotective strains. Phagocytic experiments by macrophages in vitro indicated that immune serum used as the opsonin promotes phagocytosis of various strains by macrophages as compared to using normal serum as the opsonin, but the rate of phagocytosis enhanced by immune serum is higher in protective strains than nonprotective strains. In studies of passive transfer of immune serum, it was found that mice passively immunized with immune serum could only protect against infection by challenging with protective strains with the exception of strain SR-98G. These results suggest that the protective effect observed with the challenge of protective strains may be due to macrophage phagocytosis enhanced by opsonization with immune serum. PMID- 1791343 TI - [Studies on clinical significance of "Streptococcus milleri group" in respiratory infections]. AB - "Streptococcus milleri group" are the part of the indigenous oral flora, and they are proposed to contain three distinct species: Streptococcus anginosus, Streptococcus constellatus, and Streptococcus intermedius. Though not included in the approved lists of bacterial names, "S. milleri group" are regarded as the causative organisms of suppurative infections, such as oral abscess, brain abscess, lung abscess and empyema. I have studied the clinical significance of the "S. milleri group" in respiratory infections. An investigation was performed to confirm the incidence of "S. milleri group" colonization in healthy 120 volunteers' (20 y/o-80 y/o) throats, and it was found that 11.7% (14/120) were positive. On the other hand, attention should be paid to the fact that the "S. milleri group" was highly isolated, 24 (24.7%) in 97 purulent respiratory specimens (94 sputa and 3 throat swabs) from which no other significant microorganism was recovered. I have measured the serum antibody titers of the "S. milleri group", employing the IFA technique, in 10 patients from whose specimens "S. milleri group" was predominantly isolated, and compared with those of 18 healthy volunteers. Whereas all of the titers of healthy volunteers reveal less than 1:256, those of the patients reveal more than 1:512. And antibody titers to "S. milleri group" showed the highest in two weeks after "S. milleri group" isolation, and came down to healthy adult levels in six weeks or more. Thus far, about half of the causative organisms of acute pneumonia have been reported unknown. In this study I have suggested that the "S. milleri group" plays an important role as the causative organism in respiratory infections including pneumonia. PMID- 1791344 TI - [The clinical significance of specific IgA antibodies in local secretions in cases with chlamydial urogenital infections--comparison with serum antibodies and analysis of antigen specificity by immunoblotting assay]. AB - IgA antibody titers to C. trachomatis in local secretions were measured by immunoperoxidase assay (Savyon kit) in male and female cases with various urogenital infections, and the clinical significance of IgA antibody in the local secretion was discussed. In addition, the antigen specificity of the IgA for C. trachomatis in the local secretions was analyzed by immunoblotting assay. 1) In female cases with cervicitis and male cases with urethritis, the positive rate of IgA antibody in their secretions was higher in cases with C. trachomatis antigen than in those without it. In addition, the IgA antibody titers in their secretions tended to be higher than in serum, suggesting that the result reflected a local immune response at the site of infection. 2) In cases with chronic prostatitis, a condition in which detection of antigen at the site of infection was difficult, the positive rate of IgA antibody in prostatic secretion was 23.6%. We confirmed that most of the IgA antibodies in prostatic secretions were of the secretory type. 3) IgA antibodies in secretions reacted to the major outer membrane protein (MOMP) and 60-Kd polypeptides of the outer membrane of C. trachomatis by immunoblotting assay, proving that they were the secretory IgA antibodies specific for C. trachomatis. These results described above confirmed that measurement of IgA antibody titers in local secretions by immunoperoxidase assay and immunoblotting assay was useful for the diagnosis of chlamydial urogenital infections such as chronic prostatitis, which the antigen detection was usually difficult. Examination of IgA antibody in local secretions was considered to be useful for making a correct diagnosis even in cases who were suspected to have C. trachomatis infection but showed negative antigen. PMID- 1791345 TI - [Studies on uptake of macrolide antibiotics by Chlamydia host cell]. AB - Minimum inhibitory concentration (MIC) of Macrolide antibiotic (ML) against C. trachomatis was found to greatly vary with the cell culture system used for the assay. We then investigated the ability of various cell cultures to uptake MLs in the relation to MIC determination. Penetration of the 14C-labeled MLs, Erythromycin, Jasamycin and Rokitamycin into cells was quantitatively studied by measuring the radioactivity incorporated into McCoy, HeLa229W and HeLa229F cells. It was found that HeLa229W cell showed the lowest MIC for the drugs, followed by HeLa229F cell and then by McCoy cell. Reversely, McCoy cell showed the lowest intracellular concentration of an ML, followed by HeLa229F cell and then by HeLa229W cell. These results indicate that MIC of an ML significantly varies depending on the ability of the test cell to uptake the drug. PMID- 1791346 TI - [Evaluation of micro particle enzyme immunoassay technique (MEIA)-IMx for the detection of antibody to hepatitis B core antigen]. AB - The new Micro Particle Enzyme Immunoassay technique (MEIA, IMx HBc, Abbott) has been recently introduced for the detection of the antibody to hepatitis B core antigen (anti-HBc). To evaluate the feasibility of using the IMx-HBc, we carried out comparison tests with this method and RIA using various sera. Results obtained were as follows: In the test of 813 sera, 427 (52.3%) were positive by both IMx and RIA, two (0.2%) were positive by RIA only, and the remaining 384 (47.3%) were negative by both methods. A good correlation between IMx and RIA was observed with a coincidence rate of 99.8% and a correlation coefficient of 0.969. Examination of diluted sera using IMx revealed that IMx can be used as efficiently was RIA: high anti-HBc titer was found among HBsAg carriers, but not among non HBsAg carriers. Anti-HBc was assayed within 45 minutes by IMx, and the procedure was simple because of the auto analyser used in this method. These results indicate that the sensitivity of IMx is equivalent to that of RIA, and that it is easier to use than RIA. PMID- 1791347 TI - [A case of adult T-cell leukemia (ATL) complicated with multiple nocardial abscesses]. AB - A 45-year-old woman was admitted to our hospital with complaints of fever and lumbago. She was treated for adult T-cell leukemia and thrombocytopenia with 20 mg/day of prednisolone. CT scan showed multiple abscesses in right peri-kidney, right iliopsoas muscle, left subcutaneous region in the abdominal wall and the brain. Left subcutaneous abscess was drained. Gram-positive organisms consisting of filaments were found, and Nocardia farcinica was grown in cultures. After two months of chemotherapy (FMOX, MINO and AMK), all abscesses except one in the brain disappeared. Cerebral abscess was cured fifty days after the start of the treatment with oral administration of Sulfamethoxazole-trimethoprim (SMX/TMP). The mortality of Nocardial cerebral abscess is high. This patient is a very rare case in which multiple Nocardial abscesses including brain abscess was cured by chemotherapy. PMID- 1791348 TI - [A case of cat scratch disease complicated by reversible encephalopathy]. AB - We described a eight-year-old girl with encephalopathy due to cat scratch disease. Cat scratch disease is a common cause of benign, self-limited, regional adenopathy seen among young people. Encephalopathy is uncommon but is a serious complication of cat scratch disease. Cat scratch disease with associated encephalopathy was described by Stevens in 1952. Since then there have been reports of only 39 cases in the English literature. As far as we know, this case is the first case in Japan. In cases of a rapidly progressive encephalopathy, the diagnosis of cat scratch disease should be considered. PMID- 1791349 TI - [Risk of hepatitis C virus infection by needlestick among medical employees]. AB - We have experienced 99 medical employees who had stuck themselves by the needles used by patients in the past 5 years. Sixteen of the 99 cases (16.2%) were of the patients who had hepatitis C Virus (HCV) antibodies. We followed up these 16 medical employees during 24.8 +/- 12.0 months. We could not find any case among them who had seroconverted HCV antibody positive in their serums. We concluded that the risk of HCV infection by the needlestick accident is not so high. PMID- 1791350 TI - [A case report of diarrhea associated with Giardia lambria and Salmonella]. AB - We report a case of diarrhea associated with Giardia lambria and Salmonella. A 28 year-old male who had no chance to go abroad visited our hospital with complaints of abdominal pain, watery diarrhea and fever, but his symptoms persisted in spite of medication. He was admitted to our hospital on the next day for definite diagnosis and treatment. Many trophozoites of Giardia lambria were recognized in the feces. The symptoms were improved using metronidazole, so he was discharged on the 8-th day. The cause of this double infection was not determined. The domestic infection like this case is rare in Japan. PMID- 1791351 TI - Non-O:1 Vibrio cholerae bacteremia: report of two cases. PMID- 1791352 TI - Extensive cellulitis with septic shock caused by Vibrio vulnificus infection--a case report with review of literature. PMID- 1791353 TI - Neurotropism, frozen muscle grafts and other conduits. AB - Axonal regeneration following nerve transection requires a number of cellular and biochemical phenomena in the axons as well as the nerve cell bodies. The nerve cells must survive the trauma. Since axonal severance means amputation of a large axoplasmic volume from the remaining parts of the nerve cell, the cell body must prepare for increased synthesis of axoplasm to replace the missing parts. A sprouting process must be initiated at the level of transection. Regenerating axonal processes are to regenerate towards peripheral targets, a process regulated by an interaction between genetic mechanisms in the nerve cell body and biochemical information at the molecular level along the pathway. PMID- 1791354 TI - Experimental studies on surgical treatment of avulsed spinal nerve roots in brachial plexus injury. AB - This review summarises studies aiming at a surgical treatment of spinal nerve root avulsions from the spinal cord in brachial plexus lesions. After dorsal root injury, regrowth of nerve fibres into the spinal cord occurs only in the immature animal. After ventral root avulsion and subsequent implantation into the spinal cord, neuroanatomical and neurophysiological data show that motoneurons are capable of producing new axons which enter the implanted root. Intra-neuronal physiological experiments demonstrate that new axons can conduct action potentials and elicit muscle responses. The neurons are reconnected in segmental spinal cord activity and respond to impulses in sensory nerve fibres. In primate experiments, implantation of avulsed ventral roots in the brachial plexus resulted in functional restitution. These studies indicate the possibility of surgical treatment of ventral root avulsion injuries in brachial plexus lesions in humans. PMID- 1791355 TI - Vascularised nerve grafts. AB - Since Taylor (1976) successfully performed the first vascularised free nerve graft, experimental and clinical data have not provided conclusive support for the superiority of this method of repairing loss of nerve substance. Experimental work yields conflicting results. Histologic results are in favour of vascularised grafts but non-vascularised fascicular grafts placed in a healthy bed recover sufficient neovascularisation within a short period of time (four to six days). In the field of brachial plexus repair, vascularised grafts give consistent results. However, if thrombosis of the anastomoses occurs, the grafts fail completely. In our experience, vascularised nerve grafts used for repairing digital nerves and arteries, have a high rate of thrombosis. There are few potential donor sites. A nerve graft cannot be considered to be physiologically vascularised if it relies only on an artery or on an arterialised vein. Given the present state of immunosuppressant treatments, vascularised allografts are not yet appropriate. Therefore, vascularised nerve grafts have limited applications. In general it is preferable to repair the tissue bed so as to promote revascularisation of conventional nerve grafts. PMID- 1791356 TI - Obstetrical brachial plexus lesions. AB - The renewal of interest in brachial plexus surgery has been led by the success of microsurgical techniques in other peripheral nerve repairs. The results in adults remain poor, but in obstetrical palsy the regenerative capacity of babies allows for dramatic recovery after nerve repair or reconstruction. Obstetrical brachial plexus injuries represent a unique group with similar aetiology, age and prognosis. PMID- 1791357 TI - A fourth type of brachial plexus lesion: the intermediate (C7) palsy. AB - A new type of brachial plexus lesion has been defined to be added to the classical types, i.e. the upper (Duchenne Erb), the lower (Dejerine Klumpke) and the total type. This new type is the intermediate palsy. The lesion is a partial involvement of the plexus, the predominant lesion of which involves C7 with a variable involvement of the upper or lower plexus. By observations during operation, and in cadavers, three different mechanisms are considered responsible for the three different types of lesion. A trauma with downwards traction principally involves the upper plexus. Trauma in abduction first involves the lower plexus while a traumatic force acting from an anterior to a posterior direction involves firstly and predominantly the C7 spinal nerve which in an anterior position and less oblique than the other roots. Avulsion from the cord or rupture are possible. 33 cases have been observed. PMID- 1791358 TI - How exact should nerve stump coaptation be? A new answer given by "cell surgery". PMID- 1791359 TI - Applying "cell surgery" to nerve repair: a preliminary report on the first ten human cases. AB - We have applied a new technique of nerve repair, based on the principles of "cell surgery", to ten nerve lesions of the upper limb. Eight lesions were recent, five to 36 hours; they were divisions of the ulnar nerve (1), median nerve (2), sensory radial nerve (1), palmar and digital nerves (4). One lesion was 15 days old (median nerve). One eight-month-old loss of 4.5 cm. of the median nerve was grafted. In nine out of the ten cases, the short-term results were encouraging. Poor local conditions (fibrosis of the nerve bed) or poor general health (chronic alcoholism) had no adverse influence on the results. In the remaining case, the protocol was not followed in its entirety: it was not possible to crystallise properly the nerve, and trimming was done with scissors in the conventional way instead of smoothly trimming the solidified tips. The functional result in this case is a failure. These preliminary results seem to indicate that correctly applying the technique in its entirety may be more important than local conditions. We think that this technique can be applied to the majority of nerve lesions. The appropriate equipment is absolutely necessary in order to apply the method. PMID- 1791360 TI - A comparative electrophysiological study on neurotisation in rats. AB - A comparative experimental study has been carried out in rats with denervated gastrocnemius muscles. Three groups of five rats were treated by three different types of implantation of nerve directly into muscle (neurotisation). In the fourth group, the common peroneal nerve was sutured to the transected tibial nerve. The fifth group was left denervated as a control. The muscles were studied by serial electrodiagnostic studies and later histologically. The results showed little difference between nerve suture and implantation of nerve directly into muscle. Extension of the common peroneal nerve with a pair of sural nerve grafts did not produce a detrimental effect. PMID- 1791361 TI - The superficial anastomosis on the palm of the hand between the ulnar and median nerves. AB - The communications between the median and ulnar innervated territories on the palm of the hand have been studied anatomically and microscopically. A communicating branch is well appreciated but its description has had little emphasis in anatomical or surgical literature. 50 cadaveric palms were dissected in both sexes and an anastomotic branch was found in 45 hands. In 43 of them it originated proximally from the ulnar nerve and proceeded distally to enter the third common digital nerve; in the other two hands it left the median nerve to reach the fourth common digital nerve. By microscopic dissection we have seen that the ulnar fibres of the anastomotic branch which join the median nerve may contribute to the sensory innervation of the radial half of the ring finger and ulnar side of the middle finger on its palmar surface. We have therefore described a cutaneous area on the palm where care must be taken to avoid surgical damage to this branch. PMID- 1791362 TI - Vasoactive intestinal peptide and nerve regeneration. AB - The role of vasoactive intestinal peptide (V.I.P.) in nerve regeneration was investigated by assessing the changes in immunoreactive V.I.P. levels in rat sciatic nerves following injury and repair. 60 rats were divided into three surgical groups and one control group: In group I (primary repair), sciatic nerves were divided and immediately repaired; in group II (secondary repair), sciatic nerves were divided and repaired two weeks later; in group III (no repair), sciatic nerves were divided and not repaired; and in group IV (controls), sciatic nerves were exposed but not divided. Animals were sacrificed at three days and at weekly intervals. Their sciatic nerves were extracted and assayed for V.I.P. concentrations by a specific radioimmunoassay. The mean V.I.P. concentration varied between 22 and 46 pg./mg. protein in the control nerves and between 60 and 529 pg./mg. protein in all other groups. In the three surgical groups the levels were significantly higher in proximal than in distal stumps. Following nerve injury, there was an increase in V.I.P. concentration in the injured and repaired areas. This increase was greater in injured non-repaired areas and was highest in the first 48 hours, but continued during regeneration. The accumulation of V.I.P. in divided nerves occurred in response to nerve injury. PMID- 1791364 TI - Lack of topographical specificity in sensory nerve regeneration through muscle grafts in rats. AB - Regenerating sensory axons of each receptor class make new connections with similar denervated receptors. This study investigates to what extent these axons return to their original receptive field. The lateral cutaneous nerves of the thigh in rats were divided and allowed to regenerate across a 6 mm. gap interposed with frozen and thawed muscle graft towards their original distal nerve stump and a "foreign" sensory nerve, the saphenous nerve. 16 weeks later, myelinated axon counts of 26 pairs of distal nerves showed no preferential growth towards the original receptive field. Lack of topographic specificity during sensory nerve regeneration may explain the faulty localisation of sensation after nerve repair in clinical practice. Following sensory nerve regeneration, the somatosensory cortex receives accurate afferent information but from disparate skin sites; this probably alters the relationship of overlapping sensory fields and may be the cause of distorted pattern recognition. PMID- 1791363 TI - Comparison of results of repair of digital nerves by denatured muscle grafts and end-to-end sutures. AB - A further report is made on patients with primary and delayed repair of digital nerves with autogenous denatured muscle grafts. There was evidence of continued improvement in threshold response to tactile stimuli, and discriminative function. These results were superior to those in 24 patients with conventional end-to-end sutures on clinical testing. PMID- 1791365 TI - Accessory nerve injury: conservative or surgical treatment? AB - In order to clarify the functional prognosis of accessory nerve injury after nerve repair and nonsurgical treatment, 27 of our cases with accessory nerve injury were studied. 20 cases were followed up for more than 8 months. In ten cases treated conservatively, the dull feeling and hypaesthesia did not improve. However, pain and dysfunction of the shoulder improved in half of these cases. In ten cases treated surgically, nerve suture was performed in two cases, nerve graft in five cases and neurolysis in three cases. In the surgically treated group, subjective complaints disappeared in all cases, but hypaesthesia or contracture of the shoulder persisted in three cases. Surgical treatment of the accessory nerve is recommended in fresh cases with complete paralysis and in cases in which there is no sign of nerve recovery within one year after the original injury. PMID- 1791366 TI - Results of primary repair of digital nerves. AB - Recovery of sensitivity following repair of 54 digital nerves was evaluated after one to seven years. Normal two-point discrimination has been regained in only seven cases (13%), two-point discrimination between 6 and 10 mm in 20 (37%), between 11 and 15 mm in 13 (24%) and protective sensation in 14 (26%). A close correlation between age and recovery of sensation after repair has been confirmed by statistical analysis. Microsurgical repair of digital nerves gives satisfactory results, since a normal or good two-point discrimination can be obtained in one-half of cases while sensation improves in the others. However a high rate of complete recovery of sensation is to be expected only in children. PMID- 1791367 TI - [Color coding in vascular Doppler echography aimed at improving lesion quantification]. AB - Color flow duplex scanning diffusion is now restricted by an expansive cost. Static or dynamic range of a faint endovascular image can better be assessed by mean velocities. Pathologic high velocities allows visualisation of the direction and the width of the jet. The Doppler cursor can be correctly aligned in the jet core and allows accurate measures, and the display of spectral analysis is better with faster computers. Recently, enhancement of low flow analysis is of particular interest in pre-occlusive or occlusive vascular pathology. PMID- 1791368 TI - [Echogenicity of blood]. AB - The echogenicity of blood is dependent of the back scattering of the ultra-sound beam by the flowing blood-stream. This back scattering is, according to the Raleigh theory, proportional to the fourth power of the frequency and to the size of the particles. So, for the frequencies in clinical use, the size of the particles is essential. Micro bubbles and aggregates of red cells can be echogenic. Micro bubbles are scare. Echoes are mainly generated by blood cells aggregated from a given size for each wave length. For instance, 225 for a 7.5 Mhz frequency. High degree hematocrits and big molecules induce aggregation, but the main factor is the flow speed or more exactly the shear rate, i.e. 8/3 of speed/vessel radius. In clinical practice, blood becomes echogenic if flow slows and if the vessel radius increases. This happens for instance for venous or even arterial aneurysms, for dilatated and dyskinetic cardiac cavities, an above all, in veins when flow slows. Echogenicity appears proximal to an organic or hemodynamic obstacle and is reversible when flow is restored. The technical conditions are important, too. Blood becomes more echogenic when the scan nears, the frequency increases and the resolution of the device goes higher. It can be expected that hemodynamic and even rheologic information will be obtainable in big vessels with computerized techniques quantifying blood echogenicity. Blood clots will be echogenic under the same conditions: red blood cells aggregated non hemolysed.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791369 TI - [Absence of a direct effect of peritoneal dialysate on venous lower limb flow]. AB - In order to verify if the presence of 21 of fluid in the peritoneum is likely to produce a slowing of the venous flow in the lower limbs, 34 patients suffering from end stage chronic renal failure and treated by continuous ambulatory peritoneal dialysis (CAPD) were followed up for two years by means of noninvasive methods. The maximum femoral venous flow velocity before and during CAPD was evaluated using Doppler effect, in 2 positions of the patients (recumbent or upright), and with or without dialysate (abdomen full or empty). The venous distensibility and the maximum venous outflow were evaluated using venous occlusion plethysmography in the recumbent position. Despite a decrease in mean arterial blood pressure (before the start of CAPD: 116.0 +/- 3.7 mm Hg; after 2 years of CAPD: 104.3 +/- 3.2 mm Hg, p less than 0.02), there was no significant slowing of the venous limb flow during the two years of treatment by CAPD, and in no case did the peritoneal fluid constitute a mechanical obstruction. PMID- 1791370 TI - [Microcirculatory hemodynamic effects of Urapidil (Eupressyl)]. AB - A laser Doppler measurement of the microcirculatory flow rate was performed in 10 patients with moderate arterial hypertension before the delivery of a 30 mg capsule of Urapidil and 3 hours later. A significant increase in this flow rate was evidenced, thus demonstrating the arteriolar vasodilative action of Urapidil. PMID- 1791371 TI - [The sapheno-femoral area: Anatomic study and concepts for the prevention of varicose recurrences]. AB - The rate of varicose recurrences from the groin after stripping of the long saphenous vein is still high in case of ligation flush with the femoral vein. Is it due to a vascular neogenesis or to the development of pre-existing collaterals? Many authors highlighted the necessity of the femoral vein dissection, but the evaluation of the recurrence risk remains uncertain. 114 patients have been operated consecutively in 1988-1989 under local anesthesia, to perform 150 long saphenous vein strippings. At the same time as the sapheno femoral junction ligation, a dissection of the front and lateral sides of the femoral vein was systematically carried out from 1 cm above down to 3 cm below the saphenous junction. 14 sub-fascial collaterals going directly to the junction lower angle (frequency rate = 9,3%), 41 internal tributaries of the femoral vein on the whole length of the junction (27,3%), 19 antero-internal (12,6%) and 14 antero-external (9,3%) tributaries of the superficial femoral vein below the junction, capable of draining a superficial area, were noticed in the 150 saphenofemoral areas. Several collaterals might exist on a same femoral vein. Only 86 (57,3%) sapheno-femoral junctions were "isolated", i.e. without deep collaterals. 90% of the antero-internal collaterals were located from 0 to 15 mm below the junction and their diameter was from 1,5 to 3 mm (in supine position, i.e. without any orthostatic reflux !) in 78,9% cases. All the antero-external collaterals were located from 10 to 30 mm below the junction, but they were nearly always equal or less than 1 mm wide.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791372 TI - [The homocysteinemia vascular risk factor. Methodologies and application to a clinical case]. AB - Early onset vascular disease unexplained until today by usual risk factors (hyperlipidemia, hypertension, tobacco, stress), can now find an explanation in sulfur amino acid metabolism defect. By transsulfuration, alimentary methionine leads to homocysteine, which is itself turn into cysteine, or remethylated into methionine. Several abnormalities of these different pathways lead to plasma accumulation of homocysteine, which will be responsible of arterial or venous occlusive lesions, concerning peripheral or deep vessels. Homocysteine stays in plasma upon several forms: 75% being linked by disulfide bounds to proteins, 22% as disulfide, homocystine (homocysteine-homocysteine) or mixed-disulfide (homocysteine-cysteine), and less than 3% as free reduced homocysteine. Plasma reduction allows total homocysteine evaluation with amino acid autoanalyzer. The basal plasma homocysteine level is less than 14 microMl. However, levels near this basal value can be found in patients with latent abnormality, which needs to be revealed by a methionine loading test. This study concerns two methodologies and their application to the exploration of a patient with unidentified neurologic disorders. The first one describes a new galenic oral form of methionine. Other authors use the methionine load of 100 mg/kg dissolving it in a fruit juice glass. In order to obtain a complete dissolution of this weakly soluble substance and to ensure its total absorbtion by the patient, we prepare a granular form aimed to give in water a perfect flavoured suspension. The second methodology concerns methionine loading test and amino acid analysis. After 10 hours fasting, a 100 mg/kg peroral methionine load is realized performing 5 EDTA blood samples before and 4, 8, 12 and 24 hours after loading.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791373 TI - [Sub-crural bypasses via saphenous vein in situ. Predictive factors of early occlusion]. AB - Twenty-six early occlusions were encountered in a series of 155 infrainguinal saphenous vein bypasses for arterial disease. By univariate and logistic regression analysis, two predictive factors were found to be strongly associated with early occlusion: vein fibrosis (F) and uncorrected intraoperative arteriographic anomaly (A). Regression coefficients were 0.775 +/- 0.343 for F and 1.125 +/- 0.352 for A. The probability (p) of early occlusion of bypass is: [formula; see text] (Exp = Exponent) The vein diameter, the quality of run-off, the site of anastomosis and the length of the bypass were not predictive of early occlusion. We conclude that 1) the presence of fibrous ipsilateral saphenous vein should prompt using the contralateral vein, and 2) routine intraoperative arteriograms of the entire length of the bypass should be obtained: any anomaly visible on the intraoperative films should be corrected immediately, even if it seems minute or if bypass flow seems otherwise adequate. PMID- 1791374 TI - [Spontaneous dissection of the internal carotid artery]. AB - Spontaneous dissections of internal carotid artery are known from more than 30 years and their incidence is now specified, several hundred cases being published. The case reported here illustrates very well the setting problems of this disease and explains why the incidence of the mild forms has been underestimated. The case of a sixty years old man with vague vertiginous feeling, headache and moderate ocular troubles is presented. The clinical signs disappeared within six weeks. The patient was seen again in good health seven years later. The medical practitioner by asking a systematic Doppler examination led to the diagnosis confirmed by arteriography. A complete recanalization of the internal carotid artery occurred. These forms with spontaneous favourable prognosis represent at least 50% of the cases. PMID- 1791375 TI - [Leg ulcers in Werner's syndrome. Report of one case]. AB - Werner's syndrome (adult progeria) is a rare autosomal recessive condition characterized mainly by a characteristic habitus (short stature, light body weight) scleroderma like changes of the limbs and premature aging. Chronic leg ulcers appears in about fifty per cent of the patients. These ulcers can be related to the combination of mechanical factors on atrophic subcutaneous tissue and skin of the feet and leg associated with early arteriosclerosis (20%) and diabetes mellitus (60%). PMID- 1791376 TI - [Behcet's disease with multiple arterial lesions and voluminous hemangioma of the brain]. AB - A case of a 43-years-old patient with a 9-year history of Behcet's disease is reported. The diagnosis was based on the past of bilateral hypopion iritis, oral aphthous ulceration and venous thrombosis. A right lower limb monoparesia occurred. CT scan and angiography showed a voluminous intracerebral angiodysplasia and an aneurysm of the left anterior communicating artery. Careful angiographic examination of visceral and peripheral arteries showed bilateral thrombosis of subclavian arteries, thrombosis of superior and inferior mesenteric arteries and an aneurysm of the coeliac trunk. Large arterial involvement is an unusual complication of Behcet's disease. A through review of the literature showed only 2 reported cases of intracranial arterial aneurysms. This case report was the first case of Behcet's disease with an intracerebral angiodysplasia. PMID- 1791377 TI - [Distal obliterating arteriopathy of the lower limbs in a systemic disease. Treatment with normovolemic hemodilution. [Report of one case]]. AB - The authors report on a 31 year old man with a generalised illness consisting of: buccal aphthous ulcers, distal arteriopathy, multiform cutaneous lesions (necrotising vasculitis, folliculitis, nodules), hypersensitivity at the site of puncture, Raynaud's syndrome and superficial venous thromboses. After the failure of various therapies (calcium heparin, ticlopidine, colchicine, corticoids, immunostimulants), the patient was successfully treated by normovolemic haemodilution on 20 occasions, obtaining each time healing of the skin lesions within 2 to 4 weeks. PMID- 1791378 TI - [Treatment of hypertension in arteritic patients]. AB - The treatment of hypertension in arteritic patients must take account of several parameters: respective severity of hypertension and of arteriopathy, possibility of other sites of atherosclerosis and supposed cause of hypertension. The association of essential hypertension and of an arteriopathy does not sum up all possibilities. Hypertension may be purely systolic, due to decreased compliance. A stenosis of the renal arteries is also worth evoking in the context of an already symptomatic atherosclerotic disease. For the confirmation of the latter hypothesis, Doppler associated to echography may be an alternative to the intravenous or intra-arterial opacification of the renal arteries. In case of moderate hypertension (diastolic pressure ranging from 90 to 104 mmHg), non medicamentous treatments should be preferred: low-sodium diet, suppression of tobacco and other risk factors, weight loss. Beta-blockers, whatever their class, reduce the walking distance in case of intermittent claudication. Though not formally contraindicated, especially when their use is justified by an associated coronary insufficiency, they are not advised in hypertensive arteritic patients. On the other hand, captopril allows both reducing blood pressure and preserving the walking distance. However, a prerequisite to the possible use of agents inhibiting the conversion enzyme is the preliminary search for a stenosis of the renal arteries. In fact, when these medications are carelessly used in case of bilateral stenosis or of stenosis on a functionally single kidney, they entail a risk of renal failure or of thrombosis of the stenosed renal artery. Calcium inhibiting agents are also anti-hypertensive substances of choice in hypertensive arteritic subjects.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791379 TI - [Non-medicamentous prevention of thromboembolic disease]. AB - Virchow's work has showed that thrombogenic situations may have a hematological, either congenital or acquired, parietal or hemodynamic nature. Primary and secondary non-medicamentous prevention of thromboembolism is aimed at screening the patients at risk, avoiding or reducing the alterations of the venous walls, and, most importantly, improving failing or altered venous hemodynamics. The authors review the various clinical and biological situations entailing an increased thrombogenic risk. They sum up the various methods of prevention of venous stasis: Nard's method, associating bandages and deambulation, as well as various techniques of contention, hemodilution, compression with inflatable boots, electric stimulation or assisted mobilization. These methods are used as ambulatory or bedside treatments and in the intra- and perioperative periods, as the case may be. The few studies relating to non-medicamentous methods of prevention of thromboembolism demonstrate their great effectiveness, which is equal to that of the modern heparin treatments. The prevention of thromboembolism is best carried out by associating the latest chemical therapies to non medicamentous physical methods, which are still of current interest. PMID- 1791380 TI - Native valve infective endocarditis at Siriraj Hospital, 1982-1989. AB - During January 1982 to June 1989, there were 105 evaluable adult cases of native valve infective endocarditis admitted to Department of Medicine, Siriraj Hospital. The incidence was approximately 2.6 per 1,000 admissions. The male to female ratio was 1.4 and the mean age was 31.6 years. Thirty (28.5%) were cases associated with intravenous drug abuse. All non-addicts had pre-existing cardiac lesions susceptible to endocarditis especially rheumatic mitral regurgitation, aortic regurgitation, VSD and PDA. The clinical features of cases without intravenous drug abuse were low grade fever for few weeks, malaise, dyspnea and heart murmur. The addicts with endocarditis presented with acute febrile illness and pulmonary symptoms. Mucocutaneous embolic lesions were detected in one third of the patients. Echocardiography detected vegetations in 50 per cent of the patients. Streptococci were the most common causative agent in 93 per cent of non addicts whereas the same percentage in addicts were caused by S. aureus. Most of the patients were treated with beta lactams (pen G, ampicillin or cloxacillin) alone or combined with aminoglycosides (streptomycin or gentamicin) for a duration from 10 days to 16 week. Six cases had valve replacement operation due to intractable heart failure and valve ring abscess, 2 had embolectomy of major arteries and 2 had craniotomy due to intracerebral hemorrhage. The overall case fatality rate was 14 per cent. The causes of death were heart failure, cerebral complications and severe pulmonary infections. Clinical response was observed sooner in non-addict patients. PMID- 1791381 TI - Causes of diplopia. AB - A prospective study of 96 diplopia patients was analyzed concerning the common types and causes in order to develop early and proper management. Two-thirds (62) of the patients were male (64.6%). The average age was 34.5 +/- 15.7 years (+/- SD). The result revealed that the common types of diplopia were horizontal, vertical and torsional diplopia, respectively. The common causes of diplopia were head trauma (38.5%), systemic diseases from diabetes mellitus, hypertension (20.8%), undetermined group (15.6%), eye diseases (9.4%), and etc. Sixth cranial nerve paralysis was frequently found among the third, fourth and sixth cranial nerves. There were 13 cases of spontaneous fusion in the primary position. Only 7 of 12 surgical cases eventually achieved satisfactory alignment and fusion. PMID- 1791382 TI - Psychiatric consultation at Srinagarind Hospital: a report on 271 cases. AB - The author reviewed psychiatric consultations at a teaching general hospital over a two year period. Two hundred and seventy-one patients or 0.6 per cent of all admission were referred for psychiatric consultation. The referral rate from the medical and surgical departments were higher than that of other departments. The most common psychiatric diagnosis by psychiatric consultants was delirium, followed by adjustment disorder and mood disorders. The delirious patients were significantly older than the other groups. The delirious state was commonly caused by infectious diseases, diseases of the nervous system and sense organs and disorders of fluid, electrolyte and acid-base balance. Most of the patients who had two or more active medical problems would have greater incidence of delirium. The delirious patients tended significantly to have behavior that disturbed the therapeutic environment. Among the functional psychiatric disorder patients, 22.4 per cent manifested suicide attempts as the principal reason for admission to non-psychiatric wards. The study revealed that the consultee could give the proper psychiatric diagnosis in only 18.3 per cent of the delirious group, 21.2 per cent in other organic mental disorder group and 24.6 per cent in functional psychiatric disorder group. Most of the consultees described only the psychiatric symptoms of the referred patients and did not specify the psychiatric diagnosis. The most frequently stated reason for psychiatric consultation was for proper evaluation and management. PMID- 1791383 TI - Diagnosis of ectopic pregnancy by ultrasound in Siriraj Hospital. AB - The study of the diagnosis of ectopic pregnancy was carried out during the whole year of 1988 in the Department of Obstetrics & Gynaecology, Siriraj Hospital, in order to find out the characteristics of ultrasonographic findings by using real time ultrasound. Real time ultrasound examination was carried out on 121 patients with suspicion of ectopic pregnancy. The final diagnosis among these patients was ectopic pregnancy, ruptured corpus luteum, ruptured appendicitis, normal pregnancy, abortion, adnexal mass and no gynecologic abnormality encountered in 21 (17.35%), 3 (2.48%), 1 (0.83%), 27 (22.31%), 4 (3.3%), 43 (35.54%) and 22 (18.18%) respectively. Of 21 patients with ectopic pregnancy 17 (80.95%) cases were between 15-30 years of age with the gestational age ranging from 6 to 12 weeks in 16 patients (76.19%). The majority of the patients 18 (85.7%) were para 0-3. The ultrasonographic findings were pelvic mass and fluid in the cul de sac, pelvic mass and fluid in the cul de sac, pelvic mass only and the presence of free fluid alone encountered in 17 (80.95%), 3 (14.28%) and 1 (4.76%) cases respectively. PMID- 1791384 TI - Lung cancer: epidemiology and chemotherapy of advanced disease: the Hong Kong perspective. PMID- 1791385 TI - Serum and urinary uric acid levels in healthy subjects and in patients with urolithiasis. AB - Serum uric acid and 24-hour urine uric acid levels were determined in 47 patients with urolithiasis and in 177 healthy volunteers. The normal volunteers had serum and urinary uric acid levels of 6.0-6.4 mg/dl, 619.4-683.7 mg/day for males and 4.6-4.8 mg/dl, 531.5-589.6 mg/day for females. Uric acid levels in both serum and urine were higher in male volunteers than in female volunteers (p less than 0.05), whereas, among patients the ranges of serum and urinary uric acid levels were not significantly different between males and females (p greater than 0.05). However, the normal distribution of the determined small experimental data, was statistically different and is obviously reliable. Patients with urolithiasis showed significantly higher levels of serum uric acid (8.0 +/- 0.3 mg/dl) than healthy volunteers (5.5 +/- 0.1 mg/dl) (p less than 0.05), but showed no difference in urinary uric acid levels compared with healthy volunteers (p greater than 0.05). The highest number of urolithiasis in both male and female patients fell within the same age range of 41-50 years. The 24-hour urine pH of healthy volunteers showed a range of 5.1-7.0 while the patients with urolithiasis had a pH range of 4.6-7.0. It was also found that 33 per cent of patients had urine pH less than 5.0. PMID- 1791386 TI - Silicosis in ceramic-industry workers with particular reference to the diagnostic value of bronchoalveolar lavage. AB - We could identify, via bronchoalveolar lavage, crystals in the lavage fluid and in the alveolar macrophages. Thus, BAL could be another method for diagnosing silicosis patients. PMID- 1791387 TI - Symptomatic vertebral haemangiomas: report of two cases. AB - The authors reported two cases of vertebral haemangiomas with spinal cord compression. The first case deteriorated during her pregnancy. Plain radiography of the thoracic spine gave the hint for the diagnosis and computed axial tomography showed the lesion. She was treated via surgical removal with minimal improvement of her paraparesis. The second case was diagnosed after operation because there was no abnormality over the relevant vertebra and the myelogram demonstrated an extradural mass lesion compressing the lower thoracic spinal cord. The patient improved satisfactorily after total removal of the tumour. Both surgical specimens were classical pictures of haemangiomas histologically. PMID- 1791388 TI - Intra-abdominal bleeding in appendicitis. AB - A 34-year-old woman, gravida 6 with 10 weeks of gestation was admitted because of abdominal pain and fainting. On physical examination she had hypotension, was pale with abdominal tenderness and guarding. Culdocentesis yielded unclotted blood. Immediate laparotomy was performed, because a diagnosis of ectopic pregnancy was made. About 2,500 ml of fresh blood was found in the abdominal cavity. Appendicular artery tear caused active arterial bleeding. The torn appendicular artery was observed to be the consequence of perforated appendicitis, which, in turn, was caused by a faecalith. Appendectomy was performed and she made a good recovery. PMID- 1791389 TI - Postoperative mitomycin-C eye drop and beta radiation in the treatment of pterygia. AB - One hundred and forty-seven eyes (137 patients) with primary pterygia were treated with excision with additional therapy, and were followed up for three months to six years after treatment. Of 85 eyes that underwent excision and postoperative instillation of 0.02 per cent mitomycin-C, there were three which had corneal recurrence (3.5%) and four had conjunctival recurrence (4.7%). The other 62 eyes were treated with beta radiation, there were nine with corneal recurrence (14.5%) and three had conjunctival recurrence (4.8%). Adjunctive therapy with mitomycin-c eye drop reduced the recurrence rate significantly (P less than 0.1). Complications occurred in five eyes (6%) by using mitomycin-c eye drop which included allergic reaction, granulation mass and mild scleral necrosis. Two of 62 eyes (3%) treated with beta radiation had complications of granulation mass. We found that pterygium excision with mitomycin-c eye drop to be effective in prevention of recurrent pterygium. PMID- 1791390 TI - Determination of teichoic acid antibody for the diagnosis of pediatric staphylococcal infections. AB - Determination of teichoic acid antibodies by Enzyme-linked Immunosorbent Assay (ELISA) was done in 39 patients with Staphylococcus aureus infections and 151 patients who did not have a history of serious staphylococcal infections. The latter who were treated for other diseases served as controls. Various levels of teichoic acid antibodies below 1:3,200 were detected in controls while significantly higher levels were seen in patients with Staphylococcus aureus infections. PMID- 1791391 TI - Efficacy of Phyllanthus amarus for eradication of hepatitis B virus in chronic carriers. AB - Sixty-five adult asymptomatic chronic carriers of hepatitis B virus were enrolled to the randomized controlled efficacy study of Phyllanthus amarus. Thirty-four received Phyllanthus amarus 600 mg per day for 30 days and 31 received placebo in identical capsules. The conversion rate of HBsAg was 6 per cent in the study group at day 30. When 20 subjects in the Phyllanthus amarus group were given a further 30-day treatment and 22 placebo recipients given Phyllanthus amarus 1,200 mg per day for 30 days, the conversion was observed in 1 (5%) in the higher dose group. Adverse effects were not observed in all patients receiving the plant. The results indicated that Phyllanthus amarus, whole plant except root, grown in the central part of Thailand, given at the studied dosage and duration, had a very minimal effect on eradication of HBsAg from Thai adult asymptomatic chronic carriers. PMID- 1791392 TI - Breast-feeding and infant growth in the first six months. AB - Weight and length of 67 breast-fed infants were followed every two weeks from birth to 6 months. All infants were healthy and developed normally. Weight curves were found to be parallel to the NCHS and Bangkok curves up to 4 months then bending slightly but not statistically significant. This supports "the breast-fed infants having a different growth pattern from the mixed (breast-formula) fed" finding observed in studies from developed countries. In comparison to the NCHS and Bangkok length data, rural male infants were significantly (p less than 0.01 and 0.05 respectively) shorter from birth onwards, whereas, median lengths of the rural female infants were significantly shorter (p less than 0.01 and 0.05 respectively) after 4 months. Genetic influence on linear growth was thought to be the cause. The cautious use of the current growth curves on breast-fed infants was emphasized. PMID- 1791393 TI - Nasopharyngeal carcinoma: results of treatment by radiotherapy vs chemotherapy plus radiotherapy. AB - To determine the efficacy of neoadjuvant chemotherapy over radiotherapy alone in locally advanced nasopharyngeal carcinoma, a prospective non-randomized study was performed from 1 January 1982 to 31 December 1985 at Ramathibodi Hospital, Thailand. There were 69 new cases who completed treatment and were followed up at least once. Thirty-three cases were treated by radical radiotherapy (RT) alone and 36 cases by chemotherapy (CT) + RT. CT were by the combination of cis diamminedichloroplatinum II and 5 fluorouracil. Of 32 cases, 2 courses of CT were given before RT and 1 after. The other 4 received 3 courses prior to RT. For both groups, RT technique and dosage were similar. Follow-up time of both groups ranged from 6-104 months (mean 50.3, median 50) and 8-100 months (mean 52.2, median 54.5), and total failures were 18/33 and 13/36, respectively, with no statistical difference (p greater than 0.05). Estimated actual survival and disease free survival from Kaplan-Meier curves at 3 years were about 75 per cent vs 75 per cent and 65 per cent vs 65 per cent, respectively, with no statistical differences (Log-Rank test). Therefore, we concluded that induction chemotherapy had some benefit but no statistical significance over RT alone. However, the role of maintenance chemotherapy is now being studied. PMID- 1791394 TI - The use of nebulized salbutamol in patients with bronchospasm during anaesthesia: a clinical trial. AB - The 2.5 mg salbutamol in 2.5 ml normal saline (Ventolin nebules) was used in 22 patients with unexpected bronchospasm via a nebulizer connected to an inspired limb of an anaesthetic machine. Recording of cardiovascular effects, specific notes of breath sound according to symptom severity (clinical lung score), arterial blood gases and airway pressure, was made every 5 minutes up to 30 minutes. The PaCO2 decreased and a/A ratio appeared to increase (improved shunt effect) significantly. However, the cardiovascular effects showed no statistical significance. The airway pressure as well as the clinical lung score appeared to decrease significantly to normal limits 20 minutes after the therapy. We conclude that the use of nebulized beta 2 selective bronchodilator is suitable in the treatment of unexpected bronchospasm without any cardiovascular disturbances. PMID- 1791395 TI - Multidisciplinary "limb salvage" treatment of osteosarcoma. AB - Intraarterial plus systemic chemotherapy of cis-diamine dichloroplatinum-II and anthracycline together with preoperative radiation and "limb salvage" treatment have increased the chance of local control and facilitated the previous surgically nonresectable to be resectable. Among 30 cases of osteosarcoma from 1986-1989, aged 9-43 years old, 10 of the 17 cases (58.8%) are still alive with the mean disease free survival of 27.8 months. Late pulmonary metastases cause the need for future protocol for prophylactic lung therapy. PMID- 1791396 TI - Community mental health. AB - They way of life in this modern day has evolved in such a way as to weaken many of the traditional supports and amenities. The extended family, the small town, the life time job (mostly agriculture), the stable marriage, the belief in Buddhism and family elders are now less available for help and comfort during a crisis. As social supports have declined, the mental health workload has multiplied both in member and range of responsibility. Before mental health well assume to be a leading problem in the changing society, we, as a mental health professionals should explain and acknowledge our collective limitations. Cooperation and support from all sectors, government and private organizations, from low level personnel to key men in administration and political positions are necessary. More realistic boundaries for our responsibilities in comprehensive Community Mental Health care should be established, but the line is not easy to draw. PMID- 1791397 TI - Cryptococcal meningitis in pregnancy: a case report. AB - We report a pregnant woman with cryptococcal meningitis. She experienced symptoms of meningitis before gestation which worsened during pregnancy. Combined treatment of amphotericin B and flucytosine, including ventriculo-peritoneal shunt gave a favorable outcome for both the patient and her child. We suggest that pregnant women with cryptococcal meningitis should continue their pregnancy and prefer to use combination of both drugs in standard doses because of the effectiveness, shorter duration of treatment and less toxicity than amphotericin B alone. PMID- 1791398 TI - Hereditary essential myoclonus. AB - A family is reported in which 11 members in 4 generations had a benign form of essential myoclonus of early onset. The myoclonic jerks were mostly asynchronous and dysrhythmic. They occurred spontaneously when relaxed, induced by movement, increased in tonus and emotional stress. Generalized seizures was found in 3 members who also had essential myoclonus. The relationship between essential myoclonus and idiopathic epilepsy was stressed. Beneficial effect was obtained with alcohol and clonazepam. PMID- 1791399 TI - Electron microscopical evaluation of connective tissue healing to periodontally involved teeth. AB - The present study was undertaken to examine if our novel root treatment for human periodontally involved teeth can facilitate a new connective tissue attachment. The novel treatment was in two parts: 1) planning and surface decalcification with citric acid on the coronal quarter of the exposed root corresponding to pocket, and 2) curettage of superficial cementum of the apical three quarters of the exposed root. The interface of the root surface and regenerating connective tissue was observed 2 and 3 weeks after surgery by light and electron microscopy. The apical migration of junctional epithelium was effectively prevented. The fibroblasts synthesized new fibrillar materials and collagen fibrils towards the curetted cementum. The results suggested the possibility that this treatment for periodontally involved teeth would provide ideal root surface conditions for the formation of new fibrous attachment. PMID- 1791400 TI - Ultrastructural study of isolated rat hepatocyte suspensions incubated in incomplete or complete culture medium. AB - Ultrastructural changes in isolated rat hepatocytes (IHC) in suspension were examined after 1, 3, 5 and 10 hr incubation, and the influence of Krebs-Henseleit (K-H) buffer as an incomplete medium and GIT culture medium (Nihon Pharmaceutical Co.) as a complete culture medium were investigated. The viability was approximately 60-75% after 1, 3 and 5 hr incubation, and was slightly higher in GIT medium than K-H buffer. Immediately after isolation, IHC showed a cuboidal shape, and after 3 and 5 hr incubation, a round shape with numerous surface microvilli. Cytoplasmic organelles appeared almost normal. After 10 hr incubation, cells reaggregated and the number of autophagic vacuoles increased. Cellular changes, such as slight dilatation of the endosplasmic reticulum and Golgi apparatus, and bleb formation in the cell surface, were more often observed in IHC incubated in K-H buffer than in GIT medium. IHC incubated in GIT medium contained glycogen particles in the cytoplasm, and lipoprotein-like particles were observed in the cisternae of Golgi apparatus and smooth endoplasmic reticulum. The lipoprotein-like particles were found in the intercellular spaces after 10 hr incubation. These results suggest that GIT medium is superior to K-H buffer in its ability to preserve normal structure and function of IHC. PMID- 1791401 TI - Immunoelectron microscopy of Fc receptors on the surface of clinical isolates of streptococci. AB - The distribution of Fc receptors on the surface of clinical isolates of streptococci was examined by immunoelectron microscopy. A unique two-layered ferritin tagging was observed on the surface of isolate MS-4 (group A). The spacing between the layers (10-40 nm) was narrower than that of the layered protein A (30-70 nm) on Staphylococcus aureus. Labeling on the other isolates, IP 28 (group A) and ES-21L (group C), showed similar rough layers, but the labeling were clearly different in thickness and density. The labeling on isolate IP-28 was also similar to that on strain AR1 (group A), reported previously, while the labeling on ES-21L was similar to that on protein G producing strain G148 (group G) in thickness. However, it was obviously thinner than that on IP-28 and AR1. These results strongly suggest that there are at least three distribution patterns of Fc receptors on streptococci, and these are distinct from that of protein A. PMID- 1791402 TI - SEM images of DNA double helix and nucleosomes observed by ultrahigh-resolution scanning electron microscopy. AB - We observed DNA double helix and nucleosomes in the chromatin of chicken erythrocytes by ultrahigh-resolution scanning electron microscopy. Specimens were prepared according to a modified microspreading technique in combination with the carbon plate method and observed without metal coating. A part of the DNA fibers without nucleosomes showed "left-handed" double-strands with twisting appearances and regular periodicities of the helix. Linker DNA between the nucleosomes showed "right-handed" appearances. Most of the nucleosome particles appeared as prolate ellipsoidal shapes of various sizes. DNA appeared to enter and exit the nucleosome particles on opposite sides winding around the histone core. PMID- 1791403 TI - Microstructures of the bony modiolus in the human cochlea: a scanning electron microscopic study. AB - The structures of the bony modiolus of the human cochlea are studied by scanning electron microscopy after macerating the organic material with a NaOCl solution. The modiolus on the scala vestibuli side had a canal for the spiral modiolar artery. Ducts for the radiating arterioles spread radially from the canal, and opened to furrows in the roof of the scala vestibuli. The surface of the modiolus facing the scala tympani was lace-like with numerous pores. Just beneath the bone surface were a modiolar canal for the spiral ganglion and spirally-arranged spaces for the anterior and posterior spiral veins. The spiral spaces for the veins had windows (fenestrations) leading to the scala tympani. The openings in the bone on the scala vestibuli and tympani sides of the modiolus are considered to be communication routes for the transport of fluids from the perineural and perivascular spaces in the modiolus to the perilymph in the scalae. PMID- 1791404 TI - An evaluation of the usefulness of air-drying biological samples from tetramethylsilane in preparation for scanning electron microscopy. AB - A survey was done, using a limited number of animal, plant and insect samples, to evaluate the quality of structural preservation obtained when chemically fixed tissue is air-dried from tetramethylsilane (TMS). Comparisons were made with critical point drying (CPD) and air-drying from acetone (Controls). CPD samples showed good structural preservation in all cases. For some animal tissue, TMS and Control samples showed structural preservation comparable to CPD. In other animal tissues the order of structural preservation was CPD greater than TMS greater than Controls. Air-drying caused gross distortion in the botanical samples. PMID- 1791405 TI - Study of noise pollution in Jeddah hospitals. AB - The present study was conducted on a sample of 6 hospitals in Jeddah to investigate the status of noise pollution there, and as related to community background noise, operational activities, hospital size and operational concepts (public vs private). Generally, the levels of noise in the clinics, patient rooms, offices, waiting areas and corridors significantly exceed the recommended standard. The noise levels in the machinery rooms significantly exceed the levels in offices, waiting areas and corridors which, in turn, significantly exceed the levels in clinics and patient rooms. Background community noise has a little impact on indoor noise due to the construction characteristics of the hospitals' buildings. However, "operational noise" from machinery and from the move of public (patients, attendants and employees) significantly contribute to indoor noise. Proper site location, city planning, traffic engineering, building construction, equipment selection, construction and equipment maintenance, and system management have been recommended for the abatement of hospital noise pollution. PMID- 1791406 TI - Construction of a local standard symphysis fundal height curves for monitoring intrauterine fetal growth. AB - The aim of the present study was to construct standard symphysis fundal height percentile curves to be used as a reference chart in monitoring fetal growth. The construction was based on 1185 observations (symphysis fundal height measured to the nearest 0.5 cm by a malleable elastic tape) obtained from follow up of 105 cases of healthy pregnant women who were: sure of date of their last menstrual period, confirmed by early dating scan "before 20th gestational week", experienced a very strict normal course of pregnancy, giving birth to normal term newborn with appropriate weight for gestational age and sex. The selection of the study sample went through several screening levels starting by 4088 cases and ending by 105 cases. The measurements were taken biweekly from the 18th week of gestation to delivery "37-42 weeks of gestation." Tenth, 25th, 50th, 75th, 90th and 95th percentiles were calculated and represented graphically. Mean, mean-1 SD, mean-2 SD, mean +1 SD, mean + 2 SD were also calculated and represented graphically. The curve of best fit was determined by polynominal regression. The resulted percentile curves and mean values were found to be comparable to those in both developed and developing countries. It was recommended to incorporate the reference charts of symphysis fundal height into the maternity services after using it in routine antenatal examination for large number of cases and establishing its sensitivity and specificity. PMID- 1791407 TI - Cloning and expression of the lepidopteran toxin produced by Bacillus thuringiensis var Sotto in Escherichia coli. AB - During sporulation, Bacillus thuringiensis var. Sotto produces a parasporal crystalline protein which is toxic for the silk-worm, Bombyx mori and the cotton leaf worm, Spodoptera littoralis. The gene coding this crystal protein is present in a single plasmid. The plasmid DNA was isolated, purified and physically mapped using restriction endonuclease enzymes (R.E.). The gene coding the delta endotoxin was inserted into Escherichia coli-Jm103, using cloning vector pUC8. Transformed E. coli cells were found to synthesize the delta-endotoxin as demonstrated by the pathogenicity of the transformed cells against 4th instar larvae of S. littoralis. PMID- 1791408 TI - Prognostic value of cerebrospinal fluid protein content and leukocyte count in infants and childhood bacterial meningitis. AB - Seventy infants and children with bacterial meningitis were studied. All children were treated with ampicillin and chloramphenicol. A significant increase in the cerebrospinal fluid protein concentration determined on admission was found in patients who died as compared to those who survived (P less than 0.05). However, no difference was observed between the admission CSF leukocyte count in those patients who died versus those who survived. From this study, it can be concluded that the determination of CSF protein level on admission is an easy, fast and reliable method that can be used to predict clinical outcomes in acute bacterial meningitis. PMID- 1791409 TI - Selection of susceptible lines of Biomphalaria alexandrina and Bulinus truncatus snails to S.mansoni and S.haematobium infection. AB - Selection of progenies from infected B.alexandrina and B.truncatus snails resulted in higher infection rates. This observation was consistent when the source of micardia were from either infected human or hamsters. Infection rate of B.alexandrina increased up to 88.2% while B.truncatus did not. Compatibility between the parasites and their intermediate hosts were also studied. PMID- 1791410 TI - Effects of maternal sickle cell haemoglobinopathy on pregnancy. AB - In order to determine the significant factors which may contribute to complications in pregnant mothers with sickle cell haemoglobinopathy, a study was considered on 100 mothers (35 SS and 65 AS) and the results were compared with 20 control women with normal haemoglobin electrophoretic pattern. The incidence of vaso-occlusive was significant in mothers with sickle cell disease. Furthermore, it was observed that high levels of fetal haemoglobin did not have any beneficial effect in patients with sickle disease during vaso-occlusive episodes. PMID- 1791411 TI - Specific rubella virus IgG and IgM in umbilical cord sera in Saudi Arabia. AB - The sensitive ELISA assay was used to measure the specific rubella virus IgG & IgM, and also the total IgM in the umbilical cord sera taken from 182 Saudi mothers during delivery in the Maternity Department at Al Ali General Hospital, Riyadh, Saudi Arabia. Nearly 84.6% (154 out of 182) Saudi women tested were found to be immune to rubella virus. PMID- 1791412 TI - Rubella virus antibodies in women of childbearing age. AB - Rubella is a common contagious disease with mild constitutional symptoms, but when it occurs during pregnancy there is significant risk of severe damage to the fetus. A study was undertaken to determine the level of rubella virus antibodies in females in the childbearing age (from 15-40). A total of one hundred and thirty sera were examined for rubella-specific IgG antibodies by hemagglutination inhibition (HAI) test. Ninety out of these sera were examined also by ELISA, for comparative purposes. It was found that, by HAI test, the percentage of antibody positive sera in the females was 72.2% (HAI titer greater than 1:16), while by the more sensitive ELISA test, the percentage of antibody positive sera was 92.2% (50 IU/ml antirubella IgG). The most susceptible females were in the age group of 20-25 years. The need to ensure the protection of seronegative susceptible women of childbearing age by immunization before marriage or pregnancy is emphasized. ELISA is more sensitive, rapid, specific, reproducible and easily adaptable test to large scale screening than the conventional HAI test. PMID- 1791413 TI - Chlamydial infection in Riyadh, Saudi Arabia. AB - Sera of patients attending a genitourinary clinic, gynaecological clinic in Al Ali General Hospital, Riyadh, Saudi Arabia and from males and females without overt genital diseases were tested for the presence of antichlamydial antibodies using an immuno-fluorescence test. Antibodies for Chlamydia trachomatis were found in 66 (46%) of 145 male patients and 72 (35%) of 200 female patients attending a genitourinary clinic and gynaecological clinic respectively and in two (2%) of 100 men and in none of 100 women without genital diseases. These results suggest that the prevalence of chlamydial infection in Saudi Arabia among both men and women is high. Since serious complications can follow chlamydial genital infection, further work has to be done in this field. PMID- 1791414 TI - Comparative study on the plaque forming cell response by two different methods of plaque assay. AB - The Cunningham and Sezenberg Technique (using mice sensitized lymphoid cells to SRBCs) was tested together with Trump's gel technique (using non sensitized mice lymphoid cell mixed with SRBCs and incubated in Marbrook culture chamber for sensitization). The study showed that the number of PFCs by the Cunningham slid was greater than that observed by the gel technique of Trump at the same lymphocyte concentration. Also it was observed that the Trump's method using the Marbrook tissue culture chamber was a time consuming technique than that obtained by the Cunningham technique. PMID- 1791415 TI - Delta virus and hepatitis B surface antigen in chronic liver diseases. AB - This work was carried out on 45 patients with chronic liver diseases, including 24 cases of liver cirrhosis and 21 cases of chronic hepatitis. Their ages ranged from 2 to 15 years (median 5). All cases were examined clinically and assessed biochemically for liver function tests. Serological studies were performed to detect hepatitis B surface antigen (HBsAg) and delta IgG antibody (IgG anti-HD) using Enzyme Immunoassay (EIA) technique. The study showed that IgG anti-HD was detected in 8.9% of cases with chronic liver diseases (all positive cases were with liver cirrhosis). On the other hand, HBsAg was detected in 53.3% of cases (54.2% of them with cirrhosis and 45.8% with chronic hepatitis) with no significant association between HBsAg positivity and type of hepatic illness. Moreover, IgG anti-HD was positive in only 4.2% of HBsAg positive cases, while 14.3% of HBsAg negative cases were positive for IgG anti-HD. A significant association was also found between delta positivity and serum glutamic oxaloacetic transferase level (SGOT). We concluded that chronic delta hepatitis appeared to be more severe than other types of chronic viral hepatitis, as all delta positive cases were with liver cirrhosis and had elevated SGOT levels. Screening of delta markers in addition to hepatitis B viral markers could improve the understanding of a number of obscure cases of chronic hepatic illnesses and would help in the control of HBV and consequently HDV infection in the general population. PMID- 1791416 TI - A possible role of crows in the spread of diarrhoeal diseases in Aden. AB - The Indian House Crow (Corvus splendens) has increased dramatically in number in Aden. These birds pollute the environment by dropping their faecal material all over the city. They may accordingly be related to important public health problems. The present work aimed at investigating the possibility that they play a role in the spread of diarrheal diseases. One hundred and fifty crows were collected and their liver, intestine and cloaca examined bacteriologically for Enterobacteriaceae and Vibrionaceas as well as for parasites. Different members of Enterobacteriaceae including Salmonella, and Shigella serotypes and Proteus strains as well as members of Vibrionaceae and Pseudomonads were isolated from a great proportion of crows. Some of them were found identical to the strains previously isolated from patients suffering from diarrhea in Aden. Giardia lamblia cysts and Hymenolepis nana ova were also recovered from crows. It was concluded that crows may participate in the spread of diarrheal diseases in Aden. PMID- 1791417 TI - Cesarean section in Kuwait, 1983 through 1988. AB - Examination of the cesarean section (CS) rate at the Ministry of Public Health hospitals in Kuwait during 1983 through 1988 revealed a rate of 9.36% and showed no significant trend. The rates in the individual 4 hospitals differed significantly. A significant weak positive correlation between the CS rate and instrumental delivery rates was found. No significant correlation was found between the CS rate and perinatal mortality rate, but a weak positive correlation was found between the CS rate and neonatal mortality rates. Based on the existing health information system in Kuwait, it was not possible to determine whether variations in CS rates were secondary to differences in the risk status of the population subgroups, or were related to physicians' practice style which offers a potential for reduction of the higher rates. Deficiencies identified in the existing health information system included unavailability of information about parity, indications of CS, and whether the procedure was a primary or repeat one. Recommendations to rectify these deficiencies were suggested. PMID- 1791418 TI - Progression of oocyte maturation from metaphase I to metaphase II is disturbed by previous immunological interference with cumulus cell function. AB - The effects of an antibody preparation reacting with preovulatory mouse cumuli oophori (anticumulus Ig) on oocyte maturation in vivo and in vitro were studied. Continuous presence of anticumulus Ig in culture medium did not impair oocyte maturation in vitro. Similarly, no effect on oocyte maturation in vivo was observed when anticumulus Ig was given to females superovulated with pregnant mare serum gonadotropin (PMSG) and human chorionic gonadotropin (hCG) at the time of hCG treatment. However, when administered earlier, anticumulus Ig brought about serious disturbances of oocyte meiotic competence, since only immature oocytes were ovulated after anticumulus Ig injection at the time of PMSG treatment and as much as 70% of the ovulated oocytes were immature when the antibody was applied 24 hr later. Previous absorption of anticumulus Ig with isolated cumulus cells removed the inhibitory effect of this preparation on oocyte meiotic competence to the same extent as absorption with whole cumuli oophori, despite the persistence of a strong reactivity of the cumulus cell absorbed antibody preparations with the cumulus intercellular matrix. The ability of oocytes obtained from antibody-injected animals to mature in vitro was also considerably impaired when the injection was made at the time of PMSG treatment. In all cases the maturation defect concerned the progression of meiosis from metaphase I to metaphase II, while the ability of oocytes to undergo germinal vesicle breakdown (GVBD) was unchanged.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791419 TI - A method for obtaining a pure population of t6/t6 mouse embryos prior to developmental arrest. AB - Developmental delay, as the result of ovariectomy, causes mouse blastocyst embryos obtained from +/t6 inter se matings to separate into two distinct populations when placed into outgrowth medium. One population remains as free floating embryos for a significantly longer period of time than the other population. Based upon their phenotypic expression following attachment and outgrowth, the former population was considered to be composed entirely of t6/t6 embryos and the latter, to be composed of +/+ and +/t6 embryos (Nadijcka et al., '81). In the present study, two-dimensional gel electrophoresis identified the embryos which were delayed in attachment as t6/t6 embryos since they synthesize only p63/6.9a, a product of the Tcp-1a locus which is unique to t-haplotypes. The early attaching embryos, assumed to be +/+ and +/t6, synthesize both p63/6.9a and b. The p63/6.9b protein is coded for by Tcp-1b on the wild-type homologous chromosome. Control +/+ blastocyst embryos synthesize only p63/6.9b. The data show that t6/t6 embryos can be identified prior to their lethal period and, thus, subjected to comparative studies to determine the cause of their lethality. Developmental delay is the first method established to enable one to unambiguously identify t6/t6 embryos prior to developmental arrest. PMID- 1791420 TI - Synergism between temperature and estradiol: a common pathway in turtle sex determination? AB - In many reptiles, the temperature at which the eggs are incubated determines the sex of the hatchlings. Administration of estradiol will counteract the masculinizing effects of a male-producing temperature, resulting in female hatchlings. To address whether temperature and estrogen are biologically equivalent, two experiments were conducted with the red-eared slider turtle, Trachemys scripta. In the first experiment, varying dosages of estrogen were administered at Stage 17 (the middle of the temperature-sensitive window) to eggs maintained at two temperatures, 26 degrees C (which normally produces all males) and 28.2 degrees C (which produces mostly males but lies at the threshold of the transition from male- to female-producing temperatures). Results indicate that estrogen and temperature exert a synergistic effect on sex determination. In the second experiment, estrogen was administered at different stages of embryonic development. The results indicate an estrogen-sensitive period ranging from Stage 14 through Stage 21, a period similar to the temperature-sensitive period for this species. The results of these experiments are consistent with the hypothesis that temperature and estradiol act in a common pathway in temperature-dependent sex determination. PMID- 1791421 TI - Effect of noradrenaline on the methaemoglobin concentration of rainbow trout red cells. AB - We studied the effect of noradrenaline on the methaemoglobin (metHb) concentration in rainbow trout red cells. The erythrocytes were incubated in physiological medium with or without noradrenaline and the percentage of metHb of total Hb content was measured. Noradrenaline lowered the metHb content significantly as compared to controls. To study if the effect of noradrenaline was caused by adrenergic intracellular alkalinization, cells were treated with noradrenaline + carbonic anhydrase or noradrenaline + acetazolamide. Carbonic anhydrase inhibits the adrenergic increase in intracellular pH, but did not reduce the effect of noradrenaline on the metHb concentration. Acetazolamide accentuates the increase in intracellular pH. However, there was no difference in the methaemoglobin content of noradrenaline-incubated and noradrenaline + acetazolamide-incubated cells. These results show that the effect of noradrenaline on the methaemoglobin content is independent from the adrenergic increase in intracellular pH. However, amiloride treatment inhibited the effect of noradrenaline on the methaemoglobin content, suggesting that the protein mediating sodium/proton exchange may also be involved in controlling cellular methaemoglobin levels. PMID- 1791422 TI - Vitellogenesis in Anolis pulchellus: induction of VTG-like protein in liver explants from male and immature lizards. AB - Vitellogenin (VTG) synthesis has been described as an ideal system to study the hormonal regulation of gene expression. In Xenopus the molecular aspects of this control have been analyzed; however, in other non-mammalian species such as reptiles, very few studies approaching this level have been undertaken. We report on the induction by estradiol-17 beta of VTG-like proteins in liver explants from adult males and immature male and female lizards (A. pulchellus). A concentration of 10(-7) M was optimum for adult males while a higher concentration (10(-6) M) is required for the immature animals. No differences were observed in the hormonal induction in male and female immature animals, suggesting that there are no sexual distinctions in the liver at this stage. The effect of the hormone in male liver appears to be primarily on mRNA synthesis, since increases in 3H uridine incorporation in total RNA were prevented by addition of 1 microgram/ml of the RNA polymerase II inhibitor alpha-Amanitin; however, rRNA synthesis was also increased as observed by agarose gel analysis. A 48 hr lag period was required for the detection of the intracellular as well as the secreted VTG-like protein. Electrophoretical analysis of the secretory products revealed the induction of a group of phosphoproteins immunologically related to yolk lipovitellin whose molecular weights range from 116,000 to 200,000. PMID- 1791423 TI - Regenerative capacity of forelimb buds after amputation in mouse embryos at the early-organogenesis stage. AB - The ability of mouse forelimb buds at stage 1 (Wanek et al., '89a) of development to regenerate after amputation was investigated. The findings were as follows: 1. Outgrowths in the form of hillocks were found at the sites of amputation in 116 (95%) out of 122 embryos examined 24 hours after amputation. Examination of the amputated region after various intervals of time revealed that the outgrowths were established from flank tissues at the anterior and posterior borders of the wound. 2. Ectodermal thickening was found on the distal margin of the outgrowths in 21 (66%) out of 32 specimens examined. These thickenings were histologically similar to the apical ectodermal ridge (AER) present on the control limb buds. 3. Alkaline phosphatase activity was detected on the ectodermal thickening in 11 (79%) out of 14 experimental limb buds examined. The pattern of expression of alkaline phosphatase activity was similar to that observed in control limb buds. 4. There was no correlation between the size of the outgrowths and the presence of the ectodermal thickening or the enzymatic activity. The outgrowths developed despite the absence of ectodermal thickening and enzymatic activity, suggesting that the thickening and the presence of alkaline phosphatase are not crucial for the initiation and formation of the outgrowths. 5. Explants of the outgrowths, when grafted beneath adult kidney capsules, differentiated extensively into various tissues, which included bones, epiphyseal plates, skeletal muscles, and skin derivatives. Control explants also gave rise to the same spectrum of tissues. Hence, the flank tissues surrounding the site of amputation in E10 mouse embryos can regenerate to form a structure that is morphologically and histochemically similar to a limb bud and the mesenchyme within the structure is histogenetically competent to produce the variety of tissues that is normally found in the adult limb. PMID- 1791424 TI - Sexing of rat embryos with antisera specific for male rats. AB - Male-specific antigenicity (H-Y antigen) of rat embryos has been examined, and the feasibility of sexing rat embryos by use of H-Y antibodies has been studied. Rat H-Y antisera were produced by immunization of female Wistar rats with a homogenate of testes from male Wistar neonates. Male specificity of the antiserum (H-Y antibody) was determined by retention of cytotoxicity to male epidermal cells after absorption with female cells. After cultivation of rat embryos for 5 to 6 hr in the presence of antibody, half of the embryos were arrested at the morula stage. However, these embryos developed into blastocysts after removal of the antiserum, and then they grew into male young in recipient foster mothers. Eighty percent of the embryos that developed to blastocysts in the presence of the antiserum grew into female young. PMID- 1791425 TI - Transformation and allelic replacement in Francisella spp. AB - We describe methods for transposon mutagenesis and allelic replacement in the facultative intracellular pathogen Francisella. Recombinant clones were constructed by insertion of partially cut F. tularensis or F. novicida DNA into pUC19 and then mutagenized with a mini-Tn10-Km transposon. F. novicida could be transformed with these plasmids either by a chemical transformation method or by electroporation, whereas F. tularensis could be transformed only by electroporation. Transformation of F. tularensis by electroporation was enhanced in the absence of the capsule. Southern blot analysis showed that the KmR marker was rescued either by integration of the plasmid into the Francisella chromosome or by allelic replacement. Allelic replacement was found to be the mechanism underlying a site-specific mutation affecting FopA, an outer-membrane protein of Francisella. F. novicida could also be transformed with chromosomal DNA carrying the KmR marker and the transformation frequency obtained using chromosomal DNA was generally greater than that obtained using plasmid DNA. F. novicida was also transformed by an IncQ plasmid containing an F. novicida DNA insert, which replicated autonomously in this host. PMID- 1791426 TI - Purification and characterization of a lecithin-dependent haemolysin from Escherichia coli transformed by a Vibrio parahaemolyticus gene. AB - Lecithin-dependent haemolysin (LDH) of Vibrio parahaemolyticus was purified from Escherichia coli C600 transformed with a plasmid (pHL591) ligated with a 1.5 kb DNA fragment of V. parahaemolyticus. The final preparation comprised two LDH proteins with different molecular masses which were immunologically cross reactive and had the same enzymic activity. The LDH was a phospholipase hydrolysing both fatty acid esters of phospholipid, i.e. it hydrolysed phosphatidylcholine (PC) to lysophosphatidylcholine (LPC) and then LPC to glycerophosphorylcholine (GPC). From this point of view, LDH should be classified as a phospholipase B. Phospholipase B, however, does not usually show haemolytic activity, because the intermediate (LPC), which is the actual haemolytic agent, is immediately hydrolysed to the final product (GPC). On the other hand, LPC formed by LDH action was comparatively stable, because the rates of the two reactions catalysed by LDH, PC to LPC and LPC to GPC, are almost the same. This is the reason that LDH shows haemolytic activity. Therefore, LDH of V. parahaemolyticus is an atypical phospholipase to be designated as phospholipase A2/lysophospholipase. PMID- 1791427 TI - Influence of capsular neuraminic acid on properties of streptococci of serological group B. AB - Neuraminic acid is thought to be a critical virulence factor of group B streptococci. The present study was designed to further characterize a previously described type III group B streptococcus and its transposon-mutagenized asialo capsular mutant. The wild-type group B streptococcus grew as short chains with a uniform turbidity and had diffuse colonies in soft agar media. In contrast, the asialo mutant grew in fluid media as a granular sediment, formed significantly longer chains and had compact colonies in soft agar. These differences, possibly related to the surface charge of the bacteria, could also be demonstrated in salt aggregation tests and hexadecane adherence studies. The wild-type group B streptococcus showed hydrophilic, and the asialo mutant hydrophobic surface properties. Removal of neuraminic acid from the wild-type strain changed the surface properties from hydrophilic to hydrophobic. A similar masking effect of capsular neuraminic acid could be observed in adherence and phagocytosis experiments. In contrast to the wild-type strain, the asialo mutant adhered significantly more to buccal epithelial cells and was phagocytosed more by polymorphonuclear leucocytes. These altered properties might possibly be of importance for group B streptococcal pathogenicity. PMID- 1791428 TI - Distinctions in DNA and protein profiles among clinical isolates of Mycoplasma pneumoniae. AB - Clinical isolates of Mycoplasma pneumoniae previously shown to exhibit significant sequence divergency in a major 170 kDa adhesin, designated P1, were further characterized using restriction enzyme fingerprinting of genomic DNA and two-dimensional gel electrophoresis of total proteins. Numerous differences in DNA restriction patterns and protein profiles were found, possibly reflecting various degrees of virulence and antigenic potential. PMID- 1791429 TI - Isolation and identification of a putative porcine transferrin receptor from Actinobacillus pleuropneumoniae biotype 1. AB - Each of two affinity isolation methods, the first based on biotinylated porcine transferrin plus streptavidin-agarose, and the second on Sepharose-coupled porcine transferrin, followed by SDS-PAGE, allowed the isolation and identification of two potential porcine-transferrin-binding polypeptides (approximately 64 kDa and 99 kDa) from total membranes of Actinobacillus pleuropneumoniae grown under iron-restricted conditions. Both polypeptides were iron-repressible and were identified as potential receptor candidates as they were not isolated when biotinylated human transferrin was used instead of biotinylated porcine transferrin. The 64 kDa polypeptide was the more easily removed from Sepharose-coupled porcine transferrin and only the 99 kDa polypeptide appeared to be an outer-membrane protein. While these results suggest that the 99 kDa polypeptide represents the porcine transferrin receptor of A. pleuropneumoniae, and that the 64 kDa polypeptide represents an associated protein serving an accessory role, other interpretations are also possible. PMID- 1791430 TI - Composition of the outer membrane of Proteus mirabilis in relation to serum sensitivity in progressive stages of cell form defectiveness. AB - A serum-resistant strain of Proteus mirabilis was used to determine whether changes in the composition of surface components could be detected following induction of progressive stages of cell form defectiveness by beta-lactam antibiotics. The critical stage was the conversion from filaments to the spheroplast form, which was accompanied by increased susceptibility to the bactericidal action of human serum. Inner and outer membranes of the bacterium, its filament form and its spheroplast form were separated by sucrose density gradient centrifugation after digestion of peptidoglycan, followed by osmotic lysis of the cells. Outer membranes of the bacterial and the filament forms sedimented at the same density, whilst the outer membrane fraction of the spheroplast form sedimented in a region of lesser density. In addition, the amounts of two major outer-membrane proteins as well as the O-polysaccharide content of the lipopolysaccharide were reduced in the spheroplast form. These results indicate a general disorganization in structure and assembly of components in regard to their interactions with one another in the outer membrane of the spheroplast form. PMID- 1791431 TI - Phenotypic variation of Pseudomonas putida and P. tolaasii affects the chemotactic response to Agaricus bisporus mycelial exudate. AB - The chemotactic response of wild-type Pseudomonas putida and P. tolaasii, and a phenotypic variant of each species, to Agaricus bisporus mycelial exudate was examined. Both P. putida, the bacterium responsible for initiating basidiome development of A. bisporus, and P. tolaasii, the causal organism of bacterial blotch disease of the mushroom, displayed a positive chemotactic response to Casamino acids and to A. bisporus mycelial exudate. The response was both dose- and time-dependent and marked differences were observed between the response time of the wild-type strains and their phenotypic variants. Phenotypic variants responded rapidly to both attractants and reached a maximum response after 10-20 min, whereas the wild-types took 45-60 min. The differences are partly explained by the more rapid swimming speed of the phenotypic variants. Both variants responded maximally to similar concentrations of Casamino acids and mycelial exudates. Investigations into the nature of the attractants contained in the mycelial exudate indicated that they are predominantly small (Mr less than 2000) thermostable compounds. Sugars present in the exudate did not elicit a chemotactic response in any isolate, but a mixture of 14 amino acids detected in the exudate accounted for between 50 and 75% of the chemotactic response of the fungal exudate. PMID- 1791432 TI - Phenotypic variation of Pseudomonas putida and P. tolaasii affects attachment to Agaricus bisporus mycelium. AB - The effect of phenotypic variation on attachment of Pseudomonas tolaasii and P. putida to Agaricus bisporus mycelium was investigated. Quantitative studies demonstrated the ability of each isolate to attach rapidly and firmly to A. bisporus mycelium and significant differences in attachment of wild-type and phenotypic variant strains were observed. This was most pronounced in P. tolaasii, where the percentage attachment of the wild-type form was always greater than that of the phenotypic variant. The medium upon which the bacteria were cultured, prior to conducting an attachment assay, had a significant effect on their ability to attach. Attachment of the wild-type form of P. putida was enhanced when the assay was performed in the presence of CaCl2, suggesting the involvement of electrostatic forces. No correlation was observed between bacterial hydrophobicity and ability to attach to A. bisporus mycelium. Scanning electron microscopy confirmed the results obtained from the quantitative studies and provided further evidence for marked differences in the ability of the pseudomonads to attach to mycelium. Fibrillar structures and amorphous material were frequently associated with attached cells and appeared to anchor bacteria to each other and to the hyphal surface. A time-course study of attachment using transmission electron microscopy revealed the presence of uneven fibrillar material on the surface of cells. This material stained positive for polysaccharide and may be involved in ensuring rapid, firm attachment of the cells. PMID- 1791433 TI - A complex chitinolytic system in exponentially growing mycelium of Mucor rouxii: properties and function. AB - Enzymological evidence has been sought for the purported involvement of chitinolysis in vegetative growth of filamentous fungi. A procedure has been developed for the production of fast growing and morphologically homogeneous exponential phase mycelium of the non-septate dimorphic zygomycete Mucor rouxii. A partially purified extract of this material has been subjected to gel permeation chromatography and the chitinolytic activity of eluate fractions has been assessed using colloidal and nascent chitin and 3,4-dinitrophenyl tetra-N acetylchitotetraoside [3,4-DNP-(GlcNAc)4] as substrates. Exponentially growing (td = 1.1 h) mycelium consisting of single short-branched hyphae contains at least seven chitinases. The two particulate ones have not been studied in detail. The soluble chitinases hydrolyse (pseudo)chito-oligomers by random cleavage of internal beta-1,4-bonds (and not by processing) and have a minimum chain-length requirement of n = 4. They are clearly distinct from beta-N-acetylglucosaminidase (beta-GlcNAc'ase) with respect to their chromatographic behaviour, substrate chain-length specificity, inhibition by chitobionolactone oxime (Ki = 175 microM), and non-inhibition by the specific beta-GlcNAc'ase inhibitor N acetylglucosaminono-1,5-lactone oxime. Their pH optima are similar (6.5-7.0), and all can hydrolyse 3,4-DNP-(GlcNAc)4 as well as nascent chitin. With respect to their charge, response to protease treatment, behaviour upon gel-permeation chromatography and ability to use colloidal chitin as a substrate, the soluble chitinases do, however, represent two distinct groups. Type A chitinases are acidic, display partial latency, show an unusual affinity to dextran gel and act weakly on colloidal chitin. Type B chitinases are basic (or neutral) and non zymogenic, do not behave anomalously upon gel filtration and can degrade performed chitin. An hypothesis is presented for the function of the complex chitinolytic system of the fungal hypha in branching and, possibly, also in apical growth. PMID- 1791434 TI - Expression of active yeast pyruvate decarboxylase in Escherichia coli. AB - We have shown by appropriate modification of the translational signals and using the strong T7 RNA polymerase promoter phi 10, that a cloned Saccharomyces cerevisiae pyruvate decarboxylase gene (pdc1) can be expressed in Escherichia coli. This protein, which migrated as a single band on SDS-polyacrylamide gels, was found to have a subunit molecular mass of approximately 62 kDa, similar to that of the enzyme produced by yeast. Polyclonal antibodies raised against purified yeast pyruvate decarboxylase recognized this bacterially produced protein. We found that this recombinant enzyme is active, indicating that the homotetramer encoded by the pdc1 gene is functional. PMID- 1791435 TI - Unique DNA plasmid pRS64 associated with chromosomal DNAs of the plant pathogenic fungus Rhizoctonia solani. AB - Unique DNA sequences homologous to the linear DNA plasmid pRS64 were investigated in chromosomal DNAs of isolates belonging to anastomosis group 4 (AG-4) of the plant pathogenic fungus Rhizoctonia solani. Chromosome-sized DNAs of isolates RI 64 and 1271 of AG-4 were separated into six bands by orthogonal-field-alternation gel electrophoresis and hybridized to a cloned segment of pRS64. A small chromosome-sized DNA band of approximately 1.1 Mb carried the sequences homologous to pRS64 DNA. Sequences homologous to pRS64 were also maintained within the chromosomal DNA of isolate 127.1 of AG-4 which does not possess the plasmid. The plasmid showed no homology to the mitochondrial DNA of isolate 1271. The possibility that the linear plasmid pRS64 may act as a transposable genetic element is discussed. PMID- 1791436 TI - Duplication of both xyl catabolic operons on TOL plasmid pWW15. AB - Pseudomonas fluorescens MT15 is the host of the large (250 kbp) TOL plasmid pWW15. We have shown by a combination of hybridization, molecular cloning and enzyme assay that pWW15 carries two distinct regions which share homology with the upper pathway operons (xylCMABN) of other TOL plasmids and two distinct regions which are homologous to the meta pathway operons (xylXYZLTEGFJQKIH) of other TOL plasmids. Both the areas of homology to the upper pathway operons appear to carry all of the structural genes for the three catabolic enzymes of the operon. One of the regions of meta pathway operon homology encodes a complete functional pathway, but the second is incomplete and appears to carry only the genes from xylF downstream. PMID- 1791437 TI - Escherichia coli metabolism in space. AB - Cultures of the bacterium Escherichia coli were grown in the orbiting Biocosmos 2044 satellite in order to evaluate the effects of the space environment- weightlessness and heavy particle radiation--on growth parameters and energy metabolism, which have previously been reported to be affected, and on induction of the SOS response, which reflects DNA damage to the cell. We found no differences between the flight samples and control ground cultures in the growth yield per gram of carbon, in mean cell mass (from which we deduce that the growth rate was unaltered) or in the level of expression of the SOS response. These observations indicate that free-growing bacterial cells do not expend significant energy fighting gravity and that cosmic radiation within a space capsule does not produce significant levels of DNA damage. PMID- 1791438 TI - Changes in cell-surface carbohydrates of Trypanosoma cruzi during metacyclogenesis under chemically defined conditions. AB - Highly purified lectins with specificities for receptor molecules containing sialic acid, N-acetylglucosamine (D-GlcNAc), N-acetylgalactosamine (D-GalNAc), galactose (D-Gal), mannose-like residues (D-Man) or L-fucose (L-Fuc), were used to determine changes in cell-surface carbohydrates of the protozoal parasite Trypanosoma cruzi during metacyclogenesis under chemically defined conditions. Of the D-GalNAc-binding lectins, BS-I selectively agglutinated metacyclic trypomastigotes, MPL was selective for replicating epimastigotes, whereas SBA strongly agglutinated all developmental stages of T. cruzi. WGA (sialic acid and/or D-GlcNAc specific) was also reactive with differentiating epimastigotes and metacyclic trypomastigotes but displayed a higher reactivity with replicating epimastigote forms. A progressive decrease in agglutinating activity was observed for jacaline (specific for D-Gal) during the metacyclogenesis process; conversely, a progressive increase in affinity was observed for RCA-I (D-Gal specific), although the reactivity of other D-Gal-specific lectins (PNA and AxP) was strong at all developmental stages. All developmental stages of T. cruzi were agglutinated by Con A and Lens culinaris lectins (specific for D-Man-like residues); however, they were unreactive with the L-fucose-binding lectins from Lotus tetragonolobos and Ulex europaeus. These agglutination assays were further confirmed by binding studies using 125I-labelled lectins. Neuraminidase activity was detected in supernatants of cell-free differentiation medium using the PNA hemagglutination test with human A erythrocytes. The most pronounced differences in lectin agglutination activity were observed between replicating and differentiating epimastigotes, suggesting that changes in the composition of accessible cell-surface carbohydrates precede the morphological transformation of epimastigotes into metacyclic trypomastigotes. PMID- 1791439 TI - Fungicidal activity of Candida albicans-induced murine lymphokine-activated killer cells against C. albicans hyphae in vitro. AB - Multiple intraperitoneal injections of inactivated Candida albicans cells resulted in the generation of cytotoxic peritoneal cells with phenotypical and functional properties similar to in vitro-generated lymphokine-activated killer (LAK) cells. Using an in vitro [3H]glucose uptake assay, C. albicans-induced LAK like (CA-LAK) cells exhibited high levels of anti-hyphal activity, the effects being effector to target cell (E:T) ratio- and time-dependent. Maximal levels of anti-C. albicans activity (approximately 60%) were observed after 4 h and at E:T greater than or equal to 300:1. Similar patterns of anti-C. albicans activity were exerted by in vivo-activated natural killer (NK) cells, in vitro interleukin 2- (IL-2) generated LAK cells and polymorphonuclear cells. The anti-hyphal activity of CA-LAK cells was enriched by separation on a Percoll gradient, F2 and F3 fractions retaining most of the activity. Experiments using immunodepressed animals demonstrated that the in vivo lethality of the C. albicans hyphal form is significantly affected by in vitro pre-exposure to CA-LAK cells. While control mice receiving C. albicans alone had a median survival time of 2 d, mice receiving C. albicans pre-exposed to CA-LAK cells (E:T = 300:1) had a median survival time of 15 d. Overall, the susceptibility of the C. albicans hyphal form to CA-LAK cells suggests that C. albicans-induced effectors might play a significant role as a second-line defence mechanism against the C. albicans hyphal form. PMID- 1791440 TI - Pseudomycins, a family of novel peptides from Pseudomonas syringae possessing broad-spectrum antifungal activity. AB - A family of peptide antimycotics, termed pseudomycins, has been isolated from liquid cultures of Pseudomonas syringae, a plant-associated bacterium. These compounds were purified using Amberlite XAD-2 and reverse-phase liquid chromatography. Pseudomycin A, the predominant peptide in a family of four, showed selective phytotoxicity, and had impressive activity against the human pathogen Candida albicans. Amino acid, mass spectroscopic, and comparative electrophoretic and chromatographic analyses revealed that the pseudomycins are different from previously described antimycotics from P. syringae, including syringomycin, syringotoxin and syringostatins. Pseudomycins A-C contain hydroxyaspartic acid, aspartic acid, serine, arginine, lysine and diaminobutyric acid. The molecular masses of pseudomycins A-C, as determined by plasma desorption mass spectrometry, are 1224, 1208 and 1252 Da, respectively. Pseudomycin D, on the other hand, has a molecular mass of 2401 Da and is more complex than pseudomycins A-C. PMID- 1791441 TI - Effects of alcohols on the respiration and fermentation of aerated suspensions of baker's yeast. AB - The immediate effects of externally added alcohols on CO2 production and O2 consumption of suspensions of washed, aerated baker's yeast were studied by stopped-flow membrane inlet mass spectrometry. Glucose-supported fermentation was progressively inhibited by increasing ethanol concentration (0-20%, v/v). The inhibition by ethanol was quite different from that observed for acetaldehyde; thus it is unlikely that toxicity of the latter can account for the observed effects. For five different alkanols (methanol, ethanol, 1-propanol, 2-propanol and 1-butanol) increasing inhibition of anaerobic fermentation was correlated with increased partition coefficients into a hydrophobic milieu. This suggests that the action of ethanol is primarily located at a hydrophobic site, possibly at a membrane. Results for respiratory activities were not as definite as for those for anaerobic metabolism because some alkanols act as respiratory substrates as well as giving inhibitory effects. PMID- 1791442 TI - pH gradients through colonies of Bacillus cereus and the surrounding agar. AB - pH-sensitive microelectrodes, constructed with a tip diameter of about 4 microns, were deployed through 24 h and 48 h colonies of Bacillus cereus incubated on CYS medium (Casamino acids, yeast extract, salts), with and without glucose. Measurements of pH were used to construct pH profiles through the colony and the surrounding agar. pH gradients could be detected for at least 800 microns into the agar beneath a 24 h colony, and to approximately 10 mm horizontally away from the edge of the colony. In older colonies, the lateral gradient extended for over 20 mm. The pH of the underlying agar was increased by up to 1.45 pH units after 48 h growth without glucose. When colonies were grown with glucose, a significant area of acidification was observed within the colony in addition to a zone of alkalinization present at its periphery. Acidification was thought to be due to the anaerobic fermentation of glucose producing organic acids whilst alkalinization was due to the aerobic oxidation of amino acids releasing ammonia. PMID- 1791443 TI - Isolation and characterization of Pseudomonas putida mutants affected in arginine, ornithine and citrulline catabolism: function of the arginine oxidase and arginine succinyltransferase pathways. AB - Pseudomonas putida mutants impaired in the utilization of arginine are affected in either the arginine succinyltransferase pathway, the arginine oxidase route, or both. However, mutants affected in one of the pathways still grow on arginine as sole carbon source. Analysis of the products excreted by both wild-type and mutant strains suggests that arginine is mainly channelled by the oxidase route. Proline non-utilizing mutants are also affected in ornithine utilization, confirming the role of proline as an intermediate in ornithine catabolism. Mutants affected in ornithine cyclodeaminase activity still grow on proline and become unable to use ornithine. Both proline non-utilizing mutants and ornithine cyclodeaminase-minus mutants are unable to use citrulline. These results, together with induction of ornithine cyclodeaminase when wild-type P. putida is grown on citrulline, indicate that utilization of citrulline as a carbon source proceeds via proline with ornithine as an intermediate. Thus in P. putida, the aerobic catabolism of arginine on the one hand and citrulline and ornithine on the other proceed by quite different metabolic segments. PMID- 1791444 TI - Emergency control of Aedes aegypti as a disease vector in urban areas. AB - Techniques for the emergency control of adult Aedes aegypti populations and their development are reviewed. Larviciding and environmental measures provide only delayed control of adult populations. Large-scale field trials of the ultra-low volume application of insecticide concentrates in Southeast Asia, South America and Africa, using aerial, ground, vehicle-mounted and hand-carried equipment, have, in most cases, resulted in satisfactory levels of control of adult populations. Sequential or indoor ULV applications of fenitrothion have provided immediate control and sustained reduction of the adult populations, often lasting well through normal peak transmission periods of dengue. Many ULV application trials in the Caribbean have not produced satisfactory control, but it is considered that this was due to the type of house construction, to the lower dosage rates of the malathion 96% ULV concentrates used, or to inappropriate droplet sizes. While ULV applications can provide rapid and effective emergency control of vectors at the time of outbreaks of disease in urban and periurban areas, they should not be used as a routine mosquito control measure nor as an alternative to reducing vector populations by environmental measures. PMID- 1791445 TI - A vision for the future. AB - An analogy is made between the Persian Gulf War and its effective, high tech weaponry and future vector control program planning. Ever increasing population pressures and environmental concerns are seen as factors driving ever more selective control strategies. Developing positive public mosquito control perceptions will be a result of greater commitment to public education. Participative management and program ownership by staff in a "bottom up" environment is encouraged. The role of host attractant development is discussed as an example of proactive involvement by members. PMID- 1791446 TI - Les maringouins du meche and the legacy of two men. AB - E. S. Hathaway and his colleague, A. B. Ritter, were directly responsible for establishing organized mosquito control in Louisiana in the late 1950s and early 1960s. They jointly sought to educate governmental officials and Louisiana citizens that mosquitoes could be controlled if the efforts were based on scientific knowledge, trained personnel and appropriate funding. These men were instrumental also in establishing the Louisiana Mosquito Control Association and subsequently involved with the formation of the first 5 parish-wide mosquito control districts in Louisiana. PMID- 1791448 TI - Aedes aegypti infestation characteristics in several Caribbean countries and implications for integrated community-based control. AB - Periodic larval surveys for Aedes aegypti were conducted in 11 Caribbean countries between 1983 and 1989. On average, there were 24 potential larval habitats per house including 4.9 which held water at the time of examination. Breteau indices for the various islands ranged from 34.7 to 121.6. In descending order of importance, water storage drums, house plants, buckets, used tires and miscellaneous small discarded containers accounted for 84% of all foci. Highest rates of infestation were found in tires (38.4%) and drums (33.8%). For the development of integrated community-based vector control programs, not only should consideration be given to the larval ecology of Ae. aegypti, but also to the sociological significance of the various container habitats and the selection of control strategies most appropriate for their management. PMID- 1791447 TI - Seasonal incidence and vertical distribution patterns of oviposition by Aedes aegypti in an urban environment in Trinidad, W. I. AB - The oviposition patterns of Aedes aegypti were investigated using modified ovitraps placed along 4 vertical transects and monitored weekly for 52 wk in St. Augustine, Trinidad, W.I. From the 832 ovitraps exposed at ground level, 1.2, 3.0 and 4.6-m elevations, 43% (361) were found containing 20,114 Ae. aegypti eggs. During the wet season, 52.7% of the eggs were collected whereas during the dry season only 47.3% were collected. Egg populations were highest at the 1.2-m elevation. The implications of these results are discussed. PMID- 1791449 TI - Control of Aedes taeniorhynchus and Culex quinquefasciatus emergence with sustained release Altosid sand granules and pellets in saltwater and freshwater test plots. AB - The efficacy of sustained release Altosid sand granules to control adult Aedes taeniorhynchus and Culex quinquefasciatus emergence was investigated. Sand granules applied at a 7-day preflood application rate of 5.6 kg/ha controlled 99% of the Ae. taeniorhynchus emergence in saltwater plots for 44 days posttreatment and 35% of Cx. quinquefasciatus in freshwater plots. A 5.6 kg/ha rate controlled 100% of the Ae. taeniorhynchus emergence for 30 days posttreatment in semi permanent saltwater plots. Altosid pellets were used at the label rate for comparison. Sand granules applied at 11.2, 16.8 and 22.4 kg/ha against Cx. quinquefasciatus in freshwater plots gave 98% emergence inhibition at the 22.4 kg/ha rate 37 days posttreatment, 93% at 16.8 kg/ha for 22 days, and 100% at 11.2 kg/ha rate for 16 days. PMID- 1791450 TI - Potential for resistance to pyriproxyfen: a promising new mosquito larvicide. AB - An organophosphorus-resistant strain of Culex quinquefasciatus was pressured with pyriproxyfen for 17 generations. Egg viability began declining in the F7 generation and became lower as the selection process continued; by the F17 generation egg viability was too low to proceed further. Susceptibility tests on larvae of the F5, F10, F15, and F17 generations showed no indication of increased tolerance to pyriproxyfen. PMID- 1791451 TI - Delayed mortality and morphogenetic anomalies induced in Culex quinquefasciatus by the microbial control agent Bacillus sphaericus. AB - Two preparations of Bacillus sphaericus 2362 were studied for their biological activity, delayed mortality and the induction of morphogenetic aberrations in larvae, pupae and adults of Culex quinquefasciatus. Longevity and fecundity of adult mosquitoes were also assessed. A dosage response line for B. sphaericus was established against 4th-instar larvae and sublethal concentrations (48 h LC50 and lower) were used against these larvae. Sublethal concentrations of B. sphaericus induced delayed mortality in larvae, pupae and adults. The magnitude of mortality increased in succeeding cohorts and developmental stages resulting from the surviving larvae. Only 10 and 25% overall emergence of viable adults occurred in the sublethal treatments (LC25) of 2 B. sphaericus preparations. The range of successful adult emergence was over 94% in the controls. A wide range of external morphogenetic aberrations in dead larvae, pupae and adults were noted. These aberrations and gross morphological features were quite similar to those reported for certain insect growth regulators. Sublethal concentrations had no marked effect on longevity of adults, egg deposition and hatch. PMID- 1791452 TI - Delayed mortality and morphogenetic anomalies induced by the microbial control agent Bacillus thuringiensis ser. (H-14) in Culex quinquefasciatus. AB - Sublethal concentrations of Bacillus thuringiensis ser. H-14 were applied to early 4th-instar larvae of Culex quinquefasciatus to assess mortality and morphogenetic aberrations in larvae, pupae and adults. At the 24 h LC10, LC25, LC50 and LC80, additional mortality occurred in surviving larvae beyond a 24 h exposure period. The cumulative mortalities increased daily and the overall mortality of larvae up to 7 days posttreatment were 12, 73, 82 and 96% at the indicated concentrations, respectively. Delayed mortality also occurred in the pupal and adult stages. Morphogenetic aberrations were noted in dead larvae and pupae but were rare in the adults. These aberrations are categorized and described. There was little or no delayed effect on the survivorship or fecundity of adults, but in all the treatments the number of emerging males was higher than females. The sex ratio in check adults was 1:1. PMID- 1791453 TI - Efficacy assessment of Quwenling, a mosquito repellent from China. AB - Quwenling, an insect repellent product of China derived from extracts of the lemon eucalyptus plant (Eucalyptus maculata citriodon), was evaluated. Laboratory tests compared Quwenling with deet against Anopheles albimanus, An. quadrimaculatus, Aedes aegypti, Ae. albopictus and field tests with Ae. taeniorhynchus. Cloth treated with Quwenling at greater than 2x the dosage of deet was effective against 2 of 4 species tested (Ae. albopictus 29 days, An. quadrimaculatus 28 days). On the skin of volunteers at 2x the dosage of deet, the duration of protection for Quwenling was significantly less than deet with Ae. aegypti and Ae. taeniorhynchus, and was not significantly different with Ae. albopictus. Both repellents were ineffective against the anopheline species. As a topically applied mosquito repellent, Quwenling has a shorter duration of effectiveness than deet. PMID- 1791454 TI - Genetic structure of natural populations of Anopheles albimanus in Colombia. AB - Electrophoretic and cytogenetic studies were undertaken on the population structure of Anopheles albimanus from 11 localities in Colombia, 3 from northern (Atlantic coast) and 8 from southern (Pacific coast) regions. Of the 25 allozyme loci examined, significant allele frequency differences were observed at 4 loci: hydroxy acid dehydrogenase (Had-1) and 3 esterases (Est-2, Est-4 and Est-6). The northern populations had higher variability, with 55% polymorphic loci, a mean heterozygosity of 20.4% and a mean of 3.0 alleles per locus. These values for southern populations were 24%, 9.1% and 1.5%, respectively. There were neither diagnostic loci nor clinal effect on frequencies of allozymes. Except for a small inversion on the X chromosome in low frequency in certain populations, all populations were homosequential in chromosomal banding patterns. Hybrids from matings between natural populations and the Gainesville laboratory strain were fully fertile. Estimates of genetic similarities (0.95-0.97 among southern and 0.99-1.00 among northern populations) suggest a lack of significant genetic differentiation among distant populations in this species. Based on the chromosomal, hybridization and electrophoretic data, we concluded that mosquitoes from the 11 collections were conspecific populations of An. albimanus. PMID- 1791455 TI - Vector competence of North and South American strains of Aedes albopictus for certain arboviruses: a review. AB - Since the introduction of Aedes albopictus into North and South America, 18 viruses in 3 families have been used in vector competence studies involving 10 North American and 4 South American geographic strains of Ae. albopictus. This review summarizes the results of these studies and discusses the potential of Ae. albopictus to become a vector of arboviruses of public health importance in areas of the Western Hemisphere where it has recently become established. PMID- 1791456 TI - Malaria transmission potential by Anopheles mosquitoes of Dajabon, Dominican Republic. AB - A field and laboratory study was conducted to determine some of the parameters relevant to malaria transmission by Anopheles mosquitoes in Dajabon Province, Dominican Republic. Although all 4 species occurring in the area, i.e., An. albimanus, An. crucians, An. grabhamii and An. vestitipennis, were included in the investigations, most of the work focused on the first and last named species because of their abundance. Gonotrophic cycles were determined to be 2.6 and 3.2 days for An. albimanus and An. vestitipennis, respectively. Mean parity rates for the 2 species were 37.3 and 20.7%, respectively, in outdoor samples. The human blood index, as determined by ELISA, was 0.08 for An. albimanus and 0.12 for An. vestitipennis. Only An. albimanus was confirmed positive for Plasmodium falciparum circumsporozoite protein, using ELISA. The vectorial capacity of An. albimanus was determined to be 0.019 and that of An. vestitipennis 0.005. PMID- 1791457 TI - Effect of carbon dioxide on the collection of adult Culicoides spp. (Diptera: Ceratopogonidae) by a new modification of black light New Jersey light traps. AB - Comparisons were made between black light-modified New Jersey traps with and without dry ice as a carbon dioxide bait. The black light trap with CO2 collected significantly more nulliparous and parous empty Culicoides variipennis than the black light trap without CO2. No significant difference was detected in the number of gravid, blood engorged or male C. variipennis collected by the 2 trap types. The baited trap collected a larger proportion of nulliparous females than the black light trap. No difference in the proportion of males or other female parity groups was detected between the 2 trap types. The total number or proportion of each parity group of C. stellifer was not significantly different between the 2 trap types. PMID- 1791458 TI - Urbanization and the efficiency of carbon dioxide and gravid traps for sampling Culex quinquefasciatus. AB - The efficiency of gravid and CO2 traps for sampling female Culex quinquefasciatus was evaluated along 2 parallel 6.4 km long urban (high housing density) to rural (low housing density) transects in east Bakersfield, Kern County, CA. There were no significant differences in the number of female Cx. quinquefasciatus collected by gravid traps within urban and rural zones. The number of females collected per trap night ranged from 6.8 to 15.5. The number of females collected by CO2 traps increased significantly from 1.4 to 3.1 per trap night in urban to 31.8 to 111.2 per trap night in rural zones and was inversely correlated with housing density. These results indicate that female Cx. quinquefasciatus were effectively sampled by gravid traps in urban subdivisions and by CO2 traps in rural mixed agricultural areas. PMID- 1791459 TI - Influence of vegetation on carbon dioxide trap effectiveness for sampling mosquitoes in the Sierra Nevada foothills of Kern County, California. AB - The effect of vegetation on sampling Culex tarsalis, Cx. quinquefasciatus and Aedes nigromaculis by CO2 traps was evaluated at an intermittent stream habitat at the base of the Sierra Nevada foothills. Carbon dioxide traps were spaced along a 450 m transect perpendicular to Poso Creek to determine female attraction to traps placed in 5 different vegetation substrates: 1) open hilltop with sparse growth of grasses and saltbush, 2) open pasture with sparse growth of saltbush, 3) peripheral understory of mule fat, 4) shaded understory of mule fat, and 5) open canopy 5 m above ground in willow and cottonwood trees. Most host-seeking Cx. tarsalis and Cx. quinquefasciatus females were collected within the open canopy and peripheral understory. Host-seeking Ae. nigromaculis females were collected predominately in the open pasture and within the peripheral understory. The association between CO2 trap catch size and vegetation suggested a relationship between the host-feeding patterns and associated hunting strategies of these bird and mammal feeding species. PMID- 1791460 TI - Comparative susceptibility of Southeast Asian Anopheles mosquitoes to the simian malaria parasite Plasmodium cynomolgi. AB - Seven Anopheles species/isolates were compared with Anopheles dirus (control) for susceptibility to Plasmodium cynomolgi B strain. The mean numbers of oocysts in paired replicates of An. dirus and An. takasagoensis were not significantly different. The remaining test species had significantly fewer mean numbers of oocysts than Anopheles dirus (P less than 0.01). Anopheles dirus had the highest percentage of mosquitoes infected with P. cynomolgi sporozoites (82%). Of the test groups, Anopheles dirus B and An. takasagoensis had the highest percentage of mosquitoes with sporozoites, 77 and 78%, respectively. Fewer than 50% of Anopheles maculatus E and An. maculatus B (NN isolate) had sporozoites in the salivary glands. Anopheles maculatus B (HK isolate) and Anopheles philippinensis were the least susceptible, with fewer than 30% having sporozoites in the salivary glands. PMID- 1791461 TI - Replacement of Aedes aegypti by Aedes albopictus in Mobile, Alabama. AB - Aedes albopictus was first detected in Mobile, AL, in 1987 during a CDC sponsored ovitrap survey in the Historic District. A comparison of ovitrap and larval surveys, done in 1957, 1984, 1987 and 1990, indicates that Ae. albopictus had replaced Aedes aegypti in urban Mobile. Possible explanations of this replacement, including displacement, are discussed. PMID- 1791462 TI - Controlled release repellent formulations on human volunteers under three climatic regimens. AB - Two controlled-release repellent formulations containing 33% (3M) and 42% (Biotek) deet and an Army repellent containing 75% deet were evaluated in 3 different climatic regimens (tropical forested, tropical open and basic hot environments). The 3 repellents provided similar protection for different time periods after application under all 3 climates against Aedes aegypti, Ae. taeniorhynchus and Anopheles stephensi whereas there was no difference in protection period against An. albimanus. PMID- 1791463 TI - Field evaluation of ultra-low volume applications with a mixture of d-allethrin and d-phenothrin for control of Anopheles albimanus in Haiti. AB - Ultra-low volume applications of d-allethrin and d-phenothrin could possibly reduce populations of Anopheles albimanus when used in conjunction with residual spraying of fenitrothion. The experiments were carried out in Les Cayes, Haiti. PMID- 1791464 TI - Distributional records from the U.S. Air Force ovitrapping program--1990. AB - During 1990, ovitrapping was conducted at 38 U.S. Air Force installations. Twelve installations were positive for Aedes albopictus. The August 24 collection of Ae. albopictus at Tinker Air Force Base, OK, is a first record for Oklahoma County. Four installations recorded the presence of Ae. aegypti; 14 installations were positive for Ae. triseriatus. During the previous 3 years, an increase in the distribution and abundance of Ae. albopictus coincided with a decline in Ae. aegypti. PMID- 1791465 TI - Comparison of host-feeding patterns between Anopheles quadrimaculatus sibling species A and B. AB - Bloodmeal sources for sympatric species A and B of Anopheles quadrimaculatus in an area of Mississippi were identified using an indirect enzyme-linked immunosorbent assay. Females had fed only on 6 species of mammals including dog/fox, pig, opossum, raccoon, cottontail rabbit and white-tailed deer. The latter species was the predominant host, representing 96.7 and 89.5% of the bloodmeals taken by species A and B, respectively. No marked difference in feeding patterns was found. PMID- 1791466 TI - Wilbur George Downs 1913-1991. PMID- 1791467 TI - The interaction of hydroxypyridinones with human serum transferrin and ovotransferrin. AB - The interaction of hydroxypyridinones with human serum transferrin and ovotransferrin has been studied by analyzing the distribution of iron between the chelator and the proteins as a function of both ligand concentration and transferrin saturation. The kinetics of iron removal by 3-hydroxypyridin-4-ones from both transferrins is slow; in ovotransferrin it appears to be monophasic, in contrast to that observed for serum transferrin. After 24 hours incubation at a 40:1 chelator:protein molar ratio, the percentage of iron removed from Fe(III) ovotransferrin is 50%-60%, and is somewhat higher in the case of serum transferrin, in line with the respective affinity constants for the metal. The 3 hydroxypyridin-2-ones and the 3-hydroxypyran-4-ones, both of which have lower affinities for Fe(III), remove smaller proportions of the metal. The percentage of desaturation obtained with bidentate and hexadentate pyridinones appears to be similar for both transferrin classes at chelator:protein molar ratios from 40:1. The degree of transferrin saturation influences the extent of chelator mediated iron mobilization in the case of serum transferrin, but not of ovotransferrin. 59Fe competition studies demonstrate that bidentate pyridin-4-ones are capable of donating iron to serum apotransferrin; the relative concentrations of ligand and protein influence the distribution of iron because their effective binding constants (at pH 7.4) for Fe(III) are similar. PMID- 1791468 TI - Synthesis, antimicrobial, and antitumor activity of a series of palladium(II) mixed ligand complexes. AB - Mixed ligand complexes of cisdichloromethioninepalladium(II) with 2 mercaptopyrimidine and 2-aminopyrimidine were synthesized and characterized by elemental analysis, conductivity data, infrared, and 1H NMR and 13C NMR spectra. In these mixed ligand complexes methionine coordinates to palladium through amino nitrogen and sulphur, thus leaving a free carboxylic acid group. The pyrimidine ligand coordinates to metal ion through N3. Mixed ligand complexes of cisdichloroethioninepalladium(II) with cytosine and guanosine were synthesized and characterized earlier. All the above mixed ligand complexes were screened for antimicrobial activity against Vibrio parahaemolyticus, Pseudomonas aeruginosa, Proteus vulgaris, Escherichia coli, Shigella flexnerri, Salmonella typhii, Klebsella pneumoniae, and Vibrio cholerae. It was found that complexes [Pd(meth)Cl2]: [Pd(meth)(2merpy)Cl]Cl; [Pd(meth)(2ampy)Cl]Cl; [Pd(ethio)Cl2]; [Pd(ethio)(cyt)Cl]Cl; and [Pd(ethio)(guo)Cl]Cl showed broad spectrum antimicrobial activity against all the human pathogens tested, however [Pd(meth)(2merpy)Cl]Cl eliminated plasmid with 100% frequency. These complexes have also been screened in vitro for antitumor activity against Hela (Epidermoid Carcinoma Cervix) and CHO cell lines. An excellent correlation between the antitumor activity of Pd(II) complexes and their ability to cure plasmids exists. PMID- 1791469 TI - On the interaction of phosvitins with ferric ion: solubility of the Fe(III) phosphoprotein complex under acidic conditions is a function of the iron/phosphate ratio and the degree of phosvitin phosphorylation. AB - The interaction of phosvitins, the polyphosphoproteins of the eggs of egg-laying vertebrates, with ferric chloride was investigated under acidic conditions at iron-to-protein phosphorus ratios ranging up to 10. Phosvitins of which all or nearly all serine residues are phosphorylated (P/ser greater than 0.8) precipitate when titrated with the iron salt. As the total Fe/P ratio reaches the value of about 0.5, precipitation becomes maximal. At Fe/P ratios above 0.5, the Fe(III)-phosvitin complex becomes increasingly soluble. At ratios above 2, solubility is essentially fully restored. Phosvitins with an appreciable portion of their serine residues non-phosphorylated (P/ser less than 0.7) show a different dependence of solubility on the Fe/P ratio. The Fe/P ratios of all precipitated complexes themselves vary within a narrow range between about 0.4 and about 1.0; the total Fe/P ratio is varied between 0 and 10. The results imply that phosvitin iron binding sites are non-uniform and that, overall, phosvitin is capable of accommodating iron in different ways, depending on the relative magnitude of the iron load and the availability of phosphoserine clusters in the phosphoprotein. PMID- 1791470 TI - Studies on the synthesis of sesquiterpene lactones, 12. Synthesis of (+) colartin, (+)-arbusculin A, and their C-4 epimers and their biological activities. AB - Colartin [9] and arbusculin A [11] have been synthesized from alpha-santonin [1] in 14.5% (11 steps) and 9.3% (13 steps) overall yields, respectively. Arbusculin A [11] and compounds 20, 21, and 22, which were derived from intermediate 2, showed significant cell growth inhibitory activity against murine lymphocytic leukemia (P-388) in vitro. Plant growth regulating activity of 11 and its synthetic intermediates 4, 5, 8, and 9 was also studied. PMID- 1791471 TI - Two new styryl lactones, 9-deoxygoniopypyrone and 7-epi-goniofufurone, from Goniothalamus giganteus. AB - Two new styryl lactones, 9-deoxygoniopypyrone [1] and 7-epi-goniofufurone [3], and a known styryl lactone, goniodiol [5], were isolated from the stem bark of Goniothalamus giganteus. The structures were elucidated by ir, ms, 1H-nmr, 13C nmr, and 1H-1H COSY spectra; the relative configurations were determined by X-ray crystallographic analysis. Unlike goniopypyrone [2] and goniofufurone [4], neither of the new styryl lactones 1 and 3 showed significant bioactivities to human tumor cells. However, goniodiol [5] showed significant and selective cytotoxicity against human lung tumor cells (A-549). PMID- 1791472 TI - New cytotoxic beta-carboline alkaloids from the marine bryozoan, Cribricellina cribraria. AB - Bioactivity-directed separations led to the isolation of the new alkaloid, 1 vinyl-8-hydroxy-beta-carboline [1], as the major cytotoxic component of the marine bryozoan Cribricellina cribraria. Another new beta-carboline alkaloid 2 with the novel sulfone structure was isolated, together with a number of known beta-carboline compounds. Cytotoxicity and antimicrobial effects are reported for these compounds and for other synthesized beta-carbolines. PMID- 1791473 TI - The crystal structure and cytotoxicity of goniodiol-7-monoacetate from Goniothalamus amuyon. AB - The styrylpyrone, goniodiol-7-monoacetate [1] [6R-(7R,8R-dihydro-7-acetoxy-8 hydroxystyryl)-5, 6-dihydro-2-pyrone], has been isolated from Goniothalamus amuyon, and its detailed molecular structure has been determined by X-ray crystallographic analysis. Goniodiol-7-monoacetate showed potent (ED50 values less than 0.1 microgram/ml) cytotoxicities against KB, P-388, RPMI, and TE671 tumor cells. PMID- 1791474 TI - Yemuoside I, a new nortriterpenoid glycoside from Stauntonia chinensis. AB - A new nortriterpenoid glycoside, named yemuoside [I] was isolated from Stauntonia chinensis. On the basis of chemical and spectral evidence, it structure was determined as 3-O-[alpha-L-arabinopyranosyl-(1----3)-alpha-L-rhamnopyranosyl-(1- --2)-alpha-L-arabinopyranosyl]-30-noroleana-12,20(29)-di en-28-oic acid 28-O [beta-D-glucopyranosyl-(1----6)-beta-D-glucopyranosyl] ester. PMID- 1791475 TI - Iridoids: a new class of leishmanicidal agents from Nyctanthes arbortristis. AB - Iridoid glucosides (arbortristosides A [I], B [2], C [3], and 6beta-hydroxy loganin [4] isolated from the traditional plant Nyctanthes arbortristis show antileishmanial activity in both in vitro (against amastigotes in macrophage cultures) and in vivo (in hamsters) test systems. PMID- 1791476 TI - An antiviral sesquiterpene hydroquinone from the marine sponge Strongylophora hartmani. AB - A new sesquiterpene hydroquinone 1, which we call strongylin A, was isolated from the marine sponge Strongylophora hartmani. Its structure was determined through spectroscopic methods, including 2D-13C homonuclear correlation spectroscopy (INADEQUATE). Both 1 and its acetate derivative are active in in vitro assays against the P-388 tumor cell line and influenza strain PR-8. PMID- 1791477 TI - Antimicrobial N-methylpyridinium salts related to the xestamines from the Caribbean sponge Calyx podatypa. AB - Two antimicrobial fractions were obtained from the sponge Calyx podatypa from the Bahamas. The less polar fraction contained the known compounds xestamines A [1] and B [2] and three new metabolites called xestamines D [3], E [4], and F [5]. The more polar fraction consisted of a mixture of xestamines G [6] and H [7]. PMID- 1791478 TI - Two new brominated tyrosine derivatives from the sponge Druinella (= Psammaplysilla) purpurea. PMID- 1791479 TI - Ryanodyl 3-(pyridine-3-carboxylate): a novel ryanoid from Ryania insecticide. AB - Ryanodyl 3-(pyridine-3-carboxylate) was isolated as a minor component from the wet CHCl3 extract of Ryania insecticide, and its structure was assigned by chemical and spectroscopic methods. This compound is essentially inactive compared with ryanodine for insecticidal activity against Musca domestica adults and Tribolium castaneum larvae, for toxicity to mice, and for competition with [3H]ryanodine at the Ca(2+)-ryanodine receptor complex of skeletal muscle. PMID- 1791480 TI - The effects of pH and rat intestinal contents on the liberation of ellagic acid from purified and crude ellagitannins. AB - This study was undertaken to measure the liberation in vitro of ellagic acid [2], a naturally occurring inhibitor of carcinogenesis, from precursor ellagitannins under conditions found in the gut tract. Enzymes, namely beta-glucosidase, esterases, and alpha-amylase, were incubated with raspberry extract. In addition, raspberry extract and casuarictin [1] were treated at different pH's and with the contents of small intestine and cecum from rats fed AIN-76A diet. The esterase activity of the enzyme samples was measured spectrophotometrically using p nitrophenol acetate as the substrate, and the amount of ellagic acid [2] released from all samples was analyzed by hplc. The hydrolysis of the ellagitannins was not catalyzed by any of the purified enzymes tested, and components of the raspberry extract were found to inhibit the purified esterases noncompetitively. Casuarictin [1] was hydrolyzed to yield high quantities of ellagic acid [2] when placed in buffer at pH 7 and 8, or when incubated with cecal contents for two hours. The release of ellagic acid [2] from the raspberry extract was optimal at pH 8, and maximal release in cecal contents occurred with 1 h. Small intestinal contents had no significant effect on ellagic acid liberation from either casuarictin [1] or raspberry extract. PMID- 1791481 TI - Chemical characterization and pharmacological activity of nazlinin, a novel indole alkaloid from Nitraria schoberi. PMID- 1791482 TI - [Annomonysvin: a new cytotoxic gamma-lactone-monotetrahydrofuranyl acetogenin from Annona montana]. AB - The structure of annomontacin [I], a novel monotetrayhydrofuran fatty acid gamma lactone (acetogenin) isolated from the seeds of Amnona montana, was determined by spectral analysis. The cytotoxicities in vitro of annomontacin [I], annonacinone [2], and annonacin were measured against murine leukemia L1210, human breast adenocarcinoma MDA-MB231, and human breast carcinoma MCF7 cell lines and compared with adriamycin. PMID- 1791483 TI - A cytotoxic and antifungal 1,4-naphthoquinone and related compounds from a New Zealand brown algae, Landsburgia quercifolia. AB - The bioactivity-directed isolation of deoxylapachol [I] from a New Zealand brown alga, Landsburgia quercifolia, is described. Compound I was active against P-388 leukemia cells (IC50 0.6 microgm/ml) and was also antifungal. 1,4-Dimethoxy-2-(3 methyl-2-butenyl)-naphthalene [3] was the major low polarity component of extracts of this seaweed, which also contained 2,3-dihydro-2,2-bis(3-methyl-2 butenyl)-1,4-naphthalenedione [6] and 2-(3-methyl-2-butenyl)-2,3-epoxy- 1,4 naphthalenedione 4,4-dimethoxy ketal [7]. Compound 7 was converted to the 2,3 epoxide of I, which had biological activities similar to those of I. PMID- 1791484 TI - Novel cytotoxic principles of Formosan Ganoderma lucidum. AB - Two new steryl esters, ergosta-7,22-dien-3 beta-yl linoleate [1] and 5 alpha,8 alpha-epidioxyergosta-6,22-dien-3 beta-yl linoleate [3], and a novel steroid, ergosta-7,22-diene- 3 beta,3 alpha,9 alpha-triol [5], have been isolated from the fruiting bodies of Formosan Ganoderma lucidum and characterized. A new lanostanoid, 3 beta-hydroxy-26-oxo-5 alpha-lanosta- 8,24-dien-11-one, and the new steroid exhibited potent inhibition of KB cells and human PLC/PRF/5 cells in vitro. PMID- 1791485 TI - Clinical heart failure trials and the design rationale of Studies of Left Ventricular Dysfunction (SOLVD). AB - Heart failure has become a major worldwide public health problem. Several million patients suffer with this malady and large epidemiologic studies have documented mortality that can be in excess of 50% at 5 years. Furthermore, morbidity is great with this disease and hospitalizations are increasing yearly. Attention must be placed on pharmacotherapeutic strategies that can attenuate the morbidity and high mortality seen in the heart failure milieu. Studies of Left Ventricular Dysfunction (SOLVD) is a large, multicenter, multinational, clinical research program with two, double-blind, randomized clinical trials designed to evaluate the effects of an angiotensin converting enzyme inhibitor, enalapril, on heart failure morbidity and mortality. The program also includes a registry and several substudies that are designed to better clarify heart failure pathophysiology. With over 13,000 subjects participating in this program, SOLVD is the largest clinical heart failure study ever mounted. It is important to consider the design rationale of this program. PMID- 1791486 TI - Mechanisms of photosensitivity in porphyric patients with special emphasis on erythropoietic protoporphyria. AB - In erythropoietic protoporphyria, protoporphyrin overproduction occurs mainly in erythroid tissue. Protoporphyrin can be released from erythrocytes in the dark, but the release is greatly increased if the erythrocytes are exposed to small amounts of light. Protoporphyrin can be bound in plasma either to albumin or to low density or high density lipoprotein. The cutaneous symptoms in erythropoietic protoporphyria are primarily elicited by protoporphyrin-sensitized photodamage of endothelial cells due to the presence of protoporphyrin in lipid structures. Which structures are damaged first in endothelial cells is unknown. Endothelial cells probably accumulate protoporphyrin from albumin or lipoproteins present in the plasma. A direct transfer from the erythrocyte membrane to the endothelial cell membrane can also occur. The transfer processes are probably facilitated by light exposure. Degranulation of mast cells, invasion of neutrophils into interstitial tissue and complement activation seem to be of less importance than endothelial cell injury in the pathogenesis of erythropoietic protoporphyria. These processes may, however, participate in the final expression of the cutaneous symptoms. Uroporphyrin and coproporphyrin are hydrophilic and are probably unbound in plasma, although weak binding to plasma proteins cannot be excluded. In the hepatic porphyrias and in erythropoietic porphyria, the clinical symptoms are probably evoked by uroporphyrin and coproporphyrin present in the interstitial tissue. Very little is known about the primary targets of uroporphyrin and coproporphyrin photodamage in these disorders, but photodamage to intercellular structures probably represents the initial event. Activation of complement may contribute to the final expression of the cutaneous symptoms. PMID- 1791487 TI - Bacteriochlorophyll-a as photosensitizer for photodynamic treatment of transplantable murine tumors. AB - Bacteriochlorophyll-a (bChla), which absorbs light of 780 nm wavelength, was tested for in vivo photodynamic activity in the SMT-F and RIF transplantable mouse tumor systems. High performance liquid chromatography (HPLC) analysis of tissue extracts showed that bChla was rapidly degraded in vivo to bacteriopheophytin-a (bPheoa) and other breakdown products. These were also photodynamically active, and tumor response could be achieved over a wavelength range of 660 to 780 nm, while tumor cure was restricted to wavelengths of 755 (bPheoa) to 780 nm. A photosensitizing product absorbing at 660 nm was also present in isolated tumor cells. Photodynamic cell kill of tumor cells isolated from tumors after bChla accumulation in vivo, using 775 or 780 nm light in vitro, was exponential up to 20-40 J cm-2. Above this light dose little or no further damage could be achieved, which is an indication of the rapid photobleaching of these sensitizers. In vivo, vascular occlusion occurred readily if light treatment was delivered shortly after sensitizer administration, but was delayed if light treatment was carried out 24 h after injection. Although up to 70% of tumor cells were lethally damaged after completion of in vivo light treatment, concurrent severe vascular destruction seemed necessary for tumor cure. Normal tissue photosensitivity totally subsided within 5 days after sensitizer administration. PMID- 1791488 TI - uvrB-dependent, recF-independent post-replication (or replication) repair in Escherichia coli. AB - In UV-damaged cells, a large fraction of pyrimidine dimers may remain unexcised and may be tolerated by a uvrB recA lexA-dependent non-excisional mode of repair (M. Sedliakova, J. Brozmanova, F. Masek and K. Kleibl, Biophys. J., 36 (1981) 429 441). We show here that a similar repair pathway operates in the Escherichia coli recF 143 single mutant but not in the recF uvrB double mutant. This indicates that the putative repair pathway is recF independent. PMID- 1791489 TI - Comparison of the effects of visible femtosecond laser pulses and continuous wave laser radiation of low average intensity on the clonogenicity of Escherichia coli. AB - To evaluate the contribution of local pulsed heating of light-absorbing microregions to biochemical activity, irradiation of Escherichia coli was carried out using femtosecond laser pulses (lambda = 620 nm, tau p = 3 x 10(-13) S, fp = 0.5 Hz, Ep = 1.1 x 10(-3) J cm-2, Iav = 5.5 x 10(-4) W cm-2, Ip = 10(9) W cm-2) and continuous wave (CW) laser radiation (lambda = 632.8 nm, I = 1.3 W cm-2). The irradiation dose required to produce a similar biological effect (a 160%-190% increase in the clonogenic activity of the irradiated cells compared with the non irradiated controls) is a factor of about 10(3) lower for pulsed radiation than for CW radiation (3.3 X 10(-1) and 7.8 X 10(2) J cm-2 respectively). The minimum size of the microregions transiently heated on irradiation with femtosecond laser pulses is estimated to be about 10 A, which corresponds to the size of the chromophores of hypothetical primary photoacceptors--respiratory chain components. PMID- 1791490 TI - Photophysics and photochemistry of new verdin compounds. AB - Five different verdins, including one zinc metal chelate, were examined by laser flash techniques. Triplet molar absorption coefficients, triplet and singlet oxygen quantum yields and triplet lifetimes were determined. Zinc methyl pyroverdin (ZNMPV), copro II verdin trimethyl ester (CVTME) and deuteroverdin methyl ester (DVME) have the highest triplet and singlet oxygen quantum yields. ZNMPV and CVTME have the longest triplet lifetimes. Our data are consistent with singlet oxygen as the primary modality for phototherapy and it is suggested that DVME and CVTME may be useful agents. PMID- 1791491 TI - Photoreactivation in humans. PMID- 1791492 TI - Tumor hypoxia, reoxygenation and oxygenation strategies: possible role in photodynamic therapy. AB - The concept of hypoxia and its role in tumor therapy are currently under re evaluation. Poor oxygenation is no longer visualized as an independent feature promoting necrosis and resistance to treatments, but rather as one of the several interdependent microenvironmental parameters associated with impaired blood perfusion. Tumor cells display several survival strategies and remain clonogenic for long periods in nutrient-deprived situations. Reoxygenation may cause lethal damage, improve the response to therapy, or else allow the cell variants adapted to hypoxia to resume proliferation with enhanced aggressiveness and resistance to treatment. The blood supply parameters, oxygenation status and metabolism of malignant cells are discussed here from the standpoint of tumor photodynamic therapy. The role of the tumor interstitial fluid as oxygen- and sensitizer carrier is discussed. Techniques for assessing tumor oxygenation and for mapping hypoxic territories are described. Strategies for locally improving the oxygenation levels or for selectively destroying the hypoxic populations are outlined. PMID- 1791493 TI - The singlet oxygen and carotenoid interaction. AB - Second-order rate constants kQ for the quenching of O2(1 delta g) by carotenoids were determined at room temperature in benzene and toluene using the technique of time-resolved luminescence. Of the C40 pigments studied, lycopene was found to be the most efficient quencher, but the increased efficiency compared with all-trans beta-carotene was less than previously reported. The efficiency of quenching of O2(1 delta g) was extended to a number of solvents with varying viscosities. kQ was found to be inversely proportional to solvent viscosity, although the relationship is not simply linear. The results suggest the involvement of thermodynamic factors. The efficiency of deactivation of O2(1 delta g) was found to increase with the number of conjugated carbon-carbon double bonds, i.e. kQ(C60) greater than kQ(C50) greater than kQ(C40). A number of xanthophylls were included in this study; it would appear that an epoxide group rather than carbonyl or hydroxyl substituents increase the reactivity of the carotenoid with respect to O2(1 delta g). PMID- 1791494 TI - Effects of pH and ionic micelles on the riboflavin-sensitized photoprocesses of tryptophan in aqueous solution. AB - The effects of pH and ionic micelles on the rates of product formation following irradiation of riboflavin in the presence of tryptophan were investigated by absorption and fluorescence spectroscopy. Under anaerobic conditions, formation of riboflavin-tryptophan adducts was inhibited in acid solutions and by the addition of anionic (sodium dodecylsulphate) and cationic (cetyltrimethylammonium bromide) micelles. The oxidation of tryptophan photoinduced by riboflavin was considerable faster in basic solutions. PMID- 1791495 TI - Action spectra for survival and spore photoproduct formation of Bacillus subtilis irradiated with short-wavelength (200-300 nm) UV at atmospheric pressure and in vacuo. AB - Spores of Bacillus subtilis are approximately ten times less likely to survive UV light irradiation in a vacuum than under atmospheric conditions. Photoproduct formation was studied in spores irradiated under ultrahigh vacuum (UHV) conditions and in spores irradiated at atmospheric pressure. In addition to the "spore photoproduct" 5-thyminyl-5,6-dihydrothymine (TDHT), which is produced in response to irradiation at atmospheric pressure, two additional photoproducts, known as the cis-syn and trans-syn isomers of thymine dimer, are produced on irradiation in vacuo. The spectral efficiencies for photoproduct formation in spores are reduced under vacuum conditions compared with atmospheric conditions by a factor of 2-6, depending on the wavelength. Because formation of TDHT does not increase after irradiation in vacuo, TDHT cannot be responsible for the observed vacuum effect. Vacuum specific photoproducts may cause a synergistic response of spores to the simultaneous action of UV light and UHV. An increased quantum efficiency, destruction of repair systems and formation of irreparable lesions are postulated for the enhanced sensitivity of B. subtilis spores to UV radiation in vacuo. PMID- 1791496 TI - Decarboxylation and singlet oxygen production in the photolysis of nalidixic acid. PMID- 1791497 TI - A possible explanation of laser-induced stimulation and damage of cell cultures. PMID- 1791498 TI - Photodynamic therapy: clinical experience at the Department of Radiotherapy at Padova General Hospital. PMID- 1791499 TI - Synthesis and accumulation of protein and carbohydrases along the rat villus column. AB - Enterocytes of the intestinal mucosa of infant and adult rats continuously proliferate in the crypt, mature as they migrate along the villus column, and are discharged from the villus tip. We examined the synthesis patterns of total protein, lactase-phlorizin hydrolase, sucrase-isomaltase, and maltase glucoamylase as well as the accumulation of these enzymes in cells during migration along the villus. Labeled leucine was administered intraperitoneally to suckling and young adult rats, and radioactivity was determined in protein and digestive carbohydrase pools of developing villus cells separated sequentially from tip to base of the villus column. The developing cells were found to continuously accumulate protein and carbohydrates as they ascended the villus column. In addition, incorporation of radioactivity into total protein and carbohydrase pools occurred at generally constant rates along the length of the villus. These studies showed that the differentiated enterocyte of both infant and young adult rat intestine exhibits a pattern of continuous growth while migrating the length of the villus column and maintains synthesis of protein and digestive carbohydrates at generally constant rates during this time. PMID- 1791500 TI - Lactose in blood in nonpregnant, pregnant, and lactating women. AB - Lactose synthesized in the mammary gland can pass into the bloodstream by either a paracellular or transcellular pathway. In nonpregnant, nonlactating women, the concentration of lactose in the blood plasma was 1.5 +/- 0.1 microM (mean +/- SEM) in 9 women and undetectable in another 11 women. During pregnancy, this concentration was 3.7 +/- 0.4 microM at 10-21 weeks of gestation, with an increase to 8.7 +/- 1.8 microM by 38-40 weeks of gestation. At the initiation of lactation, the concentration of lactose peaked 3-5 days after birth, with a mean peak concentration of 75 +/- 18 microM, and then decreased to 30 +/- 8 microM when lactation was well established at 6 weeks after birth. These findings suggest that the mammary glands are synthetically active by the beginning of the second trimester of pregnancy and reach maximum synthetic capacity soon after birth. Measurement of concentrations of lactose in the blood plasma during pregnancy and lactation may allow an assessment of the successful initiation of both lactogenesis I and II. PMID- 1791501 TI - Metabolites of lactose synthesis in milk from women during established lactation. AB - Metabolites in the lactose synthesis pathway were measured in human milk during established lactation. The mean concentrations (range) were: lactose, 198 mM (175 233); glucose, 1.5 mM (0.1-2.4); glucose 6-phosphate, 11 microM (4-23); glucose 1 phosphate, 2.7 microM (1.6-6.8); UDP-glucose, 2.7 microM (0.6-6.0); UDP galactose, 0.7 microM (less than 0.1-2.5); inorganic phosphate, 2.2 mM (0.8-2.9). During storage of milk within the breast for 2 h, glucose 6-phosphate concentration increased by 1.4 +/- 0.5 microM, while UDP-glucose decreased by 1.0 +/- 0.4 microM. None of the other metabolites showed significant changes in concentration during this period. Only glucose showed a circadian rhythm in concentration, with the highest concentrations between 1400 and 1800 h. The volumes of milk produced by the mothers ranged from 178 to 1,739 ml/24 h. Despite this variation, there were no significant relationships between the 24-h average concentrations of glucose, glucose 6-phosphate, glucose 1-phosphate, UDP-glucose, UDP-galactose, or inorganic phosphate and the amount of lactose produced over 24 h. PMID- 1791502 TI - Adherence of medium-chain fatty acids to feeding tubes of premature infants fed formula fortified with medium-chain triglyceride. AB - Adherence of medium-chain triglyceride (MCT) oil to feeding tubes during gavage feeding of Enfamil formula was quantitated. Infants were fed similar volumes of either unfortified formula (n = 11) or MCT oil-fortified formula (0.5 ml/oz); either the MCT oil was mixed with the formula before feeding (n = 11) or the MCT oil was delivered into the feeding tube and then was followed by formula (n = 11). The fat residue in the feeding sets was quantitated by gravimetry, and individual fatty acids were characterized by gas-liquid chromatography. The data show that only trace amounts of lipid (0.23 +/- 0.04%) adhered to feeding sets during feeding of unfortified formula. Significantly more lipid (p less than 0.0005) adhered when formula was fortified with MCT oil, and the method of feeding greatly affected lipid adherence, i.e., 1.52 +/- 0.21% when the MCT oil was followed by formula versus 10.20 +/- 1.76% when the MCT oil was mixed with formula before feeding. Analysis of the fat residue of fortified formula showed that greater than 90% was composed of C8:0 and C10:0, the major fatty acid components of MCT oil. We suggest that care be exercised when fortifying infant formula with MCT oil. PMID- 1791503 TI - Immunogenicity evaluation of protein hydrolysates for hypoallergenic infant formulae. AB - Casein and soy protein were enzymatically hydrolyzed for potential use in a hypoallergenic infant formula. To assess the relative immunoreactivity of the hydrolysates, rabbits were immunized with either the intact proteins or the protein hydrolysates using a vigorous immunization protocol. Serum samples were tested using ELISA methods that quantitated IgG antibody specific for the immunizing protein hydrolysates and the corresponding intact proteins. The results showed that the protein hydrolysates had substantially lower immunogenicity than the parent proteins. Also, antibody specific for the parent protein showed very low cross-reactivity with the hydrolysates. Both of the protein hydrolysates seem to be promising candidates for use in hypoallergenic infant feeding systems. PMID- 1791504 TI - Soluble interleukin-2 receptor as a marker of lymphocyte activation in childhood Crohn's disease. AB - Serum concentrations of the soluble form of the interleukin-2 receptor (sIL-2R) were determined by an enzyme-linked immunosorbent assay in a group of 39 pediatric and adolescent patients with Crohn's disease and in age-matched ulcerative colitis patients and controls. sIL-2R levels were found to be elevated in patients with Crohn's disease (p less than 0.001), and increased sIL-2R levels were detected in patients with clinically more severe disease. sIL-2R levels correlated more closely with other laboratory markers of disease activity than with a disease activity score. A progressive increase in sIL-2R levels was noted to correlate with endoscopic measurement of disease extent, while sIL-2R levels did not correlate with other markers of systemic lymphocyte activation, suggesting possible local mucosal production. Sequential determinations in individual patients revealed a good correlation between sIL-2R and clinical course. More important, elevated levels of sIL-2R preceded clinical relapse of asymptomatic patients. We conclude that sIL-2R measurement may be a useful adjunct to clinical assessment and routine laboratory testing in pediatric and adolescent patients with Crohn's disease and that serial levels may be predictive of clinical course and the response to therapy. PMID- 1791505 TI - A prospective analysis of cholestasis in infants supported with extracorporeal membrane oxygenation. AB - Cholestasis develops in many infants supported with extracorporeal membrane oxygenation. We prospectively investigated the role of hemolysis and di-(2 ethylhexyl) phthalate exposure in the development of this cholestasis. Both di-(2 ethylhexyl) phthalate levels and hemolysis, as measured by maximum free hemoglobin, were significantly (p less than 0.025) associated with the degree of cholestasis. Other clinical and laboratory factors that may contribute to cholestasis were also investigated and not found to be related to the degree of cholestasis. We speculate that hemolysis during extracorporeal membrane oxygenation support produces a large bilirubin load whose excretion is inhibited by mechanisms similar to the inspissated bile syndrome and/or by di-(2 ethylhexyl) phthalate. This would result in a predominantly direct hyperbilirubinemia with little evidence of hepatocellular or canalicular injury. PMID- 1791506 TI - Duodenal intubation and aspiration test: utility in the differential diagnosis of infantile cholestasis. AB - A prospective study involving 27 infants with cholestatic jaundice was carried out to evaluate the diagnostic utility of the 24-h duodenal drainage test. Extrahepatic cholestasis was confirmed by either exploratory laparotomy or autopsy in 12 of 13 cases without bile drainage, with only one false-positive result. The sensitivity of this test for extrahepatic cholestasis was 100% while the accuracy and specificity were 96.3 and 93.3%, respectively. The corresponding sensitivity, accuracy, and specificity for liver biopsy in patients with extrahepatic cholestasis were 83.3, 92.6, and 100%, respectively. It is concluded that the duodenal drainage test is a simple, rapid, and inexpensive procedure with high sensitivity and specificity in the diagnosis of infantile cholestasis. PMID- 1791507 TI - Chronic inflammatory bowel disease in children and adolescents in Sweden. AB - The incidence and prevalence of chronic inflammatory bowel disease (IBD) in children was established during 1984 and 1985 in a prospective study in Sweden. The patients with IBD were classified as having ulcerative colitis (UC), Crohn's disease (CD), probable Crohn's disease (PCD), and indeterminate colitis (IC) according to defined histopathologic, endoscopic, and radiologic criteria. The study covered 1.51 million children less than 16 years of age (93% of all children in Sweden). The incidence of IBD was 5.0 and 4.5 and the prevalence was 17.6 and 18.2 per 100,000 children during the 2 years, respectively. The mean prevalence of UC was 7.5 per 100,000 and of CD + PCD was 6.2 per 100,000. The prevalence of IC was 4.2 per 100,000, which corresponds to 23% of the children with IBD. PMID- 1791508 TI - Coincidence of congenital toxoplasmosis and biliary atresia in an infant. AB - A 4-week-old infant presenting with neonatal cholestasis was found to have congenital toxoplasmosis and biliary atresia. This is the first patient in which their coincidence is reported. Because biliary atresia can coexist with either congenital infection or inborn errors of metabolism, evaluation for an obstructive etiology of jaundice in infants with a recognized cause of intrahepatic cholestasis is necessary. PMID- 1791509 TI - Spontaneous rupture of a choledochal cyst: clues to diagnosis and etiology. AB - A healthy 3-year-old black girl had acute onset of abdominal pain, vomiting, and elevated aminotransferase, amylase, and lipase levels. Sonographic evaluation suggested a choledochal cyst, but hepatobiliary scintigraphy clearly showed an extrahepatic biliary leak. Exploratory laparotomy confirmed bile peritonitis and a ruptured choledochal cyst. Other cases with this unusual presentation is reviewed in the literature. An anomalous insertion of the pancreatic duct into the common duct appears to facilitate reflux of pancreatic secretions into the biliary tree and may contribute to formation and even perforation of a choledochal cyst. PMID- 1791510 TI - Prolonged postprandial abdominal pain following Kawasaki syndrome with acute gallbladder hydrops: association with impaired gallbladder emptying. AB - Acute hydrops of the gallbladder is a well-recognized complication of Kawasaki syndrome. We report a case of a child with this syndrome whose gallbladder hydrops slowly resolved after intravenous gamma-globulin therapy. However, he continued to experience postprandial right upper quadrant abdominal pain. Hepatobiliary scintigraphy revealed normal filling of the gallbladder but marked impairment of meal-stimulated gallbladder emptying. Endoscopy with biopsy of the esophagus, stomach, and duodenum was normal, ruling out peptic complications of his aspirin therapy. This child's discomfort improved slowly over several months, finally ending approximately 6 months after the onset of his illness. A repeat gallbladder emptying study done ultrasonographically at that time revealed near normal meal-stimulated gallbladder emptying. We conclude that poor emptying of the gallbladder may be associated with prolonged abdominal pain in Kawasaki syndrome. Meal-stimulated gallbladder emptying can be assessed by a simple ultrasonographic technique and should be considered in any patient with Kawasaki syndrome and abdominal pain. PMID- 1791511 TI - Thickening the alphabet soup--hepatitis P? PMID- 1791512 TI - Sex ratio of gastroesophageal reflux in infancy. PMID- 1791513 TI - Whey protein hydrolysate formula for infants with gastrointestinal intolerance to cow milk and soy protein in infant formula. PMID- 1791514 TI - Calculating DWI/DWAI recidivism with limited data: using state driver license file for drinking and driving research. AB - One major research issue in drinking-driving is the volume of DWI/DWAI recidivism in a political unit during a given period of time. This article addresses a methodological issue: How can limited data from the official driver license file be used to calculate drinking-driving recidivism rates? New York State maintains one of the most comprehensive driver license files in the nation, but a dynamic process purges records on the file that are more than ten years old. The magnitude of the recidivism rate calculated from this file, thus, is influenced by the number of data points included: the more years of data included, the higher the rate. We used OLS to examine the impact of the dimension of the data on the recidivism rate and mathematically extended the file to the point where the impact of the data dimension is minimum. We, then, calculated the New York State DWI/DWAI recidivism with an "extended dimension." PMID- 1791515 TI - Negative social effects of being a smoker. AB - Three studies were done to examine the social effects of being a tobacco smoker. In Study 1, 135 subjects rated target persons as dating and marriage prospects. All else being equal, the nonsmoker subjects showed consistent preference for nonsmokers. The subjects' personal preference for nonsmokers was significantly greater than their estimates of the preference of people in general. In Study 2, thirty-five subjects who preferred nonsmokers for marriage provided their reasons. All together, they gave eleven different reasons. In Study 3, which involved sixty-two subjects, the belief underlying each of the eleven preference reasons was found to predict degree of preference for nonsmokers. The results of the three studies are discussed as providing potentially useful information for smoking prevention interventions. PMID- 1791516 TI - Personal and social motivations as predictors of substance use among college students. AB - The Drug Use Survey was administered via a direct mail to a simple random sample of 2200 students enrolled at a large southwestern U.S. university. A purpose of the study was to determine the predictability of self-reported drug use utilizing motivations (personal and social) commonly reported by substance users. Two subscales were developed, one for each category of motivations. Reliability for each subscale as estimated by coefficient alpha was .80 and .86, respectively. A series of step-wise multiple regression analyses were computed in which individual drug use indices served as criterion variables, while the predictor variables were the personal motivations subscale (PMS) and the social motivation subscale (SMS) for each model. The results indicated that the PMS was the stronger predictor in every model with the exception of the model that predicted the alcohol use index. The SMS was the best predictor for alcohol use. PMID- 1791517 TI - Early childhood and maternal antecedents to drug use. AB - In a longitudinal study, the substance use/abuse histories were obtained on a community sample of 640, (mean age of 24.9 years) randomly selected from the 8,000 Philadelphia black subjects who had been studied comprehensively from birth to seven years of age in the National Collaborative Perinatal Project (NCPP). Among other conclusions, it is postulated from some of the many significant associations found between early life variables and substance use/abuse in early adulthood, that an infant is at risk who has the following combination of characteristics and family situation: outgoing, responsive, assertive or impulsive, or willful, and who is in an unfavorable family environment, with a mother who is generally negative toward the infant, has a larger number of small children and has had more fetal deaths, in a generally poor social environment. PMID- 1791518 TI - Prevalence and correlates of alcohol use in a survey of rural elementary school students: the New Hampshire study. AB - Alcohol use by 1190 fourth, fifth and sixth grade students was assessed in a survey of four rural New Hampshire school districts. Half the students surveyed (596) drank, but not regularly; 5 percent (59) were regular drinkers, and an additional 2 percent (19) were regular drinkers and had been drunk at least once. Reported alcohol use increased with both grade and age, and males drank more than females. The child's attitude toward drinking, perceived family attitudes towards drinking, the number of drinking friends, and self-perceived wrongdoing by the child were four factors strongly related to alcohol use. Increased alcohol use was also associated with experimental and current use of cigarettes, marijuana, and smokeless tobacco. PMID- 1791519 TI - The impact of a hospital based educational program on adolescent attitudes toward drinking and driving. AB - The High Risk Adolescent Trauma Prevention Program is situated in a teaching hospital setting, where adolescents who are considered to be high risk-takers tour a shock trauma unit. Results from a pretest-posttest longitudinal evaluation design with 351 adolescent participants indicated marked changes in participants attitudes toward driving after drinking, riding with someone who has been drinking and preventing a friend from driving after drinking. These changes in attitudes are still evident, though with some decline in magnitude, after twelve months. PMID- 1791520 TI - Antecedents of rural adolescent alcohol use: a risk factor approach. AB - The present study examines the association between risk factors and alcohol use for a sample of young adolescents in a rural eastern community. Family relations, family structure, marks in school, participation in academic activities, frequency of church attendance, and deviant behavior were found to be significantly associated with alcohol use two years later. No gender or age differences were found in these predictors of alcohol use. These six risk variables were combined to form a risk index. A 3 x 2 x 2 (User group by Gender by Grade) ANOVA was used to examine the association between the risk index score at Year 1 and level of alcohol use at Year 3. Only the main effect for User group was significant. Thus, the number of risk factors at Year 1 was predictive of alcohol use at Year 3. The risk index also predicted frequency of alcohol use in a replication sample. Implications for the risk factor approach, prevention, and intervention are discussed. PMID- 1791521 TI - [Chromic oxidation and synthesis of barbiturate metabolites]. AB - Chromic oxidation using chromium trioxide in acetic medium is presented as a tool for the synthesis of models of metabolites of various barbiturates. When the pyrimidinetrione is monosubstituted in position 5, a hydroxy group is introduced on the ring. For 5,5-disubstituted barbiturates, branched chains are preferentially converted into tertiary alcohols, while ethylenic chains are, according to their substitution, oxidized into ketones or carboxylic acids. Secondary alcohols lead to ketones but an alcohol function can be protected by esterification. Oxidations followed by other transformations and oxidations of related heterocycles are also described. PMID- 1791522 TI - [Impregnation and liberation of nicotine with hydrogen copolymer discs]. AB - Reticulated copolymers with products N-vinyl-2 pyrrolidone (NVP), hydroxy-2 ethyl (HEMA) and methyl methacrylate (MMA) were realized in disc form. Nicotine was used as active principle. On these discs the following study was carried out: permeation, percentage of liquid absorbed, texture, as well as nicotine release kinetics. A 2-variable (NVP and HEMA/MMA), 5-level experimental plan has enabled the outlining of the significant differences on the action of these parameters. The release kinetics show particularly that these discs behave as forms of prolonged released and that the released quantities are sufficient to envisage the use of these reticulated copolymers within the framework of a transdermal system. PMID- 1791523 TI - Derivative spectrophotometric determination of antiprotozoal drugs in two component tablet preparation. AB - First (D1-) and second (D2-) derivative spectrophotometric methods for the determination of diloxanide furoate and metronidazole in two-component preparation are presented. The methods are based on the direct measurements of diloxanide furoate in 0.1N hydrochloric acid solution at 262 nm and 248 nm for D1 and D2- curves, respectively without the interference of the coexisting component. Metronidazole, on the other hand is determined before and after its acid extraction from chloroformic solution and the subsequent D1- measurement at 288 nm and D2- measurement at 296 nm. The methods have been applied for the determination of both components in laboratory made mixtures and in tablet with a coefficient of variation less than 2%. PMID- 1791524 TI - Polarographic determination of N-acetyl-L-cysteine in pharmaceutical preparations. AB - The polarographic behaviour of N-acetyl-L-cysteine in Britton Robinson Buffer (BRB) over the whole pH range was studied. At pH 10, a well-defined anodic wave was developed. The wave was irreversible, one-electron, diffusion-controlled and partially affected by adsorption phenomenon. Adopting both direct current (DCT) and differential pulse polarographic (DPP) modes, the current concentration plot is rectilinear over the range 0.05 to 1.0 mM and 0.01 to 0.75 mM, respectively, with a minimum detection limit of 0.0005 mM using the DPP mode. The proposed method was successfully applied to the determination of N-acetyl-L-cysteine in pharmaceutical preparations. The obtained results were in a good agreement with those obtained by the official method. PMID- 1791525 TI - [Tolerance to nitrate derivatives: clinical implications]. AB - With chronic use of organic nitrates, attenuation of their clinical efficacy in angina pectoris and in congestive heart failure can occur. This attenuation is more pronounced if controlled release preparations for oral or transdermal use, leading to continuous high plasma concentrations of the nitrates, are used. Twenty-four hour protection, e.g. in a patient with angina pectoris, is not possible with nitrates, and other substances such as beta-adrenergic blockers and calcium antagonists will often have to be associated. The introduction of "nitrate-free periods" to overcome tolerance is discussed. The use of SH providing substances such as N-acetylcystein to counteract the development of nitrate tolerance is, at this moment, only experimental. PMID- 1791526 TI - [The effect of chirality in clinical pharmacology]. AB - Many drugs have one or more asymmetric centres and are used as a racemate: equimolar mixture of enantiomers. Drug enantiomers may interact differently with biological macromolecules. Hence, the influence of chirality in relation to pharmacokinetics and pharmacodynamics needs to be studied. Many pharmacokinetic and pharmacodynamic examples stress on the major influence of chirality. The valuable knowledge acquired from such studies can lead to a better understanding of drug interactions and mechanisms of drug action and to an optimization of drug therapy either by a better use of still marketed racemate drugs of by the development of pure enantiomers. PMID- 1791527 TI - [Reaction and interactions of drugs]. PMID- 1791528 TI - Role of hydrogen bonding in general anesthesia. AB - The importance of hydrogen bonding in determining the potency of a general anesthetic is controversial. In order to investigate the role of hydrogen bonding further, we have used a multiple linear regression approach to quantify the relative importance of various physical properties of an anesthetic molecule (i.e., its ability to donate or accept a hydrogen bond, its dipolarity and polarizability, and its size) in determining its anesthetic potency. For comparison, we have applied the same approach to partitioning between water and three simple, but contrasting solvents (n-octanol, n-hexadecane, and N,N dimethylacetamide) and to inhibition of an enzyme (firefly luciferase) which mimics many of the properties of general anesthetic target sites in animals. We present equations which accurately predict potencies (over many orders of magnitude) for producing general anesthesia and inhibiting the firefly luciferase enzyme. We find that the aqueous potency (defined as the reciprocal of the aqueous EC50 concentration) of a molecule as a general anesthetic or an inhibitor of luciferase is determined overwhelmingly by its size (which increases potency) and its ability to accept a hydrogen bond (which decreases potency), but only marginally by its ability to donate a hydrogen bond or by its dipolarity and polarizability. We conclude that general anesthetic target sites in animals must have, in addition to their overall hydrophobicity, a polar component which is a relatively poor hydrogen bond donor, but which can accept a hydrogen bond about as well as water. PMID- 1791529 TI - Intranasal bioavailability of insulin powder formulations: effect of permeation enhancer-to-protein ratio. AB - The intranasal administration of powder formulations containing insulin and the permeation enhancer sodium tauro-24,25-dihydrofusidate (STDHF) were investigated in the sheep model. Both the hypoglycemic response and the serum insulin levels increased as the mole ratio of STDHF to insulin was increased from 0 to 16.8. In vitro dissolution rates of the powders and the rapid tmax (approximately 5 min) observed after intranasal administration suggest that the absorption of insulin is not dissolution limited. The bioavailabilities (F) of the powder formulations ranged from 2.9 to 37.8%. In comparison, the F values for a solution formulation with a STDHF:insulin ratio of 8.4 administered as either drops or spray were 15.7 and 37.4%, respectively. The permeation enhancer STDHF increases mucosal permeability and reduces the average molecular weight of the insulin species. PMID- 1791530 TI - Pharmacokinetic modeling of plasma and cerebrospinal fluid methotrexate after high-dose intravenous infusion in children. AB - A pharmacokinetic study was performed in plasma and cerebrospinal fluid (CSF) of patients suffering from brain tumors to describe the disposition of methotrexate. An open three-compartment model was developed to fit together the data obtained in plasma and CSF. The pharmacokinetic parameters obtained by the model agreed with those obtained with classical analysis and the fitting correctly depicted the plasma and CSF concentration decays. According to the results, such a model could be applied to other anticancer drugs. PMID- 1791531 TI - Three-dimensional structure and molecular dynamics of cis(Z)- and trans(E) chlorprothixene. AB - cis(Z)-Chlorprothixene has antidopaminergic potency, while trans(E) chlorprothixene is virtually inactive. In order to reveal the structural features causing the difference in activity, the three-dimensional molecular and electronic structures of cis(Z)- and trans(E)-chlorprothixene were examined by computer graphics and molecular mechanical and quantum mechanical calculations. The internal molecular motions of the isomers were studied by molecular dynamics simulations in vacuo and in aqueous solution. The cis(Z)-isomer had lower potential molecular energy than the trans(E)-isomer, mainly due to electrostatic interactions within the side-chain and between the dimethylamino group and the chlorine atom. During molecular dynamics simulations in aqueous solution, the side-chain of the trans(E)-isomer stayed closer to the central S-C axis of the ring system than did the side-chain of the cis(Z)-isomer. The molecular electrostatic potentials were significantly lower in the vicinity of the chlorine atom in the trans(E)- than in the cis(Z)-isomer. Differences in molecular electrostatic potentials and in three-dimensional structure are suggested to be the main reasons for the difference in pharmacological activities of cis(Z)- and trans(E)-chlorprothixene. PMID- 1791532 TI - Transdermal-controlled administration of oxycodone. AB - The permeability of hairless mouse skin membrane to the weak base narcotic analgesic oxycodone (pKa = 8.53) was investigated. The effects of pH on the solubility and skin permeation rate were also studied. The results of the study of skin permeation of drug through hairless mouse skin suggest that the permeability of oxycodone base is approximately 7.4 times higher than that of protonated oxycodone. The nonionic species of oxycodone, at various drug loadings, was then incorporated in a Dow-Corning silicone elastomer for the evaluation of the release rate and skin permeation rate. It was found that Q/t1/2 is directly proportional to the square root of the drug loading dose, as expected by Higuchi's equation (where Q is the cumulative amount released and t is time). However, the skin permeation rate was observed to increase initially with drug loading and level off at the loading dose of 60 mg/cm3. PMID- 1791533 TI - Percutaneous penetration of drugs: a quantitative structure-permeability relationship study. AB - Human skin permeation data taken from the literature were analyzed for quantitative relationships with physicochemical properties and structural descriptors. No correlations exist with molecular weights and solvent-accessible surface areas. In most cases, skin permeation was inversely correlated with the parameter delta log Poct-hep (i.e., log Poctanol minus log Pheptane), which is mainly a measure of the H-bond donor acidity of the solutes. Lipophilicity itself, as expressed by log Poctanol, also contributes positively to skin permeation in some cases. The results of this quantitative structure-permeability relationship study are interpreted in terms of a unified mechanistic model whereby drugs can permeate via an intercellular route (correlation with both delta log Poct-hep and log Poct) and/or a transcellular route (correlation with log Poct only). PMID- 1791534 TI - Intranasal absorption of physostigmine and arecoline. AB - Physostigmine, an acetyl cholinesterase inhibitor, and arecoline, a muscarinic agonist, have been shown to improve Alzheimer presenile dementia in some patients when administered parenterally. Both of these compounds are ineffective orally due to first-pass metabolism. The nasal route was examined as an alternative route of administration for both drugs. Nasal bioavailabilities and dispositions for both drugs were determined in rats. Physostigmine nasal bioavailability was 100% as compared with iv bioavailability, and that of arecoline was 85% when compared with bioavailability following im administration. PMID- 1791535 TI - A random walk method for percutaneous drug absorption pharmacokinetics: application to repeated administration of a therapeutic timolol patch. AB - A random walk method for predicting percutaneous drug absorption pharmacokinetics was proposed. The profiles predicted by this method were compatible with those predicted by the analytical method. The random walk method is particularly useful for predicting complex processes such as repeated topical application of a drug. The amount of a drug released into skin from four therapeutic timolol patches was measured when the patches were serially applied for 2.5 h each on the same site of six healthy male volunteers. On the average, 33.2, 23.4, 15.1, and 16.5% of the applied dose was released into skin from the first, second, third, and fourth patches, respectively. This pattern was comparable with the predicted profiles (43.9, 30.2, 24.4, and 21.1%) of amounts of drug which were expected to be released from the first to fourth patches into skin, respectively. The estimation method for the normalized skin-capillary boundary clearance is also described and applied in examining the percutaneous absorption of timolol. The estimated value for this parameter was much greater than the diffusion parameter, indicating that the removal process of timolol by the local circulation is much faster than the diffusion process through skin. PMID- 1791536 TI - Characterization of distribution behavior of 2-imidazolines into multilamellar liposomes. AB - The distribution of 2-imidazolines in neutral dimyristoylphosphatidylcholine (DMPC) liposomes, in negatively charged liposomes containing dicetylphosphate (DCP) or phosphatidylserine (PS), and in positively charged liposomes containing stearylamine (STA), has been investigated. Electrophoretic mobilities of multilamellar liposomes have also been measured as a function of drug concentration. Apparent equilibrium partition coefficients (log K'm) increased as a function of the DCP or PS concentration in DMPC liposomes whereas log K'm decreased with STA concentration, except for lofexidine and clonidine. Similarly, the electrokinetic parameters increased in DMPC liposomes that exhibited a small, positive surface charge, decreased in DMPC/cholesterol/DCP (7:1:2 mole ratio) liposomes, and increased in DMPC/STA (3:1 mole ratio) liposomes, except for clonidine which showed a decrease, as a function of the 2-imidazoline concentration. Surface potential change (delta psi o) due to drug inclusion in the liposomes obtained from theoretical considerations exhibited a positive linear relationship with log K'm. Values of delta psi o were greater but less sensitive to log K'm in negatively charged than in neutral or positively charged liposomes at 1 mM drug concentration. Likewise, surface charge densities varied in the same order as the surface potentials as a function of log K'm of the 2 imidazolines, except for clonidine and lofexidine. These data indicate the relative importance of the membrane surface characteristics on the partitioning behavior, and also possibly the membrane transport behavior, of the 2-imidazoline drugs. PMID- 1791537 TI - Mutagenic and analgesic activities of aniline derivatives. AB - Phenacetin (1), acetaminophen (2), acetanilide (3), 4-aminophenol (4), and aniline (5) were tested in S.J.L. Swiss mice for their mutagenic and analgesic activities. The S-analogues of 1 and 2, 4-mercaptoacetanilide (6) and 4 ethylthioacetanilide (7), respectively, were synthesized and tested in the same way to define if both activities could be separated by molecular modification. All the compounds tested exhibited analgesic activity with ED50 values ranging from 12.6 to 158.5 mg/kg. The compounds could be arranged in a decreasing order of analgesic activity as follows: 3 greater than 4 congruent to 5 congruent to 6 greater than 1 congruent to 7 greater than 2. All the compounds, except 6, were positive mutagens in the micronucleus test (statistically significant). The order of relative mutagenic potencies was 1 congruent to 7 greater than 4 greater than 2 congruent to 3 congruent to 5. A narrow dose-response curve relationship was found for 5 and its metabolite 4, the relative mutagenic potencies of which suggest ring hydroxylation as the major pathway of biotoxification. No parallelism was found between analgesic and mutagenic activities, so they could be separated by pharmacomodulation: 6 was more effective as an analgesic in the acetic acid test than 2, and no mutagenic activity was found at the doses assayed. PMID- 1791538 TI - Tissue levels and some pharmacological properties of an acetylated metabolite of phenelzine in the rat. AB - The metabolic generation of N2-acetylphenelzine by rats treated with phenelzine, and the activity of this metabolite as an inhibitor of monoamine oxidase enzymes in vivo were confirmed. The isomeric amide N1-acetylphenelzine was not a metabolic product of phenelzine and also did not inhibit monoamine oxidase enzymes. Levels of N2-acetylphenelzine in rat blood, after treatment with a dose (0.1 mmol.kg-1) of N2-acetylphenelzine sufficient to inhibit monoamine oxidase enzymes but not to increase brain levels of dopamine or noradrenaline, were higher than those generated metabolically from a higher dose (0.38 mmol.kg-1) of phenelzine which did increase brain levels of these biogenic amines. Metabolically derived N2-acetylphenelzine, therefore, probably does not contribute in any significant way to monoamine oxidase inhibition by phenelzine. PMID- 1791539 TI - Hydrophobicity parameter of diazines. II: Analysis and prediction of partition coefficients of disubstituted pyrazines. AB - The partition coefficient in a 1-octanol-water system (log P) of a number of disubstituted pyrazines was measured. The increment produced by introduction of two substituents [pi(disubst)PR] was analyzed in terms of the pi value of substituents in monosubstituted pyrazine (pi 2PR) and other physicochemical substituent parameters, considering electronic and steric interactions operating bidirectionally between individual partners of substituents and aza-functions. When the substituents were nonamphiprotic and their steric interaction was not significant, the pi (disubst)PR value was approximately predicted by the summation of the pi 2PR values of corresponding substituents. For amphiprotic substituents, a correction for electronic interactions between the two substituents was needed but it was less important than that required in disubstituted benzenes. The results suggest that the difference in the pi values between disubstituted pyrazine and benzene systems was mostly governed by that between monosubstituted pyrazine and benzene systems with component substituents. In 2,6- and 2,3-disubstituted derivatives, bulky substituents had steric effects in such a way that the log P value was lowered. PMID- 1791540 TI - Determination of specific rate constants of specific oligomers during polyester hydrolysis. AB - Aliphatic polyesters have great utility as temporary prosthetics and surgical aids, and in drug delivery systems. Knowledge of the mechanism and pathways of hydrolysis can form a basis for the design and selection of a controlled-release system. Because of the importance of hydrolysis to the properties of such a system, a technique was developed to accurately determine the specific rate constants and relevant kinetic parameters for the specific oligomers from the reaction mixture of polyesters undergoing hydrolysis. A detailed kinetic analysis of the acid hydrolysis of well-characterized oligomers of polyesters is presented. Several oligomers of poly(butylene tartrate)s were synthesized and their kinetic behavior was studied under acidic conditions. The oligomers and their degradation products were monitored by HPLC and identified by fast-atom bombardment mass spectrometry. From the rates of hydrolysis measured from pH 1 to 3.0 and at temperature of 75 degrees C, it becomes evident that the degradation of the oligomers obeys pseudo-first-order kinetics. The rate of hydrolysis among the homologous series of oligomers increases as the molecular weight increases. The hydrolysis was catalyzed by hydrogen ion; the catalytic rate constant increased predictably with the number of ester linkages present in the molecule. The reaction is first order with respect to the catalyst concentration and the number of ester linkages. Good agreement was obtained with a model in which the individual rate of bond cleavage depends only on the statistical factor. The technique described in this paper is unique for the determination of polyester hydrolysis pathways and isolation of any structural effects on the rates of hydrolysis. PMID- 1791541 TI - Equivalency of hydrochloric acid and distilled water extraction media for determining residual ethylene oxide in medical devices. AB - An alternate method for determining residual ethylene oxide (EtO) in medical devices was compared with the aqueous extraction method suggested by the Association for the Advancement of Medical Instrumentation (AAMI). Residual EtO was extracted from EtO-sterilized samples of acrylic polymer (XT250-301 glass tinted formulation) in pellet form by immersion in 1 M HCl at 37 +/- 2 degrees C (alternate method) or immersion in distilled water (AAMI method). The EtO residuals in the extracts were determined using gas chromatography and were statistically compared using a two-sample t test. Results obtained using the alternative method agreed within 10% of those obtained using the AAMI method. PMID- 1791542 TI - Quaternary and tertiary quinuclidine derivatives as inhibitors of choline uptake. AB - The uptake of choline into cholinergic neurons for acetylcholine (ACh) synthesis is by a specific, high-affinity, sodium- and temperature-dependent transport mechanism (HAChU). Of several quaternary quinuclidinol derivatives tested, the N allyl derivative proved to be most potent. Though the methyl, ethyl, and isopropyl derivatives were less potent at comparable concentrations, at higher concentrations they also maximally inhibited HAChU. The benzyl, hydroxyethyl, and methoxyethyl derivatives failed to inhibit HAChU by greater than 50% at concentrations up to 100 microM. N-Allyl-3-quinuclidinol (NAQ) proved to be a specific inhibitor of HAChU (IC50 = 0.9 microM) and a poor inhibitor of both sodium-independent transport (IC50 = 680 microM) and choline acetyltransferase activity (Ki = 200 microM). The NAQ exhibited noncompetitive type inhibition compared with N-methyl-3-quinuclidinol, a competitive inhibitor of HAChU. Thus, substitution at the N-functional group not only alters potency, but may change the mechanism by which inhibition is produced. The optical isomers of NAQ and several derivatives were prepared and employed to examine the stereochemical selectivity for inhibition of choline uptake. The S(+)-isomer of NAQ (IC50 = 0.1 microM) had approximately 100-fold greater inhibitory activity for HAChU than the corresponding R(-)-isomer (IC50 = 10 microM). With all other quinuclidinols tested, the S(+)-isomers were also more potent than the corresponding R(-) isomers. In an effort to obtain a tertiary inhibitor of HAChU that would be expected to cross the blood-brain barrier following peripheral administration, 3 biphenyl-3-quinuclidinol (BHQ) and 3-naphthyl-3-quinuclidinol (NHQ) were synthesized and evaluated.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791543 TI - Synthesis and anticonvulsant evaluation of some new 2-benzylsuccinimides. AB - A series of 2-benzylsuccinimides (4a-f) were prepared for evaluation as potential anticonvulsants. Primary (Phase I) screening of these compounds indicated that succinimides 4d and 4e, containing lipophilic (+ pi), electron-withdrawing (+ sigma) phenyl substituents, were the most effective in controlling seizures induced by maximal electroshock (MES) and subcutaneous pentylenetetrazol (scMet). Compounds 4a, 4c, and 4d showed activity against scMet-induced seizures equal to that of their 2-phenylsuccinimide analogues and were somewhat more effective in the MES test. In quantitative (Phase II) testing, when administered ip in mice, 4d and 4e both demonstrated anticonvulsant potency superior to that of the prototype drug (ethosuximide) by the MES and scMet assays. However, they also exhibited greater neurotoxicity than ethosuximide in the rotorod test. PMID- 1791544 TI - Physical characterization and dissolution properties of ibuprofen: Eudragit coprecipitates. AB - Ibuprofen:Eudragit coprecipitates were prepared in 10:3 ratios and their physical properties and related dissolution characteristics were determined. The Eudragit polymers used for the studies were three anionics (Eudragit L100, Eudragit L100 55, and Eudragit S-100), one anionic:cationic mixture used in a 1:1 ratio (Eudragit S100 + E100), and four zwitterionics (Eudragits RL 100, RS 100, RSPM, and RLPM). Physical characterizations were made using qualitative and quantitative X-ray diffractometry, IR spectrophotometry, and differential scanning calorimetry (DSC). Except for Eudragit S100 + E100 coprecipitates, no sizeable interaction at a molecular level was detected between the drug and the polymer. The crystalline structure of the drug was slightly modified in the coprecipitates. Regardless of the lack of interaction, dissolution of ibuprofen was retarded from all the coprecipitates studied (except Eudragit L100), especially in the pH 6.8 to 7.5 media in which the drug is freely soluble. The dissolution rate constants of the coprecipitates, calculated using Higuchi equation, demonstrated that dissolution decreased in the order of anionics greater than zwitterionic greater than anionic + cationic mixtures. The data obtained suggest that the release mechanisms involved are the swelling and slower dissolution of the polymer matrix relative to precipitated ibuprofen. The coprecipitates possess improved flow properties compared with ibuprofen with the exception of Eudragit RLPM and Eudragit RSPM. Eudragit coprecipitates can be useful tools in preparing ibuprofen sustained-release tablets. The coprecipitation technique used is simple and minimizes the use of organic solvents. PMID- 1791545 TI - Exact dosing times calculations in linear pharmacokinetics. AB - The problem of determining the particular dosing time, tau, that results in a certain ratio between peak and trough drug levels at steady state (ss) is addressed. Calculation of tau in combination with simple dose linearity principles ensures constraint on the drug level variations at ss, contrary to calculations based on only clearance principles. It is shown that the dosing time problem is solved using a nested, single-variable rootsolving. Using a derivative free, robust, single-variable rootsolver enables automatic, reliable calculations of tau. An algorithm and computer program, SSTATE, for the automatic calculation of tau in intra- and extravascular dosings are presented. Contrary to various approximation formulae proposed in the past, SSTATE provides solutions that are exact. SSTATE provides additional ss parameters such as time to peak, and maximum, minimum, and mean levels, and can also be executed in a simulation mode to explore various practical dosage regimen schemes. Dosage regimen calculations for quinidine are presented to demonstrate the practical utility of the proposed approach. It is also demonstrated by simulation studies that some approximation formulae previously proposed may produce excessive errors, especially when applied to extravascular dosings. PMID- 1791546 TI - On the Kolbe-Schmitt synthesis of pharmacologically useful salicylates: carboxylation of 2,4-di-t-butylphenol and identification and reduction of the formation of 2,2'-dihydroxy-3,3',5,5'-tetra-t-butylbiphenyl in the synthesis of 3,5-di-t-butylsalicylic acid. AB - The initial yield of 3,5-di-t-butylsalicylic acid obtained via Kolbe-Schmitt carboxylation of the potassium salt of 2,4-di-t-butylphenol was less than 1% and was accompanied by a 65% yield of 2,2'-dihydroxy-3,3',5,5'- tetra-t butylbiphenyl, a dimer of the 2,4-di-t-butylphenol formed by ortho coupling of phenoxide radicals. Formation of this dimer was decreased to 8%, and the yield of 3,5-di-t-butylsalicylic acid was increased to 68% by optimizing reaction time and temperature and decreasing the amount of oxygen present during carboxylation. This modification of the Kolbe-Schmitt reaction conditions may be generally helpful in the synthesis of all pharmacologically useful salicylates. PMID- 1791547 TI - Pharmacokinetic consequences of product stereoselectivity in the metabolism of nafimidone: estimation of fraction metabolized. PMID- 1791548 TI - Custom airway for choanal atresia: a clinical report. PMID- 1791549 TI - A two-stage impression technique for the indirect fabrication of multiple cast dowel and cores. AB - Making an accurate impression of root canals prepared for cast dowel and cores can be impeded by the number of teeth involved and the working time of the impression material. These factors aside, the technique described can be used to obtain a detailed full-arch impression that precisely captures remaining tooth structure and all canal spaces. The two-stage technique involves first fitting tapered plastic sprues and making individual canal impressions. A full-arch pickup impression is then made to capture the individual canals. This simple and easily correctable procedure ensures an accurate master cast on which dowels and cores can be indirectly made. PMID- 1791550 TI - Evaluation of marginal adaptation of all-ceramic crowns and metal ceramic crowns. AB - The marginal adaptation of Renaissance crowns is compared with that of the widely used metal ceramic and Dicor crowns. This investigation shows that Dicor and metal ceramic crowns fit better than Renaissance crowns. Clinical implications of all three restorations are discussed. PMID- 1791551 TI - Film thickness of die coating agents. AB - Die coating agents are often used during the fabrication of porcelain margins for crowns and fixed partial dentures. These agents seal microscopic irregularities within the stone die and resist abrasion. This investigation measured the film thickness of several die coating agents. A specific reference point was used during the measurement process. The results indicate that there is no significant difference between the die coating agents examined under the conditions of the study. The film thickness measurements ranged between 0.367 microns for Duro Super Glue Material and 2.3 microns for Zap CA material. PMID- 1791552 TI - Variables affecting the spectral transmittance of light through porcelain veneer samples. AB - The spectral transmittance of porcelain laminate veneers was measured at three different thicknesses (0.50, 0.75, and 1 mm) and three different opacities (25%, 75%, and 100%). The results indicated that the thickness of the porcelain veneer was the primary factor affecting light transmission and not the opacity. The measured values of transmittance were then used to estimate the setting time for light-cured luting agents of a porcelain veneer. PMID- 1791553 TI - The effect of oxidation heat treatment of porcelain bond strength in selected base metal alloys. AB - Base metal alloys have been widely used for fixed partial dentures in the past decade. The oxidation heat treatment (degassing) of these alloys is a controversial step to prepare the metal surface for bonding porcelain. This study evaluated the effect of oxidation heat treatment on the porcelain bond strength of base metal alloys and investigated composition changes that may have occurred during this process. PMID- 1791554 TI - Shear resistance of composite resin to enamel using color-modifying resins and variously applied unfilled bonding resins. AB - The effects of bond layer thickness of color-modifying resins and variously applied unfilled resins on composite resin/enamel shear bond strengths were compared. Composite resin columns were bonded to etched enamel surfaces in vitro with either applied unfilled resins or with filled color-modifying resins. The bond layer thickness and the force required to shear the 17 specimens of each of six groups were measured. ANOVA with Tukey's test was performed to determine if significant differences at the alpha = 0.05 level existed for the mean bond layer thicknesses as well as the mean forces required to debond the specimens of six groups. Color-modifying resins resulted in a 5 to 327 times greater bond thickness than the unfilled resins. Only one of the unfilled resin groups showed a statistically significant difference in shear resistance compared with a color modifying resin group. The method of application and resulting thickness of unfilled resin appeared to have little effect on composite resin/enamel shear bond strengths. PMID- 1791555 TI - Stresses at the dentinoenamel junction of human teeth--a finite element investigation. AB - A three-dimensional, linear, elastic finite element model of a maxillary first premolar from longitudinal ground sections was developed to investigate stress variation in the enamel and dentin adjacent to the dentinoenamel junction (DEJ). The effect of regional variation in the contour of the DEJ on the stress patterns for enamel and dentin was also analyzed. The normal (compressive or tensile) and shear stresses in the dentin and enamel surfaces of the DEJ were computed for a vertical load of 170 N acting on the entire occlusal surface of the model. The normal stresses in dentin and enamel were maximum on the occlusal surface of the model and diminished along the buccal and lingual surfaces of the DEJ. However, the magnitude of the normal stresses increased at the cervical enamel, which also showed increased values for shear stress distribution. The normal and shear stresses were markedly affected by the contour of the DEJ and the thickness of enamel in the occlusal third on the buccal and lingual surfaces. The results suggested that because the mechanical interlocking between enamel and dentin in the cervical region is weaker than in other regions of the DEJ, enamel in this region may be susceptible to belated cracking that could eventually contribute to the development of cervical caries. PMID- 1791556 TI - Twin-tables technique for occlusal rehabilitation: Part II--Clinical procedures. AB - Molar disclusion is determined by the cusp-shape factor and the angle of hinge rotation. A new twin-tables technique has been introduced for developing molar disclusion by using two incisal tables. It is a relatively uncomplicated technique and does not require special equipment. The final prosthesis with the twin-tables technique ensures a restoration with a predictable posterior disclusion and anterior guidance in harmony with the condyle path. PMID- 1791557 TI - Vertical dimension: a dynamic concept based on facial form and oropharyngeal function. AB - Craniofacial vertical dimension is a more accurate measure of facial proportion than mere measurement of the mid and lower part of the face. Craniomaxillary dimension is skeletally determined, whereas facial height of the lower part of the face is partly dependent on the vertical dimension of occlusion. Alterations in the vertical dimension of occlusion can dramatically affect the esthetics of the soft facial tissue. The "Golden Proportion" quantitatively defines ideal measured relationships and encourages a scientific appreciation of beauty. Faces with deficiencies in lower facial balance (brachyfacial) often exhibit insufficient height of the occlusal plane. The scientific literature has suggested a pliability of skeletal muscle allowing for physiologic variance in vertical facial height. Temporomandibular joint compliance is demonstrated with elevations in resting muscle length. Facial balance and location of the occlusal planes are the primary determinants for establishing an appropriate vertical dimension of occlusion. PMID- 1791558 TI - The relationship between lateral border movements of the mandible and the determinants of occlusion. AB - Border movements of the mandible were measured with a jaw movement analyzer in nine subjects. This instrument records movement with 6 degrees of freedom and has the ability to accurately and linearly record the full range of jaw movement. The result of this study showed a relationship between the presence of balancing-side molar contacts and restricted contralateral jaw border movements. This restriction is probably due to aberrant external pterygoid muscle activity. PMID- 1791559 TI - Amalgam onlay restoration. AB - This article discusses a conservative class II amalgam cavity preparation that is similar to a cast onlay preparation except for the absence of the lingual and facial bevels. When extensive decay is removed and undermined cusps are present, onlays from amalgam support tooth structure and prevent fractures. To achieve this, cusps must be reduced to provide for a sufficient bulk of amalgam. The described technique can be applied to class II cavity preparations with weak cusps, class I cavity preparations when the remaining cavity provides adequate retention, and to endodontically treated teeth for which finances do not permit cast restorations. PMID- 1791560 TI - The effect of toothbrushing on a hybrid composite resin. AB - This study observed the effect of various toothpastes on a hybrid composite resin to determine the difference in surface roughness as measured by a profilometer. Slurries (100 gm dentifrice/100 gm H2O) of eight toothpastes were tested by brushing composite resin samples 20,000 times and recording changes in surface smoothness with a profile meter. The surface topography of a hybrid composite resin was altered by routine toothbrushing; the effect of Colgate toothpaste was a statistically smoother surface than found with the other dentifrices; and the surface topography of acrylic resin was altered less by Colgate, Crest, Viadent, and Supersmile than the more abrasive Shane, Sensodyne, Rembrandt, and Topol dentifrices. PMID- 1791561 TI - A method for testing denture adhesives. AB - An in vitro test method is described simulating the in vivo fate of a denture adhesive, i.e., destruction of the adhesive, dilution, and dissolution, by measuring the bond strength for the adhesive placed between acrylic resin plates. Between each measurement, the adhesive was exposed to isotonic saline. The bond strength for two ointment denture adhesives, Super Corega and Fixodent, was measured and the results were compared with those obtained for one of them in a previous in vivo test. The test method described for denture adhesives seems useful to depict the fate of a denture adhesive in clinical use. PMID- 1791562 TI - A comparative study of mastication between complete denture wearers and dentate subjects. AB - A computer system was used for simultaneously collecting and processing mandibular movements and the myoelectric activities of the masticatory muscles of 15 dentate subjects and 11 complete denture wearers. The displacement, velocity, cycle of mandibular movements, and the muscular mean potentials were indices in observing mastication. A good complete denture should perform with physiologic characteristics, and restore masticatory function and oral health. The kinetic energy from the velocities of lateral and vertical directions can serve for the chewing and comminution of food, but lateral comminution may affect denture retention. The mean myoelectrical potentials of the mandibular elevator muscles of complete denture wearers tend to increase at the opening phase; however, the potentials decrease at the closing phase. PMID- 1791563 TI - The transverse strengths of three denture base resins. AB - Ten specimens each of (1) Lucitone 199, short- and long-cured, (2) Accelar 20, and (3) Triad materials were broken using a 3-point load on an Instron Universal testing machine after processing and air drying. Five specimens of each resin also were broken after storage in deionized distilled water at 37 degrees C for 30, 60, and 90 days. Triad material demonstrated the lowest transverse strengths of all three materials overall. However, Triad material was unaffected by water storage. The other resins all showed decreased strengths with water storage. PMID- 1791564 TI - An analysis of the relationship between mandibular alveolar bone loss and a low Frankfort-mandibular plane angle. AB - A group of complete denture patients was studied to determine the effect of a low Frankfort-mandibular plane angle on the loss of residual ridge height in the mandible. Measurements were made from tracings of cephalometric films. The low FMA group did not experience statistically greater amounts of alveolar ridge loss when compared with the group with an FMA larger than 20 degrees. The loss of residual ridge height for both groups followed a linear relationship from year 5 to year 20. There was some indication that the residual ridge height was smaller initially in the low-FMA group. The relative effect of the loss of residual ridge height, combined with smaller residual ridge height originally, indicates that the low-FMA patients are more likely to have anatomic deficiencies and problems with complete dentures associated with this lack of mandibular residual ridge height. PMID- 1791565 TI - Veterans Administration Cooperative Dental Implant Study--comparisons between fixed partial dentures supported by blade-vent implants and removable partial dentures. Part IV: Comparisons of patient satisfaction between two treatment modalities. AB - This study compares treatment assessments made by two groups of patients with Kennedy class I or class II mandibular edentulous conditions, who received either a removable partial denture (RPD) (N = 115) or one or two fixed partial dentures (FPDs), each supported distally by a blade implant (N = 113). Two questionnaires were administered, one at 16 weeks after the implant or RPD insertion and at the 6-month interval and the other at 18, 36, and 60 months. Marked functional improvements were perceived by a large majority of patients in both groups after the insertion of prosthesis. At 6 months, a higher percent of patients with RPDs than those with FPDs found it easy to clean their RPDs and experienced chewing discomfort, restriction of food choices, feeling of insecurity with their RPDs, and difficulty with their pronunciation. The exclusion of assessments by 25 RPD patients, whose treatment was judged to be a failure functionally, made the mean differences between the two treatments statistically significant (p less than 0.05) only for ease of cleaning in favor of the RPD and fewer restrictions of food choices in favor of the FPD group. At 60 months, significant differences between the percents of patients with the most favorable responses occurred for perceptions of eating enjoyment, food particles seldom getting under the removable partial denture, and improvement in social life in favor of the FPD treatment and for the ease of cleaning the removable partial denture in favor of the RPD treatment. The results seem to support superiority of the FPD in terms of patient satisfaction, but not enough to favor this type of prosthesis over the RPD without consideration of other pertinent factors. PMID- 1791566 TI - Tissue compatibility of methylmethacrylate in cranial prostheses: a preliminary investigation. AB - An in vivo study using 48 disease-free male Lewis rats was conducted to determine the histologic difference between an alloplastic cranial prosthesis made with a monomer directly from the manufacturer and a triple-distilled monomer. The histologic difference in the tissue reaction between a cranial prosthesis sterilized with ethylene oxide and one sterilized with cobalt-60 irradiation was also evaluated. Histologic tissue biopsies of the cranium and brain tissues were obtained at 1, 3, 6, and 12 weeks. Tissue biopsies after the third week showed minimal inflammation and the microscopic findings were consistent with the reparative stage of wound healing. The findings also suggest that distillation of the monomer in heat-polymerized methyl-methacrylate is unnecessary for cranial prostheses. Cobalt-60 irradiation was found to be an effective alternative method of sterilization for such prostheses. PMID- 1791567 TI - Tarnish and corrosion with the use of intraoral magnets. AB - Intraoral magnets are small enough and provide sufficient retentive forces to be used in various prosthodontic procedures. This study described 25 patients with 60 magnetic attachments. All implant abutments gave evidence of tarnish, as did 68% of the magnetic keepers in patients with natural teeth. Corrosion was found in 41.7% of the magnetic keepers. Although 88% of the patients were satisfied at 3 months, only 28% were satisfied at 2 years. Rare earth magnets probably can be used for retention of removable prostheses. However, the magnets are likely to tarnish and corrode, making them unacceptable for use intraorally at this time. PMID- 1791568 TI - Diagnostic tests used in determining the role of the occlusion in temporomandibular joint disorders. AB - Two diagnostic tests, positive tenderness to palpation of the inferior bellies of the lateral pterygoid muscles and a positive stress test, are helpful in determining whether the dental occlusion is a principal etiologic factor in ischemic pain in the muscles of mastication. To avoid a noxious occlusal contact, the muscles of mastication, and particularly the lateral pterygoid muscles, must increase their activity. The ability of the patient to supply the oxygen for this activity is variable. When it is inadequate, to relieve ischemic pain the muscular activity must be decreased or the oxygen supply increased. The dentist has the option of using four modalities for the treatment of these painful muscles: physiotherapy, drug therapy, psychotherapy, and occlusal therapy. When the lateral pterygoid muscles are not tender to palpation and the stress test is negative, occlusal therapy is not indicated. PMID- 1791569 TI - Long-term prognosis of extensive polyunit cantilevered fixed partial dentures. AB - The aim of this retrospective study was to elucidate the long-term prognoses of extensive fixed partial dentures including unilateral or bilateral polyunit cantilevers in patients with healthy but reduced periodontal support. Following periodontal therapy 36 cross-arch fixed partial dentures with two or more cantilever units unilaterally or bilaterally were fitted in 34 patients. In the prosthodontic design, special attention was given to the retention to long parallel preparations, to the dimensions of the framework, and to the occlusal design. After completion of therapy, the patients were enrolled in a regular maintenance care program and followed up for a period of 5 to 12 years. During this follow-up period one abutment tooth was fractured in one patient. One fixed partial denture with extremely reduced periodontal support was lost as a result of complete periodontal breakdown from occlusal trauma. For 33 fixed partial dentures, neither periodontal nor technical complications occurred. PMID- 1791571 TI - A barrier technique for laboratory pressure pot. AB - A routine culture of the internal surfaces of a laboratory pressure pot was performed. Candida albicans, Pseudomonas sp., and an unidentified gram-negative rod were isolated. Disposable plastic bags filled with water were used as a barrier to cross contamination during polymerization of repair acrylic resin in a pressure pot. No leakage of plastic bags occurred. The technique is practical and inexpensive. PMID- 1791570 TI - The effects of sodium fluoride and stannous fluoride on the surface roughness of intraoral magnet systems. AB - Four types of intraoral magnets used for retention of overdentures and maxillofacial prostheses were exposed in vitro to SnF2 and NaF to determine the effects of fluoride rinses on surface roughness. The surface roughness (Ra) was measured, after simulated 1, 2, and 5 years' clinical exposure to fluoride (31, 62, and 155 hours). The mean change in Ra was calculated for each period of simulated exposure to fluoride for each magnet type. Two-way ANOVA was used to compare mean change in Ra between magnets within fluorides, and between fluorides within magnets. Paired t tests were used to compare mean change in Ra within fluorides within magnets. The mean change in Ra increased for all magnets after simulated 1, 2, and 5 years of exposure to SnF2 and NaF (p less than 0.03). Using the change in Ra as an indicator for corrosion, PdCo encapsulated SmCo5 magnets and their keepers demonstrated the least corrosion with either fluoride. PMID- 1791572 TI - Bonding of plastic teeth to denture base resins. AB - This study evaluated the bond strengths of some new and traditional resin denture teeth and denture base resins. It included regular monolithic acrylic resin teeth (Bioform), monolithic acrylic resin-IPN teeth (Bioform IPN), and multilithic acrylic resin-composite resin teeth (Vivosit), with relatively new light activated resin (Triad), conventional heat-cured resin (Lucitone 199), and autopolymerizing resin (Hygenic) denture base materials. The results of four point flexure testing showed that the traditional materials gave the highest bond strength values. The autopolymerizing resin systems demonstrated interfacial failure with all resin denture teeth, showing that the common practice of treating teeth with the respective autopolymerizing monomer failed to produce adequate bond strength. Combinations of acrylic resin, IPN, and multilithic denture teeth with light-activated resins gave results calling for improvements in basic bonding system design, since interface debonding was prevalent. No failures occurred between the lap-ridge region of the multilithic tooth system and conventional heat-cured denture base resin. PMID- 1791573 TI - Verifying the adaptation of final impression trays. PMID- 1791574 TI - Use of a modified Boley gauge in determining vertical jaw relations. PMID- 1791575 TI - Clinical practice--delivery of services. PMID- 1791576 TI - Communicating patients' esthetic needs to the dental laboratory. PMID- 1791577 TI - Invited review. The links between stress and illness. AB - Evidence relating stress with illness has emerged from a variety of experimental, clinical and epidemiological research strategies. Psychobiological stress responses emerge through an imbalance between demands and psychosocial resources, and many factors relevant to this transaction have been identified, including the chronicity and predictability of stimulation, opportunities for control, psychological coping responses and the availability of social supports. By contrast, the mechanisms through which stress responses may increase risk of illness are poorly understood, and investigators are frequently obliged to fall back upon a poorly defined 'biological predisposition' to account for individual differences in susceptibility to disease or variations in clinical course. It is argued in this review that several distinct cognitive-behavioural and psychophysiological mediating processes may be postulated, and that these are relevant to different types of influence on health (acute and chronic effects, causal and facilitatory processes, impact on aetiology, maintenance, relapse or recurrence). It is through the recognition and identification of separate processes that questions concerning the specificity of illness outcome, personal resilience, the limits of the impact of psychosocial factors, and the appropriate forms of therapeutic intervention, may be resolved. PMID- 1791578 TI - The interactive effects of Type A behavior and hostility on bleeding time thromboxane and prostacyclin formation. AB - Sixty-six male university students were classified as Type A or B on the basis of the Structured Interview of Rosenman and as hostile or non-hostile on the basis of the Cook-Medley scale. Vascular production of prostacyclin and platelet thromboxane in response to a standard vessel injury was evaluated. Basal thromboxane production, measured as the primary metabolite, thromboxane B2, in blood oozing from the bleeding-time site, was highest among hostile Type A subjects with significantly lower thromboxane production in hostile Type Bs and all non-hostile groups combined. Following an exercise treadmill test hostile subjects produced more thromboxane than non-hostile ones, and hostile Type As had significantly shorter bleeding times than hostile Type Bs. No significant differences on any measure were observed following a stressful color naming task. The observed interaction of hostility and Type A behavior on bleeding time thromboxane formation links behavior to an adverse aspect of a thrombosis-related parameter thought to be involved in the genesis of cardiovascular disease. PMID- 1791579 TI - Women's experience of the menstrual cycle. AB - The present study was concerned with the evaluation of a number of factors which have claimed to be associated with women's experience of the menstrual cycle. The experience was assessed by obtaining self-report measures of mood, sexual arousal and attribution about feelings among women. These factors were related to cycle phase, awareness of phase and number and severity of symptoms. The results indicated that there were no significant differences among the phase groups in strength of mood or number and severity of symptoms. There was a positive relationship between number and severity of symptoms and strength of mood. The results suggest that both culturally held attitudes towards menstruation and biological events should be considered in any explanation of a woman's experience of the menstrual cycle. PMID- 1791580 TI - Personal control and coronary artery disease: how generalized expectancies about control may influence disease risk. AB - Generalized expectancies about control are examined as a possible independent risk factor for coronary artery disease in a sample of subjects undergoing coronary angiography. This characteristic is also examined as a possible underlying component of the Type A behavior pattern which may contribute to the latter's association with heart disease. Regression analyses adjusting for age, sex, income and known risk factors for heart disease (hypertension, serum cholesterol, smoking, diabetes, angina, family history of CHD, hostility and Type A behavior pattern) indicate that having a stronger belief in personal mastery or control is an independent predictor of more severe coronary atherosclerosis. This characteristic, however, is not significantly related to the Type A behavior pattern. PMID- 1791581 TI - Cognitive response to a cold pressor challenge in high and low blood pressure reactive subjects. AB - To examine the relationship between cognitive and cardiovascular reactions to a cold pressor challenge, 20 high and 20 low blood-pressure-reactive males were identified. Subjects were trained using a think-aloud procedure and asked to report their thoughts aloud during task presentation. In comparison to low reactors, high-reactive subjects exhibited greater increases in systolic and diastolic blood pressure, but not heart rate, in response to the task. High reactive subjects reported fewer distracting self-statements than low-reactors during the task. No group differences in positive, neutral, or negative self statements were observed. These findings corroborate the importance of distraction strategies in mediating acute cardiovascular reactions to stress. PMID- 1791582 TI - Predictors of return to former leisure and social activities in MI patients. AB - Outcome after myocardial infarction (MI) is commonly conceptualized as exercise tolerance, recurrent infarction and return to work. In the present study a relative measure of return to former leisure and social activities (LSA) was tested in 366 myocardial infarction (MI) patients. Next, the hypothesis that psychosocial factors are more important predictors for return to LSA than medical ones, was tested. It appeared that at baseline (3 weeks after MI) 36%, at post test (3 months after MI) 51% and at follow-up (1 year after MI) 54%, reached former levels of LSA. It could be shown, both in multiple regression analysis and path analysis, that psychological vulnerability at baseline is the most important predictor of return to former LSA. Females, older patients, single patients and patients with angina pectoris showed an unfavorable psychological profile at baseline. It is suggested that more attention should be given to the improvement of the psychological status soon after MI for the categories of patients mentioned. PMID- 1791583 TI - Use of a diary technique to investigate psychosomatic relations in atopic dermatitis. AB - Previous research on the relationship between stress and atopic dermatitis has employed retrospective approaches such as interviews and measurement of life events and daily hassles. These studies have yielded inconsistent results. In the current study, 50 atopic dermatitis sufferers completed a diary for a fortnight, recording their daily emotional states and skin condition. The results of meta analyses indicated that both interpersonal stress and depression were significantly related to changes in skin condition. Meta-analyses of lag sequential analyses indicated that interpersonal stress on Day X predicted skin condition on Day X + 1 and that this relationship was reciprocal. Depression was predicted by the skin condition of the previous day but this relationship was not reciprocal. These results were integrated and their implications for psychosomatic relationships between stress, depression, and atopic dermatitis were discussed. PMID- 1791584 TI - Northern Ireland: political violence and self-reported physical symptoms in a community sample. AB - In order to investigate the possible relationship between physical health and political violence in Northern Ireland a random sample of residents of four electoral areas (two with relatively high violence and two with relatively low violence) was interviewed at home. Each person was asked to rate their health in terms of common physical symptoms, to indicate their use of family doctor and hospital services, and to rate the level of political violence in their neighbourhood. Analysis of covariance (with a measure of psychological well being, a measure of trait neuroticism plus age and socioeconomic status as covariates) revealed that women reported more physical symptoms than did men, people in the 'high' violence areas reported more symptoms than did those in the 'low' violence areas, while those who rated their own neighbourhood most highly in terms of perceived violence also reported the greatest number of physical symptoms. However, a series of chi 2 tests revealed no association between political violence or perceived political violence and uptake of services. PMID- 1791585 TI - Towards a definition of PMS.II: A factor analytic evaluation of premenstrual change in women with symptomatic premenstrual change. AB - We have examined the value of the Premenstrual Assessment Form (PAF) in 109 women with prospectively validated symptomatic premenstrual change. Results were compared with those of non-complaining women previously published (J Psychosom Res 1990; 34: 439-446.), there was considerable overlap in categorical and numerical scales so that selection of homogeneous populations of complainers could not be achieved. However, fewer than 7% of complainers had a total PAF numerical score in the normal range (defined as 2 SD above the mean total score of controls). Factor analysis of numerical scores in women with symptomatic premenstrual change suggested three factors similar to but not identical with those of non-complaining women. These were physiological depression, anxiety volatility and increased well-being. While the negative syndromes are compatible with clinical experience, prospective investigation will be required to assess their homogeneity. PMID- 1791587 TI - Psychological and somatic distress in relation to perceived hearing disability, hearing handicap, and hearing measurements. AB - Acquired hearing loss has frequently been reported to cause strains in everyday life, but few attempts have been reported where the affliction is related to the concept of stress. In this within-subjects investigation of 48 middle-aged to elderly hearing impaired patients, the relationships between hearing measurements, experienced disability and handicap (HMS), and psychological and somatic distress symptoms (SCL-90(R)) were analyzed. The variations in experienced hearing disability was found to correlate to the occurrence of a few, but more severe distress symptoms, and by loss of hearing for high frequencies. The experienced handicap, defined as emotional responses and personal opinions, was found to correlate to a general level of distress. In particular those distress items expressing insecurity were related to handicap experience. It was suggested that insecurity in social settings, and diminished hearing for contextual sounds, could cause a perceived loss of control, which could induce stress reactions. PMID- 1791586 TI - Mood changes during the menstrual cycle and their relation to the use of oral contraceptive. AB - The relation between the use of oral contraceptives and changes in positive and negative affect over the course of the menstrual cycle was studied in 50 women who completed a mood questionnaire daily during their menstrual cycle. Results indicated that users of oral contraceptives experience a higher level of positive affect during the cycle than do non-users. Positive affect scores were significantly higher than negative affect scores in the menstruation, follicular and luteal phases of the cycle. There were no significant differences between the groups and no discernible phasic changes on negative affect. Discussion of these findings centers on their implications concerning the relation between positive affect and oral contraceptives, the support they provide for the independence of positive and negative affect, and future directions for research in this area. PMID- 1791588 TI - Childhood traumas and lower educational and income levels in the development and progression of essential hypertension in 50 year-old Norwegian men. PMID- 1791589 TI - Difference between C3H mice and Wistar rats in the effect of external gamma irradiation on 59Fe release from alveolar macrophage-ingested 59Fe-iron hydroxide colloid. AB - The effect of external gamma-irradiation on 59Fe release from alveolar macrophages (AMs) that had ingested 59Fe-iron hydroxide colloid was determined in C3H mice and Wistar rats with an in vitro assay system. The release of 59Fe from AM was increased by irradiation in mice but not in rats. A significant increase in 59Fe release was seen in mouse AM cultured for 72 hrs after irradiation at a dose of more than 25 Gy; but, graded doses of gamma-irradiation up to 100 Gy had no effect on 59Fe release from rat AMs. This difference between mice and rats may be attributable to the magnitude of death of or damage to AM because the survival of AMs assessed by vital staining with crystal violet decreased much more in mice than in rats. PMID- 1791590 TI - Tritium precipitation in European cities and in Osaka, Japan owing to the Chernobyl nuclear accident. AB - Tritium precipitations in European cities and in Osaka, Japan were analyzed before and after the Chernobyl nuclear plant accident by the time series analysis code Census IIX11 developed by US Department of Commerce Bureau of the Census. Results of this analysis showed no significant tritium precipitation was produced by the accident although marked amounts of other radioactive nuclides were detected in Europe and Japan immediately after the accident. PMID- 1791591 TI - Strain difference in the susceptibility of thymocytes to radiation-induced apoptosis: in vitro study. AB - The susceptibility of thymocytes from STS/A to radiation-induced cell death was compared with that of thymocytes from BALB/cHeA. After in vitro exposure to 12 Gy X-ray, thymocytes were incubated at 37 degrees C for 8 h and then cell mortality was assessed by 0.02% erythrosin B exclusion. Cell death took place from 2 h in the incubation period, reaching a maximum at 6 h for both strains. The dose effect on cell death at 4 h of incubation was examined after 1-24 Gy of X irradiation. An increase in cell death was detectable even at 1 Gy in both strains. The number of dead cells in BALB/cHeA gradually increased with doses of more than 1 Gy, finally to a maximum (approximately 60%) in the dose range of 8 12 Gy, whereas the maximum cell death in STS/A was approximately 40%. The difference between the strains at maximum cell death was significant (P less than 0.005). The difference in the radiosensitivity of thymocytes between the two strains could not be attributed to a difference in the composition of their subpopulations because flow cytometric analysis based on the expression of CD4 and CD8 showed no intrinsic difference in the thymocyte subpopulations of BALB/cHeA and STS/A. PMID- 1791592 TI - RBE of HTO to 60Co gamma-rays for cell killing of a radioresistant E. coli harboring plasmid. AB - Radioresistant E. coli TGl harboring pUC 18 plasmid which was Ampicillin resistant was exposed to 60Co gamma-rays or 3H beta-rays in saline to determine whether the relative biological effectiveness of 3H beta-rays is higher than one. After exposure to 60Co gamma-rays at a dose rate of 0.465 Gy/min, the D0 by colony formation was 145 Gy in the presence of Ampicillin in or absence from the agar medium; whereas, the D0 was calculated as 118 Gy with and without Ampicillin after exposure to 3H beta-rays at a dose rate of 0.431 Gy/min. The relative biological effectiveness established for 3H beta-rays to 60Co gamma-rays was 1.23. The reason for the higher effectiveness of 3H beta-rays as compared to the reference 60Co gamma-rays is discussed in terms of nascent 0 production. PMID- 1791593 TI - Response to HM Government's consultative document: 'The Health of the Nation'. PMID- 1791594 TI - Secondary school teachers' viewpoint on sex education. AB - The success of any sexuality education programme in the school is directly related to the expertise of teachers and their willingness to provide instructions. This study assesses the knowledge of human sexuality education among 351 secondary school teachers in Ibadan, Nigeria, and their attitude towards inclusion of sex education in the schools' curriculum. Results revealed that none of the respondents was able to define sex education adequately and 34.8% could not identify content areas of sex education for inclusion in the schools' curriculum. Surprisingly, married female teachers and those aged 40 years and above were less favourably disposed to the introduction of sex education in schools. PMID- 1791595 TI - Birth order, socioeconomic status and birth height of Saudi infants. AB - A survey of 4498 singleton births of Saudi infants provided information on birth height, gestational age, birth order and socioeconomic status. The average birth height for the Saudi infant was 49.8 centimeters. The study results indicated a linear relationship between birth order and birth height significant at the probability level 0.001. The relationship between birth height and socioeconomic status was not statistically significant. PMID- 1791596 TI - A survey of dog bites in Salisbury. AB - A recent survey of patients attending an Accident and Emergency (A&E) department serving several economically depressed Thanet coastal towns found that around 3 per 1000 of the resident population attended each year for the treatment of dog bite injuries (Thomas and Banks, 1990). We report a study of dog bite injuries treated in the A&E department serving Salisbury, a small prosperous Cathedral city, and surrounding villages. In comparison with Thanet, age specific incidence rates for dog bites show a similar pattern but only about half the overall incidence. Some reasons for these findings are suggested and extrapolations for national treatment figures are made. PMID- 1791597 TI - European food safety forum. PMID- 1791598 TI - Building a future in Europe--the EEC directive on construction products. PMID- 1791599 TI - On dissipating the Chernobyl blues. PMID- 1791600 TI - Health and housing--annual lecture. PMID- 1791601 TI - Regulations and the quality of care. PMID- 1791602 TI - Food hygiene--caterer's obligations. PMID- 1791603 TI - The present and future handling of the mentally disturbed offender. Part II. PMID- 1791604 TI - Tape worm and diet. PMID- 1791605 TI - Isolated systolic hypertension in the elderly: implications of Systolic Hypertension in the Elderly Program (SHEP) for clinical practice and for the ongoing trials. AB - The Systolic Hypertension in the Elderly Program (SHEP) was a double-blind placebo-controlled outcome trial on the treatment of isolated systolic hypertension (systolic pressure: 160-219 mmHg and diastolic pressure less than 90 mmHg). From 447, 921 screenes (age greater than or equal to 60 years) 4,736 patients were randomised. A significant reduction of non-fatal stroke (37%), non fatal myocardial infarction (33%) and left ventricular failure (54%) was observed in the active treatment group. By contrast, the reduction in transient ischaemic attacks (25%), and in total (13%), cardiovascular (20%), cerebrovascular (29%) and coronary (20%) mortality did not reach a level of statistical significance. SHEP is a landmark trial on the treatment of isolated systolic hypertension (ISH) in the elderly. However, the question to what extent the SHEP results can be extrapolated to clinical practice remains open for debate. Indeed, it is possible that due to selection, the SHEP patients were not entirely representative of the elderly with ISH in the population at large. By contrast with previous intervention studies in elderly patients with combined systolic and diastolic hypertension, the SHEP trail did not demonstrate a significant beneficial effect of antihypertensive treatment on any of the cardiovascular mortality endpoints. Confirmation or rejection of the SHEP results in other trials, including the Syst Eur study, conducted by the rejection of the SHEP results in other trials, including the Syst-Eur study, conducted by the European Working Party on High Blood Pressure in the Elderly and the Chinese trial in elderly ISH patients, is now awaited. PMID- 1791606 TI - Serum calcium and blood pressure. AB - The association between serum calcium and blood pressure was examined in a sample of 7,735 healthy middle-aged British men (The British Regional Heart Study). There was a small but significant correlation between serum calcium and both systolic and diastolic blood pressure (r = 0.15 and 0.11, respectively; P less than 0.0001) after adjusting for age. This association was diminished after adjustment for serum albumin, but remained significant (r = 0.10 and 0.07; P less than 0.0001). This finding is consistent with results from previous studies. To assess whether the association between serum calcium and blood pressure is independent of the levels of other blood constituents, 20 biochemical and haematological factors were examined to identify possible confounding factors. The association between calcium and blood pressure disappeared after adjustment for serum globulins and haematocrit in addition to age and serum albumin. Thus, these factors appear to mediate the weak association between serum calcium and both systolic and diastolic blood pressure. There does not appear to be an independent relationship between serum calcium and blood pressure. PMID- 1791607 TI - The association between blood pressure, calcium and other divalent cations: a population study. AB - This report investigated the associations between blood pressure and the levels of various divalent cations in blood and urine in the population at large. The 1,982 participants (963 men and 1019 women; mean age 48 years) constituted a stratified random sample of the population of 4 Belgian districts. Systolic/diastolic pressure averaged 133/78 mmHg in men, and 128/76 mmHg in women. Serum total calcium (2.37 mmol/l), serum magnesium (1.00 mmol/l) and blood cadmium (10.0 nmol/l) were on average similar in the two sexes. By contrast, serum zinc (13.1 and 12.6 mumol/l, respectively), blood lead (0.56 and 0.36 mumol/l) and the urinary excretions of calcium (4.86 and 3.95 mmol/24h), copper (0.16 and 0.13 mumol/24h), and cadmium (9.4 and 7.2 nmol/24h) were significantly higher in men than in women. After adjustment for significant blood pressure covariates (age, body mass index, pulse rate, log gamma-glutamyltranspeptidase, smoking habits, and in women the contraceptive pill), serum total calcium was independently and positively correlated with systolic pressure in both sexes, and with diastolic pressure in women. After similar adjustments systolic pressure was positively correlated with urinary copper in men and women. In addition, systolic pressure and blood lead, and diastolic pressure and urinary cadmium were negatively correlated in men. In conclusion, this population study demonstrated a positive relationship between systolic blood pressure and both serum total calcium and urinary copper. PMID- 1791608 TI - The role of sex hormones and sodium intake in postmenopausal hypertension. AB - To determine the role of sex hormones and sodium intake in hypertension seen in postmenopausal woman, 12 women (aged 50 to 59 years) in whom blood pressure increased for the first time to above 150/90 mmHg after cessation of menstruation were examined in comparison with 7 age-matched postmenopausal normotensive women (118 +/- 2/62 +/- 3 mmHg). All subjects were admitted to the hospital and their sodium intake was maintained at 204 (normal), 306 (high), and 51 (low) mmol/day for 5 days each. In each period, body weight, blood pressure, heart rate, serum levels of sex hormones and vasoactive hormones, and urinary excretions of sodium, kallikrein and dopamine were determined. The plasma levels of prolactin, progesterone, oestrone, and oestradiol in the hypertensive women were all significantly lower than those in the normotensive women in all study periods. With a change in sodium intake from high to low, blood pressure in 8 out of 12 hypertensive patients decreased by more than 10% from 160 +/- 2/100 +/- 2 mmHg to 144 +/- 2/87 +/- 2 mmHg, while in the normotensive women, only 1 out of 7 patients responded to this change in sodium intake. The changes in sodium intake did not alter the plasma levels of sex hormones in the hypertensive and normotensive subjects. Among the hypertensive patients, three had a history of pregnancy-induced hypertension, while none of the normotensive subjects had such a history. The results of the present study suggest that decreases in sex hormones and increased sensitivity to sodium are important factors in the genesis of postmenopausal hypertension.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791609 TI - Reversal of the relationship between heart rate and blood pressure in phaeochromocytoma: a non-invasive diagnostic approach? AB - A comparison was made between the relationship of heart rate and blood pressure over 24 hours in three patients with phaeochromocytoma and in 56 patients with untreated essential hypertension. All patients wore a non-invasive ambulatory monitor (Accutracker) for 24 hours. A diurnal rhythm of BP and pulse was seen in essential hypertension [daytime; BP 155 +/- 18/86 +/- 12 mmHg (mean +/- SD), pulse 79 +/- 13. Night-time; 142 +/- 21/73 +/- 14 mmHg, pulse 68 +/- 12, P less than 0.05] and a positive correlation was observed between BP and pulse (r = +0.53). Patients with phaeochromocytoma had no diurnal rhythm of BP and all three had a negative relationship between BP and pulse (r = -0.66, -0.51 and -0.79). This negative relationship was abolished by alpha blockade and became positive (+0.5 and +0.6) in two patients who were cured by surgery. The 'normalisation' of this relationship was associated with an increase in plasma volume of approximately 500 ml and probably reflects an intact baro-reflex system in phaeochromocytoma. The observation of a lack of diurnal rhythm together with a negative correlation between BP and pulse may be a clue to phaeochromocytoma in patients with raised blood pressure. PMID- 1791610 TI - The normal hourly variation of blood pressure in women: average patterns and the effect of work stress. AB - The purpose of this study was to examine the pattern of diurnal variation of blood pressure in normotensive working women, and to assess the effect of work stress on this pattern. The subjects were 121 normotensive (based on clinic readings less than 140/90 mmHg) young women (age = 30.2 +/- 7.3 years; range 20 50) who wore an ambulatory blood pressure monitor on a workday from 9 am to 6 am the next day. The effect of work stress on the pattern of variation was assessed by comparing the hourly averages among women who perceived greater stress at work on the day of study ('work stressed') (n = 67) with those of women who perceived greater or equal stress at home on the day of study ('home stressed') (n = 54). The results showed that the systolic pressure of 'work stressed' women was 5-8 mmHg higher (P less than 0.05) and diastolic 3-4 mmHg higher (P less than 0.05) than 'home stressed' women for nearly every hour from 9 am to 6 pm. From 7 pm to 6 am, both groups were similar hour by hour. These data suggest that there is no intrinsic pattern of diurnal blood pressure variation (other than an awake-sleep cycle) in working women. The data also provide a reference standard for comparison with hypertensive women. PMID- 1791611 TI - Comparison of the free radical scavenging activity of captopril versus enalapril: a three month in vivo study in hypertensive diabetic patients. AB - Lipid peroxides and fluorescent serum proteins, possible markers of free radical activity, are increased in diabetic patients, particularly those with angiopathy. Captopril, an angiotensin converting enzyme (ACE) inhibitor, scavenges free radicals in vitro independently of ACE inhibition. This is probably due to the presence of a sulphydryl group which is not present in other ACE inhibitor drugs. We have compared the effects of captopril and enalapril on free radical activity in thirty-two diabetic subjects with hypertension (BP greater than 160/95 mmHg). After a three week run-in period on no antihypertensive therapy, patients were randomly allocated to receive captopril or enalapril, the dose titrated according to BP response. After three months, BP was well controlled in both groups and glycaemic control unchanged. Both drugs were associated with a reduction of fluorescent IgG (captopril:Baseline [BL] 0.564 vs. 12 weeks [w] 0.428, P less than 0.05, enalapril:BL 0.603 vs. 12w 0.422 P less than 0.05) and thiobarbituric acid reactive material (captopril:BL 2.35 nmol MDA vs. 12w 1.46 nmol, P less than 0.05, enalapril:BL 2.44 nmol vs. 12w 1.72 nmol, P less than 0.01). In contrast to in vitro studies, there was no significant difference between the drugs when used in therapeutic doses, questioning a hypothesised advantage of captopril over enalapril. PMID- 1791612 TI - Nifedipine and nisoldipine in hypertensive diabetics. AB - The effects of nisoldipine and slow release nifedipine on mild to moderate hypertension and glycaemic control were studied in 28 diabetic hypertensives, all except one of whom were non-insulin dependent. After two weeks placebo treatment patients were randomised to receive either nisoldipine 5 mg twice daily or nifedipine 10 mg twice daily. If, after four weeks of treatment, diastolic blood pressures (DBP) were 95 mmHg or more, the doses were doubled. On the 'optimum' dose patients were reviewed at weeks 4, 8, 12 and 24. At each visit blood was taken for haematology, biochemistry, glucose and glycosylated haemoglobin (GHb). Twenty-four hour home blood glucose (HBG) profiles were done at the end of the placebo period, and at weeks 8, 12, and 24, when on 'optimum' treatment. Mean sitting blood pressure fell from 173/99 to 161/92 (nisoldipine) and 158/86 mmHg (nifedipine) on the lower doses. Responses to higher doses were less marked. Changes in post breakfast blood glucose and GHb were not statistically significant. There were no significant changes in 24 hr HBG profiles on nisoldipine 5 mg and only minor decreases on 10 mg. On nifedipine 10 mg there was a similar change but on 20 mg an increase in HBG was seen at all points. PMID- 1791613 TI - Introduction: control of blood pressure by combination therapies. PMID- 1791614 TI - From stepped care to tailored therapy. AB - In 1977 the National Heart, Lung and Blood Institute in the USA drew together a panel of experts as the first 'Joint National Committee' to provide guidelines on the detection, evaluation and management of hypertension. This was the birth of 'stepped care', which was internationally adopted, and consisted of: step 1--a diuretic; step 2--if step 1 is inadequate, add a beta-blocker; step 3--if step 2 is inadequate, add a vasodilator (e.g. hydralazine). With the evolution of a broader, multiple risk factor approach to the management of hypertension, and the development of newer agents, this simple system was modified during the 1980s. The relative importance of non-pharmacological intervention resulted in step 1 becoming drug-free, and alternative agents necessitated wider 'steps'. The interaction of hypertension with other coronary heart disease (CHD) risk factors, the disappointing effect of thiazides and beta-blockers on CHD events in intervention trials, and the increasingly large list of potential drug combinations meant that by 1989 several international consensus bodies no longer considered stepped care to be viable. Stepped care has been replaced by 'tailored therapy'. That is, based on an assessment of the patient's overall cardiovascular risk profile, the choice of first-line drug therapy has been broadened beyond diuretics and beta-blockers to include ACE inhibitors, calcium antagonists and selective alpha 1-blockers. Many hypertension experts are now of the opinion that, except in limited circumstances, diuretics and beta-blockers should only be used as second-line or third-line agents. PMID- 1791615 TI - Ambulatory blood pressure measurement in the diagnosis and management of hypertension. AB - Before the diagnostic potential of 24-hour non-invasive BP measurement can be assessed, the accuracy of ambulatory recorders must be established, and normal reference values determined. The accuracy criteria of four ambulatory BP measuring systems (the SpaceLabs 90207, the Novecor DIASYS 200, the Takeda TM 2420 and the Del Mar Avionics Pressurometer IV) have been assessed according to the British Hypertension Society (BHS) protocol, and the Medilog, Suntech Accutracker II and the SpaceLabs 90202 according to the standard of the Association for the Advancement of Medical Instrumentation (AAMI). The SpaceLabs 90202 and 90207, the DIASYS 200 and the Medilog fulfilled the AAMI criteria. The best devices with the BHS grading system are the SpaceLabs 90207 and the DIASYS 200. Normal reference values for daytime, night-time and 24-hour ambulatory BP have been provided by the Allied Irish Bank study of 815 healthy individuals, which showed clear age and sex differences. The mean 24-hour ambulatory pressure for the entire group was 118/72 mm Hg. 24-hour ambulatory BP measurement possesses clear advantages over conventional clinic measurement in evaluating drug efficacy, as it provides many more readings, allowing for the possibility of reducing the number of patients in antihypertensive drug studies and eliminating the need for a placebo-controlled crossover design. It allows assessment of night time BP, which is important in view of the fact that excessive BP reduction may put patients at risk of myocardial infarction.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791616 TI - The mechanisms of hypertension and the role of ACE inhibitors. AB - Hypertension, a condition characterized by narrowing of the arteriolar lumen, is related in part to vasoconstriction and in part to vascular hypertrophy. Complex and interlocking mechanisms involving the autonomic nervous system and both circulating and local vasoconstrictor and vasodilator hormones contribute to this narrowing. Endothelin, 5-HT (serotonin), the kinins and ouabain may all participate by altering sodium, potassium and calcium fluxes in vascular smooth muscle cells. Recently the concept of insulin resistance as a mechanism of hypertension has emerged. Insulin may be a vascular growth factor as well as a local hormone facilitating a rise in intracellular sodium concentration. The observation that ACE inhibitors lower BP when plasma renin and angiotensin levels are low has led to an increased interest in local non-circulating renin angiotensin systems. These systems probably influence arteriolar tone as well as vascular hypertrophy, and their inhibition leads to reduction in BP and some reversal of arteriolar thickening. Thus the ACE inhibitors represent a logical and effective method of treating hypertension and their use is likely to increase in the next few years. PMID- 1791617 TI - Use of ambulatory blood pressure monitoring in pharmacological trials. AB - Four factors govern precision in clinical trials with antihypertensive drugs: the magnitude of the differences in BP to be detected; uniformity in the responses to the antihypertensive agents; the accuracy of the diagnosis of hypertension; and the reproducibility of BP measurements. Ambulatory monitoring has an obvious bearing on all these points. Accuracy is needed for the diagnosis of hypertension. In a group of 255 subjects, 34% had 'false hypertension' on the basis of clinic BP measurements. Unless reproducibility of BP estimates is high, clinical trials must include large numbers of subjects if they are to detect modest differences in BP. With ambulatory monitoring the standard deviation of the difference between two BP readings is reduced by 50%. Changes in DBP of less than 5 mm Hg are not clinically relevant. A trial must be able to detect at least this order of difference. With ambulatory BP monitoring, this is achievable using a small number of subjects, whereas with clinic readings large-scale trials are required. Precision in clinical trials must be improved if antihypertensive drugs are to be introduced on the correct dose regimen. Uniformity in the response to antihypertensive agents has been little studied. Yet none of the agents in common use reduces DBP by more than 10 mm Hg in 50% of hypertensive subjects. Non uniformity of response necessitates the use of crossover design and an accurate estimate of BP. PMID- 1791618 TI - What does the future hold for ACE inhibitors? AB - The most common cause of death in hypertensive patients is myocardial infarction (MI), being three times more common than stroke. Lowering raised BP results in 40% fewer strokes, but only 14% fewer MIs. This may be because other coronary risk factors that often accompany hypertension (e.g. obesity, lipid and thrombotic disturbances, insulin insensitivity, increased plasma renin activity and increased sympathetic activity) are either unaffected or exacerbated by some of the traditional antihypertensive agents. Some of these risk factors show a diurnal rhythm peaking at 07.00-10.00 hours, thus this time constitutes a 'vulnerable period' for sudden death or death from MI. beta-blockers and diuretics have been effective in preventing stroke, but diuretics (at least potassium-losing diuretics) might actually increase the incidence of sudden death and MI in young to middle-aged hypertensive subjects (though elderly patients may benefit). Quality of life can be impaired by some beta-blockers, and diuretics can cause metabolic upset and male impotence. Thus, antihypertensive agents that are not only effective and well tolerated but are beneficial to the broader coronary risk profile are desirable. ACE inhibitors should prove particularly useful in terms of: good quality of life; non-exacerbation or improvement of coronary risk factors; treating patients with impaired left ventricular function; reversing left ventricular hypertrophy and vascular wall hypertrophy, thus improving coronary flow reserve; atheroma regression; renal protection, particularly in diabetes; and prevention or regression of LV dilatation (remodelling) following MI. PMID- 1791619 TI - Patient selection factors in angiographic studies: a conceptual formulation and empirical test. AB - Studies using coronary angiography patients as the study population to assess etiologic relationships are vulnerable to bias produced by patient selection factors, but the direction and magnitude of the bias in any particular study are uncertain. Partly for this reason, some authors have questioned the use of angiography data for studies of etiology. Nevertheless, this type of data continues to be used in etiologic studies. Therefore, in this paper a conceptual framework is described to quantify the degree of bias under different assumptions about the process whereby patients are selected for angiography. The direction and degree of bias depend on the pattern of patient selection, as well as the measure of association used (e.g., the risk ratio or odds ratio). One method is then described, based on assessing how physicians refer patients to angiography, which estimates the degree of bias produced by selection factors. This study is limited to the situation of a two-level risk factor (e.g., type A/B behavior) in relation to a two-level outcome measure (e.g., significant coronary artery occlusion versus no significant coronary artery occlusion). While type A/B behavior is used as an example in this paper, the concepts apply to any behavioral or nonbehavioral predictor variable. PMID- 1791620 TI - Hostility-related variables and plasma lipid levels. AB - The present study was conducted to examine whether lipid levels would be related to cynical hostility (an attitudinal component of hostility), expressive hostility (a behavioral component of hostility), and neurotic hostility (an emotional component of hostility). Subjects were 74 men and 54 women who were free of potential medical factors affecting lipoprotein levels. Across both genders, expressive hostility was found to be positively related to total cholesterol and low-density lipoprotein (LDL). Neurotic hostility was not related to lipid levels for either men or women. These results are congruent with other evidence, suggesting that expressive hostility but not hostile emotions contributes to atherogenesis. For men but not women, cynical hostility was found to be positively related to LDL. These results for men are congruent with findings, albeit not consistent, of a relation between cynical hostility and coronary artery disease. PMID- 1791621 TI - Type A behavior and marital interaction: hostile-dominant responses during conflict. AB - Previous research has indicated that the risk conferred by men's Type A versus B behavior depends, in part, on the personality characteristics of their spouses. In the present study of 60 married couples, we found that couples consisting of two Structured Interview-defined Type A's showed a larger increase in hostile/dominant behavior during discussions of marital conflicts than did couples consisting of two Type B's or a Type A husband and a Type B wife. Couples consisting of a Type B husband and a Type A wife displayed an intermediate level of hostile dominance. These results are consistent with previous speculations about interpersonal dynamics in Type A behavior and interaction patterns which might underlie spouse effects on Type A behavior and coronary risk. PMID- 1791622 TI - Cynical hostility, attempts to exert social control, and cardiovascular reactivity in married couples. AB - Chronically hostile persons may be at greater risk of cardiovascular illness, perhaps because of their more pronounced physiologic responses to interpersonal stressors. The present study of married couples examined the association between Cook and Medley Hostility (Ho) Scale scores and cardiovascular reactivity while couples were engaged in a discussion task with or without an incentive to exert control over their partner. Cynical hostility was associated with greater heart rate (HR) reactivity among husbands in both conditions and with greater systolic blood pressure (SBP) reactivity among husbands attempting to influence their wives. Further, husbands' cynical hostility was associated with greater SBP reactivity in their wives. Wives' cynical hostility was unrelated to their own or their husbands' reactivity. These results underscore the importance of social contexts in the association between hostility and psychophysiologic processes and suggest that the motive to exert social control may be important for hostile persons. PMID- 1791623 TI - Long-term changes in Type A behavior: a 27-year follow-up of the Western Collaborative Group Study. AB - This study examined the long-term stability of Type A behavior pattern in the Western Collaborative Group Study for 1180 surviving participants in a 27-year follow-up examination during 1986-1987. Subjects were readministered the Structured Interview (SI), originally developed for this study and first administered at intake in 1960-1961. Subjects were also given the Jenkins Activity Survey (JAS) and were asked to evaluate their behaviors currently and in the past using two short descriptions of Type A and Type B behaviors. Analyses of changes in global SI ratings, JAS score, and self-ratings showed no relationships between self-perceived changes reported in questionnaires and observed changes when assessed by the SI. Using the SI ratings, 61% of subjects retained their initial classification and 39% of subjects were rated differently, with a higher percentage of those originally typed B being rerated as A than A being rerated as B. Type B subjects rerated as A were significantly younger, retired earlier, reported better health, and were less likely to have been in a managerial or professional position than the subjects who changed from A to B. PMID- 1791624 TI - Incidence of laboratory-based heart rate reactivity during typical daily events. AB - Heart rate reactivity to a standardized laboratory stressor (mental arithmetic under timed and competitive conditions) was measured in 37 men and women, drawn from white- and blue-collar occupations. In addition, heart rate reactivity data during 4 hr of work were gathered on each of these subjects and analyzed to determine (1) the presence during work time of reactivity equal to or greater than that to the mental arithmetic stressor; (2) the incidence of reactivity of 5, 10, 15, and 20 bpm during work time, and (3) the predictability of frequency of work time reactivity by mental arithmetic reactivity. Data suggested that, although there were several incidences of heart rate reactivity responses during work which were similar to those noted in the laboratory, these work heart rate responses were not able to be significantly predicted by laboratory heart rate responses. PMID- 1791625 TI - Smokers unlikely to quit. AB - Data from a population survey were used to examine the relationships of the number and the duration of previous smoking cessation attempts with current confidence and perceived difficulty of quitting, beliefs about reasons for current smoking and for previous relapses, and preferences for different forms of assistance with cessation. There were significant positive relationships between the duration of previous cessation attempts and perceived difficulty and between the number of previous cessation attempts and confidence. Those who had made more cessation attempts and who had been able to abstain for less than a week were more likely to attribute both relapse and current smoking to uncontrollable factors such as addiction. There were no relationships between cessation attempts and preferences expressed for personalized, or any other, forms of assistance with cessation. These results support the proposition that multiple and short duration smoking-cessation attempts are related to reduced optimism regarding future cessation. PMID- 1791626 TI - Dentists evaluate their patients: an empirical investigation of preferences. AB - Dental treatment is a dyadic encounter. Yet research on the dentist-patient dyad has tended to focus on patient perceptions of dentist, to the neglect of dentist perceptions of patient. Previous theoretic and qualitative work on caregiver perceptions of patients suggested three dimensions of evaluation. Dentists (N = 618) rated their patients on items taken from two prior studies. Dentists' responses were subjected to confirmatory factor analysis. The analysis substantiated the existence of three evaluative dimensions: compliance, tractability, and likability. Further analysis showed that the three dimensions formed a Guttman simplex, revealing a second-order factor of selectivity and allowing a classification of dentists on the basis of patient selectivity. PMID- 1791627 TI - Cell behavior during early development in the South American annual fishes of the genus Cynolebias. AB - Living embryos of three species of South American annual fishes, Cynolebias constanciae, C. nigripinnis, and C. whitei, were observed from fertilization through the 10-somite stage. A description of normal stages of development applicable to all three species of Cynolebias is presented. Cleavage (stages 1 10) is meroblastic and produces a typical teleost blastoderm. Following cleavage (stages 11-13) blastomeres segregate into two populations, viz., 1) a population of deep blastomeres that will disperse as single motile cells, and 2) a hemispherical shell of outer blastomeres that flattens to form an enveloping cell layer (EVL). When epiboly of the EVL and the yolk syncytial layer (YSL) commences (stage 14), deep blastomeres clump together as a consolidation mass and then migrate outward as single cells on the YSL. When epiboly is concluded (stage 19), deep blastomeres have completely dispersed. If diapause does not intervene, the dispersed phase lasts only a few days. Subsequently, the dispersed cells come together to form a definitive aggregate (stage 27). Embryogenesis within the reaggregated mass of previously dispersed cells produces a typical teleost embryo. Early development in Cynolebias resembles that of other South American annual fishes, such as Austrofundulus, in that a phase of deep blastomere dispersion and reaggregation spatially and temporally separates epiboly from embryogenesis. Several features of development markedly differ from Austrofundulus. There are far fewer (250 vs. 2,500) deep blastomeres. Deep cells of Cynolebias are flattened rhomboids with filipodial extensions in contrast to the amoeboid cells of Austrofundulus. Blastomeres of dispersion and reaggregation stages in Cynolebias send out numerous cell surface extensions onto the YSL and in contact with one another, and often line up in rows as do some African annual fishes, e.g., Nothobranchius. During Dispersion II (stage 21), Reaggregation I (stage 22), and Reaggregation II (stage 23), deep cells move in an oriented pattern with respective mean velocities of 3.48 +/- 0.91, 1.28 +/- 0.46, and 1.31 +/- 0.31 microns/minute. Cells move toward a granular mass of unknown composition, located at the YSL-yolk interface in the lower hemisphere of the egg. This mass appears to coincide with the site of cell reaggregation. PMID- 1791628 TI - Functional analysis of a specialized prey processing behavior: winnowing by surfperches (Teleostei: Embiotocidae). AB - Several surfperches (Embiotocidae), including the black surfperch, Embiotoca jacksoni, exhibit a specialized prey handling behavior known as winnowing, in which ingested food and non-nutritive debris are separated within the oropharyngeal cavity. Prey items are swallowed, and unpalatable material is ejected from the mouth. Winnowing is believed to play an important role in the partitioning of food resources among sympatric embiotocids. We present a mechanistic model for this separative prey processing based on high-speed video analysis, cineradiography, electromyography, and buccal and opercular cavity pressure transducer recording. Winnowing by embiotocids is characterized by premaxillary protrusions repeated cyclically with reduced oral gape. Protrusion is accompanied by depression of the hyoid apparatus and adduction of the opercula. Alternating expansion and contraction of the buccal and opercular cavities generate regular pressure waveforms that indicate bidirectional water flow during processing. Separation of food from debris by Embiotoca jacksoni occurs in three phases. The prey-debris bolus is transported anteriorly and posteriorly within the oropharyngeal cavity and is then sheared by the pharyngeal jaws. Mechanical processing is complemented by the rinsing action of water currents during hydraulic prey transport. The feeding apparatus of Embiotoca jacksoni is functionally versatile, although not obviously specialized relative to that of nonwinnowing surfperches. Protrusion of the premaxillae and depression of the hyoid apparatus are critical to both prey capture and subsequent prey processing. The pharyngeal jaws exhibit kinematic patterns during separation of food from debris distinct from those observed during mastication of uncontaminated prey. This behavioral flexibility facilitates resource partitioning and the coexistence of E. jacksoni in sympatric embiotocid assemblages. PMID- 1791629 TI - Nucleoside transport inhibition and fMLP-stimulated whole blood luminescence. AB - Adenosine (ADO) has a pharmacological profile which makes it an interesting 'drug' to handle many of the problems arising with ischemia and reperfusion. In human blood, however, it is rapidly taken up by the red blood cells and metabolized to inactive inosine and hypoxanthine. This transporter-mediated uptake can be specifically inhibited in vitro by a few drugs, known as nucleoside transport inhibitors. It has been reported that ADO can inhibit platelet aggregation in whole blood in the presence of dipyridamole, and it is well-known that ADO can inhibit the respiratory burst of purified neutrophils induced by certain stimuli. We investigated the effect of some of these drugs on the ADO mediated inhibition of the fMLP-induced respiratory burst in neutrophils (as measured by lucigenin-enhanced luminescence), in undiluted whole blood. The combination of R 75,231 (a newly developed analog of mioflazine, with unique pharmacokinetic properties, for details see with ADO (0.1 microM) inhibited the luminescence by 40 +/- 4% (n = 10), while either R 75,231 or ADO alone did not affect the response to fMLP. In the presence of ADO (1 microM), R 75,231 (EC50 = 1.9 +/- 0.3 x 10(-7) M) (n = 3) was almost as potent as dilazep (EC50 = 1.1 +/- 0.2 x 10(-7) M) (n = 3), but far more potent than dipyridamole (EC50 = 1.2 +/- 0.2 x 10(-6) M) (n = 3). The present data show that ADO can inhibit PMN activation in whole blood in the presence of R 75,231 or of other nucleoside transport inhibitors.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791630 TI - Developmental changes in ventricular action potential properties in guinea-pigs are modulated by age-related changes in the thyroid state. AB - Previous studies have demonstrated that in different cardiac preparations action potential duration (APD) increases with age. As in various species, thyroid hormone levels increase developmentally, and since hyperthyroidism shortens APD while hypothyroidism prolongs it, we hypothesized that developmental changes in APD result from age-related variations in the thyroid state. The hypothesis was tested by analysing ventricular action potentials and total T4 (TT4) levels in guinea-pigs in the age range of 0 days to 3 months (adult), and in hyperthyroid and hypothyroid newborns (0-5 days old). We found that APD50 increased exponentially with age with a time constant of 6.7 days, from 100.6 +/- 3.4 ms in newborns (0-5 days old) to 147.4 +/- 5.2 ms in adults (P less than 0.001). TT4 decreased exponentially with age with a time constant of 4.8 days, from 3.9 +/- 0.4 micrograms/dl in newborns to less than 1.0 microgram/dl in adults. In the age range studied, APD50 and TT4 were linearly correlated: Y = -12.13X + 142, r - 0.865. In contrast to the marked changes in APD, resting potential and action potential amplitude were age-independent, and Vmax only slightly increased with age. Alterations in the thyroid state in newborns affected ventricular action potentials as predicted by the hypothesis. In euthyroid (TT4 = 3.9 +/- 0.4 micrograms/dl), hypothyroid (TT4 = 1.6 +/- 0.4 micrograms/dl) and hyperthyroid (TT4 = 39.8 +/- 10.8 micrograms/dl) newborns, APD50 was: 100.6 +/- 3.4 ms, 117.7 +/- 4.2 ms and 63.7 +/- 7.4 ms, respectively (P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791631 TI - Functional and structural impairment in human, rat and guinea-pig atrial muscle in response to in vitro calcium overload: a cytochemical study on cellular calcium distribution. AB - Critical accumulation of cellular calcium in ischaemic myocardium is involved in irreversible cell damage. In human right atrial trabeculae and in rat and guinea pig left atria, we investigated whether direct calcium overload by increasing the extracellular calcium concentration, [Ca2+]o, leads to similar impairment of function and ultrastructure as observed after ischaemia. The force of contraction was measured during two consecutive cumulative increases in [Ca2+]o (1-25 mmol/l) separated by 30 min of incubation at low [Ca2+]o. Compared to the first Ca2+ challenge, the positive inotropic effect of increasing [Ca2+]o was depressed during the second one and the after-contractions, and the increase in resting tension developing with high [Ca2+]o tended to be larger. The ultrastructure of the tissue fixed immediately after excision was well preserved. When fixed after the second Ca2+ challenge, half of the cells were severely damaged with various signs of cellular Ca2+ overload similar to those observed after ischaemic damage: the sarcolemma lost its Ca(2+)-binding properties, sarcomeres showed contraction band necrosis, the mitochondria had disrupted cristae and contained either large clusters of Ca2+ precipitate or amorphous densities (Jennings granules). In many cells, calcium precipitates were present in the cytoplasm. The morphological and functional changes were similar in the three species studied. Our results suggest that the deterioration of atrial myocardium after challenge with high [Ca2+]o or after severe ischaemia may be traced back to a common mechanism, i.e. the sarcolemma loses its competence as a permeable barrier for Ca2+ and therefore facilitates excessive Ca2+ entry. However, for the direct demonstration of calcium precipitates as a sign of cytosolic Ca2+ overload, high [Ca2+]o are required with are not normally present in the myocardium. PMID- 1791632 TI - Cell shape and organization of the contractile apparatus in cultured adult cardiac myocytes. AB - The isolation and culture of adult cardiac myocytes has proved to be an ideal model system to explore myocardial biology at the cellular level. A major criticism of this model, however, has been that organ-specific characteristics such as cell shape and subcellular structural organization cannot be retained in vitro for prolonged periods of time. Encasing freshly isolated myocytes in a matrix of calcium alginate enables one to maintain the rod-like, three dimensional (3D) shape of the cultured myocyte. Such preparations more closely resemble their in vivo counterparts with respect to the organization of the contractile apparatus, the transverse tubular system and the sarcoplasmic reticulum than do heart cells cultured on a two-dimensional (2D) plastic surface. Stereologic measurements reveal that myofibrillar volume density (VvMYF) decreases in both non-beating preparations over a 2-week interval, but VvMYF is conserved in cells cultured in an alginate matrix when compared to those myocytes maintained on a laminin-coated substratum. The present observations suggest that in the absence of contractile function myofibrillar atrophy appears responsible for the decline in VvMYF in alginate (3D) preparations, whereas atrophy and subcellular remodelling probably mediate the myofibrillar loss and reorganization that develops when adult heart cells are cultured on a 2D surface. PMID- 1791633 TI - Nuclear size and DNA content in rat cardiac myocytes during growth, maturation and aging. AB - Changes in nuclear volume and DNA content were examined in cardiac myocytes isolated from 21-day-old (weanling, W), 3-month-old (adult, A), and 2-year-old (old, O) rats to document normal parameters for nuclear growth and DNA content. Nuclear volume was calculated from direct measurements of isolated myocyte nuclear profiles and DNA content was measured from DAPI-stained nuclei using an image analysis microdensitometry system. Myocyte volume was measured with a Coulter Channelyzer system. Nuclear volume increased 79% from W to A as a result of an increase in nuclear length. Nuclear width was unchanged. Nuclear volume was not changed from A to O. Approximately 98% of the left ventricular myocytes from all three rat groups contained a diploid DNA content with the remainder of nuclei being tetraploid. The degree of polyploidy increased slightly, but significantly, in right ventricular myocytes from O. Due to the substantially greater increase in myocyte volume relative to nuclear volume, nuclear volume percentage decreased from 3.65 +/- 0.28 to 1.64 +/- 0.13 from W to A but was unchanged from A to O. To summarize: (1) nuclear volume of rat cardiac myocytes increases significantly during normal physiological growth (W to A) but the rate of nuclear growth is less than that of cell volume; (2) the increase in nuclear size from W to A is not due to an increase in DNA content; (3) cardiac myocytes from Sprague-Dawley rats are predominantly diploid; and (4) there is little change in DNA content of cardiac myocytes from rats of this strain during growth, maturation and aging. PMID- 1791634 TI - Increased myocardial inositol trisphosphate levels during alpha 1-adrenergic stimulation and reperfusion of ischaemic rat heart. AB - Although stimulated [3H] inositol phosphate turnover has been demonstrated in isolated, perfused [3H] inositol prelabelled rat hearts, there is still no information regarding Ins (1,4,5)P3 levels in intact cardiac muscle. Using a D myo-Ins(1,4,5)P3 assay system, Ins(1,4,5)P3 levels were determined in isolated perfused rats hearts during ischaemia, reperfusion and alpha 1-adrenergic stimulation via noradrenaline (3 x 10(-5) M). Control hearts contained +/- 674 pmols Ins(1,4,5)P3/g dry heart weight. Myocardial Ins(1,4,5)P3 levels were significantly decreased (+/- 389 pmols/g dry heart weight) after exposure to 20 mins of normothermic ischaemic cardiac arrest (NICA). Reperfusion produced a marked increase in Ins(1,4,5,)P3 levels (+/- 1,115 pmols/g dry heart weight) after only 30 s. Noradrenaline caused a 3-4 fold increase in tissue Ins(1,4,5)P3 levels within 30 s. After 20 mins stimulation with noradrenaline, the Ins(1,4,5)P3 levels were still significantly elevated. The rise in tissue Ins(1,4,5)P3 levels during reperfusion as well as during noradrenaline administration was counteracted by neomycin (0.5 x 10(-3) M), an inhibitor of phosphoinositidase specific phospholipase C. In both events neomycin restored the Ins(1,4,5)P3 levels to control values. For correlation of tissue Ins(1,4,5)P3 levels with mechanical events, noradrenaline (3 x 10(-5) M), in the presence of 10 mM LiCl, 10(-7) M propranolol and 10(-7) M atropine, was administered to isolated perfused rat hearts and the mechanical performance recorded over a period of 20 mins. Noradrenaline caused a significant increase in peak systolic pressure and work performance which was maintained for at least 10 mins, suggesting that the positive inotropic effects of noradrenaline may be provoked by Ins(1,4,5)P3. Furthermore, the finding that 20 min NICA followed by 30 s reperfusion causes an immediate significant increase in Ins(1,4,5)P3 content suggests a role for the phosphatidylinositol pathway in the intracellular Ca2+ overloading, characteristic of ischaemia-reperfusion. PMID- 1791635 TI - Discordant effects of nisoldipine on coronary vascular resistance and permeability changes during reflow after ischemia in isolated rabbit hearts. AB - Effects of a low dose (5 nM) of nisoldipine on vascular and ventricular function were assessed in isolated rabbit hearts during 2 h of reperfusion after 40 min of global, zero-flow ischemia. External detection of bolus injections of 125I-BSA and pressure data generated during the experiment provided repeated estimates of albumin permeation and vascular hemodynamics (resistance, vascular volume, and fractional rate of intravascular washout of 125I-BSA (k01]. In control hearts perfused continuously for 3.5 h, vascular resistance, vascular volume, LVEDP, and k01 remained constant, while maximum +dP/dt and -dP/dt increased 25% above baseline values, and estimates of albumin permeation increased 1.7 x baseline. Addition of 5 nM nisoldipine to the perfusate after the baseline period produced sustained decreases in vascular resistance (16% vs mean baseline value) without significantly affecting any other parameter. Postischemic perfusion of hearts increased vascular resistance and vascular volume approximately 50% above baseline, decreased k01 by 25% (intravascular washout of 125I-BSA was prolonged), and increased albumin permeation approximately 5 x baseline. While LVEDP remained elevated 3 x baseline, maximum +dP/dt and -dP/dt recovered 100% of baseline values (75-80% of untreated control values at comparable time points). Addition of 5 nM nisoldipine to the perfusate prior to ischemia prevented the increased vascular resistance during reflow, prevented the decrease in k01 and the increase in vascular volume, but did not affect the increased albumin permeation and, in general, did not affect the rate of recovery of left ventricle function. These results indicate that a low dose of nisoldipine preserves postischemic coronary vascular hemodynamics, but has little or no effect on the increased vascular leakage of albumin. PMID- 1791636 TI - Persistence of an embryonic intermediate filament-associated protein in the smooth muscle cells of elastic arteries and in Purkinje fibres. AB - During differentiation of most myogenic tissues, vimentin is transiently expressed as the intermediate filament (IF) protein subunit and is progressively replaced by desmin. However, smooth muscle cells of mature vascular tissue contain variable amounts of vimentin whose cellular content decreases as function of the distance from the heart. IFAPa-400 is a developmentally regulated IF crosslinker protein whose expression appears to parallel that of vimentin during chick myogenesis. Immunohistological and immunoblot techniques were employed to study the expression of this protein in cardiac and vascular smooth muscle cells of the adult chicken. As observed for vimentin, the expression of IFAPa-400 persists in the mature smooth muscle cells of the large arteries as they leave the heart. However, both of these proteins are down-regulated according to a proximo-distal gradient with respect to the distance from the heart. Conversely, desmin is much more abundant in the distal segments of the aorta. Thus, the co ordinate expression of vimentin with IFAPa-400 may be a characteristic feature of elastic vascular tissue in which it could meet mechanical requirements close to those of the embryonic cells expressing them. This hypothesis is supported by the observation that the single cell type which continues to express the vimentin IFAPa-400 combination in the mature heart is the Purkinje fibres, which are also subjected to high mechanical tensions but in which myofibrils are generally sparse compared to working myocytes. PMID- 1791637 TI - Migration patterns of donor astrocytes after reciprocal striatum-cerebellum transplantation into newborn hosts. AB - Fragments of striatum or cerebellum from E 25 rabbit embryo were implanted into either the striatum or the mesencephalon of newborn mice. Implanted rabbit astrocytes were selectively identified by monoclonal antibodies to the GFAP which are unable to combine with mouse GFAP. Previous investigations had shown that xenogenic astrocytes have the capacity to migrate in host CNS. The purpose of this study was to compare the patterns of migration of transplant-derived astroglial cells according to the topographic origin of the transplant and location of the grafting site. We found that the migration pattern of the grafted cells from any of both selected sites of implantation was independent from the topographic origin of the transplant. The routes as well as the distances of migration were similar after homo- or heterotopic transplantation. We conclude that astroglial cells or their precursors do not express information which would direct them to move specifically toward a defined region in the host brain according to the region of origin in the donor. PMID- 1791638 TI - Neuronal specific protein NP185 is enriched in nerve endings: binding characteristics for clathrin light chains, synaptic vesicles, and synaptosomal plasma membrane. AB - The neuronal specific protein NP185, found associated with brain clathrin-coated vesicles, formed a complex with unphosphorylated, but not with phosphorylated, clathrin light chains. The NP185-clathrin light chain complex was associated with casein kinase II activity, which, in the presence of polylysine, phosphorylated clathrin light chain b but not the NP185. The dissociation of this complex with 50% ethylene glycol pH 11.5 suggests that NP185 binds to hydrophobic domains of clathrin light chains. When NP185 molecules were retained by monoclonal antibody linked Sepharose beads, they bound synaptic vesicles, decoated vesicles and synaptosomal plasma membrane. Immunohistochemistry on mouse cerebellar tissue sections using 8G8, a monoclonal antibody raised against NP185, showed neuronal specific labeling closely following synaptic distribution. In immunoblots, NP185 shares similar epitopes to those detected in another assembly polypeptide, AP 180, an indication that both proteins are identical. It appears that NP185 plays a specific role in nerve ending functions through its ability to induce clathrin to polymerize into cages, its interaction with synaptic vesicles, with the plasma membrane and with clathrin coat components. PMID- 1791639 TI - Protein kinase C stimulation enhances the process formation of adult oligodendrocytes and induces proliferation. AB - Oligodendrocytes (OL) isolated from adult pig brains regenerate their processes and form a network of fibers after 14-18 days in vitro (DIV). Stimulation of protein kinase C (Pk-C) by tumour promoters such as 12-O-tetradecanoylphorbol-13 acetate (TPA) produces at day 7 in vitro a similar network after only 20 hr. H-7, an inhibitor of Pk-C, as well as amiloride, which inhibits the subsequent Na+/H+ exchange, reversibly suppress this effect. Activation of the protein kinase A or calmodulin pathway do not result in an increased OL process production. Furthermore, TPA induced proliferation in a subpopulation of OL. We conclude that the stimulation of Pk-C is of utmost importance for OL regeneration. PMID- 1791640 TI - Monoclonal antibodies to the heavy neurofilament subunit (NF-H) of Torpedo cholinergic neurons. AB - Previous studies from our laboratory suggest that Alzheimer's disease sera contain a repertoire of antibodies to the heavy neurofilament subunit (NF-H) and that a subpopulation of these antibodies bind specifically to epitopes highly enriched in NF-H isolated from the purely cholinergic electromotor neurons of Torpedo. In the present study, we prepared and characterized monoclonal antibodies (MAbs) that bind to epitopes specifically enriched in Torpedo cholinergic neurons. This was performed by a differential enzyme-linked immunosorbent assay (ELISA) in which MAbs were selected that bind to epitopes much more abundant in the NF-H protein of Torpedo cholinergic neurons than in NF H from the chemically heterogeneous Torpedo spinal cord. This yielded four MAbs, three of which (TC4, TC8, and TC21) were found to be specific to NF-H and one (TC15) that reacts with both NF-H and the medium-size neurofilament subunit NF-M. Dephosphorylation abolishes the binding of MAbs TC4 and TC15 to Torpedo cholinergic NF-H, partially reduces that of MAb TC21 and has no effect on the binding of MAb TC8. This suggests that the antigenic sites specific to Torpedo cholinergic NF-H contain phosphorylated as well as non phosphorylated epitopes. All the MAbs cross-react with rat brain NF-H. PMID- 1791641 TI - Taurine-deficient cultured cerebellar astrocytes and granule neurons obtained by treatment with guanidinoethane sulfonate. AB - Mouse cerebellar granule neurons and astrocytes grown in the presence of 2 mM guanidinoethane sulfonate (GES) exhibited a progressive and rapid decrease in taurine concentration. A reduction of 20% was observed as early as 1 hr after exposure to GES and the loss of cell taurine continued until the taurine pool was reduced by about 90%. This remaining taurine persisted without further decrease even after 3 weeks of exposure to GES. Taurine reduction caused by GES was similar in both types of cells. The effect of GES was dose-dependent, with significant decreases in taurine levels already detected at 100 microM. It was selective for taurine, since none of the other free amino acids were affected. Taurine depletion induced by GES was totally reversible. Intracellular taurine was not mobilized by GES. Taurine uptake in both astrocytes and granule neurons, examined at the taurine concentration present in the culture medium, was practically abolished by 2 mM GES. This approach represents an in vitro model of taurine depletion that may be useful to investigate the cell abnormalities responsible for the failure of differentiation and migration of granule cells and astrocytes observed in taurine-deficient cats. PMID- 1791642 TI - Epidermal growth factor and transforming growth factor alpha induce c-fos gene expression in retinal Muller cells in vivo. AB - Epidermal growth factor (EGF) and transforming growth factor alpha (TGF alpha) are peptides that act at a common receptor and are mitogenic for immature astrocytes and trophic for developing brain neurons in vitro. However, a role for these growth factors in the mature nervous system has not been established. To investigate the actions of EGF and TGF alpha in the adult central nervous system (CNS) in vivo, the growth factors were injected into the vitreous cavity of adult male rabbits. After varying intervals, the retinas were examined for c-fos mRNA by Northern blot hybridization or Fos (and Fos-related antigen) protein by immunocytochemistry. EGF induction of c-fos mRNA occurs within 30 min and persists more than 4 hr. Fos nuclear immunostaining is induced selectively in nuclei of Muller cells by both EGF and TGF alpha. Fos-like immunoreactivity appears within 1 hr and persists more than 9 hr after EGF injection. These observations demonstrate that mature retinal Muller cells respond to exogenously applied EGF and TGF alpha in vivo, although the effect of the growth factors is not necessarily direct. The expression of c-fos and other immediate early genes provides a short-term marker that can be used to investigate the role of growth factors in normal retinal physiology and responses to injury. PMID- 1791643 TI - The children's vaccine initiative...and other promises to keep. PMID- 1791644 TI - Does breastfeeding influence mortality in children hospitalized with diarrhoea? AB - The association between breastfeeding and mortality in children hospitalized for diarrhoea was investigated in a prospective manner in 309 subjects below 18 months of age. In multivariate logistic regression analysis, 36 cases who died were compared with 273 controls who were discharged in a satisfactory condition. Breastfeeding had a strong protective effect against mortality even after allowance was made for confounding variables (including nutritional status, chronicity of illness, associated non-enteral infections) and a possible bias of interruption of breastfeeding as an early consequence of the terminal illness. The adjusted odd's ratio (OR) and 95 per cent confidence intervals (95 per cent CI) for the protective effect were 2.7 and 2.1-3.6, respectively. The adjusted OR's (95 per cent CI's) were 6.0 (3.6-10.2), 2.6 (2.0-3.4), and 1.8 (1.4-2.5) for the age intervals 0-6, 7-12, and 13-18 months, respectively (P less than 0.001, less than 0.01, and less than 0.05, respectively). Further stratified analyses suggested a greater benefit in children with severe wasting, severe stunting, protracted illness, and diarrhoea as the sole illness. It is concluded that in children up to 18 months of age, breastfeeding offers substantial protection against death in children hospitalized with diarrhoea. PMID- 1791645 TI - Survey on immunization, diarrhoeal disease and mortality in Quang Ninh Province, Vietnam. AB - A survey on EPI, CDD, child morbidity, and mortality was conducted in 1988 in one province of northeastern Vietnam. Thirty out of 114 communes were randomly selected for the survey and the interviews were made by 60 students from the provincial nursing school, supervised by 10 teachers. It was found that 23 per cent of the children (n = 211) were fully vaccinated, while 54 per cent had partial coverage. Lack of information or ignorance were the main causes of vaccination failure. The adjusted yearly diarrhoeal rate was 1.6 per child under 5 years of age (n = 9.691). Infant mortality and under-five mortality rates were found to be 28 per thousand live births (95 per cent confidence interval: 21-35; n = 2.321) and 44 (36-52), respectively. High literacy among mothers, good breast feeding practices, low mortality due to diarrhoea, malaria, and measles, and a well-functioning rural health care system were considered to be the main contributing factors to the low infant mortality. The results also point out the weaknesses in the existing reporting system and indicates the need for follow-up studies. PMID- 1791646 TI - Post-partum anovulation in nursing mothers. AB - An analysis of breastfeeding and ovulation data from 72 nursing mothers is presented. A proportional hazards model of the data strengthens the hypothesis that a pattern of short, frequent bouts of nursing defines a risk-set of women less susceptible to post-partum ovulation than those who choose to nurse on a schedule of relatively lengthy and infrequent bouts. In contrast, no effect of maternal weight-for-height on the month-specific rate of post-partum ovulation could be detected in the study population comprised of American mothers trained in self-observation of fertility signs. PMID- 1791647 TI - Recurrent and persistent diarrhoea in a rural Zimbabwean community: a prospective study. AB - Prospective surveillance of patterns of diarrhoeal disease was conducted in a cohort of 204 young children living in a rural community in Zimbabwe. Trained field assistants recorded morbidity data obtained by weekly recall of mothers. Diarrhoea was defined by a commonly used local word, and a diarrhoea-free gap of three or more days was taken to signify a new attack. Diarrhoea was common in this study population with a peak incidence between 6 and 18 months of age. There was, however, wide individual variability in diarrhoea attack rates (range 0 to 20 attacks) during the 22 month study period. Whilst only 6 per cent of the recorded diarrhoea episodes were persistent (lasting longer than 14 days), a high proportion (26 per cent) of subjects had at least one attack of persistent diarrhoea (PD) during follow up. Children who had frequent attacks of acute diarrhoea also tended to have PD; PD was rare in those with few attacks. Thus, within this uniformly deprived African community, there were individuals who had a much higher susceptibility to diarrhoea compared to others. An understanding of this variability may point the way towards more effective interventions in the control of diarrhoeal disease. PMID- 1791648 TI - Aflatoxin exposure and its relationship to kwashiorkor in African children. AB - The urinary excretion of aflatoxins in normal children from a periurban area, as well as those hospitalized with kwashiorkor and marasmus was assessed. In no case was aflatoxin isolated from the urine. It is concluded that aflatoxin exposure is unusual in this population and that aflatoxins do not play a primary role in the pathogenesis of kwashiorkor. PMID- 1791649 TI - Frequency of behaviour disorder and related factors in school children in Lusaka. AB - In a cross-sectional study of behaviour disorders amongst children attending three primary schools in Lusaka 210 children, aged 8-12 years, were assessed by means of the behaviour rating questionnaire developed by Rutter for teachers. The frequency of behaviour disorder was 14.8 per cent with sex ratio 1.9:1 (boy:girl). Children's mothers were interviewed to obtain background social and demographic information about the family, and anthropometric measurements were made on the children. Behaviour disorder was largely associated with characteristics of the school, socio-economic status, mother's occupation, play facilities at home and past history of hospitalization. The relevance of the behaviour rating questionnaire for developing countries is discussed. PMID- 1791650 TI - Early detection of leprosy in children. AB - Healthy children contacts of leprosy patients had their humoral and cell-mediated immunological status assessed using the Fluorescent Leprosy Antibody Absorption Technique (FLA-ABS) and the Lepromin test, respectively. Subsequently, they were followed up for 2 1/2 years to study the development of overt disease. Two hundred children were studied and classified into four groups, viz. Group I comprised of children who were FLA-ABS positive and Lepromin positive; Group II = FLA-ABS positive and Lepromin negative; Group III = FLA-ABS negative and Lepromin positive; Group IV = FLA-ABS negative and Lepromin negative. The good cell mediated immune (CMI) response in the 107 children in Group I prevented them from developing the disease though they had been infected. Out of the 37 children in Group II, 15 developed the disease. There were no children in Group III. None of the 56 children in Group IV developed the disease, possibly because they had not been significantly infected. All these findings were statistically significant (P less than 0.01). This study highlights the protective role of cell-mediated immunity in leprosy. It also suggests the need to carry out surveillance surveys in the endemic population to identify and follow up those at risk. PMID- 1791651 TI - Infectious disease risks among Filipino adoptees. PMID- 1791652 TI - Chloramphenicol therapy of typhoid fever and its relationship to hepatic dysfunction. PMID- 1791653 TI - The relationship between birth weight, and arm and chest circumference in Egypt. AB - This paper is concerned with the prediction of birth weight using simple anthropometric indices, namely mid-arm and chest circumferences. Such indices are important tools in the identification of low birth weight infants in areas where scales are not widely available or where they are likely to be not robust enough to withstand rough treatment. This paper reports data from a study in Assiut, Egypt. The aim was to identify which of the two indices was the better predictor or whether measurements on both arm and chest circumference were required. The results show that chest circumference is the better predictor of birth weight, partly perhaps because its measurement is more replicable. Cut-off points for the identification of low birth weight infants are then identified. PMID- 1791654 TI - Brachial plexus injuries in Malaysian neonates: incidence and associated risk factors. AB - A prospective study was carried out on 26,176 Malaysian neonates born in the Maternity Hospital, Kuala Lumpur over a 12-month period to determine the incidence and associated risk factors of brachial plexus injuries. This condition was found in 42/26,176 neonates (1.6 per 1000 livebirths). Multiple logistic regression analysis of affected and control neonates from a nested case-control study showed that increasing birth weights and breech deliveries were the significant risk factors. Our study suggests that to reduce the occurrence of this condition, there is a need for: (i) better assessment of fetal size and maternal pelvimetry to enable earlier diagnosis of cephalo-pelvic disproportion, and (ii) review of the indications and techniques of breech delivery. PMID- 1791655 TI - Endocrine and amino acid changes in protein energy malnutrition (PEM) PMID- 1791656 TI - Simple indicator for screening of low birth weight (LBW) infants in the community. PMID- 1791657 TI - Simultaneous outbreak of varicella and measles in a Nigerian secondary school. PMID- 1791658 TI - Corneal representation within the trigeminal subnucleus caudalis and adjacent bulbar lateral reticular formation of the cat. AB - Corneal units in the trigeminal subnucleus caudalis and adjacent bulbar lateral reticular formation were studied in urethane-chloralose anesthetized cats. Corneal units were categorized into four classes: low-threshold corneal (LTC) units, high-threshold corneal (HTC) units, wide dynamic range (WDR) units with corneal input, and subnucleus reticularis ventralis (SRV) units with corneal input. Corneal receptive fields of these four classes of corneal afferent units consisted of 3-6 spots. Mechanical thresholds of LTC units were lower than 30 mg (2.6 g/mm2) and were comparable to the sensory threshold of the human cornea measured in patients with cataract. Mechanical thresholds of the other 3 classes of corneal afferent units were well above the pain threshold in the human cornea. LTC units were located in the magnocellular layer of trigeminal subnucleus caudalis and were intermingled with cutaneous low-threshold mechanoreceptive units. HTC units were coexistent with nociceptive specific units in the marginal layer and in the outer zone of substantia gelatinosa. WDR units with corneal input were found in the lateral part of trigeminal lamina V equivalent, which corresponds to the lateral part of subnucleus reticularis dorsalis. These 3 classes of corneal units were found at a level 2.7-3.5 mm caudal to the obex. SRV units were found in the dorsolateral part of SRV along the entire length of the medulla oblongata caudal to the obex. These results support the suggestion that either nonpainful sensation or pain can be evoked from the cornea. PMID- 1791659 TI - Thermal and mechanical responses of the amphibian skin to nerve stimulation. AB - The isolated calf skin of the toad and bullfrog was found to generate a burst of heat in response to stimulation of the cutaneous nerve. The electric responses of the skin evoked by nerve stimulation invariably lagged behind the heat burst. The generation of a heat burst was followed by a slow mechanical response of the skin. Suppression of these responses by adrenergic blocking agents suggests that heat is produced at the junction between the gland cells and the sympathetic nerve fibers. Large mechanical changes in the skin were observed when noradrenaline was applied to the inner surface of the skin. PMID- 1791660 TI - Regulation of vascular compliance and stress relaxation by the sympathetic nervous system. AB - We measured the changes in central venous pressure (CVP) and circulating blood volume (CBV) in dogs consequent to fluid infusion under halothane anesthesia, and compared the CVP and CBV responses to those obtained after blocking the autonomic nervous system by total spinal anesthesia (TSA) and stimulating the alpha receptor with methoxamine (MTX). Under TSA, the change in CVP consequent to fluid infusion was less than that under halothane anesthesia, while with MTX, the change in CVP was larger than that under halothane anesthesia. The recovery time of CVP response toward the baseline level after the end of fluid infusion was fastest under halothane anesthesia, while the recovery time of CVP was two times longer under TSA and MTX. Based on the relationship between changes in CVP and BV, we quantified effective vascular compliance and stress relaxation using mathematical analysis. The effective vascular compliance increased to 13.3 +/- 3.2 ml.mmHg-1.kg-1 under TSA as compared to 5.6 +/- 0.3 ml.mmHg-1.kg-1 under halothane anesthesia, and it decreased to 2.6 +/- 0.2 ml.mmHg-1.kg-1 with MTX. Stress relaxation was determined as the time constant in the unit response of CVP. The time constant for stress relaxation was 39 +/- 7 min under halothane, 74 +/- 12 min with TSA, and 92 +/- 25 min with MTX. These results suggest that the autonomic nervous system modifies cardiac preload by changing effective vascular compliance and stress relaxation. PMID- 1791661 TI - Blood pressure and heart rate changes in streptozotocin diabetic rats, with special reference to postural hypotension. AB - Blood pressure and heart rate changes were recorded on supine or prone head-up tilt and on carotid artery occlusion in normal and streptozotocin diabetic rats (65 mg/kg). In general supine tilt induced a larger blood pressure fall, slower blood pressure recovery from the fall and larger heart rate fall than prone tilt, both in normal and diabetic rats. Heart rate recovery from the fall was slightly larger in prone than in supine tilt in normal rats. The blood pressure fall and heart rate fall accompanying the tilt were statistically larger in diabetic than in normal rats. Furthermore, blood pressure recovery from the fall was statistically more rapid and larger in normal than in diabetic rats. The exaggerated blood pressure fall with the tilt of diabetic rats might correspond to postural hypotension. Blood pressure rise and heart rate rise with carotid artery occlusion were smaller in diabetic than in normal rats. Blood pressure changes with cervical sympathetic or vagus stimulation were almost the same in normal and diabetic rats. However, in diabetic rats such cervical autonomic nerve stimulation produced larger heart rate changes than in normal rats. PMID- 1791662 TI - Dynamic profile of cardiovascular activity in relation to augmented ventilation and humoral agents during hypercapnic hypoxia. AB - A time course of cardiovascular activity in 8 healthy males in relation to augmented ventilatory activity and humoral factors was observed during step CO2 elevation with constant hypoxia. During the first step increase, by 3 Torr in end tidal PCO2 (PETCO2), the heart rate (HR) initially tended to decrease, then slowly increased to slightly below that of the previous eucapnic level, whereas ventilation maintained a gradual rise throughout this period. On the other hand, during second step PETCO2 elevation, by a further 3 Torr, both HR and ventilation progressively increased. The plasma catecholamine (CA) concentration was also significantly elevated during this period, suggesting a concomitant enhancement in sympathetic activity. Blood pressure (Bp) was progressively augmented throughout the entire hypoxic challenge. We conclude that 1) the characteristic profile of HR change may be explained by the observation that initial HR depression by peripheral chemoreceptor stimulation is gradually overridden by delayed hyperventilation, CA elevation, and enhanced sympathetic activity; 2) Bp augmentation may be elicited by increased CA release and sympathetic activity; and 3) plasma K+ concentration does not change so as to affect cardiovascular and respiratory activity. PMID- 1791663 TI - ECG analysis of golden hamsters exposed to long-term -Gz conditions: ordinary and pathological findings. AB - Changes of ECG due to long and intense -Gz acceleration was investigated in anesthetized Syrian golden hamsters. The R-R interval decreased (heart rate increased) slightly at the very initial phase of steady -Gz load. However, the R R interval increased during the rest of the whole steady -Gz period. The P-R interval increased with a smaller -Gz load (-4 and -6 Gz), but it decreased with a larger -Gz (-8 and -10 Gz). The size of the QRS complex was measured as R amplitude. It decreased in all -Gz conditions. Effects were a little different for smaller and larger -Gz, as was observed in the case of P-R changes. Pathological ECGs were frequently observed. They were: (1) Arrhythmia of heart rate with or without atrio-ventricular blocks. (2) Abnormal P wave; e.g., splitting, flattening, or abolition of P wave. (3) Alteration of the QRS complex in amplitude or contour. (4) Changes in ST-T components. In spite of all these changes, however, it should be noted that several Syrian golden hamsters could tolerate up to -10 Gz for as long as 1,000 s. PMID- 1791664 TI - Effect of hypertonic saline infusion on renal vascular resistance in anesthetized dogs. AB - Changes in renal vascular resistance (RVR) and their mechanisms were investigated following infusion of 7.5% hypertonic saline (4 ml/kg) in anesthetized dogs. In all animals the left kidney was perfused at a constant perfusion flow (59 +/- 6 ml/min) with heparinized blood using a pulsatile roller pump. Renal perfusion pressure (RPP), systemic blood pressure (SBP), central venous pressure (CVP), and heart rate (HR) were measured simultaneously. Electrical stimulation of renal sympathetic nerves was also performed to evaluate the neurally mediated change in renal vasculature before and after infusion of hypertonic saline. In animals with intact vagi, intravenous administration of hypertonic saline resulted in significant increases in both mean blood pressure (MBP) and CVP, and caused significant decreases in HR and RVR. These effects were not affected by bilateral cervical vagotomy. In both intact and vagotomized animals, changes in RVR in response to renal nerve stimulation were attenuated after infusion of hypertonic saline. These results suggest that reduction in RVR after intravenous infusion of hypertonic saline is not a reflex effect mediated by vagal afferents. Instead, vascular response of the renal artery to hypertonic saline may result from a suppression of neurotransmission from renal sympathetic nerve endings to renal vascular smooth muscle. PMID- 1791666 TI - [The maternity ward of the district hospital in Ekenas, wet Nyland]. PMID- 1791667 TI - [Observations following Irmeli's birth]. PMID- 1791665 TI - An improved method for using cisternal cerebrospinal fluid in conscious rats for application in the measurement of catecholamines. AB - This paper describes an improved method for the application of cerebrospinal fluid (CSF) in conscious rats. The modified polyethylene catheter was chronically inserted into the cisterna magna through a hole drilled in the skull of an anesthetized rat. Fifty microliters of CSF was taken from the recovered conscious rat for radioenzymatic analysis of catecholamines. The values of noradrenaline were 540 +/- 142 pg/ml (mean +/- S.D., n = 50) in Wistar rats and 494 +/- 175 (42) in spontaneously hypertensive rats. However, values of adrenaline and dopamine were less than the lower limits for detection. PMID- 1791668 TI - [Evaluation of Finnish health policy performed by the WHO expert group]. PMID- 1791669 TI - [Eeva Kuuskoski, Minister of Health and Social Affairs on Midwifery Days, 6-7 Nov. 1991]. PMID- 1791670 TI - [Pregnant women's needs for continuous instruction]. PMID- 1791671 TI - [Why must one adapt oneself to compulsory treatment?]. PMID- 1791672 TI - [How can maternity care and midwives answer women's and families' expectations?]. PMID- 1791673 TI - [Purposeful work for developing midwifery education and practice]. PMID- 1791674 TI - [The current status of maternity care]. PMID- 1791676 TI - [Resources of the national health service and their allocation]. PMID- 1791675 TI - [Midwifery education--integration in Europe]. PMID- 1791677 TI - [Midwives' activities are the most important in human life, their education cannot be compromised]. PMID- 1791678 TI - [The old and glorious traditions of our midwifery education are a challenge for the future]. PMID- 1791679 TI - [Homonymous hemianopsia]. AB - Anatomical principles of the suprachiasmatic pathway. The neuro-ophthalmological examination of homonymous hemianopia: qualitative perimetry (confrontation tests), quantitative perimetry (campimetry on the Bjerrum screen, kinetic perimetry, static perimetry, automatic computer controlled perimetry, perimetry with colours, flickerfusion frequency-perimetry), oculomotor disturbances (gaze strategies, opto-kinetic nystagmus), pupillary disturbances, visual evoked potentials, anosognosia, Riddoch-phenomenom, hemiachromatopsia. Synopsis of different forms of homonymous hemianopsia: Unilateral, total or quadrant, bilateral, temporal half moon preserved or not, homonymous scotomas, horizontal hemianopsia. Pathogenetic analysis: tumors, infarcts, cerebral injuries, neuro surgical operations, inflammatory conditions, congenital or perinatal brain damages, migraine. Additional disturbances of visual space recognition (hemineglect), of colour vision and of reading ability (alexia). In connection with the above mentioned theme appreciation of the scientific work of Prof. E. Aulhorn (Tubingen) regarding the perimeter apparatus, the perimetric examination technique and the interpretation of the perimetric results. PMID- 1791680 TI - [Diagonal incision in capsulotomy for extracapsular cataract extraction]. AB - From previous experience with all current surgery methods and kinds of anterior capsulotomy as well as of 6-year follow-up observation we developed our own diagonally-shaped (linear) capsulotomy technique. This technique was used in more than 500 successive extracapsular cataract extractions, followed by implantation of a posterior chamber lens. Both, intraoperative advantages and postoperative positive experience, will now be described. PMID- 1791681 TI - [Indications for coagulation in diabetic maculopathy]. AB - Macular changes of 333 eyes of 266 diabetic patients were analized regarding number of microaneurysms, area of intraretinal lipids and hermorrhages and the amount of leckage and capillary occlusion in fluorescein angiography. The changes were observed in a central and peripheral area centered around the fovea. The distribution of the changes observed were correlated with the visual acuity of the patients. Only the number of peripheral microaneurysms and the presence of foveal intraretinal edema correlated with a reduction in visual acuity. These parameters are therefore clinical indicators for the severity of diabetic maculopathy. Regarding the visual acuity after a minimal follow up of six months the presence of foveal intraretinal edema was the most important factor with a high risk of short term visual loss. The presence of fovealmacular edema might therefore be the most important indicator for macular photocoagulation treatment. PMID- 1791682 TI - [Testing vision in children]. AB - Measurement of visual acuity in children is more difficult than in adults. Children tend to riet when the threshold is reached and become inattentive. However the exact determination of visual acuity in children is important in some situations (Screening, Amblyopia). In this paper we examined whether an automated procedure is more exact than measurement by an examiner. Three series of experiments were done. In n = 173 we measured visual acuity first by an examiner using an optotype projector and second by an automated procedure (computer, keyboard, television screen). Both, the examiner and the computer used the same test-procedure and threshold criterion (DIN-Norm). The correlation coefficient was 0.84. In n = 53 children (age 4 to 7) visual acuity was measured by an examiner without a special strategy. Afterwards visual acuity was measured by the automated procedure. The correlation coefficient was 0.1. In n = 63 children (age 5-7) visual acuity was measured by an examiner using a strategy and a threshold criterion. Afterwards the automated procedure was used. The correlation coefficient was 0.69. The results show, that without a strategy and defined threshold criterion it is not possible to compare the measurements of visual acuity in different times. An automated procedure presented in this paper guaranties constant test conditions in an optimal way. PMID- 1791683 TI - [Video fluorescein angiography studies in acute anterior ischemic optic neuropathy]. AB - Acute anterior ischemic optic neuropathy (AION) is a circulatory disorder of the short posterior ciliary arteries and their branches. 74 patients with AION were examined with video fluorescein angiography for disturbance of the retinal circulation. The armretina time (ART) was slightly (15%, p less than 0.01) increased in patients with AION (12.9 +/- 3.9 s) as compared to healthy persons (11.2 +/- 3.3 s). The prolonged ART was more prominent in the 26 (35.1%) diabetic patients (14.2 +/- 3.9 s). Because of the ART being only moderately prolonged and since the Doppler ultrasonography of the carotid arteries showed in only 3 patients an occlusion or a hemodynamically relevant stenosis of greater than or equal to 50%, prolonged ART may play a considerable role in the course of AION in only few patients. The retinal arteriovenous passage time (AVP) is considerably (77%, p less than 0.01) increased in AION (2.57 +/- 0.89 s) as compared to healthy persons (1.45 +/- 0.40 s). In patients with duration of symptoms less than 10 days (2.78 +/- 0.96 s) the AVP was increased (p less than 0.01) as compared to patients with duration of symptoms between 11 and 30 days (2.11 +/- 0.46 s). The comparison between the eye with AION and the not affected eye showed no difference in ART but an increase of AVP in the eye with AION. The AVP in AION patients without and with diabetes was not different. No differences in ART and in AVP were found between arteriitic and non-arteriitic patients with AION. The results indicate that the retinal microcirculation is disturbed in patients with arteriitic and non-arteriitic AION. This condition may worsen the in AION affected microcirculation of the optic nerve head through the mechanism of decreased blood flow in the retinociliary anastomoses. PMID- 1791684 TI - [Changes in ocular circulation in halothane-nitrous oxide intubation anesthesia with special reference to the arterial CO2 partial pressure. II. Mechanisms of change]. AB - In part I of this study [Hessemer and associates, Klin. Mbl. Augenheilk. 199 (1991) 346-355] the phenomenology of the ocular circulatory changes, found during general anesthesia using halothane and nitrous oxide, has been described. These changes are analyzed with respect to their mechanisms.-- RESULTS: There was a significantly (P less than 0.05) linear relation between the anesthesia-induced reduction of the systolic ocular (retinal and ciliary) blood pressures and the decrease of the systolic brachial artery pressure (delta Ps,bra). The same relation was present between the reduction of the systolic ocular (retinal and ciliary) perfusion pressures and delta Ps,bra. The correlation coefficients for the designated relations ranged between 0.37 and 0.58. The relation between the anesthesia-induced intraocular pressure reduction and delta Ps,bra was--in tendency--linear (P = 0.07), at least for the time period 5-15 min after intubation; the correlation coefficient amounted to 0.37. The reduction of both the ocular pulsation volume (PVoc) and the pulsatile ocular blood flow (Fp,oc) did not depend on the systemic blood pressure, but on the arterial CO2 tension (PCO2): Decreasing PCO2--i.e., increasing hyperventilation--was paralleled by decreases of PVoc and Fp,oc. The relations PVoc vs. PCO2 and Fp,oc vs. PCO2 were significantly linear (P less than 0.01), the correlation coefficients ranged between 0.58 and 0.7.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791685 TI - [Therapeutic follow-up using automatic perimetry in chronic cerebroretinal ischemia in elderly patients. Prospective double-blind study with graduated dose ginkgo biloba treatment (EGb 761)]. AB - The chronic cerebral retinal insufficiency syndrome in elderly patients is an organ specific expression of a generalized vascular cerebral deficiency. The progress of the disease is characterized by complex symptoms, variation in course, spontaneous remissions and, until recently inadequate diagnostic measurement methods. The new method of automated perimetry with the octopus 2000 P offers a patient-friendly procedure for indirect non-invasive diagnosis of circulatory state in limited cerebral retinal perfusion. In the present study measurements were made with this method on 24 patients (4 men and 20 women with an age of 74.9 +/- 6.9 years). The effect of the extract of Ginkgo biloba (EGb 761) on the reversibility of visual field disturbances was tested using a randomized and double blind study-design in two phases and with two dose levels. The main parameter investigated in this study was the change in the luminous density difference threshold after therapy with EGb 761. In group B (EGb 761 dose 160 mg/day) a significant increase in retinal sensitivity was seen within 4 weeks (p less than 0.05). In the lower dose (80 mg EGb 761/day) group (A), this change in retinal sensitivity was first seen after increasing the dose to 160 mg/day (p less than 0.01). The relative sensitivity of damaged retinal areas was more strongly influenced than "healthy" areas. The assessment by both doctors and patients of the general condition of the patients showed a significant improvement after the course of therapy. The results presented here show that damage to the visual field by chronic lack of bloodflow are significantly reversible.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791686 TI - [Chronic subgaleal abscess as a cause of eyelid swelling]. AB - A 36 year-old female patient presented with a massive swelling of the eyelid, cheek, and neck. We could not explore any cause for those swellings. Finally, magnetic resonance imaging of the head showed a hugh subgaleal abscess. It was caused by minor scalp trauma. PMID- 1791687 TI - [Ross syndrome: Adie syndrome with disorders of sweat and body temperature regulation]. AB - In 1958 Ross described a triade consisting of tonic pupils, hyporeflexia and sudomotor denervation. Etiology and pathogenesis are unknown. 14 cases of Ross' syndrome have been mentioned in the literature up to now. Three additional cases are demonstrated. PMID- 1791688 TI - [Contusion-induced traumatic aniridia]. AB - Total aniridia occurred after a severe blow on the eyeball of a 65 year old man. The entire iris was torn off the ciliary body and escaped out of the eye through a small corneal wound. The zonular fibres were found to be intact and the posterior parts of the eye showed no traumatic changes. PMID- 1791689 TI - [Endogenous candida endophthalmitis: a new therapy]. AB - A thirty-year-old patient underwent an extensive abdominal surgery because of a precancerosis due to a colitis ulcerosa. An accompanying smoldering panuveitis led under immunosuppressive therapy to the loss of sight of one eye. Only an increasing vitritis of the second eye allowed the diagnosis of an endogenous Candida endophthalmitis (ECE) following a vitrectomy. A systemic administration of the common antifungal medications was impossible because of the patient's pathological blood-picture and a severe cholestasis. We report the successful use of Fluconazol (Diflucan), an antimycotic agent we never used before in this connection. PMID- 1791690 TI - [Exudative retinal detachment, pigment epithelium tear and subretinal exudate in a case of central serous retinopathy]. AB - A thirty year old patient with central serous chorioretinopathy on his right eye is presented. The signs of his disease were exsudative retinal detachment with shifting fluid, rip of the retinal pigmentepithelium and a mass of whitish yellowish subretinal protein. After the diagnosis was made light-coagulation was performed. Within half a year the retina reattached completely, most of the subretinal protein was reabsorbed and vision slowly normalized. PMID- 1791691 TI - [Venous vascular anomalies within the myelinated retinal nerve fiber area]. AB - We report the case of a 25 year old caucasian female who was presented to our clinic with a four year history of recurrent vitreous hemorrhages, myelinated retinal nerve fibers and ipsilateral anisometropic myopia, astigmatism and amblyopia of her right eye. On fluorescein angiography small, postcapillary venous malformations in the area of myelinization were diagnosed. Vascular anomalies within regions of myelinated retinal nerve fibers have not been described so far. Even if actual leakage itself from the anomalous vessels could not be documented, vitreous hemorrhaging did not recur after successful lasercoagulation and obliteration of the vascular anomalies. PMID- 1791692 TI - [Ptosis operations with silicone suspension at the eyebrow]. AB - In severe ptosis with minimal or absent levator muscle function the lid can be connected with the frontalis muscle by means of silicone material. In our 18 patients (21 ptotic lids) the silastic rods arranged as a double sling to Crawford gave better results than the thinner silastic tube single slings. PMID- 1791693 TI - [Complications following cataract incision 1751]. AB - In 1751 the oculist Joseph Hillmer was expelled as charlatan from Petersburg by an expert opinion, which was founded on 125 case reports on his Russian clients, amongst them 60 suffering from cataracts, which had been couched on 80 eyes. Beside 82% of failures these case reports on cataract-couching contain postoperative complications, epicritically symptomatic for today's clinical pictures, which have been etiologically unknown in 1751. At least five eyes suffered postoperatively blindness by supposed detachment of the retina. The experts believed Hillmer's unexact, rough handling of the cataract needle to have been the reason. No less than 18 cases were complicated post operationem by secondary glaucomata, which ended at least twice as absolute glaucoma. We also recognize acute glaucoma, caused by couching the cataract. Secondary glaucomata were associated with severe iridocyclitis. In three cases there are indications of sympathetic ophthalmia. The experts seem to have been well acquainted with that threat to the untreated second eye. We are enabled to recognize a vitreous hemorrhage and an abscess in vitreum. No less than 21 times the couched crystalline lenses had set up again, in one case repeatedly after having been couched a second time. PMID- 1791694 TI - [Dangerous disinfection with tetraseptan]. PMID- 1791695 TI - [Sharing operating rooms with ophthalmologists]. PMID- 1791696 TI - [A case of tumor of the left heart ventricle]. PMID- 1791697 TI - [Borderline conditions]. PMID- 1791698 TI - [Diagnostic strategy in internal medicine]. PMID- 1791699 TI - [Thrombophilic conditions and their clinical aspects]. PMID- 1791700 TI - [Chronic gastritis]. PMID- 1791701 TI - [Late results of roentgenological endovascular dilatation of the renal arteries (multicenter study)]. PMID- 1791702 TI - [Painless myocardial ischemia as seen by a clinician]. PMID- 1791703 TI - [Status of the immune system and the reparative processes in peptic ulcer]. PMID- 1791704 TI - [Polychemotherapy and the prevention of drug incompatibility]. PMID- 1791705 TI - [Anti-cardiolipin antibodies in beta-thalassemia]. PMID- 1791706 TI - [Streptococcal infection and the chronic course of the rheumatic process]. PMID- 1791707 TI - [Serum type III procollagen in dilated cardiomyopathy]. AB - A radioimmunoassay study of procollagen type III end protein (PEP) was conducted in the serum of 11 patients with confirmed dilated cardiomyopathy (DCMP) and 9 patients with coronary heart disease. For DCMP patients PEP levels averaged 8.8 +/- 7.9 micrograms/l, for coronary patients 4.4 +/- 1.6 micrograms/l, in donors 1.7 +/- 1.4 micrograms/l. Thus, the difference between DCMP and coronary patients, donors appeared significant (p less than 0.05). PEP concentrations over 4.5 micrograms/l occurred in 54% of DCMP patients. Growing of PEP turned out most substantial in severe disease (circulatory failure stage IIB-III, pulmonary thromboembolism). Determination of PEP is thought valid for laboratory diagnosis of myocardial inflammation and fibrosis. The discussion covers possible causes and mechanisms underlying high production of PEP from the view point of impaired collagen production. PMID- 1791708 TI - [Value of ultrasonographic examination of the inferior vena cava in congestive heart failure]. AB - The analysis of 118 ultrasonographies of the vena cava inferior (VCI) in 57 patients with congestive heart failure complicating valvular disease suggested that VCI ultrasonic evaluation may contribute to detection of the greater circulation insufficiency. The VCI calibre increase in the circulatory insufficiency stage IIB and III correlates with elevated venous pressure. Ultrasonic follow-up of the VCI condition may serve a basis for conclusions on the effectiveness of the therapy conducted. PMID- 1791709 TI - [Characteristics of the treatment of ischemic heart disease with delayed-action verapamil]. AB - Pre- and posttreatment indices of platelet and plasma hemostasis, parameters of long-term ECG-ST monitoring were measured in 30 coronary patients on long-term verapamil regimens. ++Anti-ischemic effect of the drug was dependent on clinical pattern of the disease and initial function of the platelets. Plasma hemostasis was found unaffected. Long-term verapamil treatment is indicated in stable angina pectoris class II and III provided platelets demonstrate enhanced functional activity. PMID- 1791710 TI - [Automated analysis of cardiac biomechanics based on apex cardiography]. AB - An automatic technique of apexcardiogram reading devised by the authors is based on calculation of the first and second apexcardiogram derivatives from which one can automatically identify phases of cardiac cycle and estimate velocity, acceleration, power and performance for each phase. Altogether 39 coronary patients with stable angina of effort functional class II with no signs of circulatory insufficiency were examined. Their age averaged 46 + 1 years, 7 had a history of myocardial infarction. 118 healthy subjects (mean age 32 + 2) served control. Central hemodynamics and exercise tolerance were studied in all the examinees. No significant differences in these parameters for patients and controls were reported. Absolute and relative parameters of velocity, acceleration, power in phases of maximal and reduced ejection, intraventricular pressure, diastolic filling declined substantially in coronary patients. PMID- 1791711 TI - [Side effects of long-term drug therapy of patients with uncomplicated arterial hypertension in a polyclinic]. AB - Pronounced side effects develop in 20% of outpatients receiving chemotherapy for arterial hypertension. Complications arise more often upon administration of clophelin, reserpine, dopegyt and combined regimens. It is established that long term outpatient treatment of hypertension stage II with clophelin and drug combinations in fixed doses of the components is not beneficial and is inferior to propranolol administration which can be used for many years without any damage to cholesterol and beta-lipoproteins serum levels. PMID- 1791712 TI - [Neurological aspects of medical ecology]. AB - The paper deals with a number of problems facing clinical neurology. They arise in neurological disorders stemming from unfavourable ecological conditions. PMID- 1791713 TI - [50 years of research in the field of bronchial asthma]. PMID- 1791714 TI - [Potentiating effect of sodium glutamate on gastric secretion and its possible use as a clinical test]. AB - The authors report a potentiating effect of sodium glutamate on gastric secretion in subjects free of gastrointestinal diseases. Similar effect has been discovered in dogs. In subjects with gastric hyposecretion (chronic gastritis, functional regulatory disturbances) sodium glutamate combined with pentagastrin is a helpful tool in overall evaluation of gastric secretion. In achlorhydria is can be used for determination of a residual capacity of the stomach to secrete the hydrochloric acid in failure of humoral stimulators. PMID- 1791715 TI - [Peptic ulcer: clinical course, diagnosis and treatment in relation to its site]. AB - 2130 inpatients with peptic ulcer have been examined for clinical, diagnostic and therapeutic aspects with reference to ulcer site. Differential diagnosis and therapeutic policy are discussed for cardial, middle-gastric , pyloric, extra bulbar and multiple ulcers. PMID- 1791716 TI - [High-intensity laser irradiation in the treatment of patients with non-healing stomach ulcers]. AB - A new modality--strong impulse laser radiation--has been tried in the treatment of 99 patients suffering from atonic gastric ulcer. It was found to promote cicatrization in 87% of cases. The effect may be due to correction of immunity and local microcirculation, affection of causative agents. Strong impulse laser radiation appears to be superior to ++trans-endoscopic treatments in safety and availability. PMID- 1791717 TI - [Possibilities of prognosis of the time of scar formation after laser therapy of peptic ulcer]. AB - 234 patients with gastroduodenal ulcer underwent clinical pretreatment examination according to 19 parameters. All of them were exposed locally to copper laser irradiation. Duration of the ulcer healing was correlated to the above parameters. A statistical analysis determined a relationship between 12 of the 19 parameters and duration of the ulcer cicatrization. A regression procedure shows feasibility of predicting effectiveness of the future phototherapy by baseline clinical-endoscopic data on the patient's condition. PMID- 1791718 TI - [Treatment of peptic ulcer with sucralfate]. AB - Sucralfate made in Bulgaria (Farmaphim) and its Yugoslavian analogue venter have been tried in gastroduodenal ulcer. The drugs were given per os (1 g, 1 tablet) 4 times a day before meals for 20 days. Sucralfate treatment was assigned to 26 patients with gastric and 26 with duodenal ulcer. The other 20 gastric ulcer patients received venter. 10 patients with gastric and 20 with duodenal ulcer entered the control group receiving placebo. Attenuation of the symptoms was reported as early as on day 4 of the treatment in 85-100% of the patients both with gastric and duodenal ulcer. The 20-day course of sucralfate treatment brought about a complete epithelization on gastric ulcer in 54% while in venter treatment in 55% of those treated versus placebo group 10%. Duodenal ulcer epithelization occurred in sucralfate-treated group in 58% against placebo group 17%. The differences in treatment results between sucralfate and venter are immaterial, whereas against placebo they are significant (p less than 0.05). Side effects were not serious. PMID- 1791719 TI - [Vagotomy in the treatment of duodenal ulcer after suturing of its perforation in young age]. AB - Follow-up results are available for 108 patients who had perforation of the duodenum at the age under 30 followed at various time intervals by vagotomy with varying gastric drainage, 91.7% of them are cured, 9 developed the recurrence, 3 underwent gastric resection. PMID- 1791720 TI - [Evaluation of the results of surgical treatment of uncomplicated duodenal ulcers based on 10=year follow-up]. AB - As shown by a 10-year follow-up of 187 patients operated on for uncomplicated duodenal ulcer, recurrent disease develops in 28.4% and 1.1% of cases following vagotomy and gastric resection, respectively. Positive response (group I and II according to Visick's scale) was reported in 48.9% of those subjected to gastric resection and in 45.3% of postvagotomy subjects. Possibilities of surgical management of uncomplicated duodenal ulcer require further research with due emphasis on detection of patients with relevant contraindications. PMID- 1791721 TI - [Blue sclera in iron deficiency conditions]. AB - The study involved 91 inpatients with anemia or/and blue sclera. Of them 66 proved iron-deficient: 59 with blue sclera against 7 without such. Twenty-three anemic patients free of iron-deficiency included 9 patients with blue sclera and 16 without them. Blue sclera were identified in 2 patients in the absence of anemia. Blue sclera as an indication of iron-deficiency has sensitivity of 89, specificity of 64 and accuracy of 82%. It is an additional sign in identification of anemia. PMID- 1791722 TI - [Efferent detoxification therapy in the complex treatment of diffuse suppurative peritonitis]. AB - Upon the analysis of efferent combined therapy for diffuse purulent peritonitis in 130 patients, it was found that efferent detoxication promotes elimination of intoxication, correction of homeostasis abnormalities, recovery of basic systems of the body, a decrease of postoperative lethality and complications. The choice of the optimal detoxication method should be individual and adjusted for a peritonitis stage and a concrete clinical purpose. PMID- 1791723 TI - [Ultraviolet irradiation of autologous blood in the complex treatment of patients with diabetes mellitus]. AB - A single reinfusion of UV-irradiated autologous blood was performed in 76 patients with non-insulin-dependent (NID) and insulin-dependent (ID) diabetes mellitus. Lipid peroxidation (LPO), activity of glycolysis and pentose cycle principal enzymes, red cell cyclic nucleotides, hormones concentrations, glucose utilization were investigated. It is shown that general physiological action of UV radiation is primarily due to LPO stimulation responsible for changes in cell membrane properties. This action may vary with baseline LPO characteristics. UV radiation is valid in combined therapy of NID diabetes mellitus as it activates intracellular metabolism, reduces concentration of ++contra-insular hormones, improves tissue utilization of glucose. ID diabetes mellitus is contraindication for UV radiation use as additional stimulation of initially high LPO entails inhibition of activity of intracellular enzymatic systems participating in glucose metabolism, leads to low production of endogenous insulin. PMID- 1791724 TI - [Sick sinus syndrome in a patient with non-rheumatic myocarditis]. PMID- 1791725 TI - Lymphatic valves of the rat pancreas. AB - The detailed structure of pancreatic lymphatic valves in rats was examined in an attempt to identify ultrastructural features that could be correlated with the ability of these delicate structures to withstand retrograde flow. Sprague-Dawley rats were perfusion-fixed and the pancreas processed for light and electron microscopy. Lymphatic vessels were identified by their typical appearance coupled with the presence of valves within their lumen. These valves were consistently formed of cuspid leaflets joined to the lymphatic wall at the bases and sides enclosing valvular pockets or sinuses between cusp and wall. Each cusp or leaflet consisted of two simple squamous endothelial layers separated by a connective tissue core and thus appeared, at first sight, as a simple infolding of the lymphatic vessel lining with its underlying connective tissue. However, certain differences were seen. Frequently the free margins of the cusps, instead of being smooth as might be expected, exhibited endothelial extensions or processes which were arranged in such a way that they could interdigitate with similar extensions on the opposing cusps and thus aid in closure of the valves. A striking difference between the endothelial lining of the vessel and that of the cusp was the presence of a distinct and almost continuous basal lamina underlying the endothelial cells which lined the surface of the cusp facing the valve pocket. The opposing surface of the cusp, which faced the central lumen was similar to the typical lining of lymphatics in showing little or no basal lamina.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791726 TI - Lymph flow transients following elevation of venous pressure in the dog hindpaw. AB - Lymph flow transients were studied in a dog paw preparation when venous pressure was elevated by 15 and 25 mmHg. The lymph flow transients showed a very rapid initial increase which then declined to a steady-state value that was one-half the peak lymph flow response for both pressure changes. Lymph flow increased in the initial 5.3 minutes following venous pressure elevation to 10.4 +/- 2.0 and 18.1 +/- 4.5 times the normal lymph flow (mean +/- standard deviation) for the 15 and 25 mmHg increases in venous pressure, respectively. However, approximately 9 minutes after attaining the maximal flow rate, the lymph flow declined to only 5.5 +/- 0.7 and 9.8 +/- 1.8 times the control values. These data demonstrate another condition in which lymph flow is not maintained at the maximal capability. Possible mechanisms causing the observed biphasic lymph flow response to capillary pressure elevation are: 1) changes in Starling forces oppose an increase in capillary pressure; 2) the rate of change in tissue fluid pressure affects lymph flow to a greater extent than does the absolute change in tissue fluid pressure; or, 3) the lymphatics empty upon elevation and refill as the capillaries filter. PMID- 1791727 TI - Primary chylopericardium with pulmonary shadow and large granular lymphocytosis: a case report. AB - A 79-year-old man with primary chylopericardium associated with large granular lymphocytosis was followed for more than 26 years. Except for development of dyspnea on exertion during the past four years and more recently cough with sputum production, he has remained largely asymptomatic over this interval. Based on detailed examinations of cellular and humoral immunity, we speculate that increased natural killer cell activity and an increased number of large granular lymphocytes circulating in his peripheral blood represent a reactive response to production of various cytokines secondary to persistent loss (? chyloptysis) and sequestration of central lymph. PMID- 1791728 TI - Vascular abnormalities in experimental and human lymphatic filariasis. AB - Whereas clinical descriptions of grotesque lymphedema and standard light microscopy in human filariasis have elucidated the natural progression of this disease, the link between the nematode and vascular abnormalities including elephantiasis remains poorly understood. Accordingly, we examined the nature and distribution of lymphatic and blood vascular derangements in a variety of tissues and organs from 37 ferrets acutely and chronically infected with Brugia malayi and in 15 patients with Wuchereria bancrofti or Brugia malayi infestation (resected skin, subcutaneous tissue, and lymph nodes) using light and transmission electron microscopy, immunohistochemistry, and in vivo microscopy. In ferrets, eosinophilic abscesses and epithelioid and giant cell granulomas with fragmented worms in various stages of disintegration were found in multiple organs. Blood microvasculopathy consisted of endothelial hyperplasia, focal thickening and stenosis, vessel obliteration with marked perivascular infiltration of lymphocytes, plasma cells, eosinophils, and numerous large macrophages laden with a coarse golden-brown pigment. Endothelial ballooning and swelling, pavementing, denuding, scarring, and sludge formation were seen along with high endothelium in atypical locations. Dilated lymphatics were most prominent near adult worms and showed plump endothelium, thickened walls and valves, thrombus formation, and often perilymphangitis and adjacent tissue fibrosis. In vivo microscopy showed wriggling live adult worms in dilated incompetent sludge-filled groin lymphatics even when microfilaremia and peripheral edema were absent. In human tissues, in addition to "pachyderm" skin changes (keratosis, papillomatosis, acanthosis and collagen deposition), there was blood vessel and lymphatic vasculopathy similar to ferrets (angiocentric inflammation, congestion, vasculitis, thrombosis, thickened vessel walls, dilated lymphatics, lymphangitis, reactive lymph nodal hyperplasia and nodal fibrosis). These changes reflect generalized endothelial damage due to worm products, physical injury to valves and vessel walls from lymphatic-dwelling live worms, and host immune reactivity. Whereas adult worms target the lymphatic apparatus, their offspring and the host immune response primarily affects the blood microvasculature. PMID- 1791729 TI - [Minicholecystectomy with local anesthesia]. AB - In suitable patients the gallbladder can be exercised in local anesthesia through a very small incision. The anatomical background of a safe local anesthesia and the operative procedure is described. Candidates for this operation are patients with gallbladder stone disease without severe acute or chronic complications, and with normal and stone free bile ducts. This type of intervention is an enlargement of the surgeon's armentarium, and it can be offered to patients unwilling to have general anesthesia or with severe contraindications to narcosis. PMID- 1791730 TI - [Does parenteral linoleic acid modify tumor growth? Studies with the Yoshida sarcoma model]. AB - In an experimental study with sprague-dawley-rats we tested the effect of parenteral substituted LCT-fats on tumor growth of the Yoshida sarcoma in its ascites form. Therefore we tested 4 groups with 10 tumor-bearing and 10 non-tumor bearing rats. We added group 1-3 LCT-fats in different doses. Group 4 was fed enterally. We found that tumor-bearing rats had a higher nitrogen retention than non-tumor-bearing rats. Non-tumor-bearing rats showed a higher nitrogen concentration in the muscles. The portion of nitrogen increased with increasing portion of fat. The content of nitrogen in the ascites, the quantity and the number of tumor cells was reversed in proportion to the portion of fat. For the host we showed that he cannot make use of the energy directly. The tumor does not grow in proportion to the available energy but has to support itself from the catabolism of the host. PMID- 1791731 TI - [Permanent arterial approach to the lower extremity using a totally implantable reservoir system]. AB - In 10 patients with peripheral arterial occlusive disease intraarterial infusions were performed using a totally implantable port system. The port is fixed to the gluteal fascia on the outside of the iliac wing. The inferior epigastric artery is dissected through an additional incision above the inguinal ligament. A 2 mm catheter is connected to the port and inserted through the epigastric artery into the external iliac artery. Using this new suprainguinal technique the groin remains intact permitting surgical and interventional procedures. In one case a dislocation of the catheter occurred. The reason for this complication was an unsafe surgical fixation. The totally implantable port system is an alternative to conventional intraarterial infusions. There are several advantages using the suprainguinal technique as described above. PMID- 1791732 TI - [Primary hepatocyte cultures as a model of experimental study of liver preservation]. AB - Primary hepatocyte cultures have been used to evaluate data concerning hypoxic liver cell injury. To show the suitability of this method in liver preservation studies hepatocyte cultures were incubated under different conditions: warm normoxia (37 degrees C, pO2 greater than 70 mm Hg), warm hypoxia (37 degrees C, pO2 less than 0.1 mm Hg), cold normoxia (4 degrees C, pO2 greater than 70 mm Hg) and cold hypoxia (4 degrees C, pO2 less than 0.1 mm Hg). Incubations were performed in Euro Collins solution (EC), University of Wisconsin solution of Belzer (UW) and histidine ketoglutarat tryptophan solution of Bretschneider (HTK) as well as in Krebs Henseleit buffer (KH) for control incubations. During 12 h of incubation hepatocyte cultures under warm normoxia lost viability continuously in EC, UW and HTK while in KH they remained stable. Under warm normoxia all cultures lost 50% of their viability during 12 h of incubation while in cold normoxia loss of viability was mild but significant. Under cold anoxia which is the standard condition of liver preservation the cultured hepatocytes remained unchanged for 12 h in KH, UW and HTK, while in EC most of the cells were dead after 6 h. It is concluded that incubations of primary hepatocyte cultures under different pO2 and temperatures are well suited to contribute to liver preservation studies on a preclinical level and thus may help to save animal experiments. PMID- 1791733 TI - [Therapy of bleeding esophageal varices in West Germany--results of a survey]. AB - An inquiry concerning bleeding of esophageal varices included 1076 surgical and medical departments in the Federal Republic of Germany (West). Prevailing forms of treatment are acute sclerotherapy or esophageal balloon tamponade followed by long-term sclerotherapy. In case of medically uncontrollable bleeding oesophagogastric devascularization procedures are preferred to portacaval shunt. Beta-blockers are applied in medical departments for the prophylaxis of recurrence. Only after several rebleedings, despite of sclerotherapy, approx. half of the departments consider an elective shunt. The distal splenorenal shunt described by Warren and portacaval anastomosis clearly prevail over all other shunts. PMID- 1791734 TI - [Role of the spleen in tumor surgery]. AB - Tumorigenesis and tumor growth are connected with the immune system. Therefore the role of the spleen respectively splenectomy have gained increasing influence. The existing experimental and clinical results are discussed with the help of a general review of the literature. A manipulation of the immune system by splenectomy seems possible. A common pathomechanism has not yet been found. But experimental investigations are transferrable to human beings only under special conditions. PMID- 1791735 TI - [Perioperative complications in thyroid gland surgery]. AB - The perioperative complication rate of 548 thyroidectomies in 536 patients was evaluated in a retrospective study. Local problems were present in 14% of the patients. Most frequent were paralysis of the recurrent nerve (5.0%) and hematoma or hemorrhage (4.3%). Systemic complications were seen in 2% of the patients, usually cardiopulmonary decompensation requiring intensive care treatment. The operative and hospitalisation mortality was 0%. Statistical evaluation revealed that patients older than 50 years and patients undergoing rethyroidectomy were at higher risk for local complications. Our results show, however, that thyroidectomy is a low risk operation at a teaching institution. PMID- 1791736 TI - [Light and scanning electron microscopy studies of the pleura. A contribution to the pathogenesis of spontaneous pneumothorax in young patients]. AB - In a prospective study of 10 patients (7 men, 3 women, mean age 26.2 years), who underwent thoracotomy because of recurrent spontaneous pneumothorax, we performed light and scanning electron microscopic investigations of the resected pleura. The purpose of our work was to explain pleural changes which allowed the penetration of air through the intact wall of the blebs. In 8 of 10 cases we found small bullae at the top of the upper lobe, the remaining 2 showed up with massive pleural scar. The morphological and ultrastructural findings indicated that the presence of air induced a reactive process at the visceral pleura which led to degeneration and scarification. The changes consisted of simple membrane formation up to complete destruction of the pleural layer. The development of blebs is due to an air fistula coming out of the lung parenchyma. Penetration of air through the bleb's wall is explained with the increasing pressure inside and the dehiscence of degenerated pleural structure. In our opinion spontaneous pneumothorax in young people is caused by a localized disease of the upper lobe. The pleural changes are the visible effects of a degenerative process induced by air fistula from lung parenchyma. Therefore wedge-resection of that region is a rational therapy in patients with spontaneous pneumothorax. PMID- 1791737 TI - [Occult hemorrhage from the small and large intestine]. PMID- 1791738 TI - AIDS and the physician's duty to warn (Part I). AB - The protective privilege ends where the public peril begins: Tarasoff v Regents of the University of California. The risk reasonably to be perceived defines the duty to be obeyed: Palsgraf v Long Island Railroad Co. This article analyzes the conflicting obligations (to maintain patient confidentiality and to warn those at risk) that a physician faces when confronted with an HIV-infected patient who is unable, or unwilling, to notify close contacts that they may have been, or will be, exposed to the AIDS virus. The ethical basis, the common law development, and the statutory establishment of each of these duties are examined, first in general, and then specifically, in regard to AIDS and HIV infection. The focus is placed on the patient's sexual partners (as persons at risk) although it is important to realize that this issue also applies to many other categories of close, and not so close, contacts. PMID- 1791739 TI - Legal and ethical problems in intensive care units. AB - The intent of this article is to increase the awareness of physicians working in intensive care units as to their legal and ethical responsibilities, and the potential for serious harm they can do to patients with the inevitable malpractice law suit if patient damage does occur. This article also suggests some defences in the event that physicians get involved in the legal cobweb. PMID- 1791740 TI - A comparative study of alcohol-related problems among a group of university students and a group of clerks in the National Capital District, Papua New Guinea. AB - This article reports a comparative study of alcohol-related problems in two groups of Papua New Guinean youth. The first group consists of 25 undergraduate students of the University of Papua New Guinea. The second group consists of 25 staff members of the Post and Telecommunications Corporation (PTC). The research subjects in both groups were selected at random. The instrument used for the study is the Brief (10 item questions) Michigan Alcoholism Screening Test (MAST). Demographic data including age, sex, educational status, marital status and province of origin were also collected using a purpose designed questionnaire. The data collected were analyzed and compared between the two groups using chi square statistical analysis. The findings and results point to the following conclusions: (a) Alcohol-related problems are more common among the clerks than among the students, but the differences are not statistically significant; (b) alcohol-related health problems (medical and neuropsychiatric complications) were not reported in the study sample; and (c) further surveys on larger samples using the Brief MAST were recommended for early detection of alcohol-related problems. The results could form a basis for future alcohol education programmes. PMID- 1791741 TI - Attitudes of medical practitioners towards alcohol and alcohol consumption. AB - Doctors frequently come into contact with problems arising from alcohol abuse and such direct exposure would be expected to make them highly aware of such circumstances. A total of 224 medical practitioners (173 men and 51 women) were studied. The questionnaire contained 124 items pertaining to socioprofessional and demographic information, opinions and attitudes. In our study 5.91% of those doctors questioned did not consider alcohol a drug. When faced with an alcoholic in the family or in the home, 45.53% said they would seek medical help for the person involved, while 40.17% responded that they would prefer to go to an alcoholics' or ex-alcoholics' association. The number of years in practice was related, together with age, to variables of attitude. Older practitioners with longer practices were less knowledgeable about alcoholism and ascribed less importance to an accurate diagnosis and appropriate treatment. PMID- 1791742 TI - Seeking psychological treatment as a cure for a medical problem. AB - Today health care providers are more likely to experience legal, moral and ethical dilemmas regarding their treatment principles given the climate of health care. Clinical practice in the United States is being affected by many external forces which can affect patient care. Government and insurance companies are attempting to legislate treatment as evidenced by DRG's and reimbursement patterns. Hospital and clinic administrators are pressuring faculty and staff to increase revenue by participating in more income generating activities. Within this milieu of dwindling resources, consumers continue to demand a variety of health care services. A case example of a woman who asked for a psychological intervention to treat a medical condition is presented. This case focuses on the important issue of offering efficacious treatments to informed patients with carefully diagnosed disorders. Whether scientific, ethically-based treatments are being rendered when any of the criteria, efficacious, informed and diagnosed are altered or missing, is open to doubt. This case is presented, not as a model of clinical management, but rather to stimulate discussion and generate ideas on how to better address future situations: (a) Where the patient requests an available treatment for a problem which would not be directly helped by such treatment; (b) how far must a clinician go to insure that informed consent has been reached?; (c) what is the physician's responsibility in providing what a patient wants in the way of treatment?; and (d) conversely, should clinicians provide medical interventions (at the patient's insistence) for psychological problems, for example, provide a penile prosthetic implant to a man whose disorder is clearly psychogenic impotence? PMID- 1791743 TI - Issues in psychiatric prevention and enforcement of treatment. AB - In this article the following issues relating to psychiatric prevention, and enforcement of treatment are discussed: Patient's rights, state interests, informed consent, transient and irreversible incompetency, prediction of the evolution of the patient's clinical state, psychiatric emergency, mode of appropriate treatment chosen, ethics, adequate treatment, malpractice, and the psychiatrist's responsibility and role. PMID- 1791744 TI - Tourists and psychiatric hospitalization with reference to ethical aspects concerning management and treatment. AB - In this brief article, it is shown how tourists may decompensate psychiatrically upon arrival in a new country. Some of the factors that explain the background of some of these patients, and some of the ethical aspects concerning management and treatment are discussed. PMID- 1791745 TI - Ethical and legal aspects of imposed sexological treatment. AB - And if everything is so nebulous about a matter so elementary as the morals of sex, what is there to guide us in the more subtle morality of all other personal contacts, associations and activities? Or are we meant to act on impulse alone? It is all the 'darkness': Ford-Madox-Ford. PMID- 1791746 TI - Contractual aspects of surrogate motherhood in The Netherlands. AB - This article presents a critical analysis of the contractual status and implications of surrogate motherhood agreements in the Netherlands. Particular attention is focussed on the notions of freedom of contract and the public interest as two distinctive but interrelated determinants in assessing the legal consequences of avoidance of the terms of surrogate motherhood agreements by the prospective surrogate mother and/or the prospective parents. PMID- 1791747 TI - Radiation resistance in Schizosaccharomyces pombe. AB - The fission yeast Schizosaccharomyces pombe serves as an excellent alternative and complementary model system for the analysis of genes and gene products involved in DNA repair. This brief review outlines the advantages of S. pombe and describes the radiation-sensitive mutants available for the analysis of DNA repair and recombination mechanisms in this organism. The progress in the cloning and characterization of representative genes is also described. PMID- 1791748 TI - Pseudomonas aeruginosa elastase and elastolysis revisited: recent developments. AB - With the determination of the three-dimensional structure of elastase and the probable identification of the active site and key residues involved in proteolytic activity, our knowledge of the molecular details of this interesting protease is rapidly increasing. Pseudomonas elastase appears to be remarkably similar to the Bacillus metalloproteinase thermolysin. A further significant development has been the discovery of the lasA gene and the fact that Pseudomonas elastase and alkaline proteinase appear to act in concert with the LasA protein to display the notable elastolytic activity exhibited by isolates of this organism. Biochemical and genetic studies indicate that LasA is a second elastase which may be an important virulence factor that has been overlooked in previous studies. PMID- 1791749 TI - Sensory transduction in the gliding bacterium Myxococcus xanthus. AB - Sensory transduction in the gliding bacterium Myxococcus xanthus is mediated by the frz genes. These genes are homologous to the chemotaxis genes of enteric bacteria and control the rate of cell reversal during gliding. Sensory transduction is hypothesized to involve the recognition of substances present in the medium at the cell surface and the subsequent stimulation of a cytoplasmic methyl-accepting protein, FrzCD. Phosphorylation of FrzE is also involved in the sensory transduction pathway. Despite the similarities between the chemotaxis proteins of enteric bacteria and M. xanthus Frz proteins, fundamental differences exist between these different bacteria in terms of the ability of cells to recognize and respond to substances in their environment. The mechanism of directional switching and the nature of the gliding motor remain obscure. It is hoped that the study of the interaction of the Frz proteins will allow greater understanding of these problems. PMID- 1791750 TI - An Agrobacterium two-component regulatory system for the detection of chemicals released from plant wounds. AB - Crown gall tumorigenesis by Agrobacterium tumefaciens requires the co-ordinate transcriptional induction of a set of pathogenesis genes. At least three classes of environmental stimuli act synergistically to induce these genes: (i) monocyclic aromatic hydrocarbons such as acetosyringone, coniferyl alcohol, and vanillin, (ii) neutral or acidic monosaccharides such as glucose and glucuronic acid, and (iii) acidic pH. Three proteins are required to sense and respond to these stimuli: (i) VirA, a transmembrane sensory protein and histidine protein kinase, (ii) VirG, a transcriptional activator which is phosphorylated by phosphoryl VirA, and (iii) ChvE, a periplasmic sugar-binding protein. VirA and VirG are members of the so-called two-component family of regulatory proteins. This regulatory system continues to offer new discoveries in the areas of signal transduction, host-microbe interactions, and host range. PMID- 1791751 TI - H-DNA formation by the coding repeat elements of neisserial opa genes. AB - The coding repeat region of opa genes from Neisseria gonorrhoeae and Neisseria meningitidis determines the expression state of their respective genes through high-frequency addition of deletion of pentanucleotide coding repeat units (CRs; CTTCT). In vitro analyses of cloned opa gene CR regions using single-strand specific nucleases, oligonucleotide protection experiments, and modifications of non-B-DNA residues indicate that the regions form structures resembling H-DNA under acidic conditions in the presence of negative supercoiling. The purine/pyrimidine strand bias and H-palindromic nature of the repeat region are consistent with sequence requirements for H-DNA formation. Sequences flanking the repeat elements are required to form the H-DNA structure in vitro as judged by the pattern of exposed non-B-DNA residues in CR sequences synthesized as oligonucleotides to form beta-galactosidase::CR translational fusions. The fusions phase vary by addition and deletion of CR elements and the rate of phase variation increases upon induction of the fusion genes. The opa gene CR region is the first reported bacterial H-DNA structure and is unique in that it lies within the coding sequence for the gene. PMID- 1791752 TI - deoP1 promoter and operator mutants in Escherichia coli: isolation and characterization. AB - Plasmid DNA containing deoP1, one of the two major promoters of the deo operon, has been mutagenized using hydroxylamine, and promoter down-mutations and operator mutations were selected. The isolated mutants are all located within a 16 bp palindromic sequence containing the -10 region of deoP1. The results show that RNA polymerase and DeoR repressor compete for the same DNA target. The deoP1 promotor activity is dependent on a TG motif one base pair upstream of the -10 consensus sequence. The sequence of the deo operator site was further verified by use of a synthetic linker. PMID- 1791753 TI - Characterization of a plasmid from Helicobacter pylori encoding a replication protein common to plasmids in gram-positive bacteria. AB - A 1.5 kb cryptic plasmid was isolated from Helicobacter pylori. Low-stringency hybridization analysis using this plasmid as a DNA probe revealed base sequence homology with other plasmids in this species. Nucleotide sequence analysis identified an open reading frame encoding a putative polypeptide of 25 kDa. This protein showed marked amino acid sequence similarity to replication-initiation proteins commonly found in small plasmids endogenous to Gram-positive bacteria which replicate by the 'rolling-circle' mechanism. Sequence motifs corresponding to the origins-of-replication consensus sequences were found on this cryptic plasmid. DNA and oligonucleotide probes to these plasmid replication sequences were used in hybridization analysis to identify similar sequences in other H. pylori plasmids. We believe this is the first plasmid isolated from a Gram negative bacterium to show replication determinants characteristic of the 'rolling-circle' group of plasmids from Gram-positive bacteria. The cloned plasmid will be used to develop a shuttle-vector for H. pylori. PMID- 1791754 TI - Mutational analysis supports a role for multiple structural features in the C terminal secretion signal of Escherichia coli haemolysin. AB - We have carried out an extensive mutational analysis of the C-terminal signal which targets the export of the 1024-residue haemolysin protein (HlyA) of Escherichia coli across both bacterial membranes into the surrounding medium. Over 60 variants of the HlyA C-terminal 53-amino-acid sequence were created by oligonucleotide-directed mutagenesis and fused to the HlyA N-terminal 830 residues. Transport of the HlyA derivatives by the HlyB/HlyD system was compared with the wild-type level and the data indicate that the HlyA C-terminal export signal lies within the last 48 amino acids and comprises three functional domains: an amphipathic, charged helix between residues 1,977 and R,996; a 13 amino-acid uncharged region from residue T,997 to S,1009; and an 8-amino-acid hydroxylated tail at the extreme C-terminus. Analogous features were found in the C-terminal sequences of an extended family of haemolysins, leukotoxins and proteases which are secreted by HlyB/HlyD-type translocators. In particular, all nine proteins which are secreted into the extracellular medium possess potential extended amphipathic helices. These results suggest a possible role for multiple regions of the HlyA C-terminal export signal in which the first two domains span the membranes and the third domain remains in the cytoplasm. PMID- 1791755 TI - Identification of Treponema pallidum subspecies pallidum genes encoding signal peptides and membrane-spanning sequences using a novel alkaline phosphatase expression vector. AB - Treponema pallidum subspecies pallidum is a pathogenic spirochaete for which there are no systems of genetic exchange. In order to provide a system for the identification of T. pallidum surface proteins and potential virulence factors, we have developed a novel expression vector which confers the utility of TnphoA transposition. The relevant features of this plasmid vector, termed pMG, include an inducible tac promoter, a polylinker with multiple cloning sites in three reading frames, and an alkaline phosphatase (AP) gene lacking the signal sequence encoding region. Library construction with Sau3A-digested T. pallidum genomic DNA resulted in the creation of functional T. pallidum-AP fusion proteins. Analysis of fusion proteins and their corresponding DNA and deduced amino acid sequences demonstrated that they could be grouped into three categories: (i) those with signal peptides containing leader peptidase I cleavage sites, (ii) those with signal peptides containing leader peptidase II cleavage sites, and (iii) those with non-cleavable hydrophobic membrane-spanning sequences. Triton X-114 detergent phase partitioning of individual T. pallidum-AP fusions revealed several clones whose AP activity partitioned preferentially into the hydrophobic detergent phase. Several of these fusion proteins were subsequently shown to be acylated by Escherichia coli following [3H]-palmitate labelling, indicating their lipoproteinaceous nature. DNA and amino acid sequence analysis of one acylated fusion protein, Tp75, confirmed the presence of a hydrophobic N-terminal signal sequence containing a consensus leader peptidase II recognition site. The DNA sequence of Tp75 also indicates that this is a previously unreported T. pallidum lipoprotein. T. pallidum-AP fusion proteins which partitioned into the hydrophobic detergent phase but did not incorporate palmitate were also identified. DNA and amino acid analysis of one such clone, Tp70, showed no cleavable signal but had a significant hydrophobic region of approximately 20 residues, consistent with a membrane-spanning domain. Immunoblot analysis of T. pallidum-AP fusions detected with a monoclonal antibody specific for AP identified several fusion proteins which migrated as doublets separated in apparent electrophoretic mobility by no more than 3 kDa. [35S]-methionine pulse chase incorporation showed that the doublet AP fusions represented precursor and processed forms of the same protein. DNA and amino acid sequence analysis of clones expressing processed fusion proteins demonstrated hydrophobic N-terminal signal sequences containing consensus leader peptidase I recognition sites. PMID- 1791756 TI - Isolation and characterization of osmosensitive vacuolar mutants of Saccharomyces cerevisiae. AB - The yeast vacuole plays an important role in nitrogen metabolism, storage and intracellular macromolecular degradation. Evidence suggests that it is also involved in osmohomeostasis of the cell. We have taken a mutational approach for the analysis of vacuolar function and biogenesis by the isolation of 97 mutants unable to grow if high concentrations of salt are present in the medium. Phenotypic analysis was able to demonstrate that apart from osmosensitivity the mutations also conferred other properties such as altered vacuolar morphology and secretion of the vacuolar enzymes carboxypeptidase Y, proteinase A, proteinase B and alpha-mannosidase. The mutants fall into at least 17 complementation groups, termed ssv for salt-sensitive vacuolar mutants, of which two are identical to complementation groups isolated by others. We conclude that in Saccharomyces cerevisiae correct vacuolar biogenesis and protein targeting is required for osmotolerance as well as other important cellular processes. PMID- 1791757 TI - Characterization, localization and transmembrane organization of the three proteins PrtD, PrtE and PrtF necessary for protease secretion by the gram negative bacterium Erwinia chrysanthemi. AB - Erwinia chrysanthemi, a Gram-negative phythopathogenic bacterium, secretes two related extracellular metalloproteases, B and C, which do not have N-terminal signal sequences. The specific pathway by which they are secreted, which has been reconstituted in Escherichia coli, comprises three proteins -- PrtD, PrtE and PrtF. Hybrid proteins containing segments of these proteins fused to the C terminus of protease B were purified and used to immunize rabbits. The antisera thus obtained were used to study the location and membrane topology of the three proteins. PrtD and PrtE were found to cofractionate almost exclusively with the cytoplasmic membrane, whereas PrtF was found to co-fractionate mostly with the outer membrane. Proteinase K accessibility experiments as well as sequence data lead us to propose that PrtF has one or both ends exposed to the periplasm, that PrtE has one transmembrane segment with its amino-terminus facing the cytoplasm and its C-terminal hydrophilic domain exposed to the periplasm, and that PrtD has six transmembrane segments with its N-terminus and its C-terminal hydrophilic domain in the cytoplasm. PMID- 1791758 TI - Sequence variation in two ipaH genes of Shigella flexneri 5 and homology to the LRG-like family of proteins. AB - Oligonucleotide primers derived from the ipaH7.8 sequence have been used to determine the boundaries of DNA sequence homology among five ipaH genes on the invasion plasmid (pWR100) of Shigella flexneri 5, strain M9OT-W. The primary structure of IpaH4.5 has been established from DNA sequence analysis. The first 197 amino acids in IpaH7.8 were replaced in IpaH4.5 by a unique set of 251 amino acids, generating two related proteins with variable and conserved sequences. The amino-terminal region of IpaH4.5 displayed an internal repeat structure, also seen in IpaH7.8, characteristic of members of the leucine-rich glycoprotein (LRG) family. The DNA sequences of ipaH2.5 and ipaH1.4 indicate that these genes are truncated versions of ipaH7.8. Western blot analysis of a lambda gt11 ipaH recombinant (W7) subclone demonstrated that the antigenicity of IpaH7.8 resides outside the leucine-rich repetitive region. PMID- 1791759 TI - DNA sequence determination of the TOL plasmid (pWWO) xylGFJ genes of Pseudomonas putida: implications for the evolution of aromatic catabolism. AB - The meta operon of the Pseudomonas putida TOL plasmid (pWWO) encodes all enzymes of a meta-cleavage pathway for the metabolism of benzoic acids to Krebs-cycle intermediates. We have determined and analysed the nucleic acid sequence of a 3442 bp region of the meta operon containing the xyl-GFJ genes whose products are involved in the post meta-ring fission transformation of catechols. Homology analysis of the xylGFJ gene products revealed evidence of biochemical relatedness, suggested enzymatic mechanisms, and permitted us to propose evolutionary events which may have generated the current variety of aromatic degradative pathways. The xylG gene, which specifies 2-hydroxymuconic semialdehyde dehydrogenase (HMSD), was found to encode a protein of 51.7 kDa. The predicted protein sequence exhibits significant homology to eukaryotic aldehyde dehydrogenases (ADHs) and to the products of two other Pseudomonas catabolic genes, i.e. xylC and alkH. Expansion of the ADH superfamily to include these prokaryotic enzymes permitted a broader analysis of functionally critical ADH residues and phylogenetic relationships among superfamily members. The importance of three regions of these enzymes previously thought to be critical to ADH activity was reinforced by this analysis. However glutamine-487, also thought to be critical, is less well conserved. The revised ADH phylogeny proposed here suggests early catabolic ADH divergence with subsequent interkingdom gene exchange. The xylF gene, which specifies 2-hydroxymuconic semialdehyde hydrolase (HMSH), was delineated by N-terminal sequence analysis of the purified gene product and is shown to encode a protein of 30.6 kDa. Homology analysis revealed sequence similarity to a chromosomally encoded serine hydrolase, especially in the region of the previously identified active-site serine residue, suggesting that HMSH may also possess a serine hydrolytic enzymatic mechanism. Likewise, the xylJ gene, which specifies 2-hydroxy-pent-2,4-dienoate hydratase (HPH), was delineated by N-terminal sequence analysis of purified HPH, and was found to encode a 23.9 kDa protein. Sequence comparisons revealed that both HMSH and HPH have analogues in the tod gene cluster, which specifies a toluene/benzene degradative pathway. Although the newly identified todF and todJ genes had been at least partially sequenced (Zylstra and Gibson, 1989), the open reading frames had not been positively identified. The presence of todJ provides strong evidence that the reactions following ring fission in the tod pathway are identical to those of the TOL pathway.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1791760 TI - Structural and genetic analysis of the bvg locus in Bordetella species. AB - The bvg locus contains two genes, bvgA and bvgS, which control the expression of the virulence-associated genes in Bordetella species by a system similar to the two-component systems used by a variety of bacterial species to respond to environmental stimuli. We determined the nucleotide sequence of the bvg loci of Bordetella parapertussis and Bordetella bronchiseptica and compared them with the previously determined sequence of Bordetella pertussis. The nucleotide and amino acid sequences of the bvg loci of these species are well conserved in those regions coding for the protein domains which have putative kinase and DNA-binding activities. In marked contrast, the region of BvgS that codes for the protein domain with putative sensor activity shows a high degree of variability. In total, we find 198 base-pair changes in the bvg loci of B. parapertussis and B. bronchiseptica relative to the bvg locus of B. pertussis. One hundred and seventy three of these base-pair changes are identical in B. parapertussis and B. bronchiseptica. This confirms our previous observation that B. parapertussis and B. bronchiseptica are more related to each other than to B. pertussis. We have mapped the mutations that cause phase changes in B. bronchiseptica and we have found that in three cases these are due to spontaneous deletions in the bvgS gene. The wild-type bvg locus present on a multicopy plasmid cannot complement avirulent derivatives of B. bronchiseptica to wild-type levels, but it can do so when the bvgA gene on the plasmid is inactivated. This suggests that hyperexpression of bvgA down-regulates the bvg system. PMID- 1791761 TI - The bvg-dependent promoters show similar behaviour in different Bordetella species and share sequence homologies. AB - The expression of the virulence-associated genes in Bordetella species is co ordinately regulated by the gene products encoded by the bvg locus. In Bordetella pertussis the expression of this locus is regulated by the P1, P2, P3 and P4 promoters which are located in a 350 bp DNA fragment also containing the PFHA promoter. Here we report the transcriptional regulation of the bvg locus and the fha gene in Bordetella parapertussis and a sequence analysis of the bvg-regulated promoters. The Pp1, Pp2, Pp4 and PpFHA promoters are indistinguishable, both in transcription initiation sites and environmental regulation, from the corresponding promoters of B. pertussis, while the Pp3 promoter is not active. Sequence homologies from nine bvg-regulated promoters show a conserved dinucleotide, 5'-TG-3', at approximately one turn of helix upstream of the -10 5' A.AaTat-3' region, and a 5'-TTTCC-3' sequence in the -90 region. Since the nucleotide sequence of the inactive Pp3 promoter shows several base substitutions with respect to the found sequence homologies, it is likely that some of these bases play an essential role in promoter activity. PMID- 1791763 TI - Physical and genetic map of the Neisseria gonorrhoeae strain MS11-N198 chromosome. AB - A macro-restriction map of the Neisseria gonorrhoeae chromosome was constructed using the enzymes Nhel and Spel. Combinations of one- and two-dimensional electrophoresis of completely or partially digested chromosomal DNA were performed to align the restriction fragments. The chromosome is circular, with an estimated size of 2.33 Mb +/- 35 kb. A genetic map was derived from the physical map; positions of over 60 defined loci were determined by Southern hybridization. PMID- 1791762 TI - The hydrogenase structural operon in Rhodobacter capsulatus contains a third gene, hupM, necessary for the formation of a physiologically competent hydrogenase. AB - The hupM gene, previously called ORFX, found downstream from and contiguous with the structural hydrogenase genes hupS and hupL in Rhodobacter capsulatus, is shown here to form a single hupSLM transcription unit with the two other genes. The hupM gene was inactivated by interposon mutagenesis. The two selected mutants, BCX1 and BCX2, which contained the kanamycin-resistance gene in opposite orientation, still exhibited hydrogenase activity when assayed with the artificial electron acceptors benzylviologen and methylene blue. However, the hydrogenase was not physiologically active in these mutants, which could not grow autotrophically and were unable to recycle electrons to nitrogenase or to respire on H2. The hupM gene starts nine base pairs downstream from the TGA stop codon of hupL gene, which encodes the large subunit of the [NiFe]hydrogenase of Rhodobacter capsulatus. The three contiguous genes hupS, hupL and hupM were subcloned downstream from the promoter of hupSL, either with the promoter in the correct orientation (plasmid pBC8) or with the promoter in the opposite orientation (plasmid pBC9), then the constructs were introduced into the mutant strains. Only plasmid pBC8 could restore the formation of a competent hydrogenase in mutants BCX1 and BCX2, indicating that the hupM gene is expressed only from the hupSL promoter. PMID- 1791764 TI - Role of plasmid multimers in mutation to tetracycline resistance. AB - As an additional system for analysing mutations that appear to be specifically induced or directed, we have used a plasmid that contains the mnt repressor gene inserted as an operon fusion with the tet gene of the plasmid pBR322. Thus, the mnt gene product acts as a negative transcriptional regulator of tet gene expression. Mutations inactivating the Mnt repressor are recessive while those destroying operator recognition (Oc) are dominant in conferring tetracycline resistance on the host. When resistance mutations were isolated on plates with high levels of tetracycline they were preferentially mnt- and the plasmids were monomers. Pre-exposure to low concentrations increased the frequency of resistant mutants by 100- to 1000-fold, and the mutations were now mostly Oc, located on one unit of a plasmid multimer. Recessive repressor mutations on one unit would not have been selected. We suggest that the high frequency of mutation in tandem multimeric plasmids may be caused by the formation of single-stranded and hence highly mutable regions by homologous pairing out of register. The role of tetracycline in promoting mutations is discussed. PMID- 1791765 TI - Distinguishing between the extracellular DNases of Vibrio cholerae and development of a transformation system. AB - Vibrio cholerae is known to secrete DNase(s) into the extracellular environment. These proteins have been thought to be responsible for the difficulties in transforming this organism. In this work we demonstrate that the dns and xds genes differ and that their products are solely responsible for the extracellular DNase activity. By site-directed mutagenesis, strains have been constructed which are mutant in one or both genes. These strains have been assessed for their ability to be transformed with plasmid DNA and for their virulence in the infant mouse cholera model. DNase-deficient mutants can be readily transformed and the product of dns appears to be the more significant barrier. No effect on virulence was observed with the mutants. PMID- 1791766 TI - Analysis of the haemolysin transport process through the secretion from Escherichia coli of PCM, CAT or beta-galactosidase fused to the Hly C-terminal signal domain. AB - Secretion of haemolysin (HlyA) is secA independent, but depends upon two accessory membrane proteins, HlyB and HlyD, encoded by the hly determinant. A fourth (cytoplasmic) protein, HlyC, is required to activate HlyA post translationally, but has no role in export. Deletion studies have previously shown that the HlyA molecule contains a targeting signal close to the C-terminus which specifically directs its secretion to the medium. This targeting signal has been variously located within the terminal 27, 53, 60 or 113 amino acids. In this paper, we have sought to confirm the presence of a C-terminal targeting signal and to analyse the specificity of the Hly transport system through fusion of C terminal fragments of HlyA to heterologous polypeptides. A C-terminal fragment (23 kDa) of HlyA, when fused at the C-terminus, efficiently promoted the secretion of the eukaryotic protein prochymosin (PCM) to the medium via HlyB and HlyD. This result is in contrast to previous findings that prochymosin, preceded by the alkaline phosphatase signal sequence, cannot be translocated across the Escherichia coli inner membrane. The HlyA targeting domain was also used to secrete to the medium varying portions of chloramphenicol acetyltransferase (CAT) and 98 per cent of the beta-galactosidase (LacZ) molecule (both E. coli cytoplasmic proteins). In the case of the PCM and CAT fusions the efficiency of secretion was reduced as the proportion of the PCM and CAT molecule increased. This result is consistent with inhibition of secretion through the irreversible folding of the larger passenger protein fragments, or the occlusion of the HlyA targeting signal by upstream sequences. Analysis of the nature of the C-terminal domain promoting secretion of prochymosin, demonstrated that shortening the signal domain from 218 to 113 amino acids significantly reduced the efficiency of secretion. This result may also reflect the importance of maintaining an independently folded signal motif well separated from a passenger domain. PMID- 1791767 TI - Menopause--a proposed new functional definition. PMID- 1791768 TI - Dydrogesterone to oppose the 100 mg oestradiol implant. AB - Ten non-hysterectomised, post-menopausal women received the 100 mg oestradiol implant which was opposed by 20 mg dydrogesterone (nocte) for 14 days each 28-day cycle, for 6 cycles. Plasma oestradiol was measured at baseline and on three further occasions over 6 cycles. Endometrial biopsies were taken 5 weeks after implant, during the unopposed oestrogen and at week 24 during the progestogenic phase (sampling failed on both occasions in one patient). Secretory endometrium was seen in all women at the end of treatment. Cycle control was good and the mean day of onset of bleeding occurred on or after day 11 of the dydrogesterone dosage by the 5th cycle. Dydrogesterone 20 mg for 14 days every 28 days seemed to be sufficiently potent to counteract the proliferative effects of the high dose oestrogen implant. PMID- 1791769 TI - Long-term treatment of atrophic vaginitis with low-dose oestradiol vaginal tablets. AB - Fifty-one post-menopausal women suffering from symptoms of oestrogen deficiency derived atrophic vaginitis were treated intravaginally with two therapeutic regimens based on doses of 25 micrograms 17 beta-oestradiol (E2) in an open, controlled study. All the patients received treatment daily for 2 weeks by way of induction therapy. They were then randomly allocated to either once-weekly (17 patients) or twice-weekly (34 patients) vaginal administration for a further 50 weeks as maintenance treatment. Endometrial histopathology was evaluated before and after 1 year of treatment. The effects on symptoms and oestrogen/gonadotrophin levels were determined before and after 2, 12, 24, 36 and 52 weeks of therapy. Nine women continued twice-weekly treatment for a further year, meaning that they underwent treatment for a total period of 2 years. Endometrial biopsies were obtained after 2 years of treatment. All the pretreatment endometrial biopsies indicated an atrophic endometrium. One patient out of the 14 who completed 1 year of therapy in the group treated once weekly showed weak proliferation of the endometrium, while the other 13 had an atrophic endometrium. In the group treated twice weekly, 2 out of the 31 patients who completed the study showed weak proliferation of the endometrium. The other 29 had an atrophic endometrium. All 9 women who received treatment for 2 years had an atrophic endometrium at the end of the treatment period. The twice-weekly dosage regimen gave complete relief of symptoms in almost all patients, whereas the majority of the patients in the group treated once weekly still had mild symptoms. No adverse effects were reported.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791770 TI - Ophthalmic complaints as a climacteric symptom. AB - The menopausal syndrome is characterized by a variety of emotional and physical symptoms of varying intensity. A total of 1287 women who attended the Outpatient Department for Climacteric Symptoms and Osteoporosis Prophylaxis (1st Department of Gynaecology and Obstetrics, University of Vienna Medical School) constituted the study population. These women, who were seeking relief from various complaints or for prophylactic assessment and treatment, visited the clinic over the period 1988-1989. We placed special emphasis on ophthalmic complaints as evidence of the incipient climacteric period. Of the 430 patients with eye complaints, 98 underwent ophthalmological investigation. Within our patient group, we analyzed the incidence and severity of menopausal eye complaints as well as therapeutic responses to hormone replacement therapy on an epidemiological scale. Potential endocrinological factors are discussed. PMID- 1791771 TI - Effects of oestradiol valerate plus two different progestogens on serum lipids during post-menopausal replacement therapy. AB - A total of 27 post-menopausal women were treated with hormone replacement therapy over a period of 6 months for climacteric symptoms. Serum total cholesterol, high density-lipoprotein (HDL) cholesterol, low-density-lipoprotein (LDL) cholesterol and triglyceride concentrations were determined before therapy commenced and during the third and sixth treatment cycles. One group (13 women) was treated with 2 mg oestradiol valerate plus 7.5 mg megestrol acetate (EV + MA). The other group (14 women) received 2 mg EV plus 0.25 mg norgestrel (Cyclabil). The serum total cholesterol concentration decreased in both groups, the fall being more marked in that treated with Cyclabil. The serum LDL-cholesterol and triglyceride concentrations also decreased in both groups. The serum HDL-cholesterol concentration fell in the Cyclabil group but did not alter in the women treated with EV + MA. Our results suggest that the cyclic addition of megestrol acetate, a 17-alpha-hydroxyprogesterone derivative, to oestrogen therapy does not affect the serum HDL-cholesterol concentration, whereas norgestrel, which is a 19 nortestosterone derivative, causes it to decrease. PMID- 1791772 TI - The effect of moderate aerobic exercise on physical fitness among women 70 years and older. AB - This study investigated benefits of 26 weeks of moderate aerobic exercise for women 70 years or older. Sixteen healthy women with a mean age of 72.0 years were randomized into exercise (n = 10) and control groups (n = 6). The exercise group walked on a treadmill 3 times per week for 20 min, at 70% of maximum heart rate. Oxygen uptake VO2max expressed in l/min and ml.kg-1.min-1, total exercise time on the treadmill (TET), maximum heart rate (HRmax) and body mass index (BMI) were measured at baseline and 6 months. Two-way repeated measures analysis of variance (ANOVA) determined the effect of exercise intervention. Both measures of VO2max in addition to TET were significantly improved by the moderate training program, compared to the control group. VO2max in the exercise group increased by +/- 6.6% (S.E. 2.9) measured in l/min and 8.4% (S.E. 3.2) measured in ml.kg-1.min-1. TET increased by 25.4% (S.E. 4.9) in the exercise group. The ANOVA was unable to detect significance between the exercise and control groups for HRmax or BMI. All exercising subjects finished the program, apparently tolerating the intervention. The results indicate that healthy women over the age of 70 years can increase fitness measures with a moderate training program. PMID- 1791773 TI - Estimation of bone turnover in climacteric women by the whole body retention of fluoride. AB - This paper reports the measurement of whole body retention using fluoride (WBRF) as an estimator of skeletal turnover in a group of climacteric women that received an oral dose of 700 mumol of sodium fluoride. WBRF is defined as 100(1 (urinary fluoride/fluoride load)). WBRF was significantly correlated with whole body retention of 99m-Tc-methylene-diphosphonate, the serum levels of the bone alkaline phosphatase and the urinary excretion of hydroxyproline. WBRF values ranged from 20% to 95% and were affected by calcium intake and the urinary calcium excretion. In normal subjects with high turnover, the measurement of serum alkaline phosphatase activity and/or urinary hydroxyproline excretion helps to distinguish these cases from patients with metabolic bone diseases due to metastases, Paget disease, etc. The fact that the fraction of fluoride not incorporated into bone is not further metabolized plus the accuracy, preciseness and rapidity of fluoride measurements in urine are the main advantages of this technique. PMID- 1791774 TI - Prevalence of fractures among 10,000 women from the 1900 to 1940 birth cohorts resident in Gothenburg. AB - The prevalence of fractures in women aged 45-86 years resident in the city of Gothenburg, Sweden, was investigated by means of a postal questionnaire. A sample of 10,000 women from seven birth cohorts (1900-1940) was obtained at random from the population register. The response rate was 70.1% in the 1900-1920 and 81.0% in the 1930 and 1940 birth cohorts. When the prevalence of fractures sustained between 25 and 46 years of age was analyzed a higher figure emerged for women from the 1930 and 1940 birth cohorts than for those from the 1900-1920 cohorts, indicating an increasing incidence of fractures over time. There was a significant independent correlation between early menopausal age and a high rate of fractures. Menopausal age decreased with increasing tobacco consumption. There was also a significant independent correlation between tobacco-smoking and a high fracture rate. The prevalence of tobacco-smoking increased from 30.0 to 38.1% between the 1930 and 1940 birth cohorts, which may further increase the fracture risk in future years. Despite increasing vitality and longevity among the elderly in Gothenburg, there are indications that the number of fractures will increase in the future. PMID- 1791775 TI - A first study to compare two dosages of dydrogesterone in opposing the 50 mg oestradiol implant. AB - Thirty post-menopausal, non-hysterectomised women received a 50 mg oestradiol implant subcutaneously and either 10 mg or 20 mg dydrogesterone daily for 14 days every 28 days for 6 months. Endometrial biopsies were taken during the initial oestrogen-only phase and again during the final progestogen phase. Of the ten initial samples which were adequate for histological diagnosis, nine showed proliferative and one non-secretory endometrium. Of the 28 samples obtained at the end of the study during the progestogen phase, all except one showed satisfactory conversion, irrespective of dose. Acceptable bleeding patterns were seen in both dosage groups. Tolerance was good and no patient discontinued treatment. This study has shown that both 10 mg and 20 mg dydrogesterone for 14 days are potent enough to oppose the proliferative effects of the 50 mg oestradiol implant. In view of the wide inter-patient variation in endometrial response to progestogens, it appears appropriate to choose the dosage of dydrogesterone on the basis of cycle control and tolerability, whilst being able to maintain confidence in endometrial protection. PMID- 1791776 TI - [A desk-top commemorative medal dedicated to the 200th anniversary of the death of John Howard--English philanthropist, humanist and plague researcher]. PMID- 1791777 TI - [The interrelation between the formation of oleandomycin and the resistance to it in different strains of Streptomyces antibioticus]. AB - Strains, producers of oleandomycin, with different level of antibiotic-formation have been studied for their resistance to their own antibiotic. The obtained highly active strain possesses double resistance to oleandomycin and 50% higher activity. Identity of oleandomycin phosphate substances synthesized by initial and produced highly active strains is shown by the HELC method. PMID- 1791778 TI - [The isolation and partial purification of 2 DNA-dependent DNA polymerases from Acholeplasma laidlawii PG-8]. AB - Two forms of DNA-dependent DNA-polymerase have been isolated and partially purified from the limited amount of biomass of cells Acholeplasma laidlawii PG-8, a typical representative of genus Acholeplasmataceae, as a result of successive chromatography on the columns with DEAE-cellulose DE-52 and Green A-sepharose. The first form of DNA-polymerase is eluted from the ion-exchange column with NaCl concentration of 0.1 M from the column with Green A-sepharose of 0.27 M, while the second form-with NaCl concentrations of 0.6 and 0.4 M, respectively. The both enzymatic activities are able to implement DNA synthesis. The conditions of DNA polymerase production proved to be rather convenient for isolation of the concentrated and highly active enzymes. PMID- 1791779 TI - [The RNAses of the mollicute Acholeplasma laidlawii PG-8: its detection and accumulation dynamics]. PMID- 1791780 TI - [The autoselection of neustonic forms of bacteria]. AB - Self-breeding of neuston forms of Methylobacterium sp., Pseudomonas putida BC-2, Alcaligenes paradoxus BC-1, Bacillus thuringiensis var. israilensis bacteria as well as of a mixed culture of methylotrophs is shown possible. In spite of ability of hydrophobicity of the cell surface the suggested method of self breeding may be used to perfect properties of larvicidal biopreparations, and bacterial preparations which intensify self-purification of water bodies. PMID- 1791781 TI - [The effect of the antibiotic AL-87 on the amino acid yield from Staphylococcus aureus 209P cells]. AB - Antibiotic AL-87 has been studied for its effect on the composition of intracellular free amino acids and of amino acids in culture fluid of Staphylococcus aureus 209 P. It is established that the content of amino acids in the culture fluid of S. aureus 209 P is doubled due to antibiotics, while the content of intracellular free amino acids considerably decreases. Spectrum of free amino acids of S. aureus 209 P is presented by 17 basic amino acids. When there is a sub-bacteriostatic concentration of the antibiotic in the medium all free amino acids tend to leave the cells, the content of aspartic acid, serine, threonine and leucine in the medium being increased. Data obtained when studying the effect of antibiotic AL-87 on the composition of free amino acids of Staphylococcus agree well with the previously obtained results from the study of the fatty acid composition of cells. In the light of these data it may be supposed that an increase of the membrane permeability and as a result of it an outlet of amino acids into the medium is one of constituents of the mechanism of antibiotic AL-87 action on Staphylococcus cells. PMID- 1791783 TI - Suicide and euthanasia. PMID- 1791782 TI - [Bacteriocinogeny in Klebsiella and the applied use of klebocins]. AB - A phenomenon of bacteriocinogeny is studied in 83 K-type strains of Klebsiella. Physicochemical (permeability through cellophane, thermo-resistance, diffusion rate in agar, inactivation by trypsin, induction by UV irradiation) and biological (activity spectrum, specificity) properties are studied. Eight preparations of klebocins are examined by electron microscopy. Conclusions are made on the possibility to use klebocinogenic and indicating K-type cultures of Klebsiella for bacteriocin typing of clinical isolates of these microbes. PMID- 1791784 TI - The Julie Ward Inquest. PMID- 1791785 TI - New medicines--their introduction and regulation. PMID- 1791786 TI - AIDS and prisons in Australia. PMID- 1791787 TI - Health, society, and the Milbank Quarterly: essays in honor of David P. Willis's editorship. PMID- 1791788 TI - The Milbank Quarterly and health services research, 1977-1990. AB - This article explores the relationship between the Quarterly and the contemporary history of health services research. Between 1977 and 1990 most of the articles in the Quarterly addressed the dominant concerns of the growing constituency that identified with the newly named field of health services research. However, the Quarterly also reflected its editor's interest in an older tradition of health care reform and public health in the United States and abroad. An analysis of the articles published in the Quarterly in three periods (1977-1981, 1981-1986, 1986 1990) reveals themes that received consistent attention, others that received increasing attention, and still others that were accorded diminished attention. This analysis highlights the value of the Quarterly as a source of insight about the individuals who have written for, edited, guided, and read it. PMID- 1791789 TI - What has bioethics to offer health policy? AB - The field of bioethics has quickly become a subject of intense public fascination; and, following on an earlier period of resistance and skepticism, bioethics has been welcomed by clinicians as well. Bioethics, however, is largely a practical activity rather than a scholarly one, and its pretensions as an academic discipline within health policy and health services research must be greeted cautiously. Continuing problems in moral theory suggest that the most secure contributions that bioethics can make to health policy research are analysis and criticism rather than positive moral claims. PMID- 1791790 TI - Inequality and access to health care. AB - Health services research has laid the groundwork for ongoing policy debates over the shortcomings of the American health care system and the need for the expansion of health insurance protection. In the early 1970s, studies of inequality in access to medical care provided the basis for proposals for national health insurance. The examination of the impact of Medicare and Medicaid demonstrated the critical role of these governmental efforts in reducing inequalities in access to care. By the 1980s the focus of investigation turned to the impact of policies designed to contain the cost of health care on access to medical services by vulnerable populations. Documentation of the negative health outcomes that followed from restrictions on access to care has set the stage for a renewed debate over universal health insurance. PMID- 1791791 TI - Risks and benefits of comparative studies: notes from another shore. AB - The fascination of American and British scholars with each other's health care systems is a case study of the risks and benefits of the comparative approach. The risks stem from the temptation to seek solutions to national problems in the experience of other countries in a way that ignores the fact that whereas institutions may, in theory at least, be exportable, their social, political, and economic environment is not. The benefits derive from the fact that only a comparative approach can hope to identify the factors that are specific to national health care systems, as distinct from being common to all such systems. Finally, a comparative perspective can extend national ideas about what is possible and at the same time provide the understanding that must precede prescription. PMID- 1791792 TI - AIDS and the news media. AB - News reports on AIDS have appeared at a time of general public concern about health risks, and, like the coverage of risk, the reporting on AIDS has been controversial. Perceptions of this disease have been linked to economic and personal stakes, professional ideologies, administrative responsibilities, and moral beliefs. It is from this perspective that news coverage of AIDS must be understood. The norms and practices of journalism, the technical uncertainties of risk evaluation, and the pressures placed on the media by various interests have influenced the reporting on this disease. However, media reports also shape the social context of the epidemic, affecting public perceptions, personal behavior, and policy agendas. PMID- 1791793 TI - [Current developments in the use of intravenous immunoglobulins]. AB - The use of intravenous immunoglobulins (IVIG) has provided a substantial therapeutic advance in the treatment of antibody deficiency syndromes improving the quality of life of the affected patients. Among the advantages there are the possibility to employ higher doses to reach higher serum levels, with a more efficacious prophylaxis against infections; the prevention of chronic lung disease if IVIG are prescribed early, at diagnosis or at least at the onset of symptoms; the significant improvement of pulmonary function. The IVIG which are likely to be the best choice are the "intact Fc" preparations. In these products, or at least in some preparations, all IgG subclasses are present, which are endowed with specific and differentiated functions. Another important requirement is the presence of specific antibodies (e.g. anti Mycoplasmas, anti Campylobacter, anti Echovirus, anti pyogenic bacteria). The benefits of the prophylactic use of IVIG in preterm and low birthweight infants to prevent neonatal and late-onset infections are widely accepted. Lastly, IVIG are employed successfully in some autoimmune diseases as PTI and immune cytopenias, myasthenia gravis, acute and chronic inflammatory demyelinating polyneuropathy, Kawasaki syndrome, childhood recurrent seizures, juvenile chronic arthritis. PMID- 1791794 TI - [Interstitial pulmonary emphysema. Combined therapeutic approach in a retrospective multidisciplinary study]. AB - Pulmonary interstitial emphysema (PIE) may occur spontaneously, as a complication of endotracheal tube displacement, intrauterine viral pneumonia or massive aspiration of formula. Nevertheless PIE occurs more frequently in neonates requiring mechanical ventilation for RDS. Untoward effects of large air collections in the extra-alveolar spaces are based on decreased perfusion and ventilation of the affected lung tissues, compression of adjacent pulmonary parenchyma and mediastinum, possible air embolism. Sometimes PIE spontaneously regress, but in some instances the process is self perpetuating, leading to an "air block syndrome". Fourteen (19.4%) of 72 infants ventilated for RDS in a three-year period had radiological evidence of PIE during the first few days of life. All 5 bilateral, 7 diffuse and 2 localized cases were treated with "vigorous pulmonary therapy". In addition to these procedures, 4 neonates were submitted to a selective bronchial intubation (SBI) and 5 different infants improved after HFV. No one of our patients underwent a surgical procedure. Infants with fine linear hyperlucencies improved sooner. All pneumothoraces (7 of 14) were preceded by X-ray appearances of PIE. Three neonates died. Mortality was observed in newborns with bilateral PIE, because of an intraventricular hemorrhage in two and an intractable under tension pneumothorax in one patient. Plain chest roentgenograms, histological pictures and treatment modalities of PIE remain separated from these considered for congenital lobar emphysema, congenital cystic adenomatoid malformation, bronchogenic cyst or lung sequestration. Surgical treatment of PIE is not as universally accepted as in congenital cystic lesions of the lung, in which it's mandatory. PMID- 1791795 TI - [Emergencies in childhood. Experience at a Pediatric First Aid Unit in a regional hospital]. AB - During 1989 4445 children, divided into four different age groups, were treated in the First Aid Unit of Carate Brianza Hospital. The paper analyses the types of pathology and reasons for using the First Aid Unit. The statistical incidence of accidents involving children, above all cranial and other injuries and the accidental swallowing of toxic substances or drugs, was assessed in an attempt to prevent the causes. The type of accident was also correlated to age group. The paper confirms the affirmation made by other researchers that the inappropriate use of emergency services is linked to the lack of relationship between the family and local pediatrician rather than the lack of primary care. PMID- 1791796 TI - [Long-term non-neurologic morbidity in low birth weight infants. A 3-year follow up]. AB - The aim of the present work is to observe non-neurological morbidity in low-birth weight-neonates during the first year of life, to define their predominance and to establish whether any correlation between the observed pathologies, gestational age and/or birth weight is evident. Respiratory infectious diseases were the most frequent cause of morbidity starting during the first months life. Anemia and osteopenia were significantly related to gestational age, both occurring with high frequency in babies born before 31 weeks of gestational age. In this gestational age group of neonates birth weight did not influence the incidence of the pathologies studied. On the contrary, morbidity was inversely related to birth weight when neonates of greater gestational age were considered. Candidiasis was significantly more frequent in newborn babies weighing at birth less than 2000 grams. Follow-up programs of low-birth-weight neonates give the opportunity to establish nutritional schedules fit for infants born prematurely and to provide precocious diagnosis and therapy apt to minimize infectious respiratory diseases, so often occurring in these babies. PMID- 1791797 TI - [Transfer of a very low birth weight newborn infant to the intensive therapy center at birth. Transfer "in utero" or after delivery?]. AB - During the 1975-1984 period, 93 infants weighing 1500 g or less were transferred to the Magenta Perinatal Center Hospital. The survival rate at discharge was 82.9% for infants transferred in utero and 63.5% for infants transferred postnatally (p less than 0.05). The incidence of major neurological sequelae was 3.1% and 23.3% respectively (p less than 0.02). This experience confirms that the high risk pregnancies should be referred to the Perinatal Center for optimal care of the mother, fetus and newborn infant. PMID- 1791798 TI - [Learning disorders in school children. An integrative approach, importance of the biological component and relational dimension]. AB - This paper concerns the development of a diagnostic procedure for learning disorders, in line with a multifactorial approach in which the contributions of the organic and psychogenetic points of view are integrated to form a common interpretative model. The aim is to identify strategies for intervening at different levels. We examined 10 patients with learning disorders which came consecutively to our Division of Child Neuropsychiatry and an equal number of control subjects which were as old as the patients and begin school at the correct age. We used an integrative approach: we interviewed parents to know history, the relational, familial and sociocultural features and moreover, organic problems, if any, neurological examination and, if necessary, skull x ray, EEG, skull CT; psychodynamic interview, drawing of human figure and family drawing; WISC; Bender test, Stambak test, Rorschach test, Blacky Pictures test. All the variables that could be quantified from the diagnostic protocols were compared statistically. Assessment of our case histories gives weight to the hypothesis of a multifactorial pathogenesis. We did find psychodynamic problems in all cases, and were able to identify aspects of generalised, and in particular, epistemophilic inhibition. PMID- 1791799 TI - [Surfactant and ambroxol in the therapy of idiopathic respiratory syndrome in newborn infants]. AB - The Authors have carried out a study on 30 newborns, affected by idiopathic respiratory distress syndrome (IRDS), divided into 3 statistically comparable groups, treated, in addition to mechanical ventilation, respectively with Tokio Akita (TA) surfactant, placebo (both by endotracheal administration) and ambroxol given by intravenous infusion. The clinical evolution of the three groups was studied, above all as related to mortality, ventilation length, oxygen need, immediate and successive pulmonary complications and cerebral haemorrhage. Mortality was lower in the group treated with ambroxol, while the ventilation length, the average insufflation pressure and the oxygen need were lower in the group treated with surfactant, compared with the other two groups. Pulmonary complications were present only in the group treated with placebo and ambroxol, whereas cerebral haemorrhage rate is higher in the group treated with surfactant. On the basis of the results achieved, some important observations are suggested and possible aetiological therapies of IRDS are formulated. PMID- 1791800 TI - [Kawasaki syndrome. Clinical report of 5 cases]. AB - The paper reports five cases of Kawasaki's syndrome diagnosed during the period 1985-89. The mean age of patients was 20 months (4/12; 4 years and 5/12). Symptomatology gradually regressed in four of these patients with a return to good health and normal cardiological controls. The fifth patient died suddenly following a cardiorespiratory failure when his general conditions were showing a marked improvement. Given that cardiac involvement is reported to be the sole cause of death in Kawasaki's syndrome, this was probably the cause of the patient's death. This event together with the presence of a number of barely symptomatic forms, which certainly escape correct diagnosis, may explain some of the cases of sudden death in early childhood. In the present case the child died suddenly due to an early stage of heart failure on awakening and may be considered a classic example of "cot death". Although the treatment protocol is well defined, it is not yet known to what extent the cardio-vascular apparatus is influenced by therapy in cases of children with Kawasaki's syndrome. PMID- 1791801 TI - [Hereditary angioedema. Description of a pediatric case]. AB - Hereditary angioedema is a disease due to deficiency or functional anomaly of the serum inhibitor of C1-esterase, clinically characterised by the recurrence of oedematous episodes in the subcutis and mucosas; if not diagnoses in time, this condition is potentially fatal (up to 50% of cases for edema of the glottis). A case diagnosed in paediatric age is reported. PMID- 1791802 TI - [Relationship between the immune system and the neuroendocrine system in childhood]. PMID- 1791804 TI - On the other side of the bed sheets. When the doctor is the patient. PMID- 1791803 TI - Discoveries. Motherhood holds lessons for physician. PMID- 1791805 TI - Subependymoma of the cervical spinal cord. A case report of long-term survival. AB - Subependymomas of the cervical spinal cord are relatively rare tumors. Thirteen cases have been reported in the literature with the longest reported follow-up and survival being six years. This paper describes a woman who survived for 14 years in reasonably good health after her diagnosis of cervical spinal cord intramedullary subependymoma. A review of reported cases and a discussion of subependymomas and their characteristics is included. PMID- 1791806 TI - Any port in a storm. The Medicare and Medicaid safe harbor regulations. PMID- 1791807 TI - More teens with AIDS. PMID- 1791808 TI - Hennepin County Task Force opposes mandatory AIDS testing. PMID- 1791810 TI - Compassion and empathy still plentiful in medicine. PMID- 1791809 TI - Congress approves AIDS bill. PMID- 1791811 TI - Diagnosing and treating environmental health problems. PMID- 1791812 TI - Metropolitan-Mount Sinai. Heritage lives on after the doors close. PMID- 1791813 TI - Alcohol-related birth defects. Minnesota's response to a critical health problem. PMID- 1791815 TI - The Board of Medical Practice and its disciplinary process. PMID- 1791814 TI - Diagnostic and therapeutic advances in pediatric cardiology (2). AB - The practice of pediatric cardiology has undergone remarkable changes over the past decade. Cardiac structural abnormalities may frequently be diagnosed with echocardiography alone, and treatment for many of these structural problems may be corrected during cardiac catheterization. Arrhythmia diagnosis and management have made similar progress, such that diagnosis of arrhythmia mechanisms and catheter ablative therapy may be performed during a single procedure, sparing the young patient a lifetime of antiarrhythmic drug therapy. Cardiac transplantation is now included among the treatment options for some patients with severe congenital or acquired cardiac abnormalities unresponsive to standard therapy. In this paper, we provide a brief description of current applications of recent advances in the practice of pediatric cardiology. PMID- 1791816 TI - The physician as organizational leader. AB - The physician manager is becoming more common. Given the need to bridge the gap between the business and the practice of medicine and given the transformations taking place in health care, physicians will likely play an increasingly important role as leaders in clinics, hospitals, HMOs, and other health care organizations. As yet, a job description for a "leader" remains elusive. However, understanding the framework described here may help build the proper foundation for successful physician leaders. PMID- 1791818 TI - MDH recommendations. PMID- 1791817 TI - State docs share growing concerns. PMID- 1791819 TI - State health care worker infected. PMID- 1791820 TI - State AIDS cases surpass 1,000. PMID- 1791821 TI - Teenage pregnancy and infant mortality. PMID- 1791822 TI - Lung association program helps families manage asthma. PMID- 1791823 TI - Battling new morbidities in children. PMID- 1791824 TI - Changes in a photoreceptor polypeptide correlating with an early-onset retinal dystrophy in the cat. AB - A preparation of rod outer segments has been used to study the polypeptides characteristic of an early-onset retinal dystrophy in cats (Rdy) by two dimensional gel electrophoresis. Comparison of 2-D gels of rod outer segment preparations from retinas of normal and Rdy animals shows several differences. In particular, a polypeptide of Mr 51 kDa and pI 7.5 is present at increased levels in preparations from Rdy cats at 6 weeks, 9 weeks and 12.5 weeks of age but not at 3.5 weeks. PMID- 1791825 TI - Adenine nucleotide degradation in cultured chick heart muscle cells. AB - Cultured chick heart muscle cells degrade ATP during metabolic inhibition via ADP to AMP. Whether AMP is primarily deaminated to IMP or dephosphorylated to adenosine depends on the 'metabolic block' (glycolysis vs. oxidative phosphorylation). Inhibition of glycolysis (deoxyglucose) results in an inosine/adenosine ratio greater than 1 in the supernatant, whereas the nucleoside ratio is less than or equal to 1 during inhibition of oxidative phosphorylation (hypoxia, rotenone). EHNA, a blocker of adenosine deaminase, has little effect on inosine release during metabolic inhibition, consistent with the reported low activity of adenosine deaminase in cardiac muscle cells. The amount of adenosine and inosine released can be largely attenuated by two nucleoside carrier inhibitors, nitrobenzyl-thioinosine and dipyridamole, which suggests that nucleosides are produced intracellularly and subsequently released. These results indicate that the amount of inosine or adenosine released from the cardiomyocyte during impaired energy metabolism (e.g. ischemia) can be controlled by the metabolic state of the cell. PMID- 1791826 TI - Putrescine uptake regulation in response to alpha-difluoromethylornithine treatment in Leishmania infantum promastigotes. AB - The putrescine uptake/efflux regulation and their regulatory role on intracellular polyamine pools have been studied in the parasitic protozoa Leishmania infantum. Putrescine uptake was age-dependent with maximal values in logarithmic phase promastigotes and minimal in stationary phase. Moreover, putrescine uptake was activated in response to depletion of intracellular polyamines by alpha-difluoromethylornithine (DFMO)--a well known irreversible enzyme-activated inhibitor of ornithine decarboxylase. Kinetic studies of putrescine uptake induction showed a notable rise in Vmax without Km changes, suggesting a de novo synthesis of putrescine carriers. Putrescine uptake was able to replenish polyamine content and also to recover the proliferative rate in cells treated during 24 hours with DFMO. PMID- 1791827 TI - Cloning and expression of a new human polypeptide which regulates protein phosphorylation in Escherichia coli. AB - A 1,820 bp full-length clone encoding for a new human protein was isolated from a lambda gt11 placental cDNA library using anti-human hexokinase antibodies. The cDNA complete sequence includes a 12 bp 5' non-coding region, a single open reading frame encoding a protein of 55 KDa (HP-10) and a 177 bp non-coding with two putative polyadenylation signals upstream of 3' poly(A)tail. The deduced amino acid sequence reveals a sequence of 492 amino acids that contains a stretch of 7 glutamic acid from position 169 and one potential glycosylation site at position 274. Although antibodies against hexokinase recognize the fusion protein and antibodies against the fusion protein recognize hexokinase, HP-10 is not human hexokinase, by a number of criteria including the alignment of determined amino acid sequences. In searching for a possible functional role of HP-10 its cDNA was inserted into a procaryotic vector which allows the expression of the non-fused protein. Bacteria expressing the HP-10 encoded protein were isolated and found to have a dramatic increase in endogenous phosphorylated proteins. Since HP-10 does not have a protein kinase activity per se it should be considered a new regulatory phosphorylation protein which is active in E. coli. PMID- 1791828 TI - Hexose metabolism in pancreatic islets. Activation of the Krebs cycle by nutrient secretagogues. AB - In rat pancreatic islets, a rise in extracellular D-glucose concentration is known to cause a greater increase in the oxidation of D-[6-14C]glucose than utilization of D-[5-3H]glucose. In the present study, such a preferential stimulation of acetyl residue oxidation relative to glycolytic flux was mimicked by nutrient secretagogues such as 2-aminobicyclo[2,2,1]heptane-2-carboxylate, 3 phenylpyruvate, L-leucine, 2-ketoisocaproate, D-fructose and ketone bodies. The preferential stimulation of D-[6-14C]glucose oxidation by these nutrients was observed at all hexose concentrations (0.5, 6.0 and 16.7 mM), coincided with an unaltered rate of D-[3,4-14C]glucose oxidation, was impaired in the absence of extracellular Ca2+, and failed to be affected by NH4+. Although the ratio between D-[6-14C]glucose oxidation and D-[5-3H]glucose utilization in islets exposed to other nutrient secretagogues could be affected by factors such as isotopic dilution and mitochondrial redox state, the present data afford strong support to the view that the preferential stimulation of oxidative events in the Krebs cycle of nutrient-stimulated islets is linked to the activation of key mitochondrial dehydrogenases, e.g. 2-ketoglutarate dehydrogenase. The latter activation might result from the mitochondrial accumulation of Ca2+, as attributable not solely to stimulation of Ca2+ inflow into the islet cells but also to an increase in ATP availability. PMID- 1791829 TI - Differential stimulation of fos and jun family members by calcitriol in osteoblastic cells. AB - We have looked at the effects of calcitriol (1 alpha,25-dihydroxyvitamin D3) on the expression of the members of the fos and jun families of protooncogenes in an osteoblastic cell line and in primary cultures of osteoblasts. Calcitriol treatment of starved, confluent cultures of MC3T3-E1 cells induced a rapid and transient stimulation of the expression of c-fos, fos-B, c-jun, and jun-B with varying kinetics. The expression of fra-1 and jun-D was not affected by calcitriol in those cells. The selective stimulation of fos and jun family members by calcitriol was also observed in primary cultures of osteoblasts isolated from newborn mouse calvaria, suggesting that this modulation is a physiological response of the bone cells and not an artefact of the established cell line. The calcitriol effect was specific and dose-dependent. The expression of the c-Fos protein correlated with the expression of the mRNA in calcitriol treated cells. The calcitriol-induced stimulation of c-fos expression was modulated, at least in part, at the level of the initiation and elongation of transcription, whereas its effects on c-jun and jun-B expression was controlled at the posttranscriptional level by a mechanism that does not implicate stabilization of their respective mRNAs. The differential stimulation of the expression of certain members of the fos and jun families by calcitriol support a role for these oncoproteins in bone cell physiology. PMID- 1791830 TI - Cyclic protein-2, a secretory product of rat Sertoli cells, is the proenzyme form of cathepsin L. AB - Previous studies demonstrated that secretion of Cyclic Protein-2 (CP-2) by mature rat Sertoli cells increased 30-fold from stage II to stages VI-VII of the cycle of the seminiferous epithelium and suggested that this protein was concentrated around compacted spermatids. Analysis of other organs revealed that CP-2 was also detectable in the epithelium of the proximal kidney tubule and in neurons originating from the supraoptic and paraventricular nuclei of the hypothalamus. We now have isolated a partial 1.8-kilobase (kb) cDNA for CP-2 mRNA, and sequence analysis revealed that CP-2 was the proenzyme form of the cysteine protease cathepsin L; this was corroborated by immunoprecipitation of CP-2 by anticathepsin L immunoglobulin G and by enzymatic analysis of purified CP-2. Northern analysis of testis mRNA revealed major (1.7 kb) and minor (2.2 kb) transcripts which differed in the length of their 3'-untranslated sequences. Low levels of CP-2/cathepsin L transcripts were detected in many organs, while high levels were only detected in testis, kidney, and liver. In seminiferous tubules, CP-2/cathepsin L mRNA was undetectable at stage II, increased to maximal levels at stages VI and VIIa,b, and was again undetectable at stage XII. At stages VI VII, CP-2/cathepsin L mRNA was present in Sertoli but not germ cells. Taken together, these data suggest that CP-2/cathepsin L gene expression is regulated in a cell-specific manner and that in Sertoli cells this expression is influenced by germ cells at specific steps of development. We propose that at stages V-VII, secreted CP-2/cathepsin L degrades adhesion molecules which bind compacted spermatids to Sertoli cells, thereby facilitating movement of these spermatids toward the lumen of the tubule. PMID- 1791831 TI - The vascular endothelial growth factor family: identification of a fourth molecular species and characterization of alternative splicing of RNA. AB - Vascular endothelial growth factor (VEGF) was recently identified as a secreted, direct-acting mitogen specific for vascular endothelial cells and capable of stimulating angiogenesis in vivo. Molecular cloning revealed multiple forms of VEGF, apparently arising from alternative splicing of its RNA transcript. We have examined various human cDNA libraries by the polymerase chain reaction technique and discovered a fourth molecular form, VEGF206. This form contains a 41-amino acid insertion relative to the most abundant form, VEGF165, and includes the highly basic 24-amino acid insertion found in VEGF189. Southern blot analysis revealed that a single gene encoded these various forms, and nucleic acid sequence analysis of a portion of the VEGF gene revealed an intron/exon structure compatible with alternative splicing of RNA as a mechanism for their generation. Transient transfection of human embryonic kidney 293 cells showed that, like VEGF189, VEGF206 was predominately cell-associated and only very poorly secreted despite the presence of the signal peptide identical to that found in VEGF121 and VEGF165, both of which are efficiently exported from the cell. Vascular permeability activity was detected in the medium of 293 cells transfected with all four forms of VEGF; however, endothelial cell mitogenic activity was apparent only with VEGF121 and VEGF165. Thus, alternative splicing of VEGF RNA can produce four polypeptides with strikingly different secretion patterns, which suggests multiple physiological roles for this family of proteins. PMID- 1791832 TI - The NPEY sequence is not necessary for endocytosis and processing of insulin receptor complexes. AB - The tetrameric amino acid sequence AsnProXTyr (NPXY), where X represents any amino acid, is conserved in the intracytoplasmic domains of several membrane proteins and has been postulated to play a role in receptor-mediated endocytosis. The human insulin receptor (hIR) contains a single copy of the sequence AsnProGluTyr (NPEY) in its intracytoplasmic domain. To determine if this putative consensus sequence is necessary for endocytic functions of hIR, we constructed a mutant receptor, hIR delta NPEY, that lacks NPEY sequence, stably expressed this mutant receptor in Chinese hamster ovary cells, and then studied its endocytic functions. When compared to wild type hIR similarly expressed in Chinese hamster ovary cells, the hIR delta NPEY mutant exhibited: 1) normal subunit organization and insulin binding affinity; 2) essentially normal internalization of covalent photoaffinity labeled insulin-receptor complexes; and 3) normal internalization of receptor-bound [125I]insulin as well as normal degradation and release of the internalized insulin. Therefore, we conclude that the NPEY sequence in the juxtamembrane domain of hIR is not necessary for its endocytic function. PMID- 1791833 TI - Interactions between rat prolactin gene promoter and enhancer regions in mammosomatotrope and lactotrope cell lines. AB - Although both promoter and enhancer sequences of the PRL gene 5'-flanking DNA are required for cell-specific, high level expression in transgenic animals, reports of the relative contributions of these elements determined in transient transfection experiments have varied. In this study we examined the transcriptional activities of proximal promoter (-422/+33) and distal enhancer ( 1956/-1530) sequences of the rat (r) PRL gene by transient transfection of hybrid genes containing these sequences into two rat pituitary cell lines, GC and 235-1. These cell lines exhibit characteristics either of mammosomatotropes, which express both PRL and the evolutionarily related GH gene (GC), or lactotropes, which express only PRL (235-1). As lactotropes are thought to differentiate from a mammosomatotrope precursor cell, comparisons between these cell lines provide the opportunity to examine the mechanisms that activate PRL and GH genes during development. We show that the relative contributions of promoter and enhancer elements differ between GC and 235-1 cells. Although maximal enhancer-driven activity was similar between these cell lines, promoter sequences were more active in GC (5-10% maximal) than 235-1 cells (1-2% maximal). However, no apparent differences in factor binding to the rPRL promoter region could be correlated with differences in activity, suggesting that differential factor modification, rather than different factors, is involved. As the rGH promoter exhibited a similar pattern of activity in these cell lines, these observations suggest that promoter as well as enhancer elements contribute to the cell specificity of PRL and GH gene expression.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791834 TI - Glycine 119 of bovine growth hormone is critical for growth-promoting activity. AB - Bovine GH (bGH) analogs with single amino acid substitutions at positions 117 (bGH-E117L), 119 (bGH-G119R), and 122 (bGH-A122D) were generated. These analogs bind to mouse liver membrane preparations with affinities similar to native bGH. However, transgenic mice which express the analogs demonstrate different phenotypes ranging from dwarfism to gigantism. For example, expression of bGH or bGH-E117L result in large transgenic mice. In contrast, transgenic mice with a growth phenotype similar to nontransgenic animals result from expression of bGH A122D. Surprisingly, transgenic mice with relatively high serum levels of bGH G119R possessed a dwarf phenotype. Together these results suggest that Gly 119 and Ala 122 are involved in growth-promoting activity of GH. PMID- 1791835 TI - Allelotype of human thyroid tumors: loss of chromosome 11q13 sequences in follicular neoplasms. AB - Two classes of genes are the targets of mutations involved in human tumorigenesis: oncogenes, the activation of which leads to growth stimulation, and tumor suppressor genes, which become tumorigenic through loss of function, often through allelic deletion. To obtain evidence for a role for tumor suppressor genes in thyroid tumorigenesis, we examined DNA from 80 thyroid neoplasms for loss of heterozygosity in multiple chromosomal loci using 19 polymorphic genomic probes. None of the informative thyroid tumors studied had allelic loss detected with probes for chromosome 2q (D2S44), 3p (D3F15S2, D3S32), 3q (D3S46), 4p (D4S125), 6p (D6S40), 8q (D8S39), 9q (D9S7), 12p (D12S14), 13q (D13S52), 17p (D17S30), or 18q (D18S10). One of eight of the follicular adenomas had a 10q deletion detected with marker D10S15, and one of 26 had a 10q deletion detected with D10S25. One of two of the follicular carcinomas had an 11p deletion in the H-ras locus. The most significant findings were on chromosome 11q13, the site containing the putative gene predisposing to multiple endocrine neoplasia type I. Four of 27 follicular adenomas had loss of heterozygosity for probes in this region. Allelic deletions were detected with the following probes: D11S149, PYGM, D11S146, and INT2. None of 13 informative papillary carcinomas and none of two follicular carcinomas had loss of heterozygosity detectable with these 11q13 markers. Allelic loss is a relatively infrequent event in human thyroid tumors. Deletions of chromosome 11q13 are present in about 14% of follicular, but not papillary, neoplasms.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791836 TI - Single amino acid substitutions in recombinant bovine prolactin that markedly reduce its mitogenic activity in Nb2 cell cultures. AB - Three amino acid residues of bovine PRL (bPRL) have been examined for their roles in the mitogenic activity of the hormone in Nb2 lymphoma cell cultures. The residues of interest, R21, R177, and K187, are conserved in eight pituitary PRLs, but not in the related, nonlactogenic bGH. Using site-specific mutagenesis, a number of recombinant methionyl bPRL variants have been prepared, each of which contained a single amino acid substitution of one of the three residues; a variety of amino acids was used for substitution. Twelve exchanges of R177 (to A, L, N, K, D, E, Y, G, S, Q, H, and F) all led to marked decreases in mitogenic activity. Even the conservative change, R177K, led to a decrease in mitogenic activity of about 90%; all the other R177 substitutions led to even more marked decreases; there was essentially complete loss of activity when the positively charged R177 was replaced by the negatively charged aspartate. Exchanges of R21 (to A, L, N, and K) were less dramatic, with the greatest decrease (79%) occurring in the case of R21A. Exchanges of K187 (to A, L, N, and R) had a relatively minor effect on the mitogenic activity of the hormone. Residues R21 and R177 in bPRL are located in putative helices 1 and 4, respectively; in the three-dimensional structure of the hormone these residues are predicted to be quite closely apposed. The results suggest that R177 and, to a lesser degree, R21 have important roles in the mitogenic activity of bPRL. PMID- 1791837 TI - Dexamethasone increases potassium channel messenger RNA and activity in clonal pituitary cells. AB - Glucocorticoid hormones are released as part of the stress response and regulate secretion by the pituitary. Since the activity of ion channels also influences secretion, we examined the effect of the glucocorticoid agonist dexamethasone on ion channel expression. K+ channel mRNA was detected in rat hypothalamus and anterior pituitary, with probes derived from the rat Kv1 gene, a member of the mammalian voltage-gated K+ channel superfamily. High levels were also detected in PRL-secreting clonal (GH3 and GH4C1) rat pituitary cells. Dexamethasone rapidly increased the steady state concentration of Kv1 mRNA in GH3 cells in a dose dependent manner. This change in gene expression was accompanied by an increase in whole cell voltage-gated K+ current [lk(i)] with similar pharmacology to the Kv1 gene product. Our findings indicate that hormones may act directly on excitable cells to produce long term effects on electrical activity and secretion by regulating K+ channel expression. PMID- 1791838 TI - DNA binding and dimerization determinants for thyroid hormone receptor alpha and its interaction with a nuclear protein. AB - The gel retardation assay was used to analyze the role of the thyroid hormone receptor alpha (TR alpha) ligand-binding domain (LBD) in controlling receptor interaction with a thyroid hormone responsive element (TRE). While wild type receptor TR alpha binds to the TRE mainly as monomer, deletion of 85 amino acids from its C-terminus results in a mutant receptor with enhanced DNA binding that forms several slow mobility complexes as revealed by gel retardation assay. Receptor deletion mutants that lack most of the LBD show significantly elevated DNA binding and are still able to bind to DNA as two complexes. Thus, the C terminal end of TR alpha appears to interfere with the dimerization/oligomerization function and DNA binding of TR alpha. All C-terminal deletion mutants have lost their T3-responsive activator function, but some show constitutive activity. Nuclear factor from several cell lines, including CV-1, F9, and GC cells, interacts with TR alpha receptor to form a larger molecular weight complex as determined by gel retardation assay. This factor could not be detected in HeLatk- cells, where TR alpha does not activate a TRE-containing reporter gene. The nuclear factor is heat sensitive and does not bind to TRE itself but can interact with TR alpha in the absence of DNA. Deletion analysis demonstrates that the leucine zipper-like sequence located in the LBD of TR alpha is involved in this interaction. Together, our data suggest that TR alpha contains a dimerization function outside the LBD which is inhibited by the carboxy-terminal region, while the leucine zipper-like sequence in the LBD is required for interaction with a nuclear factor. PMID- 1791839 TI - Expression of colony-stimulating factor-1 (CSF-1) messenger RNA in human endometrial glands during the menstrual cycle: molecular cloning of a novel transcript that predicts a cell surface form of CSF-1. AB - Colony-stimulating factor-1 (CSF-1) has been primarily characterized as a hematopoietic growth factor required for the proliferation and differentiation of monocytic cells. Recent immunohistological observations have shown that this growth factor is also synthesized by the glandular epithelial cells of the pregnant human endometrium and by first trimester human trophoblasts. In the present study endometrial glands were purified from nonpregnant human endometria collected through the menstrual cycle and examined for CSF-1 mRNA expression. The two major mRNAs (4.0 and 3.0 kilobases in length) detected in midproliferative and midsecretory phases differed in the size of the exon 6 and coded, respectively, for a secreted and a cell surface form of CSF-1. The 3.0-kilobase transcript represented a novel CSF-1 mRNA species that was molecularly cloned and sequenced. These data raise the possibility that CSF-1 may be involved in both distant and cell to cell regulatory pathways of cell proliferation and differentiation in the human endometrium. PMID- 1791840 TI - Regulation by estrogen through the 5'-flanking region of the transforming growth factor alpha gene. AB - Expression of transforming growth factor alpha (TGF alpha) mRNA and protein can be stimulated by estrogens such as 17 beta-estradiol (E2) in estrogen-responsive rodent and human breast cancer cells. To ascertain if E2 can directly regulate TGF alpha expression through the 5'-flanking region of the human TGF alpha gene, E2-responsive MCF-7 or ZR-75-1 human breast cancer cells or E2-nonresponsive MDA MB-231 breast cancer cells were transiently transfected with a plasmid containing an 1140-base pair (bp) Sac-I fragment of the TGF alpha 5'-flanking region ligated to the chloramphenicol acetyltransferase (CAT) gene. Cells that were transfected and subsequently treated with physiological concentrations of E2 (10(-11)-10(-8) M) for 24 h exhibited a 2- to 10-fold increase in CAT activity. The E2 stimulation of CAT activity was dose-dependent with an increase first found at 10(-10) M E2. The increase in CAT activity could be detected within 24-36 h after the addition of E2. There was no significant change in CAT activity in transiently transfected MDA-MB-231 cells as mediated through the TGF alpha 5' flanking region after E2 treatment. MCF-7 cells were also transiently transfected with different fragments of the TGF alpha 5'-flanking region ligated to the luciferase gene. In the absence of E2 treatment, no detectable luciferase activity was found.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791841 TI - Structure and function of a human insulin-like growth factor-I gene promoter. AB - We have identified and characterized a promoter regulatory region for the human insulin-like growth factor-I (IGF-I) gene. The 5'-ends of IGF-I mRNAs were first mapped to a series of sites within a 158-nucleotide portion of exon 1 that was found to be structurally similar to the recently delineated transcription start region of the chicken IGF-I gene. In both species multiple initiation sites are probably a reflection of the absence of typical transcriptional regulatory signals, such as a TATA or CCAAT box, in the proximal promoter, although neither gene sequence resembles a GC-rich housekeeping promoter, which also controls a dispersed initiation region. To test promoter function, hybrid genes were constructed linking human IGF-I DNA to a promoterless reporter plasmid. Fusion genes containing from 385-4300 nucleotides of the IGF-I 5'-flanking region enhanced luciferase activity after transfection into the IGF-I-producing SK-N-MC cell line. A plasmid with 1630 nucleotides of 5'-DNA gave maximal activity and directed accurate initiation of the hybrid gene while the same promoter fragment inserted in the reverse orientation was inert. Although cognate recognition sequences were identified for several transcription factors in the 1630 nucleotides 5' to the transcription start region, no sites were found that resembled the putative GH response element recently mapped to the proximal promoter of the rat Spi2.1 gene.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1791842 TI - Proopiomelanocortin gene promoter elements required for constitutive and glucocorticoid-repressed transcription. AB - The POMC gene is expressed predominantly in the anterior pituitary. The high level of POMC transcription in this tissue is modulated by peptide hormones and repressed by glucocorticoids. In this present study we have investigated promoter elements required for the high basal transcription and glucocorticoid repression using transient transfection and in vitro transcription assays. We first determined that the region between -77 to -51 of the promoter, which has previously been shown to harbor a glucocorticoid receptor-binding site, is required for high basal expression both in vivo and in vitro. This promoter domain is also required for glucocorticoid repression of transcription in vivo. Two site-directed mutants within this area both decreased basal transcription, but were fully repressed by glucocorticoids, implying that the -77 to -51 region is a complex regulatory region harboring separable basal and glucocorticoid repressible elements. Electrophoretic mobility shift and exonuclease III footprinting analysis revealed the existence of two factors that bind in this region. We also examined the effect of broad promoter deletions on basal expression and glucocorticoid repression. These experiments revealed that the region between -480 and -320 is also required for glucocorticoid repression. Taken together, the data suggest a model in which high basal transcription is generated by direct interaction of factors binding between -480 to -320 and -77 to -51. Glucocorticoid repression could occur by direct receptor disruption of these interactions. PMID- 1791843 TI - Inhibition of estrogen receptor activity by the tumor promoter 12-O tetradeconylphorbol-13-acetate: a molecular analysis. AB - Cell proliferation and phenotype of cells from female reproductive tissues are regulated by estrogens. It is therefore important to understand how estrogen action can be modulated. It recently has been reported that certain nuclear receptors can antagonize the tumor promoter 12-O-tetradeconylphorbol-13-acetate (TPA) by direct interaction with the transcription factor AP-1, and that the AP-1 constituents cJun and cFos can inhibit receptor activity. This mutual antagonism appears to be based on direct protein-protein interaction. In the human breast cancer cell line MCF-7, TPA leads to growth arrest and altered cell morphology. We have investigated here whether in MCF-7 cells and other cell lines AP-1 and estrogen receptors (ERs) can inhibit each other's activity. We find that TPA or the AP-1 components cJun and cFos can inhibit estradiol-dependent estrogen receptor activity in most cell lines investigated. In addition, ER mRNA is rapidly down-regulated in MCF-7 cells. Gel retardation experiments show that ER DNA binding is inhibited in vitro by cJun protein, while ER also can inhibit cJun DNA binding. However, in vivo we do not observe inhibition of AP-1 activity by ER in the cell lines investigated here. On the contrary, we observed an enhancing effect at low ER concentrations on AP-1. Together our data suggest a new regulatory pathway by which ER activity can be modulated by AP-1. Several mechanisms including ER-AP-1 protein interaction appear to be involved. PMID- 1791844 TI - Evidence that heat shock protein-70 associated with progesterone receptors is not involved in receptor-DNA binding. AB - In the absence of hormone, human progesterone receptors (PR) are recovered in the cytosolic fraction of cell lysates as a multimeric complex containing the steroid binding polypeptide, heat shock protein-90 (hsp90), and heat shock protein-70 (hsp70). Activated forms of human PR that acquire the ability to bind to DNA are dissociated from hsp90, but retain association with hsp70. The present study has examined whether associated hsp70 has a function in receptor-DNA binding. When activated PR was bound to specific target DNA in a gel shift assay, no hsp70 was detectable in the PR-DNA complex, as evidenced by the failure of several antibodies to hsp70 to affect the mobility or the amount of complexes. To determine whether hsp70 might indirectly influence DNA-binding activity, we have examined the effect of hsp70 dissociation on PR-DNA-binding activity. Dissociation was achieved either by treatment of immunoaffinity-purified immobilized PR complexes with ATP or by the binding of PR complexes to ATP agarose, followed by elution with high salt. Under both conditions, dissociation from hsp70 neither enhanced nor impaired the ability of PR to bind to specific DNA. These results suggest that hsp70 is not involved in PR binding to DNA, either directly by participating in DNA binding or indirectly by modulating PR DNA-binding activity. This implies that hsp70 functions at an earlier stage in the receptor activation pathway. Consistent with the known involvement of hsp70 in stabilizing unfolded states of other target proteins, we propose that hsp70 may assist in nuclear transport of PR or in assembly-disassembly of the 8-10S multimeric complex. PMID- 1791845 TI - Prohormone-converting enzymes: regulation and evaluation of function using antisense RNA. AB - Several putative peptide-processing endoproteases have been identified by homology to the yeast Kex2 endoprotease, including furin, PC2, and PC1. However, the question is still open as to which might be involved in peptide posttranslational processing. To enable detailed comparisons of physiological changes in peptide processing with biochemical and molecular biological studies, we cloned rat pituitary cDNAs for PC1 and PC2. The amino acid sequence homologies among rat, human, and mouse PC1, PC2, and furin are consistent with each being a highly conserved but distinct member of a larger family of mammalian subtilisin like proteases. PC1 and PC2 mRNAs show a restricted distribution among rat tissues and cultured cell lines, consistent with a role in tissue-specific peptide processing; the occurrence of furin mRNA among these tissues and cell lines is much more widespread, being high in many nonneuroendocrine tissues. In the neurointermediate pituitary, PC1 and PC2 mRNAs are strikingly regulated in response to dopaminergic agents, in parallel with mRNAs for POMC, peptidylglycine alpha-amidating monooxygenase, and carboxypeptidase-H. In AtT-20 cells, PC1 mRNA is coregulated with POMC and peptidylglycine alpha-amidating monooxygenase mRNAs in response to CRH and glucocorticoids. When the endogenous PC1 mRNA level in AtT 20 cells is significantly and specifically decreased by stable expression of antisense RNA to PC1, biosynthetic labeling of newly synthesized POMC-derived peptides shows a substantial blockade of normal POMC processing. These data are consistent with a role for PC1 protein in endoproteolysis, either as a processing endoprotease or as the activator of the actual processing endoprotease(s). PMID- 1791846 TI - The polymerase chain reaction: a new tool for the understanding and diagnosis of HIV-1 infection at the molecular level. AB - The polymerase chain reaction (PCR) is at present the most powerful analytical tool for detection of specific nucleic acid sequences. The method is based on the in vitro amplification of DNA segments before detection with conventional hybridization techniques or visualization following electrophoresis and staining. The current diagnostic methods for HIV-1 do not allow easy identification of subgroups of infected patients including infants born to seropositive mothers, individuals with delayed serological responses to the virus, infected patients with indeterminate serology results, and patients with dual retroviral infections. Furthermore, response to antiviral therapy cannot be evaluated with serological assays. The rationale for applying PCR in those situations is elaborated here. The applications of this technique for HIV-1 as a diagnostic test and for the understanding of the pathogenesis of this retrovirus are described. Potential limitations of this technique for diagnostic purposes include mainly the possibility of false-positive results due to contamination and false-negative reactions caused by Taq polymerase inhibition. Non-isotopic means for detection of amplified products have been described and should allow for a wider application of this technology. Modifications of PCR which make use of internal standards seem promising for quantitative analysis of nucleic acids. PCR has great potential for viral diagnosis but still requires further studies and better characterization. PMID- 1791847 TI - Evaluation of three new techniques for the detection of STb-positive Escherichia coli strains. AB - A study was conducted to compare different techniques for the detection of heat stable enterotoxin b (STb)-positive E. coli strains. Antisera against purified STb was used to develop an enzyme-linked immunosorbent assay (ELISA). STb positive strains identified by ELISA were tested for bioactivity in rat jejunal loops. Our ELISA was as sensitive as, but less specific than, the bioassay for detection of STb-positive strains. A non-radioactive DNA probe to detect the gene coding for STb was also developed by incorporating digoxigenin-11-dUTP into DNA by the random primed labelling technique. The non-radioactive digoxigenin labelled DNA probe demonstrated a similar detectability to the radioactive probe and was more convenient to manipulate but was less sensitive and specific than the bioassay and the radioactive probe. In addition, the polymerase chain reaction (PCR) was used to amplify a specific portion of the gene coding for STb. The PCR was a highly specific and practical technique for the detection of STb positive strains. All E. coli strains tested containing the STb gene produced the STb toxin. PMID- 1791848 TI - Non-radioactive DNA probe for the rapid identification of Mycobacterium avium complex from clinical specimens. AB - We evaluated an alkaline phosphatase labelled oligonucleotide probe (SNAP(TM), Syngene Co., Molecular Biosystems, Inc., San Diego CA) for the direct culture identification of Mycobacterium avium complex (MAC) isolated from clinical specimens. Mycobacterial species identified by conventional biochemical methods were retested with this DNA probe using the Centri-Dot(TM) format. The probe accurately identified all 69 pigmented M. avium complex and 15 non-pigmented isolates of M. avium complex. There were no false-positives with 45 non-MAC mycobacteria isolates (10 species) and 16 non-mycobacteria organisms (10 species). The sensitivity and specificity of the SNAP(TM) culture identification for M. avium complex were 100%. The alkaline phosphatase labelled DNA probe is stable for at least 9 months. The procedure can be completed within 2 h and is easily adapted in the clinical laboratory. For the strains encountered in our laboratory, we conclude that the SNAP(TM) hybridization is a rapid, specific, and reliable method for culture identification of M. avium complex. PMID- 1791849 TI - Specific detection of the toxic shock syndrome toxin-1 gene using the polymerase chain reaction. AB - A rapid and specific assay for toxic shock syndrome toxin-1 gene (tst gene) detection in Staphylococcus aureus was developed using the polymerase chain reaction. A two-primer set and an oligonucleotide detection probe were synthesized. After 40 cycles of amplification, detection of a 160-bp amplified DNA fragment was carried out by agarose gel electrophoresis and Southern blot hybridization. This assay was sensitive since it was able to detect 1-10 bacteria. It was also specific since no amplification was documented with DNAs from enterotoxigenic S. aureus or Gram-negative bacteria devoid of the tst gene. PMID- 1791850 TI - Detection of hepatitis B virus DNA in serum with nucleic acid probes labelled with 32P, biotin, alkaline phosphatase or sulphone. AB - To facilitate the clinical application of dot-blot hybridization for assaying hepatitis B virus (HBV) DNA, we compared the ability of nucleic acid probes labelled with 32P or with various non-radioactive markers to detect HBV DNA in patient serum. Cloned HBV DNA was hybridized with (1) 32P-labelled HBV DNA cloned in M13, (2) the 32P-labelled HBV RNA probe included in the HepProbe kit, (3) an alkaline phosphatase-labelled synthetic oligonucleotide of HBV, (4) biotin labelled HBV DNA, and (5) sulphonated HBV DNA. Detection was either by autoradiography or an enzymatic colour reaction. The lowest level of detection of cloned HBV DNA was achieved with the 32P-labelled HBV RNA probe (0.3 pg HBV DNA, corresponding to 3 x 10(4) genomes in 50 microliters), followed by the 32P labelled DNA probe (0.3-2 pg), sulphonated DNA (1-2 pg), biotin-labelled DNA (4 pg), and an alkaline phosphatase-labelled synthetic oligonucleotide (30 pg). Subsequently, sera from 159 patients with various constellations of HBsAg, HBeAg, and anti-HBe were tested with the most sensitive radioactive method (HepProbe) and the corresponding nonradioactive method (sulphonation). The overall concordance rate was 71% (r = 0.42). Compared with HepProbe results, sulphonation showed a sensitivity of 80% and a specificity of 67%. We conclude that radiolabelling (in particular 32P-labelling of HBV RNA) still allows the most sensitive and reliable detection of HBV DNA in patient serum using conventional dot-blot hybridization. PMID- 1791851 TI - Precise gene dosage determination by polymerase chain reaction: theory, methodology, and statistical approach. AB - We developed a general method of quantifying relative copy numbers of specific DNA sequences based on the theoretical accumulation of polymerase chain reaction (PCR) products when two DNA sequences are amplified together (co-amplified). Our experiments illustrate the development and theory of the technique. The precision of our estimates is demonstrated by statistical confidence intervals. Tests for effects introduced by experimental factors were performed. The precision of the technique was established by examining the relative gene dosage of the X-linked dystrophin gene in human genomic DNAs from a male, a normal female, a 47,XXX female, and a 48,XXXX cell line. The sensitivity was sufficient to distinguish three copies of the gene from four copies; equivalent to detecting loss of heterozygosity in half the cells of a tumour. Confidence intervals allowed us to reject the hypothesis that there was no difference between DNA samples. Four sample pairs would be required to demonstrate relative gene dosage ratios of 2.0 to 1.0; eight sample pairs would be required to demonstrate a relative gene dosage ratio of 1.3 to 1.0. This method should be useful in detecting gene amplification and deletion in a variety of situations. PMID- 1791852 TI - Leishmaniasis in a domestic goat in Kenya. AB - The pathological and electron-microscopic features of the first case of autochthonous leishmaniasis affecting a domestic goat in Kenya are described. They are similar to what have been described in man and other animals. Using a short amino-acid sequence common to all the species of leishmania as primers for kDNA synthesis, the intervening sequence of 120 bases was amplified in the goat's tissues by polymerase chain reaction (PCR). The leishmania kinetoplast DNA sequence was detected in all the different infected tissues of the goat examined. The sensitivity and specificity of this assay are discussed. The result of the assay used was consistent with the parasite being either L. major or L. aethiopica as the infecting agent. The isoenzyme studies were consistent with L. aethiopica as the strain responsible for this goat's infection. The control of leishmaniasis and its vector must take into account the potential role of animal reservoirs in the environment. Even though Kenya and other East African countries are endemic for kala-azar, the presence of kala-azar in goats is of considerable veterinary public health importance in Africa. Efforts must not be spared to identify and detect other possible animal reservoirs in the subregion. Using DNA amplification techniques, which are sensitive and specific, such as the one described in this paper, sera and other biological fluids and tissues from different animal species should be utilized for detecting additional reservoirs for leishmania parasites particularly in known endemic areas of the world. PMID- 1791853 TI - A DNA sequence for the discrimination of Neisseria gonorrhoeae from other Neisseria species. AB - A 350 base pair Neisseria gonorrhoeae DNA restriction fragment was cloned after subtractive hybridization to Neisseria meningitidis DNA. This restriction fragment hybridized to 105 out of 106 N. gonorrhoeae strains tested. While three N. meningitidis strains did not hybridize to this probe, Neisseria mucosa DNA exhibited cross-hybridization. This particular clone was used to screen a N. gonorrhoeae genomic DNA library. A positive 2.4 kilobase pair clone was shown by DNA sequencing to contain two long open reading frames. One open reading frame did not hybridize to N. mucosa and other Neisseria species, while it retained specificity for the original 105 N gonorrhoeae strains. This open reading frame also showed significant homology to cytosine DNA methyltransferases. PMID- 1791854 TI - cDNA cloning and analysis of RNA 2 of a Prunus stem pitting isolate of tomato ringspot virus. AB - Recombinant plasmids containing sequences derived from the genome of a tomato ringspot virus (TomRSV) isolate associated with both stem pitting disease of stone fruits and apple union necrosis and decline were constructed. Selected inserts were subcloned into the polylinker region of the SP6 transcription vector pSP64. Using the SP6 promoter flanking this region, high specific activity 32P labelled cRNA probes were generated by SP6 RNA polymerase. cRNA probes were specific for TomRSV RNA 2 present in purified virions or in extracts from woody and herbacous hosts. No sequence relatedness was detected between TomRSV RNA 2 and genomic RNA from tobacco ringspot, arabis mosaic, strawberry latent ringspot, or cucumber mosaic virus in Northern blot analysis using TomRSV cRNA probes. These probes detected TomRSV infection in woody and herbaceous hosts in dot-blot hybridization assays. PMID- 1791855 TI - Use of PCR amplification for diagnosis of HTLV-I infection after blood transfusion. AB - We studied the seroconversion to human T-cell leukemia virus type-1 (HTLV-I) in two immunocompromised patients after transfusions of cellular blood components. One patient produced IgM antibodies against the viral p19 protein 149 days post transfusion (a serum on day 43 was negative). Both patients showed indeterminate Western-blots (IgG anti-p19 and anti-gp46 but no anti-p24). Using the polymerase chain reaction (PCR) with two primer pairs (SK43/44 and SK54/56), we demonstrated HTLV-I infection prior to seroconversion. This infection was confirmed by Southern blot. PMID- 1791856 TI - Quantitation of DNA hybridization in a silicon sensor-based system: application to PCR. AB - Rapid, quantitative hybridization assays with good sensitivity are needed in many applications, for example, determining the amount of specific product from PCR. We have developed an assay which relies on the hybridization of a biotinylated oligomer and a fluoresceinated oligomer to a single-stranded target in solution. The hybridized complex is captured by streptavidin to a biotinylated membrane. After capture, the hybridization complex is detected by an antifluorescein-urease conjugate which binds to the fluoresceinated probe. The membrane-bound urease conjugate is exposed to urea and assayed with a pH-sensitive silicon sensor. The total assay time is less than 2 h and the sensitivity limit is 20 x 10(6) molecules with a coefficient of variation, CV, of less than 10%. The assay was applied to the analysis of a model target using PCR. We were able to measure the amount of specific product and the amplification factor during the exponential phase of PCR. Using extrapolation from the measured amounts of amplified product, the initial amounts of target molecules were calculated to be 1.2 x 10(6) and 4.0 x 10(2) when the added quantities were 3 x 10(6) and 3 x 10(3), as determined by serial dilution. PMID- 1791857 TI - Nucleotide sequence of p49a, a genomic Y-specific probe with potential utilization in sex determination. AB - The nucleotide sequence of probe 49a, a genomic polymorphic probe located on the long arm of the Y chromosome, is described. It is an untranslated sequence of about 750 bp with a high A + T content. This sort of selectively neutral sequence can be used with the polymerase chain reaction in sex determination. PMID- 1791858 TI - Capsular typing of Haemophilus influenzae with a DNA probe. AB - We describe the use of a DNA probe for genotyping clinical isolates of Haemophilus influenzae. The probe, containing capsulation genes, differentiates between the six Haemophilus serotypes in a Southern blotting procedure. It also hybridizes with a distinctive pattern to DNA from capsule-deficient mutants of serotype b strains, while failing to hybridize to DNA from typical clinical isolates of non-serotypable H. influenzae. The probe can thus resolve issues of serotyping uncertainty such as arise, for example, when capsulate strains are found to have lost reactivity with serotyping reagents after storage or transmission from one laboratory to another. The probe has proved useful in the evaluation of Haemophilus infections in infants following administration of H. influenzae type b vaccine. In an illustrative example, the probe was used to resolve serotyping ambiguity in a case of Haemophilus bacteraemia in a vaccine recipient, providing compelling evidence that the organism responsible was neither type b nor derived from a type b strain. The widespread introduction of vaccines against H. influenzae type b disease will increase the importance of the precise identification of strains infecting immunized children. This need can only be met by the development of 'gold standards' such as capsulation gene probes. PMID- 1791859 TI - Post-mortem diagnosis of human T lymphotrophic virus type-1 (HTLV-1) associated myelopathy by detection of HTLV-1 DNA in the spinal cord of a patient with post transfusional myelopathy. AB - Human T lymphotrophic virus type-1(HTLV-1) is thought to be an etiological agent of HTLV-1 associated myelopathy (HAM). Therefore, a definitive diagnosis of HAM can not be made if information on the presence of antibody against HTLV-1 is not available, even though clinical and histopathological features strongly indicate the disease. In this study, HTLV-1 DNA was detected in the formalin-fixed, paraffin-embedded spinal cord of an autopsy case with post-transfusional myelopathy using the polymerase chain reaction (PCR). Ante-mortem HAM was not suspected of and the antibody has not been examined. Neuropathological examination of the sequential sections revealed a loss of axons and myelin sheaths in the white matter, resembling the histopathology of HAM. The post mortem detection of HTLV-1 DNA by PCR may be useful for the confirmation of HAM in cases which were not provided with appropriate clinical data. PMID- 1791860 TI - A simple method for diagnosing M. tuberculosis infection in clinical samples using PCR. AB - Species identification of Mycobacterium tuberculosis remains a cumbersome process. We have developed a simple method for treating clinical samples which permits direct polymerase chain reaction (PCR) amplification of mycobacterial target DNA without organic extraction. Samples were boiled for 30 min in TE Triton, then were subjected to 30 cycles of amplification using primers derived from the repetitive clone pMTb4 developed by Patel and coworkers (1990; Journal of Clinical Microbiology 28, 513). Specificity of amplification was confirmed by hybridization with a specific probe labelled non-isotopically. In a model system consisting of cultured bacilli, this system routinely allows detection of a single organism in a sample. In preliminary studies examining applicability of this method to 96 clinical samples, 74 were positive by both PCR and mycobacterial culture, and eight were negative by both methods. Fourteen samples were negative by culture and positive by PCR, and none were positive by culture and negative by PCR. These results suggest that the PCR method may provide a sensitive alternative to conventional species-specific diagnostic methods, and that non-isotopic labelling can be used to detect hybridization in this assay. PMID- 1791861 TI - [Affective, schizoaffective and schizophrenic psychoses. A comparative long-term study]. AB - A total of 402 patients were followed up for, on average, 25 years after the onset of their illness. The diagnoses, made longitudinally, were as follows: schizophrenic disorder (n = 148); schizoaffective disorder (n = 101); affective disorder (n = 106). The remaining 47 patients did not fulfil the criteria for any of these diagnoses. A distinction was made between "episode" (cross-sectional diagnosis) and "illness" or "disorder" (longitudinal diagnosis). The "episodes" (cross-sectional diagnosis) were classified according to slightly modified DSM III criteria into schizophrenic, affective (melancholic, manic, manic-depressive mixed), schizoaffective (schizodepressive, schizomanic, schizomanic-depressive mixed) and non-characteristic episodes. The criteria for the episodes are: Schizophrenic episode: criteria of DSM-III, slightly modified. Melancholic episode: according to "Major Depression, Melancholic Type" of DSM-III-R. Manic episode: according to the criteria of DSM-III, slightly modified. Manic depressive mixed episode: Presence of manic and depressive symptomatology during one episode. Schizodepressive episode: Presence of schizophrenic and depressive symptomatology during one episode. --Schizomanic episode: presence of schizophrenic and manic symptomatology during one episode. Schizomanic-depressive mixed episode: Presence of schizophrenic, manic and depressive symptomatology during one episode. The diagnosis of an "illness" or "disorder" (longitudinal diagnosis) took account of all the kinds of episodes that occurred during the whole course. The final diagnosis (longitudinal diagnoses) were defined as follows: Schizophrenic disorder: only schizophrenic episodes during the whole course Affective disorder: only affective episodes during the whole course (melancholic, manic, manic-depressive mixed episodes). Schizoaffective disorder: at least one schizoaffective episode during the course (schizodepressive, schizomanic, schizomanic-depressive mixed episode), independently of the type and number of other episodes, or sequential manifestation of schizophrenic and affective episodes. The principal instruments of investigation and evaluation were: Global Assessment Scale (GAS); Disability Assessment Schedule (WHO/DAS); Psychological Impairment Rating Schedule (WHO/PIRS); Present State Examination (PSE); Criteria for social class and social mobility according to Kleining and Moore (also transferred to the criteria of Hollingshead and Redlich) - A pool of items based on WHO instruments for social parameters; Items for pharmacological treatment and prophylaxis. PMID- 1791862 TI - [Seasons and affective state in the general population. A multiphase study of epidemiology, biology and therapeutic response (phototherapy) of seasonal affective changes]. PMID- 1791863 TI - Evolution for survival. PMID- 1791864 TI - Hard times all around. PMID- 1791865 TI - Job satisfaction among British and American hospital staff nurses. AB - The basic research design was descriptive, correlational, and non-experimental. Sampling was nonprobability; a convenience sample was obtained after subjects gave informed consent. A Likert-type attitude scale was used to collect data on job satisfaction. The population was full-time hospital staff nurses and a total sample of 146 participated in the project. The settings were four hospitals, two in the north of England and two in the midwest United States. The British study was done three years after the American. Data were collected by questionnaire, which was distributed by hand and collected personally. Results revealed British nurses were very dissatisfied with pay. If it were not for the pay component, the British nurses would have scored significantly higher than Americans on overall satisfaction. American nurses perceived greater satisfaction with their nursing colleagues than the British but were less satisfied with administration. However, British nurses perceived a more cooperative relationship with physicians. British nurses, despite their complete dissatisfaction with pay, would overwhelmingly choose nursing again. PMID- 1791866 TI - Irresponsible authorship: who's on first? PMID- 1791867 TI - Effect of extern experiences on clinical competence of graduate nurses. AB - The purpose of this study was to examine the effect of externships, offered collaboratively between schools of nursing and hospitals, on the clinical competence of new graduates in their first nursing position. The scores of 24 pairs of graduate nurses and their preceptors (N = 48) on the Clinical Competency Rating Scale (CCRS; Scheetz, 1989) were compared in three areas: problem solving, applying theory to practice, and psychomotor skills. New graduates rated themselves higher than their preceptors on all items in the CCRS. Analyses via t tests indicated significant differences between the nurses' own ratings and those of their preceptors on problem solving, applying theory to practice, and psychomotor performance as well as total CCRS. The clinical competence of new graduates who had been externs during their nursing programs was compared to that of graduates who did not have this clinical experience. Nurses who had been externs rated themselves significantly higher than nonexterns on psychomotor performance (t = 2.72, P = .013) and the total CCRS score (t = 2.22, P = .04). Preceptor ratings, however, indicated no differences between these groups. PMID- 1791868 TI - When is a nurse not a nurse? PMID- 1791869 TI - Expanding the clinical specialist's role through outreach. AB - Reimbursement changes within the health care system have continued to challenge nurse administrators to generate innovative strategies for cost-efficient and effective services. This has resulted in restructured delivery systems for patient care and newly developed services in nursing. A consultation/outreach program was developed to support the clinical nurse specialists (CNS) in their delivery of quality care and to provide services to surrounding rural hospitals while producing revenue for the department of nursing. For the hospital described, the institutional visibility has increased, new revenue has been generated, and the referral base for potential clients has been expanded. PMID- 1791870 TI - Mentor, mentee, mentoring: building career development relationships. AB - An understanding of the process of mentoring can be useful for career development in the clinical, research and educational arenas of the nursing profession. The roles of mentor and mentee/protege as guide and learner are described. Several purposes for mentoring are discussed and five stages of the mentoring relationship are delineated. Potential problems, obstacles and factors which facilitate successful mentoring are explored. Through mentoring, individual, organizational and professional development can be fostered in cost-effective and fulfilling ways. PMID- 1791871 TI - RNs and DAs collaborate to prevent drug abuse. AB - Two unique disciplines have come together in a large urban community to provide a community-based drug prevention program for children--Pupils, Lawyers, and Nurses (P.L.A.N.) Against Drugs. This unique relationship brings two sets of expertise to better respond to the complex problem of drug abuse. The program approaches drug abuse prevention by focusing on law enforcement and nursing as career options for inner city children. Cooperation was emphasized from the initial planning stages through project implementation. Other contributors to this program include school district leaders, teachers, community leaders, representatives from the state division of substance abuse, nursing faculty, and district attorneys. The program has received international and national recognition for its efforts. This paper describes the advantages of the collaborative approach to a complex problem. PMID- 1791872 TI - Human monoclonal antibodies in sepsis. PMID- 1791873 TI - Logistic multiple regression analysis of factors predicting recurrence of hyperthyroidism after medical treatment of toxic diffuse goitre. AB - In order to determine which factors predict the outcome of short term antithyroid drug treatment we studied 42 patients with diffuse goitre in whom 43 instances of thyrotoxicosis were treated. Treatment duration ranged from 24 to 61 wk (median 30 wk). All patients received high-dose carbimazole and thyroid hormone substitution. Patients in remission were followed for 39 to 134 wk (median 73 wk). The relapse rate at 1 yr and at 2 yr after cessation of antithyroid drug treatment was 51%. Of the parameters studied presence or absence of eye signs and initial serum levels of thyroxine, triiodothyronine and immunoglobulin-G in the relapse group and in the remission group showed significant differences in univariate analysis. No significant differences were found for age, sex, family history of thyroid disease, thyroid gland volume or TSH-receptor stimulating autoantibodies. Linear discriminant analysis shows that of the four remaining factors thyroxine is not important in separating both groups. Cox analysis yields only initial serum triiodothyronine and eye signs as significant prognostic factors. With these two factors 18 out of 23 predictions of remission and 16 out of 18 predictions of relapse in the 41 patients with known initial serum triiodothyronine concentrations are correct. Such predictions can be used in the choice of therapy, short-term medical treatment for patients with a low risk and long-term medical treatment or, at the appropriate time, a destructive form of therapy for patients with a high risk of relapse. PMID- 1791874 TI - Sellar granulomatous mass in a pregnant woman with active Crohn's disease. AB - At the end of her third pregnancy, a woman with a history of chronic active proctocolitis which had been diagnosed as Crohn's disease complained of deterioration of visual acuity. The patient was found to have hypopituitarism and progressive bitemporal hemianopia caused by an intrasellar mass with suprasellar extension. At transsphenoidal surgery an intrasellar granuloma was found without remnants of pituitary tissue. This sellar granuloma could have been an extra intestinal granuloma of Crohn's disease. However, the possibility that giant cell granulomatous hypophysitis had been present was considered more likely. The occurrence of this disorder in the postpartum period has not been reported before. PMID- 1791875 TI - Light chain deposition disease without detectable light chains in serum or urine. Report of a case and review of the literature. AB - A patient presenting with a nephrotic syndrome and chronic renal failure caused by light chain deposition disease (LCDD) without detectable light chains in serum and urine is presented. Only a few patients with LCDD but without detectable light chains in serum and urine have hitherto been reported. The diagnosis was made by light-microscopic and immunofluorescent examination of a percutaneous renal biopsy. The histological differential diagnosis of LCDD includes diabetic glomerulosclerosis, renal amyloidosis and membranoproliferative glomerulonephritis. For the histological diagnosis of LCDD, immunofluorescence using anti-kappa and anti-lambda antisera is essential. Although renal involvement is a constant feature in LCDD, other sites of deposition of light chains have been reported. The absence of detectable light chains in serum or urine is discussed. PMID- 1791876 TI - Bartter's syndrome, hypomagnesaemia and chondrocalcinosis. AB - A 45-yr-old normotensive woman with hypokalaemic alkalosis and hypomagnesaemia was diagnosed as suffering from Bartter's syndrome. A diagnosis of chondrocalcinosis had been made because of arthralgia and calcifications of cartilage of the knees. The association between both diagnoses is described as well as the possible role of hypomagnesaemia as the intermediary. The effect of spironolactone on urinary excretion of magnesium in this patient with Bartter's syndrome was studied. PMID- 1791877 TI - Aseptic bone necrosis in patients on glucocorticoid replacement therapy. AB - The incidence of aseptic bone necrosis in 167 patients on glucocorticoid replacement therapy in our hospital was found to be 2.4% (4 patients). The diagnosis was made 16 months to five years after initiation of the therapy. A review of eight other cases reported in the literature is presented. The incidence of aseptic bone necrosis in patients on glucocorticoid replacement therapy seems much higher than might be expected. It is suggested that the dose of glucocorticoid substitution therapy be established individually at the lowest acceptable level. PMID- 1791878 TI - The microcirculation and essential hypertension. AB - Essential hypertension is characterized by a progressive increase of the mean arterial pressure paralleled by a concomitant increase in the total peripheral resistance. This elevated resistance is the consequence of (a) a decreased internal diameter, (b) an increased wall-to-lumen ratio or (c) a decreased number of small arteries or arterioles. A considerable part of the elevated vascular resistance is determined at the microcirculatory level. This paper reviews the studies performed to unravel the resistance-elevating mechanisms in the microvasculature of different tissues. Furthermore the possible role of the microcirculation in the pathogenesis of essential hypertension is discussed. PMID- 1791880 TI - From IgA to neuro-immunomodulation: a travelogue through immunology. AB - In this travelogue through Immunology, an overview is presented on studies by the author and his colleagues. It starts with the exploration of immune complexes in the lung, leading to the establishment of bronchus-associated lymphoid tissue. This then developed into the concept of the so-called mucosa-associated lymphoid tissue involved in local immune defence to orally presented antigens. Oral infection with Nippostrongylus brasiliensis initiated studies on mast cells, and the effects of neuropeptides like substance P on mast cell function in vitro. The enteric nervous system shows a close association with mast cells, which can be investigated in in vitro cocultures between mast cells and nerves. This position of mast cells in the dialogue between the immune system and nervous system is illustrated by conditioning experiments showing the degranulation of mast cells by a conditioning stimulus. PMID- 1791879 TI - Life-saving immunotherapy with cross-reactive monoclonal antibodies against endotoxin: a critical evaluation of experimental and clinical studies. AB - In this paper clinical and experimental studies are reviewed for evidence that monoclonal antibodies (MoAbs), directed against common epitopes in the core glycolipid region of lipopolysaccharide (LPS) of gram-negative bacteria, protect against the lethal effect of bacteremia of serologically unrelated gram-negative bacteria. Only those experimental studies that included control MoAbs and excluded the possibility of survival due to endotoxin tolerance, provided evidence for the protective efficacy of cross-reactive MoAbs. Two recently performed clinical trials evaluating the protective value of the MoAbs HA-1A and E5 showed beneficial effects (enhanced survival) by each MoAb in different subgroups of patients with proven gram-negative bacterial infections. It is concluded that immunotherapy by MoAbs is a promising new tool in the treatment of gram-negative bacterial septic shock. However, the pathophysiological mechanism of protection remains to be elucidated and the group of patients which may benefit most remains to be defined more clearly. Therefore, further experimental and clinical studies are warranted. PMID- 1791881 TI - Structure-function relationships in human immunoglobulins. AB - The majority of monoclonal antibodies having potential for in vivo diagnostic and therapeutic applications, in man, are of mouse or rat origin. They need to be "humanized" to prevent rejection by the human immune system and, where indicated, to activate host effector mechanisms. Genetic engineering techniques have made all nine human immunoglobulin isotypes available, but we do not have a sufficient understanding of their functional activities to determine which isotype may be optimal for a given application. This review discusses the major effector systems identified and recent studies directed at defining the structural basis for immunoglobulin recognition by Fc receptors and complement. Site-directed mutagenesis has demonstrated that ligand-binding sites can be modulated by single amino acid substitutions. Additionally, it has been shown that glycosylation is essential for full functional activity. It appears that there is a subtle interplay between the polypeptide and oligosaccharide structures to generate these ligand binding sites. Taken together, these findings suggest that it will be possible to generate "customized" antibody molecules having a pre-determined profile of effector functions. PMID- 1791882 TI - Humoral immunodeficiency: from description to the cellular and molecular basis of the defect. AB - Primary humoral immunodeficiency comprises a number of syndromes which in a descriptive manner indicate the nature and extent of the defect in the synthesis of specific antibodies and likewise of immunoglobulins. The understanding of humoral immunodeficiency has greatly advanced with the increase in knowledge about the cellular and molecular mechanisms of the development of B lymphocytes, which are the precursors of antibody-secreting plasma cells. This article reviews the advances made in the almost forty years that have passed since the first patient with agammaglobulinaemia was described. As far as X-linked agammaglobulinaemia is concerned, it is now clear that this is a disease of B lymphocytes, and that expression of the XLA gene prevents B cell development beyond the pre-B cell stage. Recent studies in patients with late-onset hypogammaglobulinaemia and selective IgA deficiency showed that there may be a common denominator for these two syndromes, since there is a close association with polymorphic antigens of the MHC class III region. Furthermore deletions or mutations of immunoglobulin genes can be the basis of selective deficiencies of one or several immunoglobulin isotypes. However, most of the humoral immunodeficiencies are based on defects in other non-immunoglobulin regulatory genes affecting or engaged in immunoglobulin-isotype synthesis. More recently patients have been described who have normal immunoglobulin isotype and complement levels and who show a selective defect in the antibody production to polysaccharide antigens. These patients most probably form a new disease entity in the spectrum of humoral immunodeficiency syndromes. PMID- 1791883 TI - Monoclonal gammopathy as a model for B-cell differentiation: from "paraprotein" to artificial antibodies. AB - During the past fifty years new biochemical and cell biological techniques have been introduced in clinico-pathological practice. Studies on the bone-marrow related malignancy multiple myeloma (MM) proved particularly rewarding for the elucidation of basic concepts in immunology. In fact, by studying the characteristic monoclonal serum components, hallmarking this disease, the basic structure of immunoglobulins and their various types could be described. Two examples of the impact of using MM as a model system in studies on immunological differentiation will be presented: the involvement of precursor cells and the homing of malignant plasma cells in MM. Conversely, two examples of the growing impact of immunology on the clinical handling of MM will be given: new differential diagnostic procedures as well as novel developments in immunotherapy of MM. PMID- 1791884 TI - Generation of the (auto)-antibody repertoire: a case of narcissism? AB - The immune system has the tremendous task of recognizing and eliminating a practically unlimited number of foreign and often harmful substances. To reach that goal, it has evolved as an apparatus generating a vast array of different antigen receptors expressed by T and B lymphocytes. Through these receptors, the cells can recognize, and respond to, foreign structures; nevertheless, the lymphocytes do not normally react to the body's own constituents. The processes that safeguard a sufficiently broad diversity and yet prevent potentially pathogenic autoimmune reactivity are only now beginning to be elucidated. We describe some of the mechanisms that are believed to play a major role in the generation of the B lymphocyte and antibody repertoire, the induction of tolerance against autologous components and the production of pathogenic autoantibodies, once tolerance is broken. PMID- 1791885 TI - Immunoregulation in man. AB - The process during which a B lymphocyte, after ligation of the antigen receptor, differentiates into a high-rate antibody-secreting plasma cell is under strict regulatory control of T lymphocytes and their soluble products. For most so called T-cell-dependent (protein) antigens, antigen-specific CD4-positive T cells or T-cell factors participate in the transition of resting into activated B cell. Terminal B-cell differentiation, including immunoglobulin class switch, is regulated by a variety of (antigen non-specific) cytokines which act in a highly coordinated fashion. The other major class of naturally occurring antigens, the so-called T-cell independent (polysaccharide) antigens, apparently can induce B cell activation in the absence of antigen-specific CD4-positive T cells. Terminal B-cell differentiation, however, also depends on the action of cytokines, although the relative contribution of individual cytokines remains to be determined. Downregulation of both T-cell-dependent and T-cell independent antigens is mediated by specific suppressor T cells. Next to this "internal control" by regulatory T cells, it is important to realize that components of the (neuro-)endocrine system (such as the endorphins and the family of insulin-like growth factors) and the complement system also exert important immunoregulatory functions. PMID- 1791886 TI - Human B-lymphoid differentiation: normal versus malignant. AB - In this review the features of B-cell development and differentiation are described for the bone marrow and peripheral B-cell system, in particular that in lymph nodes follicles. These features show many similarities to those of malignant B-cell populations. Frequently the "normal counterparts" of malignant B lineage cells are seen in particularly high frequency in the foetal lymphoid tissues. For example, foetal bone marrow shows abundant CD10+ precursors and foetal lymph nodes contain many CD5+ B cells. These similarities contribute to a better understanding of B-cell malignancy. On the other hand they provide observations also useful in interpretation of immunodeficiency such as X-linked agammaglobulinaemia and lymph nodes after HIV-1 infection. The identification of target cells in lymphoid malignancies will be important for understanding the mechanism of tumour development because the gene alterations also show target cell specificity. PMID- 1791887 TI - B-cell activation and regulation of immunoglobulin synthesis by platelet activating factor. AB - Platelet activating factor (PAF) is a highly potent phospholipid mediator known to be active in many biologic systems. To date little is known of the effect of PAF on B lymphocytes. Using three immunoglobulin (Ig)-secreting B-lymphoblastoid lines, we have demonstrated that PAF can influence both early activation and late differentiation events. Following addition of 10(-7) to 10(-11) M PAF, but not the inactive metabolite lyso-PAF, all three cell lines demonstrated rapid, dose dependent increases in free cytosolic Ca2+ concentrations ([Ca2+]i). The changes in [Ca2+]i resulted from release of intracellular stored Ca2+ as well as transmembrane Ca2+ uptake. In parallel PAF caused significant alterations in the kinetics of Ig secretion in the Ig-secreting lymphocyte lines. A 6-12-fold increase in Ig production was detectable after 24 h of stimulation with PAF, which was followed by a plateau over the next 48 h. All of these events were inhibited by the specific PAF antagonists Web2086 and CV3988. PAF antagonists themselves had a profound effect, diminishing Ig production by the B-cell lines by up to 90%. These data indicate that PAF may have an important immunomodulatory role in B lymphocytes. PMID- 1791889 TI - Conditioning of the immune response. AB - Experimental studies in humans and experimental animals document the acquisition and extinction of classically conditioned alterations of different parameters of humoral- and cell-mediated immune responses. Although the aversive effects of cyclophosphamide in a taste aversion learning paradigm has been the most frequently used model, conditioned immunomodulatory effects are not confined to this conditioning procedure, and they are not limited to cyclophosphamide or, for that matter, the use of immunomodulating drugs as unconditioned stimuli. Conditioned changes in immunologic reactivity have also been found to modulate the progression of spontaneously-developing or experimentally-induced pathophysiological processes in experimental animals. The available data on the immunoregulatory effects of conditioning indicate that the immune system, like other systems operating in the interests of homeostasis, is integrated with other physiological processes and is therefore influenced by and capable of influencing the brain. PMID- 1791888 TI - Recent developments in idiotypic network theory. AB - A recent class of mathematical models of the immune network is reviewed. The models in this class are based upon the bell-shaped activation function that is known to be characteristic for receptor cross-linking. These network models have a large number of self-regulatory properties. This review discusses of number of these properties, i.e. immunological memory, suppression, and repertoire selection. PMID- 1791890 TI - Feed-back interactions between immunological cells and the hypothalamus-pituitary adrenal axis. AB - There is now increasing evidence that complex networks of interactions between immunological cells and endocrine, autonomic and brain structures operate during physiological and pathological conditions. Such interactions imply the existence of afferent messengers derived from the immune system, such as lymphokines and monokines, capable of integrating immune-neuroendocrine circuits. The operation of a glucocorticoid-associated immunoregulatory circuit is discussed as an example of these interactions. Under basal conditions, in non-overtly immunized animals, endogenous levels of glucocorticoids affect the number of immunoglobulin secreting cells. At the time of the peak of the immune response to innocuous antigens, as well as following inoculation of infective agents, endotoxins or tumour cells, immunological cells release cytokines which can stimulate the pituitary-adrenal axis. The acute effect of these cytokines is mediated by stimulation of the release of corticotropin-releasing factor from the hypothalamus. Thus, immunological cells are not only influenced by glucocorticoids but their products can also control the activity of the hypothalamus-pituitary-adrenal axis. The possible relevance of these findings for immunoregulation and their implications for pathology are discussed. PMID- 1791891 TI - The contribution of neuroendocrine substances to the immune response. AB - The neuroendocrine system and the immune system have been shown to be mutually interacting at different levels. In the present report we focus on the mechanism(s) by which the activity of the immune system can be influenced by the neuroendocrine system. In the first part we describe some major pathways involved in neuroendocrine-immune interactions at the level of functional effects as well as cell biological mechanisms involved. Evidence is summarized showing that the ultimate effect of a myriad of hormones and neurotransmitters will determine the ultimate outcome of the immune response. In the second part we describe the regulation of the secretion of the neuropeptide beta-endorphin by cells of the immune system. PMID- 1791892 TI - Stress and differential alterations in immune system functions: conclusions from social stress studies in animals. AB - Psychosocial factors are implicated in the development, in the course of, and in the recovery from disease. The immune system may be a mediator of the disease. Studies with animal models using social interactions in rodents suggest that short- and long-term social stress does not invariably suppress immune system functions. The magnitude and direction of changes in diverse compartments of the immune system are highly correlated to the social position of the animal. Furthermore, genetic, developmental, and adult experience may predetermine the animal's coping strategy both in terms of behaviour and neuroendocrinology, and hence in immunology as well. It is argued that disease processes should be considered as a function of baseline immunological state. PMID- 1791893 TI - Contributions of basic immunology to human health. AB - Considerable progress has been achieved in immunology and the development of novel immunological intervention strategies. In this review some new concepts in immunology, and particularly the role played by T cells, are discussed: new ideas on the pathogenesis and possible treatment of autoimmune diseases, on the pathogenesis and immunological treatment of HIV infections, new approaches to transplantation, novel concepts in tumour immunology and cancer immunotherapy and the development of new (molecular) vaccines against infectious diseases. It is anticipated that these new concepts will lead to novel immunological drugs. PMID- 1791894 TI - Clinical immunology: past, present and future challenges and prospects. AB - Over the past four decades, immunology has undergone a revolution changing from a largely phenomenological science into a deeply analytical and technical field. Questions concerning the primary cell involved in cell-mediated immunity, the mechanisms responsible for antibody diversity as well as the molecules used by the network of immunological cells to communicate with one another that could barely be asked in the 1950s, have been definitely answered. A major contributor to this revolution in immunological knowledge has been the scientist focussing on patient-oriented clinical immunology, a form of clinical research requiring the presence of the patient or materials freshly derived from the patient. This type of research has led to the discovery of new diseases, the definition of new infectious agents causing disease and the delineation of functional defects using applied variables on mononuclear cells removed from the patient. Moreover, this type of research is absolutely required to test hypotheses concerning the pathogenesis of disease in humans and to provide the scientific basis for the development of new approaches to therapy. As I look to the future, there are great threats to patient-oriented clinical research. The road ahead seems long and daunting. Nevertheless, I am encouraged that the patient-oriented clinical research scientist in the future will make major contributions to the use of the immune system in preventing human disease, in the development of immunological methods for diagnosis, and in the use of immune intervention to provide a new perspective for the prevention of allograft rejection, and for the treatment of neoplastic, immunodeficiency, and autoimmune disease. PMID- 1791896 TI - Animal models for aging research. Venice, Italy, September, 26-28, 1990. Proceedings. PMID- 1791895 TI - New models for new perspectives in the biology of senescence. AB - This essay presents examples of life history patterns that are not often discussed. Life spans range nearly a million-fold between different species of higher animals and plants and must be species characteristics under considerable genetic control. A comparative approach to senescence reveals a vast variety in temporal organization, both among species as well as between and within populations that may vary over as large ranges of scale and qualitative characteristics as do morphological and biochemical variations. Species comparisons across many levels of biological organization involving the life histories of many species besides the usual few mammals, insects, and nematodes importantly expand the view of mechanisms that limit life spans. The presumption that age-correlated changes are all adverse to some degree and that most components of an organism should decay as the life span is approached is reevaluated. PMID- 1791897 TI - Development of animal models of aging at the National Institute of Aging. AB - The suitability of various animal species as experimental models of aging has been a continuing concern of the National Institute on Aging (NIA) for over 20 years. The history of the decisions made by NIA in providing aged animals for research may be helpful to individual investigators seeking to understand why certain models are available and which of them to choose for their work. PMID- 1791898 TI - Use of rodents as models for the study of "normal aging": conceptual and practical issues. AB - Certain guidelines may exist for selecting and using rodent models for aging research. These are based, however, on only operational criteria because we presently lack good biomarkers for (or even a suitable definition of) normal aging. Longevity and disease characteristics of the experimental population are the most important of the operational criteria for choosing a particular rodent model. These factors, in turn, are influenced by genetics and by environmental factors, including diet, housing, and physical activity. PMID- 1791899 TI - Relevance of the rodent model to human aging studies. AB - Rodents have proven to be a useful general model for aging research. Although they are not necessarily appropriate for the study of such specific human age associated diseases as atherosclerosis, rodents have provided the basis for important age-related findings in many diverse areas, including nutrition, behavior, immunology, physiology, oncology, biochemistry, and neurobiology. Contributions in these areas are briefly reviewed. PMID- 1791900 TI - Suggested guidelines for the housing and husbandry of rodents for aging studies. AB - The available published guidelines for the housing of rodents are reviewed, and assessments are made with regard to whether the data on which these guidelines are based appear to be sound. Ambient air temperature, relative humidity, lighting levels and photoperiods, sound levels, cage sizes, and ventilation rates are discussed, and a summary is provided covering the relationship between these and other factors and the well-being of laboratory rats and mice exposed to such conditions. PMID- 1791901 TI - Age-associated versus husbandry-related pathology of aging rats. AB - Longevity studies in four rat strains, Han:WIST, Han:SPRD, DA/Han, and BDII/Han are surveyed. These animals were kept under specified pathogen free conditions in the same animal house under the same maintenance conditions from weaning to natural death. Genetic and pathologic influences on longevity of these four strains are summarized. PMID- 1791902 TI - Necessity of a more standardized microbiological characterization of rodents for aging studies. AB - The establishment of germ-free, gnotobiotic, and SPF animal colonies is a major component of any effort to develop suitable animal models for aging research. Epidemic and endemic disease in laboratory animals can lead to unacceptable losses, contamination of research results, and exposure of staff and investigators to unnecessary health risks. Monitoring the health status and microbiological burden of the animals is particularly important. These issues are discussed, with accompanying guidelines and protocols in pragmatic, tabular form. PMID- 1791903 TI - Necessity of a more standardized virological characterization of rodents for aging studies. AB - Characterization of the microbiological status is an important facet of a quality assurance program for laboratory animals. This paper addresses basic issues with regard to standardization of the characterization of murine viral status. Methods for such characterization include clinical signs, virus isolation, and serological tests. Significant considerations are screening profiles; sample collection, processing, and shipment; and sampling schedules. International standardization of programs and methods to control and characterize the microbiological status of laboratory animals is being developed, and will be highly significant in future efforts to produce, control, and maintain laboratory animals free of viral infections. PMID- 1791904 TI - Genetic quality control of laboratory animals used in aging studies. AB - Laboratory rodents provide a useful model for aging processes in humans. Various genetic "types" of stock are available, including outbred stocks and inbred strains and their derivatives. Inbred strains, which can be regarded as clones of genetically identical individuals, provide a powerful research tool for studies in many disciplines, including gerontology. However, some form of genetic quality control is essential to ensure that the strains are authentic. Single gene polymorphisms, particularly those detected by electrophoresis and immunological methods, provide a powerful tool for such quality control, though these methods are expensive and require considerable expertise. Methods based on several loci studied simultaneously include skin grafting and polyvalent alloantisera. These methods are often quick and technically relatively easy, but are less flexible than the single locus methods. Methods based on DNA restriction fragment length polymorphisms (RFLPs) fall into both categories depending on whether a single locus or a multilocus probe, such as the fingerprinting probes, is used. These DNA-based methods have many advantages, and are likely to be the methods of choice in the future. PMID- 1791905 TI - Nutritional considerations in the production of rodents for aging studies. AB - Dietary restriction in the maintenance of animals for aging research has been the subject of intense recent interest. This interest may be justified. Current formulas for laboratory animal diets were a natural progression from those for farm animals, but the objectives and conditions for maintaining laboratory and farm animals are often quite different. Indeed, the practice of ad lib feeding current laboratory animal formulations may actually have deleterious effects that can be reduced or eliminated by restricting food intake. This paper reviews many of the major considerations in the development and application of dietary restriction protocols, including formulation, nutritional management during long term studies, and practical considerations. PMID- 1791906 TI - Divergence of biological and chronological aging: evidence from rodent studies. AB - Literature on aging populations of rodents supports the intuitive view that significant functional variation exists among like-aged, elderly individuals: chronological age as a solitary measure is a poor indicator of biological age. In this report, we review a variety of studies which classify aged rodents based on genetic and/or behavioral similarities, in addition to chronological age, and have provided valuable neurobiological and physiological information on age related changes which accompany functional impairments, or the lack of them. Beyond their descriptive value for gerontological research, these findings suggest ways in which biological aging can be manipulated to promote good function in aged individuals. PMID- 1791907 TI - Efficient experimental design in aging studies. AB - Aged animals for research are expensive, take time to develop, and require rigorous attention to husbandry. As such, it behooves the investigators who use aged animals to do so efficiently. Moreover, correlations of many variables with longevity, and increased heterogeneity with age tend to bias aging research toward negative results. Multiple age groups, longitudinal assays, necropsy, and multidisciplinary experiments are factors in efficient experimental design that may significantly enhance the statistical power and interpretability of aging studies. PMID- 1791908 TI - In honor of Lawrence Austin on the occasion of the 65th birthday. PMID- 1791909 TI - Lawrie Austin: the man and the scientist. PMID- 1791910 TI - The NGF complex from the African rat Mastomys natalensis. AB - The 7S NGF complex from the male mouse submaxillary gland consists of the alpha, gamma, and beta subunits in the ratio alpha 2 gamma 2 beta. The beta (NGF) subunit contains all the known biolocial activity of 7S NGF. The alpha and gamma subunits are both members of glandular kallikrein gene family, yet only gamma subunit has protease activity. The gamma subunit plays a role in the processing of preproNGF to its mature form, while the role of the alpha subunit is not yet understood. Despite the fact that 7S NGF has been extensively characterized, no other NGF complex has been characterized, nor have the alpha or gamma subunits been observed in tissues which express NGF. We have therefore purified and characterized the NGF complex from the submaxillary glands of the rat Mastomys natalensis in order to more fully understand the roles of the alpha and gamma subunits. The NGF complex from M. natalensis contains subunits similar to those found in mouse 7S NGF. Although similar, there are significant differences between mouse and M. natalensis NGF complexes, especially in the degree of post translational modification of the gamma and NGF subunits, the expression of esterase activity and the ease with which the complexes dissociate. Evidence is presented that suggests that the NGF complex from M. natalensis may consist of subunits in the ratio alpha 2 gamma beta. The amino acid sequence of the M. natalensis NGF suggests some, but not all, ways in which these differences arise. PMID- 1791911 TI - Blot and culture analysis of neuronotrophic factors in nerve regeneration chamber fluids. AB - The fluid accumulating in silicone nerve regeneration chambers implanted between the cut ends of rat sciatic nerve contains neuronotrophic activities towards embryonic chick ciliary and sympathetic neurons. The blot and culture technique of Carnow et al. was used to determine if part of the neuronotrophic activities is due to ciliary neuronotrophic factor, which supports the survival of both types of neurons in vitro. The technique involves separating the fluid proteins by SDS-polyacrylamide gel electrophoresis, Western transfer, and then culturing of purified neurons on the nitrocellulose blots. After 24 hr surviving neurons are restricted to regions of the blot where neuronotrophic factor is present. Analysis of 1 and 2 day fluids showed that a multitude of factors are present, particularly in the 19-30 kD molecular weight range, with discrete peaks of activity at molecular weights consistent with those reported for ciliary neuronotrophic factor. There were several other peaks of activity present in the fluids in addition to these. PMID- 1791912 TI - Properties of receptors for neurotoxic phospholipases A2 in different tissues. AB - A radioiodinated derivative of OS2 (125I-OS2), a neurotoxic monochain phospholipase A2 isolated from taipan venom, was previously found to bind to a specific brain membrane receptor with very high affinity. 125I-OS2 is now used to identify the properties of neurotoxic phospholipase receptors in other tissues. Heart, skeletal muscle, kidney, lung, liver, pancreas, and smooth muscle membranes also contain high-affinity binding sites for toxic phospholipases A2. In most tissues, two different types of receptor sites have been characterized for 125I-OS2 with Kd1 and Kd2 values in the 1-5 pM and the 10-50 pM range respectively. Whereas all receptors are similar in the different tissues in terms of their affinity for 125I-OS2, maximal binding site capacities were very different, varying from 1.3 pmol/mg of protein in brain to 0.01 pmol/mg of protein in pancreas. In brain, heart, and skeletal muscle, receptor densities vary with in vivo development. Affinity labeling experiments have identified the subunit composition of OS2 receptors and indicated that these receptors do not have identical structures in the different tissues. Binding competition studies with OS2 and other toxic phospholipases showed tissue-dependent pharmacological profiles. All these results taken together suggest the existence of a family of receptors for neurotoxic phospholipases. PMID- 1791913 TI - Expression of actin and myosin genes during PC12 cell differentiation. AB - We have measured the accumulation of transcripts for myosin and actin during NGF induced differentiation of PC12 cells. Beta (beta) and gamma (gamma) actin and myosin light chains (MLC) 2 and 3 show different patterns of expression, with transient elevations in gene expression one day after NGF addition. This elevation occurs earlier than that of neurite outgrowth, neurofilament protein (NF68) (16) and Thy-1 glycoprotein gene expression. These results suggest differing mechanisms of control of actin and myosin expression, together with a varying function and relationship between them during NGF-induced neurite differentiation. PMID- 1791914 TI - Duchenne muscular dystrophy and dystrophin: sequence homology observations. AB - Duchenne muscular dystrophy (DMD) is a genetically transmitted disease characterized by progressive muscle weakness and usually leads to death. DMD results from the absence, deficiency or dysfunction of the protein dystrophin. Analysis of protein data bases, including homology alignments and domain recognition patterns, have located highly significant correlations between dystrophin and other calcium regulating proteins. In particular, a major portion of the dystrophin sequence has been found to contain repeating units of approximately 100 amino acid residues. These repeating units were found to exhibit significant homology to troponin I. Troponin I has been found to bind to the calcium binding proteins calmodulin and troponin C. The regions of highest homology were characterized by patterns of high localization of charged amino acids and thus could represent a possible calmodulin or troponin C surface accessible binding site. Since subcellular localization studies have indicated that dystrophin is associated with the triadic junction, these findings imply that dystrophin could be involved in controlling intracellular calcium homeostasis. PMID- 1791916 TI - Effects of prolonged artificial photoperiod on circulating prolactin and melatonin levels in seasonal ewes. AB - Crossbred ewes exposed to long days for 46 months prior to photoperiod reversal showed no alteration in the duration or amplitude of the circulating melatonin peak between 24 and 46 months of continuous long day exposure. By 3 months after photoreversal to short days, both the amplitude and duration of the peak had adapted to the new scotophase. In short day treated ewes, the melatonin peak was abolished by 46 but not 24 months of short day exposure, and was not fully restored in all ewes 3 months after photoreversal. Mean prolactin levels over 24 h remained high up to 46 months of long day treatment, and declined 3 months after short day exposure. Conversely, mean prolactin levels remained low up to 46 months of short day treatment, increasing 3 months after exposure to long days. Thus: (i) depletion of the melatonin-synthesizing capability of the ovine pineal gland by prolonged exposure to long nights is not completely reversed after 3 months of continuous long day exposure, and (ii) a nocturnal melatonin peak is not essential for maintenance of plasma prolactin levels under these conditions. PMID- 1791915 TI - Reduction of cellular damage induced by cerebral ischemia in rats. AB - A model of incomplete cerebral ischemia involving bilateral ligation of the common carotid arteries in rats, was used to examine the potential of a Chinese herbal preparation and of nifedipine to reduce cell damage following cerebral ischemia. The herbal preparation contained ginsengosides and extracts of Panax notoginseng, Ligusticum chuanxiong Hort., Carthamus tinctorius L. and Salvia militorrhiza Bge. Histological evidence of cell damage and the formation of peroxidation products were both reduced in rats pretreated with the herbal preparation or with nifedipine. It has been suggested that the free radical reaction is involved in tissue damage, particularly in the pathological neurocyte injury of cerebral ischemia. The results show that in this model of incomplete cerebral ischemia, the degree of lipid peroxidation can be lowered by the pretreatment with Chinese herbs containing ginsengosides or with nifedipine. These drugs maybe beneficial in the treatment of cerebral ischemia in humans. PMID- 1791917 TI - How peptidergic neurons cope with variation in physiological stimulation. AB - A general scheme for neuropeptide metabolism is outlined and the potential sites of regulation are discussed. Two major sites of regulation are distinguished: transcription which ultimately limits the rate of translation to form the prepropeptide, and post-translational processing steps. The consequences of up regulation of these steps in response to increased metabolic demand are discussed. An alternative strategy for peptidergic neurons, reliance on a large pool of neuropeptide, is proposed. Data on the response of enkephalin-containing cells to increased levels of stimulation are reviewed. It is concluded that there is good evidence for genomic up-regulation, perhaps in association with regulation of processing. Evidence based on studies on enkephalin-containing amacrine cells in the chicken retina is also reviewed. It is suggested that these cells rely on a large pool of neuropeptide to cope with changes in demand. PMID- 1791919 TI - Current bibliographies of neuropeptides prepared by the University of Sheffield Biomedical Information Service. PMID- 1791920 TI - Natural killer cell activity in patients with neuroendocrine tumours of the gastrointestinal tract; relation with circulating gastrointestinal hormones. AB - We have evaluated the peripheral blood natural killer (NK) cell activity and the in vitro effect of recombinant gamma-interferon (r gamma-IFN) on NK cell activity in 23 patients with a neuroendocrine tumour of the pancreas, small intestine or liver, and 23 healthy controls. Patients with a gastrinoma showed a NK cell activity which was not different from that of the control group, whereas patients with another type of neuroendocrine tumour had a decreased NK cell activity compared to the controls (p less than 0.05) and the gastrinoma patients (p less than 0.02). The impaired NK cell activity in these patients was as such not related to the presence of liver metastasis or performance status of the patients. r gamma-IFN significantly stimulated the NK cell activity in patients and controls. However, the cytotoxic response of the patients with a hormone production other than gastrin remained lower than in the two other groups. Follow up studies in 8 patients showed NK cell activities not to vary with stable disease, to decrease with progressive disease, and to increase with regression of disease. In conclusion, NK cell activity is suppressed in patients with neuroendocrine tumours that produce hormones other than gastrin. This impairment is not related to the presence of metastasis but seems to be related to the course of the disease. PMID- 1791918 TI - Behavioral and pharmacological unravelling of memory formation. AB - A brief description of how a passive avoidance task, using one day-old chicks, has been used to test for memory formation is given. Chicks will peck at bright shiny beads but if a bead is painted with a bitter tasting chemical, after tasting it once, the chicks will refuse to peck on subsequent presentation of that bead. The chick associates the bitter taste with the particular characteristics of the bead. These experiments have led to the development of a model of memory. The basic model is made of short-term memory, which lasts 10 minutes, intermediate memory that has two phases A and B and lasts for 30 minutes and finally long-term memory. The use of certain classes of drugs to prolong, delay or abolish the various phases is described and then it is shown that many hormones and certain behavioral manipulations can modulate memory. Experiments are described which examine not only the temporal storage but delineate spatial storage within the brain. A brief discussion of current methodologies for looking at the exact spatial location of memory traces is given. The article concludes by emphasizing how even minor differences in protocols across laboratories can have large effects on the memory traces and stresses the significance of the narrow temporal windows, around the training trial, when memory can be modulated. PMID- 1791921 TI - Endothelin stimulates 86Rb efflux in rat glioma C6-Bu-1 cells. AB - Endothelin-1 (ET) elevates intracellular calcium ([Ca2+]i) and increased [Ca2+]i has been associated with K+ efflux. Therefore, we investigated ET stimulation of K+ efflux in rat glioma C6-BU-1 cells. K+ efflux was measured by monitoring the release of 86Rb+ from cells pre-loaded with 86RbCl. ET stimulated 86Rb+ efflux with an EC50 of 5.9 nM. ET-stimulated 86Rb+ efflux was insensitive to Ca2+ channel blockade, however it was reduced by 68% in Ca(2+)-free buffer, suggesting a sizable dependence on an extracellular source of Ca2+ influx through non voltage-operated Ca2+ channels. ET-stimulated 45Ca2+ efflux slightly preceded 86Rb+ efflux, again suggesting the presence of Ca2+ dependent K+ channels. ET stimulated 86Rb+ efflux was insensitive to glyburide suggesting that efflux is not through ATP-sensitive K+ channels. ET-stimulated 86Rb+ efflux was insensitive to pertussis toxin (PTX) pre-treatment. Pre-incubation with the protein kinase C (PKC) inhibitor, staurosporine, inhibited 86Rb+ efflux by 66%, suggesting the involvement of PKC activation in ET-mediated 86Rb+ efflux. In summary, in C6-BU-1 cells, ET stimulates Ca2+ dependent K+ efflux which is mediated in part by protein kinase C activation, but not a PTX sensitive G-protein, nor through an ATP-sensitive K+ channel. These data extend the intracellular mechanisms initiated by ET to include Ca2+ dependent K+ efflux in glial cells and further support a neuromodulatory role for ET. PMID- 1791922 TI - Primary structure of two isoforms of the vitellogenesis inhibiting hormone from the lobster Homarus americanus. AB - The amino acid sequence of two isoforms of the Vitellogenesis Inhibiting Hormone from the lobster Homarus americanus (one biologically active and one inactive in a heterologous bioassay) has been established by gas-phase microsequencing and fast-atom bombardment mass spectrometry. These two isoforms, isolated from sinus glands display the same sequence of 77 amino acid residues (m.w.: 9135 Da) and have a free N-terminus. Structurally related to Crustacean Hyperglycemic Hormone and Molt Inhibiting Hormone, the Vitellogenesis Inhibiting Hormone of the lobster clearly appears as an original member of the newly described family of neuropeptides, so far proper to crustaceans, which are involved in the control of major physiological functions. PMID- 1791923 TI - Localization of diazepam-binding inhibitor (DBI) mRNA in the rat brain by high resolution in situ hybridization. AB - An endogenous peptide, named diazepam-binding inhibitor (DBI) capable of displacing benzodiazepines from binding sites has been recently fully characterized. In order to clearly identify the cell types responsible for the biosynthesis of DBI in the rat central nervous system, we have performed high resolution in situ hybridization in the area postrema, hypothalamus and cerebellum, using a [35S]-labeled single stranded RNA probe. Hybridization signal was detected in both semithin and ultrathin sections. In all the brain areas examined, specific labeling was exclusively observed in non-neuronal cells including ependymal and subependymal cells bordering the third ventricle. The results obtained clearly establish that DBI is synthesized by non-neuronal cells in the rat brain. PMID- 1791924 TI - The inhibition effect of cholecystokinin in human colonic lamina propria lymphocyte proliferation, and reversal by the cholecystokinin receptor antagonist L-364718. AB - Cholecystokinin (CCK) is a potent neuropeptide hormone with activity on various gastrointestinal organs during the digestive process. It was recently suggested that CCK may also act on the immune system. In this study we investigated the effect of CCK on the human mucosal immune system as represented by colonic lamina propria lymphocytes (LPL). Our results demonstrated that CCK at concentrations of 10(-13) M to 10(-7) M inhibits thymidine incorporation into Con A-stimulated LPL DNA by up to 40%. Moreover, this inhibitory effect was reversed by the specific CCK receptor antagonist, L-364718, at concentrations of 10(-8) M to 10(-5) M. In addition, CCK did not affect DNA synthesis of LPL stimulated with phorbol ester (PDB) and calcium ionophore (ionomycin). It is postulated that the CCK effect may involve intracellular metabolic steps proximal to protein kinase C activation and calcium flux. Our results suggest that CCK may play a role in modulating the human mucosal immune system during digestion and thus, should be added to the list of the neuropeptides that affect the mucosal immune system. PMID- 1791925 TI - Effects of neuropeptide Y on insulin and glucagon secretion in the pig. AB - Neuropeptide Y (NPY)-nerves occur in the pancreas. We therefore infused synthetic porcine NPY directly into the pancreatic artery in anaesthetized pigs to study its direct in vivo influence on pancreatic blood flow and on insulin and glucagon secretion. NPY was given both under basal, normoglycemic conditions, and during an ongoing intravenous infusion of glucose, which raised plasma glucose levels to 20 mM. NPY was infused at 0.5 (n = 2), 5 (n = 3), 35 (n = 7), or 175 (n = 5) pmol/min. We found that NPY at 5, 35, and 175 pmol/min inhibited glucagon secretion. Furthermore, at 35 and 175 pmol/min, NPY also reduced pancreatic blood flow. In contrast, only at 175 pmol/min, NPY inhibited basal and glucose stimulated insulin secretion. We conclude that in the pig NPY might participate in the regulation of glucagon secretion (as an inhibitor) and of pancreatic blood flow (as a vasoconstrictor). In contrast, NPY does not seem to be involved in the regulation of insulin secretion. PMID- 1791926 TI - Oxytocin-induced inhibition of feeding and drinking: no sexual dimorphism in rats. AB - The effect of oxytocin on feeding and drinking behaviours was compared in male and female rats. Dose-dependent feeding and drinking inhibition was observed in either sex to about the same degree, both following intracerebroventricular or intraperitoneal administration. The results were obtained whether in animals with free access to food and water or in schedule-fed animals fasting for 21h and in two different models of thirst (water deprivation for 16h, s.c. administration of hypertonic saline). These data show that there is no sexual dimorphism in oxytocin-induced inhibition of feeding and drinking. PMID- 1791927 TI - Bombesin-like peptides in alveolar macrophage: increased release in pulmonary inflammation and fibrosis. AB - Rat bronchoalveolar cells (99% alveolar macrophages (AM] were obtained by bronchoalveolar lavage and examined for their content of bombesin-like immunoreactivity (BLI) by radioimmunoassay (RIA), immunocytochemistry and high performance liquid chromatography (HPLC) analysis. Rat AM contained and released in their culture media significant levels of BLI, the major molecular form corresponding to gastrin-releasing peptide (GRP). Release of BLI by AM was not affected by in vitro activation of AM with lipopolysaccharide and muramyl dipeptide, but was enhanced following in vivo treatment with inflammatory agents. AM from animals with inflammation and fibrosis released higher levels of BLI than controls at 3 and 6 weeks after treatment. These changes were correlated with a significant increase in the proportion of low density mature AM as determined by Percoll density gradient fractionation. Together, our data indicate that increased release of BLI by AM may be related to AM maturation and support a role for bombesin-like peptides as modulator(s) of inflammatory reactions. PMID- 1791928 TI - A PET study of word finding. AB - We have used PET in conjunction with psychological activations to identify cortical areas involved in the intrinsic activation of word representations. In four normal subjects intrinsic generation of a word (verbal fluency) was associated with an increase in left dorsolateral prefrontal cortical activity (BA 46) and a bilateral decrease in activity in auditory and superior temporal cortices. Conversely, when subjects made lexical decisions about words that were heard, there was an increase in superior temporal activity with no change in area 46. We suggest that the superior temporal regions are the site of stored word representations and that inhibitory modulation of these areas by the left prefrontal cortex is the basis of intrinsic word generation. PMID- 1791929 TI - Functional anatomy of language processing: neuroimaging and the problem of individual variability. AB - This paper discusses the long-standing concepts of a participation of frontal opercular and inferior parietal cortex in high-order language processing with respect to contradictory inferences from recent positron emission tomographic (PET) activation studies (cf. Petersen et al. [49]). The main thrust of the present argument is that the technique of intersubject PET image averaging may be inappropriate due to intersubject variability. Evidence is presented which suggests that intersubject variability is at least two-fold: (i) Intraoperative stimulation has demonstrated diversity in location of language functions in the left frontal and temporoparietal association cortex; (ii) Morphometrical imaging studies have demonstrated diversity of brain shape and gyral pattern which is difficult to correct by anatomical standardization of individual brains. Both factors add noise in spatially standardized PET images and may render circumscribed high-order language foci undetectable. It is argued that PET studies of higher cognitive functions including language must focus on individual anatomo-functional organization using techniques such as intrasubject averaging. PMID- 1791930 TI - The influence of attention on the dichotic REA. AB - Laterality researchers have frequently neglected to control for possible attentional components of perceptual asymmetries. Attention was manipulated in a dichotic listening paradigm by presenting a pre-exposural tone cue to the ear from which the subject was required to report. The time period between the onset of the cue and the onset of the trial (Stimulus Onset Asynchrony--SOA) was varied such that the time available to orient attention was manipulated. In two experiments, sizeable REAs were apparent at the shortest SOA (150 msec) but were substantially attenuated at longer intervals (450 and 750 msec SOA). In addition, a much larger effect of SOA on left-ear than on right-ear performance was observed. These effects were taken as evidence of an attentional bias to the right ear in the typical dichotic listening situation. PMID- 1791931 TI - Hand motor patterns after the correction of left-nondominant-hand mirror writing. AB - In a previous report, the author studied a left-nondominant-hand mirror writer, postulating that her mirror writing resulted from the failure to reverse the right-hand writing motor patterns when transmitted from the left to the right cerebral hemisphere. In this study, the patient was asked to write in normal fashion with the left hand; the result was a mixture of handwriting motor patterns which included normal letters, letters with reversed direction tracings, letters with one or more than one loop-tracings and illegible letters. The author considers this result to be a further support for the above-proposed hypothesis. PMID- 1791932 TI - Dissociation of the acute effects of alcohol on implicit and explicit memory processes. AB - The effects of alcohol (0, 0.3 and 0.6 g/kg) on learning and memory were assessed in independent groups of male student volunteers. Subjects were shown a list of words and asked to form an image of a scene involving each word 1 hr after drinking an alcohol-containing beverage. Alcohol consumption impaired the ability of subjects to explicitly remember the words in a test of free recall. However, no impairment was observed if memory for the same material was assessed implicitly using a backwards-reading or word-completion task. That is, both alcohol-and placebo-treated subjects showed similar degrees of priming. The data indicate that alcohol's effects on memory are selective. PMID- 1791933 TI - Deficit to stimulus-centered, letter shape representations in a case of "unilateral neglect". AB - A brain-damaged subject is described whose pattern of performance in various reading tasks can be explained by proposing damage at a level of the word recognition process in which a representation with stimulus-centered, rather than retinal- or word-centered, coordinates is processed. Analysis of her reading performance as a function of topographical arrangement of letters, position of errors in the letter string, and the effects of letter spacing and of adding a prefix or suffix provide evidence not only for the existence of this level of representation (the letter-shape map in a model proposed by Caramazza and Hillis [3]), but also for specific assumptions about its functioning and structure. PMID- 1791934 TI - Preserved access and processing of social knowledge in a patient with acquired sociopathy due to ventromedial frontal damage. AB - Acquired damage to ventromedial frontal cortices produces abnormalities of decision-making that are especially marked in the realm of social conduct. The pathogenesis of this disorder remains unexplained. One possible mechanism posits that patients with lesions of ventromedial frontal cortices, while retaining the ability to recognize the entities and events that compose social situations, lose the ability to generate an appropriate array of response options to social stimuli, and to conceptualize the future consequences of choosing a particular option. To explore the validity of this mechanism, we tested a prototypical patient with bilateral ventromedial frontal injury and social conduct disorder, along with a group of matched controls, in a series of laboratory probes designed to examine the manipulation of response options and projected outcomes to social stimuli. The experimental subject (patient E.V.R.) exhibited normal or superior performance on tasks that measure the ability to (1) generate possible response options to social situations, (2) consider the future consequences of pursuing particular response options, (3) conceptualize effective measures to achieve given social objectives, (4) predict the likely outcome of a particular configuration of social stimuli, and (5) perform moral reasoning at an advanced developmental level. These findings suggest that: (1) the base of social knowledge that E.V.R. acquired during his normal development is still intact; and that (2) his capacity to access and process components of such knowledge is also intact, in the conditions specified in our experiment. PMID- 1791935 TI - Dual-task interference in left-handed subjects: hemispheric specialization vs manual dominance. AB - Thirty-six left-handed subjects performed a dichotic listening task and two concurrent (verbal plus finger-tapping) tasks. Baseline tapping scores revealed both left- and right-hand dominance within left-handed subjects. Moreover when subjects were categorized as consistent or inconsistent for 'sidedness advantage' (e.g. consistent = same side for dominant hand and ear advantage), it was shown that the dual-task interference effects found on the concurrent tapping tasks were due to both hemispheric specialization and manual dominance. PMID- 1791936 TI - No link between left-handedness and maternal age and no elevated accident rate in left-handers. AB - No significant link was found between maternal age and handedness of offspring for 154 left-handers and 560 right-handers. Questionnaire data on traffic accidents for 302 left-handers and 719 right-handers failed to support the claim that left-handers have an elevated risk for accidents. PMID- 1791937 TI - Grading of intracranial tumors following the WHO classification. AB - The grading scheme contained in the WHO classification "Histological Typing of CNS Tumors" has been introduced after long and controversial discussions. Of the three major systems for grading intracranial tumors which were at hand, Zulch's is closest to the WHO system. The criteria for, and general remarks about, the WHO system for the evaluation of malignancy grades are delineated. Their almost complete concordance with Zulch's "horizontal" scheme is emphasized, although some minor differences are mentioned. It is the author's belief, which may, however not be theoretically fully justified, that this system has been applied successfully since the publication of WHO classification. Opposition to WHO grading mostly reflects general pessimism about the possibility of gaining information concerning proliferation from morphology. However, the analysis of therapeutic trials in the last decades has shown that histological grade is of great predictive value. This correlation can be improved by the broad and exact application of the system. PMID- 1791938 TI - Indication for invasive diagnostic studies and surgical therapy in cerebral ischemia, based on results of non-invasive transcranial Doppler sonography. AB - In order to better define patients who might benefit from cerebral revascularization surgery, transcranial Doppler sonography was used in more than 480 patients. Thus invasive diagnostic studies could be limited to probable surgical candidates. Transcranial Doppler sonography has proven to be reliable for the study of the degree of efficacy of intracranial collateral pathways in hemodynamic borderline situations. Over the last 4 years, the application of the algorithm presented in this paper resulted in a reduction of the number of candidates for surgical revascularization to 19. PMID- 1791939 TI - Comparison of Doppler CO2 test, patterns of infarction in CCT, and clinical symptoms in carotid artery occlusions. AB - In patients with an internal carotid artery (ICA) occlusion the CO2 reactivity (autoregulatory reserve) is supposed to give information about the function of the collateral supply. To prove this hypothesis we compared the CO2 reactivity measured by transcranial Doppler sonography to the ipsilateral clinical symptoms and the patterns of infarction in cranial computed tomography (CCT). We studied 251 cases of ICA occlusion. Of the 141 cases with normal autoregulatory reserve, 37 (27%) had recently developed an ipsilateral neurological deficit. Of the 44 cases with exhausted CO2 reactivity, 28 (64%) had experienced an event. The difference is highly significant (p less than 0.0001). In 59 of the 75 patients for whom CCT images were available, we found signs of vascular-ischemic lesions. Of the 30 patients with hemodynamic infarctions, 13 showed an exhausted autoregulatory reserve, while of 19 cases with territorial infarctions only 1 and of 10 with lacunar infarctions none had an exhausted CO2 reactivity. The difference is significant (p less than 0.01). PMID- 1791940 TI - Clinico-radiological spectrum of giant intracranial aneurysms. AB - A review of a series of 56 patients with a giant intracranial aneurysm showed that 28 presented with signs related to the mass effect and 19 with subarachnoid hemorrhage (SAH). Additional clinical signs observed were seizures, ischemia, and endocrinological disturbances. Fourty-five aneurysms involved the carotid artery territory and eleven the vertebrobasilar system. On computed tomography (CT) images partially thrombosed aneurysms (23 cases) showed 1) a marginal or central "target" appearance on contrast enhanced scans corresponding to the non thrombosed lumen as demonstrated by angiography, 2) capsular enhancement in 16 cases and 3) calcifications in 9. SAH occurred in 13 and 6 cases of non thrombosed and partially thrombosed aneurysms, respectively. Magnetic resonance imaging (MRI) in 6 cases showed several layers of thrombosis in 4 cases and a small signal void close to the parent artery. In one case of a non-thrombosed aneurysm, thrombosis was mimicked by flow artifacts of MRI. PMID- 1791941 TI - Cerebral blood flow and cerebrovascular reserve 5 years after EC-IC bypass. AB - CBF-studies using the Xenon-133-inhalation technique were performed in 18 patients with a unilateral carotid artery occlusion, 5.4 years after a STA-MCA procedure. For comparison we used the CBF data of 29 patients with the same diseases who had had conservative treatment for a variable period of time. CBF was measured during rest and after the intravenous administration of 1 g acetazolamide. During rest we found a significant interhemispheric difference in both groups. After activation with acetazolamide this difference disappeared in the bypass group, but not in the conservatively treated patients. Our data show that the bypass procedure obviously affects the vascular reserve capacity in a positive way over a long period of time. One criteria for success of STA-MCA procedures might be the cerebral reserve capacity tested with CBF-studies under activation. PMID- 1791942 TI - Clinical analysis and results of operative treatment of 41 brain abscesses. AB - In this study, 41 cases of cerebral abscess operated on in our clinics between 1977 and 1986 were investigated retrospectively. The surgical strategy and the factors affecting the mortality rate were discussed. It was confirmed that the most important factor affecting the mortality rate was the consciousness level of patients in the preoperative period. The importance of computed tomography (CT) for early diagnosis and management of brain abscess is stressed. PMID- 1791943 TI - Primary spinal malignant schwannoma: clinical, histological and cytogenetic findings. AB - Of the 19 patients who presented between 1980 and 1990 to the Department of Neurosurgery, University of Hamburg, F. R. G. with malignant schwannoma, 5 patients suffered from primary malignant spinal schwannoma (mean age 44 years, only one patient with von Recklinghausen's disease). Here we report the clinical, histological, and cytogenetic features of the five cases with primary malignant spinal schwannoma and discuss the prognostic aspects of this rare tumor. PMID- 1791944 TI - The anterior inferior cerebellar artery (AICA): clinical and radiological significance. AB - It is well known that the anterior inferior cerebellar artery (AICA) is difficult to visualize radiologically. As the analysis of 50 clinical cases shows, although the main branches of the AICA at the level of the basilar artery can be analyzed angiographically, the peripheral course is only vaguely visible. We examined 26 brains (postmortem) after selective resin-injection and preparation under an operation-microscope. Our results: 1. There is a reciprocal relationship between the development of the AICA and the PICA. 2. We can draw no conclusions concerning the pattern of the AICA of one side to the pattern on the other side. 3. The size of the AICA at the level of the basilar artery gives an indirect indication of the peripheral course. 4. The AICA and the cranial nerves are in a constant relationship to each other. Consideration of these relationships can help in the interpretation of angiograms done before microsurgical operations in the area of the cerebello-pontine angle. PMID- 1791945 TI - Amyloid angiopathy--a rare cause of intracerebral hemorrhage. AB - The cerebral amyloid angiopathy (CAA), morphologically characterized by amyloid deposition in the vessel walls which are altered to rigid tubes, is a chronic disease of the cortical and meningeal vessels and can cause intracerebral hemorrhages (1.5% of all intracerebral bleedings). We report the course of five surgically treated patients with lobar space-occupying intracerebral hemorrhages and CAA confirmed by histological examination. All patients were elderly (74-84 years), in good condition, and self-providing before the hemorrhage. There were no signs of dementia of the Alzheimer's type. In four cases, CT showed a hematoma in the parieto-occipital, and in one case in the temporo-parietal, region. After surgical evacuation, two patients recovered, one patient remained in bad condition, and two patients died from recurrent hemorrhage within two weeks. Spontaneous intracerebral hemorrhage of lobar localization in an elderly patient strongly suggests CAA. The prognosis seems to be poor in cases with recurrent hemorrhage, the other patients presented an uneventful course, comparable with patients operated on for intracerebral bleeding of other origin. Further investigations are necessary to elucidate the prognosis of this entity. PMID- 1791946 TI - Clinical signs associated with megadolichobasilar artery anomaly. AB - The elongation and ectatic course of the basilar artery (BA), called megadolichobasilar artery anomaly (MDBAA) is a macroscopic description of a neuroradiologic finding. Clinically ischemic brain stem syndromes and peripheral cranial nerve disturbances especially of the trigeminal and facial nerves, cerebellar dysfunction and CSF circulation disturbances are observed. Seldom a subarachnoid hemorrhage is proven. In CT and MRI often a tumorlike mass with a ringlike contrast enhancement combined with a nonhomogeneous lesion due to partial thrombosis, is detected. Angiography in most cases shows fusiform dilatation of the BA, elongation of the top of the basilar trunk, asymmetric tortuosity or dislocation of the irregular shaped wall of the BA. Fifteen patients within the last 12 years are demonstrated. The role of reticular fiber deficiency in the media and defects of the elastic lamina as the basis of these malformations is reported. We discuss coincidental findings of MDBAA with atherosclerosis, congenital factors causing generalized vasculopathy, metabolic disturbances in form of so called inborn errors of metabolism and endocrine deficiencies. In cases with clinical signs the morbidity is remarkably high. PMID- 1791947 TI - Intraspinal hemangiopericytoma: case report and review of the literature. AB - Hemangiopericytoma, a tumor whose origin is controversial, rarely affects the central nervous system and is even more rarely spinal. We report a case of the spinal variety and discuss its clinical and pathological features, diagnosis, and treatment in the light of relevant literature. PMID- 1791948 TI - Multifactorial genesis of neuroradiological "leucoencephalopathies.". AB - Three cases of neuroradiologically diagnosed "leucoencephalopathy" are reported. Histopathological examination disclosed Binswanger's encephalopathy in Case 1, congophilic angiopathy with secondary leucoencephalopathy in Case 2, and HIV encephalopathy with secondary white matter changes in Case 3. These three cases demonstrate the unspecificity of neuroradiological findings in "leucoencephalopathy". PMID- 1791949 TI - Vasospasm after traumatic subarachnoid haemorrhage: transcranial Doppler evaluation. Case report. AB - A case of vasospasm after traumatic subarachnoid haemorrhage (SAH) is reported here. Transcranial Doppler Sonography (TCD) was used to evaluate mean flow velocity (MFV) changes of the basal cerebral arteries related to vasospasm. Acceleration of MFV of the right middle cerebral artery (MCA) indicating vasospasm was first noted on TCD evaluation, and then proved by carotid angiography (CAG). Evaluation of all TCD results revealed that the process of relaxation or normalization of the spastic artery started from the proximal side of the basal intracranial artery and gradually moving to the distal side. This interesting phenomenon could be a common process found in vasospasm cases. PMID- 1791950 TI - [The current status of liver transplants]. PMID- 1791951 TI - [Acute pseudoabdomen. A proposed nosographic picture]. AB - The authors put forward a new and original classification of the clinical pictures of acute pseudo-abdomen. They separate the cases due to extra-abdominal causes which are not marked by the essential features of acuity and severity from those which do not require surgery. PMID- 1791952 TI - [Our experience in the treatment of upper digestive bleeding due to a nonvaricose lesion]. AB - The authors examine the causes and incidence of upper digestive bleeding by no variceal lesions, emphasizing the better and better results obtained by endoscopic management of this surgical emergency. Personal experience with urgent endoscopic sclerotherapy of these haemorrhages and the good results obtained are then reported. PMID- 1791953 TI - [The surgical therapy of pulmonary aspergilloma. Our experience]. AB - Between 1971 and 1986 11 patients suffering from pulmonary aspergilloma were seen in the thoracic surgery service at Genova-Sampierdarena Hospital. Nine patients underwent thoracotomy. Lobectomy was the most frequent operation. Complications occurred in 3 patients (33%). There were no recurrent symptoms in any of them over a mean follow-up of 4 years. The remaining two patients were treated by instillation of antifungal agents into the aspergilloma cavity. There was no systemic toxicity and in one patient the mycetoma resolved. The authors conclude that pulmonary resection can provide effective long-term treatment, while intracavity infusion of antifungal agent can be a successful nonoperative method in critically ill patients. PMID- 1791954 TI - [The treatment of the patient undergoing a thoracotomy after pneumonectomy. Our experience in 2 clinical cases]. AB - The authors report personal experience in two patients undergoing thoracotomy after previous pneumonectomy. They examine the risks and the complications of such surgical procedure (right ventricular failure, respiratory failure). Management consists of restriction of liquid infusions, digitalis administration, use of drugs that have little effect on haemodynamics, epidural analgesia by morphine. PMID- 1791955 TI - [The endoluminal drainage of the main biliary tract. The indications for and advantages of a 2-way "gastro-duodeno-choledochal" tube]. AB - The authors reports his personal experience in performing intraluminal drainage of the common biliary duct by a two-way "Gastroduodenal-choledochal" tube, specifically realized. The author has been using this biliary drainage technique in some patients and prefers this suction method as an alternative to other in carrying out some biliary surgical procedures. PMID- 1791956 TI - [Acute diverticulitis of the cecum. A clinical contribution and review of the literature]. AB - Even if it is a rare disease, acute cecal diverticulitis is a diagnostic and therapeutic challenge for the surgeon. The authors present their experience synthetically and compare their results with the literature. Their experience is not very different from the results reported by many other authors. Five cases underwent radical treatment (right colectomy) and 6 cases were treated with a more conservative operation (diverticulectomy and/or invagination). Only one patient was treated medically. Acute diverticulitis of the cecum requires the solution of three difficult questions: 1) preoperative diagnosis; 2) intraoperative diagnosis; 3) correct therapeutic procedure. PMID- 1791957 TI - [Coarctation and hypoplasia of the abdominal aorta]. AB - In this study we report one case of abdominal aortic coarctation of unknown etiology, probably congenital or connatal, and two cases of aortoiliac occlusion in young non-diabetic patients, with an intrinsically small aortoiliac tree. These syndromes usually appear in young age; the principal clinical features are arterial insufficiency involving the lower extremities, often well tolerated, and hypertension. The differential diagnosis is with primitive atherosclerotic or inflammatory pathology. Echography and Doppler-echography can be helpful in the diagnosis, but intra arterial digital angiography is mandatory in confirming it. Medical therapy is usually unsuccessful, especially in controlling blood pressure, therefore surgery still remains the treatment of choice, together with PTA that can be applicable in selected cases. PMID- 1791958 TI - [Intrathoracic hemangiopericytoma localized in the mediastinum]. AB - The paper reports a case of intrathoracic hemangiopericytoma localised in mediastinum which was brought to the authors attention and treated surgically. Having analysed the tumour's macro- and microscopic histological and biological features and the most suitable methods of diagnosis, the authors stress that, in line with international literature, radical surgery extended to the surrounding tissues is the elective surgical treatment for hemangiopericytoma in a mediastinal site. PMID- 1791959 TI - [A choledochal diverticulum. A case report]. AB - Due to the rarity of choledochal cystic dilatation, the authors report a clinical case of common bile duct diverticulum. This diverticulum was histologically composed of gastric ectopic mucosa (pyloric type) and it clinically caused chronic abdominal pain (in a young woman). The authors analyse the literature of the above pathology. PMID- 1791960 TI - Building the hothouse: how mothers construct academic environments. PMID- 1791961 TI - Pressure or challenge in preschool? How academic environments affect children. PMID- 1791962 TI - Early academics: introduction to the debate. PMID- 1791963 TI - Disadvantaged children and curriculum effects. PMID- 1791964 TI - Public school preschools and the disadvantaged. PMID- 1791965 TI - Preschool education: for whom and why? PMID- 1791966 TI - Alzheimer's disease: beta-amyloid precursor protein expression in plaques varies among cytoarchitectonic areas of the medial temporal lobe. AB - The anatomic distributions of beta-amyloid peptide (beta AP) and beta-amyloid precursor protein (beta APP) in the medial temporal lobe were examined with immunocytochemistry in Alzheimer's disease. beta AP-containing plaques were found most frequently in the cortical and basal regions of the amygdala, and in the hippocampal CA1, subiculum, and dentate molecular layer. beta APP expression in plaques was found in a similar distribution, with some, but not all beta AP plaques also showing beta APP. In the cortical and basal amygdala, some cases showed beta APP in the centers of plaques, whereas in the hippocampus, all cases displayed beta APP mainly in plaque neurites. The lateral regions of the amygdala contained mainly diffuse beta AP plaques which had little beta APP. These findings suggest that although beta APP expression and beta AP deposition generally colocalize, processing of beta APP may vary among closely interconnected anatomic regions. PMID- 1791967 TI - The expression of a fucosyl-ganglioside in the molecular layer of the dentate gyrus following entorhinal cortical lesions. AB - alpha-Galactosyl (alpha-fucosyl) GM1 is a ganglioside present in the outer two thirds of the molecular layer of the dentate gyrus of the rat. This region is the terminal zone for afferents from the entorhinal cortex. In order to evaluate changes in ganglioside expression in this region following deafferentation, a monoclonal antibody (WCC4) was used to monitor the ganglioside from 3 to 30 days following a lesion to the entorhinal cortex. From 7 to 14 days postlesion, there was a relative decrease in the width of the band of immunohistochemical staining on the ipsilateral (lesioned) as compared with the contralateral (non-lesioned) side. The results of these studies indicate that alpha-galactosyl (alpha-fucosyl) GM1 is likely to be associated with dendritic shafts in the dentate molecular layer. PMID- 1791968 TI - The histochemical localization of acetylcholinesterase in the rainbow trout saccular macula by electron microscopy. AB - The hair cells of the teleost saccular macula are morphologically similar to type II vestibular hair cells of higher vertebrates. The two types of nerve endings at the base of the saccular hair cells are the non-vesiculated endings, thought to be afferent, and the vesiculated terminals, presumed to be efferent. The vesicles in the presumptive efferent endings are predominantly round and clear, and a few are dense cored. The morphological characteristics of the vesiculated endings resemble those of presumptive efferent cholinergic endings present in the inner ear of higher vertebrates. In the present study, vesiculated nerve endings were examined histochemically for acetylcholinesterase. The reaction product was observed along the plasma membranes of the vesiculated nerve endings synapsing both with the hair cells and afferent endings, but was not seen at non vesiculated endings on hair cells. No staining was observed in control specimens incubated in the presence of eserine sulfate, an inhibitor of acetylcholinesterase. These results suggest that the vesiculated nerve endings in the trout saccular macula contain cholinergic elements. PMID- 1791969 TI - Further behavioral evidence that colorectal distension is a 'noxious' visceral stimulus in rats. AB - 'Noxious' stimuli are pain-producing stimuli and have been traditionally defined as tissue damaging. This definition is not valid for visceral stimuli. Hence, behavioral definitions are needed. Awake, unanesthetized rats learned to passively avoid colorectal distension. The rate of acquisition increased as a function of the distending pressure. Two manipulations, intrathecal morphine and neonatal treatment with capsaicin, attenuated acquisition of avoidance behavior whereas the production of colorectal inflammation using turpentine enhanced acquisition of this behavior. These findings are consistent with the hypothesis that aversion to the stimulus is due to the 'noxious' nature of the stimulus. PMID- 1791970 TI - The glossopharyngeal nerve of the axolotl labeled with carbocyanine dye (diI). AB - Fluorescent carbocyanine dye (diI) was used to label the glossopharyngeal (IX) nerve in the fixed preparation of the Mexican salamander, axolotl. When the cell bodies were viewed with a confocal laser scanning microscope and Nomarski optics, the cytoplasm was brightly fluorescent, but not the cell nucleus. The cell bodies which send peripheral axons in the two branches of the IX nerve were mainly distributed in the rostral part of the combined glossopharyngeal-vagus ganglion, but a few cells were also distributed in the middle and caudal parts. This may indicate a relatively undifferentiated organization of the IX nerve in the ganglion. PMID- 1791971 TI - Reduction of [125I]Bolton Hunter CCK8 and [3H]MK-329 (devazepide) binding to CCK receptors in the substantia nigra/VTA complex and its forebrain projection areas following MPTP-induced hemi-parkinsonism in the monkey. AB - Cholecystokinin (CCK) receptors were visualized autoradiographically using [125I]Bolton Hunter CCK8 ([125I]BHCCK8) in the fore- and midbrain of 3 monkeys rendered hemi-parkinsonian by unilateral intra-carotid infusion of 1-methyl-4 phenyl-1,2,3,6-tetrahydropyridine (MPTP). More specifically, CCK-A receptors were detected using [3H]MK-329 (devazepide), a peripheral-type (CCK-A) receptor antagonist. In the substantia nigra pars compacta, ipsilateral to the toxin infusion, where dopamine D2 receptors (labelled with [3H]sulpiride) were lost, there was a decrease in the binding of both [125I]BHCCK8 and [3H]MK-329. Binding of the two CCK ligands was also reduced in the ipsilateral nucleus accumbens and most medial part of the caudate nucleus, whereas 3H-sulpiride binding was increased in the lateral caudate nucleus and putamen. These results indicate that CCK-A receptors may be located on dopaminergic cells within the substantia nigra, which are lost in the parkinsonian brain, and may also be present on dopaminergic terminals within restricted regions of nigral/ventral tegmental area projection sites. PMID- 1791972 TI - The effects of external calcium on the N-methyl-D-aspartate induced short-term potentiation in the rat hippocampal slice. AB - The effect of altered extracellular Ca concentration was studied on the N-methyl D-aspartate (NMDA) induced short-term potentiation (STP) of the population excitatory post-synaptic potential recorded from the stratum radiatum of CA1 of the rat hippocampal slice. Perfusion of 130 microM of NMDA for 10 s in control media containing 2.0 mM extracellular Ca evoked an STP with a maximum amplitude of 46% and a duration of 16 min. Perfusion of media containing a reduced Ca concentration of 0.8 mM or 1.0 mM did not alter the amplitude or time course of the STP. However, raising the Ca concentration to 3.0 mM or 4.0 mM caused a significant reduction in the amplitude of the STP to 23% and 2% respectively. The abolition of the NMDA induced STP in 4 mM Ca could not have been produced by response saturation since an identical long-term potentiation (LTP) was produced in this high Ca media as in the control media. These studies show that the NMDA induced STP has a very different Ca dependency to LTP. PMID- 1791973 TI - Normal beta-NGF content in Alzheimer's disease cerebral cortex and hippocampus. AB - Nerve growth factor (beta-NGF) is known to have beneficial effects on cholinergic cell survival and to function both in vivo and in vitro. It has been speculated that this protein, or the lack of it, may be involved in the aetiology of Alzheimer's disease (AD). We describe the measurement of beta-NGF content in 4 regions of the cerebral cortex and the hippocampus in AD brain compared with brain tissue from age-matched normal subjects using a sensitive sandwich immunoassay (ELISA). There was no difference in beta-NGF content in any region examined in AD compared with normal values despite the marked loss of cortical cholinergic function. PMID- 1791974 TI - Effects of NMDA and calcium channel antagonists on regional cerebral blood flow. AB - N-Methyl-D-aspartate (NMDA) antagonists and voltage-dependent calcium channel antagonists were tested to determine potential effects on regional cerebral blood flow in the normal rabbit brain. Ketamine had no effects on cortical or hippocampal blood flow, but was found to significantly decrease blood flow in the inferior colliculus. MK-801 decreased blood flow in almost all regions of the brain tested. On the other hand, nimodipine significantly increased flow in the cortex, hippocampus, and tegmentum. Dextromethorphan and dextrorphan, which have been shown to act at the NMDA receptor as well as the dihydropyridine calcium channel, decreased blood flow in the inferior colliculus, but showed no effects in the cortex or hippocampus. These results suggest that the neuroprotective NMDA antagonists do not increase blood flow primarily in the normal brain. PMID- 1791975 TI - The effects of quisqualate and nocodazole on the organization of MAP2 and neurofilaments in spinal cord neurons in vitro. AB - The relationship between microtubules, neurofilaments and microtubule-associated protein (MAP)2 was investigated in spinal cord neurons grown for up to 14 days in vitro. Neurons were labelled using antibodies against MAP2, neurofilaments and tubulin, and immunofluorescence analyzed by confocal microscopy. A well structured network of neurofilaments and microtubules was observed in unstimulated cultures. MAP2 staining was poorly structured but became more filamentous following depolymerization of microtubules with nocodazole. Double staining experiments suggested that MAP2 was now closely associated with neurofilaments in cell bodies and dendrites. Stimulation of cultures with excitatory amino acids increased the resistance of the microtubular cytoskeleton to depolymerization by nocodazole. Again double-labelling experiments demonstrated an increased association between neurofilaments and MAP2 immunofluorescence. Previous results suggested that the stability of the neuronal cytoskeleton could be modulated by glutamate receptors acting through an increased binding of MAP2 to microtubules. From the results presented here, we further suggest that cross-linking of neurofilaments to microtubules may also play a role in this process. PMID- 1791976 TI - Muscarinic receptor activation induces a prolonged post-stimulus afterdepolarization with a conductance decrease in guinea-pig olfactory cortex neurones in vitro. AB - The persistent excitation of guinea-pig olfactory cortical neurones in vitro by the muscarinic agonist oxotremorine-M (OXO-M) was investigated. In OXO-M (10-20 microM), a slowly-decaying afterdepolarization (sADP) accompanied by sustained repetitive firing was induced following a long depolarizing stimulus. The corresponding slow inward current (IADP) revealed under voltage clamp behaved like a K(+)-mediated tail current, but was associated with a decreased membrane conductance. IADP was insensitive to tetrodotoxin (TTX), Ba2+, Cs+, or 4 aminopyridine (4-AP), but was blocked by 500 microM TEA or TBA (tetrabutylammonium). The OXO-M response and IADP were also reduced by Cd2+ or Ca(2+)-free solution, suggesting a dependence on Ca(2+)-entry. We propose that OXO-M induces a novel outward K+ current that can be slowly de-activated by Ca(2+)-entry during a depolarizing stimulus. Summation of IADP tail currents could contribute to the sustained muscarinic excitation of mammalian cortical neurones. PMID- 1791977 TI - A neural network model of neural activity in the monkey globus pallidus. AB - A 3-layer neural network model was constructed to determine the discharge patterns of neurons within the globus pallidus (GP) which would be required to run a sequence of movements at the motor cortical level. The model was based on the presence of tonic and phasic neuronal activity within the motor cortical region; that positive feedback was required to maintain tonic neuronal activity and that phasic neuronal activity was required to initiate and terminate the tonic neuronal activity. The model predicted the presence of both phasic and tonic activity within the middle layer (layer 2; GP) of the model in order for the motor cortical regions (layers 1 and 3) to be able to run and to maintain the movement sequence. This prediction was in keeping with our electrophysiological findings within GP. PMID- 1791978 TI - Neuronal dysfunction at the border of focal lesions in cat visual cortex. AB - Traditional concepts assume that traumatic or ischemic brain lesions are surrounded by regions with depressed neuronal function. More recently hyperactivity gained increasing attention as excitotoxic mechanisms become effective at certain stages of neuronal injury. Single cell recordings in the surrounding of small focal lesions in the cat visual cortex revealed both types of functional pathology 1-30 days after lesioning. A rim of suppressed neurons surrounded a completely silent core. Cells further away from the lesion showed bursts and long lasting hyperactivity with extremely high discharge rates. Consequently, the volume of disturbed tissue was considerably larger than the region of initial cell death. This halo of dysfunction may be important for neurological symptoms evoked by cortical lesions. PMID- 1791979 TI - Immunoneutralization suggests that calcitonin gene related peptide regulates gastric emptying in the rat. AB - The role of calcitonin gene related peptide (CGRP) in controlling gastric emptying was examined in conscious gastric fistula rats. Rats were immunized with CGRP conjugated to thyroglobulin to produce circulating antibodies for neutralization of the endogenous peptide; control rats received carrier thyroglobulin alone. In the latter acid, protein and hypertonic solutions delayed gastric emptying; in rats with CGRP antibodies the action of acid and hyperosmolal solutions, but not protein, was reversed. The data are compatible with the idea that acid and hyperosmolal solutions release CGRP at the peripheral terminals of visceral afferents in the upper gastrointestinal tract which in turn modifies motility to slow gastric emptying. PMID- 1791980 TI - Cysteinyldopamine is not incorporated into neuromelanin. AB - The pigment of human substantia nigra, neuromelanin, has been thought to be derived from dopamine. To examine the genesis of neuromelanin, we advanced a new hypothesis that neuromelanin is formed by oxidation of dopamine and cysteinyldopamine. On the basis of this hypothesis, synthetic neuromelanins were obtained by tyrosinase oxidation of dopamine in the presence of various ratios of cysteine and were hydrolyzed with hydriodic acid to obtain 4-amino-3 hydroxyphenylethylamine (AHPEA). The AHPEA content in these synthetic melanins was shown to be proportional to the sulfur content. Eleven samples of human substantia nigra were treated as well and contents of AHPEA were found to be only trace amounts. These results suggest that cysteinyldopamine may not be incorporated into neuromelanin. PMID- 1791982 TI - Calretinin, a neuronal calcium binding protein, inhibits phosphorylation of a 39 kDa synaptic membrane protein from rat brain cerebral cortex. AB - The neuronal calcium binding protein calretinin was studied for possible effects on brain protein phosphorylation. Calretinin (100 nM) inhibited the appearance of a calcium stimulated 39 kDa phosphoprotein within a synaptic membrane fraction following sucrose density centrifugation. Calmodulin or a specific protein kinase C inhibitor had no effect on either the phosphorylation of the 39 kDa protein or the inhibition produced by calretinin. At the same concentration, calretinin produced a slight increase in the phosphorylation of several other synaptic membrane proteins which appeared additive with the stimulation produced by either calmodulin or phosphatidylserine in the presence of calcium. PMID- 1791981 TI - Dopamine- and adenosine-3':5'-monophosphate (cAMP)-regulated phosphoprotein of Mr 32,000 (DARPP-32) in the retina of cat, monkey and human. AB - The cellular localization of a dopamine- and cAMP-regulated phosphoprotein of Mr 32,000 (DARPP-32) was investigated in cat, monkey and human retina by immunohistochemistry. In cat, DARPP-32-immunoreactive cell bodies identified as Muller cells were demonstrated in the inner nuclear layer (INL) with processes closely surrounding the cell soma of photoreceptors in the outer nuclear layer. Some DARPP-32-IR cells were also seen in the nerve fiber layer (NFL) sending processes to the inner plexiform layer. In monkey and human retina, DARPP-32-IR cell bodies were also demonstrated in the INL, with few cells located in the NFL. PMID- 1791983 TI - Neurogenesis of ascending supraspinal projection neurons: ipsi- versus contralateral projections. AB - The present study tests the hypothesis that contralaterally projecting supraspinal projection neurons (SPNs) are generated prior to ipsilaterally projecting SPNs. Neuronal time of origin was determined by injecting pregnant rats with tritiated thymidine on one of embryonic (E) days E12 through E15. In mature offspring of thymidine-treated dams, SPNs in the lumbar cord were retrogradely labelled with True Blue delivered at the site of a hemisection in spinal segment C3. Ipsi and contralaterally projecting SPNs in laminae I, VII and VIII and the lateral spinal nucleus, which are known to give rise to long sensory pathways, were generated simultaneously throughout their neurogenic period (E12 E14), while ipsilaterally projecting SPNs in lamina IV and the nucleus dorsalis, which give rise to short sensory pathways, completed neurogenesis one day later (E15). Results suggest that the projection target and its distance from the nerve cell body of origin are more consistent correlates of the duration of the neurogenic period than the course of the axon. PMID- 1791984 TI - Neuroma formation and numbers of axons in a rat model of experimental peripheral neuropathy. AB - Two weeks following chronic partial constriction of rat sciatic nerve, the perineurium was disrupted and a neuroma had formed at the constriction site in all nerves (n = 5). Axon counts demonstrated an 84-99% and a 62-84% decrease in myelinated and unmyelinated axons respectively, distal to the lesion. Distally, the majority of surviving myelinated axons had diameters of less than 5.0 microns. There was considerable disparity in fiber loss from animal to animal, but similar behavioral changes were demonstrated by all animals. These results are discussed with reference to previously published data and possible mechanisms underlying the behavioral manifestations of this neuropathy model. PMID- 1791985 TI - Stimulation of mono- and diacylglycerol lipase activities in ibotenate-induced lesions of nucleus basalis magnocellularis. AB - Ibotenic acid was injected into the nucleus basalis magnocellularis region of rat brain in order to study whether an elevation of lipase activities was associated with the degeneration of cholinergic neurons in this potential animal model of Alzheimer's disease. Two plasma membrane fractions were prepared from different regions of ibotenate injected (right hemisphere) and non-injected (left hemisphere) rat brain. One plasma membrane fraction was from synaptosomes (SPM) and the other from glial and neuronal cell bodies (PM). Activities of mono- and diacylglycerol lipases in these plasma membrane fractions were markedly increased (3- to 5-fold) in hippocampus, midbrain and frontal cortical regions of rat brain at 10 days after the injection of ibotenate. The activity of choline acetyltransferase was decreased in frontal cortex but unchanged in hippocampus and midbrain. Our results suggest that the increase in lipase activity is much more widespread and non-specific than is the decrease in cholinergic function. PMID- 1791986 TI - Sequencing of exons 16 and 17 of the beta-amyloid precursor protein gene in 14 families with early onset Alzheimer's disease fails to reveal mutations in the beta-amyloid sequence. AB - A mutation within exon 17 at codon 717 of the beta-amyloid protein precursor (APP) gene is one cause of early onset familial Alzheimer's disease. Direct sequencing of exons 16 and 17 of the beta-amyloid precursor protein gene in 14 families with familial early onset Alzheimer's disease without the known pathogenic mutation (APP717) failed to reveal other mutations within the beta amyloid sequence in this form of the disorder. PMID- 1791987 TI - Anatomical evidence for an intergeniculate leaflet in Rana pipiens. AB - The projections of the nucleus of Bellonci and the anterior thalamic nucleus in Rana pipiens appear to be remarkably similar to those that have been described for the mammalian intergeniculate leaflet. The connections of these nuclei were examined using both the anterograde and retrograde transport of horseradish peroxidase. Afferents to the neuropil of Bellonci and its nucleus include bilateral projections from the retina, the contralateral nucleus of Bellonci, and anterior thalamic nucleus as well as bilateral projections from the pretectum and the ipsilateral suprachiasmatic nucleus. Efferent projections observed following HRP injections in the anterior thalamus consist of three components: (1) a ventral hypothalamic-suprachiasmatic and commissural projection, (2) a dorsal descending tract to the pretectum and tectum, and (3) a ventral descending tract to the somatomotor brainstem. PMID- 1791988 TI - Acetylcholine and muscarinic agonists increase synaptic ribbon numbers in the rat pineal. AB - Mammalian pinealocytes possess synaptic ribbons (SR) which are commonly present in photoreceptor cells at synaptic junctions. Pineal SR numbers undergo a diurnal rhythm parallel to that of pineal N-acetyltransferase (NAT) activity and melatonin levels. Recent findings suggest that SR numbers, unlike NAT activity and melatonin synthesis and release, do not seem to be regulated by adrenergic mechanisms or neuropeptides in adult rats. Since the pineal gland also receives cholinergic nerve fibres, we have investigated in vitro effects of acetylcholine (ACh) and carbamyl-beta-methylcholine (CBMC; a specific muscarinic agonist) in the presence and absence of pirenzipine (a specific inhibitor of muscarinic M1 receptors). ACh and CBMC increased SR numbers significantly. Pirenzipine inhibited the CBMC-induced increase in SR numbers. On the basis of these findings, it is suggested that cholinergic agonists increase pineal SR numbers by acting through muscarinic M1 receptors. Hence muscarinic mechanisms may have a functional role in pineal physiology. PMID- 1791989 TI - Alterations of [3H]inositol 1,4,5-trisphosphate binding in the postischemic rat brain. AB - Chronological changes of [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. One day after the ischemia, [3H]IP3 binding sites decreased significantly compared with the control values in the lateral segment of the caudate putamen and the cerebral cortex, both supplied by the occluded MCA. Moreover, 3 days after the ischemia, a significant decrease of [3H]IP3 binding sites was observed in the substantia nigra of ischemic side. In the ipsilateral thalamus, however, there was no 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- 1791990 TI - Sino-aortic baroreceptors are not involved in the potentiation of vasopressin or oxytocin secretion observed after noxious stimuli in the rat. AB - The possibility that arterial baroreceptors may be involved in the potentiation of vasopressin or oxytocin secretion observed after noxious stimuli was tested in male rats after sino-aortic denervation (SAD). There was no significant difference in plasma level of vasopressin or oxytocin between the SAD and the corresponding sham-operation control (SHAM) groups with or without electric shocks. An i.p. injected alpha 1-adrenergic receptor antagonist, prazosin, decreased arterial blood pressure both in the SAD and in the SHAM groups. However, the increased levels of these hormones after prazosin were significantly lower in the SAD than in the SHAM groups. Reflexly evoked tachycardia after prazosin occurred in the SHAM but not in the SAD groups. These results suggest that afferent neural signals originating from arterial baroreceptors are not involved in potentiation of vasopressin and oxytocin secretion after noxious stimuli in the rat. PMID- 1791991 TI - Evidence for intrinsic control of scrapie pathogenesis in the murine visual system. AB - Using the optic nerve to route scrapie infection into the brain reduces the initial spread of the disease to well-defined neuronal relays, and simplifies the observation of cause and effect of agent transport, replication and degeneration of the nervous system. One drawback of intraocular targeting of infection is the relatively long incubation periods required to produce clinical disease. By using highly-enriched fractions of infectivity and two models of murine scrapie, we have found that this time delay is not simply due to the limited amount of infective inoculum that can be injected into the eye. This provides evidence of intrinsic control of scrapie pathogenesis within the murine visual system. PMID- 1791992 TI - [3H]PK 11195 and the localisation of secondary thalamic lesions following focal ischaemia in rat motor cortex. AB - The peripheral-type benzodiazepine binding site (PTBBS) ligand, PK 11195, is known to be a marker of damage in the central nervous system, the binding being predominantly to macrophages. Using photochemically induced focal cortical ischaemia as a lesion model in the rat, we have investigated the detection of secondary lesions using [3H]PK 11195 and ex vivo autoradiography. Secondary lesions in the thalamus became apparent during the second week post-lesioning, at a time when [3H]PK 11195 binding around the primary lesion was beginning to subside. Using Brain Browser software, the identity of the labelled thalamic nucleus was confirmed, objectively, as the ventrolateral nucleus, known to have reciprocal connections with the lesioned cortical area. As with the primary lesion, high densities of PTBBS correlated with infiltration of macrophages. Three-dimensional reconstruction of [3H]PK 11195 autoradiograph images showed binding along white matter tracts between the primary and secondary lesions. We conclude that radiolabelled PK 11195 given in vivo can be used in the visualisation of secondary lesions and their associated degenerating tracts. PMID- 1791993 TI - Motoneuron survival in vitro: effects of pyruvate, alpha-ketoglutarate, gangliosides and potassium. AB - When grown in a serum and muscle extract containing medium, about 20% of chick motoneurons survived for one week. The presence of pyruvate during the first hour of culture doubles the number of motoneurons that survive. The subsequent addition of 5 mM alpha-ketoglutarate, 10-20 mM potassium, or 100 microM GM1 ganglioside results in a further increase in motoneurons surviving. These effects of alpha-ketoglutarate, potassium and GM1 ganglioside are not additive. Using such compounds in the culture medium, one can have a three-fold increase in the survival of motoneurons. PMID- 1791994 TI - Differential effects of alcohols on the spike threshold of an identified motor axon in a crab (Pachygrapsus crassipes). AB - Observations were made on the fast bender excitor (FBE) axon in autotomized crab limbs bathed in salines made up with different alcohols. It has been shown previously that the presence of ethanol at a certain level causes a single action potential to generate additional spikes in the peripheral axon branches. The present study examines the level of different alcohols required to induce peripheral spike generation. For primary alcohols, increasing the molecular weight decreased the level of alcohol required to produce peripheral spike generation. The threshold level of 2-butanol was greater than 1-butanol, but less than tertiary-butanol. These results are explained in terms of the partition coefficient, so that an alcohol with a higher partition coefficient enters the lipid bilayer more readily, thus a lower threshold level of that alcohol is required in the saline to generate additional spikes. PMID- 1791995 TI - c-Fos response to administration of catecholamines into brain by microdialysis. AB - The present studies investigated the use of microdialysis for the infusion of catecholamines into the brain in studies of immediate early gene (IEG) activation. c-Fos like immunoreactivity was examined histochemically in cortical tissue surrounding a dialysis probe implanted in the medial prefrontal cortex. No c-fos reactivity was observed at 48 h post implantation in control animals not probe-infused or infused 2 h earlier with Ringer's buffer. Marked reactivity was found in animals infused with a solution of norepinephrine (NE). The latter was blocked by coinfusion of the beta adrenoceptor antagonist, timolol. It is concluded that direct infusion of NE by dialysis can induce c-fos expression in cells of the cerebral cortex and that this effect is primarily via beta adrenoceptors. Microdialysis therefore represents a useful technique in studies of IEG responses to brain catecholamines. PMID- 1791996 TI - A human phase-response curve to light. AB - Using 'classical' experimental protocols, a human phase-response curve (PRC) to a single 3-h bright light pulse has been established. When the light pulse was centred slightly before the time of body temperature minimum, the circadian system delayed, whilst a pulse slightly after the minimum advanced it. Maximum phase shifts were about 2 h. When light pulses over 3 successive cycles were used, larger shifts (4-7 h) were produced. It is concluded that the human PRC does not differ in principle from that found in other species, except with respect to the light intensity required. PMID- 1791997 TI - Comparison of fast responses to serotonin and 2-methyl-serotonin in voltage clamped N1E-115 neuroblastoma cells. AB - The activation of 5-HT3 receptors by 5-HT and 2-methyl-5-HT was studied with 'concentration-jump' techniques in voltage-clamped N1E-115 cells grown in culture. When applied to single cells with a fast perfusion technique, both agonists induced currents the on-rate kinetics of which were concentration dependent. Based on the time constants of current kinetics and subsequent estimates of agonist association and dissociation rates, an apparent Kd of 1.3 microM was determined for 5-HT, a value in agreement with binding and functional studies. Receptor activation by 2-methyl-5-HT was slower, consistent with its lower potency as compared to the parent compound. In addition, the rise time of 2 methyl-5-HT-mediated currents was affected by hyperpolarizing membrane potential. The results show evidence of different molecular behaviors for the two agonists. PMID- 1791998 TI - Alpha-tocopherol supports the survival and neurite extension of neurons cultured from various regions of fetal rat brain. AB - The effects of alpha-tocopherol on neurons of fetal rat brain were studied in tissue culture. alpha-Tocopherol supported the survival and enhanced neurite extension of neurons cultured from cerebral cortex, hippocampus, striatum, and septum. The survival effect was observed at concentrations of 10(-9) to 10(-6) M. More than 60% of the cortical neurons could survive for 9 days at 10(-7) or 10( 6) M alpha-tocopherol, whereas almost all neurons died within 2 days in its absence. These results suggest that alpha-tocopherol may be involved in mechanisms regulating neuronal survival and neurite formation in the central nervous system, and indicate that alpha-tocopherol may be an excellent reagent to facilitate neuronal survival in culture. PMID- 1791999 TI - Impairments in reaching during reversible inactivation of the distal forelimb representation of the motor cortex in the cat. AB - We report changes in the performance of a prehension task in the cat following focal inactivation of the rostrolateral subregion of the distal forelimb area of motor cortex (MCx) produced by muscimol microinjection. Animals reached into a cylindrical target to retrieve a morsel of food. Movements consisted of distinct lift and forward thrust phases following which the food was grasped and retrieved. In separate blocks of trials an obstacle was inserted in the path of the limb. Impact evoked an immediate compensatory trajectory change to bypass the obstruction and, on subsequent trials, an adaptive trajectory change to avoid impact. Inactivation produced three major defects: (1) uncompensated aiming biases to a location above the target; (2) loss of coordination of the grasp and food retrieval; and (3) impairment in trajectory adaptation to avoid impact of the limb with an obstacle. Thus, focal inactivation of the distal forelimb area of MCx produced disordered control of all forelimb joints. The impairment in trajectory adaptation and failure to compensate for aiming biases suggests that the MCx is important in motor learning. PMID- 1792000 TI - Comparisons between patterns of convulsions induced by two beta-carbolines in 10 inbred strains of mice. AB - The beta-carbolines, methyl-beta-carboline-3-carboxylate (beta-CCM) and 6,7 dimethoxy-4-ethyl-beta-carboline-3-carboxylate (DMCM) are known to have pharmacological properties opposite to those of agonistic benzodiazepines. Convulsions induced by these drugs lead to differential patterns, such as clonus, myoclonic or tonic seizures. In 10 different inbred strains of mice we investigated whether the responsiveness to the two drugs was the same, irrespective of the pattern of convulsions. We found the same ranking in the responsiveness of the strains to both drugs in the case of myoclonic seizures. No such correlation could be found for clonus or tonic seizures. Our conclusion is that the same genetic factors determine myoclonic seizures, whereas a plurality of mechanisms underly the other patterns. Thus, myoclonic seizures seem to be the most appropriate index for evaluating the convulsant action of beta-carbolines in genetic experiments. PMID- 1792001 TI - Reduced protein kinase C activity in sporadic Alzheimer's disease fibroblasts. AB - A decrease in the protein kinase C immunoreactivity and an altered protein phosphorylation have been reported in patients with Alzheimer's disease, but discordant results have been obtained from determinations of protein kinase C activity. By assaying the calcium- and phospholipid-dependent phosphorylation of a lysine-rich histone after detergent extraction, we have determined the total protein kinase C activity in fibroblasts from patients with sporadic Alzheimer's disease, age-matched controls and young subjects. The activity was not significantly different between young and aged controls, whereas it was significantly lower (0.70 +/- 0.12 vs 1.16 +/- 0.23 nmol/min/mg protein, P less than 0.01) in the patients. The total amount of protein kinase C estimated from the binding of phorbol dibutyrate to intact cells was also significantly lower (1.70 +/- 0.41 vs 2.48 +/- 0.54 pmol/mg protein, P less than 0.01). This decrease in protein kinase C activity suggests that abnormal protein phosphorylation might play a role in the pathogenesis of the disease. PMID- 1792002 TI - 5-Hydroxytryptamine hyperpolarizes CA3 hippocampal pyramidal cells through an increase in potassium conductance. AB - The firing rate of hippocampal pyramidal cells recorded from the CA3 subfield is inhibited by 5-hydroxytryptamine (5-HT, serotonin) or by electrical stimulation of the ascending serotonergic fibers from the raphe. The mechanism of action of this inhibitory effect produced by 5-HT has not been determined. Intracellular recording techniques in the hippocampal slice preparation were used to measure the effect of 5-HT perfusion on membrane properties of CA3 pyramidal cells. In 15 out of 16 cells tested, 5-HT elicited a pronounced hyperpolarization concomitant with a decrease in membrane resistance. The hyperpolarization was not altered with either potassium chloride or potassium methylsulphate electrodes; the hyperpolarization by 5-HT was not present when electrodes were filled with cesium chloride. The reversal potential of the 5-HT mediated response was determined to be-105.5 mV in 3 mM KCl buffer using single electrode voltage clamp techniques. Based on these results we conclude that the mechanism of action of the 5-HT inhibition of CA3 hippocampal pyramidal cell excitability is due to an increase in potassium conductance. PMID- 1792003 TI - Identification of 11-cis-retinal and demonstration of its light-induced isomerization in the chicken pineal gland. AB - Direct evidence is not available that (1) rhodopsin-like photopigment exists in the chicken pineal and that (2) the visual pigment is responsible for the light sensitivity of the gland. Therefore, the objective of this study was to test for the existence of visual pigment in the chicken pineal by means of the identification of 11-cis-retinal in this organ. 11-cis- and all-trans retinoids were extracted from light- and dark-adapted chicken pineals and analyzed by high performance liquid chromatography (HPLC) using the formaldehyde method. 11-cis Retinal was initially identified by coelution with an authentic standard. Further characterization was carried out by collecting the retinal from the HPLC eluant, subjecting it to reduction by sodium borohydride and then identifying the derived 11-cis-retinol using HPLC. Proportions of 11-cis-retinal to total pineal retinals were also studied from decapitated heads after light and dark adaptation. Analyses of dark-adapted, pooled chicken pineals revealed equal proportions of 11 cis and all-trans retinals at 2 h after dark and at night. Two hours of light adaptation resulted in the reduction of the 11-cis proportion (from 50%) to 26% of total retinals. These observations prove that 11-cis-retinal exists in the chicken pineal and that it undergoes light-induced cis to trans isomerization in a manner similar to the visual pigment chromophores in the vertebrate retina. PMID- 1792004 TI - Advances in ethopharmacology. Proceedings of a conference. Lisek, Czechoslovakia, April 2-6, 1991. PMID- 1792005 TI - Ethopharmacology: a historical perspective. AB - Ethopharmacology can be defined as the study of behavioral and other effects of drugs through the use of ethological concepts. The study of drug effects on natural action patterns (motor acts and postures listed in ethograms), with respect to natural settings and to behavior as a whole (all identifiable behaviors occurring during the measurement) represents the basic concepts of ethopharmacology. Although pioneers drew attention to the potential of the ethological approach in pharmacology in the early 1960s, the number of publications utilizing this approach has steadily grown only since the mid-1970s. In the 1980s, modern technology, such as videorecorders, microcomputers and software, has been more widely applied in ethopharmacological experiments, greatly facilitating the observation and quantitative analysis of multiple data. Ethopharmacology is not "another" behavioral pharmacology, but an integral part of it. Rather, it represents one of the tools which can be useful (and sometimes even indispensable) in achieving a better understanding of the behavioral effects of drugs. It is to be hoped that it will be used in concert with other approaches in the future. PMID- 1792006 TI - Measuring behaviour: the tools and the strategies. AB - Animal behaviour can be viewed as a stream of elements, which, once accurately described, can be counted and timed. Data acquisition techniques and tools are reviewed, and some strategies for collection and analysis of data using PC computers are suggested. Automated instruments are not satisfactory for the study of complex behaviour and as such systemic observation remains irreplaceable. IBM PC-type computers, with a wide range of analytical software (e.g., spreadsheets, statistical packages, technical graphics), are practical for data acquisition. Several systems which can satisfy different applications are reviewed. Some systems can communicate with a videorecorder, a facility which remarkably increases the accuracy of measurement; this is essential for meaningful analyses of the internal structure of behavioural streams (sequences, time patterns) or communication processes. The power of new tools enables behavioural measurement with the necessary complexity to allow a whole new set of questions to be addressed. However, it also increases demands for meaningful content and analysis of data. PMID- 1792007 TI - The description of rat drug-induced behavior: kinematics versus response categories. AB - The study of rat drug-induced locomotor behavior is largely based on the assumption that behavior consists of a sequence of response categories performed by the whole animal one at a time. By analysing this behavior under (+) amphetamine (5 mg/kg), we illustrate how even a precise definition of such categories may not be sufficient for the establishment of behavioral variables that have a "physiological reality." We describe the changes of relation between the parts of the rat's body in reference to selected coordinate systems, and show that a great variety of locomotor patterns observed under amphetamine can be reduced to as few as 3 descriptive component-variables. These continuous and relatively independent variables, which behave predictably in the course of drug action, operate simultaneously. Variations in their relative timing of onset and termination account for the apparent variability in observed behavior. The economy and generality of a description based on these variables suggest the existence of corresponding central mechanisms of control. PMID- 1792008 TI - Cholecystokinin-induced anxiety: how is it reflected in studies on exploratory behaviour? AB - Central cholecystokinin (CCK)-ergic neurotransmission has been implicated in the genesis of negative emotions. Most animal studies on the neurochemical background of CCK-induced anxiety have, up to date, exploited exploratory activity paradigms. The interaction of CCK with GABAergic inhibitory neurotransmission, mediated probably through CCK-B receptors, could be the neurochemical substrate for anxious type of exploratory behaviour. However, the CCK-A and CCK-B receptor mediated interactions of this neuropeptide with mesencephalic dopaminergic regulation of motivation for locomotor activity have the potential to interfere with the behavioural outcome from routine exploratory activity tests. Systemic treatment with CCK receptor antagonists is likely to influence both GABA- and dopamine-linked CCK-ergic neurotransmission, and therefore their effects in exploratory activity tests should be interpreted with caution. PMID- 1792009 TI - Exposure to the calls of predators of mice activates defensive mechanisms and inhibits consummatory behaviour in an inbred mouse strain. AB - As two-minute exposures to the tape-recorded calls of barn and tawny owls activate endogenous opioid-mediated analgesia mechanisms in laboratory mice, the behavioural effects of the calls of a variety of predator and nonpredator species were ethologically assessed. While no clear effect could be seen on cage orientated behaviour, the calls of the barn owl and tawny owl produced consistent increases in self-orientated, call-orientated and defensive behaviour indicating that these calls were recognised as belonging to predators. The call of the gull also produced an increase in defense, but, as this could be attributed to an increase in attend only, test animals may react to a change in stimulus properties without the gull call unequivocally representing a potential threat. These results indicate recognition of, and appropriate reaction to, the calls of known night-hunting, airborne primary predators of mice by an inbred laboratory strain. PMID- 1792010 TI - Differential effects of novel ligands for 5-HT receptor subtypes on nonopioid defensive analgesia in male mice. AB - The effects of a number of 5-HT receptor ligands were examined on nonopioid defensive analgesia in male DBA/2 mice. MDL 73005EF (0.05-1.0 mg/kg), a selective 5-HT1A receptor agonist, potently and dose-dependently inhibited the analgesic consequences of social defeat. CGS 12066B (0.5-10.0 mg/kg) and MK-212 (0.3-10.0 mg/kg), selective agonists for 5-HT1B and 5-HT1C sites, respectively, failed to influence this particular form of adaptive pain inhibition. Two 5-HT2/1C receptor antagonists, ritanserin (0.05-10.0 mg/kg) and ICI 169.369 (0.3-10.0 mg/kg), were also devoid of specific effects upon defensive analgesia. Both ritanserin and ICI 169,369 were found to have intrinsic analgetic efficacy and to induce behavioural changes indicative of increased defensiveness. These data, together with previous findings, confirm the specific involvement of 5-HT1A receptor mechanisms in the analgesic consequences of social defeat in male mice. Results are discussed in relation to the role of anxiety in adaptive pain inhibition. PMID- 1792011 TI - Ethopharmacology of copulatory disorder induced by chronic social conflict in male mice. AB - The present study was designed to investigate how the experience of fighting affects copulatory behavior in male mice and also to determine the effect of naloxone on the interaction between social conflict and copulatory disorder. To generate intraspecific fighting a resident-intruder paradigm was employed. Agonistic confrontations were terminated after 10 or 20 attack bites, and were repeated for 5 consecutive days. Twenty-four hours after the last confrontation test, both resident and intruder mice were tested with estrus females for 10 min. Compared to the control group without agonistic confrontation, intruder mice that had been attacked repeatedly showed a significant reduction of copulatory behavior. In contrast, attacking resident mice showed a significant increase in copulatory behavior. Pretreatment with naloxone (1 and 3 mg/kg, IP) prior to daily fighting failed to antagonize defeat-induced copulatory disorder. It would, therefore, appear that endogenous opioid mechanism may not participate in this phenomenon. PMID- 1792012 TI - Interacting effects of oxazepam in late pregnancy and fostering procedure on mouse maternal behavior. AB - The present study was designed to assess the proactive effects of late pregnancy benzodiazepine (BDZ) treatment on maternal behavior in the postpartum period, using cross-fostering procedures to control for the role of changes produced prenatally in the offspring. Outbred CD-1 mouse dams were treated with either oxazepam (OX, 15 mg/kg PO twice/day on pregnancy days 12-16) or vehicle (VEH). After parturition, entire litters were exchanged either within treatments (in fostered groups, IF) or between treatments (cross-fostered groups, CF), while additional litters were left undisturbed (un-fostered groups, UF). The behavior of lactating dams was observed in their home cages at 4, 8, and 12 days postpartum. Maternal responses, particularly nursing, were reduced in the OX-UF and OX-CF conditions and either normal or enhanced in the OX-IF condition. Correspondingly, locomotor/exploratory activity was markedly enhanced in the former conditions and close to the control level in the latter condition. In sum, the fostering variable appeared to determine whether pups raised by dams treated previously with BDZ receive either insufficient or exaggerated maternal care. This points to the need for a better understanding of mother/pup interactions in studies aimed at characterizing drug and toxicant effects on offspring development. PMID- 1792013 TI - Fluprazine inhibits intermale attack and infanticide, but not predation, in male mice. AB - The effects of fluprazine (1, 2, and 5 mg/kg) on intermale attack, infanticide and predation (insect larvae) by male mice were assessed. Fluprazine dose dependently inhibited attacks by males on conspecific intruders and genetically unrelated mouse pups. However, predatory attack on insect larvae was unaltered by any dose of the compound. Thus the neurohumoral substrates underlying intraspecific attack and pup killing may be similar to each other, but different from those modulating predatory attack and prey killing. These data support the hypothesis that male infanticide is a form of intraspecific aggression and not an expression of intraspecific predation (cannibalism). Drug-induced stimulation of paternal behavior in some previously infanticidal males suggests that serotonergic substrates may also be involved in the natural mechanisms which mediate the inhibition of infanticide and promote parental care. PMID- 1792014 TI - An ethopharmacological approach to the development of drug addiction. AB - In a rat model of alcoholism, different stages of the development towards a drug addiction can be discriminated. During the phase of "controlled" intake, drug consumption is reversibly modified by the social situation (housing conditions) and the individual's social role (in particular his dominance rank). In Wistar rats, this period lasts about half a year. During the next few months, the consumption of ethanol rises without a concomitant loss of its behavioral effects. After an abstinence period of nine months, the rats maintain a high preference for alcohol which cannot be suppressed by adulteration with (unpleasantly tasting) quinine. Ethanol-taking behavior can no longer be modified by external stimuli or by dominance rank. This irreversible state is called "behavioral dependence." It is drug-specific (i.e., other drugs like diazepam cannot substitute the alcohol) and not related to physical dependence. In behaviorally dependent rats, the effects of ethanol are altered; very low doses tranquillize the rats, higher ones stimulate them. PMID- 1792015 TI - Ethology and pharmacology of hypothalamic aggression in the rat. AB - Stimulation of a restricted area of the rat's hypothalamus elicits unprovoked violent attacks of a species-specific and strain-specific nature. Serotonergic drugs affecting 5HT1 receptors, propranolol, the 5HT re-uptake inhibitor fluvoxamine, and the anxiolytic oxazepam, inhibit hypothalamic attack selectively. However, hypothalamic attack is extremely unsensitive for many drugs that do affect attack provoked by natural stimuli. The pharmacology, the form, the impulsive nature, the absence of preliminaries, the insensitivity for contexts and ultimate aims of aggressive behaviour, suggest that a mechanism with the limited function of damaging adversaries of any kind is activated in the hypothalamus. This hypothalamic attack release mechanism (harm) requires specific sensory input for the expression of specific motor components, such as biting and kicking. The back and dorsal part of the opponent's head are the important attack releasing and directing stimuli. Attacks of this nature are part of the "aggressive" repertoire of the rat in natural settings. "Lateral" or "sideways" postures, specific for intermale fighting cannot be induced by hypothalamic stimulation. Drug, lesion, and stimulation studies suggest that attack and "sideways" postures are under the control of different central mechanisms. These results suggest new ways to describe the patterning of aggressive behaviour. There are interesting ethopharmacological similarities between hypothalamic responses and obsessive compulsive disorders (OCD) in man. It is suggested that further study of the ethopharmacology of hypothalamic responses may shed light on the pathophysiology of impulsive behavioural symptoms which in man seem to be beyond the control of appraisal or context. PMID- 1792016 TI - Is antidepressant efficacy revealed by drug-induced changes in rat behaviour exhibited during social interaction? AB - Remission from depressive illness is associated with a modification in patients' behavioural reactions to environmental/social stimulation, and requires continuous drug treatment. We have examined the effects of antidepressant drug treatment and repeated electroconvulsive shock (ECS) on the behaviour of rats during social interaction (SI) to determine whether antidepressant treatments modify behavioural patterns of experimental animals that may be related to their ability to modify reactive human behaviour. Acute treatment of short-term isolated resident rats with nonsedative doses of antidepressant drugs, or sedative doses of haloperidol and diazepam, dose relatedly reduced aggressive behaviour exhibited during SI. Conversely, chronic antidepressant treatment (including ECS), but not chronic haloperidol or diazepam treatment, increased the aggressive behaviour of resident rats. These studies have revealed selective, diametrically opposite, effects of acute and chronic antidepressant treatment on rodent aggressive behaviour that may be indicative of antidepressant efficacy. The effects of chronic antidepressant treatment in particular may indicate a disinhibition of rodent social behaviour which may mirror the externalisation of emotions associated with the remission of depressive illness. PMID- 1792017 TI - Neural control of predatory aggression in wild and domesticated animals. AB - The neural mechanisms of predatory aggression in laboratory animals were investigated in a variety of rodents and members of the order Carnivora. Experimental enhancement of brain serotonin (5-HT) blocked killing behavior in rats, mice, mink and silver foxes, indicating that there is a 5-HT inhibiting mechanism of predatory aggression in animals of different species. Suppressed killing behavior, at least in some strains of mice, does not depend for expression on the inhibitory effect of the brain 5-HT system, but is caused by the low tonus of the system activating predatory behavior. Long-term satiation of mink increased the level of 5-hydroxyindole acetic acid in the lateral hypothalamus and amygdala and enhanced the latency of predatory aggression. It is suggested that 5-HT represents a dietary responsive endogenous factor regulating predatory behavior in carnivores. Selection of Norway rats over many generations for tamed behavior towards man (domestication) leads to an increase in level and turnover of 5-HT in the midbrain and hypothalamus, but does not change predatory aggression. Substantially reduced defensive behavior of domesticated rats is thus unconnected with the neural mechanism of predatory aggression. PMID- 1792018 TI - Neuroreceptor imaging of the brain. PMID- 1792019 TI - Why clinical PET? PMID- 1792020 TI - Radionuclide limb blood flow in peripheral vascular disease: a review of 1100 measurements. AB - Radionuclide limb blood flow measurements using 99Tcm-labelled human serum albumin and a gamma camera have been performed on normal volunteers and on patients with suspected or confirmed peripheral arterial disease. The normal range of flow was found to be 10.0-22.3 ml per 100 ml tissue per min. Flow in the symptomatic legs of patients with arterial disease varied from 9.0 ml per 100 ml tissue per min in mild claudication to less than 1.0 ml per 100 ml tissue per min in rest pain. The technique has been used as an initial screening procedure, to resolve diagnostic problems, to measure objectively the treatment response and to assess patients with critical ischaemia. The results of 1100 measurements are reported and the clinical utility in routine vascular surgical practice is discussed. PMID- 1792021 TI - Factor analysis of gated cardiac blood-pool data: application to patients with congenital heart disease. AB - Ventricular emptying was evaluated in patients with congenital heart disease (CHD) with left-to-right (L-R) shunt by factor analysis of gated equilibrium radionuclide angiography. In 36 (95%) of 38 ventricular septal defect patients and 20 (95%) of 21 atrial septal defect patients with small L-R shunt (pulmonary to systemic blood flow, Qp/Qs less than or equal to 2.5), as well as all patent ductus arteriosus patients, two significant cardiac factors corresponding to the ventricles (ventricular factor) and the atria plus large vessels (atrial factor) were extracted. However, in all of nine ventricular septal defect patients with large L-R shunt (Qp/Qs greater than 2.5), two different ventricular factors were determined which corresponded to the right and left ventricles (RV and LV). The RV factor showed a delay of ejection phase compared with the LV factor, and the delay was correlated with the value of Qp/Qs (r = 0.82, P less than 0.01). In eight (80%) of 10 ASD patients with large L-R shunt (Qp/Qs greater than 2.5), RV was described by the two different ventricular factors located in the septal and free-wall regions. The LV was extracted in the same factor as that located in the septal region of RV. This study demonstrates the capability of factor analysis in the pathophysiological investigation of CDH with L-R shunt. PMID- 1792022 TI - Technetium-labelled autologous lymphocytes: clinical protocol for radiolabelling using a high concentration and low volume of 99Tcm-exametazime. AB - Little clinical work has been performed using technetium-labelled lymphocytes due to the difficulty of effecting an imaging dose of technetium on the small number of lymphocytes available. We have successfully labelled lymphocytes using a high concentration and low volume of 99Tcm-exametazime. In eight readings from three patients and two volunteers, the labelling efficiency was 27% (4 S.D.). The radiolabel was stable in plasma in vitro up to 4 h. Viability of the lymphocytes as determined by trypan blue exclusion was greater than 95%. PMID- 1792023 TI - Effects of hypothyroidism and thyrotoxicosis on metaiodobenzylguanidine kinetics in the rat heart. AB - Metaiodobenzylguanidine (MIBG), a norepinephrine (NE) analogue, has been used to study cardiac sympathetic innervation. Although MIBG uptake and washout generally parallel the kinetics of cardiac NE (an accepted marker of sympathetic nerve function), quantitative differences exist between NE and MIBG. To determine the value of MIBG as a marker of cardiac sympathetic nerve function, cardiac MIBG uptake and washout were measured in rats with hypothyroidism and thyrotoxicosis which cause increased and decreased sympathetic nerve function, respectively. Rats were made hypothyroid by the ingestion of water containing 0.03% methimazole and thyrotoxic by the intraperitoneal injection of L-thyroxine. After 3 weeks of treatment, rats were injected with 25 mu Ci of 125I-MIBG. Rats were sacrificed at 1.5, 4, 8 and 24 h after injection and heart MIBG activity was determined. Initial uptake and cardiac washout (T1/2) were calculated in both treated groups and compared to controls. MIBG washout was similar in all three groups although it tended to be faster in the hypothyroid group. Uptake was highest in the hypothyroid group (130% of controls) and lowest in the hyperthyroid group (79% of controls). These results suggest that MIBG may be a marker of cardiac sympathetic nerve function although its kinetics may differ from NE. PMID- 1792024 TI - Differential renal uptake of 201Tl: requirements for acquisition, display and quantification. AB - Renal uptake of 201Tl may have a role in screening for renal asymmetry in hypertensive patients (HP) who are referred for myocardial scintigraphy. The qualitative aspects of digitized planar images, and quantified differential renal uptake (DRU) of 201Tl were rated by comparing a simple technique (S) for outlining each kidney with an interpolative background subtracted technique (IB). These parameters were assessed in an initial series of patients by varying the length of acquisition (from 1 to 5 min), delay in acquisition (from 10 to 210 min after injection), and image preparation (nine-point smoothing). Six blinded observers rated the quality of coded images. Image quality was improved (P less than 0.01) by increasing the length of acquisition to at least 2 min, by smoothing of the images and by imaging within 2 h of 201Tl injection. Variability in quantification of DRU was suboptimal with acquisition for only 1 min and was more adversely affected with S than with IB. Clinical application of the quantitative technique was assessed in 180 HP and 32 normotensive controls. With IB, the normal range for DRU was slightly greater than for S. The two techniques were comparable in identifying abnormal cases and found 21 +/- 3% (S) and 19 +/- 3% (IB) of HP as lying outside the normal 99% confidence interval. Both quantitative techniques showed excellent agreement with renal angiography (n = 24). Furthermore, preliminary experience with surface markers and with 180 degrees tomography suggests the potential for simultaneous correction for renal depth. These data justify the use of adjunctive renal imaging during myocardial scintigraphy with 201Tl. PMID- 1792025 TI - Oesophageal involvement in rheumatoid arthritis patients: a study with oesophageal radionuclide transit using 81Krm. AB - Rheumatoid arthritis (RA) is an inflammatory disease affecting mainly the joints. In addition, signs of systemic disease are likely to be present although they are not always clinically evident. Oesophageal motility dysfunction, present in 75% of progressive systemic sclerosis patients, was also reported in various other connective tissue diseases. The present study involved 32 rheumatic patients devoid of any gastrointestinal complaints or diseases: 16 RA, nine Raynaud's syndrome and seven mild osteoarthritis as controls. Oesophageal transit was assessed by using 81Krm radionuclide scan, a sensitive and non-invasive technique. Diffusing lung capacity for carbon monoxide (DLCO) was performed as evidence of subclinical systemic involvement. Abnormal oesophageal transit was observed in 5/16 RA (31%). Two of them were subsequently discarded due to the presence of asymptomatic goiter and asymptomatic gastrointestinal reflux leaving 3/14 RA for analysis. They all had extra-articular features (EAF) (pericarditis, nodules) and two of them had diminished DLCO. Two with Raynaud's syndrome had abnormal oesophageal transit but none of the controls had abnormal oesophageal transit. Upper gastrointestinal dysfunction after exclusion of symptomatic patients appears thus to be not very frequent in RA, even when a sensitive technique is used. Radionuclide transit scanning of the oesophagus is not a more useful method than others in detecting early EAF in RA. PMID- 1792026 TI - Lymphoscintigraphic assessment of leg oedema following arterial reconstruction using a load produced by standing. AB - Lymphoscintigraphy using a test involving standing from a supine position and performed following an intradermal injection of 99Tcm-human serum albumin (HSA) was developed to evaluate the function of the lymphatic system in the lower extremities of patients who developed lymphoedema following arterial reconstructive surgery. In normal subjects, the load produced by standing tended to increase lymphatic function as indicated by the frequent appearance of a large spiking wave and a rapid stepwise increase in tracer activity and, less often, a phase of decreasing tracer activity. However, there was either no or less activation of lymph flow following standing in the group which developed leg oedema postoperatively. These findings indicate that lymphatic disruption is responsible for the leg oedema seen in these patients. Performance of this test following an intradermal injection of 99Tcm-HSA is technically simple, requires no special apparatus, and can be completed in 30 min. Lymphoscintigraphy using our new method can provide useful information on abnormalities in lymphatic function. PMID- 1792027 TI - No-stitch surgery: good, bad, or both? PMID- 1792028 TI - Common-sense determination of intraocular lens power. PMID- 1792029 TI - Transscleral cyclophotocoagulation of human autopsy and monkey eyes. AB - We studied the effect of uveal pigmentation on contact Nd:YAG transscleral cyclophotocoagulation in 36 human autopsy and eight cynomolgus monkey eyes. Ten autopsy eyes from black individuals required less energy to create a lesion than 23 eyes from whites. The mean lesion diameter at the posterior pars plicata was similar in all these eyes; however, the mean energy required was 4.4 J in the black and 6.4 J in the white eyes. Transscleral cyclophotocoagulation lowered intraocular pressure (IOP) in four monkey eyes with elevated IOP, but did not in four other eyes without elevated IOP. Treatment over conjunctival pigmentation burned the conjunctiva, even at the lowest energy tested (3.5 J). Contrary to other investigators' findings, transmission electron microscopy showed at least short-term loss of scleral architecture in both the human autopsy and monkey eyes. PMID- 1792030 TI - Argon laser pretreatment 4 to 6 weeks before Nd:YAG laser iridotomy. AB - Argon laser pretreatment followed by Nd:YAG laser iridotomy 4 to 6 weeks later was performed in the right eye of 10 patients. Primary Nd:YAG laser iridotomy was performed in the left eye. Significantly more Nd:YAG laser energy was needed to produce an iridotomy in pretreated eyes (P less than .001). Pretreated eyes developed a significantly larger pigment epithelium defect around the iridotomy site and a greater degree of pigmentation of the inferior part of the trabecular meshwork 6 months following treatment. Argon laser pretreatment followed by Nd:YAG laser iridotomy 4 to 6 weeks later appears to offer no advantages over primary Nd:YAG laser iridotomy. PMID- 1792031 TI - Postoperative complications and visual loss following Molteno implantation. AB - A retrospective review of 16 initial, consecutive cases of Molteno implantation with at least 6 months of follow up showed that all eyes developed either or both early-onset (12 eyes) or late-onset (7 eyes) complications. The early-onset complications, which included choroidal effusions and flat anterior chambers, tended to resolve without difficulty. By contrast, the late-onset complications, which included 4 implant extrusions, 2 vitreous hemorrhages, 1 persistent hyphema, 1 cystoid macular edema, 1 opacified vitreous face, and 1 tractional detachment with fibrous ingrowth, tended to herald poor visual prognoses. Implant removal was required in three cases. Overall, vision improved in 3 eyes (18.8%), remained unchanged in 3 (18.8%), and deteriorated two or more lines in 10 (62.4%). In 3 eyes vision deteriorated to no light perception; 2 of them became phthisical. These complications often occurred despite successful control of intraocular pressure (less than 23 mm Hg). The relatively high complication rates in this series as compared with previously reported ones probably reflects a combination of factors not necessarily related to the Molteno surgery; primarily, the patients in this small series may have had more severe disease and more prior surgeries than those in other such series. PMID- 1792032 TI - Long-term vitreous replacement in primates with intravitreal Vitreon or Vitreon plus silicone. AB - Six African green monkeys (six eyes) underwent vitrectomy and vitreous replacement with Vitreon (perfluorophenanthrene) or Vitreon plus silicone. A seventh animal served as a control. Vitreon alone and in combination remained optically clear and allowed fundus examination up to 162 days. No toxic effects to the retina were detectable. Vitreon exhibited some degree of emulsification and formed some globules at 45 days postoperatively. Interestingly, Vitreon emulsification occurred at a later time (80 days) in one of the silicone plus Vitreon eyes. The combination of silicone plus Vitreon may offer the advantage of tamponading the inferior and superior retina in phakic eyes. PMID- 1792033 TI - Hemorrhagic choroidal detachment with anterior vitreoretinal adhesions. AB - We present three cases of large intraoperative or postoperative hemorrhagic choroidal detachment with subsequent adherence of the retina to anterior segment structures. Surgical management involved bimanual vitrectomy through anterior sclerotomy sites and dissection within the anterior segment. Successful retinal reattachment was achieved in two of these cases (18-months' follow up). In the third case, the retina remained attached for 4 months but then redetached. PMID- 1792034 TI - Results in the management of Bacillus endophthalmitis. AB - Eighteen cases of culture-proven Bacillus endophthalmitis were reviewed. The majority (13/18) were secondary to penetrating ocular trauma. Others were secondary to corneal ulcer (1), postoperative (1), and endogenous (3). Bacillus cereus was the most commonly identified species (12/18). Antibiotic sensitivities demonstrated uniform sensitivity to vancomycin and the aminoglycosides. Visual prognosis was generally poor; only two patients maintained 20/200 or better in the affected eye. Fourteen eyes were enucleated or eviscerated. The remaining two eyes had light perception vision at the last follow-up examination. PMID- 1792035 TI - Ab externo sulcus fixation. AB - A new suturing method for sulcus fixation of posterior chamber lenses is described. This technique involves using a 28-gauge hollow-bore needle on an insulin syringe and a straight suture needle carrying 10-0 polypropylene. Both of these needles penetrate the eye wall in ab externo fashion, with measurements guiding their insertion. This technique promotes reproducible suture placement and reliable sulcus fixation of the implant. PMID- 1792036 TI - Must physicians always do what their patients demand? PMID- 1792037 TI - Appropriateness of short-stay admissions for procedures in six Veterans Affairs hospitals. AB - Admissions records were reviewed for six acute care Veterans Affairs Medical Centers (VAMC's) in New England to determine appropriateness of short-stay admissions (two days or less) in fiscal years 1986 and 1987 for certain medical and surgical procedures. Results indicated that such admissions accounted for 18,588 (22%) of a total of 84,266 admissions for the six hospitals; of these admissions, 4,362 were for procedures commonly performed on an outpatient basis. Criteria developed by a peer review board of physicians was applied to a sample of 728 (16.7%) of the 4,362 short-stay admissions for these procedures; 190 (26.1%) admissions from this sample were found to be inappropriate. Inappropriateness rates (9.1% to 46.1%), as well as the number and type of procedures, varied among the six VAMCs. Some VAMCs may be able to improve efficiency by performing more procedures on an outpatient basis. PMID- 1792038 TI - Quality assurance in emergency medical service systems in Michigan: report of a survey. AB - To determine the characteristics and effects of quality assurance programs in emergency medical service (EMS) systems in Michigan, medical directors of all EMS medical control authorities in Michigan were mailed a survey consisting of 14 closed-ended and open-ended questions including 2 using a subjective continuum scale; the study included phone follow-up of nonrespondents. Twenty-nine (56%) of 52 authorities surveyed responded; 28 reported that they conducted quality assurance activities. Physicians were the most commonly reported reviewers and emergency medical technicians were the practitioners most frequently reviewed. Although 26 (92%) respondents reported that their quality assurance program made a difference in the quality of care delivered, lack of standards and resources were most frequently listed as program weaknesses. Survey findings prompted the EMS Division of the Department of Public Health, State of Michigan, to address quality assurance in statewide seminars and to develop guidelines for statewide implementation. PMID- 1792039 TI - Development of an acute pain service monitoring and evaluation system. AB - In 1990, Schumpert Medical Center, Shreveport, Louisiana--a 625-bed acute care hospital--established an acute pain service (APS) department and implemented the ten-step monitoring and evaluation process as recommended by the Joint Commission to facilitate the quality assurance program for pain management therapy. The program, which entails the cooperative effort of anesthesiologists and registered nurses, is intended to provide individualized pain management therapy to qualified APS patients on a 24-hour, seven-day-a-week basis. Through continuous, systematic monitoring and evaluation of six aspects of care and their indicators and thresholds, the quality of APS patient care can be determined and improved. PMID- 1792040 TI - [Arthroscopic partial meniscectomy]. AB - On the basis of the authors' observations (167 arthroscopic meniscectomies in 159 patients aged 14-58 years) there have been proven advantages of the arthroscopic operative method. There have been interpreted problems of the techniques of diagnostic and operative arthroscopy. There are presented arthroscopic data on the frequency of meniscus injuries (internal--69.3%; external--27.1% and both- 3.6%). There is given an arthroscopic description of meniscus injury types: transchondral longitudinal--40%, paracapsular--20%, flapped--25%, horizontal--8%, injuries of the discoid external meniscus--2.4%, combined--4.6%. There is emphasized complexity of diagnosis and operations in case of the internal meniscus injuries in the area of its posterolateral angle. There are described indirect signs of pathology and special methods of arthroscopic revision from the side of anterior part of a joint and from the posteromedial area. There are given recommendations as to the techniques of operative meniscectomy, described mistakes and complications. There is drawn a conclusion on high efficiency of the method, on expediency of its broad application under the condition of compulsory training of orthopedists--traumatologists in the skills of diagnosis and operative arthroscopy. PMID- 1792041 TI - [Biomechanical substantiation of osteosynthesis of certain fractures by the method of octahedral wire cerclage]. AB - In the process of experimental studies on 28 cadavers there has been stated the value of traction of the musculus quadriceps femoris, musculus triceps brachii, musculus gluteus medius, musculus peroneus brevis and calculated their arithmetical means. In the work there has been proven dependence between the muscle traction value and anthropometric data of the limb segment and the possibility of its calculation by means of the proposed formula. In the clinical practice in case of fractures of bones of kneecap, tip of the elbow, greater trochanter, base of the V metatarsal bone there has been substantiated an expediency of application of osteosynthesis by means of the octahedral wire cerclage with measured force of the fractured fragment compression, neutralizing the force of dysalignment. PMID- 1792042 TI - [Biomechanical evaluation of the effectiveness of surgical treatment of patients with injuries of the bursal and ligamentous apparatus of the knee joint]. AB - Comparative analysis of data of biomechanical examination of statics and walking of 26 patients with fresh and 20 with inveterate damages of bursal and ligamentous apparatus of the knee joint indicated that transformation of the fresh damages in the inveterate ones inevitably leads to formation of compensatory-adaptable mechanisms in locomotor apparatus directed to compensation of disturbed functions. Early operative treatment of fresh damages of bursal and ligamentous apparatus of the knee joint is a highly effective method that is confirmed by normalization of rhythm of movement at all parts of podographic relief bench in 92,5% patients. After plastic operations on ligamentous structures in case of inveterate damages the rhythm of walking is normalized only in 80,7% cases. PMID- 1792043 TI - [Alloplasty in combination with internal osteosynthesis in the treatment of partial defects of articular ends of the tibia]. AB - In the article are presented the modern possibilities of surgical treatment of posttraumatic inveterate defects of articular ends of tibia on the basis of alloplasty and perosseous osteosynthesis application. There are described indications for operation, its, peculiarities due to accompanying injuries, methods of postoperative rehabilitation, complications. There has been stated that the application of perosseous apparatus, allowing for early joint functioning, ensures reduction of the patient treatment terms by 2 times under the conditions of unloading of the osteochondrous allotransplant. Favourable functional outcomes have been achieved with the predominant number of the operated patients and what's more, two-thirds of the results were assesses as good ones. PMID- 1792044 TI - [Use of extracorporeal connection of xeno-spleen or administration of perfusate of xenogeneic spleen in multimodal treatment of chronic osteomyelitis]. AB - There are presented the results of complex treatment of 154 patients with chronic posttraumatic and hematogenic osteomyelitis. Complex treatment of 51 of them has been supplemented with biostimulation by extracorporal connection of xenospleen (26 patients) or administration of perfusate of xenospleen (25 patients). After application of extracorporal connection of xenospleen and administration of perfusate there have been detected statistically significant decrease of leucocytosis, erythrocyte sedimentation rate, normalization of lymphocyte and monocyte numbers in the laboratory indices as well as positive dynamics of immunologic indices. There have been obtains positive nearest results with 95,5% patients, observed shortening of hospital stay in average by 7 days as compared with the traditional methods of treatment. PMID- 1792045 TI - [HLA antigens in patients with osteoarticular tuberculosis and chronic hematogenic osteomyelitis]. AB - There have been examined 93 patients with the tuberculosis of bones and joints, 28 patients with chronic hematogenic osteomyelitis. All patients have been typed in accordance with the antigens of loci HLA-A, B, C and DR by means of standard microlymphocytotoxic test. 135 healthy donors have been typed according to the same loci++ HLA as controls (105 persons have been typed according to antigens of locus HLA-DR). All examined persons have been Uzbeks. There have been stated that in the patients with the tuberculosis of bones and joints, as compared with osteomyelitis, is observed the increase of frequency of antigens HLA-B27 and HLA DR2, while in case of bone osteomyelitis is noted association with antigens HLA A9, B7 and B18. PMID- 1792046 TI - [Features of anatomo-functional disorders in tuberculous osteitis of the hip joint in children]. AB - Anatomo-functional disturbances of hip joint in case of its focal osteo tuberculous affection in children develop already during the first 1-3 months of disease. Growth disturbance extent, orientation of the osteochondrous elements of hip joint, manifestation of degenerative symptoms correlate with the duration of the process. In case of tuberculous osteitis there are observed less favourable functional deviations of the joint end of femur, especially in children under school age. PMID- 1792047 TI - [Histological features of interdigital muscles in lengthening of underdeveloped fingers in children]. AB - There has been carried out histologic examination of vermicular and interosseal muscles in case of underdevelopment of fingers before and after the restoration of their length by method of distraction in 45 children aged 4-14 years. There has been stated that in case of congenital finger underdevelopment the hand muscles are subjected to hypoplasia. However they are endowed with high ability of regeneration and restore their structure in response to distraction after adequate regenerative changes. PMID- 1792049 TI - [Errors and complications of orthopedic-surgical treatment of children with cerebral palsy]. PMID- 1792048 TI - [Role of hormonal factors in the regulation of bone tissue metabolism in children with cerebral palsy]. AB - In the article are presented the results of examination of 98 patients (aged 6-16 years) with infantile cerebral paralysis. There were used X-ray and radioimmune investigations of bone age, enchondral ossification, state of foot bone structure and blood concentration of "osteotropic" hormones. Bone age corresponded mainly to the passport one; ossification rate overtake and deceleration have been revealed in a third of the examined children and concentric atrophy in 30% patients. Structural disturbances of osseous tissue as the different forms of osteoporosis have been detected in 89.5% cases. There have been stated direct correlation between the frequency of disturbances and the form of infantile cerebral paralysis. There have been noted reliable increase of hydrocortisone level and significant decrease of somatotropic hormone concentration (by 70% and 3.5-3.7 times as compared with the control) and sexual differences in concentrations of osteotropic hormones. The results are discussed from the point of view of neurohumoral relation disturbances and the presence of vegetative dystonia syndrome with predominance of sympathetic-adrenal system activity. PMID- 1792050 TI - [Use of closed anterograde intramedullary osteosynthesis in diaphyseal fractures of the femur and tibia]. PMID- 1792051 TI - [Our experience in conservative treatment of fractures of the calcaneus]. PMID- 1792052 TI - [Conservative treatment of fractures of femoral and tibial condyles]. PMID- 1792053 TI - [Internal fixator for osteosynthesis of long bones]. PMID- 1792054 TI - [A method of treatment of habitual shoulder dislocation]. PMID- 1792055 TI - [A method of plastic surgery of the Achilles tendon in patients with infantile paralysis]. PMID- 1792056 TI - [Diagnosis of a traumatologic-orthopedic patient in the practice of therapeutic preventive institutions and medical and labor examination commissions]. PMID- 1792057 TI - [Instability of the shoulder joint in habitual shoulder dislocation]. PMID- 1792058 TI - [Firearm wounds of the limbs]. AB - In the article is analyzed treatment of firearm wounds of limbs in 161 victim. After antishock measures and primary surgical treatment with observation of its all elements, including application of delayed and tension sutures (31), the primary healing of wounds has been observed with 71, secondary--with 61, suppuration--with 23 and osteomyelitis--with 17 persons. 5 patients have been subjected to amputation of lower limb. 125 (77.5%) patients recovered and 33 (20.5%) became invalids. 3 patients have died. Successful treatment of these victims depends not only upon specialized but upon timely aid at pre-hospital stage as well. Sound primary surgical treatment of wounds is decisive measure in the prophylaxis of wound infection, the method of choice to immobilize a limb after operation is a liningless plaster bandage or skeletal traction in combination with plaster immobilization. PMID- 1792059 TI - [A rare case of urate gout]. PMID- 1792060 TI - [Epiphysiolysis and osteoepiphysiolysis]. PMID- 1792061 TI - [Mikhail Ivanovich Nikiforor (the centennial of his birth)]. PMID- 1792062 TI - [Hip joint prosthesis: current status and prospects of method development]. PMID- 1792063 TI - [Micro-fractures of the bone tissue]. AB - The object of this report is to inform the traumatologists on some problems of the bone micro-destruction, which can be important for diagnosis, selection of fracture treatment tactics and complication prophylaxis. The obtained results can be used in practice. PMID- 1792064 TI - Synaptic inputs to histaminergic neurons in the rat posterior hypothalamus. AB - Histamine is thought to be a neuroactive substance in the brain and have various physiological functions such as biological rhythms and autonomic regulation. It can be speculated, therefore, that synaptic inputs to histaminergic neurons may exert powerful influences upon those histaminergic functions. Synaptic connections between histaminergic neurons and substance P (SP) or neuropeptide Y (NPY) afferents in the caudal magnocellular nucleus (CM) of the hypothalamus were examined using an immunoelectron microscopic mirror method. SP-immunoreactive (SR IR) and NPY-immunoreactive (NPY-IR) terminals made synaptic contacts with histidine decarboxylase immunoreactive (HDC-IR) neurons. Furthermore, the relationship between HDC-IR neurons and glycine receptor-immunoreactive (Gly-R IR) profiles was examined in the CM by the same method as described above. A low to moderate density of dot-like Gly-R-IR profiles was seen at the light microscopic level. At the electron microscopic level, HDC-IR neurons were identified to have Gly-R immunoreactivity at postsynaptic sites on their somata. Our findings suggest that SP, NPY and possible glycinergic afferents exert monosynaptic influences on the central histaminergic neuronal system. PMID- 1792065 TI - Preparation of a drug-induced allergic hepatic disorder model with penicillin as hapten. AB - A drug-induced allergic hepatic disorder model was established using a hapten and carrier. Penicillin G was bound to glycine for the preparation of N-hydroxy succinic imidylglycinyl benzylpenicillate (PG-Gly-OSu). Using this as the hapten and liver protein as the carrier, guinea pigs were sensitized with liver protein bound to PG-Gly-OSu. After 2 weeks, the sensitized guinea pigs were directly challenged with hepatocytes bound to PG-Gly-OSu through a mesenteric vein and hepatocellular disorder was induced. When the sensitized guinea pigs were challenged with PG-Gly-OSu alone or with liver protein alone, hepatocellular disorder could not be induced. These results suggest that the combination of PG Gly-OSu as the hapten and liver protein as the carrier elicits a hepatocellular disorder similar to drug-induced allergic hepatitis. PMID- 1792066 TI - Erythrocyte deformability in workers exposed to lead. AB - Erythrocyte deformability and other hematological indicators were determined in 17 male workers exposed to lead at a secondary lead refinery and 13 controls. Blood lead, urine lead, urine coproporphyrin, delta-aminolevulinic acid and erythrocyte zinc protoporphyrin were determined to evaluate the degree of lead exposure in the lead workers above. For the measurement of erythrocyte deformability, the microfilter method was used. The results were summarized as follows: 1. The mean values of blood lead, urine lead, urine coproporphyrin, urine delta-aminolevulinic acid and erythrocyte zinc protoporphyrin levels in lead workers were 53.5 micrograms/100g, 141.4 micrograms/l, 115.9 micrograms/l, 12.0 mg/l and 68.9 micrograms/dl respectively, suggesting a moderate influence of lead exposure. 2. The mean values of erythrocyte count, hematocrit and hemoglobin were significantly lower in lead workers than those in controls. No significant differences were found in the mean values of mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration and corpuscular natrium and potassium between lead workers and controls. 3. Erythrocyte deformability was significantly reduced in lead workers compared with controls. PMID- 1792067 TI - The effect of lipo-prostaglandin E1 on the production of interleukin 1 and platelet-activating factor by hepatic sinusoidal endothelial cells in mice. AB - We first studied the production of interleukin 1 (IL1) and platelet-activating factor (PAF) by mouse hepatic sinusoidal endothelial cells and then the effect of Lipo-prostaglandin E1 (Lipo-PGE1) on IL1 and PAF production by these cells. The incubation of mouse hepatic sinusoidal endothelial cells with lipopolysaccharide (LPS) or calcium-ionophore (CaI) A23187 resulted in a concentration-dependent production of IL1 and PAF. However, Lipo-PGE1 dose-dependently decreased the LPS- or CaI A23187-induced production of IL1 and PAF. These results suggested that Lipo-PGE1 acts on hepatic sinusoidal endothelial cells to decrease the production of IL1 and PAF, thereby ameliorating inflammatory reactions in the liver. PMID- 1792068 TI - Effect of sho-saiko-to (TJ-9, Japanese herbal medicine) on estradiol receptors in the cytosol of hepatic sinusoidal endothelial cells. AB - We first confirmed the presence of estradiol receptors in the cytosol of rat hepatic sinusoidal endothelial cells and then studied the effects of Sho-saiko-to (TJ-9) on the level of these cytosol estradiol receptors. As a result, we found that estradiol receptors are present in the cytosol of hepatic sinusoidal endothelial cells from rats. Moreover, when these cells were incubated with TJ-9, the level of cytosol estradiol receptors increased. These results suggested that TJ-9 acts on hepatic sinusoidal endothelial cells to increase the level of estradiol receptors, thereby affecting the immune reactions in the liver. PMID- 1792069 TI - Effects of indocyanine green dye enhanced diode laser photocoagulation in non pigmented rabbit eyes. AB - Dye enhanced photocoagulation using indocyanine green (ICG) and diode laser has recently been introduced for occlusion of the choroidal neovascular tissue of age related maculopathy. However, the effects of photocoagulation generated only by dye enhancement have not yet been studied. To discover the threshold amount of ICG for the minimum effect of photocoagulation, various photocoagulation parameters were tried in the fundus of albino rabbit. That is to say, ICG dosage laser power and exposure time were varied at the range of 0.5 mg to 14.0 mg/Kg, 80 to 500 mW and 0.2 or 1.0 sec, respectively. Histopathologic evaluation revealed that the effect of the enhanced photocoagulation was more marked in the choroid than in the retina, and was particularly noticeable in the large vessels in the deep layer of the choroid, even in lower threshold lesions. In clinical application, we should take into consideration the excessive reaction in the choroid. PMID- 1792070 TI - Advanced techniques for management of head and neck neoplasms. PMID- 1792071 TI - Mediastinal dissection and gastric pull-up. PMID- 1792072 TI - Surgery for advanced thyroid malignancy. AB - Advanced thyroid malignancy can occur early in the course of the disease, or as late as 20 to 25 years after the initial diagnosis. The basic treatment is total thyroidectomy with central node dissection regardless of the histologic type. the nonresectable disease is treated with 131I if the tumor has iodine uptake. Further ablative surgery for resectable disease is governed by location and histologic cell type. Otherwise external radiation and chemotherapy (Adriamycin) is used. Anaplastic, primary squamous cell, and pure papillary and some predominantly papillary carcinomas and some Hurthle cell carcinomas do not have 131I uptake and fall into this latter category. The surgeon must be aware of this problem in the noniodine uptake tumors and take special care to remove all surgically resectable disease. PMID- 1792073 TI - Jejunal transplantation for pharyngoesophageal reconstruction. AB - The reconstruction of circumferential and noncircumferential defects of the pharynx and cervical esophagus remains a challenging problem. A variety of different techniques are presently in use for this reconstruction. Free jejunal autografts were the first tissue to be transferred to the head and neck using microvascular techniques. A review of the literature on free jejunal autografts provides a collective experience that permits evaluation of the success rates and complications of the procedure. The results of this review reveal that this method of reconstruction is highly successful in restoring various ablative defects with an acceptable morbidity. PMID- 1792074 TI - Microvascular free flaps for soft-tissue defects. PMID- 1792075 TI - Laryngotracheal reconstruction. Extended vertical partial laryngectomy: reconstruction combining epiglottoplasty and the rotary door flap. AB - This article explores various surgical techniques for vertical, partial laryngectomy in the treatment of laryngeal cancer. Potential for reconstruction and broader indications for such surgical procedures may be achieved by combining laryngeal epiglottoplasty with the rotary door sternohyoid myocutaneous flap. PMID- 1792076 TI - Laryngeal transplantation. The future. AB - The ethics, justification, history, future, and rejection of laryngeal transplantation are examined in this article. The authors believe that laryngeal transplantation will be a viable alternative for a select group of patients before the end of this century. PMID- 1792077 TI - Mandibular reconstruction using vascularized bone grafts. AB - Total oromandibular reconstruction following cancer extirpation remains a significant challenge to the head and neck surgeon. Reconstructive goals must address occlusion, salivary continence, mastication, deglutition, and articulation. In this article, various methods of mandibular reconstruction, with special attention to the most recent advances in vascularized bone and free tissue transfer techniques, are reviewed. PMID- 1792078 TI - Prosthetic plate mandibular reconstruction. AB - The head and neck surgeon may choose one of several available methods to reconstruct the mandible following tumor ablation. This article discusses the use of metallic mandibular prostheses, the indications for alloplastic mandibular reconstruction, techniques of plate application (AO and THRP), and associated complications. PMID- 1792079 TI - Distraction osteogenesis. Applications for mandibular regrowth. AB - One experimental surgical technique of bone replacement demonstrates the greatest potential for clinical applicability in the near future: the regrowth of bone by distraction (stretching). Distraction osteogenesis defines the technique of growing new bone by stretching existing bones. Although this technique does not represent the ultimate method of mandibular reconstruction, it shows sufficient promise that its eventual use for specific types of mandibular defects probably will occur in the near future. PMID- 1792080 TI - Craniofacial disassembly in the management of skull-base tumors. AB - Craniofacial disassembly now plays a major role in the management of tumors that invade the skull base. The chief advantage of this technique is the greatly improved operative exposure it provides, allowing the surgeon to resect such tumors more completely and with an added margin of safety. Microneurosurgical advances have made it possible to preserve cranial nerve function in many cases, and modern reconstructive methods employing vascularized flaps have helped to reduce postoperative complications and deformity. Through the combination of craniofacial techniques and oncologic principles, the outlook for patients with skull base tumors is improving. PMID- 1792081 TI - Radical surgery for nasal cavity and paranasal sinus tumors. AB - Radical surgery for sinonasal neoplasms in combination with radiation therapy has vastly improved the outlook for these tumors. Magnetic resonance imaging (MRI) combined with high resolution computerized tomography (CT) scanning and recognition of symptoms suggestive of extensive disease has allowed more accurate determination of surgical margins. Long-term follow-up is still needed to define the limits of radical surgery necessary to treat very extensive tumors. PMID- 1792082 TI - Management of the cavernous sinus and carotid siphon. AB - The rationale for direct surgery of the cavernous sinus is presented along with a discussion of patient selection and preoperative evaluation. The surgical approaches for exposing the cavernous sinus and microsurgical techniques used to prepare and open the sinus are described. Principles for the management of neuronal and arterial structures within the sinus are stated and references are given for other technical details. PMID- 1792083 TI - The transnasal approach to advanced lesions of the sphenoid sinus and pituitary. AB - The techniques of transseptal transsphenoidal hypophysectomy are discussed in detail in this article. The span of disease that may be treated by this method in addition to the need for a team approach of otolaryngologists and neurosurgeons is illustrated with several pertinent case reports. PMID- 1792084 TI - Photodynamic therapy for head and neck neoplasms. AB - A comprehensive updated review of the current status of photodynamic therapy using hematoporphyrin and the argon dye-pumped laser is presented. Indications, advantages, and disadvantages of photodynamic therapy are stressed, and future directions for research are suggested. PMID- 1792085 TI - Advanced techniques in radiation therapy for head and neck cancers. AB - This article focuses on a number of innovative radiotherapeutic methods to improve local and regional control with increased chances of preservation of normal function compared with the use of standard external beam irradiation alone in the management of selected head and neck cancers. Some of these radiotherapeutic techniques are well established (brachytherapy and neutron therapy in advanced salivary gland tumors); some have a large body of experience accumulated and are currently being investigated in phase III trials (thermoradiotherapy and altered fractionation); whereas the other techniques (intraoperative therapy, charged-particle therapy, and sterotactic radiosurgery) are highly experimental. PMID- 1792086 TI - Umbilical cord: factors which influence the separation time. AB - The separation time of the umbilical cord was studied in 98 healthy Indonesian newborns with the aim of determining the normal time of separation and to evaluate factors which may influence it. The authors looked for a relationship between cord separation and sex, birthweight, gestational age, parity of the mother and nutrition of the newborn. Mean separation time was 10.9 days (S.D. 3: range 5-23 days). None of the factors analysed had a statistically significant influence. Cord care consisted of triple dye; no umbilical infections were found. PMID- 1792087 TI - Acute lymphoblastic leukemia in the Department of Child Health, School of Medicine, University of North Sumatera/Dr. Pirngadi Hospital Medan (1980-1988). AB - A retrospective study on acute lymphoblastic leukemia (ALL) was conducted to assess the pattern of childhood ALL at the Subdivision of Pediatric of Hematology, School of Medicine, University of North Sumatera/Dr. Pirngadi Hospital, Medan, in a period of 8 years (1980-1988). There were 120 cases, consisting of 63 (52.5%) males and 57 (47.5%) females. By the FAB classification (Bennett, 1976) (77.5%) were found as FAB L 1, 25 (20.8%) as FAB L 2, and 2 (1.7%) as FAB L 3. The youngest was 4 months old. The majority of signs and symptoms appeared in the forms of pallor 102 (85%), fever 84 (70%), hemorrhage 52 (43.3%), hepatomegaly 64 (53.3%), splenomegaly 54 (45%) and lymphadenopathy 18 (15%). On first admission, 76 (63.33%) cases were with a leukocyte count of less than 20,000/microliters, and 72 (60%) with Hb content of less than 5 g/dl. Twenty one cases died in the first year. The received cytostatic protocol; 11 (52.38%) were treated regularly and first remission were found in 8 (72.73%) cases. The average of admissions per year for the age group of 2-8 years was higher than the age groups of 0-2 years and 8-16 years (p less than 0.05). PMID- 1792088 TI - Diarrhea in neonates at the Subdivision of Perinatology Dr. Pirngadi Hospital, Medan. AB - A retrospective study on diarrheal manifestation in newborn babies was conducted at the ward of Neonatology, Dr. Pirngadi Hospital Medan from January to December 1988. There were all 3367 babies hospitalized during the study period. One hundred and thirty five (4.0%) had diarrhea, including 106 (78.5%) babies with birth weights of greater than or equal to 2500 gram. Of 2478 babies with spontaneous delivery, 34 (1.4%) babies had diarrhea, while of 889 babies with obstetrical intervention delivery 101 (11.4%) babies had diarrhea. The difference was statistically significant (p less than 0.001). Of 135 babies with diarrhea, there were 82 (60.7%) with moderate and 31 (23.0%) with severe dehydration. The mortality rate was 47.5% in patients with accompanying diseases and 0.0% in them without. The mortality rate in babies with birth weights less than 2500 gr was 37.9% and 16.9% in babies with birthweights greater than or equal to 2500 gram (p less than 0.001). The mortality rate increased with the increase of severity of dehydration (p less than 0.03). PMID- 1792089 TI - Measles enteritis in infants and children. AB - The incidence, mortality and clinical features of measles enteritis were reported among 6484 infants and children admitted to the Pediatric Ward Dr. Pirngadi General Hospital Medan from 1st January 1987 until 31st December 1988. Of these 6484 children, 2685 suffered from gastroenteritis and 82 from measles. There were 31 cases of measles enteritis (1.2% of all gastroenteritis cases or 37.8% of measles cases). Most of measles enteritis cases (74.2%) were in the age group of 6-24 months and no case was found under six months old. The mortality of measles enteritis with bronchopneumonia and encephalitis was 25.0% while the mortality of measles enteritis with bronchopneumonia was 13.3%. There were no deaths in children just with measles enteritis alone. The overall mortality of measles enteritis with or without accompanying disease was 12.9%. The age specific death rate of measles enteritis was highest (23.1%) in the 13-24 month age group. PMID- 1792090 TI - Pattern of diseases associated with fever among infants aged 1-6 months. AB - This study was carried out retrospectively to evaluate the pattern of diseases associated with fever among infants aged 1-6 months at Gunung Wenang General Hospital Manado. During the period of January 1988-December 1989, 189 infants with age ranging 1-6 months, were evaluated. Diseases associated with fever predominantly occurred in infants of 3 months old (73.0%). The final clinical diagnosis of diseases associated with fever were gastroenteritis (39.15%), pneumonia (28.05%), meningitis (9%), respiratory tract infection (15.4%), post vaccination (4.20%) and septicemia (4.3%). The fever ranged from 37.8-38.3 degrees C (38%), 38.4-39.5 degrees C (49%), 39.6-41 degrees C (10%) and more than 41 degrees C (3%). The elevated body temperature was significantly related to the duration of fever (p 0.01). Increased erythrocyte sedimentation rate and thrombocytopenia were not correlated significantly (p greater than 0.05) with elevated body temperature while the total white cell count had a significant relationship (p less than 0.05). PMID- 1792091 TI - Measles enteritis in Gunung Wenang General Hospital Manado. AB - The incidence and mortality rate of 48 measles enteritis cases has been evaluated retrospectively, during the period of January 1986 to December 1989. Children under 2 years old were 21 cases (43.8%), between 2-5 years old 16 cases (33.3%) and more than 5 years old 11 cases (22.9%). Nutritional status based on the classification of Wellcome Trust Working Party revealed normal 33 (68.8%), moderate malnutrition 12 (25%) and severe malnutrition 3 cases (6.3%). Diarrhea and mild dehydration was found in 36 (75%), moderate dehydration 10 (20.83%) and severe dehydration 2 cases (4.2%) Six (12.5%) out of 48 cases had had measles vaccination. Twenty four cases (50%) of measles enteritis had other complications. The mortality rate was 2.1% comprising one patient, who suffered from measles enteritis with severe dehydration, bronchopneumonia, encephalitis and severe malnutrition. PMID- 1792092 TI - Plasma concentrations of urea and creatinine in primary school children in Ujung Pandang. AB - A study of plasma concentrations of urea creatinine in 202 primary school children aged between 6 to 15 years was carried out in Ujung Pandang from November 1, 1988 through February 28, 1989. Sampling was done using multi-stage random sampling method. Plasma urea concentrations were not affected by sex, age and nutritional status. Normal distribution of plasma urea concentrations in P2.5 and P97.5 were 8.13 mg/dl and 24.09 mg/dl respectively (95% confidence level). There was no difference of creatinine concentration between the two sexes. The overall mean creatinine concentrations was significantly higher in the well nourished group (0.73 +/- 0.081) mg/dl) as compared to PEM group (0.63 +/- 0.066 mg/dl). This study revealed a correlation between age and plasma creatinine concentrations in the well-nourished (r = 0.46, p less than 0.01) as well as in PEM (r = 0.37, p less than 0.01) group. Hence, normal distribution of plasma creatinine concentrations should be base on values in each age group. This study showed no correlation between plasma urea and creatinine concentrations. PMID- 1792093 TI - Decreased urinary excretion of dopamine and sodium in diabetic children with incipient nephropathy. AB - It has been suggested previously that a decrease in urinary dopamine output might be related to a decrease in the urinary sodium excretion in subjects with diabetic nephropathy suffering from type 2 diabetes. To investigate the renal dopamine status in children with type 1 (insulin-dependent) diabetes mellitus, we measured the 24-hour urinary excretion of dopamine, norepinephrine and sodium in 12 patients with incipient nephropathy (group A, 24-hour albumin excretion rate 70-200 micrograms/min), in 20 age matched patients with normal microalbuminuria (group B, AER less than 20 micrograms/min) and in 8 healthy controls (group C). The mean values for urinary excretion of dopamine and norepinephrine were significantly lower in group A compared to groups B and C (25.6 +/- 14.8 vs. 65.9 +/- 25.5 and 73.3 +/- 18.0 micrograms/day, p less than 0.001 and 11.8 +/- 4.6 vs. 25.1 +/- 12.1 and 28.4 +/- 8.9 micrograms/day, p less than 0.01, respectively). The mean value for the urinary excretion of sodium was also significantly lower in group A than in groups B and C (98.4 +/- 24.1 vs. 206.2 +/- 59.5 and 198.1 +/- 42.8 mEq/day, p less than 0.01). The 24-hour urinary excretion of dopamine correlated significantly with the sodium excretion (r = 0.65, p less than 0.001). Arterial blood pressure was elevated in group A compared to group C (p less than 0.01). Our results suggest that a decrease in endogenous dopamine could play a role in the low urinary sodium excretion thereby resulting in sodium retention which may in turn lead to the development of higher blood pressure in diabetic children with incipient nephropathy. PMID- 1792094 TI - [Trends in perinatal, neonatal and post-neonatal mortality in Austria and Tyrol, with special reference to 1979-1988]. AB - Analysis of neonatal, perinatal and infant mortality rates is a useful basis to compare the quality of neonatal care in a country. During the last decades these parameters have been falling steadily in Austria as well as in other industrialized countries. Regarding the various provinces of Austria substantial regional differences occur. Apparently the decline in mortality rates is not only contributable to medical progress but as strongly influenced by social and economic changes. In the mid-seventies absolute and relative neonatal mortality rates in Austria definitely decreased, most probably attributable to the installation of neonatal intensive care units. During 1968-1978 the decrease in neonatal mortality was mainly due to reduced first-day-mortality, whereas during the following decade it was mainly due to reduced mortality of the 2nd until 7th day of life. Interestingly, the rate of preterm infants in Austria remained virtually constant during 1968-1988 despite improved pre- and perinatal care. Paralleling the development in full-term neonates the peri-/neo- and postneonatal mortality rates of preterm infants decreased. Predictably - as in other countries - the highest improvement was found in the low birth weight groups Nevertheless, premature births have accounted for the majority of neonatal and perinatal deaths. PMID- 1792095 TI - [Regional mucoviscidosis screening using immunoreactive trypsin in umbilical cord blood]. AB - In all neonates delivered at the Steyr Landeskrankenhaus from 1987 to 1989, immunreactive trypsin (IRT) in the umbilical cord blood was determined to enable early diagnosis of mucoviscidosis (cystic fibrosis, CF). Amongst 4,507 neonates 75 were found in whom the IRT was over the cut-off value of 1,204 ng/ml. Of these babies, 69 were presented at the age of six weeks for determination of elecrolytes in their sweat. Mucoviscidosis could be diagnosed in two patients. The sensitivity of our test is likely to be 100%. There is no question that the specificity (98.38%) requires improvement. The incidence of mucoviscidosis in our catchment area is 1: 2,254. The hypertrypsinemia detected was probably transient in 73 babies. Ten of these patients showed a one-minute Apgar score of less than seven. PMID- 1792096 TI - Depression in children with cancer. AB - The results of a standardized evaluation of the occurrence of depression in a group of 34 children suffering from cancer are presented. The children (13 male, 21 female) were admitted to the oncological unit of the Department of Pediatrics at the University of Graz, Austria, during a 14 months-course (January 1987-March 1988). We rated each child 4 times in 4 weekly intervals after admission and start of induction chemotherapy. To access the occurrence and severity of depression and to monitor progress during treatment we performed a psychiatric interview and also applied the psychiatric rating scale CDRS (Children's Depression Rating Scale) by Poznanski et al 1979 and SCMDD (Self-Report Symptom Checklist for Major Depressive Disorders) by Kashani et al 1985 derived from DSM III. 340 diagnostic ratings were performed by 3 raters; two of them were psychotherapeutically trained pediatricians (M. D., P. J. S.) and one psychologist (L. W.). A "clearcut" depression was found in 25 of the 340 ratings i.e. in 6 of the 34 children, demonstrating that the occurrence of depression in pediatric cancer patients was lower than primarily assumed. PMID- 1792097 TI - [You make the diagnosis. Pneumomediastinum]. PMID- 1792098 TI - [The kinetics of specific serum antibodies in sheep infested with sheep bot larvae]. AB - The kinetics of specific antibodies of the blood serum of sheep experimentally infested with 80, 160 and 1000 specimens of Oestrus ovis larvae was examined. The affinity pure serum IgG and the immunoferment analysis (ELISA) were used for qualitative estimation of specific antibodies. It has been shown that the level of specific antibodies correlates with the larval biomass and is connected with ontogenesis of this parasite. The younger animals, which were infested for the first time, are characterized by more intensive production of specific IgG than adult reinfested ones. The ways of immunity response formation in animals infested with Oestrus ovis larvae are considered. PMID- 1792099 TI - [The correlation variability of the morphometric traits in 4 species of ixodid tick species (Ixodidae)]. AB - Correlation analysis of 10 characters was run in three species of Dermacentor, D. nuttalli, D. ushakovae, D. niveus, and in Ixodes persulcatus, separately for each phase and sex. Correlation coefficients are very low in larvae of all species. In male nymphs correlation coefficients are on the same level in all species while the correlation coefficient level in female nymphs reflects the degree of independence of the development of characters. This defines the degree of manifestation of sexual dimorphism at the nymphal phase: the more rigid the connections between the characters the less number of characters shows sexual differences. At the phase of imago the lowest correlation coefficients are in I. persulcatus. This species displays most distinct differences in the morphology of females and males. On the basis of comparison of correlation and variability coefficients the functional role of the characters is discussed. PMID- 1792100 TI - [Hysterothylacium petteri sp. n. (Nematoda: Ascaridata) from the Pacific Ocean swordfish]. AB - Hysterothylacium petteri sp. n. was recovered from the stomach of Xiphias gladius occurring in the Kuroshio. The morphological difference of H. petteri from all other species of this genus is the extremely long ventricular caecum (two times more than pharynx). The species is very similar to H. corrugatum Deardorff et Overstreet, 1980 from swordfish off the American shores and corresponds to the description of Hysterothylacium sp. by Petter, Maillard, 1987. The third stage larvae of H. petteri sp. n. are probably those larval forms which were described as Contracaecum sp. l. Type IIA in Brunsdon in Boyle, 1966; Contracaecum sp. Otsuru et al.--type-B (Kikuchi et al.--type-A) in Kagei et al., 1970; Thynnascaris from Todarodes pacificus in Oshima, 1972; Contracaecum--type larva (B) in Shiraki, 1974; Hysterothylacium L3 in Weerasooriya et al., 1986; Porrocaecum sp. l. in Gaevskaya, Nigmatullin, Schuchhalter. New morphometric data on these larvae are given. PMID- 1792101 TI - [The fatty acids of trichinellae]. AB - The composition of fatty acids of lipids in the muscles of rats and larvae of Trichinella spiralis and T. nativa developing in them were studied. Both species are characterized by practically the same composition of fatty acids, only in the frost-resistant species T. nativa there was a sufficient amount (up to 3.5%) of docosapenta- and docosahexaenic acids (22:5 and 22:6). The comparison of the content of individual fatty acids in larvae and in muscles of the host by means of statistical correlation analysis suggests that larvae obtain a considerable portion of palmitic acid from the host and transform in into necessary long-chain saturated and unsaturated fatty acids by means of elongating and desaturating enzymes. Changes in the contents of fatty acids in larvae extracted from dead rats, which during some days were undergone freezing at negative temperatures (-8 10 degrees), are the same in quality for both species. These changes can be explained if we assume that the activity of elongases and desaturases of Trichinella decreases with cooling to a greater extent than the supply of palmitic acid from the host's tissues. A higher frost-resistance of T. nativa may be associated as with a greater protection of enzymes in the membranes by long chain polyene acyls so with a higher thermal stability of proteins themselves. PMID- 1792102 TI - [The fauna of anoplocephalid tapeworms in domestic and wild animals of Vietnam]. AB - 101 species of oribatid mites and 12 species of helminths--anoplocephalids, transmitted by these mites, were found out by Soviet-Vietnam studies in agroecosystems and tropical forests of northern and southern Vietnam. Helminths were recorded from graminivorous mammals as follows: horses, zebu, sheep, goats, buffaloes, deer, hares, elephant, 2 species of rates, 5 species of monkeys and 11 species of birds. PMID- 1792103 TI - [Carcinoma of the bladder today]. PMID- 1792105 TI - [Lupus glomerulonephritis. Study of 21 cases: clinico-morphological correlations]. AB - The authors report their experience, based on 21 cases, on lupus glomerulonephritis with clinic-morphological correlation and follow-up. They classified renal biopsies utilizing WHO classification and applying a numerical score system proposed by Austin. This system considers the morphological characters referable to duration (chronicity index: C.I.) and activity (activity index: A.I.) of renal disease. Histological data have been connected with clinical evolution of renal disease. Patients have been followed for periods varying from 8 months to 8 years. From data obtained we can see that there is not a constant relation between a high chronicity index or activity index and unfavorable evolution of disease. Besides the authors report a revision of literature considering the possibility of connection between morphological data and the prognosis of lupus glomerulonephritis. They refer contrasting judgements about this. PMID- 1792104 TI - [Utility and limitations of flow cytometry DNA content analysis in neoplastic cells]. AB - A review of the literature concerning the analysis of nuclear DNA content by flow cytometry is made and it is compared with own experience. The advantages and the limits of this technique are examined. The practical problems in the interpretation of the histograms and the value of the measurements are discussed. The importance of this analysis in diagnosis and in staging of many tumors and the clinical involvements are emphasized. In many tumors DNA ploidy represents a new independent prognostic variable that is useful to separate the cases with a potential worse behaviour in an early stage, when other classic parameter are not available. It is also stressed the importance of flow cytometric DNA analysis of tumor cells. This is made on the same tissues that pathologists use for histopathological diagnosis and the results are important in many cases for a diagnostic accuracy. PMID- 1792106 TI - [Argyrophilic nucleoproteins of the cervical epithelium in HPV infection and intraepithelial neoplasia]. AB - 50 colposcopic biopsies of cervical epithelium were studied, using a silver colloid technique. These comprised 28 cases of human papillomavirus infection of the cervix, 8 cases of cervical intraepithelial neoplasia (CIN) I, 8 cases of CIN II, 6 cases of CIN III. The AgNOR mean number of the basal and parabasal cells of the cervical epithelium was significantly different in virus infected cells and in CIN. Different patterns of AgNOR distribution were observed: they were single and compact in virus infection without dysplasia whereas they appeared small and often loosely arranged in dysplastic lesions. Our data suggest that this simple technique is diagnostically useful in the evaluation of borderline lesions. PMID- 1792107 TI - [Problems and limitations of frozen section diagnosis. A review of 470 consecutive cases]. AB - A retrospective review of 470 consecutive frozen section consultations from two Venetian hospitals (O.C.R. and O.A.M.) was performed in order to assess the accuracy of the procedure. The overall accuracy was 89.4% with a cumulative error rate of 3.6% (false positive + false negative + different diagnosis). Such values are in accord with that reported in literature with the exception of deferred diagnosis whose rate was 7.0% of total diagnosis. It was examined with criticism the latter aspect, focusing on problems and limitations of the method and suggesting a system of quality control by means of periodic review of cases. PMID- 1792108 TI - [Clinical, histological and ultrastructural study of a case of giardiasis]. AB - A case is described concerning an adult male whose work create a risk for infestation by Giardia. The patient had a long history of diarrhea with malabsorption which was resistant to the common therapies. Only after a EGDS examination the diagnostic possibility of infestation by parasites could be proposed; this was confirmed by means of ultrastructural examination of biopsy material. The Authors suggest that in case of inexplicable malabsorption and/or chronic diarrhea, one must always take into consideration in differential diagnosis the possibility of an infestation by Giardia especially when there is a history which could be suggestive for such an infestation (immunodeficiency, homosexuality, frequent trips to foreign countries). PMID- 1792109 TI - [Localized primary cutaneous nodular amyloidosis]. AB - A case of cutaneous nodular amyloidosis in a 60-year-old man is described with reference to histological, immunohistochemical and ultrastructural features. Clinically, the patient presented two brownish nodules on his face. Histologically, a massive dermal collection of eosinophilic, homogeneous material showing positivity for Congo red stain was revealed. Immunoreactivity for both Ig light chains was detected in dermal plasma cells as well as in amyloid material. Ultramicroscopically, the typical fibrillary pattern of amyloid was found. Clinical and instrumental examinations failed to demonstrate amyloid depositions elsewhere in the body. PMID- 1792110 TI - [Pindborg tumor or odontogenic calcifying epithelial tumor. A clinical case]. AB - Calcifying epithelial odontogenic tumour (CEOT) is an uncommon odontogenic neoplasm first recognized as a distinct entity by Pindborg in 1955. One of the frequent histological findings is the occurrence of amorphous deposits of so called amyloid like material within the tumour. A case of this tumour is reported in a 75 years woman. PMID- 1792111 TI - Initial development of an emic methodology for classification of stressful work situations. AB - Research on stress in the workplace has generally focused on situations which the investigator a priori perceives to be stressful for people at work. In the current study, an emic (insider) approach to identification of what constitutes a stressful work event is described as a complement to the outsider's perspective. Using content analysis, two broad categories of work-related stressful events were used to classify situations which the employee perceived to be stressful. Recommendations for research using the methodology are provided. PMID- 1792112 TI - Effect of educational kinesiology upon simple response times and choice response times. AB - The purpose of this study was to determine whether Educational Kinesiology integration movements or repatterning in conjunction with the integration movements affect the response times of college students to a visual stimulus. Ten men and ten women were randomly assigned to each of the three conditions: control, Edu-K movement, or repatterned Edu-K movements. Each subject was pretested on simple and choice response-time tasks. Following the pretest, subjects in the control group sat quietly for 10 minutes. The movement group utilized seven Brain Gym activities. Subjects in the repatterned group experienced Dennison's Laterality Repatterning prior to doing the same Brain Gym activities. All subjects were then retested to assess changes in performance using 30 trials of each task. Statistical analyses indicated significant differences in improvement between the groups on the 4-choice task, with the repatterned group showing greater change than the Edu-K movement-only group, who in turn showed greater improvement than the control group. The groups improved by 6%, 3 1/2%, and 1%, respectively. No group differences were significant on the simple task, although a similar trend was indicated. Men responded faster than women on both tasks; however, the amount of improvement was similar for both. PMID- 1792113 TI - Interrelationships of trunk and extremity muscle strengths and body awareness following unilateral brain lesions. AB - From 11 hemiparetic adults measurements of muscle strength of lateral trunk flexion and of extremities of paretic side were intercorrelated. Their varied magnitudes and correlations with body awareness suggested strengths of trunk and extremities are not exclusive and that decreased muscle strength is more likely for patients with decreased body awareness. Possible explanations are considered. PMID- 1792114 TI - Do the hemispheres interact during object naming? Evidence from tachistoscopic viewing and time-sharing paradigms. AB - Here we report an experiment in which 16 right-handed young adults named a series of unilaterally presented pictures during concurrent unimanual finger tapping with the right and left hands at separate times. A multivariate analysis of variance showed no significant differences in picture-naming reaction time between left versus right visual-field stimulations. Also the test for finger tapping was nonsignificant, with the magnitude of disruption being symmetrical for the right and left hands as a function of visual fields. It was proposed that the two cerebral hemispheres interact with each other at later processing stages when performing tasks requiring both left and right hemispheric processing resources. PMID- 1792115 TI - Relation of physical education to self-concept. AB - This study investigated the relation of an elementary school program in physical education to the self-concepts of children in Grades 1 to 4. Two parochial schools were selected, one with a physical education program (n = 126 children) and one without such a program (n = 86 children). The Martinek-Zaichkowsky Self concept Scale was administered during the first two weeks of September and again during the last two weeks of April. A 2 (pre-posttest) x 2 (group) x 4 (grade) analysis of variance with repeated measures on the first factor was used to analyze each measure, with post hoc tests to follow up. The self-concept results indicated that physical education did not enhance the self-concepts of children, except for those children in the second grade. PMID- 1792116 TI - Geriatric depression scale: consistency of depressive symptoms over time. PMID- 1792117 TI - Eye color and feeding behavior of animals. PMID- 1792118 TI - Self-control in a sample of elementary school-age gifted youth. AB - Self-control was studied for 34 boys and 34 girls who ranged in age from 8 to 14 years and resided in a rural southern area. Boys tended to rate themselves higher than did the girls. PMID- 1792119 TI - Influence of vocabulary-age on unilateral picture-naming reaction times of normal subjects. AB - The present study measured naming reaction times of normal subjects to unilaterally presented pictures corresponding to vocabulary levels of less than 5.5, 9.5 - 10.5, and greater than 18.0 years of age. An analysis of variance of latencies showed a significant interaction between visual fields and stimuli. Post hoc tests were interpreted to suggest that the normal right hemisphere was capable of performing certain differential picture encoding operations up to 10.5 years of age and not beyond. Also, unlike the left hemisphere, the right hemisphere does not appear to be organized on a developmental hierarchy, which corresponds with the clinical literature. PMID- 1792120 TI - Trust and adolescent sports: starters vs nonstarters. AB - Confirming earlier research, starters in basketball were found to be less trusting than nonstarters among junior high school boys (n = 12) and girls (n = 18). Researchers should explore the etiology of these differences. PMID- 1792121 TI - Social integration and suicide in the Caribbean Islands. PMID- 1792122 TI - Correlations among field dependence-independence, sex, sex-role stereotype, and age of preschoolers. AB - Preschoolers (27 boys, mean age = 4.7 yr.; 24 girls, mean age = 4.6 yr.) were assessed for field dependence-independence (Preschool Embedded Figures Test), sex role stereotyping (Sex-role Learning Inventory), and receptive verbal intelligence (Peabody Picture Vocabulary Test--Revised). Relative to the girls, the boys were significantly less field-independent and significantly more sex role stereotyped. After age and Peabody IQs were partialled out by multiple regression, same-sex typing in boys and cross-sex typing in girls were significant predictors of field independence. The regression analysis also suggested that, by 5.3 yr. of age, the boys as a group surpassed the girls on field independence. Limitations of the present research and educational implications of the over-all findings are discussed. PMID- 1792123 TI - Differential motion thresholds to sinusoidal gratings at two eccentricities. AB - Differential motion thresholds were measured at eccentricities of 9 degrees and 16.6 degrees using computer-generated sinusoidal gratings. Three spatial frequencies (0.51, 0.25, and 0.13 cycles/deg) were examined at reference velocities of 2, 4, 8, 16, 32, and 48 deg/sec. Minimum differential velocity thresholds were between 20 and 30% of the reference velocities for the three spatial frequencies at both eccentricities. Increasing eccentricity produced an increase in the velocity at which minimum velocity discrimination occurred. Temporal frequency tuning was between 4 and 8 Hz, regardless of eccentricity. PMID- 1792124 TI - Dissociation in ambidextrous students. AB - 95 students completed Bernstein and Putnam's Dissociative Experiences Scale and Annett's Handedness Questionnaire. Greater dissociation was statistically associated with ambidexterity of these undergraduates. PMID- 1792125 TI - Gender differences in perceived intensity and affect of pain between athletes and nonathletes. AB - The present investigation was conducted to test empirically possible gender differences between athletes and nonathletes on measures of perceived intensity and affect of pain. Athletes were 7 male and 7 female NCAA Division I track athletes. The nonathletes, 7 men and 7 women, were randomly selected from undergraduate classes in physical activities. Responses on visual analogue scales for perceived pain intensity and pain affect were recorded for a cold-water pressor test. Significant group differences examined by Bonferroni contrasts indicated differences between nonathletic women and the other 3 groups on intensity of pain and for male and female athletes on pain affect, as well as for male athletes and nonathletes on pain affect. Univariate analyses of variance indicated significant differences on intensity and affect associated with pain. Research must explore whether differences are related to socialization or personality. PMID- 1792126 TI - Visual memory development in preschool children. AB - 113 3-, 4-, 5-, and 6-yr.-old preschool children were administered the Bannatyne Visuospatial Memory test to obtain cross-sectional data on a downward extension of the test instrument. Means, standard deviations, and correlation coefficients for the sample as well as estimates of validity and reliability are reported. Analysis of variance for the number of correct matches indicated significant differences for age but not for sex. Results were consistent with previous findings and support the efficacy of this test in assessing motor-free visuospatial memory of preschool children as young as three. PMID- 1792127 TI - Stability of emotionality scores. AB - We hypothesized the stability of scores on emotionality given by 111 young adults, whose mean age was 16.6 yr, 132 adults, whose mean age was 29.9 yr., and 48 older adults, whose mean age was 53.3 yr. Significant correlations were obtained between scores given to 210 words across age and sex groups. Pearson correlations were calculated over words and not over subjects. The correlations between scores of young people and adults were .90, between young and older people .80, and between adults and older people .87. Men's and women's scores correlated .89. PMID- 1792128 TI - Grip strength as a function of repetitive trials. AB - An experiment on repetitive hand-gripping tasks was conducted to determine the functional relationship between the maximum grip strength and number of trials. Nine male subjects performed 30 gripping trials at their maximum strengths with 15-sec. rests between trials. Performance dropped significantly after two trials. Over-all, there was a 30% drop in maximum grip strength after 30 trials. The decrease in strength over trials is described by a logarithmic function. PMID- 1792129 TI - Open-field parameters and maze learning in aggressive and nonaggressive male mice. AB - Significant differences were observed in thigmotaxis, ambulation, and latency to move (time to start ambulating) between highly aggressive (TA) and low aggressive (TNA) male mice. The former displayed more thigmotaxis, ambulated more, and had a shorter latency to move than the TNA animals. Also they voided a greater number of urinary spots and defecated less than TNA. Further they were superior to the TNA mice in maze-learning capacity. The tendency to enter inner partitions of the field as well as total ambulation increased after learning by TA mice. The training toward nonaggressiveness of TA mice suppressed aggressive responses, thigmotaxis, and the number of urinary spots but enhanced defecation. All measures returned to their initial levels after one month of rest. The attacking behaviour of TA animals increased both thigmotaxis and ambulation. PMID- 1792130 TI - On the hypothesized physiological correspondence between perceptual and imagery processes. AB - This research examined some aspects of the interaction between imagery and perception of 16 male and 84 female undergraduate students in psychology. The data indicate that, when a subject is imagining with open eyes, a modification in the external stimulation of the retina, produced by covering the eyes, strongly modifies the imaginative activity. The majority of the subjects observed a loss of mental image. In 54% of the subjects the loss of image was provoked by covering only one of the two eyes. Other subjects presented interesting alterations of the mental image. The observed differences among subjects are interpreted by hypothesizing a correspondence between perceptual and imaginative styles that could employ common neurophysiological structures at central and perhaps peripheral levels. PMID- 1792131 TI - Cardiac-locomotor coupling while finger tapping: Part II. A cross-over control study. AB - Cardiac-locomotor coupling (CLC) has been reported by us while people finger tap at cadences natural to them. Since then, we have developed a simple cross-over control strategy in which the heart rate of one subject is related to the finger tapping rate of another. Of the 20 normal subjects previously studied while tapping a telegraph key at a comfortable rate for 10 min., reevaluation of their data showed that 9 (45%) and 4 (20%) of them, under test and control conditions, respectively, appeared to couple at a single-digit integer ratio. Neither the incidence nor the intensity of apparent CLC under the two conditions was significantly different. Raster plots of the most tightly related rates gave no evidence of phase locking. These results have two implications. First, previously published reports on CLC (and other entrainment phenomena) should be interpreted with caution, and cross-over controls should be considered in future research. Second, the absence of CLC during finger tapping suggests that CLC may only be functionally significant during exercise of large muscle groups (e.g., by minimization of cardiac afterload) or when impact-loading occurs (e.g., by enhancing cardiac ventricular emptying. PMID- 1792132 TI - Smooth periodic eye movements can entrain perceptual alternation. AB - The reversal signals and eye movements of three subjects looking at a Necker cube that moved sinusoidally in the subject's field of view were recorded. The aim of the experiment was to provide evidence of possible synchronisation of perceptual alternation with smooth periodic eye movements. The occurrence of synchronisation was demonstrated for a proper choice of the eye oscillation period by both a sharp reduction in the fluctuations of the reversal time and a change in the mean value of this parameter. Such variations resulted in a close match of the mean reversal time to a multiple of the eye oscillation period. Further, inversions of the direction of eye movements elicited pattern reversals in a systematic way, characteristic for each subject. The described phenomenon, which is a typical example of nonlinear-resonant behaviour, stresses a new important aspect of the complex interaction pattern relating pursuit eye movements to visual perception. PMID- 1792133 TI - Effectiveness of a personalized fitness module on knowledge, attitude, and cardiovascular endurance of fifth-grade students: "heart smart". AB - The effectiveness of a Personalized Fitness Module was compared to a Traditional Fitness Unit, both of which were designed to develop knowledge, behavioral skills, fitness and positive attitudes. 95 students in Grade 5 and from intact physical education/health classes within two public schools participated in a seven-week cardiovascular fitness program. The experimental group of 48 participated in the personalized and noncompetitive fitness module. The control group of 47 participated in the traditional unit, a teacher-centered fitness module. Students received a total of 14 55-min. lessons over seven weeks. Pre- and posttest measurements included the Superkids-Superfit Knowledge Test, the Children's Attitudes Toward Physical Activity Inventory, and the one-mile run/walk. Data were analyzed using group mean gain scores on eight dependent variables (knowledge, six subscales of attitude, and one-mile run/walk) followed by a multivariate analysis of variance. A significant difference between groups led to a discriminant function analysis as a post hoc test. Findings indicated that the use of the personalized unit can substantially improve one-mile run/walk time. The use of modules of this type in health and physical education programs may promote life-long exercise patterns and fitness. PMID- 1792134 TI - Discrete finger response latencies in a simple reaction time task. AB - The present study evaluated the potential for neuroanatomical factors to operate in a simple reaction time task. That is, response latencies were recorded for all ten fingers on a Donders' A reaction time task. Two finger-placement conditions were used, a single response key condition and a multiple response key condition. This latter condition required subjects to place all ten fingers on response keys. 30 male, right-handed subjects participated. No significant effects were found, indicating that there are no intrinsically slow or fast fingers. This finding is discussed in the context of reaction time differences between individual stimulus-response (finger) pairs in choice-reaction time tasks. PMID- 1792135 TI - Characteristics of handwriting of subjects with multiple sclerosis. AB - Multiple sclerosis is a widespread neurological disorder with a variety of symptoms, some of which are noticeable in handwriting. The handwritings of two groups of 23 subjects each (people with multiple sclerosis and a comparison group), matched for age and gender, were compared, using the Roman-Staempfli Psychogram, a graphological charting system with seven additional categories. Of 50 indicators examined, statistical analysis showed means of 37 to be significantly different. The one-way analyses of variance showed that 26 of the 32 indicators originally expected to be significantly different between the groups were. 14 of the 17 predictions of higher MS scores were significantly confirmed as were 11 of the 15 predictions of lower MS scores. These results suggest that neurological damage is reflected in handwriting and can be measured graphologically for physical or psychological characteristics. Possible reasons for variance from the hypotheses were discussed. PMID- 1792136 TI - Frequency and intensity effects upon temporal and aerodynamic aspects of vocal fold diadochokinesis. AB - The present study of vocal fold diadochokinesis in 18 young adult women yielded statistically significant differences in intensity (at percentiles 25%, 50%, 75% of range) of production for vowel /lambda/ repetition rate. In addition, there were statistically significant differences for vocal frequency and intensity effects for airflow rate through the vocal folds at the 25th, 50th, and 75th percentile points within the functional vocal range. Clinical applications of the data are suggested. PMID- 1792137 TI - Sleep-quality among girls with different involvement in competitive sports during fall in the Arctic Circle. AB - Eight high-school girls participating in competitive sports and six non participating girls living north of the polar circle recorded their sleep once a week during the Fall, including the period when the sun does not rise above the horizon. Sleep-quality scores were computed as the sum of answers identical to a present "right" answer indicating good sleep-quality. Significant differences on sleep-quality between the two groups were found, but a significant influence of amount of daylight or exercise could not be confirmed. When sleep-quality was ranked during three periods through the Fall, the girls participating in competitive sports showed a trend of increasing sleep-quality and the nonparticipants a decreasing one. An explanation based on influence of exercise thresholds upon sleep-quality is presented. PMID- 1792138 TI - Discriminating artists from nonartists by their eye-fixation patterns. AB - Discriminant analysis was used to differentiate 15 artists from 15 non-artists on the basis of their eye-fixation patterns. Contributing significantly to the discriminant function were fixation densities on the less important aspects of familiar and unfamiliar paintings. PMID- 1792139 TI - Olfactory deficits in elderly subjects and Parkinson patients. AB - Two groups of subjects, 8 Parkinson patients and 16 normal elderly people, were examined on a matching and a naming olfactory task. On the former, subjects had to recognize among four a previously sniffed odour, while on the latter they had to label an odour by choosing among four alternatives proposed by the examiner. Analysis indicated different trends for the two groups, Parkinson patients being more efficient in naming than in matching, and the elderly people showing the opposite pattern. Data are discussed with reference to the loss of dopamine in Parkinson patients and the decline of memory processes in elderly people. PMID- 1792140 TI - Visual detection of body weight change in young women. AB - To assess whether small changes in body weight can be visually detected, college students (58 women and 42 men) were asked to select the less heavy person shown in two photographs for each of 33 young women. All of these women had been photographed twice in a standardized pose and attire, separated by an 8-wk. interval during which most of them lost weight. These pairs were presented in varying orders to control for the order and side of presentation. One photograph was reliably selected as the lighter person for 64% of the pairs, but the picture selected was in fact lighter only 57% of the time. The accuracy of selecting the lighter photograph was not correlated with the percent weight change for the person shown in the pairs of photographs. The results suggest that small changes in women's weight may not have a significant perceptual effect, particularly for male perceivers. PMID- 1792141 TI - The Egocentricity Index as a measure of self-esteem and egocentric personality style for inpatient adolescents. AB - The Egocentricity Index (EI) was assessed as a measure of self-esteem, egocentric behavior, and a basic statistic in a population of 60 predominantly behavior disordered, inpatient adolescents. Millon Adolescent Personality Inventory (MAPI) scales served as criterion measures. A low mean EI was found in these youngsters but was not mediated by low self-esteem as the Index was uncorrelated with self esteem/self-concept measures. The Index did correlate with an histrionic type of egocentric personality style. The purported association between the EI components of pair and reflection responses was not observed here. PMID- 1792142 TI - Comparative time estimation skills of Hispanic children. AB - 76 Hispanic and 47 Caucasian children from an urban school district located in a racially mixed neighborhood were compared on their ability to make functional time estimates. The findings indicate that initial differences in ability to make time estimations dissipate across Grades 1 to 5. PMID- 1792143 TI - Response: effects of aerobic exercise on transient mood state. PMID- 1792144 TI - Oral contraceptive use, caffeine consumption, field-dependence, and the discrimination of colors. AB - We attempted to validate laboratory research which indicated that single doses of oral contraceptives (OCs) and caffeine affect the ability to discriminate colors (Bohme & Bohme, 1985). We did this in a nonlaboratory setting by surveying habitual use of OCs and caffeine by 43 female college students and relating that information to their performance on the Farnsworth-Munsell 100-Hue Test. When field-dependence, conceptualized as an indirect measure of sensitivity of the nervous system and previously shown to be strongly related to color discrimination, was included in the analyses, the results supported Bohme and Bohme's findings. For Trays 2 and 3 of the 100-Hue Test (yellow through blue of the color spectrum), higher caffeine consumption among OC users was related to poorer color discrimination, whereas, among nonusers of OCs, it was related to better performance. Study design limitations do not permit attribution of causation to either caffeine or OCs at this time. PMID- 1792145 TI - Reliability of naive judges of genuine suicide notes. PMID- 1792146 TI - Students' perceptions of male teachers: effects of teachers' dress and students' characteristics. AB - The purpose of this study was to explore the effects of a male teacher's clothing and selected students' characteristics on students' perceptions of teachers' characteristics. The sample consisted of 152 male and female high school students. Respondents selected one of four photographs of a male teacher model dressed in four different clothing styles for each of 20 teachers' characteristic statements. The mediating effects of students' gender, formality of clothing, and perceptions of the importance of clothing were also investigated. Significant differences among the four clothing styles were found for all 20 statements. Students' gender and rated importance of clothing had some influence on this relationship. The results supplement previous research on female teachers by suggesting that different types of clothing also influence students' perceptions of male teachers and that students' characteristics have some mediating effect. PMID- 1792147 TI - Personality of healthy young adults with sleep paralysis. AB - Sleep paralysis occurs in normal persons. This phenomenon had been studied psychoanalytically or in terms of the deviation of the victims' personality. This present study aimed to assess the personalities of such persons by using the MMPI and the Maudsley Personality Inventory. The subjects showed a slightly higher mean T score on the MMPI Paranoia Scale than those who did not have this experience. Although this personality difference might be related to the occurrence of the phenomenon, this difference is probably too small to take a major role. It is unlikely that the subjects developed paranoic behavior through their experiences of sleep paralysis, since their experiences were very few. Some of the subjects might have only overestimated their behavior and experiences concerning delusions and hallucinations, with the result that their Paranoia scores were higher and perhaps their kanashibari experiences exaggerated. PMID- 1792148 TI - Relationship between body-image and self-consciousness. AB - The purpose of this study was to assess whether there is a relation between body image and self-consciousness and if there are any sex differences on measures of these two concepts. A total of 267 undergraduates, 56 men and 211 women whose ages ranged from 19 to 25 years, were tested. Analysis indicated a significant negative correlation between body-image and self-consciousness and between body image and social anxiety. Private and public self-consciousness correlated positively with each other as well as with social anxiety. Men and women differed significantly on social anxiety only. PMID- 1792149 TI - Memory psychophysics for areas: distortion in natural memory of a school campus. AB - As the perceived magnitude of a stimulus is related by power function t o the physical magnitude, the remembered visual areas and length are also related by power function to the actual areas and length. The main purpose of this study is to examine whether the power law is also applicable to remembered areas in natural environment, e.g., a school campus, and to its old memory. 31 junior high students and seven university undergraduates who graduated from the same junior high school seven years before were asked to draw a layout of the school campus. The areas of the school facilities and field, and other features of drawings such as the number of recalled facilities and objects, and direction of the sketch were assessed. Analysis showed that the areas remembered by the junior high subjects followed the power law while those remembered by the undergraduates did not. The divergence of exponents observed for undergraduates was accounted for by reconstruction by schema. PMID- 1792150 TI - [Diagnostic accuracy of breast sonography. Comparison among three different techniques]. AB - Mechanical arc scanning is widely used for breast sonography in Japan. The authors have used three different kinds of devices over the past seven years. The diagnostic accuracy was compared among three groups of patients with pathologically confirmed breast masses. In group A, 309 cases (77 carcinomas) were evaluated with a 10 MHz contact compound scanner, and the sensitivity, specificity and accuracy rates were 77.9%, 97.8% and 92.9%, respectively. In group B, 306 cases (56 carcinomas) were evaluated with a 5 or 7.5 MHz mechanical arc scanner, and the sensitivity, specificity and accuracy rates were 89.3%, 84.8% and 85.6%, respectively. In group C, 296 cases (71 carcinomas) were evaluated with a 7.5 MHz real time scanner, and the sensitivity, specificity and accuracy rates were 95.8%, 92.4% and 93.2%, respectively. In cases with T1 breast cancer, the methods had sensitivities of 60.0%, 85.7% and 94.5%, respectively. The sensitivity of the real-time scanner was not significantly different from that of the mechanical arc scanner. In conclusion, the hand-held real-time scanner with high-frequency transducer is a simple, useful device with high diagnostic accuracy for breast examination and can be used as a substitute for the mechanical arc scanner. PMID- 1792151 TI - [Magnetic resonance imaging of the adrenal gland]. AB - Adrenal imaging was performed using magnetic resonance (MR) was in 100 patients who had no clinical or biochemical evidence of adrenal abnormality and in 19 patients with 24 adrenal lesions (adenoma in 5, hyperplasia in 2, metastasis in 5, (lung cancer in 1, hepatoma in 4) adrenal cancer in 1, pheochromocytoma in 3, neuroblastoma in 3). Normal adrenal glands showed intermediate intensity between muscle and liver, and were detected in over 90% of cases on T1-weighted images (T1-weighted SE, inversion recovery). Adenomas and hyperplasias had the same intensity as normal glands. Medullary masses showed extreme hyperintensity on T2 weighted images and could be differentiated from cortical masses. Neuroblastomas were detected as hyperintense tumors with intratumoral hemorrhage and necrosis on T2-weighted MR images. Metastatic adrenal tumors from lung cancer were hyperintense on T2-weighted images, while metastasis from hepatoma showed low intensity on the same pulse sequence. In diagnosing adrenal metastasis, we must compare and contrast the tumor intensity and structure with those of the primary lesions. MR is considered a useful modality in characterizing adrenal tissue. PMID- 1792152 TI - [Three-dimensional axial volume acquisition on meniscal lesions of the knee]. AB - Axial three-dimensional volume scans obtained by magnetic resonance (MR) imaging were used to evaluate meniscal lesions of the knee in 28 knees of 26 cases. Axial 0.7 mm thin-sliced images with volume scan outlined the overall meniscal appearance for the first time. Axial volume scan was essential to the diagnosis of discoid lateral meniscus because only it could depict the characteristic elongated appearance of discoid lateral meniscus. Radial meniscal tears were depicted only by this technique: conventional sagittal and coronal views could not detect this type of meniscal tear. Volume scan could detect the precise extent of lesions with horizontal meniscal tears and meniscal degeneration. These MR findings obtained by axial volume scans were confirmed by arthroscopy in all cases. We concluded that volume scans were extremely useful in the evaluation of meniscal lesions because they offered axial views that provided much information on menisci located horizontally in the knee. PMID- 1792153 TI - [Embolotherapy of varicocele by stainless steel coil]. AB - Fifty-two patients with varicocele underwent embolotherapy using stainless steel coils. Forty-six of the patients complained of infertility, four of scrotal mass and two of scrotal pain. The procedure was successful in 42 of the 52 patients (81%). Positive semen analyses increased 53% (16/30), and the number of subsequent pregnancies was five of 33 (15%). We conclude that embolotherapy with the coils is a useful therapeutic procedure for varicoceles. PMID- 1792154 TI - [The assessment of cortical and spongy bone mineral content with quantitative computed tomography. A comparison of measurement sites in relation to certain diseases with metabolic bone disorder]. AB - The CT numbers of cortex at the level of 20 cm (CT20) and spongiosa in the lateral condyle at the level of 2 cm (CT20) proximal from the distal end of the femur, and the bone mineral density of spongiosa in the L3 body (BMD), were obtained by QCT. The study included 43 female patients with rheumatoid arthritis (RA), 71 female patients with primary osteoporosis (OP), 20 female nondialyzed patients with chronic renal failure (CRF:nonHD), 37 hemodialyzed patients (CRF:HD), including 13 parathyroidectomized patients (CRF:HD, PTX), and 10 healthy volunteers. CT20 correlated closely with age in RA. CT02 and BMD correlated closely with age in RA and OP. CT20 and CT02 correlated closely with the duration of hemodialysis in CRF:HD, but not with the duration of disease in RA. The values of CT20 and CT02 in the CRF:HD. PTX group were significantly lower than those in the other CRF groups. BMD in the RA groups was not different from that of healthy volunteers. The CT20 values of the one-third of RA patients older than 60 years were extremely low compared with those of the other two-thirds. The results indicated that BMD was useful in assessing bone mineral content in OP, but not in RA. CT02 and CT20 were useful in assessing bone mineral content in these three diseases, CT20 was especially useful for patients in the CRF:HD group and those with RA older than 60 years, but it was not useful in the CRF:nonHD group. PMID- 1792155 TI - [Low-dose rate telecobalt therapy as a boost against esophageal carcinomas]. AB - The results of treatment of 54 esophageal carcinomas managed with low-dose-rate telecobalt therapy (LDRT) as a boost were compared with those of 89 esophageal carcinomas treated with conventionally fractionated irradiation alone (CFI). The LDRT (1 Gy/hr, 5-7 Gy/day, to a total dose of 14-20 Gy) was boosted about 10 days after the CFI dose of 60 Gy. Although the LDRT group included more advanced cases than the CFI group, local effects and survival rate of the LDRT group, especially those with tumorous X-P and serrated types, were better than those of the CFI group. Late complications were more severe in the LDRT group. However, they were acceptable when the total dose in the LDRT group was brought under 80 Gy. PMID- 1792156 TI - [Radiation effect on anti-tumor activity of C3H mouse spleen cells to MH134 hepatoma cells]. AB - Tumor-specific immunity was induced in C3H mice by immunizing with syngeneic MH134 hepatoma cells. The radiation sensitivity of tumor-specific effector cells in the immunized spleen cells and that of non-specific effector cells in normal spleen cells were compared. The spleen cells, both immunized and normal, were irradiated in vitro, then mixed with the tumor cells. The anti-tumor activity of the cells was measured by Winn assay and by a cytostatic test in vivo with diffusion chambers, on the basis of growth inhibition of tumor cells. The growth of tumor cells was inhibited by immune spleen cells more effectively than by normal spleen cells. The anti-tumor activity of immunized and normal spleen cells decreased dose-dependently in the respective ranges of 2.5-20 Gy and 2.5-10 Gy irradiation. In the normal spleen cells, anti-tumor activity was mainly detected in the fraction of non-adherent cells, not in adherent cells. The anti-tumor activity of non-adherent cells was diminished with 2.5 Gy irradiation. These results indicated that the radio-resistance of anti-tumor effector cells in C3H mice was increased by immunization with syngeneic MH134 hepatoma cells. Based on these and other findings in this experimental system, we concluded that tumor specific effector cells that were radiosensitive at 10-20 Gy might involve delayed-type hypersensitivity (DTH) effector cells (macrophages) and that non specific effector cells that were radiosensitive at 2.5-10 Gy might involve natural killer cells and lymphokine-activated killer cells. PMID- 1792157 TI - [Clinical application of asialoglycoprotein receptor-mediated liver scintigraphy using 99mTc-DTPA-galactosyl-human serum albumin]. AB - Technetium-99m-diethylenetriaminepentaacetic acid-galactosyl-human serum albumin (99mTc-GSA) is a new liver scintigraphy agent which binds to asialoglycoprotein receptors on the hepatocytes. Studies were performed in three normal volunteers and 19 patients with chronic liver diseases. Serial scintigrams and time-activity curves of heart and lever were obtained for 60 min following a single intravenous injection of 99mTc-GSA (1 mg/185 MBq). % Injected dose (%ID) in the blood at 60 min after injection and that in the liver were determined. Excellent hepatic images were obtained for 60 min in normal subjects, and neither blood pool image nor extrahepatic uptake was recognized. In the studies of patients, however, blood pools were also visualized in various degrees suggesting altered receptor quantity, although the livers were visualized clearly. The %ID in the blood at 60 min after the injection showed significant correlations with serum albumin levels (r = -0.741, p less than 0.0001), retention rates of ICG at 15 min (r = 0.855, p less than 0.0001), plasma disappearance rates of ICG (r = -0.760, p less than 0.0005), prothrombin times (r = -0.696, p less than 0.002), hepaplastin tests (r = -0.575, p less than 0.05), total bilirubin levels (r = 0.689, p less than 0.001) and Child Turcotte scores (r = 0.769, p less than 0.0001). Significant differences of %ID in both blood and liver were observed between normal subjects and patients in accordance with severities of the hepatic disorders. These results suggest that 99mTc-GSA liver scintigraphy is useful in evaluating the liver function. PMID- 1792159 TI - Family theory for rural research and practice. PMID- 1792158 TI - [MR-angiography of veins in the lower extremities]. AB - Phase contrast MR-angiography (MRA) of veins in the lower extremities was performed in 10 healthy volunteers and 2 patients with deep vein thrombosis of the lower extremities. In all volunteers, MRA demonstrated bilateral large saphenous veins, femoral veins and popliteal veins. Deep veins in the leg were visualized in only 3 out of 20 legs examined, but with compression of the thigh they were visualized in 4 out of 7 legs subjected to compression. In patients with deep vein thrombosis, obstruction of the femoral veins and development of the collateral veins were clearly visualized. It is concluded that MRA may be a valuable technic for the evaluation of the veins patency in the lower extremities. PMID- 1792160 TI - On fear and courage: a first encounter with AIDS in rural Vermont. PMID- 1792161 TI - Telephone reassurance: a social support intervention. PMID- 1792162 TI - Crisis intervention and suicide prevention from a rural perspective. PMID- 1792163 TI - Innovative approaches to emotional support and mental health needs in a rural setting: initiation, implementation, and expansion. PMID- 1792164 TI - The role of rural community hospitals: opportunities and challenges for rural health nurses and nursing. PMID- 1792165 TI - Swing beds: providing extended care in rural acute-care hospitals. PMID- 1792166 TI - The nurse administrator in the rural hospital: selected issues, challenges, and rewards. PMID- 1792167 TI - Rural research: the Lamoille County experience. PMID- 1792168 TI - Shared governance in a rural health care setting. PMID- 1792169 TI - Nursing on Swans Island, Maine, 1938-1975. PMID- 1792170 TI - Rural health nursing. PMID- 1792171 TI - Being there and caring: a philosophical analysis and theoretical model of professional nurse caring in rural environments. PMID- 1792172 TI - Implementing rural preceptorships in baccalaureate nursing education. PMID- 1792173 TI - Distance learning: new partnerships for nursing in rural areas. PMID- 1792174 TI - Rural nursing: developing the theory base. PMID- 1792175 TI - Mental health and illness nursing in rural Vermont: case illustration of a farm family. PMID- 1792176 TI - Training family caregivers of rural elderly. PMID- 1792177 TI - Medication-taking by the frail elderly in two ethnic groups. AB - A complex and dangerous area of medical intervention with the elderly population is drug therapy. Although drugs have contributed to the well-being of many older persons, some elderly individuals are at risk due to polypharmacy and age-related factors. The purpose of this preliminary study was to investigate the medication taking behaviors of two ethnic groups of noninstitutionalized frail elderly individuals. The findings indicate that these individuals may be at risk for harm due to their medication-taking practices. Healthcare professionals must evaluate drug use by the elderly and be aware of the risks of drug misuse by this vulnerable group. PMID- 1792178 TI - Primary health care: toward equity and efficiency in the accident and emergency department in Australia. AB - Primary health care in the accident and emergency department has been a philosophy of care that reacts to more than a client's presenting complaint (reactive care). It aims not only to manage the presenting complaint, but also to integrate continuing care with disease prevention and health promotion. Primary health care in the AED is intended to build fences around the cliffs forming our healthcare problems. At the same time it also encourages the provision of intensive care ambulances for those clients unfortunate to fall before the fences are finished or who fall over the fences. PMID- 1792179 TI - Death from a spiritual perspective. PMID- 1792180 TI - The "either/or" theory of nurse decision making. PMID- 1792181 TI - An ecofeminist analysis of nursing knowledge. AB - The planet is facing ecological disaster, yet the environmental domain of nursing is currently understood as the immediate surroundings or circumstances of the individual or family. Such a definition keeps nurses from addressing the larger social, political, economic, and global issues that affect health. The author suggests that nursing, essentially a women's profession, and the environment share a long history of domination and oppression; and that an ecofeminist perspective offers a conceptual foundation for developing a new consciousness of the environment with the potential for liberating both. PMID- 1792182 TI - Further studies on the musculo-fibrous anomaly of the Barrett's mucosa in esophageal carcinomas. AB - A total of 50 esophagi with carcinoma were reviewed for the presence of histological changes in the subepithelial tissues of the Barrett's mucosa. Those changes consisted in the thickening of the muscularis mucosae, the presence of muscle fibres in the lamina propria mucosae, fibrosis of the submucosa and sometimes total obliteration of the subepithelial tissues by collagen-rich sclerosis. Those changes have been connoted as "musculo-fibrous anomaly". Barrett's mucosa was present in all 18 specimens with adenocarcinoma and in 13 of the remaining 32 specimens with squamous cell carcinoma. Musculo-fibrous anomaly of the Barrett's mucosa occurred in all 18 specimens with adenocarcinoma and in 10 of the 13 specimens with a concomitantly growing squamous cell carcinoma. Esophageal and metaplastic glands were surrounded, compressed and deformed by the fibrotic tissue. The histological changes described explain the difficulties in the differential diagnosis--in biopsy specimens--between normal glands or glands with dysplastic changes "trapped" in the collagen-rich fibrotic tissue and true invasive adenocarcinoma of the Barrett's esophagus. PMID- 1792183 TI - Morphology of lymph nodes in the resected rectum of patients with rectal carcinoma. AB - In 424 patients with rectal carcinoma the lymph nodes of resection specimens were investigated with computer-aided morphometry. Number and size of the lymph nodes and metastases as well as the morphological data of the follicular and paracortical hyperplasia were determined. The distribution of these lymph node parameters according to the anatomical localization of the nodes was also noted. The morphometrical analysis of the 12,957 lymph nodes showed that incidence of the metastases and the lymph node reactions depends on the localization of the nodes, and the lymph node reactions may be related to the tumor. Furthermore our data suggest that the detection of lymph nodes depends first of all on the carefulness of the pathologist, which can be supported by special procedures as step sections and fat clearing. PMID- 1792184 TI - A simple, efficient, and reproducible method for estimating the malignant potential of uveal melanoma from routine H & E slides. AB - The malignant potential of 100 intraocular melanomas was assessed by determining the mean of the ten largest nucleoli (MTLN) using a modification of previously described techniques. For each microslide, a five millimeter path through the central portion of the tumor was traversed on a manually controlled mechanical stage. Selected nucleoli in this area were measured at 2000x power using a digital filar micrometer. In their reproducibility and correlation with malignant potential, these measurements proved comparable to standard deviation of nucleolar area (SDNA), which has been well documented as an objective histologic predictor of mortality from intraocular melanoma. This new method for measuring MTLN requires less than 11 minutes per case, compared to an average of 28 minutes for the original method. The measurements of SDNA required approximately 40 minutes per case and a much more elaborate system than that needed for MTLN. PMID- 1792185 TI - Atypical stromal giant cells of cervix uteri--evidence of Schwann cell origin. AB - The report describes atypical multinucleated giant cells adjacent to proliferated nerve fascicles in a circumscribed subepithelial area of the cervix uteri of a 44 year-old multipara. Ultrastructural examination revealed cytoplasmatic processes, basal lamina, intracytoplasmic microfibrils, bizarre nuclear shapes with pseudoinclusions and nuclear fragments connected by small chromatin bridges (nucleotesimals). Immunohistochemical examination showed positive staining for vimentin and S-100 protein. Quantitative topography exhibited an isotropic distribution of the giant cells in an anisotropic architecture of mononuclear cells. A Schwann cell origin of the atypical giant cells is postulated. Aetiopathogenetically the lesion is regarded to be due to a trauma during delivery followed by regenerative proliferation of nerve fascicles and degenerative alterations of proliferating Schwann cells. The knowledge of this lesion is considered important, because the atypical cells could be confounded with malignant neoplastic cells. PMID- 1792186 TI - Silver staining of senile plaques and neurofibrillary tangles in paraffin sections. A simple and effective method. AB - A one-step silver staining method using a protective colloidal developer of gelatin and formic acid was originally established for demonstration of argyrophilic nucleolus organizer regions by controlled reduction of silver. We describe here a new application of this silver technique that can easily be performed to demonstrate senile plaques (SP) and neurofibrillary tangles (NFT) on paraffin sections. Preliminary results in ten cases of senile dementia of Alzheimer type and five cases of amyloid congophilic angiopathy showed a reliable demonstration of amyloid and neuritic type SP as well as NFT in all 15 cases. In addition, deposits of perivascular amyloid and areas of fibrillar amyloid, the diffuse type of senile plaques, were revealed. The success seems to depend particularly on the low concentration of formic acid in the developer, which might be the responsible agent for the careful revealing of buried argyrophilic structures in SP and NFT. The staining features were quite similar to those with anti-beta and anti-tau immunostaining. This result suggests a high specificity of this method for extracellular and intraneuronal cerebral amyloid. The detailed staining of delicate morphological structures points to a high sensitivity for cerebral amyloids, senile plaques and neurofibrillary tangles, respectively, by this simple and inexpensive method. PMID- 1792187 TI - Matrix remodelling and fibroblast phenotype in early lesions of human cutaneous leishmaniasis. AB - The connective matrix participates directly in early pathological events observed in the cutaneous lesion of leishmaniasis, due to Leishmania braziliensis guyanensis. A sample of 19 skin biopsies was examined by light and electron microscopy, in order to identify the matrix components (collagen isotypes I to IV, elastin and membrane associated proteins) of the dermal infiltrate, and the pattern of organization of the reparative connective matrix. An extensive remodelling process of apparently parasite-independent nature involves different fibroblast sub-populations. The original organization of this immune-mediated lesion offers a rare opportunity to study in situ the local inflammatory mediators inducing the activation of fibroblasts and macrophages. PMID- 1792188 TI - Innervation of spinal ligaments of patients with disc herniation. An immunohistochemical study. AB - The purpose of this work was to demonstrate whether neural elements are present in the spinal ligaments removed from patients with disc herniation. The tissue samples were stained by an immunohistochemical technique using antibodies to neurofilament protein (NFP) subunits as specific markers. Numerous NFP immunoreactive nerve fibers and free nerve endings were demonstrated within the ligamentous structures. These findings were discussed relative to the low-back pain of disc herniated patients. PMID- 1792189 TI - Congenital hydrocephalus associated with anomalies of midline telencephalic structures. A case report. AB - Hydrocephalus is classified into communicating, if cerebrospinal fluid (CSF) can flow freely from the ventricle to the subarachnoid space, and into non communicating, if it cannot. The cause of hydrocephalus is diverse, either congenital or acquired conditions causing obstruction to the flow of CSF. The location of the lesion is more important than the size or nature of the lesion. We describe an unusual case of congenital communicating hydrocephalus associated with multiple malformations of midline telencephalic structures. This was a premature male baby of 30 weeks gestational age. The pregnancy was terminated after revealing a hydrocephalus by ultrasonography. The cerebral hemispheres showed marked thinning of parenchyme with dilated lateral ventricles, communication of lateral and third ventricles with dilated foramina of Monro, absence of the septum pellucidum, and hypoplasia or focal agenesis of posterior portion of corpus callosum with dorsal dilation of the third ventricle. The right fornix appeared as a single thick midline cord in its approximately normal position and the hippocampi were poorly developed, especially in the left side. The left fornix was rudimentary. PMID- 1792190 TI - Somatotropic adenomas without acromegaly. AB - Seventeen somatotropic adenomas removed from patients without acromegaly were studied. Thirteen of them presented as a prolactinoma with amenorrhea and/or galactorrhea and elevated serum PRL levels. According to basal serum GH levels, the patients were divided into two groups, namely Group I: GH slightly elevated (n = 4) and group II: GH less than or equal to 5 micrograms/l (n = 13). The tumoral GH secretion was proved by immunocytochemistry in all cases and by intratumoral RIA, in vitro study and/or in situ hybridization in five of them. Pathological, clinical and biochemical relationships suggested two anatomoclinical aspects. In group I, the tumors were small, well-differentiated somatotropic adenomas with clinically silent GH hypersecretion. It is probably an early stage of the disease. In group II, the tumors were large with normal GH serum levels. They were poorly differentiated and secreted very low amounts of GH. In nine of them, PRL and/or PRL mRNA expression were also detected. These tumors do not secrete enough GH to increase serum levels and cause acromegaly. The somatotropic adenomas without acromegaly correspond to two anatomoclinical aspects of the disease. PMID- 1792191 TI - Apparently silent somatotroph adenomas. AB - We describe here 9 patients with somatotroph adenomas associated with mild features of acromegaly and basal plasma GH levels in the normal range. In 5 women and 4 men, 26 to 61 yrs old, the diagnosis of prolactinoma or non-secreting pituitary adenoma had been previously made on the basis of amenorrhea galactorrhea or tumoral symptoms. However, they had discrete signs of coarsening of the facial features and moderate but evolutive changes of hand and foot sizes. Basal GH levels were in the normal range (0.4 to 4.5 micrograms/l, N less than 5 micrograms/l) but unaffected by oral glucose and insulin tolerance tests while IGF-I concentrations were elevated in all the cases (range 1.7 to 5.8 U/ml, N: 0.37-1.41 U/ml). Plasma PRL concentrations were elevated in 5 patients (range 16 to 80 micrograms/l, N less than 13 micrograms/l in men and N less than 19 micrograms/l in women). The 9 patients had a macroadenoma with an extrasellar extension in 8 of them and all were operated on by the transsphenoidal route. Immunocytochemical studies demonstrated IRGH-cells in all the adenomas and IRPRL cells in 5 of them. Electron microscopic analysis of 3 tumors showed that the secretory granules were sparse and the Golgi apparatus poorly developed. Molecular biology of 7 tumors showed the presence of small amounts of GH mRNA. This result was in agreement with the morphological aspect, suggesting a low rate of GH synthesis. Thanks to these different approaches the diagnosis of silent somatotroph adenoma should sometimes be reconsidered.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792192 TI - Apolipoproteins and immunohistological differentiation of cells in the arterial wall of kidneys in transplant arteriopathy. Morphological parallels with atherosclerosis. AB - 22 nephrectomy specimens of renal allografts in chronic rejection after periods between 3 and 96 months, were studied immunohistologically. Various cell types in the arterial wall were characterized with antibodies specific against different cells of the mononuclear phagocyte system, against smooth muscle cells, and against differentiating lymphoid cells. In addition, the metabolism of lipoproteins was investigated using appropriate antibodies against several apolipoproteins. Subendothelial plaques of foam cells were found to consist of macrophages in foamy transformation. At the stage of intimal fibrosis the smooth muscle cells are more prominent. Lymphatic infiltration consists almost exclusively of T-lymphocytes. Apolipoprotein analysis reveals deposits of Apo A1, A2 and B1, most of them extracellular. According to these results, it is not only immunologic factors that are involved in arterial wall reactions during chronic transplant arteriopathy, but disorders of the lipoprotein metabolism--probably due to endothelial dysfunction--are also playing an important role like in atherosclerosis. PMID- 1792193 TI - Histological patterns of bone and articular tissues after orthopaedic reconstructive surgery (artificial joint implants). AB - Revision surgery after failures of joint replacements leads to histological studies on joint and bone tissues close to the implanted material. Aspectic loosening is the main complication. The surgical pathologist has to identify wear debris (metal, polyethylene, polymethylmethacrylate, chiefly) which promotes a histiocytic granuloma. Some surgical procedures such as cup or resurfacing arthroplasties create a new articular surface and a bone remodeling or necrosis. Cemented joint prostheses show various membrane structures between bone and the cement mantle while there is an association of bone resorption and formation. Non cemented, porous-coated joint prostheses induce little bone ingrowth, even in satisfactory clinical results. Mechanical factors are predominant in massive limb prostheses. For silicone elastomer implants or artificial ligaments, wear of material promotes many tissular reactions. Often used bone grafts show little creeping substitution process in case of homografts, even well-incorporated on X rays. More retrieval specimen studies are necessary to delineate precise topographical histological lesions, including non-loosened joint implants. PMID- 1792194 TI - The histopathology of the skin basal cell carcinoma with areas of intermediate differentiation. A metatypical carcinoma? AB - The histopathology of the skin basal cell carcinomas (BCCs) with areas of intermediate differentiation (ID) has been investigated. In a series of 127 BCCs, areas of ID were found in 28 tumors (22%), and also in an additional 10 cases of other series. These areas consisted of compact masses of cells without peripheral palisading, and with intermediate differentiation between basal and squamous cells. In comparison with the common undifferentiated BCCs, the BCCs with the ID areas may behave in a more aggressive fashion, since they displayed more precocious ulceration in small tumors (p less than 0.001), greater infiltrative features (p less than 0.001), more atypical cells (p less than 0.001) with increased nuclear-cytoplasmic ratio and more mitoses (p less than 0.001). The relation of such basal cell carcinomas to the metatypical carcinoma of the skin was discussed. Metatypical carcinoma, however, has been poorly defined and thus has no general acceptance in the literature. The new definition of the basosquamous cell carcinoma and the presence of intermediate areas of differentiation in this tumor were emphasized, and it was suggested that metastatic basal cell carcinoma and metatypical carcinoma may be the same tumor. PMID- 1792195 TI - Computer simulation analysis of morphological patterns in human melanocytic skin tumours. AB - Tumour cell proliferation and particularly tumour cell motility are considered to be essential pre-requisites for invasive tumour growth. Despite abundant in vitro data on tumour cell motility, the behaviour of tumour cells in complex human tumour tissues is yet unknown. In this study, estimates of proliferation and motility are statistically derived from morphological tumour patterns in human melanocytic skin tumours. Two-dimensional, discrete, random computer simulations of tumour growth were carried out in order to determine the influence of tumour cell proliferation and motility on morphological patterns. A set of binary morphological criteria turned out to facilitate a significant estimate of the relative probabilities of motility and proliferation (CART analysis). When the same morphological criteria were applied to H & E stained slides of 45 melanocytic skin tumours, benign common nevi showed a predominance of motility, whereas primary and metastatic malignant melanoma revealed a predominance of proliferation. The direct assessment of the number of proliferating cells by Ki 67 staining shows a steep increase from benign nevi to primary and metastatic melanoma. These data provide first evidence that in benign common nevi the overall motility exceeds the very low degree of proliferation, whereas in malignant melanocytic tumours proliferation considerably exceeds tumour cell motility. PMID- 1792196 TI - Pyogenic granuloma (lobular capillary hemangioma): a clinicopathologic study of 178 cases. AB - Pyogenic granuloma (lobular capillary hemangioma) is a common acquired vascular lesion of the skin and mucous membranes in the pediatric age group. This is a retrospective analysis of 178 patients, 17 years of age and younger (mean age 6.7 yrs). Forty-two percent of the lesions occurred in the first five years of life; only 12% appeared in infants less than 1 year old. The male:female ratio was 3:2. Most patients (74.2%) had no history of trauma or predisposing dermatologic condition. The mean lesional size was 6.5 mm and the mean duration at diagnosis was 3.8 months. The granulomas were most commonly located in the head and neck area (62.4%), followed in order of decreasing frequency by trunk (19.7%), upper extremity (12.9%), and lower extremity (5.0%). The preponderance (88.2%) occurred on the skin, the remaining ones involved the mucous membranes of the oral cavity and conjunctivae. Histologic examination demonstrated normal numbers of mast cells, in contrast to increased mast cells characteristic of proliferative phase hemangiomas. Most lesions (n = 149) were treated by full-thickness skin excision and linear closure; there were no recurrences in this group. The recurrence rate in 23 lesions treated by shave (intradermal) excision and cautery or cautery alone was 43.5%. PMID- 1792197 TI - Piezogenic papules of the feet in healthy children and their possible relation with connective tissue disorders. AB - Piezogenic papules (PP) are pressure-induced lesions that appear on the heels while bearing weight, due to herniation of fat tissue into the dermis. They are present in the majority of adults. Because of the poor quality of connective tissue in hereditary disorders of connective tissue, such as the Ehlers-Danlos syndrome, it has been suggested that PP would be larger in number and diameter in this group of disorders. If papules are present, they might be painful as well. In view of this hypothesis 322 healthy pupils aged 4 to 13 years from a Dutch primary school were examined in order to study the prevalence and characteristics of piezogenic papules and signs of connective tissue disorders (Ehlers-Danlos) such as hypermobility and skin fragility. Of the 322 children investigated, 72% had one or more PP, the average number being five, with a mean diameter of 3.3 mm. The mean papule diameter increased with age and body weight. None of the papules were painful. Hypermobile joints occurred in 4.3% of the children. Mean body weight was the same in hypermobile and nonhypermobile children of the same age. The numbers of PP were equal in both groups, as was the number of children with and without PP. None of the children showed skin fragility. Our conclusion is that PP are present in the majority of healthy children, and are never painful. PMID- 1792198 TI - Lichen aureus in childhood. AB - Lichen aureus is a rare asymptomatic dermatosis of unknown origin that is now classified in the group of pigmented purpuric dermatoses. The eruption consists of asymptomatic, roundish or irregular, lichenoid erythematous-purpuric papules with a tendency to coalesce in patches, most prevalent on the limbs. No meaningful laboratory abnormalities have been found. Histologically, the epidermis is normal, with a lymphohistiocytic, bandlike infiltrate with extravasated blood red cells and hemosiderin deposits observed in the dermis. During the last 20 years we have followed eight new patients, which represent 0.05% of our hospitalized patients. In five of eight patients the disease resolved in two to four years. No therapy has been carried out on these children, since lichen aureus has a tendency for slow, spontaneous improvement and resolution. PMID- 1792199 TI - Infantile acropustulosis. AB - Infantile acropustulosis is a recurrent, pruritic, vesicopustular eruption appearing mostly on the palms and soles. The present survey of 25 children with infantile acropustulosis is the most extensive reported since this entity was first described in 1979. Our cases conform to the recognized clinical course, but disclaim any male or ethnic origin predominance. Although the etiology of infantile acropustulosis is obscure, it may be ascribed to some infective agent. It is not limited to young children, and has been found in the siblings of patients who were followed. Suppressive therapeutic measures, such as topical corticosteroids under occlusion, were found to be effective. The disorder does not seem to be as rare as one might gather from the literature. PMID- 1792200 TI - Lichen planus in childhood: a report of 17 patients. AB - Lichen planus is a dermatosis of unknown origin with a very limited frequency in children. Over a period of one and a half years we observed 17 cases of childhood lichen planus. The classic form of the disease as seen in adults was the most common in these children; unlike adults, however, mucosal and nail involvement was uncommon. The natural history of the disease was similar to that in adults. PMID- 1792201 TI - Solitary morphea profunda in a 5-year-old girl: case report and review of the literature. AB - A 5-year-old girl had a solitary sclerotic plaque on the back of recent onset. The histopathologic features were consistent with morphea profunda. Thickening and homogenization of collagen bundles were demonstrated in the dermis and subcutaneous tissues, admixed with a prominent lymphocytic and plasma cell inflammatory infiltrate. Solitary morphea profunda is a variant of localized scleroderma that has not been reported previously in childhood. Cases described in the literature as nodular or keloid morphea may represent a similar entity. PMID- 1792202 TI - Alpha 1-antitrypsin deficiency-associated panniculitis: case report and review of the literature. AB - Alpha 1-antitrypsin is the primary serum proteinase inhibitor. Alpha 1 antitrypsin deficiency, especially the ZZ genotype, has been linked mainly to emphysema and cirrhosis; it is also associated with paniculitis. A case of alpha 1-AT-associated panniculitis was documented in a 13-year-old girl in whom a deficiency of the enzyme was known to be present from infancy. This is unusual, since alpha 1-AT panniculitis previously was described in older patients without prior knowledge of the duration of the deficiency. Our patient developed erythematous, subcutaneous nodules subsequent to trauma, which later developed into deep, painless ulcers. We report this case so that the condition may be suspected in patients with panniculitis. The diagnosis may be confirmed by measuring quantitative alpha 1-AT serum levels and by enzyme genotyping. The treatment of choice is dapsone. PMID- 1792203 TI - Nevus comedonicus: case report and brief review of the literature. AB - We report extensive nevus comedonicus in a female patient that involved half of her body entirely, with infected cystic lesions as well as typical scars, limited by the midline. The lesions worsened at the beginning of puberty. A brief review of the literature highlights the histopathologic, etiopathogenic, and therapeutic aspects. PMID- 1792204 TI - Infantile myofibromatosis: a case report. AB - A male infant had three nodules on the left cheek, right forearm, and right neck. Biopsy specimen revealed infantile myofibromatosis (IM). Further evaluation revealed a solitary pulmonary nodule in the right middle lobe located far from mediastinal structures, which had no evidence of tumor enlargement on follow-up tomographic scan. Immunoperoxidase studies were negative for desmin and positive for actin. This is a potentially life-threatening multiorgan system disease; however, if lesions are limited mainly to the skin and soft tissues, the prognosis becomes more favorable. Although many reports suggest spontaneous and complete healing of the cutaneous lesions, our patient had profound atrophy at lesion sites as resolution occurred. PMID- 1792205 TI - Linear IgA dermatosis of childhood: case report with an immunoelectron microscopic study. AB - A 7-year-old girl developed a cutaneous bullous eruption with genital and nasal mucous membrane involvement. Direct immunofluorescence revealed linear deposits of IgA and IgM at the basement membrane zone. No circulating antibasement membrane zone antibodies were detected. Small bowel biopsies showed a partial villous atrophy. The clinical, histologic, and immunopathologic findings were consistent with a diagnosis of linear IgA dermatosis of childhood. Immunoelectron microscopy revealed IgA deposits in the lamina lucida in association with hemidesmosomes, confirming results of two recent studies. PMID- 1792206 TI - Cutaneous lesions in severe combined immunodeficiency: two case reports and a review of the literature. AB - Two patients with severe combined immunodeficiency (SCID) in whom cutaneous lesions were the first clinical feature were studied. Neither the morphology nor the histology of the lesions was uniform, although we have noted some common findings that can, in subsequent cases, lead us to suspect SCID. The immunologic defects were not uniform, representing the two poles of the spectrum of SCID. We believe that early recognition of the skin lesions is very important, since the patient's life expectancy can be increased by a bone marrow transplantation (1). PMID- 1792207 TI - Unilateral eruptive psoriasis and lichen striatus. AB - A 2-year-old boy experienced lichen striatus localized to the left half of the body. Some weeks later he developed a peculiar form of eruptive psoriasis limited to the right half of the body. To our knowledge, unilateral eruptive psoriasis has never been described in the literature. The coincidence in this young patient of lichen striatus and this unusual form of psoriasis arising in so short a period of time leads us to hypothesize a common trigger factor. PMID- 1792208 TI - Basidiobolomycosis: a case report. AB - A case of subcutaneous entomophthoromycosis caused by Basidiobolus haptosporus in a five year-old child was presented. The case has unusual aspects: extensive ulceration, caseation necrosis and a lack of response to potassium iodide. The lesion was cured using an association of potassium iodide and ketoconazole. PMID- 1792209 TI - Localized cutis marmorata telangiectatica congenita. AB - Cutis marmorata telangiectatica congenita (CMTC) is a rare, usually sporadic, congenital, reticulated vascular anomaly. It may be widespread or segmental, with atrophy or ulceration, and may be associated with other congenital abnormalities. We report a case of CMTC with atrophy, restricted in size to a small area on the back. PMID- 1792210 TI - Juvenile xanthogranuloma and neurofibromatosis. PMID- 1792211 TI - Allergy consultation in the management of atopic dermatitis. AB - Allergists and dermatologists both care for patients with atopic dermatitis, and their roles may be complementary. Questions regarding food allergy, aeroallergens, and the interpretation of skin and RAST testing are answered by an allergist. PMID- 1792212 TI - Ehlers-Danlos syndrome. PMID- 1792213 TI - The case of the blue boy. PMID- 1792214 TI - [Mitral valve prolapse as an indirect cause of death. Autopsy findings in an exhumed cadaver]. PMID- 1792215 TI - ["The giant of Tegernsee"--pathophysiologic and pathomorphologic aspects of a case with unusual gigantism]. PMID- 1792216 TI - [Spindle cell hemangioendothelioma. Histomorphologic, immunohistochemical and DNA cytometry findings]. PMID- 1792217 TI - [Myelolipoma of the adrenal gland of unusual size]. PMID- 1792218 TI - [Generalized melanosis with metastatic melanoma--immunohistologic studies]. PMID- 1792219 TI - [A rare cutaneous manifestation of mucormycosis]. PMID- 1792220 TI - [Author frequency in pathologic specialty publications]. PMID- 1792221 TI - [Regnier de Graaf (1641-1673)]. PMID- 1792222 TI - [Pileate mushrooms and algae--objects of cosmic biology]. PMID- 1792224 TI - Transferrin is a growth factor for the bloodstream form of Trypanosoma brucei. AB - A method for the selective depletion of transferrin from bovine serum is presented. Bloodstream forms of Trypanosoma brucei cannot grow in medium containing transferrin-deficient serum, whereas reconstitution with transferrin restores normal growth. We conclude that transferrin is an essential growth factor for the mammalian stage of the parasite. PMID- 1792223 TI - Effect of trypsin and 2-mercaptoethanol on the exposure of sugar residues on the surface of Leishmania donovani chagasi. AB - Using transmission electron microscopy, gold-labeled lectins, morphometry and enzyme-linked lectin assay, we could show that treatment of promastigotes of Leishmania donovani chagasi with trypsin did not interfere with the binding of lectins (concanavalin A, peanut agglutinin, wheat germ agglutinin and Ricinus communis agglutinin) to the parasite surface. These observations are in agreement with results we previously obtained using a biochemical approach. Treatment of fixed promastigotes with 2-mercaptoethanol induced a significant increase in the density of concanavalin A (Con A) receptors on the surface of L. d. chagasi in relation to the control. We suggest that this increase is due to the unfolding of one or more surface glycoproteins after cleavage of disulfide bonds between cystein residues in adjacent protein loops, exposing second-order Con A receptors that are otherwise hidden in the protein quaternary structure. PMID- 1792225 TI - Further characterization of Trypanosoma cruzi GP57/51 as the major antigen expressed by differentiating epimastigotes. AB - Study of Trypanosoma cruzi metacyclogenesis under chemically defined conditions showed that the expression of a group of acidic polypeptides with a molecular weight of 45-50 kDa is markedly increased on adhesion of epimastigotes to the culture vessels. Immunochemical analysis revealed that these developmentally regulated polypeptides are structurally related to, and possibly homologous with, a major T. cruzi antigen, namely, GP57/51, a glycoprotein that has recently been characterized as a cysteine proteinase. The differentiation of epimastigotes into metacyclic trypomastigotes is accompanied by a 2- to 5-fold reduction in the concentration of GP57/51 antigen as determined by radioimmunoassays using monoclonal antibodies. Two-dimensional polyacrylamide gel electrophoretic analysis of metabolically labelled parasites indicated that this antigen is synthesized as a precursor with a molecular weight of 60 kDa, which is then processed to a level of 45-50 kDa via the formation of at least one intermediate processing product. The observation that expression of GP57/51-related products increases during epimastigote differentiation suggests an important role for this proteinase during the life cycle of T. cruzi. PMID- 1792227 TI - Novel ribonucleic acid species in Eimeria nieschulzi are associated with RNA dependent RNA polymerase activity. AB - Sporulated oocysts of Eimeria nieschulzi, E. tenella and E. acervulina were screened for the presence of putative viral nucleic acids. An RNA-dependent RNA polymerase activity in E. nieschulzi correlated with the presence of unknown nucleic acid species that were absent in the two other species of Eimeria. The novel nucleic acid species also served as templates for RNA-polymerase activity in in vitro synthesis of full-length labelled transcripts. These nucleic acid species were shown to be RNAse-sensitive and were suspected to represent the genomic RNA of a putative virus. PMID- 1792228 TI - Ultrastructural changes following treatment with a microwave pulse in the oocyst of Eimeria magna Perard, 1925. AB - The ultrastructure of oocysts of Eimeria magna was studied before and after their exposure to unique pulse of microwaves (2.450 MHZ; 600 W) of different durations (10, 15 and 20 s). Following treatment, the progressive destruction of the three layers of the oocyst wall was observed, the innermost being destroyed first. Internal structures were also affected, resulting in swollen mitochondria, a loss of ribosomes and fragmentation of the rough endoplasmic reticulum; moreover, the wall-forming bodies were no longer identifiable. Further studies using microwave pulses on biological material should be carried out to improve our understanding of the consequences of such treatment and to investigate its utility in the control of transmissible pathogenic organisms. PMID- 1792226 TI - Down-regulation of murine lymphocyte responsiveness to mitogens after treatment with antigens of Entamoeba histolytica. AB - Injection of mice with pathogenic Entamoeba histolytica (strain HM1-IMSS) antigens resulted in a decreased capacity of splenocytes to respond to mitogen induced blastogenesis following a challenge with concanavalin A (Con A), phytohemagglutinin (PHA), and lipopolysaccharide (LPS), whereas no inhibition was observed in mice that had previously been injected with equivalent amounts of non pathogenic E. histolytica-like Laredo antigens. Depletion of adherent cells in the splenocyte preparation indicated that these cells were not a major contributor to the observed immunosuppression. Quantification of splenic T lymphocyte subsets demonstrated a significant decrease in Thy-1+ and Lyt-1+ cells, but Lyt-2+ cells were not affected. Splenocytes treated with pathogenic amoebic antigens in vitro affected the capacity of these cells to respond optimally to Con A- and LPS-induced blastogenesis but not to that induced by PHA. These findings demonstrate that amoebic antigens affect lymphocyte function and may be important co-factors in the immunoregulation and pathogenesis of amoebiasis. PMID- 1792229 TI - DNA probes detect Theileria parva in the salivary glands of Rhipicephalus appendiculatus ticks. AB - The ability of Theileria parva-specific DNA probes to detect T. parva sporoblasts and sporozoites in samples prepared from the salivary glands of infected Rhipicephalus appendiculatus ticks was evaluated. The two DNA probes used, pgTpM 23 and IgTpM-58, were selected from a genomic library of T. parva (Muguga) piroplasm DNA. In all, 25-200 adult ticks infected with each of 6 different T. parva stocks were tested. One salivary gland from each tick was processed for DNA hybridization, whereas the other was stained and examined by light microscopy to determine the number of infected acini. The correlation for the detection of infected acini between the two methods was 90%-100% for both probes, except when the pgTpM-23 probe was hybridised to salivary glands from ticks infected with the Mariakani stock of T. parva (84% correlation). The discrepancy lay within the range expected, based on the observation that in 12.5% of the ticks, only one salivary gland was infected. The probes did not hybridize to salivary glands from uninfected ticks. PMID- 1792230 TI - Evaluation of anticoccidial drugs in chicken embryos. AB - Infections of Eimeria tenella in chicken embryos were used to compare the anticoccidial activity of ten drugs. The minimal inhibitory concentration (MIC) and minimal toxic concentration (MTC) were affected by the time of inoculation into the embryos and by the chemical nature of the compounds. Some compounds (nicarbazin, amprolium) had no effect on the development of coccidia when they were injected into embryos after the day of infection. Drugs that act early in the life cycle of coccidia (robenidine, clopidol, decoquinate, diclazuril, halofuginone, monensin, salinomycin, and lasalocid) were active at 5-125 micrograms/embryo when they were injected on the day of infection. The ionophores and halofuginone were highly toxic to embryos; most synthetic compounds were nontoxic. The incubation of merozoites in drug suspensions prior to the infection of embryos did not result in embryo toxicity, but the resultant MICs were much higher than those obtained when drugs were injected directly into the embryos. Several products were essentially inactive. Neither nicarbazin nor amprolium prevented oocyst formation. The widely divergent endpoints for the MIC and MTC of anticoccidials in embryos seriously limits the application of this technique as a screen for anticoccidial drugs. PMID- 1792231 TI - Possible formation of calcareous corpuscles by the brood capsule in secondary hepatic metacestodes of Echinococcus multilocularis. AB - In secondary hepatic metacestodes of Echinococcus multilocularis at 156 days post infection, a few small structures exhibiting a central body and a small number of concentric layers were found on the outer surface of the brood capsule, and many such structures were detected on the germinal layer. As these structures are believed to represent immature calcareous corpuscles, we think that not only germinal layer cells but also brood capsule cells of E. multilocularis metacestodes can form calcareous corpuscles. PMID- 1792232 TI - Histopathological criteria for the diagnosis of abdominal angiostrongyliasis. AB - An increasing number of cases of abdominal angiostrongyliasis have recently been diagnosed in southern Brazil. A comparative study of 19 confirmed cases and 15 suspected cases was undertaken to review the anatomo-pathology of the disease and to establish histopathological criteria for its diagnosis. The results were similar in both groups, except for the identification of the worm in the confirmed cases. Macroscopic features comprised two types: a predominant thickening of the intestinal wall (pseudo-neoplastic pattern) and a congestive necrotic lesion (ischemic-congestive pattern). Microscopically, three fundamental histopathological findings were detected: (1) a massive infiltration of eosinophils in all layers of the intestinal wall, (2) a granulomatous reaction and (3) eosinophilic vasculitis affecting arteries, veins, lymphatics and capillaries. We conclude that observation of this histopathological triplet excludes other causes of "eosinophilic gastroenteritis" and establishes the diagnosis of probable abdominal angiostrongyliasis. PMID- 1792233 TI - Effect of bis(benzyl)polyamine derivatives on polyamine transport and survival of Brugia pahangi. AB - A potent filaricidal effect of bis(benzyl)polyamine derivatives is reported; the addition of 1 microM MDL 27695 to Brugia pahangi maintained in vitro killed the worms within 1 week. Using the labelled derivative, MDL 27391 uptake was demonstrated and evidence was provided for an uptake system that is independent of and clearly distinguishable from those for polyamines. The Km value for the uptake of MDL 27391 was determined to be 2 microM, and that for putrescine, spermidine, and spermine was 4.9, 1.7, and 4.8 microM, respectively. The uptake of MDL 27391 was not affected by polyamines. In contrast, bis(benzyl)polyamines were shown to be strong inhibitors of both the putrescine and the spermidine/spermine uptake system. As shown for MDL 27391, bis(benzyl)polyamines are not metabolized after uptake by Brugia worms; therefore, it is expected that the filaricidal effect of the drug depends on its interaction with potential polyamine-binding sites. PMID- 1792234 TI - Localization of phenoloxidase in the midgut of Periplaneta americana parasitized by larvae of Moniliformis moniliformis (Acanthocephala). AB - In cockroaches infected with Moniliformis moniliformis, the melanogenic enzyme phenoloxidase (PO) was histochemically localized in the posterior midgut and in haemocytes. Midguts were incubated with either 3-hydroxytyramine-HCl (dopamine) or 3-(3,4-dihydroxyphenyl)-L-alanine (dopa), and the resulting electron-dense reaction products of PO activity were found to be homogeneously distributed in the cytoplasm of both midgut cells and haemocytes. Following experimental infection, the first acanthors that reached the outer surface of the gut elicited a haemocyte response similar to that observed during wound healing. Larvae that remained attached to the gut became melanized or developed successfully. PO activity gradually decreased as the course of infection proceeded (10-50 days post-infection) but was apparently not inhibited in either midgut cells or haemocytes that were closely associated with the parasites. PO was lacking in the midgut cells of uninfected cockroaches. The results of the present study are discussed with respect to the defence reactions of the host and the survival mechanisms of the parasite. PMID- 1792235 TI - Investigations on the host seeking and finding of Argas (Persicargas) walkerae (Ixodoidea: Argasidae). AB - In investigations concerning the influence of stimuli emitted by chickens on the host-finding behaviour of hungry female adult Argas walkerae ticks, we found that 92.5% of the ticks migrated to the stimulus source following their simultaneous exposure to odours and to a CO2 gradient increasing in the direction of the chicken, as opposed to 67.5% following their exposure to kairomones of chickens in the absence of CO2. Migration of the ticks toward the stimulus source was precipitated by a wide range of CO2 concentrations (varying from 0.06 to 1 vol% within the odour mixture) but always required an increasing CO2 gradient in the direction of the chicken, whereby differences in concentration of 0.01 vol% over a distance of 2.5 cm were sufficient. During exclusive confrontation with either CO2 or heat in a gradient otherwise analogous to that emitted by a chicken, only 27.5% and 55% of the female ticks migrated to the stimulus source, respectively. Accordingly, odours emitted by chickens are considered to represent an essential stimulus modality, whereas body heat and CO2 are regarded merely as secondary, non-specific stimulatory agents. Investigations involving the exposure of ticks to a habitat similar to a chicken roost revealed that host seeking and finding are not influenced by gravity and occur only in darkness and that the portion of host-finding ticks diminishes with increasing distance from the blood donor. PMID- 1792236 TI - The peritrophic membrane of Ixodes ricinus. AB - A peritrophic membrane was found in all three stages of Ixodes ricinus at no later than 18 h after their placement on rabbits. It was found to remain intact until at least 11, 30 and 10 days after repletion in larvae, nymphs and females, respectively. In blood-feeding I. ricinus, the peritrophic membrane is an uneven single layer with a thickness of about 0.03-0.48 micron in larvae, 0.03-0.79 micron in nymphs and 0.04-0.93 micron in females. It covers the whole surface of the midgut epithelium at a distance of about 0.2-0.8 micron. After repletion, the peritrophic membrane becomes thicker and thicker and more and more winding and simultaneously becomes multi-layered mainly in its arched parts. The distance between the peritrophic membrane and the midgut epithelium increases considerably and in the arched parts can reach as much as about 13 and 16 microns in metamorphosing larvae and nymphs, respectively and 25 microns in ovipositing females. PMID- 1792237 TI - Migration of Trichobilharzia ocellata schistosomula in the duck and in the abnormal murine host. AB - The migration of Trichobilharzia ocellata schistosomula in the duck host and the accidental mouse host was studied by the detection of [75Se]-methionine in radiolabelled cercariae using autoradiography of compressed host tissues and by the recovery of schistosomula following the mincing and incubation of host tissues. Exposure via duck feet (30 min) and mouse tails (60 min) resulted in low infection rates: 3.9% in the duck and 3.1% in the mouse. However, when mice were infected via the abdominal skin using the ring method, 25% of the cercariae were recovered in the skin. In the duck, schistosomula left the skin within 3 days post-infection (p.i.) and were detected in the lungs between days 2 and 4 p.i. Thereafter, only few radioactive foci were found in the liver, kidney and intestine. In the mouse, schistosomula were detected in the lungs within 10 h and for up to 6 days p.i., and some foci were detected in the liver and intestine on days 2-5 p.i. On days 3-4 p.i., 36% of the detectable parasites in the mouse (91 foci in 10 mice) had migrated from the skin to other organs. Living schistosomula could be extracted from mouse skin and lungs only until day 4 p.i. The schistosomula of T. ocellata migrate faster within their vertebrate hosts than do those of Schistosoma mansoni, indicating that the former may use other transformation and immune-evasion mechanisms. PMID- 1792238 TI - Significance and measurement of DNA double strand breaks in mammalian cells. AB - Techniques for measuring DNA double strand breaks in mammalian cells are being used increasingly by researchers studying both physiological processes, such as recombination, replication, and apoptosis, as well as pathological processes, such as clastogenesis induced by ionizing radiation, chemotherapeutic drugs, and chemical toxicants. In this review we evaluate commonly used assays for measuring DNA double strand breaks, focusing on neutral filter elution and pulsed field gel electrophoresis, and explore the advantages and limitations of applying these techniques to problems of current interest in carcinogenesis and genetic toxicology. PMID- 1792239 TI - Drug glucuronidation in humans. AB - Glucuronidation is a major metabolic pathway for a large number of drugs in humans. Conjugation of drugs and other chemicals with glucuronic acid is catalyzed by the multigene UDP-glucuronosyltransferase family. It is believed that a number (unspecified at present) of glucuronosyltransferase isozymes, which probably differ in terms of substrate specificity and regulation, contribute to drug glucuronidation. Factors known to influence the pharmacokinetics of glucuronidated drugs in man, presumably via an effect on specific glucuronosyltransferases, include age (especially the neonatal period), cigarette smoking, diet, certain disease states, coadministered drugs, ethnicity, genetics and hormonal effects. PMID- 1792240 TI - Embryonic angiogenesis factors. AB - The vascular system develops during embryonic development by at least two distinct processes; vasculogenesis is the development of blood vessels from in situ differentiating angioblasts and angiogenesis is the sprouting of capillaries from pre-existing vessels. The molecular mechanisms involved in the regulation of these processes are poorly understood. Endoderm-mesoderm interactions seem to play an important role in angioblast differentiation and vasculogenesis. Soluble angiogenic factors may be involved in the vascularization of some embryonic organs, e.g. kidney and brain. Angiogenic growth factors have been isolated and purified from embryonic brain and identified as acidic and basic fibroblast growth factors. More specific endothelial cell growth factors such as platelet derived endothelial cell growth factor and vascular endothelial growth factor may also play a role in embryonic angiogenesis. PMID- 1792241 TI - Interactions of colchicine with tubulin. AB - Colchicine exerts its biological effects through binding to the soluble tubulin heterodimer, the major component of the microtubule. The colchicine-binding abilities of tubulins from a variety of sources are summarized, and the mechanism of colchicine binding to brain tubulin is explored in depth. The relationship between colchicinoid structure and tubulin binding activity provides insight into the structural features of colchicine responsible for high affinity binding to tubulin and is reviewed for analogs in the colchicine series. The thermodynamic and kinetic aspects of the association are described and evaluated in terms of the binding mechanism. Colchicine binding to tubulin results in unusual alterations in the low energy electronic spectra of colchicine. The spectroscopic features of colchicine bound to tubulin are discussed in terms of the nature of the colchicine-tubulin complex. Attempts to locate the high affinity colchicine binding site on tubulin are presented. PMID- 1792242 TI - Structure and function of G proteins. AB - G proteins are heterotrimeric proteins involved in the transduction of a variety of external signals in all eukaryotic organisms. This review analyzes the molecular aspects of G protein structure and function. The cloning of cDNAs coding for a great variety of G protein subunits has allowed us to deduce the primary and secondary structure of the subunits. Emphasis is given to the dissection of the molecular regions of the G alpha subunits implicated in the binding and hydrolysis of GTP and in the interaction with the receptor, with the effector and with the beta gamma dimer. The localization of these regions in a two-dimensional model of the G alpha subunit is attempted to provide a more comprehensive view of the structure and function of G proteins. PMID- 1792243 TI - [History of venous circulation]. PMID- 1792244 TI - [History of the valvula venosa]. PMID- 1792245 TI - [Variations and valve structure of the truncal femoro-popliteal system]. AB - Study of valves is inseparable from that of the main veins in which they are located. While a modal femoro-popliteal system, satellite to the arterial system, is by far the commonest, major variations are seen in approximately 10% of cases. Each main collecting vein has its specificity, according to its width, the course which it follows and whether or not there is a satellite wide calibre artery. Additional features include the chief affluents which its receives, wavering of its course, the supple or rigid perivascular environment and the proximity of large muscle masses. All these features play a role in the quality of drainage, in particular during exercise, and in anti-reflux function. In practice, variations come down to two broad possibilities: the single collector, sometimes made up of several different embryological segments, resulting in a hybrid vessel and an aberrant course, either axial, satellite to the sciatic nerve, or profunda femoris, satellite to the shaft of the femur. Doubling (bifid or by bifurcation) opens up an additional channel, either parallel or divergent, which considerably modifies the conditions of venous return. A lesion affecting one branch only, e.g. a solitary thrombus, may have no clinical manifestations and marking if collectors during imaging. The topography of the valves of the main veins tends to be fairly fixed. They are preferentially located proximal to the main confluents, to winding parts of the course of the vessel, or at certain hemodynamic levels which vary little from one individual to another. An attempt is made at nomenclature, classification and topography. The chief feature, the terminal valve of the lower limb, is located most often at the femoral ring. It alone is capable of opposing the long cavo-iliac reflux caused by effort. Analysis of retrograde phlebography films with caval occlusion shows that reflux is not directly exerted on the valve. The point of interruption is high, in the terminal portion of the external iliac vein. This hemodynamic barrage is purely functional. When there is incontinence of the terminal valve varying degrees of reflux diffusely affect the femoral axis. At the same time, there is regurgitation of contrast medium into the visceral areas of the true pelvis, normally sealed off. This coupling between anti-reflux function of the lim and that of the pelvis is one of the unexpected aspects of valve activity. PMID- 1792246 TI - [Functional exploration of the deep venous system by duplex]. AB - The development of new direct methods for treatment of deep venous insufficiency requires improvement of the ultrasonographic investigation of valve function. The combination of imaging and pulsed Doppler provides more accurate diagnoses and can be used to establish deep venous hemodynamic cartography. Four essential rules must then be followed: an examination in standing position, proximal decompression tests, examination by one third segments and by thirds of each segment, analysis of the forgotten veins of the leg (soleus, gemellar) and thigh (profunda femoris, quadriceps, posterior ischiatic anastomotic flow) and of the deep muscular anastomoses. The hemodynamic direction of each feature of the venous map is then noted. This investigation enables the following in the context of disease: the diagnosis of deep venous pain affecting an apparently non varicose area; precise monitoring of the post-thrombotic status of a deep vein, avoiding diagnostic errors related to a painful repermeation syndrome; preselection of cases of deep venous insufficiency suitable for anatomical surgical treatment or a hemodynamic technique (CHIVP) as indicated by the deep hemodynamic cartography which this investigation makes possible. PMID- 1792247 TI - [Importance of the lymphatic valvular activity]. PMID- 1792248 TI - [Valves and valve pockets of the thoracic duct: sites of stagnation of neoplastic cells]. AB - The thoracic duct was excised and histologically examined in 53 patients who died due to cancer. 11 specimens showed intraluminal cancer cells without signs of tumor migration through the duct wall. The malignant cells were either unattached in the lumen, caught within the valve pocket or had invaded the valve tissue. These findings add to the importance of lymphotropic cytotoxic agents. PMID- 1792249 TI - [The function of security valves of the lymphatic vessels. The role of the valvulae]. PMID- 1792250 TI - [Reflux in healthy valves of the great saphenous vein]. PMID- 1792251 TI - [Ostial valves in a patient with varicose veins. Endoscopic examination]. AB - Twenty three endoscopies were performed, including six of the great saphenous region, fourteen of the small saphenous region and three involving the region of the medial gemellar perforators. Two types of valves may be seen on the basis of their endoscopic appearances: certain valves have a transparent appearance with very thin valvular tissue which tears easily when a catheter is passed against the direction of venous flow. These valves are located in the main saphenous veins and their collaterals, at a distance from bifurcations and the point of entry of perforating veins. The only type of lesion seen affecting these valves was tearing of their tissue. Their sole role appears to be to favourize the progression of venous flow in an anterograde direction. Other valves have an opaque appearance with valvular tissue thickened by an actual fibromuscular skeleton and strengthening of the free edge to form a lip. These resist counter grade catheterisation and may prevent progression of the endoscope or of a stripper. These valves are located at the ostium of the terminal portions of the saphenous veins and directly proximal to the point of entry of certain collaterals and perforators. The latter, when reflux is present, behave as ostial valves, playing the role of an anti-reflux system as well as favourizing preferential hemodynamic circuits which explain certain varicose cartographic patterns.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792252 TI - [Endoscopic aspects of the valves in patients with varicose veins]. PMID- 1792253 TI - [Intravenous ultrasonography]. AB - The author used in vivo endovenous ultrasonography to study the architecture and dynamics of varicose veins of the lower limbs. In this study, segments of the great saphenous vein were examined, before and after sclerosing injections, using a miniaturised 20 mHz ultrasound probe. This probe incorporated in a 1.6 mm diameter flexible catheter was inserted into the varicose vein. The probe was then pivoted mechanically in order to obtain, in transverse section and in real time, 360 degree two-dimensional venous images. The anatomical structures of the wall, lumen and venous valves were visualised. The layers of the vein wall, the intima and adventitia, were seen to be echogenic structures while the media was an anechogenic zone. The spread between valve cusps, endoluminal diameter and the thickness of the layers of the vein wall were measured. It is concluded that endovenous ultrasonography provides precise images of the morphology and dynamics of valves, lumen and vein wall. This new technique is useful before, during and after the treatment of venous diseases by sclerosing injections or surgery. PMID- 1792254 TI - [Phleboscopy and valvular systems]. PMID- 1792255 TI - [Parietal valves of the internal saphenous vein]. PMID- 1792256 TI - [Valve repair at the level of the sub-inguinal deep venous plexus. Gadget technique or efficacious surgery?]. AB - Between 1988 and 1990, the authors performed 35 valvuloplasties for major reflux syndrome involving the sub-inguinal deep venous system. Twenty two patients with a mean follow-up period of 23 months (1 year--3 years) were reviewed clinically and hemodynamically. Only one of the 10 patients with a chronic ulcer had developed a recurrence. This concerned the only postoperative thrombosis seen in this series. Results from a hemodynamic standpoint were as follows: Reflux evaluated preoperatively was Kistner type 4 with a popliteal venous reflux index (VRI) with a mean grade of 1.1. Postoperative evaluation (Duplex-Scan) showed the absence of reflux below the valvuloplasty in 86 p. cent of cases and VRI was normalised (less than 0.50) to the same extent. Mean venous filling time (PPG, peripheral pressure gradient measurement) after application of a supra-malleolar tourniquet was 8" (-8n + 4) preoperatively. It became normal in 13 patients and improved in 8 (mean of 82 p. cent). The results of valvuloplasty in this series confirm those published by other teams. They are notably superior to those offered by transposition and transplantation procedures. Unfortunately, this effective technique can only rarely be used in post-thrombotic syndromes and is useful essentially in Primary Deep Valve Insufficiency. PMID- 1792257 TI - [Cartography of varices]. PMID- 1792259 TI - [Instruments for ambulatory phlebectomy]. PMID- 1792258 TI - [Indications for ambulatory phlebectomy]. AB - The indications of Out-Patient Phlebectomy have been defined and confirmed. These indications are multiple and cover broad range. Anatomical indications concerning the lower limb essentially concern: primary varicose veins, residual varicose veins after surgery, varicosities affecting long or collateral veins, systems at the top of the thigh or in the popliteal fossa, varicose veins of the foot. Indications concerning the upper limb, abdomen and face must be carefully weighed. In a context of post-phlebitis, meticulous analysis of hemodynamics and careful monitoring are required. Superficial thrombophlebitis is a good indication for out-patient phlebotomy. Decisions concerning esthetic indications must be based upon a certain number of criteria: informed consent of the patient, assessment of general risk factors, assessment of esthetic risk factors. PMID- 1792260 TI - [Treatment of varicose external saphenous vein by ambulatory phlebectomy]. AB - In 1972, the French Society of Phlebology undertook a study of the treatment of the varicose S.S. vein which revealed an avalanche of problems concerning both surgery and sclerosing injections. Since 1960, there have been such advances in out-patient phlebectomy that it enables combination of the efficacy of surgery with the benign nature of sclerosing injections. It has proved possible to avoid the only true risk of out-patient phlebectomy (damage to the lateral saphenous nerve) by proscribing the use of a hook on the main S.S. and accessing it via a collateral. PMID- 1792261 TI - [Ambulatory ligation of the sapheno-femoral junction. Complement of Dr. Muller's ambulatory phlebectomy technique]. AB - The early diagnosis of incompetence of the sapheno-femoral junction is made possible by combined ultrasonography/Doppler. Thus when the great saphenous vein is not too dilated and is not the site of severe ectasia, ligation of the junction may be sufficient to deal with malfunction of the latter. This is an outpatient procedure. Following local anesthesia (lidocaine 0.25%), a 4 cm incision is made in the inguinal fold between the femoral artery and the tendon of gracilis muscle. Dissection of the great saphenous exposes a lake distal to the collaterals of the sapheno-femoral junction and--by traction--obtains maximal exposure of the junction. A wide Weck hemoclip is used to interrupt reflux in the incompetent junction. We ligate the pudendal veins entering the femoral vein separately. This procedure neutralizes a major perforator under local anesthesia by an out-patient technique free of morbidity. Varicose veins are removed subsequently using the technique of Dr. R. Muller. PMID- 1792262 TI - [The perforating vein of the Hunter's canal: incidence in varicose pathology and treatment]. AB - Hunter's perforator is a vein which joins the great saphenous vein with the femoral vein by passing through the aponeurosis of the adductor (Hunter's) canal, more or less at the junction of the lower and middle thirds of the thigh. It is constant, very variable in terms of its origin and may be twin or more, though there is a degree of regularity concerning its ending. It is important to detect its incontinence in varicose pathology, notably when there is recurrence following stripping of the great saphenous. Clinical examination is the most important, often combined with Doppler investigation and much more rarely with phlebography. The treatment of this perforator is essentially medical, by sclerosing injections, and sometimes surgical, after indications have been carefully weighed. New methods of treatment, such as the CHIVA technique, are also being developed but there is an insufficient follow-up time to enable any objective conclusion to be drawn. PMID- 1792263 TI - [Histochemical study of elastic system fibers of the walls of normal and pathological saphenous veins]. AB - Normal, varicose and phlebitic saphenous veins were studied by histochemical methods to establish the qualitative variations of their structural components. The histologic preparations were stained by hematoxylin-eosin Gomori's trichrome, orcinol-neofuchsin and resorcin-fuchsin. Normal saphenous vein showed two layers of smooth muscle cells--an internal circular and an external longitudinal. The components of the elastic system were found in the three layers. Elastic fibers were present in the adventitia under an elongated and wavy conformation. In the media they were present in the external portion. Elaunin fibers were found in the media and intima. The oxytalan fibers were not consistently found. The media and intima of varicose veins showed contracted smooth muscle cells associated with fragmented elastic fibers and augmentation of elaunin fibers. In cases of thrombophlebitis the same alterations observed in varicose veins were found together with a decrease of elastic system fibers in the media and intima. The muscle cells showed a loss of their morphologic characteristics. PMID- 1792264 TI - [Venous ultrasonography of the lower limbs in the diagnosis of thrombosis. Examination methodology and presentation of results]. AB - Two criticisms are levelled against venous ultrasonography: its operator dependent nature and the absence of any overall imaging document which can serve as a reference and be read by all. A very precise investigation technique is suggested to deal with the first criticism. This describes the investigation in detail, level by level from the inferior vena cava to the lower third of the leg and indicates the optimal position of patient and operator, in particular concerning the leg. A method of imaging presentation is proposed to deal with the second criticism. The site and extent of venous thromboses are shown on a precise anatomical diagram including muscle veins. This diagram reproduced by reduction on a four-fold card is given to the patient to be used during subsequent follow up. It can be used as a reference document in case of suspected extension or recurrence. Ultrasonography has several advantages over phlebography: a better reliability rate, better sensitivity for lesions in muscles and where there are twin veins, possibilities of differential diagnosis of DVT and of the discovery of concomitant pathology. It should now always be performed as the investigation of primary intention. PMID- 1792265 TI - [Polyaneurysmal disease]. PMID- 1792266 TI - [External plastic surgery of the pre-ostial valve in sapheno-femoral junction insufficiency. Experimental studies and clinical cases]. AB - External plasty of the pre-ostial valve is a surgical technique which has the aim of correcting reflux resulting from incompetence of the sapheno-femoral valve and at the time retaining the anatomical structure of the region. The artificial stenosis produced by external valvuloplasty of the pre-terminal valve complex has been studied in physical experiments, the first results of which already appear to be significant. The authors have operated upon 18 patients, with follow-up too short for the presentation of final results, but already sufficient to permit discussion of findings after a short period of time. PMID- 1792267 TI - [Functional venous pathology and natural defense processes in chronic venous insufficiency]. PMID- 1792268 TI - [A comparative study of the protective effect of different phlebotonic agents on endothelial cells in hypoxia]. AB - Numerous reported findings indicate that the etiology of venous diseases is multifactorial. One of the chief factors is certainly stasis of blood in the veins of the lower limbs during long periods spent standing up. This stasis causes tissue hypoxia which first affects the venous wall. Because of their location at the interface between blood and vein wall and because of their fragility, endothelial cells are the first to suffer from the lack of oxygen. With the aim of understanding these events, the authors have developed a model of endothelial cells in culture subjected to hypoxia in vitro which mimics the conditions encountered clinically. This model has enabled us to test various drugs commonly used in venous disease. These included GbE, the active ingredient of GINKOR FORT, diosmin and procyanidol oligomers. It was thus shown that only GbE was not toxic to endothelial cells. GbE was also found to be capable of effectively protecting cells exposed to hypoxia. Protection under the influence of diosmin was obtained only at concentrations very close to toxic doses. In contrast, procyanidol oligomers offered no protection. The protective effect of GbE is believed to be due to the action of terpenes on the energy metabolism of the cell. PMID- 1792269 TI - [Effects of heptaminol adenosine phosphate on the lymphatic circulatory flow]. PMID- 1792270 TI - Effects of counselor's profanity and subject's religiosity on content acquisition of a counseling lecture and behavioral compliance. AB - Effects of counselor's profanity and subject's religiosity on acquisition of lecture content and behavioral compliance were investigated. 40 male and 80 female undergraduate students volunteered to attend a lecture about "coping with problems of daily living." They were divided into low, medium, or high religiosity groups based upon scores on Rohrbough and Jessor's Religiosity Scale. Each subject listened to a 15-min, videotaped rational-emotive mental health presentation which included a recommendation that they pick up a card (initial compliance) and send for a free book (delayed compliance) expanding upon the principles discussed in the tape. Half listened to a tape containing 16 profane words and half watched a nonprofane tape. At the end of the tape subjects were given a test on content. Analysis showed that profanity had a negative effect on acquisition of content and on initial compliance. Religiosity had no effect on any of the dependent variables. In contrast to the behavior modeled by some senior clinical practitioners, it was concluded that counselors be wary of using profanity in an initial session. Also, in keeping with the 1989 recommendations of Heppner and Claiborn, the importance of studying behavioral measures in influence studies was stressed. PMID- 1792271 TI - Successful careers and cognitive style: a follow-up study of childhood family discontinuity. AB - It was predicted that those participants who experienced discontinuity (death, divorce, and separations) from their parent(s) in childhood and who had successful careers in adulthood would manifest more innovative than adaptive cognitive styles on the Kirton Adaption-Innovation Inventory. The original research showed 61% of the sample members (n = 41) experienced family discontinuity. Ninety percent (n = 37) of the previous participants responded and showed 59% family discontinuity. Fifty-four percent in the follow-up study chose an alternative career path (counterstriving), the same percentage as in the original sample. When both family discontinuity and counterstriving were present, statistically significant innovation scores occurred. Family discontinuity in childhood and a successful career in adulthood are likely to be associated with high striving-motivation and an innovative (paradigm-breaking) problem-solving style. PMID- 1792272 TI - Smoking-specific locus of control. AB - A smoking-specific locus of control scale was developed by modifying a drinking related locus of control scale. The new scale, Rotter's I-E scale, and a smoking questionnaire were administered to 70 subjects. Estimates of reliability indicated that the new scale had reasonably high internal consistency. Scores differed as a function of subjects' reports of their addiction to cigarettes but not as a function of their current smoking status. 15 addicted individuals scored more externally on the new scale than did 24 nonaddicted individuals. There were no differences for scores on the Rotter I-E scale as a function of reported addiction or smoking status. The new scale appears to be a more sensitive measure of locus of control than Rotter's scale. The two locus of control scales were not significantly correlated, indicating their independence. Individuals apparently maintain a distinct locus of control for smoking rather than having a general expectation for control. PMID- 1792273 TI - Factor analysis of the Career Decision Scale on South African high school students. AB - A factor analytic study of the Career Decision Scale-High School version of Hartman and Hartman on 312 white South African adolescents from Grades 11 and 12 was undertaken. A simple two-factor structure emerged which accounted for 47.36% of the total variance in the scores. These results support the use of the version as a differential measure of career indecision and indicate that the number and structure of factors can change across populations. The implications of these results for research in South Africa are considered. PMID- 1792274 TI - The relationship between war and homicide rates. AB - A time-series study from 1933 to 1986 in the USA showed that the nation's military participation rate was concurrently associated with lower homicide rates among nonwhite but not white individuals. PMID- 1792275 TI - Evangelical renewal therapy: a proposal for integration of religious values into psychotherapy. AB - The importance of incorporating religious values into psychotherapy that is used in treating the mental health needs of Evangelical Christians was examined. Rationality and pathology were analyzed from an Evangelical Christian perspective. Guilt was seen as the primary psychological consequence of self defeating behaviors. Evangelical Renewal Therapy was offered in response to the apparent need for a religious psychotherapy that would focus on the mental health needs of Evangelical Christians. The Atheistic Ideation Complex purports that atheistic ideations as measured by the Atheistic Ideation Reference Scale lead to unwanted emotional consequences. Repentance, the process of change in Evangelical Renewal Therapy, is achieved through the analysis of moral action, rebuke, confession, prayer, recompense, and mortification through good works. PMID- 1792276 TI - Age differences in health attitudes and beliefs. AB - In a telephone interview, samples of 196 older and 280 younger adults completed a series of 24 items designed to assess health beliefs. Differences may have implications for health care expenditures now and in the future. PMID- 1792277 TI - Relationship of computer hassles, somatic complaints, and daily hassles. AB - The relationships between computer hassles, measured by the Computer Technology Hassles Scale, daily hassles, measured by the Daily Hassles Scale, and somatic complaints, measured by the Hopkins Symptom Checklist, were investigated in a college sample of 103. Computer hassles were correlated .57 with daily hassles and .39 with somatic complaints. Daily hassles were correlated .62 with somatic complaints. In general, these measures were uncorrelated with computer experience or computer knowledge. The daily Hassles Scale, a measure of stress, is a better correlate for the Computer Technology Hassles Scale, a measure of computer related stress, than the Perceived Stress Scale. PMID- 1792278 TI - How empathy, egocentrism, Kohlberg's moral development, and Erikson's psychosocial development are related to attitudes toward war. AB - In this exploratory study 91 students took a questionnaire which measured their feelings of oneness with all humanity, their egocentrism, level of moral development according to Kohlberg, psychosocial development according to Erikson, and their attitude toward war, diplomacy, the Gulf war, civilians and soldiers in the Gulf area, etc. The hypothesis that empathy with humankind leads to concern about those involved and opposition to war was supported. These individuals were more likely to endorse values expressed in Kohlberg's Level 6. Students endorsing Level 4, law-and-order mortality, especially if they had no friends overseas and used no news source other than the usual U.S. mass media, were more likely to be pro-war, believe President Bush and the military briefings, and opposite reliance on diplomacy. If people had experienced war, they were more frequently against it. However, hardship experienced, lack of egocentrism, believing in a greater good for a greater number of people (Kohlberg's Level 5), and Erikson's psychosocial development were not associated with students' orientation toward war. Further research is suggested. PMID- 1792279 TI - Depression, general anxiety, test anxiety, and rigidity of gifted junior high and high school children. AB - 27 gifted students in junior high and high school from north central Kansas school districts were administered the Children's Depression Inventory, the Beck Depression Scale, Test Anxiety Scale, General Anxiety Scale, and Breskin's Rigidity Scale. Sex, age, and grade were not considered, as the sample was small. The gifted students' mean scores for depression were below the cut-off score while their test anxiety, general anxiety, and rigidity scores were at moderate levels. Pearson correlations were significant for Beck Depression with the Children's Depression (r = .82) and General Anxiety Scales (r = .60). Scores on the General Anxiety Scale correlated significantly with those on the Children's Depression Inventory (r = .69) and the Test Anxiety Scale (r = .55). Rigidity scores were not correlated significantly with any other measure and scores on the depression scales did not correlate significantly with those on the Test Anxiety Scale. PMID- 1792281 TI - Service on the Maryland board: reflections and comments. PMID- 1792280 TI - Differences between essential and reactive alcoholics on tests of neuropsychological functioning and affect. AB - This study tested the hypothesis that Essential Alcoholics (n = 15) develop a more severe form of alcoholism than Reactive Alcoholics (n = 12). VA alcoholic patients were classified as Essential or Reactive Alcoholics, using the Rudie McGaughran questionnaire, and tested on four neuropsychological tests, the Neuropsychological Impairment Scale, the Beck Depression Inventory, Tarter's Hyperactivity/Minimal Brain Dysfunction questionnaire, and Latcham's Measure of Antisocial Behavior. While the two groups did not differ in age, education, or Family History of alcoholism. Essential Alcoholics had an earlier age of onset and a longer chronicity of alcoholism. After analysis of covariance was used to control for group differences in age of onset and chronicity, Essential Alcoholics were still significantly higher on depression and significantly more impaired on five subtests of the Neuropsychological Impairment Scale: global measure, total items, general, learning-verbal, and frustration. Nonsignificant group differences, in the expected direction, were found for the Shipley Mental Age and Tarter's questionnaire. These results suggest that Essential Alcoholics have higher depression scores and greater impairments in neuropsychological functioning than Reactive Alcoholics. PMID- 1792282 TI - Boredom proneness: its relationship to positive and negative affect. AB - 170 undergraduate students completed the Boredom Proneness Scale by Farmer and Sundberg and the Multiple Affect Adjective Checklist by Zuckerman and Lubin. Significant negative relationships were found between boredom proneness and negative affect scores (i.e., Depression, Hostility, Anxiety). Significant positive correlations also obtained between boredom proneness and positive affect (i.e., Positive Affect, Sensation Seeking). The correlations between boredom proneness "subscales" and positive and negative affect were congruent with those obtained using total boredom proneness scores. Implications for counseling are discussed. PMID- 1792283 TI - Self-esteem, alcoholism, sensation seeking, GPA, and Differential Aptitude Test scores of high school students in an honor society. AB - 29 high school students (10 boys, 19 girls), members of an honor society from a rural north central Kansas school district, were administered the MacAndrew Alcohol Scale, the Coopersmith Self-esteem Inventory--School Form, and the Sensation Seeking Scale (Form V). Their GPAs and the Differential Aptitude Test scores (verbal reasoning, numerical reasoning, verbal plus numerical reasoning) were collected from their school files. Although ranges were restricted, this group's scores fell within normal levels on these measures. Boys scored higher on the MacAndrew scale, verbal plus numerical reasoning, and sensation seeking than girls. The seniors and juniors scored higher on sensation seeking than the sophomores. Correlations among scores were of low magnitude and likely reflected social pressures on this small scholastically able group. PMID- 1792284 TI - Treating drug offenders with Moral Reconation Therapy: a three-year recidivism report. AB - 70 male felony offenders treated with the cognitive behavioral approach of Moral Reconation Therapy during and after incarceration were assessed for rearrests and reincarceration 38 months after their release. They were compared to a nontreated control group of 82 male felony offenders. Recidivism in the treated group was 24.3% as compared to 36.6% for the control group. Analysis showed that steps completed significantly correlated with rearrests and recidivism and that the correlation between number of aftercare sessions and recidivism approached significance. PMID- 1792285 TI - Taste preference for brussels sprouts: an informal look. AB - An inquiry of the taste preference of 442 business students for brussels sprouts showed about a 50% dislike of the vegetable, 40% indifference, and a 10% like. Some implications of the findings are suggested. PMID- 1792286 TI - Interactional coping strategies of normal-weight bulimic women in intimate and nonintimate stressful situations. AB - Coping strategies of bulimic women in intimate and nonintimate stressful situations were assessed using the Ways of Coping Questionnaire. Compared to a group of 30 women who exercised frequently, the 28 bulimic women felt a greater sense of threat and made greater use of escape-avoidant coping in both types of situations although the groups did not appraise the situations differently. Findings were discussed in terms of behavioral and interactional explanations of symptom maintenance in bulimia. PMID- 1792287 TI - Relationship between the basic personality inventory and the NEO-Personality Inventory in a nonpatient sample. AB - The relation between psychopathology measured by Jackson's 1989 Basic Personality Inventory and personality dimensions measured by Costa and McCrae's 1985 NEO Personality Inventory was investigated in a nonpatient sample of 457 female subjects. The results contribute to the validation of both instruments and agree with the relevant findings reported in the literature. They also provide support for the cross-cultural invariance of these instruments. PMID- 1792288 TI - Cross-cultural application of the Center for Epidemiological Studies Depression Scale: a study of black South African students. AB - This article reports normative and psychometric data for the Center for Epidemiological Studies Depression Scale when used with black South African students. Subjects were 450 undergraduate students in psychology. The reliability, validity, and factor structure of the scale were consistent with previously reported findings. The correlations of CES-Depression Scale scores with certain demographic variables are also reported. PMID- 1792289 TI - Comment on large gender difference on death anxiety in Arab countries. AB - In the recent interesting and excellent article by Abdel-Khalek (2) the large mean difference between Death Anxiety Scale (6) for males and females in Lebanon was noted. I have also noted such large differences in other studies with subjects in Arab countries (1, 3, 4). These studies and that of Abdel-Khalek (2) provide a total of 12 gender differences in four different countries--Egypt, Kuwait, Lebanon, and Libya. Although these large gender differences would be notable in comparison to those of most studies in the United States or other English-speaking countries, the comparison was made with the differences provided by the two studies that presented norms and norm-like information (5, 8). These two studies contain 12 pairs of means for both sexes. Eight of the 12 Arab difference means were higher than the highest American difference mean (chi 2 = 12.00, p less than .01). The reason(s) for the larger gender differences on death anxiety are not known, but it appears reasonable to suggest that in countries in which there are large sex-role differences that likely include bravery, men would be more expected to report lower death anxiety than women. Cross-cultural and demographic research with the recently developed Death Depression Scale (7) would likely yield interesting findings. PMID- 1792290 TI - Evidence fails to support more punishment as remedy for childhood violence. AB - Insisting that more punishment will produce more justice for children who are "victims of violence" at the hands of other children overlooks the fact that discipline should also change behavior. Evidence indicates that abandonment of mediation and "nonjudicial" methods in favor of stronger "police forces" for children is ill-advised. There is support for Purkey's (1990) conclusion that there is no "one-best method." How students respond to any strategy designed to reduce violence behavior is likely to be a function of background variables as well as the nature of the method. PMID- 1792291 TI - Teachers' implicit "theories" of children's intelligence. AB - Information about teachers' implicit notions of children's intelligence was obtained by having 50 student-teachers and 79 teachers with 1 to 4 years of experience rate 150 descriptors on applicability to an hypothetical child described as above average, average, or below average in intellectual functioning. Each teacher-subject was classified by dogmatism score and by years of teaching experience. A factor analysis disclosed that Academic Skills and Interpersonal Competencies summarize the implicit notions. Analysis of variance showed that all levels of hypothesized intelligence only affected teachers' expectations of academic skills and that the effect of intelligence was dependent upon the teachers' dogmatism. There were no clear-cut findings associated with years of experience. Results supported previous observations that people have implicit "theories" of intelligence; however, the specific composition of their ideas varies according to the context within which the rater and the person observed are placed. PMID- 1792292 TI - Ego identity status and family environment: a correlational study. AB - The study reported here investigated the relationship between individuals' perceptions of their families' functioning and of their own emerging identity. Individuation from the parents is closely intertwined with identity formation; families supportive of young people's separation and individuation more often have identity-achieved young people. 83 college students responded to an assessment of their perceptions of their families in 10 areas related to goals, separateness of family members, and over-all functioning. They also responded to the Extended Version of the Objective Measure of Ego Identity Status of Bennion and Adams. Correlations among family dimensions and the identity status scales indicate family factors were related to identity status in the following ways: Little conflict predicted the foreclosure identity status for both sexes. Identity achievement is related to aspects of family functioning differently for the two sexes. Indeed, gender-related aspects of family functioning best predict identity status. Valuing independence and achievements predicts men's identity achievement and emotional expression predicts women's identity achievement. Lack of family integration is related to the diffusion status in both sexes. PMID- 1792293 TI - Teaching professional ethics to undergraduate counseling students. AB - Teaching ethics to undergraduates is a topic of increasing interest among mental health professionals; knowledge of ethics is particularly important to students who seek employment in agencies after graduation. This article describes methods of presenting ethics of practice both in a separate ethics course and as part of an undergraduate counseling practicum. Sources of materials used for course readings are presented. PMID- 1792294 TI - Health psychology and community psychology: a comparison through content analysis of representative journals. AB - This is an extension of previous analyses comparing the content of health psychology journals with the content of journals in health education and clinical psychology. The present content analysis of two journals in health psychology and two journals in community psychology identified commonalities and differences between the two specialties as well as between the two community psychology journals. PMID- 1792295 TI - Childhood trauma and adult life satisfaction in a random adult sample. AB - 640 randomly selected adults were surveyed about childhood traumatic events and their current life satisfaction. Respondents who had experienced traumatic childhood events rated themselves significantly less satisfied with life and were less likely to be home owners and more likely to live in families with lower incomes than respondents who had not experienced traumatic events (ns ranged from 44 to 232, depending on the items). PMID- 1792296 TI - The Personality Inventory Scales: a self-rating clinical instrument for diagnosis of personality disorder. AB - A personality inventory was developed as an aid in securing history and beliefs relevant to the assessment of personality structure and the diagnosis of personality disorders. The inventory was developed by restating DSM diagnostic criteria in everyday language, rewording the resulting statements in the form of True/False questions, and placing these questions in a short, self-paced booklet which subjects could complete in about 15 minutes. The following assessments were made and discussed: construct validity, split-half reliability, test-retest reliability, comparison with a standardized interview, and comparison with actual clinical assessments. The personality inventory is discussed as a useful accompaniment to the diagnostic interview in clinical settings and for research into personality structure and personality disorders. PMID- 1792297 TI - Cortical modulation of visual contrast. AB - The mechanisms that produce simultaneous contrast have been thought to depend on retinal gain control and the retina is supposed to send signals to the brain only in terms of local-border contrast (Shapley, 1986). However, it was found that, when an object on a uniform background and border-concealing stimuli are presented to different eyes, the brightness of the object is greatly influenced if the border-concealing stimuli are perceptually superimposed on the border of the object. The change in the object's brightness in this condition is almost identical to that observed when both the object and the border-concealing stimuli are presented to the same eye, suggesting that the brain can compute brightness by using luminosity information when contrast information is disrupted. PMID- 1792298 TI - The effects of hemispheric differences on feature perturbations. AB - Hemispheric differences for feature perturbations were investigated in two experiments. Stimulus displays consisting of five small squares arranged in a single row were presented tachistoscopically, with the subject instructed to state in which square a horizontal tick mark was located. Ticks could occur in any of the three middle squares, with half of the ticks presented on the inside and half presented on the outside of the square in relation to the fovea. Experiment 1 presented each array of five squares to the right or left of fixation at one of three distances from the fovea. Experiment 2 manipulated the distance between the squares and kept foveal distance constant. In each experiment, fewer errors were made when stimuli were presented to the left visual field/right hemisphere than when they were presented to the right visual field/left hemisphere, when ticks migrated toward the fovea. Experiment 1 found that increasing the distance from the fovea increased the error rate, but did not change the hemispheric differences. Experiment 2 found that increasing the distance between the squares did not change hemispheric effects reliably. The data imply that hemispheric differences for perceptual processing begin very early during sensory analysis. PMID- 1792299 TI - The effects of target discriminability and retinal eccentricity on saccade latencies: an analysis in terms of variable-criterion theory. AB - Two experiments are reported that studied changes in saccade latencies (SLs) in a target-identification task as a function of target discriminability and eccentricity. SLs were found to be longer when target discriminability was low and eccentricity was large, both factors showing a significant interaction. Variable-criterion theory (Grice, 1968) was used to derive a working model of the perceptual and decisional processes influencing SLs in the present task. Application of the measurement operations of the theory provided a good quantitative description of individual SL distributions. The analyses in terms of variable-criterion theory suggest that the perceptual process influencing SLs starts earlier and operates at a faster rate when the saccade target can be discriminated on the basis of global-visual features (e.g., size) than when local features (e.g., gaps) have to be extracted. PMID- 1792300 TI - Size invariance in visual number discrimination. AB - This study deals with the observer's ability to discriminate the numerosity of two random dot-patterns irrespective of their relative size. One of these two patterns was a reference one that was always composed of 32 dots randomly distributed within a K x K invisible square window (K = 1.92 degrees). The second one was the test pattern with one of the five magnifications (K = 0.64 degrees, 1.28 degrees, 1.92 degrees, 2.56 degrees, 3.20 degrees) and the relative number of dots varied on 11 levels (N = -15, -12, -9, -6, -3, 0, 3, 6, 9, 12, or 15 dots). The observer's task was to indicate which of the two patterns contained more dots. The results show that the stimulus size, as an irrelevant stimulus attribute, can be ignored in the judgements about relative numerosity. This means that the perceived numerosity is size invariant, at least for a 1.6-times magnification and a 3-times reduction of the test pattern. The size invariance observed constrains the range of potential models, since the perceived numerosity can be identified only by means of a feature of the stimulus that will remain invariant after any change in the absolute stimulus size. PMID- 1792301 TI - Context effects in the processing of familiar faces. AB - In this paper we report five experiments that investigate the influence of prime faces upon the speed with which familiar faces are recognized and named. Previously, priming had been reported when the prime and target faces were closely associated, e.g., Prince Charles and Princess Diana (Bruce & Valentine, 1986). In Experiment 1 we show that there is a reliable effect of relatedness on a double-familiarity decision, even when the faces are only categorically related, e.g., Kirk Douglas and Clint Eastwood. Then it was shown that such an effect emerges only on a double decision task (Experiments 2 and 3). Experiment 4 showed that on a primed naming task, faces preceded by a categorically related prime were responded to more quickly than those preceded by an unrelated prime, and the effect was due to inhibition. Experiment 5 replicated this effect and also showed that when associatively related primes were used, a facilitatory, and not an inhibitory, effect is found. It is argued that the facilitation of associative priming arises at an earlier locus than the inhibition of categorial priming. PMID- 1792302 TI - Tonality and perception: musical scales primed by excerpts from The Well-Tempered Clavier of J. S. Bach. AB - The psychological relevance of the musicians' concept of tonality was tested in the context of the music of J. S. Bach. Musically trained listeners were instructed to sing the musical scale that first came to mind immediately after hearing short excerpts from Preludes of J. S. Bach's The Well-Tempered Clavier. For each Prelude, the tonic (first note) and the mode (major or minor) of the scale produced were compared to the tonic and mode designated by Bach. Results indicated that listeners (1) often established the designated tonic and mode within the first four notes of the piece; (2) within the first four bars, often established tonalities different from that of the designated key, a tendency that increased by the eighth bar; and (3) reestablished the tonic in the last four bars. These observations validate, in general, music-theoretic assumptions about the listener's hearing of tonality, and raise issues regarding the salient relations that engage the cognitive structures underlying tonality perception. PMID- 1792303 TI - Spatial distribution of attention in a visual alignment task: a reply to Hotopf and Brown. PMID- 1792304 TI - [p53 gene as a tumor suppressor gene]. PMID- 1792305 TI - [The promotion of plant growth by ultraviolet radiation]. PMID- 1792306 TI - [Protein translocation across membranes]. PMID- 1792307 TI - [Methods for studying protein import into isolated mitochondria]. PMID- 1792308 TI - The relation between radiotherapist, surgeon, pathologist and physicist in the treatment of early breast cancer. AB - In order to obtain optimal treatment results, close cooperation between the different disciplines involved in multimodality treatment of breast cancer is absolutely necessary. Open communication between radiotherapist, surgeon, pathologist and physicist forms a chain, as strong as its weakest link. PMID- 1792309 TI - Quality assurance in conservative treatment of early breast cancer, a consensus meeting. December 13-14, 1990, Tubingen, Germany. PMID- 1792310 TI - Rationale for a quality assurance programme in clinical trials of conservative management of breast carcinoma. European Organization for the Research and Treatment of Cancer. AB - The EORTC Consensus Meeting held at Tubingen on 13-14 December, 1990 reviewed the treatment sequence in conservative management of early breast cancer from the standpoint of quality assurance. These reports considered the most relevant criteria for evaluating pathology, surgery and radiotherapy techniques, not only for selected institutions participating in prospective randomised trials but also aiming at developing quality control procedures that could be used anywhere for routine standard treatment. This paper lists the various steps justifying quality control procedures in radiotherapy of the breast and actions to be taken according to the score of observed deviations. At last, it includes a discussion of the justification of quality control and of its potential consequences on the results of trial in the EORTC trial 22881/10882 (boost treatment versus no boost in conservative management of early breast cancer) in which the accrual of 1500 patients is planned. PMID- 1792311 TI - Quality control in breast cancer treatment: what information can the surgeon provide? AB - In terms of quality control, the surgeon carries responsibility for the accurate measurement and recording of clinical signs at the time of first presentation. Furthermore, the surgeon has to obtain efficiently a histopathological specimen of the primary tumour and also to formulate a plan for the most effective treatment of the primary tumour and axillary lymph nodes. As part of quality control in management of infiltrating carcinomas, axillary clearance should be intrinsic to the primary treatment whether this is mastectomy or a breast conservation technique. Failure to clear the axilla can result in under-staging so that adjuvant systemic therapy may not be given to patients who might benefit from such treatment. There is need for close cooperation between radiotherapists and surgeons in the management and follow up of patients with early breast cancer. PMID- 1792312 TI - The impact of surgical and pathological findings on radiotherapy of early breast cancer. AB - Treatments results in breast conserving therapy show considerable variation with local breast control rates from 1 to 13% at 5 years of follow-up. This wide variation and reports on prognostic factors (e.g. age, extensive ductal carcinoma in situ component and margin involvement) having an adverse effect on local control raise questions about the safety of this treatment. An attempt is made to identify surgical and pathological factors which make modifications in the radiotherapeutic treatment necessary in order to reach the perfect balance between good local control and optimal cosmetic results. For this purpose, the literature is reviewed including three randomized trials on this subject (Milan, NSABP-06 and EORTC 10801) and those studies providing sufficient data on most of the mentioned prognostic factors. Looking at the treatment characteristics of the above mentioned studies, a considerable variation is observed with regard to surgical margins, the boost dose and the application of adjuvant systemic treatment. Microscopic margin evaluation and identification of extensive in situ component (EIC) is performed in about half of these studies and the implications of these findings are very different. Although a number of authors perform multivariate analyses, this is rarely done on a complete set of variables. This results in different treatment results and conflicting data on prognostic factors. There is no agreement on one single prognostic factor and best results in terms of local control are seen in those centres combining a very wide excision with a moderate boost or a less wide excision with a high boost.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792313 TI - Breast cancer treatment: which inhomogeneities have to be taken into account? AB - A true three-dimensional algorithm has been developed at the Gustave Roussy Institute, which can evaluate the dose distribution in inhomogeneous media. In this paper, an explanation is given that, in our view, problems of inhomogeneity cannot be solved without accounting for the third dimension and its contribution to scattered dose calculation. PMID- 1792314 TI - Should inhomogeneity corrections be applied during treatment planning of tangential breast irradiation? AB - Due to the inclusion of lung tissue in the treatment volume, some parts of the breast will get a higher dose during tangential breast irradiation because of the lower lung density. Data on the accuracy of dose calculation algorithms, investigated by phantom measurements, determinations of the geometry and density of the actual lung in the patient and the results of in vivo dose measurements, are presented. From this information it can be concluded that a lung correction varying between about 3% and 7% is needed but its magnitude is slightly overpredicted in a number of commercial treatment planning systems. Because this increase in dose is already in a high dose region, it is recommended that inhomogeneity corrections should be applied during tangential breast irradiation. PMID- 1792315 TI - Improved dose distribution homogeneity in conservative breast cancer irradiation. AB - At the occasion of recent meetings of the radiation oncology community, the description of a whole breast irradiation technique making use of cranio-caudal oriented wedge filters to compensate for dose distribution inhomogeneity in this direction has given rise to some discussions and misunderstandings. It is the scope of this presentation to describe the technique and its possible use for other localizations. PMID- 1792316 TI - Improved dose homogeneity in the breast using tissue compensators. AB - The improvements achievable by introducing individual tissue compensators in photon therapy of the breast were assessed. In 37 patients the dose ranged from +15% to -10% of the mid target dose using combinations of wedge filters and beam weights alone. With a tissue compensator the dose ranged from +4% to -11% provided that allowance was made for lung attenuation. A megavoltage imaging system is a potential source of the X-ray transmission data which can provide a basis for the calculation of thickness of the compensator. PMID- 1792317 TI - Three-dimensional dose distribution of tangential breast treatment: a national dosimetry intercomparison. AB - From August 1990 to February 1991, a dosimetry intercomparison of breast treatment was performed at all 21 radiotherapy centres in The Netherlands. The absorbed dose was measured in three planes in a breast phantom during tangential breast irradiation, according to a prescribed technique. The beam energy could be chosen by the radiotherapy centre as normally applied for this type of "patient", and varied between 60Co and 8 MV X rays. The dose measured by the visiting team in 22 points inside the phantom was compared with the dose calculated by the institution using their local treatment planning system. In the institutions the mean ratio (the mean value of the ratios of the absolute calculated dose and the measured absolute dose in the 22 points) varied between 0.92 and 1.08 with an overall mean ratio of 1.04. There was no significant difference in this ratio between the three planes in a particular institution. In the isocentre the mean ratio of calculated and measured dose was 1.021 with a SD of 0.028, i.e. the algorithms in the six different commercial treatment planning systems calculate the dose generally somewhat too high. In order to explain the results, a measurement of the output under reference conditions was performed at each treatment unit. The mean ratio of the dose stated by the institution and the dose measured by the visiting team was 1.011 with a SD of 0.015 with a maximum deviation of 0.040. This small deviation explains therefore only part of the variation in the ratio of calculated and measured dose for tangential breast irradiation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792319 TI - Improvement of the method used at Creteil for early breast cancer: 1970-1990. PMID- 1792318 TI - Breast irradiation in the lateral decubitus position: technique of the Institut Curie. AB - Breast irradiation in the lateral decubitus (LD) position is a technique used at the Institut Curie for more than 30 years in the breast-conserving management of patient with breast cancer. This technique is described in detail in this article. The patient's position allows the breast to flatten over a support, hence providing a rather homogeneous thickness throughout the treated volume. Dose at mid-thickness on the beam axis can be easily determined from entrance and exit dose measurements. Disadvantages and advantages of the LD technique are discussed. We presently recommend this technique for patients with large breasts (more than 6 cm thickness in LD position). PMID- 1792320 TI - In vivo dosimetry during tangential breast treatment. AB - The 3-dimensional (3-D) dose distribution as calculated in clinical practice for tangential breast treatment was verified by means of in vivo dosimetry. Clinical practice in our institution implies the use of 8 MV X-ray beams, a 2-D treatment planning system, collimator rotation and a limited set of patient data for dose calculations. By positioning diodes at the central beam axes as well as in the periphery of the breast the magnitude of the dose values at the isocentre and in points situated in the high-dose regions behind the lung could be assessed. The position of the diodes was verified by means of an on-line portal imaging device. The reproducibility of these in vivo dose measurements was better than 2% (1 SD). Our study showed that on the average the dose delivery at the isocentre is 2% less and at the points behind the lung, 5.7% higher with respect to the calculated dose values. Detailed analysis of these in vivo dosimetry results, based on dose measurements performed with a breast shaped phantom, yielded the magnitudes of the errors in the predicted dose due to several limitations in the dose calculation algorithms and dose calculation procedure. These limitations are each introducing an error of several percent but are compensating each other for the dose calculation at the isocentre. We concluded that the dose distribution in a patient for our treatment technique and dose calculation procedure can be predicted with a 2-D treatment planning system in an acceptable way. A more accurate prediction of the dose distribution can be performed but requires an estimation of the lack of scatter due to missing tissue, the change in the dose distribution due to oblique incident beams and the incorporation of the actual output of the treatment machine in the assessment of the number of monitor units. PMID- 1792321 TI - Entrance and exit TL-dosimetry in the conservative treatment of breast cancer: a pilot study for the EORTC-Radiotherapy Cooperative Group. AB - Mailed dosimetry, using thermoluminescent dosimeters, can play an important role in quality assurance procedures in radiotherapy. In 1989, a pilot study was started with the main aim to show the feasibility of this method for the multicentre EORTC trial 22881 on the conservative management of breast carcinoma. Two anthropomorphic breast phantoms and six patients with breast carcinoma were irradiated according the prescriptions of the protocol. TLD measurements of the entrance and exit dose were performed in 6 MV tangential X-ray beams. It proved to be possible to correlate the dose measured in the entrance and exit points of the beams to the calculated dose closely under the surface. A thickness of at least 5 mm bolus material must be applied over the dosimeters and a distance of at least 3 cm from the lateral and medial field borders must be maintained in order to reach a clinically acceptable accuracy in the measurements. PMID- 1792322 TI - In vivo dosimetry for tangential breast irradiation: role of the equipment in the accuracy of dose delivery. AB - Entrance dose measurements (920) have been performed on both tangential treatment fields for 105 breast cancer patients. About half of them (52) were treated on a modern unit (Mevatron, Siemens), supplied with an automatic verification system, the other half (53) were treated on an old therapy unit (cobalt-60). A team of three radiographers worked on the modern unit, while on the old unit only one radiographer was responsible for the treatment set-up. A small systematic error (+ 1.4%) has been detected on the old unit: a small discrepancy existed in the region of the maximum dose between the measured and the published percentage depth-dose values (Br. J. Radiol., Suppl. 17), the latter being used for dose calculation. A striking difference has been observed for the rate of large deviations (deviations of 5% and more from the mean dose): 2.3% (10/430) for the modern unit versus 15% (75/490) for the old one. This shows clearly that the precision in dose delivery is strongly dependent on the characteristics and staffing of the therapy unit, the modern unit being supplied with a check-and confirm system and with the beam accessory devices in a fixed position in the beam and a team of radiographers being responsible for the set-up. PMID- 1792323 TI - Quality assurance of the EORTC trial 22881/10882: "assessment of the role of the booster dose in breast conserving therapy": the Dummy Run. EORTC Radiotherapy Cooperative Group. AB - The EORTC trial 22881/10882 is a randomised trial with the aim to assess the role of the boost dose in breast conserving therapy in stage I and II breast cancer. In order to detect potential protocol deviations concerning irradiation technique and in the dose specification procedure of participating institutions before actual patient accrual, a Dummy Run was performed. Three transverse sections of a patient were sent to 16 participating institutions with a request to make a three plane treatment plan according to the protocol prescriptions. A treatment chart and beam data were also requested for recalculation of the dose. Additional information was asked in a questionnaire. On evaluation, the techniques differed considerably with respect to photon beam energy, varying between 60Co gamma-rays and 8 MV X-rays, and the use of wedge filters. Two institutions did not apply wedges, whereas wedge angles in the other institutions varied between 6 degrees and 45 degrees. Twelve institutions used collimator rotation and/or a table wedge to diminish the amount of irradiated lung volume. The dose was specified in a point according to the protocol prescription in 11 institutions and to the 90, 95 or 100% isodose curve in four. Twelve institutions applied lung density corrections during treatment planning, while nine reported problems with their planning system in off-axis dose distribution calculation and/or the simulation of collimator rotation. Recalculation of the dose at the isocentre showed agreement within 2% compared with the stated dose. The dose reported in the tumour excision area varied between 93 and 100%.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792324 TI - Quality assurance in daily treatment procedure: patient movement during tangential fields treatment. AB - Fifteen women undergoing breast radiotherapy following wide local excision of an early stage breast cancer were submitted to repeated measurements of surface landmarks to check the reproducibility of patient positioning, and to portal imaging using a megavoltage imaging device. When the patient is being set-up the mean rise and fall of a lateral skin mark (tattoo) was within 4 mm in 95 observations of 15 patients. At the end of the lateral field exposure, the mean displacement of the lateral tattoo was close to zero, with only 15/95 (16%) observations falling outside the range +/- 2 mm. The daily measurements of lung thickness fell above and below the simulated lung thickness, consistent with random fluctuations. Eighty-eight percent of lung thickness measurements were within +/- 5 mm of the simulator position. A tentative conclusion is made that more sophisticated immobilisation and imaging devices may be unnecessary for breast irradiation with a high degree of reproducibility. PMID- 1792325 TI - Quality control in the conservative treatment of breast cancer: patient dosimetry using silicon detectors. AB - Twenty patients with early breast cancer were treated with external irradiation, delivered with two tangential beams (6 MV X-rays) using a half-beam block (HBB) and 3-D compensating filters. All patients were immobilized with individualized cellulose acetate casts. Patient dosimetry was performed using p-type silicon detectors. Midline doses were calculated by combined entrance and exit dose measurements. The mean ratio of the measured and the prescribed doses was 96.6 +/ 3.8% at the reference point, 96.8 +/- 4.3% at off-axis points on the central plane and 96.8 +/- 7.6% at off-plane points. PMID- 1792326 TI - Tangential breast irradiation: influence of technique of set-up on transfer errors and reproducibility. AB - Using conventional portal films, the influence of the technique of set-up on the transfer error from simulator to treatment couch and on the subsequent reproducibility was made for the irradiated volume in the treatment of breast cancer. A total number of 376 portal films have been performed on 14 patients. All the patients were treated on a 6 MV Linac supplied with an automatic verification system excluding, however, the couch parameters. The overall precision of the treatment delivery is evaluated by the global analysis of the discrepancies between the simulator films and the different portal films. For the patient group lying on a inclined plane with (group 2) or without (group 1) fixed arm support, a narrow gaussian distribution is obtained in the anteroposterior (AP) direction with a SD of 4 mm. In the craniocaudal (CC) direction, the frequency of distribution of the patients treated without fixed arm support is much larger than in the other group: the SD is respectively 15.5 mm for the first and 5.5 mm for the second one. The reproducibility of the series of set-ups of the two groups estimated by reference to the mean value are similar in the AP direction. The SD within the series of portal films in the CC direction is 5.8 mm for the first group and 3.7 mm for the second group. Their comparison with the discrepancies of 15.5 mm and 5.5 mm when assessing the deviation between the simulated and portal films shows the importance of systematic errors. The localisation of the irradiation port can be improved by using support systems with fixed arm indicators. PMID- 1792327 TI - Early breast cancer irradiation after conservative surgery: quality control by portal localization films. AB - A review of geometrical errors on portal localization films in 20 patients undergoing breast irradiation after conservative surgery is presented. Patients were immobilized using a cellulose acetate individual cast. Good precision in daily set-up has been noted with a mean ventrodorsal shift of 2.7 mm on medial films and 3.0 mm on lateral films; a mean craniocaudal shift of 1.8 mm on medial films and of 2.0 mm on lateral films have been also observed. The mean half-beam block rotation error has been minimal, ranging 0.8 degrees on medial and 1.1 degrees on lateral films. A new cast was made in 3/20 (15%) patients depending on variation of breast morphology during treatment and on geometrical errors noted by portal localization film check. PMID- 1792328 TI - Portal imaging for the verification of breast treatments. AB - Increasing demands are being made for more accurate versatile and precise methods of quality control for radiation therapy, in general. To this end, we have used a digital, on-line, megavoltage imaging system for the verification of breast treatments, in particular. Quick, high-quality images are produced from which the depth of lung irradiated during treatment is very easily determined using the system software. We describe how this quantitative clinical information has been used to assess critical aspects of the treatment technique, and also patient orientated criteria, throughout the course of treatment. PMID- 1792329 TI - Accuracy in tangential breast treatment set-up: a portal imaging study. AB - To test the accuracy and reproducibility of the tangential breast treatment set up used in The Netherlands Cancer Institute, a portal imaging study was performed in 12 patients treated for early stage breast cancer. With an on-line electronic portal imaging device (EPID) images were obtained of each patient in several fractions and compared with simulator films and with each other. In five patients, multiple images (on the average 7) per fraction were obtained to evaluate set-up variations due to respiratory movement. The central lung distance (CLD) and other set-up parameters varied within one fraction about 1 mm (1 SD). The average variation of these parameters between various fractions was about 2 mm (1 SD). The differences between simulator and treatment set-up over all patients and all fractions was on the average 2-3 mm for the central beam edge to skin distance and the central lung distance. It can be concluded that the tangential breast treatment set-up is very stable and reproducible and that respiration does not have a significant influence on treatment volume. The EPID appears to be an adequate tool for studies of treatment set-up accuracy like this. PMID- 1792330 TI - Quality assurance in conservative treatment of early breast cancer. Report on a consensus meeting of the EORTC Radiotherapy and Breast Cancer Cooperative Groups and the EUSOMA (European Society of Mastology). AB - A consensus on a quality assurance programme of the treatment of early breast cancer was reached in a multidisciplinary meeting of surgeons, pathologists, radiotherapists, physicists and radiographers. Guidelines for treatment preparation and execution have been set up, including careful location and excision with marking of the primary tumour. The target volumes for irradiation of the whole breast and boost area have been defined. Radiation dose prescription rules, specification and checking procedures are given, together with measures to achieve a homogeneous dose within the target volume. The rules for a quality assurance programme in each clinic are designed for checking equipment and treatment method. PMID- 1792331 TI - Application of reproductive technology to the Australian livestock industries. AB - Current use of reproductive technology in the Australian livestock industries is limited, though it increased in line with higher prices for beef and wool through the 1980s. The required techniques, many of which were developed in Australia, are available and the level of expertise is comparable to the best in the world. However, the extensive pastoral industries do not readily lend themselves to these procedures. Only in the dairy industry is artificial insemination used to a significant degree. On the other hand, application of the technology in the pastoral industries is confined largely to studs and breeding cooperatives which provide breeding animals for producer flocks and herds. Hence the impact of applied technology may be more widespread than first appears. Until recently, little regard was paid to application of the technology along sound breeding principles. Artificial insemination and multiple ovulation and embryo transfer (MOET) have not been used so much in planned breeding programmes aimed at local improvement of stock, but more to proliferate genes of reputedly superior stock, imported either from overseas or elsewhere in Australia. This is particularly true of MOET, where the incentive to use it is commonly a short term cash gain made from proliferating breeding stock of a particularly valuable and usually novel strain or breed. Recent technological improvements which render the use of reproductive technology cheaper and more effective will lead to its more widespread use in commercial practice. Techniques for embryo freezing and splitting have been greatly simplified and quickly put into practice. The novel livestock technologies of in vitro oocyte maturation and fertilization have already found commercial application overseas. Fecundity-enhancing products have also been adopted by the livestock industries. There is potential value for greater use of reproductive technology in the livestock industries provided it is implemented according to sound breeding principles and provided associated management practices are applied simultaneously. PMID- 1792332 TI - Morphometry of the epididymis of the tammar wallaby, Macropus eugenii, and estimation of some physiological parameters. AB - About 14 ductuli efferentes (mean length 48 cm) leave the testis of the tammar. The caput, corpus and cauda epididymidis constitute 37%, 42% and 21% respectively of the total length of the ductus epididymidis (estimated to be 34.9 m long). The initial segments of the ductus epididymidis are longer, relative to body or testis mass, in the tammar than in eutherian mammals such as the rat. The main morphometric features of the male excurrent duct system of the tammar are a high ratio of surface area of luminal border:luminal volume of the ductuli efferentes (which reabsorb most of the fluid leaving the testis), a high ratio of epithelial volume:luminal volume in the caput and corpus epididymidis (which are involved in sperm maturation) and a low ratio of epithelial volume:luminal volume in the cauda epididymidis (which is involved in sperm storage). Estimates of fluid reabsorption by the ductuli efferentes and protein secretion by the caput epididymidis were respectively 8.9 microL cm-2h-1 and 2.8 micrograms cm-2h-1. Other estimates for the ductuli efferentes, caput, corpus and cauda epididymidis respectively were: sperm velocity (4.5, 4.8, 2.2, and 0.9 mm min-1), duration of sperm transit (107 min, 1.9 days, 4.7 days, and 6.3 days), total number of spermatozoa (4950 x 10(6)) and distribution of extragonadal spermatozoa (0.6, 14, 36 and 49% of the total). The values are within the ranges estimated for eutherian mammals. PMID- 1792333 TI - Immunization of merino ewes with a synthetic inhibin peptide or with preparations obtained from bovine and porcine follicular fluids by immunoaffinity chromatography result in different effects on ovulation rate and on plasma gonadotrophin concentrations. AB - Ewes were immunized with either a synthetic peptide (peptide 1-32) that has an amino acid sequence identity with the first 32 amino acids at the amino terminal of the alpha-subunit of porcine inhibin, or with bovine or porcine monoclonal antibody purified inhibin (bMPI and pMPI respectively), obtained by immunochromatography from follicular fluids. The peptide 1-32 was conjugated to albumin before use. Peptide 1-32 and bMPI increased ovulation rate and number of follicles (greater than or equal to 5 mm diameter). Although bMPI increased plasma FSH concentration the peptide did not. pMPI had no effect on ovarian activity but markedly elevated both plasma FSH and LH concentrations. The plasma LH concentration was lowered in ewes immunized with peptide 1-32. It appears, therefore, that ovulation rate can be increased following increased plasma FSH concentrations at luteolysis or in the absence of such an increase. Conversely, greatly increased plasma gonadotrophin concentrations at luteolysis (pMPI) were not followed by an increase in ovulation rate. Antibodies in the plasma of ewes immunized with peptide 1-32 and bMPI bound to iodinated synthetic human inhibin alpha-chain 6-30 peptide. The results suggest that ovulation rate is at least partly determined by intraovarian factors. PMID- 1792334 TI - Concentrations of immunoactive inhibin in serum during human pregnancy: evidence for an ovarian contribution. AB - Immunoactive inhibin (ir-inhibin) concentrations in maternal serum during normal human pregnancy have been established in two separate studies employing cross sectional and longitudinal sampling regimes. Ir-inhibin concentrations rose from the mid-luteal phase (geometric mean + 95% confidence intervals 1.490 (1.086 2.028) U mL-1) to peak at week 11 of gestation (3.77 (3.26-4.35) U mL-1), declined to a plateau from 14 to 25 weeks with means ranging from 1.8 to 2.3 U mL 1, and subsequently rose slowly to a peak of 6.53 U mL-1 at 41 weeks. In the longitudinal study, similar results were obtained and no differences were found in maternal inhibin levels in women carrying male or female fetuses. Paired cord blood and maternal samples showed no significant difference in ir-inhibin concentrations irrespective of the sex of the fetus. However, in all such pregnancies amniotic fluid ir-inhibin levels were 2-3 fold greater than maternal or fetal levels raising the possibility that the amnion may secrete inhibin. In 12 women without functional ovaries in whom a singleton pregnancy was achieved by donation of oocytes and in vitro fertilization, the ir-inhibin levels showed a similar pattern in the first trimester of pregnancy but the concentrations achieved were markedly lower (peak 1.1 U mL-1 at 9 weeks). In five women from the group in whom samples were available late in gestation, three showed greater than normal levels and two had subnormal levels.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792335 TI - Ovariectomized does do not require progesterone priming for oestrous behaviour. AB - Ewes need to be primed with progesterone in order to achieve sensitivity to oestrogen. This relationship was examined in goats. In experiment 1 the median effective dose of oestradiol benzoate (ODB) required to induce oestrus during the breeding season (July) in progesterone-primed ovariectomized does was 15 micrograms, a dose similar to that reported to be required in ewes. In experiment 2 (initiated in March) the requirement for progesterone priming before injection of ODB to induce oestrus after a period without any exogenous hormone treatment, was compared in goats and sheep. Without progesterone priming, ovariectomized does were sensitive to doses of ODB between 20 and 80 micrograms, whereas ewes were not. This indicates that, unlike sheep, goats may not require progesterone priming in order to exhibit oestrus at the beginning of the breeding season. After being primed with progesterone, ewes were more sensitive to ODB than were does. In primed ewes the median effective dose of ODB was 12 micrograms whereas in does it was 27 micrograms. These differences may be due to a seasonal effect on oestrous behaviour or differences in sensitivity to oestrogen between the species. PMID- 1792337 TI - Opioid involvement in LH release during the negative feedback effects of oestradiol and progesterone in dairy cows. AB - To create a clearly defined and uniform feedback phase of oestradiol, 1 mg oestradiol benzoate (OE2) was injected i.m. either 15-43 days post partum in 7 cows (Expt 1), or 12 h after prostaglandin oestrus synchronization of 4 cyclic cows (Expt 2 and 3). An endogenous opioid peptide (EOP) antagonist (250 mg naloxone), an EOP agonist (300 mg morphine), or a combination of the two was given in Expt 1, 2 and 3 respectively as a single i.v. injection in cows 16-18 h after OE2, i.e. in the negative feedback phase and before the expected onset of an induced luteinizing hormone (LH) surge. Blood samples were collected every 15 min for 1 h before and 2 h after each treatment. In Expt 1, naloxone failed to increase LH release when given during the negative feedback phase, but caused excessive release in one cow in which the LH surge had just begun. In all cows in Expt 2, morphine suppressed LH release (P less than 0.05). In Expt 3, naloxone prevented the suppressive effects of morphine for the first hour after treatment; a transient rise in LH occurred in one cow in which treatment was given 1 h before the start of the LH surge. In Expt 4, 250 mg naloxone was injected i.v. into 4 cows that had a plasma progesterone concentration of 1.5-3.1 ng mL-1 in the luteal phase of the oestrous cycle: naloxone failed to increase LH concentrations. It is concluded that LH can be further suppressed by opiates given to cows during the negative feedback phase of oestradiol.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792336 TI - Effects of season, GnRH administration and lupin supplementation on the ovarian and endocrine responses of merino ewes treated with PMSG and FSH-P to induce superovulation. AB - Administration of gonadotrophin releasing hormone (GnRH) 24 h after sponge withdrawal did not affect the numbers of corpora lutea (CL) or persistent large follicles (LF) in ewes superovulated with 400 I.U. pregnant mare serum gonadotrophin and 12 mg follicle stimulating hormone in spring (11.6 +/- 0.9 v. 13.0 +/- 0.9 CL and 0.8 +/- 0.9 v. 0.9 +/- 0.3 LF, for +GnRH and -GnRH ewes, respectively). However, it did increase the ovulatory response of ewes superovulated in autumn (15.8 +/- 1.2 v. 11.8 +/- 1.1 CL). The incidence of ewes with prematurely regressed CL was also greater in autumn than in spring (21/89 v. 5/88). Supplementary feeding with lupin grain in autumn had no effect on numbers of CL but did increase the incidence of ewes with LF (18/48 v. 7/46) and caused a marked reduction in the incidence of ewes with regressed CL (1/44 v. 20/45). For ewes treated in autumn, there were no effects of lupin supplementation or GnRH administration on peak oestradiol-17 beta (E2) or peak luteinizing hormone (LH) levels. However, when peak E2 concentrations in the plasma were adjusted for numbers of preovulatory follicles, higher concentrations were observed for ewes in the +lupin/-GnRH group (12.4 +/- 2.9 pg mL-1) than in other treatment groups (range 4.3 +/- 0.4 to 5.7 +/- 0.3 pg mL-1). Moreover, the time of the LH peak was advanced by both lupin supplementation and GnRH treatment.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792338 TI - Studies on the role of liver cytochrome P-450 and oestradiol metabolism in the effects of nutrition and phenobarbital on ovulation rate in the ewe. AB - Coopworth ewes were differentially fed to produce 60 heavy (62 kg) and 80 light (45 kg) ewes. They were then fed a low protein (100 g protein kg-1 dry matter) pelleted ration. On Day 7 of the oestrous cycle after synchronization the following treatments were commenced in groups of 10 ewes: 4 low liveweight groups received low protein (LP), high protein (HP; 230 g protein kg-1 dry matter), LP + phenobarbital (PB; 1 g per os per day in gelatin capsules for 10 days) and LP + triacetyloleandomycin (TAO, 0.5 g day-1 in capsule for 10 days); while 3 high liveweight groups received LP, HP and HP + carbon tetrachloride (CCl4, 0.1 mL kg 1 bodyweight as a single dose). The experiment was repeated using another 7 groups of 10 ewes at an interval of 3 weeks. PB, TAO, high liveweight, and protein diet increased the ovulation rate whereas treatment with CCl4 reduced the ovulation rate. Because of the small number of ewes in some treatment protocols, only changes due to liveweight and protein diet were statistically significant. Liver weight and microsomal protein were increased by all treatments except CCl4 which caused a decrease. PB and TAO increased cytochrome P-450 and associated enzyme activities, in particular those related to cytochrome P-450p or P-450NF (including oestradiol 2-hydroxylation) in the human liver. In vitro, TAO binding indicated that the specific cytochrome was induced by PB and TAO but there were no direct effects of protein diet and liveweight. Most of the data support the theory that nutritionally induced increases in ovulation rate in ewes could result from changes in oestradiol metabolism, but the lack of induction of the specific cytochrome by protein diet and high liveweight suggests that increased ovulation caused by these factors may be the physiological response to several metabolic changes. PMID- 1792339 TI - Screening for Neisseria gonorrhoeae and Chlamydia trachomatis in a donor insemination programme. AB - Cultures of all 4450 specimens of semen from 193 semen donors were negative for N. gonorrhoeae. A MicroTrak direct fluorescence microscopy test for the detection of Ch. trachomatis was used to screen 448 specimens from all 268 recipients of semen on an insemination programme for 3 1/2 years; all pre-insemination endocervical samples and all subsequent endocervical samples were negative. It is considered that the incidence of gonorrhoeae or chlamydia in our recipients or donors is very low. Fluorescence microscopy is a specific and cost-effective screening technique for Ch. trachomatis. PMID- 1792340 TI - The generalizability and clinical application dilemma. PMID- 1792341 TI - Effects of a skin refrigerant/anesthetic and age on the pain responses of infants receiving immunizations. AB - Although pain management is an important nursing responsibility, few interventions for minimizing distress of infants during painful procedures have been studied. Sixty infants, 2 through 6 months of age, were studied during a routine DPT immunization in order to examine (a) the effectiveness of cooling the skin in reducing distress behaviors and (b) the relationship between age and distress behavior. Infants were randomly assigned to experimental or control groups. Prior to the injection, the sites were sprayed for 2 to 3 s with either a skin refrigerant/anesthetic or compressed air. Behaviors were video- and audio taped during and 60 s post injection, and coded for (a) facial expression, (b) cry, and (c) body movements. MANOVA revealed fewer distress behaviors following refrigerant spray and more complex, varied behavioral responses for older infants. The findings provide further evidence that infants perceive pain and that nursing interventions for pain reduction should be tested and extended to the very young. PMID- 1792342 TI - Risk factors for urinary incontinence one year after nursing home admission. AB - Secondary data analysis was conducted from a longitudinal nursing home study to identify nonurologic risk factors for continence outcomes at 1 year after admission. Of 434 nursing home admissions, 196 subjects (45%) remained. At 1 year prevalence of incontinence was 43.8%. Age was not associated with prevalence or incidence. Risk factors identified were of male gender, urinary incontinence and poor behavioral adjustment at 2 weeks, presence of dementia and impaired mobility at 2 months. Once established, incontinence tended to persist. The data suggest types of residents who might be targeted for early preventive intervention. PMID- 1792343 TI - Clinical predictors of intravenous site symptoms. AB - The purpose of this prospective multi-site study was to determine the frequency of intravenous (IV) site symptoms and to develop a preliminary model of the factors implicated in the number of these symptoms. In a sample of 514 patients from four institutions, IV site symptoms including pain, redness, swelling, induration, and/or a venous cord were present in 205 (39.9%) of the patients. The IV catheters were in place an average of 48.7 hr. There were no significant differences in symptoms by hospital site. Using multiple regression techniques, a seven-factor model explained 18% of the variance in number of IV site symptoms. Further research is required to explore other potential causes for the numbers of IV site symptoms. PMID- 1792344 TI - Perceived stressors and coping responses in persons with recurrent genital herpes. AB - This descriptive study was designed to examine the disease experience of persons who have genital herpes by identifying the nature and frequency of disease related stressors and coping responses associated with these stressors. Participants were 34 women and 26 men who were on average 5.3 years postdiagnosis, and experienced a mean of 6.4 recurrences per year. Respondents reported a wide range of disease-related stressors (M = 7). The category of stressors identified most often was related to disease consequences (73.9%), and included difficulty with intimate relationships, difficulty with relationships involving family and friends, fear of transmission through both sexual activity and casual contact, and concern about negative effect on health. Respondents tended to use active coping, planning, and acceptance more often than passive strategies such as denial. Implications for clinical assessment and intervention are discussed. PMID- 1792345 TI - Beliefs about AIDS, health, and illness among low-income Latina women. AB - The purposes of this study were to describe (a) the health beliefs of Latina women about acquired immunodeficiency syndrome (AIDS); and (b) the relationship of these beliefs to the subjects' traditional beliefs about illness and its treatment. The sample consisted of 59 low-income Latina women attending nutrition programs in Los Angeles. A qualitative approach was used to gather the data in semi-structured focus group interviews. Content analysis was used to classify data according to causes of AIDS and prevention and treatment of AIDS. Causes of AIDS included all of the current biomedical and public health explanations of transmission, current popular beliefs and misconceptions about transmission, and long-standing traditional beliefs about the causes of illness. Prevention and treatment of AIDS reflected these same three perspectives. The women's beliefs consisted of accurate, inaccurate, and incomplete information about AIDS. Implications were drawn from the findings for AIDS education and prevention programs which are congruent with the participants' cultural beliefs, values, attitudes, and expectations. PMID- 1792346 TI - An empirical test of Rogers' original and revised theory of correlates in adolescents. AB - The purpose of this study was to examine Rogers' original and revised theory of correlates in adolescents. The correlates were measured by Perceived Field Motion, Human Field Rhythms, Creativity, Sentience, Fast Tempo, and Waking Periods. The original theory was tested with data obtained from samples of early (n = 116), middle (n = 116), and late (n = 116) adolescents. The revised theory was tested in a fourth selectively combined sample of adolescents, aged 12 to 21 (n = 89). Data were collected in classroom settings. Although the findings did not support either theory, they did indicate that: (1) four of the six correlates studied performed as correlates when examined in three discrete phases of adolescence, as determined by chronological age, (2) the means of the individual correlates increased slightly in frequency levels developmentally, and (3) the correlates emerged at different frequency levels when examined in adolescents, aged 12 to 21. PMID- 1792347 TI - Coefficient alpha: conceptualizations and anomalies. AB - In this article distinctions are made among some of the different conceptualizations of, and formulas for, Cronbach's coefficient alpha as it is applied to dichotomous or nondichotomous, standardized or unstandardized, and weighted or unweighted data. Issues regarding the statistical significance of alpha and the occasionally encountered anomalies of artificially high alpha and negative values of alpha are given particular attention. PMID- 1792348 TI - Conservatism in maximally exposed individual (MEI) predictive exposure assessments: a first-cut analysis. AB - The United States Environmental Protection Agency (USEPA) sometimes applies exposure assessment models based upon the concept of a hypothetical "maximally exposed individual" (MEI) as a means of dealing with uncertainty. This concept has been described in the benzene NESHAPS rule, the proposed RCRA Corrective Action Rule, and the Clean Air Act reauthorization debate. This paper describes a first-cut analysis of the level of conservatism of the current MEI approach relative to a central estimate of exposure of the most exposed population around a source. The inherent level of conservatism of the current MEI model, which appears to be at least one order of magnitude, is usually left unstated. The significance of this conservatism is described along with some proposals for future research. PMID- 1792349 TI - Quantitative prediction of human cancer risk from rodent carcinogenic potencies: a closer look at the epidemiological evidence for some chemicals not definitively carcinogenic in humans. AB - The existence of rodent carcinogens for which at least one epidemiological study found no evidence of human carcinogenicity has been claimed to provide evidence of the poor predictivity of rodent bioassays (F. K. Ennever, T. J. Noonan, and H. S. Rosenkranz (1987). Mutagenesis 2, 73-78). We have performed quantitative comparisons of the rodent and human carcinogenic potencies for these same chemicals. Starting with the rodent TD50 at the most sensitive site, we derived a predicted human incidence for the degree of exposure and duration of follow-up corresponding to the most comprehensive epidemiological study available, and then we compared the predicted incidence with the observed incidence. If a chemical produced no statistically significant increase in cancer at any site in the exposed population, consistency with rodent results is inferred if the minimum rodent TD50 is sufficiently high that no attributable cases would have been expected under the actual conditions of human exposure and follow-up. For 18 of the 22 chemicals examined, the human evidence is consistent with the predictions based on the rodent bioassay results. For two chemicals, dichlorobenzidine and ethylene thiourea, there is not enough epidemiological information to make a useful comparison with rodent bioassay data. For the two remaining chemicals, actinomycin D and vinylidene chloride, the human evidence is inconsistent with the predictions. But the conditions of the rodent bioassay of actinomycin D were inappropriate for the comparison, and for vinylidene chloride the human exposure dose and duration were uncertain; either chemical might yet demonstrate consistency with the rodent results in future epidemiological studies. PMID- 1792350 TI - Classification of carcinogens: polemics, pedantics, or progress? AB - Rodent carcinogens may, for physiological or other reasons, induce cancer by a variety of mechanisms which vary in their ability to affect humans. While the current approach of some regulatory agencies to carcinogen risk assessment and regulation may possibly be justified with most genotoxic carcinogens, this is not true with all nongenotoxic carcinogens. Mechanisms attributable to high dose toxicity occasioned by misuse of the maximum tolerated dose concept, imbalancing of homeostasis, unphysiological conditions, and induced cellular proliferation are reviewed. The greatest present need for meaningful regulation of carcinogens is to obtain public acceptance of the fact that some carcinogens are species specific and probably will not exert their effects in humans. PMID- 1792351 TI - Predictive value of animal studies in toxicology. AB - The three main purposes of experimental toxicology are (1) determination of the toxicological spectrum in selected laboratory animal species; (2) extrapolation to other species and prediction of adverse effects in man; and (3) determination of safe levels of exposure. Toxicology has reached a satisfactory level of performance in identifying toxicity in animals, and experimental techniques are now available to characterize the toxicological potential of chemical substances in great detail. In many instances, extrapolation of toxicological findings in animals to man is possible. It must also be admitted that toxicological studies have, at times, failed to predict human toxicity. In many cases, this can be explained by biological differences between animals and man. A particularly difficult problem is the "low incidence responses" that occur only in especially sensitive individuals. They represent a challenge that can be met only be a determined research effort. Failure to predict toxic responses in man is sometimes also brought about by the toxicologists' own faults. It is essential, therefore, that we analyze the errors committed in the past and continuously evaluate and improve our performance. Society's demand for specific safe levels of exposure is difficult to meet. After a long period of confusion and confrontation, toxicology appears to be on the road to a truly science-based methodology for risk assessment. PMID- 1792352 TI - Meta-analysis: methods for combining data to improve quantitative risk assessment. AB - Although individual studies that constitute the data base for a risk assessment are each evaluated quantitatively as well as qualitatively, assessment of the total data base frequently results in selection of data from particular studies, rather than an effort to combine data quantitatively. Meta-analysis, or the analysis of analyses, provides an approach for the joint evaluation of the results of several studies. In this report, two very similar cancer bioassays of trichloroethylene were used to illustrate some simple meta-analytic techniques and to evaluate the validity and value of these procedures. The results demonstrate that concepts such as the upper 95% confidence limit are highly dependent upon assumptions if several data sets are involved. Use of a Monte Carlo procedure resulted in an increase in the 95% upper confidence limit relative to the value determined by EPA, but by determining the variance of the maximum likelihood estimate of the linear coordinate of the estimated dose response curve, the 95% upper confidence limit of the cancer potency factor was reduced. PMID- 1792353 TI - Endod: safety evaluation of a plant molluscicide. AB - Toxicity tests, in accordance with the Minimal Data Requirements (Tier 1) of the OECD Guidelines for Pre-Market Chemicals, were conducted on a standard extract (Endod-S) from the unripe berries of Phytolacca dodecandra, a potent botanical molluscicide of potential importance in the control of schistosomiasis. In acute mammalian toxicity tests, except for the eye irritation toxicity test which indicated severe irritancy, all test results were classified as either nontoxic or slightly toxic. Eye protection is therefore recommended during berry crushing and handling of dry powders. Ecotoxicity tests indicated that Endod is no more toxic than currently recommended synthetic molluscicides; however, environmental fate and additional local ecotoxicity tests are recommended for nontarget aquatic organisms present in the endemic situations of field trials. Given these toxicological data and recognizing the need for an affordable, locally cultivated, botanical molluscicide, it is concluded that field trials of Endod in schistosomiasis control are now justifiable. PMID- 1792354 TI - Generally recognized as safe (GRAS) evaluation of 4-hexylresorcinol for use as a processing aid for prevention of melanosis in shrimp. AB - 4-Hexylresorcinol (C12H18O2) is proposed for use as a processing aid for prevention of melanosis ("black spot") in shrimp and as an alternative to the currently approved sulfites. A safety evaluation was conducted to affirm, based upon scientific procedures, the generally recognized as safe ("GRAS") status of 4 hexylresorcinol for proposed use. The GRAS safety evaluation compiled, reviewed, and analyzed data on the following areas: chemical identity, analytical methodology, historical and proposed uses, functionality, and safety. The publicly available safety data on 4-hexylresorcinol cover a broad range of potential toxicity concerns including acute and subacute toxicity, subchronic toxicity, carcinogenicity, mutagenicity, and allergenicity. These studies, along with the aforementioned data, demonstrate that 4-hexylresorcinol presents no risk of toxicity at the levels proposed for treatment of shrimp, and the use of 4 hexylresorcinol as a processing aid to prevent melanosis in shrimp is GRAS. PMID- 1792355 TI - Review of research on sight word instruction. AB - This review of 20 years of literature on sight word instruction for individuals with handicaps identifies several effective procedures. These procedures are described for the two types of learning required in sight word instruction--word recognition and comprehension. Criteria for procedural selection are recommended. Research limitations are critiqued with suggestions provided for further evaluation of sight word instruction. PMID- 1792356 TI - Attentional aspects of classroom behavior and discrimination learning. AB - Teachers' ratings of their mentally handicapped pupils' classroom behavior were examined as correlates of the child's performance on a discrimination learning task. Teachers completed the 23-item version of the Attention/Distraction Inhibition/Excitation Classroom Assessment Scale (ADIECAS) for a total of 77 pupils. Factors identified as attention/distractibility and responsivity to consequences correlated significantly with number of errors and number of trials to criterion during acquisition of a simultaneous visual discrimination. Attention/distractibility scores also correlated significantly with number of dimensions "attended to" during discrimination learning. PMID- 1792357 TI - A comparison of stress and coping by fathers of adolescents with mental retardation and fathers of adolescents without mental retardation. AB - This investigation was an attempt to provide comparative information regarding stress and coping in fathers of adolescents with mental retardation and fathers of adolescents without mental retardation. Subjects for the study were 40 fathers of adolescents with mental retardation and 31 fathers of adolescents without mental retardation. PMID- 1792358 TI - Group psychotherapy with mentally retarded adults: issues related to design, implementation, and evaluation. AB - Although the mental health needs of mentally retarded persons are becoming increasingly acknowledged by service providers, psychotherapy is still neglected as a treatment modality. This paper provides a framework for considering issues related to the design, implementation, and evaluation of group psychotherapeutic endeavors to benefit dually diagnosed clients. A social systems approach to psychopathology is described to illustrate how a variety of potentially treatable aspects of dysfunctioning can be identified and selected as treatment goals for group psychotherapy with mentally retarded individuals. Treatment models are presented to assist in the pragmatic blending of behavioral and psychodynamic interventions that are relevant for conducting group psychotherapy with this population. Administrators and clinicians are provided with a prototype of how to establish and maintain cost-effective linkages between mental health and mental retardation agencies, so that dually diagnosed clients are not excluded from receiving services they need. Finally, process and outcome evaluation strategies are considered which might provide an empirical basis for documenting the effectiveness of group psychotherapy as a viable, nondrug approach to treating psychopathology in mentally retarded individuals. PMID- 1792359 TI - Whose needs are we meeting? Results of a consumer satisfaction survey of persons with developmental disabilities in Colorado. AB - Results of one state's attempt to survey consumers and/or their families regarding their level of satisfaction with existing services, their needs for alternative or additional services, and their perceptions of overall quality of life are presented. Two hundred forty-seven individuals with developmental disabilities ranging in age from 0-72 years were interviewed. Information on consumer satisfaction and levels of integration, productivity and independence were measured for the following services: case management, residential, education, vocational, health, individual support, transportation, and caregiver support. PMID- 1792360 TI - The relationship of staff:client ratios, interactions, and residential placement. AB - The behavior of staff and persons with severe handicaps was surveyed in nine settings, including four traditional institutions, three large community-based units, and two groups of small homes. Data were collected that established the relationship among staff:client interactions, client responding, and the size of staff:client groups. The latter showed that the institutions were characterized by larger client and staff groups than the large community units. Large client and staff groups were virtually absent in the small homes. Two general conclusions could be drawn about the relationship between staff:client ratios and client behavior: (a) when one or two staff were together, improvements in the level of the staff interactions and client adaptive functioning occurred as the client group decreased in size and the staff size remained constant; (b) improvement in staff performance and client behavior arising from the addition of staff to a client group of a given size was marginal or nonexistent. The results were discussed in terms of their implications for the design of residential environments. PMID- 1792361 TI - Reliability analysis of the Motivation Assessment Scale: a failure to replicate. AB - The Motivation Assessment Scale (MAS) has been proposed as an efficient questionnaire for identifying the source of reinforcement for an individual's self-injurious behavior (SIB). A previous reliability analysis of the MAS (Durand & Crimmins, 1988) reported interrater correlation coefficients ranging from .66 to .92, based on a comparison of responses provided by classroom teachers. In this study, the reliability of the MAS was reexamined with two independent groups of developmentally disabled individuals who exhibited SIB (N = 55). For the institutional sample (n = 39), the MAS was given to two staff members (a supervisor and therapy aide) who work with the individual daily. For the school sample (n = 16), the MAS was given to the teacher and teacher's aide who taught the student. The correlational analyses completed by Durand and Crimmins (1988) were repeated; in addition, a more precise analysis of interrater reliability was calculated based on the actual number of scoring agreements between the two raters. Results showed that only 16 of the 55 raters agreed on the category of reinforcement maintaining their client's or student's SIB, that only 15% of the correlation coefficients obtained were above .80, and that none of the reliability scores based on percent agreement between raters was above 80%. PMID- 1792362 TI - Comparison and item analysis of the MESSY for autistic and normal children. AB - Seventeen autistic children were matched for age, race, and sex with 17 nonautistic children, and group differences in social skills were assessed. Appropriate social skills and levels of inappropriate assertiveness/impulsiveness were assessed and evaluated using the Matson Evaluation of Social Skills with Youngsters (MESSY). Significant differences in both the appropriate and inappropriate social behaviors displayed by the two groups were found. The implications of these results are discussed. PMID- 1792363 TI - Assertiveness and problem-solving training for mildly mentally retarded persons with dual diagnoses. AB - This study investigated the differential effectiveness of assertiveness and problem-solving training on dually diagnosed patients' adaptive social behavior, distress and psychiatric symptoms, anger control, and problem-solving coping skills using a counterbalanced design. Assessments were conducted at pretreatment, midphase, posttreatment, and a 3-month follow-up examination. A combined assertiveness and problem-solving training package was effective for treatment of individuals with mild mental retardation with dual psychiatric diagnoses. Specifically, improvements occurred regarding both self-report measures of distress and caregiver ratings of adaptive functioning; however, no essential differences were found between these two treatment protocols. The importance of using self-regulatory models of therapy with this population is highlighted, and recommendations were made for future research. PMID- 1792364 TI - Significant progress in child language intervention: an 11-year retrospective. AB - This literature review summarizes knowledge gained from 151 articles on child language intervention published between 1978 and 1988. A general theoretical framework for viewing language development is offered as a basis for evaluating progress in the development of language intervention efforts. New developments and issues requiring further investigations are highlighted for five themes that characterize much of the language intervention research in recent years: (1) the development of augmentative and alternative communication systems, (2) the provision of language stimulation to take advantage of observational learning, (3) the teaching of various language functions, (4) the teaching of language as a means of environmental- and self-control, and (5) the study of different types of generalization processes. PMID- 1792365 TI - Expectancy effects in social validation methodology: are there differential expectations for employees with mental retardation? AB - Although the social validation methodology has been found useful in identifying work skills associated with job success, it is uncertain as to whether respondents who have had experience working with persons with mental retardation respond differentially to surveys than individuals without previous experience. In the present study, the responses of respondents who had prior experience working with employees with mental retardation were compared to those of persons without such experience. Also, the effects of specified verbal referents in surveys were investigated. The findings revealed that prior experience did not appear to affect ratings; however, several differences were identified. The findings are discussed in respect to employment preparation programs. PMID- 1792366 TI - Rating problem behaviors in outpatients with mental retardation: use of the Aberrant Behavior Checklist. AB - Parent and teacher ratings of behavior problems of an outpatient sample of 110 children, adolescents, and young adults with IQs ranging from severe mental retardation to borderline were obtained using a modified version of the Aberrant Behavior Checklist (ABC). Using factor analytic techniques, the five-factor structure of the parent data corresponded extremely well with the five factors originally obtained from staff ratings of mentally retarded inpatients (i.e., Irritability, Withdrawal, Hyperactivity, Stereotypies, and Inappropriate Speech). Factor content was virtually identical between the parent and original ABC data with differences involving only one or two items per scale. The teacher data also revealed a factor structure that corresponded to the same five factors as the parent and original data. Although the teacher and parent factors showed a high degree of similarity, the teacher data suggested that the Stereotypies and Inappropriate Speech factors of the parent and original analyses were not the same constructs for teacher respondents. Age was related to the withdrawal factor for parent data; level of intellectual functioning was the only subject characteristic related to factor scale scores in both parent and teacher data. Test-retest reliabilities were adequate to excellent for all factors for both parent and teacher data. Parent-teacher cross-informant reliabilities were adequate for at least four of the factors. The results of the report indicate that the ABC is a useful, reliable instrument for assessing maladaptive behaviors in young, developmentally disabled outpatients. PMID- 1792367 TI - [Predictive medicine, preventive medicine]. PMID- 1792368 TI - [Cortical and trabecular bone lesions in insulin-dependent diabetes mellitus]. AB - To determinate which type of bone is damaged in IDDM, we assessed the bone mineral content (BMC) in both cortical and trabecular bones, in a group of 48 IDDM patients without hepatic or kidney diseases, or any other pathology with implications in the mineral metabolism. For the evaluation techniques of single photon absorptiometry (SPA) and double photon absorptiometry (DPA) were used. All the patients controlled their disease with insulin. The results showed the presence of osteopenia in both types of bone. It was more evident in male group. In the patients group the mean value of serum osteocalcin (BGP) was significantly decreased (2.34 +/- 1.05) in comparison with the controls (p less than 0.001). The deficient of BMC is neither related with the parameters of new bone formation nor with the time of disease evolution. PMID- 1792369 TI - [A comparative study of nisoldipine and alpha-methyldopa in aged patients with isolated systolic hypertension]. AB - A comparative, randomized and cross clinical trial between nisoldipine and alpha methyldopa in 50 aged patients with isolated systolic hypertension during 12 weeks. The therapeutic aim (SAP less than or equal to 160 mmHg) was reached after the first period in the 60% of the patients treated with nisoldipine and the 63% of those who took alpha-methyldopa (ns), and after the second period: 77% in nisoldipine group and 82% for alpha-methyldopa (ns). Adverse effects were experienced in the 21.7% of the patients treated with nisoldipine and in the 60.8% of the patients who received alpha-methyldopa (p less than 0.001. Nisoldipine had a lower effect that alpha-methyldopa over the diastolic arterial pressure. It was not any change in the biochemical parameters related to both antihypertensive drugs. PMID- 1792370 TI - [Inflammatory pseudotumor of the lung: presentation of 2 cases, one of them endobronchial]. AB - Inflammatory pseudotumor (IP) is a rare pathological entity. Although, the pulmonary affection is the most frequent, any other organ can be involved. Its etiopathology is unknown. The disease is considered as a reactive process constituted by chronic inflammatory elements and a benign behavior. The lack of a specific clinical setting and the low profitability of the bloodless techniques makes mandatory the thoracostomy for a definitive diagnosis. We report two cases of pulmonary IP. One of them with an endobronchial localization which is a infrequent variety, scantily reported in the medical literature. We discuss the clinical and etiopathologic aspects of this rare pathological entity. PMID- 1792371 TI - [Intracranial calcifications in the differential diagnosis of epileptic disease]. AB - We report the case of a patient with a history of goiter operation 26 years before who present recurrent convulsive episodes diagnosed of epilepsy. Our study shows that this clinical setting is a Fahr's Syndrome (intracranial calcifications and chronic Hypoparathyroidism). We compare our case with others of the medical literature and analyze the neurological findings in regard to the type of intracranial calcifications and the severity and duration of hypocalcemia. PMID- 1792372 TI - [Diabetes insipidus and Langerhans-cell histiocytosis without changes in cerebral CAT and NMR]. AB - In LCH extended disease CNS involvement in is not infrequent. Diabetes insipidus, due to the affectation of hypothalamus-hypophysis axis, is its most frequent finding. The solitary affectation of hypothalamus-hypophysis axis is exceptional. At times, it's a difficult diagnosis and could precede the diagnosis of LCH several years. Usually, CAT and NMR show morphologic lesions. We report a patient who was diagnosed of idiopathic diabetes insipidus when he was 16 years old. Seven year later, he was diagnosed of LCH after underwent a bone marrow biopsy examination, just when the disease involved the bone and lung. Cerebral CAT and NMR didn't show morphologic lesions. In the presence of morphologic lesions in hypothalamus and/or hypophysis, proved by cerebral CAT and NMR, or a clinical setting of DI, the possibility of LCH must be considered. PMID- 1792373 TI - [Bone tumor of difficult diagnosis in a young woman]. PMID- 1792374 TI - [Autosomic dominant polycystic disease. Right nephrectomy with unexpected anatomopathological findings]. PMID- 1792375 TI - [Is the determination of hemopexin in the ascitic fluid useful?]. PMID- 1792376 TI - [Dilated cardiomyopathy as initial clinical manifestation of acromegaly]. PMID- 1792377 TI - [Long-term evolution of hepatic amyloidosis into massive tumorous form]. PMID- 1792378 TI - [Indiscriminate determination of antibodies to human immunodeficiency virus]. PMID- 1792379 TI - [Hypoparathyroidism and heart failure: protagonist calcium]. PMID- 1792380 TI - [Extreme sinus bradycardia in anorexia nervosa]. PMID- 1792381 TI - [Diarrhea and intestinal sub-occlusion as manifestation of pelvic inflammatory disease]. PMID- 1792382 TI - [Liver abscess caused by non-typhi Salmonella in patients infected with HIV]. PMID- 1792383 TI - [Leukoerythroblastic syndrome associated with visceral leishmaniasis]. PMID- 1792384 TI - [Bivariant analysis of clinical features that define the stasis liver]. PMID- 1792385 TI - [Bartter's syndrome versus familial hypokalemic tubulopathic syndrome and anorexia nervosa]. PMID- 1792386 TI - Smoking and Parkinson's disease--a new perspective. AB - This paper examines fresh the evidence for an inverse relationship between smoking behaviour and Parkinson's disease. The frequent epidemiological observation, that the relative risk of a smoker having Parkinson's disease is approximately 0.5 that of a non-smoker, is fairly well established. Possible explanations are examined in the light of available epidemiological and biochemical evidence. Despite much biochemical work suggesting a protective role for cigarette smoke against the development of Parkinson's disease, the epidemiological data points away from such a mechanism. Instead, the epidemiological work favours two alternative hypotheses: either that there is selective mortality of smokers with Parkinson's disease such that their conditions deteriorate and death occurs at an accelerated rate (resulting in fewer smokers with Parkinson's disease-especially in the older age groups when Parkinson's disease is most common), or that the latent phase of Parkinson's disease (before symptoms become apparent) involves subtle personality changes producing the so-called Parkinsonian personality and an associated aversion to cigarette smoking. The latter changes may be a consequence of progressive nigrostriatal dopamine depletion resulting eventually in Parkinson's disease. Future approaches that would allow a more definitive understanding of the processes underlying the intriguing link between smoking and Parkinson's disease are considered. PMID- 1792387 TI - Indoor air pollutants. A literature review. AB - The literature on the important indoor air pollutants, their sources, their effect on human welfare, and methods for controlling their presence is reviewed. The review is chiefly concerned with the air in homes, offices, schools, and public buildings, rather than in industrial facilities. PMID- 1792388 TI - Non-target and environmental hazards of pesticides. AB - When compared with pesticide pollution from other sources and pollution by other agents, the hazards of atmospheric pollution by pesticides appear relatively insignificant. The high persistency in the environment observed especially with the organochlorines suggests that there could be a gradual accumulation of residual pesticides in the atmosphere. Thus, in addition to the function of redistributing pesticides by air currents and aerial drifts, the atmosphere may become a major reservoir for drift prone finely divided particulate pesticides and highly volatile compounds. Indiscriminate aerial spraying should be avoided. A more selective approach should be adopted whereby forest areas are sprayed without contaminating streams, lakes and inland waters. Improvement in spraying devices are needed such that pesticides are more precisely delivered to target. Direct spraying of water bodies should be avoided as much as possible. Treatment of waste water for pesticide removal or neutralization prior to effluence from factories and disposal of effluence to legally designated sites in addition to chemical treatment of contaminated water are more ways of reducing water pollution. Pesticide residues in soil, in addition to eliminating or reducing parasitic microbes, are also toxic to the non-parasitic and ecologically useful soil microbial and vertebrate population. Pesticides may reduce certain microorganism populations while they stimulate the growth of others, especially the saphrophytic and spore forming types. Soil chemical properties may also be altered by accumulation of residual pesticides and their metabolites. These processes may disrupt the ecological balance in the soil microenvironment, first by simplifying the microbial population, and possibly by reducing soil fertility and its ability to support life. Non-target or residual pesticide toxicity would also disrupt the population of some of the valuable soil invertebrates like earthworms, predatory mites, centipedes and carabid beetles. Accumulation of pesticides in resistant or tolerant species may provoke episodes of toxicity to organisms higher in the food chain. The chlorinated hydrocarbons are likely to be most ecotoxic. Use of such pesticides ought to be restricted. Efforts to find alternatives to pesticides, especially research into biological control, should be intensified. PMID- 1792389 TI - Industrial effluent B.O.D. Quanta and expected causes. AB - The biological oxygen demand (B.O.D.) is an important parameter for the measurement of organic pollutants in waste water. The present paper deals with the various causes which may be responsible for B.O.D. variations in waste water of different types of industrial effluents. PMID- 1792390 TI - The influence of smoking on arterial diseases and COPD; a biological basis. PMID- 1792391 TI - [The golden jubilee of the School of Nursing of the University of Sao Paulo]. PMID- 1792392 TI - [The influence of the education process on the control of arterial hypertension]. AB - A study was carried out with 23 hypertensive individuals after educational process in order to verify the retention of knowledge and its influence on the hypertension control. After drug treatment it was observed that the level of knowledge was inversely proportional to the blood pressure levels. PMID- 1792393 TI - [The role of the nurse, the nurses' aide and the nurses' assistant in caring for the patient in communicable disease isolation]. AB - The instrumental and expressive activities performed by nurses and nurse's aides in the caring given to patients carrier of communicable diseases and that were hospitalized in an isolation unit of a general hospital were surveyed. The authors concluded that nursing team performed more instrumental activities than expressive ones the nursing attendant was one who did the higher number of the first activities, followed by the nursing auxiliary and the nurse. PMID- 1792394 TI - [The preparation of the undergraduate nurse to work on a hospital infection control committee (HICC)]. AB - The goal this study is to verify how is the preparation of nursing student during undergraduate course in Brasil in order to work as a member of Hospital Infection Control Committee (HICC). The results demonstrated that this teaching is assistematic and not planned. The authors propose a teaching recommendation on nurse's practice job in the HICC. PMID- 1792395 TI - [Touch and interpersonal distance between nurses and patients in nursing consultations]. AB - The present article reports on the observation made during adults nursing consultation in a hospital of the of City Sao Paulo: concerning about time and place where nurse and patient contacted each other during the consultation; the interpersonal distance maintained between then during all time; and take comments about the meaning of nonverbal signs in interpersonal interaction. It discusses the objects used by nurses and patients which were useful for identification or definition of the maintained relationship. PMID- 1792396 TI - [The nursing consultation in geriatrics: the topics to be addressed in the interview--I]. AB - The nursing consultation allows systematic and continuous care of the patient. The author describes important topics such as identification and initial data collection during nurses' interview of geriatric patient. PMID- 1792397 TI - [The nursing care of patients with a behavioral manifestation arising from a withdrawal from reality]. AB - With this study the authors want to furnish the nurses with one more reference source to guide their actions in caring for the patient with manifestation of reality withdrawal. Some concepts of withdrawal are presented and, summarily, the clinical manifestation. Nursing care is described considering their problems and general measures to be taken into account for patients individuality. PMID- 1792398 TI - [The use of the educational game in the teaching of nursing]. PMID- 1792399 TI - [The arterial pressure values checked by the client, the nurse and the outpatient physician compared with those recorded at home. A preliminary note]. AB - This study analyses the importance of self-recorded blood pressure at home. The data will be compared with measurements by patient, nurse and physician in ambulatory. PMID- 1792400 TI - [Comparative study of propofol with thiopental and etomidate in anesthetic induction]. AB - Anesthetic characteristics were studied in three homogeneous groups of twenty patients ASA I who underwent intravenous anesthetic induction with propofol 2 mg/kg; thiopental 5 mg/kg; or etomidate 0.3 mg/kg. The unconsciousness time was similar in the three groups, whereas awaking time and time of response and orientation were longer after thiopental and etomidate than after propofol. Intravenous injection of the three anesthetic agents was followed by a decrease in systolic and diastolic arterial pressure. Heart rate increased after thiopental and etomidate and had only slight fluctuations after propofol. After tracheal intubation there was a significant increase in systolic and diastolic arterial pressure and heart rate in thiopental and etomidate group. These changes were minimal after propofol. The highest number of complications occurred after etomidate. PMID- 1792401 TI - [Results of functional analysis on an obstructive model of the lung using an Ergojet CVT high-frequency jet respirator. Comparison with the normal pattern]. AB - This paper expands a previous study on functional analysis of high frequency jet (HFJV) "Ergojet CVT" ventilation module inserted in Ergotronic 3 (Temel SA) respirator. The analysis was made on a pulmonary monoalveolar model with a compliance of 50 ml/cmH2 = and a resistance of 20 cmH2O/l/se simulating an obstructive pattern. Results were also compared with those obtained in a previous study on normal lung. HFJV was applied using a jet with or without additional gas input (VE) at respiratory rates of 90, 120, 150, 180, 210, 240, 270, and 300 per minute varying in each frequency the releasing pressure of the jet (PG 1, 2, and 3 kg/cm2) and the inspiratory time (Ti 30 to 50%) giving rise to a total of 96 different situations. In each of these conditions we measured the air way pressure (Paw) and the alveolar pressure (PA) and we calculated the tidal volume (VT) and the trapped volume (VAT). These measurements were correlated with those monitored by the respirator and those obtained in the normal lung. Results show that the VT is composed almost exclusively by the jet volume (VTjet), being only of consideration the VE with a Ti of about 33% and a PG of 2 to 3 kg/cm2. When the normal pattern was compared with the obstructive one, a small reduction in VT (average of 15%) and a marked increase in peak Paw (average of 75%) were observed. The use of a Ti of 50% has no clinical interest due to the large VAT that it produces.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792402 TI - [The perennial relevance of a classic: Fidel Pages and epidural anesthesia]. PMID- 1792403 TI - [Metameric anesthesia. 1921]. PMID- 1792404 TI - [The concept of pain in Greek science and culture]. PMID- 1792405 TI - [Acute water intoxication. A complication of treatment with synthetic oxytocin]. PMID- 1792406 TI - [A clarification concerning the figure of Juan Vicente Edo]. PMID- 1792407 TI - [Additional facts about rectal etherization in the treatment of Asiatic cholera disease]. PMID- 1792408 TI - [Measuring cardiac output. Use of erroneous information]. PMID- 1792409 TI - [Re-morphinization with alfentanil]. PMID- 1792410 TI - Factors affecting variations in pulmonary diffusing capacity resulting from postural changes. AB - The relation of postural changes to the diffusing capacity of the lung for carbon monoxide (DLCO) was investigated in 12 normal nonsmokers in order to evaluate the influence of body position on several components of lung resistance to gas diffusion. The well-known increase in CO diffusing capacity in the supine position was obtained only for data corrected for alveolar volume (KCO: 6.18 +/- 0.75 vs. 5.45 +/- 0.67 ml/min/mm Hg/l; p less than 0.005). Moreover, only the membrane component (Dm) increased significantly in supine subjects (KDm = 2.81 +/ 1.32 vs. 1.82 +/- 0.54 ml/min/mm Hg/l; p less than 0.05), the increase in capillary blood volume (Vc) being not significant (KVc = 12.54 +/- 4.22 vs. 11.17 +/- 3.79 ml/l; NS). These data could be interpreted as a demonstration of a more homogeneously distributed ventilation with respect to diffusion surface in healthy young people in a supine position. The amount of surface available for diffusion seems therefore to be a limiting factor to gas flow across the lungs in these subjects. Thus a straightforward attribution of posturally influenced changes in CO diffusing capacity exclusively to factors affecting Vc is not recommended, particularly in pathological conditions, if information about variation in distribution of ventilation is unavailable. PMID- 1792411 TI - Control of breathing in patients with chronic pulmonary obstructive disease: response to bamiphylline. AB - In two groups (A and B) of patients with severe chronic obstructive pulmonary disease (COPD), matched for age and routine pulmonary function testing, we evaluated inspiratory muscle strength (MIP), breathing pattern, mouth occlusion pressure (P0.1), inspiratory neural drive, assessed in terms of electromyographic activity of both diaphragm (EMGd) and intercostal (EMGint) muscles, and P0.1/EMGd ratio, an index of inspiratory neuromuscular coupling. Group A (8 patients) was studied before and after a 7-day period of a new oral xanthine derivative (bamiphylline, 1.2 g daily), and group B (7 patients) was given a placebo. Under control conditions, compared with an age-matched normal control group, groups A and B both exhibited a decrease in MIP, more rapid (increase in respiratory frequency RF) and shallower (decrease in tidal volume; VT) breathing (RSB), a marked increase in both EMGd and EMGint and a lower P0.1/EMGd ratio. With bamiphylline FEV1 and PaO2 significantly increased, while a substantial increase in MIP was found in 5 out of the 8 patients. VT and inspiratory time (Ti) also significantly increased, and RF decreased. Both EMGd and EMGint significantly decreased, whereas P0.1/EMGd exhibited a substantial increase in 5 out of the 8 patients. Conversely, no significant changes were observed in group B during the study period. From these data we conclude that in patients with COPD, clinical manifestations, probably associated with inspiratory muscle overloading (decrease in muscle strength, RSB, increase in respiratory neural drive, and derangement in neuromuscular coupling) may benefit from a short-term treatment with bamiphylline. PMID- 1792412 TI - Air-driven nebulised high-dose salbutamol in severe chronic obstructive airways disease: is it safe? AB - The increasing use of air-driven nebulised bronchodilators by patients with airflow obstruction has raised concern about the safety of this practice. We have investigated the effects of 10 mg salbutamol, nebulised in air, on blood gas tensions, heart rate and plasma potassium (K+), when administered alone to 9 patients with severe chronic obstructive airway disease and then in combination with a therapeutic dose of oral sustained-release theophylline to 5 of them on 2 separate occasions. No significant reductions in PaO2 were observed with either treatments. Heart rate increased significantly from 77.8 +/- 3.7 beats/min (mean +/- s.e.m.) at baseline to a peak of 87.1 +/- 4.4 beats/min at 45 min (p less than 0.001) with salbutamol alone and there was a similar trend of increase after combined therapy. K+ decreased significantly from a baseline of 4.0 +/- 0.3 to a minimum of 3.6 +/- 0.2 mmol/l at 90 min (p less than 0.001) with combined therapy but did not change significantly with single therapy. No subject developed any significant cardiac arrhythmias on either occasion. Although the number of subjects studied is small, our data suggest that air-driven nebulised high-dose salbutamol may be safe in the treatment of severe chronic obstructive airway disease but when combined with oral theophylline, a significant fall in plasma potassium may occur. This could be of clinical significance in hypokalaemic patients. When combination treatment is used, monitoring of plasma potassium is recommended. PMID- 1792413 TI - Effect of diethylcarbamazine on the alveolitis of tropical eosinophilia. AB - Bronchoalveolar lavage studies in 33 patients with acute untreated tropical eosinophilia have demonstrated intense eosinophilic alveolitis. Following treatment with a standard 3-week course of diethylcarbamazine, there was a significant fall in lung eosinophils (p less than 0.001). However, a mild alveolitis characterised by hypercellular lavage fluid due to a significant increase in absolute alveolar macrophages (p less than 0.001) and due to an increase in both the absolute number (p less than 0.01) and percentage of eosinophils (p = 0.02) was persisting at 1 month despite treatment. Long-term follow-up is essential to know the fate of alveolitis. PMID- 1792414 TI - Does the patient's posture affect the detection of chest radiographic findings suggestive of pulmonary embolism? AB - Although it is accepted that thoracic structures are enlarged in supine chest radiographs, it is not known whether the lying posture may also influence the radiographic detection of abnormalities, such as those suggestive for pulmonary embolism (PE). For this purpose, we performed planar chest radiographs both in the seated and supine positions, keeping the target-to-film distance at 2 m, in 20 patients with acute PE. Chest radiograph was then repeated 1 month later in either position with the radiological conditions unchanged to investigate the effect of posture on the detection of resolution of signs. The detection of signs due to modifications of preexisting thoracic structures (elevation of the diaphragm and enlargement of the heart, right descending pulmonary artery and azygos vein) in acute PE was different between films taken in the supine and seated positions: both hemidiaphragms were more elevated (p less than 0.001), heart and central vessels were wider (p less than 0.05 or less) when patients were supine. On the contrary, the detection of signs of new occurrences ('sausage'-like appearance of the descending pulmonary artery, linear atelectasis, densities compatible with pulmonary infarction, pleural effusion and focal hyperlucency) was not influenced by the patient's position. During recovery, both kinds of abnormalities were reduced concomitantly in seated and supine radiographs. In conclusion, in acute PE, chest radiographs should be obtained in the seated position since the supine posture may overestimate signs due to modifications of preexisting thoracic structures even though it does not influence the detection of signs of new occurrences. On the contrary, films taken in either position are useful to follow the evolution of PE, provided the film is obtained in the same position and with the same technique as in the acute phase. PMID- 1792415 TI - Comparison of bacteraemic community-acquired lobar pneumonia due to Streptococcus pneumoniae and Klebsiella pneumoniae in an intensive care unit. AB - In a study of 41 consecutive patients with bacteraemia-associated community acquired lobar pneumonia due to Streptococcus pneumoniae and Klebsiella pneumoniae an attempt was made to determine whether distinguishing criteria of disease due to these organisms could be identified according to demographic features and the results of initial clinical and laboratory investigations. Such information would aid in the early initiation of appropriate antimicrobial therapy. The most significant difference between the two groups of patients was the lower platelet count in the K. pneumoniae group (p less than 0.005). In addition leucopenia (p less than 0.05), higher serum albumin (p less than 0.05), and the male sex (p less than 0.05) featured with an increased frequency in patients with pulmonary infection due to K. pneumoniae. Initial antimicrobial therapy in critically ill patients with community-acquired lobar pneumonia and thrombocytopenia, particularly when associated with leucopenia and in male patients, should include agents effective against K. pneumoniae. PMID- 1792416 TI - Respiratory effects of occupational exposure to tobacco dust. AB - The ventilatory capacities of 195 tobacco factory workers exposed to tobacco dust and 190 Libyan men not exposed to tobacco dust were measured. In both groups, the forced vital capacity (FVC) and forced expiratory volume in 1 s were found to be correlated with age, stature, sitting height and body surface area. Those exposed to tobacco dust have decreased ventilatory capacity values as compared with age matched unexposed workers. The duration of exposure to tobacco dust does not appear to have any significant effect on the ventilatory function. There was no significant difference in the lung function test values between the smokers and nonsmokers in both groups. The flow-volume curves were constructed for the unexposed and exposed groups of workers. At 25% FVC, in the group exposed to tobacco dust, there was a decrease in air flow by 20.8% as compared to age matched normal unexposed Libyans. This indicates that the small airways are affected by exposure to tobacco dust. Flow-volume curves are useful in the assessment of lung function status. PMID- 1792417 TI - Effects of hemodialysis and anemia on pulmonary diffusing capacity, membrane diffusing capacity and capillary blood volume in uremic patients. AB - The study aimed at investigating pulmonary function in uremic patients, emphasizing the lung diffusing capacity for CO (DLCO) and its membrane and pulmonary capillary blood volume (Vc) components. The study sample comprised 25 uremic patients without clinical/radiological evidence of lung disease. They were enrolled in a chronic hemodialysis (HD) program and had anemia requiring transfusions. The subjects were tested for their lung function before and after both a first HD and a HD with blood transfusion (BT) that followed a few days later. After HD-induced removal of body fluid, and increase in pre-HD reduced forced vital capacity, alveolar volume and mid-expiratory flow rate (FEF25-75%) was observed. HD-induced DLCO decrease (p less than 0.005) was observed and was related to decreased Vc. The second HD with BT increased DLCO, due to partially normalized Hb. On average, a 7.2% DLCO increase corresponded to each 10-g/l Hb rise. In conclusion, (1) the beneficial effect of HD in uremic patients reverts the small-airway obstruction; (2) the lower values of DLCO in these patients are due to reduced Hb and HD causes further DLCO reduction via decrease of Vc, and (3) HD with BT still increases DLCO because improvement of Hb predominates. PMID- 1792418 TI - Effects of daily cigarette consumption on respiratory symptoms and lung function in a general population sample of north-Italian men. AB - We assessed the respiratory effects of the number of cigarettes smoked daily (CIGD) in 748 male smokers of a general population sample living in the unpolluted area of the Po Delta (Italy). A standardized questionnaire, flow volume curves (V/V), the diffusing capacity of carbon monoxide (DLCO) and the slope of the alveolar plateau of nitrogen (DN2%/l) were used. Subjects were divided according to the median value of the observed distribution of CIGD (1-19, 20+) and according to the tertile values of the observed distribution of pack years (an index representing lifetime cigarette consumption; 1-7, 8-21, 22+). In those with a higher CIGD, the prevalence rate of chronic phlegm was always significantly increased, while the prevalence rate of wheeze was significantly higher if they had smoked 8+ pack-years. Using analysis of variance, adjusted for pack-years, DLCO indexes, FEF75-85 and Vmax75 were significantly reduced in those with higher CIGD. When multiple logistic models, accounting for the independent effects of age and pack-years, were used, significantly increased odds ratios (ORs) for symptoms (e.g. OR = 2.0 for phlegm, OR = 1.8 for cough, OR = 1.6 for wheeze) and abnormal DLCO (OR = 1.9) or DN2%/l (OR = 1.6) were associated with a daily consumption of 10 cigarettes. In conclusion, the amount of cigarettes currently smoked may add a negative effect to that caused by lifetime cigarette consumption on respiratory symptoms and lung function. Moreover, the use of diffusing capacity in general population surveys is advisable. PMID- 1792419 TI - Expectoration disturbances and bronchial obstruction. AB - Two methods for the efficacy evaluation of the respiratory tract clearance by cough, measuring the time of expectoration (Texp) of sputum mixed with hem containing indicators after their inhalation were used in patients with bronchial obstruction. In the first method, the patients studied inhaled their own hemoglobin (Hb) and in the second one they inhaled a finely pulverized powder of hem-containing substances which were obtained from donor erythrocyte mass. 195 subjects were examined: 44 with intrinsic bronchial asthma (BA), 71 with obstructive bronchitis (OB) and 22 with purulent obstructive bronchitis (POB). Patients expectorating not less than 30 ml/day of sputum were selected. The control group consisted of 18 patients with non-obstructive bronchitis (NOB) and 40 healthy volunteers, nonsmokers. The sputum for analysis after the inhalation of the indicator in healthy persons was collected during coughing stimulated by inhaling a hypertonic solution (15% NaCl+1% NaHCO3). It was found that Texp depends on the form of illness (means +/- SEM): (1) with Hb technique, BA: 41.5 +/- 3.4 h; OB: 59.3 +/- 5.7 h and POB: 128.8 +/- 15.3 h and (2) with the powdered indicator technique, BA: 53.4 +/- 7.6 h; OB: 68.8 +/- 6.6 h and POB: 101.1 +/- 11.8 h. CONTROL GROUP: in patients with NOB, Texp measured with the Hb technique was 31.4 +/- 4.3 h and with the powdered indicator 30.0 +/- 10.3 h. In healthy volunteers, the presence of hem-containing substances in sputum after 36 h was not found.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792420 TI - Lipoprotein analysis in a chyliform pleural effusion: implications for pathogenesis and diagnosis. AB - A chyliform effusion is an uncommon high lipid pleural effusion that does not result from a leakage of the thoracic duct. Characteristically, it emerges from chronic pleurisy and contains high levels of cholesterol. The origin of this cholesterol is unknown, but it is often attributed to the degeneration of red and white blood cells. In this study we have carried out detailed lipoprotein analyses in a chyliform effusion, a chronic tuberculous effusion and three inflammatory effusions of recent onset, in an attempt to elucidate the process of cholesterol accumulation and possible lipoprotein alterations. Mean cholesterol was 92 mg/dl in the inflammatory exudates and 1,237 mg/dl in the chyliform effusion. In inflammatory effusions of recent onset most cholesterol was bound to low density lipoprotein (LDL) with corresponding apoprotein B levels. The chronic tuberculous exudate showed a shift of cholesterol binding towards high density lipoprotein (HDL). In the chyliform effusion most cholesterol was found in the HDL region. Our results suggest that in acute inflammation, the pleural barrier opens to plasma LDL. We hypothesize that in chronicity this cholesterol becomes trapped in the pleural space and undergoes a change in lipoprotein binding characteristics. In a chyliform effusion, cholesterol further accumulates and builds complexes containing triglycerides and proteins. In clinical routine, total cholesterol values above 200 mg/dl strongly suggest a chyliform effusion. Since triglyceride values may be as high as in chylous effusions (greater than 110 mg/dl), the diagnostic routine in all suspected high lipid effusions should involve cholesterol and triglyceride measurements. PMID- 1792421 TI - The length of time healthy subjects and patients with chronic obstructive pulmonary disease are able to withstand maximal inspiratory pressure. AB - We measured the length of time that healthy subjects and patients with chronic obstructive pulmonary disease (COPD) were able to withstand an inspiratory pressure equal to or over 80% of the maximal static inspiratory pressure (PImax). For the purpose 10 patients with COPD, during a stable period of their illness, and 10 healthy subjects were studied. The mean values for PImax, maximal expiratory pressure (PEmax) and the length of time to withstand PImax (TPImax) were significantly lower in patients with COPD than in healthy individuals. In the group of patients with COPD, 50% exhibited a TPImax of less than 3 s and none were able to withstand PImax for more than 4.30 s. However, it should be pointed out that, even among healthy individuals, there were 4 subjects who were unable to withstand PImax for more than 3 s. PMID- 1792422 TI - Pulmonary hemodynamics in chronic obstructive pulmonary disease of the emphysematous type. AB - Pulmonary hemodynamics have been extensively investigated in patients with chronic bronchitis or in 'mixed' patients (chronic bronchitis + emphysema) but rarely in patients with markedly predominant emphysema. We have investigated a large series (n = 151) of such patients, emphysema having been assessed on radiological, clinical and functional grounds. The mean age was 58 +/- 10 years; vital capacity (VC, % of predicted) = 81 +/- 19; forced expiratory volume in 1 s (FEV1) = 1,198 +/- 589 ml; FEV1/VC = 38 +/- 12%; PaO2 = 72 +/- 11 mm Hg; PaCO2 = 37.5 mm Hg. Pulmonary hypertension (PH), defined by a resting pulmonary artery pressure (PAP) of greater than or equal to 20 mm Hg, was present in only 31 of 151 patients. During steady-state exercise (40 W or less) an abnormally high PAP (greater than or equal to 30 mm Hg) was observed in 99 of 151 patients. Resting and exercising PAP were poorly correlated with resting PaO2 and PaCO2, but were better correlated with the amplitude of the respiratory pressure swings, FEV1, the transfer factor and exercising PaO2. Patients with PH (n = 31) showed significantly more obstruction and pulmonary distension than the remainder, but they did not differ from the non-PH patients with regard to resting PaO2. It is concluded that: (1) resting PH is not the rule in diffuse emphysema but exercising hypertension is frequent (2 of 3 patients), and (2) hypoxemia is not a determining factor of hemodynamic abnormalities in emphysema. PMID- 1792423 TI - Relationship between body mass and tolerance to physical stress in obese patients. AB - Eleven obese patients, 5 males; age: 17-42; body mass index (BMI): 40; % of ideal weight: 187%, and 10 normal subjects (5 males; age: 19-39; BMI: 22; % of ideal weight: 103%), both groups without heart and respiratory disorders, underwent a cycloergometric test with subsequent 20-watt increases every 4 min until exhaustion. During the test, ventilation/minute, expiratory gas concentration and heart rate were measured, and the anaerobic threshold (AT) was determined in each subject. The obese patients showed a significantly lower AT than normal subjects (p less than 0.01); showing values which decreased with the increase in the grade of obesity expressed in BMI or in percent of their ideal weight. Moreover, in the obese patients, the O2 consumption (VO2) had significantly increased compared to that of normal subjects at no resistance and at all work levels. The negative correlation between the AT value and the BMI in obese patients can attribute their increase in VO2 during stress to (1) the inertial overloading caused by obesity especially considering the adipose tissue of their legs, or (2) to their level of 'fitness' being lower than that of normal subjects. PMID- 1792425 TI - Pulmonary nontuberculous mycobacteriosis showing wandering shadows in chest roentgenograms. AB - The case of a 68-year-old woman with pulmonary nontuberculous mycobacteriosis, whose chest roentgenograms showed unusual wandering shadows on separate occasions, is presented. Acid-fast bacilli were detected in her sputa and by bronchial washing, and were identified as Mycobacterium chelonae, subspecies abscessus. The findings of computed tomography and transbronchial lung biopsy were also unique because of multiple peribronchial inflammations. Chemotherapy with anti-tuberculosis agents and a new quinolone drug was successful in this case. PMID- 1792424 TI - Community acquired pneumonia caused by Chlamydia pneumoniae strain TWAR in chronic cardiopulmonary disease in the elderly. AB - The role of Chlamydia pneumoniae in respiratory infections is controversial. Seroepidemiological studies in different countries have shown an incidence of around 50% of previous contact, whereas prospective studies only in the USA have detected 6-10% of C. pneumoniae in community acquired pneumonias; in a similar Swedish study no cases were detected. There have been no descriptions of this Chlamydia in Mediterranean countries. The acute antibody response indicative of recent infection is accepted if the microimmunofluorescence test shows a fourfold rise in antibody or a titer 1/6 or higher of the IgM fraction. Since the introduction of the microimmunofluorescence test in our hospital, we have detected 4 cases of pneumonia associated to TWAR antibody in a current study of 63 cases of community acquired pneumonias which required hospitalization. All 4 patients presented chronic cardiopulmonary diseases. These facts and additional seroepidemiological studies with a frequency of 53% of previous contact, show that C. pneumoniae has a nonrare etiology in Spain and could be an endemic condition. PMID- 1792426 TI - Desquamative interstitial pneumonitis causing acute respiratory failure, responsive only to immunosuppressants. AB - We present a case of a 66-year-old man who suffered from acute respiratory failure due to desquamative interstitial pneumonia. The pneumonitis was resistant to steroids, but responded promptly to cyclophosphamide, with immediate relapse upon withdrawal of the drug. PMID- 1792427 TI - Partial anomalous pulmonary venous drainage in a patient with Turner's syndrome. PMID- 1792428 TI - Ectopic intratracheal thyroid presenting as bronchial asthma. AB - Benign ectopic thyroid tissue within the trachea is a rare cause of upper airway obstruction. Nevertheless, it may present considerable difficulties in diagnosis and management, and can be mistaken for bronchial asthma. Thorough history taking and careful physical examination in patients assumed to be asthmatics but not responding to bronchodilator therapy may be the key to establishing diagnosis of diseases simulating asthma. The following case report illustrates this point and emphasizes the fact that not all wheezes are asthma. PMID- 1792429 TI - Chronic bronchopneumonia with recurrent hemoptyses and resultant severe anemia. AB - A female patient, 69 years old, was hospitalized because of a 2-year history of recurrent hemoptyses resulting in severe anemia. X-ray examination of the chest showed a mass lesion in the right lower lung field, which had grown over the preceding 2 years. Bronchographic, arteriographic and CT examinations excluded the possibilities of bronchiectasis, pulmonary A-V fistula or sequestration. Histological examination following right lower lobectomy revealed no evidence of neoplasms or tuberculosis, fungal and parasitic infections but showed a predominant mononuclear cell infiltration and abundant small vessels in the affected small bronchi, and peribronchiolar and adjacent alveolar regions. To our knowledge, no case with chronic bronchopneumonia accompanied by such massive hemoptyses, as seen in this case, has been reported to date. PMID- 1792430 TI - [Reverse arterial hypertension. Evidence of the role of an autoimmune mechanism: value of plasma exchange]. AB - Reverse high blood pressure is new entity recently described. Our study shows that as well as our sister is not a boy, the diastolic value of blood pressure can clumber up the systolic level when the systolic value become too low to be more high than the diastolic one. This phenomenon is secondary to an excess plasma N concentration secondary to the cleavage of Na molecule in two parts in the helicoidal tubular lumen of the kidney, followed by N reabsorption and A urinary excretion. Our results provide evidence about an immunological mechanism which support the utility of plasma exchanges. PMID- 1792431 TI - [Human immunodeficiency virus infection in patients over 60 years of age. A cohort study of 31 patients followed-up at the Regional University Hospital Center of Bordeaux]. AB - Thirty-one patients aged 60 years or more and infected with the human immunodeficiency virus type 1 (HIV-1) were followed up retrospectively and prospectively at the Regional University Hospital of Bordeaux. These patients represented 2.3 percent of all HIV infected patients followed up by the AIDS Clinical Epidemiology Group of Aquitaine. The male-to-female sex ratio was 1.4/1. Contamination resulted from blood transfusion in 58 percent of the cases. In 45.2 percent of these patients the belated diagnosis was revealed by a pathology pointing to AIDS. The most frequent clinical signs were candidiasis, herpes zoster or neurological manifestations which created a difficult differential diagnosis problem with senile dementia. The prognosis of the HIV infection was severe, with a 39.7 percent probability of survival at 18 months (confidence limits 95 percent: 18.6%, 60.8%). This prognosis could be improved by an earlier diagnosis and by a treatment suitable for elderly people. PMID- 1792432 TI - [Current aspects of Paget's bone disease]. AB - The clinical and laboratory signs, as well as the imaging and course of Paget's disease of bone, are now well known. This chronic and usually benign disease is characterized by excessive remodelling of bone tissue, associated with an increase, sometimes considerable, of osteoclast resorption and osteoblast formation activities. Studies conducted during the last two decades were aimed at determining more precisely some aspects of the disease, notably: its epidemiological aspect and in particular its geographical distribution; its aetiological aspect using data obtained from electron microscopy, immunocytology and hydridization in situ, which has led to the hypothesis of a viral origin, and finally its therapeutic aspect with the recent introduction of truly effective treatments such as calcitonin and biphosphonates. PMID- 1792433 TI - [Lumbar post-puncture syndrome]. AB - About 30% of lumbar punctures are complicated by the lumbar puncture syndrome the main symptom of which is a characteristically posture-dependent headache (the so called "spinal headache"), sometimes accompanied by nausea, vomiting and stiff neck. The syndrome usually begins in the days which follow lumbar puncture and subsides within 10 days. The most common pathogenetic theory is that perforation of the dura mater results in CSF leakage responsible for a fall in intrathecal pressure. Treatment of the lumbar puncture syndrome consists of rest in supine position and copious hydration, usually by the oral route. The epidural blood patch technique is seldom used. Prevention relies entirely on the use of small calibre lumbar puncture needles; keeping the patient lying supine after the puncture is a classical recommendation, but its preventive value has not yet been fully demonstrated. PMID- 1792434 TI - [Lung transplantation]. AB - Lung transplantation began to expand in 1983, after the advent of cyclosporin and the publication of the Toronto lung transplant group study. Single lung transplantation was first performed in patients with interstitial pneumopathy to be extended later to pulmonary emphysema, then to primary or secondary pulmonary arterial hypertension. Double lung transplantation provides patients suffering from chronic lung infection (e.g. cystic fibrosis) with a useful alternative to their ordinary treatment. The experience acquired throughout these years has resulted in wider criteria for patients' inclusion. More than acute rejection, bacterial infections directly condition the immediate prognosis. The frequency and severity of cytomegalovirus lung diseases lead to a discussion on the possibility of prophylactic and curative antiviral therapy. The occurrence of obliterative broncholitis, which reflects chronic lung rejection, jeopardizes the long-term results of transplantation. The functional results of the various types of lung grafting are analysed, and the position of lung transplantation in thoracic surgery is reassessed. PMID- 1792435 TI - [Neurologic manifestations related to HTLV-1 viruses]. AB - The human T-cell leukaemia virus type 1 was the first human retrovirus to be isolated in 1980 by R. Gallo and coworkers. As its name indicates, this virus is responsible for adult T-cell leukaemia. In 1985, the neurological manifestations associated with this disease were isolated from the tropical spastic paraplegia group in Martinique. Since that time, such manifestations have been reported in non-tropical countries in other foci of viral endemia and sporadically outside these regions. These neurological manifestations are totally independent of the haematological manifestations with which they are virtually never associated. Frequent in areas of viral endemia, they may be encountered in other countries open to human migrations, where they are too often overlooked. PMID- 1792436 TI - [Anaphylactic manifestations during protected sexual intercourse disclosing allergy to latex]. AB - Reports of allergy to latex have been increasingly frequent during the last few years. The culprit is the natural Hevea Brasiliensis latex which is present in numerous latex-containing materials for daily use. Clinical manifestations are usually benign. Systemic manifestations have been reported mainly in general anaesthesia. We report a case of severe anaphylactic manifestations that occurred during a condom-protected sexual intercourse. The responsibility of latex for this accident was demonstrated by skin and biological tests. PMID- 1792437 TI - [Amnesic syndrome in sarcoidosis]. AB - We report a case of neurosarcoidosis characterized by central nervous system involvement 6 years after the onset of the disease. Our case is remarkable for the gradual development of an amnesic syndrome. Although neurological examinations gave normal results, the semeiological profile of the cognitive disorder suggests the presence of a hypothalamic sarcoid lesion involving the basal forebrain. PMID- 1792438 TI - [Pseudo-septicemic pyoderma gangrenosum and breast cancer. Apropos of a case caused by an intramuscular injection]. AB - We report a case of pyoderma gangrenosum (PG) mimicking a severe infectious skin disease in a woman with metastatic breast cancer. PG started at the site of an intramuscular injection administered a few days previously, and it subsequently extended. The skin disease was cured by high-dose corticosteroid therapy and clofazimine, but it marked a turn for the worst in the course of the breast cancer which became rapidly fatal. PMID- 1792439 TI - [Pheochromocytoma disclosed by isolated inflammatory syndrome]. AB - Among the atypical forms of phaeochromocytoma the isolated inflammatory form is rare and difficult to diagnose clinically. The authors report such a case, where computerized tomography and magnetic resonance imaging contributed enormously to the diagnosis. PMID- 1792440 TI - [Cortisone-induced osteoporosis: from physiopathology to treatment]. AB - Corticosteroid-induced osteoporosis, the principal cause of "secondary" osteoporosis, is usually observed in patients under prolonged systemic corticosteroid therapy and results from the multiple effects exerted by these drugs on bone cell metabolism. Corticosteroids reduce the intestinal absorption of calcium and its tubular reabsorption, thereby negativating the calcium balance and inducing a parathyroid reaction. This reaction is responsible for an increase in bone cell remodelling, but the main manifestation of the direct effect of corticosteroids on bone is osteoblast depression, so that there is disparity between bone resorption and formation, which in turn is responsible for bone tissue deficit. Sex hormone deficiency (due to menopause or treatment) and lack of physical activities (due to the causal disease or to iatrogenic myopathy) amplify bone rarefaction. By quantifying the bone loss, modern densitometry methods provide an early risk evaluation. Osteoporosis of varying intensity exposes some 20% of patients to fractures, vertebral collapse and rib fractures. Preventive measures are always recommended, including minimal effective dose corticosteroid therapy, sodium-free diet, calcium and vitamin D supplement, sex hormone replacement and pursuance of physical activities. Once the stage of fractures by osteoporosis has been reached, the "curative" treatment aims at reducing the incidence of new fractures, either by slowing down osteoclast resorption, or by restoring the bone tissue reserve through stimulation of the osteoblasts. The usefulness of these therapeutic measures in the preventive treatment of corticosteroid-induced osteoporosis remains controverted. PMID- 1792441 TI - [Myositis, hypothyroidism and fibrates]. PMID- 1792442 TI - [Disappearance of megacapillaries in intricate connectivitis]. PMID- 1792443 TI - [A case of acquired hypocholesterolemia disclosing Waldenstrom's disease]. PMID- 1792445 TI - Pulmonary function testing: a task for general practitioners. PMID- 1792444 TI - [Acute ulceration of the esophagus after ingestion of doxycycline]. PMID- 1792446 TI - Obstructive ventilatory impairment. An investigation in general practice. AB - We estimated the prevalence of obstructive ventilatory impairment and its relationship to sex, age, chronic bronchitis, asthma, and smoking in a cross sectional epidemiological study. The population consisted of 3119 persons greater than or equal to 16 years listed as patients in our general practice. From this group, 2740 (88%) underwent dynamic spirometry (Vitalograph). The main results showed a high prevalence of obstruction. 26% had MMEF values less than 75%, 8% FEV-1 less than 75% and 5% FEV-1/FVC less than 65%. Obstruction was significantly correlated with old age, chronic bronchitis, asthma, and smoking. PMID- 1792447 TI - Do physical signs reflect the degree of airflow obstruction in patients with asthma or chronic obstructive pulmonary disease? AB - The aim of the study was to relate the physical signs of the chest to the degree of airflow obstruction in asthma and COPD. METHODS: 113 patients with COPD and 76 patients with asthma were recruited from general practice. A standard physical examination of the chest was performed by trained medical students. Physical signs were related to the degree of airflow obstruction. RESULTS: the signs correlating closely with the degree of airflow obstruction were: a prolonged expiratory phase, low-standing diaphragm, decreased expiratory breath sounds, noisy inspiratory sounds, and decreased diaphragmatic excursions. There was a fair correlation between the number of physical signs and the degree of airflow obstruction. This was especially the case in asthma (r = 0.62), but it was less clear in COPD (r = 0.45). Sensitivity of separate physical signs to detect airflow obstruction was less than 50%, but at least one of the signs was present in 70% of the patients with obstruction. Specificity of separate signs was more than 85%, apart from wheezing in asthma. CONCLUSION: the combination of physical signs can offer relevant information in monitoring the severity of airflow obstruction in asthma and COPD. PMID- 1792448 TI - Injury surveillance at emergency departments in an urban area. Methodology and quality control. AB - An injury surveillance system has been developed and tested in a pilot study at two emergency departments in the Stockholm area. The object was to develop an all age, all-injury registration at all hospital emergency departments and primary care units treating injured patients. The information will be used at the local level for preventive measures, and on a national level for comparison with other areas. All injured patients were given a record-sheet that served both as a registration form and a medical record. The NOMESKO-code was used as a basis for classifying intent, activity, type of location, and injury mechanism. Altogether, 11,327 injured patients were registered. One day each month was randomly selected from the registration for control of registry completeness. The drop-out rate was on average 13%. The reasons were that patients had not been provided with the injury form, or that the copy of the form had not been sent to, or had not reached the Epidemiological Unit where data entry was performed. 6% of the injuries occurred in patients living outside the Stockholm area. The average shortfall-rate in filling in the NOMESKO-code on the registration form was 10%. The rate of registry drop-outs and incomplete forms should decrease when registration has become a routine procedure, provided that the staff can be engaged in the preventive work and the registration procedure can be adjusted to the routines of trauma management in each emergency department. PMID- 1792449 TI - Outcome after hip fracture in different health care districts. Rehabilitation of 837 consecutive patients in primary care 1986-88. AB - The social and functional outcome for 837 consecutive hip fracture patients rehabilitated in primary care was studied during 1986-1988. Of patients coming from their own home (59%) the majority (76%) were back at home four months after fracture and had a good functional status, while 9% were dead. Predictors of managing ADL (dressing/personal hygiene) four months after hip fracture were age, type of fracture, sex, and having regular social contacts outside the home before fracture. Health care districts differed in the incidence of hip fractures, the patients hospital stay, housing, type of fracture, and age. These differences had consequences on costs. Total costs per patient were lowest in districts where most of the patients were discharged to their own homes. No significant differences in fracture incidence were seen between rural and urban primary health care districts. PMID- 1792450 TI - Old persons' contact with general practitioners in relation to health: a Danish population study. AB - The study describes health, social situation, and contact with general practitioners in a random sample of non-institutionalized persons 70-95 years old in Denmark. There was a strong correlation between health and contact with general practitioners. A small group, 3% of the respondents, had no health problems, but had been in contact with a general practitioner within the previous month. This group was characterized by a strong social network and a high degree of life satisfaction. Another small group, including 3% of the respondents, had extensive health problems, but had nevertheless not been in contact with a general practitioner within the previous year. This group was characterized by a weak social network and a low degree of life satisfaction. PMID- 1792451 TI - Cost analysis and ethical aspects of hospital-based home-care for terminal cancer patients. AB - A study was undertaken to measure the costs of caring for 20 terminally ill/dying cancer patients at home, within a hospital-based home-care system. A new method was used, by which all staff expenses were registered and the work costs per minute were calculated for each personnel category (e.g. nurses, physicians). The total number of care days amounted to 857. The average daily cost was 509 Skr. (range 87-2999), but it was higher for patients with the shortest periods of home care ( = the dying patients). Comparisons were made between the costs of hospital based home-care and those of hospital care in 1) a geriatric unit, 2) other somatic departments, and 3) those departments from which the patients had been referred. The costs of hospital-based home-care were 40%, 55%, and 67% lower than the three different forms of hospital care, respectively. All the patients had relatives at home and were intensely dependent on their families. The important part played by the relatives contributed to the relatively low costs. The ethical aspects of caring for dying cancer patients at home are discussed. PMID- 1792452 TI - The Tromso Study: associations between self-reported arrhythmia, psychological conditions, and lifestyle. AB - In a survey, 19222 males and females aged 12-64 answered a question about sudden changes of heart rate or rhythm during the preceding year. The prevalence of reported arrhythmia was 12.4% in males and 17.2% in females. Multiple logistic regression was performed with self-reported arrhythmia as the dependent variable and psychological, lifestyle, and coronary risk factors as independent variables. The highest odds ratio for reported arrhythmia concerned poor compared with excellent health status; 3.86 in males and 2.98 in females. The relative risk for reported arrhythmia according to frequency of physician consultations was 2.28 in males and 1.70 in females, and odds ratios in both sexes were significant for psychological problems and smoking. The findings suggest that attention should be paid to the psychological conditions and lifestyle of patients who report irregular heartbeats. Self-reported arrhythmia may be a minor problem from a clinical point of view, but we still do not know its prognostic implications. Further work is necessary to determine the predictive strength of self reported arrhythmia for morbidity and mortality. PMID- 1792453 TI - Subjective dysfunction after stroke. A study with sickness impact profile. AB - In 1986, the functional capacity of 124 patients with an acute stroke was assessed one week after admission to Sodertelje hospital, Sweden. In order to analyse health-related quality of life, interviews were undertaken to determine sickness impact 6-9 months after stroke. 57 of the 91 surviving patients could participate. 53 persons were living in their own homes. 70% had a clinically significant subjective dysfunction, which correlated both to the objective functional capacity and to age. Sickness Impact Profile was a useful measure, yielding information of value for planning of long-term rehabilitation and home care. PMID- 1792454 TI - Problem of objective performance assessment of primary health care physicians. AB - Training programmes for primary health care physicians often lack methods for valid and reliable performance assessment of the trainees. A set of rating scales has been developed with the aim of increasing the objectivity of measurement of practical skills required for the management of cardiac failure. To prove the validity of the content and structure, as well as the inter-observer reliability, the scales were tested by the method of "competent judges" with the use of video recorded clinical simulation. Calculated Kendall's coefficient of concordance W was at the minimum acceptable level of 0.5. The results reveal considerable differences among examiners (competent judges) regarding internal criteria of acceptable level of performance, and they point out the need for further search for more objective methods of performance assessment. PMID- 1792455 TI - Leucocyte count as an alternative to ESR in general practice? AB - We investigated the ability of the leucocyte count to discriminate between "inflammatory diseases and malignancies" on the one hand and other, often harmless and self-limiting diseases on the other, and compared this ability with that of the erythrocyte sedimentation rate (ESR) in general practice. In cooperation with nine general practitioners (GP) we prospectively followed 151 patients who were seen by their GP because of a new complaint for which the GP wanted to know their ESR. ESR and one leucocyte count measurement (Technicon H6000) were performed at the local hospital laboratory. The patients were seen again after three months, to determine the follow-up diagnoses. By comparing the test results with the follow-up diagnoses, ESR was found to have a better discriminating ability than the leucocyte count test (ESR: sensitivity = 53%, specificity = 84%, positive predictive value = 29%, negative predictive value = 93%, Odds Ratio = 5.73). Using Receiver Operating Characteristic analysis, this conclusion could be shown to be independent of the chosen reference values. We conclude that the determination of the leucocyte count is not a clinically interesting alternative to ESR. PMID- 1792456 TI - Parental perceptions of health care for children with chronic illness--a population-based study in a Swedish primary care district. AB - The division of responsibilities between specialized and primary health care for children with chronic illness is unclear. The utilization and perceptions of primary and specialized care were examined by means of a questionnaire mailed to the parents of all chronically ill children and a randomly selected control group. No difference in sociodemographic variables of responders (70%) and nonresponders was found. The study comprised 98 index and 168 control children. The index children utilized both primary and specialized care more than controls. The overall satisfaction with health care was high, but primary care did not come up to the expectations of many chronically ill children's parents. Satisfaction with specialized care but not with primary care had improved during the previous 15 years. Recognition in primary care of childhood chronic illnesses and their psychosocial consequences is important. In co-operation, the two health care levels together could enable a comprehensive, well-coordinated, and continuous care for these children. PMID- 1792457 TI - Mental health problems in primary care before and after sectorization of psychiatric care--a study of patients utilizing both primary health care and psychiatric care. AB - Frequencies of noted mental health problems, diagnoses, and drug prescriptions performed by general practitioners were studied in a Swedish health district before and after the sectorization of the psychiatric care in patients (N = 252, N = 294, respectively) who had contacted both the outpatient psychiatric care and the primary health care. The frequencies of noted mental health problems before the sectorization were similar to other studies, but decreased after the sectorization. After the organizational change, psychiatric diagnoses decreased whereas psychosomatic diagnoses increased. After the sectorization, prescription of psychotropic drugs was reduced. PMID- 1792459 TI - Papers from the International Society for Clinical Biostatistics Eleventh International Meeting. September 1990. PMID- 1792458 TI - Use of primary health care in Spili, Crete, and in Dalby, Sweden. AB - A computerized medical record system was introduced in Greek primary health care (PHC) in the village of Spili in Crete. The present study was carried out to study similarities and differences in the pattern of PHC use in Dalby Health Centre, Sweden (DHC), and Spili Health Centre, Greece (SHC). In both Dalby and Spili more than half the population contacted their respective health centre during 1989. Patients contacted DHC more often than SHC, 3.33 vs 2.30 times. Relatively more females than males used the health services in Dalby (64% vs 50%) but not in Spili (57% vs 55%). More visits were made by appointment at DHC than SHC (36.0% vs 12.6%). There were great similarities in the two areas in the ten most common diagnoses, analysed in four age-groups. In both areas, acute upper respiratory infections dominated in the youngest age-groups, and hypertension and diabetes in those aged 45 years and above. PMID- 1792460 TI - Methods for dose finding studies in cancer clinical trials: a review and results of a Monte Carlo study. AB - We discuss some of the statistical approaches to the design and analysis of phase I clinical trials in cancer. An attempt is made to identify the issues, particular to this type of trial, that should be addressed by an appropriate methodology. A brief review of schemes currently in use is provided together with our views of the extent to which any particular scheme addresses the main issues. Some simulations are provided together with graphical illustration of the operating characteristics of the particular methods. It appears that the continual reassessment method is preferable to other contending schemes. PMID- 1792461 TI - A general parametric approach to the meta-analysis of randomized clinical trials. AB - Meta-analysis provides a systematic and quantitative approach to the summary of results from randomized studies. Whilst many authors have published actual meta analyses concerning specific therapeutic questions, less has been published about comprehensive methodology. This article presents a general parametric approach, which utilizes efficient score statistics and Fisher's information, and relates this to different methods suggested by previous authors. Normally distributed, binary, ordinal and survival data are considered. Both the fixed effects and random effects model for treatments are described. PMID- 1792462 TI - Falsificationism and clinical trials. AB - The relevance of the philosophy of Sir Karl Popper to the planning, conduct and analysis of clinical trials is examined. It is shown that blinding and randomization can only be regarded as valuable for the purpose of refuting universal hypotheses. The purpose of inclusion criteria is also examined. It is concluded that a misplaced belief in induction is responsible for many false notions regarding clinical trials. PMID- 1792463 TI - Calculating centile curves using kernel density estimation methods with application to infant kidney lengths. AB - Observing a clinical measurement for an individual is of little value, unless it can be compared with measurements obtained from a healthy population, thought of as standard. The range of measurements observed will, in general, vary with age or some function of time. The usual approach is to assume a distributional form for the population density, but this is inappropriate for variables which do not follow a simple distribution. A method of estimating the centiles of a conditional distribution using multi-dimensional kernel density estimation, to allow conditioning on the value of one or more covariates, is proposed. By careful choice of the kernel used, the percentiles may easily be calculated using a Newton-Raphson procedure. The method is illustrated using kidney lengths and birthweights of a sample of newborn infants. PMID- 1792464 TI - Analysis of failure time data with ordinal categories of response. AB - When failure times are observed, additional information concerning the type of failure is often recorded. A method which simultaneously models the failure times and additional information in the form of ordinal categories is discussed. An application to clinical trial data, in which the failure times are times of onset of headache, and the headaches are classified into the ordinal categories mild, moderate and severe, illustrates how this method may be used and how the final model can be interpreted. The continuation ratio model, which is used in this method, is described in detail. PMID- 1792465 TI - Multivariate analysis of spect images with illustrations in Alzheimer's disease. AB - Modern neuroimaging techniques such as positron emission tomography and single photon emission computed tomography (SPECT) often generate datasets consisting of a large number of variables measured on a small number of subjects. In addition, the data contain large 'subject effects' which must be adjusted for in any statistical analysis. This paper illustrates the dangers inherent in naive univariate analysis and proceeds to demonstrate the application of multivariate methods such as Hotellings T2-test, canonical correlation analysis and discriminant analysis. The issues and statistical methods are illustrated using a dataset from a SPECT study of groups of normal control subjects and subjects with a clinical diagnosis of Alzheimer's disease. PMID- 1792466 TI - The detection of artefacts in EEG series. AB - In a clinical trial of an anticonvulsant drug, series of electroencephalogram readings are sometimes obtained. These may contain artefacts, that is patches of atypical values which must be identified and either removed or compensated for before a full analysis can be carried out. Methods for identifying such artefacts are discussed. These include non-parametric methods and also parametric ones combining the ideas of autoregressive modelling and of influence in regression. These methods are described and illustrated on typical data sets. PMID- 1792467 TI - Subacute sclerosing panencephalitis in England and Wales: transient effects and risk estimates. AB - Data on cases of subacute sclerosing panencephalitis (SSPE) with onset in 1970-89 show a marked increase in the interval from initial measles attack to onset of SSPE by year of onset. It is shown that this increase is a transient effect resulting from the decline in measles incidence following the introduction of mass vaccination in 1968. The risk of SSPE after measles is estimated to be 4.0 x 10(-5) (18 x 10(-5) after measles under one year of age) and the risk after vaccination to be no greater than 0.14 x 10(-5), thus confirming that vaccination is effective in reducing the incidence of SSPE. The paper makes use of methods developed to estimate the incubation period of AIDS. PMID- 1792468 TI - Estimation of relative risk functions. AB - The risk associated with different levels of a quantitative factor X is often measured relative to the level corresponding to X = 0. There are situations, however, where there is no natural zero for X, for example where the risk factor is the age of an individual. In this case it is more natural to measure risk relative to an overall average for the study population. To use the whole population in this way also raises the possibility of regarding X as truly continuous, rather than as a grouped variable. This gives rise to the concept of a relative risk function. Methods for estimating such functions are discussed, concentrating for the most part on the discrete case. The extension to higher dimensions permits the investigation of joint effects of several factors, while the problem of controlling for confounding variables can be handled by fitting multiplicative risk models. Relating the latter to the log-linear model permits the estimation of adjusted relative risk functions. The method is illustrated using data on childhood cancer. The continuous case can in principle be handled in a similar way using density estimation techniques. PMID- 1792469 TI - Comparative efficiency of a survival-based case-control design and a random selection cohort design. AB - Ambidirectional studies are useful when information about disease status is available on a cohort but a risk factor has still to be recorded. An example is the study of the influence of HLA phenotypes on the progression of HIV carriers towards AIDS. An ambidirectional design is proposed in which the cases and controls are defined by the survival duration of the subjects; it includes as special cases some other ambidirectional designs. Its efficiency is compared with that of a random selection cohort design both analytically and by computer simulation. It is shown that when the size of the cohort is large, appreciable gains in power can be achieved by this type of design even when there is no censoring. PMID- 1792470 TI - [Knee resection prosthesis in tumor reconstructive surgery: comparative study between the use of cryopreserved bone allografts and non-biologic material]. AB - From july 1983 to december 1990, 34 patients with aggressive or malignant bone tumors in the knee have been treated by radical resection and endoprosthesis replacement with or without allograft. The follow up was three years. We have a comparative study between allograft and plastic spacer. The functional character is better with endoprosthesis with non biologic material (75% excellent and good versus 66.6%). The complications were similar in both. PMID- 1792471 TI - [Therapeutic indications of monoamine oxidase inhibitors]. PMID- 1792472 TI - [Carpal tunnel syndrome]. PMID- 1792473 TI - [Philosophy and medicine]. PMID- 1792474 TI - [Teaching, practice and research]. PMID- 1792475 TI - [Auricular electrodermic reflex in humans: experimental study]. AB - Several sets of experiments have been performed for the following purposes: 1) to show that spontaneous pain as well as thermalgesic stimuli provoke the auriculoelectrodermic reflex (AER); 2) to investigate the action of local, general and rachianaesthesia on the AER, and 3) finally, to know the afferent, efferent and spinal pathways of the AER. As painful stimulus was utilized noxius heat (45 degrees C during 30 seconds) and the AER wss registered by means of a Servoscope (Sedatelec). Local and rachianaesthesia suppressed the AER but the general anaesthesia decreased only its intensity. The study of the AER in paraplejic patients revealed that the thermalgesic impulses responsible for the AER, enter in the spinal cord not only through the dorsal root corresponding to the stimulated dermatome, but also through the 4-5 cranealer roots. On the other hand, the intraspinal pathway of the AER impulses is bilateral, with a slight ipsilateral predominance. The polyradicular input and spinal bilaterality difference the thermalgesic from the other nociceptive impulses. The results obtained in tetralejic patients allow to conclude that the integration of the AER is spinal, corresponding to the supraspinal centres a modulatory influence. PMID- 1792476 TI - [Selective deficiency of immunoglobulin A]. PMID- 1792477 TI - [Phadiatop: a new in vitro test for diagnosing respiratory allergy]. AB - Respiratory diseases are very frequent in childhood, for the discrimination between atopic and non atopic causes. We therefore investigated a new in vitro test for specific IgE to inhalant allergens. Sera from 29 patients pediatrics with suspected allergic symptoms of the respiratory tract were analysed. Diagnosis was established by clinical history, PRIST, laboratory test, intradermal skin tests. The issue of our study show that Phadiatop can be effectively screened in the diagnosis of allergy in young children. PMID- 1792478 TI - [Electrocardiographic changes with the use of aminophylline and salbutamol in adult patients with chronic bronchial asthma]. AB - Fifteen patients diagnosed with bronchial asthma were examined to evaluate the cardiotoxicity caused by the combined intravenous treatment using methylxanthine aminophylline 250 mg and a beta agonist: salbutamol 0.5 mg. The following observations were made: four patients had sinus tachycardia and another suffered from ventricular extrasystoles as seen in the electrocardiographic register; another two patients had sinus tachycardia when the bronchial dilator dosage was doubled. From a clinical and electrocardiographic standpoint, arrhythmias do not seem to be a grave problem among the population studied. PMID- 1792479 TI - [Allergological study of pollen of mango (Magnifera indica) and cross reactivity with pollen of piru (Schinus molle)]. AB - With immediate skin test, we studied hypersensitivity to pollen of mango (Magnifera indica), and its probability cross-sensitivity to pollen of piru (Schinus molle), from anacardaceae class. We have made one extract of Magnifera indica, with 0.485 mg per 100, of protein nitrogen. With this extract we carry out skin test on non-atopic subjects and atopic subjects with bronchial asthma and or allergy rhinitis and common stock of aerealergen. (Freeman stock). We studied seventy-one subjects, both sexes, from 14 to 40 years old. The prevalence of cutaneous sensitive to mango (Magnifera indica) were 66%, and sensitivity from Schinus molle were 31%. Those with sensitivity Schinus molle, were sensitivity from Magnifera, too. Statistical analyisis of correlation, with McNemar Test was p 0.001 under the conditions of the study we conclude that there are hypersensitivity to pollen of Magnifera, and there are cross-reactivity with Schinus molle. Therefore mangifera should be included within the stock of skin test in the areas were this anacardaceae is present. PMID- 1792480 TI - [Skin response to the allergen of the roach in allergic patients]. AB - Cockroach is an insect that is very frequent in urban areas. There are many research in the last years who shows the relationship between positive prick test to cockroach and respiratory allergy. We made a retrospective study with patient of the out patient clinic of allergy during July to December 1989, and who had a skin test to cockroach. We found a 27% positivities in the skin test, and most of the patients came from the urban area. The positivity of cockroach and dust mite were present in almost 80% of the patients. PMID- 1792481 TI - [Cardiological evaluation of the asthmatic adult in the allergologist's office]. AB - The basic and clinic measurements in the initial cardiovascular work-up of the adult asthmatic are reviewed. This is complemented with the physiopathology of the two problems the frequently arise when an asthmatic is evaluated: 1) if asthma could cause a heart disease and 2) if a heart disease may be hidden in a presumed asthma. PMID- 1792482 TI - [Ketotifen in allergic diseases]. AB - This study included the review of 1000 clinical histories of allergic diseases, in a retrospective way, that was seeing in the Service of Allergy of the Instituto Nacional de Pediatria in Mexico city. All the patients were previously diagnosed with several allergic pathologiest like: bronchial asthma, rhinitis, asthma and rhinitis, atopic dermatitis, etc. All the patients received as main therapeutic treatment ketotifen at least during 3 months to 12 months. Global improvement in all patients with the use of ketotifen, reach 84%, including all the pathologiest studied. The tolerance of the drug specially in children was very good. PMID- 1792483 TI - [Atopic dermatitis. Treatment with transfer factor. A controlled clinical trial]. PMID- 1792484 TI - [Allergenic flora in the Valley of Mexico. Relation with food hypersensitivity of vegetal origin (3)]. PMID- 1792485 TI - [Treatment with oral prednisone in ambulatory asthma patients. Effects on various immunological aspects]. PMID- 1792486 TI - [Achieving urinary continence]. AB - Development of urinary continence, which is necessary for species survival and comfort of human being, begins with the organization of vesico-sphincteric automatism, as part of nervous system growth. Micturitional reflex are successively integrated inside the ganglionic plexuses in the foetus, the sacral spinal cord in the newborn and the pontine center in the child. Voluntary control of this automatism needs, at first, feeling an sensitive information about the bladder fullness, that is to say a "desire of urinate". Child first controls his striated sphincter, what makes him able to avoid urine leakage and enlarges his bladder capacity. Latter, he can initiate or refuse, voluntarily, bladder contraction, doing his bladder the most intelligent organ and, consequently, the most psychologically vulnerable one. Timing of these different steps is variable; in addition to the natural maturity processes which progress more or less quickly, training adds it effects, more useful for developing continence during daytime than during night-time. PMID- 1792487 TI - [Urination control during sleep]. AB - The authors present their approach to the sleep factor in children with enuresis, based on a still on-going exploration of manometric changes in bladder activity. Twenty patients have already been examined by cystomanometry in day time and polygraphic sleep recording at night, combined with continuous measurement of bladder pressure. This method derives from the studies of Gastaut and Broughton, in 1963, but takes into account the concept of bladder immaturity. The patients studied fell into two homogeneous groups, depending on whether enuresis was obviously due to bladder immaturity (Group I) or was strictly isolated (Group II). No disorder of sleep organization has been found in none of these two groups, but both had apparently nonspecific irritant factors. The enuresis episode is described. It tends to occur frequently at the beginning of the night, is prepared by an increase in bladder pressure which is always very pronounced in Group I subjects, and is associated with insufficient awakening reaction due to an apparently exceedingly high awakening threshold. The physiopathological and therapeutic implications of these findings are discussed. PMID- 1792488 TI - [Antidiuretic hormone (ADH) and urination]. AB - The role played by antidiuretic hormone in enuresis remains controversial. As a symptomatic treatment, desmopressin (DDAVP) has already proved to be a useful addition to the measures applied against this condition. PMID- 1792489 TI - [Clinical examination of children with urination disorder]. AB - The management of a child with disorders of urination must begin with a high quality clinical examination. Detailed questioning in an atmosphere of confidence yields information on the type of disorder (dysuria, frequencies, urgencies, burning sensation at voiding, enuresis, incontinence) either alone or in association. Physical examination aims to find signs pointing to the cause of the disorder. Particular attention must be paid to an inspection fo the external genitalia and to a search for possible abnormalities affecting the pinna of the ear and the extremities, since they are frequently found in association with deep malformations of the urinary tract. Collecting the urine provides an opportunity to observe the process of urination and possible abnormalities in the initial, middle and terminal voiding streams. The reagent dipstick is a minute but true laboratory test accessible to children, which makes it possible to detect glomerular, tubular and interstitial lesions. This clinical examination will lead to a precise diagnosis, inform on the need, if any, for additional explorations and enable the clinician to select the correct treatment. PMID- 1792490 TI - [Urological studies in urination disorders in children]. AB - Enuresis nocturna in children must not be confused with incontinence associated with disorders of urination. Questioning and clinical examination are sufficient to distinguish between these two entities. The former is a psychogenic condition which does not require urological examination, whereas the latter is of urological or neurological origin and requires additional explorations to reach an aetiological diagnosis. These explorations (urography, cystography, cystomanometry, neurophysiological and/or neuroradiological studies) are determined according to the type of the presumed lesion and to the child's age. PMID- 1792491 TI - [Treatments of enuresis]. AB - The current management of nocturnal enuresis is based on simple therapeutic schedules, available if the child, his parents and physician, are determined. The treatment first includes motivational therapy and bladder training exercises. If bedwetting is not controlled, conditioning alarm procedures can offer a high rate of positive results with a low risk of relapse. Tricyclic antidepressants should be avoided because of their severe cardiac and hepatic potential side-effects, and because they provide quite the same short and long-term results than desmopressin. Intranasal desmopressin (20 to 40 micrograms/day) offers a 40 to 60% rate of positive results, and can be administrated over a long period in relapsing patients. PMID- 1792492 TI - [Treatments of urination disorders in children (vesico-sphincteral disorders other than enuresis)]. AB - Disorders of urination are a frequent cause of consultation in paediatric urology units, even when enuresis is excluded. These disorders consist of frequencies, dysuria, urgencies, burning sensation at voiding and incontinence. Since their mechanisms are diverse, their treatment should be increasingly specific. PMID- 1792493 TI - [Tumor suppressor genes in cancers of colon and rectum]. PMID- 1792494 TI - [Temporomandibular arthroscopy. A useful diagnostic and therapeutical tool if used properly]. PMID- 1792495 TI - [Age related macular degeneration and subretinal neovessels. Primary cause of acquired blindness in adults in France]. PMID- 1792496 TI - [Methods of the diagnosis of dementias. It is still very difficult to confirm the existence of dementia and to determine the type]. PMID- 1792497 TI - [Bullous lupus erythematosus. A current diagnostic pitfall in dermatology]. PMID- 1792498 TI - [Evolutive aspects of seromucous otitis. When should it be treated?]. PMID- 1792499 TI - [Hemochromatosis]. AB - The first part of this study deals with well known as well as new data on normal iron metabolism. The second part will concern Genetic Haemochromatosis, a recessively transmitted disease principally determined by a gene located on the sixth chromosome near the A locus of HLA system: phenotypic expression of the gene, clinical features, iron overload assessment, mechanism of iron toxicity, pathogenesis of iron overload. The third part considers iron overload secondary to anaemias, to chronic alcoholic liver diseases, to porphyria cutanea tarda, to chronic haemodialysis... and their relation to the Genetic Haemochromatosis. Beyond what is already well established still lies a large number of questions with answers, at this stage, uncertain or incomplete. PMID- 1792500 TI - [Formation of the bile]. AB - Bile is an aqueous isotonic solution of bile acids, cholesterol, phospholipids, bile pigments and inorganic electrolytes. It is secreted by the hepatocytes into the bile canaliculi and modified by the bile ducts and gallbladder. The chief mechanisms of bile formation are: 1. active transport of bile acids, responsible for the bile acid-dependent flow. This is the consequence of an osmotic flux of water and electrolytes in response to bile acid secretion. Ursodeoxycholic acid (and other bile acids) have an hypercholeretic effect, probably through a chole hepatic circulation. 2. Transport of other compounds, responsible for the bile acid-independent flow. These compounds are incompletely identified: organic compounds (such as glutathione) or inorganic electrolytes could be involved. 3. Reabsorption of water and electrolytes in the bile ducts and in the gallbladder, and secretion of bicarbonate by the bile ducts, stimulated by secretin. Cholestasis may be extra or intrahepatic. Extrahepatic cholestasis is always due to obstruction of bile ducts. Intrahepatic cholestasis may result from obstruction of intrahepatic bile ducts or alteration of secretory mechanisms by the hepatocyte. PMID- 1792501 TI - [Beginning and development of pediatric oncology]. PMID- 1792502 TI - [The Saint Louis Hospital museum]. PMID- 1792503 TI - [Blood transfusion and products derived from blood (except platelets and leukocyte concentrates). Immunologic bases and indications]. PMID- 1792504 TI - [Concepts of specific inflammation: lymph node tuberculosis]. PMID- 1792505 TI - [Cough. Diagnostic orientation]. PMID- 1792506 TI - [Hemophilia and Duchenne muscular dystrophy. Genetic]. PMID- 1792507 TI - [Acute edema of the face. Diagnostic orientation and management]. PMID- 1792508 TI - [Bacterial infections in newborn infants. Diagnostic criteria, principles of treatment, prevention]. PMID- 1792509 TI - [Mental retardation. Diagnostic orientation]. PMID- 1792510 TI - [Learning difficulties. Diagnostic and therapeutical orientation]. PMID- 1792511 TI - [Non drug-induced elevation of transaminases. Diagnostic orientation]. PMID- 1792512 TI - [Threatening premature labor. Etiology, diagnosis, principles of the treatment]. PMID- 1792513 TI - The duration of breast-feeding. A longitudinal prospective study in Denmark. AB - A longitudinal prospective study was performed to investigate the total duration of breast-feeding. Three hundred and sixty-six mothers were followed-up until 3 years after delivery. At 1 month 93% were breast-feeding, at 3 months 73%, at 6 months 52%, at 1 year 20% and 1% breast-fed more than 3 years. Correlations were found between duration of breast-feeding and maternal age, education and social class. Mothers who had breast-fed an older child usually breast-fed the next child for a period of similar length. Solid food was most frequently introduced when the infants were 4 months old. At 6 months 4% were still exclusively breast fed. Breast-feeding has become popular: only 1% did not want to breast-feed at all and 89% of mothers intended to breast-feed their children for 6 months or more. Even though the mothers now breast-feed longer than earlier, only 39% succeeded in breast-feeding for as long as or longer than they had intended. PMID- 1792514 TI - Role modelling and cigarette smoking: vulnerable working class girls? A longitudinal study. AB - Risk factors for the onset of cigarette smoking were examined by means of a prospective longitudinal study in 1230 Norwegian adolescents aged 12-18. In particular the importance of role modelling was focused. The findings revealed that the age period between 12 and 15 is most important when it comes to the initiation of smoking. Among those who initiate smoking, the incidence rates of quitting is low, indicating that most of the initiators quickly seem to develop a relatively stable smoking habit. Smoking initiation can be divided into two stages. The first, experimental one, is predicted by peer modelling and low socioeconomic status (SES). The second, establishing a regular pattern of use, is predicted by modelling of parental smoking and the interaction between female sex and low SES. Studying the characteristics of the regular smokers cross sectionally, peer modeling showed the strongest correlates. Studying the predictors of the transitions longitudinally, the more complex picture described above was uncovered. This indicates that the complexity of the role modelling process can only be simulated adequately by means of prospective research methods and by paying attention to such parameters as gender, age, SES and stage in the smoking acquisition process. PMID- 1792515 TI - Social class and cardiovascular risk factors in Danish men. AB - During the last 25 years, a series of epidemiological studies in North-Western Europe and U.S.A. have demonstrated a negative association between social class and the incidence of cardiovascular disease (CVD), that is, an increasing incidence the lower the social class. In studies where possible explanations of this negative gradient have been analyzed, it was concluded that the traditional individual risk factors, such as elevated blood pressure, high serum cholesterol, and smoking, could explain about one half of the differences demonstrated. In a prospective study of a cohort of 504 men from the County of Copenhagen, the participants were examined when 40 and 51 years old. At both examinations the social class of the participants was recorded in addition to a number of cardiovascular risk factors. The latter included both the traditional risk factors and some not previously analyzed in relation to social class. At the 51 year examination we found statistically significant negative associations between social class and the following risk factors: plasma fibrinogen (p less than 0.001), short height (p less than 0.001), smoking (p less than 0.05), physical inactivity in leisure time (p less than 0.01), shift work (p less than 0.05), job strain (p less than 0.05), living alone (p less than 0.01), and having a poor social network (p less than 0.05). Two factors showed a significant opposite association with social class: Type A behaviour (p less than 0.001) and physical inactivity at work (p less than 0.001). In the last 10-15 years, a tendency has been demonstrated in many countries towards a strengthened association between social class and cardiovascular risk factors. This tendency was not found in our cohort. It has been discussed whether some of the social inequalities observed could be due to selection, so that people with a favourable cardiovascular risk profile socially were upward mobile. We found no support for such a selection hypothesis in our study. PMID- 1792516 TI - A perinatal audit of stillbirths in three Danish countries. AB - All stillbirths in 1985 and 1986 in three Danish counties were assessed in a perinatal audit. The aim was to investigate if departure from generally accepted standards of satisfactory perinatal care might have contributed to stillbirths, and also to investigate if differences in the structure of antenatal care and the delivery systems might have any influence on the rate of stillbirths. 119 cases evaluated, 70 were classified as unavoidable deaths, in 48 cases a different treatment might have improved the infant's possibility of survival and in one case consensus was not reached. The most frequent cause of suboptimal care was inadequate antenatal care of obvious signs of intrauterine growth retardation. Directives for visitation between surgical and obstetric departments were essential to the rate of stillbirth. The results indicate that it might be possible to achieve a further decrease in the number of stillbirths by intensifying the postgraduate training of the professionals and by issuing guidelines for the sharing of care responsibilities. PMID- 1792517 TI - Event, incidence, and fatality rates of cerebrovascular diseases in Enkoping Habo, Sweden, 1986-1988. AB - In order to study the need for medical care among elderly stroke patients, a prospective registration of cerebrovascular diseases started on January 1, 1986 in Enkoping-Habo health service district, Sweden. This article reports the design of the stroke register and the registration procedures, the annual events of stroke, both first-ever and recurrent, during 1986-1988 and the fatality rate with special regard to the very old population. The annual incidence of first ever stroke was 0.33/1,000 among persons younger than 65 years of age, 10.6/1,000 among persons aged 65-84 years, and 34.5/1,000 among persons aged 85 years and older. The fatality rate of first-ever strokes was 7.5% within one month for persons younger than 65 years of age, 20.3% in the age-group 65-84 years, and 41% for the population 85 years and older. These results are compared with a similar Swedish study from Soderhamn and four comparable international studies. The results from this study gave a basis for designing special care programs in hospital and in home-care also for old stroke patients. PMID- 1792518 TI - Longitudinal studies on environmental factors and disease. A model for analysis of ethical conflicts. AB - The use of individual-based data in research has recently come in for much discussion. The basic issue of the discussion is how to balance between different legitimate interests: the interest in improving knowledge on matters important to human health and the interest in respecting individual autonomy. In this paper we will use a model for description and analysis of ethical conflicts in individual based research. The model consists of two dimensions: the first specifies the persons involved in the conflict, the second specifies the relevant ethical principles. We have chosen the case of the Ronnskar study as an example. For illustration we distinguish between: no study, a study without informed consent and a study with informed consent. In the Ronnskar study the decision between the three situations rests upon an assessment of the conflict between two obligations: to improve the working environment and to respect autonomy. PMID- 1792519 TI - The social consequences of insulin-treated diabetes mellitus in patients 20-50 years of age. An epidemiological case-control study. AB - In order to investigate the social consequences of diabetes we sent a questionnaire to all diabetic patients aged 20-50 years and 1.125 matched non diabetic controls living in the county of Vasterbotten in Northern Sweden. The response rate was 87% and 72%, respectively. Patients more often lived alone (18 vs 13% p less than 0.05) and had no children (39 vs 31% p less than 0.01). They were more often the only child of their parents (14 vs 8%, p less than 0.01). Thirty-seven percent of the patients and 22% of the controls (p less than 0.001) had been absent from work because of illness more than one month continuously during the last 3 years and had more often than controls prematurely retired from work (8 vs 2% p less than 0.001). Patients more often had hobbies (86 vs 76%, p less than 0.001) and were participating in social activities (52 vs 41%, p less than 0.001), but were less satisfied with their leisure time (71 vs 80%, p less than 0.001). Forty percent of the patients vs 31% of the controls (p less than 0.01) did not visit neighbours. Fifty-one percent of the patients vs 44% of the controls (p less than 0.05) never spent leisure time with their work mates. No significant differences were found in education, socioeconomic class, dwelling or household economy. The study shows that there are social differences between diabetic patients and non-diabetic people even though they are not overwhelming. PMID- 1792520 TI - Life events and coping patterns reported in HIV-infected hemophiliacs a year after diagnosis. AB - A nationwide study of the psychosocial situation of HIV-infected hemophiliacs was made in Sweden. Forty-three HIV-infected hemophiliacs aged between 12 and 72 years were compared with 30 age matched non-infected hemophiliacs. A group of 17 parents of HIV-infected boys was also studied. An unexpectedly high number of residential moves was found in the infected group during the period of diagnosis. The HIV infection diagnosis was rated the most disastrous event compared to all other studied events (including death of family member), particularly among parents of HIV-infected boys. With regard to coping, subjects were asked to record their "content of life" for the past, the present and the future. The most striking findings were the pessimistic ratings of expected number of activities with other people in the future. Such activities were assumed to decrease significantly in the infected, but not in the non-infected group. Furthermore, the ratings of possibility to influence activities were lower in the infected group compared to the non-infected. The content of activities, on the other hand, differed very little between the two groups, although non-infected men reported more hobbies and leisure activities and social activities than infected men. PMID- 1792521 TI - Long-term sick-listing, medical rehabilitation and life quality change: a patient evaluation. AB - This evaluation of the health service at one of the hospitals of the National Insurance Board in Sweden is primarily based on the perspective of the patient. One interview group of 32 patients (I-group) made life quality ratings before after their hospital stay. In responding to a postal questionnaire one year after discharge from hospital, another group of 93 former patients (Q-group) made parallel self-ratings. Due to prolonged sick-listing, the patients had been admitted to the hospital for rehabilitation/examination according to paragraph 2:11 in the general insurance law. The basis for their sick-listing was hereby critically reviewed. Within the framework of additional examinations (interview and structured general questions), more than 40% of the respondents stated that the hospital stay was mainly satisfying and a great majority appreciated the nursing care. However, the self-ratings showed that the patients did not ascribe any particularly great significance to the hospital stay. In the short term, it even seemed to have a certain negative impact on the life quality of the patients. No obvious positive bias seems to be built into the ratings. Thus, the assessment package applied may also work well in similar evaluative settings. PMID- 1792522 TI - Musculoskeletal capacity and its changes among aging municipal employees in different work categories. AB - Aging effects on musculoskeletal capacity were studied among 83 subjects over a four-year period beginning at about 51 years of age, and the associations between work demands and musculoskeletal capacity were studied in a cross-sectional investigation comprising 137 subjects (mean age about 55 years). The follow-up study showed significant changes in musculoskeletal capacity, maximal isometric trunk strength having decreased 16-22% and 9-10% among the men and women, respectively, and maximal trunk muscular endurance and back mobility having increased 21 and 14%, respectively, among the men. The cross-sectional study showed statistically significant differences in isometric handgrip strength and leg mobility among the men and in isometric trunk flexion strength and trunk muscular endurance among the women in the three studied work groups. The investigation suggested that changes in musculoskeletal capacity can be marked after the age of 50 years and that physically heavy occupations do not maintain a sufficient level of capacity among elderly workers. PMID- 1792523 TI - Performance efficiency and its changes among aging municipal employees. AB - The aims of the study were to compare the performance efficiency of aging municipal workers in different work categories and to determine the changes that occurred in visual search, short-term memory, and fine motor performance over a four-year follow-up period beginning at about 51 years of age. The mental capacity of the workers in mental work was better than that of the workers in physical and mixed physical and mental work, and the results between the physical and mixed work groups did not differ significantly. In four years, the workers' complex short-term memory weakened 6-7% in all three work content groups. Fine motor speed decreased 2-7% in the physical and mental work groups. It was concluded that the mental capacity of older workers depends on the mental demands of their work tasks. The weakening of performance is 2-7% between the ages of 51 to 55 years. PMID- 1792524 TI - Classification of municipal occupations. AB - Eighty-eight job titles were analyzed with the "ergonomic job analysis procedure" [Arbeitswissenschaftliche Erhebungsverfahren zur Tatigkeits-analyse abbreviated (AET) in German]. The objective was to classify the wide range of municipal jobs into homogeneous groups according to job demand and to provide better possibilities to study the relationships between work and health among the aging municipal working population. Altogether 216 items were classified. First, a hierarchical cluster analysis was made, and a dendrogram of the analyzed job titles was drawn. Second, a profile analysis was done in which the single items were grouped into 39 sum items, and a graphic profile was drawn. Finally, the stress factors were listed and drawn in ranking order. The cluster analysis formed 13 groups. Groups exposed to the highest stress factor level were kitchen supervisors, dentists, and physicians. More than 10 stress factors (greater than 50% of the maximum) were found in nursing, administration, installation, transport, and technical supervision. PMID- 1792525 TI - Associations between functional capacity and work ability among elderly municipal employees. AB - The relationship between objectively measured physical and mental functional capacity and work ability was studied among 137 workers with a mean age of 55 years. Of the physical capacity tests muscular strength correlated the best with the constructed work ability index. Cardiorespiratory capacity and work ability did not correlate statistically significantly. About 50% of the subjects was classified uniformly, and less than 10% not uniformly, with respect to muscular strength. The correlation between cardiorespiratory capacity and work ability was significant for those without, but not for those with, a musculoskeletal disease. The mental capacity tests had systematically lower correlations with work ability than the tests for physical capacity. The highest statistically significant correlation was found between visuomotor speed and work ability. Objective measurements of muscular strength seem useful for defining work ability, but other tests need to be improved to be more work-related. Furthermore, musculoskeletal diseases should be checked for when cardiorespiratory capacity is assessed. PMID- 1792526 TI - Work load and individual factors affecting work ability among aging municipal employees. AB - The effects of work stressors, individual characteristics, symptoms, and diseases on work ability were studied among 4255 municipal employees. Work ability was assessed by a work ability index in two cross-sectional inquiries, one in 1981 and the other in 1985. The most impairing for work ability were mental symptoms and musculoskeletal disease. Among the work stressors, high physical demands at work, poor physical work environment, and lack of freedom were associated with impaired work ability. Muscular work, disturbing temperatures at the workplace, and lack of freedom particularly affected employees with disease, whereas poor work postures and role conflicts at work were particularly injurious for healthy employees. The worst situation was observed when a worker with many symptoms and disease was exposed to many different work stressors. Life satisfaction, sitting work posture, a good basic education, and physical exercise during leisure time were associated with good work ability. PMID- 1792527 TI - Summary and recommendations of a project involving cross-sectional and follow-up studies on the aging worker in Finnish municipal occupations (1981-1985). AB - This report is a summary of the main findings of 15 studies comprising a multidisciplinary research project. Recommendations are also made on the basis of the findings, and they emphasize the following points: (i) work demands should change with age, (ii) work should be designed for unhealthy people, (iii) work ability should be promoted, (iv) work ability should be regularly monitored, (v) special attention to stress reactions is needed, (vi) knowledge of aging is needed, and (vii) action programs are needed. PMID- 1792528 TI - Stress and strain of elderly employees in municipal occupations. AB - Cardiorespiratory and musculoskeletal stress and strain during work were investigated for 129 men and women aged 45 to 58 years. In physical work the women had more physical demands (34% of the workshift) than the men (21%) although the men had more peak loads (heavy and very heavy) than the women. Cardiorespiratory strain varied between 63 and 131 beats.min-1, which equaled a metabolic rate of 68 to 223 W.min-2. The relative cardiorespiratory strain of the older subjects was the same as that of the younger subjects. Among the physical workers with good cardiorespiratory capacity the absolute and relative strain was 10 and 18% lower, respectively, than among those with poor or moderate capacity. Poor work postures were the most common in physical work (17% of the workshift) and more common among the women (22%) than among the men (15%). It seems that work is often physically heavy for elderly women because of their decreased physical work capacity. PMID- 1792529 TI - Changes in the content of Finnish municipal occupations over a four-year period. AB - The data of this study are based on questionnaire surveys made in 1981 and 1985. The sample consisted of 1799 men and 2456 women in the age range of 48-62 years. Physical demands were more common in 1985 than in 1981, and more common among the women than among the men. In addition problems with the physical-chemical environment were more common in 1985 and more common among the men. The changes in tasks were evaluated more often as positive than negative. The mental load had increased between 1981 and 1985 due to an increase in the amount of work and the knowledge needed at work. In addition changes in social contacts and client relations increased the mental load. PMID- 1792530 TI - Mortality, disability and changes in occupation among aging municipal employees. AB - During a four-year follow-up period the indicators of work load, individual factors, and stress reactions predicting mortality, disability, and change of occupation were studied. In 1981, 6257 active workers aged 44-58 years answered a questionnaire. The study was repeated in 1985 when 1% of the subjects had died, 9% had become disabled, and 5% had changed their occupation. These changes had occurred the most often in occupations which included muscular work, poor work postures, and a poor physical environment. The highest mortality rate was observed for the male installation and auxiliary workers who had reported the presence of cardiovascular, but no musculoskeletal, disease four years earlier. The highest disability rate was well predicted by a poor index of work ability. Major diseases leading to disability included malignant tumor, coronary artery disease, congestive heart failure, rheumatoid arthritis, bronchitis or bronchial asthma, and mental disease. Work-related stress reactions were associated with both mortality and disability. PMID- 1792531 TI - Prevalence and incidence rates of diseases and work ability in different work categories of municipal occupations. AB - The purpose of this study was to determine the relationship between the health status and work ability of individuals representing a variety of municipal occupations. In both 1981 and 1985, 4255 employees answered a postal questionnaire. The subjects, aged 44-58 years in 1981, were grouped into physical, mental, or mixed physical and mental job categories. Occupational groups with a high disease prevalence in 1981 had a high, and occupational groups with a low disease prevalence in 1981 a low, disease incidence during the follow up period. In 1985 every second subject suffered from a musculoskeletal disease. The highest disease prevalence was observed for physically demanding occupations and for men in work with mixed physical and mental demands. Female auxiliary workers, domestic helpers and cooks, and also male installation and transport workers, had the poorest health. The men and women in mental work had the best health and work ability. PMID- 1792532 TI - Background and objectives of the Finnish research project on aging workers in municipal occupations. AB - In Finland, the proportion of 45- to 64-year-old people in the work force is expected to increase from 31.1 to 40.1% between 1980 and 2000. A multidisciplinary study was carried out to test the factors of work, health, work ability, functional capacity, and perceived strain as criteria for determining new concepts for retirement age. The first phase of the project comprised cross sectional studies in which the age of the 6257 working subjects ranged from 45 to 58 years. The second phase covered a four-year follow-up of these same subjects. The main results of the 15 various studies are given in separate articles. Recommendations for improving the work and promoting the work ability of the aging worker have been made on the basis of the findings of the project. PMID- 1792533 TI - The aging worker. PMID- 1792534 TI - Effect of retirement on health and work ability among municipal employees. AB - A questionnaire was sent to 6257 active employees, mean age 50.5 years, in 1981, and again in 1985, when 4255 of the workers were still actively working, 402 had retired because of age, and 468 had retired for medical reasons. After retirement, regardless of reason or previous work content, the prevalence of musculoskeletal diseases changed little among the women but increased markedly among the men retired from mental work. Among the men retired from mental work because of age, the prevalence of cardiovascular diseases increased after retirement. After disability pensioning the prevalence of cardiovascular diseases increased for both the men and the women. The prevalence of poor work ability increased in all the work categories irrespective of the type of retirement. Work ability did not improve after old-age pensioning, but health status was improved among the men and women in some occupational groups. Therefore light, part-time work should not be excluded for retired people. PMID- 1792535 TI - Symptoms of mental and physical stress in different categories of municipal work. AB - The aim of this study was to clarify the stability of differences in reactions to work stress in different municipal occupations. The subjects were 1799 men and 2456 women in the same occupation in 1981 and 1985. At the time of the follow-up in 1985 their age range was 48-62 years. On the basis of the work content, they were clustered into 13 profile groups. Long-term cardiorespiratory, musculoskeletal, and psychological symptoms and symptoms indicating immediate physical stress at work were used to measure stress reaction. The order of the profile groups with respect to harmful stress reactions was the same in both years. According to the first and also the follow-up questionnaire, harmful stress reactions were the most common in physical work and in some profile groups with mixed physical and mental work demands. Although these differences were the greatest for the reactions to physical stress, they were also seen for mental stress. PMID- 1792536 TI - Work-related stress symptoms of aging employees in municipal occupations. AB - The objective of the study was to investigate the relationship between stress symptoms and work stressors among aging employees in municipal occupations. The subjects were 1799 men and 2456 women aged 48-62 years and representing 40 different occupations. Stress reactions were identified on the basis of long-term cardiorespiratory, musculoskeletal, and psychological symptoms. Work stressors were described by means of physical and mental work demands. Two factors describing the possibilities for regulating one's own work load were used as indicators for the adjustment of work according to individual capacities. The effect of work stressors on cardiovascular, musculoskeletal, and psychological symptoms was studied in separate analyses, controlling for the relevant disease group. Both chronic diseases and work stressors were related to the occurrence of symptoms. However, stress identified on the basis of symptoms was not only a phenomenon determined by health status. Work stressors and possibilities for regulating one's own work load were systematically related to symptom level. PMID- 1792537 TI - Work load and individual factors affecting work disability among aging municipal employees. AB - A cohort of 6165 municipal workers 44 to 58 years of age was followed during 1981 1985. The most impairing work loads were poor work postures and poor physical climate, whereas good possibilities for development at work prevented work disability. Aging particularly increased the incidence of work disability, whereas physical exercise maintained work ability. Among workers who suffered from any cardiovascular disease, a low level of muscular work and a high level of leisure-time physical exercise decreased work disability. Compared with the work ability of active workers, work disability was more linked to individual than to work load factors. PMID- 1792538 TI - Changes in maximal cardiorespiratory capacity among aging municipal employees. AB - Before and after a four-year follow-up, maximal oxygen consumption (VO2max) was determined for 67 municipal employees (initial age about 51 years). The VO2max (ml.kg-1) decreased 6% among the women and increased 8% among the men, the greatest and smallest change occurring for employees doing mental and physical work, respectively. The men's increase was associated with an increase in leisure time physical activity. Work content was not associated with the level of VO2max for either gender. After the four years the women's absolute VO2max was about 66% of the men's. There were marked changes in VO2max at the individual level, the most marked decreases being associated with the use of medication in some cases. After the four years the women's VO2max of 63% was insufficient according to current recommendations. Therefore physically demanding jobs are not generally recommended for older women. PMID- 1792539 TI - [Caries prophylaxis--a central matter of concern]. PMID- 1792540 TI - [The in vitro testing of the sensitivity of human cryopreserved pulp cells]. AB - The purpose of this in vitro study was to evaluate the sensibility of frozen human pulp cells, in order to examine the cytotoxicity of dental products. The cell cultures and the biological assessments, using still incomplete human premolars and pulp germs, were achieved according to a standardized method. The sensibility of frozen cells was assessed by comparison of cell reactions before and after 1, 3 and 6 months of congelation, for two dental products called Aquacem and Pulpdent, the cytotoxicity and biocompatibility of which were further confirmed. The behaviour of cells with and without congelation was microscopically evaluated, the growth and morphology of cells were assessed after 7, 14, 21 and 28 days. The comparison of the results showed a similar behaviour between cells with and without congelation, except for few cell alterations in the form of granula which occurred during a short period, probably due to the congelation process. This cell liability offers the opportunity to elaborate a bank of cells available on demand for preliminary cytotoxicity assessments. PMID- 1792541 TI - [The oral health of an East German population of a large city. The basic research of the Dresden prevention study on 2500 16- to 35-year-olds]. AB - Oral health behaviour, oral health state, dental care effectiveness and preventive-curative care needs were subject of a basic examination using 2500 randomly selected patients aged 16-35 years in 6 Dresden state health services in 1988. The spectrum of methods included extended anamnesis, plaque index according to Silness & Loe, DMF/T index and DMF/S index according to WHO criteria without X ray diagnostics, GPM/T index, CPITN, as well as assessment of gingival recessions, acute and chronic trauma and the prosthetic status. Considering a mean DMF/T of 9.88, DMF/S of 17.93 and GPM/T of 11.9 in patients being 16-19 years and a DMF/T of 15.21, DMF/S of 40.94 and GPM/T of 12.9 in patients being 30 35 years, as well as the insufficient dental care, the majority of patients was in need of preventive care measures. Filling therapy and gingivitis treatment were necessary from the curative point of view. Early chronic tooth surface loss required early preventive-curative intervention. The key for an effective care in the early and middle adult age is a functioning individual concept with preventive emphasis which should include a basic and a risk strategy. PMID- 1792542 TI - [Caries prevalence and gingival inflammation in recruits in 1985: the influence of prevention]. AB - A total of 753 conscripts (age 20) examined in 1985 showed on average 8.6 DMF teeth upon clinical examination. When subjected to a standardized examination supplemented by bite-wing radiographs of the buccal segment, 0.5 MT, 4.2 DT and 5.4 FT equivalent to a DMFT of 10.1 were found. Three per cent of the subjects were caries-free (DFT = 0). Caries experience in anterior teeth DFS greater than 0) was diagnosed in 21% of the recruits but 85% of them had suffered dentinal caries or showed fillings on the bite-wing radiographs (DFS greater than 0). Among the total of 18.8 DF sites, 5 were D sites, and 83% of the D sites were dentinal radiolucencies in molars and premolars. An annual increase of 1.55 DFS was estimated for the age interval 15-20 years. Recruits from communities with preventive programs at school had 17.0 DFS (9.1 DMFT) while those from communities lacking organized prevention at school had 21.2 (11.3 DMFT). The recruits from the Canton of Vaud, who had benefited from a program of salt fluoridation, comprising salt for domestic use and for bakeries and restaurants, from 1970 to 1985, showed only 11.6 DFS (7.1 DMFT). There was less gingival bleeding and calculus in recruits from the Canton of Zurich where supervised toothbrushing has been carried out 4 to 6 times a year since 1963/64 at least through school-grades 1-6 than in the remaining recruits. PMID- 1792543 TI - Use of BANA hydrolysis as a diagnostic test for identifying periodontopathic environments. AB - The purpose of the present study was to evaluate the diagnostic value of the BANA hydrolysis test using the Perio Scan kit to identify subgingival periodontopathogens (P. gingivalis, T. denticola and B. forsythus) and to determine whether the BANA reaction reflected the presence or absence of clinical signs for periodontitis. 10 patients with periodontitis (AP), 10 healthy subjects (HS) and 10 subjects with treated periodontitis under supportive therapy (MP) participated in the study. Subgingival plaque was sampled and the presence or absence of the above mentioned bacteria assessed with BANA reagent cards (Perio Scan). Additionally, all samples were analyzed for the presence or absence of P. gingivalis and/or T. denticola using an ELISA. The BANA test yielded a high specificity (86.7%) and a high sensitivity (77.0%) for the presence of periodontopathogens when compared with the ELISA results as reference parameter. The diagnostic features of the BANA test result compared to the clinical parameters yielded a high degree of accuracy for overall clinical judgement and for probing depth (PD 5 mm), but to a lesser degree, for bleeding on probing. PMID- 1792544 TI - [Resorbable membranes (I). Periodontal tissue regeneration by the use of resorbable membranes--the clinical aspects]. PMID- 1792545 TI - [Oral rehabilitation following an erosive situation. The oral rehabilitation of an erosive situation with galvanized ceramic crowns and ceramic veneers]. PMID- 1792546 TI - [Tooth-colored lateral dental restorations. Tooth-colored lateral dental restorations--the landmarks and clinical concept]. PMID- 1792547 TI - [Facts for the discussion of the questions of European integration]. PMID- 1792548 TI - [Nondiscrimination comes before standardization]. PMID- 1792549 TI - [The principles for a European health system]. PMID- 1792550 TI - [Caries prophylaxis with fluorides: the current recommendations]. PMID- 1792551 TI - [The announcements of the Intercantonal Control Office for Drugs concerning BSE and human drugs]. PMID- 1792552 TI - [The physician-patient relation and patient rights]. PMID- 1792553 TI - The activation of mammalian sperm. AB - Our understanding of the cascade of events that result in the activation or capacitation of sperm which thereby acquire the ability to effect fertilization has developed considerably in recent years. Capacitation of mammalian sperm in vivo is a complex, dynamic process which may be mimicked in vitro by a number of different methods. A variety of components have been implicated in capacitation including the alteration of membrane cholesterol/phospholipid ratios, removal of seminal plasma-coating proteins and cell-surface components, and alterations of membrane potential. All these events appear to be implicated in an eventual change in membrane permeability to calcium ions. The subsequent rise in intracellular calcium precipitates the multiple membrane fusion event known as the acrosome reaction. The calcium-dependent enzyme phospholipase A2 has been implicated in this event. PMID- 1792554 TI - Mental illness in a cross-national perspective. Results from a Brazilian and a German community survey among the elderly. AB - Findings for unselected samples for the elderly in two urban populations - one in Mannheim, Germany (n = 418) and the other in Sao Paulo, Brazil (n = 111) - are compared and contrasted. Each study was restricted to persons aged over 65 years living in private households, and each employed a single-stage method of psychiatric case-identification, based on the Clinical Interview Schedule (CIS). Apart from marked differences in educational standards and proportions living alone the two samples were broadly similar in their recorded socio-demographic characteristics. Comparison revealed no significant difference in total prevalence, though there was a trend towards a higher case-frequency in Sao Paulo (29.7%) than in Mannheim (23.3%). The clinical-item profiles for the two samples indicated a higher rate of symptom reporting in Sao Paulo, whereas the Mannheim sample had higher mean scores for a number of psychiatric abnormalities observed at interview. Separate cluster analyses carried out on the two data sets divided the samples into four pairs of sub-groups with similar clinical profiles, which were designated respectively as 'organic', 'depressive', 'neurotic' and 'normal'. While a more careful standardization of method would probably reduce the observed disparities between the samples, some of these are thought to be real and to relate to sociocultural differences, as well as to the greater stresses of daily life in Sao Paulo. PMID- 1792555 TI - Qualitative differences in psychiatric symptoms between high risk groups assessed on a screening test (GHQ-30). AB - Scores on five subscales derived from the GHQ-30 have been examined in various groups at risk for psychiatric disorder, to determine whether different patterns of symptoms are found. The subscales are based on a factor analysis of a population sample of over 6,000 adults (Huppert et al. 1989) which identified five robust factors corresponding to symptoms of anxiety, feelings of incompetence, depression, difficulty in coping and social dysfunction. Previous studies have identified certain groups of people who are vulnerable to mental illness and are therefore likely to obtain a high score on the GHQ. These include unemployed men, single women with dependent children, and elderly people in poor health. The results show marked differences in symptom patterns among these three at-risk groups. For example, while scores on anxiety and depression subscales were significantly raised in most at-risk groups, young unemployed men did not show significant anxiety whereas elderly men in poor health did not show significant depressive symptoms. However both these groups showed difficulty in coping, unlike older unemployed men or elderly women in poor health. Single women with dependent children reported the highest rate of psychiatric symptoms, particularly anxiety and depression, but had difficulty in coping only if they were also employed. These findings suggest that this method of analysing data from the GHQ-30 has potential value in yielding qualitative as well as quantitative information about psychiatric symptoms. PMID- 1792556 TI - Health care occupations and suicide in Sweden 1961-1985. AB - The sex and age standardized incidence rates of suicide and undetermined deaths in Sweden were described for physicians, dentists, registered nurses, attendants in psychiatric care and auxiliary nurses for the five years following each of the censuses, 1960, 1970, 1975 and 1980. Amongst men all the occupations apart from registered nurses show increasing suicide rates from 1960, with significantly higher suicide rates during the seventies than the total male working population. A radical fall in the number of suicides amongst physicians, dentists and registered nurses took place in the period 1981-85, whilst attendants in psychiatric care and auxiliary nurses show a continuing significant excess in suicide rate. Among female physicians, there was an extremely high suicide rate in 1960, followed by a distinct fall until the period 1981-85 although the rates were significantly elevated in all periods. Female dentists show consistently high suicide rates during the seventies and eighties. Registered nurses show a reduction from a significantly high rate in the period 1961-65 and the seventies to a level equal to the total female working population. Female attendants in psychiatric care and auxiliary nurses have low rates in almost all periods. These suicide trends are compared with an increase in the proportion of women in gainful employment as well as the radical alteration in family patterns in Sweden during the seventies. Further research should emphasize the change in social roles, both in the labour market and in the family. PMID- 1792557 TI - Observer bias in the assessment of anxiety and depression. AB - Two studies are described here. In the first, an attempt is made to examine the relationship between the complaints of anxiety and depression using the results of a survey of a dermatology clinic. The Hospital Anxiety and Depression scale (HAD) and Clinical Interview Schedule (CIS) were both used in 117 unselected clinic attenders. The results showed that the self-report scales (HAD and first section of CIS) showed a closer relationship between anxiety and depression than the second section of the CIS that requires clinical judgement. In the second study, an attempt was made to distinguish between two possible explanations for this phenomenon; that psychiatrists use the constructs of anxiety and depression more carefully than patients, or alternatively that psychiatrists show an observer bias. A sample of psychiatrists were asked to complete symptom profiles for anxiety and depression; both for an imaginary 'patient' and for their own emotions, allowing psychiatrists' beliefs concerning the relationship between anxiety and depression to be studied. The results indicated that the psychiatrists thought there was a negative correlation between anxiety and depression in patients in contrast to the consistent empirical finding that anxiety and depression are positively correlated. Psychiatrists also thought anxiety and depression were less closely related in patients than in themselves. It is likely that psychiatric assessments of anxiety and depression requiring clinical judgement on the part of the interviewer are subject to observer bias. It is argued that self-report measures of psychiatric symptoms will provide more convincing evidence to resolve diagnostic disputes. PMID- 1792558 TI - Occupational characteristics and the occurrence of psychotic disorders. AB - This study was undertaken to investigate whether individuals working under various occupational stressors are at increased risk of three forms of psychotic conditions. This paper presents prospective analyses of antecedent occupational stressors in psychotic conditions with interview data from a community sample in five US metropolitan areas--the NIMH Epidemiologic Catchment Area Program. Three non-overlapping conditions were defined using DSM-III definitions as assessed by the Diagnostic Interview Schedule (DIS): (1) DSM-III schizophrenia criterion A; (2) full schizophrenia; and (3) criterion A and affective episode. Artistic (RR = 3.32, 95% CI 1.08-10.14) and construction trades occupations (RR = 2.58, 95% CI 1.15-5.77), "noisome working conditions" occupations (RR = 1.20, 95% CI 0.99 1.47) and physically demanding occupations (RR = 1.39, 95% CI 1.05-1.72) were associated with increased risk of developing DIS/DSM-III schizophrenia criterion A, even after adjustment for sociodemographic and psychopathology factors including alcohol and marijuana use. Psychologically demanding occupations (RR = 0.85, 95% CI 0.75-0.95) were associated with decreased risk of developing DIS/DSM III schizophrenia. This finding is supported by results from experimental studies on the arousability of pre-schizophrenics. Finally, teachers (RR = 11.35, 95% CI 2.56-50.38), sales occupations (RR = 4.16, 95% CI 1.00-21.30) and occupations characterized by low control over work were associated with increased risk of developing DIS criterion A and affective episode, resembling previous findings on occupational stressors and depression. Overall, our results replicate and extend previous work on occupational stressors and psychotic conditions through use of prospective data, several psychotic conditions, multiple assessment of occupational stressors and adjustment for potential confounders. PMID- 1792559 TI - Assessing the needs for care of non-psychotic patients. A trial with a new standardized procedure. AB - Recent psychiatric epidemiological studies using standardized interviews in the community have yielded high rates of non-psychotic disorders. The implications for service provision in terms of treatment and planning remain unclear. No methodology exists to link the individual needs for care and services to problems associated with disorders. The Needs for Care Assessment Schedule (NFCAS) is a relatively new procedure for assessing the needs of long-term mentally ill patients, mostly psychotic and attending psychiatric services. We report here a trial application of a modified version of the NFCAS on a sample of 39 non psychotic patients, most of whom were attending psychiatric outpatient services. The results show that the modified procedure requires further refinement to achieve acceptability and reliability. Some improvements are suggested for refining items and for the collation of others. The difficulties encountered underline the key issues in developing such technology: specifying the threshold for recognizing the problems, detailing the interventions considered appropriate, defining the model of care and specifying the composition of the research team. PMID- 1792560 TI - Distributions of hallucinations in the population. AB - Hallucinations are often manifestations of severe psychiatric conditions seen clinically. However, little is known about the distribution of incident hallucinations in the community, nor whether there has been a change over the past century. Data from the NIMH Epidemiologic Catchment Area Program is used here to provide descriptive information on the community distribution, and data from the Sidgewick study from a century earlier provides comparative information. In the ECA data, the incidence of visual hallucinations was slightly higher in males (about 20 per 1000 per year) than females (about 13 per 1000 per year) across the age span from 18 to 80 years old, with a subsequent increase in the rate for females (up to about 40 per 1000 per year) after age 80. For auditory hallucinations there was an age 25-30 peak in males with a trough for females, and a later age 40-50 peak for females. Overall, there were substantial gender differences, and the effect of aging to increase the incidence of hallucinations was the most consistent and prominent. The Sidgewick study showed a much higher proportion of visual hallucinations than the ECA program. This might be due to factors affecting brain function as well as social and psychological changes over time, although methodological weaknesses in both studies might also be responsible. PMID- 1792561 TI - [Pathologic, morphologic and anthropologic characteristics of Avarian teeth and jaws from graves in Becej]. AB - During the reconstruction of the water pipe lines, in Pionirska street, at Bechej in 1989, a part of a large graveyard was uncovered. Human remains were found in graves, below the level of the underground water, so that the most of the human skeletons were either completely destroyed, or partly preserved. A few graves were damaged during excavations in previous ears and some of the graves were robbed also at an earlier period. Paleopathological and anthropological investigation carried out at the Department of Anatomy, Faculty of Medicine in Novi Sad, revealed that these remains belong to an Avarian population which had similar epigenetic and anthropometric characteristics as the Avarian population found at the well known site at Kiskoros Vagohid, in Hungary, precisely the skeleton from the grave No. XXXV. Study of the teeth and jaws complete these results. At six mandibles, which belong to the mature skeletons, was found narrowness in the frontal region of the mandibular alveolar arch was recorded. Degree of narrowness of the frontal mandibular dental arch, deficient in space at mandibles was different, and varied from 2 mm to 8.5 mm, or 3 to 24.38%, which is necessary to set the teeth in the correct line in a mandible. PMID- 1792562 TI - [Complications of stapedectomy involving the middle ear structures]. AB - On the basis of personal experience and data from literature, the authors enumerate possible complications of the middle-ear structures during stapedectomy: perforation of the eardrum, disturbed function of the chorda tympani, peripheric paralysis of the facial nerve, incus luxation, haematotympanon, inflammatory complications, late improvement of the hearing, reoperative granuloma, cholesteatoma and sudden damage of the hearing. PMID- 1792563 TI - [The effect of rehabilitation procedures on pulmonary function in patients with chronic obstructive bronchitis]. AB - Modern treatment of patients with chronic obstructive bronchitis consists of a parallel and simultaneous carrying out of medicinal treatment and appropriate rehabilitation. The authors studied the effect of rehabilitation on the pulmonary function in 31 patients (rehabilitation group A-1) with chronic obstructive bronchitis within three weeks (position drainage on the oscillation table and vibro-message for 15-30 min. after aerosol-therapy, and respiratory diaphragmatic exercises). The control group was composed of 30 patients (medical group A-2) with chronic obstructive bronchitis treated with medicaments only. On the basis of the results before and after the treatment, the authors established that only group A-1 patients showed, at the end of treatment, a statistically greater forsed expiratory volume in the first second, reduced thoracic gas volume, reduced specific resistance and increased lung conduction in airways. PMID- 1792565 TI - [Thrombophlebitis of the sigmoid sinus and otogenic sepsis]. AB - Lateral sinus trombophlebitis and sepsis otogenes are rare complications of chronic osteitic otitis, but often resulting in delayed recognition and high mortality rate. During ten years in the period 1979-1989, we cured 5 patients with lateral sinus pathology and sepsis otogenes. All patients were successfully cured by surgical and conservative treatment. The incidence of these complications in our results confirm the events in recent literature that it is rare but complex condition with widespread clinical features which may range from subtle signs to gross toxaemia. PMID- 1792564 TI - [Development of resistance to aminoglycoside drugs in hospital strains of Staphylococcus aureus]. AB - The purpose of this study is to determine the development of the resistance of hospital strains of Staphylococcus aureus to four aminoglycosides. Study observation was conducted in three periods with five years elapsed between each of them. The first pre-amikacin period (211 strains) lasted for 16 months. The second and the third post-amikacin periods lasted for 8 (53 strains) and 18 (230 strains) months, respectively. A total of 494 strains od S. aureus from 458 patients were examined. In the first period 40% strains were resistant to gentamicin, tobramycin and kanamycin. The percentage was increased to 90% in the second and the third period. No statistically significant difference among gentamicin, tobramicin and kanamicin in any of three periods was noticed. However, the frequency of the strains resistant to amikacin was increased from 36% in the second period to over 50% in the third. Nevertheless, statistically significant smaller number of strains was to be resistant to amikacin in respect to resistance to gentamicin, tobramicin and kanamicin (Fb = 54,84; p less than 0.01). The degree of resistance during the second and third period indicates a significant increase of MIC for gentamicin and amikacin (p less than 0.01). During this work phenotype exchange of strains took place. Hence, the phenotype TK from the first period was replaced with GTK during the second and with GKTA in the third. PMID- 1792566 TI - [Repeat argon laser trabeculoplasty in the treatment of primary open-angle glaucoma]. AB - Twenty-one eyes of eighteen patients with clinically uncontrolled open angle glaucoma, 3 to 49 months after the initial laser treatment underwent repeat argon laser trabeculoplasty. Retreatment was successful in eleven eyes (52%). Ten eyes (48%) has marked increases in intraocular pressure, necessitating urgent filtering surgery. Repeat argon laser trabeculoplasty was effective for these patients who show a prolonged response to their initial treatment. PMID- 1792567 TI - [Disorders of heart rhythm in patients with mitral valve prolapse detected by continuous electrocardiography]. AB - Prolapse of the mitral valve is a frequent occurrence. It is usually benign. However, because of frequent arrhythmias that can provoce sudden death, its detection and treatment are of great importance. In 20 patients with prolapse of the mitral valve the authors detected arrhythmias on a 24-hour electrocardiogram. The results were as follows: ventricular arrhythmias in 50% of patients; auricular arrhythmias in 50% of cases; atrioventricular and sinoatrial block in 5% of subjects, and block of the left bundle-branch in 2% of patients. PMID- 1792568 TI - [Postmenopausal osteoporosis--definition, pathogenesis, prevention and therapy]. AB - Osteoporosis represents one of the major health and socioeconomic problems of the modern society. Although numerous risk factors have been identified in the last decade, the pathogenesis of the disorder has not been elucidated yet. However, recent advances in the understanding of the biology of bone as well as the possibility to measure bone mass from the basis for better understanding of the of the pathogenesis of the disorder. In this review article the author discusses current hypotheses of the pathogenesis of osteoporosis with particular view to the role of estrogen deficiency, the role of calcitonin and possible involvement of other hormones and local factors. Histomorphometric studies have shown that osteroporosis is heterogenecus disorder which might explain different results obtained with different therapeutic approaches. It is well accepted that prevention of osteoporosis is more successful and therefore more important than treatment once the bone loss has occurred. In this review the author discusses primary role of estrogen replacement in the prevention of osteoporosis as well as the results of either preventive or therapeutic trials with different medications such as calcium, calcitonin, sodium fluoride and biphosphonates. PMID- 1792569 TI - [Rheumatic fever in the 80s]. AB - Two contradictory changes related to rheumatic fever existed in the 80's. A constant, almost dramatic fall of rheumatic fever incidence occurred in the second half of the 80's. This fact was explained by improvement of living conditions and way of life, as well as by a developed health service. But, unexpectedly, a sudden rise of rheumatic fever incidence occurred in many states of the United States of America in that period. The medical experts were reminded that similar danger might also be expected in other countries. This increase of rheumatic fever incidence was followed by severe forms of the disease. In the 80's intensive epidemiologic, microbiologic and molecular researches of the beta haemolytic streptococcus A and parallel genetic investigations of the population with rheumatic fever, were undertaken. The aim of these studies was to discover the rheumatogenic factor in the streptococcus and to differentiate it from the immunogenic one, as well as to detect the genetic factor in the sick people. In this way these findings would be the best contribution to the knowledge of the pathogenesis of rheumatic fever and to a more efficacious protection (vaccination). PMID- 1792570 TI - [Colonic sphincters--Hirsch's sphincter]. AB - Anatomic and physiological sphincters of the colon are localized narrowness of the colon with adequate name. These sphincters appear due to the thickening of longitudinal and circular muscle fibers in the wall of colon or due to the reflex irritation of the autonomous nervous system which innervates the colon. If they appear isolated, their radiographs look similar to those of an organic stenose of the colon. This leads to a false diagnosis and the patient has to undergo an operation. It is not so rare to find the sphincter of the colon instead of a malignant process during the operation. The authors present a patient with Hirch's sphincter of the colon addressed to their institution with the diagnosis: Tucoli ascendentis based on irrigoscopy and irrigography previously performed in another institution. On repeated irrigoscopy and irrigography with double contrast in hopotonia with Glucagon the ascendent part was clearly enlarged with normal wall contours and mucous pattern. The patient had been discharged with the diagnosis of anatomic Hirsch's sphincter and she is in quite good condition. PMID- 1792571 TI - [A patient with chronic pulmonary disease and histologically proven alpha 1 antitrypsin deficiency]. AB - The author depicted a patient with chronic pulmonary disease associated with alpha-1-antitrypsin deficiency. The patient had suffered for a long time from chronic pulmonary disease, clinically diagnosed as bronchial asthma and he suddenly died with signs of chronic respiratory insufficiency. The basic pathological change in the lungs was chronic panacinar emphysema, with chronic inflammation, bronchiectasis and fibrosis. Numerous eosinophilic periodic acid Schiff stain-positive globules resistant to diastase digestion, most probably alpha-1-antitrypsin, were found in his liver, which was otherwise without special changes. The author concluded that among patients with chronic pulmonary diseases, alpha-1-antitrypsin deficiency should be taken into account. This can quite easily be demonstrated in liver biopsy specimens by the characteristics globules in the hepatocytes. PMID- 1792572 TI - [Transplantation of nigral and adrenal tissue into the striatum in rats--an experimental model for the surgical treatment of Parkinson disease]. AB - Transplantation of fetal nigral tissue, fetal and adult adrenal tissue into the dorsal segment of caudate nucleus was performed in 28 rats (wistar). Ventral mesencephalon of fetuses aged 16-17 weeks was used as a nigral graft. Adrenal medulla was taken from fetuses aged 17-20 weeks and from adult rats. In 12 rats denervation of striatum was previously performed. In six of them the lesion was made by mechanical cut of nigrostriatal pathway and in other six by 6-OH DA injection into ventral mesencephalon, according to previously established coordinates. Tissue pieces of 1 mm3 were placed in previously prepared cavity trough the cortex and corpus callosum into the dorsal surface of the caudate nucleus. In two rats transplantation was performed 4 weeks after preparing the cavity. By determining the level of DA and NA 2-3 weeks after transplantation the authors found that the graft substitutes a deficit of these monoamines in this period. In all cases with denervated striatum, the reduction of motor disorders occurred immediately after transplantation. Survival of intracaudate fetal cell grafts was noted in 23%, as well as the fatal and adult adrenal medulla grafts in 38,9% of biochemically studied cases. PMID- 1792573 TI - [Iatrogenic surgical injuries of the peripheral nerves]. AB - Iatrogenic nerve injuries in operative area are undesirable but relatively common complications in relation to the total number of nerve injuries. These injuries are mostly caused by objective factors, especially by the nature of surgical lesion. Unfortunately, the role of surgeon is not irrelevant in large number of cases. The authors analyze a series of 39 iatrogenic surgical nerve injuries and the results of 30 repaired cases. PMID- 1792574 TI - [Drug therapy of vesico-ureteral reflux in children]. AB - The results of medical management of primary vesicoureteric refluc in 138 children aged 3 months to 15 years are presented. All children were kept on long term, low-dose continuous chemoprophylaxis of urinary tract infection. During the 2-6 years follow-up period serial urine cultures, interval radiographic revaluation, renal function tests and blood pressure measurements were performed. Refluc disappeared spontaneously in 91 patients (66%), persisted in 9.4% and was later on surgically corrected in 20% of children. The refluc grade at presentation was the most important factor affecting the outcome: the refluc disappeared from 72% of affected ureters with grade I and II, and from 28% of ureters with grade III and IV. The presence of renal scaring and recurrence of urinary tract infection during the chemophylaxis did not influence the percentage of cured patients. Nevertheless, the mean duration of refluc from diagnosis to its spontaneous resolution was significantly longer in children with renal scars and urinary tract infections compared with its duration in children who had neither scars, nor further infections. Renal scarring progressed in 2.8% patients. Chronic renal failure developed, in spite of spontaneous resolution of refluc, in only one child with hypertension and bilateral renal scars at presentation. It is concluded that medical treatment of vesicoureteric refluc in most of the children is successful and in regard of preserving renal function stage. PMID- 1792575 TI - [Modern aspects of treatment of medulloblastomas/primitive neuroectodermal tumors of the posterior cranial fossa in children]. AB - The authors present 34 medulloblastoma/primitive neuroectodermal tumours of the posterior fossa in children operated during the last ten years (1979-1989). Total removal of tumours has been performed in 13, and maximal-subtotal resection in 19 patients. Only four tumours were classified as small (group T1-T2). Partial reduction and biopsy were possible in four cases. The average period from surgery to the beginning of radio-oncologic treatment was 31 days. Radio- and chemotherapy were applied according to international standards. Permanent cerebrospinal fluid derivation preceded surgery in 9 patients (VA shunt in 6 and VP in 3) and after surgery of the posterior fossa in four children. Early postsurgical mortality rate, related to the first five years of this study, was 5.6%. Seven children (20.6%) survived from five to ten years after operation. The authors are advocating for standardization of diagnostical and surgical procedures, and for unification of postoperative control with intention to obtain longer duration of survival of these seriously sick children. PMID- 1792576 TI - [Comparative overview of the nutritional status of patients on hemodialysis and peritoneal dialysis]. AB - Malnutrition is often seen in patients on dialysis. Only few methods could be used in evaluation of nutritional state because of metabolic disorders which are present in patients with uraemia. In this article we evaluated nutritional condition of 50 patients which were divided in three groups according to the type of dialysis: I group--24 patients treated with haemodialysis during 6-42 months; II group--12 patients treated with intermittent peritoneal dialysis during 8-36 months, and III group--14 patients treated with continuous ambulatory peritoneal dialysis during 6-34 months. Nutritional state was evaluated with anthropometric and biochemical indicators, such as body weight, triceps skin-fold thickness, mid arm muscle circumference, serum albumin, transferrin, C3, C4. The results have shown that signs of malnutrition were markedly present in the first year of dialysis in 33 (66%) patients. There was no significant difference in nutritional state between the three observed groups. PMID- 1792577 TI - [Relation between body mass, body height and the blood picture to vital capacity in students exposed to air pollution]. AB - The authors examined the relationship between body mass, body height, haemogram and vital capacity in two groups of pupils exposed to long aeropollution. The first group consisted of children with low vital capacity. In the second group the spirometric test was normal. The authors found differences between these two groups in relation to body mass and hemoglobin concentration. PMID- 1792578 TI - [The significance of objective functional classification in the evaluation of physical fitness in patients after myocardial infarction]. AB - Coronary disease decreases physical fitness of patients. This is due to decreased inotropic and chronotropic cardiac reserves. The study concerned 400 male patients, aged 40-50 years, one year after infarction of the myocardium and appropriate rehabilitation. The aim of the investigation was to define the importance of subjective and objective criteria for the evaluation of physical fitness of patients. On the basis of results of physical testing the patients were divided into two groups: group A (n = 200), patients with ischaemic ECG changes, and group B (n = 200), patients without ischaemic ECG changes. The results of the trail revealed the necessity of measuring the maximal oxygen demand the index of functional aerobic capacity, the maximal heart-rate frequency, and the index of chronotropic heart-rate. PMID- 1792579 TI - [Microvascular disease in diabetics--discrimination analysis of risk factors]. AB - The study concerned 206 diabetic patients, aged 35-54 years, from the urban Kragujevac area. Of this number 40.3 per cent had macrovascular disease, including vascular heart disease (34.9%), diseased leg blood vessels (12.1%) and cerebral stroke (2.4%). According to the results of discriminative analysis of potential risk factors (age, sex, body weight index, cigarette smoking, systolic and diastolic blood pressure, glycemia, triglycerides, lipoproteins, total cholesterol, HDL and LDL cholesterol, onset and duration of diabetes, family history) diabetic patients with macrovascular disease and patients with vascular heart disease predominated in female population with early onset of diabetes and high level of diastolic blood pressure. PMID- 1792580 TI - [Volunteer blood donors--relation between gender and motivation]. AB - The study included 1,825 persons, aged from 18 to 65 years. A representative sample was formed of 1,325 persons who donated blood for the first time, and of 500 persons who donated blood five or more times till the moment of investigation. Among blood donors in the Republic of Serbia, regardless the number of blood donations, the percentage of female donors is significantly lower compared to the percentage of male blood donors. The first time donor population consisted of 22.26% of female and 77.74% of male blood donors. The multiple blood donor population was composed of 15.8% of female and 84.2% of male blood donors. Motives for blood donation were studied in 500 persons who donated blood five or more times. The following motives were recorded: a) altruism in 85% of multiple donors; b) the other motives (habit, superiority and/or inferiority complex, self punishment and benefit) were recorded in 8% of them; c) in 7% of donors the primary motive for blood donation could not be determined. PMID- 1792581 TI - [Correlation between the stress test electrocardiogram and Holter monitoring in asymptomatic myocardial ischemia]. AB - The author separated a group of 22 patients with ischaemic ST depression revealed by Holter-monitoring without symptoms, and compared it with the results obtained by ergonometry testing. Angina pectoris, a key symptom on which were based many epidemiological and clinical studies, could not be considered as a reliable criterion for the evaluation of patients with ischaemic heart disorder. Non invasive diagnostic methods (ergometry testing and Holter-monitoring) used by the author in this study were particularly significant in the establishment of early diagnostic of cardiac ischaemic disorder and detection of symptomatic and asymptomatic episodes of myocardial ischaemia. Asymptomatic myocardial ischaemia during ergometry testing and Holter-monitoring has equal importance in surviving of patients as ischaemia followed with angina pectoris. For that reason, early ischaemia are of great importance for patients' fate. PMID- 1792582 TI - [Surgical treatment of destructive diseases of the cornea]. AB - The role of surgery in destructive corneal disease is: to protect cornea; remove the cause of the disease; remove the altered tissue and transplant the healthy one; and to repair ocular surface. This can be achieved by penetrating keratoplasty, lamellar keratoplasty, sclerokeratoplasty, keratectomy, peritomy, conjunctival transplantation or keratoepithelioplasty. Some of the combinations of these surgical techniques in our hands are presented, and the relevant literature is reviewed. PMID- 1792583 TI - [Subjective sensitivity to noise]. AB - It is likely that individual variations in subjectively estimated noise sensitivity influence different social and psychophysiological reactions of people exposed to noise. Subjective noise sensitivity might be a relatively stable personal characteristic. A correlation have been found between high sensitiveness to noise and some medical symptoms (sleep disturbance, nervousness, depression), and worse work performance in noisy environments. An introvert person with neurotic symptoms is more frequently found in people highly sensitive to noise. Testing for subjective sensitivity to noise might be helpful in professional selection and orientation for noisy work-places as well as in housing advising. PMID- 1792584 TI - [Reconstruction of the iris in iridodialysis after a contusion injury of the eye]. AB - Iridodialysis, occurring as a consequence of contusion injury of the eye ball, may initiate certain subjective disturbances (monocular diplopia, esthetic defect) indicating surgery in such cases. There is no uniform opinion as to the time of surgery. The time ranges from two weeks to one year after injury. The surgical technique is a standard one consisting of chamber opening with a corneal sclerar incision at the site of iridodialysis. Our patient had iridodialysis as a consequence of eye ball contusion occupying a half of the base circumference. Microsurgical reconstruction of the iris was performed with an excellent end result. The specificity of this case, for which reason we are presenting it, is the duration of time elapsed from the moment of injury to surgery (14 years). The patient was injured in early childhood and the successful operation was performed when he was 20 years old. The second characteristic is that this was the case of injury and operation of a high myopic eye. PMID- 1792585 TI - [Megacolon congenitum (Hirschsprung's disease) in adults]. AB - Hirschsprung's disease is rare in adults and represents a unique problem in the diagnosis and therapy. The permanent symptoms of the disease are persistent chronic constipation and meteorism. The degree of constipation depends on the length and narrowing of the aganglionary segment, diet and compensatory capacities of the bowel. Already known characteristics of agangliosis (absence of ganglions cells in intramuscular and submucous plexus, changes in nerve fibers and increased cholinesterase activity of the parasympathetic nerve fibers) cause impairment in peristalsis of the aganglionary segment and insufficient relaxation of the internal anal sphincter. The result is a functional refractory constipation. The disease can be diagnosed on the basis of the history, RTG examination, electromanometry and histopathology. In the majority of cases RTG examination is very reliable if performed according to generally accepted criteria. It is important to reveal the narrowed aganglionary area by oblique and profile images during irrigoscopy and irrigography. The treatment is surgical. The preferred operations are those with a combined transabdominal-transanal approach. Such operations are the most successful in management of constipation and maintenance of contingency. The authors present three cases. Three patients were old between 21 and 23 years. Their stools ranged from 10 days to two months (a stool per 10 days to two months). The diagnosis was established for all three patients by RTG examinations and histopathological findings. All bore the operation very successfully. Three various operation techniques were used according to surgeon's choice. PMID- 1792586 TI - Changes in the incomes of age groups, 1984-89. AB - In terms of changes in the incomes of age groups, the 1984-89 period was very different from the periods that immediately preceded it. This summary focuses on changes for aged family units. During the 1984-89 period, the rate of growth of real median income of aged units was substantially lower than in other subperiods since 1967, the first year for which comparable detailed estimates are available. During the 1984-89 period, the ratio of aged to nonaged median incomes fell for 4 consecutive years, after generally rising since about 1970. The relative medians of almost all detailed aged age groups fell at least slightly from 1984 to 1989, after a period of substantial rises. The increases in income for aged units during 1984-89 were higher for high-income units than for low-income units, producing an increase in inequality. The percentage of aged persons who were poor fell slightly from 1984 to 1989, but that percentage remained above the rates for other adult age groups. A relatively high percentage of aged persons had income that was less than 50 percent above the poverty threshold. The increase in the real mean total income of aged units from 1984 to 1989 was the net result of substantial increases in earnings and pension income and a substantial decrease in property income. In contrast, the much larger increase in real mean total income for aged units from 1979 to 1984 was characterized by a large increase in property income, substantial increases in Social Security benefits and pension income, and a small decrease in earnings. PMID- 1792587 TI - Social security implications of a reunified Germany. PMID- 1792588 TI - Violent deaths in the United States: a need to know more. PMID- 1792589 TI - Impact of fraudulent claims on health care costs. AB - The U.S. health care system, considered one of the best in the world for technological sophistication and availability of services, is being seriously threatened by continually escalating costs. Although there are many reasons for this, fraud within the industry accounts for 10 percent of the nation's annual health care bill. By the end of the decade, the fraud factor may cost the industry $160 billion a year. Health insurers and state and government agencies are joining forces to share information and intensify their efforts in the battle against fraud. MetLife's in-house efforts include a specialized unit devoted entirely to the prevention, detection and prosecution of fraud. In 1990 the company's vigilance saved its policyholders over $38 million. PMID- 1792590 TI - Firearm mortality among persons aged 1 to 34. AB - Firearms claim more than 30,000 lives each year in the United States. In 1988 more than half of these deaths were among ages 1-34, with firearms accounting for 15 percent of all deaths in this age group. Total firearm deaths, as well as firearm homicide rates, have been increasing since 1984, taking a disproportionate toll on America's minority youth. The firearm homicide rate among all adolescents aged 15-19 rose 67 percent between 1984 and 1988. Among blacks aged 15-24, the firearm homicide rate was 72.0 per 100,000 during 1986-88 versus 8.1 among white males of this age. Geographic differences also exist, with Texas, California and New York leading in firearm homicides among white males aged 15-24, and Michigan, D.C., and California leading among blacks of this age. PMID- 1792591 TI - 1990 census results. AB - The April 1990 Census found that, for the most part, the major demographic trends of the 1970s continued into the 1980s. The population gain in California, Texas and Florida accounted for more than half of the national increase in the past decade. The rapid growth of these states was mainly attributed to the large influx of persons of Hispanic origin, as well as Asians and Pacific Islanders to California. The government acknowledged that there was an undercount but, nevertheless, decided not to adjust the original April 1990 Census numbers. PMID- 1792592 TI - Charges for substance abuse hospitalization: regional variations, 1990. AB - MetLife 1990 group health insurance costs for a substance abuse hospitalization averaged $7,660. The highest average total charges were reported in Texas and New Mexico, each with costs 30 percent or more above the U.S. average. The lowest average costs (those more than 30 percent below the norm) were reported in Oregon, Iowa, Minnesota and Massachusetts. Physician charges comprised less than 10 percent of the average total charges. Ancillary fees ranged from 6 percent of the hospital portion of the bill in Montana to 41 percent in Texas. PMID- 1792593 TI - [The clinical efficacy and pharmacokinetic characteristics of theopek and theobiolong in bronchial asthma patients]. AB - The pharmacokinetics of theopec (TP) and theobiolong (TB) was studied and compared to theotard and durophylline in 24 bronchial asthma patients. The efficacy of the continuous use of TP and TB was examined in 64 patients. Theophylline (TPh) was absorbed from TP tablets according to the laws of the kinetics of the first order, i. e. one-third of the dose was absorbed rapidly whereas the remaining two-thirds 7.5 times were slowly. The kinetics of TPh absorption from TW was marked by the zero order at a constant rate of 45 mg/h. The volume of distribution, the elimination rate constant, the total clearance, and bioavailability of the drugs under comparison did not differ significantly. During continuous treatment with TP and TB, equiponderant concentrations of TPh were attained by the 4th day, the mean maximum concentration of TPh for TP was 10.6 +/- 1.8, that for TB 9.6 +/- 0.9 micrograms/ml. By the 7th day of the treatment with TP and TB a beneficial clinical effect was reached in 79 and 81% of the patients, respectively, in spite of the fact that there was no well defined correlation with the changes in the volume of forced expiration per second. During TP and TB intake, the side effects common to TPh occurred equally often (in 19 and 23% of cases, respectively), but they were short-lived and disappeared by themselves or after correction of the dosage. As for TP, the side effects were mostly recorded on the part of the gastrointestinal tract whereas TB provoked tachycardia, cardialgia which should be taken into account in cases where the drug is prescribed to patients with concomitant diseases. PMID- 1792594 TI - [The problems, mental disorders and quality of life of rheumatoid arthritis patients]. AB - There were 157 patients with rheumatoid arthritis. Of these, only 65 patients (41.4%) failed to show any factor at the disease onset, which could be estimated as provoking. Psychoemotional factor was most common (in 47.7% of cases). Later the indicated factor played a more important part: only 5.1% of the patients denied or doubted it. In most cases, the distress was caused by family relations. There was an appreciable difference in the intensity of the problems in family and single patients. Affective disorders (neurotic and hypopsychotic depressions) were mostly recorded among mental disorders. The life quality determined in accordance with the self-estimation of the "health" and happiness" noticeably depended both on biological factors (pain intensity, the degree of damage to the bones and joints, and the disease stage) and on social factors--the educational level and social position. The degree of personality merits defined according to the self-estimation of the "mentality" and "character" appeared higher in persons with higher education and in patients suffering from erosive arthritis. The data obtained provide evidence for the necessity of psychosomatic orientation of practicing physicians. PMID- 1792595 TI - [Ankylosing spondylarthritis beginning in childhood]. AB - As many as 200 patients underwent comparative clinicoroentgenological and genetic examinations. The patients suffered from ankylosing spondylarthritis and were followed up for a long time. The patients were distributed into 2 groups depending on the age at which the disease commenced. Group I included 40 persons with the juvenile variant of the disease onset (under 16 years), group II comprised 160 subjects who fell ill at an age over 16 years. It has been shown that the patients who fell ill at an age under 16 years are prone to a more acute disease onset with involvement of the peripheral joints, to a slower and not so pronounced damage to the spine whereas the rate and the degree of injury to the iliosacral joints are practically the same in both the groups. On the contrary, adults are characterized by a gradual onset with earlier clinicoroentgenological signs of injury to the axial skeleton, which leads to rapid derangement of the posture in such patients. PMID- 1792596 TI - [A new Soviet allergen made from bee venom for the specific diagnosis of allergic reactions to bee stings]. AB - Overall 46 patients with allergic reactions to bee stings were examined. As a result of making skin prick, scarification and intracutaneous tests with an allergen from bee venom, allergy to bee stings was revealed in all the 46 patients, whereas only 37 patients responded to an allergen from the bee body. Specific IgE-antibodies using RAST were detected in 29 out of 31 patients. All the 29 patients had positive skin tests with an allergen from bee venom and only 22 with an allergen from the bee body. Specific histamine release was detected in all 13 patients examined by means of the indicated test. 100% coincidence was recorded with the results of intracutaneous tests with an allergen from bee venom. Only 11 out of the 13 patients had positive intracutaneous tests with an allergen from the bee body. Thus, the new Soviet allergen obtained from bee venom is effective in the diagnosis of allergy in response to bee stings. PMID- 1792597 TI - [Medicinal leeches: their medical use in the therapy clinic]. AB - The authors analyze the laboratory and instrumental data obtained before and after single administration of leeches. Demonstrate that the animal's saliva corrects the coagulation properties of the circulating blood; inhibits platelet aggregation; that it may be used for blood letting; possesses hypotensive and anti-sclerotic properties; improves myocardial supply and its contractility. Based on a large clinical material the authors provide evidence for advisability of the use of hirudotherapy in patients suffering from coronary heart disease, essential hypertension, atherosclerosis, chronic cer pulmonale, and circulatory decompensation. PMID- 1792598 TI - [The prognosis of the blood pressure level after an operation to portalize the adrenal blood flow]. AB - A statistical method of multidimensional regression analysis was used to study relations of systolic and diastolic arterial pressure to different parameters of preoperative examination of patients suffering from arterial hypertension and hyperaldosteronism in order to determine possibilities of predicting the surgical treatment effect. It has been established that the best prognostic combination for systolic and diastolic arterial pressure includes 3 parameters: diastolic arterial pressure, basal activity of plasma renin and the zone of the lack of the vascular pattern of the right kidney according to the angiography data. To predict the degree of the hypotensive effect of portalization, 2 types of the prognostic formulas were designed for separate computing of systolic and diastolic pressure. In predicting systolic pressure, the absolute mean-square error was equal to 11.7 mm Hg, the relative one to 7%. As to diastolic pressure, it was 7.5 mm Hg and 8%, respectively. PMID- 1792599 TI - [The dispensary care of patients with chronic alcoholic diseases of the liver]. PMID- 1792600 TI - [Selective involvement of the gastrointestinal tract in amyloidosis in a female patient with periodic disease and intact kidneys]. AB - The authors describe a rare case of amyloidosis in a female patient suffering from periodic disease (PD) for 18 years without any clinico-laboratory signs of renal impairment but with marked clinical, (malabsorption, cachexia), endoscopic, x-ray and other manifestations of gastrointestinal amyloidosis. This case is of interest since patients suffering from amyloidosis due to PB develop malabsorption very rarely, namely in 2-3% of cases. As a rule, it develops in patients with pronounced chronic renal failure on hemodialysis or with a history of kidney transplantation. In this particular case, the patient demonstrated selective marked damage to the gastrointestinal tract, with the kidneys remaining practically intact. A possibility of the indicated variety of amyloidosis should be considered in specification of the genesis of persistent diarrhea in PB patients. PMID- 1792601 TI - [Intrathoracic and generalized granulomatosis in chronic diffuse liver diseases caused by the hepatitis B virus]. AB - In 7 patients suffering from chronic diffuse liver diseases, they were combined with intrathoracic (3 patients) and generalized (4 patients) granulomatosis. Acute viral hepatitis or risk factors of infecting hepatitis viruses revealed in the case reports of 5 patients preceded the appearance of the signs of both lung and pulmonary damage. In 2 patients (without any indications in the case report to acute viral hepatitis and risk factors of infecting by hepatitis viruses) both the processes were established at a time. HBV markers were detected in all the 7 patients: in the blood serum in 3 and in the blood serum and liver tissue in 4 patients. Besides, HBsAg was identified in the smears of the lavage fluid sediment in 3 patients examined for that purpose. The role of HBV in both etiology of chronic diffuse liver diseases and granulomatosis is under discussion. PMID- 1792602 TI - [The immunological validation and the potentials and prospects of using immunocorrective agents in treating hemoblastoses]. AB - Immunocorrection was provided to 94 patients with hemoblastoses. Of these, 50 patients suffered from lymphogranulomatosis and 8 from acute leukemias. Levamisole (decaris, Hungary) and the Soviet drug tactivin were applied as immunocorrectors. The effects of levamisole and tactivin in chronic lymphoid leukemia are combined. They are related to immunologic differentiation of the cells. The patients showed an increase of the count of E-RFC, a decline of the B cell count with superficial immunoglobulins, Em-RFC, changes in the T mu: T gamma cell ratio, and the maintenance of the level of serum immunoglobulins. As a result of the continuous administration of immunocorrectors, there was a rise of the count of B cells with immunoglobulins in the cytoplasm. The continuous use of immunocorrectors favours stabilization of the course of the underlying disease, an increase of the patients' life expectancy. In patients with lymphogranulomatosis, the use of levamisole as part of the multimodality treatment leads to an increase of the count of E-RFC, augmentation of the life expectancy. The treatment with immunocorrectors should be carried out under control of the immunity parameters. PMID- 1792603 TI - [The development of multiple myeloma in chronic diffuse liver diseases with a long course of monoclonal immunoglobulinopathy (a description of 2 cases)]. AB - The authors describe 2 patients with chronic active hepatitis accompanied for many years by stable monoclonal immunoglobulinopathy. In addition to the formation of liver cirrhosis, these patients were diagnosed to have multiple myeloma. Analysis of the authors' and reported data (including those on transformation of liver cirrhosis associated with monoclonal immunoglobulinopathy to hepatocellular carcinoma) makes it possible to regard patients suffering from chronic diffuse liver diseases associated with monoclonal immunoglobulinopathy as a group at risk for paraproteinemic hemoblastosis and hepatocellular carcinoma. The pathogenesis of the development of paraproteinemic hemoblastoses and hepatocellular carcinoma in the indicated group of patients is under discussion. PMID- 1792604 TI - [The creation of an all-Union registry of typed donors--the first stage towards bone marrow transplantation from an unrelated donor]. AB - The changes in tactic approaches may be recorded in clinical transplantation of the bone marrow (TBM). The countries of Europe and America realize TBM from the HLA-compatible unrelated donor. The first stage in such TBM is the establishment of the All-Union Register of typified donors which includes about 8,000 persons and is the member of the World Donor International Association. The authors describe the scientific and organizational principles of the work in the international regime; provide the ethnic and genogeographic characteristics of the All-Union Register. Give brief data on the activity of the All-Union Register during April 15 -- December 1, 1990. PMID- 1792605 TI - [Improvement in the forms of control over the knowledge of interns in a department of polyclinical therapy]. AB - The authors summarize their experience gained with the methods of perfection the subinterns' knowledge control at the chair of polyclinical therapy. While taking the course of polyclinical therapy, the subinterns are to take 3 tests: the first one after the 4-day studies of urgent conditions which the district physician faces, the second one after the 5-day studies into expert medical evaluation of the working capacity in the activity of the district internist, and the third one after a cycle of studies into polyclinical therapy. During such tests, the knowledge may often be checked in writing. PMID- 1792606 TI - [The use and side effects of antibacterial preparations in chronic bronchitis]. PMID- 1792607 TI - [Lipoproteins and lipid peroxidation in hypertension and the management of hypotensive therapy]. PMID- 1792608 TI - [Drug-induced lesions of the heart]. PMID- 1792609 TI - [Asthma of physical effort and the effect of nifedipine and diltiazem]. AB - In 13 patients with bronchial obstruction due to or enhanced by effort, the bronchodilatory effects of calcium antagonists (nifedipine and diltiazem) were studied and compared during the two-week treatment with each drug with a weekly interval. The appearance of bronchospasm at the 3d-5th minute after submaximal exercise (decrease of the volume of forced expiration during 1s by not less than 20% of the initial value) was regarded as a sign of asthma of effort. In 4 patients, bronchial obstruction in response to exercise was the only clinical sign of the disease, in 6 it was coupled with allergy, and in 3 patients, it aggravated the health status during exacerbation of bronchopulmonary infection. The patients were under observation during clinical remission of the disease. The clinical and instrumental data were estimated to reveal no well-defined correlation between the drugs. Both of them influenced bronchial patency, mainly at the level of the large and medium bronchi. Nifedipine was found to produce a more remarkable bronchodilatory effect. PMID- 1792610 TI - [The effect of therapeutic plasmapheresis on changes in the rheological properties of the blood in bronchial asthma patients]. AB - Bronchial asthma runs its course in association with marked blood viscosity which lies in a decrease of deformability of red blood cells and suspension stability of red blood cells, an increase of their aggregation capacity and of whole blood viscosity, of platelet proneness to decelerated and little noticeable aggregation, in hyperfibrinogenemia and hyperglobulinemia. Therapeutic plasmapheresis produces a favourable action on changes of the rheological blood properties in bronchial asthma patients. Plasmapheresis entails an improvement of whole blood viscosity and red blood cell aggregation, accompanied, however, by aggravation of the aggregation properties of platelets. Therapeutic plasmapheresis can be used for correction of the syndrome of high blood viscosity in bronchial asthma patients. PMID- 1792611 TI - [The results of the dynamic observation of bronchial hyperreactivity in risk group subjects and in bronchial asthma patients. Some corrective procedures]. AB - The following bronchial provocation tests were carried out: 310 with acetylcholine, 216 with submaximal physical exercise, 246 with cold air inhalation, and 103 with aspirin in healthy subjects, relatives of bronchial asthma patients, in patients with preasthma and asthma in a stage of exacerbation abatement or remission. Based on the data obtained the authors show nonspecific hyperreactivity of the bronchi in healthy relatives of bronchial asthma patients, heterogeneity and a high incidence of responses to acetylcholine, cold air and physical exercise, augmentation of the reaction intensity to different stimuli in all asthma patients. The follow-up of bronchial hyperreactivity discovered its progression in the absence of the treatment and the lowering of its intensity as a result of the treatment with calcium antagonists, magnesium sulfate, punctate massage, sublaminal physical exercise, ultraviolet radiation of autologous blood, specific desensitization with aspirin. PMID- 1792612 TI - [The results of the comparative study of nadolol, propranolol, prazosin and hydrochlorothiazide in patients with arterial hypertension in a 12-month stepped plan treatment (cooperative research). The Working Group of the Cooperative Program to Study New Preparations in the Prevention of Arterial Hypertension. I. The research protocol and results of monotherapy]. AB - The paper concerns a cooperative open study with participation of 10 centers of the USSR. After receiving placebo 419 men aged 30-59 years suffering from arterial hypertension (diastolic arterial pressure in the sitting position greater than or equal to 95 mm Hg) were given antihypertensive drugs after randomization. The treatment was provided in accordance with a stepped scheme and was started from monotherapy with the beta-adrenoblockers nadolol or propranolol (PP), or with the indirect vasodilator prazosin (PS) or the diuretic. If monotherapy failed, the patients were administered combinations of the indicated drugs. The treatment lasted one year, with a monthly control being exercised. 356 patients completed the studies. Of these, 131 patients (36.8%) had received monotherapy toward the end of the year. During the entire year, monotherapy was provided to 48.9% of the patients who started treatment from nadolol and completed the studies, to 34.1% who started treatment from PP, to 35.5% who started treatment from PS, and only to 14.4% of the patients who started treatment from the diuretic. Comparison of the patients' group given the diuretic with all the remaining groups demonstrate the difference to be significant. By the end of the treatment with nadolol, PP and PS, the diastolic arterial pressure reduced 10-11%, whereas toward the end of monotherapy with the diuretic, it dropped 6%, with the difference being significant. In patients on monotherapy, the negative chronotropic effect of nadolol exceeded that in patients given PP. Nadolol is an effective long-acting beta-blocker. By the intensity of the antihypertensive effect the drug is not inferior to PP or PS and compares very favourably with the diuretic. PMID- 1792613 TI - The results of the comparative study of nadolol, propranolol, prazosin and hydrochlorothiazide in patients with arterial hypertension in a 12-month stepped plan treatment (cooperative research). The Working Group of the Cooperative Program to Study New Preparations in the Prevention of Arterial Hypertension. II. The results of combined therapy. Side effects. The reasons for dropouts. Conclusion. AB - The efficacy and safety of nadolol (N), propranolol (PP), prazosin (PS) and a diuretic (D) were studied and compared with the aid of a total systems approach in a cooperative open study with participation of 10 centers of the USSR. As many as 419 men suffering from arterial hypertension (diastolic AP 95 mm Hg) were entered into the study. After randomization the patients received one of the 4 drugs. In case the monotherapy failed, combinations of 2-3 drugs were administered. The treatment lasted one year, with a monthly control being exercised. The patients' from the study accounted for 15% including the final points which constituted 1.9%. Of these, 6 patients suffered myocardial infarctions (one with a fatal outcome) and 2 presented with cerebral circulatory disorders. 3.8% of the patients were withdrawn from the study because of the side effects of the drugs. Out of 356 patients who completed the studies, 36.8% received one, 43% two, and 20.2% three drugs by the end of the year. The protocol of the study and the results of the monotherapy were provided in Communication I. Combined therapy with two or three drugs was effective whatever the combination and brought about a 12-16% decrease of diastolic AP. The negative chronotropic effect of N exceeded that of PP. The stable effect, t. e. the effect that lasted continuously over 6 months, was seen in less that half the patients treated for a year. Therefore, N is an effective, comparatively safe and long-acting beta blocker. As for its efficacy, it does not yield to PP or PS and compares very favourably with D. The drug can successfully be used in long-term treatment of arterial hypertension. PMID- 1792614 TI - [Modern drug preparations in pulmonology]. PMID- 1792615 TI - [The efficacy of basic antianginal preparations in patients with stenocardia after the aortocoronary bypass operation]. AB - A study was made of the clinical course of angina pectoris and of the efficacy of the basic antianginal drugs in patients with coronary heart disease, undergoing aortocoronary shunting (ACS). After the surgical treatment angina pectoris ran a typical course in the majority of cases. It was marked by a favourable clinical course and was amenable by medicamentous correction. According to the results of acute pharmacodynamic tests, monotherapy turned out effective in 120 patients (72.3%), combined therapy in 31 patients (18.7%). The desirable results were attained only in 15 subjects (9.0%). It is recommended that these patients may be subjected to repeated ACS. From the viewpoint of evaluating certain drug groups, preference should be given to mono- and combined therapy with calcium antagonists. PMID- 1792616 TI - [Holter monitoring in assessing the efficacy of quantum hemotherapy in patients with unstable stenocardia]. AB - In addition to a complex of treatment measures, 51 patients with unstable angina pectoris received quantum hemotherapy--laser and ultraviolet blood irradiation. The control group was made up of 18 patients given pharmacological agents. The treatment efficacy was judged from the decrease of the frequency, duration and depth of painful and painless myocardial ischemia, the rate of ventricular and supraventricular premature heart beat in accordance with the data of Holter's monitoring and the rise of exercise tolerance by the bicycle ergometry data. It has been established that quantum hemotherapy raises the treatment efficacy in patients resistant to the conventional pharmacological therapy. The anti-ischemic and antianginal action was found to be more remarkable in laser blood irradiation. The antiarrhythmic action of both modalities manifests in curtailment of high grades premature heart beats. PMID- 1792617 TI - [Oxygen barotherapy in the combined treatment of patients with chronic ischemic disease]. AB - As many as 20 patients with coronary heart disease (CHD) were examined for the efficacy of oxygen pressure chamber therapy (OPCT) combined with drugs. Optimal modes of OPCT were elaborated. The treatment consisted of 10-15 daily sessions with the partial oxygen pressure 0.25 MPa and the exposition 50-60 minutes. The treatment with compressed oxygen arrested or decreased heart pain, improved sleep. OPCT ameliorated the ECG readings, raised exercise tolerance, and made lipid metabolism return to normal. Satisfactory long-term results have also been obtained. PMID- 1792618 TI - [A comparative evaluation of the antianginal efficacy of aldizem and korinfar in patients with stable stenocardia]. AB - As many as 46 men suffering from coronary heart disease combined with angina pectoris of effort, functional classes II-IV, were examined. The two-week treatment with nifedipine (30-60 mg/day) and aldizem (180-270 mg/day) exerted an antianginal action in 47.8 and 39.1% of the cases, respectively, which was supported by the data of clinical examinations, loading tests, and by the data of ECG monitoring. Nifedipine turned out most effective in patients of functional class II with arterial hypertension. PMID- 1792619 TI - [The comparative efficacy and prognosis of the long-term treatment with korinfar of men and women suffering from hypertension]. AB - The paper is concerned with the results of the corinfar treatment for a year of men and women suffering from stage II stable essential hypertension. The treatment efficacy, the influence on central hemodynamics were estimated as was the prognostic significance of different variants of acute pharmacological tests (sublingual, oral, oral with the use of static loading) compared with the treatment results. The long-term monotherapy with corinfar was shown to be effective in the majority of patients suffering from stage II stable essential hypertension. However, in women with essential hypertension, the hypotensive effect was more stable, the effective doses were lower, and tolerance was better than in men. To predict the efficacy of the long-term monotherapy a method of acute pharmacological test with the use of static leading devised by the authors is suggested. The method has a high prognostic significance. PMID- 1792620 TI - [Delayed balloon dilatation of the coronary arteries after thrombolytic therapy in acute myocardial infarct: a comparison with thrombolytic therapy]. PMID- 1792621 TI - [The clinico-biochemical activity and tolerance of the hypolipidemic preparation lipanthyl]. AB - There were 56 patients with hyperlipoproteinemias, treated with lipantil in a dose of 300-600 mg/day. After 8 weeks of the treatment the blood triglyceride content declined by 65.4%, the blood content of total cholesterol 24.1%, that of low density lipoprotein cholesterol 21.1%, of very low density lipoprotein cholesterol 34.1%; the content of high density lipoprotein cholesterol rose by 28.0%. The drug also exerted a uricosuric action. The rate of side effects was 3.6%. PMID- 1792622 TI - [The clinical aspects of using Vazaprostan in patients with atherosclerotic involvement of the vessels of the extremities]. AB - A study was made of the clinical efficacy of vasaprostane and its influence on peripheral hemodynamics, microcirculation and hemostasis. The results of the studies made it possible to ascertain that the drug is highly effective, which enables the abatement of the ischemic syndrome to be attained. Vasaprostane was found to improve regional hemodynamics and microcirculation. In addition, it corrected hemostatic disorders. PMID- 1792623 TI - [The treatment of erosive-ulcerative lesions of the upper gastrointestinal tract at a polyclinic]. AB - The data obtained demonstrate the efficacy of the local and oral use of antioxidant dibunol in the treatment of ulcerous lesions of the upper alimentary tract. Besides, dibunol can be used for preventing disease exacerbations. Unlike dibunol, low-energy laser radiation makes it possible to shorten the time of ulcer healing which is particularly manifest in ulcers of the body of the stomach and duodenal ulcers 0.5--0.6 cm in diameter. The times of counteracting the painful and dyspeptic syndromes using dibunol and laser radiation did not differ appreciably. Both the treatment modalities can successfully be applied under outpatient conditions. PMID- 1792624 TI - [The content of biologically active substances in the margin of a stomach ulcer being treated with a copper-vapor laser]. AB - A study was made of the effect of laser therapy on the content of she biologically active substances serotonin, histamine, PGE2 and PGF2 alpha as well as on the adenylate cyclase system--adenylate cyclase activity and cGMP content. Direct exposure to laser produced an appreciable increase of the content of serotonin and histamine, PGE2 and PGF2 alpha, cAMP and of adenylate cyclase activity. On the healing of ulcerous defect after 5-6 sessions of laser therapy a decrease of the content of serotonin, a rise of histamine, PGE2, PGF2 alpha, cAMP accumulation and adenylate cyclase activation were recorded. PMID- 1792625 TI - [The effect of cimetidine and gastrozepin on liver function and the pharmacotherapy of "hepatogenous" gastroduodenal ulcers and erosions]. AB - Toxic hepatitis developed but in one out of 127 peptic ulcer patients treated with cimetidine. In patients (n-142) treated with gastrozepine, no cases of toxic hepatitis were recorded. These anti-ulcer agents did not influence absorptive capacities of the liver or hepatic blood flow. Meanwhile microsomal exidase (antitoxic) function of hepatocytes noticeably declined as a result of cimetidine treatment in every 8th patient with peptic ulcer subjected to the continuous 5 week treatment with the drug and in every 5th patient given the treatment (maintenance included) for a longer time. In patients suffering from liver cirrhosis with secondary gastroduodenal ulcers or multiple erosions, the 5-week treatment either with almagel and platyphylline or gastrozepine provided approximately similar results and promoted ulcer and erosion healing in half the cases. Adjuvant 3-week therapy with sucralfate (venter) having cytoprotective properties led to the disappearance of gastroduodenal ulcers and erosions in 23 out of 26 patients, in whom the previous treatment was ineffective. PMID- 1792626 TI - [The clinico-morphological characteristics of the gastric mucosa during peptic ulcer therapy with the autotransfusion of hemosorbent-treated blood]. AB - A study was made of gastric biopsy specimens withdrawn on repeated endoscopy in 35 patients with chronic gastric ulcers before and 2 weeks after the treatment by autohemotransfusion of hemosorbent-treated blood (AHTB). In 30 patients, the ulcer healed or reduced in size, in 5 patients, the effect was lacking. Morphologic and morphometric studies were carried out on cryostat sections stained by means of PAS and according to Romanovsky-Giemsa. They involved determination of the specific area of the gland and count of free cells of the stroma surrounding the gland followed by an analysis of correlations between effector cells of the immune system. A comprehensive estimation of the accumulation and distribution of the cells infiltrating m. mucosae of the stomach and of their interaction revealed the dependence on the use of AHTB. PMID- 1792627 TI - [Chromosome aberration levels and their dynamics during the treatment with cytotoxic preparations of patients with primary and lupus glomerulonephritis]. AB - As many as 96 patients with chronic glomerulonephritis (CGN) and 25 with lupus glomerulonephritis (LGN) were examined for chromosomal aberrations (CA) in peripheral blood lymphocytes in different clinical variants and morphological forms of CGN and LGN as well as for their dynamics under the influence of cytotoxic drugs. In patients with active CGN and LGN, chromosomal instability may develop. The treatment with cyclophosphamide in a dose of 2.0-2.5 mg/kg/day appreciably increases chromosomal instability the level of which rises progressively with the treatment period increase. The treatment with azathioprine in a dose of 1.5-2.0 mg/kg/day is not associated with a noticeable increment of the rate of CA. The studies of the level of CA can be used for estimating CGN and LGN activity. Chronic renal failure did not change the level of CA either in CGN or in LGN. In different morphological forms of glomerulonephritis, the rate of CA was determined by the clinical variant of the disease. In order to reduce potential complications provoked by the treatment with cytotoxic drugs, dynamic studies of the CA rate should be carried out in addition to the conventional tests. PMID- 1792628 TI - [The course of chronic kidney failure during acetate and bicarbonate hemodialysis]. AB - In patients with chronic renal failure (CRF) given acetate (n = 55) and bicarbonate (n = 45) hemodialysis, the dynamics of the progress of uremia symptoms estimated in marks, the index of the lean body weight, the rate of urea generation, the magnitudes of the dialysis indices according to creatinine and urea, TACur and TADur were studied on a monthly basis for many years. The actual survival rates were calculated. It has been demonstrated that as compared to acetate hemodialysis, in patients on bicarbonate hemodialysis, the progress of uremia symptoms is significantly decelerated (p less than 0.05) and hypercatabolism of proteins is decreased by the 4th year of the observation period. This enhances the patients' medical rehabilitation and noticeably increases the actual survival of the patients (p less than 0.001). Advantages of the treatment of CRF patients by bicarbonate hemodialysis are under discussion. PMID- 1792629 TI - [Hemostatic homeostasis in rheumatoid arthritis patients after "radiosynoviorthesis" with radioactive gold]. AB - Six to nine months (7.2 months, on the average) after injection of 198Au into large joints of patients with rheumatoid arthritis there was a decrease of blood thrombophilia characteristics of these patients and refractory to correction with conventional remedies. Functional activity of platelets and fibrinolysis studies were the most sensitive laboratory tests enabling one to reveal the lowering of the patients' blood thrombogenic potential after radionuclide therapy. Comparison of the time-course of changes in these parameters with those of the immunological blood status of the treated patients forms the basis for suggestions that the coagulologic laboratory tests may be used for estimating the efficacy of the treatment carried out. PMID- 1792630 TI - [The clinico-prognostic assessment of DNA antibodies and antinuclear factors in rheumatoid arthritis patients]. AB - As many as 195 patients with rheumatoid arthritis (RA) were examined for the clinical characteristics of the disease course depending on the presence or lack of antibodies to DNA or of antinuclear factor (ANF). Provided the patients' blood serum contained antibodies to DNA and ANF, RA was noted to run a graver course associated with a high-active process, marked erosive and destructive lesions of the joints, and the development of systemic manifestations. Excess production of the antibodies in question was accompanied by an increase of circulating immune complexes and rheumatoid factor, and a decrease of serum IgG. Glucocorticoids were demonstrated to be effective in suppression of autoimmune disorders. The presence of antibodies to DNA and of ANF is a prognostically unfavourable sign, indicating the development of systemic manifestations. PMID- 1792631 TI - Prevalence of obstructive lung disease in a general population: relation to occupational title and exposure to some airborne agents. AB - BACKGROUND: The importance of occupational exposure to airborne agents in the development of obstructive disease is uncertain. Studying the relation in a community population has the benefit of reducing the healthy worker effect seen in studies of working populations. METHODS: The prevalence of obstructive lung disease was examined in a Norwegian general population aged 18-73 in a two phased cross sectional survey. In the second phase a stratified sample (n = 1512) of those responding in the first phase was invited for clinical and spirometric examination (attendance rate 84%). Attenders were asked to state all jobs lasting greater than 6 months since leaving school and to say whether they had been exposed to any of seven specific agents and work processes potentially harmful to the lungs. RESULTS: The prevalence of asthma and chronic obstructive lung disease was 2.4% and 5.4%, respectively; spirometric airflow limitation (FEV1/FVC less than 0.7 and FEV1 less than 80% of predicted values) was observed in 4.5% of the population. All jobs were categorised into three groups according to the degree of potential airborne exposure. Having a job with a high degree of airborne exposure increased the sex, age, and smoking adjusted odds ratio for obstructive lung disease (asthma and chronic obstructive lung disease) by 3.6 (95% confidence interval 1.3 to 9.9) compared with having a job without airborne exposure; the association with spirometric airflow limitation was 1.4 (0.3 to 5.2). Occupational exposures to quartz, metal gases, aluminium production and processing, and welding were significantly associated with obstructive lung disease after adjusting for sex, age, and smoking habit, the adjusted odds ratios varying between 2.3 and 2.7. Occupational exposure to quartz and asbestos was significantly related to spirometric airflow limitation in people older than 50. CONCLUSION: Occupational title and exposure to specific agents and work processes may be independent markers of obstructive lung disease in the general population. PMID- 1792632 TI - Interphase nucleolar organiser regions and survival in squamous cell carcinoma of the bronchus: a 10 year follow up study of 138 cases. AB - BACKGROUND: Good prognostic indicators for patients with squamous cell carcinoma of the lung would help to determine the most appropriate treatment for individual patients. METHODS: A silver colloid technique that shows interphase nucleolar organiser regions (AgNORs) has been applied to representative paraffin sections from 138 cases of squamous cell carcinoma of the bronchus treated by surgical resection of the primary tumour at East Birmingham Hospital in 1977. Of the 138 patients, 23 (17%) were alive 10 years after their operation. RESULTS: The mean (SD) AgNOR count per cell was significantly higher for all grades of malignancy (well differentiated 10.5 (2.6), moderately differentiated 10.7 (3.2), and poorly differentiated 12.7 (4.5)) than for normal pseudostratified columnar epithelium from non-affected areas (2.3 (0.78)). There was a trend for AgNOR counts to be higher in poorly differentiated tumours, but a wide range of AgNOR counts was observed in all histological grades. AgNOR counts did not predict clinical outcome, irrespective of the stage of the disease, and did not relate to DNA ploidy or the percentage of cells in the proliferation phase of the cell cycle. Nine of 47 patients (19%) with tumours classified as DNA diploid and eight of 63 patients (13%) with DNA aneuploid tumours were alive 10 years after operation. Principal component analysis identified the clinicopathological stage of disease as the variable best related to survival. The percentage of patients surviving 10 years was 30% for stage I, 20% for stage II, 10% for stage IIIa, 9% for stage IIIb, and none for stage IV. CONCLUSION: The AgNOR technique is not of prognostic value in postoperative patients with squamous cell carcinoma of the bronchus. PMID- 1792633 TI - Correlation of morphological patterns of nucleoli in alveolar macrophages with HLA-DR antigen expression in sarcoidosis. AB - BACKGROUND: Alveolar macrophages from patients with sarcoidosis express increased quantities of HLA-DR during activation. Because silver staining has been described as a sensitive indicator of cellular activity a study was performed to examine whether it relates to HLA-DR antigen expression. METHODS: The relation between silver staining patterns of nucleoli and HLA-DR antigen expression was examined in alveolar macrophages collected by bronchoalveolar lavage from 11 patients with pulmonary sarcoidosis and 11 control subjects. RESULTS: The mean (SD) number of silver stained protein dots associated with the nucleolar organiser regions (AgNORs) was significantly higher in alveolar macrophages from patients with sarcoidosis (7.5 (1.5)) than in those from control subjects (5.6 (0.6)). The number of silver stained dots in alveolar macrophages correlated significantly with the intensity and the density of HLA-DR antigen expression in the patients with sarcoidosis. CONCLUSIONS: Silver staining may be a sensitive tool for the investigation of the biological cell activity of alveolar macrophages in sarcoidosis. PMID- 1792634 TI - Cystic fibrosis: current survival and population estimates to the year 2000. AB - BACKGROUND: Survival from cystic fibrosis is increasing rapidly. Estimates of the extent of this improvement should allow health care facilities to be planned to deal with the expanding population of patients with cystic fibrosis. Estimates of life expectancy are also essential if accurate information on current prognosis is to be given to parents of an affected child, or to prospective parents deciding whether to proceed with a pregnancy where the fetus may be affected. METHODS: Survival trends in the national data on cystic fibrosis have been analysed to produce estimates of the likely size of the cystic fibrosis population over the next decade and to predict the life expectancy of children born with cystic fibrosis in the years up to 1990. RESULTS: In England and Wales the estimated number of patients with cystic fibrosis is at present about 5200, of whom 3300 (63%) are aged under 16 years. By the year 2000 the total population will increase to 6000, with 3400 (57%) aged under 16. Thus the number of children with cystic fibrosis will remain fairly constant over the next 10 years, whereas adult numbers will increase by about 36% (from 1901 to 2577). The median life expectancy of children with cystic fibrosis born in 1990 is estimated to be 40 years, double that of 20 years ago. CONCLUSION: This study suggests that health service provision for children will not need to change substantially over the next 10 years whereas services for adults will need to increase by about a third. Parents can be counselled that the median life expectancy of a newborn child with cystic fibrosis is currently likely to be of the order of 40 years. PMID- 1792635 TI - Characteristics of attenders and non-attenders at an asthma education programme. AB - BACKGROUND: A controlled trial of asthma education was conducted but only 51 out of 164 eligible patients participated. METHODS: Differences between subjects who participated in the trial and those who expressed initial interest but subsequently declined were studied. RESULTS: Women, non-smokers, and those whose attending physician was concerned in the study were significantly more likely to attend the programme. Higher socioeconomic status was associated with greater attendance, but this did not reach significance. Psychosocial malfunctioning due to asthma was also associated with attendance, but this was not significant when sex and education level were taken into account. There was no difference between attenders and non-attenders with respect to age, number of previous admissions, airway function, self reported asthma severity, knowledge about asthma, and self management practices. CONCLUSION: The results suggest that many asthmatic patients recovering from a severe exacerbation of airflow obstruction will not participate in hospital based health education programmes. Alternative strategies may be required to improve the self management behaviour of these patients. PMID- 1792636 TI - Effect of a volumatic spacer and mouth rinsing on systemic absorption of inhaled corticosteroids from a metered dose inhaler and dry powder inhaler. AB - BACKGROUND: High doses of inhaled corticosteroids are absorbed systemically and may cause long term side effects. As rinsing the mouth out after use and inhaling through a spacing device may reduce systemic absorption this has been further investigated. METHODS: Three crossover studies were carried out to assess the effect of budesonide given by dry powder inhaler (Turbuhaler) with and without mouth rinsing and beclomethasone dipropionate given by metered dose inhaler with or without a spacing device (Volumatic) on serum cortisol concentrations and urinary cortisol excretion in patients with asthma taking an inhaled corticosteroid. Each treatment period was two weeks with in a two week washout period. Serum cortisol concentrations at 0800 hours on day 14 and the 24 hour urinary excretion of cortisol were measured. In study 1 24 patients taking beclomethasone dipropionate 500 micrograms twice a day inhaled with (n = 10) or without (n = 14) a Volumatic spacing device were switched to a budesonide dry powder inhaler, 600 micrograms to be taken twice a day without mouth rinsing. In study 2 10 patients took budesonide 800 micrograms twice a day with and without mouth rinsing and without swallowing the rinsing water. In study 3 17 patients took budesonide 800 micrograms twice daily with mouth rinsing and beclomethasone dipropionate 500 micrograms twice daily with the spacing device and mouth rinsing. RESULTS: In study 1 no difference was seen between budesonide without mouth rinsing and beclomethasone dipropionate without a spacer: beclomethasone with spacer caused less suppression of cortisol (mean (SD) serum cortisol concentration: beclomethasone and spacer 487(148), budesonide 368(145) nmol/l). In study 2 mouth rinsing caused less suppression of morning serum cortisol concentrations (rinsing 440(63), no rinsing 375(56) nmol/1). In study 3 there was no difference in serum or urinary cortisol concentrations between twice daily beclomethasone dipropionate 500 micrograms inhaled by Volumatic spacer or budesonide by Turbuhaler 800 micrograms twice daily, both with mouth rinsing. Individual serum cortisol values were within the normal range in all patients except one in study 1. CONCLUSION: Systemic absorption of a corticosteroid inhaled from a metered dose inhaler is reduced by using a spacing device and that from a dry powder inhaler by mouth rinsing. PMID- 1792637 TI - Epidemiology of seasonal and perennial rhinitis: clinical presentation and medical history. AB - BACKGROUND: Little is known about the epidemiology of rhinitis, particularly the perennial and non-allergic forms. The aim of this study was to compare the symptoms, atopic state, and medical history of individuals with seasonal and perennial rhinitis. DESIGN: Of 7702 adults aged 16-65 years registered with a London general practice, 2969 (30%) were screened by postal questionnaire. Samples of 113 subjects without rhinitis, 51 with seasonal symptoms alone, 128 with perennial symptoms and seasonal exacerbations were then interviewed. Atopic and non-atopic subjects were distinguished by skinprick testing with five common allergens. RESULTS: The estimated minimum prevalence of rhinitis was 24%: 3% had seasonal symptoms only, of whom 78% were atopic; 13% had perennial symptoms only, of whom 50% were atopic; and 8% had perennial symptoms with seasonal exacerbations, of whom 68% were atopic. Seasonal rhinitis was characterised by sneezing, itching, and a high prevalence of diurnal variation in symptoms. The most common provoking factors were dust, pollens, and infections. By comparison, perennial rhinitis was characterised by a higher prevalence of nasal blockage and catarrh, and a lower prevalence of diurnal variation and provocation by pollen. There were no significant differences among the groups in the sociodemographic characteristics examined. Subjects with seasonal rhinitis were more likely to be atopic and to have eczema and a family history of hayfever than those without rhinitis. Those with perennial rhinitis were more likely to have past or current eczema or migraine, be wheezy or labelled asthmatic, or have a family history of nose trouble other than hayfever. Subjects with both seasonal and perennial symptoms presented an intermediate clinical picture. CONCLUSIONS: Seasonal and perennial rhinitis differ in their atopic state, clinical presentation, and medical history. The extent to which these differences are genetically or environmentally determined requires further investigation. PMID- 1792638 TI - Pneumococcal capsular antigen detection and pneumococcal serology in patients with community acquired pneumonia. AB - BACKGROUND: Methods to determine the microbial cause of community acquired pneumonia include detection of pneumococcal antigen and measurement of pneumococcal capsular antibody response. Their usefulness compared with conventional microbiological techniques was investigated in patients with pneumonia, some of whom had been treated with antibiotics. METHODS: Pneumococcal capsular antigen was detected by latex agglutination in sputum and the results compared prospectively with results of conventional microbiological techniques in 90 patients with community acquired pneumonia. Serum, urine, and pleural fluid samples were also tested for antigen. Serum pneumococcal capsular antibody titres were measured. RESULTS: A diagnosis was established by conventional microbiological techniques in 53 patients, 30 of whom had pneumococcal pneumonia. The sensitivity of antigen detection in first day sputum specimens (n = 18) in those with pneumococcal pneumonia was 94%; antigen was present in 23 of the 27 patients who produced representative sputum on admission and during follow up. The specificity of antigen detection in sputum in patients with non-pneumococcal pneumonia and lung infarction was 87%. Antigen was present in 12 of 25 patients with pneumonia of unknown aetiology who produced representative sputum. Antigen was rarely detected in serum and urine, but was present in pleural fluid in three of four patients with pneumococcal pneumonia and in all four patients with pneumonia of unknown aetiology. Pneumococcal antigen remained detectable in patients treated with antibiotics. Pneumococcal capsular antibody detection was as specific (85%) as antigen detection, but had a lower sensitivity (50%). CONCLUSION: Pneumococcal antigen detection in sputum or pleural fluid is of value in making a rapid diagnosis and provides an additional diagnostic result in patients with pneumococcal pneumonia, especially those receiving antibiotic treatment. PMID- 1792639 TI - Effect of cigarette smoking on evolution of ventilatory lung function in young adults: an eight year longitudinal study. AB - BACKGROUND: There are few data on the quantitative effects of cigarette smoking on lung function in young adults. These effects are important in the understanding of the early stages of chronic airflow obstruction. METHODS: A longitudinal study over eight years was carried out to estimate quantitatively the effect of cigarette smoking on ventilatory lung function in young adults and to examine the possibility that the effect is modified by other factors. The study population were 15 to 40 years of age at initial examination, when they underwent spirometry and completed an interviewer administered questionnaire on respiratory health. Eight years later 391 of the subjects were re-examined (38% response rate). The quantitative effect of cigarette smoking during the study period on the average change of forced expiratory volume in one second (FEV1) over time (delta FEV1) was estimated in two linear regression models that included potential confounders and other determinants of outcome. RESULTS: The first model showed a significant dose-response relation between the average rate of smoking during the study period and delta FEV1, giving an estimate of annual change in FEV1 of -0.42 ml for each cigarette smoked per day (-8.4 ml for each pack) (p = 0.04). In the second model, which took smoking before the study period as a potential confounder, the effect of smoking during the study period was slightly smaller (-0.33 ml/year for each cigarette smoked per day). This indicated that smoking before the study period had a marginal latent effect on delta FEV1 during the study. However, neither the effect of smoking before the study nor that of smoking during the study was significant, presumably because of collinearity. Interactions between cigarette smoking and gender, wheezing, atopy, and exposure to environmental tobacco smoke during the growth period were not significant with respect to their effect on the relation between cigarette smoking and delta FEV1. CONCLUSION: Cigarette smoking has a dose related adverse effect on the evolution of ventilatory lung function in young adulthood. PMID- 1792640 TI - Long term effects of smoke inhalation in survivors of the King's Cross underground station fire. AB - BACKGROUND: In most accidents causing smoke inhalation only a few victims actually inhale the smoke. The fire at King's Cross provided an opportunity to assess the long term effects of smoke inhalation in a larger number of patients. METHODS: Fourteen survivors from the King's Cross underground station fire were assessed for respiratory disability six months after the disaster and 10 were reassessed at two years. All had inhaled substantial quantities of smoke and 10 had skin burns of differing severity. RESULTS: Six months after the fire nine survivors admitted to one or more symptoms, which included hoarseness (two cases), cough (five cases), and breathlessness (six cases); and a survivor with asthma noted a worsening of his symptoms. The remaining five denied new symptoms. Peak expiratory flow, spirometric indices, and transfer factor for carbon monoxide were within the predicted normal ranges. The mean residual volume, however, was greater than the predicted value and the mean maximum expiratory flow at 25% of vital capacity (V25) less than predicted, with no significant differences between smokers (n = 7) and non-smokers (n = 7). At least one of these ventilatory defects, suggesting small airways obstruction, was present in 11 survivors at six months and they had persisted in the seven patients who were reassessed at two years. CONCLUSION: Smoke inhalation may be associated with injury to the small airways. PMID- 1792641 TI - Familial idiopathic granulomatosis: sarcoidosis and Crohn's disease in two Indian families. AB - The coexistence of sarcoidosis and Crohn's disease in different members of the same family is rare and only two instances are on record. Two Indian families showing this association have been studied. In one a brother and sister are affected, and in the other seven and possibly eight persons in two generations have been affected. The familial occurrence of both these conditions supports the view that a transmissible agent may be concerned in the genesis of both diseases in genetically susceptible individuals. PMID- 1792642 TI - A school microepidemic of tuberculosis. AB - BACKGROUND: Microepidemics of tuberculosis continue to occur in countries with a low incidence of tuberculosis. METHODS AND RESULTS: A microepidemic of tuberculosis in a secondary school with 604 girls in Cork city, Ireland, in 1986 with follow up to 1990 is described. Neonatal BCG vaccination was discontinued in the city in December 1972 so most of the 342 pupils who had received BCG were aged 14 years or more. Six active cases and 75 tuberculin positive cases were found. Four of the six girls with active disease had had neonatal BCG. The 75 pupils with a positive (grade 3 or 4) Heaf test response were given chemoprophylaxis with rifampicin and isoniazid for six months; none had developed active tuberculosis four years later. The brother of the girl who was the probable index case, however, developed active tuberculosis in 1988 despite similar chemoprophylaxis. CONCLUSION: The episode highlights the fact that children who have had neonatal BCG can develop active tuberculosis as teenagers. PMID- 1792643 TI - Spontaneous hypoglycaemia due to a pleural fibroma: role of insulin like growth factors. AB - A 64 year old woman with a long history of "drop attacks" and dizzy spells was found to have spontaneous hypoglycaemia. A slowly enlarging pleural mass had been present for at least five years. At thoracotomy the mass (weight 1.7 kg) was excised and the hypoglycaemia ceased. Histologically the tumour was a pleural fibroma, with no features of malignancy. Endocrine tests before surgery showed a subnormal growth hormone response to spontaneous hypoglycaemia, a reduced concentration of serum insulin like growth factor I (IGF-I), and an inappropriately high concentration of serum insulin like growth factor II (IGF II). After resection of the tumour the growth hormone response to insulin induced hypoglycaemia and the IGF-I and IGF-II concentrations were normal. These data suggest that the hypoglycaemia was due to production of IGF-II by the tumour, causing increased glucose utilisation and an impaired growth hormone counterregulatory response to hypoglycaemia. PMID- 1792645 TI - Endoscopic bougie and balloon dilatation of multiple bronchial stenoses: 10 year follow up. AB - This paper reports 10 year follow up data on four patients who underwent mechanical dilatation of multiple bronchial stenoses (sarcoidosis two cases, berylliosis one case, idiopathic stenoses one case). Two patients enjoyed symptomatic and physiological improvement during the nine years before they presented with a recurrence of stenosis. The other two had recurrences sooner, and improved only slightly after they had started prednisolone treatment. PMID- 1792644 TI - Spontaneous hypoglycaemia and pleural fibroma: role of insulin like growth factors. AB - Spontaneous hypoglycaemia was the presenting feature of a man with a large subpleural fibroma. Preoperative and postoperative studies support the view that the tumour induced hypoglycaemia was due to the secretion of peptide hormones by the tumour. PMID- 1792646 TI - Pneumocystis carinii pneumonia as a complication of methotrexate treatment of asthma. AB - A 32 year old man with chronic severe asthma, requiring maintenance oral corticosteroids, was started on a weekly dose of methotrexate. Eleven weeks later he developed Pneumocystis carinii pneumonia. In the two years following treatment there has been no recurrence while oral corticosteroid treatment has been continued. Pneumocystis pneumonia should be considered in asthmatic patients taking methotrexate who present with fever, pulmonary infiltrates, and hypoxia. PMID- 1792647 TI - Cephalometric measurements in snorers, non-snorers, and patients with sleep apnoea. PMID- 1792648 TI - [International reporting of adverse drug reactions. Final report of CIOMS ADR Working Group]. AB - Under the auspices of the Council for International Organizations of Medical Sciences, a working group composed of representatives of seven multinational pharmaceutical manufacturers and six regulatory authorities developed and implemented a standardized method for reporting post-approval adverse drug reactions (ADR). The method is based on a set of uniform definitions and procedures and a single reporting form, and has been demonstrated to be feasible and effective. Regulators and manufacturers, in establishing requirements and systems for reporting of adverse drug reactions, should consider adopting this method. PMID- 1792649 TI - [Clinical trials in dermatology. The phase I trials]. AB - Application of the new topical product on the diseased skin should be preceded by its safety evaluation on the healthy skin in human volunteers. We propose here guidelines for the evaluation of the irritation, sensitization, phototoxicity and photoallergy potentials for topical products. The methods for evaluation of percutaneous absorption are also discussed. The studies presented here are not the object of any regulations. Therefore, we propose here an approach for the safety evaluation of topical products in human volunteers. PMID- 1792650 TI - [Clinical trials in dermatology. Evaluation of the tolerability and efficacy of a topical anti-inflammatory treatment in atopic dermatitis]. AB - Study designs for assessment of topical anti-inflammatory drugs in atopic dermatitis are discussed. Atopic dermatitis is a chronic disease with symmetrically distributed lesions. In order to avoid individual and spontaneous variation and to obtain an early impression of the efficacy of a new topical drug, bilaterally paired lesions can be used. Further drug development requires controlled double-blind parallel group design. General recommendations regarding inclusion criteria, and the measurement of efficacy and safety parameters are presented. Methods available for data evaluation and the particularities of different clinical designs are discussed. PMID- 1792651 TI - [Clinical trials in dermatology. Evaluation of the tolerability and efficacy of a topical antipsoriatic treatment]. AB - There has been considerable variations between different authors in the evaluation of antipsoriatic therapies. Improvement homogeneity must be achieved in this field. The main specific methods have been investigated: inclusion criteria, assessment of disease progress and safety parameters in phase II and III clinical trials, evaluating antipsoriatic treatment. PMID- 1792652 TI - [Clinical trials in dermatology. Evaluation of the tolerability and efficacy of a topical antifungal agent in the treatment of superficial mycoses]. AB - There is no single method for evaluating topical antifungal drugs. The localisation and the type of fungal, determine the treatment duration (from few days to several months). The main methodological characteristics of clinical trials in tinea pedis treatment (athlete's foot type) are reported. Aspects related to other clinical forms such as tinea versicolor and onychomycosis are also described. In any case, the main criteria of activity remains the mycological examination based on KOH microbiology and culture performed at the end of the treatment and again afterwards. PMID- 1792653 TI - [Clinical trials in dermatology. Statistical support]. AB - To determine the efficacy or safety of new topical treatments, more or less standardized studies must be performed. This article presents several examples of statistical analyses of the data currently seen in the dermatology area, and some guidelines for study sample size determination. More importantly, it indicates, for as soon as phase I studies, the need for preliminary informations such as development strategy, historical data, literature references or pilot studies, to determine or adapt appropriate designs and sample sizes. This need can be filled by close collaboration among clinicians, statisticians and sponsor. PMID- 1792654 TI - [Clinical pharmacology of prostacyclin and stable analogs]. AB - Prostacyclin (PGI2) has vasodilatory effects and a powerful platelet anti aggregating action. Receptors which may be common to prostaglandin E1 have been described on the platelet membranes, the uterus and various human arterial segments. The platelet activity is linked to the activation of adenylate-cyclase, coupled with a G protein. The mechanisms of the vasorelaxant effect have still not been fully studied. PGI2 is synthesized and released in vessels by the endothelium and the smooth muscle cells, and is very unstable. Its short half life probably restricts its role to local regulation of platelet activity and vasomotricity. The kinetics and pharmacological effects of prostaglandins have been studied during intravenous injections in healthy volunteers and patients. The synthesis of numerous stable analogues is designed to produce drugs which can be administered orally to treat arteriopathies. The side-effects linked with the vasodilatory effects restricts the use of maximally active dosage. PMID- 1792655 TI - Pharmacology of thromboxane A2, prostacyclin and other eicosanoids in the cardiovascular system. AB - The eicosanoids, a group of endogenous metabolites of the cell membrane phospholipid-derived fatty acid arachidonic acid (AA), are formed from AA via three main enzymatic pathways (cyclooxygenase, lipoxygenase, cytochrome P450) and include the classical prostaglandins (PGF2 alpha, E2, D2), TxA2, PGI2, the leukotrienes and HETEs/HPETEs, the lipoxins and various epoxy metabolites. In the cardiovascular system the current interest is focussed on TxA2 and PGI2. TxA2 is released from activated platelets, shows potent platelet aggregating and vasoconstricting properties and is therefore considered to be important in thrombotic and ischaemic diseases. Therapeutic strategies directed at interfering with endogenous TxA2 include inhibition of synthesis (aspirin, selective TxA2 synthase inhibitors) and, more recently, specific blockade of TxA2 receptors. PGI2 is released mainly from the vascular intima, potently inhibits platelet aggregation and shows vasodilator and cytoprotective properties. PGI2 and chemically stable PGI2-derivatives have been shown to be effective in the treatment of severe peripheral ischaemic diseases and offer further interesting prospectives like prevention of vascular reocclusion in bypass surgery and balloon catheter angioplasty as well as organ preservation in transplant surgery. Other eicosanoids like PGD2 and the leukotrienes may also be important mediators in cardiovascular disease. Whether they represent targets for innovative drug therapy in cardiovascular disease remains to be investigated. PMID- 1792656 TI - [Prostanoids and hemostasis]. AB - Thromboxane A2 (TXA2) and prostacyclin (two prostanoids) are produced from arachidonic acid through the cycloxygenase pathway. The enzyme cyclooxygenase is inhibited by aspirin. Prostanoids are short-lived and thus exert their effects locally. Activated platelets synthetize TXA2 which reinforces activation of those platelets and platelets in the vicinity of the former. Complete activation however can occur in the absence of TXA2 synthesis. Prostacyclin is able to block all the platelet responses, but this would be achieved in vivo together with intense vasodilation. Primary adhesion remains unaffected, since it does not require platelet activation. There are other molecules endowed with inhibitory effects on platelets: PGD2, PGE1, adenosine, and EDRF (nitric oxide). These molecules, and prostacyclin, also have effects on other cells than platelets and smooth muscle cells: leukocytes, endothelial cells. Clinical investigations on the prostanoid system in physiology and pathology of the cardiovascular system have been hampered by analytical problems. Taking into account all these restrictions, a rational pharmacological approach is difficult, but newer molecules with dual and selective activity against TXA2 (both inhibitor of TX synthetase and antagonist at the TXA2-receptor level) seem promising as anti thrombotic agents. PMID- 1792657 TI - [Effects of PGE1 in neonatal aortic coarctation]. AB - In order to estimate the efficacity of prostaglandine E1 (PGE1) to dilate the obstruction in coarctation of the aorta (CoAo), we studied 16 full term neonates with heart failure. Over the 16 neonates, there was 5 with isolated CoAo and 11 with an intracardiac shunt. Over the 11 neonates, 7 had pulmonary hypertension. PGE1, at a dose of 0.05 microgram/kg/min associated to the classical treatment of heart failure were given on the 6 day of life. Effects of PGE1 were evaluated on clinical basis (presence of femoral pulse, blood pressure), echocardiographical basis (ductus arteriosus and aortic isthmus diameter) and morphological basis. In 15 neonates, the ductus arteriosus was open, in all cases CoAo diameter was the same. In 7 neonates with pulmonary hypertension, femoral pulse appeared. In conclusion, PGE1 increases post ductal perfusion by a right to left shunt through the ductus arteriosus, only in cases where pulmonary hypertension is present. No direct action on the aortic isthmus was observed. PMID- 1792658 TI - Prostanoids in therapy of peripheral arterial occlusive disease. AB - Therapy of chronical arterial occlusive disease primarily includes evaluation and treatment of risk factors as prophylaxis for preventing progression of arteriosclerosis. When patients suffer from claudication walking exercise is the therapy of choice. Only in cases with severe claudication (walking distance under 100 m) and rest pain or ischemic ulcers reopening procedures are necessary. Bypass surgery is supported by the different transluminal angioplasty techniques, which are suited even for the older and multimorbide patients. A pharmacological treatment of peripheral arterial occlusive disease should be introduced only for preventing progression of the disease or reocclusions following surgery or angioplasty or in those cases in whom reopening techniques are not possible or not successful. Here prostaglandin E1 has been proven to be effective in many clinical trials. The combination of surgery, angioplasty and pharmacological treatment allows to avoid major amputations in most patients with critical limb ischemia. PMID- 1792659 TI - [Round table on the methodology of clinical evaluation of prostaglandins in the treatment of arteriopathies]. PMID- 1792660 TI - [Pirbuterol: a new beta 2-sympathomimetic agent. An open multicenter study]. PMID- 1792661 TI - [Diarrhea caused by Cyclo 3 fort]. PMID- 1792662 TI - [Potentiation of the anticoagulant effect of fluindione by propafenone]. PMID- 1792663 TI - [Drug consumption in sports and school medicine]. PMID- 1792665 TI - [Food habits are important for both the healthy and the ill]. PMID- 1792664 TI - [Pre-Christmas agony]. PMID- 1792666 TI - [Changes in the lipid pattern in acute myocardial infarction]. AB - This study comprised 20 patients who were hospitalized for acute myocardial infarction 0.5-12.5 hours after onset of chest pain. Lipid and lipoprotein values during the first seven days after the infarction were compared with the values three months later in order to assess whether lipid analysis in the acute phase provides sufficiently representative values to recommend dietary or medical intervention. Total cholesterol on admission was similar to the control value, but was significantly reduced during subsequent days. Triglyceride concentrations in the acute phase did not differ from the control value, but HDL- and LDL cholesterol were significantly lower than in the control sample. The HDL cholesterol/total cholesterol ratio on admission was similar to the control ratio, but was significantly reduced when analyzed later. Thus, total cholesterol and HDL-cholesterol/total cholesterol ratio on admission are representative, and are useful as a basis for intervention, provided that the delay from onset of infarction until hospitalization does not exceed 12.5 hours. PMID- 1792667 TI - [Spirometry]. PMID- 1792668 TI - [Treatment of hypercholesterolemia in adults. A treatment program 1991]. AB - A Norwegian programme for treatment of hypercholesterolemia in adults was published in 1988. In 1990 the Norwegian Medical Association appointed a group to modify this programme in the light of current knowledge, and taking into consideration the recommendations of the Consensus Conference on Cholesterol of October 1989. The present article presents this modified programme. When evaluating the risk of developing coronary heart disease a combined risk score should be calculated which also takes into account important risk factors other than cholesterol, such as family history, sex, age, smoking, hypertension, presence of diabetes etc. For those considered to be at high risk of developing coronary heart disease, the programme gives guidelines on how to intervene. With regard to treatment, special emphasis is placed on changing the diet. PMID- 1792669 TI - [Critical assessment of dietary lists in the treatment of hyperlipidemia]. AB - The article describes problems connected with use of diet lists in treating hyperlipidemia. Outdated diet lists are still in circulation. When such is the case, individual counselling on diet leads to better reduction of blood lipids than using a diet list does. Advice on diet is often focused on what you should not eat. This may lead to less variation in choice of foods, and therefore little variation in intake of nutrients. We think this affects the patients quality of life. When advising patients on diet one should try to suggest various suitable alternative foods. Protein intake tends to increase when intake of fat is reduced. It is more favourable to increase the proportion of complex carbohydrates in the diet. We already eat enough protein to maintain health. Therefore, as diet counsellors we should deliberately focus on advising foods that are rich in complex carbohydrates. PMID- 1792670 TI - [Prioritization of health services in Oregon--what can we learn?]. AB - The authors present the state of Oregon's recent proposal for prioritizing the health services. We suggest that the proposal involves certain problems, and suggest alternative methods of making priorities. It is also pointed out, however, that there may be certain lessons to be learned from this proposal in terms of the method used to obtain a prioritized list of health care services. PMID- 1792671 TI - [What does cigarette smoking cost society?]. AB - Deaths from cigarette smoking have been estimated to 7,500 persons per year in Norway. Half of these are assumed to die before reaching 70 years of age. It is calculated that cigarette smoking costs the society about NOK 1.2 billion per year in direct health care, NOK 1.6 billion in indirect morbidity, and NOK 4.2 billion in lost productivity due to premature death. PMID- 1792672 TI - [Restrictions of the right to disability pension]. PMID- 1792673 TI - [The revolutionary potential of patient-oriented medicine]. PMID- 1792674 TI - Marriage law and practice in the Sahel. AB - The legal systems of Sahelian African countries combine customary law, Islamic law, French colonial law, and civil law introduced since independence in 1960. Utilizing a framework developed by the Faculty of Law, University of Dakar, Senegal, and the Development Law and Policy Program, Center for Population and Family Health, Columbia University, the Sahel Institute undertook a comprehensive study of the legal and social status of women in Burkina Faso, Mali, Niger, and Senegal. Since 1960, Burkina Faso, Mali, and Senegal have replaced French family law with national marriage codes. Niger has not yet adopted a family code; the laws on the family inherited from the French remain in force. The postindependence marriage codes have attempted to give young women more say in choosing a husband, to regulate the practice of bride price, and to limit the practice of polygyny. They have done this by integrating customary law and government-passed civil law. Mali, Niger, and Senegal have repealed provisions in their codes prohibiting the distribution of contraception, based on a 1920 French law. Although it has taken no formal legal action, Burkina Faso has adopted family planning policies that effectively nullify the 1920 law. PMID- 1792675 TI - Family planning programs: efforts and results, 1982-89. AB - According to a set of 30 indices that assess the strength of large-scale family planning programs in developing countries, a strong upward shift in effort scores occurred between 1982 and 1989. During that period, many countries established or augmented their family planning programs, and effort scores improved in all developing regions and in all four dimensions of effort--policies and stage setting activities, service and service-related activities, record keeping and evaluation, and availability of contraceptive methods. By region, the sharpest improvement was not in East Asia, where levels were already high, but in sub Saharan Africa, where the movement was clearly upward, from a low base. Earlier associations between program effort and fertility declines are reaffirmed, additive to the contribution of socioeconomic improvements. In order to compute scores ranging from zero to 30 for each of the 30 indices, a detailed questionnaire was sent to 4-6 respondents in each of 103 developing countries having more than one million population. Respondents included program staff, donor agency personnel, local observers, and knowledgeable foreigners. The scores indicate that developing countries are continuing to move toward more favorable policy positions and stronger implementation of action programs, with consequent fertility effects. For the fertility decline to match the medium population projections of the United Nations, however, a substantial enlargement in the number of contraceptive users is necessary, not only to compensate for the enlarging base of couples, but also to increase the proportion who use contraceptives. PMID- 1792676 TI - Family planning and induced abortion in the USSR: basic health and demographic characteristics. AB - In 1988, the USSR Ministry of Public Health published official statistics on abortion for the first time in 60 years. Using the official data published in 1988 and unofficial statistics from a variety of independent sources, this report attempts to describe some of the basic features of fertility regulation in the USSR. Induced abortion is the main method of fertility regulation throughout the country, and a high proportion of induced abortions are unregistered and performed illegally. The availability and use of modern contraceptives is low; among those who practice contraception, traditional methods predominate. The official data leave much to be desired in the way of accuracy, reliability, and completeness. However, it is clear that the level of induced abortion is higher in the USSR than in any other country in the world. PMID- 1792677 TI - Prospects for increased contraceptive pill use in Japan. AB - Although oral contraceptives are not commercially available in Japan, a low-dose contraceptive pill is expected to become available soon. The current rate of pill use is less than 1 percent, but recent survey data indicate that about 10 percent of currently married women of reproductive age intend to use the pill when it comes on the market. Those who favor the pill do so because it is highly effective in preventing unwanted pregnancies, and because it reduces the need for abortions. Many other women report uncertainty about the pill because of concern about side effects. Given that Japan has a contraceptive failure rate of about 25 percent, with 29 percent of women having had at least one abortion, many women who do not yet favor the pill may shift to it once the low-dose pill comes on the market and they are reassured about its safety. Thus, the rate of pill use is likely to rise well above 10 percent. PMID- 1792678 TI - Does choice make a difference to contraceptive use? Evidence from east Java. AB - This study investigates sustained use of contraceptives among women in East Java, Indonesia. Interest is focused on the effect of whether the client's choice of contraceptive method was granted or denied, and the interaction between whether choice was granted or denied and husband-wife concurrence concerning method choice. Data were collected twice in a panel survey. The first round was conducted in family planning clinics among women initiating contraceptive use; the second was a follow-up household survey carried out 12 months later. Whether the user was granted her choice of method was found to be a very important determinant of sustained use of contraceptives. The interaction between whether choice was granted and whether there was husband-wife concurrence on method choice was also important. The highest rate of discontinuation occurred when method choice was denied in the presence of husband-wife agreement on method choice, and the lowest rate occurred when method choice was granted in the presence of such concurrence. The results imply that contraceptive continuation can be enhanced either when family planning workers pay more attention to the stated desires of their clients, or when policy is instituted allowing clients to use their method of choice. PMID- 1792679 TI - Improving abortion care in Zambia. PMID- 1792680 TI - Zimbabwe 1988: results from the Demographic and Health Survey. PMID- 1792681 TI - The severely and chronically mentally ill in America: retrospect and prospect. PMID- 1792682 TI - Devils in the heart: a nineteenth-century perspective on women and depression. PMID- 1792683 TI - Stigma and epilepsy. PMID- 1792684 TI - Staff needs and patient care: seclusion and restraint in a nineteenth-century insane asylum. PMID- 1792685 TI - Making psychiatry respectable: Earl Bond, Edward Strecker, Kenneth Appel, and the Institute of Pennsylvania Hospital. PMID- 1792686 TI - Mad-doctors in the dock: forensic psychiatry's early claims to expert knowledge. PMID- 1792687 TI - Role of adenosine in the trophic effects of sympathetic innervation. PMID- 1792688 TI - Pharmacological control of altitude sickness. AB - Acute mountain sickness has long been recognized as a potentially life threatening condition afflicting otherwise healthy individuals who ascend rapidly to high altitude, where the partial pressure of oxygen in the air is reduced. The symptoms of acute mountain sickness are probably a consequence of disturbances in fluid balance brought about by severe tissue hypoxia. Acute mountain sickness can be prevented by an adequately slow ascent, which is the best method, but for those with limited time there are several drug therapies that provide a relatively good protection. John Coote describes these treatments and their possible mechanisms of pharmacological action. PMID- 1792689 TI - Taking stock of cognition enhancers. AB - An increasing number of structurally heterogeneous compounds, which may act via very different categories of neuronal mechanisms, have been proposed to facilitate attentional abilities and acquisition, storage and retrieval of information, and/or to attenuate the impairments of such cognitive functions associated with age or dementia. In this article, Martin Sarter briefly reviews the data on putative cognition enhancers and examines the possible bases for the discrepancy between preclinical predictions of efficacy and the fact that unequivocal demonstration of drug-induced cognition enhancement in humans has only rarely been reported. Previous preclinical research strategies appear to have focused on the demonstration of drug effects in a wide variety of tests of uncertain validity, rather than on determination of the specific psychological and neurobiological processes affected by putative cognition enhancers. Some criteria are proposed for evaluating the validity of preclinical tests for cognition enhancers. PMID- 1792690 TI - Heterogeneity of the endothelial cell and its role in organ preference of tumour metastasis. AB - The vascular endothelium is a remarkably heterogeneous organ. In addition to well characterized anatomical diversity in situ, specific differences are increasingly being recognized between surface antigens on endothelial cells from different tissues, including absence of the classic endothelial marker factor VIII-related antigen (von Willebrand factor) from many endothelial cells. Microvascular heterogeneity extends to properties of endothelial cells thought to be involved in tumour angiogenesis and metastasis, such as growth factor responsiveness and expression of cell adhesion molecules. These findings are not only of relevance to the unambiguous identification and characterization of cultured endothelial cells, but, as Roy Bicknell and colleagues discuss, may explain the phenomenon of preferential organ tumour metastasis and provide novel opportunities for antitumour therapy. PMID- 1792691 TI - The neurobiology of tobacco addiction. AB - The key property that makes nicotine addictive is an ability to support the drug seeking behaviour that has been demonstrated in self-administration and place preference experiments. This reinforcing effect is complex, possibly involving subjective states of euphoria, cognitive enhancements, changed adaptation to stress, and relief from the nicotine withdrawal syndrome. The neural mechanisms, described here by Ian Stolerman and Mohammed Shoaib, include a primary action on central nicotinic acetylcholine receptors, associated with selective activation of the mesolimbic dopamine system that also mediates other sources of reinforcement. Structures such as the mesopontine tegmentum may also contribute to the reinforcing effect, whereas hippocampal and striatal regions seem to mediate other behavioural changes. PMID- 1792692 TI - Risk of tuberculosis infection in Edirne primary schools and a review of its epidemiological indices. AB - The study population was defined as all first and fifth grade pupils from 17 primary schools located within Edirne Municipality. Of these 3188 pupils, aged 6 14 years, 569 had not received the BCG vaccine, and were tested for Tb with strengths of 1.3 or 5 TU PPD, and the reactions were evaluated. The annual risk of infection (AIR), a relatively new indice in Tb epidemiology, was determined in the different subgroups in which age, school grade and sex were taken into consideration. The results of each subgroup were compared with each other and with those reported in foreign countries. Global AIR was found to be 1.54 percent, a relatively very high value when compared with those reported in Syria and Egypt. The relative risk ratio was recorded as 22.4 percent in the Netherlands. Another rate parameter which is almost as important as AIR is the annual variation in AIR. In Turkey this rate has been varying annually by an average of 5% for over the past 21 years. These figures may be the result only of normal socioeconomic development rather than the effect of campaigns waged in the fight against Tb. We are convinced that under the conditions prevailing in Turkey, widespread, early vaccination with BCG is the best way to control Tb. PMID- 1792693 TI - Rotavirus diarrhea in newborn infants. AB - In this study, the frequency of rotavirus infection and also the relation of rotavirus pathogens to necrotizing enterocolitis were investigated in newborns with diarrhea. We observed that rotavirus is a very important agent as a cause of nosocomial infection and also that it has a role in the development of NEC. PMID- 1792694 TI - The effect of epidermal growth factor on serum zinc levels. AB - Epidermal growth factor is a potent stimulator of the growth of epithelial and mesenchymal cells. In this study the effect of epidermal growth factor on the cells of developing mice intestine and on the serum zinc concentrations were assessed. Higher serum zinc concentrations (840.21 +/- 187.82 mg/dl) were found in the mice given epidermal growth factor (n: 10) as compared to the values obtained in the controls (347.55 +/- 108.88 mg/dl), (n: 12) (p less than 0.05). PMID- 1792695 TI - IgG subclass deficiency in children with recurrent infections. AB - IgG subclass levels were studied in 12 children, aged between 2.5-12 years with recurrent respiratory tract infections. They did not have low IgG levels or IgA deficiency. We found combined deficiency of IgG2-IgG4 in one patient and selective IgG2 deficiency in another (16.6% of patients). These two patients had bronchiectasis due to recurrent severe pneumonia, however one patient with bronchiectasis had normal IgG subclass concentrations. Our IgG subclass-deficient patients who did not respond to prophylactic antibiotic therapy were given gammaglobulin therapy. IgG subclass deficiency should be considered in children with unexplained recurrent infections even in the presence of normal serum immunoglobulin levels. PMID- 1792696 TI - Encopretic children: experience with fifty cases. AB - Fifty children with encopresis were admitted to the Pediatric Surgery Department of Sisli Children's Hospital between October 1, 1987 and January 1, 1990. Two treatment regimens were used. Thirteen patients received mineral oil and glycerine suppositories and 37 patients received rectal irrigations and Lactulose. Five patients were lost to follow-up and 40 patients have completed their six month treatment schedule. The results of our study suggest that encopresis is a complex abnormal motility disorder, requiring a multidisciplinary approach. Best results will be obtained by good parent-child-doctor cooperation and close follow-up. PMID- 1792697 TI - Creation of right ventricle-pulmonary artery continuity without cardiopulmonary bypass. AB - A closed technique was applied successfully in a patient with Fallot's tetralogy in whom total correction had been previously performed, for creation of continuity between the right ventricle and left pulmonary artery without the use of cardiopulmonary bypass. A surgical approach was achieved by an anterolateral thoracotomy incision in the left third intercostal space. A Dacron non-valved tubular graft, 10 mm. in diameter, was anastomosed to the proximal end of the left pulmonary artery. The proximal end of the graft was anastomosed to the pericardial outflow tract patch with a running technique using a monofilament suture. The peripheral arterial oxygen saturation increased postoperatively, and the patient's condition improved dramatically. PMID- 1792698 TI - Hereditary fructose intolerance in a patient with phenylketonuria. AB - Classical phenylketonuria (PKU) and hereditary fructose intolerance (HFI) are two inborn errors of metabolism that have an autosomal recessive mode of inheritance. In this paper, we described a 3-year-old girl with PKU and HFI. The occurrence of these two defects in the same patient is thought to be fortuitous and not genetically related since this is the first reported case and the statistical probability of such an occurrence is very low. PMID- 1792699 TI - Multiple primary malignancy: a report on Langerhans cell histiocytosis associated with Hodgkin's disease. AB - Since multiple primary malignant tumors are rare in children, their presence can be a diagnostic and therapeutic problem. In this report, we present a six-year old boy with Langerhans cell histiocytosis and Hodgkin's disease. On admission, the patient had lytic lesions and a periosteal reaction on the left trochanter major from which an open bone marrow biopsy was performed. The biopsy revealed Langerhans cell histiocytosis. Eight months later, the child presented with enlarged left cervical lymph nodes and the biopsy demonstrated Hodgkin's disease. Although there was an eight-month interval between the two histopathological diagnoses, the diffuse pulmonary parenchymal infiltration observed on the first admission, was later confirmed by an open-lung biopsy as Hodgkin's disease. The patient was said to have two concurrent lymphoreticular malignancies. To our knowledge, this is the youngest case reported with this association in the English language literature. PMID- 1792700 TI - Urethrocutaneous fistula due to a coil of hair. AB - Strangulation of the penis by a coil of hair is often an unrecognized clinical entity with severe potential complications. In this report, a five-year-old boy with urethrocutaneous fistula caused by the wrapping of a single strand of hair around the penis is presented. PMID- 1792701 TI - The history of beta-thalassemia in Turkey. AB - The first two patients with beta-thalassemia major in Turkey, were reported in 1941. However, the importance of beta-thalassemia as a health problem was brought to the attention of physicians only after 1950. In Turkey, the clinical and hematological pictures of beta thalassemia were found to be mostly heterogenous. Hematological data of patients with mild disease (beta-thalassemia intermedia) severe beta-thalassemia (beta-thalassemia major) and heterozygotes indicate that patients can be grouped according to the content of Hb F, Hb A2 and red cell indices. PMID- 1792702 TI - Neural cell adhesion molecules. AB - Adhesion molecules are expressed on the surface of various cells and establish cell-cell interaction, playing important roles in development, inflammatory reaction, immune response, and tissue regeneration. Neural adhesion molecules, found on neurons or glial surfaces, are involved in the migration of neurons, neurite formation, myelination, and denervation--reinnervation. The roles of cell adhesion molecules in malignancies, normal and abnormal development and as receptors in viral infections, constitute major fields of research and may have important diagnostic and therapeutic implications. PMID- 1792703 TI - Effect of endocrine therapy on a brain metastatic lesion of prostatic carcinoma. AB - We describe a 62-year-old male with brain metastasis from prostatic carcinoma, which regressed with medical and surgical endocrine therapies. The patient's presenting complaints were left periocular and deep ocular pain and a defect of the left visual field. During treatment of the above symptoms, macrohematuria, dysuria and pollakiuria occurred. Pathological examination of a transrectal needle biopsy disclosed moderately differentiated adenocarcinoma of the prostate. Computerized tomographic scan (CT) and magnetic resonance imaging demonstrated a brain tumor at the frontal skull base and the region of the frontal lobe suspected to be a metastasis of the prostatic carcinoma. One week after a period of daily administration of estramustine phosphate sodium, the prostate was observed to be softened and slightly decreased in size. The visual field defect and disturbance of urination gradually improved. The prostate decreased to normal size and no tumor mass could be detected on the brain CT after 3 months of treatment. PMID- 1792704 TI - Management of ureterosigmoidal anastomotic stricture by balloon dilatation. AB - Ureterosigmoidal anastomotic stricture is seen in nearly half of the patients who had ureterosigmoidostomy. Many of these patients are in need of reoperation. Balloon dilatation via percutaneous nephrostomy is an alternative method which avoids reoperation. PMID- 1792705 TI - Solitary urethral recurrence of sigmoid colon carcinoma. AB - We report a rare case of a solitary urethral recurrence of sigmoid colon cancer. The recurrence developed 2 years after a radical resection of sigmoid colon cancer invading the bladder. The involved portion of the urethra was resected and an end-to-end anastomosis was made. The patient has been able to urinate per urethram and has remained free of recurrence for 7 years after the urethral resection. PMID- 1792706 TI - Penile cancer--the sentinel lymph node controversy. AB - The management of lymph nodes in penile cancer has always been a problem. Sentinel lymph node biopsy was supposed to solve this problem but has not been universally accepted due to conflicting results. We herein present a case of penile cancer with bilateral pathologically positive inguinal lymph nodes associated with concurrent negative sentinel lymph node biopsies. We discuss the possible reasons for this situation and suggest guidelines to study this issue. PMID- 1792707 TI - Flow cytometric DNA analysis of stage D2 prostatic carcinoma. AB - Flow cytometric DNA analysis was performed on 34 samples of prostatic carcinoma patients with stage D2 disease to study the relationship between DNA ploidy pattern, Gleason sum score, and prognosis. Nuclei were extracted from paraffin embedded needle biopsy specimens. The DNA ploidy pattern was diploid in 53% of the tumors, tetraploid in 38%, and aneuploid in 9%. A significant correlation between DNA ploidy pattern, Gleason sum score, and prognosis was not proved. It was considered that DNA ploidy pattern and Gleason sum score of limited primary lesion did not allow a prognosis of the patients with stage D2 prostatic carcinoma to be made. PMID- 1792708 TI - Effects of prostaglandins and prostaglandin synthetase inhibitors on acutely obstructed kidneys in the dog. AB - An intact canine model was developed to study the effects of prostaglandins (PG) and prostaglandin synthetase inhibitors on acutely obstructed kidneys. Totally implanted nephrostomy tubes were placed to measure renal pelvic pressure. Complete ureteral obstruction was obtained with a Fogarty balloon catheter inflated in the distal ureter; by this method renal pelvic pressure reached 40-50 mm Hg. Renal pelvic pressure was reduced after intravenous indomethacin and dipyrone administration, whereas blood pressure showed no major changes. Exogenous prostaglandins had both immediate and contrary effects: PGE2 caused a significant decrease, whereas PGF2 alpha caused a significant increase in renal pelvic and blood pressure. The reduced rise in renal pelvic pressure appears to be the main reason for the analgesic effects of prostaglandin synthetase inhibitors. The efficiency of these drugs in the treatment of renal colic is supported by this study, that of prostaglandins cannot be proved. PMID- 1792709 TI - Angiodynography (color-coded duplex sonography) in the evaluation of vasculogenic impotence. AB - The penile arteries of 18 men with erectile dysfunction were examined by angiodynography (color-coded duplex sonography). Blood flow velocity was measured before and after intracavernous injection of papaverine/phentolamine. The angiodynographic findings were compared to arteriography. Normal values of peak flow velocity (after injection) were obtained from 6 men with normal arteriographic findings (deep artery greater than 25 cm/s, superficial artery greater than 30 cm/s). Angiodynography enables good imaging of the four penile arteries superior to duplex sonography. A strong correlation with the arteriographic findings could be found. Thus noninvasive angiodynography may replace penile arteriography for the routine evaluation of impotence. PMID- 1792710 TI - Anesthetic requirements during electromagnetic extracorporeal shock wave lithotripsy. AB - An important aspect of modern extracorporeal shock wave lithotripsy is the ability to perform the procedure without anesthesia. Between June 1987 and April 1990, a total of 7,500 treatments were performed in our Lithotripsy Unit, using the Lithostar (Siemens AG, Erlangen, FRG): moreover 80% of the treatments were carried out as an anesthesia-free outpatient service. All treatments were reviewed for anesthetic requirements. Epidural anesthesia was performed in 74/7,500 (0.98%) treatments: during the initial period, the first 70 procedures were systematically performed under epidural anesthesia, and in 4 later cases of simultaneous endoscopic stone manipulation. Local skin infiltration was applied at the coupling site in 658/7,500 (8.7%) treatments. With increasing experience and technological improvement, 6,229/7,500 (83%) procedures were performed later on with only mild sedation: 1 mg of lorazepam orally 30 min before the treatment. Intravenous sedation was required in 510/7,500 (6.8%) cases because of painful local irritation, especially when treating calculi close to sites where shock waves can progress along the ribs. General anesthesia was required in all 28 children (0.4%). PMID- 1792711 TI - Arteriovenous fistula associated with adenocarcinoma of the kidney. AB - We present a case of a large renal arteriovenous fistula associated with an adenocarcinoma. The clinical and radiological findings are presented together with a brief review of the literature. PMID- 1792712 TI - Arteriovenous fistula simulating a solid tumor of the kidney. AB - In this report we describe a 57-year-old male hemophiliac with an acquired renal arteriovenous (AV) fistula presenting as a renal mass. Even after intravenous pyelography, ultrasound and computed tomography, a carcinoma seemed possible. Causes, symptoms and therapy of renal AV fistulas are shown and pitfalls in the usual diagnostic approach are discussed. PMID- 1792713 TI - Spontaneous renal subcapsular hematoma. An unusual presentation. AB - We report a 76-year-old patient with an unusual presentation of spontaneous renal subcapsular hematoma. The etiology of the bleeding remains unexplained after extensive workup including laparotomy and follow-up of 12 months. PMID- 1792714 TI - A case of solitary varices arising from the retroperitoneum. PMID- 1792715 TI - Malignant hemangiopericytoma of the pelvis. Report of a case with urological implications and immunohistochemical analysis. AB - A case of a malignant hemangiopericytoma located in the pelvic fossa of a 50-year old man is reported. The tumor displaced the urinary bladder and caused bilateral hydronephrosis. Light microscopic diagnosis was followed by immunohistochemistry. After surgery the patient was successfully treated by chemotherapy and irradiation. This paper reviews clinicopathological features in respect of prognosis and a possible treatment. PMID- 1792716 TI - Appendicular abscess presenting as a bladder tumor with painless gross hematuria. AB - Microscopic hematuria is a well-known finding in several patients with acute appendicitis. We present a case of long-standing, painless gross hematuria as the only symptoms of an appendicular abscess. PMID- 1792717 TI - Educational differences in health status and health care. AB - Includes estimates by years of education for limitation of activity, restricted activity days, assessed health status, physician contacts, hospital discharges and days, incidence of acute conditions, and prevalence of chronic conditions. Level of education is cross-classified by age, sex, race, poverty status, Hispanic origin, geographic region, place of residence, major activity, marital status, and employment status. All estimates are shown as unadjusted and age adjusted and are based on data collected in household interviews by the U.S. Bureau of the Census for the National Health Interview Survey during 1989. PMID- 1792718 TI - [Cerebral hemodynamic function in patients with the initial manifestations of brain blood supply failure under the influence of pelotherapy combined with the electrophoresis of vasoactive preparations]. AB - The examination was performed of 80 patients exhibiting initial signs of defective cerebral circulation in the presence of cerebral atherosclerosis, cervical osteochondrosis, vascular dystonia. Clinical and rheoencephalographic evaluation of the patients treatment by application of peloids in combination with electrophoresis of vasoactive drugs (cavinton and trental) allowed a differential approach to assignment of the above modalities. PMID- 1792719 TI - [The efficacy of the combined health resort treatment of patients with early circulatory encephalopathy]. AB - Sanatorium treatment results were evaluated for 31 patients suffering from dyscirculatory encephalopathy following atherosclerosis, arterial hypertension or both of them. Combined treatment involving chlorine-sodium baths, electrophoresis of 1% nicotinic acid according to the oculo-occipital technique, physical exercise, massage of the head, diet produced a marked positive effect on general brain symptoms, cerebral hemodynamics, lipid metabolism and coagulation. A subjective response was recorded in 90.3% of the patients. PMID- 1792720 TI - [The action of decimeter waves on the nuclear DNA of cerebral cortex cells]. PMID- 1792721 TI - [An experimental study of the action of weak-intensity superhigh-frequency electromagnetic radiation in the millimeter range on the metastatic process in malignant neoplasms]. PMID- 1792722 TI - [The combined use of sinusoidal modulated currents, mud preparations and phytotherapy in peptic ulcer]. AB - Numerous observations and examinations led the authors to the conclusion on high therapeutic effectiveness of combined physiotherapy in peptic ulcer. Oral administration and electrophoresis of peloidin are beneficial in the lesions of the gastric and duodenal mucosa. Plants infusions per os combined with the exposure to sinusoidal modulated currents can be recommended in the disease aggravations, scarry ulcerative deformities. PMID- 1792723 TI - [The normalizing action of mineral waters on the function of the digestive organs]. AB - Basing on literature reports and original investigations, the author considers recovery of normal gastrointestinal function as one of the mechanisms of mineral water action. Curing effect is realized by normalizing the function of the affected organ rather than gastric secretion and is due to a beneficial effect of the water on the regulatory gastrointestinal systems. PMID- 1792724 TI - [Therapeutic physical exercise in the system of the preoperative preparation of patients with complex ventral hernias]. PMID- 1792725 TI - [The immunomodulating effect of microwaves and of an ultrahigh-frequency electrical field in patients with systemic lupus erythematosus]. AB - Bitemporal exposure of the adrenals to UHF electric field and decimeter waves was studied as a component of combined therapy for stage I-II chronic SLE. The best therapeutic response was achieved at bitemporal employment of UHF electric field directed to the system hypothalamus-hypophysis. This may be due to enhanced glucocorticoid activity of the adrenals and immunomodulating effect: a rise in the T-lymphocytes number, humoral immunity suppression. Antiinflammatory action was seen from a positive trend in clinical symptoms. Less therapeutic response to the direct stimulation of the adrenals with decimeter waves stems from the deficient function of the latter consequent to long-term corticosteroid therapy. PMID- 1792726 TI - [The physical work capacity of disabled patients following amputation of the extremities]. AB - The examination was performed of 125 invalids. Fifty-five of them underwent amputation of the upper limbs, seventy--of the lower limbs. Reduction of physical performance turned out dependent on body mass loss that is level of the amputation. The authors developed motor regimens, permissible exercise loads, criteria of the follow-up check-ups for the handicapped with various levels of limb amputation. PMID- 1792727 TI - [The effect of "dry" immersion on the indices of the arterial pressure and hemodynamics in hypertension patients]. PMID- 1792728 TI - [Changes in the tolerance for physical loading and in the gas exchange of patients with chronic bronchitis during graded bicycle therapy]. PMID- 1792729 TI - [The effect of physical factors on esophageal function in cardiospasm patients]. PMID- 1792730 TI - [The effect of mud procedures at different temperature regimens on the condition of children with infantile cerebral palsy]. PMID- 1792731 TI - [Trilon B phonophoresis in the combined treatment of patients with traumatic myositis ossificans]. PMID- 1792732 TI - [The role of amino compounds in the biological activity of the lyophilized residue of naftusia water]. PMID- 1792733 TI - [The use of therapeutic physical factors in obliterating diseases of the peripheral arteries]. PMID- 1792734 TI - [Physical methods in the medical rehabilitation of patients with vascular brain diseases]. PMID- 1792735 TI - [Physical factors in the prevention and treatment of ejaculatory sterility]. PMID- 1792737 TI - [An invitation to cooperation]. PMID- 1792736 TI - [The 115th anniversary of the Odessa Balneological Society]. PMID- 1792738 TI - [The microsomal enzyme system of the liver and its role in the mechanism of action of physical therapeutic factors]. PMID- 1792739 TI - [The prevalence of lactase deficiency among the peoples of the USSR]. PMID- 1792740 TI - [Physiologic energy requirements of miners working in deep coal mines]. AB - A time course study of energy balance was conducted in miners working in deep coal mines under a strict control of their nutrition using the method of estimating the energy value of food received and body mass. It has been established that mean daily energy requirement of a "standard" miner (body mass- 70 kg, age--25-35 years) comprises 16529.7 kJ (3950.7 kcal) under conditions of fulfillment of the standard output, 6-hour working day, 2 days off. PMID- 1792741 TI - [The effect of food intake on the content of proteolytic enzymes and gastrin in the blood of patients with peptic ulcer and chronic atrophic gastritis]. AB - Radioimmunoassay was used to determine trypsin, pepsinogen and gastrin content in the blood serum with the use of kits produced by the firm "Oris" (France). A total of 43 patients with peptic ulcer (25 with duodenal ulcer and 18 with gastric ulcer), 20 patients with chronic gastritis and 10 normal subjects were investigated. The study was conducted on an empty stomach and after a test breakfast consisting of 2 boiled eggs, 100 g of cheese, 100 g of white bread, 25 g of butter, 50 g of sugar and 200 g of tea (57 g of proteins, 63 g of fats, 103 g of carbohydrates; calorie value comprised 1212 kcal). It has been shown that food intake is a regulator of gastrin, pepsinogen and trypsin production that permits evaluating functional possibilities of gastrin-producing cells, the main gastric cells and acinar cells of the pancreas. The investigation conducted has evidenced that compensatory shifts in the levels of gastrin, pepsinogen and trypsin taking place in gastroduodenal disease are directed to the improvement of digestive processes. PMID- 1792742 TI - [The use of the pasty "Zdorov'e" ("Health") in the treatment of iron deficiency anemia]. AB - Paste "Zdorovie", a product with high content of protein and assimilable iron, developed at the Moscow Institute of Applied Biotechnology, has been proved to be effective in the combined antianemia therapy. Improved hemograms and biochemical parameters were recorded in 60 pregnant women and nursing mothers suffering from iron-deficiency anemia (IDA). The data obtained have permitted the authors to recommend paste "Zdorovie" for combined treatment of IDA in pregnant women and to consider it promising in prevention of IDA in nursing mothers. PMID- 1792743 TI - [The efficacy of the use of lactic acid lactobacterin enriched with zinc in the treatment of patients with celiac disease]. AB - Zinc sulfate-enriched lactic acid lactobacterin was used in the combined treatment of 23 children with celiac disease, aged from 1 to 10 years. A group of 23 children with celiac disease who received lactic acid lactobacterin without zinc were used as control. The patients treated with lactobacterin containing zinc showed a higher increase in body mass, total protein and zinc levels in the blood serum and elevated activity of metalloenzymes-ceruloplasmin and cytochrome oxidase. PMID- 1792744 TI - [The amino acid spectrum of plasma and erythrocytes in children with kidney diseases at the stage of chronic kidney insufficiency]. AB - The effect of diets with varying protein restrictions on the amino-acid spectrum of plasma and erythrocytes was studied in 46 children with total chronic renal insufficiency (CRI), stages I and II, resultant from tubulo-interstitial diseases of the kidneys and glomerulonephritis. Qualitative and quantitative changes in the spectrum of blood amino acids are recorded at the initial stage of CRI and depend on the degree of protein restriction in the diet. The diet with a sharp protein restriction (Giordano-Giovanetti type) produces hypoazotemic effect and possesses anabolic properties. Disorders in amino-acid metabolism serve indications for using essential amino acids and their ketoanalogues in children with uremia. PMID- 1792746 TI - [A statistical analysis of the formation of a pool of free amino acids in the rat liver]. PMID- 1792745 TI - [The absorption function of the small intestine and the effect on it of diet therapy in food allergy in children]. AB - Small intestine absorption function was studied in 46 children with food allergy basing on the results of D-xylose test and estimating protein absorption by blood serum ovalbumin assay in circulating immune complexes. Decreased carbohydrate and increased protein absorption was recorded in the small intestine of the patients and the normalizing effect of the elimination diet on these changes was shown. PMID- 1792748 TI - [An experimental study of the biological value of milk proteins with differing ratios of casein and blood proteins]. AB - To improve amino acid composition and to rise the sum of sulfur-containing amino acids, 5 samples of milk protein with varying ratios of casein and serum proteins (24:76; 45:55; 61:39; 73:27; 94:6) were prepared with the use of the membrane technology under conditions of experimental production. Biological experiments conducted with the use of "growth" and "balance" methods have shown a rise of biological value with the increasing of serum protein share reaching its maximum value at a ratio of 61:39. Further elevation of the serum protein share (73:27; 94:6) led to a decrease of biological value. Advantages are stressed of the membrane technology in the production of high-quality milk products. PMID- 1792747 TI - [Changes in the enzyme activity in the liver and blood of albino rats due to high fat rations based on 3 types of modified fats]. PMID- 1792749 TI - [The effect of cow's milk and its hydrolysates on the metabolism of 17 hydroxycorticosteroids and the functional state of the gastrointestinal tract in guinea pigs]. AB - Two groups of noninbred male guinea pigs (initial bw 250-300 g) received test rations in which 50% of standard ration protein were substituted for milk protein (P 20/80) and its enzymatic hydrolysate (H 20/80). The influence of P 20/80 and H 20/80 on some parameters of the gastro-intestinal tract (GIT) barrier function and 17-OCS metabolism was studied. The action of H 20/80 as compared to P 20/80 was expressed in the intensified excretion of free fraction of 17-OCS and glucuronides. The content of hydroxylated glucocorticoids increased in both fractions. At the same time elevated total proteolytic activity in the gastric mucosa and a tendency to decreased GIT permeability for chicken ovalbumin macromolecules were observed in animals that received H 20/80. It has been suggested that enzymatic hydrolysates of food proteins influence endocrine regulation of metabolic processes. PMID- 1792750 TI - [The effect of an increased dietary intake of organic selenium on the resistance of rats to ionizing radiation, aflatoxin B1 and infection]. AB - Varying concentrations of the selenium biological compound "Selena" were tested in animals subjected to the action of extremal factors simulating those that affected the population at the territories radiocontaminated as a result of the catastrophe at the Chernobyl NPS (131I and external irradiation in falling down doses). The death rate in the group of animals that were not given "Selena" comprised 30% during 6 months after irradiation, their body mass was 120 g lower as compared to the animals in the group of biological control; among the animals given 0.03 mg of selenium/day the death rate was 4 times lower. PMID- 1792751 TI - [Vitamin D and calcium metabolism in relation to different levels of vitamins B6 and D]. AB - The influence of vitamin B6 deficiency on some vitamin D-dependent processes was studied in animals. The following parameters changing in relation to the level of vitamin D providing were investigated: activity of alkaline phosphatase in the serum and small intestine mucosa, the levels of Ca, P and parathormone, concentration of vitamin D metabolites and enzyme activity; and only 25 hydroxyvitamin D (25-OVD) concentration in the blood serum, under conditions of combined vitamin B6 and D deficiency was significantly lower as compared to cases with vitamin D deficiency alone. In the presence of vitamin B6 deficiency recovery of 25-OVD level in the blood serum, after vitamin D administration to the animals, had a tendency to delay as compared to that in the animals provided with vitamin B6. Vitamin B6 deficiency produced similar effect on 25-OVD 1 hydroxylase activity. The data obtained have evidenced a possibility of vitamin B6 influence on vitamin D metabolism. PMID- 1792752 TI - [Iron deficiency anemia in preschoolers and pregnant women in the People's Republic of China]. PMID- 1792753 TI - [The stability of vitamin C in powdered mixes for beverages]. AB - Factors influencing vitamin C stability in powder mixtures for beverages were studied and the main ways of its decomposition in products preserved in glass containers or paper packages covered with polymeric film were established. The phenomenon of vitamin C self-stabilization has been observed. PMID- 1792754 TI - [Microbiological, physicochemical and cytologic indices of milk in cows with latent (subclinical) mastitis]. AB - To detect latent (subclinical) mastitis in cows lactenin isolated from the alveolar mucosa epithelium and udder milk cisterns of cows suffering from mastitis was used in combination with a mastitis diagnostic agent. Lactenin produced a bactericidal effect on pathogenic Escherichia and Streptococcus, and p6cteriostatic effect on toxicogenic Staphylococcus and Salmonella, depending on the cow resistance. The diagnostic agent components were destroyed by epitheliocyte lactenin and transformed into mucosal mass and gel-like coagulate. The mixture of milk with the diagnostic agent in the absence of lactenin presents a uniform fluid. PMID- 1792755 TI - [A comparison of fluorescent methods of determining the concentration of vitamin B2 in blood]. AB - Three methods of riboflavin assay in the human blood were comparatively studied. It has been found that firmly-bound flavin forms present in erythrocytes inhibit their complete transmission into the riboflavin form. Low specificity of the method using riboflavin fluorescence suppression with dithionite has been proved. Dithionite capacity for suppressing fluorescence of riboflavin-like substances significantly rises detectable levels. The use of riboflavin-binding protein permits one to determine only free riboflavin form. It has been established that the lumiflavin method is most reliable and specific for riboflavin assay in erythrocytes. PMID- 1792756 TI - [The role of diet therapy in the complex therapy of hepatic encephalopathy]. PMID- 1792757 TI - [The determination of tocopherol in child nutrition products]. PMID- 1792758 TI - [M.N. Shaternikov's school: physiologic and social aspects]. PMID- 1792760 TI - [The quality standards of patient treatment in hospital departments]. AB - Standards have been compiled on the basis of the clinical picture of the disease as well as objective, laboratory, instrumental-apparatus data. The dynamics of the patient's health were evaluated using concrete indices--normalization or reduction by 10-30% of the initial systolic pressure, absence of painful sensations, increase of range of articular movements, normalization of body temperature, blood indices, urine and oth. Treatment quality values were determined by comparison of results to the preplanned and are evaluated by a three-point rate--good, fair, poor. PMID- 1792759 TI - [Obstructive lung diseases and pregnancy]. PMID- 1792762 TI - [The significance of Helicobacter pylori in the pathogenesis of peptic ulcer]. PMID- 1792761 TI - [Plasmapheresis in the treatment of patients with ischemic heart disease]. PMID- 1792763 TI - [The treatment of patients with chronic primary gastroduodenitis]. PMID- 1792764 TI - [The health protection of those working with ultrasonic apparatus]. PMID- 1792765 TI - [Medicine and the cultural-political existence of our nation]. PMID- 1792766 TI - [The data from clinical, instrumental and laboratory studies as markers in the prognosis of the restabilization process in patients with a history of unstable stenocardia]. AB - With the purpose of preventing the development of acute clinical ischemic lesions of the myocardium, and their further progression, regression of coronary atherosclerosis the authors followed up for more than one year 250 patients with unstable stenocardia and singled out two groups of these patients, each group having important differences as to coronary reserve, functional state of the myocardium, lipid spectrum, dynamics of vasoactive substances, immunological reactivity, thrombocytic activity. Early detection of groups with an unfavourable course of IHD in patients with unstable stenocardia will allow to optimize treatment and avoid development of acute coronary catastrophies. PMID- 1792767 TI - [The lipid peroxidation characteristics in the liver function disorders of patients with vasorenal hypertension]. AB - The authors investigated the functional state of the liver and lipid peroxidation in vasorenal hypertension. Results indicate that the functional state of the liver in vasorenal hypertension is disturbed as a result of the main renal disease and also under the effect of arterial hypertension as a destabilizing factor leading to disorders of the hemodynamics and furthering potentiation of lipid peroxidation processes in the body. PMID- 1792768 TI - [The early rehabilitation of patients, operated on for peptic ulcer and cholelithiasis, at Mirgorod health resort]. AB - The authors analyzed the condition of 51 patients in the early period of operation for ulcer and cholelithiasis. It was found that most patients showed asthenic, dyspeptic and pam syndromes, anemia, hypoacidic or achylous gastritis, inflammation at the operative site. As a result of treatment at the Mirgorod health resort (physiotherapy, mineral water) there occurred a significant improvement in the patients' condition. It is concluded that rehabilitation of patients following surgical intervention on the 20th day of operation for ulcer and cholelithiasis at the Mirgorod health resort has good perspectives. PMID- 1792769 TI - [The histophotometric characteristics of the hepatocytes in acute blood loss and pulmonary artery thromboembolism (based on the data from early autopsies)]. AB - A comparative morphological study of the liver in acute blood loss and massive thromboembolism of the pulmonary artery was carried on basis of early autopsies. Histoenzymatic and correlation analysis was used to study the characteristic features of the metabolism of hepatocytes in conditions of acute blood loss and massive pulmonary artery thromboembolism. PMID- 1792770 TI - [Factors affecting the treatment results with pulmonary tuberculosis patients]. AB - A study is presented of the effect of social factors on the outcomes of pulmonary tuberculosis in patients with freshly detected disease mainly in rural localities in 1985-1989. The outcomes of treatment depended mainly on the form and extension of the pathological process and terms of treatment. It was also established that the outcomes of tuberculosis are also influenced by unfavourable social factors which are more pronounced in persons with an extensive process. Treatment results were better in women with higher education than in similarly educator men. Among agricultural workers treatment efficacy was worse than among office workers and housewives. Life in the family effects more favourably treatment results than single life. Treatment results were worse in those living in unsatisfactory conditions, engaged in hard physical work, suffering of concomitant diseases and bad habits. PMID- 1792771 TI - [The intravital detection of spontaneously incorporated radionuclides in the human body]. AB - A trial has been done for the first time to use historadiography for detection of spontaneously incorporated radionuclides in the body of persons who participated in liquidation of the Chernobyl atomic station disaster. The effect of incorporated radiation on the gastric mucosa, blood and bone marrow was studied. 88% of patients showed different degrees of accumulation of radionuclides in mucosal epithelium and submucosal layer of the stomach. PMID- 1792772 TI - [Lymphocyte cytotoxic activity in radiation lesions]. AB - A study is presented of the effect of roentgen radiation on the cytotoxic activity and spontaneous rosette formation of guinea pig lymphocytes. The animals were irradiated by roentgen rays in 2.58 mC/kg and 180.60 mC/kg. Results indicate that 24 hours after irradiation there was a significant reduction of the cytotoxic activity (38% as compared with the control) and doses-dependent reduction of rosette formation cells. PMID- 1792773 TI - [An analysis of the prevalence of chronic noninfectious diseases among the workers of industrial enterprises]. AB - The authors carried out a prophylactic examination of 1274 workers of industrial enterprises by skilled specialists. It was established that 69.2% of the examined could not name any risk factor of chronic non-infectious diseases, 53% required medical treatment. The diagnosis made by shop physicians did not coincide with the diagnosis made during the prophylactic examination in 33% of patients. It is necessary to increase the level of hygienic knowledge of workers as well as the quality of shop physicians. PMID- 1792774 TI - [The characteristics of the course of typhoid-paratyphoid diseases combined with acute dysentery]. PMID- 1792775 TI - [A statistical analysis of the cellular and protein indices of the cerebrospinal fluid in patients with bacterial meningoencephalitis]. AB - Clinico-liquorological comparisons were carried out in 300 patients with bacterial meningoencephalitis. The method of mathematical analysis proved able to reveal the prognostic significance of criteria of protein dispersion in the cerebrospinal fluid as one of the factors of clinical evaluation of the possible sequels of the disease. PMID- 1792776 TI - [Chronic bronchitis: the concept of its step-by-step development, its essence and significance (a lecture)]. PMID- 1792777 TI - [Changes in the clinical and immunological indices of patients with disseminated sclerosis being treated with prednisolone]. AB - The authors examined clinically and immunologically 60 patients with multiple sclerosis. One group (30 patients) received prednisolone in the complex treatment while the second group (30 patients) received only complex treatment. A control group of 20 healthy persons was examined. Patients of the first group showed marked neurological and immunological disorders which is considered as a complication due to the empiric prednisolone doses. PMID- 1792778 TI - [The characteristics of the disorders of the immune status in gout patients]. AB - An analysis was made of some immunological indices in patients with podagra. It was established that women showed a more pronounced reduction of T-lymphocytes in the peripheral blood and their functional activity in tests with phytohemagglutinin and concanavalin as well as a deficit of B-lymphocytes, hyperproduction of C-immunoglobulin and antibodies to DNA in the blood serum. Males showed an increased level of B-lymphocytes. M-immunoglobulin and antirenal antibody titers. The concentration of circulating immune complexes in the blood rose equally independent of age. PMID- 1792779 TI - [The superoxide dismutase activity of the brain and liver tissues in a rabbit with an experimental brain concussion]. AB - A study is presented of the activity of superoxidedismutase and catalase in the brain and liver in the dynamics of mild head injury in experiments on rabbits. It was established that the activity of catalase in the brain show a three-times reduction within 15 minutes after the injury. The catalase activity in the liver remains practically unchanged. The activity of superoxidedismutase in the liver in the posttraumatic period does not differ from control values. In the brain superoxidedismutase activity reduces by 38% only on the 7 and 14 days after injury. PMID- 1792780 TI - [The role of lipid peroxidation and the activity of energy metabolism enzymes in the pathogenesis of acute closed craniocerebral trauma]. AB - The state of lipid peroxidation and activity of dehydrogenases, transaminases and creatinphosphokinase was studied in rats and 94 patients with mild and average- severe head injuries. A relationship has been found between activation of peroxidation and reduction of activity of enzymes participating in energy reactions that along with activation of transamination evidences reduction of the energy charge of the body. Activation of peroxidation plays a major role in the development of posttraumatic brain edema and especially after mild head injury. PMID- 1792782 TI - [The use of sporulating bacteria in treating patients with dysbacteriosis]. AB - In the treatment of patients with different forms of dysbacteriosis routine bacterial preparations (coli-, lacto-, bifidumbacterin) were supplemented by sporeforming aerobic Bacillus bacteria. It was found that efficacy of treatment in patients receiving sporeforming bacteria was 20-30% higher than traditional bacterial agents. PMID- 1792781 TI - [The clinico-laboratory characteristics of errors in the diagnosis of chronic gastritis]. AB - The authors analyze results of a study of 100 patients with chronic gastritis showing secretory insufficiency with a dubious diagnosis. Endoscopy and intragastric pH-metry were used. The diagnosis of chronic gastritis was confirmed in 35 patients and of them with secretory insufficiency only in 21 patients that evidences inadequate attention to the complaints, anamnesis, incomplete examination and use of laboratory and other data. PMID- 1792783 TI - [The diagnosis of stomach cancer by the morphological study data from gastric biopsies]. PMID- 1792784 TI - [Cytochemical study of alkaline phosphatase activity as a cancer cell marker in exudates from serous-membrane lined cavities]. AB - Cytochemical demonstration of levamisole-sensitive alkaline phosphatase (AP) have been used for the identification of tumor cells in serous effusions. AP-activity is not demonstrable in mesothelial cells and histiocytes-macrophages in serous effusions in 18 noncancer patients. Enzyme activity is detected in cancer cells in serous effusions in 19 from 52 cancer patients. Oncoassociated antigens are detected on the membranes of AP-positive cancer cells more rare that AP-negative cancer cells. PMID- 1792785 TI - [The treatment of patients with cancer of the corpus uteri using the gamma emitter 137Cs]. AB - A study is presented of 51 patients (age 52-77 years) suffering of uterine body cancer with marked extragenital pathology. It is shown that treatment of inoperable cancer of the uterine body using the SELECTRON apparatus for contact irradiation (cesium-137 source, 066-MEV photons). With this method exact dose control is possible. The preferred regime of dose fractionation in intracavitary radiation of endometrium cancer is a single dose of 1000 cGr weekly and a summary dose of 7000-8000 cGr. PMID- 1792786 TI - [The diagnosis and treatment of patients with acute intermittent porphyria]. AB - Four patients with acute intermittent porphyria (AIP) were treated and followed up. It was established that in AIP urinary pigments have specific absorption spectra in the visible light range. Clinical manifestation and the severity of the disease course correlated with the amount of excretion of copro- and uroporphyrin and their characteristic spectrum of light absorption. It is concluded that of significance in the AIP pathogenesis is the level of formation of copro- and uroporphyrin isomers which may directly effect the nervous tissue and clinical manifestations of AIP. It is recommended to use plasmapheresis in biohemosorption by means of extracorporeal donor spleen. PMID- 1792787 TI - [The characteristics of the diagnosis and clinical course of traumatic hematomas located basally]. AB - The authors analyzed 27 patients with traumatic subdural hematomas of basal location. Hematomas of this location are distinguished by a different clinical course and difficulties of diagnosis. The informative value of different methods of diagnosis is discussed. The method of choice was computerized axial tomography of the brain. Radical surgical treatment is the method of choice. PMID- 1792788 TI - [The combined use of physiotherapeutic methods in treating hypertension in pregnant women]. PMID- 1792789 TI - [B12-folic-acid-deficiency anemia in a patient occurring as a result of exposure to ionizing radiation]. PMID- 1792790 TI - [Glucose intolerance in a patient after craniocerebral trauma]. PMID- 1792791 TI - [An atypical course of prostatic cancer in young patients]. PMID- 1792792 TI - [The work of a research institute under cost-accounting procedures]. PMID- 1792793 TI - [The history of the development of the surgical shop in Uzhgorod in the 16th to 19th centuries]. PMID- 1792794 TI - [Significance of vaginal and cervix flora with reference to ascending infections]. AB - The role of the vaginal and cervical flora and the extent of alterations in the flora in ascending infections of the female genital tract were evaluated in a microbiological study of 86 patients with a clinical diagnosis of pelvic inflammatory disease (PID). The patients were classified as having acute salpingitis (n = 15), an acute inflammatory adnexal tumour (n = 21), subacute salpingitis (n = 38), or chronic salpingitis (n = 12). 100 symptom-free women formed a control group. The spectrum of microorganisms found in the two groups was similar. However, there were significant differences in the distribution of pathogenic and apathogenic organisms. Negative cultures and cultures with exclusively apathogenic organisms were found in 16% of the patients with PID and 43% of the healthy women. Growth of exclusively apathogenic aerobic organisms was seen in 3.5% of the patients with PID and 18% of the controls. Exclusively apathogenic anaerobic organisms were found in 7% of the patients with PID and 32% of the controls. Mycoplasmas were significantly more common in the PID group than in the controls (31% v. 10%). The rates of Chlamydia trachomatis did not differ significantly (13% v. 10%). Patients with pathogenic organisms had a 3.88 (odds ratio) or 2.27 (col-2 risk) higher risk of PID than those with negative cultures or exclusively apathogenic organisms. There were no significant associations between the microbiologic results and individual parameters of inflammation. The microbiologic results did not reflect the course or severity of the disease.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792796 TI - [Effect of incubation time in deep freezing human sperm]. AB - For the protection of spermatozoa against deleterious influences during freezing and thawing, so-called "cryoprotective agents" are mixed with the ejaculate before freezing. Clinical experience indicated a decrease in the number of post thaw motile sperms after increasing the incubation period of sperms with the added cryoprotective agents and prompted us to investigate this finding. In experiment 1 we used 21 ejaculates which had a mean motility rate of 63.3%. The ejaculates were divided into 3 portions (1 a, 1 b, 1 c), which were frozen after 10 (1 a), 30 (1 b), and 60 (1 c) minutes of equilibration respectively. After thawing, 18.4% (1 a), 12.8% (1 b), and 7.1% (1 c) of the sperms were motile. This decrease in sperm motility was highly significant (p = 0.0012). Cryosurvival was investigated more fully within the first 10 minutes of incubation in a second experiment with another 18 ejaculates. The ejaculates were divided into 2 portions; portion 2 a was mixed with the cryoprotectant and frozen immediately and portion 2 b was frozen after a 10 minute incubation time. There was no significant difference in post-thaw motility and in recovery rate between the groups 2 a and 2 b. Our results indicate that the cryoprotective agent has a toxic time-dependent negative influence on sperm quality during equilibration, which significantly increases after an incubation time of more than 10 minutes. We consider that the results of this study are applicable to other glycerol containing cryoprotectants and we recommend that the incubation period is kept short. PMID- 1792795 TI - [Steroid hormone receptors in synovial tissue]. AB - Among the variety of symptoms of the postmenopausal syndrome joint pain seems to be an important problem for the patient as well as for her doctor. Because of the excellent response of the hormone substitution therapy it is asked if the synovial membrane is a target organ for oestradiol. Biopsies from the knee joint of ten women (not having any hormone therapy)--excised during knee joint surgery- were examined. Only in two cases oestrogenreceptors were found. Accordingly the synovial membrane cannot be seen as a direct target organ for oestradiol and so other mechanisms must play a role in the pathogenesis of postmenopausal joint pain. PMID- 1792797 TI - [Danazol in treatment of cystic mastopathy]. AB - Numerous endocrine disorders may cause benign breast diseases, such as increased oestrogen and prolactin, decreased progesterone. The antigonadotropic effects of Danazol counteract these hormonal changes. It has been used for a few years in the treatment of benign breast diseases at a dosage of 200-800 mg daily. Treatment of benign breast cysts represents a special problem--after puncture fluid builds up again very often after a short while. In a randomized study we demonstrate the positive effects of Danazol, such as reduction of cyst diameter and prevention of recurrence after puncture. Cysts with a diameter of more than 20 mm were punctured. The test group was treated with 400 mg Danazol daily; the control group was treated conventionally with prolactin antagonist and progesterone We treated 26 patients with Danazol over a 3 months period. In the control group we observed more recurrences after puncture than in the Danazol group. Danazol also proved effective in the reduction of cyst diameter in women with cysts under 20 mm in diameter which had not been punctured. Tolerance of Danazol was good; side effects were cycle irregularities and weight gain. PMID- 1792798 TI - [Delivery of quadruplets after in vitro fertilization: perinatologic and ethical aspects]. AB - Progress in modern reproductive medicine has brought much success to infertile couples. A side effect of IVF procedure are multiple pregnancies with clinical, ethical, perinatal and social problems. We report about the first case of quadruplets after IVF born in Austria and try to illustrate the perinatal, social and ethical problems. The 34 year old woman was treated in our sterility outpatient clinic because of secondary sterility. In 1988 finally she underwent IVF procedure. Four oocytes were retrieved by means of vaginal follicle puncture. 4 embryos were transferred, and after 3 weeks 4 viable embryos were seen at an ultrasound investigation. Due to placental insufficiency a cesarean section had to be performed in the 31st week of gestation. The weights of the premature infants were 1280 g, 1340 g, 1260 g and 1250 g. Two years after birth two infants show neurologic defects and need permanent care. PMID- 1792799 TI - [Myelosarcoma of the ovary]. AB - The case is reported of a patient with granulocytic sarcoma of the right ovary and infiltration of granulocytic precursor cells into abdominal lymph nodes without any evidence of acute leukaemia on examination of the blood and bone marrow. Removal of the tumour and subsequent polychemotherapy was followed by remission. A local recurrence was treated with radiation and high-dose polychemotherapy. The patient has now been in complete remission for seven years. Thus, granulocytic sarcoma may have a good prognosis if treated with aggressive therapy, including operation, radiation, and high-dosage polychemotherapy. PMID- 1792800 TI - [Recent knowledge of the function of glucose transport molecules in cell membranes, of the regulation of their composition and of modification of their activity and changes in concentration in diseases (diabetes mellitus, Tumors)]. AB - In the outer membrane of animal cells there exist different isoforms of glucose transporters (GluT), that contain pores for the facilitative intake of glucose. The content of the various forms of GluT in the different cells is influenced by the stage of development and by the plasma-concentration of glucose. In the regulation of the glucose-concentration in the plasma the content of the skeletal musculature and of the adipose tissue in GluT type 4 plays an important role: It is insulin-dependent. In diabetes mellitus the content of the outer membranes of the cells of the mentioned tissues in GluT 4 is - in dependence of the degree of the disturbance - more or less reduced. The binding of insulin to the receptor in the musculature and in adipose tissue stimulates the transport of GluT 4 from the interior of the cells to the outer membrane. Fasting causes an increase in the content of GluT 4 in the musculature and a decrease in the adipose tissue. Tumor cells have an increased uptake of glucose with the help of GluT. PMID- 1792801 TI - [Venous capacity and drainage volumes of arm veins]. AB - On 29 test persons after clinical angiological and cw-Doppler-sonographic exclusion of an obstruction of the deep veins and an arterial occlusive disease on the upper extremities the capacity of the veins and the drainage volume were determined by means of the venous-occlusion plethysmography. The angiological measuring places Compactus 540 and Periquant 3800, respectively, of the firm Gutmann (group 1) and the 2-channel occlusion plethysmography of the former nationally owned measuring device factory Ballenstedt (VEB Messgeratewerk Ballenstedt) (group 2) were at our disposal. Apart from the obsolute values of the capacity of the veins and of drainage volume on account of the large interindividual dispersions the quotients were determined in the comparison of sides. In the two groups the drainage volume showed significantly larger values on the right arm than on the left one. In group 2 the measuring of the capacity of the veins and the drainage volume resulted in essentially larger values than in group 1. In contrast to the absolute values the quotients of the measuring values did not show any significant differences between the two groups so that it seems that these are better suitable of the judgment of the venous obstruction behaviour. PMID- 1792802 TI - [Blood fluidity in essential hypertension, arterial occlusive disease and diabetic angiopathies]. AB - Microcirculatory disturbances are important complications in hypertension, arterial occlusive disease (PAVK) and diabetic angiopathies. The special haemorrheological diagnostics for the judgment of the terminal vascular bed tended to the comprehension of the haemorheological risk. Due to the increase of the aggregation of erythrocytes and viscosity of the plasma in peripheral arterial occlusive disease and diabetic angiopathies this risk proved to be distinctly increased, in diabetes mellitus without vascular complications and essential arterial hypertension it proved less distinctly increased. In hypertension the application of diuretic drugs should be done more critically and more controlled, in order to avoid conditions of hyperviscosity with their sequels for the microcirculation. The internal therapy in PAVK and diabetic angiopathies must include the amelioration of the disturbed blood fluidity. PMID- 1792803 TI - [Interdisciplinary preventive use of iodine in former East Germany following reunification and the status of packaged iodized table salt for improving alimentary iodine supply. Retrospect and prospects]. AB - The general interdisciplinary iodine prophylaxis which began in the former GDR in 1985/86 led to the amelioration of the alimentary supply with iodine and to success which was taken notice of also internationally. The amelioration of the supply with iodine was above all derived from the use of iodized mineral mixtures in animal production. According to the analyses performed up to 1990 the state of development could be maintained for the time being. With the German reunification the general iodine prophylaxis was deprived of its legal fundament and with the reorganization of agriculture the expanding use of iodized mineral mixtures was no more guaranteed. Respecting the principle of voluntariness the application of iodized kitchen salt is to be propagandized above all in children, adolescents and pregnant women and the use in big kitchens, restaurants and in the foodstuff industry. PMID- 1792804 TI - [Value of color-coded duplex sonography in diagnosis of extracranial vascular changes]. AB - 72 patients at the age of 44 to 76 years with transitory ischaemic attacks which happened and for a short time reversible deficits, respectively, were diagnosed both conventionally duplex-sonographically and with the colour-coded duplex sonography under the question of vascular stenotic process in the region of the cervical vessels. After the ultrasound examination within two weeks an angiography was performed. As a result was shown that in 10 patients with an angiogram without pathological findings by means of the colour-coded duplex sonography in 3 cases plaque formations could be proved which could be clearly diagnosed only by colour marking. PMID- 1792805 TI - [Heinrich Friedrich Delius (1720-1791). On the 200th anniversary of his death 22 October 1791]. AB - The 200th anniversary of the death of Heinrich Friedrich Delius gives the occasion to the remembrance of life and work of this many-sided university teacher. More than 4 decenniums the Halle doctorand Delius worked as Professor in Ordinary at Erlangen University and was co-determining for its scientific profile. In the association of the Imperial Academy of Naturalists he held the office of president. PMID- 1792806 TI - [Patient-specific determinants of delay in goal-oriented patient behavior in acute myocardial infarct. Results of the post-infarct late potential study]. AB - 369 (63%) of 586 consecutive patients with confirmed myocardial infarction were admitted to hospital within 6 h of symptom onset. Patients' arrival to hospital followed a characteristic circadian distribution with a marked morning increase between 0600 and 1200 hours, and a corresponding decrease in the late night hours. There were no differences in the occurrence of late potentials and in ECG data between early and late arrival group. The early group (less than 5.9 h) was, however, characterized by significantly higher cardiac enzyme levels than the late group (greater than 6.0 h); they also experienced more arrhythmic events in the acute phase (16.0% vs. 9.7%; p less than 0.032). Catecholamines were significantly more often necessary (26.4% vs. 10.3%; p less than 0.0001). Six month prognosis after AMI was markedly worse. The time between symptom onset and hospital arrival was not affected by age and risk factors. In univariate analysis, pain history and recurrent infarction also had no influence on delay of admission to hospital. The time interval was, however, significantly shorter when the acute event occurred during the night (18.4% vs. 8.3%; p less than 0.0001). Absence of prodromi in the prehospital phase (18.5% vs. 12.0%; p less than 0.04) and a higher socio-economic level (68.3% vs. 61.0%; p less than 0.077) also shortened the admission time, whereas a hyperactive behavioral pattern prolonged the delay time (21.1% vs. 28.9%; p less than 0.05). PMID- 1792807 TI - [Initial clinical experiences with a transvenous-subcutaneous defibrillation system]. AB - In 19 patients with an indication for an implantable defibrillator, it was tried to avoid thoracotomy by using two electrodes positioned via the subclavian vein in the right ventricle (for pacing, sensing, and defibrillation) and the superior vena cava or coronary sinus (for defibrillation), and one electrode positioned subcutaneously near the ventricular apex (for defibrillation). In 17 patients (89%) the transvenous-subcutaneous leads were implanted, whereas in the remaining two patients an epi-/pericardial lead system was subsequently used due to an insufficient defibrillation threshold. Perioperatively, no major complications were observed and patients were rapidly mobilized. Within a follow-up period of 7 +/- 4 months, no malfunction of the lead system became evident. Sixty-eight episodes of spontaneous ventricular tachyarrhythmias occurred, all of which were successfully terminated. In one patient an infection of the lead system developed after 2 months that proved refractory to antibiotics and required surgical removal. Thus, transvenous-subcutaneous placement of leads for implantable defibrillators yielded a sufficient defibrillation threshold in the majority of patients. Long-term efficacy was excellent and no malfunctions were observed. This approach seems to be feasible and advisable in patients with an increased risk for thoracotomy. PMID- 1792808 TI - [Combined anti-bradycardia/anti-tachycardia pacemaker-cardioverter-defibrillator systems in patients with recurrent ventricular tachyarrhythmias]. AB - In 41 patients with recurrent sustained ventricular tachycardia and/or ventricular fibrillation an integrated pacemaker-defibrillator-system (PCD, Medtronic, model 7216 A or 7217 B) was implanted. In 21 out of 24 (88%) patients a new transvenous implantation technique in combination with a subcutaneous patch electrode was used. The implanted devices comprise antibradycardiac pacemaker functions, two different forms of antitachycardiac pacemaker functions (ramp and burst pacing), and internal cardioversion or defibrillation capabilities. During a mean follow-up of 8 months 147 episodes of ventricular tachycardia were detected, 131 of them were terminated successfully by antitachycardiac pacing; in 13 episodes internal cardioversion was applied to revert ventricular tachycardia. Twenty-seven episodes of ventricular fibrillation or rapid ventricular tachycardia (greater than 200/min) were detected and successfully terminated by internal defibrillation. In six patients with intermittent rapid atrial fibrillation, change of antiarrhythmic therapy was required to avoid activation of the device. The new integrated pacemaker-defibrillator systems improve therapy in patients with life-threatening tachyarrhythmias by reducing the number of internal cardioversions/defibrillations; the non-thoracotomy approach reduces the post operative risk. PMID- 1792809 TI - [Percutaneous endocardial Nd-YAG laser energy: experimental studies of ablation of the ventricular myocardium]. AB - The in vitro and in vivo effects of endocardial laser ablation were assessed. Energy was supplied by a Nd-YAG laser (wavelength approximately 1064 nm) and transmitted via a quartz core fiber (phi: 0.4 mm) housed within a specially designed 7 F catheter. In vitro, the effects of increasing output power (5, 10, 20, 40 watt) and impulse duration (1, 2, 4, 8 s) on lesion size were assessed in myocardial preparations of canine hearts. Preparations were superfused with saline or blood, respectively; the distance of the optical fiber to the endocardium was 5 mm. Lesion size increased in diameter (range: 0-4.0 mm) and depth (range: 0-5.2 mm) in a power- and time-dependent manner. Superfusion with blood significantly enhanced the diameter of the lesions, whereas depth of the lesions significantly decreased. In 16 anesthetized mongrel dogs, a total of 52 laser impulses (output power: 10, 20, 40 w; impulse duration: 1, 2, 4 s; energy: 10-160 J) were delivered to apical and apico-inferior sites of the left ventricle. Postmortem, 40 lesions with a diameter of 2.6-19.4 mm and a depth of 3.7-16.2 mm were found. 19 lesions revealed central vaporized craters with a depth up to 11.2 mm. Perforation of the left ventricle occurred in two cases following 80 and 160 J, respectively. In vitro and in the intact animal (in apical and apico-inferior sites of the left ventricle) endocardial laser ablation is feasible to induce distinct myocardial lesions in a power- and time-dependent manner.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792810 TI - [Hemodynamic characteristics of heart transplant patients in the early postoperative period]. AB - In spite of good long-term results, heart transplantation continues to carry a significant risk of hospital mortality (about 10%). Among cardiac deaths, right heart failure due to an elevated pulmonary vascular resistance represents a main contributing factor. Since no quantitative data on the hemodynamic situation early after transplantation are available, we monitored 27 heart transplant patients during the first four postoperative days. Data derived from right-heart catheterization, dosages of catecholamines and vasodilative substances were measured at 2, 4, 16, 24, 48, 72, and 96 h after the operation. Oxygen consumption and serum lactate levels were determined until 48 h postoperatively. During that time cardiac output remained constant (2 h: 6.6 +/- 1.4 l/min). The dosage of catecholamines was highest immediately after transplantation (2 h: 0.229 +/- 0.136 micrograms adrenaline/kg/min) and could be reduced thereafter. Highest values of pulmonary vascular resistance were obtained 2 h postoperatively (160 +/- 48 dyn.s.cm-5). This early postoperative situation may result in the development of right-heart failure as observed in two patients who died despite the use of prostacycline on the third and eighth postoperative days. To counteract the systemic vasodilative side-effects of prostaglandins, temporary atrial pacing seems to be useful. In our study atrial stimulation led to an increase of cardiac output and a moderate elevation of mean arterial blood pressure. Only a poor correlation between pre- and postoperative (2-h) pulmonary vascular resistance data could be observed. In most patients the pulmonary vascular resistance decreased during the postoperative course. This was not the case in patients with fixed pulmonary hypertension. We, therefore, conclude that preoperative diagnostics should be refined to recognize patients at risk in order to reduce postoperative mortality. PMID- 1792811 TI - [Acute and long-term effects of pimobendan (UD-CG 115) in NYHA II and III heart failure. Results of a randomized multicenter double-blind study]. AB - The effects of pimobendan (UD-CG 115) on hemodynamics and exercise capacity after acute (single dose) and chronic (6 month) oral treatment, as well as acute treatment after 6 months were investigated in 67 patients with chronic heart failure of NYHA classes II or III, which had persisted in spite of treatment with diuretics and digitalis. They were treated with pimobendan (2.5 mg bid or 5 mg) or placebo in a randomized, double-blind multicenter trial. With a single administration before and after 6 months' treatment there was-compared to placebo a significant fall in pulmonary capillary pressure (PCP) at rest (R) and during exercise (E) of 7% to 24%. Right atrial pressure (R) and pulmonary arterial pressure (PAP) (R, E) decreased after pimobendan on day 1; cardiac index (E) increased significantly. All other parameters were not influenced. After chronic therapy, PCP (E), PAP (E), LV stroke work index (E), and pulmonary resistance (R and E) values were significantly lowered by pimobendan when compared to day 1. Exercise duration was prolonged after 6 months by 83 s and 47 s after 5 and 10 mg/day, resp., compared to the placebo group (group difference not significant). Subjective wellbeing was improved in all three groups (no group difference). Clinical symptoms were not altered; six patients (two in each group) died suddenly. Another nine patients discontinued the trial prematurely because of poor efficacy or adverse events (no group difference). Overall, pimobendan was well-tolerated and had favorable effects on both acute and chronic hemodynamics and on exercise capacity. There was no evidence of any tolerance development. PMID- 1792812 TI - [7th report on the structure and performance figures of the heart catheterization laboratory in Germany. Results of a survey of the Commission of Clinical Cardiology of the German Society of Cardiovascular Research during 1990 with the collaboration of the German Society of Pediatric Cardiology]. PMID- 1792813 TI - Latest developments in K-channel modulator pharmacology. AB - Synthetic modulators of smooth muscle potassium (K) channels now comprise a large number of chemically-diverse molecules which possess either K-channel-opening or K-channel-blocking properties. First-generation openers are typified by the benzopyran, BRL38227 which exhibits little tissue selectivity in vivo or in vitro. Under current development are second-generation molecules such as the benzopyran, HOE234, and the guanidine, LY211808, both of which exhibit some tissue selectivity. Until recently, tetraethylammonium, the aminopyridines and the sulphonylureas like glibenclamide were the most important types of synthetic K-channel blocker available. Recent work has now identified several novel K channel blockers active in smooth muscle. These include the bradycardic agents tedisamil and alinidine and the anorectic agent ciclazindol. The effects of K channel openers on transmitter release are now under detailed study. Although postganglionic neuroeffector transmission in blood vessels seems little affected, transmitter release in bronchial, gastrointestinal and genitourinary preparations is reduced. Whether these effects are primarily pre- or post-ganglionic is unclear. Transmitter release is also reduced in certain areas of the CNS. No clear picture of the type of smooth muscle K-channel with which the openers interact has yet emerged. The ability of glibenclamide to antagonise the effects of K-channel openers apparently favours the involvement of KATP, although the selectivity of glibenclamide and the existence of KATP in smooth muscle remain to be firmly established. PMID- 1792814 TI - Vascular and cardiac actions of aldosterone and spironolactone. AB - Classical pharmacology confines the mechanism of action of aldosterone and its antagonists to the modulation of ion transport in the distal tubule of the nephron. The purpose of this overview is to examine the evidence for the presence of extrarenal and, namely, vascular and cardiac sites of action for aldosterone and spironolactone. Beside its specific action in primary and secondary hyperaldosteronism, spironolactone is effective in lowering blood pressure in essential hypertension, despite normal levels of aldosterone production, and without necessarily producing significant changes in Na+ and K+ urinary excretion. This is particularly the case when therapy is applied chronically and at relatively low doses. This suggests that spironolactone may act by antagonizing the effects of aldosterone directly on the cardiovascular system. Electrophysiological studies have shown that spironolactone may reduce contractions of rat portal vein strips. This action was found to be mediated by the inhibition of the slow calcium channels. Spironolactone binds to the calcium channels, at sites different from those of dihydropyridines and phenylalkylamines. It interacts at these binding sites in vascular membranes by decreasing their density and accelerating the rate of dissociation of the ligand. In humans, spironolactone 50 mg and 75 mg o.d. produced a dose-dependent decrease of total vascular resistance and in vascular reactivity to vasopressor agents. In the heart, spironolactone produces a direct inotropic action in the mammalian myocardium with an increase of both the amplitude and duration of action potential. Finally, the direct role of aldosterone in promoting fibroblast growth producing cardiac hypertrophy in models of experimental hypertension have been recently emphasized.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792815 TI - Dihydropyridines and vascular diseases. AB - Ca antagonists of the dihydropyridine class (DHPs) are a heterogeneous group of drugs that interfere with Ca entry into vascular smooth muscle cells of resistance arterioles through type-L calcium channels producing arteriolar vasodilation. This leads to a reduction of vascular tone and, therefore, they have been successfully used in the treatment of systemic hypertension, myocardial ischemia (stable, variant, and unstable angina and silent ischemia), and Raynaud's phenomenon. Furthermore, recent clinical trials have indicated that DHPs may induce regression or slowing the progression of atheroma in coronary arteries. The results obtained with DHPs in the prophylaxis of migraine headache and in treating ischemic stroke and cerebral artery vasospasm are encouraging. However, more carefully designed, double-blind, large-scale, long-term studies are needed to better define the therapeutic value of DHPs in these disorders, the severity of adverse effects, and the mechanism responsible for their therapeutic effects. PMID- 1792816 TI - Effects of hypoxia on a potassium channel in cat cerebral arterial muscle cells. AB - We have shown that exposure of isolated cat cerebral arterial muscle cells to hypoxic environments increases K+ channel activity when recorded in the cell attached mode. Inhibition by glibenclamide of the "hypoxia-induced" increase in K+ channel activity may suggest that increased activity is mediated by an ATP sensitive K+ channel. Thus, the level of O2 may modulate cerebral vascular tone by an action on membrane K+ channels, possibly mediated by the concentration of intracellular ATP. PMID- 1792817 TI - Potassium channels and modulating factors of channel functions in the human myometrium. AB - Hexoprenaline, a beta-adrenergic agonist of clinical importance in preventing preterm labor, and the calcitonin gene-related peptide (CGRP) that is known to have receptors in the plasmalemma of myometrial cells were investigated to ascertain whether in human myometrium K+(Ca++)channels are involved in the relaxant mechanism. Small sections from the fundus and the corpus of vaginal dissected uteri were isolated under limitation of the operation collective (age of women 35-50 years). Strips of 1-cm length were cut for isometric measurement of contraction. After an equilibration of 60 min under 10 mN tension at 37 degrees C, spontaneous activity occurred and experiments were performed. By enzymatic disaggregation with papain and collagenase single cells were isolated. Electrophysiological experiments were performed using the patch-clamp technique in the cell-attached and excised inside-out configurations. We observed K+ channels with a conductance of 158 pS between -20 and 20 mV in [K+]o/[K+]i of 5.4/140 mM with a reversal potential at about -70 mV. The channel was sensitive to the free calcium concentration on the cytoplasmic side and open probability (Po) increased with membrane depolarization. 0.5 mM ATP facing the cytoplasmic side of the patches (at 40 mV depolarization and pCa of 6) showed no inhibition. Hexoprenaline and CGRP both increased the Po of the K+ (Ca++)channels in the cell attached mode at steady-state kinetics. Forskolin failed to be an activator of K+ (Ca++)channels. In isometric measurements of human myometrial strips spontaneous activity is suppressed by hexoprenaline 10(-5) M and CGRP 10(-7) M, but these effects are antagonized by 2 mM TEA.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792818 TI - Calcium regulation of hormonal-sensitive phospholipase C. AB - Numerous hormones or neurotransmitters regulate the activity of their target cell via the activation of a specific phospholipase C. Two intracellular second messengers are generated, diacylglycerol which activates protein kinase C and inositol (1,4,5)P3 which mobilizes calcium from intracellular stores. Both these molecules trigger within the cell biological effects associated with the hormone considered. In these transduction mechanisms, calcium mobilization is a consequence of primary activation of phospholipase C. However calcium is also able to regulate phospholipase C activity since, in many cellular systems, calcium by itself stimulates phosphoinositol lipid metabolism. Such results imply that all molecules which modify the intracellular calcium concentration may be considered as potent regulators of phospholipase C activity. Data obtained on different cell systems favours this hypothesis: Activators of calcium influx stimulate intracellular inositol phosphate accumulation and molecules which reduce intracellular calcium concentration reduce inositol phosphate production. Thus calcium may play an important role in the regulation of hormonal sensitive phospholipase C activities. PMID- 1792819 TI - Mass measurement of inositol phosphates from the longitudinal muscle of the guinea-pig small intestine: a comparison with radiotracer studies. AB - Changes in the levels of inositol phosphate isomers during muscarinic stimulation of longitudinal smooth muscle fragments have been measured in terms of their mass and their radioactivity value. The mass has been determined by combining a popular h.p.l.c. separation method with desalting, dephosphorylation, and final measurement of inositol liberated using an inositol dehydrogenase--NADH-linked bioluminescence reaction. The h.p.l.c. elution profiles of radiolabelled inositol phosphates were compared with the h.p.l.c. elution profiles of their masses. PMID- 1792820 TI - Venous tone: are the phlebotonic properties predictive of a therapeutic benefit? A comprehensive view of our experience with Daflon 500 mg. AB - Venodilation has been shown to enhance clinical expression of venous insufficiency and, therefore, it has been suggested that increase of venous tone should improve clinical symptoms. Four controlled double-blind clinical trials versus placebo, or versus a new micronized flavonoid fraction, have shown the activity of Daflon 500 mg, which has been evaluated on venous tone using venous plethysmography. The first, randomized cross-over Phase II pharmacoclinical trial has shown that Daflon 500 mg is significantly more effective than placebo on pathological legs, as well as normal legs. In this study, which included 20 patients suffering from post-thrombotic syndrome. Daflon 500 mg decreased: 1) venous capacity (p less than 0.001); 2) venous distensibility (p less than 0.001); and 3) venous outflow time, measured by the two parameters: total emptying venous time (p less than 0.001) and T2p (p less than 0.001). These modifications were observed 2 h after administration without any significant change in T50 outflow, cardiac index, capillary filtration index, blood pressure, cardiac or respiratory rates. The same acute effect of increasing venous tone has been demonstrated in another pharmaco-clinical trials, 1 and 2 h after ingestion by three groups, each composed of 10 women suffering from venous insufficiency: group I without varicose veins, group II during pregnancy, and group III with a post-thrombotic syndrome.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792821 TI - [Adrenal histostructure in the postnatal ontogeny of the Greenland seal, Pagophilus groenlandica Erxleben, 1777 (Phocidae)]. AB - Histological structure of adrenal gland is studied in four age groups of the harp seal: in adults, in two juvenile groups (6 and 1-1.5 months), and in newborns (1 1.5 days). Development of the adrenal gland in this species is analogous to that of terrestrial mammals, but also has some peculiarities of its own. Differentiation of the definitive cortex occur in the prenatal development. In the newborns it is, though weakly developed, clearly differentiated into arched, fascicle and reticular zones. The foetal cortex is discovered in newborns, which further develops in juveniles and is present (without any signs of involution and degeneration) in adults. Adrenal gland persistence was previously known in horses only, but in that case the foetal cortex was partly degenerated in adults. Chromaffin cells undergo differentiation in embryonic development, as newborns already possess two types of such cells. The final differentiation ends in juvenile of 1.5 months old. PMID- 1792822 TI - [The tumor as an atavistic adaptive reaction in environmental conditions]. AB - In sponges, coelenterates, bryozoans, and ascidians, blastogenesis associated with the formation of resting buds and resting blastogenetic structures is similar to the oncogenesis. Just as the tumours, such buds and structures: 1) when released from control of the parent organism, developed independently of the latter and cause its destruction; 2) originate due to the action of various external and internal causes; 3) are hardy to anoxia, dehydration, overcooling; 4) consist of little differentiated and de-differentiated cells. These similarities can be explained in the frame of hypothesis which considers tumours an atavistic resting structure. PMID- 1792823 TI - [The morphogenetic causes of parallelisms in the dental system of rodents]. AB - Morphogenetic causes of the origin of true hypsodonty and transformation of bunodont teeth pattern to lophodont one in the rodent evolution are discussed. Wide distribution of these processes in different rodent groups and many other mammals can be explained by the universality of morphogenetic mechanisms of teeth development and by scantiness of their possible transformation pathways. PMID- 1792824 TI - [The developmental patterns of the cartilaginous elements in vertebrate ontogeny]. AB - Comparative embryological data presented in the paper support an idea that chondrification of the mesenchyme does not begin until the latter becomes condensated. Size and density of the skeletogenous rudiments are not the same in different vertebrates. As a rule, in animals with much of the mesenchyme (chondrichthyans, amniotes), the prochondral condensations contain more cells and have both greater mass and density. The distribution pattern of the mesenchyme is also significant for the future development of the cartilaginous elements which at the earlier stages grow largely by the recruitment of surrounding mesenchymal cells. Such kind of the growth mode is probably most similar to the cartilage fusion mode: both processed take place in the absence of the perichondrium. The non-skeletal dense structures influence on the development of the cartilaginous skeleton primarily by determining distribution pattern of the mesenchyme, particularly the condensation of skeletogenous cells. THe growing cartilages themselves can influence mechanically on the surrounding organs. PMID- 1792825 TI - Effect of added lipids on the texture of minced hake (Merluccius merluccius L.), megrim (Lepidorhombus whiffiagonis W.) and sardine (Sardina pilchardus W.) during frozen storage. AB - The effect of added cod liver oil and oxidized cod liver oil on the measurement of texture in minced hake (Merluccius merluccius L.), megrim (Lepidorhombus whiffiagonis W.) and sardine (Sardina pilchardus W.) has been measured during frozen storage (-18 degrees C). The results show that added neutral and oxidized lipids, even at high rancidity levels, do not affect shear resistances measured by the Kramer shear-compression cell in non-formaldehyde forming species such as megrim and sardine, over the frozen storage period. However, in a formaldehyde forming species such as hake, in the presence of neutral and oxidized lipids at the end of the storage period, the values of shear resistances may be lower than in the absence of these lipids, probably owing to formation of less formaldehyde in these cases. Although it is very difficult to estimate the importance of a single compound or group of compounds on texture, these results seem to indicate that formaldehyde is a much more important factor than oxidized lipids in changes of texture in fish. PMID- 1792826 TI - Changes in benzo(a)pyrene content in fermented salami. AB - The benzo(a)pyrene (BaP) content of fermented salami was monitored during the technological processes of cold smoking, ripening and storage. The changes in BaP content were not so great as in products smoked with hot smoke. However, the decrease in BaP content caused by destructive action of physico-chemical environmental factors was compensated by successive dehydration of the fermented product. After recalculating the BaP content on a dry weight basis a concentration decrease was evident. Significant changes were registered during smoking and ripening while storage under different conditions caused no further effect on these changes. PMID- 1792827 TI - Determination of levamisole and thiabendazole in meat by HPLC and photodiode array detection. AB - An HPLC method for the analysis of levamisole and thiabendazole has been developed with recoveries varying over 63-75%. The two anthelmintics are extracted from meat with ethyl acetate, purified by liquid/liquid extraction and analyzed quantitatively on a mu Bondapak C18 column. The optimum detection is achieved by means of a photodiode array detector at 240 nm for levamisole and at 300 nm for thiabendazole. The detection limits for both compounds in meat are 25 micrograms/kg and 5 micrograms/kg, respectively. PMID- 1792828 TI - [Computer-assisted data analysis of injuries of the skeletal system in polytrauma patients]. AB - The data of 366 patients with multiple injuries were evaluated by application of data processing over a period of seven years. Age and sex distribution, location and combination of injuries, mortality, mechanism of accident, diagnostics as well as therapy were analysed. 91.3% of our patients had injuries of the skeleton. The male to female ratio was 2:1. In 55.4% the age of the patients ranged from 10 to 39 years. The mortality rate of all patients was 27.2%. In the third decade only 16.9% of the patients died. Whereas the mortality of the patients in the 1. decade as well as between the 7. and 9. decades of life was very high (33% and 50%). Most of the skeletal injuries were located in the shank (24% open fractures). The mortality rate increases with the number of injuries (Table III). Patients with concomitant injuries, such as head injuries and fractures of the extremities were the most common combination of multiple injuries. 20% of the patients in this group died. Patients with combined injuries of the head, chest, abdomen and skeleton had highest mortality (57%). X-ray examination of the skull, chest, extremities and mainly of the spine and pelvis should be subjects of routine diagnostics. In patients who were suspected of having a blunt abdominal trauma, the first diagnostic technique will be ultrasound. On account of the various number of concomitant injuries as well as the patients individuality, the estimation of prognosis by systems for the classification of the severity of injury is fraught with difficulties. The analysis of the evaluated data showed that previously small number of variables may predict the prognosis of the course of disease. PMID- 1792829 TI - [The most frequent tendon injury: the "mallet finger". Review, therapeutic concept and results]. AB - This study covers treatment and after-treatment of 126 extensor tendon injuries of the DIP-joint in 125 patients over a period of 4 years. Tendon injuries were classified into 4 types and the final results were evaluated using a modified Riedeberger and Zeumer scale. In recent subcutaneous tendon injuries conservative therapy is indicated, depending on the primary extension deficit (less than 20 degrees modified Stack splint, greater than 20 degrees Mommsen plaster of Paris or special dressing). Chip fractures should be stabilized by pull-out suture. PMID- 1792830 TI - [Intraoperative complications in hand surgery]. PMID- 1792831 TI - [Osteomyelitis in tropical countries]. AB - A retrospective study was made of 13 patients admitted to the pediatric ward of Gondar College of Medical Sciences from October 1987 to May 1988. It was found that the disease occurs mainly in males. In the most cases there are clear clinical and radiological findings. The main reasons turned to be traumatic and spontaneous with unknown causes. Gram cocci takes the leading bacteries found on cultures taken from the discharging sinuses. Treatment was performed with appropriate antibiotics and surgical intervention when indicated. In regard to response to our treatment most of the patients showed good clinical improvement. With early treatment the course is found to be much more benign. PMID- 1792832 TI - The intra-arterial ultrasonography as an exclusive exploration method to determine atherosclerotic lesions of the arterial wall in a preclinical stage. AB - An intravascular ultrasonography of the peripheral arterial system was applied following on the coronarography to 56 patients suffering from one or several critical stenoses on the coronary arteries. Though the clinical vascular examination and the subsequent noninvasive examination of the peripheral arterial system of all these patients turned out to be completely normal, the intra arterial ultrasonography was able to reveal important atherosclerotic alterations in the wall of the abdominal aorta and of the iliac arteries in the case of 51 of these patients. The intra-arterial ultrasonography appears to be a very sensitive method of exploration, permitting atherosclerotic changes of the arterial wall to be detected at a very early pre-clinical stage, even long before these anomalies could have caused a specific pattern of complaints. PMID- 1792833 TI - Radiofrequency ablation of a slow pathway in AV-nodal tachycardia. AB - A 35-year-old woman with frequent attacks of paroxysmal supraventricular tachycardia and psychiatric background was submitted to ablation of AV-nodal tachycardia. Before ablation, tachycardia with a cycle length of 455 ms was easily induced with regular atrial stimulation or with one extrastimulus. Radiofrequency current (35 Watts) was applied on a site, localized between the His bundle and the ostium of the coronary sinus. The local electrogram showed an atrial activation 20 ms before the atrial activation at the His bundle site during tachycardia. Application terminated AV-nodal tachycardia within 2.5 seconds. Two back-up applications were given during sinus rhythm. At the control study, conduction over the slow pathway was abolished, and the fast conduction remained intact with a Wenckebach 2:1 block point at 180 beats/min. She remained free of recurrences with a follow-up of more than 3 months. The possibility of selective ablation of the slow pathway in AV-nodal tachycardia is discussed. PMID- 1792834 TI - Induced electrophysiological isolation of the myocardium prevents ventricular fibrillation. AB - STUDY OBJECTIVE: to investigate whether an encircling procedure without ventriculotomy, not involving the endocardium, may have a protective effect against ventricular fibrillation (VF), by achieving a physiological rather than anatomic entrenchment. DESIGN: the occurrence of VF was tested by DC application within an area entrenched by a circular "dotted" line formed by LASER (Nd-Yag) point by point applications. The result was compared with that from similar DC applications before the successful LASER entrenchment or beyond the restricted area. SUBJECTS: 16 anaesthetized mongrel dogs, weights 14-20 kg were used. MEASUREMENTS AND RESULTS: VF occurred 13/118 times by applying DC within the entrenched area and 86/114 times by applying the current outside this area or before the intervention (P less than 0.0005). The pacing threshold was significantly (P less than 0.001) increased within the circumscribed area (4.625 +/- 5.335 vs 0.859 +/- 0.947 mA). The maximal rate at which the ventricles could be driven by pacing at double threshold intensity was not significantly altered by the encircling procedure. Histological examination showed crater-like epicardial destruction with necrosis, loss of myocardial striation, haemorrhage, and polymorphonuclear infiltration, extending about 0.5 cm from the necrotic tissue. The subendocardial area was spared showing only hyperaemia, while the endocardium was intact. CONCLUSIONS: Encircling a small area by LASER point by point applications prevents the occurrence of VF when DC is applied within the restricted area, while permitting the conduction of paced beats. The size of the encircled area necessary to this effect is of importance, possibly reflecting the critical mass needed for the occurrence and maintenance of VF. PMID- 1792835 TI - Evaluation of systolic time intervals in a group of healthy children 10-12 years old. AB - The normal values of the systolic time intervals (STI) in children and their possible relationship with heart rate have not been studied thoroughly. From a group of 9760 healthy school-children 10-12 years old, 488 subjects of both sexes were randomly selected in order to measure the STI and calculate the respective indices. The final population study was composed of 479 children, 249 males and 230 females, aged from 10/1 to 12/2 years/months (mean age 11/1 +/- 0/4 years/months). In each child, the following STI were measured: total electromechanical systole (Q-S2), left ventricular ejection time (LVET), mechanical systole (S1-S2), preejection period (PEP), PEP/LVET ratio and isovolumic contraction time (ICT). For each parameter, the regression equation with heart rate was calculated using a linear model and was verified if a real difference existed between linear regressions of males and females. Moreover, for each parameter, the index from the respective regression equation was calculated as well as its normal value and the standard deviation. Finally, the diastolic time (% diastole) and its correlation with heart rate were calculated. Our results demonstrate that in children, a close correlation exists between the STI and heart rate, although less striking than in adults; only the PEP/LVET ratio appears independent from heart rate, as in adults. The % diastole versus heart rate non-linear relationship shows the same behaviour as in adults. Finally, in agreement with other authors, our results show that in childhood the relationship between the STI and heart rate behaves alike in males and females. PMID- 1792836 TI - [Respiratory complications in severe acute pancreatitis]. AB - The two basic mechanisms underlying most of the pleuropulmonary complications of severe acute pancreatitis include pulmonary atelectasis and alveolar flooding. Like in any abdominal catastrophe, pleural effusion and limited diaphragmatic excursion due to pain and intestinal atony are the main factors responsible for alveolar collapse and secondary infection. Physical therapy and needle pleural evacuation are the cornerstones of management. Owing to its pathophysiologic mechanisms adult respiratory distress syndrome is peculiar to acute pancreatitis. Alveolar capillary membrane injury is related to pancreatic necrosis, to its regional extent and to the subsequent over-amplification of the inflammatory reaction. Diversion of those potential mediators of the syndrome either surgically or by thoracic duct drainage is essential in order to improve survival in these patients. PMID- 1792837 TI - [Acute dilatation of the colon]. AB - Dilated colon is provoked by obstructing lesions, toxic megacolon or colonic pseudoobstruction. The obstructing lesions of the colon are colonic volvulus, inflammatory bowel disease with stenosis or colonic cancer. Toxic megacolon is more often caused by I.B.D. and rarely by infectious diseases. Etiological diagnosis is possible after clinical and radiological evaluation. Colonoscopy is always indicated, except in toxic megacolon. Balloon dilatation of strictures, palliative treatment of colonic carcinoma by Laser procedures, reduction of colonic volvulus and aspiration of colonic pseudoobstruction are the principal indications of therapeutic colonoscopy in the non surgical treatment of dilated colon. PMID- 1792838 TI - [Endoscopic treatment of hemorrhagic gastroduodenal ulcer]. PMID- 1792839 TI - [Acute hepatic insufficiency: medico-surgical therapeutic approach]. PMID- 1792840 TI - [Interferon and chronic non-A, non-B hepatitis: status of the problem]. AB - Alpha interferon is the only effective therapy in patients with chronic non-A, non-B hepatitis. Alpha interferon administration during 6 months, in a dosage of 3 millions units, three times per week, induces a complete response defined by the normalisation of transaminases in about 50% of the patients. The normalisation of transaminases is correlated to an improvement of liver histologic activity. A relapse, with the re-increase of transaminases, is often observed after withdrawal of interferon. One year after therapy, less than 20% of the patients treated have a sustained complete response defined by persistently normal transaminases. Studies are in progress about the efficacy of higher dosage or longer duration of alpha interferon administration. PMID- 1792841 TI - [Invasive cancer of the esophagus]. PMID- 1792842 TI - [Achalasia of the cardia]. PMID- 1792843 TI - [Duodenal ulcer: long-term treatment]. PMID- 1792844 TI - Polypes degeneres du colon. [Degenerated colonic polyps]. PMID- 1792845 TI - [Villous tumors of the rectum]. PMID- 1792846 TI - [Choledochal lithiasis with an in-situ gallbladder]. PMID- 1792847 TI - Medico-surgical management of pancreatic carcinoma. PMID- 1792848 TI - [Cysto-enterostomy in chronic pancreatitis]. PMID- 1792849 TI - [Pancreatic drainage in pancreatitis]. PMID- 1792850 TI - Etiology and management of single small CT lesions in patients with seizures: understanding a controversy. AB - Single, small (less than 1 cm) enhancing lesions are frequent findings on CT scans of Indian patients with seizures. These lesions have also been reported in patients from other parts of the world. They often resolve spontaneously and their etiology has been disputed for over a decade. Initially diagnosed in Indian patients as tuberculomas, a number of other etiologies have been suggested. More recently, based on biopsy data, we have shown that a majority of these lesions are caused by cysticercosis. This review traces the development of the controversy and reports the current understanding of their etiology. A logical approach to their management is also discussed. PMID- 1792851 TI - A prolonged prospective follow-up study of 306 epileptic patients in New Delhi. AB - A prolonged prospective follow-up study of 306 cases of epilepsy was carried out and patients followed up for at least 3 years. The aim of this study was to know the range of seizure types, the severity of epilepsy, and the results of the treatment in a developing country like India. The results indicate that the reported familial incidence of seizures was low. Two-thirds of cases were adequately treated with a single drug. There was no significant teratogenic effect of the drugs. Majority of patients had seizure recurrence within 3 months of stopping anticonvulsant drugs. PMID- 1792852 TI - Clinical parameters in 74 consecutive patients shunt operated for normal pressure hydrocephalus. AB - Seventy four consecutive patients diagnosed as normal pressure hydrocephalus (NPH) and operated with a ventriculo-peritoneal shunt were followed prospectively for an average of 2.1 years. The mean age was 64 years. The effect of the operation was estimated by calculating 6 indices expression social functioning, neurological signs, gait ability, continence, psychometric performance and psychiatric condition. Ninety-six % had mental symptoms, 95% gait disturbances and 75% incontinence. Improvement was observed in 78% after shunt surgery, while 22% deteriorated. Psychiatric improvement was seen in 80% and 76% improved in gait ability. Improvement was highest in the group caused by subarachnoid hemorrhage (98%) while 73% with idiopathic NPH improved. Old age was not correlated to poorer response, while long-standing pre-operative symptoms yielded worse results. No single symptom or sign could predict a positive outcome of the operation. Eleven % of the patients could leave long-term care institutions and there was a 36% reduction of aid in daily living. Complications to shunt surgery were observed in 50% of the patients and shunt related mortality was 1%. Shunt malfunction was the most frequent complication (31%) followed by infection (19%). Epilepsy developed in 9% after surgery. All shunt complication except one appeared within the first year after surgery. PMID- 1792853 TI - Hypersomnia in dystrophia myotonica: a neurophysiological and immunogenetic study. AB - Ten patients with dystrophia myotonica (8 adults and 2 prepubertal children), from three unrelated families, were investigated for diurnal sleepiness, using a sleep questionnaire and multiple sleep latency test (MSLT). Immunogenetic study was also carried out to assess the involvement of HLA region genes in modulating susceptibility to excessive diurnal sleepiness (EDS). EDS was reported by 5 patients and confirmed in each case by MSLT. In the whole patients group, mean daytime sleep latency was significantly shorter than in healthy controls matched for age and sex. At clinical or neurophysiological evaluation, EDS did not show the features associated with the narcoleptic type. In only one case hypersomnolence could be explained by underlying sleep-disordered breathing. HLA patterns were different from those frequently observed in the narcoleptic or non narcoleptic types of hypersomnia. In patients with EDS, the frequency of the DQW1 and particularly of the DRW6-DQW1 haplotype appeared to be over-represented. PMID- 1792854 TI - Continuous intravenous infusion of TRH-T: clinical, cardiovascular and endocrinological effects. AB - Seven patients, six suffering from amyotrophic lateral sclerosis (ALS) and one from Friedreich ataxia, were treated with a placebo i.v. infusion during the first day and with TRH-T i.v. infusion at a rate of 2 mg/h for 8 h daily (total daily dosage 16 mg) on the 2 consecutive days. Continuous blood pressure (BP) and EKG monitorings were performed during 3 days infusion. Blood samples were collected for endocrinological evaluations. The neurological evaluation after acute TRH-T treatment showed an objective improvement in 3 of the 8. We found significantly higher values of systolic (max. difference of 10.1 mm Hg) and diastolic (max. difference of 8.8 mm Hg) BP than during placebo, beginning from the 5th h of the infusion (p less than 0.05). A trend in progressive increase of the heart rate (HR) reached statistical significance (p less than 0.01) at the 8th h of the second TRH-T infusion. The cardiovascular changes during the i.v. continuous TRH-T infusions were clinically irrelevant and never required the interruption of the treatment. PMID- 1792855 TI - Doppler CO2-test in patients with vertebrobasilar ischemia. AB - The pathogenesis of vertebrobasilar ischemia (VBI) is still uncertain. Embolism and systemic hypotension have been discussed as possible causes. We evaluated the basilar arteries of 35 VBI-patients by transcranial Doppler-sonography at rest and under hypercapnic conditions and compared these findings with the basilar flow velocities in 10 healthy volunteers matched by age. We found no difference between the controls and the VBI-patients for the basilar flow velocities at rest. Under hypercapnia (end-tidal CO2-concentration 8.5%), the basilar blood flow velocities in the healthy controls increased by an average of 53.0% but only by 32.3% in the VBI-patients (p less than 0.005). The reduction of CO2 dependent vasomotor reactivity was observed in all VBI-patients, except in patients with infarction in the posterior cerebral artery area, possibly indicating a different pathogenic mechanism of stroke. The results in all other patients revealed no obvious correlation to the clinical course or angiographic or dopplersonographic findings. As CO2 dependent vasomotor reactivity and brain perfusion pressure dependent cerebral autoregulation have similar mechanisms, we conclude that systemic hypotension might play an important part in VBI. PMID- 1792856 TI - Genetic factors in epileptic seizures: evidence from a large twin population. AB - The Finnish Twin Cohort study (27,776 individuals; all twins of the same sex born before 1958 and alive in 1967) detected 316 cases of epileptic seizures occurring in 310 twin pairs: 89 monozygotic pairs and 221 dizygotic pairs, including three concordant monozygotic pairs and three concordant dizygotic pairs. The ratio of the observed to expected number of concordant pairs for epileptic seizures was 5.48 (90% CL 1.5-14.2) in monozygotic and 2.12 (90% CL 0.6-5.5) in dizygotic pairs. The results suggest that 8% to 27% of the incidence of epileptic seizures is related to genetic variability. The study of environmental differences in discordant monozygotic pairs should provide insights into the etiology of this group of disorders. PMID- 1792857 TI - Interrater agreement for CT scans of patients with lacunar infarcts and leuko araiosis. AB - A total of 74 CT scans from patients with lacunar syndromes were presented to 10 raters, most of them experienced in neuroradiology. The attributes to be judged were: lacunar infarcts (yes/no), leuko-araiosis (decreased density of the cerebral white matter) (yes/no), cortical atrophy (yes/no), and normal (yes/no). The chance corrected kappa coefficients were 0.641 for decreased density, 0.445 for lacunar infarcts and 0.206 for cortical atrophy. Taking into consideration the attribute cortical atrophy, the kappa coefficient for the attribute normal was 0.330, and without taking cortical atrophy into consideration, it was 0.523. Studies of lacunar infarcts and of leuko-araiosis should be based on clear definitions in order to guarantee a minimum level of interrater agreement. PMID- 1792858 TI - Platelet monoamine oxidase and plasma dopamine-beta-hydroxylase activities in patients with multiple sclerosis. AB - Platelet monoamine oxidase (MAO) and plasma dopamine-beta-hydroxylase (DBH) activities were determined in a large group of multiple sclerose patients in relapse (49 patients) and in remission (28 patients), and compared with an age- and sex-matched control group (52 normal subjects). The activities of both enzymes did not differ from normal in both patient groups. Women had higher MAO activities both in normal and in patient groups. Multiple linear regression analysis revealed an association of low platelet MAO to the score in the mental subscale in the Kurtzke Disability Status Scale. Both male and female patients with mental symptomatology had significantly (p = 0.02) lower platelet MAO activities compared to the patients without. The possibility of a relationship between MAO activity and psychiatric vulnerability in MS is considered. PMID- 1792859 TI - Painful tonic spasms: an interesting phenomenon in cerebral ischemia. AB - We report a case of bilateral cerebral ischemia with frequent painful tonic spasms involving face, both upper and sometimes both lower extremities. The spasms subsided after treatment with diazepam. PMID- 1792860 TI - Absence of antibodies to Borrelia burgdorferi in multiple sclerosis. PMID- 1792861 TI - Empty sella in Sheehan's syndrome. PMID- 1792862 TI - Reassessment of a new model of complete cerebral ischemia in rats. Method of induction of clinical death, pathophysiology and cerebrovascular pathology. AB - The present study was undertaken to ascertain the role of the microcirculation in the phenomenon of hypoperfusion following complete cerebral ischemia. The experiments were performed on rats under superficial ether anesthesia. Cerebral ischemia was induced by cardiac arrest for 3.5 or 10 min, with survival periods that lasted from 3 min to 7 days. A special metal hook-like device was inserted into the chest cavity at the third intercostal spaces for occluding the cardiac vessel bundle. The effect of this procedure was total cessation of systemic circulation, i.e., clinical death. In 52% of animals with 10-min clinical death, resuscitation (external heart massage and artificial ventilation) restored heart activity. When brain circulation was restored, respiratory activity, pain reaction, corneal reflex, bioelectric activity of the cortex, and normal activities of the rats returned. Scanning electron microscopy was applied to study the effect of ischemia on the vessel wall and endothelial cells (EC). Ischemia produced a remarkable increase in the numbers of microvilli and pit-like invaginations on the luminal EC surface. The luminal wall surface of many of the microvessels (MV) formed ridges. Frequently, microthrombi of varying sizes were observed. The most prominent changes were noted from 3 min to 6 h of recirculation, and they correlated with hypoperfusion after ischemia. Seven days later, these changes completely disappeared. The data presented here indicate that progressive hypoperfusion after ischemia occurs with significant alterations in the MV walls. These studies collectively suggest that the focal responses in select MVs may be associated with receptor molecule up-regulation of some, but not all, affected ECs. Our data provide further characterization of a new and unique chronic model of brain ischemia that can be applied to relevant clinical studies. PMID- 1792863 TI - Relationship between glial reaction to a stab wound and tumor development after receiving transplacental ethylnitrosourea in the rat. AB - Fisher 344 rats born from mothers treated with ethylnitrosourea (ENU) 50 mg/kg intravenously were injured at the 1st and 2nd month of extrauterine life by a transcranial stab. The wound affected cerebral cortex, white matter and basal ganglia. The animals were killed 15 and 45 days and 5 months after injury and cell reaction was studied histologically and immunohistochemically. Bromodeoxyuridine (BrdUrd) was administered 1 h before sacrifice and the labeled cells were evaluated. In ENU-treated rats injured at 1 month of age only minor differences were found in comparison with injured controls. In ENU rats injured at 2 months of age and killed 15 days later, a higher number of BrdUrd-labeled cells was found in comparison with controls; 45 days after injury the cell reaction acquired the aspect of a microtumor, however, no microtumor unrelated with the needle track was present. In ENU rats killed 5 months after the injury, there was no difference between injured and not injured ENU-treated rats, as far as the aspect and the number of tumors were concerned. The tumor phenotype was, thus, anticipated by the cell response to trauma in ENU rats. The interpretation is that the additional cell division, in response to trauma, anticipate not only the phenotypic, but also the cell kinetics changes, as indicated by BrdUrd labeling. PMID- 1792864 TI - Neuropathological findings in muscle-eye-brain disease (MEB-D). Neuropathological delineation of MEB-D from congenital muscular dystrophy of the Fukuyama type. AB - Congenital muscular dystrophy (CMD) associated with cerebro-ocular dysplasia named muscle-eye-brain disease (MEB-D) is described in two sisters. Progressive hypotonia, mental retardation and severe visual failure appeared immediately after birth. Pathological examination demonstrated muscular dystrophy, hydrocephalus, type II lissencephaly and defective eye development of foetal origin. The great similarity of the clinical and neuropathological picture of both sisters is in agreement with an autosomal recessive inheritance. Neuropathological distinction between Fukuyama-CMD and MEB-D is a more severe and earlier cerebral developmental defect and the association with ocular dysplasia in MEB-D. PMID- 1792865 TI - Mitochondrial abnormalities in the postviral fatigue syndrome. AB - We have examined the muscle biopsies of 50 patients who had postviral fatigue syndrome (PFS) for from 1 to 17 years. We found mild to severe atrophy of type II fibres in 39 biopsies, with a mild to moderate excess of lipid. On ultrastructural examination, 35 of these specimens showed branching and fusion of mitochondrial cristae. Mitochondrial degeneration was obvious in 40 of the biopsies with swelling, vacuolation, myelin figures and secondary lysosomes. These abnormalities were in obvious contrast to control biopsies, where even mild changes were rarely detected. The findings described here provide the first evidence that PFS may be due to a mitochondrial disorder precipitated by a virus infection. PMID- 1792867 TI - The topographic distribution of brain atrophy in Alzheimer's disease. AB - The extent of regional atrophy in ten patients, aged 52-74 years, dying with Alzheimer's disease uncomplicated pathologically by the effects of advanced old age or cerebrovascular disease, was quantified by image analysis of fixed coronal brain slices. Atrophy of the cerebral cortex was globally distributed, although the temporal lobe was most severely affected. Grey and white matter was in general affected equally. Atrophy was also present within the basal ganglia, particularly the caudate nucleus and putamen. Cerebral cortical atrophy is probably due mostly to neurofibrillary degeneration and loss of intrinsic pyramidal cells and their processes (grey matter) and axons (white matter) although loss of ascending subcortical fibres from regions such as nucleus basalis and locus caeruleus will contribute. Atrophy of the basal ganglia may relate to loss of descending cortical projections. PMID- 1792866 TI - Neuronal injury and expression of 72-kDa heat-shock protein after forebrain ischemia in the rat. AB - We evaluated the relationship between the induction of the 72-kDa heat-shock protein (hsp 72) and the presence of necrotic neurons in the rat hippocampus, 48 h after an 8-min episode of forebrain ischemia in eight rates. Hsp 72 was detected using the monoclonal antibody C92 on vibratome brain tissue sections. Hematoxylin and eosin (H&E) staining on adjacent paraffin-embedded sections was used to determine histopathological features. All morphologically intact CA1/2 neurons, 70% of which are destined to become necrotic 7 days after ischemia, exhibited intense hsp 72 staining, while necrotic or damaged neurons were devoid or low in hsp 72. Hsp 72 was also detected in CA3 neurons destined to survive 7 days after ischemia. Blood vessels positive for hsp 72 were detected in focal brain regions, in which severely damaged neurons were either devoid or low in hsp 72 staining. Occasional glial cells expressed hsp 72 in both normal and damaged brain regions. Hsp 72 response to a transient forebrain ischemia seemingly reflects differences in the selective ischemic vulnerability of CA1/2 and CA3 neurons. Further, the presence of hsp 72 within a neuron is likely only a marker of stress and is not necessarily indicative of eventual neuronal survival. PMID- 1792868 TI - Uncompacted lamellae as a feature of tomaculous neuropathy. AB - Clinical findings suggested an inherited tendency to pressure palsies, but in this case without a family history. This was confirmed pathologically by the identification of a tomaculous neuropathy showing some atypical features including the presence of uncompacted lamellae in a high proportion of fibres. PMID- 1792869 TI - A new syndrome of mental retardation and epilepsy characterized by dense microsphere accumulation. AB - Dense microspheres (DMS) are enigmatic structures found within dendrites in the normal human cortex; their composition and function are unknown. We describe a case of a 29-year-old male with a history of mental retardation and epilepsy in whom the unique neuropathological finding was a marked excess of DMS, most notably in the neocortex. This is a previously undescribed neuropathological syndrome, and represents the first unequivocal association of DMS with a neurological disorder. PMID- 1792870 TI - Concomitant Creutzfeldt-Jakob and Alzheimer diseases. AB - We report a 69-year-old female with cerebral and cerebellar symptomatology of 15 month duration. At autopsy, both panencephalopathic Creutzfeldt-Jakob and plaque predominant Alzheimer diseases were found. Plaque amyloid was exclusively of the beta/A4 type, but abundant abnormal protease-resistant protein was identified by Western blot analysis of brain extracts. PMID- 1792871 TI - An autopsy case of mitochondrial encephalomyopathy with prominent degeneration in olivo-ponto-cerebellar system. AB - We describe a sporadic case of adult-onset, complex I deficiency mitochondrial encephalomyopathy (MEM), the clinical and pathological features of which failed to fit any of the known subgroups of MEM, such as Kearns-Sayre syndrome, mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes or myoclonus epilepsy with ragged-red fibers. Clinically, this patient had only progressive cerebellar ataxia, generalized muscle weakness and hearing loss. The principal finding at autopsy was degeneration of the olivo-ponto-cerebellar system. This case suggests that mitochondrial disease could underlie some cases of olivo-ponto-cerebellar atrophy. PMID- 1792872 TI - [Development of total knee prostheses in the last 20 years, classification]. PMID- 1792873 TI - Design of Kinemax total knee replacement. Bearing surfaces. AB - Wear and deformation of the plastic patella component and the tibial bearing surface are recognised concerns in condylar knee designs. This paper discusses an approach to minimising the wear and deformation, while allowing sufficient laxity for activities of everyday living. The femoral component was designed from an average geometry based on sectioning of whole knees. The patella groove of the femoral component has an anatomical profile. The patella component is a close fit in the skyline view, providing a wide area of contact. The laxity requirements were satisfied, based on a 3-D motion study. For the tibial-femoral surfaces, 3-D motion studies showed that plus/minus 12 degrees rotation were needed about neutral, and 13 mm of A-P displacement. A computer program was written to generate the tibial surfaces which allowed for these motions. The contact stresses were considered acceptable for low wear. However, if interchangeability was not required, the stresses could be reduced further. Finally, if the required motion was reduced, especially A-P displacement, stresses could be reduced by over 24 percent. Such a surface was designed for use in heavy, young and active patients. PMID- 1792874 TI - [The treatment of static metatarsalgia using osteotomy of the base of the metatarsus, and its potential association with the Hohmann technique for treatment of hallux valgus]. PMID- 1792875 TI - Results and complications of the LCS (Low Contact Stress) knee system. AB - Low Contact Stress moveable bearing (meniscal and rotating) total results are reported in a prospective FDA-related series. Multi-center results (918 cemented, 963 cementless) were good/excellent in over 95%. More recently analyzed meniscal bearing data in non-inflammatory arthritis revealed good/excellent results in 93.7% of 355 cemented and 93.5% of 451 cementless knees with 2-5 year follow-up. Personal experience with 275 LCS knees (all types/all diagnoses) over 2 years revealed 97.4% good/excellent results. Evaluation scores improved from 53 to 89 points. Device-related complications have decreased from 5.8% cemented to 2.8% cementless. However, fewer sizes were available in the cemented series, contributing to increased loosening. Tibial bearing problems were under 2%. Patella complications have remained under 1%, with or without patella resurfacing. Survival analysis has been greater in the cementless group. The LCS design has remained unchanged for 11 years. PMID- 1792876 TI - [Critical assessment of the functional advantage of preserving the 2 cruciate ligaments in total knee prosthesis. Experience with the Hermes' prosthesis]. PMID- 1792877 TI - [Semi-constrained prosthetic arthroplasty of the knee following tibial osteotomy]. PMID- 1792878 TI - [Stability defects in total knee prostheses. Causes--consequences--prevention]. PMID- 1792879 TI - [Aseptic loosening of semi-constrained knee prostheses]. PMID- 1792880 TI - [Septic complications in semi-constrained total knee prostheses]. PMID- 1792881 TI - [The dorsal release technique in the treatment of static metatarsalgia. Apropos of 182 surgical cases]. PMID- 1792882 TI - Organizational and investigational aspects of bone banking in Belgium. AB - Our experience with the bone banking methodology that we have used over the last years is reported. The technical and investigational aspects of the procurement, storage and treatment of the donor bone and related tissues are presented. For different purposes, we have prepared sterile and nonsterile procured implants. Appropriate donor selection and sterility controls remain the two major concerns of bone banking activities. PMID- 1792883 TI - [Massive bone allografts sterilized by irradiation: evaluation following 5 years of use]. PMID- 1792884 TI - Experimental ligament reconstruction by allogeneic tendon graft in a canine model. AB - The revascularization and remodelling of fresh-frozen allografts used to replace the anterior cruciate (ACL) and medial collateral ligaments (MCL) of the knee were studied by microangiographic, histological and biomechanical methods. The allografts were produced from the patellar tendons of dogs. No bone was attached on either end. The tissue was frozen and thawed immediately before grafting. The grafts were shaped to either 4 to 4.5 mm (for ACL or MCL) or 8 to 9 mm wide (for ACL), and fixed into the drill holes made in the femur and tibia with sutures and buttons after excision of the original ligaments. The animals were sacrificed from 3 to 52 weeks postoperatively. Microangiographically, the ACL and MCL allografts were revascularized from the sixth postoperative week, and later developed an intrinsic vascular pattern similar to that of a normal ACL or MCL. Histologically, both the allografts regained a fibrous framework similar to that of normal ligaments, and showed no evidence of immunological rejection. Biomechanical tests on the ACL allografts showed that their mean maximum tensile loads at 52 weeks were 36% of those for the control ACLs, or 27% of those for the allografts before reconstruction. The tests on the MCL allografts showed that their maximum tensile loads at 52 weeks were 73% of those for the normal MCLs, or 60% of those for the allografts before reconstruction. PMID- 1792885 TI - [Reconstruction of the anterior cruciate ligament with a free graft of the patellar tendon: allograft versus autograft]. PMID- 1792886 TI - [Palliative mixed intra- and extra-articular allograft surgery of the ligaments in chronic anterior laxity of the knee (technical note)]. PMID- 1792887 TI - [Decompensation of the 2d metatarsophalangeal joint--biomechanics and therapeutic approach]. PMID- 1792888 TI - Osteochondral allografts in arm and forearm surgery. AB - Osteochondral allografting can restore the skeletal continuity anatomically after a limb salvage procedure. Evaluation of the clinical function indicates that a good result can be anticipated. Fracture was the most frequent complication, and the fixation technique we used initially predisposed the problem. The major advantage of allograft is the possibility of reinsertion of soft tissue to help stabilize the new joint. In addition, any part of the limb can potentially be reconstructed with an allograft. PMID- 1792889 TI - The fate of hemijoint allografts after tumor resection about the knee. AB - Distal femoral or proximal tibial resection was performed in 15 patients for bone tumor and replaced by defrosted allogeneic osteoarticular transplants. The patients were followed for a median of 11 years (range 2 to 18 years). The major complications were 3 fractures, one delayed union, 3 graft resorptions, and one secondary infection to salvage by total knee prosthesis. Sixteen reoperations were performed in 8 patients. The small number of bone healing problems was accounted for by the autologous bone sleeve in the graft-host junction. The knee motion improved considerably after early mobilization in hinged orthosis. The early results (1 to 7 years) were as follows: excellent--3, good--6, and fair--6. The late results (8 to 18 years) were: good--4, fair--5, and poor--1. The poor result was salvaged to fair by arthrodesis. It is concluded that osteoarticular allografting yields an alternative to salvage the limb, but still presents unsolved immunologic and preservation problems which make the prognosis unpredictable. PMID- 1792890 TI - [Bone allografts and resection for malignant tumor of the lower limbs]. PMID- 1792891 TI - Osteoarticular allografts. AB - Over the past eighty years, osteoarticular allografts have provided the possibility of limb-sparing procedures in tumor surgery. Several authors have now reported up to 80 per cent successful use of these types of grafts, and large well-documented series give evidence that limb reconstruction following extensive resection of bone and joints has been possible with their use. In conjunction with their successful applications, studies of the fate of osteoarticular allografts have provided useful information on their associated problems. Infection has been a major complication, affecting up to 12 per cent of recipients and frequently resulting in re-operations and occasionally amputations. Studies have suggested however that almost half of these infections are due to soft-tissue complications rather than to the allografts. Fractures and non-unions, affecting up to 10 per cent of recipients, have proven easier to treat, and few if any patients lose their grafts after fractures. A recent study of retrieved osteoarticular allografts has shown that incorporation of these massive bone segments is slow but progressive, and ultimate incorporation of the grafts can be expected in most patients. The fate of the cartilaginous portion of the grafts has also been evaluated. Our laboratory has suggested that although cryopreservation of the articular portion of the grafts appears feasible in vitro, the fate of transplanted cryopreserved cartilage is dependent on many factors, including accurate sizing and ligamentous reconstruction around the replaced joints. In determining indications for massive osteoarticular allografts, we have found that these grafts are not a panacea for all problems encountered in bone tumor resection, but should be used advisedly for the treatment of specific problems.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792892 TI - [Diagnosis of sensorineural hearing loss by ipsilateral masking of brain stem auditory evoked potentials]. AB - The Authors show their original technique for the differential diagnosis of cochlear and retrocochlear hearing loss which employs ipsilateral masking of the A.B.R. in order to define the difference in V wave latency between a standard technique (clicks at 21 pps without noise) and a sensitized technique (clicks at 21 pps with noise at S/N of +40). This difference in latency has been named Sensitizing Latency Difference (SLD). Sixty normal subjects, 85 patients with cochlear hearing loss and 6 with retrocochlear hearing loss, were studied. The obtained data showed a SLD value: in normal hearing of: a) 0.31 msec. (+/- 0.14 SD) from 18 to 40 years old; b) 0.36 msec. (+/- 0.26 SD) from 41 to 60 years old; c) 0.48 msec. (+/- 0.21 SD) over 60 years old; in patients with cochlear hearing loss 0.12 msec. (+/- 0.14 SD) in 2 subjects affected by retrocochlear hearing loss a value superior to 1.5 msec. in the other 4 cases the V waves disappeared during recording of the sensitized test. A differential value of 1 msec. between cochlear and retrocochlear hearing loss was established by the Authors who with this value correctly identified all the patients with retrocochlear hearing loss and 97.8% of the subjects with cochlear hearing loss. An incorrect diagnosis of the hearing loss origin (false positives) was made in 2.2% of the patients with cochlear hearing loss. In conclusion, the Authors feel that the SLD evaluation, in consideration of its large clinical utility and of the high reliability of obtained data, is a particularly useful test in making a differential diagnosis between cochlear and retrocochlear hearing loss. PMID- 1792893 TI - [Incidence of Meniere's disease in the Siena Local Health Unit 30 area]. AB - Incidence of Meniere's disease has been the subject of many epidemiologic papers in Literature. Nevertheless, it varies greatly in studies from different countries and it is unclear to what degree these differences can be attributed to epidemiologic differences and to what degree to problems of methodology (selection and assessment of the patient). The objective of this paper is to evaluate the incidence of Meniere's disease in the USL district 30 of the Siennese Area following definite and easily reproduced criteria. A total of 33 new cases of Meniere's disease was identified during a 10-year period from 1981 to 1990. Thus, in relation to the total number of residents in the USL 30 of the Siennese Area (120,000), the average annual incidence rate may be calculated at 27.5 x 10, a relatively modest figure in comparison with other studies. Given this, the Authors discuss the methodological problems relative to the epidemiological assessment. PMID- 1792894 TI - [Intraoperative extemporaneous examination of the parathyroid gland: what is the role of the pathologist in parathyroid pathology?]. AB - Hyperparathyroidism (HPT), once considered a rare disease, is nowadays observed and diagnosed more frequently. Consequently, surgical treatment of HPT is often performed with good therapeutic results. The success of parathyroid surgery depends mainly on the accuracy of histopathologic diagnosis through intraoperative examination of frozen tissue specimens. Yet, parathyroid gland pathology is very complex and some of its topics even controversial. Terminology and clinico-pathological concepts in this field are constantly changing and even basic characteristics such as weight, stromal fat content and "normal " histologic patterns of these glands are still actively discussed. The pathologist must often determine, merely by studying a small bioptic specimen, not only the parathyroidal (or non-parathyroidal) origin of the examined tissue, but also the histological "normal" or "abnormality" of the tissue. In carrying out his work the experienced pathologist takes on an important task and responsibility in distinguishing between normal, early hyperplastic (asymmetric), hyperplastic or adenomatous parathyroid glands. New diagnostic technical approaches (such as Electron Microscopy, intracellular fat morphometric evaluation, parenchymal cell mass study by density gradient, etc.) enhance the possibility of reaching a reliable pathologic diagnosis, but they do not solve all the present problems and sometimes can even lead the pathologist astray. Presently the diagnosis and treatment of primary HPT should be considered an open and current problem inasmuch as definite criteria to be followed in distinguishing between normal or single enlarged glands microscopically are still lacking. Neither the degree of accuracy of intraoperative frozen section examination during parathyroid surgery nor the possibility of misleading observations in such a study has been fully evaluated. A close cooperation between the pathologist and head and neck surgeon is of utmost importance to assure the best therapeutical results obtainable from parathyroid surgery in HPT. PMID- 1792895 TI - [Antitumor activity of adherent LAK cells (A-LAK) in a model of squamous carcinoma of the head and neck]. AB - Local adoptive immunotherapy employed on a selected population using IL2 activated immune cells (A-LAK cells) and IL2 resulted in complete growth inhibition of a human squamous cell carcinoma of the head and neck implanted three to seven days previously and growing in nude mice. Although the in vitro cytotoxicity of A-LAK cells against the carcinoma cells was not higher than that of the whole population (LAK cells), the in vivo antitumor efficacy was from 4 to 9 times higher for A-LAK cells, as confirmed by the total number of injected cells needed for a complete growth inhibition. In addition, local A-LAK cell administration was characterized by early peritumoral erythema and swelling, not observed during LAK-cell therapy, which disappeared at the end of therapy. Histology of the tumors, during and at the end of therapy, showed an initial granulocytic and plasma cellular infiltration followed by mononuclear infiltration of the stroma of the tumor. The tumors showed a terminal-like differentiation with an increase of the keratinic layer and decrease of basal epithelial cells. These effects were proportional to the number of A-LAK cells injected. With the highest number of A-LAK cells, a complete epithelial disorganization was observed and 4 weeks from therapy termination the tumors were reduced to keratinic areas surrounded by connective tissue. These observations suggest the possibility of a A-LAK cell-dependent process of accelerated tumor differentiation and keratinization leading to tumor regression in nude mice. PMID- 1792896 TI - [A case-control study of multiple occupational risk factors in relation to laryngeal cancer]. AB - In this work the A.A. present the results of a case-control study on 2,997 subjects carried out to evaluate the role of professional factors in the development of laryngeal cancer. Our analysis included only cases of laryngeal neoplasia at first diagnosis in 1990. From a statistical point of view we calculated the Odds Ratio (OR) and confidence limits at 95% following Miettinen. The analysis was made on 113 cases and 754 controls, all males smokers or ex smokers, aged between 35-80 years. The results show a statistically significant correlation between laryngeal cancer and jobs in agriculture (OR = 3.77), in iron steel industries (OR = 3.25), in metal-mechanic industries (OR = 1.72). Precise knowledge of such data could be very useful in promoting primary and secondary prevention campaigns in the above-mentioned work places. The A.A. stress the need to make experimental cancerogenesis studies to evaluate the effects of the association of occupational risk factors, tobacco smoke and alcohol consumption on the natural history of laryngeal cancer. PMID- 1792897 TI - [Thyroid gland involvement in cancer of the larynx]. AB - Numerous diseases that require surgical treatment often occur in the thyroid, one of the most important organs in the neck. An example of such pathologies are benign and malignant neoplasms. It is still not well known, however, if certain secondary malignant neoplasms may also arise there. While this pathology is relatively frequent, and often asymptomatic, the incidence of secondary lesions observed clinically in the thyroid is much lower than that found in series based on necroscopy. The thyroid may be involved by metastatic spreading of systemic malignant neoplasms (of the kidney, breasts, lung, colon, rectum, etc.) or by direct extension of laryngeal, hypopharyngeal or esophageal cancer, the latter being more frequent. In this paper the Authors report their experience with regard to the incidence of tumorous involvement of the thyroid in 23 patients (22 of which were males between the ages of 48 and 69--average age, 65) under observation for laryngeal cancer from 1986 to 1990. All the patients had an epidermoid carcinoma of the larynx that, due to its location and size, required a hemithyroidectomy or an isthmectomy associated with laryngectomy (20 total laryngectomies with hemithyroidectomies and 3 subtotal laryngectomies with isthmectomy). Upon pathologic examination, 7 thyroid specimens (30%) revealed tumorous involvement of the thyroid and in those cases of males who had undergone total laryngectomy with hemithyroidectomy, thyroid involvement was found. In 5 cases, tumorous involvement was immediately evident upon microscopic examination (1 case of solitary tumor metastasis and 4 of direct extension).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792898 TI - [Carotid body tumor: expedient surgical technique]. AB - Six hundred cases of carotid body tumors are reported in Literature. This tumor originates from ganglia cells which are able to produce catecholamines. The percentage of bilateral involvement is 32%. The hystological examination of specimens of this tumor reveals atypical cellular features in 30% of the cases. Clinically we divide this tumor into two classes: the first includes tumors whose growth is limited in the adventitial layer of the artery, while the second includes tumors with invasive growth in the arterial wall. In this paper a case of a large carotid body is reported. The importance of a correct pre-operative diagnosis based on supra-aortic-trunk angiography is stressed. A peri-adventitial surgical approach carried out with the aid of the operatory microscope is described. Particular emphasis is placed on intra-operative electroencephalographic monitoring which allows a safe vascular reconstructive surgery of the carotid complex when required. PMID- 1792899 TI - Bias in evaluating CNS complications following pertussis immunization. AB - Bias in the evaluation of CNS complications following pertussis immunization are the following: 1) Notifications of postimmunization adverse events, 2) Publications by vaccine producers on the frequency of adverse reactions, 3) Comparison of permanent brain damage after DPT and DT immunization, 4) Pro immunization, 5) Immunization associated viral encephalitis, 6) Accuracy of statistics, 7) Personal. A review of these points indicates an underestimation of CNS complications after pertussis immunization. PMID- 1792900 TI - Neuronal differentiation of Ewing's sarcoma induced by cholera toxin B and bromodeoxyuridine--establishment of Ewing's sarcoma cell line and histochemical study. AB - An Ewing's sarcoma (ES) cell line was established from a metastatic bone marrow specimen in a patient with advanced disease, and some histochemical characteristics were investigated by neuronal differentiation induced with cholera toxin B (CTB) and bromodeoxyuridine (BrdU). Neuronal differentiation was investigated by the expression of neurofilament and Leu-7, and glial differentiation was observed by expression of S-100 protein. Neurofilament (NF) and Leu-7 were positive in ES cells and these were expressed more intensively by induction with CTB than with BrdU. There was no expression of S-100 protein in untreated or differentiated ES cells. ES cells became differentiated to neuronal cells with CTB and BrdU, but it was not observed, that ES cells had the potential to differentiate to glial cells. It appears that ES is of more primitive neural origin than neuroblastoma, primitive neuroectodermal tumors and other related neural tumors. PMID- 1792901 TI - Dysmorphology in children with congenital metabolic disorders. AB - The prevalence of minor morphological aberrations was evaluated in 54 children with various congenital metabolic disorders. Similarly to major malformations, minor malformations were not more common in the patients than in our control population. The dysmorphic appearance of some of the affected children was caused by minor variants that arose after organogenesis. PMID- 1792902 TI - Coronary arterial calcification in Kawasaki disease. AB - The purpose of this paper is to describe the clinical characteristics and significance of the coronary arterial calcification due to Kawasaki disease (KD), based on our five patients. The coronary arterial lesions (CAL) were in segments 1, 2, 5, 6 and 11 according to the classification of the American Heart Association. The interval from the onset to the first appearance of coronary calcification was 17 months to 61 months. Progression of CAL into coronary arterial stenosis or myocardial infarction occurred in all five patients. In the comparative study between the patients with calcified CAL and those with non calcified CAL, the maximal size of CAL of the former was 8 mm or larger in contrast with that of the latter (less than 8 mm). It is concluded that coronary arterial calcification is one of the important signs which suggest the presence of the advanced CAL in the follow-up of children with a history of KD. PMID- 1792903 TI - Efficacy of once weekly erythropoietin therapy in children on continuous ambulatory peritoneal dialysis. AB - The efficacy of recombinant human erythropoietin (rHuEPO) on 10 anemic children undergoing continuous ambulatory peritoneal dialysis (CAPD) was evaluated. A mean dose of 93 U/kg of rHuEPO was given once a week for 24 weeks, either intravenously to 5 children or subcutaneously to the other 5. Anemia improved in all children by this therapy. The mean hemoglobin and hematocrit levels increased gradually but significantly from 6.9 g/dl and 20.2% to 9.4 g/dl and 30.1%, respectively, at the end of the study. Elevation of blood pressure or other side effects were not noted in any patient. The present study indicates that the once a-week injection of rHuEPO by the intravenous or subcutaneous route is effective in children undergoing CAPD. PMID- 1792904 TI - Evaluation of lumbar bone mineral density by dual energy x-ray absorptiometry. AB - Using dual-energy x-ray absorptiometry (DEXA), the lumbar spinal bone mineral density (BMD) in 49 Japanese children with or without metabolic bone disease (MBD) was determined. The following results were obtained: (a) The normal data for healthy Caucasians (J Clin Endocrinol Metab 1990; 70: 1330-1333) appear to be applicable to Japanese children; (b) BMD was normal in patients with congenital hydronephrosis with normal renal function; (c) One patient with congenital renal failure and one with Lowe syndrome had low BMD, but the MBD in the former improved markedly with peritoneal dialysis; (d) A reduced BMD was found in patients treated with long-term steroids, probably because of decreased turnover of bone; (e) A reduction in BMD was pronounced in preterm infants during the first few months of life. In conclusion, DEXA is a useful method of bone densitometry in MBD in children. PMID- 1792905 TI - Mitral valve prolapse in childhood: the incidence and clinical presentations in different age groups. AB - To elucidate the incidence and natural history of mitral valve prolapse (MVP) during childhood, we investigated a total of 4,238 children (aged from 1 day to 15 years) classified by age into 4 groups: Group 1:1 to 28-day-old full-term normal newborns (n = 108), Group 2: 6 to 18-month-old infants (n = 391), Group 3: 6 to 7-year-old children (n = 2,801), and Group 4: 12 to 15-year-old children (n = 938). The incidence of MVP was determined by videorecorded two-dimensional echocardiography in a double-blind method twice-over. There were 109 cases diagnosed as having MVP. The incidence rates of MVP were as follows: Group 1: 0%, Group 2: 0.25%, Group 3: 2.1% and Group 4: 5.1%. Arrhythmias were detected in 49% (27/55) by Holter ECG, and by exercise stress test in 4.7% (2/43). Eighty-three (77%) of 108 cases in Groups 3 and 4, excluding the 1 case in Group 2, showed no symptoms. Ventricular premature contraction (VPC) was the most common arrhythmia, and was benign in all cases. A mid-systolic click (MSC), late systolic murmur (LSM), MSC + LSM, and a pansystolic murmur were detected in 23.1%, 3.7%, 4.6% and 5.6%, respectively. Symptoms caused by MVP increased and appeared more apparently with age. Further prospective long-term follow-up studies to adulthood are necessary. PMID- 1792906 TI - Mucopolysaccharidosis VI (Maroteaux-Lamy syndrome) with hearing impairment and pupillary membrane remnants. AB - A Japanese boy aged 13 months was referred to us because thickened ribs had been observed on a chest X-ray taken during a respiratory infection. mucopolysaccharidosis type VI (MPS VI) was diagnosed based on urinary glycosaminoglycan analysis and low activity of arylsulfatase B in peripheral leukocytes. He had mild pupillary membrane remnants, but no corneal opacities. The auditory brainstem response revealed moderate hearing impairment, which may have caused his subnormal DQ score of 85 at the age of 19 months. Although MPS VI is characterized by normal intellectual development with normal hearing in early infancy, it is important to examine for hearing loss, especially when an infant with this disease shows developmental delay. PMID- 1792907 TI - Familial juvenile nephronophthisis in two siblings--histological findings at an early stage. AB - We present two female siblings with familial juvenile nephronophthisis (FJN) which was diagnosed at the early stage of renal failure. Diagnosis was made during the investigation of anemia in case 1 and by a subsequent family survey in case 2. Most patients with FJN are not identified until the terminal stage of renal failure and such cases have rarely been reported in Japan. Case 2 had a reduction in the maximum urinary concentration ability but no azotemia, and among the FJN patients reported in Japan so far she has the least advanced renal disease. Histological examination of the renal biopsy in case 1 showed typical findings of FJN, such as thickening and lamination of the tubular basement membrane (TBM), interstitial fibrosis, and round cell infiltration of the interstitium. In case 2, renal biopsy revealed an irregular marked thickening of the TBM with trivial interstitial changes and a normal glomerular appearance. The histology of these two cases suggests that the TBM may be the primary site affected in FJN. PMID- 1792908 TI - Summer-type hypersensitivity pneumonitis in a child. AB - Summer-type hypersensitivity pneumonitis (HP) is a unique disease in Japan. The clinical features of this disease are as follows: 1) cough, fever and dyspnea as a clinical triad, 2) diffuse reticulonodular opacities on the chest X-ray film, 3) restrictive impairment and decrease in DLco, 4) hypoxia, 5) initiation in summer, 6) worsening of the condition when the patient returns home, 7) granuloma formation and alveolitis in the lung biopsy specimen, 8) familial clustering. The etiologic agent of this disease is debatable. In 1984 Ando et al reported that the etiologic agent was T. cutaneum. Now many people are pursuing the argument to its logical conclusion. We report a case of summer-type HP. It is uncommon in children, especially in a child in whose serum antibody to T. cutaneum can be demonstrated. PMID- 1792909 TI - An unusual gastric foreign body. AB - Ingestion of foreign bodies is common in children. The majority of those which reach the stomach will pass uneventfully through the gastrointestinal tract. We report here an 9-month-old boy who swallowed an earring. Several roentgenologic examinations revealed a small, closed earring in the stomach. Endoscopic removal failed. At surgery the earring was seen grasping the pyloric ring and one end had eroded the gastric mucosa. These caused the earring to anchor firmly to the pylorus, as if it were attached to an ear lobe. The unusual way in which it was lodged in the stomach caused the impediment to its further progress, but fortunately, this was without serious consequences. Early endoscopic examination for retained foreign bodies in the stomach is recommended. PMID- 1792910 TI - Chromosome abnormalities and prognosis in childhood acute leukemia. AB - We report here on the leukemic cell karyotypes of 134 children with acute nonlymphocytic leukemia (ANLL) examined at Saitama Children's Medical Center (SCMC), and of 88 children with acute lymphoblastic leukemia (ALL) referred to SCMC. The patients were mainly treated according to the protocol of the Tokyo Children's Cancer Study Group. Of 106 ANLL cases with adequate banding, 18% were normal, 34% had miscellaneous clonal abnormalities, and 48% were classified into known cytogenetic subgroups: t(8;21) (n = 21), 11q23 abnormalities (n = 14), 7/del(7q) (n = 6), inv (16)/del(16) (n = 5), and t(15;17) (n = 5). According to the FAB classification, M7 (21.7%) were more frequent than in previous reports because this study included a number of Down's Syndrome patients with M7 morphology. The present study confirmed the well-known association of t(15;17) with M3, t(8;21) with M2, 11q23 abnormalities with M4 and M5, and inv (16)/del(16) with M4. Patients with t(8;21) or inv (16)/del(16q) ANLL fared no better overall than the entire group. Of 51 ALL cases with adequate banding, 13.7% were normal, and 86.3% were classified into abnormal subgroups: translocation (n = 14), hyperdiploidy (greater than 50) (n = 13), and miscellaneous abnormalities (n = 17). Cases with hyperdiploidy (greater than 50) were restricted to a common phenotype and fared better overall than the entire group. Patients with translocation were found in all phenotypes, and had a poor prognosis. We concluded that childhood acute leukemia could be subgrouped according to karyotypic patterns, and that patients with translocations had a poor prognosis in ALL as well as ANLL. PMID- 1792911 TI - Immunological classification of childhood acute lymphoblastic leukemia. AB - Seven hundred and forty-four newly diagnosed patients with acute leukemias between 1978 and 1990 were classified on the basis of immunological phenotypes. The majority of the patients were enrolled in the Tokyo Children's Cancer Study Group (TCCSG) studies. The incidence of subclassification of acute leukemias in this study was as follows: 522 patients with ALL (70%), 139 patients with ANLL (18%), 29 patients with biphenotypic leukemia, 8 patients with Ph1-positive acute leukemia (Ph1-AL), and 45 patients with infant leukemia. ALLs were classified into common ALL (cALL, 77%), T-ALL (15%), B-ALL (4%), and unclassified ALL (3%). The incidence of ALL subtypes in this study reflected those of TCCSG. Biphenotypic leukemias were categorized into 4 groups as follows; 1) cALL with positive myelomonocytic antigen(s) (N = 11), 2) unclassified ALL with positive myelomonocytic antigen(s) (N = 5), 3) ANLL with positive B-lymphoid antigen(s) (N = 4), and 4) acute leukemia with positive T-lymphoid and myeloid antigen(s). Infant leukemias were classified into ALL type (N = 27) and ANLL type (N = 18). In this present study, clinical features and immunological phenotypes of the acute leukemias with a poor prognosis, i.e. biphenotypic leukemia, Ph1-AL, and infant leukemia are analyzed and discussed. PMID- 1792912 TI - Treatment of acute lymphoblastic leukemia in the Tokyo Children's Cancer Study Group--preliminary results of L84-11 protocol. AB - The Tokyo Children's Cancer Study Group (TCCSG) has performed prospective randomized controlled studies since 1984 for childhood acute lymphoblastic leukemia (ALL). Four hundred and ninety-eight newly diagnosed patients were treated with 5 different regimens designated as S1, S2 for a standard risk group (SRG), H1 and H2 for a high risk group (HRG) and HEX for an extremely high risk group of patients. We added intermediate-dose methotrexate as early intensification therapy in the S2 and H2 groups to reduce extramedullary and medullary relapses. Event-free survival of all patients at 4 years 6 months from the start of this regimen (median follow-up period 32 months) was 67.5%. The CNS relapse rate was significantly decreased to 2.2% compared to previously reported studies and our own experience. There were some unexpected complications of the CNS such as myelopathy and/or leukoencephalopathy. For the SRG early ID-MTX seemed to be useful to improve the prognosis, but triple intrathecal injections (TIT) should be limited in number. The 24Gy cranial irradiation (CRX) was effective but possibly excessive for the HRG. As evidenced by the success of the HEX group regimen, more intensive multi-drug consolidation in the early post remission phase might be necessary to improve further the prognosis and to make it possible to shorten the treatment periods. PMID- 1792913 TI - Improved prognosis of acute nonlymphocytic leukemia in children: results of the 12th-ANLL protocol of Tokyo Children's Cancer Study Group. AB - Thirty-one children with ANLL were treated using the 12th-ANLL Protocol of the Tokyo Children's Cancer Study Group incorporating an ACMP 2-step regimen. Induction therapy consisted of two 4-day courses of adriamycin (ADR) and cytosine arabinoside (ARA-C) given with a 7-day interval. Those patients who achieved remission were given one more course as early intensification. Late intensification consisted of a 5-day course of ARA-C and one dose of ADR which was repeated until the cumulative dosage of ADR reached 465 mg/m2. After this point, treatment was divided into 2 courses. Both courses included ARA-C and one course had achlacinomycin in addition. Twenty-seven children (87%) attained remission after one or two courses of induction therapy. Kaplan-Meyer analysis revealed that the continuous complete remission rate and event-free survival were 71% and 51%, respectively, 5 years after diagnosis. Toxicity was minimum with only one death during the remission. These results are encouraging and warrant further trials. PMID- 1792914 TI - Extramedullary relapse in childhood leukemia. AB - As long-term survival of children with leukemia is increasing, the prophylaxis of extramedullary leukemia has become a more important part of treatment. We studied the pattern of occurrence of extramedullary leukemia in a retrospective review. This review included a total of 2,317 childhood leukemia patients aged 15 years or less who had been treated at 38 institutes in Japan between 1976 and 1985. Extramedullary leukemia developed in 386 of 1,724 ALL patients (22.4%) and 63 of 544 patients with ANLL (16.3%). Among the ALL patients, CNS-L was the most common form and was observed in 315 cases (81.6%), followed by testicular leukemia in 89 (23.0%). In the case of ANLL, the most common form of extramedullary leukemia was CNS-L (45 cases, 71.4%), followed by cutaneous leukemia in 10 cases (15.9%). In addition, leukemia of the lymph nodes, ovaries, bones, kidneys and eyes was observed in 7, 5, 5, 4 and 4 cases, respectively. The survival rate of ALL patients with CNS-L was 40.1% for isolated relapse and 2.7% for bone marrow relapse, and no more deaths occurred after 6 years from relapse. The survival rate of patients with testicular leukemia was 40.1% for isolated relapse and 5.9% for complicating bone marrow relapse, and no deaths occurred after 7 years from relapse. Cutaneous leukemia tended to occur late in older children with ALL and early in infants with ANLL, and all these patients died. Infiltration into the kidney was observed in 4 patients, all of whom died. More than 75% of patients died after isolated relapse of leukemia of the bones, ovaries, lymph nodes and eyes.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792915 TI - Allogeneic bone marrow transplantation in childhood leukemia. AB - Allogeneic bone marrow transplantation was performed in 94 patients with hematologic malignancies or other various diseases during the period between March 1982 and November 1990 at Tokai University Hospital. Projected disease-free survival rates of HLA genotypically identical marrow recipients were 88.9% for chronic myeloid leukemia transplanted in the first chronic phase (N = 9), 90.9% for acute leukemia in the first complete remission (N = 15), 54.5% for acute leukemia in later remissions (N = 14), 62.5% for solid tumors (N = 8) and 0% for patients transplanted in relapse (N = 7). The rate for HLA-mismatched marrow recipients with leukemia was 27.8% (N = 16). For patients with non-neoplastic diseases it was 100% regardless of HLA-compatibility (N = 26). The quality of life in long-term surviving pediatric marrow recipients has been acceptable. Common abnormalities among survivors are long-lasting hypogonadism due to radiation and subclinical impairment of lung function in the first year post-BMT. About two-thirds of children experienced a transient decrease in growth velocity in the immediate posttransplant period. PMID- 1792916 TI - Comparison of autologous and allogeneic bone marrow transplantation in children with acute leukemia. AB - Thirty-one patients with acute non-lymphocytic leukemia (18 patients) or with high-risk refractory acute lymphocytic leukemia (13 patients) underwent bone marrow transplantation between March 1980 and March 1990. The high-dose conditioning regimen employed included cyclophosphamide followed by fractionated total body irradiation (12 GY). Fourteen patients who had an HLA-identical sibling donor received allogeneic bone marrow transplantation (allo-BMT); the other 17 patients received autologous bone marrow transplantation (auto-BMT) purged with 4-hydroperoxycyclophosphamide (4HC). Four of the 14 allo-graft recipients died of leukemic relapse and 2 others died of graft-versus-host disease. Three of the 17 auto-graft recipients died of relapse and 1 suffered relapse in the testes. The actuarial risk of relapse was 29% for the allo-BMT patients and 24% for the auto-BMT patients (P less than 0.05). The event-free survival rate at five years was 57% and 74% respectively (P less than 0.05). Although there was no difference between them, a trend toward a higher survival rate and a lower mortality and morbidity was observed in the auto-BMT group. These results suggest that autologous bone marrow transplantation purged with 4HC is an effective and useful treatment for children with acute non-lymphocytic and lymphocytic leukemia who have no HLA-identical donor. PMID- 1792917 TI - Infectious complications in childhood leukemia. AB - Since children with acute leukemia have prolonged periods of severe neutropenia due to the disease itself or its intensive chemotherapy, they often develop life threatening infectious complications. A protected environment and prophylactic antibiotics for patients with severe neutropenia have been shown to decrease the incidence of infectious morbidity. In spite of the high mortality rate of infections, on the other hand, their diagnosis is not well established because the percentage of microbiological detectability by blood culture is low. The differentiation of infections may be possible by using some supplementary measures and particular laboratory parameters. Febrile neutropenic patients with leukemia should promptly receive empiric treatment with combinations of two or three broad-spectrum antibiotics that are bactericidal and synergistic toward the presumed pathogens, or with antifungal drugs if patients are resistant to antibiotics, as well as supportive measures such as granulocyte transfusion, intravenous gamma-globulin and granulocyte colony-stimulating factor. PMID- 1792918 TI - Late effects of childhood acute leukemia and its treatment. AB - Late effects of childhood acute leukemia and its treatment were studied in 776 patients (684 ALL, 73 ANLL, and 9 others) in Japan who had remained in remission for more than 1 year after their first complete remission. Delayed adverse sequelae involve a wide variety of organs and their functions. Short stature was present in 2.61%, obesity in 3.79%, abnormalities of growth hormone secretion in 1.5%, delayed secondary sex characteristics in 1.5% of males and 0.6% of females, motor disturbances in 1.17%, sensory disturbances in 0.91%, intellectual and learning disabilities in 2.48%, abnormal findings in routine neurologic examinations in 1.31%, EEG abnormalities in 4.30%, brain CT abnormalities in 5.09% and cardiac dysfunction in 1.07%. Various other disorders were seen in 20 patients. Many of these delayed adverse sequelae are caused by or related to central nervous system prophylaxis and systemic combination chemotherapy. The results suggest that it is needed to improve therapeutic methods through the stratification of patients by risk factors and detailed analysis of prognostic factors. Moreover it is important to render medical and psychosocial support to long-term survivors of childhood leukemia through interactions between the patient, parents and medical staff. PMID- 1792919 TI - Principles of total care for children with leukemia--psychosocial interventions. AB - Today about 70% of children with leukemia are cured by intensive chemotherapy. Therefore how to deal with the children and their families before, during, and after the treatment has become a major concern for caregivers. And it is a fact that there are still a few patients who relapse and are destined to die. We are now taking care of two groups of patients. One group is truly cured and one group is dying. We have been trying to establish a good total care system that fits our society. We have formed medical teams which consist of doctors, nurses, and care workers. From our experience, we think the most important principle for the caregivers is frankness. Sometimes this is very difficult. Other important points of total care, especially from psychosocial aspects, are mentioned. PMID- 1792920 TI - Gender differences in the incidence of definite schizophrenia and atypical psychosis--focus on negative symptoms of schizophrenia. AB - In a catchment area study of 101 first inceptions of schizophrenia, mania and atypical psychoses, women were significantly more likely to have atypical psychosis and men were more likely to have definite schizophrenia. Negative symptoms such as affective flattening and poverty of speech were already present in many cases, and were significantly increased in patients with definite schizophrenia (geometric mean 5.6) compared with those with atypical psychosis (geometric mean 3.2) and mania (geometric mean 1.5). Negative symptoms were also twice as severe in men (geometric mean 5.5) than women (geometric mean 2.6). There was a significant increase in negative symptom severity with longer illness and greater depression, but the diagnosis and the sex effects were not caused by these factors. We suggest that our findings are further support for the hypothesis that men have a greater biological vulnerability to negative symptoms and consequent social disability in the face of psychosis, particularly a schizophrenic psychosis, and that this may be one explanation for the apparently greater risk of definite schizophrenia and its poorer prognosis in men. PMID- 1792921 TI - The criteria of Cloninger et al. and von Knorring et al. for subgrouping alcoholics: a comparison in a clinical population. AB - There is increasing evidence that meaningful subgroups of alcoholics may exist. Cloninger et al. and von Knorring et al. have developed criteria to delineate what both call type 1 and type 2 alcoholism. However, when we compared their criteria in a predominantly inpatient sample of male alcoholics, we found large differences between the approaches in identifying type 1 and type 2 alcoholism. Concordance was equally low in a subsample of 34 alcoholics exhibiting antisocial behavior and when subjects were divided by whether the first alcohol-related problem began before or after 20 years of age. Similar findings emerged when we limited our analyses to primary alcoholics and alcoholics with no other mental disorders. PMID- 1792922 TI - De novo mania among elderly people. AB - De novo mania is defined as the occurrence of a first manic episode in a patient with no history of mood disorder, after exclusion of organic etiologies. Although it is believed to be rare in elderly populations, the authors nonetheless report 6 cases encountered over a 2-year period. The literature regarding mania among elderly people is reviewed, and the authors formulate their recommendations in view of more frequent recognition and better management of these patients. PMID- 1792923 TI - Puerperal psychosis in a teaching hospital in Saudi Arabia: clinical profile and cross-cultural comparison. AB - The clinical profile of 39 women with puerperal psychosis admitted within 90 days of childbirth to a teaching hospital in Riyadh, Saudi Arabia is described and compared with groups of women with a similar diagnosis admitted to Royal Edinburgh Hospital within the same period after delivery. The majority of women in both groups had an affective illness, acute presentation and similar interval between parturition and onset of illness. There were significant differences between the groups as regards parity, duration of illness prior to admission and presence of motility disturbances. These differences were attributed to sociocultural factors that are briefly discussed. PMID- 1792924 TI - An evaluation of DSM-III-R personality disorders. AB - This study evaluated the extent to which the features of personality disorders are organized into the 11 diagnoses proposed by DSM-III-R. The traits composing personality disorder diagnoses were identified in earlier studies. Seventy-nine traits were required to represent personality diagnoses. Self-report scales were developed to measure each trait. The factorial structure underlying the trait scales was examined in a sample of 158 patients with a primary diagnosis of personality disorder and a sample of 274 general population subjects. Eleven principal components were extracted from each data set and were rotated to the same oblique criterion. The decision to extract 11 components was based on a priori expectations derived from DSM-III-R. Factor comparability coefficients were computed to quantify the similarity of the 2 solutions. A high degree of similarity was observed between the factor structure in the clinical and general population samples, suggesting that features of personality pathology are continuous dimensions. Although a number of factors demonstrated a degree of resemblance to some DSM-III-R diagnostic categories, the overall correspondence was not strong. A second-order factor analysis failed to reproduce the 3 Axis II diagnostic clusters. The results do not support the categorical model used in DSM III-R and they provide only limited support for DSM-III-R diagnostic concepts. PMID- 1792925 TI - Suicide in the Canary Islands, 1977-1983. AB - We studied suicide in the Canary Islands between 1977 and 1983 and found 775 cases, twice the official number of 381. This indicates the lack of validity and reliability of official figures for suicide in Spain today. The figures reveal an upward trend in the Canary Islands, with the annual rate of 6.81 per 100,000 in 1977 having increased to 10.64 per 100,000 in 1983. There were no significant differences in the frequency of suicide according to season, month or day of the week. PMID- 1792926 TI - Changes in antisocial aggressiveness during treatment in a hierarchical therapeutic community. A prospective study of personality changes. AB - Thirty-six consecutive substance abusers were examined at intake and after 1 year of residency in a hierarchical therapeutic community using the personality instruments Million Clinical Multiaxial Inventory (MCMI) and Basic Character Inventory. Two antisocial aggressiveness subgroups were identified: a no-increase group (n = 11) that had high intake scores on MCMI antisocial aggression, small changes during the stay and a high dropout rate (45%) as outpatients; and an increase group (n = 25) with lower scores at intake and a low dropout rate (20%). A high level of antisocial aggressiveness at intake was related to dropout in the no-increase group, and a high degree of increase in antisocial aggressiveness was related to dropout in the increase group. The results show the importance of monitoring antisocial aggressiveness during treatment. PMID- 1792927 TI - Comparison of the Chinese Depression Inventory and the Chinese version of the Beck Depression Inventory. AB - Using a sample of 329 currently depressed patients from 24 hospitals across China, the Chinese Depression Inventory (CDI) was developed based on its own culture and verbal expression styles. The reliability and validity of CDI were much better for these patients than the Chinese version of the Beck Depression Inventory (CBDI). This study demonstrated that the CDI is both a culturally sensitive and cross-culturally useful self-report scale for measuring the severity of depression in Chinese. The authors suggest that such a rating scale would eliminate serious cultural biases, control for the severity of illness among different ethnic groups and thereby make cross-cultural studies more valid. PMID- 1792928 TI - Outcome of attempted suicide and psychiatric consultation: risk factors and suicide mortality during a five-year follow-up. AB - A total of 1018 self-poisoned patients were treated during the year 1983 in the emergency room of Helsinki University Central Hospital. By the end of a 5-year follow-up period, 3.2% of these had committed suicide, making annual suicide mortality 589 per 100,000. During the first year after the index attempt, suicide mortality was 1768 per 100,000, a 50-fold risk compared with that of the total population in Helsinki. Risk factors were being male of advancing age, having mental disorders, previous suicide attempts, a nonimpulsive index suicide attempt, moderate to very serious lethality and severe intention to die during the index suicide attempt. When the lethality was assessed as being very serious or intention to die as certain, 21% later committed suicide. The relative risk for those left without psychiatric consultation was 0.6 when the lethality was mild and 1.6 when it was severe. Results indirectly indicate that psychiatric consultation seemed to have a positive effect on the outcome of these attempted suicides. PMID- 1792930 TI - Factor structure of DSM-III-R personality disorders shown by self-report questionnaire: implications for classifying and assessing personality disorders. AB - A modified version of the revised Personality Diagnostic Questionnaire (PDQ-R), based on DSM-III-R personality disorders (PD), was completed by 74 psychiatric patients. A factor analysis of the scores for each of the PD (i.e. of the number of positive DSM-III-R criteria for each of the PD) yielded 3 factors that defined 3 PD clusters. These were similar to the 3 DMS-III-R PD clusters for 7 of the 11 PD categories. The 3-group solution of a cluster analysis of the patients (using their scores of positive criteria for each of the PD) did not reflect these factors; the main discriminating variable between the 3 groups of patients was the total number of positive PD criteria. It is suggested that, for the routine assessment of patients, the most important derivative of the DSM-III-R classification of PD is the total score of positive PD criteria. PMID- 1792929 TI - Dopaminergic hypothesis for retarded depression: a symptom profile for predicting therapeutical responses. AB - We assessed the therapeutical efficacy of various antidepressants (amineptine, minaprine and clomipramine) in patients affected by retarded depression. All patients exhibited symptoms of retardation, including hypokinesia, anergia, reduction of speech, increased salivation, hypersomnia, Parinaud's syndrome, reduced sexual activity, slowness, hypomimia, orthostatic hypotension, dysphagia and drowsiness. Antidepressant drugs were administered for a 6-week period in a randomized double-blind vs placebo design. The rank order of clinical effectiveness (amineptine much greater than minaprine greater than clomipramine greater than placebo) paralleled the specificity of antidepressants as dopaminomimetic agents. These results support the view that a reduced dopaminergic transmission contributes to the pathophysiology of retarded depression. PMID- 1792932 TI - Relationship of dose to antidepressant prophylactic efficacy. AB - We studied 75 patients on prophylactic antidepressants (imipramine or amitriptyline) to examine the effect of antidepressant dose on long-term prophylaxis of depression and to see whether lowering the dose during the prophylactic period affected subsequent relapse. There was no statistically significant difference in maintenance and prophylactic doses between the group that completed the 2 years free of a depressive episode, the group that had a depressive relapse and the group that dropped out of treatment before the end of the prophylactic period. However, the group that completed the 2 years free of a depressive episode had significantly less of a difference between the maintenance and prophylactic doses than the other 2 groups. Overall, 11/31 who remained on the same dose during the prophylactic period vs the maintenance period relapsed vs 17/25 who had their dose lowered during the prophylactic period vs the maintenance period. The difference was statistically significant. PMID- 1792931 TI - Moclobemide in depression: a randomized, multicentre trial against isocarboxazide and clomipramine emphasizing atypical depression. AB - Moclobemide was compared with isocarboxazide and clomipramine in patients with depression. A total of 167 outpatients were allocated to daily treatment with 300 mg moclobemide, 30 mg isocarboxazide or 150 mg clomipramine for 6 weeks. Moclobemide was slightly inferior to clomipramine, whereas isocarboxazide had an intermediate position. There was no interaction between treatment and atypical or nonatypical depression. Anticholinergic symptoms and orthostatic hypotension were most pronounced in the clomipramine group. PMID- 1792933 TI - Confirmatory and disconfirmatory feedback in families of schizophrenics, pathological controls and normals: replication and expansion. AB - The question of whether or not there are types of family communication specific to schizophrenia was addressed by a replication of a previous study and expanding the material. The interaction between parents of schizophrenics (S) (n = 17), non schizophrenic pathological controls (NS) (n = 15) and normals (N) (n = 14) was observed during consensus couple Rorschach. Their communication was analyzed by a newly developed revised edition of the Confirmation and Disconfirmation Coding System, CONDIS-R. Studies of intrarater agreement and split-half estimates supported the reliability of CONDIS-R. The results showed that S had more egocentric communication and active disqualifications than NS and N. S were also less likely to communicate that they kept track of and understood the other spouse's communication. PMID- 1792934 TI - Interaction between carbamazepine and fluvoxamine. AB - In 3 patients the addition of fluvoxamine to a constant dosage of carbamazepine (CZP) caused a substantial rise of plasma CZP accompanied by symptoms of intoxication. As this drug combination may occur increasingly in the future, this probably pharmacokinetic interaction is of practical relevance. PMID- 1792935 TI - Attenuation of carbon dioxide-induced panic after clonazepam treatment. AB - Ten patients meeting the DSM-III-R criteria for panic disorder were treated with clonazepam. Prior to clonazepam treatment and after a 5-week treatment period, patients underwent a 35% carbon dioxide challenge procedure. Following clonazepam treatment, a significant reduction in carbon dioxide vulnerability was observed. PMID- 1792936 TI - Ultraweak photon emission in germinating seeds: a signal of biological order. AB - Photon emission from germinating gram seeds at various stages of growth exhibits a definite pattern. The pattern of emission changes when a seed is disrupted by physical processes, e.g. mechanical crushing, cooling or heating. The disrupted seeds do not grow. The change in the biological order responsible for seed growth and the observed changes in the pattern of photo emission suggest a link between the macroscopic spatio-temporal organization and metabolic processes. PMID- 1792937 TI - Estimation of tyrosine by the attenuation of 4-iodophenol enhanced chemiluminescence. AB - Tyrosine markedly attenuates the chemiluminescence output intensity from the 4 iodophenol enhanced chemiluminescence assay system in a manner consistent with competition between the amino acid and luminol for the 4-iodophenoxy radical. This effect provides the basis for a sensitive assay of tyrosine. Interference by the other amino acids has been assessed; major interference by cysteine can be removed by incubation with iodoacetic acid. PMID- 1792938 TI - Total bile acids in hyperlipidaemic serum determined by bioluminescent and spectrophotometric methods. AB - A simple, rapid and sensitive bioluminescent method has been used to measure total bile acids in hyperlipidaemic serum. We found that the levels of total bile acids in hypertriglyceridaemic and hypercholesterolemic sera determined by a spectrophotometric method were four-fold higher than those measured by the bioluminescent method (6.73 +/- 4.07 mumol/l (mean +/- SD) by bioluminescent and 26.10 +/- 13.42 mumol/l by the spectrophotometric method). There was no difference in total bile acid levels between these two methods for normal serum (4.72 +/- 3.38 mumol/l by bioluminescence and 4.49 +/- 3.27 mumol/l by the spectrophotometric method). PMID- 1792939 TI - Regulation of osteoblast proliferation by leukemia inhibitory factor. AB - We recently showed that leukemia inhibitory factor (LIF) stimulates 45Ca release from neonatal mouse calvariae in vitro and that it increases DNA and protein synthesis in this model. To elucidate further the actions of LIF on bone we now report the effects of this cytokine on DNA synthesis and cell proliferation in isolated fetal rat osteoblasts and in the osteogenic sarcoma cell line, UMR-106. In both actively growing and growth-arrested rat osteoblasts, LIF stimulated [3H]thymidine incorporation in a dose-dependent manner. The increase in DNA synthesis was time dependent, was associated with an increase in the number of osteoblasts, and was not blocked by indomethacin. LIF-treated cells showed reduced [3H]thymidine incorporation in comparison with control, as they approached confluence, possibly because of the increased cell density in the LIF treated cultures. In UMR-106 cells, treatment with LIF inhibited [3H]thymidine incorporation in both actively growing and growth-arrested cultures. The effect was dose dependent and sustained with time. There was a corresponding decrease in cell numbers. It is concluded that although LIF causes an early stimulation of proliferation in isolated osteoblasts, it has opposing effects on UMR-106 cells. It is not possible to determine which of these effects is more relevant to the actions of LIF in vivo. The demonstration of a LIF effect on both these cell types, however, provides further evidence that this cytokine acts directly on osteoblasts. PMID- 1792940 TI - Interleukin-6 messenger RNA expression and interleukin-6 protein secretion in cells isolated from normal human bone: regulation by interleukin-1. AB - Recent evidence suggests that cytokines, in addition to regulating hematopoiesis and immune functions, may be important paracrine regulators of bone turnover. Interleukin-1 (IL-1) and IL-6 are cytokines that are produced by and affect both hematopoietic and nonhematopoietic cell types. IL-1 stimulates bone resorption and inhibits osteoblast proliferation and collagen production. Previous reports that IL-6 was secreted in murine osteoblast and bone organ cultures in response to IL-1 and PTH suggested that IL-6 has paracrine effects on bone resorption or formation. To determine whether IL-6 has a paracrine function in human bone, IL-6 expression in cells isolated from normal human bone was investigated. IL-6 mRNA levels in untreated cultures were low and variable, and IL-6 secretion was undetectable. PTH had no effect on IL-6 mRNA levels or IL-6 secretion. IL-1 beta increased IL-6 mRNA levels, maximally 40-fold at 12 h. IL-1 beta increased IL-6 secretion to 0.13 nM, more than 80-fold that of untreated controls at 12 h. IL-1 beta also increased IL-1 beta mRNA levels, maximally 9-fold at 12 h, but did not increase cellular levels or secretion of IL-1 beta protein. Recombinant human IL 6 at 0.5-5 nM stimulated resorption in neonatal mouse calvarial organ cultures but had no effect on human bone-derived cell DNA synthesis or type I procollagen mRNA levels. The results suggest that IL-6 production by human osteoblasts may function to enhance osteolytic activity of IL-1 but does not affect proliferative and matrix biosynthetic aspects of bone formation that were tested. Because osteoblasts and bone marrow cells are in close proximity, IL-6 produced by osteoblasts may also function to amplify IL-1 stimulation of immune responses and hematopoiesis in bone marrow. PMID- 1792942 TI - Pamidronate reduces PTH-mediated bone loss in a gene transfer model of hyperparathyroidism in rats. AB - We evaluated spinal and femoral bone mass and density utilizing dual-energy x-ray absorptiometry (DEXA) in rats in which severe hyperparathyroidism was produced by the expression of the gene for human PTH-(1-84) (hPTH). This gene was incorporated into a retroviral vector that was transfected into fibroblasts which were subsequently injected into their peritoneal cavities. Further, we examined the effect of the administration of pamidronate on bone mass and density in the presence of extremely high concentrations of hPTH. Three groups of rats were studied. Groups 1 and 2 receive the hPTH-secreting fibroblasts; group 2 subsequently received pamidronate (2.5 mg/kg IV) 18 and 27 days after receiving the fibroblasts. These animals developed levels of hPTH greater than 1.0 microgram/liter and became hypercalcemia within 20 days. These animals became lethargic and were significantly lower in weight than age-matched controls (group 3, p less than 0.05). After accounting for the animal weight there was a further significant decrease in bone mineral content and density (BMC and BMD) on day 29 attributable to hPTH-mediated bone loss. Treatment with pamidronate resulted in a higher BMC of the lumbar spine than in the untreated animals, with elevated concentrations of hPTH. The BMD was significantly higher at both the lumbar spine and femur in the pamidronate-treated animals (p less than 0.05). The CV of paired measurements of BMD was 2.7% at the spine and 1.5% of a femur, respectively. The BMC of the lumbar spine and femur was closely correlated with the ashed weight of the same bones (r = 0.92 and 0.85, respectively). PMID- 1792941 TI - Actions of calcipotriol (MC 903), a novel vitamin D3 analog, on human bone derived cells: comparison with 1,25-dihydroxyvitamin D3. AB - The actions of a novel vitamin D3 analog calcipotriol (MC 903), on human bone derived cells were compared to those of 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3]. Both calcipotriol and 1,25-(OH)2D3 inhibited the proliferation of human osteoblast-like cells in a dose-dependent manner (10(-10)-10(-6) M), an effect observed at different cell densities. Lower concentrations of either agent exerted no marked effect on the growth of the cells compared to untreated cultures. Calcipotriol and 1,25-(OH)2D3 were equipotent in stimulating the activity of alkaline phosphatase and the synthesis of osteocalcin in human osteoblast-like cells. The stimulation of alkaline phosphatase activity and osteocalcin synthesis by both compounds was evident by 24 h and was increased progressively up to 96 h in a dose-dependent manner over the concentration range of 10(-10)-10(-6) M. The increment in both proteins was dependent on cell density and was attenuated at higher cell densities. In contrast to these actions, neither calcipotriol nor 1,25-(OH)2D3 (10(-14)-10(-6) M) affected the synthesis of prostaglandin E2. These studies indicate that calcipotriol and 1,25-(OH)2D3 exhibit a similar spectrum of activity on human osteoblast-like cells in vitro. PMID- 1792943 TI - Relation of fractional 47Ca retention to season and rates of bone loss in healthy postmenopausal women. AB - Fractional whole-body retention of 47Ca (retention fraction) in 58 healthy postmenopausal women participating in a calcium supplementation trial was examined for seasonal variation and for relationships to rates of bone loss and plasma vitamin D levels. Retention fraction was measured after 18 months in the trial. Bone mineral densities of the radius, femoral neck, and lumbar spine were measured at baseline, 12 months, and 24 months in the trial, and plasma 1,25 dihydroxyvitamin D [1,25-(OH)2D] and 25-hydroxyvitamin D (25-OHD) at 12, 18, and 24 months. The adjusted retention (retention fraction adjusted for total calcium intake, smoking status, and log years since menopause) was significantly higher in women evaluated in the months of August through October (mean +/- SD, 19.8 +/- 4.1%, n = 13) than in March through May (mean +/- SD, 17.0 +/- 4.7%, n = 18, p = 0.05). Plasma 25-OHD was associated with retention fraction only in women with low calcium intakes (partial r = 0.69 controlling for total calcium intake and log body mass index, n = 14, p = 0.01). Plasma 1,25-(OH)2D was not related to retention fraction. Adjusted retention, independent of total calcium intake, log years since menopause, smoking status, and season, explained 8% of the variability in the annual change in radius density (partial r = 0.29, p less than 0.05). No significant associations were seen at the spine and femur.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792944 TI - A new method for measuring cancellous bone erosion depth: application to the cellular mechanisms of bone loss in postmenopausal osteoporosis. AB - We have devised a new method for measurement of final depth of erosion in cancellous bone with an intra-individual precision of 4.3% and applied it to determine the mechanism of continuing reduction in trabecular thickness after menopause. Mean erosion depth (SD) was 40.8 (2.0) microns in 10 healthy postmenopausal women and 41.4 (2.1) microns in 10 age-matched patients with postmenopausal osteoporosis; the difference was not statistically significant. In contrast, wall thickness, using a method based on density differences between new and old bone, was 39.5 (2.0) microns in the normal subjects and 35.3 (2.0) microns in the patients with osteoporosis (p less than 0.0001). The balance per remodeling cycle (delta BMU) was -1.34 (2.49) microns in the normal subjects and 6.11 (1.95) microns in the patients with osteoporosis. This difference was also highly significant (p less than 0.001). Indirect estimations of erosion depth and delta BMU, based on the fall in trabecular thickness from an assumed premenopausal value of 147 microns and the number of remodeling cycles accumulated since menopause, agreed closely with the measured values. Erosion depth measured by the Eriksen method also showed no significant difference between the two groups, but because the values were substantially higher delta BMU was improbably high in both groups, did not differ significantly between groups, and was inconsistent with the observed difference in trabecular thickness.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792945 TI - Osteoclast-specific monoclonal antibodies coupled to magnetic beads provide a rapid and efficient method of purifying avian osteoclasts. AB - Osteoclasts are the major cell type responsible for normal and pathologic bone resorption. Obtaining highly purified populations of these multinucleated cells has been problematic, although such populations would greatly facilitate investigations of osteoclast regulation and activity. A new immunomagnetic protocol has been devised to surmount these difficulties, employing avian osteoclast-directed monoclonal antibodies (designated 121F, 35L, and 75B) surface coupled to uniformly small, magnetic polystyrene beads covalently conjugated with sheep antimouse IgG. Presentation of these antiosteoclast antibody-coated beads to mixed cell preparations derived from marrow-depleted, collagenase- and/or trypsin-treated chick tibiae and wing bones, followed by magnetic separation and washing, results in efficient and selective binding of osteoclasts to the immunomagnetic beads within minutes. The specific nature of this bead-cell interaction is further demonstrated by the progressive decline in antiosteoclast antibody-coated bead binding to osteoclasts by uncoated beads or beads coated with an irrelevant antibody. Under optimal conditions, these isolations typically yield more than a 100-fold enrichment and greater than a 90% purification of osteoclasts from subpopulations of either predominantly nonviable or viable osteoclasts. Although scanning electron microscopy reveals that immunomagnetically purified and cultured osteoclasts internalize large numbers of the antibody-coated beads, such cells appear unimpaired in their ability to attach to tissue culture plastic or devitalized cortical bone slices and to produce resorption pits characteristic for osteoclasts. Additional studies to ascertain the most effective method for removal (desorption) of antibody-coated beads from magnetically isolated osteoclasts demonstrate that moderate physical agitation is at present the most effective protocol to dislodge antibody-coated beads from the cell surface while maintaining osteoclast viability and function. This immunomagnetic technique therefore provides a gentle method for the isolation of highly purified populations of osteoclasts from heterogeneous bone cell populations in a rapid, efficient, and selective manner. PMID- 1792946 TI - No evidence for an effect of lactase deficiency on bone mass in pre- or postmenopausal women. AB - The potential role for lactase deficiency in the development of low bone mass was examined in 342 adult female twins. Diminished lactase activity, defined as greater than 20 ppm increase in expired hydrogen at 2 or 2.5 h after an oral lactose load, was examined: (1) by comparing bone mass between members of twin pairs discordant for lactase activity; (2) by examining the linear association between bone mass and total expired hydrogen gas; and (3) by comparing all lactase-deficient individuals to those with persistent lactase activity. Among members of discordant (primarily DZ) pairs, the lactase-deficient member had greater bone mass 54% of the time. The correlations between the increase in expired hydrogen and bone mass at various sites were between -0.02 (femoral neck) and 0.11 (midshaft radius), suggesting no association between these variables. Finally, all lactase-deficient subjects were compared with those with normal lactase activity, regardless of twin status, and at each skeletal site the differences in bone mass were 1% or less. Thus, all primary hypotheses were not supported by these data; that is, in this large sample we could find no evidence of a detrimental effect of lactase deficiency on adult bone mass. However, baseline expired hydrogen was consistently and positively associated with bone mass at all sites, independently of age, suggesting the possibility that some aspect of intestinal function related to the activity of bacterial anaerobes may be positively associated with bone mass. PMID- 1792947 TI - Bone morphogenetic protein-2b stimulation of growth and osteogenic phenotypes in rat osteoblast-like cells: comparison with TGF-beta 1. AB - The biologic effects of recombinant human bone morphogenetic protein-2b (BMP-2b = BMP-4) were studied and compared with transforming growth factor-beta 1 (TGF-beta 1) in fetal rat osteoblast-like (ROB) cells. Similar to the effects of TGF-beta 1, BMP-2b stimulated DNA and collagen synthesis as well as protein accumulation. Unlike TGF-beta 1, which inhibited alkaline phosphatase activity, BMP-2b enhanced enzyme activity eight-to ninefold over the control level. The present study demonstrates direct actions of BMP-2b on bone-associated cells to stimulate osteogenic phenotypes in vitro and provides a cellular mechanism for the induction of bone formation by BMP-2b in vivo. PMID- 1792948 TI - Stereotactic Vim-Vo-thalamotomy for choreatic movement disorder. AB - Two cases with hemichorea and dopa induced dyskinesia (DID) were successfully treated with Vim-Vo thalamotomy. The findings of MRI and PET of these cases were variable because of the difference of their underlying disease processes. In the patients with hemichorea, high electrical activities with irregular bursts of discharge were recorded in Vo and Vim. These may be related to dysfunction of Vo underlying choreatic movement. Regardless of the causes, their choreatic movement was abolished by Vim-Vo thalamotomy affecting mainly Vo after physiological identification of Vim. PMID- 1792949 TI - Thalamic stimulation for the treatment of tremor and other movement disorders. AB - Thalamic stimulation for the treatment of tremor and other motor movement disorders is attractive in view of the fact that it is a non-destructive procedure. With the experience of 26 cases indications can be defined. The method is an alternative for treatment of tremor only when thalamotomy carries a high risk of complications. Not only is the cost a limiting factor but also repeated operations for replacing the neuro-pacemaker and thus the risk of infection have to be taken in consideration. PMID- 1792950 TI - Therapeutical neurostimulation--indications reconsidered. PMID- 1792951 TI - Epidural spinal electrical stimulation in the treatment of severe arterial occlusive disease. AB - The effect of epidural spinal cord stimulation (ESES) on peripheral circulation in 10 cases with advanced vascular occlusive disease has been tested, using transcutaneous oxygen measurement (TcpO2), contact thermography and laser-speckle measurements. The values in all cases increased. Improvement was more pronounced during the first 2-3 weeks. Indications and limitations of this treatment modality are discussed. PMID- 1792952 TI - Open stereotactic neurosurgery: 57 cases. AB - The two main neurosurgical tools are the operative microscope and stereotactic apparatus. The operative microscope is essential in cisternal or ventricular surgery and the stereotactic apparatus is essential in approaching intracerebral lesions. Both given their best performance when the one aids the other. Small convexity lesions are best approach with stereotactic aid, and excellent microsurgical intracerebral lesions can be debulked with the operative microscope. Malignant tumours pursue their inevitable course but slow growing tumours and angiomas may have long survival even with one subtotal removal. The major problem in removing slow-growing tumors is the difficulty in distinguishing tumour from normal brain, but the stereotactic guide is useful in delimitating tumour volume. The results in 57 cases are described. PMID- 1792954 TI - Chronic motor cortex stimulation for the treatment of central pain. AB - Twelve patients with deafferentation pain secondary to central nervous system lesions were subjected to chronic motor cortex stimulation. The motor cortex was mapped as carefully as possible and the electrode was placed in the region where muscle twitch of painful area can be observed with the lowest threshold. 5 of the 12 patients reported complete absence of previous pain with intermittent stimulation at 1 year following the initiation of this therapy. Improvements in hemiparesis was also observed in most of these patients. The pain of these patients was typically barbiturate-sensitive and morphine-resistant. Another 3 patients had some degree of residual pain but considerable reduction of pain was still obtained by stimulation. Thus, 8 of the 12 patients (67%) had continued effect of this therapy after 1 year. In 3 patients, revisions of the electrode placement were needed because stimulation became incapable of inducing muscle twitch even with higher stimulation intensity. The effect of stimulation on pain and capability of producing muscle twitch disappeared simultaneously in these cases and the effect reappeared after the revisions, indicating that appropriate stimulation of the motor cortex is definitely necessary for obtaining satisfactory pain control in these patients. None of the patients subjected to this therapy developed neither observable nor electroencephalographic seizure activity. PMID- 1792953 TI - Pathophysiology of central (thalamic) pain: a possible role of the intralaminar nuclei in superficial pain. AB - In 15 patients with central pain (thalamic pain) after stroke, CT, PET scan and intraoperative thalamic microrecordings were performed. The results are considered together to evaluate a possible role of thalamic intralaminar nuclei in the genesis of central pain, especially of superficial pain. In the non thalamic lesion group (deep pain dominant), thalamic background neural activity (BNA) was relatively high in Vim but low in CL. Conversely, in the thalamic lesion group (superficial pain dominant), thalamic BNA was higher in CL than in Vim, and markedly decreased in VC. In this group, regional cerebral oxygen consumption (rCMRO2) was relatively maintained, and regional oxygen extraction ratio (raOEF) and the relative value of regional cerebral glucose utilization (CMRGL), compared to rCMRO2, was increased in the cerebral cortex around the central sulcus. The genesis of superficial pain is discussed. PMID- 1792955 TI - Location of a DBS-electrode in lateral thalamus for deafferentation pain. An autopsy case report. AB - Pain relief was obtainable when deep brain stimulation was tried in the sensory thalamic nucleus in a patient with deaffereantation pain to cervical myelopathy. The electrode was histologically verified in post-mortem examination after 20 months and the localization of contact points of the implanted electrode was estimated. The cathode appeared to have been placed in the region from Vim to the rostral border of Vci while the anode was in the medical lemniscus region. Stimulation of the Vim nucleus might have had a pain relieving effects because no facial paraesthesiae was evoked by stimulation. The implanted electrode caused only minor histological changes. PMID- 1792956 TI - Bilateral versus unilateral percutaneous high cervical cordotomy as a surgical method of pain relief. AB - The present report is concerned with the results of bilateral percutaneous high cervical cordotomy (60 patients) compared with those of unilateral cordotomy (161 patients). The result of pain relief is classified into 4 grades based on Hitchcock's criteria; grade 1: complete pain relief, grade 2: almost complete pain relief with slight residual pain, grade 3: persisting pain, but tolerable, grade 4: persisting pain, untolerable. In cases of bilateral cordotomy (60 patients), 76% of the cases showed grade 1, 19% being grade 2, 3% being grade 3 and 2% being grade 4. On the contrary, the unilateral cordotomy (161 patients) showed less impressive results, particularly in grade 1, namely, grade 1 being 64%, grade 2 being 18%, grade 3 being 14% and grade 4 being 4%. Clinically acceptable results (grade 1 plus grade 2) were, therefore, obtained in bilateral cordotomy (95%) as compared with unilateral cordotomy (82%). The difference in pain relief between bilateral and unilateral procedure observed in the present investigation is contrary to that reported previously by others. The possible explanation for less impressive result in regard to grade 1 of unilateral cordotomy is that unilateral cordotomy was performed in this series to alleviate the major side of patient's pain, followed by latent pain on the other side postoperatively, which is not uncommon phenomenon in cancer pain. Whereas all of the bilateral cordotomies were done either for midline pain or bilateral pain, unilateral cordotomy gave satisfactory pain relief in some cases of midline pain. Midline pain, therefore, does not necessarily require bilateral cordotomies from a clinical point of view.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1792957 TI - Stereotactic open craniotomy and laser resection of brain tumours. A five years experience. AB - In 23 cases of deep-seated brain tumours stereotactically guided laser vaporization has been done, using a 60 watts CO2 laser. The experiences and results of the 18 first cases with a follow-up of 10 months to 5 years are presented. The technique is described. PMID- 1792958 TI - Surgical treatment for epilepsy. Results after a minimum follow-up of five years. AB - Forty-two patients have been surgically treated for medically uncontrollable epilepsy, using the Talairach and Bancaud methodology. The mean age of the patients was 19 years (range 6-54 years). The location of the epileptogenic zone was:frontal in 18 patients, temporal in 14, temporo-parieto-occipital junction in 4, parietal in 4 and occipital in 2. The overall surgical results are: 20 patients are seizure free and 6 patients had occasional seizures (62% success rate). There has been a significant decrease in the number of seizures in 12 patients. The seizures persist in 4 patients. Only two patients, both with a parietal focus, presented additional postoperative neurological deficit (mild paresis in the contralateral lover limb). This was preoperatively foreseen, and accepted by the patient, on guarantees of the removal of the epileptogenic zone and amelioration of seizures. PMID- 1792959 TI - Deep seated cerebral lesion removal, guided by volumetric rendering of morphological data, stereotactically acquired clinical results and technical considerations. AB - The theoretical advantages of microsurgery guided by volumetric reconstruction of anatomy in stereotactic space, compared to traditional technique are discussed. Preliminary clinical results in 30 cases and technical considerations, concerning future developments, are presented. PMID- 1792960 TI - Trans-fissural or trans-sulcal approach versus combined stereotactic microsurgical approach. AB - The combined stereotactic-microsurgical approach has been used mainly to allow the removal of small subcortical lesions, determining their location and the route to be followed. In our experience, this approach has been most useful in 5 cases of small paraventricular AVMs and another 6 small deep-seated tumoural lesions. Since the availability of MRI, we have systematically applied Yasargil's proposal to perform dissection of the cisterns or sulci to reach a lesion with minimal or no injury to normal neuroanatomy. Assisted by Computer Aided Design software, we can superimpose the MR images with those provided by conventional or digital angiography (mainly the venous phase). MRI allows us to select a route or pathway through a sulcus, and angiography helps us in locating it on the brain surface. We have applied this technique systematically during the past year, and can report 20 cases (1 AVM, 12 tumoural lesions, 1 abscess and 6 haematomas). This trans-fissural or trans-sulcal approach has allowed us resection with minimal surgical damage, after a prompt and precise location. We think that both methods are not mutually exclusive, although the trans-sulcal approach is more adequate because of less discomfort for the patient, the smaller cerebral parenchyma injury and greater anatomofunctional information for the surgeon. PMID- 1792961 TI - Toxicology and kinetics of long-term intraventricular infusion of phenytoin and valproic acid in pigs: experimental study. AB - The effect of continuous intraventricular infusion of phenytoin and valproic acid into the brain of pigs was studied through quantitative measurement of animal behavior, pathological study of animal's brain and measurement of the levels of these drugs in the blood and C.S.F. Two groups of five animals each were treated with increasingly doses of the drugs until the apparition of toxic effects and the dead of animals. Normal behavior was observed with doses up to 3 mg/day of phenytoin and 1.5 mg/day of valproic acid. Toxic effects consisted on severe unsteadiness and muscular rigidity. Pathological study of the brains revealed that there were no damage attributable to the intraventricular infusion of the drugs. The present study suggests that intrathecal or intraventricular infusion of phenytoin and valproic acid could be well tolerated by humans and it leads us to consider subsequent clinical studies in epileptic patients. PMID- 1792962 TI - Endoscopic procedures in stereotactic neurosurgery. AB - A new prototype of an endoscope for stereotactic interventions is described. This endoscope is adapted to the Mundinger-Birg stereotactic system. Stereotactic endoscopic procedures are carried out for brain-tumour-biopsy as well as for evacuation of haematomas, brain-cysts and abscesses. Ventriculoscopy is performed on hydrocephalus and biopsy of ventricle-relating tumours. One-year experience with stereotactic endoscopy is reviewed. PMID- 1792963 TI - Towards a neural transplantation therapy for Parkinson's disease: experimental principles from animal studies. AB - Animal experimentation is necessary to identify the optimal parameters and procedures for clinical application of neural tissue transplantation. Experiments in animal models of Parkinson's disease are briefly reviewed. Embryonic nigral tissues survive transplantation well and yield good functional recovery on a variety of motor tests. The age of the donor, the implantation technique, and the site of placement in the host brain all influence graft efficacy. Nevertheless there are theoretical limits to the power of current procedures, and even under optimal circumstances full recovery cannot be expected. PMID- 1792964 TI - Transplantation of cultured fetal adrenal medullary tissue into the brain of Parkinsonian. AB - In an experimental study human fetal adrenal medullary tissue was cultured and its cytoplasmatic catecholamine storing vesicles, NA and dopamine (DA) concentration controlled for 8 days. High secretory function of DA was maintained. This cultured human fetal tissue was transplanted to the subcortex of adult rabbits. Some of the crafts survived several months and maintained secretory function. In a clinical study 17 patients with Parkinson's disease received a transplantation of human fetal adrenal medullary tissue, which was cultured for one week and then transplanted into the head of both caudate nuclei. During follow-up of 3-18 months all of them improved. PMID- 1792965 TI - Adrenal medulla autograft in caudate nucleus as treatment for Parkinson disease. AB - The personal experience of four Parkinson's disease patients operated on with adrenal medulla autograft in the caudate nucleus is reported. Results on long term, possible only in two patients, are moderately fair. PMID- 1792966 TI - A comparative evaluation of clinical rating scales and quantitative measurements in assessment pre and post striatal implantation of human foetal mesencephalon in Parkinson's disease. AB - Six patients with advanced Parkinson's Disease were evaluated before and after implantation of human fetal ventral mesencephalic tissue to the head of the right caudate nucleus. The results of clinical assessment indicate that attempts to characterise patient fluctuations requires a combination of clinical rating scales and timing of specific limb tasks. PMID- 1792967 TI - Grafting of fetal dopamine neurons in Parkinson's disease. The Czech experience with severe akinetic patients. AB - Preliminary results in three patients with Parkinson's disease, who had transplantation of human embryonic mesencephalic tissue into the caput nuclei caudati, are reported. Some improvement was achieved. PMID- 1792968 TI - A series of experimental surgery for advanced Parkinson's disease by foetal mesencephalic transplantation. AB - 12 patients with advanced Parkinson's Disease who had right caudate implantations of late stage foetal mesencephalon have been followed up for 1 to 2 years with extensive clinical and physiological assessments. Three patients failed to comply and were excluded. Seven of the remaining 9 patients showed substantial initial improvement which was well maintained in 4. Two of the 3 remaining patients of this group maintained lesser improvement. One returned to pre-operative state. Two patients with greatly advanced disease had only slight but brief improvement. A series of 24 matched patients have been treated and continue under investigation. PMID- 1792969 TI - Digital X-ray apparatus especially designed for precise biometry in stereotactic surgical procedures. AB - Modern stereotactic surgical procedures were developed mainly because digital CT image gave us the opportunity to recognize the morphology and the site of a brain lesion, and, at the same time, CT offered a very easy and reliable way to calculate target coordinates because the brain scans are digital maps. Digital x ray image obtained with an x-ray-intensifier and a TV Analog/Digital converter is not suitable for stereotactic use because image distortion is multifactorial and it is impossible to rectify. We have developed a new apparatus (Neurogil) for intra-operative use that is able to produce a digital image on a display, the measures displayed match exactly with the patient's brain. A linear array of 1024 photodiodes is working in front of an x-ray source and it collects the density image of the patient's head positioned between them. It shows the patient's head with the stereotactic frame exactly as a radiogram, but no distortion is present. Digital brain angiograms are possible with electronic subtraction, mathematical enhancement and with a stereoscopic view on a particular display. Any kind of mathematical calculation or computer-graphic application is possible. A special software was developed for stereotactic closed and open surgery. PMID- 1792970 TI - An ultrasound-guided stereotactic apparatus for intracranial mass lesions. AB - One of disadvantages of conventional stereotactic operation for intracranial mass lesions is that it is basically a blind procedure even if the operation is performed in a gantry of a CT scan. High resolution ultrasound image gives real time information on intracranial pathology such as bleeding, remaining cyst fluid or haematoma. The authors report an ultrasound guided stereotactic apparatus which gives real-time images of the lesion during operation. PMID- 1792971 TI - Application of multimodality imaging stereotactic localization in the surgical management of vascular lesions. AB - Multidimensional image preplanning and accurate pre and intraoperative localization for intracranial vascular lesions have been implemented. Methodology include carbon fiber base ring, localizer plates, any X-ray tubes, PC compatible software and intraoperative localizing unit. Surgical management of deep arteriovenous malformations is especially suitable for this technique, including the use of intraoperative digital angiography. PMID- 1792972 TI - Contemporary stereotactic atlasses: merging of functional data with individual morphological MRI acquisitions. AB - The traditional concept of the sterotactic brain atlas, utilized as an anatomical piece of information, to be integrated with neuroradiological data in order to organize functional observations, is evolving towards the creation of a powerful database for clinical and functional data, contained in anatomical structures. Actual computational resources make it possible to use this information, interactively adapted to each patient's anatomy, and updated, following each procedure. PMID- 1792974 TI - A new surgical but less invasive treatment of central brain tumours Preliminary report. AB - Our goal was always to reduce the risks of anaesthesia and surgery to a minimum. Therefore we introduced the interstitial thermotherapy of central brain tumours. The center of the tumour is calculated with the help of computer tomography, then we reach the target stereotactically. The last step includes the insertion of a Nd:YAG laser fiber and the denaturation of the tumour under real time magnetic resonance control. The whole procedure is carried out in local anaesthesia. Methods and first clinical results are demonstrated. PMID- 1792973 TI - The stereotactic approach to brain stem lesions: a follow-up of 29 cases. AB - Stereotactic biopsy is the safest and most reliable method for the histological diagnosis of intraaxial brain stem lesions. The definitive pathological diagnosis permits the selection of adequate therapy. No operative and/or adjuvant therapy must be proposed without a previous histological diagnosis. This approach avoids the complication of inappropriate therapy and provides valuable prognostic information. PMID- 1792975 TI - Stereotactic laser therapy in cerebral gliomas. AB - The 1.06 micron Nd:YAG laser and a new fiberoptic delivery system, the Interstitial Thermo-Therapy (ITT) laser fibre, allows stereotactic interstitial irradiation of cerebral tumours. In experimental rat brain studies we found typical laser-tissue effects with a central necrosis and a sharply demarcated oedema towards the normal brain. The size of the lesion depended on the energy and exposure time applied. In a pilot series we treated 5 patients with cerebral gliomas WHO grade II-III in functionally important regions and monitored the therapeutic effects by MR imaging and PET scan. Early post-operative results showed irreversible necrotic changes in the tumour centre and reversible oedematous changes at the tumour margin. Long-term results will show if stereotactic interstitial laser therapy is a useful supplementary method in the treatment of malignant cerebral tumours. PMID- 1792976 TI - Development of a second generation stereotactic apparatus for linear accelerator radiosurgery. AB - Linear accelerator radiosurgery technique is based on a multiple intersecting arc irradiations procedure. The coincidence of the axis of two rotation movements (of gantry and treatment couch) into the isocenter is critical for focusing irradiation. In October 1989, our linear accelerator was changed and the stereotactic apparatus had to be adapted to the new machine. After multiple mechanical tests of the new machine, the stereotactic head frame was fixed to the roller bearing allowing rotation of the couch. The new apparatus is described. PMID- 1792977 TI - Gamma knife surgery for cerebral metastasis. AB - Twenty-six cerebral metastatic tumours treated with the Gamma knife employing a large single dose were followed by repeated clinical and CT examinations. In most cases Gamma knife surgery was the only treatment. The follow up time has been longer than 6 months with a median follow up of 9 months. In all but one of the cases a remarkable progressive shrinkage of the tumour started 2-4 months after the therapy. The therapeutic results indicate that radiosurgery used even as the only form of treatment is the best treatment alternative for cerebral metastasis presently available. PMID- 1792978 TI - Open stereotactic surgery. AB - Open Stereotactic Surgery [OSS] may be defined as the use of precise stereotactic techniques to facilitate conventional neurosurgical procedures. The field has expanded in recent years particularly in the areas of imaging, instrumentation and co-ordinate transfer. The factors influencing the developments are explored. PMID- 1792979 TI - Solitary brain metastasis: radiosurgery in lieu of microsurgery in 32 patients. AB - Thirty-two consecutive patients with 34 small brain metastases underwent boost stereotactic radiosurgery using the first North American Gamma Unit between May 1988 and July 1990. The majority of tumors (n = 24; 71%) were considered resistant to conventional, fractionated irradiation (malignant melanoma, n = 13; non-small cell lung carcinoma, n = 7; renal cell carcinoma, n = 4). During the follow-up period (median = 10 months; range = 1.5-15 months) no patient suffered a complication of radiosurgical treatment, and no patient died from a radiosurgically-treated metastasis. Shrinkage or growth-arrest was documented in 20 of 23 patients (87%) available for follow-up. Median survival after treatment was 10 months. PMID- 1792980 TI - Radiosurgical treatment of low flow carotid-cavernous fistulae. AB - The good results obtained by stereotactic radiosurgery in arteriovenous malformations has led the authors to expect similar results in low flow carotid cavernous fistulae. In this paper, 20 cases who underwent radiosurgery with a conventional gamma source are presented. The total dose delivered was 36 to 40 Gy. 90% of the patients were cured after radiosurgery after a mean time of 7 months. Those presenting a mild improvement after a mean time of 2 months and those with a marked improvement after 4 months. PMID- 1792981 TI - Assessing outcome of stereotactic and functional neurosurgery for clinical audit. PMID- 1792982 TI - [Prolific psychiatric authors of the 1st 3d of the century in Spain]. AB - The 45 main authors of articles on psychiatry from 1901 to 1931 are studied together using a repertory of the author as a source. It contains the psychiatric production in 32 important Spanish medical journals in that time. The following variables have been considered for the collective biographical analysis of the authors: year and place of birth, universities where they studied, institutions for their professional practising, cities for their professional residence, medical specialty, professional position, number of original articles on the subjects of psychiatry published and contained in the reference repertory, productivity index and signatures per work index. We can say that 0.2 of the prolific authors were born from 1880 to 1889 and 0.2888 of them were from Madrid and Barcelona. In those cities, 0.3334 of them studied Medicine and 0.6444 of them lived there; 0.6 of them worked in hospitals and 0.2222 of them worked in madhouses. Most of them were neuropsychiatrists. The occasional producers were 0.6908 of them and the reports with only one signer were 0.9492 of the total. Abdon Sanchez Herrero was the greatest producer on the specialty with 348 articles. PMID- 1792983 TI - [The practice of intensive care medicine as a stress situation]. AB - A study about the problem of stress in physician who work in intensive care units requires a previous reflection about the stress concept itself. Selye's conception undoubtedly signified a great progress for the comprehension of the processes of biological adaptation, but it seems it can not be easily applied to the psychological and social field. The decrease of psychosomatic diseases during the last world war is one of the many examples that make question the causal relationship between stress and disease. The concept of life event in anglo-saxon psychiatry is also discussed, as well as its attempt to measure the stressor character of these circumstances through a scale of points. The concept of "pathogenic situation" of German psychiatry is proposed in exchange. From this perspective, medicine in general and intensive medicine in particular can be seen as human activities constituting "pathogenic situations" for the ones who exercise them. The corresponding literature allows to establish that medicine generates more pathology in physicians than other professions, but intensive medicine does not seem to be more pathogenic than other specialties. The elements of the "medical act" which could be responsible for the stress or pathogenic situation are studied. Respecting intensive medicine, two are the characteristics which seem to contribute to make it "pathogenic" for those who exercise it: a mistaken vision of death as an "enemy" which has to be fought a outrance, and the "temporality of urgency", proper to an ICU, which makes that the doctor can not give himself time enough for listening to the patient and telling him the adequate word of consolation. PMID- 1792984 TI - [Suicide in the elderly]. AB - Being the suicide a conduct very old, it's at present a problem with the epidemic characteristics and it's for this question that it has aroused a great interest. But, we have observed that the interest is only about the suicide youngest persons. They are little the factors and tendencies suicides studies in years old persons ("third age"), though also the suicide in years old persons is augmenting. We have analyzed 74 suicides in greater 60 years old persons occurred in our community. We have studied several epidemiological factors: sex, age, civil condition, the suicide mechanism, place where it's occurred, hour, day, month, the pathological antecedents and the other case antecedents. PMID- 1792985 TI - [Psychopathological disorders in otorhinolaryngological neoplasms]. AB - The authors analyze the psychopathologic disorders at the patients affected from O.R.L. cancers. They refer specially to larynx cancer, because of the significance on the loss in speech ability, if the treatment includes total laryngectomy, added to the fear characteristic of the patient with cancer. The highly incidence of alcoholism before diagnosis is also verified, what imply the addiction of psychopathologic disorders. It's estimated a well order to take part actively in their rehabilitation besides the lower incidence of alcoholism after surgery. PMID- 1792986 TI - [Adjustment scale for the I. B. Q. questionnaire for the Spanish clinical population]. AB - The aim of this work is to build a scale that permits the use of Pilowsky's Illness Behaviour Questionnaire (I.B.Q.), with a Spanish clinical population. To develop this scale we have used a global sample of 627 subjects (359 men and 286 women) from different hospitals and health units in the region of Murcia. PMID- 1792987 TI - [Prevalence of mental illness among parents of a sample of pedopsychiatric patients]. AB - We see in this study the association between parental mental disorder and the possibility of psychopathology in their children, at the same time pediatric patients. The children of 155 parents suffering of 10 mental disorders have been compared to 267 normal parent's children. The first group has significantly a greater frequency of emotional problems, developmental difficulties, behavioral disorders and a worst academic achievement. The association was more important if to the parental psychopathology was joined a pathological socio-familial milieu. PMID- 1792988 TI - [Carcinoma of the prostate in 1991]. PMID- 1792989 TI - [Priapism of low flow]. AB - The results obtained after treating 13 patients with low flow priapism diagnosed by cavernous gasometry, penile ecodoppler and cavernosography are explained. Seven cases of priapism (53%) developed following intracavernous injection of vasoactive drugs and had a good response to aspiration lavage and alpha-agonist medication. None of the cases needed shunt technique to achieve detumescence and all showed good evolution with regard to the erectile function. Six cases of priapism (47%) were idiopathic and they all needed some type of venous by-pass. Later, only one had normal erections. PMID- 1792990 TI - [Treatment of ureterocele in the adult]. AB - Review of 18 cases of ureterocele in the adult. The first clinical symptoms are unspecific, with a long-term evolution, and were found while carrying out routine urological examinations. The association to secondary lithiasis in over 60% cases and the presence of complete duplicity in 44% cases is highlighted. The choice treatment is by endoscopy in the simple cases without hydronephrosis or associated reflux. The technique of transversal incision in 'smiling mouth' at the base of the ureterocele produces good results. PMID- 1792991 TI - [Prospective studies for determining the duration of prevention in superficial tumors of the bladder]. AB - The study covers a series of 221 patients with pTa or pT1 vesical tumours who were treated by RTU and had an endovesical cytostatic agent instilled prophylactically for a year. Before beginning the tumour resection, biopsies in map with cold forceps were routinely taken from the trigone, side walls, bottom walls and vesical cup. It was decided to monitor the patients by performing cystoscopies and biopsies in map with cold forceps every quarter. During the second and third year the endoscopic and bioptic monitoring was done every six months. During the time when the cytostatic agents were instilled, a significant decrease (p less than 0.01) in the percentage of patients with 'CIS' was observed. After discontinuing the instillation, the percentage of patients with 'CIS' reversed to similar figures as seen prior to the study. It can be deduced from this observation that prophylaxis can be effective against those elements of the urothelial disease which influence the arrival of new events and the increase of the tumoral stage, and that the control of those factors disappears when the prophylaxis is discontinued. The study illustrates that prophylaxis in the urothelial disease should be maintained indefinitely. PMID- 1792992 TI - [Echography and cystoscopy: 2 diagnostic means in bladder tumor (1)]. AB - Study of 88 patients with vesical tumour who were performed a vesical ultrasound scan followed by cystoscopy. Comparison of both methods as to their ability to discriminate the location, size and number of the tumours. Both ultrasound scan and cystoscopy diagnosed vesical tumour in 81.8% and 100% cases respectively, the ultrasound scan showing higher ability to detect tumours affecting both sides of the bladder. PMID- 1792993 TI - [Evaluation of tumor staging using echography in bladder tumors (2)]. AB - The paper shows the value of echography in tumoral grading based on 87 patients who besides cystoscopy, bimanual touch and histology study by transurethral resection, had an echography performed. Sensitivity achieved for tumour detection through echography was 85% with a positive predictor value of 98.8%. On the 72 patients who were diagnosed a tumour through echography, TUR histology showed an echography under-grading of 2.7% (2 cases) and an over-grading of 9.7% (7 cases) with grading correlation in 86.3% cases. PMID- 1792994 TI - [Orchiectomy and buserelin in combination with flutamide: comparative results in metastatic prostatic carcinoma]. AB - In a prospective, non-randomized study in 44 patients with metastatic prostate carcinoma (D2), without previous hormone therapy, two alternative therapeutic courses to achieve complete androgenic blockade were compared. A first group (n = 29) was assigned to received Flutamide plus Buserelin, whereas the second group (n = 15) underwent orchidectomy, also in association to Flutamide. Both regimes were sustained without interruption, except when progression was evident, and both achieved castration levels of testosterone plasma titres. Mean follow-up duration was 13 months and 7 days, ranging between 2 and 36 months. There were no significant differences between both groups with regard to therapy objective responses and survival. Whereas the responses (CR + PR + E) were 93% in the LHRH analogues group and 86% in the orchidectomy group, overall survival was 66% and 67%, respectively. There were no secondary complications related to the surgical procedure nor adverse effects to drug therapy which required its cessation. PMID- 1792995 TI - [Primary abscess of the psoas. Report of 3 cases and review of the literature]. AB - Three cases of abscesses rated as primary of the psoas, after dismissing any likely cause that can be involved in the genesis of secondary abscesses of the psoas, are presented. A review of the literature is made, emphasizing the etiological change in the psoas' abscesses as well as the possible causes involved in the etiopathology of this picture which appears to be caused by distant dissemination from a septic nucleus. This theory is also supported by over 80% cases where Staphylococcus aureus is the causative organism. Reference is made to which clinical data is most relevant and to the value of the traditional diagnostic procedures: simplex x-ray, u.i.v., ultrasound techniques, radionuclides and CAT, the latter being the ideal diagnostic procedure in these processes. Finally, different therapy approaches are presented. Percutaneous draining (supported by ultrasound scanning and CAT) appears to have greater acceptance by most authors, relegating the surgical drainage for selected cases. PMID- 1792996 TI - [Uterovaginal duplication with right hematocolpos caused by imperforate septum and ipsilateral renal agenesia: report of a case diagnosed using non-invasive methods]. AB - Case report of a pubertal female patient with clinical signs of hypogastric pain initiated with the menarche, dysmenorrhoea and a palpable pelvic mass. The suspected clinical signs, ultrasound scans, urographies and CAT, confirmed the existence of an uterovaginal duplicity with right hematocolpos due to imperforate septum and pool of menstrual blood, as well as ipsilateral renal agenesis. The vagina examination and resection of the septum under sedation solved the case. PMID- 1792997 TI - [Micrographic surgery and inguinal lymphadenectomy: elective therapy in carcinoma of the penis (stage I and II)]. AB - The squamous cancer of the penis has a very low incidence in our environment which means that very few centres have any cases and therefore lack any major experience. This handicap together with their treatment being divided between Urologists and Dermatologists decreases even more the number of cases seen and precludes the obtention of valid considerations. This report presents 15 cases of squamous cancer of the penis seen and followed-up for at least 5 years, and which were treated according to an established protocol in which the differential element, based in our results, is that ilial lymphadenectomy does not offer better results than chemotherapy in high-stage disease, with 33% survival, whereas in low-stage disease the use of surface and deep bilateral inguinal lymphadenectomy, in conjunction with micrographic surgery achieves survival rates of 100%. Morbidity in this case is standard (transient lymphedema, 100% patients; inguinal skin necrosis, 4% patients), while ilial lymphadenectomy has a high morbidity and some mortality. PMID- 1792998 TI - [Excretory azoospermia secondary to a cyst of the seminal vesicle]. AB - A case report of malformation of the right mesonephric ductus, involving a seminal vesicle cyst and ipsilateral renal and ureteral agenesis. The infrequency of such pathology is recalled and the oddity, in our case, of its presentation in the fashion of infertility secondary to excretory azoospermia highlighted. The deferentovesiculography, ultrasound scanning, urography and CAT were highly illustrative in the diagnosis. The treatment of choice in symptomatic cases is surgical exeresis, which in our patient secured the resolution of the azoospermia. PMID- 1792999 TI - [Infrequent retroperitoneal tumor: benign schwannoma]. AB - Case report of a retroperitoneal benign Schwannoma diagnosed accidentally during ultrasound scanning for a different pathology and treated by surgical exeresis. The diagnostic and therapeutic features of this rare neoplasia are reviewed. PMID- 1793000 TI - [Renal actinomycosis: presentation of a case]. AB - Renal actinomycosis is rarely suspected and is difficult to diagnose, limited to a few cases in any series. A 56-year-old man with renal actinomycosis and Rendu Osler disease is described. Long-term therapy with penicillin resulted in a clinical cures. A case report is presented. PMID- 1793001 TI - [Immunohistochemistry as diagnostic method of a amelanotic malignant melanoma of the penis]. PMID- 1793002 TI - [Adenocarcinoma in bladder. Apropos of a case]. AB - Finding an adenocarcinoma at the vesicle suggests three possible diagnosis: Intestinal adenocarcinoma with vesical location. Adenocarcinoma of the urachus. Vesical primitive adenocarcinoma. Presentation of one case of intestinal adenocarcinoma, revealed by its mictional symptomatology, with the endoscopic appearance of being a single vesical tumour, later shown to be a vesical adenocarcinoma, on which extended surgery of the gut and partial surgery of the bladder was performed. PMID- 1793003 TI - The early development of the neopallial wall and area choroidea in fetal rats. A light and electron microscopic study. AB - The telencephalic wall was studied by light and electron microscopy in 11-13 day old fetal rats (E11-13). A few specimens from E14-16 were also included for comparisons. Two areas were selected: the dorso-lateral convexity of the hemispheric vesicles, called the neopallial wall, and the area choroidea, the posterior part of the telencephalic roof which unites the two hemispheres. Our observations and a review of the literature have shown that on E11-12 the neopallial wall, the telencephalic roof, and the hippocampal anlage between them form a continuous, nonstratified, cohesive monolayer of columnar and mitotic cells, which essentially is similar to epithelial monolayers elsewhere in the body. This simple structure is modified late on E12 or early in E13 in the neopallial wall when postmitotic neurons appear and migrate in order to form the cortical plate. However, bipolar radially oriented cells, which span the entire width of the wall, still predominate. These cells, now called radial glial cells, increase greatly in number and length during the period of neuronal migration. The cuboidal cells in the neural tube, the columnar cells in the early neopallial wall, and the radial glial cells in the period of neuronal migration have the same basic structure. They are axially polarized epithelial cells which are characterized by the following basic features. They have an elongated bipolar shape which is maintained by a cytoskeleton of longitudinally oriented microtubules. Opposite ends are different structurally and functionally. Thus, the apical ends, connected by tight junctions, face the fluid-filled cavity while the outer ends, covered by a basal lamina, face mesenchymal tissue including blood vessels. A polarization of cytoplasmic organelles is also evident, e.g. the Golgi apparatus has always a supranuclear position. During the early development of the telencephalon this basic epithelial structure is maintained but is modified locally in order to serve various functions. The columnar/radial glial cells in the neopallial wall are elongated and slender, have a narrow Golgi apparatus, profiles of RER and vesicles, relatively few ribosomes, and show a few examples of micropinocytosis. These cells grow continuously in length during development. On the other hand, the cells in the area choroidea have a low columnar or cuboidal shape, which does not change during development. The inner portion (between the nucleus and the ventricle) contains a voluminous Golgi apparatus, many mitochondria, RER cisternae which contain electron-dense material, SER, and many vesicles. The inner ends of the cells project into the ventricular cavity as bulbous or apical protrusions which contain many organelles, especially MVBs.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1793004 TI - Structural aspects of metal liganding to functional groups in proteins. PMID- 1793005 TI - Copper protein structures. AB - The structural comparison of copper-containing proteins has provided a new dimension to the relationships suggested by sequence similarities. Ryden (1988) summarized the putative relationships, suggesting that a primordial single-domain cupredoxin evolved into the multidomain copper oxidases. The structures have revealed the fact that the differences reside primarily in insertions and deletions at junctions between secondary-structure elements. The mechanism of evolution (e.g., integration of new sequences into regions not essential to the Greek key fold) remains unknown. Which of the properties of a cupredoxin fold are necessary for function is the subject of site-directed mutagenesis studies. Can two of the ligands be interchanged (e.g., the upstream histidine and partially answered by the multidomain copper oxidase structure. The Tyr-Cys-Thr sequence in plastocyanin (in which threonine is a member of the hydrogen-bonding pair) is homologous with the His-Cys-His sequence in ascorbate oxidase. In the latter electron transfer is believed to flow from the type I copper (bound by the cysteine) to the trinuclear cluster, probably via these histidine residues. Hence, one might infer that the tyrosine and threonine have some role in electron transfer. Tyr-83 has been previously implicated in NMR studies as a primary site of electron transfer. The multi-copper protein structures have revealed interesting new features. The extra coppers are bound at domain interfaces, and can be single metals or the novel trinuclear cluster, depending on the availability of liganding histidines. A structural model of ceruloplasmin suggests that it will have at least two type I sites and, possibly, a third type I site such as stellacyanin (no methionine ligand), as well as a binding site for a trinuclear cluster. The similarity of the sequences of N2O reductases and a domain of cytochrome oxidase to the sequences of proteins with known structures suggests that these, too, will have Greek key domains. Galactose oxidase and hemocyanin do not have Greek key folds in their functional domains, although each does have a Greek key domain. The need for a Greek key fold remains obscure. The apoproteins are clearly stable without metals; there are examples other than immunoglobulins of Greek key folds. So far copper seems to be found in a very limited subset of structures; other chapters in this volume show that zinc, for example, has a much wider variety of environments in proteins, as does iron. It may be that the copper-containing Greek key proteins represent a very small evolutionary niche.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1793006 TI - Perspectives on non-heme iron protein chemistry. PMID- 1793007 TI - Structural biology of zinc. AB - The biological function of zinc is governed by the composition of its tetrahedral coordination polyhedron in the metalloprotein, and each ligand group that coordinates to the metal ion does so with a well-defined stereochemical preference. Consequently, protein-zinc recognition and discrimination requires proper chemical composition and proper stereochemistry of the metal-ligand environment. However, it should be noted that the entire protein behaves as the "zinc ligand," since residues that are quite distant from the metal affect recognition and function by through-space (either solvent or the protein milieu) or through-hydrogen bond coulombic interactions. Additionally, long-range interactions across hydrogen bonds serve to orient ligands and therefore minimize the entropy loss incurred on metal binding. Since zinc is not subject to ligand field stabilization effects, it is easy for the tetrahedral protein-binding site to discriminate zinc from other first-row transition metal ions: It is only for Zn2+ that the change from an octahedral to a tetrahedral ligand field is not energetically disfavored. Structural considerations such as these must illuminate the engineering of de novo zinc-binding sites in proteins. Zinc serves chemical, structural, and regulatory roles in biological systems. In biological chemistry zinc serves as an electrophilic catalyst; that is, it stabilizes negative charges encountered during an enzyme-catalyzed reaction. The coordination polyhedron of catalytic zinc is usually dominated by histidine side chains. In biological structure zinc is typically sequestered from solvent, and its coordination polyhedron is almost exclusively dominated by cysteine thiolates. Structural or regulatory zinc is found as either a single metal ion or as part of a cluster of two or more metals. In multinuclear clusters cysteine thiolates either bridge two metal ions or serve as terminal ligands to a single metal ion. Even in complex multinuclear clusters, Zn2+ displays tetrahedral coordination. The structural biology of zinc continues to receive attention in catalytic and regulatory systems such as leucine aminopeptidase, alkaline phosphatase, transcription factors, and steroid receptors. For example, zinc-mediated hormone-receptor association has recently been demonstrated in the binding of human growth hormone to the extracellular binding domain of the human prolactin receptor (Cunningham et al., 1990). To be sure, structural studies of zinc in biology will continue to be a fruitful source of bioinorganic advances, as well as surprises, in the future. PMID- 1793008 TI - Calcium-binding sites in proteins: a structural perspective. PMID- 1793009 TI - Anti-inflammatory effects of LY221068 and LY269415. AB - LY221068, 5-[[3,5-bis(1,1-dimethylethyl)-4-hydroxy phenyl]methylene]-3 (dimethylamino)-4-thiazolidinone, and the monomethylamino analog, LY269415, are anti-oxidants and potent inhibitors of iron dependent lipid peroxidation and 5 lipoxygenase enzyme. Since oxygen radical species, lipid peroxides and products of the arachidonic acid cascade have been implicated as important mediators in a variety of inflammatory diseases including arthritis, LY221068 and LY269415 were studied in the Freund's Complete Adjuvant Induced Arthritis (FCA) model in rats. The compounds were administered orally and inhibition of bone damage and paw swelling of both the injected and uninjected paws was assessed. At 50 mg/kg p.o., LY221068 inhibited soft tissue swelling in the uninjected paw by 72% while LY269415 at 25 mg/kg p.o. exhibited 74% inhibition. Bone damage was also significantly inhibited by both compounds. In a dose response study, the minimum effective dose for LY221068 was 10 mg/kg p.o. and for LY269415 was 5 mg/kg p.o. In the established FCA model in rats, LY221068 at 50 mg/kg p.o. inhibited the uninjected paw swelling by 71% while LY269415 at 25 mg/kg p.o. inhibited 70%. These results suggest that LY221068 and LY269415 may be useful in the treatment of arthritis. PMID- 1793010 TI - CoA-independent transacylase has characteristics distinct from those of PLA2 enzymes. AB - CoA-independent transacylase (CoA-IT) catalyzes the transfer of arachidonic acid from acyl- to alkyl-linked phospholipids. The removal of arachidonic acid from the sn-2 position of the donor phospholipid is a PLA2-like reaction. However, examination of CoA-IT in U937 cells demonstrated that CoA-IT has many characteristics that are distinct from those of PLA2 enzymes, including activity in the absence of Ca2+, activity that was heat and acid unstable and stable in 10 mM 2-mercaptoethanol and that was inhibited by detergents. Compounds that inhibit PLA2 activity did not inhibit CoA-IT activity, including quinacrine, aristolochic acid and arachidonic acid. All of these characteristics of CoA-IT are in contrast to those of most PLA2 enzymes. These data suggest that CoA-IT is biochemically different from, and has a mechanism of action unique from PLA2 enzymes. PMID- 1793011 TI - Phosphonate-phospholipid analogues inhibit human phospholipase A2. AB - A phosphonate-containing phospholipid (PL) analogue (Compound 1) designed as a transition-state inhibitor competively inhibits non-human extracellular PLA2 at a mole fraction of 0.003 in the kinetic "scooting mode" (Jain et al., Biochem 28:4135 (1989]. To further profile the activity of Compound 1, we examined its activity with purified human enzyme and in whole cell systems. Compound 1 effectively inhibited a 14 kDa human PLA2 purified from joint synovial fluid of patients with rheumatoid arthritis using 3H-AA labeled E. coli as substrate (IC50 = 1.7 microM) and a high MW PLA2 (110 kDa) isolated from the cytosol of a human monocytic cell line, U-937, which selectively hydrolyzes AA-containing PL (IC50 = 165 microM). It failed to reduce A23187-induced PGE2 or LTC4 production by human adherent monocytes or LTB4 release from human neutrophils which may be due, in part, to poor membrane partitioning. PMID- 1793012 TI - Macrophage-mediated killing of splenic lymphocytes in adjuvant-induced arthritis. AB - After 72 hrs in culture, unseparated spleen cells from rats with adjuvant-induced arthritis (AA) stimulated with high concentrations of Con A (greater than 0.63 micrograms/ml) leaked more lactate dehydrogenase (LDH) than did either unstimulated cultures or cultures stimulated with lower concentrations of Con A. This reflects an increase in dead or dying cells at concentrations of Con A greater than 0.63 micrograms/ml. Since Con A did not increase LDH leakage in macrophage-depleted cultures of AA splenocytes, the decreased viability in unseparated, Con A-stimulated cultures appears to be a macrophage-dependent phenomenon. Since the increase in LDH release at high concentrations of Con A paralleled the decrease in [3H]-thymidine incorporation, these results suggest that Con A (greater than 0.63 micrograms/ml) induces macrophages from AA rats to kill splenic lymphocytes in culture. PMID- 1793013 TI - Methoxyalkyl thiazoles: a novel series of potent, orally active and enantioselective inhibitors of 5-lipoxygenase. AB - Methoxyalkyl thiazoles are novel 5-lipoxygenase inhibitors which are neither redox agents nor iron chelators and are exemplified by ICI211965 [1-(3-(naphth-2 ylmethoxy)phenyl)-1-(thiazol-2-yl)prop yl methyl ether]. ICI211965 potently inhibits LTC4 synthesis in murine macrophages (IC50 = 0.0085 microM) and its selectivity with respect to cyclo-oxygenase (greater than 5800) is greater than any previously reported lipoxygenase inhibitor. ICI211965 also selectively inhibits LTB4 synthesis by human blood in vitro (IC50 = 0.45 microM) and rat blood ex vivo (ED50 = 10 mg/Kg, p.o.). Methoxyalkyl thiazoles exhibit a tight structure activity relationship and resolution of a chiral member of the series demonstrates that 5-lipoxygenase inhibition resides largely in one enantiomer. Methoxyalkyl thiazoles represent the first class of agents for which 5 lipoxygenase inhibition is mediated by specific, enantioselective interaction with the enzyme. PMID- 1793014 TI - Phospholipase A2 (PLA2) activity in bovine pulmonary artery endothelial cells. AB - We have investigated the role of recombinant human interleukin-1 beta (rIL-1 beta) and recombinant human tumor necrosis factor alpha (rTNF-alpha) on PLA2 activity, protein synthesis and eicosanoid production in bovine pulmonary artery endothelial cells. Cellular PLA2 activity increased 4-fold and production of PGE2 increased 3-fold at 1-2 hrs in the presence of 10 units/ml rIL-1 beta. PLA2 activity increased 3-fold at 30 min and PGE2 production increased 2-fold with 5 x 10(-9) M rTNF-alpha. The data show that endothelial cells respond more rapidly to rIL-1 beta (2-6 hr) and rTNF-alpha (30 min) than do chondrocytes and synovial cells (6-16 hrs), suggesting endothelial cells may play a primary role in initiating the inflammatory response. PMID- 1793015 TI - Are tolfenamic acid and tenidap dual inhibitors of 5-lipoxygenase and cyclo oxygenase? AB - Tolfenamic acid and tenidap have been reported to be dual inhibitors of cyclo oxygenase and 5-lipoxygenase. In this study inhibition of 5-lipoxygenase by tenidap and tolfenamic acid in plasma-free leukocyte suspensions (IC50 values = 10 microM) required concentrations more than 100 fold higher than those which inhibited cyclo-oxygenase (IC50 values = 0.05 and 0.02 microM respectively). The potencies of tolfenamic acid and tenidap as cyclo-oxygenase inhibitors were markedly reduced in blood (IC50 = 6.5 and 10 microM respectively) and neither significantly inhibited 5-lipoxygenase. Since both drugs also failed to inhibit 5 lipoxygenase in rat blood ex vivo, we conclude that, at physiological levels of plasma proteins, tolfenamic acid and tenidap are selective cyclo-oxygenase inhibitors. PMID- 1793016 TI - Relationship of blood markers to disease severity and drug efficacy in rat adjuvant arthritis. AB - Rat adjuvant arthritis (AA) was used as a model to evaluate several blood markers as possible predictive indicators of drug efficacy. AA was induced in Sprague Dawley rats by the injection of complete Freund's adjuvant into the right hind foot pad. The rats were dosed p.o. from day 18 to day 31 with levamisole (10 mg/kg), indomethacin (1 mg/kg), diclofenac sodium (0.5 & 1 mg/kg), and prinomide (10 & 20 mg/kg). Disease severity was assessed by paw circumference on day 31. The following blood markers were analyzed: hyaluronate by ELISA, prostaglandin E2 by RIA, ESR by micro-dispette, total PMN by Technicon H-1, and albumin by BCG dye. Blood marker correlation (r) to disease severity was: hyaluronate (0.71), prostaglandin E2 (0.58), ESR (0.52), PMN (0.58), and albumin (-0.71). The relative rank order of drug efficacy (indomethacin, diclofenac sodium, and prinomide) did not differ using the change in paw circumference (day 31-day 17) or blood markers. Levamisole exacerbated the disease as measured by all the above parameters. Thus, these blood markers provide additional information for the statistical evaluation of drugs in rat adjuvant arthritis. PMID- 1793017 TI - Development of high-throughput radioligand binding assays for interleukin-1 alpha (IL-1 alpha) and tumor necrosis factor (TNF-alpha) in isolated membrane preparations. AB - Cytokine binding has been studied in a variety of intact cells, and in isolated receptor preparations. Each approach is associated with limitations with regard to screening large numbers of samples on a repetitive basis. In order to provide a more reproducible system of screening for compounds which modify IL-1 alpha and TNF-alpha binding, we have developed isolated membrane preparations for studying agents which can alter the association of these ligands with their receptors. These results demonstrate IL-1 alpha binding to BALB/c 3T3 cell membranes and TNF alpha binding to HeLa S3 cell membranes, and indicate that this is a viable approach to high-throughput screening. PMID- 1793018 TI - Pharmacological properties of five diclofenac metabolites identified in human plasma. AB - Five metabolites of diclofenac sodium (Voltarol) have been identified in human plasma. All five metabolites were more than 50 times less potent than diclofenac in inhibiting PGE2 production in zymosan-stimulated mouse macrophages and LTC4 synthesis was not inhibited in these cells. Anti-inflammatory activity (adjuvant arthritis and carragheenan-induced paw oedema in rats) and analgesic activity (phenyl-p-benzoquinone writhing, mouse) of the metabolites were at least 10 times lower when compared to diclofenac. There was a good correlation between in vitro PGE2 inhibition and in vivo activities for diclofenac and its metabolites indicating that inhibition of prostaglandin synthesis is a major mechanism responsible for their pharmacological actions. PMID- 1793019 TI - 2,6-Diamino-N-([1-oxotridecyl)-2-piperidinyl]methyl)hexanamide (NPC 15437): a selective inhibitor of protein kinase C. AB - NPC 15437 inhibited protein kinase C (PKC) activity and [3H]phorbol 12,13 dibutyrate (PDBu) binding to the enzyme in a concentration-dependent manner (IC50 values, 19 +/- 2 microM and 23 +/- 4 microM, respectively). No inhibition of cAMP dependent protein kinase A (PKA) or calcium/calmodulin-dependent myosin light chain kinase (MLCK) was observed. A detailed kinetic analysis of the interaction of NPC 15437 and a homogeneous preparation of PKC-alpha revealed a competitive type of inhibition with respect to activation of the enzyme by both phorbol 12 myristate 13-acetate (PMA) (Ki = 5 +/- 3 microM) and phosphatidylserine (PS) (Ki = 12 +/- 4 microM). Mixed inhibition (predominantly of the non-competitive type), with respect to activation of the enzyme by calcium, was also observed. These studies indicate that NPC 15437 is a selective inhibitor of PKC, interacting at the regulatory region of the molecule. NPC 15437 inhibited phorbol ester-induced ear edema in mouse (IC50 = 175 micrograms/ear) demonstrating the ability of NPC 15437 to inhibit PKC-mediated activity in intact cells. PMID- 1793020 TI - A synthetic mycobacterial heat shock peptide prevents adjuvant arthritis but not proteoglycan-induced synovitis in the rat. AB - Intradermal immunization of female Lewis rats with 100 micrograms of a nine-amino acid synthetic peptide corresponding to the arthritic T cell-reactive epitope of mycobacterial heat shock protein, three weeks prior to induction of adjuvant arthritis, produced inhibition of day 16 ankle swelling and histologic score. Intraarticular injection of 10 micrograms of bovine articular cartilage proteoglycan monomer emulsified in heavy mineral oil into normal Lewis rat stifle joints produced several hallmarks of chronic synovitis at day 16. Pre-treatment with nonapeptide did not inhibit proteoglycan-induced synovitis. These results indicate that tolerance to the critical epitope of heat shock protein does not abrogate the ability of proteoglycan to induce synovitis in rats. PMID- 1793021 TI - 15-Deoxyspergualin (15-DOS) has a curative effect on the development of SLE-like autoimmune disease in MRL/1 mice. AB - Treating MRL/1pr mice, which spontaneously develop systemic lupus erythematosus and rheumatoid arthritis, with 15-DOS resulted in a decrease in the amount of autoantibodies and inhibited proteinuria of the developing glomerulonephritis with an improved survival rate of these autoimmune mice. 15-DOS treatment also lowered the percentage of animals with swollen lymph nodes and inhibited the development of splenomegaly. In the established disease 15-DOS returned urine protein values and renal function (serum urea and creatinine) to normal levels. Circulating rheumatoid factor and autoantibodies to double-stranded DNA were reduced and the increase in paw volume (signs of a polyarthritis) was inhibited. PMID- 1793022 TI - 15-Deoxyspergualin (15-DOS) for therapy in an animal model of multiple sclerosis (MS): disease modifying activity on acute and chronic relapsing experimental allergic encephalomyelitis (EAE). AB - We examined the therapeutic effect of 15-DOS in the two models of acute and chronic relapsing EAE in Lewis rats. In the first model adult rats developed an acute severe EAE and by day 16 all animals died. Lewis rats treated with 15-DOS showed a delayed and reduced onset of clinical symptoms and mortality was prevented. In the second model Lewis rats (aged animals) developed a chronic relapsing EAE with up to three relapses. The second and third episodes were both milder and shorter in duration. All animals treated with 15-DOS survived the delayed first attack and developed no further relapses. PMID- 1793023 TI - Corticosteroids and immunosuppressive agents in rabbit heterolamellar corneal transplant model. AB - Bovine cornea (epithelium and stroma) was transplanted on to the rabbit cornea from which the epithelium and stroma had been removed. Conjuntival hyperemia and edema occurred from day 1-5 post-operation, followed by neovascularization and graft rejection within 7-10 days. Topical dexamethasone (0.1%) and prenisolone (1%) t.i.d. inhibited post-surgical hyperemia, edema, delayed hypersensitivity and neovascularization. These agents and the immunosuppressants (cyclosporin A and rapamycin) inhibited graft rejection observed up to 20 days. After cessation of treatment on the 20th day, grafts remained viable up to 35 days with dexamethasone, 10 days with prednisolone and rapamycin, and 5 days with cyclosporin A. PMID- 1793024 TI - IgM-rheumatoid factor and responses to second-line drugs in rheumatoid arthritis. AB - We have examined the relationship between IgM-rheumatoid factor (RF) and responses to second-line drugs in patients with rheumatoid arthritis (RA). Patients with active RA who were beginning treatment with gold, methotrexate or both were studied. Clinical responses were assessed with ESR, joint count, grip strength and activities of daily living questionnaire scores. Production of IgM RF by peripheral blood mononuclear cells in vitro and plasma levels of IgM-RF were measured by ELISA. Overall, 31 of 44 patients completing more than 6 months treatment improved including 10 treated with gold, 12 with MTX and 9 with both. Production of IgM-RF by peripheral blood mononuclear cells was decreased by 59% in patients who improved on treatment, but increased 2-fold in the unimproved group. Plasma levels of IgM-RF were decreased from 121 to 66 micrograms/ml in the improved group after 6 months of treatment, with similar decreases seen for each of the three treatments. In contrast, plasma IgM-RF levels in the unimproved group did not decrease until 1 year of treatment was completed. Nine patients converted to seronegativity, and all but one of these were in the improved group. The results suggest that IgM-RF is correlated with responses to second-line drug in RA patients. PMID- 1793025 TI - Histamine is a transient marker of small intestinal injury induced by luminal acetic acid and casein. AB - We compared the time course of histamine release with other markers of intestinal injury in a rabbit model of necrotizing enterocolitis. Injury was induced by luminal acetic acid (200 mM) and casein (10 mg/ml) and experiments terminated after 45 min or 3 hr. Compared to saline controls there was a significant elevation of epithelial permeability (51Cr-EDTA clearance) and luminal protein levels at both time points. Luminal fluid histamine levels were approximately 120 fold greater than saline controls at 45 min but were indistinguishable from control values at 3 hr. We conclude that although mast cell activation is a characteristic of this model, elevations in histamine levels are transient. PMID- 1793026 TI - Platelet activating factor as a proinflammatory mediator in acetic-induced colitis in the rat. AB - Platelet activating factor (PAF) induces neutrophilia and produces a variety of gastrointestinal lesions. The role of PAF as a proinflammatory mediator was examined by measuring the production of PAF and the efficacy of the PAF antagonists WEB 2086 and Ro 24-0238 in acetic acid (HOAc)-induced colitis. PAF levels within the colonic mucosa, as measured by radioimmunoassay, increased from 259 +/- 119 ng/mg in control tissue, to 616 +/- 266 ng/mg in HOAc inflamed tissue. The accumulation of neutrophils within the mucosa was decreased by 53 +/- 10% by pretreatment with 3 mg/kg WEB 2086, and by 43 +/- 11% by 3 mg/kg Ro 24 0238. PAF-induced neutrophilia had no effect on the severity of HOAc-induced colitis, therefore, PAF my be involved in sustaining the chronic inflammation of colitis. PMID- 1793027 TI - Misoprostol attenuates acetic acid-induced damage in rabbit distal small intestine. AB - The influence of misoprostol pretreatment (100 micrograms/loop intraluminally) on small intestinal damage induced by acetic acid was evaluated in anesthetized rabbits. In this model injury was induced by intraluminal administration into loops of distal small intestine, of a solution of calcium gluconate (50 mg/ml) and acetic (200 mM). After 3 hr damage was associated with increase in loop fluid volume, loop fluid protein levels and epithelial permeability to 51Cr-EDTA, all of which were attenuated by misoprostol pretreatment. Similar protective effects were noted 45 min after the insult, suggesting that misoprostol may be therapeutically useful in conditions where the epithelial barrier is compromised. PMID- 1793028 TI - Quantitation of bronchiolar epithelial proliferation in A23187-exposed guinea pigs. AB - Aerosol exposure to the ionophore A23187 results in PMN accumulation, airway epithelial injury and prolonged airway constriction. Bronchiolar epithelial damage in ionophore-exposed guinea pigs was quantitated by measuring epithelial proliferation using bromodeoxyuridine (BRDU). Animals were killed at 24, 48 or 72 hours post-ionophore exposure and lungs were collected for H & E and immunostaining. Numerical scores were assigned for morphologic changes and the number of labeled cells per mm of airway was determined. Significant increases in labeled epithelial cells were evident at 48 hours. Inflammation and epithelial damage scores also were elevated. These results indicate that ionophore exposure results in pulmonary inflammation and bronchiolar epithelial proliferation as assessed by BRDU labeling. PMID- 1793029 TI - An in vitro model system to evaluate pulmonary macrophage, endothelial cell, and neutrophil interactions. AB - Pasteurella haemolytica, the cause of fibrinous pleuropneumonia in cattle, produces extensive microvascular endothelial cell (EC) damage. We have developed an in vitro model system to study the inflammatory process of this disease involving the interaction of pulmonary alveolar macrophages (AM), neutrophils (PMN), and EC. Bovine EC are grown to confluency in 24 well tissue culture plates. To mimic the vascular component, 10(6) PMN are later added to the EC monolayers. Bovine AM are plated onto millicell inserts and placed into the wells containing EC and PMN. The millicell insert serves as a semi-permeable barrier between AM and EC, allowing the exchange of only diffusible material. Preliminary work demonstrates that P. haemolytica stimulated AM resulted in EC damage presumably due to both soluble lipopolysaccharide and AM secreted products. PMID- 1793030 TI - Attenuation of bradykinin-induced mucosal inflammation by topical budesonide in rat trachea. AB - The extravasation of plasma proteins and formation of interendothelial gaps in submucosal microvessels by mucosally-applied bradykinin (BK), were studied in the rat trachea. The effects of topical and systemic (s.c.) glucocorticoid budesonide (BUD) were investigated in the presence or absence of inhibitors of BK-degradtive enzymes (captopril and thiorphan 10 microM to inhibit angiotensin converting enzyme (ACE) and neutral endopeptidase (NEP), respectively). Inhibition of these enzymes markedly increased the inflammatory responses to BK. Topical BUD (3 microM, 10 min contact, 90 min before BK) significantly decreased the volume of plasma in the tracheal lumen, both in the absence and presence of the enzyme inhibitors. Thus, the main anti-transudation mechanism of topical BUD is not related to modulation of BK-breakdown. However, this may be the mechanism for systemic BUD. Neither topical nor systemic BUD prevented interendothelial gap formation. PMID- 1793031 TI - Dissociation between LPS-induced bronchial hyperreactivity and airway edema in the guinea-pig. AB - The interactions between LPS-induced bronchial hyper-reactivity (BHR) and lung inflammation (LI) were investigated. LPS-induced LI was assessed with the augmented alveolo-capillary permeability (ACP) and with the increased migration of neutrophils into the broncho-alveolar lavage fluid. BHR was defined as the increase in the response to a standard dose of serotonin. Mepyramine and the PAF antagonist WEB 2170 blocked LPS-induced increase of ACP, whereas aspirin was inactive. By contrast, neither LPS-induced neutrophil attraction to airways, nor LPS-induced HBR were inhibited by these agents. Our results indicate that LPS induced edema and BHR are dissociated. PMID- 1793032 TI - Evidence for the involvement of carbohydrate moieties in the adhesion of U937 cells to tumor necrosis factor-alpha (TNFalpha)-stimulated vascular endothelium in vitro. AB - Treatment of U937 cells with fructose 1-phosphate (P) and fucoidan dose dependently inhibited the adhesion of these monocytic cells to TNF alpha stimulated human umbilical vein endothelial cells (HUVEC) (IC50 = 1 mM and 10 micrograms/ml respectively). These carbohydrates (CHO) failed to inhibit U937 adhesion to unstimulated (basal) HUVEC or phorbol 12, 13 dibutyrate (PdBu) stimulated HUVEC. At 10 mM concentration, both fucose 1-P and lactose 1-P inhibited TNF alpha-stimulated adhesion while the latter also inhibited basal adhesion. Fructose 6-P, fucose, galactose 1-P, glucose 1-P, glucose 6-P, glucuronic acid, beta-glycerol 1-P, mannose 1-P, mannose 6-P, ribose 1-P and ribose 5-P tested at 10 mM did not inhibit U937 cells adhesion to basal or TNF alpha-stimulated HUVEC. These data suggest that CHO may play an important role in modulating monocytes adhesion to cytokine-induced adhesion molecule(s) on the surface of HUVEC. PMID- 1793033 TI - Magnetic resonance imaging of the rabbit knee: detection of cartilage proteoglycan degradation. AB - Intra-articular (i.a.) injection of papain causes a reversible loss of proteoglycan in intact rabbit knees. Twelve rabbits were scanned with magnetic resonance imaging (MRI) at 0, 24, 48 and 72 hours after 5 units of papain i.a. in a 1.5 Tesla Signa with a three inch surface coil using spin echo sequence. Total cartilage thickness in proton density images was 1.08 +/- 0.09 mm prior to papain injection. The magnetic resonance images showed a reduction in articular cartilage thickness in papain-treated rabbit femurs at 24 hours to 0.69 +/- 0.18 mm and partial restoration by 72 hours to 0.77 +/- 0.21 mm. PMID- 1793034 TI - Synergism of basic fibroblast growth factor and interleukin-1 beta to induce articular cartilage-degradation in the rabbit. AB - Interleukin-1 beta (IL-1) and basic fibroblast growth factor (bFGF) synergistically induce proteases in vitro. To investigate this synergy in vivo, we injected IL-1 and bFGF alone and in combination into the lapine knee. Three days later, we compared the glycosaminoglcan (GAG) content of tibial cartilage of cytokine-treated and contralateral control-knees. IL-1 caused significant increases of granulocytes and GAG in the synovial fluid but minor cartilage-GAG losses of 11, 11 & 16% at 5kU, 10 kU and 100 kU IL-1/knee, respectively. bFGF at 2 and 10 micrograms/knee caused no changes. 10 micrograms bFGF in combination with 10 kU IL-1 induced a 33% GAG loss (p less than 0.01) that lasted 21 days. IL 1/bFGF induced cartilage degradation may be useful to 1) evaluate agents which modulated proteoglycan catabolism and 2) assess factors that accelerate cartilage repair. PMID- 1793035 TI - Elevation of synovial plasminogen activator activity after injection of interleukin-1 alpha into rabbit knee joint. AB - We investigated production of plasminogen activator (PA) and cartilage degradation induced by injection of recombinant human interleukin-1 (rhIL-1 alpha) in rabbit knees. Rabbits were injected intra-articularly (i.a.) with 100 ng rhIL-1 alpha and necropsied at 0, 3, 6, 18 and 54 h and synovial lavage and articular cartilage were collected. PA activity in the joint lavage was measured using Z-Lys-thiobenzyl ester as a substrate. Cartilage degradation was assessed by quantitating sulfated glycosaminoglycan (S-GAG) to hydroxyproline (Hyp) and appearance of keratan sulfate (KS) in synovial lavage by and ELISA. The PA activity in the lavage of IL-1 injected knees at 3, 6, and 18 h was elevated 8 to 10 fold compared to vehicle controls. At 54 h the activity declined to approximately one third of that seen at the earlier time points. KS in the joint lavage was highest at 18 h, suggesting proteoglycan degradation. The maximal loss of cartilage proteoglycan (S-GAG/Hyp) occurred by 54 h. These observations demonstrate that i.a. injection of IL-1 stimulated the production of PA activity within the rabbit joint. Since elevation of PA activity is followed by cartilage degradation, we investigated effect of anti-inflammatory agents on PA activity and cartilage degradation in this model. We found that triamcinolone, indomethacin and dexamethasone were able to suppress PA activity but not the cartilage degradation. These observations suggest that in this model of cartilage degradation suppression of PA is not sufficient to inhibit cartilage degradation. PMID- 1793036 TI - Sucralfate induces proliferation of dermal fibroblasts and keratinocytes in culture and granulation tissue formation in full-thickness skin wounds. AB - Sucralfate is used to induce healing of gastrointestinal tract ulcers. We evaluated its potential utility in the healing of skin wounds. Initial experiments examined the effects of the sucralfate on proliferation of cultured dermal fibroblasts and keratinocytes. Sucralfate induced proliferation in quiescent cultures of both cell types. Additionally, sucralfate enhanced prostaglandin E2 synthesis in basal keratinocytes and in interleukin-1-stimulated keratinocytes and dermal fibroblasts. Basal interleukin-1 and 6 release were not affected by sucralfate, but the agent enhanced interleukin-1-stimulated interleukin-6 release from fibroblasts. When applied daily to full-thickness wounds in rats, sucralfate increased the thickness of granulation tissue when assessed at day 12. PMID- 1793037 TI - Evidence for a role of bradykinin in experimental pain models. AB - Pretreatment with captopril, a kininase II inhibitor, at 10 mg/kg i.p. or s.c., significantly increased the writhing response induced by a minimum effective dose (0.75 mg/kg i.p.) of phenylbenzoquinone (PBQ), by 91-148%. 1,10-Phenanthroline, a carboxypeptidase B inhibitor (2 mg/kg i.p.), in combination with captopril enhanced the algesic effect of PBQ by 309-360%. Captopril also doubled the number of writhes induced by a minimum effective dose of BK (5 micrograms/kg i.p.) in PGE2-pretreated mice. The writhing responses induced by higher doses of PBQ or BK were not affected by these inhibitors. The hyperalgesic effect of BK (1 micrograms) injected into the hindpaw of rats was significantly increased and prolonged by coinjection of captopril (30 micrograms) and 1,10-phenanthroline (30 micrograms) and was prevented by carboxypeptidase B (1 mg). These data indicate that BK plays a role in pain in these models, a role which appears of greatest relevance at threshold algesic stimulation. PMID- 1793038 TI - Lactobacillus casei-induced polyarthritis in Lewis rats: histopathological scoring system for evaluation of anti-rheumatic drugs. AB - A histopathological scoring system which grades drug effects on cellular infiltration, pannus formation, cartilage degradation and bone resorption in L. casei-induced polyarthritis in rats is described. Reference anti-rheumatic and anti-inflammatory agents administered on days 2-60 after induction of arthritis were evaluated for effects on paw swelling weekly and graded histopathologic changes on day 60. This animal model affords a tool to evaluated therapeutic agents on the joint destruction resulting from chronic inflammation. PMID- 1793039 TI - Comparison of the ulcerogenic properties of tepoxalin with those of non-steroidal anti-inflammatory drugs (NSAIDs). AB - The ability of tepoxalin to render the gastric mucosa susceptible to injury by a topically applied irritant was compared to that of indomethacin, naproxen and diclofenac. While the three NSAIDs significantly increased the extent of mucosal damage at doses in the 1-30 mg/kg range, tepoxalin failed to significantly augment damage at doses of up to 300 mg/kg. Daily treatment with tepoxalin (10 100 mg/kg) for 4 days also did not significantly affect the susceptibility of the gastric mucosa to damage. The absence of ulcerogenic properties of tepoxalin at doses previously shown to be anti-inflammatory may be related to its relative lack of activity as an inhibitor of gastric prostaglandin synthesis, or to its 5 lipoxygenase inhibitory activity. PMID- 1793040 TI - Development of a rapid screen for detecting and differentiating immunomodulatory vs. anti-inflammatory compounds in rats. AB - Polyarthritis can be induced in rats using a synthetic adjuvant, N,N-dioctyldecyl N', N-bis(2-hydroxyethyl) propanediamine (LA) suspended in oil. The disease is morphologically indistinguishable from the classic adjuvant arthritis induced by Freund's complete adjuvant (FCA). LA injection (7.5 mg/animal) consistently induced paw swelling, splenomegaly and fibrinogen level increases at certain time points. Studies evaluating various protocols and parameters determined that a 15 day assay where agents administered from days 9 through 13, would differentiate immunomodulatory and anti-inflammatory compounds. Parameters utilized were body weight, paw volumes, spleen weights, and fibrinogen levels. Immunomodulatory agents reduce paw swelling, splenomegaly and in some cases fibrinogen levels. NSAIDS reduce paw swelling, increase splenomegaly and have no effect on fibrinogen levels. These results indicate that compounds active in the traditional FCA assay can be detected and differentiated with respect to anti inflammatory vs. immunomodulatory activity in a rapid screen. PMID- 1793041 TI - Transient inhibition of murine progressive ankylosis by indomethacin. AB - Murine progressive ankylosis (MPA) is an heritable disorder which produces acute arthritis and ankylosis of peripheral and axial joints similar to ankylosing spondylitis. Because indomethacin inhibits heterotopic bone formation in vivo, we studied its effects on MPA. Indomethacin was administered for 6 weeks beginning at weaning to litters from heterozygote breeder pairs. Progression curves for peripheral, spinal and thoracic joint ankylosis in treated and untreated ank/ank animals wer compared. There was no delay in ankylosis of peripheral or spinal joint ankylosis in MPA animals treated with indomethacin. interestingly, transient delay of thoracic ankylosis occurred in indomethacin treated MPA animals. PMID- 1793042 TI - Calcergy in murine progressive ankylosis. AB - Murine progressive ankylosis (MPA) is characterized by periarticular ossification and joint ankylosis. We studied calcergy and calciphylaxis in MPA. Calcergy represents a chemical attraction between heavy metal salts and apatite followed by hydroxyapatite deposition around collagen. Mice were injected subcutaneously with FeCl2, PbAcetate, and saline, and sacrificed at intervals between 5 minutes and 14 days. Section of skin and subcutaneous tissues were stained with Von Kossa's stain. No mice developed calcifylaxis. PbAcetate produced calcergy in all mice. MPA mice exhibited calcergy qualitatively and quantitatively the same as normal mice suggesting abnormal calcergy is not responsible for joint ankylosis in MPA. PMID- 1793043 TI - Structural and functional organization of the human neutrophil 60 kDa bactericidal/permeability-increasing protein. AB - We have isolated, after limited proteolysis of the bactericidal/permeability increasing protein (BPI) of human polymorphonuclear leukocytes (PMN), two fragments representing roughly the two halves of the BPI molecule. The 25 kDa N terminal fragment possesses all the antibacterial activities of the 60 kDa parent protein, while the ca. 30 kDa C-terminal fragment has no detectable activity. The 25 kDa fragment is as potent on a molar basis as holo-human BPI against rough Escherichia coli, is more potent than holo-BPI against more resistant smooth E. coli, and retains the specificity of BPI toward Gram-negative bacteria. The findings suggest that all of the molecular determinants of the antibacterial properties of BPI reside within the N-terminal half of the molecule, implying a novel structural/functional organization for a cytotoxic protein. PMID- 1793044 TI - Contribution of the monocyte to thrombotic potential. AB - The circulating monocyte exhibits the capacity to initiate and accelerate the coagulation cascade. We have devised a simple whole blood clotting assay which quantitates the monocyte's contribution of procoagulant (a marker of monocyte activation) to the clotting process and in addition, measures the in vivo activation of the cell. Citrated whole blood is added to saline and the recalcification time (RT) determined without incubation (RT control), with two hours incubation (RT saline), or added to endotoxin with incubation (RT endotoxin). The reduction in value between RT control and RT saline is a measure of monocyte activation in vivo. The reduction in time between RT saline and RT endotoxin is a marker of monocyte activation in vitro. This simple test enables the measurement of monocyte activation and this cells contribution to the hypercoagulability described in many disease states. PMID- 1793045 TI - The effects of estrogens on cartilage degradation using in vivo and in vitro models. AB - We have investigated the effects of estradiol on cartilage breakdown. The model of arthritis used involved the subcutaneous implantation of rat femoral head cartilage (FHCs) into the dorsal region of female mice. The FHCs had been previously wrapped in sterile 5 mg cotton to provoke the growth of granulomatous tissue adjacent to cartilage. Animals were dosed daily, a day after implantation, for 14 days with either 17 beta-estradiol or tamoxifen at different doses. The FHCs were removed and analysed for glycosaminoglycan (GAG) content. The results demonstrated that estradiol accelerated cartilage breakdown in a dose dependent manner, an effect which is blocked by tamoxifen. In addition, estradiol was found to increase cartilage degradation in an in vitro model using FHCs. This effect was enhanced by the addition of fibroblasts. PMID- 1793046 TI - Isolation and partial characterization of a full-length cDNA clone for 3 alpha hydroxysteroid dehydrogenase: a potential target enzyme for nonsteroidal anti inflammatory drugs. AB - Homogeneous 3 alpha-hydroxysteroid dehydrogenase (3 alpha-HSD; EC 1.1.1.50) of rat liver cytosol is a monomeric (Mr 34000) NAD(P)+ dependent oxidoreductase which displays 9-, 11- & 15-hydroxyprostaglandin dehydrogenase activity. The enzyme is potently inhibited by nonsteroidal anti-inflammatory drugs (NSAIDs), suggesting that 3 alpha-HSD may be a target enzyme for NSAIDs. A monospecific, polyclonal anti-sera raised against the purified enzyme was used to screen a lambda gt11 expression library and oligonucleotide probes complementary to the 5' and 3' ends of immunopositive clones were used to isolate a 2.1 kb full-length cDNA. Digestion of the full-length cDNA with Eco RI generated two fragments of 1.1 and 1.0 kb in length. Both fragments were subcloned into pGEM3 and partially sequenced. The 1.1 kb fragment contains the C-terminus of 3 alpha-HSD which was confirmed by an in-frame stop codon and comparison of the predicted amino acid sequence to peptide sequence obtained from two endo lys-C peptides of 3 alpha HSD. The 1.0 kb fragment is 5' to the 1.1 kb fragment and is sufficient in length to contain the remainder of the entire open reading frame for 3 alpha-HSD. Dideoxysequencing reveals significant sequence homology with bovine lung prostaglandin PGF2 alpha synthase. These findings support the role 3 alpha-HSD in inflammation and suggest that hydroxysteroid dehydrogenases, hydroxyprostaglandin dehydrogenases and prostaglandin F2 alpha synthase may be members of a common gene family. PMID- 1793047 TI - Effects of the prostaglandin analogue misoprostol on inflammatory mediator release by human monocytes. AB - The effect of misoprostol (M) on IL-1 beta, TNF-alpha, and lipid mediator release (assessed by RIA) by adherent (assessed by electron microscopy) human monocytes were studied in vitro. Human monocytes stimulated with E. Coli-derived lipopolysaccharide showed an increase in both IL-1 beta and TNF-alpha release. Incubation of the monocytes with LPS and M (18 hrs.), resulted in a reduction of both IL-1 beta and TNF-alpha levels. Leukotriene B4 levels did not increase in response to LPS or M. LPS also caused an increase in thromboxane (TXB2). M decreased TXB2 levels. 6-keto PGF1 alpha (6KP). Incubation with LPS and M stimulated release. LPS caused an increase in PGE2 levels. M (100 microM) caused an increase in PGE2 levels, M (1 microM) had no effect on PGE2. These data suggest a possible immunomodulatory role for misoprostol in inflammatory diseases. PMID- 1793048 TI - Cytotoxicity of human phagocytes studied in vitro in a novel model based on neutral red absorbtion. AB - The aim of these investigations was to establish a model for the study of neutrophil (NEU) and monocyte (MO) mediated cytotoxicity (TOX), and to study the protective actions of model protease inhibitor, peroxide scavengers and glucocorticoids in this model. Confluent human fibroblasts were used as target cells (T) and NEU and MO were used as effector cells (E), ratio E/T was 5-10:1. After triggering E with PMA (16-48 nM) for about 24 hours, remaining viable T were detected by incorporation of Neutral Red (NR). Oxidant-induced TOX was performed with H2O2 and t-BuOOH. In contrast to MO TOX, NEU TOX was inhibited by antiprotease and scavengers. On the other hand, MO TOX was inhibited by glucocorticosteroids. This indicates different TOX mechanisms by NEU and MO. PMID- 1793049 TI - Crystal-neutrophil interactions lead to interleukin-1 synthesis. AB - Normal human blood neutrophils were studied for their capacity to synthesize and release interleukin-1 (IL-1) species after phagocytosis of triclinic monosodium urate (MSU) and calcium pyrophosphate dihydrate crystals (CPPD). MSU crystals were more potent inducers of IL-1 generation than CPPD or unopsonized zymosan. Microcrystal-stimulated neutrophils characteristically secreted most of the newly synthesized IL-1. Colchicine partly inhibited the secretion of IL-1 by neutrophils during phagocytosis of solid particles. However, colchicine selectively inhibited IL-1 synthesis induced by microcrystals. These results suggest that neutrophil-derived IL-1 may contribute to the pathogenesis of crystal-induced arthritis. PMID- 1793050 TI - Cytokine production in whole blood ex vivo. AB - Interleukin-1 beta (IL-1 beta) and tumor necrosis factor-alpha (TNF-alpha) have been reported to contribute to the pathogenesis of many inflammatory diseases, e.g., rheumatoid arthritis. As monocytes are believed to be the primary source of these cytokines in peripheral blood, the present study was conducted to establish ranges and patterns of IL-1 beta and TNF-alpha secretion. Using heparinized unseparated whole blood obtained from normal human volunteers, peripheral blood monocytes were stimulated with Sal. minnesota LPS or BSA/anti-BSA immune complex coated beads (BSA-beads). ELISAs for IL-1 beta and TNF-alpha were employed to quantitate cytokine levels in blood plasma without performing arduous and time consuming extraction procedures. Over the course of a 6 hr incubation, LPS elicited a dose-dependent increase in TNF-alpha and IL-1 beta production. Preincubation of whole blood with interferon-gamma prior to the addition of a suboptimal dose of LPS or BSA-beads resulted in a synergistic potentiation of IL 1 beta/TNF-alpha production. Dexamethasone, utilized in the treatment of rheumatoid arthritis, proved to be a potent inhibitor of cytokine biosynthesis in whole blood ex vivo. The measurement of cytokine biosynthesis in a relevant physiologic environment not only avoids non-specific monocyte activation, but also may increase our ability to predict clinical outcomes in rheumatoid arthritis and/or other inflammatory diseases. PMID- 1793051 TI - Effects of anti-arthritic drugs on IL-1 induced inflammation in rats. AB - Intra-articular injection of IL-1 in rats results in profound changes in the synovial joints including edema, synovitis, cartilage degeneration and fibroblast proliferation. We have tested the efficacy of several anti-arthritic drugs in this model to characterize the mechanism of IL-1 induced inflammatory lesions. The response to IL-1 was evaluated by measurement of soft-tissue swelling and by histological scoring. Dexamethasone, and several NSAIDS were effective in reducing the soft tissue swelling but only some were effective in improving the histological lesions. The slow-acting antirheumatic D-penicillamine and immunosuppressive agents such as cyclosporine A were ineffective. These observations provide further evidence that in vivo, at least some aspects of IL-1 induced changes in rat knee joints are likely to be prostaglandin mediated. PMID- 1793052 TI - Effects of IL-1 muteins on cartilage degradation and as inducers of acute inflammation. AB - IL-1 peptides with N-terminal amino acid mutations were cloned and expressed to help characterize structural requirements for activity. Addition of Thr-Asn to the N-terminus (DP516) or substitution of the first two residues (Ala-Pro) of mature, native IL-1 beta with Thr-Met (DuP118) had no effect on the potency of the muteins in stimulating proteoglycan breakdown and inhibiting proteoglycan synthesis in vitro, or inducing mouse paw swelling in vivo. When Arg in position 4 of DuP118 was replaced by Glu (Glu-4), proteoglycan-synthesis-inhibitory activity was reduced to 20% and proteoglycan-degrading activity to 2% of that induced by native IL-1 beta. Glu-4 was much less active in inducing mouse paw swelling and gave maximal swelling about 40% that of native IL-1 beta. The data suggest that the presence of the positively charged side chain of Arg in position 4 may be important for the activity of IL-1 and may be useful in designing specific IL-1 receptor agonists/antagonists. PMID- 1793054 TI - Pharmacological modulation of rat monocytes: in vivo effects on Ia expression and interleukin-1 production. AB - We have shown that during the developing phase of adjuvant disease (AD) in rats the expression of MHC class II (Ia) antigens on blood monocytes (BM) was enhanced. The results of a study in established AD are reported now. Four agents were tested: indomethacin and diclofenac-sodium (1 mg/kg/day); levamisole and prinomide (10 mg/kg/day), administered orally from day 18-31 after induction of AD. We assessed the following BM parameters: Ia expression, interleukin-1 (sIL-1) production, and membrane bound IL-1 (mIL-1). In AD Ia expression was enhanced, no changes occurred in mIL-1 or sIL-1. Indomethacin treatment reduced sIL-1 production, levamisole Ia expression and mIL-1 activity, prinomide all three parameters measured and diclofenac, though clinically effective, none. PMID- 1793053 TI - The effect of treatment with recombinant gamma-interferon on adjuvant-induced arthritis in rats. AB - We have investigated the effects of recombinant rat gamma-interferon (rIFN gamma) on adjuvant-induced arthritis (AA). Lewis rats, inoculated in the left hind-paw with adjuvant (day 0), were given 10(5) U/rat of rIFN gamma daily (days 0 to 20), subcutaneously and intramuscularly on alternate days. rIFN gamma suppressed the secondary phase of swelling of both hind-paw on and after day 18 without influencing the earlier phases, both primary and secondary, of swelling. rIFN gamma also reduced the hind-paw bone lesions, the degree of splenomegaly, and the increase in erythrocyte sedimentation rate and plasma fibrinogen. These results indicate a new aspect of the regulatory role of IFN gamma in chronic inflammation. PMID- 1793055 TI - AGN 190383, a novel phospholipase inhibitor with topical anti-inflammatory activity. AB - AGN 190383 is a 5-hydroxy-2(5H)-furanone ring analog of the marine natural product manoalide. When applied topically, AGN 190383 inhibits phorbol ester induced mouse ear edema. It is a potent inhibitor of bee venom phospholipase A2 and blocks the release of arachidonic acid from calcium ionophore A23187 stimulated human neutrophils. AGN 190383 also inhibits both hormone-operated and depolarization-dependent calcium mobilization in GH3 cells, as well as fMLP stimulated increases in free cytosolic calcium in human PMNs. Furthermore, it is also able to block the release of the neutral protease elastase from stimulated neutrophils. The effects of AGN 190383 on arachidonic acid metabolism and leukocyte function may account, in part, for its anti-inflammatory activity in vivo. PMID- 1793056 TI - BI-L-239, a 5-lipoxygenase inhibitor, blocks inhaled antigen-induced airway hyperresponsiveness in conscious guinea pigs. AB - Male Hartley guinea pigs were actively sensitized to ovalbumin (OA). Respiratory system resistance (Rrs) was measured by forced oscillations superimposed on tidal breathing. Airway responsiveness (inhaled methacholine PC100) was determined three days prior and three days after (day 10) three alternate day inhalations of OA. Airway cell composition was assessed on day 10 by lung lavage. Three groups (n = 5-6) were studied: A) vehicle challenged, B) OA challenged/placebo treated, C) OA challenged/BI-L-239 (2,6-dimethyl-4-[2-(4-fluorophenyl)ethenyl]phenol) treated (10 x 0.75 mg/actuation, 10 minutes prior to each OA challenge). Animals were treated with pyrilamine and indomethacin (10 mg/kg i.p.) 30 minutes prior to each OA challenge. OA induced acute increases in Rrs of 143 +/- 29%, 238 +/- 73% and 102 +/- 43% in placebo and 86 +/- 34%, 45 +/- 35% (p, 0.05 vs. placebo) and 102 +/- 31% in BI-L-239 treated. OA induced a significant (p less than 0.05) increase in airway leukocytes in placebo (487 +/- 36 to 1615 +/- 421 x 10(3)/ml) but not BI-L-239 treated (to 881 +/- 155 x 10(3)/ml) and decrease in methacholine PC100 in placebo (1.487 +/- 0.49 to 0.39 +/- 0.18 mg/ml) but not BI-L-239 treated (0.99 +/- 34 to 1.04 +/- 0.39 mg/ml). We conclude that BI-L-239 attenuates the airway constriction, inflammation and hyperresponsiveness induced by repeated antigen inhalations in conscious guinea pigs. PMID- 1793057 TI - Antiflammin-2 (HDMNKVLDL) does not inhibit phospholipase A2 activities. AB - A basic nonapeptide P2 (antiflammin-2, HDMNKVLDL) which is identical to a portion of the amino acid sequence (residues 246-254) of lipocortin I, has been described to have antiinflammatory activity in a rat paw edema model (Nature 335: 726-730 [1988]). P2 (0.05 microM) was also reported to inhibit porcine pancreatic phospholipase A2 (PLA2). The effect of synthetic P2 (98% pure) on PLA2 was evaluated in two assay systems. Using porcine pancreatic PLA2 and phosphatidylcholine/deoxycholate mixed micellar substrate, P2 (0.005-50 microM) had no effect on PLA2 activity, even in the presence of 2-mercaptoethanol to prevent peptide oxidation. In another assay, using human synovial fluid PLA2 as the enzyme and [14C]-oleate-labelled E. coli substrate, P2 (0.005-50 microM) had no significant effect on PLA2 activity. A reported PLA2 inhibitor, manoalide, was a potent inhibitor of PLA2 in both assay systems. On the basis of these results, we conclude that P2 is devoid of PLA2 inhibitory activity. PMID- 1793058 TI - Comparison of antiinflammatory and antiallergic drugs in the melittin- and D49 PLA2-induced mouse paw edema models. AB - Melittin (MLT) (10 micrograms/paw) and D49 (0.4 micrograms/paw) were injected into the hind paw of male CD-1 mice and elicited 70-80% of maximal paw edema responses at 60 and 30 min after injection, respectively. D49 paw edema was significantly inhibited by anti-histamine/serotonin agents, a PAF antagonist, a PLA2 inhibitor, and some but not all 5-LO and CO inhibitors, indicating that this edema is produced by several classes of inflammatory mediators with mast cell degranulation apparently playing a major role. In contrast, MLT paw edema was not inhibited effectively using the same pharmacological agents except theophylline, suggesting it was elicited via a different sequence of inflammatory events. In summary, D49 and MLT paw edema models were found to be ineffective models to identify experimental PLA2 compounds in our laboratory. PMID- 1793059 TI - Selective muscarinic antagonists as bronchodilators. AB - The non-selective muscarinic antagonist ipratropium is widely used as bronchodilator. Due to its pharmacokinetic properties this drug, after inhalation, acts only locally on the airways and no unwanted anticholinergic side effects are observed. Another approach is the use of selective muscarinic antagonists. Based on their selectivity for M3- and/or M1-receptors such drugs might show bronchospasmolytic properties without the occurrence of typical atropine-like side effects even after systemic administration. Pharmacological data of the in vivo bronchoselectivity of pirenzepine (M1-selective) and AQ-RA 721 (high affinity for M1- and M3-receptors) is presented and the use of these drugs as bronchodilators is discussed. PMID- 1793060 TI - Telenzepine and its enantiomers, M1-selective antimuscarinics, in guinea pig lung function tests. PMID- 1793061 TI - Evaluation of slow-release theophylline pharmacokinetics by Fourier's harmonic analysis. AB - Theophylline absorption from two sustained-release theophylline formulations was examined over 2 consecutive days during continuous therapy in 7 asthma patients. We compared two twice daily formulations of Teotard capsules (TC) and Teolin tablets (TT). Bioavailability for each 12-h period was defined as: BIO = (AUC oral/AUC iv) x (Dose iv/Dose oral)x100. The amount of theophylline absorbed during each 2-h interval was calculated using modified Wagner-Nelson equation for multiple dose drug administration. Mean serum theophylline concentrations were analysed by Fourier's harmonic analysis (FHA) and by F test. There were not statistically significant differences between TT and TC neither for BIO nor for fractional absorption calculated for 2-h sampling intervals. On the other hand FHA of mean SCT disclose more predictable theophylline absorption from TT compared to TC. We conclude that in order to obtain complete pharmacokinetic profile of slow-release formulation FHA should also be included into the calculations. PMID- 1793062 TI - Development of novel leukotriene--based anti-asthma drugs: MK-886 and MK-571. AB - A potent, selective and orally active receptor antagonist of leukotriene D4, MK 571, was discovered and developed from a styrylquinoline lead structure based on a hypothetical model of the leukotriene D4 receptor. MK-571 blocks the action of LTD4 in animals and man, and is effective in a number of animal models of antigen induced bronchoconstriction at plasma concentration at or below 2 micrograms/mL. MK-571 also blocks antigen-induced asthmatic responses in man. In addition a series of 2-indolealkanoic acids was discovered to be inhibitors of leukotriene biosynthesis. From this series, MK-886, a nanomolar inhibitor of leukotriene biosynthesis was developed. The mechanism of action of MK-886 has been found to be the inhibition of activation of the 5-lipoxygenase enzyme. This inhibition is mediated by interaction with a specific 18 kD protein termed 5-lipoxygenase activating protein (FLAP). MK-886 is an inhibitor of leukotriene biosynthesis and of antigen-induced bronchoconstriction in animal models and in asthmatic men. PMID- 1793063 TI - Hydroxamic acids and hydroxyureas as novel, selective 5-lipoxygenase inhibitors for possible use in asthma. AB - Inhibition of 5-lipoxygenase (5-LO) is a potential target for therapeutic intervention in asthma. Acetohydroxamic acids such as BW A4C are potent and selective 5-LO inhibitors in vitro and also inhibit 5-LO activity in vivo following oral administration. In man, BW A4C is metabolised relatively rapidly (t1/2 = approx. 2h) but nevertheless inhibits 5-LO with reasonable persistence. Chemical modification of BW A4C has resulted in compounds, including the alpha methyl analogues BW B218C and BW A360C and the hydroxyurea BW B70C, that retain high in vitro potency as selective 5-LO inhibitors and, compared to BW A4C, have a higher potency and longer duration of action in vivo. Members of both the hydroxamic acid and hydroxyurea series of 5-LO inhibitors are presently being considered as potential anti-asthma drugs. PMID- 1793064 TI - WY-50, 295 tromethamine: an orally active 5-lipoxygenase inhibitor with anti allergic activity. AB - WY-50,295 tromethamine inhibited antigen-induced peptidoleukotriene (pLT) release from fragmented sensitized guinea pig lung (IC50 = 0.63 microM), antagonized LTD4 induced contractions of isolated guinea pig trachea (pA2 = 6.06), and suppressed antigen-induced contraction of sensitized guinea pig trachea over the 0.1-10 microM concentration range. In vivo, WY-50,295 tromethamine inhibited LTD4 induced bronchoconstriction (ED50 = 1.3 mg/kg i.v. and 6.6 mg/kg p.o.) and antigen-induced bronchoconstriction (ED50 = 2.5 mg/kg i.v. and 7.3 mg/kg p.o.) in anesthetized guinea pigs. Peak activity vs antigen was noted at 4-6 h after oral dosing and remained significant through 18 h. These studies demonstrate that WY 50,295 tromethamine possesses the complimentary actions of 5-LO inhibition and LTD4 receptor antagonism. PMID- 1793065 TI - GR32191 and the role of thromboxane A2 in asthma--preclinical and clinical findings. AB - Thromboxane sensitive (TP)-receptors are widely distributed in the airways smooth muscle of various species. In man they mediate constrictor responses, not only to TxA2 but also to other prostanoids such as PGD2 and PGF2 alpha. The evidence for the involvement of these TP-receptors in human asthma is equivocal; however, the recent development of potent, selective TP-receptor blocking drugs such as GR32191 has provided the opportunity to answer this question. GR32191 (80mg p.o.) caused a marked inhibition of PGD2 but not methacholine-induced bronchospasm in asthmatic subjects, and also caused a modest reduction in allergen-induced bronchospasm. However, it had no inhibitory effect against the bronchoconstriction resulting from inhaled PAF or from exercise. Finally, GR32191 was tested in moderate to severe asthmatics for its ability to reduce symptom scores. At a dose of 40mg four times a day for three weeks, GR32191 had no effect upon morning or evening peak expiratory flow rates, on subjective symptom score, on bronchodilator usage or on occurrence of nocturnal dyspnoea. These results do not support a key role for prostanoids acting through TP-receptors in the aetiology of asthma. PMID- 1793066 TI - UK-74,505, a novel and selective PAF antagonist, exhibits potent and long lasting activity in vivo. AB - UK-74,505, a potent and selective PAF antagonist in vitro, has been shown to be extremely active given orally or intravenously to various species. In anaesthetised guinea pigs UK-74,505 at 30 & 100 micrograms/kg i.v. inhibited bronchoconstrictor responses to aerosolised PAF without affecting blood pressure or heart rate. The increased cutaneous vascular permeability to intradermal PAF in rats was inhibited by UK-74,505 with an ED50 of 280 +/- 5 micrograms/kg p.o. In conscious dogs, complete inhibition of PAF-induced whole blood aggregation ex vivo occurred for at least 14 hours after an oral dose of 75 micrograms/kg. It is concluded that UK-74,505 is an effective, orally active PAF antagonist of long duration with the potential for once daily dosing. PMID- 1793068 TI - Development of airway hyperreactivity in the guinea-pig following allergic reactions. AB - It has been reported previously that acute allergic reactions in the anaesthetized guinea-pig do not evoke changed airway reactivity to histamine, animals sensitized to ovalbumin in aluminum hydroxide and exposed to allergen intravenously or by inhalation develop increased responsivity to histamine that persists for several hours. Animals that have been sensitized passively, by intravenous injection of antibody and exposed to allergen by intravenous injection, or which receive freshly prepared immune complexes by intravenous injection develop comparable airway reactivity. PMID- 1793067 TI - The effects of hetrazepine PAF antagonists in preclinical models of asthma. AB - In different disease related animal models of asthma selective and potent hetrazepine paf-antagonists (like the hetrazepines WEB 2086 and WEB 2170) inhibit (i) allergen-induced bronchoconstriction, (ii) antigen-induced infiltrations of eosinophils, (iii) lung-edema formation by antigen, (iv) late phase response and (v) bronchial hyperreactivity to antigen. In addition the formation and release of other mediators (like leukotrienes, thromboxanes, histamine) are inhibited in vivo, although a direct interaction of hetrazepinoic paf-antagonists with these mediators has been excluded. The participation of paf in a chain of pathophysiological events involving other mediators, and the possibility of synergistic interactions, open up the possibility that antagonists of paf may have apparent effects extending beyond those anticipated for a single mediator. PMID- 1793069 TI - Changes in airway sensitivity to histamine are not necessarily paralleled by changed sensitivity to acetylcholine. AB - In allergic asthmatics, it has been shown that airway sensitivity to histamine closely parallels sensitivity to methacholine, a finding which underlies the widely-held view that airway hyperreactivity of asthma is non-selective. We have been interested to evaluate the capacity of various agents to influence reactivity to intravenous injections of both histamine and acetylcholine in the anaesthetized guinea-pig. Intravenous infusion of PAF or (+/-)isoprenaline are procedures which increase airway reactivity to histamine, but leave reactivity to acetylcholine unaffected; by way of contrast, there is comparable enhancement of hyperreactivity to both histamine and acetylcholine following endotoxin infusion. These observations do not accord with the concept that obstruction of the airways per se accounts for changed reactivity of the airways and question the presumption that PAF might be a pivotal mediator of airway hyperreactivity in allergic asthma. PMID- 1793070 TI - Sch 37370: a new drug combining antagonism of platelet-activating factor (PAF) with antagonism of histamine. AB - Multiple mediators are involved in the pathophysiology of allergic and inflammatory disorders. Drugs that affect the action of more than one mediator may, therefore, be particularly effective in these disorders. Two such mediators are platelet-activating factor (PAF) and histamine. From a structural series with documented antihistamine activity, Sch 37370 has been identified as a dual antagonist of PAF and histamine. In vitro, Sch 37370 selectively inhibits PAF induced aggregation of human platelets (IC50 = 0.6 microM) and also competes with PAF binding to specific sites in membrane preparations from human lungs (IC50 = 1.2 microM). Sch 37370 also blocks the binding of [3H]pyrilamine to histamine H1 receptors in rat brain membranes. In guinea pigs, orally administered Sch 37370 is effective against bronchospasm to histamine (ED50 = 2.4 mg/kg), PAF (ED50 = 6.0 mg/kg) or serotonin (ED50 = 9.6 mg/kg). In contrast, it only weakly antagonizes methacholine-induced bronchospasm (ED50 = 51 mg/kg) and is totally inactive at 50 mg/kg against bronchospasm due to leukotriene C4 or substance P. Sch 37370 blocks hypotension in rats and a cutaneous reaction in monkeys induced by either PAF or histamine, as well as PAF-induced edema in the rat pleural cavity. In addition, Sch 37370 blocks bronchospasm induced by either antigen in sensitized guinea pigs or hyperventilation in nonsensitized guinea pigs. Sch 37370 also inhibits antigen-induced lung eosinophilia in sensitized guinea pigs and a reverse passive Arthus reaction in rats. Although Sch 37370 is not the most potent PAF antagonist or antihistamine, it is the first compound that combines these pharmacologically relevant activities and may offer important advantages over currently available antihistamine therapies. PMID- 1793071 TI - Inhibitory effect of oral ketotifen on ex vivo platelet activating factor-induced platelet aggregation. PMID- 1793072 TI - SDZ MKS 492. AB - SDZ MKS 492 (R(+)-(8-[( 1-(3,4-Dimethoxyphenyl)-2-hydroxyethyl)amino]-3,7-dihydro 7-(2- methoxyethyl)-1,3-dimethyl-1H-purine-2,6-dione) relaxes airway smooth muscle in vitro and impairs, or reverses, spasm of guinea-pig airways in vivo. Effects on bronchospasm in the guinea-pig may additionally include actions on airway hyperreactivity, since SDZ MKS 492 can inhibit the development, or expression, of airway hyperreactivity due to infusion of PAF, (+/-)isoprenaline, endotoxin or injection of immune complexes. In addition to influencing airway tone, inhaled SDZ MKS 492 diminishes the pulmonary accumulation of macrophages, eosinophils and neutrophils that follows inhalation of allergen by actively sensitized guinea-pigs. SDZ MKS 492 offers the prospect of a monotherapy for asthma, combining bronchodilator and anti-inflammatory activities with prophylactic efficacy. PMID- 1793073 TI - The importance of inflammatory cells in asthma. AB - The development of research into the mechanisms and so of treatment of asthma has reached a crossroads. Research into the physiology of 'mature' inflammatory cells and their mediators have not provided treatments as effective as steroids. Whilst it is tempting to pursue this systematic approach, new ideas are emerging which beckon the scientist along a separate path. From molecular biology and modern genetics emerges the idea that a regulatory dysfunction of a lymphocyte is the fundamental abnormality of asthma. Bone marrow transplantation and transfer of 'asthma' from one individual to another supports this view. From lung transplantation has emerged the idea that the distribution of the infiltrate of inflammatory cells may be important in airway hyperresponsiveness. Transplantation also points to the possibility of correlating pathology with physiology by use of small lung biopsies. Perhaps completely new treatments may result from such a novel and 'human' based approach. PMID- 1793074 TI - Measurement of cell accumulation. PMID- 1793075 TI - Endothelin potently constricts rat airways in vivo. AB - We investigated the effects of aerosolized endothelin (ET) on pulmonary mechanics of anesthetized spontaneously breathing rats. ET inhalation caused a concentration-dependent increase in pulmonary resistance (RL). In control condition RL was 0.17 +/- 0.04 cmH2O/ml/s (mean +/- SE; n = 6) and increased to 1.45 +/- 0.28 cmH2O/ml/s (p less than 0.05) after ET 4 x 10(-5) M. The pulmonary responses to ET lasted up to 60 minutes. These results suggest a role for endothelin in the regulation of airway smooth muscle tone. PMID- 1793076 TI - Airway eosinophilia and airway hyperreactivity are parallel rather than sequential events in the guinea-pig. AB - It is known that eosinophil activation in the airways is associated with epithelial damage in both guinea-pigs and man and it has been presumed that airway hyperreactivity arises in consequence of these events. However, infusion of (+/- )isoprenaline induces airway hyperreactivity in the guinea-pig despite a reduction of eosinophil numbers in the airway lumen, whilst rh-GM-CSF or rh-IL3 induce eosinophilia of the airways without attendant airway hyperreactivity. These findings complement earlier studies which showed that airway hyperreactivity in sensitized animals reacting to inhaled allergen could not be correlated with the number of eosinophils in the airway lumen. PMID- 1793077 TI - Measurement and pharmacology of mucociliary clearance. AB - Airways mucociliary clearance (MCC), which continuously removes inhaled particles and cellular debris from the lungs is impaired in a number of diseases such as bronchitis, asthma and cystic fibrosis. Regulation of MCC under normal conditions is not well understood and the cause of its impairment is ill defined. Animal models have been used to study the regulatory mechanisms of both mucus secretion and MCC and to ascertain the involvement of neural pathways. Cholinergic stimulation is a most effective means of enhancing MCC in molluscs, frogs and mammals including man. Recent data from mammals suggest that MCC is also regulated by neuropeptides either directly (substance P) or by facilitating the stimulatory effect of cholinergic agents. A better understand of basic regulatory mechanisms of MCC is vital to an understanding of its impairment in respiratory diseases. PMID- 1793078 TI - The effects of BRL 38227 on antigen-induced extravasation and cellular infiltration into the peritoneal cavity of actively sensitised rats. AB - The ability of the potassium channel activator cromakalim to relax smooth muscle of the airways is now well established. The compound has been shown to be an effective bronchodilator in animal models, and more importantly, to attenuate induced bronchoconstriction and nocturnal asthma in man. Evidence now exists to suggest that BRL 38227, the 3S,4R enantiomer of cromakalim, is the predominantly active moiety and shares the same profile of activity. Further evaluation of BRL 38227 in a rat model of active peritoneal anaphylaxis provides evidence that potassium channel activators may exert beneficial effects in terms of inhibition of extravasation and inflammatory cell infiltration. PMID- 1793079 TI - Airway plasma exudation in detection of antiasthma drugs. AB - Increased numbers of cells and levels of cellular mediators in the airways may be without consequence or reflect tissue repair and can, therefore, not be equated with inflammation. Many tissue responses to inflammation are non-specific in that they are only exaggerations of base-line functions (blood flow, secretion, tone etc) which are stimulated also by non-inflammatory influences. In contrast, when there is plasma exudation in the airways this is a specific defence/inflammatory response. Accordingly, plasma exudation is not an increase in the normal capillary exchange of solutes but a dramatic increase in venular permeability. Plasma exudation is a graded response to mucosal inflammatory provocations and it is well correlated to symptoms in airway disease. The plasma exudate always crosses the epithelial lining to enter the airway lumen. Indeed, exudative indices in samples of airway surface liquids faithfully reflect intensity and time course of inflammatory processes in the underlying airway tissue. Drugs will reduce the exudation by any action that is a significant antiinflammatory effect, be it on recruitment/activation of cells on formation/release/action of mediators or directly on the permeability-regulating endothelial cells in the venular wall. The notion that plasma exudation is a significant pathogenetic mechanism in its own right in asthma does not reduce its instrumentality in the detection of new drugs to combat this disease. PMID- 1793080 TI - An in situ preparation of rat trachea for studying the effects of mucosally applied anti-asthma drugs on mediator-induced plasma exudation. AB - An animal model is described for testing the effects of anti-asthma drugs on mediator-induced airway inflammation. An in situ segment of trachea is slowly perfused with normal saline in spontaneously breathing, anaesthetised rats. Both the anti-asthma drug and the inflammatory mediator can be applied directly to the airway mucosal surface at the same and/or different times. The amount of plasma in samples of perfusate is monitored. Application of a mediator, such as bradykinin, results in an increase in the amount of plasma in the tracheal lumen (and hence in the perfusate). Plasma in the perfusate can be estimated without injecting a labelled tracer for plasma exudation by using a protein native fluorescence (PNF) method as described by Miller-Larsson & Brattsand (3). PMID- 1793081 TI - New approaches to the attenuation of sensory reflexes in airway inflammation. PMID- 1793082 TI - Actions of SDZ PCO 400 and cromakalim on airway smooth muscle in vivo. AB - SDZ PCO 400, and cromakalim are potassium channel opening drugs which relax airway smooth muscle and reverse airway obstruction due to intravenous administration of airway spasmogens. Reduction of airway obstruction by these drugs may be attributed to actions upon airway reactivity as well as airway smooth muscle spasmolysis; for, at concentrations which do not induce overt relaxation of airway smooth muscle, both SDZ PCO 400 and cromakalim suppressed development of airway hyperreactivity due to administration of immune complexes, PAF or (+/-)isoprenaline and reversed established airway hyperreactivity due to allergic reactions. When administered as aerosols prior to inhalation of allergen in actively sensitized guinea-pigs, or by the oral route in guinea-pigs with idiopathic eosinophilia, neither cromakalim nor SDZ PCO 400 influenced the influx of eosinophils into the airway lumen. Thus, SDZ PCO 400 and cromakalim may readily be distinguished from established prophylactic anti-asthma drugs such as cromoglicate and ketotifen. By influencing airway reactivity, potassium channel openers provide a novel approach to the resolution of airway obstruction in asthma. PMID- 1793083 TI - The effect of potassium channel opening drugs on pulmonary nerves. AB - In the present study, the effects of cromakalim were studied in the in vitro innervated tracheal tube preparation. Cromakalim did not affect response of the trachea to exogenous acetylcholine but inhibited contractions of the tracheal preparation to stimulation of cholinergic pulmonary nerves via both transmural and preganglionic vagal stimulation. Glibenclamide significantly reduced the inhibitory effect of cromakalim on both preganglionic and field stimulated preparations. When tracheal tone was raised by a spasmogen, cromakalim had no effect on noradrenergic relaxations but facilitated nonadrenergic-noncholinergic relaxations to transmural stimulation. PMID- 1793084 TI - [Measurement of cellular activity with the MTT test. Optimization of the method]. AB - Since a few years activity of mitochondrial dehydrogenases has been determined by MTT-test as alternative method to measurement of the cellular activity and proliferation by incorporation of tritiated thymidine. In this test the tetrazolium salt MTT is converted into blue, insoluble formazan dye crystals, which have to be dissolved by a suitable extraction mixture. The present paper describes a modified extraction method using an isopropanol-dimethylformamide mixture acidified to pH 5.5. The modified method enables an optimal, easy to handle, less time and work consuming MTT-assay. A MTT concentration of 1 mg/ml was found to be optimal. The extinction maximum was identified at 566 nm. PMID- 1793085 TI - Bestatin-induced enhancement of in vivo phagocytosis determined by a new simple assay. AB - Pretreatment of mice by the immunostimulator bestatin resulted after four days in a significant enhancement of the phagocytic activity of peritoneal cells. For quantification of the phagocytic process of murine peritoneal phagocytes a new in vivo assay is proposed. Fluorescein isothiocyanate (FITC)-labeled Escherichia coli bacteria were i.p. injected. After ten minutes peritoneal cells were harvested and the phagocytic index of peritoneal phagocytes was fluorescence photometrically assessed. The frequency distribution of phagocytized bacteria per cell found by the this assay corresponded to Poisson distribution. This coincidence allowed estimation of the minimum number of cells needed for detecting a significant difference of phagocytosis indices, resulting in an enhancement of test efficiency. PMID- 1793086 TI - Relationship between IgE and IgG antibodies in type I allergy. AB - Serum samples of human patients with immediate type allergy were examined for both IgE (by radioallergosorbent test) and IgG (by enzyme immunoassay) antibodies to several of the common inhalant and food allergens. The results show a statistically significant correlation between the titers of anti-allergen antibodies of both isotypes. The data indicate that immune stimulation in atopic individuals is not restricted to the IgE isotype, but equally affects the IgG producing antibody systems. The statistical relationship observed may either be due to common pathways in the production of both antibody classes in atopic people, or may be explained by preferential binding of allergens to circulating IgE-IgG immune complexes. PMID- 1793087 TI - The MTT-assay as a rapid test for cell proliferation and cell killing: application to human peripheral blood lymphocytes (PBL). AB - The possibility to use the colorimetric MTT assay for measuring proliferation and cell death of human peripheral blood lymphocytes (PBL) was studied. In a range from 100,000-800,000 cells/well a linear correlation between the optical signal (OD signal at 570 nm) and the cell number was found. It is necessary to incubate the cells with the MTT at least 2 hours. After stimulation by different PHA concentrations a very good correlation between [3H] thymidine incorporation and MTT assay was found. A comparison of daunomycin cytotoxicity, measurement by trypan blue exclusion and MTT assay, gave also a good correlation between both methods. It can be pronounced that the MTT assay is a suitable method to measure cell proliferation and cell death of human PBL. The assay is easy to handle, a large number of probes can be assayed in a relatively short time and no radioactivity is necessary. For the measurement of the colored product a common ELISA reader can be used. PMID- 1793088 TI - [Characterization of a monoclonal antibody against a differentiation antigen of human natural killer cells (NK cells)]. AB - The new murine monoclonal antibody BL-(H5) reacts with a novel surface molecule which is mainly expressed on human NK and B cells. The antigen is not expressed on peripheral T lymphocytes, thymocytes and different human T-cell lines. BL-(H5) does not bind to erythrocytes and platelets. The monoclonal antibody reacts in western blotting experiments with an antigen of 78kDa. PMID- 1793089 TI - [Quantitation of Acinetobacter calcoaceticus in mixed bacterial cultures by an enzyme immunoassay]. AB - An enzyme-linked immunosorbent assay using polyclonal antibodies from rabbits has been developed for quantification of Acinetobacter calcoaceticus. Bacteria were added to the wells of a microtiter plate coated with anti-Acinetobacter immunoglobulin. For detecting bound cells the peroxidase-labelled immunoglobulin fraction was used. Over a distinct range there is a linear correlation between bound bacteria and measured absorbance allowing a quantification of bacteria in an order from 10(7) to 10(8) per milliliter. The specificity of the assay was evaluated by the heterologous bacteria Pseudomonas putida, Pseudomonas aeruginosa, Proteus vulgaris, Escherichia coli and Citrobacter freundii. Only a minimal cross-reactivity was observed. Within a certain range of error it is possible to quantitate Acinetobacter calcoaceticus in mixtures with one or several other bacterial species. Mixed with bacteria of one other species the differences to the value for Acinetobacter calcoaceticus alone do not exceed +/- 10% with a tendency to lower values. Mixed with several other species only negative differences up to -15% were obtained. Treatment of Acinetobacter calcoaceticus with 0.5% formaldehyde results in a loss of reactivity up to 15%. In conclusion, the enzyme-linked immunosorbent assay is a useful method for quantitating bacteria not only with respect to the high sensitivity, specificity and good reproducibility but also for the minimal technical equipment and the short assay time. PMID- 1793090 TI - Theory-based screening for prevention: focusing on mediating processes in children of divorce. AB - Prevention programs in mental health theoretically can benefit from selecting participants who have a greater likelihood of developing psychological problems because of their exposure to the putative mediators targeted for change in an intervention. Screening on mediators may increase statistical power to detect program effects, enhance the cost-effectiveness of intervention trials, and decrease the possibility of iatrogenic effects. The circumstances that optimize the strategy of screening on the basis of mediating variables are discussed, and data are presented to illustrate the development of a mediational selection strategy to identify families who might best benefit from a preventive intervention for children of divorce. In addition, we present evidence that adjustment problems for children experiencing a divorce, as with most mental health problems, are not the result of one specific factor, but are jointly determined by several mediating processes that occur subsequent to the divorce. The mediational selection strategy developed illustrates the utility of measuring a set of mediational processes central to conferring risk for mental health problems to children of divorce. PMID- 1793091 TI - Comparison of mediational selected strategies and sequential designs for preventive trials: comments on a proposal by Pillow et al. AB - Compared the strengths and weaknesses of a novel intervention design strategy called mediational selection, proposed by Pillow et al. (1991), with designs based on a sequence of trials, that is, those which build on prior work and at each stage are administered to subjects from subpopulations who have high risk or as yet poorly quantified risk. Both designs would be most useful in short-term preventive trials. The goals behind these two approaches, however, are quite different. Mediational selection strategies attempt to improve the chances that an intervention developed to modify theoretically important mediational factors will have significant impact by selecting a subject subpopulation that is expected to benefit the most. Sequential designs attempt to identify the extent to which an intervention succeeds or fails to work in subpopulations and allows for adjustment of the intervention to these subpopulations as necessary. PMID- 1793092 TI - Mediational screening: is the benefit worth the cost? AB - Argued that Pillow et al. (1991) may have overestimated the benefits of mediational screening and underestimated the costs involved in the procedure. The three benefits they suggest: increased statistical power to detect prevention effects, increased cost-effectiveness, and decreased iatrogenic effects are shown to be modest at best. Costs associated with misclassifying people as either false positives or false negatives are considered in the total cost/benefit analysis of mediational screening. Because we cannot accurately predict who will react to the occurrence of life stress by developing the conditions we are interested in preventing, universal interventions are advocated. PMID- 1793093 TI - Mediational screening in theory and in practice. AB - Pillow et al.'s (1991) argument for mediational selection omits discussion of what may be the strategy's greatest advantage, the early identification of risk. The theoretical benefits to prevention of identifying developmental processes are briefly noted here. At the same time, practical limitations of mediational selection are noted, particularly in relation to establishing and interpreting the correlation found between mediational and outcome variables. It is concluded that mediational selection is one, but only one, selection strategy worthy of consideration in prevention research. PMID- 1793094 TI - Targeting preventive interventions: enhancing risk estimates through theory. AB - Incorporation of mediational screening procedures within targeted preventive interventions must be grounded in a substantial theoretical and epidemiological knowledge base. Essential information includes an etiological model of the disorder(s) to be prevented and epidemiological confirmation that risk factors used for the selection of intervention recipients have been prospectively confirmed. Targeting these recipients using a combination of indicated and selective criteria is expected to increase the base rate at which the disorder(s) to be prevented occurs in the intervention population and thus the power of the evaluation design used to confirm reductions in proximal and distal indices of disorder(s). Caution is urged, however, to consider the potential iatrogenic effects of overly focused targeting and the potential reductions in intervention effectiveness resulting from application to homogeneous vs. heterogeneous populations. Mediational screening's heuristic contribution to theory is discussed. PMID- 1793095 TI - Mediational screening as a model for prevention research. AB - Examined here is Pillow, Sandler, Braver, Wolchik, and Gersten's (this issue) strategy for screening prevention trial participants. The reviewer concludes that their selection strategy should increase the statistical power of prevention outcome studies, increase intervention cost effectiveness, and help to prevent their possible iatrogenic effects. Also, their model points up inadequacies in the longitudinal data on which most prevention strategies are based, and their model could well serve as a template for future research. PMID- 1793096 TI - Small theory and the strategic choices of prevention research. AB - Our comments on the discussion of mediational screening for prevention research highlight two issues: (a) There are advantages to giving a high priority to theory in a strategic sequence of prevention research studies. (b) Screening to identify a subgroup that is experiencing problems on processes the program is designed to change may be useful in accomplishing specific goals within an overall strategy of prevention research studies. PMID- 1793097 TI - Home environmental consequences of commute travel impedance. AB - The physical and perceptual dimensions of commuting travel impedance were again found to have stressful consequences in a study of 99 employees of two companies. This quasi-experimental replication study, which focuses here on home environment consequences, investigated the effects of physical impedance and subjective impedance on multivariate measures of residential satisfaction and personal affect in the home. Both sets of residential outcome measures were significantly related to the two impedance dimensions. As predicted, gender was a significant moderator of physical impedance effects. Women commuting on high physical impedance routes were most negatively affected. Previously found subjective impedance effects on negative home mood, regardless of gender, were strongly replicated with several methods and were buttressed by convergent results with objective indices. The theoretical conjecture that subjective impedance mediates the stress effects of physical impedance was supported by the personal affect cluster but only for one variable in the residential satisfaction cluster. Traffic congestion has increased in metropolitan areas nationwide, and commuters, families, and organizations are absorbing associated hidden costs. The results are reviewed in terms of our ecological model, and the moderating effects of gender are discussed in terms of choice and role constraints. PMID- 1793098 TI - Effects of an intervention program for pregnant adolescents: educational outcomes at two years postpartum. AB - Examined postpartum effects of a school-based intervention program for pregnant adolescents. Interviews were conducted with 102 innercity black, low-income, school-aged mothers who had attended the program, and their academic and medical records were reviewed. For teenagers who had been poor students prior to becoming pregnant, a strong linear effect was found for duration of program attendance: with sufficient time in the program, poorer students became indistinguishable from better students in educational success. Most of the better students were educationally successful at 2 years postpartum, independent of their length of time in the program. For all students, longer durations of postnatal intervention were predictive of lower likelihood of subsequent childbearing. Numerous academic, medical, social, and demographic variables were ruled out as possible confounding factors that might have produced the positive educational outcomes for poorer students. The results suggest that adolescents who appear to have minimal academic promise prior to their pregnancy are nevertheless very responsive to school-based intervention. PMID- 1793099 TI - Organizational and family systems factors in stress among ministers. AB - Forty-one Protestant ministers completed measures of stress-related symptoms, family of origin contact, church governing body density, history of pastor-parish conflict in the church, and a measure of Bowen's (1959b/1985) concept of emotional triangles. A denominational executive provided ratings of each church's history of pastor-parish conflict. Path analysis using multiple regression showed support for a model in which governing body density and history of conflict predicted emotional triangles, and emotional triangles predicted stress symptoms. Contact with the pastor's family of origin moderated the relationship between emotional triangles and stress symptoms. Results suggest that the organizational and family ecology of the ministerial role can be important in understanding occupational stress among ministers. PMID- 1793100 TI - The provision of advocacy services to women leaving abusive partners: an examination of short-term effects. AB - Examined the short-term impact of providing advocacy services to women leaving battered women's shelters. The study employed a true longitudinal experimental design. Women in the advocacy condition received intensive one-on-one services with trained paraprofessional advocates. Advocates assisted women in accessing needed community resources. Women in the control condition received no additional postshelter services. Findings corroborated earlier research suggesting that battered women lack many resources necessary for independent living and that working with advocates produced greater effectiveness in accessing needed resources. Ongoing research will examine the long-term impact on life satisfaction, future victimization, and living arrangements. PMID- 1793101 TI - A study of the effect of perchloroethylene exposure on semen quality in dry cleaning workers. AB - The purpose of this investigation was to determine the effects of perchloroethylene (PCE) exposure on human semen quality. We compared the semen quality of 34 dry cleaners with that of 48 laundry workers. We examined the relationships of 17 semen parameters to expired air levels of PCE and to an index of exposure based on job tasks in the last three months. The average sperm concentration was over 80 million for both dry cleaners and laundry workers, but approximately one-quarter of each group was oligospermic. The overall percentage of abnormal forms was similar for the two groups; however, sperm of dry cleaners were significantly more likely to be round (t = -3.29, p = 0.002) and less likely to be narrow (t = 2.35, p = 0.02) than the sperm of laundry workers. These effects were dose-related to expired air levels and to the exposure index after controlling for potential confounders (e.g., heat exposure). The average percent motile sperm for both groups was slightly over 60%; however, sperm of dry cleaners tended to swim with greater amplitude of lateral head displacement (ALH) than those of laundry workers (t = -1.73, p = 0.09), and level of PCE in expired air was a significant predictor of ALH in the multiple regression model (t = 2.00, p = 0.05). In addition, exposure index was a significant negative predictor of the sperm linearity parameter (t = -2.57, p = 0.01). These results suggest that occupational exposures to PCE can have subtle effects on sperm quality. Additional analyses are required to determine whether these effects are associated with changes in fertility. PMID- 1793102 TI - A study of the effect of perchloroethylene exposure on the reproductive outcomes of wives of dry-cleaning workers. AB - The purpose of this investigation was to compare the reproductive outcomes of wives of men exposed to perchloroethylene in the dry-cleaning industry compared to those of wives of laundry workers. Seventeen female partners of dry cleaners and 32 partners of laundry workers were interviewed. The number of pregnancies and the standardized fertility ratios were similar between the two groups. Wives of dry cleaners did not have higher rates of spontaneous abortions. However, wives of dry cleaners were more than twice as likely to have a history of attempting to become pregnant for more than 12 months or to have sought care for an infertility problem. Cox proportional hazards models indicated that dry cleaners' wives had half of the per-cycle pregnancy rate of wives of laundry workers, when controlling for other potential confounders (estimated rate ratio of 0.54, 95% C.I. = 0.23, 1.27). PMID- 1793103 TI - Renal function in dry cleaning workers exposed to perchloroethylene. AB - Perchloroethylene (PCE) is a widely used dry cleaning and degreasing solvent. Although there is evidence in animals and humans for renal effects at extremely high doses, there are few studies of its potential renal toxicity at typical occupational concentrations. This study reports on the relationship of PCE in breath and estimates of chronic exposure with the urinary ratios of total urinary protein, albumin, and n-acetyl-glucosaminidase (NAG) to creatinine in dry cleaning workers exposed to PCE. Regression models including one or more exposure variables, demographic variables, mean arterial blood pressure (MAP), and the presence of diseases affecting kidney function were examined. Urine samples, breath samples, exposure histories, and medical histories were obtained from 192 dry cleaning workers. The results failed to demonstrate any consistent relationship between exposure and renal outcome variables. However, protein/creatinine and albumin/creatinine were significantly, although weakly and positively, associated with MAP; NAG/creatinine was weakly but significantly positively associated with age; mean NAG/creatinine was also higher in non whites. The reasons why an association between exposure and renal outcome was not found are discussed. PMID- 1793104 TI - Evaluation of selection bias in a cross-sectional survey. AB - Selection bias is inherent in all occupational cohorts. Selection bias at entry has long been known and is commonly referred to as a "healthy worker effect." Less well appreciated is selection during the life of a cohort resulting from life-style factors (e.g., cigarette smoking); aging with accompanying chronic diseases, economic and demographic circumstances; and diseases that might result from exposures suffered by the cohort being studied, that influence whether individuals remain in a trade. These factors weigh differently at different times. Thus, at any point in time, "surviving" members of a cohort reflect an amalgam of selection factors. When such groups are studied in cross-sectional surveys there can be uncertainty whether clinical, radiological and physiological findings are necessarily representative for the trade or occupation as a whole. We analyzed the results of a large clinical field survey of long-term asbestos insulation workers to investigate whether the non-participants differed substantially from those who were examined. Five thousand three hundred and fifty five (5,355) men, of an initial cohort of 17,800 established January 1, 1967, had reached 30 or more years from onset of their work by July 1, 1981. All were invited to come for examination. Two thousand and seventy-seven (2,077) came, and 3,278 did not. We questioned a sample of 1,393 non-responders to see why they failed to appear. The answers did not give evidence of significant health-related selection influence. Sickness only infrequently kept them away. We then followed both groups--those examined and those not examined--to the end of 1987 for their mortality experience. There was no great difference. The non-responders had somewhat fewer deaths overall and proportionately fewer of asbestos-associated cancers, such as mesothelioma and lung cancer. The results indicated that, in this cohort, there did not seem to be health-related selection bias that determined whether or not cohort members responded to invitations for examinations. PMID- 1793105 TI - Scientific basis for an occupational standard for cadmium. AB - The U.S. Occupational Safety and Health Administration (OSHA) has proposed a revised 8-hour permissible exposure limit (PEL) for cadmium in air of either 1 or 5 micrograms/m3, based upon the prevention of lung cancer and kidney dysfunction. To evaluate the scientific basis for these alternative standards, we compare the OSHA estimates of risk, derived from mathematical modelling of selected studies, to empirical data on lung cancer and kidney dysfunction in the published literature. At least seven epidemiologic studies examine renal tubular proteinuria by cumulative cadmium exposure. Three suggest increased proteinuria at cumulative exposures below 500 micrograms/m3-year (equivalent to a PEL of 11.1 micrograms/m3 over 45 working years). One shows prevalence increasing at cumulative exposures between 100 and 299 micrograms/m3 (equivalent to a PEL between 2.2 and 6.6 micrograms/m3). Insufficient data exist to estimate a no effect level for kidney toxicity. For lung cancer, qualitative evidence of carcinogenicity in humans is seen in four of five occupational cohorts. Quantitative estimates of risk based on epidemiologic data provide lower and more plausible estimates of lifetime risk than do estimates from a rodent bioassay. The data overall suggest that the PEL for cadmium should not exceed 5 micrograms/m3 to protect workers from kidney dysfunction and lung cancer over a working lifetime. PMID- 1793106 TI - The incidence of malignant mesothelioma in Australia 1982-1988. AB - From 1980 to 1985, the Australian Mesothelioma Surveillance Program, and since 1986, the Australian Mesothelioma Register, have been collecting data on all cases of malignant mesothelioma that could be ascertained in Australia. Incidence rates were calculated on 854 Program and 696 Register cases (total 1271) diagnosed in Australia between January 1, 1982 and December 31, 1988. Australia has one of the highest national rates of mesothelioma in the world (15.8 cases per million of population aged 20 years and older), and the rate is rising. The rate is far higher in males (28.3) than females (3.3). The Western Australian rate (28.9) is the highest among the states, as may be expected because of the crocidolite mine at Wittenoom; however, the largest numbers of cases occur in the more populous and industrial New South Wales. The high incidence rate, its expected continuing increase, and absence of a history of exposure to asbestos in approximately 28% of cases, demand consideration of potential environmental factors other than asbestos in the causation of this tumor, as well as continued surveillance. PMID- 1793107 TI - An algorithm for matching anonymous hospital discharge records used in occupational disease surveillance: anonymous record matching algorithm. AB - The expense of collecting primary data, coupled with limited authority to mandate reporting, requires alternative methods of implementing an occupational disease registry in Illinois. One alternative data source for surveillance of some occupational diseases is hospital discharge records. Because these records lack personal identifiers, it has been impossible historically to match records belonging to the same individual and obtain reliable case estimates. To circumvent this difficulty, an algorithm has been developed to match anonymous hospital discharge records collected from all Illinois hospitals. The algorithm was based on the assumption that specific combinations of occupational disease code, sex, zip code, and date of birth would identify an individual to whom multiple hospitalizations belong. Matching with the algorithm reduced the 1986 case estimates from 597 to 499 for all cases of coal workers' pneumoconiosis, asbestosis, and silicosis. PMID- 1793108 TI - Lung function and chest radiograph abnormalities among construction insulators. AB - We carried out a prevalence survey of pulmonary health parameters among current and retired construction insulators (50 years old and older) from all areas of British Columbia, Canada. The study population included 59 active workers (81 percent participation in this group) and 29 workers who were retired or inactive due to illness (69% participation). Radiograph results were compared to those from actively working bus mechanics from the same age group, and retired grain and civic workers, who were all tested in the same manner. Chest radiographs were read independently by two readers and were graded according to the ILO classification system. Pleural abnormalities alone were found in 34% (20) of active workers (5% in comparison group) and 45% (13) of non-active workers (14% in comparison group). Rates for parenchymal abnormalities for these same groups (ILO grade 1/0 or higher) were 17% (5%) and 20% (5%), respectively. Airflow obstruction was present in 35% (31) of the insulators and was associated with age and the presence of diffuse pleural thickening, and 5 or more years of employment in pulp mills. Restrictive lung function was present in 22% (19) of the insulator population and was associated with age and radiographic evidence of parenchymal fibrosis. The results indicate that construction insulators, a group at high risk for asbestos-related lung disease, also have a high prevalence of airflow obstruction. This was associated not only with smoking, but also with diffuse pleural thickening and a history of pulp-mill employment, suggesting that airflow obstruction in this population is also partly work related. PMID- 1793109 TI - Changing attitudes and opinions regarding asbestos and cancer 1934-1965. AB - Literature published in the years 1934-1965 was reviewed to determine attitudes and opinions of scientists as to whether asbestos is a cause of cancer. In Germany, the issue was decided in 1943 when the government decreed that lung cancer, when associated with asbestosis (of any degree), was an occupational disease. In the United States, however, there was no consensus on the issue until 1964. Opinions of scientists over a 22 year period are shown and the contributions of various cultural, social, economic and political factors to these opinions are discussed. A lack of experimental and epidemiological evidence played a major role in delaying a consensus. Other important factors included a rejection of science conducted outside of the U.S. during this period, particularly a rejection of German scientific thought during and after WWII, and a rejection of clinical evidence in favor of epidemiological investigations. Individual writers rarely changed their minds on the subject of asbestos as a cause of cancer. PMID- 1793110 TI - Cadmium mortality assessment. PMID- 1793111 TI - Occupational standards are controversial. PMID- 1793112 TI - Benzene health effects: unanswered questions still not addressed. AB - Data which could have helped answer many of the scientific questions posed in 1983 concerning the carcinogenicity of benzene are not yet available. Since we do not know of any safe level above zero, the problems that have been plaguing the health protection process relative to benzene can perhaps be best resolved by setting current recommended maximum levels of exposure to 0.004 to 0.1 ppm, and, to the extent possible, avoiding any exposure at all to benzene and benzene containing products. PMID- 1793113 TI - Occult asbestos exposure. PMID- 1793114 TI - The therapist with the three-track mind. AB - This article reports some of the results of the American Occupational Therapy Association/American Occupational Therapy Foundation Clinical Reasoning Study. Therapists are thought to use three different types of reasoning when solving problems in day-to-day practice. Procedural reasoning guides the therapist in thinking about the patient's physical performance problems. Interactive reasoning is used when the therapist wants to understand the patient as a person. Conditional reasoning is used to integrate the other two types of reasoning as well as to project an imagined future condition or situation for the person. Experienced occupational therapists seem to shift smoothly from one mode of thinking to another in order to analyze, interpret, and resolve various types of clinical problems. PMID- 1793115 TI - Achieving intersubjective understanding: examples from an occupational therapy treatment session. AB - Occupational therapists, like other health care professionals, must balance their application of treatment techniques with an understanding of their patients' life experiences. This paper reviews the literature from interpretive and medical sociology regarding the interplay between professional power and the achievement of an understanding of another person. It analyzes how an occupational therapist, during a single treatment session, enters into her patient's life-world and simultaneously controls and manages the treatment process. The concepts of knowledge schemata (the expectations and beliefs people bring to a situation) and footings (the shifts in alignment, or focus, that occur during interaction) are central to this analysis. The process of achieving a balance between professional power and an understanding of the patient's experience may be fostered in education and in clinical supervision through increased emphasis on the importance of understanding the values and beliefs of patients and on the development and refinement of interactive skills. PMID- 1793116 TI - An emerging view of mastery, excellence, and leadership in occupational therapy practice. AB - The recent focus on clinical reasoning in occupational therapy, specifically on how therapists solve complex problems, has stimulated interest in how master clinicians think in practice. By gaining insight into how clinicians think and what they think about when they identify and solve problems, we may be able to identify clinical reasoning patterns and processes that occupational therapy students and novice therapists need to experience in order to progress in their practice or to emerge as leaders in their field. Observation of the way in which clinical masters and leaders view challenges and solve problems as manifested in their clinical reasoning may provide new and potential therapists with clues as to how to best bone their skills and knowledge for future success in practice. This paper describes a study that examined the relationship of mastery, excellence, and leadership in occupational therapy. Ten master clinicians were interviewed to determine the characteristics of their mastery and excellence in practice and to explore the degree to which they engaged in leadership behavior. The findings revealed that mastery, excellence, and leadership are independent of one another but that some characteristics are common to all of these phenomenas. PMID- 1793117 TI - Clinical reasoning and new ideas on intelligence: implications for teaching and learning. AB - Some recent research efforts have been focused on the attainment of a better understanding of intelligence and reasoning. One such study is the Clinical Reasoning Study funded by the American Occupational Therapy Association and the American Occupational Therapy Foundation. Other studies have been conducted by theorists of human development. The findings of both groups reveal three common themes: the multiple aspects of intelligence, the importance of understanding the patient's story, and the use of the caring perspective. This article examines these shared themes and discusses their implications for new directions in occupational therapy curricula. PMID- 1793118 TI - Staff development through analysis of practice. AB - Dreyfus and Dreyfus's (1986) five-stage model of skill acquisition is integrated with findings from the American Occupational Therapy Association/American Occupational Therapy Foundation Clinical Reasoning Study. This model is presented as an organizing framework for staff development. Strategies for the recognition and retention of experienced clinicians who can serve as mentors for newer colleagues are identified. PMID- 1793119 TI - Occupational therapy diagnostic reasoning: a component of clinical reasoning. AB - The occupational therapy process involves the assessment and treatment of problems in occupational status. Assessment entails the sensing and defining of patients' problems and is accomplished through diagnosis. As a process, diagnosis involves the creation of a clinical image of the patient through cue acquisition, hypothesis generation, cue interpretation, and hypothesis evaluation. This sequence of cognitive activities is called diagnostic reasoning. As a product, diagnosis summarizes a patient's occupational deficits in terms of occupational role performance, occupational performance, and the components of occupational performance. To serve adequately as a basis for planning intervention, the occupational therapy diagnosis describes the problem, explains the potential cause of the problem, gives the cues whereby the problem is recognized, and names the pathologic agent. Occupational therapy assessment is broader than diagnosis and includes a delineation of the patient's assets as well as deficits. In the resolution of problems in occupational status, assets may be used to offset deficits. The clinical image represents a balanced view of occupational status by reflecting assets and deficits. PMID- 1793120 TI - Anthropology, occupational therapy, and action research. AB - This paper describes the research process and methodology used in the American Occupational Therapy Association/American Occupational Therapy Foundation Clinical Reasoning Study. This study examined the clinical reasoning of occupational therapists through a 2-year ethnography of therapists at one hospital site. The research was innovative in several important respects. One important innovation was a combined ethnographic and action research design that involved collaboration between the research team and those therapists being studied. Therapists who were research subjects became actively involved in examining and reflecting on their own practice through group analysis of videotaped sessions with clients. One outcome of this action research component was that the study served as both a research and a staff development project. PMID- 1793121 TI - What is clinical reasoning? AB - This paper offers a concept of clinical reasoning that differs from many of the traditional definitions of clinical reasoning in occupational therapy and the health professions in general. Here, clinical reasoning in occupational therapy is described as a largely tacit, highly imagistic, and deeply phenomenological mode of thinking. It is argued that clinical reasoning involves more than the ability to offer explicit reasons that justify clinical decisions because it is also based on tacit understanding and habitual knowledge gained through experience. Clinical reasoning also involves more than a simple application of theory, particularly theory as understood in the natural sciences, because complex clinical tasks often require that the therapist improvise a treatment approach that addresses the unique meaning of disability as it relates to a particular patient. PMID- 1793122 TI - Clinical reasoning in medicine compared with clinical reasoning in occupational therapy. AB - This article highlights some observations made in the American Occupational Therapy Association/American Occupational Therapy Foundation Clinical Reasoning Study, an ethnographic study of 14 occupational therapists working in a large teaching hospital. Concepts and premises that frequently appear in the clinical reasoning in medicine literature are discussed and compared and contrasted to observations and interpretations made of the practice and reasoning strategies of the occupational therapists who were participants in the Clinical Reasoning Study. It is postulated that similarities in the reasoning strategies of the members of the two professions are a result of use of the scientific model that calls for hypothetical reasoning. Differences, it is proposed, are accounted for by the difference in the particular focus, goals, and tasks of the two professions and the nature of the practice in those arenas. Five hypotheses are proposed as questions for further research in clinical reasoning in occupational therapy. PMID- 1793123 TI - The narrative nature of clinical reasoning. AB - Narrative reasoning is a central mode of clinical reasoning in occupational therapy. Therapists reason narratively when they are concerned with disability as an illness experience, that is, with how a physiological condition is affecting a person's life. In this paper, narrative reasoning is contrasted with propositional reasoning, and two kinds of narrative thinking are examined. The first is the use of narrative as a mode of speech that can be contrasted with biomedical discourse, in which disability is framed as physical pathology. The second involves the creation rather than the telling of stories. Therapists try to "emplot" therapeutic encounters with patients, that is, to help create a therapeutic story that becomes a meaningful short story in the larger life story of the patient. PMID- 1793124 TI - Integration of nonthematic details in pictures and passages. AB - Nonthematic details in naturalistic scenes were manipulated to produce four stimulus versions: color photos, black-white copies, and elaborated and unelaborated line drawings (Experiment 1); analogous verbal descriptions of each visual version were produced for Experiment 2. In Experiment 1, two or three different versions of a scene were presented in the mixed condition; the same version of the scene was repeated either two or three times in the same condition, and a 1-presentation control condition was also included. In Experiment 2, the same presentation conditions were used across different groups of subjects who either viewed the pictures or heard the descriptions. An old/new recognition test was given in which the nonstudied versions of the studied items were used as foils. Higher false recognition performances for the mixed condition were found for the visual materials in both experiments, and in the second experiment the verbal materials produced equivalently high levels of false recognition for both same and mixed conditions. Additionally, in Experiment 2 the patterns of performances across material conditions were differentially affected by the manipulation of detail in the four stimulus versions. These differences across materials suggest that the integration of semantically consistent details across temporally separable presentations is facilitated when the stimuli do not provide visual/physical attributes to enhance discrimination of different presentations. Further, the evidence derived from the visual scenes in both experiments indicates that the semantic schema abstracted from a picture is not the sole mediator of recognition performance. PMID- 1793125 TI - Effect of surface characteristics and style of production on naming and verification of pictorial stimuli. AB - Theories of object recognition that are based purely on part decomposition do not take into account the role of textural, shading, and color information, nor do they differentiate between stylistic factors in the preparation of line-drawn pictorial stimuli. To investigate these factors, naming and verification experiments were performed using line drawings, monochrome photographs, and color photographs of common objects. For line drawings, it was shown that line width, exposure, and contrast affected naming latency, which increased for lines of narrow width and extremes of exposure. Naming latencies were compared for objects drawn by a professional artist, with varying degrees of surface detail, and objects produced by a computer-aided design (CAD) system, with no surface detail. The mean naming latencies for the artist set were faster than for the CAD set, though not significantly, with a significant degree of object correlation being observed. However, in certain cases there were significant differences between objects. These were investigated in a further experiment in which subsets with common properties of present or absent surface detail were selected from the artist-drawn stimuli. It was found that the presence of surface features resulted in lower response latencies even for those objects that intuitively could be recognized by parts alone. The time to name photographic and line-drawn stimuli was compared, and a progressive decrease in naming latency from line to monochrome to color stimuli was observed. In a verification task, no significant advantage for color or monochrome photographs over line drawings was found, either when comparing stimuli of equivalent or of different mode. However, there was a tendency for the comparison of different modes to take longer than the comparison of same modes. The results are discussed in terms of theories of human visual processing and cognitive and computational models of object recognition. PMID- 1793126 TI - Influence of color on odor identification and liking ratings. AB - The effects of color on odor identification were tested under color appropriate, inappropriate, and blindfolded conditions. Subjects made fewer errors in identifying solutions that were colored appropriately (e.g., red-cherry) than in either the blindfolded condition, where there were no color cues, or the inappropriate color condition (e.g., red-lemon). Identification accuracy was greatest for typical odor-color combinations (e.g., red-cherry) compared with appropriate but nontypical odor-color combinations (e.g., red-watermelon). Response latencies were fastest for odors in the appropriately colored solutions. Subjects also rated appropriate color-odor combinations as most pleasant. However, this effect is probably due to the increase in identification accuracy of the appropriately colored solutions. In all three conditions, correctly identified odors were liked more than odors that were not correctly identified. Thus, color is an important perceptual variable in odor identification because it biases subjects toward a color category that facilitates identification if the color is "correct". This ability to identify an odor in turn influences the affective response to the odor. PMID- 1793127 TI - Comprehension by learning-disabled and nondisabled adolescents of personal/social problems presented in text. AB - Four groups of 14-year-olds, differing in reading level, learning disability status, and socioeconomic status, read and retold short problem narratives and answered questions. The pattern of reporting components of the problem schema (goal/obstacles/choices) differed for problems presented with or without a statement of the character's priority for action, suggesting that including priorities adds another level of information to the problem text and changes its macrostructure. Even the poorest readers showed this sensitivity to text structure. Three of the four measures of problem representation (idea units recalled, problem-schema components reported, and error rate) reflected overall reading ability. However, the degree to which extraneous information was incorporated into problem representations did not. Learning-disabled students made more importations, and more implausible importations, than did non-disabled students. Moreover, this pattern was associated with poor problem solving. Only proficient readers showed awareness of the source of the information (text or extratext) on which their predictions were based. PMID- 1793128 TI - Similarity ratings and confusability of lipread consonants compared with similarity ratings of auditory and orthographic stimuli. AB - Similarity ratings of pairs of lipread consonants were obtained using a 5-point scale. Matrices were constructed showing mean similarity ratings and confusions among stimuli. Both the similarity and the confusion data provide normative data useful for researchers in many areas. Lipread data collected here are compared with similarity ratings of orthographically and auditorily presented consonants collected by Manning (1977). These comparisons provide information about how stimulus similarity both within and between presentation formats may affect information processing of the three types of stimuli. These data are of special interest to researchers studying the visual processing of speech and the effect of format of presentation on recall. PMID- 1793129 TI - [The risks for fetus and mother depending on the type of cesarean section]. AB - The author points out the tendency to the increasing frequency of cesarean section (mainly) in the interest of the fetus and mother and emphasizes that in some cases the cesarean section itself represents a risk factor. This factor evolves from the direction and place of the uterine incision--transverse and longitudinal. The isthmic transverse incision of the uterine wall, proposed by Kehrer in 1981, is not always the most suitable, since in could not always assure sufficient space for elegant extraction of the fetus. This remark is referred especially to cases, when cesarean section is performed for a fetus under 32 weeks' gestation and then the lower uterine segment is not dilated enough and the transverse isthmic orifice is small for atraumatic extraction of the fetus. For these and some other states--twin pregnancy, transverse oblique presentation of the fetus, placenta previa varicose vessels of both sides of the uterus and very large fetus, the author proposes low isthmic longitudinal hysterectomy and emphasizes the motives for decision making. Except for advantages for the fetus and mother he points out more perfect adaptation of the edges--a guarantee for healthy and elastic edge, in which dehiscences are observed more rarely during the following deliveries according to foreign authors). The experience of the author in low isthmic longitudinal incision of the uterus is made on 62 cesarean sections, performed by 13 obstetricians, all convinced that this incision creates greater space possibilities--conditions for atraumatic extraction of the fetus. PMID- 1793130 TI - [Short-term antibiotic prophylaxis in cesarean section and hysterectomy]. AB - The usage of antibiotics for prevention of infection in surgical practice is taken into consideration with the most frequent pathogenic agents, which are isolated from the genital tract and their sensitivity to antibiotics, pharmacokinetic properties of the antibiotic-tissue penetration, duration of action, concentration (without any risk) and established clinical efficiency. The potential benefit from prophylactic antibiotic should always be balanced against the possible damage. The duration of prophylaxis should be as short as it could be, in order to avoid the danger for occurrence of resistant strains. A single antibiotic dose is ideal. Cephalosporins are the most suitable for current prophylaxis. PMID- 1793131 TI - [A parallel study between the magnitude of smooth-muscle contraction in vitro and the prostanoid content of the incubation medium of the preparation after the introduction of blood serum from women]. AB - An attempt is made to establish dependence between stimulation of smooth-muscle contraction and the concentration of prostanoids in biologically active sera of women on the basis of two various methods: physiological test with smooth-muscle strips in vitro and radioimmunological determination of prostanoids. Three prostanoids are examined PgF2 alpha PgI2, TxA2 are examined and it is found that lineal dependence between the prostanoid concentration and activation of contraction (for the whole range) is observed only for PgF2 alpha, which allows graphic interpolation for this prostaglandin. PMID- 1793132 TI - [Changes in the immune status of patients with cancer of the female genitalia]. AB - Some immunological parameters were examined in 198 women with morphologically verified carcinoma of their genitals (ovaries, body and cervix of the uterus). Various degree of suppression of cellular mediated immunity (CMI), phagocytosis an increase of CIK with consumption of the complement and dysimmunoglobulinemia was established. These changes were manifested mostly in women with ovarian carcinoma and in women with nondifferentiated carcinoma. The degree of deviations in the immune status is of some prognostic value. PMID- 1793133 TI - [The clinical characteristics of atypical endometrial hyperplasia]. AB - An analysis is made on the clinical symptoms of 72 women with diagnosis of atypical hyperplasia established morphologically. The clinical data are manifested in accordance with the periods of the woman: reproductive climacteric and menopausal. Dysfunctional uterine bleedings, combined with endocrine metabolic disturbances, predominate. A substantial connection between the atypical hyperplasia and the frequency of patients with myoma of the uterus is established as well as the closeness between the clinical picture of atypical characteristic and endometrial adenocarcinoma. Patients with atypical characteristics are formed as risk group for occurrence of endometrial carcinoma. It is necessary to know risk factors for occurrence of endometrial pre-carcinoma as well as indispensable condition for organization of more effective prophylaxis. PMID- 1793134 TI - [The sociomedical problems of pregnancy and labor in adolescents]. PMID- 1793135 TI - [The use of prostaglandin E2 to induce labor and abortion in the second trimester]. PMID- 1793136 TI - [Diprivan-propofol and its use in obstetrics and gynecology]. PMID- 1793137 TI - [Contraception via a vaginal hormonal ring]. PMID- 1793138 TI - [The antenatal diagnosis of the sex of the fetus by the cytological determination of sex chromatin]. AB - Forty women between 17 and 23 weeks' gestation were included in the study, whose interruption of pregnancy was performed by medical and social indications. The method of Aburel-Atanasov was used as in 10 ml of the removed amniotic fluid sex chromatin was examined cytologically on cellular smears. Staining and determination of sex chromatin was made by the method of Dokumov. The fetus of male sex, when there was no sex chromatin, but the sex was female, when it was present in various percentage of cells. The genuine sex of the fetus was determined after interruption of pregnancy. Coincidence of cytological and genuine sex of the fetus was found in 36 cases (92.31%), but the sex was determined not exactly in 3 cases (7.69%). There was no sufficient material for preparation of high-grade cytological smears in one case. 14 out of 40 fetuses were of female sex (with sex chromatin in 28.57% of cells on the average) and 25 of male sex. The significance and advantages of the method in comparison with other methods for determination of fetal sex at the same term of pregnancy are discussed. PMID- 1793139 TI - [The progesterone test and uterine sonography as screening methods in women during the postmenopause with and without diabetes mellitus]. PMID- 1793140 TI - [The echographic diagnosis of torsion of the pregnant uterus]. PMID- 1793141 TI - [Low obstructive uropathy--its antenatal ultrasonic diagnosis]. PMID- 1793142 TI - [A term tubal pregnancy with a live infant]. PMID- 1793143 TI - [The diagnostic problems in a case suspected to be an abdominal pregnancy]. PMID- 1793144 TI - [Kidney presentation as mechanical dystocia]. PMID- 1793145 TI - [A rare case of endometrial adenoacanthoma in a young woman in combination with the Stein-Leventhal syndrome]. PMID- 1793146 TI - [Our experience in treating nonspecific vaginitis with pinol gel]. PMID- 1793147 TI - [The treatment and prevention of premenopausal uterine hemorrhages]. PMID- 1793148 TI - [The role of cardiotocographic study in older primiparae]. AB - The authors aimed to study the significance of cardiotocographic examination (ECTE) for determination of fetal risk in elderly primiparas (EP). Data on NST, one the one hand, and the state of the newborn and perinatal outcome on the other, were, compared for its realization. 207 primiparas were investigated, 73, of whom were EP (35 years). The fetal reactivity and variability of fetal heart frequency (FHF) were evaluated during the performed NST. Semiquantitative evaluation of FHF was also made, in order to improve the quality of NST. FHF score was examined as well. The following inferences were made as a result of the examination: 1. Lacking reactivity of the fetus, variability 5 min beats per min, FHF score--6 points and even curve of NST as a signal for fetal distress were found mainly in EP. 2. These cardiotocographic criteria were encountered in EP with accompanying and worsening the pregnancy diseases and should pray a leading role in determining obstetric management. 3. The performance of ECTE is compulsory in EP. PMID- 1793149 TI - Suppression of bone marrow by low-density lipoproteins in renal disease patients. AB - Patients with chronic renal disease in whom erythropoietin production is inadequate invariably experience moderate to severe debilitation-induced fatigue. Unlike the direct humeral control of erythropoiesis, neutropenia in the same cohort of patients appears to be under indirect control, very likely brought about by the suppressive effect of increased levels of low-density lipoprotein (LDL) on granulocyte-monocyte colony formation. Markedly elevated LDL levels were identified in plasma samples obtained from a study population of 179 chronic renal disease patients. The effect of the elevated LDL levels in the plasma of these patients resulted in a greater than 60% decrease in granulocyte-macrophage colony-forming unit in comparison with age-matched plasma from normal individuals. Careful review of all nutritional and therapeutic events in these patients did not offer any evidence, other than the elevated LDL levels, in support of the etiology of the chronically low absolute neutrophil counts. PMID- 1793150 TI - Growth after bone marrow transplantation in children. AB - Growth of the patients with hematological malignancies, aplastic anemia, Fanconi's anemia, and Wiscott-Aldrich syndrome who had been treated with bone marrow transplantation (BMT) was studied. Fourteen out of 21 patients showed suppression of linear growth after BMT. Recovery of the growth velocity after 1-2 years tended to occur if BMT was performed at younger age. Six of eight patients with chronic graft-versus-host-disease (CGVHD) had impaired growth after BMT, whereas eight of 13 (61%) without CGVHD did. Provocative tests for growth hormone (GH) performed 5-72 months after BMT revealed three boys who showed poor response to more than two different stimuli. Two of these three boys had prolonged suppression of growth. Neither the age at BMT, difference in disease, nor presence of posttransplant growth retardation gave significant difference in the response of GH to provocative tests. It was concluded that approximately two thirds of marrow-grafted children experienced transient decrease in growth velocity after BMT. PMID- 1793151 TI - Intra-arterial cisplatin given prior to surgery in osteosarcoma: grade of necrosis and size of tumor as major prognostic factors. AB - From January 1983 to August 1987, 29 evaluable patients with high-grade osteosarcoma were treated in our institution with preoperative intra-atrial cisplatin, 100 mg/m2 every 14 days for three courses. Surgery was done on day 42. Surgery consisted of limb salvage in six, amputations in 15, and disarticulations in eight. Postoperative chemotherapy included Adriamycin (ADR), 45 mg/m2 for 2 days every 6 weeks, alternated with cisplatin 120 mg/m2 every 6 weeks. The nephrotoxicity (18 out 29) was reversible in all cases. Cardiotoxicity was prominent; it was observed in 31% of patients. In six, there was congestive heart failure, but there were no fatal cases. The hematological toxicity was severe. There were three patients with fatal infections who had no evidence of disease after they had finished treatment. Seventeen of 29 patients (58.6%) were good responders and showed 60-100% tumoral necrosis after intra-atrial cisplatin. The 6-year, relapse-free survival rate was 58.6%--70.5% for the good responders and 41.6% for the poor responders (p less than 0.05). The size of the tumor was the other important prognostic factor. The rate of 6-year, relapse-free survival was 73.6% for small tumors (those measuring less than 100 cm2) and 33.3% for large tumors (p less than 0.05). PMID- 1793152 TI - An outbreak of an infection associated with circulating activated monocytes and hemophagocytes in children in Bombay, India. AB - From May 1985 to December 1989, while doing blood counts on hospitalized children in Bombay, over 300 blood smears showed an impressive number of activated monocytes (AMs) and hemophagocytes (HPs). Many AMs resembled macrophages. The AM HPs were visible in blood for 1-10 days, accompanied by a neutrophilia and a marked thrombocytopenia. Clinical features associated with these smears were fever, unresponsiveness to antibiotics, symptoms referable to the CNS and respiratory and/or gastrointestinal tracts, and bleeding. Ninety percent of affected children were under 2 years of age. The illness resolved completely or was fatal in 30%, with bleeding or respiratory failure, within 2 weeks. Children older than 2 years had underlying illness and high fever, and 40% died. Surgical candidates had obstructive gastrointestinal pathologic findings, from the stomach to the ileum. Babies under 1 month of age died, with clinical signs of deterioration and bleeding. Bone marrows were unremarkable. Few or no AM-HPs were seen. The fibrin split product tests were positive. Liver function test results were normal. Autopsies on six cases revealed edema and bleeding or thrombosis in the lungs, brain, and gastrointestinal tract. Only one neonate had a mild histiocytic infiltration in the lungs and liver. Features in common with and differences from virus-associated hemophagocytic syndromes are discussed. PMID- 1793153 TI - Prophylaxis with factor concentrates in preventing hemophilic arthropathy. AB - Seven children with severe hemophilia A on prophylactic substitution therapy since a mean age of 5 years (group I) were investigated in 1978 (at ages 6-12 years) and in 1988 (at ages 16-22 years). The results were compared with those of seven children aged 5-12 for whom such treatment was started at a mean age of 3 years (group II). In group I, four had each had more than 20 ankle hemarthroses at the first investigation, while in group II, only one boy had experienced such a high bleeding frequency. Radiological changes in ankles were found in one of seven in group II compared with five of seven in group I. Progression of these changes was shown in eight of 10 ankles of group I at reinvestigation. Regular prophylactic therapy must start early, at ages 1-2 years, to prevent changes in ankle joints, and parents and children must learn to recognize ankle bleeding. Modern Factor VIII concentrates must be administered to children two or three times per week in dosages of 3,000 U/kg/year in order to reduce hemarthroses to a minimum. The dosages can probably be lowered if the intervals are shortened. Children on prophylactic treatment can engage in regular sports activities. PMID- 1793155 TI - Familial alloimmune neutropenia of NA-2 specificity. AB - Three siblings with alloimmune neonatal neutropenia are presented. An immunoglobulin G (IgG) antineutrophil antibody specific for NA-2 antigen was demonstrated in maternal serum and in both of the three affected infants who were studied as neonates. The mother's neutrophils were negative for NA-2 antigen. The father and all four children, including the three known to be affected, had neutrophils that expressed NA-2 antigen. One patient studied sequentially demonstrated an inverse relationship between the antineutrophil antibody titer and the absolute neutrophil count. Exchange transfusions did not appear to benefit two of the infants. PMID- 1793154 TI - High-dose cyclophosphamide-high-dose methotrexate with coordinated intrathecal therapy for advanced nonlymphoblastic lymphoma of childhood: results of a Pediatric Oncology Group study. AB - The Pediatric Oncology Group (POG) investigated a high-dose cyclophosphamide (CPM) high-dose methotrexate (MTX) regimen to determine therapeutic efficacy in confirmed advanced nonlymphoblastic non-Hodgkin's lymphoma (NHL) (stages III and IV) and B-cell acute lymphatic leukemia (B-ALL) in children. Another goal was to determine the comparative effectiveness of shortened maintenance treatment (2 versus 6 courses) in the study population. Systemic induction therapy included vincristine, prednisone, cyclophosphamide, and intermediate-dose MTX with leucovorin rescue. Superimposed intrathecal (IT) therapy included cytosine arabinoside for 2 successive days followed on day 3 by MTX. Intrathecal MTX was given 3 times during induction. At the end of induction, 2 days of triple (hydrocortisone, MTX, and cytosine arabinoside) therapy were given intrathecally (TIT). All patients then received a consolidation course of 4 doses of TIT, 2 doses of cyclophosphamide, and 4 more courses of vincristine and MTX with leucovorin rescue. Patients were then randomized to receive either 2 or 6 cycles of vincristine plus MTX with leucovorin rescue. The TIT was given with each cycle. Complete response rates by histology and Murphy stage (1) were as follows: undifferentiated lymphoma (DUL) stage III, 84/105 (80%): stage IV, 5/12 (42%); and other NHL [primarily large cell lymphoma (LCL)] stage III, 21/28 (75%); stage IV, 2/3 (67%). Event-free survival (EFS) at greater than 2 years was similar for patients with DUL and LCL, i.e., 65 and 61%, respectively. No significant difference in outcome was noted between patient groups receiving 2 or 6 maintenance treatments (p = .76). Treatment was notable for its modest toxicity following the early change to single-dose CPM therapy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793156 TI - Vincristine therapy for severe platelet alloimmunization. AB - A 19-month-old girl with idiopathic severe aplastic anemia refractory to multi agent immunosuppressive therapy developed severe platelet alloimmunization following several months of platelet transfusions. She became refractory to human leukocyte antigen (HLA)-matched platelet transfusions and experienced frequent episodes of bleeding. She was treated with intravenous vincristine administered weekly for three doses and showed marked improvement in both clinical and laboratory response to platelet transfusions. When vincristine was held for 3 weeks, she again became refractory to HLA-matched platelet transfusion. Reinstitution of vincristine resulted in cessation of clinical bleeding and improved response to platelet transfusion. The mechanism of response likely involves selective delivery of cytotoxic drug to macrophages. To our knowledge this is the first reported case of alloimmune thrombocytopenia responsive to vincristine. PMID- 1793157 TI - Early bone marrow transplantation in an infant with Wiskott-Aldrich syndrome. AB - The Wiskott-Aldrich Syndrome (WAS) is a rare X-linked immunohematological disorder characterized by eczema, profound thrombocytopenia, and progressive immunodeficiency. Severe hemorrhage, overwhelming sepsis, or lymphoreticular malignancy usually cause death in childhood. Recently, bone marrow transplantation (BMT) has been curative in some well-established cases, but there is no general agreement about the place of BMT in infants with WAS before the development of significant immunological abnormalities. We describe the successful use of early histocompatible BMT in a 10-month-old infant in whom WAS was diagnosed on the basis of eczema, thrombocytopenia, small platelets, and raised serum immunoglobulin A (Ig) and IgE, but before the development of immunodeficiency as evidenced clinically by recurrent infections, or immunologically by low serum IgM or consistently abnormal lymphocyte responses to mitogens. After an unstable period for several weeks posttransplantation when he developed marked hepatomegaly and severe interstitial pneumonitis, he made a good recovery. His eczema and thrombocytopenia resolved and he has shown no clinical or laboratory evidence of immunodeficiency. It is now over 2 years since his BMT. Because of the poor prognosis of WAS, where a histocompatible donor is available, BMT at the earliest opportunity, despite the inherent risks of such a procedure, may be the best option for an infant with WAS. PMID- 1793158 TI - Recurrent disseminated retinoblastoma treated by high-dose chemotherapy, total body irradiation, and autologous bone marrow rescue. AB - A case of recurrent, disseminated retinoblastoma is presented. The primary intraocular tumor, a metastatic mass at recurrence, and the tumor cells infiltrating bone marrow were all positive for the anti-GD2 monoclonal antibody (Mab) 3A7. Indirect immunofluorescence using the monoclonal antibody 3A7 was an effective method of detecting residual disease in the marrow. After remission was achieved by conventional therapy, the patient underwent autologous bone marrow transplantation (ABMT). The preparative regimen consisted of VP-16, cisplatinum, high-dose melphalan, and total body irradiation. The autologous marrow inoculum was clean of tumor cells at the detection level of 1:10,000. The transplant course was uneventful, and the patient is well and disease-free 17 months after ABMT. We conclude that high-dose chemotherapy and total body irradiation in an ABMT setting is feasible and a potentially curative approach to disseminated retinoblastoma. PMID- 1793159 TI - Erythroblastopenia in two patients after splenectomy and polychemotherapy. AB - Acquired erythroblastopenia is a rare disorder of the hematopoietic system associated with viral infections, autoimmune diseases, and drugs. We report on two patients who became anemic due to maturation-arrest at the proerythroblast level, without alterations of white blood cell or platelet counts. Both patients had been splenectomized and had undergone chemotherapy for nephroblastoma or Hodgkin's disease, respectively, at the same pediatric oncology unit. Erythropoietin levels were elevated in both patients. Antibodies against specific viruses, particularly parvovirus B 19, could not be detected in patient sera. Both patients responded to infusions of 7 S immunoglobulin with a rapid increase of the reticulocyte counts. In both cases, complete clinical remission was observed after a duration of 5 months. Heat-inactivated serum obtained during the acute phase and after remission as well was found to be inhibitory for normal bone marrow granulocyte and erythrocyte progenitor growth in vitro. The simultaneous appearance of this rare disorder in two otherwise unrelated patients treated at the same unit prompts speculations about a viral etiology. PMID- 1793160 TI - Danazol therapy for chronic immune-mediated thrombocytopenic purpura in a patient with common variable immunodeficiency. AB - We describe a patient with common variable immunodeficiency (CVI) and chronic immune-mediated thrombocytopenic purpura (ITP), refractory to treatment with corticosteroids, splenectomy, and intravenous immunoglobulin. He had a prompt response to danazol, and the platelet counts have been maintained in the normal range with low-dose, alternate-day, danazol therapy. This case provides evidence that danazol is effective in the treatment of chronic ITP in patients with immunodeficiency and indicates that some patients can be maintained on an alternate-day regimen. PMID- 1793161 TI - Monosomy 7 syndrome in an infant with neurofibromatosis. AB - A 9-month-old boy with known familial neurofibromatosis type I (NF-1) presented with a clinical and laboratory picture suggestive of juvenile chronic myelomonocytic leukemia (JCMMoL). Chromosomal studies obtained from the bone marrow indicated, however, that he had monosomy 7 syndrome. We believe this is the first reported case of monosomy 7 syndrome in a child with NF in the United States, and that this case complements a recent report of two cases of NF, JCMMoL, and monosomy 7 in Japanese children. Since monosomy 7 syndrome is very difficult to differentiate from JCMMoL or acute nonlymphocytic leukemia (ANLL) unless appropriate chromosomal studies are obtained, we believe it is possible that monosomy 7 may occur with increased frequency in patients with NF-1. Monosomy 7 syndrome might therefore be a significant cause of the known association between NF-1 and nonlymphoid leukemia. PMID- 1793162 TI - Sideroblastic anemia showing unique response to pyridoxine. AB - We treated and followed up for 6 years a patient with pyridoxine-responsive sideroblastic anemia. The patient was a boy age 1 year and 9 months, who was diagnosed on the basis of peripheral red cell morphology and an increased number of sideroblasts in the bone marrow. Bone marrow erythroblasts showed a marked reduction of delta-aminolevulinic acid synthase (ALA-S) activity. The response of the patient to pyridoxine and its active form, pyridoxal phosphate, was unique. After the first course of pyridoxal phosphate therapy (300 to 500 mg/day i.v. for 4 days), all hematological data were restored to normal and remained normal for 29 months without the further administration of pyridoxal phosphate. The second course of pyridoxal phosphate therapy (500 mg/day i.v. for 2 days) was effective for 6 months. The third, fourth, and fifth courses of the therapy consisted of daily oral pyridoxine hydrochloride at a dose of 180 mg/day for 4 to 6 weeks, and the respective periods of hematological remission were 7, 12, and greater than 18 months. These observations suggest the presence of a complicated ALA-S activating or inactivating system, or both, in our patient. PMID- 1793163 TI - Use of recombinant erythropoietin in treatment of the anemia of prematurity. AB - The anemia of prematurity is defined by a progressive decline in hemoglobin level occurring over the first 2 months of life. Unlike term newborns whose "physiologic anemia" rarely if ever necessitates any treatment, preterm infants may become anemic enough to have clinical symptoms that indicate a need for red blood cell transfusions. Various factors contribute to the development of this anemia. Some of these factors, such as the short life span of erythrocytes in preterm infants, increased sensitivity of the erythrocytes to oxidative injury, and the blood losses caused by repeated phlebotomies, would normally be expected to induce corrective reticulocytosis. Characteristically, however, this anemia is hyporegenerative. Thus, it is associated with relative reticulocytopenia, low serum erythropoietin levels, and bone marrow erythroid hypoplasia. The recent availability of recombinant human erythropoietin has opened new perspectives in the management of a variety of anemias. Based on current knowledge of the regulation and pathophysiology of fetal and neonatal erythropoiesis, recombinant erythropoietin may represent a logical and efficient alternative to giving red blood cell transfusions in the treatment of the anemia of prematurity. Clinical trials have been initiated in several countries using different approaches and methodology. At this early stage these trials do not yet fully affirm that recombinant erythropoietin can be used as the first-line therapy in infants with the anemia of prematurity. Our own observations, however, suggest that this agent is well tolerated by preterm infants and may exert a corrective effect on the anemia of prematurity. PMID- 1793164 TI - Plasma protein C levels in children with sickle cell disease. PMID- 1793165 TI - Homage to Fred Walberg on his 70th birthday. PMID- 1793166 TI - The GABAergic cerebello-olivary projection in the rat. AB - Immunocytochemical detection of glutamate decarboxylase (GAD), the predominant biosynthetic enzyme of gamma-aminobutyric acid (GABA), reveals the presence of a dense GABAergic innervation in all parts of the inferior olive. One brain center that provides a substantial projection to the inferior olive is the cerebellar nuclei, which contain many small GABAergic neurons. These neurons were tested as a source of GABAergic olivary afferents by combining retrograde tract tracing with GAD immunocytochemistry. As expected from previous studies, injections of wheat germ agglutinin-conjugated horseradish peroxidase (WGA-HRP) into the inferior olive retrogradely label many small neurons in the interposed and lateral cerebellar nuclei and the dorsal part of the lateral vestibular nucleus, and fewer neurons in the ventro-lateral region of the medial cerebellar nucleus. These projections are predominantly crossed and are topographically arranged. The vast majority, if not all, of these projection neurons are also GAD-positive. The relative contribution of this projection to the GABAergic innervation of the inferior olive was tested by lesion of the cerebellar nuclei, or the superior cerebellar peduncle. Within 10 days the lesion eliminates most GAD-immunoreactive boutons in the principal olive, the rostral lamella of the medial accessory olive, the ventrolateral outgrowth, and the lateral part of the dorsal accessory olive ventral fold. Thus, the effectiveness of this depletion demonstrates that the cerebellar nuclei provide most of the GABAergic innervation to regions of the inferior olive known to receive a cerebellar projection. Moreover, when the lateral vestibular nucleus is damaged, the dorsal fold of the dorsal accessory olive is depleted of GABAergic boutons. The synaptic relations that boutons of the GABAergic cerebello-olivary projection share with olivary neurons were investigated at the electron microscopic level by GAD-immunocytochemistry, anterograde degeneration of the cerebellar axons or anterograde transport of WGA HRP. All of these methods confirm that GABAergic, cerebello-olivary axon terminals contain pleomorphic vesicles, and synapse on various portions of olivary neurons, and especially on dendritic spines within glomeruli, often in very close proximity to the gap junctions that characteristically couple the dendritic profiles. These results demonstrate four major points: that virtually all of the GABAergic, and presumably inhibitory, neurons of the cerebellar and dorsal lateral vestibular nuclei are projection neurons; that a large portion of the inferior olive receives GABAergic afferents from the cerebellar nuclei; that a portion of the dorsal accessory olive receives GABAergic afferents from the dorsal lateral vestibular nucleus; and that cerebello-olivary fibers often synapse near gap junctions, and therefore could influence electrical coupling of olivary neurons. PMID- 1793167 TI - Brainstem projections of different branches of the vestibular nerve: an experimental study by transganglionic transport of horseradish peroxidase in the cat. II. The anterior and posterior ampullar nerves. AB - The brainstem projections of the ampullar nerves from the vertical semicircular canals, the anterior (AAN) and the posterior ampullar nerve (PAN), were studied in adult cats using the transganglionic horseradish peroxidase (HRP) method. Each nerve was exposed in three experiments. Two animals in each group had labeling which allowed detailed mapping. From the AAN, terminal-type labeling was found in two separate groups, one laterally and one medially, both in the lateral (LV) and in the superior (SV) vestibular nucleus. In addition, such labeling was found in all parts of the medial vestibular nucleus (MV). Labeled structures were found also in the descending vestibular nucleus, (DV) more densely over its lateral part, except for cell group f, where no labeling was found. From the PAN, terminal-type labeling was found medially and laterally in the LV and in the medial part of the SV. In the MV, such labeling was evenly distributed rostrally but concentrated laterally in caudal parts. In the DV, terminal-type labeling was present rostrally, whereas no labeling was seen caudally. In the interstitial nucleus of the vestibular nerve, terminal-type labeling was observed from the AAN but not from the PAN. No labeled fibers from either of the two ampullar nerves were seen outside the vestibular root and nuclei, except for small-caliber fibers from the SV heading towards the brachium conjunctivum. The findings clearly indicate a specific termination for each of the two ampullar nerves. PMID- 1793168 TI - Scanning electron microscopic study of the splenic vascular casts in common tree shrew (Tupaia glis). AB - Splenic vascular casts of the common tree shrew, Tupaia glis, were constructed with Batson's No. 17 plastic mixture and studied with the scanning electron microscope (SEM). Fifteen adult animals of both sexes, weighing between 120 and 180 g were used. Under ether anaesthesia, each animal was injected with 0.05 ml heparin intracardially; the right atrium was cut open and then 250 ml of 0.9% NaCl, followed by 50 ml of 10% neutral formalin, (in four animals) was injected through the left ventricle. Plastic mixture was injected through the same opening. After complete polymerization of the plastic, the spleen and surrounding tissues were removed and macerated in 40% KOH. The air-dried casts were then coated with carbon and gold before viewing and photographing under SEM at 15 kV. It was found that the splenic arteries penetrated deep into the organ before they divided into trabecular arteries and divided again into central arterioles. Each central arteriole sent out 15 to 30 radiating arterioles, called penicillar arterioles, and further divided into smaller vessels entering the marginal zone and red pulp. In this area each arteriole continued directly into either marginal or red pulp sinusoids. The sinusoids emptied into pulp venules which joined to form trabecular veins. Most of the trabecular veins travelled to the cortical area underneath the splenic capsule before approaching the hilum, where they finally drained into splenic and short gastric veins. It is likely that the spleen of the common tree shrew has a closed circulation. PMID- 1793169 TI - A note on the development of the vestibulo-ocular pathway in the chicken. AB - The vestibulo-ocular pathways have been examined in embryonic chicks using horseradish peroxidase or diI as retrograde and anterograde tracers. The vestibular neurons project to the rostral, external eye motor nuclei over one or the other of three separate pathways; the ipsilateral and contralateral medial longitudinal fascicle and the contralateral brachium conjunctivum. The brachium conjunctivum component originates dorsally in the superior vestibular region and projects to the contralateral inferior oblique and superior rectus motor nuclei. An ipsilateral component of the medial longitudinal fascicle is labeled from more ventral sites in the vestibulo-cerebellar process and terminates in the ipsilateral superior oblique and inferior rectus nuclei. The contralateral medial longitudinal fascicle component originates still more ventrally and terminates in the contralateral superior oblique and inferior rectus motor nuclei. Accordingly, the vestibulo-ocular pathways in chickens operate predominantly on synergistic pairs of external eye muscles. These selective terminal fields are established within a day or two after the first terminals invade the eye motor nuclei during embryogenesis. PMID- 1793170 TI - Distribution of synapses on an intracellularly labeled small pyramidal neuron in the cat motor cortex. AB - The morphological characteristics and distribution of synapses on a small pyramidal neuron in layer III of the cat motor cortex have been studied by combining intracellular HRP staining and electron microscopic examination. The stained neuron showed spiny apical and basal dendritic profiles under the light microscope, and exhibited the morphological features of a pyramidal neuron. Ultrastructural analysis indicated that about 80% of the presynaptic terminals formed asymmetrical synapses with spines of distal apical and basal dendrites. On proximal apical dendrites, 64% of the synapses were found to make contact with spines, and 16.7% of the synapses were of symmetrical type and formed with dendritic shafts. Two types of terminal could be identified on the soma; they were alternately located and established symmetrical and asymmetrical synaptic contacts respectively. Possible functional implications are discussed. PMID- 1793171 TI - Quantitative morphology of the nervous system: expanding horizons. AB - In this review, we show how some of the recent developments in quantitative morphology (QM) are creating exciting new opportunities for studying the structure of the nervous system. We begin with a brief overview of QM, focusing on the problems neurobiologists are likely to encounter when collecting and interpreting data from tissue sections. Many of these problems, which range from selecting a sampling method to learning the latest methods, are being solved by creating a new generation of research tools. We describe several of these new tools and show how they can be used to assemble new quantitative methods for in situ hybridization, immunocytochemistry, and camera lucida drawings. The review includes examples of how QM is being used to study the brain and concludes with a brief discussion of diagnostic pathology and its need for new quantitative approaches. PMID- 1793172 TI - The use of the optical disector to estimate the total number of neurons in the developing chick lateral motor column: effects of purified growth factors. AB - Competition between neurons for limited amounts of trophic factors is believed to be the basis for large-scale neuronal death during the normal development of the vertebrate nervous system. In this study, an unbiased stereological counting method, an optical disector/Cavalieri combination, was used to estimate the total number of motor neurons in the lateral motor column of the developing chick and to assess the effects of four growth factors on neuronal numbers. The total number of neurons in lateral motor columns at embryonic day 6 (E6), E8, E10 and E12 were 18,747 +/- 1,369 (mean +/- SD), 15,037 +/- 1,816, 10,245 +/- 940, and 8,802 +/- 797, respectively. Daily exposure from E6 to E9 to three of the growth factors (basic fibroblast growth factor, bFGF; leukemia inhibitory factor, LIF; nerve growth factor, NGF) had no effect on total neuron number at E10. However, exposure to ciliary neurotrophic factor (CNTF) from E6 to E9 significantly increased (P less than 0.05) the number of neurons in the lateral motor column (13,610 +/- 725, compared with 10,058 +/- 204 in normal saline controls). These results are in agreement with previous reports of large scale neuronal death in the developing chick lumbar lateral motor column between E6 and E12 and confirm that exposure to growth factors such as CNTF can mitigate the course of normal ontogenetic cell death. The optical disector/Cavalieri combination is an efficient method for counting neurons: on average, following sectioning and staining, less than 30 min was required to estimate the total number of motor neurons in a lateral motor column with a coefficient of error of approximately 10%. PMID- 1793173 TI - A morphometric and computer-assisted three-dimensional reconstruction study of neural tube formation in chick embryos. AB - The origin of the driving forces for neural tube formation remains uncertain but is currently thought to involve the participation of microfilament bundles situated in the apical ends of neuroepithelial cells. In the work presented here, we show how morphometric measurements that map local variations in the apical geometry of neuroepithelial cells (especially apical constriction) can provide information on the distribution of motive forces within the neuroepithelium during neural tube formation. When used in combination with computer-assisted, three-dimensional reconstruction, it becomes possible to analyze the morphometric data from a dynamic, three-dimensional perspective. As an example application of this method, we have used morphometry to evaluate the effects of ionomycin on the developing neuroepithelium. Treatment of early (stages 6-8) chick embryos with 5 microM ionomycin was found to cause rapid bending of the neuroepithelium within 1 min of exposure and a dramatic acceleration of the normal sequence of neural tube formation. Electron microscopy and morphometry revealed that this acceleration was coincident with a marked increase in the local degree of apical constriction of neuroepithelial cells, presumably a consequence of enhanced contractile activity of apical microfilament bundles. This work shows that transient elevation of free calcium levels can accelerate the usual sequential phases of NT formation. The rapidity of the response (hours of normal development reduced to minutes), increased prominence of apical microfilament bundles, and the enhanced degree of apical constriction strongly support a direct causal role for apical microfilament bundles and apical constriction of neuroepithelial cells in bending of the neuroepithelium. PMID- 1793174 TI - Widespread release of peptides in the central nervous system: quantitation of tannic acid-captured exocytoses. AB - Tannic acid methods have been applied to capture the exocytosis of peptide containing granules from peptidergic neurons. The captured exocytoses have been quantitated to assess the proportion and amount of peptide released at different parts of the neuronal membrane. Examination of hypothalamic synaptic boutons shows that only about one-half of the peptidergic vesicles is exocytosed into the synaptic cleft and also that exocytosis also occurs from undilated peptidergic axons. Study of the magnocellular neurosecretory system reveals that all parts of their extensive terminal arborization appear to be equally capable to exocytose peptide. Only about one-half of their peptide is released from their nerve endings, which about the capillaries. The remainder is released much deeper in the lobules of secretory tissue where its principal target(s) could be the pituicytes and/or neurosecretory axons. Dendrites of magnocellular neurons are also capable of releasing peptide by exocytosis and dendrites could release sufficient oxytocin and vasopressin to account for the peptide known to be released into the hypothalamus. We conclude that peptidergic neurons release substantial amounts of peptides from all of their processes and that this must be taken into account when considering what functions those peptides might serve. PMID- 1793175 TI - Gonadotropin-releasing hormone mRNA in the rat: distribution and neuronal content over the estrous cycle and after castration of males. AB - The decapeptide gonadotropin-releasing hormone (GnRH) stimulates release of luteinizing hormone (LH) and follicle-stimulating hormone (FSH) from the anterior pituitary. In the present study we used a 51-base oligonucleotide probe and in situ hybridization to study the neuronal content of GnRH mRNA at several time points in the estrous cycle and 7 days after castration of male rats. GnRH mRNA containing cells were found in the medial septum (SEPT), the vertical and horizontal limbs of the diagonal band of Broca (DBB), and throughout the preoptic area (POA) from the organum vasculosum of the lamina terminalis (OVLT) to its caudal merger with the anterior hypothalamus. The number of neurons producing detectable quantities of GnRH mRNA was not different either among females killed at 0700 h proestrus, 1000 h estrus, or 1900 h of diestrus 1 or between intact male rats and male rats killed 1 week after castration. We did, however, detect a significant difference in the number of GnRH mRNA producing neurons between males and females (P less than 0.05), where females had 20% more labeled cells. We detected no significant difference in the relative copy number of GnRH mRNA molecules (grains per labeled cell) either over the estrous cycle or between intact and castrate males. However, females overall had 24% more grains per labeled cell than males (P less than 0.05). These results suggest that gonadal steroid regulation of GnRH both over the estrous cycle and after short-term castration of males is mediated primarily by cellular processes subsequent to GnRH gene regulation. Furthermore, these results suggest that biosynthetic activity of GnRH is higher in females than in males. PMID- 1793176 TI - Unbiased stereological estimation of the total number of neurons in thesubdivisions of the rat hippocampus using the optical fractionator. AB - A stereological method for obtaining estimates of the total number of neurons in five major subdivisions of the rat hippocampus is described. The new method, the optical fractionator, combines two recent developments in stereology: a three dimensional probe for counting neuronal nuclei, the optical disector, and a systematic uniform sampling scheme, the fractionator. The optical disector results in unbiased estimates of neuron number, i.e., estimates that are free of assumptions about neuron size and shape, are unaffected by lost caps and overprojection, and approach the true number of neurons in an unlimited manner as the number of samples is increased. The fractionator involves sampling a known fraction of a structural component. In the case of neuron number, a zero dimensional quantity, it provides estimates that are unaffected by shrinkage before, during, and after processing of the tissue. Because the fractionator involves systematic sampling, it also results in highly efficient estimates. Typically only 100-200 neurons must be counted in an animal to obtain a precision that is compatible with experimental studies. The methodology is compared with those used in earlier works involving estimates of neuron number in the rat hippocampus and a number of new stereological methods that have particular relevance to the quantitative study of the structure of the nervous system are briefly described in an appendix. PMID- 1793177 TI - Medial nucleus of the amygdala in the adult Syrian hamster: a quantitative Golgi analysis of gonadal hormonal regulation of neuronal morphology. AB - The medial nucleus of the amygdala (Me) processes both chemosensory and hormonal input. In the male Syrian hamster the integrity of this nucleus is essential for normal reproductive behavior. To determine if gonadal steroids modulate neuronal structure in this nucleus, the morphology of Golgi-stained neurons in the anterior and posterior regions of Me were compared in castrated and reproductively intact adult hamsters. In castrated males, neurons in the posterior, but not the anterior, region of Me undergo structural changes, as indicated by a decrease in the mean highest dendritic branch level and mean somal area compared to intact males. To further elucidate the importance of testosterone and its metabolites in maintenance of neuronal structure in the adult, seven groups of male Syrian hamsters were studied. Animals were castrated and received a blank silastic capsule or a capsule filled with either testosterone, dihydrotestosterone, or estradiol, or two capsules containing both metabolites, dihydrotestosterone and estradiol. Two groups of reproductively intact animals were included: brains from one group were processed simultaneously with the castrated and hormone-treated groups (control intact group), and the other group was processed at the beginning of the experiment. Animals were tested for mating behavior and flank glands were measured to test whether the capsules were effective in releasing the hormones into circulation. After a 12-week survival period, the brains were processed with Golgi stain and well-impregnated neurons from the posterior Me were quantitatively analyzed for somal area, highest dendritic branch, total dendritic length, and density of spines. All the measures analyzed revealed a consistent pattern of response to the different gonadal steroids. Castration resulted in a decrease in the mean somal area, the mean highest dendritic branch, and the percentage of neurons with tertiary branch segments. Dihydrotestosterone treatment also resulted in a significant decrease in somal area, mean highest dendritic branch, and percentage of neurons with tertiary dendritic branches. In addition, the total dendritic length and spine density on terminal dendrites were reduced in these brains. The remaining hormone treatment groups were not significantly different from the control group. These results suggest that in orchidectomized male Syrian hamsters, testosterone or its aromatized form, estradiol, but not dihydrotestosterone, is sufficient to maintain the normal morphology of the neurons in the posterior part of the medial nucleus of the amygdala. PMID- 1793178 TI - Spatial segregation between populations of ponto-cerebellar neurons: statistical analysis of multivariate spatial interactions. AB - This study applies terms and methods for describing spatial interactions between multivariate spatial point patterns, which are, to our knowledge, new in neurobiology. We consider two categories of points, type 1 and 2, distributed within a certain reference volume (such as a nucleus of the brainstem or a cortical area). The points may, for example, represent different categories of labelled cells or axonal fields of termination. We say that there is spatial neutrality between points of type 1 and 2 if the types are signed by random labelling. If a mechanism drives the two point categories together, we say that the point patterns are positively associated. Conversely, if a mechanism drives type 1 and 2 points apart, we say that they are segregated. By comparing two cumulative distribution functions of distances between points, we can distinguish neutrality, positive association, and segregation. One function, H12(t), is the cumulative distribution function of the distance t between a pair of randomly selected points of type 1 and 2. The other, H00(t), is the corresponding function for a pair of points randomly selected without reference to type. Plots of the estimated difference between these two functions give an indication of positive association, neutrality, or segregation. A statistical test, based on simulations of random (neutral) distributions, can be used to see whether deviations from neutrality are significant. We apply the analysis described above to a major pathway of the brain, namely the ponto-cerebellar projection. Different types of cells in the pontine nuclei are retrogradely labelled with the fluorescent tracers Rhodamine-B-isothiocyanate, Fluoro-Gold, and Fast Blue. The tracers are injected in adjacent or more distant folia of the cerebellar paraflocculus. The location of the somata of labelled cells are recorded and the total distribution reconstructed in three dimensions and displayed on a dynamic graphics workstation. We ask whether different units (folia) in the paraflocculus receive information from the same population, from two different positively associated populations, or from segregated cell populations. We find a statistically significant tendency for cell populations projecting to adjacent folia to be positively associated, although there are few cells containing multiple labels. Populations of neurons projecting to folia wider apart are significantly segregated. From inspections of the reconstructions, using real-time rotations, we find that the swarms of labelled neurons tend to accumulate in shells or lamellae in the pons. Within the lamellae, the cells are aggregated in clusters and bands with empty holes (containing unlabelled ponto-cerebellar cell bodies, presumably projecting to other cerebellar targets) in between.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1793179 TI - Dendritic and synaptic properties of collicular neurons: a quantitative light and electron microscopical study of Golgi-impregnated cells. AB - The present study deals with a light- and electron microscopic morphometric analysis of Golgi-impregnated neurons in the superior colliculus of rats with the purpose to unravel inter- and intralaminar differences in their dendritic and synaptic organization. In particular, layer IV was studied and compared with its boundary layers III and V. The results show that collicular cells in layer IV basically form a homogeneous population with respect to the number of primary dendrites, the total length of impregnated dendrites, and the diameter, ellipticity, and orientation of dendritic fields and somata of Golgi-impregnated neurons. Somata of reconstructed small cells in layer III and IV as well as V have all a similar density of about 40 synaptic contacts per 100 microns2 surface. However, the cell bodies of large multipolar cells in layer V have a slightly but significantly larger synaptic density (about 50 per 100 microns2). Dendrites of large and small collicular cells had no significantly different synaptic densities (43 and 48 per 100 microns2, respectively). In conclusion, the present results show only minor dendritic and synaptic differences between individual cells in the same layer, as well as in neighboring layers, which implies a low degree of cellular and synaptic intra- and interlaminar differentiation. It is discussed that this organization differs markedly from that in other visual centers, including the collicular homologue, the tectum of lower vertebrates, and the mammalian visual cortex, where pronounced inter- and intralaminar differentiations exist. Such an organization may provide a framework of laminar specificity by which distinct cell types may select a restricted set of input out of all information available. The present quantitative investigation suggests that a similar framework is not present in the superior colliculus. PMID- 1793180 TI - Ipsilaterally projecting rubrospinal neurons in adult and developing opossums. AB - We have combined injections of Fast Blue with lesions of the rubrospinal tract rostral and contralateral to them to determine if an ipsilateral rubrospinal projection exists in adult or developing opossums and, if so, to characterize the neurons giving rise to it. Although the results indicate that some rubral neurons project ipsilaterally, they are very few in number. Using quantitative and image analysis techniques, we have shown that 0.6% of the rubral neurons that project to the lumbar cord in adult opossums do so ipsilaterally and that such neurons are comparable in location and size to those that project contralaterally. Similar results were obtained in developing opossums. Our results are discussed in light of rubrospinal development and ongoing experiments related to rubrospinal plasticity. PMID- 1793181 TI - Quantitative non-radioactive in situ hybridization of preproenkephalin mRNA with digoxigenin-labeled cRNA probes. AB - Non-radioactive detection of mRNA with in situ hybridization histochemistry has emerged as an important new technology for the study of gene expression. Quantitative in situ hybridization studies have generally relied upon counting of autoradiographic grains in the emulsion overlying cells containing hybridized, radioactively labeled probe. However, such high resolution studies require tedious grain counting over individual cells, frequently in addition to weeks of exposure to nuclear emulsion. The present report describes a quantitative, non radioactive approach to the detection of a specific mRNA in the brain with the advantages of comparatively rapid tissue processing and computerized image analysis. The validity of this approach was tested by measuring the haloperidol induced increase in the level of preproenkephalin mRNA in striatal sections of the rat brain using an RNA probe labeled with digoxigenin-11-UTP. Detection of probe hybridized to tissue sections was carried out enzymatically following complex formation with an antidigoxigenin-alkaline phosphatase conjugate. Using computerized image analysis, it was found that chronic treatment of rats with haloperidol resulted in a 50 +/- 6% increase in striatal neuronal optical density, a value in good agreement with previous studies using low-resolution radioactive methods, showing a 30-80% increase in striatal preproenkephalin mRNA hybridization signal. PMID- 1793182 TI - Verification of the disector method for counting neurons, with comments on the empirical method. AB - The empirical and disector methods are unbiased sampling methods for determining numbers of neurons. The present study verifies and thus calibrates these methods by determining true numbers of ganglion cells in serial reconstructions and then using each method to estimate the same populations. The empirical method gives accurate counts but is laborious (inefficient). Five separate disector analyses, distinguished by height (h), were done for each ganglion. The findings are: (1) that the estimates are consistently low when h is minimal (reference and look-up sections are adjacent), but (2) the estimates are accurate when h is greater (one to four sections intervene between reference and look-up sections). We ascribe the difficulties with the first disector to "lost" or "invisible" caps. We emphasize that we would not have known of the problem unless we verified our counts. If there is suspicion that difficulties with profile recognition might occur, we recommend that serial sections of an appropriately chosen sample of tissue be prepared and 500-1,000 neurons (or, more generally, particles) be reconstructed. Then the method of choice can be used on the issue of choice to make certain of the necessary accuracy before proceeding with the main study. PMID- 1793183 TI - Layered collagen fabric of cerebral aneurysms quantitatively assessed by the universal stage and polarized light microscopy. AB - We evaluated the effectiveness of the Universal stage, an instrument for measuring three-dimensional orientation of birefringent materials, for studying the collagen fabric in the wall of brain aneurysms. Vessels from autopsy were fixed at normal arterial distending pressure with 10% formalin, and prepared for polarized light microscopy, with paraffin embedding and staining with picrosirius red for birefringent enhancement. Quantitative data were obtained from tangential and oblique sections (7 microns thickness) of an intact 8 mm aneurysm, a 1.5 mm aneurysm, and a tangential section (3 microns thickness) of a cerebral artery. Sections of full-size aneurysms seen through the microscope, adjusted either for plane or circularly polarized light, revealed distinctive layers of collagen across the aneurysmal wall, which at higher magnification were further subdivided. Three-dimensional measurements, numbering 1,082, were made by use of the Universal stage attachment to the polarizing microscope. They were plotted by computer-controlled graphics on Lambert projections and analyzed by circular statistics. When assessed layer by layer, the collagen spanned a full range of orientations relative to the tangential plane. The circular standard deviation, a measure of the spread of alignment about the mean, was as low as 10 degrees for coherently organized collagen and as high as 40 degrees for the least coherently organized collagen, values characteristic of either the organized tunica media, or the least organized tunica adventitia of cerebral arteries. Although there was a marked thinning of the wall of one aneurysm, there was no evidence of structural weakness based only on the directional organization assessed by our measurements. PMID- 1793184 TI - [Duodenogastric reflux]. PMID- 1793185 TI - [Lymphoblastic non-Hodgkin's lymphoma: estimation of the survival of patients with the disseminated form of the disease (stages III and IV) treated by the LSA2 L2 protocol]. AB - We analyze the survival rate in 17 pediatric patients (twelve males and five females) that were diagnoses of non-Hodgkin's lymphoblastic lymphoma (cases with Burkitt's lymphoma were excluded) during the period from 1982 to 1990. All of them were treated using the LSA2-L2 therapeutic protocol. The follow-up period ranged from 14 to 99 months (follow-up median 43 months). Staging of our newly diagnosed patients, we found 9 patients in stage III and 8 in stage IV disease. Survival was analyzed by the Kaplan-Meier method. The overall survival rate of our patients is 69.5% and the disease free survival is 62.6%. The disease free survival for separated stages is 66.5% for stage III and 58.3% for stage IV. We compare our results with other casuisties published in literature. PMID- 1793186 TI - [Accidents in childhood: apropos of 14,301 cases treated in the course of one year]. AB - The present study aims: to revise all the cases of paediatric accidents attended at a Emergency Service of a tertiary Hospital; to analyze the epidemiological variables; and to try to draw conclusions in view of prevention. In order to achieve that, the 14.301 accidents attended during 1989 have been collected. The relation between little boys and little girls is 58.2:41.8. The average age is 7.12 years, though the mode has been 2 years. A larger number of accidents occur during non holiday. 44.3% of cases are attended between 18 and 23 hours. 89% of the accidents are, first of all, traumatisms and/or wounds; secondly, those which are produced by strange bodies (4.4%). In 51.9% of cases no complementary trial was carried out. Only 2.9% of cases were admitted to hospital, whereas 104% requires observation, and the rest returns home. The variables in the admitted patients are also analyzed, and a brief exposition of results for each of the 6 diagnostic groups is made. PMID- 1793187 TI - [Treatment of acute epiglottitis]. AB - We analyze 13 children between 1 and 3 years old (mean: 24.6 +/- 6.5 months), who were diagnosed (by direct or radiological examination) of epiglottitis. Seven were male. All of them had fever and respiratory distress. Six blood cultures (46%) were positive for Hemophilus Influenzae, and in 5 cases were resistant to beta-lactamases. Diagnose was made by radiology (70%) or by direct examination (30%). Five patients were not intubated (38%), with a favorable outcome. One died after a cardiorespiratory arrest due to self-extubation. We describe in this study our experience in the conservative treatment of epiglotitis, although initial nasotracheal intubation is the safest method for the management of this entity. PMID- 1793188 TI - [Inflammatory disease of intestine in the child]. AB - We review 28 patients with IBD (14 UC and 14 CD) diagnosed in a period of eight years (1982-1990). The age at the onset of symptoms was similar in both groups (8.1-8.7 years), but the delay in diagnosis was significantly higher in CD (16.2 months). Fever, growth retardation and oral and perianal lesions were more frequent in CD. Articular, mucocutaneous and hepatic were the more usual extraintestinal manifestations. All of them were more frequent in CD. The same comment can be made with respect to the abnormal laboratory test results. Colonoscopy including histological studies was the useful diagnostic method. An increase of the incidence of IBD it has been observed. PMID- 1793189 TI - [Supraventricular paroxysmal tachycardia without congenital heart disease: clinical, therapeutic aspects and course in 65 children]. AB - We have reviewed the records of 65 children with paroxysmal supraventricular tachycardia (PST) without congenital heart disease followed a mean of 4 years, with a total of 121 episodes. PST appeared before 6 months of age in 42 (64.6%) children. Thirteen patients (20%) had a present factor which might predispose to PST in 66.2% of the patients who were younger than 6 months of age, and in only 4.3% of those over 6 months. Wolff-Parkinson-White syndrome was present on surface ECG during sinus rhythm in 26.1% of children younger than 6 months, and in 39.1% of those over 6 months. Digoxin was the initial treatment in 84.3% of the episodes with a success rate of 75% when were employed alone and of 84.2% when were employed in combination of quinidine. PST recurred at least once in 35 children (53.8%), the 90% within three months of the first episode. All patients were alive and 63 (96.9%) doing well. One patient developed cerebral anoxia and now has hemiparesia and another patient has incessant PST. We conclude that children with PST without congenital heart disease and without delay in diagnosis had a good outcome. PMID- 1793190 TI - [Use of antihistaminics in pediatric dermatology]. PMID- 1793191 TI - [Ornithine-transcarbamylase deficiency: prognostic difficulties]. AB - We report six cases of Ornithine-transcarbamylase deficiency. Unlike some classical descriptions but in accordance with recent reports, sex had no determinant influence on the outcome. PMID- 1793192 TI - [Risk factors in 130 children suspected with hip dysplasia ]. AB - The authors report the result of a statistical study under stake for screening of congenital dislocation of the hip. Several factors was analyzed (season, maternal age, delivery, gestational age, sex, weight). 6.135 newborn child study in 36 months. In 130 (2.1%) baby were suspected congenital dislocation and the traumatological exploration was: 76 baby (58%) were normal; 54 baby (41%) were diagnosed congenital dislocation of hip. The incidence was 0.8% and the rate female/male: 6/1. PMID- 1793193 TI - [Congenital non-bullous ichthyosiform erythroderma, evolutive form of "collodion baby". Apropos of a case]. PMID- 1793194 TI - [Pulmonary hypertension and intracardiac thrombosis. Complications of ventriculoatrial shunt]. PMID- 1793195 TI - [Pyloric atresia-- congenital epidermolysis bullosa syndrome: report of a new case]. PMID- 1793196 TI - [Severe anaphylactic reaction to the rupture of a hydatid cyst caused by abdominal trauma]. PMID- 1793197 TI - [Pseudo-cardiomyopathy secondary to chronic incessant supraventricular tachycardia]. PMID- 1793198 TI - [Fever of unusual etiology during the postoperative period following extracorporeal heart surgery]. PMID- 1793199 TI - [Dysgenesis of the anterior horns and nuclei of the brain stem in multiple congenital arthrogryposis. Presentation of a case]. PMID- 1793200 TI - [Autosomal dominant polycystic kidney disease in a newborn]. PMID- 1793201 TI - [Osteoarticular tuberculosis]. PMID- 1793202 TI - [Biological profile and value of the determination of tartrate resistant acid phosphatase in children]. PMID- 1793203 TI - Antigen-specific tolerance induced by autoimmunization with photoinactivated syngeneic effector cells. AB - Development of a protocol that could invoke specific suppression of an undesired immune response, while sparing normal immune competence, would be of great clinical value. This report demonstrates that multiple infusions of splenocytes sensitized in vivo to sheep red blood cells (SRBC) and photoinactivated in vitro with 8-methoxypsoralen and ultraviolet A light can render a syngeneic recipient selectively unresponsive to subsequent challenge with this antigen. Mice treated in this fashion did not develop a T cell-mediated delayed type hypersensitivity (DTH) reaction to SRBC. In contrast, control mice exposed to nonimmune splenocytes pretreated in an identical manner developed a normal DTH response to SRBC, thereby demonstrating that drug and light in the absence of effector T cells were not suppressive. Inhibition of the DTH response was antigen specific, since animals rendered unresponsive to SRBC developed a normal DTH response to chicken red blood cells. Cell transfer experiments demonstrated that unprimed recipients of splenocytes from mice rendered unresponsive to SRBC could not mount a DTH reaction when challenged. Moreover, this procedure can also suppress established immunity to that antigen. The use of photoinactivated syngeneic antigen-reactive effector cells as immunosuppression agents suggests that this method may be clinically useful in inhibiting pathogenic antigen-specific immunologic reactions. PMID- 1793204 TI - T cell vaccination in autoimmune diseases. AB - The effectiveness and the mechanism of T cell vaccination were studied in two experimental models of autoimmune disease. The attempt to modulate autoimmune disease via idiotypic regulation of autoreactive antigen-specific T cells was first shown in the rat experimental autoimmune encephalomyelitis (EAE) model where inactivated EAE-inducing T cells could both immunize and protect rats from EAE. We previously reported that low dose T cell vaccination against EAE in Lewis rats was immunologically specific, long lasting and extremely efficient in preventing adoptive transfer of the disease. In experimental autoimmune uveitis (EAU) T cell vaccination was also found to be effective. In both cases, antigen or mitogen activation of the T cells prior to inoculation was required. In the EAE model, T cell vaccination appeared to be associated with two sets of T lymphocytes (CD4+ CD8- helper and CD4- CD8+ cytotoxic/suppressor cells) which were cloned and found to be specifically reactive to the vaccine cells. These anti-idiotypic T cell clones were able to antagonistically modulate the in vitro proliferation of encephalitogenic Z1a cells. In vivo, transfer of the lymph node cells (from which the anti-idiotypic clones were derived) from vaccinated animals to naive syngeneic recipients conferred resistance to EAE. In the EAU model, we also found a consistent immunological response raised against different activated T cells (four T cell lines with irrelevant specificities and mitogen-activated lymphoid cells) in addition to the anti-idiotypic cells. This response, apparently directed to T cell activation markers, might combine with the anti idiotypic response to regulate autoimmunity. PMID- 1793205 TI - Photopheresis: a clinically relevant immunobiologic response modifier. AB - Photopheresis, the process by which peripheral blood is exposed in an extracorporeal flow system to photoactivated 8-methoxypsoralen (8-MOP), is an effective new treatment for certain disorders caused by aberrant T lymphocytes. It has become a standard therapy for advanced cutaneous T cell lymphoma and shows promise in the treatment of four autoimmune disorders (pemphigus vulgaris, the progressive systemic sclerosis form of scleroderma, rheumatoid arthritis, systemic lupus erythematosus) and in reversal of immunologic rejection of transplanted organs. Positive immunologic alterations observed in patients with AIDS-related complex merit further investigation, and preliminary trials in the management of patients with multiple sclerosis, myasthenia gravis and autoimmune insulin-dependent diabetes mellitus have recently been initiated. The inability of the treatment to meaningfully alter the course of the B cell malignancy, chronic lymphocytic leukemia, suggests that B cell proliferations, at least those involving malignant cells, may be more resistant to this treatment. The mechanism of action of photopheresis is likely to be multifaceted, but at least in experimental systems appears to involve an immunization against the pathogenic T cells, in a highly specific manner. Photoactivated 8-MOP initiates a cascade of cellular events by forming covalent photoadducts with nuclear DNA, with cell surface molecules and possibly with other cytoplasmic components of the ultraviolet exposed leukocytes. For reasons not yet clear, exposure of populations of T cells containing expanding a clone(s) of pathogenic T cells to photoactivated 8-MOP alters these cells so that their reinfusion induces a therapeutically significant immunologic reaction that targets unirradiated T cells of the same pathogenic clone(s). It is suggested that the specificity of the induced immunologic reaction may result, in sequence, from the exquisitely titratable damage that 8-MOP inflicts upon cells of the pathogenic clone(s), the return of these cells to an immunocompetent individual, the removal of the photo damaged cells from the blood by the reticuloendothelial system and the preferential induction of an immune response against cells of the pathologically expanded clone(s). PMID- 1793206 TI - Adult T cell leukemia/lymphoma. Perspectives on the treatment. PMID- 1793207 TI - Photopheresis for cutaneous T cell lymphoma. PMID- 1793208 TI - Anti-idiotypic immunity as a potential regulator in myeloma and related diseases. AB - In this paper some recent and partly preliminary results on anti-idiotypic immunity against clonal B cells in human monoclonal gammopathies are summarized. B cell lines producing antibodies to idiotypic determinants on autologous monoclonal immunoglobulin could be propagated after activation with Epstein-Barr virus of peripheral blood lymphocytes from patients with MGUS and MM clinical stage I but not from untreated persons with advanced MM. Blood T lymphocytes from patients with MGUS and Waldenstrom's macroglobulinemia were activated to DNA synthesis and production of interleukins by the autologous M protein. In another series of experiments T cell clones raised from patients with MM clinical stage I and MGUS bound F(ab')2 fragments of the autologous M protein and were stimulated to DNA synthesis by the idiotope-bearing protein. Control experiments demonstrated the specificity for idiotypic determinants. Ten of eleven clones were CD4-/CD8+. Finally, using a panel of 8 mAbs to alpha/beta V region epitopes, we noted a clonal expansion of CD4+ and CD8+ T cells in MGUS and MM patients. PMID- 1793209 TI - T cell molecular targets for psoralens. PMID- 1793210 TI - Photopheresis in the treatment of autoimmune disease: experience with pemphigus vulgaris and systemic sclerosis. PMID- 1793211 TI - Photopheresis for rheumatoid arthritis. AB - For rheumatoid arthritis, an effective therapy with minimal toxicity would be welcome. In a six-month pilot study of seven patients with a variety of presentations and previous treatments, we tested a therapy involving the extracorporeal photoactivation of biologically inert methoxsalen (8 methoxypsoralen) by ultraviolet A energy to a form that covalently cross-links lymphocyte DNA; the injured cells are returned to the patient. Prior experimental studies had indicated that this regimen produces an immune reaction against antigens on treated T Cells, and a clinical trial in cutaneous T cell lymphoma had been successful. The current patients were treated on two successive days monthly (or, later on, biweekly). Between 12 and 16 weeks of therapy there appeared to be a breakpoint after which joint counts and joint scores of four patients began to improve. In three of them, these measures eventually diminished by mean values of 71% and 80%, respectively, of their baseline values, along with variable improvement in less direct indicators of clinical response. The joints of the fourth patient improved modestly (by 33% and 59%, respectively, of baselines) but he required alternative therapy, and those of the remaining three patients did not improve. Mean slopes for the joint counts were significantly different from zero after the apparent breakpoint (but not before), whether one examined the four apparent responders (p = 0.01) or the entire group of seven (p = 0.01). After completion of therapy, there was also a delay, of two to three months, in the clinical deterioration of those who had improved. There was only one mechanical adverse effect--a single episode of transient hypotension in 102 treatment sessions--and no toxic ones. This preliminary study suggests that extracorporeal photochemotherapy may be effective at least in the short term in certain patients with rheumatoid arthritis, with less apparent toxicity than that of any of the drugs currently used for this disorder. It deserves further evaluation. PMID- 1793212 TI - Antigen-driven peripheral immune tolerance. Suppression of organ-specific autoimmune diseases by oral administration of autoantigens. PMID- 1793213 TI - Immunotoxins and cytokine toxin fusion proteins. AB - Paul Ehrlich first suggested the simple and elegant concept of creating specific cell toxins or "magic bullets" through the fusion of cell-specific antibodies and toxins. In practice it has proven difficult to create safe and effective "magic bullets." In the past several years, several immunotoxins have been applied to clinical testing. These immunotoxins have been created by the biochemical coupling of cell- or lineage-specific monoclonal antibodies to plant toxins or fragments thereof. These immunotoxins have been used to treat bone marrow transplant recipients and patients with autoimmune disorders. In recent years, another strategy has also been pursued to create hybrid toxins. Rather than use antibodies as the targeting moiety, cytokines have been used to target a select population of cells bearing a high copy number of receptors for the specific cytokine. Rather than biochemically couple a cytokine to the toxin, the cytokine and toxin are fused by a peptide bond established via genetic engineering. A prototype IL-2 diphtheria toxin-related fusion protein is now being tested in the clinic for treatment of hematopoietic malignancies and autoimmune disorders. PMID- 1793214 TI - Immunopotentiation of anti-viral and anti-tumor immune responses using anti-T cell receptor antibodies and mitogens. AB - Although the immunosuppressive properties of anti-CD3 mAbs are now widely recognized, we have accumulated data characterizing the T cell activating properties of these antibodies. While in some situations these activating properties may be viewed as unwanted side-effects (for instance OKT3-mediated T cell activation may be responsible for some of the first dose toxicity seen with patients receiving OKT3 for suppression of allograft rejection), we have shown that anti-CD3 mAb therapy can augment host immune responses and provide protection against some tumors and viral infections. Importantly, this augmented response allows the development of long term, specific immunity. Because the immunosuppressive and activating properties of anti-CD3 mAbs are so closely overlapping, we have sought to identify other agents that are capable of activating T cell subsets selectively. We have found that SEB activates T cell subsets selectively in vivo and that this activation can be exploited to prevent the outgrowth of a malignant murine tumor. Studies currently in progress, including phenotypic and functional analysis of TILs and in vivo T cell subset depletions, should result in a more precise understanding of how SEB-induced T cell activation inhibits tumor growth. PMID- 1793215 TI - The problems of presentation of T cell receptor peptides by activated T cells. PMID- 1793216 TI - Cytokine release by peripheral blood lymphocytes targeted with bispecific antibodies, and its role in blocking tumor growth. PMID- 1793217 TI - Antigen-induced tolerance to organ allografts. PMID- 1793218 TI - Protein engineering of DAB-IL-2 fusion toxins to increase biologic potency. PMID- 1793219 TI - Photopheresis for the treatment of lupus erythematosus. Preliminary observations. PMID- 1793220 TI - Immunophenotypic marker analysis of peripheral blood lymphocytes during extracorporeal photopheresis. PMID- 1793221 TI - Preparation and combining site characterization of mouse monoclonal anti-B blood group substances. PMID- 1793222 TI - Role of T cell activation in the pathogenesis of psoriasis. PMID- 1793223 TI - Prevention of in vivo alloreactions by adoptive immunotherapy with lymphokine activated killer cells. PMID- 1793224 TI - Release of oxygen-free radicals by neutrophils is reduced by photopheresis. PMID- 1793225 TI - Acetylcholine receptor-reactive T cells in murine experimental myasthenia react to all subunits of the receptor. PMID- 1793226 TI - An outer surface protein is a major T cell antigen in experimental Lyme disease in CB6F1 mice. PMID- 1793227 TI - Immunological alterations during photopheresis and D-penicillamine treatment of systemic sclerosis. PMID- 1793228 TI - DAB486IL-2 (IL-2 toxin) selectively inactivates high-affinity IL-2 receptor bearing human peripheral blood mononuclear cells. PMID- 1793229 TI - Effect of prednisolone and cyclophosphamide on inhibition of the response to alloantigen induced by treatment with photoinactivated effector T cells (PET cells). PMID- 1793230 TI - Tum- antigens, TSTA, and T cell immune surveillance. PMID- 1793231 TI - Thymocyte activation and death: a mechanism for molding the T cell repertoire. AB - The programmed death of thymocytes and T cells was studied. Injection of anti-TCR antibodies into adult mice caused the specific deletion of CD4+ CD8+ thymocytes, an effect that was largely reversed by cyclosporin A. Surprisingly, using either anti-TCR antibodies or superantigens, it was found that the susceptibility of these thymocytes to clonal deletion changed during ontogeny. Double positive thymocytes from newborn and young (3 week old) mice were readily depleted, whereas thymocytes from 1 week old mice were relatively refractory. The differences between these groups could not be accounted for by cell surface TCR expression, TCR-mediated early signal transduction pathways such as phosphoinositide hydrolysis or Ca2+ mobilization, or differences in susceptibility to Dex- or ionomycin-induced programmed cell death. These results suggest that there is a relatively synchronous wave of maturing thymocytes that are susceptible to deletional signals during fetal life and shortly after birth, but not 7 days after birth. By 3 weeks of age, the next wave (or waves) of susceptible cells have populated the thymus. These observations closely follow the experimental model known as "neonatal tolerance," and we suggest that the failure to tolerize 1 week old mice in that system reflects an alteration in the cells' susceptibility to clonal deletion. In a separate set of experiments exploring the mechanisms of PCD, it was found that although the activation- and glucocorticoid-induced PCD pathways were distinct (being distinguishable by their sensitivity to CsA and the glucocorticoid antagonist RU-486), they were mutually antagonistic. Attempts to identify the level of the antagonism failed to demonstrate any direct interference between the two stimuli, up to and including the transcription and translation of a GRE-controlled reporter gene. Based upon these observations, we propose the following model of thymocyte development: glucocorticoids eliminate thymocytes with little or no avidity for self; antagonism between glucocorticoids and cellular activation allows thymocytes that recognize self with low or moderate avidity to survive (positive selection); activation of thymocytes that recognize self with high avidity dominates the antagonistic effect of glucocorticoids, leading to PCD (negative selection). PMID- 1793232 TI - Immunoregulation of autoimmune disease by vaccination with T cell receptor peptides. AB - Restricted TCR gene usage in animal models of autoimmune disease has led to strategies for control of these diseases by targeting the idiotypic determinants within the TCR sequence. Rats can be rendered resistant to EAE by immunization with synthetic peptides representing sequences contained within the V beta, J alpha and VDJ beta regions of the TCR that are conserved among encephalitogenic T cells. We propose that the mechanism of immunoregulation thus produced results from the stimulation of an anticlonotypic response directed at endogenously synthesized TCR peptides presented by Class I MHC on the surface of the autoreactive T cell, and that this mechanism may be part of the natural immunoregulation of T cell responses. The experimental data demonstrate the utility of this therapeutic approach and its potential for treatment of any pathogenic condition mediated by specific, oligoclonal T cell populations. PMID- 1793233 TI - T cell V-gene usage in man in some normal and abnormal situations. PMID- 1793234 TI - Inhibition of antiskin allograft immunity induced by infusions with photoinactivated effector T lymphocytes (PET cells). Is in vivo cell transferrable? AB - We previously reported producing donor-specific tolerance to alloantigens by intravenous exposure to pretreated antidonor T cells. The current study extends that work by adoptively transferring the donor-specific tolerance into naive syngeneic recipients. Eight days after BALB/c mice received histoincompatible CBA/j skin grafts, their splenocytes which included an expanded population of cells mediating rejection were treated with 100 ng/ml 8-methoxypsoralen (8-MOP) photoactivated by 1 Joule/cm2 of ultraviolet A (UVA) light prior to infusion into naive BALB/c recipients. Whereas 8-MOP itself is biologically inert, photoactivated 8-MOP crosslinks DNA by covalently binding to pyrimidine bases. Recipient BALB/c mice which had been previously demonstrated to be hyporesponsive to CBA/j alloantigens in mixed leukocyte culture (MLC), cytotoxicity (CTL) and in vivo delayed type hypersensitivity (DTH) assays were the donors of spleen cells for the adoptive transfer experiments. Fifty to one hundred million viable spleen cells from these pretreated BALB/c mice were transferred into naive syngeneic recipients which then were tested for DTH response and allograft survival to the relevant and irrelevant antigens. The radiosensitivity of this transferrable suppression was evaluated by exposing the adoptively transferred cell population to 3200 rads of C-irradiation prior to cell transfer. The phenotype of the cells transferring this suppressive response was performed by depleting specific populations of cells with monoclonal antibodies prior to cell transfer. In vivo the DTH response of the pretreated BALB/c mice was specifically suppressed to the relevant alloantigen, correlating with retention of CBA/j skin grafts for up to 42 days post engraftment without visual evidence of rejection, in comparison to control mice complete rejection of the skin graft in less than 8 days. In vitro, splenocytes from BALB/c recipients of pretreated syngeneic splenocytes containing large numbers of BALB/c anti-CBA/j T cells proliferated less in MLC and generated lower cytotoxic T cell responses to CBA/j alloantigens than did controls and suppressed the naive and sensitized BALB/c MLC and CTL responses to CBA/j alloantigen. This specific suppressive response to alloantigen was optimally transferred into syngeneic naive recipients when the adoptive transfer was performed on the sixth day after the last infusion received by the spleen cell donor mice. The adoptive transfer of this suppressive response was abrogated by the prior X-irradiation of the donor spleen cells and significantly abolished by the depletion of Thy-1+, Lyt-2+, L3T4- T lymphocytes.(ABSTRACT TRUNCATED AT 400 WORDS) PMID- 1793235 TI - Structure and construction: the system of skin flaps. AB - Studies done on the skin's blood circulation have also resulted in the development of new, more complex flaps. This complexity has made a standardized classification of flaps no longer possible. As a result of this, we have tried to analyze the inner system of flaps. This analysis has made a connection between the construction and the vascular structure of the flaps evident. Based on the fundamental construction and basic vascular structure, we are able to divide the flaps into three elementary types. All the complex flaps are composed of these three elementary types. This composition takes place in the form of a parallel connection or in the form of a sequential connection of the elementary types or both. To ensure the adequate blood supply of a flap, it is necessary to maintain the continuity of the elementary vascular patterns. PMID- 1793236 TI - Subcutaneous pedicle hypothenar island flap. AB - The status of the blood supply to the hypothenar skin was investigated by anatomical and radiological studies. The investigation revealed that the hypothenar skin receives a rich blood supply from the arterial network by branches from the palmar ulnar artery of the little finger and the hypothenar branches. By making use of this abundance of vascular networking, a subcutaneous pedicle flap was obtained from this site. This method was clinically applied to 7 patients, and the procedures and advantages of the method are described. PMID- 1793237 TI - The distally based posterior interosseous island flap for the coverage of skin loss of the hand. AB - Eight patients with skin coverage of the hand by the distally based posterior interosseous island flap (DBPIIF) are presented. The first web was reconstructed in 6 and the volar and dorsal aspect of the hand in 2 patients. Primary closure of the donor sites has always been possible. An echo Doppler examination is indicated to verify the presence and size of the vessel and the direction of its flow. The dissection of the vascular pedicle, however, is frequently quite complex and time consuming. To better appreciate the cosmetic aspect of the DBPIIF and its donor site, a random study has been undertaken to compare this flap with the radial forearm and the groin flap and their corresponding donor sites. Females have more often preferred the groin flap, whereas doctors preferred the DBPIIF. Reliability, a good aesthetic result at the donor site, and the preservation of the main vessels of the hand are the specific merits of the DBPIIF. PMID- 1793238 TI - Low-power HeNe laser treatment of venous leg ulcers. AB - Clinical observations have suggested that low-energy lasers, mainly helium-neon (HeNe) lasers, might stimulate wound healing. A controlled study of the effects of low-power HeNe laser was performed in conjunction with a standard treatment for healing chronic venous leg ulcers on 46 patients divided randomly into two groups. All patients received standard treatment (paste-impregnated bandage and a self-adhesive elastic bandage) plus either HeNe laser (wave-length, 632.8 nm; beam power, 6 mW; continuous emission, energy density, 4 J/cm2) or placebo HeNe laser twice weekly for 12 weeks. The areas of healing were examined and compared percentage-wise after 2, 4, 6, 8, and 12 weeks. There were no significant differences in the proportion of healed ulcers or ulcer area in the HeNe group compared with the placebo group. PMID- 1793239 TI - In vitro fabrication of bioartificial mucosa for reconstruction of oral mucosa: basic research and clinical application. AB - Bioartificial mucosa can be fabricated with living cells in vitro and used for mucosal grafting. In this report, we describe our culturing methods for preparation of bioartificial mucosa and its morphological characteristics. Bioartificial mucosa has bilayered components, namely, mucosal epithelium and submucosal tissue. Submucosal tissue was composed of fibroblasts and type I collagen lattice. Mucosal epithelium was formed by an epithelial segment grafted on the submucosal tissue surface. Between epithelial and submucosal tissues, basement membrane was observed under a transmission electron microscope. In animal experiments, the bioartificial mucosa was well vascularized and survived completely without immunological rejections. Based on the findings from these animal experiments, we applied this bioartificial mucosa to humans and succeeded in reconstructing their mucosal defects. We also present an overview of the problems relevant to the use of such methods. PMID- 1793240 TI - The facial distribution of port wine stains on patients presenting for laser treatment. AB - During a 2-year period, 232 patients with port wine stains presented for laser treatment. They were analyzed for the position of the port wine stain with respect to the right and left ophthalmic, maxillary, and mandibular divisions of cranial nerve V and the right and left cervical plexus. Fifty-one percent of the facial lesions were confined to either the right or left maxillary division, and 72% of the lesions were confined to just one of the eight nerve regions; 5.9% of the lesions occupied regions on both sides of the face, whereas 49.8% were confined to the right side and 44.3% to the left. In comparison with a group of 103 patients studied by Ohtsuka of Japan, there appeared to be significantly more patients in the maxillary division (p less than 0.0001) and significantly fewer patients in the ophthalmic division and in the combination of ophthalmic and maxillary divisions (p less than 0.00001). PMID- 1793241 TI - Analysis of silicon in human breast and capsular tissue surrounding prostheses and expanders. AB - Diffusion of polydimethylsiloxane from silicone breast prostheses and soft-tissue expanders has been associated with capsular contraction. We used electron dispersive x-ray analysis and scanning electron microscopy to assess the presence of silicon in capsular tissue surrounding three categories of breast prostheses and expanders. Breast and subcutaneous tissues external to the capsules were used as control specimens. Semiquantitative results allowed capsules to be ranked according to implant type. Silicon was localized within the inner 2.0 mm of capsular tissue. The analyses of tissues from 2 patients exhibiting unilateral, Baker grade IV contraction after bilateral placement of prostheses showed less silicon present in the severely contracted capsule than in the less-contracted capsule. Results from this study diminish the importance of silicon as the initiator of capsular contraction. PMID- 1793242 TI - Penetration of antibiotics through omiderm in vitro and on split-thickness skin grafts in burn patients. AB - Penetration of antibiotic preparations (gentamicin, neomycin, silver sulfadiazine, mupirocin) through Omiderm, a synthetic wound covering, was tested in vitro and in 5 patients with full-thickness burns who had undergone tangential excision and split-thickness skin grafting. All antibiotic preparations tested penetrated both meshed and unmeshed Omiderm. Omiderm did not affect the zones of inhibition of antimicrobial activity as compared with controls. PMID- 1793244 TI - Reconstruction of penile and scrotal lymphedema. AB - Acquired genital chronic lymphedema and elephantiasis are not common problems in the United States. Most noncongenital cases are due to lymph node dissection, injury, or irradiation. Genital lymphedema is a functionally disabling and emotionally incapacitating entity, especially in the elderly population. Methods of reconstruction reported in the literature involve either lymphangioplasty or direct excision of the involved tissue with local tissue reconstruction. We report a case of acquired genital elephantiasis in an elderly man following radical cystectomy and pelvic irradiation for transitional cell bladder cancer. Our technique of reconstruction consisted of (1) excision of all involved lymphedematous skin of the penis and scrotum, and (2) use of posterior scrotal flaps, superiorly based flap of the pubic area for testicular coverage, and split skin graft to the penis. Genital lymphedema presents a formidable challenge for reconstructive surgeons. The low morbidity and successful outcome observed in this case, however, indicate that the procedure described herein can and should be offered to elderly patients to improve function and quality of life. PMID- 1793243 TI - Inhibition of wound contraction by papaverine: in vitro analysis with a submucosal tissue model. AB - We studied the effect of topical application of papaverine, a smooth-muscle relaxant, on the contraction of open, dorsal skin wounds in rats. Wound contraction was inhibited significantly in papaverine-applied wounds compared with saline-dressed control wounds. The in vitro effect of papaverine on wound contraction was studied by using human oral fibroblasts cultured three dimensionally in the hydrated collagen gels containing papaverine. Papaverine inhibited collagen gel contraction in a dose-dependent manner. Any change in actin filament organization in fibroblasts cultured three-dimensionally in the collagen gels was observed by staining the filaments with fluorescent dye conjugated phalloidin. In the control cultures, well-organized stress fibers were formed in the cell projections; in papaverine-treated fibroblasts, during the early stages of the treatment, the stress fibers were disrupted and actin filament aggregation was observed. In addition, papaverine induced a delay in the formation of the processes in fibroblasts cultured in collagen gels. These results indicate that wound contraction inhibition by papaverine is mediated by its effects on the organization of actin filaments of fibroblasts. PMID- 1793245 TI - Bilateral lower limb salvage with free flaps in a patient with sickle cell ulcers. AB - A patient with long-standing bilateral circumferential lower extremity sickle cell ulcerations refractory to conservative management was successfully treated with bilateral free latissimus muscle transfers. This report confirms the value of free tissue transfer in the treatment of these difficult skin ulcerations. Exchange transfusions that brought the SS hemoglobin below 30% were crucial to the prevention of sickling in the microcirculation of the flap during its obligate period of ischemia. Furthermore, they protected the flap during a period of ischemia that exceeded 4 hours following a postoperative arterial thrombosis. In the presence of severe thrombocytosis associated with sickle cell disease, prophylactic treatment with aspirin may be of significant value. PMID- 1793246 TI - Giant melanoma of the inner thigh: a homeopathic life-threatening negligence. AB - The strange case of a 37-year-old modern, Western woman who presented with a giant black mass on her inner right thigh is presented. She was treated 10 months before this present admission by an excision of a nodular melanoma, and she was treated, thereafter, by a homeopathic practitioner until she came late to follow up. The woman is discussed with special attention to the fact that alternative medicine does not always constitute good advice, and the relevant literature is reviewed. PMID- 1793247 TI - [Disinfection of endoscopes in gastroenterology. Bacteriologic evaluation of the procedure employed in the endoscopic unit at the Mongi Slim Hospital of Tunisia]. AB - An evaluation was made of the incidence of contamination of the endoscopes during gastroscopy and colonoscopy and of the efficacy of the disinfection procedure used in our digestive endoscopy unit. Serial bacteriological samples were made before and after the endoscopy session and also between patient procedures. These samples were taken on the endoscopes and their accessories and also on the walls, examination table, gloves and the uniforms of the staff. Over 60 p. cent of the samples were positive showing that the disinfection technique was not bacteriologicaly satisfactory. Most of the micro-organisms found were opportunists. Firm guidelines regarding adequate disinfection are important and regular micro-biological control of disinfection procedures must be performed. PMID- 1793248 TI - [Nitrates in the drinking water and cancer]. AB - Nitrates originating from food and particularly from water are supposedly precursors of carcinogenic N-nitroso compound (NOC) formed within the organism. According to Correa and al. these transformations could be a consequence of bacterial gastric pullulation resulting from certain hypochlorhydric conditions. Much epidemiological research has tried to establish a relationship between exposure to nitrates in drinking water and cases of gastric cancer. The present article deals with research into this relationship in France, in a region where the rate of nitrates in water supplies is among the highest. Death statistics (from cancers of the digestive and urinal tracts) are issued by INSERM and these of the population by INSEE. Towns are classified according to nitrate concentration and the number of deaths is established according to tumour detection by sex and age. Research into death rate divergencies is found by chi 2 and the correlated coefficient. The average relative risk for any age group is calculated for all types of cancer. Research on frequency is carried out from tumour records. Comparative frequency rates are established by direct standardisation according to the structural age of any one European population. Results are analysed in relation to (1) mortality rates and (2) incidence rates. (1) None of the cancers studied, of the digestive or urinary systems, whatever the age on sex, is significantly linked to the quantity of nitrates in water supplies. When all these cancers are taken into account, the death rate does not vary significantly for increasing concentration of nitrates. Towns exceeding the maximum concentration permitted by law do not have a higher mortality rate than other towns.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793249 TI - [Value of smectite in the preparation of patients having abdominal echography]. PMID- 1793250 TI - [Current status of Clostridium difficile: recent advances in diagnostic materials and treatment of colitis and diarrheas associated with antibiotic therapy]. AB - Clostridium difficile infection covers several clinical pictures which have been identified only recently. The majority are based upon imbalance in the intestinal ecosystem. Major advances in recent years concerning this type of infection have involved: a) better knowledge of pathophysiological mechanisms, in particular the demonstration of a 2nd toxin, essential to the understanding of C. difficile infections; b) better codification of the management of these disorders. This is aimed today at treating the infection while maintaining the balance of the intestinal ecosystem. PMID- 1793251 TI - [Metastasis of urogenital cancers. Introduction]. PMID- 1793252 TI - [Metastasis of renal cancer]. AB - The prognosis of renal cell carcinoma (RCC) is related to the initial staging, assessed by nephrectomy. Metastases are present at the time of diagnosis in 30% of cases. Solitary metastases are rare. The most common metastatic sites include lungs, lymph nodes and bones. Anatomical pathways as well as local events in the secondary sites are responsible for the site specificity of the tumor spread. Patients with disseminated disease have a 5 years survival rate of less than 10%. RCC is intrinsically chemo-resistant. Vinblastine leads to a global response rate (RR) of 15%. In view of the lack of effective chemotherapeutic agents, interest has been directed towards the potential value of biological response modifiers (BRM). Response rates are about 15% with IFN alpha. Significant synergy between IFN alpha and vinblastine has not been proved. Interleukin-2 (IL-2) with or without Lymphokine Activated Killer (LAK) cells leads to a RR of 20%. Some durable complete remissions have been reported. Ideal doses and schedules remain to be determined. PMID- 1793253 TI - [Metastasis of cancers of the kidney calyx, the ureter and the bladder]. AB - Cancers of the renal pelvis, the ureter and the bladder are often accompanied by bone, lung and liver metastases. The frequency of metastases, which may occur early during the course of the disease, is directly correlated with the stage. The metastatic potential can be partially evaluated using certain prognostic factors: local extent of lesions, cytogenetic abnormalities, oncogenes and suppressor oncogenes, factors secreted by the tumor, proliferative activity. Chemotherapy produces an overall response in 50-75% of patients, 10-15% of whom achieve a long term response. Several agents are active, particularly cisplatinum and methotrexate; in addition, combination regimens (especially M-VAC) have proven more effective than single agents used alone. Neo-adjuvant chemotherapy administered prior to local treatments given encouraging results, as does adjuvant chemotherapy. However, additional investigations are still required to evaluate the exact role of chemotherapy in the therapeutic strategy for these para-malpighian cancers. PMID- 1793255 TI - [Metastases of urogenital cancers. The viewpoint of the urologist]. PMID- 1793254 TI - [Metastasis of prostatic cancer. Mechanisms and sites, therapeutic management and review of published results. Strategies of prevention of metastases during initial treatment]. AB - Cancer of the prostate is the leading cause of death from cancer in men over 75 years of age, and the second cause in younger men. Metastases are present at the time of diagnosis in 40% of cases. The existence of growth factors and the role of male hormones, as well as the relationship between tumor cells and stroma now provide a clearer picture of why prostate cancer metastases have an affinity for bone and produce osteoblastic lesions. The treatment of these metastases depends primarily on the suppression of androgen activity which can be achieved at several levels. Although hormone therapy can influence the course of the tumor in 80% of cases, the objective response rate for first line therapy rarely exceeds 50%. In most cases, resistance to hormone therapy occurs in the first 18 months. In such cases chemotherapy can be expected to produce a 30-35% objective response rate. The modalities of hormone therapy (single agents or "complete hormonal blockade") and the role of chemotherapy are still controversial issues. Measures designed to avoid metastatic spread at the time of initial therapy are discussed. PMID- 1793256 TI - Hominid brain evolution: two conceptions of science. AB - This paper re-examines the repeatedly-offered hypothesis (Fialkowski 1978, 1986, 1987, 1988) that hominid brain expansion was largely a side effect of evolutionary response to increased heat stress under conditions of primitive hunting, and resulted in a preadaptation to enhanced cognitive abilities. Fialkowski's hypothesis, previously shown to be based on data that are seriously inaccurate, continues to be presented in a manner that precludes testing. Consequently, however interesting these ideas may be, they are beyond the conventional domain of anthropology as a legitimate subdiscipline of modern science. PMID- 1793257 TI - Preparation, reconstruction and interpretation of seven human skeletons from the late Bronze age (urn-field-culture) found at a storage pit in Stillfried/March, lower Austria. AB - In the first published paper "Stillfried-Archaologie-Anthropologie" (Felgenhauer, Szilvassy, Kritscher & Hauser 1988) emphasis of study was laid on morphological, metric and radiological analyses of the 7 skeletons from the late Bronze age (urn field-culture) found at a storage pit in Stillfried/March in Lower Austria. The present publication deals with the methods of reconstruction of this spectacular discovery. When the skeletal material was disinterred in 1976 it was decided to make appropriate arrangements for an in-situ-presentation at a later stage. After the preparatory work and the scientific investigations were concluded, an in-situ presentation of the 7 skeletons was placed as a key-exhibit in the anthropological displays in the Natural History Museum in Vienna. The 7 skeletons represent three grown-ups and four children i.e. a man about thirty years of age, a woman of forty and one of forty five years of age, as well as a girl of nine and three boys eight, six and three years of age. The reconstruction of this outstanding discovery demanded not only an answer to the genealogical question but also an interpretation of the circumstances of death making use of forensic evidence. Additionally, the personal state of the seven individuals, their physical shape, state of health, and their racial attachment were discussed. PMID- 1793258 TI - Computer-tomographic (CT) studies and anthropological measurements in patients with atlanto-occipital fusion. AB - Computer tomographic (CT) studies and anthropological measurements were performed in individuals showing complete or partial atlanto-occipital fusion. In 13 patients and 13 matched controls all measurements excepting head length and head breadth gave smaller, and in some instances significantly smaller values in the patients. The two head measurements, on the other hand, turned out to be somewhat, though not significantly larger. This suggested a certain amount of hydrocephalus internus. Computer-tomographic (CT) studies in 11 patients and 9 controls gave some--not very clearcut--evidence in favor of this hypothesis. Moreover, some other mild anomalies such as prominent and dilated sulci and cisterns were observed in 9 of 11 patients and in 3 of 9 controls (P1 one tailed = 0.0399). PMID- 1793259 TI - Seasonal effects on fetal selection related to AB0 blood groups of mother and child. AB - An association of AB0 blood groups and month of birth was examined in two groups, students and newborns in Tokyo. Among 4919 students born mainly in the 1960s, an apparent seasonal variation was shown in births of blood group B students. Among 3592 newborns at an obstetric clinic in the 1980s seasonal variation was also observed in all four blood groups. The ratio of 0 group to A group newborns (0/A ratio) from 0 mothers was lower than that from A mothers among the 0 and A pairs contrary to the expected effects of 0-A incompatibility. The 0/A ratio was apparently different by season and the 0/A ratio from 0 mothers was significantly lower than that from A mothers among those born during August-January. It is assumed that an association of birth season with AB0 blood group may be caused by some seasonally and secularly changing environmental "infertility factors" such as infectious microorganism which may have some common components with a particular blood group substance respectively and induce a loss of embryos selectively at a particular season. PMID- 1793260 TI - A rare dermatoglyphic finger pattern in a Canadian kindred. AB - A Canadian three generation pedigree is presented where a woman has a rare radial loop plus radial loop pattern on the second digit of her left hand and her son has the same rare configuration on the same digit. We hope that this pedigree will encourage others to search for pattern configurations beyond the conventional arch-loop-whorl divisions. PMID- 1793261 TI - Dermatoglyphics in juvenile hypertension. AB - Dermatoglyphics of 172 children and young adults (116 males, 56 females) with hypertension, 13-27 years old, were compared with those of 130 healthy male and 110 female controls. Several differences were observed between the two groups. Hypertensive patients had a somewhat lower frequency of fingertip ulnar loops, higher frequency whorls and a higher total finger ridge count. They also had a somewhat higher mean atd angle, significantly more frequent distal position of the axial triradius (mostly in t' position) and more missing axial triradii compared to controls. The differences between a-b ridge counts, the interdigital, thenar and hypothenar patterns were generally small and sometimes limited to one sex or one hand only. The observed differences seem to indicate a genetic influence in the etiology of essential hypertension. PMID- 1793262 TI - Prospects for malaria control in urban and rural Kinshasa. AB - Malaria is a major cause of paediatric illness and death in Kinshasa, and all 3 million inhabitants are at risk. In view of the increasing chloroquine-resistance of Plasmodium falciparum, the early treatment of fever cases as the sole malaria control measure is no longer acceptable. The prospects for vector control are determined by the effectiveness, the acceptability and the practicability of the various methods in the local conditions of Kinshasa. Pronounced differences in the level of endemicity exist between the various parts of the town. These differences, and the ecological and socio-economic factors that underlie them, must be taken into account when estimating the potential of a control method. The reduction of man-vector contact through personal protection with impregnated bednets is the only realistic goal at this moment, but even a very marked decrease of the inoculation rate will produce little apparent effect in the highly endemic (semi-)rural districts at the periphery of town. In the urbanized center of Kinshasa, where the moderate to low intensity of transmission is more susceptible to a critical reduction, the same method may have an impact on malaria morbidity. Moreover, the big nuisance from non-vector mosquitoes in the urban area is an important motivating factor for the acceptance and the use of bednets. A mass effect, on the other hand, only is to be expected in isolated villages. Field trials are needed to evaluate the short- and long-term effect on malaria transmission and on its' clinical expression, as well as on the build-up of natural immunity, in the epidemiologically distinct areas. However, the final outcome of a large scale implementation of malaria control with impregnated mosquitonets will equally depend on health education, on the availability of bednets at low cost, on the creation of the appropriate structures for the (re)impregnation and distribution of the nets, and finally on the sustainability of the whole effort. PMID- 1793263 TI - [Campaign against malaria vectors in the framework of a rural development project in Burundi]. AB - In the context of a large project for the socio-economic improvement of the Imbo area, measures were taken for the integration at all levels of malaria control: health centres for improvement of curative care; hygiene and sanitation centres, communes and agricultural projects for vector control; craftsmen, cooperatives and social centres for the manufacture and selling of impregnated bed-nets. The adopted strategy for malaria control results from preliminary epidemiological studies. The recommended measures are the improvement of medical care and vector control. The latter is based on indoor spraying of malathion, once a year. Malathion is only active during the period (2 months) of highest transmission, which occurs at the end of the rainy season. Occasionally other insecticides are used. Impregnated bed-nets with deltamethrin and village draining are complementary methods. In villages of the rice-growing area with good participation of the community, vector control activities have a considerable impact on malaria prevalence. About 70% before the intervention, the prevalence does not exceed 10% in 1990. High parasitaemia (greater than 2000 troph./microliters), and hence morbidity, decreased considerably (35% in 1983 to less than 5% in 1990). In villages with poor community participation, the decrease of prevalence is less spectacular (from 70% to 25%). Drains are not kept in repair and constitute new breeding places of vectors in the populated areas. The use of mosquito bed-nets is not common, a better information campaign should overcome this unpopularity. In peri-urban villages, inhabitants are complaining about indoor spraying, but the results are satisfactory. This programme demonstrates that reducing malaria prevalence and morbidity with conventional measures is feasible in particular biotopes. Health education activities in the Imbo Centre must be pursued and adapted according to the professional activities of the community. PMID- 1793264 TI - [The impact of impregnated mosquito nets on prevalence and morbidity related to malaria in sub-Saharan africa]. AB - Insecticide treated bed nets (permethrin, deltamethrin and lambda cyalothrin) were used for malaria control in The Gambia, Burkina Faso and Tanzania where Anopheles gambiae (and An.funestus in Burkina Faso) is the main vector. Treated mosquito nets are efficient when used on a large scale and not on an individual level. Such a large scale use, acting on longevity and infectivity of vectors, always induced a decrease of malaria transmission by more than 90%. Treated bed nets had no significant effect on the overall parasite rate, showing that malaria transmission was not stopped. But it was usually found that there was a significantly smaller number of children with parasitemia higher than a critical threshold, a sensitive parameter of malaria morbidity. Indeed, in the three situations studied, malaria morbidity (fever + high parasitemia greater than critical level in the concerned area) has generally shown a similar drop of 60%. These data demonstrate that treated bed nets are useful to reduce transmission and morbidity. Advised as a new way for reduction of nuisance, treated bed nets were always welcomed by the populations and this method may be considered as a complementary weapon in public health. PMID- 1793265 TI - Trypanosomatid--vector interactions. AB - Over recent years there has been an increasing interest in the interaction between Trypanosomatids and in particular the genera Trypanosoma and Leishmania and their vectors. These studies on the "vector parasite interface" have been wide ranging but often suffer from the difficulties of manipulating some of the vector systems. It is now likely that molecular biological and protein analysis techniques can be more effectively applied in dissecting these interactions with a view to identification and characterisation of molecules which control parasite behaviour in vectors. This presentation will review recent studies on Glossina lectins in relation to trypanosome behaviour in flies including recent studies on different G. palpalis subspecies as well as review evidence that trypanosomatids have an effect on their insect hosts for example, on feeding behaviour, susceptibility to insecticides and longevity of infected vectors. Sugars are known to influence development and transmission of Leishmania and recent studies have indicated that aphid/or coccid honeydew is taken by sandflies, the relevance of this to Leishmania/sandfly interactions will be discussed. The basic mechanisms of attachment observed in all trypanosomatid interactions are described and the presence of molecules associated with attachment have been identified. The genetic basis of susceptibility is also becoming better understood and it is to be expected that modern molecular techniques when applied to well defined systems can give results which could permit an attempt at intervention; even if this is not achieved the basic understanding of a widespread phenomenon of the insect/parasite association will have been furthered to permit a better epidemiological knowledge. PMID- 1793266 TI - The fate of Plasmodium gallinaceum in Anopheles stephensi Liston and possible barriers to transmission. AB - Plasmodium gallinaceum develops up to the ookinete stage in the non-compatible mosquito, Anopheles stephensi, this development occurring over the same time period and with the same success as in the compatible vector, Aedes aegypti. The slower digestive rate in An. stephensi, smaller blood-meal and lower enzyme activity than in Aedes, and an acceleration of the formation of the peritrophic membrane (PM) do not inhibit the development of the parasite. However, the ookinetes are not able to penetrate the midgut epithelium. The role of blood, vector and parasite in establishing a parasite infection in the mosquito are all considered. In particular, the role of vector-parasite recognition mechanisms in determining vector-parasite specificity are discussed. PMID- 1793267 TI - Chemical control of disease vectors: quel avenir? PMID- 1793268 TI - Vector immunity to filariasis: new potential for disease control? AB - These experiments describe investigations into the mode of microfilarial killing in the haemocoel of immune Aedes aegypti and Simulium ornatum. Antibody blocking experiments indicate that sarcotoxin IIA-like and sarcolectin-like molecules maybe involved. The use of carbohydrate in the infecting blood meal indicates that gut lectins may be involved in preventing migration of Brugia microfilariae into the haemocoel. This appears to be a strain factor linked to innate susceptibility. These physiological mechanisms may develop into useful handles in the control of vectors by genetic manipulation, or in developing new chemotherapeutic agents. PMID- 1793269 TI - [Functioning of virus-vector systems]. AB - The transmission of viruses by arthropod vectors is a very complex biological phenomenon, and a very efficient one epidemiologically speaking; it takes place in three successive stages: arthropod infection, virus replication and dissemination within the arthropod, transmission to the vertebrate with, possibly, trans-stadial, vertical and/or venereal transmission. Many factors influence this transmission: endogenous factors, specific of the two components of the system (physiology, biology, genetics of the virus as well as the arthropod) determining vectorial competence, and exogenous environmental factors, which, along with previous ones, condition vectorial capacity. These facts have important consequences on arbovirus evolution, through different mechanisms for segmented or non-segmented genome viruses. They also have practical implications on epidemiology of arbovirus infections, through selective pressures exerted on each development stage of these viruses. These considerations lead us to state some directions for future researches: exact mechanisms of the different virus development stages within their vectors and type of their genetical control, defense reactions of arthropods and pathogenic effects of the viral infection, possible interference with other micro-organisms or with homologous or heterologous antibodies,.. Researchers working in that field should approach the problem not only with "arboviruses" and their vectors, but with consideration for all virus-arthropod relationships, and should take in account the necessity of not too much wandering from conditions of the nature in their experiments. PMID- 1793270 TI - Insecticide resistance: can it be avoided? AB - The genetic background related to resistance against insecticides has abundantly been demonstrated during the last decades, hence slowing down the development of resistance has to be adapted accordingly. Currently, assays are designed to monitor the mechanisms of resistance in individual insects. Remarks on the interpretation of results obtained with the available bioassays are given together with some recommendations to control resistance. PMID- 1793271 TI - Vector population responses to control interventions. AB - In 1981, Kenyan authorities attempted eradication of tsetse (Glossina pallidipes) from the Lambwe valley, by sequential aerial spraying of endosulfan. Fly populations were reduced by over 99.9% in the main habitats, but recovered to their original levels within one year. In 1986, an Argentine research team attempted local elimination of domestic Triatominae (Triatoma infestans) in an area of Santiago del Estero. House infestation rates were reduced to an apparent zero, but recovered to pre-control levels in two years. In Sri Lanka, a combination of mosquito control with active case detection and treatment reduced malaria incidence to just 17 cases in 1964. Interruption of the programme then saw case incidence return to over 500,000 by 1969. These three examples-from African trypanosomiasis, South American Chagas disease and malaria-all illustrate the same process. Vector populations, infestation rates, and rates of disease transmission, can be reduced. The real problem is not in achieving the initial reduction, but in subsequently either driving the disease to extinction or maintaining it below acceptable levels. And this problem takes us beyond the simple analysis of interventions, into the complex realms of population behaviour set in its political, social and economic context. It seems that we have been too rarely concerned to plan and implement the long term surveillance and selective interventions that are required to translate initial gains into real success. In biological terms, we tend to ignore the complexity and robustness of vector populations and disease transmission cycles, especially their varied capacity to recover from interference. Moreover, in socio-political terms, a reduced problem even one representing potential for future catastrophe-tends to claim less priority than present problems, even though premature redeployment of resources may abnegate gains already achieved. The problem is strongly compounded by methods of economic analysis where the benefits of avoiding future problems are strongly discounted in favour of short-term temporary gains. This paper seeks to open discussion on these long-term planning issues. PMID- 1793272 TI - [Current approach to the study of cytotaxonomy of vectors]. AB - In order to avoid the slowness of the classical analysis of polytene chromosomes in insect vectors of diseases, a programme of image analysis on computer has been perfected. In its actual form, it allows to obtain a real straight image of the chromosome, the curve of DNA optic density for all the bands and the possibility to bring all the obtained images to a same standard length. The whole of the operations takes between 3 and 5 minutes per chromosome. Then, the author describes a way of approach to complete this programme in order to obtain a comparison of the analysed chromosomes allowing the automatic location of inversions. PMID- 1793273 TI - A genetic study of Plasmodium susceptibility in the African malaria vector Anopheles gambiae. AB - We are studying the interaction between malarial parasites and their mosquito hosts by a process based on the genetic selection of lines of the mosquito vector that will not support normal parasite development. The model system we are using is the mosquito Anopheles gambiae and a number of different human and non-human primate malarial parasites. Our first effort in this general approach involved the selection of a strain of An. gambiae that was able to encapsulate the malarial parasite during or just after its penetration of the mosquito midgut. This mosquito has been found to be highly refractory to a wide variety of different Plasmodium species and at least partially refractory to all four human malarial parasites. The basis of this phenomenon appears to be the mosquito's enhanced ability to mount a normal encapsulation response against invading pathogens or parasites. The late ookinete is enclosed in a heavily melanized capsule approximately 16-24 hours after the mosquito takes an infective blood meal. Encapsulation appears to be primarily humoral; electron microscopy reveals evidence of the phenomenon as the ookinete passes through or between midgut cells, and no hemocyte involvement has been observed. Subcellular structures in newly encapsulated parasites appear normal, indicating that live rather than dead or dying parasites are encapsulated. Preliminary studies suggest that two unlinked loci contribute to the refractory mosquito phenotype. One of these loci is very closely linked to a region of the mosquito genome that includes two esterases.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793274 TI - Community participation in vector borne disease control: facts and fancies. AB - The community involvement in solving their problems was spontaneous when the society as a whole had extensive control over the natural resources. However, this trend was lost during the industrial revolution when the social structure started disintegrating. Simultaneous discovery of antiparasitic drugs and powerful insecticides created a euphoria that all vector borne diseases could be controlled if not eradicated. Though the use of these tools resulted in control or eradication of vector borne diseases in many parts of the developed world, in poor developing countries the initial gains could not be sustained. This is partly due to non acceptance of technology by the beneficiary. Realizing that technology without the people is not going to solve the problem, the idea of community participation was revived. Since then, community participation has become a popular slogan and most programmes claim to have achieved community participation. The projects have not originated from the community and fail to differentiate between the gain achieved due to community effort and that due to the project personnel. The technical and material inputs provided are much higher than the national programmes can afford, carried out in limited areas for short periods and sustainability never demonstrated. Community participation in vector borne disease control has considerable potential specially in source reduction, reduction in man vector contact or accepting antiparasitic or antivector measures. True sustainable participation is possible only when the present trend of top-down planning is reversed to bottom-up planning; decision making power is handed over to the community; the people involved in conceiving, planning, implementation and evaluation of all developmental programmes and if the programmes are responsive to local needs and priorities. PMID- 1793275 TI - Cost-effectiveness of environmental management for vector control in resource development projects. AB - Vector control methods are traditionally divided in chemical, biological and environmental management approaches, and this distinction also reflected in certain financial and economic aspects. This is particularly true for environmental modification, usually engineering or other structural works. It is highly capital intensive, as opposed to chemical and biological control which require recurrent expenditures, and discount rates are therefore a prominent consideration in deciding for one or the other approach. Environmental manipulation requires recurrent action, but can often be carried out with the community participation, which raises the issue of opportunity costs. The incorporation of environmental management in resource projects is generally impeded by economic considerations. The Internal Rate of Return continues to be a crucial criterion for funding agencies and development banks to support new projects; at the same time Governments of debt-riden countries in the Third World will do their best to avoid additional loans on such frills as environmental and health safeguards. Two approaches can be recommended to nevertheless ensure the incorporation of environmental management measures in resource projects in an affordable way. First, there are several examples of cases where environmental management measures either have a dual benefit (increasing both agricultural production and reducing vector-borne disease transmission) or can be implemented at zero costs. Second, the additional costs involved in structural modifications can be separated from the project development costs considered in the calculations of the Internal Rate of Return, and financial support can be sought from bilateral technical cooperation agencies particularly interested in environmental and health issues. There is a dearth of information in the cost effectiveness of alternative vector control strategies in the developing country context. The process of integrating vector control in the general health services will make it even more difficult to gain a clear insight in the matter. PMID- 1793276 TI - Science and technology for development. A contribution to vector control activities. PMID- 1793277 TI - [Which structures in anti-vector control?]. AB - The lack of efficient tools is often incriminated to explain the absence of anti vectorial activities in control programmes of vector borne diseases. However, we must recognize that the available tools are under utilized due to the lack of appropriate structures. Existing structures are reviewed. So far, results achieved by the Primary Health Care System (PHCS) are scarce. In fact, even simple methods need specific know-how for execution and specialised knowledge for planning and supervision, which differ from those needed for medical care committed to the PHCS. To develop the use of simple methods, adequate structures have to be elaborated, maintaining a peripheral character but in direct connection with a central level, which provides expertise, supervision of the activities and evaluation of the results. The association of research and operational programmes is essential to face problems linked with epidemiological, environmental, socio-economical modifications or changes in sensitivity to insecticides and for the integration of new techniques. It is also this tandem "research-control operations" which will provide the best environment for training. PMID- 1793278 TI - Alternatives to chemical methods for vector control. AB - Under the concept of the integrated approach for disease vector control, chemical pesticides in many cases can be complemented or replaced by ecologically safer alternatives. Environmental management and physical or biological methods of control are attractive adjuncts. Recent advances in biochemical, immunological and genetic studies of host-parasite relationships are creating innovative tools for interrupting vector-borne disease transmission cycles. PMID- 1793279 TI - [Campaign against sleeping sickness in South-West Uganda by trapping tsetse flies]. AB - An outbreak of human trypanosomiasis due to Trypanosoma brucei rhodesiense has been affecting the Busoga district of Uganda since 1976. More than 40,000 cases have been recorded up to 1990. Since two years the epidemic area has been extending to the Tororo district. The vector is Glossina fuscipes. In order to stop the disease transmission a vector control project was launched in 1988 in Busoga area. It is based on tsetse fly trapping, using pyramidal optic traps impregnated with deltamethrin (10 traps per square kilometer). The results were excellent. Everywhere fly populations were reduced by more than 95%. In some parishes flies elimination was achieved. The number of new human cases of trypanosomiasis has been reduced in the same proportions. A complete break down of the transmission in the Busoga area can be reasonably expected in the near future. Since 1990 the trapping has been extended to the epidemic areas of the Tororo District. The results after only a few months were also excellent. Because cattle in the main blood source for tsetse flies in this area, the monthly treatment of cattle with pour-on of deltamethrin has been experimented in a small area to strengthen trapping. First results are promising. The cost of the protection is 0.9 US $ per person and per year. PMID- 1793280 TI - [Evaluation of control measures against Simuliidae in the framework of the OCP (Onchocerciasis Control Program)]. AB - To control the vector S. damnosum s.l., the Onchocerciasis Control Programme in West Africa (OCP) uses larvicides which are sprayed mainly by air. Despite the more or less reversible resistance of some species of the S. damnosum complex to the organophosphorus compounds (temephos and chlorphoxim), the Programme has succeeded in finding effective replacement insecticides. These larvicides, which are used in rotation, taking into account the river discharges, blackfly species present, and their susceptibility to the different insecticides, have made it possible to maintain the good results obtained by the Programme. Through vector control alone, OCP has been able to bring the disease under control in more than 90% of the initial area. Resettlement is taking place on the fertile lands which were formerly deserted because of onchocerciasis and many socioeconomic development projects are currently being carried out. The extensions made towards the western and the southern parts of the Programme area and the use of ivermectin, a microfilaricide, will enable these results to be improved further. PMID- 1793281 TI - The contribution of sandfly control to leishmaniasis control. AB - Without doubt the single most important constraint on assessing the value of vector control in leishmaniasis control is the lack of well documented examples of intervention; information is usually anecdotal and therefore it is simply not possible to evaluate precisely the significance of sandfly control in disease control. Where the vector is peri-domestic, house spraying with residual insecticides has been employed, but this has usually been as a by-product of anti malarial control (e.g. N.E.India). Increasing incidence of leishmaniasis following the cessation of mosquito control is cited as evidence of efficacy. However, habitat modification such as the destruction of mammal reservoirs and their burrows, has been effective in arid regions of the Middle East and Central Asia, and forest clearance in combination with insecticides in French Guiana. There have been several imaginative attempts at controlling sandflies by applying insecticides to non-domestic resting sites (eg. emergent trees in rain-forest; termite hills in Kenya and S. Ethiopia) but these have met with varying degrees of success. Fortunately there is little evidence of insecticide resistance. Therefore, there is still scope for exploring control methods based on either the systematic application of insecticides alone, the impregnation of nets or curtains, or even the use of insecticides or chemosterilants in conjunction with an attractant (eg. sugar or pheromones). PMID- 1793282 TI - [Going into the 21st century: should one dream or act?]. AB - A historical review of vector control is made. Despite the available tools, vector borne diseases are still a priority in Public Health. Magic tools, like DDT, were often misused. Adapted strategies and structures for vector control are now required. Progress will mainly result from research and evaluation done in the framework of vector control programmes. Discovery of new tools will find in these operational programmes a point of fall for their application. PMID- 1793283 TI - Chagas disease control in Brazil: which strategy after the attack phase? AB - The main target of Brazilian Chagas Disease Programme (CDP) has been the control of domestic triatomine bugs, since more than 80% of human disease is attributable to transmission by these vectors. The global CDP attack phase began in 1983, after a political and technical decision to cover all the 2,400 municipalities of the endemic area with regular insecticide spraying. At present, this vertical and almost military approach is ending, with good entomological results in nearly 70% of the whole area and drastic reduction of the disease. The consolidation of the programme now presupposes the development of a vigilance phase, carried out at regional levels and supported by intensive community participation. Not only residual triatomine foci, but chiefly those resulting from eventual house invasion by secondary sylvatic or peri-domestic species must be detected and sprayed, so avoiding new colonization. More than 700 Brazilian municipalities are in this phase, still controlled by the Ministry of Health ("SUCAM"), with regional voluntary posts established in each municipality to coordinate and respond to any denuciation of infested premises. Special attention is given to the peridomestic environment, where most of the foci are being detected after the attack phase and where the current insecticides do not work so well as indoors. The great challenge is to maintain a continuous and effective surveillance against triatomines, chiefly in the poorest and more isolated rural areas. At medium term, the trend of domestic Brazilian triatomines will depend on three different kinds of factors such as: those linked to the improvement and continuity of the programme (political decision), those that depend on human activity over the environment (extensive agriculture, deforestation, urbanization, etc.) and those associated with promotion and organization of the communities. New strategies and improvement of the existing ones must still be a target for research in the present context of Brazilian triatomines. Also, new ecological situations must be foreseen, such as the expansion of agricultural frontier, rupture of the Amazonian barrier, etc. Finally, an integrated control of Chagas Disease must emphasise complementary activities such as housing improvement and the active control of blood banks to eliminate transfusional transmission, besides the development of a realistic medical care system. PMID- 1793284 TI - Re-assessment of tick control after immunization against East Coast fever in the Eastern Province of Zambia. AB - East Coast Fever, caused by the protozoon Theileria parva and transmitted by the ixodid tick Rhipicephalus appendiculatus is one of the most important cattle diseases in east and central Africa, responsible for considerable direct losses and necessitating expensive control measures. Traditionally, the disease was controlled by means of intensive tick control. The Belgian Animal Disease Control Project was requested to study the disease epizootiology and vector ecology in order to formulate and implement a control program adapted to the requirements and capabilities of the cattle owners in the Eastern Province of Zambia. The weaknesses of a rigorous tick control program were demonstrated. It was decided to initiate an immunization program in the enzootic areas. The overall calf mortality rate was lowered by 90% and it was shown that none of the other tick borne diseases caused significant problems in the absence of tick control. The tick ecology studies had indicated that the climatic conditions in the area were so unfavourable that the important vector species (Amblyomma variegatum, Boophilus microplus and R. appendiculatus) would not attain problem levels. It was therefore recommended to suspend all tick control in the area. Control of East Coast Fever in the epizootic and disease-free areas is still a more complex issue. It appears unlikely that the latter will remain disease-free, because of the proximity of the enzootic areas and because of considerable cattle movement in the province. Given the advantages of control by immunization, it can be argued that a longterm solution should be based on this approach.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793285 TI - [The impact of anti-vector measures in unstable malaria zones in Africa]. PMID- 1793286 TI - [Occupational risk factors in the biotechnology industry and workers' health status]. AB - The mechanisms of the pathogenic effect of microbial cultures used in biotechnological industry and the products of their vital activity on the workers were investigated. A unique classification of the components of the disease incidence with temporary disability is described. The necessity of detecting prepathological conditions and initial occupational affections in the workers for preventing severe consequences of occupational diseases is indicated. On the basis of complex investigations of disease incidence in the workers, revision of the present sanitary and hygienic regulations may be of need. PMID- 1793287 TI - [Preparation of immunoenzyme conjugates of beta-lactamase from Bacillus licheniformis 749/c and horseradish peroxidase with human antibodies to HIV-1]. AB - By using three different linkage methods with carbodiimide, glutaraldehyde and periodite, immunoenzyme conjugates of beta-lactamase from Bacillus licheniformis 749/c and horse radish peroxidase with human antibodies to HIV-1 were prepared. The human antibodies were purified by the affinity procedure on Protein-A Sepharose 6B. The conjugates were tested in a solid phase immunoenzymatic system for the HIV-1 antigen. It was shown that the conjugates prepared by the carbodiimide linkage method had the highest titer, the beta-lactamase conjugate being superior by its titer to the respective peroxidase conjugate. In the lyophilized state the conjugates prepared with the carbodiimide linkage method were stable. PMID- 1793288 TI - [Various methods to assay carbenicillin activity against Pseudomonas aeruginosa]. AB - It was shown that the cultures of Pseudomonas aeruginosa were sensitive to 75-100 micrograms/ml and resistant to 25-50 micrograms/ml of carbenicillin when tested by the method of serial dilutions in the synthetic medium developed by the authors and in Jorgensen's medium. The cultures were incubated for 4 and 16 hours, respectively. The data did not confirm the resistance of the cultures to 25-75 and 100 micrograms/ml carbenicillin when it was determined with the serial dilution method in Pal's medium and the disk diffusion method, respectively. The advantages of the medium developed by the authors for testing P. aeruginosa sensitivity to carbenicillin are discussed. PMID- 1793289 TI - [Comparative study on growth kinetics of organisms causing purulent infections in the presence of ofloxacin and ciprofloxacin]. AB - The comparative study of the antimicrobial effect of ofloxacin and ciprofloxacin on the in vitro kinetic models of the pathogen growth showed that ciprofloxacin was more active against Staphylococcus aureus and Pseudomonas aeruginosa. The post-antibiotic effect depended of the drug concentration and period of the pathogen content with ofloxacin and ciprofloxacin. With respect to the both pathogens, the post-antibiotic effect of ciprofloxacin was more pronounced. PMID- 1793290 TI - [Antimicrobial activity of pefloxacin in comparison with other quinolones]. AB - The antibiotic sensitivity of 338 microbial cultures isolated from patients with inflammatory renal and urinary diseases was studied. 66.3 per cent of the isolates proved to be poly-resistant which corresponded to rurological patient specificity. It was shown that abactal (pefloxacin, LEK, Yugoslavia) had a higher antimicrobial activity than the nonfluorinated quinolones especially against Staphylococci and a lower antimicrobial activity than the fluorinated quinolones in vitro. The abactal sensitivity to Pseudomonas aeruginosa amounted only to 23 per cent which was likely to be due to development of cross-resistance to ofloxacin. 1/3 of the polyresistant isolates were sensitive to abactal. The activity of abactal weakly depended on the medium pH. The MBC was generally no more than 2 MICs. PMID- 1793291 TI - [Effects of sulfalene on the thymus, spleen and adrenals in an experiment]. AB - The effect of sulfalen on the weight and structure of the thymus, spleen and adrenal glands was studied. The findings were compared with the results observed in control rats. It was shown that after administration of sulfalen, the weight of the adrenal glands markedly decreased while their structure did not change. Thymus specimens showed a large number of hypertrophic epitheliocytes, in the medulla which was accompanied by a decrease in its weight. PMID- 1793292 TI - [Effect of pentoxyl, ibuprofen and acetylsalicylic acid on the thymus, spleen and adrenals in an experiment]. AB - The effect of acetylsalicylic acid, ibuprofen and pentoxyl on the histological and morphometric pattern of the thymus and the weight of the thymus and spleen was studied in rats. There was decreased function of the thymus and its atrophy with acetylsalicylic acid and ibuprofen. Pentoxyl increased the secretory activity of the thymus. The effect of the drugs on the thymus and spleen was unidirectional. PMID- 1793293 TI - [Development of integrative vectors for Actinomycetes--producers of antibiotics]. AB - The integrative vectors pSU 475 and pSU 476 with variable numbers of copies per genome were developed for antibiotic producing actinomycetes. For this, the amplifying sequence AUD-Sr 1 of Streptomyces rimosus and the BamHIB fragment of the eSA 1 genetic element from Streptomyces antibioticus were used. The eSA 1 fragment was an element required for integration of a vector to the actinomycete chromosomes since it was homologous with the chromosomal DNAs of S. lividans, S. erythraeus and S. antibioticus. At the first stage the AUD-Sr 1 sequence within the actinomycete plastid pSU 23 was cloned by the vector pUC 19 to E coli. In that experiment the 12.4-kb plasmid pSU 449 was isolated. At the second stage the BamHIB-fragment of the eSA 1 element was incorporated into the resultant hybrid plasmid pSU 449. The 16.5-kb hybrid plasmids pSU 475 and pSU 476 were isolated. In these plasmids the BamHIB fragment of eSA 1 was present in two orientations. The developed vectors were useful in cloning DNA to S. lividans and S. erythraeus. PMID- 1793294 TI - [Myelotoxicity of epirubicin]. AB - Epirubicin (pharmorubicin, India), an antitumor antibiotic of the anthracycline group, was studied in regard to its effect on peripheral blood, bone marrow and lymphoid organs (the thymus and spleen) of CBA mice after its intraperitoneal administration in a single dose equal to the MIC (7.8 mg/kg) and in a course dose (1/5 of the MIC 5 times a day). The cytogenetic impairments induced by the cytostatic were estimated on metaphase plates with the bone marrow specimens and by counting the peripheral blood erythrocytes with micronuclei (the micronuclear test). It was shown that epirubicin induced cytogenetic disturbances in the hemopoietic cells within the first 72 hours. The antibiotic had a marked reversible effect on the erythroid population and lymphoid tissues and a moderate toxic action on the granulocyte population. The antibiotic did not affect thrombocytopoiesis. The single administrations had a more pronounced and prolonged myelotoxic and lymphotropic effect. PMID- 1793295 TI - [Pharmacokinetic monitoring during aminoglycosides: optimal therapy method of individual amikacin dosing]. AB - One of the most successful approaches to adjustment of dosage regimens on the basis of single determinations of drug contents in blood specimens provides the blood sampling at the "ideal" moment (t*), i. e. at the time equal to the inverse value of the elimination rate constant. The above version of the one-point method is applicable to drugs obeying the one-compartment model. In practice, however, it is never known a priori whether the individual pharmacokinetic profile (PKP) is monoexponential or not. An attempt was made to apply the one-point method to individual amikacin (Am) intravenous bolus dosing in 27 patients with PKPs described not only by mono- but also by biexponential equations. The individual doses (Dc) estimated on the basis of Am concentrations recorded at the "ideal", point (2.75 hours after the administration) by the equation Dc = Dp.Cp(t*)/Ci(t*) were compared to the doses (DCl) found on the basis of greater than or equal to 4 determinations of the Am concentration (within 0.5 to 6 hours after the administration), i. e. by the equation DCl = Dp.Cli/Clp, where: Dp is the population value of an Am dose (7.5 mg/kg); Cp (t*) is the population value of an Am concentration at t* (6.7 mg/l), Clp is that of the total clearance [81.2 ml/(h.kg)] and Ci (t*) and Cli are the individual values of an Am concentration and clearance, respectively. The correlation coefficient of the DCl vs. Dc estimates was equal to 0.87. In 17 patients with monoexponential PKPs it was higher (r = 0.99).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793296 TI - [Prolonged antibacterial action of polymer coated suture materials]. AB - The antimicrobial activity of capromed, a surgical polymer-coated sutural material containing dioxidine, quinoxidine or gentamicin was studied in vitro and in vivo. Capromed was shown to be active against the hospital strains of S. aureus, E. coli, Proteus spp., Klebsiella spp. and P. aeruginosa. The antimicrobial activity of ADH and AG threads was preserved for 3 to 4 days after implantation. The DH-2 and G-2 threads preserved their activity for 6 to 7 days. It was concluded that the duration of thread antimicrobial activity depended on the properties of the polymer coating the thread. Capromed was applied to 280 operation wounds in 275 patients. There was no wound suppuration in the group of patients after pure operations (n = 62). In the group of patients after conditionally pure operations (n = 130) suppuration was observed in 2 patients (1.3 per cent). In patients with contaminated wounds (n = 88) suppuration in 5 of them (5.7 per cent) was recorded. The total number of the purulent complications after using capromed in surgical operations amounted to 2.5 per cent. In the control group purulent complications were stated in 8.2 per cent of the cases. PMID- 1793297 TI - [Pefloxacin pharmacokinetics in pyo-inflammatory diseases of the kidneys and urinary tract]. AB - The factors defining the therapy efficacy were studied in 15 patients with purulent inflammatory diseases of the kidneys and urinary tract. It was found that after the use of pefloxacin, urine bactericidal properties against a pathogen was pH-dependent due to high urinary norfloxacin levels. To predict the efficacy of pefloxacin therapy in renal and urinary diseases, the pathogen should be tested for sensitivity to pefloxacin and norfloxacin within a wide range of pH values. Pefloxacin concentrations correlated with plasma bactericidal properties with respect to the pathogen and was applicable in defining the optimal treatment schemes and doses based on the data of individual drug pharmacokinetics. Monitoring of plasma and urine bactericidal properties in regard to the pathogen proved to be useful in estimating the therapy efficacy. PMID- 1793298 TI - [Importance of aminoglycoside antibiotics in modern therapy of infectious inflammatory diseases]. PMID- 1793299 TI - [Amikacin--main properties and particulars of application]. PMID- 1793300 TI - [Taxonomic characteristics of soil Mycobacteria and their antibiotic properties]. AB - Morphological, cultural and chemotaxonomic properties of 12 gram-positive soil cultures isolated were studied by using a test system developed for screening the organisms producing broad-spectrum antibiotics among Nocardiaforms (Coryneforms). The cultures were found to belong to Actinomycetales, Nocardioforms, Mycobacteriaceae and Mycobacterium. The saprophytic rapidly growing soil mycobacteria showed antibiotic activity against a large number of gram-positive and gram-negative test microbes including those belonging to Pseudomonas and Proteus resistant to the majority of the antibiotics currently used in medicine. PMID- 1793301 TI - [Determination of nystatin component composition using HPLC and TLC with densitometry]. AB - The component composition of nystatin produced by an improved strain of Streptomyces noursei was determined by HPLC on Milichrom chromatograph (USSR). It was shown that the antibiotic consisted of nystatins A1, A2, A3 and B and admixture substances. The data appeared to be in good agreement with the results of the complex TLC investigation, by using densitometry. The component composition of the samples was evidenced by SIEAP mass spectrometry. Physiochemical and biological characteristics of separate components are presented. PMID- 1793302 TI - [Contributions of nuclear medicine and problems of cardiology]. PMID- 1793303 TI - [Volume and function of the right ventricle before and after intraluminal pulmonary valvuloplasty]. AB - With the purpose of studying the right ventricular infundibulum response to the obstruction of the pulmonary blood flow, the authors inform the results of the right ventricular volumes, and function changes before and after pulmonary intraluminal valvuloplasty performed in six adult patients with congenital stenosis of the pulmonary valve. After the valvuloplasty, all right ventricular volumes increased but only slightly, except for the end systolic volume at the right infundibulum, which decreased after valvuloplasty (for alpha = 0.10, p less than 0.10). The ejection fraction of this infundibulum increased after valvuloplasty (for alpha = 0.05 p less than 0.03), while the ejection fraction of the inflow chamber remained unaltered. In the same way decreased the work and power of the inflow tract of the right ventricle, regardless the decreased in the ventricular overload post-valvuloplasty; however, the ratio work vs. end diastolic volume of the right ventricle decreased (for alpha = 0.05, p less than 0.03). The authors discuss these results in relation with the changes produced by the obstruction, acute or chronic, of the pulmonary blood flow on the infundibular wall tension and contractility, whose structure and behavior allow to propose that the function of the infundibulum by means of contraction protects the pulmonary vasculature, against right ventricle hypertension. PMID- 1793304 TI - [Changes in the mass and function of the left ventricle after renal transplantation]. AB - We undertook a study of cardiac function in 13 patients with end-stage renal disease with conventional echocardiography. Measurements in systolic and diastolic function were assessed before and after renal transplantation. Improvement in left ventricular mass was observed (mu +/- SD) from 362.4 +/- 150.2 to 178.4 +/- 62.4 (p less than 0.001), also in left ventricular mass index (left ventricular mass/body surface) from 229 +/- 86.3 to 115.6 +/- 41.3 (p less than 0.001), ejection fraction from 0.44 +/- .196 to 0.64 +/- .165 (p less than 0.01) and velocity of circumferential fiber shortening (mu +/- SD) from 19.5 +/- 11.04 to 31 +/- 11.6. Renal transplantation procedure induce favorable modifications in left ventricular functions. If cardiac dysfunction is present in a end stage renal disease patient, it should be not considered a contraindication for transplantation. We were unable to demonstrate that hemoglobin values play an important role in the development or maintenance left ventricular dysfunction. A prospective, larger and longer trails are needed to clarify the risk factors associated with cardiovascular morbid event. PMID- 1793305 TI - [Primary pulmonary arterial hypertension in children under 2 years of age]. AB - A retrospective analysis of 18 patients under two years of age who suffered from primary pulmonary hypertension was made between july 1982 november 1988 in order to define their clinical course and prognosis. Perinatal history was irrelevant. In 13 patients diagnosis was established before the first year of life and in 8 of them in the neonatal period. All patients presented the same symptomatology: Cyanosis, dyspnea and/or repeated respiratory infections. The electrocardiogram showed various degrees of enlargement of the right atrium and right ventricle as well as an uneven ST segment in the precordial leads; these could not be related to the systolic or diastolic pressures of the right ventricle. In the chest roentgenogram the most important and constant feature was the heart enlargement. Cardiac catheterization showed a mean pulmonary systolic arterial pressure of 64.46 mmHg and a mean pulmonary arterial resistance of 6.4 U/m.2 These parameters could not be related to a bad prognosis. Three patients were given vasodilators (hydralazine) with positive clinical and echocardiographic results. Five patients died (27%) two months after the diagnosis was made and three months after the onset of symptomatology, four of them died due to congestive heart failure and one had sudden death. This study shows the early onset of the disease as well as its short term high mortality. PMID- 1793306 TI - [Electrocardiogram of the healthy premature infant]. AB - At the Hospital de Ginecobstetricia del Centro Medico "La Raza", were taken EKG to 30 healthy premature newborn during a six month period. The first EKG was recorded 3 hours after birth, the second in 8 hours, the third in 24 h, the fourth in 48 h, the fifth in 72 hours, the sixth at the end of the first week, the seventh at the fifteen days and the eighth at 30 days after birth. The mean heart rate was 135 +/- 10 beats/min in the first week. There were heart rate elevation for the first three days after birth. The QRS mean axis were + 130 +/- 25 degrees, without changes during the study time. The QTc interval in all cases was higher than 0.42 sec. The voltage of waves R and S at right and left precordial leads were similar. At this gestational age the ventricular masses are equals. The T waves changes reflected hemodynamic changes. It is concluded what the healthy premature newborn had a typical EKG as a reflex to the cardiocirculatory adaptations. PMID- 1793307 TI - [Medico-surgical experience in dysfunction of heart valve prostheses. Report of 55 cases]. AB - The medical and surgical outcome of 55 patients with prosthetic valve disfunction are reported (39 bioprosthesis and 16 mechanical). Fifty patients were operated and five had medical treatment. The group of patients with mechanical prosthesis had a functional class of 2.4 +/- .74 vs patients with bioprosthesis who had a functional class of 2.8 +/- .71. Forty eight patients (87%) had congestive heart failure, four systemic emboli and three infective endocarditis. Three cases with mechanical prosthesis in tricuspid position were subjected to thrombolysis with streptokinase and experienced clinical and echocardiographical improvement. Time elapsed from original implantation and valve disfunction was 66 +/- 56 months for mechanical prosthesis vs 108 +/- 37 months in bioprosthesis (p less than 0.01), three patients died at surgery and two during the waiting period. All deaths resulted from cardiogenic shock. All of them were previously on functional class IV. PMID- 1793308 TI - [Catecholamine-producing tumors]. AB - We report 93 patients with catecholamine producing tumors that were analyzed at the Hormone Laboratory of the Institute of Cardiology. They are 75 pheochromocytoma patients and 18 children with neuroblastoma. Fluorimetric methods were used to measure urinary and plasma catecholamines on neuroblastoma and pheochromocytoma patients. Dopamine high excretion (mean value 2889 micrograms/24 hs), was constantly observed in the neuroblastoma children as were adrenaline and noradrenaline in the benign and malignant pheochromocytoma patients. The mean values for the malignant tumours were 53 for adrenaline and 1436 micrograms/24 hs for noradrenaline. Structural and biochemical differences of the catecholamine producing tumours are reflected on the clinical manifestations which are observed in the patients bearing such neoplasms. PMID- 1793309 TI - [The hospital course of patients with acute myocardial infarction after discharge from the coronary unit]. AB - The in-hospital clinical course of 100 patients discharged from the CCU with a Acute Myocardial Infarction (AMI) were studied at the Instituto Nacional de Cardiologia "Ignacio Chavez" 86 were men and 14 women, the age in the majority was between 50 and 80 years. The diaphragmatic necrosis was predominant. 11 patients had angina pectoris after the infarction, five cardiac failure, 4 a new AMI and 5 died (5%). Coronary angiography was performed in 35 patients, and treadmill test at 63. The treadmill test results had a good correlation with the angiographic findings. Coronary bypass grafts surgery was performed in 18 patients, 17 had good evolution, without post surgery angina or cardiac failure. One died at the OR. 3 pts more had PTCA, two in the AD and one a circumflex incomplete dilatation. All 3 were discharged asymptomatic. Four patients had another AMI, two died with cardiogenic shock, and two good clinical course, including one who had AMI after had graft surgery. Five pts died. Two with another AMI, one at the OR and two had a sudden death. One of these had previous cardiac failure and PVC. It is concluded that: patients with a new AMI and cardiac failure have poor prognosis. The coronary graft surgery has great therapeutic value in pts with angina post AMI. The treadmill test has a good correlation with the coronary damage found at angiography. PMID- 1793310 TI - [Clinical and prognostic implications of age in acute myocardial infarct]. AB - The purpose of this study was to evaluate the clinical characteristics and the factors related to early mortality in the acute myocardial infarction of the geriatric population. We studied 814 consecutive patients with their first acute myocardial infarction admitted to the coronary care unit at tha Hospital General de Galicia. 401 patients were older than 65 years (Group A) and 413 were younger (Group B). Group A was found a significantly lower percentage of males (64.7% versus 88.4%; p less than 0.001) and smokers (46.7% versus 72.7%; p less than 0.001; and older patients showed a greater incidence of diabetes mellitus (28.1% versus 15.2%; p less than 0.001) and arterial hypertension (45.6% versus 31.7%; p less than 0.01). In the geriatric population, the clinical course of the acute myocardial infarction is characterized by a greater incidence of heart failure (35.3% versus 11.1%; p less than 0.001), cardiogenic shock (18% versus 5.7%; p less than 0.001) and post-acute myocardial infarction angina pectoris (18.3% versus 12.2%; p less than 0.05). Early mortality (first month) was significantly higher in elderly patients (22.7% versus 6.3%; p less than 0.001). The multivariate analysis by stepwise logistic regression identified cardiogenic shock, age and heart failure as the only independent predictive variables for early mortality. We conclude that early mortality in the acute myocardial infarction is high and related to severe degrees of pump failure and age. PMID- 1793311 TI - [Clinical features of idiopathic mitral valve prolapse]. AB - This paper ask a question; is there a generalized defect of the connective tissue among subjects with primary mitral valve prolapse? Based on clinical methods it was found that paired subjects with and without primary mitral valve prolapse, are different in respect of an arbitrary score of joint hypermobility and phenotypic features. This is a statistically significant difference and suggest a possible molecular defect affecting connective tissue in people with primary mitral valve prolapse. Therefore, biochemical and molecular studies should be done to further characterize this abnormality. PMID- 1793312 TI - [Electrocardiographic differences between standard 12-lead recording and modifications in exercise testing]. AB - Modified limb electrode positions proposed by Mason and Likar are often used in exercise electrocardiograms. In some cases, such modifications induced considerable differences in electrocardiographic waveforms of the frontal plane leads. To assess the magnitude of these changes, 55 patients were studied with standard and modified limb electrodes. We observed a significant verticalization (p less than 0.01) of all electrical axis in the modified ones: there was a difference of 19.6 +/- 1.7 grades for the P wave, 36.4 +/- 8 grades for the QRS axis and 26.0 +/- 3.3 for the T wave in the frontal plane. When classified by electrocardiographic pathology, old transmural inferior myocardial infarction and S1, S2, S3 pattern did not change electrical axis. There was also a significant increase (5 +/- 1 mseg, p less than 0.01) in the intrinsic deflection onset of the unipolar lead a VF of the modified one. Such finding suggests the recording of a more lateral region when compared with the onset of intrinsic deflection of the precordial leads. We conclude that modified limb electrode position induces a significant verticalization of the electrical axis in the frontal plane. The recorded myocardial region in such electrocardiograms seems to be different from that recorded in the standard one. For some cases, we suggest to explore the inferior myocardial region by using the standard aVF location in the postexercise recordings. PMID- 1793313 TI - [New techniques in nuclear cardiology: SPECT, PET and antimyosin]. AB - Nuclear Cardiology offers non-invasive techniques of high reproducibility for cardiovascular assessment. These techniques have advanced enormously in the latest years. The advances in areas such as general technology and computer systems, medicine, immunology and research, allow us to obtain and interpret cardiac information with immediate or potential clinical applications unavailable few years ago. This paper describes 3 of these new techniques in nuclear cardiology: Single Photon Computed Tomography (SPECT); Positron Emission Tomography (PET) and; the use of an Antimyosin monoclonal antibody. PMID- 1793314 TI - [Guidelines for the training of practitioners in coronary angiography and angioplasty, the organization and equipment of centres of coronary angiography and transluminal angioplasty]. PMID- 1793315 TI - [Life expectancy after a first attack of sustained monomorphic ventricular tachycardia. Apropos of 295 patients with a follow-up of more than 5 years]. AB - Analysis of actuarial cardiac mortality of 295 patients after a first attack of sustained monomorphic ventricular tachycardia followed up for an average of 5.1 years showed that: the aetiology was the main prognostic factor. Patients with a normal left ventricle had a zero 5 year mortality rate (normal heart) or 3% (arrhythmogenic right ventricular dysplasia) compared with 24% in patients with cardiomyopathy and 40% with myocardial infarction: p less than 0.01. Similar results were obtained if sudden death was considered; in patients with left ventricular disease, the role of pump function assessed by the ejection fraction was essential: the 5 year mortality was 14.5% (cardiomyopathy) and 30% (myocardial infarction) if this was greater than 0.3 compared to 43% and 51% respectively when less than 0.3 (p less than 0.01); the heart rate of spontaneous ventricular tachycardia and that of tachycardia induced during endocavitary investigation had no influence on the mortality. However, the mortality following a first tachycardia with syncope was higher than that following a well tolerated tachycardia (p less than 0.5 if the ejection fraction less than or equal to 0.3 and p less than 0.001 if greater than 0.3).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793316 TI - [Characteristics of jets in adult bicuspid aortic valve by color Doppler imaging]. AB - Color flow mapping of 15 adults with bicuspid aortic valves confirmed angiographically and at surgery comprising 8 regurgitations and 7 stenoses was analysed, retrospectively in 12 cases. The object was to detect any special features of the jets of this congenital abnormality. The site of emergence of the jet at the aortic orifice and its direction in the left ventricle were studied in the long axis, short transaortic and left ventricular axes by sequential analysis. Two types of regurgitant jet were observed: eccentric anterior origin (5, Type I), eccentric posterior origin (3, Type II), extending towards the structure opposite to their origin in the left ventricular outflow tract. In cases of stenosis, the cross-sectional view of the jet had an almost transverse slit-like appearance extending from one side of the aortic orifice to the other or an anterior or posterior eccentric oval shape. The Type I cases and the slit like anterior stenoses had fusion of the coronary cusps whilst the Type II and posterior slit-like stenoses had fusion of the right coronary and non-coronary cusps. This preliminary study suggests that bicuspid aortic valves are associated with jet characteristics related to the abnormal commissural axis which allows diagnosis and precision of the anatomic type in adults despite the presence of calcification. PMID- 1793317 TI - [Percutaneous mitral valvuloplasty by Inoue's technique. Apropos of an experience of 71 cases]. AB - Seventy-one consecutive, unselected patients underwent percutaneous mitral valvuloplasty by Inoue's technique between February and November 1990. The mean age was 53 years (range 32 to 75 years). Fifteen of the 71 patients had previously undergone surgical mitral commissurotomy. Three patients had Bjork aortic valve prostheses. The mitral valve surface area increased from 1.1 +/- 0.2 cm2 to 1.95 +/- 0.5 cm2 (p less than 0.01) and the mean transmitral pressure gradient fell from 12 +/- 3 mmHg to 5 +/- 2 mmHg (p less than 0.05). Grade 3+ mitral regurgitation was observed in 4 patients. There were no cases of cardiac perforation or tamponade. The only complications were related to the catheterisation and not to the technique valvuloplasty (one case of prolonged fever which regressed with antibiotic therapy, one case of arteriovenous fistula at the site of femoral artery puncture). The QP/QS ratio was 1.1 +/- 0.2 at the end of the procedure. A QP/QS ratio greater than 1.5 was observed in one patient. A left-to-right shunt was observed in 53% of cases in the immediate post valvuloplasty period with Doppler color flow imaging. In all, 78% of patients had a satisfactory result (mitral surface area greater than 1.5 cm2 and mitral regurgitation less than or equal to 2/4). These results are identical to those observed with the double balloon technique with a lower rate of complications. The duration of the procedure (104 +/- 13 min p less than 0.02) and of radioscopy (16 +/- 8 min, p less than 0.02) were shorter than with the double balloon technique.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793318 TI - [Isolated ST segment depression from V2 to V4 leads, an early electrocardiographic sign of posterior myocardial infarction]. AB - ST segment depression in leads V2 to V4 in a clinical and biochemical context of myocardial infarction is usually interpreted as a sign of non-Q wave anterior walls infarction. In order to determine if this clinical electric entity could indicate transmural posterior or posterolateral infarction, as recently suggested, we undertook a prospective study of 328 primary myocardial infarctions. Isolated ST depression in leads V2 to V4 was observed in 28 patients (8.5%). It was maximal in V3 (1.8 +/- 0.7 mm) or V4 (2 +/- 1 mm). The T wave was always positive. All these case had segmental wall motion abnormalities of the left ventricular posterolateral wall on 2D echocardiography. The Q wave confirming the transmural character of the infarct was observed in leads V7, V8 and V9 on average 33 hours after the onset of pain (10-56 hours) as did the increase in the R/S ratio in leads V1 and V2. Coronary angiography performed in 26 patients showed significant disease of the left circumflex artery in all cases. This was isolated (39%) or associated with left anterior descending (15%), right coronary artery disease (19%) or both (27%). In conclusion, isolated ST segment depression in leads V2-V4 in the clinical context of acute myocardial infarction indicates a transmural posterior localisation of the necrosis. It corresponds to reciprocal subepicardial posterior ischaemia. In cases of inferior infarction, it reflects postero-lateral extension rather than associated anterior wall ischemia. PMID- 1793319 TI - [Changes in high amplitude ECG during hospitalization for myocardial infarction]. AB - The aim of this study was to determine the optimal time for recording the signal averaged electrocardiogram in order not to miss cardiac events after acute myocardial infarction. Three signal averaged electrocardiograms were recorded by Simson's method in the early post infarction period at Day 1 (24 to 48 hours after the onset of symptoms) at Day 8 (8 days after the onset) and Day 15 (2 weeks after the onset) in 66 patients. The results showed late potentials in only 18% of patients at Day 1 and that this was not related to a greater risk of ventricular arrhythmia in the acute phase. Late potentials were recorded in 34.8% of patients on Day 8 and 28.7% at Day 15. We suggest that signal averaged electrocardiography be performed one to two weeks after the onset of myocardial infarction; 13 of 66 patients had abnormalities at Day 8 but not on Day 1. PMID- 1793320 TI - [Changes in high amplification ECG during the 2 years following the acute phase of myocardial infarction]. AB - Late potentials have been reported 1 to 15 days after the onset of myocardial infarction but the evolution during long-term follow-up is not so well known. In order to determine if the signal averaged electrocardiogram remained stable or if it was necessary to repeat the investigation during a period of 2 years, 90 patients underwent 2 recordings on average 3 weeks after the onset of the infarct and then 2 years later. After the first recording, 16 patients (18%) had late potentials. The second recording was performed under the same conditions by the same operator. Globally, the signal averaged electrocardiogram recorded by Simson's method remained remarkably stable (83/90). It was rare to observe late potentials occurring for the first time after the initial recording (4 cases, 5%) in this study. It was more common to observe their disappearance (3 cases, 19%). No explanation could be found except in one case. These possible long-term changes in the signal averaged electrocardiogram suggest that the investigation should only be repeated in patients with abnormalities on the initial recording. Some authors have reported a better prognosis in patients in whom late potentials disappeared but this was not verified in this study. PMID- 1793321 TI - [Results of pulsed laser angioplasty of peripheral arteries guided by spectroscopy]. AB - Seventy-six patients with complete occlusion of the iliac, femoropopliteal or distal arteries underwent laser angioplasty after failure of attempted mechanical recanalization by conventional angioplasty. The energy source was a dye pulsed laser emitting at 480 nm, 2 microseconds, 35 to 50 mJ/pulse and 5 Hz. The laser was coupled with an optical fiber of 200 microns diameter covered by a metallic spring. In order to center the laser in the arterial lumen, the fibre optic was introduced with a balloon catheter or a modified Van Andel catheter with a tapered and curved distal end with controlled torsion to direct the laser towards the lesion to be treated. The therapeutic laser was connected to a diagnostic Helium-Cadmium laser emitting at 325 nm, 50 ms and 5 mW, for the induction of tissue fluorescence analysed by a multichannel detector, itself connected to a computer programmed to differentiate atheromatous from normal tissues. The therapeutic laser was only activated when atheromatous tissue was in contact with the distal tip of the fiber optic. After vaporizing a narrow pilot channel conventional balloon angioplasty was performed. The immediate success rate was 83%; it was higher in iliac than in femoral arteries. This was less dependent on the length of occlusion than on the presence of calcification which was a common cause of failure. The complications were immediate reocclusion, perforation due to the sharp tip of the fibre and dissections without major clinical consequences. After 18 months, 64% of the arteries remained patent.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793322 TI - [Leukocytes and arteriosclerosis]. AB - Human atherosclerotic plaques contain two type of leucocytes: 1. Monocytes/macrophages comprise almost two thirds of the cells in the center of the lesion (lipid core), and a quarter of the cells in its periphery (fibrous cap); 2. T lymphocytes comprise 10 to 15% of the plaque cells. Polymorphonuclear granulocytes are only present in very small number. The abundance of leucocytes, together with sclerosis and proliferation of mesenchymatous cells (arterial smooth muscle cells), confer to atherosclerosis the aspect of a chronic inflammatory reaction, a fact which has been recognised for a long time. Monocytes/macrophages may contribute to the development of atherosclerosis in several ways: stimulation of the fibro-muscular reaction, endothelial injury, accumulation of intimal lipids. The role of T lymphocytes is still poorly understood. According to some observations, they might be involved in an immunological reaction of the arterial wall which could be determinant in the evolution of the lesion. Arterial leucocytes have somewhat complicated, but also widened our pathogenic hypotheses of atherosclerosis. A major issue now is to identify the nature of the arterial aggressions which provoke the involvement of leucocytes, and the reasons why the defences they oppose are overwhelmed to result eventually in severe thrombo-occlusive events. Recent evidence has strengthened the possibility that viral infection plays a role in atherosclerosis. Beyond their pathogenic interest, these acquisitions might soon provide interesting therapeutic approaches. PMID- 1793323 TI - [Initial primary sarcoma of the pulmonary valve and trunk of the pulmonary artery]. AB - Primary sarcomas arising from the trunk or branches of the pulmonary artery are exceedingly rare and usually diagnosed at autopsy. The authors report the case of a 31 year old man referred for investigation of recurrent syncope. Echocardiography, right ventriculography and the thoracic computed tomography led to early diagnosis of a pulmonary artery tumour and surgical resection. Histology revealed a primary sarcoma. The early postoperative course was uncomplicated but one month after surgery a local recurrence was diagnosed at routine echocardiographic examination. The syncopal symptoms recurred seven months after surgery and echocardiography showed tumour recurrence on the interventricular septum and in the pulmonary artery. A second palliative operation was attempted but was unsuccessful because of the size of the tumour. PMID- 1793324 TI - [Hydatid cyst of the interventricular septum. Contribution of magnetic resonance imaging]. AB - Cardiac localisation of hydatid cysts is rare representing 0.5 to 2% of all clinical forms of this condition. Hydatid cysts are usually observed in the left ventricle and involvement of the interventricular septum is exceptional. The principal diagnostic and preoperative investigations are serology and imaging by echocardiography and computed tomography, which can give conflicting results. The authors report a case of hydatid cyst of the interventricular septum in which computed tomography was non-contributory whereas echocardiography (the key investigation in all cases of hydatid cyst) associated with nuclear magnetic resonance imaging provided particularly accurate preoperative information. The latter investigation also allowed diagnosis of pulmonary, hepatic, splenic and renal involvement of the disease. PMID- 1793325 TI - [Mitral valvuloplasty for endomyocardial fibrosis in a child with acute leukemia and hypereosinophilia]. AB - The authors report the case of a child with acute lymphoblastic leukaemia and hypereosinophilia complicated by left sided endomyocardial fibrosis. Despite the need for urgent treatment and severe mitral valve disease, a complex mitral valvuloplasty was performed, consisting of mobilisation and reconstruction of the posterior leaflet, burying the chordae with plicature of the papillary muscle of the anterior leaflet associated with an annuloplasty. Decortication was performed by a transvalvular approach. The technique of mobilisation-reconstruction of the posterior mitral leaflet with a pericardial patch should widen the indication of conservative surgery in this condition, in the presence of dominant mitral regurgitation in the child. PMID- 1793326 TI - [Spontaneous calcified coronary embolism and myocardial infarction. Apropos of a case]. AB - The authors report a rare case of myocardial infarction due to calcific coronary embolisation in a patient with previously asymptomatic calcific aortic stenosis. The diagnosis was suggested by the finding of a lacunar image in the distal segment of the left anterior descending artery exactly corresponding to a punctiform mobile calcification visible before opacification of the coronary arteries. The clinical features of coronary embolism and in particular of calcific embolism are reviewed. PMID- 1793327 TI - [Apropos of the article: "Silent ischemic cardiopathies in arteritis. Diagnosis and 5-year prognosis in a group of 418 patients" by J. Ponsonnaille et al]. PMID- 1793328 TI - [Mass and geometry of the left ventricle. Contribution of ultrafast computed x ray tomography and magnetic resonance imaging]. AB - Ultrafast computed tomography and magnetic resonance imaging are two new methods of cardiac imaging. Measurements of left ventricular volume (end-diastolic, end systolic volume, stroke volume) and mass have been validated with both methods. The calculations are independent of the geometric shape of the ventricle. Although regional analysis is difficult because of the complex movement of the left ventricle in the tomographic cuts, these methods present a number of advantages: excellent temporospatial tomographic resolution, approximately the same in all dimensions, appreciation of endocardial movement from an epicardial centre, the potential to record their transform spatial data in 3 dimensions from initial planar acquisition. However, all potential regional measurements are still being validated as they are operator-dependent and require visual identification and manual tracing of the cardiac contours or local infrastructures which affect the results of these techniques which are still relatively little used in cardiac imaging. In the context of clinical evaluation, these relatively non-invasive methods will become extremely accurate in the appreciation of parameters of left ventricular geometry and function. They will become very useful in the determination of the myocardial effects of drugs, surgery or other interventional procedures in different models of cardiac disease. PMID- 1793329 TI - [Ultrafast computed tomography and measurement of the left ventricular volume]. AB - Ultrafast computed tomography is a method of acquiring cardiac tomographic images 8 mm thick of high resolution in a very short time (about 50 ms). It is particularly well adapted to evaluation of the anatomy and quantification of the volume of the left ventricle. Acquisition of the image is initiated by the R wave of the electrocardiogram. Short axis or long axis views of the heart may be recorded. There are usually 12 short axis tomographic cuts from the apex to the base and for each there are 13 acquisitions in the RR cycle at 58 ms intervals. The half circulation time must be determined beforehand as 50 cc of contrast medium have to be injected peripherally to visualise the cardiac chambers. The contrast medium enhances the endocardium and papillary muscle borders enabling semi-automatic contour tracings. End diastole and end systole are easily determined from the 13 acquisitions in the cardiac cycle, and the wall motion of the left ventricle can be analysed using a cineloop facility. Akinesia, dyskinesia and even wall thickness can be determined. After tracing the endocardial contour, the microprocessor calculates the surface of the enclosed area, and the volume of this simple cylinder can be derived by multiplication of the thickness of each slice. The total volume at each of the 13 instances is obtained by summation. End diastolic, end systolic volumes and ejection fraction can thereby be determined. Left ventricular mass may also be evaluated by tracing the epicardial border.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793330 TI - [Cardiomyopathy in the Syrian hamster. Physiological and therapeutic aspects]. AB - The primary hereditary cardiomyopathy of the Syrian hamster is a particularly interesting model of experimental cardiomyopathy 1) because of its slow progression to cardiac failure unlike acute experimental volume and pressure overloading; 2) because of the reproducibility and predictable nature of the mechanical, biochemical and electrophysiological abnormalities observed at each stage of the disease; 3) because of involvement of other muscle groups, and particularly, skeletal muscle. The physiopathology is not fully understood but a disturbance of intracellular calcium homeostasis appears to play a major role. From the therapeutic point of view, a number of calcium antagonists have been shown to be effective in restoring myocardial function, but they have no effect on skeletal muscular lesions. Recently, early prophylactic intervention with therapeutic doses of perindopril has been shown to prevent the decrease of certain parameters of myocardial contractility in vitro in the dilated group, before the appearance of any signs of cardiac failure. This study also showed that angiotensin converting enzyme inhibitors had no intrinsic negative inotropic effects. PMID- 1793331 TI - [Perindopril and chronic heart failure]. AB - Haemodynamic studies performed in patients with cardiac failure have shown that perindopril decreases right and left ventricular filling pressures, systemic blood pressure and peripheral resistances, slightly reduces the heart rate and increases cardiac output. Flammang showed that these haemodynamic changes are sustained after 12 months' treatment. A randomised double blind multicenter trial versus placebo was carried out over 3 months following a 15 days pre-inclusion period in 125 patients with NYHA Stage II and III cardiac failure stabilised by digitalis and diuretic therapy. Perindopril was administered at a dosage of 2 or 4 mg according to initial systolic blood pressure and efficacy was evaluated at 1 and 3 months according to the NYHA classification, a score of clinical severity, the duration of two exercise stress tests on a bicycle ergometer or treadmill and the cardiothoracic ratio. There were no cases of cardiac decompensation (NYHA Stage IV) in the group of perindopril whilst 3 cases were observed in the placebo group. Significant improvements in the clinical scores and effort capacity were observed in the perindopril group. The duration of exercise on the treadmill was 778 seconds with perindopril compared to 544 seconds in the placebo group. Systolic blood pressure did not change and there was a slight decrease in standing diastolic pressures. No significant increases in blood urea or creatinine levels were observed. To study the effects on blood pressure, a major factor in the management of a patient with cardiac failure, McFadyen compared the changes in blood pressure after a single dose of perindopril, enalapril, captopril and placebo.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793332 TI - [Left ventricular geometry and remodeling]. PMID- 1793333 TI - Psychrotrophic, lactic acid-producing bacteria from anoxic waters in Ace Lake, Antarctica; Carnobacterium funditum sp. nov. and Carnobacterium alterfunditum sp. nov. AB - Heterofermentative, lactic acid-producing, gram-positive, motile bacteria were isolated from the waters of Ace Lake, Antarctica. All strains produced virtually only L(+)lactic acid from D(+)glucose. D(--)-ribose was fermented to lactic, acetic, and formic acids, and ethanol. Cell walls contained meso-diaminopimaleic acid. The strains did not grow at 30 degrees C and were psychrotrophic. Whole cells contained 18:1 cis 9 as a major component of their fatty acids. At 20 degrees C, the strains grew better anaerobically than aerobically and all strains lacked catalase, oxidase and respiratory lipoquinones. DNA that coded for most of the 16S rRNA gene of one of the strains was amplified by the polymerase chain reaction and sequenced. The strain was phylogenetically most closely related to Carnobacterium mobile (Knuc = 0.0214). The isolates separated into two phenotypes. DNA/DNA homology studies determined on a representative from each phenotype showed low homology between the phenotypes (38 +/- 8%), and with Carnobacterium mobile (26 +/- 2%, 34 +/- 2%). Carnobacterium funditum sp. nov. produced acid from mannitol, trehalose, but not amygdalin. The G + C content of the DNA was 32-34%, and the Type strain is DSM 5970 (=ACAM 312). Carnobacterium alterfunditum sp. nov. produced acid weakly from amygdalin but not from mannitol trehalose. The G + C content was 33-34%, and the Type strain is DSM 5972 (=ACAM 313). PMID- 1793334 TI - Codon usage and G + C content in Bradyrhizobium japonicum genes are not uniform. AB - To date, the sequences of 45 Bradyrhizobium japonicum genes are known. This provides sufficient information to determine their codon usage and G + C content. Surprisingly, B. japonicum nodulation and NifA-regulated genes were found to have a less biased codon usage and a lower G + C content than genes not belonging to these two groups. Thus, the coding regions of nodulation genes and NifA-regulated genes could hardly be identified in codon preference plots whereas this was not difficult with other genes. The codon frequency table of the highly biased genes was used in a codon preference plot to analyze the RSRj alpha 9 sequence which is an insertion sequence (IS)-like element. The plot helped identify a new open reading frame (ORF355) that escaped previous detection because of two sequencing errors. These were now corrected. The deduced gene product of ORF355 in RSRj alpha 9 showed extensive similarity to a putative protein encoded by an ORF in the T-DNA of Agrobacterium rhizogenes. The DNA sequences bordering both ORFs showed inverted repeats and potential target site duplications which supported the assumption that they were IS-like elements. PMID- 1793335 TI - Structure and expression of the Chlorobium vibrioforme hemA gene. AB - The green sulfur bacterium, Chlorobium vibrioforme, synthesizes the tetrapyrrole precursor, delta-aminolevulinic acid (ALA), from glutamate via the RNA-dependent five-carbon pathway. A 1.9-kb clone of genomic DNA from C. vibrioforme that is capable of transforming a glutamyl-tRNA reductase-deficient, ALA-dependent, hemA mutant of Escherichia coli to prototrophy was sequenced. The transforming C. vibrioforme DNA has significant sequence similarity to the E. coli, Salmonella typhimurium, and Bacillus subtilis hemA genes and contains a 1245 base open reading frame that encodes a 415 amino acid polypeptide with a calculated molecular weight of 46174. This polypeptide has over 28% amino acid identity with the polypeptides deduced from the nucleic acid sequences of the E. coli, S. typhimurium, and B. subtilis hemA genes. No sequence similarity was detected, at either the nucleic acid or the peptide level, with the Rhodobacter capsulatus or Bradyrhizobium japonicum hemA genes, which encode ALA synthase, or with the S. typhimurium hemL gene, which encodes glutamate-1-semialdehyde aminotransferase. These results establish that hemA encodes glutamyl-tRNA reductase in species that use the five-carbon ALA biosynthetic pathway. A second region of the cloned DNA, located downstream from the hemA gene, has significant sequence similarity to the E. coli and B. subtilis hemC genes. This region contains a potential open reading frame that encodes a polypeptide that has high sequence identity to the deduced E. coli and B. subtilis HemC peptides. hemC encodes the tetrapyrrole biosynthetic enzyme, porphobilinogen deaminase, in these species.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793336 TI - Fermentation of cellulose and production of cellulolytic and xylanolytic enzymes by anaerobic fungi from ruminant and non-ruminant herbivores. AB - Four anaerobic fungi were grown on filter paper cellulose and monitored over a 7 8 days period for substrate utilisation, fermentation products, and secretion of cellulolytic and xylanolytic enzymes. Two of the fungi (N1 and N2) were Neocallimastix species isolated from a ruminant (sheep) and the other two fungi were Piromyces species (E2 and R1) isolated from an Indian Elephant and an Indian Rhinoceros, respectively. The tested anaerobic fungi degraded the filter paper cellulose almost completely and estimated cellulose digestion rates were 0.25, 0.13, 0.21 and 0.18 g.l-1.h-1 for strains E2, N1, N2, R1, respectively. All strains secreted cellulolytic and xylanolytic enzymes, including endoglucanase, exoglucanase, beta-glucosidase and xylanase. Strain E2 secreted the highest levels of enzymes in a relatively short time. The product formation on avicel by enzymes secreted by the four fungi was studied. Both in the presence and absence of glucurono-1,5-delta-lactone, a specific inhibitor of beta-glucosidase, mainly glucose was formed but no cellobiose. Therefore the exoglucanase secreted by the four fungi is probably a glucohydrolase. PMID- 1793337 TI - Prolonged environmental stress via a two step process selects mutants of Escherichia, Salmonella and Pseudomonas that grow at 54 degrees C. AB - A prolonged incubation of Escherichia, Salmonella or Pseudomonas at 48 degrees C with nalidixic acid selected mutants (T48) able to grow at 48 degrees C. A prolonged incubation at 54 degrees C of the T48 mutants selected mutants (T54) able to grow at 54 degrees C. These mutants were susceptible to the same bacteriophages as the original mesophilic strains. Auxotrophic phenotypes of Escherichia coli and Salmonella typhimurium mesophilic parents were demonstrated by these mutants if they were cultivated on minimal agar with cellobiose at 48 degrees C or 54 degrees C or on a minimal agar with glucose at 37 degrees C. The T48 alleles mapped in the gyrA region of E. coli or S. typhimurium chromosome. In S. typhimurium the T54 alleles, which permit growth at 54 degrees C, were shown by cotransductional analysis to be linked to gyrA. PMID- 1793339 TI - [Hypersensitivity to Aspergillus fumigatus in mucoviscidosis]. PMID- 1793338 TI - Release of transforming plasmid and chromosomal DNA from two cultured soil bacteria. AB - The release of chromosomal and plasmid DNA from Acinetobacter calcoaceticus and Bacillus subtilis cultivated in minimal medium and broth over a period of 50 h was monitored and related to growth phase, autolysis, DNase production and natural competence. The released DNAs were biologically active in natural transformation. In addition, the circular integrity of a released B. subtilis shuttle vector (pHV14) was demonstrated by artificial transformation of Escherichia coli. In cultures of both strains high molecular weight DNA accumulated, particularly during the stationary and death phase (up to 30 micrograms ml-1). Generally, despite the presence in culture fluids of DNase activity (and of an intracellular enzyme, catalase, indicating some cell lysis) there was high transforming activity of chromosomal and plasmid DNA even 40 h after the cultures reached the stationary phase. In cultures of B. subtilis in minimal medium a presumably active release of intact plasmids and chromosomal DNA occurred during the competence phase. The release of biologically functional DNA during essentially all growth phases of a gram-positive and a gram-negative member of soil bacteria might facilitate horizontal gene transfer by transformation in natural habitats. PMID- 1793340 TI - [Do non-steroidal anti-inflammatory agents have a role in the treatment of otitis in infants and children?]. PMID- 1793341 TI - [Mucoviscidosis and allergic bronchopulmonary aspergillosis]. AB - Allergic bronchopulmonary aspergillosis (ABPA) is a severe disease inducing bronchopulmonary anatomic lesions which complicate those already present in patients with cystic fibrosis. The frequency of this association is estimated between 0.6 and 10% according to American studies. Diagnosis of ABPA is difficult, as findings such as sibilant rales, pulmonary infiltrates, bronchiectasies, anti-aspergillus precipitins may be present as single features in patients with cystic fibrosis. Thus it is important to ascertain the diagnosis as oral corticosteroid treatment is the only one able to prevent evolution towards bronchiectasies and pulmonary fibrosis. PMID- 1793342 TI - [Early tubular involvements in lead poisoning in children]. AB - One of the main targets of lead poisoning is the kidney. Chronic poisoning can lead to kidney failure, and acute poisoning to tubulopathy with Toni-Debre Fanconi syndrome. The primum movens of this tubulopathy is a distortion of mitochondrial energetic metabolism. We studied 27 children presenting with non symptomatic poisoning. Serum creatinine levels were normal. There was neither proteinuria nor glycosuria and only one child presented with hyperaminoaciduria. One third already presented with signs of tubulopathy, as shown by an increase in beta 2 microglobinuria in 36.5% of the cases studied (8 times in 22 samples) and enzymuria in 30.4% of the cases (23.5% if one excludes the children having had a chelation before the study). Kidney is therefore involved early in lead poisoning in children. PMID- 1793343 TI - [Severe Crohn's disease in children. Retrospective study of 38 cases]. AB - Thirty-eight children presenting with severe Crohn's disease (CD) were studied retrospectively over a mean period of 6 years. The severity of CD was estimated according to an activity score. This was initially 66 +/- 19 reaching 100 in 16% of cases. Initial involvement included ileon and large intestine only (n = 23), large intestine (n = 11) and ileon only (n = 4), with upper GI tract or perineal involvement in 32 and 75% of cases respectively. The treatments consisted of corticosteroids (n = 34), azathioprine (n = 11), continuous enteral feeding (CEF) (n = 25), parenteral nutrition (PN) (n = 30). Mean recurrence rates per patient and per year were 0.6 in the groups including ileon and large intestine or the large intestine only and 0.3 in the ileal group. A surgical resection was performed in 20 cases with a mean rate of reoperation of 40% at 5 years. Reoperations were necessary only in the group involving the ileon and large intestine. Mean weight catch-up in 3 months and height growth speed were 6 kg and 1.7 to 3.1 cm/year under CED and/or PN. After a 6 year follow-up the activity index was decreased by 70% with a quality of life considered to be good in 60% of cases. PMID- 1793344 TI - [Vertex spikes in newborn infants in acute cerebral anoxia. Prognostic value]. AB - The authors report 10 cases of newborns with neonatal hypoxic encephalopathy and presence of spikes in the vertex area on EEG. Evolution was characterized by the onset of a spastic paraparesy with frontal atrophy on CT scan examination and disappearance of the spikes after 2 months of age. This graphic pattern is usually absent in neonatal anoxic encephalopathy. Vertex spikes thus appear to have a prognostic value in neonates with brain anoxia. PMID- 1793345 TI - [Long-term outcome of congenital diaphragmatic hernia. A study of 17 patients]. AB - In order to better define the outcome of patients with neonatal congenital diaphragmatic hernia (CDH), 17 patients between 3 and 19 years of age, among 34 survivors from 100 CDH have been re-examined clinically. All had a lung radiography, lung function studies, and radionuclide (Technetium 99m, Xenon 133) lung scans. Three patients suffered from asthma, 2 had recurrent bronchitis, 4 poor tolerance to effort, 3 gastrooesophageal regurgitation leading to endobrachyoesophagus and oesophagitis in one, 3 had scoliosis. Lung scans demonstrated hypoperfusion of the herniated side (less than 40%) in 6 patients. Chest films showed hypovascularisation on the herniated side. Lung function studies, performed in 4 of these 6 patients, showed a restrictive syndrome in 1 patient. Our results confirm those in the literature: perfusion is more altered than ventilation. Chest films at one year of age, completed if necessary by radionuclide lung scans, allow identification of children who have important pulmonary hypoplasia. These children need a regular follow-up: respiratory, digestive and orthopedic complications must be treated in order to preserve the respiratory function in adulthood. PMID- 1793346 TI - [Recurrent coxopathy, isolated manifestation of Gaucher's disease]. AB - A case of Gaucher's disease is reported in a 12 year-old girl. Presenting signs consisted of relapsing hip arthritis, while no splenomegaly was detectable. The authors comment the inflammatory or moderately hemorrhagic nature of articular fluid and the diagnostic value of an early decreased uptake on bone scintiscan. The value of magnetic resonance imaging for evaluating bone involvement is emphasized. PMID- 1793347 TI - [Asymptomatic placental Listeria infection]. AB - A case of Listeria monocytogenes placental infection without foetal contamination is reported. The infant, normal at birth, developed progressive and severe neurological involvement. At 8 months of age, magnetic resonance imaging showed a bilateral cerebral atrophy. The responsibility of placental damage in altering the utero-placental blood flow with subsequent foetal hypoxia is discussed. PMID- 1793348 TI - [Dubowitz syndrome. A diagnosis not to be missed]. AB - Dubowitz syndrome is a rare hereditary disorder whose main features are intra uterine and post-natal growth retardation, characteristic facies, microcephaly, mental retardation and poor feeding. Because of the eczema which was present in half of the cases after 4 years of age, it cannot be mistaken for the more frequent fetal alcohol syndrome. We report 5 cases, among whom two sibs, confirming the recessive autosomal mode of inheritance and the necessity for genetic counseling. PMID- 1793349 TI - [Early neurotoxicity of high-dose of methotrexate and tetrahydrobiopterin deficiency]. AB - Transient neurologic dysfunction associated with high-dose methotrexate and citrovorum factor rescue (MTX-CF) has been previously reported. At the biochemical level, there are at least two important pathways in central nervous system metabolism which might be disturbed by MTX: MTX may deplete the cell of the de novo synthesis of purine nucleotides and thymidylate through its action on dihydrofolate reductase (DHFR), and also inhibit dihydropteridine reductase (DHPR), an enzyme maintaining the cofactor of phenylalanine-hydroxylase in its active tetrahydrogenated form (tetrahydrobiopterin), and hence interfere with the supply of the neurotransmitters derived from tyrosine and tryptophan. We describe such a neurologic disease in a patient with acute lymphoblastic leukemia (ALL) receiving chemotherapy. Significant increase in cerebrospinal fluid biopterins supports the hypothesis of an inhibition of dihydropteridine reductase by MTX, and provides additional suggestions in terms of etiology, diagnosis and treatment. PMID- 1793350 TI - [Iconographic rubric. Osteochondrodysplasia]. PMID- 1793351 TI - [Treatment of acute malaria in children]. PMID- 1793352 TI - [A case of familial proconvertine (factor VII) deficiency]. PMID- 1793353 TI - [Autochthonous typhoid fever in children. Value of the search fpr the source of contamination]. PMID- 1793354 TI - [Treatment of septicemia and neonatal infections. Choice of antibiotherapy]. PMID- 1793355 TI - [Congenital long QT syndrome disclosed during the induction treatment of acute promyelocytic leukemia]. PMID- 1793356 TI - [Cup-feeding in newborn infants]. PMID- 1793357 TI - Cu(II) complex of an estradiol derivative with potent anti-inflammatory properties. AB - In the present study, the A-ring of estradiol was converted to an acetylsalicylic structure which was further complexed with Cu(II). The aim was to combine the anti-inflammatory properties of estrogens with those of Cu(II) complexes. Key intermediate of the synthesis was 2-formyl-estradiol (2) which was prepared in quantitative yield through reaction of the phenoxymagnesium bromide of estradiol with formaldehyde in the presence of HMPA. For a successful reaction, an excess of ethylmagnesium bromide was required, and the mechanism is discussed. The target complex 5 exhibited potent anti-inflammatory properties, comparable to those of indomethacin, in the carrageenan-induced rat paw edema. This biological activity was not due either to the steroidal ligand or to the complexed Cu(II) alone. PMID- 1793358 TI - Imidazo[4,5-b]pyridine derivatives of potential tuberculostatic activity, II: Synthesis and bioactivity of designed and some other 2-cyanomethylimidazo[4,5 b]pyridine derivatives. AB - Based on the analysis of Quantitative Structure--Activity Relationships (QSAR) three representatives of imidazo[4,5-b]pyridine derivatives of predicted high antibacterial activity against Mycobacterium tuberculosis were synthetized and tested bacteriologically. Excellent agreement of the predicted and experimentally observed bioactivity was noted. Additional new derivatives of 4-methyl-4H-2 cyanomethylimidazo[4,5-b]pyridine (7) and 2-(alpha-methylcyanomethyl)imidazo[4,5 b]pyridine (22) were also synthesized and some of them were tested for tuberculostatic activity. The compounds synthesized according to a standard "trial and error" approach appeared generally inactive. PMID- 1793359 TI - [Synthesis, biotransformation and pharmacodynamics of a new theophylline derivative]. AB - 7-[(RS)2-((S)-1-Methyl-2-phenyl-ethylamino)propyl]-theophylline (3) was not described until now. This fenetylline analogue is available by reaction of 7 with an excess of 2 at 150 degrees C. If 2 reacts with 4, an E2-elimination overwhelms SN-nucleophilic displacement yielding compound 5. In vivo studies with male White Wistar rats, comparing biotransformation of 3 and 1, demonstrate, that the amount of 2 is decreased from 4.7% of (RS)-2 to 1%, probably due to steric hindrance of the attacking monooxygenases by the methyl group at C-11 of 3. Pharmacodynamic studies of 3, tested with mice, gave similar results to those obtained with 1. PMID- 1793360 TI - Synthesis and hypocholesterolemic activity of some N-diphenylmethylpiperazine derivatives. AB - The synthesis and preliminary assays as hypocholesterolemic agents of five N diphenylmethylpiperazines are described. The evaluations were carried out in hypercholesterolemic mice and two of these compounds were more effective than bezafibrate in the test employed. The di-p-chlorosubstituted compounds showed higher activity than their corresponding dechlorinated analogs. PMID- 1793361 TI - Acute toxicity of amine-boranes and related derivatives in mice. AB - Three boron derivatives, i.e. trimethylamine-carbomethoxyborane, tetrakis-mu (trimethylamine-boranecarboxylato)-bis(trimethylamine- carboxyborane) dicopper(II), and N,N-dimethyl-n-octadecylamine borane were evaluated for acute toxicity in male mice, at 1, 2 or 5 x their therapeutic dose in rodents for pharmacological activity. Based on organ weights, clinical chemistry, hematopoietic parameters and tissue morphology, the trimethylamine carbomethoxyborane was shown to be free of toxicity. The dicopper(II) complex and N,N-dimethyl-n-octadecylamine borane demonstrated slight toxicity with marginal disturbance in hepatic and kidney morphology. The dicopper(II) complex may cause marginal myocardial damage and the N,N-dimethyl-n-octadecylamine borane caused elevations in cholic acid. All three derivatives demonstrated reductions in hematocrit. PMID- 1793362 TI - [Airway secretion]. PMID- 1793363 TI - [A clinical investigation of the role of allergic factors in the severity of bronchial asthma]. AB - In order to study whether allergic factors have role in the severity of asthmatic attack, two hundred and forty adult asthmatics were clinically investigated (142 male, 98 female, aged 36.5 +/- 14.3). Fifty-seven extrinsic asthmatics were selected from the adult asthmatic group. The relationship between the total serum IgE levels, RAST scores, intracutaneous reactions to the twenty antigens, and the severity of bronchial asthma categorized according to the guidelines of the Japanese Society of Allergology, and methacholine bronchial responsiveness (Dmin(u)) were determined. In extrinsic asthma, there was a significant correlation between the severity of bronchial asthma, the intensity of asthmatic attack and bronchial responsiveness. However, there was no significant correlation between the severity of asthma, the Dmin(u) values and the total serum IgE levels, RAST scores, and the intensity of intracutaneous reaction, although there was a significant correlation between the Dmin(u) values and the numbers of positive intracutaneous reactions. In conclusion, it is suggested that there is no direct correlation between allergic factors and the severity of bronchial asthma in adult asthmatics. PMID- 1793364 TI - [Development of hen's egg with low antigenicity for allergic patients]. AB - We tried to prepare hen's egg with low antigenicity for allergy patients. First, we examined the effects of pH, heating temperature and time on antigenicity of egg. Dried whole egg solid (DES) was dissolved in the buffer solution adjusted at various pH and heated at 120 degrees C for 10, 20 and 40 min. As a result the antigenicity didn't significantly decrease. Next, DES was treated with succinic anhydride, sodium hydroxide and was heated. The antigenicity of the resultant modified whole egg solid (MES) was much lower than that of heated whole egg solid. Antigenicity was measured precisely by enzyme immunoassay, inhibition ELISA, RAST inhibition and PCA. It was found that the antigenicity of MES was decreased less than 1/1000 of that of DES. Then SDS-polyacryl-amide gel electrophoresis and gel filtration were performed to clarify the degree of the change of egg proteins. The bands and peaks which corresponded to ovalbumin and ovomucoid known to be major allergenic proteins responsible for egg allergy disappeared and new bands and peaks were detected. PMID- 1793365 TI - [Halothane or enflurane treatment in life-threatening asthma]. AB - We performed inhalation anesthetic therapy in an attempt to produce improvement in cause of life-threatening asthma, which were standard pharmacological therapy. We analysed the results obtained in 6 cases given inhalation anesthetic therapy (4 cases were treated with halothane and 2 cases with enflurane). The following observations were made: 1) The criteria for starting inhalation anesthetic therapy were persistent hypoxycemia or hypercapnia, persistently high inspiratory intra-airway pressure, clinical exhaustion and bronchial toilet with bronchofiberscope. 2) We treated the patients with halothane concentrations of between 1.0 and 2.0% and enflurane concentrations of between 1.0 to 4.2%. 3) No major complications were observed in inhalation anesthetic therapy. PMID- 1793366 TI - [The effect of an oral gold compound, auranofin, on bronchial responsiveness to inhaled methacholine in well-controlled bronchial asthma]. AB - Recently, in Japan, auranofin (6 mg/day) has been demonstrated to be a useful treatment for patients with moderate to severe asthma in a double-blind clinical trial. Therefore, to investigate the mechanism of auranofin on bronchial asthma, we examined pulmonary functions and bronchial responsiveness to inhaled methacholine in well-controlled asthmatics after 12 wks of treatment with auranofin, in a double-blind, placebo-controlled fashion. Twenty-five adult patients with asthma received orally 3 mg of auranofin or inactive placebo twice daily for 12 weeks. Bronchial responsiveness, pulmonary function tests and concentrations of gold in the blood were measured before and 6 and 12 wks after the therapy. Bronchial responsiveness (PD35-Grs) was significantly decreased after 12 wks of treatment with auranofin, compared with that 12 wks after treatment with inactive placebo. We suggest that inhibition of bronchial hyperresponsiveness by auranofin is one of the mechanisms by which auranofin is effective against bronchial asthma. PMID- 1793367 TI - [The involvement of rice protein 16KD in cross-allergenicity between antigens in rice, wheat, corn, Japanese millet, Italian millet]. AB - Cross-reactivity between rice, wheat, corn, Japanese millet and Italian millet in Poaceae family were studied by absorption test, radioallergosorbent test (RAST), and RAST inhibition assay. In absorption test using Phadebas RAST discs, more than 50% absorption of IgE antibodies was observed between rice, wheat and corn. There were significant correlations of RAST values for cereal grains including rice, wheat, corn, Japanese millet and Italian millet. RAST inhibition assay between every combinations of these cereals showed dose-dependent decrease in IgE binding. These data indicated cross-reactivity with IgE antibodies between the five cereals in Poaceae family. RAST values for RP16KD significantly correlated with those for Italian millet as well as rice but not with those for corn and wheat. There was a trend of positive correlation between RAST values for RP16KD and Japanese millet. In RAST inhibition assay using sera with positive RAST for these five cereal grains and RP16KD, RP16KD inhibited IgE-binding to these all cereal discs in dose-dependent manner. Similarly, all of five cereal grain extracts showed an effective diminution in IgE-binding to RP16KD disc. These results indicated possible participation of IgE-binding structure on RP16KD in cross-reactivity between these cereal grains in Poaceae family. PMID- 1793368 TI - [Relationship between immediate hypersensitive reactions by buckwheat ingestion and specific IgE for rice in subject with positive IgE-RAST for buckwheat]. AB - IgE-mediated mechanisms are important in immediate hypersensitive reactions (IHR) to buckwheat. However, a part of subjects with high IgE for buckwheat show no IHR to buckwheat ingestion. Inspite of cross-allergenicity between buckwheat and rice, rice ingestion rarely induces IHR even in subjects with high IgE for rice unlike buckwheat-induced IHR. We speculated that there were some relationships between the presence of IHR to buckwheat and recognition of cross-allergenic determinants on buckwheat components with rice components. We examined IgE-RAST for rice in 58 subjects with positive IgE-RAST for buckwheat. IgE-RAST for Dermatophagoides pteronyssinus (Dp), egg white and cow's milk as unrelated antigens with rice were also assessed for a comparison. Subjects (n = 33) without IHR to buckwheat showed higher IgE-RAST values for rice than those (n = 25) with IHR, whereas there were no differences in IgE-RAST values for Dp, egg white and cow's milk between two groups with and without IHR. IgE-RAST values for buckwheat showed significant close correlations to those for rice in subjects without IHR to buckwheat but not in those with IHR. There were no significant correlations between IgE-RAST values for buckwheat and for Dp, egg white or cow's milk in both groups with and without IHR. These results suggested that the IgE from subjects without IHR to buckwheat recognized cross-allergenic determinants with rice on the buckwheat components. PMID- 1793369 TI - [Analysis of clinical factors and IgE-RAST of Dermatophagoides farinae and rice in atopic dermatitis by multiple factor analysis of quantification theory type II]. AB - Twelve clinical factors and IgE-RAST of Dermatophagoides farinae (DF) and rice were analysed in three hundred patients with atopic dermatitis by multiple factor analysis of quantification theory Type II. Atopic dermatitis was simply defined here, as a patient who had typical eczematous eruption on the flexural portions of the body, such as the cubital fossa and/or the tibial fossa and/or the neck. The results were as follows: 1) Five clinical items such as onset age, age, history of asthma, sex, and history of allergic rhinitis were selected as significant variables to discriminate the objective variable of DF RAST, and influenced the discrimination in the order. The category of "less than 10 years old" in the item of onset age, mostly influenced on the positive DF RAST, followed by the categories of "more than 20 years-old" in age, "presence of asthma", "presence of allergic rhinitis", and so on, in the order. 2) Five clinical items such as duration of the disease, eruption on the face, eruption on the trunks and/or extremities, sex, and age were selected as significant variables to discriminate the objective variable of rice RAST, and influenced the discrimination in the order. The category of "more than 5 years" in the item of duration of the disease, mostly influenced on the positive rice RAST, followed by the categories of refractory signs such as "lichenification on the face", "lichenification on the trunks and/or extremities", and so on, in the order. Based on the results by the multiple factor analysis, rice antigen was strongly suspected to have relation with refractory patients with atopic dermatitis. PMID- 1793370 TI - [Hypodense eosinophils are much labeled with 32P than normodense eosinophils]. AB - Peripheral blood eosinophils from the patients with atopic dermatitis were isolated on a Percoll gradient and incubated with H3(32)PO4. After stopping the reaction, SDS/PAG electrophoresis was performed and autoradiographs were prepared to determine the incorporation of 32P into proteins. Eosinophils developed at least 14 protein bands below 66.2 K by SDS/PAG electrophoresis and the differences of the staining patterns between hypodense and normodense eosinophils were observed. In the autoradiographs 5 distinct radioactive bands were observed below 31 K. 32P incorporation into the bands of hypodense eosinophils were stronger than that of normodense eosinophils, suggesting possible involvement of protein phosphorylation in the activation process of eosinophils. PMID- 1793371 TI - [Immune system response in pneumonia in children during the first year of life]. AB - Lung, immune organs, hypophysis and adrenals of 74 children aged from 1 month to 1 year who died from acute pneumonia are studied. It is found that fatal pneumonia in one-year-old children developed as a rule against the grave premorbid background. Late hospitalization resulted in death of 47% of the patients within first 24 hrs after admission to hospital. Invasion of pathogenic agents results in secondary immunodeficiency as a response to stress during the development of general adaptation syndrome. Preventive measures are recommended for the prophylaxis of respiratory infections in subjects with abnormal premorbid background, early hospitalization and immunomodulating treatment under the control of immune system and adrenal cortex. PMID- 1793372 TI - [Neutrophilic leukocyte reaction in the course of diffuse purulent peritonitis]. AB - Peritoneum biopsies from patients with various stages of peritonitis were studied electron microscopically. As distinct from the widespread opinion of a significant phagocytic activity of neutrophil leucocytes in early peritonitis this activity was not found. The authors consider this as a cause of peritonitis progression and fatality of the disease in the absence of surgical treatment. Phagocytic activity is restored after the elimination of the causative factors, i.e. after the sanative operation. PMID- 1793373 TI - [Morphofunctional characteristics of the immunocompetent system in hypotrophy and its correction by thymogen]. AB - Administration of the synthetic thymic peptide-thymogen to the pigs with symptoms of hypotrophy exerted a positive effect on the course of this pathological condition this resulting from the stimulation of the central and peripheral parts of the immunogenesis. 230 days after the treatment the positive effect still persisted. PMID- 1793374 TI - [Comparative morphology of spontaneous hepatitis A in lower Old World monkeys]. AB - Detailed description of liver damage in two species of macaques (rhesus and fascicularis) and green monkeys with spontaneous hepatitis A (HA) induced by the virus similar to human hepatitis. A virus (HAV) is given. Evolution of histological changes was followed by serial liver biopsies. The picture of the hepatitis in the above monkey species resemble that of human NA as well as HA in other monkey species susceptible to HAV. Only in 8 of 21 monkeys the disease lasted for 2-5 months, others exhibited undulating and lingering course which lasted 8-19 months from the beginning of the infection. The lingering course of the infection was caused by HAV persistence in the host with its periodical elimination in faeces. PMID- 1793375 TI - [Thymus hyperplasia: classification, problems of patho- and morphogenesis, importance in human pathology]. AB - Thymus hyperplasia may be congenital (thymomegaly) and acquired (acquired thymomegaly, "tumour-like" hyperplasia, lymphofollicular hyperplasia). Congenital thymomegaly is represented by variants with hypo- and hyperfunction of an adequately formed thymus and results from the congenital neuro-endocrine disturbances. Thymomegaly with a thymus hypofunction is a marker of the immunodeficiency. Acquired thymomegaly is also represented by two variants with hypo- and hyper-function of the thymus and is in fact a "phenocopy" of the congenital one. "Tumor-like" thymus hyperplasia is a rare form of its pathology with a thymic weight reaching 800 g thus resulting in a syndrome of the mediastinum organs compression. Lymphofollicular thymus hyperplasia can not be always considered to be a thymus pathology but it is characteristic of autoimmune and infectious-allergic diseases with lymphoid follicles localizing in the hyperplastic intralobular perivascular spaces. Thymus parenchyma changes depend on the main disease and play a main role in the development of thymus dysfunction, for example, in the autoimmune diseases. Formation of lymphoid follicles in the dilated perivascular spaces is a non-specific process. PMID- 1793376 TI - [Influence of recombinant interleukin-2 on the course and pathomorphology of intraperitoneal staphylococcal infection in mice]. AB - Resistance to the lethal doses of the infectious agent (3 DL100) develops in mice 6 days after the intraperitoneal non-lethal dose of staphylococcus in combination with recombinant interleukin-2 (RIL-2). This effect may be due to the activation of T- and B-dependent zones of the regional lymph nodes and spleen, activation and proliferation of the liver stellate reticulo-endotheliocytes, enhancement of the phagocytic activity of the circulating neutrophil granulocytes. These structural and functional mechanisms may be due to both direct RIL-2 effect in combination with an antigenic stimulation and indirect effect through other interleukins produced by lymphocytes activated by RIL-2. PMID- 1793377 TI - [Lectin-histochemical characteristics of the epithelium in intestinal metaplasia, polyps and cancer of the stomach]. AB - Distribution of lectins (PNA, SBA, WGA, and Con A) has been studied in 53 stomach biopsies. Positive lectin reaction in the foveolar epithelium is observed, including dysplastic foci in the apical plasmalemma and in the cytoplasm around the nucleus this corresponding to the Golgi complex. It was mainly the apical plasmalemma of the columnar epithelium in the foci of intestinal metaplasia. Differences in the receptor localization were established in non-complete intestinal metaplasia, hyperplastic polyps and adenomas this depending on the cell type. Carcinoma cells not infrequently had all the plasmalemma stained with granules of the reaction product being distributed through all the cytoplasm. Lectin reactions are more pronounced in carcinomas accumulating mucus. Lectin binding by tumorous cells containing mucus was enhanced after the elimination of sialic acid as a result of the incubation with neuraminidase. Intensity of lectin reactions somewhat differs in various histological forms of stomach cancer. PMID- 1793378 TI - [Morphologic characteristics of the myocardium of people dying after the Chernobyl Nuclear Power Station accident]. AB - Two types of histological changes were found in the myocardium of 27 persons who died after the accident at Chernobyl atomic station: small foci of lesions (contractures, myocytolysis, fragmentation) and pathology, associated with vascular disturbances (venous hyperemia, statis, sludge-phenomenon, interstitial oedema, haemorrhages) typical for all cases. 6 persons had small-focal myocardial infarction, foci of infection were found in 3 cases. Small foci of lesions in the myocardium might produce disturbances of the heart rhythm revealed clinically. PMID- 1793379 TI - [Monocyte-macrophage infiltration in portions of atherosclerotic lesions of the human aorta]. AB - Human thoracic aorta was taken from trauma victims aged from 6 to 40 years. Cell composition of the intimal layer was investigated in the lesion predisposed (LP) areas of the aorta and in the lesion resistant (LR) areas. By double immunofluorescent staining with mono and polyclonal antibodies to monocytes/macrophages (Mn/Mph) and smooth muscle cells (SMC) the presence of Mn/Mph was revealed in all aortas studied. The number of these cells was 2-6 fold higher in LP areas, compared to LR areas in all persons over 21 years of age. Scanning electron microscopy revealed Mn on the luminal surface of the vessel the number of which was frequently higher in LP areas. Mn/Mph in LP areas were heterogeneous in their structure depending on the depth of their localization in the intima. The revealed Mn/Mph infiltration in aortas of young subjects may be the earliest manifestation of the atherosclerotic lesion. PMID- 1793380 TI - [Mediastinal chorionepithelioma in a man]. AB - A rare case of ectopic chorionepithelioma of the mediastinum in a 36 year old male with bilateral gynecomastia but without involvement of sex organs. Autopsy: large grey-red nodular conglomerate of tumours in the anterior mediastinum. Rapid tumour progression was followed by the growth into the pleura, pericardium, diaphragm, development of numerous metastases into the lymph nodes, liver, omentum, brain. HISTOLOGY: tumour consisted of groups of proliferating trophoblast elements with various degree of differentiation of syncytial elements and cells of Langhans type, with polymorphism, invasion, foci of fibrinoid necrosis, recent and old haemorrhages. Rarity of the disease, difficulties in clinical diagnosis, high rate of non-correspondence between clinical and pathological diagnosis, examples of a successful treatment of chorionepithelioma by chemicals confirm the necessity of a thorough clinical examination of such patients. PMID- 1793381 TI - [Ganglioneuroma of the adrenal medulla]. AB - Ganglioneuroma of the left adrenal medulla is found in a 46 year old patient dying from the arterial hypertension. A crucial role of the tumour in the genesis of hypertension is suggested. According to the literature the development of ganglioneuroma occurs most frequently in utero or during first years of life. This tumour may influence the adrenal function and result in the imbalance of the host hormonal status. PMID- 1793382 TI - [Lectin-peroxidase markers of the microglia in paraffin sections]. AB - Human brain of healthy persons and those with meningoencephalitis was studied with the use of five lectins (castor-oil plant, elder black, arachis, graphe snail and bean trefoil) conjugated with peroxidase. Lectins of castor-oil plant and elder are proved to be convenient markers of microglia. Lectin of the elder stained also components of vascular wall. Some increase of microglia content was observed in the peak of meningoencephalitis. Destruction of microgliocytes with the formation of giant forms of these cells was noted in long lasting meningoencephalitis when characteristic perivascular accumulations of large SNA- and RCA-positive cells appeared. Lectin of the bean trefoil showed increased affinity to the cytoplasmic glycopolymers of the pyramid neurocytes, astrocytes, vascular wall components. The character of the bean trefoil lectin binding with brain components changed in the meningoencephalitis. PMID- 1793383 TI - [Mikhail Fedorovich Glazunov]. PMID- 1793384 TI - [Synthesis of mucous in tumors of the large intestine]. AB - Review concerning the disturbances of the mucus synthesis in the colon tumours. Changes in the histochemical composition of the mucus, their biochemical mechanisms, diagnostic importance, influence on the clinical manifestations. PMID- 1793385 TI - [Mechanisms of immunosuppression in surgical pathology]. AB - The mechanisms of immunodeficiency in surgical pathology are described. They are consequences of stress, anesthesia, operation, endotoxinemia, blood loss. The duration of secondary immunodeficiency and prognosis depend on the degree of tissue traumatization, scope of operation, peculiarities of pathologic process and the state of host defence, its capacity for mobilization in extreme situation. Transient damages of the early postoperative "shock" period are most pronounced and form a "window" for immunodeficiency development and infections association in subsequent period. Hence it seems reasonable to conduct immunoprophylaxis in the preoperative period and immunocorrection after the operation this aiming at lower lethality in surgical pathology. PMID- 1793386 TI - Prognostic validity of brainstem electric response audiometry in infants of a neonatal intensive care unit. AB - This study compared the results of brainstem electric response audiometry (BERA) in infants of a neonatal intensive care unit to those obtained on the same children with pure-tone audiometry at 3 years of age. Six hundred children were initially tested in infancy, and complete follow-up information was obtained on 333. In 297 (89%) the BERA results accurately predicted the hearing status at the age of 3 years. Twenty-nine (9%) of the discrepancies were related to conductive hearing losses: 17 patients with a conductive hearing loss in the first few months of life had normal hearing at 3 years, and 12 patients normal in infancy had a conductive loss at 3 years. Two patients evaluated as a sensorineural hearing loss by BERA had normal hearing. These may have been due to a conductive loss. Six patients assessed as normal by BERA had significant hearing losses at the age of 3 years. Five of these had normal hearing at one frequency between 1,000 and 4,000 Hz. The sixth may have developed a sensorineural hearing loss after birth. PMID- 1793387 TI - Cross-correlation function in the analysis of auditory brainstem response in spinocerebellar degeneration. AB - Cross-correlation functions were derived from the analysis of auditory-evoked brainstem response (ABR) and compared with measurements of wave latency and computed tomography findings in the assessment of ABR findings in spinocerebellar degeneration (SCD). Gender-specific normative ABR templates were produced from 30 normal males and 30 normal females separately. The cross-correlation indices used were the correlation coefficient at time 0, the maximal correlation coefficient and the latency delay in milli-seconds. The technique was applied to 33 patients with SCD. The incidence of abnormal cross-correlation functions (81.8%) was greater than the incidence of abnormal ABR peak latencies assessed according to gender (75.8%) which, in turn, was more common than the abnormal peak latencies assessed conventionally (69.7%). Moreover, the incidence of abnormal cross correlations and latencies in Meniere's disease was much lower (less than 8%). These results suggest that the evaluation of ABR waveform characteristics with cross-correlation functions using normative ABR templates of the same gender contributes to the precise detection of abnormality in the brainstem auditory pathway. PMID- 1793388 TI - Growth of masking in sensorineural hearing loss. AB - The purpose of the present study was to measure the growth of masking in both normal-hearing and sensorineural hearing-impaired subjects. The masker was a narrow band of noise centered at 1,000 Hz, and masked thresholds for signal frequencies both above and below the masker frequency were obtained for a range of masker levels. For signal frequencies above the masker frequency, the slopes of the growth of masking functions were greater than 1 dB/dB for the normal hearing group, while for the hearing-impaired subjects the slopes were less than those of the normal subjects, and in many cases slopes were less than 1. The slope of masking was inversely related to the threshold at the signal frequency. These data support the concept that a loss of nonlinearity at the signal place is responsible for the slower growth of masking in hearing-impaired subjects for signal frequencies greater than the masker. In addition, the slower-than-normal growth of masking of the hearing-impaired subjects suggests that some hearing aid signal-processing strategies which provide greater amounts of high-frequency emphasis at high input levels may not be appropriate. PMID- 1793389 TI - Effects of stimulus parameters on human evoked potentials to shifts in the lateralization of a noise. AB - Changing the interaural time difference (ITD) of a continuous binaural noise causes a shift in the perceived lateralization of the noise and evokes a late auditory evoked potential with negative peak at 130 ms and a positive peak at 220 ms. The response is mainly evoked by stimulus frequencies below 2,000 Hz and is mediated through the middle and apical regions of the cochlea. The threshold for perceiving the lateralization reversal and for eliciting a clear evoked potential is approximately 15 dB higher than the intensity required to perceive the onset of the noise. Increasing the ITD up to 1.0 ms increases the amplitude of the evoked potential and the perceived lateralization of the noise. Further increases in the ITD decrease the amplitude of the evoked potential and make the perception of the sound less 'compact'. Decreasing the intensity of the sound in one ear decreases the response to a change in ITD, but recognizable responses occur with interaural intensity differences up to 30 dB. PMID- 1793390 TI - Cervical cancer screening--the good news at last. PMID- 1793391 TI - The general practitioner and terminal care of cancer patients. AB - Terminal care management can be a taxing task, but with the right approach and adequate backup facilities it can be highly rewarding. The author deals with a number of practical issues that are unlikely to be discussed in books. PMID- 1793392 TI - "Doctor, what are my chances"? AB - There can be no more difficult consultation than one in which the clinician has to explain a diagnosis of cancer and provide information on likely outcomes. The considerable skills in communication that are necessary are not usually part of medical training and the generalisations of the textbooks are of little value. PMID- 1793393 TI - The abnormal mammogram--what to do. AB - When an abnormality is detected in a mammogram the following questions should be answered: 1. Does a significant abnormality exist, that is, is the abnormality present in at least two views? 2. Should special imaging techniques, such as ultrasound, be used? 3. What is the conclusion of the radiologist? 4. Is the radiological abnormality clinically palpable? 5. Is the opinion of a breast specialist required? 6. Can fine needle aspirations cytology of the area be performed accurately and without trauma? 7. Should biopsy be undertaken? By posing these questions in sequence and obtaining firm answers, small cancers should not be missed and the biopsy rate will be kept to an acceptably low level. PMID- 1793394 TI - Cancer prevention: what's worth doing in general practice? AB - Primary prevention aims to circumvent the onset of malignant change. Secondary prevention aims to detect early cancer or lesions with high malignant potential before extensive local growth or metastatic spread compromises the effectiveness of treatment. This article should help general practitioners appraise the value of cancer prevention measures and plan an effective approach to cancer prevention in clinical practice. PMID- 1793395 TI - Life after cancer. AB - Almost 50 per cent of people diagnosed with cancer will be cured. The physiological and psychosocial costs associated with cure for some long-term survivors can be relevant to their continuing care. General practitioners need to be aware of potential problems and seek appropriate advice about new symptoms. PMID- 1793396 TI - Risk factors in breast cancer. AB - Risk factors are identified in less than 25 per cent of women who develop invasive breast cancer. The risk factors include a family history of breast cancer in a first degree family relative, late menopause, nulliparity, a first full term pregnancy after the age of 35 years, increasing age, P2 and DY mammographic parenchymal patterns, increasing dosage of non contraceptive oestrogens, mammary dysplasia associated with epithelial proliferation, a previous invasive breast carcinoma and carcinoma in situ. PMID- 1793397 TI - A descriptive survey of skin cancer in a geriatric centre 1988-1989. AB - The permanent residents of a geriatric centre in a Victorian provincial city were surveyed to estimate the prevalence of skin cancer and to assess the results of treatment. Basal cell and squamous cell carcinoma predominated. Irradiation was the most common form of treatment and resulted in a high recurrence rate of 41.6 per cent in basal cell carcinoma and 55 per cent in squamous cell carcinoma. It would appear that irradiation is the least cost effective treatment. PMID- 1793398 TI - Prescribing oral contraceptives and the medical record. AB - Scripts for the oral contraceptive pill are written by general practitioners every day, but how organised are their prescribing habits? The author describes the use of a supplementary insert to medical records to aid the busy general practitioner. PMID- 1793399 TI - Aspects of ageing. PMID- 1793400 TI - Doctor, watch your words. PMID- 1793401 TI - Dizziness (vertigo). AB - The presenting problem of dizziness or vertigo can be one of the real brain teasers of general practice. A careful history including drug intake (prescribed drugs or illicit drugs) will help determine whether the problem is true vertigo or pseudovertigo and pinpoint the diagnosis. Important serious causes to keep in mind are cerebral tumours and cardiac dysrhythmias. PMID- 1793402 TI - Validity of measurements and research. PMID- 1793403 TI - Childhood immunisation advisory service for general practitioners. AB - A study of 270 general practitioners associated with the University of Sydney, Division of Family Medicine, was conducted to examine the need for a childhood immunisation advisory service. Forty-three per cent of respondents had deferred immunisation or altered the schedule of immunisation of children attending them over the previous month. The majority stated that an immunisation advisory service would be beneficial. The preferred option was a telephone service operating from 9 am to 5 pm. PMID- 1793404 TI - Patient education. Anxiety. PMID- 1793405 TI - Ruptured Achilles tendon. PMID- 1793406 TI - Right bundle branch block. PMID- 1793407 TI - Diagnosing the hysterical 'unconscious' patient. PMID- 1793408 TI - Neurofibromatosis. PMID- 1793409 TI - Editorial comment and the Quality Assurance Project papers. PMID- 1793410 TI - Touching in psychotherapy. PMID- 1793411 TI - Medical student learning and expectations. PMID- 1793412 TI - Assessment of improvement in treatment trials of acute mania. PMID- 1793413 TI - Robert Lowell: the search for the father or the result of trauma? PMID- 1793414 TI - The classification of depression. PMID- 1793415 TI - The changing nature of psychiatry. AB - The traditional role of psychiatrist as the central figure in the delivery of mental health services is changing. First, the advent of structured diagnostic interviews means that the diagnosis of mental disorders is no longer the exclusive preserve of psychiatrists; second, the growth of community mental health services staffed by non-psychiatrists means that psychiatrists now treat a minority of the patients with mental disorders; and third, the psychiatrists' continued endorsement of dynamic psychotherapy means they are becoming identified with an unproven and very expensive treatment. These changes should be seen against the broader background of a profession that is well-trained, active in evaluating performance, supported by a burgeoning research base in cognitive science and neuroscience, and delivering services efficiently and inexpensively. PMID- 1793416 TI - Psychological distress and psychiatric morbidity in women prisoners. AB - The population of a women's prison (n = 92) was screened for psychological distress and psychiatric morbidity with the 12-item General Health Questionnaire, the Hamilton Depression Rating Scale, a Recent Stressful Life Events questionnaire and the Structured Clinical Interview for DSM-III-R. High levels of symptoms of psychological distress were recorded. Distress was correlated with recent stressful life events and was more severe in women awaiting trial. Fifty three per cent of the prisoners were diagnosed as current cases of a psychiatric disorder and the most frequent diagnoses were adjustment disorder with depressed mood and personality disorders. Lifetime prevalence of psychoactive substance use disorders was 54 per cent. Aboriginal women were over-represented in this prison population. A follow-up survey after 4 months showed no fall in the prevalence of psychological distress and psychiatric morbidity. PMID- 1793417 TI - A systems approach to loss. AB - Following the death of a family member, the mourners' experiences of grief are inevitably influenced by and, in turn, influence the experiences of their relatives. Therapy should apply a model which takes this interactive process into account. A systems approach can fulfil this requirement in certain cases. Three case histories are provided to illustrate the potential effectiveness of a systems-oriented intervention. The questions still remain as to when the model is optimally applied, and whether it has a role in preventive psychiatry. PMID- 1793418 TI - Psychosocial needs of torture survivors. AB - Growing recognition that the world faces a modern epidemic of torture has stimulated widespread interest amongst mental health professionals in strategies for the treatment of survivors. In this article we outline the distinctive experiences of torture survivors who present for treatment in western countries. These survivors are usually refugees who, in addition to torture, have suffered a sequence of traumatic experiences and face ongoing linguistic, occupational, financial, educational and cultural obstacles in their country of resettlement. Their multiple needs call into question whether "working through" their trauma stories in psychotherapy will on its own ensure successful psychosocial rehabilitation. Drawing on our experience at a recently established service, we propose a broader therapeutic aim. PMID- 1793419 TI - The role of specialised units in the treatment of affective disorders. AB - Units which specialise in the treatment of affective (mood) disorders are gaining popularity in Australia and overseas. This paper examines the history, role and function of these units with particular reference to their benefits and disadvantages. Specialised units can offer advantages in the assessment and management of depression and bipolar illness, as well as being centres for research and education. Further research into their effectiveness is needed to enable their rational integration into existing psychiatric services. PMID- 1793420 TI - Potentially reversible dementia: a review. AB - Potentially reversible dementia is reviewed with reference to diagnosis, causes and outcome. Many disorders which cause cognitive impairment, such as drug toxicity and depression, fail to meet diagnostic criteria for dementia. These tend to have the best prognosis. Studies of the neuropsychiatric syndromes associated with disorders causing potentially reversible dementias suggest that dementia is an infrequent outcome and when it does occur, few cases recover. Factors predictive of improvement are short duration of symptoms and mild degree of cognitive impairment, usually subcortical in type. It is suggested that potentially reversible cognitive impairment would be a more accurate term as many cases are due to delirium and depression. While cases of well established dementia do not require extensive investigation, all cases should have a thorough clinical assessment as in many instances dual pathology exists and all require psychosocial management. PMID- 1793421 TI - The relationship between divorce, unemployment and female participation in the labour force and suicide rates in Australia and America. AB - Identical data sets for Australia and the USA from 1946 to 1984 were analysed to explore the association of unemployment rates, female participation in the labour force and divorce with suicide rates. While female participation in the labour force was related to suicide rates in Australia, unemployment was not. For the USA, both female participation in the labour force and unemployment were related to suicide rates. PMID- 1793422 TI - Cognitive-behavioural group therapy for Hong Kong Chinese adults with mental health problems. AB - Ninety-one Chinese in the community, aged between 18 and 45, with mental health problems ranging from mild to moderate degree, were treated by cognitive behavioural group therapy (CBGT) for a period of 3 months. All subjects were assessed on multiple measures at 4 time points: screening, pre-treatment (after 3 months), post-treatment and at 3-month follow-up. Attendance was good. A standard practice manual was developed to ensure consistent treatment by 2 group workers. After controlling for the placebo effect in the waiting period, treatment effect was demonstrated which was sustained after a three month period. The all-round improvement included a decrease in psychiatric symptoms, improvement in self assessment, better and more social activities and being more able to cope with problems. In terms of psychiatric diagnosis, depressed subjects gained the most benefit and personality disorder subjects the least. Parents seemed to benefit more than non-parents. PMID- 1793423 TI - Changing patterns of electroconvulsive therapy use: results of a five-year survey. AB - Despite its proven efficacy and safety, electroconvulsive therapy (ECT) continues to be a controversial treatment. Ongoing scrutiny is therefore particularly important. We reviewed 315 patients who received 3903 ECT treatments over a five year period, and found a gradual decline in the use of ECT, due mainly to a reduction in ECT for schizophrenic patients. Eighty percent of treatments were given with bilateral electrode placement, although we did find the incidence of adverse effects to be greater with bilateral ECT. Most patients concurrently received medications which raise the seizure threshold. The administration of ECT to patients unable or unwilling to give informed consent raises ethical and medicolegal issues. We found that such difficulties had arisen with at least 16% of patients. PMID- 1793424 TI - Treatment outlines for antisocial personality disorder. The Quality Assurance Project. AB - The notion of antisocial behaviour as mental disorder is reviewed and criteria to distinguish it from criminality described. The natural history and familial nature of the disorder are emphasised. The literature was searched unsuccessfully for accounts of effective treatments. The sample of practising psychiatrists and the nominated experts were agreed, in the absence of any specific remedy, about the management of such patients. There are three principles. Clarify the real reason help is being sought, treat intercurrent conditions energetically, and remember that as remission is common by mid-life what happens to the patient before then may materially affect their ability to manage later. PMID- 1793425 TI - Chaos theory: a new paradigm for psychotherapy? AB - Thomas Kuhn's concept of paradigm as central to the functioning of a mature science is linked with Johnson-Abercrombie's recognition that perception itself is shaped by the schemata available to the subject. The rapidly advancing field of non-linear mathematics, in offering conceptual forms to represent complex events, may provide a useful framework in which to place various psychodynamic formulations about the development of the personality, and suggests the possibility of a new approach to research concerning the efficacy of psychotherapy. Dan Stern's latest concept of "moments" as the basic unit in structuring the personality, leading to the complex representational patterns and feed-back loops he terms "RIGS" may be viewed in this context. The paradigm may be extended to include such concepts as Peterfreund's linkage of psychodynamic theorising with aspects of information theory generated by the study of computers, and with Sullivan's concepts of repetitive patterns of behaviour recognisable, and changing, throughout the course of a therapy. PMID- 1793426 TI - Psychosis in a 15 year old hypothyroid girl: myxoedematous madness? AB - The case of a fifteen year old girl with sudden onset of a psychotic illness thought to be related to marked hypothyroidism is reported. Apart from the age several features of this case warrant discussion and the value of screening for thyroid disease in psychotic illnesses is highlighted. PMID- 1793427 TI - A model for comparative ratings in studies of within-family differences. AB - Comparative ratings between pairs of siblings or other relatives are commonly used to refine measures of intrafamily variation. A simple model, based on signal detection theory, is proposed which shows how comparative ratings can be used to estimate within-pair variances of true scores, which can, in turn, be modeled with any of the conventional approaches to partitioning genetic and environmental variance within families. PMID- 1793428 TI - Semidominant expression of absence-like seizure in tremor rats. AB - Tremor rats (tremor homozygous rats) exhibit spontaneous absence-like seizure, which is characterized by a sudden immobility with staring and the appearance of 5- to 7-Hz spike and wave complexes in cortical and hippocampal electroencephalogram (EEG). In this study, we examined the development of the seizure and the mode of inheritance. All tremor homozygous and heterozygous rats exhibited the seizure by 14 and 26 weeks of age, respectively. The frequency and total duration in tremor heterozygous rats were significantly lower in comparison with those in tremor homozygous rats. None of the seven tremor wild-type homozygous rats exhibited the seizure. In an EEG study of backcross progeny of (BN/fMaiKyo x tremor heterozygous rats)F1 (tm/+) x tremor heterozygous rats at 5 months of age, the ratio of rats with and without the seizure was 23:7 (chi 2 = 0.09 for 3:1 ratio). These results suggest that the absence-like seizure is semidominantly expressed, in contrast to other recessive mutant traits in tremor rats. PMID- 1793429 TI - The genetic properties of homosexual copulation behavior in Tribolium castaneum: diallel analysis. AB - The rate of homosexual copulation has been defined as the ratio between the number of homosexual mountings and the total number of mountings (homo and heterosexual) performed by a Tribolium castaneum male during a period of 30 min. In a laboratory population, the average rate when a number of males (m) and females (k x m) are tested together has been estimated in each of the six situations defined by m = 2 and 10 and k = 0.5, 1, and 2, k being the sex ratio among scored individuals. Good agreement was found between the observed rates of homosexual copulation and those expected assuming random contacts between pairs of individuals totally indiscriminate with respect to sex. The genetic properties of the trait have been investigated by means of a diallel analysis of six highly inbred lines derived from the same population and their F1 crosses. Significant general and specific combining ability effects were detected. When noninbred females were used for testing, the rate of homosexual copulation is expected to be higher for inbred than for noninbred males. This prediction, implying the existence of inbreeding depression for the trait, also was confirmed by the data. PMID- 1793430 TI - Behavior Genetics Association Abstracts. PMID- 1793431 TI - Further studies on the effects of diets containing dried coffee pulp: growth performance, blood and carcass characteristics of pigs. AB - 4 groups of 5 pigs each were fed rations containing 0, 10, 20, or 30% of dried coffee pulp over a period of 10 weeks. The inclusion of these rations had no significant influence on the feed intake, growth rate and feed conversion efficiency. There were no significant differences in the blood parameters either (glucose, protein, P, Ca, cholesterol) or in the slaughter weight. Pigs fed the coffee pulp had less backfat and higher liver weights. PMID- 1793432 TI - [Biosynthetic paths of acyclic lipoxygenase metabolites of polyenic acids]. AB - The review deals with the basic features of the fatty acid lipoxygenation resulting in the formation of leukotrienes, hydroxy fatty acids, lipoxins, hepoxylins. The biological role, prospects for the further studies of this class of bioregulators are discussed. PMID- 1793433 TI - [Chemical modification of steroid-hydroxylating monooxygenases with fluorescein isothiocyanate]. AB - Chemical modifications of cytochrome P-450scc and cytochrome P-450(11) beta with fluorescein-, diiodofluorescein-, eosine- and rhodamine isothiocyanate have been carried out. At a low reagent/protein ratio and neutral pH, a selective chemical modification was known to take place which did not affect the spectral properties of cytochrome P-450scc. Covalent chromatography was found useful to discriminate between covalent modification of cytochrome P-450scc and non-specific binding of FITC with cytochrome P-450scc. Proteolytic modification of cytochrome P-450scc and structural analysis indicate that a lysine residue of the C-terminal sequence of cytochrome P-450scc is accessible to FITC. The residue was shown, by the analysis of the chymotryptic hydrolysate of the fragment F2, to be Lys338. Effect of modification with FITC on the interaction of cytochrome P-450scc with cholesterol or adrenodoxin, on the reduction kinetics and on the conversion of cholesterol to pregnenolone was also studied. PMID- 1793434 TI - [Chromatin proteins in rat liver cells, interacting with reactive oligothymidylate derivatives]. AB - Upon alkylation of the rat liver chromatin with a hexadecadeoxyribothymidylate derivative bearing 4-(N-2-chloroethyl-N-methylamino)benzylamine residue on the 5' terminal phosphate two nonhistone proteins were modified under conditions of the reagent's forming complementary complexes with poly(A) sequences in DNA. The sequence-specific nature of the reaction is proved by the competition experiments: free oligothymidylate prevented the proteins from alkylation whereas arbitrary oligonucleotide did not. Modification with the reactive oligonucleotide derivatives can be used for the identification of proteins located in the vicinity of the specific open DNA regions in chromatin. PMID- 1793435 TI - [Conformational analysis of tachykinins. III. C-terminal fragment Asx-Xaa-Phe-Yaa Gly-Leu-Met-NH2]. AB - Theoretical conformational analysis of C-terminal fragments of tachykinin peptides with a common amino acid sequence Asx-Xaa-Phe-Yaa-Gly-Leu-Met-NH2 suggested the conformational states to be independent of the nature of Xaa and Yaa residues. It is shown that among plausible spatial forms of the C-terminal fragments an alpha-helix with the hydrophobic coat consisted of identically oriented side chains is energetically the most stable structure. The preference of this conformation for tachykinins functioning is discussed. PMID- 1793436 TI - [A simple way of introducing a transcription initiation signal in vector DNA]. AB - A new effective method of site-specific mutagenesis in the close vicinity of unique restriction sites of plasmids, based on the use of two oligonucleotide primers, mutagenic and auxiliary, has been suggested. A site-specific insertion of Pribnow box (TATAATG) before promoterless gal operon of the promoter-testing plasmid pHD-001-14-11 has been performed with the yield of mutants up to 95%. Data on the gal operon expression and S1-nuclease mapping of the transcription start point indicate the formation of an active promoter in the region of the insertion. PMID- 1793437 TI - [Observation of thiotepa-deoxyguanosine-5'-phosphate modification products by mass spectrometry with isolation of Californium-252 fragments]. PMID- 1793438 TI - Effect of moderate hypertriglyceridemia on the relation of plasma total and LDL apo B levels. AB - The risk of premature coronary artery disease is related to an important degree to the number of particles of low density lipoproteins (LDL) in plasma, an estimate given by measurement of LDL apo B. In clinical practise, though it is total, not LDL apo B, which is measured. The purpose of the present study therefore was to compare plasma total and LDL apo B in the presence and absence of moderate hypertriglyceridemia. The results demonstrate that within the range of plasma triglyceride levels examined, i.e., values of triglyceride up to 500 mg/dl, there is close correspondence between total and LDL apo B, with the latter more than 90% of the former. VLDL composition was also examined and two patterns found in hypertriglyceridemic patients: those with normal apo B had markedly lipid enriched VLDL while those with elevated apo B had VLDL which was normal in composition except for a moderate increase in triglyceride content. Thus total apo B within the circumstances studied reflects principally LDL apo B. Moreover measurement of apo B allows distinction between two different forms of hypertriglyceridemia, only one of which - that with an increased LDL particle number - has previous work shown to be associated with increased coronary risk. Total apo B, therefore, provides additional information not available from conventional plasma and lipoprotein lipids which allows more precise physiologic classification and may lead to more rational choice of pharmacologic therapy in normolipidemic and hypertriglyceridemic patients. PMID- 1793439 TI - Cholesterol feeding increases plasma and aortic tissue cholesterol oxide levels in parallel: further evidence for the role of cholesterol oxidation in atherosclerosis. AB - To determine the relationship between plasma and arterial wall oxysterols, plasma and aortic tissue from 7 New Zealand White rabbits fed a high cholesterol (1%) diet for 6 weeks was compared to plasma and aortic tissue from 7 normocholesterolemic rabbits fed standard rabbit chow. Cholesterol and cholesterol oxide fractions were isolated and analyzed by gas chromatography. Normocholesterolemic plasma and aortic tissue contained low levels of cholest-5 ene-3 beta, 7 alpha-diol, cholesta-3,5-dien-7-one, 5,6 alpha-epoxy-5 alpha cholestan-3 alpha-ol, cholest-5-ene-3 beta, 7 beta-diol, and 5 alpha-cholestane-3 beta, 5,6 beta-triol while hypercholesterolemic plasma and atherosclerotic aorta contained significantly higher levels (P less than 0.05) of these products. Furthermore, 5,6 beta-epoxy-5 alpha-cholestan-3 beta-ol not found in normocholesterolemic plasma or aortic tissue was present in substantial amounts in both hypercholesterolemic plasma and atherosclerotic aortic tissue. Cholest-5 ene-3 beta,25-diol and 3 beta-hydroxycholest-5-ene-7- one not present in normocholesterolemic aorta were present in the atherosclerotic aorta. The oxysterol chromatographic patterns of normocholesterolemic plasma and normocholesterolemic aortic tissue were similar to each other as were the oxysterol chromatographic patterns of hypercholesterolemic plasma and atherosclerotic aortic tissue. The chromatographic patterns between the normocholesterolemic and hypercholesterolemic samples differed however. Possible absorption of the low levels of cholesterol oxides present in the cholesterol feed could account for the elevation of only some of the oxysterols. We conclude that cholesterol oxides exist at some basal level in normocholesterolemia and that these levels are increased by cholesterol-feeding which results in hypercholesterolemia. Our findings demonstrate that there is a strong relationship between plasma and aortic arterial wall levels of cholesterol oxides and suggest that in addition to exogenous sources, formation of cholesterol oxides proceeds via free radical oxidation acting upon elevated cholesterol levels resulting in the accumulation of these potentially cytotoxic and atherogenic products. PMID- 1793440 TI - Rapid screening for specific mutations in patients with a clinical diagnosis of familial hypercholesterolaemia. AB - We describe a rapid screening procedure to identify known DNA sequence changes in individuals diagnosed as having heterozygous familial hypercholesterolaemia (FH). The screening is made possible by combining a rapid DNA extraction protocol and small scale polymerase chain reaction DNA amplification, followed by oligonucleotide melting or restriction enzyme digestion. We have screened for two different mutations; firstly a mutation in the apolipoprotein B (apo B) gene that results in the substitution of glutamine (Gln) for arginine (Arg) at amino acid residue 3500 (apo B3500 mutation). Apo B is the principal component of the protein moiety of low density lipoprotein (LDL) and the mutation reduces the affinity for the LDL receptor (LDL-R). Secondly we have screened for a point mutation in the LDL-R gene itself that creates a new Pst I restriction enzyme site. This mutation in the LDL-R gene (LDL-R664 mutation) results in the substitution of leucine (Leu) for proline (Pro) at amino acid 664 and is known to slow processing of the LDL-R precursor to the mature form and to reduce the affinity of the receptor on the cell surface for LDL. In 77 unrelated patients with a clinical diagnosis of FH two out of 77 (2.6%) were positive for the apo B3500 mutation. Three (3.9%) were positive for the LDL-R664 mutation. Thus these two mutations might account for 5-6% of patients in the U.K. with a clinical diagnosis of FH (5000-6000 people).(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793441 TI - Effect of linoleic acid hydroperoxide on replication of adenovirus DNA in endothelial cells of bovine aorta. AB - The effect of linoleic acid hydroperoxide on replication of adenovirus type 2 DNA in cultured endothelial cells of bovine aorta was studied to elucidate the deleterious effect of lipid peroxides on replication of DNA in the arterial endothelial cells. When, just after the infection, the cells were incubated with 1 nmol (measured by the thiobarbituric acid reaction and expressed in terms of malondialdehyde) of the hydroperoxide, the replication of adenovirus type 2 DNA was markedly reduced. The level of the messenger RNA for adenovirus type 2 DNA polymerase was also reduced. In accordance with the reduction of the messenger RNA, the synthesis of the polymerase in the cells was reduced. The inhibition of DNA replication in the arterial endothelial cells by lipid peroxides was discussed in relation to atherogenesis. PMID- 1793442 TI - Synergetic effect of desialylated and glycated low density lipoproteins on cholesterol accumulation in cultured smooth muscle intimal cells. AB - We have studied the combined effect of non-enzymatically glycosylated and desialylated low density lipoproteins (LDL) on the cholesterol content of cells cultured from unaffected human aortic intima. Native LDL did not alter the intracellular cholesterol level while glycated LDL taken in the concentration percent, respectively. The effect of the same concentrations of glycated LDL treated with neuraminidase (desialylated-glycated LDL) was twice as powerful. Desialylated LDL in the concentration of 50 and 100 micrograms/ml raised the cholesterol level by 1.4- and 2.1-fold, respectively. Simultaneous incubation of cells with glycated (50 micrograms/ml) and desialylated (50 micrograms/ml) LDL brought about a 3.4-fold increase in intracellular cholesterol. The obtained data suggest that intensive development of atherosclerosis in diabetes mellitus may be partially explained by synergetic effects of desialylated and glycated lipoproteins as well as LDL with both types of modification. PMID- 1793443 TI - Ethnic immunity to coronary heart disease? AB - Dietary fat intake is often regarded as a major determinant of coronary heart disease (CHD) rate and it has been deemed unnecessary to invoke racial or other factors to explain the differences in CHD rates among different ethnic groups. Despite a high prevalence of CHD risk factors such as hypertension, obesity, and smoking, CHD remains a rarity in westernized black Africans. Cord blood total cholesterol (TC), low density lipoprotein cholesterol (LDLC) and apolipoprotein B (apo B) levels were measured and found to be respectively 12.1%, 18.3% and 22.4% lower in black neonates when compared to white neonates. These differences were again studied in a group of young black African males and a comparable group of age-matched whites who had been exposed to the same environment and western diet for at least 2 years. Although the body mass indices and serum albumin concentrations in the adult males were not significantly different, serum levels of TC, LDLC and apo B were 10.7%, 18.7% and 39.7% lower in the blacks, respectively. Furthermore, high density lipoprotein cholesterol (HDLC) and Apolipoprotein AI were 20.2% and 9.5% higher, homocysteine 45.6% lower and coagulation factor VII 26.6% lower in the adult black Africans. It is concluded that blacks are biochemically less responsive to an atherogenic diet than whites and these differences are already present at birth. PMID- 1793444 TI - Lipid-protein particles secreted from activated platelets reduce macrophage uptake of low density lipoprotein. AB - Cellular uptake of low density lipoprotein (LDL) was reduced by 30-40% in macrophages that were preincubated with platelet conditioned medium (PCM) obtained from activated platelets. LDL mediated cholesterol accumulation and cholesterol esterification in macrophages were substantially inhibited by macrophages preincubation with PCM. This inhibitory effect was found to be dose dependent, and resulted from a reduction in the number of LDL receptors (decrement of 35% in "apparent Vmax"). The active component in PCM was present only in medium obtained from activated platelets and was found to be of a molecular weight higher than 25,000 dalton. It comprised of both protein and cholesterol but upon PCM delipidation only the lipid fraction demonstrated the inhibitory effect on macrophage uptake of LDL. Specific uptake of the PCM lipoprotein-like particle via the scavenger receptor on macrophages was found to be essential for the expression of LDL receptor reduced activity. Furthermore, LDL mediated cholesterol esterification was not inhibited by PCM in U937 macrophages, a cell line that lacks the scavenger receptors. It is concluded that activated platelets secrete a lipoprotein-like particle which is recognized by the macrophage scavenger receptor. Subsequent to PCM-macrophage interaction, cellular LDL uptake was reduced. This effect could be attributed to the PCM lipid constituents. PMID- 1793445 TI - Estrogens inhibit copper and cell-mediated modification of low density lipoprotein. AB - The effects of estrogens on LDL modification by copper ions, U 937 monocyte-like cells or endothelial cells was studied by determination of the lipid peroxidation product content and measurement of the relative electrophoretic mobility. The presence of estradiol, estriol and estrone inhibited LDL oxidation in a dose dependent manner in the range of concentrations from 5 to 50 microM. In the case of oxidation by Cu2+, the decreasing order of efficiency was: estradiol, estriol, estrone. In monocyte-induced oxidation, the protective effect of estrogens was more marked, and the order of efficiency was the same, except that estrone was as active as estriol. Pretreatment of monocyte cells with estrogens also inhibited the subsequent modification of LDL by these cells, tested in the absence of the hormones. Testosterone had no effect in all the studied systems. Furthermore, the degradation by J774 macrophage like cells of LDL modified either by Cu2+ or monocytes was markedly reduced when modification has been performed in the presence of estrogens. Since oxidative modification of LDL is believed to be involved in the appearance of atherosclerotic plaques, this effect of estrogens might be related to their protective action against atherosclerosis. PMID- 1793446 TI - Cholesterol lowering and bile acid excretion in the hamster with cholestyramine treatment. AB - Cholestyramine was administered to hamsters at 6 doses in the diet for 1 week. Plasma cholesterol, LDL + VLDL cholesterol and HDL cholesterol were measured after this period. Bile acid excretion was measured in faeces collected over the final 24 h of the experiment. A dose-response curve for each parameter measured was constructed using data from individual hamsters. For the bile acid and the cholesterol measurements a maximum response was observed at the highest doses. A correlation between the bile acids excreted over 24 h and the LDL + VLDL cholesterol showed that the maximum effect of cholestyramine on lowering plasma and lipoprotein cholesterol occurred at a submaximal excretion level of bile acids. Comparison of the efficiency of cholestyramine in reducing plasma cholesterol in the hamster with limited data in the dog and in man suggest that a greater lowering of plasma cholesterol is achieved in the dog and in man for an equivalent increase in bile acid excretion caused by the sequestrant. As is already known, cholestyramine treatment caused an increase in hepatic cholesterol 7 alpha-hydroxylase and HMG-CoA reductase activity. Interestingly in this study the novel observation was made that the bile acid sequestrant reduced the activity of hepatic acyl-CoA: cholesterol acyltransferase. PMID- 1793448 TI - Elevated serum neopterin levels in atherosclerosis. AB - Plasma levels of neopterin were determined in patients with different clinical stages of atherosclerosis. Non-hospitalized patients with atherosclerosis had serum and plasma neopterin levels within the normal range of the assay (6 +/- 2 nM). These values were not significantly different from those reported for healthy blood donors (5 +/- 2 nM). In contrast, about 50% (29 out of 61) of hospitalized patients undergoing conservative or surgical therapy had neopterin plasma levels, which exceeded the normal range (greater than 10 nM) up to 10 fold. The two groups differ on a significance level of P less than 0.01. For further evaluation hospitalized patients were subgrouped according to neopterin levels. In the subgroup with elevated neopterin levels patients with higher Frederickson types of atherosclerosis were overrepresented compared to patients with normal neopterin levels. Type 4 differed significantly from patients without pathological changes of lipoprotein (P less than 0.05). Only 3 patients suffered from minimal skin necrosis, two of them had elevated neopterin levels. Significantly more patients with peripheral artery occlusions had elevated neopterin levels than patients with occlusions of central arteries (P less than 0.05). All other criteria used for comparison (sex, age, smoking, antioxidant status, diabetes, hypertension, adipositas, hyperuricemia) did not vary significantly in both subgroups. These data indicate that neopterin plasma levels might be a valuable parameter in activity staging and therapeutic follow up of atherosclerotic patients. Additionally, an involvement of the nonspecific immune system in atherogenesis is suggested by the increased plasma neopterin concentrations. PMID- 1793447 TI - Comparison of effects of fish oil and corn oil supplements on hyperlipidemic diet induced atherogenesis in swine. AB - The addition of a fish oil supplement rich in n - 3 unsaturated fatty acids to a high cholesterol, high saturated fat (BT) diet for swine has been shown previously to result in modest lowering of plasma cholesterol levels and in marked retardation of atherogenesis. It has been suggested that the effect was due to the change in polyunsaturated (PUFA) to saturated fatty acid ratios (P/S) and that a supplement of PUFA of the n - 6 series might have the same effect as the fish oil. We have tested this hypothesis in swine fed an atherogenic diet by comparing the effect of a fish oil supplement producing a P/S ratio of 0.28 to that of corn oil in the same amount producing a ratio of 0.46. The P/S ratio of the atherogenic diet without supplements was 0.16. Thirteen young male Yorkshire swine were fed either BT alone (n = 4), BT + cod liver oil (n = 4) or BT + corn oil (n = 5) for 6 months and then killed for quantitative studies of atherosclerosis in the aortas and coronary arteries including lesion areas, number of lesion cells, and number of monocytes attached to endothelium. Plasma cholesterol levels were determined periodically and lipoproteins were separated terminally by density gradient ultracentrifugation, Pevikon block electrophoresis and immunoelectrophoresis. The fish oil supplement resulted in a 30% reduction in time-weighted average plasma cholesterol levels, and a marked shift in terminal lipoprotein patterns from predominantly apo B and E containing ones to predominantly apo B only ones. Atherogenesis was reduced by the fish oil supplement as judged by several morphometric criteria including size of lesions, number of lesion cells, and number of monocytes attached to lesion endothelium. The corn oil supplement produced no significant reductions in any of these variables from those in swine fed the atherogenic BT diet without the supplement. We conclude that the n - 3 fatty acid rich fish oil supplemented diet retarded atherogenesis, but that this effect was not shared by the corn oil supplemented diet which had an even higher P/S ratio. PMID- 1793449 TI - Change in endothelial cell morphology at arterial branch sites caused by a reduction of intramural stress. AB - Arterial branch sites have very high intramural stresses at physiologic intraluminal pressures; the same sites have a predilection for atherosclerosis. The effect of intramural stress on endothelial cell morphology was investigated. Five rabbits had permanent casts placed around a segment of the abdominal aorta left renal artery branch area during controlled hypotension, thus reducing intramural stress without narrowing the lumen. These five animals, and three normal rabbits, were sacrificed after 4-8 weeks, and the vessels were perfused with buffered 2.5% glutaraldehyde for 2 h at 100 mm Hg pressure. The aortas were examined by scanning electron microscopy. In normal aortas, the distal region of the ostia of the left renal and celiac arteries just beyond the flow divider displayed many morphologically altered endothelial cells ranging from spindle shape to cobble-stone shape. The same aortic area of casted rabbits, as well as the straight abdominal aorta in all rabbits, showed a smooth surface of endothelial cells with intact cell borders and no morphologically altered cells. At branch sites, the occurrence of morphologically altered endothelial cells may be due to increased intramural stress. When intramural stress is reduced, the morphology of branch endothelial cells changes to resemble that of the unbranched regions. In conclusion, endothelial cell morphology changes in response to changes in intramural stress. PMID- 1793450 TI - Aortic response to relaxing agents in Watanabe heritable hyperlipidemic (WHHL) rabbits of different age. AB - Serum and aortic tissue cholesterol levels in parallel with aortic relaxation to endothelium-dependent and independent drugs were determined in Watanabe heritable hyperlipidemic (WHHL) rabbits in comparison with New Zealand (N.Z.) normocholesterolemic rabbits, aged 4-14 months. Serum cholesterol was elevated (626 +/- 99 mg/100 ml) in 4-6-month-old WHHL rabbits and significantly lower in 12-14-month-old animals (344 +/- 51 mg/100 ml). Cholesterol infiltration in thoracic aorta was high in young WHHL compared with N.Z. rabbits (0.88 +/- 0.3 mg/100 mg fresh tissue vs. 0.08 +/- 0.003 mg/100 mg, respectively) and it did not vary with age. In N.Z. rabbits, serum and aortic cholesterol levels were low from 4 to 14 months of age. The aortic relaxation to acetylcholine (0.03-3 microM) on EC50 noradrenaline precontracted rings was similar in 4-6-month-old WHHL and N.Z. rabbits of the same age. In WHHL rabbits, the relaxation to acetylcholine was significantly reduced in 7-11- (-35% at maximum) and in 12-14-month-old rabbits ( 40% at maximum). In N.Z. rabbits the response to acetylcholine was not modified in the 3 age groups. The relaxation to ATP (30 microM to 3 mM) was reduced by age both in N.Z. and in WHHL rabbits, but in 12-14-month-old WHHL rabbits the maximal relaxing response was significantly more elevated than in age-matched N.Z. rabbits (50.1 +/- 2.5% vs. 35.1 +/- 3.2%, respectively). The aortic relaxation to NaNO2 (10 microM to 3 mM) was reduced by age both in N.Z. and in WHHL rabbits.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793451 TI - Increased plasma immunoreactive endothelin-1 concentration in hypercholesterolemic rats. AB - This study examined the influence of hypercholesterolemia on the concentration of plasma immunoreactive (ir) endothelin-1 in rats. Plasma ir-endothelin-1, total cholesterol, triglycerides, and lipoprotein fraction concentrations were measured in three groups of rats; ie, fed a standard diet, a high cholesterol diet, or a high cholesterol diet supplemented with the antihypercholesterolemic drug clinofibrate for 4 and 8 weeks. In the rats fed cholesterol for 8 weeks, morphological changes in thoracic and abdominal aortas were examined. Plasma total cholesterol, low density lipoprotein (LDL), very low density lipoprotein (VLDL) and ir-endothelin-1 concentrations increased significantly in the cholesterol-fed rats after both 4 and 8 weeks. In the clinofibrate-treated rats, these lipid parameters and plasma ir-endothelin-1 levels after 4 and 8 weeks were significantly lower than in the cholesterol-fed rats. The plasma ir-endothelin-1 concentration was correlated with plasma total cholesterol, LDL, and VLDL concentrations in the three study groups after 4 and 8 weeks. Morphologically, neither foam cells formation nor intimal thickening was observed in rats fed the high cholesterol diet for 8 weeks. These observations indicate that hypercholesterolemia without atherosclerosis elevates the plasma ir-endothelin-1 level in rats. The observed increase in plasma ir-endothelin-1 associated with hypercholesterolemia may play a role in the initiation or development of atherosclerotic vascular lesions. PMID- 1793452 TI - Tumor necrosis factor-alpha in human arterial wall with atherosclerosis. AB - Tumor necrosis factor-alpha (TNF-alpha) was demonstrated in human normal and atherosclerotic aorta, iliac and femoral arteries by immunohistochemistry using monoclonal and polyclonal antibodies. TNF was present in the cells of the arterial wall and as granular and diffuse extracellular deposits in the connective tissue matrix. Quantitative determinations of TNF by ELISA showed mean values of 21.7 +/- 0.7 ng/100 mg total extracted protein in normal intima, 38.2 +/- 0.5 in intimal thickenings, 25.5 +/- 1.1 in fibrous plaques and 16.8 +/- 0.2 ng/100 mg total extracted protein in media. Intimal thickenings presented the highest amounts of TNF with a statistically significant difference when compared to normal intima (P less than 0.05) and media (P less than 0.01). TNF-alpha concentrations in arterial eluates were about 200 times higher than in the corresponding serum samples. Western blotting analysis confirmed TNF-alpha eluted from the arterial wall to be about 17 kDa similar to human recombinant TNF-alpha. TNF-alpha in human atherosclerotic wall could be actively involved in the inflammatory events associated with atherosclerosis. PMID- 1793453 TI - International Commission for Protection Against Environmental Mutagens and Carcinogens. Report of ICPEMC Subcommittee 7/1. The possible involvement of somatic mutations in the development of atherosclerotic plaques. PMID- 1793454 TI - Probucol, a superoxide free radical scavenger in vitro. AB - Free radical (FR) mediated oxidation of low density lipoproteins (LDL) has been implicated in atherogenesis. Probucol is a lipid lowering agent with antioxidant properties which may protect the LDL from FR mediated damage. The specific mechanism by which probucol acts as an antioxidant has not previously been reported. We therefore studied the FR scavenging properties of probucol in vitro and results show that this drug is a powerful superoxide scavenger. This property may be relevant in its use as a lipid lowering drug in the retardation of the atherosclerotic process. PMID- 1793455 TI - Effects of gemfibrozil on serum apolipoprotein E distribution in hypercholesterolemic patients. PMID- 1793456 TI - Arterial wall oxygenation, oxyradicals, and atherosclerosis. AB - The oxygen supply of inner media and thickened intima of atherosclerosis prone arteries depends largely on diffusion from the endothelium. Conditions which increase wall thickness and oxygen diffusion or reduce oxygen transmissibility produce hypoxia and steep PO2 gradients within the wall. Cerebral injury and myocardial reperfusion studies indicate that intermittent hypoxia and steep PO2 gradients lead to oxyradical formation and tissue damage. Products of lipid and sterol peroxidation are found in atherosclerotic plaques and can be generated by arterial wall cells in culture. It is likely that peroxidation occurs directly within the arterial wall. Sufficient oxyradical generation occurs during normal oxygen metabolism that local scavenger mechanisms are required to avoid tissue damage. Experimental hypertension, hyperlipemia and balloon injury produce medial hypoxia with steep PO2 gradients and redistribution of the pattern of arterial wall antioxidant enzymes. This suggests that minor deviations from normal arterial wall anatomy and function can lead to oxyradicals which can be directly injurious and can amplify the atherogenic potential of lipoprotein infiltration. PMID- 1793457 TI - Long-term sequelae on pulmonary function in survivors of the adult respiratory distress syndrome. PMID- 1793458 TI - Proteolytic inactivation of alpha-1-anti-chymotrypsin. Sites of cleavage and generation of chemotactic activity. AB - The effect of several microbial and mammalian proteinases on the inhibitory activity of human plasma alpha-1-anti-chymotrypsin (alpha-1-Achy) has been tested. Most of these enzymes caused rapid inactivation of the inhibitor by cleavage at single sites within the reactive-site loop between P5 Lys and P3' Leu, with additional cleavages also being detected in some cases near the NH2 terminus of the native protein. In contrast, two of the enzymes tested failed to inactivate alpha-1-Achy, although they could cause removal of peptides near the NH2 terminus. Studies of neutrophil chemotaxis revealed that native or NH2 terminally truncated alpha-1-Achy was not stimulatory. However, testing of two enzymatically inactivated forms of the inhibitor (alpha-1-Achy), cleaved at widely different positions within the reactive-site loop, indicated that they had become potent chemoattractants at concentrations within the nanomolar range. Competition studies using proteolytically inactivated alpha-1-proteinase inhibitor suggested that the chemotactic activity of the two inactivated serpins was probably mediated by the same mechanism. The physiological relevance of this chemotactic activity is underscored by the results of plasma elimination studies which indicate that alpha-1-Achy is eliminated at approximately the same rate as native alpha-1-Achy, thus prolonging chemotactic stimuli within the tissues. PMID- 1793459 TI - Ossification in nude mice. 2. A histological, histochemical and immunohistochemical study. AB - The autopodia of proximal limbs as well as the proximal growth plates of the tibia of newborn nu/nu including super nu/nu, nu/+ and +/+ mice were studied. No differences in the ossification of proximal limb autopodia (regarding the distribution of alkaline phosphatase, acid phosphatase or glycosaminoglycans) were observed in mice of genotypes studied. On the other hand, a thinner proximal tibial growth plate characterizes one-month-old nu/nu mice, and also the architecture and alkaline phosphatase pattern were altered. The results suggest a postnatal secondary effect of the nu/nu genotype on skeletal development. PMID- 1793460 TI - Amyloid plaques, neurofibrillary tangles and neuronal loss in brains of transgenic mice overexpressing a C-terminal fragment of human amyloid precursor protein. AB - Alzheimer's disease (AD) affects more than 30% of people over 80 years of age. The aetiology and pathogenesis of this progressive dementia is poorly understood, but symptomatic disease is associated histopathologically with amyloid plaques, neurofibrillary tangles and neuronal loss primarily in the temporal lobe and neocortex of the brain. The core of the extracellular plaque is a derivative of the amyloid precursor protein (APP), referred to as beta/A4, and contains the amino-acid residues 29-42 that are normally embedded in the membrane-spanning region of the precursor. The cellular source of APP and the relationship of its deposition to the neuropathology of AD is unknown. To investigate the relationship between APP overexpression and amyloidogenesis, we have developed a vector to drive expression specifically in neurons of a C-terminal fragment of APP that contains the beta/A4 region, and have used a transgenic mouse system to insert and express this construct. We report here that overexpression of this APP transgene in neurons is sufficient to produce extracellular dense-core amyloid plaques, neurofibrillary tangles and neuronal degeneration similar to that in the AD brain. PMID- 1793461 TI - Choroidal vasculitis in acute posterior multifocal placoid pigment epitheliopathy. AB - A 24-year-old Caucasian female presented with acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and associated infiltration round some of the larger choroidal blood vessels. This infiltration dissipated as the patient's clinical condition improved and did not induce any permanent alteration of the overlying retinal pigment epithelium. We suggest that the infiltration round the choroidal vessels was due to a choroidal vasculitis. The finding of choroidal inflammation in this case lends support to the hypothesis that choroidal vasculitis is an underlying pathological process in APMPPE. PMID- 1793462 TI - [Ventricular arrhythmias in patients with cor pulmonale]. AB - This paper reported the results of 24 hours continuous ECG, day time and overnight arterial blood gas/pH and serum electrolytes in 20 patients with cor pulmonale, in order to investigate the rule of changes of ventricular arrhythmias (VA). The results were as follows: (1) Incidence of VA in 24 hours Holter Monitoring was 100%. (2) Frequent VPBs were increased significantly in period of acute attack (40%, P less than 0.05). (3) Non-sustained VT in the nocturnal (40%) was more than the day time in period of attack (P less than 0.05). (4) Relationship between VA and variables in period of attack: PaCO2 (r = 0.90) greater than arterial blood pH (r = -0.87) greater than PaO2 (r = -0.63); in relieved period VA were only related to serum potassium (r = -0.86). The authors speculated the severity of VA in period of attack was related with worse of arterial blood gas/pH, cardiac dysfunction and compensated enhance of sympathetic activity. It seems that the view accorded with theory of Yin-Yang in TCM. PMID- 1793463 TI - Technetium-99m HMPAO labeled leukocytes in inflammation imaging. AB - Technetium-99m-HMPAO (Tc-99m-HMPAO) labeled leukocyte imaging was carried out in 19 patients at 3-5 hr after reinjection. There were no side effects noted. Tc-99m leukocyte images showed gall bladder, colon, kidney, and urinary bladder activity in normal distribution as a result of excretion of the eluted Tc-99m complex. They yielded a sensitivity of 93%, a specificity of 100% and an accuracy of 95%. They were correctly positive in 14 out of 19 cases. But one false negative case was seen in a patient with pyonephrosis showing a lack of renal function with decreased renal blood flow. It was concluded that they have some advantages over In-111 leukocyte images, but we have to consider the fact that the ureteral obstruction or the lack of renal function with decreased renal blood flow may result in a false positive or a false negative case. PMID- 1793464 TI - Chronic hepatitis B infection in Singapore. AB - Four hundred and four patients (273 men, 131 women) aged 3 to 85 years with chronic Hepatitis B virus (HBV) infection seen during a five year period were analysed. At presentation, 177 patients (44%) were Hepatitis B e Antigen (HBeAg) positive (mean age 32 years) and 217 patients (54%) were anti-HBe-positive (mean age 40 years). Ten patients (2%) were negative for HBeAg and anti-HBe. Serum HBV DNA was detected in 169 patients (42%). 85% of the HBeAg-positive patients had detectable serum HBV-DNA and 9% of the HBeAg-negative patients were positive for serum HBV-DNA. The mean serum Alanine amino-transferase (ALT) and Aspartate amino transferase (AST) levels were higher in HBeAg-positive patients (75 and 52 iu/l) than in HBeAg negative patients (46 and 37 iu/l) (P less than 0.001). Liver biopsies were performed in 135 patients. Fifty-three (39%) had minimal changes, 61 (45%) chronic hepatitis (CPH, CLH & CAH) and 21 (16%) cirrhosis. There was no significant difference in the histologic distribution between HBeAg-positive and HBeAg-negative groups. Two hundred and fifty eight patients were followed up for a mean duration of 2 years (range 3 to 108 months). The cumulative probability of clearing HBeAg at the end of the first, second and third year were 14%, 16% and 18% respectively. Of these, the cumulative probability of developing anti-HBe over one, two and three years were 8%, 9% and 11% respectively. Reversion to HBeAg occurred in 1.5% of patients who were HBeAg-negative at presentation and 11% of HBeAg-positive patients who cleared HBeAg.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793465 TI - [Margretta Madden Styles--a distinguished nurse-scholar. Interview by VA Lanara]. PMID- 1793466 TI - [A new reality for a new millenium]. PMID- 1793467 TI - [The nurse's role in a child psychiatric unit of St. Sophia Children's Hospital, Athens, Greece]. AB - The role of the nurse in a child psychiatric unit is defined by the systems: a. Nurse-child b. Nurse-child-family c. Nurses-children d. Nurses-disciplinary team (a). In these systems the nurse: assesses the child, identifies the problems, sets the goals, provides care, educates the child. (b). Reinforces the parents' role, intervenes to help the relationships in the family. (c). Facilitates the team interactions and also the healthy behaviour in the peer group team, provides secure relationships. The nurse also functions as a reinforcement which leads to maturity. (d). The nurse is an equal member in the therapeutic team, is the link for communication and the main source for information. He participates in the organization and management of the team. Many nurses are specialized in psychiatric and child psychiatric nursing. All nurses believe in the continuing education and they attend various seminars. Through the activities in the unit the nurses have an update information on the subject of their work. Supervisions with educational character have been established for the nursing team. The nurse works on the base of the "special nurse-child" relationship and has the full responsibility of the child. The special nurse fulfills the nursing history. Systematic observation and evaluation are performed by the special nurse: he identifies the problems, sets the goals, formulates a programme, writes down and evaluates the results which means that he works with the implementation of the nursing process. PMID- 1793468 TI - [Nursing and HIV/AIDS--focus on counseling]. PMID- 1793469 TI - [Influence of chronic renal failure on nutritional status. Principles of nutrition]. AB - Chronic renal failure influences the metabolism of nutrients. Low protein diet has been found very helpful in a longer survival of uremic patients, before they start some kind of dialysis (hemodialysis or peritoneal dialysis). Such a diet should be followed very carefully in order to avoid problems with patient's nutrition. The evaluation of nutritional status (history, body weight, anthropometric indices, biochemical parameters) is necessary. Moreover, the nephrology team should know the protein and potassium content of different nutrients for the purpose of a better nursing of chronic renal patients. PMID- 1793470 TI - Synthesis and immunomodulating activity of condensed N-aryl-2-cyano-3-oxo-3 pyrazolyl-propanamides. AB - A series of condensed N-aryl-2-cyano-3-oxo-3-pyrazolyl-propanamides were synthesized and evaluated for immunomodulating activity following intraperitoneal administration. These new molecules were found to enhance macrophage cytotoxicity and stimulate host mediated antibacterial defences in mice. The compound 3-cyano 3-(1,4-dihydro-1-phenyl-[1]-benzothiopyrano[4,3-c]pyrazol- 3-yl]-3-oxo-N-phenyl propanamide, chosen for wider pharmacological investigation, proved effective in preventing adjuvant-induced arthritis development in rats. PMID- 1793471 TI - Methoctramine-related polymethylene tetraamines. 4. Chirality effect on M2 muscarinic receptor blocking activity. AB - Chiral methoctramine-related compounds (3 and 4), bearing two asymmetric atoms in the terminal benzylic moieties, were synthesized and evaluated for their blocking activity on M2 and M3 muscarinic receptors of guinea pig left atrium and ileum, respectively. It turned out that insertion of these chiral centers in methoctramine structure is ineffective in the ileum whereas it produces a significant decrease in potency in the atrium when compared to methoctramine (1). Furthermore, the enantiomers of 3 and 4 did not display significant enantioselectivity at both M2 and M3 muscarinic receptors. PMID- 1793472 TI - Synthesis and evaluation of in vitro antitumor activity of some substituted 5 pyridazinyl-styrylketones. AB - A series of twenty pyridazinyl-styrilketones, substituted at position 4 with linear or cyclic tertiary amino groups, were synthesized and evaluated in vitro as antitumor agents against 60 human tumor cell-lines. Moderate activity and differential cell sensitivity were found for several of the compounds. Cell-line XF-498L (panel:Brain) showed differential cell sensitivity towards compound 5b (more than 1000 times the mean sensitivity of all cell-lines). PMID- 1793473 TI - Synthesis and in vitro antibacterial properties of 2-(3-bromo-5 isoxazolylideneamino-oxy)acetamido-beta-lactam derivatives. AB - The synthesis of new 2-(3-bromo-5-isoxazolylideneamino-oxy)acetic acids and their condensation derivatives with suitable beta-lactam nuclei is reported. Their antibacterial properties have been tested in vitro. An interesting activity against Gram-positive bacteria including beta-lactamase-producing microorganisms was found among the cephalosporanic acid derivatives. PMID- 1793474 TI - Synthesis and biological activity of pyrimido[2,1-b][1,3]thiazine, [1,3]thiazino[3,2-a]purine and [1,2,3]triazolo[4,5-d][1,3]thiazino[3,2 a]pyrimidine derivatives and thiazole analogues. AB - Some series of thiazolo[3,2-a]pyrimidine, pyrimido[2,1-b] [1,3]thiazine, thiazolo[3,2-a]purine, [1,3]thiazino[3,2-a]purine, thiazolo[3,2 a][1,2,3]triazolo[4,5-d]pyrimidine and [1,2,3]triazolo[4,5-d][1,3]thiazino[3,2 a]pyrimidine derivatives, variously functionalized, were prepared. The compounds were tested for antimicrobial and antimycotic activity on a number of strains, namely: E. coli, Proteus vulgaris, P. mirabilis, Pseudomonas aeruginosa, Salmonella sp., Staphylococcus aureus, S. faecalis, Bacillus subtilis, Sarcina lutea, Candida albicans, C. tropicalis, Aspergillus sp., and for antiviral activity on Herpes simplex virus Type 1, Vesicular stomatitis virus and Coxsackievirus B5. The compounds proved to be devoid of activity against viruses and gram-negative bacteria, while some of them exhibited modest activity against gram-positive bacterial strains. PMID- 1793475 TI - Chemotherapeutic agents with an imidazole moiety. III. Synthesis and microbiological activity of new 1,4-diarylimidazole and 1,4 pyrrolimidazolphenylene derivatives. AB - New 1,4-diarylimidazole and 1,4-pyrrolimidazol-phenylene derivatives were prepared in attempt to deepen S.A.R. study on chemotherapeutic agents with an imidazole moiety. Antimicrobial data in comparison with antifungal antibiotic pyrrolnitrin showed that all tested compounds are practically inactive against blastomycetes but some derivatives exhibited selective activity against strains of gram-negative bacteria. The results obtained are discussed on the basis of structure-activity relationships. PMID- 1793476 TI - Synthesis and anticonvulsant properties of 3-(1,3,4-thiadiazol-2-yl) thiazolidin 4-ones. AB - A series of 2-substituted 3-(1,3,4-thiadiazol-2-yl)thiazolidin-4-ones were synthesized and evaluated for anticonvulsant activity in a genetic model of reflex epilepsy (sound-induced seizures in DBA/2 mice). The combination of preferred substituents in the 2-position coupled with the introduction of a mercapto group on the thiadiazole moiety led to a number of active compounds. The anticonvulsant activity of most derivatives is better than that of the clinically useful anticonvulsant sodium valproate and some of them appear to possess potencies in the same range as phenytoin and clobazam. PMID- 1793477 TI - Researches on antiinflammatory agents. Studies on some 1-methyl- or 1-phenyl-6-(2 substitutedphenyl)-pyrazolo[3,4-d]-1,3-oxazin-4(1H)-ones. AB - Following our research on analgesic and antiinflammatory active compounds containing the pyrazole nucleus, a number of new 1-methyl- or 1-phenyl-6-(2 substitutedphenyl)-pyrazolo[3,4-d]-1,3-oxazin- 4(1H)-ones was synthesized and tested, together with a few analogues previously obtained, for their analgesic and antiinflammatory activities, as well as for their acute toxicity and ulcerogenic effects. One of the tested compounds showed activity comparable to that of phenylbutazone and, at the same time, higher LD50 and a very low ulceration index. PMID- 1793478 TI - Synthesis and nootropic activity of 2-oxo-1-pyrrolidinesulfonic acid derivatives. AB - The synthesis of a series of 2-oxo-1-pyrrolidinesulfonic acid derivatives, as potential nootropic agents, is reported. Such compounds were designed to have chemical and physico-chemical properties intermediate between 2-oxo-1 pyrrolidineacetamides (e.g. oxiracetam) and 1-acyl-2-pyrrolidinones (e.g. aniracetam). The ability of these compounds to counteract the ECS-induced amnesia in mice was assessed in a one trial, step through, passive avoidance paradigm. Whilst oxiracetam and aniracetam confirmed their antiamnestic action, none of the title compounds showed a statistically significant activity. PMID- 1793479 TI - Research on antibacterial and antifungal agents. IX--Synthesis and microbiological activity of new N-arylpyrroles. AB - The synthesis and antiblastomycete activity of new N-arylpyrrole derivatives are reported. Antimicrobial data in comparison with those obtained with pyrrolnitrin and miconazole showed that all tested compounds possess weak or poor activity. The obtained results are discussed on the basis of structure-activity relationships. PMID- 1793480 TI - Fifty years of the University of Texas M.D. Anderson Cancer Center and the study of carcinogenesis. PMID- 1793481 TI - Evidence that toxic injury is not always associated with induction of chemical carcinogenesis. AB - Long-term rodent bioassays with chemicals administered at maximum tolerated doses identify noncarcinogens as well as carcinogens. Thirty-one chemicals recently evaluated for carcinogenic potential by the National Toxicology Program provide unique data on the relationships between mutagenicity, toxicity, and carcinogenicity. Twenty-two substances were classified as carcinogens, and nine showed no evidence of carcinogenicity. Although cellular proliferation does play an intrinsic role in neoplastic processes, the responses associated with chronic toxicity in these studies were not always sufficient to induce neoplasia. Regardless of their mutagenic potential, 19 carcinogens induced toxic effects at sites that did not show neoplastic changes; similar toxic lesions were also seen among the mutagenic and nonmutagenic noncarcinogens. Although many nonmutagens induced neoplasia at sites that showed toxic effects, some of the same chemicals also exhibited toxicity at other sites that showed no neoplastic effect. These results suggest that for some chemicals, properties other than mutagenicity or toxicity may be responsible for their carcinogenic potential. PMID- 1793482 TI - Mutations in the p53 tumor suppressor gene in human cutaneous squamous cell carcinomas. AB - In this study, we analyzed 10 human squamous cell carcinomas (SCCs) for alterations in the p53 tumor suppressor gene in exons 4 through 9 by single strand conformation polymorphism (SSCP) analysis. We found that 2 of 10 SCCs displayed unusual SSCP alleles at exon 7 of the p53 gene. Subsequent cloning and sequencing of PCR-amplified exon 7 DNA from these two tumors revealed that one had a G----A transition at the first position of codon 244, predicting a glycine to-serine amino acid change, while the other tumor exhibited a G----T base change at the second nucleotide of codon 248, predicting an arginine-to-leucine substitution. Because the mutations in the p53 tumor suppressor gene in both tumors were located opposite potential pyrimidine dimer sites (C-C), it is consistent with these mutations having been induced by the ultraviolet radiation present in sunlight. These studies demonstrate that inactivation of the p53 tumor suppressor gene, as well as activation of ras oncogenes, may be involved in the pathogenesis of some human skin cancers. PMID- 1793483 TI - Activation of Ki-ras gene by point mutation in human liver angiosarcoma associated with vinyl chloride exposure. AB - Point mutations of c-ras genes were investigated in human angiosarcomas of the liver associated with occupational exposure to vinyl chloride. DNA prepared from either frozen or paraffin-embedded tissues was amplified by the polymerase chain reaction, and putative point mutations at codons 12, 13, and 61 of c-Ha-ras, c-Ki ras, and N-ras were analyzed by dot-blot hybridization with allele-specific oligonucleotides. A G.C----A.T transition in the second nucleotide at codon 13 of the c-Ki-ras-2 gene was detected in 5 of 6 tumors. This mutation is likely a consequence of vinyl chloride-DNA adduct formation. It leads to the substitution of glycine by aspartic acid in the resulting p21 protein, a consistent amino acid substitution found so far in all types of human cancer exhibiting a codon 13 mutated Ki-ras gene. PMID- 1793484 TI - Ki-ras mutations in spontaneous and chemically induced renal tumors of the rat. AB - A high frequency of point mutations at codon 12 of the Ki-ras gene has previously been reported for rat kidney mesenchymal tumors induced by methylating N-nitroso compounds. In this study, we analyzed renal tumors with divergent histogenesis, i.e., mesenchymal tumors (sarcomas), cortical epithelial tumors (carcinomas), and embryonal tumors (nephroblastomas). Renal mesenchymal tumors and carcinomas were induced in juvenile or young adult Wistar rats by a single dose of N nitrosodimethylamine (NDMA) while nephroblastomas were induced in Nb hooded rats by a single transplacental dose of N-nitrosoethylurea (NEU). Nephroblastomas developing spontaneously in WAB/Not rats were also examined. Amplification of Ki ras sequences from formalin-fixed, paraffin-embedded tissue by the polymerase chain reaction was followed by direct DNA sequencing. GGT----GAT point mutations at codon 12 of the Ki-ras gene were found in 9 of 12 (75%) renal mesenchymal tumors and in 9 of 12 (75%) cortical epithelial tumors induced by NDMA. Even higher incidences were observed in nephroblastomas (8/8; 100%) induced by NEU and in spontaneous nephroblastomas (10/11; 91%). These results indicate that Ki-ras mutations are frequent events during the development of kidney tumors irrespective of their histogenesis and suggest that they may play an important role in renal carcinogenesis in rats. These data further indicate that mutational activation of Ki-ras proto-oncogenes in carcinogen-induced rat kidney tumors occurs in a tissue-specific, rather than cell-specific, manner. PMID- 1793485 TI - Involvement of fos in spontaneous and ultraviolet light-induced genetic changes. AB - Transient overexpression of ras, mos, or fos transcribed from various inducible promoters in NIH 3T3 cells causes significant increases in the frequency of chromosomal aberrations and, as shown for fos, in gene mutations. Under the experimental conditions of exponential growth and full serum supply, overexpression of the oncogenes does not increase the proliferation rate of cells. The generation of ras- and mos-induced chromosomal aberrations was suppressed in cells that had been deprived of fos protein by antisense c-fos oligodeoxynucleotides. The induction of chromosomal aberrations by ultraviolet irradiation is also suppressed by antisense c-fos oligodeoxynucleotides. The data suggest that fos protein alone, or a transcription factor that contains fos protein as a subunit, activates or induces the synthesis of one or several mutator functions. Oncogene-driven mutagenesis could account for the accumulation of additional mutations after the activation of an oncogene, which may furnish a mechanistic basis for tumor promotion and tumor progression. PMID- 1793486 TI - Expression of human O6-methylguanine-DNA methyltransferase in Chinese hamster ovary cells and restoration of cellular resistance to certain N-nitroso compounds. AB - We have constructed a plasmid in which the expression of human O6-methylguanine DNA methyltransferase (MGMT) cDNA is driven by the Rous sarcoma virus promoter sequence. Transfection of this plasmid into Chinese hamster ovary (CHO) cells results in expression of MGMT and in cellular resistance to N-methyl-N'-nitro-N nitrosoguanidine (MNNG) and 1-(2-chloroethyl)-1-nitrosourea (CNU), but not to N nitroso-N-ethylurea. The specific activity of MGMT in transfected CHO cells correlated well with their resistance to MNNG and CNU. Southern analysis showed that the plasmid had been integrated into the CHO cell genome. Western analysis of extracts from transfected CHO cells using an antibody against a peptide corresponding to the carboxyl-terminal end of the human MGMT protein demonstrated a single band with a molecular size of 24-25 kDa; no such band was observed in extracts from wild-type CHO cells. These transfected cells may therefore be used to study the role of MGMT in the repair of alkylating DNA lesions and to determine its importance in carcinogenesis as well as in chemotherapy. PMID- 1793487 TI - Stable expression of rat cytochrome P450IA2 cDNA and hydroxylation of 17 beta estradiol and 2-aminofluorene in V79 Chinese hamster cells. AB - In continuation of our work toward the establishment of a working cell bank for metabolic and toxicological studies, V79 Chinese hamster cells were genetically engineered for stable expression of rat cytochrome P450IA2. Full-length cDNA encoding rat P450IA2 was obtained by searching a cDNA library made from Aroclor 1254-induced rat liver mRNA and by joining a small 5'-end fragment to a fragment containing the rest of the cDNA. The sequence of the cDNA was confirmed by DNA sequencing and comparison to a previously published cDNA sequence. The reconstructed full-length cDNA was inserted into a simian virus 40 early promoter containing eukaryotic expression vector and cotransferred with the neomycin phosphotransferase gene as a selective marker into V79 cells by the calcium/phosphate-coprecipitation technique. G418-resistant V79 cell clones were checked for chromosomal integration of the cDNA by Southern blotting, for expression of authentic mRNA and protein by northern and western blotting, and for P450IA2-specific enzymatic activities such as hydroxylation of 17 beta estradiol and 2-aminofluorene. PMID- 1793488 TI - Expression of mouse cytochrome P450IA1 cDNA in repair-deficient and repair proficient CHO cells. AB - Recombinant DNA techniques have been used to develop Chinese hamster ovary cell lines for studying chemically induced genotoxicity. These cell lines express a specific cytochrome P450 isozyme responsible for the metabolism of polycyclic aromatic hydrocarbons and exhibit defined differences in DNA repair capacity. A bacterial gene (neo) conferring resistance to gentamicin was inserted into the pcD expression vector containing the mouse cytochrome P1450 (P450IA1) cDNA to facilitate the selection of transformed cells. This plasmid was introduced into the nucleotide-excision-repair-deficient UV5 cell line by electroporation. Transformed clonal isolates expressing the P1450 cDNA were identified by differential cytotoxicity assays using benzo[a]pyrene (B[a]P). One such clone, termed UV5P1, was mutagenized with ethyl methanesulfonate and selected for resistance to killing by UV radiation to derive a repair-competent clone that expresses similar P1450 activity to that of the parental cell line. Two repair competent clones were selected and called 5P1R1 and 5P1R3. The resulting cell lines (UV5P1, 5P1R1, and 5P1R3) expressed arylhydrocarbon hydroxylase activity. UV5P1 and 5P1R3 were compared in terms of cytotoxicity and mutagenicity after exposure to B[a]P. Induced mutations were measured at the adenine phosphoribosyltransferase (aprt) and hypoxanthine guanine phosphoribosyltransferase (hprt) loci. Repair-deficient UV5P1 cells were killed by B[a]P at concentrations below 0.1 microM, while the repair-proficient 5P1R3 cells showed no toxicity up to 60 microM. Mutation induction at both loci was also much more efficient in UV5P1 cells. These new cell lines provide a more sensitive system that can be used in a battery of assays to evaluate the genotoxicity of chemicals requiring P450IA1 metabolic activation and to assess the role of DNA repair in modulating the biological effects of DNA damage. PMID- 1793489 TI - Ultraviolet stimulation of intermolecular homologous recombination in Chinese hamster ovary cells. AB - We previously showed that ultraviolet (UV) irradiation of cotransfected plasmid DNA molecules stimulated genetic transformation that depended on intermolecular homologous recombination in Chinese hamster ovary (CHO) cells. Repair-proficient cells and an excision repair complementation class 1 (ERCC1) UV-sensitive DNA repair-deficient mutant responded similarly to UV stimulation in cotransfections with plasmids containing linker insertion-disrupted copies of the herpes simplex virus thymidine kinase (HSV-TK) gene. In this study, we cotransfected homologous DNA molecules containing nonoverlapping deletions of the hamster adenine phosphoribosyltransferase (APRT) gene into APRT-deficient CHO ERCC1 (UVL-10) and ERCC2 (UVL-1) excision-repair mutants and parental repair-proficient CHO cells. UV damage in cotransfected circular plasmid molecules stimulated transformation in repair-proficient cells and an ERCC1 mutant, but not in an ERCC2 mutant. Linearization of plasmids prior to cotransfection greatly enhanced transformation frequencies in all three cell lines, but UV stimulation using linear recombination substrates was no longer evident. Our results suggest (i) that the ERCC1 gene defect in CHO UVL-10 cells does not affect UV stimulation of homology dependent extra-chromosomal recombination, and (ii) that a CHO cell ERCC2 excision-repair mutant, although recombination proficient, may exhibit altered recombination in response to UV damage. PMID- 1793491 TI - Experimental studies of moderate temperature burns. AB - The pathology and characteristics of moderate temperature burns have been investigated in rats with a heating apparatus capable of applying thermal doses varying in temperature and exposure time, to which the responses have been observed both macroscopically and microscopically. The macroscopic examination showed only erythema and greyish necrosis. The microscopic changes were divided into six grades of severity from 0 to 5. From the time-temperature threshold curves made by microscopic observations, the critical temperatures for superficial and deep dermal burns, and full skin thickness burns were 37.8 degrees C, 41.9 degrees C and 47.9 degrees C, respectively. According to the data, almost all commercially available topical heaters are considered hazardous. Susceptibility to thermal injury was markedly increased by compression and ischaemia, the effects of which are thought to be due mainly to rapid heat accumulation (heat damage) and hypoxaemia (hypoxic damage). PMID- 1793490 TI - Expression and localization of the matrix metalloproteinase pump-1 (MMP-7) in human gastric and colon carcinomas. AB - The expression of members of the family of matrix-degrading metalloproteinases (MMPs) is believed to contribute to the complex process of invasion and metastasis. In this study, specific cDNA probes for three members of the stromelysin subfamily of MMPs--stromelysin (MMP-3), stromelysin-2 (MMP-10), and pump-1 (MMP-7)--were used to examine the expression of these three different MMPs in human gastric and colonic carcinomas and in adjacent normal mucosa. The expression of pump-1 mRNA in malignant colon and stomach samples was striking. In a total of 10 gastric carcinoma samples examined, eight (80%) expressed pump-1 transcripts; similarly, 6 of 8 (75%) colon carcinoma samples were also positive. Stromelysin and stromelysin-2 mRNAs were not detected in any of these samples. Expression of the MMPs examined was not detected in any of the adjacent, grossly normal tissue samples. Using in situ hybridization and affinity purified anti pump-1 antibodies, the expression of pump-1 mRNA and protein was localized to tumor cells and was not detected in stromal or lymphocytic cells. This data suggests that the inappropriate expression of pump-1 by malignant cells may contribute to the neoplastic phenotype. PMID- 1793492 TI - Proteoglycan synthesis in human skin and burn scar explant cultures. AB - The synthesis of proteoglycans (PG) by normal human skin, and normal and hypertrophic scars were compared using tissue explants in culture. Newly synthesized PG were labelled with [35S]Na2SO4. Significant differences were found in the proportion of [35S]-radio-labelled incorporation of PG in the tissue and accumulation of [35S]PG in culture medium in the different tissues. The rate of PG biosynthesis in all three tissue types occurred in two phases. There was an initial phase of PG synthesis occurring at 0-3 h and a later phase that occurred at 3-18 h [35S]-labelled PG were isolated and characterized by Sepharose CL-6B chromatography and cellulose acetate electrophoresis. The results showed that the hypertrophic scar tissue and its culture medium contained higher proportions of dermatan sulphate (DS), chondroitin sulphate (CS) and DS' PG than the normal skin fractions. These results suggest that abnormal scarring is related to a change in the level of PG synthesis during the burn injury repair process. PMID- 1793493 TI - The state of leucocyte adhesiveness/aggregation (LAA) in the peripheral blood of burned mice: an early and sensitive inflammatory indicator and a marker of pulmonary leukostasis. AB - The inflammatory response during thermal injury increases the adhesiveness of white blood cells. A direct slide test was used to compare the state of leucocyte adhesiveness/aggregation (LAA) in the peripheral blood of mice subjected to a thermal injury with the findings in control animals. The state of LAA in the peripheral blood increased from baseline values of 1.1 +/- 1.1 per cent to 6.5 +/ 1.3 per cent within 1 h and to 11.0 +/- 1.2 per cent and 14.8 +/- 4 per cent after 3 and 6 h respectively following thermal injury. The respective leucocyte counts were 3075 +/- 277/mm3 (baseline), 3871 +/- 359, 3840 +/- 687 and 6395 +/- 1152 cells/mm3. The LAA values had subsided by 5 days following burning and correlated with the degree of pulmonary leukostasis. Our study suggests that the LAA is an early and sensitive marker of inflammation and that it can be used as a marker for the presence of pulmonary leukostasis during thermal injury. PMID- 1793494 TI - Further explorations of abnormalities in serum proteins following burns. AB - This report extends our earlier studies of the abnormal protein bands found in burn sera by use of Western blotting and ion exchange chromatography. The current studies indicated that some of the protein bands contained materials with immunosuppressive activity. One of these materials cross reacted with anti human haptoglobin antibody. Many of the other proteins in the bands were found to be acute phase reactant proteins without immunosuppressive activity. Some proteins in these bands have not yet been characterized or tested for immunosuppressive activity. PMID- 1793495 TI - Pulmonary oedema in isolated lung lobe after inhalation injury. AB - Pulmonary oedema was produced in isolated lung lobes with steam and provided direct continuous measurements of transudation as it occurred. Transvascular flux (Qf) and weight gain (Gw) of the lobe increased immediately and the transudation reached its peak within half an hour after inhalation injury. Studies of protein content, colloid osmotic pressure of bronchial exudate and water content of lung, reconfirmed the increase in pulmonary capillary permeability. Marked haemoconcentration was revealed. Plasma leaked 113 g (25 per cent), plasma protein leaked 1.96 g (9.7 per cent) during the experiment. Based on the measured arterial pressure (Pa), vein pressure (Pv), arterial occlusion (Pao), venous occlusion (Pvo), double occlusion (Pdo) and blood flow through the lobe (Qt), the total vascular (Rt), arterial (Ra), middle compartment (Rmid) and venous (Rv) resistances were calculated. All the resistances were increased and the Qt showed a decrease after inhalation injury. PMID- 1793496 TI - Microskin grafting of rabbits with pigskin xenograft overlay. AB - Pigskin xenografts were used to replace allografts in microskin grafting (10:1 expansion ratio) on 15 rabbits. Rabbits were selected randomly for the removal of the overlaid pigskin at days 7, 10 or 14 for the evaluation of the degree of epithelialization. Histological examination of the removed pigskin 7 days after application showed obvious eosinophilic changes in the epidermal cells and pyknotic changes of the nuclei, however in some areas newly formed epidermis could be found. The pigskin became an eschar or slough on day 14. The microskin autografts proliferated and expanded actively under the protection of this overlaid pigskin. The epidermis increased in thickness and with increasing differentiation. The dermal layer was well vascularized with a large number of capillaries and fibroblasts. The wound was covered by the neoepithelium with almost normal skin texture on day 14, by which time the overlaid pigskin became a dry eschar. In areas where the overlaid pigskin was sloughing, the epithelialization of the underlying microskin grafts was not complete at the same time. In these animal studies of microskin grafting, these overlaid pigskin xenografts showed the same effects as those of allografts. PMID- 1793497 TI - Psychological consequences of burn injury. AB - The major psychological sequelae experienced by patients 1 year after burn injury were investigated. Data were collected on a consecutive series of adult burn patients, (n = 55), including major demographic and epidemiological characteristics. Participants (n = 23) completed the Hospital Anxiety Depression Scale (HADS), the Impact of Event Scale (IES) and a questionnaire covering functional impairment, visibility of the burn, experience of pain, etc. Over one third of the patients (36.4 per cent) were found to have premorbid characteristics which could predispose them to injury. Over one-third (34.7 per cent) were still experiencing significant psychological problems. Anxiety was most common, followed by posttraumatic stress symptoms and depression. The visibility of the burn was found to be a useful factor in the prediction of psychological outcome (P = 0.001-0.018). No additional variables were found to increase the significance of prediction. Patients indicated that practical advice in the form of staff-led discussions, before or immediately after discharge, would be the most valuable help. PMID- 1793498 TI - Electrical burns treated in an Indian hospital. AB - A 17-year survey of all electrical burns admitted to the Department of Plastic and Reconstructive Surgery at the Kilpauk Medical College Hospital, Madras between 1973 and 1990 has been made. A total of 8040 cases of burns were treated in this Department and in this group 923 were pure electrical burns. The majority of electrical burns occurred in the age group 20-40 years. Some of the clinical features of our electrical burns resembled closely those of a crush injury. Most of the patients required primary reconstruction and this was delayed when the viability of tissues was in doubt. Human error was responsible for the injury in 68 per cent of patients and all the 64 patients who were below the age of 10 years belonged to this group. PMID- 1793499 TI - Effectiveness of burns resuscitation using two different formulae. AB - Prior to 1989 burns were resuscitated at the Burns Unit Frenchay Hospital according to the Mount Vernon formula. In 1989 a 33 per cent modification was introduced as suggested by Watson, Walker and Sanders. The aim of this study was to examine retrospectively the effects of the resuscitation protocols on morbidity and mortality. The total numbers of burns admitted to Frenchay in 1988 were 93 adults and 58 children. This compares with 82 adults and 55 children admitted in 1989. Of these, approximately one-fifth required intravenous resuscitation. No statistical difference was found between the two groups for age, body weight, distribution of burn, or delay in arriving at the burns unit (taken from the time of burn). In both years the volume of albumin used in resuscitation exceeded the calculated requirement after the third period (P less than 0.05). The 1989 patients were transfused with greater volumes, resulting in increased urine output (P less than 0.001). No difference in morbidity or mortality was shown. However, the investigation did show that the 1989 patients achieved urine outputs indicative of overtransfusion. It is concluded that the Watson-Walker modification is unnecessary and possibly undesirable. PMID- 1793500 TI - Two years in burn care, an analysis of 12,423 cases. AB - This is a retrospective study analysing 12,423 patients treated at our institution from 1 July 1988 to 30 June 1990. Burn incidence and mode of treatment were classified according to age and sex, as well as causative agent, place of the accident, length of treatment and outcome. 96.6 per cent of the patients were surgically treated, about 41 per cent of the patients were under 14 years of age. The most frequent cause of injury was related to meal preparation, with more than two-thirds of the accidents occurring at home. Only large or complicated burns (1094-8.8 per cent) were admitted, with 49 deaths occurring during this period. We conclude that children and younger adults are at greater risk of being burned and preventative measures should be oriented towards the prevention of such accidents. PMID- 1793501 TI - Treatment of full skin thickness burn injury using cultured epithelial grafts. AB - This report presents the experience gained from 26 patients treated with autogenic cultured epithelial grafts (auto-CEG). All auto-CEG were applied to wounds clinically defined as full skin thickness injury. In total 89 separate sites were grafted. The overall estimate of 'take' ranged from 0 to 98 per cent with a mean value of 15 per cent. The highest level of 'take' (43 per cent) was observed when auto-CEG were applied to wounds which had been previously covered with allogenic split-thickness skin grafts. An increased incidence of wound colonization with pathogenic species of bacteria corresponded with a decreased graft 'take'. Ps. aeruginosa and Staph. aureus were found to be present on 32.6 per cent and 60.5 per cent of wound swabs respectively, where 10 per cent or less 'take' of auto-CEG was seen, indicating that bacterial infection is in part responsible for graft failure. However, in 20.9 per cent of such instances, no growth of bacteria was detected, perhaps suggesting that certain wound beds may not present the correct physical environment necessary to support proliferating epithelial cells isolated from their underlying dermal component. PMID- 1793502 TI - Initial experiences with surgical treatment of deep burns at a USSR children's burn unit. AB - Thirty-eight consecutive children with deep burns who underwent early burn wound excision and grafting are reported from the 6th Surgical Department and the All Union Pediatric Burn Center, Children's Hospital no.9, Moscow, USSR. Early excision represents a radical departure from previously employed expectant treatment. Infection rate fell from 25-48 per cent to 15 per cent. Two children died during a time period when, based on prior experience, seven to eight children would have been expected to succumb. With additional experience with this technique, results should improve even further. PMID- 1793504 TI - Treatment of severe electrical burns of the genitalia and perineum by early excision and grafting. AB - A patient with severe electrical burns to his perineum and genitalia is presented. Evaluation of such patients necessarily includes local wound exploration, cystourethroscopy and proctoscopy. The principles of early serial debridement and wound closure were applied to all tissues including testis and penis. Removal of non-viable tissue and wound closure was accomplished by postburn day 10 without sacrifice of viable tissue and without wound sepsis. The benefits of early debridement and wound closure are reduction of infection, earlier onset of physiotherapy, quicker recovery of function, and shortened hospital stay. PMID- 1793503 TI - Application of sulcated half-ring external fixator for treating bone and joint injuries of burned lower extremities: a report of four cases. AB - Four patients with burned lower extremities complicated with severe bone and joint injuries were treated with sulcated half-ring external fixators. The results were satisfactory. This apparatus is simple, easy to handle and effective. Using this fixator, the burn wounds as well as the bone and joint injuries could be managed at the same time, without mutual interference. As it seems a desirable method for the management of such compound injuries, the advantages and disadvantages of this apparatus are discussed. PMID- 1793505 TI - Thromboembolic events in a severely burned patient. AB - A patient with severe burns suffered spontaneous bilateral peripheral arterial thromboses which were successfully treated with recombinant human tissue plasminogen activator (rt PA) (Actilyse). The patient later died from complications of burns. PMID- 1793506 TI - Synthesis and analgesic activity of 1-(N-methylanilinoethyl)indoles. AB - The synthesis of two series of 1-(N-methylanilinoethyl)indoles is reported. The first arises from the N-alkylation of indole-3-acetic acid or its methylester, while the second was prepared by means of the Witting reaction on the appropriate aldehyde. The compounds were tested in mice (hot plate test and phenyl-p benzoquinone induced writhing test) for their analgesic activity. None of the compounds was significantly active in the hot plate test. However, N methylanilinoethyl 1-(N-methylanilinoethyl)-3-indolylacetate (7) was the most active one in the phenyl-p-benzoquinone induced writhing test, which indicates that 7 has a peripheral analgesic effect. PMID- 1793507 TI - Loss of nitroglycerin during passage through two different infusion sets. AB - The loss of nitroglycerin (GTN) during passage through a polyvinyl chloride (PVC) or polyethylene (PE) infusion set was investigated. The GTN concentration had no influence on the GTN loss in the PVC set. The study confirmed reports in the literature that the greatest loss of GTN occurs at the slowest rate of infusion. Interestingly, the lowest concentration of GTN is seen when the volume equivalent to the capacity of the infusion set has passed through the set. When we simulated the procedure recommended by the health authorities in Norway and Sweden, we observed a loss of up to 70% during infusion through the PVC set in the first 30 minutes, which decreased to 30% over the next seven hours. The loss from the PE set did not exceed 15% over eight hours. PMID- 1793508 TI - Hypolipidemic activity of aliphatic dicarboxylic acids in rodents. AB - Small molecular weight aliphatic dicarboxylic acids, i.e. dimethylmalonic acid, diethylmalonic acid and maleic acid, afford greater than 35% reduction in serum cholesterol and triglycerides levels in CF1 mice at 20 mg/kg/day, i.p. Furthermore, these agents lowered greater than 40% serum cholesterol levels in rat after oral administration at 20 mg/kg/day. Dimethylmalonic and diethylmalonic acids lowered rat serum triglyceride levels by at least 23%. Rat tissue lipids, e.g. liver, small intestinal mucosa and aorta wall, were reduced in concentration and fecal lipids were elevated by dimethyl- and diethylmalonic acids. Rat serum lipoproteins after 14 days of treatment demonstrated reduction of VLDL and LDL cholesterol levels with elevated HDL cholesterol levels by dimethylmalonic and maleic acids. The agents also inhibited de novo hepatic enzyme activities, specifically mitochondrial citrate exchange, acetyl-CoA synthetase, ATP-dependent citrate lyase, acyl-CoA:cholesterol acyltransferase, cholesterol-7 alpha hydroxyase, sn-glycerol-3-phosphate acyltransferase and phosphatidate phosphohydrolase, which would result in the reduction of de novo synthesis of fatty acids, cholesterol and triglycerides. PMID- 1793509 TI - Kinetics of the acid-catalyzed hydrolysis of acyclovir and an ester prodrug in aqueous solution. AB - The kinetics of hydrolysis of acyclovir was studied in 0.01-0.5 M hydrochloric acid solutions (pH 0.5-2.2) at 80 degrees C. The hydrolytic cleavage of the 9-C-N bond in acyclovir to give guanine was found to proceed almost quantitatively (greater than 90%) as evidenced by HPLC analysis. The rate of hydrolysis was subject to apparent specific acid catalysis, the specific hydrogen ion catalytic rate constant being 4.9 x 10(-2) M-1 min-1 at 80 degrees C and mu = 0.5. The possible significance of acid-catalyzed hydrolysis for the stability of acyclovir during its transit through the stomach after peroral administration was found to be negligible. A novel 4-(morpholinomethyl)benzoate ester prodrug of acyclovir was found to be three times more stable in acidic solutions than acyclovir itself despite the ester group being an additional site of degradation. The dominating degradation reaction of the ester was found to be cleavage of the 9-C-N bond. The higher stability of the ester was ascribed to the greater electron-withdrawing effect of the ester group relative to the hydroxyl group which decreases the tendency of the 9-C-N bond to be ruptured by an A-1 mechanism. PMID- 1793510 TI - Removal of inhaled 99mTc-labelled particles of disodium cromoglycate from the lungs. AB - Disodium cromoglycate particles were labelled with 99mTc by spray-drying technique. The in vitro dissolution profile as well as the leakage of radioactivity from the drug particles were determined using a through-flow cell method. The radioactive drug particles were mixed with a lactose carrier and inhaled from a dry powder device by five healthy volunteers. The removal of the inhaled drug particles from the lungs was evaluated by a gamma camera. A close relationship between the dissolution of the drug as such and the leakage of radioactivity was noted. Gamma scintigraphy indicated a biphasic exponential removal of radioactivity from the lung region. The slow component with the halftime of about 55 min was mainly due to the dissolution of drug particles in the lungs. The halftime of the fast component describing mucociliary clearance was less than 10 min. This process was the dominating one for the removal of the drug from the lungs. The experiment thus showed that the main fraction of the inhaled dose was deposited in the tracheobronchial region. Accordingly, only a small portion of the dose initially deposited in the lung can be absorbed and induce a therapeutic effect. PMID- 1793511 TI - Characterization of enteric-coated tablets and pellets by two in vitro dissolution methods and by scanning electron microscopy. AB - The in vitro dissolution rates of enteric-coated pellets and tablets containing dexchlorpheniramine maleate (DCPM) were obtained using the USP XXI paddle and a flow-through method. Pellets were produced by extrusion and spheronization. Tablets were produced by direct compaction, and by wet granulation. The products were coated with different amounts of Eudragit L30D using fluid-bed technology. Onset of release, determined by fitting of the Weibull function, was the only factor found to be affected by the amount of coating of the tablets. For pellets, both onset of release and dissolution rate showed significant differences. Scanning electron microscopy was used to study the effect of different dissolution media on the coating. Acidic medium was found to alter the coating surface, but the coating did not rupture during the time used in this study. PMID- 1793512 TI - Quantitation of diltiazem in human plasma by HPLC using an end-capped reversed phase column. PMID- 1793513 TI - Evaluation of the transdermal route for administration of narcotic analgesics: human skin permeability studies of methadone and pethidine. PMID- 1793514 TI - Antimycotic imidazoles: X-ray powder diffraction data for econazole and miconazole. PMID- 1793515 TI - Protein C degradation in vitro by neutrophil elastase. AB - Purified protein C is completely degraded into small peptides by in vitro incubation with purified elastase. Protein C is a rather sensitive substrate as degradation is already accomplished by low elastase concentrations (molar enzyme to-substrate ratio 1:510) and short incubation periods (5 min-60 min). Protein C in a PPSB coagulation factor concentrate is equally degraded and similar split products are detected by blotting techniques. The protein C activity (measured by a chromogenic substrate) is faster reduced by elastase than the protein C concentration (measured by an ELISA). Incubation of normal plasma with high elastase concentrations (5.7 nmol/ml plasma) results in reduction of the protein C band while no split products are detectable. The pathophysiologic significance of the effects of elastase on protein C remains to be elucidated. PMID- 1793516 TI - Microbial metabolism of quinoline and related compounds. XI. Degradation of quinoline-4-carboxylic acid by Microbacterium sp. H2, Agrobacterium sp. 1B and Pimelobacter simplex 4B and 5B. AB - From soil enrichment cultures four strains, using quinoline-4-carboxylic acid as sole source of energy and carbon, have been isolated. According to their physiological properties these bacteria have been identified as Microbacterium sp. designated H2, as Agrobacterium sp. designated 1b and Pimelobacter simplex designated 4B and 5B. Metabolites of the degradation pathway of quinoline-4 carboxylic acid have been isolated and identified. With Pimelobacter simplex 4B and 5B 2-oxo-1,2-dihydroquinoline-4-carboxylic acid and 8-hydroxycoumarin-4 carboxylic acid were isolated. The Agrobacterium strain accumulated 2-oxo-1,2 dihydroquinoline-4-carboxylic acid and 2-oxo-1,2,3,4-tetrahydroquinoline-4 carboxylic acid in the media during growth; with Microbacterium sp. H2 we only found 8-hydroxycoumarin-4-carboxylic acid. With mutants of Microbacterium sp. H2 which were induced with N-methyl-N'-nitro-N-nitrosoguanidine we found 2-oxo-1,2 dihydroquinoline-4-carboxylic acid, 8-hydroxy-coumarin-4-carboxylic acid and 2,3 dihydroxyphenyl-succinic acid. PMID- 1793517 TI - Nucleotide-activated oligosaccharides are intermediates of the cell wall polysaccharide of Methanosarcina barkeri. AB - The cell wall of Methanosarcina barkeri consists of a heteropolysaccharide (methanochondroitin), which resembles the eukaryotic chondroitin. From cell extracts of Methanosarcina barkeri four uridine diphosphate and one undecaprenyl pyrophosphate-activated intermediate(s) of the methanochondroitin were isolated. In contrast to the known biosynthetic pathways of polysaccharides from other prokaryotes and eukaryotes, nucleotide activated oligosaccharide precursors are involved in the case of the methanochondroitin. Usually, oligosaccharides are synthesized at the lipid stage. PMID- 1793518 TI - Primary structure and oxygen-binding properties of the hemoglobin from the lesser hedgehog tenrec (Echinops telfairi, Zalambdodonta). Evidence for phylogenetic isolation. AB - The primary structures of the alpha- and beta-hemoglobin chains of the lesser hedgehog tenrec (Echinops telfairi, Zalambdodonta) are presented. Chain separation was performed by carboxymethyl-cellulose chromatography. The peptides, obtained by tryptic digestion of the oxidized chains, were prefractionated by gel chromatography and isolated by reversed-phase HPLC. For sequence analysis gas and liquid phase sequencers were employed. The tenrec hemoglobin consists of one alpha- and two beta-chains the latter occurring in a 1:1 ratio and differing in beta 16 Gly/Cys and beta 118 Phe/Leu. Two external cysteine residues at beta 16 and beta 52 cause reversible polymerization to octamers and most likely irreversible formation of higher polymers. A comparison of the whole chains and certain positions of tenrec hemoglobin with those of Insectivora sensu strictu, Scandentia and Proto- and Metatheria corroborates a long and independent evolution of tenrec and its phylogenetic isolation from the Insectivora s.str. (hedgehog, musk shrew and mole). Replacements at positions involved in heme and subunit interface contacts are discussed. Compared to human hemoglobin the tenrec pigment shows a low intrinsic oxygen affinity as well as lower chloride and temperature sensitivities, a reduced Bohr effect and a strong response to 2,3 DPG. The possible adaptive significance of these properties is discussed in relation to the large diurnal body temperature variations seen in tenrecs. PMID- 1793519 TI - Purification and some properties of the tungsten-containing carboxylic acid reductase from Clostridium formicoaceticum. AB - Judged by properties observed during the purification and based on the sequence of the first 25 amino acids, the enzyme from Clostridium formicoaceticum catalysing the reversible reduction of non-activated carboxylic acids to aldehydes at the expense of reduced viologens, is astonishingly different from that found by us in C. thermoaceticum. According to native and SDS gel electrophoresis the reductase is nearly homogeneous after only 26-fold purification. The specificity for various substrates and artificial electron carriers is also broad, but V of the purified aldehyde dehydrogenase activity (54 U/mg enzyme for butanal) is about 1 order of magnitude lower than that of the enzyme from C. thermoaceticum. The reductase is a dimer of two identical subunits with an Mr of 67,000 each. Increased enzyme concentrations seem to lead to higher oligomers. Per dimer 11 +/- 1 iron, 16 +/- 1 acid labile sulphur, 1.4 tungsten and after permanganate oxidation 1.6 mol pterin-6-carboxylic acid have been found. PMID- 1793520 TI - Treatment of mild congestive heart failure. The potential for new drugs to reduce the risks. PMID- 1793521 TI - Drug-induced orthostatic hypotension. AB - Drug-induced orthostatic hypotension is an important clinical problem. When symptomatic, it is poorly tolerated by the patient, and can be a cause for discontinuing treatment. It may have more serious consequences if it leads to syncope, falls and injury, or to sustained loss of perfusion of vital organs resulting in heart attack or stroke. Orthostatic hypotension is easily detected by procedures available to all physicians, who should maintain a high index of suspicion when prescribing drugs commonly known to cause this condition, especially in the elderly. Since the medical conditions calling for the use of these drugs are extremely prevalent, the screening and monitoring of orthostatic hypotension should be instituted as a routine precaution in appropriate patients. Hypertension affects two-thirds of elderly patients. Orthostatic hypotension is an infrequent adverse effect of most of the drugs in current use in the treatment of hypertension; it is, however, more common with alpha 1-blockers (first dose), adrenergic blockers and centrally acting drugs. Sudden loss of blood volume, or excess diuresis, may precipitate orthostatic hypotension in any hypertensive patient. Drugs used for the treatment of psychiatric illnesses are all associated with a significant incidence of orthostatic hypotension: phenothiazines, tricyclic antidepressants and monoamine oxidase inhibitors. Cardiovascular drugs associated with hypotension include dopamine agonists, antianginals and antiarrhythmics. PMID- 1793524 TI - Adverse drug reactions leading to hospital admission. AB - This article describes the implementation of a simple method of drug surveillance set up at a hospital emergency ward. From a total of 48,678 patients admitted, the medical records of those presenting with one or more of a pre-established list of admission diagnoses (n = 7728; 15.8%) were checked. Of these 554 (1.1%) were diagnosed as experiencing an adverse drug reaction. When the medical record suggested an adverse drug reaction, drugs taken before admission were ascertained by interviewing the patients with a structured questionnaire. After excluding upper gastrointestinal bleeding (226 cases) and certain bone marrow blood dyscrasias (42 cases), 286 patients with drug-induced events leading to hospital admission were identified in 2 years. Fatal adverse drug reactions, previously undescribed reactions, and some specific examples, such as digoxin-amiodarone interaction, drug-induced pancreatitis, nicardipine-induced AV block, severe skin reactions, and NSAID-induced bronchospasm, are described. Basically, this method consists of assembling series of cases systematically, and is therefore devoid of selective bias. In addition, it allows a more in-depth clinical and anamnesic study of specific diseases, as compared with voluntary reporting. PMID- 1793525 TI - Toxic interaction between fluvoxamine and sustained release theophylline in an 11 year-old boy. AB - An 11-year-old boy with asthma had been receiving a controlled release theophylline preparation. He was prescribed fluvoxamine for a depressive disorder and within a week complained of severe headaches, tiredness and vomiting. His serum theophylline concentration had increased from 14.2 mg/L (shortly before fluvoxamine was started) to 27.4 mg/L. Fluvoxamine was withdrawn and theophylline concentrations decreased. Clomipramine was substituted for fluvoxamine with no further problems, and a later theophylline concentration was 13.7 mg/L. Competitive inhibition of hepatic microsomal enzymes by fluvoxamine may have been responsible for the elevated theophylline concentrations and toxicity observed in this case. PMID- 1793526 TI - Structural features of allergens large and small with emphasis on recombinant allergens. AB - The application of recombinant DNA techniques to the study of allergen structure has increased our knowledge of primary structures and B- and T-cell determinants. Thus, knowledge of the molecular bases of isoallergens and allergenic cross reactivities is about to be rapidly expanded. Findings from the early applications of molecular cloning strategies to the study of some polypeptide allergens, together with a summary of our current knowledge of drug allergenic determinants, are presented here. PMID- 1793523 TI - Drug-related lupus. Incidence, mechanisms and clinical implications. AB - Adverse side effects to drugs and chemicals in which immune mechanisms may be responsible have been described in drug-related lupus (DRL). The spectrum of drugs that may elicit DRL includes such classes as the hydrazines, arylamines, and chemicals that can be metabolised to amines. The 2 major pathways of metabolism--acetylation and N-hydroxylation--are described in detail. The events leading to autoantibody production are not well understood; however, specific consideration of the genetic makeup of patients who are candidates for treatment with these drugs may help identify those at risk of developing DRL. PMID- 1793522 TI - Poisoning due to calcium antagonists. Experience with verapamil, diltiazem and nifedipine. AB - The calcium antagonists are a heterogeneous class of drugs which block the inward movement of calcium into cells through 'slow channels' from extracellular sites. By inhibiting phase 0 depolarisation in cardiac pacemaker cells and phase 2 plateau in myocardium, and by depressing calcium ion flux in smooth muscle cells of blood vessels, these agents may exert profound effects on the cardiovascular system, particularly in susceptible individuals or in overdose. Sinus node depression, impaired atrioventricular (AV) conduction, depressed myocardial contractility, and peripheral vasodilatation may result. Pharmacokinetic features of calcium antagonists include rapid and complete absorption from the gastrointestinal tract, with extensive first-pass hepatic metabolism yielding generally low bioavailability. The volume of distribution is generally large and protein binding is high. Elimination is almost entirely by the liver. Impaired renal function does not affect pharmacokinetics. Verapamil is the most potent inhibitor of cardiac conduction and contractility, with diltiazem also showing such effects. Nifedipine is the most potent vasodilator, but only occasionally impairs the sinus node or AV conduction. Significant pharmacodynamic effects are common during combination therapy with calcium antagonists, especially verapamil and beta-blockers. Verapamil may significantly elevate serum digoxin concentrations and may exert additive negative effects on chronotropism and dromotropism when this combination is used. Overdoses of calcium entry blockers are becoming more frequent and reflect an extension of the known pharmacodynamic profile of these agents. Typical features include confusion or lethargy, hypotension, sinus node depression and cardiac conduction defects. Onset of symptoms may be delayed if a sustained release preparation is ingested. Management of calcium antagonist overdose includes gut decontamination with lavage and activated charcoal. All symptomatic patients and patients with a history of ingesting a sustained release preparation should be admitted for ECG monitoring. If bradycardia and/or conduction defects contribute to hypotension, atropine or isoprenaline (isoproterenol) may accelerate the ventricular rate. Transvenous pacing may be required. Depressed myocardial contractility usually responds well to calcium chloride or calcium gluconate administration, but further inotropic support may be required. Peripheral vasodilation should be managed with intravenous fluids and a pressor agent such as dopamine or norepinephrine (noradrenaline). PMID- 1793527 TI - Regulation of IgE synthesis by cytokines. AB - Considerable progress has been made in our understanding of the mechanisms underlying regulation of human IgE synthesis. Interleukin-4 induces IgE production specifically, but costimulatory signals provided by T cells are required. Other cytokines modulate interleukin-4-induced IgE synthesis. The roles of T cells and cytokines in regulating IgE switching are discussed. PMID- 1793528 TI - Cytokine production by mast cells and basophils. AB - Mast cells and/or basophils have been implicated in the expression of a wide variety of biological responses, including immediate hypersensitivity reactions, host responses to parasites and neoplasms, angiogenesis, tissue remodeling, and immunologically non-specific inflammatory and fibrotic conditions. Recent findings suggest that an important mechanism by which mast cells influence such biological responses is through the production of a broad panel of multifunctional cytokines. In contrast, the extent to which basophils can produce cytokines is uncertain. PMID- 1793529 TI - Atopic allergy: asthma and atopic dermatitis. AB - During the past 2 years much progress has been made in our understanding of allergic diseases: there is now increasing evidence for a direct causal relationship between exposure to allergen and the chronic diseases, asthma and atopic dermatitis; furthermore, it seems very likely that exposure to indoor allergens is the most common cause of the inflammation of the lungs that is characteristic of asthma. PMID- 1793530 TI - Food allergy. AB - Food allergy is now known to encompass a number of distinct clinical entities that follow the ingestion of specific food or food additives. Research continues to shed light on immediate reactions to foods and food protein-induced enterocolitis of newborns and infants. Adverse reactions to food additives remain an area of health concern. Studies of food allergies have entered an era in which improved clinical design is the hallmark of the research and conclusions may now be drawn reliably. PMID- 1793531 TI - Regulation of autoimmunity. AB - Despite the prevalence of self-reactive T cells, the healthy organism is not in a state of all-out war. Potent regulatory mechanisms exist at every level to permit the successful integration of the various aspects of the immune system, allowing only minor skirmishes, which ordinarily can be neutralized. PMID- 1793532 TI - Neurological diseases. AB - Recent advances have improved our understanding of the T-cell recognition process in neuroimmunological autoimmune disease as well as the involvement of major histocompatibility complex molecules and cell adhesion molecules in the autoimmune attack. PMID- 1793533 TI - Insulin-dependent diabetes mellitus. AB - Type I diabetes occurs as a result of T-cell-mediated beta-cell destruction. Several candidate antigens have been described recently, including glutamic acid decarboxylase, heat shock protein 65 and peripherin. Restricted T-cell receptor V beta gene usage in non-obese diabetic mice has been suggested but not yet proven. In addition to major histocompatibility genes, several non-H-2 predisposing genes have been mapped on chromosomes 1, 3 and 11. PMID- 1793534 TI - The nephritogenic immune response. AB - Recent work has improved our understanding of a number of aspects of the nephritogenic immune response. Progress has been made in the understanding of the development of idiotypic networks, and in understanding the structural nature of the targets of self-reactive T cells and the paracrine mediators that are released as part of the local inflammatory response. PMID- 1793535 TI - Rheumatoid arthritis. AB - The immunopathogenesis of rheumatoid arthritis is discussed in two ways. First, we consider the major question of whether T cells are likely to drive the disease. Second--and assuming T cells to be important--we discuss available data on the components of the trimolecular complex (major histocompatibility complex class II-antigen-T-cell receptor), which are possibly involved in the disease. Our two main points are that the most important questions concerning the pathogenesis of rheumatoid arthritis require answers from immunointervention in patients, and that animal experiments can be increasingly used in interpreting current experiments in humans. PMID- 1793536 TI - Systemic lupus erythematosus. AB - Systemic lupus erythematosus is a prototypic autoimmune disease characterized by antinuclear antibody production. In recent investigations, the contributions of various polymorphic immune response gene systems to disease pathogenesis have been analyzed. Unique cellular and molecular studies have also established the role of 'autoantigen drive' in autoantibody induction and its relationship to polyclonal B-cell activation. PMID- 1793537 TI - Heat shock proteins in immunopathology. AB - In recent years, studies have suggested that autoimmunity and/or immunopathology may sometimes result from the immune response to heat shock proteins of autologous cells and microorganisms. Focusing on the T-cell mediated responses, we review the latest literature on this issue with regard to three hypothetical concepts of immunopathology in which heat shock proteins might play a role. PMID- 1793538 TI - Autoimmunity associated with infection: leprosy, acute rheumatic fever and Lyme disease. AB - This review examines the links between autoimmunity and three common infectious diseases. These disorders are associated with a variety of clinical and serological autoimmune phenomena. In addition they might conceivably trigger autoimmune diseases themselves. Mechanisms that may be responsible for these links, including molecular mimicry, are explored. PMID- 1793539 TI - Immunotherapy in autoimmune diseases. AB - Over the past decade, much progress has been made in our understanding of immunological tolerance of self-antigens and the genetic and molecular basis of T cell recognition and activation that involves a ternary interaction of foreign or self-antigens with major histocompatibility complex molecules and T-cell antigen receptor gene products. Using this trimolecular complex as a target for immune intervention, animal models of spontaneously occurring and experimentally induced autoimmune diseases have provided opportunities for new immunomodulatory therapeutic approaches. Some of these have encouraging potential and are currently being applied in the immunotherapy of human autoimmune diseases. PMID- 1793540 TI - Atopic allergy and other hypersensitivities. PMID- 1793541 TI - Autoimmunity. PMID- 1793542 TI - Complex between the subtilisin from a mesophilic bacterium and the leech inhibitor eglin-C. AB - The alkaline proteinase from the mesophilic bacterium Bacillus mesentericus has been crystallized in a 1:1 complex with the inhibitor eglin-C from the medical leech. The crystals have cell dimensions of a = 43.0, b = 71.9, c = 48.3 A and beta = 110.0 degrees and are in the space group P2(1). Three-dimensional data to 2.0 A have been recorded on film from a single crystal. The orientation and position of the complex in the unit cell have been established using the refined coordinates of subtilisin Carlsberg and of eglin-C as independent models. The structure of the complex has been refined by restrained least-squares minimization. The crystallographic R factor (= sigma[magnitude of Fo - magnitude of Fc[/sigma magnitude of Fo) is 15.1% including two Ca2+ ions and 312 water molecules. The structure is discussed in terms of its physicochemical properties in solution and its relation to other Bacillus subtilisins. PMID- 1793543 TI - Studies on 1,3-diaryltriazene analogues of berenil: molecules with potential GC base-pair selectivity. AB - 1,3-Bis(4-acetylphenyl)triazene (II): C16H15N3O2, Mr = 281.32, monoclinic, P2(1)/c, a = 14.002 (5), b = 12.359 (3), c = 8.457 (3) A, beta = 96.35 (2) degrees, V = 1454.5 A3, Z = 4, Dx = 1.287 Mg m-3, Cu K alpha, lambda = 1.54178 A, mu = 0.672 mm-1, F(000) = 592, T = 294 K, final R = 0.089 for 1890 unique observed reflections. 1,3-Bis(4-[2-dimethylamino)ethoxycarbonyl]phenyl)triazene monohydrate (III): C22H29N5O4.H2O, Mr = 445.52, triclinic, P1, a = 9.500 (2), b = 11.753 (3), c = 13.328 (2) A, alpha = 62.84 (1), beta = 66.60 (2), gamma = 77.58 (2) degrees, V = 1214.1 A3, Z = 2, Dx = 1.172 Mg m-3, Cu K alpha, lambda = 1.54178 A, mu = 0.640 mm-1, F(000) = 476, T = 294 K, final R = 0.063 for 1100 unique observed reflections. Both crystal structures have extended conformations for the 1,3-diaryltriazene groups, with a cisoid arrangement of phenyl rings. The terminal N--N bonds of each triazene are non-equivalent, and a hydrogen atom has been located in the N==N--NH moiety. Extensive molecular-orbital (MNDO) calculations on the model core 1,3-diphenyltriazene system have confirmed that this geometry is energetically favoured, and have revealed the shape of the energy surface for rotation about the N--NH bond in the triazene linkage. PMID- 1793544 TI - Structure of 1,8-naphthalenedicarboxylic acid (naphthalic acid), C12H8O4: ring geometry and hydrogen-bonding effects. AB - C12H8O4, Mr = 216.19, orthorhombic, Pbca, a = 15.308 (2), b = 17.926 (2), c = 7.093 (2) A, V = 1946.4 (5) A3, Z = 8, Dx = 1.48 g cm-3, lambda (Mo K alpha) = 0.71073 A, mu = 1.05 cm-1, F(000) = 896, T = 296 K, R = 0.043 for 912 unique reflections having I greater than 3 sigma (I). In this structure, 1,8 naphthalenedicarboxylic acid departs significantly from planarity. While the average deviation of carbons from the best least-squares plane for the naphthalene core is 0.055 (4) A, the carboxyl carbons adopt positions +0.403 (4) and -0.350 (4) A from that plane. The carboxyl groups are twisted in the same direction with respect to that plane and make an average dihedral angle of 42.6 (3) degrees with it. The nearly equal lengths of the C--O distances within the carboxyl groups [mean value 1.267 (5) A] indicate almost complete disorder of the H atoms of these groups. Hydrogen bonding occurs in cyclic dimer fashion between two molecules related by a center of inversion. The carboxyl hydrogens appear to be subject to a symmetric double-minimum potential and to be disordered via tunneling; there is no evidence that the carboxyl oxygens are disordered. The mean carboxyl H--O acceptor distance is 1.90 (7) A. PMID- 1793545 TI - Structural study of aldose reductase inhibitors. Ten oxazolecarbamate derivatives. AB - (1) Benzyl 4-isopropyl-5-phenyl-2-oxazolecarbamate, C20H20N2O3, Mr = 336.39, P1, a = 19.469 (7), b = 11.270 (3), c = 8.667 (3) A, alpha = 95.48 (3), beta = 99.61 (3), gamma = 104.96 (3) degrees, V = 1792 (1) A3, Z = 4, Dm = 1.266 (2), Dx = 1.247 g cm-3, lambda (Cu K alpha) = 1.5418 A, mu = 6.49 cm-1, F(000) = 712, T = 288 K, R = 0.048 for 5244 reflections. (2) Benzyl 4-ethyl-5-phenyl-2 oxazolecarbamate, C19H18N2O3, Mr = 322.37, P2(1)/n, a = 9.131 (7), b = 18.81 (1), c = 9.680 (8) A, beta = 101.07 (3) degrees, V = 1631 (2) A3, Z = 4, Dm = 1.310 (2), Dx = 1.313 g cm-3, lambda (Cu K alpha) = 1.5418 A, mu = 6.92 cm-1, F(000) = 680, T = 288 K, R = 0.063 for 2535 reflections. (3) Benzyl 4-methyl-5-phenyl-2 oxazolecarbamate, C18H16N2O3, Mr = 308.34, P2(1)/n, a = 9.210 (7), b = 8.785 (6), c = 19.800 (9) A, beta = 99.60 (3) degrees, V = 1580 (2) A3, Z = 4, Dm = 1.299 (3), Dx = 1.300 g cm-3, lambda (Cu K alpha) = 1.5418 A, mu = 6.93 cm-1, F(000) = 648, T = 288 K, R = 0.057 for 2190 reflections.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793546 TI - Crystals of isoenzyme 3-3 of rat liver glutathione S-transferase with and without inhibitor. AB - The isoenzyme 3-3 of rat liver glutathione S-transferase (GST 3-3) isolated from a baculovirus expression system has been crystallized with and without inhibitor. The crystals grown in the absence of an inhibitor belong to space group P2(1) with cell dimensions a = 119.7, b = 96.2, c = 136.7 A and beta = 103.3 degrees, and diffract to 3 A resolution. The crystals grown in the presence of an inhibitor belong to space group C2 with cell dimensions a = 88.3, b = 69.7, c = 81.4 A and beta = 105.3 degrees, and diffract to at least 2.5 A resolution. The inhibitor used is either methylmercury chloride or ethylmercury chloride; both are weak inhibitors. PMID- 1793547 TI - Crystallographic refinement of bovine pro-phospholipase A2 at 1.6 A resolution. AB - Bovine pro-phospholipase A2 (Mr = 14,520), trigonal, P3(1)21, a = b = 46.5, c = 102.0 A, one molecule per asymmetric unit, lambda (Cu K alpha) = 1.54 A. The model incorporating 895 protein atoms, two molecules of 2-methyl-2,4-pentanediol, and 60 solvent water molecules, was refined by restrained least squares to a residual R = 0.194 for 14,667 reflections from 5 to 1.6 A resolution. PMID- 1793548 TI - The structure of 6-phosphogluconate dehydrogenase refined at 2.5 A resolution. AB - The three-dimensional structure of ovine 6-phosphogluconate dehydrogenase, refined at 2.5 A resolution with a residual for all data of 18.5%, is reported. This model, based on improved diffraction data and a corrected sequence, supersedes that reported earlier. Each subunit of the dimer has three domains: a beta-alpha-beta domain binds NADP; an all alpha domain provides much of the dimer interface; the C-terminal tail burrows into the second subunit. PMID- 1793549 TI - Clinicians' requirements for chemical sensors for in vivo monitoring: a multinational survey. AB - We report on a survey of senior clinicians in 11 countries which asked about what they see as the main areas where in vivo chemical sensors will be most useful in medicine, and about what their operating characteristics should be. This information may help those designing such sensors to match available and new technologies to clinical needs. PMID- 1793550 TI - The design and development of new chemical sensors for in vivo monitoring. AB - The latest workshop of the European Community (EC) Concerted Action on 'Chemical sensors for in vivo monitoring' was held in Nauplion, Greece, in April this year. This fifth workshop focused on 'The design and development of new sensors for in vivo monitoring', and was organized into five sessions: design and development of new sensors; operational considerations; performance of analytical systems; novel sensors/tissue heterogeneity; and infra-red spectroscopy. PMID- 1793551 TI - Application of cell culture toxicity tests to the development of implantable biosensors. AB - Cell culture toxicity testing methods were modified and applied to the development of implantable glucose microsensors, and positive and negative control materials suitable for the microsensor assessment were established. The location, source and degree of the toxic effect in a multi-component biosensor was spatially visualized with cell monolayers. A freshly prepared sensor showed moderate toxicity, mainly as a result of the presence of glutaraldehyde and the residual solvents in the polymer layers. However, it was possible to reduce the toxicity by removing the leachable toxic substances through extraction in phosphate buffer, and a non-toxic sensor was readily obtained. PMID- 1793552 TI - Glucose oxidase immobilized electrode for potentiometric estimation of glucose. AB - Glucose oxidase has been immobilized onto a thin platinum strip, by co crosslinking with bovine serum albumin and glutaraldehyde. The retention of redox characteristics of glucose oxidase has been verified by cyclic voltammetry. The activity of the immobilized enzyme reduces to a quarter of its value when the enzyme is in solution but improves when coimmobilized with 1 M urea. The potentiometric response builds up and remains stable after 100 s. It is sensitive to the thickness of the immobilizing matrix. pH and temperature. An improvement in the performance of the electrode has been achieved by co-immobilizing 2 M urea and metal ions such as Mg2+ and Mn2+. The presence of Cu has been proved to be detrimental. The electrode has been calibrated in the 0.1-5.0 mM glucose concentration range. It gives a stable response for more than 50 independent assays and can be stored for 60 days without significant loss of function. PMID- 1793553 TI - Development of acetylcholine sensor using carbon fiber (amperometric determination). AB - An enzyme sensor is developed using carbon fiber to measure acetylcholine concentration. The mechanism is based on the detection of H2O2 which is a product of the sequential enzyme reactions of acetylcholinesterase and choline oxidase. The fabrication of the electrode is described. The sensor is polarized at 1.2 V. Enzymes are co-immobilized in polyvinyl alcohol containing styryl pyrydinium (photo-crosslinkable polymer). A fast response time of 0.8 min is obtained. A linear correlation is observed between 0.2 and 1.0 mM. Other optimal operational conditions with respect to pH, temperature and stability are discussed. The use of carbon fiber containing co-immobilized enzymes could offer several novel advantages especially in neuroscience research. In conclusion, the aims of the present work are centered on carbon fiber electrode fabrication, immobilization and electrochemical measurements. PMID- 1793554 TI - Tris(2,2'-bipyridine)ruthenium (II) as a peroxide-producing replacement for enzymes as chemical labels. AB - The concentration of the ruthenium-based label is determined from the rate of hydrogen peroxide production elicited by photolysis. Electron transfer quenching of the photoexcited label by methyl viologen (1,1'-dimethyl-4,4'bipyridinium dication, MV2+) and/or oxygen in the presence of EDTA generates hydrogen peroxide. Both flow injection and direct photolysis techniques were tested, with the latter showing better results. Direct photolysis is more sensitive, faster, requires only a 20 microliters sample volume, uses only 30 mW laser power and shows a smaller background. The presence of 5% normal human serum in the sample did not interfere with the measurements. Linear calibration curves were obtained in the nanomolar concentration range for goat antimouse antibody labeled with the ruthenium complex. The determination of membrane-surface-bound labeled IgG is accomplished by direct photolysis of a membrane that covers a platinum microelectrode. PMID- 1793555 TI - Conjugation of N-acylated amino sugars to protein by reductive alkylation using sodium cyanoborohydride: application to an azo derivative of alpha-amanitin. AB - Reductive alkylation mediated by cyanoborohydride is an attractive approach to the conjugation of small molecules, such as drugs, to proteins. This reaction is specific for protein amino groups and can be conducted under mild conditions with little risk of protein polymerization. However, the lability of the aldehyde function that is needed in such reactions presents a difficulty. We have investigated the use of derivatives of D-galactosamine and D-glucosamine in reductive alkylation, since these sugars contain aldehyde groups that are inherently protected and that may be readily linked to other molecules through their amino groups. The amino groups of these sugars were acylated with N-4-nitro benzoylglycylglycine. Studies of the reductive coupling of the resultant adducts to bovine serum albumin revealed that conjugation to albumin is strongly dependent on cyanoborohydride, is much faster in the presence of borate, and shows a marked increase in rate between pH 7.0 and 9.0. In the presence of borate, the glucosamine derivative coupled much more rapidly than did the galactosamine derivative. The aryl nitro group of the glucosamine adduct was selectively reduced to an amine, diazotized, and reacted with alpha-amanitin to form an azo compound. This azo derivative was reductively coupled to form conjugates that inhibit calf thymus RNA polymerase II. PMID- 1793556 TI - Characterization of plasminogen binding to human capillary and arterial endothelial cells. AB - Phenotypic diversity of endothelial cells that line the various vascular spaces has been well established. However, it is not known if biochemical differences also exist, particularly in the numbers of receptors for plasma proteins. Equilibrium binding techniques were used to assess potential differences in the binding of 125I-labelled plasminogen to cultured human umbilical arterial endothelial cells and capillary endothelium, as compared with umbilical venous cells. The kinetic behaviour of plasminogen binding to all three types of cells was similar, with optimal binding occurring between 20 and 30 min of incubation. Binding of plasminogen to arterial, capillary, and venous cells was concentration dependent and reversible upon addition to excess unlabelled plasminogen. Scatchard analyses showed that artery, capillary, and venous endothelial cells all possess low affinity sites for plasminogen with Kd values of 0.30 +/- 0.07, 0.40 +/- 0.06, and 0.40 +/- 0.08 microM, respectively. Vein cells also possess an additional higher affinity binding site with a Kd of 0.07 +/- 0.01 microM, exhibiting a 6-fold greater affinity for plasminogen than the lower affinity sites on capillary and arterial endothelial cells. Assuming a stoichiometry of 1:1 for binding, the data indicate that arterial and capillary endothelial cells contain approximately 4.2 (+/- 0.9) x 10(6) and 4.1 (+/- 0.6) x 10(6) plasminogen receptors per cell. Venous cells contain both low and high density binding sites with 6.2 (+/- 0.8) x 10(6) and 12.4 (+/- 2.4) x 10(6) sites per endothelial cell. The presence of a higher affinity site on vein cells, but not on artery or capillary cells, may signal functional differences relating to fibrinolytic activity on the surface of these cells.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793557 TI - Expression of the preproenkephalin A gene in the heart of cardiomyopathic hamsters. AB - The expression of the preproenkephalin A gene (Enk gene), which codes for the precursor of enkephalins, was investigated in the heart of hamsters with a hereditary cardiomyopathy at four different stages of the disease: the prenecrotic stage (30 days), the necrotic stage (60 days), the hypertrophic stage (120 days), and the final stage (200 days). In control atria and ventricles, the relative abundance of the Enk mRNA, as assessed by Northern blot analysis, did not change upon ageing. In the ventricles of cardiomyopathic hamsters, however, it increased about two- to three-fold at the necrotic stage, but was unaltered at the other time points studied; whereas in the atria, it progressively decreased to reach about half that of control hamsters at the final stage. Enkephalin levels, as measured by radioimmunoassay, decreased at 60 days in both the atria and ventricles of control hamsters, and also in the atria of cardiomyopathic hamsters, and remained stable thereafter, corresponding to one-third to one-half of those at 30 days. However, in the ventricles of cardiomyopathic hamsters, the peptide level decreased only slightly, the consequence being that at 60, 120, and 200 days, it was about two- to three-fold that of control hamsters. The lack of correlation between peptide levels and the relative abundance of the Enk mRNA suggests that translational and (or) post-translational mechanisms are important in the control of the expression of the Enk gene in the heart of hamsters. PMID- 1793558 TI - Essential fatty acids and serine as plasmalogen precursors in relation to competing metabolic pathways. AB - Interest in altered ether-lipid metabolism, associated with peroxisomal disorders including adrenoleukodystrophy and Zellweger's syndrome, has highlighted present limitations in our understanding of the biosynthesis and turnover of plasmalogens. These 1-alkenyl ethanolamine phosphoglycerides are major phospholipids in brain, vascular tissue, neutrophils, and most tumors, and they constitute 15-20% of total phospholipids in cultured glioma cell. In glioma, turnover of polyunsaturated acyl chains in the sn-2 position of plasmalogens was examined in relation to selectivity for the (n - 3) and (n - 6) families. Remodeling of acyl chains was more dependent on chain length than on selectivity between families, consistent with plasmalogens enriched in polyunsaturated, but not specifically (n - 3), fatty acids. Extracellular serine was a precursor of serine and ethanolamine phosphoglycerides and was associated with plasmalogens due to decarboxylation and headgroup exchange. Incorporation of extracellular serine ceased within 8 h, even though more than 50% of the label remain in the medium. Analyses of medium and cellular water-soluble components indicated rapid conversion of serine to glycine and other metabolites not used in phospholipid biosynthesis. Thus, nutrient molecules as precursors of plasmalogens are involved in complex competitive interactions. As functions of plasmalogens are clarified, regulation of plasmalogen turnover becomes an increasingly important issue and elucidation of these processes is essential. PMID- 1793559 TI - Dietary lipid modification of renal disorders and ether phospholipid metabolism. AB - The formation of arachidonic acid derived eicosanoids, including thromboxane A2 and leukotriene B4, as well as platelet-activating factor (1-O-alkyl-2-acetyl glycerophosphocholine), has been implicated in various renal pathophysiologies. Alteration of the fatty acid composition of membrane phospholipids in platelets, the glomerulus, and inflammatory cells, and of 1-O-alkyl-2-acyl glycerophosphocholine (platelet-activating factor precursor) can be attained by dietary lipid modifications (e.g., consumption of fish oil containing n - 3 polyunsaturated fatty acids). These changes have been associated with an attenuation in renal disease progression and modifications in the synthesis and actions-interactions of eicosanoids, cytokines, and platelet-activating factors. PMID- 1793560 TI - Intramitochondrial fatty acid metabolism: riboflavin deficiency and energy production. AB - Inborn errors of fatty acid beta-oxidation have contributed significantly to our understanding of intracellular fatty acid metabolism. The first intramitochondrial step in beta-oxidation of fatty acyl-CoA of different chain lengths is catalyzed by the three chain length specific acyl-CoA dehydrogenases. Inherited deficiency of these enzymes has been reported. Some are riboflavin responsive. The first step of fatty acid oxidation is reviewed with specific emphasis on beta-oxidation in newborn infants, rendered riboflavin deficient by phototherapy. Given that medium chain fatty acids are not stored as triacylglycerols and undergo rapid beta-oxidation, they have been proposed as superior substrates compared with long chain triglycerides in times of metabolic stress. This review also examines medium chain triglycerides as an alternate energy source. When medium chain triglycerides were fed as 50% of total energy, glucose sparing was present with little loss of energy as dicarboxylic acids. PMID- 1793561 TI - Vinca revisited--another happenstance in the discovery of vinblastine. PMID- 1793562 TI - Kinetics of a rapid, luminol dependent chemiluminescence signal induced in HL-60 cells by amphotericin B and other stimulants. AB - Addition of the polyene antibiotic amphotericin B or tissue culture medium to nondifferentiated HL-60 cells in the presence of luminol induces a chemiluminescence signal that reaches a peak value within a few seconds and decays exponentially in less than a minute. The kinetics of the signal and its modulation by superoxide dismutase, catalase, and horseradish peroxidase are consistent with a series of solution biochemical processes with a rate determining step corresponding to the disproportionation of a luminol-superoxide complex. The effects of the enzymes demonstrate that superoxide is a precursor to the rate-determining intermediate and that both catalase and peroxide enhance a reaction that competes with the rate-limiting process. PMID- 1793563 TI - Interaction of neutrophil elastase with hydrophobic polyanionic chelators. AB - The polyanionic calcium chelators, ethylenediamine-tetraacetic acid (EDTA), ethylene-bis-(oxyethylenenitrilo)-tetraacetic acid (EGTA), [bis-(O-aminophenoxy) ethane-N,N,N',N'-tetraacetic acid (BAPTA), 1-[2-amino-5-(6-carboxyindol-2-yl) phenoxyl]-2-(2'-amino-5'-methylphenoxy)ethane-N,N,N1, N1-tetraacetic acid (INDO 1), 1-[2-(5-carboxyoxazol-2yl)-6-phenoxyl]-2-(2'-amino-5'- methylphenoxy)ethane N,N,N',N'-tetraacetic acid (FURA-2), and 2-([2-bis-(carboxymethyl)-amino-5 methylphenoxy]-methyl(-6-methyl-8- bis-(bis-(carboxymethyl)-aminoquinoline (QUIN 2), are all inhibitors of amidolytic activity of human neutrophil elastase (HNE). With MeOSuc-Ala-Ala-Pro-Val-pNA as substrate, these chelators all display mixed partial competitive and partial noncompetitive inhibition, but with the smaller substrate, pGlu-Pro-Val-pNA, only the noncompetitive component persists. The most effective inhibitor is FURA-2, with an apparent Ki of 0.5-0.7 mM. QUIN-2 is somewhat less effective, with a Ki of 2 mM, while EDTA is much less effective, with a Ki of 7 mM. In general, the more hydrophobic chelators are the best inhibitors, although INDO-1, which is about the same size as FURA-2, is surprisingly ineffective as an inhibitor. The chelators no longer function as effective inhibitors if their carboxyl groups are blocked by esterification with acetoxymethyl groups or by complexation with calcium ions, indicating that their binding to HNE is mediated in part through electrostatic interactions with a center of positive charge on the protein.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793564 TI - Nonlinear steady-state kinetics of chloramphenicol acetyltransferase. AB - Steady-state kinetic analysis of chloramphenicol acetyltransferase showed that medium effects (higher temperatures or pH, higher ionic strengths, or lower values for dielectric constant) altered the kinetic behaviour of the enzyme with acetyl-CoA as substrate, but did not significantly affect behaviour with chloramphenicol. This was manifest as an increase in the degree of the rate equation to a 2:2 function. This is interpreted in terms of perturbations to the enzyme at or near the acetyl-CoA binding region of the enzyme. PMID- 1793565 TI - Correlation between levels of ferritin and the iron-containing component of ribonucleotide reductase in hydroxyurea-sensitive, -resistant, and -revertant cell lines. AB - The reduction of ribonucleotides to deoxyribonucleotides, a rate-limiting step in DNA synthesis, is catalyzed by ribonucleotide reductase. This enzyme is composed of two components, M1 and M2. Recent work has shown that inhibition of ribonucleotide reductase by the antitumor drug hydroxyurea leads to a destabilized iron centre in protein M2. We have examined the relationship between the levels of ferritin, the iron storage protein, and the iron-containing M2 component of ribonucleotide reductase. These studies were carried out with hydroxyurea-sensitive, -resistant, and -revertant cell lines. Hydroxyurea resistant mouse L cells contained M2 gene amplification and elevated levels of enzyme activity, M2 message, and total cellular M2 protein concentration. Hydroxyurea-revertant cells exhibited a wild-type M2 gene copy number, and approximately wild-type levels of enzyme activity, M2 message, and M2 protein concentration. In addition, we observed that the hydroxyurea-resistant cells possessed elevated levels of L-chain ferritin message and total cellular H-chain ferritin protein when compared to wild-type cells. In contrast, the revertant cell population contained approximately wild-type levels of ferritin mRNA and protein. In keeping with these observations, obtained with mouse L cells, was the finding that hydroxyurea-resistant Chinese hamster ovary cells with increased ribonucleotide reductase activity exhibited elevated expression of both ferritin and M2 genes, which declined in drug-sensitive revertant hamster cell lines with decreased levels of ribonucleotide reductase activity.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793566 TI - Phospholipid modifications influence acyl-CoA:1-acyl-glycero-3-phosphocholine O acyltransferase in rat liver plasma membranes. AB - The influence of the membrane lipid composition and physical state on the activity of acyl-CoA:1-acyl-sn-glycero-3-phosphocholine O-acyltransferase in rat liver plasma membranes has been investigated. The membrane's lipid composition has been modified either by lipid transfer proteins or by partial delipidation with exogenous phospholipases. The results indicate that membrane fluidity is of particular importance for membrane-bound palmitoyl-CoA: and oleoyl-CoA:1-acyl glycero-3-phosphocholine acyltransferase. The incorporation of phospholipids that induce membrane fluidization such as dioleoylphosphatidylcholine, egg yolk phosphatidylcholine, phosphatidylinositol, phosphatidylserine, and phosphatidylethanolamine was accompanied by an elevation of acyltransferase activity. On the contrary, the phospholipids causing augmentation of membrane rigidity induced a decrease of this activity. A suggestion is made concerning the possible role of the membrane physical state for the deacylation-reacylation cycle in rat liver plasma membranes. PMID- 1793567 TI - Molecular species of phospholipid in rats in primary and transplanted fibrosarcomas induced by soybean oil containing tocopherol acetate. AB - When soybean oil containing tocopherol acetate was given to rats once a week subcutaneously for 10-12 months, it caused the development of fibrosarcomas at the injection site in 11 of 15 rats. A tumor produced in this manner proved eminently transplantable into other rats. The molecular species of phospholipid subclasses were determined in primary and transplanted tumors. The molecular species composition of the phospholipid subclasses in both types of tumors were similar. The percentages of diacyl and alkylacyl glycerophosphocholine (GPC) were 90-93 and 6-8% of total phosphatidylcholine, respectively. The percentages of diacyl and alkenylacyl glycerophosphoethanolamine (GPE) were 51 and 45%, respectively, of total phosphatidylethanolamine (PE). Diacyl and alkylacyl GPC species containing arachidonic acid (20:4) composed about 15-16 and 37-40% of each subclass, respectively. Diacyl and alkenylacyl GPE species containing 20:4 composed about 38-40 and 56-60% of each subclass, respectively. Disaturated species of diacyl and alkylacyl GPC composed about 22-24 and 13% of each subclass, respectively, whereas these species of PE composed less than 2%. The fatty acid composition of the other tumor phospholipids was analyzed. PMID- 1793568 TI - Bistability and the ordered bimolecular mechanism. AB - An equation describing the instantaneous velocity of an ordered bimolecular enzymatic reaction that exhibits inhibition by substrate and product was derived. Using kinetic constant values for horse liver alcohol dehydrogenase, the velocity expression was applied to an open-reaction system. The calculated steady-state surfaces displayed regions of bistability, which further substantiates the link between substrate inhibition and multiple steady states. This general computational approach may be applied to any system that can be described by an instantaneous velocity equation. PMID- 1793569 TI - Effect of transfection manipulations on mouse cell cycle progression. AB - BalB/C-3T3 mouse fibroblasts and a temperature-sensitive derivative, ts 2e, were transfected by the calcium phosphatedimethyl sulphoxide procedure to examine the effect of this manipulation on cell cycle progression. Cells were synchronized by growth to confluence in the presence of [2-14C]thymidine to generally label cellular DNA, and then subcultured from the G0 state. Plasmid pSV3-neo or pSV2 neo DNA was added to cells at 24 h post-plating, at peak S phase. At designated intervals prior to, during, and after the transfection procedure, cells were labelled with [methyl-3H]thymidine for 1 h to monitor nascent DNA synthesis and thereby assess cell cycle position. In all experiments performed, irrespective of the time of DNA addition, the transfection manipulations resulted in a reproducible, transient interruption of cell cycle progression, of about 5 h, and manifested as a delay in movement across the subsequent G1-S interface. Thereafter, the cycle resumed normally. The results indicated that the temporal sequence of the cell duplication cycle is altered when cells are exposed to exogenous DNA:Ca3 (PO4)2. PMID- 1793570 TI - Cloning and expression of a functional rat liver D-beta-hydroxybutyrate dehydrogenase-beta-galactosidase fusion protein in Escherichia coli. AB - A rat liver bacteriophage lambda expression library was probed using polyclonal antibodies raised to purified rat liver D-beta-hydroxybutyrate dehydrogenase (BDH). A clone was selected that contained a 1.2-kb insert. The insert placed in an expression plasmid was utilized to transform Escherichia coli. These cells were shown to possess phosphatidylcholine-dependent BDH activity. Cells transformed with only the plasmid had no detectable BDH activity in the presence of phosphatidylcholine. The expressed activity in E. coli could be inhibited in a dose-dependent manner by BDH antiserum. PMID- 1793571 TI - Interaction of troponin I and troponin C: 19F NMR studies of the binding of the inhibitory troponin I peptide to turkey skeletal troponin C. AB - We have used 19F nuclear magnetic resonance spectroscopy to study the interaction of the inhibitory region of troponin (TnI) with apo- and calcium(II)-saturated turkey skeletal troponin C (TnC), using the synthetic TnI analogue N alpha acetyl[19FPhe106]TnI(104-115)amide. Dissociation constants of Kd = (3.7 +/- 3.1) x 10(-5) M for the apo interaction and Kd = (4.8 +/- 1.8) x 10(-5) M for the calcium(II)-saturated interaction were obtained using a 1:1 binding model of peptide to protein. The 19F NMR chemical shifts for the F-phenylalanine of the bound peptide are different from the apo- and calcium-saturated protein, indicating a different environment for the bound peptide. The possibility of 2:1 binding of the peptide to Ca(II)-saturated TnC was tested by calculating the fit of the experimental titration data to a series of theoretical binding curves in which the dissociation constants for the two hypothetical binding sites were varied. We obtained the best fit for 0.056 mM less than or equal to Kd1 less than or equal to 0.071 mM and 0.5 mM less than or equal to Kd2 less than or equal to 2.0 mM. These results allow the possibility of a second peptide binding site on calcium(II)-saturated TnC with an affinity 10- to 20-fold weaker than that of the first site. PMID- 1793572 TI - A simple and rapid method for screening transgenic plants using the PCR. PMID- 1793573 TI - Comparison and modification of rRNA sequencing methods. AB - In this study, modification of two methods of RNA sequencing resulted in more definitive sequencing bands. In one method of sequencing, the bands of lane A and lane G sometimes were not clear. Modifications of this method by changing the concentrations of ddATP and ddGTP resulted in the bands of lane A and lane G becoming more readable. Although a second sequencing method was found to have clearer bands than the first method, and the bases immediately downstream from the primer binding site could be read by using r-32P-labeled primer, the bands on the top of lane A still were not clear. Modifications of this second method by changing the ddATP/dATP ratio resulted in the bands of lane A becoming much clearer. PMID- 1793574 TI - Vector PCR. AB - A strategy employing PCR technology to facilitate the amplification of DNA segments inserted in plasmid vectors is described. Nine oligonucleotide primers specific for vector sequences bracketing cloning sites in seven commonly used vectors were designed. We used these primers for the amplification of 25 different inserts ranging in size from 0.4-4.8 kb. Vector PCR-generated products used as radiolabeled DNA probes in Southern hybridization compared favorably with conventionally prepared probes. This strategy was successfully applied to single colonies of bacteria containing recombinant plasmids for direct amplification of the plasmids insert from the bacterial lysate. Vector PCR enabled the production of microgram quantities of DNA from limited amounts of starting material without the time-consuming steps required for bacterial culture and purification of plasmid DNA. The amplification reaction is independent of the DNA segment to be amplified, rendering the method universally applicable. PMID- 1793575 TI - A rapid and efficient method of lysis of Listeria and other gram-positive bacteria using mutanolysin. AB - A rapid and simple procedure is described for cell lysis for preparation of nucleic acids and intact ribosomal RNA from Gram-positive bacteria. Commercial mutanolysin (purified from Streptomyces globisporus) was used for inducing lysis. Listeria, Lactobacillus and Lactococcus strains were very sensitive to mutanolysin when compared to lysozyme. Susceptibility to mutanolysin was improved by a preliminary treatment with acetone, and sodium dodecyl sulfate reduced the efficiency of lysis when used together with mutanolysin. The procedure was also effective for recovering plasmids from these bacteria. PMID- 1793576 TI - Systematic site-saturation mutagenesis of ROB-1 beta-lactamase: efficiency of T4 polymerase and oligonucleotide synthesis. PMID- 1793577 TI - Method for marking the location of sample application when using a blotting manifold. PMID- 1793578 TI - Large fragment of DNA polymerase I from Bacillus stearothermophilus (Bst polymerase) is stable at ambient temperature. PMID- 1793579 TI - Inexpensive method for air-drying polyacrylamide electrophoresis gels. PMID- 1793580 TI - A simplified method for drying agarose gels. PMID- 1793582 TI - Quick drying procedure for DNA sequencing gels. PMID- 1793581 TI - An inexpensive gel-drying system. PMID- 1793583 TI - Conditions affecting direct gene transfer into rodent muscle in vivo. AB - This report extends our previous findings that mouse muscle cells in situ can take up naked DNA injected intramuscularly in vivo. Various conditions such as needle type, speed of injection, volume of injection fluid, tonicity of injection fluid, type of solute, type of muscle, physiologic condition of the muscle and age of the animals were appraised for their effect on the levels of luciferase activity expressed from the pRSVL plasmid. Specific conditions such as the use of normal saline as an injection fluid increased the efficiency of expression. The implantation of DNA pellets was an effective way to deliver DNA to muscle, especially for smaller muscle groups. Also, newborn and adult rat muscles expressed plasmid DNA delivered intramuscularly. PMID- 1793584 TI - A method for using low-temperature embedding media for electron microscopy of cells grown on microporous supports. AB - Attempts were made to embed Madin-Darby canine kidney (MDCK) cells grown on nitrocellulose microporous supports in Lowicryl, a medium designed for the retention of antigenicity for electron microscopic immunocytochemical studies. It was found that the membrane fragmented during the prescribed embedding procedure leading to loss of the cell sample. This necessitated the formulation of a new combination of fixative and dehydration agents which would allow: (i) preservation of membrane and cellular integrity; (ii) infiltration and embedding in Lowicryl; and (iii) detection of a specific antigen in thin sections. The cellular monolayer and organelle profiles were best preserved with glutaraldehyde fixation at room temperature followed by ethanol dehydration. Since the latter was carried out at temperatures attainable with an ice-salt bath, there was no need for a special ultralow-temperature apparatus. This procedure was applied to a MDCK cell clone that consisted of stable secretors of human growth hormone (hGH), as a result of being transfected with a plasmid containing the hGH gene. Thus, it was demonstrated that hGH could be detected by immunogold labeling of thin sections and localized to specific cellular structures. The procedure developed in this report is applicable to cells grown on two other supports and may be extended further. PMID- 1793585 TI - Electric measurements can be used to monitor the attachment and spreading of cells in tissue culture. AB - A new electrical assay to measure the attachment and spreading of cells in tissue culture has been developed and substantiated by comparison with a more conventional assay. Small gold electrodes are vacuum deposited on the bottom of standard polystyrene culture dishes and coated with various proteins. As mammalian fibroblasts attach and spread on these surfaces, the measured impedance of the electrodes changes. These impedance changes reflect the amount of area blocked by the spreading cells. Since the weak electrical signals used have no noticeable effects on the cells, this is a very convenient method that is both quantitative and sensitive for measuring cell attachment and spreading. PMID- 1793586 TI - Use of the polymerase chain reaction for screening and evaluation of recombinant baculovirus clones. AB - We report the application of the PCR for screening and high-resolution characterization of recombinant baculovirus clones. Starting with less than 10 nanograms of viral DNA, it is possible to 1) demonstrate that the DNA sequence to be expressed has not been deleted or rearranged during the co-transfection or homologous recombination events, 2) test for the presence of wild-type virus in the isolate and 3) generate amplified DNA that can be used for nucleotide sequence analysis or high-resolution restriction analysis. The method is based upon PCR of genomic viral DNA prepared from primary amplified stocks of extracellular virus using a small-scale procedure. The approach has special relevance for definitive characterization of recombinant virus used to express point mutant proteins and for characterization of recombinant virus generated through use of mixed oligonucleotides or random mutagenesis. PMID- 1793587 TI - Dot-blot hybridization: quantitative analysis with direct beta counting. AB - The suitability of using direct beta counting (DBC) for quantitating radioactivity of the probe:target complex in dot-blot hybridization was evaluated using a Packard Matrix 96. A comparison of blots analyzed using autoradiography followed by densitometry scanning (film/densitometry) with those analyzed using direct beta counting revealed similar data trends with the two methods. However, direct beta counting quantitated the amount of radioactivity in the dot blots directly (without film exposure or additional sample preparation), which significantly reduced the time required to obtain results. Blots analyzed first with direct beta counting and then liquid scintillation counting exhibited similar data trends with both methods. Despite a decreased counting efficiency, analysis with direct beta counting has the following advantages compared with liquid scintillation counting: 1) no additional sample preparation is required (no vials or cocktail are used), 2) no sample destruction occurs due to analysis and 3) quantitative results are obtained more rapidly (since the radioactivity for all 96 samples in a dot blot is simultaneously determined in real time). Analysis with direct beta counting was also shown not to interfere with the successful reprobing of stripped dot blots with either unique sequence or total genomic probes. Overall, direct beta counting provides quick, quantitative results for dot blots while saving considerable time and effort. PMID- 1793588 TI - A modified reaction cartridge for direct protein sequencing on polymeric membranes. AB - A newly designed reaction vessel implements a vertical cross-flow type reactor with the Applied Biosystems multi-mode reaction cartridge design. This cartridge is designed for sequencing samples on polyvinylidine difluoride-type membranes. The benefits of this design include a reduced reaction chamber volume that results in lower rates of chemical consumption and less risk of sample loss or contamination during sequencing. Visualization of the membrane in the reaction chamber during sequencing facilitates optimization of drying, washing, extraction and transfer times. The cycle modifications described in this report are designed to optimize post-coupling extraction, cleavage and post-cleavage extraction steps during "flow across" conditions for polymeric membranes. Also, efficient washing and drying of membranes allows for a fast cycle time of 30 minutes when using Pulsed Liquid chemistry. Examples of Blott cartridge utility for sequencing polyvinylidine difluoride-bound proteins in the low picomole range are shown by analyzing samples prepared by a two-dimensional purification scheme using the 230A HPEC and sodium dodecyl sulfate polyacrylamide gel electrophoresis. PMID- 1793589 TI - [The assistance of the laboratory in presentation of clinical cases in orthodontics]. PMID- 1793590 TI - [Application of controlled electric discharge to the construction of overlay dentures]. PMID- 1793591 TI - [Complete single jaw rehabilitation in metal porcelain. 1]. PMID- 1793592 TI - [Implant-supported facial prosthesis]. PMID- 1793593 TI - Analysis of a murine male germ cell-specific transcript that encodes a putative zinc finger protein. AB - A cDNA species, corresponding to a gene with testis-specific expression (TSGA), was isolated from a testis cDNA library. The temporal and spatial expression of TSGA was studied by in situ hybridization as well as RNA filter hybridization. In tissue sections, the TSGA sequence was confined to cells within the seminiferous tubules. For filter hybridization, RNA was isolated from testis of prepubertal rats of different ages as well as from enriched populations of various germ cell types. It was found that TSGA is expressed only in male germ cells and that the steady-state level of TSGA transcripts reaches a maximum during the meiotic and the postmeiotic stages of germ cell development, suggesting a meiotic or postmeiotic function for the encoded protein. TSGA encodes a putative protein having 1,214 amino acids and contains a zinc finger, a structure that previously has been shown to mediate binding to nucleic acids. PMID- 1793594 TI - Activation of a two-cell stage-specific gene following transfer of heterologous nuclei into enucleated mouse embryos. AB - Zygotic gene activation occurs at the two-cell stage in the mouse embryo, resulting in the appearance of many new proteins, including a stage-specific family of related proteins of Mr 70,000. The mechanisms that regulate the stage specific expression of these proteins were examined by transplanting nuclei from oocytes, four-cell-stage blastomeres, inner cell mass cells cultured embryonic stem cells, or differentiated endoderm-like PYS2 cells to enucleated one-cell embryos. Although none of these cell types synthesizes the 70 kDa complex, all were able to direct the synthesis of the 70 kDa complex following transplantation and overnight culture to the two-cell stage. These results suggest that the embryonic cytoplasm can exert a dominant, positive regulatory influence on a variety of heterologous nuclei that results in the transcription of a stage specific gene. In addition, these results indicate that activation of the gene(s) coding for the 70 kDa complex is not dependent on prior programming during oogenesis and oocyte maturation, and that repression of the gene(s) coding for this complex after the two-cell stage does not involve irreversible gene inactivation. PMID- 1793595 TI - junD mRNA expression differs from c-jun and junB mRNA expression during male germinal cell differentiation. AB - The members of the jun family of protooncogenes (junB, c-jun, and junD) share a high degree of sequence homology and function as transcriptional regulators. Here we compare the pattern of junD mRNA expression during spermatogenesis to that of junB and c-jun (Alcivar et al.: J Biol Chem 265:20160-20165, 1990). junD transcripts are present at high levels in total RNA obtained from both prepuberal and adult intact testes, with the highest levels at stages containing predominantly premeiotic and postmeiotic germ cells. Analyses of cells isolated from testes of 8-day-old mice indicate that the level of the 1.8 kb junD mRNA is higher in type B spermatogonia than in type A spermatogonia. In testes of 17-day old mice, the highest junD mRNA levels are detected in preleptotene spermatocytes compared to leptotene/zygotene and prepuberal pachytene spermatocytes. In cells from adult testes, the junD mRNA levels are higher in postmeiotic round spermatids and residual bodies/cytoplasts than in meiotic pachytene spermatocytes. An additional junD transcript of about 1.6 kb is detected in postmeiotic cells. Analyses of polysomal and nonpolysomal RNAs prepared from isolated testicular cells indicate that in early meiotic cell types the junD transcript is more efficiently loaded onto polysomes than in later cell types. In summary, the pattern of expression of junD differs from that of junB and c-jun during spermatogenesis most notably in that 1) junD mRNA levels do not increase following dissociation of testicular cells and 2) in contrast to the nearly undetectable levels of junB and c-jun mRNAs in adult postmeiotic testicular cells, high levels of junD mRNAs are seen.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793596 TI - Liposome-mediated DNA uptake by sperm cells. AB - To investigate the potential use of sperm cells as vectors to transfer exogenous DNA via the fertilization of oocytes into the germ line of mice, we have used liposomes to transfect DNA into the sperm head. Although the DNA transfer into sperm mediated by liposomes was very efficient and no obvious reduction in the fertilization frequency of oocytes could be detected, we were unable to generate transgenic mice by this method. PMID- 1793597 TI - Patterns of transgene inheritance in rainbow trout (Oncorhynchus mykiss). AB - There have been very few studies of the inheritance of introduced genes (transgenes) in fish. We have followed the inheritance of the mammalian fusion gene MTrGH from founder generation transgenics (originating from eggs microinjected with the MTrGH DNA) to offspring in crosses with control fish. Initial screening of the founder generation transgenics was by analysing DNA from blood samples. Only three out of six fish which carried the novel gene in blood DNA transmitted it to their offspring, despite the presence of the gene in DNA extracted from the sperm of all four male fish in this group. The frequency of transgenics in the progeny groups from the three fish which transmitted the gene varied widely: in one of these groups more than one type of MTrGH restriction pattern was found. These results suggest widespread mosaicism in founder generation transgenics. PMID- 1793598 TI - Studies on murine embryo-derived platelet-activating factor (EPAF). AB - Studies were carried out using the splenectomized mouse bioassay (SMB) to investigate the nature of embryo-derived platelet-activating factor (EPAF) and its relationship to synthetic platelet activating factor (PAF). While both C16 PAF and embryo conditioned media (ECM) induced a significant platelet decline in the SMB at 15 min postinjection, C18-PAF induced a similar effect at 30 min postinjection. The degree of EPAF activity in ECM was not altered with increasing embryo number from 2 to 40/ml of media. In contrast, PAF (C16/C18 mixture) induced a linear increase in activity with increasing concentration, leading to lethal effects at high concentrations. While EPAF activity was not significantly altered when ECM was diluted 1/1,000, PAF activity was abolished at 1/10 dilution. EPAF in ECM was not inactivated by mouse plasma; however, lipid extracted ECM, like PAF, underwent rapid inactivation in the presence of plasma. Aggregometer studies using horse platelets showed that ECM and lipid-extracted ECM were unable to induce platelet aggregation, while thin-layer chromatography (TLC) purified ECM (Rf 0.23) successfully aggregated horse platelets in vitro. Results suggested that EPAF and PAF are not homologous. EPAF might consist of PAF bound to a regulatory carrier molecule and appears to be associated with EPAF inhibitor substance(s) in ECM. PMID- 1793599 TI - Developmental potential and chromosome constitution of strontium-induced mouse parthenogenones. AB - The brief exposure of recently ovulated mouse oocytes to M16 embryo culture medium supplemented with strontium chloride (M16 Sr2+) for 2-10 min was observed to induce a high incidence of parthenogenesis. A lower incidence of activation and a significant rate of oocyte degeneration was observed when oocytes were incubated in M16 Sr2+ medium for 20-60 min. The majority of the oocytes exposed to this agent for 2-10 min developed as single-pronuclear haploid parthenogenones. The incidence of this parthenogenetic class was reduced as the duration of exposure to M16 Sr2+ was increased from 2 to 30 min. Under these conditions a greater proportion of the activated oocytes developed as two pronuclear diploid parthenogenones, due to failure of second polar body extrusion. The activation frequency and the proportionate incidence of the pathways of parthenogenetic development observed following the exposure of ovulated oocytes to calcium-free M16 medium differed significantly from that induced by exposure to M16 Sr2+. Cytogenetic analysis of the single-pronuclear haploid class of Sr(2+)-induced parthenogenones at metaphase of the first cleavage mitosis has shown that this agent did not induce a significant increase in the incidence of chromosome segregation errors during the completion of the second meiotic division. Analysis of the developmental potential of the two pronuclear class of diploid Sr(2+)-induced parthenogenones during the preimplantation stages of embryogenesis revealed that their cell number and rate of cell division were less than those of fertilised embryos retained either in vivo or in vitro. The novel methods of activating oocytes indicated in this study present new opportunities to improve the efficiency of embryo cloning techniques with the ruminant species. PMID- 1793600 TI - Cryopreservation of mouse half-morulae and chimeric embryos by vitrification. AB - Mouse half-morulae were cryopreserved less than or equal to 1, 3, 6, and 12 hr after bisection by the vitrification method using 25% glycerol and 25% 1,2 propanediol as cryoprotectant. The developmental rates of the frozen-thawed half embryos to blastocysts in vitro were 77.8% (63/81), 82.0% (41/50), 92.1% (117/127), and 0% (0/37), respectively. Sixty-one of the half-embryos that had been vitrified 6 hr after the bisection followed by transfer to five recipients resulted in a total of ten (16.4%) normal fetuses. Chimeric mouse embryos constructed by two half-morulae were also vitrified 6 and 16 hr after aggregation. Survivors were obtained from the former case: 40 (80.0%) of 50 frozen-thawed embryos developed in vitro to blastocysts, and, after transfer, six chimeric offspring were obtained from the 34 vitrified chimeric embryos. These results showed that mouse half-morulae and chimeric embryos could be cryopreserved by the vitrification method. It seems possible to manufacture a chimeric mouse embryo of defined genotypic composition that can be analyzed during its frozen state using the identical half-embryos of the components. PMID- 1793601 TI - Reduction of embryotoxicity by protein in embryo culture media. AB - Experiments tested the hypothesis that one role of protein in embryo culture media is protection of embryos against potentially embryotoxic substances in the media. Mouse embryos were cultured in modified Krebs-Ringer bicarbonate medium and in modified Tyrode's medium, aliquots of which were supplemented with 4 mg/ml of the protein bovine serum albumin (BSA), while other aliquots were left protein free. The media were prepared using water samples that differed in purity, as reflected by differences in conductivity, with tap water being least pure (and considered to have the greatest potential for being embryotoxic) and water that had been purified by reverse osmosis, Milli-Q filtration, and triple distillation being most pure. Embryos were placed in the media while in the two-cell stage of development and their development was assessed after 24, 48, and 72 hr of culture. Rate of embryo development in BSA-supplemented media was greater than that in protein-free media only when the media were prepared with the least purified water samples. Because these water samples would have contained substances not contained in media prepared with purer water, or would have contained the substances in higher concentration, the data supported the hypothesis that protein can protect embryos during culture by negating effects of embryotoxic substances in the media. PMID- 1793602 TI - Quantitative light and scanning electron microscopy of ferret sperm. AB - Sperm were obtained via electroejaculation from Domestic ferret, (Mustela putorius furo), Siberian ferret (M. eversmanni), Black-footed ferret (M. nigripes), and a hybrid between Siberian and Domestic, called the Fitch ferret (M. sp.). Comparisons of sperm were made by four different microscopy techniques to determine whether differences exist among species. First, Nomarski differential interference microscopy could be used to distinguish domestic ferret sperm from the others on the basis of the structure of the posterior part of the acrosome. Second, both silver staining, which demonstrates argentophilic protein distribution, and scanning electron microscopy (SEM), revealed differences among the morphology of sperm for each species; variation in the unique appearance of the acrosome in ferret sperm was detected especially well by SEM. To quantify differences in morphology, five sperm head parameters were measured using image analysis; light microscopy produced significantly larger values than did SEM (all parameters and all species but Fitch), and there were significant differences owing to species for all parameters but one. Generally, our data demonstrate the value of complementary techniques to distinguish among sperm of closely related species and more specifically may help establish evolutionary relationships among the ferret species studied. In addition, they provide baseline data important for the captive breeding of the endangered Black-footed ferret. PMID- 1793603 TI - Effect of ethanol and methanol on the motility of Saccostrea commercialis sperm and sperm models. AB - The organic solvents methanol and ethanol at concentrations of 2.5% and 5% (v/v), respectively, were found to significantly (P less than 0.001) decrease the radius of curvature and track velocity of S. commercialis sperm. To observe the effects of the solvent directly on the axoneme, S. commercialis sperm models were prepared by extraction with Triton X-100 and reactivation with ATP in media containing acetate anions, DTT, magnesium, and cAMP. Concentrations of 0.1% Triton X-100 demembranated sperm while 0.01% and 0.05% Triton X-100 permeabilized sperm. Sperm models were successfully produced after reactivation with 1 mM ATP. At pH 8.25, 1% (v/v) ethanol or methanol was observed to increase waveform asymmetry and significantly (P less than 0.001) decrease track velocity of 0.1% Triton X-100 demembranated sperm models. Similarly 1% (v/v) ethanol increased tail-wave asymmetry and decreased track velocity of 0.01% and 0.05% Triton X-100 permeabilized sperm models. Reactivated motility of 0.05% Triton X-100 permeabilized sperm models prepared at pH 7.8 were poor and improved after treatment with 7% (v/v) ethanol, which increased waveform asymmetry and doubled the track velocity of sperm. This stimulatory effect of ethanol was unchanged in the presence of the alcohol dehydrogenase inhibitor pyrazole. Concerning the precise mechanism of action of ethanol on the axoneme, we conclude that a stimulatory or inhibitory effect of ethanol is dependent on the pH of the sperm model system used. PMID- 1793604 TI - Improvement of flow cytometry analysis and sorting of bull spermatozoa by optical monitoring of cell orientation as evaluated by DNA specific probing. AB - Flow cytometry is a potential method for the separation of X and Y bearing spermatozoa, on the basis of their relative DNA content evaluated by the fluorescence emission intensity due to specific fluorochrome DNA staining. However, spermatozoa DNA is highly condensed and nuclei exhibit flat non spherical shape, which can produce artefacts impeding accurate analysis. In order to avoid these limitations, decondensation of DNA performed by enzymatic treatment and a modification of the flow cytometer that orients the spermatozoa relative to the laser beam are generally used. In this work, we describe alternative methods and materials for selection of 1) decondensed and thus dead spermatozoa without orientation, sorted on the basis of only the 10% spermatozoa containing the least DNA (expected Y) and the 10% spermatozoa containing the more DNA (expected X), or 2) native spermatozoa homogeneously oriented using a simultaneous measurement of Axial light loss (extinction) and Forward angle light scatter. For testing enrichment of each selected fraction we have worked out a molecular hybridization procedure using X and Y specific DNA probes. We analyse and sort bull spermatozoa on these basis: the purity obtained for these fractions is 80% without orientation after enzymatic treatment, and 70% on live spermatozoa "optically" oriented. PMID- 1793605 TI - Qualitative and quantitative changes in protein synthesis of bovine follicular cells during the preovulatory period. AB - To understand the mechanisms governing oocyte maturation better, the effects of the gonadotropin surge were studied on follicular cells of bovine preovulatory follicles. For this purpose, qualitative and quantitative changes in protein synthesis by both granulosa cells and cumulus cells were compared relative to the luteinizing hormone (LH) surge and the resumption of meiosis in the oocyte. Follicular cells were collected at different times before and up to 25 hr after the LH surge. For each individual preovulatory follicle, granulosa and cumulus cells were incubated separately for 3 hr with 3H-methionine or with 35S methionine. Newly synthesized cytosolic proteins from granulosa and cumulus cells and proteins secreted into the medium were analyzed by polyacrylamide gel electrophoresis. The radioactivity was measured by liquid scintillation counting after slicing of the gels or revealed by fluorography. Three major peaks of the newly synthesized proteins, with molecular weights of 76, 56, and 30 kDa, were studied throughout the preovulatory period. After the LH surge, the overall level of protein synthesis increased in granulosa cells. In addition, the pattern of cytosolic proteins in granulosa cells changed, and, in particular, the relative synthesis of the 30 kDa peak decreased. These changes in cytosolic protein synthesis may be due to the action of LH since they could be reproduced in vitro in LH-stimulated granulosa cells. A predominant peak of 56 kDa was secreted by granulosa cells throughout the experimental period. No significant change was observed in proteins synthesized by cumulus cells under the same experimental conditions. The amounts of radioactivity incorporated into the three major proteins secreted by granulosa cells, however, were correlated significantly with the amounts of radioactivity incorporated by similar proteins synthesized by cumulus cells. These results indicate that cumulus cells respond differently from granulosa cells to the gonadotropin surge but not in an independent manner. PMID- 1793606 TI - Preparation of spermatogenic cell populations at specific stages of differentiation in the human. AB - Studying biochemical events in human spermatogenesis requires separated populations of spermatogenic cells. Dissociation of these cells was performed by a Trypsin-DNAse method adapted from the technique used for rodents. Cell separation was performed by centrifugal elutriation. Seven populations were collected, one further purified by Percoll gradient centrifugation, giving nine different cell populations. The efficiency of the cell separation was evaluated by phase contrast microscopy, flow cytometric DNA analysis, and electron microscopy. Five populations were enriched in spermatids: two in round spermatids (87% and 73%), another in round (52%) and elongating (44%) spermatids, another constituted by 80% elongating spermatids, and the last by 90% elongated spermatids. Two of the four remaining populations were enriched in primary spermatocytes (74% and 54%); another population was the upper part of the Percoll gradient and constituted cytoplasmic lobes and residual bodies (89%); the last population was made up of various cells, with no specific enrichment. Electron microscopic observations revealed good preservation of the separated cells; only the flagella from elongated spermatids were lost. Furthermore, an unusual pattern of nucleoplasm distribution during stages 2-4 of spermatid differentiation was observed and its signification is discussed with regard to the shape of the human spermatozoon. PMID- 1793607 TI - On the mechanism of permanent brain dysfunction in hyperphenylalaninemia. PMID- 1793608 TI - Structure-function relationships in the peroxisome: implications for human disease. AB - Progress relevant to human peroxisomal disorders over the past 3 years includes improved biochemical delineation of disease phenotypes and new insights into peroxisomal structure and biogenesis. Immunoblotting studies using antibodies to peroxisomal beta-oxidation enzymes have defined mutations affecting each step of the pathway, some with clinical phenotypes as severe as disorders with global peroxisome deficiency. The latter disorders, typified by Zellweger syndrome, often lack matrix proteins but retain major membrane species of 150, 70, 35, and 22 kDa in empty peroxisomal "ghost" structures. The hypothesis that peroxisomal deficiency disorders result from altered targeting or import of peroxisomal matrix proteins has been strengthened by the demonstration of a carboxy terminal peroxisome-targeting signal which is distinct from amino terminal signals directing proteins to mitochondria. A mutation which mistargets alanine/glyoxylate aminotransferase from peroxisomes to mitochondria in primary hyperoxaluria provides a graphic example of these signals. The structural significance of membrane function is supported by the primacy of membrane assembly in normal ontogeny or regenerating liver. The coordinate control, targeting, and striking inducibility of peroxisomal proteins suggests a potential vehicle for gene and enzyme therapy. PMID- 1793609 TI - Muscle fatigue: conduction or mechanical failure? AB - It is well documented that repeated voluntary activity or electrical stimulation of skeletal muscle results in a decline in force production or power output. However, the precise physiological causes of "muscle fatigue" are not yet well understood. It is conceivable that the mechanism(s) may lie either in the conduction of action potentials in the central and peripheral nervous systems or in the transformation of the electrical event into mechanical force production by the muscle itself. In fact, none of the components of the electrical pathway from generation of impulses in the brain to their conduction over the neuron and the excitable membranes of the muscle can as yet be ruled out as potential contributors to the fatigue process. Relative to that on conduction failure, more information exists concerning the possibility that a defect in the excitation contraction coupling process in skeletal muscle, e.g., intracellular acidosis, inadequate supply of energy for contraction, or a disruption in Ca2+ homeostasis may also be significant in compromising force production following sustained activity. Despite this, the amount of conflicting data derived from these experiments has hindered the resolution of this question. In the future more attention must be given to such issues as the type of activity used to elicit fatigue and the fiber composition of the muscles studied. This is imperative as these factors clearly impact the nature of correlations between the biochemical and physiological events in muscle that are required to support prospective fatigue mechanisms. PMID- 1793610 TI - Atherosclerosis and acetaldehyde metabolism in blood. AB - Acetaldehyde elimination in blood homogenates and erythrocyte aldehyde dehydrogenase (ALDH) activity were studied in 64 patients operated before the age of 60 years because of symptomatic stenosis of aorta, iliac, or carotid arteries and in 38 healthy controls. The disappearance of acetaldehyde in blood homogenates was biphasic. Patients showed an enhanced elimination of acetaldehyde during the second phase (30-60 min), as compared to controls (T1/2 of acetaldehyde was 103 +/- 47 and 198 +/- 93 min, respectively, P less than 0.001). No correlation was found between ALDH activity and acetaldehyde elimination rate. Acetaldehyde elimination in blood homogenates and [14C]acetaldehyde binding to plasma proteins, hemoglobin, and erythrocyte membranes were studied in 10 patients with atherosclerotic disease and in 12 healthy controls. There was a significant correlation between unstable binding of [14C]acetaldehyde to plasma proteins and the half-life of acetaldehyde in the elimination test (p = 0.74, P less than 0.005). Fractionation of plasma proteins after incubation with [14C]acetaldehyde revealed no difference between patients and controls in the distribution of radioactivity. The binding of [14C]acetaldehyde to hemoglobin or erythrocyte membranes did not differ between patients and controls. These results indicate that patients with angiopathy and an enhanced acetaldehyde elimination in blood have reduced binding of acetaldehyde to plasma proteins. As unstable binding of acetaldehyde to proteins is known to involve free amino groups of amino acid residues, modification of these residues in atherosclerotic disease is conceivable. PMID- 1793611 TI - Spurious elevation of serum high-density lipoprotein cholesterol in patients with cholestatic liver diseases. AB - Strikingly discrepant values were obtained by two commercial precipitating reagents for serum HDL cholesterol determination in three patients with cholestatic liver diseases (two patients with primary biliary cirrhosis and one patient with chronic hepatitis). An abnormal alpha 2-migrating lipoprotein (slow alpha-lipoprotein) was observed in agarose gel electrophoresis for each serum. The slow alpha-lipoprotein was partly recovered in the supernatant by precipitation with polyethylene glycol, and was completely precipitated with a polyanion-containing reagent, which well explains the discrepancy. The slow alpha lipoprotein isolated from one of the cases is notable for (1) having an intermediate particle size between normal LDL and normal HDL, (2) containing apo E as the major apolipoprotein, and (3) being enriched with cholesterol (esterified and free) and phospholipid. Cholesterol accumulation was also found in another HDL subclass, alpha 1-migrating HDL. A severe impediment in the clearance of cholesterol-loaded HDL particles from plasma was implied. Electrophoresis of serum lipoproteins and/or the measurement of serum apo E concentrations are necessary to avoid an erroneous estimation of HDL cholesterol in patients with hepatobiliary diseases. PMID- 1793612 TI - Biotin uptake, utilization, and efflux in normal and biotin-deficient rat hepatocytes. AB - Biotin uptake, utilization, and efflux were studied in normal and biotin deficient cultured rat hepatocytes. Biotin-deficient cells accumulate about 16 fold more biotin than do normal cells when incubated with a physiological concentration of biotin for 24 h. This difference is due to the greater amount of protein-bound biotin relative to free biotin in biotin-deficient hepatocytes, and is attributable to the presence of more apocarboxylases in deficient cells. The rate of biotin uptake and the rate of activation of the carboxylases, acetyl-CoA carboxylase, pyruvate carboxylase, propionyl-CoA carboxylase, and beta methylcrotonyl-CoA carboxylase, are proportional to the concentration of exogenous biotin. Increases in carboxylase activities are proportional to the concentration of biotin only at exogenous biotin concentrations of less than 410 nM. Concentrations of 410 nM or more biotin increase carboxylase activities to normal or near normal. Biocytin inhibits biotin uptake at very high concentrations, whereas desthiobiotin and lipoic acid have no effect. Biocytin in the medium results in carboxylase activation either intracellularly or extracellularly by conversion to biotin by biotinidase. Investigation of the efflux of biotin from normal and biotin-deficient cells preincubated with the vitamin showed greater retention of biotin by biotin-deficient cells than by normal cells over 24 h. Retention of free biotin is similar in biotin-deficient and normal cells. The greater amount of biotin retained by biotin-deficient cells is accounted for by the greater amount of bound biotin in these cells. These results suggest that the free and bound biotin pools are independently regulated. The ready loss of free biotin from these cells has implications for the treatment of inherited, biotin-responsive carboxylase deficiencies. PMID- 1793613 TI - Impaired insulin mediated potassium uptake in adolescents with IDDM. AB - Insulin-dependent diabetes mellitus is known to be associated with impaired ability of insulin to enhance tissue glucose uptake. However, no information is available whether or not this insulin resistance extends to insulin-mediated potassium (K+) uptake. Insulin-mediated decrease in serum potassium (K+) and in blood urea nitrogen (BUN) concentration was evaluated in 20 adolescents with IDDM and 10 matched controls during a 3-h hyperinsulinemic (1.7 mU/kg/min)-euglycemic clamp study. Insulin-mediated glucose disposal rate was lower in IDDM compared with controls (37.4 +/- 3.2 vs 63.8 +/- 5.4 mumol/kg/min, P less than 0.001). The decline in serum K+ concentration following hyperinsulinemia was significantly smaller in adolescents with IDDM than controls (0.29 +/- 0.06 vs 0.67 +/- 0.08 meq/liter, P = 0.002). Similarly the decline in BUN concentration was smaller in IDDM compared with control subjects (2.10 +/- 0.40 vs 3.70 +/- 0.56 mg/dl, P = 0.03), suggestive of decreased suppressibility of proteolysis. The changes in serum K+ and BUN concentrations were correlated (r = 0.64, P = 0.02) in controls but not in diabetics. Similarly, the decrement in serum K+ concentration showed a positive correlation with the rate of insulin-mediated glucose disposal (r = 0.68, P = 0.02) in controls but not in diabetics. The correlation of glucose disposal rate with the decline in BUN concentration did not reach a level of significance (r = 0.43, P = 0.1). These results indicate that adolescents with IDDM are resistant to the ability of insulin to stimulate in vivo K+ uptake and to suppress proteolysis. PMID- 1793614 TI - Immunoreactive enzyme protein in medium-chain acyl-CoA dehydrogenase deficiency. AB - Medium-chain acyl-CoA dehydrogenase (MCAD) deficiency is a common inborn error of mitochondrial fatty acid oxidation. To determine if immunoreactive enzyme protein is present in patients with MCAD deficiency, we studied cultured skin fibroblasts from patients with the 985 point mutation, present in about 85% of cases, and cell lines from patients in which the point mutation is not present or only involves one allele. Immunoblotting studies, using a polyclonal antibody to the purified protein, showed an absence of immunoreactive protein in mitochondrial fractions prepared from fibroblasts from MCAD-deficient patients. To determine whether MCAD protein accumulated in the cytosol because of impaired transport into the mitochondria, we immunoprecipitated MCAD protein from the fibroblast homogenate. MCAD protein was detected in the immunoprecipitates from controls, but not in those from the MCAD-deficient patients. These results suggest that either the MCAD protein is not synthesised or, if produced, it is rapidly degraded. PMID- 1793615 TI - A sensitive sandwich enzyme-linked immunosorbent assay of rat apolipoprotein A-I: effect of various sample treatments on apolipoprotein A-I immunoreactivity and an application to young and aged rat sera. AB - A highly sensitive sandwich enzyme-linked immunosorbent assay for rat apo A-I was developed. Samples and standards were added to each well of microtiter plates precoated with immunoaffinity-purified IgG. Bound apo A-I was detected with immunoaffinity-purified Fab'-horseradish peroxidase conjugate by a colorimetric method. The sensitivity reached 2.5 pg/well, and the working range for the measurement of serum apo A-I concentration was 0.1 to 1.0 ng/well. The mean intra and interassay coefficients of variation were 2.8 and 4.1%, respectively. The epitopes of apo A-I in serum were effectively exposed by the use of 6 mol/liter guanidine.HCl. Serum apo A-I concentrations in 36- to 40-week-old rats (62.3 +/- 8.6 mg/dl, mean +/- SD, n = 16) were significantly higher (P less than 0.05) than those in 8- to 12-week-old rats (55.1 +/- 4.3 mg/dl, n = 9). But the age-related change of serum apo A-I was much smaller than that of serum apo E. Apo A-I was contained in smaller HDL particles (or HDL2) in normal rat serum. PMID- 1793616 TI - Human manganese superoxide dismutase is readily detectable by a copper blotting technique. AB - Manganese-superoxide dismutase (MnSOD) in human fibroblast and liver lysates was found to bind copper avidly under the conditions of a copper blotting technique which also detects known copper-binding proteins. Competition studies suggest that the copper-binding site of the molecule under these conditions is distinct from its manganese-binding site. Copper blotting provides a sensitive way to detect MnSOD in human tissues, and may be generally applicable to studies of copper-binding by biological molecules. PMID- 1793617 TI - Depletion of sialic acid without changes in sialidase activity in glomeruli of uninephrectomized diabetic rats. AB - The role of sialidase in the depletion of glomerular sialic acid induced by diabetes has been investigated in uninephrectomized rats. Four months after streptozotocin administration, diabetic rats showed an enhanced urinary excretion of albumin and transferrin, which was associated with a decrease of sialic acid concentration in isolated glomeruli. Despite the sialic acid depletion, the glomerular sialidase activity was unchanged. These results indicate that the decreased glomerular sialic acid concentration observed in diabetic nephropathy might be caused by a disturbance of the sialylation of glomerular structures. PMID- 1793618 TI - Alterations in membrane fluidity of diabetic polymorphonuclear leukocytes. AB - Plasma membrane fluidity of polymorphonuclear leukocytes was investigated in 28 patients with insulin dependent diabetes mellitus and 30 healthy controls. Membrane fluidity was measured by steady-state fluorescence anisotropy of 1-(4 trimethylammoniumphenyl)-6-phenyl-1,3,5-hexatriene (TMA-DPH) incorporated into the plasma membrane. The fluorescence anisotropy values in resting (unstimulated) polymorphonuclear leukocytes from diabetic subjects were significantly higher than those of controls (0.318 +/- 0.003 vs 0.287 +/- 0.003, P less than 0.001). The addition of the respiratory burst stimulus phorbol myristate acetate induced a stable increase in fluorescence anisotropy values in both groups. Fluorescence anisotropy values of stimulated polymorphonuclear leukocytes from the diabetic and control groups were not significantly different (P greater than 0.05). These data demonstrate a decrease in plasma membrane fluidity of resting polymorphonuclear leukocytes obtained from diabetic subjects. This finding could be in part explained by an increase in their basal respiratory burst activity. PMID- 1793619 TI - Calpain is activated during hypoxic myocardial cell injury. AB - Cell death during hypoxia rose to 80% after 6 h. Calpain activity increased to 4 units during hypoxia, much higher than the 0.7 units seen in aerobic condition at 6 h. This activity was markedly inhibited by calpain-specific inhibitor I (n acetyl-leucyle-leucyle-norleucinal). beta-Adrenergic blocking agents and calcium antagonists suppressed the calpain activity and decreased cell death during hypoxia. On the other hand, alpha-adrenergic blocking agents did not affect calpain activity and cell death under hypoxic conditions. These results prove that beta-adrenergic blocking agents and calcium antagonists prevent protein degradation during hypoxic cell injury. PMID- 1793620 TI - [Catheter-balloon valvuloplasty in mitral valve stenosis (selection of the method of procedure, immediate results and the criteria of patient selection]. AB - Catheter-balloon valvuloplasty (CBV) was carried out in 80 patients with rheumatic mitral stenosis, whose ages ranged from 22 to 68 years. Seventeen of these patients were operated on for mitral valve restenosis; I-II degree calcinosis of the mitral valve was revealed in 18 patients; seven women underwent surgery in the 24th-32nd week of pregnancy. After applying various methods (19 cases) the authors used in the last series of operations (61 cases) the Silin Sukhov method using an original dilatation catheter with a balloon measuring in diameter up to 34 mm, which allowed pressure of up to 8 atm. to be produced during a working cycle no longer than 8 sec. As the result of CBV, the area of the mitral orifice was enlarged by no less than twice in all patients, the pressure gradient through the mitral valve and systolic pressure in the pulmonary artery reduced. The total number of complications which called for operative treatment was 3.75%. CBV is a still developing method, but already today it may be considered the method of choice in the treatment of uncomplicated forms of mitral stenosis, in I-II degree calcinosis, and when the risk of the traditional surgical intervention on the heart is increased. PMID- 1793621 TI - [Treatment of mitral valve stenosis in pregnant women by the method of balloon valvuloplasty]. AB - Catheter-balloon mitral valvuloplasty was performed in 7 females with rheumatic mitral stenosis on the 19th-32nd week of pregnancy. Four patients were operated on with signs of cardiac insufficiency, two--in a state of pulmonary pre-edema. Edema of the lungs in one patient continued developing on the operating table. The results of the treatment were good in all cases. The area of the mitral orifice increased from 0.9-1.75 to 2.4-3.5 cm2. The pressure gradient between the left atrium and the left ventricle dropped from 25-40 to 2-8 mm Hg. This was attended by the disappearance of the diastolic murmur and the clinical manifestations of stasis in pulmonary circulation in all patients. The development of mitral regurgitation after the operation was not encountered in any of the patients. The period of roentgenoscopy lasted 17.5 min. on the average. Screens were used to protect the fetus from the direct effect of the X rays. Pregnancy ended in delivery in 6 patients; spontaneous labor at term occurred in 4, cesarean section had to be performed in one patient with placenta previa; one woman gave birth to twins on the 36th week of pregnancy. All the babies were healthy. Catheter-balloon valvulotomy does not yield to closed mitral commissurotomy in efficacy. The fact that it is only mildly injurious and does not need general anesthesia make this intervention preferable for pregnant women suffering from mitral stenosis. PMID- 1793622 TI - [Complications of catheter-balloon valvuloplasty (analysis of their causes and the methods of prevention and treatment]. AB - The authors analyse the results of 1,404 operations of catheter-balloon valvuloplasty in stenoses of the pulmonary, aortic, and mitral valves. The experience was accumulated by the leading heart surgeons of the country from 1984 to 1990. The total number of complications was 77 (5.4%), 23 (1.6%) of them were fetal. The least number of complications (1.88%) occurred in catheter-balloon valvuloplasty in pulmonary stenosis, 1% were fetal. Complications in aortic stenosis were encountered in 11.3% of cases, 4.8% were fatal. The greatest number of complications (44) were recorded in mitral stenosis with a relatively low mortality (2.7%). The authors distinguish unspecific complications connected with the use of standard diagnostic catheters and instruments, and specific complications linked with the use of balloon catheters or caused by the course of the disease, and the character of the valve affection. As the result of analysis of the causes of complications, the authors suggest a system for preparation of patients for operation and the principles of its safe accomplishment and describe the order of the acts undertaken by the surgeon for the management of complications. Analysis of complications of catheter-balloon valvuloplasty demonstrates the efficacy and mild injurious character of this method, which makes it possible to rank it among the generally accepted cardiosurgical methods for the correction of heart valvular stenoses. PMID- 1793623 TI - [Treatment of complicated forms of mitral valve stenosis by the method of balloon dilatation]. AB - The degree of the anatomical changes of the valvular apparatus and the severity of the hemodynamic disorders affect the results of radiologically-guided intravascular treatment of mitral stenosis. The complicated forms of mitral stenosis included cases of multivalvular affections (52), calcinosis (61), coarse fibrosis (119), pulmonary hypertension (91), atriomegaly (79), aortic incompetence exceeding I degree (37), and anomalies in patients over 50 years of age (77). The listed conditions were an additional risk factor in performing 221 interventions for percutaneous catheter-balloon valvuloplasty. They call for individual alteration of the techniques of balloon dilatation and dosed manipulation on the valvular structures in accordance with the concrete form of the valvular disease. Such an approach made it possible to reduce the frequency of complications (from 30 to 4.8%) and mortality (from 9.6 to 0.59%). PMID- 1793624 TI - [Surgical tactics in patients with ischemic heart disease, extensive cicatricial myocardial lesions and circulatory insufficiency]. AB - The article discusses the results of surgical treatment of patients suffering from ischemic heart disease with extensive cicatricial affections of the myocardium and circulatory insufficiency. Thirteen patients of group I were treated by various reconstructive operations (resection of an aneurysm, formation of an aortocoronary shunt, septoplasty), 10 patients of group 2 underwent orthotopic heart transplantation. Perioperative and long-term (up to 3 years) mortality rates were, respectively, 7.6 and 8% in group I and, respectively, 30% and zero in group 2. The unfavorable prognosis of survival and medicamentous therapy in such patients, the lack of donors, and the acceptable results of reconstructive operations are evidence that they should be undertaken whenever possible. The main criteria of the selection of patients for a reconstructive operation are the values of regional contractility of the left ventricle, the severity of the dystrophic processes in the preserved segments, and the condition of the coronary arteries. PMID- 1793625 TI - [The first experience with the treatment of Wolff-Parkinson-White syndrome]. AB - Some experience in surgical management of the Wolff-Parkinson-White syndrome is generalized. Operations were performed on 7 patients (2 males and 5 females) whose ages ranged from 17 to 53 years. Endocardial electrophysiological examination and intraoperative mapping were the main diagnostic methods. In 5 patients the Wolff-Parkinson-White syndrome was combined with organic heart anomalies (atrial septal defect, mitral stenosis or incompetence) which were corrected with simultaneous removal of Kent's bundle. In 2 patients Kent's bundle was removed by epicardial electrodestruction and in 5 patients by Seely's operation. Signs of preexcitation and tachycardia disappeared subsequently in all patients who were operated on. PMID- 1793626 TI - [Results of the treatment of patients with Leriche's syndrome and ulcerous necrotic foot changes]. AB - A comparative analysis of two groups of patients with Leriche's syndrome was conducted: 88 patients suffered only from intermittent claudication (stage III of the disease), while 128 patients had pyo-necrotic changes on the feet (stage IV). All patients were subjected to revascularization of the ischemic extremities by restorative operations with the use of a synthetic prosthesis. The necrotic lesions of the feet were encountered mostly in patients with a combined affection. Due to the severe condition of the patients, however, one-stage operations on the ++aorto-popliteal and femoropopliteal segments were not undertaken. An aortic deep femoral shunt was formed, but if ischemia of rest was maintained reconstruction in the femoropopliteal segment was performed in a second stage. Comparative analysis of the immediate and late-term results in patients of these two groups was conducted. It is shown that the operative risk is higher in stage IV than in stage III. But operations in patients with necrotic changes can be considered well grounded because the late-term results (preservation of the extremity, frequency of deep suppurations) hardly differ from those in patients with intermittent claudication. PMID- 1793627 TI - [Differentiated approach to the method of sternum stabilization in surgical treatment of funnel chest in children]. AB - Experience in surgical treatment of 186 patients with funnel chest deformity (FCD) is generalized. With consideration for the great variety of the forms of deformity of the plastron, simple and complicated forms of FCD are distinguished. The simple forms include isolated, symmetrical, low (beginning from the level of the fourth rib) II-III degree deformities, the complicated forms include wide, II III degree deformities beginning from the level of the second rib, and flat asymmetrical deformities. The use of a metal plate as a stabilizer in complicated forms of FCD is suggested. The optimal method of treatment in simple forms of the deformity is thoracoplasty with fixation of the sternum in the corrected position by means of a nitinol clip. PMID- 1793628 TI - [Balloon dilatation of aortic coarctation]. AB - Endovascular balloon dilatation of coarctation of the aorta is a manipulation for radical correction of the anomaly with an evident hemodynamic effect in patients with the isolated form, in combination of coarctation of the aorta with aortic stenosis, and in atypical forms of the anomaly. Up to 90% of good immediate results were produced among these patients. Balloon dilatation may also be conducted in recoarctation after the traditional surgical management. Being devoid of some of the negative factors of the accepted methods of treatment, endovascular angioplasty is a sparing and a relatively safe method. Paradoxical hypertension does not develop as a rule. Rare complications in the zone of the approach were encountered. Balloon dilatation may be combined with endovascular correction of other anomalies, and may be repeated many times. In recoarctation and atypical forms of the anomaly balloon dilatation helps in avoiding complex and dangerous operations using the traditional methods. Coarctation in the form of a diaphragm is the most "favourable" type of the anomaly for balloon dilatation. The operation is also indicated in coarctation in patients with hypoplasia of the arch and isthmus, despite its palliative character. PMID- 1793629 TI - [Prognosis and prevention of post-traumatic pneumonia in closed thoracic injuries]. AB - The authors elaborated the criteria of prognosticating the development of posttraumatic pneumonia on the basis of diagnostic information (clinical, radiological, endoscopic findings) gained in the first hours after hospitalization of patients with closed chest trauma, and compiled a prognostic table by means of which the probability of the development of pneumonia was appraised in 236 patients. Individual clinical prognostication allowed opportune and differentiated application of a complex of special therapeutic and preventive measures including, along with the traditional methods, the use of the possibilities of therapeutic endoscopy, modern antibacterial, physiotherapeutic, and immunocorrective treatment. The applied tactics made it possible to reduce posttraumatic pneumonia incidence and achieve its favourable course in most patients. PMID- 1793630 TI - [Benign tumors of the esophagus]. AB - The results of treatment of 53 patients with benign esophageal tumors are discussed. The diagnosis was mainly established by the radiologic and endoscopic methods. Leiomyoma of the esophagus was recognized in 29 patients, fibroma in 19, a cyst in 2, a polyp in 2 patients and a lipoma in one patient. Operations were carried out on 42 patients. Complications and fatal outcomes did not occur in the postoperative period. All patients recovered fully. PMID- 1793631 TI - [Substantiation of the expediency of performing extensive lymph node dissection in surgical treatment of esophageal cancer]. AB - The performance of extensive lymph node dissection+ in esophageal carcinoma is substantiated. From their own data the authors conclude that squamous cell carcinoma of the esophagus possesses high lymphatic metastatic activity and point to the statistically significant increase of the incidence of involvement of the superior perigastric lymph nodes in localization of the tumor in its infrathoracic part. At the same time, the frequency of affection of the mediastinal lymph collector does not depend on the localization of the tumor. The authors emphasize that extensive subsequent lymph node dissection+ of the mediastinum and upper part of the abdominal cavity should be an obligatory stage of an operative intervention in esophageal carcinoma. PMID- 1793633 TI - [Protection of the myocardium during operations with extracorporeal circulation]. PMID- 1793632 TI - [Complex endoscopic ultrasonographic diagnosis of esophageal diseases]. AB - Complex endoscopic and transesophageal ultrasonic examination makes it possible to identify distinctly the character and localization of the pathological process, its boundaries and its spread to the adjoining organs. Ultrasonic examination is especially effective in new growths of the esophagus. PMID- 1793634 TI - [Simultaneous surgical correction of severe post-infarction ventricular septal defect with posterior left-ventricular aneurysm and lesions of the coronary arteries]. PMID- 1793635 TI - [Repeated prosthesis of the mitral valve with correction of tricuspid insufficiency and removal of giant calcified thrombus from the left atrium 18 years after mitral valve prosthesis]. PMID- 1793636 TI - [A case of fibromuscular dysplasia of the renal arteries in a patient 7 years after plastic surgery of aortic coarctation]. PMID- 1793637 TI - [Unusual course of neurogenic tumors of the lungs]. PMID- 1793638 TI - [Rare complications of chemical burns of the esophagus and stomach in a child]. PMID- 1793639 TI - [Mesothelial cyst of the diaphragm]. PMID- 1793640 TI - [Balloon valvuloplasty in pulmonary valve stenosis]. PMID- 1793641 TI - Preventive care of elderly people: how good is our training? PMID- 1793642 TI - Medical practice and the double-blind, randomized controlled trial. PMID- 1793643 TI - Link between the ability to detect and manage emotional disorders: a study of general practitioner trainees. AB - Independent ratings were made of videotaped consultations involving six general practice vocational trainees, of whom three were poor identifiers and three were able identifiers of emotional illness. Taped consultations were selected so that each trainee was rated interviewing five patients with low general health questionnaire scores, and five patients with high scores. It was found that able identifiers of emotional illness were more likely than poor identifiers to offer patients information, advice and treatment relevant to their illness, and that they did so in a manner likely to maximize patient satisfaction and cooperation. This was true for both distressed and non-distressed patients. It is argued that both the ability to identify emotional disturbances and the ability to manage emotional illness are characteristics of a generally superior interview style. This may reflect a common variable: the possession of good communication skills. PMID- 1793644 TI - Experience of using rating scales for the assessment of vocational trainees in general practice. AB - For two years trainers in the northern half of the south western region have been asked to assess their trainees with a condensed version of the new Manchester rating scales for vocational training in general practice and to send copies to the regional adviser. The condensed version retains the 23 scales but does not include the subscales. Trainers' workshops and comments from individuals suggested that no radical improvements to the scales were required and that they were an adequate statement of what was required from trainees. The response rate of 89% for returning at least one assessment and 38% for returning all three suggested that use of this condensed version would be more feasible than using the full version of the scales. Analysis of 86 first assessments and 48 sets of three assessments showed a range of variation both in trainee ratings and use of individual scales that was consistent with expectations. A lack of significant rank correlations between the scales indicated that each of the scales measured a different characteristic of behaviour. We suggest that the most useful way to achieve systematic assessment of vocational trainees is by the use of the 23 main rating scales, with regional variations where appropriate. PMID- 1793645 TI - Discriminating ability of the erythrocyte sedimentation rate: a prospective study in general practice. AB - Despite its frequent use, little is known about the ability of the erythrocyte sedimentation rate to discriminate between 'pathology' (inflammatory diseases and malignancies) and 'no pathology' in general practice. This has been studied by following 362 patients who presented to their general practitioner with a new complaint, for which the general practitioner considered determination of the erythrocyte sedimentation rate to be indicated. The test was performed at the local hospital laboratory and the patients were seen again after three months, in order to establish the follow-up diagnoses. By comparing the test results with the follow-up diagnoses, combined with receiver operating characteristic curves and regression analysis, the erythrocyte sedimentation rate was found to have a reasonable discriminating ability with respect to malignancies and inflammatory diseases (sensitivity 53%, specificity 94%, positive predictive value 48%, negative predictive value 91%, odds ratio 15.1). The upper limit for the normal erythrocyte sedimentation rate should be set at approximately 12 mm hour-1 for men and 28 mm hour-1 for women, and needs no correction for age. It is concluded that the erythrocyte sedimentation rate still deserves a place in the general practitioner's daily routine. PMID- 1793646 TI - Mothers' concepts of normality, behavioural change and illness in their children. AB - Several sociological models have been put forward to explain illness behaviour. However, little research has examined general practitioners' understanding of mothers' perceptions of their children's health and illness. The aim of this study was to attempt to understand the cultural context of children's illness. Mothers' concerns about their children's health and illnesses were examined by describing the mothers' own perceptions of alterations in their children's behaviour. The mothers' perceptions of normality appeared to underpin their negotiation of illness. The concept of normality was found to change over time, to be uniquely based on individual experience, to be related to health, and to a process of normalization. The mothers' perceived importance of children's behavioural changes are discussed: they may be precursors or results of illness, causes for concern in their own right, or a management problem for the household. Identifying and acknowledging the unique way in which mothers perceive health and illness in their children may lead to enhanced understanding and satisfaction for both the general practitioner and mother in the consultation process. PMID- 1793647 TI - Incidence of toxoplasmosis in patients with glandular fever and in healthy blood donors. AB - The differential diagnosis of the clinical syndrome of glandular fever may include Epstein-Barr virus, cytomegalovirus and Toxoplasma gondii infection. Some general practitioners and clinical laboratories choose to perform serological investigations for toxoplasmosis in all patients with glandular fever, who have negative Paul-Bunnell test results. The validity of this approach was assessed by a comparison of the incidence of toxoplasmosis in healthy blood donors and in a group of patients with clinically diagnosed glandular fever who had negative Paul Bunnell tests. The results showed no significant difference in the frequency of acute or chronic toxoplasma infection between the two groups. In view of these findings, together with evidence of the lack of appropriate effective therapy for toxoplasmosis in immunocompetent individuals, and the dangers of failing to recognize concurrent severe disease of a separate aetiology, we recommend that Paul-Bunnell negative patients with clinically diagnosed glandular fever are not investigated for toxoplasmosis as a routine. However, these guidelines do not apply to patients at risk of severe sequelae from toxoplasma infection, notably pregnant women, who still require a full assessment. PMID- 1793648 TI - Does nose blowing improve hearing in serous otitis? A community study. AB - Otitis media with serous effusion (glue ear) is one of the most common problems seen by family doctors. In order to evaluate the effect of regular nose blowing on the resolution of serous otitis a randomized trial was carried out in a community health audiology department in Oxfordshire over the period 1983-87. A total of 84 children aged three and a half to four and a half years, found to have a conductive hearing loss owing to serous otitis were included in the study. The hearing test combined a discrimination test of seven named toys and full audiometry with earphones. The children's ears were examined by otoscope and Rinne's tuning fork test was performed. Randomly selected children were advised to blow their noses or were given no advice. The children were retested two months later and the outcome determined for children who were or were not given advice and who were or were not naturally good nose blowers. A record was made of any surgical intervention by insertion of ventilating tubes carried out before the children started school and of the results of the children's routine hearing tests on school entry. No significant differences in the proportion of children passing the second hearing test were found between children advised to blow their noses and those given no advice or between those children who were naturally good at nose blowing and those who were not. Neither was there any association between the proportion of children passing the school audiometry test and nose blowing advice being given, nose blowing ability or surgical intervention.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793649 TI - The General Practice Research Club. AB - The General Practice Research Club was established in 1969, and now has 120 members. A meeting of the club is held twice a year, at which various papers, from research ideas through to completed, published studies are presented. A survey of 40 individuals who had presented papers at meetings during the period 1984-89 showed that almost half (18) had presented papers on clinical topics. As a result of the presentation, 29 individuals had modified their research, with 11 undertaking major alterations. The meeting was rated most highly by those offering ideas and plans for research. Most individuals responded positively to the meetings, commenting that they valued peer review, found the meetings encouraging, and useful for focusing ideas. Lack of criticism and feedback was commented upon. The club has an important role to play in encouraging research by service general practitioners. PMID- 1793650 TI - Screening elderly people: a review of the literature in the light of the new general practitioner contract. AB - There is a considerable volume of literature on the needs of elderly people, derived from both the medical and social sciences. This article reviews material relevant to preventive care and the best ways of arranging it, with particular reference to the developments as a result of the new general practitioner contract. It is argued that although the new contract disregards much of the medical research, there are still some benefits to be gained by applying research findings within the new framework, as well as by reviewing its operation in the light of research and experience currently available. PMID- 1793651 TI - Patient satisfaction; a cause for concern. PMID- 1793652 TI - Home artificial nutritional support. PMID- 1793653 TI - Hospice care. PMID- 1793654 TI - Quality or inequality in health care? PMID- 1793655 TI - Factors influencing prescribing habits. PMID- 1793656 TI - Patient education and attendance rates. PMID- 1793657 TI - Patient participation. PMID- 1793658 TI - Sampling endocervical cells on cervical smears. PMID- 1793659 TI - Breast cancer screening. PMID- 1793660 TI - Opportunistic screening. PMID- 1793661 TI - The screening process. PMID- 1793662 TI - The 'single' doctor. PMID- 1793663 TI - Ultra-high-resolution scanning electron microscopic studies on the sarcoplasmic reticulum and mitochondria of the rat intrafusal muscle fibers. Part I. The capsular sleeve region. AB - The three-dimensional structure of the transverse-axial tubular system, sarcoplasmic reticulum (SR) and mitochondria in the capsular sleeve region of the intrafusal muscle fibers of the rat lumbrical muscle was observed by ultra-high resolution scanning electron microscopy after removal of the cytoplasmic matrix by the osmium-DMSO-osmium procedure. Nuclear chain fibers were seen to have slender I-band limited mitochondria, and thick column-forming mitochondria which occasionally exhibited I-band branches. The transverse tubules (T-tubules) ran at the level of the A-band side of the A-I junction and were sandwiched between two large terminal cisternae for most of their length, forming triads. The sarcotubules arising from the terminal cisternae formed single-layer networks at the A-band level, and well developed, double-layer, three-dimensional networks at the I-band level. Occasionally, tetrads and pentads were also seen. Nuclear bag2 fibers possessed column-forming mitochondria of medium size, practically devoid of I-band branches. The T-tubules ran at the level of A-band adjacent to the A-I junction and were coupled with terminal cisternae of various lengths at intervals. As a rule, the SR formed single-layered networks at the level of the A band and double-layered networks at the I-band level, and was less developed than in chain fibers. Nuclear bag1 fibers contained slender column-forming mitochondria devoid of I-band branches. The T-tubules were located at the level of the A-I junction. Both the T- and the axial-tubules were occasionally coupled with small terminal cisternae, forming dyads or triads. At the I-band level, the SR was well developed and formed single layer networks, but at the A-band level only a few longitudinally arranged sarcotubules and axial tubules were recognized. PMID- 1793664 TI - Quantitative aspects of water buffalo (Bubalus bubalis) spermatogenesis. AB - In the buffalo, seminiferous tubules occupy about 82% of the testis. Spermatogenesis can be divided into 6 stages according to characteristic cellular associations in the seminiferous epithelium. A-spermatogonia have a volume of approximately 1,400 microns3 and the highest absolute mitochondrial volume of all spermatogenic cells. B-spermatogonia display cellular, nuclear and mitochondrial volumes of approximately half the values of A-spermatogonia. From preleptotene (approximately 470 microns3) to late diplotene (approximately 2,300 microns3), the volume* of primary spermatocytes increases nearly five-fold; their nuclear volumes increase by 3.5 times within the same period. During zygotene mitochondrial cristae start to dilate. Grouping of mitochondria by a dense intermitochondrial substance is most prominent during pachytene and diplotene. In pachytene the absolute size of the Golgi apparatus more than doubles, indicating a high secretory activity. Through zygotene only rER is encountered; in pachytene and diplotene a tubular sER makes its first appearance. Secondary spermatocytes are found only in stage 4 of the cycle. Due to partial cell necrosis and autolytic events, late maturation phase spermatids display no more than 25% of the size of cap phase spermatids. There is no morphological evidence for an active uptake and digestion of residual bodies by the Sertoli cells. Also, no lipid cycle is present in the buffalo seminiferous epithelium. Morphometric evaluations reveal that 63% of all theoretically possible germ cells disappear from the seminiferous epithelium during spermatogenesis. Heavy cell loss is observed in stage 4 of the cycle in the spermatogonial fraction as well as during the second meiotic division. PMID- 1793665 TI - Immunocytochemical localization of synaptophysin on the smooth-surfaced tubular membranes present in nerve terminal and preterminal areas in the rat cerebellar cortex. AB - The distribution of synaptophysin, a major protein of the synaptic vesicle membrane, was immunocytochemically examined in the rat cerebellar cortex. A monoclonal antibody against synaptophysin recognized the epitope to be present in the presynaptic membranous structures including synaptic vesicles, presynaptic membrane, coated vesicles, and vacuoles of endocytotic origin. In the nerve terminal as well as preterminal areas, the antibody labeled the smooth-surfaced tubular membranes which were located in the relatively interior parts of these areas and consistent in size and appearance with the short tubules comprising the thinner parts of the axonal reticulum. However, the antibody did not stain the short tubular membranes, though similar in appearance to the above, which existed right below the axolemma in the preterminal and nerve terminal areas. The results are discussed with special reference to the precursor membrane compartments of synaptic vesicles. PMID- 1793666 TI - Immunocytochemical and immunochemical detection of a 32 kDa nonamelogenin and related proteins in porcine tooth germs. AB - Porcine tooth germ was investigated immunochemically and immunocytochemically using antibodies against a synthetic N-terminal peptide fragment from a 32 kDa nonamelogenin found in the inner (old) secretory enamel. In immunochemical preparations, these antibodies reacted to many proteins of differing molecular weights, especially to 140 kDa, 89 kDa, 56 kDa, 45 kDa, and 32 kDa proteins. Analysis of the layers of enamel suggested that the 140 kDa and/or 89 kDa proteins, both of which were found in newly formed enamel, were the parental proteins secreted by the ameloblasts, and that they were degraded to produce 32 kDa and other low molecular-weight proteins associated with progressive mineralization. In immunohistochemical preparation, immunoreactivity at the differentiation stage was detected initially over the amorphous dense material or fine fibrils around calcified globules in predentin, while the stippled material was devoid of immunoreactivity. The amorphous dense material seemed to give rise to a continuous layer of initial enamel. At the matrix formation stage, the immunoreactivity of immature enamel just beneath the putative secretory face of the Tomes' processes was intense. From the surface of the enamel matrix to a depth of about 100 microns, immunoreactivity of prism sheaths was weaker than that of enamel prisms, producing a reverse honeycomb pattern. In the enamel matrix deeper than 100 microns, immunoreactivity was weak and homogeneously distributed. The Golgi apparatus and secretory granules of the secretory ameloblasts showed immunoreactivity. These results suggest that the likely parent proteins of the 32 kDa nonamelogenin protein, i.e., the 140 kDa and/or 89 kDa proteins, play a significant role in the calcification of the enamel matrix. PMID- 1793667 TI - Demonstration of connective tissue sheaths surrounding working myocardial cells and Purkinje cells of the sheep moderator band. AB - Morphological studies were carried out to delineate the characteristics of connective tissue sheaths surrounding working myocardial cells and Purkinje cells in the moderator band of adult sheep hearts, using a series of techniques including silver staining, immunohistochemistry, transmission electron microscopy (TEM) and scanning electron microscopy (SEM). For SEM, tissue blocks were treated with 2N NaOH at room temperature to digest cellular elements. Individual working myocardial cells were ensheathed by thin argyrophil fibers (reticular fibers), while fascicles of 4-8 Purkinje cells (Purkinje strands) were encircled by rather thick reticular fibers. Some collagen fibers were located between masses of myocardial cells as well as between the Purkinje strands. Immunohistochemical analyses indicated that reticular fibers directly surrounding both myocardial cells and Purkinje strands showed moderately positive reactions for anti-type I collagen and intensely positive reactions for anti-type III collagen. Deserves particular note is that the three-dimensional architecture of the reticular sheaths varied widely at different places. The thin reticular sheaths surrounding each myocardial cell consisted of fibrils which were arranged in a coarse network and directed circularly along the long axis of cells. By contrast, the sheaths enclosing Purkinje strands were thicker, and their reticular fibrils were woven into a compact "felt-like" texture. The functional significance of these connective tissue sheaths is also discussed. PMID- 1793668 TI - Clastic cells of Hassall's corpuscles during acute involution of the thymus induced by cyclophosphamide in guinea pigs. AB - General and histochemical observations of the thymus were carried out in guinea pigs after injection of cyclophosphamide (280 mg/kg). Acute involution of the thymus induced by cyclophosphamide was accompanied by marked enlargement of Hassall's corpuscles in the first week after injection. However, the markedly enlarged Hassall's corpuscles disappeared entirely by the fourth week. Large cells characterized by pale nuclei with one or two prominent nucleoli became aggregated in the enlarged Hassall's corpuscles by the second week. Their cytoplasm frequently was foamy or vesicular in appearance. Histochemical observations revealed strong activities of nonspecific esterase, acid phosphatase and beta-glucuronidase in these cells. Staining for these lysosomal hydrolytic enzymes was evident not only intracellularly but also extracellularly, indicating the dissolution of Hassall's corpuscles by intensive extracellular enzyme release. PMID- 1793669 TI - Immunoelectron microscopic studies of gonadotrophs in the male and female rat anterior pituitaries, with special reference to their changes with aging. AB - Gonadotrophs immunocytochemically identified with an antibody to LH beta were studied in both male and female rats of various ages, viz., 2, 14 and 23 months after birth. The rat gonadotrophs are classified into two cell types, i.e., Type I containing large (300-700 nm) and small (150-200 nm) secretory granules, and Type II containing only small (100-200 nm) secretory granules. In normal young adults, the male rat pituitary contains a large number of Type I cells (more than 90% of all gonadotrophs), whereas the female pituitary contains much more Type II cells (more than 70%) than Type I cells. With age, Type I gonadotrophs in the male rat pituitary decrease remarkably to less than 25%, while Type II cells constitute more than 70% at the age of 23 months; the ratio of Type I to Type II comes to be the same as in the female. The main cause of this change is the decrease in the number of large secretory granules as the animal ages. FSH and LH levels in both the pituitary and serum were determined by radioimmunoassay. Pituitary FSH content decreased gradually in the male with age, while that in the female showed no change. LH content in the male decreased slowly, but LH in the female increased with aging. The large secretory granules indicating the presence of FSH markedly decreased with aging. The Type II cells contain only small secretory granules which probably contain LH. Thus the results of morphological counting of each type of gonadotroph and those of radioimmunoassay of gonadotropins during aging were essentially parallel. Some signs of degeneration were observed in the gonadotrophs in the aged rat pituitaries. PMID- 1793670 TI - GRP (gastrin-releasing peptide)-containing nerves in the rat stomach and stress induced depletion of their synaptic vesicles. An electron microscope study. AB - Gastrin-releasing peptide (GRP)-containing nerves are extremely numerous in the mucosa of the gastric body. Our previous study demonstrated that depletion of GRP from the nerves occurred in close relation to ulceration in the stomach. The present study deals with the ultrastructure of the GRP-immunoreactive nerves under normal conditions and its changes induced by conditions of stress. The immunoreactivity for GRP was recognized selectively in large cored vesicles in the swollen axoplasm of the nerves. The same axoplasm further revealed immunonegative small clear vesicles which were believed to contain acetylcholine. In materials where the GRP-immunoreactive nerves markedly decreased in number, both large and small synaptic vesicles were depleted from the nerves. These findings suggest that GRP and acetylcholine coexist in single nerves in the oxyntic mucosa, and that by nerve stimulation, they are coreleased into the lamina propria. PMID- 1793671 TI - Bone remodeling in W/Wv mast cell deficient mice. AB - Strong experimental evidence exists for a relationship between mast cells and bone disease, but the role of mast cells in the regulation of bone remodeling is unknown. In order to address this question, mast cell deficient mice (W/Wv) were paired with their mast cell sufficient (+/+) littermates and evaluated for differences in response to an induced cycle of bone remodeling. This was achieved using a tooth egression protocol, in which a synchronous cycle of bone remodeling was induced in the mandibular buccal alveolar periosteum by extraction of the opposing dentition. Quantitative histomorphometric changes during the activation, resorption, reversal, and formation phases of bone remodeling were documented using standard techniques. Most cell deficient mutants exhibited the following defects in response to an induced cycle of bone remodeling: (a) the onset of the remodeling cycle was delayed by a prolonged activation phase, (b) the duration and extent of the active formation phase was decreased, and (c) the amount of new bone matrix synthesized was diminished while mineralization rates were found to be normal. These results suggest that mast cells and their mediators provide a paracrine mechanism which influences the recruitment of osteoclast and osteoblast progenitors and their participation in bone remodeling. Nonetheless, since bone remodeling occurs in mast cell deficient mice, albeit less efficiently, this mechanism is most likely one of several redundant mechanisms that provide for adequate skeletal homeostasis. PMID- 1793672 TI - Parathyroid carcinoma associated with polycythemia vera. AB - A link between hyperparathyroidism and the growth of hematopoietic stem cells is suggested by this report of a parathyroid carcinoma with polycythemia vera. A 56 year-old white woman presented with splenomegaly, a palpable neck mass and hypercalcemia, recurrent six years after resection of a parathyroid tumor. She had pancytosis with a subnormal serum concentration of erythropoietin. Radiographs showed subperiosteal erosions an dosteopenia. Nephrocalcinosis was absent. Bone biopsy showed a decreased cortical width with many intracortical osteoclasts. The cancellous bone area remained normal, but the osteoid area/bone area, osteoblast perimeter and osteoclast perimeter were increased. At surgery, a parathyroid carcinoma was found in the same location operated on previously. As in two other reported cases, postoperative improvement in the hypercalcemia was associated with remission of the blood dyscrasia. A novel finding in this case is that when the hypercalcemia eventually recurred, it was again accompanied by pancytosis. With bisphosphonate therapy, the serum intact parathyroid hormone level increased in response to a decrease in the ionized calcium level, indicating that the cancer was not autonomous. This case suggests that in the presence of the ionized hypercalcemia, the parathyroid tumor may have produced or induced production of a growth factor that can stimulate pancytosis. The differential diagnosis of polycythemia and hypercalcemia should be expanded to include parathyroid tumors in addition to hepatic, adrenal, renal, and ovarian neoplasms. PMID- 1793673 TI - Morphological and biochemical studies of a mouse mutant (fro/fro) with bone fragility. AB - The mutation fragilitas ossium (fro) was discovered in a random-bred stock of mice during an experiment aimed at detecting recessive lethal mutations after treatment of the postmeiotic germ cells of male mice with tris (1 aziridinyl)phosphine sulphide. The affected mice were moderately runted and had deformities in all four limbs. The radiological and histological findings indicate that the mutant is similar to human osteogenesis imperfecta. The ash content of long bones was lower in the mutant. A defect of type I collagen could not be detected. The electrophoretic patterns of alpha bands of type I and V collagen and CB derived peptides of type I collagen from bone and skin showed no abnormalities. The total collagen synthesis and secretion in cultures of dermal fibroblasts, as well as the gel electrophoresis of procollagen and collagen chains synthesized, and of their CB peptides, were the same as those found in the controls. The percentage of type I and type V collagen synthesized was similar; that of type III was lower in the mutants. Bone osteonectin was found to be decreased by 30% and bone sialoprotein by 5%. The mRNA level for osteonectin was decreased in the fibroblasts of the mutant by about 50%. Whether the defective expression of the osteonectin in fro/fro mice is due to a mutation in the gene itself or its regulatory site(s), or is secondary to other factors remains to be established. The fro/fro mouse may represent a model for some forms of human bone fragility without collagen abnormalities. PMID- 1793674 TI - Preservation of ectopically induced bone in the mouse by estradiol. AB - The effects of estrogen on bone formation and bone resorption were examined in an experimental model of ectopic bone induction. In this experimental model, ectopic ossicles of uniform size were elicited reproducibly in three weeks by implanting pellets containing murine osteosarcoma derived bone morphogenetic protein (BMP), into the muscles of mice. Thereafter the induced ossicles showed a gradual reduction in bone mass due to negative bone balance. To estimate the effects of estrogen on bone formation and bone resorption, beta-estradiol-3-benzoate was administered exogenously to host mice from day 21 to day 41 (0.45 micrograms/g body weight, on alternate days, 10 treatments). Radiologic and histologic analysis confirmed the positive effect of estradiol on preserving bone mass over this period. Quantitative analysis showed an increase in the Ca content in ossicles after 21 days of estradiol treatment (139.1% of the baseline value on day 21). In the control group, the bone mass was reduced (47.4% of that on day 21). Bone resorption was determined by the reduction in 45Ca radioactivity from ossicles prelabeled with this radioisotope before estradiol administration. The rate of loss of the prelabeled 45Ca radioactivity was suppressed by estradiol (68.8% of prelabeled value in estradiol treated group and 87.7% in control group). The effect of exogenous estrogen on the bone forming phase of bone turnover in the ossicles was quantified by incorporation of 45Ca and 3H-proline. These bone formation parameters were increased to 2.2 and 1.9 times higher than those of the control group.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793675 TI - Serum-free gamma carboxyglutamic acid (free Gla) is a poor biochemical marker of bone resorption in early postmenopausal women. AB - In this study, we assessed the potential value of serum-free Gla to reflect changes of bone turnover at menopause. Serum-free Gla was measured in 49 healthy postmenopausal women and 19 healthy age-matched premenopausal women. No difference in serum-free Gla concentrations was observed between the two groups. In a double-blind longitudinal study of 36 postmenopausal women (a subgroup of the above 49 women) treated with either oral oestradiol valerate in a cyclical combination with cyproterone acetate (n = 19) or placebo (n = 17) for nine months, the serum-free Gla concentration was unchanged with placebo and decreased by only 10% after hormonal replacement therapy. Initial serum-free Gla concentrations in postmenopausal women did not correlate with other biochemical markers of bone turnover. The predictive value of serum-free Gla concentration for the spontaneous rate of bone loss in early postmenopause was also assessed, and the marker showed no correlation to bone loss. These data indicate that the serum concentration of free Gla is not a useful marker of the bone turnover rate in the early postmenopause. PMID- 1793676 TI - Serum osteocalcin levels before and after 1,25 dihydroxy-vitamin D stimulation in a family with hypophosphatasia. AB - Because defective bone mineralization occurs in hypophosphatasia (HP) and the source of bone alkaline phosphatase is the osteoblast, we investigated another marker of osteoblast activity, namely the production of osteocalcin in an HP family and controls. The mean basal osteocalcin levels in the two affected young adults and their parents (the apparent heterozygotes) were 3.4 ng/ml (range 2.5 4.6) and were not different from the levels in age- and sex-matched controls (3.6 ng/ml; range 2.5-4.6). Furthermore, the ratio of carboxylated to total osteocalcin was normal. The rise in osteocalcin after 1,25 dihydroxycholecalciferol stimulation (2 micrograms daily for one week) was slightly greater in the controls than in the HP family. These results support the concept that there is no global defect in osteoblast function in this family with HP. PMID- 1793677 TI - Macroscopic shape of, and lamellar distribution within, the upper limb shafts, allowing inferences about mechanical properties. AB - Collagen orientation maps were determined for the long bones of the upper forelimb (humerus, ulna, radius) using previously described techniques. All three bones had characteristic, non-random patterns of collagen fibre orientation. In the humerus, transverse collagen predominated in the medial and posterior cortices proximally and in the anterior and posterior cortices at the mid diaphysis. In the distal radius, the medial and anterior cortices contained mostly transverse collagen. In the proximal ulna, transverse collagen was found in the anterior and anterolateral cortices. These findings may be correlated to the distribution of bending forces that may be operative in these bones. PMID- 1793678 TI - RGDS tetrapeptide binds to osteoblasts and inhibits fibronectin-mediated adhesion. AB - The mechanisms of osteoblast attachment to surfaces were probed using the adhesive tetrapeptide RGDS (Arg-Gly-Asp-Ser) and the related but non-adhesive RGES (Arg-Gly-Glu-Ser). Specifically, RGDS and RGES were investigated for their ability both to bind to a suspension of well-characterized neonatal rat calvarial osteoblasts and to inhibit cell attachment to fibronectin-coated microtiter plates. RGDS bound to the cells with an average Kd approximately 9.4 x 10(-4) M, and RGES bound with an average Kd approximately 3.0 x 10(-4) M; at saturation, the osteoblasts bound almost twice as much RGDS as RGES. RGDS partially inhibited cell adhesion (55% to 60%) in a competitive, dose-dependent manner. In contrast, RGES had minimal effect on cell attachment. Since complete inhibition of attachment was not observed, it is likely that a synergistic adhesion site in the fibronectin molecule and/or cell surface molecules such as proteoglycans are active in mediating osteoblast/substrate adhesion. PMID- 1793679 TI - Requirement of vitamin C for cartilage calcification in a differentiating chick limb-bud mesenchymal cell culture. AB - Mesenchymal cells isolated from stage 21-24 chick limb-buds plated in a micro mass culture differentiate to form chondrocytes and synthesize a calcifiable matrix. In the presence of inorganic phosphate (4 mM), hydroxyapatite mineral deposits around cartilage nodules. Ascorbic acid is, in general, an essential co factor for extracellular matrix synthesis in culture, since it is required for collagen synthesis. In this study we demonstrate that in the absence of ascorbic acid supplementation in the mesenchymal cell cultures, mineral deposition (indicated by X-ray diffraction, measurement of Ca:hydroxyproline ratio, and 45Ca uptake) does not occur. Concentrations of 10-50 micrograms/ml ascorbate were compared to find the "optimal" concentration for cell mediated mineralization; 25 micrograms/ml was selected as optimal based on matrix appearance at the EM level and the rate of 45Ca uptake. High concentrations of ascorbic acid (greater than 75 micrograms/ml), while increasing the amount of hydroxyproline in the matrix synthesized, caused some cell death and hence less cell-mediated mineralization. This study demonstrates both the need for viable cells and a proper matrix for in vitro cell-mediated mineralization, and shows that varying the concentration of L ascorbate (vitamin C) in the medium can have a marked effect on mineralization in vitro. PMID- 1793680 TI - Effects of nicotine on cellular function in UMR 106-01 osteoblast-like cells. AB - We examined the effect of nicotine on cellular proliferation, as measured by [3H]thymidine (TdR) incorporation and cell count, and on alkaline phosphatase activity in UMR 106-01 rat osteoblastic osteosarcoma cells. The cells were cultured with varying concentrations of nicotine in serum-free medium for 2 to 72 hours. Nicotine produced a dose-dependent suppression of TdR incorporation, with maximum suppression seen at 10 mM (7% of control); the EC50 for suppression of TdR incorporation was 10 microM. 1 microM nicotine decreased cell number by 20% to 30%. The time course of the effect of 100 microM nicotine on DNA synthesis was measured by TdR incorporation. TdR uptake was measured at 2, 4, 6, 24, 48, and 72 hours. After the addition of nicotine, the following biphasic response in TdR incorporation was observed: a 15% decrease at 2 hours, recovery to near control value at 6 hours, a 27% decrease by 24 hours, and a maximum decrease of 88% by 48 hours. Over a dose range of 1 nM to 10 mM, nicotine produced a dose-dependent increase in alkaline phosphatase activity with maximum stimulation seen at 1 microM (189% of control). We conclude that nicotine suppresses cellular proliferation and stimulates alkaline phosphatase activity in UMR 106-01 osteoblast-like cells. These results may be of significance in the development of osteoporosis and alveolar bone loss associated with the use of tobacco. PMID- 1793681 TI - Hypophosphatemic rickets with hypocalciuria following long-term treatment with aluminum-containing antacid. PMID- 1793682 TI - Synthesis of 1-(3-alkyl-2,3-dideoxy-D-pentofuranosyl)uracils with potential anti HIV activity. AB - 1-(3-Alkyl-2,3-dideoxy-alpha,beta-D-erythro-pentofuranosyl)uracils and 1-(3-alkyl 2,3-dideoxy-alpha,beta-D-threo-pentofuranosyl)uracils have been prepared from (E) 4,5-di-O-acetyl-2,3-dideoxy-aldehydo-D-glycero-pent-2-enose by a Michael addition reaction of the appropriate organocopper reagent followed in subsequent order by glycosidation of the resulting 3-alkyl-4,5-diacetoxypentanal with methanolic hydrogen chloride, protection with p-methoxybenzoyl chloride, and trimethylsilyl triflate catalyzed coupling with 2,4-di-O-(trimethylsilyl)uracil. The nucleosides were deprotected by treatment with 33% methylamine in absolute ethanol and separated by reversed-phase HPLC. PMID- 1793683 TI - A strategy for ranking environmentally occurring chemicals. Part VI. QSARs for the mutagenic effects of halogenated aliphatics. AB - A strategy for the systematic analysis and priority ranking of environmental chemicals has been applied to a class of 58 halogenated aliphatic hydrocarbons. A training set of ten compounds representing this class, was selected by statistical design. The training set compounds were then subjected to biological testing in the Salmonella typhimurium reverse mutation assay (Ames test). The measured biological data, recorded as dose-response curves, were analyzed to determine the mutagenic potency (slope of the initial portion) and the mutagen dose (MD 50) required to increase the number of revertants above the background by 50%. For each compound, four mutagenic potency estimates and four MD 50 values were determined, all originating from the tester strains TA 100 and TA 1535 with and without metabolic activation. The obtained responses were analyzed with multivariate techniques to give QSAR models relating the mutagenic potency data to the physico-chemical properties of the compounds. Finally, the derived QSARs were used to predict the mutagenic potencies and the MD 50S for the non-tested compounds in the class. PMID- 1793684 TI - Source modelling of the rolandic focus. AB - In rolandic epilepsy, consideration of the stereotyped ictal symptomatology suggests that the epileptic zone is likely to be in the same cortical structure in different patients. Routine EEG tracings of the interictal spike activity suggests a deep Sylvian fissure location. On the basis of the predominantly tangential potential field at the peak spike negativity seen in this group of patients, the inferior bank of the Sylvian fissure appears to be a good candidate. Without invasive studies, little refinement to this rather imprecise localization can be made as there is neither neurologic deficit nor lesion to provide a marker on radiological imaging. However, the application of source modelling technique using a simple single-dipole spherical head model has resulted in improved understanding of the generator behaviour, and facilitated the generation of new ways of analyzing spikes (e.g., stability index). Review of newer quantitative approaches including matrix and singular value decomposition of the dataset, spatial-temporal constrained source estimates etc. suggest other fruitful approaches. At least in some patients with partial epilepsy, the source characteristics of interictal scalp spikes appear to contain information of the ictal generator. Under certain circumstances, such derived information which is not otherwise available from routine electrophysiology may influence clinical management and prognosis. This is an additional bonus to the primary objectives of quantification and data reduction. PMID- 1793685 TI - EEG dipole modeling in complex partial epilepsy. AB - Visual inspection and qualitative impressions of clinical EEG abnormalities are being replaced by quantitative characterization of scalp voltage fields and dipole modeling of underlying cerebral sources. Three approaches have been used in the analysis of focal spikes of complex partial epilepsy. 1) Instantaneous, single dipole, inverse solutions for the voltage topography of the spike peak have revealed two distinct equivalent dipole configurations in the brain lobe beneath the negative extreme-radial and oblique (mixed radial and tangential). Only radial dipoles have been found for frontal and fronto-central spikes, while either type have been found for temporal and occipital spike foci. 2) Dipole stability can be assessed by an inspection of sequential instantaneous solutions encompassing the spike complex or by calculating the standard deviation of dipole location (x,y,z) and orientation (elevation, azimuth) parameters during this period. Two-thirds of spike dipoles of the radial type and essentially all of the oblique equivalent dipoles were found to be stable, whereas one-third of the radial dipoles were unstable in position or orientation. 3) Spatio-temporal analysis can identify multiple underlying sources and their potentials. Modeling separate radial and tangential dipoles over the course of the spike has revealed a composite character for spike fields with oblique dipoles and often has defined leads or lags in activity that suggested propagation between infero-mesial and lateral temporal cortex. Correlations with clinical and intracranial EEG data suggest that patients with mesial temporal sclerosis have spikes with oblique and stable equivalent dipoles; patients with discrete cortical lesions have spikes with radial and stable dipoles; patients with extensive or multi-focal cortical insults have spikes with radial and unstable dipoles. PMID- 1793686 TI - Seeing through the skull: advanced EEGs use MRIs to accurately measure cortical activity from the scalp. AB - There is a vast amount of untapped spatial information in scalp-recorded EEGs. Measuring this information requires use of many electrodes and application of spatial signal enhancing procedures to reduce blur distortion due to transmission through the skull and other tissues. Recordings with 124 electrodes are now routinely made, and spatial signal enhancing techniques have been developed. The most advanced of these techniques uses information from a subject's MRI to correct blur distortion, in effect providing a measure of the actual cortical potential distribution. Examples of these procedures are presented, including a validation from subdural recordings in an epileptic patient. Examples of equivalent dipole modeling of the somatosensory evoked potential are also presented in which two adjacent fingers are clearly separated. These results demonstrate that EEGs can provide images of superficial cortical electrical activity with spatial detail approaching that of O15 PET scans. Additionally, equivalent dipole modeling with EEGs appears to have the same degree of spatial resolution as that reported for MEGs. Considering that EEG technology costs ten to fifty times less than other brain imaging modalities, that it is completely harmless, and that recordings can be made in naturalistic settings for extended periods of time, a greater investment in advancing EEG technology seems very desirable. PMID- 1793687 TI - Source localization of EEG versus MEG: empirical comparison using visually evoked responses and theoretical considerations. AB - Theoretically, the information we can obtain about the functional localization of a source of brain activity from the scalp, for instance evoked by a sensory stimulus, is the same whether one uses EEG or MEG recordings. However, the nature of the sources and, especially of the volume conductor, poses constraints such that appreciable differences between both types of data may exist. We present here empirical and theoretical data that illustrate which are the main constraints and to what extent they may affect electric potential and magnetic field maps. The empirical data consists of visual evoked potential and magnetic fields to the appearance of a checkerboard pattern (half-visual field stimulation). The concept of equivalent dipole is presented and its limitations are discussed. It is considered that the concept of equivalent dipole (ED) yields only an approximate description of the activity of a patch of cortex. A main difference between EEG and MEG recordings is the fact that radially oriented dipoles can hardly be seen in the MEG in contrast with the EEG. Accordingly, a weak tangential dipole component is difficult to distinguish in the EEG if a strong radial component is also present. However, a combination of both methods can give useful complementary information in such cases. A factor that influences largely such differences is the model of volume conductor used. A four concentric spheres model, as commonly used for solving the inverse problem of source localization, causes appreciable errors when EEG data are used but much less in case of the MEG. The use of a model consisting of eccentric spheres fitting the four compartments, brain, CSF, skull and scalp, provides a better approximation of the real geometry of the head and allows to obtain comparable results for visual evoked potentials and magnetic fields. It is emphasized that for precise localization of EDs, especially based on EEG recordings, a realistic model of the different compartments of the head is necessary. The latter must be tailor made to a given subject using MRI-scans, in view of the large variability in head geometry between subjects. PMID- 1793688 TI - Use of prior knowledge in brain electromagnetic source analysis. AB - Using multichannel measurements of EEG and/or MEG, macroscopic source activities can be estimated in the human brain using brain electric source analysis (BESA, Scherg 1990). If a discrete number of brain areas is active, functional brain images which depict the locations and orientations of equivalent dipole sources as well as the dynamics of the local macroscopic currents can be obtained from such data--in principle--without external knowledge. However, given a certain number of sources or 'neural masses' (Freeman 1975) which contribute to an event related response (ERP), it can be difficult to find the correct solution due to background noise in the data and distortions from the head model. Prior knowledge based on anatomy and physiology can be useful to constrain spatial or temporal parameters of the model and to define better cost functions for fitting locations and orientations. An analysis of the auditory evoked N100 complex and of the auditory mismatch negativity (MMN) is presented which illustrates the use of spatial constraints. Also, the use of a modified cost function is demonstrated which limits source currents in certain time intervals. PMID- 1793689 TI - A visual study of surface potentials and Laplacians due to distributed neocortical sources: computer simulations and evoked potentials. AB - A "picture book" of surface potentials, Laplacians, and magnetic fields due to distributed, neocortical sources is presented. The mathematically simulated data is based on 4200 current sources at the macrocolumn scale. Estimated scalp surface maps are based on the three-concentic spheres model of the head. Emphasis is placed on the effects of sampling with a limited number of electrodes, the choice of reference electrode, and the use of the spline Laplacian to improve spatial resolution. The spline Laplacian is applied to median and ulnar nerve somatosensory evoked potentials and to auditory evoked potentials including P300. Substantial improvement in spatial resolution over conventional methods is obtained. The implementation of practical high resolution EEG systems based on the spline Laplacian is considered. PMID- 1793690 TI - Advantages and limitations of magnetic source imaging. AB - The term "magnetic source image" (MSI) describes the distribution of neuronal activity in the brain that can be deduced from measurements of the field pattern it produces across the scalp. The signals which provide the basis for an MSI are obtained from the magnetoencephalogram (MEG) which is conventionally recorded with superconducting detectors. Advances in MSI techniques during the past decade have revealed numerous aspects of the functional organization of human sensory systems that were previously unknown. In addition, studies of spontaneous signals, such as those in the alpha bandwidth, have identified specific cortical areas that support rhythmic activity. Extensions of this approach to cognitive research are able to determine the active cortical areas where spontaneous activity is suppressed when a person is engaged in a task such as mental imagery and auditory memory recall. Because only the component of the intracellular current tangential to the overlying skull contributes to the extracranial field, a confined source--modeled as a current dipole--has a characteristic field pattern that simplifies the pattern recognition problem of identifying the underlying sources. This advantage is illustrated by the identification of simultaneously active sources in auditory primary and association cortex. Their separate localization makes it possible to characterize their functional differences. Because the source strength in an MSI may be inferred without knowledge of the electrical conductivities of intervening tissue, it is also possible to estimate the extent of cortical involvement. From the tangential source strength in an MSI, it is possible in most cases to determine the total source strength by taking account of the orientation of the cortical surface. This provides an objective, quantitative measure of the strength of neuronal activity. At present, the major limitation in more extensive use of MSI is the cost of instrumentation. While it requires no contact with the head, and measurements can commence within a few minutes of the arrival of the subject or patient, the present cost of a large array of sensors is two to three million dollars. PMID- 1793691 TI - Regression to the mean. PMID- 1793692 TI - Empirical comparison of the MEG and EEG: animal models of the direct cortical response and epileptiform activity in neocortex. AB - This review directly addresses the appropriateness of the dipole model as a physical representation of neocortical sources produced by evoked and spontaneous epileptiform activity in neocortex. Three dimensional electrical measurements of cellular currents in rat sensory neocortex are compared to the extracranial magnetic fields these currents produce. Comparisons are performed for the direct cortical response (DCR) evoked by electrical stimulation of the cortical surface, and for evoked and spontaneous interictal and ictal discharge of the penicillin focus in the same animal preparation. Our data support the hypothesis that evoked and epileptiform magnetic fields result from intradendritic currents oriented perpendicular to the cortical surface. Furthermore, magnetic fields can be detected from epileptic foci smaller than 3 x 3 mm2. This work provides an empirical foundation for physical models with which to interpret noninvasive neuromagnetic recordings of epileptic discharge in human focal seizure disorders. The dipole approximation appears to be appropriate for the interpretation of magnetic field phenomena in neocortex. PMID- 1793693 TI - EEG versus MEG localization accuracy: theory and experiment. AB - We first review the theoretical and computer modelling studies concerning localization accuracy of EEG and MEG, both separately and together; the source is here a dipole. The results show that, of the three causes of localization errors, noise and head modelling errors have about the same effect on EEG and MEG localization accuracies, while the results for measurement placement errors are inconclusive. Thus, these results to date show no significant superiority of MEG over EEG localization accuracy. Secondly, we review the experimental findings, where there are again localization accuracy studies of EEG and MEG both separately and together. The most significant EEG-only study was due to dipoles implanted in the heads of patients, and produced an average localization error of 20 mm. Various MEG-only studies gave an average error of 2-3 mm in saline spheres and 4-8 mm in saline-filled skulls. In the one study where EEG and MEG localization were directly compared in the same actual head, again using dipoles implanted in patients, the average EEG and MEG errors of localization were 10 and 8 mm respectively. The MEG error was later confirmed by a similar (but MEG-only) experiment in another study, using a more elaborate MEG system. In summary, both theory and experiment suggests that the MEG offers no significant advantage over the EEG in the task of localizing a dipole source. The main use of the MEG, therefore, should be based on the proven feature that the MEG signal from a radial source is highly suppressed, allowing it to complement the EEG in selecting between competing source configurations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID- 1793694 TI - An evaluation of clinical aspects of post-operative autotransfusion, either alone or in conjunction with pre-operative aspirin, in cardiac surgery. AB - Two groups of 21 otherwise healthy patients undergoing coronary artery bypass grafting (CABG) for the first time were studied in order to evaluate the advantages and disadvantages of post-operative autotransfusion using a red cell 'salvage' method. Group 1 patients (control group) were transfused using donor blood only. Group 2 patients were transfused with their own (autologous) blood, salvaged post-operatively, although donor blood was also available to them if needed. The two groups were further subdivided according to whether the patients received aspirin pre-operatively or not. The four subgroups thus formed were comparable pre- as well as intra-operatively, with respect to all available clinical and laboratory criteria. The post-operative data, however, showed that the combination of pre-operative aspirin and autotransfusion leads to excessive post-operative bleeding, together with increased donor blood requirement. It was also shown that autotransfusion without aspirin does reduce the need for donor blood transfusion without any increase in post-operative bleeding. Although aspirin alone did not increase post-operative bleeding or donor blood requirement, its combination with autotransfusion should be avoided. PMID- 1793695 TI - Malignant melanoma--a review: early diagnosis is the key. AB - The face of malignant melanoma is changing. The incidence is rising, and the disease is tending to affect a younger age group. Publicity about the disease is intense, and the trend is towards earlier diagnosis. Early diagnosis is essential, as the only effective treatment remains surgical excision, which is curative for thin lesions. PMID- 1793696 TI - HLA and disease. AB - It is nearly 20 years since the first reports appeared linking genes within the human major histocompatibility complex, the HLA region, with disease. The literature now contains many hundreds of papers confirming an increased frequency of different HLA antigens in a diverse spectrum of conditions, ranging from narcolepsy to diabetes. Over the years many different hypotheses have been proposed to explain this association, but none has been proven. Nevertheless, our knowledge of the HLA region and the function of its many genes is expanding rapidly and the pathogenesis of many HLA-linked diseases may soon become apparent. In this review we aim to provide clinicians with a broad understanding of the basis for the association between HLA and disease. We will describe the genes of the HLA region before discussing the diseases with which they are linked. Finally, we will explore mechanisms through which HLA genes might influence disease. PMID- 1793697 TI - Histamine-induced coronary artery spasm: the concept of allergic angina. AB - Histamine, the main amine released during allergic reactions, can provoke coronary arterial spasm manifested as angina pectoris. This has been shown during clinical and laboratory studies. The effects of histamine on cardiac function are mediated via H1- and H2- receptors situated on the four cardiac chambers and coronary arteries. Coronary arteries of cardiac patients are hyperactive and contain stores of histamine which can initiate coronary artery spasm. Clinical observations indicate that angina pectoris or acute myocardial infarction can be provoked by acute allergic reaction. The coincidental occurrence of chest pain and allergic reaction accompanied by clinical and laboratory findings of classical angina pectoris seems to constitute the syndrome of allergic angina. The clinical symptoms of allergic angina include chest discomfort, dyspnoea, faintness, nausea, pruritus and urticaria. They are accompanied by signs such as hypotension, diaphoresis, pallor and bradycardia. There are also electrocardiographic findings indicating myocardial ischaemia, arrhythmias and conduction defects. Thus, in patients undergoing acute allergic reaction, the development of chest pain could be explained by the mechanism of coronary arterial spasm provoked by the release of histamine, which constitutes the syndrome of allergic angina. PMID- 1793698 TI - Coronary artery spasm. PMID- 1793699 TI - Wilson's disease, Kayser and Fleischer's sign and Walshe's treatment. AB - Wilson's disease is named after Kinnier Wilson (1878-1937), a famous British neurologist. It is an inherited condition, due to an excess of copper in the liver and brain. The mechanism is unknown, but the gene has been mapped to chromosome 13. The worldwide prevalence is about 30 per million. Patients present with liver disease and/or neuropsychiatric manifestations. Early diagnosis is crucial because there is an effective treatment. This treatment, usually with penicillamine, must be continued for life and without interruption. Liver transplantation may be lifesaving in patients with fulminant hepatitis, or with severe liver disease which is unresponsive to treatment. PMID- 1793700 TI - Which antibiotic for surgical nosocomial infection? AB - Nosocomial infection means hospital-acquired infection. In this article we discuss treatment of nosocomial infections which relate to, or arise as a consequence of, general surgical procedures. Most such infections become apparent during the patient's stay in hospital, but some patients with nosocomial infection first present to their general practitioners after discharge and this group should not be overlooked. PMID- 1793701 TI - Night sweats--presentation of an often forgotten diagnosis. AB - Night sweats are not uncommon complaints in the elderly and they are readily associated with disorders of catecholamine excess, solid malignancies and tuberculosis. We report night sweats as the presenting feature of giant cell arteritis. PMID- 1793702 TI - Portal hypertension due to hepatosplenic schistosomiasis: a case report and review of the literature. AB - Although hepatosplenic schistosomiasis is the commonest cause of liver disease worldwide, the diagnosis is not often considered in European countries. A case of Schistosomiasis mansoni complicated by portal hypertension is reported to demonstrate how diseases endemic to an immigrant's homeland can present many years later in non-endemic countries. PMID- 1793703 TI - Fatal pulmonary fat embolism during total hip replacement due to high-pressure cementing techniques in an osteoporotic femur. AB - High-pressure cementing techniques, involving the use of a cement gun and cement restrictor, placed within the femoral medullary cavity, are commonly used to secure the femoral component of hip arthroplasties. Such techniques have been shown to be important in maintaining the integrity of the bone-cement interface and also the integrity of the cement itself. This case report illustrates that such techniques are not without complications. PMID- 1793705 TI - Traumatic cardiac tamponade: a heartbreaking tale. AB - Penetrating cardiac injuries following civil violence are less common in Britain than in other parts of the world, but, in the light of recent evidence, the incidence of the problem is likely to increase. The patient described in this report demonstrates the pitfalls in the management of traumatic cardiac tamponade and highlights the need for a change in the management of the seriously injured patient. PMID- 1793704 TI - Bleeding intracranial aneurysm? Pituitary apoplexy! AB - Pituitary apoplexy describes the clinical syndrome characterised by headache, visual impairment and ophthalmoplegia caused by sudden enlargement of a pituitary adenoma. This is usually due to extensive tumour infarction or haemorrhage. Pituitary apoplexy is rare, mimics spontaneous intracranial bleeding, and thus may be easily mistaken for acute subarachnoid haemorrhage. Urgent surgical intervention and hormone replacement therapy are required. PMID- 1793706 TI - Roux-en-Y loop jejunal necrosis: another pancreatitis associated enteropathy. AB - Severe acute pancreatitis is frequently associated with systemic and local complications. Local sequelae include disorders of the stomach, duodenum, small and large bowel, collectively termed pancreatic enteropathies. We describe a patient with post-gastrectomy acute haemorrhagic pancreatitis which was complicated by necrosis and perforation of an intra-thoracic Roux-en-Y jejunal loop. This does not appear to have been previously reported. PMID- 1793708 TI - Audit: whose outcome is it anyway? PMID- 1793707 TI - Crohn's disease of the vulva in childhood. AB - A case of vulval Crohn's disease in childhood is presented. The presentation of this disease as a vulval lesion is well recognised, either as the initial complaint, or as a metastatic lesion. Crohn's disease in childhood is well recognised and up to 49% of sufferers may have perianal disease. Vulval Crohn's disease in children, however, is uncommon, especially when it is the presenting symptom. PMID- 1793709 TI - Barriers for the control of sexually transmitted diseases. PMID- 1793710 TI - Pets and disease. PMID- 1793711 TI - Pets and atopic disorders in infancy. AB - This population-based prospective study assessed the relationship between pets and atopic disorders in infancy. One or more pets were found in 61.4% of households. Pets were found in homes with a family member affected by asthma or rhinitis as often as in homes with no allergy in the family. The presence of pets was not shown to affect the development of atopic manifestations in the first 12 months of life. Infants exposed to cats developed skin prick test sensitivity to cat dander significantly more often (p = 0.01) than those infants who had had no such exposure. PMID- 1793712 TI - The management of the second stage of labour in primiparae with epidural analgesia. AB - One hundred and ninety-four primiparae with lumbar epidural analgesia established during the first stage of labour were discouraged from pushing until the fetal head was visible at the perineum or until three hours had elapsed since full dilation of the cervix. The outcome in this group was compared with a similar group in whom pushing was commenced as soon as the second stage was diagnosed. The observed increase in spontaneous deliveries did not reach statistical significance. There was a reduction in non-rotational forceps (p less than 0.05), but no change occurred in the incidence of rotational forceps deliveries. The high rates of oxytocin augmentation in these primiparous labours may account for the failure of delayed pushing to increase the spontaneous delivery rate in our population.